Objective To develop and compare prediction models for hyperuricemia(HUA)in perim-enopausal and postmenopausal women using Lasso regression,random forest,and multivariate logistic regres-sion.Methods A multi-stage,stratified cluster sampling method was used to select 12 790 subjects from An-ning City,Yunnan Province.Prediction models for HUA were constructed using Lasso regression,random for-est,and multivariate logistic regression.The efficacy of the model was evaluated by accuracy,sensitivity,speci-ficity,F1 score,and area under the curve(AUC).Results LASSO regression analysis screened 19 variables for inclusion in the model,such as age,waist circumference,diastolic blood pressure,BMI,HDL-C,fasting blood glucose(FBG),etc.The accuracy rate was 0.701,the sensitivity was 0.703,the specificity was 0.680,and the F1 score was 0.806.The AUC(95%CI)was 0.770(0.748-0.792).The results of the random forest model show that variables such as creatinine,triglyceride-glucose index(TyG),TG,BMI,TC,Urea nitrogen(Urea),and ALT were relatively important,with an accuracy rate of 0.663,a sensitivity of 0.653,a specificity of 0.738,and an F1 score of 0.774.The AUC(95%CI)was 0.763(0.741-0.785).Multivariate logistic re-gression results showed that 11 variables including creatinine(Cr),TyG,BMI,Urea,and ALT were included in the model,with an accuracy rate of 0.705,a sensitivity of 0.707,a specificity of 0.686,an F1 score of 0.809,and an AUC(95%CI)of 0.771(0.749-0.793).Conclusion The overall performance of LASSO re-gression and multivariate logistic regression models is better.The random forest model has a strong variable screening ability and high specificity,and can be used as a supplement to provide more accurate predictions.

AIM:To investigate the protective ef-fect of midazolam(MID)on cardiac function and angiogenesis in myocardial infarction(MI)rats and its effect on c-Jun N-terminal kinase-signal trans-ducer and activator of transcription 3(JNK/STAT3)pathway.METHODS:MI rat model was established by left anterior descending coronary artery ligation method.A total of 68 rats were modeled.After ex-cluding the rats that died(n=3,mortality rate≈4.4％)or failed modeling(n=5),the 60 MI rats in-cluded in this experiment were randomly divided in-to the model group(Model group),MID low,medi-um and high dose group(1 mg/kg MID-L group,3 mg/kg MID-M group,6 mg/kg MID-H group),MID high dose+JNK activator Anisomycin group(6 mg/kg MID-H+Anisomycin group),12 rats in each group.Another 12 rats undergoing sham surgery were selected as the control group.All rats were echocardiographic and evaluated for cardiac func-tion.The myocardial tissue pathological morpholo-gy and the myocardial fibrosis degree were ob-served by hematoxylin-eosin(HE)staining and Mas-son staining.The serum myocardial injury markers[creatine kinase isoenzyme(CK-MB)and brain na-triuretic peptide(BNP)]and inflammatory factors[tumor necrosis fa ctor-α(TNF-α),interleukin-1β(IL-1β)and C-reactive protein(CRP)],myocardial tis-sue oxidative stress indicators[malondialdehyde(MDA),superoxide dismutase(SOD)and reduced glutathione(GSH)]levels were detected by enzyme-linked immunosorbent assay(ELISA).The vascular endothelial growth factor(VEGF),vascular endothe-lial growth factor receptor 2(VEGFR2),p-JNK,JNK,p-STAT3 and STAT3 proteins expression levels were detected by Protein blot method(Western blot).RE-SULTS:Compared with Control group,the myocar-dial tissue damage degree in Model group was more severe,the myocardial interstitial fibrosis de-gree was greatly deepened,the collagen volume fraction was significantly increased,the left ventric-ular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),CK-MB,BNP,CRP,TNF-α,IL-1β and MDA levels were significantly in-creased,the left ventricular ejection fraction(LVEF),left ventricular short axis shortening rate(LVFS),GSH and SOD levels were significantly de-creased,and the VEGF,VEGFR2 proteins expression levels were significantly decreased,the p-JNK/JNK and p-STAT3/STAT3 were significantly increased(P＜0.05).Compared with Model group,with the MID dose increase,the myocardial tissue damage de-gree in MID-L,MID-M and MID-H groups was signif-icantly reduced,the myocardial interstitial fibrosis degree was reduced,the collagen volume fraction was decreased,the LVESD,LVEDD,CK-MB,BNP,CRP,TNF-α,IL-1β and MDA levels were significantly decreased,the LVEF,LVFS,GSH and SOD levels were significantly increased,and the VEGF,VEGF2R protein expression levels were significantly in-creased,p-JNK/JNK and p-STAT3/STAT3 were signifi-cantly decreased(P＜0.05).Compared with MID-H group,the myocardial tissue damage degree in MID-H+Anisomycin group was more severe,the myocardial interstitial fibrosis degree was greatly deepened,the collagen volume fraction was signifi-cantly increased,the cardiac function was weak-ened,the oxidative stress and inflammation were aggravated,LVESD,LVEDD,CK-MB,BNP,CRP,TNF-α,IL-1β and MDA levels were increased,the LVEF,LVFS,GSH,SOD,VEGF and VEGFR2 proteins expres-sion levels were significantly decreased,p-JNK/JNK and p-STAT3/STAT3 were significantly increased(P＜0.05).CONCLUSION:MID may improve myocardial tissue damage in MI rats by regulating JNK/STAT3 pathway,reduce oxidative stress and inflammatory response,promote angiogenesis,so as to play a role in cardiac protection.

AIM:To investigate the protective ef-fect of midazolam(MID)on cardiac function and angiogenesis in myocardial infarction(MI)rats and its effect on c-Jun N-terminal kinase-signal trans-ducer and activator of transcription 3(JNK/STAT3)pathway.METHODS:MI rat model was established by left anterior descending coronary artery ligation method.A total of 68 rats were modeled.After ex-cluding the rats that died(n=3,mortality rate≈4.4％)or failed modeling(n=5),the 60 MI rats in-cluded in this experiment were randomly divided in-to the model group(Model group),MID low,medi-um and high dose group(1 mg/kg MID-L group,3 mg/kg MID-M group,6 mg/kg MID-H group),MID high dose+JNK activator Anisomycin group(6 mg/kg MID-H+Anisomycin group),12 rats in each group.Another 12 rats undergoing sham surgery were selected as the control group.All rats were echocardiographic and evaluated for cardiac func-tion.The myocardial tissue pathological morpholo-gy and the myocardial fibrosis degree were ob-served by hematoxylin-eosin(HE)staining and Mas-son staining.The serum myocardial injury markers[creatine kinase isoenzyme(CK-MB)and brain na-triuretic peptide(BNP)]and inflammatory factors[tumor necrosis fa ctor-α(TNF-α),interleukin-1β(IL-1β)and C-reactive protein(CRP)],myocardial tis-sue oxidative stress indicators[malondialdehyde(MDA),superoxide dismutase(SOD)and reduced glutathione(GSH)]levels were detected by enzyme-linked immunosorbent assay(ELISA).The vascular endothelial growth factor(VEGF),vascular endothe-lial growth factor receptor 2(VEGFR2),p-JNK,JNK,p-STAT3 and STAT3 proteins expression levels were detected by Protein blot method(Western blot).RE-SULTS:Compared with Control group,the myocar-dial tissue damage degree in Model group was more severe,the myocardial interstitial fibrosis de-gree was greatly deepened,the collagen volume fraction was significantly increased,the left ventric-ular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),CK-MB,BNP,CRP,TNF-α,IL-1β and MDA levels were significantly in-creased,the left ventricular ejection fraction(LVEF),left ventricular short axis shortening rate(LVFS),GSH and SOD levels were significantly de-creased,and the VEGF,VEGFR2 proteins expression levels were significantly decreased,the p-JNK/JNK and p-STAT3/STAT3 were significantly increased(P＜0.05).Compared with Model group,with the MID dose increase,the myocardial tissue damage de-gree in MID-L,MID-M and MID-H groups was signif-icantly reduced,the myocardial interstitial fibrosis degree was reduced,the collagen volume fraction was decreased,the LVESD,LVEDD,CK-MB,BNP,CRP,TNF-α,IL-1β and MDA levels were significantly decreased,the LVEF,LVFS,GSH and SOD levels were significantly increased,and the VEGF,VEGF2R protein expression levels were significantly in-creased,p-JNK/JNK and p-STAT3/STAT3 were signifi-cantly decreased(P＜0.05).Compared with MID-H group,the myocardial tissue damage degree in MID-H+Anisomycin group was more severe,the myocardial interstitial fibrosis degree was greatly deepened,the collagen volume fraction was signifi-cantly increased,the cardiac function was weak-ened,the oxidative stress and inflammation were aggravated,LVESD,LVEDD,CK-MB,BNP,CRP,TNF-α,IL-1β and MDA levels were increased,the LVEF,LVFS,GSH,SOD,VEGF and VEGFR2 proteins expres-sion levels were significantly decreased,p-JNK/JNK and p-STAT3/STAT3 were significantly increased(P＜0.05).CONCLUSION:MID may improve myocardial tissue damage in MI rats by regulating JNK/STAT3 pathway,reduce oxidative stress and inflammatory response,promote angiogenesis,so as to play a role in cardiac protection.

Diabetes, hypertension, and dyslipidemia, collectively referred to the " Three Highs, " represent increasingly prevalent metabolic risk factors in China. Many individuals experience all three conditions concurrently, significantly heightening the risk of cardiovascular disease and mortality. Although the National Metabolic Management Center(MMC) has been established for over eight years and has its unique features, the awareness, treatment, and control rates of these diseases in China remain low, and the efficiency of community management is insufficient. According to the previous two editions of management guidelines and the most recent domestic and international diagnostic and treatment guidelines, this paper conducts an in-depth analysis of the operational experience and management strategies of the MMC. Its aim is to improve the efficiency of grassroots MMC mode management for " Three Highs" patients and ensure that patients receive more standardized management.

Objective　To investigate the application value of nucleic acid mass spectrometry (MassARRAY) in the detection of drug resistance genes of Mycobacterium tuberculosis (MTB). Methods Pulmonary samples (sputum, bronchoalveolar lavage fluid) from suspected pulmonary tuberculosis patients and tissue and pus samples from suspected extrapulmonary tuberculosis patients were collected from Xi'an Chest Hospital from September 2022 to May 2023. Two samples from the same patient were subjected to both the melt curve method and the MassARRAY method to detect common drug resistance genes in patient samples, alongside mycobacterial culture and microplate drug susceptibility test. The efficacy of the Melt curve method and MassARRAY method for the detection of various drugs was evaluated using the microporous plate method as the standard. Results A total of 72 pulmonary specimens (40 sputa, 32 bronchoalveolar lavage fluids) and 36 extrapulmonary (18 tissues and 18 pus) were collected. The positive rate of mycobacterial culture was 32.4% (35/108). The detection rate of drug resistance genes by nucleic acid mass spectrometry was 52.8% (57/108). The resistance detection rates for rifampicin by nucleic acid mass spectrometry, melting curve, and microplate method were 14.0% (8/57), 13.0% (6/46), and 20.0% (7/35) respectively, with no significant difference among the three methods (F=0.851, P>0.05). There was no significant difference in the detection rates of isoniazid, ethambutol, streptomycin, and fluoroquinolones among the three methods. Using phenotypic drug susceptibility results of culture-positive samples as the reference standard, the Kappa values of rifampicin, isoniazid, ethambutol, and streptomycin detected by nucleic acid mass spectrometry were 1.000, 1.000, 0.635, and 0.821, respectively. Conclusions Nucleic acid mass spectrometry is a highly sensitive and specific method for detecting drug-resistance genes in Mycobacterium tuberculosis samples. It is a rapid, sensitive, accurate, and flexible molecular detection method with a promising application prospect in diagnosing drug-resistant tuberculosis.

Colorectal cancer(CRC)is the third leading cause of cancer death in the world,and the incidence of colorectal cancer is also increasing year by year,and the treatment options such as radiotherapy,chemotherapy and surgical removal of cancerous sites are not ideal,so there is an urgent need to find a new treatment strategy and solution.The adjuvant treatment of colorectal cancer with traditional Chinese medicine has the characteristics of multi-target,multi-level,multi-link and overall regulation,which plays an increasingly important role in tumor treatment and has become a hot field for anti-tumor drug screening.Skullcap has been widely studied as one of the main drugs adjuvant to treat colorectal cancer by traditional Chinese medicine.This paper reviews the anti-colorectal cancer effect of skullcap and its active ingredients and the current research progress,aiming to provide the background information and the reference for the treatment of colorectal cancer.

Colorectal cancer(CRC)is the third leading cause of cancer death in the world,and the incidence of colorectal cancer is also increasing year by year,and the treatment options such as radiotherapy,chemotherapy and surgical removal of cancerous sites are not ideal,so there is an urgent need to find a new treatment strategy and solution.The adjuvant treatment of colorectal cancer with traditional Chinese medicine has the characteristics of multi-target,multi-level,multi-link and overall regulation,which plays an increasingly important role in tumor treatment and has become a hot field for anti-tumor drug screening.Skullcap has been widely studied as one of the main drugs adjuvant to treat colorectal cancer by traditional Chinese medicine.This paper reviews the anti-colorectal cancer effect of skullcap and its active ingredients and the current research progress,aiming to provide the background information and the reference for the treatment of colorectal cancer.

Diabetes, hypertension, and dyslipidemia, collectively referred to the " Three Highs, " represent increasingly prevalent metabolic risk factors in China. Many individuals experience all three conditions concurrently, significantly heightening the risk of cardiovascular disease and mortality. Although the National Metabolic Management Center(MMC) has been established for over eight years and has its unique features, the awareness, treatment, and control rates of these diseases in China remain low, and the efficiency of community management is insufficient. According to the previous two editions of management guidelines and the most recent domestic and international diagnostic and treatment guidelines, this paper conducts an in-depth analysis of the operational experience and management strategies of the MMC. Its aim is to improve the efficiency of grassroots MMC mode management for " Three Highs" patients and ensure that patients receive more standardized management.

Abstract: Objective To compare the diagnostic efficacy of the upgraded version of the GeneXpert automated fluorescent quantitative PCR system (GeneXpert MTB/RIF Ultra, GeneXpert Ultra) and the original version of the GeneXpert system (GeneXpert MTB/RIF, Xpert), real-time fluorescent quantitative nucleic acid detection (FQ-PCR), real-time fluorescent thermostatic amplification of Mycobacterium tuberculosis RNA (SAT-RNA), real-time fluorescent thermostatic amplification detection of DNA (thermostatic amplification method) and traditional BACTEC MGIT 960 liquid culture (culture method) for special specimens of tuberculosis, in order to analyze its application value in clinical detection. Methods Using prospective research methods, a total of 170 special specimens (including 47 pleural and ascites effusion samples, and 34 24-hour urinary sediment specimens, 49 tissue specimens and 40 fester specimens) were collected i'an Chest Hospital from January to September 2021. GeneXpert Ultra, Xpert, FQ-PCR, SAT-RNA, isothermal amplification, and traditional culture were used for detection. Clinical diagnosis was used as the standard, and sensitivity, specificity, positive predictive value, negative predictive value, coincidence rate, and Kappa value were compared among the methods. Results The sensitivities of GeneXpert Ultra, Xpert, FQ-PCR, SAT-RNA, isothermal amplification, and traditional culture were 65.18% (73/112), 49.11% (55/112), 37.50% (42/112), 19.64% (22/112), 8.04% (9/112), and 22.32% (25/112), respectively. The sensitivity of GeneXpert Ultra was higher than that of the other five methods, and the differences were statistically significant (χ2=66.25, 42.10, 28.89, 13.09, 4.92, 15.18, all P<0.05). GeneXpert Ultra result analysis showed that: 5.48%(4/73) cases had trace, that is, trace Mycobacterium tuberculosis load, 79.45% (58/73) cases were extremely low, 10.96% (8/73) cases were low, 2.74% (2/73) were medium, , and 1.36% (1/73) were high load. In 4 trace samples, the Xpert detection was negative for all. Of the 73 GeneXpert Ultra positive reports, 63 were rifampicin-sensitive, 6 were rifampicin-resistant, and 4 were rifampicin-resistant but of unclear resistance. Of the 55 Xpert positive reports, 45 were rifampicin-sensitive, 2 were rifampicin-resistant, and 8 were rifampicinresistant but of unclear resistance.. Conclusions The new generation of GeneXpert MTB/RIF Ultra has high sensitivity, specificity and drug resistance detection rate, and its advantage is even more apparent in the pathogenic diagnosis of special specimens of tuberculosis. It can be used as one of the preferred methods in samples with low bacterial load.

Objective:To assess the prevalence of metabolic syndrome(MS) and its relationship with hyperuricemia(HUA) in perimenopausal women in Anning city, Yunnan province.Methods:This is a cross-sectional survey. In May 2021, a multi-stage stratified sampling method was used to collect demographics and clinical data [ethnicity, living community, height, weight, waist circumference, blood pressure, fasting plasma glucose, triglycerides(TG), serum uric acid, high density lipoprotein-cholesterol(HDL-C), alanine transaminase(ALT), etc] in a total of 6 721 perimenopausal women aged 45-60 years.Results:A total of 6 721 perimenopausal women were included in this study. The prevalences of MS and HUA were 14.05%(95% CI 13.22%-14.88%) and 6.46%(95% CI 5.88%-7.07%), respectively. The average age, HDL-C, urea, direct bilirubin, and albumin levels in the perimenstrual HUA population were lower than those in the non-HUA population while the levels of TG, ALT, heart rate, body mass index(BMI), and creatinine were higher(all P<0.05). The prevalence of HUA in perimenopausal women with ethnic minorities and family history of chronic diseases was higher than that in Han nationality and without family history of chronic diseases. The prevalence of MS in perimenopausal women was increased with the increase of serum uric acid( Z=-15.313 8, P<0.001). Multivariate logistic regression model showed that HUA was positively correlated with MS( OR=1.526, 95% CI 1.192-1.954) after adjusting for covariates such as BMI and ethnicity, and the incidence of MS in perimenopausal women in HUA group was 1.526 folds higher than that in non-hyperuricemia group. Conclusion:HUA is highly positively correlated with MS in perimenopausal women. The management of uric acid level in perimenopausal women should be strengthened.