To compare the performance differences between the multidisciplinary team (MDT) model and the conventional diagnostic and treatment model for lung cancer, and to explore a high-quality development pathway for optimizing lung cancer diagnostic and treatment resources.

Pulpotomy, which belongs to vital pulp therapy, has become a strategy for managing pulpitis in recent decades. This minimally invasive treatment reflects the recognition of preserving healthy dental pulp and optimizing long-term patient-centered outcomes. Pulpotomy is categorized into partial pulpotomy (PP), the removal of a partial segment of the coronal pulp tissue, and full pulpotomy (FP), the removal of whole coronal pulp, which is followed by applying the biomaterials onto the remaining pulp tissue and ultimately restoring the tooth. Procedural decisions for the amount of pulp tissue removal or retention depend on the diagnostic of pulp vitality, the overall treatment plan, the patient's general health status, and pulp inflammation reassessment during operation. This statement represents the consensus of an expert committee convened by the Society of Cariology and Endodontics, Chinese Stomatological Association. It addresses the current evidence to support the application of pulpotomy as a potential alternative to root canal treatment (RCT) on mature permanent teeth with pulpitis from a biological basis, the development of capping biomaterial, and the diagnostic considerations to evidence-based medicine. This expert statement intends to provide a clinical protocol of pulpotomy, which facilitates practitioners in choosing the optimal procedure and increasing their confidence in this rapidly evolving field.
Humans ; Calcium Compounds/therapeutic use* ; Consensus ; Dental Pulp ; Dentition, Permanent ; Oxides/therapeutic use* ; Pulpitis/therapy* ; Pulpotomy/standards*

Intentional tooth replantation (ITR) is an advanced treatment modality and the procedure of last resort for preserving teeth with inaccessible endodontic or resorptive lesions. ITR is defined as the deliberate extraction of a tooth; evaluation of the root surface, endodontic manipulation, and repair; and placement of the tooth back into its original socket. Case reports, case series, cohort studies, and randomized controlled trials have demonstrated the efficacy of ITR in the retention of natural teeth that are untreatable or difficult to manage with root canal treatment or endodontic microsurgery. However, variations in clinical protocols for ITR exist due to the empirical nature of the original protocols and rapid advancements in the field of oral biology and dental materials. This heterogeneity in protocols may cause confusion among dental practitioners; therefore, guidelines and considerations for ITR should be explicated. This expert consensus discusses the biological foundation of ITR, the available clinical protocols and current status of ITR in treating teeth with refractory apical periodontitis or anatomical aberration, and the main complications of this treatment, aiming to refine the clinical management of ITR in accordance with the progress of basic research and clinical studies; the findings suggest that ITR may become a more consistent evidence-based option in dental treatment.
Humans ; Tooth Replantation/methods* ; Consensus ; Periapical Periodontitis/surgery*

Objective To explore the predictive value of serum angiopoietin-like protein 4(ANGPTL4)and C-X3-C motif chemokine ligand 1(CX3CL1)for poor prognosis in patients with acute cerebral infarction(ACI)undergoing intravascular intervention therapy.Methods A total of 180 ACI patients undergoing endovascular intervention in our department from January 2021 to February 2024 were prospectively recruited and served as the study group,and according to the prognosis,they were divided into a good prognosis group(97 cases)and a poor prognosis group(83 cases).Another 180 individuals who taking healthy checkup in the same period served as the control group.The levels of ANGPTL4 and CX3CL1 were measured by ELISA.Results The ser-um ANGPTL4 level was significantly lower while that of CX3CL1 was obviously higher in the study group than the control group(P＜0.01).The poor prognosis group had notably longer time from onset to admission and larger proportions of having NIHSS score at admission≥15 and an-terior circulation cerebral infarction,lower serum ANGPTL4 level and higher CX3CL1 level when compared with the good prognosis group(P＜0.01).Multivariate logistic regression analysis showed that time from onset to admission,NIHSS score at admission,location of cerebral infarc-tion,and CX3CL1 were risk factors,and ANGPTL4 was a protective factor for poor prognosis in ACI patients(P＜0.05,P＜0.01).ROC curve analysis showed that the AUC value of serum ANGPTL4,CX3CL1 and their combinzation in predicting poor prognosis in ACI patients was 0.816(95％CI:0.755-0.877),0.860(95％CI:0.791-0.930),and 0.901(95％CI:0.846-0.956),respectively,and the combined indicators showed better predictive value than each indicator alone(Z=2.716,Z=2.732,P＜0.05).Conclusion Serum ANGPTL4 and CX3CL1 levels are abnormal-ly expressed in ACI patients after intravascular intervention therapy,and are related to prognosis.Their combined detection can improve the predictive value for poor prognosis.

Objective:To investigate the potential profiles of imposter phenomenon in undergraduate nursing interns, and to analyze inter-group differences and associated influencing factors.Methods:A total of 216 undergraduate student nurses on placement from January 2023 to July 2024 were surveyed using a general information questionnaire, the Imposter Phenomenon Scale, and the Social Support Rating Scale. The data were used to identify latent profiles and influencing factors associated with imposter phenomenon among the student nurses, with the use of Mplus 8.3 and SPSS, respectively.Results:The mean imposter phenomenon score of the nursing students was (57.88±10.38) points. They were divided into three groups: low-, intermediate-, and high-level imposter syndrome groups, accounting for 17.13%, 38.89%, and 43.98%, respectively. Sex (odds ratio [ OR]=10.514, 95% CI: 3.021-36.588), monthly family income ( OR=0.154, 95% CI: 0.051-0.469), undergraduate grades ( OR=4.947, 95% CI: 1.924-12.723), and social support ( OR=0.051, 95% CI: 0.008-0.322) were factors influencing the profiles of imposter phenomenon among the students. Conclusions:The imposter syndrome of the undergraduate nursing interns is generally at an intermediate level. Nursing managers and nursing educators should provide more assistance to the intermediate- and high-level groups, with a more comprehensive social support system and targeted intervention strategies, so as to effectively reduce their imposter phenomenon level.

Objective:To mine risk signals of adverse events (AE) in agalsidase beta therapy for Fabry disease and provide reference for the safe use in clinical practice.Methods:The AE reports with agalsidase beta as the primary suspect drug in the US Food and Drug Administration Adverse Event Reporting System (FAERS) database from the first quarter of 2004 to the third quarter of 2024 were collected and the clinical information of patients involved was analyzed descriptively. AEs were standardized and categorized using the preferred term (PT) and system organ class (SOC) in Medical Dictionary for Regulatory Activities version 26.0. Signal mining was performed using the reporting odds ratio (ROR) method and Bayesian confidence propagation neural network (BCPNN) method. A PT was defined as the risk signal if the number of reports was ≥3, the lower limit of the 95% confidence interval ( CI) of ROR was >1, and the information component minus two times standard deviation ( IC025) was >0. Descriptive statistical analysis were then conducted on the risk signals. The relative risk of target adverse events in gender subgroups was evaluated using the ROR method. Results:A total of 24 163 AE reports with agalsidase beta as the primary suspect drug were collected, involving 7 763 patients and 2 382 PTs. Severe adverse events accounted for 34.9% (2 712/7 763). A total of 121 risk signals (namely PTs) across 15 SOCs were obtained. The top 5 PTs ranked by number of reports were pyrexia (483 cases), chills (449 cases), infusion related reaction (282 cases), chest pain (221 cases), and cerebrovascular accident (218 cases). The top 5 PTs ranked by signal intensity were cornea verticillata ( ROR=56.44, IC025=4.59), drug specific antibody present ( ROR=54.13, IC025=5.46), cerebral calcification ( ROR=24.82, IC025=3.16), myocardial necrosis marker increased ( ROR=24.14, IC025=3.83), and infusion site rash ( ROR=20.41, IC025=3.46). Among the top 30 PTs ranked by number of reports and signal intensity, there were 4 and 13 PTs not documented in the drug label, respectively. The former included atrial fibrillation, cellulitis, neuralgia, and pallor, while the latter included cornea verticillate, cerebral calcification, auricular swelling, vein discoloration, aortic dilatation, bundle branch block, myocardial fibrosis, cardiac infection, vein rupture, sudden hearing loss, meningitis viral, deafness transitory, and corneal opacity. Subgroup analysis by sex showed that males had higher risks in developing chills, tremor, drug specific antibody detection, renal failure, and renal impairment, while females had higher risks in weight increase and dizziness. Conclusions:The main risk signals of adverse events of agalsidase beta include pyrexia, chills, and infusion related reactions, which are consistent with those documented in package inserts. In addition, potential new risk signals such as atrial fibrillation, cellulitis, neuralgia, cornea verticillate, auricular swelling, and sudden hearing loss were also detected. The relative risks of some target adverse events vary between genders, and it is recommended to strengthen targeted drug monitoring and individualized management in clinical practice.

Objective To explore the predictive value of serum angiopoietin-like protein 4(ANGPTL4)and C-X3-C motif chemokine ligand 1(CX3CL1)for poor prognosis in patients with acute cerebral infarction(ACI)undergoing intravascular intervention therapy.Methods A total of 180 ACI patients undergoing endovascular intervention in our department from January 2021 to February 2024 were prospectively recruited and served as the study group,and according to the prognosis,they were divided into a good prognosis group(97 cases)and a poor prognosis group(83 cases).Another 180 individuals who taking healthy checkup in the same period served as the control group.The levels of ANGPTL4 and CX3CL1 were measured by ELISA.Results The ser-um ANGPTL4 level was significantly lower while that of CX3CL1 was obviously higher in the study group than the control group(P＜0.01).The poor prognosis group had notably longer time from onset to admission and larger proportions of having NIHSS score at admission≥15 and an-terior circulation cerebral infarction,lower serum ANGPTL4 level and higher CX3CL1 level when compared with the good prognosis group(P＜0.01).Multivariate logistic regression analysis showed that time from onset to admission,NIHSS score at admission,location of cerebral infarc-tion,and CX3CL1 were risk factors,and ANGPTL4 was a protective factor for poor prognosis in ACI patients(P＜0.05,P＜0.01).ROC curve analysis showed that the AUC value of serum ANGPTL4,CX3CL1 and their combinzation in predicting poor prognosis in ACI patients was 0.816(95％CI:0.755-0.877),0.860(95％CI:0.791-0.930),and 0.901(95％CI:0.846-0.956),respectively,and the combined indicators showed better predictive value than each indicator alone(Z=2.716,Z=2.732,P＜0.05).Conclusion Serum ANGPTL4 and CX3CL1 levels are abnormal-ly expressed in ACI patients after intravascular intervention therapy,and are related to prognosis.Their combined detection can improve the predictive value for poor prognosis.

Objective:To mine risk signals of adverse events (AE) in agalsidase beta therapy for Fabry disease and provide reference for the safe use in clinical practice.Methods:The AE reports with agalsidase beta as the primary suspect drug in the US Food and Drug Administration Adverse Event Reporting System (FAERS) database from the first quarter of 2004 to the third quarter of 2024 were collected and the clinical information of patients involved was analyzed descriptively. AEs were standardized and categorized using the preferred term (PT) and system organ class (SOC) in Medical Dictionary for Regulatory Activities version 26.0. Signal mining was performed using the reporting odds ratio (ROR) method and Bayesian confidence propagation neural network (BCPNN) method. A PT was defined as the risk signal if the number of reports was ≥3, the lower limit of the 95% confidence interval ( CI) of ROR was >1, and the information component minus two times standard deviation ( IC025) was >0. Descriptive statistical analysis were then conducted on the risk signals. The relative risk of target adverse events in gender subgroups was evaluated using the ROR method. Results:A total of 24 163 AE reports with agalsidase beta as the primary suspect drug were collected, involving 7 763 patients and 2 382 PTs. Severe adverse events accounted for 34.9% (2 712/7 763). A total of 121 risk signals (namely PTs) across 15 SOCs were obtained. The top 5 PTs ranked by number of reports were pyrexia (483 cases), chills (449 cases), infusion related reaction (282 cases), chest pain (221 cases), and cerebrovascular accident (218 cases). The top 5 PTs ranked by signal intensity were cornea verticillata ( ROR=56.44, IC025=4.59), drug specific antibody present ( ROR=54.13, IC025=5.46), cerebral calcification ( ROR=24.82, IC025=3.16), myocardial necrosis marker increased ( ROR=24.14, IC025=3.83), and infusion site rash ( ROR=20.41, IC025=3.46). Among the top 30 PTs ranked by number of reports and signal intensity, there were 4 and 13 PTs not documented in the drug label, respectively. The former included atrial fibrillation, cellulitis, neuralgia, and pallor, while the latter included cornea verticillate, cerebral calcification, auricular swelling, vein discoloration, aortic dilatation, bundle branch block, myocardial fibrosis, cardiac infection, vein rupture, sudden hearing loss, meningitis viral, deafness transitory, and corneal opacity. Subgroup analysis by sex showed that males had higher risks in developing chills, tremor, drug specific antibody detection, renal failure, and renal impairment, while females had higher risks in weight increase and dizziness. Conclusions:The main risk signals of adverse events of agalsidase beta include pyrexia, chills, and infusion related reactions, which are consistent with those documented in package inserts. In addition, potential new risk signals such as atrial fibrillation, cellulitis, neuralgia, cornea verticillate, auricular swelling, and sudden hearing loss were also detected. The relative risks of some target adverse events vary between genders, and it is recommended to strengthen targeted drug monitoring and individualized management in clinical practice.

Objective:To investigate the potential profiles of imposter phenomenon in undergraduate nursing interns, and to analyze inter-group differences and associated influencing factors.Methods:A total of 216 undergraduate student nurses on placement from January 2023 to July 2024 were surveyed using a general information questionnaire, the Imposter Phenomenon Scale, and the Social Support Rating Scale. The data were used to identify latent profiles and influencing factors associated with imposter phenomenon among the student nurses, with the use of Mplus 8.3 and SPSS, respectively.Results:The mean imposter phenomenon score of the nursing students was (57.88±10.38) points. They were divided into three groups: low-, intermediate-, and high-level imposter syndrome groups, accounting for 17.13%, 38.89%, and 43.98%, respectively. Sex (odds ratio [ OR]=10.514, 95% CI: 3.021-36.588), monthly family income ( OR=0.154, 95% CI: 0.051-0.469), undergraduate grades ( OR=4.947, 95% CI: 1.924-12.723), and social support ( OR=0.051, 95% CI: 0.008-0.322) were factors influencing the profiles of imposter phenomenon among the students. Conclusions:The imposter syndrome of the undergraduate nursing interns is generally at an intermediate level. Nursing managers and nursing educators should provide more assistance to the intermediate- and high-level groups, with a more comprehensive social support system and targeted intervention strategies, so as to effectively reduce their imposter phenomenon level.

Objective Compared the 3-year retention rate and efficacy of levetiracetam(LEV),lamotrigine(LTG)and valproic acid(VPA)in patients with newly diagnosed epilepsy.Methods According to the antiepileptic drugs selected for the first time,323 patients with newly diagnosed epilepsy were divided into the LEV group,LTG group and VPA group.They were followed up for more than 3 years by telephone and outpatient clinic.Results There were significant differences in the single drug retention rate and epileptiform discharge rate among the LEV group,LTG group and VPA group in the first 3 years(all P<0.05).Compared with those in LEV group,the single drug retention rates in LTG group were significantly decreased in the first year and the second year(χ2=6.265,χ2=5.376;all P<0.025),the epileptiform discharge rate were significantly increased in the first year and the second year(χ2=14.011,χ2=8.574;all P<0.025);the single drug retention rate in VPA group were significantly decreased in the second year and the third year(χ2=6.226,χ2=10.112;all P<0.025),the epileptiform discharge rate was significantly increased in the first year,the second year and the third year(χ2=11.504,χ2=14.206,χ2=7.596;all P<0.025).There were significant differences in the survival curve of single drug retention and epileptiform discharge among the LEV group,LTG group and VPA group(χ2=9.349,P<0.05;χ2=7.395,P<0.05).The survival curve of single drug retention in LEV group was significantly higher than that in LTG group(χ2=4.451,P<0.05)and VPA group(χ2=9.464,P<0.05).The survival curve of epileptiform discharge in LEV group was significantly lower than that in VPA group(χ2=7.523,P<0.05).There was no significant difference in drug effective rate and no epileptic seizure rate in the first 3 years between LEV group,LTG group and VPA group(all P>0.05).There was a significant difference in the incidence of adverse drug reactions among the LEV group,LTG group and VPA group(χ2=8.068,P=0.018).Compared with that in LEV group,the incidence of adverse drug reactions in LTG group and VPA group were significantly increased(χ2=6.153,P=0.013;χ2=7.109,P=0.008).The main reasons for drug withdrawal,drug addiction and dressing change in LEV group were unsatisfactory curative effects,while those in LTG group and VPA group were adverse drug reactions.Conclusion The 3-year single drug retention rate of LEV is higher than that of LTG and VPA,and the EEG epileptiform discharge rate and the incidence of adverse drug reactions are significantly reduced,which was more suitable as the first choice for single drug treatment in patients with newly diagnosed epilepsy.