Objective To establish an expert consensus on in-hospital transfer safety management for patients undergoing invasive mechanical ventilation,providing guidance for clinical medical teams to conduct standardized transfers,reduce transfer risks,and ensure patient safety.Methods Through systematic searching,screening,evaluation,and summary of evidence related to in-hospital transfer safety management for patients on invasive mechanical ventilation,we extracted recommendations to form a preliminary draft of the expert consensus.From July to October 2024,totally 2 rounds of expert consultations,and 2 rounds of expert reviews were conducted,and the content was refined and finalized based on expert feedback.Results The final consensus encompasses 9 aspects,including transfer assessment and decision-making,pre-transfer preparation of medical staff,pre-transfer patient preparation,pre-transfer equipment preparation,pre-transfer medication preparation,monitoring and intervention during transfer,emergency events and management,transfer handover and documentation,and post-transfer management.Conclusion This consensus demonstrates strong practicality and operability,offering professional guidance for enhancing the safety of in-hospital transfers for patients on invasive mechanical ventilation.

Objective:To investigate the clinical value of serum ferritin (SF) and neutrophil-to-lymphocyte ratio (NLR) in predicting intravenous immunoglobulin (IVIG) resistance in Kawasaki disease (KD).Methods:Clinical data from 193 KD children hospitalized at Kunming Children's Hospital (January 2018 - December 2023) were retrospectively analyzed. Patients were stratified into IVIG-sensitive ( n=159) and IVIG-resistant ( n=34) groups. Demographic characteristics and laboratory parameters (SF, NLR, etc.) were compared. Normally distributed continuous variables were expressed as xˉ± s and analyzed by independent samples t-test; non-normally distributed data were expressed as M ( Q1, Q3) and compared by Mann-Whitney U tests. Categorical data were expressed as case(%) and compared by χ2 tests. Pearson's analysis was used on correlation analysis, logistic regression was used on multivariate analysis. Predictive accuracy was evaluated by receiver operating characteristic (ROC) curves. Results:SF [(429.56±307.74) μg/L], NLR (7.52±4.80), WBC [(19.66±9.02) × 10 9/L], NEUT [(15.41±6.81) × 10 9/L], AST [46.00 (23.00, 130.25) U/L], ALT [113.50 (36.50, 205.00) U/L], CRP [(123.66±59.38) mg/L] and ESR [(76.47±25.97) mm/h] were higher in the IVIG resistant group than the IVIG sensitivity group [(213.89±127.98) μg/L, 3.88±3.71, (14.58±5.15) × 10 9/L, (9.76±4.64) × 10 9/L, 27.00 (22.00, 40.00) U/L, 40.00 (17.00, 95.00) U/L, (81.40±55.65) mg/L, (65.40±23.05) mm/h]. LYMP [(2.77±1.97) × 10 9/L] and albumin [(29.10±4.96) g/L] were lower in the IVIG resistant group than the IVIG sensitivity group [(3.66±1.86) × 10 9/L, (32.52±4.04) g/L], and the differences were statistically significant (statistical values were t=4.01, t=4.17, t=3.17, t=4.61, Z=2.74, Z=3.39, t=3.97, t=2.48, t=2.51, t=4.30, respectively, P values were 0.001, 0.001, 0.001, 0.001, 0.006, 0.001, 0.001, 0.014, 0.013, 0.001). Logistic regression analysis showed that serum ferritin ( OR=1.004, 95% CI: 1.001-1.006) and NLR ( OR=1.108, 95% CI: 1.007-1.218) were risk factors for IVIG resistance (P values were 0.035 and 0.002, respectively). The area under ROC curve for predicting IVIG resistance using serum ferritin combined with NLR was 0.812, with sensitivity and specificity of 76.47% and 72.96%, respectively. Conclusion:High levels of SF and NLR are independent risk factors for predicting IVIG resistance. SF combined with NLR has a certain predictive value for IVIG resistance in Kawasaki disease.

Objective: To evaluate the feasibility of dynamic contrast-enhanced MRI (DCE-MRI) in differentiating tumor deposits (TDs) from metastatic lymph nodes (MLNs) in rectal cancer. Materials and Methods: A retrospective analysis was conducted on 70 patients with rectal cancer, including 168 lesions (70 TDs and 98 MLNs confirmed by histopathology), who underwent pretreatment MRI and subsequent surgery between March 2019 and December 2022. The morphological characteristics of TDs and MLNs, along with quantitative parameters derived from DCE-MRI (K trans , kep, and v e) and DWI (ADCmin, ADCmax, and ADCmean), were analyzed and compared between the two groups.Multivariable binary logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic performance of significant individual quantitative parameters and combined parameters in distinguishing TDs from MLNs. Results: All morphological features, including size, shape, border, and signal intensity, as well as all DCE-MRI parameters showed significant differences between TDs and MLNs (all P < 0.05). However, ADC values did not demonstrate significant differences (all P > 0.05). Among the single quantitative parameters, v e had the highest diagnostic accuracy, with an area under the ROC curve (AUC) of 0.772 for distinguishing TDs from MLNs. A multivariable logistic regression model incorporating short axis, border, v e, and ADC mean improved diagnostic performance, achieving an AUC of 0.833 (P = 0.027). Conclusion The combination of morphological features, DCE-MRI parameters, and ADC values can effectively aid in the preoperative differentiation of TDs from MLNs in rectal cancer.

China has become the country with the highest global burden of heart failure(HF).Despite the widespread use of prognostic-improving medications today,the mortality rate of HF remains high,reaching 13.7％at one year-particularly among patients with heart failure with reduced ejection fraction(HFrEF).HF interventional device therapy(structural intervention)targets the structural factors underlying HF,including atrial pressure,ventricular remodeling,and valvular intervention.It leverages the heart's intrinsic physiological properties and pathological progression mechanisms to deliver treatments through interventions without external active forces,achieving anatomical or functional repair.This field has emerged as a rapidly growing area and plays an increasingly critical role in HF management.This article provides a comprehensive review and summary of the latest advancements in HF and cardiomyopathy interventional therapy over the past year.It covers various novel technologies and products currently in the research phase,aiming to provide an in-depth analysis of the current status and future directions of HF interventional therapy,and further advance the development of this discipline.

Objective To establish an expert consensus on in-hospital transfer safety management for patients undergoing invasive mechanical ventilation,providing guidance for clinical medical teams to conduct standardized transfers,reduce transfer risks,and ensure patient safety.Methods Through systematic searching,screening,evaluation,and summary of evidence related to in-hospital transfer safety management for patients on invasive mechanical ventilation,we extracted recommendations to form a preliminary draft of the expert consensus.From July to October 2024,totally 2 rounds of expert consultations,and 2 rounds of expert reviews were conducted,and the content was refined and finalized based on expert feedback.Results The final consensus encompasses 9 aspects,including transfer assessment and decision-making,pre-transfer preparation of medical staff,pre-transfer patient preparation,pre-transfer equipment preparation,pre-transfer medication preparation,monitoring and intervention during transfer,emergency events and management,transfer handover and documentation,and post-transfer management.Conclusion This consensus demonstrates strong practicality and operability,offering professional guidance for enhancing the safety of in-hospital transfers for patients on invasive mechanical ventilation.

Recent studies have shown that the physiological homeostasis of oral mucosal cells is regulated by the circadian clock.Dis-ruption or dysfunction of the circadian clock is closely associated with the development of oral squamous cell carcinoma(OSCC).Research based on the circadian clock offers a novel perspective on the pathogenesis and therapeutic strategies for OSCC.However,there is current-ly limited research on this topic,and people generally have insufficient understanding and recognition of the circadian clock.Given the complexity and challenges of circadian clock which is the fourth dimension of medical research,we organize relevant experts based on summarizing the current research results of circadian clock in the pathogenesis and precision diagnosis and treatment of OSCC,combining the scientific principles of the circadian clock's role and their long-term research experience,then summarizes and recommends the con-sensus opinions for the research of circadian clock in the pathogenesis mechanism and precision diagnosis and treatment of human OSCC,with the hope of providing guidance for the basic research and clinical application of circadian clock or circadian rhythm in the pathogene-sis mechanism and precision diagnosis and treatment of oral and maxillofacial squamous cell carcinoma.

AIM To investigate the in vivo pharmacokinetics of chlorogenic acid,isoquercetin,ferulic acid,isorhamnetin and shionone in Asteris Radix et Rhizoma in rats.METHODS Twelve rats were randomly assigned into 2 groups and given intragastric administration of conventional dose(0.63 g/kg)and large dose(3.3 g/kg)of Asteris Radix et Rhizoma extracts,respectively,after which blood collection was made at 0.083,0.167,0.33,0.5,0.75,1,1.5,2,4,6,8,12,24 h,UPLC-MS/MS was adopted in the plasma concentration determination of various effective constituents,and main pharmacokinetic parameters were calculated.RESULTS Various effective constituents in the large dose group demonstrated prolonged t1/2,MRT0-∞ as compared with those in the conventional dose group(P＜0.05).After dose correction,Cmax of chlorogenic acid,isoquercetin,shionone in the large dose group displayed no obvious changes(P＞0.05),while Cmax of ferulic acid,isorhamnetin,and AUC0-t,AUC0-∞ of various effective constituents were higher than those in the conventional dose group(P＜0.05).CONCLUSION Various effective constituents in the high dose of Asteris Radix et Rhizoma can maintain high-concentration and long-time effects on rat bladder tissue.

Aim To study whether intravenous injec-tion of miR-129-3p mimetic(agomir)can resist bone loss caused by hind limb disuse,and to provide new i-deas for preventing bone loss in microgravity environ-ment.Methods Forty-eight C57BL/6J male mice were randomly divided into the control group(CON),tail suspension model group(TS),tail suspension+miR-129-3p agomir administration group(miRNA)and tail suspension+miR-129-3p negative sequence agomir control group(NC).The miRNA group was given 4 mg·kg-1 miR-129-3p agomir by intravenous injection into the medial canthus twice a week.The NC agomir group were consistent with those in the miR-129-3p agomir group,and the CON and TS groups were given only equal volumes of normal saline.After four weeks,all mice were sacrificed and samples were collected.Micro-CT scan of femur,three-point femur bending test,serum bone metabolism index detection,oxidative stress index detection and osteogenesis-related protein expression analysis in bone tissue were per-formed.Results After four weeks,the number of tra-becular bone in the TS group was significantly re-duced,and Tb.BMD,Tb.Th,Tb.N,Tb.BS/TV and Tb.BV/TV were significantly lower than those in the CON group(P＜0.01).While Tb.Sp TS group was significantly higher than the CON group(P＜0.05),the maximum load and flexural strength of the femur significantly decreased(P＜0.01),the content of ser-um bone formation index PINP was significantly lower than that of the CON group(P＜0.01),and the con-tent of bone resorption index CTX-I was significantly higher than that of the CON group(P＜0.01),the content of serum oxidative damage indexes 8-iso-PGF2α and 8-OHdG significantly increased(P＜0.01),and the expression of osteogenesis-related pro-teins in bone tissue markedly decreased(P＜0.01).However,the increase or decrease of all indexes in miRNA group was significantly lower than that in TS group.Conclusions miR-129-3p mimetic can signifi-cantly reduce bone loss caused by hind limb disuse.This experiment provides a new idea and method for preventing bone loss in microgravity environment.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To investigate the clinical value of serum ferritin (SF) and neutrophil-to-lymphocyte ratio (NLR) in predicting intravenous immunoglobulin (IVIG) resistance in Kawasaki disease (KD).Methods:Clinical data from 193 KD children hospitalized at Kunming Children's Hospital (January 2018 - December 2023) were retrospectively analyzed. Patients were stratified into IVIG-sensitive ( n=159) and IVIG-resistant ( n=34) groups. Demographic characteristics and laboratory parameters (SF, NLR, etc.) were compared. Normally distributed continuous variables were expressed as xˉ± s and analyzed by independent samples t-test; non-normally distributed data were expressed as M ( Q1, Q3) and compared by Mann-Whitney U tests. Categorical data were expressed as case(%) and compared by χ2 tests. Pearson's analysis was used on correlation analysis, logistic regression was used on multivariate analysis. Predictive accuracy was evaluated by receiver operating characteristic (ROC) curves. Results:SF [(429.56±307.74) μg/L], NLR (7.52±4.80), WBC [(19.66±9.02) × 10 9/L], NEUT [(15.41±6.81) × 10 9/L], AST [46.00 (23.00, 130.25) U/L], ALT [113.50 (36.50, 205.00) U/L], CRP [(123.66±59.38) mg/L] and ESR [(76.47±25.97) mm/h] were higher in the IVIG resistant group than the IVIG sensitivity group [(213.89±127.98) μg/L, 3.88±3.71, (14.58±5.15) × 10 9/L, (9.76±4.64) × 10 9/L, 27.00 (22.00, 40.00) U/L, 40.00 (17.00, 95.00) U/L, (81.40±55.65) mg/L, (65.40±23.05) mm/h]. LYMP [(2.77±1.97) × 10 9/L] and albumin [(29.10±4.96) g/L] were lower in the IVIG resistant group than the IVIG sensitivity group [(3.66±1.86) × 10 9/L, (32.52±4.04) g/L], and the differences were statistically significant (statistical values were t=4.01, t=4.17, t=3.17, t=4.61, Z=2.74, Z=3.39, t=3.97, t=2.48, t=2.51, t=4.30, respectively, P values were 0.001, 0.001, 0.001, 0.001, 0.006, 0.001, 0.001, 0.014, 0.013, 0.001). Logistic regression analysis showed that serum ferritin ( OR=1.004, 95% CI: 1.001-1.006) and NLR ( OR=1.108, 95% CI: 1.007-1.218) were risk factors for IVIG resistance (P values were 0.035 and 0.002, respectively). The area under ROC curve for predicting IVIG resistance using serum ferritin combined with NLR was 0.812, with sensitivity and specificity of 76.47% and 72.96%, respectively. Conclusion:High levels of SF and NLR are independent risk factors for predicting IVIG resistance. SF combined with NLR has a certain predictive value for IVIG resistance in Kawasaki disease.