Objective:To investigate the therapeutic value of visual endoscopic retrograde appendicitis therapy (vERAT) in pediatric patients with acute suppurative appendicitis (ASA).Methods:This was a retrospective cohort study. A total of 55 ASA patients who underwent vERAT at the Pediatric Department of the Tangdu Hospital of Air Force Medical University between November 2023 and January 2025 were selected and divided into groups based on the presence or absence of fecaliths: fecalith group and non-fecalith group. The baseline characteristics, initial treatment success rates, treatment costs, hospital stay duration, procedure time, and recurrence rates between two groups were compared. Mann-Whitney U test and χ2 test were used to evaluate group differences. Results:A total of 55 ASA patients were enrolled, including 38 males and 17 females, with the age of 11.2 (9.2, 13.1) years. Based on the presence of fecaliths, patients were divided into two groups: fecalith group (32 cases) and non-fecalith group (23 cases). No statistically significant differences were observed between the two groups in terms of age, gender, duration of abdominal pain, white blood cell count, neutrophil percentage, diameter of appendix, thickness of appendix clinical symptoms or signs (all P>0.05). The initial treatment success rates were 91% (29/32) in fecalith group and 96% (22/23) in non-fecalith group, with no statistically significant difference ( P=0.632). However, significant differences were noted in stent placement ( χ2=5.85, P=0.026) and procedure time ( Z=4.75, P<0.001). The follow-up duration time was 6.0 (2.0, 12.0) and 7.0 (2.0, 8.5) months for the fecalith and non-fecalith groups, respectively, with no significant difference ( Z=0.05, P=0.962). The recurrence rates were 14% (4/29) in fecalith group and 5% (1/22) in non-fecalith group, with no statistically significant difference ( P=0.375). Conclusions:vERAT can safely and effectively treat pediatric ASA, regardless of the presence or absence of fecaliths. It can provide a new treatment option for ASA.

Objective:To compare the burden of benign prostatic hyperplasia（BPH）between China and the United States from 1990 to 2021.Methods:The prevalence，incidence，years lived with disability（YLD），and their age-standardized rates for BPH in China and the United States from 1990 to 2021 were obtained from the Global Burden of Disease Study 2021（GBD 2021）. The average annual percentage change（AAPC）of the age-standardized incidence rate（ASIR）and the age-standardized YLD rate（ASYR）was calculated using Joinpoint regression analysis. In addition，the YLD burden of BPH，prostate cancer，kidney cancer，bladder cancer，and three other urological diseases were compared between the two countries.Results:From 1990 to 2021，the number of BPH cases in China increased from 1.460 4 million to 3.244 5 million，the number of prevalent cases rose from 9.940 5 million to 23.111 2 million，and YLDs grew from 0.2 million person-years to 0.460 2 million person-years，with AAPCs of 2.63%，2.78%，and 2.75%，respectively. In 2021，the numbers of incident cases，prevalent cases，and YLDs were 0.577 9 million，4.930 3 million，and 0.095 9 million person-years in the United States，and 13.787 6 million，112.502 million，and 2.235 7 million person-years globally. China’s ASIR decreased from 363.07/100 000 to 299.14/100 000（AAPC -0.60%），and ASYR from 57.33/100 000 to 45.84/100 000（AAPC -0.70%），both of which were higher than those in the United States but lower than the global level. Age-specific analyses showed declining incidence and YLD rates across all age groups in China，while certain age groups in the United States demonstrated increasing trends. From 1990 to 2021，the proportion of YLDs attributable to BPH among seven urological diseases in China rose from 61.4% to 69.2%. In 2021，YLDs due to prostate cancer accounted for the highest proportion among seven urinary system diseases in the United States，reaching 54.5%. Projections indicate that although ASIR and ASYR in China will decline from 2022 to 2040，the absolute numbers of incident cases and YLDs are projected to continue to rise，reaching 4.97 million and 0.78 million，respectively，by 2040.Conclusions:Between 1990 and 2021，the number of incidence cases，prevalence cases，and YLDs of BPH in China increased markedly，while ASIR and ASYR declined. The disease burden of BPH remains substantial，with a higher proportion of YLDs among urological diseases compared with the United States. By 2040，the number of BPH cases and YLDs in China is projected to further increase，underscoring the need for greater public health attention.

The coinfection of respiratory viruses and bacteria is a major cause of morbidity and mortality worldwide, despite the development of vaccines and powerful antibiotics. As a macromolecule that is difficult to absorb in the gastrointestinal tract, a homogeneous polysaccharide from Houttuynia cordata (HCPM) has been reported to exhibit anti-complement properties and alleviate influenza A virus (H1N1)-induced lung injury; however, the effects of HCPM without in vitro antiviral and antibacterial activities on more complicated pulmonary diseases resulting from viral-bacterial coinfection remains unclear. This study established a representative coinfection murine pneumonia model infected with H1N1 (0.2 LD₅₀) and methicillin-resistant Staphylococcus aureus (MRSA, 10⁷ CFU). HCPM significantly improved survival rate and weight loss, and ameliorated gut-lung damage and inflammatory cytokine production. Interestingly, the therapeutic effect of HCPM on intestinal damage preceded that in the lungs. Mechanistically, HCPM inhibited the overactivation of the intestinal complement (C3a and C5a) and suppressed the activation of the NLR family pyrin domain-containing 3 (NLRP3) pathway, which contributes to the regulation of the Treg/Th17 cell balance in the gut-lung axis. The results indicate the beneficial effects of an anti-complement polysaccharide against viral-bacterial coinfection pneumonia by modulating crosstalk between multiple immune regulatory networks.

Objective:To investigate the therapeutic value of visual endoscopic retrograde appendicitis therapy (vERAT) in pediatric patients with acute suppurative appendicitis (ASA).Methods:This was a retrospective cohort study. A total of 55 ASA patients who underwent vERAT at the Pediatric Department of the Tangdu Hospital of Air Force Medical University between November 2023 and January 2025 were selected and divided into groups based on the presence or absence of fecaliths: fecalith group and non-fecalith group. The baseline characteristics, initial treatment success rates, treatment costs, hospital stay duration, procedure time, and recurrence rates between two groups were compared. Mann-Whitney U test and χ2 test were used to evaluate group differences. Results:A total of 55 ASA patients were enrolled, including 38 males and 17 females, with the age of 11.2 (9.2, 13.1) years. Based on the presence of fecaliths, patients were divided into two groups: fecalith group (32 cases) and non-fecalith group (23 cases). No statistically significant differences were observed between the two groups in terms of age, gender, duration of abdominal pain, white blood cell count, neutrophil percentage, diameter of appendix, thickness of appendix clinical symptoms or signs (all P>0.05). The initial treatment success rates were 91% (29/32) in fecalith group and 96% (22/23) in non-fecalith group, with no statistically significant difference ( P=0.632). However, significant differences were noted in stent placement ( χ2=5.85, P=0.026) and procedure time ( Z=4.75, P<0.001). The follow-up duration time was 6.0 (2.0, 12.0) and 7.0 (2.0, 8.5) months for the fecalith and non-fecalith groups, respectively, with no significant difference ( Z=0.05, P=0.962). The recurrence rates were 14% (4/29) in fecalith group and 5% (1/22) in non-fecalith group, with no statistically significant difference ( P=0.375). Conclusions:vERAT can safely and effectively treat pediatric ASA, regardless of the presence or absence of fecaliths. It can provide a new treatment option for ASA.

Objective:To compare the burden of benign prostatic hyperplasia（BPH）between China and the United States from 1990 to 2021.Methods:The prevalence，incidence，years lived with disability（YLD），and their age-standardized rates for BPH in China and the United States from 1990 to 2021 were obtained from the Global Burden of Disease Study 2021（GBD 2021）. The average annual percentage change（AAPC）of the age-standardized incidence rate（ASIR）and the age-standardized YLD rate（ASYR）was calculated using Joinpoint regression analysis. In addition，the YLD burden of BPH，prostate cancer，kidney cancer，bladder cancer，and three other urological diseases were compared between the two countries.Results:From 1990 to 2021，the number of BPH cases in China increased from 1.460 4 million to 3.244 5 million，the number of prevalent cases rose from 9.940 5 million to 23.111 2 million，and YLDs grew from 0.2 million person-years to 0.460 2 million person-years，with AAPCs of 2.63%，2.78%，and 2.75%，respectively. In 2021，the numbers of incident cases，prevalent cases，and YLDs were 0.577 9 million，4.930 3 million，and 0.095 9 million person-years in the United States，and 13.787 6 million，112.502 million，and 2.235 7 million person-years globally. China’s ASIR decreased from 363.07/100 000 to 299.14/100 000（AAPC -0.60%），and ASYR from 57.33/100 000 to 45.84/100 000（AAPC -0.70%），both of which were higher than those in the United States but lower than the global level. Age-specific analyses showed declining incidence and YLD rates across all age groups in China，while certain age groups in the United States demonstrated increasing trends. From 1990 to 2021，the proportion of YLDs attributable to BPH among seven urological diseases in China rose from 61.4% to 69.2%. In 2021，YLDs due to prostate cancer accounted for the highest proportion among seven urinary system diseases in the United States，reaching 54.5%. Projections indicate that although ASIR and ASYR in China will decline from 2022 to 2040，the absolute numbers of incident cases and YLDs are projected to continue to rise，reaching 4.97 million and 0.78 million，respectively，by 2040.Conclusions:Between 1990 and 2021，the number of incidence cases，prevalence cases，and YLDs of BPH in China increased markedly，while ASIR and ASYR declined. The disease burden of BPH remains substantial，with a higher proportion of YLDs among urological diseases compared with the United States. By 2040，the number of BPH cases and YLDs in China is projected to further increase，underscoring the need for greater public health attention.

Objective To explore the role and significance of secretory phospholipase A2(sPLA2)in peripheral blood in preterm premature rup?ture of membranes(pPROM)and infection of amniotic cavity. Methods RT-PCR was used to detect the expression levels of sPLA2 mRNA in pe?ripheral blood of 30 patients with pPROM (experimental group),30 non-full term normal pregnant patients without pPROM (normal control group)and 30 full term patients with PROM(full-term control group)before and after delivery. Fetal membranes were collected at the time of deliv?ery of patients with pPROM for pathologic examination to determine histological chorioamnionitis(HCA). Results The expression levels of sPLA2 mRNA in peripheral blood were 1.079±0.746 and 0.651±0.481 in the experimental group and the normal control group before delivery,respectively, indicating that the expression of sPLA2 mRNA was increased in the experimental group compared with the normal control group(P=0.011). The expression levels of sPLA2 mRNA in peripheral blood were 2.439±0.086 and 2.575±0.036 in the experimental group and the full-term control group at labor onset,respectively,indicating that there was no statistically significant difference in the level of sPLA2 mRNA in peripheral blood between the experimental group and the full-term control group at labor onset(P=0.787). The level of sPLA2 was related to chorioamnionitis in the experi?mental group at labor onset. Conclusion The increase of sPLA2 may participate in the pathogenesis of preterm premature rupture of membranes and is related with the infection of chorioamnionitis.

Objective To study thyroid hormone changes in women with pre-eclampsia patients,the characteristics of thyroid disease and its relationship with pre-eclampsia.Methods From May 2011 to December 2012 171 patients with pre-eclampsia who delivered in Shengjing Hospital of China Medical University were recruited as prc-eclampsia(PE) group,among which 114 cases were defined as early onset pre-eclampsia (EP) group and 57 cases were defined as late onset pre-eclampsia (LP) group.And 171 healthy women with same age and same stage of pregnancy were selected as the control group.Their blood pressures were normal and they had no obstetrical complications.Serum thyrotropin (TSH),free triiodothyronine (FT3) and free thyroxine (FT4) levels were determined by solid-phase chemiluminescent enzyme immunoassay method (CMIA).Thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb) were measured by electro-chemiluminescent assay (ECLIA).The positive rate was calculated (TPOAb ＞ 5.6 U/L,TGAb ＞ 4.1 U/L were defined as positive result).The relationship between TSH,FT3,FT4 level and blood pressure was analyzed in women with pre-eclampsia.Results (1) The median values of TSH,FT4 and FT3 in PE group were 3.4 mU/L,(12.0 ± 3.0) pmol/L and(3.9 ± 0.9) pmol/L.In the control group,they were 1.9 mU/L,(13.4 ± 2.4) and (5.0 ± 1.3) pmol/L.There were statistically significant differences between the two groups(P ＜ 0.01).In EP group,the median values of TSH,FT4 and FT3 were 3.3 mU/L,(12.1 ± 3.4) pmol/L and (3.8 ± 0.9) pmol/L.The differences between EP group and the control group were statistically significant (P ＜ 0.01).In LP group,the median values of TSH,FT4 and FT3 were 3.4 mU/L,(11.9 ± 3.1) pmol/L and (3.9 ± 1.0) pmol/L.There were statistically significant differences compared to the control group(P ＜0.01).While there was no difference between EP group and LP group (P ＞ 0.05).(2) The positive rate of TPOAb and TGAb in PE group were 15.2％ (26/171)and 21.6％ (37/171),and were 12.3％ (21/171) and 14.6％ (25/171) in the control group.There was statistically significant difference in the TGAb positive rate (P ＜ 0.01),but the difference in TPOAb positive rate was not statistically different(P ＞0.05).The TPOAb positive rates in EP group and LP group were 12.3 ％ (14/114) and 21.1％ (12/57),respectively,with no statistically significant difference (P ＞ 0.05).And the positive rates of TGAb in EP group and LP group were 21.9％ (25/114)and 21.1％ (12/57),respectively,with no statistically significant difference(P ＞ 0.05).The positive rate of TPOAb in LP group and in the control group had statistically significant difference(P ＜0.01).(3) The morbidity of thyroid disease in PE group and in the control group were 47.4％ (81/171) and 16.4％ (28/171),with statistically significant difference (P ＜ 0.01).(4) The morbidity of subclinical hypothyroidism or hypothyroidism in PE group and in the control group were 45.0％ (77/171) and 16.4％ (28/171),with statistically significant difference(P ＜0.01).(5) The morbidity of subclinical hyperthyroidism in PE group and in the control group were 2.3 ％ (4/171) and 1.8 ％ (3/171),with no statistically significant difference (P＞0.05).(6) In PE group,women with TSH level of 0.3-3.3 mU/L had systolic pressure of(170 ± 21)mmHg (1mmHg =0.133 kPa)and diastolic pressure of(112 ± 15) mmHg; women with TSH ＞ 3.3 mU/L had systolic pressure of(166 ± 21)mmHg and diastolic pressure of(109 ± 13)mmHg.There was no statistically significant difference(P ＞ 0.05).But the diastolic pressure in EP group and LP group had statistically significant difference(P ＜ 0.01).In PE group,no correlation was found among TSH,FT4 levels and systolic pressure,diastolic pressure(P ＞ 0.05).FT3 level was negatively correlated to diastolic pressure (r =-0.172,P =0.023).Conclusions It is common that pre-eclampsia is complicated with thyroid dysfunction,mainly subclinical hypothyroidism.Thus it is nessesary to test thyroid hormone and thyroid antibodies in women with pre-eclampsia.The decrease of FT3 and FT4,the increase of TSH and the presence of TPOAb and TGAb are related with the presence of pre-eclampsia.

Objective To study the effects of quantitative 24-hour urinary protein on the thyroid hormone levels in patients with severe preeclamp-sia,and clarify the impact of severe urinary protein on hypothyroid in severe preeclampsia patients. Methods A total of 166 patients with severe pre-eclampsia were recruited for the study and divided into mild proteinuria group(2.0-4.9 g/d),midrange group(5-10 g/d)and severe group(>10 g/d)according to the quantitative 24-hour urinary protein. 268 healthy female individuals with normal blood pressure and uric routine in the same stage of pregnancy and of the same age were selected into control group. Serum thyrotropin(TSH),free triiodothyronine(FT3)and free thyroxine (FT4)levels were determined by solid-phase chemiluminescent enzyme immunoassay method(CMIA). The thyroid peroxidase antibody(TPOAb) and thyroglobulin antibody(TGAb)concentration were detected by electrochemiluminescent assay(ECLIA). Results TSH levels were signifi-cantly higher in patients comparing to the control group(P<0.01). In addition,severe group showed higher TSH levels than mild group(P<0.01). FT4 and FT3 levels were obviously decreased with the progression of the disease(P<0.01 and P<0.05). The positive rate of TPOAb in mild group was significantly higher than that in moderate group(OR=9.8,P<0.05). There was no significant difference of the TGAb positive rate among three patient groups(P>0.05). The incidence of subclinical hypothyroidism and clinical hypothyroidism in severe group was significantly higher than that in mild group and in control group(OR=2.5,P<0.05 and OR=9.0,P<0.05;OR=8.0,P<0.01 and OR=43.4,P<0.01). Conclusion Our re-sults indicated that 24-hour urine protein in severe preeclampsia patients has extensive effects on thyroid hormones levels. With the increasing of quantitative 24-hour urinary protein,the level of TSH increased and the FT4 decreased. Thyroid autoantibody positiveness has extensive effects on 24- hour urine protein. Incidence of hypothyroid increased with the increase of quantitative 24-hour urinary protein. 24-hour urinary protein quantitative was a risk factor for hypothyroidism in severe preeclampsia patients. More attention should be paid to the monitoring of 24-hour urinary protein in se-vere preeclampsia patients.

Objective To study effects of different degree of hypothyroidism in severe preeclampsia (S-PE) pregnant women on renal function and the correlation between them.Methods 46 S-PE patients with subclinical hypothyroidism (SCH) registered for treatment in the Shengjing Hospital of China Medical University from May 2011 to March 2013 were selected into SCH group,and 23 S-PE with overt hypothyroidism (OH) were selected into OH group,and 109 S-PE with normal thyroid stimulating hormone (TSH) levels were selected into simple group.Thyroid hormone and kidney function tests were analyzed in pregnant women with S-PE.We made an analysis of the relative risk of the detection rate of abnormal renal function and also the relationship between the levels of thyroid hormone and serum uric acid,serum urea and creatinine in patients with S-PE.Results (1) In SCH group serum TSH was (6.1±3.2) mU/L,free triiodothyronine (FT3) was (4.0±0.6) pmol/L,free thyroxine (FT4) was (11.8± 1.5) pmol/L; in OH group serum TSH was (5.2± 1.3) mU/L,FT3 was (3.7±0.6) pmol/L,FT4 was (9.3±0.5) pmol/L; in simple S-PE group serum TSH was (1.9±0.8) mU/L,FT3 was (4.0±0.8) pmol/L and FT4 was (11.9±1.9) pmol/L.TSH in SCH group was significantly higher than that in simple S-PE group (P＞0.01),the difference of in SCH and OH group were not statistically significant (P＞0.05).The difference of FT3 in three groups were not statistically significant (P＜0.05) ;FT4 in OH group was significantly lower than thoes in SCH and simple groups (P＜0.05).(2)Serum uric acid,creatinine and urea levels in OH group was (436± 114),(75± 15) μmol/L and (6±3)mmol/L,in simple S-PE group they were (378± 114),(65 ±22) μmol/L and (5±3) mmol/L.In comparison,the differences was statistically significant(P＜0.05).The differences were not statistically significant in SCH and OH groups (P＞0.05).(3)The abnormal detection rate of uric acid was significantly higher in SCH than that in OH group [46％ (21/46) versus 22％ (5/23),OR=3.0,P＜0.05].The comparison of remaining index has no statistical significance(P＞0.05).(4)In SCH group there was a significant inverse correlation of serum FT3 with serum urea levels,serum creatinine and serum uric acid (r=-0.32,-0.58,-0.35,P＜0.05).There was not a correlation of serum TSH,FT4 with indicators of renal function (P＞0.05).In OH group there was a negative correlation between FT3 and serum creatinine concentrations (r=-0.40,P＜0.05).In OH group there was not a correlation of FT3 with serum uric acid and urea (P＞0.05).There was a positive correlation between TSH and serum creatinine in simple S-PE group (r=0.20,P=0.04).There was not a correlation between TSH and serum urea(r=0.04,P=0.65),and serum uric acid (r=0.12,P=0.20).Conclusions There was effect of different hypothyrosis state in pre-eclampsia patients on renal function.Serum uric acid,urea and creatinine concentrations in S-PE pregnant women with OH were significantly higher than those in simple S-PE group with normal TSH.There was a negative correlation between FT3 and serum creatinine in S-PE.Hence the thyroid function should be regularly monitored in S-PE patients to find damage of renal function and management hypothyrosis.

Objective To use the first trimester-specific reference intervals of thyroid-related hormones to explore the prevalence of thyroid dysfunction during early pregnancy and to analyze effectiveness of different screening strategies. Methods In this study 2 899 pregnant women were enrolled during the first trimester of gestation. TSH, FT4, FT3, and thyroid peroxidase antibody (TPOAb) were measured and thyroid disorders of pregnant women were diagnosed based on the first trimester-specific reference intervals. Results The prevalence of hypothyroidism was significantly higher in the high-risk group than in the non-high risk group ( 16.3% vs 5.3%,RR = 3.1,95% CI 2.4-4.0, P＜0.01 ). TPOAb ( RR = 4.7, 95 % CI 3.6-6.0, P＜0.01 ), and personal history of thyroid diseases ( RR=3.2, 95% CI 1.9-5.4, P＜0.01 ) increased the risk of hypothyroidism. The prevalence of hyperthyroidism was higher in the high-risk group (3.1% vs 1.4%, P = 0. 006, RR = 2.2, 95% CI 1.2-3.9, P=0.006). TPOAb (RR=2.6, 95%CI 1.3-5.0, P=0.007), and presence of personal history of thyroid diseases( RR=4.7, 95% CI 1.7-12.5, P=0.006) also increased the risk of hyperthyroidism. 56.7% women with hypothyroidism and 64. 7% women with hyperthyroidism were in the non-high risk group. Conclusion We recommend that screening all pregnant women for thyroid disorders in the first trimester with TSH, FT4, and TPOAb is more effective than the case-finding approach.