1.Auxiliary liver transplantation: Opportunities and challenges in improving donor liver utilization rate
Aishanjiang AIZIMANTI ; Kai ZHONG ; Tulahong ALIMU ; Qiang GUO ; Ruiqing ZHANG ; Aji TUERGANAILI
Journal of Clinical Hepatology 2026;42(6):1462-1468
Liver transplantation is the standard treatment for end-stage liver disease, but it has long been limited by the shortage of donor livers. In clinical practice, three types of donor liver (domino donor livers, small-for-size grafts, and steatotic donor livers) are limited due to issues such as metabolic defects, insufficient volume, and poor quality. This article systematically reviews the definition, clinical application, and bottlenecks of the above three types of donor livers and elaborates on the unique value and clinical practice advances of auxiliary liver transplantation (a special surgical procedure that retains part or all of the recipient’s own liver and superimposes donor liver function support) in avoiding small-for-size syndrome, compensating for metabolic defects, and expanding the application of marginal livers, in order to provide a targeted clinical practice reference for optimizing liver transplantation strategies for end-stage liver disease and improving donor liver utilization rate.
2.Research Progress on the Mechanism of Mitochondrial Biogenesis in Cerebral Ischemia-Reperfusion Injury
Jingjing LI ; Ruiqing LI ; Jianyun ZHANG
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong 2025;54(2):298-304
Ischemic stroke(IS)is an acute cerebrovascular disease caused by sudden obstruction or occlusion of cerebral blood vessels,and is one of the major causes of disability and death in China.The main therapeutic goal is to restore blood flow as soon as possible after the onset of symptoms,and intravenous thrombolysis and endovascular thrombectomy are often adopted.However,post-thrombolysis blood recirculation is prone to lead to cerebral ischemia-reperfusion injury(CIRI).CIRI is a key pathological process in IS,so it is critical to find ways to mitigate CIRI.Mitochondrial biogenesis(MB)coordinates synthe-sis of new mitochondria from existing ones.When cerebral ischemia occurs,the body maintains mitochondrial homeostasis by ac-tivating MB,alleviates oxidative stress and inflammatory response,and prevents the body from further damage.Understanding the molecular mechanism of MB and its activation pathway will provide a new direction for the treatment of CIRI.This review summarizes the molecular mechanism of MB,the protective mechanism of MB for CIRI by maintaining mitochondrial homeosta-sis,inhibiting oxidative stress and inflammation after IS,and the potential therapeutic targets to improve CIRI by activating MB.It will provide new ideas for clinical treatment of CIRI.
3.Recurrence Prediction Model of DLBCL Patients within 2 Years based on SMOTE-ENN Combined with Improved Dynamic Ensemble Selection Algorithm
Gaoyuan ZHANG ; Ruiqing ZHAO ; Yanbo ZHANG
Chinese Journal of Health Statistics 2025;42(1):50-55,61
Objective The prediction model of recurrence within two years after complete remission of diffuse large B-cell lymphoma(DLBCL)patients was constructed based on frienemy indecision region dynamic ensemble selection(FIRE-DES)to provide decision-making basis for the treatment of patients.Methods To collect data of 498 patients who achieved complete response after treatment from January 2010 to January 2020 in a Grade-A hospital in Shanxi Province.A FIRE-DES combination prediction model based on four common category-disequilibrium treatment methods was constructed and compared with five traditional single classifiers and two integrated classifiers.Results Among the four categories of unbalance algorithms,synthetic minority oversampling technique and edited nearest neighbor(SMOTE-ENN)algorithm has obtained the optimal classification performance.On this basis,the classification effect of dynamic ensemble selection performance(DESP),K-nearest oracle union(KNORAU)and meta-learning for dynamic ensemble selection(META-DES)dynamic integration selection algorithms is obviously superior to the traditional single classifier and ensemble classifier model.The classification effect of the improved DESP,KNORAU and META-DES dynamic selection algorithms based on Frienemy Indecision Region is further improved.The classification performance of FIRE-META-DES was the best(Accuracy=0.909,Precision=0.906,Recall=0.967,AUC=0.879,F1-Score=0.936,Brier Score=0.088).Conclusion Aiming at the actual DLBCL data set,SMOTE-ENN+FIRE-META-DES combined prediction model for recurrence used in this paper achieves the optimal performance and low computational complexity,which can provide a strong reference for DLBCL recurrence prediction.
4.Research progress on the strategy and mechanism of sonodynamic immunotherapy
Zesheng LI ; Beibei ZHANG ; Shaobo DUAN ; Ruiqing LIU ; Yaqiong LI ; Yuzhou WANG ; Rong HUANG ; Lianzhong ZHANG
Chinese Journal of Ultrasonography 2025;34(4):357-363
Sonodynamic therapy(SDT)has garnered significant attention in cancer treatment modalities due to its superior tissue penetration capabilities,non-invasive approach,and controllability. SDT operates by utilizing sonosensitizers and ultrasound-responsive devices to induce the production of reactive oxygen species(ROS)under ultrasound stimulation,thereby eliciting immunogenic cell death(ICD)in tumor cells and the release of damage-associated molecular patterns,which in turn trigger an immune response against the tumor.However,the tumor microenvironment often results in a relatively weak immune response post-cancer treatment. To address this issue,extensive research is being conducted on combining SDT with immunotherapy,particularly focusing on immune checkpoint blockade(ICB)therapies. This review synthesizes the mechanisms of SDT,its integration with immunotherapy,especially ICB therapies,and the current state of research,with the objective of providing strategic guidance for the advancement of sonodynamic immunotherapy.
5.Recurrence Prediction Model of DLBCL Patients within 2 Years based on SMOTE-ENN Combined with Improved Dynamic Ensemble Selection Algorithm
Gaoyuan ZHANG ; Ruiqing ZHAO ; Yanbo ZHANG
Chinese Journal of Health Statistics 2025;42(1):50-55,61
Objective The prediction model of recurrence within two years after complete remission of diffuse large B-cell lymphoma(DLBCL)patients was constructed based on frienemy indecision region dynamic ensemble selection(FIRE-DES)to provide decision-making basis for the treatment of patients.Methods To collect data of 498 patients who achieved complete response after treatment from January 2010 to January 2020 in a Grade-A hospital in Shanxi Province.A FIRE-DES combination prediction model based on four common category-disequilibrium treatment methods was constructed and compared with five traditional single classifiers and two integrated classifiers.Results Among the four categories of unbalance algorithms,synthetic minority oversampling technique and edited nearest neighbor(SMOTE-ENN)algorithm has obtained the optimal classification performance.On this basis,the classification effect of dynamic ensemble selection performance(DESP),K-nearest oracle union(KNORAU)and meta-learning for dynamic ensemble selection(META-DES)dynamic integration selection algorithms is obviously superior to the traditional single classifier and ensemble classifier model.The classification effect of the improved DESP,KNORAU and META-DES dynamic selection algorithms based on Frienemy Indecision Region is further improved.The classification performance of FIRE-META-DES was the best(Accuracy=0.909,Precision=0.906,Recall=0.967,AUC=0.879,F1-Score=0.936,Brier Score=0.088).Conclusion Aiming at the actual DLBCL data set,SMOTE-ENN+FIRE-META-DES combined prediction model for recurrence used in this paper achieves the optimal performance and low computational complexity,which can provide a strong reference for DLBCL recurrence prediction.
6.Research Progress on the Mechanism of Mitochondrial Biogenesis in Cerebral Ischemia-Reperfusion Injury
Jingjing LI ; Ruiqing LI ; Jianyun ZHANG
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong 2025;54(2):298-304
Ischemic stroke(IS)is an acute cerebrovascular disease caused by sudden obstruction or occlusion of cerebral blood vessels,and is one of the major causes of disability and death in China.The main therapeutic goal is to restore blood flow as soon as possible after the onset of symptoms,and intravenous thrombolysis and endovascular thrombectomy are often adopted.However,post-thrombolysis blood recirculation is prone to lead to cerebral ischemia-reperfusion injury(CIRI).CIRI is a key pathological process in IS,so it is critical to find ways to mitigate CIRI.Mitochondrial biogenesis(MB)coordinates synthe-sis of new mitochondria from existing ones.When cerebral ischemia occurs,the body maintains mitochondrial homeostasis by ac-tivating MB,alleviates oxidative stress and inflammatory response,and prevents the body from further damage.Understanding the molecular mechanism of MB and its activation pathway will provide a new direction for the treatment of CIRI.This review summarizes the molecular mechanism of MB,the protective mechanism of MB for CIRI by maintaining mitochondrial homeosta-sis,inhibiting oxidative stress and inflammation after IS,and the potential therapeutic targets to improve CIRI by activating MB.It will provide new ideas for clinical treatment of CIRI.
7.Research progress of musculoskeletal ultrasound technique in the evaluation of limb spasticity after stroke
Shuaidi ZHANG ; Jianyun ZHANG ; Jingjing LI ; Changyu GU ; Jian GUO ; Ruiqing LI
The Journal of Practical Medicine 2025;41(1):134-140
Limb spasticity is a common complication after stroke,with clinical manifestations such as increased muscle tone,limb stiffness and pain,which reduces the quality of patients'daily life and increases the economic burden.Currently,scales,surface electromyography and biomechanical methods are mostly used to assess limb spasticity in clinical practice,but clinical scales rely on experience and are highly subjective;surface electromyography is prone to compensations and test errors;and biomechanical methods are more restrictive.Musculoskeletal ultrasound is not only capable of detecting muscle parameters and providing quantitative information such as muscle hardness and elasticity,but also has the unique advantages of high-resolution and real-time imag-ing,which has been increasingly used in clinical diagnosis and treatment.In this paper,we review the evidence related to musculoskeletal ultrasound and limb spasticity assessment,with the aim of exploring a simple and reasonable quantitative assessment method,which will provide some thoughts for the future clinical assessment of limb spasticity.
8.Efficacy and influencing factors of antiviral therapy for hepatitis B e antigen-positive chronic hepatitis B in children
Pengfei XU ; Yufeng ZHANG ; Xiaoyan WANG ; Ruiqing LIU ; Le YAN ; Nan JIA ; He SONG ; Huiling DENG
Chinese Pediatric Emergency Medicine 2025;32(6):464-469
Objective:To investigate the efficacy of antiviral therapy and influencing factors of hepatitis B surface antigen(HBsAg) negative conversion for hepatitis B e antigen(HBeAg)-positive chronic hepatitis B(CHB) in children.Methods:The clinical data of 38 children with CHB who received antiviral treatment in Children's Hospital Affiliated to Xi'an Jiaotong University from January 2019 to August 2024 were collected.All patients were treated with interferon alpha monotherapy or combined with nucleoside analogues for 48 weeks.The patients were divided into HBsAg negative group and HBsAg non-negative group according to the therapeutic results at 48 weeks.Multivariate Logistic regression were used to identify influencing factors of HBsAg negative conversion at 48 weeks.The receiver operator characteristic(ROC)curve was used to analyze the predictive value of each factor to HBsAg negative conversion.Results:The alanine aminotransferase normalization rate,hepatitis B virus DNA negative rate,HBeAg negative rate and HBsAg negative rate were 76.3%,94.7%,39.5% and 47.4%,respectively at 48 weeks.There were 18 cases in HBsAg negative group and 20 cases in HBsAg non-negative group.There were statistical significant differences in age and HBsAg decline level at 12 and 24 weeks of antiviral treatment between HBsAg negative group and HBsAg non-negative group( P<0.05).Multivariate Logistic regression analysis showed that age and HBsAg decline level at 12 and 24 weeks of antiviral treatment were independent predictors of HBsAg negative conversion at 48 weeks( OR=0.664,95% CI 0.473-0.932, P=0.018; OR=8.719,95% CI 1.920-39.604, P=0.005; OR=6.182,95% CI 2.083-18.347, P=0.001).The area under the curve of age and HBsAg decline level at 12 and 24 weeks were 0.737(95% CI 0.576-0.899, P=0.012),0.847(95% CI 0.725-0.969, P<0.001)and 0.939(95% CI 0.811-0.991, P<0.001),respectively.When the age was less than 4.625 years,the sensitivity,specificity,positive predictive value and negative predictive value of HBsAg negative conversion at 48 weeks were 83.3%,65.0%,68.2% and 81.3%,respectively.A decrease in HBsAg level of >1.07 lg IU/mL at 12 weeks of treatment had a sensitivity,specificity,positive predictive value,and negative predictive value of 72.2%,90.0%,86.7%,and 78.3%,respectively,for predicting HBsAg seroclearance at 48 weeks.A reduction in HBsAg of >1.92 lg IU/mL at 24 weeks of treatment showed a sensitivity,specificity,positive predictive value,and negative predictive value of 83.3%,90.0%,88.2%,and 85.7%,respectively,in predicting HBsAg seroclearance at 48 weeks. Conclusion:The children with CHB have a higher rate of HBsAg negative conversion after antiviral therapy at 48 weeks.Age and HBsAg decline level at 12 and 24 weeks of antiviral treatment can serve as early predictors for HBsAg negative conversion in children with CHB.
9.Clinical characteristics and drug resistance of 138 cases of non-typhoidal Salmonella enteritis in children
Xiru YANG ; Yufeng ZHANG ; Xiaoyan WANG ; Kairui LEI ; Lu CAO ; Pengfei XU ; Ruiqing LIU
Chinese Pediatric Emergency Medicine 2025;32(8):586-590
Objective:To investigate the clinical characteristics of non-typhoidal Salmonella(NTS)enteritis in children and the drug resistance of NTS strains.Methods:The clinical data of 138 children who were hospitalized in Children's Hospital Affiliated to Xi'an Jiaotong University from 2022 to 2023 with diarrhea as the main complaint and NTS detected in stool culture were analyzed retrospectively, and the clinical characteristics and drug resistance were summarized.Results:Among 138 children with NTS enteritis,89 were males and 49 were females,with a male-to-female sex ratio of 1.81∶1 and an average age of 1.9(1.0,3.6)years,with a high incidence rate in June,July and August.Seventeen(12.31%)cases had a history of suspected unclean diet before illness.All the children had diarrhea symptoms with changes in fecal frequency and character,including 74 cases of pus and bloody stool,119 cases of mucus stool,and 70 cases of watery stool.One hundred and twenty-five(90.57%)cases had fever.Among 138 cases of fecal culture,there were 47 (34.05%) strains of Salmonella typhimurium,36(26.09%) strains of Salmonella enteritidis,and 55(39.85%) strains of other serotypes of Salmonella .One hundred and twenty-two(88.40%)NTS strains were resistant to more than one antimicrobial agent,and 29(21.01 %)were multi-drug resistant.The resistance rates to ampicillin,ampicillin/sulbactam,ceftriaxone,trimethoprim/sulfamethazole,ceftazidime,cefepime and piperacillin/tazobactam were 73.91%,71.01%,29.71%,29.71%,23.19%,11.59%,and 3.62%,respectively.All strains were sensitive to carbapenem antibiotics(meropenem,imipenem,and ertapenem).The drug resistance rates of Salmonella typhimurium to ceftazidime and trimethoprim/sulfamethoxazole were higher than those of Salmonella enteritidis(38.30% vs 8.33%),the difference was statistically significant ( P < 0.05). Conclusion:Infants and young children are the high-incidence group of NTS enteritis,with the peak incidence period being from June to August each year,manifested by mucus-pus-blood stools, abdominal pain, vomiting,fever and other symptoms.Reasonable selection of antibiotics in time according to the local epidemic strains,changes of antimicrobial resistance and the results of drug sensitivity test of strains can effectively resist infection and reduce the production of drug-resistant beads.
10.Effect of variants in the non-coding region of ABO blood group alleles on the weak expression of antigens
Hua WANG ; Yunxiang WU ; Fei WANG ; Yajun LIANG ; Qing LI ; Jiangtao ZUO ; Yi XU ; Zhicheng LI ; Ruiqing GUO ; Xin ZHANG ; Demei ZHANG
Chinese Journal of Medical Genetics 2025;42(5):628-632
Objective:To explore the regulatory mechanisms underlying the weak expression of ABO blood group antigens due to variants in the non-coding regions of the ABO gene. Methods:From June 2014 to October 2023, a total of 29 samples from the Taiyuan Blood Center and local hospitals, which were serologically identified as having weak ABO antigen expression without detectable coding region mutations, were selected for this study. Full-length ABO gene sequencing was performed using third-generation long-read sequencing technology (Pacific Biosciences) to obtain complete haplotype sequences of the ABO gene. Variants in the non-coding regions were compared and identified to infer their regulatory effects on weak antigen expression. The procedures followed in this study were in accordance with the ethical standards of the World Medical Association′s Declaration of Helsinki (2013 revision). The Medical Ethics Committee of Taiyuan Blood Center has granted an exemption from ethical review. Results:18 bp deletions in the -35 to -18 region of the promoter were identified in 7 samples. Variants in intron 1 (+ 5.8 kb) were detected in 7 samples, including ABO* A (28+ 5792_5793delCT (1 case) and ABO* B (28+ 5793T>C) located in the GATA binding region; ABO* B (28+ 5808C>T) (1 case) in the E-box region; and ABO* B (28+ 5875C>T) (4 cases) in the RUNX1 binding region. Nucleotide variants at splice sites were detected in 2 samples, namely ABO* B (C.98+ 1G>A) and ABO* B (C.204-2A>C). Conclusion:Variants in the non-coding regulatory sequences of the ABO gene are a significant factor contributing to weak ABO antigen expression. In clinical ABO sequencing, it is essential to screen not only the conventional coding regions but also the flanking sequences, introns, and splice sites of the ABO gene to facilitate precise blood transfusion.

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