AIM: To explore preoperative risk factors affecting residual astigmatism after Toric intraocular lens(IOL)implantation, and construct and verify a clinically applicable prediction model.METHODS: This retrospective study included patients who underwent Toric IOL implantation at Puyang Oilfield General Hospital and the Second People's Hospital of Puyang City from October 2023 to August 2025. Patients were categorized into two groups according to residual astigmatism at 3 mo postoperatively: >0.25 D group and ≤0.25 D group. Preoperative clinical data and ocular parameters of the two groups were collected and compared. Multivariate Logistic regression analysis was used to screen risk factors, and a nomogram prediction model was established accordingly. Receiver operating characteristic(ROC)curve, calibration curve, and Hosmer-Lemeshow test were adopted to evaluate discrimination, calibration, and clinical applicability of the model. Bootstrap method was applied for internal validation.RESULTS: Totally 103 patients(103 eyes)were included, with 72 patients(72 eyes)in the group with residual astigmatism ≤0.25 D, including 38 males and 34 females, with an average age of 67.35±6.12 y; There were 31 cases(31 eyes)in group with residual astigmatism >0.25 D, including 19 males and 12 females, with an average age of 69.87±6.45 y. The proportion of patients with a history of diabetes, as well as the values for axial length, horizontal corneal diameter, flat corneal curvature(K1), steep corneal curvature(K2), astigmatic axis and proportion of lens nuclear hardness grade III-IV were significantly higher in the residual astigmatism group >0.25 D than those in the residual astigmatism ≤0.25 D group(all P<0.05). Multivariate analysis identified increased horizontal corneal diameter, higher K1 value, higher K2 value, and higher lens nuclear hardness(grade III-IV)as independent risk factors for postoperative residual astigmatism >0.25 D(all P<0.05). The nomogram constructed from these factors demonstrated that the area under the ROC curve(AUC)was 0.794, with a sensitivity of 80.31% and a specificity of 75.20%. The concordance index(C-index)of internal validation was 0.865. Calibration curve and Hosmer-Lemeshow test(χ2=5.231, P=0.734)indicated good consistency between predicted and actual values of the model.CONCLUSION: The nomogram model established based on horizontal corneal diameter, K1, K2 and lens nucleus hardness exhibits favorable predictive performance. It can effectively predict the risk of residual astigmatism prior to Toric IOL surgery, providing reference for individualized clinical surgical planning.

Objective To investigate relationship between the level of support needs and post-traumatic stress disorder(PTSD)among fathers of preterm infants in neonatal intensivecare unit(NICU).Methods A total of 209 fathers of preterm infants admitted to NICU were selected as survey subjects.The basic information questionnaire for preterm infants,the basic information questionnaire for fathers,the NICU Newborn Father Support Scale,and the civilian version of the Post-traumatic Stress Disorder Checklist were used to survey their conditions.Results The score of support needs among fathers of preterm infants was(88.69±11.04).Gestational age,cesarean section,length of stay in the NICU,father's educational level,monthly per-capita family income,and spouse's health status were all significant influencing factors of father's support needs(P＜0.05).The score of PTSD among fathers of preterm infants was(32.27±5.96).Gestational age,birth weight,birth way,fa-ther's age,whether the father had received prenatal health education,and support needs were all in-fluencing factors of PTSD occurrence among fathers of preterm infants(P＜0.05).There was a sig-nificant negative correlation between father's support needs and PTSD.Conclusion The level of support needs among fathers of preterm infants in the NICU is negatively correlated with PTSD.Medi-cal staff should pay attention to the level of support needs among fathers of preterm infants to reduce the occurrence of their PTSD.

Collagen, a vital matrix protein for various tissue and functions in animals, is widely applied in biomaterials. In type Ⅰ collagen, missense mutations of glycine (Gly) in the Gly-Xaa-Yaa triplet of the triple helix are a major cause of osteogenesis imperfecta (OI). Clinical manifestations exhibit marked heterogeneity, spanning a broad disease spectrum from mild skeletal fragility (Type Ⅰ) to severe limb deformities (Type Ⅲ) and perinatal lethal forms (Type Ⅱ). This study utilized recombinant collagen as a model to further elucidate whether Gly→Ala/Val mutations at the N-terminus of the integrin-binding sequence GFPGER affect collagen structure and function, and to explore the underlying mechanisms by which missense mutations impact the biological function of collagen. By introducing Ala and Val substitutions at seven Gly positions N-terminal to the GFPGER sequence, we systematically assessed the effects of these amino acid replacements on the triple-helical structure, thermal stability, integrin-binding ability, and cell adhesion of recombinant collagen. All constructs formed a stable triple-helix structure, with slightly compromised thermal stability. Gly→Val substitutions increased the susceptibility of recombinant collagen to trypsin, which suggested local conformational perturbations in the triple helix. In addition, Gly→Val substitutions significantly reduced the integrin-binding affinity and decreased HT1080 cell adhesion, with the effects stronger than Gly→Ala substitutions. Compared with Gly→Ala substitutions, substitution of Gly with the larger residue Val had enhanced negative effects on the structure and function of recombinant collagen. These findings provide new insights into the molecular mechanisms of osteogenesis imperfecta and offer theoretical references and experimental foundations for the design of collagen sequences and the development of collagen-based biomaterials.
Recombinant Proteins/biosynthesis* ; Glycine/genetics* ; Humans ; Osteogenesis Imperfecta/genetics* ; Integrins/metabolism* ; Collagen/metabolism* ; Collagen Type I/metabolism* ; Amino Acid Substitution ; Mutation ; Mutation, Missense

Objective:To explore the effects of happy PERMA intervention on resilience, stigma and quality of life in colostomy patients with colorectal cancer.Methods:According to convenience sampling method, 120 patients with colorectal cancer who underwent permanent colostomy in the hospital were enrolled from September 2021 to August 2023. According to admission order, they were divided into control group (60 cases, September 2021-August 2022) and study group (60 cases, September 2022-August 2023). The control group was given routine nursing, while the study group was additionally given happy PERMA mode nursing intervention for 8 weeks. The scores of Connor-Davidson resilience scale (CD-RISC), social impact scale (SIS), ostomy adjustment inventory-20 (OAI-20), quality of life questionnaire core 30(QLQ-C30), general well-being schedule(GWB) and self-care ability before and after 8 weeks of intervention were compared between the two groups using SPSS 22.0 software.Results:After the intervention, the scores of resilience (45.28±2.59), strength (26.34±2.47), optimism (11.05±0.78), and the total CD-RISC score (80.95±3.47) in the study group were significantly higher than those in the control group (37.46±2.08, 18.55±1.96, 8.96±0.63, 65.11±2.32) ( t=18.235, 19.137, 16.146, 29.394, all P<0.05). The scores of internalized stigma (13.09±1.97), economic discrimination (6.85±0.78), social isolation (14.15±1.98), social exclusion (16.93±2.54), and the total SIS score (50.17±2.35) in the study group were significantly lower than those in the control group (13.97±2.44, 7.36±0.95, 16.94±2.37, 19.55±3.42, 58.69±2.83)( t=2.174, 3.214, 6.998, 4.764, 13.756, all P<0.05). The score of persistent worry (11.95±2.16) in the study group was significantly lower than that in the control group (16.57±1.92) ( t=12.383, P<0.05), while the score of acceptance (15.28±1.16), positive life attitude (17.38±2.31), and the total OAI-20 score (58.64±2.08) in the study group were significantly higher than those in the control group (12.19±0.97, 14.55±1.94, 46.30±1.57) ( t=15.829, 7.267, 36.679, all P<0.05). The scores of role function (86.27±3.15), emotional function (81.25±4.33), social function (79.63±3.16), cognitive function (83.55±3.97), general health (83.15±3.16), and the total QLQ-C30 score (407.13±15.92) in the study group were significantly higher than those in the control group (77.62±4.38, 73.85±4.96, 71.80±3.98, 79.42±4.31, 75.34±3.62, 372.65±11.58)( t=12.419, 8.706, 11.935, 5.459, 12.590, 13.567, all P<0.05). The GWB score (86.95±3.57) and self-care ability score (91.13±3.45) in the study group were significantly higher than those in the control group (73.82±4.06, 87.55±4.68)( t=18.812, 4.769, both P<0.05). Conclusion:Happy PERMA mode intervention can effectively improve resilience, reduce stigma and improve quality of life in colostomy patients with colorectal cancer.

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*

Instrument separation is a critical complication during root canal therapy, impacting treatment success and long-term tooth preservation. The etiology of instrument separation is multifactorial, involving the intricate anatomy of the root canal system, instrument-related factors, and instrumentation techniques. Instrument separation can hinder thorough cleaning, shaping, and obturation of the root canal, posing challenges to successful treatment outcomes. Although retrieval of separated instrument is often feasible, it carries risks including perforation, excessive removal of tooth structure and root fractures. Effective management of separated instruments requires a comprehensive understanding of the contributing factors, meticulous preoperative assessment, and precise evaluation of the retrieval difficulty. The application of appropriate retrieval techniques is essential to minimize complications and optimize clinical outcomes. The current manuscript provides a framework for understanding the causes, risk factors, and clinical management principles of instrument separation. By integrating effective strategies, endodontists can enhance decision-making, improve endodontic treatment success and ensure the preservation of natural dentition.
Humans ; Root Canal Therapy/adverse effects* ; Consensus ; Root Canal Preparation/adverse effects*

Objective To analyze the monitoring of healthcare-associated infection(HAI)in the intensive care unit(ICU)over the past 12 years based on Joinpoint regression model,and evaluate the trend changes and relevant fac-tors of HAI incidence.Methods ICU patients in a tertiary first-class hospital from January 2012 to December 2023 were selected and performed prospective monitoring.Trend changes of HAI incidence and the correlation with con-sumption of hand hygiene products as well as HAI management measures were analyzed.Results From 2012 to 2023,6 929 ICU patients were included in the monitoring,543 patients had 655 episodes of HAI,with incidence and case incidence of HAI being 7.84％ and 9.45％,respectively.The average severity of the disease was 3.62,and the adjusted HAI incidence was 2.17％.The daily incidence of ventilator-associated pneumonia(VAP),cathe-ter-associated urinary tract infection(CAUTI),and central line-associated bloodstream infection(CLABSI)were 6.19‰,3.45‰,and 1.23‰,respectively.The consumption of hand hygiene products was 122.98 mL/bed-day.The compliance rate and correct rate of hand hygiene were 90.63％and 90.46％,respectively.From 2012 to 2023,incidence of HAI(51.29％vs 4.39％),case incidence of HAI(72.41％vs 4.94％),the adjusted incidence of HAI(15.98％vs 1.04％),daily incidence of VAP(22.50‰ vs 4.33‰),daily incidence of CAUTI(14.23‰ vs 1.64‰),and daily incidence of CLABSI(10.60‰ vs 0.20‰)all decreased significantly(all P＜0.05).Both con-sumption of hand hygiene products(75.16 mL/bed-day vs 147.35 mL/bed-day)and correct rate of hand hygiene(85.00％vs 90.28％)increased significantly(both P＜0.05).A total of 1 946 pathogens were detected,with an increase in the proportion of Staphylococcus aureus(1.30％ vs 9.57％)and a decrease in the proportion of fungi(11.04％vs 1.74％).The daily consumption of hand hygiene products negatively correlated with the incidence of HAI,the case incidence of HAI,as well as the daily incidence of CAUTI and CLABSI(all P＜0.05).Incorpora-ting HAI real-time monitoring system and HAI management into performance assessment could decrease HAI-rela-ted incidence(P＜0.05).Conclusion HAI-related incidence presents a downward trend.Scientific and comprehen-sive HAI prevention and control management measures such as healthcare workers'hand hygiene management,on-line HAI real-time monitoring system,and incorporating HAI management into performance assessment can de-crease HAI-related incidence and promote the improvement of medical quality.

Objective:To explore the effects of happy PERMA intervention on resilience, stigma and quality of life in colostomy patients with colorectal cancer.Methods:According to convenience sampling method, 120 patients with colorectal cancer who underwent permanent colostomy in the hospital were enrolled from September 2021 to August 2023. According to admission order, they were divided into control group (60 cases, September 2021-August 2022) and study group (60 cases, September 2022-August 2023). The control group was given routine nursing, while the study group was additionally given happy PERMA mode nursing intervention for 8 weeks. The scores of Connor-Davidson resilience scale (CD-RISC), social impact scale (SIS), ostomy adjustment inventory-20 (OAI-20), quality of life questionnaire core 30(QLQ-C30), general well-being schedule(GWB) and self-care ability before and after 8 weeks of intervention were compared between the two groups using SPSS 22.0 software.Results:After the intervention, the scores of resilience (45.28±2.59), strength (26.34±2.47), optimism (11.05±0.78), and the total CD-RISC score (80.95±3.47) in the study group were significantly higher than those in the control group (37.46±2.08, 18.55±1.96, 8.96±0.63, 65.11±2.32) ( t=18.235, 19.137, 16.146, 29.394, all P<0.05). The scores of internalized stigma (13.09±1.97), economic discrimination (6.85±0.78), social isolation (14.15±1.98), social exclusion (16.93±2.54), and the total SIS score (50.17±2.35) in the study group were significantly lower than those in the control group (13.97±2.44, 7.36±0.95, 16.94±2.37, 19.55±3.42, 58.69±2.83)( t=2.174, 3.214, 6.998, 4.764, 13.756, all P<0.05). The score of persistent worry (11.95±2.16) in the study group was significantly lower than that in the control group (16.57±1.92) ( t=12.383, P<0.05), while the score of acceptance (15.28±1.16), positive life attitude (17.38±2.31), and the total OAI-20 score (58.64±2.08) in the study group were significantly higher than those in the control group (12.19±0.97, 14.55±1.94, 46.30±1.57) ( t=15.829, 7.267, 36.679, all P<0.05). The scores of role function (86.27±3.15), emotional function (81.25±4.33), social function (79.63±3.16), cognitive function (83.55±3.97), general health (83.15±3.16), and the total QLQ-C30 score (407.13±15.92) in the study group were significantly higher than those in the control group (77.62±4.38, 73.85±4.96, 71.80±3.98, 79.42±4.31, 75.34±3.62, 372.65±11.58)( t=12.419, 8.706, 11.935, 5.459, 12.590, 13.567, all P<0.05). The GWB score (86.95±3.57) and self-care ability score (91.13±3.45) in the study group were significantly higher than those in the control group (73.82±4.06, 87.55±4.68)( t=18.812, 4.769, both P<0.05). Conclusion:Happy PERMA mode intervention can effectively improve resilience, reduce stigma and improve quality of life in colostomy patients with colorectal cancer.