ObjectiveTo establish a mouse model of particulate matter 2.5 （PM_2.5）-induced dry eye and investigate whether Chufeng Yisuntang can ameliorate the PM_2.5-induced ocular surface damage by regulating the reactive oxygen species （ROS）/p38 mitogen-activated protein kinase （p38 MAPK） signaling pathway. MethodsSixty 8-week-old male C57BL/6J mice were used. Ten were randomly selected as the control group. The remaining 50 mice received topical instillation of 1 drop （0.1 mL） of 5 g·L^-1 PM_2.5 suspension in both eyes， four times daily. Successfully modeled mice were randomized into four groups （n=10）： Model， p38 MAPK inhibitor， Chufeng Yisuntang， and combination （Chufeng Yisuntang at 7.3 g·kg^-1 + p38 MAPK inhibitor SB203580 at 5 mg·kg^-1）. Chufeng Yisuntang was administered via gavage， and the inhibitor group via intraperitoneal injection. The control and model groups received equal volumes of distilled water by gavage. All treatments lasted for 4 weeks. General conditions were dynamically observed. Tear secretion， tear film break-up time， and corneal fluorescein staining were assessed. After intervention for 4 weeks， hematoxylin and eosin （HE） staining was used to examine the histopathological changes. Enzyme-linked immunosorbent assay （ELISA） was adopted to measure serum levels of ROS， malondialdehyde （MDA）， superoxide dismutase （SOD） 1， and SOD2. Western blot and Real-time PCR were employed to determine the protein and gene levels， respectively， of p38 MAPK， B-cell lymphoma-2 （Bcl-2）， Bcl-2-associated X protein （Bax）， and cysteinyl aspartate-specific proteinase-3 （Caspase-3） in the corneal tissue. ResultsCompared with the control group， the model group exhibited reduced tear secretion volume and tear film breakup time， along with increased corneal fluorescein staining scores （P<0.01）. Compared with the model group， the Chufeng Yisuntang group， p38 MAPK inhibitor group， and combination group demonstrated increased tear secretion volume and tear film breakup time， along with decreased corneal fluorescein staining scores （P<0.01）. HE staining revealed that compared with the control group， the model group exhibited marked increases in corneal epithelial cell layers and epithelial thickness， along with reduced meibomian gland acini and intensely stained， densely packed nuclei around the acini. Compared with the model group， the Chufeng Yisuntang group， p38 MAPK inhibitor group， and combination group showed intact corneal structure， improved cell morphology， and reduced damage severity. ELISA revealed elevated ROS and MDA levels （P<0.01） and decreased SOD1 and SOD2 levels （P<0.01） in the model group compared with the control group. Compared with the model group， Chufeng Yisuntang， p38 MAPK inhibitor， and the combination lowered ROS and MDA levels （P<0.01）， while raising SOD1 and SOD2 levels （P<0.05， P<0.01）. Western blot revealed that compared with the control group， the model group exhibited increased protein levels of p38 MAPK， Bax， and Caspase-3 （P<0.01） and reduced protein level of Bcl-2 （P<0.01）. Compared with the model group， Chufeng Yisuntang， p38 MAPK inhibitor， and the combination down-regulated the protein levels of p38 MAPK， Bax， and Caspase-3 （P<0.01）， while up-regulating the protein level of Bcl-2 （P<0.01）. Compared with the Chufeng Yisuntang group， the combination group exhibited decreased protein levels of p38 MAPK， Bax， and Caspase-3 （P<0.01） and increased protein level of Bcl-2 （P<0.01）. Real-time PCR revealed that compared with the control group， the model group exhibited upregulated mRNA levels of p38 MAPK， Bax， and Caspase-3 （P<0.01）， and downregulated mRNA level of Bcl-2 （P<0.01）. Compared with the model group， Chufeng Yisuntang， p38 MAPK inhibitor， and the combination down-regulated the mRNA levels of p38 MAPK， Bax， and Caspase-3 （P<0.01）， while up-regulating the mRNA level of Bcl-2 （P<0.05， P<0.01）. Compared with the Chufeng Yisuntang group， the combination group exhibited decreased mRNA levels of p38 MAPK， Bax， and Caspase-3 expression （P<0.05， P<0.01） and increased mRNA level of Bcl-2 （P<0.01）. ConclusionChufeng Yisuntang may partially protect against PM_2.5-induced corneal injury by inhibiting the ROS/p38 MAPK pathway， enhancing antioxidant defense， and reducing epithelial apoptosis.

Objective:To investigate the gene expression of pulmonary metastatic papillary thyroid cancer (PTC) and its association with lung metastasis, facilitating risk assessment and personalized therapeutic strategies.Methods:A retrospective cohort study was conducted on 269 PTC patients (61 males, 208 females, age (38.9±11.9) years) treated at the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University from January 2017 to June 2020, including 60 cases with lung metastasis and 209 without. Primary tumor tissues underwent targeted next-generation sequencing (tNGS). Univariate and multivariate logistic regression analyses were performed to identify risk factors for lung metastasis, and χ2 test was used to evaluate the differences between the effective and ineffective groups of radioactive iodine (RAI) therapy. Results:In 60 PTC patients with lung metastasis, the mutation rates of B-Raf proto-oncogene, serine/threonine protein kinase (BRAF) V600E, telomerase reverse transcriptase (TERT) promoter, and rearranged in transformation (RET) fusion mutations were 28.3%(17/60), 25.0%(15/60), and 26.7%(16/60), respectively. Univariate analysis demonstrated that age≥55 years, multifocality, lateral cervical lymph node metastasis, extrathyroidal extension, BRAF V600E mutation, RET fusion, and TERT promoter mutation were significantly associated with lung metastasis in PTC ( Wald χ2 values: 4.13-31.28, all P<0.05). However, no significant statistical associations were observed between lung metastasis and gender, rat sarcoma type GTPase family (RAS) mutation, tumor protein p53 (TP53) mutation, phosphatidylinositol-4, 5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) mutation, neurotrophic tyrosine receptor kinase 1 (NTRK1) fusion, or anaplastic lymphoma kinase (ALK) fusion ( Wald χ2 values: 0.01-3.50, all P>0.05). Multivariate analysis identified TERT promoter mutation (odds ratio ( OR)=11.86, 95% CI: 3.68-38.29, P<0.001), multifocality ( OR=5.30, 95% CI: 2.41-11.69, P<0.001), extrathyroidal extension ( OR=3.98, 95% CI: 1.77-8.98, P=0.001), and lateral cervical lymph node metastasis ( OR=3.13, 95% CI: 1.28-7.68, P=0.013) as independent risk factors for lung metastasis in PTC. Conversely, BRAF V600E mutation emerged as a potential protective factor ( OR=0.09, 95% CI: 0.04-0.21, P<0.001). The proportions of BRAF V600E mutation ( χ2=20.49, P<0.001) and TERT promoter mutation ( χ2=4.91, P=0.027) were higher in the RAI ineffective group. Conclusions:BRAF V600E mutation, TERT promoter mutation and RET fusion are related gene expression in lung metastasis of PTC. Multifocality, extrathyroidal extension, lateral cervical lymph node metastasis and TERT promoter mutation are risk factors for lung metastasis of PTC (TERT is an independent molecular risk marker), while BRAF V600E mutation may be a protective factor. RAI treatment efficacy of PTC patients with lung metastasis and BRAF V600E mutation/TERT promoter mutation is worse.

Under the background of the integrated development of the Guangdong-Hong Kong-Macao Greater Bay Area,the demand for medical services from Hong Kong and Macao residents in Guangdong continues to grow.As the main force in pro-viding medical services in Guangdong,public hospitals play a crucial role.This article aims to explore the current situation of the development of medical services for Hong Kong and Macao residents in Guangdong and propose development strategies from the perspective of hospitals to contribute to the integrated development of the Greater Bay Area.The SWOT method is used to system-atically evaluate the strengths,weaknesses,opportunities,and threats of Guangdong public hospitals in the development of medi-cal services for Hong Kong and Macao residents.A SWOT matrix is then constructed to formulate development countermeasures.The analysis shows that Guangdong public hospitals have advantages such as convenient transportation,cultural affinity,abundant medical resources,high service efficiency,and relatively low costs.However,they also face challenges such as inadequate cover-age of cross-border medical insurance,immature specialized services,inconsistent service standards,and insufficient exploration of cross-border medical care.At the same time,there are opportunities provided by national strategic support and strong market demand,while fierce market competition and slow integration of medical regulations among the three regions pose external threats.Based on the analysis,this article proposes countermeasures and suggestions,including strengthening publicity and innovative in-dustry cooperation,phased development of business,striving for policy coverage,enhancing business coordination,accelerating cooperation with the Hong Kong and Macao in medical care,and promoting international accreditation of hospitals.These sugges-tions provide decision-making references for the development of medical services for Hong Kong and Macao residents in Guang-dong's public hospitals.

To summarize the research progress and to discuss current drug supplement status of radiation preventive and curative drugs,which would provide fresh thoughts for nuclear emergency rescue and therapy.Classification of clinically available and under-development radiation prevention and treatment drugs has been presented in terms of symptomatic and causative prevention and treatment drugs.We analyzed the necessity and challenges of establishing a supply system for radiation prevention and treatment and put forward counter measures and thinking prospects.Clinical stockpile of symptomatic drugs is relatively sufficient.Allopathic drugs are widely developed,however,the barriers between research and clinical translation and the inadequate market supply system pose greater demands and challenges to the provision of hospital radiation allopathic drugs.

Objective:To investigate the gene expression of pulmonary metastatic papillary thyroid cancer (PTC) and its association with lung metastasis, facilitating risk assessment and personalized therapeutic strategies.Methods:A retrospective cohort study was conducted on 269 PTC patients (61 males, 208 females, age (38.9±11.9) years) treated at the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University from January 2017 to June 2020, including 60 cases with lung metastasis and 209 without. Primary tumor tissues underwent targeted next-generation sequencing (tNGS). Univariate and multivariate logistic regression analyses were performed to identify risk factors for lung metastasis, and χ2 test was used to evaluate the differences between the effective and ineffective groups of radioactive iodine (RAI) therapy. Results:In 60 PTC patients with lung metastasis, the mutation rates of B-Raf proto-oncogene, serine/threonine protein kinase (BRAF) V600E, telomerase reverse transcriptase (TERT) promoter, and rearranged in transformation (RET) fusion mutations were 28.3%(17/60), 25.0%(15/60), and 26.7%(16/60), respectively. Univariate analysis demonstrated that age≥55 years, multifocality, lateral cervical lymph node metastasis, extrathyroidal extension, BRAF V600E mutation, RET fusion, and TERT promoter mutation were significantly associated with lung metastasis in PTC ( Wald χ2 values: 4.13-31.28, all P<0.05). However, no significant statistical associations were observed between lung metastasis and gender, rat sarcoma type GTPase family (RAS) mutation, tumor protein p53 (TP53) mutation, phosphatidylinositol-4, 5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) mutation, neurotrophic tyrosine receptor kinase 1 (NTRK1) fusion, or anaplastic lymphoma kinase (ALK) fusion ( Wald χ2 values: 0.01-3.50, all P>0.05). Multivariate analysis identified TERT promoter mutation (odds ratio ( OR)=11.86, 95% CI: 3.68-38.29, P<0.001), multifocality ( OR=5.30, 95% CI: 2.41-11.69, P<0.001), extrathyroidal extension ( OR=3.98, 95% CI: 1.77-8.98, P=0.001), and lateral cervical lymph node metastasis ( OR=3.13, 95% CI: 1.28-7.68, P=0.013) as independent risk factors for lung metastasis in PTC. Conversely, BRAF V600E mutation emerged as a potential protective factor ( OR=0.09, 95% CI: 0.04-0.21, P<0.001). The proportions of BRAF V600E mutation ( χ2=20.49, P<0.001) and TERT promoter mutation ( χ2=4.91, P=0.027) were higher in the RAI ineffective group. Conclusions:BRAF V600E mutation, TERT promoter mutation and RET fusion are related gene expression in lung metastasis of PTC. Multifocality, extrathyroidal extension, lateral cervical lymph node metastasis and TERT promoter mutation are risk factors for lung metastasis of PTC (TERT is an independent molecular risk marker), while BRAF V600E mutation may be a protective factor. RAI treatment efficacy of PTC patients with lung metastasis and BRAF V600E mutation/TERT promoter mutation is worse.

Transcatheter aortic valve replacement(TAVR)has become an important therapeutic approach for severe aortic stenosis.However,complications associated with TAVR cannot be overlooked,among which contrast agents induced acute kidney injury(AKI)is a common complication.To explore methods to reduce the occurrence of AKI,this article reports two cases of successful treatment of severe aortic stenosis by TAVR under pure echocardiographic guidance,both of whom were elderly women aged 75 and 69,respectively,and both were implanted with a Evolute Pro 26 mm valve.Postoperative echocardiography showed good valve positioning and function.

To summarize the research progress and to discuss current drug supplement status of radiation preventive and curative drugs,which would provide fresh thoughts for nuclear emergency rescue and therapy.Classification of clinically available and under-development radiation prevention and treatment drugs has been presented in terms of symptomatic and causative prevention and treatment drugs.We analyzed the necessity and challenges of establishing a supply system for radiation prevention and treatment and put forward counter measures and thinking prospects.Clinical stockpile of symptomatic drugs is relatively sufficient.Allopathic drugs are widely developed,however,the barriers between research and clinical translation and the inadequate market supply system pose greater demands and challenges to the provision of hospital radiation allopathic drugs.

OBJECTIVE To establish a closed-loop management system for the whole-process traceability of outpatient drugs based on internet of things(IoT)and blockchain technology,and evaluate its implementation effects.METHODS A closed-loop management system for the whole-process traceability of outpatient drugs covering the entire drug lifecycle was designed using drug traceability codes integrated with IoT and blockchain technology.System effectiveness was evaluated from three dimensions:work efficiency,medication management quality and data safety by comparing indicators such as the acceptance time of incoming drugs and the number of collected drug traceability codes before the system implementation(October to December 2024)and after the system implementation(January to March 2025).RESULTS A closed-loop management system for the whole-process traceability of outpatient drugs,centered around the drug traceability code management system,was successfully established.The acceptance time for incoming drugs was shortened from(4.65±0.26)h before implementation to(0.34±0.08)h after implementation(P＜0.05).The number of collected drug traceability codes increased from 419 018 to 1 236 522,and the coverage rate of traceability codes rose from 28.36%to 89.88%(P＜0.05).The time pharmacists spent on drug expiry management per week decreased from(128.40±19.20)min to(0.56±0.13)min(P＜0.05),and the dispensing time for a single prescription(excluding a part of injections and repackaged drugs)was reduced from(143.25±17.67)s to(15.24±10.08)s(P＜0.05).The time for drug return was reduced from 129.90(122.32,137.00)s to 104.36(89.91,117.33)s(P＜0.05);the number of drug dispensing errors decreased from 2 cases to 0 cases.After the system was launched,there were no data security incidents in our outpatient pharmacy.CONCLUSIONS The constructed closed-loop management system for the whole-process traceability of outpatient drugs can significantly enhance drug traceability accuracy and drug management quality,improve pharmacist work efficiency,and reduce drug management risks,thus providing a feasible solution for the digital transformation of hospital pharmaceutical services.

Transcatheter aortic valve replacement(TAVR)has become an important therapeutic approach for severe aortic stenosis.However,complications associated with TAVR cannot be overlooked,among which contrast agents induced acute kidney injury(AKI)is a common complication.To explore methods to reduce the occurrence of AKI,this article reports two cases of successful treatment of severe aortic stenosis by TAVR under pure echocardiographic guidance,both of whom were elderly women aged 75 and 69,respectively,and both were implanted with a Evolute Pro 26 mm valve.Postoperative echocardiography showed good valve positioning and function.

In recent years,significant breakthroughs have been achieved in the immunotherapy for Alzheimer's disease.In line with global advancements,two anti-amyloid-β monoclonal antibodies have been approved and successfully launched in China for clinical use.Lecanemab and Donanemab were officially used in June 2024 and April 2025 in China,respectively.In order to standardize the rational and safe application of anti-amyloid-β monoclonal antibodies for Alzheimer's disease in China,this article integrates recom-mendations from the clinical trials and real-world experience from the author's team and domestic peers to further update the recom-mendations for the clinical use of anti-amyloid-β monoclonal antibody based on the 2024 version.It includes indications for therapy,pre-treatment evaluation and preparation,administration protocols and safety measures during treatment,and post-treatment monitor-ing strategies.