AIM:To investigate whether direct stimulation of the Du Meridian improves autism-like behaviors in mice by modulating synaptic pruning.METHODS:Pregnant mice received intraperitoneal injections of valproic acid(VPA)or saline on gestational day 12.5.Offspring from saline-treated mice were assigned to the saline group.Offspring from VPA-treated mice were randomly divided into the model(VPA)group and the VPA-model-DuMaiTuiFa(VPA-DMTF)group.Each group included five mice.The VPA-DMTF group received direct stimulation along the Du Mai at 80 times per minute,10 minutes per session,twice daily for 21 days.After treatment,behavioral tests were conducted,in-cluding the three-chamber test for social interaction and the open field test for anxiety-like behavior.Hippocampal tissue was collected for analysis.Golgi staining was used to assess dendritic spine density.Immunofluorescence staining for post-synaptic denisty protein(PSD95)and synapsin 1(SYN1)was performed to evaluate synaptic protein expression.Staining for ionized calcium-binding adapter molecule 1(IBA1)and CD68 was used to assess microglial phagocytosis.Western blot analysis was conducted to evaluate hippocampal expression levels of PSD95,SYN1,IBA1,complement component 1,q subcomponent(C1q),complement component 3(C3),and complement receptor 3(CR3).RESULTS:Compared with the saline group,VPA mice showed reduced social behavior and increased anxiety(P<0.05).The expression levels of IBA1,PSD95,and SYN1 were significantly increased(P<0.05),whereas C1q,C3,and CR3 were significantly de-creased(P<0.05).Microglial phagocytosis declined.Immunofluorescence analysis showed increased levels of synaptic proteins(PSD95 and SYN1)in the VPA group(P<0.05).Golgi staining revealed a higher dendritic spine density and an increased proportion of immature dendritic spines(P<0.05).Compared with the VPA group,VPA-DMTF mice showed improved behavior,reduced IBA1,PSD95,and SYN1 levels(P<0.05),and increased expression of C1q,C3,and CR3(P<0.05).Microglial phagocytosis was enhanced,and dendritic spine number was reduced.CONCLUSION:Direct stimulation of the Du Mai alleviates autism-like behaviors in mice.This effect may be mediated by upregulation of comple-ment proteins C1q and C3,which enhance microglia-mediated synaptic pruning and reduce synaptic overabundance.

AIM:To investigate whether direct stimulation of the Du Meridian improves autism-like behaviors in mice by modulating synaptic pruning.METHODS:Pregnant mice received intraperitoneal injections of valproic acid(VPA)or saline on gestational day 12.5.Offspring from saline-treated mice were assigned to the saline group.Offspring from VPA-treated mice were randomly divided into the model(VPA)group and the VPA-model-DuMaiTuiFa(VPA-DMTF)group.Each group included five mice.The VPA-DMTF group received direct stimulation along the Du Mai at 80 times per minute,10 minutes per session,twice daily for 21 days.After treatment,behavioral tests were conducted,in-cluding the three-chamber test for social interaction and the open field test for anxiety-like behavior.Hippocampal tissue was collected for analysis.Golgi staining was used to assess dendritic spine density.Immunofluorescence staining for post-synaptic denisty protein(PSD95)and synapsin 1(SYN1)was performed to evaluate synaptic protein expression.Staining for ionized calcium-binding adapter molecule 1(IBA1)and CD68 was used to assess microglial phagocytosis.Western blot analysis was conducted to evaluate hippocampal expression levels of PSD95,SYN1,IBA1,complement component 1,q subcomponent(C1q),complement component 3(C3),and complement receptor 3(CR3).RESULTS:Compared with the saline group,VPA mice showed reduced social behavior and increased anxiety(P<0.05).The expression levels of IBA1,PSD95,and SYN1 were significantly increased(P<0.05),whereas C1q,C3,and CR3 were significantly de-creased(P<0.05).Microglial phagocytosis declined.Immunofluorescence analysis showed increased levels of synaptic proteins(PSD95 and SYN1)in the VPA group(P<0.05).Golgi staining revealed a higher dendritic spine density and an increased proportion of immature dendritic spines(P<0.05).Compared with the VPA group,VPA-DMTF mice showed improved behavior,reduced IBA1,PSD95,and SYN1 levels(P<0.05),and increased expression of C1q,C3,and CR3(P<0.05).Microglial phagocytosis was enhanced,and dendritic spine number was reduced.CONCLUSION:Direct stimulation of the Du Mai alleviates autism-like behaviors in mice.This effect may be mediated by upregulation of comple-ment proteins C1q and C3,which enhance microglia-mediated synaptic pruning and reduce synaptic overabundance.

Objective:To investigate the correlation between intraplaque hemorrhage (IPH) and new-onset embolic cerebral infarction after basilar artery angioplasty or stenting.Methods:Consecutive patients with severe basilar atherosclerotic stenosis underwent basilar artery angioplasty or stenting in the Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine from January 2015 to February 2022 were retrospectively enrolled. High resolution magnetic resonance vessel wall imaging (HRMR-VWI) and diffusion-weighted imaging (DWI) were performed within one week before procedure, and brain DWI or CT examination was performed within 72 h after procedure to determine the patients with new-onset embolic cerebral infarction.Results:A total of 32 patients were enrolled in the analyze. IPH existed in 10 patients with basilar artery culprit plaque, and 5 had new-onset embolic cerebral infarction after procedure. The incidence of embolic cerebral infarction in the IPH group was significantly higher than that in the non-IPH group (50% vs. 0%; P=0.001). The proportion of patients with IPH in the embolic cerebral infarction group was significantly higher than that in the non-embolic cerebral infarction group (100% vs. 18.5%; P=0.001). Conclusion:IPH may be associated with new-onset embolic cerebral infarction after basilar artery angioplasty or stenting.

OBJECTIVE: To explore the genetic basis of a Chinese patient featuring global developmental delay. METHODS: Peripheral venous blood samples from the proband and his parents and sister were taken for the extraction of DNA. Target capture and next generation sequencing was carried out to detect genetic variants associated with the disease. Suspected variant was validated by Sanger sequencing. RESULTS: Genetic testing discovered that the proband has carried hemizygous c.150G>T and c.150+1G>T variants of the KDM5C gene which are inherited from his mother. His younger sister also carried the variants. The c.150+1G>A variant was unreported previously, which has altered a splice site and was predicted to be pathogenic by bioinformatics analysis. CONCLUSION The hemizygous c.150+1G>T variant of the KDM5C gene, known to underlie X-linked Claes-Jensen type syndromic mental retardation, probably accounts for the disorder in the patient. Identification of this variant has enriched the variant spectrum of the KDM5C gene.

Objective: To investigate the changes in coagulation of sepsis rats with protein-malnutrition or energy-malnutrition. Methods: 108 male Sprague-Dawley (SD) rats were divided into three groups by random number table, with 36 rats in each group. The rats in normal feeding group were given a free diet (27 g/d, containing 18% protein fodder), and the rats in protein-malnutrition group were given a low protein diet (27 g/d, containing 5% protein fodder). The rats in energy-malnutrition group were given a low energy diet (9 g/d, containing 18% protein fodder). After 4 weeks of continuous feeding, 8 rats from each group were sacrificed for malnutrition evaluation. The weights of body, thymus and spleen were measured. The percentages of spleen T lymphocyte subsets and M1 macrophage were determined by flow cytometry. Plasma interleukins (IL-6 and IL-10) levels were determined by enzyme-linked immunosorbent assay (ELISA). The remaining 28 rats in each group were collected for cecal ligation and puncture (CLP) to reproduce the sepsis model, 20 rats of which were used for Kaplan-Meier survival analysis, and the other 8 rats were sacrificed at 8 hours after CLP. The levels of plasma IL-6 and IL-10 were determined by ELISA, and the percentage of spleen M1 macrophages was determined by flow cytometry. The mRNA expressions of tissue factor (TF) and plasminogen activation inhibitor-1 (PAI-1) in liver tissue were determined by reverse transcription-polymerase chain reaction (RT-PCR). Pearson correlation method was used to analyze the correlation between the mRNA expressions of TF and PAI-1 and IL-6 in rats after CLP. Results: ① After 4 weeks of feeding, the rats in the normal feeding group and protein-malnutrition group gained weight, while those in the energy-malnutrition group lost 25% of their initial body weight. The weights of body, thymus and spleen in the protein-malnutrition group and the energy-malnutrition group were significantly lower than those in the normal feeding group. Compared with the normal feeding group and the protein-malnutrition group, the percentages of spleen CD3⁺T lymphocytes, CD4⁺T lymphocytes, M1 macrophages and plasma IL-6 levels were significantly increased in the energy-malnutrition group [CD3⁺T lymphocytes percentage: (52.1±3.7)% vs. (46.9±3.9)%, (44.5±2.2)%; CD4⁺T lymphocyte percentages: (35.0±3.6)% vs. (26.3±2.2)%, (25.1±2.3)%; M1 macrophage percentages: (8.7±2.0)% vs. (3.2±1.3)%, (4.2±1.1)%; IL-6 (ng/L): 129.4±16.2 vs. 48.1±10.0, 53.0±8.3, all P < 0.05]. ② Kaplan-Meier survival analysis at 7 days after CLP showed: all rats in the energy-malnutrition group died, and the 7-day cumulative survival rate was significantly lower than that in the normal feeding group and the protein-malnutrition group [0% (0/20) vs. 35% (7/20), 55% (11/20), both P < 0.05]. The mortality of the normal feeding group was 65%, which was consistent with moderate CLP mortality, indicating that the CLP model was successfully prepared. After CLP, the plasma IL-6 level in the protein-malnutrition group was significantly lower than that in the normal feeding group [IL-6 (ng/L): 154.6±34.7 vs. 233.4±41.2, P < 0.05]. Compared with the normal feeding group, the mRNA expressions of TF and PAI-1 in liver and plasma IL-6 levels in the energy-malnutrition group were significantly increased [TF mRNA (2^-ΔΔCT): 4.5±2.2 vs. 1.1±0.7, PAI-1 mRNA (2^-ΔΔCT): 3.3±1.8 vs. 1.3±0.9, IL-6 (ng/L): 382.7±118.2 vs. 233.4±41.2, all P < 0.05], the percentage of M1 macrophages in spleen was significantly lowered [(8.9±2.4)% vs. (15.2±5.4)%, P < 0.05]. There was no significant difference in plasma IL-10 level among all the groups. Correlation analysis showed that the mRNA expressions of TF and PAI-1 in the liver of rats after CLP were positively correlated with plasma IL-6 level (r₁ = 0.644, r₂ = 0.574, both P < 0.01). Conclusions Long-term sustained stress (starvation) leads to sustained chronic inflammatory state, and stimulated the release of related inflammatory factors and activation of the coagulation system after infection. And the inflammatory factors in sepsis rats without sustained stress protein malnutrition were significantly reduced.

Objective To explore the difference in efficacy between multiparametric MRI (Mp-MRI) based on prostate imaging reporting and data system version 2 (PI-RADS v2) and abbreviated biparametric MRI (Bp-MRI) in detecting prostate cancer (PCa) and clinically significant prostate cancer (csPCa), and to evaluate the consistency of image interpretation between different readers. Methods The imaging, pathological and clinical data of patients with prostatic Mp-MRI in our hospital from February 2015 to June 2018 were retrospectively analyzed. At the beginning, 250 patients were randomly selected. Two radiologists visually evaluated the images of those patients using two 5-point scoring schemes based on Mp-MRI and Bp-MRI. The remaining cases were independently proceeded by one of the radiologists using two schemes respectively. Weighted Kappa test was used to assess the consistency of the results interpreted by the two radiologists. The receiver operating characteristic (ROC) curve was used to evaluate the efficiency of the two scoring schemes in detecting PCa and csPCa, and with Z test to investigate whether there was any difference in detection efficiency between the two schemes. Results Nine hundred and seventy eight patients were eventually enrolled in the study. The results of the consistency assessment showed that there was good agreement between the two radiologists, whether using Mp-MRI or Bp-MRI, with the weighted Kappa coefficient of 0.800 and 0.812, respectively. The ROC curve analysis showed that the area under the curve (AUC) of PCa detected by Mp-MRI and Bp-MRI was 0.873 and 0.879, respectively, and the AUC of csPCa detected was 0.922 and 0.932, respectively. In addition, there was no statistically significant difference between the AUC of PCa and csPCa detected by the two schemes (P>0.05). Conclusion The Bp-MRI scoring scheme has good stability in the evaluation of benign and malignant prostate, and its detection efficiency of PCa or csPCa is not lower than that of standard Mp-MRI based on PI-RADS v2.

OBJECTIVE: To investigate the changes in coagulation of sepsis rats with protein-malnutrition or energy-malnutrition. METHODS: 108 male Sprague-Dawley (SD) rats were divided into three groups by random number table, with 36 rats in each group. The rats in normal feeding group were given a free diet (27 g/d, containing 18% protein fodder), and the rats in protein-malnutrition group were given a low protein diet (27 g/d, containing 5% protein fodder). The rats in energy-malnutrition group were given a low energy diet (9 g/d, containing 18% protein fodder). After 4 weeks of continuous feeding, 8 rats from each group were sacrificed for malnutrition evaluation. The weights of body, thymus and spleen were measured. The percentages of spleen T lymphocyte subsets and M1 macrophage were determined by flow cytometry. Plasma interleukins (IL-6 and IL-10) levels were determined by enzyme-linked immunosorbent assay (ELISA). The remaining 28 rats in each group were collected for cecal ligation and puncture (CLP) to reproduce the sepsis model, 20 rats of which were used for Kaplan-Meier survival analysis, and the other 8 rats were sacrificed at 8 hours after CLP. The levels of plasma IL-6 and IL-10 were determined by ELISA, and the percentage of spleen M1 macrophages was determined by flow cytometry. The mRNA expressions of tissue factor (TF) and plasminogen activation inhibitor-1 (PAI-1) in liver tissue were determined by reverse transcription-polymerase chain reaction (RT-PCR). Pearson correlation method was used to analyze the correlation between the mRNA expressions of TF and PAI-1 and IL-6 in rats after CLP. RESULTS: (1) After 4 weeks of feeding, the rats in the normal feeding group and protein-malnutrition group gained weight, while those in the energy-malnutrition group lost 25% of their initial body weight. The weights of body, thymus and spleen in the protein-malnutrition group and the energy-malnutrition group were significantly lower than those in the normal feeding group. Compared with the normal feeding group and the protein-malnutrition group, the percentages of spleen CD3⁺T lymphocytes, CD4⁺T lymphocytes, M1 macrophages and plasma IL-6 levels were significantly increased in the energy-malnutrition group [CD3⁺T lymphocytes percentage: (52.1±3.7)% vs. (46.9±3.9)%, (44.5±2.2)%; CD4⁺T lymphocyte percentages: (35.0±3.6)% vs. (26.3±2.2)%, (25.1±2.3)%; M1 macrophage percentages: (8.7±2.0)% vs. (3.2±1.3)%, (4.2±1.1)%; IL-6 (ng/L): 129.4±16.2 vs. 48.1±10.0, 53.0±8.3, all P < 0.05]. (2) Kaplan-Meier survival analysis at 7 days after CLP showed: all rats in the energy-malnutrition group died, and the 7-day cumulative survival rate was significantly lower than that in the normal feeding group and the protein-malnutrition group [0% (0/20) vs. 35% (7/20), 55% (11/20), both P < 0.05]. The mortality of the normal feeding group was 65%, which was consistent with moderate CLP mortality, indicating that the CLP model was successfully prepared. After CLP, the plasma IL-6 level in the protein-malnutrition group was significantly lower than that in the normal feeding group [IL-6 (ng/L): 154.6±34.7 vs. 233.4±41.2, P < 0.05]. Compared with the normal feeding group, the mRNA expressions of TF and PAI-1 in liver and plasma IL-6 levels in the energy-malnutrition group were significantly increased [TF mRNA (2^-ΔΔCT): 4.5±2.2 vs. 1.1±0.7, PAI-1 mRNA (2^-ΔΔCT): 3.3±1.8 vs. 1.3±0.9, IL-6 (ng/L): 382.7±118.2 vs. 233.4±41.2, all P < 0.05], the percentage of M1 macrophages in spleen was significantly lowered [(8.9±2.4)% vs. (15.2±5.4)%, P < 0.05]. There was no significant difference in plasma IL-10 level among all the groups. Correlation analysis showed that the mRNA expressions of TF and PAI-1 in the liver of rats after CLP were positively correlated with plasma IL-6 level (r₁ = 0.644, r₂ = 0.574, both P < 0.01). CONCLUSIONS Long-term sustained stress (starvation) leads to sustained chronic inflammatory state, and stimulated the release of related inflammatory factors and activation of the coagulation system after infection. And the inflammatory factors in sepsis rats without sustained stress protein malnutrition were significantly reduced.
Animals ; Male ; Malnutrition ; Rats ; Rats, Sprague-Dawley ; Sepsis ; Spleen ; Tumor Necrosis Factor-alpha

Objective To investigate the consistency of fetal gallbladder volume (FGV) during middle-late pregnancy with three-dimensional ultrasonic virtual organ computer-aided analysis (VOCAL) technique at different rotation angles,and to analyze the correlation between FGV and gestation age.Methods A total of 157 healthy pregnant women underwent prenatal screening were included.The reference range of FGV was measured with three-dimensional ultrasonic VOCAL at 30°,18° and 12° rotation angle,respectively.The correlation between FGV and gestation age was observed,and the consistency of FGV values measured with VOCAL at different rotation step angles was compared.Results The correlations between FGV values measured with VOCAL at 30°,18°,12° rotation step angles and gestation age were all excellent (r=0.92,0.88,0.90;all P＜ 0.001).The consistency of FGV values measured with VOCAL at different rotation step angles was very good (30° and 18°,ICC=0.94;30° and 12°,ICC=0.97;18° and 12°,ICC=0.94).Conclusion Three-dimensional ultrasonic VOCAL can be used to establish the reference range of fetal gallbladder volume in middle-late pregnancy.The consistency of FGV values measured with VOCAL at different rotation step angles was very good,and the correlation between FGV and gestation age was excellent.

Objective To analyze the bone metabolism in hospitalized patients with Graves disease and the changes after 131I therapy.Methods The differences of bone metabolism were analyzed between 315 patients with Graves disease and 300 normal controls in a case-control study.The changes in bone turnover markers and BMD levels before and one year after 131I therapy were observed in 60 patients.Results Compared to normal control,bone turnover markers were markly higher and BMD levels were lower in patients with Graves disease.The level of thyroid hormones were positively related to bone turnover markers,while negatively related to total hip BMD (Z-score).But there was no linear relationship with lumbarand femoral neck BMD (Z-score).After one year of 131I therapy,bone turnover markers were markly lower than that before treatment,while BMD levels were partly higher than that before treatment.Conclusions In Graves disease patients,bone turnover markers were generally increased,while BMD levels decreased compared with normal people.After 131I therapy,along with the improvement of thyrotoxicosis,the high bone turnover rate can be suppressed,and BMD can partly recover.