Objective To observe the effects of early exercise on the expression of synaptophysin pro-tein and Nissl bodies in the hippocampus after hypoxic-ischemic brain damage( HIBD) , and to investigate possi-ble mechanisms. Methods A total of 35 neonatal Wistar rats aged 7 days were randomly divided into a train-ing group of 13, a control group of 11 and a sham-operation group of 11. HIBD was induced in the rats of the training and control groups, while those in the sham-operation group had the left common carotid artery separa-ted, but without ligation. Seven days after successful modeling, the training group began swimming training for 10 min every day lasting for 14 days, while the other groups were not trained. Western blotting was used to detect the expression of synaptophysin in the affected hippocampus of the brain based on the ratio of the gray band val-ues for synaptophysin and beta. Nissl staining was applied to observe the number of Nissl bodies and the morphol-ogy of the neurons in the hippocampus. Results The average expression of synaptophysin in the sinistrocere-bral hippocampus of the rats in the control group was significantly lower than that in the sham-operation group, but significantly higher than that of the training group. The control group had significantly fewer Nissl bodies than the sham-operation group, but significantly more than the training group. Conclusion Early training can in-crease the expression of synaptophysin and the number of Nissl body in the hippocampus after hypoxic-ischemic brain damage.

Objective To observe any effect of intensive training on the degree of depression and the expression of Kalirin-7 in the hippocampus of rats modeling with post-stroke depression,and to investigatc possible mechanisms.Methods Forty male Wistar rats were randomly divided into a post-stroke depression (PSD) group,a routine training group,an intensive training group and a sham-operation group (n =10 for each group).All except the sham-operation group were given the middle cerebral artery occlusion using the intraluminal thread method,and chronic mild stress was applied.The PSD group and the sham-operation group were not given any training.The routine training group was trained oncc a day,and the intensive training group was trained twice a day.The sucrose preference test,open field test and forced swimming test were conducted at the outset and after 14 and 28 days of training.The expression of Kalirin-7 in the left hippocampus was detected using Western blotting.Results After 14 days of training,significant differences were found in the test results of the sham-operation group compared with the other groups (P＜0.05).There were also significant differences in the average results on all 3 tests among all of the groups except the sham-operation group.At both 14 and 28 days after training,the average expression of Kalirin-7 in both the routine and intensive training groups was significantly higher than in the PSD group (P＜0.05),and that of the intensive training group was significantly higher than that of the routine training group at the same time points (P＜0.05).Conclusion Intensive training can relieve depression and increase the expression of the Kalirin-7 in the hippocampus,at least in rats.

Objective To observe the effect of intensive training on lower extremity motor function and depression after stroke.Methods Thirty patients with post-stroke depression were randomly divided into an intensive training group and a control group,each of 15.Both groups received conventional anti-stroke and antidepressant drug therapy,and rehabilitation training.The intensive training group,however,was additionally provided with lower extremity motor function training each day.Hamilton Depression Rating Scale,the Fugl-Meyer assessment (FMA),10-meter maximum walking speed test (10MWT) and the Holden functional ambulation categories (FAC) were conducted before treatment,and 2 and 4 weeks after the treatment.The level of human β-endophin (β-EP) and brain derived neurotrophic factor (BDNF) in the serum were also detected.Results After 4 weeks of treatment,the FAM,10MWT,BDNF and β-EP were significantly improved in both groups compared to those before the treatment (P＜ 0.05).No significant differences,however,were found between the 2 groups in the above measurements after 2 weeks of treatment (P＞0.05).After 4 weeks of treatment,the FAM (20.67±6.79),10MWT [(0.48±0.22)m/s],BDNF [(10.81±2.33)μg/L] and β-EP [(164.02±42.15)ng/L] of the intensive training group were significantly improved compared to those of the control group (P＜0.05).Both after 2 weeks and 4 weeks treatment,the HAMD scores of the intensive training group (16.33±6.74 and 12.13±5.44) were significantly better than those of the control group (P＜ 0.05).However,there was no significant difference in terms of FAC between the two groups either after 2 weeks or 4 weeks of treatment (P＞0.05).Conclusion The intensive training can improve motor function and relieve poststroke depression of stroke survivors.It is worth promoting and applying in clinical practice.

Ultraviolet light hardening therapy is an effective method for the treatment of polymorphic light eruption (PLE) . Recent studies have shown that narrow-band ultraviolet B (NB-UVB) is effective and safe for the prevention of recurrence of PLE. However, its treatment mechanisms still need further elucidation, and clinical studies with large sample size are needed for long-term tracking and assessment of initial dose of photohardening, dose-addition principle, treatment frequency and maintenance treatment protocols, in order to confirm the clinical application value of ultraviolet light photohardening therapy.

Objective To observe the effects of mycophenolate mofetil (MMF) on the differentiation and proliferation of Helper T cells 17 (TH 17),so as to reveal its role and the possible mechanism in inducing immunological suppression.Methods Sixteen Balb/c mice of SPF level aged 8 weeks were randomly divided into two groups:MMF group and control group,with 8 mice in each group.In MMF group,the mice received intragastric administration of MMF (40 mg·kg-1· day-1 ),and those in control group received intragastric administration of identical volumetric saline every day.After three weeks,peripheral blood was collected and spleen cells were prepared.Flow cytometry was used to determine the proportions of CD4+ TH 17 and CD4+ CD25+ Tregs,then the ratio of TH 17/Tregs was calculated,and the concentrations of interleukin-1 7 (IL-1 7) and interleukin-23 (IL-23) in serum were measured by ELISA.Results The proportion of CD4+ TH 17 in the peripheral blood and spleen was (1.95 ± 0.08) and (2.42 ± 0.06) in MMF group,and (3.19 ± 0.07)％ and (4.21 ± 0.25)％ in control group,respectively.There were significant differences between the two groups (P ＜0.05).Meanwhile,the ratio of TH 17/Tregs in MMF group,both in the peripheral blood and spleen,was significantly decreased as compared with the control group (P＜0.05).The concentration of IL-17 in MMF group was lower,but that of IL-23 in MMF group was higher than in the control group (P＜0.05).Conclusion MMF could obviously suppress the differentiation and proliferation of CD4+ TH 17 in vivo,reduce the ratio of TH17/Tregs and the IL-17 secretion,thus facilitate the induction of immune tolerance.

Objective To investigate the etiology,clinical manifestations,diagnosis and outcomes of lichen scrofulosorum (LS).Methods Clinical data collected from 7 infants with LS,who visited Department of Dermatology,Tianjin Children's Hospital between 2010 and 2018,were analyzed retrospectively,and the etiology,clinical manifestations,diagnosis,development and outcomes of LS were investigated.Results All the 7 infants developed LS after bacillus Calmette-Guérin (BCG)vaccination,and the clinical manifestations of LS were reddish or hazel papules mainly distributed on the trunk with small scales attached to the surface.No abnormal laboratory examination results were observed.Histopathological examination showed granuloma in the dennis.Without any treatment,all rashes of the 7 patients disappeared within 6 months,and no scar or hyperpigmentation remained.Conclusions Infant LS usually appears 2-3 months after BCG vaccination,clinically presents as papules mostly on the trunk,pathologically characterized as granuloma in the dermis,and can heal spontaneously.

Objective To evaluate the clinical application value of reflectance confocal microscopy(RCM) in the diagnosis of several common diseases manifesting as papules in children, including lichen nitidus, verruca planae, lichen striatus, milium, molluscum contagiosum and lichen pilaris. Methods A total of 579 children clinically characterized by papules were recruited into this study. RCM was used to observe lesions and perilesional normal skin. The RCM features of 6 diseases manifesting as papules were analyzed and compared. Results Based on RCM images, 236 patients were diagnosed with lichen nitidus, 70 with verruca planae, 123 with lichen striatus, 40 with milium, 53 with molluscum contagiosum and 57 with lichen pilaris. All the 6 diseases had typical RCM features. Concretely speaking, RCM images of lichen nitidus lesions showed infiltration of dense inflammatory cells and melanophages in enlarged dermal papillae. In RCM images of verruca planae lesions, cells in the granular and spinous layers were arranged in concentric circles, giving a rose cluster?like appearance. RCM images of lichen striatus lesions revealed focal swelling of stratum spinosum, absent or local liquifaction degeneration of basal cells, and clustering of a moderate number of inflammatory cells in the superficial dermis. In RCM images of milium lesions, well?circumscribed round or oval structures containing highly but nonuniformly refractive materials could be seen in the dermis. RCM images of molluscum contagiosum lesions showed intact cystoid structures containing highly refractive molluscum bodies. Lowly to moderately refractive cutin ? like materials were observed along with the dilation of hair follicle infundibula in RCM images of lichen pilaris lesions. In RCM images, the 6 diseases were distinguished mainly based on structural features(patterns and refractivity)of skin lesions shown by continuous vertical scanning. Conclusion RCM is of great value to the diagnosis of diseases manifesting as papules in children.

Objective To explore the effect of environmental enrichment intervention on spatial memory function,expressions of phosphorylated cAMP response element binding protein (pCREB) and apoptotic regulated genes (Bcl-2 and Bax) in the hippocampus of immature rats with hypoxic-ischemic brain damage (HIBD).Methods Two kinds of raising environments were chosen:standard environment and environmental enrichment.Thirty-two Wistar rats aged 7 days were randomly divided into sham-operated group (n=10),environmental enrichment group (n=11) and standard environment group (n=11).Rats in both environmental enrichment group and standard environment group were induced animal models of HIBD using the way of Rice-Vannucci.Rats in the sham-operated group and standard environment group were raised in standard environment,while rats in the environmental enrichment group were raised in environmental enrichment.After 21 days of environmental enrichment intervention,the escape latency for searching the hidden platform of immature rats was detected by Morris water maze navigation test.The pCREB protein expression was detected by Western blotting;Bcl-2 and Bax expressions in the hippocampus were detected by immunohistochemisty.Results (1) On the fourth and fifth days of Morris water-maze test,the escape latency in the environmental enrichment group was shorter significantly as compared with that in the standard environment group (P＜0.05).(2) As compared with the lesion lateral hippocampus of standard environment group,the expressions ofpCREB (0.435±0.121 vs.0.756±0.101) and Bcl-2 (0.103±0.028 vs.0.165±0.017) in the lesion lateral hippocampus of environmental enrichment group were significantly higher (P＜0.05);however,the expression of Bax in the environmental enrichment group was statistically lower (0.402± 0.028 vs.0.325±0.019,P＜0.05).Conclusion Environmental enrichment intervention can improve the spatial memory ability in the hippocampus after HIBD,which indicates that the effectiveness of environmental enrichment intervention might be through the pathway of CREB-pCREB-apoptotic regulated genes (Bcl-2 and Bax).

Objective:To explore the clinical characteristics and predictors of severe acute pancreatitis complicated with acute respiratory distress syndrome (SAP-ARDS).Methods:Clinical data of consecutive 313 SAP patients hospitalized from January 2000 to January 2020 in Peking Union Medical College Hospital, were retrospectively analyzed, including 258 cases with ARDS (ARDS group) and 55 cases without ARDS (non-ARDS group). According to the severity of ARDS, ARDS group were further divided into mild ARDS group (165 cases) and moderate to severe ARDS group (93 cases). Clinical symptoms, laboratory examination and imaging results, ICU admission time and clinical outcome, as well as the local and systemic complications, acute physiology and chronic health evaluation (APACHEⅡ) within 24 h after admission, bedside index for severity in acute pancreatitis (BISAP), CT severity index (CTSI), sequential organ failure assessment (SOFA) and quick sequenctial organ failure assessment(qSOFA) score were recorded. Univariate and multivariate logistic regression were performed to analyze independent risk factors of SAP complicated with moderate to severe ARDS. Receiver operating characteristics curves (ROC) was drawn to calculate area under the ROC curve (area under curve, AUC) and evaluate the performance of WBC and hsCRP in predicting SAP complicated with moderate to severe ARDS, and assess the performance of APACHEⅡ, BISAP, CTSI, SOFA and qSOFA scores in predicting SAP-ARDS endotracheal intubation.Results:The ICU length of stay and mortality rate of SAP-ARDS patients were significantly higher than those without ARDS [(8.3±11.6 day vs 5.7±7.7 day, 12.4% vs 3.6%, all P value <0.05)]. Univariate analysis showed that elevated WBC ( OR 4.52, 95% CI 1.64-12.4) and hsCRP ( OR 3.69, 95% CI 1.29-10.48) on admission were independent risk factors for moderate to severe ARDS with SAP. The AUC of WBC and hsCRP for predicting SAP with moderate to severe ARDS at admission were 0.651(95% CI 0.532-0.770) and 0.615 (95% CI 0.500-0.730), respectively. The predicted cut-off values (Cut-off values) were 17.5×10 9/L and 159 mg/L, respectively, and the sensitivity was 53.1% and 78.1%, the specificity was 78.1% and 48.4% respectively. The area under the ROC curve for APACHEⅡ, BISAP, CTSI, SOFA, and qSOFA score 24 h after admission in the early prediction of endotracheal intubation were 0.739 (95% CI 0.626-0.840), 0.705 (95% CI 0.602-0.809), 0.753 (95% CI 0.650-0.849 ), 0.737 (95% CI 0.615-0.836) and 0.663 (95% CI 0.570-0.794), and the optimum Cut-off values were 14 points, 3 points, 5 points, 7 points, 2 points, and the sensitivity and specificity for these predictors were 58.8% and 81.4%, 79.4% and 60.0%, 73.5% and 67.1%, 38.2% and 98.6%, 45.5% and 83.3%, respectively. Conclusions::Elevated blood WBC and hsCRP on admission were independent risk factors for moderate to severe ARDS in SAP. APACHEⅡ≥14, BISAP≥3, CTSI≥5, SOFA≥7, or qSOFA≥2 within the 24 h admission indictaed that the risk of SAP patients to receive endotracheal intubation was high.