OBJECTIVE To explore the changes of serum Toll-like receptor(TLR)2,TLR4 and 25 hydroxyvitamin D[25(OH)D]in the general anesthesia orthopedic surgery patients with postoperative pulmonary infections and analyze the distribution and drug resistance of pathogens.METHODS A total of 59 general anesthesia orthopedic surgery patients with postoperative pulmonary infections who were treated in Tianjin Fifth Central Hospital from Jul.2019 to Jul.2024 were chosen as the infection group,meanwhile,65 patients who underwent the same surger-y but did not have postoperative pulmonary infection or other acute and chronic infections were chosen as the non-infection group.The etiological characteristics of the postoperative pulmonary infections and the drug re-sistance rates were analyzed.The clinical data and the levels of serum TLR2,TLR4 and 25(OH)D were observed and compared between the two groups of patients.The values of the above indicators in diagnosis of the postopera-tive pulmonary infections in the general anesthesia orthopedic surgery were analyzed.RESULTS Totally 63 strains of pathogens were isolated from the 59 general anesthesia orthopedic surgery patients with postoperative pulmona-ry infections,36(57.14％)of which were gram-negative bacteria.3 of 15 Pseudomonas aeruginosa strains were resistant to meropenem;4 of 12 Klebsiella pneumoniae strians were resistant to meropenem;all of the 11 Staph-ylococcus aureus strains were methicilin-resistant S.aureus.The proportions of patients with age,hypoproteine-mia and diabetes mellitus,the serum TLR2 and TLR4 levels were higher in the infection group than in the non-infection group(P＜0.05),while the 25(OH)D level of the infection group was lower than that of the no in-fection group(P＜0.05).The area under the curves(AUCs)of serum TLR2,TLR4,25(OH)D and the joint de-tection of the above indicators were respectively 0.817,0.801,0.787 and 0.917 in diagnosis of postoperative pul-monary infections in the general anesthesia orthopedic surgery patients,and the AUC of the joint detection of the indicators was greater than that of the single detection(P＜0.05).CONCLUSIONS The general anesthesia or-thopedic surgery patients with postoperative pulmonary infections show high expressions of serum TLR2 and TLR4 and the low expression of 25(OH)D.The joint detection of the above indexes has higher diagnostic value.The gram-negative bacteria are dominant among the pathogens causing the infections.The pathogens vary in the drug resistance.

OBJECTIVE To explore the changes of serum Toll-like receptor(TLR)2,TLR4 and 25 hydroxyvitamin D[25(OH)D]in the general anesthesia orthopedic surgery patients with postoperative pulmonary infections and analyze the distribution and drug resistance of pathogens.METHODS A total of 59 general anesthesia orthopedic surgery patients with postoperative pulmonary infections who were treated in Tianjin Fifth Central Hospital from Jul.2019 to Jul.2024 were chosen as the infection group,meanwhile,65 patients who underwent the same surger-y but did not have postoperative pulmonary infection or other acute and chronic infections were chosen as the non-infection group.The etiological characteristics of the postoperative pulmonary infections and the drug re-sistance rates were analyzed.The clinical data and the levels of serum TLR2,TLR4 and 25(OH)D were observed and compared between the two groups of patients.The values of the above indicators in diagnosis of the postopera-tive pulmonary infections in the general anesthesia orthopedic surgery were analyzed.RESULTS Totally 63 strains of pathogens were isolated from the 59 general anesthesia orthopedic surgery patients with postoperative pulmona-ry infections,36(57.14％)of which were gram-negative bacteria.3 of 15 Pseudomonas aeruginosa strains were resistant to meropenem;4 of 12 Klebsiella pneumoniae strians were resistant to meropenem;all of the 11 Staph-ylococcus aureus strains were methicilin-resistant S.aureus.The proportions of patients with age,hypoproteine-mia and diabetes mellitus,the serum TLR2 and TLR4 levels were higher in the infection group than in the non-infection group(P＜0.05),while the 25(OH)D level of the infection group was lower than that of the no in-fection group(P＜0.05).The area under the curves(AUCs)of serum TLR2,TLR4,25(OH)D and the joint de-tection of the above indicators were respectively 0.817,0.801,0.787 and 0.917 in diagnosis of postoperative pul-monary infections in the general anesthesia orthopedic surgery patients,and the AUC of the joint detection of the indicators was greater than that of the single detection(P＜0.05).CONCLUSIONS The general anesthesia or-thopedic surgery patients with postoperative pulmonary infections show high expressions of serum TLR2 and TLR4 and the low expression of 25(OH)D.The joint detection of the above indexes has higher diagnostic value.The gram-negative bacteria are dominant among the pathogens causing the infections.The pathogens vary in the drug resistance.

Objective The study aims to find a suitable obesity index for predicting hyperuricemia (HUA)in Chinese adults. Methods The obesity indexes of 8133 subjects in China Health and Nutrition Survey in 2009 were calculated, and the basic situation of them was analyzed descriptively. χ² test and t test were used to test the differences of categorical variables and continuous variables between the HUA group and the non-HUA group. The area under the curve (AUC) and receiver operating characteristic (ROC) curves were used to analyze the predictive value of these indices for HUA. Binary logistic regression was used to analyze the relationship between obesity and HUA. Results Demographic covariates, prevalence and Body Mass Index (BMI) all have impacts on the prevalence of HUA. Obesity indexes have a good predictive effect on HUA, and the Lipid Accumulation Product (LAP) is the best (AUC=0.77 (95% CI [0.75, 0.78]). Obesity indexes all have a significant correlation with HUA. When covariates were not adjusted, LAP had the highest OR value (OR=5.87, 95% CI [5.08, 6.77]). Conclusion LAP index is significantly related to HUA, and it can be used as an emerging index to assess the prevalence of HUA in Chinese adults.

Objective To explore the association between dietary quality and perceived stress among adult Chinese. Methods The China Health and Nutrition Survey (CHNS) was used to investigate the association between dietary quality and perceived stress in Chinese adults. The Chinese Perceived Stress Scale (CPSS) was used to assess the perceived stress in Chinese adults. Binary logistic regression models were utilized to explore the relationship between diet quality and perceived stress. Restricted cubic splines (RCS) were utilized to clarify the dose response relationship between diet quality and perceived stress. Results Binary logistic regression models revealed that adults with CHEI score ranged from P25 to P50 and higher than P75 had 15.1% (OR=0.849，95%CI：0.738-0.977) and 23.0% (OR=0.770，95%CI：0.666-0.891) reduced risk of high perceived stress after multivariable adjustment when compared with adults with CHEI score less than P25. RCS results showed that the OR value of high perceived stress risk decreased gradually with increasing CHEI score in the overall population, but this association was not statistically significant in adults with lower CHEI score. Conclusion High dietary quality is associated with a reduced risk of high perceived stress. This study provides a theoretical reference for the health effects of high dietary quality on high perceived stress risk reduction.

Objective To investigate the relationship between body mass index (BMI) and homocysteine,pregnancy outcomes in patients with gestational diabetes mellitus.Methods From Jan,2013 to Oct,2015,120 patients with gestational diabetes mellitus were prospectively enrolled in this study.According to BMI level,all patients were divided into obese group (BMI≥25 kg/m2) and the control group (BMI ＜ 25kg/m2).The main outcome measures included homocysteine and pregnancy outcomes of the both groups.Results When compared with the control group,patients in the obese group got a significantly higher level of homocysteine (11.09 ± 1.91 vs 8.92 ± 1.57μmol/L,P =0.000);and BMI was positively associated with homocysteine (r =0.410,P =0.000).When compared with the control group,patients in the obesity group got a significantly higher rate of cesarean section (30.00％ vs 15 ％,P =0.049);a higher rate of macrosomia (20.00％ vs 5.00％,P =0.027);and a higher level of neonatal weight (3672.15 ± 475.45 vs 3220.93 ± 461.36g,P =0.000).There was no significantly difference between the two groups in weeks of gestation,postpartum hemorrhage,cephalopelvic said,abnormal fetal position,uterine atony,premature rupture of fetal membranes and neonatal asphyxia rate (P ＞ 0.05).Conclusion BMI in patients with gestational diabetes mellitus is positively correlated with homocysteine,cesarean section,macrosomia and neonatal weight.

Objective To investigate the effects of Chaishao Chengqi Decotion on intestinal microbiota and intestinal mucosal lesion in severe acute pancreatitis(SAP).Methods 46 Patients with SAP were randomized into two groups.Routine medical management was initiated in two groups.The treatment group received Chaishao Chengqi Decotion for 1 week.The plasma concentrations ofDiamine Oxidase (DAO),D-lactate were detected and changes of microflora were evaluated by bacterial culture.Results The levels of DAO in the treatment group (4.65 ±0.82)U/ml were significantly lower than those in the control group (5.66 ±2.17) U/ml (P ＜ 0.05) 7 days after treatment.The levels of D-lactate in the treatment group (10.65 ± 5.24)mg/L were significantly higher than those in the control group (5.42±2.13)mg/L (P＜0.05).Bacterial culture revealed that the amount of bifidobaterium (6.02± 1.42)In/g and lactobacilli (7.21 ± 2.02) In/g were significantly increased when compared to those before treatment (3.74± 1.71)In/g and (4.03 ± 1.79)In/g respectively,while there was imbalance of intestinal microflora to some extent in the control group.Conelusien Chaishao Chengqi Decotion exerted the protective effects on gut barrier function by alleviating the damage of intestinal mucosa and balancing the intestinal microbiota following severe acute pancreatitis.