The modification of proteins with ubiquitination is closely related to the occurrence and development of chronic liver disease and hepatocellular carcinoma. The tripartite motif (TRIM) family of proteins is one of the E3 ubiquitin ligase subfamily, which participates in various biological processes such as intracellular signal transduction, apoptosis, autophagy, and immunity by regulating the ubiquitination of target proteins. A growing body of research shows that the TRIM family of proteins plays an important role in chronic liver disease. This article systematically reviews the role and molecular mechanism of TRIM protein in the process of chronic liver disease, with the aim of exploring its potential application in the clinical diagnosis and treatment.

Objective To investigate the value of high density lipoprotein-cholesterol (HDL-C) in the diagnosis and risk assessment of non-alcoholic fatty liver disease (NAFLD).Methods A cross-sectional study and multistage stratified random sampling method were performed in epidemiological survey.According to inclusion and exclusion criteria,a total of 3 312 individuals were enrolled and divided into NAFLD group (913 cases) and non-NAFLD group (2 399 cases).The serum lipid levels were compared between the two groups.Receiver operating characteristic (ROC) curve was performed to evaluate the value of HDL-C in the diagnosis of NAFLD.The binary logistic regression models were established based on HDL-C level.The differences in liver function indexes were compared among the research objects with different HDL-C levels.T test and MannWhitney U test were performed for statistical analysis.Results The serum levels of total cholesterol,triglyceride and low density lipoprotein-cholesterol (LDL-C) of NAFLD group were all higher than those of non-NAFLD group ((5.24 ±0.92) mmol/L vs.(4.98 ±0.92) mmol/L,(1.95 ± 1.41) mmol/L vs.(1.13 ± 0.68) mmol/L,(3.31 ± 0.84) mmol/L vs.(3.09 ± 0.84) mmol/L),and the differences were statistically significant (t =-7.29,-22.38 and-6.84,all P ＜ 0.01).However the serum HDL-C level of NAFLD group was lower than that of non-NAFLD group((1.30 ±0.33) mmol/L vs.(1.64 ±0.40) mmol/L),and the difference was statistically significant (t =24.93,P ＜0.01).The incidence of hypercholesterolemia,hypertriglyceridemia,hypo-high-density lipoprotein cholesterolemia and hyper-low-density lipoprotein cholesterolemia of NAFLD group was 48.0％ (438/913),44.8％ (409/913),31.0％ (283/913) and 82.8％ (756/913),respectively,which were significantly higher than that of non-NAFLD group (36.8％,882/2 399;13.2％,317/2 399;10.5％,251/2 399;71.8％,1 723/2 399),and the differences were statistically significant (x2 =34.65,385.43,206.18 and 42.37,all P ＜ 0.01).Using the cut-off values of HDL-C ≤ 1.66 mmol/L in female and ≤ 1.33 mmol/L in male,the area under curve (AUC) values for NAFLD diagnosis were 0.720 (95％ confidence interval (CI) 0.693 to 0.747) and 0.708 (95％ CI 0.679 to 0.737),respectively,the sensitivity was 79.1％ and 76.6％,and the specificity was 55.0％ and 54.6％.The results of binary logistic regression models based on HDL-C level indicated that prevalence of NAFLD in female with low HDL-C was 4.584 times (95％ CI 3.530 to 5.940,P ＜0.01) higher than that in female with high HDL-C;the prevalence of NAFLD in male with low HDL-C was 3.898 times (95％ CI 3.020 to 5.030,P ＜0.01) higher than that of male with high HDL-C.The alanine aminotransferase (ALT),aspartate transaminase (AST),gamma glutamyl transpeptidase (GGT) and alkaline phosphatase (ALP) levels of low HDL-C group were all higher than those of high HDL-C group (20.10 U/L,14.40 U/L to 29.40 U/L vs.16.80 U/L,12.70 U/L to 23.00U/L;19.20 U/L,16.00 U/Lto23.70 U/Lvs.19.00 U/L,16.00 U/Lto22.17 U/L;22.00 U/L,14.00 U/L to34.00 U/L vs.15.00 U/L,11.00 U/L to 23.00 U/L and 71.00 U/L,59.00 U/L to 85.00 U/L vs.66.00 U/L,55.00 U/L to 82.00 U/L),and the differences were statistically significant (Z =-10.53,-2.20,-14.19 and-5.87,all P＜0.05).Conclusion The serum HDL-C level is negatively correlated with the risk of NAFLD level,and the NAFLD risk of individuals with low HDL-C level is significantly higher than individuals with high HDL-C level.

OBJECTIVETo explore clinical features and mutation types in patients from Fujian area with glutaric academia type I(GA I).

METHODSSerum acylcarnitine and urine organic acid of 3 patients were determined with tandem mass spectrometry and gas chromatographic mass spectrometry. The patients also underwent magnetic resonance imaging analysis for the cranial region. Genomic DNA was extracted from peripheral blood samples, and the 12 exons and flanking regions of the GCDH gene were amplified with PCR and subjected to direct DNA sequencing. One hundred healthy newborns were used as controls.

RESULTSMutations of the GCDH gene were identified in all of the 3 patients. Two patients have carried compound heterozygous mutations including c.1244-2A>C and c.1147C>T(p.R383C), c.406G>T(p.G136C) and c.1169G>A(p.G390E), respectively. One has carried homozygous c.1244-2A>C mutation. The same mutations were not detected among the 100 healthy newborns. Only one patient received early intervention and did not develop the disease. The other two had irreversible damagesto their intelligence.

CONCLUSIONc.1169G>A(p.G390E) is likely pathogenic mutations for GA I patients from Fujianarea. Early screening of neonatal metabolic diseases is crucial for such patients.

Objective? To investigate the feasibility of Modified Early Warning Score (MEWS) in evaluating the condition of emergency patients and as a basis for emergency triage. Methods? A total of 1 643 patients in the Rescue Room of Emergency Department of Suzhou Integrated Traditional Chinese and Western Medicine Hospital were selected by convenience sampling method from 11th April 2016 to 2nd August 2017. All patients were followed up, and MEWS of patients with different directions were compared. The area under the curve of MEWS and Yoden index were calculated by ROC curve to predict the mortality of patients. Comparing the MEWS of patients in general wards and ICU, the area under the curve of the MEWS was predicted by ROC curve, and the critical value was selected by Yoden index. Results? There were 475 cases discharged, 326 cases observed in hospital, 768 hospitalized (101 cases were admitted to ICU, 667 cases were admitted to general wards) and 74 cases died. There was significant difference in MEWS among the four groups (H=236.45, P＜0.001). When the best critical point was 3.5 of MEWS, the area under ROC curve for predicting death was 0.910, 95%CI (0.87-0.95), and Yoden index was 0.72. There was significant difference in MEWS between patients admitted to general wards and ICU (Z=-9.005, P＜ 0.001). When picking 2.5 of MEWS as the best critical point, the area under the ROC curve for predicting ICU admission was 0.786, 95%CI (0.73-0.85), and the Youden index was 0.50. Conclusions? The MEWS has clinical significance in predicting the death of emergency patients and assessing the severity of patients. It provides an objective basis for the correct shunt of emergency patients and the correct identification of potentially critically ill patients.

Objective To investigate the psychological response and demands of family of hospitalized children with pneumonia, in order to take specific nursing intervention measures. Methods From May 2015 to April 2016, a total of 200 cases of pneumonia children and their family members in Lishui People's Hospital were selected. Symptom Checklist-90 (SCL-90) and Chinese version of Family Members Demands Scale in Critically Ill Patients were used to investigate the psychological status and needs of the families of children. Results Family members of hospitalized children were all in anxiety, depression, nervousness, interpersonal sensitivity, hostility and other adverse psychological disorders, among which anxiety accounted for 85.5%. In the Demand Scale, the fields with scores from high to low were disease assurance (3.67±0.31), access to children (3.25±0.28), access to information (3.12±0.25), access to support (2.97±0.27), and their own comfort (2.83±0.26). 100% of children's families considered that "children can get the best treatment" and "to be able to understand the health conditions of children in a timely manner" were 2 important or very important items. Conclusions Medical staff should pay attention to the psychological status and needs of family members of hospitalized children and should strengthen communication with the families of children, which is conducive to the establishment of a good relationship between doctors and patients, so as to improve the satisfaction of nursing.

Objective To construct the drug delivery system of gentamicin/chitosan microspheres for local injection, and evaluate its physicochemical properties and cell cytotoxicity.Methods Gentamicinwas used as model drug, chitosan as carrier, lecithinand hydroxypropyl-β-cyclodextrin as accessories, and the microspheres of gentamicin/chitosan/lecithin/hydroxypropyl-β-cyclodextrinwas prepared by spray drying method.The physicochemical properties and cell cytotoxicity of themicrospheres were investigated by UV spectrophotometry , scanning electron microscopy, X-ray diffraction, dynamic membrane dialysis and MTT assay.Results Five kinds of chitosan microspheres ( A, B, C, D and E) with different drug/carrier ratios were successfully prepared by spray drying method.The yield, drug loading and entrapment efficiency of the drug-loaded microspheres were 34.38%~46.94%, 10.20% ~18.67%, 61.20% ~74.72%, respectively.SEM results showed that compared with microspheres A, B and C, microspheres D and E own the spherical shape with wrinkled surface and uniform particle size, particle size between 0.5 ~3 μm, no adhesion.X-ray diffraction analysis showed that the drug was encapsulated in the microspheres.The results of in vitro release indicated that microspheres D had a good sustained release effect in the four drug-loaded microspheres.The results of cytotoxicity test showed that when the concentration of gentamicin reached 400 μg/mL, the relative growth rate of microspheres D was still higher than 80% with the cytotoxicity grade was one, ie, no cytotoxicity.Conclusion The microspheres D with good physicochemical properties, sustained-release effect and biocompatibility, is expected to be a good carrier of prostate local drug delivery.

Objective To prepare thermosensitive chitosan (CTS) hydrogels containing astragalus polysaccharides (APS)/CTS microshperes (MS), and evaluate its physicochemical properties. Methods The APS/CTS MS (APS-MS) were prepared by spray drying method, and characterized by Scanning Electron Microscopy (SEM) and Laser Granularity Analyzer. Depending on the gelation temperature and gelating time, thermosensitive CTS hydrogels (HG) containing APS-MS (APS-MS-HG) were optimized by signal factor experiments, and the morphological characteristics were observed by SEM. In vitro release behaviors of APS-MS, hydrogels containing APS (APS-HG) and APS-MS-HG in pH 6.8 phosphate buffer were evaluated by dialysis tube method. Results The APS-MS were well dispersed with nearly spherical shapes and slightly wrinkled surfaces. The surface weighted mean D[3,2] of APS-MS was 8.078μm. The optimal APS-MS-HG, APS-MS-HG J, contained 3.012% APS-MS which were agitated with a magnetic stirrer for 3h. Observed by SEM, APS-MS were stayed spherical and dispersed unevenly in HG J, but the porous structure of HG J was disappeared in APS-MS-HG J. The release of APS from APS-MS-HG J was without initial burst release, and the cumulative amount of APS was about 74.75% after 36h. Conclusion Suppressing the phenomenon of sudden release at the first stage of delivery, APS-MS-HG J holds great promise for topical applications as a sustained-release nasal delivery system.

Objective To prepare quercetin ( QUE) loaded chitosan nanoparticles ( CS-NPs), evaluate its physicochemical properties and antioxidation activity in vitro.Methods Quercetin chitosan nanoparticles were prepared by ionic crosslinking method and self-assembly method.The preparation method was optimized using entrapment efficiency (EE), drug loading (DL) and size as indexes.The best formulation and preparation conditions were optimized by orthogonal test based on single-factor test, evaluation indicator as particle size and EE.The physicochemical properties of the obtained QUE-CS-NPs were characterized by the following methods: the transmission electron microscope (TEM), dynamic light scattering (DLS) analysis for morphology, size distribution and Zeta potential.In vitro release behavior in 0.5% SDS solution was evaluated by dialysis tube method.In vitro antioxidant activity assays were performed by evaluating the abilities of the microspheres for hydroxide radicals and superoxide anions .Results TEM results revealed QUE-CS-NPs with round and uniform.Particle-size analysis showed that the diameters and Zeta potential of the QUE-CS-NPs were (282.9 ±20) nm and (30.5 ±2) mV, with uniform distribution (polydispersity below 0.185).DL and EE of QUE-CS-NPs were (8.81 ±0.65) %and (80.02 ±1.04) %, respectively.QUE-CS-NPs showed extended administration times with 66.2% cumulative release within 72 h.QUE-CS-NPs showed pronounced antioxidant activity and a concentration dependent, even more substantial than that of pure QUE.Conclusion QUE-CS-NPs show a good size, sustain release effect and pronounce antioxidant activity.

One of the most important characteristics of adult liver is its regenerative ability to maintain its original mass and function after injury. With remarkable self-replication ability, hepatocytes play a critical role in liver regeneration. When there is a restriction in the proliferation capacity and/ or a massive loss of mature hepatocytes,other cells in liver can contribute to liver regeneration in different ways. Deep study on the effects and mechanisms of various hepatic cells’contribution to liver regeneration is helpful for increasing the understanding about liver regeneration and providing new insights for diagnosis and management of various advanced liver diseases.

Objective To prepare proanthocyanidins/bletilla striata polysaccharide/chitosan microspheres ( PC/BSP/CTS ) and the physic-chemical characterizations were investigated.Methods The PC/BSP/CTS microspheres were prepared by spray drying method.The morphology of PC/BSP/CTS microspheres was observed by Scanning Electron Microscopy(SEM), and its physic-chemical characteristics such as diameters, release in vitro, moisture content, swelling ratio, solid density were studied.ResuIts The PC/BSP/CTS microspheres were successfully prepared by spray drying method, SEM showed that PC/BSP/CTS microspheres had the spherical shape with smooth surfaces.The diameters of microsphere A, B and C were 10~20, 2~15, 10~25μm.The in-vitro release showed that the cumulative release of three kinds of microspheres A, B, C was 25.07 %, 38.83 %and 60.00 % in 24 h, which had no burst release, while with time prolonged to 48 h, the cumulative release was 28.89%, 43.17% and 72.86%, respectively.The results of moisture content, swelling ratio, solid density were 15.35% ~23.51%, 46.50% ~105.80%, 0.375 ~0.496. ConcIusion The PC/BSP/CTS microspheres are successfully prepared by spray drying method which possess good characteristics and sustained-release effect, which would be as a good pulmonary drug delivery system.