ObjectiveTo investigate the effect and mechanism of simvastatin pretreatment on kidney ischemia reperfusion injury （IRI） in mice. MethodsFifteen male C57BL/6 mice aged 6-8 weeks were divided into three groups： Sham operation group （Sham group）， kidney IRI group （IR group）， and simvastatin pretreatment+kidney IRI group （SIM group）. Hematoxylin-eosin （HE） staining of kidney tissue and detection of serum creatinine （SCr） and lactate dehydrogenase （LDH） were used to evaluate kidney injury. The levels of superoxide dismutase （SOD）， reduced glutathione （GSH）， malondialdehyde （MDA） and reactive oxygen species （ROS） were detected to evaluate oxidative stress. The contents of ferrous iron （Fe²⁺） and ferric iron （Fe³⁺） in kidney tissue were detected， and the morphological changes of mitochondria were observed by transmission electron microscope. The relative expression levels of Kruppel-like factor 2 （KLF2）， glutathione peroxidase 4 （GPX4）， solute carrier family 7 member 11 （SLC7A11）， and acyl-coa synthetase long chain family member 4 （ACSL4） protein in kidney tissue were detected. ResultsCompared with the IR group， the SIM group had significantly reduced renal tubular injury and decreased contents of Scr and LDH in serum （P < 0.001）. It also showed increased expression of SOD and GSH and decreased expression of MDA and ROS （P < 0.01）. Simvastatin pretreatment reduced the contents of Fe²⁺ and Fe³⁺ in the tissues （P < 0.01） and alleviated mitochondrial damage. It also promoted the expression of KLF2 （P < 0.01）， up-regulated the expression of ferroptosis-related protective proteins GPX4 and SLC7A11， and down-regulated the expression of ferroptosis-related damage protein ACSL4 （P < 0.05）. ConclusionSimvastatin pretreatment may inhibit kidney ferroptosis by promoting the expression of KLF2 to alleviate kidney IRI.

Objective : To investigate the expression of programmed death 1 (PD1) on CXCR5 - CD4 + T cells from the patients with systemic lupus erythematosus ( SLE) and to analyze the clinical relevance to disease severity. Methods : The expression of PD1 on CXCR5 - CD4 + T cells was examined from 47 SLE patients and 35 healthy controls (HC) by the technique of flow cytometry. The expression of PD1 including percentage of PD1 + CXCR5 -CD4 + T cells and mean fluorescence intensity (MFI) on CXCR5 - CD4 + T cells was compared between SLE patients and HC. And its correlation with clinical indicators , laboratory inspection and the percentage of plasmablasts was analyzed. Moreover, the predictive value of the expression of PD1 on CXCR5 - CD4 + T cell was explored. Results: ① The percentage of PD1 + CXCR5 - CD4 + T cells from SLE patients significantly elevated compared with HC (P= 0. 008 3 , U = 540. 5) , and the MFI of PD1 on CXCR5 - CD4 + T cells from SLE patients significantly elevated compared with HC (P < 0. 000 1 , U = 187. 0) . ② The percentage of PD1 + CXCR5 - CD4 + T cells was associated with C3 ( rs = - 0. 335 2 , P = 0. 022 8) , anti - SSA (P = 0. 016 6 , t = 2. 5) , anti - histone (P = 0. 030 3 , t =2. 3) , treatment (P = 0. 020 2 , t = 3. 4) , plasmablasts ( rs = 0. 387 1 , P = 0. 0072) in SLE patients. The MFI of PD1 on CXCR5 - CD4 + T cells was associated with SLEDAI ( rs = 0. 403 1 , P = 0. 005 0) , ESR ( rs = 0. 356 1 , P= 0. 017 7) , CRP ( rs = 0. 337 4 , P = 0. 028 9) , RBC ( rs = - 0. 297 0 , P = 0. 042 6) , HGB ( rs = - 0. 302 9 , P= 0. 038 5) , HCT ( rs = - 0. 381 6 , P = 0. 008 1) , L ( rs = - 0. 393 7 , P = 0. 006 2) , L% ( rs = - 0. 391 2 , P= 0. 006 5) , N% ( rs = 0. 315 0 , P = 0. 031 1) , NLR ( rs = 0. 373 0 , P = 0. 009 8) , LMR ( rs = - 0. 431 5 , P =0. 002 5) , dNLR ( rs = 0. 315 0 , P = 0. 031 1) , anti⁃Ro52 (P = 0. 029 5 , t = 63. 5) , treatment (P = 0. 035 5 , W= 21) , plasmablasts ( rs = 0. 315 8 , P = 0. 030 6) . ③ Logistic regression analysis showed that the MFI of PD1 on CXCR5 - CD4 + T cells was a risk factor for SLE. ④ ROC analysis showed the AUC of the MFI of PD1 on CXCR5 -CD4 + T cells was 0. 886. A further established model based on combination of the MFI of PD1 on CXCR5 - CD4 + T cells and HGB showed predictive value in distinguishing SLE from HC with AUC of 0. 979. And predictive value was positively associated with SLEDAI ( rs = 0. 313 6 , P = 0. 030 3) . Conclusion Increased percentage of PD1 + CXCR5 - CD4 + T cells and increased MFI of PD1 on CXCR5 - CD4 + T cells in SLE are associated with disease severity and activity , and a model based on combination of the MFI of PD1 on CXCR5 - CD4 + T cells and HGB shows prominent value for predicting SLE.

Objective : To investigate the expression of programmed death 1 (PD1) on CXCR5 －CD4 + T cells from the patients with rheumatoid arthritis (RA) and to analyze the clinical relevance to disease severity． Methods : The expression of PD1 on CXCR5 －CD4 + T cells were examined from 82 RA patients and 46 healthy controls (HC) by the technique of flow cytometry．The expression of PD1 including mean fluorescence intensity (MFI) on CXCR5 - CD4 + T cells and percentage of PD1 + CXCR5 －CD4 + T cells were compared between RA patients and HC．Moreo- ver，its correlation with laboratory inspection was analyzed. Results : ① The percentage of PD1 + CXCR5 －CD4 + T cells and the MFI of PD1 on CXCR5 －CD4 + T cells from RA patients were significantly elevated compared with HC (P＜0. 000 1，U = 1 082 ; P ＜0. 000 1 ，U = 917. 5) . ② The percentage of PD1 + CXCR5 － CD4 + T cells in RA patients were positively associated with rheumatoid factors (RF) (rs = 0. 267 9，P = 0. 022 9) ，increased RF (rs = 0. 419，P = 0. 001 1) ，increased anti-cyclic citrullinated peptide (anti-CCP) (rs = 0. 260 7，P = 0. 040 7) ，the percentage of plasmablasts (rs = 0. 302 4，P = 0. 029 3) ，DAS28-ESR (rs = 0. 244 7，P = 0. 042 7) . ③ The MFI of PD1 on CXCR5 －CD4 + T cells in RA patients were negatively with lymphocytes number (rs = －0. 338 7，P = 0. 002 0 ) ，lymphocytes percentage ( rs = －0. 347 9 ，P = 0. 001 4 ) ，lymphocyte-to-monocyte ratio ( rs = - 0. 263 7，P = 0. 017 4) ．The MFI of PD1 on CXCR5 － CD4 + T cells in RA patients were positively associated with neutrophil percentage ( rs = 0. 304 7 ，P = 0. 005 4 ) ，neutrophilto-lymphocyte ratio ( rs = 0. 341 1 ，P = 0. 001 8) ，platelet-to-lymphocyte ratio (rs = 0. 232 1，P = 0. 037 1) ，systemic immune inflammation index (rs = 0. 288 0，P = 0. 009 1) ，derived Neutrophil to lymphocyte ratio ( rs = 0. 320 3，P = 0. 003 6) ，erythrocyte sedi- mentation rate (rs = 0. 259 5，P = 0. 019 3) ，patient visual analogue scale (rs = 0. 241 6，P = 0. 043 9) ．The MFI of PD1 on CXCR5 － CD4 + T cells from high active RA patients was significantly elevated compared with non-high active group (P = 0. 040 7，U = 406. 0) ． Conclusion The abnormal expression of PD1 on CXCR5 －CD4 + T cells are observed in patients with RA．Increased expression of PD1 on CXCR5 － CD4 + T cells are associated with the production of antibody，the percentage of plasmablasts，inflammation，and also disease activity.

Objective:To observe the clinical efficacy of Governor Vessel-unblocking and brain-refreshing scalp acupuncture for cerebral palsy (CP) complicated with intellectual disabilities. Methods:A total of 300 CP cases aged between 1 and 5 years were randomly allocated into a treatment group (n=150) and a control group (n=150). Patients in the treatment group were treated with Governor Vessel-unblocking and brain- refreshing scalp acupuncture combined with rehabilitation training, whereas patients in the control group received rehabilitation training alone. The Beijing Gesell developmental (Gesell) scale and gross motor function measure (GMFM) scale were used to assess the motor and intellectual development before and 3 months after the treatment. In addition, the head CT/MRI examination was applied to assess the brain nerve repair before and after the treatment. Results:After the treatment, the total effective rate in the treatment group was 78.0%, versus 42.7% in the control group, showing a statistical significance (P<0.05). As for scores of five subscales in the Gesell scale, there were significant intra-group differences in the treatment group (allP<0.05); and the scores in the treatment group were significantly better than those in the control group (allP<0.05). As for scores of five dimensions in GMFM scale, there were significant intra-group differences in the treatment group (allP<0.05); and the scores in the treatment group were significantly better than those in the control group (allP<0.05). According to the head CT/MRI findings, the total effective rate was 73.3% in the treatment group, versus 62.0% in the control group, showing a statistical significance (P<0.05). Conclusion:When used in combination with rehabilitative training, Governor Vessel-unblocking and brain-refreshing scalp acupuncture can significantly improve the clinical efficacy for cerebral palsy complicated with intellectual disabilities. It can also improve the patients' motor function, intelligence and language ability.

Objective To explore the clinical features oflymphoplasmacytic diseases with MyD88 L265P mutation.Methods To analyze the distribution of MYD88 L265P mutation in patients with lymphoplasmacytic diseases by using of ARMS PCR-CE.Results There were 25(30.9％) MyD88 L265P mutated patients in 81 patients.The mutation was frequently observed in 14 patients with WM (77.8％,14/ 18),2 patients with lymphoplasmacytic lymphoma (66.7％,2/3),1 acute lymphocytic leukemia patient (50.0％,1/2),3 multiple myeloma patients (30.0％,3/10),1 patient with monoclonal gammopathy of undetermined significance (25％,1/4),3 patients with chronic lymphocytic leukemia (13.0％,3/23) and 1 lymphoma patient (4.8％,1/21).20 (80％,20/25) patients were identified with IgM subtype.Compared with wild-type group of 56 cases,mutated patients were older (median age:67 years vs 55 years,P＜ 0.001),with lower WBC count (median count:5.23 × 109/L vs 10.80× 109/L,P=0.001),lower HGB level (median count:85 g/L vs 119 g/L,P＜0.001).Conclusion MyD88 L265P mutation was mainly observed in patients with IgM subtype lymphoplasmacytic diseases,and Waldenstrom's macroglobulinemia was the most common disease.Compared with the wild-type group,patients with MyD88 L265P mutation were older and had lower WBC count,lower level of HGB.However,further studies were needed to test the prognostic value of MyD88 L265P mutation.