Objective  To promote the development of high-quality health standards in China and summarize the characteristics of global health standards management systems and development processes.  Methods  We conducted a systematic search of relevant databases and the websites of standardization institutions. A descriptive method was used to analyze the basic characteristics of the standard management systems and development processes.  Results  The majority of the investigated countries and organizations primarily implement voluntary standards, with the exception of Chinese and the European Committee for Standardization that enforce compulsory standards. All countries and organizations have health standards at the national, group, and enterprise levels. In China and Japan, standards authorities are subordinate to the government, while in other countries or organizations, they operate as independent civil societies. The development process for health standards generally involves five stages: "Project/Proposal → Draft → Enquiry → Review → Publication". However, the specific steps in the development of health standards vary across different countries and organizations. Furthermore, China ranks high in the number of both standards and health standards issued, but the proportion of health standards is only 2.06%.  Conclusions  There are significant differences between China and other countries in terms of the management system and development process of health standards. To promote the management and development of high-quality health standards in China, we recommend promoting the coordination mechanism for standard development, increasing efforts to publicize standards and evaluate the implementation effect, strengthening the construction of personnel for the development of health standards, optimizing the efficiency of standard development and improving the internationalization level of health standards.

Background::The 2017 American College of Cardiology/American Heart Association (ACC/AHA) blood pressure (BP) guideline lowered the threshold defining hypertension to 130/80 mmHg. However, how stage 1 hypertension defined using this guideline is associated with cardiovascular events in Chinese adults remains unclear. This study assessed the association between stage 1 hypertension defined by the 2017 ACC/AHA guideline and clinical outcomes in the Chinese population.Methods::Participants with stage 1 hypertension ( n = 69,509) or normal BP ( n = 34,142) were followed in this study from 2006/2007 to 2020. Stage 1 hypertension was defined as a systolic blood pressure of 130–139 mmHg or a diastolic blood pressure of 80–89 mmHg. None were taking antihypertensive medication or had a history of myocardial infarction (MI), stroke, or cancer at baseline. The primary outcome was a composite of MI, stroke, and all-cause mortality. The secondary outcomes were individual components of the primary outcome. Cox proportional hazards models were used for the analysis. Results::During a median follow-up of 11.09 years, we observed 10,479 events (MI, n = 995; stroke, n = 3408; all-cause mortality, n = 7094). After multivariable adjustment, the hazard ratios for stage 1 hypertension vs. normal BP were 1.20 (95% confidence interval [CI], 1.13–1.25) for primary outcome, 1.24 (95% CI, 1.05–1.46) for MI, 1.45 (95% CI, 1.33–1.59) for stroke, and 1.11 (95% CI, 1.04–1.17) for all-cause mortality. The hazard ratios for participants with stage 1 hypertension who were prescribed antihypertensive medications compared with those without antihypertensive treatment during the follow-up was 0.90 (95% CI, 0.85–0.96). Conclusions::Using the new definition, Chinese adults with untreated stage 1 hypertension are at higher risk for MI, stroke, and all-cause mortality. This finding may help to validate the new BP classification system in China.

Objective:To evaluate safety and efficacy of B-type suture method ileostomy.Methods:Clinical data from 204 patients undergoing laparoscopic low anterior resection combined with protective ileostomy was analysed. Patients were divided into B-type suture ileostomy group ( n=67) and traditional ileostomy group ( n=137). Results:compared with traditional ileostomy group, B-type suture ileostomy group showed statistically significant differences in total operation time [(164±26) min vs. (172±24) min, t=2.229, P=0.027], ileostomy time [(12.7±2.3) min vs. (14.8±2.2) min, t=-6.565, P<0.001], blood loss [(57±20) ml vs. (69±31) ml, t=-2.797, P=0.006], postoperative hospital stay [(10.2±1.9) d vs. (11.8±2.3) d, t=-4.851, P<0.001], specimen incision infection rate (0 vs. 5.1%, P=0.047), postoperative body pain [82 (79-84) vs. 78 (76-80), Z=-5.805, P<0.001], and ileostomy incorporation time [(46±11) min vs. (51±12) min, t=-2.540, P=0.012]. Conclusion:B-type suture ileostomy for prophylactic ileostomy in laparoscopic low anterior resection for rectal cancer is safe and feasible.

Objective:To investigate the perinatal risk factors and correlation between bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP).Methods:A retrospective analysis was performed on 173 preterm infants born at less than 32 weeks' gestation with BPD who were admitted to the neonatal intensive care unit (NICU) of the Women and Children's Hospital of Qingdao University from June 2017 to July 2022. According to the diagnostic criteria for ROP, these preterm infants were divided into the ROP group ( n=64) and the non-ROP group ( n=109). Chi-square test, two independent samples t-test, and Mann-Whitney U test were used to compare the general data, treatment, and the incidence of complications between the two groups. Multivariate logistic stepwise regression analysis was used to analyze the independent risk factors of ROP in preterm infants with BPD and the receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of independent risk factors on ROP. The correlation between the severity of BPD and the incidence of ROP was analyzed. Results:The gestational age at birth [(28.0±1.1) vs. (28.8±1.2) weeks, t=4.01], the birth weight [(1 075.9±141.4) vs. (1 143.2±168.6) g, t=2.68], the partial pressure of carbon dioxide [42.5 mmHg (1 mmHg=0.133 kPa) (34.0-51.0 mmHg) vs. 47.0 mmHg (39.0-54.0 mmHg), Z=－2.31], and the total fluid intake on the first day of birth [80.0 ml (72.3-88.7 ml) vs. 83.6 ml (76.6-92.8 ml), Z=－2.28] in the ROP group were all lower than those in the non-ROP group (all P<0.05). While the prothrombin time [15.7 s (14.1-17.7 s) vs. 14.6 s (13.1-16.7 s), Z=－2.17], activated partial thromboplastin time [64.7 s (52.9-77.9 s) vs. 55.8 s (48.4-68.9 s), Z=－2.12], the proportion of patients treated with pulmonary surfactant [71.9% (46/64) vs. 49.5% (54/109), χ 2=8.25], the total duration of oxygen supplementation [50.5 d (40.0-64.0 d) vs. 45.0 d (37.0-52.0 d), Z=－2.77], the duration of invasive ventilation [5.0 d (1.0-11.0 d) vs. 1.0 d (0.0-5.0 d), Z=－4.03], the duration of noninvasive ventilation or high-flow oxygen therapy [(31.7±12.7) vs. (26.4±13.1) d, t=－2.59], and the incidence of neonatal respiratory distress syndrome [76.6% (49/64) vs. 57.8% (63/109), χ 2=6.22] were increased in the ROP group (all P<0.05). There was no significant difference in the proportion of BPD treated with corticosteroids between the ROP and non-ROP groups [60.3% (38/63) vs. 74.3% (81/109), χ 2=3.67, P=0.055]. Multivariate logistic stepwise regression analysis showed that smaller gestational age ( OR=1.599, 95% CI: 1.126-2.272, P=0.009), less fluid intake on the first day ( OR=1.033, 95% CI: 1.004-1.062, P=0.024), and longer duration of invasive ventilation ( OR=1.076, 95% CI:1.017-1.138, P=0.011) were independent risk factors for ROP in BPD infants, while glucocorticoid treatment was an independent protective factor ( OR=0.378, 95% CI:0.173-0.827, P=0.015). Most patients with mild or moderate BPD did not develop ROP [64.6% (73/113) and 66.7% (34/51)], while those with severe BPD were more likely to be complicated by ROP (7/9) ( χ 2=6.84, P=0.033). Conclusions:BPD infants with smaller gestational age, longer duration of invasive ventilation, and less fluid intake on the first day of birth are more likely to develop ROP, while glucocorticoid therapy can reduce the incidence of ROP in this population. Severe BPD may increase the risk of ROP in infants.

Objective:To explore the clinical application and triage management value of using blood circulating cell-free DNA (cfDNA) (cysteine dioxygenase type 1 gene, CDO1, and Homeobox protein A9 gene, HOXA9) hypermethylation level to detect and diagnose ovarian cancer.Methods:A case-control study was conducted on patients who went for surgery at Chengdu Womens and Childrens Central Hospital from November 2022 to October 2023. Blood samples were collected before surgery for evaluation of cancer antigen 125 (CA125), human epididymis protein 4 (HE4), risk of ovarian malignancy algorithm (ROMA) score, and DNA methylation testing. The basic clinical information, biomarkers, and transvaginal ultrasound (TVS) information were collected simultaneously. Information from a total of 151 patients was collected, including 122 cases with benign pathology and 29 ovarian cancer cases. The pathologic diagnosis of ovarian tissue was defined as the gold standard. The multivariate logistic regression analysis was used to identify high-risk factors for ovarian cancer. The clinical efficacy of DNA methylation detection for ovarian cancer was analyzed using the area under curve (AUC).Results:The results showed that the age, menopausal status, CA125 and HE4 detection, ROMA score, positivity rate of CDO1 gene and HOXA9 gene single or combined testing in ovarian cancer patients were higher than those in the benign group and showed significant differences ( P<0.05). Among these detection protocols, the AUC of CDO1 and HOXA9 dual gene methylation testing for ovarian cancer was the highest at 0.936 (95% CI, 0.878-0.994), with 89.7% (95% CI 73.6%-96.4%) sensitivity and 97.5% (95% CI 93.0%-99.2%) specificity, respectively. The positive detection rate of CDO1 and HOXA9 dual gene methylation in early ovarian cancer FOGO I-II stage is 12/14 higher than other tests. Conclusion:Blood cfDNA methylation detection, a simple, non-invasive, and highly sensitive detection method, is superior to the current ovarian cancer testing in the risk assessment and early detection.

ObjectiveTo compare wild and cultivated Paeoniae Radix Rubra（PRR） in three aspects， including character， microscope， determination of primary and secondary metabolites. MethodSeventeen batches of wild and nine batches of cultivated PRR were collected，their character data were measured by vernier caliper and scales， and their paraffin sections were made by safranin-fixed green dyeing for the observation of microscopic features. The content of ethanol-soluble extracts and total tannin from wild and cultivated PRR was determined by the method of general principle 2201 and 2202 in the 2020 edition of Chinese Pharmacopoeia， the content of polysaccharides was determined by phenol-sulfuric acid method. Anthrone colorimetry was used to determine the content of starch， and Van Soest method of washing fiber was used to determine the content of fiber. The contents of fructose， glucose and sucrose in wild and cultivated PRR were determined by ultra-high performance liquid chromatography evaporative light scattering detection（UPLC-ELSD）， and the secondary metabolites（gallic acid， methyl gallate， catechin， oxypaeoniflorin， albiflorin， paeoniflorin， ellagic acid， 1，3，4，6-tetragalloylglucose， galloylpaeoniflorin， 1，2，3，4，6-O-pentagalloylglucose， naringenin， benzoylpaeoniflorin and benzoylalbiflorin） were determined by UPLC. Principal component analysis（PCA） and orthogonal partial least squares-discriminant analysis（OPLS-DA） were used to analyze the data of wild and cultivated PRR， the contribution of different factors to the difference was determined according to the variable importance in the projection（VIP） value>1 and P<0.05. ResultIn term of characters， wild PRR showed the traditional characteristic of Zaopi Fencha， its outer skin was loose and easy to fall off， its surface had longitudinal furrow and wrinkle， but the outer skin of cultivated PRR was not easy to fall off， and its surface was relatively smooth. The radial texture of xylem of wild PRR cross-section was more obvious， showing radial striations， vacuoles and more cracks， while the radial texture of xylem of cultivated PRR cross-section was not obvious， dense and some had cracks. Microscopically， the number of radial vessels arranged in the xylem of wild PRR was more than that of cultivated PRR， the number of calcium oxalate clusters in the phloem and xylem of wild PRR was more than that of cultivated PRR， while the number of starch grains was significantly higher in cultivated PRR. In terms of the content of primary chemical constituents， the contents of polysaccharides and starch of cultivated PRR were significantly higher than those of wild PRR（P<0.05）， while the contents of cellulose， lignin， fructose and glucose of wild PRR were significantly higher than those of cultivated PRR（P<0.05）. The results of determination of 13 secondary metabolites showed that the contents of paeoniflorin， methyl gallate， catechin and oxypaeoniflorin in wild PRR were significantly higher than those in cultivated PRR（P<0.05）， while the contents of albiflorin， gallic acid， ellagic acid， naringenin， benzoylpaeoniflorin and benzoylalbiflorin were significantly lower than those of cultivated PRR（P<0.05）. A total of 10 variables contributing to the differentiation between wild and cultivated PRR were screened， including albiflorin， cellulose， benzoylpaeoniflorin， oxypaeoniflorin， naringenin， ellagic acid， starch， lignin， paeoniflorin and total tannins. ConclusionThere are significant differences between wild and cultivated PRR in characters， microscopic characteristics， contents of primary and secondary metabolites. It is suggested that the content ratio of paeoniflorin and albiflorin， the contents of oxypaeoniflorin and cellulose can be used as indicators to characterize production methods of PRR so as to improve the quality standard of PRR. This study can provide reference for the improvement of quality standard of PRR and the guidance of high quality production of PRR.

OBJECTIVE To explore the impact of placental polypeptide on the Runt-related transcription factor 3 （RUNX3）/ Notch signaling pathway in rats with cyclophosphamide-induced premature ovarian failure （POF）， and its effects on ovarian function and oxidative stress. METHODS A POF rat model was induced by intraperitoneal injection of cyclophosphamide. Sixty POF rats of the model were randomly assigned to model group， low-dose （1 mg/kg） and high-dose （2 mg/kg） placental polypeptide groups， placental polypeptide plus empty vector group [placental polypeptide （2 mg/kg）， empty vector （1 μg）]， and placental polypeptide plus RUNX3 silencing group [placental polypeptide （2 mg/kg）， RUNX3 small interfering RNA （1 μg）]， with 12 rats in each group. Additionally， 12 healthy rats were selected as a control group. The intervention lasted for 4 weeks for all groups. After the final administration， the levels of sex hormones [estradiol （E2）， anti-Müllerian hormone （AMH）， follicle- stimulating hormone （FSH）] in rat serum and oxidative stress indicators [malondialdehyde （MDA）， superoxide dismutase （SOD）， catalase （CAT）， reactive oxygen species （ROS）] in ovarian tissue were measured. The pathology of rat ovarian tissue and apoptosis of ovarian granulosa cells were examined； the expression of apoptosis-related proteins [caspase-3， cleaved-caspase-3， B-cell lymphoma-2 （Bcl-2）， Bcl-2 associated X protein （Bax）and RUNX3/Notch signaling pathway-related proteins in rat ovarian tissue were detected. RESULTS Compared with the model group， the low and high doses of placental polypeptide groups showed an increase in the number of normal follicles and a marked decrease in the number of atretic follicles， with significant increases in the serum levels of E2 and AMH， the ovarian tissue levels of SOD and CAT， as well as the expression levels of Bcl-2， RUNX3 and Notch1 proteins， and significant decreases in the serum FSH levels， the ovarian granulosa cell apoptosis rate， and the ovarian tissue levels of MDA and ROS， as well as the expression levels of cleaved-caspase-3， caspase-3 and Bax proteins （P＜0.05）； the changes in the high-dose group were significantly more pronounced （P＜0.05）. Compared with the high-dose placental polypeptide group and the placental polypeptide plus empty vector group， the placental polypeptide plus RUNX3 silencing group showed a decrease in the number of normal follicles and a significant reversal of the above indicators （P＜0.05）. CONCLUSIONS Placental polypeptide may alleviate the symptoms of rats with POF by upregulating the RUNX3/Notch signaling pathway， improving sex hormone secretion， oxidative stress， ovarian granulosa cell apoptosis and ovarian function.

Objective:To observe the clinical features, treatment and prognosis of ciliary body tumors.Methods:A retrospective clinical study. From November 2011 to March 2023, 8 cases (8 eyes) with ciliary body tumours confirmed by pathohistological examination at the Department of Ocular Oncology, Beijing Tongren Hospital were included in the study. Patients' age, gender, involved eyes, symptoms, best corrected visual acuity (BCVA), intraocular pressure, cataract, lens subluxation, and imaging manifestations were collected in detail. All affected eyes were treated surgically. The follow-up time after surgery ranged from 1 to 10 years. The patients' clinical presentation as well as imaging, pathohistological features and treatment and prognosis were analysed retrospectively.Results:Among 8 cases (8 eyes), there were 3 males (3 eyes) and 5 females (5 eyes), 3 and 5 eyes in the right and left eyes, respectively. The median age was 44 years. Ciliary body medulloepitheliomas, melanoma, squamous cell carcinoma, leiomyoma, schwannoma, and adenoma of the nonpigmcnted ciliary epithelium were in 2, 2, 1, 1, 1, and 1 eyes, respectively. All reported decreased or loss of vision. Cataract, vitreous opacity, red eye and or (ocular pain), retinal detachment, lens subluxation, and secondary glaucoma were 6, 4, 4, 2, 1, and 1 eyes, respectively. Diagnostic imaging was consistent with pathological findings in 3 eyes. The first surgery was performed for enucleation and orbital implantation in 2 eyes, the patients were 9 and 10 years old with medullary epithelioma; the follow-up time after surgery was 1 and 5 years, respectively. Local tumour resection was performed in 6 eyes. Among them, 3 eyes with benign tumours were followed up for 1 to 9 years after surgery; 2 eyes showed significant improvement in visual acuity, 1 eye with adenoma of the nonpigmcnted ciliary epithelium had a preoperative BCVA of finger count/1 m, and a postoperative BCVA of 0.5, and 1 eye with leiomyoma had a preoperative BCVA of 0.06, and a postoperative BCVA of 0.5; and 1 eye was lost to follow-up. Malignant tumour in 3 eyes, of which 2 eyes recurred after surgery. Re-operation for enucleation and local tumour excision combined with local cryotherapy in 2 eyes of recurrence were 1 eye each, respectively. The follow-up period after surgery was 2 and 4 years, respectively. No recurrence after surgery in 1 eye, but there was no significant improvement in visual acuity during follow-up. No recurrence or metastasis was observed in any of the eyes during the follow-up period or at the final follow-up.Conclusions:Ciliary body tumour types and clinical presentations are complex and varied; imaging can detect tumours but is poor at determining the nature of the lesion. Benign tumours do well with local excision surgery; malignant tumours do well with enucleation.

The effect of Radix isatidis polysaccharide(IRPS)on TLR3/TRIF innate immune path-way and type Ⅰ interferon secretion in 3D4/21/CD163 cells infected by porcine reproductive and re-spiratory syndrome virus(PRRSV)was tested by Western blot and ELISA;moreover,the effect of IRPS on the immunosuppression infected by PRRSV was further verified with the TLR3 agonist poly(I∶C).The results showed that the protein levels of TLR3,TRIF,IRF3,IRF7 and type Ⅰ in-terferon secretion were significantly decreased at 18,24 h of PRRSV infection,while IRPS signifi-cantly inhibited this process;poly(I∶C)alleviated the protein levels of TRIF,IRF3 and IRF7 as well as the phosphorylation levels of IRF3 and IRF7 infected by PRRSV;at the same time,IRPS is synergistic with poly(I∶C).The results indicate that IRPS is able to alleviate immunosuppression caused by PRRSV infection via the TLR3/TRIF pathway.

Radiation-induced heart disease (RIHD) is a common complication of radiotherapy and one of the main causes of non-cancer death in patients with thoracic malignant tumors, which seriously affects the clinical outcome and quality of life of patients. PET imaging is able to assess myocardial perfusion, abnormal myocardial metabolic, cardiac sympathetic disorders, myocardial fibrosis and inflammation, and is of great value in the early diagnosis and detection of RIHD. This article reviews the progress of PET imaging in the early detection of RIHD.