To evaluate the features of carotid web (CW) by ultrasonography.

A total of 66 patients with CW were retrospectively enrolled from January 2018 to June 2019 at Xuanwu Hospital, Capital Medical University. All patients were examined by both ultrasonography and CTA, and were divided into either a<50% stenosis group (54 cases) or a ≥50% stenosis group (12 cases). The ultrasonographic characteristics of CW, including the length, thickness, direction (forward or backward to the flow), acute angle between the web and carotid wall, and thrombus between the web and carotid wall were compared between the two groups. The stenosis degrees of carotid artery were compared between patients with and without ischemic stroke.

Forty-two (42/66, 63.6%) patients were diagnosed with CW by initial CDFI examination, of whom 21 (21/66, 31.8%) were diagnosed with ulcerative plaque and 3 (3/66, 4.5%) were diagnosed with carotid dissection at first but confirmed by second examination. There were no differences in the web length, thickness, direction, or thrombus detected between the two groups (P>0.05). The angle between the web and carotid wall in the<50% stenosis group was significantly smaller than that of the ≥50% stenosis group (median angel 39o vs 73o, P=0.002), and the percentage of patients with an angle≤ 60o in the<50% stenosis group was significantly higher than that of the ≥50% stenosis group (74.1% vs 41.7%, P=0.042). The diameter of the residual carotid artery at CW location in the<50% stenosis group was significantly larger and peak systolic velocity was significantly higher in the<50% stenosis group than in the≥50% stenosis group (P<0.001). The stenosis degrees of carotid artery were not statistically different between patients with and without ischemic stroke (P=0.321).

Ultrasonography can be used to evaluate the characteristics of carotid web in 2D and color mode. When the angle between the CW and carotid wall is large, the carotid artery stenosis ≥ 50% is more likely to happen, but carotid artery stenosis is not the main cause of ischemic stroke.

The aim of the present study was to evaluate the efficiency of sling exercise, therapeuticultrasound, therapeuticultrasound and sling exercise in patients to alleviate pain and improve lumbar function with lumbar disc herniation.

Individuals were selected from a list of patients being followed at the department of Rehabilitation in the third hospital of Hebei Medical University. 30 patients who were diagnosed with lumbar disc herniation were collected, the diagnoses were established upon medical history, physical examination, and results of imaging studies. The patients were randomly divided into three groups: therapeuticultrasound group received 14 sessions of ultrasonic therapy to the lumbar region, Sling exercise group received 14 sessions of sling exercise, and therapeuticultrasound and sling exercise group received therapeuticultrasound and sling exercise therapy 14 sessions of therapeuticultrasound to the lumbar region,7 sessions per week, 2 weeks. The VAS and ODI were compared with the assessment of the patients before and at the end of the therapy.

At the end of treatment, three groups VAS scores (F=3.069, P=0.043) and ODI scores (t=12.676, P<0.001) was lower than that at the beginning of treatment (P<0.05), at the end of treatment the VAS scores (F=59.400, P<0.001) and of the ODI scores (t=12.737, P<0.001) of ultrasonic and sling exercise therapy group was lower than the other group, the difference is significantly.

All three groups could reduce pain and improve lumbar function, and the ultrasonic and sling exercise therapy was most effective for lumbar disc herniation treatment in the three groups.

To analyze the treatment of different types of traumatic cerebral infarction in children, and explore its pathogenesis in combination with literature so as to improve the cure rate and reduce disability rate.

The clinical data of 42 cases of traumatic cerebral infarction in children were retrospectively analyzed in The Hospital of 81^st Group Army PLA from January 2015 to December 2019. The diagnosis of traumatic cerebral infarction in children was made by CT scan and MRI scan. According to different conditions, children with traumatic cerebral infarction were classified, and different treatment strategies were selected. Children with lacunar infarction were treated with calcium antagonists and neurotrophic drugs, supplemented by hyperbaric oxygen and exercise rehabilitation. The children of focal cerebral infarction and complex cerebral infarction treated by junior dehydrant and hormone also included the calcium antagonist and nutritional nerve drugs. The therapeutic regimen perhaps adjusted by the evolution of the disease. The children of extensive cerebral infarction underwent emergency cranial decompression, and was treated by reducing intracranial pressure and preventing complications after operation. The treatment results and recovery were observed.

In 42 cases of traumatic cerebral infarction in children, 35 cases (83.3%) were good recovery, 4 cases (9.5%) were moderate disability, 2 cases (4.8%) were severe disability, 1 case (2.4%) died, and no vegetative state. The good recovery rate of lacunar infarction was 100%, that of focal cerebral infarction was 62.5%, that of mixed cerebral infarction was 60%, and that of extensive cerebral infarction was 50%.

It is of great significance to improve the therapeutic effect and prognosis of children with traumatic cerebral infarction to adopt different treatment schemes for different types of cerebral infarction.

To characterize the patients with supratentorial hypertensive intracerebral hemorrhage (ICH) in the Tibetan Plateau over an altitude of 4000 meters.

A total of 68 cases with supratentorial hypertensive ICH were retrospectively included in Ali Regional People’s Hospital from January 2017 to September 2018. The clinical and laboratory data were collected. A simple linear correlation analysis was applied to analyze the correlation between the amount of bleeding and sex, age, nationality, time from onset , systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum triglyceride (TG), and cholesterol. According to computed tomography (CT) findings, 68 cases were divided into the basal ganglia ICH group (33 cases) and the lobar ICH group (35 cases). The characteristics between two groups were analyzed using t-test or χ² test.

The data of sex, age, nationality, time from onset, SBP, DBP, Hb, TG, and cholesterol of 68 cases on admission did not show any definitive correlation with the hematoma volumes (P＞0.05). The SBP and DBP of patients in the basal ganglia ICH group were significantly higher than that in the lobar ICH group, respectively [(184.9±28.5) mmHg vs (164.6±24.4) mmHg; (113.0±18.1) mmHg vs (103.0±18.4) mmHg] (t=0.499, 0.486; P=0.002, 0.033).

The relevant factors of hematoma volumes in patients with ICH in plateau area were not yet clear. Diastolic and systolic blood pressure of patients in the basal ganglia ICH group was higher than that in those in lobar ICH group.

To compare the efficacy evaluation of electrospun composite biomaterials and a porcine small intestine submucosa mesh for hernia repair.

A randomized, single-blind, controlled multicenter trial was performed in 3 hospitals in Shanghai. Eligible adult patients with primary unilateral reducible groin hernias were randomly assigned (1∶1) to electrospun composite biomaterials (experimental group) or porcine small intestine submucosa (control group) mesh groups. Patients were treated with the tARB technique and assessed at 1,3 and 6 months after the surgery. The primary endpoint was hernia recurrence. The secondary endpoints were postoperative complications including groin pain and operative site infections.

172 patients were assigned to experimental (n=86) and control (n=86) groups. At 6 months follow-up, postoperative complications occurred in 5 patients (5/86, 5.95%) and 2 (2/86, 2.35%) patients in the control and experimental groups, respectively (P>0.05). There was no significant difference in VAS or SVS score between the two groups.

We demonstrate that electrospun composite biomaterial mesh can be used as a ideal choice for inguinal hernia repair. Electrospun composite biomaterial has the characteristics of low recurrence rate, absorbability and long-term comfort.It can be further applied in clinical practice in the future.

Pancreaticoduodenectomy(PD)remains one of the most complicated hepatobiliary operations. The development of minimally invasive surgery for PD has always been an hot spot. Laparoscopic pancreaticoduodenectomy(LPD) has not been widespread carried out due to its difficulty and long learning curve. LPD accounts for 9% of all PD, according to the National Cancer Data base. Compared with laparoscopic surgery, robotic surgery system has significant advantages in the field of minimally invasive PD, including stereotactic amplified vision, filtering hand tremor and simulating the wrist. The article would review the surgical techniques and notes, which could provide clinical reference for other surgeons.

To investigate the anti-biofouling effect of a polymer coating that combines cell membrane-mimetic phosphorylcholine groups and benzophenone (BP) photoresponsive groups on polymethyl methacrylate (PMMA) denture base material.

A photoreactive monomer containing BP groups, 4- (3-methacryloyloxy-2-hydroxypropyloxy) benzophenone (MHPBP), was synthesized and copolymerized with cell membrane-mimetic 2-methacryloyloxyethyl phosphorylcholine (MPC) via free-radical polymerization to prepare photoreactive three PMH polymers with different MPC/MHPBP molar ratios (9∶1, 8∶2, 7∶3). Coatings were constructed on PMMA surfaces by dip-coating followed by UV irradiation. The optimal formulation (PMH82) was selected based on water contact angle measurements. Anti-fouling performance was evaluated by protein adsorption, cell adhesion, and bacterial adhesion assays, and biocompatibility was assessed using CCK-8 and hemolysis tests. Multiple group comparisons were performed using one-way ANOVA with Tukey′s test, while comparisons between two groups were performed using independent samples t-test.

The MHPBP monomer and three polymers, PMH91, PMH82, and PMH73, were successfully synthesized. The protein adsorption amount on bare PMMA was (4.0 ± 0.5) μg/cm², which was significantly reduced to (2.6 ± 0.2) μg/cm² on the PMH82-coated surface (t = 4.8, P = 0.008). The adhesion of Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) on bare PMMA was (4.2 ± 0.9) × 10⁵ and (4.3 ± 0.5) × 10⁵ CFU/cm², respectively, and these values decreased to (2.2 ± 0.2) × 10³ and (1.4 ± 0.1) × 10³ CFU/cm² on the PMH82-coated surface (t_{S. aureus} = 7.5, P_{S. aureus} = 0.002; t_{E. coli} = 13, P_{E. coli}<0.001). Cell adhesion assays showed that almost no cells adhered to the PMH82 coating. After 5 days of co-culture, cell viability exceeded 95% in the CCK-8 assay. The hemolysis rate of the coating was only (0.22 ± 0.15) %.

The polymer coating significantly inhibits cell adhesion, bacterial adhesion, and protein adsorption, exhibits good cytocompatibility and an extremely low hemolysis rate, and provides a simple and efficient chairside anti-fouling modification strategy for PMMA denture bases, showing promising prospects for clinical translation.

To construct polyacrylamide hydrogel models with graded Young's moduli and comparable surface roughness, and to evaluate their feasibility for studying stiffness-related changes in the actin cytoskeleton, spreading, and early osteogenic gene expression of mouse bone marrow mesenchymal stem cells (mBMSCs) .

Three groups of polyacrylamide hydrogels with low, medium, and high stiffness were prepared, characterized for Young's modulus and surface roughness, activated with sulfo-SANPAH, and functionalized with type I collagen. The morphology of F-actin and the relative spreading area of mBMSCs were assessed by fluorescence imaging. Actin polymerization was perturbed with cytochalasin D, followed by 7 days of osteogenic induction and measurement of Alpl and Runx2 expression. Statistical analyses were performed using GraphPad Prism 8. Comparisons among multiple groups were conducted using one-way analysis of variance (ANOVA) or the Kruskal-Wallis test, as appropriate, according to the data distribution and homogeneity of variances. Post hoc pairwise comparisons were performed using Tukey's multiple comparisons test or Dunn's multiple comparisons test, respectively. A two-sided P value of <0.05 was considered statistically significant.

The average Young's moduli of the low-, medium-, and high-stiffness hydrogels were 1.09, 11.37, and 29.24 kPa, respectively, with statistically significant differences (F = 766.60, P<0.001 for all pairwise comparisons), whereas surface roughness did not differ significantly among groups (H = 5.956, P>0.05). Increasing stiffness was associated with more prominent actin bundles and greater cell spreading (H = 14.73, low stiffness group-high stiffness group: P = 0.000 4). Under control conditions, Alpl and Runx2 expression were higher on the high-stiffness group than in the low-stiffness group (F_Alpl = 91.54, P_Alpl = 0.003 9; F_Runx2 = 12.93, P_Runx2 = 0.002 5). After cytochalasin D treatment, the differences between the low- and high-stiffness groups were not significant (F_Alpl = 91.54, P_Alpl = 0.401 9; F_Runx2 = 12.93, P_Runx2 = 0.887 3) .

The polyacrylamide hydrogel model developed in this study exhibited distinct levels of Young's modulus while maintaining comparable surface roughness. The effects of matrix stiffness on the early osteogenic responses of stem cells may depend, at least in part, on cytoskeletal actin filaments.

Peri-implantitis is a major cause of implant failure, and conventional treatments are limited by incomplete debridement, insufficient drug concentration, and poor bone regeneration capacity. Extracellular vesicles (EVs), as membrane-enclosed structures secreted by cells, show promise in regulating inflammation, promoting tissue regeneration, and enabling targeted therapy. However, natural EVs suffer from insufficient targeting and rapid clearance in vivo. The functional combination of EVs with biomaterials enables local sustained release, enhanced stability, and synergistic promotion of bone regeneration together with scaffold materials. This article reviews the construction strategies for EV-functionalized biomaterials and the research progress on the application of engineered EVs in the prevention and treatment of peri-implantitis, aiming to provide novel engineering strategies and theoretical foundations for the precise management of peri-implantitis.

Vat photopolymerization (VPP) is a crucial 3D printing technology for fabricating ceramic dentures. However, nonlinear dimensional deviations and warpage distortion during the fabrication process severely restrict their clinical adaptability. This review aims to systematically summarize the latest research progress in digital morphological design and deformation compensation strategies for VPP 3D-printed ceramic dentures, providing theoretical guidance for high-precision manufacturing. In geometric morphology design, the applications of artificial intelligence (AI) algorithms, such as 3D convolutional neural networks, generative adversarial networks, and PointNet methods, were analyzed. Regarding deformation compensation, linear compensation algorithms like anisotropic scaling factors and slice contour offsets were examined. Crucially, nonlinear pre-deformation compensation strategies, including finite element thermodynamic simulations, AI-based nonlinear shrinkage prediction models, and conformal support structures, were discussed in detail. Results indicated that AI algorithms are driving the transition of denture design from experience-based paradigms to data-driven and high-fidelity intelligent models. While linear compensation algorithms effectively correct macroscopic dimensional deviations, they struggle with non-uniform distortions. Conversely, finite element simulations and AI nonlinear shrinkage prediction models can effectively suppress complex nonlinear deformations, significantly improving the final clinical adaptation accuracy of ceramic dentures. Ultimately, digital morphological design and nonlinear deformation compensation technologies are fundamental to improving the accuracy of VPP ceramic dentures. Future research should further explore denture design under dynamic biomechanical coupling and promote the clinical application of AI pre-deformation algorithms for complex, personalized dentures.

To systematically elucidate the molecular mechanism by which Porphyromonas gingivalis lipopolysaccharide (P. gingivalis-LPS) modulates carnitine palmitoyltransferase 1A (CPT1A) to influence metabolic reprogramming and apoptosis in foam cells, and to explore the potential link between periodontal pathogen infection and the progression of atherosclerosis.

Transcriptome sequencing was employed to analyze the whole-genome expression profiles of foam cells stimulated by P. gingivalis-LPS. Differentially expressed genes (DEGs) were screened, and functional enrichment analysis was conducted using bioinformatics methods. Further validation of the core regulatory role of CPT1A in lipid metabolism and apoptosis was performed through gene overexpression and apoptosis assays.

Transcriptomic analysis identified 427 DEGs (318 upregulated and 109 downregulated) under the thresholds of |log₂FC|>1 and FDR<0.05. GO and KEGG enrichment analyses based on these DEGs indicated significant enrichment in lipid- and sterol-related biological processes, as well as the PPAR signaling pathway, fatty acid metabolism, and steroid biosynthesis. GSEA results showed that cholesterol/sterol biosynthesis-related pathways were negatively enriched, whereas fatty acid transport and adaptive lipid metabolic processes were positively enriched. In addition, apoptosis-related pathways, including the p53 pathway, were also positively enriched. Among these, CPT1A expression was markedly elevated and confirmed as a key regulator. Functional studies demonstrated that CPT1A overexpression enhanced cell viability and suppressed apoptosis (P<0.05) .

CPT1A may mediate the promotion of atherosclerotic foam cell pathogenesis by periodontal pathogen infection via coordinating lipid metabolic reprogramming and apoptosis resistance.

To systematically analyze the publication characteristics, research hotspots, and international collaboration patterns in the field of organ donation and transplantation worldwide from 2016 to 2025 based on the Web of Science Core Collection (WoSCC) database, and to provide decision-making references for discipline development and internationalization.

Literature was retrieved from the WoSCC database using a topic-search strategy. The R package Bibliometrix and Biblioshiny platform were used to perform bibliometric and visualization analyses of annual publication trends, core source journals, author and country collaboration networks, keyword co-occurrence, and the topological relationships of document co-citation.

A total of 4 771 articles related to organ donation and transplantation from 2016 to 2025 were included from the WoSCC database, comprising 4 223 articles and 548 reviews. Over the past decade, the annual publication volume showed an overall fluctuating upward trend, with a compound annual growth rate of 2.76%, reaching its peak in 2021 (565 articles). The proportion of international co-authored articles was 18.13%, and the average number of co-authors per article was 8.56. High-frequency keyword analysis showed that kidney transplantation, liver transplantation, living donor, donation after cardiac death, and clinical practice were the core themes in this field. Keyword co-occurrence analysis indicated that " transplantation" had the highest betweenness centrality value (32.369), serving as a significant global hub. Technical terms such as " machine perfusion" and " preservation" had relatively low betweenness centrality values. Combined with the analysis of highly cited literature, organ preservation and machine perfusion technologies have become key emerging frontiers. Document co-citation analysis showed that the knowledge base of the field is mainly built upon reports from international registries, clinical guidelines, and conventional donor classification criteria. The country collaboration network showed that the United States occupied an absolutely central position, with a betweenness centrality value of 9.386 and a weight of 0.117. European countries such as the United Kingdom and Germany demonstrated strong intermediary effects in the collaboration network. China showed a relatively high volume of research output, but its betweenness centrality value in the collaboration network was low (0.099).

Global research on organ donation and transplantation is undergoing a multidimensional transition from a primary focus on surgical clinical outcome evaluation toward precision management of donor quality, standardization of donation after cardiac death criteria and protocols, optimization of organ perfusion technologies, and the development of ethical and sociological governance systems. China has established a certain research foundation in this field. However, there remains considerable room for improvement in its hub position within the international collaboration network.

To investigate postoperative hepatitis B recurrence and its risk factors in liver transplant recipients with HBV-related end-stage liver disease.

Clinical data of 138 recipients, who underwent liver transplantation for HBV-related end-stage liver disease at the First Affiliated Hospital of Anhui Medical University from January 2016 to December 2024, were retrospectively collected. Recipients were divided into a recurrence group (n=13) and a non-recurrence group (n=125) based on the presence or absence of postoperative hepatitis B recurrence. The homogeneity of variances between the two groups was assessed using Levene′s test. When variances were equal (P>0.05), comparisons between groups were performed using the group t-test; when variances were unequal (P≤0.05), the adjusted t-test was used. For continuous data with a non-normal distribution, the Mann-Whitney U test was used for intergroup comparisons. Categorical data were compared using the chi-square test. Logistic regression analysis was used to identify risk factors for postoperative hepatitis B recurrence. Survival curves were plotted using the Kaplan-Meier method and compared using the log-rank test. A P-value < 0.05 was considered statistically significant.

Follow-up was conducted until December 31, 2025, with a median follow-up duration of 39.8 (7.7, 116.7) months. Statistically significant differences were observed between the two groups in mean serum tacrolimus concentration [(9.54±1.87) and (7.97±2.22) ng/mL] within the first postoperative year and the incidence [84.6%(11/13) and 53.6% (67/125) ] of postoperative complications (t=-2.461, χ²=4.609, all P<0.05). Multivariate logistic regression analysis revealed that serum tacrolimus concentration within the first postoperative year (OR=1.500, 95%CI: 1.050-2.141) was an independent risk factor for postoperative hepatitis B recurrence in HBV-related liver transplant recipients (P<0.05). The 1-, 3-, and 5-year cumulative overall survival rates for the 138 recipients were 97.8%, 90.7% and 81.7%, respectively. During follow-up, three recipients in the recurrence group died due to intrahepatic recurrence of hepatocellular carcinoma, intrahepatic hepatocellular carcinoma recurrence with pulmonary metastasis, and fulminant liver failure caused by HBV reactivation. There were 14 recipients died in the non-recurrence group: 4 died of multiple organ failure, 3 died of liver failure caused by disease progression following hepatocellular carcinoma recurrence, 3 died of liver failure secondary to immune rejection, 3 died of biliary complications, and 1 died of gastrointestinal hemorrhage. The 1-, 3-, and 5-year cumulative survival rates of recipients were 92.3%, 84.6% and 76.2% in the recurrence group, and 97.6%, 91.5% and 82.5% in the non-recurrence group. The log-rank test showed no statistically significant difference in cumulative survival was observed between the two groups at follow-up endpoint(χ²=0.709, P>0.05).

Higher mean serum tacrolimus concentration within the first postoperative year may be a risk factor for postoperative hepatitis B recurrence in liver transplant recipients with HBV-related disease.

To evaluate the preoperative nutritional status of pediatric liver transplant recipients, explore its correlations with early postoperative recovery course and short-term clinical outcomes, and provide empirical evidence for targeted precise perioperative nutritional intervention.

A prospective study was performed. Clinical data of 309 children who underwent liver transplantation at the First Affiliated Hospital, Zhejiang University School of Medicine between January 2023 and August 2025 were collected. Preoperative nutritional status was assessed according to the Growth Standards for Children Under 7 Years Old. Patients were divided into a malnutrition group (n=197) and a well-nourished group (n=112). In addition, all subjects were stratified into two groups based on postoperative ICU stay duration: ≤5 days group (n=152) and >5 days group (n=157). Early prognostic indicators, including time to first postoperative feeding and length of ICU stay, as well as hematological parameters on postoperative day 7, were compared between the two nutritional groups. The t-test was used for intergroup comparison of normally distributed measurement data, the Mann-Whitney U test was applied for non-normally distributed measurement data. Spearman′s rank correlation analysis was conducted to analyze the correlations between preoperative nutritional status scores and early postoperative clinical indicators, and stratified analyses were performed based on whether ICU stay exceeded 5 days. P<0.05 was defined as statistically significant.

The incidence of preoperative malnutrition among the 309 pediatric liver transplant recipients was 63.8% (197/309). Median time to first postoperative feeding was significantly shorter in the well-nourished group [6.0 (5.0, 10.0) days] than that in the malnutrition group [7.0 (6.0, 11.0) days]. On postoperative day 7, the well-nourished group had higher ALT, AST and gamma-glutamyltransferase (GGT) levels [128.0 (79.5, 229.5), 55.5 (36.0, 89.0), 137.5 (76.3, 231.8) U/L] compared with the malnutrition group [110.0 (60.0, 174.0), 46.0 (30.0, 77.0), 104.0 (65.0, 167.0) U/L]. By contrast, white blood cell count and lymphocyte count were lower in the well-nourished group [9.7 (6.5, 14.4)×10⁹/L, 3.1 (1.6, 5.5)×10⁹/L] versus the malnutrition group [11.1 (7.9, 14.7)×10⁹/L, 4.0 (2.4, 6.7) ×10⁹/L]. All intergroup differences were statistically significant (Z=5.592, 5.503, 4.181, 8.792, 4.086, 4.696; all P<0.05). Preoperative nutritional status scores were negatively correlated with time to first postoperative feeding, early postoperative lymphocyte count and white blood cell count (r=-0.135, -0.123, -0.115; all P<0.05), and positively correlated with early postoperative ALT (r=0.134), AST (r=0.117) and GGT (r=0.169) levels (all P< 0.05). Stratified analyses demonstrated that in children with ICU stay ≤5 days, preoperative nutritional status scores were negatively correlated with duration of mechanical ventilation and time to first postoperative feeding (r=-0.192, -0.149; all P<0.05), and positively correlated with postoperative GGT levels (r=0.198; P<0.05). Among patients with ICU stay >5 days, preoperative nutritional status scores were negatively correlated with early postoperative lymphocyte count and white blood cell count (r=-0.216, -0.195; all P<0.05), and positively correlated with postoperative GGT levels (r=0.171; P<0.05).

Preoperative malnutrition is highly prevalent in pediatric liver transplant recipients, and it is closely associated with delayed recovery of postoperative gastrointestinal function, inflammatory response aggravation and changes in liver function parameters. The favorable preoperative nutritional status facilitates the recovery of respiratory function in children with short ICU hospitalization; whereas malnutrition significantly impairs postoperative immune regulation in patients requiring prolonged ICU stay.

To investigate the immune response, cardiac functional changes, and tissue remodeling following xenotransplantation of gene-edited pig hearts into rhesus macaques under current immunosuppressive strategies.

A pig-to-rhesus macaque heterotopic heart xenotransplantation model was established using a donor pig with five genes modifications (α-1, 3-galactosyltransferase/β-1, 4-N-acetylgalactosaminyltransferase 2/human CD46 transgene/human CD55 transgene/human thrombomodulin transgene). The immunosuppressive regimen comprised induction and maintenance phases and was based on anti-CD154 antibody and methylprednisolone. During the induction phase, anti-CD20 antibody, antithymocyte globulin, and cobra venom factor were additionally administered. During the maintenance phase, mycophenolate mofetil was added and methylprednisolone was gradually tapered. In the event of acute rejection, intensified methylprednisolone therapy was administered. Postoperative assessments included physiological parameters, cardiac function, immune cell dynamics, and histological features of the recipient monkey.

The recipient monkey survived for 46 days after transplantation. The recipient′s general condition remained relatively stable during the perioperative and early postoperative periods, with no hyperacute or acute rejection observed. Both the donor and recipient hearts maintained effective contractility after transplantation. The left ventricular ejection fraction of the recipient monkey′s native heart remained above 50% throughout the study, whereas that of the donor porcine heart was generally lower. Progressive thickening of the left and right ventricular endocardium was observed in the donor heart, reaching approximately threefold above baseline by the experimental endpoint. Leukocyte counts increased during the early postoperative period, whereas erythrocyte and platelet counts showed no sustained decline. Aminotransferase, total bilirubin, coagulation parameters, and troponin levels fluctuated over different postoperative phases. Immunohistochemistry showed higher CD68 and IgG Fc expression in porcine myocardium than in monkey myocardium. Flow cytometry showed that the proportion of peripheral blood CD3⁺ CD19^- cells increased to 74.9% on postoperative day 5, and thereafter remained between 76.2% and 89.7%. The proportion of CD3^-CD19^- cells decreased from 89.2% on the day of surgery to 81.7% on postoperative day 1, and thereafter remained between 10.2% and 25.0%. The proportion of CD3^-CD19⁺ cells remained below 0.1% throughout the observation period. The proportion of CD3⁺ CD19⁺ cells increased to 3.4% on postoperative day 7, with no marked increase observed at the other time points.

T cell-mediated cellular immune responses are the primary drivers of graft structural changes and functional deterioration under effective humoral immune suppression.

Acute-on-chronic liver failure (ACLF) is a severe syndrome characterized by acute decompensation due to triggers such as infection or alcohol abuse in patients with chronic liver disease, marked by rapid deterioration of liver function accompanied by multiple organ failure and high short-term mortality. Effective therapeutic options are currently lacking, and liver transplantation remains the only life-saving intervention, which can achieve favorable outcomes in strictly selected patients, although prognosis is influenced by multiple factors. Given the high incidence of ACLF, persistent shortage of donor livers, and expanding indications for liver transplantation, the role of liver transplantation in ACLF remains controversial. This article reviews the etiology, diagnosis, and prognostic models of ACLF, and systematically analyzes the current status of liver transplantation application, predictors of post-transplant mortality, recipient selection, and evidence for optimal timing, aiming to provide references for clinical decision-making.

Partial heart transplantation (PHT) refers to the procedure where fresh aortic or pulmonary valve as well as the associated root are procured from the donor heart and transplanted into children with congenital heart valve diseases. It is also known as allogeneic " living valve" transplantation or replacement. Compared with traditional mechanical or biological valves, the advantage of PHT lies in the fact that the transplanted valve tissue has the potential for growth and can grow synchronously with the development of the children. Moreover, the durability of the valve is good, and there is rarely any valve functional failure, thereby avoiding the risk of multiple surgical replacements required as the children grows. Although immunosuppressive treatment is still necessary after the operation, the required drug dosage is significantly lower than that of full heart transplantation, and the treatment time may be shorter, which helps children safely pass through critical growth periods. In recent years, the clinical feasibility, safety, and effectiveness of PHT have been gradually verified, bringing a paradigm shift to surgical treatment of congenital heart valve diseases. This article aims to systematically review the current clinical research progress in the field of PHT, including its surgical indications, techniques, efficacy and challenges.

Liver transplantation serves as a vital therapeutic modality for patients with end-stage liver disease and certain hepatic malignancies. Sarcopenia is a skeletal muscle disorder characterized by reduced muscle mass, diminished muscle strength, and impaired physical performance. In liver transplant candidates and recipients, sarcopenia is influenced by factors such as the catabolic effects of end-stage liver disease, malnutrition, surgical stress, immunosuppressive therapy, and postoperative metabolic reconstruction. Consequently, it constitutes a significant risk factor for perioperative complications, hospital readmissions, and compromised long-term rehabilitation outcomes. Standardized assessment, stratified management, and multimodal interventions for sarcopenia in the context of liver transplantation facilitate the identification of high-risk recipients and provide a foundation for perioperative rehabilitation management. Digital rehabilitation platforms can complement outpatient care by capturing data on physical activity and exercise adherence, thereby providing valuable support for continuous follow-up and functional monitoring. This article reviews the dynamic evolution, clinical assessment, and intervention strategies regarding sarcopenia in liver transplant recipients. It focuses specifically on the tripartite assessment framework-encompassing muscle strength, muscle mass, and physical performance-as well as the application of nutritional support, exercise rehabilitation, and pharmacologic adjuncts. Additionally, the article discusses the supportive value of digital rehabilitation platforms in continuous follow-up, functional monitoring, and the adjustment of rehabilitation regimens, while also delineating the current boundaries of the supporting evidence.