Objective To investigate the roles of endoscopic biopsy and third ventriculostomy in the diagnosis and treatment of pineal region tumors in children. Methods Endoscopic biopsy and third ventriculostomy were performed in 9 pediatric patients with pineal region tumors. Results Successful third ventriculostomy, confirmed by MRI, was performed in 9 cases of children with obstructive hydrocephalus. No complications were found in all patients. Conclusion Endoscopic biopsy and third ventriculostomy are effective neuroendoscopic procedures in minimally invasive preferential management of pineal region tumors.

Objective To investigate the efficacy of microsurgery treatment with small craniotomy lateral fissure approach for hyperten-sive basal ganglia intracranial hemorrhage. Methods From December 2013 to February 2015, 30 patients with hypertensive basal ganglia intracranial hemorrhage ( blood loss within 30~60 mL) were analyzed respectively. Summarized the methods and techniques of this microsur-gery treatment and analyzed its advantages and disadvantages compared with the traditional operation. Results The hematomas were excluded more than 90% which were proved by reexamination after opreation. There was one case of temporal lobe infarction,but there was no re-bleed case and death case. The recovery of consciousness is good, and the limb function and language function were improved by early rehabilitation treatment. Conclusion Microsurgery treatment with small craniotomy lateral fissure approach for hypertensive basal ganglia intracerebral hemorrhage has the advantages of minimal invasion,complete hematoma removal and low complication and disability rates, which is worthy of promotion and application.

Objective: To analyze the clinical features and risk factors of ulcerative colitis (UC)complicated with Epstein-Barr(EB)-viremia and the effect of antiviral therapy on the remission of the symptoms. Methods: From April 2014 to January 2018, data of 239 UC patients hospitalized at the Department of Gastroenterology of Second Hospital of Hebei Medical University were collected. The patients were divided into EB-viremia group (trial group, n=43) and non-EB-viremia group (control group, n=196) according to EB virus-DNA detection. The general condition, clinical characteristics and therapeutic efficacy of the two groups were compared. The risk factors and the effect of antiviral therapy on the remission of symptoms of UC complicated with EB-viremia were analyzed. Chi-square test and logistic analysis were used for statistical analysis. Results: There were no significant differences in gender, age, clinical type, lesion range, the proportion of patients treated with 5-aminosalicylic acid or corticosteroids, the percentage of patients with diarrhea and bloody stool, the proportion of patients with spontaneous bleeding, platy ulcer and longitudinal ulcer under colonoscopy, the course of disease or Mayo score between the trial group and control group (all P>0.05). The proportions of patients with smoking history and severe disease, treatment with azathioprine and 6-mertocapurine (6-MP), treatrnent with infliximab, symptoms of fever or abdominal pain and deep and large ulcer under colonoscopy in the trial group were all higher than those in the control group, and the differences were all statistically significant (χ²=5.304, 6.608, 6.718, 6.939, 8.783, 4.493 and 5.425, all P<0.05). The results of multivariate logistic regression analysis showed that smoking history and treatment with azathioprine and 6-MP were risk factors of UC complicated with EB-viremia (OR=2.801 and 9.343, 95%CI 1.170 to 6.703 and 1.749 to 49.922, P=0.021 and 0.009). The improvement rates of the trial group and control group were 79.1%(34/43) and 95.4%(187/196), respectively. There was a significant difference in the improvement rate between the two groups (χ²=10.551, P=0.001). In the trial group, 12 patients (27.9%) received ganciclovir treatment, fonr patients (9.3%) had foscarnet sodium treatment, 21 patients (48.8%) were treated with the combination of these two medications and six cases (14.0%) did not received any antiviral treatment. After three weeks, the improvement cases of the above regimens were 8, 4, 16 and 6, respectively. There were no statistically significant differences in the improvement rate of patients with and without antiviral treatment, further more, no difference was found in the improvement rate of patients with different antiviral treatments (all P>0.05). Conclusions Smoking history and purine treatment are risk factors of UC complicated with EB-viremia.

Objective To investigate the expression of neuron-specific enolase(NSE) and bone morphogenic protein 4(BMP4) in different hippocampal areas of pentylenetetrazol(PTZ) kindled epilepsy rats and explore their relationship with the pathogenesis of epilepsy and brain injury.Methods Fifty male SD rats were divided into experimental group(n=40) and control group(n=10).The rats in experimental group were kindled into epilepsy by chemical method,and according to the kindling process,subdivided into four groups(grade Ⅰ,Ⅲ,Ⅳ,Ⅴ).Immunohistochemistry,in situ hybridization labeled with Dig-oligonucleotide probe and the image analyzing system were used to observe the expressions of NSE and BMP4 in rat hippocampus.Results In PTZ kindled epilepsy rats,the number of cells positive for NSE and BMP4 was increased in many regions of hippocampal formation.Compared with control group,the expressions of NSE and BMP4 in CA3 and DG was elevated obviously in the grade Ⅲ group and grade Ⅳ group(P

Objective: To explore the effects of macrophages with high expression of TL1A on the activation and proliferation of HSCs in vitro. Methods: The Bone marrow-derived macrophages (BMMs) and peritoneal macrophages (PMs) from wild type (WT) and myeloid-overexpressed TL1A transgenic mice were isolated, differentiated and activated. HSCs were harvested from activated macrophages culture supernatant (CM). HSCs were detected by immunofluorescence and real-time Q-PCR. And the proliferation was detected by CCK-8 and BrdU assay kit. The levels of IL-1β and PDGF-BB in macrophage culture supernatants were determined by enzyme-linked immunosorbent assay (ELISA). Results: BMMs-derived CM-intervention HSCs were used to detect the expression of α-smooth muscle actin (α-SMA) on the 2nd, 4th and 6th day respectively by immunofluorescence method. There was no significant difference between the two groups on the 2 nd and the 6th day, P > 0.05; On day 4, the CM/Tg group was significantly higher than that of CM/WT group, P < 0.01; the results of CMs derived from PMs were consistent with the above trend. The expression of α-SMA mRNA on the 2nd, 4th and 6th day was detected by real-time Q-PCR method using BM-derived CMs. No significant difference was found between the groups on the 2nd day (P > 0.05).α-SMA mRNA increased further on the 4th and 6th day, and the level of CM/Tg in CM/Tg group was significantly higher than that in CM/WT group (P < 0.05). The detection results of CMs derived from PMs were consistent with the above trend. The results of CCK-8 assay and BrdU assay showed that the proliferation rate of HSCs in CM Tg group was significantly higher than that in CM/WT group (P < 0.01). The CMs derived from PMs were used to interfere with HSCs. And the results were consistent with the above trend. For BMMs, the levels of IL-1β and PDGF-BB in the lipopolysaccharide (LPS) + IFNγ/Tg culture supernatant were significantly higher than those in the LPS+IFNγ/WT group (P < 0.01). For the culture supernatants of PMs Liquid test results consistent with the above trend. Conclusion Macrophages with high expression of TL1A could enhance the activation and proliferation of HSCs by increasing the secretion of IL-1β and PDGF-BB.

Objective:To explore the differences of attention bias performance between patients with heroin dependence in methadone maintenance treatment(MMT) and healthy controls.Methods:A total of 38 heroin dependent patients in the Fourth People's Hospital of Huainan from January 2018 to September 2018 were selected as MMTgroup, and 32 gender-and age-matched healthy controls were selected as healthy control(HC) group.The attention bias was evaluated by Emotional Stroop Task, and the difference between the two groups was compared.Results:The error number of the herion-related words in Emotional Stroop Task of MMT group was lower than that of HC group[0.75(2, 5) vs.1(0, 2)], the difference was statistically significant( Z=-2.184, P=0.029). The number of errors in point and neutral words and reaction time of point, neutral word and clue word had no statistically significant differences between MMT group and HC group[1(0, 4) vs.1(0, 2); 3(2, 5) vs.2(2, 3); (1 055.14±303.50)ms vs.(985.40±173.71)ms, (1 126.89±347.82)ms vs.(1 022.76± 173.62)ms; (1 188.53±371.80)ms vs.(1 113.23±225.11)ms]( Z=-1.331, P=0.183; Z=-1.723, P=0.085; t=1.150, P=0.254; t=1.539, P=0.129; t=1.001, P=0.320). There were no statistically significant differences in attention bias influenced by the dosage and duration of methadone between MMT group and HC group(all P>0.05). Conclusion:These results demonstrate that heroin dependence patients in MMT have attentional bias in heroin-related words.Methadone has no effect on attention bias in patients with heroin dependence during maintenance treatment intervention.

Objective To investigate the effects of tumor necrosis factor-related ligand-1A(TL1A)on activation of T helper 9(Th9)cells of colonic tissues in chronic experimental colitis mice.Methods The chronic experimental colitis mice model was established with drinking dextran sulfate sodium salt(DSS).A total of 32 lymphocytes TL1A highly expressed mice and wild type(WT)mice were divided into WT control group, transgene control group,WT modeling group and transgene modeling group.The mice of control groups were administrated with distilled water. The mice of modeling groups received 3% DSS in drinking water discontinuously.The mice were sacrificed on 29 days after modeling.Body mass was measured,length of colon was recorded,scores of gross colon and the disease activity index(DAI)were calculated.The colonic morphological changes were observed by hematoxylin-eosin(H-E)staining.The lamina propria mononuclear cells(LPMC)were isolated and the number of Th9 cells was tested by flow cytometry.The levels of interleukin-9(IL-9)in serum and LPMC were detected by enzyme-linked immunosorbent assay(ELISA).The expressions of IL-9 protein and mRNA of the colonic tissues were measured by Western blotting and real-time polymerase chain reaction(PCR),respectively.T test and single factor analysis of variance were performed for statistical analysis.Results The percentage of body mass loss of WT modeling group was lower than that of transgene modeling group(16.2% ± 1.0% vs 18.9% ± 1.2%),and the difference was statistically significant(t=4.90, P<0.05).The scores of gross colon,DAI and pathology of transgene modeling group were all higher than those of WT modeling group(2.80 ± 0.64 vs 1.60 ± 0.31,2.55 ± 0.20 vs 1.58 ± 0.17,and 11.85 ± 0.86 vs 9.50 ± 0.79),and the differences were statistically significant(t=4.77,10.45 and 5.69,all P<0.05).The number of LPMC in transgene modeling group was higher than that of WT modeling group(3.70×106± 0.28×106vs 2.65×106± 0.32 × 106)and the difference was statistically significant(t= 6.98,P< 0.05).The percentage of Th9 in total CD4+T cells of LPMC in colonic tissues of transgene modeling group was higher than that of WT modeling group(0.54% ± 0.04% vs 0.23% ± 0.03%),and the difference was statistically significant(t= 17.54,P< 0.05).The serum IL-9 level of transgene modeling group was higher than that of WT modeling group((170.23 ± 5.69)pg/mL vs(150.62 ± 6.45)pg/mL),and the difference was statistically significant(t= 6.50,P< 0.05).The level of IL-9 secreted by LMPC of transgene modeling group was higher than that of WT modeling group((265.21 ± 8.76)pg/mL vs (237.58 ± 10.24)pg/mL),and the difference was statistically significant(t= 5.80,P< 0.05).The expressions of IL-9 protein and mRNA of transgene modeling group were higher than those of WT modeling group(1.31 ± 0.09 vs 1.18 ± 0.03,and 8.26 ± 1.13 vs 2.25 ± 0.29,respectively),and the differences were statistically significant(t=3.88 and 14.57,both P< 0.05).Conclusion TL1A high expression in lymphocytes can promote Th9 cells differentiation and IL-9 secretion which involved in the genesis of chronic experimental colitis.

Objective: To analyze the consistency of gastroscopic biopsy in the diagnosis of high grade intraepithelial neoplasia(HGIN) and postoperative pathological diagnosis, and explore the risk factors associated with missed diagnosis of HGIN. Methods: From January 2012 to December 2018, the clinical data of 63 patients who were diagnosed with HGIN by gastroscopic biopsy prior to operation and underwent complete resection in the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were retrospectively analyzed. There were 55 males and 8 females, with a median age of 60 (35 to 76) years old. The gender, age, endoscopic lesion shape, longest diameter, CT image and inflammatory markers were analyzed, to investigate the correlation between them and pathological upgrading after operation. Receiver operating characteristic (ROC) curve was drawn to analyze the cut off value of measurement data, and the comparison of count data was performed by chi-square test or Fisher exact probability method. Univariate analysis was used to screen potential risk factors, and multivariate logistic regression analysis was futher utilized to analyze the independent risk factors of postoperative pathological upgrading. Results: A total of 63 patients were enrolled, including 47 cases underwent surgical resection and 16 cases underwent endoscopic submucosal dissection(ESD). Among them, 19 patients(30.2%) were pathologically diagnosed with HGIN, while 44 patients(69.8%) were pathologically diagnosed with invasive cancer after resection. Preoperative contrast-enhanced CT showed that 11 patients(17.5%) with perigastric fat spiculation around the lesion, all of which were confirmed as invasive carcinoma after operation. Univariate analysis showed that the longest diameter of the lesion ≥2 cm (P=0.002), ulcer lesions under gastroscopy (P=0.013), platelet to lymphocyte ratio (PLR) ≥103 (P=0.030), lymph node enlargement (P=0.046) and spiculation of the perigastric fat (P=0.025) were significant differences between the groups. Logistic regression analysis showed that the longest diameter of the lesion ≥2 cm (P=0.033) and ulcer lesions under gastroscopy (P=0.007) were independent risk factors for predicting postoperative pathological upgrading. Conclusions Gastroscopy biopsy in the diagnosis of high-grade intraepithelial neoplasia of the stomach has poor consistency with pathological diagnosis after operation. Clinicians should take active surgical intervention, especially for cases with the longest diameter of the lesions ≥2 cm, ulcer or perigastric fat spiculation on CT.

Objective:To explore the risk factors, clinical features, endoscopic characteristics and the efficacy of antiviral therapy in ulcerative colitis (UC) patients complicated with cytomegaloviremia (CMV) and Epstein-Barr (EB) viremia.Methods:From April 1, 2014 to January 31, 2019, at The Second Hospital of Hebei Medical University, a total of 320 UC patients hospitalized at the Department of Gastroenterology were enrolled. According to the pathogens, the patients were divided into four groups: complicated with CMV and EB viremia group ( n=35), only complicated with CMV viremia group ( n=33), only complicated with EB viremia group ( n=52) and without CMV and EB viremia group ( n=200). Clinical features and the efficacy of antiviral therapy of the patients were retrospectively analyzed. Multivariate logistic regression was used to analyze the risk factors of UC complicated with CMV and EB viremia. Kruskal-Wallis H test, Chi-square test and Fisher exact test were used for statistical analysis. Results:The proportion of patients of age>60 years old (42.86%, 15/35), the rate of glucocorticoid use (51.43%, 18/35) within three months before onset and the inefficacy rate of glucocorticoid treatment (22.86%, 8/35) of UC complicated with CMV and EB viremia group were all higher than those of UC without CMV and EB viremia group (14.00%, 28/200; 24.50%, 49/200; 1.00%, 2/200), and the differences were statistically significant ( χ2=17.062, 10.598 and 29.769; all P<0.01). However, there were no statistically significant differences between UC complicated with CMV and EB viremia group and UC without CMV and EB viremia group in gender, and treatment of 5-aminosalicylic acid (5-ASA), azathioprine and infliximab within three months before onset (all P>0.05). The proportion of patients with fever (54.29%, 19/35), abdominal pain (91.43%, 32/35), hematochezia (94.29%, 33/35), weight loss (28.57%, 10/35), severe disease activity (94.29%, 33/35), total colon involvement (91.43%, 32/35), serum albumin less than 30 g/L (71.43%, 25/35) and hemoglobin less than 100 g/L (48.57%, 17/35) of UC complicated with CMV and EB viremia group were all higher than those of UC without CMV and EB viremia group (13.50%, 27/200; 43.00%, 86/200; 44.00%, 88/200; 13.50%, 27/200; 38.00%, 76/200; 65.00%, 130/200; 18.00%, 36/200 and 18.50%, 37/200), and the differences were statistically significant ( χ2=31.475, 27.945, 32.930, 5.100 and 40.194, Fisher exact test, χ2=44.242 and 15.220, all P<0.01). However, there were no statistically significantl differences in clinical classification and disease course (all P>0.05). The incidence rates of deep ulcer (45.71%, 16/35), irregular ulcer (42.86%, 15/35) and longitudinal ulcer (8.53%, 3/35) under endoscopy of UC complicated with CMV and EB viremia group were significantly higher than those of UC without CMV and EB viremia group (1.50%, 3/200; 3.50%, 7/200 and 1.00%, 2/200), and the differences were statistically significant ( χ2=72.521 and 49.837, Fisher exact test, all P<0.01). The incidence rates of deep ulcer and irregular ulcer under endoscopy of UC complicated with CMV and EB viremia group were higher than those of UC only complicated with EB viremia group (15.38%, 8/52 and 11.54%, 6/52), and the differences were statistically significant ( χ2=9.663 and 11.206, P=0.002 and 0.001). The results of Multivariate Logistic regression analysis showed that severe disease activity, serum albumin level less than 30 g/L, and deep ulcer and irregular ulcer under endoscopy were risk factors of UC patients complicated with CMV and EB viremia (odds ratio=48.519, 44.352, 53.432 and 39.989, 95% confidence interval 9.057 to 587.669, 4.499 to 437.245, 3.302 to 864.670 and 3.418 to 467.910, all P<0.05). The improvement rate of antiviral therapy in UC complicated with CMV and EB viremia group (73.53%, 25/34) was significantly lower than those of UC only complicated with CMV group (96.88%, 31/32) and UC only complicated EB viremia group (95.65%, 44/46), and the differences were statistically significant ( χ2=6.989 and 6.310, P=0.008 and 0.012). Conclusions:UC patients with severe disease activity, serum albumin level less than 30 g/L, and deep ulcer and irregular ulcer under endoscopy are more likely to develop CMV and EB viremia. The more severe the disease, the worse the treatment response, so it is necessary to strengthen the screening to CMV and EB virus infection in UC patients.

Objective: To explore the correlation between different nutritional status and depressive symptoms among adolescents, so as to provide a theoretical basis for targeted improvement of nutritional status and depressive symptoms in adolescents. Methods: A total of 8 102 adolescents aged 12-17 years in Shanghai, Urumqi, Changsha and Kunming were selected by random cluster sampling. Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression Scale(CES-D). Height and weight were measured. Kruskal Wallis H test, Chi square test and ordinal Logistic regression were used to analyze the relationship between nutritional status and depressive symptoms in adolescents. Results: The overall detection rate of depressive symptoms in adolescents was 25.6%, with girls (30.1%) higher than that of boys (21.1%) ( χ 2=87.60, P <0.01). There were statistically significant differences in the scores of depressive symptoms among girls with different nutritional status ( Z =8.34, P <0.05). The detectable rate of depressive symptoms increased with BMI among girls( χ 2 trend =6.04, P <0.05). After controlling for confounding factors, ordinal Logistic regression showed that the obese girls had higher risks in depressive symptoms detection compared with normal weight girls ( OR=1.45, 95%CI=1.10-1.91, P <0.05). Conclusion The nutritional status of girls is better than boys, but the prevalence of depressive symptoms is higher than boys. The risk of depressive symptoms in girls increases with BMI.