Autoimmune hepatitis(AIH)is a chronic inflammatory liver disease caused by immune abnormalities.Genetic factors play an important role in AIH.The analysis of genes has shown that new genetic markers can help to deepen the understanding of the risk of AIH and develop treatment measures.This article reviews the research advances in human leukocyte antigen,single nucleotide polymorphism,and epigenetics,in order to provide a reference for clinical treatment and research on AIH.

Objective To explore the clinical efficacy of superselective arterial embolization in children with Parkes-Weber syndrome(PWS),and the prevention and treatment of postoperative complications.Methods Nine patients with PWS diagnosed by clinical and imaging examinations were selected.Under general anesthesia,the catheter was cannulated to all levels of branch arteries and lesion sites using the Seldinger technique.Absorbent gelatin sponge particle(or lipiodol)was selected according to the angiographic situation,and then target vessel embolization was performed.Patients with venous malformations were treated with local sclerotherapy at the same time.The patients were followed up for 1 month,3 months,6 months and 1 year after the operation to observe the clinical efficacy and complication.Results All 9 patients were successfully treated with interventional therapy.Arteriography showed that micro arteriovenous fistula existed at the distal end of multiple branch arteries,and the arteriovenous fistula had been closed after embolization.Review after 1 month of interventional therapy,the color spot of the affected limb became lighter,the temperature decreased,the leg circumference decreased,and the pain was relieved of all 9 cases.Three patients had skin deep color 2-3 days after the operation,so they were given hirudoid local smear,3 times/day,local warm water wet compress,raised limb position,local massage and other methods,and the local skin color gradually recovered after 1 week;On the 15th day after the operation,2 patients suffered from ischemic necrosis at the embolic site,skin color deepened,and tenderness.They were locally disinfected with hirudoid,aurantium peptide,normal saline,and iodophor.The skin broke and scabbed more than 1 month after the operation,the skin ulcer improved and new granulation tissue grew up 1.5 months after the operation;One case had no obvious reduction of the lesion 1 month after the operation,so the second intervention was performed.Conclusion Superselective arterial embolization is effective in the treatment of PWS in children,but the prevention of complications should be paid attention to and complications should be timely treated.

Autoimmune hepatitis(AIH)is a chronic inflammatory liver disease caused by immune abnormalities.Genetic factors play an important role in AIH.The analysis of genes has shown that new genetic markers can help to deepen the understanding of the risk of AIH and develop treatment measures.This article reviews the research advances in human leukocyte antigen,single nucleotide polymorphism,and epigenetics,in order to provide a reference for clinical treatment and research on AIH.

Objective To explore the clinical efficacy of superselective arterial embolization in children with Parkes-Weber syndrome(PWS),and the prevention and treatment of postoperative complications.Methods Nine patients with PWS diagnosed by clinical and imaging examinations were selected.Under general anesthesia,the catheter was cannulated to all levels of branch arteries and lesion sites using the Seldinger technique.Absorbent gelatin sponge particle(or lipiodol)was selected according to the angiographic situation,and then target vessel embolization was performed.Patients with venous malformations were treated with local sclerotherapy at the same time.The patients were followed up for 1 month,3 months,6 months and 1 year after the operation to observe the clinical efficacy and complication.Results All 9 patients were successfully treated with interventional therapy.Arteriography showed that micro arteriovenous fistula existed at the distal end of multiple branch arteries,and the arteriovenous fistula had been closed after embolization.Review after 1 month of interventional therapy,the color spot of the affected limb became lighter,the temperature decreased,the leg circumference decreased,and the pain was relieved of all 9 cases.Three patients had skin deep color 2-3 days after the operation,so they were given hirudoid local smear,3 times/day,local warm water wet compress,raised limb position,local massage and other methods,and the local skin color gradually recovered after 1 week;On the 15th day after the operation,2 patients suffered from ischemic necrosis at the embolic site,skin color deepened,and tenderness.They were locally disinfected with hirudoid,aurantium peptide,normal saline,and iodophor.The skin broke and scabbed more than 1 month after the operation,the skin ulcer improved and new granulation tissue grew up 1.5 months after the operation;One case had no obvious reduction of the lesion 1 month after the operation,so the second intervention was performed.Conclusion Superselective arterial embolization is effective in the treatment of PWS in children,but the prevention of complications should be paid attention to and complications should be timely treated.

Objective To construct a continuous nursing quality evaluation indicator system for inflam-matory bowel disease patients and provide a basis for the evaluation of continuous nursing quality.Methods On the basis of Donabedian's three-dimensional(structure,process,and outcome)quality structure,we employed liter-ature review,qualitative interview,Delphi method,and hierarchical analysis to determine the content and weights of indicators of continuous nursing quality for the patients with inflammatory bowel disease.Results A total of 15 experts completed 2 rounds of consultation,which had the questionnaire recovery rates of 100％,the expert authority coefficients of 0.930 and 0.919,and the Kendall harmony coefficients of 0.149 and 0.177(both P＜0.001),respectively.The established nursing quality evaluation indicator system included 3 first-level indicators,10 sec-ond-level indicators,and 39 third-level indicators.Conclusion The continuous nursing quality evaluation indi-cator system for the patients with inflammatory bowel disease that was constructed in this study was reasonable,reliable,and practical,providing reference for evaluating the continuous nursing quality for the patients with in-flammatory bowel disease.

Objective To investigate the serum levels of semaphorin 3E(Sema3E)in patients with intracranial aneurysms,revealing the correlation between Sema3E and 1-month poor prognosis after interventional embolization.Methods This study was a prospective single-center cohort study,recruiting 102 consecutive patients with intracranial aneurysms who underwent interventional surgery from June 2020 to January 2022 in our hospital.Among them,11 patients were excluded.Clinical and radiological profiles were collected.Peripheral blood was collected after admission,and serum Sema3E levels were determined by enzyme-linked immunosorbent assay.All the aneurysms were treated with endovascular coil embolization or stent-assisted coil embolization.The primary outcome was evaluated with the Glasgow Outcome Scale(GOS)1 month after interventional therapy.The favorable outcome was defined as a GOS score of 4-5,and a poor outcome was defined as a GOS score of 1-3(severe disability,vegetative state,or death).Univariate and multivariate logistic regression analyses were used to identify potential prognostic factors after interventional therapy.Results The average age of 91 patients with intracranial aneurysm was 59.9±11.0 years old,including 70 cases(76.9%)with favorable prognosis and 21 cases(23.1%)with poor prognosis.The mean preoperative Glasgow Coma Scale(GCS)score of the poor prognosis group(9.4±4.5)was significantly lower than that of the favorable prognosis group(13.3±2.5;P<0.001).In the poor prognosis group,the Hunt-Hess grade(3.6±0.6 vs.2.0±1.3,P<0.001)and the serum Sema3E levels[(6.21±1.58)μg/L vs.(4.38±1.77)μg/L,P<0.001]were significantly higher than those in the favorable prognosis group.Logistic regression analysis showed the Hunt-Hess grade(OR =7.150,P =0.003),stent-assisted coil embolization(OR =15.777,P =0.010),and the serum Sema3E level(OR =1.756,P =0.027)were independent prognostic factors for intracranial aneurysms after interventional therapy.Conclusions The serum Sema3E level is closely correlated with the severity of intracranial aneurysms.The serum Sema3E level is a prognostic factor for interventional treatment,which can be used as a biomarker for predicting poor outcomes.

Objective:To investigate the effect of modified bowel examination schedule and corresponding bowel preparation protocol on bowel preparation quality and satisfaction of patients with Crohn′s disease (CD) undergoing CT enterography (CTE) and colonoscopy during follow up.Methods:A total of 207 patients with CD in our hospital from December 2021 to October 2022 were prospectively included in the study, among whom 94 patients from West Hospital and South Hospital were used as control group, with routine examination arrangement and intestinal preparation protocol; 113 patients from East Hospital were used as observation group with modified examination arrangement and intestinal preparation protocol, meaning that these two examinations were adjusted to the same day and were combined with oral laxative bowel preparation. The differences between the two groups in the quality of bowel preparation, satisfaction and adverse effects of oral laxatives were analyzed.Results:Observation group was higher qualified rate of intestinal preparation (88.50% vs. 86.17%), and lower the adverse reaction rate of intestinal preparation (6.19% vs. 7.45%) as compared to, and both the differences were not statistically significant (both P>0.05). The total score of patient satisfaction (very satisfactory and satisfactory) in the observation group was significantly higher than that in the control group (92.04% vs. 53.20%), and the difference was statistically significant ( P<0.05) . Conclusion:Modified examination arrangement and intestinal preparation protocol are suitable for patients with CTE and colonoscopy during follow-up, which do not affect the quality of intestinal preparation and do not increase the incidence of adverse reactions, while can improve patient satisfaction. This protocal is worthy of clinical promotion and implementation.

Objective:To investigate the effect of modified bowel examination schedule and corresponding bowel preparation protocol on bowel preparation quality and satisfaction of patients with Crohn′s disease (CD) undergoing CT enterography (CTE) and colonoscopy during follow up.Methods:A total of 207 patients with CD in our hospital from December 2021 to October 2022 were prospectively included in the study, among whom 94 patients from West Hospital and South Hospital were used as control group, with routine examination arrangement and intestinal preparation protocol; 113 patients from East Hospital were used as observation group with modified examination arrangement and intestinal preparation protocol, meaning that these two examinations were adjusted to the same day and were combined with oral laxative bowel preparation. The differences between the two groups in the quality of bowel preparation, satisfaction and adverse effects of oral laxatives were analyzed.Results:Observation group was higher qualified rate of intestinal preparation (88.50% vs. 86.17%), and lower the adverse reaction rate of intestinal preparation (6.19% vs. 7.45%) as compared to, and both the differences were not statistically significant (both P>0.05). The total score of patient satisfaction (very satisfactory and satisfactory) in the observation group was significantly higher than that in the control group (92.04% vs. 53.20%), and the difference was statistically significant ( P<0.05) . Conclusion:Modified examination arrangement and intestinal preparation protocol are suitable for patients with CTE and colonoscopy during follow-up, which do not affect the quality of intestinal preparation and do not increase the incidence of adverse reactions, while can improve patient satisfaction. This protocal is worthy of clinical promotion and implementation.

The clinical data of a child with bronchial Dieulafoy disease treated in Wuhan Children′s Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, was analyzed retrospectively.The patient was a 9-month-old boy, who was admitted to hospital due to " intermittent hematemesis vomiting blood for 6 hours" . Chest CT suggested ground-glass opacity in both lungs.Electronic bronchoscopy showed that the neoplasm bulged into the lumen at the opening of the right inferior lobar bronchus, and fresh blood oozed from the basal segment of the neoplasm during the operation.Bronchial arteriography and transcatheter bronchial artery embolization were performed due to recurrent hemoptysis, during which the patient was diagnosed with bronchial arterial vascular malformation and finally diagnosed with bronchial Dieulafoy disease after consulting the relevant literatures.The disease is infrequent and characterized by rupture hemorrhage of bronchial submucosal malformed artery, the etiology and pathogenesis of which are still unclear, and it may be related to congenital vascular malformation in children.Bronchoscopy for hemoptysis of unknown cause in children should be performed with caution.If small and smooth protruded nodular lesions are seen under the bronchoscope, the bronchial Dieulafoy disease should be considered, and the lesions should not be touched too much or subjected to biopsy blindly.Fatal massive hemorrhage can be avoided by bronchial arteriography and bronchial artery embolization.

Objective:To investigate the application value of Jinfeng pill combined with long-acting gonadotropin-releasing hormone agonist (GnRH-a) in frozen-thawed embryo transfer (FET).Methods:A retrospective analysis of 220 cases of FET in the Department of Reproductive Medicine, the Second Hospital of Hebei Medical University during January 1, 2017 and December 31, 2017 was performed. All cases were divided into Jinfeng pill combined with long-acting GnRH-a group (experimental group, n=102) and long-acting GnRH-a group (control group, n=118) according to whether the endometrium was prepared in combination with Jinfeng pill or not. The general data, embryo resuscitation rate, number of transplanted embryos, embryo implantation rate, clinical pregnancy rate, endometrial proliferation time, serum estradiol level on the day of endometrial transformation and endometrial thickness on the day of endometrial transformation were compared between the two groups. Results:Compared with control group, the experimental group had a shorter endometrial proliferation time [(14.03±3.39) d vs. (16.40±1.45) d, P<0.001], and the serum estradiol level was higher [(347.67±26.78) ng/L vs. (259.57±24.78) ng/L, P<0.001]. The endometrium on the endometrial transformation was thicker [(11.89±1.57) mm vs. (9.69±0.85) mm, P<0.001], the difference was statistically significant. The embryo implantation rate and the clinical pregnancy rate in experimental group were higher than those in control group (32.66% vs. 31.70%; 53.92% vs. 50.85%), but the difference was not statistically significant ( P>0.05). There were no significant differences in age, infertility duration, primary infertility ratio, anti-Müllerian hormone (AMH), antral follicle count (AFC), body mass index (BMI), number of thawing, embryo resuscitation rate, number of transplanted embryos, and multiple pregnancy rates between the two groups ( P>0.05). Conclusion:Jinfeng pill combined with long-effect GnRH-a can improve the pregnancy outcome of FET.