Chronic liver diseases with common causes including viral infections， alcohol abuse， and autoimmune diseases. Alkaloids， as a class of plant-derived compounds， have shown significant potential in regulating chronic liver diseases. Recent studies have shown that alkaloids are able to exert a therapeutic effect on chronic liver diseases through multiple pathways. These compounds have a regulatory effect on key pathological processes such as liver fibrosis， inflammatory response， oxidative stress， and cell apoptosis， and they also regulate the metabolic homeostasis of hepatocytes by modulating multiple signaling pathways， thereby playing a role in regulating chronic liver diseases. This article reviews the role and mechanism of alkaloids in the treatment of chronic liver diseases， in order to provide new ideas and directions for the treatment of chronic liver diseases.

OBJECTIVE To provide practical basis and policy recommendations for improving the pharmacovigilance （PV） system construction in medical institutions across China. METHODS A questionnaire survey was conducted using a mixed sampling strategy of “online random sampling+offline supplementary sampling” to distribute questionnaires among pharmaceutical professionals in tertiary medical institutions nationwide. The questionnaire covered aspects such as the construction of PV systems， job position settings， information system support， operational practices， and multi-stakeholder collaboration. The data were analyzed using descriptive methods and SPSS 20.0 statistical software. RESULTS A total of 70 valid questionnaires were collected from 66 medical institutions， primarily Class A tertiary hospitals. The survey found that 90.00% had designated PV personnel and 74.29% routinely conducted PV activities. However， there were notable disparities in resource allocation and information system capacity， with less than 50% of the institutions conducting post-marketing drug re-evaluation. PV activities were primarily focused on the collection and reporting of adverse drug reactions， with limited capabilities in signal detection and risk assessment. CONCLUSIONS Among the surveyed tertiary hospitals， PV systems have begun to take shape. However， challenges persist in terms of system establishment， resource allocation， risk assessment， and inter-organizational coordination. Policy efforts should focus on strengthening regulatory frameworks， improving information sharing mechanisms， enhancing professional training， and strengthening collaboration between hospitals and market authorization holders to ensure the effective implementation of PV in medical institutions.

Objective:To analyze the effects of shift work on the renal function of oil workers and investigate whether there is a measured response relationship between shift work and renal dysfunction.Methods:In this study, oil workers who participated in physical examinations at the North China Oilfield Downhole Hospital were selected as the study subjects, and the physical examinations as well as questionnaires of the study subjects in 2017 and 2018 were collected as the baseline data, which included blood biochemical indexes, socio-demographic characteristics, history of life behaviors, occupational exposures, and occupational histories. Three follow-up surveys were subsequently conducted in April 2019, April 2020, and January 2021. The presence of renal dysfunction in the study population was determined based on the glomerular filtration rate tested at the medical examination hospital. The exposure of the study subjects to shift work was assessed using the weighted shift index (WSI), the relationship between different levels of shift work and renal dysfunction was analyzed using Cox regression, and the measure of WSI and renal dysfunction was explored by restricted cubic spline (RCS). response relationship.Results:A total of 2292 study participants were included in this study, and the prevalence density of renal dysfunction was 87.44 k/year, of which the prevalence of renal dysfunction in females (30.31%), those with per capita monthly income <2, 000 yuan (27.00%), those who consume alcohol (27.10%), those who are hypertensive (23.05%), those who are exposed to high temperatures (27.37%), those who are exposed to organic solvents (30.42%), and those who are engaged in shift work (25.87%) were to be found had a higher prevalence of renal dysfunction ( P<0.05). After correcting for age, sex, and other risk factors, there was a nonlinear association between intensity of shift work and renal dysfunction, with a hazard ratio ( HR) of 1.29 (95% CI: 0.98-1.59) for the development of renal dysfunction in petroleum workers for shift work performed at higher intensities, and moderate intensity of exposure to shift work reduced the risk of renal dysfunction in petroleum workers ( HR=0.54 with a 95% CI: 0.39-0.75, P<0.001) . Conclusion:Prolonged shift work increases the risk of renal dysfunction in oil workers, and the occurrence of renal dysfunction in oil workers is influenced by multiple factors.

Objective To explore the influencing factors of coronary artery lesion severity in patients with acute coronary syndrome (ACS). Methods Clinical data of ACS patients admitted to Zhongshan Hospital, Fudan University from December 2017 to December 2019 were consecutively collected. The modified Gensini score was used to assess the severity of coronary artery lesions. Univariate and multivariate linear regression analyses were performed to identify independent factors associated with coronary artery lesion severity. Results A total of 1 689 ACS patients were included, with an average age of (64.04±11.45) years; 1 353 (80.11%) were male, and the mean modified Gensini score was (8.12±4.03). Multivariate linear regression analysis revealed that sex (β＝0.97, P＝0.001), age (β＝0.03, P＝0.021), estimated glomerular filtration rate (eGFR; β＝－0.03, P＜0.001), low-density lipoprotein cholesterol (LDL-C; β＝0.58, P＜0.001), apolipoprotein A1 (Apo A1; β＝－1.28, P＝0.012), lipoprotein(a) [Lp(a); β＝0.001, P＝0.033], and glycated hemoglobin A_1C (HbA_1C; β＝0.45, P＜0.001) were independent influencing factors of the modified Gensini score. Conclusions Metabolic indicators, including Apo A1, LDL-C, HbA_1C, and Lp(a), may serve as risk factors for coronary artery lesion severity in ACS patients, with Apo A1 demonstrating the strongest impact.

Objective: To investigate the mechanism of action of curcumol on mitochondrial autophagy in hepatic stellate cells and its molecular mechanism against liver fibrosis. Methods : Hepatic stellate cells were divided into blank group, model group(lipopolysaccharide 5 mg/L), and low, medium and high curcumol group(12.5, 25 and 50 mg/L); Thiazolyland(MTT) was used to detect the effects of curcumol on the viability of hepatic stellate cells; flow cytometry was used to detect the effects of curcumol on apoptosis of hepatic stellate cells; 5,5′,6,6′-Tetrachloro-1,1′,3,3′-tetraethylimidacarbocyanine iodide(JC-1) was used to detect the mitochondrial membrane potential; effects of curcumol on mitochondrial morphology and autophagosome were detected by transmission electron microscopy; effect of curcumol on mitochondrial localisation were detected by fluorescent probe; Immunoblotting assay was performed to detect the effects of curcumin on PTEN-induced putative kinase 1(PINK1), Parkinson's disease protein(Parkin), microtubule-associated protein light chain 3(LC3), autophagy-associated protein(Beclin1), mitochondrial inner membrane translocase 23(Timm23), mitochondrial outer membrane translocase 20(Tomm20), Bcl-2 associated X protein(Bax), B lymphocytoma-2(Bcl2), cleaved-cysteine protease 3(Caspase3), α-smooth muscle actin(ɑ-SMA), collagen type Ⅰ(Collagen Ⅰ), and collagen type Ⅲ(Collagen Ⅲ) protein expression. Results : Compared with the blank control group, cell proliferation rate, Caspase3, Bcl2, LC3Ⅱ, Beclin1, PINK1, Parkin, ɑ-SMA, CollagenⅠ, CollagenⅢ proteins significantly increased in the model group(P<0.01), co-localisation of mitochondria and lysosomes increased, and the number of mitochondrial autophagosome significantly increased(P<0.01), while Timm23 and Tomm20 proteins, mitochondrial membrane potential decreased significantly(P<0.01), apoptosis rate decreased, and Bax protein expression decreased. Compared with the model group, after curcumol intervention, cell proliferation rate, Bcl2, Timm23, Tomm20, α-SMA, CollagenⅠ and CollagenⅢ protein expression significantly decreased in the curcumol low-, medium-and high-concentration groups(P<0.01), and the mitochondrial membrane potential significantly decreased(P<0.01), whereas apoptosis rate, Caspase3, Bax, LC3Ⅱ, Beclin1, PINK1 and Parkin proteins significantly increased(P<0.05), the co-localisation of mitochondria and lysosomes increased, and the number of mitochondrial autophagosome significantly increased(P<0.01). Conclusion Curcumol exerts ameliorative effects on hepatic fibrosis by modulating mitochondrial hyperautophagy mediated by the PINK1/Parkin signaling pathway, and promoting hepatic stellate cell apoptosis.

Objective To understand the changes in self-rated health among middle-aged and elderly individuals in China and the influencing factors,providing a reference for improving health and promoting healthy aging.Methods Using data from the China Health and Aged Care Tracking Survey(CHARLS)from 2011 to 2020,this study analyzed 3595 middle-aged and elderly individuals(≥45 years old)who participated in all five rounds of the survey from 2011 to 2020.Univariate analysis and multinomial logistic regression were employed to analyze the influencing factors of self-rated health changes.Results Among the 3 595 middle-aged and elderly individuals,26.54％reported an increase in self-rated health,28.40％reported a decrease,and 45.06％reported no change.The multinomial logistic regression results indicated that compared to those with unchanged self-rated health,individuals whose self-rated health declined were more likely to have an increased number of Activities of Daily Living(ADLs),a higher number of chronic diseases,not engaging in at least 10 minutes of light physical activity per week,and a decline in life satisfaction levels.The odds ratios for these factors were 1.415(OR=1.415,95％CI:1.181～1.694),1.479(OR=1.479,95％CI:1.225～1.785),1.454(OR=1.486,95％CI:1.172～1.804),and 1.263(OR=1.237,95％CI:1.043～1.530),respectively.In contrast,individuals whose self-rated health improved,compared to those with unchanged health,were more likely to report an increase in life satisfaction levels,while an increase in ADLs and chronic diseases negatively impacted self-rated health improvement.The odds ratios for these factors were 1.698(OR=1.698,95％CI:1.425～2.023),0.769(OR=0.769,95％CI:0.646～0.915),and 0.689(OR=0.689,95％CI:0.549～0.865),respectively.Conclusion From 2011 to 2020,the self-rated health of middle-aged and elderly individuals in China has slightly declined,with a focus on improving physical health status,increasing physical activity,and addressing mental health as key areas for enhancing self-rated health among the elderly in China.

Objective:To analyze the effects of shift work on the renal function of oil workers and investigate whether there is a measured response relationship between shift work and renal dysfunction.Methods:In this study, oil workers who participated in physical examinations at the North China Oilfield Downhole Hospital were selected as the study subjects, and the physical examinations as well as questionnaires of the study subjects in 2017 and 2018 were collected as the baseline data, which included blood biochemical indexes, socio-demographic characteristics, history of life behaviors, occupational exposures, and occupational histories. Three follow-up surveys were subsequently conducted in April 2019, April 2020, and January 2021. The presence of renal dysfunction in the study population was determined based on the glomerular filtration rate tested at the medical examination hospital. The exposure of the study subjects to shift work was assessed using the weighted shift index (WSI), the relationship between different levels of shift work and renal dysfunction was analyzed using Cox regression, and the measure of WSI and renal dysfunction was explored by restricted cubic spline (RCS). response relationship.Results:A total of 2292 study participants were included in this study, and the prevalence density of renal dysfunction was 87.44 k/year, of which the prevalence of renal dysfunction in females (30.31%), those with per capita monthly income <2, 000 yuan (27.00%), those who consume alcohol (27.10%), those who are hypertensive (23.05%), those who are exposed to high temperatures (27.37%), those who are exposed to organic solvents (30.42%), and those who are engaged in shift work (25.87%) were to be found had a higher prevalence of renal dysfunction ( P<0.05). After correcting for age, sex, and other risk factors, there was a nonlinear association between intensity of shift work and renal dysfunction, with a hazard ratio ( HR) of 1.29 (95% CI: 0.98-1.59) for the development of renal dysfunction in petroleum workers for shift work performed at higher intensities, and moderate intensity of exposure to shift work reduced the risk of renal dysfunction in petroleum workers ( HR=0.54 with a 95% CI: 0.39-0.75, P<0.001) . Conclusion:Prolonged shift work increases the risk of renal dysfunction in oil workers, and the occurrence of renal dysfunction in oil workers is influenced by multiple factors.

OBJECTIVE To know about the perception and current status of drug risk management among pharmacists in Chinese medical institutions,providing insights and recommendations for enhancing the drug risk management system in medical institutions.METHODS A questionnaire survey was conducted across 28 provinces,cities,and autonomous regions;stratified radom sampling was employed to study the population of medical workers and pharmaceutical professionals in medical institutions nationwide.The survey included information on the survey population,the current status of drug risk management implementation in medical institutions,the cognition,definition and process of drug risk management related concepts,and the content and mode of drug risk management work in medical institutions.Finally,suggestions were collected from various medical institutions on the system construction of drug risk management.Descriptive statistical analysis was adopted to summarize the obtained data.RESULTS A total of 446 questionnaires were collected in this survey,including 420 valid questionnaires and 26 invalidquestionnaires.The questionnaire collection rate was 100％,and the effective rate was 94.17％.51.19％ of the respondents based their understanding of drug risk management on Management Measures for Adverse Drug Reaction Reports and Monitoring,while 87.38％ recognized the need for drug risk management throughout the drug use process.63.33％ of the participants stated that their medical institutions had dedicatedpositions related to drug risk management,with the highest proportion (72.17％) was in third-grade class A medical institutions.66.43％ reported implementing risk management across all drug use stages.Suggestions for the development of drug risk management systems in medical institutions by the research participants focused on enhancing guiding documents,clarifying concepts,establishing information-sharing mechanisms.CONCLUSIONS The overall awareness of drug risk management in China's medical institutions is high,with practices in place across various stages in multiple forms.However,there remains a need to strengthen institutional documents,management regulations,system development,and information-sharing mechanisms to improve collaborative governance,improve drug management levels,and ensure patient safety.

BACKGROUND:In recent years,the development of liver organoids has made it a hot spot in the field of international liver disease research,but there is still no article on the bibliometric analysis of liver organoids. OBJECTIVE:To explore the hot trends in liver organoids in the last 20 years based on bibliometrics and visualization analysis. METHODS:We searched the articles about liver organoids in the Web of Science Core Collection from January 1,2002 to November 12,2022.Origin,Office,and CiteSpace software were used for bibliometrics and visualization analysis.We statistically analyzed the number of annually published articles,countries,institutions,authors,journals,and keywords of the articles by generating charts. RESULTS AND CONCLUSION:The number of articles,citation frequency,institutions and personnel involved in the research about liver organoids showed an overall upward trend in the last 20 years,indicating that the field was growing rapidly and attention was increasing.The USA had published the most papers and had the strongest influence in this field.Although it had invested a lot of time and energy,the number of papers published by a single research institution in the USA was not the highest among many research institutions.China was second only to the USA in the number of publications,with the Chinese Academy of Sciences and Fudan University leading the list.Utrecht University in the Netherlands was the institution with the most publications.Clevers H was the author with the highest number of articles.The article with the highest co-citation frequency was"Long-term culture of genome-stable bipotent stem cells from adult human liver".The main fields of study for liver organoids were Molecular Science,Biology,and Immunology.The most frequently occurring keywords were stem cell,in vitro,and culture.The research hotspots in the liver organoids field were mainly focused on in vitro stem cell three-dimensional culture,differentiation and gene expression.

Chronic liver disease(CLD)tends to have a high incidence rate and impose a serious burden on society and families.Studies have shown that metal ion metabolism is closely associated with CLD,and some Chinese herbal medicines can play a role in the prevention and treatment of CLD by regulating metal ion metabolism.At present,the synthetic drugs currently used for the treatment of CLD fail to achieve a satisfactory effect,and therefore,a variety of Chinese herbal medicines are being used as supplementary and alternative therapies for CLD.This article introduces the role of metal ion metabolism in CLD and the regulatory effect of Chinese herbal medicines and their active components on CLD,and the analysis shows that metal ion metabolism is expected to provide new ideas for the research on CLD and a theoretical basis for the clinical treatment of CLD.For the role of metal ion metabolism in the treatment of CLD,more prospective clinical study data are needed in the future to provide effective and safe treatment regimens for patients with CLD.