Objective To investigate the relationship between serum ferritin and nonalcoholic fatty liver diseases in obese children.Methods Obese children aged 6 to 14 years old were enrolled.Duration of obesity, anthropometric parameters (height, body weight, waist circumference, hip circumference), bioelectrical impedance analysis (body fat), serological parameters (liver transaminases, lipid metabolism, fasting blood glucose, fasting insulin, serum ferritin) and liver ultrasonography were recorded.Insulin resistance (IR) index was calculated by homeostasis model assessment (HOMA).All subjects were divided into 3 groups according to liver ultrasound and liver transaminases : simple obese children (SOC) group, obese children with nonalcoholic simple fatty liver (NAFL) group and obese children with nonalcoholic steatohepatitis (NASH) group.Results 86 obese children entered the study, with a mean age of (10.4 ± 1.9) years, including 26 in the SOC group, 28 in the NAFL group and 32 in the NASH group.Waist circumference standard deviation score (SDS or Z-score), waist-to-hip ratio, HOMA-IR index and serum ferritin in the NASH group were obviously higher than those in the NAFL group [2.3 ± 0.3 vs.2.1 ± 0.3, P =0.020;1.0 ± 0.0 vs.0.9 ± 0.1,P=0.014;4.0±1.7 vs.2.9±1.8, P=0.006;(104.1 ±49.6) μg/Lvs.(68.4 ±22.7) μg/L, P=0.004] and the SOC group [2.3 ±0.3 vs.1.9 ±0.3, P=0.000;1.0±0.0vs.0.9 ±0.1, P=0.012;4.0 ±1.7 vs.2.5 ±1.6, P=0.001;(104.1 ±49.6) μg/Lvs.(59.2 ±28.9) μg/L, P=0.001], while there was no significant difference in body mass index Z-score [2.8 ± 0.5 vs.2.7 ± 0.6, P =0.524;2.8 ± 0.5 vs.2.7 ± 0.6, P =0.662].There were no significant differences between the NAFL group and the SOC group in the above indicators [2.1 ±0.3 vs.1.9 ±0.3, P =0.260;0.9 ±0.1 vs.0.9 ±0.1, P =0.952;2.9 ± 1.8vs.2.5±1.6, P=0.283;(68.4±22.7) μg/Lvs.(59.2±28.9) μg/L, P=0.161].Mter controlling age, body mass index, waist circumference, waist-to-hip ratio, triglyceride, and HOMA-IR index, serum ferritin was still positively correlated with the magnitude of nonalcoholic fatty liver diseases in obese children (r =0.335, P =0.002).Conclusion Serum ferritin is probably an independent risk factor for NASH in obese children.

Objective To analyze the effect of smoking on blood lipid before percutaneous coronary intervention(PCI)in male coronary heart disease(CHD).Methods The clinical data in 124 cases of CHD with PCI were randomly extracted and divided into the smoking group (n = 88 )and the non-smoking group (n = 36 ).The age,past disease history,triglycerides (TG),cholesterol (CHOL),low density lipoprotein(LDL)and high density lipoprotein(HDL)were retrospectively investigated.Results The LDL level of the smoking group was(3.1±1.34)mmol/L,which was significantly higher than(2.5 ±0.95)mmol/L in the non-smoking group with statistical difference between them(P <0.05);the level of TG,HDL and LDL in the CHOL≥4.5 mmol/L group were (2.5±1.49)mmol/L,(0.99±0.29)mmol/L and(3.6 ±1.13)mmol/L respectively,which were hither than(1.8 ±1.23)mmol/L, (0.88±0.20)mmol/L and(2.2±0.69)mmol/L in the CHOL≤4.5 mmol/L group respectively,the differences among them had statistical significance(P <0.05 );the Sperman analysis found that there was a positive correlation between the level of vascular change with CHOL and LDL,at the same time the smoking level was negatively correlated with LDLA.Conclusion Smoking, CHOL and LDL have a close relationship with the male coronary heart disease.Moreover,smoking can affect the lipid metabolism and probably increase the risk of coronary heart disease.

Objective To study the relationship between the genetic polymorphism of interleukine-6 (IL-6)-174 and the response to benazepril treatment in patients with hypertensive renal damage. Methods Two hundred and eighty-four patients with hypertension were enrolled in this study. The hypertensive renal damage was defined by the measurement of urinary albumin excretion rate (UAER). One hundred and sixty healthy subjects were enrolled simultaneously as control group. Blood samples were obtained from all the subjects, and plasma levels of IL-6 and the genotype of gene IL-6-174 were detected. The patients with hypertensive renal damage were treated with benazepril for 16 weeks. The responses were evaluated by the changes of UAER level to benazepril in different genotypes. Results Genotype CC was the most common of the gene IL-6-174 in patients with hypertension, followed by GG and GC successively, with the G/C allele frequency of 47%and 53%(P<0.05), while in patients with hypertensive renal damage, GG was the most common genotype of the gene IL-6-174, followed by GC and CC successively, with the G/C allele frequency of 68%and 32%(P<0.05). After benazepril treatment, the UAER was decreased most in patients with genotype CC, followed by GC and GG successively ( P<0.05). Conclusion The G allele frequency of the gene IL-6-174 is related with hypertensive renal damage in patients in Ningxia, with GG as the most common genotype. The patients with CC genotype have the best response to benazepril treatment, with most decreased UAER.

Objective To study the correlation between the genetic polymorphism of tumor necrosis factor-α(TNF-α)-308 with benazepril treatment response in the patients with hypertensive renal damage in Ningxia area.Methods Two hundred and eighty-four patients initially diagnosed as hypertension were enrolled and the hypertensive renal damage defined by the measurement of urinary albumin excretion rate(UAER).At the same time 160 individuals undergoing healthy physical examination were selected as the normal blood pressure control group.The plasma samples were obtained from all the subjects,and plasma level of TNF-α and TNF-α-308 gene polymorphism were detected.Then the patients with hypertensive renal damage were interfered with benazepril as one of the antihypertensive drugs,and the treatment response of different TNF-α-308 genotypes to benazepril was observed,and the comparative analysis was performed.Results Among the TNF-α-308 genotypes in the patients with simple hypertension,genotype GA was the most common,followed by GG and AA successively,with the G/A allele frequency of 53 ％/47 ％ (P＜0.05).In the patients with hypertensive renal damage,genotype GG was the most common,followed by GA and AA successively,with the G/A allele frequency of 70％/30％,the genotypes and allele frequency had no statistical difference(P＜0.05).Before and after benazepril treatment,the change range of UAER in the patients with genotype AA was maximal,followed by the genotype GA and GG,the difference among 3 groups was statistically significant(P＜0.05).Conclusion The TNF-α-308 gene is correlated with hypertensive renal damage and its response to benazepril treatment.

Objective To analyze the positive features of cytomegalovirus antibodies in children aged 0-12 years in Shandong.Methods 1 429 inpatients and outpatiens w ho came to Shandong Provincial Hospital Affil-iated to Shandong University from January 2014 to December 2016 were enrolled in the study.Cytomegalovir-us IgG and IgM antibodies were detected by chemiluminescence.SPSS21.0 software was used for statistical a-nalysis.Results The positive rate of IgG and IgM antibody of cytomegalovirus was 89.36% and 16.59% re-spectively,and the positive rate of IgG antibody of cytomegalovirus in male was 88.04%,which was signifi-cantly lower than 91.32% in female (P<0.05).The positive rate of cytomegalovirus IgM antibody in male was 14.07%,which was significantly lower than 20.31% in female (P<0.05).The positive rate of IgG anti-body of cytomegalovirus was the lowest in 6-12 months age group ( 73.68%),the highest in 0-<6 months age group (92.73%);cytomegalovirus IgM antibody positive rate was the lowest in 4-12 year-old age group (10.26%),and the highest in 1-3 year-old age group (21.57%).The positive rate of IgM antibody of cyto-megalovirus was the highest in winter (22.92%) and the lowest in autumn (11.11%),and the differences of positive rate between the four seasons were statistically significant (P<0.05).A total of 4 cytomegalovirus antibody combination patterns were detected,with the most common type of cytomegalovirus IgG antibody positive and cytomegalovirus IgM antibody double negative,accounting for 73.27%.Conclusion There were differences in sex,age and season in the positive rates of CMV antibody in Shandong area.Prevention and con-trol of cytomegalovirus infection in children should be strengthened.

Objective To evaluate the effect and mechanism of rivaroxaban, an inhibitor of coagulation factor Ⅹa (FⅩa), on endotoxin-induced injury to human umbilical vein endothelial cells (HUVEC). Methods When cultured HUVEC grow to 80% fusion, they were divided into four groups according to the random number method: blank control group (DMEM medium), lipopolysaccharide (LPS) group (cells were challenged by 100 μg/L LPS for 16 hours), FⅩa+LPS group (cells were challenged by LPS for 16 hours after they were cultured with 100 nmol/L FⅩa for 24 hours), and FⅩa+RIV+LPS group (cells were challenged by LPS for 16 hours after they were cultured with 100 nmol/L FXa and 1 μmol/L rivaroxaban for 24 hours). After each group of cells were challenged with LPS, the cell activity was detected by the cell proliferation and toxicity kit (CCK-8); the cell migration ability was detected by cell scratch experiments;the abilities of cells migration were measured by scratch-wound-healing assay; the apoptosis of cells were evaluated using flow cytometry; the endothelial barrier of cells was assessed by Transwell and Evans blue; the levels of tumor necrosis factor-α(TNF-α), interleukin (IL-1β, IL-6) were detected by the enzyme linked immunosorbent assay (ELISA); the expressions of nuclear factor-κB (NF-κB) and mitogen activated protein kinase (MAPK) signaling pathway were detected by Western Blot. Results Compared with blank control group, the cell viability in LPS group was significantly decreased, and the migration ability, number of apoptotic cells, and barrier permeability of endothelial cells was significantly increased, the levels of TNF-α, IL-1β and IL-6 were significantly increased, and the expressions of phosphorylation of c-Jun N-terminal kinase (p-JNK), phosphorylation of p38MAPK (p-p38MAPK), phosphorylation of transforming growth factor kinase 1 (p-TAK1) and phosphorylation of NF-κBp65 (p-NF-κBp65) were significantly increased. It indicated that LPS could stimulate the inflammatory response of vascular endothelial cells, and had a significant impact on cell activity, apoptosis and function. There was no significant difference in above indexes between FⅩa+LPS group and LPS group, except for the level of IL-6 being higher in FⅩa+LPS group. Compared with FⅩa+LPS group, in FⅩa+RIV+LPS group, the cell activity was significantly increased (A value: 0.42±0.02 vs. 0.33±0.02), and migration ability was significantly decreased (folds: 1.78±0.17 vs. 2.24±0.20), the number of apoptotic cells was significantly decreased [(11.30±0.70)% vs. (21.03±0.19)%], and permeability of monolayers endothelial cells was significantly decreased [(149±12)% vs. (253±15)%], the levels of inflammatory cytokines were significantly decreased [IL-1β(ng/L): 163.2±20.7 vs. 477.8±20.2, IL-6 (ng/L): 69.3±0.5 vs. 238.0±24.1, TNF-α(ng/L): 117.0±13.1 vs. 196.2±4.5], the expressions of p-TAK1 and p-NF-κBp65 were significantly decreased (p-TAK1/TAK1: 0.74±0.09 vs. 1.85±0.15, p-NF-κBp65/NF-κBp65: 1.15±0.17 vs. 2.36±0.20), with statistically significant differences (all P <0.05). There was no significant difference in the p-JNK, p-p38MAPK expressions between FⅩa+RIV+LPS group and FⅩa+LPS group (p-JNK/JNK: 1.64±0.12 vs. 1.65±0.15, p-p38MAPK/p38MAPK: 2.31±0.32 vs. 2.35±0.20, both P > 0.05). Conclusion Rivaroxaban can effectively relieve the inflammatory response of HUVEC stimulated by LPS, which may be related to the inhibition of NF-κB signaling pathway activation rather than MAPK signaling pathway.

Objective:To explore the application of home nutrition support in children with intestinal failure.Methods:Children with intestinal failure admitted to Division of Pediatric Gastroenterology and Nutrition and Department of Pediatric Surgery in Xinhua Hospital were retrospectively enrolled since January 2009. The details of home nutrition support, nutritional status and home parenteral nutrition (HPN) associated complications were collected.Results:A total of 10 children received HPN support, 7 of whom were with short bowel syndrome (SBS) and the other 3 with pediatric intestinal pseudo-obstruction. The average length of remnant small bowel in 7 SBS children was (36.7±32.4) cm. The average age at HPN onset was (5.4±4.7) years. The average duration of follow-up was (3.1±2.1) years. The average duration of HPN was (619.5±669.1) days after (391.8±340.1) days of parenteral nutrition support in our hospital. All 10 cases started home enteral nutrition (HEN) with tube feeding (3 cases transited to oral feeding during treatment). The average duration of HEN was (536.1±429.6) days. Daily calorie intake was 104.0%±39.0% of the recommended intake according to the guideline, with 46.5%±21.3% via HPN and 57.5%±29.2% via HEN. During follow-up, 3 cases were found with severe malnutrition, 5 with moderate malnutrition and 2 with mild malnutrition. Four children suffered from catheter-related thrombosis and five children were identified with catheter-related blood stream infection. No intestinal failure associated liver disease was observed.Conclusions:HPN is feasible but needs the support of national medical insurance policy. At present, there are still frequent nutritional deficiencies and complications in HPN. Nutrition support team (NST) should provide guidance for more scientific nutrition screening and nutrition management.