1.Research progress and clinical challenges in immunosuppressive regimens for xenotransplantation
Yu ZHANG ; Kun WANG ; Xuyuan ZHU ; Yuxiang CHEN ; Tao LI ; Xiaojie MA ; Hongtao JIANG
Organ Transplantation 2026;17(1):28-35
As a pivotal strategy to alleviate the shortage of organ donors, xenotransplantation has achieved remarkable advances in both pre-clinical and clinical studies in recent years, driven by continuous optimization of gene modification techniques and immunosuppressive regimens. Nevertheless, clinical translation still confronts formidable challenges, including rejection and heightened infection risks, which severely compromise long-term graft survival. Consequently, the role of immunosuppressive regimens in xenotransplantation has become increasingly prominent. This article summarizes the mechanisms underlying xenogeneic immune rejection, the latest developments in immunosuppressive regimens, cutting-edge strategies for inducing immune tolerance and the major hurdles facing clinical xenotransplantation. It delves into potential optimization strategies and directions for future clinical research, aiming to offer theoretical insights and practical guidance for the safe and effective application of clinical xenotransplantation.
2.Application of optimized combination prediction model in the prediction of hand, foot and mouth disease
Weijie TIAN ; Qian GAO ; Kun YANG ; Zhirong ZHAO ; Jian CHEN
Journal of Public Health and Preventive Medicine 2026;37(1):58-62
Objective To explore scientific and accurate prediction methods for the incidence of hand, foot, and mouth disease in the post-pandemic era, and to address modeling challenges caused by abnormal fluctuations in case numbers from 2020 to 2023. Methods The seasonal index was used to pre-process the data. The traditional seasonal autoregressive integrated moving average (SARIMA) model, singular spectrum analysis (SSA)-ARIMA model, ARIMA-Long short-term memory (LSTM) model, and SSA-ARIMA-LSTM model were used to fit the incidence from 2013 to 2023, and the incidence of hand, foot and mouth disease in 2024 was predicted. The real data collected in 2024 were used as the test set to compare the prediction performance of the models. Results The fitting performance of the constructed models was as follows: the ARIMA model had MAE=107.50 and RMSE=144.53, the SSA-ARIMA model showed MAE=2.84 and RMSE=4.33, the ARIMA-LSTM model achieved MAE=99.46 and RMSE=131.59, and the SSA-ARIMA-LSTM model had MAE=96.35 and RMSE=132.13. In terms of prediction performance, the ARIMA model resulted in MAE=151.64 and RMSE=146.70, the SSA-ARIMA model demonstrated MAE=41.22 and RMSE=57.01, the ARIMA-LSTM model yielded MAE=220.75 and RMSE=257.89, and the SSA-ARIMA-LSTM model recorded MAE=58.83 and RMSE=72.06. Conclusion The SSA-ARIMA model has the best fitting degree and the highest prediction accuracy, and is suitable for predicting the incidence trend of hand, foot and mouth disease.
3.Research on the Correlation Between "Tiangui (天癸)" and Female Reproductive Genetic Diseases
Kun MA ; Ling WANG ; Lihua SUN
Journal of Traditional Chinese Medicine 2026;67(9):1027-1032
This article further reveals the significance of "tiangui (天癸)" in female reproductive genetic diseases by analyzing the core influence of the "kidney-tiangui-chong and ren mai (冲任)-uterus" reproductive axis on the processes of birth, growth, robustness, and aging in females. Approaching tiangui through its heredity, material basis, temporality, rhythmicity, functional diversity and genetic polymorphism, and integrating reproductive genetics with epigenetics, it explores the potential associations between the characteristics of tiangui and the pathogenesis, clinical features, and therapeutic targets of female reproductive genetic diseases. This study furnishes a novel genetic interpretation of the physiological and pathological features of tiangui, offering scientific basis for the integrated prevention and treatment of female reproductive genetic diseases with traditional Chinese and western medicine.
4.Overcoming organ shortage: key clinical application technology breakthroughs and future prospects in xenogeneic organ transplantation
Junze CHEN ; Cheng ZHANG ; Yongyuan JIAN ; Kun DONG ; Shuaijun MA ; Chunqiang DONG
Organ Transplantation 2026;17(3):393-404
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.
5.Research on the Correlation Between "Tiangui (天癸)" and Female Reproductive Genetic Diseases
Kun MA ; Ling WANG ; Lihua SUN
Journal of Traditional Chinese Medicine 2026;67(9):1027-1032
This article further reveals the significance of "tiangui (天癸)" in female reproductive genetic diseases by analyzing the core influence of the "kidney-tiangui-chong and ren mai (冲任)-uterus" reproductive axis on the processes of birth, growth, robustness, and aging in females. Approaching tiangui through its heredity, material basis, temporality, rhythmicity, functional diversity and genetic polymorphism, and integrating reproductive genetics with epigenetics, it explores the potential associations between the characteristics of tiangui and the pathogenesis, clinical features, and therapeutic targets of female reproductive genetic diseases. This study furnishes a novel genetic interpretation of the physiological and pathological features of tiangui, offering scientific basis for the integrated prevention and treatment of female reproductive genetic diseases with traditional Chinese and western medicine.
6.Imaging Measurement of the Safe Distances of Acupuncture at Fengfu (GV 16) in Children Aged 4 to 8 Based on CT Three-Dimensional Reconstruction
Kun LI ; Tianyi WANG ; Xing WANG ; Zhijun LI ; Peng WU ; Yang YANG ; Yunteng HAO ; Hailong ZHAO ; Yuan MA ; Shaojie ZHANG
Journal of Traditional Chinese Medicine 2026;67(14):1523-1527
ObjectiveTo measure the distance from the surface of Fengfu (GV 16) to the deep important bony structures in children aged 4 to 8 years based on CT three-dimensional reconstruction technology, thereby providing imaging reference data for clinical acupuncture safe operations in terms of different age groups and needle insertion angles. MethodsCervical CT image data were collected from healthy children aged 4 to 8 years with five age groups (4-, 5-, 6-, 7-, 8-year-old groups), 20 cases in each group. The images were imported into Mimics 21.0 software for three-dimensional reconstruction. The straight-line distances from the skin model surface of the Fengfu (GV 16) to the first underlying bony barrier (such as the lower edge of the occipital bone, the posterior arch of the atlas vertebra) were measured at intervals of 5° on both the transverse section (0° ± 35°) and the sagittal section (40° upward to 40° downward on the diagonal). The correlation between the measured distance, age, and angle was analyzed. ResultsIn the transverse and sagittal sections, the measured distance from the skin surface to the underlying bone of Fengfu (GV 16) at each angle increased with age. In the transverse section, the increase was relatively small within the 0° to 20° angle range, whereas a more pronounced increase was observed when the angle exceeded 20°; at measurement angles of 30° to 35°, the distance of the skin surface to the bone at Fengfu (GV 16) in the 7- and 8-year-old groups was significantly greater than that in the 4-year-old group (P<0.05). In the sagittal section, the measured distance from the skin surface to the bone at Fengfu (GV 16) was shortest and changed greatly at oblique upward angles of 15° to 40° within each age group, and increased markedly at near-vertical angles of 0° to 10°; it was longest at oblique downward angles of -40° to -5° and showed relatively gradual changes. ConclusionThis study obtained the imaging distance data from Fengfu (GV 16) to the surrounding bony structures in children aged 4 to 8 years through three-dimensional modeling, finding that this distance has clear age and angle dependence, which can provide quantitative evidence for developing individualized and precise safe acupuncture schemes at Fengfu (GV 16) in pediatric clinical practice.
7.Imaging Measurement of the Safe Distances of Acupuncture at Fengfu (GV 16) in Children Aged 4 to 8 Based on CT Three-Dimensional Reconstruction
Kun LI ; Tianyi WANG ; Xing WANG ; Zhijun LI ; Peng WU ; Yang YANG ; Yunteng HAO ; Hailong ZHAO ; Yuan MA ; Shaojie ZHANG
Journal of Traditional Chinese Medicine 2026;67(14):1523-1527
ObjectiveTo measure the distance from the surface of Fengfu (GV 16) to the deep important bony structures in children aged 4 to 8 years based on CT three-dimensional reconstruction technology, thereby providing imaging reference data for clinical acupuncture safe operations in terms of different age groups and needle insertion angles. MethodsCervical CT image data were collected from healthy children aged 4 to 8 years with five age groups (4-, 5-, 6-, 7-, 8-year-old groups), 20 cases in each group. The images were imported into Mimics 21.0 software for three-dimensional reconstruction. The straight-line distances from the skin model surface of the Fengfu (GV 16) to the first underlying bony barrier (such as the lower edge of the occipital bone, the posterior arch of the atlas vertebra) were measured at intervals of 5° on both the transverse section (0° ± 35°) and the sagittal section (40° upward to 40° downward on the diagonal). The correlation between the measured distance, age, and angle was analyzed. ResultsIn the transverse and sagittal sections, the measured distance from the skin surface to the underlying bone of Fengfu (GV 16) at each angle increased with age. In the transverse section, the increase was relatively small within the 0° to 20° angle range, whereas a more pronounced increase was observed when the angle exceeded 20°; at measurement angles of 30° to 35°, the distance of the skin surface to the bone at Fengfu (GV 16) in the 7- and 8-year-old groups was significantly greater than that in the 4-year-old group (P<0.05). In the sagittal section, the measured distance from the skin surface to the bone at Fengfu (GV 16) was shortest and changed greatly at oblique upward angles of 15° to 40° within each age group, and increased markedly at near-vertical angles of 0° to 10°; it was longest at oblique downward angles of -40° to -5° and showed relatively gradual changes. ConclusionThis study obtained the imaging distance data from Fengfu (GV 16) to the surrounding bony structures in children aged 4 to 8 years through three-dimensional modeling, finding that this distance has clear age and angle dependence, which can provide quantitative evidence for developing individualized and precise safe acupuncture schemes at Fengfu (GV 16) in pediatric clinical practice.
8.Prediction of Hepatosplenic Hemodynamics Combined with Clinical Features Based on Dual-Energy CT for Esophageal Varices at High Risk of Cirrhosis
Jiewen CHEN ; Weikang HUANG ; Liyang YANG ; Kun MA ; Tingting CAI ; Ge WEN
Chinese Journal of Medical Imaging 2025;33(3):292-297
Purpose To explore the predictive value of hepatosplenic hemodynamic indexes obtained by dual-energy CT combined with clinical features in non-invasive assessment of high-risk esophageal varices(EV)in cirrhosis.Materials and Methods We retrospectively collected 93 patients with cirrhosis from March 2022 to May 2023 in Zengcheng Branch of Nanfang Hospital.All patients underwent epigastric enhanced energy spectrum scan and gastroscopy.EV severity as assessed by gastroscopy(none,EV0;mild,EV1;medium,EV2;severe,EV3)were divided into low-risk EV group(EV0 and EV1)and high-risk EV group(EV2 and EV3).Age,gender,Child-Pugh grade,ascites and platelet of the two groups were collected,and dual-energy CT parameters including liver and spleen volume,mean iodine content in liver and spleen and liver and spleen iodine volume were measured.The difference of parameters between the low-risk EV and the high-risk EV group were analyzed,and the model was constructed by Logistic regression analysis.Receiver operating characteristic curve was used to evaluate the diagnostic performance of the model for high-risk EV.Results There were significant differences in age,Child-Pugh grade,ascites,platelet,liver and spleen volume,liver and spleen iodine volume between low-risk EV and high-risk EV groups(Z/χ2=-5.921-16.343,all P<0.05).Ascites,platelet,liver and spleen volume,liver and spleen iodine volume were included in multivariate regression analysis to construct regression models,and the results showed that spleen iodine volume(OR=1.002,P<0.001),ascites(OR=5.319,P=0.009),platelet(OR=0.99,P=0.062)were independent risk factors for predicting the high risk of EV.Hosmer-Lemeshow test showed that the regression model fit the observed values well(P=0.303),with accuracy of 83.9%,sensitivity of 78.6%,specificity of 88.2%,positive prediction rate of 84.6%and negative prediction rate of 83.3%.The area under the curve of this regression model was 0.894.Conclusion Spleen iodine content based on dual-energy CT,platelet and ascites can noninvasively predict high-risk EV.
9.Effects of Hedysarum polybotrys polysacchcaide on FXR-FGF19 signal pathway in diabetes rats
Lei ZHANG ; Sheng-fang WAN ; Ya-ling LI ; Qian-kun LIANG ; Yi-hong TIAN ; Xin-xin MA ; Qian GUO
The Chinese Journal of Clinical Pharmacology 2025;41(1):76-80
Objective To study the effects of Hedysarum polysaccharides polysaccharide(HPS)on the farnesoid X receptor(FXR)-fibroblast growth factor-19(FGF19)signaling pathway of diabetes rats.Methods Twelve Wistar male rats were randomly selected as the normal group,and the other rats were fed with a single intraperitoneal injection of streptozotocin(50 mg·kg-1 STZ)and a high sugar and high-fat diet to replicate the diabetes rat model.Model rats were randomly divided into model group,positive control group(given 400 mg·kg-1·d-1 suspension of Bifidobacterium quadruplex live bacterial tablets by gavage),experimental-H,-M,-L groups(given 200,100,and 50 mg·kg-1·d-1 doses of HPS suspension by gavage);normal group,and model group were given equal volume of purified water by gavage once a day for 8 consecutive weeks.Glucose(Glu)was detected by a blood glucose meter;and serum total glyceride(TG)and total cholesterol(TC)were detected by enzyme-linked immunosorbent assay reagent kit;the expressions of FXR、fibroblast growth factor receptors 4(FGFR4)relative mRNA expression level and protein were detected by real-time fluorescence quantitative polymerase chain reaction method and Western blot.Results The Glu concentrations in the normal group,model group,positive control group,and experimental-H groups were(7.66±0.61),(29.25±1.64),(23.31±3.02)and(19.31±5.13)mmol·L-1,respectively;the TG content were(957.00±113.73),(1 345.00±246.44),(958.00±96.53)and(964.00±130.22)μmol·L-1,respectively;the TC content were(161.65±4.53),(302.19±5.35),(236.09±5.14)and(165.58±2.58)μmol·L-1,respectively;the expression of FXR relative mRNA expression level were 1.00±0.06,0.48±0.02,0.67±0.04 and 0.92±0.04,respectively;the expression of FGFR4 relative mRNA expression level were 1.00±0.04,0.17±0.01,0.48±0.04 and 0.41±0.03;respectively.The above indexes of the model group were compared with the control group,and the above indexes of the control group and the experimental-H group were compared with the model group,and the differences were statistically significant(all P<0.01).Conclusion HPS improves blood sugar,lowers blood lipids,and protects liver and intestinal tissues,possibly by regulating the FXR-FGF19 signaling pathway in intestinal tissue,and regulating bile acid synthesis.
10.Efficacy observation of pelvic floor autologous fascia integrated repair based on membrane anatomy for complete rectal prolapse
Zhibiao MEI ; Yongli CAO ; Bingbing LV ; Siyuan WANG ; Kun TIAN ; Qingli LIU ; Linzi MA ; Yunshuai WANG ; Dong WEI
Chinese Journal of Gastrointestinal Surgery 2025;28(12):1441-1447
Objective:To compare the clinical efficacy of laparoscopic pelvic floor autologous fascia integral repair based on membrane anatomy versus transperineal proctosigmoidectomy (Altemeier procedure) in the treatment of patients with complete rectal prolapse (CRP).Methods:This study employed a retrospective observational cohort design. Clinical data were collected from a total of 55 CRP patients who underwent surgical treatment between January 2018 and July 2023, including 25 patients from Luoyang Central Hospital, affiliated with Zhengzhou University, and 30 patients from the 989th Hospital of the Joint Logistics Support Force & Military Anorectal Surgery Research Institute. All patients undergoing surgery met the following criteria: aged ≥ 18 years, rectal prolapse protruding outside the anus, prolapse length > 5 cm with inability to self-reduce, conforming to the diagnostic criteria for CRP, and being first-time treated patients. Twenty-seven patients who underwent the Altemeier procedure between January 2018 and March 2021 were assigned to the Altemeier group; 28 patients who underwent laparoscopic pelvic floor autologous fascia integral repair based on membrane anatomy between April 2021 and July 2023 were assigned to the integral repair group. The therapeutic efficacy differences between the two groups were analyzed and compared, including the CRP length (DCRP), Wexner Constipation Score, Wexner Fecal Incontinence Score, and Gastrointestinal Quality of Life Index (GIQLI) before surgery and at 6, 12, and 24 months after surgery, as well as postoperative complications and recurrence at 24 months after surgery.Results:There were no statistically significant differences between the two groups in terms of gender distribution, age, preoperative body mass index (BMI), defecation frequency, DCRP, Wexner Constipation Score, Wexner Fecal Incontinence Score, and GIQLI (all P>0.05). All patients completed the surgery. The length of hospital stay and intraoperative blood loss in the integral repair group were significantly less than those in the Altemeier group (both P<0.01). At 6, 12, and 24 months after surgery, the DCRP, Wexner Constipation Score, Wexner Fecal Incontinence Score, and GIQLI in both groups significantly improved compared with the preoperative values (all P<0.001). At 6, 12, and 24 months after surgery, the CRP treatment effect, Wexner Constipation Score, Wexner Fecal Incontinence Score, and GIQLI in the integral repair group were significantly better than those in the Altemeier group (χ2=15.821, P<0.001; χ2=18.238, P<0.001; χ2 = 12.558, P=0.001; and χ2 =22.413, P<0.001, respectively). In the integral repair group, 4 patients (14.3%) developed grade I-III postoperative complications, including 2 cases of urinary retention, 1 case of anastomotic bleeding, and 1 case of anastomotic stenosis. In the Altemeier group, 11 patients (40.7%) developed grade I-III postoperative complications, including 4 cases of urinary retention, 3 cases of anastomotic bleeding, 1 case of anastomotic stenosis, 2 cases of intestinal fistula, and 1 case of fecal incontinence. The difference between the two groups was statistically significant (χ2=4.850, P=0.028). There was no recurrence of CRP in the integral repair group at 24 months after surgery, while 7 cases of CRP recurrence were observed in the Altemeier group at 24 months after surgery. The difference between the two groups was statistically significant (χ2=6.148, P=0.013). Conclusion:The autologous fascia repair technique based on membrane anatomy and the pelvic floor integral theory is superior to the transperineal Altemeier procedure in the treatment of CRP. Furthermore, it is an effective surgical method for CRP.


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