1.Reporting Status of Clinical Practice Guideline Protocols: A Systematic Analysis
Huayu ZHANG ; Xufei LUO ; Hui LIU ; Qi ZHOU ; Yishan QIN ; Ye WANG ; Yuanyuan YAO ; Haodong LI ; Xiaohui WANG ; Yaolong CHEN
Medical Journal of Peking Union Medical College Hospital 2026;17(1):255-262
To systematically analyzed the reporting status of core elements in publicly available clinical practice guideline(hereafter referred to as "guideline") protocols published domestically and internationally over the past decade, identified existing problems, and provided evidence to inform the standardized writing and publication of future guideline protocols. A systematic search was conducted in Chinese and English databases for clinical practice guideline protocols published during the past ten years. The basic characteristics and reporting of core elements—including registration information, conflict of interest management, evidence grading, development process and timeline planning, as well as dissemination and implementation—were extracted and analyzed. Chi-square tests were performed to explore associations between protocol characteristics and the reporting of core elements. A total of 94 guideline protocols were included, of which 67 were in Chinese(71.28%) and 27 were in English(28.72%). Overall, 82.98% of the guideline protocols were registered, 92.55% reported management of conflicts of interest, 97.87% reported evidence searching, 88.30% reported evidence grading, and 89.36% described dissemination and implementation strategies. However, only 55.32% reported the guideline development process, and merely 23.40% reported timeline planning. Further analysis indicated that the reporting of registration, evidence searching, development process, and timeline planning was associated with year of publication. Differences were observed between domestic and international guidelines in reporting registration, conflict of interest management, development process, time planning, and dissemination and implementation. Guidelines intended for development exhibited higher reporting rates for registration, development process, and dissemination and implementation compared to those planned for updating or adaptation. Although current guideline protocols demonstrate relatively adequate reporting of methodological elements, deficiencies remain in development process and timeline planning. Future efforts should focus on promoting the publication and standardized reporting of guideline protocols, enhancing the international recognition of registration platforms, and strengthening the development process and timeline planning to advance the scientific rigor and transparency of guideline development.
2.Damage of stored red blood cell supernatant to vascular endothelial cells and its underlying mechanisms
Xuanzhi ZHANG ; Yaping LONG ; Tengyu CAO ; Huayu LIN ; Chunya MA ; Yuanyuan LUO ; Yi LIU ; Liping SUN ; Yang YU
Chinese Journal of Blood Transfusion 2026;39(5):580-588
Objective: To investigate the damaging effects of red blood cell supernatant (RBC-S) stored for different durations (7 d, 14 d, and 28 d) on vascular endothelial cells, and to explore the underlying mechanisms using bioinformatics analysis, so as to provide references for optimizing red blood cell transfusion strategies. Methods: Human umbilical vein endothelial cells (HUVECs) were co-cultured with RBC-S stored for 7, 14 and 28 days, designated as the 7 d group, 14 d group and 28 d group respectively, which were collectively defined as the experimental groups. Cell damage was evaluated by cell proliferation assay (Cell Counting Kit8, CCK8), lactate dehydrogenase (LDH) release assay, 4′, 6diamidino2phenylindole (DAPI) staining, and flow cytometry for apoptosis and reactive oxygen species (ROS) levels. The damage degree of RBC-S on vascular endothelial cells was assessed by statistical analysis of damage data among different groups. Since the damage effect reached a plateau at all time points, the 28 d storage group was selected as the representative for further mechanistic studies. Transcriptomic analysis was performed to explore the role of frizzled class receptor 1 (FZD1) and Wnt signaling pathway in red blood cell storagerelated endothelial dysfunction. Results: Compared with the control group, the storage groups treated with 7 d, 14 d, and 28 d RBC-S showed significantly decreased cell proliferation rates [control group 100%, 7 d group (69.51±2.30)%, 14 d group (74.54±2.89)%, 28 d group (73.59±2.36)%, P<0.05], significantly reduced numbers of DAPI-stained cell nuclei [control group (213±12.5) per field, 7 d group (140.33±17.04) per field, 14 d group (152.00±23.72) per field, 28 d group (144.33±19.09) per field, P<0.05] and significantly increased LDH release [control group (1), 7 d group (8.33±1.41), 14 d group (9.23±0.83), 28 d group (9.16±0.60), P<0.05]. There was no significant difference in the degree of damage caused by RBC-S among different storage groups (P>0.05). With the prolongation of storage time, free hemoglobin (FHb) gradually increased [control group (not detected), 7 d (16.57±6.38) mg/L, 14 d (76.80±22.83) mg/L, 28 d (286.97±29.02) mg/L, P<0.05]. The apoptotic rate (20.53±2.94)% and ROS relative intensity (5.13±0.91) in the 28 d storage group were significantly higher than those in the control group (P<0.05). Transcriptomic analysis showed that FZD1 played a key role in vascular endothelial dysfunction induced by red blood cell storage and was closely related to the Wnt signaling regulatory network. Conclusion: RBC-S stored for 7 d, 14 d, or 28 d can all significantly damage vascular endothelial cells, and the damaging effect reaches a plateau at 7 d of storage. Mechanistic investigation of the 28 d group indicated that the downregulation of the FZD1/Wnt signaling pathway may play a critical role in vascular endothelial dysfunction induced by red blood cell storage, providing a theoretical basis for further optimizing red blood cell storage and transfusion strategies.
3.Influence mechanism of strategic human resource management ability on organizational performance in clinical departments of a tertiary public hospital
Ying QU ; Xingmiao FENG ; Huayu ZHANG ; Kaijie SUN ; Kai MENG ; Tao LUO
Chinese Journal of Hospital Administration 2025;41(5):383-389
Objective:To explore the impact mechanism of strategic human resource management (SHRM) capabilities in hospital clinical departments on departmental organizational performance, providing references for improving the overall performance of hospitals.Methods:The research subjects were 46 clinical departments of a tertiary public hospital in Beijing. Using a stratified sampling method, at least one middle-level manager was selected from each department, and 30% of the medical staff were randomly sampled from each professional title level within the department. A self-made questionnaire was used to investigate the SHRM capabilities of each department from September to December 2023. The organizational performance of clinical departments was assessed using the departmental performance evaluation system established by the hospital. First, the performance target values for each department in 2023 were set based on the historical data from 2020 to 2022. Then, the actual performance evaluation data of 2023 were compared with the target values to calculate the achievement rate or deviation. Finally, the comprehensive performance scores of each department were calculated by weighting. The performance scores of the departments in 2023 were used as the outcome variable, while SHRM capabilities, department size, number of beds, and whether the department was a key department were used as antecedent condition variables. Fuzzy-set qualitative comparative analysis (fsQCA) was employed to explore the combinations of antecedent conditions that lead to high and low organizational performance in clinical departments.Results:A total of 1 391 valid questionnaires were collected. The weighted average score of SHRM capabilities in clinical departments was (4.23±0.27) points, and the total score of organizational performance evaluation in 2023 was 70.75 (52.50, 79.47) points. The consistency of each antecedent condition variable did not reach the critical value of 0.90, indicating that none of them were sufficient to be a necessary condition for high or low organizational performance in the departments. Two pathways to high organizational performance and two pathways to low organizational performance were identified. The solution consistency for the high organizational performance pathway was 0.83, with a coverage of 0.35, and both core conditions, acquisition capability and maintenance capability, were present. The solution consistency for the low organizational performance pathway was 0.85, with a coverage of 0.08, and the core conditions, development capability, was absent.Conclusions:Different combinations of antecedent condition variables, including the strategic human resource management capability of clinical departments, had varying impacts on the organizational performance of clinical departments. The possession of human resource acquisition, maintenance, and development capabilities by clinical departments was an essential condition for achieving high organizational performance. It is recommended to strengthen the construction of these three capabilities and emphasize the coordinated development of human resource management capabilities to enhance the organizational performance of clinical departments.
4.Influence mechanism of strategic human resource management ability on organizational performance in clinical departments of a tertiary public hospital
Ying QU ; Xingmiao FENG ; Huayu ZHANG ; Kaijie SUN ; Kai MENG ; Tao LUO
Chinese Journal of Hospital Administration 2025;41(5):383-389
Objective:To explore the impact mechanism of strategic human resource management (SHRM) capabilities in hospital clinical departments on departmental organizational performance, providing references for improving the overall performance of hospitals.Methods:The research subjects were 46 clinical departments of a tertiary public hospital in Beijing. Using a stratified sampling method, at least one middle-level manager was selected from each department, and 30% of the medical staff were randomly sampled from each professional title level within the department. A self-made questionnaire was used to investigate the SHRM capabilities of each department from September to December 2023. The organizational performance of clinical departments was assessed using the departmental performance evaluation system established by the hospital. First, the performance target values for each department in 2023 were set based on the historical data from 2020 to 2022. Then, the actual performance evaluation data of 2023 were compared with the target values to calculate the achievement rate or deviation. Finally, the comprehensive performance scores of each department were calculated by weighting. The performance scores of the departments in 2023 were used as the outcome variable, while SHRM capabilities, department size, number of beds, and whether the department was a key department were used as antecedent condition variables. Fuzzy-set qualitative comparative analysis (fsQCA) was employed to explore the combinations of antecedent conditions that lead to high and low organizational performance in clinical departments.Results:A total of 1 391 valid questionnaires were collected. The weighted average score of SHRM capabilities in clinical departments was (4.23±0.27) points, and the total score of organizational performance evaluation in 2023 was 70.75 (52.50, 79.47) points. The consistency of each antecedent condition variable did not reach the critical value of 0.90, indicating that none of them were sufficient to be a necessary condition for high or low organizational performance in the departments. Two pathways to high organizational performance and two pathways to low organizational performance were identified. The solution consistency for the high organizational performance pathway was 0.83, with a coverage of 0.35, and both core conditions, acquisition capability and maintenance capability, were present. The solution consistency for the low organizational performance pathway was 0.85, with a coverage of 0.08, and the core conditions, development capability, was absent.Conclusions:Different combinations of antecedent condition variables, including the strategic human resource management capability of clinical departments, had varying impacts on the organizational performance of clinical departments. The possession of human resource acquisition, maintenance, and development capabilities by clinical departments was an essential condition for achieving high organizational performance. It is recommended to strengthen the construction of these three capabilities and emphasize the coordinated development of human resource management capabilities to enhance the organizational performance of clinical departments.
5.Expression of CD88 in esophageal squamous cell carcinoma and relationship with epithelial-mesenchymal transition
Kunming XU ; Xiang LIU ; Kai ZHU ; Huayu LUO ; Linrui FAN ; Zhongyu ZHANG ; Hongzheng REN
Chinese Journal of Clinical and Experimental Pathology 2024;40(6):615-620
Purpose To study the relationshiPbetween CD88 expression and clinicopathologic features and epithelial-mesenchymal transition(EMT)in esophageal squamous cell carcinoma.Methods TCGA and TIMER database were used to analyze the expression level of CD88 in esophageal squamous cell carcinoma and adjaecnt esophageal squamous cell epithelium and its relationship with epithelial-mesenchymal transition.Par-affin specimens were collected from 199 patients with clinically diagnosed esophageal squamous cell carcinoma.Immunohisto-chemical EnVision method was used to detect the expression of CD88 and EMT-related proteins in esophageal squamous cell carcinoma and adjacent tissues,the relationship between CD88 expression and clinicopathological features,prognosis and EMT in ESCC tumors was analyzed.Results There were 86 cases with high CD88 expression and 113 cases with low CD88 expres-sion.The expression level of CD88 in esophageal squamous cell carcinoma was significantly higher than that of paracancerous tis-sue(P<0.001).The group with high CD88 expression had lower ESCC differentiation level(P<0.001)and higher T stage(P=0.03).The 5-year survival of patients with high CD88 ex-pression was significantly lower than that of patients with low CD88 expression(P=0.002).Cox univariate and multivariate analysis showed that CD88 expression was an independent prog-nostic factor for overall survival of patients with esophageal squa-mous cell carcinoma(P=0.013).The high expression of CD88 was negatively correlated with E-cadherin(r=-0.146,P=0.039),and positively correlated with vimentin(r=0.387,P=1.61e-08)and N-cadherin(r=0.304,P=1.3e-05).Con-clusion CD88 is highly expressed in esophageal squamous cell carcinoma.CD88 may affect the occurrence,development,in-vasion and metastasis of esophageal squamous cell carcinoma through EMT,and it might be used as a prognostic marker for e-sophageal squamous cell carcinoma patients.
6.Analysis of the Current Status of China's Adaptation Guidelines
Ling WANG ; Yaxuan REN ; Xufei LUO ; Di ZHU ; Zhewei LI ; Ye WANG ; Bingyi WANG ; Huayu ZHANG ; Shu YANG ; Yaolong CHEN
Medical Journal of Peking Union Medical College Hospital 2024;15(1):192-201
7.Protective effect of Acronychia pedunculata water extract on photoaging keratinocyte model and its mechanism
Xiuling LUO ; Yuan ZHOU ; Binbin ZHAO ; Manli HUANG ; Wenyu LI ; Runge FAN ; Sijian WEN ; Jichao LI ; Huayu WU ; Youkun LIN
Chinese Journal of Medical Aesthetics and Cosmetology 2022;28(6):517-521
Objective:To investigate the protective effect and mechanism of Acronychia pedunculata water extracts on UV-induced light damage of human keratinocytes.Methods:The experiment was conducted from December 2018 to April 2020 in the Guangxi Medical University Laboratory of Genetics. The photoaged keratinocyte model was used, the cells were co-cultured with different concentrations of Acronychia pedunculata water extracts. The cell proliferation rate was detected by CCK-8 method. The levels of reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX) and total antioxidant capacity (T-AOC) of cells were detected by a test kit. The levels of IL-1β, IL-6 and tumor necrosis factor-alpha (TNF-α) were determined by ELISA.Results:The proliferation of HaCaT cells was promoted by 0.5 mg/L-2.0 mg/L of the extracts. Compared with control group, the proliferation rate of HaCaT cells in the experimental group was significantly increased ( P<0.05). Compared with control group, the contents of ROS was decreased ( F=214.67, P<0.05), MDA was decreased ( F=811.88, P<0.05), SOD was increased ( F=28.95, P<0.05), CAT was increased ( F=213.31, P<0.05), GPX was increased ( F=65.10, P<0.05), T-AOC was increased ( F=305.58, P<0.05), IL-1β was decreased ( F=15.46, P<0.05), IL-6 was decreased ( F=59.2, P<0.05), and TNF-α was decreased ( F=33.13, P<0.05). Conclusions:The extracts of 0.5-2.0 mg/L of Acronychia pedunculata have protective effects on the photoaging cell model, which may be related to the increase of SOD, CAT, GPX and other antioxidant enzymes and the level of T-AOC in photoaging HaCaT cells, and the decrease of ROS, MDA content and the expression of inflammatory cytokines.
8.Prenatal diagnosis and genetic analysis of a 46,XN,del(11)(q14q22) fetus.
Liping ZHAO ; Huayu LUO ; Guixiang LUO ; Xianrong QIU ; Yanjie LIAO
Chinese Journal of Medical Genetics 2020;37(8):879-882
OBJECTIVE:
To diagnose a 46,XN,del(11)(q14q22) fetus by non-invasive prenatal testing (NIPT), karyotype analysis and whole genome sequencing (WGS).
METHODS:
Peripheral blood sample of the gravida was taken for NIPT screening. Blood samples of the gravida, her husband, and umbilical cord blood were also taken for chromosome karyotyping and whole genome sequencing (WGS).
RESULTS:
NIPT screening indicated the fetus has carried partial deletion of chromosome 11, while no chromosomal abnormality was found with the cord blood sample due to the low resolution of G-banding analysis. WGS analysis of the cord blood indicated 46,XN,del(11q14.3q22.1). seq[GRCh37/hg19] (90 623 404-97 469 319)×1, 6.85 Mb. The karyotype of the fetus was eventually determined as 46,XN,del(11)(q14q22). Karyotyping analysis suggested that the gravida and her husband were 46,XX,del(11)(q14q22)[8]/46,XX[92] and 46,XY, respectively. However, neither of them was found to harbor the del(11)(q14q22) by WGS.
CONCLUSION
The abnormal karyotype of the fetus has derived from its mother's low percentage mosaicism. Combined NIPT, karyotyping analysis and WGS can detect chromosomal disorders with accuracy.
9.Application of various genetic techniques for the diagnosis of Prader-Willi syndrome.
Wuyan HUANG ; Shuna LI ; Huayu LUO ; Xiangshu WEN ; Cui LIN ; Shuxia CHEN ; Liping ZHAO ; Gefei XIAO
Chinese Journal of Medical Genetics 2020;37(8):875-878
OBJECTIVE:
To discuss the advantages and technical limitations of various molecular genetic techniques in the diagnosis of two infants featuring all-round developmental retardation.
METHODS:
The two patients were initially screened by using chromosomal microarray analysis (CMA). For patient 1, his parents were also subjected to CMA analysis, and the data was analyzed by using ChAS and UPD-tool software. For patient 2, methylation-specific PCR (MS-PCR) was carried out.
RESULTS:
Patient 1 was diagnosed with maternal uniparental disomy (UPD) type Prader-Willi syndrome (PWS) by CMA and UPD-tool family analysis. His chromosomes 15 were of maternal UPD with homology/heterology. Patient 2 was diagnosed with deletion type PWS by combined CMA and MS-PCR.
CONCLUSION
Correct selection of laboratory methods based on the advantages and limitations of various molecular techniques can help with diagnosis of genomic imprinting disorders and enable better treatment and prognosis through early intervention.
10.Genetic analysis of a fetus with partial 18p tetraploidy syndrome.
Huayu LUO ; Qizhi XIAO ; Wen SU ; Shuxia CHEN ; Min JIANG ; Gefei XIAO
Chinese Journal of Medical Genetics 2018;35(5):719-722
OBJECTIVETo analyze a fetus with abnormal cardiac ultrasound by using various techniques and explore its genotype-phenotype correlation.
METHODSLymphocytes derived from umbilical cord blood sample were subjected to G-banding analysis. Short tandem repeats quantitative fluorescence PCR (STR-QF-PCR) was used for analysis of fetal DNA as an auxiliary test. Low-coverage whole genome sequencing (WGS) was used to detect chromosomal deletion/duplication which exceeded 100 kb in size.
RESULTSThe karyotype of the fetus was 47,XN,+mar. As detected by STR-QF-PCR, the copy number of GATA178F11 locus on chromosome 18 was 4, and the duplicated fragment was derived from the mother. WGS suggested that the fetus to be 46,XN,dup(18p11.21p11.32).seq [GRCh37/hg19](10 001-15 378 887)× 4, with the duplicated fragment spanning approximately 15.38 Mb.
CONCLUSIONThe cardiac malformation of the fetus may be attributed to the partial duplication of chromosome 18p. Combined cytogenetic and molecular methods can facilitate prenatal detection of genetic abnormalities.

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