Objective:To investigate the effect of type 2 taste receptor(T2R)38 activation on ferroptosis of human airway epithelium NuLi-1 cells induced by cigarette smoke exposure,and to clarify its possible mechanism.Methods:The human airway epithelial NuLi-1 cells were divided into control group(without any treatment),cigarette smoke extract(CSE)group(treated with 5％CSE for 24 h)and CSE+T2R38 specific agonist phenylthiocarbamide(PTC)group(CSE+PTC group)(treated with 5％CSE and 1 mmol·L-1 PTC for 24 h).The expression levels of T2R38 mRNA and protein in NuLi-1 cells in various groups were determined by real-time fluorescence quantitative PCR(RT-qPCR)and Western blotting methods.The cell viabilities in various groups were determined by cell counting kit-8(CCK-8)assay.The activities of inducible nitric oxide synthase(iNOS),endothelial nitric oxide synthase(eNOS),and superoxide dismutase(SOD)in the cells in various groups were measured by kits.DAX-J2 red fluorescence probe was used to determine the levels of nitric oxide(NO)in the cells in various groups.The reactive oxygen species(ROS)levels in the cells in various groups were detected by fluorescent probe kit.The levels of malondialdehyde(MDA),Fe2+,and reduced glutathione(GSH)in the cells in various groups were determined by enzyme-linked immunosorbent assay(ELISA)method.Western blotting method was used to determine the expression levels of nuclear factor erythroid 2-related factor 2(Nrf2)and glutathione peroxidases 4(GPx4)proteins in the cells in various groups.Results:Compared with control group,the expression levels of T2R38 mRNA and protein in NuLi-1 cells in CSE group were increased(P＜0.05).Compared with control group,the viability of NuLi-1 cells in CSE group was decreased(P＜0.05),the activities of iNOS and SOD in cells in CSE group were increased(P＜0.05),the levels of NO and ROS were increased(P＜0.05),the levels of MDA and Fe2+were increased(P＜0.05),and the GSH level and the expression levels of Nrf2 and GPx4 proteins were decreased.Compared with CSE group,the viability of NuLi-1 cells in CSE+PTC group was increased(P＜0.05),the activity of SOD and the GSH level in the cells were increased(P＜0.05),the activity of iNOS in cells was decreased(P＜0.05),the levels of NO and ROS in cells were decreased(P＜0.05),the levels of MDA and Fe2+were decreased(P＜0.05),and the expression levels of Nrf2 and GPx4 proteins were increased(P＜0.05).There was no significant difference in eNOS activity among control group,CSE group,and CSE+PTC group(P＞0.05).Conclusion:Activation of bitter taste receptor T2R38 can inhibit ferroptosis in human airway epithelium NuLi-1 cells induced by cigarette smoke exposure,and its mechanism may be related to the reduction of iNOS activity in the cells.

Cataract combined with retinopathy can seriously affect the vision of patients. Vitrectomy combined with one-stage implantation of multi-focal intraocular lens (MIOL) has been paid more and more attention. The application of MIOL shows potential in improving the visual quality of patients, but its effect is affected by many factors, and refractive drift is a key problem to be solved. At present, the research mainly focuses on cataract patients with high myopia, and further research on other types of retinopathy is needed. In the future, multi-center, large-sample, long-term clinical studies and interdisciplinary cooperation are needed to optimize surgical and management programs to enhance the application effect of MIOL in the treatment of retinopathy and improve the quality of life of patients.

Background and purpose:Malnutrition and deterioration of nutritional status are common in patients after surgery for gastric cancer,especially in the elderly,and severely affect patient prognosis.Studies have shown that oral nutritional supplements(ONS)can improve the nutritional status and clinical outcomes of patients after surgery for gastric cancer with nutritional risk.This study analyzed elderly patients who underwent radical surgery for gastric cancer in a previous randomized controlled trial to explore the impact of ONS on elderly patients after surgery for gastric cancer with nutritional risk.Methods:Patients discharged after gastric cancer radical surgery with nutritional risk who received treatment at Zhongshan Hospital affiliated with Fudan University from January 2017 to December 2018 were selected.The control group received dietary advice three months after discharge,while the ONS group received dietary advice combined with ONS three months after discharge.The weight,body mass index(BMI),hemoglobin,plasma albumin,and chemotherapy tolerance of the two groups were compared three months after discharge.The data for this study was based on a previous randomized controlled trial(ChiCTR2000029708)which had received ethical approval.This study was approved by the Ethics Committee of Zhongshan Hospital Affiliated to Fudan University(B2019-257R2).Results:A total of 125 patients who met the inclusion criteria were finally selected,including 69 in the ONS group and 56 in the control group.After 3 months of intervention,there were no significant differences in weight,BMI,hemoglobin,and plasma albumin levels between the two groups.However,the ONS group showed a significantly smaller decrease in weight change during the intervention period compared to the control group[(2.50±1.60)kg vs(4.24±1.80)kg,P＜0.05].The chemotherapy tolerance of the ONS group was significantly improved compared to the control group,with a decrease in the overall chemotherapy change rate(15.9%vs 41.1%,P=0.002),and fewer patients in the ONS group experienced chemotherapy delays,reduced drug dosages,and discontinuation of chemotherapy than those in the control group.Multivariate analysis showed that body weight,plasma albumin,hemoglobin,NRS2002,and BMI had no significant effect on the normal course of chemotherapy(P＞0.05);only ONS was a significant protective factor,significantly reducing the risk of chemotherapy modification(OR=0.227,P=0.001).Conclusion:ONS helps improve the chemotherapy tolerance of elderly postoperative gastric cancer patients and to some extent enhances their nutritional outcomes.For elderly postoperative gastric cancer patients with nutritional risk,nutritional intervention after discharge has a positive impact on improving clinical outcomes.

Background and purpose:Malnutrition and deterioration of nutritional status are common in patients after surgery for gastric cancer,especially in the elderly,and severely affect patient prognosis.Studies have shown that oral nutritional supplements(ONS)can improve the nutritional status and clinical outcomes of patients after surgery for gastric cancer with nutritional risk.This study analyzed elderly patients who underwent radical surgery for gastric cancer in a previous randomized controlled trial to explore the impact of ONS on elderly patients after surgery for gastric cancer with nutritional risk.Methods:Patients discharged after gastric cancer radical surgery with nutritional risk who received treatment at Zhongshan Hospital affiliated with Fudan University from January 2017 to December 2018 were selected.The control group received dietary advice three months after discharge,while the ONS group received dietary advice combined with ONS three months after discharge.The weight,body mass index(BMI),hemoglobin,plasma albumin,and chemotherapy tolerance of the two groups were compared three months after discharge.The data for this study was based on a previous randomized controlled trial(ChiCTR2000029708)which had received ethical approval.This study was approved by the Ethics Committee of Zhongshan Hospital Affiliated to Fudan University(B2019-257R2).Results:A total of 125 patients who met the inclusion criteria were finally selected,including 69 in the ONS group and 56 in the control group.After 3 months of intervention,there were no significant differences in weight,BMI,hemoglobin,and plasma albumin levels between the two groups.However,the ONS group showed a significantly smaller decrease in weight change during the intervention period compared to the control group[(2.50±1.60)kg vs(4.24±1.80)kg,P＜0.05].The chemotherapy tolerance of the ONS group was significantly improved compared to the control group,with a decrease in the overall chemotherapy change rate(15.9%vs 41.1%,P=0.002),and fewer patients in the ONS group experienced chemotherapy delays,reduced drug dosages,and discontinuation of chemotherapy than those in the control group.Multivariate analysis showed that body weight,plasma albumin,hemoglobin,NRS2002,and BMI had no significant effect on the normal course of chemotherapy(P＞0.05);only ONS was a significant protective factor,significantly reducing the risk of chemotherapy modification(OR=0.227,P=0.001).Conclusion:ONS helps improve the chemotherapy tolerance of elderly postoperative gastric cancer patients and to some extent enhances their nutritional outcomes.For elderly postoperative gastric cancer patients with nutritional risk,nutritional intervention after discharge has a positive impact on improving clinical outcomes.

Cataract combined with retinopathy can seriously affect the vision of patients. Vitrectomy combined with one-stage implantation of multi-focal intraocular lens (MIOL) has been paid more and more attention. The application of MIOL shows potential in improving the visual quality of patients, but its effect is affected by many factors, and refractive drift is a key problem to be solved. At present, the research mainly focuses on cataract patients with high myopia, and further research on other types of retinopathy is needed. In the future, multi-center, large-sample, long-term clinical studies and interdisciplinary cooperation are needed to optimize surgical and management programs to enhance the application effect of MIOL in the treatment of retinopathy and improve the quality of life of patients.

ObjectiveTo evaluate the clinical effectiveness and safety of Bairui Granules （百蕊颗粒） in the treatment of acute pharyngitis with wind-heat syndrome. MethodsA multicenter， double-blind， double-simulation， randomised controlled trial was conducted， in which 162 patients with acute pharyngitis and wind-heat syndrome from 7 centers were recruited， and each center was divided into trial group and control group on the ratio of 2∶1. In the trial group， 108 cases were orally administered with Bairui Granules plus Reyanning Granules （热炎宁颗粒） simulant， and in the control group， 54 cases were orally administered with Reyanning Granules plus Bairui Granules simulant for 5 days， with a follow-up visit on the 6th day. Full analysis set （FAS） analysis and per protocol set （PPS） were used for analysis， respectively. The primary efficacy index was the disappearance rate of sore throat after 5-day treatment； the secondary efficacy indexes were the disappearance rate of sore throat after 3-day treatment， as well as the visual analogue score （VAS） of sore throat before treatment， every day during the treatment， and follow-up on day 6， and the traditional Chinese medicine （TCM） syndrome score was performed before treatment and at the follow-up on day 6. The effectiveness on TCM syndrome was evaluated at the follow-up on day 6， and the changes of vital signs， blood routine， urine routine， liver functions， kidney function， the adverse events before and after the treatment were recorded， and safety analysis set （SS） was analysed. Results162 patients entered the FAS and SS analyses， and 158 cases （105 cases in the trial group and 53 cases in the control group） entered the PPS analysis. FAS analysis showed that the disappearance rate of sore throat after 5-day treatment was 80.56% （87/108） in the trial group and 64.81% （35/54） in the control group， and the difference between groups was statistically significant （χ² = 5.10， P = 0.0239）. PPS analysis showed that the disappearance rate of sore throat after 5-day treatment was 80.00% （84/105） in the trial group and 64.15% （34/53） in the control group， and the difference between groups was statistically significant （χ² =4.85， P = 0.0277）. FAS and SS analyses both showed that the difference in disappearance rate of sore throat between groups on 3-day treatment was not statistically significant （P＞0.05）. Compared with those before treatment， the VAS scores of sore throat were lower in both groups during treatment on day 2， 3， 4， 5， and follow-up on day 6 （P＜0.01）， but the difference between groups at each time point was not statistically significant （P＞0.05）. TCM syndrome scores of both groups at the follow-up were lower than that before treatment， and those of the trial group were lower than those of the control group （P＜0.01）. The cure rate and effective rate of TCM syndrome of the trial group were significantly higher than those of the control group （P＜0.01）. There was no significant difference in blood routine， urine routine， liver function， kidney function between groups before and after treatment （P＞0.05）， and no serious adverse events occured in both groups. ConclusionBairui Granules showed clinical effectiveness in the treatment of acute pharyngitis of wind-heat syndrome， and it could significantly improve the clinical symptoms， accelerate the disappearance time of sore throat with good safety.

Objective:To explore the predictive factors for prepatellar subfascial gas in patients with closed patellar fracture and their impacts on the early infection following internal fixation.Methods:A retrospective analysis was performed in the 148 patients with closed patellar fracture who had been treated at Department of Orthopaedic Surgery, Zhangjiagang Hospital Affiliated to Soochow University from January 2018 through December 2021. All patients underwent preoperative three-dimensional CT examination of the knee joint and was treated by open reduction and internal fixation of patellar fractures. According to the presence or absence of gas in the prepatellar fascia, the patients were divided into 2 groups. In the gas group of 18 patients, there were 12 males and 6 females with an age of (58.3±14.5) years; in the gas-free group of 130 patients, there were 57 males and 73 females with an age of (60.5±14.6) years. The risk factors for prepatellar subfascial gas were screened out by comparing the gender, age, body mass index, injury mechanism, AO/OTA classification, diabetes, primary hypertension, neutrophil percentage, lymphocyte percentage, white blood cell count, neutrophil count, lymphocyte count, C-reactive protein, erythrocyte sedimentation rate, procalcitonin, and albumin before operation between the 2 groups. A receiver operating characteristic (ROC) curve for risk factors were made to identify the best screening points. The impacts of prepatellar subfascial gas were analyzed on early infection after internal fixation.Results:The preoperative neutrophil percentage was the risk factor for prepatellar subfascial gas ( P<0.05). The area under the ROC curve of preoperative neutrophil percentage for prediction of prepatellar subfascial gas was 0.700 (95% CI: 0.554 to 0.847), the optimal critical value was 78.45%, and the sensitivity and specificity were 0.556 and 0.831, respectively ( P=0.006). In the gas group, the incidence of early postoperative infection was insignificantly higher ( P=0.058) , but the time for postoperative antibiotic use was significantly longer and the dressing changes were significantly more frequent than those in the gas-free group ( P<0.05). Conclusions:In patients with closed patellar fracture, preoperative neutrophil percentage >78.45% can be used as an effective non-imaging indicator for prepatellar subfascial gas. A patient with prepatellar subfascial gas could be more prone to early postoperative infection.

Malnutrition is closely related to clinical outcomes and accurate evaluation of nutritional status is the cornerstone of nutritional therapy. However, consistent diagnostic criteria for malnutrition have been absent for quite a long period. The Global Leadership Initiative on Malnutrition (GLIM) criteria were introduced in September 2018 and served as a consensus-based evaluation tool. As per GLIM criteria, evaluation of malnutrition should follow a two-step approach with nutritional screening as the first step and then malnutrition diagnosis assessment and severity grading based on etiologic as well as phenotypic metrics. Since debut, GLIM criteria have been applied in different countries, healthcare settings and populations, showing good accuracy and prognostic value for outcomes such as complications and survival. However, most of the studies are retrospective in nature and high-quality prospective studies are needed to better validate GLIM criteria. The way to steer nutritional interventions based on GLIM criteria is also worth future investigation.

The European Society for Clinical Nutrition and Metabolism held the 43 rd annual academic conference online from September 9 to 14,2021. Based on reports from the con-ference, the authors launched a review on the current hot topics in clinical nutrition.

Objective:To explore the changes of corneal neuropathy and ocular surface flora in patients with type 2 diabetes, and the correlation between corneal neuropathy and ocular surface flora changes.Methods:According to the results of fundus fluorescein angiography, 65 patients with type 2 diabetes (130 eyes in total) who were treated with insulin alone and without comorbid retinopathy in the Department of Endocrinology, Henan People′s Hospital from March to June 2019 were selected. Sixty-five age-matched normal glucose tolerance subjects (130 eyes in total) were also enrolled. Confocal microscopy was performed and conjunctival sac secretions were collected. Through 16S rRNA analysis and sequencing and PICRUSt bacterial gene function prediction, the relationship between patients with type 2 diabetes and the difference in the degree of corneal neuropathy and the composition of ocular surface flora and function prediction in healthy people were explored, and the correlation between corneal neuropathy and ocular surface flora was analyzed as well.Results:Compared with healthy people, patients with type 2 diabetes have more severe corneal neuropathy, and it was related to the changes in ocular surface flora. Brevibacillus and paenibacillus were significantly positively correlated with the degree of corneal neuropathy ( P<0.05), and enhydrobacter and proteobacteria were significantly negatively correlated with the degree of corneal neuropathy ( P<0.05). PICRUSt analysis showed that the degree of enrichment of metabolism-related genes in the ocular surface flora of patients with type 2 diabetes was significantly changed compared with healthy people. Conclusion:Patients with type 2 diabetes present with more severe corneal neuropathy. The diversity of ocular surface flora and metabolic function have significant changes. The degree of severity corneal neuropathy is related to brevibacillus, paenibacillus, enhydrobacter, and proteobacteria.