Oxaliplatin serves as a basic therapeutic agent for various malignant tumors.Oxaliplatin-induced hypersensitivity reactions are potentially life-threatening,and frequently lead to treatment discontinuation.Alternative therapies may be less effective and/or more expensive,with varying tolerability.Oxaliplatin hypersensitivity reactions typically manifest as a classic type Ⅰ allergy,as well as cytokine release reactions and mixed types.In clinical practice,management of anaphylaxis and questions relative to rechallenge with oxaliplatin after occurrence of hypersensitivity reactions are of utmost concern.Therefore,based on evidence-based medicine and clinical practice experience,the expert panel carried out a comprehensive assessment and discussion on the definition,clinical characteristics,diagnosis,classification and grading criteria,management,and rechallenge of hypersensitivity reactions to oxaliplatin.Eventually,the"Chinese expert consensus on whole-process management of oxaliplatin-induced hypersensitivity reactions(2024 edition)"was formulated to further standardize the whole-process management of oxaliplatin-induced hypersensitivity reactions.The consensus has been registered on Practice guideline REgistration for transPAREncy(PREPARE)with the registration number PREPARE-2024CN371.

OBJECTIVE To provide a basis for the rational use of nonsteroidal anti-inflammatory drugs （NSAIDs） in the perioperative period， and provide practical methods and technical references for the evaluation and selection of NSAIDs in medical institutions. METHODS Initiated by the Affiliated Hospital of Qingdao University， Clinical Pharmacy Professional Committee of the Shandong Pharmacists Association， Clinical Individualised Drug Testing and Guidance Branch of the Shandong Medical Association， Comprehensive Clinical Medication Evaluation Working Committee of the Shandong Pharmacists Association， Pain Branch of the Shandong Medical Association in conjunction with several medical institutions in Shandong Province organized 22 pharmaceutical experts and medical experts from 17 hospitals in Shandong Province to form a consensus on the rational use and comprehensive clinical evaluation of NSAIDs in the perioperative period through the literature research method， expert interview method and questionnaire survey method based on evidence-based medicine. A comprehensive clinical evaluation was also conducted on a total of 13 specifications of 9 commonly used clinical drug varieties in Shandong Province， including celecoxib， etoricoxib， imrecoxib， ibuprofen （containing reference/original drugs and national/Shandong Province’s centralized volume-based procurement varieties）. RESULTS & CONCLUSIONS A consensus opinion was formed on preoperative prophylactic use and postoperative use of NSAIDs， as well as contraindications， digestive tract risk， cardiovascular system risk， bleeding risk and kidney injury risk in the perioperative period. The evaluation and selection criteria of perioperative use of NSAIDs were established， involving 6 dimensions of safety， efficacy， economy， innovation， appropriateness， and accessibility. The results of comprehensive clinical evaluation showed that the top 6 drugs （scores over 70） were Celecoxib capsules （Celebrex） and Celecoxib capsules （Naiqi）， Diclofenac sodium sustained-release tablets，Etocoxib tablets （Arcoxia） and Etocoxib tablets （Qimingshu）， and Parecoxib sodium for injection. With the progress of clinical research， this consensus will be further updated and adjusted， and medical institutions can combine with the practice to develop a comprehensive clinical evaluation system of NSAIDs suitable for their institutions.

Narcotic drugs and class Ⅰ psychotropic substances have always been special management drugs in medical institutions. Although relevant policies and regulations have been introduced at the national level ，there are problems of poor policy understanding and inconsistent implementation in medical institutions in the process of policy implementation. In order to standardize the management of narcotic drugs and class Ⅰ psychotropic substances in medical institutions of Yunnan province ， based on the preliminary research and Delphi expert consultation ，this editing group finally formed the Expert Consensus on Key Links Quality Control Management of Narcotic Drugs and Class I Psychotropic Substances in Medical Institutions of Yunnan Province by focusing on the key aspects of quality control of key links for narcotic drugs and class Ⅰ psychotropic substances in medical institutions ，aiming to provide reference for the clinical use and management of narcotic drugs and class Ⅰ psychotropic substances in medical institutions of Yunnan province.

Substantial evidence has suggested that deep brain stimulation of the cuneiform nucleus has become a remarkable treatment option for intractable pain, but the possible mechanism is poorly understood. Using a melanocortin-4 receptor (MC4R)-green fluorescent protein (GFP) reporter knockin mouse, we showed that a large number of MC4R-GFP-positive neurons were expressed in the cuneiform nucleus. Immunofluorescence revealed that approximately 40%-50% of MC4R-GFP-positive neurons expressed mu opioid receptors, indicating that they were opioidergic signaling. Our findings support the hypothesis that MC4R expression in the cuneiform nucleus is involved in the modulation of opioidergic signaling.
Animals ; Gene Expression Regulation ; Gene Knock-In Techniques ; Genes, Reporter ; Green Fluorescent Proteins ; genetics ; metabolism ; Mice ; Mice, Transgenic ; Microtomy ; Midbrain Reticular Formation ; cytology ; metabolism ; Neurons ; cytology ; metabolism ; Receptor, Melanocortin, Type 4 ; genetics ; metabolism ; Receptors, Opioid, mu ; genetics ; metabolism ; Recombinant Fusion Proteins ; genetics ; metabolism ; Signal Transduction