Anxiety and fear,as common symptoms of psychiatric disorders,remain inadequately understood in terms of their pathogenesis.Changes in immune inflammation are considered to play a significant role in both the pathological and physiological processes associated with these mental illnesses.In recent years,it has been demonstrated that stress can regulate immune inflammation through multiple pathways,including the regulation of the autonomic nervous system,the hypothalamic-pituitary-adrenal axis,indoleamine 2,3-dioxygenase and its metabolite kynurenine,and the gut-brain axis.These pathways are implicated in the onset and treatment of anxiety and fear-related mental illnesses.This article focuses on the relationships between anxiety and fear-related mental illnesses and immune inflammatory responses.

Glucagonoma is a rare neuroendocrine tumor derived from the pancreatic α cells, and alopecia is an uncommon clinical manifestation. We report a case of glucagonoma presenting with marked alopecia, aiming to raise clinicians′ awareness of this rare presentation.

Glucagonoma is a rare neuroendocrine tumor derived from the pancreatic α cells, and alopecia is an uncommon clinical manifestation. We report a case of glucagonoma presenting with marked alopecia, aiming to raise clinicians′ awareness of this rare presentation.

AIM:To investigate the impact of homocysteine(Hcy)on the inflammatory response mediated by BV2 mouse microglia,and to explore the mechanism of Ras-related protein 1a(Rap1a)in the Hcy-induced inflammatory response in BV2 cells.METHODS:Mouse microglial cell line BV2 was cultured in vitro,and Hcy intervention was used to establish a hyperhomocysteinemia cellular model.The cells were divided into 4 groups:blank control group,and 50 μmol/L,100 μmol/L and 150 μmol/L Hcy groups.The mRNA expression levels of M1 polarization markers,inflammatory factors IL-6,IL-1β and TNF-α,and Rap1a in BV2 cells were detected by RT-qPCR.Additionally,the levels of inflamma-tory factors IL-6,IL-1β and TNF-α in BV2 cells were measured using an ELISA kit.The protein expression level of Rap1a was detected by Western blot assay.To verify the function of Rap1a,viral transfection was employed for both over-expression and knockdown experiments.RESULTS:Under the intervention of Hcy concentration above 100 μmol/L,BV2 cells exhibited inflammatory polarization,as indicated by the increased mRNA expression of M1 polarization markers CD80 and CD86(P＜0.05).The mRNA and protein expression levels of inflammatory factors IL-6,IL-1β and TNF-α were significantly up-regulated(P＜0.05).Additionally,the mRNA and protein expression levels of Rap1a also showed a significant increase(P＜0.05).Moreover,Rap1a mRNA level was positively correlated with CD80 mRNA,IL-1β content and TNF-α content(P＜0.05).The multiplicities of infection of the viruses with Rap1a overexpression and Rap1a knock-down were both 80,and the effective transfection was observed through fluorescence microscopy.Overexpression of Rap1a exacerbated the inflammatory polarization of BV2 cells induced by Hcy(P＜0.05),while knockdown of Rap1a attenuated this polarization(P＜0.05).CONCLUSION:Hcy can promote M1 polarization of BV2 mouse microglia,leading to in-flammatory response,which indicates that Rap1a could potentially serves as a critical regulatory factor in the Hcy-induced inflammatory response of BV2 cells.

Objective:To investigate the construction and application of telemedicine system in Tibet Autonomous Region.Methods:From June to July 2020, medical institutions at all levels in Tibet Autonomous Region were visited. Relevant information was collected through discussion, questionnaires and field visits, and the data of effective questionnaires were statistically analyzed.Results:A total of 125 medical institutions were visited, covering 7 regions of Tibet Autonomous Region, of which 74 medical institutions were able to realize audio-video two-way communication with the telemedicine platform of the PLA General Hospital. Seventy-three valid questionnaires were collected, and 64(88%)hospitals had software or hardware audio and video terminals. Twenty-five hospitals had never carried out remote consultation, accounting for 34%. The annual remote consultation amount of 35 hospitals was less than 10 cases, and that of 11 hospitals was 11-100 cases. Only 2 hospitals had carried out remote ECG and remote ultrasound diagnosis, with an annual consultation volume of more than 100 cases.Conclusions:The hospitals at or above the county level in Tibet Autonomous Region have established telemedicine system, but there are few remote services, the system idle rate is high, and the distance education resources are not matched.

Objective: To establish depression model in female C57BL / 6 mice using chronic unpredictable stress + sleep deprivation + castration and observe the change of behavior and neuroendocrine of this model to provide basis for screening anti-depressant drugs. Methods: To simulate the etiopathological mechanism of perimenopausal depression or depression symptoms, C57BL/6 female adult mice were exposed to chronic unpredictable stress + sleep deprivation + castration to establish perimenopausal depression model. The mice were randomly divided into perimenopausal group, model group, sham operation group, which of behavioral and neuroendocrine differences were observed. Results: (1)Compared with the sham operation group((21.48±0.79)g, (0.02±0.06), (93.02±6.17)%) and the perimenopausal group((22.02±0.15)g, (0.06±0.09)score, (90.30±11.68)%), the body weight ((20.16±1.03)g), coat state score (0.39±0.04) and sucrose preference((58.11±11.97)%) in the model group had significant differences(all P<0.05). (2)Compared with the perimenopausal group and sham operation group, the horizontal movement, the vertical movement score and the percentage of central cells in the open field experiment, the percentage of immobility state and immobility state in forced swimming and tail suspension experiment of model mice were all significantly different (P<0.05). (3)Compared with the perimenopausal group and the sham-operation group, the latent period of eating, the total time of exploration and single exploration in NSFT had significant difference(P<0.05). (4)Compared with the sham operation group((46.16±7.72)pmol/ml, (320.77±23.19)ng/ml) and the perimenopausal group ((9.75±1.77)pmol/ml, (386.42±37.58)ng/ml), serum estradiol ((9.99±0.37)pmol/ml) were elevated and corticosterone ((426.31±105.01)ng/ml) were increased in the model group, which had significant differences (P<0.05). Conclusion C57BL/6 female mice show depression-like behavior after ovariectomy, 4 weeks of chronic unpredictable stress and sleep deprivation intervention.

Objective To observe the analgesic effect of Qilong Toutong Granule and explore its underlying mechanisms of action. Methods Kunming mice were randomly divided into blank group, Zhengtian pill group, ibuprofen group, and high-, medium- and low-dose of Qilong Toutong Granule groups. After completing the prophylactic treatment for 3 days, hot-plate test and acetic acid-induced writhing test were used to observe the pain reaction of mice. SD rats were randomly divided into blank group, Zhengtian pill group, model group, rizatriptam group, and high-, medium- and low-dose of Qilong Toutong Granule groups. After gavaged for continuous 7 days, rats were intraperitoneally injected nitroglycerin (10 mg/kg), and 4 hours later, blood samples were collected from postcava for measuring the levels of plasma CGRP and β-EP by radioimmunoassay. Subsequently, rats were perfused transcardially and the brain tissues containing the trigeminal nucleus caudalis (Sp5C) were achieved for detecting the expression of Fos protein by immunohistochemical method. Results Qilong Toutong Granule significantly raised the pain threshold, reduced the number of writhing response of mice, remarkably down-regulated the levels of plasma CGRP, up-regulated the levels of plasmaβ-EP and inhibited the expression of Fos protein in Sp5C of rats compared with the model group. Conclusion Qilong Toutong Granule has good analgesic effect and its mechanisms on relieving migraine may be through regulating the levels of neurotransmitters or neuropeptides, and inhibiting the activation of Fos pathway.

Objective To investigate the effect of diabetes on the expression of the glucose transporter (GLUT-1) in blood brain barrier (BBB) endothelial cell at different time points. Methods Forty male SD rats were randomly divided into normal control and diabetic group. Diabetic model of SD rats was established by intravenous streptozotocin(50 mg/kg) injection. Ten rats in each group were sacrificed on the 2nd month and 10th month respectively. The rat' s prefrontal cortex was removed to observe the expression of GLUT-1 in BBB EC with immunohistochemical(IHC) staining. Results By IHC method, the number of GLUT-1 positive microvessels was significantly decreased in diabetic group in the 2nd month (4. 3 ± 0. 9) compared with that of control group (6.4 ± 1.7, t = 7. 586, P < 0. 01 ) ; the number of GLUT-1 positive microvessels was significantly increased in the diabetic group in the 10th month (8.4 ± 1.4) compared with that of control group (5. 8 ± 1.7, t = 15.922,P < 0. 01 ). Conclusions Short-term diabetes GLUT-1 expression in BBB EC is downregulated in early stage, while it is upregulated in advanced stage.

Objective To investigate the characteristics of the patients with post-stroke depression (PSD).Methods208 cases of patients with stroke were analyzed retrospectively. Results and ConclusionThe PSD occurred more frequently within the first month but less on the first week (P<0.001). The incidence of PSD was higher in female than in male (P<0.001).Frontal, temporal, parietal cortices lesion significantly increased the incidence of the PSD compared with in other area(P<0.01). The more severely the neural function was damaged, the higher the incidence of the PSD was. The muscle strength of patients with PSD recovered poorer than those without PSD. There was significant difference in the incidence of the PSD between the middle age group and aged group (P<0.01).

Objective:To explore the effect of Naoshuning on the protein expression of Matrix metalloproteinases(MMPs) in experimental injuried brain tissue of rats. Methods:Immunohistochemistry was used to determine the changes of protein expression of MMPs. Brain tissue water content,permeability and ultramicrostructure of blood-brain barrier(BBB) were also observed. Results:Compared with the sham group,the brain tissue water and EB content of injured side and the level of MMP-2 and MMP-9 protein expression in brain tissue around contusion in model group increased obviously(all P