BACKGROUND:Macrophage migration inhibitory factor(MIF)is a pleiotropic cytokine,which is secreted in different types of stem cells and can regulate the proliferation,differentiation and migration of various types of stem cells.Our previous research has confirmed that human embryonic stem cells secrete MIF and that its concentration in the culture medium is relatively stable.However,whether MIF is involved in the survival,proliferation and differentiation of human embryonic stem cells remains unclear. OBJECTIVE:To investigate the effects of MIF on survival,proliferation,and differentiation of human embryonic stem cells. METHODS:(1)Human embryonic stem cells H9 were cultured.The growth curve of cells was detected and plotted by CCK-8 assay.Enzyme-linked immunosorbent assay was used to determine the level of MIF in the medium.(2)To determine the effects of exogenous MIF on the survival and proliferation of human embryonic stem cells,different groups were established:the control group,which was cultured in stem cell medium without any modifications;the exogenous MIF group,which was treated with different concentrations(30,100,300 ng/mL)of MIF in the stem cell medium;the MIF inhibitor ISO-1 group,which was treated with different concentrations(2,7,21 μmol/L)of ISO-1 in the stem cell medium;and the MIF+ISO-1 group,which was treated with different concentrations of ISO-1 along with 100 ng/mL of MIF.Cell viability was assessed using the CCK-8 assay.(3)To further elucidate the effect of MIF gene on survival and proliferation of human embryonic stem cell,the MIF knockout H9 cell line was constructed by CRISPR-Cas 9 technology to observe the lineage establishment.(4)To determine the effect of high concentrations of MIF on human embryonic stem cell differentiation,100 ng/mL MIF and 100 ng/mL of CXCR4 neutralizing antibody were separately added to the normal stem cell culture medium.The expression levels of self-renewal factors(KLF4,c-MYC,NANOG,OCT4,and SOX2)and differentiation transcription factors(FOXA2,OTX2)were measured using real-time quantitative polymerase chain reaction,immunofluorescence staining,and western blot analysis. RESULTS AND CONCLUSION:(1)The logarithmic growth phase of H9 cells was between 3-6 days.Under normal growth conditions,human embryonic stem cells secreted MIF at a concentration of approximately 20 ng/mL,independent of cell quantity.(2)Compared to the control group,the addition of different concentrations of MIF had no effect on the proliferation of human embryonic stem cells(P>0.05).ISO-1 significantly inhibited the proliferation of human embryonic stem cells,with a stronger inhibition observed at higher concentrations of ISO-1(P<0.05).The addition of MIF in the presence of ISO-1 reduced the inhibitory effect of ISO-1(P<0.05).(3)Real-time quantitative polymerase chain reaction showed that knocking out 50%of the MIF gene resulted in a significant decrease in the growth vitality of human embryonic stem cells and failure to establish cell lines.(4)Adding 100 ng/mL exogenous MIF to the culture medium resulted in a decrease in the mRNA,protein,and fluorescence expression levels of the self-renewal transcription factor KLF4,while the mRNA,protein,and fluorescence expression levels of the differentiation factor FOXA2 increased.(5)When 100 ng/mL CXCR4 neutralizing antibody was added to the culture medium,the mRNA and protein expression levels of KLF4 increased,while the mRNA and protein expression levels of FOXA2 decreased,contrary to the expression trend observed in the MIF group.In conclusion,the endogenous secretion of MIF by human embryonic stem cells is essential for their survival.The addition of MIF to the culture medium does not promote the proliferation of human embryonic stem cells.However,it can lead to a decrease in the expression of the self-renewal factor KLF4 and an increase in the expression of the transcription factor FOXA2.This provides a clue for further investigation into the effects and mechanisms of MIF on the differentiation of human embryonic stem cells.The MIF-CXCR4 axis plays a regulatory role in this process.

BACKGROUND: There are few multi-city studies on the association between temperature and mortality in basin climates. This study was based on the Sichuan Basin in southwest China to assess the association of basin temperature with non-accidental mortality in the population and with the temperature-related mortality burden. METHODS: Daily mortality data, meteorological and air pollution data were collected for four cities in the Sichuan Basin of southwest China. We used a two-stage time-series analysis to quantify the association between temperature and non-accidental mortality in each city, and a multivariate meta-analysis was performed to obtain the overall cumulative risk. The attributable fractions (AFs) were calculated to access the mortality burden attributable to non-optimal temperature. Additionally, we performed a stratified analyses by gender, age group, education level, and marital status. RESULTS: A total of 751,930 non-accidental deaths were collected in our study. Overall, 10.16% of non-accidental deaths could be attributed to non-optimal temperatures. A majority of temperature-related non-accidental deaths were caused by low temperature, accounting for 9.10% (95% eCI: 5.50%, 12.19%), and heat effects accounted for only 1.06% (95% eCI: 0.76%, 1.33%). The mortality burden attributable to non-optimal temperatures was higher among those under 65 years old, females, those with a low education level, and those with an alternative marriage status. CONCLUSIONS Our study suggested that a significant association between non-optimal temperature and non-accidental mortality. Those under 65 years old, females, and those with a low educational level or alternative marriage status had the highest attributable burden.
Female ; Humans ; China/epidemiology* ; Cities ; Cold Temperature ; Hot Temperature ; Mortality ; Temperature ; Time Factors ; Middle Aged ; Male

Objective To investigate the difference between self-perceived risk and objective risk of stroke in the elderly population in Haikou area and explore the related factors in order to deter-mine the role of stroke knowledge in self-perceived risk.Methods A cross-sectional questionnaire survey was conducted on 584 elderly patients who were selected by convenience sampling from those taking physical examination in the First Affiliated Hospital of Hainan Medical College from September 2022 to April 2023.According to the accuracy of self-perceived risk of stroke,they were divided into an under-estimation group(170 cases),an accurate-estimation group(329 cases)and an over-estimation group(85 cases).Their self-perceived risk of stroke was assessed with the Stroke Risk Perception Questionnaire,and the objective risk of stroke was assessed with the Screening Criteria of Stroke High-Risk Group Screening Intervention Project of National Health Commission.Multivariate logistic regression model was used to analyze the factors related to the accuracy of self-perceived risk of stroke.One-way ANOVA was used to analyze the correlation be-tween the accuracy of self-perceived stroke risk and stroke knowledge.Results The participants with low,moderate,and high self-perceived risk of stroke accounted for 75.5％,20.5％and 3.9％,respectively.Compared with the objective risk assessment,the percentages of the participants with self-perceived stroke risk were 29.1％,56.3％and 14.6％,respectively,in the under-,accurate-and over-estimation groups.Significant differences were observed in gender,education level,smoking,drinking,exercise,fatty diet,fruit,overweight or obesity,and dyslipidemia among all groups(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that smoking,regular exercise,overweight or obesity and dyslipidemia were associated with accuracy of stroke risk perception in the accurate and the over-estimation groups when the under-estimation group was regarded as control(P＜0.01).The total score of stroke knowledge was 6.81±3.63,7.17±3.47 and 8.07± 3.24,respectively in the 3 estimation groups.The accuracy of self-perceived stroke risk was corre-lated with stroke knowledge(F=3.756,P=0.024).Conclusion Targeted health education should be implemented to make the elderly establish correct awareness of stroke risk,promote healthy behaviors and habits,and achieve the goal of early stroke prevention.

Objective To summarize the clinical characteristics of children with drug-induced hypersensitivity syndrome(DIHS)complicated with herpesvirus reactivation,and to promote the early and accurate identification,diagnosis,and treatment of DIHS in children.Methods The medication history,clinical manifestations,treatment,and prognosis of 12 children confirmed DIHS complicated with herpesvirus reactivation in Guangzhou Women and Children's Medical Center between January 2018 and March 2023 were retrospectively analyzed.The changes in hematological parameters,inflammatory indexes,and hepatic and renal function within 5 d before the eruption,5 d,and 6-10 d after eruption were compared.Results Of the 12 patients,the male-to-female ratio was 5∶1,with a median age of 27(interquartile range 20.50-34.75)months.Two or more antibiotics were used at least two to six weeks before onset,with a combination of 3 or more antibiotics in 7 children,and a combined or sequential application of 2 antibiotics in 5 children.The antibiotics included cephalosporins(n=12),semisynthetic penicillins(n=5),vancomycin(n=4)and azithromycins(n=7).All 12 patients presented fever,rashes,and multiple organ involvement.The rashes were red maculopapules in the early stage and then gradually developed into massive fusion exceeding 50%of the whole body.Among them,seven children were accompanied by facial edema,and two had purplish-red facial rashes.11 children suffered from exfoliative dermatitis in the later stage.12 children presented obviously enlarged lymph nodes.Liver involvement was the most common(100%,simple increase of transaminase in four children,cholestasis in six children,and hepatic failure in two children),and lung involvement was found in nine children.Laboratory examination showed no significant increase in leukocytes or eosinophils within 5 d before the eruption,but low levels of atypical lymphocytes.After the eruption,leukocytes,eosinophils,and atypical lymphocytes increased progressively.Inflammatory indexes of hypersensitive C-reactive protein(CRP),procalcitonin(PCT)increased dramatically before and after the eruption.All the children received intravenous immunoglobulin(IVIG)and methylprednisolone,two children were given antiviral therapy,and nine children were treated with multiple plasma exchanges.After treatment,nine children were cured,one developed immune reconstitution syndrome,and two died of hepatic failure.Conclusions Antibiotics are common allergenic drugs for DIHS in children.Its clinical manifestations include fever and rashes,accompanied by multiple organ involvement,such as the liver and lung.When leukocytes,eosinophils,and atypical lymphocytes are progressively elevated after the eruption,DIHS should be highly suspected,herpesvirus activation should be monitored,medication history should be traced,and early active immunotherapy and antiviral therapy should be conducted if necessary.

Occupational contact dermatitis is the most common occupational skin disease. It has a high incidence among healthcare workers, especially nurses. It has an impact on work and life. This paper reviews the research progress, risk factors, intervention measures, evaluation indicators of nurses′ hand occupational contact dermatitis, and provides references for the future researches.

Objective To explore the clinical characteristics including the morbidity, clinical manifestation, and pathogens of late-onset sepsis (LOS) in very low birth weight (VLBW) infants in neonatal intensive care unit (NICU). Methods Clinical data of all VLBW infants in NICU from January 2011 to December 2013 were collected. According to the results of blood culture, the VLBW infants diagnosed with LOS were divided into confirmed LOS group and clinical LOS group. The morbidity, clinical manifestations, common pathogens, and drug sensitivity of LOS were retrospectively analyzed. Results In 226 VLBW infants, there were 117 cases of LOS with the morbidity at 51.8%. Forty-five infants were confirmed to have LOS by blood culture, accounting for 19.9% (45/226); another 72 infants were diagnosed with clinical LOS, accounting for 31.9% (72/226). The rates of tachycardia and temperature fluctuation in confirmed LOS group were higher than those in clinical LOS group, and there were significant differences (P<0.05). There were 51 strains of pathogenic bacteria, with 32 Gram-negative bacteria (62.7%), 16 Gram-positive bacteria (31.4%), and 3 fungi (5.9%).The common pathogenic bacteria were Klebsiella pneumoniae and coagulase negative Staphylococcus,the most of which were multidrug-resistant bacteria.Conclusions The incidence of LOS in VLBW infants is high. The main clinical manifestations are sudden changes in breathing, heart rate, mental state, and skin color. Although these manifestations are not specific,they could serve as early warning.The common pathogenic bacteria are Klebsiella pneumoniae and coagulase negative Staphylococcus,and both of them are multidrug resistant.

Objective A series of 4 substituted salidroside derivatives were designed and synthesized .Their anti-fatigue effects were investigated .Methods With five-acetyl glucose and different 4-substituted benzyl tyrosols as the starting materi-als ,salidroside derivatives were synthesized through glycosidation and deacetylation reactions .The exercise exhaustive mice model was used to study the anti-fatigue effects of those synthesized derivatives by comparing the loading swimming time of mice .Results 10 novel salidroside derivatives were synthesized .The loading swimming tests showed that the swimming time of the mice in the positive group (salidroside) and 3a-1 group (phenethyl-β-D-glucoside) was longer than that in the control group with statistically significant difference(P<0 .05) .The swimming times for other groups were similar to control group with no statistically significant difference .Conclusion This synthetic method for salidroside derivatives was convenient and feasible for large production .The 4-hydroxyl groups on the benzene ring of salidroside and its derivatives may be the active site responsible for their anti-fatigue activity .

Objective To evaluate the effect of caffeine citrate on oxygen metabolism in brain and intestine in premature infants with neonatal respiratory distress syndrome (NRDS).Methods Preterm infants aged 30-34 weeks with NRDS admitted in Guangzhou Women and Children's Medical Center during May 2015 and April 2016 were enrolled.They were administrated with maintainance dose of caffeine citrate at the 2nd day after birth.The oxygen metabolism in brain and intestine 1 h before,during and after the administration were recorded by near infrared spectroscopy.Results The cerebral oxygen saturation (ScO2) showed a less significant change before,during and after treatment.While a marked increase was seen in intestinal oxygen saturation (SsO2) during and after caffeine citrate administration,as well as the change of SsO2/ScO2 than before.SsO2/ScO2 was dramatical higher in infants with nasal continuous positive airway pressure (nCPAP) than in those with incubator oxygen supply and mechanical ventilation during and after caffeine citrate treatment than before.Conclusion Caffeine citrate may improve the delivery of oxygen and may increase the oxygenation in local tissues for preterm infants with NRDS,especially for infants with nCPAP.

Objective To investigate the effect of comprehensive nursing intervention and evaluate its role in the entire clinical course of in the treatment of children with severe burns. Methods A total of 60 children with 1-5 years old with clinical diagnosis of severe burns were randomly divided into experimental group and control group by random digits table method, 30 cases in each group. The control group received routine burn care. The experimental group received comprehensive nursing interventions on the basis of routine burn care and the intervention time covered the entire course of treatment. During hospitalization, the recovery and family social system were evaluated by anxiety scales and social support scales combined with the cure rate and hospitalization of children. Results Before intervention, the score of Anxiety Rating Scale was high in both groups of families, while Social Support Scale was lower, the difference was not statistically significant between the two groups (P>0.05). After intervention, the score of Anxiety Rating Scale and was Social Support Scale were (52.31±7.81), (31.52± 5.48)points in the experimental group, and (62.51 ± 6.52), (23.62 ± 5.62) points in the control group, and there were significant differences (t=5.491 3, 5.512 5, P<0.01). The length of stay was (18.34±3.58) d in the experimental group, and (21.82 ± 4.23) d in the control group, and there was significant difference(t=3.439 6, P<0.05). The cure rate was 93.33%(28/30) in the experimental group, and 56.67%(17/30) in the control group, and there was significant difference(χ2=10.755 6, P<0.05). Conclusions The comprehensive nursing intervention can provide comprehensive refinement of the overall care in children and their families, promote physical and psychological rehabilitation of children with severe burns, and repair their family and social support systems. The comprehensive nursing intervention has far-reaching implications for the rehabilitation of children with severe burns.

OBJECTIVE:To investigate the clinical application of warfarin in inpatients of our hospital,and provide reference for standardized application in clinic. METHODS:Totally 267 inpatients records used warfarin in our hospital from Jan. 2013 to Jun. 2014 were investigated to retrospectively analyze the indications,dosage,international normalized ratio(INR)monitoring and bleeding complications of warfarin. RESULTS:Warfarin was mainly used for patients with deep vein thrombosis,cerebral infarc-tion,rheumatic heart disease and pulmonary embolism in our hospital;the dosage of inpatients was in the range of 0.625-6.875 mg with average daily dosage of (2.15 ± 0.72) mg;the INR lower than 1.8 accounted for 52.8%,the INR in the range of 1.8-3.0 (reaching the standard) accounted for 31.8% and INR higher than 3.0 accounted for 15.4%;incidence of adverse reactions was 5.6%,mainly subcutaneous blood spots (petechiae) and urine occult blood,and incidence of severe hemorrhage (intracerebral hemorrhage) was 0.7%. CONCLUSIONS:At present,the clinical application of warfarin is still deficient,and qualified rate of INR is still low. It's important to actively carry out medication intervention and clinical pharmaceutical care.