OBJECTIVES: This study aimed to investigate the perception of dental outpatient care quality from multiple perspectives of administrators, physicians, nurses, and patients and propose nursing care quality evaluation indices that are consistent with the clinical reality to provide reference for the construction of a scientific, systematic, and comprehensive dental outpatient care quality evaluation system. METHODS: A total of 39 interviewees, including 7 administrators, 11 doctors, 11 nurses, and 10 patients, were selected for semi-structured in-depth interviews in five regionally representative tertiary-level A stomatological specialty hospitals nationwide during January-April 2024 by using a multistage sampling method. Colaizzi 7-step analysis was used to analyze and summarize the interview data. Themes were extracted on the basis of the Structure-Process-Outcome (SPO) three-dimensional quality assessment model. RESULTS: Five main themes and 15 secondary themes were extracted from three quality dimensions: structure, process, and result. The related topics of structural quality were as follows: disinfection and isolation norms, equipment and consumable management, nursing manpower ratio and nurse education structure, and emergency capability. The related topics of process quality were as follows: pre-diagnosis risk assessment, patient triage and guidance, communication and attitude, health education, humanistic care, continuous care, specialty operation, and four-hand operation. The related topics of result quality were as follows: satisfaction, adverse event management and analysis, effective complaints and disputes. CONCLUSIONS Structure quality is the foundation, process quality is the core, and result quality is the key in the evaluation of the quality of oral outpatient care. The standardization of disinfection and isolation, equipment and consumable management, allocation of reasonable nursing manpower and post capacity, implementation of high-quality nursing services, and improvement of the quality and satisfaction of medical cooperation are necessary guarantees to ensure the quality of oral outpatient care.
Humans ; Quality of Health Care ; Ambulatory Care/standards* ; Dental Care/standards* ; Outpatients

OBJECTIVES: This study aimed to construct an evaluation index system for nursing quality management in outpatient dental clinics based on the structure-process-outcome model and provide an objective standard for the evaluation of nursing quality in outpatient dental clinics. METHODS: Through literature review, multi-subject interviews, and expert meetings, the first draft of the evaluation index for nursing quality management in outpatient dental clinics was formulated. The Delphi method was adopted to select and invite 15 experts in the fields of hospital infection management, nursing management, and specialized oral care from across the country to modify the first draft. RESULTS: The positive coefficients of the experts in the two rounds of consultation were 86.7% and 92.3%, respectively. The total authority coefficients of the experts were 0.791 and 0.717, respectively. The mean scores of the importance and feasibility of the third-level indices in the two rounds of consultation were all ≥4.333; the coefficients of variation were all ≤0.150; and the Kendall's coordination coefficients were 0.308 and 0.184 respectively, with P<0.05 for all. These results indicated that the experts were motivated to participate in this study. They recognized the importance and feasibility of the overall items in this index system, and their opinions were relatively consistent. Finally, an evaluation index system, which included 3 first-level indices, 7 second-level indices, 22 third-level indices, and 69 index connotations, for nursing quality management in outpatient dental clinics was determined. The weights of the three first-level indicators were all 0.333. Patient satisfaction (0.076, outcome dimension), hand hygiene (0.061, outcome dimension), chair care ratio (0.057, structural dimension), and turnover rate (0.057, structural dimension) were the top tertiary indicators in terms of portfolio weight. CONCLUSIONS The construction method of the evaluation index system for nursing quality management in outpatient dental clinics is scientific and reliable. It can provide a reference for the evaluation of the management level of nursing quality in outpatient dental clinics and promote the continuous improvement of nursing quality in outpatient dental clinics.
Humans ; Dental Clinics ; Delphi Technique

Objective:To analyze the screening results of the Urban Cancer Early Diagnosis and Treatment Project in Qinghai Province from 2019 to 2024.Methods:A summary and statistical analysis were conducted on six years of screening data from the Urban Cancer Early Dia-gnosis and Treatment Program in Qinghai Province,with the high-risk rate,screening rate,and detection rate calculated separately for each type of cancer.Results:From 2019 to 2024,56,882 high-risk individuals were identified.The high-risk rates for lung,colorectal,breast,up-per gastrointestinal,and liver cancer were 22.02%,21.57%,14.23%,13.52%,and 6.10%,respectively.Overall,13,592 individuals com-pleted clinical screening,with detection rates of 0.32%for lung cancer,0.41%for liver cancer,0.08%for precancerous gastric lesions,3.63%for precancerous colorectal lesions,0.08%for esophageal cancer,0.16%for gastric cancer,and 0.14%for colorectal cancer.Conclusions:The implementation of the Urban Cancer Early Diagnosis and Treatment Program in Qinghai Province aids in the early detection of cancer,improves early diagnosis and survival rates,and reduces mortality.Nevertheless,due to low public awareness and limited participation,en-hancements in program management and public outreach are required.

Objective:To analyze the screening results of the Urban Cancer Early Diagnosis and Treatment Project in Qinghai Province from 2019 to 2024.Methods:A summary and statistical analysis were conducted on six years of screening data from the Urban Cancer Early Dia-gnosis and Treatment Program in Qinghai Province,with the high-risk rate,screening rate,and detection rate calculated separately for each type of cancer.Results:From 2019 to 2024,56,882 high-risk individuals were identified.The high-risk rates for lung,colorectal,breast,up-per gastrointestinal,and liver cancer were 22.02%,21.57%,14.23%,13.52%,and 6.10%,respectively.Overall,13,592 individuals com-pleted clinical screening,with detection rates of 0.32%for lung cancer,0.41%for liver cancer,0.08%for precancerous gastric lesions,3.63%for precancerous colorectal lesions,0.08%for esophageal cancer,0.16%for gastric cancer,and 0.14%for colorectal cancer.Conclusions:The implementation of the Urban Cancer Early Diagnosis and Treatment Program in Qinghai Province aids in the early detection of cancer,improves early diagnosis and survival rates,and reduces mortality.Nevertheless,due to low public awareness and limited participation,en-hancements in program management and public outreach are required.

Bacteremia induced by periodontal infection is an important factor for periodontitis to threaten general health. P. gingivalis DNA/virulence factors have been found in the brain tissues from patients with Alzheimer's disease (AD). The blood-brain barrier (BBB) is essential for keeping toxic substances from entering brain tissues. However, the effect of P. gingivalis bacteremia on BBB permeability and its underlying mechanism remains unclear. In the present study, rats were injected by tail vein with P. gingivalis three times a week for eight weeks to induce bacteremia. An in vitro BBB model infected with P. gingivalis was also established. We found that the infiltration of Evans blue dye and Albumin protein deposition in the rat brain tissues were increased in the rat brain tissues with P. gingivalis bacteremia and P. gingivalis could pass through the in vitro BBB model. Caveolae were detected after P. gingivalis infection in BMECs both in vivo and in vitro. Caveolin-1 (Cav-1) expression was enhanced after P. gingivalis infection. Downregulation of Cav-1 rescued P. gingivalis-enhanced BMECs permeability. We further found P. gingivalis-gingipain could be colocalized with Cav-1 and the strong hydrogen bonding between Cav-1 and arg-specific-gingipain (RgpA) were detected. Moreover, P. gingivalis significantly inhibited the major facilitator superfamily domain containing 2a (Mfsd2a) expression. Mfsd2a overexpression reversed P. gingivalis-increased BMECs permeability and Cav-1 expression. These results revealed that Mfsd2a/Cav-1 mediated transcytosis is a key pathway governing BBB BMECs permeability induced by P. gingivalis, which may contribute to P. gingivalis/virulence factors entrance and the subsequent neurological impairments.
Animals ; Rats ; Bacteremia/metabolism* ; Blood-Brain Barrier/microbiology* ; Caveolin 1/metabolism* ; Gingipain Cysteine Endopeptidases/metabolism* ; Permeability ; Porphyromonas gingivalis/pathogenicity* ; Transcytosis ; Virulence Factors/metabolism*

Objectives:To establish a grading model on prognosis of drug-coated balloon (DCB) treatment on femoropopliteal de novo lesions, and assess whether patients at high risk could benefit from combination of directional atherectomy(DA).Methods:The clinical data of 114 patients with femoropopliteal de novo lesions admitted to Department of Vascular Surgery, Peking University People′s Hospital from October 2015 to January 2019 were collected retrospectively. There were 95 patients(108 limbs) underwent DCB treatment, including 66 males and 29 females, aged 71.9 years old(range:48 to 91 years), and 19 patients (21 limbs) underwent DA combined with DCB treatment, including 13 males and 6 females, aged 69.5 years old(range: 62 to 80 years). The demographic data, intraoperative and postoperative conditions of the patients were collected. Cox regression model was performed for modeling and then goodness of fit was tested. Kaplan-Meier estimate was carried out between the two groups for patients at high risk and low risk, respectively.Results:All patients were followed up for more than 24 months. Restenosis occurred on 34 limbs in DCB group and 3 limbs in DA+DCB group. Severe calcification( HR=3.804, 95% CI:2.460 to 5.883), popliteal artery involvement ( HR=2.104, 95% CI:1.368 to 3.236), long lesion ( HR=1.824, 95% CI:1.196 to 2.780), poor runoff( HR=1.736, 95% CI:1.025 to 2.940), chronic kidney disease( HR=1.601, 95% CI:1.040 to 2.463) were independent risk factors of restenosis after DCB treatment, and were defined 3, 2, 1, 1 and 1 points, respectively. Total points≥3 was regarded as high risk group. Kaplan-Meier analysis showed that patients in low risk group did not benefit from DA+DCB comparing with DCB with regard to primary patency at 24 months (77.78% vs. 90.31%, P=0.271) while patients benefited from DA+DCB comparing with DCB in high risk group(88.26% vs. 20.80%, P<0.01). Conclusions:The grading model shows satisfying clinical value. The clinical effect of DA+DCB is better than DCB along in high risk group. Patients at high risk are supposed to receive aggressive vessel preparation like DA.

Objectives:To establish a grading model on prognosis of drug-coated balloon (DCB) treatment on femoropopliteal de novo lesions, and assess whether patients at high risk could benefit from combination of directional atherectomy(DA).Methods:The clinical data of 114 patients with femoropopliteal de novo lesions admitted to Department of Vascular Surgery, Peking University People′s Hospital from October 2015 to January 2019 were collected retrospectively. There were 95 patients(108 limbs) underwent DCB treatment, including 66 males and 29 females, aged 71.9 years old(range:48 to 91 years), and 19 patients (21 limbs) underwent DA combined with DCB treatment, including 13 males and 6 females, aged 69.5 years old(range: 62 to 80 years). The demographic data, intraoperative and postoperative conditions of the patients were collected. Cox regression model was performed for modeling and then goodness of fit was tested. Kaplan-Meier estimate was carried out between the two groups for patients at high risk and low risk, respectively.Results:All patients were followed up for more than 24 months. Restenosis occurred on 34 limbs in DCB group and 3 limbs in DA+DCB group. Severe calcification( HR=3.804, 95% CI:2.460 to 5.883), popliteal artery involvement ( HR=2.104, 95% CI:1.368 to 3.236), long lesion ( HR=1.824, 95% CI:1.196 to 2.780), poor runoff( HR=1.736, 95% CI:1.025 to 2.940), chronic kidney disease( HR=1.601, 95% CI:1.040 to 2.463) were independent risk factors of restenosis after DCB treatment, and were defined 3, 2, 1, 1 and 1 points, respectively. Total points≥3 was regarded as high risk group. Kaplan-Meier analysis showed that patients in low risk group did not benefit from DA+DCB comparing with DCB with regard to primary patency at 24 months (77.78% vs. 90.31%, P=0.271) while patients benefited from DA+DCB comparing with DCB in high risk group(88.26% vs. 20.80%, P<0.01). Conclusions:The grading model shows satisfying clinical value. The clinical effect of DA+DCB is better than DCB along in high risk group. Patients at high risk are supposed to receive aggressive vessel preparation like DA.

Objective To investigate the imaging features of the cerebral complications of infective endocarditis (IE)and the evolution process of infective cerebral infarction.Methods The clinical and imaging data from 5 patients diagnosed as IE with neurological complications were retrospectively and comprehensively reviewed,so that the imaging features of cerebral complications and infective cerebral infarctions were summarized.Results Among the 5 cases,3 showed multiple acute infarctions,including 2 massive ones.All the 5 cases showed multiple hemorrhagic lesions at different stages.The infarction and hemorrhage were mostly located at the corticalGmedullary junction.1 case of subarachnoid hemorrhage and 1 case of meningitis were also observed.Two massive infarctions mentioned above showed irregular patchy shape,which evolved into cerebral abscesses after 1 2 and 1 5 days of neurological symptoms showing up,then abscesses started shrinking after 33 and 3 1 days,respectively.Conclusion MRI can accurately reflect the features of cerebral complications of IE and the evolution process of infective cerebral infarctions,which provides evidences for physicians to make correct diagnoses and the treatment plans.

Objective: To analyze the epidemiological characteristics and the molecular types of human adenovirus (HAdV) from influenza-like illness (ILI) samples with negative influenza virus in Xi'an from January 2013 to December 2015. Methods: Samples from patients with ILI were collected from two national influenza sentinel surveillance hospitals during 2013—2015 in Xi′an. HAdV was detected by real-time PCR, and then the positive samples were inoculated into Hep-2 cells to isolate the viruses. The amplified products were purified and sequenced of hexon gene, and the sequences were compared with the Genebank data and phylogenetic trees were constructed. Results: In 2367 samples, 88 samples were positive for HAdV, the positive rate was 3.72%. There were 7 subtypes detected, and the rates of each subtype are as follows: HAdV-1 was 9.09%, HAdV-2 was 22.73%, HAdV-3 was 23.86%, HAdV-4 was 5.68%, HAdV-5 was 7.95%, HAdV-6 was 3.41% and HAdV-7 was 1.14%. Males had higher infection rate than females, but there was no significant difference. The patients were divided into 6 groups according to age. There were 3 positive samples among those under 1 year of age, 36 positive samples among those 1 to 3 years old, 26 positive samples among those 4 to 6 years old, 16 positive samples in those 7 to 18 years old, 5 positive samples in 19 to 59 years old and 2 positive samples in those older than sixty years of age. HAdV infection was primarily confined to children under 7 years of age. Conclusions HAdV-3 and HAdV-2 were the dominant epidemic strains during 2013—2015 in Xi′an. Children younger than 7 years were the main susceptible population. HAdV infections circulate all year-round and there was no considerable seasonal variation.

Objective To observe the effects of botulinum toxin injection on shoulder pain following stroke under ultrasonog -raphy and the recovery of the affected limb .Methods Seventy-five patients with shoulder pain following stroke were randomly divided into 3 groups: the botulinum toxin injection +conventional rehabilitation group ( group A ) , the triamcinolone acetonide therapy +conventional rehabilitation group (group B), and the conventional therapy group (group C).Fugl-Meyer upper-limb function scores, VAS scores and range of shoulder motion before and after treatment were evaluated and compared between the groups .Results Before treatment, there were no significant differences in Fugl-Meyer scores, VAS scores and range of motion (ROM) of shoulder for the pa-tients of the 3 groups(P>0.05).Four weeks after treatment, Fugl-Meyer scores, VAS scores and shoulder ROM all improved, as com-pared with those before treatment, and statistical significance could be seen, when comparisons were made between them (P<0.05). Fugl-Meyer scores , VAS scores and shoulder ROM for the patients of group A and B improved more significantly after 4 weeks of treat-ment, as compared with those of group C, with statistical significance (P<0.05).More significant improvement of Fugl-Meyer scores, VAS scores and shoulder ROM could be noted in the patients of group A (49.3 ±7.4,2.3 ±1.1,103.7 ±11.2,91.5 ±7.4), when com-pared with those of group B (40.0 ±5.1,3.7 ±1.2,79.4 ±9.3,74.3 ±9.2)(P<0.05).Conclusion Botulinum toxin injection com-bined with conventional rehabilitation training in the treatment of should pain following stroke was of great significance to the recovery of upper limb function following stroke , and without any adverse reactions .For this reason , it was worth further clinical popularization .