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 detect safety signals and characterize the time-to-onset (TTO) profile of letermovir-associated adverse events (ADE) based on the U. S. Food and Drug Administration Adverse Event Reporting System (FAERS) database.

FAERS data from Q4 2017 to Q2 2025 were retrieved. Disproportionality analyses were performed using reporting odds ratio, proportional reporting ratio, and Bayesian confidence propagation neural network. TTO was calculated and fitted using the Weibull distribution, with stratification by designated medical events (DME).

A total of 1 007 letermovir-related reports were identified, yielding 65 positive signals across 15 system organ classes. Among 778 cases with valid TTO, the overall median TTO was 43 (8, 124) days with a Weibull shape parameter β=0.58, indicating an early-onset pattern (cumulative proportion ≤30 days: 44.1%; ≤90 days: 66.8%). For key DMEs, liver failure exhibited typical early onset [median 5 (5, 5) days, β=0.88], whereas agranulocytosis [median 74 (40, 95) days, β=1.44] and acute kidney injury [median 88 (14, 579) days, β=0.68] demonstrated delayed and prolonged risk profiles.

Letermovir-associated ADE predominantly occurs early, but onset patterns vary across organ toxicities. Hepatic monitoring should be prioritized during early therapy, while hematologic and renal surveillance should be extended over a longer window.

To analyze the incidence and clinical characteristics of de novo malignancies in kidney transplant recipients.

We retrospectively reviewed the clinical data of 9, 000 recipients who underwent kidney transplantation at the Kidney Disease Center, the First Affiliated Hospital, Zhejiang University School of Medicine, between May 1988 and January 2025. Recipients were categorized into a malignancy group (n=485) and a non-malignancy group (n= 8 515) according to whether de novo malignancy occurred after transplantation. We assessed the incidence, tumor types, and time to onset of de novo malignancies, as well as the number and proportional distribution of malignancy events diagnosed during 1988-2000, 2001-2015, and 2016-2025. Between-group comparisons were performed using independent-samples t tests for normally distributed continuous variables, Mann-Whitney U tests for non-normally distributed continuous variables, and χ² tests or Fisher's exact test for categorical variables. P<0.05 was considered statistically significant.

Compared with the non-malignancy group, recipients in the malignancy group were older at transplantation [(43.6±10.9) vs. (38.1±11.3) years], more likely to be female (42.1% vs. 34.2%), and more likely to have received a kidney from a deceased donor (87.2% vs. 68.5%), all differences were statistically significant (t/χ²=10.426, 12.378, and 75.746, all P<0.05). During follow-up, the overall incidence of de novo malignancy after kidney transplantation was 5.39% (485/9 000); the incidence was 4.78% (281/5 880) in men, 6.54% (204/3 120) in women, and 1.21% (3/247) in children. Among the 485 recipients with de novo malignancies, 505 malignancy events were diagnosed. Digestive system tumors were the most common (121 events, 24.0%), followed by urinary system tumors (87 events, 17.2%), thyroid cancer (70 events, 13.9%), lung cancer (61 events, 12.1%), and post-transplant lymphoproliferative disorder (PTLD) (49 events, 9.7%). The mean age at diagnosis was (52.7±12.0) years, and the median time from transplantation to diagnosis was 91 (2-416) months. Kaposi sarcoma occurred earliest, with a median onset of 38 (12-205) months after transplantation. PTLD showed a bimodal distribution, with a median onset of 105 (2-301) months; early-onset cases (within 1 year after transplantation) accounted for 18.4%. All 3 malignancies in pediatric recipients were PTLD, all occurring within 1 year after transplantation (4-11 months). Solid organ tumors (lung cancer, digestive system tumors, and urinary system tumors) occurred later, with median onset times all >80 months. The numbers of de novo malignancy events diagnosed after kidney transplantation during 1988-2000, 2001-2015, and 2016-2025 were 96, 278, and 131 events, respectively.

The incidence of de novo malignancies after kidney transplantation is significantly higher than that in the general population, with digestive system tumors being the most common. Given the distinct temporal patterns in the onset of different tumor types, phased follow-up and screening strategies based on risk windows should be implemented for high-risk populations.

To investigate the effects of low-dose glucocorticoid combined with optimized supportive therapy on renal function and proteinuria in patients with recurrent or de novo IgA nephropathy (IgAN) after kidney transplantation.

A retrospective analysis was conducted on the clinical data of 36 patients with biopsy-confirmed post-transplant IgAN at Jiangxi Provincial People′s Hospital from September 2021 to December 2024. Based on whether a low-dose glucocorticoid regimen was administered, the patients were divided into the low-dose glucocorticoid group (n=17) and the control group (n=19). The control group received optimized supportive therapy alone. The low-dose glucocorticoid group received low-dose prednisone (0.5 mg·kg^-1·d^-1) for 8 weeks on top of the optimized supportive therapy, followed by a monthly reduction of 5 mg, until a long-term maintenance dose of 10 mg/d was reached after 6 months. Serum creatinine (Scr), 24-hour urinary protein, and allograft survival rates before and after treatment were compared between the two groups. Normally and non-normally distributed quantitative data were compared using the Student′s t-test and the Mann-Whitney U test, respectively. Categorical data were compared using the Pearson′s chi-square test or Fisher′s exact test. Odds ratios (ORs) were used to assess relative risk. Survival analysis was performed using the Kaplan-Meier method, and survival rates were compared using the log-rank test. A value of P<0.05 was considered statistically significant.

There were no statistically significant differences between the two groups in baseline parameters including age, sex, donor type, donor age, number of HLA mismatches, anti-thymocyte globulin (ATG) induction therapy, time from transplantation to biopsy, Oxford classification pathological scores, and baseline levels of Scr and 24-hour proteinuria at the time of biopsy (t/χ²/Z=-0.786, 0.001, 0.001, -0.485, 0.571, 0.358, 159, -0.786, 0.001, 0.001, -0.485, 0.571, 0.358, 159, all P>0.05). At the end of follow-up, the Scr level in the low-dose glucocorticoid group was significantly lower than that in the control group [(117.8±30.2) vs. (156.7±19.2) μmol/L, t=4.248, P<0.05]. The 24-hour urinary protein also decreased significantly [0.5 (0.2-1.6) vs. 1.5 (0.3-2.7) g/d, Z=83, P<0.05]. The proportion of patients achieving 24-hour proteinuria <0.3 g/d was higher in the low-dose glucocorticoid group than in the control group (8/17 vs. 4/19), though the difference was not statistically significant (χ²=2.731, P>0.05), with an OR of 3.33 (95%CI: 0.78-14.31). In the control group, there were no significant changes in Scr and 24-hour urinary protein levels before and after treatment (t/Z=-0.152/197, all P>0.05). In contrast, the Scr and 24-hour urinary protein levels in the low-dose glucocorticoid group after treatment were significantly lower than those before treatment (t/Z=2.125/32, all P<0.05). In the low-dose glucocorticoid group, 3 cases of hyperglycemia and 2 cases of mild pulmonary infection occurred, all of which recovered after management; no adverse reactions occurred in the control group. The 3-year cumulative allograft survival rates in the low-dose glucocorticoid group and the control group were 92.9% and 81.4%, respectively, with no statistically significant difference (χ²=0.522, P>0.05).

Low-dose glucocorticoid combined with optimized supportive therapy can significantly improve renal function and proteinuria control in patients with IgAN after kidney transplantation, and the adverse reactions are manageable.

Analysis of the dynamic changes in serum cystatin C(Cys-C) and β2-microglobulin(β2-MG) levels in the early period after renal transplantation, and evaluation of their diagnostic value for the recovery of graft renal function.

A total of 70 patients who underwent allogeneic kidney transplantation in the Second People′s Hospital of Shanxi Province from June 2018 to December 2020 were retrospectively collected as the transplant group. 30 healthy physical examination subjects in the same period were randomly selected as the control group. Blood samples were collected from the transplantation group before operation, and at 1, 7, 14 and 30 days after operation, while fasting blood samples were collected from the control group on the day of physical examination. The levels of serum creatinine (SCr), blood urea nitrogen (BUN), Cys-C, β2-MG, and estimated glomerular filtration rate (eGFR) were measured, respectively. Differences in quantitative variables within groups were analyzed using repeated-measures ANOVA, and intergroup comparisons were conducted with the independent samples t-test. Pearson correlation analysis was used to examine the linear association. A combination of logistic regression and receiver operating characteristic (ROC) curve analysis was performed to assess the integrated diagnostic value of Cys-C and β2-MG for renal allograft function.

All parameters (SCr, BUN, Cys-C, β2-MG, eGFR) in the transplant group at pre- and post-transplant stages differed significantly from controls (all P< 0.01). Within 30 days post-transplant, SCr, BUN, Cys-C and β2-MG in recipients continuously decreased while eGFR steadily increased, with all changes statistically significant vs. baseline (all P< 0.01). Pearson correlation analysis showed that BUN, Cys-C, and β2-MG were significantly negatively correlated with eGFR (r=-0.719, -0.780, and -0.711). ROC curve analysis demonstrated that the areas under the curve (AUC) of Cr, BUN, Cys-C, and β2-MG for evaluating renal allograft function were 0.955 (95%CI: 0.936-0.975), 0.940 (95%CI: 0.917-0.963), 0.992 (95%CI: 0.984-0.999), and 0.918 (95%CI: 0.891-0.945), respectively (all P<0.01). The optimal cutoff value of Cys-C was 1.305 mg/L, with a sensitivity of 0.996 and specificity of 0.966. For β2-MG, the sensitivity and specificity at the cutoff value were 0.826 and 0.922, respectively. The AUC of combined detection of Cys-C and β2-MG for diagnosing renal allograft function was 0.991 (95%CI: 0.983-0.999, P<0.01).

Cys-C is a superior indicator for evaluating the early recovery of renal allograft function. Compared with Cys-C alone, the combined detection of Cys-C and β2-MG shows no significant advantage in evaluating the early recovery of renal allograft function after renal transplantation.

To analyze microbial specimen submissions, distribution of isolated pathogens and their antimicrobial resistance among heart transplant patients and provide evidence-based guidance for infection prevention and antimicrobial therapy in these patients.

A retrospective analysis was performed on various microbial specimens collected from 508 heart transplant recipients admitted to Fuwai Hospital, Chinese Academy of Medical Sciences, from January 2019 to December 2024. A total of 1 322 primary isolates were initially obtained. After excluding duplicate isolates from the same anatomical site of an individual recipient, 517 nonduplicate isolates were included for analysis. WHONET 5.6 software was used to analyze invitro antimicrobial susceptibility test results in accordance with the Clinical and Laboratory Standards Institute (CLSI) M100S34 (2024).

Among the 517 isolates, 483 were bacteria and 34 were fungi. Gramnegative bacteria predominated, accounting for 73.3% (379/517). The top five isolated pathogens were Klebsiella pneumoniae (32.1%, 166/517), Escherichia coli (9.9%, 51/517), Pseudomonas aeruginosa (8.1%, 42/517), Enterococcus faecium (6.4%, 33/517), and Enterobacter cloacae (5.2%, 27/517). Specimenbased distribution showed respiratory specimens constituted the largest proportion (60.8%), followed by urine specimens (17.3%), blood specimens (7.1%), and secretion specimens (5.5%). The detection rates of carbapenemresistant Klebsiella pneumoniae (CRKP), carbapenemresistant Pseudomonas aeruginosa, and methicillinresistant Staphylococcus aureus were 10.8%, 7.1% and 6.7%, respectively. No vancomycinresistant enterococci were detected.

Respiratory specimens dominate the submitted samples from heart transplant recipients. Gramnegative bacilli are the predominant isolates. Overall antimicrobial resistance rates are lower than the national average resistance level in China. Nevertheless, the detection rate of CRKP shows an upward trend, which warrants close clinical attention.

To explore the therapeutic efficacy of liver transplantation(LT) in patients with biliary tract cancer (BTC).

A retrospective analysis was conducted on the clinicopathological data and survival outcomes of BTC patients who underwent LT at Beijing Tsinghua Changgung Hospital between January 1, 2018, and June 30, 2024, with regular follow-up. The cohort included 6 cases of perihilar cholangiocarcinoma (pHCC), 8 cases of intrahepatic cholangiocarcinoma (ICC), 13 cases of combined hepatocellular-cholangiocarcinoma (cHCC-CCA), and 1 case of gallbladder carcinoma (GC). Survival rates were calculated and survival curves were plotted using the Kaplan-Meier method. Survival analysis was performed using the log-rank test. P value <0.05 was considered statistically significant.

As of the follow-up deadline of June 30, 2025, the median follow-up time for the 28 recipients was 19 (5-80) months. 19 patients experienced tumor recurrence, and 18 patients died (17 from end-stage tumor disease and 1 from myocardial infarction without recurrence). The 1-year overall survival and 1-year recurrence-free survival rates for all 28 recipients were 71.4% and 50.0%, respectively. The single GC recipient survived 53 months without recurrence by the end of follow-up. For recipients with pHCC, ICC, and cHCC-CCA, the 1-year overall survival rates were 50.0%, 87.5%, and 69.2%, respectively; the 1-year recurrence-free survival rates were 33.3%, 37.5%, and 61.5%, respectively; and the median survival times were 15.5 (8-20), 29 (8-80), and 44 (5-80) months, respectively. The difference in overall survival among the three primary disease groups was statistically significant (χ²=4.822, P<0.05), whereas the difference in recurrence-free survival was not statistically significant (χ²=3.287, P>0.05). Recipients with T1-stage cHCC-CCA had significantly better overall survival and recurrence-free survival than those with non-T1-stage disease (χ²=8.170 and 5.232, P all <0.05).

The efficacy of LT for BTC is unsatisfactory due to the high rate of tumor recurrence and relatively short post-transplant survival. Exploring appropriate recipient selection criteria and targeted downstaging/conversion strategies may help optimize long-term outcomes.

To investigate the applicability of NMF criteria in determining the optimal timing for initiating RRT in patients experiencing AKI following liver transplantation.

A retrospective analysis was conducted on the clinical data of patients with AKI following liver transplantation, who were admitted to ICU at LiHuili Hospital, affiliated of Ningbo University, from January 2018 to June 2023. Based on previous research findings, criteria for NMF were established, and 173 patients were categorized into four distinct groups: (1) Group A (n=41), comprising patients who met the NMF criteria and received renal replacement therapy (RRT) within 6 hours of ICU admission; (2) Group B (n=55), consisting of patients who met the NMF criteria but either did not receive RRT or received RRT after ≥ 6 hours post-ICU admission; (3) Group C (n=18), including patients who did not meet the NMF criteria but received RRT within 6 hours of ICU admission; and (4) Group D (n=59), comprising patients who neither met the NMF criteria nor received RRT, or who received RRT after ≥ 6 hours post-ICU admission. Conduct a comprehensive analysis and comparison of patient demographic and clinical characteristics, including age, gender, BMI, etiology, SOFA score, APACHE Ⅱ score, timing of transplant surgery, surgical technique, and incidence of hepatic coma. Evaluate clinical indicators such as serum creatinine, MELD-Na score, and blood ammonia levels preoperatively, postoperatively, and on the third and seventh days following transplantation. Assess prognostic outcomes by examining cumulative durations of mechanical ventilation, ICU stay, and total hospitalization, as well as 28-day, 90-day, and 1-year mortality rates. Additionally, evaluate the occurrence of CRBSI, CKD, liver dysfunction, and the requirement for long-term RRT. For intergroup comparisons, employ the t-test for normally distributed continuous variables, the Mann-Whitney U test for non-normally distributed continuous variables, and the chi-square test or Fisher′s exact test for categorical variables. A P-value of less than 0.05 will be considered indicative of a statistically significant difference.

Statistically significant differences were observed in serum creatinine and blood ammonia levels between patients in Group A and Group B on the third and seventh days following surgery, as well as in MELD-Na scores on postoperative day 7 (U/t= 2.245.30, 7.37, 7.55, 2.73, all P<0.05). Significant differences in serum creatinine and blood ammonia levels were noted between patients in Group C and Group D on the third day post-surgery (U=2.21 and 5.20, both P<0.05). Furthermore, significant differences were identified in the total length of hospital stay and the incidence of tracheostomy, concurrent CKD and long-term RRT between Group A and Group B (t/χ²=3.23, 4.59, 3.93, all P<0.05). Additionally, a statistically significant difference was found in the incidence of CRBSI between Group C and Group D (P<0.05).

According to the NMF criteria, patients with AKI who receive RRT following liver transplantation demonstrate significant improvements in postoperative serum creatinine levels, MELD-Na scores, and blood ammonia levels. Additionally, these patients experience a reduced total hospital stay, a lower incidence of CKD complications, and a decreased necessity for long-term RRT. Conversely, patients who do not meet the NMF criteria yet undergo RRT exhibit a heightened incidence of CRBSI.

To investigate the correlation between single nucleotide polymorphism (SNP) of chemokine receptor genes in allogeneic hematopoietic stem cell transplantation (allo-HSCT) donors and the occurrence of acute graft-versus-host disease (aGVHD) in recipients.

50 cases of allo-HSCT from February 2023 to December 2024 were selected to detect the polymorphism in the donor′s chemokine receptor genes. Polymorphisms of donor chemokine receptor genes were analyzed, including CCR5 (rs2227010, rs2734648, rs1799987, rs1799988, rs1800023, rs1800024), CCR6 (rs1556413, rs3093024, rs1854853, rs3093023), and CXCR3 (rs2280964, rs34334103). Associations between specific genotypes and aGVHD development were evaluated.

Among the 50 recipients, 23 (46%) developed aGVHD. The CCR5-rs1800024 CC genotype in donors was associated with a lower incidence of aGVHD compared to the CT+ TT genotypes (8/25 vs 15/25, P<0.05) and reduced liver involvement (0 vs 5/25, P=0.05). The heterozygous CT genotype correlated with a higher incidence of cutaneous aGVHD compared to homozygous genotypes (CC+ TT) (14/23 vs 8/27, P<0.05). CXCR3-rs34334103 CC genotype in donors showed a lower incidence of hepatic aGVHD compared to CT+ TT genotypes (3/46 vs 2/4, P<0.05). The CCR6-rs1854853 heterozygous AG genotype in donors was associated with a higher incidence of grade Ⅲ-Ⅳ aGVHD compared to homozygous AA+ GG genotypes (6/12 vs 0, P<0.05). The CXCR3-rs2280964 CC genotype demonstrated superior treatment efficacy compared to CT+ TT genotypes, with a higher overall response rate (14/14 vs 6/9, P<0.05).

The occurrence and clinical severity of aGVHD in recipients are significantly influenced by polymorphisms at four donor loci: CCR5-rs1800024, CXCR3-rs34334103, CCR6-rs1854853, and CXCR3-rs2280964. These findings highlight the potential role of chemokine receptor gene variants in modulating post-transplant immune responses and suggest avenues for personalized donor selection strategies.

The application value of dynamically observing the chimerism rate in whole blood in the treatment of myelodysplastic syndrome (MDS) with haploidentical hematopoietic stem cell transplantation (haplo-HSCT).

A retrospective case analysis was conducted on 43 patients who received haplo-HSCT treatment in the Hematology Department of North China University of Science and Technology Affiliated Hospital from January 2012 to January 2024. These patients were divided into a complete chimerism group of 33 patients (14 in the high-risk group and 19 in the low-risk group) and a mixed chimerism group of 10 patients (4 in the high-risk group and 6 in the low-risk group). The differences in overall survival (OS) rate, event-free survival (EFS) rate, cumulative incidence of relapse (CIR), and non-relapse mortality (NRM) rate were compared between the groups.

Follow-up was conducted until December 2024, with a median follow-up time of 34 (6-78) months after haplo-HSCT. The OS rate and EFS rate in the complete chimerism group [69.7% (95%CI: 52.2%-82.8%) and 57.6% (95%CI: 40.9%-72.6%), respectively] were higher than those in the mixed chimerism group [40.0% (95%CI: 16.8%-61.7%) and 30.0% (95%CI: 10.8%-50.3%), respectively], with statistically significant differences (χ²=4.258, 4.058, both P<0.05).There were no statistically significant differences in CIR and NRM rates between the two groups (both P>0.05). The OS and EFS rates in the high-risk complete chimerism group [64.3% (95%CI: 38.8%-83.7%) and 50.0% (95%CI: 26.8%-73.2%)] were higher than those in the high-risk mixed chimerism group [0 (95%CI: 0-49%) and 0 (95%CI: 0-38.7%)], with statistically significant differences (χ²=6.187, 6.187, both P<0.05). However, there were no significant differences in OS rate, EFS rate, CIR, and NRM rate between the low-risk complete chimerism group and the mixed chimerism group (both P>0.05). Multivariate Cox analysis revealed that post-transplantation relapse (HR=5.85, 95%CI: 1.98-17.20), high-risk MDS (HR=4.71, 95%CI: 1.45-15.30), and mixed chimerism status (HR=3.32, 95%CI: 1.12-11.15) were independent risk factors affecting overall survival in MDS patients.

The dynamic detection of chimerism rate, combined with risk stratification, aids in the early identification of high-risk relapsed populations, and provides certain guidance for stratified individualized treatment in MDS patients after haplo-HSCT.

Kidney transplant recipients frequently experience comorbid diabetes mellitus. Suboptimal glycemic control adversely impacts both the short- and long-term prognosis of these patients, and glucose-lowering management strategies require comprehensive treatment including antidiabetic drugs. Sodium-glucose co-transporter 2 inhibitors (SGLT2i), beyond the glucose-lowering efficacy, exhibit cardiac and renal protective effects as well as metabolic benefits, and are widely used in general patients with diabetes. However, evidence-based medical evidence supporting their use in the specific population of kidney transplant recipients with diabetes remains relatively limited. This review briefly summarizes the mechanisms of action of SGLT2i and their potential benefits and risks for kidney transplant recipients with diabetes, aiming to enhance clinicians′ awareness regarding the application of these agents in this unique patient group.

Kidney transplantation significantly improves the quality of life and prolongs survival in patients with end-stage renal disease. However, the shortage of donor organs results in prolonged waiting times for patients. Currently, standardized assessment and management systems for the kidney transplant waiting period remain lacking both domestically and internationally. This paper systematically reviews the assessment and management of dialysis patients during the kidney transplant waiting period, covering key aspects such as transplant eligibility, lifestyle during the waiting period, health status, common complications, immunologic assessment, and psychosocial assessment. The aim is to raise clinical awareness and provide a reference for the development of standardized management protocols.

Lung transplant recipients face a substantial risk of multidrug-resistant organisms (MDRO) colonization or infection during their ICU hospitalization. This risk can′t be attributed solely to mechanical ventilation, indwelling catheters, or prolonged length of stay; instead, it should be understood as the consequence of multiple synergistic factors including donor-derived microorganisms, pretransplant recipient colonization, intensity of immunosuppressive therapy, impaired airway defense mechanisms in the transplanted lung, abnormal bronchial anastomotic healing, and frequent airway manipulation procedures. The early post-transplant period carries a heightened risk of MDRO colonization or infection, with the lower respiratory tract being the most common site of infection. Furthermore, infection, primary graft dysfunction, and acute rejection frequently present with overlapping clinical manifestations, imaging findings, and inflammatory biomarkers, thereby complicating both microbiological diagnosis and antimicrobial agent selection. This review synthesizes the epidemiological characteristics of MDRO infections in lung transplant recipients during the ICU phase, encompassing donor-, recipient-, and graft-related risk factors, lower respiratory tract microbiological surveillance, differentiation between colonization and infection, antimicrobial stewardship, and multidisciplinary collaborative prevention and control strategies. Concurrently, it proposes an integrated approach that consolidates data from electronic medical records, microbiology, mechanical respiratory support, immunosuppressive regimens, imaging modalities, and environmental epidemiology. By incorporating dynamic risk prediction, antimicrobial resistance patterns, transmission chain analysis, and artificial intelligence applications, this review outlines future perspectives for MDRO prevention and control strategies in lung transplantation.