OBJECTIVE To assess the scientific rigor， clarity and feasibility of the recommendations of the Guidelines for Evidence-based Use of Biological Agents for the Clinical Treatment of Osteoporosis （hereinafter referred to as the Guideline） through external review， in order to further revise and improve the Guideline recommendations. METHODS This study employed a cross-sectional survey research design， a convenience sampling method was adopted to select frontline medical workers in the field of osteoporosis （including clinical doctors， clinical pharmacists， and nurses） as well as patients or their family members. External review was conducted through a combination of closed-ended and open-ended electronic questionnaires to get feedback from them on the appreciation，clarity and feasibility of the 32 preliminary recommendations in the Guideline. RESULTS A total of 90 external review subjects from 15 hospitals were collected， including 45 clinical doctors， 15 clinical pharmacists， 15 nurses and 15 patients or their family members. The overall appreciation degree of recommendations was 99.38%， the overall clarity degree of recommendations was 98.92%， and the overall feasibility degree of recommendations was 99.65%. At the same time， 111 subjective suggestions were collected， which provided an important reference for the further improvement of the Guideline recommendations. Based on the above feedback， the Guideline steering committee and core expert group revised the wording of 12 draft recommendations without deletion， and finally determined 32 recommendations. CONCLUSIONS The external review provides an important basis for the final formation of the Guideline， further improves the scientific rigor， clarity and feasibility of the recommendations， and ensures the standardization， practicality and implementability of the Guideline.

Ovarian sclerosing stromal tumor(OSST)is a benign tumor originating from the ovarian sex cord-stroma,accounting for only 2%-6%of ovarian stromal tumors.It predominantly occurs in young women,and cases of OSST concurrently presenting with Meigs syndrome are extremely rare.This study reports a case of OSST,summarizes its clinical manifestations,and reviews relevant literature.The patient,a 22-year-old female,was admitted due to abdominal distension for 2 months,worsening over the past week.The physical examination results revealed abdominal distension,shifting dullness,mild tenderness,and no muscle tension or rebound tenderness.A mass measuring approximately 16.0 cm×14.0 cm×8.0 cm was palpated in the pelvic and abdominal cavity,with a firm texture,moderate mobility,and no tenderness.The gynecological ultrasound results showed a mixed cystic-solid echo of about 15.3 cm×14.0 cm×8.4 cm above the left side of the uterus,with clear boundaries,and fluid-filled dark areas in the pelvic and abdominal cavity,with a maximum anteroposterior diameter of about 11.9 cm.The-CT results revealed a cystic-solid mixed-density mass in the lower abdomen and right adnexal area,suggestive of a neoplastic lesion,with increased glucose metabolism in the solid portion,leaning toward malignancy.Carbohydrate antigen 125(CA125)was>800 U·mL-1,and pelvic puncture cytology indicated no cancer cells.The findings suggested a benign or borderline ovarian tumor,requiring differentiation from ovarian malignant tumors.Based on intraoperative observations and rapid pathological results,a left ovarian tumor enucleation was performed.Postoperative pathology confirmed ovarian sclerosing stromal tumor.Follow-up over 2 years showed no abnormalities.As a benign ovarian tumor,the clinical manifestations of OSST often mimic those of malignant tumors,leading to frequent misdiagnosis.Early diagnostic accuracy should be improved to develop the optimal treatment plan for patients.

Objective To investigate the impacts and mechanism of circular RNA polyribonucleotide nucleotidyltransferase 1(Circ-PNPT1)on glucose and lipid metabolism and offspring outcomes in rats with GDM through microRNA-345-3p(miR-345-3p)/lipid raft scaffold protein 2(FLOT2)axis.Methods 75 pregnant female rats were divided into normal control(NC)group,GDM group,si-NC group,si-Circ-PNPT1 group,and si-Circ-PNPT1+miR-345-3p-inhibitor group,with 15 rats in each group.Glucose and lipid metabolism indexes were detected in each group.FIns was detected by ELISA.The survival rate and body weight of fetal rats were compared in each group.The expression of Circ-PNPT1,miR-345-3p and FLOT2 mRNA in placenta was detected by qRT-PCR.The double luciferase reporter gene experiment verified the targeting relationship between miR-345-3p and Circ-PNPT1 and FLOT2.Western blot was used to detect the expression of FLOT2 protein in rat placenta.Results Compared with the NC group,the level of FPG,FIns,HOMA-IR,TC,TG,LDL-C,embryo weight,and the expressions of Circ-PNPT1,FLOT2 in GDM group increased,the level of HDL-C,embryo survival rate and the expression of miR-345-3p decreased(P<0.05).Compared with GDM group,the level of FPG,FIns,HOMA-IR,TC,TG,LDL-C,embryo weight,and the expression of FLOT2 in si-Circ-PNPT1 group decreased,the level of HDL-C,embryo survival rate and the expression of miR-345-3p increased(P<0.05);MiR-345-3p-inhibitor reversed the improvement of si-Circ-PNPT1 on GDM rats(P<0.05).Conclusions Knocking down Circ-PNPT1 can up-regulate miR-345-3p and down-regulate FLOT2 to improve glucose and lipid metabolism and offspring outcome in GDM rats.

Objective To explore and study the new nationwide centralized volume-based procurement model of Chinese patent medicines(CPM),aiming further to promote the normalization and institutionalization of such procurement practices.Methods This study conducts a retrospective analysis of the entire 2023 national CPM procurement process,comparing it with the 19-province alliance procurement,the national chemical drugs procurement,and the national insulin special procurement and highlighting its similarities and differences.Results In contrast to the 19-province alliance procurement,the national CPM alliance procurement introduced a daily average cost rule to reduce the price selection deviation.It also improved and optimized the criteria for qualification,bidding unit formation principles,selection rules,resurrection mechanisms,and principles for allocating procurement volumes under agreements.A comprehensive analysis of the results from two rounds of CPM procurement indicates statistically significant differences in resurrection rates,brand substitution rates,and reduction in selected prices,with the national procurement outperforming the 19-province alliance procurement.Compared with the national chemical drugs and special insulin procurements,this procurement distinctly showcases its unique characteristics.Conclusion The new mode of the national CPM alliance procurement is innovative and has contributed valuable experiences towards the sustained advancement of CPM procurement and establishing a medical insurance payment standard system.

Objective:To develop and validate the Pain nursing Competency Evaluation Questionnaire for Nursing Students to provide an effective tool for measuring the pain management competency of nursing students in China.Methods:The questionnaire was constructed through literature review, semi-structured interviews, focus group discussions, Delphi expert consultation, and a pre-survey. From September 2023 to January 2024, a convenience sampling method was used to select 250 nursing students from Hangzhou Normal University and Lishui University in Zhejiang Province for the survey. Reliability and validity of the developed questionnaire were tested. A random sample of 30 nursing students was selected for retesting after two weeks.Results:A total of 10 female experts were consulted through correspondence. The Pain Care Competency Evaluation Questionnaire for nursing students consists of 36 items. Through exploratory factor analysis, five common factors were extracted: pain health education, comprehensive pain assessment, pain screening and assessment, analgesic interventions, and analgesic side effects nursing, which together explained 61.695% of the variance. The content validity of the questionnaire was 0.96, and the item-level content validity index ranged from 0.900 to 1.000. The overall Cronbach′s α coefficient was 0.924, and the Cronbach′s α coefficients for the five dimensions ranged from 0.856 to 0.915. The test-retest reliability was 0.831. Conclusions:The Pain Care Competency Evaluation Questionnaire for nursing students developed in this study has good reliability and validity. It can be used as a tool to assess nursing students′ competency in pain care and provides a reference for the design and optimization of pain care courses and clinical practice programs for nursing students in undergraduate institutions.

Objective To investigate the impacts and mechanism of circular RNA polyribonucleotide nucleotidyltransferase 1(Circ-PNPT1)on glucose and lipid metabolism and offspring outcomes in rats with GDM through microRNA-345-3p(miR-345-3p)/lipid raft scaffold protein 2(FLOT2)axis.Methods 75 pregnant female rats were divided into normal control(NC)group,GDM group,si-NC group,si-Circ-PNPT1 group,and si-Circ-PNPT1+miR-345-3p-inhibitor group,with 15 rats in each group.Glucose and lipid metabolism indexes were detected in each group.FIns was detected by ELISA.The survival rate and body weight of fetal rats were compared in each group.The expression of Circ-PNPT1,miR-345-3p and FLOT2 mRNA in placenta was detected by qRT-PCR.The double luciferase reporter gene experiment verified the targeting relationship between miR-345-3p and Circ-PNPT1 and FLOT2.Western blot was used to detect the expression of FLOT2 protein in rat placenta.Results Compared with the NC group,the level of FPG,FIns,HOMA-IR,TC,TG,LDL-C,embryo weight,and the expressions of Circ-PNPT1,FLOT2 in GDM group increased,the level of HDL-C,embryo survival rate and the expression of miR-345-3p decreased(P<0.05).Compared with GDM group,the level of FPG,FIns,HOMA-IR,TC,TG,LDL-C,embryo weight,and the expression of FLOT2 in si-Circ-PNPT1 group decreased,the level of HDL-C,embryo survival rate and the expression of miR-345-3p increased(P<0.05);MiR-345-3p-inhibitor reversed the improvement of si-Circ-PNPT1 on GDM rats(P<0.05).Conclusions Knocking down Circ-PNPT1 can up-regulate miR-345-3p and down-regulate FLOT2 to improve glucose and lipid metabolism and offspring outcome in GDM rats.

Objective:To develop and validate the Pain nursing Competency Evaluation Questionnaire for Nursing Students to provide an effective tool for measuring the pain management competency of nursing students in China.Methods:The questionnaire was constructed through literature review, semi-structured interviews, focus group discussions, Delphi expert consultation, and a pre-survey. From September 2023 to January 2024, a convenience sampling method was used to select 250 nursing students from Hangzhou Normal University and Lishui University in Zhejiang Province for the survey. Reliability and validity of the developed questionnaire were tested. A random sample of 30 nursing students was selected for retesting after two weeks.Results:A total of 10 female experts were consulted through correspondence. The Pain Care Competency Evaluation Questionnaire for nursing students consists of 36 items. Through exploratory factor analysis, five common factors were extracted: pain health education, comprehensive pain assessment, pain screening and assessment, analgesic interventions, and analgesic side effects nursing, which together explained 61.695% of the variance. The content validity of the questionnaire was 0.96, and the item-level content validity index ranged from 0.900 to 1.000. The overall Cronbach′s α coefficient was 0.924, and the Cronbach′s α coefficients for the five dimensions ranged from 0.856 to 0.915. The test-retest reliability was 0.831. Conclusions:The Pain Care Competency Evaluation Questionnaire for nursing students developed in this study has good reliability and validity. It can be used as a tool to assess nursing students′ competency in pain care and provides a reference for the design and optimization of pain care courses and clinical practice programs for nursing students in undergraduate institutions.

Objective To explore and study the new nationwide centralized volume-based procurement model of Chinese patent medicines(CPM),aiming further to promote the normalization and institutionalization of such procurement practices.Methods This study conducts a retrospective analysis of the entire 2023 national CPM procurement process,comparing it with the 19-province alliance procurement,the national chemical drugs procurement,and the national insulin special procurement and highlighting its similarities and differences.Results In contrast to the 19-province alliance procurement,the national CPM alliance procurement introduced a daily average cost rule to reduce the price selection deviation.It also improved and optimized the criteria for qualification,bidding unit formation principles,selection rules,resurrection mechanisms,and principles for allocating procurement volumes under agreements.A comprehensive analysis of the results from two rounds of CPM procurement indicates statistically significant differences in resurrection rates,brand substitution rates,and reduction in selected prices,with the national procurement outperforming the 19-province alliance procurement.Compared with the national chemical drugs and special insulin procurements,this procurement distinctly showcases its unique characteristics.Conclusion The new mode of the national CPM alliance procurement is innovative and has contributed valuable experiences towards the sustained advancement of CPM procurement and establishing a medical insurance payment standard system.

Spinocerebellar ataxia (SCA) is a group of progressively aggravated neurodegenerative disease with autosomal dominant inheritance. Cerebellar ataxia is the core symptom, which may be accompanied by pyramidal tract signs, extrapyramidal signs, cognitive dysfunction and peripheral neuropathy. Although SCA can be accurately diagnosed by genetic testing, treatment is still difficult. We review the pathogenesis and therapeutic targets of SCA in recent years, in terms of genetic or gene regulation abnormalities, disruption of protein quality control (PQC) network, disruption of energy homeostasis, stability maintenance of PQC system, maintenance of cerebellar Purkinje cell function, and regulation of neuroinflammation, so as to promote the transformation of preclinical research into human therapy.

Objective:To study the epidemiological and clinical characteristics of brucellosis in Xinjiang Uygur Autonomous Region.Methods:A retrospective analysis method was used to collect medical records of 581 patients with brucellosis who visited the Xinjiang Uygur Autonomous Regional People's Hospital from January 2009 to December 2019. Demographic and epidemiological characteristics, clinical symptoms and signs, and laboratory test results of the patients were analyzed.Results:Among 581 patients with brucellosis, the male to female ratio was 2.8 ∶ 1.0 (428 ∶ 153). The age was (44.41 ± 16.25) years old, ranging from 1 - 83 years old, and mainly concentrated in 35 - 60 years old, accounting for 70.91% (412/581). The ethnic distribution was dominated by Uyghur, accounting for 50.60% (294/581). The occupational distribution was mainly farmers, accounting for 43.20% (251/581). A total of 186 patients had a clear history of contact with cattle and sheep, accounting for 32.01% (186/581). The clinical stage was dominated by patients in the acute stage, accounting for 55.25% (321/581). There were 48 cases of complications, accounting for 8.26%(48/581). The main clinical symptom of brucellosis patients was pain and fever, accounting for 73.67% (428/581) and 66.61% (387/581), respectively. Laboratory tests were dominated by increased blood sedimentation and C-reactive protein, accounting for 29.09% (169/581) and 23.06% (134/581), respectively. The positive rate of Brucella culture was low, accounting for 4.48% (26/581). Conclusions:The majority of brucellosis patients in Xinjiang Uygur Autonomous Region are young and middle-aged males, with the main occupation being farmers. The clinical symptoms are mostly pain and fever. The positive rate of Brucella culture in patients is relatively low. It is recommended to combine epidemiological and clinical features for diagnosis to reduce missed diagnosis and misdiagnosis, and detect and treat it early.