To guide transfusion practice in critically ill children who often need plasma and platelet transfusions, the Transfusion and Anemia Expertise Initiative-Control/Avoidance of Bleeding (TAXI-CAB) developed Recommendations and Expert Consensus for Plasma and Platelet Transfusion Practice in Critically Ill Children. This guideline addresses 53 recommendations related to plasma and platelet transfusion in critically ill children with 8 kinds of diseases, laboratory testing, selection/treatment of plasma and platelet components, and research priorities. This paper introduces the specific methods and results of the recommendation formation of the guideline.

[摘 要] 目的：探究中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值（PLR）、淋巴细胞/单核细胞比值（LMR）及预后营养指数（PNI）对免疫检查点抑制剂（ICI）联合抗血管生成药物治疗晚期肝细胞癌（HCC）患者疗效及预后的预测价值。方法:收集2020年1月至2023年12月间在大理大学第一附属医院收治的使用ICI联合抗血管生成药物治疗的85例晚期HCC患者的一般临床资料、治疗前患者的NLR、PLR、LMR、PNI、临床疗效及预后。采用受试者工作特征（ROC）曲线计算NLR、PLR、LMR、PNI的最佳截断值，以此将患者分成高、低2组。使用Kaplan-Meier法绘制生存曲线，采用Cox比例风险回归模型进行单因素、多因素分析各指标对患者OS的影响。结果:低NLR组、低PLR组、高LMR组、高PNI组患者治疗有效率均分别高于高NLR组、高PLR组、低LMR组和低PNI组（均P < 0.05）。低NLR组、低PLR组患者OS率均分别显著高于高NLR组、高PLR组（均P < 0.05）；高LMR组、高PNI组患者OS率均分别显著高于低LMR组和低PNI组（均P < 0.05）。NLR ≥ 1.94、男性、乙型肝炎病毒感染是晚期HCC患者预后的独立危险因素（均P < 0.05）。结论: NLR ≥ 1.94、男性、乙型肝炎病毒阳性是影响患者疗效、预后的危险因素，NLR ≥ 1.94评估晚期HCC患者免疫联合靶向的疗效及预后有一定的临床价值。

[摘 要] 目的：探究钾钙激活通道亚家族N成员4（KCNN4）在胰腺癌组织中的表达及其对胰腺癌进展的影响，解析KCNN4在胰腺癌临床诊断及预后判断中的作用。方法：利用GEPIA2数据分析平台，结合TCGA和GTEx数据库的数据分析KCNN4在胰腺癌组织中的表达水平及其与患者预后的关系。收集24例海军军医大学长海医院手术切除的胰腺癌患者的癌及癌旁组织标本，通过qPCR、WB法和免疫组化染色技术验证KCNN4在胰腺癌组织中的表达水平。利用shRNA敲低人胰腺癌细胞中BXPC3和PANC-1中KCNN4的表达，通过CCK-8和克隆形成实验检测细胞增殖与生长情况。利用小鼠胰腺癌KPC细胞构建胰腺癌原位成瘤模型，观察敲低KCNN4对胰腺原位成瘤的影响，统计小鼠生存期（OS）。结果：整合TCGA和GTEx数据库数据分析结果发现，KCNN4在胰腺癌组织中高表达（P < 0.05），且与患者OS和DFS缩短相关（均P < 0.05）。胰腺癌组织中KCNN4 mRNA和蛋白表达量均显著高于癌旁组织（均P < 0.01）。KCNN4敲低后，胰腺癌细胞生长速率显著减慢、克隆形成数量显著减少（均P < 0.01）。小鼠胰腺原位荷瘤实验结果表明，KCNN4敲低可抑制肿瘤细胞在胰腺原位的生长并延长小鼠OS。结论：KCNN4在胰腺癌组织中高表达，其能促进胰腺癌细胞增殖和胰腺癌进展，与患者预后密切相关，有望作为胰腺癌临床诊断及预后评估的靶点。

Objective: To explore the correlation among picky eating levels in preschool children, parental self-efficacy and parenting stress. Methods: A convenience sampling method was employed to conduct an electronic questionnaire survey among 459 children aged 3-6 years and their parents from five kindergartens in Urumqi in November 2023. The survey included a general information questionnaire, the Children s Eating Behavior Questionnaire (CEBQ), the Parenting Sense of Competence Scale (PSOC), and the Parenting Stress Index-Short Form (PSI-SF). The Mann-Whitney U-test was used for twogroup comparisons, and the Kruskal-Wallis H-test was applied for multi-group comparisons. Spearman correlation analysis was conducted to examine the relationships between children s picky eating levels and parenting selfefficacy as well as parenting stress. Results: The picky eating score of preschool children was 10.00 (4.00), and the parenting self-efficacy score was 58.00 (12.00), both indicating a moderate level. The parenting stress score was 75.00 (16.00), reflecting a moderately low level. Spearman correlation analysis showed that children s picky eating levels were negatively correlated with the total score of parenting self-efficacy ( r =-0.28) and positively correlated with the total score of parenting stress( r =0.25)( P <0.01). Conclusions Picky eating levels of preschool children are closely associated with parenting self-efficacy and parenting stress. Picky eating behaviors in children can be reduced by implementing various effective measures to enhance parenting self-efficacy and alleviate parenting stress.

PURPOSE: This study aimed to evaluate the accuracy of the ultrasonic jaw tracking system by comparing with the conventional electronic system in recording condylar movements. MATERIALS AND METHODS: Twenty-six subjects with normal occlusion participated in the study. The CADIAX® 4 and Jaw Motion Analyzer (JMA) systems were used to record condylar movement trajectories during mandibular border movements (protrusive/retrusive, lateral, and wide mouth opening), with each movement repeated three times. Both systems used facebows and sensors to locate the condylar axis points and capture movement trajectory data. Paired t-tests were used for normally distributed data, while the Wilcoxon rank-sum test was applied to non-normally distributed data. The level of significance was set at α = .05. RESULTS: The maximum condylar displacement in the sagittal plane during mandibular border movements and the sagittal condylar inclination (SCI) values on both the left and right sides showed no significant difference between the two systems (P > .05). The Bennett angle (BA) values on both the left and right sides measured by the JMA system were significantly higher than those measured by the CADIAX® 4 system (P < .05). The comfort levels of the JMA system were significantly higher than the CADIAX® 4 system (P < .05). CONCLUSION Through this study, it was found that the accuracy of the ultrasonic jaw tracking system was comparable with the conventional electronic system, except for the Bennett angle measurement. In terms of comfort and ease of use, the ultrasonic jaw tracking system is more favored.

Background: Cardiovascular diseases are the leading cause of mortality after liver transplantation (LT). Although the impact of secondary tricuspid regurgitation (TR) with severe pulmonary hypertension (PH) is well investigated, the impact of primary TR with tricuspid valve incompetence (TVI) on LT outcomes remains unclear. We aimed to investigate the prevalence and impact of primary TR with TVI on LT outcomes in a large-volume LT center. Methods: We retrospectively examined 5 512 consecutive LT recipients who underwent routine pretransplant echocardiography between 2008 and 2020. Patients were categorized based on the presence of anatomical TVI, specifically defined by incomplete coaptation, coaptation failure, prolapse, and flail leaflets of tricuspid valve (TV). Propensity score (PS)-based inverse probability weighting (IPW) was used to balance clinical and cardiovascular risk variables. The outcomes were one-year cumulative all-cause mortality and 30-day major adverse cardiovascular events (MACE). Results: Anatomical TVI was identified in 14 patients (0.3%). Although rare, these patients exhibited significantly lower post-LT one-year survival rates (64.3% vs. 91.5%, P < 0.001) and higher 30-day MACE rates (42.9% vs. 16.9%, P = 0.026) than patients without TVI. They also had worse survival irrespective of echocardiographic evidence of PH (P < 0.001) and exhibited higher one-year mortality (IPW-adjusted hazard ratio: 4.09, P = 0.002) and increased 30-day MACE rates (IPW-adjusted odds ratio: 1.24, P = 0.048). Conclusions Primary TR with anatomical TVI was associated with significantly reduced one-year survival and increased post-LT MACE rates. These patients should be prioritized similarly to those with secondary TR with severe PH, with appropriate pretransplant evaluations and treatments to improve survival outcomes.

PURPOSE: This study aimed to evaluate the accuracy of the ultrasonic jaw tracking system by comparing with the conventional electronic system in recording condylar movements. MATERIALS AND METHODS: Twenty-six subjects with normal occlusion participated in the study. The CADIAX® 4 and Jaw Motion Analyzer (JMA) systems were used to record condylar movement trajectories during mandibular border movements (protrusive/retrusive, lateral, and wide mouth opening), with each movement repeated three times. Both systems used facebows and sensors to locate the condylar axis points and capture movement trajectory data. Paired t-tests were used for normally distributed data, while the Wilcoxon rank-sum test was applied to non-normally distributed data. The level of significance was set at α = .05. RESULTS: The maximum condylar displacement in the sagittal plane during mandibular border movements and the sagittal condylar inclination (SCI) values on both the left and right sides showed no significant difference between the two systems (P > .05). The Bennett angle (BA) values on both the left and right sides measured by the JMA system were significantly higher than those measured by the CADIAX® 4 system (P < .05). The comfort levels of the JMA system were significantly higher than the CADIAX® 4 system (P < .05). CONCLUSION Through this study, it was found that the accuracy of the ultrasonic jaw tracking system was comparable with the conventional electronic system, except for the Bennett angle measurement. In terms of comfort and ease of use, the ultrasonic jaw tracking system is more favored.

PURPOSE: This study aimed to evaluate the accuracy of the ultrasonic jaw tracking system by comparing with the conventional electronic system in recording condylar movements. MATERIALS AND METHODS: Twenty-six subjects with normal occlusion participated in the study. The CADIAX® 4 and Jaw Motion Analyzer (JMA) systems were used to record condylar movement trajectories during mandibular border movements (protrusive/retrusive, lateral, and wide mouth opening), with each movement repeated three times. Both systems used facebows and sensors to locate the condylar axis points and capture movement trajectory data. Paired t-tests were used for normally distributed data, while the Wilcoxon rank-sum test was applied to non-normally distributed data. The level of significance was set at α = .05. RESULTS: The maximum condylar displacement in the sagittal plane during mandibular border movements and the sagittal condylar inclination (SCI) values on both the left and right sides showed no significant difference between the two systems (P > .05). The Bennett angle (BA) values on both the left and right sides measured by the JMA system were significantly higher than those measured by the CADIAX® 4 system (P < .05). The comfort levels of the JMA system were significantly higher than the CADIAX® 4 system (P < .05). CONCLUSION Through this study, it was found that the accuracy of the ultrasonic jaw tracking system was comparable with the conventional electronic system, except for the Bennett angle measurement. In terms of comfort and ease of use, the ultrasonic jaw tracking system is more favored.

Background: Cardiovascular diseases are the leading cause of mortality after liver transplantation (LT). Although the impact of secondary tricuspid regurgitation (TR) with severe pulmonary hypertension (PH) is well investigated, the impact of primary TR with tricuspid valve incompetence (TVI) on LT outcomes remains unclear. We aimed to investigate the prevalence and impact of primary TR with TVI on LT outcomes in a large-volume LT center. Methods: We retrospectively examined 5 512 consecutive LT recipients who underwent routine pretransplant echocardiography between 2008 and 2020. Patients were categorized based on the presence of anatomical TVI, specifically defined by incomplete coaptation, coaptation failure, prolapse, and flail leaflets of tricuspid valve (TV). Propensity score (PS)-based inverse probability weighting (IPW) was used to balance clinical and cardiovascular risk variables. The outcomes were one-year cumulative all-cause mortality and 30-day major adverse cardiovascular events (MACE). Results: Anatomical TVI was identified in 14 patients (0.3%). Although rare, these patients exhibited significantly lower post-LT one-year survival rates (64.3% vs. 91.5%, P < 0.001) and higher 30-day MACE rates (42.9% vs. 16.9%, P = 0.026) than patients without TVI. They also had worse survival irrespective of echocardiographic evidence of PH (P < 0.001) and exhibited higher one-year mortality (IPW-adjusted hazard ratio: 4.09, P = 0.002) and increased 30-day MACE rates (IPW-adjusted odds ratio: 1.24, P = 0.048). Conclusions Primary TR with anatomical TVI was associated with significantly reduced one-year survival and increased post-LT MACE rates. These patients should be prioritized similarly to those with secondary TR with severe PH, with appropriate pretransplant evaluations and treatments to improve survival outcomes.

OBJECTIVE To evaluate the therapeutic efficacy of 5 regimens of colistin sulfate for common Gram-negative bacilli infection based on pharmacokinetics （PK）/pharmacodynamics （PD） theory and Monte Carlo simulation. METHODS Minimal inhibitory concentration （MIC） data of colistin sulfate against Acinetobacter baumannii， Pseudomonas aeruginosa， Klebsiella pneumoniae， Escherichia coli and Enterobacter cloacae in 2023 were collected from the China Antimicrobial Resistance Surveillance System. Monte Carlo simulation was conducted with the ratio of the area under the concentration-time curve from 0 to 24 hours in the unbound state to the MIC （fAUC0－24 h/MIC） ≥15 as the target value， the probabilities of target attainment （PTA） of 5 regimens of colistin sulfate to achieve the target ratio were obtained at different MIC； and the expected population PTA， specifically the cumulative fraction of response （CFR）， for each regimen within a specific bacterial population was further calculated， to evaluate the therapeutic efficacy of the five colistin sulfate regimens. RESULTS When bacterial MIC≤0.5 µg/mL， PTA of all colistin sulfate regimens （500 000 IU， q12 h； 500 000 IU， q8 h； 750 000 IU， q12 h； 750 000 IU， q8 h； 1 000 000 IU， q12 h） were all more than 90%. When bacterial MIC＝1 µg/mL， PTA for regimen （750 000 IU， q8 h） against A. baumannii， K. pneumoniae， P. aeruginosa， E. coli and E. cloacae， and for regimen （1 000 000 IU， q12 h） against the other four bacterial species （excluding P. aeruginosa） remained above 90%. When bacterial MIC≥2 µg/mL， PTA of 5 colistin sulfate regimens were all lower than 90%. For E. coli， the CFR of only colistin sulfate regimen （500 000 IU， q12 h） was less than 90%； for K. pneumoniae， the CFR of only colistin sulfate regimen （750 000 IU， q8 h and 1 000 000 IU， q12 h） was greater than 90%； for the other three bacteria， CFR of 5 regimens were all less than 90%. CONCLUSIONS When the MIC of Gram-negative bacteria is less than 0.5 µg/mL， colistin sulfate regimen with a routine dose can be selected for treatment. When MIC was 1 µg/mL， an increase in the dosing amount or frequency is required. The empirical treatment of the other four bacterial infections excluding E. coli requires the use of off-label doses.