The recombinant human thyroid-stimulating hormone (rhTSH) can be used for differentiated thyroid cancer (DTC) preparation before ¹³¹I therapy, and follow-up. Since its approval by the American Food and Drug Administration (FDA) in 1998, rhTSH has been clinically used in European countries, the United States, and other countries for nearly 30 years. In April 2024, China’s first independently developed rhTSH agent was approved. Based on clinical experience and evidence from domestic and international studies, an expert consensus on the application of rhTSH has been developed following thorough consultations among experts. The consensus offers evidence-based recommendations to guide the appropriate use of rhTSH in clinical practice.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

OBJECTIVE To investigate the effects and potential mechanism of paeoniflorin on oxidative stress of ulcerative colitis(UC)mice based on adenosine monophosphate-activated protein kinase(AMPK)/nuclear factor-erythroid 2-related factor 2(Nrf2)pathway.METHODS Male BALB/c mice were randomly divided into control group,model group,inhibitor group(AMPK inhibitor Compound C 20 mg/kg),paeoniflorin low-,medium-and high-dose groups(paeoniflorin 12.5,25,50 mg/kg),high-dose of paeoniflorin+inhibitor group(paeoniflorin 50 mg/kg+Compound C 20 mg/kg),with 8 mice in each group.Except for the control group,mice in all other groups were given 4%dextran sulfate sodium solution for 5 days to establish the UC model.Subsequently,mice in each drug group were given the corresponding drug solution intragastrically or intraperitoneally,once a day,for 7 consecutive days.The changes in body weight of mice were recorded during the experiment.Twenty-four hours after the last administration,colon length,malondialdehyde(MDA)content,and activities of superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)in colon tissues were measured;histopathological morphology of colon tissues,tight junctions between intestinal epithelial cells,and histopathological scoring were all observed and evaluated;the mRNA expressions of AMPK and Nrf2,as well as the protein expressions of heme oxygenase-1(HO-1),occludin and claudin-1,were all determined in colon tissue.RESULTS Compared with model group,paeoniflorin groups exhibited recovery from pathological changes such as inflammatory cell infiltration and crypt damage in the colon tissue,as well as improved tight junction damage between intestinal epithelial cells.Additionally,significant increases or upregulations were observed in body weight,colon length,activities of SOD and GSH-Px,phosphorylation level of AMPK,and protein expression of Nrf2,HO-1,occludin,claudin-1,and mRNA expressions of AMPK and Nrf2;concurrently,MDA content and histopathological scores were significantly reduced(P＜0.05 or P＜0.01).In contrast,the inhibitor group showed comparable(P＞0.05)or worse(P＜0.05 or P＜0.01)indicators compared to the model group.Conversely,the addition of AMPK inhibitor could significantly reverse the improvement of high-dose paconiflorin(P＜0.01).CONCLUSIONS Paeoniflorin can repair intestinal epithelial cell damage in mice,improve tight junctions between epithelial cells,upregulate the expression of related proteins,and promote the expression and secretion of antioxidant-promoting molecules,thereby ameliorating UC;its mechanism may be associated with activating AMPK/Nrf2 antioxidant pathway.

Objective:To identify the relevant factors for the first-course remission of acute myeloid leukemia (AML) and to develop a predictive model as well as assess its predictive capability.Methods:Clinical data of 749 patients newly diagnosed with AML admitted to the Department of Hematology, the First Affiliated Hospital, Zhejiang University, School of Medicine from January 1, 2019, to April 30, 2023, were collected and randomly divided into training and validation sets. Multivariate logistic regression analysis was conducted to determine variables associated with complete remission in the first course of induction therapy, and a predictive model was established based on these variables. The receiver operating characteristic (ROC) curve of the predictive model was plotted, and the area under the curve (AUC) was calculated.Results:The indicators predicting the first remission course included peripheral blood white blood cell count during onset, CBF::MYH11 fusion gene, CEBPA bZIP region mutation, myelodysplastic syndrome-related gene mutation, and induction chemotherapy regimen selection as independent factors for the first remission course. The model’s area under the training and validation curves was 0.738 (95% CI: 0.696-0.780) and 0.726 (95% CI: 0.650-0.801), respectively. The Hosmer-Lemeshow test results yielded P-values of 0.993 and 0.335, respectively. Conclusion:In this study, the developed model demonstrates a strong predictive capability for the efficacy of the first course of patients with AML, providing valuable guidance to clinicians in assessing patient prognosis and selecting appropriate treatment strategies.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To establish a set of reasonable,reliable and easy-to-operate evaluation index system for the clinical application of ventilators,so as to carry out all-round clinical evaluation for application of ventilators.Methods:A research group on the evaluation index system for the clinical application of ventilators was formed by 5 clinical engineers,who came from the Department of Medical Engineering of the First Affiliated Hospital of Zhejiang University School of Medicine,to form a primary evaluation index system for the clinical application of ventilators through literature review and internal discussion,and invited 14 experts from different provinces and cities engaged in respiratory therapy or ventilator maintenance management,after two rounds of online discussion and optimization,the importance scores of each evaluation index were obtained by the Delphi method,and the relative importance of each evaluation index was calculated by analytic hierarchy process.An evaluation index system for the clinical application of ventilators was established from three dimensions:technical performance,clinical effect and after-sales service.The ventilators of brand A and brand B used in the hospital during the same period were selected,and the clinical application of the two different brands of ventilators was compared and evaluated by using the evaluation index system.Results:The constructed evaluation index system for clinical application of ventilator included 3 first-level indicators(technical performance,clinical effect and after-sale service),and 8 second-level indicators and 35 third-level indicators.The combined weight of indicators showed that the ratio of importance of"technical performance"of the first-level indicators accounted for more than half,and the relatively important indicators in the second-level indicators were successively design for safety,static performance,reliability,service quality and applicability.The comprehensive average score of ventilator A was 4.468 points,and that of ventilator B was 4.117 points.The overall performance of ventilator A was better than that of ventilator B in the evaluation of this round,which was consistent with the actually clinical application of the two ventilators.Conclusion:The evaluation index system for clinical application of ventilator can conduct comprehensive evaluation for the effect of clinical application of various kinds of ventilators,and clarify the advantages and disadvantages of various kinds of ventilators,and provide reference basis for medical institutions in selecting ventilator's brands,and for manufacturers in improving product's performance.

Objective:To establish a set of reasonable,reliable and easy-to-operate evaluation index system for the clinical application of ventilators,so as to carry out all-round clinical evaluation for application of ventilators.Methods:A research group on the evaluation index system for the clinical application of ventilators was formed by 5 clinical engineers,who came from the Department of Medical Engineering of the First Affiliated Hospital of Zhejiang University School of Medicine,to form a primary evaluation index system for the clinical application of ventilators through literature review and internal discussion,and invited 14 experts from different provinces and cities engaged in respiratory therapy or ventilator maintenance management,after two rounds of online discussion and optimization,the importance scores of each evaluation index were obtained by the Delphi method,and the relative importance of each evaluation index was calculated by analytic hierarchy process.An evaluation index system for the clinical application of ventilators was established from three dimensions:technical performance,clinical effect and after-sales service.The ventilators of brand A and brand B used in the hospital during the same period were selected,and the clinical application of the two different brands of ventilators was compared and evaluated by using the evaluation index system.Results:The constructed evaluation index system for clinical application of ventilator included 3 first-level indicators(technical performance,clinical effect and after-sale service),and 8 second-level indicators and 35 third-level indicators.The combined weight of indicators showed that the ratio of importance of"technical performance"of the first-level indicators accounted for more than half,and the relatively important indicators in the second-level indicators were successively design for safety,static performance,reliability,service quality and applicability.The comprehensive average score of ventilator A was 4.468 points,and that of ventilator B was 4.117 points.The overall performance of ventilator A was better than that of ventilator B in the evaluation of this round,which was consistent with the actually clinical application of the two ventilators.Conclusion:The evaluation index system for clinical application of ventilator can conduct comprehensive evaluation for the effect of clinical application of various kinds of ventilators,and clarify the advantages and disadvantages of various kinds of ventilators,and provide reference basis for medical institutions in selecting ventilator's brands,and for manufacturers in improving product's performance.

Objective:To identify the relevant factors for the first-course remission of acute myeloid leukemia (AML) and to develop a predictive model as well as assess its predictive capability.Methods:Clinical data of 749 patients newly diagnosed with AML admitted to the Department of Hematology, the First Affiliated Hospital, Zhejiang University, School of Medicine from January 1, 2019, to April 30, 2023, were collected and randomly divided into training and validation sets. Multivariate logistic regression analysis was conducted to determine variables associated with complete remission in the first course of induction therapy, and a predictive model was established based on these variables. The receiver operating characteristic (ROC) curve of the predictive model was plotted, and the area under the curve (AUC) was calculated.Results:The indicators predicting the first remission course included peripheral blood white blood cell count during onset, CBF::MYH11 fusion gene, CEBPA bZIP region mutation, myelodysplastic syndrome-related gene mutation, and induction chemotherapy regimen selection as independent factors for the first remission course. The model’s area under the training and validation curves was 0.738 (95% CI: 0.696-0.780) and 0.726 (95% CI: 0.650-0.801), respectively. The Hosmer-Lemeshow test results yielded P-values of 0.993 and 0.335, respectively. Conclusion:In this study, the developed model demonstrates a strong predictive capability for the efficacy of the first course of patients with AML, providing valuable guidance to clinicians in assessing patient prognosis and selecting appropriate treatment strategies.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.