Objective To investigate the effects of two cholesterol-lowering probiotics, DM9054 (Lac-tobacillus Rhamnosus GG, LGG) in combination with 86066 (Lactobacillus plantarum WCFS1, LP), on the metabolism of bile acid via a rat model of non-alcoholic fatty liver disease (NAFLD) and the possible mecha-nism. Methods Twenty-one SD male rats were randomly divided into three groups including control group, NAFLD model group and probiotics intervention group. Rats in the control group received normal diet. The rat model of NAFLD was established by feeding rats with chronic high fat diet (45% of calories derived from fat di-et) for 20 weeks. Rats in the probiotics intervention group were given high fat diet together with cholesterol-low-ering probiotics through oral gavage. General indexes of each group including body weight and the levels of tri-glyceride, cholesterol and CK18-M30 in serums samples were detected. The expression of cholesterol 7-alpha hydroxy-lase (CYP7A1), fibroblast growth factor receptor 4 (FGFR4), farnesoid X receptor (FXR), fibroblast grwoth factor 15 (FGF15) and apical sodium-dependent bile acid transparter(ASBT) at mRNA level were de-tected by using real-time polymerase chain reaction (real-time PCR). Western blot assay was used to detect the protein expression of CYP7A1, FXR in liver tissues and ASBT in ileum tissues. The expression of FXR in liver and ileum tissues were analyzed by immunohistochemistry. Results Rats with NAFLD showed loss of body weight and decreased levels of the serological markers after treating with the probiotics (P<0. 05). Compared with the rats in model group, enhanced expression of CYP7A1 and inhibited expression of FXR in liver tissues, activated FXR-FGF15 pathway in ileum tissues as well as down-regulated expression of ASBT in ileum tissues were detected in rats receiving probiotics intervention (P<0. 05). No significant difference in the expression of FGFR4 at mRNA level was observed between NAFLD rats with or without probiotics intervention (P>0. 05). Conclusion Probiotics intervention might up-regulate the expression of CYP7A1 by suppressing the FXR path-way in liver tissues and inhibiting the expression of ASBT in ileum tissues. Treating NAFLD rats with cholester-ol-lowering probiotics could activate the FXR-FGF15 pathway in ileum tissues and enhance the metabolism of bile acid, which contributed to the alleviation of NAFLD.

Objective To analyze the roles and mechanisms of lactitol and Bifidobacterium infantis in the treatment of rat constipation and to investigate their effects on aquaporin3 (AQP3) and interstitial cells of Cajal (ICC) in colon tissues.Methods Thirty SD male rats were recruited in this study,6 of which were randomly selected as the control and the rest were given 4 mg/kg.d of loperamide for 5 consecutive days to construct the rat model of constipation.The rats with constipation were randomly divided into four groups including model group,lactitol treatment group,Bifidobacterium infantis treatment group and lactitol in combination with Bifidobacterium infantis treatment group.General indexes including food intake,water intake,body weight,fecal water content and intestinal transit rate of each rat were measured after receiving corresponding treatments for 7 consecutive days.The levels of substance P (SP) and vasoactive intestinal peptide (VIP) in serums samples were detected by ELISA.The expression of protein kinase A (PKA) and neurokinin-1 receptor (NK-1) at mRNA level in colon tissues were detected by real-time polymerase chain reaction (real-time PCR).Western blot assay and real-time PCR analysis were used to detect the expression of AQP3 and c-kit at protein and mRNA levels,respectively.Results Compared with the rats in model group,the levels of fecal water content and intestinal transit rate,the concentrations of SP and VIP in serums samples,the expression of PKA and NK-1 at mRNA level and the expression of AQP3 and c-kit at mRNA and protein levels were significantly increased in rats from the three treatment groups (P＜0.05).The most effective treatment was lactitol in combination with Bifidobacterium infantis,followed by the lactitol treatment and then the Bifidobacterium infantis treatment.Conclusion The combination therapy with lactitol and Bifidobacterium infantis increased the serum levels of SP and VIP in rats with constipation.SP could enhance the contraction of gastrointestinal smooth muscles and improve the intestinal motility by binding to the NK-1 receptor on the membrane of ICC.VIP could promote the absorption of water in intestinal tracts,soften stools and alleviate constipation by upregulating the expression of AQP3 at both protein and mRNA levels via the cyclic adenosine monophosphate-PKA (cAMP-PKA) signaling pathway.

Objective To assess the value of acoustic radiation force impulse (ARFI) imaging in the pathological damage of Henoch-Schonlein purpura nephritis on children by comparison with renal biopsy.Methods 50 cases of healthy control group as group A; 58 children with HSPN were divided into three groups according to pathological grading:Ⅰ ～ Ⅱ class (group B),Ⅲ class (group C) and Ⅳ ～ Ⅵ class (group D).ARFI was then used to measure the shear wave velocities(SWV) of renal cortex of each group,compared the differences SWV of each group.Results SWV values of children's renal cortex with HSPN were significantly higher (t =5.883,P =0.017) than those in the group A.Pairwise comparisons found that there were statistically significant differences between group D and the other three groups (P ＜0.05).According the ROC curve,the cut-off value of SWV was 2.59 m/s when the maximum area under the curve equal to 0.719,the sensitivity and specificity were 63％ and 67％.Conclusions ARFI technology can quantify the elastic properties of the kidney,which is expected as an important indicator to evaluate the pathological extent of damage of the HSPN.

Purpose To quantitatively evaluate longitudinal strain and strain rate (SR) of left ventricular (LV) in normal infants and young children using velocity vector imaging (VVI). Materials and Methods A total of 50 normal infants and young children were enrolled in the study. The longitudinal strain peaks and SR peaks in three sections of LV walls during systole period and relaxation period were measured by VVI from apical four-chamber view, apical two-chamber view and long axis view, respectively. Results Forty-one cases (82%) presented a smooth strain curve without incisures and a double peak in SR curve (systolic peak and single diastole peak). The strain in anterior septum and posterior septum, the systolic SRs and diastolic SRs decreased from basal to apical segments. However, only the strain in basal segment and that in apical segment in anterior septum showed statistic difference (t=1.79, P<0.05);the systolic SRs of the same level in different walls and those in the same wall at different levels had no statistic difference (P>0.05). Conclusion Most normal infants and young children present a smooth diastolic strain curve and a double peak SR curve of LV, which can provide clinical guidance in the early diagnosis of myocardial abnormality for infants and young children.

Objective To investigate the application of echocardiography in the diagnosis of neonatal ductus arteriosus aneurysm (DAA).Methods A total of 27 neonates with DAA were detected by echocardiography.Echocardiographic features in these cases were explored and outcome of these neonates were followed up.Results There were four crucial features in DAA detected by echocardiography:① A vessel bump was shown on the left side of the origination of left pulmonary artery(LPA) in the high parasternal short-axis view.②A horizontal shunt jet from the bump to the origination of LPA was shown when interrogate the top of the bump.③The bump joined the descending arota when interrogate it down and back orientately.A ‘V' shaped sign was shown when the aortic arch appeared on the right side and the bump on the left side.④A slow red flow signal was found in bump when the scale of color Doppler was cut down.The follow-up echocardiography showed spontaneous closure of the DAA when 3 months of age except one case lost.There were no abnormality in the figure and function in heart.Conclusions Echocardiography can be a valuable method for the diagnosis of neonatal ductus arteriosus aneurysm.Neonate with DAA have a good outcome.

Objective To evaluate the clinical value of ultrasonography in the diagnosis of hermaphroditism.Methods Ultrasonographic appearances of 45 cases with hermaphroditism were reviewed retrospectively,and the results were compared with clinical data.Results All cases were confirmed pathologically.5 cases showed true hermaphroditism (11.1％),14 cases showed male pseudohermaphroditism (31.1 ％),24 cases showed female pseudohermaphroditism (53.3 ％),2 cases showed gonadal dysgenesis(4.4％).Compared with pathological results in the ultrasound examination,4 cases showed true hermaphroditism,the coincidence rate was 80％.11 cases showed male pseudohermaphroditism,the coincidence rate was 78.6％.20 cases showed female pseudohermaphroditism,the coincidence rate was 83.3％.1 cases showed gonadal dysgenesis,the coincidence rate was 50.0％.Conclusions Ultrasonography can not only evaluate internal reproductive organs in the patients,but also estimate the site,size,morphology and structure,which provides important imaging evidence for the clinical diagnosis and treatment.

Objective To investigate the ultrasonographic performance of infantile hepatic hemangioendothelioma(IHHE).Methods Clinical and ultrasonographic findings in 14 cases with IHHE were reviewed retrospectively,and compared with CT and MR.Results Among 14 cases,there were 6 cases with single mass,5 cases with multiple masses and 3 cases with diffuse masses.Ultrasonography displayed single mass and multiple masses with clear boundary,heterogeneous inner echo,calcification was detected in 4 cases and anechoic areas were detected in 6 cases.Diffuse masses were small,ill-defined,the echogenicity of the whole liver was extremely disorder.The hepatic artery and the proximal abdominal aortic dilatation was found in 4 cases,and the abdominal aorta which below the coeliac artery became relatively thinner in these cases.Color Doppler showed rich blood supply and intratumoral vasodilation in 8 cases,PW detection of intratumoral arteriovenous fistula in 4 cases.Conclusions Ultrasonography findings of IHHE have some characteristic feature.

Objective To investigate the changes of the shear wave velocities on thyroid tissues in patients with Graves disease(GD) and its correlation with thyrotropin (TSH).Methods Forty GD patients and 30 health adults who underwent an ultrasound-based acoustic radiation force impulse (ARFI) technique,the shear wave velocity of thyroid tissues was obtained using virtual touch tissue quantification (VTQ) of ARFI technique,and the changes of the shear wave velocities on thyroid tissues with GD patients and its correlation with the serum TSH level were analyzed.Results The shear wave velocities of thyroid tissues in patients with GD was lower than that of normal,thas were significant difference( P ＜0.05),but there were no significant differences among different locations in GD patients( P ＞0.05).The shear wave velocities of thyroid tissues were correlated with the serum TSH level in patients with GD,the correlation coefficient was 0.707.Conclusions The shear wave velocity may be considered as a helpful index in diagnosing GD and indirectly reflect the serum TSH level,provide some reference for therapy of the GD.

Objective To evaluate the accuracy of double contrast-enhanced ultrasonography(DCUS) and endoscopic ultrasonography (EUS) in the preoperative T staging of gastric cancer.Methods A total of 136 consecutive patients with histologically confirmed gastric carcinoma were enrolled into this study.DCUS and EUS were performed in all patients to estimate depth of invasionin (T stage) before surgery.All patients underwent surgery.The findings of the histopathologic examination of resected specimens were considered as gold standard and were retrospectively compared with the results of DCUS and EUS.Results The accuracy of DCUS and EUS in determining the T stage of gastric cancer were 80.1％ ( T165.5 ％,T2 79.5％,T386.5％,T487.5％) and 81.60％ ( T182.8％,T276.9％,T382.7％,T487.5％) respectively.There was no significant difference between two methods ( P ＞0.05) except T1 staging.Conclusions There is no significant difference between DCUS and EUS in overall T-staging of gastric cancers,but there is a significant difference between two methods in T1 staging.Either of these two methods has its advantages and disadvantages.If two methods are carried out simultaneously to make up for each other,the accuracy of preoperative T-staging of gastric cancers can be improved and this improvement can influence treatment algorithms.

ObjectiveTo explore the value of virtual touch tissue quantification (VTQ) in the evaluation of clinical pathological typing of advanced gastric cancer.MethodsFifty six patients who had been diagnosed as gastric cancer were examined using acoustic radiation force impulse.According to clinical pathological typing,all cases were divided into highly-moderately differentiated adenocarcinoma (14 cases) and non-highly-moderately differentiated adenocarcinoma (42 cases).A comparison with clinical pathologic results was made after surgery.The correlation of VTQ results and clinical pathological typing of gastric cancer was analyzed.ResultsThe VTQ value of highly-moderately differentiated adenocarcinoma was lower than that of non-highly-moderately differentiated adenocarcinoma [(1.49 ± 0.44) m/s vs (2.12 ± 0.45) m/s],with statistical significance( t =-4.53,P ＜0.05).According to the maximum area under the ROC curve,the cutoff value of VTQ was 1.795 m/s,the sensitivity and specificity were 78％ and 86％,respectively,the Youden's index was 0.64,and with high reproducibility(Kappa =0.81).ConclusionsVTQ could initial estimate the clinical pathological typing of advanced gastric cancer before operation.