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:By analyzing peripheral blood indicators, we constructed and validated a novel lung cancer prediction model using machine learning algorithms for riskassessment of lung cancer.Methods:A retrospective case-control design was conducted on the clinical data of 194 newly diagnosed lung cancer patients [mean age: (66.80±9.09) years, 126 males and 68 females] admitted to Qilu Second Hospital of Shandong University between January 9, 2020, and December 31, 2024, serving as the case group. During the same period, 290 healthy individuals undergoing physical examinations [mean age: (61.18±14.31) years, 155 males and 135 females J were enrolled as the control group. A total of 46 peripheral blood indicators-including routine blood tests, coagulation parameters, liver function markers, and tumor-related indices-along with two basic characteristics (age and sex) were included in the analysis. Eleven machinelearning algorithms including logistic regression, randomforest, support vector classifier, extreme gradient boosting, gradient boosting decision tree, decision tree, multilayer perceptron, linear discriminant analysis, adaptive boosting, Gaussian naive Bayes and light gradient-boosting machine-were trained for early diagnosis of lung-cancer.Model performance was evaluated by the area under the ROC, accuracy, positive predictive value, negative predictive value, F1-score and 95% confidence interval (95% CI). The best performing algorithm was selected, and feature importance was ranked with Shapley Additive Planation(SHAP) values. Results:The support-vector classifier achieved the best performance for predicting lung-cancer risk (AUC=0.974; 95 % CI 0.951-0.989) and was retained for final model establishment. After 20 rounds of stratified 10-fold cross-validation the mean AUC was 0.950; learning-curve, decision-curve and calibration analyses confirmed its superior generalizability, clinical utility and calibration.SHAPley additive explanations and decision-tree feature importance consistently identified neuron-specific enolase, carcinoembryonic antigen, and squamous-cell carcinoma antigen as the three most critical predictors of lung-cancer risk. Conclusion:An SVM-based lung cancer prediction model was successfully established to determine the risk of developing lung cancer.

HDAC7, a member of class IIa HDACs, plays a pivotal regulatory role in tumor, immune, fibrosis, and angiogenesis, rendering it a potential therapeutic target. Nevertheless, due to the high similarity in the enzyme active sites of class IIa HDACs, inhibitors encounter challenges in discerning differences among them. Furthermore, the substitution of key residue in the active pocket of class IIa HDACs renders them pseudo-enzymes, leading to a limited impact of enzymatic inhibitors on their function. In this study, proteolysis targeting chimera (PROTAC) technology was employed to develop HDAC7 drugs. We developed an exceedingly selective HDAC7 PROTAC degrader B14 which showcased superior inhibitory effects on cell proliferation compared to TMP269 in various diffuse large B cell lymphoma (DLBCL) and acute myeloid leukemia (AML) cells. Subsequent investigations unveiled that B14 disrupts BCL6 forming a transcriptional inhibition complex by degrading HDAC7, thereby exerting proliferative inhibition in DLBCL. Our study broadened the understanding of the non-enzymatic functions of HDAC7 and underscored the importance of HDAC7 in the treatment of hematologic malignancies, particularly in DLBCL and AML.

Background and Aims:Radical resection is the only potentially curative treatment for intrahepatic cholangiocarcinoma(ICC),yet the high recurrence rate results in poor prognosis.In recent years,"textbook outcome"(TO)has been proposed as a comprehensive quality metric,but its association with prognosis remains unclear.This study aimed to analyze the risk factors influencing the achievement of TO after radical resection of ICC and to explore the relationship between TO and survival.Methods:A retrospective analysis was conducted on the clinical data of 180 ICC patients who underwent radical resection at the 904th Hospital of the Joint Logistic Support Force of the PLA between February 2018 and February 2023.Univariate and multivariate Logistic regression analyses were performed to identify risk factors associated with TO,and survival analysis was carried out using the Kaplan-Meier method and Log-rank test.Results:Of the 180 patients,66 achieved TO.Multivariate Logistic regression analysis indicated that preoperative total bilirubin＞22 μmol/L,preoperative CA19-9＞35 U/mL,maximum tumor diameter＞5 cm,poor tumor differentiation,microvascular invasion(MVI),and lymph node metastasis were independent risk factors for failing to achieve TO(all P＜0.05).Survival analysis demonstrated that patients who achieved TO had a significantly longer median survival compared with those who did not(36 months vs.16 months,P＜0.001).Conclusion:Preoperative total bilirubin＞22 μmol/L,preoperative CA19-9＞35 U/mL,maximum tumor diameter＞5 cm,poor tumor differentiation,MVI,and lymph node metastasis are independent risk factors for not achieving TO after radical resection of ICC.Patients who achieved TO exhibited markedly longer survival,suggesting that TO not only reflects perioperative treatment quality but also serves as an important prognostic indicator.Greater attention to these risk factors and optimization of perioperative management may improve the likelihood of achieving TO and enhance long-term outcomes.

Objective To study the correlation between expression levels of serum Spexin and Pannexin 1 protein,glucose and lipid metabolism and insulin resistance in elderly patients with diabetic cataract.Methods A total of 118 elderly diabetic cataract patients were selected as the case group,and 103 elderly diabetic non-cataract patients were selected as the control group who were treated in the same hospital during the same period.Serum levels of Spexin and Pannexin1 were detected by enzyme-linked immunosorbent assay(ELISA).Fasting blood glucose(FPG)and glycosylated hemoglobin(HbA1c)were measured.Lipid metabolism related indicators including triacylglycerol(TG),high density lipoprotein cholesterol(HDL-C),total cholesterol(TC)and low density lipoprotein cholesterol(LDL-C)were detected in two groups of patients.Insulin resistance related indexes:fasting insulin(FINS),insulin sensitivity index(ISI),insulin resistance index(HOMA-IR)and islet beta cell function index(HOMA-β)were also detected.The correlation between serum Spexin and Pannexin1 levels,glucolipid metabolism and ISI was detected by Pearson method.Receiver operating characteristic(ROC)curves were used to assess the predictive value of serum Spexin and Pannexin1 levels and their combination in the development of cataract in elderly diabetic patients.Results The level of Spexin was lower in the observation group than that in the control group,and the level of Pannexin1 was higher than that in the control group(P＜0.01).Levels of TG,TC,LDL-C,FPG,HbA1c,FINS and HOMA-IR of the observation group increased compared with the control group,while HDL-C,ISI and HOMA-β levels decreased compared with the control group(P＜0.01).Pearson correlation analysis showed that serum Spexin level was positively correlated with ISI and HOMA-β,and negatively correlated with TG,TC,LDL-C,FPG,HbA1c,FINS and HOMA-IR in elderly patients with diabetic cataract(P＜0.05).Serum Pannexin1 was negatively correlated with ISI and HOMA-β,and positively correlated with TG,TC,LDL-C,FPG,HbA1c,FINS and HOMA-IR(P＜0.05).There was no correlation between the above indexes and HDL-C(P＞0.05).The combination of both serum Spexin and Pannexin1 predicted the development of cataracts in elderly diabetic patients was better than serum Spexin and Pannexin1 assessed individually(Z both combination-Spexin=3.220,P=0.001,Z both combination-Pannexin1=4.838,P＜0.001).Conclusion In elderly patients with diabetic cataract,the expression of serum Spexin decreases and the expression of Pannexin1 increases,and they have a certain correlation with glucose and lipid metabolism and insulin resistance

The global incidence rate of cancer is increasing yearly,and chemotherapy-induced gastrointestinal mucosal injury has become a crucial factor affecting patients'therapeutic prognosis;however,there is currently a lack of effective therapeutic drugs to address this issue.There is thus an urgent need to establish more ideal animal models of chemotherapy-induced gastrointestinal mucosal injury,to support the exploration of its pathogenesis and the development of therapeutic drugs.This review considered relevant literature published during the period from 2019 to 2024,to provide a comprehensive summary and analysis from several perspectives,including the selection of experimental animals,chemotherapeutic drugs and modeling method,evaluation indicators,and practical applications.Furthermore,we highlight several existing issues with current models,including the lack of standardized modeling method,insufficient research on models with a tumor background,and inadequate exploration of novel cell death mechanisms.This collation of the literature also revealed the gradual emergence of traditional Chinese medicine as a research hotspot,with potential for the treatment of gastrointestinal mucosal injury.Further studies of effective medicines are warranted to identify interventional strategies for chemotherapy-induced gastrointestinal mucosal injury.

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.

Background and Aims:Radical resection is the only potentially curative treatment for intrahepatic cholangiocarcinoma(ICC),yet the high recurrence rate results in poor prognosis.In recent years,"textbook outcome"(TO)has been proposed as a comprehensive quality metric,but its association with prognosis remains unclear.This study aimed to analyze the risk factors influencing the achievement of TO after radical resection of ICC and to explore the relationship between TO and survival.Methods:A retrospective analysis was conducted on the clinical data of 180 ICC patients who underwent radical resection at the 904th Hospital of the Joint Logistic Support Force of the PLA between February 2018 and February 2023.Univariate and multivariate Logistic regression analyses were performed to identify risk factors associated with TO,and survival analysis was carried out using the Kaplan-Meier method and Log-rank test.Results:Of the 180 patients,66 achieved TO.Multivariate Logistic regression analysis indicated that preoperative total bilirubin＞22 μmol/L,preoperative CA19-9＞35 U/mL,maximum tumor diameter＞5 cm,poor tumor differentiation,microvascular invasion(MVI),and lymph node metastasis were independent risk factors for failing to achieve TO(all P＜0.05).Survival analysis demonstrated that patients who achieved TO had a significantly longer median survival compared with those who did not(36 months vs.16 months,P＜0.001).Conclusion:Preoperative total bilirubin＞22 μmol/L,preoperative CA19-9＞35 U/mL,maximum tumor diameter＞5 cm,poor tumor differentiation,MVI,and lymph node metastasis are independent risk factors for not achieving TO after radical resection of ICC.Patients who achieved TO exhibited markedly longer survival,suggesting that TO not only reflects perioperative treatment quality but also serves as an important prognostic indicator.Greater attention to these risk factors and optimization of perioperative management may improve the likelihood of achieving TO and enhance long-term outcomes.

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.

The global incidence rate of cancer is increasing yearly,and chemotherapy-induced gastrointestinal mucosal injury has become a crucial factor affecting patients'therapeutic prognosis;however,there is currently a lack of effective therapeutic drugs to address this issue.There is thus an urgent need to establish more ideal animal models of chemotherapy-induced gastrointestinal mucosal injury,to support the exploration of its pathogenesis and the development of therapeutic drugs.This review considered relevant literature published during the period from 2019 to 2024,to provide a comprehensive summary and analysis from several perspectives,including the selection of experimental animals,chemotherapeutic drugs and modeling method,evaluation indicators,and practical applications.Furthermore,we highlight several existing issues with current models,including the lack of standardized modeling method,insufficient research on models with a tumor background,and inadequate exploration of novel cell death mechanisms.This collation of the literature also revealed the gradual emergence of traditional Chinese medicine as a research hotspot,with potential for the treatment of gastrointestinal mucosal injury.Further studies of effective medicines are warranted to identify interventional strategies for chemotherapy-induced gastrointestinal mucosal injury.