Clinical practice guidelines represent the best recommendations for patient care. They are developed through systematically reviewing currently available clinical evidence and weighing the relative benefits and risks of various interventions. However, clinical practice guidelines have to go through a long translation cycle from development and revision to clinical promotion and application, facing problems such as scattered distribution, high duplication rate, and low actual utilization. At present, the clinical practice guideline information platform can directly or indirectly solve the problems related to the lengthy revision cycles, decentralized dissemination and limited application of clinical practice guidelines. Therefore, this paper systematically examines different types of clinical practice guideline information platforms and investigates their corresponding challenges and emerging trends in platform design, data integration, and practical implementation, with the aim of clarifying the current status of this field and providing valuable reference for future research on clinical practice guideline information platforms.

Objective:To understand the epidemiological characteristics of injury deaths in local residents in Nanjing from 2009 to 2023, and provide evidence for the development of injury prevention and control strategies.Methods:The injury mortality data in Nanjing from 2009 to 2023 were analyzed based on the death cause surveillance system. In the recorded 33 542 injury death cases, 19 906 (59.35%) were men, and 13 636 (40.65%) were women. The crude mortality rate, age-standardized mortality rate, age-specific mortality rate, cause-eliminated life expectancy (CELE), potential gains in life expectancy (PGLEs) and life loss rate, were calculated. Joinpoint 5.0 software was used to estimate the average annual percentage change (AAPC) and its 95% CI to assess temporal trends of injury deaths. Results:In Nanjing, the crude injury mortality rate showed an upward trend (AAPC=2.11%), while the age-standardized mortality rate exhibited a downward trend (AAPC=-1.27%) from 2009 to 2023. The ranking of injury deaths in all causes of death declined from the 4 th in 2009 to the 6 th in 2023. The crude and age-standardized injury mortality rates in men were consistently higher than those in women. The primary cause of injury deaths was fall (31.42%). Drowning was the primary cause of injury deaths in age group 0-14 years (35.94%), while traffic accident was the primary cause in age group 15-64 years. For residents aged ≥65 years, fall was the primary cause of injury deaths. From 2009 to 2023, the CELE (AAPC=0.61%, 95% CI: 0.34%-0.89%, P<0.05) and the PGLEs (AAPC=1.73%, 95% CI: 0.21%-3.29%, P<0.05) showed increasing trends. The PGLEs and life loss rate due to injury were consistently higher in men than in women, but the AAPC of PGLEs and life loss rate was higher in women. Conclusions:From 2009 to 2023, the age-standardized injury mortality rate decreased, but the life loss due to injury deaths showed an upward trend in Nanjing, indicating that injury still has non-negligible negative impact on life expectancy.

Objective:To understand the epidemiological characteristics of injury deaths in local residents in Nanjing from 2009 to 2023, and provide evidence for the development of injury prevention and control strategies.Methods:The injury mortality data in Nanjing from 2009 to 2023 were analyzed based on the death cause surveillance system. In the recorded 33 542 injury death cases, 19 906 (59.35%) were men, and 13 636 (40.65%) were women. The crude mortality rate, age-standardized mortality rate, age-specific mortality rate, cause-eliminated life expectancy (CELE), potential gains in life expectancy (PGLEs) and life loss rate, were calculated. Joinpoint 5.0 software was used to estimate the average annual percentage change (AAPC) and its 95% CI to assess temporal trends of injury deaths. Results:In Nanjing, the crude injury mortality rate showed an upward trend (AAPC=2.11%), while the age-standardized mortality rate exhibited a downward trend (AAPC=-1.27%) from 2009 to 2023. The ranking of injury deaths in all causes of death declined from the 4 th in 2009 to the 6 th in 2023. The crude and age-standardized injury mortality rates in men were consistently higher than those in women. The primary cause of injury deaths was fall (31.42%). Drowning was the primary cause of injury deaths in age group 0-14 years (35.94%), while traffic accident was the primary cause in age group 15-64 years. For residents aged ≥65 years, fall was the primary cause of injury deaths. From 2009 to 2023, the CELE (AAPC=0.61%, 95% CI: 0.34%-0.89%, P<0.05) and the PGLEs (AAPC=1.73%, 95% CI: 0.21%-3.29%, P<0.05) showed increasing trends. The PGLEs and life loss rate due to injury were consistently higher in men than in women, but the AAPC of PGLEs and life loss rate was higher in women. Conclusions:From 2009 to 2023, the age-standardized injury mortality rate decreased, but the life loss due to injury deaths showed an upward trend in Nanjing, indicating that injury still has non-negligible negative impact on life expectancy.

To systematically construct a guideline to provide a methodological guide for researchers to develop patient decision aids.

Bone Transplantation/adverse effects* ; Transplantation, Autologous/adverse effects*

To systematically construct a guideline to provide a methodological guide for researchers to develop patient decision aids.

Objective:To explore the effect of potentially inappropriate medication (PIM) on frailty among community-dwelling elderly patients with mild cognitive impairment (MCI).Methods:From March to July 2021, a total of 252 elderly patients with MCI in Hefei community were selected.The data of basic information and PIM of subjects were collected.All subjects were assessed by the comprehensive frailty assessment instrument (CFAI), Montreal cognitive assessment scale-basic (MoCA-B), and the Barthel index (BI). The subjects were divided into PIM group ( n=136) and non-PIM group ( n=94) according to whether there was PIM.Taking the confounding factors as the matching condition, the subjects of the two groups were matched with 1∶1 propensity score.After matching, there were 52 in the PIM group and 52 in the non-PIM group.SPSS 23.0 was used for data analysis.Multivariate Logistic regression analysis was performed to analyze the effect of PIM on frailty of subjects. Results:(1)Before matching, the incidence of frailty in PIM group and non-PIM group were 80.9% and 19.1%, respectively, with statistically significant differences ( P<0.01). Logistic regression analysis revealed that PIM was a risk factor for the frailty ( β=1.704, OR=5.495, 95% CI=2.539-11.892). (2)After matching, the confounders of age, hearing status, chewing function, activities of daily living, Charlson comorbidity index, handgrip strength, and cognitive function were balanced and comparable between the two groups.The incidence of frailty in PIM group and non-PIM group were 67.9% and 32.1%, respectively.The differences remained statistically significant ( P<0.01). PIM remained a risk factor for frailty ( β=1.791, OR=5.998, 95% CI=2.393-15.032). Conclusion:PIM is a risk factor for the occurrence of frailty in elderly patients with MCI.Therefore, the accurate screening and standardized management of PIM will provide a new target for the frailty management of elderly patients with MCI.

Objective To investigate whether Helicobacter pylori (H.pylori) infection correlated with primary infertility,whether H.pylori infection caused the abnormal elevation of pro-inflammatory cytokines in primary infertility women,and whether cytotoxin associated gene A (CagA) protein played a key role in it.Methods From September 2015 to August 2016,213 patients with primary infertility (infertility group) and 97 healthy individuals (control group) were selected.According to the common etiologies,patients with primary infertility were divided into groups with single-factor infertility,multifactorial infertility and unexplained reason groups.Serum H.pylori IgG antibody and CagA antibody were examined by H.pylori antibody type test kits.The levels of interleukin (IL)-2,IL-4,IL-5,IL-6,IL-8,IL-10,IL-13,IL-18,IL-1β,granulocyte-macrophage-colony stimulating factor (GM-CSF),interferon-γ (IFN-γ),tumor necrosis factor-a (TNF-a) and IL-12p70 were tested by ProcartaPlex Immunoassays.Chi square test and independent sample t test were performed for statistical analysis and risk was assessed.Results The positive rate of serum H.pylori IgG antibody of patients with primary infertility was higher than that of healthy control group (74.0％,37/50 vs 56.7％,55/97),and the difference was statistically significant (odds ratio (OR) =2.173,95 ％ confidence interval (CI) 1.028 to 4.595,x2=4.216,P =0.040).There was no statistically significant difference in the positive rate of CagA antibody between primary infertility group and healthy control group (71.7 ％,91/127 vs 74.5 ％,41/55,OR=0.863,95％CI0.421 to1.772,P＞0.05).The serum levels ofIL-8,IL-18 andIFN-γ of H.pylori positive primary infertility patients were (35.14 ± 12.16),(11.83 ± 4.01) and (11.05 ±3.17) ng/L,respectively,which were all higher than those of H.pylori positive healthy control group ((21.44±12.35),(9.89±2.23) and (8.90±1.45) ng/L,respectively) and H.pylori negative primary infertility group ((11.45±8.63),(7.90±0.99) and (8.18±1.10) ng/L,respectively),and the differences were statistically significant (t=6.947,3.366 and 4.811;15.596,8.900 and 8.068;all P＜0.05).The levels of IL-8,IL-18 and IFN-γ of H.pylori positive unexplained reason primary infertility group were (39.97 ± 11.52),(13.12±4.61) and (13.06±3.70) ng/L,respectively,which were all significantly higher than those of single-factor infertility group ((31.65 ±11.20),(11.12 ± 3.46) and (10.14 ± 2.41) ng/L,respectively) and multifactorial infertility group ((30.47±8.49),(11.13±3.79) and (10.07±2.50) ng/L,respectively);and the differences were statistically significant (t=4.217,2.942 and 5.738;5.138,2.562 and 5.218;all P＜0.05).In H.pylori positive primary infertility group,the levels of IL-8,IL-18 and IFN-γ of CagA positive patients were (40.42 ± 13.80),(13.04 ± 4.19) and (11.51± 3.41) ng/L,respectively,which were all significantly higher than those of CagA negative patients ((23.49 ± 11.57),(9.08 ± 1.43) and (10.04 ± 2.29) ng/L,respectively) and CagA positive individuals in healthy control group ((21.85 ± 12.14),(10.20 ± 2.29) and (9.31 ± 2.38) ng/L,respectively);and the differences were statistically significant (t =6.507,5.533 and 2.380;7.417,4.069 and 3.738;all P＜0.05).Conclusion CagA positive H.pylori infection can increase the level of serum pro-inflammatory cytokines,which may be a risk factor of primary infertility.To patients with unexplained primary infertility,this may be the cause of infertility.

Objective To establish an eukaryotic vector of monkey B virus glycoprotein D gene and analyze the expression of gD gene in human embryonic kidney 293T cells.Method First, the protein of monkey B virus glycoprotein D was obtained by gene synthesis.The gene fragments were digested with Pst I and Not I, and ligated to pEGPF-N3. Then, the recombinant plasmid pEGPF-N3-GD was transfected into 293T cells.The expression of gD protein in the cells was detected by Western blot, and the expression localization was investigated using laser scanning confocal microscopy. Results The recombinant plasmid pEGPF-N3 carrying gD gene was successfully constructed, and normally expressed in the 293T cells.Conclusions Glycoprotein D of monkey B virus is expressed successfully in the 293T cells and the protein is located on the cell surface.It may be useful for the preparation of specific recombinant antigen to the glycoprotein D of monkey B virus on cell surface, and can be also used for preparation of antigen slide for detection of monkey B virus.

Objective To get the gene encoding extracellular domains of gB protein of B virus and analyze its expression in the eukaryocyte cell.Methods synthesizing gene fragment encoding extracellular domains of gB protein of B virus was by using synthesis gene, then digested with the restriction endonucleases BamHⅠand NotⅠand inserted into eukaryotic expressing vector pEGFP-N3.pEGFP-N3-GB合 was transfected into 293 cells.After protein extraction, the expression of gene was detcted by western blotting, and the cellular localization of the gene was analyzed by immunofluorescence and laser scanning confocal microscopy.Results pEGFP-N3-GB合were expressed in 293 cells and on the cell membrane.Conclusion eukaryotic expressing system can produce specific antigen recombination protein of B virus gB protein and express on the cell membrane.