Radiopharmaceuticals operate by combining radionuclides with carriers. The radiation energy emitted by radionuclides is utilized to selectively irradiate diseased tissues while minimizing damage to healthy tissues. In comparison to external beam radiation therapy, radionuclide drugs demonstrate research potential due to their biological targeting capabilities and reduced normal tissue toxicity. This article reviews the applications and research progress of radiopharmaceuticals in cancer treatment. Several key radionuclides are examined, including ²²³Ra, ⁹⁰Y, Lutetium-177 (¹⁷⁷Lu), ²¹²Pb, and Actinium-225 (²²⁵Ac). It also explores the current development trends of radiopharmaceuticals, encompassing the introduction of novel radionuclides, advancements in imaging technologies, integrated diagnosis and treatment approaches, and equipment-medication combinations. We review the progress in the development of new treatments, such as neutron capture therapy, proton therapy, and heavy ion therapy. Furthermore, we examine the challenges and breakthroughs associated with the clinical translation of radiopharmaceuticals and provide recommendations for the research and development of novel radionuclide drugs.
Humans ; Radiopharmaceuticals/therapeutic use* ; Neoplasms/radiotherapy* ; Radioisotopes/therapeutic use* ; Animals

Digital biopsy for liver diseases is characterized by the deep integration of artificial intelligence （AI） technologies and large-scale liver disease data， through which intelligent analytics are applied to support clinical decision-making and full-cycle management. This article reviews the AI technical framework based on standardized data governance and centered on multimodal large medical models， covering the application of natural language processing， knowledge map， generative AI， and large language models in the establishment of databases for specialty diseases， diagnosis， prognosis prediction， treatment， and automated medical documentation. This article also discusses the application prospects of this framework in medical education， scientific research， and healthcare management. Although this technique shows broad application potential， it still faces challenges in areas such as multi-center data integration， model interpretability， ethics， and data security. In the future， a smart ecosystem with closed-loop optimization and human-AI collaboration should be established to promote the comprehensive implementation of digital biopsy in the whole process of medicine， education， research， and management， thereby providing help for the precise prevention and control and holistic health management of liver diseases.

To explore the biological characteristics related to the pathogenesis and severity of respiratory syncytial virus (RSV) bronchiolitis by RNA sequencing of white blood cells in children with RSV bronchiolitis. This study is a case-control study. A total of 87 children diagnosed with bronchiolitis and RSV antigen positive and/or RSV nucleic acid positive in the pediatric respiratory department of the Second Affiliated Hospital of Wenzhou Medical University from October 2019 to April 2022 were selected as the case group. The case group was divided into three groups based on the condition: mild, moderate, and severe, and there were two groups according to the presence or absence of atopic symptoms: the atopic group and the non -atopic group, forty healthy children in the same period were selected as the control group. The whole blood leukocyte RNA of the children in the case group and the control group was extracted for RNA sequencing, and the data were analyzed to obtain differentially expressed genes (DEGs). Then, the immunobiological pathways and genes related to the pathogenesis, disease condition, and atopy were screened through Gene Ontology (GO) annotation, Kyoto Gene and Genome Encyclopedia (KEGG) annotation, and protein interaction network (PPI) construction methods. Construct the weighted gene co-expression network analysis (WGCNA) module to identify potential biological indicators related to disease severity.Compared with the control group, the case group had a total of 1 782 DEGs, including 1 586 upregulated genes and 196 downregulated genes. The GO pathway enrichment of DEGs is mainly enriched in molecular functions such as peroxidase activity and oxidoreductase activity. In the cytological components, it is mainly enriched in cytoplasmic vesicle lumen and secretory granule lumen. In biological processes, it is mainly enriched in processes such as neutrophil activation involved in immune responses, neutrophil degranulation, and neutrophil activation. KEGG analysis is mainly concentrated in the signal pathway of the viral protein interaction with cytokine and cytokine receptor. A PPI network was constructed to screen four genes at the core position, including CCL2, IL-10, MMP9 and JUN. The DEGs obtained by comparing different disease groups with the control group are mainly enriched in retrograde endocannabinoid signaling and cell apoptosis pathways. WGCNA analysis showed that the brown module related to oxygen saturation was most closely related to the disease, and its gene was mainly enriched in the RNA helicase retinoic acid inducible gene-I (RIG-I) like receptor signal pathway. There are 230 specific DEGs in the atopic group and 444 in the non -atopic group. KEGG enrichment analysis results show that both groups are enriched to NF-κB signaling pathway, the characteristic does not cause significant changes in immune response and transcriptome characteristics in children with RSV bronchiolitis. In conclusion, neutrophil activation, degranulation pathway and signal pathway of interaction between viral protein and cytokine and cytokine receptor are involved in the immune response of RSV bronchiolitis host. CCL2, IL-10, MMP9 and JUN genes may be associated with the pathogenesis. They might be potential biomarkers related to disease severity in RIG-I like receptors, cell apoptosis, and endogenous cannabinoid related signaling pathways.

Drug literacy is one of the important components of health literacy,and in recent years,the research on drug literacy has gradually deepened.The polypharmacy treatment and irrational drug use in the patients with HIV/AIDS has increased the burden of drug use,therefore improving the level of drug literacy is the key to maintain the medication efficacy,drug self-administered and safe medication.This paper summa-rized the definition,current status of assessment tools,influencing factors and interventional measures of drug literacy of HIV/AIDS patients in domestic and foreign research in order to provide reference for the develop-ment of assessment tools for drug literacy of HIV/AIDS patients,improve the level of drug literacy of pa-tients,and promote safe and rational use of drugs.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To evaluate the efficacy and safety of hybutimibe in the treatment of hypercholesterolemia.Methods:Relevant databases and clinical trial registration websites at home and abroad were searched (up to March 27, 2023), and randomized controlled trials (RCTs) of hybutimibe in the treatment of hypercholesterolemia have been collected. Patients in the trial group were given hybutimibe with or without other hypolipidemic agents, and those in the control group were given placebo or other hypolipidemic agents as same as that in the trial group. The primary outcome in effectiveness was the change rate of low-density lipoprotein cholesterol (LDL-C). The primary outcomes in safety were incidences of overall adverse events (AEs), serious AEs (SAEs), the trial termination due to AEs, and trial drug-related AEs. The secondary outcome in safety was incidence of the major AE reported in ≥ 2 trials. Meta-analysis was performed using RevMan 5.4 software. The effect sizes of counting data were expressed by the relative risk ( RR) and its 95% confidence interval ( CI). The effect sizes of measurement data were expressed by mean difference ( MD) and its 95% CI. Results:A total of 4 RCTs and 1 488 patients were entered in the analysis, including 952 patients in the trial group and 536 in the control group. The results of meta-analysis showed that at 8-12 weeks of treatment, the decrease rate of LDL-C in the trial group (hybutimibe 20 or 10 mg daily with or without atorvastatin 10 mg daily) was significantly greater than that in the control group (hybutimibe 20 mg daily: MD=-13.36%, 95% CI: -15.28% - -11.44%, P<0.001; hybutimibe 10 mg daily: MD=-10.80%, 95% CI: -14.90%- -6.71%, P<0.001); at 52 weeks of treatment, the average decrease rate (from baseline) of LDL-C in the trial group (hybutimibe 20 or 10 mg combined with atorvastatin 10 mg daily) was significantly greater than that in the control group with atorvastatin 10 mg daily monotherapy (-41.92% and -39.34% vs. -31.56%, all P<0.001); the incidences of overall AEs [47.94% (338/705) vs. 49.75% (202/406), RR=0.99, 95% CI: 0.87-1.12], SAEs[2.64% (16/606) vs. 2.79% (10/358), RR=1.19, 95% CI: 0.53-2.66], trial termination due to AEs[4.11% (29/705) vs. 4.68% (19/406), RR=0.67, 95% CI: 0.17-2.65], and trial drug-related AEs [12.38% (75/606) vs. 11.45% (41/358), RR=0.87, 95% CI: 0.37-2.06] were similar between the 2 groups at 8-12 weeks of treatment (all P>0.05). Conclusion:Hybutimibe could effectively reduce LDL-C level in patients with hypercholesterolemia, with good medication safety.

Along with the reforms of the assessment and approval regime for new drugs in China in recent years, independently researched and developed innovative drugs and conditionally approved drugs in China have been more and more. The pre-market clinical trials, assessment and approval system (especially the conditional approval system), and post-market monitoring and management of new drugs in China are still in a continuous improvement stage. Thus we need to specially pay attention to the safety of innovative drugs that independently developed in China and do a good job in post-marketing safety supervision. More evidence-based information for safe use of this type of medication in patients can be provided through the following aspects: strengthening the drug safety monitoring, conducting systematic evaluation of literature data, widely collecting drug safety data through high-quality real-world research, and conducting in-depth mining of information from drug safety reports.

Objective:To evaluate the efficacy and safety of hybutimibe in the treatment of hypercholesterolemia.Methods:Relevant databases and clinical trial registration websites at home and abroad were searched (up to March 27, 2023), and randomized controlled trials (RCTs) of hybutimibe in the treatment of hypercholesterolemia have been collected. Patients in the trial group were given hybutimibe with or without other hypolipidemic agents, and those in the control group were given placebo or other hypolipidemic agents as same as that in the trial group. The primary outcome in effectiveness was the change rate of low-density lipoprotein cholesterol (LDL-C). The primary outcomes in safety were incidences of overall adverse events (AEs), serious AEs (SAEs), the trial termination due to AEs, and trial drug-related AEs. The secondary outcome in safety was incidence of the major AE reported in ≥ 2 trials. Meta-analysis was performed using RevMan 5.4 software. The effect sizes of counting data were expressed by the relative risk ( RR) and its 95% confidence interval ( CI). The effect sizes of measurement data were expressed by mean difference ( MD) and its 95% CI. Results:A total of 4 RCTs and 1 488 patients were entered in the analysis, including 952 patients in the trial group and 536 in the control group. The results of meta-analysis showed that at 8-12 weeks of treatment, the decrease rate of LDL-C in the trial group (hybutimibe 20 or 10 mg daily with or without atorvastatin 10 mg daily) was significantly greater than that in the control group (hybutimibe 20 mg daily: MD=-13.36%, 95% CI: -15.28% - -11.44%, P<0.001; hybutimibe 10 mg daily: MD=-10.80%, 95% CI: -14.90%- -6.71%, P<0.001); at 52 weeks of treatment, the average decrease rate (from baseline) of LDL-C in the trial group (hybutimibe 20 or 10 mg combined with atorvastatin 10 mg daily) was significantly greater than that in the control group with atorvastatin 10 mg daily monotherapy (-41.92% and -39.34% vs. -31.56%, all P<0.001); the incidences of overall AEs [47.94% (338/705) vs. 49.75% (202/406), RR=0.99, 95% CI: 0.87-1.12], SAEs[2.64% (16/606) vs. 2.79% (10/358), RR=1.19, 95% CI: 0.53-2.66], trial termination due to AEs[4.11% (29/705) vs. 4.68% (19/406), RR=0.67, 95% CI: 0.17-2.65], and trial drug-related AEs [12.38% (75/606) vs. 11.45% (41/358), RR=0.87, 95% CI: 0.37-2.06] were similar between the 2 groups at 8-12 weeks of treatment (all P>0.05). Conclusion:Hybutimibe could effectively reduce LDL-C level in patients with hypercholesterolemia, with good medication safety.

Along with the reforms of the assessment and approval regime for new drugs in China in recent years, independently researched and developed innovative drugs and conditionally approved drugs in China have been more and more. The pre-market clinical trials, assessment and approval system (especially the conditional approval system), and post-market monitoring and management of new drugs in China are still in a continuous improvement stage. Thus we need to specially pay attention to the safety of innovative drugs that independently developed in China and do a good job in post-marketing safety supervision. More evidence-based information for safe use of this type of medication in patients can be provided through the following aspects: strengthening the drug safety monitoring, conducting systematic evaluation of literature data, widely collecting drug safety data through high-quality real-world research, and conducting in-depth mining of information from drug safety reports.

Objective:To explore the clinical effect of a self-designed wound measurement grid on the design of lobulated perforator flap.Methods:From January 2019 to December 2022, soft tissue defects in limbs of 9 patients were reconstructed by lobulated perforator flaps in the Department of Orthopaedics and Traumatology of Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine. The patients were 7 males and 2 females aged 21-55 years old with 40.3 years old in average. There were 6 upper limb defects and 3 lower limb defects. Self-designed wound measuring grids were applied to guide the design and excision of lobulated perforator flaps during surgery. Five patients were treated by lobulated perforator flap pedicled with the descending branch of lateral circumflex femoral artery and 4 by perforator flaps pedicled with dorsal interosseous artery. The areas of soft tissue defect were 4.0 cm×1.5 cm-26.0 cm×8.0 cm, and the sizes of the flaps were 4.5 cm×1.8 cm-22.0 cm×10.0 cm. After surgery, the blood supply of flaps, flap survival and wound healing were monitored. Flap survival, donor site recovery and limb function were observed at outpatient clinic over the postoperative follow-up, and the limb function was evaluated by the Evaluation Standard of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association and Lower Extremity Measure(LEM).Results:In this study, a total of 17 of 18 lobes of the lobulated perforator flaps survived after surgery. One flap had venous occlusion and after exploration and further treatment, a necrosis occurred in 1 lobe of the lobulated flap and then a free flap transfer was performed again. All the wounds achieved stage-I healing. Postoperative follow-up lasted for 3-18 months with 8.6 months in average. All flaps had good colour and texture, satisfactory appearance and only linear scars remained in the donor sites, without pain and scar contracture. The reconstructed upper extremity defect were evaluated according to the Evaluation Standard of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, with 4 patients were in excellent and 2 in good. The reconstructed lower extremity defects were evaluated according to the LEM, and 2 patients were in excellent and 1 in good.Conclusion:The self-designed wound measurement grid was successfully applied in the design of lobed perforator flaps. It can accurately measure a wound surface and quickly extract a wound profile, and it is more convenient and intuitive to guide the design of flaps. It has a good effect in clinical application and further clinical trials are required.