As a critical measure for treating patients with end-stage organ failure, organ donation and transplantation has become an important benchmark reflecting a country’s comprehensive capacity in healthcare, modernization of governance and progress in social civilization. In 2024, the total number of organ transplant procedures worldwide exceeded 180 000, representing an annual growth rate of 2.4%. China ranked second globally with 24 000 transplant procedures, accounting for 13.8% of the global total. Meanwhile, driven by the growing burden of transplantation-related non-communicable diseases, the global demand for organ transplantation has reached an all-time high. At present, the global development of organ donation and transplantation features a landscape of coexisting strategic opportunities and risks and challenges. On the one hand, technological breakthroughs and institutional innovations have accelerated the rapid development of the field. On the other hand, issues such as uneven regional development, supply-demand imbalance, and lagging governance remain to be addressed. This study integrates multi-dimensional authoritative monitoring data, systematically summarizes twelve key characteristics of the global organ donation and transplantation sector, distills ten major developmental features and regional leading effects of China at the current stage, and elaborates on the practical connotation and contemporary value of the “Chinese Model”. The findings not only provide important references for countries to promote the sustainable development of the industry, narrow regional development gaps, and improve the equitable access to medical resources, but also offer comprehensive research support and scientific decision-making basis for China to consolidate its developmental advantages, refine Chinese solutions, and deeply participate in the construction of the global organ donation and transplantation governance system.

Currently, driven by rigid health demands, technological iteration and innovation, and the reshaping of the global development landscape, the global field of organ donation and transplantation presents a development trend featuring "continuous expansion of transplantation scale, diversified donor sources, multiple breakthroughs in core technologies, and sustained optimization of supporting policies". Meanwhile, it still faces profound challenges including prominent contradiction between supply and demand, unbalanced regional development, increasing governance difficulties, and lack of dynamic adaptation of ethical norms. Under the continuous initiative and promotion of the United Nations, the World Health Organization and relevant international academic groups, organ donation and transplantation have become an important issue for promoting the harmonious development of human society and improving global public health governance. At the present stage, the reshaping of the global development pattern and the impact of uncertainties in the international situation cannot be ignored, which not only brings challenges to transnational cooperation in the field of organ donation and transplantation, but also forces all countries to accelerate the construction of an independent, controllable, safe and efficient working system. Based on the development characteristics revealed by data insights, this paper further sorts out the innovative practical progress, policy evolution context and latest orientations of countries around the world in solving the development dilemmas of organ donation and transplantation in recent years, analyzes the core challenges and prospectively judges future policy trends. It not only provides experience reference for countries to carry out industrial governance, but also consolidates the decision-making foundation for China to build an independent knowledge system and a discourse system with Chinese characteristics, and deeply participate in the construction of the global governance system.

Objective Network pharmacology and molecular docking techniques were used to predict the potential mechanisms by which the active components of Piper nigrum(PN)regulate depressive-like behaviors in chronic restraint stress(CRS)mice.Methods The major chemical components and targets of PN were screened using the Traditional Chinese Medicine Systems Pharmacology database.Targets related to ferroptosis and depression were obtained from the Online Mendelian Inheritance in Man,GeneCards,and FerrDB databases.The intersecting targets were then subjected to Gene Ontology and Kyoto Encyclopedia of Genes and Gnomes(KEGG)pathway enrichment analyses,and molecular docking was performed to validate the binding capacities between the core targets and their corresponding active components.Finally,we established a CRS mouse model.Mice were treated with PN 75,150,and 300 mg/kg for 4 weeks,followed by behavioral assessments and reverse transcription-quantitative polymerase chain reaction(RT-qPCR)to verify the expression of core genes.Results Nine active components were screened from PN,corresponding to 27 targets,and 8377 targets related to depression and 547 targets associated with ferroptosis were screened from the databases.The intersection of these three sets resulted in 25 target genes.KEGG enrichment analysis revealed that these core targets were predominantly enriched in signaling pathways,including cholinergic synapses,serotonergic synapses,and neuroactive ligand-receptor interactions.Molecular docking result showed that the main active components of PN had strong binding affinities for the targets CHRM2,SLC6A4,PTGS2,and SLC6A2.Behavioral assessments demonstrated that PN significantly increased the sucrose preference index(P＜0.01,P＜0.001),reduced immobility time in the tail suspension and forced swimming tests(P＜0.01,P＜0.001),and enhanced exploratory behavior in the open field test(P＜0.05.P＜0.01,P＜0.001).PN significantly reduced the serum levels of inflammation markers(P＜0.05.P＜0.01,P＜0.001),as shown by enzyme-linked immunosorbent assay,and neurotransmitter analysis revealed that PN significantly increased the levels of serotonin and acetylcholine in the mouse hippocampus(P＜0.05).RT-qPCR showed that PN demonstrated the mRNA expression of SLC6A4(P＜0.05.P＜0.01,P＜0.001).Conclusions PN may improve depressive-like behavior in mice by modulating serotonin and acetylcholine levels,inhibiting inflammatory responses,participating in immune regulation,and exerting neuroprotective effects.

Objective Network pharmacology and molecular docking techniques were used to predict the potential mechanisms by which the active components of Piper nigrum(PN)regulate depressive-like behaviors in chronic restraint stress(CRS)mice.Methods The major chemical components and targets of PN were screened using the Traditional Chinese Medicine Systems Pharmacology database.Targets related to ferroptosis and depression were obtained from the Online Mendelian Inheritance in Man,GeneCards,and FerrDB databases.The intersecting targets were then subjected to Gene Ontology and Kyoto Encyclopedia of Genes and Gnomes(KEGG)pathway enrichment analyses,and molecular docking was performed to validate the binding capacities between the core targets and their corresponding active components.Finally,we established a CRS mouse model.Mice were treated with PN 75,150,and 300 mg/kg for 4 weeks,followed by behavioral assessments and reverse transcription-quantitative polymerase chain reaction(RT-qPCR)to verify the expression of core genes.Results Nine active components were screened from PN,corresponding to 27 targets,and 8377 targets related to depression and 547 targets associated with ferroptosis were screened from the databases.The intersection of these three sets resulted in 25 target genes.KEGG enrichment analysis revealed that these core targets were predominantly enriched in signaling pathways,including cholinergic synapses,serotonergic synapses,and neuroactive ligand-receptor interactions.Molecular docking result showed that the main active components of PN had strong binding affinities for the targets CHRM2,SLC6A4,PTGS2,and SLC6A2.Behavioral assessments demonstrated that PN significantly increased the sucrose preference index(P＜0.01,P＜0.001),reduced immobility time in the tail suspension and forced swimming tests(P＜0.01,P＜0.001),and enhanced exploratory behavior in the open field test(P＜0.05.P＜0.01,P＜0.001).PN significantly reduced the serum levels of inflammation markers(P＜0.05.P＜0.01,P＜0.001),as shown by enzyme-linked immunosorbent assay,and neurotransmitter analysis revealed that PN significantly increased the levels of serotonin and acetylcholine in the mouse hippocampus(P＜0.05).RT-qPCR showed that PN demonstrated the mRNA expression of SLC6A4(P＜0.05.P＜0.01,P＜0.001).Conclusions PN may improve depressive-like behavior in mice by modulating serotonin and acetylcholine levels,inhibiting inflammatory responses,participating in immune regulation,and exerting neuroprotective effects.

Public trust is the foundation for supporting the sustainable development of various social donation systems. However, the construction of trust system is continuous, long-term, and easily lost and difficult to defend. This study explored the multi-object and multi-dimensional trust demands of the public, donors and their families in interpersonal, system, social and supervision aspects. It was proposed that participating institutions and practitioners should take the multidimensional claims as an action-oriented, break the crisis of trust by building two major support systems centered on the public and donors’ families, and jointly safeguard the sustainable and high-quality development of organ donation.