Guidelines, consensuses and standards play a significant role in guiding clinical diagnosis and treatment practices, optimizing the allocation of medical resources and reducing medical costs. To fully leverage the pivotal role of the National Clinical Research Center as a bridge between research evidence, recommendations of guidelines, consensuses and standards, and clinical practice, it is particularly urgent to construct a set of appropriate and efficient management system for guidelines, consensuses and standards. The National Clinical Research Center for Geriatric of West China Hospital, Sichuan University (hereinafter referred to as the center) has set the overall goal of " transparency, standardization, coordination, linkage and innovation leadership" and three phased goals of " achieving scientific, transparent and applicable management" " improving the multi-level, multi-subject coordination and linkage mechanism" and " promoting the homogenization of diagnosis and treatment services, process guarantee and standardized management" to explore the establishment of a management system for guidelines, consensuses and standards. Under this framework, the center has established the management committee and office for guidelines, consensuses and standards; build a dual-channel funding support model of " out-of-hospital+ in-hospital", established differentiated implementation models and formulated standardized processes; respectively formed clinical expert groups, methodology expert groups and evidence synthesis working groups, and carried out personnel training; and constructed a support platform for formulation, evaluation and promotion. As of October 2024, relying on the established management system for guidelines, consensuses and standards, the center has achieved a series of results in three aspects: formulating international evidence-based clinical practice guidelines, establishing a system of guidelines, consensuses and standards for geriatric disability, and building a standard system for medical and nursing integration, which has strongly supported clinical practice and the improvement of people′s livelihood by the government, and preliminarily completed the construction goals of the first phase, and can provide references for medical institutions committed to building a management system for guidelines, consensuses and standards.

Guidelines, consensuses and standards play a significant role in guiding clinical diagnosis and treatment practices, optimizing the allocation of medical resources and reducing medical costs. To fully leverage the pivotal role of the National Clinical Research Center as a bridge between research evidence, recommendations of guidelines, consensuses and standards, and clinical practice, it is particularly urgent to construct a set of appropriate and efficient management system for guidelines, consensuses and standards. The National Clinical Research Center for Geriatric of West China Hospital, Sichuan University (hereinafter referred to as the center) has set the overall goal of " transparency, standardization, coordination, linkage and innovation leadership" and three phased goals of " achieving scientific, transparent and applicable management" " improving the multi-level, multi-subject coordination and linkage mechanism" and " promoting the homogenization of diagnosis and treatment services, process guarantee and standardized management" to explore the establishment of a management system for guidelines, consensuses and standards. Under this framework, the center has established the management committee and office for guidelines, consensuses and standards; build a dual-channel funding support model of " out-of-hospital+ in-hospital", established differentiated implementation models and formulated standardized processes; respectively formed clinical expert groups, methodology expert groups and evidence synthesis working groups, and carried out personnel training; and constructed a support platform for formulation, evaluation and promotion. As of October 2024, relying on the established management system for guidelines, consensuses and standards, the center has achieved a series of results in three aspects: formulating international evidence-based clinical practice guidelines, establishing a system of guidelines, consensuses and standards for geriatric disability, and building a standard system for medical and nursing integration, which has strongly supported clinical practice and the improvement of people′s livelihood by the government, and preliminarily completed the construction goals of the first phase, and can provide references for medical institutions committed to building a management system for guidelines, consensuses and standards.

Objective To investigate the association of frailty with serum inflammatory biomarkers and geriatric parameters.Methods A total of 299 elderly people aged 60 and over were recruited,received frailty and comprehensive geriatric assessment,and were tested on serum levels of interleukin-10 (IL-10),interleukin-1β (IL-1β),monocyte chemoattractant protein-1 (MCP-1),monocyte chemoattractant protein-3 (MCP-3),macrophage inflammatory protein 1a (MIP-1α),macrophage inflammatory protein-1β (MIP-1β),tumor necrosis factor α (TNF-α),nuclear factor-κB (NF-κB) and sirtuin-1 (SIRT-1).Potential association of frailty with these biomarkers and several geriatric parameters was analyzed.Results Statistical differences in serum levels of MCP-1,MIP-1α and MIP-1β were detected between the frailty group and the non-frailty group (H=10.766,10.766 and 8.217,respectively;P =0.005,0.043 and 0.016,respectively).Logistic regression analyses showed that MCP-1 and MIP-1β were associated with frailty after adjustment for age,sex,body mass index (BMI),smoking,drinking,comorbidity and comprehensive geriatric assessment (OR=2.493,2.531,both F＜0.05).Conclusions MCP-1 and MIP-1β are risk factors for frailty.

Frailty is a common state or syndrome with a decline in physiological reserves and an increase in an individual's vulnerability for stress in the elderly.Frailty can increase the risk of disability,falls,hospitalization,delirium and mortality.However,the intervention of frailty is under the scarcity and its effectiveness is not satisfied.We need to find new targets to treat frailty according to the pathophysiology of frailty.Human physiology is very similar to that of mouse,thus,mouse can be an ideal animal model of human disease.Mouse models can provide insight into pathogenesis of frailty by reducing the influence of genetic and environment factors and provide more basic data for further studies of frailty.At present,the research on a mouse model of frailty is still in its infancy and still needs further study.This review will summarize the related studies and propose some new ideas for future studies on mouse model of frailty.

Objective:To provide clinical evidence-based prognosis for patients with postpartum HEELP syndrome complicated with acute renal failure. Methods:The clinical question was proposed. Some database was searched to assess the evidence. Results:A total of 4 studies were included,however,the quality of the studies was low. The results of the studies was suitable for our patients. The death of patients with postpartum HEELP syndrome complicated with acute renal failure was attributed to multiple organ failure. The risk factors for poor prognosis was primipara, delivery after twin pregnancy, absence of typical symptoms, rapid clinical progression, high blood pressure, epigastric pain. Early assessment and diagnosis for maternal and infant, positive in intervention and be caution for the DIC and multiple organ failure, using plasmapheresis can improve the prognosis. Conclusion:Patients with postpartum HEELP syndrome complicated with acute renal failure have an acute process and poor prognosis, especially for patients without typical symptoms.