Objective To compare the cost and efficacy of ambulatory versus hospitalized surgery for lung tumor patients. Methods Two researchers independently conducted a computer search on February 14, 2025, in databases including CNKI, PubMed, Web of Science, Ovid Medline, Cochrane Library, and Wanfang Database, with the search period covering from the inception of these databases to February 2025. The outcome indicators were postoperative complication rate, length of hospital stay, hospitalization costs, et al. For the included randomized controlled trials and non-randomized controlled trials, we used the Cochrane risk of bias assessment tool and the Newcastle Ottawa Scale (NOS) respectively to evaluate the quality of the literature, and extracted data from the included studies for meta-analysis using RevMan 5.4 and Stata 18.0. Results A total of 12 researches were ultimately included, consisting of 2 randomized controlled trials, 2 prospective cohort studies, and 8 retrospective cohort studies, involving a total of 76 403 patients. All researches were evaluated as high-quality. Meta-analysis showed that the ambulatory surgery group had advantages over the hospitalized surgery group in terms of operation time [MD=−21.07, 95%CI (−30.55, −11.58), P<0.001], length of hospital stay [MD=−2.17, 95%CI (−3.25, −1.09), P<0.001], hospitalization costs [SMD=−1.22, 95%CI (−2.18, −0.26), P=0.01], and overall postoperative complications [OR=0.48, 95%CI (0.32, 0.74), P<0.001]. There was no statistically significant difference between the two groups in terms of postoperative hoarseness [OR=0.62, 95%CI (0.24, 1.61), P=0.33] and postoperative chylothorax [OR=0.27, 95%CI (0.07, 1.07), P=0.06]. Conclusion Compared to conventional hospitalized lung tumor resection, ambulatory lung tumor resection can significantly reduce the patient’s surgery and hospital stay time, decrease hospitalization costs, and reduce the incidence of postoperative complications. Ambulatory surgery can improve hospital efficiency while reducing the economic burden on patients. It is worthy of further promotion and application.

Objective To analyze the association between eye-related behaviors and myopia among preschool chil-dren in Ningxia Hui Autonomous Region,and to develop a predictive nomogram model.Methods Using stratified cluster random sampling,36 062 preschool children from 400 randomly selected kindergartens in Ningxia Hui Autonomous Region were enrolled between October and December 2023.Primary caregivers of participants completed structured question-naires.Data were randomly split into a training set(n=25 243,70％)and a validation set(n=10 819,30％)in a ratio of 7∶3.The training set was used for model construction,and the validation set for external validation.Calibration plots and the Hosmer-Lemeshow(H-L)goodness-of-fit test assessed agreement between predicted and observed risks.Decision curve analysis(DCA)and clinical impact curve analysis(CICA)evaluated clinical utility.Results The myopia preva-lence among preschool children in Ningxia Hui Autonomous Region was 3.8％.A nomogram model based on binary Logistic regression showed area under the curve(AUC)values of 0.88(95％CI:0.87-0.89)for the training set and 0.89(95％CI:0.87-0.90)for the validation set,indicating strong discriminative ability.Calibration curves and H-L tests revealed good model fit(training set:x2=4.92,P=0.766;validation set:x2=5.52,P=0.961),with all P＞0.05.DCA and CICA confirmed clinical utility.The nomogram identified parental myopia,academic pressure,frequency of eye fatigue,daily screen time,and regular vision checks as the top five predictors of myopia.Conclusion The nomogram demonstrates promising potential for predicting myopia risk in preschool children in Ningxia Hui Autonomous Region,serving as a robust tool for clinical and educational myopia risk assessment.

This consensus was developed by the Orthodontic Society of the Chinese Stomatological Association to provide a systematic, scientific, and practical guideline for informed consent in orthodontic care. Orthodontic treatment is typically lengthy, highly individualized, and involves multiple factors such as growth and development, occlusal function, and facial esthetics. Rapid technological advances and diverse risk profiles make the traditional reliance on orthodontist experience or institutional templates insufficient to ensure patients′ full understanding and autonomous decision-making. To address this, the expert panel conducted extensive reviews of domestic and international guidelines, analyzed representative dispute cases, and performed multicenter patient-clinician surveys. Using a multi-round Delphi method, the group established a standardized informed consent framework covering the initial consultation, treatment, and retention phases. The consensus emphasizes that informed consent is not only a fundamental legal and ethical requirement but also a key step in building trust, improving patient compliance, and enhancing treatment satisfaction. Orthodontists should clearly and comprehensively explain treatment plans, potential risks, uncertainties, and associated costs, while respecting the autonomy of patients or guardians, and maintain continuous communication and dynamic evaluation throughout the treatment process. The release of this consensus provides unified and authoritative guidance for clinical orthodontics, helping to standardize informed consent, enhance its transparency, safeguard patient rights, reduce medical risks, and promote high-quality, sustainable development of orthodontic practice.

Objective:To evaluate whether the mechanism by which high glucose attenuated the cardioprotective effect of sevoflurane postconditioning was associated with the hypoxia-inducible factor-1α (HIF-1α)/monocarboxylate transporter 4 (MCT4) signaling pathway in rat cardiomyocytes.Methods:H9C2 cardiomyocytes were cultured at a 1∶4 ratio and then divided into 8 groups ( n=21 each) using a table of random numbers: control group (N+ Con group), hypoxia-reoxygenation (H/R) group (N+ H/R group), sevoflurane postconditioning group (N+ SPostC group), high glucose control group (H+ Con group), high glucose-H/R group (H+ H/R group), high glucose sevoflurane postconditioning group (H+ SPostC group), high glucose sevoflurane postconditioning + HIF-1α agonist group (H+ SPostC+ D group), and high glucose sevoflurane postconditioning + HIF-1α agonist + MCT4 inhibitor group (H+ SPostC+ D+ A group). N+ Con, N+ H/R and N+ SPostC groups were cultured in conventional culture dishes, while high-glucose group was incubated in high-glucose (35 mmol/L) DMEM. Cells were subjected to 3 h of hypoxia in serum-free and glucose-free DMEM using a three-gas incubator, followed by 3 h of reoxygenation in fresh DMEM in a CO 2 incubator. Sevoflurane postconditioning was performed as follows: Cells were incubated at 37 ℃ in a three-gas incubator filled with sevoflurane (2.4%) for 15 min. At 2 h before hypoxia, H+ SPostC+ D group was incubated in medium containing 1 mmol/L DMOG (HIF-1α agonist), and H+ SPostC+ D+ A group was incubated in medium containing 1 mmol/L DMOG and 10 μmol/L AZD0095 (MCT4 inhibitor). The viability of cardiomyocytes (by CCK8 assay), levels of LDH in culture medium (by microplate assay), levels of lactate (by WST-8 assay), levels of ATP (by chemiluminescence assay), apoptosis rate of cells (by flow cytometry), mitochondrial membrane potential (by fluorescence probe assay), and expression of HIF-1α and MCT4 (by Western blot) were measured. Results:Compared with N+ H/R group, the cell viability, levels of lactate, levels of ATP and mitochondrial membrane potential were significantly increased, the levels of LDH in culture medium and apoptosis rate of cells were decreased, and the expression of HIF-1α and MCT4 was up-regulated in N+ SPostC group ( P<0.05). There were no significant differences in each parameter between H+ H/R group and H+ SPostC group ( P>0.05). Compared with H+ SPostC group, the cell viability, levels of lactate, levels of ATP and mitochondrial membrane potential were significantly increased, the levels of LDH in culture medium and apoptosis rate of cells were decreased, and the expression of HIF-1α and MCT4 was up-regulated in H+ SPostC+ D group ( P<0.05). Compared with H+ SPostC+ D group, the cell viability, levels of lactate, levels of ATP and mitochondrial membrane potential were significantly decreased, the levels of LDH in culture medium and apoptosis rates of cells were increased, and the expression of HIF-1α and MCT4 was down-regulated in H+ SPostC+ D+ A group ( P<0.05). Conclusions:The mechanism by which high glucose attenuates the cardioprotective effect of sevoflurane postconditioning may be related to the inhibition of the HIF-1α/MCT4 signaling pathway in rat cardiomyocytes.

Objective:In order to effectively educate students on tooth defect diseases and restoration techniques, the teaching and research team at the School of Stomatology of Qingdao University developed an integrated course operative dentistry. This course is specifically designed to align with the undergraduate curriculum reform requirements of "Three Early, Two Multiple and One Integration".Methods:The teaching practice of operative dentistry was conducted with the stomatology undergraduates of grade 2020 and 2021. The course group redesigned the curriculum by reorganizing teaching content, rebuilding teaching resources, reconstructing teaching mode, and reshaping the evaluation system. Evaluation of the curriculum design included test scores, satisfaction questionnaires, and teacher self-evaluation. Statistical analysis was performed using SPSS 27.0 software, including independent sample t-tests for numerical variables and Fisher's exact test or Wilcoxon rank sum test for categorical variables. Results:Through the integrated course learning, 92.68% (38/41) of the students of grade 2020 and 97.44% (38/39) of the students of grade 2021 can basically or completely master various dental defect repair schemes and understand the importance of preserving natural tooth. 82.93% (34/41) of the students of grade 2020 and 100.00% (39/39) of the students of grade 2021 could basically or completely master the key points of various dental defect restorations.Conclusions:Through the practice of teaching, it has been confirmed that the integrated course of operative dentistry is beneficial to students' mastering the knowledge and skills of dental defect diseases and their restoration in a more comprehensive way, and is conducive to the cultivation of clinical thinking, hands-on ability and the patient-centered, comprehensive problem-solving thinking, which is in line with the guidance on the innovation and development of medical education.

Objective:To investigate the related factors affecting the survival of adult patients with newly diagnosed chronic myeloid leukemia in the chronic phase (CML-CP) treated with tyrosine kinase inhibitor (TKI) and the prognostic predictive effect of the nomogram constructed according to them.Methods:A retrospective cohort study was conducted. Clinical general information and laboratory index data of 243 newly diagnosed adult CML-CP patients treated with TKI in the First Hospital of Lanzhou University from December 2008 to June 2023 were collected, and they were divided into a training set (194 patients) and a validation set (49 patients) by complete randomization in the ratio of 8∶2. In the training set, variables affecting poor overall survival (OS) of patients were analyzed using univariate and multivariate Cox proportional hazards models by R4.3.2 software to obtain the independent influences of poor OS, on the basis of which the Cox regression model was constructed and the nomogram predicting the OS rate at 8 and 10 years was plotted. Kaplan-Meier method was applied to analyze the OS in all 243 patients and patients stratified by the screened independent influencing factors for poor OS, and log-rank test was used for comparison between the groups. In the training and validation sets, receiver operating characteristic (ROC) curve was used to analyze the effect of the nomogram on predicting 8- and 10-year OS rates of patients with actual survival as the gold standard; calibration curve was used to assess the accuracy of predictions of the nomogram; decision curve analysis (DCA) was used to assess the clinical utility of the nomogram.Results:The median age of 243 CML-CP patients [ M ( Q1, Q3)] was 46 (35, 58) years old, 150 cases (61.7%) were male and 9 cases (38.3%) were female, 119 cases (49.0%) had comorbidities, and the efficacy of 82 cases (33.7%) reached molecular response (MR) 5.0. Differences in patient compositions for age and gender, levels of major indicators for peripheral blood and bone marrow, spleen size, comorbidities, short-term efficacy, Sokal score, and long-term survival score of European Treatment and Outcomes Study between the training and validation sets were not statistically significant (all P > 0.05). Multivariate Cox regression analysis showed that patients with elevated age ( HR = 1.04, 95% CI: 1.01-1.08, P = 0.041), comorbidities (with vs. without, HR = 3.48, 95% CI: 1.23-9.86, P = 0.019), and those who did not achieve MR5.0 (achieved vs. unachieved, HR = 0.13, 95% CI: 0.02-0.97, P = 0.046) were independent risk factors for poor OS in TKI-treated newly diagnosed adult CML-CP patients. By the last follow-up (December 2023), the median follow-up was 72 months, with the range of 6-180 months. Kaplan-Meier method analysis showed that the 8- and 10-year OS rates of 243 patients were 83.7% and 81.6%, respectively; patients with age ≥46 years compared to <46 years, with comorbidities compared to without comorbidities, and who did not achieve MR5.0 in terms of efficacy compared to who achieved MR5.0, the OS was poorer, and the differences were statistically significant (all P < 0.01). The nomogram of 8- and 10-year OS rates in TKI-treated newly diagnosed adult CML-CP patients was constructed based on the screened independent influencing factors of poor OS. The area under the ROC curve was 0.910 and 0.851 in the training set and 0.778 and 0.764 in the validation set for the predicted 8- and 10-year OS rates based on the nomogram, respectively, and the calibration curve showed that the predicted 8- and 10-year OS rates based on the nomogram were in high agreement with the actual ones in the training and validation sets; the DCA showed that the nomogram within a certain prediction threshold could benefit the clinical decision-making in both the training and validation sets. Conclusions:Having comorbidities, not reaching MR5.0 in efficacy and old age are independent risk factors for poor survival of TKI-treated adult patients with newly diagnosed CML-CP, and the nomogram constructed based on these 3 factors has a good predictive ability for the survival of such patients.

Objective·To develop a multi-algorithm collaborative computational biology strategy for constructing a predictive model of the peripheral morphine tolerance network and for screening high-confidence candidate targets.Methods·A murine model of morphine tolerance was established across multiple treatment time points.Bulk RNA sequencing was performed on harvested dorsal root ganglion(DRG)tissues.Using the expression matrix as a basis,a weighted gene co-expression network was constructed to identify co-expressed gene modules.Candidate genes were subsequently screened through the integration of differentially expressed genes(DEGs)with key weighted gene co-expression network modules.These candidates underwent functional annotation via Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses.A protein-protein interaction(PPI)network was established,and hub genes were systematically identified using the cytoHubba algorithm.Three distinct machine learning approaches,least absolute shrinkage and selection operator(LASSO)regression,support vector machine recursive feature elimination(SVM-RFE)model,and random forest(RF)model,were strategically integrated to screen characteristic signature genes.Finally,gene set enrichment analysis(GSEA)was implemented to functionally validate both the hub and signature genes.Results·Weighted gene co-expression network analysis(WGCNA)identified 8 297 key module genes,of which 177 candidate genes overlapped with DEGs.These genes were significantly enriched in biological processes including ion channel regulation and vascular smooth muscle contraction.A combination of PPI network analysis and machine learning revealed four signature genes[actin γ2,smooth muscle(Actg2),centriolar coiled-coil protein 110(Ccp110),neural cell adhesion molecule 2(Ncam2),and selenium binding protein 1(Selenbp1)]and six hub genes[actin α2,smooth muscle(Acta2),von Willebrand factor(Vwf),cellular communication network factor 2(Ccn2),integrin β4(Itgb4),integrin α11(Itga11),and TEK receptor tyrosine kinase(Tek)]closely associated with morphine tolerance.Conclusion·In this study,we successfully constructed a multi-algorithm collaborative peripheral nerve regulation network prediction model for morphine tolerance,and screened out 10 core genes with high confidence.

Objective To analyze the association between eye-related behaviors and myopia among preschool chil-dren in Ningxia Hui Autonomous Region,and to develop a predictive nomogram model.Methods Using stratified cluster random sampling,36 062 preschool children from 400 randomly selected kindergartens in Ningxia Hui Autonomous Region were enrolled between October and December 2023.Primary caregivers of participants completed structured question-naires.Data were randomly split into a training set(n=25 243,70％)and a validation set(n=10 819,30％)in a ratio of 7∶3.The training set was used for model construction,and the validation set for external validation.Calibration plots and the Hosmer-Lemeshow(H-L)goodness-of-fit test assessed agreement between predicted and observed risks.Decision curve analysis(DCA)and clinical impact curve analysis(CICA)evaluated clinical utility.Results The myopia preva-lence among preschool children in Ningxia Hui Autonomous Region was 3.8％.A nomogram model based on binary Logistic regression showed area under the curve(AUC)values of 0.88(95％CI:0.87-0.89)for the training set and 0.89(95％CI:0.87-0.90)for the validation set,indicating strong discriminative ability.Calibration curves and H-L tests revealed good model fit(training set:x2=4.92,P=0.766;validation set:x2=5.52,P=0.961),with all P＞0.05.DCA and CICA confirmed clinical utility.The nomogram identified parental myopia,academic pressure,frequency of eye fatigue,daily screen time,and regular vision checks as the top five predictors of myopia.Conclusion The nomogram demonstrates promising potential for predicting myopia risk in preschool children in Ningxia Hui Autonomous Region,serving as a robust tool for clinical and educational myopia risk assessment.

This consensus was developed by the Orthodontic Society of the Chinese Stomatological Association to provide a systematic, scientific, and practical guideline for informed consent in orthodontic care. Orthodontic treatment is typically lengthy, highly individualized, and involves multiple factors such as growth and development, occlusal function, and facial esthetics. Rapid technological advances and diverse risk profiles make the traditional reliance on orthodontist experience or institutional templates insufficient to ensure patients′ full understanding and autonomous decision-making. To address this, the expert panel conducted extensive reviews of domestic and international guidelines, analyzed representative dispute cases, and performed multicenter patient-clinician surveys. Using a multi-round Delphi method, the group established a standardized informed consent framework covering the initial consultation, treatment, and retention phases. The consensus emphasizes that informed consent is not only a fundamental legal and ethical requirement but also a key step in building trust, improving patient compliance, and enhancing treatment satisfaction. Orthodontists should clearly and comprehensively explain treatment plans, potential risks, uncertainties, and associated costs, while respecting the autonomy of patients or guardians, and maintain continuous communication and dynamic evaluation throughout the treatment process. The release of this consensus provides unified and authoritative guidance for clinical orthodontics, helping to standardize informed consent, enhance its transparency, safeguard patient rights, reduce medical risks, and promote high-quality, sustainable development of orthodontic practice.

Objective:To explore the current status and influencing factors of non-verbal communication needs in mechanically ventilated patients in ICU using an interpretive sequential mixed research design to inform the future development of targeted non-verbal communication strategies for mechanically ventilated patients in the ICU.Methods:Convenience sampling was used to select 262 mechanically ventilated patients from the general ICUs of two Class Ⅲ Grade A hospitals in Shanghai, from January to June 2023 for the study. Patients were surveyed using the General Information Questionnaire and the Surgical ICU Tracheal Intubation Patient Communication Needs Scale. Multiple linear regression was used to analyze the factors influencing the non-verbal communication needs of mechanically ventilated patients in the ICU. A total of 262 questionnaires were distributed in the quantitative study, and 256 valid questionnaires were recovered, with a valid recovery rate of 97.71% (256/262) . Purposive sampling was used to select 16 ICU mechanically ventilated patients for semi-structured in-depth interviews. The information was analyzed using the Colaizzi 7-step analysis method.Results:In 256 mechanically ventilated patients, the total non-verbal communication needs score was (144.33±12.82) , and the items average scores of physiological needs, safety needs, love and belongingness needs, and self-esteem needs were (3.39±1.83) , (3.35±0.98) , (3.32±1.21) , and (3.29±1.32) , respectively. Multiple linear regression analysis showed that the duration of mechanical ventilation, history of intubation, and education level were the factors influencing the non-verbal communication needs of mechanically ventilated patients in the ICU ( P<0.05) . Five themes were distilled from the qualitative study, including communication needs for shared decision-making about disease trajectories, communication needs for accurate management of disease symptoms, communication needs for psychological stress adjustment, communication needs for social system support, and communication needs for dignity preservation. Integrating and analyzing the quantitative and qualitative results revealed that they complemented each other in explaining and validating ideas in elaborating the current status and intrinsic relationship of non-verbal communication needs of mechanically ventilated patients in ICU. Conclusions:The non-verbal communication needs of mechanically ventilated patients in the ICU are prevalent and influenced by a variety of factors. It is recommended that hospital administrators construct an effective non-verbal communication support system based on the status quo of patients' non-verbal communication needs in order to promote the whole process and multidimensional health management services for ICU mechanically ventilated patients and to improve patients' quality of life.