Objective:To explore the clinical warning value of ischemic modified albumin (IMA) and IMA to human serum albumin (HSA) ratio (IMAR) in the development of pre-eclampsia (PE) and its severity.Methods:A total of 156 pregnant women with PE admitted to the Haidian District Maternal and Child Health Hospital of Beijing from April 2022 to March 2023 were collected as the PE group, and 156 healthy pregnant women with the same age and gestational age were matched as the control group. PE pregnant women were further divided into severe PE group (78 cases) and non-severe PE group (78 cases). Severe PE pregnant women were divided into emergency group (42 cases) and non-emergency group (36 cases) according to the disease progression time.All pregnant women were stratified according to their HSA levels (<30 g/L, 30-32 g/L, ≥32 g/L), and the peripheral blood IMA, HSA, and IMAR of pregnant women in different periods and subgroups were compared, and also the difference of IMA levels in umbilical artery blood. Bivariate correlation analysis was used to explore the correlation between severe PE and IMA or IMAR, and receiver operating characteristic (ROC) curves was used to analyze the diagnostic value of IMA, HSA, and IMAR for PE and severe PE.Results:(1) The IMA level and IMAR in peripheral serum of pregnant women in the PE group at diagnosis, and the IMA level in umbilical artery blood at delivery, and peripheral serum at 2 days after delivery were higher than those in the control group. The HSA level in peripheral serum was lower than that in the control group at diagnosis, and the differences were statistically significant (all P<0.001). (2) The IMA level and IMAR in the peripheral serum of pregnant women with severe PE were higher than those in the non-severe PE group at diagnosis, while the HSA level were lower than those in the non-severe PE group. The differences were statistically significant (all P<0.05). At diagnosis, the IMA level and IMAR in peripheral serum of pregnant women in the emergency group were higher than those in the non-emergency group, while the HSA level was lower than that in the non-emergency group. The differences were statistically significant (all P<0.05). When diagnosed, the peripheral serum IMA levels of pregnant women in the PE group were compared between subgroups with HSA<30 g/L, 30-32 g/L, ≥32 g/L, and there was no statistically significant difference ( F=0.366, P=0.694). However, the IMAR was compared between the three subgroups, and the difference was statistically significant ( F=28.544, P<0.001), which increased with the decrease of HSA levels. In the subgroup with HSA≥32 g/L, the peripheral serum IMA level and IMAR of pregnant women in the PE group were higher than those in the control group at diagnosis, and the differences were statistically significant (all P<0.001). (3) The severe PE manifestations positively correlated with peripheral serum IMAR at diagnosis include systolic blood pressure ( r=0.279), mean arterial pressure ( r=0.212), and urinary protein quantification ( r=0.277), while the severe PE manifestations negatively correlated include HSA levels ( r=-0.644) and newborn birth weight ( r=-0.305), all of which were significantly correlated ( P<0.05). (4) The area under curve (AUC) for IMAR diagnosis of PE was 0.875 (95% CI: 0.833-0.916), with the highest diagnostic efficiency at a cutoff value of 2.06, sensitivity of 72.5%, and specificity of 85.1%. The AUC for diagnosing severe PE was 0.871 (95% CI: 0.822-0.919), with the highest diagnostic efficacy at a cutoff value of 2.18, sensitivity of 72.3%, and specificity of 88.3%. The diagnostic efficacy of IMAR for PE and severe PE were higher than those of IMA and HSA levels. Conclusions:The level of IMA and IMAR in pregnant women with PE are higher than those in normal pregnant women. IMA and IMAR are correlated with the severity of PE, with IMAR changes occurring earlier and more significantly. IMAR could be considered as one of the evaluation indicators for the development of PE, or as a more sensitive PE severity warning indicator than HSA.

Objective:To analyze the clinicopathological features and prognosis of idiopathic membranous nephropathy (IMN) in children, and to investigate the factors influencing their prognosis.Methods:The clinical and pathological data of 128 children with IMN hospitalized in the First Affiliated Hospital of Zhengzhou University from January 2012 to December 2019 were retrospectively analyzed.They were divided into 2 groups according to the pathological manifestations: group A[typical membranous nephropathy(MN) group] and group B (atypical MN group), and the clinicopathological characteristics of the 2 groups were compared.Different treatment regimens and their efficacy were summarized, and the prognosis and its influencing factors were analyzed.The primary endpoint event at follow-up was the occurrence of end stage renal disease (ESRD), and the secondary endpoint event was the occurrence of renal insufficiency.Children with IMN were further divided into endpoint event group and non-endpoint event group according to the presence or absence of endpoint events at the last follow-up.Survival analysis was performed using the Kaplan-Meier survival curve method.The Cox proportional risk model method was used to analyze the factors influencing the prognosis of poor kidney outcomes in children with IMN. Results:(1)A total of 128 children were included, with the male-to-female ratio of 1.13∶1.00.The median age of onset and peak age of onset were 13.0 (10.3, 15.0) years, and 12-16 years (68.8%), respectively.Massive proteinuria was detected in 119 cases (93.0%), including 103 cases (80.5%) with massive proteinuria and hematuria, 4 cases(3.1%) with simple hematuria, and 5 cases (3.9%) with non-renal proteinuria.There were 29 cases (22.7%) in group A and 99 cases (77.3%) in group B. (2)Blood triacylglycerol level was significantly higher in group B than that of group A[2.1 (1.5, 3.0) mmol/L vs.1.7(1.1, 2.5) mmol/L], while high-density lipoprotein[1.5(1.1, 1.8) mmol/L vs.1.8(1.4, 2.1) mmol/L], serum albumin[22.0(17.0, 27.3) g/L vs.25.5 (21.0, 32.5) g/L] and complement C3[(1.1±0.2) g/L vs.(1.2±0.2) g/L] were significantly lower in group B than those of group A (all P<0.05). (3)Complete clinical data during hospitalization and follow-up data were obtained from 91 children with IMN, with a median follow-up time of 87.0 (49.0, 104.5) months.Among them, 5 cases (5.5%) progressed to ESRD, involving 3 cases received renal transplantation, and 9 cases (9.9%) had secondary endpoints.Cumulative renal survival rate for ESRD at 5 and 10 years were 96.2% and 92.9%, respectively, which, for the secondary endpoints at 5 and 10 years were 95.2% and 84.8%, respectively.(4)Kaplan-Meier survival analysis showed no significant difference in the cumulative renal survival between group A and group B ( P>0.05). Multifactorial Cox regression analysis showed that tubular atrophy/interstitial fibrosis was an independent risk factor for renal insufficiency in children with IMN ( HR=0.102, 95% CI: 0.011-0.940, P<0.05). Conclusions:Massive proteinuria combined with hematuria is the major clinical manifestation of IMN in children, and atypical MN is the major pathological manifestation.Tubular atrophy/interstitial fibrosis is an independent risk factor for renal insufficiency in children with IMN.

Objective:To explore the impact of different referral timing on postponing early-onset pre-eclampsia (PE), postponing severe pre-eclampsia (SPE), reducing SPE severe complications and improving maternal and neonatal outcomes by analyzing the pregnancy outcomes of SPE patients who were referred from primary hospitals to tertiary referral center in the referral system.Methods:The clinical data of 159 SPE patients who were referred from primary hospitals, treated and then terminated their pregnancy in Peking University Third Hospital from January 2020 to October 2021, were observed and analyzed in this clinical observational study. According to the clinical stage of PE at the time of referral, they were divided into four groups: 38 cases were referred after onset of SPE severe complications (SPE-C group), 72 cases were referred after onset of SPE (a-SPE group), 15 cases were referred after onset of PE (a-PE group) and 34 cases were referred after detection of PE early warning-signs (Warn-s group). And then these 159 cases were divided into different color groups according to the project management system for high-risk pregnant women. Patients of Red color (highest risk) and Orange color (higher risk) were required to be referred to tertiary hospitals (Red-Orange group, 113 cases), and patients of Yellow color (high risk) could be treated under tertiary hospitals (Yellow group, 46 cases). The maternal and neonatal outcomes of different referral timings were analyzed and compared.Results:(1) Pregnancy outcomes of different referral timings grouped by PE clinical stage at the time of referral: the later the referral timing, the higher the rate of SPE severe complications, the shorter the interval from referral to termination of pregnancy. The rate of SPE severe complications in the SPE-C group was significantly higher than those of the other three groups, and the interval from referral to termination of pregnancy in the SPE-C group was significantly shorter than those of the other three groups (all P<0.05). The referral gestational age of Warn-s group was earlier than those of the other three groups (all P<0.05). The average gestational ages for onset of SPE, termination of pregnancy, and onset of SPE severe complications were all after 34 gestational weeks, and were later than those of a-SPE group and SPE-C group; the rates of SPE onset before 34 gestational weeks, SPE severe complications onset before 34 gestational weeks, terminating pregnancy before 34 gestational weeks, neonatal intensive care unit (NICU) hospitalization, and pregnancy giving up before 28 gestational weeks were lower than those of a-SPE group and SPE-C group, the length of NICU stay was shorter than those of a-SPE group and SPE-C group, and its rate of take-home-babies was 100%, significantly higher than those in a-SPE group and SPE-C group (all P<0.05). The gestational ages for onset of SPE and termination of pregnancy in a-PE group were later than those in a-SPE group and SPE-C group, the rates of SPE onset before 34 gestational weeks, terminating pregnancy before 34 gestational weeks, and NICU hospitalization were lower than those of a-SPE group and SPE-C group, the length of NICU stay was shorter than those of a-SPE group and SPE-C group (all P<0.05). (2) Pregnancy outcomes of different referral timings grouped by the color classification of PE clinical characteristics: among the 159 cases of SPE, 113 cases (71.1%, 113/159) were in the Red-Orange group which were required to be referred to tertiary hospitals, and 46 cases (28.9%, 46/159) were in the Yellow group,which were not in the range of referral requirements, but actually referred to the tertiary hospital and eventually developed SPE. Gestational ages for onset of SPE, termination of pregnancy, and onset of SPE severe complications in the Yellow group were later than those of the Red-Orange group, while the rates of SPE onset before 34 gestational weeks, SPE severe complications onset before 34 gestational weeks, terminating pregnancy before 34 gestational weeks, NICU hospitalization, and pregnancy giving up before 28 gestational weeks were lower than those of the Red-Orange group, the length of NICU stay was shorter than that of the Red-Orange group, and its rate of take-home-babies was higher than that in the Red-Orange group (all P<0.05). (3) Analysis of different clinical referral timings in the Yellow group: among these 159 SPE patients, 46 cases (28.9%, 46/159) would be excluded from the range of referral requirements which belonged to the Yellow color grade, but 6 cases still developed SPE severe complications (4 cases in Warn-s group and 2 cases in a-PE group), 17 cases were terminated pregnancy before 34 weeks of gestation (12 cases in Warn-s group and 5 cases in a-PE group), and 23 cases developed SPE before 34 weeks of gestation (17 cases in Warn-s group and 6 cases in a-PE group). (4) Multivariate analysis: referral after detection of PE early warning signs was the independent protective factor for postponing the onset of SPE severe complications ( P<0.05). Referral after detection of PE early warning signs and referral after onset of PE were both protective factors for postponing the onset of SPE and early-onset PE (all P<0.05). Conclusions:Different referral timing in the referral system is one of the key points that affect the maternal and neonatal outcomes of SPE. Referral after detection of PE early warning signs and timely referral after onset of PE would reduce early-onset PE, postpone the onset of SPE and reduce the severe complications of SPE. The clinical development and evolution of PE is really complicated, and referral based on specific clinical situations is better than referral based on fixed mode.

  Objective  To study the demographic and clinical characteristics, correlation of genotype and phenotype and treatment of Blau syndrome to facilitate early diagnosis and timely treatment of Blau syndrome.  Methods  Seventy-two patients with Blau syndrome from 11 centers from May 2006 to April 2022 were retrospectively analyzed, and their general information, clinical data, laboratory examination and treatment medication were collected.  Results  The distribution of patients with Blau syndrome was uniform in geographical north and south of China, and there was no obvious gender bias. The mean age of onset was (14.30±12.81) months, and the age of diagnosis was (55.18±36.22) months. 35% of patients with Blau syndrome happened before 1 year old, and all patients developed before 5 years old. 87.50% (63/72) had granulomatous arthritis, 65.28% (47/72) had rash, 36.11% (26/72) had ocular involvement, 27.78% (20/72) had fever, and 15.28% (11/72) had pulmonary involvement. Arthritic manifestations of Blau syndrome were most at risk, followed by rash, ocular involvement, and fever.The first 25 months of the disease, the risk of developing a rash was the greatest. The risk of developing arthritis was the greatest between 25 months and 84 months. The main mutations were p.R334Q and p.R334W, and patients with p.R334Q mutation had relatively high incidence of fever (35.71%[5/14] vs. 14.29%[1/7], P=0.43) and ocular involvement (42.86%[6/14]vs. 28.57%[2/7], P=0.51). There was a relatively high incidence of rash (85.71%[6/7] vs. 64.29%[9/14], P=0.59) in patients with the p.R334W mutation. Forty-five patients(62.50%)were treated with a combina-tion of glucocorticoid and methotrexate. Twenty-two patients were treated with tumor necrosis factor antagonist in addition to glucocorticoid and methotrexate.  Conclusions  The risk of different clinical manifestations of Blau syndrome from high to low was arthritis, followed by rash, ocular involvement and fever. The main treatment was glucocorticoid combined with methotrexate, to which biological agents could be added.

Objective:To explore the feasibility and key point of improvement in preventing and postponing the onset of severe pre-eclampsia (SPE) and its severe complications in the tertiary referral system by analyzing the clinical characteristics of SPE in a single tertiary referral center.Methods:The clinical data of 217 patients with SPE who were hospitalized and terminated pregnancy in Peking University Third Hospital from January 2020 to December 2020 were retrospectively analyzed. The risk factors, clinical characteristics and severe complications of SPE between the patients referred from primary hospitals (referral group) and the patients received regular prenatal care in the tertiary referral center (central group) were compared, as well as the influence of the referral timing on the characteristics and perinatal outcome.Results:(1) Clinical characteristics: among the 217 cases of SPE, 84 cases were in the referral group and 133 cases were in the central group. The gestational ages at SPE clinical diagnosis [31.5 weeks (28.1-34.6 weeks) vs 35.6 weeks (33.3-37.2 weeks); Z=-6.547, P<0.01], termination of pregnancy [32.3 weeks (29.5- 35.1 weeks) vs 36.3 weeks (34.4-37.5 weeks); Z=-6.554, P<0.01] and onset of SPE severe complications [30.6 weeks (26.4-32.7 weeks) vs 34.9 weeks (32.7-36.5 weeks); Z=-4.040, P<0.01] in the referral group were significantly earlier than those in the central group, the rates of ICU [10.7% (9/84) vs 3.8% (5/133); χ2 =4.126, P=0.042] and neonatal ICU hospitalization [72.9% (51/70) vs 54.7% (70/128); χ2 =6.286, P=0.012] were higher than those in the central group, while the live birth rate [83.3% (70/84) vs 96.2% (128/133); χ2 =10.736, P=0.001] was lower than that of the central group. (2) Analysis of risk factors: for the patient whose risk factors were obesity, advanced age or pre-eclampsia history, the gestational ages at SPE clinical diagnosis and termination of pregnancy in the referral group were significantly earlier than those in the central group ( P<0.05). For those with chronic hypertension, the gestational ages at severe complications onset in the referral group were significantly later than those in the central group ( P<0.05). For those without obvious risk factors, the gestational ages at SPE clinical diagnosis, termination of pregnancy and onset of SPE severe complications in the referral group were earlier than those in the central group ( P<0.05). (3) Analysis of severe complications: the top three severe complications in the referral group and the central group were hypertensive encephalopathy/cerebrovascular accident [20.2% (17/84) vs 7.5% (10/133)], HELLP syndrome [7.1% (6/84) vs 8.3% (11/133)] and placental abruption [8.3% (7/84) vs 7.5% (10/133)]. The rate of hypertensive encephalopathy/cerebrovascular accident in the referral group was significantly higher than that in the central group ( χ2 =7.645, P=0.006). (4) Analysis of referral timings: the timings included referral after onset of SPE severe complications (8.3%, 7/84), referral after onset of SPE (67.9%, 57/84), referral after detection of SPE early warning signs (14.3%, 12/84) and referral after detection of SPE risk factors in the 2nd and 3rd trimester (9.5%, 8/84). The earlier the referral, the longer the interval from clinical diagnosis to onset of severe complications, from referral to termination of pregnancy, and from referral to severe complications onset ( P<0.05). The earlier the referral, the lower the NICU hospitalization rates, the higher the live birth rates. The ICU hospitalization rate of referrals after severe complications onset was significantly higher than those of the other three referral timing groups ( P<0.05). Conclusions:SPE occurs in hospitals of different levels. Although tertiary referral center may postpone the onset of SPE and its severe complications, reduce the severity of SPE and prolong the gestational age, its awareness of prevention and control still needs to be further improved. Early identification of the risk of SPE and timely referral are important parts of improving SPE adverse outcomes in primary medical institutions. The significance and value of referral system need to be brought into full play.

ObjectiveTo assess the specificity of P50 auditory-evoked potential in schizophrenic patients with violent and aggressive behaviors， so as to provide objective biological markers for predicting violent behaviors of schizophrenic patients. MethodsA total of135 schizophrenic patients who met the diagnostic criteria of the International Classification of Diseases， tenth edition （ICD-10） were divided into aggressive group （n=70） and non-aggressive group （n=65） according to the assessment results of the Modified Overt Aggression Scale （MOAS）， meantime， another 60 healthy individuals matched for age and gender were set as healthy group. Then the P50 auditory-evoked potentials of all selected individuals were measured using EP/EMG system （MEB-9200， Nihon Kohden， Japan）. ResultsAmp S2 of the aggressive group was significantly higher than those of the non-aggressive group and healthy control group， with statistical differences ［（9.86±6.04）μV vs. （7.06±3.88）μV， P=0.004； （9.86±6.04）μV vs. （7.82±3.87）μV， P=0.031］. The proportion of S2/S1 ratio ≥0.5 was 72.88%， 43.86% and 30.00% in aggressive group， non-aggressive group and healthy group， which was the highest in aggressive group， with statistical differences （P<0.01）. The amplitude difference of P50 （S1-S2） of the aggressive group was lower than those of the non-aggressive group and the healthy control group， the differences were of statistical significance ［（4.35±9.39）μV vs.（9.89±8.48）μV， P=0.001； （4.35±9.39）μV vs.（13.42±9.81）μV， P<0.01］. ConclusionThe violent and aggressive behaviors in schizophrenic patients may be related to the sensory gating deficit.

Objective: To observe the dynamic changes of human serum albumin (HSA) level during pregnancy and study the early warning significance of HSA level on the onset of preeclampsia (PE) . Methods: Totally 369 PE pregnant women (PE group) and 309 normal pregnant women (control group) without PE who admitted in Haidian Maternal and Child Health Hospital from January 2013 to December 2017 were selected. HSA levels were tested before meeting the criterion of PE in the first trimester, the early-third trimester and the late-third trimester, the difference between the two groups were compared. The relationship between the HSA level and the incidence of complications in PE patients was analyzed. Results: (1)The mean values of HSA level in PE group and control group were (41.9±3.1) versus (40.0±2.2) g/L, (34.2±2.7) versus (35.4±2.7) g/L and (33.7±2.9) versus (36.7±3.3) g/L in the first trimester,the early-third trimester and the late-third trimester respectively,the difference in the first trimester was no significance (P>0.05), while the differences in the early-third trimester and the late-third trimester were both significant (all P<0.05). (2) The HSA level during pregnancy of PE group showed a continuous downward trend, while the control group was V-shaped trend. The receiver operating characteristic (ROC) curve analysis showed that PE could be early warned by the decrease of HSA level in PE group [area under curve (AUC)=0.742, cut-off value=5.97 g/L, sensitivity 70.8%, specificity 62.8%], the same result was in severe PE (AUC=0.756, cut-off value=6.85 g/L, sensitivity 70.8%, specificity 72.0%). The level of HSA was negatively correlated with the incidence of complications (r=-0.19, P<0.01). Conclusions Excessive decrease of HSA level is an early warning factor for PE onset. The higher the baseline of HSA level and the greater the extent of pregnancy decline, the risk of PE in pregnant women is higher. The lower of HSA level in PE, the incidence of complications is higher. The excessive decrease of HSA level may be the first clinical manifestation before the onset of clinical symptoms of PE, so it may be the warning factor and one of the laboratory indicators in the PE sub-clinical stage.

Objective:To analyze the epidemiological and clinical characteristics of children with brucellosis, and to provide a practical basis and experience for clinical diagnosis and treatment of brucellosis.Methods:Retrospective analysis was used to collect clinical data of children with brucellosis diagnosed at the Children's Hospital Affiliated to Zhengzhou University from May 2015 to October 2017, and their epidemiological characteristics, clinical manifestations, laboratory tests, and clinical diagnosis and treatment were summarized.Results:A total of 24 children were included, including 14 males and 10 females, with an average age of 6 years (1 year 2 months to 12 years old). Except February, onset throughout the year, higher incidence was from May to July (14 cases, 58.33%). The exposure history of the children was mainly exposure to cattle and sheep and consumption of beef and mutton (18 cases, 75.00%). The main clinical manifestations were fever in 24 cases (100.00%), bone and joint pain in 14 cases (58.33%), hepatomegaly in 9 cases (37.50%), splenomegaly in 7 cases (29.17%). Tube agglutination test (SAT) was positive in 21 cases (87.50%), weakly positive in 1 case (4.17%) and negative in 2 cases (8.33%). Brucella was detected in all 24 cases by microbial culture, and in 18 cases (75.00%) by blood culture. Eighteen cases (75.00%) had liver dysfunction. Thirteen cases were misdiagnosed, and the misdiagnosis rate was as high as 54.17%. Twenty-two cases had been cured after treatment, 2 cases relapsed and recovered after continued treatment. Conclusions:Children with brucellosis have diverse epidemiology and clinical features, and are easily misdiagnosed. For children with fever, bone and joint pain and exposure history, pediatricians should be alert to the possibility of brucellosis, conduct microbiological and serological tests, in order to timely, accurate and standardized diagnosis and treatment of children with brucellosis.

Objective:To evaluate the biosafety of medical injectable carboxymethyl glycosaminoglycan gel.Methods:Ames test, chromosome aberration test in vitro and gene mutation test in vitro were used to detect the genotoxicity of the medical carboxymethyl glycosaminoglycan gel. The gel saline extract (50 ml/kg) was injected slowly through the marginal vein of the ear into Japanese big-eared rabbits. The body temperature was measured and the temperature rise was calculated. The gel saline extract (50 ml/kg) and normal saline (control) were injected intraperitoneally and intravenously into the Kunming mice, respectively. The toxicity response in mice was observed after injection, and bodyweight change was valued. The gel saline extract, normal saline and distilled water were added into the rabbit anti-clotting, to detect the rate of hemolysis.Results:Under active and inactive conditions, the number of spontaneous revertants of the 4 strains of gel saline extract group and gel DMSO extract group did not reach 2 times of that of the corresponding negative control group. The rate of chromosome aberration of the three dose groups were 0. There was no significant increase in the large colony mutation frequency, small colony mutation frequency and total mutation frequency in three dose groups (all P>0.05). After injection of gel saline extract for 24, 48 and 72 h, no toxic reaction was found in each group of mice. With the extension of time after injection, the body weight of mice in the sample group and the control group increased, but the difference was not statistically significant ( P>0.05). After injection of gel saline extract, the temperature rise of 3 Japanese big-eared rabbits were 0.0, 0.3 and 0.2 ℃ respectively. The results of hemolysis test showed that the hemolysis rate of the polycarboxymethyl glucosamine gel was 0.1%. Conclusions:No genetic toxicity changes were found in carboxymethyl glycosaminoglycan to induce gene mutation or chromosome damage in bacteria and cells, and no pyrogenicity, acute systemic toxicity and hemolysis were observed. These results indicate that thecarboxymethyl glycosaminoglycan gel has good biosafety.

Objective To evaluate the effect of cardiopulmonary bypass (CPB) on the expression of hypothalamic nerve growth factor precursor (proNGF) and the influence of hypothalamic proNGF on the sympathetic output of paraventrucular nucleus. Methods Forty-two male SD rats, aged 3-4 months, weighing 350-500 g, were divided into control group, CPB group and ischemia reperfusion (IR) group. At the end of CPB for 110 min, hypothalamus and dorsal root ganglion (DRG) were taken to measure the levels of proNGF mRNA and hypothalamic proNGF protein. Mini pipe was put into bilateral paraventrucular nucleus (PVN) and human recombination proNGF protein was injected into PVN for 7 d before the local field potentials (LFP) of RVLM was recoreded. Human recombination proNGF protein was administrated into lateral ventricle, the prior-administration-LFP of PVN and post-administration-LFP were recorded and compared. At the end of the experiment, hypothalamus was taken to measure the levels of glutamate and gammer amino butyric acid (GABA). Results Hypothalamic proNGF protein in CPB group and IR group was higher than that in the control group (P ＜ 0.05); NGF mRNA of hypothalamus and DRG in CPB and IR group were higher than those of control group (P ＜ 0.05). In PVN and RVLM, after the administration of proNGF protein, the power of delta band significantly decreased and other bands increased (P ＜ 0.05). The hypothalamic GABA level decreased (P ＜ 0.05) with no change of hypothalamic glutamate after proNGF was injected into lateral ventricle. Conclusion CPB increases the expression of proNGF in the hypothalamus contributing to the changes of hypothalamic sympathetic output.