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.

The pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a serious impact on global public health and the economy. SARS-CoV-2 infiltrates host cells via its surface spike protein, which binds to angiotensin-converting enzyme 2 on the host cell membrane. As a result, small molecules targeting spike protein have emerged as a hotspot in anti-SARS-CoV-2 drug research. Activity screening is an important step in seeking small molecule drugs. Therefore, this article aims to review the biological activity evaluation methods of small molecule inhibitors targeting SARS-CoV-2 spike protein, with the goal of laying the foundation for the discovery of new anti-SARS-CoV-2 drugs.

On May 25, 2024, Shanghai Municipal Administration for Market Regulation released Shanghai local standard Requirements for Outdoor Smoking Areas Setting Up and Management (DB 31/T 1482‒2024) (hereinafter referred to as Standard), which scheduled for official implementation from September 1, 2024. This article provided an interpretation of the key provisions in the Standard, with a particular emphasis on the scope of application, establishment and management requirements. In addition, the significance and potential difficulties and challenges during subsequent implementation of the Standard was summarized and outlined simultaneously, so as to provide a guarantee for users to fully comprehend and effectively implement the Standard.

Objective To observe the clinical efficacy of lesion removal,bone grafting,fusion,and external fixation in the treatment of late-stage wrist tuberculosis.Methods From October 2015 to May 2019,25 patients with late-stage wrist tubercu-losis were treated using lesion removal,bone grafting,fusion,and external fixation.Among these patients,there were 14 males and 11 females,aged from 40 to 74 years old,with an average age of(60.72±8.45)years old.The duration of the disease ranged from 5 to 24 months,with an average of(11.52±7.61)months.There were 11 cases of left wrist tuberculosis and 14 cases of right wrist tuberculosis,with 5 cases accompanied by sinus formation.Postoperative regular anti-tuberculosis treatment was continued.Visual analogue score(VAS),inflammatory indicators,Gartland-Werley wrist function score,and upper limb function score were observed before and after treatment.Results All 25 patients were followed up for ranging from 12 to 36 months with an average of(19.7±6.3)months.At the latest follow-up,all wounds were healed satisfactorily,and there was no recurrence of tuberculosis or infection.VAS at one week before operation and three months after operation were(5.16±1.14)score and(1.68±0.80)score respectively.One week before operation and three months after operation,erythrocyte sedimenta-tion rate(ESR)was(44.20±20.56)mm·h-1 and(14.44±1.14)mm·h-1,and C-reactive protein(CRP)was(12.37±7.95)mg· L-1and(4.3±3.37)mg·L-1.The differences in all three data sets were statistically significant(P＜0.01).According to Gartland-Werley wrist function scoring,the scores at one week before operation and one year after operation were(21.32±3.44)and(14.96±1.37)respectively,showed a statistically significant difference(P＜0.01).According to the upper limb function score(disabilities of the arm,shoulder,and hand,DASH),the score was(70.52±7.95)at one week before operation and(28.84± 2.30)at one year after operation.The difference was statistically significant(P＜0.01).At the latest follow-up,no patient had a recurrence of tuberculosis.Conclusion The short-term clinical efficacy of treating wrist tuberculosis with lesion removal,bone grafting,fusion,and external fixation is satisfactory.

Transcatheter aortic valve replacement(TAVR)has become one of the effective methods for treating patients with aortic valve disease.With the continuous maturity of technology,innovation of instruments and increasing experience,the indications for TAVR has been expanded.Following international trends,the number of TAVR in China has steadily increased with each passing year.In 2023,the long-term follow-up results of TAVR in low-risk AS patients further confirm the long-term benefits of TAVR.The relevant research on TAVR for patients with aortic regurgitation and patients with bicuspid aortic stenosis provide evidence support for the expansion of TAVR indications.At the same time,the development of valve devices and new technological innovations are emerging in an endless stream,and the new concept of full life cycle management is increasingly being valued.Especially in China,the development of local devices is progressing rapidly,and multiple devices have entered the clinical research stage.The clinical manifestations and research results are worth pursuing.

Objective To investigate the effect of glycyrrhizin(GA)on the spasticity of hemiplegic spasticity in stroke rats by regulating the phosphoinositide 3-kinase(PI3K)/protein kinase B(Akt)/glycogen synthase kinase 3β(GSK3β)signaling pathway.Methods A rat model of post-stroke spasm(PSS)was established by middle cerebral artery occlusion(MCAO).Rats were divided into control group,sham operation group,model group,GA-L group,GA-H group and baclofen group.Rats in the model group,sham operation group and control group were intragastrically administered with the same amount of 0.9％NaCl every day,GA-H group was given 10.8 g·kg-1 GA by gavage daily,GA-L group was given 5.4 g·kg-1 GA by gavage every day,baclofen group was intragastrically administered with 5.4 mg·kg-1 baclofen every day for 4 weeks.Muscle tone was assessed by modified Ashworth scale.The volume of cerebral infarction was analyzed by 2,3,5-triphenyltetrazolium chloride(TTC)staining.The protective effect of GA on neuronal injury after cerebral ischemia-reperfusion injury was observed by Nissl staining and transmission electron microscopy.The expression levels of phosphorylated PI3K(p-PI3K),phosphorylated Akt(p-Akt)and phosphorylated GSK3β(p-GSK3β)in cerebral infarction and peripheral brain stem were detected by immunohistochemical staining.Results The volume of cerebral infarction in sham operation group,model group,GA-L group,GA-H group and baclofen group were 0,(34.23±1.21)％,(24.12±1.03)％,(18.26±1.08)％and(26.38±1.35)％,respectively.The contents of Nissl bodies in control group,sham operation group,model group,GA-L group,GA-H group were(126.23±8.13)％,(131.14±9.62)％,(52.21±6.11)％,(84.29±6.17)％and(112.24±8.21)％,respectively.At 4 weeks,the expressions of p-PI3K in sham operation group,model group,GA-L group,GA-H group and baclofen group in brain tissue surrounding cerebral infarction were 5.45±0.44,4.89±0.34,5.54±0.42,20.59±1.35,25.34±1.46 and 6.47±0.45;the expression of p-PI3K in the brain tissues around brain stem were 14.47±1.48,10.82±1.24,15.39±1.45,13.51±1.32,25.55±1.49 and 8.84±0.74;the expression levels of p-AKT in brain tissue surrounding cerebral infarction were 6.47±0.41,6.18±0.32,5.58±0.51,19.54±1.48,28.56±1.48 and 14.39±1.56;the expression of p-Akt in the surrounding brain tissue were 6.45±1.41,8.09±1.32,6.05±1.12,13.63±1.45,16.58±1.61 and 10.75±1.01;the expression levels of p-GSK3β in brain tissue surrounding cerebral infarction were 8.64±0.52,5.18±0.61,18.54±1.45,39.56±1.63,43.57±1.59 and 18.43±1.48;the expression of p-GSK3β in the surrounding brain tissue were 8.04±1.39,6.91±1.01,6.82±1.16,15.59±1.33,15.65±1.18 and 5.18±0.47.Compared with model group,the expressions of p-PI3K,p-Akt and p-GSK3β in cerebral infarction and peribrainstem brain tissue of rats in GA-L and GA-H groups were significantly up-regulated(all P＜0.05).Conclusion The inhibitory effect of GA on spasticity in PSS rats may be related to the up-regulation of PI3K/Akt/GSK3β pathway,which may be a supplementary treatment strategy for PSS.

The National Medical Products Administration have become an official applicant of the Pharmaceutical Inspection Co-operation Scheme(PIC/S)in 2023,and the good manufacturing practice appendix and inspection memorandum are key documents of PIC/S.Based on the analysis of the history,framework and main contents of the appendix and inspection memorandum of PIC/S investigational medicinal products,this paper discusses the key contents of the appendix and inspection memorandum of PIC/S clinical trial drugs,and provides reference for the inspection work.

Objective To observe the effects of abdominal penetrating moxibustion combined with acupuncture at the"four chong points"on balance,walking function and trunk control in patients recovering from stroke.Methods Seventy-eight patients recovering from stroke were randomly divided into an observation group and a control group,with 39 patients in each group.The control group was given conventional rehabilitation exercises,while the observation group was given abdominal penetrating moxibustion combined with acupuncture at the"four chong points"on the basis of the control group.Both groups were treated for 2 consecutive months.After 2 months of treatment,the clinical efficacy of the two groups was evaluated,and the changes in the Berg Scale score and the Timed Up and Go Test(TUGT)were observed before and after treatment.The changes in the National Institutes of Health Stroke Scale(NIHSS)scores were compared before and after treatment between the two groups.The Sheikh Trunk Control Scale scores were also evaluated.Results(1)The total effective rate of the observation group was 94.87%(37/39),and the total effective rate of the control group was 80.00%(31/39),and the 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 Berg scores of the patients in the two groups were significantly increased(P＜0.05),and the Berg scores of the observation group were higher than those of the control group,and the difference was statistically significant(P＜0.05).(3)After treatment,the TUGT time and NIHSS score of patients in the two groups were significantly improved(P＜0.05),and the TUGT time of the observation group was shorter than that of the control group,and the NIHSS score was lower than that of the control group,and the difference was statistically significant(P＜0.05).(4)After treatment,the Sheikh trunk control scores of the two groups were significantly increased(P＜0.05),and the Sheikh trunk control score of the observation group was higher than that of the control group,and the difference was statistically significant(P＜0.05).Conclusion Abdominal penetrating moxibustion method combined with acupuncture at the four chong points for the treatment of stroke recovery can effectively restore the patients'balance and walking function,improve the patients'trunk control ability,and the therapeutic effect is precise.

Background Di(2-ethylhexyl) phthalate (DEHP) is the highest consumed and the most widely used phthalic acid ester, their effects on lipid metabolism have attracted the attention of many scholars. However, the associated mechanism is still unclear. Objective To observe the effect of DEHP on lipid metabolism in rats, probe its possible mechanism, and provide a research basis for the effect of DEHP on human lipid metabolism. Methods Forty healthy male SD rats were randomly divided into 4 groups: solvent control (0 mg·kg⁻¹ DEHP), low DEHP (187 mg·kg⁻¹), medium DEHP (375 mg·kg⁻¹), and high DEHP (750 mg·kg⁻¹) groups. DEHP was administered by oral gavage for 6 d per week, consecutively 8 weeks. The rats were weighed once a week during the exposure period. At 24 h after the last exposure, the rats were anesthetized with 20% urethane and sacrificed by apical puncture. Rat livers were harvested and weighed before hematoxylin-eosin (HE) histopathological observation. Reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the mRNA levels of lipid metabolism-related genes Janus kinase 3 (JAK3), signal transducer and activator of transcription 5b (STAT5b), and peroxisome proliferator-activated receptor γ (PPARγ) in liver, and Western blot was used to detect the expression levels of lipid metabolism-related proteins JAK3, STAT5b, and PPARγ in liver. Results Compared with the control group, there was no significant difference in the body weight gain of the rats in each group (P>0.05). The liver organ coefficients of the DEHP exposure groups were higher than that of the control group (P<0.001), and increased with higher DEHP dosages. The level of high-density lipoprotein cholesterol (HDL-C) in serum decreased in all DEHP exposure groups (P<0.05), and the level of low-density lipoprotein cholesterol (LDL-C) in serum increased in the high DEHP group (P<0.05). The results of liver histopathological morphology showed that the hepatocytes of each DEHP group were enlarged and edematous in varying degrees, with loose stroma and irregular arrangement of cells, which were manifested as inflammatory cell infiltration and fatty degeneration of liver cells. Compared to the control group, the mRNA levels of JAK3, STAT5b, and PPARγ in liver tissues of rats in each DEHP group decreased (P<0.001). Compared to the control group, the relative expression levels of JAK3 in each DEHP group decreased (P<0.05), and the relative expression levels of STAT5b and PPARγ in the medium and high DEHP groups decreased (P<0.05). Conclusion DEHP exposure can induce abnormal lipid metabolism in rats, and the mechanism may be related to DEHP inhibiting the activation of JAK3/STAT5b/PPARγ signaling pathway.

Nitazoxanide is an FDA-approved antiprotozoal drug. Our previous study found that oral administration of nitazoxanide inhibited Western diet (WD)-induced hepatic steatosis in ApoE^-/- mice. However, the specific mechanism remains to be elucidated. In the present study, we performed an untargeted metabolomics approach to reveal the effect of nitazoxanide on the liver metabolic profiles in WD-fed ApoE^-/- mice, and carried out the cellular experiments to elucidate the underlying mechanisms. UPLC-MS-based untargeted metabolomics analysis was used to investigate the effect of nitazoxanide on global metabolite changes in liver tissues. The differential metabolites were screened for enrichment analysis and pathway analysis. Hepatocytes were treated with tizoxanide, the metabolite of nitazoxanide, to investigate the underlying mechanism based on the findings in metabolomics study. The improvement of liver lipid metabolism disorders by nitazoxanide treatment in WD-fed ApoE^-/- mice was mainly through regulating glycerophospholipid metabolism, D-glutamine and glutamate metabolism, glutathione metabolism, and arginine biosynthesis metabolism. Tizoxanide, the active metabolite of nitazoxanide, increased glutathione (GSH) contents and glutamate-cysteine ligase catalytic subunit (Gcl-c) and glutathione reductase (Gsr) mRNA expressions in HepG2 cells. Tizoxanide increased cystathionine β-synthase (CBS) and phosphatidylethanolamine N-methyltransferase (PEMT) protein levels, inhibited lipid accumulation in hepatocytes induced by free fatty acid (FFA). Tizoxanide increased S-adenosyl-L-homocysteine hydrolase (SAHH) protein levels in HepG2 cells and mouse primary liver cells stimulated with free fatty acid (FFA). Tizoxanide increased N-acetyl glutamate synthase (Nags) and carbamoylphosphate synthetase 1 (Cps1) mRNA expressions in HepG2 cells. In conclusion, nitazoxanide improves WD-induced hepatic steatosis in ApoE^-/- mice and the underlying mechanisms include increasing CBS expression, GSH content, PEMT protein expression, Nags and Cps1 mRNA expression in hepatocytes.