BACKGROUND:Autoimmune regulator gene(Aire)and Wnt signaling pathway play an important role in the maintenance and differentiation of mouse embryonic stem cell pluripotency.However,whether the Wnt signal and Aire are involved in the differentiation of embryonic stem cells to thymic epithelial progenitor cells remains poorly understood. OBJECTIVE:To investigate the relationship of the Wnt signaling pathway and Aire with the differentiation of embryonic stem cells. METHODS:A two-step differentiation method was used to induce mouse embryonic stem cells to differentiate into endoderm and then into thymic epithelial progenitor cells.Mouse embryonic stem cells were infected with Aire shRNA lentivirus,and monoclonal stable strains were screened by puromycin.Mouse embryonic stem cells were collected on days 0,3 and 10 of the directed induction of differentiation after the induced differentiation by the two-step differentiation method.Cellular immunofluorescence,flow cytometry,western blot assay,and real-time qPCR were used to detect the expression changes of related genes and proteins. RESULTS AND CONCLUSION:(1)Immunofluorescence staining showed positive expression of SSEA1 and OCT4 on day 0 of targeted induction of differentiation.(2)Immunofluorescence staining showed double-positive expression of SOX17 and FOXA2 on day 3 of targeted induction of differentiation.(3)Flow cytometry results showed positive expression of EPCAM1,K5 and K8 on day 10 of targeted induction of differentiation.(4)Compared with undifferentiated mouse embryonic stem cells,the expressions of Wnt7a,β-catenin,and Gsk-3β proteins were elevated,and the expression level of Aire protein was decreased in induced differentiated thymic epithelial progenitor cells.(5)Compared with undifferentiated mouse embryonic stem cells,the expressions of Wnt7a,β-catenin,Gsk-3β and Aire mRNA were elevated in thymic epithelial progenitor cells.(6)Compared with normal cultured mouse embryonic stem cells and their ultimately differentiated thymic epithelial progenitor cells,the expression levels of Wnt7a,β-catenin and Gsk-3β proteins were reduced in mouse embryonic stem cells with knockdown of Aire genes and their final differentiated thymic epithelial progenitor cells.In conclusion,the Wnt signaling pathway and Aire are jointly involved in the process of targeted induction of differentiation of mouse embryonic stem cells into mouse thymic epithelial progenitor cells.

Objective:This study is to understand the hot spots and trends in the recruitment of clinical trial subjects in China over the past 20 years, explore the existing problems and countermeasures, and provide scientific ideas for domestic clinical trial institutions to effectively solve the problem of subject recruitment.Methods:Bibliometric analysis was used to study the relevant literature from three major domestic databases from 2001 to 2021, analyzing key indicators such as annual publication volume, journal distribution, institutional distribution, regional distribution, and high-frequency keyword co-occurrence.Results:A total of 162 articles were selected. The results showed that the overall publication volume in this field showed an upward trend, and the research institutions were diversified, with a concentration of medical and pharmaceutical institutions and universities. The current research hotspots in this field focused on quality and efficiency improvement of subject recruitment, with themes of subject protection, ethical review, regulation development, standardized management, etc.Conclusions:The research in this field has made significant progress, but the overall research level is still relatively weak. Therefore, it is suggested that the country should play a role in macro-regulation, on the one hand, starting with top-level design, promoting the construction of a standardized management system for subject recruitment, continuously strengthening subject protection, and enhancing the effectiveness of scientific recruitment. On the other hand, releasing the potential of grassroots institutions and giving full play to the volume advantage by promoting the sinking of advantageous resources. Meanwhile, great importance should be attached to the development of Phase I clinical trials, giving full play to the strong internal energy of traditional medicine and promoting the development of Chinese traditional medicine. These multi-measures should provide a theoretical basis for exploring the transformation of ′clinical research hospitals′, and promote the high-quality development of new drug research and development in China.

【Objective】 To explore the correlation between intraoperative SedLine data and postoperative delirium (POD) in elderly patients with diabetes mellitus. 【Methods】 Between October 2019 and January 2020, elderly patients (≥65 years old) with diabetes undergoing elective surgery under general anesthesia were selected in the study, with cardiac function and ASA physical status of Ⅰ-Ⅲ. We excluded patients who underwent neurosurgical, cardiac, or transplantation surgery, were unsuitable for placement of electrodes on the head, or were not cooperative in the evaluation completion. Basic data were collected, including age, sex, body mass index, education, smoking, and cardiopulmonary co-morbidities. In addition to routine intraoperative monitoring, the patients received SedLine multi-channel electroencephalogram (EEG) monitoring and spectrum analysis, including original EEG, patient state index (PSI), burst suppression (BS), electroencephalogram (EMG) and density spectral array (DSA). The intraoperative SedLine data of the patients were observed and recorded. During hospitalization, Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and Montreal Cognitive Assessment (MoCA) were performed on the day before operation and postoperative day 1, 2, 3 and 7 to diagnose POD and postoperative cognitive dysfunction (POCD), respectively. T-test was used to screen the intraoperative EEG parameters with differences among groups. Associations were analyzed using binary Logistic regression analysis and ROC curve was used to calculate the cut-off score, sensitivity and specificity. 【Results】 There was no significant difference in baseline data between the two groups. The incidence of POCD in patients with POD was 57.2% higher than that in patients without POD (P=0.019). The two groups did not significantly differ in the duration of operation and anesthesia or hospital stay. There was no significant difference in the time of PSI<25 or BS between the two groups. Intraoperative EEG spectrum domain analysis showed that the alpha power in 10-14 Hz of patients with POD was significantly lower than that of non-POD patients (P<0.05). There was a significant correlation between them (P<0.05, OR=1.4, 95% CI: 1.036-1.855). The area under the ROC was 0.8 (95% CI: 0.6-0.9), and the diagnostic sensitivity and specificity were 66.7% and 80.4%, respectively when the diagnostic limit value was 0.5. 【Conclusion】 There is a significant correlation between the low alpha wave power of EEG during operation and the occurrence of POD in elderly patients with diabetes mellitus.

Objective:To investigate the differences in clinical features and imaging findings of cirrhotic patients with fundic varices between gastroesophageal varices type 2 (GOV2) and isolated fundic varices type 1 (IGV1).Methods:Clinical and imaging data of cirrhotic patients with fundic varices treated in Union Hospital, Tonji Medical Colloge, of Huazhong University of Science and Technology from October 2013 to March 2021 were retrospectively analyzed.Results:A total of 210 patients were enrolled, including 139 patients of GOV2 (GOV2 group) and 71 patients of IGV1 (IGV1 group). Blood routine examination results showed that the median value of hemoglobin in GOV2 group was lower than that in IGV1 group(91.00 g/L VS 112.00 g/L, P<0.05). The incidence of portal hypertensive gastropathy (PHG) in GOV2 group was higher than that in IGV1 group [20.14% (28/139) VS 5.63% (4/71), P<0.05]. The incidence of peptic ulcer was lower in GOV2 group than that in IGV1 group [12.23% (17/139) VS 38.03% (27/71), P<0.05]. The median diameter of portal veins in GOV2 group was larger than that in IGV1 group (15.09 mm VS 12.85 mm, P<0.05), and the volume of gastric fundus varices in GOV2 group was smaller than that in IGV1 group (2.14 mL VS 10.00 mL, P<0.05). The proportion of afferent veins in left gastric vein in GOV2 group was higher than that in IGV1 group [98.43% (125/127) VS 77.78% (42/54), P<0.05], and the median diameter of left gastric vein in GOV2 group was larger than that in IGV1 group (5.58 mm VS 4.53 mm, P<0.05). The efferent vessels mainly included gastrorenal shunt and splenorenal shunt. The incidences of gastrorenal shunt [27.56% (35/127) VS 66.67% (36/54)] and splenirenal shunt [12.60% (16/127) VS 25.93% (14/54)] in GOV2 group were lower than those in IGV1 group ( both P<0.05). The incidences of venae parumbilicales vein [38.58% (49/127) VS 12.96% (7/54)] and retroperitoneal collateral shunt [30.71% (39/127) VS 11.11% (6/54)] in GOV2 group were higher than those in IGV1 group (both P<0.05). Conclusion:There is significant heterogeneity in clinical features and imaging findings between cirrhotic patients complicated with GOV2 and IGV1. Recognizing and understanding the differences between the two types of patients is beneficial to taking appropriate clinical measures and improving patient prognosis.

Objective To explore the effects of knowledge-attitude-behavior theory based health education combined with health diary on medication adherence and quality of life in ulcerative colitis patients. Methods From February 2018 to January 2019, we selected 100 ulcerative colitis patients of Department of Gastroenterology at People's Hospital of Zhengzhou as subjects by convenience sampling. Patients were divided into control group and experimental group based on odd-even admission order, 50 cases in each group. There were 8 cases lost to follow-up due to out of touch in control group, and 4 cases withdrew from the study for various reasons in experimental group. Finally, totals of 42 cases were in control group and 46 cases were in experimental group. Control group carried out routine health education and discharge follow-up. On the basis of that, experimental group implemented knowledge-attitude-behavior theory based health education, and guided and supervised patients' health diary. The medication adherence and quality of life of patients between two groups were evaluated with the Morisky medication adherence scale and 36-item short-form health survey (SF-36). Results Before intervention, there was no statistical difference in the scores of medication adherence patients between two groups (P＞0.05). After intervention, the score of medication adherence of experimental group was higher than that of control group with a statistical difference (P＜ 0.01). Before intervention, there were no statistical differences in the scores of 8 dimensions of SF-36 of patients between two groups (P＞0.05). After intervention, the scores of bodily pain, general health status, vitality, social function, mental health of patients in experimental group were higher than those in control group with statistical differences (P＜ 0.05), but there were no statistical differences in the scores of other dimensions between two groups (P＞ 0.05). Conclusions Knowledge-attitude-behavior theory based health education combined with health diary can improve medication adherence and quality of life of ulcerative colitis patients which has the generalization and application value.

In order to learn the enzymatic hydrolysis characteristics of steam-explosion pretreated corn straw by cellulase, the effects of substrate concentration, cellulase concentration and temperature were determined. The kinetics of the hydrolysis reaction could be described with the Michealis-Menten equation, and the hydrolysis reaction obeyed the classical first-order reaction rate in the first three hours. In the condition of 45 degrees C and pH 5.0 and the stirring rate 120 r/min, the Michealis constant (Km) and maximum rate (Vm) for 1.2 FPU/mL of cellulase were 11.71 g/L and 1.5 g/(L x h). The kinetic model, including the parameters such as substrate concentration, enzymatic concentration and temperature, was suit for the hydrolysis reaction under the temperature range from 30 degrees C-50 degrees C.
Catalysis ; Cellulase ; chemistry ; Hydrolysis ; Kinetics ; Plant Stems ; Steam ; Zea mays

Objective To compare the clinical features and severity of thoracoabdominal combined injuries(TACI) and thoracoabdominal multiple injuries(TAMI) so as to guide the diagnosis and management of trauma. Methods A total of 167 cases of chest trauma complicated by abdominal trauma were reviewed and divided into two groups. Group TACI(132 cases) was associated with diaphragmatic rupture but group TAMI(35 eascs)not. The injury features and the clinical characteristics of both groups were analyzed and the trauma severity of two groups e-valuated by trauma score system. Results The overall mortality was 9.6 %(16/167)of all the cases. The mortality was 14.3% in group TACI (5/35)and 8.3% in group TAMI(11/132). There was no significant difference in revised trauma score(RTS) and thoracic Abbreviated Injury Scale(MS) between the two greups(P> 0.05),but the patients in the TACI group had higher Glasgow Coma Scale(C, CS)and abdominal AIS (P < 0.05), and the patients in the TACI group had higher injury severity scale (ISS) (P < 0.01). Conclusion TACI and TAMI have differ-ence in clinical characteristics,injury severity and treatment results. So it is necessary to take different measurements to reduce the complica-tions and improve the prognosis.

According to current situation of the undergraduates'scientific research,proposal of establishing the systematic research capacity training program was given,and this program's effects on undergraduates at our school were analyzed.

AIM:To investigate the effect of L-arginine(L-Arg) on expression of bcl-2,bax mRNA during pulmonary ischemia and reperfusion injury(PIRI) in rabbits.METHODS: Single lung ischemia and reperfusion animal model was used in vivo.The rabbits were randomly divided into three groups: sham operated group(sham,n=12),ischemia-reperfusion group(I/R,n=12) and I/R+ L-arginine group(L-Arg,n=12).Changes of several parameters,which included apoptotic index(AI),wet to dry ratio of lung tissue weight(W/D) and index of quantitative assessment of histologic lung injury(IQA),were measured at 300 min after reperfusion in lung tissue.Meanwhile the location and expression of bcl-2,bax mRNA as well as the ratio of bcl-2 mRNA/bax mRNA were observed.The lung tissue was prepared for light microscopic and electron microscopic observation at 60,180 and 300 min after reperfusion.RESULTS: As compared with I/R group,in intima and extima of small pulmonary artery,alveoli,and bronchiole epithelia,the expression of bcl-2 mRNA and the ratio of bcl-2 mRNA/bax mRNA were increased,and the expression of bax mRNA was decreased in L-Arg treatment group.The values of AI,W/D and IQA showed significantly lower than that in I/R group at 180 minutes after reperfusion in lung tissue(P