The year 2025 is a crucial one for the leapfrog development of basic research in liver transplantation in China. This article systematically reviews and summarizes the major original contributions made by Chinese scholars in the field of liver transplantation during the year. In the field of xenotransplantation, our research teams have successively completed the world's first gene-modified pig-human in situ and auxiliary liver transplantation, marking that China is leading globally in the clinical transformation of xenogeneic organs. In the aspect of donor liver source expansion and repair, the deep integration of domestic bionic oxygenation machine perfusion system with cell-loaded microgels and 3D bioprinting technology has successfully achieved the dynamic functional repair of marginal donor livers and the preliminary construction of artificial liver tissues. Regarding elderly donor livers, the mechanism of the interaction-driven network between senescent hepatic sinusoidal endothelial cells and hepatocytes was revealed for the first time, promoting the transformation from "passive treatment" to "active management of aging risks". In addition, domestic research has systematically revealed the multi-dimensional pathological mechanisms of ischemia-reperfusion injury, including acetylation regulation and cell pyroptosis, ferroptosis, etc. and innovatively proposed cutting-edge strategies such as "hibernation mechanism-driven organ protection" and "donor-specific thymus vaccine". In the aspects of liver transplantation for hepatocellular carcinoma and precise management, the deep integration of multi-omics technology and artificial intelligence has demonstrated high accuracy in postoperative complication prediction and tumor recurrence prediction, providing solid evidence-based basis for enhancing the international discourse power of "Chinese standards". Through this annual academic review, this article aims to showcase the core breakthroughs in basic research on liver transplantation in China, and contribute wisdom to promoting the transformation of clinical diagnosis and treatment paradigms and achieving international academic alignment.

Objective To compare the efficacy of controlling pediatric myopia progression between defocus incorpo-rated multiple segments(DIMS)spectacle lenses combined with low-concentration atropine(0.1 g·L-1)(DIMSA)and orthokeratology(OK)lenses.Methods A prospective cohort study was conducted on myopic children treated at the De-partment of Ophthalmology,Children's Hospital of Nanjing Medical University between January 2022 and February 2023.Participants were divided into a DIMSA group(88 cases)and an OK lens group(73 cases).Only right eye data were in-cluded for statistical analysis,and the children were followed up for 1 year.The axial length(AL)and spherical equivalent refraction(SER)were measured for the DIMSA group while only AL was measured for the OK lens group at baseline and each follow-up visit.The AL regression rate[(AL regression rate=the number of AL regression cases/total cases in the group)× 100％]and axial elongation(AE)were calculated to compare the myopia control efficacy between the two groups.Results The baseline age of the OK lens group was significantly larger than that of the DIMSA group(P=0.001).The AE value in the DIMSA group was significantly smaller than that in the OK lens group after following up for 6 months,following up for 1 year,and adjusting for baseline age(all P＜0.05).Multiple linear regression analysis revealed that baseline age was the only factor influencing the AE value[OK lens group:unstandardized β=-0.024,standardizedβ=-0.266(P=0.022);DIMSA group:unstandardized β=-0.052,standardized β=-0.487(P＜0.001)].There was a negative correlation between AE and baseline age(OK lens group:r=-0.30,P＜0.001;DIMSA group:r=-0.42,P＜0.001).In the DIMSA group,baseline age was positively correlated with SER progression(r=0.28,P=0.001 5).After following up for 1 year,the proportions of children with different AE velocities differed significantly between the two groups(x2=11.09,P=0.004).AE was controlled better in the DIMSA group than that in the OK lens group.AL regression rates in the DIMSA group were significantly higher than those in the OK lens group after 6 months and 1 year of follow-up(all P＜0.05).No severe ocular adverse events occurred in either group.Conclusion DIMSA demonstrates superior effi-cacy over OK lenses in controlling myopia progression in children with mild-to-moderate myopia.Ophthalmologists should tailor myopia control strategies based on individual needs and characteristics.

Objective:To analyze the influencing factors of extremely high cost cases under disease diagnosis related grouping (DRG) payment, for references for further improving China′s medical insurance payment system.Methods:The inpatient medical record homepage and medical insurance settlement list data of medical insurance settlement cases in a tertiary hospital in 2022 were Collected; 19 potential influencing factors such as gender, age, and hospitalization status were used as independent variables, and extremely high cost cases as dependent variables. Single factor analysis and directed acyclic graphs were used to screen for independent variables; Logistic regression model was used to analyze the influencing factors of extremely high cost cases.Results:A total of 17 028 hospitalized patients were contained, including 815 cases with extremely high costs. After analysis, the older the age, the greater the positive impact on cases with extremely high costs ( P<0.001); Third/fourth level surgery had a positive impact on these cases ( P<0.05); Emergency/critical hospitalization negative impact on extremely high cost cases ( P<0.001); Coding downgrade, surgical, intensive care unit discharge, and death positive impact cases with extremely high costs ( P<0.001); The higher the proportion of drugs, the greater the positive impact on cases with extremely high costs ( P<0.001); Compared with treatment costs accounting for ≤10%, treatment costs accounting for (10%, 30%] had a positive impact on cases with extremely high costs ( P<0.001), while treatment costs accounting for >30% had a negative impact ( P=0.007); Complications and/or comorbidities negative impact on thses cases ( P<0.001); The higher the weight of the disease group, the greater the negative impact on cases with extremely high costs ( P<0.001). Conclusions:There were many influencing factors for extremely high cost cases, among which factors such as advanced age, emergency/critical hospital admission, third/fourth level surgery, code downgrade, and high drug proportion would increase the number of extremely high cost cases, accompanied by complications and/or comorbidities, and the high weight of disease group reduce the number of extremely high cost cases. Medical institutions should strengthen internal management by standardizing admission management and optimizing the structure of hospitalization expenses; The medical insurance management department should focus on improving the DRG grouping scheme, scientifically setting the weight of disease groups, and jointly promoting the reform of China′s medical insurance payment system.

Liver transplantation has currently become an important treatment for patients with end-stage liver disease or hepatocellular carcinoma (HCC), significantly improving patients’ prognosis. However, liver transplantation still facing many challenges, such as donor sources, liver preservation technology, transplant rejection, biliary complications and postoperative tumor recurrence after HCC liver transplantation, which urgently need to be solved and optimized. With the development of new technologies, liver transplantation in our country is facing new opportunities and challenges. Domestic research teams actively respond to the needs of the times and continuously promote innovation and breakthroughs in the basic research of liver transplantation. This article reviews the cutting-edge progress in the field of basic liver transplantation research in 2024 and evaluates the important research achievements obtained by Chinese research teams in this field. The systematic sorting out of these research advances not only helps to promote the integration of Chinese characteristic liver transplantation research into the international academic system and the docking of Chinese liver transplantation research with the global forefront, but also helps researchers and clinical surgeons to fully understand the current status of basic liver transplantation research in China, provides a clear direction for future basic research, and thus promotes the vigorous development of Chinese liver transplantation cause.

Objective:To obtain a prevalent respiratory syncytial virus (RSV) clinical isolate in Beijing and analyze the genotype and biological characteristics of the strain.Methods:A nasopharyngeal secretion specimen was collected from a child with RSV infection in Beijing in 2023 and used for viral isolation. Viral nucleic acid was amplified using qRT-PCR. The isolated virus was identified by transmission electron microscopy, indirect immunofluorescence assay, and plaque formation assay. A phylogenetic analysis was conducted based on the whole-genome sequencing results. Virus titers were determined, and replication characteristics were analyzed. The efficacy of the isolated strain for in vitro screening of antiviral drugs was validated. Results:A clinical RSV isolate, named hRSV/C-Tan/BJ 202301, was successfully isolated, which could form syncytia in Hep-2 cells. Spherical, filamentous, and irregular virus particles were observed by electron microscopy. Immunofluorescence detection showed green fluorescence in Hep-2 cells, and plaque assay showed round plaques, which were similar to the Long strain in morphology. Genomic sequence analysis showed that it belonged to ON1 genotype. It exhibited similar cell growth kinetics characteristics with the Long strain and could be used for antiviral drug screening in vitro. Conclusions:In this study, one RSV strain is successfully isolated and identified. The biological characteristics and the phylogenetic relationship of this strain reflect the characteristics of the circulating strains in Beijing, which provides experimental material for RSV vaccine development and antiviral drug screening in China.

Objective To compare the efficacy of controlling pediatric myopia progression between defocus incorpo-rated multiple segments(DIMS)spectacle lenses combined with low-concentration atropine(0.1 g·L-1)(DIMSA)and orthokeratology(OK)lenses.Methods A prospective cohort study was conducted on myopic children treated at the De-partment of Ophthalmology,Children's Hospital of Nanjing Medical University between January 2022 and February 2023.Participants were divided into a DIMSA group(88 cases)and an OK lens group(73 cases).Only right eye data were in-cluded for statistical analysis,and the children were followed up for 1 year.The axial length(AL)and spherical equivalent refraction(SER)were measured for the DIMSA group while only AL was measured for the OK lens group at baseline and each follow-up visit.The AL regression rate[(AL regression rate=the number of AL regression cases/total cases in the group)× 100％]and axial elongation(AE)were calculated to compare the myopia control efficacy between the two groups.Results The baseline age of the OK lens group was significantly larger than that of the DIMSA group(P=0.001).The AE value in the DIMSA group was significantly smaller than that in the OK lens group after following up for 6 months,following up for 1 year,and adjusting for baseline age(all P＜0.05).Multiple linear regression analysis revealed that baseline age was the only factor influencing the AE value[OK lens group:unstandardized β=-0.024,standardizedβ=-0.266(P=0.022);DIMSA group:unstandardized β=-0.052,standardized β=-0.487(P＜0.001)].There was a negative correlation between AE and baseline age(OK lens group:r=-0.30,P＜0.001;DIMSA group:r=-0.42,P＜0.001).In the DIMSA group,baseline age was positively correlated with SER progression(r=0.28,P=0.001 5).After following up for 1 year,the proportions of children with different AE velocities differed significantly between the two groups(x2=11.09,P=0.004).AE was controlled better in the DIMSA group than that in the OK lens group.AL regression rates in the DIMSA group were significantly higher than those in the OK lens group after 6 months and 1 year of follow-up(all P＜0.05).No severe ocular adverse events occurred in either group.Conclusion DIMSA demonstrates superior effi-cacy over OK lenses in controlling myopia progression in children with mild-to-moderate myopia.Ophthalmologists should tailor myopia control strategies based on individual needs and characteristics.

Objective:To obtain a prevalent respiratory syncytial virus (RSV) clinical isolate in Beijing and analyze the genotype and biological characteristics of the strain.Methods:A nasopharyngeal secretion specimen was collected from a child with RSV infection in Beijing in 2023 and used for viral isolation. Viral nucleic acid was amplified using qRT-PCR. The isolated virus was identified by transmission electron microscopy, indirect immunofluorescence assay, and plaque formation assay. A phylogenetic analysis was conducted based on the whole-genome sequencing results. Virus titers were determined, and replication characteristics were analyzed. The efficacy of the isolated strain for in vitro screening of antiviral drugs was validated. Results:A clinical RSV isolate, named hRSV/C-Tan/BJ 202301, was successfully isolated, which could form syncytia in Hep-2 cells. Spherical, filamentous, and irregular virus particles were observed by electron microscopy. Immunofluorescence detection showed green fluorescence in Hep-2 cells, and plaque assay showed round plaques, which were similar to the Long strain in morphology. Genomic sequence analysis showed that it belonged to ON1 genotype. It exhibited similar cell growth kinetics characteristics with the Long strain and could be used for antiviral drug screening in vitro. Conclusions:In this study, one RSV strain is successfully isolated and identified. The biological characteristics and the phylogenetic relationship of this strain reflect the characteristics of the circulating strains in Beijing, which provides experimental material for RSV vaccine development and antiviral drug screening in China.

Objective:To analyze the influencing factors of extremely high cost cases under disease diagnosis related grouping (DRG) payment, for references for further improving China′s medical insurance payment system.Methods:The inpatient medical record homepage and medical insurance settlement list data of medical insurance settlement cases in a tertiary hospital in 2022 were Collected; 19 potential influencing factors such as gender, age, and hospitalization status were used as independent variables, and extremely high cost cases as dependent variables. Single factor analysis and directed acyclic graphs were used to screen for independent variables; Logistic regression model was used to analyze the influencing factors of extremely high cost cases.Results:A total of 17 028 hospitalized patients were contained, including 815 cases with extremely high costs. After analysis, the older the age, the greater the positive impact on cases with extremely high costs ( P<0.001); Third/fourth level surgery had a positive impact on these cases ( P<0.05); Emergency/critical hospitalization negative impact on extremely high cost cases ( P<0.001); Coding downgrade, surgical, intensive care unit discharge, and death positive impact cases with extremely high costs ( P<0.001); The higher the proportion of drugs, the greater the positive impact on cases with extremely high costs ( P<0.001); Compared with treatment costs accounting for ≤10%, treatment costs accounting for (10%, 30%] had a positive impact on cases with extremely high costs ( P<0.001), while treatment costs accounting for >30% had a negative impact ( P=0.007); Complications and/or comorbidities negative impact on thses cases ( P<0.001); The higher the weight of the disease group, the greater the negative impact on cases with extremely high costs ( P<0.001). Conclusions:There were many influencing factors for extremely high cost cases, among which factors such as advanced age, emergency/critical hospital admission, third/fourth level surgery, code downgrade, and high drug proportion would increase the number of extremely high cost cases, accompanied by complications and/or comorbidities, and the high weight of disease group reduce the number of extremely high cost cases. Medical institutions should strengthen internal management by standardizing admission management and optimizing the structure of hospitalization expenses; The medical insurance management department should focus on improving the DRG grouping scheme, scientifically setting the weight of disease groups, and jointly promoting the reform of China′s medical insurance payment system.

Objective:To investigate the effects of celastrol (CSR) on dendritic cell (DC) and T follicular helper cell (Tfh) subsets in the mouse of ulcerative colitis (UC) .Methods:Forty-eight male BALB/c mice were randomly divided into healthy control group, model group, and CSR intervention group, with 16 mice in each group. The healthy control group was fed with normal purified water, while the mice in model group and CSR intervention group were fed with 3% DSS solution to induce UC model. Since the induction, the mice in CSR intervention group were gavaged with 1mg/kg of CSR, and the mice in UC group were gavaged with equal volume of saline once a day. The weight and stool characteristics of the mice were recorded, and disease activity index (DAI) were evaluated. After the 8-day intervention, the length of the mouse colon was measured, the histopathological changes were observed, and the histopathological score was evaluated. Flow cytometry was used to detect the percentage of DC, conventional DC (CD8α + cDC1, CD103 + cDC1, cDC2), plasmacytoid DC (pDC), and Tfh subsets in colon lamina propria, mesenteric lymph nodes and spleen. Cytometric bead array kit was used to detect the expression levels of DC and Tfh related cytokines [interleukin 6 (IL-6), tumor necrosis factor α (TNF-α), interleukin 21 (IL-21) ] in colon tissue. The influence of CSR on naive CD4 +T cell proliferation and Tfh differentiation were validated in vitro experiments. Results:The modelling success rate was 100% and all mice survived. Compared with model group, mice in CSR intervention group had heavier weight, lower DAI, and ameliorated colonic length shortening, with all differences being statistically significant (all P < 0.05). The intestinal mucosal structure of mice in model group was disordered, with a large number of inflammatory cell infiltration; the intestinal mucosal barrier of mice in CSR intervention group approached normal structure, with fewer inflammatory cells, and the histopathological scores were significantly decreased ( P<0.05). In the colon lamina propria, compared with model group, the percentages of DC, CD8α + cDC1 and Tfh decreased, while the percentage of CD103 + cDC1 increased in CSR intervention group, and these differences were all statistically significant (all P<0.05). In mesenteric lymph nodes, the percentage of CD8α + cDC1 decreased, while the percentages of DC, CD103 + cDC1, cDC2 and Tfh increased in CSR intervention group compared with model group, and these differences were all statistically significance (all P<0.05). In the spleen, compared with model group, the percentage of pDC was significantly reduced in CSR intervention group ( P<0.05) .The expression levels of IL-6, TNF-α and IL-21 in colon tissues of CSR intervention group were lower, while IL-10 was higher than those of model group, and these differences were statistically significant (all P<0.05). In vitro experiments, CSR could inhibit naive CD4 + T cell proliferation and Tfh differentiation, with statistically significant differences (all P < 0.05) . Conclusion:CSR can alleviate intestinal damage in UC mice, potentially by modulating the local immune microenvironment through regulating DC and Tfh subsets.

Oral submucous fibrosis(OSF)is a chronic and inflammatory mucosal disease caused by betel quid chewing,which belongs to oral potentially malignant disorders.Abnormal fibroblast differentiation leading to disordered collagen metabolism is the core process underlying OSF development.The epithelium,which is the first line of defense against the external environment,can convert external signals into pathological signals and participate in the remodeling of the fibrotic microenvironment.However,the specific mechanisms by which the epithelium drives fibroblast differentiation remain unclear.In this study,we found that Arecoline-exposed epithelium communicated with the fibrotic microenvironment by secreting exosomes.MiR-17-5p was encapsulated in epithelial cell-derived exosomes and absorbed by fibroblasts,where it promoted cell secretion,contraction,migration and fibrogenic marker(α-SMA and collagen type I)expression.The underlying molecular mechanism involved miR-17-5p targeting Smad7 and suppressing the degradation of TGF-β receptor 1(TGFBR1)through the E3 ubiquitination ligase WWP1,thus facilitating downstream TGF-β pathway signaling.Treatment of fibroblasts with an inhibitor of miR-17-5p reversed the contraction and migration phenotypes induced by epithelial-derived exosomes.Exosomal miR-17-5p was confirmed to function as a key regulator of the phenotypic transformation of fibroblasts.In conclusion,we demonstrated that Arecoline triggers aberrant epithelium-fibroblast crosstalk and identified that epithelial cell-derived miR-17-5p mediates fibroblast differentiation through the classical TGF-β fibrotic pathway,which provided a new perspective and strategy for the diagnosis and treatment of OSF.