Objective To systematically analyze the literature characteristics of Journal of Organ Transplantation since its inception. Methods Using the China National Knowledge Infrastructure (CNKI) academic journal full-text database as the data source, all articles published in the Journal of Organ Transplantation from January 2010 to August 2025 were retrieved. After excluding non-academic papers, a total of 1 568 research papers were included. R language 4.3.0, Bibliometrix package 3.2.1, and Citespace software were used to analyze the number of publications, publishing institutions, authors, keywords and other aspects. Results The number of publications in Journal of Organ Transplantation increased from an average of 82 articles per year in the early years after its inception to 113 articles per year in recent years, a growth of 37.8%. The geographical distribution of publishing institutions covers 32 provinces, cities and autonomous regions nationwide, mainly concentrated in the South China, East China and North China regions, and has now basically covered the central and western regions in recent years. The author collaboration network includes 45 authors distributed across 7 major collaboration clusters, forming a stable multi-level national research system centered on key university-affiliated hospitals. The high-frequency keywords are dominated by "liver transplantation" (425 times) and "kidney transplantation" (396 times). The theme evolution shows a clear three-stage characteristic: initially focusing on clinical technology application, deepening to immune mechanism exploration in the middle stage, and recently (since 2022) focusing on cutting-edge research areas such as xenotransplantation. Conclusions Journal of Organ Transplantation has witnessed the rapid development of China's organ transplantation cause, fully reflecting the research status and trends in China's organ transplantation field, and has provided an important platform for the future development and international cooperation in China's organ transplantation field.

ObjectiveTo construct a large language model （LLM）-based intelligent pre-consultation system for traditional Chinese medicine （TCM） to improve efficacy of clinical practice. MethodsA TCM large language model was fine-tuned using DeepSpeed ZeRO-3 distributed training strategy based on YAYI 2-30B. A weighted undirected graph network was designed and an agent-based syndrome differentiation model was established based on relationship data extracted from TCM literature and clinical records. An agent collaboration framework was developed to integrate the TCM LLM with the syndrome differentiation model. Model performance was comprehensively evaluated by Loss function， BLEU-4， and ROUGE-L metrics， through which training convergence， text generation quality， and language understanding capability were assessed. Professional knowledge test sets were developed to evaluate system proficiency in TCM physician licensure content， TCM pharmacist licensure content， TCM symptom terminology recognition， and meridian identification. Clinical tests were conducted to compare the system with attending physicians in terms of diagnostic accuracy， consultation rounds， and consultation duration. ResultsAfter 100 000 iterations， the training loss value was gradually stabilized at about 0.7±0.08， indicating that the TCM-LLM has been trained and has good generalization ability. The TCM-LLM scored 0.38 in BLEU-4 and 0.62 in ROUGE-L， suggesting that its natural language processing ability meets the standard. We obtained 2715 symptom terms， 505 relationships between diseases and syndromes， 1011 relationships between diseases and main symptoms， and 1 303 600 relationships among different symptoms， and constructed the Agent of syndrome differentiation model. The accuracy rates in the simulated tests for TCM practitioners， licensed pharmacists of Chinese materia medica， recognition of TCM symptom terminology， and meridian recognition were 94.09%， 78.00%， 87.50%， and 68.80%， respectively. In clinical tests， the syndrome differentiation accuracy of the system reached 88.33%， with fewer consultation rounds and shorter consultation time compared to the attending physicians （P＜0.01）， suggesting that the system has a certain pre- consultation ability. ConclusionThe LLM-based intelligent TCM pre-diagnosis system could simulate diagnostic thinking of TCM physicians to a certain extent. After understanding the patients' natural language， it collects all the patient's symptom through guided questioning， thereby enhancing the diagnostic and treatment efficiency of physicians as well as the consultation experience of the patients.

Objective:To explore the expressions of calcium-activated chloride channel protein 1(ANO1)and E-cadherin in colorectal cancer(CRC)tissue and their relationships with the clinicopathological characteristics of the CRC patients,and to clarify their clinical significances.Methods:The surgical tissue specimens from 77 patients with primary CRC were collected.Immunohistochemistry(IHC)method was used to detect the protein expressions of ANO1 and E-cadherin in CRC tissue;Spearman correlation analysis method was used to analyze the correlation between their expressions;PCR fluorescence probe method was used to detect the KRAS/NRAS mutations in CRC tissue;chi-square test or Fisher's exact probability method was used to analyze the relationships between the expressions of ANO1 and E-cadherin and clinicopathological characteristics of the CRC patients.Results:The IHC results showed that the positive expression rate of ANO1 in CRC tissue was 24.7％,and the positive expression rate of E-cadherin was 63.6％.The Spearman analysis results showed that the expressions of ANO1 and E-cadherin in CRC tissue were positively correlated(r=0.458,P<0.05).Compared with the patients with tumor located in rectum,the positive expression rate of ANO1 in cancer tissue of the CRC patients with tumor located in colon was significantly increased(χ2=5.499,P=0.019);compared with the patients with TNM stageⅢ-Ⅳ,the positive expression rate of ANO1 in cancer tissue of the CRC patients with TNM stageⅠ-Ⅱ was significantly increased(χ2=4.774,P=0.029);compared with the patients with lymphnode metastasis,the positive expression rate of ANO1 in the CRC patients without lymphnode metastasis was significantly increased(P=0.034).Compared with the CRC patients with T4 stage,the positive expression rate of E-cadherin in the CRC patients with T1-T3 stage was significantly increased(P=0.024).Compared with the CRC patients with p53 positive,Ki-67≥90％,PMS2 positive and KRAS wild-type,the positive expression rate of ANO1 in cancer tissue of the CRC patients with p53 negative,Ki-67<90％,PMS2 negative and KRAS mutant was significantly increased(P=0.031,P=0.036,P=0.048,P=0.028).Conclusion:The expressions of ANO1 and E-cadherin in primary CRC tissue of the patients are positively correlated;ANO1 and E-cadherin are associated with multiple clinicopathological characteristics of the patients;ANO1 and E-cadherin may be involved in the occurrence and progression of CRC.

Glutamate-ammonia ligase (GLUL, also known as glutamine synthetase) is a crucial enzyme that catalyzes ammonium and glutamate into glutamine in the ATP-dependent condensation. Although GLUL plays a critical role in multiple cancers, the expression and function of GLUL in gastric cancer remain unclear. In the present study, we have found that the expression level of GLUL was significantly lower in gastric cancer tissues compared with adjacent normal tissues, and correlated with N stage and TNM stage, and low GLUL expression predicted poor survival for gastric cancer patients. Knockdown of GLUL promoted the growth, migration, invasion and metastasis of gastric cancer cells in vitro and in vivo, and vice versa, which was independent of its enzyme activity. Mechanistically, GLUL competed with β-Catenin to bind to N-Cadherin, increased the stability of N-Cadherin and decreased the stability of β-Catenin by alerting their ubiquitination. Furthermore, there were lower N-Cadherin and higher β-Catenin expression levels in gastric cancer tissues compared with adjacent normal tissues. GLUL protein expression was correlated with that of N-Cadherin, and could be the independent prognostic factor in gastric cancer. Our findings reveal that GLUL stabilizes N-Cadherin by antagonizing β-Catenin to inhibit the progress of gastric cancer.

BACKGROUND:At present,many drugs used in the treatment of polycystic ovary syndrome are super-designated drugs,and the treatment of patients with polycystic ovary syndrome still faces great challenges.Studies have shown that human umbilical cord mesenchymal stem cells can repair ovarian function,but few studies have reported their therapeutic effect on polycystic ovary syndrome. OBJECTIVE:To investigate the therapeutic effect of human umbilical cord mesenchymal stem cells on polycystic ovary syndrome,and to preliminarily explore the correlation between mitochondrial autophagy and the improvement of polycystic ovary syndrome by human umbilical cord mesenchymal stem cells. METHODS:Polycystic ovary syndrome mouse model was established by subcutaneous injection of dehydroepiandrosterone for 20 days into C57BL/6J mice.Human umbilical cord mesenchymal stem cells(2×106)were injected through the caudal vein.After treatment,vaginal secretions were collected for 10 consecutive days to detect the estrus cycle of mice.At 2 weeks after treatment,the levels of sex hormones in the peripheral blood of mice,including luteinizing hormone and follicle-stimulating hormone,were detected by ELISA.Hematoxylin-eosin staining was used to evaluate ovarian histopathology.Finally,mitochondrial autophagy in ovaries was observed by transmission electron microscopy. RESULTS AND CONCLUSION:(1)After human umbilical cord mesenchymal stem cell therapy,follicles at different stages(primitive follicles,primary follicles,and secondary follicles)appeared in the ovary of polycystic ovary syndrome mice,and luteal tissue could be seen,indicating that ovulation function of mice was effectively improved.(2)Polycystic ovary syndrome mice treated with human umbilical cord mesenchymal stem cells had sex hormone levels.(3)Untreated polycystic ovary syndrome mice were found to be in the estrous stage for a long time,lacking estrous interphase and estrous phase,but after human umbilical cord mesenchymal stem cell therapy,the estrous cycle returned to a normal level.(4)After treatment with human umbilical cord mesenchymal stem cells,the mitochondrial autophagy of polycystic ovary syndrome mice was significantly reduced.(5)The results show that human umbilical cord mesenchymal stem cells can effectively improve the symptoms of endocrine disorders and promote ovulation in polycystic ovary syndrome mice,which may be related to the inhibition of mitochondrial autophagy.

Objective To explore the bidirectional causal relationships between periodontitis and asthma using the two-sample Mendelian randomization(MR)method to provide a basis for exploring the etiology and formulating preven-tive and therapeutic measures of periodontitis and asthma.Methods We performed two-sample bidirectional Mende-lian randomization analysis using publicly released European genome-wide association studies(GWAS)statistics for periodontitis(n=34 615)and asthma(n=408 422).The inverse variance weighted(IVW)method was employed as the main approach to estimate the bidirectional causal relationships between periodontitis and asthma.In addition,weighted median(WM),MR-Egger regression,maximum likelihood,and Mendelian randomization robust adjusted profile score(MR-RAPS)were used as supplementary analyses.Sensitivity analyses were conducted using Cochran's Q test,Mende-lian randomization pleiotropy residual sum and outlier(MR-PRESSO),and leave-one-out analysis.Results A total of 12 and 43 single-nucleotide polymorphisms(SNPs)were included as instrumental variables for periodontitis and asthma,respectively.The results of IVW,WM,MR-Egger regression,maximum likelihood,and MR-RAPS showed that periodon-titis was not causally related to the risk of asthma(IVW:OR:1.003,95%CI:0.973-1.035,P=0.828,WM:OR:0.990,95%CI:0.951-1.031,P=0.641;MR-Egger regression:OR:0.988,95%CI:0.960-1.028,P=0.573;maximum likeli-hood:OR:1.003,95%CI:0.972-1.035,P=0.834;MR-RAPS:OR:1.002,95%CI:0.970-1.036,P=0.890)among the European population,and no causal effect of asthma on periodontitis was found(IVW:OR:1.021,95%CI:0.938-1.111,P=0.633,WM:OR:1.011,95%CI:0.894-1.142,P=0.866;MR-Egger regression:OR:1.042,95%CI:0.824-1.319,P=0.731;maximum likelihood:OR:1.021,95%CI:0.938-1.112,P=0.631;MR-RAPS:OR:1.017,95%CI:0.931-1.110,P=0.713)among the European population.Cochran's Q test showed no heterogeneity among the included in-strumental variables,MR-PRESSO test found no horizontal pleiotropy,and the leave-one-out method did not identify out-lier SNPs.Conclusion The results of this study,based on European genetic data,do not support a bidirectional causal association between periodontitis and asthma in the European population.

Objective:To evaluate the efficacy of modified femoral neck osteotomy(mFNO)in the surgical treatment of patients with ankylosing spondylitis(AS)and severe spinal kyphosis combined with hip flexion contracture.Methods:A retrospective analysis was conducted on 61 AS patients(103 hips)with spinal kyphosis and hip flexion contracture who underwent pedicle subtraction osteotomy(PSO)and total hip arthroplasty(THA)from January 1,2019 to November 15,2023.Data on mFNO operation time,blood loss,preoperative and postoperative values of the angle of the trunk and lower limb(ATL),hip passive range of motion(ROM),visual analogue scale(VAS),and incidence of in-hospital compli-cations were recorded.Statistical analysis was performed using paired-samples t test.P＜0.05 was con-sidered statistically significant.Results:The study ultimately included 10 cases,9 males and 1 female,with an average age of(41.30±9.03)years.These patients underwent surgery for a total of 52 times,including 19 hips both receiving mFNO and THA,and 14 times PSO.The average operation time for nine bilateral mFNO was(133.11±34.81)min,with blood loss of(433.33±187.10)mL.A unilateral mFNO took 60 min with 200 mL of blood loss.The preoperative ATL of 19 hips was 40.37°±13.66°,and the postoperative ATL value was 88.47°±12.46°(P＜0.05).The preoperative VAS score was 0,while the postoperative VAS score was 5.95±1.51(P＜0.05).The preoperative hip extension ROM was 37.37°±18.13°,while the postoperative hip extension ROM was-4.95°±21.24°(P＜0.05).Hip flexion ROM improved from 37.37°±18.13° to 50.79°±20.36° after FNO(P＜0.05).There were three cases of in-hospital complications(3/52,5.67％):One case of postoperative atelectasis fol-lowing PSO(1/52,1.92％),one greater trochanter fracture identified during THA(1/52,1.92％),and one early dislocation post-THA(1/52,1.92％).Conclusion:mFNO significantly improves the ATL in AS patients with severe spinal kyphosis combined with hip flexion contracture,facilitating PSO and THA surgeries.

Hepatocellular carcinoma(HCC)is one of the leading causes of cancer-related deaths in the world.Due to the insidious onset and rapid progression and a lack of effective treatments,the prognosis of patients with HCC is extremely poor,with the average 5-year survival rate being less than 10%.The tumor microenvironment(TME),the internal environment in which HCC develops,can regulate the oncogenesis,development,invasion,and metastasis of HCC.During the process of cancer progression,HCC cells can regulate the biological behaviors of tumor cells,cancer-associated fibroblasts,cancer-associated immune cells,and other cells in the TME by releasing exosomes containing specific signals,thereby promoting cancer progression.However,the exact molecular mechanisms and the roles of exosomes in the specific cellular regulation of these processes are not fully understood.Herein,we summarized the TME components of HCC,the sources and the biological traits of exosomes in the TME,and the impact of mechanical factors on exosomes.In addition,special attention was given to the discussion of the effects of HCC-exosomes on different types of cells in the microenvironment.There are still many difficulties to be overcome before exosomes can be applied as carriers in clinical cancer treatment.First of all,the homogeneity of exosomes is difficult to ensure.Secondly,exosomes are mainly administered through subcutaneous injection.Although this method is simple and easy to implement,the absorption efficiency is not ideal.Thirdly,exosome extraction methods are limited in number and inefficient,making it difficult to prepare exosomes in large quantities.It is important to ensure that exosomes are used in sufficient quantities to trigger an effective tumor immune response,especially for exosome-mediated tumor immunotherapy.With the improvement in identification,isolation,and purification technology,exosomes are expected to be successfully used in the clinical diagnosis of early-stage HCC and the clinical treatment of liver cancer.

Objective:To analyze the cardiac dosimetry of lymph node irradiation in the internal breast region after left-sided breast cancer surgery and to assess its impact on patients' quality of life.Methods:The clinical data of 108 patients who underwent inverse intensity modulated radiotherapy (IMRT) after left-sided breast cancer surgery in Cancer Hospital of Nantong University from May 2019 to May 2021 were collected and retrospectively analyzed, and divided into a study group (with internal breast, 55 cases) and a control group (without internal breast, 53 cases) according to whether the postoperative radiotherapy included lymph node irradiation in the internal breast region. The dosimetric indexes of planned target area (PTV) , cardiac tolerance, serum myocardial injury markers and quality of life before and after radiotherapy were compared between the two groups.Results:In terms of PTV dosimetry, the conformality index (CI) of the study group and the control group were 0.73±0.07 and 0.75±0.08, the homogeneity index (HI) were 0.17±0.03 and 0.17±0.02, the D max were (55.69±1.02) Gy and (55.46±1.13) Gy, the D mean were (50.54±0.23) Gy and (50.48±0.21) Gy respectively, there were no statistically significant differences ( t=1.38, P=0.169; t<0.01, P>0.999; t=1.11, P=0.269; t=1.41, P=0.160) . In terms of cardiac receptivity, the D mean of the two groups were (5.93 ± 0.32) Gy, (5.64 ± 0.30) Gy, V 40 were (0.47 ± 0.10) %, (0.41 ± 0.11) %, and V 30 were (2.48 ± 0.51) %, (2.06 ± 0.49) % respectively, and there were statistically significant differences ( t=4.86, P<0.001; t=2.97, P=0.004; t=4.36, P<0.001) . The levels of serum troponin Ⅰ (cTnⅠ) before radiotherapy in the study group and the control group were (0.09±0.02) ng/ml and (0.09±0.01) ng/ml, creatine kinase isoenzyme MB (CK-MB) were (0.27±0.08) U/L and (0.25±0.08) U/L, myoglobin (MYo) were (3.84±1.02) μg/L and (3.69±0.97) μg/L, and brain natriuretic peptide (BNP) were (172.35±16.24) pg/ml and (169.81±15.93) pg/ml respectively, there were no statistically significant differences ( t<0.01, P>0.999; t=1.30, P=0.197; t=0.78, P=0.436; t=0.82, P=0.414) . One month after radiotherapy, the levels of serum cTnⅠ in the two groups were (0.09±0.03) ng/ml and (0.09±0.02) ng/ml, CK-MB were (0.29±0.09) U/L and (0.28±0.08) U/L, MYo were (4.06±1.08) μg/L and (4.01±1.03) μg/L, and BNP were (175.13±17.09) pg/ml, (172.47±16.28) pg/ml respectively, there were no statistically significant differences ( t<0.01, P>0.999; t=0.61, P=0.544; t=0.25, P=0.806; t=0.83, P=0.410) . The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) scores before radiotherapy in the study and the control groups were (60.24±5.13) points and (61.19±5.46) points, (74.12±7.20) points and (75.35±7.88) points at 1 month after radiotherapy, (77.53±7.14) points and (78.95±7.08) points at 6 months after radiotherapy, and (75.02±6.93) points and (76.68±6.74) points at 1 year after radiotherapy respectively, there were no statistically significant differences ( t=0.93, P=0.353; t=0.85, P=0.399; t=1.04, P=0.302; t=1.26, P=0.210) . The EORTC QLQ-C30 scores at 1 month, 6 months, and 1 year after radiotherapy were higher than those before radiotherapy in the two groups, and there were statistically significant differences (all P<0.001) . Conclusion:IMRT containing lymph node irradiation in the internal breast region after left breast cancer surgery brings a certain degree of increased cardiac dose, but it is feasible to control it within a certain range and does not affect the patients' cardiac function or quality of life in the short term.

Objective:To study the molecular phylogeny and virulence gene profile of Francisella salimarina. Methods:Phylogenetic analysis of Francisella salimarina was performed based on the global genome data of related Francisella species on GenBank database. The consistency in phylogenetic analysis based on single marker genes (such as 16S rRNA gene, rpoB gene and mdh gene) and the core genome as compared. Virulence genes and antibiotic resistance genes were annotated using the virulence factor database (VFDB) and the Comprehensive Antibiotic Resistance Database (CARD), respectively. The virulence of Francisella salimarina was analyzed with a Galleria mellonella (greater wax moth) infection model using Francisella philomiragia ATCC 25015 T as reference strain. Results:The phylogenetic analysis revealed that Francisella salimarina was closely related to Francisella philomiragia. The phylogenetic tree based on mdh gene was highly similar to that based on the core genome. Francisella salimarina could be differentiated from other related species by 16S rRNA gene or mdh gene, with the latter being more accurate. Eight Francisella salimarina strains carried multiple virulence genes, mainly involved in secretion, adhesion, immune regulation, motility and stress survival. Moreover, beta-lactam resistance gene blaFPH was identified in all eight strains. Francisella salimarina showed high lethality in the Galleria mellonella infection model, which was similar to Francisella philomiragia ATCC 25015 T. Conclusions:Francisella salimarina was a rare pathogen with similar pathogenicity to Francisella philomiragia. The mdh gene could be used as a molecular target for rapid identification of Francisella salimarina.