Objective To investigate the relationship between the comorbidity of dyslipidemia, hypertension and diabetes and lifestyle of adult residents in Hebei Province in 2018, and to provide reference for the development of chronic diseases prevention measures. Methods Using data from the surveillance of chronic diseases and their risk factors among adults in Hebei in 2018, 7 711 permanent residents aged ≥18 years were selected as the research subjects. Multivariate logistic regression analysis was used to analyze the relationship between the comorbidity of dyslipidemia, hypertension, and diabetes and lifestyle in adult residents. Results A total of 7 711 subjects aged ≥18 years were included in 2018. The comorbidity rates of hypertension and dyslipidemia, diabetes and dyslipidemia, and hypertension and diabetes were 16.88%, 7.91%, and 8.13%, respectively. The comorbidity rate of hypertension, diabetes, and dyslipidemia was 22.65%. These comorbidity rates increased with age and BMI. Multivariate logistic regression results showed that male, age, overweight/obesity, physical inactivity, daily sedentary behavior time ≥5 hours, and sleep problems were risk factors for the comorbidity of the "three highs". Conclusion The prevalence of the "three highs" comorbidities is relatively high in Hebei Province, and there are multiple common risk factors. Maintaining a healthy lifestyle and implementing comprehensive prevention and control measures are the key to improving the health level of residents.

Objective To investigate the influencing factors of stroke patients with hypertension and their compliance with antihypertensive drugs, and to provide targeted intervention measures for stroke prevention in hypertensive patients.  Methods Using the method of multi-stage cluster sampling, a total of 59,434 permanent residents aged 40 and above were selected from 48 monitoring sites in 9 cities of Hebei Province from December 2019 to December 2020. Unconditional logistic regression analysis was used to explore the influencing factors of stroke complicated with hypertension and the compliance of patients with antihypertensive drugs.  Results Among the 59 434 subjects, the prevalence rate of stroke was 4.33% and the prevalence rate of stroke complicated with hypertension was 82.47%. The results of univariate analysis showed that the proportion of women, rural areas, dyslipidemia, diabetes, obesity, and people with family history of stroke was higher in stroke patients with hypertension, and the difference was statistically significant (P<0.05). Multivariate logistic regression analysis showed that rural areas, dyslipidemia, diabetes, obesity, and family history of stroke significantly increased the risk of stroke, and the OR (95%CI) values were 1.29 (1.03-1.62), 1.39 (1.12-1.72), 1.58 (1.25-1.99), 1.61 (1.22-2.12) and 1.60 (1.26-2.04), respectively. Among stroke patients with hypertension, 92.71% of patients took antihypertensive drugs. It was found that women's compliance with antihypertensive drugs was good, with an OR (95%CI) value of 1.46 (1.01-2.09).  Conclusion The prevalence rate of stroke complicated with hypertension is high in people aged 40 and above in Hebei Province. Hypertensive people should lower blood lipids, control blood glucose, and lose weight as soon as possible to prevent the occurrence of stroke.

Objective To investigate the association between the Chinese visceral adiposity index (CVAI) and diabetes mellitus, hypertension, diabetes mellitus or hypertension, and diabetes with hypertension among elderly people in Hebei Province. Methods In 2020, a stratified multi-stage random sampling was used to conduct questionnaire survey, physical examination and laboratory detection among permanent residents of 10 monitoring sites in Hebei Province. Logistic regression was used to analyze the association between CVAI and diabetes mellitus, hypertension, diabetes mellitus or hypertension, and diabetes with hypertension. The area under the ROC curve (AUC) was used to evaluate the predictive value of CVAI for diabetes mellitus, hypertension, diabetes mellitus or hypertension, and diabetes with hypertension. Results The detection rates of diabetes mellitus, hypertension, diabetes mellitus or hypertension, and diabetes with hypertension were 19.8%, 74.6%, 78.2%, and 16.2%, respectively. Multivariate logistic regression analysis showed that compared with the lowest quartile of CVAI group Q1, the OR (95% CI) of diabetes mellitus, hypertension, diabetes mellitus or hypertension, and diabetes with hypertension in the highest quartile Q4 group were 3.55 (2.58~4.89), 2.52 (1.92~3.31), 3.09 (2.31~4.12), and 4.92 (3.40~7.12), respectively. The ROC curve results showed that CVAI had the best predictive value in the diagnosis of diabetes with hypertension, and the optimized critical values in males and females were 128.54 and 141.88, respectively. Conclusion The detection rates of diabetes mellitus and hypertension are high in the elderly population in Hebei Province. CVAI is positively associated with the risk of diabetes mellitus, hypertension, diabetes mellitus or hypertension, and diabetes with hypertension among the elderly in Hebei. CVAI has the strongest prediction ability for diabetes with hypertension.

Objective:To assess the efficacy and safety of Tacrolimus（TAC）in combination with glucocorticosteroid（GC）for treating IgA vasculitis nephritis（IgAVN）in children.Methods:A retrospective analysis was conducted on pediatric patients who were diagnosed with IgAVN from January 2015 to January 2022 in Children's Hospital of Hebei Province.The patients presented with nephrotic-range proteinuria or persistent urine protein（>0.5g/24 h）despite adequate glucocorticoid and other treatments in patients who do not reach massive proteinuria levels.They were treated with TAC combined with GC. The following laboratory parameters were obtained for outcome assessment: 24-hour urinary protein excretion, serum albumin, serum creatinine levels, and fasting blood glucose measurements. The efficacy and adverse reactions of TAC were summarized.Results:A total of 97 children (55 males and 42 females) were included. The average age of diagnosis of IgA vasculitis was (8.65±2.46) years, and 95.9% of the children developed renal involvement within 30 days after diagnosis. Pathological examination of renal puncture: 5 cases of grade Ⅱa, 2 cases of grade Ⅱb, 31 cases of grade Ⅲa, 57 cases of grade Ⅲb, and 2 cases of grade Ⅳb.Remission rate at 3 months was 96.9%（94/97）.Three patients failed to achieve clinical remission who were treaed with other immunosuppressants.After 1, 3, 6 and 12 months of TAC treatment, the urine protein levels of 94 children were lower than those before treatment, and the differences were statistically significant ( P < 0.05), showing a gradual downward trend. Serum albumin levels were higher than those before treatment, and the differences were statistically significant ( P < 0.05), showing a gradual upward trend.After 3 months and 6 months of TAC treatment, the serum creatinine and fasting blood glucose of the children increased. With the remission of the disease, TAC dosage decreased, the mean values of serum creatinine and fasting blood glucose decreased after 12 months of treatment.The average treatment time of TAC was (10.8±2.6) months, the average follow-up time was (3.33±1.56) years, and the longest follow-up time was 8 years. During the follow-up period, there were no serious adverse reactions such as gastrointestinal discomfort, liver function damage and severe infection. After stopping GC and TAC treatment, 80 children got sustained remission. Conclusion:The combination of TAC and GC has been proved to be effective in treating IgAVN in children.The overall effective rate is high,and clinical remission can be achieved quickly with relatively mild adverse reactions.

Objective To observe the clinical efficacy of belimumab combined with glucocorticoids in the treatment of children with systemic lupus erythematosus(SLE).Methods A total of 64 children with SLE were randomly divided into the observation group and the control group,with 32 cases in each group.The control group was treated with oral prednisone tablets combined with hydroxychloroquine sulfate tablets,while the observation group was treated with belimumab on the basis of treatment in the control group.After 6 months of treatment,the clinical efficacy,systemic lupus erythematosus disease activity index(SLEDAI)scores and laboratory indicators[complement C3,complement C4,immunoglobulin IgG(IgG),B lymphocytes,white blood cell count(WBC),erythrocyte sedimentation rate(ESR),serum C-reactive protein(CRP),24-hour urine protein quantification(24 h UP),serum creatinine(SCr)and blood urea nitrogen(BUN)]were compared between the two groups.Results After 6 months of treatment,the total effective rate was higher in the observation group than that of the control group(93.8%vs.75.0%,P＜0.05).Compared with before treatment,both groups showed lower SLEDAI scores,IgG,B lymphocytes,ESR,CRP,SCr,24 h UP and BUN after treatment,while C3,C4 levels and WBC were higher.Moreover,the improvement of all indicators was better in the observation group than that in the control group(P＜0.05).Conclusion Belimumab combined with glucocorticoids can improve the clinical efficacy,control disease activity and enhance immune function in children with SLE.

Objective:To analyze the prevalence of chronic kidney disease (CKD) and influencing factors of adults in Hebei Province, and provide scientific evidence for the development of comprehensive CKD prevention and control strategies.Methods:In China Adult Chronic Disease and Nutrition Surveillance in Hebei in 2018, a total of 7 562 permanent residents aged ≥18 years were selected by multi-stage stratified cluster random sampling from 13 surveillance points in Hebei for questionnaire survey, medical examination and laboratory test.Results:A total of 1 067 CKD patients were detected in the adults aged ≥18 years in this survey, with a weighted prevalence rate of 12.10%. The results of multivariate analysis showed that the daily total static behavior time ( OR=1.07, 95% CI: 1.04-1.09), living in rural area ( OR=1.50, 95% CI: 1.14-1.97), coal use ( OR=1.37, 95% CI: 1.16-1.61), coal gas/liquefied gas/natural gas/biogas use ( OR=2.92, 95% CI: 2.40-3.54) and solar energy/electricity use ( OR=1.75, 95% CI: 1.36-2.25), insufficient fruit intake ( OR=1.39, 95% CI: 1.06-1.83), insufficient physical activity ( OR=1.35, 95% CI: 1.11-1.64), suffering from hypertension ( OR=1.80, 95% CI: 1.44-2.24) and suffering from diabetes ( OR=1.77, 95% CI: 1.27-2.45) were risk factors for CKD in adults in Hebei. High education level ( OR=0.41, 95% CI: 0.19-0.91), excessive drinking ( OR=0.53, 95% CI: 0.28-0.99), central obesity ( OR=0.75, 95% CI: 0.58-0.97), history of allergic diseases ( OR=0.44, 95% CI: 0.27-0.72) were protective factors for CKD. Conclusions:The prevalence of CKD in adults in Hebei was relatively high, especially in those who had too long average daily static behavior, lived in rural area, used coal, gas/liquefied gas/natural gas/biogas, solar energy/electricity, had inadequate intake of fruits, lacked physical activity and suffered from hypertension and diabetes. It is necessary to pay attention to the early prevention and treatment of CKD, strengthen the health education about healthy lifestyle and improve the management of patients with chronic disease, such as hypertension and diabetes, to further reduce the risk for CKD.

Objective:To compare the role of double-balloon enteroscopy (DBE) and dual-energy CT enterography (DCTE) in evaluating the clinical characteristics of Crohn′s disease (CD).Methods:From July 1, 2016 to November 1, 2023, 72 patients with CD who underwent both DBE and DCTE (with an interval of less than 3 months) in the First Affiliated Hospital of Soochow University were enrolled in this retropective study. Among them, 4 patients underwent both DBE and DCTE twice (a total of 76 cases). The data of DBE and DCTE in the diagnosis of 76 CD cases were analyzed, including the diagnostic rate of CD, the consistency of the 2 methods in detecting the lesion location (ileocecal, colonic, ileocolonic, and upper gastrointestinal tract involvement), and the detection rates of stenosis, ulcer and the location, long ulcer (long-diameter≥2 cm), and fistula. Kappa test was performed for the consistency analysis, and Chi-square test was used for statistical analysis.Results:The diagnostic rate of CD by DBE was higher than that by DCTE (80.3% (61/76) vs. 65.8% (50/76)), and the diagnostic rate of combination of the 2 methods (89.5% (68/76)) was higher than that by DCTE alone, and the differences were statistically significant ( χ2=4.04 and 12.28, P=0.044 and <0.001). The result of Kappa consistency test showed that the consistency of CD lesion location detected by DBE and DCTE was poor (Kappa value=0.29, t=3.17, P=0.002). The detection rate of stenosis by DBE was higher than that by DCTE (46.1% (35/76) vs. 13.2% (10/76)), the detection rate of stenosis by combination of the 2 methods (52.6% (40/76)) was higher than that by DCTE alone, and the differences were statistically significant ( χ2=19.73 and 26.82, both P<0.001). There were no statistically significant differences in the detection rates of fistula among DBE, DCTE, and the combination of the 2 methods (3.9%(3/76), 2.6% (2/76), 5.3% (4/76); all P>0.05). The detection rate of ulcer by DBE was higher than that by DCTE(73.7% (56/76) vs. 7.9% (6/76)), the detection rate of ulcer by combination of the 2 methods (76.3%(58/56)) was higher than that by DCTE alone, and the differences were statistically significant ( χ2=68.10 and 72.98, both P<0.001). The detection rates of long ulcer and non-terminal ileum ulcer by DBE were both 17.9% (10/56). All the 6 cases with ulcer detected by DCTE were located in the terminal ileum, and no long ulcers were observed. Conclusions:In the diagnosis of CD, as well as in the detection of stenosis and ulcer, DBE and the combination of DBE and DCTE have more advantages over DCTE alone. The consistency between DBE and DCTE in identifying the location of lesion is poor. DBE has advantages in detecting long ulcer and non-terminal ileum ulcer.

Objective:To analyze the prevalence of chronic kidney disease (CKD) and influencing factors of adults in Hebei Province, and provide scientific evidence for the development of comprehensive CKD prevention and control strategies.Methods:In China Adult Chronic Disease and Nutrition Surveillance in Hebei in 2018, a total of 7 562 permanent residents aged ≥18 years were selected by multi-stage stratified cluster random sampling from 13 surveillance points in Hebei for questionnaire survey, medical examination and laboratory test.Results:A total of 1 067 CKD patients were detected in the adults aged ≥18 years in this survey, with a weighted prevalence rate of 12.10%. The results of multivariate analysis showed that the daily total static behavior time ( OR=1.07, 95% CI: 1.04-1.09), living in rural area ( OR=1.50, 95% CI: 1.14-1.97), coal use ( OR=1.37, 95% CI: 1.16-1.61), coal gas/liquefied gas/natural gas/biogas use ( OR=2.92, 95% CI: 2.40-3.54) and solar energy/electricity use ( OR=1.75, 95% CI: 1.36-2.25), insufficient fruit intake ( OR=1.39, 95% CI: 1.06-1.83), insufficient physical activity ( OR=1.35, 95% CI: 1.11-1.64), suffering from hypertension ( OR=1.80, 95% CI: 1.44-2.24) and suffering from diabetes ( OR=1.77, 95% CI: 1.27-2.45) were risk factors for CKD in adults in Hebei. High education level ( OR=0.41, 95% CI: 0.19-0.91), excessive drinking ( OR=0.53, 95% CI: 0.28-0.99), central obesity ( OR=0.75, 95% CI: 0.58-0.97), history of allergic diseases ( OR=0.44, 95% CI: 0.27-0.72) were protective factors for CKD. Conclusions:The prevalence of CKD in adults in Hebei was relatively high, especially in those who had too long average daily static behavior, lived in rural area, used coal, gas/liquefied gas/natural gas/biogas, solar energy/electricity, had inadequate intake of fruits, lacked physical activity and suffered from hypertension and diabetes. It is necessary to pay attention to the early prevention and treatment of CKD, strengthen the health education about healthy lifestyle and improve the management of patients with chronic disease, such as hypertension and diabetes, to further reduce the risk for CKD.

Objective:To compare the role of double-balloon enteroscopy (DBE) and dual-energy CT enterography (DCTE) in evaluating the clinical characteristics of Crohn′s disease (CD).Methods:From July 1, 2016 to November 1, 2023, 72 patients with CD who underwent both DBE and DCTE (with an interval of less than 3 months) in the First Affiliated Hospital of Soochow University were enrolled in this retropective study. Among them, 4 patients underwent both DBE and DCTE twice (a total of 76 cases). The data of DBE and DCTE in the diagnosis of 76 CD cases were analyzed, including the diagnostic rate of CD, the consistency of the 2 methods in detecting the lesion location (ileocecal, colonic, ileocolonic, and upper gastrointestinal tract involvement), and the detection rates of stenosis, ulcer and the location, long ulcer (long-diameter≥2 cm), and fistula. Kappa test was performed for the consistency analysis, and Chi-square test was used for statistical analysis.Results:The diagnostic rate of CD by DBE was higher than that by DCTE (80.3% (61/76) vs. 65.8% (50/76)), and the diagnostic rate of combination of the 2 methods (89.5% (68/76)) was higher than that by DCTE alone, and the differences were statistically significant ( χ2=4.04 and 12.28, P=0.044 and <0.001). The result of Kappa consistency test showed that the consistency of CD lesion location detected by DBE and DCTE was poor (Kappa value=0.29, t=3.17, P=0.002). The detection rate of stenosis by DBE was higher than that by DCTE (46.1% (35/76) vs. 13.2% (10/76)), the detection rate of stenosis by combination of the 2 methods (52.6% (40/76)) was higher than that by DCTE alone, and the differences were statistically significant ( χ2=19.73 and 26.82, both P<0.001). There were no statistically significant differences in the detection rates of fistula among DBE, DCTE, and the combination of the 2 methods (3.9%(3/76), 2.6% (2/76), 5.3% (4/76); all P>0.05). The detection rate of ulcer by DBE was higher than that by DCTE(73.7% (56/76) vs. 7.9% (6/76)), the detection rate of ulcer by combination of the 2 methods (76.3%(58/56)) was higher than that by DCTE alone, and the differences were statistically significant ( χ2=68.10 and 72.98, both P<0.001). The detection rates of long ulcer and non-terminal ileum ulcer by DBE were both 17.9% (10/56). All the 6 cases with ulcer detected by DCTE were located in the terminal ileum, and no long ulcers were observed. Conclusions:In the diagnosis of CD, as well as in the detection of stenosis and ulcer, DBE and the combination of DBE and DCTE have more advantages over DCTE alone. The consistency between DBE and DCTE in identifying the location of lesion is poor. DBE has advantages in detecting long ulcer and non-terminal ileum ulcer.

Objective:To assess the efficacy and safety of Tacrolimus（TAC）in combination with glucocorticosteroid（GC）for treating IgA vasculitis nephritis（IgAVN）in children.Methods:A retrospective analysis was conducted on pediatric patients who were diagnosed with IgAVN from January 2015 to January 2022 in Children's Hospital of Hebei Province.The patients presented with nephrotic-range proteinuria or persistent urine protein（>0.5g/24 h）despite adequate glucocorticoid and other treatments in patients who do not reach massive proteinuria levels.They were treated with TAC combined with GC. The following laboratory parameters were obtained for outcome assessment: 24-hour urinary protein excretion, serum albumin, serum creatinine levels, and fasting blood glucose measurements. The efficacy and adverse reactions of TAC were summarized.Results:A total of 97 children (55 males and 42 females) were included. The average age of diagnosis of IgA vasculitis was (8.65±2.46) years, and 95.9% of the children developed renal involvement within 30 days after diagnosis. Pathological examination of renal puncture: 5 cases of grade Ⅱa, 2 cases of grade Ⅱb, 31 cases of grade Ⅲa, 57 cases of grade Ⅲb, and 2 cases of grade Ⅳb.Remission rate at 3 months was 96.9%（94/97）.Three patients failed to achieve clinical remission who were treaed with other immunosuppressants.After 1, 3, 6 and 12 months of TAC treatment, the urine protein levels of 94 children were lower than those before treatment, and the differences were statistically significant ( P < 0.05), showing a gradual downward trend. Serum albumin levels were higher than those before treatment, and the differences were statistically significant ( P < 0.05), showing a gradual upward trend.After 3 months and 6 months of TAC treatment, the serum creatinine and fasting blood glucose of the children increased. With the remission of the disease, TAC dosage decreased, the mean values of serum creatinine and fasting blood glucose decreased after 12 months of treatment.The average treatment time of TAC was (10.8±2.6) months, the average follow-up time was (3.33±1.56) years, and the longest follow-up time was 8 years. During the follow-up period, there were no serious adverse reactions such as gastrointestinal discomfort, liver function damage and severe infection. After stopping GC and TAC treatment, 80 children got sustained remission. Conclusion:The combination of TAC and GC has been proved to be effective in treating IgAVN in children.The overall effective rate is high,and clinical remission can be achieved quickly with relatively mild adverse reactions.