Uric acid (UA) is the final metabolite of purines in the human body. An imbalance in UA production and excretion that disrupts homeostasis leads to elevated blood UA levels and the development of hyperuricemia (HUA). Approximately one-third of UA is excreted through the intestinal tract. As a crucial component of the intestinal microenvironment, the gut microbiota plays a pivotal role in regulating blood UA levels. Alterations or imbalances in gut microbiota composition are linked to the onset of HUA, which implies the potential of gut microbiota as a novel target for the prevention and treatment of HUA. This review introduces the occurrence mechanism and damage of hyperuricemia, examines the association between HUA and the gut microbiota and their metabolites, and explores the molecular mechanisms underlying gut microbiota-targeted therapies for HUA. Furthermore, it discusses the potential applications of probiotics, prebiotics, and traditional Chinese medicine (including both single herbs and compound formulas) with UA-lowering effects, along with cutting-edge technologies such as fecal microbiota transplantation and machine learning in HUA treatment. This review provides valuable perspectives and strategies for improving the prevention and treatment of HUA.
Hyperuricemia/microbiology* ; Humans ; Gastrointestinal Microbiome/physiology* ; Probiotics/therapeutic use* ; Uric Acid/blood* ; Fecal Microbiota Transplantation ; Prebiotics ; Medicine, Chinese Traditional

Objective To explore the correlation between the expression of serum microRNA(miR)-1298-5p,miR-625-5p,and miR-155 with the degree of Helicobacter pylori(Hp)infection in elderly gastric cancer patients.Methods From January 2021 to November 2023,120 elderly patients with gastric cancer admitted to the hospital from January 2021 to November 2023 were selected as the gastric cancer group,and 130 non-gas-tric cancer patients who underwent gastroscopy were selected as the control group.The expression levels of miR-1298-5p,miR-625-5p and miR-155 in serum were detected by fluorescence quantitative PCR(qPCR).Car-bon 13 urea breath test was used to detect the positive rate of Hp infection in two groups,and the degree of Hp infection in elderly patients with gastric cancer were evaluated.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum miR-1298-5p,miR-625-5p,and miR-155 expression levels for Hp infection in elderly gastric cancer patients.Pearson method was applied to analyze the correlation between serum miR-1298-5p,miR-625-5p,miR-155 expression and positive rate of Hp infection in elderly gas-tric cancer patients.Results Compared with the control group,the expression levels of miR-1298-5p and miR-625-5p in serum of gastric cancer group decreased(P＜0.05),while the positive rate of Hp infection and the expression level of serum miR-155 increased(P＜0.05).The expression levels of serum miR-1298-5p and miR-625-5p in elderly gastric cancer patients with Hp grade Ⅰ,Ⅱ,and Ⅲ infection were lower than those without Hp infection,while the expression level of miR-155 was higher(P＜0.05).Patients with poor differ-entiation,lymph node metastasis,and TNM stage Ⅲ-Ⅳ had lower expressions of serum miR-1298-5p and miR-625-5p(P＜0.05),and higher expression of miR-155(P＜0.05)than those with moderate-high differen-tiation,no lymph node metastasis,and TNM stage Ⅰ-Ⅱ.The expression levels of serum miR-1298-5p and miR-625-5p were negatively correlated with the positive rate of Hp infection in elderly patients with gastric cancer(r=-0.443,-0.386,both P＜0.001),and the expression levels of serum miR-155 were positively correlated with the positive rate of Hp infection(r=0.525,P＜0.001).The area under the curve(AUC)of serum miR-1298-5p,miR-625-5p and miR-155 combined diagnosis of Hp infection in elderly gastric cancer pa-tients was higher than that of single diagnosis(P＜0.05).Conclusion The expression levels of miR-1298-5p and miR-625-5p in serum of elderly gastric cancer patients with Hp infection decrease,while the expression level of miR-155 increases.These three factors are related to the degree of Hp infection and have good diag-nostic value for the occurrence of Hp infection.

Objective:To compare the clinical efficacy and safety of nanomicroneedle- versus ultrasound-mediated delivery of tranexamic acid for the treatment of melasma.Methods:A prospective, randomized, controlled study was conducted. Patients with melasma were collected from the Department of Dermatology, Guangzhou Dermatology Hospital from March 2023 to May 2024, and divided into a nanomicroneedle group (receiving nanomicroneedle-mediated delivery of tranexamic acid) and an ultrasound group (receiving ultrasound-mediated delivery of tranexamic acid) using the random number table method. Both groups underwent the treatment once a week for a total of 8 sessions. At week 12, outcomes including melasma area and severity index (MASI) scores, treatment response rates, VISIA brown spot scores, pain scores, and adverse reactions were evaluated and compared between the two groups. Statistical analyses were carried out using two-independent-sample t test, Mann-Whitney U test, and chi-square test. Results:A total of 80 patients with melasma were included, with 40 in each group. In the nanomicroneedle group, the patients were aged 40.35 ± 7.39 years (range: 25 - 55 years), with the disease duration being 8.45 ± 4.77 months (range: 1 - 16 months) ; in the ultrasound group, the patients were aged 40.25 ± 7.76 years (range: 25 - 55 years), and their disease duration was 10.45 ± 5.07 months (range: 2 - 17 months) ; there were no significant differences in ages or disease duration between the two groups (both P > 0.05). At week 12, both groups demonstrated reduced MASI scores compared to baseline scores, and the MASI scores were significantly lower in the nanomicroneedle group ( M[ Q1, Q3]: 5.80[4.20, 9.35]) than in the ultrasound group (8.65[5.70, 10.80], Z = 2.50, P = 0.012). The overall response rate was significantly higher in the nanomicroneedle group (97.5%, 39/40) than in the ultrasound group (55.0%, 22/40; χ2 = 19.95, P < 0.001). The lateral facial VISIA brown spot scores were also significantly lower in the nanomicroneedle group (left side: 126.18 ± 36.54 points; right side: 138.50 ± 40.76 points) than in the ultrasound group (left side: 142.37 ± 32.40 points; right side: 157.13 ± 39.59 points; t = -2.10, -2.07, P = 0.039, 0.041, respectively). In the nanomicroneedle group, the pain scores were 4.12 ± 1.47 points, and varying severity of adverse reactions such as erythema, edema and dryness occurred after operation, all of which resolved spontaneously within 48 hours. No marked adverse reactions were observed in the ultrasound group. Conclusion:Nanomicroneedle-mediated delivery of tranexamic acid demonstrated superior clinical efficacy and favorable safety profiles compared to the ultrasound-mediated delivery, providing more options for the treatment of melasma.

Objective:To compare the clinical efficacy and safety of nanomicroneedle- versus ultrasound-mediated delivery of tranexamic acid for the treatment of melasma.Methods:A prospective, randomized, controlled study was conducted. Patients with melasma were collected from the Department of Dermatology, Guangzhou Dermatology Hospital from March 2023 to May 2024, and divided into a nanomicroneedle group (receiving nanomicroneedle-mediated delivery of tranexamic acid) and an ultrasound group (receiving ultrasound-mediated delivery of tranexamic acid) using the random number table method. Both groups underwent the treatment once a week for a total of 8 sessions. At week 12, outcomes including melasma area and severity index (MASI) scores, treatment response rates, VISIA brown spot scores, pain scores, and adverse reactions were evaluated and compared between the two groups. Statistical analyses were carried out using two-independent-sample t test, Mann-Whitney U test, and chi-square test. Results:A total of 80 patients with melasma were included, with 40 in each group. In the nanomicroneedle group, the patients were aged 40.35 ± 7.39 years (range: 25 - 55 years), with the disease duration being 8.45 ± 4.77 months (range: 1 - 16 months) ; in the ultrasound group, the patients were aged 40.25 ± 7.76 years (range: 25 - 55 years), and their disease duration was 10.45 ± 5.07 months (range: 2 - 17 months) ; there were no significant differences in ages or disease duration between the two groups (both P > 0.05). At week 12, both groups demonstrated reduced MASI scores compared to baseline scores, and the MASI scores were significantly lower in the nanomicroneedle group ( M[ Q1, Q3]: 5.80[4.20, 9.35]) than in the ultrasound group (8.65[5.70, 10.80], Z = 2.50, P = 0.012). The overall response rate was significantly higher in the nanomicroneedle group (97.5%, 39/40) than in the ultrasound group (55.0%, 22/40; χ2 = 19.95, P < 0.001). The lateral facial VISIA brown spot scores were also significantly lower in the nanomicroneedle group (left side: 126.18 ± 36.54 points; right side: 138.50 ± 40.76 points) than in the ultrasound group (left side: 142.37 ± 32.40 points; right side: 157.13 ± 39.59 points; t = -2.10, -2.07, P = 0.039, 0.041, respectively). In the nanomicroneedle group, the pain scores were 4.12 ± 1.47 points, and varying severity of adverse reactions such as erythema, edema and dryness occurred after operation, all of which resolved spontaneously within 48 hours. No marked adverse reactions were observed in the ultrasound group. Conclusion:Nanomicroneedle-mediated delivery of tranexamic acid demonstrated superior clinical efficacy and favorable safety profiles compared to the ultrasound-mediated delivery, providing more options for the treatment of melasma.

Based on the theory of "one qi circulation" founded by HUANG Yuanyu， the core disease mechanism of colorectal cancer is the innate spleen deficiency and stomach qi failing to bear downward， which leads to the turbidity assemble in large intestine， forming the carcinoma toxin， and ultimately transforms into colorectal cancer. The treatment should base on recovering the circulation of qi， Huangya Decoction （黄芽汤） as the basic formula， the circulation of qi ascending and descending as the base， adjusting ascending and descending together with Xiaqi Decoction （下气汤）， and differentiating the syndrome on yin-yang excess-deficiency； for spleen-kidney yang deficiency syndrome， treated with Tianhun Decoction （天魂汤） to supplement liver， kidney and assist yang； for liver-kidney yin deficiency syndrome， treated wtih Dipo Decoction （地魄汤） to supplement lung， kidney， and assist yang. They jointly prompt one qi circulation to provide the thoughts for the treatment of colorectal cancer by traditional Chinese medicine.

Objective:To observe the value of two-dimensional echocardiography(2DE)combined with color Doppler flow imaging(CDFI)in the diagnosis for hypertrophic cardiomyopathy(HCM).Methods:A total of 480 HCM patients who admitted to Northwest Women's and Children's Hospital from January 2019 to January 2021 were selected as case group,and 200 healthy individuals who underwent health physical examination were included into health control group.All receivers underwent 2DE and CDFI examinations,and the 2DE and CDFI detection indicators of two groups were calculated by statistical method and were compared.The diagnostic efficacies of single 2DE,single CDFI and the combination of them were analyzed.Results:The thickness of left ventricular posterior wall(LVPW),interventricular septum thickness(IVST)and left atrial diameter(LAD)of the case group were significantly higher than those of the control group,and the differences were statistically significant(t=5.896,14.861,8.974,P<0.05),respectively.The E peak/A peak(E/A)of anterior flow of mitral valve and early diastolic velocity of mitral valve(Em)of the case group were respectively lower than those of the health control group,while the early diastolic blood flow velocity of mitral valve opening(E)/Em(E/Em)of the case group was higher than that of the health control group,with statistically significant differences(t=6.782,5.189,10.738,P<0.05).The optimal critical points(detection sensitivity)of the receiver operating characteristic(ROC)curves of single 2DE,single CDFI and combination of them in diagnosing HCM were respectively 67.83%,65.38%and 82.38%.The detection specificities of them were respectively 65.48%,64.58%and 80.66%.The area under curve(AUC)values of ROC curves of them were respectively 0.6835,0.6949 and 0.8136,and the accuracies of them were respectively 68.35%,69.49%and 81.36%,and the 95%confidence intervals of them were respectively 0.608-0.803,0.606-0.823 and 0.835-0.943.The sensitivity,specificity and accuracy of the combination of 2DE and CDFI were respectively higher than those of single 2DE and CDFI.Conclusion:Both 2DE and CDFI have a certain value in diagnosing HCM,but their combination can further improve the diagnostic efficacy for HCM.

Objective:To investigate the mechanism of miR-1290 mediated by ultrasound microbubbles on the proliferation, apoptosis and invasion of ovarian cancer cells by regulating the expression of DKK3.Methods:Logarithmic SKOV3 cells were divided into Control group, miR-1290 NC group, microbubble treatment (MB) group, miR-1290 inhibitor group and miR-1290 inhibitor-MB group. The targeting relationship between miR-1290 and DKK3 was verified by double luciferase assay; RT-PCR was used to detect the expression of miR-1290 and DKK3 mRNA in SKOV3 cells; the activity of SKOV3 cells was detected by MTT assay; the apoptosis of SKOV3 cells was detected by flow cytometry; cell scratch test and Transwell test were used to detect the migration and invasion abilities of SKOV3 cells; Western blot was used to detect the expression of protein.Results:The double luciferase experiment showed that miR-1290 had a targeting relationship with DKK3, and miR-1290 could negatively target DKK3; Compared with miR-1290 NC group [24, 48, 72 h: (0.53 ± 0.05), (0.82 ± 0.06), (1.24 ± 0.06) ], MB group [24, 48, 72 h: (0.43 ± 0.06), (0.71 ± 0.03), (1.03 ± 0.03) ], miR-1290 inhibitor group [24, 48, 72 h: (0.41 ± 0.03), (0.66 ± 0.04), (0.78 ± 0.05) ], miR-1290 inhibitor MB group [24, 48, 72 h: (0.33 ± 0.04), (0.54 ± 0.05), (0.67 ± 0.06) ] SKOV3 cell proliferation activity decreased significantly ( P<0.05), compared with the migration rate and invasion number of SKOV3 cells in miR-1290 NC group [ (45.98 ± 4.11) %, (235.14 ± 5.78) ], the migration rate and invasion number of SKOV3 cells in MB group [ (36.77 ± 4.24) %, (189.57 ± 4.58) ], miR-1290 inhibitor group [ (32.14 ± 3.78) %, (165.35 ± 5.01) ], and miR-1290 inhibitor MB group [ (20.40 ± 3.01) %, (86.21 ± 4.23) ] decreased significantly,the expression of DKK3 mRNA and protein, apoptosis rate, apoptosis promoting protein C-Caspase-3 and Bax in SKOV3 cells increased greatly ( P<0.05) ; the above indexes of SKOV3 cells in miR-1209 NC group and Control group had no great difference ( P>0.05) . Conclusion:MiR-1290 can negatively regulate the expression of DKK3, while ultrasound microbubble can down regulate the expression of miR-1290 and up regulate the expression of DKK3, thereby inhibiting the proliferation, migration and invasion of ovarian cancer SKOV3 cells and promoting the apoptosis of cancer cells.

Anti-contactin associated protein-like 2 (CASPR2) antibody encephalitis is a rare autoimmune encephalitis with variable clinical symptoms and atypical imaging manifestations. The prognosis of the patients with severe disease is poor. Reversible posterior leukoencephalopathy syndrome is rarely reported in autoimmune encephalitis. The clinical data, diagnosis and treatment of a patient with anti-CASPR2 antibody encephalitis complicated with reversible posterior encephalopathy syndrome were reported, in order to improve the understanding of clinicians on the rare disease complicated with atypical imaging manifestations.

Objective: To explore the fear of evaluation in college student with social anxiety, in order to reveal the existence of implicit fear of evaluation and its relationships with explicit fear of evaluation. Methods: A total of 490 college students, selected from Fuzhou University by using convenience cluster sampling method, were surveyed with Interaction Anxiousness Scale (IAS). Finally, 65 valid subjects have completed the Implicit Association Test. Results: Social anxiety students explicit fear of evaluation was significantly higher than those of non social anxiety college students, including positive and negative ( t =7.03, 5.66 , P <0.01). There were significant differences between self positive evaluation of college students social anxiety (1 019.26±124.44 ms) and self neutral evaluation (909.78±175.20 ms)( t =5.67, P <0.05). In two groups of college students, there were significant differences between self negative evaluation[(1 142.54±157.06, 1 120.88± 216.33 )ms] and self neutral evaluation[(921.53±161.28, 783.72±140.74)ms]( t =9.17, 12.33, P <0.01). Implicit fear of evaluation were found to exist among students with social anxiety and without social anxiety. There was a low correlation between explicit and implicit fear of evaluation between social anxiety students and non social anxiety students( P >0.05); There was no significant gender difference between implicit and explicit fear of evaluation( P > 0.05 ). Conclusion Social anxiety college students have explicit and implicit fear of evaluation, with separate and independent effects.

Objective: To investigate the efficacy and adverse effects of sustained lung inflation (SLI) combined with pulmonary surfactant (PS) in the treatment of neonatal respiratory distress syndrome (NRDS). Methods: This prospective randomized controlled trial included 124 premature infants (gestational age <34 weeks and birth weight <2 000 g) diagnosed with NRDS and in need of PS treatment in Shenzhen Maternity & Child Healthcare Hospital affiliated to Southern Medical University from July 1, 2016 to October 31, 2018. They were randomly divided into experimental or control group, with 62 cases in each. Infants in the experimental group were treated with SLI using T-piece and intratracheal PS, while those in the control group were given PS only. Blood gas analysis and measurement of fraction of inspiration O₂ (FiO₂) and ratio of partial pressure of oxygen (PO₂) over FiO₂ were performed before and 1 h after PS injection. Results of the treatments and incidence of complications were compared. Paired samples t-test, two independent samples t-test, rank-sum test and Chi-square test were used for statistical analysis. Results: There were 56 participants in the experimental group and 54 in the control group who were eventually analyzed. In the experimental group, the pH value, partial pressure of carbon dioxide (PCO₂), FiO₂ and PO₂/FiO₂ at 1 h after PS injection were all improved compared with those before treatment [pH value: 7.26±0.09 vs 7.19±0.09, t=3.814; PCO₂: (51.5±12.6) vs (59.8±16.3) mmHg (1 mmHg=0.133 kPa), t=2.610; FiO₂: 26.0 (21.0-31.5)% vs 40.5 (38.5-51.5)%, U=392.000; PO₂/FiO₂: (284.6±117.9) vs (173.4±59.7) mmHg, t=6.427; all P<0.05]. The overall decrement of FiO₂ after PS injection in the experimental group was more significant than that in the control group [-10.0 (-15.0 to -5.0)% vs -5.0 (-8.0 to 0.0)%, U=706.500, P<0.001]. The experimental group had a higher rate of extubation within 24 h than the control group [80% (45/56) vs 71% (32/54), χ²=5.830, P=0.016]. However, no significant differences were shown in total mechanical ventilation time, non-invasive/high-flow nasal cannula ventilation time, the ratio of re-intubation within 72 h, or the incidence of air leak, bronchopulmonary dysplasia, periventricular-intraventricular hemorrhage, necrotizing enterocolitis or patent ductus arteriosus between the two groups (all P>0.05). Conclusions SLI combined with PS for NRDS babies can increase the rate of extubation within 24 h and promote the down-regulation of FiO₂ without causing significant complications.