BACKGROUND:The self-renewal and multi-directional differentiation of pluripotent stem cells possess the potential to revolutionize people's understanding of biology,medicine,development,and disease.Stem cells play an important role in the early stage of embryonic development,and the study of them could be beneficial to understanding of the basic principles of biological development and tissue or organ formation,exploring the potential mechanisms of various diseases,studying the repair and regeneration of damaged tissues or organs,and promoting drug discovery and personalized treatment. OBJECTIVE:To review the research progress of pluripotent stem cells,summarize and categorize the fundamental types of pluripotent stem cells,and elucidate the lineage situations of various types of pluripotent stem cells in common mammals. METHODS:PubMed,Web of Science,CNKI,and WanFang databases were searched systematically,with the keywords"pluripotent stem cells;embryonic stem cells;induced pluripotent stem cells;expanded potential stem cells;livestock pluripotent stem cells"in English and Chinese.The 99 articles related to mammalian pluripotent stem cells were systematically screened according to inclusion and exclusion criteria,and then reviewed. RESULTS AND CONCLUSION:(1)According to classical theory in mouse embryonic stem cell research,the pluripotent state of stem cells is divided into two forms:na?ve and primed.Na?ve state corresponds to the inner cell mass of pre-implantation embryos before attachment to the uterine wall,while primed state corresponds to the epiblast after implantation.These two states exhibit significant differences in epigenetic features,transcriptional activity,external signal dependency,and metabolic phenotype.It is later discovered that there is an intermediate state between na?ve and primed called formative pluripotency.Therefore,the pluripotency of pluripotent stem cells is a continuous developmental process rather than a unique cell state.(2)In addition to obtaining pluripotent stem cells from the inner cell mass,there are various methods and lineages for acquiring pluripotent stem cells,including embryonic germ cells established using primitive germ cells from mouse embryos,induced pluripotent stem cells created by the dedifferentiation of adult mouse and human fibroblasts with four factors—Oct3/4,Sox2,c-Myc,and Klf4;embryonic stem cell-like cell lines cultured from somatic cell nuclear transfer,parthenogenesis,neonatal or adult testicular or ovarian tissue,very small embryonic-like stem cells derived from various adult tissues and expanded pluripotent stem cells derived from pre-implantation stages.These pluripotent stem cells all share the common characteristics of continuous self-renewal,expressing core pluripotency factors and possessing the ability to differentiate into the three primary germ layers.(3)Currently,pluripotent stem cells are being used for disease modeling to study the mechanisms of various diseases and develop new drugs.Simultaneously,scientists are attempting to use pluripotent stem cells to cultivate various tissues and organs,offering new possibilities for regenerative medicine and transplantation.However,the clinical application of pluripotent stem cells faces safety challenges,including issues of cell mutations and immune rejection.Continual improvement in the methods of generating pluripotent stem cells will make them safer and more efficient for clinical applications.(4)Based on the methods of obtaining and lineage establishment of pluripotent stem cells in mice and humans,various types of pluripotent stem cells have been established in livestock,including embryonic stem cells,induced pluripotent stem cells,germ lineages of pluripotent stem cells,and expanded potential stem cells.Research on livestock pluripotent stem cells opens up new avenues for animal reproduction,breeding,genetic engineering,disease modeling,drug screening,and the conservation of endangered wildlife.

Donors with a serum sodium concentration of >155 mmol/L are extended criteria donors for liver transplantation (LT). Elevated serum sodium of donors leads to an increased incidence of hepatic dysfunction in the early postoperative period of LT; however, the exact mechanism has not been reported. We constructed a Lewis rat model of 70% hepatic parenchymal area subjected to ischemia-reperfusion (I/R) with hypernatremia and a BRL-3A cell model of hypoxia-reoxygenation (H/R) with high-sodium (HS) culture medium precondition. To determine the degree of injury, biochemical analysis, histological analysis, and oxidative stress and apoptosis detection were performed. We applied specific inhibitors of the epithelial sodium channel (ENaC) and Na⁺/Ca²⁺ exchanger (NCX) in vivo and in vitro to verify their roles in injury. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) levels and the area of hepatic necrosis were significantly elevated in the HS+I/R group. Increased reactive oxygen species (ROS) production, myeloperoxidase (MPO)‍-positive cells, and aggravated cellular apoptosis were detected in the HS+I/R group. The HS+H/R group of BRL-3A cells showed significantly increased cellular apoptosis and ROS production compared to the H/R group. The application of amiloride (Amil), a specific inhibitor of ENaC, reduced ischemia-reperfusion injury (IRI) aggravated by HS both in vivo and in vitro, as evidenced by decreased serum transaminases, inflammatory cytokines, apoptosis, and oxidative stress. SN-6, a specific inhibitor of NCX, had a similar effect to Amil. In summary, hypernatremia aggravates hepatic IRI, which can be attenuated by pharmacological inhibition of ENaC or NCX.
Animals ; Reperfusion Injury/drug therapy* ; Hypernatremia/complications* ; Rats ; Liver/metabolism* ; Rats, Inbred Lew ; Male ; Apoptosis ; Sodium-Calcium Exchanger/antagonists & inhibitors* ; Reactive Oxygen Species/metabolism* ; Oxidative Stress ; Epithelial Sodium Channel Blockers/pharmacology* ; Epithelial Sodium Channels ; Cell Line ; Liver Transplantation

Objective: To explore the current status of hyperopic reserve and its related factors among non-myopia preschool and primary school students aged 5 to 12 years in Guangdong Province, so as to provide a basis for formulating intervention strategies for the pre myopia stage of children. Methods: From October to December 2023, by using stratified cluster random sampling method, a survey on hyperopic reserve among preschool children and primary school students in Guangdong were conducted. And a total of 10 567 children from the senior class of kindergarten to the sixth grade of primary school who completed autorefraction measurements with and without cycloplegia and the questionnaire survey were included in the study. The prevalence characteristics of low hyperopic reserve among non-myopia children were analyzed, and multivariable Logistic regression was used to analyze the related factors. Results: The prevalence rate of low hyperopic reserve among 8 790 non-myopia children was 62.4%. The average spherical equivalent (SE) for children aged 5 to 12 years was 0.88 (0.25, 1.25)D, decreasing from 1.13 ( 0.75 , 1.50)D in senior kindergarten to -1.00 (-2.50, 0.38)D in sixth grade, with the difference was statistically significant ( H=2 475.3, P <0.01). Multivariable Logistic regression analysis, after adjusting for confounders including gender, urban and rural, and grade, revealed that parental myopia was a risk factor for low hyperopic reserve in the preschool stage (one parent with myopia: OR=1.62, 95%CI =1.35-1.93; both parents with myopia: OR=2.05, 95%CI = 1.66 -2.55); in the lower primary school stage, parental myopia (one parent with myopia: OR=1.46, 95%CI =1.27-1.68; both parents with myopia: OR=1.58, 95%CI =1.33-1.89), frequently or always reading or using electronic screens while lying down or on one s stomach ( OR=1.43, 95%CI =1.13-1.81), and never or occasionally maintaining a viewing distance of over 3 meters when watching TV/playing video games ( OR=1.34, 95%CI =1.04-1.72) were risk factors; in the higher primary school stage, failing to take a break every hour during near work ( OR=1.79, 95%CI =1.16-2.75) was a risk factor (all P <0.05). Conclusions The emmetropization of children aged 5-12 years in Guangdong Province is accelerated, and non-myopia children generally exhibit insufficient hyperopic reserve. The contributing factors for insufficient hyperopia reserve in non-myopia children vary across different educational stages, necessitating targeted precision interventions.

Objective: To analyze the correlation between refractive errors and physical development indicators among primary school students aged 6 to 9, so as to provide a scientific basis for the development of effective prevention and control measures. Methods: A stratified cluster random sampling method was used to recruit 2 833 elementary school students aged 6 to 9 from Guangdong Province for vision screening, ocular biometry, and physical examinations in Octorber, 2020. The Chi square test, t-test, and ANOVA were employed to compare myopia rates and indicator values across different groups. Multiple linear regression models were used to analyze the correlations between height, weight, and body mass index (BMI) with refractive development indicators. Results: The screening myopia rate among primary school students aged 6 to 9 was 16.7%, and the myopia rate increased with age ( χ 2= 51.58 , P <0.01). The height and weight of the myopic group [(126.96±7.41)cm, (26.59±6.45)kg] were higher than those of the non myopic group [(124.76±7.77)cm, (25.42±5.87)kg] ( t =5.84, 3.65, P <0.01). The mean values of spherical equivalent (SE), axial length (AL), anterior chamber depth (ACD), and AL/corneal curvature radius (CR) ratio for students aged 6 to 9 were (-0.17±1.04)D, (22.96±0.78)mm, (3.38±0.24)mm, and (2.95±0.08), respectively, with statistically significant differences across different age and myopia severity groups ( t =37.08, 119.20, 41.54, 133.60; 935.30, 184.10, 73.95, 498.50, P < 0.01). After adjusting for gender, age, and residence, the multiple linear regression model showed that height was positively correlated with AL and CR, weight was positively correlated with ACD, and BMI was positively correlated with AL and ACD ( β = 0.191 , 0.070, 0.035, 0.013, 0.007, P <0.05). When stratified by myopia status, results for the non-myopic group were similar to the overall results, whereas in the myopic group, the correlations between height, BMI, and AL were not statistically significant ( P > 0.05). Conclusions Among primary school students aged 6 to 9, height and BMI are positively correlated with AL in the non myopic group but no similar correlation is observed in the myopic group, indicating that factors other than physical development, such as environmental and behavioral factors, should be considered for their impact on refractive development.

Objective:To investigate the evaluation efficacy and predictive prognostic value of alpha-fetoprotein (AFP) response in tyrosine kinase inhibitors (TKIs) in combination with PD-1 inhibitors (α-PD-1) for intermediate-to-advanced hepatocellular carcinoma (HCC).Methods:The retrospective cohort study was conducted. The clinicopathological data of 205 patients with intermediate-to-advanced HCC who were admitted to 9 medical centers, including Mengchao Hepatobiliary Hospital of Fujian Medical University et al, from March 2020 to July 2022 were collected. There were 178 males and 27 females, aged (52±12)years. Based on AFP response at 6-8 weeks after treatment, patients were divided into the AFP response group (AFP level decreased by ≥50% compared to baseline) and the AFP no response group (AFP level decreased by <50% compared to baseline). Observation indicators: (1) AFP response evaluation of anti-tumor efficacy; (2) comparison of patient prognosis; (3) analysis of factors affecting patient prognosis. Measurement data with normal distrubution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range) and M( Q1, Q3). Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test. The Kaplan-Meier method was used to draw survival curve and calculate survival rate, and the Log-Rank test was used for survival analysis. The COX proportional risk model was used for univariate analysis and the COX stepwise regression model was used for multivariate analysis. Results:(1) AFP response evaluation of anti-tumor efficacy. Before treatment, all 205 patients were positive of AFP, with a baseline AFP level of 1 560(219,3 400)μg/L. All 205 patients were treated with TKIs in combination with α-PD-1, and the AFP level was 776(66,2 000)μg/L after 6 to 8 weeks of treatment. Of the 205 patients, 88 cases were classified as AFP response and 117 cases were classified as AFP no response. According to the response evaluation criteria in solid tumors version 1.1, the objective response rate (ORR) and disease control rate (DCR) were 42.05%(37/88) and 94.32%(83/88) in patients of the AFP response group and 16.24% (19/117) and 64.10% (75/117) in patients of the AFP no response group, showing significant differences between them ( χ2=16.846, 25.950, P<0.05). According to the modified response evaluation criteria in solid tumors, the ORR and DCR were 69.32% (61/88) and 94.32% (83/88) in patients of the AFP response group and 33.33% (39/117) and 64.10% (75/117) in patients of the AFP no response group, showing significant differences between them ( χ2=26.030, 25.950, P<0.05). (2) Comparison of patient prognosis. All 205 patients were followed up for 12.4(range, 2.4-34.0)months after treatment. The median progression free survival time and total survival time were 5.5 months and 17.8 months, respectively. The 1-year, 2-year progression free survival rates were 20.8% and 7.2%, and the 1-year, 2-year overall survival rates were 68.7% and 31.5%, respectively. The median progression free survival time, 1-year and 2-year progression free survival rates were 9.7 months, 39.6% and 14.2% in patients of the AFP response group and 3.7 months, 7.8% and 2.0% in patients of the AFP no response group, showing a significant difference in progression free survival between them ( χ2=43.154, P<0.05). The median overall survival time, 1-year and 2-year overall survival rates were not reached, 85.2% and 56.3% in patients of the AFP response group and 14.6 months, 56.3% and 14.5% in patients of the AFP no response group, showing a significant difference in overall survival between them ( χ2=33.899, P<0.05). (3) Analysis of factors affecting patient prognosis. Results of multivariate analysis showed that invasion of large blood vessels, extrahepatic metastasis, combined hepatic artery intervention therapy, and AFP response were independent factors influencing progression free survival in patients with intermediate-to-advanced HCC who were treated with TKIs in combination with α-PD-1 ( hazard ratio=1.474, 1.584, 0.631, 0.367, 95% confidence interval as 1.069-2.033, 1.159-2.167, 0.446-0.893, 0.261-0.516, P<0.05), and Eastern Cooperative Oncology Group score, invasion of large blood vessels, extrahepatic metastasis, and AFP response were independent factors influencing overall survival in patients with intermediate-to-advanced HCC who were treated with TKIs in combination with α-PD-1 ( hazard ratio= 1.347, 1.914, 1.673, 0.312, 95% confidence interval as 1.041-1.742, 1.293-2.833, 1.141-2.454, 0.197-0.492, P<0.05). Conclusions:AFP response at 6-8 weeks after treatment can effectively evaluate anti-tumor efficacy of TKIs in combination with α-PD-1 for intermediate-to-advanced HCC. AFP response is the independent factor influencing progression free survival and overall survival in patients with intermediate-to-advanced HCC who were treated with TKIs in combination with α-PD-1.

Based on the theory of "one qi circulation" founded by HUANG Yuanyu， the core disease mechanism of colorectal cancer is the innate spleen deficiency and stomach qi failing to bear downward， which leads to the turbidity assemble in large intestine， forming the carcinoma toxin， and ultimately transforms into colorectal cancer. The treatment should base on recovering the circulation of qi， Huangya Decoction （黄芽汤） as the basic formula， the circulation of qi ascending and descending as the base， adjusting ascending and descending together with Xiaqi Decoction （下气汤）， and differentiating the syndrome on yin-yang excess-deficiency； for spleen-kidney yang deficiency syndrome， treated with Tianhun Decoction （天魂汤） to supplement liver， kidney and assist yang； for liver-kidney yin deficiency syndrome， treated wtih Dipo Decoction （地魄汤） to supplement lung， kidney， and assist yang. They jointly prompt one qi circulation to provide the thoughts for the treatment of colorectal cancer by traditional Chinese medicine.

Objective: The study aims to analyze the prevalence and associated factors of myopia among 4 to 9 grade students in Guangdong Province in 2022, so as to provide a scientific basis for targeted intervention measures for myopia in children and adolescents. Methods: From September to October 2022, stratified cluster random sampling was used to select 29 095 of 4 to 9 grade students from Guangzhou, Jiangmen, and Meizhou in Guangdong Province for myopia screening and questionnaire surveys. The Chisquare test was applied to compare the differences between groups, and multivariable Logistic stepwise regression analysis was used to analyze factors associated with myopia. Results: The myopia detection rate of 4 to 9 grade students was 61.7%, with detection rates of 51.5% for 4 to 6 grade primary school students and 71.95% for 7 to 9 grade junior high school students. Multivariable Logistic regression analysis showed that higher myopia rates were detected among girls (OR=1.39, 95%CI=1.30-1.49), students with one (OR=1.82, 95%CI=1.69-1.96) or both parents having myopia (OR=2.86, 95%CI=2.56-3.18), and indoor sedentary time >6 h(OR=1.28, 95%CI=1.17-1.39) in the 4 to 6 grade. Lower myopia rates were detected in the county (OR=0.92, 95%CI=0.86-0.99) and outdoors at recess activities (OR=0.88, 95%CI=0.81-0.95). Meanwhile, higher myopia rates were detected among girls (OR=1.84, 95%CI=1.69-1.99), students with one (OR=1.87, 95%CI=1.71-2.04) or both parents having myopia (OR=3.03, 95%CI=2.63-3.50), and indoor sedentary time >6 h/d (OR=1.11, 95%CI=1.01-1.23) in the 7 to 9 grade. Lower myopia rates were detected in the county (OR=0.74, 95%CI=0.68-0.80), outdoors at recess activities (OR=0.83, 95%CI=0.76-0.91), and outdoor activity time ≥2 h/d(OR=0.87, 95%CI=0.80-0.95)(P<0.05). Conclusions The detection rate of myopia among 4 to 9 grade students in Guangdong Province is relatively high. Place of recess activities, daily outdoor activity and indoor sedentary duration are associated with myopia. Therefore, targeted intervention measures should be adopted, such as appropriately increasing outdoor activity to reduce the occurrence of myopia among primary and middle school students.

Objective To study the application of serum microRNA(miR)-338-3p and miR-495-3p levels in the diagnosis and disease evaluation of severe adenovirus pneumonia in children.Methods A total of 130 chil-dren with adenovirus pneumonia who were treated in Cangzhou Central Hospital from November 2020 to No-vember 2022 were enrolled as an observation group.According to the severity of the disease,the children were divided into a mild pneumonia group with 90 children and a severe pneumonia group with 40 children.A total of 130 healthy children who were examined in Cangzhou Central Hospital during the same period were en-rolled as the control group.The observation and control groups and the children with different disease severity were compared in terms of the serum levels of miR-338-3p and miR-495-3p.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum miR-338-3p and miR-495-3p for severe adeno-virus pneumonia.Multivariate Logistic regression was used to analyze the influencing factors of severe adeno-virus pneumonia.Results The observation group had a significantly lower serum level of miR-338-3p and a significantly higher serum level of miR-495-3p than the control group(P＜0.05).There were significant differences in electrolyte disturbance,circulatory system complications incidence,miR-338-3p level,miR-495-3p level,sequential organ failure score and Murray lung injury score between the mild pneumonia group and the severe pneumonia group(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of serum miR-338-3p and miR-495-3p in the auxiliary diagnosis of severe adenovirus pneumonia were 0.745(95％CI 0.662-0.828)and 0.774(95％CI 0.685-0.863),respectively.And the AUC of the combination of the two was 0.884(95％CI 0.821-0.946),which was better than that of each index alone(Z=2.593,1.963,P＜0.05).Conclusion The level of serum miR-338-3p is decreased and the level of serum miR-495-3p is increased in children with severe adenovirus pneumonia.The combined detection of miR-338-3p and miR-495-3p has a certain value in the diagnosis of severe adenovirus pneumonia and can be used as a serum indica-tor to evaluate the severity of severe adenovirus pneumonia.

Objective:To investigate the protection of Active Breathing Coordinator(ABC)technique for heart and its substructures in radiotherapy for left breast cancer.Methods:A total of 50 patients with left breast cancer who underwent radiotherapy in our department were retrospectively selected,and treatment plans with intensity modulated radiotherapy(IMRT)were designed on the images of ABC combined with deep inspiration breath hold(ABC-DIBH)computed tomography(CT)and free-breathing(FB)CT,respectively.The dose parameters of the organ at risks(OARs)of heart and its substructures,including left ventricle(LV),left atrium(LA),right ventricle(RV),right atrium(RA),left main coronary artery(LMCA),left anterior descending coronary artery(LAD),left circumflex coronary artery(LCX)and right coronary artery(RCA),were compared between the two conditions.Results:Compared with FB,the dose of 2%volume(D2),the mean dose(Dmean),the percent volumes covered by different doses(V30,V20,V10,V5)decreased respectively 32.91%(absolute reduction of 1279.11 cGy),36.12%(195.94cGy),58.95%(2.8%),54.32%(3.58%),50.14%(5.56%)and 46.22%(9.67%)of heart under ABC-DIBH condition,and the differences were significant(t=10.28,12.81,9.16,10.28,12.82,12.24,P＜0.01),respectively.In addition,the Dmean values of LV,LA,RV,RA,LMCA,LAD,LCX and RCA decreased by 37.64%(absolute reduction was 285.92 cGy),15.38%(23.68 cGy),34.12%(118.93cGy),9.72%(12.52 cGy),22.17%(47.99 cGy),31.81%(820.63 cGy),16.51%(34.72 cGy)and 14.86%(34.11cGy)under ABC-DIBH condition,respectively,the differences were significant(t=9.50,3.71,6.20,8.65,3.18,10.92,4.26,6.71,P＜0.05).Conclusion:ABC technique can greatly reduce the received doses of heart and its substructures by extending the distance between the heart and the target region with DIBH,thus can form a very effective protection for the heart and its substructures.In addition,it can eliminate the dynamic variation of target location of breast cancer caused by respiratory,and avoid a series of problems,such as target missing,overexposure on normal tissue,and dose deviation.

Objective:To compare the dosimetric differences between active breathing coordinator (ABC) and Catalyst for respiratory gating after breast conserving surgery for left breast cancer.Methods:Data of 48 female patients with left breast cancer after breast conserving surgery admitted to the Radiotherapy Department of Shenzhen People′s Hospital from November 2020 to August 2021 were retrospectively selected. They were randomized to receive dynamic intensity modulated radiotherapy (IMRT) plans with ABC or Catalyst. The dosimetric differences in targets and organs at risk between the two groups were analyzed.Results:Comparison of the two respiratory gating IMRT plans revealed no statistically significant differences ( P > 0.05) in D90%, D98%, Dmax, Dmean, conformity index (CI), homogeneity index (HI), and monitor unit parameters in the target volume, (i.e., chest wall), as well as the ipsilateral lung and heart under the deep inhalation breath hold (DIBH) mode. The Dmean, Dmax, and D2% of the left anterior descending coronary artery (LAD) in the Catalyst group were better than those in the ABC group [(1 047.72 ± 1 401.84) vs. (454.48 ± 206.26), (1 619.28 ± 809.05) vs.(1 068.53 ± 419.63), (1 405.85 ± 798.30) vs. (1 016.54 ± 592.00) cGy], with statistically significant differences ( t= -2.07, -3.18, -2.07, P<0.05). Conclusions:Both ABC and Catalyst respiratory gating systems meet the requirements for clinical treatment, with the latter more effective in reducing the exposure dose of LAD.