[ ABSTRACT] AIM:To observe the effect of ursodeoxycholic acid ( UDCA) on the treatment of infantile hepatitis syndrome ( HIS) and to investigate its mechanism.METHODS:The children with infantile hepatitis syndrome were divid-ed into conventional treatment group and the UDCA treatment group.Twenty healthy children were selected as normal con-trol.The children in conventional therapy group were given antiviral and hepatoprotective treatments.The children in UD-CA treatment group were given ursodeoxycholic acid (10 mg? kg-1? d-1 ) in addition to the conventional treatment group for 2 to 3 weeks.The levels of total bilirubin (TBIL), direct bilirubin (DBIL), alanine aminotransferase (ALT), glu-tamyltransferase ( GGT) , total bile acids ( TBA) and TNF-α, IL-6 were detected before admission and 2 weeks later.RE-SULTS:The levels of TNF-αand IL-6 were significantly higher in the children with IHS than those in the normal control (P<0.01).The levels of TBIL, DBIL, ALT, GGT, TBA, TNF-αand IL-6 in conventional treatment group were reduced after therapy (P<0.01).All the above index in UDCA treatment group were decreased compared with conventional treat-ment group (P<0.01).CONCLUSION:On the basis of conventional therapy, ursodeoxycholic acid effectively alleviates the systemic inflammatory response in the children with IHS, reduces the liver damages.

Objective To observe the effect of Danshen in the treatment of severe hand-foot-and-mouth disease and investigate its mechanism.Methods One hundred and forty cases of children with severe hand foot and mouth diseases who hospitalized the intensive care unit were enrolled in the study from February 2012 to July 2014.The children were randomly divided into a control group and an observation group,with 70 cases in each group.The control group was given antiviral to reduce the intracranial pressure and intravenous immunoglobulin and the observation group was given Danshen in addition to the control group.The levels of neuron specific enolase (NSE)、S-100βprotein、TNF-α and IL-6 were detected at admission and checked again seven days after treatment.The changes of the above indicators and the clinical curative effect were compared before and after therapy.Results The total effective rate of the control group and the observation group was 80.0% and 92.9% respectively,showing statistical significance(P<0.05). After treatment, observation group of serum NSE (9.42 ± 2.56μg/Lvs. 11.71 ± 3.21μg/L,t=2.159), S-100β (177.34 ± 87.28 ng/Lvs. 286.14 ± 159.69 ng/L, t=2.315), TNF-α (15.98 ± 4.35 ng/Lvs. 23.17 ± 4.80 ng/L, t=4.297), IL-6 (41.72 ± 6.64 ng/Lvs. 52.05 ± 9.33 ng/L,t=3.492) , the level of were lower than those in the control group(P<0.05 orP<0.01). In the observation group, serum. The fever clearance time、the disappearance time of rash and the hospitalization time in the observation group (3.55 ± 1.02 d vs.4.55 ± 1.09 d, 7.14 ± 1.04 d) were shorter than those in the control group (4.46 ± 0.97 d vs.5.88 ± 1.44 d, 8.68 ± 1.06 d;t=5.409, 6.161, 8.677 respectively, P<0.01).Conclusions On the basis of conventional therapy,Danshen can effectively alleviate the systemic inflammatory response in children with severe hand foot and mouth diseases, reduce brain damage and improve the clinical efficacy.

Objective:To obtain the normal reference range of ultrasound hemodynamic parameters after liver transplantation through big data query and statistical analysis, and to analyze its influencing factors.Methods:The clinical liver transplantation Ultrasound Image Database Software V1.0 developed by Tianjin First Center Hospital was used to query adult patients after liver transplantation from December 2012 to June 2021. The ultrasonic hemodynamic parameters including the diameter of portal vein (PVD), the flow velocity of portal vein (PVV), the peak flow velocity of hepatic artery (S), the end diastolic flow velocity of hepatic artery (D), the S/D of hepatic artery, the resistance index of hepatic artery (RI), the diameter of middle hepatic vein (MHVD), the flow velocity of middle hepatic vein (MHVV), the diameter of right hepatic vein (RHVD), the flow velocity of right hepatic vein (RHVV), in the first day (1D), the seventh day (7D), the first month (1M), the sixth month (6M), the first year (1Y), the fifth year (5Y) and the tenth year (10Y) after operation were analyzed statistically, and the 95% reference value range of each parameter was obtained.Results:A total of 1 740 patients with 12 242 monitoring results after adult liver transplantation were included, and the longest follow-up time was 22 years. There was no significant change in PVD. PVV decreased slightly from postoperative 1D to long-term follow-up. The S and D of hepatic artery were the highest in group 7D after liver transplantation, and then decreased gradually with the extension of postoperative time. Hepatic artery S/D was the lowest in group 7D after operation, with the extension of monitoring time after liver transplantation, it showed an upward trend, but fluctuated. Hepatic artery RI was the highest in postoperative 1D group, and fluctuated with the extension of monitoring time after liver transplantation. There was no significant change in MHVD and RHVD.MHVV and RHVV were the highest in group 7D after liver transplantation, with the extension of postoperative monitoring time, they showed a decreasing trend and fluctuated. The normal range of each parameter was estimated according to the range of 95% medical reference value. The influencing factors of blood flow monitoring of transplanted liver were analyzed, including the various factors in perioperative period, the surgery, the primary disease before operation, the source of donor, the postoperative infection, rejection, drug damage, individual differences and so on.Conclusions:This study obtains the trend of each parameter with the extension of follow-up time and the reference value range of each parameter after liver transplantation, which is of great clinical significance for early detection and diagnosis of postoperative vascular complications. However, the blood flow after adult liver transplantation is affected by many factors. In clinical monitoring, it is necessary to make judgment combined with the individual state of patients and conduct dynamic follow-up.

Objective:To investigate the relationship between YES-related protein 1(YAP1)and prostate-specific antigen(PSA)in human castration-resistant prostate cancer(CRPC), and explore the regulation mechanism of YAP1 on PSA.Methods:The luciferase reporter gene was used to detect the activity change of the PSA gene promoter region after the over expression of YAP1 in LNCaP and C4-2 cells.The effect of over expression of YAP1 gene on PSA protein in different prostate cancer cell lines was detected by Western blot(WB)method, and the effect of YAP1 silencing on PSA protein in C4-2 cells was observed.The Q-PCR method was used to further verify the expression change of PSA mRNA affected by YAP1 gene over expressed in C4-2 cells.Meanwhile, WB was used to explore the effect of YAP1 on androgen receptor(AR)in C4-2 cells.Results:After over expression YAP1 in CRPC, the luciferase experiment showed that the average C4-2 cell ratio of experimental group to control group was 3.17815892(>2 times, P<0.001). After Q-PCR detection of all over-expressed YAP1 gene fragments, the measured PSA mRNA values in the experimental groups were 2.306667, 1.553333333, 2.613333333, and 2.673333333, respectively, which were higher than those in the control group(1 time, P<0.001), indicating that the PSA expression was significantly increased.WB analysis showed that after C4-2 cells over expressed YAP1, the AR band was significantly enhanced in the experimental group compared with the control group, suggesting that the AR protein expression in the nucleus was significantly increased in the YAP1 over expression group. Conclusions:YAP1 might positively regulate the PSA expression in CRPC and have an ability to promote AR translocation into the nucleus.

Objective:To investigate the correlation between Doppler ultrasound parameters and pressure gradient of portal vein in pediatric liver transplant patients, and to analyze the diagnostic value of Doppler ultrasound for portal vein stenosis.Methods:This retrospective study involved the data from 92 pediatric liver transplant patients in Tianjin First Central Hospital from June 2014 to September 2021, who underwent pressure gradient measurement. The collected ultrasonic parameters included the diameter and flow velocity of the native portal vein, the portal vein anastomosis, and the donor portal vein. The anastomotic stenosis rate=(the native portal vein diameter–the portal vein anastomosis diameter)/the native portal vein diameter, the velocity ratio=the portal vein anastomosis velocity /the native portal vein velocity, the velocity difference=the portal vein anastomosis velocity–the native portal vein velocity. According to the diagnostic standard of portal vein stenosis, pressure gradient more than 5 mmHg was the portal vein stenosis group, and the pressure gradient less than 5 mmHg was the non-stenosis group. The correlation and differences between ultrasonic parameters and pressure gradient were analyzed. ROC curve was used to evaluate the diagnostic efficiency of each parameter.Results:Firstly, there was a positive correlation between pressure gradient and the portal vein anastomosis velocity, the velocity difference and the velocity ratio ( r=0.521, 0.531, 0.417; all P<0.001). And there was a negative correlation between pressure gradient and the anastomotic diameter ( r=-0.284, P=0.004). Secondly, the portal vein anastomotic velocity, velocity difference and velocity ratio in stenosis group were significantly higher than those in non-stenosis group [135.5(111.0, 169.0)cm/s vs 103.7(72.9, 118.7)cm/s, (112.2±40.3)cm/s vs (67.9±30.5)cm/s, 5.56(3.73, 7.26) vs 3.85(2.78, 4.70); all P≤0.001]; Furthermore, by ROC curve analysis, the cut-off value, the area under the ROC curve, Jordan index, accuracy, sensitivity and specificity of each parameter for the diagnosis of portal vein stenosis were: the anastomotic velocity 124.5 cm/s, 0.814, 0.592, 80.0%, 65.5% and 93.7%; velocity ratio 5.67, 0.760, 0.488, 73.0%, 48.8% and 100%; velocity difference 107.25 cm/s, 0.797, 0.511, 76.0%, 51.9% and 100%. Conclusions:The anastomosis velocity, velocity difference and velocity ratio of portal vein in pediatric liver transplant patients are correlated with the pressure gradient, and there is higher accuracy and specificity of each parameter for diagnosing portal vein stenosis, but the sensitivity is slightly lower.

Objective To investigate the application value of the tissue diffusion quantitative analysis technique of real-time elastic( RTE) imaging in evaluation of liver damage caused by brain death . Methods Fifty cases of brain dead donor liver were examined by ultrasound elastography ,at the same time , 11 parameters were obtained by the tissue dispersion quantitative analysis software ,included MEAN ( mean relative strain value within the ROI) ,SD( standard deviation of the relative strain value within the ROI) ,％AREA (area of low strain within the ROI) ,COMP(complexity of low strain area within the ROI) ,KURT (kurtosis) ,SKEW(skewness) ,CONT (contrast) ,ENT(entropy) ,IDM(inverse difference moment) ,ASM (angular second moment) ,CORR(correlation) ,and the pathologic specimens in the process of operating were obtained . According to pathological findings ,50 patients were divided into damaged group and non-damaged group ,and the results were compared and analyzed . The correlation analysis of electronic speculum results and RTE were carried out . According to the ROC curve ,the RTE parameters'cut-off value and AUC were obtained .Results Among 11 parameters of tissue diffusion analysis ,MEAN and IDM in damaged group were higher than those in non-damaged group( all P < 0 .05) ;and SKEW and ENT were lower in damaged group than those in non-damaged group ( all P <0 .05) ;there was no significant difference in the other parameters between the two groups(all P >0 .05) . The MEAN ,SKEW ,COMP ,ENT and IDM had correlativity with electronic speculum( r = -0 .633 , P =0 .000 ;r =0 .388 , P =0 .005 ;r =0 .315 , P =0 .026 ;r = 0 .324 , P = 0 .022; r = -0 .314 , P = 0 .026 ,respectively ) . The diagnostic efficiency and sensitivity of MEAN were the highest , the critical value of MEAN was 125 .84 , AUC was 0 .907 . Conclusions The tissue dispersion quantitative analysis technique is a noninvasive method to preliminary evaluation of liver damage caused by brain death . M EAN had the highest effectiveness in eleven parameters .

Objective:To explore the characteristics of postoperative hemodynamic changes in patients with early allograft dysfunction (EAD), and to provide clinical imaging support for the early diagnosis of EAD.Methods:A total of 907 patients who underwent liver transplantation in Tianjin First Central Hospital from December 2012 to June 2021 were retrospectively selected, and they were divided into EAD group (361 cases) and non-EAD group (546 cases) according to EAD diagnostic criteria. The peak systolic velocity(PSV) of the hepatic artery, end-diastolic velocity(EDV) of the hepatic artery, resistance index(RI), S/D(PSV/EDV), diameter of the portal vein(PVD), velocity of the portal vein(PVV), diameter of the middle hepatic vein(MHVD), velocity of the middle hepatic vein(MHVV), the diameter of the right hepatic vein(RHVD), and the velocity of the right hepatic vein (RHVV) were collected from 1 to 7 days after operation (a total of 5 573 ultrasound examination results), and the differences in ultrasound hemodynamic parameters were compared between the two groups. The correlation of S/D<2, PSV<25 cm/s, PVV<15 cm/s, MHVV or RHVV<15 cm/s within 3 days after operation with the occurence of EAO were analyzed by multivariate Logistic regression analysis.Results:①The PSV and EDV of the hepatic artery in the EAD group and the non-EAD group showed a slow upward trend at 1-7 days after operation, while the hepatic artery RI and PVV showed a downward trend, the MHVV and RHVV did not fluctuate significantly. ②The hepatic artery in the EAD group showed low-resistance blood flow in the early postoperative period, and the EDV were significantly higher than that in the non-EAD group on 1 d, 2 d, 3 d and 5 d, RI was significantly lower than that of the non-EAD group (all P<0.05); At 4 d, 6 d and 7 d, there was no significant differences of EDV and RI between the two groups(all P>0.05). The PSV of the EAD group was higher than that of the non-EAD group on 3 d ( P<0.05). Among the parameters of portal vein blood flow, the PVV in the EAD group was significantly higher than that in the non-EAD group on 1 d ( P<0.05), and there was no significant difference of PVD between the two groups at day 1-7. Among the parameters of hepatic venous blood flow, the MHVV and RHVV in the EAD group were significantly lower than those in the non-EAD group (all P<0.05), there was no significant difference between the two groups of MHVD and RHVD at 1-7 days. ③The incidence of grafted hepatic artery S/D<2 within 3 days after operation in EAD group was higher than that in non-EAD group. Binary Logistic regression multivariate analysis showed that the occurrence of grafted hepatic artery S/D<2 within 3 days after operation was significantly correlated with the occurrence of EAD[Exp(B)=1.878, P<0.05]. Conclusions:Patients who develop EAD after liver transplantation show low-resistance blood flow in the hepatic artery during the perioperative period, and the occurrence of hepatic artery S/D<2 within 3 days after operation can early predict the occurrence of EAD.

Objective:To identify the risk factors for supine hypotension syndrome (SHS) after spinal anesthesia and establish a predictive model in parturients.Methods:The medical records from pregnant women undergoing elective cesarean section were retrospectively analyzed. According to the standard that SBP dropped by 30 mmHg or below 80 mmHg after spinal anesthesia, the parturients were divided into non-SHS group and SHS group. The general data from patients and difference of external iliac vein flow (ΔIVF) during postural changes before anesthesia were collected. The factors with statistically significant differences between groups were included in the logistic regression model, the risk factors were identified and the weighted score regression prediction model was established, and the receiver operating characteristic curve was drawn to evaluate the model.Results:There were 64 parturients developed SHS after spinal anesthesia, with an incidence of 54.7%. Logistic regression analysis showed that fetal abdominal circumference, amniotic fluid index, ΔIVF and consumption of norepinephrine were independent risk factors for SHS after spinal anesthesia. The area under the receiver operating characteristic curve was 0.983, 95% confidence interval was 0.968-0.999, the sensitivity was 90.6%, the specificity was 96.2%, and the Youden index was 0.868. The prediction model of the line chart was tested by Hosmer-Lemshow, P=0.984, and the C index visualized the line chart model was 0.983. Conclusions:Fetal abdominal circumference, amniotic fluid index, ΔIVF and consumption of norepinephrine are independent risk factors for SHS after spinal anesthesia in parturients, and the risk prediction model can effectively predict the occurrence of SHS after spinal anesthesia.

Objective To measure the air-absorbed dose rate of gamma radiation in public areas for the situation of the local radiation environment. Methods Using a large-volume γ spectrometer system with a NaI(Tl) detector mounted on a UAV, we conducted large-scale airborne radiation monitoring in public areas in southwestern China, to measure the air-absorbed dose rate at a height of 1 m from the earth’s surface. Results The airborne radiation monitoring data were used to analyze the local radiation environment. The mean air-absorbed dose rate at a height of 1 m was 43.6 ± 12.9 nGy/h. Seven abnormal radiation points were detected, and two of them were located where construction was ongoing. At one of the abnormal radiation points, FH40G meter measurements showed that the air-absorbed dose rate at a height of 1 m was up to 22.0 μGy/h. Field soil samples were collected for HPGe γ spectrometer analysis: the ²³²Th radionuclide activity concentration was 96.0 kBq/kg, and the ²²⁶Ra radionuclide activity concentration was 9.9 kBq/kg. Conclusion Using the UAV-mounted large-volume γ spectrometer system with NaI(Tl) detectors for large-scale airborne monitoring is a fast and effective method for dragnet monitoring of the level of radiation in public areas.