To develop a guideline terminology system and promote its standardization, thereby enhancing medical staff's accurate understanding and correct application of guidelines.

To introduce and analyze guideline terminology related to clinical question formulation, evidence retrieval and appraisal, and recommendation development.

Objective·To explore the biological functions and underlying mechanisms of anaphase-promoting complex subunit 10(ANAPC10)in the development and progression of liver hepatocellular carcinoma(LIHC,often abbreviated as HCC).Methods·By integrating data from The Cancer Genome Atlas(TCGA)_LIHC,the hepatitis B virus-related subgroup(HBV)of the China Hepatocellular Carcinoma Genome Project(CHCC),and the Gene Expression Omnibus(GEO),the expression pattern of ANAPC10 in HCC was analyzed.Western blotting and quantitative real-time PCR(q-PCR)were used to verify the findings in HCC cell lines.shRNA-mediated knockdown of ANAPC10 was performed in MHCC-97H and SNU-398 cell lines to investigate the effect of ANAPC10 depletion on the in vitro proliferation of HCC cells.An orthotopic liver cancer model with Anapc10 knockout was constructed using the hydrodynamic tail-vein injection technique in mice to further confirm the impact of ANAPC10 deficiency in the liver on the development and progression of HCC.Kyoto Encyclopedia of Genes and Genomes(KEGG)and Gene Ontology(GO)enrichment analyses were performed on the RNA-sequencing data from TCGA_LIHC and CHCC_HBV.Results·ANAPC10 was highly expressed in tumor tissues,and its expression level was closely related to patient survival.Downregulation of ANAPC10 in vitro and in vivo effectively inhibited HCC progression.ANAPC10 mainly reprogrammed the metabolism of tumors by affecting the PI3K-AKT-mTOR pathway.In the tumor tissues of the orthotopic liver cancer mouse model in the Anapc10 knockout group,the phosphorylation levels of Akt and S6k were decreased,and changes in the key downstream lipid metabolism proteins Fasn and Scd1 were verified.Conclusion·ANAPC10 is highly expressed in HCC and is positively correlated with poor prognosis.It promotes HCC occurrence and progression by activating the PI3K-AKT-mTOR signaling pathway and enhancing lipid metabolism reprogramming,thereby promoting tumor cell proliferation.These findings expand the understanding of ANAPC10 in tumor progression and suggest potential therapeutic targets for HCC.

Objective·To explore the function and potential mechanism of suppressor of zeste 12(SUZ12)in hepatocellular carcinoma(HCC).Methods·The expression of SUZ12 in HCC patients was analyzed using R language in liver cancer datasets,and relevant survival curves were drawn.Stable knockdown of SUZ12 was established in the liver cancer cell lines LM3 and Huh7.The knockdown efficiency of SUZ12 was assessed using quantitative real-time PCR(qPCR)and Western blotting.Cell proliferation ability was assessed using CCK-8 assay and colony formation assay.Using the hydrodynamic tail vein injection(HTVI)method,Suz12 was knocked out in the livers of fully immunocompetent mice to explore its tumorigenic function in vivo.The molecular mechanism of SUZ12 regulating HCC was explored using The Cancer Genome Atlas(TCGA)database.R language was used to analyze the relationship between SUZ12 and the expression of cancer stem cell(CSC)markers as well as key glycolysis-related genes.Findings were validated in liver cancer cell lines and mouse tumor tissues.Results·The expression of SUZ12 in liver cancer tissues was higher than in adjacent non-tumor tissues,and its expression increased with higher tumor stage.HCC patients with high SUZ12 expression had poorer prognoses.In LM3 and Huh7 liver cancer cell lines,stable knockdown of SUZ12 reduced cell proliferation ability.In the de novo MYC/Trp53-/-mouse liver cancer model,tumor nodule number and size,and tumor burden in liver tissue were reduced after endogenous knockout of Suz12.TCGA analysis showed that high SUZ12 expression in HCC was enriched in multiple tumor proliferation-and metabolism-related pathways.The expression of SUZ12 was positively correlated with CSC markers and key genes in glycolysis pathway.The mRNA levels of CSC markers and key genes in glycolysis pathway were decreased in liver cancer cell lines with stable SUZ12 knockdown and Suz12 knockout mouse HCC tissues.Conclusion·The expression of SUZ12 is significantly increased in HCC patients and is associated with poor prognosis.Stable knockdown of SUZ12 weakens the proliferative ability of liver cancer cells.Knockout of Suz12 in mice in vivo can suppress the occurrence and development of HCC.The high expression of SUZ12 maintains the CSC pool,induces metabolic reprogramming,and promotes the occurrence and progression of HCC.SUZ12 can serve as a potential biomarker for poor prognosis and a novel target for potential therapeutic intervention in HCC.

Objective:To design an inspection system for quality of metabolism tester based on alcohol combustion mode for human body,so as to realize assessment for accuracy degree of human metabolism tester.Methods:According to the specific indicators that were measured by the metabolism tester for human body,a simulation of bidirectional controllable flow and a simulation of component concentration of exhaled breath were designed and realized.Then,the ratio of alcohol consumption to oxygen consumption and carbon dioxide production were calculated by the formula of alcohol combustion.Finally,the metabolic indexes(volume of gas flow,oxygen consumption,dioxide carbon production,rate of energy metabolism,respiratory quotient)that were outputted by the inspection system for quality were calculated according to Weir formula.Furthermore,the verification for precision of simulation modules of exhale and inhalation,and weighing device module was carried out,and an application test of inspection system for quality was also carried out.Results:The errors of the volume of gas flow and alcohol consumption that were outputted by simulation modules of exhale and inhalation,and weighing device module were all within±1%,and the errors between the reference value of the metabolic index of the inspection system for quality and the actually measured value of the metabolic index of the hood calorimeter were all within 10%.Conclusion:There was higher consistency between inspection system for quality of metabolism tester for human body and the actual measurement data of calorimeter,which can better simulate the process of respiratory metabolism of human body,and provide standardized testing means for the performance verification of metabolic tester.

Objective:To explore the pathogenesis,clinical features,treatment strategies,and prognosis of pediatric lymphoepithelioma-like carcinoma(LELC).Methods:A retrospective analysis was conducted on the clinical data of patients with LELC aged<18 years,treated at Sun Yat-sen University Cancer Center from March 2008 to June 2023.Results:A total of 19 children and adolescents were included in the analys-is,comprising 10 males(52.6%)and 9 females(47.4%),with a median age of 12.9(4.3-17.0)years.Fourteen patients(73.7%)lived in Guangdong province,with the remainder scattered across other regions.Primary LELC sites were the mediastinum(11 cases,57.9%),parot-id glands(4 cases,21%),neck(1 case,5.3%),lungs(1 case,5.3%),salivary glands(1 case,5.3%),and submandibular glands(1 case,5.3%).Among these,15 patients(78.9%)had at least one distant metastasis at initial diagnosis,with common metastasis sites being cervical lymph nodes.Multivariate Cox regression analysis identified tumor volume≥801 cm3 as an independent adverse prognostic factor of poor overall survival(OS)(P<0.01).The 2-year OS and progression-free survival(PFS)rates were 84.2%and 57.9%,respectively.The 2-year OS for pa-tients who underwent surgery,chemotherapy,and radiotherapy was 100%,compared with 25%for those who received only partial treat-ment(P=0.007).The 2-year PFS rate was significantly higher in patients receiving first-line combination therapy with programmed death-1(PD-1)antibodies(100%)compared with those not treated with PD-1 antibodies(38.5%)(P=0.020).For patients with tumor volume≥801 cm3,the 2-year OS was 40.0%,whereas for those with a tumor volume<801 cm3,the 2-year OS was 100%(P<0.001).The 2-year OS for pa-tients who underwent radiotherapy was 100%,while it was 0 for those who did not receive radiotherapy(P<0.001).Conclusions:Pediatric LELC exhibits a relatively favorable prognosis with multidisciplinary treatment,including surgery,chemotherapy,and radiotherapy.The com-bined use of PD-1 antibodies at the time of initial diagnosis could offer potential benefits and warrants further exploration.

Objective To screen out the indexes of medical insurance fund under China Healthcare Security Diagno-sis Related Groups(CHS-DRG)payment based on Delphi method and improve the efficiency of medical insurance fund supervision.Methods Using the Delphi method,32 experts in the medical insurance field were selected and 2 rounds of expert questionnaires were conducted to design an evaluation scale for the monitoring indicators of medi-cal insurance funds under CHS-DRG payment.The consultation results were evaluated from three aspects of motiva-tion,authority,and coordination.Results A medical insurance fund supervision index system based on three dimen-sions of medical insurance fund use quality,efficiency and safety supervision is constructed,including 3 first-level indicators,7 second-level indicators and 44 third-level indicators.Results The construction ofmedical insurance fund supervision index system under CHS-DRG payment should respect the actual clinical diagnosis and treatment,strengthen the intelligent supervision method,and timely intervene in medical insurance fund management risks.

Objective:To develop and validate a prediction model for medication adherence among patients receiving allergen sublingual immunotherapy (SLIT).Methods:A prospective cross-sectional study was conducted, and a total of 288 patients who received SLIT treatment at an allergy center in the First Affiliated Hospital with Nanjing Medical University (Jiangsu Province Hospital) from December 2023 to July 2024 were assigned to the modeling group. Additionally, 122 patients from August to October 2024 were assigned to the validation group. Data of patients′ general information, medication beliefs, anxiety levels, social support, disease perception, and medication adherence were collected. Single-factor analysis and LASSO regression were utilized to identify potential predictors, and a prediction model for medication adherence was constructed using multifactorial logistic regression. A nomogram was then developed based on the model. The model′s discriminatory ability was evaluated using receiver operating characteristic curve (ROC), the area under curve (AUC), sensitivity, and specificity. The model was then validated in the validation cohort.Results:Single-factor analysis and LASSO regression identified a total of nine predictive factors. Logistic regression revealed that medical belief tendency [ OR (95% CI) =2.420 (1.116-5.248), P=0.025], the somatic control dimension in self-rating anxiety scales [ OR (95% CI)=1.404 (1.241-1.589), P<0.001], the subjective support dimension in social support assessment [ OR (95% CI)=0.784 (0.725-0.847), P<0.001], and the cognitive dimension in illness perception [ OR (95% CI)=0.725 (0.647-0.813), P<0.001] were independent predictors of medication adherence in patients undergoing SLIT. The AUC value of the model was 0.899 (95% CI=0.863-0.934) in the modeling group and 0.882 (95% CI=0.820-0.944) in the validation group, indicating good discriminatory ability. The optimal cutoff value of the model was 0.493, with a sensitivity of 81.1% and specificity of 85.7% in the modeling group, and a sensitivity of 87.3% and specificity of 82.5% in the validation group. Conclusion:The medication adherence prediction model developed in this study for patients undergoing SLIT exhibits good predictive performance and provides valuable guidance for early intervention by clinical healthcare professionals.

Objective:To establish a three-dimensional U-shaped residual coordinated attention network (URCA-Net) based on enhanced CT images for small bowel polyp detection and analyze its application effectiveness in intelligent detection of small bowel polyps.Methods:Abdominal CT data of patients with small bowel polyps were collected from the Air Force Medical Center between June 2019 and July 2023. All patients underwent bowel preparation followed by thin-slice spiral CT scanning to obtain enhanced CT arterial phase images. The data were randomly divided into training, validation and test sets in an 8∶1∶1 ratio. The URCA-Net deep learning model was used for small bowel polyp segmentation. The training set was used for model parameter training, the validation set for hyperparameter adjustment and monitoring of model generalization performance and the test set for final unbiased evaluation of the model. An early intelligent detection model for small bowel polyps was constructed, and its performance was evaluated. Evaluation metrics included pixel-level metrics for the segmentation task [Dice Similarity Coefficient (DSC)], as well as sensitivity and precision for polyp detection. A two-stage segmentation strategy was adopted: the first stage segmented the small bowel region to remove external interference, and the second stage performed polyp segmentation within the small bowel region.Results:A total of 78 subjects were included in the study, with an average age of (54±7) years. A total of 23 400 scan images were extracted, including 136 hyperplastic polyps, 298 hamartomatous polyps, 14 adenomatous polyps, and 4 cancerous polyps. On the test set, the average DSC for the first stage (small bowel segmentation) and the second stage (polyp segmentation) was 0.790 and 0.314, respectively. In the second stage task (polyp segmentation based on small bowel region), the polyp segmentation DSC increased to 0.701, with a precision of 0.836 (95% CI: 0.700-0.972) and a sensitivity of 0.759 (95% CI: 0.631-0.888) for polyp detection. Conclusion:The URCA-Net deep learning technique demonstrates good auxiliary diagnostic effectiveness in small bowel polyp detection and can provide a reference for screening and detection of small bowel polyps. The model is capable of generating high-quality segmentation results, which could facilitate evaluating polyp lesion morphology and provide support for downstream tasks such as preoperative navigation and risk prediction.

Objective To screen and analyze 23 mutation sites of deafness susceptibility genes in newborns in Shenzhen using microfluidic chip technology,aiming to enhance the efficiency and accuracy of early diagnosis of congenital deafness.Methods A total of 10 561 newborns delivered in 19 hospitals in Shenzhen between November 2021 and January 2023 were selected.Heel blood samples were collected from them,and 23 key mutation sites within four core deafness susceptible genes(GJB2,SLC26A4,12S rRNA and GJB3)were detected using microfluidic chip technology.Results The results revealed that 21.87%(2 310/10 561)of the newborns carried at least one mutation in deafness susceptibility genes,with the mutation carrier rate of the GJB2 gene reaching as high as 20.42%(2 157/10 561),57 newborns were found to has compound heterozygous mutations.To further verify the accuracy of the screening results,1 203 newborns out of the 2 310 initially screened as deafness gene carriers were recalled for Sanger sequencing,the gold standard,for verification.The verification results were fully consistent with the initial screening results.Conclusion The method combining microfluidic chip technology with Sanger sequence verification significantly improves the detection efficiency and accuracy of neonatal deafness genes,providing scientific evidence and practical guidance for implementing the three-level prevention strategy for congenital deafness.