Background: Advanced glycation end products (AGEs), a group of food processing byproducts, have been implicated in the development of various diseases. However, the relationship between circulating AGEs and sleep disorders remains uncertain. Methods: This cross-sectional study elucidated the association of plasma AGEs with sleep disorders among 1732 Chinese adults who participated in the initial visit (2019–2020) of the Tongji–Shenzhen Cohort (TJSZC). Sleep behavior was assessed using self-reported questionnaires and precise accelerometers. Plasma levels of AGEs, including Nε-(Carboxymethyl)lysine (CML), Nε-(Carboxyethyl)lysine (CEL), and Nδ-(5-hydro-5-methyl-4-imidazolone-2-yl)-ornithine (MG-H1), were quantified by ultra-high performance liquid chromatography–tandem mass spectrometry (UPLC-MS/MS). Results: In logistic regression, per IQR increment in individual AGEs was associated with an increased odds ratio of short sleep duration (CML: 1.11 [1.00, 1.23]; CEL: 1.16, [1.04, 1.30]), poor sleep quality (CML: 1.33 [1.10, 1.60]; CEL: 1.53, [1.17, 2.00]; MG-H1: 1.61 [1.25, 2.07]), excessive daytime sleepiness (CML: 1.33 [1.11, 1.60]; MG-H1: 1.39 [1.09, 1.77]), and insomnia (CML: 1.29 [1.05, 1.59]). Furthermore, in weighted quantile sum regression and Bayesian kernel machine regression analyses, elevated overall exposure levels of plasma AGEs were associated with an increased risk of sleep disorders, including short sleep duration, poor sleep quality, excessive daytime sleepiness, and insomnia, with CML being identified as the leading contributor. Insufficient vegetable intake and higher dietary fat intake was associated with an increase in plasma CEL. Conclusions: These findings support a significant association between plasma AGEs and sleep disorders, indicating that AGEs may adversely influence sleep health and reducing the intake of AGEs may facilitate preventing and ameliorating sleep disorders.

随着医学的发展及科技成果快速应用于临床,培养具有科研创新能力的医学人才成为医学院校培养目标之一.文章根据笔者指导本科生科研过程经历,分析目前医学本科生科研创新能力培养中面临的科研创新能力认识不足、学生理论知识薄弱、动手能力差、创新能力缺乏、平台建设及经费不足、教师投入回报不对等各种问题,对医学本科生科研创新能力培养方法进行探讨,明确本科科研教育目标、开展课堂和项目依托的培养途径、建立政策支持及平台建设,为医学本科生科研创新能力培养提供参考.

为探索病理生理学实验教学改革模式,提高实验教学质量,文章探讨了SPOC+BOPPPS教学模式在病理生理学实验教学中的应用效果,并提出改进意见,为医学实验教学改革提供了新思路.

目的 探讨银杏二萜内酯葡胺对阿尔茨海默病(AD)大鼠学习记忆障碍的改善作用及对突触相关蛋白表达的影响.方法 40 只大鼠随机分为假手术组、模型组和银杏二萜内酯葡胺低、中、高剂量组(1.5、3.0、6.0 mg/kg).通过侧脑室定位注射Aβ1-42 建立AD大鼠模型,尾静脉注射给药 4 周后,通过Morris水迷宫实验检测大鼠学习记忆能力,蛋白免疫印迹法检测大鼠脑组织海马中突触蛋白NR2B、PSD95、BDNF表达,以及下游信号通路蛋白ERK1/2、CaMKⅡ、CREB、TrkB表达.结果 与模型组比较,银杏二萜内酯葡胺中、高剂量组大鼠逃避潜伏期缩短(P<0.01),穿越平台次数、目标象限停留时间和游程增加(P<0.01),海马 p-NR2B、p-CaMKⅡ、p-ERK、p-CREB、PSD95、BDNF、p-TrkB蛋白表达升高(P<0.01).结论 银杏二萜内酯葡胺能改善AD大鼠学习记忆能力,其机制可能与激活NR2B相关的CaMKⅡ/ERK/CREB信号通路,增强PSD95、BDNF表达,激活TrkB信号通路相关.

针对病理生理学实验传统教学存在的问题,将成果导向教育理念引入临床医学专业病理生理学实验教学中,结合课程特点制定三维课程目标,构建混合式教学模式,采用多元考核方式,重视课堂互动与学生反馈,达成以学习结果 产出为导向的预期目标,持续改进教学质量,为实验教学改革提供思路.

Aim. To explore the role of Rac1 on sorafenib resistance in hepatocellular carcinoma. Methods. CCK-8, wound healing assay, Transwell, and cell cycle assay were used to detect the tumor cells development. Cell viability was assessed by MTT. The glycolytic pathway was revealed by cellular metabolism assays. Result. We recovered that Rac1 upregulation was related to HCC patients’ poorer prognosis. Forced expression of Rac1 promoted cell development and sorafenib chemoresistance in HCC cells. Rac1 inhibitor EHop-016 and sorafenib combination markedly prevented cell viability, G2/M phase cycle arrest, and apoptosis than single therapy. Furthermore, combination therapy decreased glycolysis in HCC cells. In vivo, the tumor growth was significantly prevented by combination therapy single therapy. Conclusion. Our research declares that Rac1 inhibition could block sorafenib resistance in HCC by decreasing glycolysis, which would provide an underlying target for HCC therapy.

Chronic stress plays a critical role in the etiology of sporadic Alzheimer's disease (AD). However, there are currently no effective drugs that can target chronic stress to prevent AD. In this study, we explored the neuroprotective effect of hydroxysafflor yellow A (HSYA) against chronic mild stress (CMS)-induced memory impairments in mice and the underlying mechanism. The Morris water maze test showed that HSYA significantly reduced CMS-induced learning and memory impairments in mice. HSYA increased the expression of brain-derived neurotrophic factor (BDNF) and activated downstream tropomyosin-related kinase B (TrkB) and phosphatidylinositol 3-kinase (PI3K)/protein kinase B(Akt)/mammalian target of rapamycin (mTOR) signaling. HSYA decreased the expression of regulator of calcineurin 1-1L (RCAN1-1L) that could promote the activity of glycogen synthase kinase-3β (GSK-3β). HSYA also attenuated tau phosphorylation by inhibiting the activity of GSK-3β and cyclin-dependent kinase-5 (Cdk5). Our data indicated that HSYA has protective effects against CMS-induced BDNF downregulation, tau phosphorylation and memory impairments. HSYA may be a promising therapeutic candidate for AD by targeting chronic stress.

根据病理生理学教学现状及存在的问题,创建并应用智慧课堂融入课程思政教学模式.通过对该教学模式创新内涵及实施过程的介绍,深层次剖析其在病理生理学教学中的应用价值及实际意义,为今后病理生理学教学改革提供参考.

新型冠状病毒肺炎疫情的爆发,体现出基础研究与临床应用双向转化的重要性,即转化医学,依托于多学科相互渗透.病理生理学是连接基础与临床的桥梁学科,与转化医学极具共性,借助于医学各学科相互交叉.因此,转化医学理念指导病理生理学教学,采用针对性的教学策略,培养学生科研思维及临床判断力,形成基于学科交叉的转化医学教学模式.文章对本教学模式的理论依据、教学策略及培养目标予以梳理,并浅评教学效果,提出改进建议,为各基础医学学科教学提供新思路,推动医学教育创新发展.

Objective To study the effects of diterpene ginkgolides meglumine injection ( DGMI) on memory impairment, activation of microglia and astrocytes and inflammatory cytokines in aged mice. Methods Twenty aged mice (22 months old) were randomly divided into two groups:aged mouse group(n=10) and DGMI group(n=10). Another 10 mice (2 months old) were selected as young mouse control group. The mice in DGMI group were received 5 mg/kg DGMI per day by tail vain injection for 4 weeks. The mice in the other two groups were received the same amount normal saline for 4 weeks. The Morris water maze was used to evaluate the function of spacial learning and memory after administration of drugs. The ex-pression of CD11b,GFAP,IL-1β,IL-6,TNF-α and NFκB in mice brain hippocampus were detected by West-ern blot. Results (1) The escape latency time of aged mouse group was significantly longer than that of young mouse control group from the 2nd day to the 7th day(P<0. 01). The times of platform crossing,time and distance in target quadrant of aged mouse group were significantly shorter than those of young mouse group (all P<0. 01). Compared with aged mouse group,DGMI significantly reduced the escape latency time of DGMI group (P<0. 01). DGMI increased the times of platform crossing,time and distance in target quad-rant of aged mouse group (P<0. 01). (2) The expressions of CD11b,GFAP in young mouse control group, aged mouse group and DGMI group were as follows respectively:CD11b:(1. 036±0. 023),(1. 757±0. 046), (1. 214±0. 024);GFAP:(1. 022±0. 071),(1. 344±0. 021),(1. 086±0. 073). DGMI reduced the expres-sion of CD11b and GFAP in hippocampus compared with aged mouse group ( t=5. 556,P<0. 01;t=5. 484, P<0. 01). (3) The expressions of IL-1β,IL-6,TNF-α and NFκB in young mouse control group,aged mouse group and DGMI group were as follows respectively:IL-1β:( 1. 003 ± 0. 057),( 2. 062± 0. 105),( 1. 182± 0. 084);IL-6:(1. 018±0. 024),(1. 583± 0. 052),( 1. 152± 0. 031); TNF-α:( 1. 021± 0. 054),(1. 449± 0. 053),(1. 211±0. 036);p-NFκB:(1. 052±0. 034),(1. 782± 0. 113),( 1. 158± 0. 066). DGMI reduced the expression of p-NFκB(t=6. 547,P<0. 01) and pro-inflammatory cytokines including IL-1β(t=8. 513,P<0. 01),IL-6(t=3. 421,P<0. 01) and TNF-α( t=5. 562,P<0. 01) in hippocampus compared with aged mouse group. Conclusion DGMI can improve the ability of learning and memory in aged mice. The mecha-nism may be related with inhibiting activity of microgliosis,astrocytosis,NFκB and neuroinflammaton.

目的:研究羟基红花黄色素A(HSYA)对β淀粉样蛋白(Aβ)诱导的氧化应激和学习记忆功能损伤的影响.方法:通过侧脑室注射Aβ建立学习记忆功能损伤的动物模型,术后通过腹腔注射HSYA进行干预,采用Morris水迷宫实验来检测学习记忆功能的改变,测定大鼠脑组织中丙二醛(MDA)、超氧化物歧化酶(SOD)和还原型谷胱甘肽(GSH)的含量以及炎症因子IL-6和TNF-α的水平.结果:HSYA能够改善由Aβ诱导的学习记忆功能损伤,降低脑组织海马中MDA的含量,增加SOD和GSH的含量;降低脑组织海马中IL-6和TNF-α的水平.结论:HSYA能抑制由Aβ诱导的脑组织中氧化应激水平和炎症反应,改善由Aβ诱导的学习记忆功能损伤.

Deregulation of microRNAs (miRNAs) is essential to tumor development, and serum miRNA profiles have been reported in several cancers. However, the serum miRNA profile in oral squamous cell carcinoma (OSCC) remained unclear. The present study aimed to explore abnormal miRNA profile in sera samples from OSCC patients and the association of miR-483-5p with patient prognosis. Microarray analysis was performed in sera from OSCC patients versus healthy controls. miR-483-5p expression was measured by reverse transcription (RT)-PCR and correlated to clinicopathological characteristics of OSCC patients. The prognostic significance was then evaluated with a Kaplan-Meier curve and log-rank tests, using a Cox proportional hazard model. According to microRNA array, 16 miRNAs were upregulated and 10 were downregulated in OSCC patient sera. miR-483-5p expression was significantly increased in OSCC patients (3.23-fold, p < 0.01), and this was significantly correlated with tumor nodal metastasis (TNM) stage and lymph nodal metastases (p < 0.01, p < 0.01). For predicting OSCC, receiver operating characteristic (ROC)/area under the curve (AUC) analysis confirmed a AUC of 0.85 (sensitivity of 0.853 and specificity of 0.746). OSCC patients with high serum miR-483-5p had lower survival than those with low expression, and multivariate analyses for overall survival revealed that high serum miR-483-5p expression was an independent prognostic factor for OSCC (HR = 2.32, 95 %CI 1.20-4.48). miR-483-5p expression increased in OSCC patient sera, and this may be a novel diagnostic and prognostic biomarker for OSCC.

Amyloid β-peptide (Aβ) has been implicated as a key molecule in the neurodegenerative cascades of Alzheimer's disease (AD). Humanin (HN) is a secretory peptide that inhibits the neurotoxicity of Aβ. However, the mechanism(s) by which HN exerts its neuroprotection against Aβ-induced ADlike pathological changes and memory deficits are yet to be completely defined. In the present study, we provided evidence that treatment of rats with HN increases the number of dendritic branches and the density of dendritic spines, and upregulates pre- and post-synaptic protein levels; these effects lead to enhanced long-term potentiation and amelioration of the memory deficits induced by Aβ1–42. HN also attenuated Aβ1–42-induced tau hyperphosphorylation, apparently by inhibiting the phosphorylation of Tyr307 on the inhibitory protein phosphatase-2A (PP2A) catalytic subunit and thereby activating PP2A. HN also inhibited apoptosis and reduced the oxidative stress induced by Aβ1–42. These findings provide novel mechanisms of action for the ability of HN to protect against Aβ1–42-induced AD-like pathological changes and memory deficits.

Homocysteine (Hcy) could induce amyloid β (Aβ) accumulation, synaptic dysfunction, and memory impairment as seen in Alzheimer disease (AD), the most prevalent neurodegenerative disorder, which affects more than 25 million people worldwide. Here we investigated the protective effect of hydroxysafflor yellow A (HSYA) on Hcy-induced Aβ accumulation, synaptic dysfunction, and learning and memory deficits. Rats were randomly divided into four groups: Control group, which received normal saline (NS); Hcy group, which received a daily vena caudalis injection of Hcy (400 μg/kg per day); Hcy+HSYA group, which received the same amount of Hcy plus 6 mg/kg per day HSYA intraperitoneally; and HSYA group, which received 6 mg/kg per day HSYA intraperitoneally for 2 weeks. Results showed that simultaneous supplementation of HSYA significantly attenuated Aβ accumulation, improved synaptic function, and reversed Hcy-induced cognitive impairment. Our data suggest that HSYA might be a promising therapeutic candidate for attenuating Hcy-induced AD-like pathological and behavioral deficits.

Objective To investigate the adjuvant effect of dimo-thylidioctyl ammonium bromide (DDA) and/or DDA-BCG polysaccharide nucleic acid( BCG-PSN), which was combined with a Mycobacterium tuberculosis fusion protein AMM ( Ag 8 5 B - MPT64190-198 - Mtb8.4 ) to boost BCG primed immunization. Methods DDA with or without BCG PSN was mixed with the fusion protein AMM to construct the boosting vaccine. Mice were immunized with BCG and then boosted twice with AMM formulated with the adjuvant DDA with or without BCG-PSN. PBS or BCG vaccination without boosting was used as control. The humoral and cell-mediated immune responses were analyzed by ELISA and ELISPOT. Moreover, the protective efficacy of BCG prime-AMM subunit vaccine boosting against Mycobacterium tuberculosis infection was analyzed. Results With in vitro stimulation of Ag85B and PPD( purified protein derivative) antigen, the number of IFN-γ secreting cells from the mice boosted twice by AMM/DDA/BCG-PSN and AMM/DDA were higher than BCG and PBS group (P <0.05). The CFU in lungs of mice boosted with AMM/DDA/BCG-PSN was less than that of PBS group(P <0.05), while the CFU of AMM/DDA-boosted mice was less than that of BCG and PBS group(P < 0.05).However, fewer lesions were seen in lungs of mice immunized with BCG alone or BCG-prime-AMM/DDA/BCG-PSN boosting than the other groups. Conclusion DDA is an idea adjuvant for tuberculosis subunit vaccine;BCG-PSN might play a role in alleviating the immunity-mediated pathology.

Objective To investigate the protective efficacy of Mycobacterium tuberculosis fusion protein subunit vaccine as a booster to enhance BCG primed immunity.Methods Mycobacterium tuberculosis fusion protein subunit vaccines were prepared by mixing dimethyl-dioctyldecyl ammonium bromide (DDA) as an adjuvant and BCG polysaccharide nucleic acid (BCG-PSN) with proteins Ag85B,Ag85B-Mpt64_(190-198)-HspX (AMH),Ag85B-Mpt64_(190-198)-Mth8.4 (AMM) and AMH+AMM respectively.C57BL/6 mice were immunized s.c.with BCG at week 0,and boosted with various subunit vaccines respectively at weeks 8 and 10,using those immunized with one dose of PBS and with one dose of BCG as controls.The serum samples of mice were collected 4 weeks after the last immunization and determined for antibody levels.Meanwhile,the splenic lymphocytes of mice were isolated for determination of IFNγ level secreted.The mice were challenged i.v.with H37Rv strain 12 weeks after the last immunization,and their lungs were taken out 6 weeks after challenge for bacterial colony counting as well as acid-fast staining and HE staining.Results The anti-Ag85B IgG levels induced by various subunit vaccines were significantly higher than that by BCG.After stimulation with Ag85B and PPD,the counts of IFNγ-secreting lymphocytes of mice boosted with various subunit vaccines were significantly higher than those receiving only primary immunization with BCG,while the areas of tubercle showed no significant difference.Only the bacterial colony counts in lung tissues of mice boosted with AMM+AMH were significantly lower than those of mice receiving only primary immunization with BCG.However,the counts of cells positive in acid-fast staining of mice boosted with AMM+AMH were significantly lower than those with AMH and with Ag85B or receiving only primary immunization with PBS and with BCG.Conclusion The booster immunization with AMH+AMM after primary immunization with BCG induced specific cellular and humoral immune responses in mice,which showed strong immunogenicity and enhanced the protective efficacy of BCG.

目的为了建立对潜伏感染细菌的保护性免疫应答，本研究选择结核分枝杆菌休眠期、对数生长期最重要的保护性抗原HspX、Mpt64的190～198位的氨基酸多肽（CD8^＋T细胞表位）及Ag85B，构建融合蛋白Ag85B-Mpt64 190-198-HspX（AMH），并对其免疫原性进行研究。方法PCR分别扩增Ag85B、Mpt64 190-198-HspX基因，并依次插入pET-28a质粒中，在大肠杆菌BL21中表达纯化AMH蛋白。将该蛋白和佐剂二甲基三十六烷基铵和卡介苗多糖核酸（DDA＋BCG—PSN）混合构建亚单位疫苗，分别于1、4、7周皮下免疫C57BL／6小鼠3次，最后一次免疫5周后检测体液免疫与细胞免疫反应。结果该融合蛋白以包涵体形式能在大肠杆菌中稳定表达，经Ni—NTA层析柱纯化得到纯度较高的蛋白；构建的亚单位疫苗免疫动物能产生针对结核杆菌特定抗原（PPD、Ag85B、Mpt64 190-198和HspX）的特异性的细胞免疫和体液免疫应答，具有较强的免疫原性。结论融合蛋白AMH作为结核亚单位疫苗候选的融合蛋白抗原有必要进一步研究。

OBJECTIVE:To investigate the activity of a novel adjuvant consisting of dimethyldioctyldecyl ammonium bromide (DDA) and BCG polysaccharide nucleic acid (BCG-PSN).METHODS:BCG-PSN was extracted by hot-phenol method, and combined with DDA and Mycobacterium tuberculosis fusion antigen AMM (Ag85B-MPT64(190-198)-Mtb8.4) to formulate the Mycobacterium tuberculosis subunit vaccine. Mice were immunized subcutaneously with a 2-week interval between the immunizations (0.2 ml/dose), and humoral and cell-mediated immunity were detected by ELISA and ELISPOT respectively.RESULTS:With the stimulation of Ag85B in vitro, the number of antigen specific IFN-gamma producing spleen lymphocytes were 222 +/- 79, 259 +/- 85, 230 +/- 64 per million respectively in the mice immunized with AMM + DDA + BCG-PSN, AMM + DDA, and BCG. Spleen lymphocytes in these 3 groups produced higher levels of IFN-gamma compared to the groups with the adjuvant of IFA or BCG-PSN alone or without adjuvant upon stimulation with Ag85B (t = 2.923-7.118, P < 0.05). Furthermore, the adjuvant consisting of DDA and BCG-PSN increased the ratio of Ig(2a)/IgG1 than DDA alone (0.125 vs. 0.025). Combined with AMM, the adjuvant DDA and the one consisting of DDA and BCG-PSN induced higher level of immunity than incomplete Freund's adjuvant (IFA), NaCl, and BCG-PSN alone.CONCLUSION:Mycobacterium tuberculosis subunit vaccine AMM + DDA + BCG-PSN induced a strong Th1-type immune response, and DDA + BCG-PSN, especially DDA promoted the immune response of the M. tuberculosis subunit vaccine in mice.

Objective To investigate the boosting efficiency of a subunit vaccine consisting of the fusion protein Ag85B-Mpt64190-198-Mth8.4 (AMM) , dimethyl-dioctyldecyl ammonium bromide (DDA) and BCG polysaceharide nucleic acid (BCG-PSN) on the primed inoculation with BCG. Methods The AMM subunit vaccine was composed of fusion protein AMM, adjuvant DDA and BCG-PSN. The first mouse experi-mental group was immunized with BCG first, then boosted with the AMM subanit vaccine in the 10th week. The second experimental group was boosted with the AMM subunit vaccine in the 8th week and the 10th week respectively with a two weeks interval after the primed with BCG. Two control groups were treated re-spectively with physiological saline alone and BCG alone. After the primed inoculation, ELISPOT and ELISA were used for the detection of the cell-mediated and humoral immune response in week 14 and week 22 re-spectively. Furthermore, the immunized mice were challenged with live BCG to mimic tuberculosis infection in the 22nd week after the primed inoculation. Subsequently the T cell typing and humoral response were de-tected by flow cytometry and ELISA, respectively. Results ( 1 ) The level of secreting IFN-γ: 14 weeks af-ter the primed inoculation,with the stimulation of the specific antigen-Ag85B, the number of cells secreting IFN-γ in the second experimental group (135±14) was more than BCG alone immunized group (19±16), t = 10. 98, P < 0.01. In the 22nd week, the number of cells secreting IFN-γ in the second experimental group (208±11) was still more than BCG alone group (57±18), t =6.43, P <0.01. (2) The level of humoral immune response: the IgG1 antibody titer in the second experimental group was obviously higher than that in the first experimental group. However, the ratio of IgG2a to IgG1, as the index reflecting the Thl-type immune response, in the experimental group 2 was lower than that in the experimental group 1. (3) The contents of CD4+ CD25+ T cells after challenged with live BCG strain: the first and the second ex-perimental groups were both higher than the BCG alone group (t1 = 3.08, t2 = 3.16, P < 0.05 ). Conclu-sion Boosting the BCG-pfimed mice with tuberculosis AMM subunit vaccine twice can induce higher level of cell-mediated and humoral immune response than BCG alone, which could activate the regulative immune response at the same time.

Objective To construct protective immunity to Mycobncterium tuberculosis latent infection, a novel fusion protein consisting of HspX, the 190 to 198 peptide of Mpt64 and Ag85B, which were confirmed to be the effective protective antigens mainly expressed in the dormancy and exponential phase of growth, was constructed and its immunogenicity was investigated. Methods Ag85B and Mpt64190-198-HspX sequences were amplified by PCR and cloned into plasmids pET-28a. The fusion protein, Ag85BMpt64190-198-HspX (AMH) was expressed in E. coli BL21 and purified with Ni-NTA resins. C57BL/6 mice were immunized three times at 2-week intervals subcutaneously with AMH formulated with the adjuvant composed of dimethyl-dioctyldecyl ammonium bromide (DDA) and BCG polysaccharide nucleic acid (BCGPSN). Humoral and cell-mediated immunity responses were analyzed at five weeks after the last injection. Results AMH was expressed stably in E. coli and could be purified well by Ni-NTA affinity chromatography. C57BL/6 mice immunized with AMH subunit vaccine generated specific cellular and humoral immunologic response to the stimulation of Ag85B, Mpt64190-198 and HspX. Conclusion It suggested that AMH was a promising candidate antigen of tuberculosis subunit vaccine.