Objective To investigate the optimal cutoff values of Kyoto gastritis score based on gastroscopy,pepsinogen(PG)combined with gastrin-17(G-17)for predicting Helicobacter pylori positive atrophic gastritis in middle-aged and elderly patients.Methods The subjects of this study were 120 middle-aged and elderly patients admitted,diagnosed with atrophic gastritis through gastroscopy examination and pathological biopsy and proved to be Hp positive via 14C urea breath test from August 2022 to June 2023.All patients were divided into atrophic gastritis group(AG group)with 68 cases and non atrophic gastritis group(non-AG group)with 52 cases according to atrophic gastritis results.The AG group was further divided per Kimura-Takemoto classification into mild AG group(n=12),moderate AG group(n=32)and severe AG group(n=24).Kyoto gastritis score based on gastroscopy was performed in all patients.And test their serum pepsinogen Ⅰ(PGⅠ),pepsinogen Ⅱ(PGⅡ),G-17 levels via chemiluminescence and calculate the PGR=PGⅠ/PGⅡ.Receiver operator characteristic curve(ROC curve)was adopted to assess the value of Kyoto gastritis score and serum PG and G-17 for predicting Hp positive atrophic gastritis in middle-aged and elderly patients.Results There were statistically significant differences in Kyoto gastritis score,serum PGⅠ,PGR and G-17 levels between AG group and non-AG group(t=13.38,P=0.000;t=50.84,P=0.000;t=26.44,P=0.000;t=9.44,P=0.000).The Kyoto score of gastritis in AG group was higher than that in non-AG group(P<0.05).The levels of serum PGⅠ,PGR and G-17 in AG group were lower than those in non-AG group(P<0.05).There was no significant difference in serum PGⅡ level between AG group and non-AG group(t=1.24,P=0.219).There were statistically significant differences in Kyoto gastritis score,serum PGⅠ,PGR and G-17 levels among mild AG group,moderate AG group and severe AG group(F=33.95,P=0.000;F=81.99,P=0.000;F=67.36,P=0.001;F=33.50,P=0.004).The mild AG group had a significantly lower Kyoto gastritis score than the moderate AG group and severe AG group(P<0.05),and the moderate AG group had a significantly lower Kyoto gastritis score than the severe AG group(P<0.05).The mild AG group and moderate AG group had significantly higher serum PGⅠ and PGR levels than the severe AG group(P<0.05),and the mild AG group was higher than moderate AG group(P<0.05).The mild AG group had a significantly lower serum G-17 level than the moderate AG group and severe AG group(P<0.05),and there was no significant difference between the moderate AG group and severe AG group(P>0.05).There was no significant difference in serum PGⅡ levels among mild AG group,moderate AG group and severe AG group(F=1.03,P=0.364).The optimal cutoff values of Kyoto gastritis score and serum PGⅠ,PGR and G-17 for predicting atrophic gastritis in middle-aged and elderly patients with Hp positive were 2.78,38.26 μg/L,1.92 and 9.54 pmol/L,respectively.The AUC of Kyoto gastritis score for predicting Hp positive atrophic gastritis in middle-aged and elderly patients was 0.780,the sensitivity was 71.42%,and the specificity was 78.62%.The AUC of PGⅠ for predicting Hp positive atrophic gastritis in middle-aged and elderly patients was 0.757,the sensitivity was 66.27%,and the specificity was 83.25%.The AUC of PGR for predicting Hp positive atrophic gastritis in middle-aged and elderly patients was 0.792,the sensitivity was 76.23%,and the specificity was 87.35%.The AUC of G-17 for predicting Hp positive atrophic gastritis in middle-aged and elderly patients was 0.672,the sensitivity was 60.24%,and the specificity was 74.28%.The AUC of the combination of the four markers for predicting Hp positive atrophic gastritis in middle-aged and elderly patients was 0.871,the sensitivity was 81.28%,and the specificity was 87.36%.Conclusion The Kyoto gastritis score based on gastroscopy,serum PGⅠ,PGR combined with G-17 have good predictive value for Hp positive atrophic gastritis in middle-aged and elderly patients,and the optimal cutoff values for the four markers are 2.78 points,38.26 μg/L,1.92 and 9.54 pmol/L in turn.

Objective:To evaluate the effectiveness of virtual case teaching integrating standardized patients (SP) and objective structured clinical examination (OSCE) in enhancing students' clinical thinking and practical skills in experimental exercise therapy course.Methods:In April 2023, 52 students from the 2021 cohort and 54 students from the 2022 cohort of the Rehabilitation Therapy undergraduate program at Xinjiang Medical University were selected and divided into the experimental group and control group according to their classes. In the shoulder joint mobilization experimental class of the exercise therapy course, virtual SP teaching was performed in the experimental group of both cohorts. For the control group, student-led SP teaching was performed in the 2021 cohort, while the traditional "lecture + demonstration" method was used in the 2022 cohort. Upon completion of teaching, theoretical exams, case analysis, practical exams, and a teaching satisfaction survey were conducted on the students. Data were analyzed using the t-test and chi-square test in SPSS 25.0. Results:In both cohorts, the experimental group had similar theoretical exam scores ( P=0.207 and P=0.097, respectively) to the control group, but had higher practical exam scores ( P=0.013 and P=0.002, respectively) than the control group. In the case analysis exam, the experimental group scored higher than the control group in the 2022 cohort ( t=2.84, P=0.006) but similarly to the control group in the 2021 cohort ( t=1.53, P=0.132). All students believed that virtual SP teaching was most engaging. In terms of understanding complex concepts, increasing active participation, and fostering clinical thinking, the 2022 cohort was more satisfied with virtual SP teaching, whereas the 2021 cohort experienced no significant difference between virtual SP teaching and student-led SP teaching. In addition, the 2021 cohort found that student-led SP teaching was more helpful for improving doctor-patient communication skills. Conclusions:The application of virtual SP teaching in the experimental exercise therapy course effectively enhances students' practical skills and case analysis capabilities, contributing greatly to their overall clinical management thinking.

Objective:To evaluate the effectiveness of virtual case teaching integrating standardized patients (SP) and objective structured clinical examination (OSCE) in enhancing students' clinical thinking and practical skills in experimental exercise therapy course.Methods:In April 2023, 52 students from the 2021 cohort and 54 students from the 2022 cohort of the Rehabilitation Therapy undergraduate program at Xinjiang Medical University were selected and divided into the experimental group and control group according to their classes. In the shoulder joint mobilization experimental class of the exercise therapy course, virtual SP teaching was performed in the experimental group of both cohorts. For the control group, student-led SP teaching was performed in the 2021 cohort, while the traditional "lecture + demonstration" method was used in the 2022 cohort. Upon completion of teaching, theoretical exams, case analysis, practical exams, and a teaching satisfaction survey were conducted on the students. Data were analyzed using the t-test and chi-square test in SPSS 25.0. Results:In both cohorts, the experimental group had similar theoretical exam scores ( P=0.207 and P=0.097, respectively) to the control group, but had higher practical exam scores ( P=0.013 and P=0.002, respectively) than the control group. In the case analysis exam, the experimental group scored higher than the control group in the 2022 cohort ( t=2.84, P=0.006) but similarly to the control group in the 2021 cohort ( t=1.53, P=0.132). All students believed that virtual SP teaching was most engaging. In terms of understanding complex concepts, increasing active participation, and fostering clinical thinking, the 2022 cohort was more satisfied with virtual SP teaching, whereas the 2021 cohort experienced no significant difference between virtual SP teaching and student-led SP teaching. In addition, the 2021 cohort found that student-led SP teaching was more helpful for improving doctor-patient communication skills. Conclusions:The application of virtual SP teaching in the experimental exercise therapy course effectively enhances students' practical skills and case analysis capabilities, contributing greatly to their overall clinical management thinking.

Objective To investigate the optimal cutoff values of Kyoto gastritis score based on gastroscopy,pepsinogen(PG)combined with gastrin-17(G-17)for predicting Helicobacter pylori positive atrophic gastritis in middle-aged and elderly patients.Methods The subjects of this study were 120 middle-aged and elderly patients admitted,diagnosed with atrophic gastritis through gastroscopy examination and pathological biopsy and proved to be Hp positive via 14C urea breath test from August 2022 to June 2023.All patients were divided into atrophic gastritis group(AG group)with 68 cases and non atrophic gastritis group(non-AG group)with 52 cases according to atrophic gastritis results.The AG group was further divided per Kimura-Takemoto classification into mild AG group(n=12),moderate AG group(n=32)and severe AG group(n=24).Kyoto gastritis score based on gastroscopy was performed in all patients.And test their serum pepsinogen Ⅰ(PGⅠ),pepsinogen Ⅱ(PGⅡ),G-17 levels via chemiluminescence and calculate the PGR=PGⅠ/PGⅡ.Receiver operator characteristic curve(ROC curve)was adopted to assess the value of Kyoto gastritis score and serum PG and G-17 for predicting Hp positive atrophic gastritis in middle-aged and elderly patients.Results There were statistically significant differences in Kyoto gastritis score,serum PGⅠ,PGR and G-17 levels between AG group and non-AG group(t=13.38,P=0.000;t=50.84,P=0.000;t=26.44,P=0.000;t=9.44,P=0.000).The Kyoto score of gastritis in AG group was higher than that in non-AG group(P<0.05).The levels of serum PGⅠ,PGR and G-17 in AG group were lower than those in non-AG group(P<0.05).There was no significant difference in serum PGⅡ level between AG group and non-AG group(t=1.24,P=0.219).There were statistically significant differences in Kyoto gastritis score,serum PGⅠ,PGR and G-17 levels among mild AG group,moderate AG group and severe AG group(F=33.95,P=0.000;F=81.99,P=0.000;F=67.36,P=0.001;F=33.50,P=0.004).The mild AG group had a significantly lower Kyoto gastritis score than the moderate AG group and severe AG group(P<0.05),and the moderate AG group had a significantly lower Kyoto gastritis score than the severe AG group(P<0.05).The mild AG group and moderate AG group had significantly higher serum PGⅠ and PGR levels than the severe AG group(P<0.05),and the mild AG group was higher than moderate AG group(P<0.05).The mild AG group had a significantly lower serum G-17 level than the moderate AG group and severe AG group(P<0.05),and there was no significant difference between the moderate AG group and severe AG group(P>0.05).There was no significant difference in serum PGⅡ levels among mild AG group,moderate AG group and severe AG group(F=1.03,P=0.364).The optimal cutoff values of Kyoto gastritis score and serum PGⅠ,PGR and G-17 for predicting atrophic gastritis in middle-aged and elderly patients with Hp positive were 2.78,38.26 μg/L,1.92 and 9.54 pmol/L,respectively.The AUC of Kyoto gastritis score for predicting Hp positive atrophic gastritis in middle-aged and elderly patients was 0.780,the sensitivity was 71.42%,and the specificity was 78.62%.The AUC of PGⅠ for predicting Hp positive atrophic gastritis in middle-aged and elderly patients was 0.757,the sensitivity was 66.27%,and the specificity was 83.25%.The AUC of PGR for predicting Hp positive atrophic gastritis in middle-aged and elderly patients was 0.792,the sensitivity was 76.23%,and the specificity was 87.35%.The AUC of G-17 for predicting Hp positive atrophic gastritis in middle-aged and elderly patients was 0.672,the sensitivity was 60.24%,and the specificity was 74.28%.The AUC of the combination of the four markers for predicting Hp positive atrophic gastritis in middle-aged and elderly patients was 0.871,the sensitivity was 81.28%,and the specificity was 87.36%.Conclusion The Kyoto gastritis score based on gastroscopy,serum PGⅠ,PGR combined with G-17 have good predictive value for Hp positive atrophic gastritis in middle-aged and elderly patients,and the optimal cutoff values for the four markers are 2.78 points,38.26 μg/L,1.92 and 9.54 pmol/L in turn.

ObjectiveTo observe the effect of bee acupuncture therapy on clinical symptoms and signs， as well as the level of inflammatory cytokine interleukin-6 （IL-6） in synovial fluid of patients with knee osteoarthritis. MethodsThe 94 patients with knee osteoarthritis were divided into the control group and the trial group by the random number table method， with 47 cases in each group. Both groups were given one tablet （60 mg） of etoricoxib orally every morning for 2 weeks. The control group also received microneedle shallow acupuncture therapy， once a day for 5 consecutive times followed 2-day pause， and continued 5 consecutive times， as a course of treatment； the trial group was treated with bee acupuncture therapy once every 2 days， 2 times a week， and 4 times as a course of treatment. Both groups have a course of treatment for 2 weeks. The changes in clinical symptoms and signs of patients in the two groups were observed and evaluated before treatment， after 1- and 2-week treatment， and 12-week follow-up and the differences in Lequesne index scores， HSS scores， Visual Analogue Scale （VAS） scores and IL-6 levels in knee synovial fluid between the two groups of patients were also compared. ResultsNo patients lost to follow up in either group. The Lequesne index scores and VAS scores were lower， and the HSS scores were higher in both groups at all time points after treatment compared with those before treatment （P＜0.05）. Compared at the same time after treatment， the Lequesne index scores and VAS scores of the trial group were lower than those of the control group， and the HSS scores were higher than those of the control group （P＜0.05）. IL-6 in synovial fluid was lower in the trial group at the 12-week follow-up than before treatment （P＜0.05）， but there was no significant difference between two groups at each time point（P＞0.05）. ConclusionBee acupuncture therapy for knee osteoarthritis can significantly improve clinical signs and symptoms， but has no significant effect on the level of IL-6 in knee synovial fluid.

Although somatic cells can be reprogrammed to pluripotent stem cells (PSCs) with pure chemicals, authentic pluripotency of chemically induced pluripotent stem cells (CiPSCs) has never been achieved through tetraploid complementation assay. Spontaneous reprogramming of spermatogonial stem cells (SSCs) was another non-transgenic way to obtain PSCs, but this process lacks mechanistic explanation. Here, we reconstructed the trajectory of mouse SSC reprogramming and developed a five-chemical combination, boosting the reprogramming efficiency by nearly 80- to 100-folds. More importantly, chemical induced germline-derived PSCs (5C-gPSCs), but not gPSCs and chemical induced pluripotent stem cells, had authentic pluripotency, as determined by tetraploid complementation. Mechanistically, SSCs traversed through an inverted pathway of in vivo germ cell development, exhibiting the expression signatures and DNA methylation dynamics from spermatogonia to primordial germ cells and further to epiblasts. Besides, SSC-specific imprinting control regions switched from biallelic methylated states to monoallelic methylated states by imprinting demethylation and then re-methylation on one of the two alleles in 5C-gPSCs, which was apparently distinct with the imprinting reprogramming in vivo as DNA methylation simultaneously occurred on both alleles. Our work sheds light on the unique regulatory network underpinning SSC reprogramming, providing insights to understand generic mechanisms for cell-fate decision and epigenetic-related disorders in regenerative medicine.
Male ; Mice ; Animals ; Cellular Reprogramming/genetics* ; Tetraploidy ; Pluripotent Stem Cells/metabolism* ; Induced Pluripotent Stem Cells/metabolism* ; DNA Methylation ; Spermatogonia/metabolism* ; Germ Cells/metabolism*

ObjectiveTo investigate the clinical and prognostic features of hypertriglyceridemic pancreatitis (HTGP) during pregnancy. MethodsA total of 77 patients with acute pancreatitis in pregnancy who were admitted to The Affiliated Hospital of Southwest Medical University from January 2013 to June 2020 were enrolled as subjects, and according to the presence or absence of HTGP, they were divided into HTGP group with 38 patients and non-HTGP group with 39 patients. The two groups were compared in terms of the clinical features including age, pregnancy, laboratory markers, complication, and prognostic indices. The independent samples t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups, and the Mann-Whitney U test was used for comparison of ranked data between two groups. According to the trimester of pregnancy, the patients were divided into early pregnancy group with 4 patients, middle pregnancy group with 14 patients, and late pregnancy with 59 patients, and blood lipid levels were compared between groups; the Kruskal-Wallis H test was used for comparison between two groups or within each group. ResultsCompared with the non-HTGP group, the HTGP group had significantly higher mean age (t=-3.000, P=0.004) and proportion of patients with diabetes (χ2=8.867, P=0.003). Compared with the non-HTGP group, the HTGP group had a significantly higher proportion of patients with disease onset in the third trimester (P＜0.001) and a significantly lower serum level of sodium (Z=-6.328, P＜0.001). Compared with the non-HTGP group, the HTGP group had significantly higher incidence rates of acute peripancreatic fluid collection (76.3% vs 33.3%, χ2=14.342, P＜0.001) and systemic inflammatory response syndrome (81.6% vs 410%, χ2=13.310, P＜0.001). There were significant differences between the two groups in the length of hospital stay, the rate of admission to the intensive care unit, and hospital costs (Z=-2.077, χ2=11.537, Z=-3.525, all P＜0.05). The levels of total cholesterol and triglyceride in the third trimester were significantly higher than those in middle pregnancy (both P＜0.05). ConclusionCompared with the non-HTGP group, the HTGP group has a higher proportion of patients with disease onset in the third trimester of pregnancy, a higher risk of complications, a longer length of hospital stay, and higher hospital costs.

Left atrial volume index (LAVI) is related to systolic and diastolic function of heart .It can reflect the se‐verity of left atrial dilation and heart failure (HF) ,and is a powerful index predicting poor prognosis of HF .This article made a review on the relationship among cardiac function ,prognosis and LAVI in HF patients ,and the diag‐nostic value of LAVI for HF patients .

BACKGROUND:After glucose regulated protein 94 (GRP94) was knockout in model mice of transplanted tumor, cel ular adhesion is terminated, thus stimulating the proliferation of liver-derived cel s and promoting the development of liver cancer. We speculate that GRP94 plays a protective role against liver cancer.
OBJECTIVE:To investigate the expression of endoplasmic reticulum molecular chaperone GRP94 mRNA and protein with smal interfering RNA technique in nude mice model of transplantable human ovarian carcinoma, and to explore the effect of GRP94 mRNA and protein expression on the growth of transplanted tumor.
METHODS:The gene sequences of human GRP94 were obtained from Gene Bank. psiSTRIKETM/GRP94 was constructed, which is eukaryotic expression vector control ed by the U6 promoter of human RNA polymerase Ⅲ. The transplantable model of human ovarian carcinoma in nude mice was established using human ovarian cancer HO-8910 cel line. The eukaryotic expression vector was transfected into the transplanted tumors in nude mice, and the growth of the tumor was observed. The nude mice models were divided into three groups, specific smal interfering RNA group, non-specific smal interfering RNA group and saline control group. The volumes of the subcutaneous tumor were determined. RT-PCR and immunohistochemistry were used to detect the mRNA and protein expression of GRP94 respectively.
RESULTS AND CONCLUSION:The recombinant plasmid of RNA interference specific for GRP94 was successful y constructed. The subcutaneous tumors appeared in al the nude mice 5 days after transplantation. The diameter of subcutaneous tumors was 7-10 mm 14 days after transplantation. The growth of subcutaneous tumors in nude mice with interference specific for GRP94 treatment was significantly decreased as compared with non-specific smal interfering RNA group and control group (P<0.05). The proliferation activity was inhibited by 65.1%. The expression of GRP94 mRNA and protein was significantly down-regulated after treatment of psiSTRIKETM/GRP94 (P<0.01). The transfection of psiSTRIKETM/GRP94 could significantly induce inhibitory effects on the growth of ovarian carcinoma in nude mice, and the underlying mechanism is associated with the down-regulated expression of GRP94 mRNA and protein.

Objective To explore the expression of glucose-regulated protein (Grp) 78 in ovarian cancer tissues and its clinical significance.Methods The expression of Grp78 in 60 cases of ovarian cancer tissue,15 cases of ovarian borderline tumor tissue,10 cases of normal ovarian tissue,10 cases of ovarian cyst tissue,was detected by immunohistochemistry,and analyzed the relationship between its expression and clinicopathological features of ovarian cancer.Results The expression of Grp78 in ovarian borderline tumor and ovarian cancer tissue was significantly higher than that in normal ovarian and ovarian cyst tissue[7/15 and 68.3％ (41/60) vs.1/10 and 1/10] (P ＜0.05).The expression of Grp78 was positively correlated with clinicopathological staging and lymphatic metastasis of ovarian cancer (P ＜ 0.05),negatively correlated with histological differentiation (P ＜ 0.05).No correlation with age and ascites (P ＞ 0.05).Conclusions The levels of Grp78 are elevated in ovarian cancer specimens; high expression of Grp78 maybe participate in the occurrence,development,and prognosis of ovarian cancer.Increased expression of Grp78 might be a useful marker for predicting the carcinogenesis and progression of ovarian cancer.