BackgroundCurrently， the problem of depressed mood in college students is becoming more prominent. The experience of childhood maltreatment is a significant contributor to depression among college students. Although the association between the two has been confirmed， the specific psychosocial mechanisms underlying how childhood maltreatment affects college students' mental health remain insufficiently evidenced. ObjectiveTo explore the mediating role of emotion regulation difficulties in the relationship between childhood maltreatment and depression among college students， and to investigate the moderated effects of psychological resilience and family socioeconomic status， aiming to provide references for improving depressive symptoms in college students. MethodsOn 14 March 2024， a cluster sampling method was employed to recruit 751 college students from a university in Heilongjiang Province. Participants were assessed with Childhood Trauma Questionnaire （CTQ）， Difficulties in Emotion Regulation Scale （DERS）， Patients' Health Questionnaire Depression Scale-9 item （PHQ-9）， 10-item Connor-Davidson Resilience Scale （CD-RISC-10） and Family Socioeconomic Status Questionnaire. Pearson correlation analysis was adopted to examine the correlation between the scores of scales. Model 4 and model 7 in Process 4.2 were used to test the mediating effects of emotional regulation difficulties and the moderated effects of psychological resilience and family socioeconomic status. Results① A total of 712 （94.81%） valid questionnaires were collected. ② College students' CTQ score was positively correlated with DERS score and PHQ-9 score （r=0.296， 0.507， P<0.01）， and negatively correlated with CD-RISC-10 score and Family Socioeconomic Status Questionnaire score （r=-0.148， -0.229， P<0.01）. ③ The indirect effect value of difficulties in emotion regulation on the relationship between childhood maltreatment and depression was 0.091 （95% CI： 0.018~0.046）， accounting for 17.95% of the total effect. ④ The first half of the mediation model "childhood maltreatment → difficulties in emotion regulation → depression" （childhood maltreatment → difficulties in emotion regulation） was moderated by psychological resilience （β=-0.030， t=-6.147， 95% CI： -0.040~-0.020） and family socioeconomic status （β=-0.051， t=-3.929， 95% CI： -0.077~-0.026）. ConclusionChildhood maltreatment exerts both a direct effect on college students' depression and an indirect effect through emotion regulation difficulties. The childhood maltreatment → emotion regulation difficulties pathway in this mediation model is moderated by psychological resilience and family socioeconomic status. ［Funded by Qiqihar Medical University Graduate Student Innovation Fund Project （number， QYYCX2023-48）； Special Research Fund Project for Young Doctors of Qiqihar Academy of Medical Sciences （number， QMSI2021B-08）］

Objective:To evaluate the efficacy and safety of once-daily tacrolimus extended-release capsules (OD-TAC) in pediatric liver transplant recipients after conversion from twice-daily tacrolimus (TD-TAC).Methods:A retrospective analysis was performed on pediatric liver transplant recipients at Tianjin First Center Hospital between January 2014 and December 2020 who were converted from TD-TAC to OD-TAC with a follow-up of at least 12 months. After conversion, all patients received OD-TAC monotherapy. The daily dose conversion ratio from TD-TAC to OD-TAC ranged from 2∶1 to 1∶2. Clinical data including demographics, tacrolimus dosage, trough concentrations, liver function, and adverse events were collected. Continuous variables with normal distribution were expressed as Mean±SD and compared using independent-samples t-test or ANOVA; non-normally distributed variables were expressed as median ( Q1, Q3) and compared using Mann-Whitney U or Kruskal-Wallis H tests. Categorical variables were expressed as frequency and percentage, and compared using χ 2 test or Fisher's exact test. P<0.05 was considered statistically significant. Results:A total of 290 children were enrolled, including 140 males (48.3%) and 150 females (51.7%). The median age at transplantation was 7.34 (6.03, 12.34) months, and the median time to conversion was 36 (29, 48) months post-transplant. Tacrolimus daily doses at 3, 6, and 12 months after conversion were slightly higher than before conversion, but without statistical significance (all P>0.05). Trough tacrolimus levels at 6 and 12 months after conversion were 2.34±1.02 μg/L and 2.23±1.07 μg/L, respectively, both lower than pre-conversion (2.77±1.43 μg/L), with statistical significance ( P=0.02 and P<0.01). Serum creatinine levels at 6 and 12 months post-conversion were 2.63±0.63 mmol/L and 2.76±0.68 mmol/L, respectively, both higher than before conversion (2.57±1.90 mmol/L, P<0.05). Triglyceride level at 12 months post-conversion was 0.87±0.25 mmol/L, significantly lower than pre-conversion (1.05±0.55 mmol/L, P<0.05). Two patients developed transient bilirubin elevation at 3 months, and another two developed transient triglyceride elevation at 6 months; all recovered without intervention. No new-onset diabetes was observed during follow-up. Thirteen patients experienced acute rejection. One patient (0.3%) died three years after conversion due to hepatic venous outflow obstruction, while all others survived. Conclusion:In pediatric liver transplant recipients, OD-TAC provides comparable efficacy and safety to TD-TAC.

Objective To elucidate the pharmacokinetic characteristics and primary metabolic pathways of anthocyanins in vivo,as well as the endogenous metabolites exhibiting sensitive responses to bilberry extract intervention in rats by LC-MS/MS technology,following oral administration of bilberry extract.Methods Multi-component pharmacokinetic technology was employed to study the systemic exposure characteristics of anthocyanins in blood,the metabolic product profile,and the dynamic concentration changes of anthocyanins and their metabolites in plasma after oral administration of bilberry extract to rats.Metabolomics technology was used to analyze changes in endogenous metabolites at the time point when most anthocyanins reached their peak plasma concentration.Results After administration of European cranberry extract,a total of 18 anthocyanin parent compounds and 14 metabolites were detected in rat plasma.Glucuronidation was identified as the primary metabolic pathway.The time to reach peak concentration(Tmax)for most parent compounds ranged from 15 to 60 minutes.Moreover,30 minutes after oral dosing with the cranberry extract,the levels of various endogenous acyl-carnitines,fatty acids,and lysophosphatidylcholines in the blood decreased.The plasma exposure of most anthocyanin components and their metabolites showed a highly linear correlation with the administered dose(R2>0.9).Conclusion This study clarified the main pharmacokinetic characteristics and metabolic pathways of anthocyanins from bilberry extract in rats,as well as the potential impact on various endogenous metabolites.It provides data support for effectively exploring the pharmacodynamic material basis and mechanism of action of bilberry extract.

Objective To elucidate the pharmacokinetic characteristics and primary metabolic pathways of anthocyanins in vivo,as well as the endogenous metabolites exhibiting sensitive responses to bilberry extract intervention in rats by LC-MS/MS technology,following oral administration of bilberry extract.Methods Multi-component pharmacokinetic technology was employed to study the systemic exposure characteristics of anthocyanins in blood,the metabolic product profile,and the dynamic concentration changes of anthocyanins and their metabolites in plasma after oral administration of bilberry extract to rats.Metabolomics technology was used to analyze changes in endogenous metabolites at the time point when most anthocyanins reached their peak plasma concentration.Results After administration of European cranberry extract,a total of 18 anthocyanin parent compounds and 14 metabolites were detected in rat plasma.Glucuronidation was identified as the primary metabolic pathway.The time to reach peak concentration(Tmax)for most parent compounds ranged from 15 to 60 minutes.Moreover,30 minutes after oral dosing with the cranberry extract,the levels of various endogenous acyl-carnitines,fatty acids,and lysophosphatidylcholines in the blood decreased.The plasma exposure of most anthocyanin components and their metabolites showed a highly linear correlation with the administered dose(R2>0.9).Conclusion This study clarified the main pharmacokinetic characteristics and metabolic pathways of anthocyanins from bilberry extract in rats,as well as the potential impact on various endogenous metabolites.It provides data support for effectively exploring the pharmacodynamic material basis and mechanism of action of bilberry extract.

Objective:To evaluate the efficacy and safety of once-daily tacrolimus extended-release capsules (OD-TAC) in pediatric liver transplant recipients after conversion from twice-daily tacrolimus (TD-TAC).Methods:A retrospective analysis was performed on pediatric liver transplant recipients at Tianjin First Center Hospital between January 2014 and December 2020 who were converted from TD-TAC to OD-TAC with a follow-up of at least 12 months. After conversion, all patients received OD-TAC monotherapy. The daily dose conversion ratio from TD-TAC to OD-TAC ranged from 2∶1 to 1∶2. Clinical data including demographics, tacrolimus dosage, trough concentrations, liver function, and adverse events were collected. Continuous variables with normal distribution were expressed as Mean±SD and compared using independent-samples t-test or ANOVA; non-normally distributed variables were expressed as median ( Q1, Q3) and compared using Mann-Whitney U or Kruskal-Wallis H tests. Categorical variables were expressed as frequency and percentage, and compared using χ 2 test or Fisher's exact test. P<0.05 was considered statistically significant. Results:A total of 290 children were enrolled, including 140 males (48.3%) and 150 females (51.7%). The median age at transplantation was 7.34 (6.03, 12.34) months, and the median time to conversion was 36 (29, 48) months post-transplant. Tacrolimus daily doses at 3, 6, and 12 months after conversion were slightly higher than before conversion, but without statistical significance (all P>0.05). Trough tacrolimus levels at 6 and 12 months after conversion were 2.34±1.02 μg/L and 2.23±1.07 μg/L, respectively, both lower than pre-conversion (2.77±1.43 μg/L), with statistical significance ( P=0.02 and P<0.01). Serum creatinine levels at 6 and 12 months post-conversion were 2.63±0.63 mmol/L and 2.76±0.68 mmol/L, respectively, both higher than before conversion (2.57±1.90 mmol/L, P<0.05). Triglyceride level at 12 months post-conversion was 0.87±0.25 mmol/L, significantly lower than pre-conversion (1.05±0.55 mmol/L, P<0.05). Two patients developed transient bilirubin elevation at 3 months, and another two developed transient triglyceride elevation at 6 months; all recovered without intervention. No new-onset diabetes was observed during follow-up. Thirteen patients experienced acute rejection. One patient (0.3%) died three years after conversion due to hepatic venous outflow obstruction, while all others survived. Conclusion:In pediatric liver transplant recipients, OD-TAC provides comparable efficacy and safety to TD-TAC.

Objective To reveal the pharmacodynamic material basis of Kaixinsan by using high performance liquid chromatography-tandem mass spectrometry(HPLC-MS/MS)and the integrated analysis of"chemical component spectrum-plasma exposure component spectrum-mitochondrial function".Methods Through a review of literature,databases,and previous studies,the chemical components of ginseng,polygala,poria,and acorus were systematically cataloged.A qualitative analysis method for the chemical constituents in the aqueous extract of Kaixinsan was developed,allowing for the identification of its chemical components.A qualitative analysis for rat plasma based on HPLC-MS/MS was established,which was applied to analyze the plasma exposure component spectrum following oral administration of Kaixinsan aqueous extract in rats.Aerobic respiration was evaluated using a seahorse cell energy metabolism analyzer,and the effect of key components of Kaixinsan on mitochondrial aerobic respiration was assessed.Results Four main types of components were identified in the Kaixinsan aqueous extract,including saponins,oligosaccharide esters,xanthones,and triterpenes,comprising a total of 231 identified compounds.Analysis of rat plasma 30 minutes after gavage with Kaixinsan identified 55 compounds.The analysis revealed that ginsenoside Rg1,3,6'-disinapoylsucrose,polygalaxanthone Ⅲ and poricoic acid B could significantly enhance mitochondrial respiratory capacity using in vitro cellular assays to detect aerobic respiration of four main components entered blood.Conclusions Saponins,oligosaccharide esters,xanthones,and triterpenes may be the material basis for the pharmacological effect of Kaixinsan by improving mitochondrial function.The integrated analysis of"chemical component spectrum-plasma exposure component spectrum-mitochondrial function"provides a new approach for in-depth exploration of the material basis underlying the efficacy of traditional Chinese medicine.

The most effective treatment for end-stage liver disease (ESLD) in children is liver transplantation (LT ). After LT, recipients must take immunosuppressants for a long time to maintain graft function. The side effects of immunosuppressants affect long-term recipient survival. Many domestic and global centers have made great efforts to taper or completely remove immunosuppressants in recipients in recent years. Some recipients successfully achieve immune tolerance after withdrawing immunosuppressants. However, there are no definite and effective protocols or indicators for immunization evaluation. And few studies focused upon the safety and long-term outcomes of immunosuppressant withdrawal. This review discussed the protocols and researches of immune tolerance after pediatric LT to provide practical guidance for a withdrawal of immunosuppressants and clinical advice of immune tolerance.

Objective:To explore the predictive value of psoas muscle index(PMI)on early survival and complications after liver transplantation(LT)in children with biliary atresia(BA).Methods:Between January 1, 2016 and September 30, 2020, the relevant clinical data are retrospectively reviewed for 244 BA children undergoing LT at Department of Pediatric Liver Transplantation, Tianjin First Central Hospital.Total psoas muscle area(PMA)at the level of the third lumbar endplate is measured based upon preoperative abdominal computed tomography(CT)and normalized by the square of length for obtaining the value of PMI.According to the survival at Year 1 post-LT, receiver operating characteristic(ROC)curve is plotted and the cut-off value calculated.According to the cut-off value, they are divided into two groups of high PMI(173 cases)and low PMI(71 cases). Then the clinical data of 2 groups are compared.Kaplan-Meier survival curves at Year 1 post-LT are analyzed.And Cox proportional hazard model is utilized for conducting a multivariate analysis of early death.Results:The cut-off value of PMI is 534.6 mm 2/m 2.Two groups are compared in terms of age, gender, weight-for-age Z-score(WAZ), length-for-age Z-score(LAZ)and preoperative laboratory parameters ( P>0.05). Significant inter-group differences existed in the types of donors and surgery( P<0.05), and the median age of recipients in low PMI is higher than high PMI group(7.77months vs 6.57 months, P<0.01). The proportion of children with a history of Kasai surgery in low PMI group(78.87% vs 53.76%, P<0.01)and the median length of stay in hospital(23 d vs 20 d, P=0.03)is higher in low PMI group, but recipients(88.7% vs 97.1%, P<0.01)and grafts(87.3% vs 96%, P=0.01)1-year survival rate are lower.Multivariate analysis indicated that high PMI is a protective factor for early postoperative survival( HR=0.132, 95% CI: 0.028~0.626, P=0.011). Conclusions:PMI is an independent predictor of early survival post-LT and has a certain predictive value for early graft loss in BA children.

Objective:To study the impact of donor left hepatic vein classification and the reconstruction methods on hepatic venous outflow obstruction (HVOO) after pediatric living-donor liver transplantation using left lateral liver segments.Methods:A retrospective study was performed on the clinical data of 653 children recipients who underwent living-donor liver transplantation with left lateral liver segments from January 2014 to December 2020 at Tianjin First Central Hospital. There were 309 males and 344 females, aged 7.0 (6.0, 10.0) months, with an age range of 3-121 months. Based on the left hepatic vein on preoperative donor enhancement CT as well as the intraoperative reconstruction methods, the recipients were divided into 3 groups: type Ⅰ group ( n=514), anastomosis using a single opening was performed directly between the donor and the recipient; type Ⅱ group ( n=118), angioplasty was performed on two adjacent recipient venous orifices before anastomosis, and type Ⅲ group ( n=21), an interposition vessel was anastomosed to two widely spaced openings or the two veins were anastomosed separately. The preoperative general status of the patient, postoperative HVOO incidences, and graft and recipient survival rates were compared among the three groups. The patients were followed up by outpatient reexamination or telephone. Results:Graft to recipient weight ratio in the type Ⅲ group was smaller than that in the type Ⅰ group and the type Ⅱ group ( P<0.05). For all the 653 patients, the incidence of postoperative HVOO was 4.59% (30/653), with the incidences of HVOO in the 3 groups of patients were 4.1% for the type Ⅰ group (21/514), 5.1% for the type Ⅱ group (6/118), and 14.3% for the type Ⅲ group (3/21), respectively. There was no significant difference among the groups ( P>0.05). The recipient cumulative survival rates at 1 and 3 years after surgery in the type I group were 97.8% and 97.0%, and the corresponding rates in the type Ⅱ group were 96.5% and 94.2%, and in the type Ⅲ group were 94.1% and 86.9%, respectively. There was a significant difference between the type Ⅰ and type Ⅲ groups ( P=0.048). The graft cumulative survival rates at 1 and 3 years in the type Ⅰ group were 97.4% and 96.9%, and the corresponding rates in the type Ⅱ group were 94.9% and 92.5%, and in the type Ⅲ group were 94.1% and 86.9%, respectively. The difference in the postoperative graft cumulative survival rates between the type Ⅰ group and type Ⅱ group was significant ( P=0.044). Conclusions:The anatomy of the left hepatic vein supplying the left lateral liver segment was highly variable, and the majority of the variations could be reconstructed. A reasonable reconstructive method could reduce the incidence of postoperative HVOO and improved the outcomes of the graft.

Clinically, routine urinalysis includes more than 10 items, such as urine protein, urinary pH, urinary bilirubin and so on. The above items are usually analyzed by dry chemical methods. The principle is that after the urine infiltrates the reagent strips, the color changes can be observed in each strip. The color depth is related to the component concentration, and the darker the color, the greater the measured component concentration, and vice versa. In this paper, four color discrimination methods in urinary dry chemical analysis were introduced, i.e. the method based on integrating sphere photoelectric conversion, the method based on charge-coupled device (CCD) image sensor, the method based on color sensor, and the method based on the combination of color sensor and fiber bundle. Besides, the four methods were compared and analyzed. Finally, the recent research progress in urinalysis was reviewed.