ObjectiveTo validate the therapeutic effect of Yinqi Sanhuang Jiedu decoction （YQSH） on a mouse model of carbon tetrachloride （CCl₄）-induced liver fibrosis and to investigate its correlations with the Piezo-type mechanosensitive ion channel component 1 （Piezo1）-Yes-associated protein （YAP） mechanical signaling axis and macrophage polarization. MethodsFifty-four C57BL/6J mice were randomized into a blank control group， a 4-week model group， a 6-week model group， a 8-week model group， a positive drug （silymarin， 55 mg·kg^-1·d^-1） group， and low-， medium-， and high-dose （8.325， 16.65， 33.3 g·kg^-1·d^-1， respectively） YQSH groups. Except the 6-week model group （n=12）， each of the other groups had 6 mice. Mice in other groups except the blank control group received intraperitoneal injections of 10% CCl₄ twice weekly for the modeling of liver fibrosis. Drug interventions began one week after the initial modeling through gavage， and the blank control and model groups received 0.2 mL of normal saline via gavage. The histopathological changes and collagen deposition in the liver were observed via hematoxylin-eosin （HE）， Masson's trichrome， and Sirius red staining. Serum activities of alanine aminotransferase （ALT） and aspartate aminotransferase （AST）， as well as serum levels of total protein （TP）， albumin （ALB）， total bilirubin （TBIL）， hyaluronic acid （HA）， laminin （LN）， procollagen type Ⅲ （PCⅢ）， and collagen type Ⅳ （Ⅳ-C）， were measured. The levels of tumor necrosis factor-α （TNF-α） and interleukin-1β （IL-1β） in the liver tissue were determined by enzyme-linked immunosorbent assay （ELISA）. The protein and mRNA levels of Piezo1 and YAP1 in the liver tissue were determined by immunohistochemistry （IHC） and Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）， respectively. Co-localization of Piezo1 with YAP1， and YAP1 with inducible nitric oxide synthase （iNOS） was observed by the immunofluorescence （IF） assay. The proportions of M1-type （F4/80⁺CD80⁺） and M2-type （F4/80⁺CD206⁺） macrophages in the liver tissue were examined by flow cytometry. Gene Ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analyses and gene set enrichment analysis （GSEA） were performed through transcriptomic sequencing. ResultsCompared with the blank control group， the model group exhibited gradually worsened liver fibrosis at the 4^th， 6^th， and 8^th weeks. The 6- and 8-week model groups showcased inflammatory cell infiltration and collagen deposition in the liver （P<0.01） and upregulated protein levels of both Piezo1 and YAP1 （P<0.01）. Compared with the model groups， treatment with YQSH improved the liver function （P<0.05， P<0.01）， alleviated liver fibrosis （P<0.05， P<0.01）， and reduced intrahepatic inflammatory cell infiltration and collagen deposition （P<0.01）. Furthermore， the treatment downregulated the protein and mRNA levels of Piezo1 and YAP1 （P<0.05， P<0.01）， lowered the levels of inflammatory factors TNF-α and IL-1β （P<0.05， P<0.01）， and decreased the ratio of CD80 （M1-type）/CD206 （M2-type） macrophage proteins （P<0.01）. The IF assay showed co-localization of YAP1 with Piezo1 and iNOS. Compared with the model groups， YQSH treatment downregulated the expression of Piezo1， YAP1， and iNOS （P<0.05， P<0.01）. Transcriptomic analysis suggested that the anti-liver fibrosis effect of YQSH may be related to the Hippo signaling pathway （P<0.05）. ConclusionThe anti-liver fibrosis effect of YQSH may be related to its inhibition of the Piezo1-YAP signaling axis and regulation of macrophage polarization.

ObjectiveTo validate the therapeutic effect of Yinqi Sanhuang Jiedu decoction （YQSH） on a mouse model of carbon tetrachloride （CCl₄）-induced liver fibrosis and to investigate its correlations with the Piezo-type mechanosensitive ion channel component 1 （Piezo1）-Yes-associated protein （YAP） mechanical signaling axis and macrophage polarization. MethodsFifty-four C57BL/6J mice were randomized into a blank control group， a 4-week model group， a 6-week model group， a 8-week model group， a positive drug （silymarin， 55 mg·kg^-1·d^-1） group， and low-， medium-， and high-dose （8.325， 16.65， 33.3 g·kg^-1·d^-1， respectively） YQSH groups. Except the 6-week model group （n=12）， each of the other groups had 6 mice. Mice in other groups except the blank control group received intraperitoneal injections of 10% CCl₄ twice weekly for the modeling of liver fibrosis. Drug interventions began one week after the initial modeling through gavage， and the blank control and model groups received 0.2 mL of normal saline via gavage. The histopathological changes and collagen deposition in the liver were observed via hematoxylin-eosin （HE）， Masson's trichrome， and Sirius red staining. Serum activities of alanine aminotransferase （ALT） and aspartate aminotransferase （AST）， as well as serum levels of total protein （TP）， albumin （ALB）， total bilirubin （TBIL）， hyaluronic acid （HA）， laminin （LN）， procollagen type Ⅲ （PCⅢ）， and collagen type Ⅳ （Ⅳ-C）， were measured. The levels of tumor necrosis factor-α （TNF-α） and interleukin-1β （IL-1β） in the liver tissue were determined by enzyme-linked immunosorbent assay （ELISA）. The protein and mRNA levels of Piezo1 and YAP1 in the liver tissue were determined by immunohistochemistry （IHC） and Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）， respectively. Co-localization of Piezo1 with YAP1， and YAP1 with inducible nitric oxide synthase （iNOS） was observed by the immunofluorescence （IF） assay. The proportions of M1-type （F4/80⁺CD80⁺） and M2-type （F4/80⁺CD206⁺） macrophages in the liver tissue were examined by flow cytometry. Gene Ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analyses and gene set enrichment analysis （GSEA） were performed through transcriptomic sequencing. ResultsCompared with the blank control group， the model group exhibited gradually worsened liver fibrosis at the 4^th， 6^th， and 8^th weeks. The 6- and 8-week model groups showcased inflammatory cell infiltration and collagen deposition in the liver （P<0.01） and upregulated protein levels of both Piezo1 and YAP1 （P<0.01）. Compared with the model groups， treatment with YQSH improved the liver function （P<0.05， P<0.01）， alleviated liver fibrosis （P<0.05， P<0.01）， and reduced intrahepatic inflammatory cell infiltration and collagen deposition （P<0.01）. Furthermore， the treatment downregulated the protein and mRNA levels of Piezo1 and YAP1 （P<0.05， P<0.01）， lowered the levels of inflammatory factors TNF-α and IL-1β （P<0.05， P<0.01）， and decreased the ratio of CD80 （M1-type）/CD206 （M2-type） macrophage proteins （P<0.01）. The IF assay showed co-localization of YAP1 with Piezo1 and iNOS. Compared with the model groups， YQSH treatment downregulated the expression of Piezo1， YAP1， and iNOS （P<0.05， P<0.01）. Transcriptomic analysis suggested that the anti-liver fibrosis effect of YQSH may be related to the Hippo signaling pathway （P<0.05）. ConclusionThe anti-liver fibrosis effect of YQSH may be related to its inhibition of the Piezo1-YAP signaling axis and regulation of macrophage polarization.

Objective To observe the value of MR T2WI intratumoral and peritumoral CT radiomics for predicting von Hippel-Lindau(VHL)gene mutation in renal carcinoma.Method Totally 150 patients with renal carcinoma were retrospectively enrolled and divided into training set(n=105)and validation set(n=45)at the ratio of 7∶3,and furtherly assigned into mutation subgroup and wild subgroup according to with VHL gene mutation or not.Multivariate logistic regression analysis was performed to screen the independent risk factors of VHL gene mutation in renal carcinoma,then a clinical model was constructed.The optimal radiomics features were extracted and screened based on intratumoral+peritumoral 2 mm regions shown on MR T2WI.Logistic regression algorithm was used to construct radiomics model,and finally a combined model was established based on radiomics model and clinical model.Receiver operating characteristic curves were drawn,and the area under the curves(AUC)were calculated to evaluate the efficacy of each model for predicting VHL gene mutation in renal carcinoma.Result Patients'age,smoking history,hypertension history,other family histories and β2-microglobulin were all independent clinical risk factors for VHL gene mutation in renal carcinoma(all P＜0.05).The efficacy of clinical model,radiomics model and combined model for predicting VHL gene mutation in renal carcinoma increased successively(all P＜0.05),with AUC of 0.758,0.831 and 0.952 in training set,0.729,0.803 and 0.896 in validation set,respectively.Conclusion MR T2WI intratumoral and peritumoral CT radiomics had good efficacy for predicting VHL gene mutation in renal carcinoma.Combining with clinical features could further improve predicting efficacy of model.

Objective To observe the value of MR T2WI intratumoral and peritumoral CT radiomics for predicting von Hippel-Lindau(VHL)gene mutation in renal carcinoma.Method Totally 150 patients with renal carcinoma were retrospectively enrolled and divided into training set(n=105)and validation set(n=45)at the ratio of 7∶3,and furtherly assigned into mutation subgroup and wild subgroup according to with VHL gene mutation or not.Multivariate logistic regression analysis was performed to screen the independent risk factors of VHL gene mutation in renal carcinoma,then a clinical model was constructed.The optimal radiomics features were extracted and screened based on intratumoral+peritumoral 2 mm regions shown on MR T2WI.Logistic regression algorithm was used to construct radiomics model,and finally a combined model was established based on radiomics model and clinical model.Receiver operating characteristic curves were drawn,and the area under the curves(AUC)were calculated to evaluate the efficacy of each model for predicting VHL gene mutation in renal carcinoma.Result Patients'age,smoking history,hypertension history,other family histories and β2-microglobulin were all independent clinical risk factors for VHL gene mutation in renal carcinoma(all P＜0.05).The efficacy of clinical model,radiomics model and combined model for predicting VHL gene mutation in renal carcinoma increased successively(all P＜0.05),with AUC of 0.758,0.831 and 0.952 in training set,0.729,0.803 and 0.896 in validation set,respectively.Conclusion MR T2WI intratumoral and peritumoral CT radiomics had good efficacy for predicting VHL gene mutation in renal carcinoma.Combining with clinical features could further improve predicting efficacy of model.

Objective:To investigate the effect of anemia on mortality in very low-weight preterm infants.Methods:A total of 200 extremely low-weight preterm infants who were admitted to the neonatal intensive care unit from September 2016 to September 2018 were selected. Demographic and clinical data of maternal and premature babies were recorded. According to whether premature infants were associated with anemia, very low weight premature infants were divided into anemia group and non-anemia group. All variables of maternal and premature babies were compared between the two groups. All-cause deaths of preterm babies during hospitalization were used as dependent variables. Statistically significant variables were used as independent variables. Multivariate binary Logistic regression analysis of independent variables and dependent variables was performed.Results:Anemia group and non-anemia group included 64 cases and 136 cases respectively. In anemia group, the mean gestational age was (26.45 ± 2.32) weeks, the mean hematocrit was (37.72 ± 3.81)% and the mean hemoglobin was (12.81 ± 1.51) g/L; in non-anemia group, the data were (27.21 ± 2.21) weeks, (48.42 ± 5.61)% and (16.89 ± 2.12) g/L, respectively. There were significant differences in the above indexes ( t values were 10.23, 12.23, 8.51, P < 0.05 or 0.01). 43 cases (67.19%) in anemia group and 52 cases (38.24%, 52/136) in non-anemia group of Apgar score 1 min < 5 points. There was significant difference between the two groups in the above index ( χ2 value was 15.55, P < 0.01). In anemia group, there were 34, 26, 32 cases of the use of vasopressin, periventricular hemorrhage and death in the first 72 hours after birth, 41, 23, 50 cases in non-anemia group, there were significant differences between the two groups ( χ 2 values were 9.80, 13.23, 8.01, P < 0.01 or 0.05). The median of red blood cell transfusion was 2 days, 75 ml/kg from birth to the first blood transfusion in anemia group, and 7 days, 45 ml/kg from birth to the first blood transfusion in non-anemia group. There was statistical difference between the two groups in the above indexes ( U values were 482.2, 781.9, P < 0.05). In the first 72 hours after birth, the use of vasopressin, periventricular hemorrhage and anemia were independent risk factors ( OR values were 12.30, 13.40, 34.89, P < 0.05). Conclusions:If very low weight preterm infants are accompanied by anemia, the use of vasopressors in the first 72 hours after birth increases the risk of death from periventricular hemorrhage.

Objective To study comparison of central line-associated bloodstream infection (CLABSI)with different catheterization methods of neonates and the comparison of each type of catheter and the general condition of neonates and the influence of catheter time on CLABSI. Methods A total of 797 neonates with umbilical venous catheter(UVC)or PICC were studied from August 2014 to September 2016,among them,278 were adopted with UVC(UVC group),262 were adopted with PICC(PICC group), and 263 were adopted with UVC and PICC catheter(combination group).Respectively recorded all the neonates′general situation,analized the differences of each group,and recorded each group of 4 days of CLABSI number, and evaluated the 10th day of CLABI progress of each group. Results There were significant differences among 3 groups of newborns in gestational weeks, birth weight, the number of respiratory distress syndrome at birth, the number of sepsis at birth, the number of cesarean delivery babies and the number of deaths were statistically significant (F=5.998, 4.943, χ2=5.160-8.970, all P <0.05). The incidence of CABSI in fourth days was 1.1% (3/278) in UVC group, 1.9%(5/262) in PICC group,and 3.0%(8/263)in combination group.On the tenth day,the incidence of CABSI was 5.4%(15/278)in UVC group,2.7%(7/262)in PICC group,and 5.1%(10/196)in combination group removing UVC, while 10.4% (7/67) in combination group without removing UVC. The PICC group and the combination group removing UVC had no significant difference in CABSI infection(P>0.05)and in UVC group,the incidence rate increased significantly (χ2=2.85, P < 0.05), combination group without removing UVC increased significantly in patients with CABSI infection and the difference was statistically significant(χ2=6.31,P<0.01). Conclusions UVC group had more risk of CABSI compared with PICC,we can choose UVC for short term,and PICC catheter for long term.