1.Effect of Oral Sodium Butyrate on Skeletal Muscle Atrophy via The Gut-muscle Axis in Antibiotic-pretreated CT26 Tumor-bearing Mice and Its Mechanism
Shu-Ling ZHANG ; Jun-Wei WANG ; Shi-Liang HU ; Tu-Tu WANG ; Shun-Chang LI ; Jia FAN ; Jun-Zhi SUN
Progress in Biochemistry and Biophysics 2026;53(3):724-739
ObjectiveTo explore the effect of oral sodium butyrate on skeletal muscle atrophy in CT26 tumor mice through the gut microbiota-skeletal muscle axis and its potential mechanism. MethodsSixty SPF BALB/c male mice aged 8 weeks were randomly divided into a normal control group (NC, n=18) and a ABX-depleted group (ABX, n=42). The ABX mice were pretreated with a quadruple antibiotic cocktail via oral gavage (0.2 ml per administration, once daily, 6 d per week, for 2 weeks), whereas NC received an equal volume of sterile water. The quadruple antibiotic cocktail consisted of metronidazole (1 g/L), vancomycin (0.5 g/L), ampicillin (1 g/L), and gentamicin (1 g/L). Following successful pretreatment, six mice from each group were randomly selected for gut microbiota sequencing analysis and designated as the Abx group and the NC0 group, respectively. Theremaining mice in ABX were subcutaneously inoculated in the dorsum with 0.2 ml of CT26 cell suspension (at a cell density of 1×107/ml). Then these mice were randomly allocated into three subgroups: a control tumor bearing model group (0_NaB, n=12), a tumor-bearing model group receiving low-dose oral sodium butyrate (L_NaB, n=12), a tumor-bearing model group receiving high-dose oral sodium butyrate (H_NaB, n=12). And mice in NC were inoculated at the same site with 0.2 ml of normal saline. The administration dose for L_NaB was 0.3 g/(kg·d), that for H_NaB was 0.5 g/(kg·d), while NC and 0_NaB were given the same volume of normal saline (0.2ml per time, once daily, 6 d per week, for 4 weeks). The general condition of mice was monitored, and forelimb grip strength gastrocnemius muscle mass and its muscle fiber cross-sectional area were measured for each group. The structural changes in gut microbiota were assessed by 16S rRNA sequencing of cecal contents. Pathological alterations in the intestinal wall were examined via HE staining. Serum and gastrocnemius muscle levels of TNF‑α, IL-6, IL-1β, and LPS were quantified using ELISA. The protein expression of ZO-1 and occludin in the small intestine, as well as proteins associated with the TLR4/MyD88/NF-κB signaling pathway in the gastrocnemius muscle, were detected by Western blot analysis. Results(1) The alpha-diversity in Abx was significantly lower than that in NC0 (P<0.01), a significant decrease of the mass and muscle fiber cross-sectional area of the gastrocnemius (P<0.01), with the majority of gut microbiota being effectively depleted. (2) Compared with NC, the subcutaneous tumors of mice in 0_NaB were prominent, a significant increase of the mass and muscle fiber cross-sectional area of the gastrocnemius, accompanied by a significant decrease in body weight at the end of the 3th and 4th week (P<0.05), and a significant weakening of the forelimb grasping strength at the 5th and 6th week (P<0.01). Compared with 0_NaB, the tumor mass of mice in L_NaB and H_NaB showed a significant decreasing trend, and the grip strength of the forelimbs significantly increased at the 5th and 6th week (P<0.05, P<0.01). (3) Compared with 0_NaB, the Shannon and Observed species indices in α diversity of L_NaB and H_NaB were significantly increased (P<0.05). At the genus level, compared with 0_NaB, L_NaB exhibited a significant decrease in the relative abundance of Parasutterella (P< 0.01), while H_NaB showed significant reductions in the relative abundances of both Escherichia-Shigella and Parasutterella (P < 0.01). (4) Compared with 0_NaB, the small intestinal tissue structure in L_NaB and H_NaB was more intact, the infiltration of inflammatory cells was significantly reduced, and the capillaries were slightly dilated. The expression levels of ZO-1 and occludin proteins in L_NaB were significantly increased (P<0.01). (5) The LPS concentration in the gastrocnemius muscle and the protein expression levels of TLR4, MyD88, p-IκBα, and p-NF‑κB p65 in L_NaB and H_NaB were significantly lower than those in 0_NaB (P<0.05). The serum TNF‑α concentration in H_NaB and TNF-α concentration in the gastrocnemius muscle of the L_NaB and H_NaB were significantly lower than those in 0_NaB (P<0.05, P<0.01, P<0.01). ConclusionOral administration of NaB can improve gut microbiota α diversity, adjusting its composition, improving intestinal mucosal barrier function, reducing the LPS-induced pro-inflammatory response, and delaying skeletal muscle atrophy. The underlying mechanism may involve down regulation of TLR4/MyD88/NF-κB signaling in skeletal muscle.
2.Research on The Genealogical Inference Efficiency of High-density SNPs
Jing LI ; Yi-Jie SUN ; Wen-Ting ZHAO ; Zi-Chen TANG ; Jing LIU ; Cai-Xia LI
Progress in Biochemistry and Biophysics 2026;53(3):740-753
ObjectiveThis study aims to explore the potential of different orders of magnitude single-nucleotide polymorphism (SNP) locus combinations for predicting distant kinship relationships. A high-density SNP locus set was constructed, and a comprehensive assessment of its inference capability was conducted. MethodsFirstly, we selected three commercial chip panels, CGA (Chinese genotyping array, Illumina), GSA (Global screening array, Illumina), Affy (23MF_V2 high-density SNP array, Affymetrix) and merged them after quality control, forming a high-density SNP locus panel(1 180 k). Secondly, we selected 161 samples and collected their peripheral blood samples by using whole-genome sequencing technology. Within this sample population, the levels of kinship relationships fully covered the range from level 1 to level 9, and the number of kinship pairs at each level was consistently maintained at over 50 pairs. From 161 samples data of whole-genome sequencing, the 1 180 k locus set was extracted, which is referred to as the high-density SNP locus set in the following text. The kinship inference was conducted using the identity-by-descent (IBD) algorithm with the selected optimal parameters. To comprehensively evaluate the performance of the high-density SNP locus set in kinship inference, we compared it with the three commercial chip panels, the intersection of these three chip loci, and the control sets constructed by randomly reducing the number of the high-density SNP locus set. Based on the changes in the IBD lengths, as well as the dynamic trends in prediction accuracy, we conducted a scientific assessment of the kinship inference capability of the high-density SNP locus set. ResultsAfter screening, a set of 1 184 334 autosomal SNPs was obtained. During the process of screening the optimal IBD length threshold, the result revealed that 0 cM, 1 cM, and 2 cM all demonstrated good applicability. However, to avoid the issue of a large amount of redundant information caused by setting a too low IBD length threshold, this study ultimately selected 2 cM as the optimal threshold. Compared with the average results of three chip panels, the high-density SNP locus set increased the total IBD length and the average IBD length across levels 1-9; the accuracy of the confidence interval for level 8 was 70.97%, which represented a 3.50% improvement; the average confidence interval accuracy for levels 1-8 was 91.39%, representing a 1.00% increase; and the false negative rates at levels 8 and 9 were reduced by 2.42% and 6.76%, respectively. The system efficacy of the high-density SNP locus set for kinship inference of first to eighth degree relationships reached 98.91%. Through random reduction of the high-density SNP locus set results, it is found that increasing the number of SNPs with the panel, the detection efficiency of IBD length showed a significant upward trend. At the same time, the overall trend in the accuracy of kinship relationship prediction as well as the confidence interval accuracy also indicated that both metrics steadily increased with the addition of more loci. ConclusionThe results show that the high-density SNPs panel significantly enhances the efficacy of distant kinship inference, accurately covering kinship degrees, with the average confidence interval accuracy for first to eighth degree relationships stably above 90%. The study finds that increasing the number of SNPs panel can improve the ability to predict distant kinship.
3.Clinical phenotypes and pathogenic mechanisms of Wilson disease with lipid metabolism disorders
Dongjing GAO ; Ruixin WANG ; Xinhua LI
Journal of Clinical Hepatology 2026;42(3):515-521
Wilson disease (WD) is a hereditary disorder of copper metabolism characterized by abnormal copper accumulation in tissues, including the liver and brain, which leads to severe hepatic and neurological damage. This disease is often accompanied by lipid metabolism abnormalities, and the exploration of related mechanisms has attracted increasing attention. This article introduces the clinical features of lipid metabolism disorders in WD patients, summarizes the research advances in the serum levels of lipids and hepatic steatosis, analyzes the potential mechanisms of the interaction between copper and lipid metabolism, and highlights the significance of lipid-related molecules in disease diagnosis and clinical evaluation. In clinical practice, the monitoring and assessment of lipid metabolism parameters should be taken seriously in patients with WD, in order to promote comprehensive disease management and improve the prognosis of patients.
4.Application of statins in the treatment of metabolic dysfunction-associated fatty liver disease
Dandan SUN ; Ruisi LI ; Xiaoyu HU
Journal of Clinical Hepatology 2026;42(3):661-667
Metabolic dysfunction-associated fatty liver disease (MAFLD) and its progressive form metabolic dysfunction-associated steatohepatitis (MASH) have become the leading causes of chronic liver diseases worldwide, and the incidence rate of MAFLD continues to rise, which is closely associated with metabolic disorders such as obesity and type 2 diabetes. The core pathogenesis of MAFLD involves insulin resistance, abnormal lipid metabolism, and chronic inflammation, which can progress to MASH and lead to liver fibrosis, liver cirrhosis, and even hepatocellular carcinoma (HCC). At present, there are still limited effective pharmacotherapies for MAFLD. Based on the PRISMA guidelines, this article systematically reviews the role of statins in MAFLD. Studies have shown that statins not only improve blood lipid profiles and the levels of liver enzyme, but also bring good benefits to patients comorbid with cardiovascular disease or type 2 diabetes, and long-term use can also reduce the risk of HCC. However, the potential risks of hepatotoxicity and myopathy should be taken seriously, which, therefore, requires individualized medication and regular monitoring of liver function in clinical practice.
5.Differentiation and Treatment of Small Cell Lung Cancer from the Perspective of "Internal Wind in Hidden Circulation"
Shengjuan HU ; Li HOU ; Tao SUN ; Li FENG
Journal of Traditional Chinese Medicine 2026;67(9):1003-1007
Small cell lung cancer (SCLC) is characterized by rapid onset, high invasiveness, and a strong tendency for recurrence and metastasis, which aligns with the pathogenic characteristics of wind pathogen in traditional Chinese medicine (TCM). This paper explores the pathological mechanism and dynamic pattern identification and treatment of SCLC from the perspective of "internal wind in hidden circulation". It is proposed that the core pathogenesis of SCLC is rooted in depletion of healthy qi, with binding of phlegm, stasis, and toxin. When pathogenic factors become excessive, the ascending and descending of yang qi becomes disordered, transforming into wind. This leads to internal wind in hidden circulation, which moves erratically and damages healthy qi. In the limited stage, cancer toxin accumulates and internal wind arises covertly, treatment for which should focus on regulating qi and resolving toxin, defending against wind and resisting pathogen with modified Bufei Decoction (补肺汤) and Shengjiang Powder (升降散). In the early extensive stage, phlegm and stasis generate wind, and internal wind spreads through collate-rals; treatment should resolve phlegm and dispel stasis, extinguish wind and resolve toxin, with modified Lingjiao Gouteng Decoction (羚角钩藤汤) combined with Tianma Gouteng Beverage (天麻钩藤饮). During the treatment stage, there is qi and yin depletion, and deficient wind harassing the interior, for which it is recommended to boost qi and nourish yin, soften the liver and extinguish wind, with modified Zhengan Xifeng Decoction (镇肝熄风汤) combined with Qingzao Jiufei Decoction (清燥救肺汤). In the progression stage, internal wind stirs again and cancer toxin scurries; treatment should focus on strengthening the healthy qi and replenishing essence, restraining wind and penetrating toxin, with modified Sanjia Fumai Decoction (三甲复脉汤). In the terminal stage, yin and yang are on the verge of dissociation and depleted yang floats upward; treatment should constrain and astringe to prevent collapse, rescue yang and contain yin, with modified Dihuang Drink (地黄饮子) combined with Laifu Decoction (来复汤).
6.Study on the role and mechanism of SPP1+ macrophages in the formation of chronic renal allograft fibrosis
Zexin YANG ; Zeping GUI ; Junqi ZHANG ; Gang ZHANG ; Hao CHEN ; Li SUN ; Shuang FEI ; Min GU ; Zijie WANG
Organ Transplantation 2026;17(3):413-421
Objective To investigate the role and potential mechanism of secreted phosphoprotein 1 (SPP1)+ macrophages in the formation of chronic renal allograft fibrosis. Methods The expression features of SPP1+ macrophages in renal allografts of chronic allograft dysfunction (CAD) patients were analyzed based on single-cell transcriptome data of renal tissues from patients with CAD. Transcription factor VIPER analysis and DoRothEA transcription factor activity analysis were performed on the single-cell transcriptome data. Renal tissue samples were collected from kidney transplant recipients, including the CAD group (n=5) and the non-renal allograft fibrosis group (CTL group, n=5). A mouse model of chronic allograft rejection was established and divided into the allogeneic kidney transplantation group (CAD group, n=3) and the syngeneic kidney transplantation group (SYN group, n=3). Hematoxylin-eosin staining was used to detect renal tissue injury in mice, and Masson staining was used to detect renal tissue fibrosis. Immunofluorescence staining was performed to detect SPP1 expression in renal tissues of transplant recipients and mouse renal allografts. Bone marrow-derived macrophages (BMDMs) were extracted from mice and subjected to hypoxia stimulation. The expression of hypoxia-inducible factor (HIF)-1α and SPP1 was detected by Western blot, and SPP1 expression was detected by flow cytometry. BMDMs were transfected with HIF-1α overexpression plasmid and HIF-1α small interfering RNA (siRNA) followed by hypoxia intervention, and the expression of HIF-1α and SPP1 was detected by Western blot. Mouse aortic endothelial cells (MAECs) were co-cultured with the supernatant of BMDMs, and the expression of endothelial-mesenchymal transition (EndMT)-related markers was detected by Western blot and immunofluorescence. Results Single-cell transcriptome analysis showed that the proportion of SPP1+ macrophages in renal allograft tissues was significantly higher in the CAD group than in the CTL group (P<0.05). The renal injury score and the percentage of interstitial fibrotic area in the CAD group were significantly higher than those in the SYN group (both P<0.05). Immunofluorescence staining showed that the proportion of SPP1+ macrophages was increased in the CAD group compared with the CTL group, and also increased in the CAD group compared with the SYN group (both P<0.05). VIPER analysis and DoRothEA transcription factor activity analysis revealed activation of the hypoxia pathway and upregulated expression of transcription factors such as HIF-1α in SPP1+ macrophages. SPP1 expression was elevated in BMDMs under hypoxic conditions. Knockdown of HIF-1α inhibited hypoxia-induced SPP1 protein expression, whereas overexpression of HIF-1α upregulated SPP1 protein levels. After co-culture of hypoxia-induced BMDMs with MAECs, the expression levels of EndMT-related markers were increased. Conclusions SPP1+ macrophages differentiated under hypoxia are significantly infiltrated in the formation of chronic renal allograft fibrosis, and may promote renal allograft fibrosis by inducing EndMT in renal vascular endothelial cells.
7.Differentiation and Treatment of Small Cell Lung Cancer from the Perspective of "Internal Wind in Hidden Circulation"
Shengjuan HU ; Li HOU ; Tao SUN ; Li FENG
Journal of Traditional Chinese Medicine 2026;67(9):1003-1007
Small cell lung cancer (SCLC) is characterized by rapid onset, high invasiveness, and a strong tendency for recurrence and metastasis, which aligns with the pathogenic characteristics of wind pathogen in traditional Chinese medicine (TCM). This paper explores the pathological mechanism and dynamic pattern identification and treatment of SCLC from the perspective of "internal wind in hidden circulation". It is proposed that the core pathogenesis of SCLC is rooted in depletion of healthy qi, with binding of phlegm, stasis, and toxin. When pathogenic factors become excessive, the ascending and descending of yang qi becomes disordered, transforming into wind. This leads to internal wind in hidden circulation, which moves erratically and damages healthy qi. In the limited stage, cancer toxin accumulates and internal wind arises covertly, treatment for which should focus on regulating qi and resolving toxin, defending against wind and resisting pathogen with modified Bufei Decoction (补肺汤) and Shengjiang Powder (升降散). In the early extensive stage, phlegm and stasis generate wind, and internal wind spreads through collate-rals; treatment should resolve phlegm and dispel stasis, extinguish wind and resolve toxin, with modified Lingjiao Gouteng Decoction (羚角钩藤汤) combined with Tianma Gouteng Beverage (天麻钩藤饮). During the treatment stage, there is qi and yin depletion, and deficient wind harassing the interior, for which it is recommended to boost qi and nourish yin, soften the liver and extinguish wind, with modified Zhengan Xifeng Decoction (镇肝熄风汤) combined with Qingzao Jiufei Decoction (清燥救肺汤). In the progression stage, internal wind stirs again and cancer toxin scurries; treatment should focus on strengthening the healthy qi and replenishing essence, restraining wind and penetrating toxin, with modified Sanjia Fumai Decoction (三甲复脉汤). In the terminal stage, yin and yang are on the verge of dissociation and depleted yang floats upward; treatment should constrain and astringe to prevent collapse, rescue yang and contain yin, with modified Dihuang Drink (地黄饮子) combined with Laifu Decoction (来复汤).
8.Protective effect of the active component DMDD from Averrhoa carambola root on myocardial injury in diabetic mice and its correlation with the NCOA4/FTH1/ATG8 axis
Yongxin CHEN ; Yuxuan LI ; Kailei GU ; Jiajun YOU ; Xiaohan SUN ; Jing MA ; Yanping ZHOU ; Xiaojie WEI
China Pharmacy 2026;37(9):1141-1147
OBJECTIVE To investigate the protective effect of 2-dodecyl-6-methoxy-2,5-diene-1,4-cyclohexanedione (DMDD), an active component from Averrhoa carambola root, on myocardial injury in diabetic mice based on the nuclear receptor coactivator 4/ferritin heavy chain 1/autophagy-related protein 8 (NCOA4/FTH1/ATG8) axis. METHODS The successfully modeled diabetic mice were randomly divided into model group and DMDD low-, medium-, and high-dose (12.5, 25, 50 mg/kg) groups, while an additional non-modeled control group was established, with 6 mice in each group. Each group received the corresponding drug solution or an equal volume of normal saline intragastically once daily for 21 consecutive days. After the administration, the levels of fasting blood glucose (FBG), serum lactate dehydrogenase (LDH), and creatine kinase isoenzyme MB (CK-MB) were measured. Myocardial pathological changes, degree of fibrosis, and myocardial cell ultrastructure were observed. Myocardial cell death index and NCOA4 protein positive index were detected. The protein expression levels of NCOA4, FTH1, ATG8, solute carrier family 7 member 11 (SLC7A11), and glutathione peroxidase 4 (GPX4) in cardiac tissue were measured. RESULTS Compared with model group, each DMDD group showed significant alleviation of cardiac pathological injury and varying degrees of improvement in the myocardial cell ultrastructure. The FBG and serum LDH and CK-MB levels, the myocardial cell death index and NCOA4 protein positive index,the protein expression levels of NCOA4, FTH1, and ATG8 in cardiac tissue were significantly decreased ( P <0.001), while the protein expression levels of SLC7A11 and GPX4 were significantly increased ( P <0.001). CONCLUSIONS DMDD can reduce blood glucose levels, alleviate myocardial histopathological injury, and inhibit cell death in diabetic mice. The mechanism is associated with inhibiting excessive activation of the NCOA4/FTH1/ATG8 axis and reducing ferritinophagy.
9.Inhibition of Epithelial-mesenchymal Transition Mechanism in Chronic Atrophic Gastritis Rats by Banxia Xiexintang via Regulating IL-17/ERK/C/EBPβ Signaling Pathway
Wenyu WU ; Xinyu ZENG ; Hao LI ; Weiqi SUN ; Jiahui REN ; Yang YU ; Tingting ZHOU ; Aili XU ; Wei WEI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):1-10
ObjectiveThis study aimed to investigate the action mechanism by which Banxia Xiexintang (BXT) inhibits epithelial-mesenchymal transition (EMT) in chronic atrophic gastritis (CAG) rats by regulating the interleukin-17(IL-17)/extracellular regulated protein kinases(ERK)/CCAAT enhancer binding protein β(C/EBPβ)signaling pathway, thereby providing new theoretical evidence for the treatment of CAG with classic traditional Chinese medicine formulas. MethodsA CAG rat model was established by using the combined factor method. After successful modeling, the rats were randomly divided into the model group, low-, medium-, and high-dose groups (0.549, 1.098, 2.196 g·kg-1, respectively) of BXT, and the positive drug group (vitacoenzyme, 0.3 g·kg-1). A normal control group was also set up. After 8 weeks of intervention, the pathological changes of gastric tissue were evaluated. The enzyme-linked immunosorbent assay (ELISA) was used to detect the contents of IL-17, tumor necrosis factor-α (TNF-α), cyclooxygenase-2 (COX-2), and C/EBPβ in serum, as well as the contents of EMT markers in gastric mucosal tissue including E-cadherin, N-cadherin, and vimentin. The immunohistochemistry method was employed to determine the localization and protein expression levels of IL-17, p-ERK, and C/EBPβ in gastric mucosal tissue. Western blot was used to detect the protein expressions of C/EBPβ, ERK, and its phosphorylated form (p)-ERK in gastric mucosa. Real-time polymerase chain reaction (Real-time PCR) was applied to measure the mRNA expression levels of ERK, COX-2, and C/EBPβ in gastric mucosa. ResultsCompared with those in the normal control group, the rats in the model group showed gastric mucosal glandular atrophy and inflammatory cell infiltration. The protein and their related mRNA expressions of C/EBPβ, ERK, and p-ERK in gastric mucosa were significantly increased (P<0.05,P<0.01). The levels of IL-17, TNF-α, COX-2, and C/EBPβ in serum were significantly increased (P<0.01). The contents of N-cadherin and vimentin in gastric mucosal tissue were significantly increased, while the content of E-cadherin was significantly decreased (P<0.01). Compared with the model group, after intervention with different doses of BXT, the pathological damage of the gastric mucosa was improved to varying degrees. The protein and mRNA expressions of C/EBPβ, ERK, and p-ERK in gastric mucosa were significantly reduced (P<0.05,P<0.01). The levels of IL-17, TNF-α, COX-2, and C/EBP β in serum were significantly decreased (P<0.01). The contents of N-cadherin and vimentin in gastric mucosa tissue were decreased, while the content of E-cadherin was increased (P<0.05,P<0.01). ConclusionBXT can effectively improve the pathological damage of gastric mucosal tissue in CAG rats. Its action mechanism may be related to reducing the levels of IL-17 and TNF-α in serum, regulating the IL-17/ERK/C/EBPβ signaling pathway and inhibiting the EMT process.
10.Analysis of factors influencing temporary deferral and return to donation due to abnormal blood pressure in pre-donation screening
Jin YANG ; Li SUN ; Qiyong BI ; Jingyao WANG ; Yong WANG
Chinese Journal of Blood Transfusion 2026;39(1):56-61
Objective: To analyze the demographic characteristics, return donation patterns, and risk of adverse reactions among donors temporarily deferred due to blood pressure abnormalities, so as to provide an evidence-based foundation for optimizing pre-donation blood pressure screening strategies, enhancing donor retention, and ensuring blood supply safety. Methods: Data from 2.939 million donor instances were collected through the Information Management System at the Beijing Red Cross Blood Center between January 2015 and August 2025. The analysis specifically focused on the 11 600 instances of donors temporarily deferred due to abnormal blood pressure, examining demographic characteristics (age, and gender) and donation-related features (number of donations, donation site, and type of donation). Further analysis was conducted on the return donation patterns, including the return rate, time interval to return, and the incidence, type, and severity of adverse reactions among returned donors. Results: Distribution of abnormal blood pressure: Among the 11 600 instances of abnormal blood pressure, the prevalence was significantly higher in males (0.48%, 10 111/2 086 909) than in females (0.17%, 1 465/852 090). The 46-55 age group had the highest prevalence (0.88%, 2 925/329 235), and the differences across age groups were statistically significant. The prevalence was, higher among repeat donors (0.41%, 5 242/1 276 452) than first-time donors (0.38%, 6 334/1 662 547). The prevalence at mobile donation sites outside the blood center (0.06%, 350/596 104) was higher than fixed donor centers (0.50%, 10 225/2 052 290) and group donation drives (0.34%, 1 001/290 608). Return donations: A total of 19.49% (2 256 out of 11 576) deferred donors returner and successfully donated. Among these donors, 36.17% (816 out of 2 256) returned within 7 days, while the highest proportion of returns was observed within 31-182 days (25.44%, 574/2 256). A higher return rate was observed among male donors (20.17%, 2 039/1 0111) compared to female donors (14.81%, 217/1 465). The return rate for repeat donors (43.02%, 2 255/5 242) was significantly higher than that of first-time donors (0.02%, 1/6 334). Individual donors showed a higher return rate (20.95%, 1 986/9 479) than group donors (12.88%, 270/2 097), with all differences being statistically significant (P<0.05). The differences in return rates across age groups were not statistically significant (P>0.05). Adverse reactions: The incidence of adverse reactions after return was 0.09% (2/2 256), significantly lower than the overall adverse reaction incidence during the same period (0.20%, 5 981/2 938 999). Both adverse reactions were local reaction (category A1, pain or bruising at the puncture site), with no reported cases of systemic vasovagal reactions (VR) or severe adverse events. Conclusion: The current blood pressure screening criteria may lead to the unnecessary deferral of eligible donors. The risk of adverse reactions is extremely low among returned donors who were deferred for abnormal blood pressure. A relaxation of the blood pressure screening criteria is therefore suggested, coupled with the optimization of donation site environment and blood pressure measurement procedure with reference to expert consensus to enhance donor retention and blood supply safety.

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