Obesity is an important risk factor of type 2 diabetes (T2D), which has become an important factor threatening human health. However, no perfect drug choice for obesity exists. Semaglutide is a kind of human glucagon-like peptide-1 (GLP-1) analog that promotes insulin secretion while inhibiting glucagon secretion through a glucose concentration-dependent mechanism. GLP-1 can also delay stomach emptying and suppress appetite to help lose weight. This review summarizes clinical evidence of the semaglutide effect on T2D and obesity and establishes expectations on future clinical trials for obesity treatment.
Diabetes Mellitus, Type 2/drug therapy* ; Glucagon-Like Peptide-1 Receptor/therapeutic use* ; Glucagon-Like Peptides ; Humans ; Hypoglycemic Agents/therapeutic use* ; Motivation ; Obesity/drug therapy*

This article aims to illustrate how to integrate "online + offline" teaching resources and organize and implement the student-centered online blended clerkship teaching under the COVID-19 epidemic. Taking the eight-year clerkship course in Xiangya Hospital of Central South University as an example, the clerkship includes autonomous learning based on online teaching platform (ICC), debriefing online discussion, CBL online discussion, and online practical operation of diagnostic skills teaching based on video feedback. According to the questionnaire survey, it suggests a high rating in student satisfaction for on-line blended teaching clerkship courses, with excellent theoretical knowledge, and remarkable improvement in clinical operation skills. It is certain that professionals in medical education would invest much more in the future to improve medical students' clinical reasoning skills and clinical operation techniques by applying and blending teaching resources.

Objective:To estimate the burden of hip fractures and related factors among the Chinese middle-aged and elderly population.Methods:Based on the data of China Health and Retirement Longitudinal Study (CHARLS) in 2015, the burden of hip fractures among Chinese middle-aged and elderly population was evaluated as the years lived with disability (YLD) rate. The relationship between gender, age (45-49, 50-59, 60-69 and ≥70 years old), educational level (no education, elementary school, junior high school, high school and above), region (urban, rural), gross domestic production (GDP) per capita (low, medium and high) and geographic area (northern, eastern, south-central, northwest and southwest regions) and the YLD rate of hip fractures were analyzed, respectively.Results:Excluding items with missing basic information and hip fracture data, a total of 17,830 subjects (8,405 males and 9,425 females) were included in the study with average age 61.6±9.8 years (range 45 to 105 years). The average age in male was 61.9±9.6 years, and that in female was 61.2±10.1 years. The prevalence of hip fractures was 2.3% (410/17,830). The total YLD rate was [694/100,000 (95% Uncertainty Interval ( UI): 462/100,000, 989/100,000)]. The YLD rates were similar between male [693/100,000 (95% UI: 461/100,000, 988/100,000)] and female [696/100,000 (95% UI: 463/100,000, 992/100,000)] subgroups. The YLD rate of hip fractures was increasing with age, which reached at maximum of 1,155/100,000 (95% UI: 769/100,000, 1,646/100,000) for participants aged 70 years or above. The rate was gradually decreased with the upgrade of the educational level. The participants with high school education and above reached the lowest of 434/100,000 (95% UI: 289/100,000, 619/100,000). In addition, the YLD rate of hip fractures in rural areas [721/100,000 (95% UI: 480/100,000, 1,027/100,000)] was higher than that in urban areas [650/100,000 (95% UI: 433/100,000, 926/100,000)]. The YLD rate in areas with higher GDP per capita [545/100,000 (95% UI: 363/100,000, 777/100,000)] was lower than that in areas with lower GDP per capita [761/100,000 (95% UI: 506/100,000, 1,084/100,000)]. Moreover, the participants living in the Northwest region were with the highest YLD rate of hip fractures [1,056/100,000 (95% UI: 703/100,000, 1,506/100,000)], followed by the Southwest region [887/100,000 (95% UI: 590/ 100,000, 1,264/100,000)] and the Northeast region [317/100,000 (95% UI: 211/100,000, 452/100,000)]. Conclusion:Hip fractures exerted heavy burdens on the Chinese middle-aged and elderly population. The YLD rate of hip fractures varied according to geographical regions, greater age, rural areas, low educational levels and low GDP per capita. These related factors could affect the disease burden of hip fractures in China.

Objective To study the changes of microarchitecture, bone mineral density (BMD) , and bone mineral content (BMC) in apolipoprtein E knockout( ApoE-/-) mice. Methods Male ApoE-/- mice at 15, 28, and 40-week of age and sex-age-matched wild-type (WT) mice were involved in the study. The trabecular and cortical bone microarchitecture were assessed by micro-CT( μCT) in the right distal femur. The total body BMD of the left femur was determined by dual-energy X-ray absorptiometry ( DXA). The relationships among BMD, microarchitecture, and BMC were analyzed. Results Compared with WT mice,the advancing age ApoE-/- mice showed an increased volumetric BMD (vBMD), tissue BMD (tBMD) , BMC, bone volume fraction (BV/TV), trabecular number (Tb. N ) , trabecular thickness (Tb. Th) with an decreased bone surface fraction ( BS/BV), trabecular separation (Tb. SP) , and the structure mode index (P <0. 05 ) in the cancellous bone of femur. The cortical bone microarchitecture parameters as inner perimeter, outer perimeter, cortical area, marrow area, total area and moment of inertia were also increased, but cortical BMD, cortical bone mineral content (C. BMC) and cortical thickness retained constant. At the age of 28 weeks,the total body BMD in ApoEE-/- mice revealed higher than WT mice (P<0. 05) and there was no changes in 15 and 40-week-old mice compared with the sex-age-matched controls. vBMD was positively correlated with BMC, BV/TV,Tb. Th, BS/BV, and C. BMC, with the correlation coefficients 0.955,0.944,0. 834,0.923, and 0.903 .respectively, and there was no correlation between vBMD and the other parameters. Conclusions ApoEE-/- mice display an increased bone mass, suggesting that ApoE has an important role in bone remodeling.

-β2 was positively correlated with OPG (r=0. 432,P<0. 01). Conclusions The reference ranges of serum TGF-β1 and TGF-β2 in healthy adult females are established. Both TGF-β1 and TGF-β2 of them are correlated with OPG and ieptin.

Objective To determine the relationship between serum testosterone level and lean body mass, body fat content, and bone mineral density (BMD) . Methods The study involved 185 healthy females in Changsha, aged 45 ～81. Fasting serum testosterone was measured by radioimmu-noassay. Hologic QDR 4500A fan beam X-ray bone densitometer was used to measure the BMD of anteroposterior lumber (AP, L_(1～4)) and total hip, to measure the bone mineral content, BMD, body fat content and muscle tissue weight of head, trunk, ribs, pelvis, spine, upper limbs, lower limbs and the total body. Body weight, lean body mass and body fat percentage were calculated. SPSS 11.0 software was used to conduct regression analysis. Results (1) Serum testosterone showed no correlation with lean body mass, body fat content, and body fat percentage. (2) Serum testosterone was positively related with the BMD of lumbar spine and hip, but showed no correlation with the BMD after adjustment of age and years since postmenopause. (3) Lean body mass showed significant positive correlation with the BMD of different sites. Total body fat content showed positive correlation with the BMD of total hip, while body fat percentage showed negative correlation with the BMD of the whole body. Conclusion Keeping lean body mass benefits postmenopausal women to maintain bone mineral content, and taking androgen should still be cautious.

OBJECTIVE: To determine the relationship between concentration of serum leptin and age in females, and to establish the reference value and compare it with other races. METHODS: Serum leptin concentration of 690 adult healthy women (aged 20 approximately 81 years) was measured with ELISA. RESULTS: The serum leptin concentration increased with age (r=0.224, P<0.001), and cubic regression was the best-fitting model. Leptin concentration had significant positive correlation with weight (r=0.574) and body mass index (r=0.618). The geometric mean of leptin concentration in normal weight, overweight and obesity was (8.94+/-1.82), (17.6+/-1.89), and (34.7+/-1.69) microg/L, respectively, with significant difference among the 3 groups (P<0.001). Leptin in pre-menopause, peri-menopause and post-menopause women was (9.68+/-1.81), (11.7+/-1.89), and (11.4+/-2.21) microg/L, respectively. The reference value of serum leptin in normal weight females was 5.30 approximately 12.6 microg/L. The curve-fitting of leptin with age in this group was significantly lower than American non Hispanic White (NHW), non Hispanic Black (NHB), and American Mexican (AM) females. CONCLUSION This study provides reliable reference value of serum leptin in adult women and discovers ethnic difference with American NHW, NHB, and AM females.
Adult ; Age Factors ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; China ; ethnology ; European Continental Ancestry Group ; Female ; Humans ; Leptin ; blood ; Middle Aged ; Reference Values ; Young Adult

Serum osteoprotegerin (OPG) concentration was measured in 647 healthy female adults (aged 20-81 years), and was compared with that of other races. The serum OPG was positively correlated with age (r = 0.276, P <0.01). The geometric mean value of serum OPG in premenopausal women was significantly lower than those in perimenopansal and postmenopausal women. The serum OPG in middle-aged Chinese women was signifieandy higher than those in middle-aged Austrian and Icelandic, but this was quite contrary to the results obtained in old-aged women.

This in vitro study demonstrated that taurine supplemented culture medium enhanced alkaline phosphatase (ALP) activity, osteocalcin secretion and mineralized matrix formation. Taurine induced activation of ERKI/2 and osteoblast differentiation, which was blocked by pretreatment of osteoblasts with ERKI/2 inhibitor (PD98059), suggesting taurine stimulated osteoblast differentiation via ERKI/2.

Objective To investigate the mechanisms of action of adiponectin on receptor activator of NF-Kb ligand(Rankl) and osteoprotegerin (OPG)expressions in human osteoblasts.Methods Real-time PCR was used to detect the expressions of RANKL and OPG mRNA in cultured human osteoblasts. The phosphorylations of JNK, p38 mitogen-activated protein kinase (MAPK) , ERK1/2 were assayed by Western blot. RNA interference for adiponectin receptor, MAPK inhibitors SB203580 and SP600125 were used for elucidating the mechanism of the action of adiponectin in regulating OPG and RANKL expressions. Results Suppression of adiponectin receptor-1 (AdR1) expression with siRNA abolished the adiponectin-regulated expressions of OPG and RANKL mRNA in human osteoblasts. Furthermore, pretreatment of osteoblasts with MAPK inhibitor SB203580 abolished the expressions of adiponectin-regulated RANKL and OPG mRNA, but SP600125 did not show the effect. Conclusion Adiponectin induces the expression of RANKL and inhibits the expression of OPG in human osteoblasts through AdR1/p38 MAPK pathways.