To explore the role of the "Clinical Practice Guidelines" column and others in the Medical Joumnal of Peking Union Medical College Hospital (Med J PUMCH) in promoting diseiplinary development.

Objective To describe and evaluate the clinical studies of postoperative pain sensitization caused by sleep deprivation through the evidence map system,understand the distribution of evidence in this field,and provide reference for subsequent evidence research.Methods A computer-based search of PubMed,EMBASE,Cochrane library,Web of Science,CNKI,Wanfang Data,VIP and Chinese Biomedical Literature Database from inception to August 2023 was conducted to obtain intervent ion studies,observational studies and systematic reviews/Meta-analysis of postoperative pain sensitization caused by sleep deprivation.The research characteristics and methodological quality were analyzed and evaluated.The Cochrane Handbook for Systematic Reviews,the Newcastle-Ottawa Scale(NOS)and the AMSTAR-2 scale were used to evaluate the quality of the included studies,and the evidence was comprehensively analyzed and displayed by means of bubble chart,table and text.Results A total of 35 observational studies(31 cohort studies and 4 case-control studies),15 randomized controlled trials and 4 systematic reviews/Meta-analyses were included.The number of publications increased rapidly after 2018 and peaked in 2022,and clinical studies in this field mainly fo-cused on cohort studies,with fewer randomized controlled trials and systematic reviews/Meta-analysis studies.The results of the evidence map showed that in terms of quality,22 studies were'high quality',24 studies were'medium quality',and 8 studies were'low quality'.Thirty studies showed that sleep deprivation could induce postoperative pain sensitization.Only 2 studies suggested that sleep disorders were not significantly asso-ciated with postoperative pain sensitization,and ten studies were uncertain whether sleep deprivation could in-duce postoperative pain sensitization.Conclusions Overall evidence shows that sleep deprivation can induce postoperative pain sensitization,but the evaluation dimensions are limited and the methodological quality of the included literature needs to be improved.More high-quality,large-sample and standardized clinical studies should be carried out in the future to provide better scientific basis for clinical work.

Objective:To review the literature on improving patients′medical experience, analyze the current research status in this field, and provide references for enhancing patients′medical experience.Methods:A search was conducted for studies related to improving patients′medical experience published from January 2015 to November 2024 in eight databases, including CNKI and Web of Science. Using software CiteSpace 6.4.R1 and VOSviewer 1.6.19 to analyze publication trends, keyword clustering, existing problems in the process of improving patients′medical experience, and the measures taken.Results:6 507 articles were included, of which 4 452 were in English (68.4%) and 2 055 were in Chinese (31.6%). The annual number of publications showed a nearly linear growth trend ( R2 = 0.983 9). The clustering analysis results indicated that domestic and international research mainly focused on patient-centered diagnostic and treatment systems, behaviors, services, and environments. Existing studies revealed that there were still problems such as long waiting times for appointments and consultations (292 articles), uneven distribution of medical resources (198 articles), and poor doctor-patient communication (155 articles). To improve patients′medical experience, the following intervention measures were proposed: accelerating the medical reform process and strengthening government responsibilities (169 articles); enhancing service concepts and innovating service models (363 articles); optimizing the consultation process and simplifying medical procedures (221 articles); improving the consultation environment and optimizing the facilities in the consultation area (181 articles); and integrating technological advantages to cover the entire medical process (346 articles). Conclusions:Research on improving patients' medical experience was increasingly attracting the attention of more and more scholars. Issues such as low service efficiency, unbalanced resource allocation, and poor doctor-patient communication need to be given special attention. In the future, it is recommended to enhance the experience of patients′ medical experience by strengthening policy and institutional guarantees, accelerating the construction of information technology, improving doctor-patient communication skills and humanistic care, and enhancing the capacity of primary medical services.

One of the important goals of assisted reproductive technology management is the safety of offspring. When the needs of patients conflict with the management of assisted reproductive technology, reproductive ethical problems arise. The storage and use of frozen embryos is a part of the management of assisted reproductive technology. When the patient has a conflict in the storage and use of frozen embryos, a small number of court decisions are consistent with the national management measures, but the vast majority of court decisions give the patient the right to ownership of frozen embryos, ruling that the patient has the right to custody and disposal, and the hospital will be difficult to implement embryo cryopreservation and management by national laws and regulations. In this paper, we review the ethical considerations in embryos, in order to provide beneficial references for embryo management in assisted reproductive technology.

One of the important goals of assisted reproductive technology management is the safety of offspring. When the needs of patients conflict with the management of assisted reproductive technology, reproductive ethical problems arise. The storage and use of frozen embryos is a part of the management of assisted reproductive technology. When the patient has a conflict in the storage and use of frozen embryos, a small number of court decisions are consistent with the national management measures, but the vast majority of court decisions give the patient the right to ownership of frozen embryos, ruling that the patient has the right to custody and disposal, and the hospital will be difficult to implement embryo cryopreservation and management by national laws and regulations. In this paper, we review the ethical considerations in embryos, in order to provide beneficial references for embryo management in assisted reproductive technology.

Objective:To review the literature on improving patients′medical experience, analyze the current research status in this field, and provide references for enhancing patients′medical experience.Methods:A search was conducted for studies related to improving patients′medical experience published from January 2015 to November 2024 in eight databases, including CNKI and Web of Science. Using software CiteSpace 6.4.R1 and VOSviewer 1.6.19 to analyze publication trends, keyword clustering, existing problems in the process of improving patients′medical experience, and the measures taken.Results:6 507 articles were included, of which 4 452 were in English (68.4%) and 2 055 were in Chinese (31.6%). The annual number of publications showed a nearly linear growth trend ( R2 = 0.983 9). The clustering analysis results indicated that domestic and international research mainly focused on patient-centered diagnostic and treatment systems, behaviors, services, and environments. Existing studies revealed that there were still problems such as long waiting times for appointments and consultations (292 articles), uneven distribution of medical resources (198 articles), and poor doctor-patient communication (155 articles). To improve patients′medical experience, the following intervention measures were proposed: accelerating the medical reform process and strengthening government responsibilities (169 articles); enhancing service concepts and innovating service models (363 articles); optimizing the consultation process and simplifying medical procedures (221 articles); improving the consultation environment and optimizing the facilities in the consultation area (181 articles); and integrating technological advantages to cover the entire medical process (346 articles). Conclusions:Research on improving patients' medical experience was increasingly attracting the attention of more and more scholars. Issues such as low service efficiency, unbalanced resource allocation, and poor doctor-patient communication need to be given special attention. In the future, it is recommended to enhance the experience of patients′ medical experience by strengthening policy and institutional guarantees, accelerating the construction of information technology, improving doctor-patient communication skills and humanistic care, and enhancing the capacity of primary medical services.

This study aims to prepare altrenogest extended-release tablets,evaluate their quality and establish a content determination method.The hydrophilic gel skeleton type,dosage and core thick-ness of altrenogest extended-release tablets were used as the investigating factors,and the release degree of the tablets was used as the investigating index,the prescription process of altrenogest ex-tended-release tablets was optimized by one-factor screening and central combinatorial design re-sponse surface method,and quality evaluation was carried out,the in vitro release model was es-tablished,and a high-performance liquid chromatography(HPLC)assay method was set up for the determination of altrenogest extended-release tablets.The results showed that the optimal pre-scription of altrenogest extended-release tablets was 2％as the main drug,70％as the solubilizer,0.5％as the lubricant,19.1％as the filler,8.4％as the hydrophilic gel skeleton material,and the thickness of the tablets was 3.8 mm.The in vitro drug release conformed to the Higuchi model,and the altrenogest showed a good linear relationship with the R2=0.999 98 in the range of 10-80 mg/L.The optimized process for the extended-release tablets was stable and had a good quality.The extended-release tablets were stable and had significant slow-release effect.The HPLC method is accurate and reliable and can be used for the determination of altrenogest in extended-release tablets.

To describe and evaluate the clinical studies of postoperative pain sensitization caused by sleep deprivation through the evidence map system, understand the distribution of evidence in this field, and provide reference for subsequent evidence research.

Objective To investigate the microbiota composition and diversity between autogenous and anautogenous Culex pipiens pallens, so as to provide insights into unraveling the pathogenesis of autogeny in Cx. pipiens pallens. Methods Autogenous and anautogenous adult Cx. pipiens pallens samples were collected at 25 ℃, and the hypervariable regions of the microbial 16S ribosomal RNA (16S rRNA) gene was sequenced on the Illumina NovaSeq 6000 sequencing platform. The microbiota abundance and diversity were evaluated using the alpha diversity index, and the difference in the microbiota structure was examined using the beta diversity index. The microbiota with significant differences in the abundance between autogenous and anautogenous adult Cx. pipiens pallens samples was identified using the linear discriminant analysis effect size (LEfSe). Results The microbiota in autogenous and anautogenous Cx. pipiens pallens samples belonged to 18 phyla, 28 classes, 70 orders, 113 families, and 170 genera, and the dominant phyla included Proteobacteria, Bacteroidetes, and so on. At the genus level, Wolbachia was a common dominant genus, and the relative abundance was (77.6 ± 11.3)% in autogenous Cx. pipiens pallens samples and (47.5 ± 8.5)% in anautogenous mosquito samples, while Faecalibaculum (0.4% ± 0.1%), Dubosiella (0.5% ± 0.0%) and Massilia (0.5% ± 0.1%) were specific species in autogenous Cx. pipiens pallens samples. Alpha diversity analysis showed that higher Chao1 index and ACE index in autogenous Cx. pipiens pallens samples than in anautogenous samples (both P values > 0.05), and lower Shannon index (P > 0.05) and Simpson index (P < 0.05) in autogenous Cx. pipiens pallens samples than in anautogenous samples. LEfSe analysis showed a total of 48 significantly different taxa between autogenous and anautogenous Cx. pipiens pallens samples (all P values < 0.05). Conclusion There is a significant difference in the microbiota diversity between autogenous and anautogenous Cx. pipiens pallens.

Objective To investigate the relationship between peripheral blood immunoglobulin,erythrocyte sedimentation rate(ESR),homocysteine(Hey)and the severity of central nervous system vasculitis(CNSV)in children,as well as its impact on prognosis.Methods A total of 103 children with CNSV from February 2018 to February 2023 were selected as the study group,and 103 healthy children as the control group.The peripheral blood levels of immunoglobulin A(IgA),immunoglobulin G(IgG),immunoglobulin M(IgM),ESR and Hcy were compared between the 2 groups to evaluate the relationship between each index and the degree of CNSV disease[Birmingham vasculitis disease activity score(BVAS)]and its predictive value for prognosis.Results The levels of peripheral blood IgA,IgG,IgM,ESR and Hcy in the study group were higher than those in the control group of healthy children(P＜0.05);the BVAS scores and the levels of peripheral blood IgA,IgG,IgM,ESR and Hcy in children with active disease were higher than those in children with inactive disease(P＜0.05);the levels of peripheral blood IgA,IgG,IgM,ESR and Hcy were positively correlated with the BVAS scores in children with CNSV(P＜0.05);two cases were lost to follow-up after 6 months.Among the children with CNSV,76 had good prognosis and 25 poor prognosis.The levels of peripheral blood IgA,IgG,IgM,ESR and Hcy in children with poor prognosis were higher than those in children with good prognosis(P＜0.05);before and after correcting for other factors,peripheral blood IgA,IgG,IgM,ESR and Hcy were all independent factors affecting the prognosis of children with CNSV(P＜0.05);the area under curve(AUC)of peripheral blood IgA,IgG,IgM,ESR and Hey for predicting the prognosis of children with CNSV was 0.747,0.808,0.841,0.839,and 0.746,respectively,with optimal cutoff values of 350.58 mg/dL,1513.06 mg/dL,124.84 mg/dL,51.22 mm/h,and 13.66 pmol/L,respectively;the AUC of peripheral blood IgA,IgG,IgM,ESR and Hey for jointly predicting the prognosis of children with CNSV was 0.943(95％CI 0.878-0.979),with a sensitivity of 92.00％and a specificity of 93.42％,which was superior to individual prediction of each indicator.Conclusion Peripheral blood IgA,IgG,IgM,ESR and Hey are positively correlated with the severity of CNSV.Abnormally high expression increases the risk of poor prognosis,and the combined predictive value is reliable.