Objective:This study aimed to systematically evaluate the efficacy of glucagon-like peptide-1(GLP-1) receptor agonists and multi-target analogs on weight reduction and cardiometabolic outcomes in non-diabetic individuals with obesity, and to compare the efficacy and safety across different GLP-1 receptor agonists.Methods:Randomized controlled trials(RCTs) published between January 2000 and March 2025 were identified through a systematic search of CNKI, Wanfang, Web of Science, PubMed, and Cochrane databases. Two reviewers independently screened the studies, extracted data, and assessed methodological quality. Meta-analysis was performed using RevMan 5.4.1 software. Results:A total of 16 RCTs involving 11 032 non-diabetic individuals with obesity were included. Meta-analysis showed that GLP-1 receptor agonists significantly reduced body weight(ΔWeight=-8.71 kg, 95% CI -10.68 to -6.74, P<0.001) and BMI(ΔBMI=-3.01 kg/m 2, 95% CI -3.77 to -2.25, P<0.001), as well as improved systolic blood pressure(ΔSBP=-4.13 mmHg, 1 mmHg=0.133 kPa, 95% CI -4.87 to -3.39, I2=60%) and diastolic blood pressure(ΔDBP=-1.39 mmHg, 95% CI -2.32 to -0.46, I2=95%). Tirzepatide showed the most pronounced effects on both weight and blood pressure reduction. In addition, GLP-1 receptor agonists significantly lowered LDL-C, TC, and TG, while moderately increasing HDL-C levels. In terms of safety, GLP-1 receptor agonists were associated with an increased risk of gastrointestinal adverse events, but did not significantly increase the risk of hypoglycemia. Conclusion:GLP-1 receptor agonists are effective in reducing weight, BMI, and blood pressure, and in improving lipid profiles in non-diabetic individuals with obesity. However, gastrointestinal side effects should be closely monitored. Given the variability in efficacy and safety among various GLP-1 receptor agonists, personalized treatment approaches are recommended.

Objective To evaluate the effectiveness of active screening in improving the detection rate of carbape-nem-resistant Enterobacterales(CRE)in the intensive care units(ICUs).Methods From July 2023 to June 2024,active screening of rectal swab CRE was conducted on ICU patients in 10 hospitals.ICU patients who underwent ac-tive screening from July 2023 to June 2024 were selected as the study group,while those who did not undergo active screening from July 2022 to June 2023 were selected as the control group.Difference in CRE detection rates between the two groups of patients was compared.Results A total of 7 803 ICU patients were included in the study group,744 CRE strains were detected,with a detection rate of 9.53％,out of which 304 CRE strains were detected through routine detection(detection rate 3.90％),3 707 patients underwent active screen,440 CRE strains were detected(detection rate 11.87％).7 561 ICU patients were included in the control group,out of which 250 CRE strains were detected through routine detection,with a detection rate of 3.31％.There was a statistically significant difference in the overall detection rate of CRE between two groups of patients(x2=246.18,P＜0.001).In the study group,CRE detection rate of active screening(11.87％)was higher than that of routine detection(3.90％),with statistically significant difference(x2=264.26,P＜0.001).A total of 17 CRE strains were detected from the study group.The proportions of Klebsiella pneumoniae(80.92％vs 73.41％)and Serratia marcescens(2.30％vs0.23％)in the routine detection group were both higher than in the active screening group,while the proportion of Escherichia coli in the routine detection group was lower(8.22％vs 19.55％),all with statistically significant differences(all P＜0.05).Conclusion The prevalence of CRE in ICUs is relatively high,with a wide range of bac-terial species.Active screening can improve the detection rate of CRE.

Objective To evaluate the effectiveness of active screening in improving the detection rate of carbape-nem-resistant Enterobacterales(CRE)in the intensive care units(ICUs).Methods From July 2023 to June 2024,active screening of rectal swab CRE was conducted on ICU patients in 10 hospitals.ICU patients who underwent ac-tive screening from July 2023 to June 2024 were selected as the study group,while those who did not undergo active screening from July 2022 to June 2023 were selected as the control group.Difference in CRE detection rates between the two groups of patients was compared.Results A total of 7 803 ICU patients were included in the study group,744 CRE strains were detected,with a detection rate of 9.53％,out of which 304 CRE strains were detected through routine detection(detection rate 3.90％),3 707 patients underwent active screen,440 CRE strains were detected(detection rate 11.87％).7 561 ICU patients were included in the control group,out of which 250 CRE strains were detected through routine detection,with a detection rate of 3.31％.There was a statistically significant difference in the overall detection rate of CRE between two groups of patients(x2=246.18,P＜0.001).In the study group,CRE detection rate of active screening(11.87％)was higher than that of routine detection(3.90％),with statistically significant difference(x2=264.26,P＜0.001).A total of 17 CRE strains were detected from the study group.The proportions of Klebsiella pneumoniae(80.92％vs 73.41％)and Serratia marcescens(2.30％vs0.23％)in the routine detection group were both higher than in the active screening group,while the proportion of Escherichia coli in the routine detection group was lower(8.22％vs 19.55％),all with statistically significant differences(all P＜0.05).Conclusion The prevalence of CRE in ICUs is relatively high,with a wide range of bac-terial species.Active screening can improve the detection rate of CRE.

Objective:This study aimed to systematically evaluate the efficacy of glucagon-like peptide-1(GLP-1) receptor agonists and multi-target analogs on weight reduction and cardiometabolic outcomes in non-diabetic individuals with obesity, and to compare the efficacy and safety across different GLP-1 receptor agonists.Methods:Randomized controlled trials(RCTs) published between January 2000 and March 2025 were identified through a systematic search of CNKI, Wanfang, Web of Science, PubMed, and Cochrane databases. Two reviewers independently screened the studies, extracted data, and assessed methodological quality. Meta-analysis was performed using RevMan 5.4.1 software. Results:A total of 16 RCTs involving 11 032 non-diabetic individuals with obesity were included. Meta-analysis showed that GLP-1 receptor agonists significantly reduced body weight(ΔWeight=-8.71 kg, 95% CI -10.68 to -6.74, P<0.001) and BMI(ΔBMI=-3.01 kg/m 2, 95% CI -3.77 to -2.25, P<0.001), as well as improved systolic blood pressure(ΔSBP=-4.13 mmHg, 1 mmHg=0.133 kPa, 95% CI -4.87 to -3.39, I2=60%) and diastolic blood pressure(ΔDBP=-1.39 mmHg, 95% CI -2.32 to -0.46, I2=95%). Tirzepatide showed the most pronounced effects on both weight and blood pressure reduction. In addition, GLP-1 receptor agonists significantly lowered LDL-C, TC, and TG, while moderately increasing HDL-C levels. In terms of safety, GLP-1 receptor agonists were associated with an increased risk of gastrointestinal adverse events, but did not significantly increase the risk of hypoglycemia. Conclusion:GLP-1 receptor agonists are effective in reducing weight, BMI, and blood pressure, and in improving lipid profiles in non-diabetic individuals with obesity. However, gastrointestinal side effects should be closely monitored. Given the variability in efficacy and safety among various GLP-1 receptor agonists, personalized treatment approaches are recommended.

Objective To investigate the therapeutic effect of low-carbohydrate diet and online lifestyle intervention on patients with lean nonalcoholic fatty liver disease(NAFLD).Methods This study was conducted among 53 patients with lean NAFLD who attended Department of Infectious Diseases in Peking University Shenzhen Hospital and Shenzhen Qianhai Shekou Free Trade Zone Hospital from December 2019 to March 2021,and the patients were given low-carbohydrate diet for calorie restriction[total calorie intake was calculated based on basal metabolic rate(BMR)and physical activity level(PAL)and was restricted within(BMR×95%×PAL-1 000)kcal to(BMR×95%×PAL-500)kcal,and carbohydrate ratio fluctuated between 10%and 55%]and lifestyle interventions for 8 weeks.An online software was used for supervision and follow-up,and the patients were observed in terms of treatment outcome and safety.The patients were compared in terms of controlled attenuation parameter(CAP),liver stiffness measurement(LSM),Anthropometric parameters,blood biochemistry,urinary protein,and urine ketone body before and after intervention.The patients were followed up after 1 year to measure body weight and body mass index(BMI).The independent-samples t test was used for comparison of normally distributed continuous data between two groups,and the paired-sample Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous;the chi-square test was used for comparison of categorical data between groups.Results After 8 weeks of intervention,CAP decreased from 304.47±31.91 db/m to 242.43±26.74 db/m,LSM decreased from 7.43±2.41 kPa to 6.36±1.79 kPa,and body weight decreased from 64.29±7.37 kg to 60.24±7.08 kg(t=11.25,3.72,and 14.07,all P<0.001).Of all patients,25(47.2%)had disappearance of fatty liver,and abnormal LSM in 12 patients(63.2%)returned to normal;52 patients(98.1%)had a mean reduction of 4.05±2.32 kg in body weight.The degree of reduction in CAP increased with the degree of reduction in body weight.After intervention,there were significant reductions in BMI,waist circumference,hip circumference,alanine aminotransferase(ALT),aspartate aminotransferase(AST),gamma-glutamyl transpeptidase(GGT),uric acid,fasting blood glucose,triglyceride(TG),total cholesterol(TC),and low-density lipoprotein(LDL)and a significant increase in high-density lipoprotein(t=12.85,13.77,10.28,7.64,6.21,8.35,6.83,6.31,7.4,4.97,5.95,and-2.21,all P<0.05).The patients with abnormal ALT,AST,GGT,uric acid,fasting blood glucose,TG,TC,and LDL at baseline which returned to normal after intervention accounted for 75%,100%,81.8%,57.1%,100%,66.7%,73.5%,and 85.3%,respectively.There were no significant changes in blood urea nitrogen,serum creatinine,urine protein,and urine ketone body(all P>0.05).There was no rebound in body weight and BMI after 1 year of follow-up(P>0.05).There were no gastrointestinal reactions during intervention or follow-up.Conclusion Low-carbohydrate diet and lifestyle intervention can improve liver fat content,liver function,and blood lipid parameters in patients with lean NAFLD,with good safety.

Objective To explore the clinical effect of endoscopic sclerosing agent and tissue glue injection combined with ligation in the treatment of rectal ectopic varices(EV)bleeding.Method A retrospective analysis was conducted on 60 patients with rectal EV bleeding who received endoscopic treatment from January 2017 to January 2022.According to the surgical method,the patients were divided into two groups,with 30 cases in the control group receiving endoscopic ligation treatment;30 cases in the observation group were treated with endoscopic scleroing agent and tissue glue injection combined with ligation.Follow up was conducted according to a cycle of 1,3,6 and 12 months after surgery,and the following indicators were compared between the two groups of patients:successful surgical hemostasis rate,incidence of postoperative complications,mortality rate,improvement of postoperative varicose vein diameter,and postoperative response rate.Result The success rate of surgical hemostasis in the observation group was 93.3%,significantly higher than 66.7%in the control group,the incidence of abdominal pain and fever in the observation group was 10.0%and 10.0%,respectively,significantly lower than 33.3%and 36.7%in the control group,there were 2 deaths in the observation group and 9 deaths in the control group,the mortality rate in the observation group was 6.7%,significantly lower than the 30.0%in the control group,the preoperative venous diameter of the observation group was(1.60±0.36)cm,and the postoperative diameter continued to decrease,at the 12th month after surgery,the diameter was(0.78±0.31)cm,while in the control group,the preoperative venous diameter was(1.52±0.26)cm,the postoperative diameter continued to increase,and at the 12th month after surgery,the diameter was(1.55±0.36)cm,the postoperative effective rate of the observation group was significantly better than that of the control group,the differences were statistically significant(P<0.05).Conclusion The combination of endoscopic scleroing agent and tissue glue injection combined with ligation for the treatment of rectal EV bleeding has a higher success rate and effective rate of surgical hemostasis,fewer postoperative complications,lower mortality rate during follow-up observation,and satisfactory clinical efficacy.It is worth further promoting and applying in clinical practice.

Objective To summarize the research status and hotspots of Wumei Pills;To provide ideas and methods for the follow-up research of Wumei Pills.Methods Related literature about Wumei Pills was retrieved from CNKI,VIP,Wanfang Data and CBM from the establishment of the databases to January 12,2023.The publication time,author,author unit and keywords were collected and extracted through NoteExpress 3.0 software to manage bibliographic data.VOSviewer 1.6.18 software was used to conduct co-occurrence and clustering analysis,and construct keyword time superposition network.Results After screening,a total of 2 105 articles were included,involving 3 554 authors,such as Yan Shuguang,Fan Heng,and Hui Yi.They were from 1 135 units,such as Dongzhimen Hospital of Beijing University of Chinese Medicine,Shandong University of Traditional Chinese Medicine and Beijing University of Chinese Medicine.The included articles contained 2 565 keywords,which appeared 7 061 times,and the research involved 4 main directions:digestive system diseases(ulcerative colitis),study on TCM classics(Shang Han Za Bing Lun),medical cases and experience,and biliary ascariasis.The hotspots of Wumei Pills were scattered in recent years.Six meridian disease to appear,opening and closing pivots,intestinal microbiota,serum inflammatory factors and insomnia were research hotspots in recent 3 years.Conclusion The research of Wumei Pills mainly focus on the research of digestive system diseases,TCM classics,medical cases and experience,and biliary ascariasis.Theoretical research of TCM and mechanism research possibly become new hotspots of this field.

Objective:To investigate the effect of different spray-coagulation time of argon plasma coagulation (APC) injury on the Glisson system primary branche(G1) in the hepatic portal of pigs.Methods:Fifty clean healthy domestic pigs (27 females and 23 males, aged 7 to 14 months) were selected, with the body weighted (100.0±9.5) kg. They were randomly divided into five groups (A, B, C, D, and E), with 10 pigs in each group. G1 models were made and sprayed by APC for 1, 2, 3, 4, and 5 seconds. The damage, maximum damage area, maximum damage depth, and damage of the three branches of the Glisson system (the first branches of the portal vein, intrahepatic bile duct, and hepatic artery) were compared among the groups. The pigs were divided into two groups based on whether the three branches were damaged or not: the three-branch damage group ( n=23) and the control group ( n=27). The maximum damage area and maximum damage depth were compared between the two groups. Results:After the APC spraying, circular or elliptical damage appeared on the surface of the G1, with changes such as yellow-brown color, brown color, charred appearance, and defects. Under the microscope, G1 capsule was found to be deficient, the fibrous tissue beneath the capsule was ruptured, and the structures of small blood vessels and small bile ducts were incomplete. " Burn marks" and damage to the three branches of the Glisson system in G1 were also observed, and the damage was more severe at the center of the spray-coagulation. As the spray-coagulation time increased, the maximum damage area of the G1 model also increased, and the two were positively correlated ( r=0.90, P<0.001). The maximum damage depth was also positively correlated with spray-coagulation time ( r=0.97, P<0.001). The numbers of pigs with damage to the three branches of the Glisson system in Groups A-E were 0, 2, 5, 6, and 10, respectively, and the number of pigs with damage increased with the spray-coagulation time. In the three-branch damage group, the spray-coagulation time, maximum damage area, and maximum damage depth were all higher than those in the control group (without three-branch damage), and the differences were statistically significant (all P<0.05). Conclusion:The degree of damage to G1 caused by APC is positively correlated with the spray-coagulation time, and damage to the three branches of the Glisson system in G1 is related to the maximum damage area, maximum damage depth, and APC spray-coagulation time.

Objective:To explore the role of transgelin(TAGLN) in the occurrence and development of papillary thyroid carcinoma (PTC) and its possible signal pathway.Methods:One hundred cases of PTC tissues and corresponding paracancerous normal thyroid tissues were collected. Realtime quantitative PCR (RT-qPCR), Western blotting, and immunohistochemistry were used to analyze the expression of TAGLN in PTC tissues and corresponding paracancerous normal thyroid tissues. PTC cells were transfected with plasmid and shRNA lentivirus vector respectively to up-regulate or down-regulate the expression of TAGLN in order to detect the effects of them on the proliferation, invasion, and migration by cell proliferation assay(cell counting kit-8, CCK-8)and cell invasion and migration assays (Transwell). The effects of TAGLN on mitogen-activated protein kinase (MAPK)/extracellular-signal regulating kinase (ERK) signal pathway was detected with Western blotting.Results:RT-qPCR showed that there was no difference in the expression of TAGLN mRNA between PTC and corresponding paracancerous normal thyroid tissues ( P>0.05); Western blotting demonstrated that the expression of TAGLN protein in PTC tissues was significantly lower than that in corresponding paracancerous normal thyroid tissues ( P<0.01). Immunohistochemical results revealed that the expression of TAGLN in PTC tissues was significantly lower than that in corresponding paracancerous normal thyroid tissues. Overexpression of TAGLN inhibited the proliferation, invasion, and migration of PTC cells ( P<0.01), but knockdown of TAGLN promoted the proliferation, invasion, and migration of PTC cells ( P<0.01). Overexpression of TAGLN decreased the expression of phosphorylated ERK ( P<0.05), whereas silencing TAGLN increased phosphorylated ERK level in PTC cells( P<0.01). Conclusion:The expression of TAGLN in PTC is significantly decreased. It is related to the occurrence and development of PTC, and its mechanism may be related to MAPK/ERK signal pathway.

Unhealthy dietary habits and a sedentary lifestyle have led to a significant increase in the prevalence rate of non-alcoholic fatty liver disease (NAFLD) in children, adolescents, and adults. In recent years, the biological-psychological-social medical pattern has attracted more and more attention, and internal psychosocial factors have become an important influencing factor for disease progression, treatment, and prognosis. Studies have shown that patients with NAFLD may experience psychosocial disorders, and this article summarizes the common psychosocial problems of these patients.