Objective:To retrospectively analyze and explore the indications, methods and prognosis of optic nerve decompression (OND) in endoscopic surgery for benign fibro-osseous lesions (FOLs) of the nasal and skull base.Methods:Among 217 cases of craniofacial fibro-osseous lesions from July 2008 to January 2025 who were treated in the Otolaryngology Head and Neck Surgery Department of Beijing Tongren Hospital Affiliated to Capital Medical University, 14 patients (6.45%, 14/217) who underwent endoscopic resection of the lesion and OND under image navigation were included in this study, including 8 males and 6 females, aged from 4 to 28 years old. Among the 14 patients, 8 had fibrous dysplasia, 5 had ossifying fibroma, and 1 had osteoma. Clinical data, imaging data, surgical data and follow-up results were collected. Best corrected visual acuity (BCVA) and other indicators before and after treatment were recorded for analysis. Statistical analysis was conducted using SPSS 26.0 software.Results:Among 14 patients, preoperative visual decline involved 17 eyes (all 8 fibrous dysplasia cases, 2/5 ossifying fibroma cases, and 1 osteoma case). Surgical approaches included: partial resection for fibrous dysplasia (8 cases; bilateral decompression in 5, unilateral in 3); total resection for ossifying fibroma (3 cases; bilateral decompression in 2, unilateral in 1) or partial resection with bilateral decompression (2 cases, including 1 aneurysmal bone cyst); and total resection with unilateral decompression for osteoma (1 case). After the operation, the vision of 10 eyes (58.82%, 10/17) had been improved. Among the 5 eyes with severe visual impairment before the operation (no light perception/light perception/exponential vision), 2 eyes improved (1 eye from no light perception to light perception, and 1 eye from visual perception to exponential vision). Eight cases (10 eyes) of patients with proptosis improved after the operation. The proptosis before and after the operation were (16.60±1.71) mm and (13.60±1.35) mm ( P<0.05). Conclusions:For patients with benign FOLs involving the optic canal at the nasal and skull base who have visual impairment, OND via endoscopic endonasal approach can achieve visual salvage effects. Those with better preoperative residual vision have significant improvement in BCVA, so the operation should be performed as early as possible.

After nearly 40 years of development,MRI has become an important imaging diagnostic method in clinical practice.Non-contrast enhanced MRI combined with contrast-enhanced MRI can provide multidimensional information,significantly improving lesion detectability and supporting the entire disease management cycle.With the decentralization of medical resources,contrast-enhanced MR technologies(such as magnetic resonance angiography,dynamic contrast-enhanced MRI and dynamic susceptibility contrast-enhanced MRI,etc.)have become popular in primary healthcare facilities.As a critical adjunct to contrast-enhanced imaging,high-pressure injection technology for contrast agents plays a determinant role in ensuring imaging quality and diagnostic validity.This technology offers distinct advantages in precise control of injection parameters(flow rate,dosage,timing),maintenance of bolus integrity and enhancement of inter-study reproducibility.However,the absence of standardized international and domestic guidelines for its application currently hinders the harmonization of imaging data and limits cross-institutional interoperability of diagnostic results.To address this gap,an expert group has developed the"Expert Consensus on the Application of High-Pressure Injection Technology for Magnetic Resonance Contrast Agents",referencing domestic and international guidelines and literature,and in conjunction with the current application status in the country.This consensus aims to provide radiology professionals with safe and effective technical application guidance and to promote standardized clinical practice.

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

BACKGROUND:Currently,the pathogenesis of Parkinson's disease is not clear.Relevant studies have shown that α-synuclein and mitochondria are closely related to the pathogenesis of Parkinson's disease.It mainly involves oxidative stress,mitochondrial complex damage,calcium homeostasis,mitochondrial dynamics and mitochondrial quality control.OBJECTIVE:To review the association between α-synuclein and mitochondrial damage in Parkinson's disease.METHODS:The first author searched more than 50 documents from CNKI and WanFang databases from 2010 to 2024 using the keywords of"Parkinson's disease,mitochondrial damage and mechanism,α-synuclein"in Chinese as well as more than 750 documents from PubMed between 2010 and 2024 using the keywords of"Parkinson's disease,alpha-synuclein,mitochondria,oxidative stress,calcium homeostasis,mitophagy,mitochondrial dynamics,mitochondrial protein introduction"in English.Finally,70 documents were included for review.RESULTS AND CONCLUSION:Recent studies have confirmed the important role of mitochondrial dysfunction in the pathophysiology of Parkinson's disease,and the interaction between α-synuclein and mitochondria is a particularly significant factor in the pathogenesis of Parkinson's disease.The cascade of events that begin with naturally unfolded α-synuclein and eventually form mature fibril is collectively known as α-synuclein aggregation.The toxicity of aggregation accumulates in dopaminergic neurons and then disrupts mitochondrial function,thereby triggering Parkinson's disease.Therefore,the underlying mechanism of this bidirectional relationship between α-synuclein and mitochondrial dysfunction may provide new insights into the pathophysiology of Parkinson's disease.

Objective:To provide evidence-based support and policy recommendations for improving the prevention and management of stable angina pectoris(SAP)within the current government chronic disease control system,based on the theory of Ambulatory Care Sensitive Conditions(ACSCs).Methods:A total of 104 066 hospitalized cases of angina pectoris were included.Using the SHA 2011 framework for total health expenditure analysis,factors influencing avoidable hospitalization for SAP were identified.Multivariable logistic regression analysis was conducted to examine the associations between these factors and hospitalization costs for SAP.Results:Avoidable hospitalizations were predominantly concentrated in tertiary hospitals(82.01％),where hospitalization costs were significantly higher than those in primary healthcare institutions.Multivariable logistic regression analysis revealed that insurance type had a significant effect on hospitalization costs,and patients treated in tertiary hospitals were more likely to incur high medical expenses.Conclusions:The current SAP prevention and treatment system faces challenges such as insufficient capacity of primary healthcare,resource concentration in tertiary hospitals,and the impact of medical insurance policies on hospital choice.It is recommended to strengthen primary healthcare services and include SAP in chronic disease management programs to reduce unnecessary hospitalizations.Additionally,expanding insurance coverage could help reduce the risk of catastrophic health expenditure among self-paying patients.

Objective:To provide evidence-based support and policy recommendations for improving the prevention and management of stable angina pectoris(SAP)within the current government chronic disease control system,based on the theory of Ambulatory Care Sensitive Conditions(ACSCs).Methods:A total of 104 066 hospitalized cases of angina pectoris were included.Using the SHA 2011 framework for total health expenditure analysis,factors influencing avoidable hospitalization for SAP were identified.Multivariable logistic regression analysis was conducted to examine the associations between these factors and hospitalization costs for SAP.Results:Avoidable hospitalizations were predominantly concentrated in tertiary hospitals(82.01％),where hospitalization costs were significantly higher than those in primary healthcare institutions.Multivariable logistic regression analysis revealed that insurance type had a significant effect on hospitalization costs,and patients treated in tertiary hospitals were more likely to incur high medical expenses.Conclusions:The current SAP prevention and treatment system faces challenges such as insufficient capacity of primary healthcare,resource concentration in tertiary hospitals,and the impact of medical insurance policies on hospital choice.It is recommended to strengthen primary healthcare services and include SAP in chronic disease management programs to reduce unnecessary hospitalizations.Additionally,expanding insurance coverage could help reduce the risk of catastrophic health expenditure among self-paying patients.

After nearly 40 years of development,MRI has become an important imaging diagnostic method in clinical practice.Non-contrast enhanced MRI combined with contrast-enhanced MRI can provide multidimensional information,significantly improving lesion detectability and supporting the entire disease management cycle.With the decentralization of medical resources,contrast-enhanced MR technologies(such as magnetic resonance angiography,dynamic contrast-enhanced MRI and dynamic susceptibility contrast-enhanced MRI,etc.)have become popular in primary healthcare facilities.As a critical adjunct to contrast-enhanced imaging,high-pressure injection technology for contrast agents plays a determinant role in ensuring imaging quality and diagnostic validity.This technology offers distinct advantages in precise control of injection parameters(flow rate,dosage,timing),maintenance of bolus integrity and enhancement of inter-study reproducibility.However,the absence of standardized international and domestic guidelines for its application currently hinders the harmonization of imaging data and limits cross-institutional interoperability of diagnostic results.To address this gap,an expert group has developed the"Expert Consensus on the Application of High-Pressure Injection Technology for Magnetic Resonance Contrast Agents",referencing domestic and international guidelines and literature,and in conjunction with the current application status in the country.This consensus aims to provide radiology professionals with safe and effective technical application guidance and to promote standardized clinical practice.

Objective:To retrospectively analyze and explore the indications, methods and prognosis of optic nerve decompression (OND) in endoscopic surgery for benign fibro-osseous lesions (FOLs) of the nasal and skull base.Methods:Among 217 cases of craniofacial fibro-osseous lesions from July 2008 to January 2025 who were treated in the Otolaryngology Head and Neck Surgery Department of Beijing Tongren Hospital Affiliated to Capital Medical University, 14 patients (6.45%, 14/217) who underwent endoscopic resection of the lesion and OND under image navigation were included in this study, including 8 males and 6 females, aged from 4 to 28 years old. Among the 14 patients, 8 had fibrous dysplasia, 5 had ossifying fibroma, and 1 had osteoma. Clinical data, imaging data, surgical data and follow-up results were collected. Best corrected visual acuity (BCVA) and other indicators before and after treatment were recorded for analysis. Statistical analysis was conducted using SPSS 26.0 software.Results:Among 14 patients, preoperative visual decline involved 17 eyes (all 8 fibrous dysplasia cases, 2/5 ossifying fibroma cases, and 1 osteoma case). Surgical approaches included: partial resection for fibrous dysplasia (8 cases; bilateral decompression in 5, unilateral in 3); total resection for ossifying fibroma (3 cases; bilateral decompression in 2, unilateral in 1) or partial resection with bilateral decompression (2 cases, including 1 aneurysmal bone cyst); and total resection with unilateral decompression for osteoma (1 case). After the operation, the vision of 10 eyes (58.82%, 10/17) had been improved. Among the 5 eyes with severe visual impairment before the operation (no light perception/light perception/exponential vision), 2 eyes improved (1 eye from no light perception to light perception, and 1 eye from visual perception to exponential vision). Eight cases (10 eyes) of patients with proptosis improved after the operation. The proptosis before and after the operation were (16.60±1.71) mm and (13.60±1.35) mm ( P<0.05). Conclusions:For patients with benign FOLs involving the optic canal at the nasal and skull base who have visual impairment, OND via endoscopic endonasal approach can achieve visual salvage effects. Those with better preoperative residual vision have significant improvement in BCVA, so the operation should be performed as early as possible.

BACKGROUND:Currently,the pathogenesis of Parkinson's disease is not clear.Relevant studies have shown that α-synuclein and mitochondria are closely related to the pathogenesis of Parkinson's disease.It mainly involves oxidative stress,mitochondrial complex damage,calcium homeostasis,mitochondrial dynamics and mitochondrial quality control.OBJECTIVE:To review the association between α-synuclein and mitochondrial damage in Parkinson's disease.METHODS:The first author searched more than 50 documents from CNKI and WanFang databases from 2010 to 2024 using the keywords of"Parkinson's disease,mitochondrial damage and mechanism,α-synuclein"in Chinese as well as more than 750 documents from PubMed between 2010 and 2024 using the keywords of"Parkinson's disease,alpha-synuclein,mitochondria,oxidative stress,calcium homeostasis,mitophagy,mitochondrial dynamics,mitochondrial protein introduction"in English.Finally,70 documents were included for review.RESULTS AND CONCLUSION:Recent studies have confirmed the important role of mitochondrial dysfunction in the pathophysiology of Parkinson's disease,and the interaction between α-synuclein and mitochondria is a particularly significant factor in the pathogenesis of Parkinson's disease.The cascade of events that begin with naturally unfolded α-synuclein and eventually form mature fibril is collectively known as α-synuclein aggregation.The toxicity of aggregation accumulates in dopaminergic neurons and then disrupts mitochondrial function,thereby triggering Parkinson's disease.Therefore,the underlying mechanism of this bidirectional relationship between α-synuclein and mitochondrial dysfunction may provide new insights into the pathophysiology of Parkinson's disease.