OBJECTIVE To systematically evaluate the influencing factors affecting the poor prognosis of drug-induced liver injury （DILI） in the Chinese population， and to provide evidence-based support for early identification and interventions of DILI. METHODS Retrieved from PubMed， Medline， Embase， the Cochrane Library， CNKI， Wanfang database， China biomedical medicine database （CBM） and VIP， clinical studies （case-control studies， cohort studies） related to influencing factors for poor prognosis of DILI were collected from inception to May 31， 2025. After literature screening， data extraction and quality evaluation of included studies， meta-analysis was carried out by using RevMan 5.4 software. RESULTS A total of 17 literature were included， involving 4 078 DILI patients， of whom 673 were in the poor prognosis group and 3 405 were in the favorable prognosis group. Meta-analysis showed that history of liver disease （OR＝2.47， 95%CI was 1.61-3.78， P ＜0.001）， alcohol drinking history （OR＝1.77， 95%CI was 1.22-2.56， P ＝0.003）， Chinese herbal medicine/Chinese patent medicine （OR＝1.87， 95%CI was 1.30-2.70， P ＜0.001）， non-hepatocellular injury type （OR＝1.70， 95%CI was 1.37-2.10， P ＜0.001）， international normalized ratio （INR） elevated （OR＝2.51， 95%CI was 1.97-3.19， P ＜0.001）， and alanine transamine （ALT） elevated （OR＝1.27， 95%CI was 1.14-1.41， P ＜0.001） were risk factors of poor prognosis in DILI. Higher albumin （ALB） level （OR＝0.47， 95%CI was 0.39-0.57， P ＜0.001）， elevated prothrombin activity （PTA） （OR＝0.88， 95%CI was 0.85-0.91， P ＜0.001） and more than 2 kinds of hepatoprotective drugs （OR＝0.62， 95%CI was 0.41-0.95， P ＝0.030） were protective factors for poor prognosis of DILI. CONCLUSIONS Patients with alcohol drinking history， history of liver disease， elevated INR， elevated ALT， taking Chinese herbal medicine/Chinese patent medicine， and non-hepatocellular injury type of DILI have a greater risk of poor prognosis， and higher ALB level， higher PTA and more than 2 kinds of hepatoprotective drugs can reduce the risk of poor prognosis of DILI.

Objective To explore the impact of number of positive regional lymph nodes (nPRLN) in N1 stage on the prognosis of non-small cell lung cancer (NSCLC) patients. Methods Patients with TxN1M0 stage NSCLC who underwent lobectomy and mediastinal lymph node dissection from 2010 to 2015 were screened from SEER database (17 Regs, 2022nov sub). The optimal cutoff value of nPRLN was determined using X-tile software, and patients were divided into 2 groups according to the cutoff value: a nPRLN≤optimal cutoff group and a nPRLN>optimal cutoff group. The influence of confounding factors was minimized by propensity score matching (PSM) at a ratio of 1 : 1. Kaplan-Meier curves and Cox proportional hazards models were used to evaluate overall survival (OS) and lung cancer-specific survival (LCSS) of patients. Results A total of 1316 patients with TxN1M0 stage NSCLC were included, including 662 males and 654 females, with a median age of 67 (60, 73) years. The optimal cutoff value of nPRLN was 3, with 1165 patients in the nPRLN≤3 group and 151 patients in the nPRLN>3 group. After PSM, there were 138 patients in each group. Regardless of before or after PSM, OS and LCSS of patients in the nPRLN≤3 group were superior to those in the nPRLN>3 group (P<0.001). N1 stage nPRLN>3 was an independent prognostic risk factor for OS [HR=1.52, 95%CI (1.22, 1.89), P<0.001] and LCSS [HR=1.72, 95%CI (1.36, 2.18), P<0.001]. Conclusion N1 stage nPRLN>3 is an independent prognostic risk factor for NSCLC patients in TxN1M0 stage, which may provide new evidence for future revision of TNM staging N1 stage subclassification.

OBJECTIVE To systematically evaluate the influential factors for all-cause mortality in patients with carbapenem-resistant Gram-negative bacteria （CR-GNB） treated with polymyxin B. METHODS PubMed， Embase， the Cochrane Library， Web of Science， Wanfang Data， VIP， CBM and CNKI were searched to collect clinical studies on all-cause death within 30 days or 28 days after treatment with polymyxin B in patients with CR-GNB infection from database establishment to July 2025. After literature screening， data extraction and evaluation of literature quality， meta-analysis was performed using RevMan 5.4 software. RESULTS A total of 12 studies were included， involving 1 326 patients， among whom 529 patients died， with a mortality rate of 39.89%. Meta-analysis results showed that combined with cardiovascular disease [OR＝2.06， 95%CI （1.37， 3.09）， P ＝0.005 ] ， increased Sequential Organ Failure Assessment （SOFA） score [OR＝1.20， 95%CI （1.07， 1.35）， P ＝0.003 ] ， mechanical ventilation [OR＝2.35， 95%CI （1.65， 3.34）， P ＜0.001 ] ， continuous renal replacement therapy （CRRT） [OR＝2.58， 95%CI （1.67， 3.97）， P ＜0.001 ] ， bloodstream infection [OR＝3.24， 95%CI （2.19， 4.78）， P ＜0.001 ] ， multiple-site infection [OR＝1.51， 95%CI （1.03， 2.20）， P ＝0.03 ] ， septic shock [OR＝3.19， 95%CI （1.94， 5.24）， P ＜0.001 ] ， use of vasoactive drugs [OR＝2.90， 95%CI （1.97， 4.27）， P ＜0.001 ] ， and the occurrence of acute kidney injury （AKI） [OR＝2.17， 95%CI （1.41， 3.36）， P ＜0.001 ] were risk factors for all-cause mortality in patients with CR-GNB infection treated with polymyxin B. Conversely， an extended duration of polymy xin B treatment [OR＝0.92， 95%CI （0.86， 0.99）， P ＝0.03 ] and early administration after CR-GNB infection [OR＝0.47， 95%CI （0.25， 0.85）， P ＝0.01 ] were protective factors. CONCLUSIONS Patients with cardiovascular disease， receiving mechanical ventilation or CRRT， having bloodstream infection， multiple-site infection or septic shock， combining with vasoactive drugs， with AKI and increased SOFA scores have a higher risk of all-cause mortality. Conversely， extending the duration of polymyxin B treatment （beyond 7 days） and early administration within 48 hours after confirmed CR-GNB infection can significantly reduce the risk of all-cause mortality.

Chronic pain causes physical suffering and can have major psychological impacts in patients.Chronic pain can induce depressive disorder,and clinical studies have consistently shown that chronic pain and depression frequently co-occur,suggesting the possibility of shared pathogenic mechanisms underlying these conditions.Acupuncture,as an alternative therapy,has been widely used for analgesia and to treat depression,with demonstrated clinical efficacy.The therapeutic mechanism of acupuncture is related to neural and endocrine regulation.This review considers the mechanism of chronic pain accompanied by depression,in relation to the brain regions and neural circuits affected by acupuncture treatment.This review provides a new approach for the treatment of depression caused by chronic pain.

Chronic pain causes physical suffering and can have major psychological impacts in patients.Chronic pain can induce depressive disorder,and clinical studies have consistently shown that chronic pain and depression frequently co-occur,suggesting the possibility of shared pathogenic mechanisms underlying these conditions.Acupuncture,as an alternative therapy,has been widely used for analgesia and to treat depression,with demonstrated clinical efficacy.The therapeutic mechanism of acupuncture is related to neural and endocrine regulation.This review considers the mechanism of chronic pain accompanied by depression,in relation to the brain regions and neural circuits affected by acupuncture treatment.This review provides a new approach for the treatment of depression caused by chronic pain.

Objective:To investigate the anti-inflammatory activity of alcohol extract of Polyrhachis dives(PDAEs)against rheumatoid arthritis(RA)in vitro and in vivo.Methods:In vivo and in vitro anti-RA inflammatory response of PDAEs was investigated using a rat model of collagenous arthritis induced by bovine type Ⅱ collagen and an LPS-induced RAW264.7 cell inflammatory model.Results:PDAEs inhibited the polarization of M1 type macrophages in vivo and in vitro,reduced expressions of TNF-α,IL-1β,IL-6,iNOS,and promoted polarization of M2 type macrophages,enhanced expressions of anti-inflammatory cytokines,such as IL-10 and TGF-β,so as to achieve the anti-inflammatory effect.The experiments in vivo also showed that PDAEs had the immunomodulatory effect,the potential mechanism may be the regulation of Th17/Treg balance by regulating the expression of PD-1 and TGF-β,thus correcting the over-strong autoimmune response.Conclusion:PDAEs may reduce the inflammatory reaction of RA through anti-inflam-matory and immunomodulatory effects.

Objectives:To observe the effect of applying denosumab after percutaneous vertebroplasty(PVP)in the treatment of osteoporotic vertebral compression fracture(OVCF)in elderly patients.Methods:217 elderly patients(male 84,female 133;aged 60-80 years old)with OVCF who received PVP in the hospital from Oc-tober 2022 to January 2024 were selected and numbered according to the order of admission,and they were divided into control group(n=73),zoledronic acid sodium group(n=72)and denosumab group(n=72)at a ratio of 1∶1∶1 by random number table method.The control group was treated with calcium carbonate D3 tablets and calcitriol capsules(oral administration,1 tablet/capsule every day for 12 months)after surgery,and the zole-dronic acid sodium group was added with zoledronic acid sodium injection(5mg,intravenous infusion,once ev ery 12 months)on the basis of the control group,and the denosumab group was treated with denosumab(60mg,subcutaneous injection,once every 6 months)based on the control group.The pain visual analog scale(VAS)score,bone mineral density,bone metabolism indicators such as serum beta collagen degradation prod-ucts(β-CTX)and procollagen type Ⅰ N-terminal propeplide(P Ⅰ NP),Oswestry disability index(ODI)and frac-ture recurrence rate were compared between the three groups before treatment and at 6 months and 12 months after treatment.Results:3 cases were lost in the control group,and 2 cases were lost in both zoledronic acid sodium group and denosumab group.Finally,70 patients were enrolled in each group.There were no statistical differences in gender ratio,age and fracture site between the three groups(P＞0.05).No significant differences were found in VAS score,bone mineral density,serumβ-CTX,P Ⅰ NP and ODI between the three groups before treatment(P＞0.05).At 6 months and 12 months after treatment,the VAS score and ODI score in the three groups of patients were significantly improved compared with those before surgery(P＜0.05),and the improvements in denosumab group were better than those in zoledronic acid sodium group and control group(P＜0.05).The levels of serum β-CTX and P Ⅰ NP in denosumab group and zoledronic acid sodium group at 6 months and 12 months after treatment were significantly decreased(P＜0.05)while the bone mineral density was significantly increased(P＜0.05),and there were no significant changes in control group(P＞0.05).After treatment,serum β-CTX and P Ⅰ NP in denosumab group were lower than those in zoledronic acid sodium group(P＜0.05),while the bone mineral density was significantly higher than that in zoledronic acid sodium group(P＜0.05).The incidence rate of fracture recurrence in denosumab group(4.29％)was significantly lower than that in control group(17.14％)at 12 months after treatment(P＜0.05),and there was no significant difference compared to zoledronic acid sodium group(P＞0.05).Conclusions:Denosumab injection after PVP in elderly patients with OVCF can relieve pain,reduce the levels of bone metabolism indicators,enhance the bone mineral density,relieve the lumbar dysfunction and reduce the fracture recurrence rate.

Objectives:To observe the effect of applying denosumab after percutaneous vertebroplasty(PVP)in the treatment of osteoporotic vertebral compression fracture(OVCF)in elderly patients.Methods:217 elderly patients(male 84,female 133;aged 60-80 years old)with OVCF who received PVP in the hospital from Oc-tober 2022 to January 2024 were selected and numbered according to the order of admission,and they were divided into control group(n=73),zoledronic acid sodium group(n=72)and denosumab group(n=72)at a ratio of 1∶1∶1 by random number table method.The control group was treated with calcium carbonate D3 tablets and calcitriol capsules(oral administration,1 tablet/capsule every day for 12 months)after surgery,and the zole-dronic acid sodium group was added with zoledronic acid sodium injection(5mg,intravenous infusion,once ev ery 12 months)on the basis of the control group,and the denosumab group was treated with denosumab(60mg,subcutaneous injection,once every 6 months)based on the control group.The pain visual analog scale(VAS)score,bone mineral density,bone metabolism indicators such as serum beta collagen degradation prod-ucts(β-CTX)and procollagen type Ⅰ N-terminal propeplide(P Ⅰ NP),Oswestry disability index(ODI)and frac-ture recurrence rate were compared between the three groups before treatment and at 6 months and 12 months after treatment.Results:3 cases were lost in the control group,and 2 cases were lost in both zoledronic acid sodium group and denosumab group.Finally,70 patients were enrolled in each group.There were no statistical differences in gender ratio,age and fracture site between the three groups(P＞0.05).No significant differences were found in VAS score,bone mineral density,serumβ-CTX,P Ⅰ NP and ODI between the three groups before treatment(P＞0.05).At 6 months and 12 months after treatment,the VAS score and ODI score in the three groups of patients were significantly improved compared with those before surgery(P＜0.05),and the improvements in denosumab group were better than those in zoledronic acid sodium group and control group(P＜0.05).The levels of serum β-CTX and P Ⅰ NP in denosumab group and zoledronic acid sodium group at 6 months and 12 months after treatment were significantly decreased(P＜0.05)while the bone mineral density was significantly increased(P＜0.05),and there were no significant changes in control group(P＞0.05).After treatment,serum β-CTX and P Ⅰ NP in denosumab group were lower than those in zoledronic acid sodium group(P＜0.05),while the bone mineral density was significantly higher than that in zoledronic acid sodium group(P＜0.05).The incidence rate of fracture recurrence in denosumab group(4.29％)was significantly lower than that in control group(17.14％)at 12 months after treatment(P＜0.05),and there was no significant difference compared to zoledronic acid sodium group(P＞0.05).Conclusions:Denosumab injection after PVP in elderly patients with OVCF can relieve pain,reduce the levels of bone metabolism indicators,enhance the bone mineral density,relieve the lumbar dysfunction and reduce the fracture recurrence rate.

Under the trend of increasing aging， integrated elderly care and medical services is an important measure to optimize the supply of elderly care services and promote the good death of the elderly. Using the cooperative production theory and the classical grounded theory， a qualitative analysis was conducted on 38 cases of elderly palliative care and 25 cases of hospital-based palliative care under the integrated elderly care and medical services model from a hospital in Nanning City using Nvivo 20.0 software. This paper found that the integrated elderly care and medical services mode emphasized the deep integration of medical and elderly care services by integrating resources and improving service efficiency， to achieve the basic experience of comprehensive health care for the elderly. The promotion of these experiences has a positive significance for building a multi-agent cooperative production system， strengthening personnel training， perfecting the performance distribution mechanism， and further promoting the development of the national palliative care pilot.

Objective To observe hierarchical differences in brain functional networks in unilateral mesial temporal lobe epilepsy(mTLE)patients with different outcomes after surgery.Methods A total of 69 unilateral mTLE patients who underwent resection of epileptogenic lesion on the affected side were retrospectively enrolled.Based on Engel classification 1 year after surgery,the patients were divided into seizure free(SF)group and non-seizure free(NSF)group.Functional connectivity gradient analysis was employed to extract principal gradient explaining the highest variance on preoperative resting-state functional MRI(rs-fMRI),then the whole-brain gradient characteristics and principal gradient values within specific functional networks were compared between groups.Results Principal gradient connected default mode network(DMN)with sensorimotor network(SMN)along a continuous axis.Compared to SF group,NSF group showed a contracted gradient range at both ends(DMN and SMN)of the functional network and weakened hierarchical differentiation,and principal gradient value of DMN was higher,while that of SMN was lower than those in SF group(both P＜0.05).Conclusion Hierarchical differences in brain functional networks in unilateral mTLE patients with different outcomes after surgery mainly present as enhanced DMN and weakened SMN in NSF ones,and the latter two might serve as important neuroimaging markers for evaluating postoperative seizure recurrence.