Objective To investigate the effects of glutathiones-transferase (GST) T1, GSTM1 and epoxide hydrolase (EPHX1) genes on skin injury in workers exposed to coal tar pitch. Methods Workers from a carbon manufacturing company involved in coal tar pitch production and use were selected as the study subjects using a judgment sampling method. Workers with skin injury after exposed to coal tar were selected as the case group (55 cases), and those with the same workshop and type of work but without skin abnormalities were selected as the control group (197 cases). Urine and blood samples were collected from the workers, and levels of polycyclic aromatic hydrocarbon metabolites, including 1-pyrenol (1-OH-P), 1-naphthol (1-OH-N) and 2-naphthol (2-OH-N), in urine were measured using ultra high-performance liquid chromatography tandem mass spectrometry. The GSTT1, GSTM1 and EPHX1 genes in blood were detected by polymerase chain reaction. Results In the case group, all 55 workers reported skin stinging, 25 workers reported itching and flaking, and 15 workers reported blackheads and pigmentation. Urinary levels of 1-OH-N and 2-OH-N were lower in the worker in the case group than that in the control group (all P<0.05). However, there was no significant difference in the level of 1-OH-P between the two groups (P>0.05). There were significant differences in the number of workers with GSTT1, GSTM1 and EPHX1(His139His) genes between the two groups (all P<0.01). The GSTT1 and GSTM1 genes were positively correlated with post-shift urinary levels of 1-OH-N, 1-OH-P, and 2-OH-N (all P<0.01). The EPHX1 (139Arg locus) gene was positively correlated with post-shift 2-OH-N levels (P=0.03). The GSTT1, GSTM1, and EPHX1 (139Arg locus) genes were associated with reduced skin damage among coal tar workers (all P<0.01), after controlling for age, length of service, gender, smoking, and alcohol consumption. Conclusion Exposure to coal tar pitch can cause skin injury in workers, and the GSTT1, GSTM1, and EPHX1 (139Arg locus) genes are protective factors against skin injury in those workers.

On August 2-4,2023,the"Third Summit Forum on'Building a Community of Shared Future for Doctors and Patients'"was jointly organized by institutions such as the Chinese Medical Ethics,the Hospital Humanities Management and Talent Training Special Committee of the China Population and Culture Promotion Association,Center for Ethical Studies of Renmin University of China,the Newspaper for China's Physicians,the China Health Law Society,the China Anti-Cancer Association,and the China Association For Ethical Studies in Harbin.The conference arranged a sub-forum for the"Seminar on the Construction of Chinese Medical Humanities",with domestic medical humanities scholars attending the conference.After heated discussions at the seminar,the Scholars'Consensus on the Construction and Development of Chinese Medical Humanities was formed.It was proposed that in the new era,it is urgent to build the medical humanities discipline,as well as lead the academic integration and development of medical humanities under the core socialist values.At the same time,for the construction of the medical humanities discipline,it is necessary to optimize the organizational mechanism,prosper and develop the overall framework of the medical humanities discipline,accelerate the construction of a professional teaching team for the medical humanities discipline,promote the establishment of a new carrier medical humanities education and teaching in cultivating morality and nurturing talents,as well as focus on solving problems related to the cultivation of medical humanities graduate students.

Objective To investigate the safety of regular plasma donors aged 55 to 60,so as to provide reference for retention and recruitment of elderly plasma donors in China.Methods Plasma donors from 9 blood products manufacturing enterprises from 2018 to 2020 and the local general population were selected as the research objects.The total protein level,albumin and globulin ratio(ALB/GLB,A/G)and adverse reactions of plasma donation of regular plasma donors and local general population were retrospectively analyzed.Results The total protein level(g/L)and A/G of plasma donors aged 56 to 60 and the general population were 61.21±5.62 vs 60.04±6.93 and 1.610±0.299 vs 1.635±0.330,respectively,and the differences were statistically significant.The total protein level of regular plasma donors was higher than that of general popu-lation,but A/G was slightly lower than that of general population.From 2018 to 2020,there were a total of 23 056 302 plas-ma donations in 108 plasma stations,and adverse reactions occurred in 20 932 donations,with a total incidence of 0.09%,with no serious adverse reactions.Conclusion It is safe for regular plasma donors aged 55 to 60 to donate plasma,and the retention of them can alleviate the pressure of plasma supply.

Objective:To explore the real experience and needs of parents of adolescent patients with non-suicidal self-injury.Methods:Using the descriptive phenomenological research method. A total of 20 parents of non-suicidal self-injury adolescent patients who received treatment at the Second Affiliated Hospital of Xinxiang Medical University (Henan Provincial Psychiatric Hospital) from May to October 2022 were selected by purposive sampling for semi-structured interviews. Colaizzi 7-step analysis method was used to analyze, summarize and extract the subjects of the data.Results:The real experience of parents of adolescents with non-suicidal self-injury could be summarized into five themes, which were complex psychological reaction in the early stage, negative impact on the family, desire for more professional support, benefit and growth and negative coping in the later stage.Conclusions:Medical staff should pay attention to the mental health of parents of adolescents with non-suicidal self-injury and the negative effect of non-suicidal self-injury on their families, meet the emotional and knowledge needs of parents of adolescents with non-suicidal self-injury, especially pay attention to their negative coping in the later stage and formulate targeted intervention plans according to different stages, so as to build a good family rehabilitation environment and reduce the incidence of non-suicidal self-injury in adolescents.

Objective To construct a predictive model for septic shock based on the propensity score matching (PSM) method and validate its effectiveness. Methods A total of 114 patients with sepsis were enrolled as study objects, and were divided into septic shock group (40 patients) and sepsis group (74 patients) according to whether they developed septic shock. PSM was performed with a ratio of septic shock to sepsis of 1∶2, resulting in the inclusion of 30 patients in the septic shock group and 60 patients in the sepsis group after matching. The levels of C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), serum amyloid A (SAA), soluble endothelial protein C receptor (sEPCR), endothelial cell-specific molecule 1 (ESM-1), clusterin (CLU), and the Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score and Sequential Organ Failure Assessment (SOFA) score at admission were compared between the two groups. Cox proportional hazards regression analysis was used to identify the factors influencing septic shock, and a predictive model for septic shock was constructed and internally validated using the receiver operating characteristic (ROC) curve. Kaplan-Meier survival curves were plotted to analyze the differences in survival prognosis among patients with different expression levels of the indicators. Results After matching, there were no statistically significant differences in general information between the two groups (P>0.05). At admission, the septic shock group had higher levels of serum PCT, CRP, SAA, IL-6, sEPCR, ESM-1, and higher APACHE Ⅱ and SOFA scores, as well as a lower level of serum CLU compared with the sepsis group (P < 0.05). Cox regression analysis showed that PCT, CRP, SAA, IL-6, sEPCR, ESM-1, APACHE Ⅱ score, and SOFA score were independent risk factors for septic shock (P < 0.05), while CLU was an independent protective factor (P < 0.05). The predictive model for septic shock, constructed based on these factors, showed an internal validation accuracy of 94.44%, an area under the curve of 0.950, a sensitivity of 93.33%, and a specificity of 96.67%. Dead patients had higher levels of PCT, CRP, SAA, IL-6, sEPCR, ESM-1, and higher APACHE Ⅱ and SOFA scores, as well as a lower level of CLU at admission compared with survivors (P < 0.05). Compared with patients with low expression levels or low scores, patients with high expression levels of PCT, CRP, SAA, IL-6, sEPCR, ESM-1, and high APACHE Ⅱ and SOFA scores had higher fatality rates, while patients with high CLU expression levels had a lower fatality rate (P < 0.05). Conclusion The serum biomarkers including PCT, CRP, SAA, IL-6, sEPCR, ESM-1, CLU, and the APACHE Ⅱ and SOFA scores in sepsis patients are closely related to the occurrence of septic shock and survival prognosis. The predictive model constructed by combining these indicators can accurately predict the occurrence of septic shock.

Objective Based on"timing it right"framework,this study explored the dynamic changes of care dilemma in caregivers of adolescents with mood disorder and non-suicidal self-injury at different stages of disease development,and provided support for the construction of intervention programs.Methods This study adopted phenomenological research and purposive sampling method to select 11 caregivers of adolescents with mood disorders and non-suicidal self-injury behavior who were treated and hospitalized in a tertiary A psychiatric hospital in Henan Province from May 2022 to February 2023 as research subjects.According to the"timing it right"theory,5 semi-structured interviews were conducted with caregivers during the adolescent diagnostic period,hospitalization period,discharge preparation period,adjustment period,and adaptation period.The data was analyzed by the Colaizzi 7-step analysis method.Results The following themes were summarized.①Diagnostic period:complex emotional reactions,facing a dilemma at a loss.②Hospitalization period:lack of knowledge of disease and childcare,self-conscious care difficulties.③Discharge preparation period:lack of confidence in home care and lower expectations for the future of adolescents.④Adjustment period:lack of care skills and desire professional care support.⑤Adaptation period:negatively coping with diseases,with persistent care difficulties.Conclusion The care dilemma of caregivers of adolescents with mood disorders and non-suicidal self-injury behavior in different stages of disease development is dynamic.Medical staff should provide personalized professional support in a planned and continuous manner based on their different stages of care experience and needs,in order to improve the quality of their care and promote adolescent rehabilitation.

Objective To investigate the effect of neutrophil extracellular traps (NETs) on inflammation of rheumatoid arthritis (RA), especially angiogenesis. Methods The presence of NETs in synovial tissues of RA and osteoarthritis (OA) was observed by immunofluorescence assay. Neutrophils were isolated from peripheral blood of health volunteers. Neutrophils were cultured in vitro, the formation of NETs was observed. NETs were extracted as a stimulating agent. The effects of NETs on the proliferation of human umbilical vein endothelial cells (HUVECs) and synovial fibroblasts (RAFLS) were evaluated by MTT, and which were classified into two groups: HUVECs group and RAFLS group, with the following treatment: control and NETs (0.28 mg/L). Wound repair assay was employed to evaluate the effect on the cell migration stimulated with NETs. The experiment was divided into three groups:control, VEGF (40μg/L VEGF) and NETs (0.28 mg/L NETs). Results (1) Compared with OA, NETs were found more in the synovial tissue of RA. (2) NETs formation was induced by stimulator in vitro. The concentration of extracted NETs-DNA was 27.8 mg/L. (3) MTT assay showed that compared with the control groups, low concentration of NETs (0.28 mg/L) promoted the proliferation of HUVECs (0.499 ± 0.011 vs. 0.393 ± 0.009, P<0.05) and RAFLS (0.266 ± 0.007 vs. 0.192 ± 0.007, P<0.05). (4) It was showed that a significant wound closure induced by low concentration of NETs (0.28 mg/L) was found compared with control. Conclusion Our present study suggests that NETs are found more in the synovial tissue of RA, and low concentration of NETs can promote angiogenesis in RA.

Objective To investigate the relationaship between liver cirrhosis patients comibined with infection or death and intestinal permeability (IP)test.Methods 48 patients with liver cirrhois and 16 healthy volunteers were enrolled in the Af-filiated Hospital of Yan’an University during 2 years from 2013 to 2014 in this prospective study.Clinical data of patients were analyzed.LMR (IP index)were caculated and dectected by HPLC differental method.Serum LBP,IL-6 and I-FABP were determined by ELISA.Patients were followed for 1 year and assessed fro survival and the occurrence of infections.Re-lated factors with IP index were analyzed by Spearman’s rho.ROC curve,kaplan-meiser curve,cox regression were used to analyze related factors with the infection-free survival.Results IP index were increased in 40 (83.3%)patients with liver cirrhosis,compared with 4 increased IP index in healthy controls (χ2=19.006,P=0.001).IP index were correlated with al-bumin,IL-6,INR,bilirubin and Child-Pugh (CTP)scores by Spearman’s rho anaylsis (rs=-0.339~0.485,all P<0.05). 20 (41.7%)liver cirrhosis patients developed infection in the one year follow-up.There were signigicant differences in asci-tes (14 vs 18),CTP scores [9(5~14)vs 10(7~14)],MELD scores [12(7~27)vs 17(9~25),IL-6 [40(10~1 200)vs 60 (10~1 800)pg/ml]and I-FABP [1 160(800~8 600)pg/ml vs 4 130(1 520~8 060)pg/ml]between non-infected cirrhosis and infected cirrhosis patients (χ2=8.400,Z=-3.310~-2.160,all P<0.05).It was found that MELD>9,acites,I-FABP>1 728 pg/ml were independent factors of infection-free survial in liver cirrhosis patients by COX regression (all P<0.05).Conclusion Although increased IP was higher in liver cirrhosis,and it failed to predict infection-free survial in liver cirrhosis patients.

Background:Small bowel Crohn's disease (CD) is a chronic nonspecific inflammatory disease with unknown etiology.There is no clear criteria for assessing the progression of CD, and the endoscopic index for assessing disease activity in CD patients is limited to a single parameter.Aims:To investigate the clinical value of endoscopic index in evaluating disease activity in patients with CD and the correlation between different parameters.Methods:Sixty cases of CD patients form Jan.2008 to Dec.2012 at Affiliated Hospital of Yanan Uuiversity were collected, 60 healthy adults were served as control group.CECDAI score, CDAI score and Lewis score were used to evaluate disease activity in patients with CD, and their relationship with CRP and ESR were analyzed.Results:Levels of CRP and ESR were significantly increased in CD patients than in controls (P<0.05).CDAI score and Lewis score were statistically different in different CECDAI score groups (F=5.53, P<0.05;F=22.64, P<0.05).CECDAI score was statistically different in different CDAI score groups (F=3.55, P<0.05), and was statistically different in different Lewis score groups (F=4.26, P<0.05).CECDAI score was correlated with CDAI score, Lewis score, CRP, ESR (P<0.05);CDAI score was correlated with CRP, ESR (P<0.05) and not correlated with Lewis score (P>0.05);Lewis score was not correlated with CRP, ESR (P>0.05) in CD patients.Conclusions:CECDAI score, CDAI score, Lewis score, CRP, ESR can reflect disease activity of CD, and can be used together to assess disease activity of CD patients.

Objective To explore whether serum amyloid A (SAA) can induce the formation of neutrophil extracellular traps(NETs)in neutrophils in vitro. Methods A stable method for inducing NETs formation in vitro was established, in-cluding isolation of peripheral blood neutrophils, cell culture, and NETs formation and observation. The neutrophils were iso-lated from peripheral blood of healthy volunteers. And cells were cultured in vitro and classified into three groups:negative control (NC) group, SAA group and lipopolysaccharide (LPS) group. Following the distinct stimulation in three groups, NETs formation was observed and its percentage was calculated. The concentration of hinstone (h) 3 in supernatant was detected by ELISA. Results The purification and vitality of isolated neutrophils were both more than 95%. The nuclei of neutrophils lost their shape and spread, NETs formation was found. More NETs formation was found in SAA group than that in NC group (P < 0.05). Moreover, the concentration of h3 in supernatant was significantly higher in SAA group than that in NC group (P<0.05). Conclusion SAA can induce the formation of NETs in vitro.