To guide clinical blood transfusion practices for pediatric patients, the National Health Commission has issued the health standard "Guideline for pediatric transfusion" (WS/T 795-2022). Blood transfusion is one of the most commonly used supportive treatments for children with hematological diseases. This guideline provides guidance and recommendations for blood transfusions in children with aplastic anemia, thalassemia, autoimmune hemolytic anemia, glucose-6-phosphate dehydrogenase deficiency, acute leukemia, myelodysplastic syndromes, immune thrombocytopenic purpura, and thrombotic thrombocytopenic purpura. This article presents the evidence and interpretation of the blood transfusion provisions for children with hematological diseases in the "Guideline for pediatric transfusion", aiming to assist in the understanding and implementing the blood transfusion section of this guideline.
Humans ; Child ; Hematologic Diseases/therapy* ; Blood Transfusion/standards* ; Practice Guidelines as Topic

To guide clinical blood transfusion practices for pediatric patients, the National Health Commission has issued the health standard "Guideline for pediatric transfusion" (WS/T 795-2022). Blood transfusion for children undergoing hematopoietic stem cell transplantation is highly complex and challenging. This guideline provides recommendations on transfusion thresholds and the selection of blood components for these children. This article presents the evidence and interpretation of the transfusion provisions for children undergoing hematopoietic stem cell transplantation, with the aim of enhancing the understanding and implementation of the "Guideline for pediatric transfusion".
Humans ; Hematopoietic Stem Cell Transplantation ; Child ; Blood Transfusion/standards* ; Practice Guidelines as Topic

To guide clinical blood transfusion practices for pediatric patients, the National Health Commission has issued the health standard "Guideline for pediatric transfusion" (WS/T 795-2022). Critically ill children often present with anemia and have a higher demand for transfusions compared to other pediatric patients. This guideline provides guidance and recommendations for blood transfusions in cases of general critical illness, septic shock, acute brain injury, extracorporeal membrane oxygenation, non-life-threatening bleeding, and hemorrhagic shock. This article interprets the background and evidence of the blood transfusion provisions for critically ill and severely bleeding children in the "Guideline for pediatric transfusion", aiming to enhance understanding and implementation of this aspect of the guidelines. Citation:Chinese Journal of Contemporary Pediatrics, 2025, 27(4): 395-403.
Humans ; Critical Illness ; Blood Transfusion/standards* ; Child ; Hemorrhage/therapy* ; Practice Guidelines as Topic

To guide clinical blood transfusion practices in pediatric patients, the National Health Commission has issued the health standard "Guideline for pediatric transfusion" (WS/T 795-2022). Children undergoing cardiac surgery are at high risk of bleeding, and the causes of perioperative anemia and coagulation disorders in neonates and children are complex and varied, often necessitating the transfusion of allogeneic blood components. This guideline provides direction and recommendations for specific measures in blood management for children undergoing cardiac surgery before, during, and after surgery. This article interprets the background and evidence for the formulation of the blood transfusion provisions for children undergoing cardiac surgery, hoping to facilitate the understanding and implementation of this guideline.
Humans ; Cardiac Surgical Procedures ; Blood Transfusion/standards* ; Child ; Practice Guidelines as Topic

Head and neck malignant tumor is one of the most heterogeneous diseases.The multi-disciplinary team(MDT)is an essen-tial component for personal precise diagnosis,treatment and integrated care management of oncologic diseases including head and neck malignant tumor.MDT clinical practice is also an important teaching mode for head and neck malignant tumors,but it is limited by time and space in actual teaching.An internet visualization platform was constructed based on the Internet,hospital HIS/PACS/LIS/EMR system,medical visualization screen,oral endoscope,remote consultation platform and other accessible audio and video terminals,and has been applied in MDT clinical teaching of head and neck malignant tumors,allowing medical students to participate in MDT through a networked visualization platform.Medical students will achieve deep learning for the most heterogeneous malignant tumor.MDT sup-ported by the internet visualization platform provides a new pathway for clinical medical education.

BACKGROUND:Acupotomy is an effective method for the clinical treatment of osteoarthritis,with affirmed clinical outcomes,but the specific mechanisms remain unclear OBJECTIVE:To investigate the role of acupotomy in modulating chondrocyte autophagy to promote chondrocyte homeostasis in osteoarthritis. METHODS:Twenty-eight New Zealand rabbits were randomly divided into control group,osteoarthritis group,acupotomy group,and hyaluronic acid group,with seven rabbits in each group.The knee osteoarthritis rabbit model was prepared using the Videman method in the latter three groups.After modeling,the control group and osteoarthritis group received no interventions.The acupotomy group received acupotomy treatment 15 minutes per time,once a week,while the hyaluronic acid group received intra-articular injection of hyaluronic acid once a week,with a continuous treatment duration of 5 weeks.The day after the final intervention,knee joint macrostructure was observed using DR imaging,chondrocyte ultrastructure was examined through transmission electron microscopy,apoptosis of chondrocytes was assessed using Tunel staining,and western blot analysis was used to detect the expression of proteins related to the PI3K/Akt/mTOR pathway. RESULTS AND CONCLUSION:The DR imaging results revealed that the osteoarthritis group exhibited narrowed knee joint spaces and the formation of periarticular osteophytes,while the hyaluronic acid group and acupotomy group showed widened knee joint spaces with a reduction in periarticular osteophytes.Transmission electron microscopy results demonstrated a decreased number of autophagosomes in chondrocytes in the osteoarthritis group,along with nuclear shrinkage,nuclear membrane rupture,incomplete organelle morphology,and a clear tendency towards cell death.In contrast,both the hyaluronic acid group and acupotomy group exhibited a significant increase in autophagosomes,intact nuclear membranes,and a well-preserved cellular state.Tunel staining results indicated a considerable decrease in the number of apoptotic cells in the hyaluronic acid group and acupotomy group compared with the osteoarthritis group.Western blot results revealed that,compared with the control group,the expression levels of Beclin1,Cath D,and LC3II/LC3I were significantly decreased in the osteoarthritis group(P<0.05),while the expression levels of p-Akt/Akt and p-mTOR/mTOR were significantly increased(P<0.05);compared with the osteoarthritis group,the expression levels of Beclin1,Cath D,and LC3II/LC3I were significantly increased in both the hyaluronic acid group and acupotomy group(P<0.05),while the expression levels of p-Akt/Akt and p-mTOR/mTOR were significantly decreased(P<0.05).To conclude,acupotomy intervention can modulate the PI3K/Akt/mTOR signaling pathway to enhance the autophagic level in chondrocytes,thereby maintaining chondrocyte homeostasis.This ultimately leads to a slowdown in cartilage degeneration.

Objective:To investigate the clinical characteristics and prognosis of neonatal chylothorax.Methods:The clinical data of newborns diagnosed with chylothorax from June 2016 to June 2023 in Neonatal Center of Beijing Children's Hospital were retrospectively analyzed, and divided into congenital group and acquired group according to the pathogenesis of chylothorax. The clinical characteristics, treatment methods and prognosis of the two groups were compared.Results:A total of 23 cases were included, including 17 cases (73.9%) in the congenital group and 6 cases (26.1%) in the acquired group. There was no significant difference in gender, gestational age and birth weight between the two groups ( P>0.05). Compared with the acquired group, the proportion of lymphocytes (97.0% vs. 85.0%), the use of erythromycin (7/17 vs. 1/6) and octreotide (9/17 vs. 1/6) and special formula milk feeding (13/17 vs. 2/6) were higher in the congenital group; the proportion of right hydrothorax (1/17 vs. 3/6), invasive mechanical ventilation (6/17 vs. 6/6) and breastfeeding (0/17 vs. 3/6) were lower in the congenital group ( P<0.05). There were no significant differences in terms of the white blood cell count in pleural fluid and plasma protein content, incidence of bilateral and left pleural fluid, proportion of closed thoracic drainage, maximum daily drainage volume, drainage duration, total drainage volume, albumin utilization rate, length of stay and survival rate between the two groups ( P>0.05). 18 cases of pleural effusion absorption without recurrence after conservative treatment; 5 cases died, of which 4 cases died after their parents abandoned treatment, and 1 case died of neonatal necrotizing enterocolitis after thoracic duct ligation surgery. Conclusions:Congenital chylothorax and acquired chylothorax were similar in severity, course of disease and overall prognosis. The utilization rate of erythromycin and octreotide in congenital chylothorax was higher than that in acquired chylothorax. The neonatal chylothorax is usually with an overall good prognosis.

Objective To study the effect of dual-mediated brain targeting liposomes(RVGPR9-SSL)as delivery vehicles on the blood brain barrier(BBB)permeability of doxorubicin(DOX),providing a new strategy for brain drug delivery.Methods The dual-mediated brain targeting liposomes(RVGPR9-SSL)were prepared by thin film dispersion/leading compound method.And the chemo-therapeutic drug DOX was encapsulated in RVGPR9-SSL(DOX@RVGPR9-SSL).Brain microvascular endothelial cells(BMVEC)were cultured and used to construct in vitro BBB models.The BBB model was then evaluated by a 4h leakage test,transmembrane resist-ance value(TEER)measurement,and tight junctions between cells observed by scanning transmission electron microscope(SEM).After the successful construction of the BBB model,the integrity of RVGPR9-SSL after crossing the BBB was investigated by confocal laser scanning microscopy using fluorescence a resonance energy transfer(FRET)pair.The effect of RVGPR9-SSL administration on BBB in-tegrity was evaluated by comparative analysis of BBB morphology and TEER values before and after liposome administration.The BBB per-meability of DOX@RVGPR9-SSL was investigated by fluorescence spectrophotometry.Results The encapsulation efficiency of DOX@RVGPR9-SSL was 97.25％.The TEER values of the constructed BBB model were all greater than 200Ω·cm2,and it was observed by SEM that the BMVEC cells were closely arranged and there were obvious tight junctions,indicating that the in vitro BBB model was suc-cessfully established and could be used for the investigation of BBB permeability.The 4h BBB cumulative permeability of DOX@RVGPR9-SSL was greater than 10％,which was significantly higher than that of free DOX.And both BBB and liposomes maintained good integrity after administration.Conclusion RVGPR9-SSL can significantly improve the BBB permeability of DOX,indicating that it is a very promising brain drug delivery vehicle.

ObjectiveTo investigate risk factors for postoperative sore throat in patients with double-lumen endotracheal intubation. MethodsThe data used in this post-hoc analysis were prospectively collected from a randomized， controlled trial. Age from 18 to 65 years old， ASAI-Ⅲ patients undergoing general anesthesia with a double-lumen endotracheal tube were enrolled. The perioperative data collected retrospectively were as follows： gender， age， smoking history， endotracheal tube diameter， duration of endotracheal tube， dose of Sufentanil， use of Flurbiprofen Axetil， cough after extubation， etc..Dynamometer was applied to assess extubation force. According to occurrence of postoperative sore throat， patients were divided into two groups： those who experienced sore throats and those who did not. Comparative analysis and multivariate logistic regression analysis were performed to screen the risk factors. ROC curve was used for predicting the predictive value of risk factors. ResultsAmong the 163 patients ， 74 （45.4%） had postoperative sore throat vs 89 （54.6%） not had. Multivariate logistic regression showed female ［OR95%CI=3.83（1.73， 8.50）， P=0.000 1］ and extubation force ［OR95%CI=1.78（1.45， 2.17）， P＜0.001］ were independent risk factors for postoperative sore throat. AUC value showed the extubation force was 0.773［95%CI（0.701， 0.846）， P＜0.001］. Youden index was 0.447， and the cut-off valve of extubation force was 13N. ConclusionFemale and extubation force were risk factors for sore throat in patients with double lumen endotracheal intubation.

Children and adults differ significantly in physiology,biochemistry and immune function,which leads to sig-nificant differences in blood transfusion strategies between children and adults.To guide the clinical transfusion practice of pediatric patients and improve the prognosis of children,the National Health Commission organized the formulation and re-lease of the health industry standard Guideline for Pediatric Transfusion(WS/T 795-2022).This paper will briefly introduce some concepts that help understand of the Standard and the preparation process of the Standard,and explain and interpret the preparation of the"scope","general provisions"and"factors to consider"of the Standard,hoping to contribute to the understanding and implementation of the Standard.