Background Acute retinal ischemia anoxic injury is common in eye disorders,such as acute glaucoma,central retinal artery occlusion and ischemic optic neuropathy,etc.This will cause retinal ischemia anoxic injury and induce retinal ganglion cells (RGCs) death in addition.Endogenous cannabinoid (CB) and its receptors are involved in the central nervous system injury,ischemia,inflammation,and poisoning and other physiological and pathological process.Objective This study was to investigate the effect of CB on RGCs damage induced by oxygen-glucose deprivation (OGD).Methods The eyeballs were obtained from 6-week-old normal C57BL/6J mice to prepare retinal frozen sectionsand the expression and distribution of cannabinoid receptors (CB1R and CB2R) in RGCs was detected by immunofluorescence staining.The eyeballs of ten newborn C57BL/6J mice (postnatal 0-3 days) were obtained after immersed by 75％ alcohol and the retinas were isolated in preeooling DMEM for the primary culture of RGCs.The cells were identified by detecting the expression of Brn3a,a marker of RGCs,with immunofluorescence staining.Then the cells cultured for 14 days were divided into normal control group (in complete culture medium+95％ air+5％ CO2) and OGD group (in glucose-free medium+95％ N2 +4％ CO2 + 1％ O2) for 20 hours.The mitochondrial damage and RGCs morphology changed were evaluated by JC-1 staining to observe the mitochondrial membrane potential change.SR141716A (CB1R antagonist,1 μmol/L),SR144528 (CB2R antagonist,1 μmol/L) and 5 or 10 μmol/L WIN 55212-2 (CB1R and CB2R agonist) were added,and the survival rate of RGCs was assayed MTT.Results CBR was positively expressed in various layers of normal mouse retinas.The cells in the normal control group showed uniform size and polygon in shape with the long and thin axons,and the expression of Brn-3a was seen in the cells.However,in the OGD group,cell shrinkage and fragments were found and most of the axons disappeared.The expression of Brn-3a was evidently weakened.The fluorescence intensity of JC-1 was evidently weakened in the OGD group compared with the normal control group,showing the reduce of mitochondrial membrane potential.MTT assay showed that the survival rate of RGCs was (100.00± 13.87)％,which was significantly higher than (89.52-± 18.16)％ in the normal control group (q =8.065,P =0.008).The mean survival rates of RGCs were (116.63±22.21)％ and (112.61 ±19.02)％ in the cells treated by SR141716A and SR144528,and that in the normal cells was (89.52 ± 18.16)％ in the OGD group,with significant differences between SR141716A-or SR144528-treated cells and normal cells (q =29.780,17.391;both at P＜ 0.01).Conclusions Hypoxia and glucose-free up-regulate the expression of CB and activate CB pathway.Inhibition of activation CBR process has a neuroprotection effect under the Hypoxia and glucose-free condition.

Objective Most of the clinical manifestations of aortic dissection and myocardial infarction are chest pain,which can easily lead to misdiagnosis and disastrous consequences.Therefore,this study intends to establish a differential diagnosis model and verify it in order to achieve early accurate prediction.Methods The relevant information of 200 patients with myocardial infarction and 120 pa-tients with aortic dissection diagnosed in the Second Affiliated Hospital of Zhengzhou University was collected,including age,gender,blood routine examination,electrolytes,markers of myocardial necrosis and blood coagulation function at admission.The patients were di-vided into myocardial infarction group and aortic dissection group.The independent risk factors were found out through t-test,AN OVA and binary Logistic regression analysis,and the nomogram was further drawn using R language to develop and validate the differential diag-nosis scoring table.Results The procalcitonin,prothrombin time(PT)、international normalized ratio(INR)、fibrin degradation product(FDP),D-dimer,white blood cell(WBC),percentage of neutrophil,percentage of lymphocyte,absolute value of neutrophil,absolute value of lymphocyte,C-reactive protein,cardiac troponin T(cTNT)、creatine kinase isozyme(CK-MB),systolic blood pressure of pa-tients in the two groups were statistically significant(P＜0.05),There was no significant difference in other indexes(P＞0.05).Binary Logistic regression analysis further showed that procalcitonin,D-dimer,C-reactive protein and systolic blood pressure were independent risk factors for diagnosing aortic dissection,while percentage of lymphocyte and absolute value of lymphocyte were independent risk factors for diagnosing myocardial infarction.According to the validation results of the score table developed by the nomogram,the the area under the receiver operating characteristic curve was 0.978,and the best cut-off value was 40.70 points.The sensitivity and specificity were 92.5％and 96.0％.Conclusion This study confirms that procalcitonin,D-dimer,C-reactive protein and systolic blood pressure are independent risk factors for diagnosing aortic dissection,while percentage of lymphocyte and absolute value of lymphocyte are independent risk factors for diagnosing myocardial infarction.The differential diagnosis scoring table proposed in this study can effectively differentiate patients with aortic dissection and myocardial infarction at an early stage,so as to guide further clinical diagnosis and treatment.

Objective:To investigate the effect of prognostic nutrition index (PNI) and clinical characteristics on the prognosis of patients with diffuse large B-cell lymphoma (DLBCL).Methods:The clinical data of 236 patients with DLBCL treated in the Affiliated Hospital of Xuzhou Medical University from November 2014 to December 2018 were retrospectively analyzed. X-Tile software and restricted cubic spline (RCS) were used to determine the best cut-off values of PNI, age and hemoglobin; Cox proportional hazard regression model was used for univariate and multivariate analyses; Kaplan-Meier method was used to analyze the overall survival (OS) of patients, and log-rank test was also performed.Results:One-hundred and fifteen of the 236 patients (48.7%) died, with a median OS time of 32 months. The 3-year OS rate was 46%, and the 5-year OS rate was 36%. The best cut-off value of PNI was 49. There was a significant non-linear relationship between PNI and the risk of poor prognosis of DLBCL ( χ2=34.64, P < 0.01); the analysis of the dose-response relationship showed that with the change of PNI, the correlation strength of the risk of poor prognosis declined non-linearly. The best cut-off value of age was 63 years old, and the correlation strength between age and the risk of poor prognosis of DLBCL showed a non-linear upward trend ( χ2=14.86, P=0.022). The best cut-off values of hemoglobin calculated by X-Tile software were 93 g/L and 129 g/L. Multivariate analysis showed that PNI, central nervous system involvement, liver involvement, age, hemoglobin, international prognostic index (IPI) score, and bulky disease were independent influencing factors of OS in DLBCL patients (all P < 0.05). In patients with germinal center B-cell-like (GCB) subtype, bcl-2-positive and bcl-6-positive, there were statistical differences in the 3-year OS rate of patients with PNI < 49 and PNI ≥ 49 (all P < 0.05). Conclusion:PNI has a certain value in the prognosis assessment of DLBCL patients, and PNI ≥ 49 indicates that the patient has a good prognosis.

Objective:To summarize the characteristics of nailfold capillaroscopy (NC) in patients with systemic lupus erythematosus (SLE) and explore its clinical significance.Methods:NC examination was performed in 162 SLE patients. The clinical data of SLE patients was collected. Tianniu NC scoring standard was used. The t test was applied to analyze the measurement data, the χ2 test was applied to analyze the counting data. the Pearson or Spearman test was used to evaluate the correlative factors of NC in patients with SLE. Results:NC abnormalities were seen in 87.7%(142/162) of SLE patients, and the incidence of mild, moderate and severe abnormalities was 29.0%(47 cases), 45.1%(73 cases) and 13.6%(22 cases) respectively. The most common NC abnormal manifestation in SLE patients was decreased blood flow velocity (86.4%). In patients with moderate to severe NC abnormalities, the proportions of patients with Raynaud's phenomenon (37.9% vs 23.9%, χ2=2.955, P=0.043) and interstitial lung disease (8.0% vs 0, χ2=5.213, P=0.023), and the level of D-Dimer [(1 992±2 279) μg/L vs (1 248±1 721) μg/L, t=-1.624, P=0.013] were significantly higher than those in the groups with normal/mild NC abnormalities. Correlation analysis demonstrated that Raynaud's phenomena, interstitial lung disease, pulmonary hypertension and D-Dimer were positively correlated with the NC abnormality. Conclusion:NC abnormalities are common in SLE patients. Decreased blood flow velocity is the most frequent manifestation. SLE patients with moderate to severe NC abnormalities should be actively screened for pulmonary hypertension and interstitial lung disease.

Objective:To explore the prognostic value of lymphocyte subsets in adult hemophagocytic syndrome (HPS).Methods:A total of 172 adult HPS patients diagnosed in 8 medical centers from January 2013 to August 2020 were selected for the study, of whom 87 were male (50.6%, 87/172), and 85 were female (49.4%, 85/172), with 68 survivors and 104 deaths. The clinical data were summarized, and variables such as lymphocyte subsets, immunoglobulin characteristics and fibrinogen were retrospectively analyzed, and the correlation between the mentioned variables and patient prognosis was analyzed. The optimal cut-off values of continuous variables were calculated by MaxStat, and the prognostic factors of HPS patients were screened based on the Cox proportional hazard regression model.Results:The median age of HPS patients was 56 (42, 66) years old, and the 5-year cumulative survival rate was 37.4% (37.4/100). The median age, platelet and albumin were 48 (27, 63) years, 84×10 9/L and 32.3 g/L in the survival group, and 59 years, 45.5×10 9/L, and 27.3 g/L in the death group, respectively. The differences between the two groups was statistically significant ( Z=?3.368, P=0.001; Z=?3.156, P=0.002; Z=?3.431, P=0.001). Patients with differentiated cluster 8+(CD8+)<11.1%, CD3+<64.9%, CD4+>51%, and CD4/CD8 ratio>2.18 had poor prognosis (χ 2=7.498, P=0.023; χ 2=4.169, P=0.041; χ 2=4.316, P=0.038; χ 2=9.372, P=0.002). Multivariable analysis showed that CD4/CD8 ratio, age, fibrinogen and hemoglobin were independent prognostic factors in HPS patients ( HR=2.435, P=0.027; HR=5.790, P<0.001; HR=0.432, P=0.018; HR=0.427, P=0.018). Conclusion:Peripheral blood lymphocyte subsets can be used to evaluate the prognosis of patients with HPS; CD4/CD8 ratio, age, fibrinogen, and hemoglobin are independent prognostic factors in HPS patients.

Developmental exposure to bisphenol A (BPA), an endocrine-disrupting contaminant, impairs cognitive function in both animals and humans. However, whether BPA affects the development of primary sensory systems, which are the first to mature in the cortex, remains largely unclear. Using the rat as a model, we aimed to record the physiological and structural changes in the primary auditory cortex (A1) following lactational BPA exposure and their possible effects on behavioral outcomes. We found that BPA-exposed rats showed significant behavioral impairments when performing a sound temporal rate discrimination test. A significant alteration in spectral and temporal processing was also recorded in their A1, manifested as degraded frequency selectivity and diminished stimulus rate-following by neurons. These post-exposure effects were accompanied by changes in the density and maturity of dendritic spines in A1. Our findings demonstrated developmental impacts of BPA on auditory cortical processing and auditory-related discrimination, particularly in the temporal domain. Thus, the health implications for humans associated with early exposure to endocrine disruptors such as BPA merit more careful examination.
Humans ; Rats ; Animals ; Benzhydryl Compounds/toxicity* ; Phenols/toxicity* ; Auditory Perception/physiology* ; Neurons/physiology*