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 assess the health risks of gaseous pollutants in the indoor air of hair and beauty salons in Jinan, and to provide technical support for strengthening the hygiene management of hair and beauty salons in Jinan and promoting the improvement of conditions. Methods Every year, indoor air samples were collected from 10-16 selected hair salons and beauty salons in Jinan, and relevant information on practitioners was also collected. According to the ^“Technical Guidelines for Environmental Health Risk Assessment of Chemicals^”, an assessment was conducted on the carcinogenic and non-carcinogenic risks of inhalation pathways of gaseous pollutants in the indoor air of hair salons and beauty salons. Results Benzene, toluene, xylene, formaldehyde, and ammonia were detected in the indoor air of hair salons and beauty salons. Formaldehyde, benzene, and ammonia all exceeded the standard in hair salons and beauty salons. The median risk values of formaldehyde and benzene for carcinogenesis in hair salons and beauty salons were both greater than 10^-6, with maximum values higher than 10^-4. The median chronic non-carcinogenic risk value of formaldehyde in the indoor air of hair salons and beauty salons was greater than 1. The median chronic non-carcinogenic risk values for benzene and ammonia were both less than 1, but the maximum risk value was greater than 1. Conclusion Benzene and formaldehyde in the indoor air of hair salons and beauty salons in Jinan City have carcinogenic and non-carcinogenic risks, while ammonia has non-carcinogenic risks, which should be paid attention to.

BACKGROUND: The transcription factor POU2F1 regulates the expression levels of microRNAs in neoplasia. However, the miR-29b1/a cluster modulated by POU2F1 in gastric cancer (GC) remains unknown. METHODS: Gene expression in GC cells was evaluated using reverse-transcription polymerase chain reaction (PCR), western blotting, immunohistochemistry, and RNA in situ hybridization. Co-immunoprecipitation was performed to evaluate protein interactions. Transwell migration and invasion assays were performed to investigate the biological behavior of GC cells. MiR-29b1/a cluster promoter analysis and luciferase activity assay for the 3'-UTR study were performed in GC cells. In vivo tumor metastasis was evaluated in nude mice. RESULTS: POU2F1 is overexpressed in GC cell lines and binds to the miR-29b1/a cluster promoter. POU2F1 is upregulated, whereas mature miR-29b-3p and miR-29a-3p are downregulated in GC tissues. POU2F1 promotes GC metastasis by inhibiting miR-29b-3p or miR-29a-3p expression in vitro and in vivo . Furthermore, PIK3R1 and/or PIK3R3 are direct targets of miR-29b-3p and/or miR-29a-3p , and the ectopic expression of PIK3R1 or PIK3R3 reverses the suppressive effect of mature miR-29b-3p and/or miR-29a-3p on GC cell metastasis and invasion. Additionally, the interaction of PIK3R1 with PIK3R3 promotes migration and invasion, and miR-29b-3p , miR-29a-3p , PIK3R1 , and PIK3R3 regulate migration and invasion via the phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/Akt/mTOR) pathway in GC cells. In addition, POU2F1 , PIK3R1 , and PIK3R3 expression levels negatively correlated with miR-29b-3p and miR-29a-3p expression levels in GC tissue samples. CONCLUSIONS The POU2F1 - miR-29b-3p / miR-29a-3p-PIK3R1 / PIK3R1 signaling axis regulates tumor progression and may be a promising therapeutic target for GC.
MicroRNAs/metabolism* ; Humans ; Stomach Neoplasms/pathology* ; Cell Line, Tumor ; Cell Movement/physiology* ; Phosphatidylinositol 3-Kinases/metabolism* ; Animals ; Mice ; Octamer Transcription Factor-1/metabolism* ; Mice, Nude ; Class Ia Phosphatidylinositol 3-Kinase/metabolism* ; Neoplasm Invasiveness ; Gene Expression Regulation, Neoplastic/genetics* ; Male ; Immunohistochemistry ; Female

Objective:To investigate the effect of "four-staff co-management" follow-up mode on risk factor control and medium-term prognosis improvement in patients with coronary heart disease after percutaneous coronary intervention (PCI).Methods:This was a intervention study. Patients with coronary heart disease who were admitted to the Xiamen Cardiovascular Hospital of Xiamen University from June 2021 to January 2022 and successfully discharged after PCI were included. According to the different types of follow-up after discharge, patients were divided into the traditional follow-up group and the "four-staff co-management" follow-up group. The "four-staff co-management" follow-up mode means that specialists, specialist managers in third-level A hospitals and general practitioners and health managers in basic hospitals were jointly responsible for post-discharge follow-up of PCI patients. Baseline clinical data were collected. The primary endpoints were the rate of compliance of coronary heart disease risk factor control at 12 months after surgery, the rate of secondary surgery, and the incidence of mid-term major adverse cardiovascular and cerebrovascular events (MACCE). Unplanned secondary PCI included symptom-driven secondary PCI and asymptomatic secondary PCI. MACCE includes myocardial infarction, hospitalization for heart failure, stroke, major bleeding, all-cause death, and composite endpoints including these events.Results:A total of 2 181 patients were enrolled, including 1 097 patients in the traditional follow-up group and 1 084 patients in the "four-staff co-management" follow-up group. At baseline, there were no statistically significant differences in gender, age, discharge diagnosis, co-existing diseases, echocardiographic indexes, and coronary artery lesions between the two groups (all P>0.05). There were no significant differences between the two groups in total PCI stent length, maximum internal diameter of stent, proportion of patients using drug balloon, proportion of patients with a planned second surgery during hospitalization, and discharge with drugs (all P>0.05). Twelve months after PCI, the reduction in HbA1c and low-density lipoprotein cholesterol was greater in the "four-staff co-management " follow-up group than that in the traditional follow-up group (all P<0.05), and the rate of reaching the standard for low-density lipoprotein cholesterol was higher than that in the traditional follow-up group ( P=0.001), but there was no statistical significance between the two groups for blood pressure and blood glucose (all P>0.05). During the follow-up period, the proportion of symptom-driven second operation patients was lower in the "four-staff co-management" follow-up group than that in the traditional follow-up group ( P<0.001), and there was no significant difference in the proportion of asymptomatic second operation patients between the two groups ( P=0.191). The proportion of hospitalized patients with heart failure in the "four-staff co-management" follow-up group was lower than that in the traditional follow-up group ( P=0.029), and there was no significant difference in the proportion of myocardial infarction, cerebral infarction, cerebral hemorrhage, massive hemorrhage, death and complex endpoint events between the two groups (all P>0.05). Conclusion:The "four-staff co-management" follow-up mode can effectively improve the control of risk factors and medium-term prognosis in patients with coronary heart disease after PCI.

Background Ozone (O₃), a key air pollutant, significantly contributes to cardiovascular disease (CVD)-related mortality, with particularly pronounced effects in the elderly. Objective To explore the association between acute O₃ exposure and mortality from CVD and its subtypes in the elderly population in Jinan, and to investigate the modifying effects of gender,age, and seasonal factors on O₃-related effects, as well as to clarify the interaction with other air pollutants. Methods Daily mortality data for CVD, air pollutants, and meteorological parameters were collected in Jinan from 2015 to 2023. Generalized additive models (GAM) combined with distributed lag nonlinear models (DLNM) were used to analyze the lag effects of acute O₃ exposure on mortalities from CVD, ischemic heart disease (IHD), and stroke in elderly individuals aged ≥60 years. Subgroup analyses were conducted to explore effect differences by gender (male vs. female), age (non-high-aged elderly<80 years vs. high-aged elderly ≥80 years), and season (warm season: April–September vs. cold season: October–March of the following year). Relative excess risk due to interaction (RERI), attributable proportion of interaction (API), and Synergy index (SI) were used to assess the interactions of O₃ with PM_2.5 and NO₂. Results During the study period, the mean daily concentration of ozone reached (105.01 ± 54.18) μg·m⁻³, exceeding the Grade I limit value specified in Ambient Air Quality Standard (GB 3095–2012). Among the 203834 CVD deaths, IHD (53.07%) and stroke (33.33%) were the predominant mortality subtypes. The single-day lag analysis revealed peak excess risk (ER) for CVD mortality at lag0 (ER=0.64%, 95%CI: 0.29%, 1.00%) per 10 μg·m⁻³ O₃ increase. The cumulative effects peaked at lag04 (ER=1.61%, 95%CI: 0.77%, 2.46%). The subtype-specific analyses showed the maximal single-day effects at lag0 were identified for both IHD (ER=0.61%, 95%CI: 0.20%, 1.03%) and stroke (ER=0.65%, 95%CI: 0.19%, 1.11%), while the cumulative risks peaked at lag04 for IHD (ER=1.54%, 95%CI: 0.56%, 2.54%) and lag03 for stroke (ER=1.74%, 95%CI: 0.76%, 2.73%). The gender subgroup analyses suggested that both male and female subgroups showed the most significant impact on CVD mortality at lag0, with ER values of 0.53% (95%CI: 0.11%, 0.95%) and 0.75% (95%CI: 0.33%, 1.18%), respectively, but the differences were not statistically significant (P>0.05). No statistically significant difference in effect values was found between high-aged and non-high-aged elderly (P>0.05) after age subgroup analyses. The seasonal subgroup analyses indicated that the effects of O₃ on CVD and its subtypes in the warm season were significantly higher than those in the cold season (P<0.05). At lag0 in the warm season, the ER values for CVD, IHD, and stroke mortality were 0.86% (95%CI: 0.57%, 1.14%), 0.84% (95%CI: 0.49%, 1.19%), and 0.84% (95%CI: 0.43%, 1.26%), respectively. The interaction analyses revealed an antagonistic effect between O₃ and PM_2.5 on stroke mortality in the elderly [RERI=−4.64% (95%CI: −9.27%, −0.01%), API=−4.39% (95%CI: −8.77%, −0.01%), SI=0.55 (95%CI: 0.26, 0.84)]. The O₃ effect remained robust in the multi-pollutant models (P<0.05). Conclusion Acute O₃ exposure increases the risk of mortality from CVD and its subtypes in the elderly, and this effect is amplified in the warm season. Additionally, O₃ and PM_2.5 have an antagonistic effect on stroke mortality in the elderly.

This article provides an interpretation of the EULAR/PReS recommendations for the diaganosis and management of Still′s disease focusing on the diagnostic criteria, therapeutic targets, and strategies for managing complications in systemic juvenile idiopathic arthritis (sJIA) and adult-onset Still′s disease (AOSD). The guidelines introduce, for the first time, the unified nomenclature of "Still′s disease" for both sJIA and AOSD, emphasizing the importance of early recognition and stepwise management. Particular attention is given to the role of IL-1 and IL-6 inhibitors in reducing glucocorticoid use. This article aims to assist clinicians in China in better understanding and applying these guidelines to enhance the diagnosis and treatment of Still′s disease.

Eosinophilic esophagitis (EoE) is a chronic inflammatory disease driven by immune mechanisms, characterized by abnormal eosinophilic infiltration of the esophageal epithelium. EoE′s pathogenesis is closely associated with food allergens, and clinical manifestations primarily include dysphagia, food impaction, and children patients may also have growth restriction. The European Society for Paediatric Gastroenterology, Hepatology, and Nutrition first published guidelines for the management of pediatric EoE in 2014. With increasing understanding of the disease mechanisms and treatment responses, the 2024 guidelines have comprehensively updated the diagnostic and therapeutic strategies.This paper provides a systematic interpretation of the 2024 guidelines, focusing on the revised diagnostic criteria, optimization of dietary therapy, and improved management strategies for esophageal strictures. Furthermore, a comparison of the 2014 and 2024 guidelines highlights significant advancements in EoE management over the past decade and their implications for clinical practice.

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.

Objective:To investigate the effect of "four-staff co-management" follow-up mode on risk factor control and medium-term prognosis improvement in patients with coronary heart disease after percutaneous coronary intervention (PCI).Methods:This was a intervention study. Patients with coronary heart disease who were admitted to the Xiamen Cardiovascular Hospital of Xiamen University from June 2021 to January 2022 and successfully discharged after PCI were included. According to the different types of follow-up after discharge, patients were divided into the traditional follow-up group and the "four-staff co-management" follow-up group. The "four-staff co-management" follow-up mode means that specialists, specialist managers in third-level A hospitals and general practitioners and health managers in basic hospitals were jointly responsible for post-discharge follow-up of PCI patients. Baseline clinical data were collected. The primary endpoints were the rate of compliance of coronary heart disease risk factor control at 12 months after surgery, the rate of secondary surgery, and the incidence of mid-term major adverse cardiovascular and cerebrovascular events (MACCE). Unplanned secondary PCI included symptom-driven secondary PCI and asymptomatic secondary PCI. MACCE includes myocardial infarction, hospitalization for heart failure, stroke, major bleeding, all-cause death, and composite endpoints including these events.Results:A total of 2 181 patients were enrolled, including 1 097 patients in the traditional follow-up group and 1 084 patients in the "four-staff co-management" follow-up group. At baseline, there were no statistically significant differences in gender, age, discharge diagnosis, co-existing diseases, echocardiographic indexes, and coronary artery lesions between the two groups (all P>0.05). There were no significant differences between the two groups in total PCI stent length, maximum internal diameter of stent, proportion of patients using drug balloon, proportion of patients with a planned second surgery during hospitalization, and discharge with drugs (all P>0.05). Twelve months after PCI, the reduction in HbA1c and low-density lipoprotein cholesterol was greater in the "four-staff co-management " follow-up group than that in the traditional follow-up group (all P<0.05), and the rate of reaching the standard for low-density lipoprotein cholesterol was higher than that in the traditional follow-up group ( P=0.001), but there was no statistical significance between the two groups for blood pressure and blood glucose (all P>0.05). During the follow-up period, the proportion of symptom-driven second operation patients was lower in the "four-staff co-management" follow-up group than that in the traditional follow-up group ( P<0.001), and there was no significant difference in the proportion of asymptomatic second operation patients between the two groups ( P=0.191). The proportion of hospitalized patients with heart failure in the "four-staff co-management" follow-up group was lower than that in the traditional follow-up group ( P=0.029), and there was no significant difference in the proportion of myocardial infarction, cerebral infarction, cerebral hemorrhage, massive hemorrhage, death and complex endpoint events between the two groups (all P>0.05). Conclusion:The "four-staff co-management" follow-up mode can effectively improve the control of risk factors and medium-term prognosis in patients with coronary heart disease after PCI.