The technology of xenogeneic organ transplantation, as one of the core strategies to address the current contradiction between the supply and demand of transplant organs, has achieved significant breakthroughs from basic research to clinical application driven by factors such as the innovation of gene modification technology, the injection of research capital and the expansion of clinical trials, especially with the first actual clinical application of a pig heart-to-human transplant. China is also at the forefront of this field. This article intends to summarize the international research trends of xenogeneic organ transplantation (including financial support, the evolution of research stages and global clinical trial cases), and analyze the evolution and optimization of xenogeneic transplantation immunosuppression schemes, as well as the breakthroughs and unresolved scientific issues in current key clinical application technologies. The aim is to comprehensively present the progress of this field from basic research to clinical transformation, and provide references for promoting the rapid development of China's xenogeneic transplantation technology and subsequent clinical transformation and research directions.

Objective To construct and validate an interpretable machine learning model integrating contrast-enhanced venous phase CT radiomics and clinical features for preoperative prediction of central lymph node metastasis(CLNM)of papillary thyroid carcinoma(PTC).Methods A case-control study was conducted on 243 histologically confirmed PTC patients.Among them,196 patients from the First Affiliated Hospital of Army Medical University were randomly allocated into a training set(n=137)and an internal validation set(n=59)at a 7:3 ratio,while the left 47 patients from No.958 Hospital of PLA Army were assigned into an external validation set.All participants completed standardized preoperative contrast-enhanced neck CT scanning.Quantitative radiomic features were systematically extracted from venous phase CT images through an open-source big data AI platform.Six machine learning classifiers,eXtreme Gradient Boosting(XGBoost),Support Vector Machine(SVM),Random Forest(RF),Logistic Regression(LR),k-Nearest Neighbors(KNN),and Decision Tree(DT)were implemented to construct clinical-radiomics integration models.The predictive performance was quantitatively assessed through receiver operating characteristic(ROC)curve analysis,with area under the curve(AUC)values calculated for training,internal validation,and external validation sets.Model interpretability was achieved using Shapley additive explanations(SHAP)framework,with particular focus on elucidating feature contributions in the best-performing model.Results The XGBoost model had an AUC value of 0.936(95%CI:0.895～0.976),0.832(95%CI:0.724～0.941),and 0.772(95%CI:0.632～0.912)in training,internal and external validation sets,respectively.SHAP analysis revealed age as the most influential clinical predictor,with younger patients showing higher CLNM risk(OR=0.968,P=0.042).Conclusion Our machine learning-based clinic-radiomic prediction model demonstrates satisfactory performance in predicting CLNM of PTC,providing valuable references for clinical decision-making.

Objective To investigate the predictive value of a nomogram for central lymph node metastasis(CLNM)in patients with papillary thyroid microcarcinoma(PTMC)based on CT features combined with clinical factors.Methods A case-control study was conducted on 256 pathologically confirmed PTMC patients from 2 tertiary hospitals from January 2022 to November 2024.All participants underwent contrast-enhanced neck CT scanning within 2 weeks before surgery and received central lymph node dissection.The 201 patients from the First Affiliated Hospital of Army Medical University were randomized into a training set(n=140)and an internal validation set(n=61)in a 7∶3 ratio.The 55 patients from the Second Affiliated Hospital of Chongqing Medical University were all assigned into an external validation set.Their clinical data and CT features were collected.Univariate and multivariate logistic regression analyses were employed to identify independent predictive factors for CLNM,and then a nomogram model was constructed.Receiver operating characteristic(ROC)curve analysis(area under the curve,AUC),calibration curve,and decision curve analysis(DCA)were performed to evaluate the model performance,discrimination and clinical utility.Results Multivariate logistic regression analysis identified 4 independent CLNM predictors(P<0.05),that is,male(OR=5.991,95%CI:2.209～18.350),tumor size≥0.82 cm(OR=18.880,95%CI:1.803～229.500),capsular involvement(OR=9.805,95%CI:4.015～26.340),and CT-diagnosed lymph node positivity(OR=2.872;95%CI:1.176～7.232).The nomogram achieved an AUC value of 0.859(95%CI:0.796～0.922),0.786(95%CI:0.671～0.901),and 0.783(95%CI:0.648～0.917)in the training and internal and external validation sets,respectively.Calibration curves demonstrated high consistency between predicted and observed probabilities(Hosmer-Lemeshow P>0.05).DCA confirmed net clinical benefits for CLNM before surgical treatment with a threshold probability range of 0.18～0.80.Conclusion Based on sex,tumor size,capsular involvement,and CT-diagnosed lymph node metastasis,our nomogram model effectively predicts CLNM risk in PTMC patients.It can be used as a quantitative tool for personalized surgical planning and shows high clinical applicability.

Objective:To analyze the value of marginal donor livers in liver transplantation for patients with acute-on-chronic liver failure (ACLF).Methods:Clinical data of 58 patients with ACLF undergoing liver transplantation at the First Affiliated Hospital of Guangxi Medical University from January 2020 to June 2023 were retrospectively analyzed, including 33 males and 25 females, aged (40.4±14.4) years. According to the source of donor (marginal or standard), recipients were divided into the marginal group ( n=28), and standard group ( n=30). The preoperative model for end-stage liver disease (MELD) score, cold/warm ischemia time, intraoperative blood loss, postoperative tracheal intubation time, intensive care unit (ICU) stay, liver function, renal function, coagulation function, postoperative complications, and survival situation were compared between the groups. Results:The MELD score, cold/warm ischemia time, intraoperative blood loss, postoperative tracheal intubation time, length of ICU stay, alanine transaminase, aspartate transaminase, total bilirubin, serum creatinine, blood urea nitrogen, estimated glomerular filtration rate, fibrinogen, postoperative infection, primary graft nonfunction, biliary complications, and vascular complications were compared between the groups (all P>0.05). The incidence of delayed graft function (DGF) recovery was 28.6%(8/28) in marginal group, higher than that in standard group 6.7%(2/30) ( χ2=5.13, P=0.038). The one-year cumulative survival rates were 89.3% and 93.3% in marginal group and standard group, respectively ( P=0.580). Conclusion:The therapeutic effect of marginal donor liver in ACLF recipients is comparable to that of standard donor liver. The incidence of DGF is higher in recipients with marginal donor liver.

Objective:To analyze the value of marginal donor livers in liver transplantation for patients with acute-on-chronic liver failure (ACLF).Methods:Clinical data of 58 patients with ACLF undergoing liver transplantation at the First Affiliated Hospital of Guangxi Medical University from January 2020 to June 2023 were retrospectively analyzed, including 33 males and 25 females, aged (40.4±14.4) years. According to the source of donor (marginal or standard), recipients were divided into the marginal group ( n=28), and standard group ( n=30). The preoperative model for end-stage liver disease (MELD) score, cold/warm ischemia time, intraoperative blood loss, postoperative tracheal intubation time, intensive care unit (ICU) stay, liver function, renal function, coagulation function, postoperative complications, and survival situation were compared between the groups. Results:The MELD score, cold/warm ischemia time, intraoperative blood loss, postoperative tracheal intubation time, length of ICU stay, alanine transaminase, aspartate transaminase, total bilirubin, serum creatinine, blood urea nitrogen, estimated glomerular filtration rate, fibrinogen, postoperative infection, primary graft nonfunction, biliary complications, and vascular complications were compared between the groups (all P>0.05). The incidence of delayed graft function (DGF) recovery was 28.6%(8/28) in marginal group, higher than that in standard group 6.7%(2/30) ( χ2=5.13, P=0.038). The one-year cumulative survival rates were 89.3% and 93.3% in marginal group and standard group, respectively ( P=0.580). Conclusion:The therapeutic effect of marginal donor liver in ACLF recipients is comparable to that of standard donor liver. The incidence of DGF is higher in recipients with marginal donor liver.

Objective To summarize the diagnosis and treatment experience of adenine phosphoribosyltransferase deficiency after kidney transplantation. Methods Clinical data of 1 patient with adenine phosphoribosyltransferase deficiency after kidney transplantation were retrospectively analyzed. Clinical characteristics, diagnosis, treatment and prognosis of adenine phosphoribosyltransferase deficiency were summarized by literature review. Results Renal biopsy showed that salt crystallization was found in most renal tubule lumen and positive results were observed under polarized light microscopy. After allopurinol, hemodialysis and anti-crystallization treatment, the graft function was gradually recovered. After postoperative 1-year follow-up, the patient's renal function was properly recovered. Conclusions Adenine phosphoribosyltransferase deficiency after kidney transplantation may lead to delayed graft function or graft dysfunction. Early detection, diagnosis and treatment may delay disease progression and improve renal function.

OBJECTIVE To establish the HPLC fingerprint of Jianpi huayu decoction， and to determine the contents of 8 components. METHODS Thermo Hypersil Gold C18 column was used with mobile phase consisted of methanol-0.05% phosphoric acid aqueous solution （gradient elution） at the flow rate of 1.0 mL/min. The column temperature was 30 ℃， the injection volume was 5 μL. The detection wavelength of matrine was 211 nm， and the other components’ detection wavelength was 283 nm. The similarity evaluation of HPLC fingerprints for 10 batches of Jianpi huayu decoction was performed by using the Similarity Evaluation System of Chromatographic Fingerprint of Traditional Chinese Medicine （2012 edition）. The contents of chlorogenic acid， vanillic acid， p-coumaric acid， ferulic acid， hesperidin， quercetin， bergapten and matrine in the samples were determined by HPLC. RESULTS HPLC fingerprint of Jianpi huayu decoction was established. A total of 27 common peaks were identified， and 8 components were identified. The similarity between 10 batches of samples and the control map ranged from 0.942-0.999. RSDs of precision， repeatability and stability tests were less than 3% （n＝6）. The average recoveries of chlorogenic acid， vanillic acid， p-coumaric acid， ferulic acid， hesperidin， quercetin， bergapten and matrine were 99.48%， 101.32%， 101.18%， 100.79%， 101.12%， 99.19%， 99.81% and 102.46%， respectively； RSDs were 1.34%， 0.93%， 1.90%， 1.84%， 0.54%， 1.53%， 1.33% and 1.01%， respectively （n＝6）. The contents were 0.021-0.061， 0.025-0.034， 0.116-0.295， 0.006- 0.062， 0.014-0.053， 0.017-0.026， 0.014-0.027 and 14.05-24.11 mg/g， respectively. CONCLUSIONS The established fingerprint and content determination method can provide a reference for the quality control and subsequent preparation development for Jianpi huayu decoction.

Plant diterpenoids are widely distributed and abundant natural products with diverse structures and functions in nature, which have been commonly used in pharmaceutical, agricultural and industrial production. In recent years, plant diterpenoids have attracted increasing attention, including their biosynthetic pathways, transcriptional regulatory networks, and biological functions. Herein, the biosynthetic pathways of diterpenoids are summarized in a modular fashion. Further, the regulatory network between diterpene biosynthesis and environmental factors is reviewed. Insights into diterpene metabolism may drive elucidation of complex active diterpene pathways and serve as a knowledge repository for metabolic engineering and cell factory construction.
Plants, Medicinal/metabolism* ; Diterpenes/chemistry* ; Metabolic Engineering ; Biosynthetic Pathways ; Biological Products/metabolism*

Objective To investigate clinical effect of local decompression and selective interbody fusion with pedicle screw fixation technique for the treatment of degenerative lumbar scoliosis. Methods Medical records of 122 degenerative lumbar scoliosis patients were retrospectively studied. All cases were treated by selective interbody fusion,local decompression and pedicle screw fixation. Group A(L5 fusion)and group B(S1 fusion)un?derwent imaging analysis,and Suk criteria was used to evaluate the fixation,decompression,bone graft fusion. JOA scores were used to evaluate curative effect of excellent and good rate. Results There were no significant difference in operating time,blood loss and postoperative drainage volume between two groups. Follow?up period for all patients is(16.2 ± 0.8)months. X?ray revealed that Cobb′s angle on the coronal plane,the correction rate of lor?dosis and sagittal Cobb′s angle after treatment,the correction rate of lordosis in group B were better than in group A (P<0.05). There were no significant differences in intervertebral fusion rate,low back pain score of JOA and the effective rate at final follow?up between two groups(P>0.05). There was no infection or screw breakage and pulling out. The incidence rate of adjacent vertebral body disease in group A was higher than that in group B(P < 0.05). Conclusions Local decompression and selective interbody fusion with pedicle screw fixation technique for the treat?ment of degenerative lumbar scoliosis can produce satisfactory short to mid?term clinical curative effect.

OBJECTIVETo explore the effect of lentivirus-mediated shRNA interference of Cx26 on epithelial-mesenchymal transition (EMT) and invasion of highly invasive human hepatocellular carcinoma cells in vitro.

METHODSSK-Hep-1 cells were infected with the lentivirus for delivering Cx26 shRNA, and the stably transfected cells were selected by puromycin. The interference efficiency of shRNA-Cx26 was assessed with real-time PCR and Western blotting. The morphological changes of the transfected SK-Hep-1 cells were observed microscopically, and the protein expressions of E-cadherin and vimentin were detected using Western blotting. The effect of Cx26 interference on the invasiveness of SK-Hep-1 cells was determined by Transwell invasion assay.

RESULTSCompared with SK-Hep-1 cells infected with empty EGFP vector and uninfected cells, the cells transfected with shRNA-Cx26 showed significantly reduced mRNA and protein expressions of Cx26 (P<0.01), which resulted in obvious morphological conversion from mesenchymal cells to epithelial cells. shRNA-Cx26-transfected cells showed significantly increased E-cadherin protein expression (P<0.01) but decreased vimentin expression (P<0.01) with obviously attenuated invasive ability in vitro (P<0.01).

CONCLUSIONTargeted down-regulation of Cx26 expression can inhibit the EMT and invasion of SK-Hep-1 cells in vitro.

Cadherins ; metabolism ; Carcinoma, Hepatocellular ; pathology ; Cell Line, Tumor ; Connexin 26 ; Connexins ; genetics ; metabolism ; Down-Regulation ; Epithelial-Mesenchymal Transition ; Genetic Vectors ; Humans ; Lentivirus ; Liver Neoplasms ; pathology ; RNA, Messenger ; RNA, Small Interfering ; Real-Time Polymerase Chain Reaction ; Transfection ; Vimentin ; metabolism