Objective To investigate the application of ultrasound and blood indicators in diagnosis of early liver cirrhosis (S4) for patients with chronic hepatitis B (CHB).Methods Data of blood and ultrasound examinations of 631 patients with CHB who received liver biopsy in the Sixth People' s Hospital of Shenyang during April 2002 and March 2011 were collected.Logistic regression analysis was performed to determine the factors independently correlated with early liver cirrhosis,and the diagnostic model was established using these indicators.The diagnostic value of the established model was assessed by using area under receiver operating characteristic curve (AUROC) and compared with FIB-4 index,aspartate aminotransferase (AST)/platelet (PLT) ratio index (APRI) and S index.Results Logistic regression analysis indicated that age,PLT,albumin globulin ratio (A/G) and splenic square area (SPS) in ultrasound findings were independently correlated to early liver cirrhosis (Wald =10056,46.236,3.751 and 10.669,P ＜0.01).AUROC of the model based on the above factors in diagnosing early liver cirrhosis was 0.908,which was higher than those of FIB-1 index,APRI index and S index (Z =8.322,4.334 and 4.087,P ＜ 0.05).Taking 0.063 as cut-off value,the sensitivity,specificity,positive predict value and negative predict value of the established model in diagnosis of early liver cirrhosis were 90.1％,77.8％,50.0％ and 97.1％,respectively.Taking ＜0.060 and ≥0.110 as the cut-off values to exclude,and diagnose early liver cirrhosis,69.7％ (440/631) patients could avoid liver biopsy.Conclusion The model based on age,PLT,A/G and SPS can effectively predict early liver cirrhosis,and can reduce liver biopsy.

Objective To evaluate VITEK2 Advanced Expert System (AES) for detection and analysis of clinically important beta-lactam phenotypes.Methods 124 known resistant phenotype strains including Staphylococcus spp, E.coli, Klebsiella spp. and Ent. cloacae were tested by VITEK2 AES. Results The resistant phenotypes for methicillin susceptible, and resistant Staphylococcus spp, producing ESBL E. coli, Klebsiella spp. and Ent. cloacae isolates, and inducible AmpC and hyperproduced AmpC Ent. cloacae isolates can be accurately identified by VITEK2 AES. The most Ent. cloacae strains for both producing ESBLs and hyperproduced AmpC were partially identified.Conclusion VITEK2 AES can be accurately identified most clinically important beta-lactam phenotypes and suggested additional therapeutic correction based on phenotype. Certain problems for Ent. cloacae in the study should be remediable with further work on AES.

AIM:To determine the effects of different-term streptozotocin(STZ)-induced diabetes on ischemia/reperfusion(I/R)injury and cell apoptosis in rats myocardial via alterations in myocardial peroxynitrite.METHODS:The models of I/R injury were induced by occlusion and reperfusion of the left descending coronary artery(LDCA)in rats.I/R-induced infarct size was determined using triphenyltetrazolium chloride(TTC)staining.Quantified caspase-3 expression was used to represent apoptosis by Western blotting analysis.Peroxynitrite formation as indicated by nitrotyrosine level was measured by morphometric analysis.RESULTS:Two weeks after STZ treatment,infarct size(35.00%?3.00%)was smaller in 2 weeks diabetic hearts(2WKD)as compared with time-matched control group(2WKC)(51.00%?3.30%),whereas after 16 weeks of diabetes(16WKD),the infarct size(61.00%?3.00%)was bigger in the diabetic hearts as compared with the 16WKC group(50.00%?2.00%,P

Objective To investigate the effect of kinesio taping on upper crossed syndrome (UCS). Methods From December, 2016 to March, 2017, 52 patients with UCS were randomly divided into control group (n=26) and observation group (n=26). The control group re-ceived exercise therapy, and the observation group received kinesio taping in addition, for four weeks. They were assessed with Visual Ana-logue Scale (VAS), forward head angle (FHA) and forward shoulder angle (FSA). Results There was no significant difference in the score of VAS, FHA and FSA between two groups before treatment (P>0.05). After treatment, the scores of VAS, FHA and FSA significantly de-creased (t>2.804, P<0.05), and they were less in the observation group than in the control group (t>2.632, P<0.05). Conclusion Exercise therapy could relieve pain and correct abnormal posture of UCS, which is more effective combined with kinesio taping.

Objective:To prepare and identify the mouse anti-human monoclonal antibodies ( mAbs) using leukocytes as im-munogens. Methods: The mice were immunized using human peripheral blood leukocytes. Then, use of B lymphocyte hybridoma technology preparation of mAbs,followed screening by immunocytochemistry and limited dilution. The secreted mAbs were identified by immunoprecipitation,mass spectrometry,Western blot,ELISA and immunohistochemistry. Results:The 35 positive polyclonal cells were obtained,of which 11 strains secreted mAbs against S100A9. And one strain was used to prepare monoclonal antibody. The purified mAb against S100A9 were purified and identified as IgG1 subtype,with the titer,purity and affinity constant was 1∶3. 18×105,95% and 3. 54×108 L/mol,respectively. This mAb generally had 0. 12% crossed reactivity to S100A8 ,and showed little or no cross reactivity to S100A12 and S100A13. The prepared monoclonal antibodies can specifically recognizes the S100A9 antigen in human breast cancer tissues. Conclusion:Successful preparation of mAb against S100A9,which can secrete specific mAb against S100A9 protein with high titers and specificity have been established successfully,which laid the foundation for the immunology application.

Objective To investigate the influencing factors of mycoplasmal pneumonia(MPP)with pleural effusion in children.Methods A total of 168 children with MPP admitted to Jinhua People's Hospital from January 2021 to November 2023 were selected and divided into non-pleural effusion group(115 cases)and pleural effusion group(53 cases)according to imaging results.Basic information,laboratory indicators and chest imaging results were collected.Multivariate Logistic regression analysis was used to explore the influencing factors of pleural effusion in MPP children.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficiency of laboratory indicators.Results The platelet count,interleukin(IL)-10 and IL-4 of children in pleural effusion group were significantly lower than those in non-pleural effusion group,C-reactive protein(CRP),procalcitonin,lactate dehydrogenase,D-dimer,glycosaminoglycan(GAG),IL-17 and interferon-γ(IFN-γ)were significantly higher than those in non-pleural effusion group(P＜0.05).Multivariate Logistic regression analysis showed that CRP,lactate dehydrogenase,D-dimer,GAG,IL-17,IL-4 and IFN-γ were independent influencing factors of pleural effusion in MPP children(P＜0.05).ROC curve analysis results showed that the areas under the curve of GAG,IFN-γ,D-dimer,CRP,IL-4,lactate dehydrogenase and IL-17 predicting pleural effusion in MPP children were 0.954,0.824,0.813,0.786,0.765,0.732 and 0.727,respectively.The sensitivity(96.4％),specificity(93.1％)and accuracy(95.4％)of serum GAG were the highest.Conclusion Serum CRP,lactate dehydrogenase,D-dimer,GAG,IL-17,IL-4 and IFN-γ are all independent influencing factors for pleural effusion in MPP children,and have certain diagnostic value for pleural effusion in MPP children.

Objective To evaluate the correlation and consistency between an artificial intelligence(AI)bone mineral density(BMD)measurement system based on 3D-Densenet neural network technology and quantitative computed tomography(QCT)in measuring BMD,as well as to assess its effectiveness in diagnosing osteoporosis(OP).Methods A total of 1 201 participants who underwent low dose computed tomography(LDCT)were retrospectively included.The AI BMD measurement system and QCT were utilized to measure the BMD of T12,L1,L2 vertebrae,and the average BMD.Consistency and correlation of BMD measurements between the two methods were assessed using Bland-Altman,Pearson,and Kappa analyses.With QCT results as the reference standard,the receiver operating characteristic(ROC)curve was drawn to evaluate the accuracy of AI BMD measurement system in diagnosing OP.Results The r and r2 for the average BMD measured by the two methods were 0.997 and 0.993,respectively.The Kappa value for the diagnosis of normal BMD,low bone mass,and OP using the AI BMD measurement system was 0.905.The area under the curve(AUC)for diagnosing OP using the AI BMD measurement system was 0.998,with a sensitivity of 0.888 and specificity of 0.997.Conclusion The AI BMD measurement system based on 3D-Densenet neural network technology has a high correlation and consistency with the QCT measurement result,which can accurately diagnose normal BMD,low bone mass,and OP.

Objective: To explore the relevant factors of behavioral development among 30-month-old infants in rural area, Shaanxi Province. Methods: The behavioral development among 977 infants aged 30-month-old was evaluated in Changwu and Binxian of Shaanxi province from July 2006 to August 2008. The inclusion criteria included single live birth between January 2004 and February 2006, mother had participated in a community-based intervention study named "Impact of multi-micronutrient supplementation during pregnancy on low birth weight and premature delivery" . Infants who had obvious deformity or other birth defects, infants who could not complete the questionnaire survey, physical examination were excluded from the study. The self-designed questionnaire was used to investigate the information of feeding patterns, disease status, physical development, and immunization status of the infants, and their behavioral development were assessed by Bayley scales of infant development (BSID). General Linear Model was used to adjust the possible confounding factors, and the analysis of variance was performed to explore the effects on the behavioral development among infants aged 30-month-old. Results: Among the infants in the study, the average age was (30.6±0.6) months old, the mean birth weight was (3 199.1±405.9)g. After adjusted the mothers' age of delivery, educational level and occupation of the parents, family ecnomic conditions and the number of children, infants whose mother exposed to toxic chemicals during pregnancy had lower score in activity (-0.179±0.961) and lower score in concentration (-0.177±1.099) compared with infants with unexposed mother (0.058±1.006, P=0.001; 0.057±0.960, P=0.003). Similarly, infants whose mother took drugs during pregnancy had lower score in persistent behaviors (-0.070±1.000) compared with infants whose mother did not(0.085±1.006, P=0.017). Compared with normal birth infants(0.043±0.981, P=0.007; 0.021±0.984, P=0.034), infants less than gestational age and low birth weight had lower score in concentration(-0.198±1.063 and-0.389±1.285, respectively). After adjusted the delivery gestational age of mothers, the months of infants, the mothers' age of delivery, educational level and occupation of the parents, family ecnomic conditions, the number of children, and the main orderlies of infants, the score of activity of infants suffered from diseases in early month age was-0.049±0.992, which was lower than those who did not(0.207±1.011, P=0.001). The infants with Rickets signs had lower score in motor coordination (-0.218±0.896) than normal infants (0.031±1.011, P=0.013). Infants whose mother with adequate micronutrient supplementation in pregnancy had higher score in concentration (0.066±0.966) than those whose mother with insufficient supplementation (-0.062±1.027, P=0.043). Furthermore, infants with fine protein added and minerals and vitamins added had higher score in activity and concentration compared with those insufficient, who scored 0.078±1.013 and 0.496±0.872 (-0.254±0.924, P<0.001; 0.001±0.997, P=0.033), respectively. Conclusion Micronutrient supplementation during pregnancy and reasonable nutrition added during childhood could affect behavioral development among infants.

Primary lymphoma of bone (PLB) is a rare extra nodal lymphoma, which accounts for 3%-7% of malignant bone tumors, about 5% of extra nodal lymphomas, and 2% of lymphomas in adults. PLB can occur in any age group, but it is more commonly found in middle-aged and elderly people with the average age of onset of 45-60 years old, and it is slightly more common in males than in females. The patients with PLB usually present with pain or swelling of local soft tissue, and the radiological feature is atypical. It must be diagnosed by pathological biopsy. At present, PLB is mainly treated by systemic chemotherapy combined with radiotherapy of the affected bone. This article will review the current progress in the diagnosis and treatment of PLB.

Objective To summarize the experience of diagnosis and treatment of Takotsubo syndrome (TTS) after liver transplantation. Methods Clinical data of one TTS patient after liver transplantation was retrospectively analyzed. Clinical features, diagnosis and treatment strategies were summarized, and literature review was conducted. Results A 43-year-old female patient successfully underwent split liver transplantation due to primary biliary cirrhosis for 8 years. At postoperative 3 d, the patient developed anxiety, irritation, dyspnea, disorientation, hypotension, N-terminal pro-brain natriuretic peptide (NT-proBNP) of > 35 000 pg/mL, creatine kinase isoenzyme (CK-MB) of 5.9 U/L and troponin I (TnI) of 1.78 μg/L. Electrocardiogram indicated the signs of sinus rhythm. Echocardiography indicated diffuse weakening of the left ventricular wall motion and spherical dilatation of the apex, accompanied with moderate and severe regurgitation of the mitral valve and tricuspid valve. The left ventricular ejection fraction (LVEF) declined to 23%, whereas no abnormal segmental motion of ventricular wall or corresponding electrocardiogram changes were observed. The possibility of acute coronary syndrome was excluded. The InterTAK diagnostic score was 73. The diagnosis of TTS after liver transplantation was considered. Metoprolol, coenzyme Q₁₀, recombinant human brain natriuretic peptide, deacetyl lanatoside and lorazepam were given. Echocardiography at postoperative 10 d showed that the left ventricular function was significantly improved and the LVEF recovered to 50%. The patient was discharged 40 d after liver transplantation. The liver function was recovered well. During postoperative follow-up, she was given with metoprolol till the submission date, and no recurrence was reported. Conclusions TTS after liver transplantation is rare in clinical practice. It is difficult to make the diagnosis. The condition of TTS is severe and clinical prognosis is poor. Prompt diagnosis and interventions should be implemented.