Objective To observe the curative effect of the microwave ablation (MWA) therapy for hepatocellular carcinoma (HCC) with arterio-venous fistula (AVF) in patients with intervention and operative contraindication,and to observe the clinical effect.Methods MWA therapy was offered to 24 patients with HCC combined with AVF accompanied with intervention and operative contraindication.The complete ablation rates,volume changes of tumors before and after treatment were observed.Color Doppler ultrasonography was performed to evaluate the peak flow rate and resistance index(RI)of AVF,width and flow rate change of portal vein.The lifetime of patients were also observed.Results All patients were treated with double needle therapy.The first time complete ablation was 75.0％ (18/24).Then they were followed up after 6 months.The volume of tumors was (72.9 ± 23.8)cm3 and (57.6 ± 19.8)cm3 (P ＜0.01) before and after treatment.The AVF disappeared in 20 cases,while flow rates of fistula orifice decreases obviously in the rest of them.The widths of portal veins decreased from (1.4 ± 0.9)cm to (1.3 ± 0.1)cm,while the flow rate of that increased from (7.5 ± 3.9)cm/s to (20.1 ± 2.9)cm/s.The survival rates of patients for one,two and three years were 66.6 ％ (16/24),37.5 ％ (9/24) and 20.8 ％ (5/24),respectively.Conclusions Most AVF disappeared after MWA therapy in HCC combined with AVF.The therapy can relieve portal hypertension symptom effectively and improve survival time and life quality of patients.So it is a good treatment for patients with HCC combined with AVF while with intervention and operative contraindication.

Objective To investigate the curative effect of low molecular heparin calcium on Henoch-Schoenlein purpura(HSP) and the preventive effect on Henoch-schonlein purpura nephritis.Methods One hundred and three patients with HSP were enrolled in the study and divided randomly into two groups,heparin group(57 cases) and control group(46 cases).Heparin group received low molecular heparin calcisymptom remission time,the incidence of recurrent skin rash were recorded.The contents of D-dipolymer and the three indicators of early renal damage were detected before and after the treatment.Results The remission times of purpura,joint pain and abdominal pain in heparin group[(15.23±3.14) d,(6.80±1.96) d and(6.68±3.42) d]were significantly shorter than those of control group[(17.11±4.79) d,(8.30±2.67)d,(8.59±4.09) d](P ＜0.05).The incidence of recurrent skin rash in heparin group(14.6%) was significantly lower than that of control group(39.1%)(P＜0.01).Compared to control group,the positive rate of D-dipolymer in heparin group was higher(15.8% vs 37.0%),and the urine levels of mALB,β2-MG and NAG were significantly decreased[(12.22±3.92) mg/L,(5.35±0.51) mg/L,(8.12±.65) U/L vs (14.15±5.17) mg/L,(6.54±2.67) mg/L,(10.04±2.60) U/L]during 3 months after treatment(P＜0.01,P ＜0.05).Conclusion Low molecular heparin can shorten the course of HSP and prevent the development of Henoch-Schonlein purpura nephritis.

Henoch-Schonlein purpura (HSP) is one of the most common clinical manifestations of systemic small vasculitis in children with non-thrombocytopenic, and mainly manifested as skin purpura, arthritis, gastrointestinal symptoms and Henoch-Schonlein purpura nephritis (HSPN). The severity of renal involvement is the main factor determining the long-term prognosis of children with HSP.Studies have revealed that the determination of pentraxin 3 (PTX3) in serum can be used for early diagnosis of HSPN and prediction of renal injury.In this paper, the origin, gene and protein structure, function, potential relationship and mechanism of action between PTX3 and HSP were discussed, so as to provide new ideas for the early diagnosis and treatment of HSPN.

Objective To assess the efficacy of combined vitamin D with calcium and vitamin D or cal-cium alone in rickets of vitamin D deficiency by meta-analysis method. Methods Searches were made in Cochrance Library , Pubmed, Web of science, Scirus, CNKI, Chinese Biological Medical Literature Database, (CBM),Wangfang from the establishment of the data base till March 2013. All randomized controlled trials about combined with vitamin D and calcium in rickets of vitamin D deficiency were eligible. Serum 25-( OH) ritamin D,phosphate ,ALP,calcium,PTH,phosphate,albumin ,radiographic score were chosen as evaluation in-dex to evaluate the weighted mean diffreence ( WMD) and 95% confidence interval ( CI) for continuous data. RevMan 5. 0. 2 software was used to make meta-analysis. Results 437 literatures were reviewed. Three eligible trials were used for meta-analysis. Meta-analysis showed that:(1)the increase of Serum 25-(OH)vitamin D:Combined therapy group and vitamin D group (MD= -7. 88,95%CI:-12. 24~ -3. 52);Combined therapy group and calcium group (MD= -18. 32,95%CI:-22. 61~ -14. 04). (2)the increase of serum phosphate:Combined therapy group and vitamin D group ( MD= -0. 64 ( 95%CI:-0. 86 ~ -0. 42 );Combined therapy group and calcium group MD= -0. 16 ( 95%CI:-0. 84 ~0. 51 ) . ( 3 ) the decrease of Serum ALP:Combined therapy group and vitamin D group (MD= 109. 99,95%CI:20. 40 ~199. 58);Combined therapy group and calcium group (MD=59. 89,95%CI:10. 09~109. 59 ). (4)the increase of serum calcium :Combined therapy group and vitamin D group (MD= -0. 71,95%CI:-0. 91,-0. 52);the decrease of Radiographic score:Com-bined therapy group and vitamin D group( MD=0. 68,95%CI:0. 42~ 0. 95). Except that the increase of serum phosphate between combined therapy group and calcium group had no significant difference,the rest had signifi-cant difference. Conclusion The long term efficacy in combined therapy group is much effective than vitamin D group or calcium group.

Objective To study the association of vitamin D receptor(VDR) gene BsmI polymorphism and the genetic susceptibility of vitamin D deficiency rickets in infants and to explore a new way of diagnosis and treat-ment. Methods Case-control study was adopted. 56 infants confirmed with rickets (case group) and 76 cases of normal infants (control group) were chosen as the subjects. PCR-RFLP was applied to examine VDR gene BsmI site polymorphism. The frequencies of the VDR genotype and allele were compared between the two groups. Results Frequencies of BB,Bb and bb genotypes were 3.6% (2/56),21.4% (12/56) and 75.0% (42/56) in the rickets group,and 1.3% (1/76),18.4% (14/76) and 80.3% (61/76) in the control group respectively(χ20.521,P> 0.05),frequencies of B,b alleles were 14.3% (16/112),85.7% (96/112) in the rickets group and 10.5% (16/152),89.5% (134/152) in the control group respectively(χ20.783,P>0.05). Multiple logistic regression analysis showed that VDR gene polymorphism Bsml had not higher risk of vitamin D deficiency rickets in Infants. Conclusion VDR gene polymorphism BsmI doesn't appear to pose risk on infants in developing vitamin D deficien-cy rickets.

Objective To determine the expression of miR-486-3p in psoriatic lesions and healthy human skin and to estimate its effect on keratin 17 (K17) expression in HaCaT human keratinocytes.Methods Bioinformatics was used to predict microRNAs that may affect the expression of K17.Tissue samples were obtained from the lesions of 10 patients with psoriasis and normal skin of 10 healthy human controls.RNA was extracted from these tissue samples and reversely transcribed into cDNA with the addition of a Poly (A) tail.Then,real time quantitative PCR was performed to measure the expression of miR-486-3p.Cultured keratinocytes were transfected with miR-486-3p mimics or negative control,and Western blot was performed to determine K17 expression at 48 hours after the transfection.To evaluate the inhibitory effect of miR-486-3p on K17 expression,cultured 293T cells were transfected with the plasmid containing K17 3' untranslated region (UTR) seed sequence,three plasmids containing the complete deletion,interval mutation or double repeats of the seed sequence,or negative control plasmid.At 24 hours after the transfection,a dualluciferase reporter (DLR) assay was performed to quantify the expression of K17.Results Real time PCR showed that the expression level of miR-486-3p was significantly lower in psoriatic lesions than in the normal skin (0.211 ± 0.120vs.0.555 ± 0.425,t =2.62,v =9,P ＜ 0.05).The HaCaT cells transfected with the mimics of miR-486-3p exhibited decreased expression of K17 compared with those transfected with the negative control.DLR assay revealed that the expression level (fluorescence intensity) of K17 in the negative control group was significantly higher than that in the 293T cells transfected with the seed sequence and those with the double repeats of the seed sequence (100.00％ vs.65.31％ ± 6.32％ and 54.18％ ± 10.01％ respectively,both P ＜ 0.05),but did not differ from that in the 293T cells transfected with the complete deletion and interval mutation of the seed sequence (100.00％ vs.114.77％ ± 16.14％ and 110.21％ ± 12.99％ respectively,both P ＞ 0.05).Conclusions The expression of miR-486-3p,which may inhibit K17 expression by binding to the seed sequence of K17 3'UTR,is lower in psoriatic lesions than in normal skin.The decreased expression and inhibitory effect of miR-486-3p may be implicated in the initiation and progression of psoriasis.

Objective To investigate the application value of magnetic resonance enterography (MRE) with multiple sequences in detection of children bowel intestinal diseases .Methods Retrospective analysis of 35 patients with bowel diseases confirmed by clini‐cal results ,surgery and pathology was performed .The patients underwent MRE with multiple sequences including T 1WI ,fat‐suppressed T2 WI ,diffusion weighted imaging (DWI) ,single‐shot fast spin‐echo (SSh‐TSE) sequence ,rapid balance fast field echo (B‐FFE) ,and unenhanced and enhanced fat‐suppressed (FFE‐IP‐SPAIR) scans .Results SSh‐TSE showed the whole intestinal distribution in 34 patients (34/35);DWI showed the lesions with high signal in 29 (29/35);T1WI and fat‐suppressed T2 WI showed hyperintensity on T2WI in 3 ,slight hypointensity on T1WI and T2WI in 2 ,and hyperintensity on T1WI and hypointensity on T2WI in 1 .Enhancement of lesion was found in 28 ,and unenhancement was in 2 .Conclusion MRE with multiple sequences with more information ,sensitivity and non‐ionizing radiation ,can be used as an important method in diagnosis of children intestinal diseases .

Objective:To evaluate the prognostic value of amplitude-integrated electroencephalogram(aEEG) on predicting long-term neurodevelopmental outcome of preterm infants.Methods:Literatures were searched in PubMed, the Cochrane library, Web of science, Wanfang database, CNKI and CBM database from inception to August, 2020.The studies which investigated the prognostic value of aEEG on neurodevelopmental outcome of preterm infants were included.Articles screening, data extraction and quality assessment were accomplished by two investigators independently, and statistical analyses were performed by Meta-disc1.4.Results:Six studies were included with 557 cases.The Meta-analysis revealed that the pooled sensitivity was 0.81 (95% CI 0.75-0.87), specificity was 0.68 (95% CI 0.63-0.73), positive likelihood ratio was 2.32(95% CI 1.52-3.52), negative likelihood ratio was 0.27(95% CI 0.19-0.37)and the area under the curve of summary receiver operating characteristic curve was 0.79(95% CI 0.75-0.82). Burst-suppression, continuous low voltage and flat trace were regard as a index of poor neurodevelopmental prognosis. Conclusion:aEEG is a valuable tool for predicting the outcome of long-term neurodevelopment in preterm infants.

Objective To explore the value of MRI in the diagnosis of fetal aortic arch anomalies. Methods We retrospectively collected 10 fetuses with aortic arch anomalies indicated by prenatal ultrasound and underwent MR examination and were subsequently proven by autopsy or post-birth follow-up from 320 pregnant women. We focused on the observations of the location of the aortic arch and brachiocephalic artery anomalies, the locations of the liver and stomach in the abdominal cavity, and the large vessels in abdomen. The above-mentioned finding were compared with prenatal ultrasound and follow-up findings. Results Of 10 cases, right aortic arch with aberrant left subclavian artery was seen in 7 cases, right aortic arch with the mirror branch, left aortic arch with aberrant right subclavian artery, right aortic arch with aberrant left subclavian artery combined with cervical aortic arch and double aortic arch was seen in 1 case, respectively. All aortic arch anomalies detected by MRI were consistent with post-birth or autopsy findings. Ultrasound misdiagnosed aortic branch malformation in 5 places, which included right aortic arch but misdiagnosed aberrant left subclavian artery in 2 cases, right aortic arch never diagnosed mirror branch anomaly in 1 case, right aortic arch with left subclavian artery misdiagnosed cervical aortic arch in 1 case, left atrial isomerism but misdiagnosed left aortic arch with aberrant right subclavian artery in 1 case;One double aortic arch was misdiagnosed as right aortic arch with aberrant left subclavian artery in ultrasound. Conclusion Fetal cardiovascular MRI is an effective and supplementary examination to complement ultrasound in diagnosis of fetal aortic arch anomalies.

OBJECTIVETo investigate reliability of FibroScan (FS) in diagnosing size of oesophageal varices (OV) in patients with liver cirrhosis.

METHODSA total of 260 patients with liver cirrhosis were enrolled in the study. All patients underwent endoscopy to assess OV stage and FS to measure liver stiffness. Receiver operating characteristic (ROC) curves were generated to evaluate the diagnostic reliability of FS.

RESULTSThe FS values according to OV stage were 20.9 ± 10.3 kPa for patients without OV, 32.2 ± 13.5 kPa for patients with mild OV, 45.6 ± 18.3 kPa for patients with moderate OV, and 55.1 ± 15.6 kPa for patients with severe OV. Significant differences were found among the groups (P < 0.001) as well as between any two groups (t=6.574, 10.533, 13.247, 4.719, 7.072 and 2.171, P less than 0.05 respectively). ROC curves of FS for the diagnoses of patients with various OV stages showed the following:with vs. without OV, 0.824 (95% CI:77.5% to 87.4%); less than moderate vs. more than moderate OV, 0.849 (95% CI:79.6% to 90.2%); and less than severe vs. severe OV, 0.871 (95% CI:81.1% to 93.0%); the corresponding FS cut-off values were 22.8 kPa, 30.6 kPa, and 34.6 kPa.

CONCLUSIONLiver stiffness measurement by FibroScan allows prediction of the oesophageal varices stage in patients with liver cirrhosis.

Adult ; Elasticity Imaging Techniques ; Esophageal and Gastric Varices ; diagnosis ; etiology ; Female ; Humans ; Liver Cirrhosis ; complications ; diagnosis ; Male ; Middle Aged