Safety of teplizumab in patients with high-risk for diabetes mellitus type 1:A systematic review

BACKGROUND The incidence of diabetes mellitus type 1(DM1)has been rising worldwide because of improvements in diagnostic techniques and improved access to care in countries with lower socioeconomic status.A new anti-CD4 antibody,Teplizumab,has been shown to delay the progression of DM1 and is the only medication approved for this indication.However,more information is needed about the safety profile of this drug.AIM To identify the odds ratios(OR)of systems-based adverse effects for Teplizumab when compared to Placebo.METHODS An extensive systematic review was conducted from the inception of the medication until December 31,2023.All clinical trials and studies that evaluated Teplizumab vs placebo were included in the initial review.The study protocol was designed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines guidelines and was registered in PROSPERO(ID:CRD42024496169).Crude OR were generated using RevMan Software version 5.4.RESULTS After screening and review,5 studies were selected to determine the risk of adverse effects of teplizumab compared to placebo.A total of 561 patients were included in the study population.Total adverse effects and system-based adverse effects were studied and reported.We determined that patients receiving Teplizumab had a higher risk of developing gastrointestinal(GI)(OR=1.60,95%CI:1.01-2.52,P=0.04),dermatological(OR=6.33,95%CI:4.05-9.88,P<0.00001)and hematological adverse effects(OR=19.03,95%CI:11.09-32.66,P<0.00001).These patients were also significantly likely to have active Epstein-Barr Virus infection(OR=3.16,95%CI:1.51-6.64,P<0.002).While our data showed that patients receiving Teplizumab did have a higher incidence of total adverse effects vs placebo,this finding did not reach statistical significance(OR=2.25,95%CI:0.80-6.29,P=0.12).CONCLUSION Our systematic review suggests that Teplizumab patients are at risk for significant adverse effects,primarily related to GI,dermatological,and hematological systems.The total adverse effect data is limited as study populations are small.More studies should be conducted on this medication to better inform the target population of potential adverse effects.

Combining GLP-1 receptor agonists and SGLT-2 inhibitors for cardiovascular disease prevention in type 2 diabetes:A systematic review with multiple network meta-regressions

BACKGROUND Glucagon-like peptide-1 receptor agonists(GLP-1RA)and sodium-glucose co-transporter-2 inhibitors(SGLT-2I)are associated with significant cardiovascular benefit in type 2 diabetes(T2D).However,GLP-1RA or SGLT-2I alone may not improve some cardiovascular outcomes in patients with prior cardiovascular co-morbidities.AIM To explore whether combining GLP-1RA and SGLT-2I can achieve additional benefit in preventing cardiovascular diseases in T2D.METHODS The systematic review was conducted according to PRISMA recommendations.The protocol was registered on PROSPERO(ID:42022385007).A total of 107049 participants from eligible cardiovascular outcomes trials of GLP-1RA and SGLT-2I were included in network meta-regressions to estimate cardiovascular benefit of the combination treatment.Effect modification of prior myocardial infarction(MI)and heart failure(HF)was also explored to provide clinical insight as to when the INTRODUCTION The macro-and micro-vascular benefits of glucagon-like peptide-1 receptor agonists(GLP-1RA)and sodium-glucose co-transporter-2 inhibitors(SGLT-2I)are independent of their glucose-lowering effects[1].In patients with type 2 diabetes(T2D),the major cardiovascular outcome trials(CVOT)showed that dipeptidyl peptidase-4 inhibitors(DPP-4I)did not improve cardiovascular outcomes[2],whereas cardiovascular benefit of GLP-1RA or SGLT-2I was significant[3,4].Further subgroup analyses indicated that the background cardiovascular risk should be considered when examining the cardiovascular outcomes of these newer glucose-lowering medications.For instance,prevention of major adverse cardiovascular events(MACE)was only seen in those patients with baseline atherosclerotic cardiovascular disease[3,4].Moreover,a series of CVOT conducted in patients with heart failure(HF)have demonstrated that(compared with placebo)SGLT-2I significantly reduced risk of hospitalization for HF or cardiovascular death,irrespective of their history of T2D[5-8].However,similar cardiovascular benefits were not observed in those with myocardial infarction(MI)[9,10].Cardiovascular co-morbidities are not only approximately twice as common but are also associated with dispropor-tionately worse cardiovascular outcomes in patients with T2D,compared to the general population[11].Therefore,it is of clinical importance to investigate whether the combination treatment of GLP-1RA and SGLT-2I could achieve greater cardiovascular benefit,particularly when considering patients with cardiovascular co-morbidities who may not gain sufficient cardiovascular protection from the monotherapies.This systematic review with multiple network meta-regressions was mainly aimed to explore whether combining GLP-1RA and SGLT-2I can provide additional cardiovascular benefit in T2D.Cardiovascular outcomes of these newer antidiabetic medications were also estimated under effect modification of prior cardiovascular diseases.This was to provide clinical insight as to when the combination treatment might be prioritized.

Congenital leukemia: A case report and review of literature

BACKGROUND Acute leukemia in newborns is also known as neonatal or congenital leukemia(CL)and is a rare disease with an incidence rate of 1-5 per 1000000 live births.After birth,infants with CL exhibit infiltrative cutaneous nodules,hepatosplenomegaly,thrombocytopenia,and immature leukocytes in the peripheral blood.These symptoms are frequently accompanied by congenital abnormalities including trisomy 21,trisomy 9,trisomy 13,or Turner syndrome.Despite significant advances in disease management,the survival rate is approximately 25%at 2 years.CASE SUMMARY Here,we document a case of trisomy 21-related acute myeloid leukemia(AML)in a female neonate.The baby was sent to the neonatal intensive care unit because of anorexia,poor responsiveness,and respiratory distress.She was diagnosed with AML based on bone marrow aspiration and immunophenotyping.Genetic sequencing identified a mutation in the GATA1 gene.After receiving the diagnosis,the parents decided against medical care for their child,and the baby died at home on day 9 after birth.CONCLUSIONS The newborn infant was diagnosed with trisomy 21-related AML.Genetic sequencing identified a mutation in the GATA1 gene.The parents abandoned medical treatment for their infant after receiving the diagnosis,and the infant died at home on the 9th day after birth.

Carrier frequency of HLA-DQB1*02 allele in patients affected with celiac disease:A systematic review assessing the potential rationale of a targeted allelic genotyping as a first-line screening

BACKGROUND Celiac Disease(CD)is an immune-mediated disorder,in which the HLA immunogenetic background(DQ2 and DQ8 heterodimers)and environmental trigger(gluten)are well established.Indeed,both factors are necessary–but not sufficient–to develop CD.However,it is very likely that CD is underdiagnosed in both developing and developed countries,due to several aspects,including the fact that a lot of patients present mild and/or atypical symptoms,without the presence of any recognized risk factors.Therefore,the possibility and feasibility of widened screening strategies to identify CD patients are debated.AIM To provide further evidence of the main epidemiological importance of HLADQB1*02 allele in the population of CD patients.METHODS We performed a systematic search in PubMed,EMBASE,Cochrane,Web of Science and Scopus databases,in order to produce a systematic review assessing the carrier frequency of HLA-DQB1*02 allele in the celiac population.Following the PRISMA guidelines,we retrieved all the original articles describing CD patients’HLA-DQB1 genotype in such a way that could allow to assess the HLADQB1*02 carrier frequency among CD patients,along with the evidence of the appropriate diagnostic work-up to achieve a correct and final diagnosis of CD.RESULTS The final output of this systematic search in the medical literature consisted of 38 studies providing the appropriate HLA-DQB1 genotype information of the respective CD population.According to this systematic review,including a pool of 4945 HLA-DQ genotyped CD patients,the HLA-DQB1*02 carrier frequency was 94.94%,meaning that only 5.06%of CD patients were completely lacking this allelic variant.Interestingly,if we consider only the studies whereby the prevalence of CD patients affected with type 1 diabetes mellitus was supposed or clearly established to be very low,the frequency of non-HLA-DQB1*02 carriers among CD patients dropped to 3.65%.CONCLUSION Such a high carrier frequency of the HLA-DQB1*02 allelic variant(which is>95%-96%in CD patients without risk factors,like type 1 diabetes mellitus comorbidity)might be exploited to consider a cost-effective and widened screening approach.If a sustainable strategy could be implemented through a low-cost targeted genetic test to detect the individual presence of HLA-DQB1*02 allele,an appropriate algorithm for serological screening in individuals resulting to be genetically predisposed to CD,might be considered.

Risk factors for lymph node metastasis in T1 esophageal squamous cell carcinoma:A systematic review and meta-analysis

BACKGROUND Lymph node metastasis(LNM)affects the application and outcomes of endoscopic resection in T1 esophageal squamous cell carcinoma(ESCC).However,reports of the risk factors for LNM have been controversial.AIM To evaluate risk factors for LNM in T1 ESCC.METHODS We searched Embase,PubMed and Cochrane Library to select studies related to LNM in patients with T1 ESCC.Included studies were divided into LNM and non-LNM groups.We performed a meta-analysis to examine the relationship between LNM and clinicopathologic features.Odds ratio(OR),mean differences and 95%confidence interval(CI)were assessed using a fixed-effects or randomeffects model.RESULTS Seventeen studies involving a total of 3775 patients with T1 ESCC met the inclusion criteria.After excluding studies with heterogeneity based on influence analysis,tumor size(OR=1.93,95%CI=1.49-2.50,P<0.001),tumor location(OR=1.46,95%CI=1.17-1.82,P<0.001),macroscopic type(OR=3.17,95%CI=2.33-4.31,P<0.001),T1 substage(OR=6.28,95%CI=4.93-8.00,P<0.001),differentiation(OR=2.11,95%CI=1.64-2.72,P<0.001)and lymphovascular invasion(OR=5.86,95%CI=4.60-7.48,P<0.001)were found to be significantly associated with LNM.Conversely,sex,age and infiltrative growth pattern were not identified as risk factors for LNM.CONCLUSION A tumor size>2 cm,lower location,nonflat macroscopic type,T1b stage,poor differentiation and lymphovascular invasion were associated with LNM in patients with T1 ESCC.

Discovery of Key Molecular Pathways of C1 Metabolism and Formaldehyde Detoxification in Maize through a Systematic Bioinformatics Literature Review

Computational systems biology approaches provide insights to understand complex molecular phenomena in living systems. Such understanding demands the need to systematically interrogate and review existing literature to refine and distil key molecular pathways. This paper explores a methodological process to identify key molecular pathways from systematic bioinformatics literature review. This process is used to identify molecular pathways for a ubiquitous molecular process in all plant biological systems: C1 metabolism and formaldehyde detoxification, specific to maize. The C1 metabolism is essential for all organisms to provide one-carbon units for methylation and other types of modifications, as well as for nucleic acid, amino acid, and other biomolecule syntheses. Formaldehyde is a toxic one-carbon molecule which is produced endogenously and found in the environment, and whose detoxification is an important part of C1 metabolism. This systematic review involves a five-part process: 1) framing of the research question;2) literature collection based on a parallel search strategy;3) relevant study selection based on search refinement;4) molecular pathway identification;and 5) integration of key molecular pathway mechanisms to yield a well-defined set molecular systems associated with a particular biochemical function. Findings from this systematic review produced three main molecular systems: a) methionine biosynthesis;b) the methylation cycle;and c) formaldehyde detoxification. Specific insights from the resulting molecular pathways indicate that normal C1 metabolism involves the transfer of a carbon group from serine through a folate-mediated pathway to methionine, and eventually the methylation of a biomolecule. In photosynthetic tissues, C1 metabolism often proceeds in reverse towards serine biosynthesis and formate oxidation. C1 metabolism, in maize, appears to be present in the developing embryo and endosperm indicating that these cells are vulnerable to perturbations in formaldehyde detoxification. These insights demonstrate the value of a systematic bioinformatics literature review process from a broad spectrum of domain literature to specific and relevant molecular pathways.

Correlation of molecular alterations with pathological features in hepatocellular carcinoma:Literature review and experience of an Italian center

Hepatocellular carcinoma(HCC)represents the primary carcinoma of the liver and the fourth leading cause of cancer-related deaths.The World Health Organization estimates an increase in cases in the coming years.The risk factors of HCC are multiple,and the incidence in different countries is closely related to the different risk factors to which the population is exposed.The molecular mechanisms that drive HCC tumorigenesis are extremely complex,but understanding this multistep process is essential for the identification of diagnostic,prognostic,and therapeutic markers.The development of multigenic nextgeneration sequencing panels through the parallel analysis of multiple markers can provide a landscape of the genomic status of the tumor.Considering the literature and our preliminary data based on 36 HCCs,the most frequently altered genes in HCCs are TERT,CTNNB1,and TP53.Over the years,many groups have attempted to classify HCCs on a molecular basis,but a univocal classification has never been achieved.Nevertheless,statistically significant correlations have been found in HCCs between the molecular signature and morphologic features,and this leads us to think that it would be desirable to integrate the approach between anatomic pathology and molecular laboratories.

A Mini-Review 5-Amino-N-Substituted Pyrazoles as Building Blocks for Bioactive Molecules

In this review a five-membered heterocyclic ring having two adjacent nitrogen atoms known as Pyrazole, we have framed 5-amino-N-substituted pyrazoles in particular focusing on its substantial role as a building block and starting materials for producing enormous heterocyclic skeletons. The existence of this moiety in larger compounds renders them to expose medicinal, pharmacological and biological therapeutic activities. Enormous drugs contain 5-amino-N-substituted pyrazoles such as celecoxib anti-inflammatory, antipsychotic, anti-obesity, analgesic, and antidepressant. We reported various routes of synthesis and the use of these compounds.

Uncertainty following an inconclusive result from the BRCA1/2 genetic test:A review about psychological outcomes

BACKGROUND An inconclusive result from BRCA1/2 genetic testing indicates that a genetic variant of uncertain significance is detected.This case constitutes the majority of genetic test results,but studies specifically addressing the psychological adjustment of people with inconclusive results are scarce.AIM To examine psychological outcomes of receiving an uninformative BRCA1/2 test result.METHODS PubMed,PsychInfo,and Cochrane Central Register of Controlled Trials were screened for studies focusing on distress,anxiety,and depression levels in individuals with inconclusive genetic test results.This review is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method.RESULTS Studies on psychological outcomes of inconclusive BRCA1/2 focused on general and specific distress,anxiety,and depression.Overall,they produced mixed results.These inconsistent findings are probably due to the uncertainty caused by this type of result,that may also influence the decisions of individuals about surveillance and prophylactic options,reducing their compliance.In addition,this review highlights specific risk and protective factors that affect psychological adjustment in individuals with an inconclusive genetic testing result.CONCLUSION Individuals with inconclusive genetic test results need specific educational programs and support to better understand the meaning of their results in order to be able to make decisions about surveillance and prophylactic options.

World Journal of Gastroentero1ogy Editorial Board and Reviewers Brief Introduction 2004-2006

Published by The WJG Press and Elsevier Inc．,PO Box 23451 Beijing 100023,China Fax:+86-(0)10-85381893 E-mail:wjg@wjgnet．com http://www．wjgnet．com The World Journal of Gastroenterology Editorial Board consists of 519 members,representing a team of worldwide experts in gastroenterology and hepatology．They are from 51 countries,including Albania(1),Algeria(1),Argentina(1),Australia(8), Austria(5),Belarus(1),Belgium(6),Brazil(1),Bulgaria(1),Canada(7),China(50),Costa Rica(1),Croatia(1),Denmark(6), Egypt(1),Finland(1),France(18),Germany(35),Greece(2),Hungary(2),Iceland(1),India(5),Iran(1),Ireland(1),Israel(2),Italy(41),Japan(132),Lithuania(1),Macedonia(1),Malaysia(3),Monaco(1),Netherlands(13),Norway(2),Pakistan(1),Philippines(1),Poland(2),Portugal(1),Russia(3),Singapore(2),Slovakia(1),South Africa(2),South Korea(6),Spain(20), Sri Lanka(1),Swaziland(1),Sweden(4),Switzerland(4),Turkey(3),United Kingdom(20),United States(90),Yugoslavia(1)． HONORARY EDITORS-IN-CHIEF Ke-Ji Chen,Professor Xiyuan Hospital,Chinese Tranditional Medicine University,Beijing 100091,China. kjchen@public．bta．net．

Disordered eating behaviour and eating disorder among adolescents with type 1 diabetes:An integrative review

BACKGROUND Type 1 diabetes(DT1)in adolescents brings behavioural changes,altered nutritional habits,and eating disorders.AIM To identify and analyze the validated instruments that examine the disordered eating behaviour and eating disorders among adolescents with DT1.METHODS An integrative review was accomplished based on the following databases:PubMed,LILACS,CINAHL,Scopus,Web of Science,and Reference Citation Analysis(RCA),including publications in Portuguese,English,or Spanish,without time limit and time published.RESULTS The main instruments to evaluate disordered eating behaviour were The Diabetes Eating Problem Survey-Revised,The Diabetes Eating Problem Survey,and the eating attitudes test-26,and for eating disorders the main instruments used were The Bulimic Investigation Test of Edinburgh,The Binge Eating Scale,The Child Eating Disorder Examination,The five questions of the(Sick,Control,One,Fat and Food),and The Mind Youth Questionnaire.These instruments showed an effect in evaluating risks regarding nutritional habits or feeding grievances,with outcomes related to weight control,inadequate use of insulin,and glycaemia unmanageability.We did not identify publication bias.CONCLUSION Around the world,the most used scale to study the risk of disordered eating behaviour or eating disorder is The Diabetes Eating Problem Survey-Revised.International researchers use this scale to identify high scores in adolescents with DT1 and a relationship with poorer glycemic control and psychological problems related to body image.

The clinical efficacy of traditional Chinese medicine in the auxiliary treatment of grade 1 hypertension: A systematic review and metaanalysis

Objective:To systematically evaluate the clinical efficacy of traditional Chinese medicine(TCM)in auxiliary treatment of grade 1 hypertension.Methods:The China National Knowledge Infrastructure,Wan Fang Data,VIP,PubMed were searched to screen the literature of randomized controlled trials of TCM or non-drug therapies assisting conventional medicine to treat grade 1 hypertension.The search time was from the establishment of the database to October 1,2020.Revman5.3 was used for meta-analysis.Results:8 Chinese literatures were included.The results of the study showed that 24h diastolic blood pressure(DBP),24h systolic blood pressure(SBP),DBP lowering effect and TCM syndrome curative efficacy of the experimental group using TCM was better than that of the control group.However,TCM combined conventional medicine did not show an advantage on SBP lowering effect,antihypertensive efficacy rate and total clinical efficacy rate.Conclusion:TCM has a significant effect on lowering blood pressure for adjuvant treatment of grade 1 hypertension and can significantly improve clinical symptoms.

Impact of PD-1/PD-L1 inhibitors on survival in stage Ⅲ non-small-cell lung cancer:A systematic review

Background:Lung cancer is the leading cause of cancer-related death,and non-small-cell lung cancer(NSCLC)is the predominant subtype.Programmed death 1(PD-1)and programmed death-ligand 1(PD-L1)inhibitors are widely used to treat stage IV NSCLC.This study systematically reviewed the literature to clarify the impact of PD1/PD-L1 inhibitor treatment on the survival of patients with stage Ⅲ NSCLC.Methods:Randomized phase Ⅲ clinical trials of PD-1/PD-L1 inhibitors administered to patients with stage Ⅲ NSCLC that were written in English and published between November 2012 and November 2022 were eligible for review.The sources of information were the MEDLINE database(last consulted on December 26,2022),ScienceDirect website(last consulted on December 26,2022),and CENTRAL register(last consulted on December 27,2022).The outcomes of interest were overall survival(OS),progression-free survival(PFS),disease-free survival(DFS),and event-free survival(EFS).Risk of bias assessments were performed according to the Cochrane Handbook for Systematic Reviews of Interventions version 5.1.0.The findings have been assessed for certainty according to the Grading of Recommendations,Assessment,Development,and Evaluations(GRADE)guidelines.Results:Fourteen eligible studies and 2788 participants were included in the review.The key characteristics used to group the participants were disease histology,percentage of PD-L1 expression in cancer cells,and timeline of therapy.OS and PFS were improved(risk ratio[RR]:0.85;95%confidence interval[CI]:0.75–0.96 and RR:0.75;95%CI:0.70–0.86,respectively)based on the use of PD-L1 inhibitors after chemoradiation and OS was improved using first-line PD-1 inhibitors plus chemotherapy in non-squamous NSCLC(RR:0.40;95%CI:0.17–0.95),with the GRADE results indicating moderate quality of evidence.

Design and technology review of the solar X-ray detector onboard the Macao Science Satellite-1B

On May 21,2023,the Macao Science Satellite-1B(MSS-1B),a low-inclination,low-latitude,and high-precision scientific exploration satellite for geomagnetic fields and space environments,was successfully launched.The solar X-ray detector(SXD),one of the two major scientific payloads onboard the MSS-1B,has obtained a large amount of solar X-ray radiation data,which reveals the distribution law of the magnetic field in the low Earth orbit,as well as the coupling law of the Earth's magnetic field and the solar radiation and energy particle distributions.First,the overall design of the multi-detection-unit,broad-energy-range,small-volume,and low-power SXD was implemented to achieve the scientific objectives of the mission.Second,the technical indicators of the instrument were decomposed into various components,and the key technologies,such as collimator,processing circuit,thermal,and payload dataset designs,were reviewed.Third,the backgrounds,including electronic noise,cosmic diffuse X-ray background,and high-energy background in the Earth's radiation belts in and out of the field of view,were analyzed for the instrument.Then,the ground calibrations of the energy response,detection efficiency,and temperature-dependent peak drift of the SXD flight model were conducted.Finally,the in-orbit temperature,energy spectrum data,background,and solar flare process observation of the instrument in the in-orbit test stage are presented,verifying the instrument design,analysis,and ground calibration,providing a foundation for obtaining accurate solar X-ray radiation data,and achieving the scientific objectives of the satellite.

铁死亡加持PD-1/PD-L1抑制剂杀伤肿瘤细胞综述

恶性肿瘤发生发展的每一环节都与免疫调节息息相关,近年铁死亡及PD-1/PD-L1抑制剂杀伤肿瘤细胞方面的研究是一大热点,因其精准治疗肿瘤的效果被越来越多地应用于临床治疗。但目前尚无将PD-1/PD-L1抑制剂与铁死亡治疗肿瘤细胞结合的研究,本文将对铁死亡的相关机制、铁死亡与肿瘤的关系和PD-1/PD-L1免疫治疗肿瘤等方面进行综述。

胰高血糖素样肽-1受体激动剂治疗儿童及青少年肥胖的疗效与安全性的系统评价

目的:系统评价胰高血糖素样肽-1(GLP-1)受体激动剂治疗儿童及青少年肥胖的疗效与安全性。方法:计算机检索PubMed、Embase、Web of Science、the Cochrane Library、中国知网、万方数据库、维普数据库中关于GLP-1受体激动剂对比安慰剂治疗儿童及青少年肥胖的随机对照试验(RCT)文献(数据库建库至2023年12月31日),根据纳入与排除标准进行文献筛选和数据提取后,运用RevMan 5.3软件进行Meta分析。结果:共纳入11篇RCT文献,涉及981例儿童及青少年肥胖患者,其中研究组542例(利拉鲁肽227例,艾塞那肽78例,司美格鲁肽134例,度拉糖肽103例),对照组439例。文献偏倚风险中等。Meta分析结果显示,与安慰剂相比,GLP-1受体激动剂可降低儿童及青少年肥胖患者的体重(MD=-3.83,95%CI=-5.94~-1.71,P=0.000 4)、体重指数(BMI)(MD=-1.94,95%CI=-3.17~-0.70,P=0.002)、BMI-Z评分(MD=-0.18,95%CI=-0.33~-0.03,P=0.02)、糖化血红蛋白水平(MD=-0.22,95%CI=-0.38~-0.07,P=0.005)、空腹血糖水平(MD=-4.43,95%CI=-8.18~-0.68,P=0.02),差异均有统计学意义。亚组分析结果显示,周制剂在降低患者体重方面可能不具有优势,但周制剂相比于日制剂能更好地降低患者的BMI、BMI-Z评分;同时,相比于不伴有2型糖尿病的儿童及青少年肥胖患者,GLP-1受体激动剂可以更好地降低伴有2型糖尿病的儿童及青少年肥胖患者的空腹血糖和糖化血红蛋白水平。相对于安慰剂,使用GLP-1受体激动剂的儿童及青少年肥胖患者的恶心(OR=3.13,95%CI=2.23~4.39,P<0.000 01)、呕吐(OR=5.97,95%CI=3.79~9.41,P<0.000 01)、腹泻(OR=1.45,95%CI=1.02~2.06,P=0.04)、头晕(OR=2.68,95%CI=1.36~5.26,P=0.004)等不良反应发生率升高,差异均有统计学意义。结论:GLP-1受体激动剂可降低儿童及青少年肥胖患者的体重、BMI、糖化血红蛋白、空腹血糖水平,但胃肠道不良反应发生率较高,使用时应注意。

抗结核药物超敏反应综合征致暴发性1型糖尿病1例并文献复习

目的探讨抗结核治疗中抗结核药物超敏反应综合征(DIHS)致暴发性1型糖尿病(FT1DM)的诊疗经验。方法回顾性分析1例抗结核药物(ATD)引起DIHS致FT1DM患者的病情变化,结合治疗经过等临床资料,总结诊疗方法。结果病例在使用抗结核药物后出现皮疹、肝功能受损,治疗过程中突然出现糖尿病酮症酸中毒,完善胰岛功能、胰岛素相关抗体、糖化血红蛋白等相关检查后确诊为FT1DM,经积极治疗后患者症状、检验指标改善。结论ATD引起的DIHS可导致FT1DM的发生,出现DIHS时,应注意临床特征变化,完善相关检查,及早诊治。

农民合作社政策回顾与展望——基于新世纪中央一号文件的分析

新世纪以来,党中央高度重视农民合作社发展,连续发布的21个一号文件均涉及农民合作社。紧密结合农民合作社理论与实践,系统分析新世纪中央一号文件,有助于农民合作社政策创新。我国农民合作社政策重心亟须由数量增长向量质齐升转变。为此,应聚焦以下数端:进一步拓展农民合作社功能;适时取消财政支持政策;大力推进农民合作社规范化建设;不断强化农民合作社绿色发展;更加重视合作社人才培养;接续引导农民合作社立法完善。只有不断推进政策创新,才能实现农民合作社高质量发展。