1.Specific RNA transcripts (SRTs): From concepts to the clinic.
Qili SHI ; Haochen LI ; Zhiao CHEN ; Xianghuo HE
Chinese Medical Journal 2025;138(22):2895-2906
Over the past decade, high-throughput RNA sequencing (RNA-seq) has vastly expanded our understanding of transcriptome dynamics in human physiology and disease. As a powerful tool for investigating systematic changes in RNA biology, RNA-seq has facilitated the discovery of novel functional RNA species. Mature RNA transcripts, which transmit genetic information from DNA to proteins, undergo intricate transcriptional and post-transcriptional regulation. This process allows a single gene to produce multiple RNA transcripts, each performing specific functions depending on the physiological or pathological context. Specific RNA transcripts (SRTs) are uniquely expressed in particular tissues or tumors and are closely associated with tissue-specific functions or disease states, particularly cancer. This review explores the generation of SRTs through key mechanisms, such as alternative splicing (AS), transcriptional regulation, polyadenylation (polyA), and the influence of transposable elements (TEs). We also examine their critical roles in normal tissue development and diseases, with an emphasis on their relevance to cancer. Furthermore, the potential applications of SRTs in diagnosing and treating diseases, especially malignancies, are discussed. By serving as diagnostic markers and therapeutic targets, SRTs hold significant promise in the development of personalized medicine and precision therapies. This review aims to provide new insights into the importance of SRTs in advancing the understanding and treatment of human diseases.
Humans
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Neoplasms/genetics*
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Alternative Splicing/genetics*
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RNA/genetics*
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Animals
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Sequence Analysis, RNA/methods*
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Polyadenylation/genetics*
2.Local abaloparatide administration promotes in situ alveolar bone augmentation via FAK-mediated periosteal osteogenesis.
Ruyi WANG ; Yuan LI ; Bowen TAN ; Shijia LI ; Yanting WU ; Yao CHEN ; Yuran QIAN ; Haochen WANG ; Bo LI ; Zhihe ZHAO ; Quan YUAN ; Yu LI
International Journal of Oral Science 2025;17(1):63-63
Insufficient alveolar bone thickness increases the risk of periodontal dehiscence and fenestration, especially in orthodontic tooth movement. Abaloparatide (ABL), a synthetic analog of human PTHrP (1-34) and a clinical medication for treating osteoporosis, has recently demonstrated its potential in enhancing craniofacial bone formation. Herein, we show that intraoral submucosal injection of ABL, when combined with mechanical force, promotes in situ alveolar bone thickening. The newly formed bone is primarily located outside the original compact bone, implying its origin from the periosteum. RNA sequencing of the alveolar bone tissue revealed that the focal adhesion (FA) pathway potentially mediates this bioprocess. Local injection of ABL alone enhances cell proliferation, collagen synthesis, and phosphorylation of focal adhesion kinase (FAK) in the alveolar periosteum; when ABL is combined with mechanical force, the FAK expression is upregulated, in line with the accomplishment of the ossification. In vitro, ABL enhances proliferation, migration, and FAK phosphorylation in periosteal stem cells. Furthermore, the pro-osteogenic effects of ABL on alveolar bone are entirely blocked when FAK activity is inhibited by a specific inhibitor. In summary, abaloparatide combined with mechanical force promotes alveolar bone formation via FAK-mediated periosteal osteogenesis. Thus, we have introduced a promising therapeutic approach for drug-induced in situ alveolar bone augmentation, which may prevent or repair the detrimental periodontal dehiscence, holding significant potential in dentistry.
Osteogenesis/drug effects*
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Periosteum/cytology*
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Parathyroid Hormone-Related Protein/administration & dosage*
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Animals
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Focal Adhesion Protein-Tyrosine Kinases/metabolism*
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Alveolar Process/drug effects*
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Cell Proliferation/drug effects*
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Phosphorylation
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Rats
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Male
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Humans
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Focal Adhesion Kinase 1/metabolism*
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Cell Movement/drug effects*
3.Protective effects of normothermic machine perfusion on the skeletal muscle of the amputated limbs of pigs
Zhibo JIA ; Yanghui DONG ; Xiangyu SONG ; Haochen ZUO ; Zhancheng YANG ; Heng CHEN ; Xiwei PENG ; Boyao YANG ; Pengkai LI ; Zhaodi MI ; Shen LI ; Mengyi CUI ; Wenjing XU ; Jiang PENG
Chinese Journal of Trauma 2025;41(1):97-105
Objective:To compare the protective effects of the static cold storage (SCS) and normothermic machine perfusion (NMP) on the skeletal muscle of the amputated limbs of pigs.Methods:Four Landrace pigs were selected, from which eight limbs were amputated and divided into SCS group ( n=5) and NMP group ( n=3) according to the random number table method. After blood collection from the carotid artery, an amputated limb model was established by amputating the limbs at the scapulohumeral joints. The limbs in the SCS group were wrapped in sterile cloth and stored at 4 ℃ for 24 hours. In the NMP group, the limbs were mechanically perfused with a red blood cell-containing perfusion fluid at 37 ℃ for 24 hours, with 70% of the perfusion fluid replaced every 6 hours. Before the experiment, cross-matching tests with the saline medium were conducted between donor and recipient pigs to evaluate blood coagulation and blood safety in the NMP group. An allogeneic red blood cell perfusion fluid was prepared and the levels of pH, Na +, K +, Cl -, Ca 2+, glucose (Glu), hematocrit (Hct), lactic acid (Lac) and osmotic pressure of the perfusion fluid were measured. At 0, 6, 12, 18, and 24 hours after perfusion, the skin temperature and oxyhemoglobin saturation (SaO 2) levels in the NMP group were monitored and the levels of pH, Glu, creatine kinase (Ck), K +, Ca 2+, and Na +levels of the perfusion fluid were analyzed to evaluate the metabolism of the skeletal muscle in the amputated limbs. The mean intercellular distance and apoptosis index of the myocytes were quantitatively analyzed and histopathological changes were observed by performing HE staining and TUNEL staining on the skeletal muscle of the amputated limbs in both groups at 0 and 24 hours after perfusion. After perfusion was ended, the weight gain rate and swelling degree of the amputated limbs were compared between the two groups and the overall state of the amputated limbs was evaluated. Results:The result of the cross-matching test between donor and recipient pig blood was negative. The parameters in the prepared red blood cell-containing perfusion fluid generally maintained within a normal range: pH 7.38±0.04, Na + concentration (138.30±4.48)mmol/L, K + concentration (3.50±0.26)mmol/L, Glu concentration (6.11±2.08)mmol/L, and osmotic pressure (305.67±3.79)mmol/L. However, slightly higher Cl - and Ca 2+ concentrations [(118.34±12.00)mmol/L and (2.00±0.15)mmol/L] and lower Hct and lactate concentrations [0.30±0.03 and (1.54±0.38)mmol/L] were detected when compared with the reference range. During the perfusion, the average skin temperature of the amputated limbs in the NMP group was (36.13±0.98)℃, with the skin temperatures at 6, 12, 18, and 24 hours after perfusion being significantly higher than that at 0 hour ( P<0.01), while no significant difference among the skin temperatures at 6, 12, 18, and 24 hours after perfusion was observed ( P>0.05). The SaO 2 levels in the skin of the amputated limbs in the NMP group averaged over 95%, which showed no significant difference at 0, 12, 18, and 24 hours after perfusion ( P>0.05), while a significant elevation was observed at 6 hours compared with that at 0 hour ( P<0.05). There were no significant differences in pH, Glu, Na +, and Ca 2+ levels in the NMP group at 0, 6, 12, 18, and 24 hours after perfusion ( P>0.05), while the Ck levels at 18 and 24 hours were both significantly higher than that at 6 hours after perfusion ( P<0.05), and the Ck levels at 6, 12, 18, and 24 hours were all significantly higher than that at 0 hour ( P<0.05). The K + level progressively increased with the perfusion time, with significant elevations at 18 and 24 hours after perfusion compared with that at 0 hour ( P<0.05). HE staining revealed well-preserved muscle fiber continuity and regular arrangement in the NMP group and the SCS group at 0 hour, with an intercellular distance of (8.95±0.60)μm. At 24 hours, the NMP group exhibited slight skeletal muscle fiber rupture and swelling, with a slightly increased intercellular distance of (14.75±0.90)μm, significantly greater than that at 0 hour ( P<0.01). At 24 hours, the SCS group showed marked skeletal muscle fiber rupture and swelling, with a significantly increased intercellular distance of (23.51±1.49)μm, significantly larger than those at 0 hour in the same group and at 24 hours in the NMP group ( P<0.01). TUNEL immunofluorescence staining indicated a tiny amount of apoptotic cells in the skeletal muscle in both groups at 0 hour, with an apoptotic index of (4.26±1.62)%. There was a small number of apoptotic cells in the skeletal muscle in the NMP group at 24 hours, with an apoptotic index of (25.94±2.69)%, significantly larger than that in the same group at 0 hour ( P<0.01). The SCS group exhibited a large number of apoptotic cells at 24 hours, with an apoptotic index of (62.97±3.22)%, significantly larger than those at 0 hour in the same group and at 24 hours in the NMP group ( P<0.01). In comparison with the SCS group at 24 hours, the amputated limbs in the NMP group showed red color in the appearance, no symptoms of ischemic muscle contracture and good joint movement despite slight edema in the subcutaneous layer. At 24 hours, the weight gain rate of the amputated limbs was (15.82±0.89)% in the NMP group, significantly higher than (0.97±0.28)% in the SCS group ( P<0.01). Conclusion:Compared with SCS, NMP with the red blood cell-containing perfusion fluid prepared with the allogeneic blood for the amputated limbs of pigs can alleviate the ischemic injury of the muscle fibers and inhibit the apoptosis of the muscle cells by sustaining stable energy and oxygen supply and balancing ion homeostasis and pH of the perfusion fluid.
4.Analysis of risk factor for complications following lateral lumbar interbody fusion surgery
Xiaopeng LI ; Haochen HU ; Penghe LI ; Wentao WAN ; Bing CHEN ; Feng LI ; Haiyun YANG ; Gang LIU ; Chao CHEN ; Xinlong MA ; Qiang YANG
Chinese Journal of Orthopaedics 2025;45(18):1177-1183
Objective:To investigate the risk factors for complications following lateral lumbar interbody fusion (LLIF) surgery.Methods:A retrospective analysis was conducted on 196 patients who underwent LLIF surgery via the psoas major muscle approach in the Department of Spinal Surgery, Tianjin Hospital, Tianjin University, from October 2018 to July 2024. The age, gender, body mass index (BMI), presence of hypertension, type 2 diabetes, heart disease, osteoporosis, history of lumbar surgery, history of abdominal surgery, history of abdominal inflammation, smoking status, operative time, surgical segments (whether the surgery was single-segment or multi-segments), and use of internal fixation or not were compared between patients with and without postoperative complications, the indicators with P<0.10 were included in the binary variable logistic regression analysis, and determine the independent risk factors for complications after LLIF surgery. Complications included anterior thigh symptoms (pain, numbness, weakness), cage subsidence, surgery-related complications (nerve injury, surgical site infection, postoperative buttock pain, urinary and fecal incontinence, etc.), and medical complications (cerebrovascular accident, deep vein thrombosis, urinary tract infection, etc.). Results:All 196 patients were followed up for 27.02 (12.6, 40.69) months. Postoperative complications occurred in 71 cases (96 times), and no complications occurred in 125 cases. In the complication group, there were 15 males and 56 females with a mean age of 61.82±7.57 years; in the non-complication group, there were 43 males and 82 females with a mean age of 62.00± 8.39 years. In the complication group, there were 43 cases of anterior thigh symptoms, 38 cases of cage subsidence, 11 cases of surgical operation-related complications, and 4 cases of medical complications. There were statistically significant differences in gender (χ 2=3.829, P=0.051), operation time ( t=2.391, P=0.018), and surgical segment (χ 2=4.245, P=0.039) between the complication group and the non-complication group. No statistically significant differences were found in age, gender, BMI, presence of hypertension, type 2 diabetes, heart disease, osteoporosis, history of lumbar surgery, history of abdominal surgery, history of abdominal inflammation, smoking status, or use of internal fixation ( P>0.10). Binary variable logistic regression analysis indicated that prolonged operative time [ OR=1.007, 95% CI(1.001, 1.013), P=0.019] and multilevel surgery [ OR=2.099, 95% CI(1.095, 4.025), P=0.026] were independent risk factors for complications following LLIF. Conclusion:Prolonged operative time and multi-segments surgery are independent risk factors for complications following LLIF.
5.Construction and application of an inpatient hospital discharge preparation service management platform
Ying LI ; Wenxin SUN ; Furong SUN ; Xinyu YAO ; Qiuning CAO ; Haochen LIU ; Xiujie SUN
Chinese Journal of Nursing 2025;60(16):2002-2008
Objective To build an inpatient hospital discharge preparation service management platform,to explore its application outcomes,and to enhance the quality of discharge preparation service management.Methods A research team was set up,and the literature was referenced.The platform was built on the basis of connecting and optimizing various existing information systems in the hospital,including 6 modules:evaluation,implementation of nursing,referral,monitoring feedback,follow-up,and continued nursing.Patients admitted to a tertiary comprehensive hospital were conveniently selected as research subjects in Shandong Province from August 2023 to January 2024.The 97 patients included after the platform application(November 2023 to January 2024)were selected as an experimental group,and the 97 patients included before the platform application(August to October 2023)were selected as a control group.The rate of unplanned readmission within 30 days,the utilization rate of"Internet+Nursing Services",and the time for assessing the demand for discharge planning service were compared between the 2 groups.In addition,in February 2024,300 healthcare professionals from the same hospital were selected to evaluate their satisfaction with the use of the platform.Results There were 7 cases dropping out in each of the 2 groups.The rate of unplanned readmission within 30 days in the experimental group was lower than that in the control group;the utilization rate of"Internet+Nursing Services"was higher than that in the control group;the time for assessing the demand for discharge planning service was less than that in the control group,with statistically significant differences(P<0.05).In the satisfaction survey of medical staff on the use of the platform,the effective questionnaire response rate was 94.67%,and the score of the clinical nursing information system effectiveness evaluation scale was(100.84±16.48)points.Conclusion The use of this platform can reduce the unplanned readmission rate of patients within 30 days,promote the development of"Internet+Nursing Services",reduce the time for assessing the needs of discharge planning services,and medical staff are highly satisfied with the use of the platform.
6.KAT7 promotes chondrocyte senescence by activating the PI3K/AKT/mTOR signaling pathway
Kang Wang ; Ying Li ; Nuo Xu ; Tingting Guo ; Yun Chen ; Xuran Zeng ; Liqi Sun ; Haochen Xu ; Wei Wei ; Shangxue Yan
Acta Universitatis Medicinalis Anhui 2025;60(8):1506-1513
Objective :
To establish an interleukin-1β (Il-1β) induced inflammatory model of rat articular chondro- cytes (ACs) , and to investigate the relationship between the expression of lysine acetyltransferase 7 (KAT7) under inflammatory stimulation and the senescence of ACs.
Methods:
Primary ACs were obtained by digestion of rat knee cartilage with collagenase type Ⅱ and identified. The inflammatory model of ACs was induced by IL-1β . KAT7 was over-expressed or knocked down in ACs by adeno-associated virus infection or small interfering RNA transfection , respectively. A negative control group was set up. Transwell assay was used to detect cell migration ability. Senes- cent cells were stained with senescence-associated β-galactosidase (SA-β-Gal) . Western blot ( WB) was used to detect the protein expression levels of KAT7 , collagen type II (Col Ⅱ ) , matrix metalloproteinase 13 (MMP13) , tumor protein p53 (p53) and cyclin-dependent kinase inhibitor 1A (p21) . The cells of negative control group and KAT7 over-expression group were performed for RNA sequencing , and WB was used to verify the related signaling pathways obtained by Kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis.
Results:
Compared with the control group , the SA-β-Gal staining was enhanced , the protein expression of Col Ⅱ decreased , the pro- tein expression of MMP13 and p53 increased , the cell migration ability decreased , and the expression of KAT7 also increased in the ACs of rats after IL-1β stimulation. Compared with the negative control group , the SA-β-Gal stai- ning was enhanced , the protein expression of Col Ⅱ decreased , the protein expression of MMP13 , p53 and p21 in- creased , and the cell migration ability decreased in the KAT7 over-expression group. Compared with the negative control group , the SA-β-Gal staining was weakened , the protein expression of Col Ⅱ increased , the protein expres- sion of MMP13 , p53 and p21 decreased , and the cell migration ability was enhanced in the KAT7 knockdown inflammatory model of ACs. KEGG enrichment analysis showed that phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) signaling pathway was activated. Compared with the negative control group , the relative protein ex⁃pression levels of phosphorylated protein kinase B (p⁃AKT)/AKT and phosphorylated mammalian target of rapamy⁃cin (p⁃mTOR)/mTOR in KAT7 over⁃expression group increased. The relative protein expression levels of p ⁃AKT/AKT and p ⁃mTOR/mTOR in KAT7 knockdown cells decreased.
Conclusion
Rat ACs with high expression of KAT7 exhibit senescence and osteoarthritis phenotype , and the mechanism may be related to the activation of PI3K/AKT/mTOR signaling pathway by KAT7.
7.Effect of omalizumab injection combined with compound glycyrrhizin tablets on chronic urticaria with low response to antihistamines
Haixia SHI ; Yuan GUO ; Yanhua LI ; Juping CHEN ; Haochen YUAN ; Yun ZHANG
The Journal of Practical Medicine 2025;41(8):1212-1216
Objective To investigate the effectiveness and safety of combining Omalizumab with compound glycyrrhetinic acid glycoside in the management of chronic urticaria that exhibits poor response to antihistamine therapy.Methods 92 patients with chronic urticaria who were treated with H1 antihistamines and still had symp-toms from February 2022 to February 2024 in the hospital were selected as the study subjects.The study partici-pants were randomly assigned to either the observation group,consisting of 46 cases,or the control group,also comprising 46 cases,using a random number table method.The control group received subcutaneous injection of omalizumab for treatment.The observation group was treated with oral compound glycyrrhizin tablets on the basis of the control group.After 24 weeks of treatment,compare the efficacy,adverse reactions,Urticaria Activity Score over 7 days(UAS7),Dermatology Life Quality Index(DLQI),Immunoglobulin(Ig)E,and High Sensitivity C-reactive protein(hs CRP)between the two groups,and record the recurrence rate.Results After treatment,the UAS7,DLQI,IgE and hs-CRP of both groups of patients decreased compared to before treatment,and the observation group demonstrated lower results compared to the control group(P<0.05).After treatment,the overall effectiveness rate in the observation group exceeded that of the control group(P<0.05),and the recurrence rate was lower than that of the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups of drugs(P>0.05).Conclusion The combination therapy of omali-zumab and compound glycyrrhetinic acid glycoside in the treatment of chronic urticaria patients with low response to antihistamines helps reduce IgE expression,improve treatment effectiveness,lower recurrence rates,and does not increase adverse drug reactions.
8.Analysis of risk factor for complications following lateral lumbar interbody fusion surgery
Xiaopeng LI ; Haochen HU ; Penghe LI ; Wentao WAN ; Bing CHEN ; Feng LI ; Haiyun YANG ; Gang LIU ; Chao CHEN ; Xinlong MA ; Qiang YANG
Chinese Journal of Orthopaedics 2025;45(18):1177-1183
Objective:To investigate the risk factors for complications following lateral lumbar interbody fusion (LLIF) surgery.Methods:A retrospective analysis was conducted on 196 patients who underwent LLIF surgery via the psoas major muscle approach in the Department of Spinal Surgery, Tianjin Hospital, Tianjin University, from October 2018 to July 2024. The age, gender, body mass index (BMI), presence of hypertension, type 2 diabetes, heart disease, osteoporosis, history of lumbar surgery, history of abdominal surgery, history of abdominal inflammation, smoking status, operative time, surgical segments (whether the surgery was single-segment or multi-segments), and use of internal fixation or not were compared between patients with and without postoperative complications, the indicators with P<0.10 were included in the binary variable logistic regression analysis, and determine the independent risk factors for complications after LLIF surgery. Complications included anterior thigh symptoms (pain, numbness, weakness), cage subsidence, surgery-related complications (nerve injury, surgical site infection, postoperative buttock pain, urinary and fecal incontinence, etc.), and medical complications (cerebrovascular accident, deep vein thrombosis, urinary tract infection, etc.). Results:All 196 patients were followed up for 27.02 (12.6, 40.69) months. Postoperative complications occurred in 71 cases (96 times), and no complications occurred in 125 cases. In the complication group, there were 15 males and 56 females with a mean age of 61.82±7.57 years; in the non-complication group, there were 43 males and 82 females with a mean age of 62.00± 8.39 years. In the complication group, there were 43 cases of anterior thigh symptoms, 38 cases of cage subsidence, 11 cases of surgical operation-related complications, and 4 cases of medical complications. There were statistically significant differences in gender (χ 2=3.829, P=0.051), operation time ( t=2.391, P=0.018), and surgical segment (χ 2=4.245, P=0.039) between the complication group and the non-complication group. No statistically significant differences were found in age, gender, BMI, presence of hypertension, type 2 diabetes, heart disease, osteoporosis, history of lumbar surgery, history of abdominal surgery, history of abdominal inflammation, smoking status, or use of internal fixation ( P>0.10). Binary variable logistic regression analysis indicated that prolonged operative time [ OR=1.007, 95% CI(1.001, 1.013), P=0.019] and multilevel surgery [ OR=2.099, 95% CI(1.095, 4.025), P=0.026] were independent risk factors for complications following LLIF. Conclusion:Prolonged operative time and multi-segments surgery are independent risk factors for complications following LLIF.
9.Effect of omalizumab injection combined with compound glycyrrhizin tablets on chronic urticaria with low response to antihistamines
Haixia SHI ; Yuan GUO ; Yanhua LI ; Juping CHEN ; Haochen YUAN ; Yun ZHANG
The Journal of Practical Medicine 2025;41(8):1212-1216
Objective To investigate the effectiveness and safety of combining Omalizumab with compound glycyrrhetinic acid glycoside in the management of chronic urticaria that exhibits poor response to antihistamine therapy.Methods 92 patients with chronic urticaria who were treated with H1 antihistamines and still had symp-toms from February 2022 to February 2024 in the hospital were selected as the study subjects.The study partici-pants were randomly assigned to either the observation group,consisting of 46 cases,or the control group,also comprising 46 cases,using a random number table method.The control group received subcutaneous injection of omalizumab for treatment.The observation group was treated with oral compound glycyrrhizin tablets on the basis of the control group.After 24 weeks of treatment,compare the efficacy,adverse reactions,Urticaria Activity Score over 7 days(UAS7),Dermatology Life Quality Index(DLQI),Immunoglobulin(Ig)E,and High Sensitivity C-reactive protein(hs CRP)between the two groups,and record the recurrence rate.Results After treatment,the UAS7,DLQI,IgE and hs-CRP of both groups of patients decreased compared to before treatment,and the observation group demonstrated lower results compared to the control group(P<0.05).After treatment,the overall effectiveness rate in the observation group exceeded that of the control group(P<0.05),and the recurrence rate was lower than that of the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups of drugs(P>0.05).Conclusion The combination therapy of omali-zumab and compound glycyrrhetinic acid glycoside in the treatment of chronic urticaria patients with low response to antihistamines helps reduce IgE expression,improve treatment effectiveness,lower recurrence rates,and does not increase adverse drug reactions.
10.Protective effects of normothermic machine perfusion on the skeletal muscle of the amputated limbs of pigs
Zhibo JIA ; Yanghui DONG ; Xiangyu SONG ; Haochen ZUO ; Zhancheng YANG ; Heng CHEN ; Xiwei PENG ; Boyao YANG ; Pengkai LI ; Zhaodi MI ; Shen LI ; Mengyi CUI ; Wenjing XU ; Jiang PENG
Chinese Journal of Trauma 2025;41(1):97-105
Objective:To compare the protective effects of the static cold storage (SCS) and normothermic machine perfusion (NMP) on the skeletal muscle of the amputated limbs of pigs.Methods:Four Landrace pigs were selected, from which eight limbs were amputated and divided into SCS group ( n=5) and NMP group ( n=3) according to the random number table method. After blood collection from the carotid artery, an amputated limb model was established by amputating the limbs at the scapulohumeral joints. The limbs in the SCS group were wrapped in sterile cloth and stored at 4 ℃ for 24 hours. In the NMP group, the limbs were mechanically perfused with a red blood cell-containing perfusion fluid at 37 ℃ for 24 hours, with 70% of the perfusion fluid replaced every 6 hours. Before the experiment, cross-matching tests with the saline medium were conducted between donor and recipient pigs to evaluate blood coagulation and blood safety in the NMP group. An allogeneic red blood cell perfusion fluid was prepared and the levels of pH, Na +, K +, Cl -, Ca 2+, glucose (Glu), hematocrit (Hct), lactic acid (Lac) and osmotic pressure of the perfusion fluid were measured. At 0, 6, 12, 18, and 24 hours after perfusion, the skin temperature and oxyhemoglobin saturation (SaO 2) levels in the NMP group were monitored and the levels of pH, Glu, creatine kinase (Ck), K +, Ca 2+, and Na +levels of the perfusion fluid were analyzed to evaluate the metabolism of the skeletal muscle in the amputated limbs. The mean intercellular distance and apoptosis index of the myocytes were quantitatively analyzed and histopathological changes were observed by performing HE staining and TUNEL staining on the skeletal muscle of the amputated limbs in both groups at 0 and 24 hours after perfusion. After perfusion was ended, the weight gain rate and swelling degree of the amputated limbs were compared between the two groups and the overall state of the amputated limbs was evaluated. Results:The result of the cross-matching test between donor and recipient pig blood was negative. The parameters in the prepared red blood cell-containing perfusion fluid generally maintained within a normal range: pH 7.38±0.04, Na + concentration (138.30±4.48)mmol/L, K + concentration (3.50±0.26)mmol/L, Glu concentration (6.11±2.08)mmol/L, and osmotic pressure (305.67±3.79)mmol/L. However, slightly higher Cl - and Ca 2+ concentrations [(118.34±12.00)mmol/L and (2.00±0.15)mmol/L] and lower Hct and lactate concentrations [0.30±0.03 and (1.54±0.38)mmol/L] were detected when compared with the reference range. During the perfusion, the average skin temperature of the amputated limbs in the NMP group was (36.13±0.98)℃, with the skin temperatures at 6, 12, 18, and 24 hours after perfusion being significantly higher than that at 0 hour ( P<0.01), while no significant difference among the skin temperatures at 6, 12, 18, and 24 hours after perfusion was observed ( P>0.05). The SaO 2 levels in the skin of the amputated limbs in the NMP group averaged over 95%, which showed no significant difference at 0, 12, 18, and 24 hours after perfusion ( P>0.05), while a significant elevation was observed at 6 hours compared with that at 0 hour ( P<0.05). There were no significant differences in pH, Glu, Na +, and Ca 2+ levels in the NMP group at 0, 6, 12, 18, and 24 hours after perfusion ( P>0.05), while the Ck levels at 18 and 24 hours were both significantly higher than that at 6 hours after perfusion ( P<0.05), and the Ck levels at 6, 12, 18, and 24 hours were all significantly higher than that at 0 hour ( P<0.05). The K + level progressively increased with the perfusion time, with significant elevations at 18 and 24 hours after perfusion compared with that at 0 hour ( P<0.05). HE staining revealed well-preserved muscle fiber continuity and regular arrangement in the NMP group and the SCS group at 0 hour, with an intercellular distance of (8.95±0.60)μm. At 24 hours, the NMP group exhibited slight skeletal muscle fiber rupture and swelling, with a slightly increased intercellular distance of (14.75±0.90)μm, significantly greater than that at 0 hour ( P<0.01). At 24 hours, the SCS group showed marked skeletal muscle fiber rupture and swelling, with a significantly increased intercellular distance of (23.51±1.49)μm, significantly larger than those at 0 hour in the same group and at 24 hours in the NMP group ( P<0.01). TUNEL immunofluorescence staining indicated a tiny amount of apoptotic cells in the skeletal muscle in both groups at 0 hour, with an apoptotic index of (4.26±1.62)%. There was a small number of apoptotic cells in the skeletal muscle in the NMP group at 24 hours, with an apoptotic index of (25.94±2.69)%, significantly larger than that in the same group at 0 hour ( P<0.01). The SCS group exhibited a large number of apoptotic cells at 24 hours, with an apoptotic index of (62.97±3.22)%, significantly larger than those at 0 hour in the same group and at 24 hours in the NMP group ( P<0.01). In comparison with the SCS group at 24 hours, the amputated limbs in the NMP group showed red color in the appearance, no symptoms of ischemic muscle contracture and good joint movement despite slight edema in the subcutaneous layer. At 24 hours, the weight gain rate of the amputated limbs was (15.82±0.89)% in the NMP group, significantly higher than (0.97±0.28)% in the SCS group ( P<0.01). Conclusion:Compared with SCS, NMP with the red blood cell-containing perfusion fluid prepared with the allogeneic blood for the amputated limbs of pigs can alleviate the ischemic injury of the muscle fibers and inhibit the apoptosis of the muscle cells by sustaining stable energy and oxygen supply and balancing ion homeostasis and pH of the perfusion fluid.


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