Transfusion and Anemia Expertise Initiative-Control/Avoidance of Bleeding developed a strategy for platelet and plasma infusion management in critically ill children based on systematic reviews and consensus meetings of international multidisciplinary experts. One good practice statement and six expert consensus statements were proposed for plasma and platelet transfusions in critically ill children following severe trauma, traumatic brain injury, and/or intracranial hemorrhage. This article introduces the specific methods and basis for the formation of recommendations in this part of the guide.

OBJECTIVE To investigate the clinical characteristics of euglycemic diabetic ketoacidosis （euDKA） induced by empagliflozin， and provide references for safe medication. METHODS Case reports of euDKA induced by empagliflozin were retrieved and analyzed from PubMed， Web of Science， CNKI， and Wanfang Data. The Naranjo’s scale was adopted to assess the causal relationship between empagliflozin and euDKA. RESULTS A total of 29 patients were enrolled， including 16 males and 13 females，with a median age of 58 years. All patients were diagnosed with type 2 diabetes mellitus； 22 patients had at least one comorbidity. The median time to euDKA onset was 60 days after administration， and 7 cases occurred within 2 weeks of treatment. Perioperative periods，fasting，and low-carbohydrate or ketogenic diets were the main predisposing factors. Common presentations included nausea，vomiting， fatigue， tachypnea，and tachycardia. The causal relationship between empagliflozin and euDKA was assessed as “probable” in all cases. According to adverse reaction severity grading， 13 cases were grade 3 （severe） and 16 cases were grade 4 （life-threatening）. All patients discontinued empagliflozin and recovered after corresponding treatment. CONCLUSIONS euDKA is a serious adverse reaction to empagliflozin， which mostly occurs early in treatment. Perioperative periods， fasting， and ketogenic diets are prone to induce euDKA. Elderly patients and those with comorbidities are at higher risk. Risk assessment should be conducted before clinical administration； blood ketones and acid-base monitoring should be strengthened in the early medication period； withhold the drug before elective surgery， avoid prolonged fasting；upon diagnosis， discontinue empagliflozin and initiate intravenous insulin， provide fluid resuscitation promptly， and use other treatments to improve patient prognosis.

Objective To analyze the epidemiological burden of age-related macular degeneration(AMD)in China and low-,middle-,and high-socio-demographic index(SDI)countries,thereby providing a theoretical foundation for the prevention and control of AMD.Methods The data published by Global Burden of Disease(GBD)from 1990 to 2021,in-cluding the number of cases,prevalence,disability-adjusted life years(DALYs),and DALYs rate,were utilized to analyze the characteristics of AMD in China and low-,middle-,and high-SDI countries and assess the burden of AMD and its corre-lation with SDI.Results In 2021,the number of patients with AMD and DALYs in China ranked first in the world.Be-sides,the age-standardized prevalence rate(ASPR)and age-standardized DALYs rate(ASDR)in China ranked 46th and 64th in the world,respectively.The number of patients with AMD and DALYs in high-SDI countries were significantly lower than those in middle-and low-SDI countries.The ASPR and ASDR in China were higher than those in high-SDI countries but lower than those in low-SDI countries,and both exceeded the global averages.The prevalence of AMD among people aged 55 years and above was significantly higher.In high-SDI countries,the highest prevalence of AMD was observed a-mong people aged 80 years or above.The prevalence of AMD in China and middle-SDI countries peaked among people aged 65-69 years;whereas that in low-SDI countries peaked among people aged 75-79 years.The AMD burden in females was significantly higher than that in males.The global number of AMD patients exhibited an increasing trend from 1990 to 2021,with the fastest increase observed in China(3.11-fold).The ASPR in China showed a wave-like increasing trend,while that in low-,middle-,and high-SDI countries showed a decreasing trend during the same period.The overall DALY showed an increasing trend,and the increase in the DALYs in China(2.84-fold)exceeded that in low-,middle-,and high-SDI countries.However,the overall ASDR declined,with the most significant decline observed in high-SDI countries.The AS-DR in China has recently rebounded after a wave-like decline from 1990 to 2021.The analysis results of the slope index of inequality(SII)and concentration index(CI)showed that the gap in the AMD burden between high-income and low-in-come countries widened progressively from 1990 to 2021,with the burden being more severe in low-SDI countries.Conclu-sion In 2021,the number of patients with AMD and DALYs in China ranked first in the world.The overall disease burden of AMD in China was between that of high-and low-SDI countries but was higher than global averages.The prevalence of AMD among people aged 55 years and above was significantly higher,and the burden was higher for females than for males.From 1990 to 2021,the number of patients with AMD and the prevalence of this disease in China exhibited an in-creasing trend,while those in low-,middle-,and high-SDI countries showed a decreasing trend.The overall DALYs in-creased,while the overall ASDR decreased.The gap in the AMD burden between high-income and low-income countries widened,and the burden was more severe in low-SDI countries.It was concluded that the burden of AMD was closely re-lated to age,gender,and SDI,and that its distribution characteristics and trends should be considered in the formulation of prevention and control strategies.

Objective To assess the global,regional,and national burdens of eye cancer between 1990 and 2021,examine its change trends with the age,sex,geographic location,and socio-demographic index(SDI)level,and provide scientific evidence for the development of eye cancer prevention and control strategies.Methods Based on the data from the Global Burden of Disease(GBD)study,the global burden of eye cancer was evaluated using the indicator system inclu-ding incidence,prevalence,mortality,and disability-adjusted life years(DALYs).The change trend of the burden of eye cancer with time was quantified with Join-point regression.Frontier analysis methods were used to evaluate the relationship between the burdens of eye cancer with SDI.Results From 1990 to 2021,the global incidence,age-standardized inci-dence rate(ASIR),prevalence and age-standardized prevalence rate(ASPR)of eye cancer showed an upward trend over time.Conversely,the mortality,age-standardized mortality rate(ASMR),DALYs,and age-standardized DALY rate(ASDR)declined during the same period.All the above indicators in males were higher than those in females.Regionally,Eastern Sub-Saharan Africa bore the highest disease burden,while Oceania had the lowest.It should be noted that East Asia experienced the most significant increase in ASIR,and Southern Sub-Saharan Africa showed the greatest rise in ASPR.Meanwhile,Southern Latin America demonstrated the most pronounced decrease in both ASIR and ASPR.East Asia also re-corded the largest reductions in ASMR and ASDR.At the national level,Malawi had the highest disease burden in 2021.To-kelau exhibited the most substantial increase while Norway showed the greatest decrease in disease burden.Age-specific analysis revealed a bimodal distribution,with children under 5 years and adults over 80 being the most affected groups.Furthermore,SDI-based analysis indicated a wave-like relationship between SDI and ASIR/ASPR,and both ASMR and AS-DR declined with the increasing SDI.Conclusion The global burden of eye cancer shows a decline trend generally.The difference in the burden of eye cancer between regional and national levels may be related to medical resource allocation and public health policies.The results of this study provide scientific evidence for the development of tailored eye cancer prevention and control strategies.It is recommended that more attention should be paid to high-burden regions,resource distribution should be optimized,early screening should be enhanced,and targeted interventions for different age and gen-der groups should be implemented.

Ocular trauma is a leading cause of permanent visual impairment and loss of working a-bility.Among them,orbital foreign body injuries are often accompanied by multiple injuries to the eye-ball and surrounding tissues,adversely affecting the quality of life.This paper reported a 33-year-old male patient with right orbital foreign body resulting in eyeball contusion,extraocular muscle injury,and restricted ocular movement.After surgical removal of the foreign body combined with integrated traditional Chinese and western medicine treatment,the patient's visual acuity improved from 0.4 to 0.8,and ocular motility function significantly improved.This suggests that comprehensive treatment contributes to promoting functional recovery and enhancing clinical efficacy.

Objective:To analyze the main chemical components of Lanqin Granules based on UPLC-Q-TOF-MS/MS; To explore the potential targets, core components and related pathways of Lanqin Granules in the treatment of respiratory tract infection through network pharmacology.Methods:Using UPLC-Q-TOF-MS/MS secondary fragment cleavage information, combined with literature and database, the chemical components of Lanqin Granules were analyzed; the related action targets of Lanqin Granules were obtained by PharmMapper; The related targets of respiratory tract infection were obtained from GeneCards and OMIM databases, and the common targets were selected by intersection with the relevant action targets of Lanqin Granules. The common targets were imported into string database, and the protein interaction data were downloaded and input into Cytoscape 3.7.2 software to obtain hub gene; Go function and KEGG pathway enrichment analysis were carried out on DAVID platform, and chemical components closely related to hub gene were obtained by using the Network Anlyzer plug-in.Results:53 chemical constituents of Lanqin Granules were obtained, including 11 alkaloids, 20 flavonoids, 5 terpenoids, 7 organic esters, 2 amino acids and 8 other compounds. 28 hub genes and 38 related core components were obtained. The results of GO analysis showed that the treatment of respiratory tract infection with Lanqin Granules was related to neutrophil degranulation, negative regulation of apoptosis, protein hydrolysis and other biological processes; extracellular exosomes, cytoplasm, extracellular components and other cellular components; the same protein binding, RNA polymerase Ⅱtranscription factor activity, ligand activated sequence specific DNA binding, protein serine/ threonine/ tyrosine kinase activity and other molecular processes. KEGG analysis results mainly involved cancer pathway, lipid and atherosclerosis, metabolic pathway and other signaling pathways.Conclusion:Lanqin Granules can treat respiratory tract infection through multi-component, multi-target and multi-channel, and play the role of anti-inflammatory, antibacterial and anti-virus.

Objective To assess the global,regional,and national burdens of eye cancer between 1990 and 2021,examine its change trends with the age,sex,geographic location,and socio-demographic index(SDI)level,and provide scientific evidence for the development of eye cancer prevention and control strategies.Methods Based on the data from the Global Burden of Disease(GBD)study,the global burden of eye cancer was evaluated using the indicator system inclu-ding incidence,prevalence,mortality,and disability-adjusted life years(DALYs).The change trend of the burden of eye cancer with time was quantified with Join-point regression.Frontier analysis methods were used to evaluate the relationship between the burdens of eye cancer with SDI.Results From 1990 to 2021,the global incidence,age-standardized inci-dence rate(ASIR),prevalence and age-standardized prevalence rate(ASPR)of eye cancer showed an upward trend over time.Conversely,the mortality,age-standardized mortality rate(ASMR),DALYs,and age-standardized DALY rate(ASDR)declined during the same period.All the above indicators in males were higher than those in females.Regionally,Eastern Sub-Saharan Africa bore the highest disease burden,while Oceania had the lowest.It should be noted that East Asia experienced the most significant increase in ASIR,and Southern Sub-Saharan Africa showed the greatest rise in ASPR.Meanwhile,Southern Latin America demonstrated the most pronounced decrease in both ASIR and ASPR.East Asia also re-corded the largest reductions in ASMR and ASDR.At the national level,Malawi had the highest disease burden in 2021.To-kelau exhibited the most substantial increase while Norway showed the greatest decrease in disease burden.Age-specific analysis revealed a bimodal distribution,with children under 5 years and adults over 80 being the most affected groups.Furthermore,SDI-based analysis indicated a wave-like relationship between SDI and ASIR/ASPR,and both ASMR and AS-DR declined with the increasing SDI.Conclusion The global burden of eye cancer shows a decline trend generally.The difference in the burden of eye cancer between regional and national levels may be related to medical resource allocation and public health policies.The results of this study provide scientific evidence for the development of tailored eye cancer prevention and control strategies.It is recommended that more attention should be paid to high-burden regions,resource distribution should be optimized,early screening should be enhanced,and targeted interventions for different age and gen-der groups should be implemented.

Objective To analyze the epidemiological burden of age-related macular degeneration(AMD)in China and low-,middle-,and high-socio-demographic index(SDI)countries,thereby providing a theoretical foundation for the prevention and control of AMD.Methods The data published by Global Burden of Disease(GBD)from 1990 to 2021,in-cluding the number of cases,prevalence,disability-adjusted life years(DALYs),and DALYs rate,were utilized to analyze the characteristics of AMD in China and low-,middle-,and high-SDI countries and assess the burden of AMD and its corre-lation with SDI.Results In 2021,the number of patients with AMD and DALYs in China ranked first in the world.Be-sides,the age-standardized prevalence rate(ASPR)and age-standardized DALYs rate(ASDR)in China ranked 46th and 64th in the world,respectively.The number of patients with AMD and DALYs in high-SDI countries were significantly lower than those in middle-and low-SDI countries.The ASPR and ASDR in China were higher than those in high-SDI countries but lower than those in low-SDI countries,and both exceeded the global averages.The prevalence of AMD among people aged 55 years and above was significantly higher.In high-SDI countries,the highest prevalence of AMD was observed a-mong people aged 80 years or above.The prevalence of AMD in China and middle-SDI countries peaked among people aged 65-69 years;whereas that in low-SDI countries peaked among people aged 75-79 years.The AMD burden in females was significantly higher than that in males.The global number of AMD patients exhibited an increasing trend from 1990 to 2021,with the fastest increase observed in China(3.11-fold).The ASPR in China showed a wave-like increasing trend,while that in low-,middle-,and high-SDI countries showed a decreasing trend during the same period.The overall DALY showed an increasing trend,and the increase in the DALYs in China(2.84-fold)exceeded that in low-,middle-,and high-SDI countries.However,the overall ASDR declined,with the most significant decline observed in high-SDI countries.The AS-DR in China has recently rebounded after a wave-like decline from 1990 to 2021.The analysis results of the slope index of inequality(SII)and concentration index(CI)showed that the gap in the AMD burden between high-income and low-in-come countries widened progressively from 1990 to 2021,with the burden being more severe in low-SDI countries.Conclu-sion In 2021,the number of patients with AMD and DALYs in China ranked first in the world.The overall disease burden of AMD in China was between that of high-and low-SDI countries but was higher than global averages.The prevalence of AMD among people aged 55 years and above was significantly higher,and the burden was higher for females than for males.From 1990 to 2021,the number of patients with AMD and the prevalence of this disease in China exhibited an in-creasing trend,while those in low-,middle-,and high-SDI countries showed a decreasing trend.The overall DALYs in-creased,while the overall ASDR decreased.The gap in the AMD burden between high-income and low-income countries widened,and the burden was more severe in low-SDI countries.It was concluded that the burden of AMD was closely re-lated to age,gender,and SDI,and that its distribution characteristics and trends should be considered in the formulation of prevention and control strategies.

Objective To investigate the correlation between the expression levels of serum calcitonin gene related peptide(CGRP),macrophage clearance receptor 1(Msr1)and pulmonary function and blood gas inde-xes in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A to-tal of 114 patients with chronic obstructive pulmonary disease(COPD)who visited the hospital from June 2019 to June 2021 were selected as study subjects,including 47 patients with AECOPD as AECOPD group and 67 patients with stable condition as COPD stable group.The gender,body mass index(BMI),age,smoking history,white blood cell count(WBC),pulmonary function index[ratio of forced expiratory volume in the first second to forced vital capacity(FEV1/FVC),and percentage of forced expiratory volume in the first sec-ond to predicted value(FEV1％pred)],blood gas indexes[arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2)]and other basic data of patients were collected,114 healthy volun-teers who were examined in the hospital at the same time were selected as the control group.The levels of ser-um CGRP and Msr1 were detected by enzyme-linked immuno sorbent assay(ELISA).The correlation be-tween the expression levels of CGRP and Msr1 in serum of patients with AECOPD and lung function and blood gas indexes was analyzed.The diagnostic value of CGRP and Msr1 expression levels in AECOPD was analyzed by receiver operating characteristic(ROC)curve.Multivariate Logistic regression was used to ana-lyze the influencing factors of AECOPD.Results The proportion of smoking history,WBC and PaCO2 levels in AECOPD group were higher than those in stable COPD group and control group,PaO2,FEV1/FVC and FEV1％pred levels were lower in stable COPD group and control group,and the differences were statistically significant(P＜0.05).The levels of serum CGRP and Msr1 in the control group,stable COPD group and AE-COPD group increased in turn,the differences were statistically significant(P＜0.05).Serum CGRP and Msr1 expression levels in AECOPD patients were positively correlated with smoking history,WBC and PaCO2(P＜0.05),and negatively correlated with PaO2,FEV1/FVC,FEV1％pred(P＜0.05).The area under the curve(AUC)of the combination of CGRP and Msr1 in the diagnosis of AECOPD was 0.927(95％CI:0.863-0.967),which was greatly higher than that of single detection of CGRP and Msr1(Z combination vs.cGRP=2.417,P=0.016;Z combination vs.Msr1=2.3 84,P=0.017).Smoking history,CGRP and Msr1 were risk factors for AECOPD in COPD patients(P＜0.05),FEV1/FVC and FEV1％pred were protective factors(P＜0.05).Conclusion CGRP and Msr1 are highly expressed in the serum of patients with AECOPD.Both of them are closely related to the lung function and blood gas indexes of patients,and have certain value in clinical diagno-sis of AECOPD.

Objective To investigate the relationship between Fat Mass- and obesity-associated gene (FTO) polymorphisms and the susceptibility of non-alcohol-related fatty liver disease (NAFLD) in a Han population from Qingdao region of China. Methods A total of 119 NAFLD patients were recruited from Qingdao Municipal Hospital and Chengyang District People's Hospital and 187 control individuals who received annual physical examination were also included. Their clinicopathological information and study questionnaire were collected. Their fasting venous blood was extracted for biochemical analyses and FTO polymorphism genotyping using the polymerase chain reaction combined with DNA sequencing. The data were statistically assessed. Results The data showed statistically significant differences in age, BMI, ALT, GGT, TG and Bil between NAFLD patients and normal controls (all P < 0.05). FTO polymorphism genotyping data showed three genotypes of FTO rs1421085 (TT, CT, and CC), rs8050136 (TT, CT, and CC) and rs9939609 (TT, AT, AA). However, there was no statistical difference in both allele frequency and genotype of FTO rs1421085, rs9939609, and rs8050136 between NAFLD and controls (all P > 0.05) and there was also no statistical difference in clinical parameters among these genotype carriers (all P > 0.05). Conclusion NAFLD patients showed significantly statistical differences in age, BMI, ALT, GGT, TG, and BIL vs. those of normal controls. However, this study did not find any association of FTO rs1421085, rs9939609, and rs8050136 polymorphisms with NAFLD susceptibility in this Qingdao region of Han Chinese population.