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.

Ulcerative colitis （UC） is a common digestive disease characterized by recurrence and remission alternation，which seriously affects the life quality and physical and mental health of patients. The pathogenesis of UC is complex，and studies have shown that the occurrence and development of UC are closely related to the transduction of multiple signaling pathways. The current western medicine treatment has many problems，such as single action target，more adverse reactions，poor patient tolerance，and easy recurrence after stopping the medicine. Traditional Chinese medicine has the advantages such as multi-targets，multi-pathways， and fewer adverse reactions， elucidating that the action mechanism of traditional Chinese medicine in the treatment of UC is the focus of current research. Therefore， this paper conducted a systematic review on how traditional Chinese medicine exerts therapeutic effects by regulating the signaling pathways related to UC in recent years，and it was found that traditional Chinese medicine can regulate nuclear factor-κB （NF-κB），adenylate-activated protein kinase （AMPK）/mammalian target of rapamycin （mTOR），Janus tyrosine protein kinase （JAK）/signal transducer and activator of transcription （STAT），phosphatidylinositol 3-kinase （PI3K） /protein kinase B （Akt），NOD-like receptor thermoprotein structural domain-related protein 3 （NLRP3）/cysteine protease-1 （Caspase-1），nuclear respiratory factor 2 （Nrf2）/heme oxygenase-1 （HO-1）， and several other pathways，thereby inhibiting oxidative stress and cellular pyroptosis，regulating the Tregs/Th17 cellular balance， promoting autophagic response and M2-type macrophage polarization，restoring the diversity and abundance of intestinal flora，promoting the repair of intestinal mucosal barrier function，and alleviating the inflammatory damage of UC colonic tissues. The holistic concept and evidence-based treatment of traditional Chinese medicine were combined with the modern molecular mechanism research of traditional Chinese medicine， and the traditional Chinese medicine combinations with different mechanisms， following regulation， were formulated into compound formulas or pairs of medicines according to the pattern of evidence. It is expected to achieve better therapeutic efficacy and to provide ideas and references for the modification of classic compound formulae of traditional Chinese medicine in UC treatment and clinical translation.

To analyze the standard establishment approach and compilation rationale for metallic pharmaceutical packaging standard development in the 2025 edition of the Pharmacopeia of the People's Republic of China.This article systematically explained the background and process of establishing the guiding principles for metallic materials and containers used in pharmaceutical packaging in the Chinese Pharmacopoeia through basic information,relevant domestic and international standards,the establishment of key quality attributes of metallic pharmaceutical packaging materials,and the construction of metallic pharmaceutical packaging material standards.The newly established guidelines,the Pharmacopeia of the People's Republic of China 9625,prioritized product critical quality attributes(CQAs)and real-world applicability.This dual emphasis on rigidity and adaptability enhances drug safety,meets the regulatory requirements,and promotes the globalization and scientific advancement of China's pharmaceutical packaging industry.

Objective To investigate the effect and mechanism of long non-coding RNA(lncRNA)NRON on myocardial fibrosis in mice with myocardial infarction(MI).Methods Thirty-two C57/BL6 mice were randomly assigned to a Sham group,MI group,MI+shNRON group or MI+NC group,with eight mice in each group.The expression level of lncRNA NRON in myocardial tissue of mice was detected by real-time quantitative PCR.Hematoxylin and eosin staining,Masson's trichrome staining,and immunohistochemistry were used to detect the degree of myocardial injury,myocardial fibrosis,and the expression level of collagen Type Ⅰ(col Ⅰ).Western blotting was used to detect the protein expression levels of TGF-β1,p-Smad2,and p-Smad3 in myocardial tissue of the mice.Results Compared with the Sham group,the expression of NRON,col Ⅰ,TGF-β1,p-Smad2,and p-Smad3 proteins were increased in the MI group.Compared with the MI group,the expression of NRON,the degree of myocardial damage and fibrosis,the expression of col Ⅰ,TGF-β1,p-Smad2,and p-Smad3 proteins were decreased in the MI+shNRON group.Conclusion Down-regulation of lncRNA NRON can alleviate myocardial injury and inhibit myocardial fibrosis in mice with MI,and the molecular mechanism may be related to inhibition of the TGF-β/Smad signaling pathway.

Aim To explore the mechanism by which dioscin regulates IL-17+γδT cells in the treatment of arthritis.Methods A collagen-induced arthritis(CIA)model was established in DBA/1 mice using bovine type Ⅱ collagen.The mice were randomly divid-ed into the CIA model group,methotrexate(MTX)positive control group,and dioscin low-dose(Dioscin-L),medium-dose(Dioscin-M),and high-dose(Dios-cin-H)groups.After intervention,the therapeutic effects were evaluated using scoring methods.Joint pathological damage was analyzed by hematoxylin and eosin(HE)staining.The levels of anti-collagen-spe-cific antibodies and the pro-inflammatory cytokine IL-17 were measured by ELISA.The expressions of γδT cells and their subtypes,as well as the secretion level of IL-17,were detected by flow cytometry.Results Dioscin significantly reduced the arthritis severity score in collagen-induced arthritis(CIA)mice,alleviated joint pathological damage,inhibited the production of IL-17 by splenic lymphocytes and the levels of anti-col-lagen-specific antibodies total IgG and IgG3,and de-creased the proportion of γδT cells in the lymph nodes,splenic γδT cells,and the Vδ4+T-cell subset.The level of IL-17 produced by the Vδ4 subtype in the lymph nodes of the intervention groups was lower than that in the model group,but the difference was not sta-tistically significant.Conclusion Dioscin has signifi-cant therapeutic effect on CIA,and its mechanism may be through the inhibition of γδT cells,but it is unlikely to be related to IL-17 derived from γδT cells.

Objective To propose a multiple regression-variational auto-encoders(MR-VAE)model to realize precise and non-invasive prediction of intra-abdominal pressure(IAP)in critically ill patients.Methods At first,a dataset was constructed by retrospectively analysing baseline characteristics and clinical indicators of 100 critically ill patients admitted to the Intensive Care Unit of Daping Hospital of Army Medical University between 30 August 2019 and 30 March 2021.Then,a MR-VAE prediction model was developed by integrating a feedforward neural network for supervised regression onto a variational autoencoder(VAE)framework and incorporating multiple regression strategies to mitigate feature interference.Finally,the MR-VAE model had its performance evaluated by its comparison with five classical models including support vector machines(SVM),convolutional neural networks(CNN),Scikit-learn integrated model(SIM),multi-layer perceptron(MLP)and K-nearest neighbors(KNN),and its prediction accuracy verified by testing the data of 10 randomly selected patients.Results The MR-VAE model behaved the best when compared with the five classical models,with a mean squared error(MSE)of 0.207,a root mean square error(RMSE)of 0.454,a mean absolute error(MAE)of 0.361,a median absolute deviation(MAD)of 0.243,an explained variance score(EVS)of 0.814 and a R2of 0.823,which also outperformed the five models in fitting performance,convergence and final loss.In random sample testing,the MR-VAE model exhibited high consistency between predicted and actual values.Conclusion The MR-VAE model proposed can accurately predict IAP,which has great potential in reducing the repeated measurements of IAP in critically ill patients and providing new ideas for the early diagnosis and treatment of IAH.

Objective:To study the current situation of the operating room nurses′ flourishing, and to explore the mediating role of self-compassion between forgiveness and flourishing, so as to provide a basis for improving the level of flourishing of operating room nurses.Methods:From September to November 2023, a total of 1 182 operating room nurses from 20 hospitals in Henan province were investigated by convenient sampling method. General data questionnaire, the Heartland Forgiveness Scale, Self-Compassion Scale and the Flourishing Scale were used to conduct an online cross-sectional survey. The mediating role of self-compassion in the relationship between forgiveness and flourishing was analyzed.Results:A total of 1 182 valid questionnaires were collected, including 261 males and 921 females. The age ranged from 21 to 54 (33.21 ± 5.72) years. In operating room nurses, the score of the forgiveness was (111.88 ± 18.77) points, the score of the self-compassion was (76.60 ± 10.75) points, the score of the flourishing was (43.48 ± 8.72) points. Forgiveness was positively correlated with self-warmth and flourishing ( r=0.545, 0.590, both P<0.05), forgiveness was negatively correlated with self-cold ( r=-0.365, P<0.05). The flourishing was positively correlated with self-warmth ( r=0.608, P<0.05), and negatively correlated with self-cold ( r=-0.509, P<0.05). self-warmth and self-cold played a mediating role between forgiveness and flourishing. The indirect effects of self-warmth and self-cold were 23.97% and 20.93% of the total mediating effects. Conclusions:The level of flourishing of the operating room nurses is at a relatively high level. Nurses′ forgiveness can affect their flourishing directly as well as indirectly through self-warmth and self-cold.

Objective:To investigate the predictive value of computed tomography (CT) combined with dynamic enhanced magnetic resonance imaging (DCE-MRI) parameters in patients with colorectal cancer after radical surgery.Methods:A total of 180 patients with colorectal cancer admitted to the Second Hospital of Hebei Medical University from Dec. 2021 to Dec. 2023 were retrospectively selected as the study objects. All patients were treated with radical resection of colorectal cancer and followed up for 12 months. They were divided into good prognosis group ( n=129) and poor prognosis group ( n=51) according to whether tumor recurrence and metastasis occurred. All patients were examined by CT and DCE-MRI. Clinical data, CT and DCE-MRI parameters were compared between the two groups. Cox regression was used to analyze the influencing factors of short-term adverse prognosis in patients with colorectal cancer, and ROC curve was drawn to analyze the value of SUV max, K trans, K ep and Ve in single or combined prediction of short-term adverse prognosis in patients with colorectal cancer. Results:SUV max, K trans, K ep and Ve in the poor prognosis group were higher than those in the good prognosis group ( P<0.05) . Cox regression analysis showed that high levels of SUV max ( HR=2.818, 95% CI= 1.808-4.393) , K trans ( HR=516.829, 95% CI=6.745-30603.733) , K ep ( HR=117.756, 95% CI= 4.598-3015.614) and Ve ( HR=9453.000, 95% CI= 63.534-1406482.337) were independent risk factors for short-term adverse prognosis in patients with colorectal cancer ( P<0.05) . The AUC value of SUVmax, K trans, K ep and Ve combined predicted short term adverse prognosis in colorectal cancer patients was higher than that of single detection ( Z=3.126, 4.359, 4.368, 3.987, P<0.05) . Conclusion:CT combined with DCE-MRI parameters have high predictive value for short term poor prognosis of patients with colorectal cancer after radical surgery.

This article reported a case of a newborn with congenital absence of the penis. The prenatal examinations were unremarkable. Physical examination of the newborn revealed abnormal external genitalia, with well-developed scrotum and fully descended testicle in normal size, but without the penis. Postnatal ultrasound showed no obvious signals of uterus and ovaries in pelvis and had normal bilateral testicles and urinary system. The diagnosis was congenital absence of the penis.

Objective To explore the value of phase contrast(PC)MRI intracranial hemodynamic parameters for predicting acute mountain sickness(AMS).Methods Totally 72 healthy young volunteers were prospectively recruited.Intracranial hemodynamic parameters of internal carotid artery(ICA)and internal jugular vein(IJV)were measured using PC MRI under normal breathing,as well as mild,moderate and severe Valsalva maneuvers(VM)in plain area.The subjects were divided into AMS group(n=9)and non-AMS group(n=63)according to results of Lake Louise score(LLS)10 h after a rapid ascent to plateau area with altitude of 4 411 m.Univariate and multivariate logistic regression analyses were performed to screen independent predictors of AMS under different states and then construct single and combined VM states prediction models.Receiver operating characteristic curves were plotted,and the area under the curve(AUC)was calculated to evaluate the predictive efficacy of each model.Results ICA pulsatility index(PIICA)under mild VM,IJV cross-sectional area(SIJV)under moderate VM and IJV resistance index(RIIJV)under severe VM were all independent predictors of AMS(all P＜0.05).The efficacy of combined VM states model(AUC=0.869)for predicting AMS was higher than each single VM state model(AUC=0.698-0.738).Conclusion The model constructed based on PIICA under mild VM,SIJV under moderate VM and RIIJV under severe VM could be used to effectively predict AMS.