177Lu-prostate specific membrane antigen(PSMA)radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China.Based on domestic clinical practice and experimental data and referred to international experience and viewpoints,the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.

Objective:To study the epidemiological characteristics of mortality and cause of death composition in patients with coal-burning-borne endemic arsenism in Ankang City, Shaanxi Province.Methods:Mortality data of patients with coal-burning-borne endemic arsenism in Ankang City from 2018 to 2023 were collected from the Shaanxi Provincial Endemic Disease Prevention and Control Information Management Platform and the National Death Cause Information Registration System. Crude and standardized mortality rates, years of life lost (YLL) due to premature death were calculated, and the population and regional distribution characteristics of death cases were analyzed. Causes of death were classified and analyzed according to the International Classification of Diseases (ICD-10) category codes.Results:From 2018 to 2023, a total of 610 patients with coal-burning-borne endemic arsenism died in Ankang City, Shaanxi Province. The average annual crude mortality rate was 5.20/100 000. The average age of death for patients was 77.78 years old, and the mortality rate showed an upward trend with age (χ 2tend = 1 163.82, P < 0.001), with a significant increase in patients over 60 years old. The male to female ratio was 3.18∶1.00 (464/146). Among the seven diseased districts and counties, Langao County had the highest mortality rate. The YLL was 6 241.68 person-years. The top four causes of death among these cases circulatory system diseases, respiratory system diseases, malignant tumors, and injuries differed from those of the entire population in Ankang City, with respiratory system diseases being more prominently ranked. Conclusions:The death cases of coal-burning-borne endemic arsenism in Ankang City are mainly elderly males, and are more common in Langao County. There are various causes of death, coexisting with circulatory system diseases, respiratory system diseases, malignant tumors, and injuries.

Objective To investigate the effects of software follow-up mode application on stigma sense,social function and survival quality in the patients with schizophrenia.Methods A total of 100 inpa-tients with schizophrenia in the psychiatric department of this hospital from January to December 2023 were selected as the study subjects and divided into the observation group(software follow-up)and the control group(telephone follow-up)according to different follow-up modes,50 cases in each group.At discharge from hospital and in 4,8,12 weeks after discharge,the Chinese version of Stigma Scale for Mental illness(SSMI-C)was adopted to evaluate the stigma sense of the patients,the Social Disability Screening Schedule(SDSS)was used to evaluate the patients'social function,the patients'survival quality was evaluated by the Generic Qual-ity of Life Inventory-74(GQOLI-74).The changes of above scores were compared between the two groups.Results The SSMI-C,SDSS and GQOLI-74 scores at discharge from hospital had no statistical difference be-tween the two groups(P＞0.05).Compared with at discharge from hospital,the SSMI-C and SDSS scores in 4,8,12 weeks of follow up in the two groups were decreased,the GQOLI-74 score was increased,moreover the scores of SSMI-c and SDSS in the observation group were lower than those in the control group,the GQOLI-74 score was higher than that in the control group,and the differences were statistically significant(P＜0.05).Conclusion Conducting the regular follow-up on discharged patients with schizophrenia by the follow-up soft-ware could reduce the stigma of the patients,improve the social functional defect and improve the survival quality.

Objective:To investigate the epidemiological characteristics of chronic pain patients based on the the 11th edition of International Classification of Diseases (ICD-11) chronic pain classification in pain clinics.Methods:A retrospective study was conducted on chronic pain patients who visited the pain department outpatient clinics of the Third Xiangya Hospital of Central South University and Anfu Street Health Center in Linli County from July 2021 to July 2024. The general situation and epidemiological characteristics of chronic pain of the survey subjects were understood through outpatient medical records, and the differences in chronic pain composition ratio, gender, age, and season between the two hospitals were compared.Results:A total of 15 783 patients with chronic pain were enrolled. The constituent ratio of patients with chronic pain was as follows: chronic cancer-related pain (5.33%, n=841), chronic secondary musculoskeletal pain (80.98%, n=12 781), chronic secondary visceral pain (3.14%, n=496), chronic secondary headache or orofacial pain (1.30%, n=205), chronic neuropathic pain (5.08%, n=801), chronic postsurgical or post traumatic pain (1.93%, n=305) and chronic primary pain (2.24%, n=354). There were statistically significant differences in the constituent ratio of chronic pain classification, season, gender and age in the two hospitals (all P<0.001). Conclusions:In general, chronic secondary musculoskeletal pain had the highest proportion in this study, followed by chronic cancer-related pain and chronic neuropathic pain. Gender, age, and season were important influencing factors of chronic pain. There were certain differences between the two hospitals.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Clinicians need to focus on various points in the diagnosis and treatment of insomnia.This article prescribed the treatment protocol based on the unique features,such as insomnia in the elderly,women experiencing specific physiologi-cal periods,children insomnia,insomnia in sleep-breathing disorder patients,insomnia in patients with chronic liver and kidney dysfunction.It pro-vides some reference for clinicians while they make decision on diagnosis,differentiation and treat-ment methods.

Objective:To evaluate the prevention and control effect of coal-burning-borne endemic fluorosis in Ankang City of Shaanxi Province, so as to provide a scientific basis for formulating precise prevention and control strategies in the future.Methods:From 2019 to 2023, according to the requirements of the "Monitoring Program of Shaanxi Province for Coal-burning-borne Endemic Fluorosis (2019 Edition)", full coverage monitoring was carried out in all affected villages in seven affected counties under the jurisdiction of Ankang City. Using the simple random sampling method, 30 households in each affected village were selected to investigate the use of improved stoves and the formation of health-related behaviors. All children aged from 8 to 12 in the village were examined for the prevalence of dental fluorosis. At the same time, 6 monitoring villages were selected in 2019, and 8 monitoring villages were selected in 2023 to collect real-time urine samples from children aged 8 - 12 for determination of urinary fluoride level. The evaluation for control and elimination of disease areas was carried out in accordance with the "Evaluation Approach for Control and Elimination of Priority Endemic Diseases (2019 Edition)".Results:From 2019 to 2023, a total of 203 880 households were monitored, the rate of qualified improved stoves and the correct use rate of qualified improved stoves were more than 95.00%. The utilization rate of improved stoves decreased from 16.34% (6 584/40 290) in 2019 to 8.89% (3 706/41 700) in 2023, showing a decreasing trend year by year (χ 2trend = 3 400.37, P < 0.001). The utilization rate of clean energy increased from 82.52% (33 247/40 290) in 2019 to 94.36% (39 350/41 700) in 2023, showing an upward trend year by year (χ 2trend = 7 506.09, P < 0.001). The correct drying rate of corn and pepper for human consumption were 100.00%. A total of 455 327 children aged 8 - 12 were examined, and 2 301 cases of dental fluorosis were diagnosed, with a detection rate of 0.51%. Children with dental fluorosis were mainly extremely mild and mild, accounting for 94.87% (2 183/2 301). The dental fluorosis index was 0.012, indicating no trend of fluorosis prevalence. The detection rate of dental fluorosis in children decreased from 0.81% (765/94 537) in 2019 to 0.24% (204/86 066) in 2023, showing a declining trend year by year (χ 2trend = 375.45, P < 0.001). The geometric mean urinary fluoride levels of children aged 8 to 12 in 2019 and 2023 were 0.48 and 0.42 mg/L, respectively, with statistically significant differences between groups ( Z = - 3.05, P = 0.002). As of 2023, 1 390 affected villages had met the elimination criteria. Conclusions:The prevention and control of coal-burning-borne endemic fluorosis in Ankang City has achieved remarkable results, with all seven affected counties reaching the elimination standard. In the future, we should strengthen the management of high fluoride coal mines, continue to promote the use of clean energy, strengthen health promotion and disease monitoring, and continuously consolidate and improve the results of prevention and control.

BACKGROUND: The early stages of tumor bone metastasis are closely associated with changes in the vascular niche of the bone microenvironment, and abnormal angiogenesis accelerates tumor metastasis and progression. However, the effects of lung adenocarcinoma (LUAD) cells reprogrammed by the bone microenvironment on the vascular niche within the bone microenvironment and the underlying mechanisms remain unclear. This study investigates the effects and mechanisms of LUAD cells reprogrammed by the bone microenvironment on endothelial cells and angiogenesis, providing insights into the influence of tumor cells on the vascular niche within the bone microenvironment. METHODS: The culture media from bone-metastatic LUAD cell A549-GFP-LUC-BM3 (BM3-CM) and A549-GFP-LUC (A549-CM) were separately applied to human umbilical vein endothelial cell (HUVEC). A colony formation assay, scratch assay, and tube formation assay were conducted to evaluate the proliferation, migration, and angiogenesis of HUVEC. Gene set enrichment analysis (GSEA) was conducted to identify enriched pathways, while reverse transcription quantitative polymerase chain reaction (RT-qPCR) and enzyme linked immunosorbent assay (ELISA) were performed to quantify hepatocyte growth factor (HGF), a protein that plays a crucial role in angiogenesis. Furthermore, the pivotal function of HGF and its underlying molecular mechanisms have been substantiated through the utilisation of recombinant proteins, neutralising antibodies, pathway inhibitors, immunofluorescence staining, and Western blot. RESULTS: BM3-CM demonstrated a more pronounced impact on the proliferation, migration, and angiogenesis of HUVEC compared to A549-CM. Bioinformatics analysis, combined with in vitro experiment, demonstrated that the secretory protein HGF was significantly elevated in BM3 cells and BM3-CM (P<0.05). The addition of HGF neutralizing antibodies to BM3-CM inhibited the promoting effect of BM3-CM on HUVEC (P<0.05), while the addition of recombinant HGF to A549-CM reproduced that promoting effect of BM3-CM on HUVEC (P<0.05). HGF can enhance the activation of YAP (Yes-associated protein) in HUVEC, and this promotion effect may be achieved by activating Src and activating YAP into the nucleus (P<0.05), but this effect can be inhibited by HGF neutralizing antibodies (P<0.05). Furthermore, the addition of recombinant HGF to A549-CM can recapitulate the YAP activation effect of BM3-CM in HUVEC (P<0.05). CONCLUSIONS Bone microenvironment reprogrammed bone-metastatic LUAD cells BM3 promote the proliferation, migration, and angiogenesis of HUVEC through the HGF/YAP axis, potentially playing a significant role in the modifications of the vascular niche.
Humans ; Hepatocyte Growth Factor/genetics* ; Signal Transduction ; Neovascularization, Pathologic/genetics* ; Human Umbilical Vein Endothelial Cells ; Bone Neoplasms/blood supply* ; Adenocarcinoma of Lung/genetics* ; Adaptor Proteins, Signal Transducing/genetics* ; Lung Neoplasms/genetics* ; Cell Movement ; Cell Proliferation ; YAP-Signaling Proteins ; Transcription Factors/genetics* ; Cell Line, Tumor ; Tumor Microenvironment ; Angiogenesis

BackgroundType 1 diabetes is caused by a chronic immune response that destroys islet beta cells， resulting in elevated blood glucose. Mesenchymal stem cells can prevent and treat the development of diabetes and its complications. However， little is known about the effects and potential mechanisms of Gingival mesenchymal stem cells （GMSCs） in preventing diabetes. The aim of this study is to investigate the mechanism of GMSCs in preventing type 1 diabetes in mice and to find targets for clinical treatment of diabetes. MethodsWe injected human GMSCs into NOD mice to observe the trend of blood glucose， observed the survival of pancreatic β-cells by immunohistochemistry， and detected the change of immune cells in the spleen of mice by flow analysis. Finally， the immune cells in NOD mice were transfused into NOD-SCID mice to observe the onset of diabetes in NOD-SCID mice. ResultsGMSCs significantly reduced the incidence of diabetes in NOD mice， with 64% of control mice developing diabetes at 27 weeks of age compared with 35% in the GMSC group， P=0.013. The percentage of Follicular B cells（FO B cell） in the spleen of GMSCs-treated mice decreased from （52.2±4.1）% to （43.2±5.3）%， P=0.008， while other types of immune cells did not change significantly. The immunohistochemical results showed that GMSCs could effectively improve the survival of pancreatic β-cells， which could continuously produce insulin to control blood glucose. Finally， we found the spleen cells transfusion could prevent the development of diabetes in NOD-SCID mice. ConclusionGMSCs can reduce diabetes in mice by reducing FO B cells in the spleen.

OBJECTIVE: To study the effect of gradient shear stress on platelet aggregation by microfluidic chip Technology. METHODS: Microfluidic chip was used to simulate 80% fixed stenotic microchannel, and the hydrodynamic behavior of the stenotic microchannel model was analyzed by the finite element analysis module of sollidwork software. Microfluidic chip was used to analyze the adhesion and aggregation behavior of platelets in patients with different diseases, and flow cytometry was used to detect expression of the platelet activation marker CD62p. Aspirin, Tirofiban and protocatechuic acid were used to treat the blood, and the adhesion and aggregation of platelets were observed by fluorescence microscope. RESULTS: The gradient fluid shear rate produced by the stenosis model of microfluidic chip could induce platelet aggregation, and the degree of platelet adhesion and aggregation increased with the increase of shear rate within a certain range of shear rate. The effect of platelet aggregation in patients with arterial thrombotic diseases were significantly higher than normal group (P<0.05), and the effect of platelet aggregation in patients with myelodysplastic disease was lower than normal group (P<0.05). CONCLUSION The microfluidic chip analysis technology can accurately analyze and evaluate the platelet adhesion and aggregation effects of various thrombotic diseases unde the environment of the shear rate, and is helpful for auxiliary diagnosis of clinical thrombotic diseases.
Humans ; Microfluidics ; Platelet Adhesiveness ; Platelet Aggregation ; Blood Platelets/metabolism* ; Platelet Aggregation Inhibitors/pharmacology* ; Platelet Activation/physiology* ; Thrombosis