This paper systematically summarizes the practical experience of the 2025 Dingri earthquake emergency medical rescue in Tibet. It analyzes the requirements for earthquake medical rescue under conditions of high-altitude hypoxia, low temperature, and low air pressure. The paper provides a detailed discussion on the strategic layout of earthquake medical rescue at the national level, local government level, and through social participation. It covers the construction of rescue organizational systems, technical systems, material support systems, and information systems. The importance of building rescue teams is emphasized. In high-altitude and cold conditions, rapid response, scientific decision-making, and multi-party collaboration are identified as key elements to enhance rescue efficiency. By optimizing rescue organizational structures, strengthening the development of new equipment, and promoting telemedicine technologies, the precision and effectiveness of medical rescue can be significantly improved, providing important references for future similar disaster rescues.

By employing the analytic hierarchy process(AHP), the CRITIC method(a weight determination method based on indicator correlations), and the AHP-CRITIC hybrid weighting method, the weight coefficients of evaluation indicators were determined, followed by a comprehensive score comparison. The grey correlation analysis was then performed to analyze the results calculated using the hybrid weighting method. Subsequently, a backpropagation-artificial neural network(BP-ANN) model was constructed to predict the extraction process parameters and optimize the extraction process for Shenxiong Huanglian Jiedu Granules(SHJG). In the extraction process, an L_9(3~4) orthogonal experiment was designed to optimize three factors at three levels, including extraction frequency, water addition amount, and extraction time. The evaluation indicators included geniposide, berberine, ginsenoside Rg_1 + Re, ginsenoside Rb_1, ferulic acid, and extract yield. Finally, the optimal extraction results obtained by the orthogonal experiment, grey correlation analysis, and BP-ANN method were compared, and validation experiments were conducted. The results showed that the optimal extraction process involved two rounds of aqueous extraction, each lasting one hour; the first extraction used ten times the amount of added water, while the second extraction used eight times the amount. In the validation experiments, the average content of each indicator component was higher than the average content obtained in the orthogonal experiment, with a higher comprehensive score. The optimized extraction process parameters were reliable and stable, making them suitable for subsequent preparation process research.
Drugs, Chinese Herbal/analysis* ; Neural Networks, Computer

BACKGROUND: Atrial fibrillation (AF) is a common cardiac arrhythmia in the elderly. This study aimed to evaluate urban-rural disparities in its prevalence and management in elderly Chinese. METHODS: Consecutive participants aged ≥ 65 years attending outpatient clinics were enrolled for AF screening using handheld single-lead electrocardiogram (ECG) from April 2017 to December 2022. Each ECG rhythm strip was reviewed from the research team. AF or uninterpretable single-lead ECGs were referred for 12-lead ECG. Primary study outcome comparison was between rural and urban areas for the prevalence of AF. The Student's t-test was used to compare mean values of clinical characteristics between rural and urban participants, while the Pearson's chi-square test was used to compare between-group proportions. Multivariate stepwise logistic regression analysis was performed to estimate the association between AF and various patient characteristics. RESULTS: The 29,166 study participants included 13,253 men (45.4%) and had a mean age of 72.2 years. The 7073 rural participants differed significantly (P ≤ 0.02) from the 22,093 urban participants in several major characteristics, such as older age, greater body mass index, and so on. The overall prevalence of AF was 4.6% (n = 1347). AF was more prevalent in 7073 rural participants than 22,093 urban participants (5.6% vs. 4.3%, P < 0.01), before and after adjustment for age, body mass index, blood pressure, pulse rate, cigarette smoking, alcohol consumption and prior medical history. Multivariate logistic regression analysis identified overweight/obesity (OR = 1.35, 95% CI: 1.17-1.54) in urban areas and cigarette smoking (OR = 1.62, 95% CI: 1.20-2.17) and alcohol consumption (OR = 1.42, 95% CI: 1.04-1.93) in rural areas as specific risk factors for prevalent AF. In patients with known AF in urban areas (n = 781) and rural areas (n = 338), 60.6% and 45.9%, respectively, received AF treatment (P < 0.01), and only 22.4% and 17.2%, respectively, received anticoagulation therapy (P = 0.05). CONCLUSIONS In China, there are urban-rural disparities in AF in the elderly, with a higher prevalence and worse management in rural areas than urban areas. Our study findings provide insight for health policymakers to consider urban-rural disparity in the prevention and treatment of AF.

Objective:To investigate the differential expression of Nuclear Factor Kappa B(NF-κB)and Tumor Necrosis Factor-Alpha(TNF-α)in endometrial polyp tissues,polyp-adjacent endometrium,and normal endometrium,and to analyze their correlation with local inflammatory responses,thereby elucidating the pathogenesis of endometrial polyps.Methods:Thirty-six patients with hysteroscopically confirmed endometrial polyps at Qingdao University Affiliated Hospital(September 2023-December 2024)were enrolled.Polyp tissues and adjacent endometrial tissues(0.5 cm-1 cm from polyps)were collected during surgery.Twenty-six patients undergoing hysterectomy for uterine fibroids,with pathologically confirmed normal endometrium,served as controls.The expression of NF-κB and TNF-α proteins was assessed using immunohistochemistry(IHC).Real-time quantitative PCR(RT-qPCR)was employed to detect the mRNA expression levels of NF-κB and TNF-α,and Western blot analysis was used to measure their protein expression.Differences among the three groups were compared.Results:Immunohistochemical analysis demonstrated:NF-κB p65 was predominantly localized to the cytoplasm and/or nucleus;TNF-α-positive expression was principally observed in the cytoplasmic compartment and/or cell membrane,manifesting as brown-yellow to brownish granules.The positive expression rate of NF-κB protein was significantly elevated in endometrial polyp tissues compared to both adjacent endometrial tissues and normal endometrial tissues(P＜0.05),whereas no statistically significant difference was observed between adjacent and normal endometrial tissues(P＞0.05).TNF-α protein expression exhibited a gradient pattern:Endometrial polyp tissues＞Adjacent endometrial tissues＞Normal endometrial tissues(with all inter-group comparisons demonstrating statistically significant differences,P＜0.05).Real-time quantitative PCR analysis revealed a significant gradient trend in the mRNA expression of NF-κB and TNF-α in endometrial polyp tissues:NF-κB mRNA:Polyp group(7.15±3.15)＞parapolyp group(4.38±2.01)＞normal group(1.03±0.30),with significant intergroup differences(all P＜0.05).TNF-α mRNA:Polyp tissue(17.66±9.25)＞parapolyp tissue(9.35±5.75)＞normal endometrium(1.16±0.58),with statistically significant differences among all groups(all P＜0.05).Western blot quantification further confirmed this trend:NF-κB protein:Expression in the polyp group(0.87±0.11)was 2.23-fold higher than in the normal group(0.39±0.02)(P=0.0007),while the parapolyp group(0.59±0.07)showed a 51％increase compared to the normal group(P=0.0435).TNF-α protein:Expression in the polyp group(1.13±0.21)was elevated by 94.8％versus the parapolyp group(0.58±0.03,P=0.0036)and by 494.7％versus the normal group(0.19±0.03,P=0.0002).One-way ANOVA indicated significant intergroup differences(F=43.56,P＜0.05).Conclusion:The TNF-α-mediated NF-κB signaling pathway is abnormally activated in endometrial polyps,exhibiting its highest expression at the polyp site.This suggests that the localized chronic inflammatory microenvironment may promote polyp formation through persistent stimulation of the NF-κB pathway.Targeted regulation of this pathway offers a novel strategy for preventing polyp recurrence.

AIM To explore the clinical effects of Supplemented Buyang Huanwu Decoction on postoperative patients with lumbar vertebral fracture complicated with spinal cord injury due to Qi Deficiency and Blood Stasis Pattern.METHODS One hundred and twenty patients were randomly assigned into control group(60 cases)for 6-week intervention of conventional treatment,and observation group(60 cases)for 6-week intervention of both Supplemented Buyang Huanwu Decoction and conventional treatment.The changes in clinical effects,TCM syndrome scores,spinal cord conduction signals(SEP amplitude,MEP amplitude),serum neurotrophic factors(NGF,IGF-1,BDNF),coagulation and inflammatory indices(PT,APTT,TNF-α,IL-1 β)and incidence of adverse reactions were detected.RESULTS The observation group demonstrated higher total effective rate than the control group(P＜0.05).After the treatment,the two groups displayed decreased TCM syndrome scores,TNF-α,IL-1β(P＜0.05),increased spinal cord conduction signals,coagulation and inflammatory indices(P＜0.05),and shortened PT,APTT(P＜0.05),especially for the observation group(P＜0.05).No significant difference in incidence of adverse reactions was found between the two groups(P＞0.05).CONCLUSION For the patients with lumbar vertebral fracture complicated with spinal cord injury due to Qi Deficiency and Blood Stasis Pattern,Supplemented Buyang Huanwu Decoction can safely and effectively promote neurological function recovery.

Objective:To investigate the differential expression of Nuclear Factor Kappa B(NF-κB)and Tumor Necrosis Factor-Alpha(TNF-α)in endometrial polyp tissues,polyp-adjacent endometrium,and normal endometrium,and to analyze their correlation with local inflammatory responses,thereby elucidating the pathogenesis of endometrial polyps.Methods:Thirty-six patients with hysteroscopically confirmed endometrial polyps at Qingdao University Affiliated Hospital(September 2023-December 2024)were enrolled.Polyp tissues and adjacent endometrial tissues(0.5 cm-1 cm from polyps)were collected during surgery.Twenty-six patients undergoing hysterectomy for uterine fibroids,with pathologically confirmed normal endometrium,served as controls.The expression of NF-κB and TNF-α proteins was assessed using immunohistochemistry(IHC).Real-time quantitative PCR(RT-qPCR)was employed to detect the mRNA expression levels of NF-κB and TNF-α,and Western blot analysis was used to measure their protein expression.Differences among the three groups were compared.Results:Immunohistochemical analysis demonstrated:NF-κB p65 was predominantly localized to the cytoplasm and/or nucleus;TNF-α-positive expression was principally observed in the cytoplasmic compartment and/or cell membrane,manifesting as brown-yellow to brownish granules.The positive expression rate of NF-κB protein was significantly elevated in endometrial polyp tissues compared to both adjacent endometrial tissues and normal endometrial tissues(P＜0.05),whereas no statistically significant difference was observed between adjacent and normal endometrial tissues(P＞0.05).TNF-α protein expression exhibited a gradient pattern:Endometrial polyp tissues＞Adjacent endometrial tissues＞Normal endometrial tissues(with all inter-group comparisons demonstrating statistically significant differences,P＜0.05).Real-time quantitative PCR analysis revealed a significant gradient trend in the mRNA expression of NF-κB and TNF-α in endometrial polyp tissues:NF-κB mRNA:Polyp group(7.15±3.15)＞parapolyp group(4.38±2.01)＞normal group(1.03±0.30),with significant intergroup differences(all P＜0.05).TNF-α mRNA:Polyp tissue(17.66±9.25)＞parapolyp tissue(9.35±5.75)＞normal endometrium(1.16±0.58),with statistically significant differences among all groups(all P＜0.05).Western blot quantification further confirmed this trend:NF-κB protein:Expression in the polyp group(0.87±0.11)was 2.23-fold higher than in the normal group(0.39±0.02)(P=0.0007),while the parapolyp group(0.59±0.07)showed a 51％increase compared to the normal group(P=0.0435).TNF-α protein:Expression in the polyp group(1.13±0.21)was elevated by 94.8％versus the parapolyp group(0.58±0.03,P=0.0036)and by 494.7％versus the normal group(0.19±0.03,P=0.0002).One-way ANOVA indicated significant intergroup differences(F=43.56,P＜0.05).Conclusion:The TNF-α-mediated NF-κB signaling pathway is abnormally activated in endometrial polyps,exhibiting its highest expression at the polyp site.This suggests that the localized chronic inflammatory microenvironment may promote polyp formation through persistent stimulation of the NF-κB pathway.Targeted regulation of this pathway offers a novel strategy for preventing polyp recurrence.

AIM To explore the clinical effects of Supplemented Buyang Huanwu Decoction on postoperative patients with lumbar vertebral fracture complicated with spinal cord injury due to Qi Deficiency and Blood Stasis Pattern.METHODS One hundred and twenty patients were randomly assigned into control group(60 cases)for 6-week intervention of conventional treatment,and observation group(60 cases)for 6-week intervention of both Supplemented Buyang Huanwu Decoction and conventional treatment.The changes in clinical effects,TCM syndrome scores,spinal cord conduction signals(SEP amplitude,MEP amplitude),serum neurotrophic factors(NGF,IGF-1,BDNF),coagulation and inflammatory indices(PT,APTT,TNF-α,IL-1 β)and incidence of adverse reactions were detected.RESULTS The observation group demonstrated higher total effective rate than the control group(P＜0.05).After the treatment,the two groups displayed decreased TCM syndrome scores,TNF-α,IL-1β(P＜0.05),increased spinal cord conduction signals,coagulation and inflammatory indices(P＜0.05),and shortened PT,APTT(P＜0.05),especially for the observation group(P＜0.05).No significant difference in incidence of adverse reactions was found between the two groups(P＞0.05).CONCLUSION For the patients with lumbar vertebral fracture complicated with spinal cord injury due to Qi Deficiency and Blood Stasis Pattern,Supplemented Buyang Huanwu Decoction can safely and effectively promote neurological function recovery.

Objective:To investigate the clinical efficacy and safety of venetoclax(VEN)in combination with hypomethylating agent(HMA)in the treatment of patients with high-risk myelodysplastic syndromes(MDS).Methods:A total of 30 patients with high-risk MDS who received the combination of VEN and HMA from March 2019 to November 2022 were included.The overall response rate(ORR),modified overall response rate(mORR),overall survival(OS),progression-free survival(PFS),and adverse events of all included patients were evaluated.Results:Among the 30 high-risk MDS patients treated with VEN combined with HMA regimen,24 cases achieved complete response(CR)/marrow complete response(mCR),2 cases achieved partial response(PR),the ORR was 24/30,the median OS was 28.1 months,and the median PFS was 28.1 months.In addition,patients who achieved complete remission/marrow complete remission after treatment had a significantly longer OS than those who did not.Moreover,12 patients were treated with allogeneic hematopoietic stem cell transplantation(allo-HSCT).There were grade 3 or higher hematologic adverse events including thrombocytopenia(14 cases),neutropenia(14 cases),febrile neutropenia(10 cases)and anemia(7 cases)as well as gastrointestinal adverse events of any grade,such as vomiting(7 cases),diarrhea(5 cases),and constipation(4 cases).Conclusion:VEN in combination with HMA is an effective and safe treatment option in patients with high-risk MDS.This regimen combined with allo-HSCT can improve the prognosis of these patients.Continuous attention to the monitoring and management of adverse events is essential for the patients'safety in this combination therapy.

Objective To summarize the epidemiological and clinical features of infectious diseases of the central nervous system(CNS)by a single-center analysis.Methods A retrospective analysis was conducted on the data of 1247 cases of CNS infectious diseases diagnosed and treated in the First Medical Center of PLA General Hospital from 2001 to 2020.Results The data for this group of CNS infectious diseases by disease type in descending order of number of cases were viruses 743(59.6％),Mycobacterium tuberculosis 249(20.0％),other bacteria 150(12.0％),fungi 68(5.5％),parasites 18(1.4％),Treponema pallidum 18(1.4％)and rickettsia 1(0.1％).The number of cases increased by 177 cases(33.1％)in the latter 10 years compared to the previous 10 years(P<0.05).No significant difference in seasonal distribution pattern of data between disease types(P>0.05).Male to female ratio is 1.87︰1,mostly under 60 years of age.Viruses are more likely to infect students,most often at university/college level and above,farmers are overrepresented among bacteria and Mycobacterium tuberculosis,and more infections of Treponema pallidum in workers.CNS infectious diseases are characterized by fever,headache and signs of meningeal irritation,with the adductor nerve being the more commonly involved cranial nerve.Matagenomic next-generation sequencing improves clinical diagnostic capabilities.The median hospital days for CNS infectious diseases are 18.00(11.00,27.00)and median hospital costs are ￥29,500(￥16,000,￥59,200).The mortality rate from CNS infectious diseases is 1.6％.Conclusions The incidence of CNS infectious diseases is increasing last ten years,with complex clinical presentation,severe symptoms and poor prognosis.Early and accurate diagnosis and standardized clinical treatment can significantly reduce the morbidity and mortality rate and ease the burden of disease.

Bacterial biofilms gave rise to persistent infections and multi-organ failure, thereby posing a serious threat to human health. Biofilms were formed by cross-linking of hydrophobic extracellular polymeric substances (EPS), such as proteins, polysaccharides, and eDNA, which were synthesized by bacteria themselves after adhesion and colonization on biological surfaces. They had the characteristics of dense structure, high adhesiveness and low drug permeability, and had been found in many human organs or tissues, such as the brain, heart, liver, spleen, lungs, kidneys, gastrointestinal tract, and skeleton. By releasing pro-inflammatory bacterial metabolites including endotoxins, exotoxins and interleukin, biofilms stimulated the body’s immune system to secrete inflammatory factors. These factors triggered local inflammation and chronic infections. Those were the key reason for the failure of traditional clinical drug therapy for infectious diseases.In order to cope with the increasingly severe drug-resistant infections, it was urgent to develop new therapeutic strategies for bacterial-biofilm eradication and anti-bacterial infections. Based on the nanoscale structure and biocompatible activity, nanobiomaterials had the advantages of specific targeting, intelligent delivery, high drug loading and low toxicity, which could realize efficient intervention and precise treatment of drug-resistant bacterial biofilms. This paper highlighted multiple strategies of biofilms eradication based on nanobiomaterials. For example, nanobiomaterials combined with EPS degrading enzymes could be used for targeted hydrolysis of bacterial biofilms, and effectively increased the drug enrichment within biofilms. By loading quorum sensing inhibitors, nanotechnology was also an effective strategy for eradicating bacterial biofilms and recovering the infectious symptoms. Nanobiomaterials could intervene the bacterial metabolism and break the bacterial survival homeostasis by blocking the uptake of nutrients. Moreover, energy-driven micro-nano robotics had shown excellent performance in active delivery and biofilm eradication. Micro-nano robots could penetrate physiological barriers by exogenous or endogenous driving modes such as by biological or chemical methods, ultrasound, and magnetic field, and deliver drugs to the infection sites accurately. Achieving this using conventional drugs was difficult. Overall, the paper described the biological properties and drug-resistant molecular mechanisms of bacterial biofilms, and highlighted therapeutic strategies from different perspectives by nanobiomaterials, such as dispersing bacterial mature biofilms, blocking quorum sensing, inhibiting bacterial metabolism, and energy driving penetration. In addition, we presented the key challenges still faced by nanobiomaterials in combating bacterial biofilm infections. Firstly, the dense structure of EPS caused biofilms spatial heterogeneity and metabolic heterogeneity, which created exacting requirements for the design, construction and preparation process of nanobiomaterials. Secondly, biofilm disruption carried the risk of spread and infection the pathogenic bacteria, which might lead to other infections. Finally, we emphasized the role of nanobiomaterials in the development trends and translational prospects in biofilm treatment.