Objective: To evaluate the effect of bioactive peptides combined with probiotics on serum uric acid (SUA) in patients with hyperuricemia (HUA), so as to provide the evidence for prevention and treatment of HUA. Methods: The patients with HUA aged 18 to 65 years were selected and randomly divided into an intervention group and a control group. The patients in the intervention group received bioactive peptides combined with probiotics for 28 days at a dose of 3 g/d, while the patients in the control group received an equal dose of placebos. Demographic information, body mass index (BMI), blood pressure and blood lipid were collected through questionnaire surveys, physical examination and laboratory tests. SUA levels were detected before and after 14 days and 28 days of interventions. The differences of SUA levels between the two groups were compared using generalized estimation equation. Results: Totally 108 patients with HUA were recruited, including 54 patients in the intervention group and 53 patients in the control group (1 dropout). Before interventions, there were no statistically significant differences in gender, age, course of HUA, exercise duration, frequency of alcohol consumption, frequency of meat broth consumption, BMI, prevalence of hypertension and prevalence of dyslipidemia between the two groups (all P>0.05). After 14 days of interventions, the SUA levels of the patients in the intervention group decreased by 3.00 μmol/L, while those in the control group increased by 7.00 μmol/L. After 28 days of interventions, the SUA levels of the patients in the intervention group and the control group decreased by 26.00 μmol/L and 16.00 μmol/L, respectively. However, there was no statistically significant interaction between the intervention time and group (both P>0.05). Subgroup analysis showed that after 28 days of interventions, the decrease in SUA levels in the patients aged 55 years and older and without hypertension in the intervention group was greater than those in the control group (both P<0.05). Conclusions Bioactive peptides combined with probiotics showed no significant difference in reducing SUA levels in patients with HUA compared to the control group. The effect was more significant for patients aged 55 years and older and without hypertension.

Abstract Childhood hypertension is becoming a substantial public health challenge with profound implications for children s quality of life and long term health. The study analyzes the global prevalence of childhood hypertension and the relationship between macroecological factors, meso environmental factors, and micro individual factors based on the perspective of life course and childhood hypertension. And it further summarizes existing prevention and control strategies: systematic prevention and control based on policy and social support, health promotion based on behavioral science theory, and dynamic monitoring and management based on individualized prevention and control, to provide a reference for promoting the advancement of childhood hypertension prevention and control strategies.

Objective:To evaluate the effect of applying high-fidelity simulation model in the teaching of lower urinary tract injury.Methods:A total of 50 junior medical students majoring in clinical medicine were enrolled. They were randomly assigned to the control group or the experimental group. The students in the control group were taught using the traditional method involving PPT presentation and videos on lower urinary tract anatomy, surgical basis of lower urinary tract injury, and operative methods for lower urinary tract injury. The students in the experimental group were taught using the simulation model for observation and related operation. After four class hours (40 minutes/class hour) of teaching, the students in the two groups were subjected to theoretical assessment and questionnaire survey. The differences between the two groups were compared and analyzed using the t and χ 2 tests in SPSS 26.0. Results:The total scores of theoretical assessment were (36.80±4.00) and (33.12±3.62) in the experimental group and the control group, respectively, and the difference was significant ( P<0.05). The results of the questionnaire showed that the self-evaluation of the experimental group was better than that of the control group in the mastery of theoretical knowledge, clinical operation, early treatment, operation process, and key steps, and the differences were statistically significant ( P<0.05). Conclusions:Compared with the traditional teaching method, the high-fidelity simulation model improves the efficiency of learning anatomy knowledge and operation process, and promotes the mastery of important and difficult knowledge in lower urinary tract injury. This method merits popularization.

Objective:To investigate the computed tomography (CT) examination anato-mical features and clinical significance of paraesophageal vein (PEV) in portal hypertension.Methods:The retrospective and descriptive study was conducted. The clinical data of 173 patients with portal hypertension who were admitted to the People's Hospital of Ningxia Hui Autonomous Region from January 2018 to June 2021 were collected. There were 124 males and 49 females, aged from 22 to 71 years, with a median age of 47 years. Observation indicators: (1) preoperative CT examinations; (2) surgical situations; (3) follow-up. Follow-up was conducted using outpatient examination to detect surgical effects once every 3 months within postoperative 6 months and once every 6 months after postoperative 6 months. The follow-up was up to June 2021. Measurement data with skewed distribution were represented as M(range) and count data were described as absolute numbers. Results:(1) Preoperative CT examinations. The CT detection rate of PEV in the 173 portal hyper-tension patients was 52.60%(91/173). Of 173 patients, 82 cases were negative with PEV and 91 cases were positive with PEV. Of the 91 patients who were positive with PEV, there were 46 cases with paraesophageal varices, 24 cases with thick PEV, 21 cases with thin PEV, 8 cases without esophageal varices and 83 cases accompanied with esophageal varices. Of the 83 patients who were accom-panied with esophageal varices, there were 44 cases with PEV converged alone with azygos vein or semiazygos vein, 39 cases with paraesophageal varices formed above the diaphragm confluent with esophageal varices into azygos vein. (2) Surgical situations. All the 173 patients underwent surgery successfully, including 8 cases undergoing splenectomy, 86 cases undergoing splenectomy combined with modified complete devascularization, 35 cases undergoing splenectomy combined with spontaneous gastrorenal shunt reconstructing devascularization, 41 cases undergoing splenectomy combined with PEV preserving devascularization and 3 cases undergoing splenectomy combined with PEV ring constriction. None of 173 patients had surgical relative death, 67 cases had complica-tions, including 3 cases undergoing splenectomy, 29 cases undergoing splenectomy combined with modified complete devascularization, 11 cases undergoing splenectomy combined with spontaneous gastrorenal shunt reconstructing devascularization, 23 cases undergoing splenectomy combined with PEV preserving devascularization and 1 case undergoing splenectomy combined with PEV ring constriction underwent complications. (3) Follow-up. Of the 173 patients, 159 cases were followed up for 6 to 42 months, with a median follow-up time of 28 months. In the 7 cases undergoing splenectomy who were followed up, there were 6 cases without esophageal varices and 1 case with recurrence of esophageal varices. In the 79 cases undergoing splenectomy combined with modified complete devascularization who were followed up, there were 5 cases without esophageal varices, 67 cases with mild to moderate residual of esophageal varices, 5 cases with severe residual of esophageal varices, 1 case with recurrence of esophageal varices and 1 case with recurrence of esophageal varices hemorrhage. In the 34 cases undergoing splenectomy combined with sponta-neous gastrorenal shunt reconstructing devascularization who were followed up, there were 7 cases without esophageal varices and 27 cases with mild to moderate residual of esophageal varices. In the 36 cases undergoing splenectomy combined with PEV preserving devascularization who were followed up, there were 4 cases without esophageal varices, 21 cases with mild to moderate residual of esophageal varices, 5 cases with severe residual of esophageal varices, 4 cases with recurrence of esophageal varices and 2 cases with recurrence of esophageal varices hemorrhage. In the 3 cases undergoing splenectomy combined with PEV ring constriction who were followed up, there were 2 cases with mild to moderate residual of esophageal varices, 1 case with severe residual of esophageal varices.Conclusions:The CT detection rate of PEV in portal hypertension patients is >50% and the internal diameter and distribution of blood vessels are different in patients. CT examination anatomical features of PEV can be used to guide the formula-tion of surgical methods.

Objective:To explore the changes of peripheral blood Th17/Treg and serum cytokines in AECOPD patients with secondary pulmonary fungal infection.Methods:Selected the clinical data of 27 AECOPD patients who were admitted between January 2018 to March 2020 in the Department of Respiratory Medicine, Hai'an People's Hospital Affiliated to Nantong University with fungal infection (fungal infection group), and 58 AECOPD patients without fungal infection (non-fungal infection group) who received treatment in the hospital during the same period. Compared the general clinical data, peripheral blood Th17 and Treg cell levels, Th17/Treg ratio, interleukin-17 (IL-17), interleukin-23 (IL-23), interferon-γ (interferon-γ, IFN-γ), and transforming growth factor-β (TGF-β) levels. Meanwhile, compared the levels of Th17 and Treg cells in peripheral blood, the ratio of Th17/Treg and serum cytokines in patients with different infection severity in fungal infection group. The measurement data with normal distribution were compared by independent samplet t-test between the two groups, one-way ANOVA between multiple groups, LSD-t test for pairwise comparision, and χ 2 test for counting data. Results:In the 27 AECOPD patients with fungal infection group, the pathogen distribution was 65.52% (19/27) of candida albicans, 10.34% (3/27) of candida tropicalis,10.34% (3/27) of candida albicans, and 6.90% (2/27) of Aspergillus. The level of Th17 [(16.18±3.15) % and (12.34±2.64) %, t=5.87, P<0.001)], the ratio of Th17/Treg [(4.70±0.85) and (2.41±0.51), t=22.87, P<0.001] in Patients with fungal infection group were higher than those in the non-fungal group. The level of Treg [(3.42±0.42) % and (5.13±0.51) %, t=20.77, P<0.001] in Patients with fungal infection group was lower than those in the non-fungal group. The levels of IL-17 [(85.67±21.51) μg/L and (53.64±14.36) μg/L, t= 8.12, P<0.001], and IL-23 [(61.38±16.58) μg/L and (38.29±12.60) μg/L, t=7.10, P<0.001] in Patients with fungal infection group were higher than those in non-fungal infection group, but the levels of IFN-γ ((47.75±17.72) μg/L and (62.37±19.06) μg/L, t=3.37, P=0.001) and TGF-β ((110.34±26.03) μg/L and (131.40±35.03) μg/L, t=2.87, P=0.007) were lower than those in non-fungal infection group, and the differences were statistically significant. There were statistically significant differences in the ratio of Th17/Treg, and the levels of Th17, Treg cells and cytokine among patients with different infection severity in the fungal infection group. With the increase of infection severity, the levels of Th17 ((13.06±1.98)%, (15.94±2.11)%, (17.75±2.20)%, F=10.19, P<0.001), the ratios of Th17/Treg ((5.01±0.60), (5.66±0.69), (6.52±0.65), F=10.77, P<0.001), the levels of IL-17 ((63.39±11.64) μg/L,(78.66±12.82) μg/L, F=9.01, P=0.001), and IL-23 ((42.52±13.11) μg/L, (59.97±15.25) μg/L, (69.75±14.30) μg/L, F=7.41, P=0.003) were increase, the levels of Treg ((4.33±0.39)%, (3.32±0.42)%, (2.50±0.35)%, F=44.42, P<0.001), IFN-γ ((57.78±10.52) μg/L, (48.82±10.39) μg/L, (38.90±10.56) μg/L, F=6.50, P=0.006), TGF-β ((126.62±18.94) μg/L, (115.34±13.66) μg/L, (102.52±17.73) μg/L, F=4.25, P=0.026) were significantly decreased. Conclusion:The imbalance of Th17/Treg ratio and related serum cytokines play an important role in the process of lung fungal infection in AECOPD patients, and their imbalance is related to the severity of fungal infection. Therefore, the levels of Th17/Treg and serum cytokines should be closely monitored in AECOPD patients.

Objective:Comparing the diagnostic performance of pulmonary infection pathogens between metagenomic next-generation sequencing (mNGS) testing and traditional assay in patients with AIDS to provide references for the diagnosis and treatment of the disease.Methods:From July 2019 to January 2021, the regular clinical assays as well as mNGS testing were performed for patients and those discharged with a diagnosis of AIDS and pulmonary infection were retrospectively reviewed in the department of infectious diseases of Beijing You An Hospital. The cases with discharge diagnosis of AIDS for whom mNGS testing was performed on samples from respiratory system were analyzed. Diagnostic performance of pathogens was compared between mNGS testing and traditional etiologyic diagnostic method. Diagnosis concordance analysis and diagnostic comparison study between mNGS and traditional etiology diagnosis method in terms of pathogens were also performed.Results:Fifty-five cases discharged with AIDS and pulmonary infection were enrolled.. For 29 cases for whom mNGS testing was performed on samples from respiratory system, the sensitivity of mNGS for diagnosing infection was higher than that of traditional etiology diagnosis method (89.7% vs. 37.9%, P<0.001) but with poor consistency (Kappa=0.249, P=0.170). A superior positivity rate in mNGS than that in traditional etiology diagnosis method for diagnosing bacterial (90.9% vs. 9.1%, P<0.001) Pneumocystis jirovecii (mNGS only), and nontuberculous mycobacteria (mNGS only). Conclusions:mNGS could yield a higher sensitivity for pulmonary pathogen identification in AIDS patients, especially for bacterial, Pneumocystis jirovecii and nontuberculous mycobacteria compared to traditional etiologic diagnostic method.

Objective:To investigate plasma levels of fibrinopeptide A(FPA)and platelet alpha-granule membrane glycoprotein 140(GMP-140), and to analyze the changes of coagulation activity in elderly patients with primary microvascular angina(PMVA).Methods:In this prospective case-control study, a total of 45 elderly patients(aged 60-80 years, 27 males and 18 females)admitted to our hospital from Jan.2019 to Dec.2020 were diagnosed as PMVA(as microvascular angina group)by clinical symptoms, electrocardiogram, dynamic electrocardiogram and coronary angiography.Forty-three age-and sex-matched elderly subjects who took a medical check-up and had no primary microvascular angina were included as the control group.Plasma levels of FPA, GMP-140 and high-sensitivity C-reactive protein were determined.The levels of systolic blood pressure, diastolic blood pressure, platelet, fasting blood glucose, triglyceride, total cholesterol, high-density lipoprotein and low-density lipoprotein, uric acid, renal function and liver function were detected.Results:The FPA level was higher in the PMVA group than in the control group[(430.32±364.05)μg/L vs.(263.73± 118.29)μg/L, t=2.913, P<0.01]. There was no difference in GMP-140 level between the PMVA group and the control group[(5.78±3.92)μg/L vs.(6.95±1.91)μg/L, t=-1.790, P>0.05]. The high-sensitivity C-reactive protein level was higher in the PMVA group than in the control group[(3.33±5.70)mg/L vs.(0.81±0.86)mg/L, t=2.927, P<0.01]. Conclusions:Compared with the control group, the FPA level is significantly increased with elevated coagulation activity in patients with primary microvascular angina.The increased inflammatory state in the PMVA group might promote the occurrence and development of microvascular angina, but whether the inflammatory state promotes the enhancement of coagulation activity needs further study to confirm.

A series of 2-(((5-akly/aryl-1-pyrazol-3-yl)methyl)thio)-5-alkyl-6-(cyclohexylmethyl)-pyrimidin-4(3)-ones were synthesized and their anti-HIV-1 activities were evaluated. Most of these compounds were highly active against wild-type (WT) HIV-1 strain (IIIB) with EC values in the range of 0.0038-0.4759 μmol/L. Among those compounds, had an EC value of 3.8 nmol/L and SI (selectivity index) of up to 25,468 indicating excellent activity against WT HIV-1. anti-HIV-1 activity and resistance profile studies suggested that compounds and displayed potential anti-HIV-1 activity against laboratory adapted strains and primary isolated strains including different subtypes and tropism strains (ECs range from 4.3 to 63.6 nmol/L and 18.9-219.3 nmol/L, respectively). On the other hand, it was observed that those two compounds were less effective with EC values of 2.77 and 4.87 μmol/L for HIV-1A (K103N + Y181C). The activity against reverse transcriptase (RT) was also evaluated for those compounds. Both and obtained sub-micromolar IC values showing their potential in RT inhibition. The pharmacokinetics examination in rats indicated that compound has acceptable pharmacokinetic properties and bioavailability. Preliminary structure-activity relationships and molecular modeling studies were also discussed.

Objective:To investigate the CT features and dynamic changes of new developed lung cancer in patients with connective tissue disease-related interstitial lung disease (CTD-ILD).Methods:A series of chest CT images of 58 CTD-ILD patients during follow-up were collected. The CT features of interstitial lung disease, the initial appearance time of lung cancer, the time of diagnosis of lung cancer, the morphological characteristics (location, shape, size) of lung cancer lesions and the dynamic changes of CT features were analyzed.Results:Among 58 patients, rheumatoid arthritis was the most common (31 cases). Chest CT images showed coexistence of two or more interstitial CT signs. During the follow-up, a total of 59 lung cancer lesions were found. The median time of lung cancer lesion occurred was 289 days. The median delay in diagnosis was 43 days. There were 44 cases of non-small cell lung cancer (including 23 cases of squamous cell carcinoma and 19 cases of adenocarcinoma), 12 cases of small cell lung cancer. Forty-three (72.9%) lesions were located in the lower lobes and 41 (69.5%) lesions were located in the area of pulmonary interstitial fibrosis. According to CT morphological characteristics of lung cancer, nodular type (37 cases), inflammatory consolidation (12 cases) and intra-honeycomb type (10 cases) were identified.Conclusions:The chest CT features of patients with CTD-ILD are complex. New developed lung cancer is easily missed or misdiagnosed in the early stage. Pay attention to the special CT characteristics of CTD-ILD with lung cancer is helpful for early diagnosis.

Objective:To investigate the CT features and dynamic changes of new developed lung cancer in patients with connective tissue disease-related interstitial lung disease (CTD-ILD).Methods:A series of chest CT images of 58 CTD-ILD patients during follow-up were collected. The CT features of interstitial lung disease, the initial appearance time of lung cancer, the time of diagnosis of lung cancer, the morphological characteristics (location, shape, size) of lung cancer lesions and the dynamic changes of CT features were analyzed.Results:Among 58 patients, rheumatoid arthritis was the most common (31 cases). Chest CT images showed coexistence of two or more interstitial CT signs. During the follow-up, a total of 59 lung cancer lesions were found. The median time of lung cancer lesion occurred was 289 days. The median delay in diagnosis was 43 days. There were 44 cases of non-small cell lung cancer (including 23 cases of squamous cell carcinoma and 19 cases of adenocarcinoma), 12 cases of small cell lung cancer. Forty-three (72.9%) lesions were located in the lower lobes and 41 (69.5%) lesions were located in the area of pulmonary interstitial fibrosis. According to CT morphological characteristics of lung cancer, nodular type (37 cases), inflammatory consolidation (12 cases) and intra-honeycomb type (10 cases) were identified.Conclusions:The chest CT features of patients with CTD-ILD are complex. New developed lung cancer is easily missed or misdiagnosed in the early stage. Pay attention to the special CT characteristics of CTD-ILD with lung cancer is helpful for early diagnosis.