Liver transplantation is the optimal treatment for end-stage liver disease and hepatocellular carcinoma, which can significantly improve clinical prognosis and quality of life of patients. However, multiple challenges, such as rejection, immune tolerance, shortage of donor liver, preservation of donor liver, ischemia-reperfusion injury and postoperative complications, etc., limit the efficacy of liver transplantation in clinical practice. Research teams in China have made significant contributions to the basic research related to liver transplantation by making continuous efforts and combining the development of emerging technologies, interdisciplinary integration and other emerging fields. In this article, the frontier progress in the basic research of liver transplantation in 2023 was reviewed, highlighting the progress made by Chinese research teams in the basic research of liver transplantation, aiming to provide reference for promoting the integration of Chinese characteristics into the research of liver transplantation, accelerate the integration of Chinese liver transplantation research with international community, and promote further advancement of liver transplantation in China.

Objective To observe the improved effect of propofol on vascular hyporeactivity in septic rats and its underlying mechanism.Methods A total of 96 SD rats(12 weeks old,both genders,weighing 200～220 g)were randomly divided into sham group(n=16),sepsis group(n=16,cecal ligation and puncture),propofol group(n=16),propofol+ROCK inhibitor Y-27632 group(n=16),propofol+PKCαinhibitor GO6976 group(n=16),propofol+IP3 inhibitor 2-APB group(n=8)and propofol+gap junction inhibitor metoclopramide sodium(Movens)group(n=8).In vitro vascular ring reactivity and vascular calcium sensitivity were measured to observe the improved effects of propofol on vascular hyporeactivity in septic rats and its relationships with RhoA/ROCK,PKCα,IP3 and cell gap junction.Results Determination of in vitro vascular ring and calcium sensitivity showed that the contractile reactivity to norepinephrine(NE)and to calcium sensitivity were significantly decreased in the arterial rings isolated from the septic rats compared with those from the sham group,with the dose-response curve shifting to the right,and most significant decrease by 51.42％in the superior mesenteric artery(SMA,P＜0.05).Propofol treatment significantly improved the hyporeactivity and calcium sensitivity of the vessels isolated from the septic rats,especially those of the femoral artery with a recovery rate of 89.57％(P＜0.05).In comparison with the propofol group,the dose-response curves of the propofol+Y-27632 group and the propofol+GO6976 group were shifting to right,indicating that Y-27632 and GO6976 could significantly inhibit the amelioration of propofol on calcium sensitivity of SMA in severely septic rats with an inhibitory rate of 146.95％and 88.63％(P＜0.05),respectively.Isolated vascular reactivity measurement demonstrated that Y-27632 and Movens treatment significantly antagonized the ameliorated role of propofol on hyporeactivity of blood vessels from the septic rats with an inhibitory rate of 40.79％and 169.90％(P＜0.05),separately,while no such effect was observed in the propofol+GO6976 and propofol+2-APB groups.Conclusion Propofol treatment can significantly improve vascular hyporeactivity of septic rats,which may attribute to the increase of vascular calcium sensitivity through RhoA/ROCK pathway.

Liver fibrosis is a dynamic wound-healing response characterized by the agglutination of the extracellular matrix (ECM). Si-Wu-Tang (SWT), a traditional Chinese medicine (TCM) formula, is known for treating gynecological diseases and liver fibrosis. Our previous studies demonstrated that long non-coding RNA H19 (H19) was markedly upregulated in fibrotic livers while its deficiency markedly reversed fibrogenesis. However, the mechanisms by which SWT influences H19 remain unclear. Thus, we established a bile duct ligation (BDL)-induced liver fibrosis model to evaluate the hepatoprotective effects of SWT on various cells in the liver. Our results showed that SWT markedly improved ECM deposition and bile duct reactions in the liver. Notably, SWT relieved liver fibrosis by regulating the transcription of genes involved in the cytoskeleton remodeling, primarily in hepatic stellate cells (HSCs), and influencing cytoskeleton-related angiogenesis and hepatocellular injury. This modulation collectively led to reduced ECM deposition. Through extensive bioinformatics analyses, we determined that H19 acted as a miRNA sponge and mainly inhibited miR-200, miR-211, and let7b, thereby regulating the above cellular regulatory pathways. Meanwhile, SWT reversed H19-related miRNAs and signaling pathways, diminishing ECM deposition and liver fibrosis. However, these protective effects of SWT were diminished with the overexpression of H19 in vivo. In conclusion, our study elucidates the underlying mechanisms of SWT from the perspective of H19-related signal networks and proposes a potential SWT-based therapeutic strategy for the treatment of liver fibrosis.
Humans ; RNA, Long Noncoding/genetics* ; Liver Cirrhosis/genetics* ; Liver/metabolism* ; Hepatic Stellate Cells/pathology* ; MicroRNAs/metabolism* ; Extracellular Matrix/metabolism* ; Drugs, Chinese Herbal

Ureteral stenosis and bladder contracture after radiotherapy for cervical cancer are challenging issues in urology. Ileal ureteroplasty combined with ileal bladder augmentation is a potential method to improve hydronephrosis and voiding function of patients, however, the surgical procedure is complex, with high surgical risks and numerous intraoperative and postoperative complications, which have hindered the widespread application of this surgical technique. This article introduces our hospital's experience through a typical surgical case. During the surgery, ileal substitution for bilateral ureters was performed in combination with ileal " N-shaped" augmentation. Two weeks after the surgery, the single-J stent was removed, and the urinary catheter was removed three weeks after the surgery. The patient achieved voluntary urination control with smooth voiding. Follow-up examinations at 3 months and 18 months postoperatively showed no hydronephrosis in the bilateral ureters, normal renal function, and a significantly expanded bladder capacity.

Objective:To investigate the clinical efficacy and safety of non-invasive bilevel positive airway pressure (BiPAP) ventilator combined with oxygen atomization in the treatment of chronic obstructive pulmonary disease (COPD) complicated with type Ⅱ respiratory failure.Methods:A total of 80 patients with COPD complicated with type Ⅱ respiratory failure admitted to Haiyan County People′s Hospital from June 2019 to July 2021 were selected, and they were divided into the observation group and the control group by the random number table method, with 40 cases in each group. Patients in both groups received conventional treatment, while patients in the control group were connected with BiPAP non-invasive ventilator and received non-invasive mechanical ventilation in S/T mode; the observation group was given aerosol inhalation drugs during ventilation, and both groups were treated for 7 d. Blood gas indicators and vital signs were collected before treatment and 7 d after treatment. Clinical symptoms were investigated by COPD patient Caring Assessment Tool (CAT) and Dyspnea Scale (DECAF). Serum levels of interleukin (IL)-10, tumor necrosis factor (TNF-α) and CD 4+/CD 8+ were determined, and treatment outcomes and adverse reactions were compared between the two groups. Results:After treatment, the partial pressure of oxygen (PaO 2) and the oxygen saturation (SaO 2) in the observation group were higher than those in the control group: (73.41 ± 5.26) mmHg(1 mmHg = 0.133 kPa) vs. (65.11 ± 4.33) mmHg, 0.921 ± 0.052 vs. 0.884 ± 0.039; the arterial partial pressure of carbon dioxide (PaCO 2), heart rate (HR), respiratory rate (RR) were lower than those in the control group: (45.20 ± 5.33) mmHg vs. (50.52 ± 5.96) mmHg, (90.12 ± 8.56) times/min vs. (98.52 ± 9.63) times/min, (17.41 ± 2.26) times/min vs. (22.10 ± 3.05) times/min, there were statistical differences ( P<0.05). After treatment, CAT scores and DECAF scores in the observation group were lower than those in the control group: (8.45 ± 1.63) scores vs. (12.77 ± 2.36) scores, (0.89 ± 0.15) scores vs. (1.15 ± 0.19) scores, there were statistical differences ( P<0.05). After treatment, the levels of IL-10 and CD 4+/CD 8+ in the observation group were higher than those in the control group: (15.28 ± 3.12) ng/L vs. (13.41 ± 2.96) ng/L, 1.71 ± 0.38 vs. 1.54 ± 0.30; while the level of TNF-α was lower than that in the control group: (215.27 ± 33.96) ng/L vs. (251.11 ± 50.95) ng/L, there were statistical differences ( P<0.05). The hospitalization time in the observation group was shorter than that in the control group: (13.52 ± 3.96) d vs. (15.22 ± 2.74) d, there was statistical difference ( P<0.05). The rates of tracheal intubation and the incidence of adverse reactions between the two groups had no significant differences ( P>0.05). Conclusions:Non-invasive BiPAP ventilator combined with oxygen atomization can improve blood gas index, vital signs and clinical symptoms of COPD patients complicated with type Ⅱ respiratory failure and reduce inflammatory response.

ObjectiveTo assess the capacity of health emergency drills for poisoning emergencies at the municipal level in Guangdong Province. Methods A total of 21 municipal teams from cities in Guangdong Province participated in the health emergency drill competition, which included comprehensive tests and practical assessments. Results The pass rate for the total score, comprehensive tests, practical assessments of 21 municipal teams was 66.7%, 33.3%, 66.7%, respectively. The pass rate of the comprehensive tests was lower than that of practical assessments (P<0.01). The pass rate for the total score, comprehensive tests, and practical assessments of team from the Pearl River Delta region was higher than those in non-Pearl River Delta regions (88.9% vs 50.0%, 55.5% vs 16.7%, 88.9% vs 50.0%). For the four comprehensive test items, the highest pass rate was for personal protective principles against chemical poisoning (57.1%). For the five practical assessment items, the highest pass rate was for the selection and matching of personal protective equipment and practice of poisoning detection (both 71.4%). Conclusion It is urgent to improve the capacity of health emergency drills at the municipal level in Guangdong Province. Emphasis should be placed on strengthening capacity building in teams from non-Pearl River Delta regions.

Objective:This study aimed to construct a risk prediction model for obstructive sleep apnea（OSA） related hypertension based on the nomogram, and to explore the independent risk factors for OSA-related hypertension, so as to provide reference for clinical treatment decision-making. Methods:The clinical data of OSA patients diagnosed by polysomnography from October 2019 to December 2021 were collected retrospectively and randomly divided into training sets and validation sets. A total of 1 493 OSA patients with 27 variables were included. The least absolute shrinkage and selection operator（Lasso） logistic regression model was used to select potentially relevant features and establish a nomogram for OSA-related hypertension.The performance and clinical benefits of this nomogram were verified in terms of discrimination, calibration ability and clinical net benefit. Results:Multivariate logistic regression showed that body mass index（BMI）, family history of hypertension, lowest oxygen saturation（LSaO2）, age and cumulative percentage of total sleep time with oxygen saturation below 90% were independent risk factors for OSA-related hypertension. Lasso logistic regression identified BMI, family history of hypertension, LSaO2 and age as predictive factors for inclusion in the nomogram. The nomogram provided a favorable discrimination, with a C-indexes of 0.835（95% confidence interval[CI ]0.806-0.863） 0.865（95%CI 0.829-0.900） for the training and validation cohort, respectively, and well calibrated. The clinical decision curve analysis displayed that the nomogram was clinically useful. Conclusion:Compared with cumulative percentage of total sleep time with blood oxygen saturation below 90%, LSaO2 may have a greater impact on the incidence of OSA-related hypertension, and the effects of different times and degrees of hypoxia on OSA-related hypertension should be further explored in the future. Apnea hypopnea index involvement is weak in predicting OSA-related hypertension, and the blood oxygen index may be a better predictor variable. Furthermore, we established a risk prediction model for OSA-related hypertension patients using nomogram, and demonstrated that this prediction model was helpful to identify high-risk OSA-related hypertension patients. This model can provide early and individualized diagnosis and treatment plans, protect patients from the serious.
Humans ; Sleep Apnea, Obstructive/complications* ; Nomograms ; Hypertension/epidemiology* ; Male ; Female ; Risk Factors ; Middle Aged ; Retrospective Studies ; Polysomnography ; Logistic Models ; Body Mass Index ; Adult

Diabetic nephropathy （DN） is one of the common chronic kidney diseases （CKD） worldwide and a major cause of end-stage renal disease （ESRD）， seriously threatening and affecting the life and health of the global population. Currently， the pathogenesis of DN is considered to be closely related to factors such as glucose metabolism disorders， abnormal lipid metabolism， oxidative stress， activation of inflammatory factors， autophagy， and cell apoptosis in the continuous high-glucose environment of the body. Renal fibrosis is an important pathological feature and ultimate pathological outcome of DN. Timely intervention in renal fibrosis is of significant clinical and practical importance for the prevention and treatment of DN. Due to the limitations of western medicine in treating DN， traditional Chinese medicine （TCM） intervention in the process of renal fibrosis in DN has been widely used as a routine and potential treatment method due to its multi-component， multi-effect， and multi-target effects， effectively delaying the progression of the disease. It has been found that the Notch signaling pathway plays an important role in the development and maintenance of homeostasis in the body， and abnormal activation of the Notch signaling pathway is associated with DN. Activation of this signaling pathway plays a key role in the process of renal fibrosis. This article reviewed the regulatory mechanism of the Notch signaling pathway in renal fibrosis in DN， focusing on the relationship between targeting Notch signaling pathway by Chinese medicinal monomers and prescriptions and renal fibrosis in DN in order to provide a theoretical basis for the development of new drugs， basic research， and clinical application of TCM in the prevention and treatment of DN.

Diabetic kidney disease （DKD）， a chronic kidney disease with unique pathological structural and functional alterations in the kidney， is a common complication of diabetes mellitus （DM）. The majority of researchers believe that the occurrence of this disease is associated with glucose metabolism disorders， oxidative stress， inflammation， endoplasmic reticulum stress， autophagy， and disorders of lipid metabolism and exosome release. The mammalian target of rapamycin （mTOR） signaling pathway， which can maintain glomerular podocyte homeostasis and participate in autophagy， renal fibrosis， oxidative stress， lipid metabolism disorders， and inflammatory response in DKD， has been discovered to play a key role in DKD. Therefore， it has emerged as a novel target for the treatment of DKD. Studies have demonstrated that traditional Chinese medicine can prevent the renal damage in DKD by regulating the mTOR signaling pathway to delay the disease progression and improve the prognosis and the quality of life of the patients. This article summarizes the structure and role of the mTOR signaling pathway in DKD and briefs the research progress in the prevention and treatment of DKD via this signaling pathway by the active components， extracts， and compound prescriptions of Chinese medicines， aiming to present new ideas and approaches for the clinical treatment of DKD with traditional Chinese medicine.

Chuanxiong Rhizoma (CX, the dried rhizome of Ligusticum wallichii Franch.), a well-known traditional Chinese medicine, is clinically used for treating cardiovascular, cerebrovascular and hepatobiliary diseases. Cholestatic liver damage is one of the chronic liver diseases with limited effective therapeutic strategies. Currently, little is known about the mechanism links between CX-induced anti-cholestatic action and intercellular communication between cholangiocytes and hepatic stellate cells (HSCs). The study aimed to evaluate the hepatoprotective activity of different CX extracts including the aqueous, alkaloid, phenolic acid and phthalide extracts of CX (CX_AE, CX_AL, CX_PA and CX_PHL) and investigate the intercellular communication-related mechanisms by which the most effective extracts work on cholestatic liver injury. The active compounds of different CX extracts were identified by UPLC-MS/MS. A cholestatic liver injury mouse model induced by bile duct ligation (BDL), and transforming growth factor-β (TGF-β)-treated human intrahepatic biliary epithelial cholangiocytes (HIBECs) and HSC cell line (LX-2 cells) were used for in vivo and in vitro studies. Histological and other biological techniques were also applied. The results indicated that CX_AE, CX_AL and CX_PHL significantly reduced ductular reaction (DR) and improved liver fibrosis in the BDL mice. Meanwhile, both CX_AE and CX_PHL suppressed DR in injured HIBECs and reduced collagen contraction force and the expression of fibrosis biomarkers in LX-2 cells treated with TGF-β. CX_PHL suppressed the transcription and transfer of plasminogen activator inhibitor-1 (PAI-1) and fibronectin (FN) from the 'DR-like' cholangiocytes to activated HSCs. Mechanistically, the inhibition of PAI-1 and FN by CX_PHL was attributed to the untight combination of the acetyltransferase KAT2A and SMAD3, followdd by the suppression of histone 3 lysine 9 acetylation (H3K9ac)-mediated transcription in cholangiocytes. In conclusion, CX_PHL exerts stronger anti-cholestatic activity in vivo and in vitro than other CX extracts, and its protective effect on the intracellular communication between cholangiocytes and HSCs is achieved by reducing KAT2A/H3K9ac-mediated transcription and release of PAI-1 and FN.