Objective:Adverse cardiovascular events are the leading cause of death in peritoneal dialysis patients.Identifying indicators that can predict adverse cardiovascular events in these patients is crucial for prognosis.This study aims to assess the value of dual-specificity phosphatase 6(DUSP6)in peripheral blood mononuclear cells as a predictor of adverse cardiovascular events after peritoneal dialysis in diabetic nephropathy patients. Methods:A total of 124 diabetic nephropathy patients underwent peritoneal dialysis treatment at the Department of Nephrology of the First Affiliated Hospital of Hebei North University from June to September 2022 were selected as study subjects.The levels of DUSP6 in peripheral blood mononuclear cells were determined using Western blotting.Patients were categorized into high-level and low-level DUSP6 groups based on the median DUSP6 level.Differences in body mass index,serum albumin,high-sensitivity C-reactive protein,and dialysis duration were compared between the 2 groups.Pearson,Spearman,and multiple linear regression analyses were performed to examine factors related to DUSP6.Patients were followed up to monitor the occurrence of adverse cardiovascular events,and risk factors for adverse cardiovascular events after peritoneal dialysis were analyzed using Kaplan-Meier and Cox regression. Results:By the end of the follow-up,33(26.61%)patients had experienced at least one adverse cardiovascular event.The high-level DUSP6 group had higher body mass index,longer dialysis duration,and higher high-sensitivity C-reactive protein,but lower serum albumin levels compared to the low-level DUSP6 group(all P<0.05).DUSP6 was negatively correlated with serum albumin levels(r=-0.271,P=0.002)and positively correlated with dialysis duration(rs=0.406,P<0.001)and high-sensitivity C-reactive protein(rs=0.367,P<0.001).Multiple linear regression analysis revealed that dialysis duration and high-sensitivity C-reactive protein were independently correlated with DUSP6 levels(both P<0.05).The cumulative incidence of adverse cardiovascular events was higher in the high-level DUSP6 group than in the low-level DUSP6 group(46.67%vs 7.81%,P<0.001).Cox regression analysis indicated that low serum albumin levels(HR=0.836,95%CI 0.778 to 0.899),high high-sensitivity C-reactive protein(HR=1.409,95%CI 1.208 to 1.644),and high DUSP6(HR=6.631,95%CI 2.352 to 18.693)were independent risk factors for adverse cardiovascular events in peritoneal dialysis patients. Conclusion:Dialysis duration and high-sensitivity C-reactive protein are independently associated with DUSP6 levels in peripheral blood mononuclear cells of diabetic nephropathy patients undergoing peritoneal dialysis.High DUSP6 levels indicate a higher risk of adverse cardiovascular events.

Objective:To investigate the clinical efficacy of adjuvant therapy with Yinhuang Qingfei Capsule in the treatment of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) caused by accumulation of phlegm and heat in the lung. Methods:A total of 300 patients with AECOPD admitted to Wenling Hospital of Traditional Chinese Medicine from January 2019 to December 2020 were included in this study. They were randomly divided into observation and control groups ( n = 150/group). The control group was treated with conventional therapy, and the observation group was treated with adjuvant therapy with Yinhuang Qingfei Capsule based on conventional therapy. All patients were treated for 14 consecutive days. The clinical efficacy, lung function indexes and serum inflammatory factors pre- and post-treatment as well as adverse reactions were compared between the two groups. Results:Total response rate was significantly higher in the observation group than the control group [88.0% (132/150) vs. 75.3% (113/150), χ2 = 8.04, P < 0.05]. After treatment, cough score [(2.31 ± 0.49) points], sputum score [(1.93 ± 0.35) points] and wheezing score [(0.91 ± 0.22) points] in the observation group were lower compared with the control group [(2.89 ± 0.54) points, (2.22 ± 0.43) points, (1.36 ± 0.27) points, t = 9.30, 6.41, 15.82, all P < 0.001]. Serum interleukin-6 (IL-6) [(3.04 ± 1.25) μg/L], C-reactive protein [(26.44 ± 2.31) mg/L] and procalcitonin [(1.25 ± 0.97) μg/L] in the observation group were lower compared with the control group [(3.66 ± 1.32) μg/L, (31.39 ± 2.26) mg/L, (1.79 ± 1.06) μg/L, t = 4.18, 11.18, 4.60, all P < 0.001]. Forced vital capacity [(1.89 ± 0.54) L], forced expiratory volume in 1 second (FEV 1) [(64.22 ± 5.80)%] and FEV 1/FVC value [(59.16 ± 5.52)%] in the observation group were higher compared with the control group [(1.58 ± 0.57) L, (60.13 ± 5.77)%pred, (54.43 ± 5.37)%, t = 4.84, 6.12, 7.52, all P < 0.05]. There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Yinhuang Qingfei Capsule can effectively relieve the clinical symptoms of patients with AECOPD caused by accumulation of phlegm and heat in the lung, improves lung function, reduces inflammatory response, and has no obvious adverse reactions. This study is innovative and scientific and deserves clinical promotion.

Objective:To observe the changes of serum micro-inflammatory and nutritional status in elderly peritoneal dialysis patients after treatment with bifidobacterium triple viable bacteria, and the impact of Bifidobacterium triple viable bacteria treatment on the endpoint.Methods:Totally 180 elderly patients receiving peritoneal dialysis were divided into control group and observation group, with 90 cases in each.Both groups were treated on the basis of the routine treatment, the observation group was treated with oral Bifidobacterium triple viable bacteria for twelve months.Before treatment, 6 months and 12 months after treatment, fasting venous blood from the patients in the two groups were collected in the morning.The levels of serum micro-inflammatory indexes[tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), interleukin-8(IL-8), C-reactive protein(CRP)]were detected by ELISA.The nutritional status and dialysis adequacy indexes[nutritional status: albumin(ALB), hemoglobin(Hb), transferrin(TRF), prealbumin(PA), calcium ion, phosphorus ion; indicators of dialysis adequacy: serum creatinine(Scr), blood uric acid(BUA), blood urea nitrogen(BUN), cystatin C(Cys-c)levels]were detected by automatic blood biochemical analyzer.After 24 months of follow-up, the occurrence of endpoint events(peritonitis, abdominal pain, malnutrition, abdominal infection, cardiovascular and cerebrovascular accidents)in the two groups was recorded.Results:After 24 months of treatment, the levels of TNF-α, IL-6, IL-8 and CRP in the two groups were lower than those before treatment, and the observation group was lower than control group[(25.7±4.0)μg/L vs.(33.6±6.0)μg/L, (2.9±0.7)ng/L vs.(4.9±1.2)ng/L, (17.0±7.2)ng/L vs.(22.8±7.9)ng/L, (4.6±0.7)mg/L vs.(6.9±1.2)mg/L]( t=10.272, 13.134, 5.040, 15.575, respectively, P<0.05 for all). After 24 months of treatment, the levels of ALB, Hb, TRF, PA and calcium ion of the two groups were higher than before treatment, and the levels of phosphorus ion were lower than before treatment, and the changes of the above indicators in observation group were more obvious than those in the control group[(45.7±5.2)g/L vs.(39.8±4.9)g/L, (72.7±8.0)g/L vs.(68.6±9.0)g/L, (4.3±1.0)g/L vs.(3.0±0.6)g/L, (321.5±29.0)mg/L vs.(297.6±25.1)mg/L, (4.9±1.3)mmol/L vs.(2.9±0.9)mmol/L, (1.3±0.9)/L vs.(1.8±0.3 mmol/L)]( t=7.737, 3.213, 9.880, 5.9 00, 11.937, 4.415, P<0.05 for all). There was no significant difference in intestinal flora between the two groups before treatment( P>0.05). After 24 months, an increase was observed in Lactobacilli and Bifidobacteria in both groups, while Enterobacteria and Enterococcus in both groups were decreased, and the changes of the above indicators in the observation group were also more obvious than those in the control group[(8.4±0.9)IgCFU/g ratio(6.4±0.9)IgCFU/g, (8.8±1.3)IgCFU/g ratio(7.9±1.3)IgCFU/g, (7.1±0.9)IgCFU/g ratio(8.0±1.1)IgCFU/g, (5.4±0.7)IgCFU/g ratio(6.9±0.9)IgCFU/g]( t=14.248, 4.339, 5.825, 12.753, P<0.05 for all). There was no significant difference in dialysis adequacy index between the two groups before treatment( P>0.05 for all). After 24 months of treatment, the levels of Scr, BUA, BUN and Cys-C in both groups decreased, and those of the observation group were lower than those of the control group[(471.5±50.5)μmol/L vs.(623.3±62.6)μmol/L, (17.5±0.5)mmol/L vs.(20.6±1.8)mmol/L, (16.4 ± 3.0)mmol/L vs.(22.5±2.0)mmol/L, (1.9±0.5)mg/L vs.(3.0±0.7)mg/L]( t=17.877, 14.976, 15.842, 11.749, P<0.05 for all). The incidence of endpoint events in the observation group was significantly lower than that in the control group(12.2% vs.2.2%, t=6.574, P<0.05 for all). Conclusions:After the treatment of Bifidobacterium triple viable bacteria in elderly peritoneal dialysis patients, the micro-inflammatory state of the patients was reduced, the nutritional status was improved, and the incidence of endpoint events was low, and has high clinical promotion and application value.

Enterotoxigenic Escherichia coli（ETEC）infection can induce watery diarrhea，leading to dehydration，electrolyte disturbance，and even death in severe cases. Recombinant B subunit/inactivated whole-cell cholera（rBS/WC）vaccine is effective in preventing ETEC infectious diarrhea. On the basis of the latest evidence on etiology and epidemiology of ETEC，as well as the effectiveness，safety，and health economics of rBS/WC vaccine，National Clinical Research Center for Child Health（The Children’s Hospital，Zhejiang University School of Medicine）and Zhejiang Provincial Center for Disease Control and Prevention invited experts to develop expert consensus on rBS/WC vaccine in prevention of ETEC infectious diarrhea. It aims to provide the clinicians and vaccination professionals with guidelines on using rBS/WC vaccine to reduce the incidence of ETEC infectious diarrhea.

Objective: To investigate the willingness to receive a COVID-19 vaccination and its influencing factors among individuals that missed the second dose of the inactivated COVID-19 vaccine in Zhejiang Province, so as to provide the evidence for improving the strategy for COVID-19 vaccination. Methods: Individuals that did not receive the second dose of the inactivated COVID-19 vaccine after 56 days of getting the first dose (missed individuals) from March and May, 2021, were randomly sampled from Zhejiang Provincial SaaS Vaccination Information System. Their basic information, status of getting the inactivated COVID-19 vaccine and willingness to receive the second dose of the inactivated COVID-19 vaccine were collected through telephone interviews. The factors affecting the willingness to receive the second dose of the inactivated COVID-19 vaccine were identified among the missed individuals using a multivariable logistic regression model. Results: Totally 562 individuals were investigated, and there were 292 (51.96%) valid respondents. There were 54 actual missed individuals, with a mean age of (40.91±16.75) years, which included 39 men (72.22%) and 15 women (27.78%). Of all missed individuals, 23 had an educational level of junior high school and below (42.59%). The mean duration from the time of investigation to the time of getting the first dose of the inactivated COVID-19 vaccine was (137±28) days. A half of the missed individuals were willing to receive the second dose of the inactivated COVID-19 vaccine. Multivariable logistic regression analysis showed high willingness to receive the second dose of the inactivated COVID-19 vaccine among the missed individuals with requirements of vaccination in the workplace (OR=5.393, 95%CI: 1.112-26.152) and low willingness among the missed individuals that felt physical discomfort after receiving the first dose (OR=0.168, 95%CI: 0.035-0.806). Conclusions The willingness to receive the second dose of the inactivated COVID-19 vaccine was low among the missed individuals, and high willingness is seen among the missed individuals with requirements of vaccination in the workplace and without physical discomfort after receiving the first dose of the inactivated COVID-19 vaccine.

Objective To study the effect of Bairui granule and Deacetylated Ligustrazin injection on plasma BNP and FABP levels in children with heart failure and pneumonia.Methods 60 children of heart failure and pneumonia who received therapy from July 2014 to June 2016 in our hospital were randomly divided into two groups, the observation group and the control group, 30 cases in each group.children in the observation group were treated with sodium phosphate creatine, and the control group was treated with 2-linolenic acid,the clinical outcomes, clinical signs, BNF, FABP, LVEF and LVEDP were compared between the two groups.Results After treatment, the total effective rate of the observation group was significantly higher than that of the control group, the difference was statistically significant (P<0.05); The heart rate, respiratory rate and blood oxygen saturation of the two groups were significantly improved compared with those before treatment ( P<0.05 ) , the heart rate and respiratory rate of the observation group were lower than those of the control group, the oxygen saturation was higher than that of the control group (P<0.05).After treatment, the BNF and FABP indexes of the two groups were lower (P<0.05), and the BNF and FABP indexes in the observation group were lower than those in the control group (P<0.05); The LVEF of the observation group was higher than that of the control group, the LVEDP index was lower than that of the control group, the difference was statistically significant (P<0.05).Conclusion Bairui granule and Deacetylated Ligustrazin injection in the treatment of heart failure with pneumonia has a good effect in the process, which will help reduce the BNP index in children, recovery of children's body function.

OBJECTIVETo investigate the temporal changes of serum interleukin-37 (IL-37) concentration following acute ST-segment elevation myocardial infarction (ASTEMI) and the relationship between IL-37 and C-reactive protein (CRP) in patients with ASTEMI.

METHODSThis analysis was conducted in a cohort of 20 patients with an established diagnosis of ASTEMI and 26 patients admitted for chest pain but with normal findings in coronary angiography (control) between June 2012 and December 2013. Venous blood was collected at days 1, 3, 5, and 7 after myocardial infarction for measurement of serum IL-37 and CRP levels using enzyme-linked immunosorbent assay (ELISA).

RESULTSCompared with the control group, the patients in ASTEMI group showed a significant acute elevation of IL-37 level on day 1 following myocardial infarction; IL-37 level reached the peak on day 3 and began to decrease on day 5, followed by a significant decrease on day 7. The time course of post-infarction CRP changes was consistent with that of IL-37 variations and showed a positive correlation the latter (r=0.63, P<0.05).

CONCLUSIONIL-37 may participate in the inflammatory responses in ASTEMI.

Objective To evaluate the usefulness of free angle M-mode echocardiography (FAM) in obtaining tricuspid annular plane systolic excursion (TAPSE) for assessing the fetal right ventricular function,and to compare the results of measurements of TAPSE by conventional M-mode(CM) and FAM.Methods Two hundred and forty-three normal fetuses in second and late trimester were divided into 5 groups by gestational age(GA):20-24 weeks,24+1-28 weeks,28+1-32 weeks,32+1-36 weeks,36+1-40 weeks.The TAPSE were measured by CM and FAM echocardiography,meanwhile multiple parameters for evaluating right ventricular function were obtained by using myocardial tissue Doppler imaging (TDI),and the correlation between TAPSE and other parameters were analyzed by linear correlation.ANOVA was used to compare CM-TAPSE,FAM-TAPSE,Em,Sm and right ventricular fractional shortening(RVFS)with different GA.Regression equation estimate was used to compare the relationship of FAM-TAPSE with GA.Independent sample t test was used to compare CM TAPSE with FAM TAPSE.Results There were significant differences in CM-TAPSE,FAM-TAPSE,Em,and Sm among 5 groups (P =0.000),the measured value of FAM-TAPSE was higher than that of CM TAPSE (P =0.000).Both FAM-TPASE and CM-TAPSE showed significant positive correlations with GA,Em and Sm,but FAM TAPSE demonstrated better correlation than CM-TAPSE.Conclusions By adjusting sample line of FAM,measuring the maximum displacement of tricuspid annular plane is feasible,and FAM may evaluate fetal right ventricular function more accurately and effectively.

Objective To investigate the temporal changes of serum interleukin-37 (IL-37) concentration following acute ST-segment elevation myocardial infarction (ASTEMI) and the relationship between IL-37 and C-reactive protein (CRP) in patients with ASTEMI. Methods This analysis was conducted in a cohort of 20 patients with an established diagnosis of ASTEMI and 26 patients admitted for chest pain but with normal findings in coronary angiography (control) between June 2012 and December 2013. Venous blood was collected at days 1, 3, 5, and 7 after myocardial infarction for measurement of serum IL-37 and CRP levels using enzyme-linked immunosorbent assay (ELISA). Results Compared with the control group, the patients in ASTEMI group showed a significant acute elevation of IL-37 level on day 1 following myocardial infarction; IL-37 level reached the peak on day 3 and began to decrease on day 5, followed by a significant decrease on day 7. The time course of post-infarction CRP changes was consistent with that of IL-37 variations and showed a positive correlation the latter (r=0.63, P<0.05). Conclusion IL-37 may participate in the inflammatory responses in ASTEMI.

Objective To investigate the temporal changes of serum interleukin-37 (IL-37) concentration following acute ST-segment elevation myocardial infarction (ASTEMI) and the relationship between IL-37 and C-reactive protein (CRP) in patients with ASTEMI. Methods This analysis was conducted in a cohort of 20 patients with an established diagnosis of ASTEMI and 26 patients admitted for chest pain but with normal findings in coronary angiography (control) between June 2012 and December 2013. Venous blood was collected at days 1, 3, 5, and 7 after myocardial infarction for measurement of serum IL-37 and CRP levels using enzyme-linked immunosorbent assay (ELISA). Results Compared with the control group, the patients in ASTEMI group showed a significant acute elevation of IL-37 level on day 1 following myocardial infarction; IL-37 level reached the peak on day 3 and began to decrease on day 5, followed by a significant decrease on day 7. The time course of post-infarction CRP changes was consistent with that of IL-37 variations and showed a positive correlation the latter (r=0.63, P<0.05). Conclusion IL-37 may participate in the inflammatory responses in ASTEMI.