Background/Aims: Impaired fear memory extinction is widely considered a key mechanism of post-traumatic stress disorder (PTSD). Recent studies have suggested that neuroinflammation after a single prolonged stress (SPS) exposure may play a critical role in the impaired fear memory extinction. Studies have shown that high mobility group box chromosomal protein 1 (HMGB-1) is critically involved in neuroinflammation. However, the role of HMGB-1 underlying the development of impairment of fear memory extinction is still not known. Methods: Thus, we examined the levels of HMGB-1 in the basolateral amygdala (BLA) following SPS using Western blot and evaluated the levels of microglia and astrocytes activation in the BLA after SPS using immunohistochemical staining. We then examined the effects of pre-SPS intra-BLA administration of glycyrrhizin, an HMGB1 inhibitor, or LPS-RS, a competitive TLR4 antagonist, on subsequent post-SPS fear extinction. Results: We found that SPS treatment prolonged the extinction of contextual fear memory after the SPS. The impairment of SPS-induced extinction of contextual fear memory was associated with increased HMGB1 and Toll-like receptor 4 (TLR4) levels in the BLA. Additionally, the impairment of SPS-induced extinction of contextual fear memory was associated with increased activation of microglia and astrocyte in the BLA. Intra-BLA administrations of glycyrrhizin (HMGB-1 inhibitor) or LPS-RS (TLR4 antagonist) can prevent the development of SPS-induced fear extinction impairment. Conclusion: Taken together, these results suggested that SPS treatment may not only produce short term effects on the HMGB1/TLR4-mediated pro-inflammation, but alter the response of microglia and astrocytes to the exposure to fear associated contextual stimuli.

Post-traumatic stress disorder (PTSD) has become a major disease that threatens human health. Neurotransmitters and the amygdala are found to be critical in the development and maintenance of PTSD. We aim to investigate the role of glycyrrhizin in treating PTSD. Contextual fear extinction and elevated plus maze test were applied to evaluate the anxiety and fear memory. Microdialysis and high-performance liquid chromatography were used to analyze the expression of amygdala neurotransmitters in PTSD animal models and to verify the effects of glycyrrhizin on major neurotransmitters. The protein levels of tryptophan hydroxylase 2 (TPH2) were examined by western bolt. Glycyrrhizin treatment significantly reduced anxiety and fear memory after 1 and 7 days of PTSD modelling. In addition, glycyrrhizin treatment restored the circadian rhythm changes of serotonin and TPH2. The present study found a significant circadian rhythm change of serotonin in the amygdala in PTSD rats. Besides, glycyrrhizin treatment restored the altered serotonin diurnal fluctuations, which raises important implications for PTSD treatment.

Objectives: The aim of this study was to investigate the safety and feasibility of nHFOV as initial respiratory support in preterm infants with RDS.Methods: This study retrospectively analyzed the clinical data of 244 premature infants with RDS who were treated in our hospital from January 2016 to January 2019 and divided into the nHFOV group (n = 115) and the BiPAP group (n = 129) based on the initial respiratory support method.Results: Respiratory outcomes showed that the rate of NIV failure during the first 72 hours of life in the nHFOV group was significantly lower than that in the BiPAP group. The time of NIV in the nHFOV group was significantly shorter than that in the BiPAP group. The time of supplemental oxygen in the nHFOV group was significantly shorter than that in the BiPAP group. The incidence of air leakage syndrome in the nHFOV group was significantly lower than that in the BiPAP group, and the length of hospital stay of the nHFOV group was also significantly shorter than that in the BiPAP group. Although the rate of infants diagnosed with BPD was similar between the two groups, the rate of severe BPD in the nHFOV group was significantly lower than that in the BiPAP group.Conclusion: This study showed that nHFOV as initial respiratory support for preterm infants with RDS was feasible and safe compared to BiPAP. Furthermore, nHFOV can reduce the need for IMV and reduce the incidence of severe BPD and air leak syndrome.

BACKGROUND Both hydrocele and cryptorchidism are common congenital abnormalities with an increasing incidence in many countries. Testicular abnormalities such as testicular hydrocele and cryptorchidism and their relationship with maternal hyperglycemia have become current research topics. This study researches whether increased blood sugar levels lead to congenital testicular abnormalities. MATERIALS & METHODS This retrospective and consecutive cohort study was conducted on singleton pregnancies having completed 20 or more weeks of gestation from the Fujian Provincial Maternity and Children’s Hospital, China. Differences were assessed with the Pearson χ2 test and the t-test for categorical and continuous variables, respectively. Univariate and multivariate logistic analyses were applied for outcomes. RESULTS A total of 37375 infants were enrolled for the selection of cases and controls. We found that oral glucose tolerance test(OGTT) of the case group's glucose level dramatically increased compared with the control group at 1 hour and 2 hours (p = 0.001, p = 0.016). In the testicular hydrocele group a remarkable increase was observed inOGTT1H and OGTT2H with the same criteria compared to the control group (p = 0.0001). Moreover, mothers were diagnosed with gestational diabetes mellitus(GDM) at a higher rate (p = 0.0001). The prevalence of premature delivery was also significantly higher in the testicular hydrocele group than in the control group (p = 0.0001). However, the OGTT0H was significantly higher in the cryptorchidism group compared to the control group (p = 0.0257). CONCLUSION The present study showed that hyperglycemia during pregnancy leads to a higher prevalence of testicular abnormality of the infants, such as testicular hydrocele and cryptorchidism. However, further investigation is required to determine whether premature delivery and GDM could contribute to the observed conditions.

BACKGROUND: GDM or prepregnancy diabetes mellitus during pregnancy will lead to an increased risk of fetal congenital malformations16-18. However, the influence of different time periods on blood glucose level is not clear, the object of this study was to explore the association between abnormal glucose regulation at different time point and congenital heart diseases during pregnancyMETHODS: This retrospective and consecutive cohort study were conducted on singleton pregnancies carried to 20 completed weeks of gestation or beyond, from the Fujian Provincial Maternity and Children’s Hospital, China, between January 1, 2014 and December 31, 2020. A diagnosis of gestational diabetes was defined according to Fasting blood glucose level and 75-g OGTT. Maternal and infant characteristics and outcomes were compared between neonates born to mothers with and without Abnormal blood glucose at different time of OGTT. Descriptive statistics are shown as mean ± standard deviation or median (range interquartile) for continuous variables and tested with ANOVA or Kruskal-Wallis rank-sum test, whereas frequency (percentage) and χ2 test were used for categorical variables. All analyses were conducted using R version 4.1.0.RESULTS: A total of 71703 normal subjects and 533 subjects with fetal cardiovascular malformations were included in this study. Pregnant women who deliver a normal fetus tend to older and have higher rate of gestational hypertension and abnormal glucose during pregnancy than those who deliver a newborn with CHD (P < 0.05). Compared to the corresponding normal group, GDM, OGTT 0 hour≥5.1mmol/L, OGTT 1 hour≥10mmol/L, and OGTT 2 hour≥8.5mmol/L confer to 55%, 48%, 54%, and 59% increase in risk of CHD, respectively. Compared to group 1 (OGTT 0h and OGTT 1h and 2h are both normal), group 3 (OGTT 0h is normal, while OGTT 1h or 2h is abnormal) and group 4 (OGTT 0h and OGTT 1h or 2h are both abnormal) exhibit higher risk of CHD (OR= 1.53 and 2.21, respectively, all P<0.05). However, group 2 (OGTT 0h is abnormal, while OGTT 1h and 2h is normal) did not demonstrate a statistically significant elevated risk.CONCLUSION: Gestational diabetes is an identified hazard factor for neonatal CHD. The effect of GDM on CHD is more reflected in impaired tolerance of glucose regulation than in elevated fasting blood glucose levels. Pregnant women with normal fasting glucose but abnormal OGTT 1 hour or 2 hour may be overlooked as an implicit risk population, and should be given adequate attention.