Objective  To promote the development of high-quality health standards in China and summarize the characteristics of global health standards management systems and development processes.  Methods  We conducted a systematic search of relevant databases and the websites of standardization institutions. A descriptive method was used to analyze the basic characteristics of the standard management systems and development processes.  Results  The majority of the investigated countries and organizations primarily implement voluntary standards, with the exception of Chinese and the European Committee for Standardization that enforce compulsory standards. All countries and organizations have health standards at the national, group, and enterprise levels. In China and Japan, standards authorities are subordinate to the government, while in other countries or organizations, they operate as independent civil societies. The development process for health standards generally involves five stages: "Project/Proposal → Draft → Enquiry → Review → Publication". However, the specific steps in the development of health standards vary across different countries and organizations. Furthermore, China ranks high in the number of both standards and health standards issued, but the proportion of health standards is only 2.06%.  Conclusions  There are significant differences between China and other countries in terms of the management system and development process of health standards. To promote the management and development of high-quality health standards in China, we recommend promoting the coordination mechanism for standard development, increasing efforts to publicize standards and evaluate the implementation effect, strengthening the construction of personnel for the development of health standards, optimizing the efficiency of standard development and improving the internationalization level of health standards.

Objective To study the the expression of cytokeratin 5/6(CK5/6)and cell proliferation an-tigen(Ki-67)in apocrine triple-negative breast carcinoma(ATNBC)and their relationship with clinicopatho-logical features and prognosis.Methods Twenty-one patients with pathologically diagnosed invasive apocrine breast cancer and negative estrogen receptor(ER),progesterone receptor(PR)and human epidermal growth factor-2(Her-2)in this hospital were selected as the ATNBC group,Twenty-two cases in non-ATNBC(NATNBC)were randomly selected as negative control(NATNBC group).The clinical pathological data and follow-up data of all patients were collected,and the expressions of CK5/6 and Ki-67,as well as their relation-ship with clinicopathological characteristics was analyzed.The prognosis in the patients with ATNBC was ana-lyzed.Results There were statistically significant differences in age(P＜0.001),age distribution(P=0.001),histological grading(P＜0.001),and distant metastasis(P=0.020)between the ATNBC group and the NATNBC group(P=0.020).There were 7 cases(33.33％)of CK5/6 positive expression in the ATNBC group and 17 cases(80.95％)in NATNBC group.There was statistically significant difference in the positive expression rate of CK5/6 between the ATNBC group and NATNBC group(P＜0.05).There were 3 cases(14.29％)of Ki-67 high proliferation in the ATNBC group and 17 cases(77.27％)in the NATNBC group.The high proliferation rates of Ki-67 had statistically significant difference between the ATNBC group and NATNBC group(P＜0.05).The positive expression rate of CK5/6 was correlated with the tumor sites and lymph node metastasis in ATNBC patients(P＜0.05).The high proliferation rate of Ki-67 was correlated with nerve invasion in ATNBC patients(P＜0.05).The survival analysis showed that there was statistically significant difference in the 5 years disease-free survival(DFS)rate between the ATNBC group and NATNBC group(P＜0.05).Conclusion ATNBC has its unique clinicopathological features,CK5/6 is less expressed in ATN-BC,the high proliferation of Ki-67 is also less,and the prognosis of ATNBC is better than that of NATNBC.

Objective:To explore the incidence and risk factors of parastomal hernia after colostomy.Methods:The retrospective cohort study was conducted. The clinicopathological data of 145 patients undergoing colostomy in Xinxiang Central Hospital from January 2015 to January 2019 were collected. There were 86 males and 59 females, aged(59±11) years. Patients received pelvic and abdominal computed tomography once every 6 months after colostomy to detect the occurrence of parastomal hernia. Measurement data with normal distribution were represented as Mean± SD, and the independent sample t test was used for comparison between groups. Measurement data with skewed distribution were represented as M(range). Count data were represented as absolute numbers, and chi-square test or Fisher exact probability was used for comparison between groups. Kaplan-Meier method was used to analyze the cumulative annual incidence of parastomal hernia. Logarithmic rank test was used to analyze the cumulative incidence based on clinical variables. COX proportional hazard regression model was used for univariate and multivariate analyses. Results:(1) Incidence of parastomal hernia after colostomy. All the 145 patients were followed up for 86(range, 60?108)months after colostomy, of which 46 cases had parastomal hernia and 99 cases had no parastomal hernia. There were significant differences in gender, age, body mass index (BMI) and chronic liver disease between patients with and without parastomal hernia after colostomy ( χ2=23.28, t=13.27, χ2=6.17, 5.82, P<0.05). (2) Annual cumulative incidence of parastomal hernia after colostomy. The 1-, 3-, and 5-year cumulative incidence of parastromal hernia after colostomy was 8.5%, 26.4% and 42.7%, respectively. When the follow-up time is more than 5 years, the incidence of parastromal hernia tended to be stable. The 5-year incidence of parastomal hernia after colostomy in female patients was higher than that in male patients (70.7% vs 20.3%, χ2=12.37, P<0.05). The 5-year incidence of parastomal hernia after colostomy in patients≥60 years old was higher than that in patients under 60 years old (49.8% vs 20.0%, χ2=10.52, P<0.05). The 5-year incidence of parastomal hernia after colostomy in patients with BMI >28 kg/m 2 was higher than that in patients with BMI ≤28 kg/m 2 (55.3% vs 33.2%, χ2=11.76, P<0.05). The 5-year incidence of parastomal hernia after colostomy in patients with chronic liver disease was higher than that in patients with non-chronic liver disease (45.2% vs 32.4%, χ2=15.32, P<0.05). (3) Analysis of risk factors for parastomal hernia after colostomy. Results of multivariate analysis showed that female, age >60 years old, BMI ≥28 kg/m 2 and chronic liver disease were independent risk factors for parastomal hernia after colostomy ( hazard ratio=2.70, 2.51, 1.85, 5.88, 95% confidence intervals as 1.39?6.74, 1.01?4.59, 1.02?4.87, 1.05?8.24, P<0.05). Conclusions:The incidence of parastomal hernia after colostomy is increasing year by year, and tends to be stable after 5 years. Female, age >60 years old, BMI≥28 kg/m 2, and chronic liver disease are independent risk factors for parastomal hernia after colostomy.

Objective : To investigate the occupational exposure to blood-borne pathogens among medical workers in a tertiary general hospital in Hangzhou City from 2010 to 2022, so as to provide the evidence for improving occupational protective measures among medical workers. Methods: The registration and follow-up data of occupational exposure to blood-borne pathogens among medical workers from 2010 to 2022 were collected from the blood-borne occupational exposure monitoring system in a tertiary general hospital in Hangzhou City. The population distribution, occurrence, protection and disposal of occupational exposure to blood-borne pathogens were analyzed using a descriptive epidemiological method. Results: A total of 1 230 cases were reported with occupational exposure to blood-borne pathogens among medical workers in the study hospital from 2010 to 2022, with the highest incidence in 2021 (4.67%) and the lowest incidence in 2010 (0.99%). The incidence of occupational exposure to blood-borne pathogens appeared a tendency forwards a rise from 2010 to 2022 (P<0.05). Of all cases with occupational exposure to blood-borne pathogens, there were 934 women (75.93%), 656 nurses (53.33%), and 514 cases with working experiences of one year and shorter (41.79%). Hand was the predominant site of occupational exposure to blood-borne pathogens (92.03%) and ward was the predominant place of exposure (35.37%), while scalp needle was the predominant mode of exposure (32.68%), and removal of needle was the predominant procedure of exposure (32.36%). A total of 1 106 cases were tested for the blood-borne pathogens in the exposure sources, and 448 cases were tested positive for blood-borne pathogens, with a detection rate of 40.51%. Hepatitis B virus, treponema pallidum and human immunodeficiency virus were the three most common blood-borne pathogens, and there were 739 cases (60.08%) with personal protective equipment during exposure. Following the follow-up surveillance for more than 6 months post-exposure, no infections occurred. Conclusions Junior nurses and hand exposure were predominant among medical workers with occupational exposure to blood-borne pathogens in the study hospital from 2010 to 2022, and hepatitis B virus was the predominant blood-borne pathogen. No post-exposure infections occurred.

Objective:To detect the level of serological indexes in patients with chronic hepatitis B and carry out magnetic resonance imaging (MRI) examination at the same time, so as to construct a diagnostic model for liver fibrosis and evaluate its diagnostic value.Methods:A total of 267 patients with chronic hepatitis B in Fushun Central Hospital from January 2018 to June 2020 were selected as the research objects. The apparent diffusion coefficient (ADC) was measured by introvoxel incoherent motion (IVIM) magnetic resonance imaging, and the related serological indexes were detected; Pearson method was used to analyze the correlation among Frons index, aspartate aminotransferase to platelet ratio index (APRI), fibrosis index based on the 4 factor (Fib-4), red blood cell volume distribution width to platelet ratio (RPR) and ADC; Logistic regression analysis was used to establish a new diagnosis model of hepatic fibrosis; receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of liver fibrosis model.Results:The pathological examination of 267 patients with chronic hepatitis B showed that there were 35 cases in F0 stage, 47 cases in F1 stage, 58 cases in F2 stage, 66 cases in F3 stage and 61 cases in F4 stage. There were significant differences in platelet (PLT), alanine aminotransferase (ALT), gamma glutamyl transferase (GGT), aspartate aminotransferase (AST), prothrombin activity (PTA), collagen Ⅳ (CⅣ), laminin (LN), hyaluronic acid (HA), precollagen Ⅲ (PCⅢ), Frons index, aspartate aminotransferase to platelet ratio index (APRI), fibrosis index based on the 4 factor(Fib-4), red blood cell volume distribution width to platelet ratio (RPR) and ADC in patients with mild liver fibrosis (F0-F1), moderate liver fibrosis (F2-F3) and severe liver fibrosis (F4) ( P<0.05). Pearson analysis showed that Frons index, APRI, Fib-4, RPR and ADC were positively correlated ( P<0.05). The comparison of value of logistic probability risk estimating (PRE) and Frons index, APRI, Fib-4, RPR in the diagnosis of chronic hepatitis B liver fibrosis showed that the area under the curve (AUC) of Frons index, Fib-4 and APRI in the diagnosis of moderate liver fibrosis were higher than that of mild and severe liver fibrosis, with AUC of 0.903, 0.928 and 0.957, respectively; the AUC of RPR in the diagnosis of mild and moderate hepatic fibrosis was higher (0.861); the AUC of PRE in the diagnosis of mild, moderate and severe liver fibrosis was 0.860, 0.861 and 0.865, respectively; the sensitivity was 64.6%, 76.6%, 73.8%, and the specificity was 96.3%, 89.5% and 95.1%, respectively. Conclusions:Frons index, APRI, Fib-4, RPR and PRE liver fibrosis diagnostic models have certain diagnostic value. Among them, the liver fibrosis diagnostic model predicted by MRI and serological indexes has the best comprehensive efficiency. The best diagnostic scheme should be selected according to the actual situation.

Objective:To investigate the feasibility and accuracy of transperineal prostate targeted biopsy guided by holographic image.Methods:Clinical data of 10 patients with transperineal prostate targeted biopsy guided by holographic image in Peking University Shougang Hospital between May and September 2020 were analyzed retrospectively. The average age was (70.9±10.3) years old, the median PSA was 15.1(6.02-1110.14) ng/ml, prostate MRI were performed before biopsy and the PI-RADS scores were all ≥ 3, and the number of suspicious target lesions was 1.4±0.5. CT examinations of urinary system were performed on the premise of mild lithotomy position and positioning stickers pasted on the skin of perineum and lower abdomen. The original data of CT and MRI were obtained, holographic image models were firstly made separately and then fused into a complete model, and the puncture paths were planned for the target lesions. At the time of puncture, the patient took the same body position as in CT scan, the operator wore a mixed reality head mounted display (HoloLens glasses), and the skin positioning stickers were used for visual registration between the holographic model and the real human body. Then under the guidance of the virtual puncture path, the puncture biopsy gun was placed, fired after reaching the predetermined depth, a transrectal ultrasound probe was placed to clarify the position of the puncture needle, and the objective accuracy of puncture was judged by comparison of ultrasound and MRI images. If the first shot was judged to be inaccurate, it was allowed to make a supplementary shot after adjusting the angle. After holographic guided biopsies, cognitive fusion targeted biopsies and 12-needle systematic biopsies were performed routinely, and the proportion of positive needles of the three different biopsy methods were calculated respectively.Results:All the 10 cases were successfully completed, including 16 holographic image guided shots, 28 cognitive fusion targeted shots and 116 systematic shots. The objective accuracy of holographic image guided biopsy after first shot judgments was 68.8% (11/16), while it raised to 87.5% (14/16) after supplementary shots. The proportion of positive needles in the three puncture methods were 56.3% (9/16), 42.9% (12/28) and 19.8% (23/116), respectively ( P=0.002). The results of subjective questionnaire showed that holographic model was helpful to improve the spatial understanding of lesions. The satisfaction of intraoperative holographic registration and guided puncture were 90% and 60%, respectively. No puncture related complication occurred in this group. Conclusion:The study preliminarily confirmed the feasibility of holographic image-guided prostate targeted biopsy. This new puncture method has better objective accuracy, and the proportion of positive needles is significantly better than systematic biopsy.

OBJECTIVE: To explore the clinical features and genetic basis for a Chinese pedigree diagnosed with congenital glycosylation disease (CGD). METHODS: Clinical manifestations of two brothers were analyzed. Whole exome sequencing was carried out for the sib pair. Suspected variants were verified by Sanger sequencing. RESULTS: Both the proband and her younger brother were found to carry compound heterozygous variants of the PMM2 gene, which included a known pathogenic mutation of c.395T>C (p.I132T) and a previously unreported c.448-1(delAG) in the 5' end of exon 6 of the gene. CONCLUSION The compound heterozygous variants of the PMM2 gene probably underlay the CGD in the sib pair.
Asians/genetics* ; China ; Female ; Glycosylation ; Humans ; Male ; Mutation ; Pedigree ; Whole Exome Sequencing

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.

Objective:To investigate the role and regulatory mechanism of UGT2A3 differential expression in colorectal carcinogenesis.Methods:Nine CRC datasets were downloaded from GEO database and TCGA. R language was used to analyze the differential expression of UGT2A3 in cancer and normal tissues. According to the expression level of UGT2A3 in TCGA, the top 20 samples with the highest expression and the lowest expression were selected from normal tissues and CRC tissues, respectively. The abundance of immune cells and immune enrichment score were compared, the differentially expressed genes and differentially expressed miRNAs were screened, and the pathway enrichment analysis of differentially expressed genes was performed.Results:UGT2A3 was down regulated in all 9 CRC datasets. In all sample types, compared with the UGT2A3 high expression group, the UGT2A3 low expression group had significantly higher ImmuneScore, EstimateScoreandStromalScore, and had higher abundance of immune cells (except memory B cells). In normal tissues, the differential expression of UGT2A3 mainly affects cancer-related pathways, while in tumor tissues, it mainly affects metabolic pathways. miR-194-2, miR-224 and miR-551b were differentially expressed in all groups, which were considered as potential UGT2A3 upstream regulatory genes in CRC.Conclusions:UGT2A3, miR-194-2, miR-224 and miR-551b can be used as potential biomarkers for the diagnosis of CRC.

Objective:To investigate the effect of miR-369-3p targeting ACTN4 expression on proliferation and apoptosis of hepatocellular carcinoma cells.Methods:Real-time quantitative polymerase chain reaction (RT-qPCR) and western blot were used to detect the expression levels of miR-369-3p and ACTN4 in hepatocarcinoma tissues and adjacent tissues. MiR-369-3p mimics, miR-negative control (NC), si-ACTN4, and si-NC were transfected into hepatocellular carcinoma MHCC97H cells by liposome method. Cell proliferation was detected by 3-(4, 5-Dimethylthiazol-2-yl)-2, 5-dipheny-ltetrazolium bromide (MTT) assay. Flow cytometry was used to detect cell cycle and apoptotic rates. The dual luciferase reporter assay was used to verify the targeted regulation of ACTN4 by miR-369-3p. Western blot was used to detect the expressions of cyclin D1, p21, Bcl-2 and Bax.Results:The expression level of miR-369-3p in liver cancer tissue was lower than that in adjacent tissues [(0.46±0.04) vs (1.00±0.08), P<0.001)], while the expression level of ACTN4 was higher than that in adjacent tissues [mRNA (3.12±0.29) vs (1.01±0.09); protein (0.61±0.06) vs (0.25±0.03), P<0.001]. Overexpression of miR-369-3p significantly decreased the cell viability[(0.71±0.06) vs (1.26±0.11), P<0.001)], increased cell apoptosis rate [(20.16±2.11)% vs (6.25±0.64)%, P<0.001], increased the proportion of cells in G 1 phase [(31.14±3.36)% vs (51.56±5.23)%, P<0.001], decreased the proportion of cells in S phase [(32.44±3.56)% vs (14.33) ±1.45)%, P<0.001], increased the levels of p21 and Bax protein ( P<0.001), and decreased the levels of cyclin D1 and Bcl-2 protein ( P<0.001). Inhibition of the expression of ACTN4 significantly reduced the cell viability [(0.78±0.07) vs (1.24±0.12), P<0.001], increased the apoptosis rate [(6.58±0.66)% vs (18.32±1.82)%, P<0.001], increased the proportion of cells in G 1 phase [(48.69±4.21)% vs (30.33±3.01)%, P<0.001], decreased the proportion of cells in S phase [(36.21±3.42)% vs (18.54±1.61)%, P<0.001], increased the protein levels of p21 and Bax ( P<0.001), and decreased the levels of cyclin D1 and Bcl-2 protein ( P<0.001). Compared with the miR-369-3p+ pcDNA group, overexpression of ACTN4 increased the proliferation ability of hepatocellular carcinoma MHCC97H cells at 72 hours of culture[(1.12±0.11) vs (0.68±0.06), P<0.001], significantly reduced the proportion of cells in G 1 stage [(38.81±3.24)% vs (51.80±4.57)%, P<0.001], significantly increased the proportion of S-phase cells [(31.65±3.11)% vs (15.69±1.44)%, P<0.001], decreased cell apoptosis rate [(13.86±1.37)% vs (22.69±2.24)%, P<0.001], increased protein expressions of cyclin D1 and Bcl-2 ( P<0.001), decreased the protein expressions of p21 and Bax ( P<0.001). Conclusion:MiR-369-3p can induce cell cycle arrest in G 1 phase, inhibit the proliferation and promote apoptosis of liver cancer cells by regulating the expression of ACTN4.