BACKGROUND:Nerve growth factor is a protein that induces nerve growth and regulates biological behaviors such as proliferation and differentiation of mesenchymal stem cells. OBJECTIVE:To investigate the promoting effect of nerve growth factor on chondrogenic differentiation of bone marrow mesenchymal stem cells. METHODS:Rabbit bone marrow mesenchymal stem cells were isolated and cultured,and nerve growth factor was transfected into bone marrow mesenchymal stem cells by lentiviral transfection.The effects of nerve growth factor on the proliferation,migration,hypertrophic differentiation,and chondrogenic differentiation of bone marrow mesenchymal stem cells were detected by CCK-8 assay,cell scratch assay,alizarin red staining,and western blot assay,using the transfected null-loaded virus as control.To further investigate the promoting effect of nerve growth factor on the chondrogenic differentiation of bone marrow mesenchymal stem cells,interleukin 1β was added in bone marrow mesenchymal stem cells transfected with empty virus and nerve growth factor for 14 days.The expression of proteins related to chondrogenic differentiation and hypertrophic differentiation was detected by western blot assay. RESULTS AND CONCLUSION:(1)CCK-8 assay results showed that nerve growth factor had no significant effect on the proliferation of bone marrow mesenchymal stem cells.(2)Compared with the control group,overexpression of nerve growth factor enhanced the migration ability of the cells,and the expression of cartilage-associated proteins type II collagen and SOX9 was up-regulated(P<0.05),while the expression of hypertrophic-associated proteins type X collagen and Runx2 was down-regulated(P<0.05).(3)Compared with the empty virus+interleukin 1β group,the expression of cartilage-associated proteins type II collagen and Sox9 was up-regulated(P<0.05),and the expression of hypertrophy-associated proteins type X collagen and Runx2 was down-regulated after overexpression of nerve growth factor(P<0.05).(4)The results indicated that nerve growth factor could promote the chondrogenic differentiation of bone marrow mesenchymal stem cells.

Objective:To determine the detection rate of myopia among primary and secondary school students in Hunan Province in 2022 and to analyze the influencing factors at both the school and individual levels, thereby providing a scientific basis for developing myopia prevention and control strategies.Methods:From October to November 2022, a multi-stage stratified cluster random sampling method was employed to select students from Year 4 of primary school to Year 3 of senior high school across 14 prefecture-level (autonomous prefecture) cities in Hunan Province for vision screening and questionnaire surveys. A multilevel regression model was utilized to analyze the influencing factors of myopia at both the school and individual levels.Results:A total of 189 343 primary and secondary school students were included in this study. The overall myopia detection rate was 55.56%, with a significantly higher prevalence observed in female students (60.49%) compared to males (51.03%) and in urban students (59.12%) versus those from rural areas (53.50%). A marked upward trend in myopia prevalence was identified with advancing grade levels (trend test χ2=16 246.13, P<0.001). Multilevel regression analysis revealed that at the individual level, female gender, higher grade level, parental myopia history, daily homework duration ≥2 hours after school, improper reading/writing postures, and taking breaks only after more than 15 minutes of near work were associated with an increased risk of myopia. Conversely, adequate sleep duration, outdoor activity ≥2 hours, and outdoor breaks during recess demonstrated protective effects. At the school level, non-compliant blackboard illumination uniformity emerged as a significant risk factor for myopia development. Conclusions:The detection rate of myopia among primary and secondary school students in Hunan Province remains relatively high and is associated with multiple factors at both the school and individual levels. Targeted interventions should be implemented at different levels to mitigate the risk of myopia.

Objective: To retrospectively analyze the early monitoring indicators before and after admission, the use of coagulation/anticoagulant medications, and the red blood cell transfusion within 24 hours in emergency trauma patients, and to identify the indicators related to the volume of red blood cells transfused during the first 24 hours of hopitalization, thereby assisting clinical judgment of the probability and required quantity of red blood cell transfusion. Methods: Data of 117 emergency trauma patients admitted to intensive care unit (ICU) from January 2022 to March 2024 were retrospectively analyzed. Patients were categorized according to whether the volume of red blood cells transfused within 24 hours exceeded specific quartile thresholds (Q1, Q2, Q3). Non-parametric tests were used for numerical variables and Chi-square tests were used for categorical variables to identify statistically significant single-factor indicators, which were subsequently incoporated into a binary logistic regression model to obtain a combined predictive probability. ROC curve analysis was performed on the multi-factor indicators and their combined predictive probability derived from the binary logistic regression model. Results: 1) The initial hemoglobin (Hb) and hematocrit (Hct) levle were independent influencing factors in the group with red blood cell transfusion volume exceeded Q1 (P<0.05), and the combined predictive probability demostrated by ROC curve analysis was AUC=0.858 (P<0.05). 2) In the group of red blood cell transfusion volume exceeding Q2, the initial Fib, transhulitic acid, human prothrombin complex, trauma category and primary trauma site were independent influencing factors (P<0.05), and the combined predictive probability of ROC curve analysis was AUC=0.966 (P<0.05). 3) Pulse pressure and trauma category were independent influencing factors in the group with red blood cell transfusion volume exceeding Q3 (P<0.05), and ROC curve analysis revealed that combined prediction probability was AUC=0.944 (P<0.05). Conclusion: Early monitoring indicators and the use of coagulation medications, before and after admission in emergency trauma patients show diagnostic value in predicting the amount of red blood cells transfused on the first day of admission. Early warning alerts established through patient monitoring indicators can reduce incidents of untimely blood supply from the blood transfusion department (blood bank) for emergency trauma patients with massive hemorrhage, especially for patients with rare blood types or during blood supply shortage.

Objective To investigate the relationship between the expression of nuclear factor ⅠB(NFⅠB)in myeloid cells and intestinal inflammation by constructing NFⅠB conditional gene knockout(cKO)mice.Methods Human Protein Atlas database,Genotype-Tissue Expression database,and FANTOM5 database were used to investigate the expression of NFⅠB in inflammatory cells.NFⅠB-floxed mice were constructed using CRISPR/Cas9 technology and hybridized with LyZ2-Cre transgenic mice.Myeloid specific NFⅠB cKO mice(NFⅠBfl/flLyz2-Cre)were obtained by self-crossing the progeny.After the genotype identification of mice by agarose gel electrophoresis,4 NFⅠB cKO mice of C57BL/6N strain were selected as experimental group,and 4 non-cKO mice were selected as control group.Both groups were induced with 2.5％dextran sulfate sodium salt(DSS)under the same condition to establish a chronic colitis model,and the severity of colitis was evaluated by clinical manifestations and histopathology.Results Analysis showed that NFⅠB was expressed in both myeloid granulocytes and monocytes,and the highest expression was found in neutrophils.NFⅠB cKO mice were successfully constructed using CRISPR/Cas9 technology and Cre-loxP system.DSS-induced enteritis NFⅠB cKO mice developed diarrhea,gross blood stools,reduced activity,and weight loss in a short time.The gross examination of the intestines showed that the colon of the NFⅠB cKO mice was significantly shorter than that of the non-cKO mice([8.23±0.35]cm vs[10.30±0.36]cm,P＜0.01).Intestinal H-E staining showed changes in mucosal glandular structure and connective tissue hyperplasia with extensive inflammatory cell infiltration in NFⅠB cKO mice.The histological score of NFⅠB cKO mice was significantly higher than that of non-cKO mice(4.25±0.50 vs 0.50±0.58,P＜0.01).Intestinal immunohistochemical staining showed that more CD11b positive cells were recruited in NFⅠB cKO mice than non-cKO mice.Conclusion Myeloid specific NFⅠB cKO mice have been successfully constructed,and NFⅠB in myeloid cells can reduce infiltration of immune cells(granulocytes or/and monocytes)to inhibit intestinal inflammation.

Objective To analyze clinical characteristics and therapeutic strategies for patients with Trichosporon asahii(T.asahii)bloodstream infection(BSI),and provide reference for clinical diagnosis and treatment for such disease.Methods Diagnosis and treatment process of a patient with T.asahii BSI were reported.China National Knowledge Infrastructure(CNKI),Wanfang,PubMed,and Web of Science databases were retrieved using key-words:"Trichosporon asahii"and"bloodstream infection".Patients'age,gender,underlying diseases,immune status,treatment,and clinical outcome as well as antimicrobial susceptibility testing results of T.asahii were ana-lyzed retrospectively.Results The leukemia patient developed T.asahii BSI during chemotherapy,and showed clinical improvement after treatment with fluconazole+flucytosine.A total of 44 cases(43 from literature plus this index case)were analyzed.Among these cases,28 were males,the median age was 54.5 years old.The underlying diseases were predominantly hematological diseases.Catheter,urinary tract,and skin were identified as concurrent culture-positive sites.Azoles exhibited good antimicrobial activity in vitro,with voriconazole showing the strongest activity and associated with significantly higher survival rates.Under the guidance of antimicrobial susceptibility tes-ting results,patients with fluconazole treatment had a higher survival rate.At minimum inhibitory concentrations(MICs)of 4-8 μg/mL of fluconazole,fluconazole combined with other agents was predominantly required.Am-photericin B demonstrated good in vitro activity,but the overall survival rate of patients was low when amphotericin B was used as monotherapy without azoles.Catheters removal,surgical intervention,and neutrophil recovery were influencing factors for enhanced survival rates.Conclusion BSI caused by T.asahii primarily occurs in patients with hematological diseases,with neutropenia being a high-risk factor.Infection sites at catheter,urinary tract,and skin may be infection sources.Clearing the source of infection and promoting the recovery of neutrophils can help to improve survival rates of patients.For voriconazole-intolerant patients,fluconazole monotherapy or in combination with flucytosine/amphotericin B can be used alternatively based on antimicrobial susceptibility testing results.

Clinical research on rare diseases has always faced multiple challenges in clinical research design and implementation due to small sample sizes of patients,high heterogeneity,and limited research resources.The rapid development of digital intelligence technology has provided innovative solutions for rare disease research.This article systematically explores the current status and response strategies of clinical research on rare diseases in the digital intelligence age.On the one hand,the efficiency of rare disease research has been optimized through adaptive design,mixed trial mode,and precision medicine stratification methods.On the other hand,solutions based on digital technology have been proposed to address the practical challenges of recruitment difficulties and underrepresentation of rare disease clinical research patients,data management and technical barriers,and insufficient coverage of natural medical history and baseline databases through digital intelligence technology.By combining international collaboration,intelligent screening,and remote experiments,a multidisciplinary collaboration and international cooperation,adaptive design,digital data platform,and patient-centered remote research model have been constructed as the core implementation strategies.Typical cases demonstrate that digital intelligence technology not only effectively shortens the drug development cycle,but also significantly enhances patient benefits,providing a replicable practical paradigm for global rare disease research.The practice of digital platforms represented by the International Rare Disease Research Alliance and the China Rare Disease Diagnosis and Treatment Collaboration Network has further verified the feasibility and promotional value of the digitalization path.In summary,digital intelligence technology has shown considerable promise in overcoming the clinical research challenges of rare diseases and accelerating the development of treatment plans,providing systematic references for researchers,regulatory agencies,and patient organizations.It is expected to drive the clinical research of rare diseases towards a more efficient and accurate future.

Objective:To determine the detection rate of myopia among primary and secondary school students in Hunan Province in 2022 and to analyze the influencing factors at both the school and individual levels, thereby providing a scientific basis for developing myopia prevention and control strategies.Methods:From October to November 2022, a multi-stage stratified cluster random sampling method was employed to select students from Year 4 of primary school to Year 3 of senior high school across 14 prefecture-level (autonomous prefecture) cities in Hunan Province for vision screening and questionnaire surveys. A multilevel regression model was utilized to analyze the influencing factors of myopia at both the school and individual levels.Results:A total of 189 343 primary and secondary school students were included in this study. The overall myopia detection rate was 55.56%, with a significantly higher prevalence observed in female students (60.49%) compared to males (51.03%) and in urban students (59.12%) versus those from rural areas (53.50%). A marked upward trend in myopia prevalence was identified with advancing grade levels (trend test χ2=16 246.13, P<0.001). Multilevel regression analysis revealed that at the individual level, female gender, higher grade level, parental myopia history, daily homework duration ≥2 hours after school, improper reading/writing postures, and taking breaks only after more than 15 minutes of near work were associated with an increased risk of myopia. Conversely, adequate sleep duration, outdoor activity ≥2 hours, and outdoor breaks during recess demonstrated protective effects. At the school level, non-compliant blackboard illumination uniformity emerged as a significant risk factor for myopia development. Conclusions:The detection rate of myopia among primary and secondary school students in Hunan Province remains relatively high and is associated with multiple factors at both the school and individual levels. Targeted interventions should be implemented at different levels to mitigate the risk of myopia.

Objective To analyze clinical characteristics and therapeutic strategies for patients with Trichosporon asahii(T.asahii)bloodstream infection(BSI),and provide reference for clinical diagnosis and treatment for such disease.Methods Diagnosis and treatment process of a patient with T.asahii BSI were reported.China National Knowledge Infrastructure(CNKI),Wanfang,PubMed,and Web of Science databases were retrieved using key-words:"Trichosporon asahii"and"bloodstream infection".Patients'age,gender,underlying diseases,immune status,treatment,and clinical outcome as well as antimicrobial susceptibility testing results of T.asahii were ana-lyzed retrospectively.Results The leukemia patient developed T.asahii BSI during chemotherapy,and showed clinical improvement after treatment with fluconazole+flucytosine.A total of 44 cases(43 from literature plus this index case)were analyzed.Among these cases,28 were males,the median age was 54.5 years old.The underlying diseases were predominantly hematological diseases.Catheter,urinary tract,and skin were identified as concurrent culture-positive sites.Azoles exhibited good antimicrobial activity in vitro,with voriconazole showing the strongest activity and associated with significantly higher survival rates.Under the guidance of antimicrobial susceptibility tes-ting results,patients with fluconazole treatment had a higher survival rate.At minimum inhibitory concentrations(MICs)of 4-8 μg/mL of fluconazole,fluconazole combined with other agents was predominantly required.Am-photericin B demonstrated good in vitro activity,but the overall survival rate of patients was low when amphotericin B was used as monotherapy without azoles.Catheters removal,surgical intervention,and neutrophil recovery were influencing factors for enhanced survival rates.Conclusion BSI caused by T.asahii primarily occurs in patients with hematological diseases,with neutropenia being a high-risk factor.Infection sites at catheter,urinary tract,and skin may be infection sources.Clearing the source of infection and promoting the recovery of neutrophils can help to improve survival rates of patients.For voriconazole-intolerant patients,fluconazole monotherapy or in combination with flucytosine/amphotericin B can be used alternatively based on antimicrobial susceptibility testing results.

Clinical research on rare diseases has always faced multiple challenges in clinical research design and implementation due to small sample sizes of patients,high heterogeneity,and limited research resources.The rapid development of digital intelligence technology has provided innovative solutions for rare disease research.This article systematically explores the current status and response strategies of clinical research on rare diseases in the digital intelligence age.On the one hand,the efficiency of rare disease research has been optimized through adaptive design,mixed trial mode,and precision medicine stratification methods.On the other hand,solutions based on digital technology have been proposed to address the practical challenges of recruitment difficulties and underrepresentation of rare disease clinical research patients,data management and technical barriers,and insufficient coverage of natural medical history and baseline databases through digital intelligence technology.By combining international collaboration,intelligent screening,and remote experiments,a multidisciplinary collaboration and international cooperation,adaptive design,digital data platform,and patient-centered remote research model have been constructed as the core implementation strategies.Typical cases demonstrate that digital intelligence technology not only effectively shortens the drug development cycle,but also significantly enhances patient benefits,providing a replicable practical paradigm for global rare disease research.The practice of digital platforms represented by the International Rare Disease Research Alliance and the China Rare Disease Diagnosis and Treatment Collaboration Network has further verified the feasibility and promotional value of the digitalization path.In summary,digital intelligence technology has shown considerable promise in overcoming the clinical research challenges of rare diseases and accelerating the development of treatment plans,providing systematic references for researchers,regulatory agencies,and patient organizations.It is expected to drive the clinical research of rare diseases towards a more efficient and accurate future.

With the rapid development of emerging technologies such as artificial intelligence, big data, and the internet of things, the field of medicine is undergoing revolutionary changes, and the cultivation of medical innovation talents is facing new challenges. Singapore has formed an effective mode for cultivating medical innovation talents with systematic strategies, innovative teaching methods, and the integration of international resources. The author summarized Singapore′s future oriented medical innovation talent training mode based on their study experience at Nanyang Technological University from March to June 2024, as well as the insights gained during visits to relevant medical colleges and research institutes, and combined with literature analysis. This included building a systematic cultivation system throughout the entire life cycle, multi-dimensional talent screening and cultivation mechanisms, innovative teaching models, and cultivating international medical talents. Then, by comparing and analyzing the problems existing in China′s medical innovation talent cultivation, it is suggested that China should highlight the coordinating role of government departments, build an integrated talent cultivation system; adhere to the strategy of education power, improve the internal and external collaborative pattern of medical innovation talent cultivation; promote the deep integration of artificial intelligence and medical education, and build new paths for medical talent cultivation.