1.Research progress on antibody-drug conjugates in the treatment of triple-negative breast cancer
Danna LIU ; Shuangshuang SONG ; Lu CHEN ; Yongqiang SUN ; Bo SUN ; Hanli ZHOU ; Xiaoli ZHAO ; Tiandong KONG
China Pharmacy 2026;37(1):124-129
Antibody-drug conjugates (ADCs) are a novel class of anti-tumor agents composed of a targeted monoclonal antibody, a cytotoxic drug, and a linker connecting the two. They combine the high specificity of antibodies with the potent cytotoxicity of chemotherapeutic agents. Triple-negative breast cancer (TNBC) is characterized by high aggressiveness, elevated risks of recurrence and metastasis, and poor prognosis, largely due to the lack of effective therapeutic targets. This review summarizes the research progress of ADCs in the treatment of TNBC. It has been found that ADCs targeting human epidermal growth factor receptor 2 (such as trastuzumab deruxtecan), trophoblast cell surface antigen 2 (such as sacituzumab govitecan and datopotamab deruxtecan), zinc transporter LIV-1 (such as ladiratuzumab vedotin), HER-3 (such as patritumab deruxtecan), epidermal growth factor receptor (such as AVID100), and glycoprotein non-metastatic melanoma protein B (such as glembatumumab vedotin) have all demonstrated promising therapeutic effects against TNBC. Despite challenges including acquired resistance and treatment-related toxicities, ADCs are undoubtedly reshaping the therapeutic landscape for TNBC and are expected to occupy a more central position in TNBC treatment in the future.
2.Clustering analysis of chronic diseases risk factors among adult residents in Rui'an City
FANG Yedong ; SUN Fanghong ; DENG Jiankai ; QIU Fangfang ; WANG Xiaozhen ; ZHOU Zumu
Journal of Preventive Medicine 2026;38(1):60-65
Objective:
To analyze the prevalence status and clustering patterns of risk factors for chronic diseases among adult residents in Rui' an City, Zhejiang Province, so as to provide a basis for formulating strategies for the prevention and control of chronic diseases and implementing risk factor interventions.
Methods:
A multi-stage random cluster sampling method was used to select residents aged ≥18 years in 5 townships (sub-districts) of Rui' an City as survey subjects from December 2023 to March 2024. Data on basic information, history of major chronic diseases, lifestyle behaviors, height, weight, and blood biochemical indicators were collected through questionnaire surveys, physical examinations, and laboratory tests. Descriptive analysis was used to analyze the prevalence status of 5 risk factors for chronic diseases. K-means clustering analysis was used to analyze clustering patterns.
Results:
A total of 3 060 people were surveyed, including 1 476 males, accounting for 48.24%, and 1 584 females, accounting for 51.76%. The median age was 49.00 (interquartile range, 25.00) years. There were 1 275 cases (41.67%) of hypertension, 462 cases (15.10%) of diabetes, and 1 460 cases (47.71%) of dyslipidemia. Insufficient fruit and vegetable intake, excessive salt intake, overweight and obesity, excessive red meat intake, and smoking involved 2 201, 1 878, 1 541, 1 337, and 571 people, with prevalences of 71.93%, 61.37%, 50.36%, 43.69%, and 18.66%, respectively. K-means clustering analysis identified 4 clustering patterns: smoking-insufficient fruit and vegetable intake type (249 people, accounting for 8.20%), low intake type (1 421 people, accounting for 46.75%). high red meat type (245 people, accounting for 8.07%), and high BMI-high salt type (1 118 people, accounting for 36.96%). The prevalences of hypertension and diabetes were higher in adult residents of the high BMI-high salt type, at 56.53% and 20.30%, respectively. The prevalence of dyslipidemia was higher in adult residents of the smoking-insufficient fruit and vegetable intake type, at 59.44%.
Conclusions
The prevalence of insufficient fruit and vegetable intake among adult residents in Rui' an City is relatively high. The clustering pattern of chronic disease risk factors is dominated by the low intake type. The prevalence of chronic diseases is higher in adult residents of the high BMI-high salt type and smoking-insufficient fruit and vegetable intake type. It is suggested to carry out health education and collaborative intervention of risk factors for different risk groups.
3.Comparison of bioelectrical impedance analysis and dual energy X ray absorptiometry in measuring body composition among Tibetan children and adolescents
Chinese Journal of School Health 2026;47(4):569-573
Objective:
To compare the consistency between bioelectrical impedance analysis (BIA) and dual energy X ray absorptiometry (DXA) in measuring body composition among Tibetan children and adolescents and to explore the applicability of BIA in plateau region, so as to provide scientific and convenient body composition measurement support among children and adolescents.
Methods:
From May to June, 2022, a total of 344 Tibetan children and adolescents aged 6-17 years were selected from Golmud Municipal National Middle School and Changjiangyuan Nationality Primary School in Qinghai Province by cluster sampling method, and their fat mass, fat mass percentage and lean mass were measured by DXA and BIA. The consistency and correlation between the two methods were assessed by using the Wilcoxon rank-sum test, Spearman correlation analysis, intraclass correlation coefficient (ICC), and Bland-Altman analysis.
Results:
DXA measured fat mass and fat mass percentage were significantly higher than those obtained by BIA (6-12 years old: Z =9.91, 11.28; 13-17 years old: Z =9.02, 10.21), while lean mass and lean mass percentage were significantly lower than BIA results (6-12 years old: Z =-11.60, -11.30; 13-17 years old: Z =-10.77, -10.36) (all P < 0.05 ). The two methods showed strong correlations in fat mass and lean mass (all r >0.80, all ICC >0.90), but exhibited poor agreement in fat mass percentage and lean mass percentage (6-12 years old: Lin s CCC =0.64, 0.41; 13-17 years old: Lin s CCC = 0.79 , 0.35). Bland-Altman analysis showed that the difference between the two methods was negatively correlated with the average value in FM%(6-12 years old: r =-0.75, 13-17 years old: r =-0.79, both P <0.01).
Conclusion
BIA and DXA show high consistency in measuring body fat mass and lean body mass in Tibetan children and adolescents, although some bias is still present in certain individuals.
4.Research progress on the association between earlier pubertal timing of children and hypertension with its mechanisms
ZHOU Shuaishuai, SUN Ying, TAO Fangbiao
Chinese Journal of School Health 2026;47(4):599-603
Abstract
In China, the onset of puberty in children has been occurring increasingly earlier, coinciding with a rising prevalence of hypertension among adolescents. The association between early pubertal timing and hypertension has become a focal point of research. The study systematically examines the relationship between earlier pubertal timing of children and hypertension during both childhood and adulthood. It explores the underlying mechanisms from multiple perspectives, including sex hormone regulation, metabolic disorders, and psychological and behavioral factors. Furthermore, based on the principles of three level prevention, relevant intervention measures have been proposed to provide new evidence for advancing the prevention and control of hypertension starting in childhood.
5.Expression of SLC7A11 in esophageal squamous cell carcinoma tissues and its preliminary study on mediating tumor cell metabolism
Huakun ZHANG ; Mengfei SUN ; Qi SUN ; Ziru ZHOU ; Jie YU ; Yunzhao CHEN ; Xiaobin CUI
Acta Universitatis Medicinalis Anhui 2026;61(2):270-276
ObjectiveTo investigate the relationship between solute carrier family 7 member 11 (SLC7A11) expression in esophageal squamous cell carcinoma (ESCC) and clinical prognosis, and to determine its effects on ESCC cell growth, migration, and other biological activities. MethodsSLC7A11 protein expression was measured in 310 ESCC tissues and 259 adjacent normal tissues using immunohistochemistry to statistically assess the association of SLC7A11 with clinicopathologic characteristics and prognosis in ESCC patients. The expression of SLC7A11 in ESCC cell lines was suppressed through siRNA-mediated knockdown. The specific effects of SLC7A11 knockdown on proliferation and migration were evaluated using CCK-8, clonogenic assay, and Transwell assays. Adenosine triphosphate (ATP), lactic acid and pyruvate assays were used to measure ESCC metabolism. ResultsSLC7A11 protein expression was localized predominantly in the cytoplasm of ESCC tissues. Significantly higher SLC7A11 expression levels were observed in ESCC tissues compared to adjacent normal tissues (P<0.001). High SLC7A11 expression was associated with poorer differentiation in patients (P<0.01). Kaplan-Meier survival analysis demonstrated significantly shorter overall survival in patients with high SLC7A11 expression compared to those with low expression (P<0.05). CCK-8 and colony formation assays demonstrated that the knockdown of SLC7A11 expression significantly suppressed the proliferative capacity of tumor cells (P<0.001). Furthermore, Transwell assays revealed a marked decline in tumor cell migration capacity following SLC7A11 suppression (P<0.001). Critically, SLC7A11 knockdown also reduced intracellular levels of ATP, lactate, and pyruvate, demonstrating that SLC7A11 modulated metabolic activity in ESCC cells(P<0.001). ConclusionThe expression level of SLC7A11 is relatively high in ESCC and is strongly associated with poor prognosis. Silencing SLC7A11 significantly inhibits esophageal cancer cell growth and migration. SLC7A11 has the ability to regulate glucose, lactic acid and ATP metabolism levels in ESCC, thereby affecting the metabolic microenvironment of ESCC.
6.Distribution of potential suitable habitats for Haemaphysalis longicornis in Nanjing City based on the maximum entropy model
Pumin ZHOU ; Jianjun XIA ; Luyao SUN ; Xuemin CHEN ; Bingdong SONG ; Shougang ZHANG
Chinese Journal of Schistosomiasis Control 2026;38(1):44-53
Objective To investigate the current distribution and predict the future suitable habitats of Haemaphysalis longicornis in Nanjing City, so as to provide insights into control and early warning of ticks and management of tick-borne diseases in Nanjing City. Methods The electronic map of Nanjing City was obtained from the National Platform for Common GeoSpatial Information Services. The distribution of H. longicornis and the longitude and latitude of distribution points from 2022 to 2024 were obtained from centers for disease control and prevention across each district in Nanjing City. Climatic and environmental variable data in Nanjing City were captured from the Worldclim database. Initially, 19 bioclimatic variables in this database were selected, including annual mean temperature, mean diurnal range, isothermality, temperature seasonality, maximum temperature of the warmest month, minimum temperature of the warmest month, temperature annual range, mean temperature of the wettest quarter, mean temperature of the driest quarter, mean temperature of the warmest quarter, mean temperature of the coldest quarter, annual precipitation, precipitation of the wettest month, precipitation of the driest month, precipitation seasonality, precipitation of the wettest quarter, precipitation of the driest quarter, precipitation of the warmest quarter, and precipitation of the coldest quarter. The elevation and normalized difference vegetation index were obtained from Data Sharing Platform of the Center for Resources and Environmental Sciences, Chinese Academy of Sciences. Then, the distribution points of H. longicornis, elevation, vegetation index and 19 bioclimatic variables were loaded into the software MaxEnt 3.4.4 to evaluate and screen out the variables with a contribution rate of 1% and higher. ArcGIS 10.8.1 software was used to extract the elevation, vegetation index and 19 bioclimatic variables of the distribution points of H. longicornis for a correlation analysis. If the absolute value of the correlation coefficient was 0.8 and higher, the variable with the higher contribution was retained. The 2050 dataset of the BCCCSM2-MR atmospheric circulation model in the coupled model intercomparison project phase 6 (CMIP6) were obtained from the Worldclim database as climate data for 2050. Screened H. longicornis species data and environmental and climate data were loaded into the maximum entropy (MaxEnt) model with the software MaxEnt 3.4.4 for training and validation, and then, all data generated from the model were imported into the software ArcGIS 10.8.1 to generate raster data and yield the map pertaining to the distribution of H. longicornis risk in Nanjing City. The accuracy of the model was evaluated with a receiver operating characteristic (ROC) curve, and the predictive effect of the model was assessed with area under the ROC curve (AUC). The suitable habitats of H. longicornis were classified in Nanjing City with the software ArcGIS 10.8.1, and the areas of distribution of suitable habitats in various categories were recorded to create the map of current H. longicornis suitable habitats classification in Nanjing City. The climatic and geographic information data in 2050 were employed as future environmental and climatic factors, and current environmental and climatic factors and current H. longicornis distribution data were additionally used to predict the future suitable habitats of H. longicornis in Nanjing City. In addition, the contributions of environmental and climatic factors to distribution of suitable habitats of H. longicornis was evaluated with the Jackknife method in Nanjing City. Results A total of 10 environmental and climatic variables were screened for analysis of the suitability of H. longicornis in Nanjing City based on correlation analyses and contributions of the MaxEnt model, including annual mean temperature, precipitation of the warmest quarter, vegetation index, precipitation of the wettest month, temperature annual range, annual precipitation, mean temperature of the warmest quarter, elevation, mean temperature of the wettest quarter, and maximum temperature of the warmest month, and annual mean temperature (34.8%), precipitation of the warmest quarter (17.3%), vegetation index (13.1%), and precipitation of the wettest month (10.8%) contributed relatively highly to the distribution of suitable habitats of H. longicornis in Nanjing City. The mean AUC of the ROC curve was 0.810 ± 0.055 for 10 repeated modeling results of the MaxEnt model, indicating high predictive performance of the model. The potential distribution areas of H. longicornis were predicted to be mainly located in Luhe District, Pukou District, Jiangning District, Lishui District, and Gaochun District in Nanjing City with the MaxEnt model. Under current climatic conditions, the area of potential suitable habitats of H. longicornis was 4 182.42 km2 in Nanjing City, including 1 252.94 km2 highly suitable habitats, which accounted for 19.00% of the total area of Nanjing City. Under the climate scenario in 2050, the area of potential suitable habitats of H. longicornis was projected to increase to 5 467.58 km2 in Nanjing City, accounting for 82.95% of the total area of the city, and these habitats were mainly concentrated in Luhe District, Pukou District, Jiangning District, Lishui District, and Gaochun District. The areas of suitable habitats of H. longicornis at various categories were predicted to vary greatly in 2050, and the area of highly suitable habitats of H. longicornis was projected to increase to 2 378.82 km2, accounting for 36.08% of the total area of Nanjing City. Based on jackknife tests and contributions of environmental and climatic variables, 6 dominant environmental and climatic factors were screened, including annual mean temperature (34.8% contribution), precipitation of the warmest quarter (17.3% contribution), vegetation index (13.1% contribution), precipitation of the wettest month (10.8% contribution), temperature annual range (5.4% contribution), and mean temperature of the warmest quarter (5.0% contribution), with cumulative contributions of 86.4%. Conclusion The distribution of H. longicornis is strongly associated with vegetation, temperature and precipitation in Nanjing City. Future climate change may lead to an expansion of the distribution area of H. longicornis in Nanjing City.
7.Olfactory Receptors Expressed in The Intestine and Their Functions
Pei-Wen YANG ; Meng-Meng YUAN ; Ying ZHOU ; Peng LI ; Gui-Hong QI ; Ying YANG ; Zhong-Yi MAO ; Meng-Sha ZHOU ; Xiao-Shuang MAO ; Jian-Ping XIE ; Yi-Nan YANG ; Shi-Hao SUN
Progress in Biochemistry and Biophysics 2026;53(3):534-549
Olfactory receptors (ORs) form the largest superfamily of G protein-coupled receptors (GPCRs). Traditionally recognized for their role in the nasal olfactory epithelium, where they mediate the sense of smell, accumulating evidence has firmly established their ectopic expression in non-olfactory tissues, including the intestine, lungs, and kidneys. The intestine, as the primary site for nutrient digestion and absorption, harbors a highly complex chemical environment. To adapt to this environment, the gut employs a sophisticated network of “chemosensors” to monitor luminal contents and maintain homeostasis. Among these sensors, intestinal ORs have emerged as crucial functional components, serving as a molecular bridge that connects environmental chemical signals—such as food-derived odorants—to specific physiological responses. This discovery has significantly deepened our understanding of how dietary flavors and compounds influence intestinal physiology at the molecular level. This review systematically summarizes the expression profiles, ligand classification, and biological functions of ORs within the gastrointestinal tract. Studies indicate that intestinal ORs exhibit distinct spatial distribution patterns across different gut segments and display cell-type specificity, particularly within enterocytes and enteroendocrine cells. These receptors function as versatile sensors capable of recognizing a wide variety of ligands, including exogenous dietary components, gut microbiota metabolites such as short-chain fatty acids, and endogenous small molecules like azelaic acid. Upon activation by specific ligands, intestinal ORs trigger intracellular signaling cascades, primarily involving the AC-cAMP-PKA pathway or calcium influx channels. A major focus of this review is to elucidate the molecular mechanisms by which these receptors regulate the secretion of gut hormones. Activation of specific ORs in enteroendocrine cells has been shown to stimulate the release of hormones such as glucagon-like peptide-1 (GLP-1), peptide YY (PYY), and serotonin (5-HT), thereby modulating systemic energy metabolism, glucose homeostasis, and gastrointestinal motility. Furthermore, the review addresses the critical roles of ORs in immune regulation and pathology. Evidence suggests that specific ORs contribute to the maintenance of intestinal immune homeostasis and may offer protection against inflammation. Beyond their involvement in inflammatory responses, ORs such as Olfr78 have been shown to regulate the differentiation and function of intestinal endocrine cells. Similarly, Olfr544 has been demonstrated to alleviate intestinal inflammation by remodeling the gut microbiome and metabolome. These findings collectively suggest that specific ORs hold promise as therapeutic targets for mitigating intestinal inflammation and maintaining gut homeostasis. Additionally, the review explores the emerging role of ORs in cancer. Although OR expression is often downregulated in tumor tissues compared to normal mucosa, activation of specific ORs by certain ligands can inhibit tumor cell proliferation and migration and induce apoptosis via pathways such as MEK/ERK and p38 MAPK. Conversely, other receptors, such as OR7C1, may serve as biomarkers for cancer-initiating cells. In conclusion, intestinal ORs represent a vital component of the gut’s sensory network. The review also discusses the translational potential of these findings. By elucidating the precise pairing relationships between dietary components and specific ORs, novel therapeutic strategies could be developed. Intestinal ORs may thus emerge as promising targets for nutritional and pharmacological interventions in metabolic diseases, inflammatory bowel diseases, and malignancies.
8.Regulatory mechanisms of exosome secretion and its application prospects in biomedicine
Ruyue LYU ; Lulu GU ; Qian LIU ; Siyi ZHOU ; Beibei LI ; Letian XUE ; Peng SUN
Chinese Journal of Tissue Engineering Research 2026;30(1):184-193
BACKGROUND:Exosomes,as a type of extracellular vesicle,have become a key medium for cell-to-cell communication due to their nanoscale size and enrichment of various bioactive substances.The study of exosome secretion regulation not only has important scientific value,but also has broad application prospects in clinical practice,and is of great significance for promoting medical progress and improving human health.OBJECTIVE:To review the biological characteristics,biological functions,biogenesis process and biochemical regulation mechanism of exosomes,and to explore the application prospects of exosomes in disease diagnosis,treatment and vaccine development,so as to provide theoretical basis and reference for basic research and clinical transformation of exosomes.METHODS:The first author searched PubMed and CNKI databases in October 2024 for relevant literature published from January 2010 to October 2024.Key words were"exosomes,biological functions,biogenesis,secretion or release,regulatory mechanisms,application prospects"in Chinese and English.Finally,92 articles were included for analysis.RESULTS AND CONCLUSION:The secretion level of exosomes can be regulated through physical or biochemical means.Exosomes show broad application prospects in the fields of disease diagnosis,treatment,and vaccine development,and may play a key role in the treatment of cardiovascular and cerebrovascular diseases as well as cancer.This review provides valuable information for the clinical translation and application research of exosomes,helping to promote future progress in exosome research and application.
9.Inhibition of Epithelial-mesenchymal Transition Mechanism in Chronic Atrophic Gastritis Rats by Banxia Xiexintang via Regulating IL-17/ERK/C/EBPβ Signaling Pathway
Wenyu WU ; Xinyu ZENG ; Hao LI ; Weiqi SUN ; Jiahui REN ; Yang YU ; Tingting ZHOU ; Aili XU ; Wei WEI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):1-10
ObjectiveThis study aimed to investigate the action mechanism by which Banxia Xiexintang (BXT) inhibits epithelial-mesenchymal transition (EMT) in chronic atrophic gastritis (CAG) rats by regulating the interleukin-17(IL-17)/extracellular regulated protein kinases(ERK)/CCAAT enhancer binding protein β(C/EBPβ)signaling pathway, thereby providing new theoretical evidence for the treatment of CAG with classic traditional Chinese medicine formulas. MethodsA CAG rat model was established by using the combined factor method. After successful modeling, the rats were randomly divided into the model group, low-, medium-, and high-dose groups (0.549, 1.098, 2.196 g·kg-1, respectively) of BXT, and the positive drug group (vitacoenzyme, 0.3 g·kg-1). A normal control group was also set up. After 8 weeks of intervention, the pathological changes of gastric tissue were evaluated. The enzyme-linked immunosorbent assay (ELISA) was used to detect the contents of IL-17, tumor necrosis factor-α (TNF-α), cyclooxygenase-2 (COX-2), and C/EBPβ in serum, as well as the contents of EMT markers in gastric mucosal tissue including E-cadherin, N-cadherin, and vimentin. The immunohistochemistry method was employed to determine the localization and protein expression levels of IL-17, p-ERK, and C/EBPβ in gastric mucosal tissue. Western blot was used to detect the protein expressions of C/EBPβ, ERK, and its phosphorylated form (p)-ERK in gastric mucosa. Real-time polymerase chain reaction (Real-time PCR) was applied to measure the mRNA expression levels of ERK, COX-2, and C/EBPβ in gastric mucosa. ResultsCompared with those in the normal control group, the rats in the model group showed gastric mucosal glandular atrophy and inflammatory cell infiltration. The protein and their related mRNA expressions of C/EBPβ, ERK, and p-ERK in gastric mucosa were significantly increased (P<0.05,P<0.01). The levels of IL-17, TNF-α, COX-2, and C/EBPβ in serum were significantly increased (P<0.01). The contents of N-cadherin and vimentin in gastric mucosal tissue were significantly increased, while the content of E-cadherin was significantly decreased (P<0.01). Compared with the model group, after intervention with different doses of BXT, the pathological damage of the gastric mucosa was improved to varying degrees. The protein and mRNA expressions of C/EBPβ, ERK, and p-ERK in gastric mucosa were significantly reduced (P<0.05,P<0.01). The levels of IL-17, TNF-α, COX-2, and C/EBP β in serum were significantly decreased (P<0.01). The contents of N-cadherin and vimentin in gastric mucosa tissue were decreased, while the content of E-cadherin was increased (P<0.05,P<0.01). ConclusionBXT can effectively improve the pathological damage of gastric mucosal tissue in CAG rats. Its action mechanism may be related to reducing the levels of IL-17 and TNF-α in serum, regulating the IL-17/ERK/C/EBPβ signaling pathway and inhibiting the EMT process.
10.Perioperative immune dynamics and clinical outcomes in patients undergoing on-pump cardiac surgery
Zhiyuan CHENG ; Xinyi LIAO ; Juan WU ; Ping YANG ; Tingting WANG ; Qinjuan WU ; Wentong MENG ; Zongcheng TANG ; Jiayi SUN ; Jia TAN ; Jing LIN ; Dan LUO ; Hao WANG ; Chaonan LIU ; Jiyue XIONG ; Liqin LING ; Jing ZHOU ; Lei DU
Chinese Journal of Blood Transfusion 2026;39(1):31-43
Objective: To characterize perioperative dynamic changes in immune-cell phenotypes and inflammatory cytokines in patients undergoing CPB (cardiopulmonary bypass) cardiac surgery, and to explore their associations with postoperative outcomes. Methods: In this prospective cohort study, 120 adult patients who underwent elective cardiac surgery under CPB at West China Hospital from May 2022 to March 2023 were enrolled. Perioperative immune-cell phenotypes and concentrations of 40 inflammation-related cytokines were measured. The primary outcomes were the sequential organ failure assessment (SOFA) score at 24 h after surgery and ΔSOFA (the peak SOFA score within 48 h after surgery minus the preoperative SOFA score). Secondary outcomes included major adverse cardiovascular events (MACE), acute kidney injury (AKI), respiratory failure, severe liver injury, and infection. Results: The mean age of enrolled patients was 57±10 years. Of these, 52% (62/120) were male and 90% (108/120) underwent valve surgery. During the rewarming to the end of CPB, neutrophil counts rapidly increased (7.39×10
/L vs preoperative 3.07×10
/L, P<0.001), with significant upregulation of CD11b (7.30×10
/L vs preoperative 3.05×10
/L, P<0.001) and CD54 (7.15×10
/L vs preoperative 2.99×10
/L, P<0.001). Lymphocyte counts increased at the end of CPB (1.75×10
/L vs preoperative 1.12×10
/L, P<0.001) but decreased significantly at 24 h after surgery (0.59×10
/L vs preoperative 1.12×10
/L, P<0.001). Plasma analysis showed that multiple pro-inflammatory cytokines increased during CPB and remained elevated up to 24 h after surgery; five chemokines and the anti-inflammatory cytokine IL-10 peaked at the end of CPB. The SOFA score increased from 1 (1, 2) preoperatively to 7 (5, 10) at 24 h after surgery, with a ΔSOFA of 6 (4, 8). Within 30 days after surgery, 48 patients (40.0%) developed AKI, 17 (14.2%) developed infection, 4 (3.3%) developed severe liver injury, 3 (2.5%) developed respiratory failure, and 3 (2.5%) experienced MACE. During the 2-year follow-up, 8 patients (6.7%) experienced MACE and 5 (4.2%) died. Conclusion: Multi-organ dysfunction is common after cardiac surgery under CPB (median ΔSOFA, 6), accompanied by perioperative activation of multiple immune-cell subsets and upregulation of pro-inflammatory, anti-inflammatory, and chemotactic mediators. This study provides data-driven evidence and research clues for further investigation of the associations between CPB-related immune perturbations and postoperative organ dysfunction and clinical outcomes.


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