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.

Objectives The combined use of bedaquiline and delamanid(BDQ-DLM)is limited by an increased risk of prolonging the QTc interval.We retrospectively evaluated patients who received DLM/BDQ-containing regimens at a TB-specialized hospital.We aimed to present clinical efficacy and safety data for Chinese patients. Methods This case-control study included patients with multidrug-resistant tuberculosis(MDR-TB)treated with BDQ alone or BDQ plus DLM. Results A total of 96 patients were included in this analysis:64 in the BDQ group and 32 in the BDQ+DLM group.Among the 96 patients with positive sputum culture at the initiation of BDQ alone or BDQ combined with DLM,46 patients(71.9%)in the BDQ group and 29(90.6%)in the BDQ-DLM group achieved sputum culture conversion during treatment.The rate of sputum culture conversion did not differ between the two groups.The time to sputum culture conversion was significantly shorter in the BDQ-DLM group than in the BDQ group.The most frequent adverse event was QTc interval prolongation;however,the frequency of adverse events did not differ between the groups. Conclusion In conclusion,our results demonstrate that the combined use of BDQ and DLM is efficacious and tolerable in Chinese patients infected with MDR-TB.Patients in the BDQ-DLM group achieved sputum culture conversion sooner than those in the BDQ group.

To explore the prevalence and related risk factors of osteoporosis (OP) in the elderly ≥60 years old in Jiuting Town, Songjiang District, Shanghai City. A total of 2 175 local residents aged ≥60 years old who participated in the questionnaire survey at the physical examination center of Jiuting Community Health Service Center, Songjiang District, Shanghai City from July 2021 to December 2022 were selected by a cross-sectional study with multi-stage sampling method. Questionnaire survey, blood test and bone mineral density (BMD) test were conducted.The differences in all the parameters among the elderly with different bone mass level were analyzed using t-test, chi-square test, binary logistic regression was used to screen the potential risk factors of OP.The results showed that the prevalence of OP in the elderly aged≥60 years old in Jiuting Town was 45.89%.The prevalence of OP increased gradually with the advanced age. The prevalence rate of male was significantly lower than that of female( χ2=211.94, P<0.01).Single factor analysis showed that Dairy products( χ2=9.01, P<0.05), taking calcium( χ2=42.88, P<0.05), physical exercise( χ2=24.73, P<0.05), exercise time( χ2=76.40, P<0.05) and sun exposure( χ2=55.71, P<0.05) were the protective factors for osteoporosis. Multifactor analysis showed that female( wald χ 2=71.46, P<0.001) were the risk factors for osteoporosis. The age of the osteoporosis group was older than that of the non-osteoporosis group [osteoporosis group (72.47±6.89) years old, non-osteoporosis group (68.73±6.34) years old, and the difference was statistically significant, t=-11.67, P<0.05]. The waist circumference, alanine aminotransferase (ALT), creatinine (CR), blood urea nitrogen (BUN) and uric acid (UA) in the non-osteoporosis group were higher than those in the osteoporosis group, and the difference was statistically significant (all P<0.05). The levels of high-density lipoprotein (HDL)[osteoporosis group (1.34±0.35) mol/L, non-osteoporosis group (1.41±0.35) mol/L, t=-4.51, P<0.05] and alkaline phosphatase (ALP)[osteoporosis group (88.46±25.65) mol/L, osteoporosis group (94.56±32.32) mol/L, t=-4.79, P<0.05] in the osteoporosis group were lower than those in the non-osteoporosis group.Low awareness of the knowledge of osteoporosis risk factors(smoking, drinking coffee, high salt and drinking alcohol are 47.28%, 24.15%, 47.79% and 44.90%, respectively), diagnosis and treatment(The symptoms, prognosis, screening methods, medication time and follow-up screening time of osteoporosis were 26.87%, 17.88%, 21.77%, 6.65% and 15.99%, respectivel) and prevention(exercise mode, high calcium food, optimal age of calcium supplementation, the effect of vitamin D on OP, and the appropriate amount of milk to prevent osteoporosis were 33.16%, 42.01%, 13.27%, 12.07%, 9.01%, respectively) were in Jiuting Town. In conclusion, the prevalent rate of OP in the elderly ≥60 years old in Jiuting Town is 45.89%.The main risk factors are female and advanced age. Drinking tea, dairy products, combination of meat and vegetable, taking calcium, physical exercise and sun exposure were the protective factors for osteoporosis. The awareness rate of osteoporosis related knowledge is low, and health education should be strengthened in order to control and prevent the occurrence and development of osteoporosis.

Objective:To construct a reliability management index system of cardiology medical equipment supply,to form a reliability evaluation strategy,and to improve the effectiveness of reliability management.Methods:13 supply management items were decomposed from the three links of spare parts before use,tracking during use and post-use processing of 126 medical equipment,and the probability of work error,probability of quality problems and risk expectation of diagnosis and treatment were evaluated in the whole process management,and the whole-process management countermeasures of grading and stratification,quality standardization and department cooperation was formed.2,000 pieces(sets)of medical equipment used in The People's Hospital of Longhua from 2021 to 2022 were selected by random sampling method,and the department cooperative management[referred to as collaborative management mode,1,000 pieces(sets)times]and reliability evaluation management[referred to as evaluation management mode,1,000 pieces(sets)times]were adopted respectively.The reliability and satisfaction of medical equipment under different management modes were compared.Results:The work error probabilities of pre-use spare parts,in-use tracking,post-use processing and supply of medical equipment adopting evaluation management mode were(4.74±2.19)%,(4.39±1.85)%,(5.75±1.88)%and(8.29±1.30)%,respectively,which were lower than the collaborative management mode,the difference was statistically significant(t=5.367,5.663,5.432,6.847;P<0.05);the probabilities of quality problems were(4.13±1.67)%,(3.89±1.25)%,(5.28±1.84)%and(7.64±1.18)%,respectively,which were lower than the collaborative management mode,the difference was statistically significant(t=6.504,6.229,5.123,6.166,P<0.05);the risk expectations of diagnosis and treatment were(2.74±0.89)%,(2.47±0.96)%,(3.42±0.95)%and(4.02±1.09)%,respectively,which were lower than the collaborative management mode,the difference was statistically significant(t=7.027,6.509,8.915,9.266,P<0.05).The satisfaction of the relevant staff on the performance quality,sterilization specifications,supply timeliness,level of collaboration and safety of the medical equipment adopting the evaluation management mode were(93.54±4.65)%,(91.67±4.11)%,(94.58±4.34)%,(92.39±3.82)%and(90.97±3.76)%,respectively,which were higher than the collaborative management mode,the difference was statistically significant(t=2.809,3.030,2.843,4.939,3.739,P<0.05).Conclusion:The reliability management model can reduce the work errors and security risks in medical equipment supply,improve the reliability of supply and improve the quality of supply service.

To explore the prevalence and related risk factors of osteoporosis (OP) in the elderly ≥60 years old in Jiuting Town, Songjiang District, Shanghai City. A total of 2 175 local residents aged ≥60 years old who participated in the questionnaire survey at the physical examination center of Jiuting Community Health Service Center, Songjiang District, Shanghai City from July 2021 to December 2022 were selected by a cross-sectional study with multi-stage sampling method. Questionnaire survey, blood test and bone mineral density (BMD) test were conducted.The differences in all the parameters among the elderly with different bone mass level were analyzed using t-test, chi-square test, binary logistic regression was used to screen the potential risk factors of OP.The results showed that the prevalence of OP in the elderly aged≥60 years old in Jiuting Town was 45.89%.The prevalence of OP increased gradually with the advanced age. The prevalence rate of male was significantly lower than that of female( χ2=211.94, P<0.01).Single factor analysis showed that Dairy products( χ2=9.01, P<0.05), taking calcium( χ2=42.88, P<0.05), physical exercise( χ2=24.73, P<0.05), exercise time( χ2=76.40, P<0.05) and sun exposure( χ2=55.71, P<0.05) were the protective factors for osteoporosis. Multifactor analysis showed that female( wald χ 2=71.46, P<0.001) were the risk factors for osteoporosis. The age of the osteoporosis group was older than that of the non-osteoporosis group [osteoporosis group (72.47±6.89) years old, non-osteoporosis group (68.73±6.34) years old, and the difference was statistically significant, t=-11.67, P<0.05]. The waist circumference, alanine aminotransferase (ALT), creatinine (CR), blood urea nitrogen (BUN) and uric acid (UA) in the non-osteoporosis group were higher than those in the osteoporosis group, and the difference was statistically significant (all P<0.05). The levels of high-density lipoprotein (HDL)[osteoporosis group (1.34±0.35) mol/L, non-osteoporosis group (1.41±0.35) mol/L, t=-4.51, P<0.05] and alkaline phosphatase (ALP)[osteoporosis group (88.46±25.65) mol/L, osteoporosis group (94.56±32.32) mol/L, t=-4.79, P<0.05] in the osteoporosis group were lower than those in the non-osteoporosis group.Low awareness of the knowledge of osteoporosis risk factors(smoking, drinking coffee, high salt and drinking alcohol are 47.28%, 24.15%, 47.79% and 44.90%, respectively), diagnosis and treatment(The symptoms, prognosis, screening methods, medication time and follow-up screening time of osteoporosis were 26.87%, 17.88%, 21.77%, 6.65% and 15.99%, respectivel) and prevention(exercise mode, high calcium food, optimal age of calcium supplementation, the effect of vitamin D on OP, and the appropriate amount of milk to prevent osteoporosis were 33.16%, 42.01%, 13.27%, 12.07%, 9.01%, respectively) were in Jiuting Town. In conclusion, the prevalent rate of OP in the elderly ≥60 years old in Jiuting Town is 45.89%.The main risk factors are female and advanced age. Drinking tea, dairy products, combination of meat and vegetable, taking calcium, physical exercise and sun exposure were the protective factors for osteoporosis. The awareness rate of osteoporosis related knowledge is low, and health education should be strengthened in order to control and prevent the occurrence and development of osteoporosis.

Objective:To discuss the postoperative survival of the gastric cancer patients with different expression levels of myeloid ecotropic viral integration site 1(MEIS1),and to analyze the predictive value of MEIS1 expression in the prognosis evaluation of gastric cancer.Methods:In a gastric cancer survival cohort,215 patients who underwent radical gastrectomy were selected.Immunohistochemical staining was used to detect the expression levels of MEIS1 in both gastric cancer and adjacent normal tissues.The relationship between expression level of MEIS1 and the clinicopathological characteristics of the patients were analyzed by x2 test or Fisher's exact probability method;survival curves were plotted by Kaplan-Meier method;the differences in survival of the patients between MEIS1 high expression group and MEIS1 low expression group were compared by Log-rank test;multivariate Cox proportional hazards regression model was used to calculate the hazard ratios(HR)and 95％confidence intervals(CI)to assess the relationship between MEIS1 expression level and the survival of the gastric cancer patients.Results:The immunohistochemical staining result showed that the expression level of MEIS1 in gastric cancer tissue was decreased.The univariate analysis results showed that the patients with high MEIS1 expression had a longer overall survival than those with low expression(P=0.049),and had a better prognosis.The multivariate Cox proprotional hazards regression analysis results showed that the low MEIS1 expression and high TNM stage were the independent risk factors for poor prognosis of the patients with gastric cancer(HR=1.577,95％CI:1.011-2.460,P=0.045;HR=2.709,95％CI:1.708-4.297,P＜0.001).Conclusion:The gastric cancer patients with low expression of ME1S1 have a shorter postoperative overall survival;MEIS1 is a promising biomarker for prognosis assessment of the patients after radical gastrectomy.

Solitary cervical submental nodule is a relatively rare case in clinical procedure and prone to miss diagnosis.Differential diagnosis with various head and neck diseases is necessary.This article reported a case of solitary cervical submental metastasis of papillary thyroid carcinoma received in the department of surgery,Civil Aviation Shanghai Hospital,Ruijin Gubei Branch,Shanghai Jiao Tong University School of Medicine.The patient came to the outpatient clinic for treatment due to"consciously larger submental tubercle than before".Ultrasound examination revealed suspicious lesions in both the thyroid and submental regions.Ultrasound-guided final needle aspiration biopsy diagnosed as malignant tumor.Surgical resection was performed and the central group lymph nodes dissected Pathological examination confirmed papillary thyroid carcinoma with solitary submental metastasis.This article reported the clinical diagnosis and treatment of this case,in order to improve the disease recognition for clinicians,and make differential diagnosis with other rare neck diseases,and avoid missing diagnoses.

Objective:To evaluate the application value of transabdominal wall suspended laparoscopic appendectomy (LA) in patients with acute suppurative appendicitis or concurrent periappendiceal abscess.Methods:The clinical data of 107 patients with acute suppurative appendicitis or concurrent periappendiceal abscess in Hexi University, Zhangye People′s Hospital from September 2019 to December 2022 were retrospectively analyzed. Among them, 53 patients underwent open appendectomy (OA) (OA group), and 54 patients underwent transabdominal wall suspended LA (LA group). The operation time, postoperative pain score, postoperative hospitalization time, recovery time of gastrointestinal function, postoperative complications and hospital cost were compared between two groups.Results:In the LA group, 2 cases were transferred to OA due to heavy abdominal adhesion and unclear anatomy, and 3 cases could not undergo transabdominal wall suspended LA due to perforation of the root of the appendix or gangrene of the appendix. There was no statistical difference in operation time between two groups ( P>0.05); the postoperative hospitalization time, recovery time of gastrointestinal function, postoperative pain score and total incidence of postoperative complications in LA group were significantly lower than those in OA group: (4.92 ± 1.70) d vs. (7.51 ± 3.96) d, (20.64 ± 7.37) h vs. (35.32 ± 10.13) h, (5.62 ± 1.12) scores vs. (6.83 ± 0.93) scores and 5.56% (3/54) vs. 24.53% (13/53), the hospital cost was significantly higher than that in OA group: (8 325.47 ± 856.22) yuan vs. (6 458.64 ± 2 085.93) yuan, and there were statistical differences ( P<0.05). Conclusions:Transabdominal wall suspended LA has the advantages of wide indications, easy operation, minimal trauma, fast recovery, and fewer complications, but with relatively high hospitalization cost.