OBJECTIVE: To optimize the formative excipients for cough remedy granules. METHODS: Effects of different excipients on the formation, moisture absorption and relative critical humidity of cough remedy granules were examined, and the optimal excipients as well as formula were selected by adoption of the comprehensive scoring method. RESULTS: The optimal excipient for preparation of cough remedy granules was lactose, and the best formula comprised of 4 doses of spraying powder and 6 doses of lactose mixture. CONCLUSIONS: The cough remedy granules thus prepared is ideal: good in granularity, easy to dissolve and not liable to moisture absorption.

Objective:To observe the effects of different moxibustion time on cartilage morphology,tumor necrosis factor(TNF)-α and interleukin(IL)-10 of the knee joint in rats with knee osteoarthritis(KOA),and to explore the best treatment time of moxibustion for KOA.Methods:Healthy male Wistar rats were randomly divided into a blank group,a model group,a 15-minute-moxibustion group,a 30-minute-moxibustion group,and a 60-minute-moxibustion group,with 10 rats in each group.Except for the blank group,the KOA model was established in all groups by injecting sodium iodoacetate solution into the knee joint cavity of rats.Rats in the 15-minute-moxibustion group,the 30-minute-moxibustion group,and the 60-minute-moxibustion group were all treated with mild moxibustion intervention for 15 min,30 min,and 60 min,respectively at Neixiyan(EX-LE4)and Dubi(ST35)points near the patella,3 times a week for 4 weeks,12 times in total.Rats in the blank group and the model group were fixed for 30 min without moxibustion intervention.Macroscopic observation for the smoothness of knee cartilage surface was performed after the intervention.Hematoxylin-eosin staining,toluidine blue staining,and Mankin score were used to evaluate the pathological changes in the cartilage.The expression levels of TNF-α and IL-10 in the serum were detected by enzyme-linked immunosorbent assay.Results:Compared with the blank group,the articular cartilage surface in the model group was rough,the chondrocyte arrangement was irregular,the Mankin score and the serum TNF-α expression were significantly increased(P＜0.05),while the expression of serum IL-10 was significantly decreased(P＜0.05).Compared with the model group,the articular cartilage surface was smoother,the chondrocytes were arranged neatly,the Mankin score and serum TNF-α expression level were significantly lower in the three moxibustion intervention groups(P＜0.05);the serum IL-10 level in the 30-minute-moxibustion group and the 60-minute-moxibustion group was increased significantly(P＜0.05).Compared with the 15-minute-moxibustion group,the articular cartilage surface in the 30-minute-moxibustion group and the 60-minute-moxibustion group was smoother,the chondrocyte arrangement was more regular,the Mankin score and the serum TNF-α level were decreased significantly(P＜0.05),and the serum IL-10 level was increased(P＜0.05).There was no significant difference in the serum TNF-α or IL-10 level between the 30-minute-moxibustion group and the 60-minute-moxibustion group(P＞0.05).Conclusion:Moxibustion can obviously improve the morphology and structure of KOA articular cartilage,protect articular cartilage,inhibit cartilage inflammation,and delay KOA cartilage degeneration.Moxibustion's effect is closely related to moxibustion time;the therapeutic effect of the 30-minute-moxibustion and the 60-minute-moxibustion is better than that of the 15-minute-moxibustion.

Osteoporosis is a common extrahepatic complication of liver cirrhosis, and it not only increases the economic burden of patients, but also brings adverse effects on their quality of life and prognosis. Recent studies have shown that sarcopenia, adiponectin, leptin, irisin, and inflammatory factors are involved in the development of osteoporosis in patients with liver cirrhosis, and commonly used anti-osteoporosis drugs include calcium supplement, vitamin D, and bisphosphonates. This article reviews the advances in the risk factors, pathogenesis, and treatment of liver cirrhosis with osteoporosis and points out that there are still controversies over the influence of some factors on osteoporosis, and further studies are needed to explore related pathogeneses and safe and effective treatment regimens.

Acute pancreatitis (AP) is a common acute abdominal disease in gastroenterology. Severe patients tend to have high mortality and poor prognosis, and early evaluation of disease conditions and prediction of clinical outcome is of particular importance to improve the prognosis of patients. In recent years, great progress has been made in related markers for predicting the severity stratification and prognosis of patients with AP. This article reviews the value of immune indices, cytokines, genes, biochemical indices, imaging findings, and other related indicators in predicting the severity, mortality, and complications of AP.

Objective To investigate the best scoring systems for predicting the severity and prognosis of hyperlipidemic acute pancreatitis (HLAP) by comparing APACHEII, BISAP, MCTSI, MEWS, POP, SPS, and PANC3 scores. Methods A retrospective analysis was performed for the data of 123 patients with HLAP who were hospitalized and treated in The Second Affiliated Hospital of Kunming Medical University from October 2017 to January 2022. The patients were divided into mild acute pancreatitis (MAP) group with 24 patients, moderate- severe acute pancreatitis (MSAP) group with 56 patients, and severe acute pancreatitis (SAP) group with 43 patients, and the three groups were compared in terms of basic data and scores of the above scoring systems. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups; the chi-square test was used for comparison of categorical data between groups. MedCalc software was used to plot the receiver operating characteristic (ROC) curve, and the area under the ROC curve (AUC) was used to compare the value of these scoring systems in predicting disease severity and local and systemic complications in HLAP patients. Results There were significant differences between the three groups in diabetes mellitus ( χ 2 =6.880, P < 0.05), length of hospital stay ( H =26.494, P < 0.001), local complications ( χ 2 =52.211, P < 0.001), acute kidney injury (AKI) ( χ 2 =38.247, P < 0.001), acute respiratory distress syndrome (ARDS) ( χ 2 =79.201, P < 0.001), and multiple organ dysfunction syndrome (MODS) ( χ 2 =45.032, P < 0.001). As for the scores of the above scoring systems, there were significant differences between the three groups in APACHE Ⅱ, BISAP, MCTSI, MEWS, POP, SPS, and PANC3 ( H =47.525, 42.662, 53.545, 31.664, 49.233, 48.543, and 9.443, all P < 0.05). APACHE Ⅱ score had a significantly higher value than MEWS score in predicting SAP ( Z =2.090, P < 0.05), and the other scores had a similar value, among which POP score had the largest AUC of 0.883. MCTSI score had the highest value in predicting local complications (AUC=0.886), with a sensitivity of 84.7% and a specificity of 74.5% at the cut-off value of 5. APACHE Ⅱ and POP scores had an AUC of 0.911 (95% confidence interval [ CI ]: 0.835-0.986, P < 0.001) and 0.920 (95% CI : 0.866-0.974, P < 0.001), respectively, in predicting AKI; APACHE Ⅱ score had a higher predictive value than MCTSI and MEWS scores, POP score had a higher predictive value than MCTSI, MEWS, and BISAP scores, and SPS score had a higher predictive value than MCTSI score. APACHE Ⅱ score had an AUC of 0.914 (95% CI : 0.854-0.973, P < 0.001) in predicting ARDS and had a higher predictive value than BISAP and MEWS ( Z =2.152 and 3.015, both P < 0.05). APACHE Ⅱ and POP scores had an AUC of 0.969 (95% CI : 0.941-0.996, P < 0.001) and 0.932 (95% CI : 0.880-0.984, P < 0.001), respectively, in predicting MODS, and APACHE Ⅱ score had a higher predictive value than SPS, BISAP, MEWS, and MCTSI. Conclusion POP score has the highest value in predicting SAP, with a comparable predictive ability to all the other scoring systems except MEWS. APACHEII and POP scores have a good value in predicting systemic complications and show a high accuracy in predicting AKI and MODS, and APACHEII score is highly accurate in predicting ARDS.

Patients with decompensated cirrhosis often have a reduction in renal function due to severe hepatic insufficiency which results in reduced inactivation of vasodilators, hemodynamic disorders, immune disorders, and infections, and without timely intervention, patients may gradually develop from early prerenal injury to late renal failure. Patients tend to have a low survival rate and great difficulties in treatment. With the gradual clarification of the classification and diagnostic criteria for kidney injury and the discovery of an increasing number of markers for kidney injury, early diagnosis and localization of kidney injury are of great importance for improving the prognosis of patients. This article analyzes the new advances in the pathogenesis, diagnostic criteria, and treatment of renal injury in cirrhotic patients in recent years, so as to provide help for the clinical diagnosis and treatment of cirrhotic patients with renal injury.

ObjectiveTo investigate the influence of sarcopenia on bone mass loss， the risk factors for bone mass loss in liver cirrhosis， and the correlation between body composition and bone mineral density （BMD） by comparing the clinical features of bone mass loss in patients with liver cirrhosis. MethodsA total of 92 patients who were hospitalized and diagnosed with liver cirrhosis in Department of Gastroenterology， The Second Affiliated Hospital of Kunming Medical University， from April to December of 2022 were enrolled， and based on the results of dual-energy X-ray absorptiometry， they were divided into bone mass loss group （osteopenia/osteoporosis） with 57 patients and normal bone mass group with 35 patients. The two groups were compared in terms of general data， laboratory examination， imaging data， and body composition analysis. The independent samples t-test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test or the continuity correction chi-square test was used for comparison of categorical data between two groups； Pearson correlation analysis and Spearman correlation analysis were used to investigate correlation； a binary logistic regression analysis was used to investigate the risk factors for bone mass loss in liver cirrhosis. ResultsCompared with the normal bone mass group， the bone mass loss group had significantly higher age （t=-3.597， P<0.05）， proportion of female patients （χ²=8.393， P<0.05）， N-terminal middle molecular fragment of osteocalcin （N-MID） （Z=-3.068， P<0.05）， β isomer of C-terminal telopeptide of type I collagen （β-CTX） （t=-2.784， P<0.05）， and proportion of patients with sarcopenia （χ²=13.884， P<0.05） and significantly lower calcitonin （CT） （Z=-2.340， P<0.05） and L3 skeletal muscle index （L3-SMI） （t=4.621， P<0.05）. Compared with the normal bone mass group， the bone mass loss group had significantly lower total muscle mass （Z=-2.952， P<0.05）， right upper limb muscle mass （Z=-2.929， P<0.05）， left upper limb muscle mass （Z=-2.680， P<0.05）， right lower limb muscle mass （Z=-3.366， P<0.05）， left lower limb muscle mass （Z=-3.374， P<0.05）， presumed bone mass （t=2.842， P<0.05）， body water mass （Z=-2.779， P<0.05）， basal metabolic rate （BMR） （Z=-3.153， P<0.05）， and BMD of L1— L4 and femoral neck （t=9.789， t=10.280， t=10.832， Z=-7.298， t=8.945， all P<0.05）. Total muscle mass， muscle mass of trunk and limbs， presumed bone mass， BMR， and body water mass in body component analysis were positively correlated with L1 — L4 BMD and femoral neck BMD （all P<0.05）， and fat mass was positively correlated with L1 — L4 BMD （all P<0.05）. Sarcopenia （odds ratio ［OR］=8.737， 95% confidence interval ［CI］： 2.237 — 34.129， P=0.002）， age （OR=1.094， 95%CI： 1.019 — 1.175， P=0.013）， and N-MID （OR=1.095， 95%CI： 1.019 — 1.176， P=0.014） were independent risk factors for bone mass loss in patients with liver cirrhosis. ConclusionOld age， female sex， sarcopenia， elevated N-MID， elevated β-CTX， reduction in CT， low muscle mass， low presumed bone mass， low BMR， and low body water mass are the features of bone mass loss in patients with liver cirrhosis， and sarcopenia， age， and N-MID are independent risk factors for bone mass loss in patients with liver cirrhosis. Detailed assessment of body composition changes can help to identify abnormal BMD in patients with liver cirrhosis.