ObjectiveTo explore the relationship between negative life events and depression severity in adolescent patients with depressive disorder， as well as the chain mediating role of insomnia symptoms and quality of life. Methods374 outpatient patients and hospitalized patients with adolescent depressive disorders were enrolled. The Adolescent Life Event Scale （ASLEC）， the Insomnia Severity Index （ISI）， the World Health Organization Quality of Life Questionnaire Short Form （WHOQOL-BREF）， and the Center for Epidemiology Depression Scale （CES-D） were used to evaluate the negative life event situation， insomnia symptoms， quality of life level and depression severity of the subjects， respectively. In addition， the PROCESS 4.0 macroprogram was used to analyze the chain mediating effect of insomnia symptoms and quality of life between negative life events and depression severity in patients with adolescent depressive disorder. ResultsThe results of correlation analysis showed that there was a significant correlation between negative life events and insomnia symptoms， quality of life， and depression severity （all P<0.05）. In addition， the results of chain mediation showed that negative life events had a significant direct effect on depression severity， with an effect size of 0.12 （P<0.001）. Insomnia symptoms and quality of life played a mediating role in the relationship between negative life events and depression severity in patients with adolescent depressive disorders， with indirect effect sizes of 0.062 （95%CI： 0.040-0.087） and 0.091 （95%CI： 0.059-0.123）， respectively. It could also play a chain mediation role， and the effect size was 0.039 （95%CI： 0.024-0.057）. ConclusionNegative life events experienced by patients with adolescent depressive disorder not only directly affect the severity of depressive symptoms， but may also indirectly exacerbate depression through insomnia symptoms and quality of life.

Objective To investigate the value of the shear wave elastography ( SWE) in the diagnosis of biliary atresia ( BA ) in infants by ultrasonography . Methods SWE was used to measure the liver stiffness measurement( LSM ) of 138 infants . Following surgical or pathological diagnosis ,the infants were subclassified into BA and non-biliary atresia ( non-BA ) groups . ROC analysis was used to determine the sensitivity and specificity of LSM ,the ultrasonic findings in the differential diagnosis of suspected BA ,and the cut-off value to diagnose BA . Results Of the 138 infants with cholestatic hepatitis ,51 were diagnosed as BA group and 87 cases were assigned to the non-BA group . The ROC analysis showed the cut-off value of LSM for diagnosis of biliary atresia in children with jaundice was 12 .35 kPa ,the AUC was 0 .936 ,and the sensitivity and specificity were 84 .3% and 89 .7% ,respectively .In the parallel test ,the triangular cord ( TC) sign combined with abnormal gallbladder ( AbGB) had the best diagnostic performance in all patients . However ,in patients older than 30 days ,the LSM combined with TC had the best AUC ( 0 .987 ) and diagnostic performance( 98 .6% ) like with TC combined with AbGB . Conclusions Both SWE and gray scale ultrasound have higher diagnostic performance for BA . LSM can be used as a valuable index for diagnosing BA by ultrasound .