Objective:To investigate the role of serum hepatitis B virus RNA (HBV RNA) in predicting HBeAg serological conversion in children with chronic hepatitis B.Methods:175 children aged 1~17 years with chronic hepatitis B who received interferon α (IFNα) for 48 weeks were selected. Patients were divided into HBeAg seroconversion and non-conversion based on whether HBeAg seroconversion occurred at 48 weeks of treatment.T-test and Mann-Whitney U test were used to compare between groups; chisquare test or Fisher exact probability method was used to compare the frequency between groups of classified variables; and Pearson correlation was used to analyze the correlation between indicators. Univariate and multivariate logistic regression analyses were used to identify influencing factors associated with HBeAg serological conversion. The predictive effect of HBV RNA, HBV DNA, and HBsAg on HBeAg serological conversion was compared and analyzed by the receiver operating characteristic curve (ROC).Results:The seroconversion rate of HBeAg at 48 weeks was 36.0% (63/175). The reduction in HBVRNA levels from baseline to the 12th, 24th, 36th, and 48th weeks of antiviral therapy was significantly greater in the HBeAg serological conversion group than that in the non-conversion group, and the difference was statistically significant between the two groups (P < 0.05). Univariate and multivariate regression analyses showed that age and a decline in HBV RNA levels at week 12 were independent predictors of HBeAg serological conversion. The area under the ROC curve (AUROC) of HBV RNA decline at week 12 was 0.677(95% CI∶0.549-0.806, P = 0.012), which was significantly better than the same period of AUROC of HBV DNA (0.657, 95% CI∶0.527-0.788, P = 0.025) and HBsAg (0.660, 95% CI∶0.526-0.795, P = 0.023) decline. HBV RNA levels decreased (>1.385 log10 copies/ml) at week 12, with a positive predictive value of 53.2%, a negative predictive value of 72.2%, a sensitivity of 77.4%, and a specificity of 57.9% for HBeAg seroconversion. Conclusion:HBV RNA level lowering during the 12th week of antiviral therapy can serve as an early predictor marker for HBeAg serological conversion in children with chronic hepatitis B.

OBJECTIVE：To improve the quality standard of Xiangsha hezhong pills. METHODS ：Based on previous quality standard of Xiangsha hezhong pills ，the items of property observation and microscopic identification were revised. TLC identification methods were established for ginger-processed Magnolia officinalis ，Pogostemon cablin and Atractylodes Lancea （stir-fried with earth ）. HPLC methods were adopted for contents determination of hesperidin ，magnolol and honokiol. RESULTS ： The description of the appearance of Xiangsha hezhong pills should be modified to “yellow brown or brown water pill ”. The description of microscopical identification was adjusted slightly. TLC chromatogram of ginger-processed M. officinalis ，P. cablin and Atractylodes Lancea （stir-fried with earth ）all showed the same color spots in the same position as the corresponding substance control or reference medicinal material ，and the negative samples had no interference. The contents determination were performed on Phenomenex Luna C 18 column with mobile phase consisted of methanol-water （40 ∶ 60，V/V，hesperidin）or acetonitrile- 1％ glacial acetic acid （52∶48，V/V，magnolol and honokiol ）at the flow rate of 1.0 mL/min. The column temperature was 30 ℃. The detection wavelengths were set at 284 nm（hesperidin）or 294 nm（magnolol and honokiol ）. The linear ranges of hesperidin ， magnolol and honokiol were 0.201 8-2.018 μg，0.035 7-0.357 4 μg and 0.028 2-0.282 4 μg（all r＝0.999 9）. The detection limits were 2.0，0.72，0.45 ng；the limits of quantitation were 7.0，2.45，1.61 ng. RSDs of precision ，reproducibility，stability and durability tests were all lower than 3％. The average recoveries were 99.92％，100.49％ and 102.08％（all RSD ＜3％）. CONCLUSIONS ：The study verifies the description of character observation and microscopical identification ，adds TLC identification methods for ginger-processed M. officinalis ，P. cablin and Atractylodes Lancea （stir-fried with earth ）based on previous quality standard of Xiangsha hezhong pills. HPLC methods were adopted to determine the contents of hesperidin ，magnolol and honokiol ，and can effectively improve the quality control standard of the preparation.

Objective: To explore the intervention effect of improved nursing measures in the treatment of patients with dystonia with deep brain stimulation in MRI localization. Methods: Twenty patients with dystonia treated with deep brain stimulation from January 2013 to December 2015 were selected as the control group. Twenty patients with dystonia treated by deep brain stimulation surgery with improved nursing from January 2016 to December 2018 were in the experimental group. The primary success rate of MRI localization, examination time related indexes and incidence of adverse reactions after intravenous anesthesia were observed in the 2 groups. Results: The primary success rate of MRI localization in the experimental group (95.00%,19/20) was higher than that in the control group (55.00%,11/20), and the difference was statistically significant (χ²=8.533, P<0.01).The total examination time of the experimental group (33.60±8.27) min was significantly shorter than that of the control group (44.30±13.43) min, and the difference was statistically significant (t=-3.663, P<0.05).The incidence of total adverse reactions to MRI localization after intravenous anesthesia was lower in the experimental group (5%, 1/20) than in the control group (30%, 6/20), and the difference was statistically significant (χ² =4.329, P < 0.05). Conclusions Improved nursing measures can effectively improve the success rate of MRI stereotactic brain target location in patients with dystonia, providing a guarantee for accurate calculation of surgical targets, enabling the operation to achieve the best results, early detection of changes in vital signs during examination, and the close cooperation of the medical team is the guarantee for the smooth completion of MRI examination.

Objective To explore the direction value of endovascular pressure differences in endovascular management of subclavian steal syndrome (SSS).Methods Eleven SSS patients accepted endovascular management,admitted to our hospital from January 2016 to December 2017,were collected in this study.Before and after operation,pressure-sensing wire was used to measure endovascular pressure differences (mean distal stenosis pressure minus mean proximal pressure),digital substraction angiography (DSA) was used to assess the stenotic rate,transcranial doppler (TCD) was used to assess the steal degrees,and electronic sphygmomanometer was used to measure the systolic pressure differences between bilateral brachial arteries.The pressure differences before and after endovascular management were compared.Before operation,the relations of pressure differences with stenotic rate,steal degrees and systolic pressure differences between bilateral brachial arteries were analyzed.After operation,the relations of pressure differences with stealing and clinical symptom improvements were analyzed.The predictive values of pressure differences and residual stenosis in clinic success were compared.Results (1) After operation,the blood stealing disappeared and the clinical symptoms improved in 10 patients;although residual stenotic rate of one patient decreased obviously,blood stealing and clinical symptoms still existed after operation;the clinic success rate was 90.9％(10/11).(2) Pressure differences before surgery ([11.2±5.7] mmHg) were significantly higher as compared with those after the surgery ([2.5±5.3] mmHg,P＜0.05).(3) Before operation,pressure differences were significantly correlated with stenotic rate (r=0.757,P=0.007) and bilateral systolic pressure differences (r=0.701,P=0.016).Six patients had pressure differences of 6-9 mmHg,enjoying degree I and Ⅱ of stealing,and 5 patients had pressure differences ≥ 10 mmHg,enjoying degree Ⅲ of stealing.(4) After operation,pressure difference was 18 mmHg in one patient without clinic success,but pressure differences were ≤ 3 mmHg in 10 patients with clinic success.(5) Significant difference was noted between the two clinic success indexes (residual stenotic rate ≤ 30％ by DSA and pressure differences ≤ 3 mmHg,P＜0.05).Conclusion Endovascular pressure differences can reflect the hemodynamic changes before and after endovascular management;as compared with residual stenosis,it is better to predict the clinic success after operation;it is useful to guide the endovascular management in the SSS patients.

Objective To investigate the alteration of subunit expression of AMPAR and NMDAR in hippocampal CA1 area of mice with contextual fear memory generalization.Methods 35 male C57BL/6 mice,aged 8 weeks,were involved in the experiment.Seven mice were randomly selected as the naive group, which didn't receive the behavioral training.28 mice experienced the context fear conditioning and contextual shift task were divided into generalization group and non generalization group according to the result.Then Western blot was used to measure the expression of AMPAR and NMDAR subunits in CA1 in the naive group,non generalization group and generalization group.Results (1)Seven mice(discrimination ratio:0.52±0.08)showed contextual generalization when undergoing the same stress level,while the other 21 mice (discrimination ratio:0.75±0.07)didn't(P<0.01),however,these two group showed similar freezing(%) in the memory acquisition process.(2)The subunit composition of AMPA receptors had no significant differ-ence in CA1 area among the Naive group,non generalization group and generalization group(P>0.05).(3) NR1 subunit was similar in the three groups(P>0.05).NR2A expression was significantly increased in the non generalization group(1.11±0.20)and generalization group(1.09±0.20)compared with that in the na-ive group(0.95±0.17)(both P<0.05).The expression of NR2B was significantly increased in generalization group(1.05±0.17)compared with that in the naive group(0.83±0.19)and non generalization group(0.80± 0.14)(both P<0.05).The ratio of NR2A/NR2B was significantly increased in non generalization group (1.23±0.25)compared with that in the naive group(0.89±0.31)and generalization group(0.86±0.17) (both P<0.05).Conclusion (1)Only part of the individuals show contextual fear memory generalization after the same stress,and this contextual generalization progress is not related to the acquisition of context fear memory.(2)There is no significant change in expression of AMPAR subunits in CA1 of mice with the contextual generalization.The rise of NR2B and the decline of ratio of NR2A/NR2B are the main changes, suggesting that consequently the alternation of synaptic plasticity maybe one of the mechanisms of contextual fear memory generalization.

Objective To study the effect of carotid artery stenting (CAS) on rCBF and rCVR.Methods Seventeen patients with unilateral internal carotid artery symptomatic severe stenosis who underwent CAS in our hospital were included in this study.Their rCBF volume and rCVR were measured by single photon emission CT scanning combined with CO2 loading test 1 week be fore and 3 months after CAS.Their data were analyzed according to the ROI in ipsilateral middle cerebral artery blood supply territory.Results Sixty eight ROIs were detected in the 17 patients with impaired rCBF in 16 ROIs (23.5％) before CAS.The mean improved rate of rCBF was significantly higher in impaired rCBF and rCVR ROI before CAS than that of rCBF in normal and impaired rCVR ROI after CAS (P=0.001).The mean improved rate of rCVR was significantly higher in normal rCBF and impaired rCVR ROI after CAS than before CAS (P=0.014).The improved rate of rCBF was significantly higher in impaired rCBF and rCVR ROI after CAS than that of normal and impaired rCVR ROI before CAS (81.3％ vs 50.0％,P=0.027).The improved rate of rCVR was significantly higher in normal rCBF ROI and impaired rCVR ROI before CAS than in impaired rCBF and rCVR ROI after CAS (59.6％ vs 31.3％,P=0.047).Conclusion CAS can improve the ROI rCBF and rCVR in patients with unilateral ICA symptomatic severe stenosis.Its modified model is closely related with rCBF before CAS.

Objective To investigate the effects of ω-3 polyunsaturated fatty acids(ω-3PUFAs)and ω-6 polyunsaturated fatty acids(ω-6PUFAs)on Toll-like receptor 4(TLR4)/nuclear factor-κB(NF-κB)signaling pathway,and the expressions of tumor necrosis factor-α(TNF-α),interleukin(IL)-1β and IL-6 in neonatal rats with brain injury induced by lipopolysaccharide (LPS). Methods Ninety-six neonatal rats were divided into control group,ω-3PUFAs group,ω-6PUFAs group,and LPS group by using random number table method. Intraperitoneal injection of LPS was performed in LPS group,ω-6PUFAs group and ω-3PUFAs group to establish models of rat brain injury. The rats in control group received 9 g/L saline. Twelve newborn rats were killed at 1 d or 5 d after intraperito-neal injection in each group for hippocampus selection. Real -time PCR and Western blot were used to detect the mRNA and protein expression levels of TLR4,NF-κB,TNF-α,IL-1β and IL-6. Results One day after mode-ling,TLR4,NF-κB,TNF-α,IL-1β and IL-6 mRNA expressions in ω-3PUFAs group (10. 63 ± 0. 07,5. 86 ± 1. 05,7. 65 ± 2. 29,5. 23 ± 1. 31,3. 36 ± 0. 72)were lower than those in ω-6PUFAs group (18. 83 ± 2. 10,8. 79 ± 2. 08,11. 95 ± 3. 23,10. 97 ± 2. 24,6. 37 ± 1. 17)and LPS group (15. 76 ± 1. 59,7. 13 ± 1. 10,9. 71 ± 2. 14,7. 83 ± 0. 85,4. 78 ± 0. 51),and the differences were all statistically significant(all P＜0. 05);which in ω-6PUFAs group were higher than those in LPS group,and the differences were all significant (all P＜0. 05). TLR4,NF-κB,TNF-α, IL-1β and IL-6 protein levels in ω-3PUFAs group (1. 57 ± 0. 11,1. 58 ± 0. 09,1. 55 ± 0. 09,1. 63 ± 0. 31,1. 36 ± 0. 12)were lower than those in ω-6PUFAs group (1. 96 ± 0. 17,2. 21 ± 0. 12,1. 95 ± 0. 23,1. 97 ± 0. 24,1. 77 ± 0. 17)and LPS group (1. 73 ± 0. 15,1. 87 ± 0. 10,1. 79 ± 0. 14,1. 83 ± 0. 15,1. 58 ± 0. 11)in 1 d,and the diffe-rences were all significant (all P＜0. 05),and those in ω-6PUFAs group were higher than those in LPS group (all P＜0. 05). Similarly,TLR,NF-κB,TNF-α,IL-1β and IL-6 mRNA and protein expression levels in ω-3PUFAs group (3. 78 ± 0. 88,3. 86 ± 0. 62,6. 26 ± 1. 94,3. 65 ± 1. 44,2. 11 ± 0. 87;1. 15 ± 0. 08,1. 32 ± 0. 10,1. 46 ± 0. 04, 1. 38 ± 0. 14,1. 21 ± 0. 09)were lower than those in ω-6PUFAs group (7. 76 ± 1. 65,5. 51 ± 0. 88,7. 96 ± 2. 13,5. 35 ± 1. 75,4. 88 ± 1. 35;1. 42 ± 0. 15,1. 51 ± 0. 36,1. 65 ± 0. 13,1. 72 ± 0. 23,1. 48 ± 0. 10)and LPS group (6. 21 ± 1. 87, 4. 98 ± 0. 73,7. 11 ± 2. 10,4. 84 ± 1. 75,4. 25 ± 0. 64;1. 35 ± 0. 13,1. 44 ± 0. 22,1. 59 ± 0. 10,1. 61 ± 0. 18,1. 35 ± 0. 07) in 5 d (all P＜0. 05),and which in ω-6PUFAs group were higher than those in LPS group,and the differences were sig-nificant (all P＜0. 05). Conclusion ω-6PUFAs can up-regulate the activity of TLR4,NF-κB,and reduce the re-lease of TNF-α,IL-1β and IL-6;and ω-3PUFAs can down-regulate the activity of TLR4,NF-κB,and reduce the release of TNF-α,IL-1β and IL-6,so it has a neural protective effect in brain injury induced by LPS.

Objective To investigate the effect of ketamine on depression-like behaviors at different developmental stages of offspring rat exposed to prenatal restraint stress (PRS).MethodsPregnant SD rats were randomly divided into control group (n=6) and PRS group (n=8).The dams of PRS group received three times(45 minutes/time)restraint stress every day.The anxiety-like and depression-like behaviors of the offsprings of the two groups were tested in the stage of juvenile,adolescence and early adulthood.Then the antidepressant effect of ketamine on prenatal stress rats at different developmental stages was observed.ResultsIn the open-field test,the time in the central area of the offspring rats in PRS group at different developmental stages (juvenile(2.50±0.43)s,adolescence(9.17±1.05)s,early adulthood(8.33±0.92)s) were significantly lower than those of the control group((8.33±1.05)s,(19.17±1.06)s,(18.83±1.30)s,all P<0.05).In the forced swimming test,the immobility time in the offspring rats of PRS group at the different developmental stages (juvenile(192.50±10.82)s,adolescence(182.75±10.12)s,early adulthood(199.88±9.20) s)were significantly higher than those of control group((76.00±19.00)s,(96.30±12.91)s,(108.30±10.98)s,all P<0.05).Ketamine could quickly and strongly reduce the immobility time of the offsprings exposed to PRS in the stage of adolescence and early adulthood (P<0.01),but the effect was weaker in the juvenile offsprings (P<0.05).ConclusionPRS leads to persistent anxiety-like and depression-like behavior in offsprings and ketamine exerts a good antidepressant effect on the offspring rats in the stage of adolescence and early adulthood.