Objective:To explore the effects of anshen jieyu decoction on hippocampal morphology and regulation of PI3K/AKT signalling pathway with hypothalamic-pituitary-adrenal axis expression in CUMS depressed rats.Methods:Rats were divided into a control group(Control),CUMS model group(CUMS),and ASJYD treatment group(CUMS+ASJYD).Rats in the CUMS and CUMS+ASJYD groups were exposed to 10 different chronic stressors to induce depressive-like behaviors.After modeling,the CUMS+ASJYD group received ASJYD via gavage.Depressive-like behaviors were assessed using the sucrose preference test and open field test.Serum levels of adrenocorticotropic hor-mone(ACTH)and corticosterone(CORT)were measured by ELISA.Hippocampal neuronal morphological changes were observed via Nissl staining,mitochondrial ultrastructure was examined using transmission electron microscopy,and hippocampal PI3K and AKT protein phosphorylation levels were detected by Western blot.Results:Compared with the Control group,the CUMS group showed significantly reduced sucrose consumption,preference rate,total travel distance in the open field,and central zone activity time(P＜0.01).Serum ACTH and CORT levels were elevated(P＜0.01),with disorganized hippocampal cell arrangement,reduced cell count,mitochondrial swelling,cristae blurring/rupture observed under electron microscopy,and decreased phosphorylation levels of PI3 K and AKT proteins(P＜0.01).After ASJYD treatment,the CUMS+ASJYD group exhibited significant improvements in sucrose consumption,preference rate,locomotor activity,and central zone exploration(P＜0.01),accompanied by reduced ACTH/CORT expression,alleviated hippocampal pathology,restored mitochondrial integrity with clear cristae,and increased PI3K/AKT phosphorylation(P＜0.01).Conclusion:Anshen Jieyu decoction significantly improved the depression-like be-haviour of CUMS rats,which may be achieved by down-regulating the hyperactive hypothalamic-pituitary-adrenal axis,regulating the expression of PI3K/AKT signaling pathway,and ameliorating the damage to hippocampal neurons and mi-tochondria.

Diabetic kidney disease （DKD） is one of the more common chronic kidney diseases，and its causes are complex. DKD is very easy to progress to end-stage renal disease，and the current therapeutic effect still needs to be improved. As an important excretive organ of the human body， the kidney has physiological functions such as discharging metabolic waste， regulating fluid balance， and maintaining the stability of the body's internal environment. These highly complex biochemical processes all depend on the energy support provided by mitochondria. Mitochondrial dysfunction is a key factor causing kidney injury， and the imbalance of mitochondrial homeostasis is an important link leading to mitochondrial dysfunction. The occurrence and development of DKD are often accompanied by the imbalance of mitochondrial homeostasis in renal cells. Mitochondrial autophagy， as a means of regulating mitochondrial homeostasis， is very important for the prevention and treatment of DKD. The PTEN-induced putative kinase 1 （PINK1）/Parkin pathway is one of the most classical pathways to regulate mitochondrial autophagy. Recent studies have found that some drugs can regulate the PINK1/Parkin signaling pathway to target mitochondrial homeostasis and exert renoprotective effects. In particular， traditional Chinese medicine has a significant effect on early and middle stage DKD by regulating PINK1/Parkin pathway-mediated mitochondrial autophagy. This article discussed the mechanism of PINK1/Parkin pathway in mitochondrial autophagy and DKD and reviewed the effect of PINK1/Parkin pathway-mediated mitochondrial autophagy on DKD. At the same time， it explored the therapeutic effect of traditional Chinese and western medicine on DKD mediated by PINK1/Parkin-mediated mitochondrial autophagy， aiming to broaden the ideas of traditional Chinese and western medicine for the prevention and treatment of DKD from the perspective of PINK1/Parkin regulating mitochondrial autophagy.

Diabetic kidney disease （DKD） is one of the more common chronic kidney diseases，and its causes are complex. DKD is very easy to progress to end-stage renal disease，and the current therapeutic effect still needs to be improved. As an important excretive organ of the human body， the kidney has physiological functions such as discharging metabolic waste， regulating fluid balance， and maintaining the stability of the body's internal environment. These highly complex biochemical processes all depend on the energy support provided by mitochondria. Mitochondrial dysfunction is a key factor causing kidney injury， and the imbalance of mitochondrial homeostasis is an important link leading to mitochondrial dysfunction. The occurrence and development of DKD are often accompanied by the imbalance of mitochondrial homeostasis in renal cells. Mitochondrial autophagy， as a means of regulating mitochondrial homeostasis， is very important for the prevention and treatment of DKD. The PTEN-induced putative kinase 1 （PINK1）/Parkin pathway is one of the most classical pathways to regulate mitochondrial autophagy. Recent studies have found that some drugs can regulate the PINK1/Parkin signaling pathway to target mitochondrial homeostasis and exert renoprotective effects. In particular， traditional Chinese medicine has a significant effect on early and middle stage DKD by regulating PINK1/Parkin pathway-mediated mitochondrial autophagy. This article discussed the mechanism of PINK1/Parkin pathway in mitochondrial autophagy and DKD and reviewed the effect of PINK1/Parkin pathway-mediated mitochondrial autophagy on DKD. At the same time， it explored the therapeutic effect of traditional Chinese and western medicine on DKD mediated by PINK1/Parkin-mediated mitochondrial autophagy， aiming to broaden the ideas of traditional Chinese and western medicine for the prevention and treatment of DKD from the perspective of PINK1/Parkin regulating mitochondrial autophagy.

Objective:To explore the effects of anshen jieyu decoction on hippocampal morphology and regulation of PI3K/AKT signalling pathway with hypothalamic-pituitary-adrenal axis expression in CUMS depressed rats.Methods:Rats were divided into a control group(Control),CUMS model group(CUMS),and ASJYD treatment group(CUMS+ASJYD).Rats in the CUMS and CUMS+ASJYD groups were exposed to 10 different chronic stressors to induce depressive-like behaviors.After modeling,the CUMS+ASJYD group received ASJYD via gavage.Depressive-like behaviors were assessed using the sucrose preference test and open field test.Serum levels of adrenocorticotropic hor-mone(ACTH)and corticosterone(CORT)were measured by ELISA.Hippocampal neuronal morphological changes were observed via Nissl staining,mitochondrial ultrastructure was examined using transmission electron microscopy,and hippocampal PI3K and AKT protein phosphorylation levels were detected by Western blot.Results:Compared with the Control group,the CUMS group showed significantly reduced sucrose consumption,preference rate,total travel distance in the open field,and central zone activity time(P＜0.01).Serum ACTH and CORT levels were elevated(P＜0.01),with disorganized hippocampal cell arrangement,reduced cell count,mitochondrial swelling,cristae blurring/rupture observed under electron microscopy,and decreased phosphorylation levels of PI3 K and AKT proteins(P＜0.01).After ASJYD treatment,the CUMS+ASJYD group exhibited significant improvements in sucrose consumption,preference rate,locomotor activity,and central zone exploration(P＜0.01),accompanied by reduced ACTH/CORT expression,alleviated hippocampal pathology,restored mitochondrial integrity with clear cristae,and increased PI3K/AKT phosphorylation(P＜0.01).Conclusion:Anshen Jieyu decoction significantly improved the depression-like be-haviour of CUMS rats,which may be achieved by down-regulating the hyperactive hypothalamic-pituitary-adrenal axis,regulating the expression of PI3K/AKT signaling pathway,and ameliorating the damage to hippocampal neurons and mi-tochondria.

Atypical sensory responsivity is widely reported in autistic individuals and is related to elevated functional difficulties. Dynamically, altered initial responses and/or habituation rates could underlie their atypical averaged responses to repeated sensory stimuli. In this study we aimed to measure the arousal level in response to different types of auditory stimuli and the dynamic change of atypical arousal level using pupillometry in autistic children. In Experiment 1, 43 autistic children and 49 neurotypical (NT) children were asked to passively listen to a mild sound and an aversive sound repeatedly. In Experiment 2, 39 autistic children and 44 NT children who went through Experiment 1 listened to a gradually emerging non-startling sound and a suddenly emerging startling sound in a random order. We found that the autistic group showed hyper-arousal in response to the aversive sound and the startling sound as reflected by their larger change in pupil area. In comparison, these autistic children demonstrated normal arousal in response to the mild sound and the non-startling sound. Dynamically, the autistic group had a larger peak pupil area change than the NT group in the first trial and a normal habituation rate to the aversive sound. In summary, our results suggest hyper-arousal to aversive and startling stimuli and the role of larger initial responses in hyper-arousal in autism. Minimizing aversive and startling sensory stimuli or gradually increasing the volume of aversive auditory stimuli to allow autistic children to adapt using the principle of habituation is recommended to reduce the arousal level and problematic behaviors of autistic children.
Humans ; Male ; Child ; Female ; Acoustic Stimulation ; Autistic Disorder/physiopathology* ; Arousal/physiology* ; Pupil/physiology* ; Habituation, Psychophysiologic/physiology* ; Auditory Perception ; Child, Preschool

Objectives:To explore the changes of some peripheral blood cells related to inflammation in patients with non-arteritis central retinal artery occlusion (NA-CRAO).Methods:A retrospective clinical study. From July 2019 to July 2021, a total of 218 patients with NA-CRAO hospitalized (NA-CRAO group) in Department of Ophthalmology, Xi'an People's Hospital (Xi'an Fourth Hospital) and 218 patients with routine physical examination (control group) during the same period were included in the study. There were no significant differences in age ( t=0.60), sex composition ratio ( χ2=0.83) and body mass index ( t=0.77) between the two groups ( P>0.05). 0.2 ml fasting peripheral blood was collected from the subject, and white blood cells (WBC), neutrophils (NEUT), lymphocytes (LYMPH), red blood cells (RBC), RBC distribution width (RDW), platelets (PLT), mean PLT volume (MPV), and large PLT ratio (PLCR) were detected. The NEUT/LYMPH ratio (NLR) and PLT/LYMPH ratio (PLR) were calculated. t test was used to compare measurement data between groups. Multiple logistic regression analysis was performed for blood cells with P <0.05. The receiver operating characteristic curve (ROC curve) was used to calculate the area under the curve (AUC) and 95% confidence interval (95% CI) of each inflammatory indicator, and the optimal cutoff value was determined according to the Jorden index (sensitivity+specificity-1). Results:Compared with control group, WBC, NEUT, NLR, RDW, PLR were increased in NA-CRAO group, while RBC and LYMPH were decreased, with statistical significance ( t=9.68, 12.43, 9.47, 3.64, 5.54, 5.18, 0.46; P<0.001). There was no significant difference in PLT, MPV and PLCR between the two groups ( t=0.32, 1.56, 0.84; P>0.05). Multivariate logistic regression analysis showed that NLR was a possible risk factor for the occurrence of NA-CRAO (odds ratio=2.51, 95% CI 0.780-0.859, P=0.031). ROC curve analysis showed that the AUC predicted by NLR was 0.819, the optimal critical value was 3.05, and the sensitivity and specificity were 59.2% and 92.7%, respectively. Conclusions:In peripheral blood cells of NA-CRAO patients, NEUT is significantly increased and LYMPH is decreased. NLR is a possible risk factor for NA-CRAO.

Objective:To observe the clinical and imaging features of non-arteriotic central retinal artery occlusion (NA-CRAO) with internal boundary membrane detachment (ILMD), and to analyze its relationship with visual prognosis.Methods:A retrospective clinical study. A total of 88 patients with NA-CRAO hospitalized in Department of Ophtalmology, Xi'an People's Hospital (Xi'an Fourth Hospital) from January 2014 to June 2023 were included in the study. Best corrected visual acuity (BCVA), optical coherence tomography (OCT) and fluorescein fundus angiography (FFA) were performed. The BCVA test used the international standard visual acuity chart, which was statistically converted to the logarithm of the minimum angle of resolution (logMAR) visual acuity. OCT observed the presence of ILMD and the thickening of the inner retina and the disappearance of anatomical stratification. FFA recorded arm-retinal circulation time (A-Rct) and retinal arterion-distal filling time (FT), and observed ciliary retinal artery, fluorescein retrograde filling, cotton spots, luciferin nodal filling, macular non-perfusion, capillary fluorescein leakage, optic disc strong fluorescence, choroidal background weak fluorescence and other characteristics. According to whether there was ILMD, the patients were divided into ILMD group and non-ILMD group, with 44 cases and 44 eyes respectively. The two groups received the same treatment. The follow-up time was 30 days after treatment. The clinical, FFA characteristics and BCVA before and after treatment were compared between the two groups. t-test was used for comparison between groups. Results:In ILMD group and non-ILMD group, there were 43 cases of male and 1 case of female, respectively, and the proportion of male was significantly higher than that of female. Before and after treatment, the logMAR BCVA of ILMD group and non-ILMD group were 2.35±0.42, 2.01±0.46, 1.47±0.60, 0.77±0.49, respectively. There were significant differences in logMAR BCVA between the two groups before and after treatment ( t=8.025, 12.358; P<0.001). Before treatment, A-Rct and FT in ILMD group were longer than those in non-ILMD group, and the difference was statistically significant ( t=3.052, 3.385; P<0.05). After treatment, there was no significant difference ( t=1.040, 1.447; P >0.05). The proportion of ciliary retinal artery and cotton plaque in ILMD group was lower than that in non-ILMD group. There was no significant difference in ciliary retinal artery between the two groups ( χ2=-0.961, P>0.05), but there was a significant difference in cotton wool plaque between the two groups ( χ2=-3.364, P <0.05). Compared to the non-ILMD group, The proportion of retrograde fluorescein filling in retinal artery ( χ2=-2.846), segment filling ( χ2=-3.907), macular non-perfusion ( χ2=-6.656), capillary fluorescein leakage ( χ2=-4.367), optic disc strong fluorescence ( χ2=-3.525) and choroidal background weak fluorescence ( χ2=-2.276) increased, the difference was statistically significant ( P<0.05). Conclusions:In patients with NA-CRAO, compared with those without ILMD, those with ILMD have more severe retinal ischemia and worse BCVA before and after treatment. ILMD is one of the poor prognostic markers of NA-CRAO vision.

Objective:To analyze the clinical application effects of different anesthesia maintenance methods in daytime pediatric sur-gery in oral maxillofacial surgery.Methods:80 children underwent anethesia for daytime surgery in oral maxillofacial region were en-rolled and divided into 2 groups(n=40).The maintenance dose of propofol was 2-3(mg·kg)/h in venous group,that was 3％to 4％sevofluranenas in opharyngeal airway-assisted inhalation group.The heart rate,mean arterial pressure,oxygen saturation,postoperative wake-up time and incidence of adverse reactions after the local anesthesia(T1),intraoperative(T2)and end-of-surgery(T3)were re-corded and compared between the 2 groups.Results:No statistical difference in heart rate change between the 2 groups at different time points(P＞0.05).The average arterial pressure decrease and the decrease of oxygen saturationin in the inhalation group were lower than those of the venous group(P＜0.01).The incidence of adverse events in the inhalation group were lower than that of the intravenous group(P＜0.05).Conclusion:Nasopharyngeal airway-assisted inhalation anesthesia has definite sedative effect in daytime pediatric pa-tients in oral maxillofacial surgery with less influence on the circulatory system and fewer adverse events.

Objective To analyze the clinical characteristics of C-TI-RADS 3 thyroid nodules with a diameter greater than 2 cm and explore their correlation with gender,nodule ingredient,contralateral cancer presence,diffuse echo changes,TPOAB and TGAB.Methods A retrospective analysis was made on the clinical and pathological information of 94 patients with thyroid nodules who were admitted to our department from September 2022 to March 2023.All the patients underwent cytological and/or histopathological examinations.The proportions of TBS I category,benign tumors,low-risk tumors,and malignant tumors were calculated.The proportion of TBS type Ⅰ,benign tumors,low-risk tumors,and malignant tumors was quantified.Subsequently,a comparative analysis was conducted among the benign,low-risk,and malignant groups in terms of clinical characteristics including gender distribution,nodule composition,contralateral cancer occurrence,diffuse echo changes presence,as well as TPOAB and TGAB levels.Results Seven cases in TBS I category were excluded.Among the remaining 87 cases with confirmed pathology results for nodules,there were 72 benign cases(38 cytology cases and 34 histology cases),5 low-risk thyroid tumors(2 cytology cases and 3 histology cases),10 malignant cases(8 PTC cases,1 FTC case,and 1 MTC case).There was a significant difference in nodule ingredient(cystic/solid)between different pathological types(x2=10.369,P=0.006).However,no statistical significance was found in terms of gender,diffuse echo changes,contralateral cancer presence,TPOAB or TGAB(P＞0.05).Further analysis showed that the proportion of solid component was higher in low-risk tumors than in benign nodules(x2=9.571,P=0.002).No statistical significance was found between malignant nodules and low-risk nodules(x2=2.143,P=0.143),or between malignant nodules and benign nodules(x2=2.165,P=0.141).Conclusion Although TI-RADS 3 nodules are generally considered as potentially benign according to various versions of thyroid imaging reporting and data system,malignant nodules still account for a certain proportion.Attention should be paid to thyroid nodules with a typical ultrasonic signs,such as cystic nodules,thyroid follicular tumors and medullary thyroid carcinoma.Ultrasound guided fine needle aspiration cytopathology is necessary for evaluating benign and malignant nodules.It is necessary to pay attention to unsatisfactory or undiagnosable specimens to improve the accuracy of diagnosis.

Objective:To investigate effects and underlying mechanisms of glutathione persulfate (GSSH) on the level of testosterone in male obese mice.Methods:Totally 45 mice were divided into 3 groups on average. Low-fat diet (LFD)+normal saline (NS) group: 15 mice were fed with LFD for 10 weeks, followed by LFD together with daily intraperitoneal injection of saline for 45 d; high-fat diet (HFD)+NS group: 15 mice were fed with high-fat diet for 10 weeks, followed by HFD and daily intraperitoneal injection of NS for 45 d; HFD+GSSH group: 15 mice were fed with HFD for 10 weeks, followed by a HFD for 45 d and daily intraperitoneal injection of GSSH (200 mg/kg). After the treatment, all mice were killed with their necks-severed, testis and serum were taken out from the mice. Serum levels of testosterone and malondialdehyde (MDA), the mRNA levels of key enzymes for testosterone synthesis ( StAR, 3β- HSD, Cyp11a1 and Cyp17a1) were measured by RT-PCR. The testicular protein levels of StAR, 3β-HSD, NR5A1 and EHD3 were measured by Western blotting assay. Protein levels of NR5A1, SOD and Nrf2 were measured in mouse Leydig TM-3 cells that were treated with 50 μmol/L and 100 μmol/L GSSH, respectively, following with treatment with 100 μmol/L H 2O 2 . Results:1) After treatment, the body weight of mice in HFD+GSSH group did not change significantly, while the body weight of mice in HFD+NS group raised by 24.53% (from 32.46 g to 40.43 g) during the 45-day-intraperitoneal injection ( P=0.002). 2) Serum level of testosterone in HFD+NS group [(12.9±1.7) μg/L] was significantly lower than that in LFD+NS group [(18.3±1.2) μg/L, P=0.020]. However, serum level of testosterone in HFD+GSSH group was (25.42±2.1) μg/L, which was significantly higher than that in HFD+NS group ( P=0.030). The RT-PCR test results showed that compared with LFD+NS group, the expression levels of all key genes involved in testosterone synthesis ( StAR, 3β- HSD, Cyp11a1, Cyp17a1) showed a significant decrease in HFD+NS group ( P=0.003, P=0.007, P<0.001, P<0.001). The expression levels of these genes were restored in the mouse testes of HFD+GSSH group ( P=0.002, P<0.001, P<0.001, P=0.006). 3) Similarly, compared with LFD+NS group [(9.00±1.59) nmol/mL], the serum MDA level of HFD+NS group [(10.61±1.73) nmol/mL] raised significantly ( P=0.016), while GSSH reversed the raised HFD+NS high level of serum MDA in HFD+GSSH group [(9.23±0.94) nmol/mL, P=0.048]. 4) Both levels of NR5A1, EHD3, StAR, and 3β-HSD were reduced in HFD+NS group ( P=0.002, P=0.012, P=0.004, P=0.043), but their levels were significantly restored in HFD+GSSH group ( P<0.001, P=0.017, P=0.004, P<0.001). 5) The levels of NR5A1, Nrf2 and SOD were obviously down-regulated in TM3 cells treated with H 2O 2 ( P<0.001, P=0.002, P=0.004). Conclusion:GSSH can raise serum level of testosterone in HFD-fed mice by up-regulating expression of genes which are important for testicular testosterone biosynthesis.