OBJECTIVE To promote the application of drones in emergency rescue and related fields， expand “low-altitude+ medical” rescue services， and advance the standardization of “low-altitude+medical” distribution services. METHODS The Consensus on Low-altitude Transport and Delivery Services for Emergency Medicines via Drones （2025 Edition） （hereinafter referred to as the Consensus） was jointly initiated by the Division of Therapeutic Drug Monitoring， Chinese Pharmacological Society and the Expert Committee on Precision Medication of the Guangdong Pharmaceutical Association. Guangzhou Red Cross Hospital served as the leading unit， organizing 53 multidisciplinary experts nationwide to participate in drafting and reviewing. A nominal group technique was employed to discuss and finalize the consensus outline， resulting in a preliminary draft. Delphi method was employed， and 11 external review experts were invited to conduct the evaluation. After the experts’ opinions were analyzed and integrated， the Consensus was finalized. RESULTS & CONCLUSIONS The finalized Consensus includes its purpose， principles， and applicable scenarios， basic requirements， and operational procedures for low-altitude transport and delivery of emergency medications； distribution requirements and precautions for controlled substances， fragile medications， and temperature-sensitive medications； and recommendations for emergency medications supplies suitable for the low-altitude transportation and distribution. The release of this Consensus is expected to provide guidance and support for the standardization of “low-altitude+medical” distribution services and the application of low-altitude economy in the healthcare sector.

Objective:To explore the causes and preventive measures of respiratory arrest following general anesthesia in children with obstructive sleep apnea （OSA）, in order to enhance the safety of OSA surgeries under general anesthesia. Methods:A retrospective analysis was conducted on the clinical and follow-up data of four pediatric cases that experienced respiratory arrest after general anesthesia for OSA at Shenzhen Hospital of Southern Medical University from March 2020 to March 2022. Results:All four children exhibited varying degrees of decreased blood oxygen saturation, cyanosis, and loss of consciousness after OSA surgery under general anesthesia, with one case experiencing respiratory and cardiac arrest. Through emergency rescue measures such as oxygen supplementation, suctioning, positive pressure ventilation, awakening, and cardiopulmonary resuscitation, all four children were stabilized. Follow-up after 2 to 6 months showed no complications. The main reasons for the occurrence are analyzed as: residual anesthetic drugs, characteristics of the OSA disease, and the unique aspects of the pediatric population. Conclusion:Children undergoing general anesthesia for OSA should be closely monitored for vital signs after surgery. If respiratory suppression occurs, active rescue measures should be taken to avoid serious consequences.
Humans ; Sleep Apnea, Obstructive/surgery* ; Anesthesia, General/adverse effects* ; Retrospective Studies ; Child ; Postoperative Complications/prevention & control* ; Male ; Female ; Child, Preschool

Objective To explore EEG characteristics and the therapeutic effect in children with electrical status epilepticus during slow sleep(ESES).Methods The eligible ESES cases in our center from 2014 to 2020 were included.The age at diagnosis of ESES,the duration of ESES,spike wave index(SWI)during wakefulness and the distribution of spike wave during the period of ESES,age at seizure onset,the clinical syndromes and the outcomes after treatment were analyzed.The ESES cases were divided into 4 groups according to the distribution of spike wave:focal ESES,unilateral ESES,bilateral asymmetric ESES,multiple foci ESES.The SWI during the awake stage were divided into 3 groups based on the different rates:≤20%,21%～49%,≥50%.The therapeutic outcomes were classified into three groups:satisfactory response,seizure control and ineffective.Results 50 cases were included,with 32 males and 18 females.The average onset age of ESES was 6 years and 7 months,and the average duration of ESES was 28 months.A significant correlation between the distribution of ESES and the thera-peutic effects was found,bilateral asymmetric ESES had a good therapeutic effects,while multiple foci ESES showed a poor therapeutic effects.The duration of ESES was significantly correlated with therapeutic effects,and the efficacy was worse when the duration was longer than 1 year.A significant relationship between the SWI during wakefulness of ESES and the therapeutic effects was detected,the patient with SWI≤20%during wakefulness had a good therapeutic effect.There was a negative correlation between the onset age of ESES and the duration of ESES and SWI index during wakefulness.There was a positive correlation between the duration of ESES and SWI index during wakefulness.Conclusion Our results suggest that onset age,distribution,duration and SWI during wake-fulness of ESES were correlated with therapeutic outcomes,The patient with SWI≤20%during wakefulness had a good therapeutic effect and have unfavorable outcomes with ESES last more than 1 year.The earlier onset of ESES,the longer duration of ESES and higher SWI during wakefulness will be showed..

Humans ; Blood Pressure/physiology* ; Cohort Studies ; Patient Discharge ; Ischemic Stroke ; Stroke ; Brain Ischemia ; Diabetes Mellitus ; Hypertension

Dravet syndrome is a rare and severe developmental epileptic encephalopathy with variable clinical phenotypes.Dravet syndrome is difficult to diagnose and treat, and related comorbidities have a profound impact on the long-term quality of life of patients and their parents.SCN1A is the main pathogenic gene of Dravet syndrome, and SCN1A mutations are found in more than 85% of the patients.In recent years, with the development of genetic testing technology and the accumulation of cases, the understanding of the characteristics of epileptic seizures, comorbidities and SCN1A gene mutation characteristics in Dravet syndrome has gradually deepened.In addition to conventional antiepileptic drugs, new antiepileptic drugs(cannabidiol, fenfluramine)have also shown good antiepileptic effects and are expected to become second-line drugs for the treatment of Dravet syndrome seizures.This article mainly reviews the research progress of unique clinical phenotype, SCN1A gene mutation characteristics and new antiepileptic drugs of Dravet syndrome, in order to deepen clinicians′ understanding of the disease.

Abnormal expression and dysfunction of voltage-gated Calcium channels (VGCCs) can give rise to a variety of neurological disorders in children, including epilepsy, migraine and ataxia.In the past, only CACNA1A, CACNA1H, CACNA2D2 and CACNB4 were considered associated with epilepsy in children.In recent years, an increasing number of VGCCs gene associated with epilepsy in children have been found, especially developmental and epileptic encephalopathy genes.This study aims to review the research progress of VGCCs gene mutations associated with epilepsy in children.

Objective To investigate the therapeutic effect of Shugan Heluo Xingpi Decoction on CCl 4 -induced liver fibrosis in rats, and the underlying molecular mechanism. Methods Sixty male SPF Wistar rats were randomly assigned to six groups: blank control, model, positive control, high, medium or low dose groups of Shugan Heluo Xingpi Decoction ( n =10 per group). The liver fibrosis rat model was induced by an intraperitoneal injection of 40% CCl 4 oil solution. Rats in the blank control and model groups were administered 10 mL/kg normal saline by gavage, rats in the positive control group were administered 50 mg/kg silibinin meglumine by gavage, while rats in high-dose, medium-dose and low-dose groups of Shugan Heluo Xingpi Decoction were administered 12.42 g/kg, 6.21 g/kg and 3.11 g/kg (crude drug/body weight) by gavage, respectively, daily for 8 weeks. Rats was sacrificed after 8 weeks, during which the physiological status of rats in each group was dynamically monitored. Following sacrifice, serum was collected to detect HYP using alkaline hydrolysis colorimetry and the expression levels of AST, ALT, total protein (TP), and Alb using an automatic biochemical analyzer. The pathological morphological changes in the liver were detected by H & E staining and Masson staining, and the mRNA and protein levels of Wnt1, β-Catenin and Cyclin D1 were detected by RT-qPCR and Western Blot. Measurement data were compared across groups using one-way ANOVA with post-hoc LSD- t test. Results Compared with the model group, after silibinin meglumine and Shugan Heluo Xingpi Decoction intervention, the physiological status of rats was significantly improved; serum levels of HYP, ALT, AST and Glo were significantly decreased, while serum levels of TP, Alb and A/G were significantly increased (all P < 0.05). Compared with the positive control group, serum levels of ALT and AST were significantly increased (all P < 0.05), while the levels of TP, Alb and A/G were significantly decreased (all P < 0.05) in low-dose group of Shugan Heluo Xingpi Decoction. H&E staining showed mild portal vein fibrosis with a few fibrous septa and mild steatosis of hepatocytes in the positive control group, obvious portal vein fibrosis with a few fiber septum in the low dose group, a few portal vein fibrosis in the medium dose group, while no obvious abnormality in the high dose group of Shugan Heluo Xingpi Decoction. Masson staining revealed that the therapeutic effect of high dose group of Shugan Heluo Xingpi Decoction on collagen deposition was superior to silibinin meglumine and medium and low dose of Shugan Heluo Xingpi Decoction (all P < 0.05), and was generally equivalent to high dose of Shugan Heluo Xingpi Decoction. Silibinin meglumine and medium and high doses of Shugan Heluo Xingpi Decoction inhibited more significantly the mRNA and protein expression of Wnt1, β-catenin and Cyclin D1 (all P < 0.05). Conclusion Shugan Heluo Xingpi Decoction shows anti-hepatic fibrosis effect, with a greater effect at higher doses. Regulating Wnt/β-Catenin signaling pathway may be one of the underlying molecular mechanisms.

Objective:To examine the occurrence of seizures and perioperative risk factors in children after obtaining cardiopulmonary bypass (CPB).Methods:Electroencephalograph (EEG) and cerebral oxygen saturation (ScO 2) were monitored in 87 patients (aged 3 days-110 months, with the median at 4.4 months) and they were admitted to the Cardiac Intensive Care Unit (CICU) from May 2018 to April 2019, with 77 patients for 72 h after CPB and 10 cases with clinical seizures after CICU discharge for 8-180 h. Clinical data were recorded every 4 hours, including blood pressure, central venous pressure (CVP), temperature, arterial blood gases, lactate, doses of Dopamine, Milrinone, and Adrenalin, and daily C-reaction protein (CRP) and N-terminal pro-brain natriuretic peptide(NT-proBNP). Demographic data, the Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery(STAT) mortality classification and clinical outcomes (duration of mechanical ventilation, CICU and hospital stay, and death) were recorded. Results:Seizures occurred in 24 patients (27.6%) within 48 h after CPB.EEG seizures appeared in 7 patients, both EEG and clinical seizures in 7 patients, and clinical seizures in 10 patients.Three patients developed epilepsy.There were 2 hospital deaths and both had EEG seizures.Patients with seizures had higher STAT categories, longer operative time and worse clinical outcomes (all P<0.05). Univariate regression revealed that the occurrence of seizures was positively related to adrenalin, temperature, lactate level (all P<0.01), blood pressure, CVP (all P<0.05) and CRP ( P<0.1), and negatively correlated with arterial carbon dioxide tension[ pa(CO 2)], ScO 2 and dose of Milrinone (all P<0.05). In multivariate regression, only dose of Adrenalin ( P<0.001) and lactate level ( P<0.01) remained significant. Conclusions:The incidence of seizures was high in children after CPB.Numerous perioperative factors that were related to seizures were identified.The most significant risk factors were higher dose of adrenaline and lactate level.Studies on neurological injury after CPB are urgently needed in China in order to reduce brain injury and improve neurodevelopmental outcomes.

Objective:In order to improve the management level of scientific research funds, strengthen the risk prevention and control of scientific research, ensure that scientific research funds are used reasonably and efficiently in compliance with regulatory requirement.Methods:Based on literature review, this article explores the current status and existing problems of scientific research project management from three perspectives: scientific research management systems, principal investigation (PI), and information systems.Taking the construction of the scientific research management work system of the Second Affiliated Hospital of Wenzhou Medical University as an example, discuss measures and countermeasures dealing with existing problems in the management of scientific research funds.Results:The establishment of the scientific research management system to some extent has improved the hospital's scientific research management level and solved the existing problems.Conclusions:Optimization suggestions are provided to further improve the management of funds of scientific research projects.Meanwhile, it provides reference for the management of scientific research funds of other hospitals.

ObjectiveTo investigate the features of hepatic myelopathy (HM) after transjugular intrahepatic portosystemic shunt (TIPS). MethodsA retrospective analysis was performed for a consecutive cohort of patients with cirrhotic portal hypertension who were successfully treated with TIPS in Department of Liver Disease and Digestive Interventional Radiology in Xijing Hospital of Digestive Diseases, Fourth Military Medical University, from 2005 to 2014 and then developed HM. Routine follow-up was performed for all patients at 1, 3, and 6 months after TIPS and every half a year subsequently. The time to disease progression was used to summarize the natural course of HM, the comparison of continuous data was made by independent samples t-test, the comparison of categorical date was made by chi-square test. The Kaplan-Meier method was used for survival analysis, and the Cox proportional hazards regression model was used to determine prognostic factors. Relief of symptoms in the lower limbs was analyzed to investigate the therapeutic effect. ResultsThe time to HM progression from grade 1 to grades 2, 3, and 4 was 40 months (range, 1-36 months), 8.5 months (range, 1-44 months), and 18.8 months (range, 54-48.6 months), respectively. In HM patients, the 1-, 3-, and 5-year cumulative survival rates were 84.19%, 5186%, and 4521%, respectively. Age of HM onset (HR=1.034, 95% CI: 1.003-1.065) and recurrent ascites (HR=3.869, 95% Cl: 1623-9225) were independent prognostic factors in patients with HM. The patients who underwent liver transplantation had a significantly higher proportion of patients with relief of symptoms than those who did not undergo liver transplantation (χ2=13.5, P=0.003), while the effects of stent flow limitation and occlusion showed no significant differences (P＞0.05). ConclusionThe course of HM consists of rapid progression stage and plateau stage, and HM patients after TIPS show good survival. At present, liver transplantation is an effective method to treat HM.