The"eighteen-character formula"encapsulates the clinical wisdom of the national medical master,Prof.LU Zhizheng,and provides crucial guidance for the prevention and treatment of gastrointestinal disorders.The"inflammation cancer transformation"of chronic gastritis is a multifaceted process involving multiple factors,stages,and mechanisms.Drawing upon Prof.LU Zhizheng's"eighteen-character formula"to explore its pathogenesis and therapeutic strategies holds substantial theoretical and clinical value.Within Prof.LU Zhizheng's academic framework,the concept of"holding the center and moving the periphery"underscores the pivotal role of the spleen and stomach,"benefiting the emotions and smoothing the qi activity"highlights the relationship between liver and stomach,liver and spleen,spleen and stomach,and"mediating moisture and dryness,restoring the normal function of spleen and stomach"reflects the balance between dryness and moisture,mutual assistance between yin and yang,aiming to restore the normal digestive and transport functions of spleen and stomach.In the clinical management of"inflammation cancer transformation"in chronic gastritis,it is imperative to focus on the spleen and stomach as the foundation,ensuring the health of the five zang-fu organs by the activation of peripheral functions;to base treatment on the balance of qi and blood,establishing vital activities by the regulation of ascending and descending movements;and to adhere to the principles of yin and yang,ensuring the normal digestive and transportive functions of the spleen and stomach by the harmonization of moisture and dryness.Our team,inspired by Prof.LU Zhizheng's theoretical framework and medicinal expertise,has developed a compound herbal formula known as Manpi Xiao.Clinical and foundational research have shown that Manpi Xiao effectively prevents and treats the malignant progression of precancerous lesions to gastric cancer,further affirming the clinical significance and value of Prof.LU Zhizheng's"eighteen-character formula".

The " inflammation cancer transformation" in chronic gastritis is a complex process that involves multiple factors,stages,and mechanisms. As the disease progresses,morphological changes occur in the gastric mucosal gland orifices and capillary vessels,and pathologically,it is characterized by a reduction in the number of glands,structural disarray,or cellular atypia. In traditional Chinese medicine,the onset of chronic gastritis is believed to be related to external pathogenic factors invading the stomach or the internal generation of various pathogenic factors. The disease process is considered to progress from qi to blood,and from meridians to collaterals,which is in line with the theory of "prolonged disease invading collaterals". This article explores the pathogenesis,prevention,and treatment of the "inflammation cancer transformation" in chronic gastritis based on the theory of the stomach collaterals,summarizing the characteristics of the disease evolution as follows:the stomach collaterals are invaded by pathogenic factors,leading to disharmony of qi and collaterals;obstruction of the stomach collaterals,resulting in the internal production of turbid toxins;and deficiency of the stomach collaterals,leading to the loss of nourishment and masses. Clinically,the therapeutic methods include expelling pathogenic factors,regulating qi,and activating collaterals;resolving stasis and detoxifying to unblock collaterals;and replenishing deficiency and eliminating masses to nourish the collaterals,thereby ensuring the patency of the stomach collaterals and the nourishment of the stomach. Starting from the theory of the stomach collaterals and integrating modern scientific research,this article aims to provide theoretical reference and practical guidance for the differential diagnosis and dynamic comprehensive management of the "inflammation cancer transformation" in chronic gastritis.

Objective To further improve the value of clinical application of a quantitative analysis method called LF-index (LFI) which based on real-time tissue elastography (RTE). Methods We prospectively enrolled 116 consecutive patients with chronic hepatitis B (CHB) and all patients underwent a liver biopsy and RTE between January 2015 and December 2015 at the First affiliated hospital of Wenzhou Medical University. Univariate and multivariate analyses were performed, and the prediction models for predicting significant fibrosis and cirrhosis were derived from independent predictors. Results (1) In multivariate analyses, spleno-portal index (SPI) (OR=13.956, P=0.002) and LFI (OR=6.283, P=0.023) were confirmed as independent predictors of significant fibrosis. In multivariate analyses of patients with and without cirrhosis, we found significant differences in the γ-Glutamyl transferase (GGT) (OR=1.012, P=0.049), SPI (OR=5.676, P=0.002) and LFI (OR=14.102, P=0.001). (2)A novel model called LFI-SPI score (LSPS) for prediction of significant fibrosis was developed (area under receiver operating characteristic curve [AUROC]=0.87), showing the superiority of diagnostic accuracy than LFI (AUROC=0.76, P=0.0109), aspartate aminotransferase to platelet ratio index (APRI) (AUROC=0.64, P=0.0031), fibrosis-4 index (FIB-4) (AUROC=0.67, P= 0.0044) and Fibroscan (AUROC=0.68, P=0.0021). (3) We also developed a LFI-SPI-GGT score (LSPGS) for predicting cirrhosis, with an AUROC of 0.93. The diagnostic accuracy of LSPGS was similar to that of Fibroscan (AUROC=0.85, P=0.134), and was superior to LFI (AUROC=0.81, P=0.0113), APRI (AUROC=0.67, P<0.0001), and FIB-4 (AUROC=0.72, P=0.0005). Conclusions We developed new formulas, LSPS and LSPGS for predicting significant fibrosis and cirrhosis in this prospective study. LSP score was mainly used for screening of significant liver fibrosis, and LSPG score was mainly used to exclude cirrhosis.

Objective To investigate the predictive value of HIT-antibodies(HIT-Ab) detection for new thrombus in suspected Heparin-Induced thrombocytopenia (HIT). Methods Retrospective cohort study. 472 suspected HIT patients were collected from July 2016 to November 2018, and all subjects under-went a 4Ts score and were sent for HIT-Ab tests. According to the results of HIT-Ab, there were four groups:412 cases of negative HIT-Ab (0-0.9 U/ml), 45 cases of weak-positive HIT-Ab (1.0-4.9 U/ml), 12 cases of moderate-positive HIT-Ab (5.0-15.9 U/ml), and 3 cases of strong-positive HIT-Ab (≥16.0 U/ml) respective-ly. Ultrasound or CT examination was used to confirm new thrombosis as a standard to evaluate the value of HIT-Ab for predicting new thrombus. The diagnostic efficacy of HIT-Ab for HIT was evaluated in clinically confirmed HIT. Results The incidence rates of new thrombus in each group were: 15.8％ in Negative HIT-Ab group (62/412), 48.9％in Weak-positiveHIT-Ab group (22/45), 75.0％in Moderate-positive HIT-Ab group (9/12), and100％in Strong-positive HIT-Ab group (3/3)(P<0.00). When HIT-Ab≥1.0 U/ml, the speci-ficity for diagnosing new thrombus was 93.0％, the sensitivity was 34.2％, the negative predictive value (NPV) was 84.2％, and the positive predictive value (PPV) was 56.5％. The diagnostic rates of HIT in each group were:negative 0％(0/412), weak-positive 62.2％(28/45), moderate-positive (12/12) and strong-positive (3/3) were 100％. When HIT-Ab≥ 1.0 U/ml, the specificity for HIT diagnosis was 96.0％, the sensitivity was 100％, NPV was 100％, and PPV was 71.5％. Conclusions In suspected HIT patients, the incidence of new thrombosis increases with the elevated HIT-Ab level. HIT-Ab detection can be used as a crucial tool for new thrombosis prediction and HIT diagnosis in suspected HIT patients. Clinicians can develop treatment strategies based on HIT-Ab levels.

ObjectiveTo identify the rate， population characteristics， and vaccination history of repeat infections among previously infected people in the current epidemic based on the rate of repeat infection and population characteristics of different mutant strains at different times in Pudong New Area of Shanghai， and to provide reference for the prevention and control strategies of novel coronavirus repeat infections. MethodsA total of 9 250 investigated subjects were randomly selected from the new cases of asymptomatic infection and confirmed cases reported by Pudong New Area from March to May 2022. The investigation mainly focused on demographic characteristics， nucleic acid or antigen test results， and symptoms after infection. The repeat infection rates among different populations were compared， and logistic regression was used to analyze the impact of gender， age， and vaccination status on repeat infections. ResultsThe survey sample of 9 250 people had a response rate of 81.85%. There were 4 043 males （53.40%） and 3 528 females （46.60%）， with a median age of 34 years old （P₂₅， P₇₅： 7， 61）. The overall vaccine uptake rate was 59.44% （4 500/7 571）. In December of 2022， there were 563 cases of repeat infection， with an infection rate of 7.44%. The lowest rate of repeat infection was seen in the 3‒ year-old group （2.86%） and the highest rate in the 30‒ year-old group （12.42%）， with significant differences between different age groups. The repeated infection rate for those who had completed their vaccinations was significantly lower （6.57%） compared to those who had not （7.11%）. The age groups of 3‒ years， 70‒79 years， as well as individuals who completed full vaccination and received booster shots were protective factors against repeat infections. ConclusionThe overall rate of reinfection among the infected in Shanghai during the spring of 2022 was low in the outbreak of the Omicron variant， and the rate of reinfection in the 3‒ year-old group was significantly lower than in other age groups. Completing the full course of vaccination significantly reduces the risk of reinfection. Although the reinfection rate is high in individuals who received booster shots， it remains a mitigating factor compared to those who do not receive the vaccine. It is recommended to continue monitoring reinfections in key populations and further strengthen immunization efforts.