Objective:To investigate the current status of endoscopic treatment for gastroesophageal varices in portal hypertension in China, and to provide supporting data and reference for the development of endoscopic treatment.Methods:In this study, initiated by the Liver Health Consortium in China (CHESS), a questionnaire was designed and distributed online to investigate the basic condition of endoscopic treatment for gastroesophageal varices in portal hypertension in 2022 in China. Questions included annual number and indication of endoscopic procedures, adherence to guideline for preventing esophagogastric variceal bleeding (EGVB), management and timing of emergent EGVB, management of gastric and isolated varices, and improvement of endoscopic treatment. Proportions of hospitals concerning therapeutic choices to all participant hospitals were calculated. Guideline adherence between secondary and tertiary hospitals were compared by using Chi-square test.Results:A total of 836 hospitals from 31 provinces (anotomous regions and municipalities) participated in the survey. According to the survey, the control of acute EGVB (49.3%, 412/836) and the prevention of recurrent bleeding (38.3%, 320/836) were major indications of endoscopic treatment. For primary [non-selective β-blocker (NSBB) or endoscopic therapies] and secondary prophylaxis (NSBB and endoscopic therapies) of EGVB, adherence to domestic guideline was 72.5% (606/836) and 39.2% (328/836), respectively. There were significant differences in the adherence between secondary and tertiary hospitals in primary prophylaxis of EGVB [71.0% (495/697) VS 79.9% (111/139), χ2=4.11, P=0.033] and secondary prophylaxis of EGVB [41.6% (290/697) VS 27.3% (38/139), χ2=9.31, P=0.002]. A total of 78.2% (654/836) hospitals preferred endoscopic therapies treating acute EGVB, and endoscopic therapy was more likely to be the first choice for treating acute EGVB in tertiary hospitals (82.6%, 576/697) than secondary hospitals [56.1% (78/139), χ2=46.33, P<0.001]. The optimal timing was usually within 12 hours (48.5%, 317/654) and 12-24 hours (36.9%, 241/654) after the bleeding. Regarding the management of gastroesophageal varices type 2 and isolated gastric varices type 1, most hospitals used cyanoacrylate injection in combination with sclerotherapy [48.2% (403/836) and 29.9% (250/836), respectively], but substantial proportions of hospitals preferred clip-assisted therapies [12.4% (104/836) and 26.4% (221/836), respectively]. Improving the skills of endoscopic doctors (84.2%, 704/836), and enhancing the precision of pre-procedure evaluation and quality of multidisciplinary team (78.9%, 660/836) were considered urgent needs in the development of endoscopic treatment. Conclusion:A variety of endoscopic treatments for gastroesophageal varices in portal hypertension are implemented nationwide. Participant hospitals are active to perform emergent endoscopy for acute EGVB, but are inadequate in following recommendations regarding primary and secondary prophylaxis of EGVB. Moreover, the selection of endoscopic procedures for gastric varices differs greatly among hospitals.

OBJECTIVE To sort out drug prophylaxis regimens for venous thromboembolism （VTE） in adult patients after artificial joint replacement， and provide a basis for clinic. METHODS Databases and related official websites were searched according to the “6S” model， including the National Institute for Health and Clinical Excellence （NICE）， the Scottish Intercollegiate Guidelines Network （SIGN）， the Guidelines International Network （GIN）， the National Guidelines Clearinghouse （NGC）， PubMed， Embase， CNKI， Wanfang database and SinoMed， to search for guidelines， expert consensuses， systematic evaluations， randomized controlled trials， and cohort studies about preventing VTE in adult patients after artificial joint replacement from the inception until December 2023. Literature that met the inclusion criteria were selected， and the quality evaluation of the literature was completed by 2 researchers independently； the evidence rating was performed by using the Joanna Briggs Institute （JBI） evidence pre-classification and evidence rank system （2014 edition）. RESULTS A total of 36 articles were included in the study， which were categorized into 9 areas of risk assessment， post-assessment prophylaxis， medication selection， medication method， duration of medication prophylaxis， medication prophylaxis observation points， contraindications to drug prophylaxis， response to bleeding， and health education， which were summarized to form 37 pieces of evidence on the pharmacological prophylaxis for postoperative VTE in patients who underwent artificial joint replacement. CONCLUSIONS The evidence of drug prophylaxis for postoperative VTE in patients who underwent artificial joint replacement summarized in this study is comprehensive， with certain scientific reference and practicality， which can provide clinical pharmacists with a scientific evidence-based basis for perioperative VTE prophylaxis management.

Objective:To investigate the clinical and pathological characteristics and prognosis of children with lupus nephritis(LN)and thrombotic microangiopathy (TMA).Methods:In this retrospective case-control study, clinical and pathological data of LN children confirmed by renal biopsy from January 2008 to January 2023 in Xuzhou Children′s Hospital, Xuzhou Medical University were analyzed.There were 46 LN children complicated with TMA (LN-TMA group). With matched age, sex and pathology, 92 LN children (1∶2) without TMA were selected as the control group (LN group). The Kaplan-Meier method was used to evaluate the overall and renal survival rates of children with LN, and the Cox regression model was used to analyze the risk factors for the progression to end-stage renal disease (ESRD).Results:TMA was moderately associated with serum creatinine, serum C3, anti-C1q antibody (a-C1q), estimated glomerular filtration rate (eGFR), endocapillary proliferation, fibrinoid necrosis, and renal C1q deposition (all r>0.5). Serum a-C1q≥20 U/mL ( HR=8.724, 95% CI: 0.976-16.114, P=0.026) and eGFR≤60 mL/(min·1.73 m 2) ( HR=12.213, 95% CI: 1.147-25.048, P=0.038) were independent risk factors for TMA in children with LN.Glomerular sclerosis ( HR=7.228, 95% CI: 0.186-22.358, P=0.016), TMA ( HR=11.387, 95% CI: 3.426-42.554, P=0.009) and eGFR≤60 mL/(min·1.73 m 2) ( HR=3.116, 95% CI: 0.592-10.064, P=0.030) were independent risk factors for developing ESRD in LN children.The 5-year and 10-year renal survival rates in the LN-TMA group were lower than those in the LN group (97.44% vs.98.28%, 80.90% vs.87.27%, χ2=4.918, P=0.027). Conclusions:Children with LN-TMA present with severe symptoms and poor prognosis.TMA is an independent risk factor for progression to ESRD in children with LN, and the mechanism may be related to complement activation.

BACKGROUND:Pressing massage applied to myofascial trigger points(MTrPs)has shown clear effect in relieving pain.However,further research is needed to investigate the effects of different levels of pressure applied during the massage. OBJECTIVE:To investigate the different strength of pressing on MTrPs in rats with chronic pain. METHODS:Sixty SPF-rated male Sprague-Dawley rats were randomly divided into a blank group of 10 rats not involved in MTrPs modeling and 50 rats involved in modeling.The MTrPs model was established in the left medial thigh muscle of rats by blunt strikes combined with centrifugal exercise and 40 rats that met the evaluation criteria after modeling were randomly divided into model group,light press group,medium press group and heavy press group,with 10 rats in each group.The rats in the blank group and the model group were not intervened,while the rats in the light press group,the medium press group and the heavy press group were intervened with a homemade press stimulator with light force(0.3 kg),medium force(0.5 kg)and heavy force(0.7 kg)to MTrPs.The intervention time was 7.5 minutes per session,with one session every other day,totaling seven sessions.Electromyogram,soft tissue tension and mechanical pain threshold were detected by electrophysiological instruments,soft tissue tension tester,and pressure painmeter,respectively.After the intervention,in the blank group,muscle tissue was taken from the inside of the left thigh,while in the other groups,MTrPs tissue was taken.The pathological morphology was observed by hematoxylin-eosin staining,while enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of cyclooxygenase-2,prostaglandin E2 and bradykinin. RESULTS AND CONCLUSION:Compared with the blank group,the model group had lower mechanical pain thresholds,higher soft tissue tone,higher amplitude frequency of spontaneous electrical activity,significant pathomorphological changes,and increased levels of cyclooxygenase-2,prostaglandin E2 and bradykinin(P<0.05).Compared with the model group,the medium press group and the heavy press group showed increased mechanical pain thresholds,decreased soft tissue tension,decreased spontaneous potential frequency amplitude,and decreased levels of cyclooxygenase-2,prostaglandin E2 and bradykinin(P<0.05),and significant recovery on pathomorphological changes.No significant changes in the above indicators were observed in the light press group(P>0.05).Compared with the medium press group,the heavy press group showed better improvement in the above indicators(P<0.05).To conclude,moderate to heavy pressing is often required to alleviate MTrPs pain.

Objective:To analyze the clinical characteristics and genetic basis of a male patient with primary infertility caused by Acephalic spermatozoa syndrome.Methods:A patient who had presented at the Henan Provincial People′s Hospital on October 1, 2022 was selected as the study subject. Clinical data and results of laboratory exams and sperm electron microscopy were collected. The patient was subjected to whole exome sequencing (WES), and candidate variants were verified by Sanger sequencing and pathogenicity analysis.Results:WES revealed that the patient has harbored compound heterozygous variants of the PMFBP1 gene, namely c. 853del (p.Ala285Leufs*24) and c. 1276A>T (p.Lys426X), which were both unreported previously. Sanger sequencing suggested that the c. 853del (p.Ala285Leufs*24) variant has derived from his deceased mother, whilst the c. 1276A>T (p.Lys426X) variant has derived from his father. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), both variants were classified as pathogenic (PVS1+ PM2_Supporting+ PP4). Conclusion:The compound heterozygous variants of the PMFBP1 gene probably underlay the Acephalic spermatozoa syndrome in this patient. The discovery of the novel variants has also enriched the mutational spectrum of Acephalic spermatozoa syndrome.

Objective To construct a usability scale for smart hospital platforms based on Quality of Experience(QoE)theory,and provide scientific measurement tool for the construction,operation,and improvement of smart hospitals.Method Literature review,focus meeting method,and pre survey were used to screen and revise the scale items,forming a formal scale.Using convenience sampling method,1 000 users from 8 smart hospital platforms in Shandong Province were selected as the research subjects to evaluate the reliability and validity of the scale.Result The availability scale of the smart hospital platform includes 6 dimensions and 24 items.Exploratory factor extraction identified 6 common factors,with a cumulative variance contribution rate of 64.045%.The overall Cronbach's with a coefficient of 0.941 for 6 dimensions.The coefficient is between 0.782 and 0.963,and the retest reliability is 0.967.The Average Standardized Content Validity Index is 0.972,and the Item-level Content Validity Index is between 0.86 and 1.00.The correlation coefficient between the six dimensions of the scale and the System Usability Scale is 0.606-0.653,and the overall correlation coefficient is 0.647.Conclusion The usability scale of the smart hospital platform developed based on QoE theory has good reliability and validity,and can be used to measure the user experience of the smart hospital platform.

Objective To construct a usability scale for smart hospital platforms based on Quality of Experience(QoE)theory,and provide scientific measurement tool for the construction,operation,and improvement of smart hospitals.Method Literature review,focus meeting method,and pre survey were used to screen and revise the scale items,forming a formal scale.Using convenience sampling method,1 000 users from 8 smart hospital platforms in Shandong Province were selected as the research subjects to evaluate the reliability and validity of the scale.Result The availability scale of the smart hospital platform includes 6 dimensions and 24 items.Exploratory factor extraction identified 6 common factors,with a cumulative variance contribution rate of 64.045%.The overall Cronbach's with a coefficient of 0.941 for 6 dimensions.The coefficient is between 0.782 and 0.963,and the retest reliability is 0.967.The Average Standardized Content Validity Index is 0.972,and the Item-level Content Validity Index is between 0.86 and 1.00.The correlation coefficient between the six dimensions of the scale and the System Usability Scale is 0.606-0.653,and the overall correlation coefficient is 0.647.Conclusion The usability scale of the smart hospital platform developed based on QoE theory has good reliability and validity,and can be used to measure the user experience of the smart hospital platform.

Objective To construct a usability scale for smart hospital platforms based on Quality of Experience(QoE)theory,and provide scientific measurement tool for the construction,operation,and improvement of smart hospitals.Method Literature review,focus meeting method,and pre survey were used to screen and revise the scale items,forming a formal scale.Using convenience sampling method,1 000 users from 8 smart hospital platforms in Shandong Province were selected as the research subjects to evaluate the reliability and validity of the scale.Result The availability scale of the smart hospital platform includes 6 dimensions and 24 items.Exploratory factor extraction identified 6 common factors,with a cumulative variance contribution rate of 64.045%.The overall Cronbach's with a coefficient of 0.941 for 6 dimensions.The coefficient is between 0.782 and 0.963,and the retest reliability is 0.967.The Average Standardized Content Validity Index is 0.972,and the Item-level Content Validity Index is between 0.86 and 1.00.The correlation coefficient between the six dimensions of the scale and the System Usability Scale is 0.606-0.653,and the overall correlation coefficient is 0.647.Conclusion The usability scale of the smart hospital platform developed based on QoE theory has good reliability and validity,and can be used to measure the user experience of the smart hospital platform.

Objective To construct a usability scale for smart hospital platforms based on Quality of Experience(QoE)theory,and provide scientific measurement tool for the construction,operation,and improvement of smart hospitals.Method Literature review,focus meeting method,and pre survey were used to screen and revise the scale items,forming a formal scale.Using convenience sampling method,1 000 users from 8 smart hospital platforms in Shandong Province were selected as the research subjects to evaluate the reliability and validity of the scale.Result The availability scale of the smart hospital platform includes 6 dimensions and 24 items.Exploratory factor extraction identified 6 common factors,with a cumulative variance contribution rate of 64.045%.The overall Cronbach's with a coefficient of 0.941 for 6 dimensions.The coefficient is between 0.782 and 0.963,and the retest reliability is 0.967.The Average Standardized Content Validity Index is 0.972,and the Item-level Content Validity Index is between 0.86 and 1.00.The correlation coefficient between the six dimensions of the scale and the System Usability Scale is 0.606-0.653,and the overall correlation coefficient is 0.647.Conclusion The usability scale of the smart hospital platform developed based on QoE theory has good reliability and validity,and can be used to measure the user experience of the smart hospital platform.

Objective To construct a usability scale for smart hospital platforms based on Quality of Experience(QoE)theory,and provide scientific measurement tool for the construction,operation,and improvement of smart hospitals.Method Literature review,focus meeting method,and pre survey were used to screen and revise the scale items,forming a formal scale.Using convenience sampling method,1 000 users from 8 smart hospital platforms in Shandong Province were selected as the research subjects to evaluate the reliability and validity of the scale.Result The availability scale of the smart hospital platform includes 6 dimensions and 24 items.Exploratory factor extraction identified 6 common factors,with a cumulative variance contribution rate of 64.045%.The overall Cronbach's with a coefficient of 0.941 for 6 dimensions.The coefficient is between 0.782 and 0.963,and the retest reliability is 0.967.The Average Standardized Content Validity Index is 0.972,and the Item-level Content Validity Index is between 0.86 and 1.00.The correlation coefficient between the six dimensions of the scale and the System Usability Scale is 0.606-0.653,and the overall correlation coefficient is 0.647.Conclusion The usability scale of the smart hospital platform developed based on QoE theory has good reliability and validity,and can be used to measure the user experience of the smart hospital platform.