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.

High-performance liquid chromatography(HPLC) was used to determine the content of three major components in Citri Reticulatae Semen(CRS), including limonin, nomilin, and obacunone. The chromaticity of the CRS sample during salt processing and stir-frying was measured using a color difference meter. Next, the relationship between the color and content of the salt-processed CRS sample was investigated through correlation analysis. By integrating the oil bath technique for processing simulation with HPLC, the changes in the relative content of nomilin and its transformation products were analyzed, with its structural transformation pattern during processing identified. Additionally, RAW264.7 cells were induced with lipopolysaccharides(LPSs) to establish an inflammatory model, and the anti-inflammatory activity of nomilin and its transformation product, namely obacunone was evaluated. The results indicated that as processing progressed, E~*ab and L~* values showed a downward trend; a~* values exhibited a slow increase over a certain period, followed by no significant changes, and b~* values remained stable with no significant changes over a certain period and then started to decrease. The limonin content remained barely unchanged; the nomilin content decreased, and the obacunone increased significantly. The changing trends in content and color parameters during salt-processing and stir-frying were basically consistent. The content of nomilin and obacunone was significantly correlated with the colorimetric values(L~*, a~*, b~*, and E~*ab), while limonin content showed no significant correlation with these values. By analyzing HPLC patterns of nomylin at different heating temperatures and time, it was found that under conditions of 200-250 ℃ for heating of 5-60 min, the content of nomilin significantly decreased, while the obacunone content increased pronouncedly. The in vitro anti-inflammatory activity results indicated that compared to the model group, the group with a high concentration of nomilin and the groups with varying concentrations of obacunone showed significantly reduced release of nitric oxide(NO)(P<0.01). When both were at the same concentration, obacunone showed better performance in inhibiting NO release. In this study, the obvious correlation between the color and content of major components during the processing of CRS samples was identified, and the dynamic patterns of quality change in CRS samples during processing were revealed. Additionally, the study revealed and confirmed the transformation of nomilin into obacunone during processing, with the in vitro anti-inflammatory activity of obacunone significantly greater than that of nomilin. These findings provided a scientific basis for CRS processing optimization, tablet quality control, and its clinical application.
Mice ; Animals ; Drugs, Chinese Herbal/pharmacology* ; RAW 264.7 Cells ; Limonins/chemistry* ; Chromatography, High Pressure Liquid ; Citrus/chemistry* ; Color ; Benzoxepins/chemistry* ; Anti-Inflammatory Agents/chemistry*

OBJECTIVE: To evaluate the efficacy and safety of Shexiang Tongxin Dropping Pill (STDP) in treating stable angina patients with phlegm-heat and blood-stasis syndrome by exercise duration and metabolic equivalents. METHODS: This multicenter, randomized, double-blind, placebo-controlled clinical trial enrolled stable angina patients with phlegm-heat and blood-stasis syndrome from 22 hospitals. They were randomized 1:1 to STDP (35 mg/pill, 6 pills per day) or placebo for 56 days. The primary outcome was the exercise duration and metabolic equivalents (METs) assessed by the standard Bruce exercise treadmill test after 56 days of treatment. The secondary outcomes included the total angina symptom score, Chinese medicine (CM) symptom scores, Seattle Angina Questionnaire (SAQ) scores, changes in ST-T on electrocardiogram and adverse events (AEs). RESULTS: This trial enrolled 309 patients, including 155 and 154 in the STDP and placebo groups, respectively. STDP significantly prolonged exercise duration with an increase of 51.0 s, compared to a decrease of 12.0 s with placebo (change rate: -11.1% vs. 3.2%, P<0.01). The increase in METs was significantly greater in the STDP group than in the placebo group (change: -0.4 vs. 0.0, change rate: -5.0% vs. 0.0%, P<0.01). The improvement of total angina symptom scores (25.0% vs. 0.0%), CM symptom scores (38.7% vs. 11.8%), reduction of nitroglycerin consumption (100.0% vs. 11.3%), and all domains of SAQ, were significantly greater with STDP than placebo (all P<0.01). The changes in Q-T intervals at 28 and 56 days from baseline were similar between the two groups (both P>0.05). Twenty-five participants (16.3%) with STDP and 16 (10.5%) with placebo experienced AEs (P=0.131), with no serious AEs observed. CONCLUSION STDP could improve exercise tolerance in patients with stable angina and phlegm-heat and blood stasis syndrome, with a favorable safety profile. (Registration No. ChiCTR-IPR-15006020).
Humans ; Double-Blind Method ; Drugs, Chinese Herbal/adverse effects* ; Male ; Female ; Middle Aged ; Angina, Stable/physiopathology* ; Aged ; Syndrome ; Treatment Outcome ; Placebos ; Tablets

AIM To study the chemical constituents from ethyl acetate fraction of Balanophora harlandii Hook.f.and their tyrosinase inhibitory activity.METHODS Separation and purification were performed using silica gel,MCI,ODS,Sephadex LH-20 and semi-preparative HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.The monophenolase inhibitory activity was determined by the tyrosinase-catalyzed oxidation of L-tyrosine.RESULTS Twenty-four compounds were isolated and identified as sesamin(1),methyl caffeate(2),quercetin(3),5,7-dihydroxychromanone(4),methyl 3,4-dihydroxybenzoate(5),esculetin(6),kaempferol(7),naringenin(8),pyrogallic acid(9),pinosylvin(10),methyl propionate(11),caffeic acid(12),saccharinol(13),ferulic acid(14),trans-p-hydroxycinnamic acid(15),cinnamic acid(16),vanillic acid(17),vanillin(18),4-hydroxyacetophenone(19),4-hydroxybenzaldehyde(20),apigenin(21),(-)-isolariciresinol(22),(-)-secoisolariciresinol(23)and meso-2,3-di(3′,4′-methylenedioxybenzyl)butane-1,4-diol(24).The IC50 values of compounds 3,5,7,8,19,and 20 ranged from(0.246 5±0.028 3)to(1.278 2±0.021 3)mmol/L.CONCLUSION Compounds 1-9、11、15、17-21、24 are isolated from this plant for the first time,and 1,6,9,17-19,24 are first isolated from genus Balanophora.Compounds 3、5、7、8、19 and 20 have tyrosinase inhibitory activity.

Objective To observe the clinical efficacy and safety of recombinant human growth hormone injection(rhGH)in the treatment of children with idiopathic short stature(ISS)and its influence on levels of insulin-like growth factor 1(IGF-1),alkaline phosphatase(AKP)and insulin-like growth factor binding protein 3(IGFBP-3).Methods Children with ISS were randomized into control group and treatment group.The control group was subcutaneously injected with 0.15 U·kg-1 of rhGH injection,while the treatment group was given subcutaneous injection of 0.20 U·kg-1 of rhGH injection,and both groups were continuously treated for 6 months.The clinical efficacy,growth status[growth velocity,height standard deviation score(HtSDS),predicted adult height(PAH)],bone metabolism indicators { AKP,osteocalcin(OC),25-hydroxyvitamin D[25(OH)D]} and serum IGF-1 and IGFBP3 levels were compared,and the safety was assessed.Results In the treatment group,46 cases were enrolled,6 cases were lost,and 40 cases were finally included in the statistical analysis.In the control group,46 cases were enrolled,1 case was lost,and 45 cases were finally included in the statistical analysis.The total effective rates in treatment group and control group after 6 months treatment were 85.00％(34 cases/40 cases)and 64.44％(29 cases/45 cases),respectively,with a statistical significance(P＜0.05).After 6 months treatment,the growth rates in treatment group and control group were(7.96±1.62)and(6.84±1.56)cm·year-1;HtSDS values were-2.38±0.24 and-2.61±0.28;PAH values were(156.86±4.18)and(155.02±4.25)cm;serum AKP levels were(278.42±47.46)and(257.14±42.79)U·L-1;OC levels were(76.92±10.17)and(72.43±10.32)μg·L-1;25(OH)D levels were(59.96±4.74)and(55.52±4.69)nmol·L-1;serum IGF-1 levels were(296.77±28.32)and(251.47±24.96)ng·mL-1;serum IGFBP3 levels were(5.76±1.22)and(4.86±0.89)μg·mL-1,respectively.Compared with the control group,the above indexes in the treatment group were statistically significant(all P＜0.05).The adverse drug reactions in treatment and control group were mainly headache,rash and joint pain,rash and joint pain.The incidence rates of adverse reactions in treatment group and control group were 12.50％(5 cases/40 cases)and 6.67％(3 cases/45 cases),without significant difference(P＞0.05).Conclusion The clinical efficacy of rhGH injection in the treatment of children with ISS is definite;and the improvement of IGF-1,AKP and IGFBP3 levels by 0.20 U·kg-1 rhGH is significantly better than that by 0.15 U·kg-1 rhGH,which is more conducive to promoting bone development and accelerating growth without increasing the incidence of adverse drug reactions.

AIM To study the chemical constituents from ethyl acetate fraction of Balanophora harlandii Hook.f.and their tyrosinase inhibitory activity.METHODS Separation and purification were performed using silica gel,MCI,ODS,Sephadex LH-20 and semi-preparative HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.The monophenolase inhibitory activity was determined by the tyrosinase-catalyzed oxidation of L-tyrosine.RESULTS Twenty-four compounds were isolated and identified as sesamin(1),methyl caffeate(2),quercetin(3),5,7-dihydroxychromanone(4),methyl 3,4-dihydroxybenzoate(5),esculetin(6),kaempferol(7),naringenin(8),pyrogallic acid(9),pinosylvin(10),methyl propionate(11),caffeic acid(12),saccharinol(13),ferulic acid(14),trans-p-hydroxycinnamic acid(15),cinnamic acid(16),vanillic acid(17),vanillin(18),4-hydroxyacetophenone(19),4-hydroxybenzaldehyde(20),apigenin(21),(-)-isolariciresinol(22),(-)-secoisolariciresinol(23)and meso-2,3-di(3′,4′-methylenedioxybenzyl)butane-1,4-diol(24).The IC50 values of compounds 3,5,7,8,19,and 20 ranged from(0.246 5±0.028 3)to(1.278 2±0.021 3)mmol/L.CONCLUSION Compounds 1-9、11、15、17-21、24 are isolated from this plant for the first time,and 1,6,9,17-19,24 are first isolated from genus Balanophora.Compounds 3、5、7、8、19 and 20 have tyrosinase inhibitory activity.

Objective To observe the clinical efficacy and safety of recombinant human growth hormone injection(rhGH)in the treatment of children with idiopathic short stature(ISS)and its influence on levels of insulin-like growth factor 1(IGF-1),alkaline phosphatase(AKP)and insulin-like growth factor binding protein 3(IGFBP-3).Methods Children with ISS were randomized into control group and treatment group.The control group was subcutaneously injected with 0.15 U·kg-1 of rhGH injection,while the treatment group was given subcutaneous injection of 0.20 U·kg-1 of rhGH injection,and both groups were continuously treated for 6 months.The clinical efficacy,growth status[growth velocity,height standard deviation score(HtSDS),predicted adult height(PAH)],bone metabolism indicators { AKP,osteocalcin(OC),25-hydroxyvitamin D[25(OH)D]} and serum IGF-1 and IGFBP3 levels were compared,and the safety was assessed.Results In the treatment group,46 cases were enrolled,6 cases were lost,and 40 cases were finally included in the statistical analysis.In the control group,46 cases were enrolled,1 case was lost,and 45 cases were finally included in the statistical analysis.The total effective rates in treatment group and control group after 6 months treatment were 85.00％(34 cases/40 cases)and 64.44％(29 cases/45 cases),respectively,with a statistical significance(P＜0.05).After 6 months treatment,the growth rates in treatment group and control group were(7.96±1.62)and(6.84±1.56)cm·year-1;HtSDS values were-2.38±0.24 and-2.61±0.28;PAH values were(156.86±4.18)and(155.02±4.25)cm;serum AKP levels were(278.42±47.46)and(257.14±42.79)U·L-1;OC levels were(76.92±10.17)and(72.43±10.32)μg·L-1;25(OH)D levels were(59.96±4.74)and(55.52±4.69)nmol·L-1;serum IGF-1 levels were(296.77±28.32)and(251.47±24.96)ng·mL-1;serum IGFBP3 levels were(5.76±1.22)and(4.86±0.89)μg·mL-1,respectively.Compared with the control group,the above indexes in the treatment group were statistically significant(all P＜0.05).The adverse drug reactions in treatment and control group were mainly headache,rash and joint pain,rash and joint pain.The incidence rates of adverse reactions in treatment group and control group were 12.50％(5 cases/40 cases)and 6.67％(3 cases/45 cases),without significant difference(P＞0.05).Conclusion The clinical efficacy of rhGH injection in the treatment of children with ISS is definite;and the improvement of IGF-1,AKP and IGFBP3 levels by 0.20 U·kg-1 rhGH is significantly better than that by 0.15 U·kg-1 rhGH,which is more conducive to promoting bone development and accelerating growth without increasing the incidence of adverse drug reactions.

Objective:To explore the effects of RNF113A on the proliferation,migration,in-vasion,apoptosis,and autophagy of hepatocellular carcinoma cells.Methods:Hep3B cells were divided into control group and RNF113A overexpression group(RNF113A-OE),HepG2 was divided into control group and RNF113A knockdown group(si-RNF113A),CCK-8 assay was used to detect changes in cell viability,clone formation assay was used to detect changes in cell proliferation abili-ty,Transwell assay was used to detect changes in cell invasion ability,wound healing assay was used to detect changes in cell migration ability,and flow cytometry was used to detect changes in cell apoptosis ability,Western blot experiments were used to detect changes in protein expression of autophagy related genes and AMPK signaling pathway related genes.Results:Compared with the control group,the proliferation,cloning,invasion,and migration abilities of Hep3B cells in the RNF113A-OE group were improved,while apoptosis and autophagy abilities were decreased,and the AMPK signaling pathway was inhibited;In the si-RNF113A group,the proliferation,cloning,in-vasion,and migration abilities of HepG2 cells were significantly reduced,while apoptosis and au-tophagy abilities were increased,and the activation of the AMPK signaling pathway was promoted.Conclusion:RNF113A promotes the proliferation,cloning,invasion,and migration of hepatocel-lular carcinoma cells,and inhibited apoptosis and autophagy by inhibiting the AMPK signaling path-way.

Objective: To investigate the risk factors for the development of deep infiltration in early colorectal tumors (ECT) and to construct a prediction model to predict the development of deep infiltration in patients with ECT. Methods: The clinicopathological data of ECT patients who underwent endoscopic treatment or surgical treatment at the Cancer Hospital, Chinese Academy of Medical Sciences from August 2010 to December 2020 were retrospectively analyzed. The independent risk factors were analyzed by multifactorial regression analysis, and the prediction models were constructed and validated by nomogram. Results: Among the 717 ECT patients, 590 patients were divided in the within superficial infiltration 1 (SM1) group (infiltration depth within SM1) and 127 patients in the exceeding SM1 group (infiltration depth more than SM1). There were no statistically significant differences in gender, age, and lesion location between the two groups (P>0.05). The statistically significant differences were observed in tumor morphological staging, preoperative endoscopic assessment performance, vascular tumor emboli and nerve infiltration, and degree of tumor differentiation (P<0.05). Multivariate regression analysis showed that only erosion or rupture (OR=4.028, 95% CI: 1.468, 11.050, P=0.007), localized depression (OR=3.105, 95% CI: 1.584, 6.088, P=0.001), infiltrative JNET staging (OR=5.622, 95% CI: 3.029, 10.434, P<0.001), and infiltrative Pit pattern (OR=2.722, 95% CI: 1.347, 5.702, P=0.006) were independent risk factors for the development of deep submucosal infiltration in ECT. Nomogram was constructed with the included independent risk factors, and the nomogram was well distinguished and calibrated in predicting the occurrence of deep submucosal infiltration in ECT, with a C-index and area under the curve of 0.920 (95% CI: 0.811, 0.929). Conclusion: The nomogram prediction model constructed based on only erosion or rupture, local depression, infiltrative JNET typing, and infiltrative Pit pattern has a good predictive efficacy in the occurrence of deep submucosal infiltration in ECT.
Humans ; Retrospective Studies ; Colorectal Neoplasms/pathology* ; Nomograms ; Neoplasm Staging ; Risk Factors

It has attracted much attention worldwide that the application of artificial intelligence (AI) in primary screening and clinical diagnosis and treatment of eye diseases. In recent years, this technology has also been widely used in various grass-roots eye disease management, effectively improving the current situation of weak eye disease diagnosis ability and shortage of human resources in primary medical institutions. At present, there is no reference standard or guideline for the management mode, implementation content and management method of vision health management based on this technology, which are in urgent need of standardization. The article described the work mode exploration of AI-assisted grass-roots visual health management in Shanghai and shared practical experience. The aim is to provide reference for other provinces in China to carry out relevant work.
Humans ; Artificial Intelligence ; China ; Reference Standards ; Workforce