Lung transplantation is currently the only recognized effective treatment for end-stage lung disease and has improved the quality of life for patients. However, lung transplantation still faces many challenges, including rejection, infection, post-transplant acute kidney injury, post-transplant diabetes mellitus, ischemia-reperfusion injury and donor shortage, etc. Chinese lung transplantation scholars made a series of important progress in the field of clinical research in 2024, focusing on the study and solution of the above problems, and providing new ideas for lung transplantation surgery. This article systematically reviews the clinical research and technological innovation in the field of lung transplantation in 2024, summarizes the achievements of clinical research in the field of lung transplantation in China in 2024, and aims to providing new directions and strategies for future research.

Lung transplantation is the optimal treatment for end-stage lung diseases and can significantly improve prognosis of the patients. However, postoperative complications such as infection, rejection, ischemia-reperfusion injury, and other challenges (like shortage of donor lungs) , limit the practical application of lung transplantation in clinical practice. Chinese research teams have been making continuous efforts and have achieved breakthroughs in basic research on lung transplantation by integrating emerging technologies and cutting-edge achievements from interdisciplinary fields, which has strongly propelled the development of this field. This article will comprehensively review the academic progress made by Chinese research teams in the field of lung transplantation in 2024, with a focus on the achievements of Chinese teams in basic research on lung transplantation. It aims to provide innovative ideas and strategies for key issues in the basic field of lung transplantation and to help China's lung transplantation cause reach a higher level.

Amino acid metabolism plays a critical role in the progression and development of breast cancer. Cancer cells, including those in breast cancer, reprogram amino acid metabolism to meet the demands of rapid proliferation, survival, and immune evasion. This includes alterations in the uptake and utilization of amino acids, such as glutamine, serine, glycine, and arginine, which provide essential building blocks for biosynthesis, energy production, and redox homeostasis. Notably, the metabolic phenotypes of breast cancer cells vary across molecular subtypes and disease stages, emphasizing the need for patient stratification and personalized therapeutic strategies. Advances in multi-level diagnostics, including phenotyping and predictive tools, such as AI-based analysis and body fluid profiling, have highlighted the potential for tailoring treatments to individual metabolic profiles. Enzymes, such as glutaminase and serine hydroxymethyltransferase, often upregulated in breast cancer, represent promising therapeutic targets. Understanding the interplay between amino acid metabolism and breast cancer biology, alongside the integration of personalized medicine approaches, can uncover novel insights into tumor progression and guide the development of precision therapies. This review explores the metabolic pathways of amino acids in breast cancer, with a focus on their implications for personalized treatment strategies.
Humans ; Breast Neoplasms/therapy* ; Female ; Amino Acids/metabolism*

Objective:To explore the influencing factors of hemodialysis (HD) initiation in non-diabetic kidney disease (NDKD) patients with predialysis arteriovenous fistula (AVF) creation.Methods:This was a single-center prospective cohort study. The NDKD patients undergoing predialysis AVF creation were enrolled at the First Affiliated Hospital of Xi'an Jiaotong University from 2015 to 2018. According to the estimated glomerular filtration rate (eGFR, the Chronic Kidney Disease Epidemiology Collaboration equation) and age, patients were divided into different subgroups, eGFR: group 1 [eGFR<10 ml·min -1·(1.73 m 2) -1], group 2 [ eGFR between 10 to 15 ml·min -1·(1.73 m 2) -1], and group 3 [eGFR > 15 ml·min -1·(1.73 m 2) -1]; age: age ≥65 years group and age <65 years group. The primary outcome was defined as the initiation of HD within 1 year after AVF surgery. The second outcome was the use of AVF access at the time of HD initiation. Cox proportional hazard regression was performed to identify which demographic and clinical factors were associated with the initiation of HD after AVF surgery. Logistic regression analysis was performed to investigate factors associated with AVF use at the initiation of HD. Results:A total of 220 patients were enrolled, with age of (48.1±16.2) years, of which 143(65.0%) were males. Overall, the clinical parameters of eGFR, cystatin C, serum albumin, 24h-Urine protein, serum phosphorus were as follows respectively, 7.7 (6.6,9.2) ml·min -1·(1.73 m 2) -1, (3.93±1.12) mg/L, (36.0±4.0) g/L, (2.22±1.36) g, (1.71±0.53) mmol/L. The proportion of patients initiating HD within 6 months ( Fisher=6.832, P=0.020) and the level of hemoglobin ( F=3.112, P=0.047) were higher in group 3 compared to the other two eGFR groups. While the median time interval between AVF creation and HD initiation ( H=6.295, P=0.043) was shorter in group 1. In age <65 years group, the level of serum albumin ( t=2.076, P=0.039), triglyceride ( t=1.995, P=0.048) were higher compared with age ≥65 years group; interestingly, the proportion of patients initiated HD within 3 months ( χ2=4.033, P=0.045) and 6 months ( χ2=5.012, P=0.025) were lower in age <65 years group. The median time interval between AVF creation and HD initiation among these patients was 84 (49,174) days. The patients initiating HD within 3 months, 6 months, and 1 year after AVF creation were 112 (50.9%), 152 (69.1%), and 202 (91.8%), respectively. Multivariate Cox regression analysis indicated that higher cystatin C level ( HR=1.283, 95% CI 1.121-1.469, P<0.001) was associated with earlier HD initiation within 1 year of AVF surgery in NDKD patients. AVF usage was accomplished in 64.3% of patients who initiated HD within 90 days, the ratio was 100.0% in those initiated HD between 91 to 180 days, and 88.0% in those ≥181 days after AVF surgery. No factor was independently associated with AVF use at HD initiation identified by multivariate logistic regression analyses in patients with NDKD. Conclusion:Serum cystatin C level is associated with HD initiation within 1 year of the predialysis AVF creation in NDKD patients.

ObjectiveTo study the effect and mechanism of Linggui Zhugantang in treating chronic bronchitis （CB） induced by exposure to cigarette smoke combined with tracheal instillation of lipopolysaccharide （LPS）. MethodSixty SPF-grade SD rats were randomly divided into normal， model， dexamethasone （1 mg·kg^-1）， and high-， medium-， and low-dose （30.06， 15.03， 7.515 g·kg^-1， respectively） Linggui Zhugantang groups by the body weight stratification method， with 10 rats in each group. Each group was administrated with 200 μL LPS （1 g·L^-1） by tracheal instillation on days 1 and 14， respectively， while the normal group was administrated with an equal volume of normal saline. Except the normal group， the other groups were exposed to cigarette smoke on days 2-13 and 15-30 （10 cigarettes/time/30 min， twice/day） for the modeling of CB. The rats were administrated with corresponding drugs by gavage for 30 consecutive days from day 2 of modeling， and the mental status， behavior， and body weights of the rats were observed and measured. The wet/dry mass ratio （W/D） of the left lung was measured 30 days after modeling. Hematoxylin-eosin staining was employed to observe the pathological changes in the lung and bronchial tissues. The bronchial mucus secretion and goblet cell proliferation were observed by Alcian blue-periodic acid Schiff （AB-PAS） staining. The levels of mucin 5AC （MUC5AC）， interleukin （IL）-13， IL-6， and tumor necrosis factor （TNF）-α in the serum were determined by enzyme-linked immunosorbent assay. The expression of phospholipase A2 （PLA2）， transient receptor potential vanilloid receptor 1 （TRPV1）， and transient receptor potential ankyrin 1 （TRPA1） in the lung tissue was quantitatively analyzed by immunohistochemistry and Western blot. ResultCompared with the normal group， the model group showcased abnormal mental status and behaviors， bloody secretion in the nose and mouth， the mortality rate of 40%， decreased body weight， severe lung bronchial structure damage， a large number of inflammatory mediators and inflammatory cell infiltration in the tube wall， hyperemia， edema， and fibroplasia， massive proliferation of goblet cells， excessive secretion and accumulation of mucus， stenosis and deformation of the lumen， and aggravation of pulmonary edema （P<0.01）. In addition， the model group had higher levels of MUC5AC， IL-13， IL-6， and TNF-α in the serum and higher expression of PLA2 in the lung tissue than the normal group （P<0.01）. Compared with the model group， the medication groups showed normal mental status and behaviors， reduced mortality rate， stable weight gain， reduced lung and bronchial injuries， decreased goblet cell proliferation and mucus secretion， and alleviated pulmonary edema （P<0.01）. Furthermore， Linggui Zhugantang lowered the levels of MUC5AC， IL-13， IL-6， and TNF-α in the serum and down-regulated the protein levels of PLA2， TRPV1， and TRPA1 in the lung tissue （P<0.01）. ConclusionLinggui Zhugantang can reduce the pulmonary inflammation and airway mucus hypersecretion in the rat model of chronic bronchitis. It may exert the effects of reducing inflammation and resolving phlegm by regulating the PLA2-TRPV1/TRPA1 pathway.

Objective:To explore the effects of infusion of irritant medications on the patients with midline catheter based on propensity score matching method and provide reference for medications infusion through midline catheter.Methods:Through a retrospective cohort study, the clinical data of 1 539 patients with midline catheter placement in Sir Run Run Shaw Hospital, Zhejiang University School of Medicine from March 2019 to October 2022 were retrospectively analyzed, and the patients were divided into irritant medications group ( n=1 120) and non-irritant medications group ( n=419) according to the characteristics of the medications they were infused with, and then compared the patients of the two groups with midline catheter-related complications and catheter indwelling time based on the propensity score matching. Results:Among 1 539 patients, there were 656 males and 883 females, aged 18-92 (59.30 ± 18.76) years old. Before propensity score matching, there were statistically significant differences in age: (58.09 ± 18.72) years old, (62.55 ± 18.50) years old; hypertension:496 cases, 210 cases; diabetes:266 cases, 129 cases; white blood cell count:7.50(5.50, 9.70) × 10 9/L, 7.00(5.10, 9.50) × 10 9/L between the irritant medications group and non-irritant medications group ( t=4.18, χ2=4.18, 7.92, Z=-1.98, all P<0.05). After propensity score matching, there were 412 patients in the irritant medications group and 412 patients in the non-irritant medications group, and there was no significant difference in the general data between the two groups (all P>0.05). After propensity score matching, the rates of oozing, bleeding, catheter occlusion, catheter-related thrombosis, catheter dislodgement and total catheter complications between the two groups showed no statistically significant difference (all P>0.05). The catheter indwelling time in the irritant medications group was 10.00 (5.25, 16.75) days, which was longer than that in the non-irritant medications group for 6.00 (4.00, 11.00) days, the difference was statistically significant ( Z=-7.25, P<0.05). Conclusions:Infusion of irritant medications has no effect on the outcome of midline catheter, but monitoring and catheter maintenance should be strengthened in order to reduce the occurrence of cutheter related complications.

The increasing focus and research on ectopic fat deposition, especially the locally impactful liver and cardiac fat, have been extensively studied. However, there has been relatively less research on renal sinus fat. The increased ectopic deposition of renal sinus fat has an independent effect on renal damage, but the underlying mechanism remains unclear. Therefore, this article will integrate current research to provide a comprehensive review of renal sinus ectopic fat deposition, covering its related imaging diagnosis, potential mechanisms influencing renal damage (mechanical pressure generated by renal sinus fat, lipotoxicity), and current interventions for renal sinus ectopic fat deposition. This is aimed at attracting more attention in clinical research to the role of renal sinus ectopic fat deposition in the occurrence and development of kidney-related diseases.

Objective:To conduct a phased summary and analysis of the operation and quality control (QC) of the first human milk bank (HMB) in East China over a ten-year period.Methods:Data on the operation of the HMB at Women's Hospital of Nanjing Medical University, characteristics of donors and recipients, clinical application of donated milk, and operational costs from August 1, 2013, to July 31, 2023, were collected, organized, analyzed, and described. Quality and safety management of the HMB began in 2016, with QC measures implemented. Chi-square tests were used to compare data related to the operation of the HMB, donors, and recipient infants before QC (2013-2015) and after QC (2016-2023). Results:Over the ten-year period since its establishment, the HMB received donor human milk (DHM) from 1 974 donors, totaling 9 390.41 liters. The qualification rate of donors was 86.47% (1 707/1 974), with a qualification rate of DHM of 98.01% (9 203.21/9 390.41) and 21 757 donation instances, with the highest individual donation count reaching 195 times. In the past 10 years, due to the epidemic of the new coronavirus in 2020, the number of milk donors, the amount of DHM and the total number of milk donations decreased significantly, but the amount of DHM per capita and the number of milk donations per capita showed a continuous upward trend. Compared to the period before QC, the qualification rate of donors [96.75% (1 253/1 295) vs. 66.86% (454/679), χ 2=340.33, P<0.001] and the qualification rate of DHM [98.19% (8 366.76/8 521.08) vs. 96.22% (836.45/869.33), χ 2=16.33, P<0.001] both improved after QC. A total of 11 197 recipients received 6 615.38 liters of DHM, with a utilization rate of 71.88% (6 615.38/9 203.21). The current operation mode of the HMB is "voluntary donation, free use". Over ten years, the costs for consumables, testing, labor, energy, and fixed assets amounted to 9.36 million CNY, with an operational cost of 996.32 CNY per liter (9.36 million/9 390.41 L) and approximately 1.00 CNY per milliliter of DHM. Conclusions:The hospital's HMB has been operating stably for ten years, and abundant DHM benefits many newborns. QC measures have effectively increased the qualification rates of both donors and DHM, providing better nutritional support for the treatment of critically ill infants. However, the operational costs of the HMB are relatively high, necessitating the exploration of an operational model suitable for China's national conditions.

Objective:Postdoctoral researchers in Chinese universities commonly face a high risk of mental health issues,such as depression,yet the underlying causes and mechanisms remain unclear.This study aims to explore the influence of childhood socioeconomic status(SES)on depression among postdoctoral researchers and the mediating roles of current subjective SES and perceived stress in this process. Methods:An online survey was conducted among postdoctoral researchers at a university.The survey included a general information questionnaire,the Childhood Socioeconomic Status Scale,the Subjective Socioeconomic Status Scale,the Perceived Stress Scale,and the Patient Health Questionnaire.A total of 505 valid responses were collected.Pearson correlation analysis was used to analyze the data,and the PROCESS macro was employed for chain mediation analysis. Results:Childhood SES was significantly positively correlated with current subjective SES(P<0.05)and significantly negatively correlated with postdoctoral tenure,perceived stress,and depression(all P<0.05).Current subjective SES was significantly negatively correlated with perceived stress and depression(both P<0.05),while perceived stress was significantly positively correlated with depression(P<0.05).The chain mediation effect of childhood SES → current subjective SES → perceived stress → depression was significant(P<0.05). Conclusion:Childhood socioeconomic status can influence depression among postdoctoral researchers through the mediating roles of current subjective socioeconomic status and perceived stress.These findings provide a target for the prevention and intervention of depression in postdoctoral populations and offer a reference for the development of mental health promotion strategies for young university faculty.

Objective To analyze the values of peripheral blood red blood cell distribution width(RDW),neutrophil(NEU)to lymphocyte(LYM)ratio(NLR),fibrinogen(FIB)to albumin(ALB)ratio(FAR)and surfactant protein A(SP-A)in evaluating patient condition and risks of acute exacerbation of COPD.Methods A total of 200 patients with COPD admitted to Hebei University Affiliated Hospital from January 2021 to December 2023 were selected as study subjects.All the patients had follow-up visits in the outpatient department within the past three months.According to the presence or absence of acute exacerbation,they were divided into exacerbation group(n=96)and non-exacerbation group(n=104).Meanwhile,50 healthy volunteers were assigned to a control group.Peripheral blood RDW,NEU,LY,FIB,ALB and SP-A in the three groups were compared.NLR and FAR were cal-culated.The correlation of RDW,NLR,FAR,and SP-A with the severity of AECOPD was analyzed.ROC curves were used to analyze the values of RDW,NLR,FAR,and SP-A in evaluating the risks of acute exacerbation of COPD.Multivariate logistic regression analysis was conducted to identify the risk factors for AECOPD.The differences in RDW,NLR,FAR,and SP-A were compared among the patients with different prognoses.Results Peripheral blood RDW,NEU,NLR,FIB,FAR and SP-A were higher in the exacerbation group than in the non-exacerbation group,whereas LYM and ALB were lower(P<0.05).Levels of RDW,NLR,FAR and SP-A were higher in the patients with grade Ⅲ AECOPD than those with grade Ⅱ or grade Ⅰ AECOPD(P<0.05).RDW,NLR,FAR,SP-A,and grade of patient condition in patients with AECOPD were positively correlated in pairs(P<0.05).The sensitivity,specificity and area under the ROC curve of combined prediction of AECOPD using RDW,NLR,FAR and SP-A were 0.798 and 0.830(95%CI:0.738～0.922),all of which were superior to prediction using a single indicator.Multivariate analysis found that smoking,RDW>14.33%,NLR>2.80,FAR>0.08,and SP-A>2.21 ng/mL were risk factors for acute exacerbation of COPD(P<0.05).RDW,NLR,FAR,and SP-A in the readmission group within 30 days after discharge were higher than those in the non-readmission group(P<0.05).Conclusions RDW,NLR,FAR,and SP-A are closely related to the patient condition of COPD,and can help to predict the risk of acute exacerbation and prognosis.Therefore,they are worthy of monitoring in clinical practice.