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.

Clinical practice guideline adaptation (hereinafter referred to as "guideline adaptation") is the consolidation and revision of existing high-quality guidelines so that the recommendations are better suited to the specific needs of different regions, thereby guiding optimal clinical practice. Currently, the guideline adaptations is increasing in number internationally, but their reporting quality still needs to be improved. In 2022, the RIGHT-Ad@pt guideline adaptation reporting checklist was released. It provides a detailed description of the guideline adaptation process and reporting content, which will significantly enhance the rigor, transparency, and standardization of guideline adaptations. This paper interprets and analyzes the 34 items on the checklist, with the aim of providing reference for guideline adapters to standardize the reporting process.

Recent studies have shown that stress can substantially facilitate breast cancer metastasis,which can be reduced by nonselective β1/β2-adrenergic receptor(β1/β2-AR)blocker.However,several side effects were identified.Thus,it is extremely warranted to explore more effective and better-tolerated β2-AR blocker.Currently,we demonstrated that baicalin(BA),a major bioactive component of Scutellaria bai-calensis Georgi,could significantly attenuate stress hormones especially epinephrine(Epi)-induced breast cancer cell migration and invasion in vitro.Mechanistically,we identified that β2-AR was a direct target of BA via the drug affinity responsive target stability(DARTS)combined with mass spectrum assay,and BA photoaffinity probe with pull-down assay,which was further confirmed by a couple of bio-physical and biochemical assays.Furthermore,we demonstrated that BA could directly bind to the Phe-193 and Phe-289 of β2-AR,subsequently inhibit cyclic adenosine monophosphate-protein kinase A-focal adhesion kinase(cAMP-PKA-FAK)pathway,and thus impede epithelial-mesenchymal transition(EMT),thereby hindering the metastatic progression of the chronic stress coupled with syngeneic and xenograft in vivo orthotopic and tail vein mouse model.These findings firstly identify BA as a potential β2-AR inhibitor in the treatment of stress-induced breast cancer metastasis.

Purpose/Significance To deeply analyze the research progress on the application of medical knowledge graph in the field of stroke,to discuss the problems of the development of stroke knowledge graph in China,and to put forward suggestions for the construc-tion of stroke knowledge graph.Method/Process By reviewing and analyzing the relevant literature,the application of medical knowledge graph in the field of stroke is sorted out and summarized.Result/Conclusion There are still many deficiencies in the development of stroke knowledge graph in China,and in the future,in-depth research can be carried out from four aspects,namely,expanding the ap-plication scope of knowledge graph,promoting the fusion of knowledge graph,developing more efficient algorithms,and upgrading to cog-nitive graph by joint artificial intelligence(AI).

Cancer toxin is the key pathogenesis of malignant tumors. The basic principle of cancer treatment is “dispelling pathogen and resolving toxins， reinforcing healthy qi and reinforcing the foundation”. As one of the “eight methods of anticancer and detoxification”， the counteracting toxin with toxin therapy is a commonly used clinical treatment of malignant tumors. This paper discussed the method of counteracting toxin with toxin and its application in the prevention and treatment of malignant tumors from the aspects of history tracing， academic connotation， application principles and clinical application. Toxic Chinese medicinals with anticancer function are required to eliminate cancer toxins based on the principles of excessive cancer toxicity and plentiful healthy qi， as well as in accordance with the various stages and classifications of tumors， thereby improving the theoretical connotation of the method of counteracting toxin with toxin， and promoting the popularization and application of the pathogenesis theory of cancer toxin in the prevention and treatment of malignant tumors.

Objective: To detect the prevalence of sleep disorders among metro staff and to analyze influencing effects of effort reward imbalance (ERI) on it. Methods: In January 2015, subway driver, dispatcher and station operator from Guangzhou subway were selected as the research object in the whole group sampling method. A total of 1200 questionnaires were distributed and 1124 were valid questionnaires, and the effective questionnaire recovery rate was 93.7%. Based on the effort reward imbalance questionnaire and the self-administered sleep questionnaire, the data of the general demographic characteristics, life satisfaction, occupational stress and sleep status of the respondents were collected. Epi.data3.1 and spss19.0 were used for analyzing. Results: A total of 1124 subway employees were surveyed, with an average age of (28±5) years; the working age was (4.5±3.6) years. ERI occupied 24.7% (278/1124) of the study population and sleep disorders as 42.2% (474/1124) . Single factor analysis showed that marital status, educational level, work position, life satisfaction and ERI could significantly influence sleep disorders of metro staff (P<0.05) . Logistic regression showed that higher effort (adjusted OR=2.56, 95%CI: 1.79-3.68) , lower reward (adjusted OR=1.90, 95%CI: 1.34-2.68) and ERI (adjusted OR=2.33, 95%CI: 1.69-3.22) could increase the risk of sleep disorders after the confounding factors were controlled. ERI (adjusted OR=2.89, 95% CI: 1.80-4.64) , and over commitment (adjusted OR=4.64, 95%CI: 2.81-7.68) could influence the risk of sleep disorders independently when over commitment was evaluated as a moderating variable. Conclusion Occupational stress as ERI could influence the risk of sleep disorders among metro staff. The situation should not be neglected for occupational health of metro staff.

Objective: To explore the mediating role of over-commitment in the relationship between occupational stressors and job burnout, and to offer more specificevidence-based information in exploring the work related health effects of over-commitment. Methods: A total of 1994 samples from electronic manufacturing service industry were collected in Guangdong province based on self-rated questionnaire after written consent from June to July, 2015. The Effort-Reward Imbalance questionnaire and Maslach Burnout Invertory-General Survey were used for the measurement of occupational stress and job burnout. And hierarchical regression and Bootstrap test were conducted for data analysis. Results: High effort (0.28, 0.24-0.33) and low reward (-0.37, -0.42--0.33) were significantly associated with high over-commitment when gender, age and position had been controlled. Standardizedregression coefficient of effort to emotional exhaustion, depersonalization and personal accomplishment were 0.63 (95%CI: 0.54-0.71) 、0.18 (95%CI: 0.10-0.26) 、0.32 (95%CI: 0.21-0.43) , P<0.05; and standardized regression coefficient of reward to emotional exhaustion, depersonalization and personal accomplishment were-0.60 (95%CI: -0.68--0.52) 、-0.93 (95%CI: -1.01--0.86) 、-0.46 (95%CI: -0.35--0.58) , P<0.05. Bootstrap test indicated the mediation of over-commitment were statistically significant, and mediating effect ranges from 0.093 to 0.218 (P<0.05) . Conclusion Over-commitment can mediate the relationship between occupational stressors (job effort and reward) and burnout, and the effect varies from different workingconditions.

Objective To study serum insulin level change and its clinical significance in the patients with chronic kidney dis-ease (CKD).Methods 800 cases of patients with chronic kidney disease were observed with 400 cases of healthy people as control group at the same time.According to whether there was a complication of diabetic,chronic nephropathy was divided into two groups:diabetic nephropathy chronic renal failure group (425 cases)and non-diabetic nephropathy chronic renal failure (375 cases).According to the classification standard,chronic renal failure and the diabetic nephropathy group was di-vided into four groups:type 1 diabetes (105 cases),type 2 diabetes (135 cases),gestational diabetes (95 cases),diabetes with other reasons(90 cases).Relevant clinical information was collected,including age,gender,height,weight,and the cor-responding body mass index (BMI)was calculated based on height and weight.After some laboratory examinations,related parameters of the research were collected,including object of urea(Urea),serum creatinine (SCr),fasting plasma glucose (FPG),fasting insulin (FIns).According to the corresponding formula,insulin sensitive index (ISI)and glomerular filtration rate (GFR)were calculated based on the above parameters.Statistical comparison was made after collection.Results Urea, Scr,FPG and FIns of the patients with chronic kidney disease were significantly higher than those of normal control group (t=36.788,35.612,137.216,9.294;all P=0.000 respectively).Age,gender and BMI calculatedfrom height and weight in three groups had differences,but they were not statistically significant (F=1,363,P=0.256;F=1.577,P=0.454;F=1.641,P=0.194),and had no effect on the occurrence of chronic kidney disease development.Comparison of patients with different types of diabetes and chronic kidney disease,when a group had higher FIns and lower ISI,it also had a smaller GFR,and the differences between groups were statistically significant (F=12.01,P=0.000;F=3.891,P=0.009;F=3.774,P=0.011).Conclusion The serum insulin were closely related to CKD.Observing the serum insulin can have a dee-per understanding of the disease development,make a more effective treatment and predict the probability to be recover.

To investigate the effects of miRNA-10b(miR-10b)on breast cancer proliferation and apoptosis in MCF-7 and MDA-MB-231, the miR-10b mimics used to increase the endogenous expression of miR-10b, and miR-10b inhibitor used to decrease the endogenous expression of miR-10b, were stably transfected into MCF-7 and MDA-MB-231 breast cancer cells. The expression level of miR-10b was determined by real-time PCR. The effects of miR-10b on proliferation were evaluated by MTT assay, while cell cycle assay and the apoptosis rate were measured by flow cytometry. Bioinformatic software was used to predict the potential targets of miR-10b, and 3′UTR luciferase reporter and qRT-PCR assay were used to verify a direct target of miR-10b. The expression levels of caspase-3 and p21 protein were measured by Western blot. Results confirmed that over-expression of miR-10b could promote the proliferation of breast cancer cells and inhibit the apoptosis by up-regulating the endogenous miR-10b, while the miR-10b inhibitor could restrain the proliferation of breast cancer cells and increase the apoptosis by reducing the endogenous miR-10b. In conclusion, miR-10b could negatively regulate the expression of caspase-3 and p21 by targeting TP53INP1, hence highlighting its potential as an oncogene in breast cancer cells.

Mounting evidence has demonstrated that CD4(+) T cells play an important role in anti-tumor immune responses. Thus, adoptive transfer of these cells may have great potential for anti-cancer therapy. However, due to the difficulty to generate sufficient tumor-specific CD4(+) T cells, the use of CD4(+) T cells in tumor therapy is limited. It has been found that IL-15 transfection enhances the proliferation and anti-tumor activity of tumor-specific CD8(+) T cells, but the effect of IL-15 transfection on CD4(+) T cells remains unknown. Here, the effects of retrovirus-mediated IL-15 expression in Ova-specific CD4(+) T cells from Do11.10 mice were evaluated and it was discovered that IL-15 transfected CD4(+) T cells expressed both soluble and membrane-bound IL-15. Retrovirus-mediated IL-15 expression led to a selective expansion of antigen-specific CD4(+) T cells by inhibiting their apoptosis. In vivo IL-15 transfected CD4(+) T cells were more effective in suppressing tumor growth than control retroviral vector transfected ones. To ensure the safety of the method, the employment of thymidine kinase gene made it possible to eliminate these transgenic CD4(+) T cells following ganciclovir treatment. Together, we show that IL-15 transfection induced a selective expansion of antigen-specific CD4(+) T cells ex vivo and enhanced their tumor-suppression effects in vivo. This has an important significance for improving the efficacy of adoptive T cell therapy.
Animals ; Antineoplastic Agents ; pharmacology ; CD4-Positive T-Lymphocytes ; cytology ; drug effects ; immunology ; Cell Proliferation ; drug effects ; Cells, Cultured ; Gene Expression Regulation ; Genetic Vectors ; genetics ; Humans ; Interleukin-15 ; metabolism ; Mice ; Mice, Transgenic ; Neoplasms ; drug therapy ; Recombinant Fusion Proteins ; genetics ; Retroviridae ; genetics