Objective To investigate the impact and the associated parameters of malnutrition and inflammation status on hospitalization and mortality of maintenance hemodialysis (MHD) patients. Method A total of 118 MHD patients were included in the study with 1 year's follow-up.The malnutrition and inflammation parameters were compared between the hospitalized patients and out-patients.Cox's proportional hazard regression model was used to explore the malnutrition and inflammation parameters which could forecast the risk of hospitalization and mortality. Result The hospitalization rate of MHD patients with mild,moderate and severe malnuttition was 32.93％,56.67％ and 83.33％ respectively,and the mortality was 3.66％,6.67％ and 80.00％ respectively.The hospitalization rate of MHD patients with or without microinflammation status was 56.45％ and 46.43％,and the mortality was 14.29％ and 1.61％.Inpatients had a higher malnutrition-inflammation score(MIS,8.36 vs 5.86,P＜0.05) and subjective global assessment of nutrition (MQSGA,14.49 vs 12.88,P＜0.05),a lower creatinine level (886.83 μmol/L vs 991.76 μmol/L,P＜0.05 ) and a lower albumin level (38.57 g/L vs 40.27 g/L,P＜0.05) than out-patients.Inpatients also had a higher level of TNF-α (65.41 μg/L vs 59.76 μg/L,P＜0.05) than out-patients.Cox proportional hazard model analysis showed that MIS and TNF-α were associated with patient's first hospitalization risk. Conclusions For the MHD patients,the more severe the malnutrition and micro-inflammation status is,the worse the clinical outcome is.The higher levels of MIS and TNF-α result in greater risk of hospitalization.

Objective To investigate the influence of probiotics assisted with routine antibiotic regimens on the short-term clinical efficacy,mucosal barrier function and inflammatory response of patients with bacterial peritonitis secondary to liver cirrhosis.Methods 60 patients with bacterial peritonitis secondary to liver cirrhosis were chosen,and they were randomly divided into two groups according to the digital table,each group in 30 cases.The control group received routine antibiotic regimens alone,and the observation group were given probiotics on the basis of the control group.The short-term clinical efficacy,the levels of DAO,D-Lac and ET before and after treatment of the two groups were compared.Results The short-term effective rates of the control group and observation group were 70.00％,96.67％,respectively.The short-term effective rate of the observation group was significantly higher than that of control group(x2 =9.14,P ＜0.05).After treatment,the levels of DAO of the control group and observation group were (4.33 ± 0.79) U/mL,(2.19 ± 0.47) U/mL,respectively.The levels of D-Lac of the control group and observation group after treatment were (15.88 ± 1.95) U/mL,(8.57 ± 1.03) U/mL,respectively.The levels of DAO and D-Lac of the observation group after treatment were significantly lower than those of the control group and before treatment(t =2.78,3.06;3.44,3.78,3.61,4.10,all P ＜ 0.05).The levels of ET of the control group and observation group after treatment were (0.09 ± 0.02) EU/mL,(0.04 ± 0.01) EU/mL,respectively.The level of ET of the observation group after treatment was significantly lower than that of the control group and before treatment(t =2.49,3.01,3.46,all P ＜ 0.05).Conclusion Probiotics assisted with routine antibiotic regimens in the treatment of patients with bacterial peritonitis secondary to liver cirrhosis can effectively relieve the symptoms and signs,improve the mucosal barrier function and is helpful to reduce the inflammatory response.

Objective:The study aimed to analyze the clinical and endoscopic characteristics of adult celiac disease (CD) to provide a scientific basis for more effective CD diagnosis and treatment.Methods:In this cross-sectional study, the clinical and endoscopic data of 96 adult CD patients treated in the Department of Gastroenterology of the People′s Hospital of Xinjiang Uygur Autonomous Region from March 2016 to December 2021 were retrospectively collected and analyzed.Results:A total of 96 CD patients were diagnosed, including 33 men and 63 women. The average age was 47±14 years (range, 18-81 years). The disease occurred mainly in the age group of 31-60 years. The median course of the disease was 2.0 (0.2-40.0) years. There were 41 (42.7%) classical and 55 (57.3%) non-classical CD patients. All patients with classical CD showed chronic diarrhea, often accompanied by abdominal pain (46.3%, 19/41), abdominal distension (17.1%, 7/41), anemia (65.9%, 27/41), and chronic fatigue (48.8%, 20/41). The main manifestations of non-classical CD were chronic abdominal pain (58.2%, 32/55), abdominal distension (32.7%, 18/55), anemia (40.0%, 22/55), and osteopenia/osteoporosis (38.2%, 21/55). Compared with non-classical CD, anemia developed more frequently in classical CD, and the difference was statistically significant ( P = 0.012). The incidence of complications in CD patients was 36.5% (35/96), and the main complications were thyroid disease (19.8%, 19/96), connective tissue disease (6.2%, 6/96), and kidney disease (6.2%, 6/96). There was no significant difference between classical and non-classical CD ( P>0.05). The frequency of endoscopic manifestations in CD patients was 84.4% (81/96). Duodenal bulb endoscopy showed nodular changes (72.9%, 70/96), grooved changes (10.4%, 10/96), and focal villous atrophy (9.4%, 9/96). The main manifestations of descending endoscopy were the decrease, flattening, or disappearance of duodenal folds (43.8%, 42/96), scallop-like changes (38.5%, 37/96), and nodular changes (34.4%, 33/96). Conclusions:Adult CD patients are mostly female. CD occurred mainly in the age group of 31-60 years. The clinical manifestations were mainly those of non-classical CD. Some patients often had other autoimmune diseases. Patients with characteristic endoscopic manifestations should be warned about the possibility of developing CD. Clinicians should strengthen the understanding of CD and reduce the related rates of missed diagnosis.