Development of patient versions of guidelines in Chinese mainland: A systematic survey of current practices and methods.

OBJECTIVES: To review current practices and methods underlying the development of patient versions of guidelines (PVGs) in Chinese mainland. METHODS: We systematically searched for PVGs created or published between January 2010 and February 2022. We conducted a framework analysis for the development process and assessed the compliance of PVGs using the Reporting Checklist for Public Versions of Guidelines (RIGHT-PVG). RESULTS: We identified 26 PVGs developed by 16 PVG-working teams. In accordance with the Guidelines International Network (GIN), only two PVGs were translated using one clinical practice guideline (CPG) provided by the CPG-working group source. Several CPGs and other information sources were integrated and translated into a single PVG by other PVG teams. Moreover, we identified various practices described by different PVG teams that could be structured into six steps. Out of the 17 RIGHT-PVG items, five items were fully reported in all PVGs, while two items ("Provide a summary of the PVG" and "Provide a list of terms and abbreviations") were not reported in any of the PVGs. CONCLUSIONS AND PRACTICAL IMPLICATIONS: A relatively small number of PVGs were developed in Chinese mainland. The development of a PVG requires comprehensive methodological guidance based on several CPGs and other sources of information as opposed to only using one.

Negative correlation between X-linked inhibitors of apoptosis and second mitochondria-derived activator of caspase expression levels in cervical carcinoma and cervical intraepithelial neoplasia.

X-linked inhibitors of apoptosis (XIAP) and second mitochondria-derived activator of caspase (Smac) have been widely reported to serve roles in the development of cervical carcinoma. The present study analyzed the associations between the expression levels of XIAP and Smac in normal cervical epithelium, cervical intraepithelial neoplasia (CIN) and cervical carcinoma. Immunohistochemistry staining of formalin-fixed, paraffin-embedded tissue sections was performed in order to analyze the expression levels of XIAP and Smac in 15 cases of normal cervical tissues, 69 cases of CIN and 76 cases of cervical carcinoma. All the tissue samples were confirmed by pathological diagnosis. The association of XIAP and Smac expression levels was analyzed using one-way analysis of variance, χ2 tests and Spearman's ρ for the nonparametric bi-variant correlation analysis. Overall survival was determined using the log-rank test and Kaplan-Meier survival curves. The expression level of XIAP was increased in CIN and cervical carcinoma tissues compared with normal cervical tissues, whereas Smac demonstrated a converse expression pattern to XIAP in these tissues. The positive staining level of XIAP protein was increased in grade 3 CIN compared with that in grade 1-2 CIN, and was significantly higher in the less-differentiated tissue of cervical carcinoma compared with the well- or medium-differentiated tissues (P<0.05). The staining level was also significantly increased in cervical carcinoma with stage 2b-3 compared with tissues from stage 1-2a carcinoma (P<0.05). The expression levels of Smac were in opposition to these results. XIAP was associated with pelvic lymph node metastasis, whereas no association was identified with Smac expression. The expression level of XIAP was significantly and negatively associated with cell survival time in cervical carcinoma, whereas the expression level of Smac was significantly and positively associated with cell survival time in cervical carcinoma. Therefore, XIAP and Smac may participate in the development of cervical cancer. The expression levels of XIAP and Smac were significantly and inversely associated. This may be useful in early diagnosis, evaluation of surgery and chemotherapy and the prognosis of cervical carcinoma.