As a novel long-acting glucagon-like peptide-1 （GLP-1） receptor agonist， semaglutide plays a pivotal role in the treatment of obesity and related metabolic diseases. This article systematically reviews the research progress of semaglutide in the treatment of obesity and related metabolic diseases from three aspects： mechanism of action， clinical applications， and existing challenges. It is found that its mechanism of action involves multi-organ synergistic regulation and metabolic intervention. Its clinical applications encompass the treatment of obesity， diabetes， polycystic ovary syndrome， and liver-related metabolic syndromes， and it demonstrates groundbreaking value in cardiovascular and renal protection. However， it still faces multiple challenges in terms of adverse reactions， individualized treatment， economic accessibility， ethical controversies， and risks. In the future， it is essential to further accumulate long-term safety data on semaglutide， optimize combination treatment regimens， and address key issues such as individualized medication for special populations， in order to fully realize its clinical application value.

A virus was successfully isolated from a sick cat exhibiting clinical signs such as oral mu-cosal ulceration,nasal mucosal redness,and increased nasal secretions utilizing F81 cells.Through a comprehensive analysis as such PCR amplication,sequencing,morphology,serology,and animal re-gression tests,the virus was identified as a feline calicivirus and named FCV-BJ,an inactivated vac-cine was developed from this isolated strain its safety and efficacy were assessed.The results re-vealed that the isolated FCV-BJ strain exhibited characteristic serological and morphological fea-tures consistent with caliciviruses.Furthermore,inoculation of cats with the FCV-BJ demonstrated the strain is highly virulent and the cats manifested the clinical signs of feline calicivirus infection.For the vaccination trial,domestic cats were immunized with inactivated fifth-generation virus cell culture at varying dilutions,followed by a booster immunization after 21 days.Fourteen days after the challenge with the virus,cats immunized with 107.0 TCID50/mL or higher remained largely healthy,while all cats in the control group developed clinical signs of FCV.These findings suggest that the inactivated vaccine derived from the FCV-BJ isolate exhibits strong immunogenicity and protective efficacy at a minimum immunization dose of 107.0 TCID50/mL.This strain holds promise as a candidate for vaccine production,providing a valuable reference and foundation for future re-search and development of feline calicivirus vaccines.

Objective:To explore the effect of early eschar dermabrasion combined with antimicrobial soft silicone foam dressing (hereinafter referred to as foam dressing) in treating the deep partial-thickness burn wounds in children.Methods:This study was a randomized controlled trial. From June 2021 to December 2022, 78 pediatric patients with deep partial-thickness burns who met the inclusion criteria were admitted to the Department of Burns in Guiyang Steel Plant Employees Hospital. According to the random number table, the pediatric patients were divided into two groups, with 38 cases left in combined treatment group (with 20 males and 18 females, aged 26.00 (16.75, 39.75) months) and 39 cases in foam dressing group (with 21 males and 18 females, aged 19.00 (14.00, 31.00) months) after the exclusion of one dropped-out child in follow-up. The pediatric patients in combined treatment group underwent eschar dermabrasion of the wound within 48 hours after injury, the wound was covered with foam dressing after operation, and the dressing was replaced once every 7 days; for the pediatric patients in foam dressing group, the wound was sterilized within 48 hours after injury and covered with foam dressing, and the dressing was replaced once every 2 to 3 days. After the wound healing, the children in both groups were routinely applied with silicone gel twice a day for 3 weeks before started wearing elastic sleeves for more than 18 hours a day, and continuously for over than 6 months. The degree of pain during dressing change was evaluated using the children's pain behavior inventory FLACC. The adverse reactions during the treatment period, number of dressing changes, and wound healing time were observed and recorded. Six months after wound healing, the Vancouver scar scale (VSS) was used to evaluate the condition of the wound scar.Results:When changing dressing, the FLACC score for pain of pediatric patients in combined treatment group was 3.5 (2.0, 5.0), which was significantly lower than 6.0 (5.0, 8.0) in foam dressing group ( Z=-5.40, P<0.05). During the treatment period, no adverse reactions such as wound edema, fluid accumulation, or peripheral skin rash allergies occurred in any pediatric patient in both groups. The number of dressing changes of pediatric patients in combined treatment group was 3 (3, 4) times, which was significantly less than 8 (7, 10) times in foam dressing group ( Z=-7.58, P<0.05). The wound healing time of pediatric patients in combined treatment group was (19±5) days, which was significantly shorter than (25±6) days in foam dressing group ( t=-4.48, P<0.05). Six months after wound healing, the VSS score for scar of pediatric patients in combined treatment group was 5 (2, 8), which was significantly lower than 7 (5, 10) in foam dressing group ( Z=-3.05, P<0.05). Conclusions:Compared with using foam dressings alone, early eschar dermabrasion combined with foam dressings can reduce the number of dressing changes, alleviate the pain during dressing changes, and shorten the wound healing time in treating children with deep partial-thickness burns, and effectively alleviate scar hyperplasia by combining with anti-scar treatment post burns.

Heart failure(HF)is a highly morbid syndrome that seriously affects the physical and mental health of patients and generates an enormous socio-economic burden.In addition to cardiac myocyte oxidative stress and apoptosis,which are considered mechanisms for the development of HF,alterations in cardiac energy metabolism and pathological autophagy also contribute to cardiac abnormalities and ultimately HF.Silent information regulator 1(Sirt1)and adenosine monophosphate-activated protein kinase(AMPK)are nicotinamide adenine dinucleotide(NAD+)-dependent deacetylases and phosphorylated kinases,respectively.They play similar roles in regulating some pathological processes of the heart through regulating targets such as peroxisome proliferator-activated receptor γ coactivator 1α(PGC-1α),protein 38 mitogen-activated protein kinase(p38 MAPK),peroxisome proliferator-activated receptors(PPARs),and mammalian target of rapamycin(mTOR).We summarized the synergistic effects of Sirt1 and AMPK in the heart,and listed the traditional Chinese medicine(TCM)that exhibit cardioprotective properties by modulating the Sirt1/AMPK pathway,to provide a basis for the development of Sirt1/AMPK activators or inhibitors for the treatment of HF and other cardiovascular diseases(CVDs).

Objective To explore the feasibility and diagnostic value of ultra-fast scanning scheme based on deep learning-based reconstruction(DLR)for cervical MR examination.Methods Thirty-six subjects were prospectively enrolled and underwent both conventional scheme(scan time:6 min 14 s)and ultra-fast scheme(2 min)cervical spine MR scanning to acquire encompassing sagittal T1WI,sagittal adipose suppression T2WI and axial T2WI.The ultra-fast MRI were reconstructed using DLR method.The subjective and objective evaluations on imaging qualities of different MRIs were compared,along with the inter-observer agreement for diagnosing intervertebral disc degeneration and herniation.Results Compared with conventional MRI,artifacts in ultra-fast DLR images significantly reduced(P＜0.05).The subjective evaluation results of MRI had good agreement(all Kappa≥0.60).Compared with conventional MRI,the sagittal T1WI,T2WI and axial T2WI obtained with ultra-fast DLR showed significantly improved signal-to-noise ratio(SNR)of the spinal cord,cerebrospinal fluid(CSF)and vertebral body,as well as the spinal cord/CSF contrast(all P＜0.001).The Kappa value of 2 physicians for diagnosing intervertebral disc degeneration based on ultra-fast DLR and conventional scheme images was 0.94 and 1.00,respectively,of intervertebral disc herniation was 0.96 and 0.98,respectively.Conclusion Compared with conventional scanning scheme,using ultra-fast DLR scheme in cervical MR examination could shorten scanning time while achieve similar image quality and diagnostic accuracy.

Objective:To explore the value of clinical and biparametric magnetic resonance imaging(bpMRI)in diagnosing extraprostatic ex-tension(EPE)of prostate cancer(PCa).Methods:This retrospective study assigned 107 patients into EPE(n=42)and organ-limited(n=65)groups based on their postoperative pathology after radical prostatectomy from August 2018 to May 2024 at Wuhu Second People's Hospit-al.The differences in the following clinical risk indicators were compared between the groups:age,total prostate specific antigen(tPSA),pro-state volume,prostate specific antigen density(PSAD)and International Society of Urological Pathology(ISUP)score for prostate puncture.The differences in MRI indicators,prostate imaging reporting and data system(PI-RADS)score and bpMRI were also identified.Binary Logist-ic regression analysis was used to construct clinical and joint models for diagnosing EPE,and screening independent influencing factors.The ROC curve analyze the independent influencing factors and diagnostic performance of the models.The DeLong test was used to compare the differences between the AUC models.A nomogram was draw,and performance evaluated.Results:The differences in tPSA,PSAD,ISUP score for prostate puncture,PI-RADS score,and bpMRI were statistically significant between the two groups(P<0.05).The clinical model AUC was 0.821;while the AUCs of the combined model and independent influencing factors PSAD(OR=25.992),ISUP score for prostate puncture(OR=1.676),and bpMRI(OR=10.729)were 0.899,0.813,0.770,and 0.793 respectively(P<0.001).The combined model was superior to the clinical model(Z=2.502 and P=0.012).The average AUC for 5-fold cross-validation was 0.887,with high model calibration and a threshold range of 5%-85%,indicating clinical benefits.Conclusions:The combined model nomogram derived from clinical and bpMRI indicators is highiy valuable for diagnosing PCa EPE.

Neoadjuvant chemoradiotherapy (nCRT) followed by total mesorectal excision (TME) and adjuvant chemotherapy serves as a traditional standard treatment for locally advanced rectal cancer (LARC). However, such treatment suffers low pathological complete response (pCR) rates, which are merely less than 15%, and low anal-preservation rates, failing to meet the demand of patients for high quality of life. Recently, total neoadjuvant therapy (TNT) whereby postoperative adjuvant chemotherapy is performed preoperatively has further increased the pCR rate, gradually becoming a novel therapeutic approach. Nevertheless, the pCR rate of TNT remains below 30%. Presently, immune checkpoint inhibitors (ICIs) have been proved to be highly successful in treating various solid tumors, yet they are scarcely employed to treat LARC. In recent years, many clinical trials have been conducted to explore the application of nCRT combined with ICIs in the treatment of LARC. This paper reviews the advances in research on this therapy.

By applying "homeostasis" to the study of the meridian and collateral system， the concept of meridian and collateral homeostasis has been proposed which refers to a balanced and stable state of meridian and collateral system， and plays an important role in maintaining body health and can provide a reference for the diagnosis and treatment of diseases. Phenomics realizes the cross-scale correlation from micro-phenotypic data， such as genome， proteome， and metabolome， to macro-phenotypic data， such as physiological state， behavioral activities， and external manifestations. From the perspective of phenomics， this paper proposes a meridian and collateral homeostasis dynamic mapping model of "macroscopic signs and microscopic expression". This model combines macro signs such as the four examinations of traditional Chinese medicine （TCM）， biophysical indicators of acupoints， and micro expression information such as genes， proteins， and metabolism， and systematically investigates the relationship between meridian and collateral homeostasis and health and disease， thereby providing ideas and references for the identification of pre-disease states as well as precise diagnosis and treatment in TCM.

Background Occupational stress is an important public health problem in the military. At present, there are few studies about occupational stress of officers and soldiers of the armed forces in China, especially the effects of plateau related environmental factors on occupational stress. Objective To understand current status and identify influencing factors of occupational stress among officers and soldiers stationed in plateaus, and provide a scientific basis for managing occupational stress. Methods In April 2023, stratified cluster sampling was used to recruit troops by deployed altitudes ranging from 500 to 3000 m into two strata of low altitude (＜2500 m) and high altitude (≥2500 m) based on the medical definition of plateau. Two regimental units were randomly selected from each stratum respectively, and one battalion unit was randomly selected from each regimental unit with all the officers and soldiers. Four selected battalion units were surveyed with a total of 2284 officers and soldiers. We designed a general questionnaire to collect their basic information, and distributed effort-reward imbalance questionnaires to evaluate occupational stress. We used logistic regression to identify potential influencing factors of occupational stress. Results Positive occupational stress was reported in 508 plateau-stationed officers and soldiers, with a prevalence rate of 22.2%. The total effort-reward imbalance score and the dimensional scores of effort, reward, and overcommitment in M (P₂₅, P₇₅) were 0.9 (0.7, 1.0), 16.0 (13.0, 19.0), 36.0 (33.0, 39.0), and 18.0 (15.0, 19.0), respectively. There were significant differences in the positive rate of occupational stress by gender, age, military service length, marital status, only child or not, physical fitness condition, reporting underlying diseases or not, exercise frequency before conscription, psychological changes after entering the plateaus, and having altitude sickness or not (P <0.05). The results of logistic regression showed that being female (OR=1.532, 95%CI: 1.061, 2.213), only child (OR=1.281, 95%CI: 1.038, 1.581), and with underlying diseases (OR=1.950, 95%CI: 1.340, 2.839) were associated with a higher risk of occupational stress. While setting 0 to <3 years of military service as the control group, the risk of occupational stress was higher in subgroups of 3 to 9 years (OR=1.380, 95%CI: 1.113, 1.710) and ≥9 years (OR=2.141, 95%CI: 1.461, 3.137). The participants reporting nervousness or fear (OR=1.728, 95%CI: 1.133, 2.635) and agitation or euphoria (OR=1.380, 95%CI: 1.113, 1.710) had a higher risk of reporting occupational stress than those with no psychological changes after entering the plateaus. Meanwhile, those who had regular exercise (OR=0.670, 95%CI: 0.492, 0.913) before enlistment, good physical fitness condition (OR=0.572, 95%CI: 0.426, 0.767) and excellent physical fitness condition (OR=0.502, 95%CI: 0.366, 0.688) had a lower risk of occupational stress. Conclusion Officers and soldiers in plateaus generally report a high rate of occupational stress. Female, military service length ≥3 years, being only child, with underlying diseases, nervousness/ fear or agitation/ euphoria after entering plateaus are risk factors for elevated occupational stress in this group; while good or excellent physical fitness condition and frequent exercise before enlistment are protective factors for occupational stress. Therefore, it is necessary to pay attention to the occupational stress problems in officers and soldiers stationed in plateaus and provide targeted intervention measures.

Objective To analyze the pathogenic bacteria and drug resistance of peritoneal dialysis-associated peritonitis(PDAP),and provide a clinical reference for the rational use of antibiotics.Methods The demographic data of PDAP patients admitted to the peritoneal dialysis(PD)Center of the First Affiliated Hospital of Soochow University from July 1,2015 to December 30,2021 were collected,and the pathogens,drug resistance and prognosis were retrospectively analyzed.Results A total of 150 episodes of PDAP occurred in 92 patients.The positive rate of PD fluid culture was 61.33％,including 65 cases(70.65％)of Gram-positive(G+)bacteria,mainly Staphylococcus and Streptococcus.Gram-negative(G-)bacteria were in 16 cases(17.39％),mainly Escherichia coli and Enterobacter cloacae.There were 11 cases(11.96％)of multiple infections,including 5 cases of combined fungal infection.From 2016 to 2021,the incidence of G+bacteria-related PDAP decreased from 14 to 8 cases.G+strains were resistant to methicillin(35.00％),and were sensitive to linezolid(100.00％),teicoplanin(100.00％)and rifampicin(100.00％).The sensitivity rate to vancomycin was 98.59％.G-strains were sensitive to ceftazidime(86.36％),ceftizoxime(88.89％)and amikacin(100.00％).The MIC of vancomycin against Staphylococcus showed an upward trend in 2019-2021.The overall cure rate of PDAP was 81.33％in patients who responded to antibiotic treatment,and the cure rate of G+bacteria was higher than that of multiple infections(89.23％vs.36.36％,P＜0.01).The outcome of patients with multiple infections,especially those with concurrent fungal infection was poor.Conclusion The incidence of PDAP in the PD center has shown a decreasing trend in recent years.G+bacteria are still the main pathogenic bacteria causing PDAP,and they are highly resistant to methicillin,so vancomycin should be used as empirical therapy.For G-bacteria,cefotaxime and amikacin can be chosen as empirical therapy.There is a drift in the MIC values of vancomycin against Staphylococcus in the study period,so it is necessary to monitor the MIC of vancomycin against Staphylococcus and its changing trend.