In patients with liver cirrhosis,variceal bleeding is a common fatal complication of portal hypertension.Varices are present in al-most half of patients with cirrhosis at the time of diagnosis.Since transjugular intrahepatic portosystemic shunt (TIPS)was first applied clini-cally in 1988,the relevant information about TIPS has been continually updated and perfected by lots of clinical trials.The role of TIPS in the prevention and treatment of variceal bleeding in cirrhotic patients with portal hypertension,including primary prevention of variceal bleeding,treatment of acute variceal bleeding,and prevention of rebleeding,is reviewed.TIPS is an effective treatment for variceal bleeding in cirrhotic patients with portal hypertension.Along with the technical development,TIPS will be available for more and more patients and will play an increasingly important role in the prevention and treatment of variceal bleeding among cirrhotic patients with portal hypertension.

Aim To investigate the chemical compo-nents and antibacterial and nematicidal activity of en-doparasitic fungi ThF-1 1 of Tripterygium hypoglaucum (Levl.)Hutch.Methods The endophyte ThF-1 1 was isolated,purified and identified based on fungal ITS sequence.The chemical components were isolated and identified with column chromatography and NMR spec-trometer,respectively.The nematicidal and antibacte-rial activity was investigated by biological active meth-od and inhibition zone method.Results The endo-phyte ThF-1 1 was identified as Penicillium simplicissi-mum,the compounds were identified as Penicillic acid [1 ],2,4-dimethoxy-6-methylphenol [2]and 5 (6)-dihydropenicillic acid [3 ] based on spectral data. Compound [1 ]showed significant activity against Cae-norhabditis elegans in a dose-dependent manner,and had antibacterial activity to Escherichia coli,Bacillus cereus,Bacillus subtilis, Staphylococcus aureus and Pseudomonas aeruginosa.Conclusion These com-pounds are firstly isolated from endophyte ThF-1 1 of T. hypoglaucum (Levl.)Hutch.Compound [1 ]shows strong nematicidal activity and antibacterial activity, and is worth further studying and developing.

Objective:To explore the effect of 1,25-dihydroxyvitamin D3 on the mast cell tryptase (MCT) in asthmatic guinea pigs. Methods:A total of 60 male or female healthy guinea pigs were randomly divided into control group (group A), asthmatic group(group B), and 1,25-dihydroxyvitamin D3 group(group C), with 20 cases in each group. To establish asthmatic guinea pig models, 1ml peanut oil was filled into stomach in the morning in group A and group B , and 1ml peanut oil with 1,25-dihydroxyvitamin D3 was filled into stomach in group C. Airway resistance (Re) of asthmatic guinea pigs was detected, and the bronchoalveolar lavage fluid (BALF) cells were counted. Lung tissue with HE and MCT immunohistochemical staining were used to observe the pathological changes in lung tissue and the distribution of MCT. Results:After injection of different concentration of acetylcholine chloride, the Re in group B and group C were increased significantly compared with group A (P<0.05);compared with group B, the Re in group C were decreased significantly (t=-5.385, -5.761, -6.184,-13.574, P<0.05);the total number of BALF cells and eosinophils were increased significantly in group B and C (t=19.618, 9.598, 10.854, 5.388, P<0.05);compared with group B, the total number of BALF cells and eosinophils in group C was decreased significantly (t=-5.555,-5.392, P<0.05);the number of tryptase positive cells in group B was increased significantly than that in group A (t=21.312, P<0.05), and in addition to the alveolar septum and submucosa, the cells were also distributed around blood vessels and outside the cells; the number of tryptase positive cells in group C was decreased significantly compared with group B, and the difference was statistically significant (t=5.043, P<0.05). Conclusions:After the asthmatic guinea pigs are treated with 1,25-dihydroxyvitamin D3, their BALF, Re, infiltration degree of inflammatory cells in the trachea and lung tissue and airway inflammatory reaction are reduced significantly. 1,25-dihydroxyvitamin D3has a certain inhibiting effect on the activation of mast cells and the release of MCT granules.

Objective: To understand the relation between obesity and chronic diseases in Tianjin. Method: The data from Tianjin in the National Nutrition and Health Survey in 2002 were used, including questionnaires, physical examination and biochemical tests of blood sugar and lipids. Height, weight, and blood pressure were examined. Results: There were significant differences on blood pressure , TC, TG, HDL-C, FBG levels between obesity group and control group (P

Objective:To explore the values of single and combined detection of mammography,ultrasound Doppler and serum markers of tumor included serum prostate specific antigen(PSA),serum carbohydrate antigen 15-3(CA153),mucin 1(MUC1)and human growth differentiation factor 3(GDF3)in diagnosing early breast cancer.Methods:A total of 96 patients with breast cancer,who admitted to Tangshan People's Hospital from January 2018 to December 2021 and were confirmed by pathological examination,were selected as breast cancer group.At the same time,70 patients with benign breast diseases who received diagnosis and treatment in our hospital were selected as benign lesions group.In addition,50 normal people who were confirmed as health by physical examination in our hospital were selected as research subjects of healthy control group.The postoperative pathological examination was used as the gold standard to compare the diagnostic values of single mammography,ultrasonic Doppler examination,serum PSA,CA153,MUC1,GDF3 and the combined examination of them for breast cancer.Results:In the breast cancer group,78 cases of the 96 patients with breast cancer were diagnosed as malignant tumor by ultrasound on breast,with a positive detection rate of 81.3%,and 80 cases of them were diagnosed as malignant tumor by mammography X-ray examination,with a positive detection rate of 83.1%.The levels of serum PSA,CA153,MUC1 and GDF3 of breast cancer group were respectively higher than those of the benign lesion group and healthy control group,and the differences were statistically significant(t=8.783,10.361,11.258,18.965,9.564,12.658,12.688,20.163,P<0.05).Using breast cancer as the dependent variable,and using serum PSA,CA153,MUC1 and GDF3 as independent variable to perform Logistic regression analysis.The results of Logistic regression analysis indicated that serum PSA,CA153,MUC1 and GDF3 were important risk factors of breast cancer(OR value =1.165,1.168,1.472,1.248,P<0.05).The results of receiver operating characteristic(ROC)curve(95%CI),sensitivity and specificity of single application of each indicator of ultrasound on breast,mammography,serum PSA,CA153,MUC1 and GDF3 were respectively[0.723(0.595-0.851),82.56%and 67.32%],[0.761(0.636-0.886),85.79%and 65.36%],[0.833(0.726-0.941),81.48%and 85.73%],[0.837(0.738-0.926),61.25%and 70.17%],[0.768(0.648-0.889),71.49%and 80.87%],[0.613(0.469-0.758),52.94%and 50.57%].However,the AUC(95%CI),sensitivity and specificity of the combined application of 6 items were respectively 0.958(0.905-0.999),96.37%and 84.83%,which had higher diagnostic efficiency.Conclusion:The combined detection performance of mammography,ultrasound Doppler and serum PSA,CA153,MUC1 and GDF3 is higher than that of single each detection,which is helpful to conduct early identification and diagnosis for breast cancer.

Objective: To understand the status quo of smoking and change pattern of smoking related behaviors in the past 20 years in the urban adults in Tianjin. Methods: Data was from the study of Chinese Chronic Disease and Risk Factors (2015). Multi stage stratified random sampling method was used to conduct a questionnaire survey in 7 surveillance sites in Tianjin. Results: in the urban residents aged>20 years were compared with those in surveys in 1996 and 2010. Results In 2015, the smoking rate in men and women aged>20 years in Tianjin were 41.1% and 4.5% respectively. The average age of starting smoking was (19.2±4.7) years for men and (24.8±10.9) years for women, showing a younger age trend. Compared with the data from 1996 and 2010, the smoking rate in the urban residents was in decrease, but the rate of successful smoking cessation was in increase in 2015, the differences were significant. Conclusions Since 1996, the rate of smoking in the urban residents of Tianjin has been in decline, however it is still at a high level, especially in women. The average age of starting smoking remains to be younger. It is necessary to strengthen the health education about harm of smoking in adolescents.

Objective: To analyze the long-term trend of mortality and years of life lost (YLL) of gastric cancer in Tianjin from 1999 to 2015. Methods: From January 1, 1999 to December 31, 2015, the data of gastric cancer deaths was collected from the Tianjin death surveillance system. The inclusion criteria of death due to gastric cancer were coded by using 151 in the 9^th edition of the international classification of diseases (ICD) (1999-2002) and C16 in the 10^th edition of ICD (2003-2015). The crude and age-standardized mortality rate (ASR) of gastric cancer was calculated according to Segi′s world standard population. YLL was calculated according to the standard method of the disease burden of WHO. The Joinpoint regression was used to calculate the average annual percentage change (AAPC) to indicate the trend of mortality and YLL of gastric cancer. Results: From 1999 to 2015, there were 20 000 deaths of gastric cancer in Tianjin. The proportion of gastric cancer death in the population aged 0-44 years old, 45-64 years old, and 65 years old and above was 4.9%, 30.4%, and 64.8%, respectively. The proportion of males and urban was 67.1% and 67.5%, respectively. From 1999 to 2015, the crude mortality rate was from 12.10/100 000 to 12.58/100 000. The ASR was from 11.04/100 000 to 7.24/100 000. The average annual YLL number was 29 625.83 person-years and the rate was 3.09 person-years per thousand people. From 1999 to 2015, the crude mortality rate and the PYLL of gastric cancer in Tianjin were stable (the AAPC was 0.34% and -0.24%, all P values >0.05). The ASR showed a downward trend (AAPC=-2.58%, P<0.001). Conclusion From 1999 to 2015, the ASR of gastric cancer in Tianjin showed a downward trend, and the YLL of gastric cancer was stable.

Objective:To investigate the clinical phenotypes, therapy and genetic features of aldehyde dehydrogenase 7 family member A1 (ALDH7A1) gene mutations in five cases of pyridoxine dependent epilepsy (PDE) with diagnosis confirmed by next generation sequencing.Methods:Retrospective analysis was carried out on clinical data of five cases of PDE children with early epilepsy onset who were treated in the Department of Neurology of Children′s Hospital Affiliated to Zhengzhou University from February 2018 to November 2019. Next generation sequencing approach was used for genetic sequencing of proband ALDH7A1 gene and the first generation Sanger was used for validation of family members. And the characteristics of gene mutations were analyzed.Results:Among the five children diagnosed with PDE, the male to female ratio was 4 ∶ 1 and ages at clinic visit ranged from two months to 10 months old. In clinical phenotypes, all five cases experienced onset in neonatal period, with repeated seizures, manifested as myoclonus, spasms or focal paroxysm. The administration of antiepileptic drugs performed poorly in seizure control while long term oral intake of large dose pyridoxine showed better efficacy. All the five cases of children came from compound heterozygous mutations of father and mother, i.e. slicing homozygous mutation c.247-2(IVS2)A>T, missense mutation c.584A>G (p.N195S) and nonsense mutation c.1003C>T(p.R335 *), missense mutation c.1553G>C(p.R518T) and c.1547A>G(p.Y516C), missense mutation c.1547A>G(p.Y516C) and frameshift mutation c.1566_1568delTAC, missense mutation c.1061A>G(p.Y354C) and nonsense mutation c.841C>T(p.Q281X, 259), among which c.247-2(IVS2)A>T was novel splicing site mutation not reported before. Conclusions:PDE is induced by ALDH7A gene mutation. Early clinical manifestations are mostly onset of refractory epilepsy in neonatal period. Antiepileptic drugs perform poorly in terms of efficacy while pyridoxine can control seizure effectively. Gene analysis should be conducted on such patients for confirmed diagnosis.

Objective:To investigate the diagnostic and diagnostic values of plasma microRNA-21-3p (miR-21-3p) and miR-551-5p expression in patients with acute pancreatitis (AP).Methods:A prospective observational study was conducted. AP patients admitted to the Third People's Hospital of Hainan Province from January 1st 2017 to December 31st 2019 were enrolled. The patients were divided into mild acute pancreatitis (MAP) group, moderate severe acute pancreatitis (MSAP) group and severe acute pancreatitis (SAP) group according to their severity. Fasting venous blood was collected from all subjects the day after admission, and real-time quantitative polymerase chain reaction (PCR) as used to detect the expression levels of plasma miR-21-3p and miR-551-5p. Rehabilitation, discharge or death were end points of study. In addition, 50 healthy people in the same period were selected as the control group. The receiver operating characteristic (ROC) curve was used to analyze the value of the expression levels of plasma miR-21-3p and miR-551-5p for the diagnosis and prognosis of SAP. Pearson correlation was used to analyze the relationship between the expressions of miR-21-3p and miR-551-5p in SAP patients.Results:A total of 164 AP patients were enrolled, including 72 MAP patients, 47 MSAP patients and 45 SAP patients. Among the SAP patients, 27 cases survived and 18 cases died. There were no deaths in MAP group and MSAP group. The levels of plasma miR-21-3p and miR-551-5p in AP group were significantly higher than those in control group [miR-21-3p (2 -ΔΔCt): 2.17±0.90 vs. 0.65±0.12, miR-551-5p (2 -ΔΔCt): 1.80±0.73 vs. 0.42±0.08, both P < 0.01]. The expression levels of plasma miR-21-3p and miR-551-5p in AP patients increased gradually with the aggravation of the disease ( F values were 11.635, 10.204 respectively, both P < 0.01), and the expression levels of plasma miR-21-3p and miR-551-5p in SAP group were significantly higher than those in MSAP group and MAP group [miR-21-3p (2 -ΔΔCt): 3.16±1.08 vs. 1.85±0.71, 1.70±0.64; miR-551-5p (2 -ΔΔCt): 2.63±0.95 vs. 1.52±0.46, 1.36±0.40; all P < 0.01]. ROC curve analysis showed that the area under the ROC curve (AUC) and 95% confidence interval (95% CI) of the joint diagnosis of SAP with miR-21-3p and miR-551-5p were significantly higher than that of miR-21-3p or miR-551-5p alone [0.898 (0.841-0.960) vs. 0.820 (0.763-0.882), 0.806 (0.748-0.867), Z1 = 4.480, Z2 = 4.916, both P < 0.05], and the sensitivity was 90.7% and the specificity was 85.0%. The expression levels of plasma miR-21-3p and miR-551-5p in the death group of SAP patients were significantly higher than those in the survival group [miR-21-3p (2 -ΔΔCt): 3.75±1.17 vs. 2.66±0.87, miR-551-5p (2 -ΔΔCt): 3.17±1.04 vs. 2.24±0.83, both P < 0.01]. ROC curve analysis showed that the AUC and 95% CI of the combined prediction of death in SAP patients with miR-21-3p and miR-551-5p were significantly higher than that of miR-21-3p or miR-551-5p alone [0.933 (0.875-0.996) vs. 0.856 (0.794-0.917), 0.816 (0.759-0.874), Z1 = 4.395, Z2 = 5.520, both P < 0.05], and the sensitivity was 95.2% and the specificity was 87.5%. Correlation analysis showed a positive correlation between the expression level of plasma miR-21-3p and miR-551-5p in SAP patients ( r = 0.827, P < 0.001). Conclusions:The increased expression of plasma miR-21-3p and miR-551-5p are positively correlated with the severity of AP patients. The combination of the two items has a better value in the diagnosis and prognosis evaluation of SAP.

Objective:To analyze the trends of mortality and years of life lost (YLL) of breast cancer in women in Tianjin and provide references for the development of intervention strategies.Methods:The crude mortality rate, standard mortality rate, cumulative rate (0-74 years old) and truncated rate (35-64 years old) of breast cancer in women in Tianjin from 1999 to 2017 were calculated. The annual percentage change of the mortality rate and YLL rate were analyzed by Joinpoint regression.Results:From 1999 to 2017, a total of 8 356 deaths of breast cancer were reported in Tianjin, resulting in a YLL of 262 835.53 person-years. The average crude mortality rate was 9.15/100 000. The average age standardized rate(ASR) (World) was 6.14/100 000. The ratio of ASR (World) between urban and rural areas was 1.73∶1. The peak mortality ratio of age groups between urban area and rural area was 3.13∶1. From 1999 to 2017, both the crude mortality rate and ASR of breast cancer in Tianjin had rising trends. In 2017, the crude mortality rate and the ASR of breast cancer increased by 113.7% and 44.4% respectively compared with 1999. The increase of urban mortality mainly came from elderly group aged ≥75 years, and the mortality of young age groups in rural area showed an fast increases, which was most obvious in age group 45-59 years (average annual percentage change=3.6%, P<0.01). Conclusions:The mortality rate of breast cancer and disease burden in women in Tianjin are still in rapid increase. We should continue to implement the prevention and control strategies such as lifestyle intervention and screening of key groups. More attention need to be paid to the increase of breast cancer incidence in rural area.