Objective: To evaluate the methodological quality and reporting quality of clinical practice guidelines or expert consensus on blood transfusion and blood use (BTBU) in China (hereinafter referred to as "guidelines/consensus"), providing reference for the development and updating of future BTBU guidelines/consensus. Methods: A systematic search was conducted in Chinese databases such as China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP Data-base, relevant guideline release platforms, and professional association websites. BTBU-related guidelines/consensus published between January 2006 and December 2025 were included. According to the inclusion and exclusion criteria, after completing literature screening and data extraction, three evaluators independently assessed the quality of the included literature using the Scientificity, Transparency, and Applicability of Guidelines Rating Tool (STAR), the Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ), and the International Practice Guideline Reporting Standards (RIGHT). Results: A total of 29 documents were included, including 5 guidelines, 22 consensus statements, and 2 protocols. The results of the STAR assessment showed that the total score was (21.7±8.8)%. The domain score ratios for registration, research protocol, funding, working group, conflict of interest, clinical question, evidence, consensus method, recommendation, accessibility and other domains were (2.2±12.1)%, 0, (36.7±25.1)%, (18.3±7.6)%, (19.2±15.3)%, (16.6±23.1)%, (15.1±6.3)%, (9.6±21.2)%, (54.3±18.4)%, (31.7±10.4)% and (10.3±31.0)%, respectively. For the AGREE Ⅱ assessment, the methodological quality of 26 articles was rated Grade B and 3 articles Grade C. The results of the RIGHT assessment indicated that the overall reporting rate of all guidelines/consensuses was (65.3±4.0)%. Conclusion: The methodological and reporting quality of current expert guidelines/consensus on BTBU in China still need improvement, and guidelines and consensus should be strictly formulated and standardized according to the standards of STAR, AGREE II and RIGHT.

Objective To observe the effects of auricular point sticking on chronic soft tissue injury of knee joint caused by military training.Methods A total of 77 patients with chronic soft tissue injury of the knee caused by military training admitted to No.901 Hospital of Joint Logistics Support Force from January to November 2022 were enrolled in this study.Auricular point sticking therapy was applied in all the patients.Visual analogue scale(VAS)score,the range of motion of the knees and knee temperature were recorded before and after treatment.Results The VAS score was 6.10±1.23,3.03±0.95,and 2.70±0.93 before treatment,15 min and 24 h after treatment,respectively.The VAS score after treatment were significantly lower than that before treatment(P<0.01).The range of motion of the knees was(79.08±11.59)°,(104.79±8.49)°,and(108.08±9.36)° before treatment,15 min and 24 h after treatment,respectively.The knee flexion after treatment were significantly higher than that before treatment(P<0.01).The knee temperature at 15 min after treatment was significantly higher than that before treatment([30.68±1.38]℃vs.[29.30±1.41]℃,P<0.01).Conclusion Auricular point sticking can reduce the pain of patients with chronic soft tissue injury of the knee and increase the range of joint motion.It is safe and simple and has good compliance.

Tumor metastasis is closely related to high mortality rate of cancer.It is well known that glutamine plays an important role in the malignant progression of cancer.Notably,as an important carbon and nitrogen donor,glutamine has been found to be closely related to tumor metastasis in recent years.Glutamine is not only involved in regulating the proliferation of tumor cells,but is also closely related to the migration and invasion of tumor cells.Furthermore,various enzymes along with transporters in the metabolism of glutamine are involved in the process of tumor metastasis through different signaling pathways.This review provided a summary of the role of glutamine in tumor metastasis in recent years and proposed therapeutic targets to provide new strategies for the clinical treatment of tumor metastases.

Objective:To investigate the therapeutic effects of photodynamic therapy (PDT) on a rat model of ulcerative colitis (UC) induced by Escherichia coli. Methods:Each rat was administered 1 ml of 1×10 9 enteric invasive E. coli to establish an UC model. Thirty-six Sprague Dawley rats were randomly divided into control, model, low-dose LD 4-PDT, medium-dose LD 4-PDT, high-dose LD 4-PDT (60, 120, 240 μg/kg), and levofloxacin (LEV) (100 mg/kg) groups, with six rats in each group. The UC model was established in all groups except the control group, which received 0.9% sodium chloride injection once. The first day of E. coli administration was recorded as day 0, and treatment was initiated on day 7 with LD 4 enema, levofloxacin gavage, and alternating enema/gavage for a total of four times. After a 30-minute exposure to each dose, the colon was irradiated using a 650 nm laser PDT system with an energy density of 25 J/cm 2, while the LEV group was not irradiated. The levels of body mass, colon length, intestinal pathological tissue, inflammatory factors interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), malondialdehyde (MDA), oxidative stress factors myeloperoxidase (MPO), glutathione (GSH), and superoxide dismutase (SOD) were compared among all groups. Results:The body mass and colon length of the model group were lower than those of the control group. The body mass and colon length of the low, medium, and high -dose LD 4-PDT groups and LEV group were higher than those of the model group. Compared to the control group, the model group exhibited more epithelial cell loss, multiple ulcers, infiltration of inflammatory cells into the mucosa and submucosa, and decreased goblet cells. In contrast, the surface mucosa of colon tissue recovered, goblet cells increased, and ulcer healing was good in the low, medium, and high-dose LD 4-PDT groups and LEV group compared to the model group. Compared to the control group, the levels of TNF-α, IL-6, and MPO inflammatory factors were significantly increased in the model group ( all P < 0.001). Compared to the model group, the levels of TNF-α, IL-6, and MPO inflammatory factors in colon tissue from the low, medium, and high -dose LD 4-PDT groups and LEV group were significantly decreased ( P < 0.05, P < 0.001). Compared to the control group, MDA levels were increased, while GSH and SOD levels were decreased in the model group. In contrast, MDA levels in the low, medium, and high-dose LD 4-PDT groups were decreased ( P < 0.05, P < 0.001), while GSH and SOD levels were increased compared to the model group. Conclusions:Low-dose LD 4-PDT promotes the healing of colon mucosa, alleviates inflammation, regulates oxidative stress, and improves symptoms of UC.

Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.

Objective    To evaluate the efficacy of hybrid ablation through compared with thoracoscopic epicardial ablation. Methods    In this study, 108 patients with all long-standing persistent atrial fibrillation (LSPAF) received thoracoscopic epicardial ablation (TEA) after enrollment. There were 82 males and 26 females at age of 56.5±9.4 years. After blanking-period, patients off antiarrhythmic therapy with sinus rhythm were divided into a hybrid ablation (HA) group (50 patients) and a TEA group (58 patients). Only patients in the HA group received catheter ablation after randomization subsequently. In at least two-year observation period, cardiovascular risk factors were observed in all groups’ patients. Results    The mean follow-up duration was 17.3-41.8 (26.9±6.1) months and there was no significant difference between two groups [8.2-40.6 (27.5±5.7) months in the HA group and 17.3-41.8 (26.4±6.7) months in the TEA group]. The off antiarrhythmic agents (AADs) sinus rhythm rate was significantly higher in the HA group than that in the TEA group at the time of postoperative 6, 12, 24 and 36 months ［96.0%, 90.0%, 83.7%, 83.7% versus 79.3%, 75.9%, 67.3%, 63.1%, HR=0.415 (95%CI 0.206-0.923)]. Conclusion    We can conclude that the efficacy of two-staged hybrid ablation for LSPAF is superior to thoracoscopic epicardial ablation alone. Patients can obtain benefit from a supplemental radiofrequency catheter ablation after blanking-period of surgical ablation, instead of those without a supplemental ablation.

Objective:To evaluate the efficacy and safety of domestic recombinant human follicle-stimulating hormone (rhFSH) in assisted reproductive technology (ART) of controlled ovarian hyperstimulation (COH).Methods:In a multicenter, randomized, double-blind, positive, parallel controlled non-inferiority clinical trial, the infertile women with normal ovarian reserve who received ART-COH in six reproductive medical centers from July 2017 to June 2019 were randomly divided into two groups: experimental group (domestic rhFSH, n=134) and control group (imported rhFSH, n=133). Eight subjects were excluded due to various reasons during the experimental process, 7 in experimental group and 1 in control group. At last, 127 subjects in experimental group and 132 subjects in control group complete the experiment following the research protocol. The total number of oocytes, usage of FSH, fertilization rate of oocytes, the number of high-quality embryos, clinical pregnancy rate, live birth rate, neonatal characteristics and the incidence of adverse reactions were compared between the two groups during the cycle of COH. Results:During the initiation cycle of ovulation induction therapy, the total number of oocytes obtained in experimental group and control group were 13.0±5.8 and 12.9±5.7, respectively, with no statistically significant difference ( P>0.05). Among the 82 intracytoplasmic sperm injection (ICSI) patients, the number of M II oocytes obtained in experimental group (39 cases) was markedly higher than that in control group (43 cases) (9.9±3.9 vs. 7.5±3.0, P=0.003). The fertilization rate of oocytes in experimental group was obviously higher than that in control group [63.82% (1048/1642) vs. 56.19% (958/1705), P<0.001]. There were no significant differences of stimulated duration and dosage of rhFSH, number of high-quality embryos, clinical pregnancy rate, preterm rate, live birth rate, incidence of neonatal abnormalities, neonatal weight or Apgar score between the two groups (all P>0.05). The incidence of ovarian hyperstimulation syndrome and other adverse reactions in treatment period were not significantly different between the two groups (all P>0.05), which were known adverse reaction occurred in the imported rhFSH. Conclusion:The efficacy and safety of domestic rhFSH were the same as that of imported rhFSH in infertile patients with normal ovarian reserve under the same ovarian stimulation regimen.

Objective:To evaluate the efficacy and safety of domestic recombinant human follicle-stimulating hormone (rhFSH) in assisted reproductive technology (ART) of controlled ovarian hyperstimulation (COH).Methods:In a multicenter, randomized, double-blind, positive, parallel controlled non-inferiority clinical trial, the infertile women with normal ovarian reserve who received ART-COH in six reproductive medical centers from July 2017 to June 2019 were randomly divided into two groups: experimental group (domestic rhFSH, n=134) and control group (imported rhFSH, n=133). Eight subjects were excluded due to various reasons during the experimental process, 7 in experimental group and 1 in control group. At last, 127 subjects in experimental group and 132 subjects in control group complete the experiment following the research protocol. The total number of oocytes, usage of FSH, fertilization rate of oocytes, the number of high-quality embryos, clinical pregnancy rate, live birth rate, neonatal characteristics and the incidence of adverse reactions were compared between the two groups during the cycle of COH. Results:During the initiation cycle of ovulation induction therapy, the total number of oocytes obtained in experimental group and control group were 13.0±5.8 and 12.9±5.7, respectively, with no statistically significant difference ( P>0.05). Among the 82 intracytoplasmic sperm injection (ICSI) patients, the number of M II oocytes obtained in experimental group (39 cases) was markedly higher than that in control group (43 cases) (9.9±3.9 vs. 7.5±3.0, P=0.003). The fertilization rate of oocytes in experimental group was obviously higher than that in control group [63.82% (1048/1642) vs. 56.19% (958/1705), P<0.001]. There were no significant differences of stimulated duration and dosage of rhFSH, number of high-quality embryos, clinical pregnancy rate, preterm rate, live birth rate, incidence of neonatal abnormalities, neonatal weight or Apgar score between the two groups (all P>0.05). The incidence of ovarian hyperstimulation syndrome and other adverse reactions in treatment period were not significantly different between the two groups (all P>0.05), which were known adverse reaction occurred in the imported rhFSH. Conclusion:The efficacy and safety of domestic rhFSH were the same as that of imported rhFSH in infertile patients with normal ovarian reserve under the same ovarian stimulation regimen.

Objective:To explore the effect of specialized games combined with bi-cardiac nursing on postoperative complications and caregivers′ emotions in children with hypospadias.Methods:A total of 100 children with hypospadias treated in our hospital from January 2018 to December 2018 were randomly divided into control group and experimental group, 50 cases in each group. The control group was given routine treatment and nursing. The experimental group was given specialized games combined with bi-cardiac nursing intervention. The incidence of complications after operation was compared between the two groups. Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were used to test the main caregivers of the two groups before and after the intervention for 3 months respectively. At the same time, their satisfaction was compared after the intervention.Results:The incidence of complications was 10.00% (5/50) in the study group and 28.00% (14/50) in the control group, the difference between the two groups was statistically significant ( χ2 value was 5.263, P=0.022); after intervention, the scores of SAS and SDS of the caregivers in the study group were 23.35 ± 7.33, 37.06 ± 8.22 respectively, and those in the control group were 32.22 ± 6.70, 40.94 ± 8.95, the difference between the two groups was statistically significant ( t values were 6.316, 2.258, all P<0.05); after the intervention, the satisfaction of the study group was 96.00%(48/50), and that of the control group was 84.00%(42/50). The difference between the two groups was statistically significant ( χ2 value was 4.000, P=0.046). Conclusions:Specialized games combined with bi-centric nursing can reduce the incidence of complications after urethroplasty in children with hypospadias, alleviate the bad mood of the main caregivers and improve nursing satisfaction.

Objective:To explore the imaging rate and diagnostic rate of positioning the fetal conus medullaris by three-dimensional ultrasound method to detect atlantoaxial intervertebral space, comparing it with the traditional two-dimensional and three-dimensional ultrasound methods.Methods:Consecutively 318 singleton fetuses received routine ultrasound screening during the second trimester were enrolled from November 2017 to December 2018 in Shenzhen Luohu People′s Hospital and Shenzhen People′s Hospital. These fetuses included 276 normal cases and 42 abnormal cases. The abnormal group contained 11 cases tethered cords fetuses(tethered cords group) and 31 cases non-tethered fetuses(non-tethered group). A new ultrasound method named detecting atlanto-axial intervertebral space with three-dimensional ultrasound and traditional two-dimensional and three-dimensional ultrasound methods were used to acquire and store the images. The positions of the fetal conus medullaris were analyzed blindly and recorded by three experienced physicians using three different methods with off-line software.Results:①The χ 2 test comparing multiple sample rates was used to compare the imaging acquisition success rate of fetal conus medullaris by three ultrasound methods. The test level was adjusted to be α′=0.05/4=0.0125, the results showed that there were no statistically significant differences between the three methods in the normal group (χ 2=7.39, P=0.025) and the abnormal group (χ 2=5.32, P=0.070). ②The χ 2 test comparing multiple sample rates was used to compare the diagnostic accuracy of fetal conus medullaris position in normal group by three methods, it showed there was no significant difference in the correct rate of conus medullaris position in the normal group (χ 2=2.52, P=0.284). ③The χ 2 test comparing multiple sample rates was used to compare the diagnostic accuracy of the fetal conus medullaris in tethered cord group and non-tethered group using 3 methods, the difference was not statistically significant in tethered cord group (χ 2=1.22, P=0.543), while the difference was statistically significant in non-tethered group(χ 2=9.69, P=0.008). Conclusions:The method of detecting atlanto-axial intervertebral space with three-dimensional ultrasound has a high imaging rate and diagnostic accuracy in positioning the fetal conus medullaris. Positioning of fetal conus medullaris by detecting atlanto-axial intervertebral space with three-dimensional ultrasound is better than traditional two-dimensional and three-dimensional ultrasound in the abnormal non-tethered fetuses, which can provide more valuable information for prenatal diagnosis consultation and prenatal and postnatal care.