Objective To predict the Hypertention by pregnancy in counting nuclear red blood cells pe-ripheral blood. Methods Blood samples were obtained from 69 pregnant women with the gestational age from 12 to 18 weeks. Peripheral blood mononuclear cells were isolated by density gradient centrifugation and then analyzed the cells marked with PE-GPA/FITC-CD71 monoclonal antibodies on the flow cytometer. Correlations between them were analyzed after tracking of hypertention by pregnancy. Results Percentage of GPA+/CD71+ cells in healthy pregnant women was 0.89 ± 0.81%, while that in pregnant women with hypertention was 3.57 ± 3.48%. There was a significant difference between the two groups (P<0.05), and the percentage of GPA+/CD71+cells in the group of hypertention by pregnancy was much higher than that in the healthy group. Conclusions The increased nuclear red blood cells in maternal peripheral blood related to hypertention by pregnancy. The counting of nuclear red blood cells in maternal peripheral blood have potential value to predict hypertention by pregnancy.

Objective To assess the characteristic of normal tension glaucoma (NTG) patients with mild cogni?tive impairment (MCI). Methods This study included twenty-six cases of normal tension glaucoma patients who were diagnosed at ophthalmology department of Peking University Third Hospital. All the participants were examined by us?ing the scales of Montreal Cognitive Assessment (MoCA), mini-mental state examination(MMSE), clinical dementia rat?ing (CDR), activities of daily living (ADL), Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), Pitts?burgh Sleep Quality Index (PSQI) and polysomnography (PSG). The patients were then divided into Group with MCI (16 cases) and Group without MCI (19 cases). Results There was no difference between the two groups in gender, age, edu?cation, depression, anxiety and body mass index (BMI) (P>0.05), but significant difference in MoCA scores (P<0.05). The incidence rate of sleep disorder of PSQI in was 28.6%(10/35 patients) of total NTG patients, 43.8%(7/16 patients) in Group with MCI, and 15.8% (3/19 patients) in Group without MCI, respectively. The PSQI score was higher in Group with MCI than in Group without MCI (P<0.05). Sleep efficiency was higher in Group without MCI than in Group with MCI (P<0.05), but no difference was found between the two groups in six other indexes of PSQI (P>0.05). The in?cidence rate of sleep structure disorder of PSG in all the NTG patients was 85.7%(30/35 patients), 87.5%(14/16 pa?tients) in Group with MCI, and 84.2%(16/19 patients) in Group without MCI. Sleep time of NREM-N3 was significant?ly shorter in Group with MCI than in Group without MCI (P<0.05), but no difference was found between those groups in total sleep time, sleep efficiency, sleep latency and REM time (P>0.05). Conclusion NTG patients with mild cogni?tive impairment are more prone to sleep disorders, especially sleep structure disturbance and short NREM-N3 time may affect cognitive function.

This study was aimed to investigate the effect of Radix Bupleuri extract (RBE) on 5-HT3R channel currents of primarily cultured hippocampal neurons in depression emotion rats.Depression emotion model ratswere duplicated.RBE was used for drug intervention.And then,the rats were evaluated by the open-field test (OFT) and the sucrose preference test.Serum of rats in each group was collected and then added into the primary cultured hippocampal neurons for 24 h.The 5-HT3R channel currents were recorded by the whole-cell patch clamp.The results showed that compared with the normal group,the total score of OFT in the model group was significantly decreased (P < 0.01); the sucrose preference ratio decreased obviously (P < 0.01); and the current density value of primary cultured hippocampal neurons in serum of the model group was significantly higher (P <0.01).Compared with the model group,the total scores of OFT in the RBE group and fluoxetine group increased significantly (P < 0.05,P < 0.01); the sucrose preference ratio also increased obviously (P < 0.05,P < 0.05); and current density value of the primary cultured hippocampal neurons in serum of the RBE group and fluoxetine group decreased significantly (P < 0.01,P < 0.01).It was concluded that RBE can effectively correct the abnormal 5-HT3R channel currents of rats with depression emotion,which may be one of the central mechanisms in the treatment of depression emotion.

OBJECTIVE To study the roles of copper transporter 1 (CTR1 )and Cu2 + transporting ATPase αpolypeptide (ATP7A)in lead exposure-induced copper accu mulation and oxidative stress in rat C6 glio ma cells.METHODS Methyl thiazolyl tetrazoliu m (MTT)assay was performed to determine the proper Pb doses (without affecting cell viability)by treated the cells with lead acetate 0 -100 μmol·L -1 for 24 h and 48 h.Superoxide dis mutase (SOD)activity or malondialdehyde(MDA)level were detected respectively by xanthine oxidase technique and thiobarbituric acid (TBA) method.Ato mic absorption spectrophoto metry was e mployed to determine the intracellular levels of Pb and Cu ions.Real-ti me quan-titative PCR and Western blot were used to detect the mRNA and protein levels of CTR1 and ATP7A, respectively.RESULTS The cell viability significantly decreased when the doses of Pb treat ment was higher than 10 μmol·L -1 ,so 10 μmol·L -1 was chosen as a working concentration of Pb exposure in this study.Co mpared with those in the normal controls,a moderately decreased T-SOD activity and an increased MDA level was determined in the cells treated with Pb 10 μmol·L -1 or Cu 5 μmol·L -1 alone, while a significant drop of T-SOD activity and a re markable increase of MDA level was found in the cells co-exposed to Pb and Cu (P<0.01 ).Pb exposure for 24 and 48 h increased the cellular Cu uptake by 1 .2 and 2.5 fold,respectively (P <0.01 ).Evidences fro m RT-PCR showed that Pb exposure for 24 and 48 h upregulated the CTR1 mRNA level by 23.2% and 58.7%,and downregulated the ATP7A mRNA level by 58.1 % and 50.0%,respectively.Results fro m Western blot confirmed that Pb exposure also resulted in an increased CTR1 expression and a decreased ATP7A expression at protein level (P<0.01 ).CONCLUSION Pb exposure lead to Cu accu mulation,by affecting the expression levels of CTR1 and ATP7A,and increased oxidative stress in C6 cells.

Objective To study the use of preoperative indocyanine green retention test at 15 minutes (ICG R15) in the prediction of liver functional reserve in patients with hilar cholangiocarcinoma (HCCA).Methods The clinical data of 62 patients with HCCA treated in our department from March 2016 to March 2018 was reviewed.The relationship between preoperative ICG R15 and postoperative hepatic insufficiency was analyzed.The relationship between preoperative ICG R15 and Child-Pugh scoring was also studied.Univariate analysis was used to evaluate the risk factors of postoperative liver dysfunction.Logistic regression was used to assess the independent risk factors of postoperative liver dysfunction.The regression equation between independent risk factors and postoperative liver dysfunction was established.Results Among the 62 patients,ICG R15 was less than 10.0％ in 26 patients,between 10.0％ and 19.0％ in 17 patients,between 20.0％ and 29.0％ in 9 patients,between 30.0％ and 39.0％ in 5 patients,and over 40.0％ in 5 patients.There were 29 patients with a Child-Pugh A grading and 33 patients with a Child-Pugh B grading in the preoperative evaluation of liver function.The Wilcoxon W rank sum test was used to compare the preoperative ICG R15 in patients with Child-Pugh grading A and B separately.The ICG R15 in Child-Pugh grading A patients was significantly lower than those in Child-Pugh B grading patients (P ＜0.05).There were no significant differences in age,gender,history of previous liver diseases,duration of operation,and intraoperative blood loss (P ＞ 0.05) between the normal liver function group and the liver dysfunction group.However,there was a significant difference in the preoperative ICG R15 and preoperative bilirubin levels (P ＜ 0.05) between the two groups.The preoperative ICG R15 and preoperative bilirubin levels were significant risk factors of postoperative hepatic insufficiency.Regression analysis suggested that preoperative ICG R15 level was an independent risk factor of postoperative hepatic insufficiency (P ＜ 0.05).A regression equation:logit(P) =0.185 × preoperative ICG R15-3.152 could be constructed.Conclusions ICG R15 is an ideal clinical indicator for evaluation of preoperative liver functional reserve in patients with HCCA.It predicted the recovery of postoperative liver function.

Objective To analyze the risk factors of microvascular complications in patients with type 2 diabetes mellitus (T2DM).Methods The demographic and clinical data of 5078 T2DM patients in six communities of Shanghai were collected during September 2014 to April 2015. The risk factors of microvascular complications in T 2DM were analyzed by classification tree model .Results Among 5078 T2DM patients there were 1007 cases of diabetic retinopathy (DR) (21.1%) and 1937 cases of diabetic nephropathy (DN) (38.4%).The classification tree models showed that the risk factors of DR were higher hemoglobin A1C ( HbA1c), fasting blood glucose ( FBG), postprandial blood glucose ( PBG) and triacylglycerol ( TG) levels;longer course of disease and younger age of onset .The model showed that the risk factors of DN were higher HbA1c, FBG, hypertension, PBG, body mass index ( BMI ) and triacylglycerol (TG) levels;and lower high-density lipoprotein (HDL) level.The HbA1c, course of disease and PBG were more closely related to DR and HbA 1c, hypertension and FBG were more closely related to DN.Conclusion HbA1c is the most important risk factor to microvascular complications; FBG and PBG are independent risk factors of microvascular complications;the course of disease and hypertension are risk factors of DR and DN , respectively .

Objective To investigate the outcomes of patients with diabetic retinopathy (DR) in Shanghai communities and the influencing factors.Methods From October 2015 to April 2016,533 type 2 diabetic patients with DR were selected by target sampling and cluster random sampling method from six community health service centers in Shanghai.Patients were followed up for 1 year.The demographic information,physical examination,laboratory tests and eye fundus exam results were documented and the DR was graded.The factors associated with the regression of DR were analyzed.Results Total 478 patients,including 280 females (58.6％) and 198 males (41.4％),were followed up for 1 year.The mean age of patients was (64±7) years and the mean disease duration was (8.85±4.20) years.The original DR lesion was remitted in 35 patients with an improvement rate of 7.3％;while the original DR lesion was aggravated in 29 patients with a progression rate of 6.1％.Ordinal logistic regression analysis revealed that age (OR=0.197,95％CI:0.056-0.699),body mass index (BMI) (OR=0.383,95％CI:0.171-0.856),glycosylated hemoglobin (HbAlc) (OR=0.287,95％CI:0.102-0.803),triglycerides (TG) (OR=0.541,95％CI:0.295-0.991),urinary albumin to creatinine ratio (ACR)(OR=0.218,95％CI:0.066-0.720) were associated with DR in type 2 diabetic patients.Conclusion The regression of DR is closely related to age,BMI,glucose,serum lipids and renal function,so it is suggested that lowering BMI,controlling glucose and serum lipids and maintaining normal kidney function are necessary for preventing the progression and promoting the improvement of DR in diabetic patients.

Objective To analyze the changes of relaxation values of different brain gray matter nuclei in patients with Parkinson's disease(PD)by synthetic magnetic resonance imaging(SyMRI),and to explore the correlation between relaxation values and clinical subtypes of PD,so as to provide some imaging basis for the diagnosis and classification of PD.Methods A total of 53 patients with PD and 34 healthy controls(HC)were scanned by SyMRI sequence.The patients with PD were divided into early group(33 cases),middle and late group(20 cases),postural instability/gait difficulty(PIGD)group and tremor dominant(TD)group.The region of interest(ROI)was drawn manually and the T1,T2 and proton density(PrD)values of different brain gray matter nuclei were measured,respectively.The differences between the groups were compared.Results There were statistical differences between the PD group and the HC group in multiple gray matter nuclei and multiple relaxation value parameters(P＜0.05).There were statistical differences in the relaxation values of gray matter nuclei such as head of the caudate nucleus,body of the caudate nucleus,putamen,globus pallidus,thalamus,red nucleus,and substantia nigra among the early PD group,the middle and late PD group,and the HC group,and red nucleus PrD value had the most testing effectiveness in the diagnosis of early PD[area under the curve(AUC)0.823,P＜0.001].There were statistical differences in the relaxation values of gray matter nuclei such as head of the caudate nucleus,putamen,and thalamus between the PIGD group and the TD group(P＜0.05).Conclusion It is found that there are statistical differences in different nuclear relaxation values between PD patients and healthy people,as well as between PD patients with different clinical types via SyMRI,suggesting that SyMRI has a certain clinical value in the diagnosis and classification of PD.

Objective:To investigate and analyze the correlation between the expression levels of CD38, HLA-DR and programmed cell death-1 (PD-1) on peripheral blood CD8 +T cells and HIV-1 RNA viral load, immune activation and exhaustion in patients with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). Methods:A total of 81 HIV/AIDS patients (64 without antiretroviral therapy and 17 with therapy) and 40 healthy donors in the same period were enrolled as the control group. Flow cytometry was used to analyze the CD4 +T lymphocyte count and the expression levels of activation markers CD38 and HLA-DR and apoptosis marker PD-1 on CD8 +T cells. HIV-1 RNA in the plasma of HIV-1 infected patients was quantitatively detected by real-time fluorescence quantitative polymerase chain reaction. Variance analysis was used to compare the expression levels of CD38, HLA-DR and PD-1 on CD8 +T cells between HIV/AIDS patients and healthy controls. Spearman correlation analysis was used to analyze the correlation between different T lymphocyte counts and HIV RNA viral load, and the correlation between HIV RNA viral load and peripheral blood CD8 +T cell CD38, HLA-DR and PD-1. Results:Among the 81 HIV/AIDS patients, 69 (85.19%) were males and 12 (14.81%) were females, with an age M ( Q1, Q3) of 58 (36.5, 65.0) years. There were 60 HIV/AIDS patients over 55 years old (74.07%) and 21 HIV/AIDS patients between 18 and 55 years old (25.93%). The results of variance analysis showed that compared with the healthy control group, the expression levels of CD38, HLA-DR and PD-1 on CD8 +T cells in HIV/AIDS patients increased, and the differences were statistically significant (all P<0.05). In addition, the expression of CD38, HLA-DR and PD-1 increased significantly in patients with CD4 +T cell count less than 350 cells/μl, and the differences were statistically significant (all P<0.05). Spearman correlation analysis showed that CD4 +and CD4 +/CD8 +were negatively correlated with viral load in HIV/AIDS patients ( r=-0.407 and -0.378, respectively, both P<0.05), and CD8 +was positively correlated with viral load ( r=0.356, P<0.05). When the HIV RNA level was≤10 5 CPs/ml, there was no correlation between the HIV RNA level and the expression levels of CD38, HLA-DR and PD-1 on CD8 +T cells (all P>0.05). However, when the level of HIV RNA was>10 5 CPs/ml, the level of HIV RNA was positively correlated with the expression levels of CD38, HLA-DR and PD-1 on CD8 +T cells ( r=0.412, 0.387, 0.395, respectively, all P<0.05). Conclusions:The activation levels of CD38 and HLA-DR and the expression of PD-1 on CD8 +T cells in the peripheral blood of HIV/AIDS patients are increased. When the viral load is high, the HIV RNA viral load is positively correlated with the activation and exhaustion levels of CD8 +T cells.

Objective To analyze the factors influencing the early recovery of renal function in patients with sepsis-associated acute kidney injury(SA-AKI).Methods A retrospective analysis was conducted on 86 SA-AKI patients treated in the Intensive Care Unit at Zhongshan Hospital,Fudan University from January 2021 to December 2022,who met both the Sepsis 3.0 diagnostic criteria and the AKI diagnostic standards.Patients were divided into a recovery group and a non-recovery group based on whether their renal function recovered within 7 days after AKI onset.Clinical data and laboratory tests of patients were compared between the two groups.Univariate and multivariate logistic analyses were used to identify risk factors affecting renal function recovery in SA-AKI patients,and ROC curve was utilized to evaluate the predictive value of these factors for early renal function recovery in SA-AKI patients.Results The renal function of 37(43.02％)patients recoveried.Compared with the recovery group,the renal replacement therapy rate,in-hospital mortality and 28-day mortality of patients in the non-recovery group were higher(P＜0.001).The multivariate logistic analysis showed that age,APACHE Ⅱ score,urine output,urine neutrophil gelatinase-associated lipocalin(NGAL),and norepinephrine dose were independent related factors affecting renal function recovery in SA-AKI patients(P＜0.05).The final model logit(P)=-4.091+0.001×urine NGAL-0.001 Xurine volume+0.040 ×age+0.073 × APACHE Ⅱ score+1.906 × norepinephrine dose.The AUC of model predicting early SA-AKI recovery was 0.823,with 73.5％of sensitivity,and 81.1％of specificity.Conclusions In SA-AKI patients,age,APACHE Ⅱ score,urine output,urine NGAL,and the dose of norepinephrine independently affect early renal function recovery,and the combined assessment of these indicators has predictive value for the early renal recovery in these patients.