1.Research progress and clinical challenges in immunosuppressive regimens for xenotransplantation
Yu ZHANG ; Kun WANG ; Xuyuan ZHU ; Yuxiang CHEN ; Tao LI ; Xiaojie MA ; Hongtao JIANG
Organ Transplantation 2026;17(1):28-35
As a pivotal strategy to alleviate the shortage of organ donors, xenotransplantation has achieved remarkable advances in both pre-clinical and clinical studies in recent years, driven by continuous optimization of gene modification techniques and immunosuppressive regimens. Nevertheless, clinical translation still confronts formidable challenges, including rejection and heightened infection risks, which severely compromise long-term graft survival. Consequently, the role of immunosuppressive regimens in xenotransplantation has become increasingly prominent. This article summarizes the mechanisms underlying xenogeneic immune rejection, the latest developments in immunosuppressive regimens, cutting-edge strategies for inducing immune tolerance and the major hurdles facing clinical xenotransplantation. It delves into potential optimization strategies and directions for future clinical research, aiming to offer theoretical insights and practical guidance for the safe and effective application of clinical xenotransplantation.
2.Clinical features of muscle changes and related risk factors in patients with porto-sinusoidal vascular disorder
Ruijia LI ; Yuxiang GONG ; Yu ZHANG ; Shasha LI ; Yongfeng YANG
Journal of Clinical Hepatology 2026;42(3):639-646
ObjectiveTo investigate the prevalence of muscle changes (including sarcopenia and myosteatosis) and related influencing factors in patients with porto-sinusoidal vascular disorder (PSVD), and to provide a theoretical basis for the early identification, prevention, and intervention of muscle changes in PSVD patients. MethodsA total of 132 PSVD patients who were diagnosed in Nanjing Second Hospital from July 2017 to July 2024 were enrolled as case group, and the hospital staff who underwent physical examination in 2025 were enrolled as healthy control group. Propensity score matching was performed based on age and sex at a ratio of 1∶1. According to muscle status assessed by abdominal CT, the subjects were divided into non-muscle change group, mild muscle change group (myosteatosis alone), and severe muscle change group (sarcopenia alone or sarcopenia comorbid with myosteatosis), with the type and severity of muscle change as the exposure factors. General information, laboratory tests, L3-level CT images, and liver biopsy data were collected for the patients in the case group, and general information and CT images were collected for the individuals in the healthy control group. Sarcopenia was diagnosed by measuring skeletal muscle index at the L3 level (<44.77 cm2/m2 for men and <32.50 cm2/m2 for women), and myosteatosis was defined by mean muscle attenuation combined with BMI (BMI <24.9 kg/m2 with attenuation <41 HU or BMI ≥25 kg/m2 with attenuation <33 HU). Demographic, laboratory, and clinical parameters were compared between the case group and the healthy control group. The independent-samples t test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups. The univariate and multivariate Logistic regression analyses were used to identify the factors associated with sarcopenia in PSVD. ResultsAmong the 132 patients with PSVD, there were 83 patients with portal hypertension (PH) and 49 patients without PH, and there were significant differences between these two groups in age, albumin, albumin/globulin ratio, leukocyte count, neutrophil count, red blood cell count, platelet count, direct bilirubin, indirect bilirubin, hemoglobin, blood calcium, cholinesterase, total bile acid, triglyceride, total cholesterol, prothrombin time, international normalized ratio, activated partial thromboplastin time, decompensation, gastroesophageal or ectopic varices, bleeding and ascites (all P<0.05). The analyses after matching showed that compared with the healthy control group, the case group had significantly higher prevalence rates of abnormal muscle structure (43.18% vs 18.94%, P<0.001), mild muscle changes (22.73% vs 7.58%, P<0.001), and severe muscle changes (20.45% vs 11.36%, P<0.001). Further comparison showed that there was no significant difference in the proportion of patients with muscle changes between the PSVD patients with PH and those without PH (42.17% vs 44.90%, P=0.760). The binary Logistic regression analysis with the presence or absence of muscle changes as the dependent variable showed that age (odds ratio [OR]=1.05, 95% confidence interval [CI]: 1.02 — 1.09, P<0.05), subcutaneous fat index (OR=1.03, 95%CI: 1.01 — 1.06, P<0.05), hemoglobin (OR=0.97, 95%CI: 0.95 — 0.99, P<0.05), and thrombin time (OR=1.26, 95%CI: 1.06 — 1.49, P<0.05) were independent influencing factors for muscle changes in PSVD patients. The multivariate ordinal Logistic regression analysis with the severity of muscle changes as the dependent variable showed that age (OR=1.04, 95%CI: 1.01 — 1.07, P<0.05) and thrombin time (OR=1.17, 95%CI: 1.01 — 1.36, P<0.05) were independent risk factors for the grading of muscle changes. ConclusionMuscle changes are common in PSVD patients, and these changes may be caused by PSVD itself rather than PH. Age, fat distribution, thrombin time, and hemoglobin are important influencing factors for muscle changes.
3.Association between bedroom nocturnal light exposure and objective sleep parameters in college students
ZHANG Anhui, YU Min, XU Yuxiang, SUN Ying
Chinese Journal of School Health 2025;46(8):1098-1101
Objective:
To investigate the cross sectional association between bedroom nocturnal light exposure and objectively measured sleep parameters in college students, so as to provide evidence for promoting sleep health.
Methods:
From September to October 2019, a convenience sampling method was used to recruit 365 healthy college students from two universities in Hefei, establishing a cohort. Bedroom nocturnal light exposure was measured at the individual level for two consecutive days using a portable illuminometer (TES-1339R; Taishi Corp, Taiwan, China). Sleep parameters were objectively measured over seven consecutive days using wrist worn accelerometers (ActiGraph GT3X-BT, Pensacola, FL). Multiple linear regression models were employed to examine the association between nocturnal light exposure and sleep parameters.
Results:
Compared to the low nocturnal light exposure (<3 lx) group, the high exposure (≥3 lx) group exhibited significantly lower sleep efficiency[(93.5± 2.7 )%,(92.2±2.9)%, t =3.93], longer wake after sleep onset (WASO)[(24.7±90.3)(29.2±11.2)min, t =-3.66], higher movement index(11.0±3.6, 12.2± 3.8, t =-2.80), and higher sleep fragmentation index(20.5±6.5,23.0±7.0, t =-3.24) (all P <0.01). After adjusting for covariates,multiple linear regression showed that,compared to the low nocturnal light exposure group, the high exposure group had reduced sleep efficiency ( β =-1.15, 95% CI =-1.78 to -0.52), increased WASO [ β (95% CI )=3.94(1.55- 6.33 )], higher movement index[ β (95% CI )=1.05(0.20-1.89)], and elevated sleep fragmentation index[ β (95% CI )=2.35(0.81-3.88)](all P <0.05).
Conclusions
Light exposure at night negatively impacts college students sleep. Optimizing bedroom lighting management may improve sleep quality in adolescents.
4.Research progress on the role of extracellular histones in xenotransplantation
Kun WANG ; Yu ZHANG ; Yuxiang CHEN ; Xiaojie MA ; Tao LI ; Hongtao JIANG
Organ Transplantation 2025;16(6):962-969
Organ transplantation faces the challenge of a shortage of donors. Although xenotransplantation holds great potential, it is limited by rejection. Extracellular histones, as key members of damage-associated molecular patterns, have been proven in recent years to play a crucial role in transplant rejection by activating innate immunity, regulating the coagulation-inflammation network, and modulating adaptive immune responses. However, the specific functions and key mechanisms remain to be clarified. Therefore, this article reviews the structural characteristics of histones, their release pathways, the biological functions of extracellular histones, and their potential roles in xenotransplantation. It summarizes the latest research progress of extracellular histones in xenotransplantation, analyzes the shortcomings of existing research and the direction for future research, with the expectation of providing references for the application of extracellular histones in xenogeneic kidney transplantation.
5.Salvianolate injection ameliorates cardiomyopathy by regulating autophagic flux through miR-30a/becn1 axis in zebrafish.
Jianxuan LI ; Yang ZHANG ; Zhi ZUO ; Zhenzhong ZHANG ; Ying WANG ; Shufu CHANG ; Jia HUANG ; Yuxiang DAI ; Junbo GE
Chinese Medical Journal 2025;138(20):2604-2614
BACKGROUND:
Salvianolate is a compound mainly composed of salvia magnesium acetate, which is extracted from the Chinese herb Salvia miltiorrhiza . In recent years, salvianolate injection has been widely used in the treatment of cardiovascular diseases, but the mechanism of how it can alleviate cardiotoxicity remains unclear.
METHODS:
The cardiac injury model was constructed by treatment with doxorubicin (Dox) or azithromycin (Azi) in zebrafish larvae. Heart phenotype, heart rate, and cardiomyocyte apoptosis were observed in the study. RNA-sequencing (RNA-seq) analysis was used to explore the underlying mechanism of salvianolate treatment. Moreover, cardiomyocyte autophagy was assessed by in situ imaging. In addition, the miR-30a/becn1 axis regulation by salvianolate was further investigated.
RESULTS:
Salvianolate treatment reduced the proportion of pericardial edema, recovered heart rate, and inhibited cardiomyocyte apoptosis in Dox/Azi-administered zebrafish larvae. Mechanistically, salvianolate regulated the lysosomal pathway and promoted autophagic flux in zebrafish cardiomyocytes. The expression level of becn1 was increased in Dox-induced myocardial tissue injury after salvianolate administration; overexpression of becn1 in cardiomyocytes alleviated the Dox/Azi-induced cardiac injury and promoted autophagic flux in cardiomyocytes, while becn1 knockdown blocked the effects of salvianolate. In addition, miR-30a, negatively regulated by salvianolate, partially inhibited the cardiac amelioration of salvianolate by targeting becn1 directly.
CONCLUSION
This study has proved that salvianolate reduces cardiomyopathy by regulating autophagic flux through the miR-30a/becn1 axis in zebrafish and is a potential drug for adjunctive Dox/Azi therapy.
Animals
;
Zebrafish
;
MicroRNAs/genetics*
;
Autophagy/drug effects*
;
Myocytes, Cardiac/metabolism*
;
Cardiomyopathies/metabolism*
;
Beclin-1/genetics*
;
Apoptosis/drug effects*
;
Plant Extracts/therapeutic use*
;
Doxorubicin
6.The epigenetic landscape of rheumatoid arthritis: Pathogenesis and drug therapeutic potentials.
Chengcheng HUANG ; Yuxiang LIANG ; Yang LI ; Quan WEI ; Liang OUYANG ; Jifa ZHANG
Acta Pharmaceutica Sinica B 2025;15(11):5601-5631
Rheumatoid arthritis (RA) represents a persistent autoimmune condition distinguished by a multifaceted etiology that encompasses both genetic and environmental factors. Recent progress in understanding the mechanisms behind RA pathogenesis has delved into the critical role of epigenetic regulatory processes, including DNA methylation, histone modifications, and the regulation by microRNAs (miRNAs). These findings provide new insights into the intricate nature of RA and pave the way for innovative therapeutic strategies. This review consolidates the latest developments in the epigenetic regulation of RA, concentrating on how these mechanisms affect the dysregulated signaling pathways associated with the disease. We analyze the roles of specific proteins that function as 'writers', 'erasers', and 'readers' in epigenetic modifications, highlighting their potential as targets for therapeutic intervention. Additionally, in view of the significance of miRNAs in the pathogenesis of RA, we deliberate on their involvement in disease progression and explore miRNA-based treatment strategies. By integrating these diverse epigenetic dimensions, this review offers a comprehensive epigenetic perspective on RA pathogenesis and identifies promising avenues for future research and therapeutic interventions.
7.Impact of childhood trauma on internet addiction in medical students: the mediating role of perceived stress
Xiaohong PENG ; Xiaoyuan LIAO ; Dantong WU ; Yanyin ZHOU ; Yelu LIU ; Yuxiang WANG ; Luoya ZHANG ; Juan DENG ; Yanjie PENG ; Kezhi LIU ; Jing CHEN ; Wei LEI
Sichuan Mental Health 2025;38(3):267-272
BackgroundWith the rapid development of the networking technologies, internet addiction has increasingly become a serious mental health issue. Previous studies have revealed the link between childhood trauma and internet addiction, while the mediating role of perceived stress in this link is not yet clear. ObjectiveTo investigate the role of medical students' perceived stress in the relationship between childhood trauma and internet addiction, so as to provide references for the intervention of internet addiction. MethodsFrom February to March 2023, a random sampling technique was used to select 1 232 undergraduate students from the School of Clinical Medical Sciences of Southwest Medical University as research subjects. The Childhood Trauma Questionnaire-Short Form (CTQ-SF), Perceived Stress Scale (PSS), Internet Gaming Disorder Scale (IGDS), and Bergen Social Media Addiction Scale (BSMAS) were used for assessment. Pearson's correlation coefficients were calculated. The mediation effect of perceived stress in the relationship between childhood trauma and internet addiction was tested using Model 4 in the SPSS Process 4.1, and Bootstrapping procedure involving 5 000 replicates was employed to confirm the statistical significance. ResultsA total of 1 016 (82.47%) valid completed questionnaires were gathered. The CTQ-SF scores of medical students were positively correlated with PSS scores, IGD scores, and BSMAS scores (r=0.583, 0.474, 0.465, P<0.01). PSS scores were positively correlated with IGD scores and BSMAS scores (r=0.369, 0.479, P<0.01). Childhood trauma in medical students was found to positively predict perceived stress (β=0.191, P<0.01), social media addiction (β=0.160, P<0.01), and internet gaming disorder (β=0.106, P<0.01). Perceived stress played a significant mediating role in the relationship between childhood trauma and internet gaming disorder, indirect effect value was 0.018 (95% CI: 0.009~0.027), accounting for 16.98%. Perceived stress also exhibited a significant mediating role in the relationship between childhood trauma and social media addiction, indirect effect value was 0.063 (95% CI: 0.048~0.079), accounting for 39.38%. ConclusionChildhood trauma in medical students may affect internet gaming disorder and social media addiction through perceived stress. [Funded by 2022 Annual Research Project of Sichuan Applied Psychology Research Center,(number,CSXL-22102)]
8.Macrophages in xenotransplantation
Xuyuan ZHU ; Yu ZHANG ; Yuxiang CHEN ; Tao LI ; Xiaojie MA ; Hongtao JIANG
Organ Transplantation 2025;16(4):495-501
Xenotransplantation is one of the effective ways to overcome the shortage of donor organs. However, the molecular incompatibility between xenotransplantation donors and recipients can cause rejection, which greatly limits the clinical application of xenotransplantation. In recent years, researchers have deeply explored the mechanism of xenotransplantation rejection through xenotransplantation models of pig-to-monkey and pig-to-brain death recipients, and found that the innate immune system plays an important role in rejection. Macrophages, as phagocytes in the innate immune system, not only damage xenografts through phagocytosis but also interact with other immune cells to influence the immune microenvironment of xenotransplantation. However, due to the heterogeneity of macrophages, their phenotypes and functions in xenotransplantation rejection remain unclear. Therefore, it is necessary to further explore the role of macrophages in xenotransplantation rejection. This article reviews the latest research progress of macrophages in xenotransplantation rejection, aiming to explore the mechanisms of macrophages in xenotransplantation rejection and provide references for future research.
9.Decision-making behavior in patients with depressive disorder and its relationship with depressive and anxiety symptoms
Yuxiang WANG ; Luoya ZHANG ; Maomao ZHANG ; Juan DENG ; Yanjie PENG ; Xiaotong CHENG ; Kezhi LIU ; Wei LEI ; Jing CHEN
Sichuan Mental Health 2025;38(1):22-27
BackgroundPatients with depressive disorder often exhibit impaired decision-making functions. However, the relationship between decision-making abilities and depressive and anxiety symptoms in these patients remains unclear. ObjectiveTo explore the characteristics of decision-making behavior in patients with depressive disorder, and to analyze its relationship with clinical symptoms. MethodsA total of 48 patients diagnosed with depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) were recruited from the Department of Psychosomatic Medicine of the Affiliated Hospital of Southwest Medical University from October 2020 to May 2023. Concurrently, 52 healthy individuals matched for age and gender were recruited from Luzhou as the control group. Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were used for assessment, and decision-making behavior was evaluated using Probabilistic Reversal Learning (PRL) task. Indicators assessed included the number of trials to criterion, perseverative errors, win-stay rate and lose-shift rate. Spearman correlation analysis was used to assess the correlation between BDI and BAI scores and PRL task indicators. ResultsThe depression group showed a significantly higher lose-shift rate compared with the control group (t=3.684, P<0.01). There were no statistically significant differences between two groups in trials to criterion, perseverative errors and win-stay rate (t=0.329, 0.132, 0.609, P>0.05). In depression group, BDI and BAI scores were positively correlated with the win-stay rate(r=0.450, 0.398, P<0.01). ConclusionPatients with depressive disorder are more likely to change their decision-making strategies following negative outcomes. Furthermore, the severity of depressive and anxiety symptoms is associated with a greater propensity to maintain existing decisions after receiving positive feedback. [Funded by 2019 Joint Project of Luzhou Science and Technology Bureau-Southwest Medical University (number, 2019LZXNYDJ39]
10.Advances in the diagnosis and treatment of hepatocellular carcinoma with bile duct tumor thrombus
Yuxiang GUO ; Maosen WANG ; Zhongyuan LIU ; Xudong ZHANG ; Pengfei MA ; Xiangkun WANG ; Renfeng LI
Journal of Clinical Hepatology 2025;41(2):359-364
Hepatocellular carcinoma (HCC) with biliary duct tumor thrombus (BDTT) is currently not common in clinical practice and is easily misdiagnosed, and previously, it was often considered an advanced stage of the disease with a poor prognosis, making its treatment challenging. However, in-depth studies in recent years have gradually deepened our understanding of this disease, leading to significant changes in diagnostic and treatment concepts. Currently, comprehensive treatment, mainly surgery, is used for treatment, but there is still controversy over the selection of clinical treatment strategies. This article provides a detailed discussion on surgical methods and prognosis, in order to provide a reference for clinical treatment options.


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