There is limited evidence to support the use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in solid organ transplants (SOTs). This systematic review and meta-analysis aimed to assess the safety and efficacy of GLP-1RAs in this population. PubMed, Embase, and Cochrane databases were a thorough literature search until July 2024 for SOTs with pre- and posttransplant diabetes mellitus (DM). Hemoglobin A1c (HbA1c), weight, and body mass index (BMI) were the primary outcomes. We estimated odds ratios and standardized mean difference (SMD) or mean difference (MD) with 95% confidence interval (CI) for dichotomous and continuous outcomes, respectively. I2 statistics measured heterogeneity. GLP-1RAs were administered to 806 subjects (99.8%) in 16 trials. Median follow-up was 12 months (interquartile range, 1–49 months). The mean age was 57.05 ± 10.24 years, with 64.6% male patients. HbA1c levels (MD, –0.61% [95% CI, –0.82 to –0.40]; p < 0.01, I2 = 72%), weight, and BMI were statistically significantly reduced. Estimated glomerular filtration rate (eGFR; SMD, –0.38 mL/min/1.73 m2 [95% CI, –1.01 to 0.25]; p = 0.24, I2 = 0%), creatinine, and blood pressure did not change significantly. Additionally, total daily insulin dosage, lipid profile, fasting plasma glucose, and urine albumin-to-creatinine ratio and tacrolimus levels (MD, –0.40 ng/mL [95% CI, –0.85 to 0.05]; p = 0.08, I2 = 42%) did not yield statistically significant. GLP-1RAs caused increased nausea and vomiting (13.9%), urinary tract infections (21.1%), and drug discontinuation (13.4%). In SOT recipients, GLP-1RAs significantly reduced HbA1c, weight, and BMI without significantly altering tacrolimus trough levels, eGFR, creatinine, or cardiovascular outcomes. Gastrointestinal side effects were the most common adverse events.

The full implementation of the dean's responsibility system under the leadership of the Party Committee trans-forms the hospital's Party Committee from its past role as the"political core"to the"leadership core".In the process of hospital management transformation,establishing a collaborative governance system between the Party and the government is key to imple-menting the dean's responsibility system under the leadership of the Party Committee.Taking the exploratory practices of Shenz-hen Hospital,Beijing University of Chinese Medicine(Longgang)as an example,this involves a comprehensive summary from improving decision-making mechanisms,leveraging the combat fortification role of Party branches and the exemplary role of Party members,and continuously expanding the service coverage of Party-building efforts.This discussion aims to explore effective im-plementation strategies for the dean's responsibility system under Party Committee leadership,to promote high-quality develop-ment of hospitals,and to provide meaningful references for the implementation of this system in public hospitals.

Objective To investigate the relationship between inflammation and blood coagulation function in the patients with acute exacerbation of chronic cor pulmonale (AECCP) and discuss the potential mechanism and influence on the patients. Methods The present study was based on 30 healthy controls and 141 cases of AECCP in our hospital from January 2011 to June 2014.Levels of white blood cell (WBC), neutrophil (NEUT), high-sensitivity C-reactive protein (hs-CRP, Complement 3 (C3), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) and thrombin time (TT) in the patients were determined. Results Compared with the healthy controls, the patients had higher levels of WBC, NEUT, hs-CRP, PT, APTT, FIB, TT (all P < 0.001) and lower level of C3 (P < 0.001). Significant positive correlations were found between the levels of WBC, NEUT and FIB (r = 0.196 and r = 0.199, both P < 0.05); hs-CRP and APTT, FIB(r = 0.234, P < 0.01 and r = 0.466, P < 0.001); C3 and FIB(r = 0.466, P < 0.001), and significant negative correlations were observed between the levels of C3 and PT, APTT, TT (r=-0.258, P<0.01;r=-0.279, P < 0.01 and r = -0.168, P < 0.05, respectively). Compared with the survival patients, the cases of death had higher levels of WBC and NEUT (both P < 0.01). The area under receiver operating characteristic curve of WBC and NEUT, predicting the prognosis, was 0.666 (95% CI 0.552, 0.780; P < 0.01) and 0.695 (95% CI 0.558, 0.801; P = 0.001) respectively. Conclusions Inflammation and blood coagulation function disorder usually coexist in the patients with AECCP, and are closely associated with the severity. Levels of both WBC and NEUT can be used as prognosis predictors for the patients.

Objective To explore the role of Th17-and Treg-derived catecholamines during collagen-induced ar?thritis (CIA) progression. Methods Eighteen male DBA/1 mice were randomly divided into control group, CIA model groupⅠ(day 35) and CIA model groupⅡ(day 55). The CIA models were induced by typeⅡcollagen (CⅡ) injection from tails. mRNA expression of Th17 specific transcription factor include ROR-γt, cytokines, IL-17 IL-22, Treg specific transcription factor, Foxp3, cytokines, TGF-βand tyrosine hydroxylase (TH) in lymph nodes were examined by real-time PCR. Co-local?ization of ROR-γt or Foxp3, with TH, vesicular monoamine transporter-2 (VMAT-2) or monoamine oxidase (MAO) in lymph nodes were observed by immunofluorescence staining. Results In lymph nodes of mice in CIAⅠgroup and CIAⅡgroup, mRNA expression of ROR-γt, IL-17, TH and IL-22 were upregulated, while mRNA expression of Foxp3 and TGF-βex?pression was downregulated compared to those expression in control group. The upregulated expression of IL-17 was signifi?cantly reduced in CIAⅡgroup compared with that in CIAⅠgroup. In the lymph nodes of both intact and CIA mice, co-lo?calization of ROR-γt or Foxp3 with TH, VMAT-2 or MAO was seen in some cells. The numbers of cells that are double-pos?itive of ROR-γt/TH,ROR-γt/VMAT-2 and ROR-γt/MAO IL-17 were increased in CIA groups compared to those in con?trol group. And they are significantly reduced in CIAⅡgroup compared with those in CIAⅠgroup. Conclusion The abili?ty to synthesize catecholamines in Th17 cells was increased in lymph node in mice from CIA groups compared to that in con?trol group. The increased catecholamines production from Th17 cells in lymph nodes may be involved in the anti-inflammato?ry progression in CIA.

Objective To study the clinical pathological features,treatment and prognosis of umbilical metastases of intra abdominal malignancies (sister Mary Joseph nodule, SMJN). Methods From January 1980 to July 2003, 17 SMJN cases were admitted. The clinical features were reviewed. Results The diagnosis of SMJN was confirmed by pathology in all cases, including epithelial ovarian carcinoma in 6 cases, gastric adenocarcinoma in 6 cases,colon adenocarcinoma in 2 cases, and endometrial carcinoma, gallbladder carcinoma and undifferentiated adenocarcinoma without identifying primary site in one each. Mean survival、half year、one year and two year survival rate in 10 palliative excision cases was 13 5 months、60%、20% and 10%, which were significantly better than 8 25 months、14 3%、0% and 0% in 7 conservative therapy cases ( P

0 05), with better results of daytime defecation frequency and anal skin irritation in IRA group( P