OBJECTIVE To investigate the clinical characteristics of drug-induced liver injury （DILI） induced by glucagon- like peptide-1 receptor agonists （GLP-1RAs）， and to provide a reference for safe clinical medication. METHODS Using search terms such as “GLP-1”“GLP-1RAs”“semaglutide” “drug-induced liver injury”， relevant studies from PubMed， Embase， the Cochrane Library， CNKI， Wanfang Data and VIP were retrieved. Descriptive analysis was performed on cases of DILI induced by GLP-1RAs. RESULTS A total of 11 studies， comprising 11 patients， were included. Among them， 4 were male （36.4%） and 7 were female （63.6%）. Patient ages ranged from 17 to 64 years； 5 patients （45.5%） were between 50 and 65 years old. Six patients were treated for diabetes， and five for weight loss. Ten patients had underlying diseases. The shortest time to the onset of DILI was 5 days after medication， while the longest was approximately 180 days. The DILIs induced by GLP-1RAs were mainly hepatocellular injury type （6 cases）； severity levels included severe （3 cases）， moderate （6 cases）， and mild （2 cases）. Gastrointestinal symptoms and jaundice were the most common clinical manifestations. The association between DILI and GLP- 1RAs was assessed as “probable” in 10 cases and “possible” in 1 case. All 11 patients improved after drug discontinuation and （or） corresponding treatment. CONCLUSIONS DILI induced by GLP-1RAs is relatively concentrated in patients aged 50-65， with a higher incidence in females. The risk may be further increased in patients with underlying diseases. Clinical use of these agents should enhance pharmaceutical care， including identification of high-risk populations and patient education （especially symptom recognition）. When relevant symptoms appear， the drug should be discontinued immediately， with liver-protective therapy initiated when necessary， to ensure patient safety of drug use.

High mobility group box 1 (HMGB1), when released extracellularly, plays a pivotal role in the development of spinal cord synapses and exacerbates autoimmune diseases within the central nervous system. In experimental autoimmune encephalomyelitis (EAE), a condition that models multiple sclerosis, the levels of extracellular HMGB1 and interleukin-33 (IL-33) have been found to be inversely correlated. However, the mechanism by which IL-33 deficiency enhances HMGB1 release during EAE remains elusive. Our study elucidates a potential signaling pathway whereby the absence of IL-33 leads to increased binding of P300/CBP-associated factor with HMGB1 in the nuclei of astrocytes, upregulating HMGB1 acetylation and promoting its release from astrocyte nuclei in the spinal cord of EAE mice. Conversely, the addition of IL-33 counteracts the TNF-α-induced increase in HMGB1 and acetylated HMGB1 levels in primary astrocytes. These findings underscore the potential of IL-33-associated signaling pathways as a therapeutic target for EAE treatment.
Animals ; Encephalomyelitis, Autoimmune, Experimental/metabolism* ; Astrocytes/metabolism* ; Interleukin-33/metabolism* ; HMGB1 Protein/metabolism* ; Acetylation ; Mice, Knockout ; Mice, Inbred C57BL ; p300-CBP Transcription Factors/metabolism* ; Mice ; Spinal Cord/metabolism* ; Cells, Cultured ; Female ; Signal Transduction

Objective:To explore the optimization of tritium internal exposure monitoring and dose estimation for radiation workers at pressurized heavy water reactor nuclear power plants (PHWR NPPs).Methods:A total of 92 radiation workers at Candu-6 PHWR NPPs were observed to calculate the distribution of quenching index (tSIE). Ten samples with tSIE values ranging from 160 to 460 were selected to make the blank urine quenching curve. By comparing with the quenching curve accompined with the equipment, the optimization of correlationship of urine tritium measurement system was carried out. In estimating tritium internal radiation dose, the dose coefficient was optimized and adjusted by comparing the Canadian algorithm with the national standard algorithm. Dead time correction curve was drawn by means of heavy water simulation experiment diluting main heat transfer system.Results:Through the analysis and optimization of tritium internal dose estimation, the optimal dose coefficient was determined to be 4.8 and the quenching curve of blank urine sample was made. By comparison, it was found that the deviation was larger when tSIE<200, which confirmed the necessity of blank curve. When the tritium concentration in urine was higher than 2.4×10 4 Bq/ml, the urine sample needed to be diluted and then measured to correct the effect of death time. Conclusions:By optimizing both tritium internal exposure monitoring and dose estimation, not only the collective dose management can be improved, but also the unplanned tritium intake can be detected and treated in time, which plays an important role in ensuring the protection and safety of the radiation workers at PHWR NPPs.

Objective: To investigate the prevalence of reproductive system diseases among female workers in a city and related occupational influencing factors. Methods: From June to September, 2016, a cross-sectional survey was used to select 9 944 female workers from six districts of Beijing and then a face-to-face questionnaire survey was performed. Univariate analysis using chi-square test and multivariate logistic regression analysis were used to investigate the risk factors for reproductive system diseases. Results: The age of 9944 female workers ranged from 18 to 65 years (mean 35.53±9.52 years) , and among them, 7 351 (73.92%) were married. The overall prevalence rate of reproductive system diseases among these 9944 female workers during the past three months was 28.29%, and the prevalence rates of hyperplasia of mammary glands, vaginitis, and hysteromyoma were 15.54%, 11.25%, and 6.77%, respectively. After adjustment for age, marital status, education level, and annual family income, the multivariate logistic regression analysis showed that frequent overtime work (odds ratio[OR]=1.119, 95% confidence interval[CI]: 1.070-1.343) , frequent night shifts (OR=1.198, 95%CI: 1.054-1.361) , standing for a long time (OR=1.197, 95%CI: 1.063-1.347) , sitting for a long time (OR=1.327, 95%CI: 1.191-1.479) , heavy workload (OR=1.429, 95%CI: 1.262-1.615) , exposure to lead (OR=1.696, 95%CI: 1.307-2.201) , exposure to mercury (OR=1.452, 95%CI: 1.086-1.940) , and exposure to ionizing radiation (OR=1.679, 95%CI: 1.424-1.980) were associated with reproductive system diseases. Conclusion The prevalence of reproductive system diseases among female workers in Beijing is not optimistic. Reproductive system diseases are associated with frequent overtime work, frequent night shifts, standing for a long time, sitting for a long time, heavy workload, and exposure to lead, mercury, and ionizing radiation.

Objective To identify the chemical structures for the components in the liposoluble portion of Achillea alpi-na L .by gas chromatography/mass spectrometry (GC-MS) .Methods Achillea alpina L .was extracted with 95% alcohol and petroleum ether .The chemical compositions in the extract were analyzed with GC-MS .The structures were identified by comparing to the authentic samples and searching NIST 10 database .The relative content of each compound in the extract was calculated by area normalization method .Results Twenty-nine compounds were separated and identified ,which accounted for 82 .74% of petroleum ether extract .The major constituents were octamethylpicen-3-ol (33.16% ) ,Lup20(29)-en-3-ol ,acetate (3b) (10 .99% ) , n-Hexadecanoic acid (7 .98% ) , Stigmasterol (3 .68% ) , Octadecanoic acid (3 .55% ) , Friedelan-3-one (3 .51% ) .Conclusion This simple and accurate method can be used for the assay of liposoluble chemicals from Achillea alpi-na L .The results provide a foundation for pharmacological research and better use the resource of Achillea alpina L .

Objective To analyze the ‘late diagnoses’ (LD) phenomena among newly identified HIV/AIDS cases in China from 2010 to 2014.Methods Newly identified HIV/AIDS cases from 2010 to 2014 were selected from the National HIV/AIDS comprehensive information system.Rates related to LD were stratified according to the demographic indicators.Results From 2010 to 2014,numbers of newly identified HIV/AIDS cases were reported as 64 338,74 517,82 434,90 119 and 103 501 in China.Among them,proportions of LD were 41.8％,42.1％,38.1％,36.8％ and 35.5％ respectively.LD proportions appeared high in medical settings,with the minimum proportion as 45％ (x2=5 174,P＜0.000 1).Proportion of LD among patients who were heterosexually transmitted appeared over 40％,which was significantly higher than that seen among men who have sex with men or injecting drug users (x2=3 066,P＜0.000 1).Proportion of LD showed more than 39％ in those newly identified cases,and was seen higher in permanent residents than in floating population (less than 30％) (x2=5 265,P＜0.000 1).Conclusion With the expansion testing coverage on HIV,newly identified HIV/AIDS increased year by year.Among the newly identified cases,late diagnosis was high,especially in medical institutions.More effective strategies and measures are needed to promote the early detection of HIV in high risk population.

Background and purpose:The effective rate of ifrst-line chemotherapy for advanced lung cancer is 30%-40%. The purpose of this study was to evaluate the efifcacy and adverse effects of pemetrexed combined with carboplatin or cisplatin in the treatment of patients with advanced non-squamous non-small cell lung cancer (NSCLC). Methods:One hundrend and twenty-one patients with advanced non-squamous NSCLC were enrolled in this study and all of these patients had been conifrmed with pathology or cytology. Among the 121 cases, 60 cases were male and 61 were female, the median age was 59 years, adnenocarcinoma in 113 patients and large cell carcinoma in 8 patients. Combination regimen: patients received pemetrexed 500 mg/m2 on day 1 and carboplatin 300 mg/m2 or cisplatin 70 mg/m2 on day 1 by intravenous infusion, administrated every 3 weeks for 2 to 6 cycles. All patients who received 2 or more cycles could be evaluated. Disease control rate (DCR) was the primary end point; secondary end points included progression-free survival (PFS), 1-year survival rate and safety.Results:There was 1 case with complete response (CR), 44 cases achieved partial response (PR), 50 had stable disease (SD) and 26 cases had progressive disease (PD) in the overall cases. ORR and DCR were 37.2% (45/121) and 78.5% (95/121), respectively. The median PFS time was 5.2 months and 1-year survival rate was 59.0%. In pemetrexed combined with carboplatin group, the ORR and DCRwere 38.3% (23/60) and 78.3% (47/60), respectively; The median PFS was 5.1 months (95%CI: 3.8-6.4 month) and 1-year survival rate was 55.2%. The patients treated with pemetrexed plus cisplatin, the ORR and DCR were 36.1% (22/61) and 78.7% (48/61), respectively. Median PFS was 6.2 months (95%CI: 4.3-8.1 month) and 1-year survival rate was 62.5%. There were no statistical differences between carboplatin/pemetrexed and cisplatin/pemetrexed for both ORR, DCR, PFS and 1-year survival rate (P>0.05). The major adverse effects were leukopenia, neutropenia, fatigue and gastrointestinal reaction.Conclusion:Pemetrexed plus platinum chemotherapy could be considered as the ifrst-line treatment option for advanced non-squamous NSCLC patients. Pemetrexed combined with carboplatin/ cisplatin regimen has efifcacy with mild toxicity and better tolerability.

ObjectiveTo observe the effects of intravesical electric stimulation (IVES) on bladder sensation of neurogenic bladder.Methods28 patients with neurogenic bladder was evaluated, which all underwent intravesical bladder stimulation. Their bladder sensation were analyzed before and after the treatment.Results57.1% of the patients increased bladder sensation after treatment, 32.1% appeared the first sensation and urge sensation after treatment, 42.9% remained stable.ConclusionIntravesical bladder stimulation is effective to improve bladder sensation in a majority of the patients with neurogenic bladder.

Objective To study the significance of artery blood gas(ABG)of neonate cord blood on the diagnosis of asphyxia neonatorum.Methods Neonates were divided into two groups:asphyxia group and control groups.ABG were measured by AVL blood gas analysis instrument.Results pH and PO2 in the asphyxial group were lower and PCO2 was higher than those in control group(P

ObjectiveTo study the videourodynamic characteristics in spina bifida patients and to discuss the urodynamic risk factors causing the upper urinary tract deterioration.Methods33 cases with spina bifida were evaluated with non-complete synchronized videourodynamic test.Filling-phase function of bladder was evaluated with bladder sensation,detrusor activity,compliance,relative safe capacity,detrusor leak point pressure and presence of vesicoureteral reflux;voiding phase function was evaluated with detrusor pressure,the synergy between detrusor and external sphincter,the pressure-flow study.Patients were classified into upper urinary tract damage group and non-damage group according to the imaging and renal function test.The urodynamic parameters between the two groups were compared statistically.Results17 cases were found upper urinary tract damage(51%)in which 11 with vesicoureteral reflux and 6 was non-reflux hydronephrosis.Bladder compliance and relative safe capacity were significantly different between the two groups.ConclusionSpina bifida patients complicate a high incidence of upper urinary damage,especially vesicoureteral reflux.Low compliance and small relative safe capacity may be the major urodynamic risk factors causing upper urinary tract damage.