Objective To investigate the current status of regulatory focus among the nurses in operating room,analyse the influencing factors and summarise nursing strategies to provide a reference for development of the programs in targeted nursing management.Methods A total of 681 operating room nurses from 18 hospitals of Grade ⅡA and above in Jiangsu Province were selected by convenience sampling method from Arprial to July 2023.The nurses who participated in the study were surveyed with a general information questionnaire,the nurse regulatory focus scale(NRFQ),spiritual climate scale(SCS),calling scale-12(CS-12),and perceived stress scale(CPSS).Results All 681 operating room nurses completed the study.The promotive focus score was lower than the defensive focus(23.57±2.64 vs.24.06±2.72).It was found that the promotive focus and defensive focus were positively correlated with spiritual climate and occupational call,and negatively correlated with perceived stress(P<0.01).Spiritual climate,occupational call and perceived stress were the influencing factors that affected the promotion focus,jointly explaining 28.00％of the variance(all P<0.05).While occupational call and perceived stress among the operating room nurses were the influencing factors to the defensive focus,jointly explaining 23.60％of the variance(both P<0.05).Conclusion This study has identified that spiritual climate of nurses in operating room positively influences promotive focus in the regulatory focus.The regulatory focus as a whole is positively regulated by occupational call and negatively influenced by perceived stress.Therefore,nursing administrators should create a favourable spiritual climate to enhance the sense of professional call,reduce the perceived stress and increase the promotive and defensive focus among the nurses in operating room,hence to increase the nursing efficiency,thereby improving the quality of nursing care.

Objective:To develop and validate an artificial intelligence (AI) diagnostic model for coronary artery disease based on facial photos.Methods:This study was a cross-sectional study. Patients who were scheduled to undergo coronary angiography (CAG) at Beijing Anzhen Hospital and Beijing Daxing Hospital from August 2022 to November 2023 were included consecutively. Before CAG, facial photos were collected (including four angles: frontal view, left and right 60° profile, and top of the head). Photo datasets were randomly divided into a training set, a validation set (70%), and a testing set (30%). The model was constructed using Masked Autoencoder (MAE) and Vision Transformer (ViT) architectures. Firstly, the model base was pre-training using 2 million facial photos obtained from the publicly available VGGFace dataset, and fine-tuned by the training and validation sets; the model was validated in the test set. In addition, the ResNet architecture was used to process the dataset, and its outputs were compared with those of the models based on MAE and ViT. In the test set, the area under the operating characteristic curve ( AUC) of the AI model was calculated using CAG results as the gold standard. Results:A total of 5 974 participants aged 61 (54, 67) years were included, including 4 179 males (70.0%), with a total of 84 964 facial photos. There were 79 140 facial photos in the training and validation sets, with 3 822 patients with coronary artery disease; there were 5 824 facial photos in the test set, with 239 patients with coronary artery disease. The AUC value of the MAE and ViT model initialized with pre-training model weights was 0.841 and 0.824, respectively. The AUC of the ResNet model initialized with random weights was 0.810, while the AUC of the ResNet model initialized with pre-training model weights was 0.816. Conclusion:The AI model based on facial photos showes good diagnostic performance for coronary artery disease and holds promise for further application in early diagnosis.

Objective:To investigate the mechanism of proanthocyanidin (PA) in regulating the osteogenic differentiation of human periodontal ligament stem cells (PDLSCs), and to explore the effects of PA on the expression and nuclear translocation of transcription factor EB (TFEB) and on the autophagy-lysosome pathway.Methods:PDLSCs were divided into control group and PA group, which were subjected to RNA sequencing analysis (RNA Seq) to detect differentially expressed genes. The osteogenic differentiation ability and autophagy level were observed by real-time fluorescence quantitative PCR (RT-qPCR) analysis, alkaline phosphatase (ALP) staining and transmission electron microscope (TEM), respectively. Scratch assay and Transwell assay were used to detect the migration ability of PDLSCs. Lysotracker and immunofluorescence staining were used to detect the biogenesis of lysosomes. The total protein expression of transcription factor EB (TFEB) as well as that in cytoplasm and nucleus were detected by Western blotting. Confocal laser scanning microscope (CLSM) was used to observe the nuclear translocation of TFEB. The PDLSCs were treated with small interfering RNA (siRNA) technology to knock down the expression levels of TFEB gene with or without PA treatment. Western blotting was used to analyze the expressions of autophagy-related proteins Beclin1 and microtubule-associated protein 1 light chain 3 (LC3B), as well as osteogenic-related proteins runt-related transcription factor 2 (RUNX2), ALP, and osteocalcin in PDLSCs.Results:Compared with the control group, the osteogenic-related and autophagy-related genes showed differential expression in PDLSCs after PA treatment ( P<0.05). The mRNA expression levels of osteogenic-related genes RUNX2 (2.32±0.15) and collagen type Ⅰ alpha 1 (COL1α1) (1.80±0.18), as well as the autophagy related genes LC3B (1.87±0.08) and Beclin1 (1.63±0.08) were significantly increased in the PA group, compared with the control group (1.01±0.16, 1.00±0.10, 1.00±0.07, 1.00±0.06, respectively, all P<0.01). Compared with the control group, the PA group had higher ALP activity, and more autophagosomes and autophagolysosomes observed by TEM. PA promoted the migration of PDLSCs ( P<0.05) and the increased number of lysosomes and the expression of lysosomal associated membrane protein 1 (LAMP1). In the PA group, the relative expression level of total TFEB protein (1.49±0.07) and the nuclear/cytoplasmic expression of TFEB protein (1.52±0.12) were significantly higher than the control group (1.00±0.11, 1.00±0.13, respectively) ( t=6.43, P<0.01; t=5.07, P<0.01). The relative nuclear/cytoplasmic fluorescence intensity of TFEB in the PA group (0.79±0.09) was increased compared with the control group (0.11±0.08) ( t=8.32, P<0.01). Knocking down TFEB significantly reduced the expression of TFEB (1.00±0.15 vs 0.64±0.04), LAMP1 (1.00±0.10 vs 0.69±0.09), Beclin1 (1.00±0.05 vs 0.60±0.05), and LC3B Ⅱ/Ⅰ (1.00±0.06 vs 0.73±0.07) in PDLSCs ( P<0.05, P<0.05, P<0.01, P<0.01). When TFEB gene was knocked down, the expression levels of Beclin1 (1.05±0.11), LC3B Ⅱ/Ⅰ (1.02±0.09), RUNX2 (1.04±0.10), ALP (1.04±0.16), and osteocalcin (1.03±0.15) proteins were significantly decreased in the PA group compared with the pre-knockdown period (1.28±0.03, 1.44±0.11, 1.38±0.11, 1.62±0.11, 1.65±0.17, respectively) ( P<0.05, P<0.01, P<0.05, P<0.01, and P<0.01, respectively). Conclusions:PA promotes the osteogenic differentiation of PDLSCs through inducing the expression and nuclear translocation of TFEB and activating the autophagy-lysosome pathway.

The molar anchorage control in orthodontic treatment is a key concern of clinicians and a hot spot in the field of orthodontic clinical research.Good molar anchorage control is a prerequisite for the success of orthodontic treatment.In recent years,clear aligner treatment has been favored by orthodontists and patients because of its aesthetics,comfort and other advantages.However,the unique biomechanical mechanism of clear aligner system has brought new changes and challenges for dentists to understand the anchorage con-trol in orthodontics.This article provides a systematic review of the research methodology,clinical efficacy and enhanced strategy of mo-lar anchorage control in clear aligner treatment,with the aim to provide a reference for the clinical research and technical development of molar anchorage control in clear aligner treatment.

Objective To explore the clinical effect of urapidil combined with recombinant human brain natriuretic peptide(rhBNP)in the treatment of high blood pressure complicated with acute heart failure.Methods Sixty patients with high blood pressure(HBP)and acute heart failure(AHF)were collected from May 2022 to December 2023 in the inpatient department of Yingtan People's Hospital were to conduct retrospective analysis.They were divided into two groups according to different clinical drugs,with 30 cases in each group.The control group received conventional drugs(amlodipine besylate+spirolactone)+intravenous furosemide infusion+administer urapidil intravenously,the experimental group was additionally given rhBNP.Both groups received treatment for 7 days in the hospital.Blood pressure,heart rate,N-terminal pro-brain natriuretic peptide(NT-proBNP),left heart function changes and adverse reactions during treatment were compared in two groups.Results After the treatment of those patients,the total effective rate and left ventricular ejection fraction of experimental group were higher than those of control group(P＜0.05).The changes of heart rate,NT-proBNP,left ventricular end-systolic diameter,left ventricular end-diastolic diameter and blood pressure in experimental group were lower than those in control group(P＜0.05).Two groups were no significant difference in the total incidence of adverse drug reactions(P＞0.05).Conclusion Urapidil and rhBNP is obviously superior to urapidil alone in the treatment of HBP complicated with AHF,and can obviously reduce blood pressure and heart rate,improve cardiacfunction,and is safe in clinical application.

Objective To investigate the current status of regulatory focus among the nurses in operating room,analyse the influencing factors and summarise nursing strategies to provide a reference for development of the programs in targeted nursing management.Methods A total of 681 operating room nurses from 18 hospitals of Grade ⅡA and above in Jiangsu Province were selected by convenience sampling method from Arprial to July 2023.The nurses who participated in the study were surveyed with a general information questionnaire,the nurse regulatory focus scale(NRFQ),spiritual climate scale(SCS),calling scale-12(CS-12),and perceived stress scale(CPSS).Results All 681 operating room nurses completed the study.The promotive focus score was lower than the defensive focus(23.57±2.64 vs.24.06±2.72).It was found that the promotive focus and defensive focus were positively correlated with spiritual climate and occupational call,and negatively correlated with perceived stress(P<0.01).Spiritual climate,occupational call and perceived stress were the influencing factors that affected the promotion focus,jointly explaining 28.00％of the variance(all P<0.05).While occupational call and perceived stress among the operating room nurses were the influencing factors to the defensive focus,jointly explaining 23.60％of the variance(both P<0.05).Conclusion This study has identified that spiritual climate of nurses in operating room positively influences promotive focus in the regulatory focus.The regulatory focus as a whole is positively regulated by occupational call and negatively influenced by perceived stress.Therefore,nursing administrators should create a favourable spiritual climate to enhance the sense of professional call,reduce the perceived stress and increase the promotive and defensive focus among the nurses in operating room,hence to increase the nursing efficiency,thereby improving the quality of nursing care.

Objective To explore the predictive value of spectral CT quantitative parameters combined with radiomics for early liver fibrosis using rat models.Methods Prospective animal experiments were conducted,and the intervention models were constructed for liver fibrosis in rats.A total of 112 spectral CT plain samples were collected from 56 rats,and quantitative parameters(40,60 and 100 keV CT values,slope of the spectral curve)were measured in the spectral CT images to assess the value of each parameter in the staging of liver fibrosis.The regions of interest were sketched out in the 60 keV monoenergetic images using 3D Slicer software,and from which the radiomics features were extracted.The t-test,correlation analysis and the least absolute contraction and selection operator algorithms were used for radiomics feature screening,and the Rad-score was calculated.According to the pathological results,they were classified into non-significant liver fibrosis and significant liver fibrosis,and 3 Logistic regression models(spectral CT model,radiomics model and combined model)were established using the selected spectral CT parameters and radiomics features.The predictive value of these models was evaluated using receiver operating characteristic curves,and calibration curves were plotted to evaluate model fit.Results Except for 100 keV CT value,spectral CT parameters and Rad-score differed statistically between non-significant and significant liver fibroses(P<0.05).The spectral CT model,radiomics model and combined model had AUC of 0.850,0.895,0.939 in the training set,and 0.818,0.803,0.883 in the test set.The calibration curves showed that the 3 models were well fitted,without significant deviation.Conclusion The model constructed with spectral CT and radiomics performes well,worthy of further optimization.

Objective To explore the predictive value of spectral CT quantitative parameters combined with radiomics for early liver fibrosis using rat models.Methods Prospective animal experiments were conducted,and the intervention models were constructed for liver fibrosis in rats.A total of 112 spectral CT plain samples were collected from 56 rats,and quantitative parameters(40,60 and 100 keV CT values,slope of the spectral curve)were measured in the spectral CT images to assess the value of each parameter in the staging of liver fibrosis.The regions of interest were sketched out in the 60 keV monoenergetic images using 3D Slicer software,and from which the radiomics features were extracted.The t-test,correlation analysis and the least absolute contraction and selection operator algorithms were used for radiomics feature screening,and the Rad-score was calculated.According to the pathological results,they were classified into non-significant liver fibrosis and significant liver fibrosis,and 3 Logistic regression models(spectral CT model,radiomics model and combined model)were established using the selected spectral CT parameters and radiomics features.The predictive value of these models was evaluated using receiver operating characteristic curves,and calibration curves were plotted to evaluate model fit.Results Except for 100 keV CT value,spectral CT parameters and Rad-score differed statistically between non-significant and significant liver fibroses(P<0.05).The spectral CT model,radiomics model and combined model had AUC of 0.850,0.895,0.939 in the training set,and 0.818,0.803,0.883 in the test set.The calibration curves showed that the 3 models were well fitted,without significant deviation.Conclusion The model constructed with spectral CT and radiomics performes well,worthy of further optimization.

Objective:To analyze the correlation between serum vitamin D level and ovarian artery blood flow index and ovarian reserve function in women.Methods:A retrospective cohort study was conducted. Women aged from 18 to 40 years who were admitted to the Department of Obstetrics and Gynecology of the Second Affiliated Hospital of Harbin Medical University from September 2020 to November 2021 and had regular sexual life were selected as subjects. The data of age, height and weight were collected. And the indexes of vitamin D, anti-Müllerian hormone (AMH), luteinizing hormone and follicle-stimulating hormone were detected in the laboratory. Color Doppler ultrasound was used to measure antral follicle count and bilateral ovarian interstitial artery blood stream resistance index (RI) and plusatility index (PI) in early follicular phase. Multiple linear regression was used to analyze the related factors of serum vitamin D level.Results:A total of 218 women were included in the study, including 137 cases of vitamin D deficiency, accounting for 62.8%, 39 cases of vitamin D insufficiency, accounting for 17.9%, 42 cases of normal vitamin D, accounting for 19.3%. Multiple linear regression analysis showed that there was a negative correlation between serum vitamin D level and ovarian blood flow ( P=0.024), but no correlation with other indexes (all P>0.05). Conclusion:Serum vitamin D level affected ovarian interstitial artery blood flow RI to some extent, but had no significant correlation with ovarian interstitial artery blood flow PI, serum AMH level and other indexes related to ovarian reserve function.

Objective:To analyze the correlation between serum vitamin D level and ovarian artery blood flow index and ovarian reserve function in women.Methods:A retrospective cohort study was conducted. Women aged from 18 to 40 years who were admitted to the Department of Obstetrics and Gynecology of the Second Affiliated Hospital of Harbin Medical University from September 2020 to November 2021 and had regular sexual life were selected as subjects. The data of age, height and weight were collected. And the indexes of vitamin D, anti-Müllerian hormone (AMH), luteinizing hormone and follicle-stimulating hormone were detected in the laboratory. Color Doppler ultrasound was used to measure antral follicle count and bilateral ovarian interstitial artery blood stream resistance index (RI) and plusatility index (PI) in early follicular phase. Multiple linear regression was used to analyze the related factors of serum vitamin D level.Results:A total of 218 women were included in the study, including 137 cases of vitamin D deficiency, accounting for 62.8%, 39 cases of vitamin D insufficiency, accounting for 17.9%, 42 cases of normal vitamin D, accounting for 19.3%. Multiple linear regression analysis showed that there was a negative correlation between serum vitamin D level and ovarian blood flow ( P=0.024), but no correlation with other indexes (all P>0.05). Conclusion:Serum vitamin D level affected ovarian interstitial artery blood flow RI to some extent, but had no significant correlation with ovarian interstitial artery blood flow PI, serum AMH level and other indexes related to ovarian reserve function.