Glucagon-like peptide-1 （GLP-1） receptor agonists are a novel class of antidiabetic drugs that also possess lipid- lowering and cardiovascular protective effects， with liraglutide and semaglutide being their representative medications. Based on a systematic literature search， this review summarizes the lipid-lowering mechanisms by which liraglutide and semaglutide exert direct effects on the liver and kidney （regulating autophagy， key lipid metabolism pathways， reverse cholesterol transport， etc.）， direct actions on adipose tissue （affecting adipocyte proliferation and differentiation， expression of lipid metabolism proteins， and gene transcription）， activation of sympathetic pathways through the central nervous system， and modulation of the gut microbiota. Additionally， it summarizes the clinical evidence of their lipid-lowering effects in populations with type 2 diabetes mellitus， overweight individuals， and others. These findings indicate that GLP-1 receptor agonists exert lipid-lowering effects by acting on multiple tissues or systems， providing crucial evidence for further elucidating the molecular mechanisms of these drugs in lipid regulation and exploring potential new ideas for their clinical applications.

Artificial intelligence （AI） and population pharmacokinetics （PPK） technologies have demonstrated significant potential in the personalized medication of immunosuppressants after organ transplantation, enabling precise prediction of drug dosages. This article provides a comprehensive review of the application status of AI and PPK in the individualized administration of immunosuppressants after organ transplantation， focuses on monitoring blood drug concentration， predicting efficacy/adverse reactions， and establishing individualized dosing models for organ transplant recipients after immunosuppressant administration， and analyzes and compares the application characteristics of different methods in different organ transplant patients as well as the integration and future development of AI and PPK technologies. AI and PPK technologies can not only significantly reduce the dependence on human resources， but also greatly improve the level of individualized treatment of immunosuppressants after organ transplantation， and reduce the discomfort and burden caused by frequent blood concentration monitoring to patients.

Objective: To analyze the status of outdoor activities on weekends among children and adolescents of different educational stages in Shanghai and their impact on myopia, so as to provide a basis for formulating more specific prevention and control protocol of myopia. Methods: From September to October 2022, a stratified cluster random sampling method was employed to select 84 schools (27 kindergartens, 21 primary schools, 15 junior high schools and 21 high schools) across Shanghai, enrolling a total of 28 654 children and adolescents aged 4 to 18 for the study. Ophthalmic examinations were conducted to ascertain the prevalence of myopia among children and adolescents. Additionally, a questionnaire survey was administered to collect data on outdoor activity duration and associated factors. Multivariate Logistic regression analysis was utilized to investigate the associated factors of outdoor activity levels on weekends. Results: The overall myopia detection rate among children and adolescents was 58.4%, with a higher rate observed in girls (59.2%) compared to boys (57.6%). The myopia detection rates for children and adolescents with an average daily outdoor activity duration of ≥2 h and <2 h on weekends were 54.6% and 68.8%, and the differences were statistically significant ( χ 2=8.12,460.89, P <0.01). Multivariable Logistic regression analysis revealed that girls ( OR =0.80), those with a myopic parent ( OR =0.68), schools from urban districts ( OR =0.72), higher education stages (primary school: OR =0.65, junior high school: OR =0.24, high school: OR =0.14) and spending≥2 h/d on homework during weekends ( OR =0.57) among children and adolescents were less likely to engage in outdoor activities for ≥2 h on weekends ( P <0.01). After incorporating gender, parental myopia status, educational stage, school location, average daily duration on weekends for spending on homework, electronic product usage and outdoor activities as dependent variables in a multivariate Logistic regression analysis, the results showed that children and adolescents with an average outdoor activity duration for ≥2 h on weekends had a lower risk of myopia ( OR =0.86, P < 0.01). Conclusions The level of outdoor activity among children and adolescents on weekends needs to be improved. Outdoor activities on weekends is an associated factor for myopia among children and adolescents. Particularly, girls, those with myopic parents, schools from urban districts, and spending long hours on homework during weekends among children and adolescents require increased attention.

Objective To explore the imaging manifestations of Rosai-Dorfman disease(RDD)in children.Methods A total of 12 children with RDD confirmed by pathology were retrospectively enrolled,including 8 cases underwent non-contrast CT(NCCT)+contrast enhanced CT(CECT),2 cases underwent NCCT+CECT+non-contrast MR(NCMR)+contrast enhanced MR(CEMR),1 case underwent NCCT+NCMR and CEMR,while 1 case underwent NCCT and X-ray examinations.Imaging manifestations of RDD in children were observed.Results Among 12 cases,intranodal type RDD was found in 7 case,extranodal type RDD in 3 cases,and mixed type(with both lymph nodes and extranodal sites affected)RDD were noticed in 2 cases.In 7 cases of intranodal type RDD,NCCT and CECT showed multiple lymph node enlargements in both sides of the neck,with uniform isodensity on NCCT and mild-moderate progressive enhancement in 5 cases,while with low-density necrotic area and ring-shaped enhancement in 2 cases.Among 3 cases of extranodal RDD,the lesion in 1 case involved nasal cavity and posterior group of ethmoid sinuses on CT and MRI,which developed circular soft tissue mass centered on nasal septum with moderate heterogeneous enhancement,also compressed the adjacent bone with destruction.In another case of extranodal RDD,CT showed that the lesion involved left ilium and bilateral parietal bones,with bone destruction accompanied by obvious periosteal reaction and soft tissue mass,which was mildly enhanced.In the rest 1 case of extranodal RDD,CT and X-ray film showed that the lesion involved the upper segment of right femur and left parietal bone,with osteolytic destruction accompanied by layered periosteal reaction.The lesions in both 2 cases of mixed type RDD involved brain(1 case involved left parieto-occipital lobe,1 case involved bilateral temporal lobes,left frontal lobe and bilateral occipital lobes),presented as isodensity on CT and equal or slightly low signal intensity on T 1WI,equal-high mixed signal intensity on T2WI,some shaped like brain gyral with mild edema of surrounding tissue,and nodular or mass-like significant enhancement.RDD involvements of bilateral lung,mediastinum and hilar lymph nodes were also observed in the above 2 cases,chest CT showed multiple nodular or small patchy uniform high-density shadows in bilateral lungs,as well as enlarged mediastinum and hilar lymph nodes.Conclusion Imaging manifestations of pediatric RDD had certain specificity,being helpful to diagnosis.

Objective To sort out the management system of clinical trial drugs in our hospital,and analyze the construction and practical experience of the information system in the whole process management of clinical trial drugs,and to further improve the efficiency and quality of clinical trials.Methods Based on the original management of clinical trial drugs,an information system in line with the situation of our hospital was applied to manage the whole process of clinical trial drugs.Results Compared with the traditional management,the information system can automatically record the data of inbound and outbound storage,distribution,retrieval and return of trial drugs in real time,pre-review the prescriptions and randomized documents of clinical trial drugs,and realise paperless office.Conclusions The information system can ensure the safety,accuracy and traceability of the data of drugs used in clinical trial.The system can also save resources,improve the efficiency and quality of clinical trial management.

Objective To sort out the management system of clinical trial drugs in our hospital,and analyze the construction and practical experience of the information system in the whole process management of clinical trial drugs,and to further improve the efficiency and quality of clinical trials.Methods Based on the original management of clinical trial drugs,an information system in line with the situation of our hospital was applied to manage the whole process of clinical trial drugs.Results Compared with the traditional management,the information system can automatically record the data of inbound and outbound storage,distribution,retrieval and return of trial drugs in real time,pre-review the prescriptions and randomized documents of clinical trial drugs,and realise paperless office.Conclusions The information system can ensure the safety,accuracy and traceability of the data of drugs used in clinical trial.The system can also save resources,improve the efficiency and quality of clinical trial management.

Objective To explore the imaging manifestations of Rosai-Dorfman disease(RDD)in children.Methods A total of 12 children with RDD confirmed by pathology were retrospectively enrolled,including 8 cases underwent non-contrast CT(NCCT)+contrast enhanced CT(CECT),2 cases underwent NCCT+CECT+non-contrast MR(NCMR)+contrast enhanced MR(CEMR),1 case underwent NCCT+NCMR and CEMR,while 1 case underwent NCCT and X-ray examinations.Imaging manifestations of RDD in children were observed.Results Among 12 cases,intranodal type RDD was found in 7 case,extranodal type RDD in 3 cases,and mixed type(with both lymph nodes and extranodal sites affected)RDD were noticed in 2 cases.In 7 cases of intranodal type RDD,NCCT and CECT showed multiple lymph node enlargements in both sides of the neck,with uniform isodensity on NCCT and mild-moderate progressive enhancement in 5 cases,while with low-density necrotic area and ring-shaped enhancement in 2 cases.Among 3 cases of extranodal RDD,the lesion in 1 case involved nasal cavity and posterior group of ethmoid sinuses on CT and MRI,which developed circular soft tissue mass centered on nasal septum with moderate heterogeneous enhancement,also compressed the adjacent bone with destruction.In another case of extranodal RDD,CT showed that the lesion involved left ilium and bilateral parietal bones,with bone destruction accompanied by obvious periosteal reaction and soft tissue mass,which was mildly enhanced.In the rest 1 case of extranodal RDD,CT and X-ray film showed that the lesion involved the upper segment of right femur and left parietal bone,with osteolytic destruction accompanied by layered periosteal reaction.The lesions in both 2 cases of mixed type RDD involved brain(1 case involved left parieto-occipital lobe,1 case involved bilateral temporal lobes,left frontal lobe and bilateral occipital lobes),presented as isodensity on CT and equal or slightly low signal intensity on T 1WI,equal-high mixed signal intensity on T2WI,some shaped like brain gyral with mild edema of surrounding tissue,and nodular or mass-like significant enhancement.RDD involvements of bilateral lung,mediastinum and hilar lymph nodes were also observed in the above 2 cases,chest CT showed multiple nodular or small patchy uniform high-density shadows in bilateral lungs,as well as enlarged mediastinum and hilar lymph nodes.Conclusion Imaging manifestations of pediatric RDD had certain specificity,being helpful to diagnosis.

Objective To investigate the clinical application value of peripheral blood lymphocyte subsets expression levels in autoimmune disease(AID) among the patients with antinuclear antibody(ANA) positive .Methods 200 patients with ANA positive and 196 patients with ANA negative were selected as the experimental group and control group respectively .The experimental group adopted indirect immunofluorescence assay (IFA) and immunoblotting assay(LIA) for detecting ANA ,moreover divided into the IFA group and LIA group according to the detection results .Meanwhile the flow cytometry was adopted to detect peripheral blood T lymphocytes ,helper T lymphocytes ,cytotoxic T lymphocyte ,NK lymphocytes and B lymphocytes absolute values of each group .The detection results were statistically analyzed .Results Helper T lymphocytes ,NK lymphocytes and B lymphocytes absolute values in the experimental group were significantly lower than those in the control group ,the differences were statistically significant(P＜0 .01);in the experimental group ,helper T lymphocytes and NK lymphocytes absolute values in the IIF group were significantly lower than those in the LIA group ,the differences were statistically significant (P＜0 .01) .Conclusion Peripheral blood lymphocytes subsets can serve as the important detection indicators during the diagnosis and treatment process of AID .

Objective To observe the clinical efficacy of ozone injection combined with extracorporeal shock wave in treatment of arthritis of perishoulderr.Methods 120 patients with arthritis of perishoulderr and treated were choiced,they were randomly divided into two groups.Patients in group C were performanced extracorporeal shock wave treatment.Patients in group H were performanced with ozone injection combined with extracorporeal shock wave.Visu-al analogue score(VAS)and rane of motion(ROM)were used to evaluate the therapeutic effect.Results There was no significant difference between the two groups preoperation.Then significant difference of VAS in the two groups for 1week,1 month,3 months and 6 months after treatment showed respectively as (4.56 ±0.27)points vs.(2.49 ± 0.25)points,t =43.57,(3.96 ±0.23)points vs.(1.86 ±0.29)points,t =43.95,(3.36 ±0.20)points vs.(1.79 ± 0.25)points,t =36.51,(3.98 ±0.23)points vs.(2.09 ±0.27)points,t =41.29,P <0.05;The ROM data were respectively(55 ±18)points vs.(67 ±16)points,t =3.86,(60 ±20)points vs.(72 ±18)points,t =3.45,(56 ±19) points vs.(78 ±15),t =7.04,(46 ±18)points vs.(77 ±14)points,t =10.53,P <0.05.Patients feeled pain eased significantly in group H was significantly higher than group C in 6 month postoperativeiy.(χ2 =38.90,P <0.01;χ2 =8.91,P <0.05).Conclusion There is significant effect in patients with arthritis of perishoulderr treated by com-bined ozone injection with extracorporeal shock wave.

Objective To evaluate the effect of the collaboration care model on posttraumatic growth and resilience in patients with breast cancer.Methods 70 patients who were diagnosed with breast cancer in department of Breast Surgery of the First Affiliated Hospital of Dalian Medical University were assigned into two groups by random number table.32 patients who completed the research in the experimental group received collaboration care while 31 patients who completed the research in the control group received routine care both for there months.The patients were investigated with the Posttraumatic Growth Inventory (PTGI) and Connor-Davidson Resilience Scale (CD-RISC) before and after intervention.Results After the intervention,there were significant differences in scores of posttraumatic growth [(63.83±11.87) scores vs.(60.33±10.09) scores,t=2.384] and resilience [(66.52±15.23) scores vs.(61.33±10.09) scores,t=2.472] between the two groups (P＜0.05).And also there were significant differences of posttraumatic growth scores before and after intervention in the experimental group [(56.24±10.01) scores vs.(63.83±11.87) scores,t=-3.988,P＜ 0.01] and the control group [(56.68±10.32) scores vs.(60.33±10.09) scores,t=-2.426,P＜0.05].Differences of resilience also existed in the experimental group [(61.28±14.40) scores vs.(66.52±15.25) scores,t=-3.225,P＜0.01] and the control group [(63.97±17.66) scores vs.(61.33±10.09) scores,t=-2.370,P＜0.05].Conclusions Collaboration care model can significantly improve the level of patients' posttraumatic growth and resilience.