BackgroundAs a high prevalence disorder， schizophrenia has caused significant burden to family and society due to the impairment of occupational and social function. Currently， the dominant vocational training model in China follows a paternalistic， clinician-led decision-making approach. Although it improves patients' social function to some extent， it undermines their autonomy and treatment adherence. Therefore， it is urgently necessary to explore a new intervention method to enhance treatment compliance and social function in patients. ObjectiveTo explore the impact of shared decision-making oriented vocational training on social function in hospitalized schizophrenia patients， so as to provide references for rehabilitation interventions. MethodsA total of 68 patients diagnosed with schizophrenia according to the International Classification of Diseases， tenth edition （ICD-10） criteria were consecutively enrolled from January to June 2024 at The Third People's Hospital of Wenjiang Distric， Chengdu. Participants were randomly allocated into the research group （n=34） and the control group （n=34） using a random number table method. Both groups received routine rehabilitation training， while the research group received shared decision-making oriented vocational training for 12 weeks， 2 times a week for 2 hours each time. Before and at the 4^th and 12^th week of intervention， two groups were evaluated by General Self-Efficacy Scale （GSES）， Stigma Scale for Mental Illness （SSMI）， Scale of Social function of Psychosis Inpatients （SSFPI） and Inpatient Psychiatric Rehabilitation Outcome Scale （IPROS）. ResultsA total of 63 participants completed the study， with 30 cases in the research group and 33 cases in the control group. Repeated measures ANOVA revealed statistically significant time effects and interaction effects in both groups for GSES， SSMI， SSFPI and IPROS scores （F=20.451， 16.022； 26.193， 12.944； 23.957， 5.023； 11.776， 3.985， P<0.05 or 0.01）， while no significant group effects were observed （F=0.188， 0.742， 1.878， 0.474， P>0.05）. At the 12^th week of intervention， there were statistically significant differences in GSES， SSMI， SSFPI and IPROS scores between the two groups. ConclusionShared decision-making oriented vocational training may help to improve social function in patients with schizophrenia. ［Funded by 2023 Chengdu Medical Research Project （number， 2023468）］

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 examine the relationship between college students'core self-evaluation and academic burnout,and to provide empirical support for intervention strategies.Methods:A two-point longitudinal study was conducted with 245 medical students over a period of 18 months(T1:May 2023,T2:November 2024)to assess participants'core self-evaluation level using the Core Self-Evaluation Scale(CSES),and the overall burnout level u-sing the Academic Study Burnout Inventory(ASBI).Cross-lagged panel model was applied to examine the bidirec-tional causal relationship.Results:The cross-lagged results showed that core self-evaluation score in T1 negatively predicted academic burnout score inT2(β=-0.21,P＜0.01),and academic burnout score in T1 also negatively predicted core self-evaluation score in T2(β=-0.20,P＜0.05).Conclusion:Core self-evaluations and academic burnout exhibit a reciprocal predictive relationship over time.

Objective:To evaluate the preventive effect of an antimicrobial peptide spray on chemoradiotherapy-induced oral mu-cositis in patients with hematologic malignancies.Methods:From December 2021 to July 2023,a total of 191 newly diagnosed pa-tients with hematologic malignancies undergoing concurrent chemoradiotherapy at our hospital were included in the study.Patients were divided into a treatment group(n=124,received antimicrobial peptide spray)and a control group(n=67,received placebo spray).All patients underwent standardized chemoradiotherapy regimens and oral care.Outcomes compared between groups includ-ed the incidence and severity of oral mucositis,ulcer healing time,pain scores,antibiotic usage,inflammatory markers[C-reactive protein(CRP),procalcitonin(PCT)],duration of neutropenia,adverse events,and quality of life.Results:The incidence of oral mucositis in the treatment group was significantly lower than in the control group(12.90％vs.31.34％,P＜0.05),with a relative risk reduction(RRR)of 58.84％,absolute risk reduction(ARR)of 18.44％,and a number needed to treat(NNT)of 5.423.The treatment group showed shorter ulcer healing time,lower pain scores,reduced antibiotic usage and intensity,lower mean levels of CRP and PCT,and a shorter duration of neutropenia.The incidence of exacerbated local pain and drug-related adverse reactions was also significantly lower in the treatment group,compared to the control group(P＜0.05),with no evident systemic toxicity ob-served.Patients in the treatment group reported higher quality of life and satisfaction scores(both P＜0.05).Conclusion:The an-timicrobial peptide spray effectively reduces the incidence and severity of chemoradiotherapy-associated oral mucositis,mitigates in-flammation and infection risk,and improves quality of life.

Objective To investigate the role of autophagy involving the protein kinase B/sterol regulatory element binding protein 1(Akt/SREBP-1)signaling pathway in diabetic retinopathy(DR).Methods DR rat models were estab-lished via the intraperitoneal injection of streptozotocin.Rats were randomized into control(normal rats)and DM-DR groups(DR rats).The expression of autophagy-related proteins(autophagy markers LC3-Ⅱ and LC3-Ⅰ,autophagy specific substrate p62,and autophagy-related protein Beclin1)in rat retinas was compared between the two groups.Rats were di-vided into control B(normal rats injected with 1 μL saline),DR(DR rats injected with 1 μL saline),DR+si-NC(DR rats injected with 1 μL of the negative control siRNA),and DR+si-SREBP-1 groups(DR rats injected with 1 μL of the SREBP-1 siRNA).All interventions were given 1 day before modeling and 8 weeks after modeling.Akt/SREBP-1 expression and retinal ganglion cell(RGC)survival were compared among groups.R28 rat retinal precursor cells were classified into con-trol C(normal glucose,24 h),HG(high glucose,24 h),HG+si-NC(si-NC transfection+high glucose,24 h),and HG+si-SREBP-1 groups(si-SREBP-1 transfection+high glucose,24 h).The expression of autophagy-related proteins and au-tophagosome-lysosome fusion were compared among groups.Western blot and immunofluorescence were used to examine the expression of Akt,SREBP-1 and autophagy-related proteins.Results The relative expression of Beclin1 and p62 pro-teins and the LC3-Ⅱ/Ⅰ ratio in the DM-DR group were significantly higher than those in the control group 1 and 8 weeks after modeling(all P＜0.001).Compared with the control B group,the DR group exhibited elevated SREBP-1 and reduced Akt protein levels 1 and 8 weeks after modeling(all P＜0.01).RGC counts in the DR and DR+si-NC groups were significantly lower than those in the control B group(P＜0.001).The RGC count in the DR+si-SREBP-1 group was significantly higher than that in the DR+si-NC group(P＜0.001).Compared with those in the control C group,the Beclin1 and p62 protein levels and the LC3-Ⅱ/Ⅰ ratio were increased in the HG and HG+si-NC groups(all P＜0.01).Compared with those in the HG+si-NC group,the Beclin1 and p62 protein levels and the LC3-Ⅱ/Ⅰ ratio were reduced in the HG+si-SREBP-1 group(all P＜0.05).The HG and HG+si-NC groups showed significantly more LC3B/LAMP1 dual-positive puncta than the control C group(P＜0.001).The HG+si-SREBP-1 group showed significantly less LC3B/LAMP1 dual-positive puncta than the HG+si-NC group(P＜0.001).Conclusion SREBP-1 knockdown enhances autophagic flux in early DR to attenuate RGC loss.Thus,the Akt/SREBP-1 axis represents a promising therapeutic target for DR.

Acute lung injury (ALI) is a significant complication of sepsis, characterized by high morbidity, mortality, and poor prognosis. Neutrophils, as critical intrinsic immune cells in the lung, play a fundamental role in the development and progression of ALI. During ALI, neutrophils generate neutrophil extracellular traps (NETs), and excessive NETs can intensify inflammatory injury. Research indicates that Taohe Chengqi decoction (THCQD) can ameliorate sepsis-induced lung inflammation and modulate immune function. This study aimed to investigate the mechanisms by which THCQD improves ALI and its relationship with NETs in sepsis patients, seeking to provide novel perspectives and interventions for clinical treatment. The findings demonstrate that THCQD enhanced survival rates and reduced lung injury in the cecum ligation and puncture (CLP)-induced ALI mouse model. Furthermore, THCQD diminished neutrophil and macrophage infiltration, inflammatory responses, and the production of pro-inflammatory cytokines, including interleukin-1β (IL-1β), IL-6, and tumor necrosis factor α (TNF-α). Notably, subsequent experiments confirmed that THCQD inhibits NET formation both in vivo and in vitro. Moreover, THCQD significantly decreased the expression of peptidyl arginine deiminase 4 (PAD4) protein, and molecular docking predicted that certain active compounds in THCQD could bind tightly to PAD4. PAD4 overexpression partially reversed THCQD's inhibitory effects on PAD4. These findings strongly indicate that THCQD mitigates CLP-induced ALI by inhibiting PAD4-mediated NETs.
Extracellular Traps/immunology* ; Acute Lung Injury/immunology* ; Animals ; Sepsis/immunology* ; Drugs, Chinese Herbal/pharmacology* ; Mice ; Neutrophils/immunology* ; Male ; Protein-Arginine Deiminase Type 4/genetics* ; Mice, Inbred C57BL ; Humans ; Disease Models, Animal ; Cytokines/metabolism*

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 explore the efficacy of ranibizumab combined with retinal laser photocoagulation in patients with macular edema secondary to branch retinal vein occlusion(BRVO)and its impact on best-corrected visual acuity(BCVA)and central macular thickness(CMT).Methods A prospective analysis was conducted on 70 patients with secondary macular edema caused by BRVO who were admitted to the 901th Hospital of Joint Logistics Support Force from March 2019 to March 2023.According to the random number table method,the patients were assigned into study group or control group,with 35 cases in each group.The control group was treated with ranibizumab,while the study group was treated with ranibizumab and retinal laser photocoagulation.The efficacy,BCVA,CMT,intraocular pressure,adverse reactions,and 36-item short form health survey(SF-36)score were compared between the two groups.Results There was a significant difference in the efficacy between the two groups(Z=2.272,P<0.05),and the total effective rate of the study group was higher than that of the control group(P<0.05).The results of repeated measure ANOVA showed that CMT and intraocular pressure decreased significantly,while BCVA increased significantly in both groups after 3 months,6 months,and 12 months of treatment(P<0.05);moreover,these parameters in the study group were superior to those in the control group(P<0.05).There were no significant differences in the incidence of cataracts,transient intraocular pressure elevation,subconjunctival hemorrhage,retinal detachment,or the total incidence of adverse reactions between the two groups(P>0.05).After 12 months of treatment,the total score of SF-36 increased in both groups(P<0.05),and the difference value of total score of SF-36 in the study group was superior to that in the control group(P<0.05).Conclusion The combination of ranibizumab and retinal laser photocoagulation can achieve a good therapeutic effect on macular edema caused by BRVO.It can effectively improve BCVA,CMT and intraocular pressure,reduce the risk of adverse reactions,and enhance the quality of life.

Objective To analyze the correlation between quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)and preoperative T staging of colorectal carcinoma(CRC).Methods The clinical data of 95 CRC patients admitted to the Second Affiliated Hospital of Nanchang University from May 2023 to July 2024 were retrospectively collected.All patients underwent DCE-MRI examination,and the quantitative parameters of DCE-MRI[rate constant(Kep),extravascular extracellular interstitial volume ratio(Ve),volume transfer constant(Ktrans),time to peak(TTP),maximum slope,maximum concentration]in patients with different T stages were compared.Kendall's tau-b correlation coefficient examined the relationship between DCE-MRI quantitative parameters and preoperative T staging of CRC,and receiver operating characteristic(ROC)curve was drawn to analyze the value of DCE-MRI quantitative parameters in the preoperative T3-4 stage of CRC patients.Results 95 CRC patients revealed 16 cases in T1 stage,32 cases in T2 stage,37 cases in T3 stage,and 10 cases in T4 stage.There were statistically significant differences in tumor diameter,Kep,Ve and Ktrans among CRC patients with different T stages(P＜0.05),and their sizes were T4＞T3＞T2＞T1.There were no significant differences in TTP,maximum slope and maximum concentration among CRC patients with different T stages(P＞0.05).Kendall's tau-b correlation coefficient test showed that Kep,Ve,Ktrans of DCE-MRI were positively correlated with preoperative T staging of CRC(P＜0.05).ROC curve results showed that area under the curve of Kep,Ve and Ktrans alone and in combination were all greater than 0.70 in the preoperative T3-4 stage of CRC patients,which had evaluation value,and the combined detection had the highest evaluation value.Conclusion The quantitative parameters of DCE-MRI are related to preoperative T staging of CRC and can evaluate the risk of T3-4 stage.