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.

Objective:To compare the clinical efficacy and safety of different myotomy procedures during peroral endoscopic myotomy (POEM) for achalasia (AC).Methods:A retrospective study was conducted involving patients diagnosed as having achalasia and underwent POEM at Peking Union Medical College Hospital from April 2020 to October 2023. Patients were divided into conventional myotomy group, short myotomy group and full-thickness myotomy group according to myotomy length and depth. Outcomes including operation duration, procedure-related complications, efficacy and incidence of postoperative reflux esophagitis were compared between conventional vs. short, and conventional vs. full-thickness groups.Results:Among 70 patients, 26 underwent conventional myotomy, 19 short myotomy, and 25 full-thickness myotomy. The short myotomy group demonstrated significantly shorter procedure duration (72.89±20.57 min) compared to the conventional group (91.81±36.70 min, t=2.197, P=0.034). There were no statistically significant differences in procedure-related complications [26.3% (5/19) VS 34.6% (9/26), χ2=0.353, P=0.553], treatment efficacy [94.7% (18/19) VS 96.2% (25/26), χ2=0.052, P=0.820], or incidence of postoperative reflux esophagitis [50.0% (5/10) VS 41.7% (5/12), χ2=0.306, P=0.580] between the short and conventional myotomy groups. No statistically significant differences were observed between the conventional and full-thickness myotomy group in procedure duration (99.64±29.13 min VS 91.81±36.70 min, t=0.336, P=0.404), procedure-related complications [28.0% (7/25) VS 34.6% (9/26), χ2=0.259, P=0.611], treatment efficacy [96.0% (24/25) VS 96.2% (25/26), χ2=0.001, P=0.977], or incidence of postoperative reflux esophagitis [35.7% (5/14) VS 41.7% (5/12), χ2=0.022, P=0.883]. Conclusion:Short myotomy POEM achieves comparable efficacy to conventional myotomy with reduced operative time and no increased complication risk. Full-thickness myotomy demonstrates similar efficacy, operative duration, and safety to conventional myotomy.

Programmed cell death 1 (PD-1) inhibitor therapy for lung adenocarcinoma may induce rare but severe hematologic adverse events, including severe anemia. Although glucocorticoids are recommended for managing immune-related adverse events, therapeutic experience with PD-1 inhibitor-induced severe anemia remains limited, and its efficacy and safety have not been fully validated. This article reports a case of advanced lung adenocarcinoma in which severe anemia developed following combination therapy with chemotherapy and PD-1 inhibitor. After comprehensive evaluation, the patient was diagnosed with anemia of inflammation (AI) and achieved significant hemoglobin recovery following high-dose glucocorticoid treatment. These findings may provide new insights into the recognition and management of this rare hematologic toxicity in clinical practice.
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Humans ; Adenocarcinoma of Lung/drug therapy* ; Programmed Cell Death 1 Receptor/antagonists & inhibitors* ; Anemia/etiology* ; Immunotherapy/adverse effects* ; Lung Neoplasms/immunology* ; Male ; Antibodies, Monoclonal/therapeutic use* ; Middle Aged

Objective:To compare the clinical efficacy and safety of different myotomy procedures during peroral endoscopic myotomy (POEM) for achalasia (AC).Methods:A retrospective study was conducted involving patients diagnosed as having achalasia and underwent POEM at Peking Union Medical College Hospital from April 2020 to October 2023. Patients were divided into conventional myotomy group, short myotomy group and full-thickness myotomy group according to myotomy length and depth. Outcomes including operation duration, procedure-related complications, efficacy and incidence of postoperative reflux esophagitis were compared between conventional vs. short, and conventional vs. full-thickness groups.Results:Among 70 patients, 26 underwent conventional myotomy, 19 short myotomy, and 25 full-thickness myotomy. The short myotomy group demonstrated significantly shorter procedure duration (72.89±20.57 min) compared to the conventional group (91.81±36.70 min, t=2.197, P=0.034). There were no statistically significant differences in procedure-related complications [26.3% (5/19) VS 34.6% (9/26), χ2=0.353, P=0.553], treatment efficacy [94.7% (18/19) VS 96.2% (25/26), χ2=0.052, P=0.820], or incidence of postoperative reflux esophagitis [50.0% (5/10) VS 41.7% (5/12), χ2=0.306, P=0.580] between the short and conventional myotomy groups. No statistically significant differences were observed between the conventional and full-thickness myotomy group in procedure duration (99.64±29.13 min VS 91.81±36.70 min, t=0.336, P=0.404), procedure-related complications [28.0% (7/25) VS 34.6% (9/26), χ2=0.259, P=0.611], treatment efficacy [96.0% (24/25) VS 96.2% (25/26), χ2=0.001, P=0.977], or incidence of postoperative reflux esophagitis [35.7% (5/14) VS 41.7% (5/12), χ2=0.022, P=0.883]. Conclusion:Short myotomy POEM achieves comparable efficacy to conventional myotomy with reduced operative time and no increased complication risk. Full-thickness myotomy demonstrates similar efficacy, operative duration, and safety to conventional myotomy.

The development of inflammatory bowel diseases (IBD) is associated with genetics, environment, immune abnormalities, and intestinal flora, including ulcerative colitis (UC) and Crohn′s disease (CD). Hypoxia-inducible factor-1α (HIF-1α) is a transcription factor that promotes the expression of multiple genes in response to the hypoxic environment, and its roles in regulating intestinal barrier function, intestinal metabolism, and inflammatory and immune responses are research hotspots. This article reviews the role of HIF-1α in IBD by analyzing the relationships between HIF-1α and intestinal epithelial barrier and inflammatory response to provide new ideas for the clinical treatment of IBD.

OBJECTIVE To identify key factors involved in the regulation of hypoxia-induced inflammation-related signaling pathways using a combination of bioinformatics methods and experiments. METHODS A cellular model of hypoxia-induced hippocampal neuronal damage was prepared by treating mouse hippocampal neuronal HT22 cells with CoCl2. The cells were then collected for transcriptome sequencing. Based on the sequencing results,key molecules were identified using differential analysis,gene ontology(GO) function and Kyoto Encyclopedia of Genomes(KEGG) pathway analysis,and protein-protein interaction network(PPI) analysis. The effects of key molecules on cells were investigated. RESULTS Differential analysis revealed a total of 8975 differential genes,which were subjected to GO and KEGG analysis. KEGG analysis revealed that these genes were involved in signaling pathways such as pancreatic cancer,EGFR tyrosine kinase inhibitor resistance,animal mitosis,base excision repair,and chronic myeloid leukemia. PPI networks were constructed for genes enriched in these pathways,and the MCC algorithm screened the top 5 key genes,which were shown to be HRAS,KRAS,PTEN,VEGFA,and SRC. HRAS and VEGFA were selected for subsequent experiments,and the results showed that after CoCl2 treatment,the viability of HT22 cells was significantly decreased(P<0.05),HRAS was significantly down-regulated and VEGFA was significantly up-regulated in CoCl2-treated cells(P<0.05),the levels of TNF-α,IL-1β,and IL-6 were significantly increased(P<0.001). However,treatment with overexpression of HRAS or low expression of VEGFA led to an increase in the activity of cell growth(P<0.05) as well as a significant decrease in TNF-α,IL-1β,and IL-6 levels(P<0.001). CONCLUSION In sleep apnea,HRAS or VEGFA may lead to cognitive impairment by affecting inflammatory factors.

The development of inflammatory bowel diseases (IBD) is associated with genetics, environment, immune abnormalities, and intestinal flora, including ulcerative colitis (UC) and Crohn′s disease (CD). Hypoxia-inducible factor-1α (HIF-1α) is a transcription factor that promotes the expression of multiple genes in response to the hypoxic environment, and its roles in regulating intestinal barrier function, intestinal metabolism, and inflammatory and immune responses are research hotspots. This article reviews the role of HIF-1α in IBD by analyzing the relationships between HIF-1α and intestinal epithelial barrier and inflammatory response to provide new ideas for the clinical treatment of IBD.

As the major part of mesencephalic locomotion region, pedunculopontine tegmental nucleus (PPN) participates in motor initiation, rhythmic and speed regulation. In addition, PPN is regarded as a novel deep brain stimulation target for patients with Parkinson′s disease due to its dramatic effect on the gait disturbance and postural instability. However, PPN also has an important role in muscle tone control and dystonia. This review is aimed at summarizing the involvement of PPN in dystonia, providing fundamental for targeting PPN for treatment of dystonia in the future.

Objective:To investigate the occurrence of pain symptoms and risk factors of carpal tunnel syndrome (CTS) in automobile manufacturing workers and provide theoretical basis for the prevention of CTS.Methods:From Nov.5th to Nov.19th, 2017, 446 workers in an automobile factory whose work age was above one year participate in questionnaires by cluster sampling. Chi square test and multifactor logistics regression analysis were used to analyze the factors related to the occurrence of CTS pain symptoms in workers.Results:The incidence of CTS pain among workers in this automobile factory was 20.8%. Working in the same position for a long time ( OR=2.137, 95% CI:1.183-3.862) and unable to work reasonably because of uncomfortable posture ( OR =2.067, 95% CI: 1.075-3.974) were identified as the risk factors of CTS pain symptoms by multifactor logistics regression analysis. Working age ( OR=0.537, 95% CI:0.311-0.926) and work break ( OR= 0.489, 95% CI: 0.282-0.849) were identified as the benefit factors of CTS pain symptoms. Conclusion:The incidence of CTS pain in automobile manufacturing workers is related to the posture in the process of labor . Effective ergonomic interventions should be carried out to prevent the occurrence of CTS pain in automobile manufacturing workers.

Objective:To investigate the occurrence of pain symptoms and risk factors of carpal tunnel syndrome (CTS) in automobile manufacturing workers and provide theoretical basis for the prevention of CTS.Methods:From Nov.5th to Nov.19th, 2017, 446 workers in an automobile factory whose work age was above one year participate in questionnaires by cluster sampling. Chi square test and multifactor logistics regression analysis were used to analyze the factors related to the occurrence of CTS pain symptoms in workers.Results:The incidence of CTS pain among workers in this automobile factory was 20.8%. Working in the same position for a long time ( OR=2.137, 95% CI:1.183-3.862) and unable to work reasonably because of uncomfortable posture ( OR =2.067, 95% CI: 1.075-3.974) were identified as the risk factors of CTS pain symptoms by multifactor logistics regression analysis. Working age ( OR=0.537, 95% CI:0.311-0.926) and work break ( OR= 0.489, 95% CI: 0.282-0.849) were identified as the benefit factors of CTS pain symptoms. Conclusion:The incidence of CTS pain in automobile manufacturing workers is related to the posture in the process of labor . Effective ergonomic interventions should be carried out to prevent the occurrence of CTS pain in automobile manufacturing workers.