Our research reveals the critical role of the suprachiasmatic nucleus (SCN) vasoactive intestinal peptide (VIP) neurons in mediating light-induced transient forgetting. Acute exposure to bright light selectively impairs trace fear memory by activating VIP neurons in the SCN, as demonstrated by increased c-Fos expression and Ca²⁺ recording. This effect can be replicated and reversed through optogenetic and chemogenetic manipulations of SCN VIP neurons. Furthermore, we identify the SCN → PVT (paraventricular nucleus of the thalamus) VIP neuronal circuitry as essential in this process. These findings establish a novel role for SCN VIP neurons in modulating memory accessibility in response to environmental light cues, extending their known function beyond circadian regulation and revealing a mechanism for transient forgetting.
Animals ; Vasoactive Intestinal Peptide/metabolism* ; Male ; Mice ; Neurons/metabolism* ; Suprachiasmatic Nucleus/physiology* ; Light ; Mice, Inbred C57BL ; Memory/physiology* ; Fear/physiology* ; Suprachiasmatic Nucleus Neurons/metabolism* ; Optogenetics ; Proto-Oncogene Proteins c-fos/metabolism*

Acute kidney injury (AKI) usually requires renal replacement therapy (RRT). Common RRT modes include peritoneal dialysis, continuous renal replacement therapy, intermittent hemodialysis and continuous low-efficiency hemodialysis. In clinical practice, there is still controversy over how to select the appropriate RRT mode for AKI patients and when initiating RRT is more beneficial for AKI patients. This article summarizes previous studies on the impact of RRT mode and initiation timing on the prognosis of AKI patients, with the aim of providing assistance for clinical decision-making.

Acute kidney injury (AKI) usually requires renal replacement therapy (RRT). Common RRT modes include peritoneal dialysis, continuous renal replacement therapy, intermittent hemodialysis and continuous low-efficiency hemodialysis. In clinical practice, there is still controversy over how to select the appropriate RRT mode for AKI patients and when initiating RRT is more beneficial for AKI patients. This article summarizes previous studies on the impact of RRT mode and initiation timing on the prognosis of AKI patients, with the aim of providing assistance for clinical decision-making.

Objective:To explore the effect of family doctor system on the risk stratification of community hypertensive population by application of Markov modelMethods:Retrospective investigation was conducted on hypertensive patients under continuing management from 13 community health service centers in Shanghai Xuhui District from January 2014 to December 2016. Among 98 996 subjects, 50 920 (51.45%) were contracted to family doctors (contracted group) and 48 046 (48.55%) did not contracted to family doctors (non-contracted group). According to the risk stratification of hypertension, the four-state Markov model (low-risk, medium-risk, high-risk, and extremely high-risk) was established. The prediction effect of the model was validated, and the changes in the risk stratification status of hypertension in the study subjects from 2017 to 2020 was predicted by using the Markov model.Results:Among all subjects the number of medium-risk and extremely high-risk accounted for the majority(>80%). Compared with 2014, in 2016 the number of low-risk patients with hypertension was decreased from 9 042 cases (17.76%) to 6 851 cases (13.45%) in contracted group; and from 9 971 cases (20.75%) to 7 906 cases (16.46%) in non-contracted group; the number of people at extremely high risk of hypertension was increased from 15 609 cases (30.65%) to 17 639 cases (34.64%) in the contracted group; from 13 847 cases (28.82%) to 15 641 cases (32.55%) in the non-contracted group. According to the Markov model one year after the risk stratification, the risk status of most subjects remained in the original one. There was not transform from extremely high-risk to low-risk state (0%), but there was transform from low-risk to extremely high-risk state in some extend, and the degree of transform in non-contracted group [2.06%(205/9 971)] was higher than the contracted group [1.85%(167/9 042)]. Predicted by the Markov model, between 2017 and 2020 the number and proportion of the medium-risk>extremely high-risk>low-risk>high-risk in both contracted group and non-contracted group. With the extension of time, low-risk proportion is gradually reduces, and the rate of reduction of the contracted group was lower than that of the non-contracted group, while proportion of medium-risk, high-risk and extremely high-risk is gradually increased.Conclusions:The constructed Markov model is accruable and stable, which can be used in the study of hypertension prognosis. The study indicates that the contracted services of family doctor have positive effects on the management of community hypertensive patients.

Objective To investigate the clinical efficacy of bronchoscopic MMC topical spraying for the treatment of tuberculous cicatricial stenosis of the central airway. Methods 45 patients with t tuberculous cicatricial stenosis of the central airway were randomly divided into a control group (14 patients), treatment group 1 (group1, 15 patients), or treatment group 2 (group 2, 16 patients), who received bronchial balloon dilatation alone, bronchial balloon dilatation combined with topical MMC spraying for one time, and for twice, respectively . The clinical efficacy was observed by using the MRC score and measuring airway diameter at the time points before treatment, end of treatment, and 3, 6, and 12 months after treatment, respectively. Results For the MRC scores at different time points, the MRC scores in group 2 (0.06 ± 0.25) and group 1 (0.33 ± 0.617) were significantly lower than those in the control group at 3 months after treatment (P < 0.05 for all comparisons);there were nosignificant differences at the other time points among the three groups. For the airway mean diameters at the different time points, the airway mean diameter was higher in group 2 than in the control group at 3 and 6 months after treatment (P < 0.01), and in group 1 at 3, 6, and 12 months (P < 0.05). No statistical differences were found in the other time points among three groups (P > 0.05). Conclusions Bronchial balloon dilatation combined with topical MMC spraying has certain short-term and long-term efficacy for improving dyspnea and maintaining the airway diameter after dilatation.

Objective To explore the clinical features of transbronchial tuberculous mediastinal lymph-adenitis and value of bronchoscopic interventional therapy. Methods The clinical data of 50 patients who had been diagnosed as tuberculous mediastinal lymphadenitis and had received bronchoscopic interventional therapy in our hospital during the period from January 2008 to January 2013 were retrospectively analyzed. The bronchoscopic change , improvement in symptoms , and time to sputum smear and culture conversion were used to assess the therapeutic effect. The patients were followed up for six months. Results The mean age of the patients was (35 ± 15) years and the male to female ratio was 1:1.2. The lesions occurred mostly at the right middle lobe in 24% (12/50) of the patients. The total effectiveness rate was up to 98% (49/50) after chemotherapy and bronchoscopic interventional therapy. The major complication associated with interventional therapy was hemoptysis (8%, 4/50). After follow-up of 6 months , 49 patients with active lesions were stable , with smooth bronchial mucosa and no obvious obstruction by granulation and caseous necrosis tissues. Conclusions The relavent clinical symptoms of transbronchial tuberculous mediastinal lymphadenitis is mainly caused by tuberculosis inflammation which destroys and blocks the airway. The fiber bronchoscopic therapy with forceps clip and drug infusion has a definite effect and fewer complications.