Acute kidney injury (AKI) is one of the most common and severe nephropathy syndromes in clinical practice and also one of the most common serious complications after organ transplantation, with high incidence and fatality. Iron is an essential trace element in the body. Ferroptosis is a form of programmed cell death induced by the accumulation of iron-mediated lipid peroxidation, and its occurrence is closely related to iron metabolism, lipid metabolism, amino acid metabolism and multiple signaling pathways. Recent studies have shown that ferroptosis plays a key role in the occurrence and development of AKI and provides therapeutic targets for AKI. This article summarizes the regulatory mechanism of ferroptosis and its role in AKI, as well as the compounds that play an important role in the prevention and treatment of AKI by inhibiting ferroptosis, providing new ideas for the future treatment and research of AKI.

Standardized reporting is a crucial factor affecting the use of patient guidelines （PGs）， particularly in the reporting and presentation of recommendations. This paper introduced the current status of PG reporting， including the research on PG content and presentation formats， and provided comprehensive recommendations for PG reporting from aspects such as overall framework， recommendations， presentation format， and readability. First， the presentation of PG recommendations should include clearly defined clinical questions， recommendations and their rationale， and guidance on how patients should implement the interventions； for specific content in the PG， such as level of evidence， level of recommendation， it is recommended to explain in text the reasons for giving different levels of recommendation， i.e.， to present the logic behind giving the level of recommendation to the patient； additional information needed in the recommendation framework should be supplemented by tracing references or authoritative textbooks and literature that support the recommendations. Subsequently， the PG text should be written based on the Reporting Checklist for Public Versions of Guidelines （RIGHT-PVG） reporting framework. Finally， to enhance readability and comprehension， it is recommended to refer to the Patient Education Materials Assessment Tool （PEMAT） for translating PG content. To enhance the readability of PGs， it is suggested to present the PG content in a persona-lized and layered manner.

Since the concept of patient versions of guidelines （PVGs） was introduced into China， several PVGs have been published in China， but we found that there is a big difference between the concept of PVG at home and abroad， and the reason for this difference has not been reasonably explained， which has led to ambiguity and even misapplication of the PVG concept by guideline developers. By analyzing the background and purpose of PVGs， and the understanding of the PVG concept by domestic scholars， we proposed the term patient guidelines （PGs）. This refers to guidelines developed under the principles of evidence-based medicine， centered on health issues that concern patients， and based on the best available evidence， intended for patient use. Except for the general attribute of providing information or education， which is typical of common health education materials， PGs also provide recommendations and assist in decision-making， so PGs include both the patient versions of guidelines （PVG） as defined by the Guidelines International Network （GIN） and "patient-directed guidelines"， i.e. clinical practice guidelines resulting from the adaptation or reformulation of recommendations through clinical practice guidelines.

At present， the process and methodology of patient guidelines （PGs） development varies greatly and lacks systematic and standardised guidance. In addition to the interviews with PG developers， we have sorted out the relevant methodology for the adaptation and development of existing clinical practice guideline recommendations and facilitated expert deliberations to achieve a consensus， so as to finally put forward a proposal for guidance on the process and methodology for the development of PGs. The development of PGs can be divided into the preparation stage， the construction stage， and the completion stage in general， but the specific steps vary according to the different modes of development of PGs. The development process of Model 1 is basically the same as the patient version of the guideline development process provided by the International Guidelines Network， i.e.， team formation， screening of recommendations， guideline drafing， user testing and feedback， approval and dissemination. The developer should also first determine the need for and scope of translating the clinical practice guideline into a patient version during the preparation phase. Model 2 adds user experience and feedback to the conventional clinical practice guideline development process （forming a team， determining the scope of the PG， searching， evaluating and integrating evidence， forming recommendations， writing the guideline， and expert review）. Based on the different models， we sort out the process and methods of PG development and introduce the specific methods of PG development， including how to identify the clinical problem and how to form recommendations based on the existing clinical practice guidelines， with a view to providing reference for guideline developers and related researchers.

Objective To explore the effects of Zengye Runzao Decoction on mRNAs and proteins related to submandibular gland tissue and the expression of Th17/Treg in peripheral blood of Sj?gren syndrome(SS)model mice.Methods SPF Balb/c mice were randomly divided into control group and modeling group,the modeling group established an SS mouse model through immune induction,while the control group was not treated.The modeled mice were randomly divided into model group,total glucosides of Paeoniae Radix Alba group and Zengye Runzao Decoction low-,medium-and high-dosage groups,with 3 mice in each group.The total glucosides of Paeoniae Radix Alba group was given 0.234 mg/g total glucosides of Paeoniae Radix Alba solution by gavage,Zengye Runzao Decoction low-,medium-and high-dosage groups were given 4,8,12 mg/g Zengye Runzao Decoction by gavage,and the control group and model group were given the same volume of distilled water by gavage,once a day for 60 consecutive days.The daily water intake,salivary flow rate and submandibular index were calculated,the tissue morphology of submandibular gland was observed by HE staining,the expressions of HOXA1,STAT3,IL-17,FOXP3 mRNA and miR-181c-3p in submandibular gland tissue were detected by qPCR,Western blot was used to detect the expressions of HOXA1,STAT3,p-STAT3,IL-17 and FOXP3 protein in submandibular gland tissue,the proportion of Th17 and Treg cells in peripheral blood was detected by flow cytometer.Results Compared with the control group,the daily water intake of the model group mice increased,saliva flow rate and submandibular gland index decreased,lymphocyte infiltration in submandibular gland tissue was significant,the expressions of HOXA1,STAT3,IL-17 mRNA increased,the expressions of FOXP3 mRNA and miR-181c-3p decreased,the expressions of HOXA1,STAT3,p-STAT3,IL-17 protein increased,FOXP3 protein expression decreased,Th17 ratio and Th17/Treg increased,and Treg ratio decreased,with statistical significance(P<0.05).Compared with the model group,the daily water intake of Zengye Runzao Decoction groups decreased,the saliva flow rate increased,and the infiltration of lymphocytes in the submandibular gland tissue was reduced to varying degrees,the expressions of HOXA1 and IL-17 mRNA decreased,while the expressions of FOXP3 mRNA and miR-181c-3p increased,the expression of HOXA1 protein decreased,while the expression of FOXP3 protein increased,the ratio of Th17 and Th17/Treg decreased,and the Treg ratio increased.The submandibular gland index increased in Zengye Runzao Decoction high-dosage group,and the expressions of STAT3 mRNA and protein,as well as p-STAT3 and IL-17 protein decreased,with statistical significance(P<0.05).Conclusion Zengye Runzao Decoction may regulate Th17/Treg cell imbalance by up-regulating the expressions of miR-181c-3p,FOXP3 and down-regulating the expressions of HOXA1,p-STAT3,STAT3 and IL-17,and then improve the function and tissue injury of submandibular gland caused by SS.

Objective To explore the correlation between hyponatremia at admission and all-cause mortality within one year after discharge in elderly patients with intestinal obstruction.Methods The 331 cases of elderly patients with intestinal obstruction(aged ≥ 60 years)who visited the General Surgery Department of Nanjing Meishan Hospital from January 2017 to December 2020 were selected as the research objects for retrospective cohort study analysis.According to the patient's blood sodium level at admission,they are divided into two groups:the hyponatremia group(Na＜135 mmol/L)and the non hyponatremia group(Na≥135 mmol/L).Divided into death group and survival group based on whether death occurred within one year after discharge.SPSS 25.0 software was used for statistical analysis.Independent sample t test,x2 test,Kaplan Meier method,and multivariate Cox regression analysis were used to observe the correlation between admission hyponatremia and all-cause mortality within one year after discharge in elderly patients with intestinal obstruction.Results A total of 331 patients were enrolled.The incidence of hyponatremia was 32.3％,and 56 deaths occurred within one year,accounting for 16.92％.The one-year mortality rate in the hyponatremia group was 23.4％(25/107),which was higher than 13.8％(31/224)in the non hyponatremia group.The difference was statistically significant(P＜0.05).The survival analysis(Kaplan Meier)results showed that the survival rate of the hyponatremia group was lower than that of the non hyponatremia group(Log Rank P＜0.05).After adjusting for other confounding factors in multivariate Cox regression analysis,hyponatremia(HR=1.88,95％CI:1.07-3.29)was an independent risk factor for one-year all-cause mortality in elderly patients with intestinal obstruction(P＜0.05).Conclusion Hyponatremia at admission is an independent risk factor for all cause mortality in elderly patients with intestinal obstruction within one year after discharge.

Objective:The purpose of this study was to analyze the pharmacoeconomic research progress on nutrition therapy for cancer patients in recent ten years and explore the research hotspots in this field.Method:Bibliometric analysis was conducted based on Web of Science core database using CiteSpace, VOSviewer, Gephi and Scimago Graphics.Results:A total of 647 researches in the field of pharmacoeconomics about nutrition therapy for cancer patients published from 2013 to 2022 were included, with the annual publication output peaking in 2022. A total of 286 authors from 94 countries or regions have conducted relevant research. Among the 306 institutions involved in our study, the World Health Organization was with the most citations, and the journal with the most citations was Clinical nutrition. The United States, China and the United Kingdom were the top three countries concerning publication outputs. Harvard University was the most important research institution in this field, and the authors with the highest publication volume was Carli Francesco. Keyword analysis identified colorectal cancer as the most important research topic. Keyword clustering resulted in 16 groups, among which enteral nutrition was the largest, and the burst keyword was enhanced recovery after surgery. Conclusions:This study found that research hotspots in nutrition therapy for cancer patients have mainly focused on colorectal cancer and enhanced recovery after surgery in the past decade, and enteral nutrition is also an important research topic in this field. With the emerging precision medicine, based on big data and individual patient conditions (especially patients with colorectal cancer), tailored whole-course perioperative nutrition management program with superior cost-effectiveness may represent the future research trend.

Bariatric surgery has been proven to be the most effective intervention for the treatment of obesity and obesity-related complications. In recent decades, medical experts as well as scholars in China have been actively promoting and pushing the development of bariatric surgery, and conducting a series of clinical and basic research. As a result of their unremitting efforts, research in the field of bariatric surgery in China has developed extremely rapidly. The authors examined the overview of literature research in the field of bariatric surgery in China through bibliometric analysis, and analyzed the current status, hot spots, trends, and frontiers of research in this field, with the aim of providing references for future research and development.

Objective:To summarize the treatment process of rapid decrease in blood flow due to centrifugal pump dysfunction during extracorporeal membrane oxygenation (ECMO) and its related thinking.Methods:On September 25, 2021, the ECMO treatment of a 14-year-old boy with severe mycoplasma pneumonia, severe viral pneumonia and acute respiratory distress syndrome (ARDS) admitted to the department of critical care medicine of the First Affiliated Hospital of Wannan Medical College was analyzed.Results:Oxygenation of the child was difficult to maintain under invasive mechanical ventilation, and lung consolidation progressed seriously. After evaluation, venous-venous ECMO (VV-ECMO) was implemented, then oxygenation was improved. In the 120th hour after VV-ECMO establishment, the blood flow sudden decreased, the speed was 3 822 r/min, while the flow was only 0.2 L/min, more over there was no change in the flow when the speed was increased. Before that, the ECMO speed was 3 530 r/min, and the flow was up to 3.4 L/min and stable. After rapid screening, it was determined that the centrifugal pump was dysfunction. ECMO was successfully replaced and the flow was satisfactory.Conclusions:At present, most ECMO centers do not routinely monitor the pressure before and after the pump. There is a lack of visual and quantitative techniques or indicators to judge the pump's function, and there is also a lack of corresponding clinical experience in treatment. This paper summarizes the investigation and treatment process of ECMO pump dysfunction of this case to provide reference.

Objective:To investigate the long-term outcomes of minimally invasive Oxford phase Ⅲ unicompartmental knee arthroplasty (UKA) for patients with medial compartment osteoarthropathy.Methods:The clinical data of 594 patients (701 knees) who underwent minimally invasive UKA with Oxford phase Ⅲ unicompartmental prosthesis at Department of Orthopedics,the Affiliated Hospital of Qingdao University from January 2007 to January 2016 were retrospectively analyzed.There were 155 males and 439 females,aged (62.6±10.9) years (range: 44 to 81 years),with a body mass index of (26.9±3.8) kg/m 2 (range: 21.1 to 36.2 kg/m 2).There were 359 left knees and 342 right knees,676 knees with osteoarthritis and 25 knees with idiopathic osteonecrosis of the medial femoral condyle.There were 487 cases underwent UKA (66 cases underwent UKA on one side and total knee arthroplasty on the other) and 107 cases underwent bilateral UKA.Patients′ prosthetic survival,complications,range of motion(ROM) of the knee,visual analogue score (VAS),Western Ontario and McMaster University (WOMAC) osteoarthritis index,and American knee society score (KSS) were collected to assess clinical outcomes.Paired sample t test was used to compare the data before and after operation. Results:All patients completed the surgery successfully.There was no intraoperative fractures,postoperative infections or symptomatic vascular embolic disease occurred.The postoperative complications,including mobile bearing dislocation,prosthesis loosening,tibial plateau collapse,the lateral compartment degeneration and postoperative pain were occurred in 18 cases (3.0%,18/594).Thirteen patients suffered complications were transferred to total knee arthroplasty,4 underwent partial revision,if this was used as the endpoint of the study,the surgical success rate was 97.1% (577/594) and the prosthetic revision rate was 2.9%.The ROM was improved from(105.9±11.8)°preoperatively to (114.0±13.3)° at the last follow-up ( t=10.796, P<0.01);the KSS clinical score was increased from 54.3±3.6 to 90.1±6.0 ( P<0.01) and the functional score was increased from 55.9±3.9 to 87.5±5.7( t=124.325, P<0.01; t=110.985, P<0.01).The WOMAC osteoarthritis index was decreased from 54.8±6.7 to 9.2±3.1 at the last follow-up( t=150.860, P<0.01) and the VAS was decreased from 6.1±1.1 to 1.5±1.0 at the last follow-up( t=74.941, P<0.01). Conclusions:Minimally invasive Oxford phase Ⅲ UKA for medial compartment knee osteoarthritis has a favorable prosthesis survival rate,low revision rate,and few complications at long-term follow-up.Patients have significant improvement in knee function with satisfactory clinical outcomes.