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.

The autonomic nervous system imbalance caused by the overactivation of the sympathetic nerve and the weakened activity of the parasympathetic nerve is closely related to the occurrence and development of myocardial infarction.Autonomic nerve regulation is a new therapeutic approach aiming at inhibiting sympathetic activity and increasing parasympathetic activity.It encompasses magnetic nerve stimulation,optogenetic neuromodulation,and microinjection of botulinum toxin,which could promote the rebalance of the autonomic nervous system,thereby curbing the deterioration of the cardiac function and reducing the occurrence of ventricular arrhythmias after myocardial infarction.This paper reviews the anatomical basis,mechanisms of action,and research advances in intervention strategies of the autonomic nervous system in myocardial infarction.
Humans ; Myocardial Infarction/physiopathology* ; Autonomic Nervous System/physiopathology* ; Autonomic Pathways

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective To investigate the incidence of hip fracture among the elderly in communities,explore related influencing factors,and develop and validate a risk prediction model.Methods A stratified sampling method was used to collect sociodemographic data,lifestyles and risk factors in hip fracture between January 2023 and January 2024 among the elderly residents in communities in Deyang.With random splitting,479 elderly people(68.00%)were assigned to the model training set,and 221(32.00%)to the model validation set.In the model training set,the participants were divided into a fracture group and a non-fracture group based on hip fracture or not.Data from both groups were compared,and R software(version 4.3.1)was employed to develop and validate the risk prediction model.Results A total of 700 elderly residents in communities were included,62 of them had hip fracture within one year yielding a cumulative incidence rate of 8.86%.The risk prediction model identified six predictors:frequent consumption of preserved foods,daily exercise time,daily sunlight exposure,osteoporosis,times of fall within a year,and with≥20 pieces of natural teeth.In the training set,the model achieved an AUC of 0.945(95%CI:0.908-0.982),with a sensitivity of 88.89%and a specificity of 89.40%.The calibration curve demonstrated a good agreement between predicted and actual values,indicating a strong calibration.Decision curve analysis(DCA)showed a positive net benefit.In the validation set,the AUC was 0.892(95%CI:0.784-0.999),with a sensitivity of 82.35%and a specificity of 93.63%,confirming a good model fit and predictive performance.The calibration curve exhibited a strong consistency,and DCA indicated a positive net benefit.Conclusion The developed risk prediction model for hip fracture in elderly community residents demonstrates a strong predictive value.It provides a practical reference for community workers and healthcare professionals to screen and assess the risk of hip fracture among the elderly residents in communities.

Objective To investigate the incidence of hip fracture among the elderly in communities,explore related influencing factors,and develop and validate a risk prediction model.Methods A stratified sampling method was used to collect sociodemographic data,lifestyles and risk factors in hip fracture between January 2023 and January 2024 among the elderly residents in communities in Deyang.With random splitting,479 elderly people(68.00%)were assigned to the model training set,and 221(32.00%)to the model validation set.In the model training set,the participants were divided into a fracture group and a non-fracture group based on hip fracture or not.Data from both groups were compared,and R software(version 4.3.1)was employed to develop and validate the risk prediction model.Results A total of 700 elderly residents in communities were included,62 of them had hip fracture within one year yielding a cumulative incidence rate of 8.86%.The risk prediction model identified six predictors:frequent consumption of preserved foods,daily exercise time,daily sunlight exposure,osteoporosis,times of fall within a year,and with≥20 pieces of natural teeth.In the training set,the model achieved an AUC of 0.945(95%CI:0.908-0.982),with a sensitivity of 88.89%and a specificity of 89.40%.The calibration curve demonstrated a good agreement between predicted and actual values,indicating a strong calibration.Decision curve analysis(DCA)showed a positive net benefit.In the validation set,the AUC was 0.892(95%CI:0.784-0.999),with a sensitivity of 82.35%and a specificity of 93.63%,confirming a good model fit and predictive performance.The calibration curve exhibited a strong consistency,and DCA indicated a positive net benefit.Conclusion The developed risk prediction model for hip fracture in elderly community residents demonstrates a strong predictive value.It provides a practical reference for community workers and healthcare professionals to screen and assess the risk of hip fracture among the elderly residents in communities.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

OBJECTIVES: Spinal cord ischemia-reperfusion injury (SCIRI) remains a major challenge in the field of organ protection due to the lack of effective prevention and therapeutic strategies. Hyperglycemia, a common perioperative condition, contributes to neurological injury via multiple mechanisms. However, its role and underlying mechanism in SCIRI are still unclear. This study aims to investigate the involvement of the precursor of brain-derived neurotrophic factor (proBDNF) in hyperglycemia-induced SCIRI in mice. METHODS: Eight-week-old male C57BL/6 mice were randomly assigned to a control group (Vehicle) or a diabetes mellitus (DM) group. The DM group was established using intraperitoneal injection of streptozotocin (STZ) combined with 10% sucrose water. The Vehicle group received an equal volume of 50 mmol/L sodium citrate buffer (pH 4.5). Fasting blood-glucose levels ≥11.1 mmol/L were considered successful DM modeling. Both Vehicle and DM groups underwent SCIRI modeling via descending aortic clamping, while the Sham group underwent a sham procedure without aortic occlusion. Lower limb motor function was assessed using the Basso Mouse Scale (BMS) and its subscale (sub-BMS). Locomotor activity was evaluated using an open field test. Immunohistochemistry was performed to detect changes in neuronal nuclear protein (NeuN) and proBDNF expression in spinal cord tissues. Real-time reverse transcription polymerase chain reaction (RT-PCR) was used to measure mRNA expression of interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). To explore the effect of proBDNF inhibition, diabetic mice were divided into groups: A DM+SCIRI+monoclonal anti-proBDNF antibody (McAb-proB) group received an intraperitoneal injection of 100 μg of McAb-proB 30 minutes before SCIRI modeling, and a DM+SCIRI+Vehicle group received an equal amount of isotype immunoglobulin G. BMS and sub-BMS scores were recorded, and the gene expression of inflammatory cytokines mentioned above were evaluated. RESULTS: Compared with the Vehicle+SCIRI group, the DM+SCIRI group showed significantly reduced BMS and sub-BMS scores, decreased NeuN expression, shorter total movement distance, slower locomotion, increased proBDNF expression, and elevated IL-1β, IL-6, and TNF-α mRNA levels (all P<0.05 or P<0.01). Compared with the DM+SCIRI+Vehicle group, the DM+SCIRI+McAb-proB group exhibited significantly improved BMS and sub-BMS scores and decreased mRNA expression of IL-1β, IL-6, and TNF-α (all P<0.05 or P<0.01). CONCLUSIONS Hyperglycemia exacerbates neural injury and inflammatory response in SCIRI through upregulation of proBDNF expression, delaying motor functional recovery. Antagonizing proBDNF expression can alleviate neurological damage and promote functional recovery in diabetic mice after SCIRI.
Animals ; Male ; Hyperglycemia/metabolism* ; Brain-Derived Neurotrophic Factor/genetics* ; Mice, Inbred C57BL ; Reperfusion Injury/metabolism* ; Mice ; Diabetes Mellitus, Experimental/metabolism* ; Inflammation/metabolism* ; Disease Models, Animal ; Spinal Cord/metabolism* ; Tumor Necrosis Factor-alpha/metabolism* ; Protein Precursors/genetics* ; Spinal Cord Ischemia/metabolism* ; Interleukin-6/metabolism* ; Interleukin-1beta/metabolism*

Objective:To observe the effect of clopidogrel bisulfate combined with isosorbide mononitrate on levels of extracellular matrix metalloproteinase inducer(EMMPRIN),free fatty acid(FFA)and salusin-β in patients with coronary heart disease(CHD).Methods:This randomized controlled study enrolled 120 CHD patients admitted Hai'an People's Hospital between September 2019 and March 2021.The patients were divided into control group(n=60,isosorbide mononitrate therapy)and combined treatment group(n=60,clopidogrel bisulfate combined with isosor-bide mononitrate).Therapeutic effect,cardiac function,hemorheology,levels of EMMPRIN,FFA and salusin-β,and incidence of adverse reactions were compared between two groups.Results:Total effective rate in combined treatment group was significantly higher than that of control group(90％vs.70％,P=0.006).After 3-month treatment,compared with patients in control group,those in combined treatment group had significant higher cardi-ac output(CO)[(6.37±0.42)L/min vs.(8.97±0.52)L/min],left ventricular ejection fraction(LVEF)[(56.85±6.28)％vs.(61.16±7.14)％]and stroke volume(SV)[(64.55±4.19)ml vs.(69.74±5.32)ml],and significant lower plasma viscosity[(1.58±0.36)mPa·s vs.(1.09±0.25)mPa·s],whole blood viscosity[(6.91±0.79)mPa·s vs.(5.27±0.84)mPa·s],hematocrit[(48.17±5.73)％vs.(42.28±5.88)％],levels of EMMPRIN[(1.31±0.19)vs.(1.08±0.18)],FFA[(0.73±0.16)mmol/L vs.(0.54±0.15)mmol/L]and salusin-β[(3.59±0.49)nmol/L vs.(2.87±0.42)nmol/L](P＜0.001 all).We detected no significant differ-ence in incidence of adverse reactions between two groups(P=0.591).Conclusion:Clopidogrel bisulfate combined with isosorbide mononitrate can effectively improve cardiac function and hemorheology,and reduce EMMPRIN,FFA and salusin-β levels in CHD patients,and the safety is good.

Objective:This study aims to investigate the influence of Xinmailong injection on cardiac function and ser-um inflammatory indexes in patients with coronary heart disease(CHD)and heart failure(HF).Methods:This ran-domized controlled study enrolled 150 CHD+HF patients admitted in Hai'an People's Hospital between August 2019 and July 2020.They were divided into control group(n=75,routine anti-HF therapy)and combined treatment group(n=75,Xinmailong injection treatment based on control group).After 7d treatment,clinical therapeutic effect,symptom improvement time,cardiac function,serum inflammatory indexes and incidence of adverse reac-tions were compared between two groups.Results:The total effective rate in combined treatment group was signifi-cantly higher than that of control group(93.33％vs.80.00％,P=0.016).Compared with patients in control group after treatment,those in combined treatment group had significant shorter improvement time of pulmonary rales,systemic edema and dyspnea,significant higher cardiac output(CO),left ventricular ejection fraction(LVEF),6min walking distance(6MWD)and vascular endothelial growth factor(VEGF)level,and significant lower left ventricular end-diastolic diameter(LVEDd),levels of N terminal pro brain natriuretic peptide(NT-proBNP)and high sensitive C reactive protein(hsCRP)(P＜0.001 all).We detected no obvious adverse reactions in two groups during treatment.Conclusion:Routine anti-HF treatment combined with Xinmailong injection could not only effectively improve cardiac function,but also relieve inflammation in patients with coronary heart disease and heart failure,and its clinical efficacy and safety are both good.

Objective:To analyze the prognostic outcomes of 1 147 patients who underwent liver transplantation at Qingdao University Affiliated Hospital and to summarize measures to enhance the efficacy of liver transplantation.Methods:A retrospective analysis was conducted on the clinical and follow-up data of 1 147 liver transplant patients at Qingdao University Affiliated Hospital.Results:The overall postoperative 1-, 3-, and 5-year survival rates for the 1 147 liver transplant patients were 87.20%, 73.40%, and 65.60%, respectively. The survival rates for benign disease liver transplant recipients were 88.01%, 84.98%, and 81.39% at 1, 3, and 5 years post-transplant, respectively, compared to recipients transplanted for malignancies of 78.11%, 64.41%, and 60.06% (all P<0.001). Among the mid vs more recent period, patients' 1-year and 3-year postoperative survival rates were 84.20%, 70.80% vs 90.50%, 71.70%, respectively,significantly in favor of recently enrolled patients ( P=0.022). In the complex surgery group, patients' 1-, 3-, and 5-year survival rates were 82.70%, 65.50%, 56.70%, while in less complicated group, it was 89.00%, 76.50%, 69.20% ( P<0.001). The primary causes of death for benign disease recipients were multi-organ failure (4.1%), while in recipients with malignant disease primary cause of death was tumor recurrence (23.7%). Postoperative complications included primary graft dysfunction, delayed graft function recovery, portal vein thrombosis, hepatic artery thrombosis, biliary stricture, post-transplant lymphoproliferative disorder, and graft-versus-host disease, with occurrence rates of 1.05%, 6.89%, 1.92%, 0.44%, 2.00%, 0.61%, and 0.44%, respectively. Conclusions:With the continuous improvement in surgical techniques and perioperative care levels, the 3-year survival rate of recipients at our center has increased. Malignant diseases and complex liver transplantation remain crucial factors affecting recipient prognosis, highlighting the need to further enhance comprehensive treatment capabilities for patients with malignant diseases and complex surgeries.