BACKGROUND: Endoscopic sphincterotomy (EST) is widely used to treat common bile duct stones (CBDS); however, long-term studies have revealed the increasing incidence of recurrent CBDS after EST. Loss of sphincter of Oddi function after EST was the main cause of recurrent CBDS. Reparation of the sphincter of Oddi is therefore crucial. This study aims to investigate the effectiveness and safety of endoclip papilloplasty (ECPP) for repairing the sphincter of Oddi and elucidate its mechanism. METHODS: Eight healthy Bama minipigs were randomly divided into the EST group and the ECPP group at a 1:1 ratio, and bile samples were collected before endoscopy and 6 months later. All minipigs underwent transabdominal biliary ultrasonography for the diagnosis of cholelithiasis 6 months after endoscopy. The biliary microbiota composition and alpha and beta diversity were analyzed by 16S ribosomal RNA gene sequencing. Differential metabolites were analyzed by bile acid metabolomics to explore the predictive indicators of cholelithiasis. RESULTS: Three minipigs were diagnosed with cholelithiasis in the EST group, while none in the ECPP group showed cholelithiasis. The biliary Firmicutes/Bacteroidota (F/B) ratio was increased after EST and decreased after ECPP. The Chao1 and observed species index significantly decreased 6 months after EST ( P  = 0.017 and 0.018, respectively); however, the biliary α-diversity was similar before and 6 months after ECPP. The β-diversity significantly differed in the EST group before and 6 months after EST, as well as in the ECPP group before and 6 months after ECPP (analysis of similarities [ANOSIM]: R  = 0.917, P  = 0.040; R  = 0.740, P  = 0.035; respectively). Glycolithocholic acid (GLCA) and taurolithocholic acid (TLCA) accumulated in bile 6 months after EST. CONCLUSIONS ECPP has less impact on the biliary microenvironment than EST and prevents duodenobiliary reflux by repairing the sphincter of Oddi. The bile levels of GLCA and TLCA may be used to predict the risk of cholelithiasis.
Animals ; Swine, Miniature ; Swine ; Cholelithiasis/prevention & control* ; Sphincterotomy, Endoscopic/methods* ; Sphincter of Oddi/surgery* ; Female ; Male

Objective:To explore the turnover intention of dental outpatient nurses, and analyze its influencing factors.Methods:From August to September 2021, multi-stage sampling was used to select nurses from 20 stomatology hospitals in 7 geographical regions of North China, East China, South China, Central China, Southwest, Northeast, and Northwest China. The survey was conducted using the General Information Questionnaire, Turnover Intention Scale, Nursing Work Environment Scale, Psychological Capital Scale for Nurses, and Work Engagement Scale.Results:A total of 1 513 questionnaires were collected, including 1 135 valid questionnaires, with a valid rate of 75.02% (1 135/1 513). The total score of turnover intention among 1 135 dental outpatient nurses was (2.22±0.56). Pearson correlation analysis showed a negative correlation between nursing work environment, psychological capital, work engagement, and turnover intention ( r=-0.421, -0.340, -0.446; P<0.01). The structural equation model showed that the nursing work environment had a direct negative effect on the turnover intention of dental outpatient nurses (β=-0.401, P<0.01) and had an indirect negative effect on turnover intention through work engagement (β=-0.106, P<0.01), with a mediating effect of 20.91%. Psychological capital had an indirect negative effect on the turnover intention of dental outpatient nurses through work engagement (β=-0.271, P<0.01), with a mediating effect of 52.83%. Conclusions:The turnover intention of dental outpatient nurses is at a high level. Managers can reduce the turnover intention of dental clinic nurses by improving the nursing work environment, developing psychological capital, and increasing work engagement.

Objective:To summarize the research on oral health education for pregnant women.Methods:The literature was described and analyzed using a scoping review method. Seven databases, such as PubMed, Embase, Web of Science, China National Knowledge Infrastructure, and WanFang Data, were electronically searched, and the search period was from database establishment to October 30, 2023.Results:A total of 43 articles were included. The implementers of health education were mainly dental professionals and prenatal healthcare personnel. The theoretical basis included the health belief model, planned behavior theory, social cognitive model and so on. The methods involved traditional teaching or lectures, family-centered, internet-based, and motivational interviews. The contents contained many aspects of oral health for pregnant women. The evaluation indicators mainly covered oral health knowledge, attitude and practice, and self-efficacy, oral health beliefs, oral health status, the incidence of oral diseases, adverse pregnancy outcomes of pregnant and postpartum women, and childhood caries incidence.Conclusions:We should establish a cooperation team of the Department of Stomatology and Obstetrics and Gynecology, incorporate oral health for pregnant women into prenatal care projects, fully utilize the platform of pregnant women's schools, explore the optimal theoretical basis for oral health education, and improve the content of oral health education for pregnant women.

Objective:To build a sensitive quality index system of dental clinic nursing.Methods:Based on the Donabedian "structure-process-results" three-dimensional quality model, the indicators at all levels of the sensitive quality index system of dental clinic nursing was preliminarily constructed through literature review. The Delphi method was used to develop a system of sensitive quality indicators for dental outpatient care through two rounds of correspondence with 15 experts from the fields of dental care management, oral health care, quality of care management, and health policy.Results:The effective response rates of the two rounds of expert inquiry questionnaires were 100% (15/15), and the average authority coefficient of the experts was 0.93. The Kendall's harmony coefficients of the overall indicators were 0.115 and 0.141, respectively ( P<0.05). A sensitive quality indicator system for dental clinic nursing was finally determined, including 3 primary indicators, 7 secondary indicators and 19 tertiary indicators. Conclusions:The sensitive quality indicator system for dental clinic nursing constructed in this research is scientific and reliable. After verification through future research, it can serve as a basis for improving the quality of dental clinic nursing.

Objective:To explore the status quo of physician-nurse collaboration among nurses in Dental Clinics in China, and analyze its influencing factors.Methods:From June to July 2020, 1 374 outpatient nurses from 18 ClassⅢ Grade A dental hospitals in 18 provinces, cities and autonomous regions were selected from 7 administrative regions of China with the convenient sampling as research objects. The nurses were investigated with the General Information Questionnaire and Nurse-Physician Collaboration Scale. Multiple linear regression analysis was used to explore the influencing factors of physician-nurse collaboration of nurses in Dental Clinics. A total of 1 374 questionnaires were distributed, and 1 321 valid questionnaires were recovered, with a valid recovery rate of 96.1% (1 321/1 374) .Results:Among 1 321 nurses in Dental Clinics, the total score of the Nurse-Physician Collaboration Scale was (84.20±13.27) . The dimension score of sharing of patient information was (33.20±4.77) , and the dimension score of joint participation in the cure/care decision making process was (38.88±7.80) . Multiple linear regression analysis showed that education background, professional title and participation in the four-hand collaboration were the influencing factors of the physician-nurse collaboration of the nurses in Dental Clinics ( P<0.05) . Conclusions:The physician-nurse collaboration among nurses in Dental Clinics is in good condition, but the joint participation of doctors and nurses in oral cure or care decision-making still needs to be improved. Hospital managers should actively carry out continuing education, strengthen the four-hand operation training and professional connotation training, improve the professional identity of nurses in Dental Clinics and the physician-nurse collaboration, so as to provide comprehensive nursing services for patients.

Objective:To investigate the current situation of working environment of nurses in a ClassⅢ Grade A hospital of stomatology in Beijing so as to provide basis for nursing managers to improve working environment of nursing staff of oral nursing staff.Methods:The convenient sampling method was used to select 894 oral nursing staff in a ClassⅢ Grade A hospital of stomatology in Beijing in August 2018 as the research objects. The General Questionnaire and the Nurses' Working Environment Evaluation electronic questionnaire were used for the survey, and the nonparametric test method was used to compare the total score and dimension scores of nurses' working environment of different social demographic data.Results:A total of 894 questionnaires were distributed and 564 valid questionnaires were recovered. The score of working environment of nurses in stomatological hospital was [96.72 (90.06, 99.30) ]. The dimension with the highest score was medical care cooperation, and the lowest dimension was hospital management participation. Univariate analysis results showed that the total scores of working environment of nursing staff in different departments were statistically different ( P<0.01) . There were statistically significant differences in the scores of nurses from different departments in the seven dimensions of hospital management participation, clinical nursing professionalism, quality management, medical care cooperation, human resource allocation, social status and salary treatment ( P<0.05) . There were statistically significant differences in scores of hospital management participation among nurses of different ages and educational backgrounds ( P<0.05) . The differences in the scores of the dimensions of leadership and communication and quality management among nurses of different positions were statistically significant ( P<0.05) . Conclusions:The working environment of nurses in stomatological hospital is generally good and the medical cooperation is close and harmonious, but the hospital management mode and nurses' salary and benefits distribution system still need to be improved. Nursing managers should improve the nurses' working environment according to the characteristics of different departments and nurse groups.

Objective:To investigate the current status of multiple leadership styles of head nurses and affective domain ability of nurses, and to explore the influence of multiple leadership styles of head nurses on affective domain ability of clinical nurses.Methods:From June and August 2019, we selected 380 clinical nurses in the Second People's Hospital of Liaocheng with the method of cross-sectional survey and convenience sampling. All nurses were investigated with the General Information Questionnaire, Multifactor Leadership Questionnaire (MLQ) and Nurse Affective Domain Ability Scale. We analyzed the influence of multiple leadership styles of head nurses on affective domain ability of clinical nurses. In this study, a total of 380 questionnaires were distributed and 372 valid questionnaires were recovered with a valid recovery rate of 97.9%.Results:Among 372 clinical nurses, the total score of perceived MLQ of head nurses was (86.30±18.59) and the item average score was (2.70±0.58) ; the total score of the Nurse Affective Domain Ability Scale and the item average score were (97.67±13.35) and (3.91±0.53) respectively. Univariate analysis showed that there were statistical differences in the total score of Nurse Affective Domain Ability Scale among nurses with different nursing ages, professional titles and educational levels ( P<0.05) . Pearson correlation analysis indicated that the total score of MLQ of head nurses had a positive correlation with the total score of the Nurse Affective Domain Ability Scale of nurses with a statistical difference ( r=0.364, P<0.05) . Hierarchical regression analysis showed that nursing ages and transformative leadership style had a predictive effect on clinical nurses' affective domain ability. Conclusions:Head nurses adopt a transformative leadership style to enhance clinical nurses' affective domain ability, so that they devote themselves to nursing work with full enthusiasm and stabilize the development of the nursing talent team.

Objective:To explore the influence of frequency of machinery heating power cleaning on dental handpiece loss and cleaning effect.Methods:This study selected 180 completely new high speed dental handpiece with machinery heating power cleaning. All of handpiece were randomly divided into group A, B and C, 60 cases in each group. Cleaning, oiling by special oiling machine, packing and sterilizing were carried out for the dental handpiece after being used. Group A, B and C implemented the process including machinery heating power cleaning, cleaning and oiling by special oiling machine, packing as well as sterilizing weekly, every other week and every three weeks respectively. This study randomly extracted 5 cases in each group to check the visible stains and monitor the cleaning effects after 3, 6 and 9 months.Results:Among group A, B and C, the using times were (56.60±24.77) , (49.70±30.08) , and (46.73±35.16) respectively with no statistical difference ( P=0.800) . There were 15 dental handpiece with trouble in 9 months, 4 in group A, 7 in group B and 4 in group C with no statistical difference ( P=0.660) ; 12 of them could be continued use after simple repair, 1 in group A, 7 in group B and 4 in group C with no statistical differences ( P=0.100) ; 3 of them could be continued use after changing central spindle, all in group A. The pass rates of visible cleanliness were all 100%. Conclusions:On the basis of cleaning and oiling by special oiling machine, machinery heating power cleaning every three weeks for dental handpiece can ensure the internal cleaning and improve working efficiency, but will not increase the loss.

Objective:To study changes of pollution conditions of the new dental unit waterlines.Methods:By means of random sampling, 7 new dental chair units of the same brand were selected. Of which, 5 dental chair units (DCU) were supplied with water after centralized treatment of municipal water and 2 dental chair units were supplied with independent water storage tanks. From the first day of clinical use, water samples of three-way syringes and high-speed dental handpieces and mouthwashes were continuously collected for bacterial culture and the number of colonies was counted.Results:A total of 343 water samples were collected. There was a statistically significant difference in the number of colonies in the water samples from the outlet of three-way syringes and high-speed dental handpieces after the waterlines was rinsed for 2 min before treatment ( P<0.01) . There was no statistically significant difference in the number of dental unit warterlines (DUWLs) colonies between the central water supply and the independent water storage tank before and after washing ( P> 0.05) . Waterline washing could significantly reduce the number of colonies in the waterlines ( P<0.01) , but there was no significant change in the number of colonies throughout the day ( P>0.05) . The number of colonies in the new DUWLs could exceed the recommended standard in the guideline on the second day of clinical use and the number of colonies increased significantly compared with that on the first day ( P<0.05) . Conclusions:In clinical work, no matter what kind of water supply method is used, in addition to waterline washing according to regulations, DUWLs should be disinfected daily.

Objective Clinical efficacy was compared among single injections of different doses of long acting gonadotropin releasing hormone agonist (GnRH-a),and daily injections of short-acting GnRH-a in order to evaluate different methods of ovarian stimulation for in vitro fertilization (IVF) cycles.Methods A retrospective study of 214 patients who underwent IVF assisted fertility treatments was conducted.Patients were allocated into four study groups:the short protocol (group A),in which daily injections of 0.1 mg GnRH-a was administered in the mid-luteal phase until the day of human chorionic gonadotropin (hCG) administration (see below);or the long protocol (group B,C & D),in which single injections of 3.75mg,2.0mg,or 0.9mg of long-acting GnRH-a was given in the mid-luteal phase,respectively.Stimulation with gonadotropins (Gn) started when pituitary down-regulation was established.When vaginal ultrasonographic scans showed that at least two follicles had reached 16-20mm in diameter,Gn stimulation was withdrawn,and serum estradiol (E2),progesterone (P),and luteinizing hormone (LH) were determined.Additionally,human chorionic gonadotropin (hCG) was administered that evening.Egg collection was performed 38 hours after hCG injection and the standard IVF procedure was performed.Results There were no statistically significant differences amongst the four groups when measuring serum LH levels,number of oocytes,number of fertilized eggs,number of good quality embryos,and clinical pregnancy rate.The total amount of Gn administered was almost identical when comparing group A and group D,as well as when comparing group B and group C.However,Group A and D required less Gn stimulation to exhibit follicles of 16-20mm in diameter,compared to group B and C (P ＜0.005).Moreover,there was a significant difference in the time required for ovulation induction between group A and group C,where group A had a shorter time to ovulation.The fertilization rate was statistically different between group B and other groups (P ＜ 0.005).Conclusion Through our data analysis,we conclude based on outcome,cost,side-effects,and simplification of treatments,that the 0.9mg long-acting GnRH-a treatment is eminent for ovarian stimulation for IVF.