Objective To investigate the relationship of PI3K/Akt signaling pathway with the activation of hepatic stellate cells (HSC) and its role in radiation-induced hepatic fibrosis.Methods HSC was treated with 6 MV X-ray irradiation (IR) together with the inhibitor of PI3K/Akt signaling pathway.The cells were divided into inhibitor group,10 Gy IR group,10 Gy + inhibitor group,20 Gy IR group,an 20 Gy + inhibitor group and blank control group.Then cell apoptosis rate was detected,the expression of transforming growth factor β1 (TGF-β1) in cell supernatant and the mRNA expressions of α-smooth muscle actin (α-SMA) and phosphorylation protein kinase B (p-Akt) were measured.Results Compared with the control group,the apoptosis rate of 10 and 20 Gy IR group increased with irradiation dose (t =8.43,11.63,P ＜0.05) but they were reduced by the inhibitor of PI3K/Akt (t =8.09,4.88,P ＜0.05).The expressions of TGF-β1,α-SMA,and p-Akt also increased with irradiation dose (t =6.91,7.80,9.28,P＜0.05) but they were declined by this inhibitor for both 10 Gy IR (t =6.17,15.11,10.34,P＜0.05) and 20 Gy IR (t =10.04,6.85,23.84,P＜0.05).Conclusions X-ray irradiation could activate HSC through PI3K/Akt signaling pathway,which may further result in hepatic fibrosis.

Exosomes are vesicles released into extracellular cells by fusion of intracellular polyvesicles and cell membranes. Exosomes are secreted by a variety of cells and exist in a variety of body fluids. Exosomes contain proteins, lipids and nucleic acids, which can participate in the information exchange between cells. Exosomes secreted by CNS cells are involved in the occurrence and development of CNS diseases. Recent studies have shown that exosomes can not only serve as early diagnostic markers for CNS diseases, but also have therapeutic potential for CNS diseases. In this paper, the development, diagnosis and treatment of CSF exosomes in CNS diseases were reviewed.

Lactoferrin in milk is a multifunctional protein. In addition, lactoferrin has antiviral, antifungal and antiparasitic activity. In this study, the N-terminus from porcine lactoferrin (PLF-N) was designed to express the antimicrobial action of recombinant porcine lactoferrin. We cloned a 1077 bp fragment of the PLF gene from mammary gland tissue of the lactating sow at the third day. Comparing nucleotide sequence with four strains of PLF gene published on GenBank, the homology was more than 99%. With the reference template of the cloned fragment of PLF-N and optimizing codon bias, we synthesized the gene of N-terminus encoding porcine lactoferrin (PLF-NS). The high expression gene of PLF-NS was cloned into the fusion expression vector pET30b and expressed in E. coli BL21 (DE3). After induced with Isopropyl beta-D-1-Thiogalactopyranoside (IPTG), the target fusion protein was successfully expressed and identified in inclusion bodies by SDS-PAGE and Western blotting. The protein had a molecular weight of 42 kDa and accounted for 32% of the total cellular protein. After purification and renaturation, the purity of the expressed protein was 98%. The expressed PLF-NS protein showed obviously antibacterial activity. This method provides an excellent way for high expression of antimicrobial proteins when optimizing codon bias.
Amino Acid Sequence ; Animals ; Anti-Infective Agents ; metabolism ; pharmacology ; Base Sequence ; Escherichia coli ; genetics ; metabolism ; Genetic Vectors ; genetics ; Lactoferrin ; biosynthesis ; genetics ; pharmacology ; Molecular Sequence Data ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; pharmacology ; Swine

Objective:Under the background of "new medical science", to construct a whole-process education path with "education as the driving force - moral cultivation as the core", and to provide a decision-making basis for the reform, innovation, and development of humanistic quality education in medical colleges.Methods:Five-year clinical medical students (freshman to fifth graders) from Qiqihar Medical University were selected as the research objects. The evaluation model and questionnaire of humanistic quality of clinical medical students were constructed by literature analysis. The Questionnaire Star platform was used to investigate and collect data by random sampling of clinical medical undergraduates, and the data results were analyzed by SPSS 26.0 to explore the path of building the whole-process education.Results:The empirical research on the cultivation of humanistic quality of medical students showed that the average humanistic attitude score of medical students was (3.47±0.75) points. From the perspective of gender, the scores of humanistic cognition, attitude, and behavior of male students were 2.81, 3.68, and 3.22 points, respectively, which were all significantly higher than those of female students (2.52, 3.22, and 2.95 points, respectively) ( P<0.05). The data from freshmen to the fifth graders showed that humanistic cognition, attitude, and behavior scores all presented an increasing trend with the grade. Using the "Knowledge, Attitude/Belief, Practice" model, it was found that the cognitive rate of humanistic quality of medical students was relatively ideal, and the awareness rate of medical students in different grades was different. The cross analysis showed that the effect of ideological morality and political literacy education on medical students in medical colleges had a significant cross-relationship with multiple choice questions. Conclusion:The humanistic quality of clinical medical students needs to be improved, and the cultivation of medical humanistic quality should run through the whole process from the first year to the fifth year, so as to improve the comprehensive training of professional ability and promote the all-round development of medical students.

Objective:To investigate the criteria for two-way referral of diabetes in China through systematic review.Methods:According to inclusion and exclusion criteria, articles on two-way referral criteria for diabetes in China were retrieved from databases of PubMed, Embase, Cochrane Library, CNKI and Wanfang from inception to July 15, 2023. The data were extracted, by author′s name, publish year, criteria for rupwards and downwards referral, sample size, study region, study type and main conclusions.Results:A total of 702 relavent articles were retrieved, and 15 of which were included in the analysis. Blood glucose levels were the basic criteria for two-way referral, The criteria for upward referral included fasting blood glucose, 2-h postpradial blood glucose, glycosylated hemoglobin and random blood glucose, but there were variations in measuement values. The criteria for downward referral included fasting blood glucose, 2-h postpradial blood glucose, glycosylated hemoglobin, with the variation in fasting blood glucose. Lipids and blood pressure were also included in the referral criteria in later literature, with the variation of blood pressure values. There was consensus on the upward referral criteria for patients with special types of diabetes and with newly diagnosed diabetes. In contrast, the referral criteria for diabetic complications were relatively vague, especially with the lack of severity classification for chronic complications.Conclusion:The two-way referral criteria for diabetes mellitus have been constantly developing, while the criteria for downwards referral to the community need to be further improved.

Objective To investigate the association between Helicobacter pylori (HP) infection and newly named "metabolic associated fatty liver disease (MAFLD)" and the value of HP infection combined with traditional risk factors in predicting MAFLD. Methods A retrospective analysis was performed for the clinical data of 350 patients who were admitted to Affiliated Hospital of Inner Mongolia University for the Nationalities and underwent carbon-13 urea breath test from January 2017 to December 2021, and according to whether fatty liver disease was diagnosed by abdominal ultrasound, they were divided into MAFLD group with 190 patients and non-fatty liver disease group with 160 patients. The independent-samples t test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data between groups. The binary Logistic regression analysis was used to investigate the risk factors for MAFLD. Results Compared with the non-fatty liver disease group, the MAFLD group had significantly higher body mass index ( t =8.73, P < 0.05), systolic blood pressure ( Z =-3.67, P < 0.05), diastolic blood pressure ( Z =-3.62, P < 0.05), triglyceride ( Z =-8.93, P < 0.05), fasting blood glucose ( Z =-9.13, P < 0.05), aspartate aminotransferase ( Z =-2.03, P < 0.05), gamma-glutamyl transpeptidase ( Z =-8.56, P < 0.05), proportion of male patients ( χ 2 =12.09, P < 0.05), and proportion of patients with hypertension ( χ 2 =37.91, P < 0.05), diabetes ( χ 2 =73.62, P < 0.05), overweight/obesity ( χ 2 =42.82, P < 0.05), hypertriglyceridemia ( χ 2 =59.12, P < 0.05), or HP infection ( χ 2 =4.53, P < 0.05), as well as a significantly lower level of high-density lipoprotein cholesterol ( Z =-6.81, P < 0.05). The Logistic regression analysis showed that fasting blood glucose (odds ratio [ OR ]=1.255, 95% confidence interval [ CI ]: 1.091-1.445, P < 0.05), HP infection ( OR =1.899, 95% CI : 1.048-3.440, P < 0.05), hypertension ( OR =2.589, 95% CI : 1.468-4.567, P < 0.05), diabetes ( OR =2.202, 95% CI : 1.123-4.315, P < 0.05), overweight/obesity ( OR =4.571, 95% CI : 2.308-9.052, P < 0.05), and hypertriglyceridemia ( OR =4.187, 95% CI : 2.411-7.271, P < 0.05) were risk factors for MAFLD, and it also showed that HP infection combined with traditional risk factors significantly increased the risk of MAFLD in subjects with diabetes, overweight/obesity, hypertriglyceridemia, and hypertension ( OR =12.267, 14.005, 7.911, and 7.364, all P < 0.05). Conclusion HP infection is associated with an increased risk of MAFLD, and its combination with traditional risk factors may further increase the risk of MAFLD.

ObjectiveTo investigate the association between the risk of increase in total cholesterol （TC） and the risk of cholelithiasis by using bidirectional Mendelian randomization （MR）. MethodsThe open gwas public database was used to obtain the single nucleotide polymorphism data associated with TC and cholelithiasis， and a secondary data analysis was performed for all summary data of genome-wide association studies. The genetic loci closely associated with TC or cholelithiasis were selected as exposure or outcome variables， and the bidirectional MR analysis was performed using the methods such as Egger regression， Weighted median， IVW random effects model， and IVW fixed effects model， with odds ratio （OR） values for evaluating the causal relationship between TC and cholelithiasis. ResultsWith TC as the exposure and cholelithiasis as the outcome， TC-cholelithiasis had an overall OR value of 0.91 （95% confidence interval ［CI］： 0.85‍ ‍—‍ ‍0.97） before elimination of heterogeneity and 0.93 （95%CI： 0.89‍ ‍—‍ ‍0.97） after elimination of heterogeneity. With cholelithiasis as the exposure and TC as the outcome， TC-cholelithiasis had an overall OR value of 0.20 （95%CI： 0.06‍ ‍—‍ ‍0.65） before elimination of heterogeneity and 0.28 （95%CI： 0.10‍ ‍—‍ ‍0.83） after elimination of heterogeneity. There was a bidirectional causal relationship between genetically predicted TC and cholelithiasis. ConclusionThis study confirms the bidirectional causal relationship between TC and cholelithiasis. The risk of cholelithiasis decreases with the increase in alleles associated with the elevation of TC level； on the contrary， the risk of elevated TC level decreases with the increase in alleles associated with the onset of cholelithiasis.

Objective:To explore the clinical characteristics, pathological features, and diagnosis and treatment strategies of nasal chondromesenchymal hamartoma (NCMH) in infants and young children.Methods:A retrospective analysis was conducted on seven cases of NCMH infants and young children admitted to Beijing Children′s Hospital, Capital Medical University from April 2015 to January 2022. The cohort included 5 males and 2 females, aged from 6 days to 2 years and 3 months. General information, clinical symptoms, imaging findings, treatment plans, postoperative complications, recurrence and follow-up time were collected, summarized and analyzed. Additionally, immunohistochemical characteristics of the lesion were examined.Results:The clinical symptoms of 7 children included nasal congestion, runny nose, open mouth breathing, snoring during sleep, difficulty feeding, and strabismus. All patients underwent electronic nasopharyngoscopy examination, with 5 cases of tumors located in the right nasal cavity and 2 cases in the left nasal cavity. No case of bilateral nasal cavity disease was found. All 7 patients underwent complete imaging examinations, with 5 patients underwent MRI and CT examinations, 1 patient underwent CT examination only, and 1 patient underwent MRI examination only. The CT results showed that all tumors were broad-based, with uneven density, multiple calcifications and bone remodeling, and some exhibited multiple cystic components. The MRI results showed that the tumor showed low signal on T1 weighted imaging and high or slightly high signal on T2 weighted imaging. All patients were diagnosed through histopathological examination and immunohistochemistry, including 7 cases of Ki-67 and SMA (+), 5 cases of S-100 and Vimentin (+), and all EMA and GFAP were negative. All patients underwent endoscopic resection surgery through the nasal approach, with 3 cases using navigation technology. Five cases of tumors were completely removed, and two cases of tumors were mostly removed. No nasal packing was performed after surgery, and no postoperative nasal, ocular, or intracranial complication occurred in all patients. Follow up assessments conducted 6 to 84 months post-surgery revealed no instances of tumor recurrence in any of the patients.Conclusions:The clinical symptoms of children with NCHM mainly depend on the size and location of the tumor. Nasal endoscopic surgery is the main treatment method. In cases where critical structures like the skull base or orbit are implicated, staged surgical interventions may be warranted. Long-term follow-up is strongly advised to monitor for any potential recurrence or complications.

Objective To explore the association between R611H(G/A,rs734312)variation of WFS1 gene and early-onset type 2 diabetes mellitus(T2DM).Methods A total of 181 Chinese patients with early-onset T2DM(T2DM group)and 196 non-diabetic controls(NC group)were enrolled in this study.The rs734312 variation was detected by PCR-direct sequencing.Genotypic and allelic frequencies of rs734312 and clinical variables were compared and analyzed between the two groups.Results Compared with the NC group,the frequencies of AA genotype and A allele in R611H(G→A)variation were significantly elevated in the early-onset T2DM group,AA vs GA+GG(OR 1.720,95%CI 1.100～2.680,P<0.05).A vs G(OR 1.500,95%CI 1.020～2.220,P<0.05).The remarkable differences of frequencies of genotype and allele in rs734312(G/A)were observed between Asians(China,Japan and Korea)and Caucasians(Denmark,Britain,Spain,France and Russia,P<0.01 for each).Compared with AA genotype,fasting and 2 hours postprandial insulin(FIns and 2 hIns)as well as HOMA-β were significantly rise in GG+GA genotype carriers of early-onset T2DM group(P<0.05).Conclusions The a allele of rs734312 in WFS1 may be a risk factor for early-onset T2DM in Chinese population,and the variation might be a potential genetic marker for predicting the islet β-cell dysfunction in early-onset T2DM in Chinese population.