Objective·To compare the effects of calcium hydroxide(CH)residues in root canals and root canal filling methods on apical closure,and to provide reference for clinical selection of root canal sealing drugs and filling methods.Methods·Seventy-five permanent mandibular premolar teeth with single root canals that were extracted due to orthodontic treatment or periodontal problems were collected from the Department of Oral and Maxillofacial Surgery of the Affiliated Hospital of Qingdao University.The crowns were removed,the root canals were prepared,and the specimens were randomly assigned into 3 groups:a water-soluble calcium hydroxide group(Group A,n=30),an oil-soluble calcium hydroxide group(Group B,n=30),and an unsealed control group(Group C,n=15).After 2 weeks of sealing,Groups A and B underwent manual preparation with a#35 K-file,followed by ultrasonic agitation and irrigation of the root canal to ensure that the calcium hydroxide residue was located roughly at the root apex and that the residue was 15%to 20%.Groups A,B,and C were randomly divided into 3 groups:the iRoot SP single-tip group(Group 1),the hot compression group(Group 2),and the cold compression group(Group 3),and root canals were filled using the iRoot SP single-tip method,the hot adhesive vertical compression filling method,and the cold adhesive lateral compression filling method,respectively.A dye penetration test was used to evaluate apical microleakage,and scanning electron microscopy was used to observe the microscopic morphology of the dentin-root canal sealer interface in each group.Statistical analysis was performed using two-way ANOVA.Results·Both root canal sealing drugs and root canal filling methods affected the apical sealing,and there was an interaction between them.The effects of residual calcium hydroxide on apical closure were analyzed.The difference between Group B and Group C was statistically significant only in Group 1.There were statistically significant differences between Group A and Group C in Group 2 and Group 3,and statistically significant differences between Group A and Group B regardless of the root filling method.Among the three root filling methods,there was a statistically significant difference between Group 1 and Group 3 in Group C(P=0.013).In Group A and Group B,there were statistically significant differences between Group 2,Group 3 and Group 1(P<0.001).Conclusion·The residual water-soluble calcium hydroxide in the root canal has a negative effect on the apical closure,but the residual oil-soluble calcium hydroxide has a small negative effect on the apical closure.iRoot SP can reduce the negative effect of residual water-soluble calcium hydroxide on root canal closure.

To standardize the management of high-alert medications in medical institutions and ensure their safe and ef-fective use,based on relevant national regulations and normative documents,international high-alert medication management guidelines,and expert opinions,the Pharmaceutical Specialized Committee of the Chinese Hospital Association led the develop-ment of the Pharmaceutical Supply Services—Key Drugs Management—High-alert Medications.This article elaborated on the for-mulation process of this standard and provides an in-depth analysis of its key contents.It aimed to offer guidance and reference for medical personnel,helping them to thoroughly understand and master the management requirements of high-alert medications,thereby enhancing the management level of high-alert medications and ensuring the safe and effective use of medications for pa-tients.

Background::Hepatitis B poses a heavy burden for children in China, however, the national studies on the distributional characteristics and health care costs of children with severe hepatitis B is still lacking. This study aimed to analyze the disease characteristics, health economic effects, and medical cost for children with severe hepatitis B in China.Methods::Based on patient information in the Hospital Quality Monitoring System, cases with severe hepatitis B were divided into four groups according to age, and the etiology and symptoms of each group were quantified. The cost of hospitalization was calculated for cases with different disease processes, and severity of disease. The spatial aggregation of cases and the relationship with health economic factors were analyzed by Moran’s I analysis. Results::The total number of children discharged with hepatitis B from January 2016 to April 2022 was 1603, with an average age of 10.5 years. Liver failure cases accounted for 43.48% (697/1603) of total cases and cirrhosis cases accounted for 11.23% (180/1603). According to the grouping of disease progression, there were 1292 cases without associated complications, and the median hospitalization cost was $818.12. According to the spatial analysis, the aggregation of cases was statistically significant at the prefectural and provincial levels in 2019, 2020, and 2021 (all P <0.05). The number of severe cases was negatively correlated with gross domestic product (Moran’s I <0) and percentage of urban population (Moran’s I <0), and positively correlated with the number of pediatric beds per million population (Moran’s I >0). Conclusion::The number of severe hepatitis B cases is low in areas with high gross domestic product levels and high urban population ratios, and health care costs have been declining over the years.

Objective·To compare the effects of calcium hydroxide(CH)residues in root canals and root canal filling methods on apical closure,and to provide reference for clinical selection of root canal sealing drugs and filling methods.Methods·Seventy-five permanent mandibular premolar teeth with single root canals that were extracted due to orthodontic treatment or periodontal problems were collected from the Department of Oral and Maxillofacial Surgery of the Affiliated Hospital of Qingdao University.The crowns were removed,the root canals were prepared,and the specimens were randomly assigned into 3 groups:a water-soluble calcium hydroxide group(Group A,n=30),an oil-soluble calcium hydroxide group(Group B,n=30),and an unsealed control group(Group C,n=15).After 2 weeks of sealing,Groups A and B underwent manual preparation with a#35 K-file,followed by ultrasonic agitation and irrigation of the root canal to ensure that the calcium hydroxide residue was located roughly at the root apex and that the residue was 15%to 20%.Groups A,B,and C were randomly divided into 3 groups:the iRoot SP single-tip group(Group 1),the hot compression group(Group 2),and the cold compression group(Group 3),and root canals were filled using the iRoot SP single-tip method,the hot adhesive vertical compression filling method,and the cold adhesive lateral compression filling method,respectively.A dye penetration test was used to evaluate apical microleakage,and scanning electron microscopy was used to observe the microscopic morphology of the dentin-root canal sealer interface in each group.Statistical analysis was performed using two-way ANOVA.Results·Both root canal sealing drugs and root canal filling methods affected the apical sealing,and there was an interaction between them.The effects of residual calcium hydroxide on apical closure were analyzed.The difference between Group B and Group C was statistically significant only in Group 1.There were statistically significant differences between Group A and Group C in Group 2 and Group 3,and statistically significant differences between Group A and Group B regardless of the root filling method.Among the three root filling methods,there was a statistically significant difference between Group 1 and Group 3 in Group C(P=0.013).In Group A and Group B,there were statistically significant differences between Group 2,Group 3 and Group 1(P<0.001).Conclusion·The residual water-soluble calcium hydroxide in the root canal has a negative effect on the apical closure,but the residual oil-soluble calcium hydroxide has a small negative effect on the apical closure.iRoot SP can reduce the negative effect of residual water-soluble calcium hydroxide on root canal closure.

To standardize the management of high-alert medications in medical institutions and ensure their safe and ef-fective use,based on relevant national regulations and normative documents,international high-alert medication management guidelines,and expert opinions,the Pharmaceutical Specialized Committee of the Chinese Hospital Association led the develop-ment of the Pharmaceutical Supply Services—Key Drugs Management—High-alert Medications.This article elaborated on the for-mulation process of this standard and provides an in-depth analysis of its key contents.It aimed to offer guidance and reference for medical personnel,helping them to thoroughly understand and master the management requirements of high-alert medications,thereby enhancing the management level of high-alert medications and ensuring the safe and effective use of medications for pa-tients.

Background::Hepatitis B poses a heavy burden for children in China, however, the national studies on the distributional characteristics and health care costs of children with severe hepatitis B is still lacking. This study aimed to analyze the disease characteristics, health economic effects, and medical cost for children with severe hepatitis B in China.Methods::Based on patient information in the Hospital Quality Monitoring System, cases with severe hepatitis B were divided into four groups according to age, and the etiology and symptoms of each group were quantified. The cost of hospitalization was calculated for cases with different disease processes, and severity of disease. The spatial aggregation of cases and the relationship with health economic factors were analyzed by Moran’s I analysis. Results::The total number of children discharged with hepatitis B from January 2016 to April 2022 was 1603, with an average age of 10.5 years. Liver failure cases accounted for 43.48% (697/1603) of total cases and cirrhosis cases accounted for 11.23% (180/1603). According to the grouping of disease progression, there were 1292 cases without associated complications, and the median hospitalization cost was $818.12. According to the spatial analysis, the aggregation of cases was statistically significant at the prefectural and provincial levels in 2019, 2020, and 2021 (all P <0.05). The number of severe cases was negatively correlated with gross domestic product (Moran’s I <0) and percentage of urban population (Moran’s I <0), and positively correlated with the number of pediatric beds per million population (Moran’s I >0). Conclusion::The number of severe hepatitis B cases is low in areas with high gross domestic product levels and high urban population ratios, and health care costs have been declining over the years.

Objective: To compare the efficiency of four methods that remove calcium hydroxide in root canals and to guide clinical practice. Methods : Sixty-five isolated mandibular single root canal premolars were collected. After crown cutting and root canal preparation, a tooth was randomly selected as the blank control group, and the remaining 64 teeth were equally divided into Groups A and B (n = 32). Group A was injected with water-soluble calcium hydroxide, and Group B was injected with oil-soluble calcium hydroxide. After 2 weeks of drug sealing, Groups A and B were randomly divided into 4 groups (n = 8), including the lateral opening syringe group, sonic vibration group, ultrasonic group, and Er: YAG laser group. Before and after calcium hydroxide removal, the samples were scanned by cone-beam CT, and the data were imported into Mimics for 3D reconstruction. The root canal was divided into the following segments: superior root segment, middle and apical, and the calcium hydroxide volume of each segment of the root canal was calculated. The volumes of calcium hydroxide before and after removal were V1 and V2, respectively, with a clearance rate = (V1-V2)/V1×100%. Three-factor ANOVA was used for statistical analysis. After Groups A and B were reconstructed, the apical region with residual calcium hydroxide was selected, and the blank control was observed by scanning electron microscopy (SEM). Results : Two types of calcium hydroxide could not be completely removed by the four flushing methods. The clearance rate of water-soluble calcium hydroxide was higher than that of oil-soluble calcium hydroxide (P<0.001). Among the three segments of the root canal, the clearance rate of the apical segment was lower (P<0.05). The Er: YAG laser treatment group showed the highest removal efficiency of two kinds of calcium hydroxide, which was higher than that of the other groups, especially in apical of the root. Compared with the sonic wave washing group and the syringe washing group, the ultrasonic wave washing group exhibited significant advantages (P<0.05). The clearance rate of the sonic wave washing group was higher in the oily calcium hydroxide root middle group than in the syringe washing group (P<0.05). SEM showed that the two kinds of calcium hydroxide could not be completely removed, but the residual rate of oil-soluble calcium hydroxide was large. Conclusion Both types of calcium hydroxide could not be completely removed, and compared to water-soluble calcium hydroxide, oil-soluble calcium hydroxide was more difficult to remove. Among the four cleaning methods, Er:YAG laser swing washing showed the higher cleaning efficiency.

This study aimed to explore key quality control factors that affected the prognosis of intensive care unit (ICU) patients in Chinese mainland over six years (2015-2020). The data for this study were from 31 provincial and municipal hospitals (3425 hospital ICUs) and included 2 110 685 ICU patients, for a total of 27 607 376 ICU hospitalization days. We found that 15 initially established quality control indicators were good predictors of patient prognosis, including percentage of ICU patients out of all inpatients (%), percentage of ICU bed occupancy of total inpatient bed occupancy (%), percentage of all ICU inpatients with an APACHE II score ⩾15 (%), three-hour (surviving sepsis campaign) SSC bundle compliance (%), six-hour SSC bundle compliance (%), rate of microbe detection before antibiotics (%), percentage of drug deep venous thrombosis (DVT) prophylaxis (%), percentage of unplanned endotracheal extubations (%), percentage of patients reintubated within 48 hours (%), unplanned transfers to the ICU (%), 48-h ICU readmission rate (%), ventilator associated pneumonia (VAP) (per 1000 ventilator days), catheter related blood stream infection (CRBSI) (per 1000 catheter days), catheter-associated urinary tract infections (CAUTI) (per 1000 catheter days), in-hospital mortality (%). When exploratory factor analysis was applied, the 15 indicators were divided into 6 core elements that varied in weight regarding quality evaluation: nosocomial infection management (21.35%), compliance with the Surviving Sepsis Campaign guidelines (17.97%), ICU resources (17.46%), airway management (15.53%), prevention of deep-vein thrombosis (14.07%), and severity of patient condition (13.61%). Based on the different weights of the core elements associated with the 15 indicators, we developed an integrated quality scoring system defined as F score=21.35%xnosocomial infection management + 17.97%xcompliance with SSC guidelines + 17.46%×ICU resources + 15.53%×airway management + 14.07%×DVT prevention + 13.61%×severity of patient condition. This evidence-based quality scoring system will help in assessing the key elements of quality management and establish a foundation for further optimization of the quality control indicator system.
Humans ; China/epidemiology* ; Cross Infection/epidemiology* ; Intensive Care Units/statistics & numerical data* ; Quality Control ; Quality Indicators, Health Care/statistics & numerical data* ; Sepsis/therapy* ; East Asian People/statistics & numerical data*

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.