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 study the changes of serum metabolites in the patients with chronic kidney disease osteoporosis(CKD-OP)to provide the new biomarkers for the early diagnosis of CKD-OP.Methods A total of 22 patients with definitely diagnosed CKD visiting in this hospital from April to Novem-ber 2023 were selected as the study subjects,and 22 subjects with physical examination in this hospital at the same period were included for conducting the control study.With the lumbar vertebral T value ≤-2.5 as the standard,the subjects were divided into the CKD-OP group(n=11),CKD non-OP group(CKD-NOP group,n=11),simple osteoporosis group(OP group,n=11)and healthy control group(NC group,n=11).The liq-uid chromatography-mass spectrometry(LC-MS)coupling technique was used to analyze the differences in se-rum metabolites among the four groups,the potential biomarkers of CKD-OP was screened,and the correla-tion between the potential biomarkers with lumbar vertebra bone mineral density(BMD),serum bone-derived alkaline phosphatase(BALP)and serum tartrate-resistant acid phosphatase-5b(TRACP-5b)was studied.Re-sults With the receiver's operating characteristic(ROC)curve's area under curve(AUC)＞0.9 as the con-dition,and four potential biomarkers of CKD-OP were screened,which were phosphorylcholine,lysophosphati-dylcholine(18∶2/0∶0),capric acid,and allantoin respectively.Serum phosphorylcholine was positively corre-lated with lumbar vertebra BMD(r=0.601,P＜0.05)and negatively correlated with serum BALP and TRACP-5b(r=-0.729,-0.623,P＜0.05).Serum allantoin was positively correlated with lumbar vertebra BMD(r=0.483,P＜0.05)and negatively correlated with serum BALB(r=-0.494,P＜0.05).Serum lyso-phosphatidylcholine(18∶2/0∶0)was positively correlated with lumbar vertebra BMD(r=0.640,P＜0.05),and negatively correlated with serum BALP and TRACP-5b(r=-0.628,-0.548,P＜0.05).Serum capric acid was negatively correlated with lumbar vertebra BMD(r=-0.444,P＜0.05)and positively corre-lated with serum BALB(r=0.587,P＜0.05).Conclusion The screened four endogenous potential biomarkers provide the new research ideas for the early diagnosis and treatment efficacy monitoring of CKD-OP.

Objective To investigate the influence of spectral CT monochromatic imaging technique on image quality and liver vol-ume measurement in computed tomography portal venography(CTPV).Methods A total of 120 patients who underwent contrast-enhanced abdominal CT examination were prospectively selected and randomly divided into group A and group B.The group A(n=60)was scanned with conventional parameters such as 120 kVp,Smart mA mode,and image reconstruction of 60％adaptive statistical iterative reconstruction-Veo(ASIR-V);while the group B(n=60)was with instantaneous switching 80/140 kVp,gemstone spectral imaging(GSI)Assist mode,and image reconstruction of 60％ASIR-V.In group B,six subgroups of images from 75 to 50 keV(with 5 keV interval)were recorded as subgroups B1 to B6.On the axial images,the CT values and standard deviation(SD)values of por-tal vein,liver and erector spinae were measured,and then the contrast-to-noise ratio(CNR)of portal vein and liver were calculated.The Liver Segmentation software was used to segment the liver in groups A and B,the liver volumes by automatic segmentation and manual segmentation(golden standard)were recorded,and then the volume difference rate was calculated.The overall image quality and automatic liver segmentation results were evaluated by two radiologists using a 5-point scale.Results In terms of overall image quality,subgroup B6 achieved the highest score and was superior to group A(P＜0.001).In terms of liver segmentation,subgroup B3 had the highest score and was superior to group A(P＜0.001).With the decrease of keV,the CT values,SD values and CNR of portal vein and liver in group B were gradually increased(P＜0.05),in which subgroup B6 was higher than that in group A(P＜0.001).The volume difference rate initially decreased and then increased with the decrease of keV.Except for subgroups B2 and B3,the differences were statistically significant between other subgroups and group A(P＜O.001),and the subgroup B3 had the lowest volume difference rate.Conclusion Spectral CT monochromatic ima-ging technique has an influence on CTPV image quality and liver volume measurement.The 50 keV images are the best for displaying portal vein,and the automatic liver segmentation volume of 65 keV images is closest to the real liver volume.

Objective The DNA methylation microhaplotype(DMH)refers to the combination of multiple methylation sites within a very short range,and these haplotypes show wide diversity.We carried out screening and validation of age-related DMHs in mouse blood.Methods We initially constructed a theoretical dataset of DMHs based on the mouse reference genome.We then screened age-related DMHs by Spearman's rank correlation analysis,using high-throughput sequencing information for DNA methylation in mouse blood from a network database.Finally,cross-validation was performed using a validation dataset.Results A total of 6787 142 DMH sites were identified within 50 bp in the mouse genome,including 98.64%of single-digit CpG sites.A total of 5835 age-associated DMHs were screened in 58 mouse blood samples(|rho|＞0.5,P＜0.01),accounting for 0.086%of DMHs.Finally,we validated the top 100 age-associated DMHs with high correlation in 95 independent samples,Resultsing in 44 loci.Conclusions The age-associated DMHs screened in this study may be useful in future studies of apparent age prediction using mouse blood and in aging studies.

Objective:To elucidate the primary elements pertaining to the perception of relapse risk and to in-vestigate the characteristics and alterations of perception of the risk of recurrence in patients with schizophrenia.Methods:By using the method of phenomenological study,semi-structured in-depth interviews were conducted among schizophrenic patients with first onset,first recurrence and multiple recurrences.Twenty-three 23 outpatient and inpatient cases that met the criteria of the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)were included,and all patients had PANSS scores below 60.The interview data were collated and analyzed according to Colaizzi analysis.Results:The perception of recurrence risk in patients with schizophrenia en-compassed 4 major themes and 11 sub-themes,namely susceptibility(limited overall understanding,transition from optimism to objectivity),detection of early warning symptoms(dynamic escalation,assistance from family mem-bers in identification),understanding risk factors(lack of understanding,the relationship between psychosocial fac-tors and relapse,dynamic understanding of medication-relapse relationship),and apprehension of the consequences of recurrence(care burden and financial constraints,impaired social functioning and maladjustment,impact on pub-lic safety,personal health risks).Conclusion:The content of risk perception of recurrence in patients with schizo-phrenia is relatively substantial.The overall level of risk perception of recurrence in patients with schizophrenia is low.

Objective:To systematically review the factors related to the aggressive behavior of hospitalized patients with schizophrenia in China.Methods:CNKI,Wanfang,VIP,China Biomedical Literature Database,PubMed,Cochrane Library,and Embase databases were searched to collect case-control studies on factors related to aggression in hospitalized patients with schizophrenia in China from its inception to June 2023.Analysis was per-formed using ReviewManager 5.3 to calculate pooled OR(95％CI)values.Results:Thirty-three studies were in-cluded.Medical staff coercive measures(OR=3.86,95％CI:2.75-5.43),unemployment(OR=1.44,95％CI:1.14-1.81),positive family history(OR=2.97,95％CI:2.29-3.87),poor medication compliance(OR=4.37,95％CI:3.36-5.69),young age(OR=3.13,95％CI:2.66-3.69),involuntary hospitalization(OR=3.34,95％CI:2.81-3.97),depression(OR=2.11,95％CI:1.68-2.66),emotional abuse(OR=1.13,95％CI:1.04-1.23),male(OR=2.70,95％CI:2.20-3.31),delusions(OR=2.14,95％CI:1.69-2.71),auditory hallucina-tions(OR=2.23,95％CI:1.70-2.94),and major life events(OR=3.21,95％CI:1.90-5.42)and previous history of aggressive behavior(OR=2.20,95％CI:2.06-2.34)were risk factors associated with aggressive be-havior in Chinese patients with schizophrenia,and social support(OR=0.46,95％CI:0.31-0.67)was a protec-tive factor.Conclusion:There are various factors related to aggressive behavior in hospitalized Chinese patients with schizophrenia,and medical staff should identify high-risk groups early according to the relevant factors,and effec-tively intervene in controllable factors to reduce the occurrence of aggressive behavior.

Purpose To explore the value of CT large reconstruction matrix 1024×1024 combined with iterative reconstruction algorithm Karl in the diagnosis of pulmonary nodules.Materials and Methods A total of 500 patients who underwent chest CT examination at the First Affiliated Hospital of Dalian Medical University from October 2021 to May 2022 were prospectively collected,and the raw data of CT scans were reconstructed to divide into group A and B.Group A was reconstructed using a conventional 512×512 matrix combined with Karl 5 reconstruction;group B was reconstructed using a large 1 024×1 024 reconstruction matrix combined with different levels of Karl algorithm to obtain four subgroups,including B1(Karl 6),B2(Karl 7),B3(Karl 8)and B4(Karl 9)subgroup.The signal-to-noise ratio was calculated by measuring the CT and standard deviation values of the tracheal lumen above the arch of the aorta(tracheal area)and the avascular area of the upper lobe of the left lung(lung parenchyma).The overall image quality of the lungs in group A and B was evaluated by two physicians.The best image quality subgroup in group B was compared with the lesion display in group A.The diagnostic efficacy was analyzed based on the surgical pathology results.Results In group B,the standard deviation values of trachea and lung parenchyma gradually decreased and the signal-to-noise ratio gradually increased as the Karl grade increased compared with group A(F=675.002-2 020.903,all P<0.05).All subjective scores in group B were significantly higher than those in group A(Z=-15.361--6.465,all P<0.05),and the highest subjective scores were found in group B4.Some solid nodules(≤3 mm)and solid nodules(6.1 mm-≤3 cm)showed no statistically significant difference in clarity(Z=-2.000,-0.378,both P>0.05).Compared with group A,group B4 showed a 12%-100%improvement in nodule clarity.Only pleural depression sign showed the difference was not statistically significant(χ2=2.143,P>0.05).Taking 43 cases of surgical pathology as the gold standard,the diagnostic accuracy of group B4 was 65.12%,which was better than that of group A,which was 41.86%(χ2=4.674,P<0.05).Conclusion The combined application of the large reconstruction matrix and the Karl iteration algorithm results in superior image quality and facilitates the diagnosis of lung nodules.

Objective:To construct an system of optimization and evaluation parameters for the archive management of medical equipment in hospital,and to optimize and improve the quality and effect of the management for the archive of medical equipment of hospital.Methods:The problems existing in the management of the archives of medical equipment in hospitals were analyzed,and the targeted measures were formulated on the basis of the optimization of management mode,the innovation of management process of the archives,the improvement of management system of archives and continuous improvement of the quality of management personnel of equipment archives.The indicator system of optimization and evaluation of the management of medical equipment archives of hospital was constructed from 6 secondary indicators included management mechanism and system construction,personnel training and capacity building,quality of archive management,efficiency of archives review,satisfaction survey of service object,and innovation ability,as well as 18 tertiary indicators under the secondary indicators.The scores of the secondary and tertiary indicators of the evaluation of indicator system between before and after the measures of indicator system of optimization and evaluation of archive management of medical equipment of Peking University School and Hospital of Stomatology were implemented were compared.Results:Before each measure that was formulated by the indicator system of optimization and evaluation of the archive management of medical equipment of hospital was implemented,the comprehensive evaluation score of archive management of medical equipment of hospital was 3.65 points.The comprehensive evaluation score was 4.9 points after the each measure was implemented.After the indicator system was implemented,the median scores of secondary and tertiary indicators were respectively 0.63(0.40-1.50)points and 0.25(0.13-0.50)points,which were all significantly higher than those before they were implemented,and the differences were all statistically significant(Z=-2.23,-3.22,P<0.05).Conclusion:The indicator system of optimization and evaluation of archive management of medical equipment of hospital can improve the quality and effect of archive management of medical equipment of hospital,and provide a basis and guarantee for the whole life cycle management of medical equipment such as procurement decision-making,quality control management,maintenance management,and scrap disposal of medical equipment of hospital.