1.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.
2.Application of marginal donor livers in liver transplantation for patients with acute-on-chronic liver failure
Kun DONG ; Cheng ZHANG ; Junze CHEN ; Guanmiao CHEN ; Yongyuan JIAN ; Ruiling SU ; Kaiyong HUANG ; Xuelin TAN ; Chunqiang DONG ; Hongwei YANG
Chinese Journal of Hepatobiliary Surgery 2025;31(2):81-86
Objective:To analyze the value of marginal donor livers in liver transplantation for patients with acute-on-chronic liver failure (ACLF).Methods:Clinical data of 58 patients with ACLF undergoing liver transplantation at the First Affiliated Hospital of Guangxi Medical University from January 2020 to June 2023 were retrospectively analyzed, including 33 males and 25 females, aged (40.4±14.4) years. According to the source of donor (marginal or standard), recipients were divided into the marginal group ( n=28), and standard group ( n=30). The preoperative model for end-stage liver disease (MELD) score, cold/warm ischemia time, intraoperative blood loss, postoperative tracheal intubation time, intensive care unit (ICU) stay, liver function, renal function, coagulation function, postoperative complications, and survival situation were compared between the groups. Results:The MELD score, cold/warm ischemia time, intraoperative blood loss, postoperative tracheal intubation time, length of ICU stay, alanine transaminase, aspartate transaminase, total bilirubin, serum creatinine, blood urea nitrogen, estimated glomerular filtration rate, fibrinogen, postoperative infection, primary graft nonfunction, biliary complications, and vascular complications were compared between the groups (all P>0.05). The incidence of delayed graft function (DGF) recovery was 28.6%(8/28) in marginal group, higher than that in standard group 6.7%(2/30) ( χ2=5.13, P=0.038). The one-year cumulative survival rates were 89.3% and 93.3% in marginal group and standard group, respectively ( P=0.580). Conclusion:The therapeutic effect of marginal donor liver in ACLF recipients is comparable to that of standard donor liver. The incidence of DGF is higher in recipients with marginal donor liver.
3.Trends in mortality and life loss of gastric cancer in Wenzhou City from 2014 to 2023
YE Zhenmiao ; FAN Lihui ; JIANG Xuexia ; ZHENG Yuhang ; ZHANG Mohan ; LUO Yongyuan ; XIE Yimin ; LI Huijun ; JIN Xi
Journal of Preventive Medicine 2025;37(3):267-271
Objective:
To investigate the trends in mortality and life loss of gastric cancer in Wenzhou City, Zhejiang Province from 2014 to 2023, so as to provide the evidence for formulating the prevention and control strategy for gastric cancer.
Methods:
The surveillance on causes of death data of permanent residents in Wenzhou City were collected through the Wenzhou Chronic Disease Monitoring and Management Information System from 2014 to 2023. The crude mortality of gastric cancer was calculated, and standardized by the data from the Sixth Chinese National Population Census in 2010. The life loss were measured using potential years of life lost (PYLL) and rate of potential years of life lost (PYLLR). The characteristics of mortality and life loss of gastric cancer in different genders and age groups were described. The trends in mortality and PYLLR of gastric cancer were analyzed using the average annual percent change (AAPC).
Results:
Totally 17 080 deaths were reported due to gastric cancer in Wenzhou City from 2014 to 2023, accounting for 12.58% and ranking third in the order of malignant tumor deaths. The crude mortality of gastric cancer was 20.73/105, and the standardized mortality was 15.22/105, showing decreasing trends (AAPC=-3.311%, -6.470%, both P<0.05). The crude mortality of gastric cancer was 29.22/105 in men and 11.61/105 in women, with standardized mortality rates of 20.81/105 and 8.74/105 (both P<0.05). The crude mortality of gastric cancer appeared a tendency towards a rise with increasing age (P<0.05), reaching the highest rate of 225.88/105 in the group aged 80 to <85 years. The PYLL and PYLLR of gastric cancer were 107 607.50 person-years and 1.37‰. The PYLLR appeared a tendency towards a decline from 2014 to 2023, with AAPC of -6.667% (P<0.05).
Conclusions
The mortality and PYLLR of gastric cancer in Wenzhou City appeared a tendency towards a decline from 2014 to 2023. Men and the elderly populations were the key groups for the prevention and treatment of gastric cancer.
4.Trends in death and life lost due to falls among the elderly in Wenzhou City from 2015 to 2023
LI Huijun ; YE Zhenmiao ; FAN Lihui ; ZHENG Yuhang ; XIE Yimin ; JIANG Xuexia ; GAO Haojun ; ZHANG Mohan ; LUO Yongyuan
Journal of Preventive Medicine 2025;37(5):460-464
Objective:
To investigate the trends in mortality and life loss due to falls among the elderly in Wenzhou City, Zhejiang Province, so as to provide the basis for formulating prevention and control measures for falls among the elderly.
Methods:
The data on fall-related deaths among the elderly aged 60 and above in Wenzhou City were collected through the Wenzhou Chronic Disease Monitoring and Management Information System from 2015 to 2023. The crude mortality was calculated and standardized using the data from the Sixth National Population Census in 2010. The life loss were measured using potential years of life lost (PYLL), average years of life lost (AYLL), and potential years of life lost rate (PYLLR). The trends in mortality and life loss among the elderly were analyzed using the annual percent change (APC) and average annual percent change (AAPC).
Results:
There were 11 378 deaths due to falls among the elderly in Wenzhou City from 2015 to 2023, with a crude mortality of 82.67/100 000 and a standardized mortality of 65.32/105, which appeared no significant changing trend (AAPC=3.401%、2.995%,both P>0.05). There was a tendency towards a rise from 2019 to 2023 (APC=12.592%、11.507%, both P<0.05). The majority of falls occurred at home, with 6 312 cases accounting for 55.48%. The primary types of fall-related deaths were slips, trips, and falls on the same level, with 8 541 cases representing 75.07%. The crude mortality and standardized mortality of falls in males were 76.63/105 and 60.86/105, which were lower than that in females at 88.72/100 000 and 70.33/100 000 (both P<0.05), and the trends were consistent with the overall population. The crude mortality of falls among the elderly increased with age (P<0.05). From 2015 to 2023, the crude mortality of falls among the elderly aged 60 to <65 years showed an upward trend (AAPC=4.860%, P<0.05), while no significant trend was observed in other age groups (all P>0.05). The PYLL was 5 123 person-years, the AYLL was 0.45 years per person, and the PYLLR was 0.37‰. From 2015 to 2023, PYLL showed an upward trend (AAPC=5.477%, P<0.05). The PYLL, AYLL, and PYLLR for males were 3.08 times, 3.48 times, and 2.67 times those of females, respectively.
Conclusions
From 2015 to 2023, the mortality of falls among the elderly in Wenzhou City had remained relatively stable. However, PYLL showed an upward trend. Males and older seniors were key groups for falls prevention. It is recommended to enhance health education and promote age-friendly home modifications to prevent falls among the elderly.
5.Association between overweight, obesity, central obesity and hypertension
YE Zhenmiao ; ZHANG Mohan ; FAN Lihui ; XIE Yimin ; JIANG Xuexia ; ZHENG Yuhang ; LUO Yongyuan ; XIA Zhezheng ; JIN Xi ; SUN Qian
Journal of Preventive Medicine 2025;37(11):1113-1118
Objective:
To investigate the association between overweight, obesity, central obesity and hypertension, so as to provide the basis for formulating targeted hypertension prevention and control strategies.
Methods:
Permanent residents aged ≥18 years were selected in Wenzhou City, Zhejiang Province from June 2023 to August 2024 by a multistage cluster random sampling method. Data on demographic information, lifestyle, height, weight, waist circumference (WC), blood pressure, and blood biochemical indicators were collected through questionnaire surveys, physical examinations, and laboratory tests. The prevalence of hypertension was calculated and standardized using the data of the Sixth National Population Census in 2010. Body mass index (BMI) was calculated to determine overweight and obesity, while WC was used to identify central obesity. The association between overweight, obesity, central obesity and hypertension were analyzed using multivariable logistic regression models.
Results:
A total of 38 593 residents were surveyed, including 19 481 (50.48%) males and 19 112 (49.52%) females. The median age was 46.00 (interquartile range, 26.00) years. The rates of overweight, obesity, and central obesity were 32.74% (12 634 individuals), 10.27% (3 963 individuals), and 27.87% (10 755 individuals), respectively. There were 11 813 cases of hypertension, with a prevalence and standardized prevalence of 30.61% and 24.41%, respectively. Multivariable logistic regression analysis showed that after adjusting for demographic information, lifestyle, diabetes and dyslipidemia, the likelihood of hypertension in the overweight and obesity groups was 1.927 (95%CI: 1.815-2.045) times and 3.724 (95%CI: 3.404-4.073) times that of the normal BMI group, respectively. The likelihood of hypertension in the central obesity group was 2.346 (95%CI: 2.214-2.486) times that of the normal WC group. The likelihood of hypertension in the central obesity only, overweight only, overweight with central obesity, obesity only and obesity with central obesity groups was 1.586 (95%CI: 1.391-1.809), 1.704 (95%CI: 1.582-1.835), 2.433 (95%CI: 2.254-2.626), 1.768 (95%CI: 1.424-2.194), and 4.466 (95%CI: 4.053-4.921) times that of the normal BMI and WC group, respectively.
Conclusions
Overweight, obesity and central obesity were all associated with hypertension among adult residents. The highest likelihood of hypertension was observed among adult residents with both general obesity and central obesity.
6.Mechanism of dexmedetomidine in improving cognitive function in rats with ischemic stroke by modulating TLR4/NF-κB/NLRP3 signaling pathway
Ming CAO ; Jianbo ZHANG ; Yongyuan MA
Journal of Clinical Medicine in Practice 2025;29(16):28-34
Objective To investigate the effect of dexmedetomidine(DEX)on cognitive func-tion in rats with cerebral ischemic stroke(CIS)and analyze its potential underlying mechanisms.Methods A rat model of CIS was established using the middle cerebral artery occlusion(MCAO)method.The rats were randomly divided into sham-operation group,model group,low-dose DEX group(25 mg/kg DEX solution,administered by gavage),high-dose DEX group(50 mg/kg DEX solution,administered by gavage),and edaravone group(3.2 mg/kg edaravone solution,adminis-tered by gavage).After treatment,cognitive function was assessed using the neurological deficit score and the novel object recognition test.Brain infarction area and histopathological damage in brain tis-sue were detected using triphenyltetrazolium chloride(TTC)staining and hematoxylin and eosin(HE)staining,respectively.The expression of the microglial marker ionized calcium-binding adapter molecule 1(Iba-1)was analyzed using immunohistochemical staining.The levels of interleukin(IL)-6,IL-18,and IL-1β in brain tissue were measured using ELISA kits.The expression of proteins related to the toll-like receptor 4/nuclear factor KB/NOD-like receptor thermal protein do-main-containing protein 3(TLR4/NF-κB/NLRP3)signaling pathway was detected using western blot.Results Compared with the sham-operation group,the model group exhibited increased or enlarged neurological scores,brain infarction area,levels of IL-6,IL-1β,IL-18,Iba-1,TLR4,p-NF-κB,NLRP3,Cleaved Caspase-1,and GSDMD-N,as well as a decreased novel object discrimination in-dex.Compared with the model group,the low-dose DEX,high-dose DEX,and edaravone groups showed decreased or shrinked neurological scores,brain infarction area,levels of IL-6,IL-1β,IL-18,Iba-1,TLR4,p-NF-κB,NLRP3,Cleaved Caspase-1,and GSDMD-N,along with an increased novel object discrimination index.Compared with the low-dose DEX and edaravone groups,the high-dose DEX group demonstrated further decreases in neurological scores,brain in-farction area,levels of IL-6,IL-1β,IL-18,Iba-1,TLR4,p-NF-κB,NLRP3,Cleaved Caspase-1,and GSDMD-N-terminal domain(GSDMD-N),as well as an increased novel object discrimination index.The differences among the aforementioned groups were all statistically significant(P<0.05).Conclusion DEX improves cognitive function in rats with CIS by inhibiting the activation of the TLR4/NF-κB/NLRP3 signaling pathway,thereby suppressing neuronal pyroptosis and micro-glial activation and alleviating the inflammatory response.
7.Application of marginal donor livers in liver transplantation for patients with acute-on-chronic liver failure
Kun DONG ; Cheng ZHANG ; Junze CHEN ; Guanmiao CHEN ; Yongyuan JIAN ; Ruiling SU ; Kaiyong HUANG ; Xuelin TAN ; Chunqiang DONG ; Hongwei YANG
Chinese Journal of Hepatobiliary Surgery 2025;31(2):81-86
Objective:To analyze the value of marginal donor livers in liver transplantation for patients with acute-on-chronic liver failure (ACLF).Methods:Clinical data of 58 patients with ACLF undergoing liver transplantation at the First Affiliated Hospital of Guangxi Medical University from January 2020 to June 2023 were retrospectively analyzed, including 33 males and 25 females, aged (40.4±14.4) years. According to the source of donor (marginal or standard), recipients were divided into the marginal group ( n=28), and standard group ( n=30). The preoperative model for end-stage liver disease (MELD) score, cold/warm ischemia time, intraoperative blood loss, postoperative tracheal intubation time, intensive care unit (ICU) stay, liver function, renal function, coagulation function, postoperative complications, and survival situation were compared between the groups. Results:The MELD score, cold/warm ischemia time, intraoperative blood loss, postoperative tracheal intubation time, length of ICU stay, alanine transaminase, aspartate transaminase, total bilirubin, serum creatinine, blood urea nitrogen, estimated glomerular filtration rate, fibrinogen, postoperative infection, primary graft nonfunction, biliary complications, and vascular complications were compared between the groups (all P>0.05). The incidence of delayed graft function (DGF) recovery was 28.6%(8/28) in marginal group, higher than that in standard group 6.7%(2/30) ( χ2=5.13, P=0.038). The one-year cumulative survival rates were 89.3% and 93.3% in marginal group and standard group, respectively ( P=0.580). Conclusion:The therapeutic effect of marginal donor liver in ACLF recipients is comparable to that of standard donor liver. The incidence of DGF is higher in recipients with marginal donor liver.
8.Effects of Different Frequencies of Electroacupuncture on the Degree of Atrophy of the Quadriceps Femoris in Rabbits with Anterior Cruciate Ligament Injury
Yongyuan HUANG ; Hong SU ; Pengyi ZHANG ; Yeteng WEI ; Zhaolin XU ; Chunhua FU ; Huijiao CHEN ; Xuejie YANG ; Jiaying LI ; Chenxi WANG
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(6):88-94
Objective To observe the effects of different frequencies of electroacupuncture on the degree of atrophy of quadriceps femoris in rabbits with anterior cruciate ligament(ACL)injury model;To explore the possible mechanisms of electroacupuncture in treating ACL injury.Methods Totally 24 New Zealand rabbits were randomly divided into blank group,model group,low-frequency electroacupuncture group and high-frequency electroacupuncture group,with 6 rabbits in each group.Except for the blank group,ACL injury models were established in the other groups.On the 7th day after modeling,the low-frequency electroacupuncture group and the high-frequency electroacupuncture group performed electroacupuncture treatment(continuous wave,frequency of 2 Hz and 100 Hz respectively,and left the needle in place for 20 min)at"Xuehai"and"Liangqiu"of the operation side,and the remaining groups were only grasped and immobilized,for 21 days.The mass ratio of the quadriceps femoris was calculated,the histopathological morphology of the quadriceps femoris tissue of the rabbits in each group was observed by HE staining,the expressions of NO,iNOS in quadriceps femoris tissue were detected by ELISA,the content of ROS in quadriceps femoris tissue was detected by fluorescent probe,the protein expressions of PERK,ATF6,IRE1,MuRF1,MAFbx in quadriceps femoris tissue were detected by Western blot.Results Compared with the blank group,the quadriceps femoris muscle mass ratio of the model group rabbits was significantly reduced(P<0.01),with irregular arrangement of muscle cells,accompanied by swelling and atrophy,significant interstitial edema,and extensive inflammatory infiltration,the contents of NO,iNOS and ROS in quadriceps femoris tissue significantly increased(P<0.01),while the expressions of PERK,ATF6,IRE1,MuRF1 and MAFbx proteins significantly increased(P<0.01).Compared with the model group,the quadriceps femoris muscle mass ratio in the low-frequency and high-frequency electroacupuncture groups significantly increased(P<0.01),with regular arrangement of muscle cells,improved swelling and atrophy of cells,and reduced interstitial edema and inflammation,the contents of NO,iNOS and ROS in quadriceps femoris tissue were significantly reduced(P<0.01),and the expressions of PERK,ATF6,IRE1,MuRF1 and MAFbx proteins significantly decreased(P<0.01).Moreover,the low-frequency electroacupuncture group had better effects than the high-frequency electroacupuncture group(P<0.05).Conclusion Different frequencies of electroacupuncture intervention in ACL injury rabbits can better delay the degree of quadriceps femoris atrophy,and its mechanism may be related to reducing the expressions of oxidative metabolites NO,iNOS,ROS,and reducing the expressions of endoplasmic reticulum stress-related proteins PERK,ATF6,IRE1 in quadriceps fermoris,which in turn inhibit the expressions of quadriceps atrophy factors MuRF1,MAFbx,and delaying the degradation of quadriceps muscle proteins.The effect of low-frequency electroacupuncture is superior to the high-frequency electroacupuncture.
9.Analysis on the Acupoint Selection Law of Acupuncture and Moxibustion for the Treatment of Temporomandibular Joint Dysfunction Syndrome Based on Data Mining Technology
Yongyuan HUANG ; Huijiao CHEN ; Hong SU ; Pengyi ZHANG ; Jilang LI ; Yeteng WEI ; Jiaying LI ; Chenxi WANG ; Xuejie YANG
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(12):63-69
Objective To analyze and summarize the acupoint selection law of acupuncture and moxibustion for the treatment of temporomandibular joint dysfunction syndrome(TMD)using data mining technology.Methods Clinical literature about acupuncture and moxibustion for the treatment of TMD was retrieved from CNKI,Wanfang Data,VIP,CBM,PubMed,Web of Science,Embase and Cochrane Library from the establishment of the databases to March 1,2024.Excel 2021 was used to establish a prescription database of acupoints.SPSS Modeler 18.0 and SPSS Statistics 27.0 were used to analyze the frequency of use of acupoints,meridians,locations,specific acupoints,and the analysis of association rules,factor analysis,and clustering analysis.Results A total of 480 articles and 480 prescriptions were included in the study,containing 90 acupoints,with a total frequency of 2 290 times.The high-frequency acupoints were Xiaguan,Hegu,Jiache,Tinggong and Ashi point;the commonly used meridians were the stomach meridian,large intestine meridian,small intestine meridian,bile meridian,and triple-energizer meridian;the most frequently chosen acupoints were the Jiaohui acupoints,Yuan acupoints and Wushu acupoints;and mostly involved acupoints were located at the head and neck area,the upper limb area and the lower limb area.The association analysis showed that the top five combinations were"Xiaguan-Hegu","Xiaguan-Jiache","Xiaguan-Hegu-Jiache","Xiaguan-Tinggong","Xiaguan-Tinggong-Jiache";clustering analysis showed that five valid clusters were extracted;factor analysis extracted seven valid common factors.Conclusion The core acupoints of acupuncture and moxibustion for the treatment of TMD is Xiaguan-Hegu-Jiache-Tinggong,and mainly follows the principle of combining proximal and distal acupoints.
10.Death and life loss due to breast cancer in Wenzhou City
YE Zhenmiao ; FAN Lihui ; ZHENG Yuhang ; JIANG Xuexia ; LI Huijun ; ZHANG Mohan ; XIE Yimin ; LUO Yongyuan ; JIN Xi
Journal of Preventive Medicine 2024;36(9):746-749
Objective:
To investigate the mortality and life loss of female breast cancer in Wenzhou City, Zhejiang Province from 2014 to 2022, so as to provide the evidence for prevention and control of breast cancer.
Methods:
Data of female breast cancer deaths in Wenzhou City were collected through the Wenzhou Chronic Disease Monitoring and Management information System from 2014 to 2012. The mortality of breast cancer was calculated, and standardized by the data from the Sixth Chinese National Population Census in 2010 (Chinese-standardized rate) and the world standard population first introduced by Segi (world-standardized rate). The life loss were measured using potential years of life lost (PYLL), rate of potential years of life lost (PYLLR) and average years of life lost (AYLL). The trends in mortality, PYLLR and AYLL were analyzed using the average annual percent change (AAPC).
Results:
Totally 2 523 deaths were reported due to breast cancer from 2014 to 2022, ranking fifth in the order of female malignant tumor deaths. The crude mortality of female breast cancer was 7.13/105, showing an increasing trend with AAPC of 2.186% (P<0.05). The Chinese population-standardized mortality and global population-standardized mortality were 5.93/105 and 4.39/105, showing no significant trend with AAPC of -0.617% and -0.602% (both P>0.05), respectively. The crude mortality of female breast cancer appeared a tendency towards a rise with age (P<0.05). The crude mortality of breast cancer in females aged 65 years and older showed an increasing trend (AAPC=3.283%, P<0.05), but there were no significant tendency aged 15 to <45 years and 45 to <65 years (AAPC=-1.011% and -1.850%, both P>0.05). The PYLL, PYLLR and AYLL of breast cancer were 41 227.50 person-years, 1.23‰ and 19.44 years per person, respectively. AYLL showed a decreasing trend (AAPC=-1.969%, P<0.05), and PYLLR showed no significant trend (AAPC=-0.527%, P>0.05).
Conclusions
The mortality of female breast cancer in Wenzhou City appeared a tendency towards a rise from 2014 to 2022, and AYLL appeared a downward trend. Females aged 65 years and older were the key groups for the prevention and control of breast cancer.


Result Analysis
Print
Save
E-mail