Enamel demineralization, the formation of white spot lesions, is a common issue in clinical orthodontic treatment. The appearance of white spot lesions not only affects the texture and health of dental hard tissues but also impacts the health and aesthetics of teeth after orthodontic treatment. The prevention, diagnosis, and treatment of white spot lesions that occur throughout the orthodontic treatment process involve multiple dental specialties. This expert consensus will focus on providing guiding opinions on the management and prevention of white spot lesions during orthodontic treatment, advocating for proactive prevention, early detection, timely treatment, scientific follow-up, and multidisciplinary management of white spot lesions throughout the orthodontic process, thereby maintaining the dental health of patients during orthodontic treatment.
Humans ; Consensus ; Dental Caries/etiology* ; Dental Enamel/pathology* ; Tooth Demineralization/etiology* ; Tooth Remineralization

Heatstroke, a life-threatening illness, poses a significant risk to human health, particularly in high-temperature and high-humidity environments. Timely and effective on-site management is critical for improving patient survival and prognosis. Rapid recognition, rapid assessment, and rapid cooling are the cornerstones of pre-hospital care. However, the absence of a standardized protocol for pre-hospital management of heatstroke has impeded the efficacy of treatment. This consensus, initiated by the Expert Group on Heatstroke Prevention of the People's Liberation Army, signifies a collaborative endeavor involving emergency medical personnel, nurses, and administrators from pre-hospital care, emergency departments, and intensive care units in both military and civilian domains. By systematically reviewing evidence-based medicine and clinical expertise in heatstroke prevention, on-site and in-transit care, as well as early treatment in emergency settings, the group has formulated the Expert consensus on pre-hospital emergency management of heatstroke (2024) after extensive discussions and iterative recommendations, which serve as a scientific and standardized framework for pre-hospital heatstroke emergency care. The consensus underscores the pivotal role of enhancing public awareness regarding heatstroke prevention and augmenting the rates of rapid recognition and rapid cooling for effective on-site heatstroke management. In high-risk industries, regions, or seasons for heatstroke, developing scientifically sound plans and conducting practical training can provide effective safety measures. Emergency personnel should undergo specialized training and assessments in knowledge and skills, ambulances should be equipped with effective cooling devices, and hospitals must maintain comprehensive emergency response capabilities. It is recommended to establish a regional heatstroke treatment network to optimize the allocation of emergency resources and streamline processes, thereby improving treatment outcomes and response times.
Heat Stroke/prevention & control* ; Humans ; Emergency Medical Services ; Consensus

Objective:To investigate the current situation of nursing information ability of head nurses in different grades of hospitals in Jiaozuo City, and analyze its influencing variables based on the random forest model, so as to provide evidence-based basis for the construction of nursing information ability improvement strategies and training programs for head nurses.Methods:From August to September 2024, the head nurses of 20 hospitals of different grades were selected by cluster sampling method in Jiaozuo City as the research subjects. General Data Questionnaire and Nursing Information Ability Scale of Head Nurses were used to conduct a cross-sectional survey. Random forest model was used to evaluate the importance of variables, lasso regression analysis was applied to complete the variable screening, and the influencing factors of nursing information ability of head nurses were explored through stepwise multiple linear regression analysis.Results:A total of 305 questionnaires were ultimately collected, of which 297 were valid, the effective rate was 97.38%. Out of 297 head nurses, 6 were male and 291 were female; 49 individuals aged 20-29 years old, 127 individuals aged 30-39 years old, 92 individuals aged 40-49 years old, and 29 individuals aged ≥ 50 years old. The total score of nursing information ability was (139.06 ± 24.62). Random forest model and lasso regression analysis showed that the top 6 variables in terms of importance were the number of years serving as head nurses, participation in information function development, number of academic conferences in the past three years, hospital grade, participating in information training, and chairing or participating in scientific research in the past three years. Stepwise multiple linear regression analysis showed that the number of years serving as head nurses, participating in information training, participating in information function development and number of academic conferences in the past three years had significant effects on nursing information ability of head nurses (t values were -4.66 to 3.81, all P<0.05). Conclusions:The nursing information ability of head nurses in Jiaozuo city is in the middle level, and the nursing information ability of head nurses in different grades of hospitals is different. It is suggested to construct a stepped information ability continuing education framework and a research-information ability coupling development mechanism, and incorporate nursing information ability into the necessary conditions for the appointment of nursing management posts, so as to realize the balanced development of nursing information management ability and the continuous iteration of nursing manager information ability.

Objective To investigate the quality of life status in patients with type 2 diabetes mellitus and its influencing factors,understand their demands for continuous nursing services,analyze the correlation,and provide a reference for formulating and implementing continuous nursing plans for diabetes in the later stage.Methods From May to December 2024,a cross-sectional survey was conducted among 294 patients with type 2 diabetes mellitus in this hospital by using the Self-Rating Anxiety Scale(SAS),the Diabetes Pa-tient-Specific Quality of Life Scale(DSQL),and the Questionnaire on the Need for Continuous Care.Results The SAS score of patients with type 2 diabetes was 45.76±7.45,DSQL score was 54.68±10.99,and the score of continuous care needs was 32.98±5.79.The quality of life of patients with type 2 diabetes mellitus is mainly influenced by factors such as age,family type,educational level,average monthly family in-come,duration of diabetes,blood glucose control,dietary compliance,intensity of physical exercise,and diabet-ic complications.The quality of life of patients with type 2 diabetes mellitus was positively correlated with need for continuous care(P<0.05).Conclusion The quality of life of patients with type 2 diabetes mellitus is influenced by multiple factors and is related to the need for continuous care.Professional continuous care plans can be formulated and implemented based on the needs of patients with type 2 diabetes mellitus.

The Occupational Classification Dictionary of the People's Republic of China (2015 Edition) has added a new occupation type, Medical Nursing Assistants, aiming to meet the strong demand for medical care in the context of the aging population in China.In order to standardize the services of medical nursing assistants for the elderly in home and community settings and contribute to healthy aging, the National Health Commission issued the " Service Standards for Medical Nursing Assistants of Older Adults in Home and Community" ( WS/ T 803—2022) on September 28, 2022.The standards regulate the service processes, service items and requirements, as well as service evaluation and improvement for elderly medical nursing assistants.The interpretation of the standard's formulation background, the compilation process, and the standard's content are as follows.

Objective:To develop a post competence assessment scale for nurses in the health management (physical examination) center and assess its reliability and validity.Methods:This study adopted an empirical approach. A total of 801 nurses from the health management (physical examination) center were recruited to participate in this study. A research team was formed in August 2024. This team transformed the previously constructed core competence evaluation index system for health management specialist nurses in the health management (physical examination) center (comprising 6 first-level indicators and 70 third-level indicators) into a preliminary post competence assessment scale. Seven experts evaluated the content validity of the scale. In September 2024, a pilot survey was conducted among 27 nurses from the health management (physical examination) center of Sichuan Provincial People′s Hospital using convenience sampling. From October to November 2024, the first main survey was administered to 385 nurses of health management (physical examination) center across 54 cities in China using both convenience sampling and snowball sampling methods, followed by exploratory factor analysis (EFA). Subsequently, utilizing the refined scale obtained after eliminating certain items, a second main survey was conducted among 389 nurses in the health management (physical examination) center, followed by a confirmatory factor analysis (CFA). The reliability of the final scale was assessed using Cronbach′s α coefficient, split-half reliability, composite reliability, and test-retest reliability.Results:The finalized scale for nurses′ post competency in health management (physical examination) center comprises five dimensions—basic nursing service competency, health management practice competency, knowledge integration competency, professional development competency, and professional attitude—with a total of 57 items. The item level content validity index (I-CVI) of the items of the content validity display scale ranged from 0.857 to 1.000, and the content validity index of each dimension ranged from 0.984 to 1.000. The scale-level Content Validity index/average (S-CVI/Ave) was 0.995. The contribution rate of the 6 factors extracted by EFA was 74.07%. After group discussion and CFA, the scale of the 5-factor structural equation model was constructed. The total Cronbach′s α coefficient of the scale was 0.986, the split-half reliability was 0.865, the composite reliability was 0.960-0.980, the total table test-retest reliability was 0.762, and the test-retest reliability of each dimension was 0.681-0.731.Conclusion:The developed assessment scale for assessing the post competence of nurses in the health management (physical examination) center demonstrates excellent reliability and validity.

Objective:To analyze the detection status and its influencing factors of ovarian-adnexal masses in the physical examination population based on the Ovarian-Adnexal Imaging Reporting and Data System (O-RADS) of the American College of Radiology.Methods:This cross-sectional study retrospectively analyzed the clinical data of 24 316 physical examination participants who underwent gynecological color Doppler ultrasound examinations at the Health Management Center of Tianjin Medical University General Hospital from January to December 2021. The subjects were classified and followed-up according to O-RADS, and the detection rate and malignancy rate of ovarian-adnexal masses in different classifications were compared. According to O-RADS classification criteria, the physical examination population were divided into healthy control group (without ovarian-adnexal masses and O-RADS 1 class, 23 188 cases), benign group (O-RADS 2 class, 946 cases) and malignant group (O-RADS 3-5 class, 182 cases). The basic information of the three groups were compared, including age, body mass index (BMI), menopausal status, marital status, smoking history, drinking history, physical exercise, complete blood count, blood glucose, blood lipids, tumor markers, etc. The logistic regression was used to analyze the factors affecting the detection of ovarian-adnexal masses.Results:A total of 24 316 individuals were included, 1 678 with ovario-adnexal masses were screened, among the cases, there were 550 normal premenopausal ovaries (32.78%), and 1 128 cases were confirmed with pathological masses (67.22%). Of the 318 cases with follow-up records, the malignancy rate for O-RADS 4 class was 50%, and for O-RADS 5 class, it was 100%, according to the follow-up results. The age ( OR=1.320, 95% CI: 1.055-1.653), BMI ( OR=0.972, 95% CI: 0.954-0.989), carbohydrate antigen 125(CA125) ( OR=1.090, 95% CI: 1.023-1.161), postmenopausal ( OR=0.919, 95% CI: 0.892-0.947) and married and cohabiting ( OR=0.921, 95% CI: 0.895-0.949) were positively correlated with risk of ovarian-adnexal masses (all P0.05). Conclusions:The O-RADS classification system has high application value in evaluating the malignant risk of ovarian-adnexal masses; the age, BMI, CA125 levels, menopausal status, and marital status are significant influencing factors for the detection of ovarian-adnexal masses.

OBJECTIVE: To observe the effect of acupuncture at back-shu points on patients with post-stroke tracheotomy on the basis of extracorporeal diaphragmatic pacing (EDP) combined with conventional acupuncture. METHODS: A total of 64 patients with post-stroke tracheotomy were randomly divided into an experiment group (32 cases, 2 cases dropped out) and a control group (32 cases, 2 cases dropped out). The control group received EDP combined with conventional acupuncture, acupuncture was applied at Baihui (GV20), Zhongwan (CV12) and bilateral Fengchi (GB20), Quchi (LI11), Hegu (LI4), Neiguan (PC6), Xuehai (SP10) , Yinlingquan (SP9), Sanyinjiao (SP6), Zusanli (ST36), 30 min each time. The experiment group was treated with acupuncture at bilateral Feishu (BL13), Pishu (BL20), Shenshu (BL23) on the basis of the treatment in the control group, 30 min each time. Acupuncture in both groups was given once a day, 5 days a week for 4 weeks. Before and after treatment, the pulmonary function (forced vital capacity [FVC], first second forced expiratory volume [FEV₁], peak expiratory flow [PEF], maximal inspiratory pressure [MIP], maximal expiratory pressure [MEP]), diaphragmatic thickening fraction (DTF), diaphragm excursion (DE), postural assessment scale for stroke patients (PASS) score and Berg balance scale (BBS) score were observed in the two groups. The extubation success rate was recorded in the two groups. RESULTS: After treatment, the FVC, FEV₁, PEF, MIP and MEP in the two groups were increased compared with those before treatment (P<0.001), and above indexes in the experiment group were higher than those in the control group (P<0.001, P<0.01). After treatment, the DTF and DE in the two groups were increased compared with those before treatment (P<0.001), the DE in the experiment group was higher than that in the control group (P<0.001). After treatment, the PASS and BBS scores in the two groups were increased compared with those before treatment (P<0.001), and the BBS score in the experiment group was higher than that in the control group (P<0.001). The extubation success rate of the experiment group was 73.3% (22/30), which was higher than 46.7% (14/30) in the control group (P<0.05). CONCLUSION On the basis of EDP combined with conventional acupuncture, acupuncture at back-shu points can improve the pulmonary function, respiratory muscle strength, trunk control and balance abilities in patients with post-stroke tracheotomy, and increase the extubation success rate.
Humans ; Acupuncture Therapy ; Male ; Female ; Middle Aged ; Aged ; Stroke/complications* ; Acupuncture Points ; Tracheotomy ; Adult ; Airway Extubation ; Treatment Outcome

Objective To explore the effect of remote ischemic conditioning(RIC)combined with binaural beat music(BBM)train-ing in patients with cognitive dysfunction after cerebral infarction.Methods From June,2024 to January,2025,200 patients with cognitive dysfunction after cerebral infarction in the Affil-iated Hospital of North China University of Science and Technology were randomly divided into control group(n=50),RIC group(n=50),BBM group(n=50)and combined group(n=50).All the groups received stan-dardized routine training,RIC group received RIC,BBM group received BBM,and the combined group received RIC+BBM,for 14 days.They were assessed with Montreal Cognitive Assessment(MoCA)and Stroke-Specific Quality of Life Scale(SS-QOL)at baseline,day 14,and day 90.Results Two cases in the control group,four in RIC group,three in BBM group and three in the combined group dropped out.For MoCA scores,the inter-group effect,intra-group effect and interaction effect were all significant(F>13.463,P<0.001).After intervention,on both day 14 and day 90,the score of MoCA was higher in each in-tervention group than in the control group(P<0.05),and was higher in the combined group than in both BBM and RIC groups(P<0.05);and on day 90,it was higher in RIC group than in BBM group(P<0.05).For SS-QOL,the score increased with time in all the groups(χ2>75.182,P<0.001).After intervention,there was signif-icant difference at each time point among four groups(H>18.260,P<0.001).On day 14 and day 90,the score of SS-QOL was higher in the combined group than in the control and BBM groups(|Z|>3.149,P<0.05);on day 90,the score was higher in RIC group than in the control group(|Z|=3.590,P<0.05),and it was higher in the combined group than in RIC group(|Z|=3.186,P<0.05).Conclusion RIC,BBM and their combination all improved cognitive function after cerebral infarction.RIC was superior to BBM,and the combined intervention yielded the greatest benefit.Both RIC and the combined intervention im-proved quality of life,with the combined approach being the most effective.

Objective:To investigate the effect of low-dose aspirin combined with dydrogesterone in the treatment of patients with polycystic ovary syndrome (PCOS) complicated with infertility and its influence on hormones and helper T cytokines.Methods:300 PCOS patients with infertility in the Second Affiliated Hospital of Air Force Military Medical University were selected from January 2018 to October 2023. A prospective randomized controlled study was performed. The study subjects were divided into control group and observation group by random envelope method, with 150 cases in each group. The control group was treated with dydrogesterone on the basis of routine intervention, while the observation group was combined with low-dose aspirin on the basis of the control group. The efficacy, pregnancy rate, hormones, Th1 and Th2 cytokines and incidence of adverse reactions were compared in between groups. Measurement data with normal distribution was represented by xˉ± s. Comparison between groups was performed by two-sample t-test and paired t-test was used for comparison before and after treatment. Enumeration data was represented by n(%). Comparison between groups was performed by χ2 test. Results:After treatment, the total effective rate of treatment and pregnancy rate in observation group were higher than those in control group [86.00%(129/150) vs. 74.67% (112/150), 63.33% (95/150) vs. 47.33% (71/150)] ( χ2=6.10, P=0.014, χ2=6.73, P=0.010). Serum levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in both groups were lower after treatment than those before treatment, and the levels in observation group were lower than those in control group [(5.27±1.01) U/L vs. (6.40±1.13) U/L, (6.78±0.87) U/L vs. (7.16±0.91) U/L], and serum estradiol level was higher than that before treatment, and the level in observation group was higher compared to control group [(93.35±8.17) ng/L vs. (82.45±9.14) ng/L] ( t=9.13, 3.70, 10.89, all P<0.001). After treatment, serum γ-interferon, interleukin (IL-2), IL-4 and IL-6 levels were all lower in both groups than those before treatment, and the above levels were lower in observation group than those in control group [(56.96±4.64) ng/L vs. (61.36±4.41) ng/L, (38.74±7.43) ng/L vs.(45.63±8.64) ng/L, (41.03±7.06) ng/L vs. (43.36±8.12 ng/L), (23.14±4.33) ng/L vs. (27.14±5.14) ng/L] ( t=8.42, 7.40, 2.65, 7.29, P<0.001, <0.0 010.008, <0.001). There was no statistical significance in the total incidence rate of adverse reactions between observation group and control group [12.67%(22/150) vs. 9.33% (14/150), χ2=0.85, P=0.356]. Conclusions:Low-dose aspirin combined with dydrogesterone has a significant clinical effect in the treatment of PCOS with infertility, and it can improve 3-month pregnancy rate, and effectively regulate hormones levels and Th1 and Th2 cytokines, and it will not increase adverse reactions, with high safety.