Objective To sort,summarize,and introduce key terms related to guideline reporting,evaluation,dissemination,implementation,and updating.Methods We systematically searched guideline de-velopment manuals and methodological literature from database inception to October 25,2024.Terms related to guideline reporting,updating,evaluation,and implementation were extracted,standardized,and finalized through a structured consensus process.Results A total of 13 guideline manuals and 32 methodological articles were included,yielding 14 core terms with standardized definitions.Conclusions This article introduces key terms such as reporting standards,external review,and research gaps across guideline development phases to promote concept application and deepen readers'understanding of guideline development.

Objective To develop and apply a self-management question prompt list for ovarian cancer postoperative patients to meet patients'information needs and promote the level of self-management.Methods The draft of the list was prepared through literature review and semi-structured interviews.From September to November 2023,the Delphi method was adopted to conduct 2 rounds of correspondence,and the list items were revised and improved based on expert opinions,and the final list was confirmed.From December 2023 to February 2024,a total of 28 ovarian cancer postoperative patients in a tertiary A hospital in Liaoning Province were conveniently selected as application subjects.The changes in patients'self-care ability before and after application were compared,and the evaluation of 28 medical staff on the implementation effect of the checklist was investigated.Results The effective questionnaire recovery rates were 95％and 100％;the expert authority coefficients were 0.92 and 0.90;the Kendall harmony coefficients were 0.284 and 0.302,respectively,all P＜0.001.The final list included 5 dimensions,including 11 items of disease and treatment,13 items of postoperative and daily care,9 items of physical symptom management,7 items of psychosocial support,and 5 items of prognosis information,with a total of 45 questions.The preliminary application results showed that there was a statistically significant difference in the scores of patients'self-care ability before and after the application of the checklist(t=14.92,P＜0.001),and the satisfaction rate of the evaluation items of the implementation effect of the checklist was 92.86％～100％.Conclusion The contents of the list items are comprehensive,targeted and practical,which can mobilize patients'subjective initiative of seeking information and improve self-management ability.

Objective To develop and apply a self-management question prompt list for ovarian cancer postoperative patients to meet patients'information needs and promote the level of self-management.Methods The draft of the list was prepared through literature review and semi-structured interviews.From September to November 2023,the Delphi method was adopted to conduct 2 rounds of correspondence,and the list items were revised and improved based on expert opinions,and the final list was confirmed.From December 2023 to February 2024,a total of 28 ovarian cancer postoperative patients in a tertiary A hospital in Liaoning Province were conveniently selected as application subjects.The changes in patients'self-care ability before and after application were compared,and the evaluation of 28 medical staff on the implementation effect of the checklist was investigated.Results The effective questionnaire recovery rates were 95％and 100％;the expert authority coefficients were 0.92 and 0.90;the Kendall harmony coefficients were 0.284 and 0.302,respectively,all P＜0.001.The final list included 5 dimensions,including 11 items of disease and treatment,13 items of postoperative and daily care,9 items of physical symptom management,7 items of psychosocial support,and 5 items of prognosis information,with a total of 45 questions.The preliminary application results showed that there was a statistically significant difference in the scores of patients'self-care ability before and after the application of the checklist(t=14.92,P＜0.001),and the satisfaction rate of the evaluation items of the implementation effect of the checklist was 92.86％～100％.Conclusion The contents of the list items are comprehensive,targeted and practical,which can mobilize patients'subjective initiative of seeking information and improve self-management ability.

To explore the role of the "Clinical Practice Guidelines" column and others in the Medical Joumnal of Peking Union Medical College Hospital (Med J PUMCH) in promoting diseiplinary development.

Objective To sort,summarize,and introduce key terms related to guideline reporting,evaluation,dissemination,implementation,and updating.Methods We systematically searched guideline de-velopment manuals and methodological literature from database inception to October 25,2024.Terms related to guideline reporting,updating,evaluation,and implementation were extracted,standardized,and finalized through a structured consensus process.Results A total of 13 guideline manuals and 32 methodological articles were included,yielding 14 core terms with standardized definitions.Conclusions This article introduces key terms such as reporting standards,external review,and research gaps across guideline development phases to promote concept application and deepen readers'understanding of guideline development.

Liver transplantation (LT) has become a standard treatment for end-stage liver diseases, and graft injury is intricately associated with poor prognosis. Granzyme B (GZMB) plays a vital role in natural killer (NK) cell biology, but whether NK-derived GZMB affects graft injury remains elusive. Through the analysis of single-cell RNA-sequencing data obtained from human LT grafts and the isolation of lymphocytes from mouse livers following ischemia-reperfusion injury (IRI), we demonstrated that 2NK cells with high expression of GZMB are enriched in patients and mice. Both systemically and liver-targeted depletion of NK cells led to a notable reduction in GZMB⁺ cell infiltration, subsequently resulting in diminished graft injury. Notably, the reconstitution of Il2rg ^-/- Rag2 ^-/- mice with purified Gzmb-KO NK cells demonstrated superior outcomes compared to those with wild-type NK cells. Crucially, global knockout of GZMB and pharmacological inhibition exhibited remarkable improvements in liver function in both mouse IRI and rat LT models. Moreover, a phosphorylated derivative of FDA-approved vidarabine was identified as an effective inhibitor of mouse GZMB activity by molecular dynamics, which could provide a potential avenue for therapeutic intervention. Therefore, targeting NK cell-derived GZMB during the LT process suggests potential therapeutic strategies to improve post-transplant outcomes.

Objective:To analyze the disease characteristics of aspiration pneumonia and its risk factors.Methods:In this retrospective case-control study, analysis was conducted on data from 92 patients aged &ge; 60 years admitted to Beijing Jishuitan Hospital, Capital Medical University between June 1, 2018 and July 31, 2022, with aspiration pneumonia(AsP) as the primary diagnosis at the time of hospital discharge and from non-AsP patients admitted during the same period.The number of participants was matched at a 1∶1 ratio.Results:The average age of the AsP group was(80.88 ± 9.41) years and 57(62.0%) were men.The average age of the control group was(77.74 ± 10.98) years and 52(56.5%) were men.There was no statistically significant difference in age and sex ratio(age: t=1.973, P=0.060; sex ratio: χ2=0.661, P=0.416).Univariate analysis showed that, at admission, body mass index(BMI) and activities of daily living(ADL) scores of the AsP group were lower than those of the non-AsP group, the proportions of patients with gastroesophageal reflux disease, acute trauma, cerebrovascular disease, history of cerebral infarction/hemorrhage and sequelae of cerebrovascular disease were higher than those of the non-AsP group(all P<0.05), and the proportions of patients receiving feeding via indwelling nasogastric intubation and tracheal intubation were also higher in the AsP group(all P<0.05).The white blood cell count, the percentage of neutrophils and the procalcitonin level in the first round of tests were higher in the AsP group than those in the non-AsP group and the maximum values of the above parameters during hospitalization were also higher than those in non-AsP patients, while the levels of albumin and prealbumin were lower than those in the non-AsP group( P<0.05 for all).Chest CT showed that 83.7%(77/92) of patients with AsP had bilateral pneumonia, higher than 55.4%(51/92) in the non-AsP group( χ2=8.569, P=0.014).Multivariate Logistic regression analysis showed that male sex( OR=16.206, 95% CI: 1.268-207.191, P=0.032) was a risk factor for AsP, and BMI( OR=0.747, 95% CI: 0.582-0.959, P=0.022) and ADL score at admission( OR=0.945, 95% CI: 0.903-0.988, P=0.014) were protective factors against AsP.ADL score at admission( OR=0.951, 95% CI: 0.907-0.982, P=0.043), tumor history( OR=6.859, 95% CI: 1.484-31.700, P=0.014), history of cerebral infarction/intracerebral hemorrhage( OR=4.368, 95% CI: 1.087-17.511, P=0.038), history of chronic renal insufficiency( OR=5.820, 95% CI: 1.445-23.440, P=0.013), acute respiratory failure( OR=5.281, 95% CI: 1.237-22.545, P=0.013) and myocardial infarction( OR=9.466, 95% CI: 2.151-41.660, P=0.003) were independent factors affecting the prognosis of pneumonia in the elderly. Conclusions:Aspiration pneumonia in the elderly is more common in men and in individuals with low BMI and low ADL scores.There is no increased risk of mortality in people with AsP, compared with people without AsP, but some risk factors in AsP patients may lead to poor prognosis, calling for increased awareness and early intervention in clinical practice.

Humans ; Non-alcoholic Fatty Liver Disease/drug therapy* ; Hypoglycemic Agents/therapeutic use* ; Liver Cirrhosis/pathology* ; Biopsy ; Patients ; Liver/pathology* ; Fibrosis

Objective:To evaluate clinical efficacy of first-line immune checkpoint inhibitors (ICI) combined with radiotherapy (RT) in patients with newly diagnosed non-small cell lung cancer (NSCLC) with brain metastasis (BM).Methods:Clinical data of patients with BM of NSCLC diagnosed in Henan Cancer Hospital from December 2017 to June 2021 were retrospectively analyzed. Patients were treated with programmed death-1 (PD-1) / programmed death-ligand 1 (PD-L1) inhibitor combined with or without brain RT. The survival rate was calculated by Kaplan-Meier analysis. Univariate analysis was performed by log-rank test and multivariate analysis was performed by Cox model.Results:The median follow-up time was 13 months (range 4-49 months). The median overall survival (OS) time was 24 months, and the 1-, 2- and 3-year OS rates were 75.8%, 44.7%, and 33.6%, respectively. The 1-year intracerebral progression-free survival (iPFS) was 68.8%. The intracerebral objective response rate (icORR) of the RT-ICI group and ICI group was 71.4% and 52.6%, respectively, and the intracerebral disease control rate (icDCR) was 96.4% and 89.4%, respectively ( P=0.122,0.291). Univariate analysis showed that the 1-, 2- and 3-year OS rates of patients with high graded prognostic assessment (GPA) scores were 100%, 85.7% and 35.7%, respectively. The 1-, 2- and 3-year OS rates of patients with low GPA scores were 68.3%, 33.6% and 33.6%, respectively ( P=0.115). The 1-, 2- and 3-year OS rates of patients in the RT-ICI group were 88.7%, 58.7% and 44.0%, respectively, and 63.6%, 20.9% and 20.9% for their counterparts in the ICI group, respectively ( P=0.022). The 1-, 2- and 3-year OS rates of symptomatic patients with BM were 60.9%, 33.8% and 33.8%, respectively, while 84.6%, 53.1% and 39.8% for asymptomatic counterparts, respectively ( P=0.021). Multivariate analysis showed that no symptoms of BM and brain RT were the independent influencing factors of OS rate ( P=0.038, 0.037). Conclusions:First-line ICI combined with brain RT can improve the survival rate of patients with BM of NSCLC. It is recommended that patients with BM should receive RT as soon as possible, especially those with brain symptoms.

Xanthocillin is a unique natural product with an isonitrile group and shows remarkable antibacterial activity. In this study, the genome of an endophytic fungus Penicillium chrysogenum MT-40 isolated from Huperzia serrata was sequenced, and the gene clusters with the potential to synthesize xanthocillin analogues were mined by local BLAST and various bioinformatics analysis tools. As a result, a biosynthetic gene cluster (named for) responsible for the biosynthesis of xanthocillin analogues was identified by further heterologous expression of the key genes in Aspergillus oryzae NSAR1. Specifically, the ForB catalyzes the synthesis of 2-formamido-3-(4-hydroxyphenyl) acrylic acid, and the ForG catalyzes the dimerization of 2-formamido-3-(4-hydroxyphenyl) acrylic acid to produce the xanthocillin analogue N, N'-(1, 4-bis (4-hydroxyphenyl) buta-1, 3-diene-2, 3-diyl) diformamide. The results reported here provide a reference for further discovery of xanthocillin analogues from fungi.
Penicillium chrysogenum/genetics* ; Huperzia/microbiology* ; Acrylates ; Multigene Family