Objective:To establish the reference intervals (RIs) of systemic immune inflammatory index (SII), platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR) and monocyte to lymphocyte ratio (MLR) in healthy pregnant women in Henan province, China.Methods:A retrospective analysis was conducted on the data of the healthy pregnant women without a history of adverse pregnancy events who participated in health check-ups from August 2016 to February 2019. A total of 4 016 healthy pregnant women were selected for establishing RIs. Data from healthy adult control group were derived from the healthy adult cohort in Henan established earlier by our team, and the Propensity Score Matching analysis was used and 3 595 healthy adult women and 3 595 healthy pregnant women to compare the indicators between the two groups. The RIs of the above indicators were established using the indirect method with a 95% confidence interval. The Tukey Rule was used to identify and remove outliers. The RIs were stratified and grouped based on the differences in each indicator during the pregnancy: SII: 3 929 cases, including 712 in the first trimester, 1 947 in the second trimester, and 1, 270 in the third trimester; PLR: 3 927 cases, no grouping; NLR: 3 925 cases, including 712 in the first trimester and 3 213 in the second and third trimesters; LMR: 3 925 cases, including 723 in the first trimester, 1 942 in the second trimester, and 1 260 in the third trimester; MLR: 3 904 cases, including 721 in the first trimester, 1 928 in the second trimester, and 1 255 in the third trimester. After the RIs were established, another 396 healthy pregnant women without a history of adverse pregnancy events who participated in health check-ups from February to April 2019 were selected for the validation of the RIs.Results:SII, NLR, LMR, MLR, and PLR differ significantly between healthy adult women and healthy pregnant women. There were significant differences in SII, LMR, and MLR among the three trimesters ( P<0.05). NLR in the first trimester was significantly lower than that in the second and third trimesters ( P<0.05), while there was no significant difference between the second and third trimester ( P=0.124). PLR only showed significant differences between the second and third trimester ( P<0.05), while no significant differences were found among the other groups. Based on the above results, the stratified RIs of each index in healthy pregnant population were established and verified. SII: first trimester (341-1 426)×10 9/L, second trimester (437-1 680)×10 9/L, third trimester (379-1 580)×10 9/L; PLR: 73-215; NLR: first trimester 1.78-5.60, second and third trimester 2.21-6.74; LMR: first trimester 2.20-6.61, second trimester 1.85-5.42, third trimester 1.63-4.82; MLR: first trimester 0.14-0.42, second trimester 0.17-0.49, third trimester 0.18-0.55. The rejection rate of 396 cases was less than 10%. Conclusions:The RIs of SII, NLR, LMR, MLR and PLR for healthy pregnant women in Hernan province of China were established and validated, and4 could be used in clinical practice.

Objective:To establish the reference intervals (RIs) of systemic immune inflammatory index (SII), platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR) and monocyte to lymphocyte ratio (MLR) in healthy pregnant women in Henan province, China.Methods:A retrospective analysis was conducted on the data of the healthy pregnant women without a history of adverse pregnancy events who participated in health check-ups from August 2016 to February 2019. A total of 4 016 healthy pregnant women were selected for establishing RIs. Data from healthy adult control group were derived from the healthy adult cohort in Henan established earlier by our team, and the Propensity Score Matching analysis was used and 3 595 healthy adult women and 3 595 healthy pregnant women to compare the indicators between the two groups. The RIs of the above indicators were established using the indirect method with a 95% confidence interval. The Tukey Rule was used to identify and remove outliers. The RIs were stratified and grouped based on the differences in each indicator during the pregnancy: SII: 3 929 cases, including 712 in the first trimester, 1 947 in the second trimester, and 1, 270 in the third trimester; PLR: 3 927 cases, no grouping; NLR: 3 925 cases, including 712 in the first trimester and 3 213 in the second and third trimesters; LMR: 3 925 cases, including 723 in the first trimester, 1 942 in the second trimester, and 1 260 in the third trimester; MLR: 3 904 cases, including 721 in the first trimester, 1 928 in the second trimester, and 1 255 in the third trimester. After the RIs were established, another 396 healthy pregnant women without a history of adverse pregnancy events who participated in health check-ups from February to April 2019 were selected for the validation of the RIs.Results:SII, NLR, LMR, MLR, and PLR differ significantly between healthy adult women and healthy pregnant women. There were significant differences in SII, LMR, and MLR among the three trimesters ( P<0.05). NLR in the first trimester was significantly lower than that in the second and third trimesters ( P<0.05), while there was no significant difference between the second and third trimester ( P=0.124). PLR only showed significant differences between the second and third trimester ( P<0.05), while no significant differences were found among the other groups. Based on the above results, the stratified RIs of each index in healthy pregnant population were established and verified. SII: first trimester (341-1 426)×10 9/L, second trimester (437-1 680)×10 9/L, third trimester (379-1 580)×10 9/L; PLR: 73-215; NLR: first trimester 1.78-5.60, second and third trimester 2.21-6.74; LMR: first trimester 2.20-6.61, second trimester 1.85-5.42, third trimester 1.63-4.82; MLR: first trimester 0.14-0.42, second trimester 0.17-0.49, third trimester 0.18-0.55. The rejection rate of 396 cases was less than 10%. Conclusions:The RIs of SII, NLR, LMR, MLR and PLR for healthy pregnant women in Hernan province of China were established and validated, and4 could be used in clinical practice.

In-stent restenosis(ISR)and in-stent thrombosis(IST)are two major complications of percutaneous coronary in-tervention(PCI)and are also the main limiting factors in the treatment of obstructive coronary artery disease.In-stent neoathero-sclerosis(ISNA)serves as the common pathological basis for ISR and IST.Current research on ISNA is mainly based on clinical imaging observations using optical coherence tomography(OCT),angioscopy,intra vascular ultrasonography(IVUS),and autop-sy reports.The specific mechanisms and treatment strategies for ISNA are not clear yet.A comprehensive understanding of the epidemiological characteristics,histological features,and pathogenic mechanisms of ISNA not only helps in the prevention and treatment of post-stent complications,but also lays the foundation for the development of the next generation of coronary stents.This review summarizes the research progress on the development history of ISNA,the pathological features of ISNA,and the pathogenic mechanisms of ISNA.

Objective To Investigate the expression of IL-21 and Blimp1 mRNA in Rheumatoid arthritis ( RA) patients and the influence on the expression of Blimp 1 in peripheral blood mononuclear cells (PBMCs) of RA patients after IL-21 stimulated; To further explore the mechanism of IL-21 and blimp1 in the pathogenesis of RA.Methods Case control study.The samples of peripheral venous blood from 50 RA patients of department of rheumatology of The First Affiliated Hospital of Zhengzhou University and 50 healthy people were collected respectively , then the plasma and PBMCs was separated.IL-21 in plasma was measured by ELISA; the correlation between patients clinical index DAS 28, anti-CCP antibody and IL-21 was analyzed.Blimp1 mRNA of patients′PBMCs was detected by qPCR; PMBCs were isolated from RA patient and then cultured in vitro.Blimp1 mRNA level was measured by qPCR and the ratio of CD 20 positive B cell and the ratio of CD138 positive cells in all groups were detected by flow cytometry after 72 h stimulated by IL-21 and CD40L.Results IL-21 content in RA patient blood plasma (130.51 ±11.35)ng/L was significantly higher than that in healthy control (25.46 ±6.05)ng/L, t=5.39,P<0.05.Besides, IL-21 level also had a close relativity with patients DAS28(r=0.658) and anti-CCP antibody (r=0.674, P=0.039 and 0.035).In addition, the expression level of Blimp1 mRNA in RA patient PMBCs (1.321 ± 0.11)was higher than that in healthy control group (1.000 ±0.000), Z=-2.48, P<0.05.While after IL-21 and/or CD40L stimulation, Blimp1 mRNA of IL-21 group and CD40L+IL-21 group(1.084 ±0.029, 1.157 ±0.028)were higher than those of control (1.000 ±0.000)(P=0.002,P=0.001), moreover the expressive level of Blimp1mRNA of CD40L+IL-21 group was higher than that of control group (t=4.862, P=0.02).Compared to negative control group , the ratio of CD20 positive B cells [2.42 ±0.35, 2.63 ± 0.33, 6.35(4.85,6.57),F=278.363,P<0.001] and the ratio of CD138 positive cells(0.474 ±0.110, 0.668 ±0.120, 0.955 ±0.170,F=49.01, P<0.001) in CD40L group, IL-21 group and CD40L+IL-21 group were much higher and the differences among CD 40L+IL-21 group with CD40L group and IL-21 group were statistically significant.Conclusion IL-21 could promote the level of Blimp 1 mRNA in peripheral blood mononuclear cells in RA patient; IL-21 and CD40L could co-promote B cell maturation though regulating Blimp1 mRNA expression and eventually participate in RA pathogenesis.

Objective:To study the relationship between atrophy of the thymus and disease severity in EAE.Methods:MOG35-55 peptide induced EAE in C57BL/6 mice and analyzed the relationship between the severity of EAE and thymic atrophy,Flow cytometry analysis was used to evaluate thymic CD4+CD8+DP cells,CD4+CD8-,CD4-CD8+SP cells in relation to the severity of the disease.Results:The number of thymocytes in mice with decreased tail tone was (20.25 ±3.49) ×106 ,hindlimb weakness(4.93 ± 0.85)×106,complete hindlimb paralysis(1.8 ±0.19) ×106,and forelimb and hindlimb paralysis(0.52 ±0.07) ×106,there were statistically significant differences between groups ( P<0.05 ).As the disease progresses, CD4+CD8+DP cells ratio decreased, CD4+CD8-,CD4-CD8+SP cell ratio increased,different disease groups was statistically significant difference (P<0.05).Conclusion: The atrophy of thymus was closely related to the severity of EAE.Migration of activated T cells in EAE may cause atrophy of thymus.