Objective To investigate the correlation between serum cytotoxic T lymphocyte associated pro-tein 4(CTLA4),high mobility group box 1(HMGB1)and the balance of helper T cell 17(Th17)/regulatory T cell(Treg),and to study their diagnostic significance for unexplained recurrent spontaneous abortion(URSA).Methods A total of 102 patients with URSA admitted to the hospital from September 2022 to September 2024 were selected as the URSA group,and another 80 healthy pregnant women who underwent prenatal examinations in the hospital during the same period were selected as the healthy group.The levels of serum CTLA4 and HMGB1 in the two groups were detected,the levels of Th17 and Treg in the two groups were detected,the Th17/Treg ratio was calculated,and the general data of the two groups were collected and recorded.Pearson was used to analyze the correlations between the levels of serum CLTA4 and HMGB1 and Th17,Treg,and Th17/Treg.logistic regres-sion was used to analyze the influencing factors of URSA occurrence.The receiver operating characteristic(ROC)curve was used to analyze the value of serum CTLA4 and HMGB1 levels in evaluating the occurrence of URSA.Results the serum CTLA4 level in the URSA group was lower than that in the healthy group,the HMGB1 level was higher than that in the healthy group,the Th17 level and Th17/Treg were higher than those in the healthy group,and the Treg level was lower than that in the healthy group(P<0.05).The serum CTLA4 level was nega-tively correlated with the Th17 level and Th17/Treg,and positively correlated with the Treg level(P<0.05).The level of HMGB1 was positively correlated with the level of Th17 and Th17/Treg,and negatively correlated with the level of Treg(P<0.05).Pregnancy frequency,serum CTLA4 level,serum HMGB1 level,Th17 level,Treg level,and Th17/Treg are independent influencing factors for the occurrence of URSA(P<0.05).The areas under the curve(AUC)of serum CTLA4 and HMGB1 levels and the combined evaluation of URSA by the two indicators were 0.841,0.787,and 0.908 respectively,and the Youden indices were 0.652,0.491,and 0.656 respectively.Conclusions The serum CTLA4 level is decreased and the HMGB1 level is increased in patients with URSA,which is related to the change of Th17/Treg balance.The levels of serum CTLA4 and HMGB1 have auxiliary diag-nostic significance for URSA.

Objective To investigate the correlation between serum cytotoxic T lymphocyte associated pro-tein 4(CTLA4),high mobility group box 1(HMGB1)and the balance of helper T cell 17(Th17)/regulatory T cell(Treg),and to study their diagnostic significance for unexplained recurrent spontaneous abortion(URSA).Methods A total of 102 patients with URSA admitted to the hospital from September 2022 to September 2024 were selected as the URSA group,and another 80 healthy pregnant women who underwent prenatal examinations in the hospital during the same period were selected as the healthy group.The levels of serum CTLA4 and HMGB1 in the two groups were detected,the levels of Th17 and Treg in the two groups were detected,the Th17/Treg ratio was calculated,and the general data of the two groups were collected and recorded.Pearson was used to analyze the correlations between the levels of serum CLTA4 and HMGB1 and Th17,Treg,and Th17/Treg.logistic regres-sion was used to analyze the influencing factors of URSA occurrence.The receiver operating characteristic(ROC)curve was used to analyze the value of serum CTLA4 and HMGB1 levels in evaluating the occurrence of URSA.Results the serum CTLA4 level in the URSA group was lower than that in the healthy group,the HMGB1 level was higher than that in the healthy group,the Th17 level and Th17/Treg were higher than those in the healthy group,and the Treg level was lower than that in the healthy group(P<0.05).The serum CTLA4 level was nega-tively correlated with the Th17 level and Th17/Treg,and positively correlated with the Treg level(P<0.05).The level of HMGB1 was positively correlated with the level of Th17 and Th17/Treg,and negatively correlated with the level of Treg(P<0.05).Pregnancy frequency,serum CTLA4 level,serum HMGB1 level,Th17 level,Treg level,and Th17/Treg are independent influencing factors for the occurrence of URSA(P<0.05).The areas under the curve(AUC)of serum CTLA4 and HMGB1 levels and the combined evaluation of URSA by the two indicators were 0.841,0.787,and 0.908 respectively,and the Youden indices were 0.652,0.491,and 0.656 respectively.Conclusions The serum CTLA4 level is decreased and the HMGB1 level is increased in patients with URSA,which is related to the change of Th17/Treg balance.The levels of serum CTLA4 and HMGB1 have auxiliary diag-nostic significance for URSA.

Objective To investigate the methylation levels of the HIF-3α gene,as well as the expression of HIF-3α mRNA and DDIT4 mRNA in peripheral blood samples from pregnant women with gestational diabetes mellitus(GDM),and their association with pregnancy outcomes,aiming to provide insights for pregnancy monitoring and clinical diagnosis and treatment of GDM patients,thereby mitigating the risk of adverse pregnancy outcomes.Methods From March 2023 to March 2024,a total of 80 pregnant women with GDM were randomly selected at the Affiliated Hospital of Xuzhou Medical University.They were divided into two groups based on glycemic control:GDM1(n=40)representing good glycemic control and GDM2(n=40)representing poor glycemic control.Addi-tionally,a control group consisting of 40 pregnant women without any pregnancy complications or comorbidities was included.Methylation-specific PCR was employed to determine the rate of HIF-3α methylation,while quantita-tive real-time PCR was used to assess the expressions of HIF-3α mRNA and DDIT4 mRNA.Adverse pregnancy outcomes were recorded across all three groups,and correlations between HIF-3α mRNA,DDIT4 mRNA,and various adverse pregnancy outcomes were analyzed using logistic regression analysis.Results Prior to pregnancy,GDM1 and GDM2 groups exhibited higher levels of FPG,HbA1c,TC,TG,LDL-C,FINS and HOMA-IR(P＜0.05),as well as lower levels of HOMA-β compared to the control group(P＜0.05).The incidence of adverse pregnancy outcomes was also higher in both GDM groups than in the control group;this difference was significant for GDM2(P＜0.05)but not for GDM1(P＞0.05).Furthermore,methylation rates of the HIF-3α gene were higher in both GDM groups compared to controls while expression levels of HIF-3α and DDIT4 mRNA were lower;these differences were significant for the GDM2 group versus controls(P＜0.05)but not for the GDM1 group ver-sus controls(P＞0.05).Finally,all adverse pregnancy outcomes among women with gestational diabetes mellitus showed a negative correlation with expression levels of both HIF-3α and DDIT4 mRNA(r＜0,P＜0.05);moreover,these two mRNAs served as protective factors against such outcomes occurring(OR＜1,P＜0.05).Conclusion The higher methylation rate of HIF-3α and the decreased expression of HIF-3α and DDIT4 genes are associated with the development of GDM and may serve as significant factors contributing to adverse pregnancy outcomes.

Objective To investigate the methylation levels of the HIF-3α gene,as well as the expression of HIF-3α mRNA and DDIT4 mRNA in peripheral blood samples from pregnant women with gestational diabetes mellitus(GDM),and their association with pregnancy outcomes,aiming to provide insights for pregnancy monitoring and clinical diagnosis and treatment of GDM patients,thereby mitigating the risk of adverse pregnancy outcomes.Methods From March 2023 to March 2024,a total of 80 pregnant women with GDM were randomly selected at the Affiliated Hospital of Xuzhou Medical University.They were divided into two groups based on glycemic control:GDM1(n=40)representing good glycemic control and GDM2(n=40)representing poor glycemic control.Addi-tionally,a control group consisting of 40 pregnant women without any pregnancy complications or comorbidities was included.Methylation-specific PCR was employed to determine the rate of HIF-3α methylation,while quantita-tive real-time PCR was used to assess the expressions of HIF-3α mRNA and DDIT4 mRNA.Adverse pregnancy outcomes were recorded across all three groups,and correlations between HIF-3α mRNA,DDIT4 mRNA,and various adverse pregnancy outcomes were analyzed using logistic regression analysis.Results Prior to pregnancy,GDM1 and GDM2 groups exhibited higher levels of FPG,HbA1c,TC,TG,LDL-C,FINS and HOMA-IR(P＜0.05),as well as lower levels of HOMA-β compared to the control group(P＜0.05).The incidence of adverse pregnancy outcomes was also higher in both GDM groups than in the control group;this difference was significant for GDM2(P＜0.05)but not for GDM1(P＞0.05).Furthermore,methylation rates of the HIF-3α gene were higher in both GDM groups compared to controls while expression levels of HIF-3α and DDIT4 mRNA were lower;these differences were significant for the GDM2 group versus controls(P＜0.05)but not for the GDM1 group ver-sus controls(P＞0.05).Finally,all adverse pregnancy outcomes among women with gestational diabetes mellitus showed a negative correlation with expression levels of both HIF-3α and DDIT4 mRNA(r＜0,P＜0.05);moreover,these two mRNAs served as protective factors against such outcomes occurring(OR＜1,P＜0.05).Conclusion The higher methylation rate of HIF-3α and the decreased expression of HIF-3α and DDIT4 genes are associated with the development of GDM and may serve as significant factors contributing to adverse pregnancy outcomes.

Objective To study the expression levels and clinical significance of nerve growth factor(NGF)and Syncytin-1 in ser-um and placental tissues of pregnant women with severe preeclampsia(SPE).Methods A total of 90 pregnant women who underwent ce-sarean delivery in the Department of Obstetrics,the Affiliated Hospital of Xuzhou Medical University in December 2021 to June 2022 were selected,and they were divided into 30 cases of early-onset SPE(early-onset group),30 cases of late-onset SPE(late-onset group),and 30 cases of normal women in the same period(control group).The maternal blood and placental tissues of the three groups were collected,and the expression levels of NGF and Syncytin-1 in each group were detected by enzyme-linked immunosorbent assay(ELISA)and immunohistochemical(IHC)staining,and their clinical significance was analyzed.Results The results of the ELISA showed that compared with healthy pregnant women in the third trimester,the expression of NGF and Syncytin-1 in the serum of pregnant women with SPE was reduced,and the early-onset group was lower than those in the late-onset group(P<0.05).The results of IHC staining showed that compared with healthy pregnant women in the third trimester,the expression levels of NGF and Syncytin-1 in pla-cental tissues were reduced in pregnant women with SPE,early-onset group was lower than those in the late-onset group(P<0.05).Conclusion The expression of NGF and Syncytin-1 in serum and placental tissues of the three groups of pregnant women was succes-sively reduced,and the expression was successively reduced in normal pregnant women,late-onset SPE and early-onset SPE,which may be involved in the occurrence and development of SPE by affecting the normal development of the placenta.

Sucrose is a natural product occurs widely in nature. In living organisms such as plants, sucrose phosphate synthase (SPS) is the key rate-limiting enzyme for sucrose synthesis. SPS catalyzes the synthesis of sucrose-6-phosphate, which is further hydrolyzed by sucrose phosphatase to form sucrose. Researches on SPS in recent decades have been focused on the determination of enzymatic activity of SPS, the identification of the inhibitors and activators of SPS, the covalent modification of SPS, the carbohydrate distribution in plants regulated by SPS, the mechanism for promoting plant growth by SPS, the sweetness of fruit controlled by SPS, and many others. A systematic review of these aspects as well as the crystal structure and catalytic mechanism of SPS are presented.
Carbohydrate Metabolism ; Glucosyltransferases/metabolism* ; Plants/metabolism* ; Sucrose

In order to build an "Internet +" innovation and entrepreneurship education practice platform, 3,752 undergraduates from 5 medical colleges and universities were investigated by questionnaire. The results showed that there was a gap between the expectation of the students and the setting of entrepreneurship and innovation courses, project guidance and so on. In view of the contradiction between the supply of educational resources and the needs of students in medical colleges and universities, we have developed the "Internet +" innovation and entrepreneurship education practice platform, that including five main functions and three layers of framework based on cloud computing and open source technology. The platform integrates various resources of medical colleges and universities to make useful exploration for cultivating students' innovation and entrepreneurship ability, accelerating the implementation of projects, and promoting the connotation development of innovation.

PBL is problem-based and student-centered learning pattern. PBL has been proved to be an effective teaching,which is helpful to improving the students’learning enthusiasm and learning efficiency,and to training their clinic thoughts and the capability of teamwork.