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.

AIM To study the effects of Jiaotai Pills and their single composition drugs on high-fat diet-induced hypothalamic inflammation in obese mice.METHODS C57BL/6J mice were randomly divided into the normal group(15 mice)and the high-fat group(75 mice).The mice given 12 weeks of high-fat diet feeding were further randomly divided into the model group,the Jiaotai Pills group,the Coptis chinensis group,the Cinnamomum cassia group and the positive metformin group,with 15 mice in each group.After 6 weeks of administration,the mice had their body weight and fasting blood glucose(FBG)levels detected;their hypothalamic expressions of IL-1β,IL-6,TNF-α and Socs3 mRNA detected by RT-qPCR;their hypothalamic expressions of TLR4,MyD88,IKKβ and activated NF-κB protein detected by Western blot;their hypothalamic expressions of Iba1 and GFAP detected by immunohistochemistry;and their ultrastructural changes of nerve tissues observed using transmission electron microscopy(TEM).RESULTS Compared with the model group,each drug group displayed decreased hypothalamic expressions of IL-1β,IL-6,TNF-α and Socs3 mRNA(P＜0.01),and improved number and morphology of nerve cells revealed by TEM.The groups intervened with Jiaotai Pills,or Coptis chinensis,or metformin shared decreased body weight and FBG levels(P＜0.05);decreased protein expressions of TLR4,MyD88,IKKβ and p-NF-κB(P＜0.05);and decreased number of hypothalamic astrocytes and microglia(P＜0.05).Additionally,decreased p-NF-κB protein expression was observed in the Cinnamomum cassia group(P＜0.05).CONCLUSION Jiaotai Pills and their single composition drugs can improve high-fat diet-induced hypothalamic inflammation in obese mice.

Lung cancer poses a serious threat to global public health security.Chemotherapy,as the main strategy for cancer treatment,faces challenges such as high toxicity and drug resistance.Anticancer peptides have the potential of being developed into new anticancer drugs due to their advantages of broad-spectrum anticancer activity,rapid action,and difficulty in generating drug resistance,but they also face shortcomings such as weak activity and strong toxic side effects.The weakly acidic microenvironment of tumors(pH 6.5-6.8)provides a good idea for the design of anticancer peptides of high-efficiency and low-toxicity.Previously,we designed the acid-sensitive antibacterial peptide pHly-1 using the wolf spider(Lycosa singoriensis)toxin Lycosin-Ⅰ as a template.In this study,we found that pHly-1 also had acid-sensitive anticancer activity.Further alanine scanning analysis of pHly-1 was carried out,and we ob-tained a mutant pHTP-2 with better acid sensitivity,whose IC50(half maximal inhibitory concentration)against A549 cells was 15.68 μmol/L at pH 6.6 and was greater than 100 μmol/L at pH 7.4.At pH 6.6,pHTP-2 could act on various lung cancer cell lines and induce the death of A549 cells by rapid ly-sis;at pH 7.4,500 μmol/L pHTP-2 had weak toxicity to red blood cells(the hemolysis rate was ap-proximately 38％)and primary myocardial cells(the inhibition rate was 49.7％,with P＜0.05).Analy-sis of its charge,particle size,morphology,and secondary structure showed that at pH 6.6,the histidine in the sequence of pHTP-2 was protonated,increasing the positive charge(P＜0.01),decreasing the hy-drated particle size(P＜0.05)and forming an α-helical structure to induce membrane lysis of A549 cells.At pH 7.4,it was deprotonated,the positive charge decreases,a β-sheet structure was formed and self-aggregation occurred,limiting its effect on the A549 cell membrane and showing weak activity.In summary,pHTP-2 could respond to the weakly acidic microenvironment of tumors to exert selective cyto-toxic activity,effectively overcoming the shortcomings of anticancer peptides such as low efficiency and high toxicity.Our findings suggest that it is a high-quality lead molecule for anticancer drugs.

Lung cancer poses a serious threat to global public health security.Chemotherapy,as the main strategy for cancer treatment,faces challenges such as high toxicity and drug resistance.Anticancer peptides have the potential of being developed into new anticancer drugs due to their advantages of broad-spectrum anticancer activity,rapid action,and difficulty in generating drug resistance,but they also face shortcomings such as weak activity and strong toxic side effects.The weakly acidic microenvironment of tumors(pH 6.5-6.8)provides a good idea for the design of anticancer peptides of high-efficiency and low-toxicity.Previously,we designed the acid-sensitive antibacterial peptide pHly-1 using the wolf spider(Lycosa singoriensis)toxin Lycosin-Ⅰ as a template.In this study,we found that pHly-1 also had acid-sensitive anticancer activity.Further alanine scanning analysis of pHly-1 was carried out,and we ob-tained a mutant pHTP-2 with better acid sensitivity,whose IC50(half maximal inhibitory concentration)against A549 cells was 15.68 μmol/L at pH 6.6 and was greater than 100 μmol/L at pH 7.4.At pH 6.6,pHTP-2 could act on various lung cancer cell lines and induce the death of A549 cells by rapid ly-sis;at pH 7.4,500 μmol/L pHTP-2 had weak toxicity to red blood cells(the hemolysis rate was ap-proximately 38％)and primary myocardial cells(the inhibition rate was 49.7％,with P＜0.05).Analy-sis of its charge,particle size,morphology,and secondary structure showed that at pH 6.6,the histidine in the sequence of pHTP-2 was protonated,increasing the positive charge(P＜0.01),decreasing the hy-drated particle size(P＜0.05)and forming an α-helical structure to induce membrane lysis of A549 cells.At pH 7.4,it was deprotonated,the positive charge decreases,a β-sheet structure was formed and self-aggregation occurred,limiting its effect on the A549 cell membrane and showing weak activity.In summary,pHTP-2 could respond to the weakly acidic microenvironment of tumors to exert selective cyto-toxic activity,effectively overcoming the shortcomings of anticancer peptides such as low efficiency and high toxicity.Our findings suggest that it is a high-quality lead molecule for anticancer drugs.

Objective:To investigate the association of serum levels of micro RNA-126(miR-126),C-peptide,secreted phospholipase A2(sPLA2)with carotid atherosclerotic plaque(CAP)and prognosis in patients with coronary heart disease(CHD).Methods:A total of 114 patients with carotid atherosclerotic coronary heart disease(CAS-CHD)admitted to-Baoding Third Central Hospital between February 2020 and February 2021 were enrolled.Patients were divided into stable plaque group(n=68)and unstable plaque group(n=46)according to carotid ultrasound findings.Serum levels of miR-126,C-peptide and sPLA2 were compared between two groups.Pearson correlation analysis was used to determine the as-sociation of miR-126,C-peptide and sPLA2 with plaque Crouse score.Binary Logistic regression analysis was used to in-vestigate the association of miR-126,C-peptide and sPLA2 with unfavorable outcome.The predictive performance of the combined detection of miR-126,C-peptide,and sPLA2 for unfavorable outcome in CAS-CHD patients was evalua-ted using the receiver operating characteristic(ROC)curve analysis.Results:Compared with patients in the stable plaque group,those in the unstable plaque group had significant higher miR-126[(0.99±0.30)vs.(0.81±0.24)],carotid inti-ma-media thickness(IMT)[(1.67±0.42)mm vs.(1.31±0.51)mm]and plaque Crouse score[(5.93±1.42)points vs.(4.30±1.32)points](P＜0.001 all).Pearson correlation analysis indicated that miR-126,C-peptide and sPLA2 were positively correlated with plaque Crouse score(r=0.267,0.309,0.351,P＜0.01 all).Binary Logistic regression a-nalysis showed that age[odds ratio(OR)=1.509,95％CI 1.055～2.157],miR-126(OR=60.595,95％CI 1.252～2932.237),C-peptide(OR=2.870,95％CI 1.249～6.595),sPLA2(OR=1.068,95％CI 1.016～1.124)and plaque Crouse score(OR=4.491,95％CI 1.824～11.059)were independently associated with unfavorable outcome(P＜0.05 or＜0.01).The area under the joint prediction curve(AUC)was 0.898(95％CI 0.825～0.948),which was significantly higher than miR-126(AUC=0.722,95％CI 0.628～0.804),C-peptide(AUC=0.818,95％CI 0.732～0.886)and sPLA2(AUC=0.806,95％CI 0.719～0.876)alone(Z=3.140,3.161,2.930,P＜0.01 all).Conclusion:Serum miR-126,C-peptide and sPLA2 levels were significantly correlated with the severity of carotid atherosclerosis in coronary heart disease.Combined detection of these three biomarkers may predict unfavorable outcome in these patients.

AIM To study the effects of Jiaotai Pills and their single composition drugs on high-fat diet-induced hypothalamic inflammation in obese mice.METHODS C57BL/6J mice were randomly divided into the normal group(15 mice)and the high-fat group(75 mice).The mice given 12 weeks of high-fat diet feeding were further randomly divided into the model group,the Jiaotai Pills group,the Coptis chinensis group,the Cinnamomum cassia group and the positive metformin group,with 15 mice in each group.After 6 weeks of administration,the mice had their body weight and fasting blood glucose(FBG)levels detected;their hypothalamic expressions of IL-1β,IL-6,TNF-α and Socs3 mRNA detected by RT-qPCR;their hypothalamic expressions of TLR4,MyD88,IKKβ and activated NF-κB protein detected by Western blot;their hypothalamic expressions of Iba1 and GFAP detected by immunohistochemistry;and their ultrastructural changes of nerve tissues observed using transmission electron microscopy(TEM).RESULTS Compared with the model group,each drug group displayed decreased hypothalamic expressions of IL-1β,IL-6,TNF-α and Socs3 mRNA(P＜0.01),and improved number and morphology of nerve cells revealed by TEM.The groups intervened with Jiaotai Pills,or Coptis chinensis,or metformin shared decreased body weight and FBG levels(P＜0.05);decreased protein expressions of TLR4,MyD88,IKKβ and p-NF-κB(P＜0.05);and decreased number of hypothalamic astrocytes and microglia(P＜0.05).Additionally,decreased p-NF-κB protein expression was observed in the Cinnamomum cassia group(P＜0.05).CONCLUSION Jiaotai Pills and their single composition drugs can improve high-fat diet-induced hypothalamic inflammation in obese mice.

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

Baihuasheshecao(Hedyotis diffusa) is a commonly used traditional Chinese medicine derived from the whole herb of H. diffusa and has been widely utilized in folk medicine. It possesses anti-tumor, antibacterial, and anti-inflammatory properties, making it one of the frequently used herbs in TCM clinical practice. However, Shuixiancao(H. corymbosa) and Xianhuaercao(H. tenelliflora), species of the same genus, are often used as substitutes for Baihuasheshecao. To substantiate the medicinal basis of Baihuasheshecao, this study systematically reviewed classical herbal texts and modern literature, examining its nomenclature, botanical origin, harvesting, processing, properties, meridian tropism, pharmacological effects, and clinical applications. The results indicate that Baihuasheshecao was initially recorded as "Shuixiancao" in Preface to the Indexes to the Great Chinese Botany(Zhi Wu Ming Shi Tu Kao). Based on its morphological characteristics and habitat description, it was identified as H. diffusa in the Rubiaceae family. Subsequent records predominantly refer to it as Baihuasheshecao as its official name. In most regions, Baihuasheshecao is recognized as the authentic medicinal material, distinct from Shuixiancao and Xianhuaercao. Baihuasheshecao is harvested in late summer and early autumn, and the dried whole plant, including its roots, is used medicinally. The standard processing method involves cutting. It is known for its effects in clearing heat, removing toxins, reducing swelling and pain, and promoting diuresis to resolve abscesses. Initially, it was mainly used for treating appendicitis, intestinal abscesses, and venomous snake bites, and later, it became a treatment for cancer. The excavation of its clinical value followed a process in which overseas Chinese introduced the herb from Chinese folk medicine to other countries. After its unique anti-cancer effects were recognized abroad, it was reintroduced to China and gradually became a crucial TCM for cancer treatment. The findings of this study help clarify the historical and contemporary uses of Baihuasheshecao, providing literature support and a scientific basis for its rational development and precise clinical application.
Humans ; China ; Drugs, Chinese Herbal/chemistry* ; Hedyotis/classification* ; Medicine, Chinese Traditional/history*

Background:To compare the efficacy and safety of monthly administrations of gonadotropin releasing hormone (GnRH) agonists LY01005 and Zoladex ? in Chinese patients with premenopausal breast cancer. Methods:From October 2020 to November 2021, 188 premenopausal breast cancer patients were enrolled in 34 hospitals and randomized 1:1 to receive either LY01005 or Zoladex ? every 28 days for a total of three injections. All patients concomitantly received oral tamoxifen (TAM). The primary efficacy endpoint was cumulative probability of maintaining menopausal level [oestradiol (E2) ≤30 pg/ml] from day 29 to day 85. The second efficacy endpoint included changes in E2, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) compared with the baseline. Pharmacokinetics (PK), pharmacodynamics (PD), and safety were analyzed. The study also evaluated the pharmacokinetic and pharmacodynamic characteristics of LY01005. Results:A total of 188 patients were randomised and 187 patients received either LY01005 or Zoladex ?. Cumulative probabilities of maintaining menopausal level (E2≤30 pg/ml) from day 29 to day 85 were 93.1% for LY01005 and 86.3% for Zoladex ?. The between-group difference was 6.8% (95% CI: -2.3%, 15.9%) and primary efficacy in the LY01005 group was not inferior to that in the Zoladex ? group. Changes in E2, LH, and FSH levels compared with the baseline were equivalent between the two groups (E2: 89.34% to 90.23% vs. 82.11% to 85.02%; LH: 88.89% to 95.52% vs. 89.70% to 97.02%; FSH: 75.36% to 80.85% vs.73.07% to 80.24%, respectively). After three consecutive doses of LY01005, the LH and FSH levels of the subjects showed a transient increase after the first dose, reached a peak on the second day and then started to decrease. The LH and FSH reached a lower level and remained at or below that level until the 85th day. Both treatments were well-tolerated. Conclusion:LY01005 is as effective as Zoladex ? in suppressing E2 to menopausal levels in Chinese patients with premenopausal breast cancer, with a similar safety profile.

Acute symptomatic osteoporotic thoracolumbar compression fracture (ASOTLF) can lead to chronic low back pain, kyphosis deformity, pulmonary dysfunction, loss of mobility, and even life-threatening complications. Vertebral augmentation is currently the mainstream treatment method for this condition. In 2019, the Editorial Board of Chinese Journal of Trauma and the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association collaboratively led the development of Clinical guideline for vertebral augmentation for acute symptomatic osteoporotic thoracolumbar compression fractures. Six years later, with advances in clinical diagnosis and treatment techniques as well as accumulating evidence in related fields, the 2019 guideline requires updating. To this end, the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association, the Spinal Health Professional Committee of China Human Health Science and Technology Promotion Association, and the Minimally Invasive Orthopedics Professional Committee of Shaanxi Medical Doctor Association have organized experts in the field to develop the Clinical guideline for vertebral augmentation of acute symptomatic osteoporotic thoracolumbar compression fractures ( version 2025) , based on the latest evidence-based medical researches. This guideline incorporates 3 recommendations retained from the 2019 version with updated strength of evidence, along with 12 new recommendations. It provides recommendations from six aspects of diagnosis, pain management, treatment option selection, prevention of postoperative complications, anti-osteoporosis therapy, and postoperative rehabilitation, aiming to provide a reference for standard treatment of vertebral augmentation for ASOTLF in hospitals at all levels.