Immune rejection following liver transplantation is a critical factor affecting long-term graft survival. While traditional immunosuppressive regimens based on calcineurin inhibitors are effective， they are often accompanied by long-term side effects， making the induction of immune tolerance an important goal. This article systematically reviews the mechanisms of immune rejection following liver transplantation and the limitations of current drugs， with a focus on the potential of mesenchymal stem cells （MSCs） as a novel strategy for inducing immune tolerance. Preliminary clinical trials have confirmed that MSC infusion has a favorable safety profile and shows an immunomodulatory effect； however， there are still multiple challenges regarding the timing of infusion， cell source， dosage， and synergy with conventional regimens. Large-scale clinical trials are needed in the future to further validate their long-term efficacy and safety， and MSC therapy is expected to become a new direction for immune management in liver transplantation.

Patients with diabetes mellitus are at a significantly elevated risk of developing cognitive impairment,which adversely impacts their quality of life and imposes a substantial burden on the healthcare system.Novel antidiabetic agents,including sodium-glucose cotransporter 2 inhibitors(SGLT-2i),dipeptidyl peptidase-4 inhibitors(DPP-4i),glucagon-like peptide-1 receptor agonists(GLP-1RAs),and dual glucagon-like peptide-1 receptor/glucose-dependent insulinotropic polypeptide receptor agonists(e.g.,Tirzepatide),have been shown to not only effectively regulate glycemic control but also mitigate cognitive decline by inhibiting inflammation,reducing oxidative stress,preventing apoptosis,attenuating amyloid β-protein(Aβ)deposition,and suppressing tau protein phosphorylation.

Patients with diabetes mellitus are at a significantly elevated risk of developing cognitive impairment,which adversely impacts their quality of life and imposes a substantial burden on the healthcare system.Novel antidiabetic agents,including sodium-glucose cotransporter 2 inhibitors(SGLT-2i),dipeptidyl peptidase-4 inhibitors(DPP-4i),glucagon-like peptide-1 receptor agonists(GLP-1RAs),and dual glucagon-like peptide-1 receptor/glucose-dependent insulinotropic polypeptide receptor agonists(e.g.,Tirzepatide),have been shown to not only effectively regulate glycemic control but also mitigate cognitive decline by inhibiting inflammation,reducing oxidative stress,preventing apoptosis,attenuating amyloid β-protein(Aβ)deposition,and suppressing tau protein phosphorylation.

Objective:To study the expressions of C-C class chemokine 17 (CCL17), C-C class chemokine 22 (CCL22), and C-C chemokine receptor 4 (CCR4) in newly diagnosed multiple myeloma (NDMM) for analyzing their correlations with clinical features and to preliminarily explore their roles in the development of NDMM.Methods:The study included 40 patients with NDMM and 20 healthy volunteers from the Department of Hematology of the Affiliated Hospital of Zunyi Medical University from July 2020 to December 2022. Peripheral blood, bone marrow, and bone marrow biopsy tissue samples were collected from the two groups. The expression levels of CCL17, CCL22, and CCR4 in patients with NDMM were analyzed using real-time quantitative reverse transcriptase polymerase chain reaction (RQ-PCR), enzyme-linked immunosorbent assay (ELISA), and immunohistochemistry. The mRNA expression levels of CCL17, CCL22, and CCR4 in the bone marrow mononuclear cell (BMMNC) of patients with NDMM were analyzed to assess their correlations with clinical indicators.Results:The mRNA expression levels of CCL17, CCL22, and CCR4 in BMMNC were higher in patients with NDMM than in controls (all P<0.05). The protein expression levels of CCL17 and CCL22 in peripheral blood supernatants and bone marrow supernatants were higher in patients with NDMM than in controls (all P<0.05). The expression levels of CCL17, CCL22, and CCR4 in bone marrow biopsy tissues were higher in patients with NDMM than in controls (all P<0.05). The mRNA expression level of CCL17 was increased in NDMM patients with combined anemia, bone damage, renal damage, and M protein level ≥30 g/L (all P<0.05). The mRNA expression level of CCL22 was increased in NDMM patients with combined anemia, bone damage, and renal damage (all P<0.05). The mRNA expression level of CCR4 was increased in NDMM patients with combined anemia and renal damage (all P<0.05) . Conclusion:CCL17, CCL22, and CCR4 were highly expressed in clinical samples from patients with NDMM compared to those from controls, and they may be involved in the occurrence and development of NDMM.

Objective To investigate the predictive effect of peripheral blood neutrophil-to-lymphocyte ratio (NLR) on short-term prognosis in primary acute intracerebral hemorrhage at admisson.Methods From December 2015 to December 2017,177 consecutive patients with acute intracerebral hemorrhage admitted to the Department of Neurology,Shengjing Hospital of China Medical University were enrolled retrospectively.According to the modified Rankin scale (mRS) scores,they were divided into either a good prognosis group (mRS ＜ 3,n =109) or a poor prognosis group (mRS ≥ 3,n =68).The clinical data,imaging data,and laboratory data of the patients in both groups were documented.The NLR values were calculated according to neutrophil count and lymphocyte count at admission,and univariate analysis was performed.The factors of P ＜ 0.05 in the results of univariate factor was further performed with multivariate logistic regression analysis of the poor prognosis in patients with acute intracerebral hemorrhage at 90 d.NLR was transformed into binary variable with the median as the cut point and was brought into the model.The receiver operating characteristic (ROC) curve was used to evaluate the sensitivity,specificity,and optimal cut-off value of NLR.Results (1) Compared with the good prognosis group,the poor prognosis group had higher NIHSS score (11 [8,16] vs.3 [2,5]) and lower GCS score (13 [6,15] vs.15 [15,15]).There were statistical differences between the two groups (all P ＜ 0.01).(2) Compared with the good prognosis group,the proportion of surgical treatment was higher in patients in the poor prognosis group.There was significant difference between the two groups (39.7％ [27/68] vs.14.7％ [16/109],P ＜ 0.0l).There were no significant differences in the other baseline data between the two groups (all P ＞0.05).(3) Compared with the good prognosis group,the poor prognosis group had higher NLR value (8.92 [4.83,16.07] vs.3.45 [2.22,5.81]) and blood glucose levels (7.36[6.19,9.25] mmol/L vs.6.33[5.27,8.18] mmol/L) at admission,the differences were statistically significant between the two groups (all P ＜0.01);There was no significant difference in creatinine levels between the two groups (P ＞ 0.05).(4) Compared with the good prognosis group,the poor prognosis group had larger hematoma volume (38.64 [16.89,77.14] ml vs.9.69[2.64,19.12] ml),higher proportion of ruptured into ventricles (60.3％ [41/68] vs.22.0％ [24/109].There were statistical differences between the two groups (all P ＜ 0.01);there was no statistically significant difference in location of cerebral hemorrhage between the two groups (P ＞ 0.05).(5) The results of multivariate logistic regression analysis showed that NLR ≥ 5.00 (OR,4.718,95％ CI 1.770-12.572),increased hematoma volume (OR,1.046,95％ CI 1.016-1.077) and higher NIHSS score (OR,1.411,95％CI 1.242-1.602) were the independent risk factors for poor prognosis at 90 d after discharge in patients with acute intracerebral hemorrhage (all P ＜ 0.01),and surgical treatment (OR,0.126,95％ CI 0.026-0.608) were the protective factors for the prognosis of acute intracerebral hemorrhage (P ＜ 0.01).(6) The area under curve of NLR was 0.779 (95％ CI0.710-0.847,P ＜0.01).When the cut-off value of NLR was 5.63,the maximum Youden index was 0.464,and its sensitivity was 72.1％ and specificity was 74.3％.Conclusions High NLR may indicate poor short-term prognosis in acute intracerebral hemorrhage.When NLR ＞ 5.63 is used as a screening index for poor prognosis of acute intracerebral hemorrhage,a comprehensive and objective assessment is needed.