Objective To explore the feasibility and reference value of allogeneic lung transplantation and postoperative monitoring in miniature pigs for lung transplantation research. Methods Two miniature pigs (R1 and R2) underwent left lung allogeneic transplantation. Complement-dependent cytotoxicity tests and blood cross-matching were performed before surgery. The main operative times and partial pressure of arterial oxygen (PaO₂) after opening the pulmonary artery were recorded during surgery. Postoperatively, routine blood tests, biochemical blood indicators and inflammatory factors were detected, and pathological examinations of multiple organs were conducted. Results The complement-dependent cytotoxicity test showed that the survival rate of lymphocytes between donors and recipients was 42.5%-47.3%, and no agglutination reaction occurred in the cross-matching. The first warm ischemia times of D1 and D2 were 17 min and 10 min, respectively, and the cold ischemia times were 246 min and 216 min, respectively. Ultimately, R1 and R2 survived for 1.5 h and 104 h, respectively. Postoperatively, in R1, albumin (ALB) and globulin (GLB) decreased, and alanine aminotransferase increased; in R2, ALB, GLB and aspartate aminotransferase all increased. Urea nitrogen and serum creatinine increased in both recipients. Pathological results showed that in R1, the transplanted lung had partial consolidation with inflammatory cell infiltration, and multiple organs were congested and damaged. In R2, the transplanted lung had severe necrosis with fibrosis, and multiple organs had mild to moderate damage. The expression levels of interleukin-1β and interleukin-6 increased in the transplanted lungs. Conclusions The allogeneic lung transplantation model in miniature pigs may systematically evaluate immunological compatibility, intraoperative function and postoperative organ damage. The data obtained may provide technical references for subsequent lung transplantation research.

Circadian rhythm is an endogenous biological clock mechanism that enables organisms to adapt to the earth’s alternation of day and night. It plays a fundamental role in regulating physiological functions and behavioral patterns, such as sleep, feeding, hormone levels and body temperature. By aligning these processes with environmental changes, circadian rhythm plays a pivotal role in maintaining homeostasis and promoting optimal health. However, modern lifestyles, characterized by irregular work schedules and pervasive exposure to artificial light, have disrupted these rhythms for many individuals. Such disruptions have been linked to a variety of health problems, including sleep disorders, metabolic syndromes, cardiovascular diseases, and immune dysfunction, underscoring the critical role of circadian rhythm in human health. Among the numerous systems influenced by circadian rhythm, the skin—a multifunctional organ and the largest by surface area—is particularly noteworthy. As the body’s first line of defense against environmental insults such as UV radiation, pollutants, and pathogens, the skin is highly affected by changes in circadian rhythm. Circadian rhythm regulates multiple skin-related processes, including cyclic changes in cell proliferation, differentiation, and apoptosis, as well as DNA repair mechanisms and antioxidant defenses. For instance, studies have shown that keratinocyte proliferation peaks during the night, coinciding with reduced environmental stress, while DNA repair mechanisms are most active during the day to counteract UV-induced damage. This temporal coordination highlights the critical role of circadian rhythms in preserving skin integrity and function. Beyond maintaining homeostasis, circadian rhythm is also pivotal in the skin’s repair and regeneration processes following injury. Skin regeneration is a complex, multi-stage process involving hemostasis, inflammation, proliferation, and remodeling, all of which are influenced by circadian regulation. Key cellular activities, such as fibroblast migration, keratinocyte activation, and extracellular matrix remodeling, are modulated by the circadian clock, ensuring that repair processes occur with optimal efficiency. Additionally, circadian rhythm regulates the secretion of cytokines and growth factors, which are critical for coordinating cellular communication and orchestrating tissue regeneration. Disruptions to these rhythms can impair the repair process, leading to delayed wound healing, increased scarring, or chronic inflammatory conditions. The aim of this review is to synthesize recent information on the interactions between circadian rhythms and skin physiology, with a particular focus on skin tissue repair and regeneration. Molecular mechanisms of circadian regulation in skin cells, including the role of core clock genes such as Clock, Bmal1, Per and Cry. These genes control the expression of downstream effectors involved in cell cycle regulation, DNA repair, oxidative stress response and inflammatory pathways. By understanding how these mechanisms operate in healthy and diseased states, we can discover new insights into the temporal dynamics of skin regeneration. In addition, by exploring the therapeutic potential of circadian biology in enhancing skin repair and regeneration, strategies such as topical medications that can be applied in a time-limited manner, phototherapy that is synchronized with circadian rhythms, and pharmacological modulation of clock genes are expected to optimize clinical outcomes. Interventions based on the skin’s natural rhythms can provide a personalized and efficient approach to promote skin regeneration and recovery. This review not only introduces the important role of circadian rhythms in skin biology, but also provides a new idea for future innovative therapies and regenerative medicine based on circadian rhythms.

Objective To explore the value of quantitative analysis of perirenal fat combined with Mayo adhesive probability(MAP)score in predicting the WHO/International Society of Urological Pathology(ISUP)nuclear grade of renal cell carcinoma(RCC).Methods The imaging data of 139 pathologically confirmed RCC patients were retrospectively analyzed.The patients were divided into low-grade group(grade Ⅰ-Ⅱ,n=112)and high-grade group(grade Ⅲ-Ⅳ,n=27)according to the WHO/ISUP nuclear grade.Spearman correlation analysis was used to assess the relationship between fat features and WHO/ISUP nuclear grade.The multivariate logistic regression model was used to detemine the related factors of high-grade RCC,and the area under the curve(AUC)of the receiver operating characteristic(ROC)curve was used to evaluate the diagnostic performance of each parameter.Results The AUC of perirenal adipose tissue(PAT)％alone for evaluating high-grade RCC was the highest,at 0.77[95％confidence interval(CI)0.69-0.83].The stepwise multivariate logistic regression model showed that perinephric fat stranding(PFS)[odds ratio(OR)=34.54,95％CI 7.60-156.87,P＜0.001],PAT％(OR=0.46,95％CI 0.32-0.66,P＜0.001),and tumor location(OR=0.26,95％CI 0.07-0.92,P=0.037)were related factors of high-grade RCC,with an AUC of 0.90(95％CI 0.84-0.94).Conclusion Quantitative analysis of perire-nal fat combined with MAP score can effectively predict the WHO/ISUP nuclear grade of RCC,providing a novel approach for per-sonalized treatment strategies to improve prognosis.

Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P＜0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P＞0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.

Diabetic kidney disease(DKD)is one of the common microvascular complications of diabetes mellitus,and it has become the main cause of chronic kidney disease and end stage renal disease.Traditional Chinese medicine can delay the progress of DKD by inhibiting oxidative stress,improving renal tissue damage,restoring renal function.This paper will summarize the relationship between oxidative stress and DKD and the prevention and treatment of DKD by traditional Chinese medicine,so as to provide reference for clinical drug application,basic research and new drug research and development of DKD.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Objective To observe the clinical effect of abdominal full-thickness skin graft combined with adipose stem cells in repairing soft tissue defects after resection of facial benign tumors.Methods A total of 180 patients with soft tissue defects after resection of facial benign tumor in our hospital from January 2019 to June 2022 were selected,the study was designed by a double-blind method,and patients were divided into the observation group and the control group by a random number table method,with 90 cases in each group.Patients in the control group were repaired by abdominal full-thickness skin graft treatment,while these in the observation group were repaired by a combination of abdominal full-thickness skin graft and adipose stem cells.The scar status scores in the surgical area,clinical efficacy,incidence of complications and satisfaction of patients in the two groups were compared.Results Compared with preoperative results,the scores of color and thickness of scars,vascular distribution,and softness in face 6 months after surgery in both groups decreased,with statistically significant differences(P<0.05).Six months after surgery,the observation group had significantly lower scores on scar color and thickness,vascular distribution,and softness compared to the control group(P<0.05);there was no difference in the effective rate of the forehead,nose,eyelids,lips,or cheeks between the observation group and the control group(P>0.05);while the observation group had higher overall effective rate than the control group(P<0.05).There was no statistically significant difference in the incidence of complica-tions between the two groups(P>0.05).There was statistically significant difference in the distribution of the satisfaction of patients between the two groups(P<0.05),and the observation group showed significantly higher satisfaction of patients than the control group(P<0.05).Conclusion Abdominal full-thickness skin graft combined with adipose stem cells can improve facial scars in repairing soft tissue defects after resection of facial benign tumors,and enhance the repair effects and satisfaction of patients,with high safety.

Objective To investigate the expression levels of serum exosomal LncRNA GAS5 in gastric cancer(GC)patients and eval-uate its clinical significance.Methods Seventy GC patients admitted to Henan Electric Power Hospital from January 2019 to Decem-ber 2020 and 70 age-and sex-matched healthy controls undergoing physical examination during the same period were enrolled.Their se-rum samples and clinicopathological data were collected.Additionally,cancer tissue and adjacent normal tissue specimens were ob-tained from 20 GC patients who underwent surgical resection.The expression levels of LncRNA GAS5 in tissues and serum exosomes were detected by real-time fluorescence quantitative PCR(qRT-PCR).The chemiluminescence method was used to detect the levels of serum carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9).The receiver operating characteristic(ROC)curve was used to assess the diagnostic efficacy of different detection indicators for GC.The correlations of serum exosomal LncRNA GAS5 levels with clinicopathological parameters and prognosis of GC patients were also analyzed.Results The expression levels of serum ex-osomal LncRNA GAS5 in GC patients were significantly lower than that in healthy controls(t=10.84,P＜0.001).The expression levels of LncRNA GAS5 in GC tissues were also significantly lower than that in adjacent tissues(t=14.94,P＜0.001).The analysis results of the ROC curve showed that the area under the ROC curve(AUCROC)of serum exosomal LncRNA GAS5 for the screening of GC was 0.807.When the cut-off value was 1.96,its sensitivity was 81.43%and specificity was 67.14%.The diagnostic efficacy of serum exoso-mal LncRNA GAS5 for GC was significantly better than traditional tumor markers CEA and CA19-9,and their AUCROC were 0.664 and 0.713,respectively.The analysis results of clinicopathological parameters of GC patients showed that low serum exosomal LncRNA GAS5 levels were significantly correlated with large tumor size,advanced TNM stage,and distant metastasis(P＜0.05).The overall survival time of patients with low expression of serum exosomal LncRNA GAS5 was significantly lower than that of patients with high ex-pression(median overall survival time:23 vs 35 months,P=0.03).Conclusion Serum exosomal LncRNA GAS5 in GC patients is down-regulated,which has good diagnostic efficacy for GC and is expected to become a potential biological marker for the diagnosis and prognosis evaluation of GC patients.

Objective To observe the effects of electroacupuncture(EA)on TGF-β1/Smads signaling pathway and epithelial-mesenchymal transition(EMT)related proteins in rats with neurogenic bladder(NB)after spinal cord injury;To explore the possible mechanism of EA in improving NB fibrosis.Methods Totally 36 female SD rats were randomly selected,with 10 rats in the sham-operation group and the remaining 26 rats undergoing complete transection of the spinal cord beneath the T8 vertebrae to establish a NB rat model.The modeling rats were randomly divided into model group and EA group,with 10 rats in each group.EA group was applied to"Ciliao","Zhongji"and"Sanyinjiao",20 min per time,once a day for 7 days.The general condition of the rats in each group was observed,the ultrasound index of the bladder was detected by ultrasound technique,the bladder function of the rats was detected by urodynamics,the body mass of the rats and the wet weight of the bladder were recorded,and the bladder index was calculated.HE staining was used to observe bladder tissue morphology,the degree of bladder tissue fibrosis and bladder wall thickness were detected by Masson staining.The positive expressions of E-cadherin,N-cadherin and Vimentin in bladder tissue were detected by immunohistochemistry.The protein expressions of TGF-β1,p-Smad2/3,E-cadherin,N-cadherin and Vimentin were detected by Western blot.Results Compared with the sham-operation group,the upper and lower diameter,anteroposterior diameter,transverse diameter,bladder volume of the model group significantly increased(P<0.001),the maximum bladder pressure,leak point pressure difference,perfusion time and maximum bladder capacity significantly increased(P<0.001),the bladder index increased significantly(P<0.001),the bladder epithelial cells were thickened and arranged irregularly,the bladder collagen volume fraction and bladder wall thickness significantly increased(P<0.001),the expressions of TGF-β1,p-Smad2/3,N-cadherin and Vimentin in bladder tissue increased(P<0.01),and the expression of E-cadherin decreased(P<0.001).Compared with the model group,the upper and lower diameter,anteroposterior diameter,transverse diameter,bladder volume of the EA group decreased significantly(P<0.05),the maximum bladder pressure,leak point pressure difference,perfusion time and maximum bladder capacity significantly decreased(P<0.05),the bladder index significantly decreased(P<0.05),the thickness of the bladder epithelial cell layer became thinner and arranged more neatly,and the bladder collagen volume fraction and bladder wall thickness of the bladder were significantly reduced(P<0.05),the expressions of TGF-β1,p-Smad2/3,N-cadherin and Vimentin in bladder tissue significantly decreased(P<0.05),and the expression of E-cadherin significantly increased(P<0.05).Conclusion EA may reduce the EMT of bladder epithelial cells and decrease the degree of bladder tissue fibrosis by inhibiting the activation of the TGF-β1/Smads signaling pathway,thereby improving bladder function in NB rats after spinal cord injury.

Objective To investigate the expression levels of serum exosomal LncRNA GAS5 in gastric cancer(GC)patients and eval-uate its clinical significance.Methods Seventy GC patients admitted to Henan Electric Power Hospital from January 2019 to Decem-ber 2020 and 70 age-and sex-matched healthy controls undergoing physical examination during the same period were enrolled.Their se-rum samples and clinicopathological data were collected.Additionally,cancer tissue and adjacent normal tissue specimens were ob-tained from 20 GC patients who underwent surgical resection.The expression levels of LncRNA GAS5 in tissues and serum exosomes were detected by real-time fluorescence quantitative PCR(qRT-PCR).The chemiluminescence method was used to detect the levels of serum carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9).The receiver operating characteristic(ROC)curve was used to assess the diagnostic efficacy of different detection indicators for GC.The correlations of serum exosomal LncRNA GAS5 levels with clinicopathological parameters and prognosis of GC patients were also analyzed.Results The expression levels of serum ex-osomal LncRNA GAS5 in GC patients were significantly lower than that in healthy controls(t=10.84,P＜0.001).The expression levels of LncRNA GAS5 in GC tissues were also significantly lower than that in adjacent tissues(t=14.94,P＜0.001).The analysis results of the ROC curve showed that the area under the ROC curve(AUCROC)of serum exosomal LncRNA GAS5 for the screening of GC was 0.807.When the cut-off value was 1.96,its sensitivity was 81.43%and specificity was 67.14%.The diagnostic efficacy of serum exoso-mal LncRNA GAS5 for GC was significantly better than traditional tumor markers CEA and CA19-9,and their AUCROC were 0.664 and 0.713,respectively.The analysis results of clinicopathological parameters of GC patients showed that low serum exosomal LncRNA GAS5 levels were significantly correlated with large tumor size,advanced TNM stage,and distant metastasis(P＜0.05).The overall survival time of patients with low expression of serum exosomal LncRNA GAS5 was significantly lower than that of patients with high ex-pression(median overall survival time:23 vs 35 months,P=0.03).Conclusion Serum exosomal LncRNA GAS5 in GC patients is down-regulated,which has good diagnostic efficacy for GC and is expected to become a potential biological marker for the diagnosis and prognosis evaluation of GC patients.