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*

BACKGROUND:Duhuo Jisheng Decoction is a classic prescription for the treatment of rheumatoid arthritis,but its specific mechanism is not clear.Extracellular vesicles have the powerful function of inter-cell communication and signal transmission,and may be the signal carrier for the Decoction.OBJECTIVE:To explore the effects of serum extracellular vesicles treated with Duhuo Jisheng Decoction on the proliferation,migration,invasion,and apoptosis of rheumatoid arthritis fibroblast-like synovial cells.METHODS:The rheumatoid arthritis fibroblast-like synovial cell model was established by co-culturing with tumor necrosis factor-α in vitro.The experiment was divided into five groups:normal group,model group,serum treated with Duhuo Jisheng Decoction group,extracellular vesicles treated with Duhuo Jisheng Decoction group,and extracellular vesicles treated with normal saline group.The optimal concentration and time of drug-containing serum and extracellular vesicles were screened by CCK-8 assay.Expression of inflammatory cytokines in the supernatants of cells in each group was detected by ELISA.The migration ability of rheumatoid arthritis fibroblast-like synovial cells was detected by scratch assay.The invasive ability of cells was measured by Transwell Invasion assay.Hoechst staining was adoped to detect cell apoptosis.The expression levels of apoptosis-related genes and proteins were detected by qRT-PCR and western blot assay.RESULTS AND CONCLUSION:(1)The optimal volume fraction of serum treated with Duhuo Jisheng Decoction was 10%and optimal mass concentration of extracellular vesicles treated with Duhuo Jisheng Decoction was 10 ng/mL;the optimal time for the interaction between the two was 24 hours.(2)Compared with the model group,serum treated with Duhuo Jisheng Decoction,extracellular vesicles treated with Duhuo Jisheng Decoction,and extracellular vesicles treated with normal saline could suppress the expression of inflammatory factors of rheumatoid arthritis fibroblast-like synovial cells(P<0.05),scratch healing(P<0.05),migration and invasion(P<0.05).Moreover,the inhibition of extracellular vesicles treated with Duhuo Jisheng Decoction was more significant(P<0.05).(3)Drug-containing serum and extracellular vesicles treated with Duhuo Jisheng Decoction promoted the apoptosis of rheumatoid arthritis fibroblast-like synovial cells.(4)Compared with the model group,serum treated with Duhuo Jisheng Decoction,extracellular vesicles treated with Duhuo Jisheng Decoction,and extracellular vesicles treated with normal saline could increase the expression of proapoptotic factors Caspase-3,Caspase-9,and Bax(P<0.05)and decrease the expression of antiapoptotic factor Bcl-2(P<0.05).Moreover,extracellular vesicles treated with Duhuo Jisheng Decoction had a more significant regulatory effect on apoptosis-related factors.Above findings indicate that extracellular vesicles treated with Duhuo Jisheng Decoction can inhibit the excessive proliferation,migration,and invasion of rheumatoid arthritis fibroblast-like synovial cells and promote their apoptosis.

Objectives:To evaluate the imaging effects of the novel sympathetic nerve imaging agent 18F-FPMBBG in healthy volunteers and heart failure patients.Methods:Four healthy volunteers and four heart failure patients were selected to undergo 18F-FPMBBG positron emission tomography/computed tomography(PET/CT)dynamic imaging,the radioactivity distribution characteristics of 18F-FPMBBG in the heart and adjacent organs of the two groups were observed,and the uptake of 18F-FPMBBG by the left ventricular myocardium was compared in the two groups.Results:No adverse effects were observed in all subjects after intravenous injection of 18F-FPMBBG.In healthy volunteers,the heart uptake was rapid and stable,lung uptake was very low,and the blood pool and liver clearance were fast.The heart/liver uptake ratios at 30,60,and 90 minutes after injection were 2.33±0.81,3.29±0.90 and 3.80±1.07,respectively.The average standard uptake value(SUVmean)of 18F-FPMBBG in the heart failure group was significantly lower than that in the healthy volunteer group(P=0.003).The washout rate(WR)was significantly higher in the heart failure group([16.53±2.76]%vs.[3.88±4.51]%,P=0.003).Conclusions:18F-FPMBBG showed good imaging and diagnostic effects in the preliminary imaging of healthy subjects and heart failure patients,and it has the potential to become an ideal cardiac sympathetic nerve imaging agent.

Background:To compare the efficacy and safety of monthly administrations of gonadotropin releasing hormone (GnRH) agonists LY01005 and Zoladex ? in Chinese patients with premenopausal breast cancer. Methods:From October 2020 to November 2021, 188 premenopausal breast cancer patients were enrolled in 34 hospitals and randomized 1:1 to receive either LY01005 or Zoladex ? every 28 days for a total of three injections. All patients concomitantly received oral tamoxifen (TAM). The primary efficacy endpoint was cumulative probability of maintaining menopausal level [oestradiol (E2) ≤30 pg/ml] from day 29 to day 85. The second efficacy endpoint included changes in E2, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) compared with the baseline. Pharmacokinetics (PK), pharmacodynamics (PD), and safety were analyzed. The study also evaluated the pharmacokinetic and pharmacodynamic characteristics of LY01005. Results:A total of 188 patients were randomised and 187 patients received either LY01005 or Zoladex ?. Cumulative probabilities of maintaining menopausal level (E2≤30 pg/ml) from day 29 to day 85 were 93.1% for LY01005 and 86.3% for Zoladex ?. The between-group difference was 6.8% (95% CI: -2.3%, 15.9%) and primary efficacy in the LY01005 group was not inferior to that in the Zoladex ? group. Changes in E2, LH, and FSH levels compared with the baseline were equivalent between the two groups (E2: 89.34% to 90.23% vs. 82.11% to 85.02%; LH: 88.89% to 95.52% vs. 89.70% to 97.02%; FSH: 75.36% to 80.85% vs.73.07% to 80.24%, respectively). After three consecutive doses of LY01005, the LH and FSH levels of the subjects showed a transient increase after the first dose, reached a peak on the second day and then started to decrease. The LH and FSH reached a lower level and remained at or below that level until the 85th day. Both treatments were well-tolerated. Conclusion:LY01005 is as effective as Zoladex ? in suppressing E2 to menopausal levels in Chinese patients with premenopausal breast cancer, with a similar safety profile.

Objective:To explore the feasibility and clinical application value of deep inspiration breath-hold SPECT pulmonary perfusion imaging (DBQ).Methods:Twenty-eight patients (15 males, 13 females, age (38±18) years) who had pulmonary diseases and visited China-Japan Friendship Hospital between September 2023 and February 2024 were prospectively included, including 18 pulmonary embolism cases, 5 chronic obstructive pulmonary disease cases, and 5 pulmonary interstitial fibrosis cases. All patients underwent DBQ, traditional pulmonary perfusion imaging (Q), and low-dose CT (LDCT). The acquisition parameters of DBQ were determined through National Electrical Manufactures Association (NEMA) International Electrotechnical Commission (IEC) phantom model research. The radioactive counts, three-dimensional registration error, and heterogeneity of DBQ and Q were compared using paired t test, while the comparison of detection rates for pulmonary embolism lesions was performed using McNemar test. Results:The radioactive counts of DBQ and Q were (3.6±0.6)×10 6 and (4.5±0.7)×10 6( t=2.48, P=0.018), respectively. In 18 patients with pulmonary embolism, compared with Q-LDCT, DBQ-LDCT detected 8 more lesions, thus increasing the detection rare (41 vs 33; χ2=8.69, P=0.004). Among the 28 patients, the registration errors between DBQ and LDCT vs Q and LDCT were (3.1±0.4) vs (8.2±0.8)mm ( t=3.82, P<0.001), respectively. The heterogeneity of DBQ was significantly different from that of Q (0.74±0.15 vs 0.85±0.11; t=2.38, P=0.029). Conclusion:DBQ shows better image quality and diagnostic effect than traditional perfusion imaging.

Objective:This study aims to explore clinical subtypes of Garden typeⅠfemoral neck fractures and develop corresponding reduction strategies based on the characteristics of the fractures.Methods:A retrospective analysis was conducted on the data of 256 patients with Garden type I femoral neck fractures admitted to Tianjin Hospital from January 2015 to January 2018. There were 89 males and 167 females included, with a mean age of 56.5±12.8 years (range, 17-86 years), and with 159 on the left side and 97 on the right side. According to the anteroposterior and lateral X-ray images, the fractures were further classified into two subtypes: 111 cases of Garden type I a (simple abduction without hypsokinesis of the femoral head), characterized by abduction and impaction of the femoral head on anteroposterior images, and no obvious hypsokinesis of the femoral head or only central impaction of the femoral head on lateral images; 145 cases of Garden I b type (femoral head abduction with hypsokinesis), characterized by abduction and impaction of the femoral head on anteroposterior images, and remarkable hypsokinesis on lateral images. The injury mechanism of type I a involved abduction and impaction caused by the violent extension, abduction, and external rotation of the hip joint. Mild flexion and adduction of the hip joint can be used to reduce the abduction and impaction. The injury mechanism of type I b is similar to type Ia in the first stage, but the violence continues to increase and leading to significant hypsokinesis of the femoral head. Reduction was achieved by excessive flexion, adduction, and mild internal rotation, tilting the femoral head backward to facilitate reduction. The surgical strategy were close reduction and cannulated screw fixation (three cannulated screws in an "inverted triangle" arrangement). Postoperatively, anteroposterior and lateral X-rays were taken immediately to assess the quality of reduction, including the Garden index, Lowell "S" curve, and screw placement. During follow-up, fracture healing and complications were recorded, and Harris score was used to evaluate hip joint function at the final follow-up.Results:All patients successfully received operative therapy and were followed up with a mean of 7.1±1.9 years (range, 5-10 years). Garden index showed 91.4%(234/256) achieved anatomical reduction, with an excellent reduction rate of 97.3%(249/256). The excellent rate of the Lowell "S" curve was 97.7%(250/256), and the excellent and good rate for screw insertion was 98.8%(253/256). All patients achieved primary fracture healing without infection, nonunion of fractures, failure of internal fixation, or other complications. Two patitents with Garden I b fractures (0.8%) developed femoral head necrosis due to premature weight-bearing at 9 and 12 months postoperatively, respectively, after fracture healing. However, with strict hip preservation treatment, their symptoms resolved without further progression of necrosis or need for reoperation. At the final follow-up, the mean Harris score was 93.9±4.5 points (range, 81-100 points), with an excellent and good rate of 98.8%(253/256).Conclusions:Garden I femoral neck fractures can be categorized into two subtypes based on their characteristics and injury mechanisms. Adopting corresponding reduction methods according to subtypes can achieve anatomical reduction and favorable early to mid-stage therapeutic outcomes (primary fracture healing and low incidence of femoral head necrosis).

Objective:To explore the feasibility of the new auxiliary analysis software in chromosomal aberration analysis of radiation workers during occupational health examinations.Methods:Health examination data of 2 469 radiation workers in Henan province were collected. Manual analysis of chromosomal aberrations in peripheral blood lymphocytes was conducted using the new auxiliary software and the Ikaros software. Then, the chromosomal aberrations detected using both software tools were compared.Results:The new auxiliary software yielded a lower chromosomal aberration rate among radiation workers compared with the Ikaros software [(0.314 ± 0.014)% vs. (0.391 ± 0.022)%, χ2 = 9.24, P = 0.002]. Notably, the new auxiliary software yielded a significantly lower rate of acentric fragments (ace) [(0.136 ± 0.009)% vs. (0.209 ± 0.020)%, χ2= 17.76, P < 0.001]. However, no statistically significant differences were observed between the result of the two software tools in the rates of dicentrics plus rings (dic + r) and translocations ( P > 0.05). According to the GBZ/T 248-2014 standard, the differences in abnormality rates of chromosomal aberrations between the two groups had no statistically significance ( P > 0.05), with both groups showing an abnormality rate of 0 for ace. Furthermore, the new auxiliary software could double the detection efficiency. Among pre-service radiation workers of various occupations, the differences in the chromosomal aberrations detected using the two software tools exhibited statistical significance ( χ2 = 10.26, P = 0.001). In contrast, the differences in the chromosomal aberrations among in-service and post-service radiation workers had no statistically different significance ( P>0.05). The Poisson regression analysis result demonstrated that the rate of chromosomal aberrations excluding ace was affected by age ( z = 2.73, P = 0.006), while gender, analysis method, service status, and occupation had no impact. Conclusions:The two software tools yielded largely consistent result in detecting chromosomal aberrations induced by exposure to ionizing radiation. Notably, the new auxiliary software can significantly improve detection efficiency, indicating the feasibility of applying it to chromosomal aberration analysis among radiation workers.

Objective To evaluate the clinical efficacy and safety of Huoxue Jiedu Prescription in the treatment of polycythemia vera with heat toxicity and blood stasis syndrome.Methods Totally 155 patients of polycythemia vera with heat toxicity and blood stasis syndrome from 5 hospitals including Langfang Traditional Chinese Medicine Hospital from October 2022 to March 2024 were collected.Patients were divided into an observation group(79 cases)and control group(76 cases)using a random number table method.Both groups received conventional Western medicine treatment.The observation group was given Huoxue Jiedu Prescription,one dosage per day,taken orally twice a day;both groups received one treatment course of one month,and three treatment courses were observed.The efficacy of Western medicine and TCM syndromes was observed,and the total symptom assessment scale of myeloproliferative neoplasms(MPN-10)scores,hematological indicators,coagulation function before and after treatment were compared.The safety indicators of the two groups were monitored.Results The control group and observation group lost 2 and 4 cases,respectively.The total effective rate of Western medicine in the observation group was 90.67%(68/75),while the control group was 67.57%(50/74),with statistical significance(P<0.01).The total effective rate of TCM syndromes in the observation group was 94.67%(71/75),while in the control group was 71.62%(53/74),with statistical significance(P<0.01).Compared with before treatment,the total score of MPN-10 in both groups significantly decreased(P<0.05);after treatment,the total score of MPN-10 in the observation group was lower than that in the control group(P<0.05).Compared with before treatment,both groups showed significant reductions in hemoglobin,white blood cell count,hematocrit and platelet count after treatment(P<0.05);after treatment,the above hematological indicators in the observation group were better than those in the control group(P<0.05).Compared with before treatment,the levels of D-dimer and fibrinogen in both groups significantly decreased after treatment,and the activated partial thromboplastin time and prothrombin time were significantly shortened(P<0.05);after treatment,the observation group showed better improvement in the coagulation function indicators compared to the control group(P<0.05).There were no significant adverse reactions in the two groups.Conclusion Huoxue Jiedu Prescription can improve clinical efficacy of polycythemia vera with heat toxicity and blood stasis syndrome,improve hematological indexes,reduce coagulation indexes,and has good safety.

Objective To explore the effect of adjuvant hydrogen inhalation therapy(AHIT)on postoperative neurological recovery in elderly patients with cerebral hemorrhage.Methods A pro-spective study was conducted on 100 patients with cerebral hemorrhage who underwent surgical treatment in our department between January 2021 and February 2023.They were randomly divid-ed into an observation group(AHIT)and a control group(conventional treatment),with 50 pa-tients in each group.Glasgow Coma Scale(GCS)score,NIHSS score,short from 36-item question-naire(SF-36)score,as well as levels of serum brain-derived neurotrophic factor(BDNF),insulin-like growth factor 1(IGF-1)and calcitonin gene-related peptide(CGRP),and incidence of compli-cations were compared between the two groups.Results The observation group obtained signifi-cantly higher GCS score and SF-36 scores at 4 and 8 weeks after treatment,and lower NIHSS score when compared with the control group(P＜0.01).At 8 weeks after treatment,the serum BDNF,IGF-1 and CGRP levels were notably higher in the observation group than the control group(P＜0.01).There was no statistical difference in the incidence of complications between the two groups(6.00％vs 10.00％,P＞0.05).Conclusion AHIT can significantly improve the neuro-logical recovery and quality of life of patients with cerebral hemorrhage,as well as elevate the lev-els of serum neurofunctional markers.