Objective To examine the iron content and the expression of hepcidin in early period after subarach-noid hemorrhage (SAH) in rats, and to explore the role of hepcidin in dysregulation of brain iron metabolism after SAH. Methods Totally 90 adult male SD rats were randomly divided into two groups:the sham-operation group and SAH group. The SAH model was established by single blood injection to prechiasmatic cistern. Immunohistochemical and Western Blotting were used to examine the expression of hepcidin at 12, 24, 48 and 72h after SAH. Meanwhile, Atomic Absorption Spectrometer was used to detect the iron content. Results Immunochemistry showed that hepcidin expression in rats in SAH group began to rise at 12 h(0.30±0.06)and gradually increased over time until 72 h(0.56±0.07)compared with the sham group(0.19±0.05). The expression of hepcidin was significantly higher in SAH group than in the sham group(F=31.911, P<0.05). Western blot showed that hepcidin expression in rats in SAH group began to rise at 12h(0.481±0.065) and gradually increased over time until 72h(1.627±0.143)Compared with the sham group(0.238±0.047). The expression of hepcidin was significantly higher in SAH group than in the sham group after SAH(F=147.314,P<0.05). Iron content in SAH group began to rise at 12h after SAH(58.50±9.19)and gradually increased until 72 h(99.34±7.68). The iron con-tents in SAH group were higher at every time points than those in sham group(43.51±4.59)(F=28.799,P﹤0.05). The ex-pression of hepcidin was correlated with the iron content in SAH group(r=0.914,P﹤0.01). Conclusion The increase in iron content following SAH is associated with the increased hepcidin expression.

Diagnostic criteria, as a critical component of clinical practice guidelines, play a direct role in guiding clinicians' diagnostic and treatment decisions. Although China has increasingly emphasized the development and updating of clinical guidelines in recent years, research focusing on the diagnostic criteria within these guidelines remains limited. This paper aims to explore the types of diagnostic criteria, the issues they present, and the processes involved in their formulation. Based on this analysis, suggestions are proposed to improve the recommendation and application of diagnostic criteria in Chinese guidelines.

This article introduces two methodological articles published by the American College of Obstetricians and Gynecologists in September 2021 on their development of clinical practice guidelines and clinical expert consensus, focusing on the composition of the guidelines committee, declaration and management of conflicts of interest, and the detailed development process. On this basis, reflections and suggestions for the development of guidelines and consensus in obstetrics and gynecology in China are presented from the perspective of developing a handbook for standardized guideline development, registration and reporting of guidelines, use of available evidence, management of conflicts of interest, and regular evaluations of relevant published guidelines.

Objective To analyze systematically the existing classification criteria and assessment tools for osteoarthritis (OA).Methods Comprehensively searched and screened the available classification criteria and assessment tools reported in OA guidelines,textbooks,including secondary and original researchs.We collected and summarized the extracted data with the methods of scoping review and also used Excel software for qualitative analysis.Results A total of 63 OA guidelines,1 textbook,239 secondary or original researches,160 supplementary records were retrieved.The 5 classification criteria and 15 systematic reviews of assessment tools (855 assessment tools) were finally included.Conclusion The existing classification criteria lack a rigorous and transparent development process,and they are also too complicate to guide clinical treatment.We suggest that the development and improvement of OA classification criteria should be linked with the streamlined assessment tools,and conduct trials to test in clinical practice.

Objective:To study the clinical effect of balloon compression closure kyphoplasty in the treatment of fresh single-segment vertebral compression fracture.Methods:A retrospective study was used to analyze the clinical data of 80 patients with osteoporotic vertebral compression fracture (OVCF) admitted to Gansu Provincial Hospital of Traditional Chinese Medicine from June 2019 to June 2021. They were divided into two groups according to the surgical methods: the simple percutaneous kyphoplasty (PKP) group and the percutaneous kyphoplasty compression group, with 40 patients in each group. The PKP group was routinely treated with PKP, and the PKP compression group was treated with balloon compression occlusion technology on the basis of the PKP group. The amount of bone cement injected, the leakage of bone cement, the height of the anterior edge of the injured vertebra, the Cobb angle of kyphosis, the visual analogue score (VAS) and the Oswestry dysfunction index (ODI) were compared between the two groups. The measurement data conforming to the normal distribution were expressed as ( ± s), and the comparison between the two groups was conducted by t-test; The counting data were expressed by n(%) and the comparison between the two groups adopts Chi-square or Fisher exact probability. Results:The amount of bone cement injected and the leakage rate of bone cement in the PKP compression group were significantly higher than those in the simple PKP group ( P<0.05). The height of the anterior edge of the injured vertebra in the two groups was significantly higher than that before the operation on the first day and three months after the operation ( P<0.05). The Cobb angle, VAS score and ODI index of the injured vertebra in the two groups were significantly lower than that before the operation on the first day and three months after the operation ( P<0.05). The height of the anterior edge of the injured vertebra in the PKP compression group was significantly higher than that in the PKP group ( P<0.05). The Cobb angle of kyphosis in the PKP compression group was significantly lower than that in the simple PKP group at 1 day and 3 months after operation ( P<0.05). There was no significant difference in VAS score between PKP compression group and PKP group on 1 day after operation ( P>0.05), and compared with PKP group on 3 months after operation ( P<0.05). There was no significant difference in the ODI index between the PKP compression group and the two groups 1 day and 3 months after PKP ( P>0.05). Conclusion:Balloon compression closure technology can significantly reduce the leakage of bone cement in PKP and increase the amount of bone cement injected, which is beneficial to reduce the pain of vertebral body and improve the function of OVCF patients, and can improve the clinical treatment effect, which is worth promoting.

Objective: Through analyzing development statue of integrative coronary heart disease clinical practice guidelines, we aim to provide a reference baseline for the future study. Methods: Databases including CBM, CNKI, WanFang, VIP were searched for published integrative coronary heart disease clinical practices. The website medlive.cn was also used as supplementary. The reporting tool for clinical practice guidelines RIGHT statement was used to evaluate the reporting quality. Results: A total of nine relevant clinical practice guidelines or experts consensuses were included, covering five integrative treatment therapy guidelines of PCI or CABG perioperative period, three myocardial infarction guidelines and one atherosclerosis guideline. Experts consensus methods were adopted in seven guidelines, the remining two guidelines used the evidence-based guidelines development methods. The evaluation of RIGHT statements showed that most guidelines reported complete information in"Basic information"and"Background"domain, however, they usually failed to provide enough description in"Evidence", "Recommendations", "Review and quality assurance", "Funding and declaration and management of interests"and"Other information"parts. Conclusion: Although some achievements have been reached in the development of integrative coronary heart disease clinical practice guidelines, the development methods and quality of reporting still needs further improvements. Researchers should explore more specific Chinese medicine guideline development methods and tools in the future.

Pathological diagnosis is vital in medicine. Developing and implementing high-quality pathology guidelines and consensus can enhance disease diagnosis accuracy and reduce unnecessary misdiagnosis and missed diagnoses. This article will cover the current status of pathology guidelines and consensus, methods for high-quality development, and the distinctions between them. Additionally, it will provide thoughts and suggestions for promoting their development in China.

In order to standardize the postoperative pain management in adults in China, the Chinese Society of Anesthesiology formulated the "Clinical practice guidelines for postoperative pain management in adults (2024 edition)" according to the methods and steps of the "Principles for Formulation/Revision of Clinical Diagnosis and Treatment Guidelines in China (2022 Edition)". This protocol mainly introduced the purpose of guideline formulation, the formation and responsibilities of the working group, the collection and selection of clinical questions, the evaluation and synthesis of evidence, the formation of recommendations and other processes.

Objective To evaluate the evidence and recommendations of the relevant clinical practice guidelines for the prevention and treatment of stroke published in the last five years. Methods The stroke and guideline-related key words and free words domestic computer retrieval platforms(China biomedical literature database,CNKI,and Yimaitong etc.),as well as foreign platforms(PubMed,NGC,GIN,etc.) were retrieved.The retrieval time limit ranged from January 2012 to May 2017.Appraisal of Guidelines for Research and Evaluation Ⅱ(AGREE Ⅱ)was used to assess the quality of the guidelines. Results A total of 9 490 documents were retrieved preliminarily and finally 16 articles were included. The average scoring rates of the 16 guidelines in the 6 fields of AGREE Ⅱ,including the scope and purpose,participants,rigor of the formulation,clarity of expression,applicability,and independence of the editors were 66.3%, 27.4%,23.0%,53.9%,18.8%,and 0%,respectively.The different guidelines all recommend that internal endarterectomy or carotid balloon dilatation and carotid artery stenting are used to extracranial carotid stenosis,while the treatment of vertebral artery stenting is recommended for extracranial vertebral artery stenosis.However,the intravascular interventional therapy is not recommended for intracranial arterial stenosis.The perioperative period of ischemic stroke intravascular intervention need to pay attention to the application of anti-platelet aggregation,anticoagulation,blood pressure,blood glucose,blood lipid management,and postoperative monitoring. For postoperative stent restenosis,especially after vertebral artery stenting,the guidelines recommend using drug-eluting stents,however,the dosage of heparin in intraoperative anticoagulation is still controversial.The intracranial aneurysm guidelines are more recommended for interventional therapy.The cerebral hemorrhage in different regions is recommended for different surgical procedures. Conclusions The guidelines in this field can reflect the key problems in clinical practice and keep up with the international concept.However,the quality of the methodology of the guidelines development needs to be improved. Some of them need to be updated and the recommendations should refer more evidence of the Chinese population.