To evaluate the features of carotid web (CW) by ultrasonography.

A total of 66 patients with CW were retrospectively enrolled from January 2018 to June 2019 at Xuanwu Hospital, Capital Medical University. All patients were examined by both ultrasonography and CTA, and were divided into either a<50% stenosis group (54 cases) or a ≥50% stenosis group (12 cases). The ultrasonographic characteristics of CW, including the length, thickness, direction (forward or backward to the flow), acute angle between the web and carotid wall, and thrombus between the web and carotid wall were compared between the two groups. The stenosis degrees of carotid artery were compared between patients with and without ischemic stroke.

Forty-two (42/66, 63.6%) patients were diagnosed with CW by initial CDFI examination, of whom 21 (21/66, 31.8%) were diagnosed with ulcerative plaque and 3 (3/66, 4.5%) were diagnosed with carotid dissection at first but confirmed by second examination. There were no differences in the web length, thickness, direction, or thrombus detected between the two groups (P>0.05). The angle between the web and carotid wall in the<50% stenosis group was significantly smaller than that of the ≥50% stenosis group (median angel 39o vs 73o, P=0.002), and the percentage of patients with an angle≤ 60o in the<50% stenosis group was significantly higher than that of the ≥50% stenosis group (74.1% vs 41.7%, P=0.042). The diameter of the residual carotid artery at CW location in the<50% stenosis group was significantly larger and peak systolic velocity was significantly higher in the<50% stenosis group than in the≥50% stenosis group (P<0.001). The stenosis degrees of carotid artery were not statistically different between patients with and without ischemic stroke (P=0.321).

Ultrasonography can be used to evaluate the characteristics of carotid web in 2D and color mode. When the angle between the CW and carotid wall is large, the carotid artery stenosis ≥ 50% is more likely to happen, but carotid artery stenosis is not the main cause of ischemic stroke.

The aim of the present study was to evaluate the efficiency of sling exercise, therapeuticultrasound, therapeuticultrasound and sling exercise in patients to alleviate pain and improve lumbar function with lumbar disc herniation.

Individuals were selected from a list of patients being followed at the department of Rehabilitation in the third hospital of Hebei Medical University. 30 patients who were diagnosed with lumbar disc herniation were collected, the diagnoses were established upon medical history, physical examination, and results of imaging studies. The patients were randomly divided into three groups: therapeuticultrasound group received 14 sessions of ultrasonic therapy to the lumbar region, Sling exercise group received 14 sessions of sling exercise, and therapeuticultrasound and sling exercise group received therapeuticultrasound and sling exercise therapy 14 sessions of therapeuticultrasound to the lumbar region,7 sessions per week, 2 weeks. The VAS and ODI were compared with the assessment of the patients before and at the end of the therapy.

At the end of treatment, three groups VAS scores (F=3.069, P=0.043) and ODI scores (t=12.676, P<0.001) was lower than that at the beginning of treatment (P<0.05), at the end of treatment the VAS scores (F=59.400, P<0.001) and of the ODI scores (t=12.737, P<0.001) of ultrasonic and sling exercise therapy group was lower than the other group, the difference is significantly.

All three groups could reduce pain and improve lumbar function, and the ultrasonic and sling exercise therapy was most effective for lumbar disc herniation treatment in the three groups.

To analyze the treatment of different types of traumatic cerebral infarction in children, and explore its pathogenesis in combination with literature so as to improve the cure rate and reduce disability rate.

The clinical data of 42 cases of traumatic cerebral infarction in children were retrospectively analyzed in The Hospital of 81^st Group Army PLA from January 2015 to December 2019. The diagnosis of traumatic cerebral infarction in children was made by CT scan and MRI scan. According to different conditions, children with traumatic cerebral infarction were classified, and different treatment strategies were selected. Children with lacunar infarction were treated with calcium antagonists and neurotrophic drugs, supplemented by hyperbaric oxygen and exercise rehabilitation. The children of focal cerebral infarction and complex cerebral infarction treated by junior dehydrant and hormone also included the calcium antagonist and nutritional nerve drugs. The therapeutic regimen perhaps adjusted by the evolution of the disease. The children of extensive cerebral infarction underwent emergency cranial decompression, and was treated by reducing intracranial pressure and preventing complications after operation. The treatment results and recovery were observed.

In 42 cases of traumatic cerebral infarction in children, 35 cases (83.3%) were good recovery, 4 cases (9.5%) were moderate disability, 2 cases (4.8%) were severe disability, 1 case (2.4%) died, and no vegetative state. The good recovery rate of lacunar infarction was 100%, that of focal cerebral infarction was 62.5%, that of mixed cerebral infarction was 60%, and that of extensive cerebral infarction was 50%.

It is of great significance to improve the therapeutic effect and prognosis of children with traumatic cerebral infarction to adopt different treatment schemes for different types of cerebral infarction.

To characterize the patients with supratentorial hypertensive intracerebral hemorrhage (ICH) in the Tibetan Plateau over an altitude of 4000 meters.

A total of 68 cases with supratentorial hypertensive ICH were retrospectively included in Ali Regional People’s Hospital from January 2017 to September 2018. The clinical and laboratory data were collected. A simple linear correlation analysis was applied to analyze the correlation between the amount of bleeding and sex, age, nationality, time from onset , systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum triglyceride (TG), and cholesterol. According to computed tomography (CT) findings, 68 cases were divided into the basal ganglia ICH group (33 cases) and the lobar ICH group (35 cases). The characteristics between two groups were analyzed using t-test or χ² test.

The data of sex, age, nationality, time from onset, SBP, DBP, Hb, TG, and cholesterol of 68 cases on admission did not show any definitive correlation with the hematoma volumes (P＞0.05). The SBP and DBP of patients in the basal ganglia ICH group were significantly higher than that in the lobar ICH group, respectively [(184.9±28.5) mmHg vs (164.6±24.4) mmHg; (113.0±18.1) mmHg vs (103.0±18.4) mmHg] (t=0.499, 0.486; P=0.002, 0.033).

The relevant factors of hematoma volumes in patients with ICH in plateau area were not yet clear. Diastolic and systolic blood pressure of patients in the basal ganglia ICH group was higher than that in those in lobar ICH group.

To compare the efficacy evaluation of electrospun composite biomaterials and a porcine small intestine submucosa mesh for hernia repair.

A randomized, single-blind, controlled multicenter trial was performed in 3 hospitals in Shanghai. Eligible adult patients with primary unilateral reducible groin hernias were randomly assigned (1∶1) to electrospun composite biomaterials (experimental group) or porcine small intestine submucosa (control group) mesh groups. Patients were treated with the tARB technique and assessed at 1,3 and 6 months after the surgery. The primary endpoint was hernia recurrence. The secondary endpoints were postoperative complications including groin pain and operative site infections.

172 patients were assigned to experimental (n=86) and control (n=86) groups. At 6 months follow-up, postoperative complications occurred in 5 patients (5/86, 5.95%) and 2 (2/86, 2.35%) patients in the control and experimental groups, respectively (P>0.05). There was no significant difference in VAS or SVS score between the two groups.

We demonstrate that electrospun composite biomaterial mesh can be used as a ideal choice for inguinal hernia repair. Electrospun composite biomaterial has the characteristics of low recurrence rate, absorbability and long-term comfort.It can be further applied in clinical practice in the future.

Pancreaticoduodenectomy(PD)remains one of the most complicated hepatobiliary operations. The development of minimally invasive surgery for PD has always been an hot spot. Laparoscopic pancreaticoduodenectomy(LPD) has not been widespread carried out due to its difficulty and long learning curve. LPD accounts for 9% of all PD, according to the National Cancer Data base. Compared with laparoscopic surgery, robotic surgery system has significant advantages in the field of minimally invasive PD, including stereotactic amplified vision, filtering hand tremor and simulating the wrist. The article would review the surgical techniques and notes, which could provide clinical reference for other surgeons.

To compare the long-term differences in hemorrhagic stroke or death between palliative embolization and conservative management in adult patients with brain arteriovenous malformations (AVM), and to evaluate the effectiveness of different treatment strategies.

This study was conducted within the prospective, nationwide multimodality treatment for brain arteriovenous malformations in Chinese mainland (MATCH) registry, and consecutive AVM patients were enrolled from August 2011 to December 2025. Patients receiving conservative management were assigned to the conservative management group, while those receiving palliative embolization were assigned to the palliative embolization group. Propensity score matching (PSM) was used to balance baseline differences between groups. Survival analyses were performed in the overall cohort and in strata defined by hemorrhage status (unruptured vs ruptured) to compare long-term rates of hemorrhagic stroke or death, as well as neurological outcomes. Subgroup analyses were conducted for the primary outcome (hemorrhagic stroke or death) to test robustness. Poisson regression was used to compare the risk of the primary outcome between the matched groups, with risk differences (RD) and their 95% confidence intervals (CI) calculated. Multivariable Cox proportional hazards regression models were constructed in the matched cohorts, and results were reported as adjusted hazard ratios (HR) with 95%CI. Cumulative incidence curves for the 10-year primary outcome were plotted, and between-group differences were assessed using the Log-Rank test. For the secondary functional outcome (modified Rankin scale score 0-1), relative risks (RR) were estimated using modified Poisson regression or log-binomial models.

A total of 824 patients received either conservative treatment or palliative embolization. After PSM, the overall matched cohort comprised 608 patients (304 pairs). The median follow-up duration for the primary outcome endpoint was 1.67 years (IQR 0.36, 6.03). The palliative embolization group had a higher incidence of long-term hemorrhagic stroke or death than the conservative group (3.71 per 100 patient-years vs 1.71 per 100 patient-years; RD=2.00, 95%CI: 0.24 to 3.77, P=0.007). In subgroup analyses, palliative embolization was not superior to conservative treatment in unruptured AVM (2.47 per 100 patient-years vs 1.52 per 100 patient-years; RD=0.95, 95%CI: -0.91 to 2.81, P=0.255), while comparable outcomes were observed in ruptured AVM (6.06 per 100 patient-years vs 3.35 per 100 patient-years; RD=2.71, 95%CI: -2.04 to 7.47, P=0.183). Stratification by embolization extent showed that patients achieving ＞50% nidus volume reduction experienced no hemorrhagic stroke or death, regardless of rupture status. In the overall cohort, patients in the palliative embolization group were less likely to have favorable functional outcomes (mRS score of 0 to 1) compared to those in the conservative treatment group [74.67% (227/304) vs 81.91% (249/304), RR=0.91, 95%CI: 0.84 to 0.99, P=0.030].

Palliative embolization was overall inferior to conservative treatment in preventing long-term hemorrhagic stroke or death in adult patients with brain AVM.

To investigate the efficacy and safety of the Chinese Tulip intrasaccular flow disruption device in the treatment of wide-necked bifurcation aneurysms of the middle cerebral artery (MCA).

A total of 43 consecutive patients with saccular MCA bifurcation aneurysms were prospectively enrolled from eight medical centers in China between March and November 2023 and completed the full follow-up protocol. Among the 43 aneurysms, 40 were classified as wide-necked. All patients underwent endovascular treatment with the Tulip device. The technical success rate, degree of aneurysm occlusion (Raymond-Roy classification), neurological functional outcomes [modified Rankin scale (mRS)], and perioperative complications were recorded. Digital subtraction angiography follow-up was completed at 12 months post-procedure.

The technical success rate was 100.00% (43/43), with a total of 44 Tulip devices successfully implanted. At the 12-month follow-up, the complete occlusion rate was 44.19% (19/43) and the adequate occlusion rate was 95.35% (41/43), and the mRS scores were 0 in 40 patients, 1 in 2 patients, and 2 in 1 patient. There were no intraoperative adverse events, and a total of 3 postoperative events including transient ischemic attack and thrombosis occurred.

The Tulip device is easy to use in the treatment of wide-necked MCA bifurcation aneurysms. Short-term follow-up reveals satisfactory occlusion rates and a low complication rate.

To compare the clinical efficacy of robot-assisted catheter drainage and craniotomy hematoma evacuation for spontaneous intracerebral hemorrhage (sICH).

This study retrospectively collected data from patients with sICH treated in the Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, from January 2023 to November 2025. Based on comprehensive neurosurgical assessment and patient or family preference, patients underwent either robot-assisted catheter drainage (robot-assisted group) or craniotomy for hematoma evacuation (craniotomy group). Propensity score overlap weighting was used to balance baseline differences between groups. The primary outcome was functional independence at 6 months, defined as a modified Rankin scale (mRS) score of 0-2. Secondary outcomes included functional independence at postoperative 3 months, favorable functional outcome (mRS score 0–3) at postoperative 3 and 6 months, Barthel index at postoperative 6 months, and mortality. After overlap weighting, binary outcomes were analyzed using weighted Logistic regression and continuous outcomes using weighted linear regression, with robust sandwich variance estimates for 95% confidence intervals (95%CI) and P values. Sensitivity analyses were performed by re-estimating propensity scores and weights after removing admission-to-surgery time from the propensity score model and, separately, after excluding infratentorial and mixed hemorrhages.

A total of 138 patients were included, with 79 in the robot-assisted group and 59 in the craniotomy group. Baseline covariates were balanced after overlap weighting. Before weighting, the postoperative 6-month functional independence rates were 40.51% (32/79) and 10.17% (6/59), the postoperative 6-month favorable functional outcome rates were 55.70% (44/79) and 25.42% (15/59), and the postoperative 6-month Barthel index scores were 57.85±42.20 and 29.83±34.23 in the robot-assisted and craniotomy groups, respectively, with significant differences between groups (χ²=15.578, 12.647, t=4.303; all P＜0.001). All-cause mortality at 3 and 6 months postoperatively did not differ significantly between groups (both P＞0.05). After overlap weighting, robot-assisted catheter drainage was associated with higher odds of functional independence at 6 months postoperatively for sICH patients (OR=4.25, 95%CI: 1.60-11.28, P=0.004). Compared with the craniotomy group, the robot-assisted group had shorter operative time [geometric mean ratio (GMR)=0.27, 95%CI: 0.24-0.32, P＜0.001], length of intensive care unit stay (GMR=0.73, 95%CI: 0.60-0.90, P=0.003), and total length of hospital stay (GMR=0.77, 95%CI: 0.64-0.94, P=0.008), as well as less intraoperative blood loss (GMR=0.03, 95%CI: 0.02-0.05, P＜0.001) and a lower incidence of pulmonary infection (OR=0.40, 95%CI: 0.19-0.83, P=0.014). No significant differences were observed in other safety outcomes (all P＞0.05).

In the overlap-weighted population, robot-assisted catheter drainage was associated with better mid-term functional outcomes and lower perioperative resource utilization for sICH patients, whereas its advantages in survival benefit and overall safety remain uncertain.

Astrocytes and neurons cooperate to maintain brain homeostasis through tightly regulated lipid metabolic coupling. Astrocytes deliver cholesterol to neurons via apolipoprotein E (ApoE)-containing lipoproteins to sustain synaptic function, while concurrently clearing excess neuronal fatty acids to alleviate lipotoxic stress. Distinct ApoE isoforms (e.g., ApoE4) differentially influence lipid transport and metabolic homeostasis, and their dysregulation is strongly implicated in the pathogenesis of neurodegenerative and cerebrovascular disorders, including Alzheimer's disease, stroke, and Parkinson's disease. Future studies should further elucidate the dynamic mechanisms of this coupling and its pathological associations. This article reviews the lipid metabolic coupling process between astrocytes and neurons, and disscusses potential research directions and therapeutic targets in the future, in order to provide new strategies for neuroprotective treatment.

In recent years, the correlation between patent foramen ovale (PFO) and stroke has attracted much attention from neurologists and cardiologists, especially in young patients with cryptogenic stroke, in whom PFO screening has become mandatory. For this purpose, this article reviews the formation of the foramen ovale, the incidence of PFO, the methods of PFO detection, the imaging characteristics of PFO-related stroke, and the treatment of PFO-related stroke. The aim is to enhance awareness of the correlation between cryptogenic stroke and PFO.

Non-acute subdural hematoma is a common disease in neurosurgery, and its burden of disease is increasing. Traditional trepanation and drainage can rapidly relieve the mass effect, but postoperative recurrence and retreatment remain common. Middle meningeal artery embolization provides a new therapeutic strategy for reducing the risk of recurrence by blocking the abnormal blood supply to the hematoma capsule, thereby reducing inflammatory exudation and repeated microbleeds. In recent years, a number of large randomized controlled studies in China and abroad have shown that using middle meningeal artery embolization as an adjunct to standard treatment can reduce the occurrence of hematoma recurrence, treatment failure or reoperation in specific patient populations, with an overall favorable safety profile. This article reviews the pathophysiological basis, efficacy and safety, technical points, patient selection, cost-effectiveness and long-term outcomes of middle meningeal artery embolization by synthesizing evidence from randomized controlled studies and real-world studies in order to provide a reference for the standardized and individualized application of middle meningeal artery embolization.

To address the growing pathogenicity and biofilm-mediated drug resistance of Pseudomonas putida (P. putida) in root canal therapy failure and refractory apical periodontitis, and to overcome the bottleneck of "extremely low sample quantity" that hinders the systemic activity evaluation of natural products. This study aims to establish a micro-scale, visual, and high-throughput drug screening platform based on microfluidic chips.

P. putida KT2440 was selected as the model strain, and a green fluorescent protein (GFP) -labeled strain was constructed to establish a microfluidic biofilm model. To accommodate rare natural products, a "qualitative rapid screening" strategy with a fixed threshold of 200 μg/mL was established. Using the length of the fluorescent line segment as a quantitative metric, 40 natural products derived from myxobacteria and plants were blindly screened for anti-biofilm activity. Calcium hydroxide and Ciprofloxacin served as the lower and upper limits of efficacy, respectively, to define the effective screening range. A t-test was used to compare results with the traditional 96-well plate micro-broth dilution method; consistency between the two methods was verified, and sample consumption was compared.

The microfluidic screening platform successfully categorized the 40 compounds into three tiers: Strong, moderate, and ineffective. Ultimately, 6 lead compounds with significant anti-P. putida biofilm activity were identified (positive detection rate of 15%), including novel macrocyclic peptides and certain monoterpenoids. Methodological validation showed high qualitative consistency between the microfluidic chip screening and traditional methods. regarding sample consumption, the platform required only nanoliter (nL) -level volumes per test, with a single compound consumption as low as 8 ng. This represented a sample saving of approximately 15 000-fold compared to the traditional 96-well plate method, significantly reducing the demand for fermentation products.

The microfluidic high-throughput screening platform constructed in this study effectively overcame the technical challenge of sample scarcity in natural product mining through a fixed-concentration qualitative screening strategy. The platform featured extremely low sample consumption, high analytical throughput, and accurate results, providing strong technical support for rapidly locking onto active lead compounds against drug-resistant bacterial biofilms.

To evaluate the in vitro antibacterial effect of freshly-prepared slightly acidic electrolyzed water (SAEW) against Enterococcus faecalis (E. faecalis), a common and persistent pathogen in root-canal therapy, and to preliminarily explore its underlying mechanism.

Freshly-prepared SAEW was produced by on-site electrolysis. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of SAEW against planktonic E. faecalis were determined. An ex-vivo infected single-rooted tooth model was established. Infected teeth were assigned into four groups by simple randomization, and root canals were irrigated with 0.9% sodium chloride solution, low-concentration SAEW (MIC), high-concentration SAEW (2×MIC), and 5.25% sodium hypochlorite solution, respectively. Immediate antibacterial efficacy was assessed by bacterial sampling and colony counting before and after irrigation. Root-canal irrigants were collected. Scanning electron microscopy (SEM) was used to observe bacterial ultrastructural alterations. Confocal laser scanning microscopy combined with SYTO 9/PI fluorescent staining was performed to quantitatively analyze the effect of SAEW on bacterial membrane integrity. The cytotoxicity of SAEW toward human gingival fibroblast cells (HGFCs) was detected using the CCK-8 assay. Statistical analyses were conducted with SPSS 26.0. Normality and homogeneity-of-variance tests were performed for quantitative data. Normally distributed data with homogeneous variances were presented as mean ± standard deviation (SD). One-way analysis of variance (ANOVA) followed by the least-significant-difference (LSD) post-hoc test was applied for multi-group comparisons. A two-sided P<0.05 was considered statistically significant.

Freshly-prepared SAEW exhibited distinct concentration-dependent antibacterial activity against both planktonic and intracanal E. faecalis. The MIC and MBC values of SAEW for planktonic E. faecalis were 6.25 and 12.50 mg/L, respectively. The overall difference in the colony reduction rates of Enterococcus faecalis among the four groups was statistically significant (F = 306.46, P<0.001). The colony reduction rates of groups A, B, C, and D were (25.69 ± 7.41) %, (73.38 ± 1.69) %, (85.89 ± 2.09) %, and (96.60 ± 1.33) %, respectively. Compared with group A, groups B, C, and D exhibited significantly higher colony reduction rates. Moreover, group C showed a significantly higher antibacterial effect than group B but a lower bactericidal efficacy than group D (all P<0.001). These results indicated that SAEW exerts a concentration-dependent antibacterial effect, while its immediate bactericidal potency is inferior to 5.25% sodium hypochlorite. Scanning electron microscopy revealed varying degrees of bacterial ultrastructural damage in each group. Quantitative confocal laser scanning microscopy with SYTO 9/PI staining showed bacterial membrane-damage rates of 0.84% for the 0.9% sodium-chloride group, 74.39% for the low-concentration-SAEW group, 87.38% for the high-concentration-SAEW group, and 92.62% for the 5.25% sodium-hypochlorite group, with significant inter-group differences (F = 2 056.72, P<0.001). These findings indicated that SAEW exerted antibacterial effects by disrupting bacterial membrane integrity in a concentration-dependent manner. At effective antibacterial concentrations, the viability of HGFCs remained above 90% in SAEW-treated groups, whereas cell viability was below 10% in the sodium-hypochlorite-treated group.

This study demonstrated that SAEW could effectively inhibit and kill E. faecalis. Although its immediate in vitro bactericidal potency may be lower than that of high-concentration sodium hypochlorite, SAEW showed promising potential as a supplementary or alternative root-canal irrigant owing to its favorable antibacterial performance and biocompatibility. Further validation using complex biofilm and in vivo models is required.

Dental caries is a highly prevalent chronic infectious disease worldwide. However, traditional preventive agents, such as antimicrobials and fluorides, face limitations including the induction of bacterial resistance and disruption of oral microecological balance. Emerging as a novel strategy, microecological regulation using probiotics to "combat bacteria with bacteria" offers a promising alternative for caries prevention. Nevertheless, current clinical probiotic products generally suffer from short retention times in the oral cavity, susceptibility to saliva rinsing, and difficulty in achieving effective colonization on dental surfaces. As an innovative delivery system, hydrogels can efficiently encapsulate probiotics, achieve lesion-targeted colonization, and significantly prolong retention time. These hydrogel systems exert anti-caries effects through competitive exclusion of cariogenic bacteria, pH regulation, secretion of antimicrobial substances, and immune modulation. This article reviews recent research progress on probiotic-loaded anti-caries hydrogels, with a particular focus on the anti-caries mechanisms, principles of strain selection, hydrogel design mechanisms, and the regulatory roles of degradation kinetics in probiotic delivery and therapy. Overall, this review aims to provide a theoretical reference for the microecological prevention and clinical translation of dental caries.

To explore the factors influencing the failure of root canal treatment in apical periodontitis, and to construct and validate a nomogram prediction model for the efficacy of root canal treatment in apical periodontitis based on these factors.

A prospective study was conducted involving 150 patients with apical periodontitis treated at Huizhou First People's Hospital from April 2024 to June 2025. All patients underwent root canal treatment and were followed up for 6 months. They were divided into the treatment failure group and the treatment success group according to the efficacy criteria of root canal treatment. Clinical data of the patients were collected. Logistic regression analysis was used to identify the factors influencing the failure of root canal treatment in apical periodontitis. A nomogram prediction model for the failure of root canal treatment in apical periodontitis was constructed, and the performance of this risk prediction model was validated.

The follow-up results showed that among the 150 patients with apical periodontitis, 35 (23.33%) had treatment failure and 115 (76.67%) had treatment success. Logistic regression analysis revealed that tooth position (posterior teeth), the number of root canal treatments (≥2 times), crown sealing effect (crown leakage), root canal filling length (underfilling/overfilling), and instrument fracture (present) were independent risk factors for the failure of root canal treatment in apical periodontitis, with odds ratios (ORs) of 2.002, 2.079, 2.255, 2.063, and 1.950, respectively. The corresponding 95% confidence intervals (CIs) were 1.080-3.711, 1.159-3.729, 1.111-4.575, 1.076-3.954, and 1.113-3.416, with P-values of 0.028, 0.014, 0.025, 0.030, and 0.020, respectively. The nomogram model developed using these five risk factors demonstrated an area under the ROC curve (AUC) of 0.836 (95% CI: 0.781-0.892), indicating good discrimination. The slope of the calibration curve was close to 1, and the Hosmer and Lemeshow test showed that the model had good fit (χ² = 7.568, P = 0.268) .

Tooth position, the number of root canal treatments, crown sealing effect, root canal filling length, and instrument fracture are risk factors affecting root canal treatment in apical periodontitis. The nomogram model constructed based on these factors has good accuracy and clinical application value, and may serve as a reference for clinical treatment of apical periodontitis.