Objective To explore the expression profile of adenosine A1 receptor in the paraventricular thalamic nucleus(PVT)in wakefulness/sleep state and its role in regulating sleep.Methods Male C57BL/6J mice(6～12 weeks old,weighing 22～28 g)were randomly divided into ZT0,ZT6,ZT10,ZT12,and sleep deprivation and recover0y sleep groups(n=16 or n=4).RT-qPCR and fluorescence in situ hybridization were used to observe the changes of adenosine A1 receptor in PVT.Whole-cell patch-clamp recording was conducted to determine the effects of adenosine on the membrane potential and discharge frequency of PVT neurons.The experimental animals were divided into adenosine A1 receptor interference group(n=8)and interference control group(n=7).After RNA interference,electroencephalography(EEG)and electromyography(EMG)were applied simultaneously to observe the changes in wake and sleep time between the 2 groups during sleep deprivation for 6 h and sleep recovery for 4 h.Results RT-qPCR and fluorescence in situ hybridization confirmed that the expression of adenosine A1 receptor in PVT was affected by wakefulness/sleep state,with the level in the ZT0 group(active stage)significantly higher than that in the ZT12 group(non-active stage,P<0.05).Whole-cell patch clamp recording indicated that adenosine exerted inhibitory effects on PVT neurons through 2 distinct response types(P<0.05),and the inhibition was in a diminishing trend with a decrease in the expression level of adenosine A1 receptor.After sleep deprivation,the expression level of adenosine A1 receptor showed significant intergroup differences:the level was significantly higher in the sleep deprivation group than the recovery sleep group(P<0.05),while that of the recovery sleep group was higher than that of the ZT6 group and that of the ZT10 group(P<0.05).After knocking down adenosine A1 receptor(shRNA-A1R)in the PVT,the wakefulness timing of the shRNA-A1R group was significantly increased,while the sleep timing was significantly decreased within 1 h after sleep recovery when compared with the interference control group(P<0.05).Conclusion The expression of adenosine A1 receptor in the PVT is dynamically regulated by sleep pressure,which was increasing as sleep pressure rises.

Objective To investigate the relationship between the incipient serum C-reactive protein (CRP) and clinicopathologic features in anti-neutrophil cytoplasmic antibody associated vasculitis (AAV).Methods Data of 138 consecutive AAV patients were collected.According to their serum CRP levels,patients were divided into group 1 with normal CRP,group 2 with slightly increased CRP and group 3 with severely increased CRP.Clinical features of AAV and histopathologic features of the kidney injury were compared among groups.Results CRP levels increased in 77.53％ AAV patients on admission.Patients in the group of severely increased CRP had the highest levels of BVAS,serum C3,serum ANCA titer,leukocyte counts and the lowest levels of hemoglobin and albumin among the 3 groups (all P ＜ 0.05).The mortality during the stage of therapy was highest in patients with severely increased CRP (P ＜ 0.05).The focal kidney damage was more obvious in patients with severely increased CRP.There was no significant difference in renal prognosis among patients with different CRP levels.Conclusion The levels of incipient serum C-reactive protein of AAV vary in different patients and are positively correlated with patients' inflammation status as well as the disease activity,but are not correlated with the severity of kidney injury.

Objective To investigate the categories of fetal anomalies detected by ultrasound scan in the third trimester.Methods From January 1,2012 to December 31,2013,492 singleton fetuses were found to have structural abnormalities on the first,second or third trimester ultrasound scan in the Peking University First Hospital,only 50 (10.2％) fetuses were detected on the third trimester (≥ 28 weeks of gestation) with no abnormalities detected on the first and second trimester scan,were enrolled.The categories of the fetal structural abnormalities were analyzed.Results The age of the mothers of the 50 fetuses with structural abnormalities was (35.7± 5.2) years (26-43 years) with an average gestation of (32.4±2.8) weeks (28.6-36.8 weeks).These abnormalities were seen in the central nervous system (42％,21/50),digestive system (28％,14/50),urinary system (16％,8/50),cardiovascular system (8％,4/50),respiratory system (4％,2/50) and facial structures (2％,1/50).Intrauterine death occurred in one case and 49 mothers had a live birth.After birth,14 neonates were normal,five needed further treatment,three cases were complicated by other abnormalities,23 had no dysfunction but need follow-up and four were lost to follow-up.Six of the 20 (30％) fetuses with central nervous system abnormalities and 2/4 fetuses with cardiovascular system abnormalities had an adverse prognosis,while 1/12 and 2/7 fetuses with digestive and urinary system abnormalities had an adverse prognosis.Conclusions The central nervous system and cardiovascular system should be examined in priority during the third trimester ultrasound scan.