Objective:This study aimed to investigate the correlation between the use of glucose-lowering drugs and the risk of pancreatic cancer through propensity score matching(PSM),which provides a scientific basis for clinical decision-making.Methods:This study retrospectively analyzed the clinical data of patients diagnosed with type 2 diabetes mellitus(T2DM)and treated with glucose-lowering drugs in Nanjing Drum Tower Hospital between 2000 and 2023.The patients were divided into two groups:those with T2DM alone and those with T2DM combined with pancreatic cancer.PSM was employed to align the baseline characteristics of patients across groups,minimizing the impact of confounding factors.According to the use of glucose-lowering drugs,the correlation between the use of various types of glucose-lowering drugs and the occurrence of pancreatic cancer was explored by logistic regression analysis,and the drug influencing factors that might potentially affect the occurrence of pancreatic cancer were screened out.Additionally,the relationship between the use of glucose-lowering medications,both as monotherapy and in combination,and the occurrence of pancreatic cancer was further analyzed.Results:The logistic regression analyses showed that previous use of sulfonylureas was significantly associated with pancreatic cancer in patients with T2DM,and previous use of dipeptidyl peptidase-4(DPP-4)inhibitors was weakly associated with pancreatic cancer,and sulfonylureas[odds ratio(OR)=0.631,95%CI:0.415-0.961,P=0.032]and dipeptidyl peptidase-4(DPP-4)inhibitors(OR=0.639,95%CI:0.388-1.052,P=0.078)may be associated with a reduced risk of pancreatic cancer in T2DM patients.Other drugs,including insulin,metformin,α-glucosidase inhibitors,and sodium-glucose transporter-2(SGLT-2)inhibitors,were not significantly associated with pancreatic cancer development.In a further analysis of glucose-lowering treatment regimens,it was shown that metformin in combination with other oral glucose-lowering agents was associated with pancreatic cancer[adjustment OR(aOR)=0.463,95%CI:0.224-0.959,P=0.038]and may be a protective factor for pancreatic carcinogenesis.Conclusion:The use of sulfonylureas and DPP-4 inhibitors in T2DM patients is related to the reduction of pancreatic cancer,and compared with the use of drugs alone,the use of drugs combined with oral hypoglycemic drugs can further reduce the incidence of pancreatic cancer.

Objective:This study aimed to investigate the correlation between the use of glucose-lowering drugs and the risk of pancreatic cancer through propensity score matching(PSM),which provides a scientific basis for clinical decision-making.Methods:This study retrospectively analyzed the clinical data of patients diagnosed with type 2 diabetes mellitus(T2DM)and treated with glucose-lowering drugs in Nanjing Drum Tower Hospital between 2000 and 2023.The patients were divided into two groups:those with T2DM alone and those with T2DM combined with pancreatic cancer.PSM was employed to align the baseline characteristics of patients across groups,minimizing the impact of confounding factors.According to the use of glucose-lowering drugs,the correlation between the use of various types of glucose-lowering drugs and the occurrence of pancreatic cancer was explored by logistic regression analysis,and the drug influencing factors that might potentially affect the occurrence of pancreatic cancer were screened out.Additionally,the relationship between the use of glucose-lowering medications,both as monotherapy and in combination,and the occurrence of pancreatic cancer was further analyzed.Results:The logistic regression analyses showed that previous use of sulfonylureas was significantly associated with pancreatic cancer in patients with T2DM,and previous use of dipeptidyl peptidase-4(DPP-4)inhibitors was weakly associated with pancreatic cancer,and sulfonylureas[odds ratio(OR)=0.631,95%CI:0.415-0.961,P=0.032]and dipeptidyl peptidase-4(DPP-4)inhibitors(OR=0.639,95%CI:0.388-1.052,P=0.078)may be associated with a reduced risk of pancreatic cancer in T2DM patients.Other drugs,including insulin,metformin,α-glucosidase inhibitors,and sodium-glucose transporter-2(SGLT-2)inhibitors,were not significantly associated with pancreatic cancer development.In a further analysis of glucose-lowering treatment regimens,it was shown that metformin in combination with other oral glucose-lowering agents was associated with pancreatic cancer[adjustment OR(aOR)=0.463,95%CI:0.224-0.959,P=0.038]and may be a protective factor for pancreatic carcinogenesis.Conclusion:The use of sulfonylureas and DPP-4 inhibitors in T2DM patients is related to the reduction of pancreatic cancer,and compared with the use of drugs alone,the use of drugs combined with oral hypoglycemic drugs can further reduce the incidence of pancreatic cancer.

Objective To summarize the clinical experience of successful liver transplantation from infant donation after cardiac death (DCD) for infant with biliary astresia (BA).Methods The donor was a 16-months-old girl with a body weight of 10 kg,who died of irreversible anoxic cerebral damage after sudden asphyxiation.The recipient was a 24-months-old girl with a body weight of 12 kg,who suffered from icteric concurrent late biliary cirrhosis after the Porta-jejunum anastomosis because of congenital BA.The DCD liver was classically orthotopically transplanted into the infants recipient.The warm ischemia time was 7 min,the cold ischemia time was 360 min,and the graft volume to the standard liver volume (GV/SLV) was 1.02.After operation,the vital signs and transplanted liver function of the recipient were monitored,and the recipient was given treatments of anti-infection,anticoagulation,and improving the microcirculation.The recipient was treated with the triple immunosuppression protocol of tacrolimus,mycophenolate and prednisone to prevent rejection.Results The operating time of the recipient was 480 min,the non-liver stage was 65 min,and the blood loss was 230 mL.The endotracheal intubation was removed from the recipient at 12 h,and the recipient started to eat at 48 h aftcr operation.The recipient had a hepatic artery thrombus on the 3rd and 15th day after operation,and the hepatic artery had re-blood-supply after the hepatic artery catheterization and continuous perfusion with urokinase.The recipient was discharged on the 42nd day,and the recipient was in satisfactory condition to present.Conclusion The infant DCD liver is a better graft for infant liver transplantation for BA.The surgical complications can be reduced with matched volume of donor-recipient liver; and it can guarantee a successful operation with perfect operative technique and careful perioperative management.