ObjectiveTo investigate the effect of nicotinamide adenine dinucleotide on vascular endothelial injury in hypertension and its molecular mechanism. MethodsC57BL/6J mice were randomly divided into saline group （Saline） and hypertension group （Ang Ⅱ， which were infused with Ang Ⅱ via subcutaneously implanted osmotic pumps）， and supplemented daily with nicotinamide mononucleotide （300 mg/kg）， a precursor of NAD⁺. Blood pressure， endothelial relaxation function and pulse wave velocity were measured after 4 weeks. Wound healing assay and adhesion assay were used to evaluate the function of endothelial cells in vitro. mtROS levels were detected by immunofluorescence staining. RT-PCR was used to detect the mRNA expression of mtDNA， SIRT3 and isocitrate dehydrogenase 2 （IDH2）. 8-hydroxy-2'-deoxyguanosine levels were detected by enzyme-linked immunosorbent assay. The protein expression levels of p-eNOS， eNOS， SIRT3 and IDH2 were detected by Western blot. ResultsNMN supplementation reduced blood pressure （P<0.001） and improved endothelial function and arterial stiffness （P<0.001） in hypertensive mice. In vitro， NMN improved endothelial function in AngII-stimulated endothelial cells （P<0.05） and attenuated mitochondrial oxidative stress levels （P<0.001）. Mechanistically， NMN elevated SIRT3 activity （P<0.001）， which subsequently enhanced IDH activity （P<0.001） and reduced oxidative stress levels in endothelial cells. Conversely， knockdown of IDH2 would reverse the effect of SIRT3 in improving endothelial function （P<0.001）. ConclusionNAD⁺ lowers blood pressure and enhances vascular function in hypertension by reducing the level of oxidative stress in endothelial cells through activation of the SIRT3/IDH2 signal pathway.

Objective To analyze the clinical features of chronic obstructive pulmonary disease (COPD) patients with heart failure (HF) in Nanjing and explore the influencing factors. Methods A total of 773 COPD inpatients were selected from January 2021 to January 2024 in Nanjing Combined Hospital of Traditional Chinese and Western Medicine, Nanjing Qixia District Hospital, Nanjing Lishui District People's Hospital, Nanjing Pukou District Hospital of Traditional Chinese Medicine and Nanjing First Hospital., and were divided into 2 groups according to the presence or absence of combined HF. The general data and medical records of the two groups were compared, the clinical characteristics of COPD patients with HF were summarized, and the influencing factors of COPD patients with HF were analyzed by multivariate logistic regression. Results Among the 242 patients (31.31%) with COPD had HF, chronic paroxysmal dyspnea was the most common first symptom, 169 patients (69.83%) had left heart failure, 63 patients (30.17%) were diagnosed as right heart failure or global heart failure , 17 patients (7.02%) had myocardial infarction. Multivariate logistic regression analysis showed that the risk of HF was 1.678 times and 1.691times higher in COPD groups ≥ 50 years old and male COPD groups than in < 50 years old and female groups, respectively; the risk of HF was 1.491 times higher in COPD groups engaged in physical work than in physical work groups; the risk of HF was 1.447 times and 1.580 times higher in COPD groups with hypertension and coronary heart disease than in COPD groups without hypertension and coronary heart disease, respectively; the risk of HF was 1.859 times higher in COPD groups smoking>400 vial/year than in COPD groups≤400 vial/ year; the risk of HF was 1.757 times higher in COPD groups with acute exacerbation frequency≥2 times/year than in COPD groups<2 times/year; the above differences were statistically significant (P<0.05). Conclusion Attention should be paid to elderly, male and heavy physical work group of COPD patients. Active treatment of hypertension and coronary heart disease, effective tobacco control and reduction of the frequency of acute exacerbation are effective ways to reduce the risk of HF in COPD patients in Nanjing.

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.

China is a high-incidence region for gastric cancer globally. The disease is characterized by a high morbidity rate, low early diagnostic rate, and poor long-term outcomes, imposing a significant burden on both patients and society. Therefore, exploring the pathogenesis of gastric cancer, developing novel therapeutic strategies, and identifying new drug targets is of great importance. Telomerase expression is broadly associated with cancer cell targeting, and its up-regulation is one of the key factors driving the initiation and progression of gastric cancer. Additionally, telomerase is intricately involved in the regulation of autophagy and autophagy-associated cell death. While autophagy can induce chemoresistance, excessive autophagy may lead to cell death, which also constitutes one of the mechanisms of chemotherapy. Telomerase not only directly contributes to gastric cancer pathogenesis but also indirectly influences its development and treatment by modulating autophagy and autophagic cell death. Therefore, telomerase holds promise as a novel therapeutic target in gastric cancer.
Humans ; Stomach Neoplasms/genetics* ; Telomerase/genetics* ; Autophagy/physiology*

Objective To establish a human monocytic THP-1 macrophage-derived foam cell model and analyze the role of the α subunit of coatomer protein Ⅰ(α-COP)in apolipoprotein A-1(apoA-1)-mediated cholesterol efflux from foam cells.Methods THP-1 cells were induced to adhere using PMA(PMA group),followed by treatment with acetylated low-density lipoprotein(Ac-LDL)to generate macrophage-derived foam cells(Ac-LDL group).Subsequent incubation with apoA-1 formed the apoA-1 group.Cholesterol efflux rates mediated by apoA-1 and intracellular lipid accumulation were quantified through liquid scintillation counting and oil red O staining.The expression patterns of α-COP were systematically analyzed using quantitative real-time PCR(qPCR),Western blotting,and laser scanning confocal microscopy.THP-1 macrophage-derived foam cells mediated by apoA-1 were transduced with scrambled shRNA(Scr group)or α-COP-specific shRNA lentivirus(α-COP shRNA group)to assess the effects of α-COP knockdown on cholesterol efflux efficiency and total cellular cholesterol content.Subcellular localization of adipopoilin(ADFP)and cholesterol probe Fil-ipin Ⅲ staining patterns were visualized via laser scanning confocal microscopy.Bioinformatics analysis of α-COP expression profiles in carotid atherosclerotic plaques was performed using datasets from the GEO data-base.Results Compared with the Ac-LDL group,the cholesterol efflux rate in the apoA-1 group was signifi-cantly increased[(9.77±0.79)%vs.(2.74±0.37)%,P＜0.001].Oil red O staining demonstrated reduced lipid accumulation in foam cells of the apoA-1 group compared with the Ac-LDL group.The relative mRNA expression level of α-COP in the apoA-1 group was significantly higher than that in the Ac-LDL group(P＜0.001),with corresponding elevation in protein expression(P＜0.001).Fluorescence intensity analysis re-vealed increased mean fluorescence intensity of α-COP in the apoA-1 group compared with the Ac-LDL group.Following α-COP knockdown by shRNA,the apoA-1-mediated cholesterol efflux rate was significantly de-creased(P＜0.05)and total intracellular cholesterol levels were increased(P＜0.001)in the α-COP shRNA group compared with the Scr group.The α-COP shRNA group exhibited enhanced red fluorescence intensity of ADFP(P＜0.05)and increased blue fluorescence intensity of Filipin Ⅲ(P＜0.01)compared with the Scr group.Database analysis indicated that α-COP mRNA expression was lower in carotid atherosclerotic plaques than in normal arterial tissues,with reduced expression in advanced-stage plaques compared with early-stage plaques(P＜0.05).Conclusion α-COP participates in apoA-1-mediated cholesterol efflux from foam cells,and interference with α-COP expression results in reduced cholesterol efflux and increased intracellular lipid accumulation.

Objective To evaluate the clinical efficacy of dynamic muscle-regulating acupuncture combined with warm needling in treating cervical spondylotic radiculopathy(CSR).Methods Sixty patients diagnosed with CSR at the Acupuncture Department of Dongguan Traditional Chinese Medicine Hospital from July to December 2024 were enrolled and randomly divided into an observation group and a control group using a random number table,with 30 cases in each group.The control group received warm needling therapy,while the observation group received additional dynamic muscle-regulating acupuncture.Treatments were administered three times weekly for a total of 10 sessions(one treatment course).After 10 sessions,clinical efficacy was evaluated,and total effective rates,changes in Yasuhiko Tanaka's cervical spondylosis symptom scale scores,Visual Analogue Scale(VAS)of pain scores were observed.The cervical range of motion(ROM),and incidence of adverse reactions were evaluated.Results(1)The total effective rate of the observation group was 93.33%(28/30),and the control group was 80.00%(24/30).The clinical efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P＜0.05).(2)After treatment,the cervical spondylosis symptom scale scores of Yasuhisa Tanaka in the two groups significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the cervical spondylosis symptom scale scores of Yasuhisa Tanaka,with a statistically significant difference(P＜0.05).(3)After treatment,the VAS scores of patients in the two groups significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the VAS scores,and the difference was statistically significant(P＜0.05).(4)After treatment,the cervical joint mobility of patients in the two groups significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving cervical joint mobility,with a statistically significant difference(P＜0.05).(5)The incidence rate of adverse reactions in the observation group was 3.33%(1/30);there were no adverse reaction events in the control group.The difference in the incidence rate of adverse reactions between the observation group and the control group was not statistically significant(P＞0.05).Conclusion The combination of dynamic muscle-regulating acupuncture and warm needling effectively improves cervical function,alleviates pain symptoms,and demonstrates high safety with significant clinical efficacy in treating CSR.

Objective:To investigate the current application of blood purification in the treatment of acute poisoning within Jiangsu Province and to evaluate the impact of extracorporeal blood purification on the clinical outcomes of critically poisoned patients.Methods:This multicenter, cross-sectional real-world observational study followed patients presenting with poisoning to the emergency departments of nine hospitals in Jiangsu Province between June 2015 and May 2019. Data were collected on demographic characteristics, vital signs within the first hour of emergency presentation, treatment modalities, length of hospital stay, and survival outcomes. Clinical data from patients who underwent extracorporeal blood purification were compared with those who did not, using the Wilcoxon rank-sum test and Chi-square test.Results:A total of 4 178 poisoning cases were included between June 2015 and May 2019. Among them, 21.7% (908/4 178) received blood purification therapy, while 78.3% (3 270/4 178) did not. Hemoperfusion (90.4%) was the most frequently employed method, followed by continuous renal replacement therapy (CRRT) (4.4%). In combined blood purification modalities, 4.8% underwent hemoperfusion combined with CRRT, 0.1% received hemoperfusion with plasma exchange, and another 0.1% underwent hemoperfusion combined with both CRRT and plasma exchange. Among patients who underwent blood purification, pesticide poisoning was the most prevalent (76.3%), with the most common toxic agents being paraquat (23.7%), dichlorvos (8.7%), methamidophos (5.2%), omethoate (4.0%), and glyphosate (3.7%). Compared to the non-blood purification group, patients in the blood purification group were more likely to present within the first hour with a low Glasgow Coma Scale (GCS) score (3-8) (22.6% vs. 9.7%, P <0.05), low mean arterial pressure (8.0% vs. 3.2%, P <0.05), longer hospital stays [5(3,9) days vs. 2(1,4) days, P <0.05] and a higher in-hospital mortality rate (21.1% vs. 5.3%, P <0.05). Follow-up via telephone 28 days after discharge revealed a survival rate of 78.9%, with a mortality rate of 21.1% in the blood purification group. Conclusions:Hemoperfusion is the most commonly utilized blood purification technique for treating poisoning in Jiangsu Province, with pesticides being the primary toxic agents treated. Although the mortality rate is higher in the blood purification group, the intervention may still contribute to improved patient outcomes.

Objective To explore the value of serum leucine-rich-alpha-2-glycoprotein-1(LRG1)and CC motif chemokine ligand 19(CCL19)detecting levels in children with henoch-schonlein purpura nephritis(HSPN)for early clinical diagnosis and prognosis.Methods A sum of 108 children with HSPN who were treated at Handan Central Hospital from May 2021 to May 2023 were selected as the study subjects,meantime,72 healthy children were as the control group.The levels of LRG1,CCL19,IgM,IgA,and IgG in serum were detected.Logistic regression method was applied to analyze the influencing factors of HSPN,receiver operating characteristic was applied to evaluate the clinical value of LRG1 and CCL19 levels for early diagnosis of HSPN in children.The differences in serum LRG1 and CCL19 levels among children with HSPN in the acute,chronic,and recovery stages were analyzed,Spearman correlation was applied to analyze and explore the correlation between serum LRG1,CCL19 levels and the duration of HSPN in children.Results The levels of LRG1(184.36±23.64 ng/L)and CCL19(463.19±89.46 ng/L)in the HSPN group were obviously higher than those in the control group(149.42±18.29 ng/L,208.83±52.97 ng/L),and the differences were significant(t=10.600,21.710,all P＜0.05).The Logistic regression results showed that LRG1[OR(95％CI):1.429(1.057～1.933)]and CCL19[OR(95％CI):1.842(1.216～2.791)]were both influencing factors for the occurrence of HSPN in children(P＜0.05).According to the analysis of receiver operating characteristic(ROC),the areas under the curve(AUC)of serum LRG1,CCL19 and their combined diagnosis of HSPN in children were 0.868,0.881 and 0.952,respectively,and their combined application in clinical diagnosis was better than that of serum LRG1 and CCL19 in their separate diagnosis(Z=3.147,3.487,all P=0.001).The levels of LRG1(203.49±24.89 ng/L,177.56±23.19 ng/L)and CCL19(591.13±98.32 ng/L,415.61±89.82 ng/L)in the serum of HSPN patients in the acute and chronic stages were obviously higher than those in the rehabilitation stage(158.53±21.96 ng/L,295.17±69.61 ng/L),and the differences were significant(t=6.917,12.101;5.320,3.102,all P＜0.05),while the levels of LRG1 and CCL19 in the serum of HSPN patients in the acute stage were obviously higher than those in the chronic stage,and the differences were significant(t=5.059,8.750,all P＜0.05).Spearman correlation analysis showed that the serum levels of LRG1 and CCL19 in children with HSPN were positively correlated with their course of disease(r=0.506,0.689,all P＜0.001).Conclusion The levels of serum LRG1 and CCL19 are elevated in HSPN children,and combined detection of serum LRG1 and CCL19 can improve the early clinical diagnostic value of HSPN and evaluate the prognosis of children with HSPN.

Objective:To observe the effects of nutritional status on the surgical outcomes, nutritional indicators, and renal anemia of maintenance hemodialysis patients with secondary hyperparathyroidism undergoing parathyroidectomy.Methods:A retrospective study was conducted on 35 patients who underwent maintenance hemodialysis with secondary hyperparathyroidism at Huadu District People′s Hospital of Guangzhou from January 2016 to January 2021. All patients underwent total parathyroidectomy with autologous forearm transplantation due to ineffective drug treatment. Before surgery, patients were divided into three groups based on their nutritional status scores: no malnutrition group (0-1 points), mild malnutrition group (2-4 points), and moderate to severe malnutrition group (5-12 points). The changes in serum parathyroid hormone, blood calcium, blood phosphorus, blood albumin, and other indicators were observed at different time points before and after surgery in different groups of patients.Results:The serum parathyroid hormone, blood phosphorus, and calcium phosphorus product of maintenance hemodialysis patients with different nutritional status who underwent parathyroidectomy at 3, 6, and 12 months were significantly decreased compared with preoperative levels, and the differences were statistically significant (all P<0.05). There were no significant changes in albumin, lymphocyte count, and total cholesterol levels in patients without malnutrition at 3, 6, and 12 months after surgery compared with preoperative levels (all P>0.05); The lymphocyte count of patients with mild malnutrition increased significantly at 6 and 12 months after surgery compared to preoperative levels (all P<0.05). The levels of albumin and total cholesterol in patients with moderate to severe malnutrition increased significantly at 3, 6, and 12 months after surgery compared with preoperative levels (all P<0.05). The Hb levels of patients without malnutrition and those with mild malnutrition increased significantly at 6 and 12 months after surgery compared with preoperative levels (all P<0.05); The Hb levels of patients with moderate to severe malnutrition increased significantly at 3, 6, and 12 months after surgery compared with preoperative levels (all P<0.05). Conclusions:Nutritional status affects the long-term outcomes of parathyroidectomy in hemodialysis patients, and parathyroidectomy can significantly improve the nutritional and anemia status of hemodialysis patients with secondary hyperparathyroidism. This effect is more pronounced in patients with moderate to severe malnutrition before surgery.