Children and adults differ significantly in physiology,biochemistry and immune function,which leads to sig-nificant differences in blood transfusion strategies between children and adults.To guide the clinical transfusion practice of pediatric patients and improve the prognosis of children,the National Health Commission organized the formulation and re-lease of the health industry standard Guideline for Pediatric Transfusion(WS/T 795-2022).This paper will briefly introduce some concepts that help understand of the Standard and the preparation process of the Standard,and explain and interpret the preparation of the"scope","general provisions"and"factors to consider"of the Standard,hoping to contribute to the understanding and implementation of the Standard.

Metabolic associated fatty liver disease （MAFLD） is a common chronic liver disease around the world， affecting more than a quarter of the adult population worldwide. MAFLD is characterized by the co-occurrence of hepatic steatosis and metabolic disturbance. As a metabolic disorder， MAFLD shares a similar pathogenesis with cardiovascular disease （CVD）， and both diseases are closely associated with the well-established cardiovascular risk factors such as obesity， type 2 diabetes， and atherogenic dyslipidemia. An increasing amount of evidence has shown that MAFLD is closely associated with CVD； however， as a new risk factor for CVD， MAFLD differs from traditional risk factors for CVD， which requires further investigation. In this context， this consensus statement used the Delphi method to achieve a consensus on the association between MAFLD and the risk of CVD through two rounds of surveys and discussed the association between MAFLD and CVD in terms of epidemiological and clinical characteristics， as well as a range of topics including pathophysiological mechanisms， surveillance， and management.

Venous thromboembolism (VTE) is a complication in children with acute lymphoblastic leukemia (ALL). The Chinese Children's Cancer Group-ALL-2015 protocol was carried out in China, and epidemiology, clinical characteristics, and risk factors associated with VTE were analyzed. We collected data on VTE in a multi-institutional clinical study of 7640 patients with ALL diagnosed in 20 hospitals from January 2015 to December 2019. First, VTE occurred in 159 (2.08%) patients, including 90 (56.6%) during induction therapy and 108 (67.92%) in the upper extremities. T-ALL had a 1.74-fold increased risk of VTE (95% CI 1.08-2.8, P = 0.022). Septicemia, as an adverse event of ALL treatment, can significantly promote the occurrence of VTE (P < 0.001). Catheter-related thrombosis (CRT) accounted for 75.47% (n = 120); and, symptomatic VTE, 58.49% (n = 93), which was more common in patients aged 12-18 years (P = 0.023), non-CRT patients (P < 0.001), or patients with cerebral thrombosis (P < 0.001). Of the patients with VTE treated with anticoagulation therapy (n = 147), 4.08% (n = 6) had bleeding. The VTE recurrence rate was 5.03% (n = 8). Patients with VTE treated by non-ultrasound-guided venous cannulation (P = 0.02), with residual thrombus (P = 0.006), or with short anticoagulation period (P = 0.026) had high recurrence rates. Thus, preventing repeated venous puncture and appropriately prolonged anticoagulation time can reduce the risk of VTE recurrence.
Humans ; Child ; Venous Thromboembolism/etiology* ; East Asian People ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/epidemiology* ; Risk Factors ; Thrombosis/chemically induced* ; China/epidemiology* ; Anticoagulants/adverse effects* ; Recurrence

Papillary thyroid carcinoma is one of the most common thyroid cancer subtypes. Although papillary thyroid carcinoma can be treated effectively with excision, microwave ablation, radioactive iodine and hormone replacement therapy, these ways are inefficient in reducing its morbidity, mortality and recurrence rates. Therefore, it is very important to seek the molecular mechanism of the occurrence and development of papillary thyroid carcinoma, to provide effectively early diagnosis, accurate treatment and better long-term prognosis for papillary thyroid carcinoma patients. This paper summarizes the molecular regulatory mechanisms of non-coding RNAs and their related signaling pathways in the occurrence and development of papillary thyroid carcinoma, in order to provide evidence for continued research of biomarkers for papillary thyroid carcinoma.

Objective To evaluate the role of clinical pharmacists on the pharmacological monitoring and management of diabetic patients. Methods 406 adult outpatients with diabetes in outpatient were selected as research object. The patients were given the questionnaire and intervened with diabetes education and management by the clinical pharmacist regularly. The patient’s knowledge of the diabetes medication before and after intervention, blood glucose and glycosylated hemoglobin values, treatment compliance, non-reserved outpatient visit, emergency, hospitalization, etc. were compared and statistically analyzed. Results After pharmacy intervention, the patients' knowledge of diabetes and drug-related information, treatment compliance, blood glucose and glycosylated hemoglobin were better than before intervention, P<0.01. Non-reserved outpatient visits and emergency cases were better than before intervention, P<0.05. There are significant differences. Conclusion Clinical pharmacists carry out diabetes chronic disease management and build a clinical pharmacist-led chronic disease management model, which helps to promote standardized treatment, improve patient compliance, promote rationalized medication, achieve the goal of controlling blood sugar and reduce complications.

Objective To analyze the related factors of foot blisters caused by long-distance weight-bearing march and to explore the pathogenesis of foot blisters to provide a useful way for the prevention and treatment.Methods After the 300 km march,counted the number who had accomplished the march,and then recorded the number of foot blisters,location of blisters,and abrasion of sole.Collected the data of gender,age,body mass index (BMI),hand dominance,and whether had bliters before the march through questionnaire.And the data were coded for analysis with SPSS 13.0 statistical package.Results The 7 cases who complete the whole march and 17 cases who already had foot blisters before the march were ruled out of the final statistics.Among the remaining 590 cases,there were 554 cases (93.9%)suffered from foot blisters.And there were 1 282 blisters in total,among which the plantar blisters occupied 98% (1 257 cases).The analysis showed that the incidence of foot blisters had no significant correlation with gender,left/right foot,hand dominance,BMI and age.The predilection sites of blisters were the second and third metatarsals (28.2%),the hallux (21.3%),the fifth metatarsal (18.1%),and the calcaneus (15.8%)of the left foot.The predilection sites of blisters were the second and third metatarsals (33.3%),the hallux (22.4%),the fifth metatarsal (18.6%),and the calcaneus (14.5%)of the right foot.In terms of the abrasion of sole,the lateral heel was worn out the most (34.6% on the left and 34.2% on the right).Conclusion The study confirmed that the incidence of foot blisters had no significant correla-tion with gender,left/right foot,hand dominance,BMI and age,which may be affected by the particularity of this march.Most of the foot blisters occurred in the planta,and the predilection sites of blisters were in accord with sites of of the abrasion of sole and the distribution of plantar shear force,which demonstrated the shear force is the most critical factor on the pathogenesis of foot blisters.

Objective To compare the effect of video‐assisted thoracoscopic(VAT) surgery and conventional thoracotomy in emergency treatment of multiple rib fracture complicating pulmonary laceration to provide the reference for clinical treatment .Meth‐ods Forty‐seven cases of multiple rib fracture complicating pulmonary laceration in our hospital from April 2013 to April 2014 were selected and divided into the VAT group(n=32) and thoracotomy group(n=15) according to the willingness of patients .The two groups performed the thoracoscopic and traditional thoracotomy titanium nickel alloy rib plate treatment respectively .The sur‐gery situation ,complications and changes of perioperative blood gas levels were compared between the two groups .Results The op‐eration time ,intraoperative bleeding volume ,ICU hospitalization time ,total hospitalization time and postoperative analgesic in the VAT group were lower than those in the thoracotomy group ,the differences were statistically significant (P<0 .05);the VAS score on postoperative 1 d had statistical difference(P<0 .01) .Compared with before operation ,arterial PaO2 ,SaO2 and PaO2/FiO2 at postoperative 12 h in the two groups were increased ,while PaCO2 was decreased ,and the differences were statistically significant (P<0 .05);PaO2 ,SaO2 and PaO2/FiO2 at postoperative 12 h in the VAT group were higher than those in the thoracotomy group , while PaCO2 was lower than that in the thoracotomy group ,and the differences were statistically significant (P<0 .05) .The occur‐rence rate of complications had no statistical difference between the VAT group and thoracotomy group (3 .1% vs .6 .7% ,P>0 .05) .The excellent rate in the VAT group was 90 .6% ,which was higher than 66 .7% in the thoracotomy group ,and the differ‐ence was statistically significant (P<0 .05) .Conclusion Thoracoscopic internal fixation for the treatment of multiple rib fractures complicating laceration has the advantages of minimal trauma ,convenient operation and high safety ,could effectively alleviate the patient′s sufferring ,improve the living quality ,and be a better way of treatment .

Objective To explore the value of energy spectrum CT in the diagnosis of breast cancer.Methods Thirty-two hospitalized patients whose American Colledge of Radiology (ACR) breast imaging reporting and data system (BI-RADS) scores were 4-5 by mammography received non-enhanced spectral CT scans.The spectrum images,spectrum curve,lesion's size,morphology were observed,and also the pectoralis major muscle and axillary lymph node metastasis were evaluated and compared with mammography.Results Thirty-two patients were confirmed by pathology,including 16 cases of invasive duct carcinomas,1 case of medullary carcinoma,15 cases of lobular carcinomas,and 11 cases of the pectoralis major muscle invaded,9 cases of the axillary lymph nodes metastasis.ACR BI-RADS scores 4 were 23 cases,5 were 9 cases.Axillary lymph node metastasis and primary tumor spectrum curves were basically the same.Energy spectrum CT showed the lesion's shape,size,the relationship with the pectoralis major muscle and axillary lymph node metastasis.In 40-70 keV spectrum curve breast cancer displayed a downward trend.There were no significant differences between energy spectrum CT and mammography for the lesion's shape,edge,internal calcification and thickening of adjacent skin (P ＞ 0.05).While energy spectrum CT exhibited obvious advantages in demonstrating the pectoralis major muscle invaded and axillary lymph node metastasis (P ＜ 0.05).Conclusion Energy spectrum CT imaging displays greater clinical value for diagnosing breast cancer,and it can provide multi-parameter image for supporting clinical practice.

A molecularly imprinted polymer (MIP) for the selective solid phase extraction of imidacloprid, imidaclothiz, thiacloprid was synthesized by polymerization for 24 h using thiacloprid as template. Dynamic adsorption and selective adsorption test showed that the MIP could quickly adsorb the imidacloprid, imidaclothiz, thiacloprid, with good selectivity for targets. The maximum static adsorption capacity of MIP was 31. 7, 36. 7 and 45. 3 mg / g, respectively. A molecularly imprinted solid phase extraction (MIP-SPE) was developed to separate, clean up and enrich the thiacloprid, imidacloprid and imidaclothiz residue in paddy water, soil, rice, tomato, cucumber. The average recoveries were 80. 2% -98. 8% , with relative standard deviation of 1. 4% -4. 5% . The MIP-SPE was used to analyses the real samples, the result was satisfied.

Objective To discuss the feasibility and clinical application of percutaneous internal fixation (PIF) combined with pecutaneous osteoplasty (POP) for the treatment of metastasis of proximal femur with impending pathological fracture. Methods Six consecutive patients with metastases of the proximal femur, who could not be able to tolerate conventional surgery, underwent PIF together with POP. The results were analyzed. Results The procedure was successfully accomplished in all six patients. Neither pulmonary embolism nor death occurred in all patients during and after the operation. No fracture at operated area was observed during follow-up period. Conclusion For stabilization of proximal femoral metastatic lesion with impending pathological fracture, percutaneous internal fixation combined with pecutaneous osteoplasty is a safe and effective technique.