Objective To evaluate the predictive value of different machine learning models constructed in a multicenter environment for potential organ donors and verify their clinical application feasibility. Methods The study included 2 000 inpatients admitted to five domestic tertiary hospitals from January 2020 to December 2023, who met the criteria for potential organ donation assessment. They were randomly divided into a training set and an internal validation set (7∶3). Another 300 similar patients admitted to the First Affiliated Hospital of Harbin Medical University from January 2024 to April 2025 were included as an external validation set. The area under the curve (AUC), sensitivity, specificity, accuracy and F1-score of three models were compared, and the consistency of the potential organ donor determination process was tested. Multivariate logistic regression analysis was used to identify predictive factors of potential organ donors. Decision curve analysis (DCA) was employed to verify the resource efficiency of each model, and the threshold interval and intervention balance point were assessed. Results Apart from age, there were no significant differences in other basic characteristics among the centers (all P>0.05). The consistency of the potential organ donor determination process among researchers in each center was good [all 95% confidence interval (CI) lower limits >0]. In the internal validation set, the XGBoost model had the best predictive performance (AUC=0.92, 95% CI 0.89-0.94) and the best calibration (P=0.441, Brier score 0.099). In the external validation set, the XGBoost model also had the best predictive performance (AUC=0.91, 95% CI 0.88-0.94), outperforming logistic regression and random forest models. Multivariate logistic regression showed that mechanical ventilation had the greatest impact (odds ratio=2.06, 95% CI 1.54-2.76, P<0.001). DCA indicated that the XGBoost model had the highest net benefit in the threshold interval of 0.2-0.6. The “treat all” strategy only had a slight advantage at extremely low thresholds. The recommended threshold interval, which balances intervention costs and clinical benefits, considers ≥50% positive predictive value (PPV) and ≤50 referrals per 100 high-risk patients. Conclusions The XGBoost model established in a multicenter environment is accurate and well-calibrated in predicting potential organ donors. Combined with DCA, it may effectively guide the timing of clinical interventions and resource allocation, providing new ideas for the assessment and management of organ donation after brain death.

Aerosol removal using flame-retardant atomized fixatives, as a major means of aerosol control, has achieved remarkable results in the field of nuclear facility decommissioning and decontamination. Traditional atomized fixatives for aerosol removal have deficiencies in high-temperature resistance and flame retardancy, rendering them inadequate for operational scenarios involving high temperatures and flammability encountered during nuclear decommissioning. This paper investigates the current development of flame-retardant atomized fixatives for aerosol removal both domestically and internationally and presents a preliminary exploration of this technology. The experiments showed that atomized fixatives modified with flame-retardant properties not only maintained excellent aerosol capture efficiency, but also exhibited significantly improved flame-retardant performance. This confirmed the technical feasibility of the proposed approach. Finally, suggestions and reflections are proposed for the development of this technology and its application in nuclear facility decommissioning.

Objective:To investigate the efficacy of azacitidine combined with CAG regimen in the treatment of acute myeloid leukemia (AML) patients who are not suitable for intensive chemotherapy.Methods:A retrospective case-series study was conducted. A total of 67 AML patients with newly diagnosed elderly, treatment-related secondary and myelodysplastic syndromes or myeloproliterative neoplasms primary transformation who were not suitable for intensive chemotherapy were selected from Heze Municipal Hospital from January 2020 to December 2023. Azacitidine combined with CAG regimen was given for treatment, and the efficacy and adverse reactions of the patients were observed.Results:Among the 67 patients, there were 32 females and 35 males with the median age [ M ( Q1, Q3)] of 68 (65, 72) years old. There were 40 cases in the high-risk group, 13 cases in the medium-risk group, and 14 cases in the low-risk group. After 1 course of treatment with azacitidine combined with CAG regimen, the overall response rate (ORR) was 38.8% (26/67), with a complete remission (CR) rate of 20.9% (14/67), a complete remission rate with incomplete recovery of blood cell count (CRi) of 11.9% (8/67), and a partial remission (PR) rate of 6.0% (4/67). After 4 courses of treatment, the ORR was 59.7% (40/67), with a CR rate of 56.7% (38/67) and a CRi rate of 3.0% (2/67). There were no PR patients. All patients in the low-risk and medium risk groups achieved at least CRi, while the ORR in the high-risk group was 40.0% (16/40). There was a statistically significant difference in efficacy between different risk groups ( P < 0.001). The patient had mild adverse reactions, mainly pain and grade 1-2 hematological adverse reactions. Conclusions:AML patients who are intolerant to intensive chometherapy are effectively treated with azacitidine combined with CAG regimen, and the adverse reactions are mild.

Apical microsurgery is accurate and minimally invasive, produces few complications, and has a success rate of more than 90%. However, due to the lack of awareness and understanding of apical microsurgery by dental general practitioners and even endodontists, many clinical problems remain to be overcome. The consensus has gathered well-known domestic experts to hold a series of special discussions and reached the consensus. This document specifies the indications, contraindications, preoperative preparations, operational procedures, complication prevention measures, and efficacy evaluation of apical microsurgery and is applicable to dentists who perform apical microsurgery after systematic training.
Microsurgery/standards* ; Humans ; Apicoectomy ; Contraindications, Procedure ; Tooth Apex/diagnostic imaging* ; Postoperative Complications/prevention & control* ; Consensus ; Treatment Outcome

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 investigate the relationship between preoperative serum CA19-9 levels and pathological grades in pseudomyxoma peritonei(PMP)and evaluate its impact on overall survival.Methods:A retrospective analysis was conducted on clinical data from 321 pa-tients with PMP who underwent initial cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy(CRS+HIPEC)by our team between October 2004 and October 2024.Receiver operating characteristic curve analysis was used to assess the discriminative value of CA19-9 for the pathological grade.Kaplan-Meier analysis was conducted to evaluate the impact of preoperative CA19-9 on overall survival.Results:Among the 321 patients included in this study,148(46.1%)had increased preoperative CA19-9 levels,which were associated with pathological grades.When preoperative CA19-9>693.3 U/mL,the pathological grade was more likely to be high-grade peritoneal mucinous carcinoma with signet ring cells(area under the curve:0.67,95%confidence interval:0.54-0.80,P=0.021).Elevated preoperative CA19-9 was an independent risk factor for overall survival in patients with PMP(mOS was 53.62 m vs.not reached in the elevated group vs.normal group,respectively,P<0.001).Conclusions:Preoperative serum CA19-9 levels were associated with pathological grades in patients with PMP undergoing initial CRS+HIPEC,with an independent negative impact on overall survival.

Imaging examinations play a crucial role in oral diagnosis.Conventional X-ray and cone beam computed tomography(CBCT)techniques are widely used in clinical practice but are associated with certain radiation risks and imaging limitations.In recent years,magnetic resonance imaging(MRI)has gained attention for its radiation-free nature and superior soft tissue imaging capabilities.This review explores the fundamental principles of MRI and its specific applications in endodontic diseases,maxillofacial surgery disea-ses,periodontitis,and implant restoration.Additionally,it further analyzes the technical challenges and difficulties of MRI in hard tis-sue imaging,aiming to provide reference and guidance for the future development of oral medical imaging.

Objective:To investigate the application value of two-dimensional ultrasound (2DUS) combined with carotid Doppler ultrasound (CDU) in differentiating the nature of thyroid nodules.Methods:This study used a prospective research design. A total of 126 patients with thyroid nodules treated at Shaoxing 7 th People's Hospital from January to September 2023 were included in this study. All patients underwent both 2DUS and CDU examinations. The diagnostic value of 2DUS and CDU was evaluated, both individually and in combination, for differentiating between malignant and benign nodules. The detection rates of specific 2DUS signs (such as indistinct margins, irregular shape, hypoechogenicity, microcalcifications, and a gravel-like appearance) were compared between malignant and benign nodules. The blood flow patterns (types I, II, and III) and parameters (end-diastolic flow velocity, peak systolic flow velocity, and resistance index) obtained from CDU were compared between malignant and benign nodules. Using surgical pathology results as the gold standard, the diagnostic value of 2DUS and CDU was compared, both individually and in combination. Results:Surgical pathology results showed that there were 78 cases of malignant nodules [61.90% (78/126)] and 48 cases of benign nodules [38.10% (48/126)]. The detection rate of malignant nodules using CDU was slightly, but not significantly, higher than that of 2DUS ( P > 0.05). However, the detection rate of malignant nodules using the combined examinations [60.32% (76/126)] was significantly higher than that of either 2DUS [41.27% (52/126)] or CDU alone [47.62% (60/126)] ( χ2 = 9.15, P = 0.002; χ2 = 4.09, P = 0.043). The detection rates of indistinct margins, irregular shape, hypoechogenicity, microcalcifications, and a gravel-like appearance in malignant nodules were significantly higher than those in benign nodules (all P < 0.001). The proportions of type II and type III blood flow in malignant nodules were significantly higher than those in benign nodules (both P < 0.05). End-diastolic flow velocities in malignant nodules were significantly lower than those in benign nodules ( P < 0.05). Peak systolic flow velocity and resistance index in malignant nodules were significantly greater than those in benign nodules (both P < 0.05). Using surgical pathology results as the standard, the accuracy, sensitivity, and specificity of the combined examinations in differentiating the nature of thyroid nodules were 96.83% (122/126), 96.15% (75/78), and 97.92% (47/48), respectively. The diagnostic accuracy and sensitivity of the combined examinations were significantly higher than those of 2DUS and CDU individually (all P < 0.05). Conclusions:The combination of 2DUS and CDU is highly valuable for the differential diagnosis of thyroid nodules. Integrating findings from 2DUS and CDU blood flow patterns and parameters offers important guidance for clinical diagnosis.