The Burgeoning Significance of Liquid-Liquid Phase Separation in the Pathogenesis and Therapeutics of Cancers.

Liquid-liquid phase separation (LLPS) is a physiological phenomenon that parallels the mixing of oil and water, giving rise to compartments with diverse physical properties. Biomolecular condensates, arising from LLPS, serve as critical regulators of gene expression and control, with a particular significance in the context of malignant tumors. Recent investigations have unveiled the intimate connection between LLPS and cancer, a nexus that profoundly impacts various facets of cancer progression, including DNA repair, transcriptional regulation, oncogene expression, and the formation of critical membraneless organelles within the cancer microenvironment. This review provides a comprehensive account of the evolution of LLPS from the molecular to the pathological level. We explore the mechanisms by through which biomolecular condensates govern diverse cellular physiological processes, encompassing gene expression, transcriptional control, signal transduction, and responses to environmental stressors. Furthermore, we concentrate on potential therapeutic targets and the development of small-molecule inhibitors associated with LLPS in prevalent clinical malignancies. Understanding the role of LLPS and its interplay within the tumor milieu holds promise for enhancing cancer treatment strategies, particularly in overcoming drug resistance challenges. These insights offer innovative perspectives and support for advancing cancer therapy.

Personalized application of antimicrobial drugs in pediatric patients with augmented renal clearance: a review of literature.

The effect of renal functional status on drug metabolism is a crucial consideration for clinicians when determining the appropriate dosage of medications to administer. In critically ill patients, there is often a significant increase in renal function, which leads to enhanced drug metabolism and potentially inadequate drug exposure. This phenomenon, known as augmented renal clearance (ARC), is commonly observed in pediatric critical care settings. The findings of the current study underscore the significant impact of ARC on the pharmacokinetics and pharmacodynamics of antimicrobial drugs in critically ill pediatric patients. Moreover, the study reveals a negative correlation between increased creatinine clearance and blood concentrations of antimicrobial drugs. The article provides a comprehensive review of ARC screening in pediatric patients, including its definition, risk factors, and clinical outcomes. Furthermore, it summarizes the dosages and dosing regimens of commonly used antibacterial and antiviral drugs for pediatric patients with ARC, and recommendations are made for dose and infusion considerations and the role of therapeutic drug monitoring. CONCLUSION:  ARC impacts antimicrobial drugs in pediatric patients. WHAT IS KNOWN: • ARC is inextricably linked to the failure of antimicrobial therapy, recurrence of infection, and subtherapeutic concentrations of drugs. WHAT IS NEW: • This study provides an updated overview of the influence of ARC on medication use and clinical outcomes in pediatric patients. • In this context, there are several recommendations for using antibiotics in pediatric patients with ARC: 1) increase the dose administered; 2) prolonged or continuous infusion administration; 3) use of TDM; and 4) use alternative drugs that do not undergo renal elimination.

Equilibrative nucleotide transporter ENT3 (SLC29A3): A unique transporter for inherited disorders and cancers.

As a crucial gene associated with diseases, the SLC29A3 gene encodes the equilibrative nucleoside transporter 3 (ENT3). ENT3 plays an essential regulatory role in transporting intracellular hydrophilic nucleosides, nucleotides, hydrophilic anticancer and antiviral nucleoside drugs, energy metabolism, subcellular localization, protein stability, and signal transduction. The mutation and inactivation of SLC29A3 are intimately linked to the occurrence, development, and prognosis of various human tumors. Moreover, many hereditary human diseases, such as H syndrome, pigmentary hypertrichosis and non-autoimmune insulin-dependent diabetes mellitus (PHID) syndrome, Faisalabad histiocytosis (FHC), are related to SLC29A3 mutations. This review explores the mechanisms of SLC29A3 mutations and expression alterations in inherited disorders and cancers. Additionally, we compile studies on the inhibition of ENT3, which may serve as an effective strategy to potentiate the anticancer activity of chemotherapy. Thus, the synopsis of genetics, permeant function and drug therapy of ENT3 provides a new theoretical and empirical foundation for the diagnosis, prognosis of evaluation and treatment of various related diseases.

Pueraria thomsonii Radix Water Extract Alleviate Type 2 Diabetes Mellitus in db/db Mice through Comprehensive Regulation of Metabolism and Gut Microbiota.

Type 2 diabetes mellitus (T2DM) is an increasingly prevalent and serious health problem. Its onset is typically associated with metabolic disorders and disturbances in the gut microbiota. Previous studies have reported the anti-T2DM effects of Pueraria thomsonii Radix as a functional food. However, the mechanism of action is still unknown. In this study, rich polyphenols and polysaccharides from Pueraria Thomsonii Radix water extract (PTR) were quantitatively determined, and then the effects of PTR on db/db mice were evaluated by pharmacology, metabolomics, and 16S rRNA gene sequencing. The results showed that PTR could alleviate pancreatic tissue damage, significantly decrease fasting blood glucose (FBG), fasting serum insulin (FINS), homeostasis model assessment insulin resistance (HOMA-IR), urinary glucose (UGLU), and urinary albumin/creatinine ratio (UACR). Metabolomics showed that the Diabetes Control (DM) group produced 109 differential metabolites, of which 74 could be regulated by PTR. In addition, 16S rRNA sequencing was performed in fecal samples and results showed that PTR could reduce the Firmicutes/Bacteroidetes(F/B) ratio and regulate three beneficial bacteria and one harmful bacterium. In conclusion, the results showed that PTR could ameliorate the T2DM symptoms, metabolic disorder, and gut microbiota imbalance of db/db mice, and it was superior to metformin in some aspects. We suggested for the first time that γ-aminobutyric acid (GABA) may be involved in the regulation of the microbiota-gut-brain axis (MGB) and thus affects the metabolic disorders associated with T2DM. This study will provide a scientific basis for the development of functional food with PTR.

Corrigendum: Bibliometric analysis of evolutionary trends and hotspots of super-enhancers in cancer.

[This corrects the article DOI: 10.3389/fphar.2023.1192855.].

Individualized antibiotic dosage regimens for patients with augmented renal clearance.

Objectives: Augmented renal clearance (ARC) is a state of enhanced renal function commonly observed in 30%-65% of critically ill patients despite normal serum creatinine levels. Using unadjusted standard dosing regimens of renally eliminated drugs in ARC patients often leads to subtherapeutic concentrations, poor clinical outcomes, and the emergence of multidrug-resistant bacteria. We summarized pharmaceutical, pharmacokinetic, and pharmacodynamic research on the definition, underlying mechanisms, and risk factors of ARC to guide individualized dosing of antibiotics and various strategies for optimizing outcomes. Methods: We searched for articles between 2010 and 2022 in the MEDLINE database about ARC patients and antibiotics and further provided individualized antibiotic dosage regimens for patients with ARC. Results: 25 antibiotic dosage regimens for patients with ARC and various strategies for optimization of outcomes, such as extended infusion time, continuous infusion, increased dosage, and combination regimens, were summarized according to previous research. Conclusion: ARC patients, especially critically ill patients, need to make individualized adjustments to antibiotics, including dose, frequency, and method of administration. Further comprehensive research is required to determine ARC staging, expand the range of recommended antibiotics, and establish individualized dosing guidelines for ARC patients.

Bibliometric analysis of evolutionary trends and hotspots of super-enhancers in cancer.

Introduction: In the past decade, super-enhancer (SE) has become a research hotspot with increasing attention on cancer occurrence, development, and prognosis. To illustrate the hotspots of SE in cancer research and its evolutionary tendency, bibliometric analysis was carried out for this topic. Methods: Literature published before Dec 31, 2022, in WOSCC, was systematically classified, and Citespace, bibliometric.com/app, and GraphPad Prism analyzed the data. Results: After screening out inappropriate documents and duplicate data, 911 publications were selected for further bibliometric analysis. The top five research areas were Oncology (257, 28.211%), Cell Biology (210, 23.052%), Biochemistry Molecular Biology (209, 22.942%), Science Technology Other Topics (138, 15.148%), and Genetics Heredity (132, 14.490%). The United States of America (United States) has the highest number of documents (462, 50.71%), followed by China (303, 33.26%). Among the most productive institutions, four of which are from the United States and one from Singapore, the National University of Singapore. Harvard Medical School (7.68%) has the highest percentage of articles. Young, Richard A, with 32 publications, ranks first in the number of articles. The top three authors came from Whitehead Institute for Biomedical Research as a research team. More than two-thirds of the research are supported by the National Institutes of Health of the United States (337, 37.654%) and the United States Department of Health Human Services (337, 37.654%). And "super enhancer" (525), "cell identity" (258), "expression" (223), "cancer" (205), and "transcription factor" (193) account for the top 5 occurrence keywords. Discussion: Since 2013, SE and cancer related publications have shown a rapid growth trend. The United States continues to play a leading role in this field, as the top literature numbers, affiliations, funding agencies, and authors were all from the United States, followed by China and European countries. A high degree of active cooperation is evident among a multitude of countries. The role of SEs in cell identity, gene transcription, expression, and inhibition, as well as the relationship between SEs and TFs, and the selective inhibition of SEs, have received much attention, suggesting that they are hot issues for research.

Mechanistic study of the effect of potassium ferrate and straw fiber on the enhancement of strength in cement-based solidified municipal sludge.

The high content of organic matter in sludge is the primary reason for the poor solidifying effect and excessive dosage of the cement base. In this study, potassium ferrate and straw fiber are utilized to synergistically enhance the solidifying effect of the cement and elaborate the strength mechanisms. Among them, potassium ferrate was selected to oxidize and crack the structure of organic matter in sludge and consume part of organic matter; straw fiber was used as an adsorption material to absorb some of the organic material and reduce its interference with the cement hydration reaction; the skeleton function of straw fiber in solidified sludge was used to improve the final solidified sludge strength. It is shown that the presence of these two additives significantly improved the cement solidification strength and reduced the moisture content of the solidified body. Moreover, the moisture content and strength followed an obvious linear relationship (adjusted R2 = 0.92), with the strength increasing as the moisture content decreased. After pretreatment with potassium ferrate, the free water content in the dewatered sludge increased by 4.5%, which was conducive to the adequate hydration reaction with cement. The analysis using X-ray diffraction (XRD), scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM/EDS), and mercury intrusion porosimetry (MIP) revealed potassium ferrate synergizes with straw fibers to promote the production of hemihydrate gypsum and gismondine. However, hemihydrate gypsum, calcium carbonate, and gismondine resulted in structural swelling, which was confirmed by the microscopic morphology and pore structure analysis. However, the adverse effects due to swelling were offset by the increase in strength brought by the above crystalline substances.

Adherence to a healthy lifestyle and its association with cognitive impairment in community-dwelling older adults in Shanghai.

Introduction: There is a growing body of recent literature linking the association of specific or multiple lifestyles with cognitive impairment, but most of these studies have been conducted in Western populations, and it is necessary to study multiple lifestyles and cognitive abilities in different populations, with the primary population of this study being a select group of community-dwelling older adults in Shanghai, China. Methods: The sample included 2,390 community-dwelling Chinese participants. Their cognitive function was assessed using the Mini-Mental State Examination (MMSE). We defined a healthy lifestyle score on the basis of being non-smoking, performing ≥210 min/wk moderate/vigorous-intensity physical activity, having light to moderate alcohol consumption, eating vegetables and fruits daily, having a body mass index (BMI) of 18.5-23.9 kg/m2, and having a waist-to-hip ratio (WHR) <0.90 for men and <0.85 for women, for an overall score ranging from 0 to 6. Results: Compared with participants with ≤2 healthy lifestyle factors, the adjusted odds ratio (OR) and 95% confidence interval (CI) for participants with 4, 5, and 6 healthy lifestyle factors were 0.53 (95% CI, 0.29-0.98), 0.40 (95% CI, 0.21-0.75), and 0.36 (95% CI, 0.16-0.79), respectively. Only WHR (OR = 0.54, 95% CI = 0.37-0.78) and physical activity (OR = 0.69, 95% CI = 0.51-0.92) were associated with cognitive impairment. A healthy lifestyle correlated with overall cognition (ß = 0.066, orientation (ß = 0.049), language ability (ß = 0.060), delayed recall (ß = 0.045) and executive function (ß = 0.044) (P all < 0.05). Conclusion: The study provides evidence on an inverse association between healthy lifestyles and cognitive impairment. We investigated whether healthy lifestyle was related to specific cognitive functions to provide a theoretical basis for accurate clinical prescription.

Exploring the role of potassium ferrate and straw fiber in enhancing the strength of cement-based solidified municipal sludge.

The effect of potassium ferrate (PF) and straw fiber (SF) on the strength of cement-based solidified municipal sludge, including the influence of reducing the organic matter in the sludge on the efficiency of the hydration of the cement, was studied. Single-factor tests, orthogonal tests, and linear weighted optimization methods were used to obtain suitable ratios to meet practical requirements, and then SEM and XRD analyses were used to explore the solidification mechanism. The results showed that PF and SF had significant influence on the strength, with SF having the greatest influence and the strength increasing with the amount of both admixtures, and cement had no significant influence on the strength. After linear weighting optimization, the ideal dosage was found to be 20% cement, 20% PF, and 5% SF, which produced a solidified sludge that had an strength of 126.87 kPa, far higher than the 50 kPa required to qualify for disposal in landfills. Analysis of the mineral content and microstructure showed that PF and SF could promote cement hydration and produce more hydration products, and the density of the optimized sample was much higher than that of the raw sludge and a sludge sample mixed with 20% cement alone.

Manipulation of time-dependent multicolour evolution of X-ray excited afterglow in lanthanide-doped fluoride nanoparticles.

External manipulation of emission colour is of significance for scientific research and applications, however, the general stimulus-responsive colour modulation method requires both stringent control of microstructures and continously adjustment of particular stimuli conditions. Here, we introduce pathways to manipulate the kinetics of time evolution of both intensity and spectral characteristics of X-ray excited afterglow (XEA) by regioselective doping of lanthanide activators in core-shell nanostructures. Our work reported here reveals the following phenomena: 1. The XEA intensities of multiple lanthanide activators are significantly enhanced via incorporating interstitial Na+ ions inside the nanocrystal structure. 2. The XEA intensities of activators exhibit diverse decay rates in the core and the shell and can largely be tuned separately, which enables us to realize a series of core@shell NPs featuring distinct time-dependent afterglow colour evolution. 3. A core/multi-shell NP structure can be designed to simultaneously generate afterglow, upconversion and downshifting to realize multimode time-dependent multicolour evolutions. These findings can promote the development of superior XEA and plentiful spectral manipulation, opening up a broad range of applications ranging from multiplexed biosensing, to high-capacity information encryption, to multidimensional displays and to multifunctional optoelectronic devices.

[Distribution Characteristics and Source Apportionment of Perfluoroalkyl Substances in Surface Soils of the Northeast Tibetan Plateau].

Surface soil samples collected at 18 sites from the northeast Tibetan Plateau were used to analyze perfluoroalkyl substances (PFASs) via ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) to study the concentration levels and sources of PFASs. The results showed that 11 PFASs were detected in the soil, and the ω(Σ11PFASs) ranged from 0.043-1.573 ng·g-1 with an average concentration of 0.398 ng·g-1. PFBA displayed the highest concentration level with a mean content of 0.164 ng·g-1, whereas PFHxA was at the lowest level (0.005 ng·g-1). The concentrations of the other PFASs were similar to each other (0.011-0.057 ng·g-1). Generally, PFASs contents in the west and north were higher than that in the southeast, and the alpine condensation effect existed for PFBA. The principal component analysis showed that PFASs in surface soils in the northeast Tibetan Plateau region mainly originated from the atmospheric transport of PFASs and their precursors. Few areas were affected by direct emissions of point source pollution, and the main sources were the industrial production of metals/minerals and other human activities.

Fourier transform infrared spectroscopy and chemometrics for the discrimination of animal fur types.

Rapid and reliable animal fur identification has remained a challenge for customs inspection. The accurate distinction between fur types has a significant meaning in implementing the correct tariff policy. A variety of analytical methods have been applied to work on distinguishing animal fur types, with tools of microscopy, molecular testing, mass spectrometry, Fourier transform infrared spectroscopy (FTIR), and Raman spectroscopy. In this research, the capability of attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR) combined with pattern recognition methods was investigated for the discrimination of animal fur in six types. This work was to explore the non-destructive application of ATR-FTIR technique in discriminant analysis of animal fur. All spectra were collected by ATR-FTIR of the wavenumber ranging from 4000 to 650 cm-1. Data pretreatments included moving average smoothing and multiplicative scatter correction (MSC). Four supervised classification algorithms were chosen to categorize the types of fur: soft independent modeling of class analogy (SIMCA), principal component analysis linear discriminant analysis (PCA-LDA), partial least squares discriminant analysis (PLS-DA), least squares support vector machine (LS-SVM). PLS-DA and LS-SVM were both effective approaches, with a 100% classification accuracy rate. The accuracy of PCA-LDA and SIMCA was 98.33% and 99.44%, respectively. Furthermore, LS-SVM model obtained using Monte-Carlo sampling method also obtained 100% prediction accuracy, while all other methods produced misclassification. LS-SVM corrected the non-linearities for the animal fur FTIR data but also remarkably improved the prediction performance level. The results of this study revealed that the combination of ATR-FTIR and chemometrics has a huge potential for animal fur discrimination.

Modulating electron population pathways for time-dependent dynamic multicolor displays.

Multicolor luminescent nanoparticles (NPs) show several potential emerging applications. In this work, we provide a new route that integrates the afterglow and upconversion (UC) that originate in a single activator to achieve color variations without the modulation of any other parameters. The Er3+ ions in Na3HfF7:Yb/Er NPs exhibit bright green afterglow upon X-ray irradiation and single-band red UC under 980 nm laser excitation, which are attributed to the significantly different electron population pathways. The UC intensity is stable and the afterglow decreases gradually over time, thus the output color is clearly changed from green to red naturally via illuminating the pre-X-ray-irradiated NPs with a 980 nm laser. Furthermore, the fine emission profiles of Er3+, Ho3+ and Tm3+ are achieved upon X-ray irradiation. Our results develop a new approach for time-dependent dynamic color displays and a simple route to revealing the electronic fine structures of lanthanide activators at room temperature.

Proteoglycan-depleted regions of annular injury promote nerve ingrowth in a rabbit disc degeneration model.

BACKGROUND: To assess the effects of proteoglycan-depleted regions of annular disruptions on nerve ingrowth in the injury site in vivo. METHODS: New Zealand white rabbits (n = 18) received annular injuries at L3/4, L4/5, and L5/6. The experimental discs were randomly assigned to four groups: (a) an annular defect was created; (b) an annular defect implanted with a poly lactic-co-glycolic acid (PLGA)/fibrin/PBS plug; (c) an annular defect implanted with a PLGA/fibrin/chondroitinase ABC (chABC) plug; and (d) an uninjured L2/3 disc (control). Disc degeneration was evaluated by radiography, MRI, histology, and analysis of the proteoglycan (PG) content. Immunohistochemical detection of nerve fibers and chondroitin sulfate (CS) was performed. RESULTS: The injured discs produced progressive and reliable disc degeneration. In the defective discs, the lamellated appearance of AF (Annulus fibrosus) was replaced by extensive fibrocartilaginous-like tissue formation outside the injured sites. In contrast, newly formed tissue was distributed along small fissures, and small blood vessels appeared in the outer part of the disrupted area in the PLGA/fibrin/PBS discs. More sprouting nerve fibers grew further into the depleted annulus regions in the PLGA/fibrin/chABC discs than in the control discs and those receiving PLGA/fibrin/PBS. In addition, the innervation scores of the PLGA/fibrin/chABC discs were significantly increased compared with those of the PLGA/fibrin/PBS discs and defected discs. CONCLUSION: ChABC-based PLGA/fibrin gel showed promising results by achieving biointegration with native annulus tissue and providing a local source for the sustained release of active chABC. Disc-derived PG-mediated inhibition of nerve and blood vessel ingrowth was abrogated by chABC enzymatic deglycosylation in an annular-injured rabbit disc degeneration model.

Prognostic Value of Pretreatment Prognostic Nutritional Index in Patients With Renal Cell Carcinoma: A Meta-Analysis.

BACKGROUND: The pretreatment prognostic nutritional index (PNI) is correlated with poor prognosis in several malignancies. However, the prognostic role of PNI in patients with renal cell carcinoma (RCC) remains unclear. Therefore, we performed a meta-analysis to investigate the prognostic significance of PNI in patients with RCC. METHODS: We searched the PubMed, Web of Science, Embase, Scopus, and Cochrane Library databases up to February 2021. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were used to estimate correlation between PNI and survival endpoints in RCC. RESULTS: Ten studies with 4,908 patients were included in the meta-analysis. The pooled results indicated that a low PNI associated with poor overall survival (HR = 2.10, 95% CI = 1.67-2.64, p<0.001), shorter progression-free survival, disease-free survival, recurrence-free survival (HR = 1.99, 95% CI = 1.67-2.36, p<0.001), and poor cancer-specific survival (HR = 2.95, 95% CI = 1.61-5.39, p<0.001). Additionally, the prognostic ability of PNI was not affected by subgroup analysis factors. CONCLUSION: The meta-analysis indicated that low PNI associated with shorter survival outcomes in patients with RCC. Therefore, PNI could be used as an effective prognostic indicator in RCC.

[Pollution Characteristics of Organophosphate Esters in Frozen Soil on the Eastern Edge of Qinghai-Tibet Plateau].

In this study, soil samples were collected from the eastern edge of the Qinghai Tibet Plateau in December 2019. The level and distribution characteristics of organophosphate esters (OPEs) in seasonal frozen soil were analyzed, and their sources were discussed. The results showed that the target analytes including tri-n-butyl phosphate (TnBP), tris(2-ethylhexyl) phosphate (TEHP), tributoxyethyl phosphate (TBEP), triphenyl phosphate (TPhP), tri(2-chloroethyl) phosphate (TCEP), trichloropropyl phosphate (TCPP), and tris-(2,3-dichloropropyl) phosphate (TDCPP) were detected with 100% frequency. Levels of Σ7OPEs in topsoil (0-10 cm) and sub topsoil (10-20 cm) were 146.7-348.7 ng·g-1 (mean:231.1 ng·g-1) and 206.5-333.2 ng·g-1 (mean:260.2 ng·g-1), respectively. The Σ7OPEs content level is comparable to that of urban soil,which is worthy of attention. TBEP and TDCPP were the most abundant compounds in the plateau soil. Point source emissions have significant influence on the spatial distribution of OPEs, and regional deposition of OPEs contributes to all sampling sites. The migration ability of different OPE compounds in soil was different. Stronger migration ability was observed for aromatic OPEs (TPhP) than chlorinated OPEs. Principal component analysis showed that the main sources of OPEs in plateau soil were atmospheric wet and dry deposition, manufactured consumer materials, and the release of OPEs from automobile interior decoration.

High-efficiency removal capacities and quantitative adsorption mechanisms of Cd2+ by thermally modified biochars derived from different feedstocks.

Adsorption characteristics of Cd2+ on the three biochars modified by pyrolysis and calcination were investigated that were derived from rice straw (TRSB), chicken manure (TCMB) and sewage sludge (TSSB). The pH effect, adsorption kinetics, isotherms and thermodynamics, and desorption were determined, and qualitative analysis of adsorption mechanisms was performed by SEM, XRD, FTIR and XPS. Maximum adsorption capacities reached 177.28, 96.03 and 74.04 mg/g for TCMB, TRSB and TSSB, respectively, which were higher than that of many previously reported biochars. Even after five adsorption-desorption cycles, TCMB showed the strongest reusability without losing significantly adsorption capacity. This suggested that thermally modified biochars, particularly TCMB, could be a preferred adsorbent for Cd2+. Relative distribution of adsorption mechanisms was examined by direct and indirect calculation, in which the precipitation and cation-exchange dominated the whole chemisorption process, jointly accounting for 84% (TRSB) to 95% (TCMB) of total adsorption. While the complexation was of minor importance in total adsorption accounting for 5%-16%. The relationship of each mechanism with the properties of biochar was also discussed. These provided new insights on the adsorption effectiveness and mechanisms for Cd2+ in the aqueous solution that was critical for evaluating the application of modified biochars.

Exendin-4 Reversed the PC12 Cell Damage Induced by circRNA CDR1as/miR-671/GSK3ß Signaling Pathway.

The purpose of this paper is to study the effect of circRNA cerebellar degeneration-related protein 1 antisense RNA(CDR1as)/miR-671/GSK3ß signaling pathway on PC12 cell injury and the mechanism of Exendin-4 (Ex-4) in PC12 cell injury protection. Quantitative reverse-transcription polymerase chain reaction (qRT-PCR) was used to detect the expression levels of circular RNA CDR1as and miR-671 in PC12 cells. By overexpressing or knocking out CDR1as, miR-671, and GSK3ß, the role of CDR1as, miR-671, and GSK3ß in PC12 cell injury was analyzed. The binding of CDR1as to miR-671 and GSK3ß to miR-671 was verified by dual luciferase reporter assay. PC12 cells were treated with 1-methyl-4 phenyl-pyridine ion (MPP+) to construct a PC12 cell damage model. PC12 cell transfection experiments were used to confirm the role of CDR1as/miR-671/GSK3ß signal axis in PC12 cell damage, and the role of Ex-4 in the association of circRNA CDR1as/miR-671/GSK3ß signaling axis and PC12 cell damage. PC12 cell damage was detected by 3-(4,5-dimethyl thiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) and cellular lactate dehydrogenase (LDH) release. Ex-4 reversed the phosphorylation levels of PI3K, AKT, and GSK-3ß in MPP+-treated PC12 cells, and reduced MPP+-induced PC12 cell damage. CircRNA CDR1as upregulated the expression of GSK3ß by sponge miR-671. Ex-4 downregulated CDR1as expression and upregulated miR-671 expression in MPP+-induced PC12 cell. Silencing of CDR1as reduced MPP+-induced PC12 cell damage. CDR1as transfection downregulated the expression of miR-671 in PC12 cells, promoted the expression and phosphorylated of GSK3ß, and induced PC12 cell damage. GSK3ß silencing reversed CDR1as-induced PC12 cell damage. CDR1as promoted the phosphorylation level of GSK3ß in PC12 cells to cause cell damage; Ex-4 reversed the phosphorylation of GSK3ß caused by CDR1as in PC12 cells and reduced the PC12 cell damage caused by CDR1as. Ex-4 reverses the damage of PC12 cells induced by CDR1as/miR-671/GSK3ß signaling pathway.