Background::Thoracic aortic aneurysm (TAA) is a fatal cardiovascular disease, the pathogenesis of which has not yet been clarified. This study aimed to identify and validate the diagnostic markers of TAA to provide a strong theoretical basis for developing new methods to prevent and treat this disease.Methods::Gene expression profiles of the GSE9106, GSE26155, and GSE155468 datasets were acquired from the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) were identified using the "limma" package in R. Least absolute shrinkage and selection operator (LASSO), support vector machine-recursive feature elimination (SVM-RFE), random forest, and binary logistic regression analyses were used to screen the diagnostic marker genes. Single-sample gene set enrichment analysis (ssGSEA) was used to estimate immune cell infiltration in TAA.Results::A total of 16 DEGs were identified. The enrichment and functional correlation analyses showed that DEGs were mainly associated with inflammatory response pathways and collagen-related diseases. Collagen type I alpha 1 chain ( COL1A1) and synaptotagmin like 2 ( SYTL2) were identified as diagnostic marker genes with a high diagnostic value for TAA. The expression of COL1A1 and SYTL2 was considerably higher in TAA vascular wall tissues than in the corresponding normal tissues, and there were significant differences in the infiltration of immune cells between TAA and normal vascular wall tissues. Additionally, COL1A1 and SYTL2 expression were associated with the infiltration of immune cells in the vascular wall tissue. Single-cell analysis showed that COL1A1 in TAA was mainly derived from fibroblasts and SYTL2 mainly from cluster of differentiation (CD)8 + T cells. In addition, single-cell analysis indicated that fibroblasts and CD8 + T cells in TAA were significantly higher than those in normal arterial wall tissue. Conclusions::COL1A1 and SYTL2 may serve as diagnostic marker genes for TAA. The upregulation of SYTL2 and COL1A1 may be involved in the inflammatory infiltration of the vessel wall and poor extracellular matrix remodeling, promoting the progression of TAA.

AIM:To investigate the activation of Cl-channels by sodium taurocholate(NaTC)in mouse pan-creatic acinar cells.METHODS:The single isolated pancreatic acinar cells from FVB/N mice were prepared using colla-genase digestion method.Whole-cell patch clamp technique was performed to record the currents.Intracellular adenosine triphosphate(ATP)dependence of the channels was examined via eliminating ATP from the pipette solution.Anion per-meability of the channels was investigated with ion-exchange method.The pharmacological characteristics of the channels was confirmed by two Cl-channel blockers.The volume sensitivity of the channels was detected using 47%hypertonic bathing solution.Extracellular Ca2+dependence of activating the channels was examined through eliminating Ca2+from the bathing solution.Intracellular reactive oxygen species(ROS)level was detected by an oxidation-sensitive fluorescent probe,2',7'-dichlorofluorescin diacetate.The experiment was repeated 6 times in each group.RESULTS:Extracellular application of 5 mmol/L sodium taurocholate induced a Cl-current,exhibiting the properties of outward-rectification,a se-lectivity sequence of I->Br-≥Cl->gluconate-and intracellularATP dependence(P<0.01).The currents were inhibited by chloride channel blocker 4,4'-diisothiocyanatostilbene-2,2'-disulfonic acid disodium salt hydrate(DIDS)and tamoxifen and by 47%hypertonicity stimulation(P<0.01).When ROS production was scavenged by N-acetyl-L-cysteine,the sodi-um taurocholate-induced Cl-currents were unaffected.The effect of sodium taurocholate on ROS production did not alter with the treatment with DIDS.Sodium taurocholate failed to induce Cl-currents when Ca2+was absent in extracellular bath-ing solution(P>0.05).CONCLUSION:Sodium taurocholate activates Cl-channels in mouse pancreatic acinar cells,which is dependent on extracellular Ca2+but not ROS pathway.

Background/Aims: Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China. Methods: A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators. Results: Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders. Conclusions In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.

Humans ; Endovascular Aneurysm Repair ; Stents ; Blood Vessel Prosthesis ; Aortic Dissection/surgery* ; Endovascular Procedures ; Aortic Aneurysm, Thoracic/surgery* ; Treatment Outcome ; Blood Vessel Prosthesis Implantation ; Retrospective Studies

ObjectiveTo investigate the willingness of middle school students to engage in medicine and its influencing factors during COVID-19 pandemic in Lanzhou， so as to provide references for the early career planning education on middle school students. MethodsConvenient sampling method was used to choose 1 795 middle school students from 5 schools in Lanzhou from July 21 to July 31， 2022 for this study where an online questionnaire survey was distributed to collect data. A self-compiled questionnaire was used to gather the general information， assess the willingness to engage in medicine and seek the underlying reasons. The psychological resilience level of students was assessed using Resilience Scale for Adolescents. Then multivariate Logistic regression analysis was conducted to screen the factors associated with the willingness of middle school students to engage in medicine. ResultsAfter the local outbreak of COVID-19 in Lanzhou， 835 （46.52%） middle school students demonstrated their willingness to engage in medicine， and the top three reasons for their willingness were being affected by medical staff during the pandemic （75.69%）， having interests in medical sciences （67.31%）， and the potential increase of attention to national medical development after the epidemic （43.23%）. Logistical regression analysis showed that female gender （OR=1.438， P<0.01）， family members engaged in the medical and health industry （OR=1.574， P<0.01） and having a high psychological resilience score （OR=1.011， P<0.01） were related to the clear willingness to engage in medicine， while studying in senior middle school （OR=0.473， P<0.01） and excessive exposure （≥50%） to negative information during the epidemic （OR=0.797， P<0.05） were related to declining willingness to engage in medicine. ConclusionAfter the COVID-19 outbreak in Lanzhou， a large proportion of local middle school students show their willingness to engage in medicine， especially among those of female gender， having family members engaged in the medical and health industry and having high level of psychological resilience. Whereas students studying in senior middle school and with excessive exposure to negative information during the outbreak indicate low willingness to engage in medicine.

This study summarizes the construction background, rules and regulations and institutional settings of the MOOC and Micro-course Club in the Second Hospital of Jilin University, discusses the means of teacher training for clinical teachers, and shows the application effect of the club. At the same time, the related problems encountered in the process of club construction are summarized and reflected. The construction of MOOC and micro-course clubs is conducive to improving the information-based teaching level of clinical teachers, and also provides new inspiration and ideas for the construction of medical clubs.

Objective:To explore the value of arterial spin labeling (ASL) in detecting epileptogenic zone (EZ) in children with drug-refractory epilepsy (DRE).Methods:From March 2018 to December 2019, 28 children with DRE were collected prospectively in Peking University First Hospital. Structural MRI, ASL sequence, and PET-CT were performed on 28 DRE children. All children underwent surgical treatment. Intraoperative electrocorticogram findings combined with postoperative MRI results were considered the gold standard for locating EZ. A total of 29 EZ were resected in 28 children. Based on the pathological results, the EZ was divided into focal cortical dysplasia (FCD) Ⅰb and Ⅱa group ( n=12), FCD Ⅱ b group ( n=11) and malformation of cortical dysplasia (MCD) group ( n=6). Structural MRI was observed for finding any abnormal changes that could induce epilepsy and was divided into the normal MRI group ( n=13) and the abnormal MRI group ( n=16). The spatial relationship between abnormal areas in the cerebral blood flow (CBF) map and PET images and the gold standard was observed, and the accurate detection rate of EZ was calculated. The region of interest (ROI) on CBF and PET images was drawn. ROIs were defined as EZ, EZ contralateral zone (EZCZ), EZ adjacent zone (EZAZ), EZAZ contralateral zone (EZAZCZ). The CBF and maximum standardized uptake value (SUV max) were measured, and the asymmetry index (AI) value of EZ and EZAZ of CBF and SUV max was calculated respectively. One-way ANOVA was used to compare the difference among 4 regions and 3 pathological types of CBF, SUV max, and AI. The independent sample t-test was used to compare the difference in AI between normal and abnormal MRI groups. Results:In CBF map, the EZ was accurately localized in 89.7% (26/29) of the lesions, in which 24 EZ had decreased perfusion, and 2 EZ had increased perfusion. Among the 24 EZ with decreased perfusion, the CBF of EZ, EZCZ, EZAZ, and EZAZCZ were significantly different( F=8.79, P<0.001). In PET-CT, the EZ was accurately localized in 93.1% (27/29) of the lesions, in which 25 EZ had decreased metabolism, and 2 EZ had increased metabolism. Among the 25 EZ with decreased metabolism, the SUV max of EZ, EZCZ, EZAZ, and EZAZCZ were significantly different ( F=6.40, P=0.001). The AI value of CBF and SUV max of EZ in the abnormal MRI group were larger than those of the normal MRI group, and the difference was statistically significant ( t=3.34, 3.09, P=0.002 , 0.004). There was no statistical difference in the AI values of CBF and SUV max among FCD Ⅰb and Ⅱa group, FCD Ⅱb group and MCD group ( F=2.05, 1.54, P=0.149, 0.234). Conclusions:ASL technology is accurate in detecting EZ. The changes in perfusion and metabolism of normal structural MRI EZ are greater than abnormal structural MRI EZ. There is no obvious difference in CBF and SUVmax changes in different pathological EZ.

Objective:To explore the risk factors associated with the clinical progression of COVID-19 infection in kidney transplant(KT)recipients during the spread of Omicron variant and evaluate the effectiveness of anti-RNA virus agents in blocking the clinical progression of COVID-19 in these recipients.Methods:Retrospective analysis was conducted for the clinical data on COVID-19 infection in 232 KT recipients followed up from December 4, 2022 to January 31, 2023 at Department of Renal Transplantation, Organ Transplantation Center, Beijing Tsinghua Changgung Hospital.Inclusion criteria were age ≥18 years and stable kidney function without renal replacement therapy.The follow-up time was 30 days after COVID-19 infection.Based upon whether or not there was an infection of COVID-19, KT recipients were divided into two groups of infection(181 cases)and non-infection(51 cases). In infection group, recipients were further assigned into two sub-groups of disease progression(n=23)and stable(158 cases)according to whether or not there was a progression to severe disease.Various factors such as gender, age, body mass index(BMI), time after transplantation, underlying diseases(history of hypertension, diabetes mellitus, coronary heart disease & chronic lung disease), smoking history and dosing of anti-RNA virus agents were collected.Pearson χ2 test or Fisher's exact probability method was utilized for examining enumeration data while Mann-Whitney U test for measurement data.Univariate Logistic regression analysis was conducted and variables with P<0.05 were included into multifactorial Logistic regression analysis to identify independent risk factors for clinical progression of COVID-19 infection in KT recipients. Results:Among 232 KT recipients, infection rate of COVID-19 was 78.0%(181/232). The clinical classification was mild(112 cases), moderate(46 cases), severe(21 cases)and critical(n=2 cases). The severe rate was 12.7%(23/181). After infection with COVID-19, the proportion of KT recipients aged ≥65 years progressing from mild/moderate to severe was higher than those aged<65 years[38.5%(5/13)vs 10.7%(18/168)]. The difference was statistically significant( P=0.014); The proportion of diabetic KT recipients progressing from mild/moderate to severe was higher than those without diabetes[19.1%(13/68)vs 8.8%(10/113)]. The difference was statistically significant( P=0.045). Univariate Logistic analysis showed similar results.Age≥65 years( OR=5.21, 95% CI: 1.54-17.64, P=0.008)or diabetes mellitus( OR=2.44, 95% CI: 1.003-5.911, P=0.049)were the risk factors for COVID-19 infection recipients progressing from mild/moderate to severe disease.Multivariate Logistic analysis revealed that age ≥65 years( OR=4.03, 95% CI: 1.14-14.34, P=0.031)was an independent risk factor for COVID-19 infection recipients progressing from mild/moderate to severe.Among 181 cases of COVID-19 mild/medium infected patients, 18 cases received nimativir/ritonavir and 10 cases had azvudine for anti-RNA virus treatment.However, none of them progressed to severe; 153 cases did not use anti-RNA virus drugs and 23 cases(15.0%)progressed to severe disease and the difference was statistically significant( P=0.028). Among 23 severe cases, 14 cases received nirmatrelvir/ritonavir and 2 cases had azivudine for anti-RNA virus treatment.The former did not progress to critical disease while 1 case in the latter progressed to critical illness and death; 1/7 recipients not using anti-RNA virus agents progressed to critical illness and died while another 6 cases did not progress to critical illness. Conclusions:KT recipients aged ≥65 years or diabetes mellitus have a greater risk of progression from mild/moderate to severe disease after COVID-19 infection.Among them, age ≥65 years is an independent risk factor for patients with COVID-19 infection to progress from mild/moderate to severe.Antiviral treatment with nirmatrelvir/ritonavir or azivudine in KT recipients during mild/moderate stage of COVID-19 infection can significantly reduce the rate of severe disease.Treatment with Nirmatrelvir/Ritonavir is still effective in the severe stage.

Objective : To investigate the effect of hypoxia/cold exposure on white fat browning in an obese rat model . Methods : Obese rat model was constructed by high⁃fat feeding and randomly divided into control group , of body weight and body fat were observed , and the morphological changes of rat adipose tissue cells were observed using HE staining and compared with the area of adipocytes . The expression of peroxisome proliferator⁃activated receptor γ2 (PPAR⁃γ2) , PR structural domain binding factor 16 ( PRDM16) and uncoupling protein 1 ( UCP⁃1) gene and the expression of UCP⁃1 protein in the adipose tissue of rats were examined by immunofluorescence , realtime fluorescence quantitative PCR and Western blot . Results : Compared with the control group , the body weight and body fat of rats in the hypoxic , hypothermic and cryogenic hypoxic groups were reduced , and the body weight and body fat of rats in the hypothermic hypoxic group were lower than those in the hypoxic and cryogenic groups (P< 0. 05) . Compared with the control group , the adipocyte area of rats in the hypoxia , hypothermia and low⁃temperature hypoxia groups was reduced , and the adipocyte area of rats in the low⁃temperature hypoxia group was lower than that in the hypoxia and low⁃temperature groups (P < 0. 05) . Compared with the control group , the expression of PPAR⁃γ2 , PRDM16 and UCP⁃1 genes all increased in the scapular brown adipose tissue ( F = 378. 495 , 102. 061 , 322. 443 , P < 0. 05) and decreased in the perirenal white adipose tissue (F = 4. 555 , P < 0. 05) in the hypoxic , hypothermic and low⁃temperature hypoxic groups of rats , PRDM16 and UCP⁃1 gene expression all increased (F = 24. 387 , 163 . 660 , P < 0. 05) . Compared with the control group , the expression of UCP⁃1 protein in scapular brown adipose tissue and perirenal white adipose tissue of rats in the hypoxic , hypothermic and low⁃temperature hypoxic groups increased (P < 0. 05) ; UCP⁃1 protein expression was lower in scapular brown adipose tissue and perirenal white adipose tissue of rats in the hypoxic and hypothermic groups compared to the hypothermic hypoxic group (P < 0. 05) . Conclusion Hypoxia/cold exposure can induce white adipose browning and affect the body weight of rats by modulating the intra⁃adipose PPAR⁃γ2 and PRDM16 pathways which lead to high UCP⁃1 expression .