1.Collection, storage and utilization of lung transplant tissue samples
Yixing LI ; Xue SHI ; Hongyi WANG ; Runyi TAO ; Ye SUN ; Ailing SU ; Liyan TONG ; Jinteng FENG ; Yanpeng ZHANG ; Shuo LI ; Yawen WANG ; Guangjian ZHANG
Organ Transplantation 2025;16(1):147-155
After continuous development and improvement, lung transplantation has become the preferred means to treat a variety of benign end-stage lung diseases. However, the field of lung transplantation still faces many challenges, including shortage of donor resources, preservation and maintenance of donor lungs, and postoperative complications. Lung tissue samples removed after lung transplantation are excellent clinical resources for the study of benign end-stage lung disease and perioperative complications of lung transplantation. However, at present, the collection, storage and utilization of tissue samples after lung transplantation are limited to a single study, and unified technical specifications have not been formed. Based on the construction plan of the biobank for lung transplantation in the First Affiliated Hospital of Xi'an Jiaotong University, this study reviewed the practical experience in the collection, storage and utilization of lung transplant tissue samples in the aspects of ethical review, staffing, collection process, storage method, quality control and efficient utilization, in order to provide references for lung transplant related research.
2.Research progress in the application of supercooling preservation technology in graft preservation
Heng ZHAO ; Jinteng FENG ; Bangrui YU ; Yixing LI ; Haotian BAI ; Haishui HUANG ; Guangjian ZHANG
Organ Transplantation 2025;16(3):394-403
Supercooling preservation technology, as a groundbreaking innovation in the field of organ preservation, significantly reduces the metabolic rate of cells and inhibits ice crystal formation by placing organs in a low-temperature environment near or below the freezing point. This technology extends the preservation time of organs and maintains their biological activity. Compared with the traditional low-temperature preservation at 4 °C, supercooling preservation effectively avoids cell damage and the accumulation of metabolic products, demonstrating significant advantages in the preservation of cells, tissues and organs. In recent years, important progress has been made in the optimization of cryoprotectants, the application of antifreeze proteins, the improvement of vitrification technology, and the development of nanotechnology-based rewarming techniques. These advancements provide new pathways to address the challenges of toxicity, ice crystal formation and uneven rewarming rates during supercooling preservation. This review summarizes the basic principles of supercooling preservation, the application of key technologies, and their practical effects in organ transplantation. It also analyzes the challenges of toxicity and rewarming efficiency, aiming to provide theoretical support and research directions for the future optimization of organ low-temperature preservation technology and its clinical application.
3.Discussion on right lung volume reduction techniques in lung transplantation surgery
Hongyi WANG ; Yixing LI ; Jinteng FENG ; Heng ZHAO ; Yanpeng ZHANG ; Shan GAO ; Jizhao WANG ; Shuo LI ; Guangjian ZHANG
Organ Transplantation 2025;16(6):907-913
Objective To investigate the clinical effects of different right lung volume reduction techniques when the donor lung is oversized and mismatched with the recipient. Methods Clinical data of 10 recipients who underwent right lung volume reduction lung transplantation at the First Affiliated Hospital of Xi'an Jiaotong University from October 2022 to June 2024 were collected, including gender, age, primary disease type, and type of transplantation. A retrospective analysis was performed on postoperative complications within 90 days, duration of mechanical ventilation, hospital stay, and survival status to explore the impact of different volume reduction techniques on the survival rate of lung transplant recipients. Results A total of 10 right lung volume reduction recipients were included in this study, with 2 cases of upper lobe reduction, 7 cases of middle lobe reduction, and 1 case of lower lobe reduction. Three recipients developed airway complications (one each with upper, middle, and lower lobe reduction). The 30-day survival rate was 90% and the 1-year survival rate was 70%. One recipient with upper lobe reduction died of septic shock during the perioperative period, one with lower lobe reduction died of airway anastomotic fistula 2 months after surgery, and one with middle lobe reduction died of renal insufficiency 1 year after surgery. All 7 recipients with middle lobe reduction successfully passed the perioperative period, with one case of airway anastomotic stenosis (1/7). The average duration of mechanical ventilation was 71 hours, and the average hospital stay was 26 days. The 30-day survival rate was 7/7, and the 1-year survival rate was 6/7. Conclusions Middle lobe reduction in right lung transplantation surgery has the advantages of low incidence of airway complications, good safety, and minimal loss of lung function, and may be a better right lung volume reduction option with potential for application.
4.Influence of serum cumulative triglyceride exposure on the risk of acute pancreatitis
Afang SU ; Xiaozhong JIANG ; Yunshui ZHANG ; Shouling WU ; Guangjian LI
Journal of Clinical Hepatology 2024;40(12):2492-2498
ObjectiveTo investigate the association between cumulative triglyceride (cumTG) exposure and the risk of acute pancreatitis (AP). MethodsA prospective study was conducted for a cohort of 56 883 workers from Kailuan Group who participated in annual physical examination for three consecutive times in 2006-2010 (2006, 2008, and 2010) and had complete TG data without the medical history of AP. According to the quartiles of cumTG calculated, the subjects were divided into four groups (Q1, Q2, Q3, and Q4 groups), and general information was compared between the two groups. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the Kruskal-Wallis H test was used for comparison of continuous data with skewed distribution between multiple groups; the chi-square test was used for comparison of categorical data between groups. The Kaplan-Meier method was used to plot the survival curve and calculate the cumulative incidence rate of AP, and the Log-rank test was used for comparison between groups; the Cox regression model was used to analyze the effect of different cumTG levels on new-onset AP events. ResultsAfter follow-up for 10.51±1.76 years, there were 158 AP events in total, with a total incidence density of 2.64 per 10 000 person-years, and the number of cases and incidence density in the Q1, Q2, Q3, and Q4 groups were 29 cases (1.93 per 10 000 person-years), 34 cases (2.27 per 10 000 person-years), 30 cases (2.01 per 10 000 person-years), and 65 cases (4.37 per 10 000 person-years). The Log-rank test showed that there was a significant difference in cumulative incidence rate between groups (χ2=22.41, P<0.001). The multivariate Cox regression analysis showed that compared with the Q1 group, the Q4 group had a significantly higher risk of AP (hazard ratio [HR]=1.94, 95% confidence interval [CI]: 1.20 — 3.13, P=0.01). Compared with cumulative triglyceride exposure for 0 year, cumulative triglyceride exposure for 4 and 6 years significantly increased the risk of AP, with an HR value of 2.04 (95%CI: 1.26 — 3.30, P<0.01) and 3.20 (95%CI: 1.98 — 5.17, P<0.01), respectively. After exclusion of the AP cases that occurred during the 2-year follow-up, the repeated multivariate Cox regression analysis showed that the Q4 group had an HR value of 1.96 (95%CI: 1.23 — 3.12, P<0.01) for the onset of AP, and after exclusion of the death cases during follow-up, the repeated multivariate Cox regression analysis showed that the Q4 group had an HR value of 1.85 (95%CI: 1.10 — 3.14, P<0.05) for the onset of AP. ConclusionThe incidence rate and risk of AP tend to increase with the increase in cumTG exposure.
5.A study on the association between exposure of uric acid accumulation and risks of acute pancreatitis
A'fang SU ; Guangjian LI ; Yunshui ZHANG ; Xiujuan ZHAO ; Shouling WU ; Xiaozhong JIANG
The Journal of Practical Medicine 2024;40(14):2009-2014
Objective To investigate the correlation between exposure of uric acid accumulation and the risks of acute pancreatitis(AP)in the population in Kailuan Group.Methods A prospective study was performed based on thesubjects receiving annual physical examination during 2006 to 2010 in Kailuan Group.All of them had no AP history but had complete data on UA.The starting point of follow-up was when the subjects completed the health examination in 2010,and the end point was new AP events,deaths or the end of follow-up(2021-12-31).Exposure of uric acid accumulation(cumUA)was calculated according to the average values of uric acid measured in each two consecutive physical examinations and the intervalbetween these two consecutive physical examinations.The cumulative incidences of AP indifferent subgroups(determined by the quartile of cumUA)were described using Kaplan-Meier product limit-method and compared by log-rank test.Multivariate Cox proportional hazards regression model was used to analyze the impacts of different cumUA subgroups on new occurrence of AP events.Results A total of 55,799 subjects were included in this study.The subjects were divided into four groups according to the quartile of cumUA.Sex ratio,average age,BMI,systolic blood pressure(SBP),diastolic blood pressure(DBP),FPG,TC,TG,LDL-C,HDL-C,smoking,alcohol consumption,education≥9 years,physical exercise,history of hypertension,and history of cholelithiasis differed significantly among the groups(P<0.05),there was no difference in diabetes history among the 4 groups(P=0.30).153 patients developed AP during an average follow-up of(10.52±1.75)years,the incidence rates were 1.65,2.76,2.13 and 3.96 per 10 000 person-year in the Q1,Q2,Q3and Q4,respectively(P<0.01).After adjusting sex,age,TC,TG,eGFR,smoking,alcohol consumption,education,physical activity,and history of hypertension,diabetes,or cholelithiasis,Multivariate analysis showed a significantly increased risk in Q4(HR=1.77,95%CI:1.07~2.92)as comparing with Q1.After excluding deaths during the follow-up period,Multivariate Cox regression analysis was performed again in Q4 HR=1.75(95%CI:1.04~2.95).Conclusions With the increase of cumUA exposure,both morbidity and risk of AP occur-rence have the tendency of rising.
6.Research on the mechanism of action of temporary party organizations in public health emergencies:a case study of Guangdong medical teams'success in pandemic response
Guangjian WANG ; Qiaojun LI ; Zongfeng WANG
Modern Hospital 2024;24(10):1495-1499,1507
In public health emergencies,medical emergency response efforts face governance challenges such as complex and variable tasks,difficulties in team organization,and uncertain working areas.The establishment of temporary party organiza-tions plays a crucial role in efficiently achieving the goals of medical emergency teams and stabilizing social order.This paper an-alyzes the functional positioning,key tasks,and operational mechanisms of temporary party organizations within Guangdong's medical teams aiding in the pandemic response.The study finds that these temporary party organizations effectively address the complex challenges of public health emergencies through functions such as strengthening political leadership,mobilizing public support,coordinating organization,and serving the community.This provides important insights for advancing the construction of governance systems for public health emergencies in China.
7.Effect of Baihe Yuzi Prescription on CFTR, AQP, and ZIP Ion Channels and Oxidative Stress in Epididymis of Oligoasthenozoospermia Rats
Guangjian WANG ; Jiajie BI ; Tianyi ZHANG ; Jing MA ; Shusong WANG ; Bo LI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(7):140-146
ObjectiveTo observe the effects of Baihe Yuzi prescription (BYP) on the cystic fibrosis transmembrane conductance regulator (CFTR), aquaporin (AQP), zinc/iron-regulated transporter-like protein (ZIP) and local oxidative stress in epididymis of oligoasthenozoospermia (OAS) rats, and to explore the mechanism of its intervention in OAS. MethodAfter 35 rats were acclimatized for 1 week, 7 rats were randomly selected as the normal group, and the remaining 28 rats were given tripterygium glycosides (TG) 30 mg·kg-1. After 4 weeks of modeling, they were randomly divided into 4 groups: model group, BYP low-dose group (LBYP), BYP high-dose group (HBYP) and levocarnitine group, with 7 rats in each group. The rats in the normal group and model group were given normal saline at the same dosage. The levocarnitine group rats were given L-carnitine oral liquid (100 mg·kg-1) by gavage. The LBYP group rats were given BYP 6.3 g·kg-1, and the HBYP group rats were given BYP 12.6 g·kg-1 by gavage once a day for consecutive 4 weeks. After the end of the intervention, sperm count and motility of all rats were detected, the histopathological structure of epididymis was observed by hematoxylin-eosin (HE) staining, and the expressions of CFTR, AQP9, AQP3, ZIP8, ZIP12 and other proteins were detected by Western blot. The contents of α-glycosidase (α-GC), sialic acid (SA), carnitine, superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and malondialdehyde (MDA) were detected by enzyme-linked immunosorbent assay (ELISA). Total zinc content was measured using an inductively coupled plasma mass spectrometer. Free zinc ion content was detected by zinc ion probes. ResultCompared with those in the normal group, the sperm count and motility of rats were decreased and the epididymal structure was disordered in the model group. The contents of α-GC and carnitine were decreased in epididymis (P<0.05). MDA levels were increased, while SOD, GSH-Px and zinc levels were decreased (P<0.05). The expressions of CFTR and ZIP12 in the head and cauda of the epididymis were down-regulated, and AQP3 expression was up-regulated. The expression of ZIP8 in the cauda epididymis was up-regulated (P<0.05). Compared with the model group, BYP can significantly improve the sperm count and motility, the epididymal structure of OAS rats and the levels of α-GC and carnitine (P<0.05). The expressions of CFTR and ZIP12 in the head and cauda of the epididymis were up-regulated, while the expressions of ZIP8 in the cauda epididymis and AQP3 in the head of the epididymis were decreased (P<0.05). The SOD and GSH-Px levels and total zinc content in epididymis were increased, and the MDA levels were decreased (P<0.05). ConclusionBYP may improve the sperm quality and repair epididymal tissue structure and function of OAS rats, by regulating the expressions of CFTR, AQP3, and ZIP12 ion channels and local antioxidant mechanism.
8.Protective Effect of Polysaccharides from Inonotus obliquus on Acute Lung Injury in Mice Based on Gut Microbiota and Metabolomics
Li YU ; Miaoyun YE ; Shaodan CHEN ; Guangjian BAI ; Huinan ZHANG ; Ming YANG ; Yaqi WANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(13):86-94
ObjectiveTo explore the protective effect of polysaccharide from Inonotus obliquus (IOP) on lipopolysaccharide (LPS)-induced acute lung injury (ALI) in mice. MethodA total of 40 male C57BL/6 mice were randomly divided into normal group, model group, dexamethasone group, and high-dose and low-dose IOP groups, with eight mice in each group. The high-dose and low-dose IOP groups were administered intragastrically with IOP at 20 and 10 mg·kg-1, respectively. The normal group and the model group were intragastrically administered with normal saline in equal volumes, and the dexamethasone group was intraperitoneally injected with dexamethasone phosphate injection of 30 mg·kg-1 for 21 days. An ALI mouse model induced by LPS was constructed, and hematoxylin-eosin (HE) staining, immunofluorescence staining, and blood routine were used to detect pathological damage of lung tissue and blood cell content. Enzyme-linked immunosorbent assay (ELISA) and Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) were used to detect the expression levels of various inflammatory factors. Changes in gut microbiota and plasma differential metabolites in mice were detected using 16S rRNA sequencing and ultra-high performance liquid chromatography-quadrupole-time of flight tandem mass spectrometry (UPLC-Q-TOF-MS). ResultCompared with the model group, the lung tissue lesions of ALI mice were significantly improved after IOP administration, and the spleen and thymus index were dramatically increased (P<0.05, P<0.01). The ratio of wet-to-dry weight of lung tissue was sensibly decreased (P<0.05, P<0.01), and the number of lymphocytes was substantially increased (P<0.05, P<0.01). The number of neutrophils was markedly decreased (P<0.01). The expression level of interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-1β (IL-1β), nuclear factor-κB(NF-κB), and nucleotide-binding oligomerization domain-like receptor 3 (NLRP3) decreased prominently (P<0.05, P<0.01) and the expression level of interleukin-10 (IL-10) increased memorably (P<0.01). The 16S rRNA sequencing results show that IOP can regulate and improve intestinal microbial disorders. The UPLC-Q-TOF-MS results indicate that the treatment of ALI mice with IOP may involve pathways related to mitochondrial, sugar, and amino acid metabolism, such as nucleotide sugar metabolism, histidine metabolism, ubiquinone, and other terpenoid compound-quinone biosynthesis, as well as starch and sucrose metabolism. ConclusionThe improvement of lung tissue lesions and inflammatory response by IOP in ALI mice may be related to maintaining intestinal microbiota balance, regulating mitochondrial electron oxidation respiratory chain, as well as sugar and amino acid metabolism pathways, and affecting the production of related microbial metabolites and tricarboxylic acid cycle metabolites.
9.COVID-19 after lung transplantation: Four case reports
Hongyi WANG ; Yixing LI ; Heng ZHAO ; Yanpeng ZHANG ; Shan GAO ; Jizhao WANG ; Yilong ZHAO ; Shuo LI ; Guangjian ZHANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2024;31(11):1697-1702
From December 2022 to January 2023, 4 lung transplant recipients (3 males and 1 female, aged 52-60 years, all received transplantation less than 1 year) were hospitalized in the Department of Thoracic Surgery of the First Affiliated Hospital of Xi'an Jiaotong University due to COVID-19 after surgery. The clinical manifestations were mostly characterized by elevated body temperature accompanied by shortness of breath, and indicators such as heart rate, oxygen saturation, and oxygenation index could reflect the severity of the condition. The therapy was timely adjusted to immunosuppressive drugs, upgraded oxygen therapy, anti-bacterial and anti-fungal therapy, prone ventilation, general treatment, and anticoagulant therapy, depending on the situation. Finally, 3 patients were cured and discharged from hospital, and 1 died.
10.Analysis of Clinical Epidemiological Characteristics of 15,967 Lung Cancer Surgery Patients in Yunnan Cancer Hospital from 2013 to 2022.
Ruke TANG ; Yujie LEI ; Lianhua YE ; Guangqiang ZHAO ; Xudong XIANG ; Gaofeng LI ; Guangjian LI ; Xi WANG ; Ying CHEN ; Kaiyun YANG ; Xiaobo CHEN ; Jiapeng YANG ; Min ZHAO ; Bingquan XIANG ; Qiubo HUANG ; Guangcan LUO ; Hongwei ZHANG ; Yunchao HUANG
Chinese Journal of Lung Cancer 2024;27(12):911-918
BACKGROUND:
Lung cancer is a disease with a high incidence rate in Yunnan province, yet there is a paucity of large-scale studies on its clinical epidemiology. This research aims to investigate the epidemiological characteristics of patients who underwent lung cancer surgery at Yunnan Cancer Hospital over the past decade, thereby providing a theoretical basis for the prevention and treatment of lung cancer.
METHODS:
Clinical data were collected from 15,967 patients who underwent lung cancer surgery at Yunnan Cancer Hospital between 2013 and 2022. A statistical analysis was conducted on the patients' general data, surgical information, pathological types of lung cancer, and other clinical epidemiological characteristics.
RESULTS:
Among the 15,967 cases of lung cancer, 46.3% were male and 53.7% were female, with the male-to-female ratio ranging from 0.68 to 1.61:1. The median age was 56 years (interquartile range: 49-63), and 37.0% of the patients were in the age group of 50-59 years. Since 2017, there has been an annual increase in the proportion of patients under the age of 60 years. The smoking status of the patients showed that 28.1% were smokers and 71.9% were non-smokers. Qujing city accounted for 41.4% and Kunming city for 23.2% of the cases in Yunnan province, with 29.6% of patients originating from Xuanwei and Fuyuan areas of Qujing city. The distribution of affected lung lobes was as follows: right upper lobe 28.2%, right middle lobe 6.3%, right lower lobe 20.1%, left upper lobe 22.7%, and left lower lobe 16.4%. The use of thoracoscopic surgery increased from 30.8% to 96.3%, with single-port thoracoscopic surgery comprising 61.3%. Lobectomy was performed in 64.2% of cases, wedge resection in 17.2%, and segmentectomy in 12.2%. The proportion of lobectomy decreased from 83.1% to 46.1%. The proportion of patients in stages 0-I increased from 43.5% to 82.8%, while stages II-IV decreased from 56.5% to 17.2%. Adenocarcinoma increased from 75.6% to 88.3%, and squamous cell carcinoma decreased from 21.5% to 8.6%. Among adenocarcinoma patients, 60.9% were female. Among sguamous cell carcinoma patients, 90.6% were male. The peak age for adenocarcinoma was 50-59 years, and for squamous cell carcinoma, it was 60-69 years. The smoking rate was higher among squamous cell carcinoma patients (65.9%) compared to adenocarcinoma patients (22.3%). Adenocarcinoma patients had a higher proportion in stages 0-I (76.3%), while squamous cell carcinoma patients were more prevalent in stages II-III (64.1%).
CONCLUSIONS
The findings indicate an increasing proportion of female patients with adenocarcinoma, a younger age of onset, a higher proportion of non-smoking lung cancer patients, and an increased proportion of stages 0-I lung cancer. These trends may reflect the epidemiological characteristics of patients undergoing lung cancer surgery in Yunnan and surrounding areas over the past decade.
Humans
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Female
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Male
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Lung Neoplasms/pathology*
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Middle Aged
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China/epidemiology*
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Aged
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Adult
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Aged, 80 and over

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