ObjectiveThis paper aims to investigate the effects and mechanism of Mimenghua prescription in modulating the mitogen-activated protein kinase kinase （MEK）/rat sarcoma viral oncogene homolog （Ras）/rapidly accelerated fibrosarcoma kinase （Raf）/extracellular signal-regulated kinase （ERK） signaling pathway to inhibit inflammatory responses in a dry eye animal model. MethodsA total of 60 C57BL/6J mice （eight weeks old， half male and half female） were used in the experiment. Ten mice were randomly selected as the blank control group， while the remaining 50 were exposed to a controlled dry system and received instillation of 0.2% benzalkonium chloride （BAC） into the eyes for four weeks to establish a dry eye mouse model. After successful modeling， the mice were randomly divided into five groups： Model group， sodium hyaluronate group， and Mimenghua prescription groups with low dose （4.83 g·kg^-1）， medium dose （9.67 g·kg^-1）， and high dose （19.34 g·kg^-1）. The mice in the model group received an equal volume of normal saline via gavage for four weeks. The mice in the sodium hyaluronate group received instillation of sodium hyaluronate eye drops twice daily for 14 consecutive days. The tear secretion volume， tear film break-up time （TBUT）， and corneal fluorescein staining were evaluated once every two weeks. After four weeks of administration， mice were euthanized， and their lacrimal gland tissues and corneas were harvested. Hematoxylin-eosin （HE） staining was used to assess histopathological morphology. Western blot was performed to detect the protein expression levels of MEK， Ras， Raf， and ERK. Enzyme-linked immunosorbent assay （ELISA） was used to measure the contents and expressions of MEK， Ras， Raf， ERK， and interleukin （IL）-1β in lacrimal gland and corneal tissues of the mice in each group. Quantitative real-time polymerase chain reaction （Real-time PCR） was employed to determine mRNA expression levels of MEK， Ras， Raf， and ERK. ResultsThe Mimenghua prescription groups and the sodium hyaluronate group exhibited significantly increased tear secretion volume （P<0.05） and prolonged TBUT （P<0.05） after treatment. Ocular surface damage of mice was visibly recovered. Western blot results indicated that protein expression levels of MEK， Ras， Raf， and ERK in the lacrimal gland and corneal tissues were significantly downregulated in the sodium hyaluronate group and Mimenghua prescription group with high dose （P<0.05）. ELISA results showed that IL-1β levels were highest in the model group but significantly reduced in the sodium hyaluronate group and Mimenghua prescription groups （P<0.05）. Both ELISA and Real-time PCR results demonstrated that the expression levels of MEK， Ras， Raf， and ERK in the lacrimal glands and corneal tissues were significantly elevated in the model group （P<0.05）， but markedly downregulated in the sodium hyaluronate group and Mimenghua prescription groups （P<0.05）， suggesting that Mimenghua prescription can decrease the expressions of MEK， Ras， Raf， and ERK in the lacrimal glands and corneal tissues. ConclusionMimenghua prescription can reduce inflammatory responses， increase tear secretion， prolong TBUT， and promote corneal recovery by inhibiting the MEK， Ras， Raf， and ERK signaling pathways in lacrimal gland and corneal tissues.

To analyze the transmission characteristics of newly reported HIV-infected students aged ≥18 years in Nanjing City from 2016 to 2022 and provide evidence for AIDS publicity and intervention among young students. The pol region sequences of newly reported HIV-infected students and non-student HIV-infected individuals in Nanjing City from 2016 to 2022 were collected, and the BLAST tool was used to search the published global non-Nanjing reported HIV infection sequences in the LANL HIV database. The basic molecular transmission network and regional molecular transmission network were constructed using the HIV-TRACE in a pairwise genetic distance threshold of 1.0%. 332 sequences of infected students aged≥18 years in Nanjing City, 1 904 sequences of non-student-infected individuals in Nanjing City and 1 698 non-Nanjing-infected individuals were obtained. Among the 332 infected students, the main route of infection was homosexual (96.39%), and the subtypes were CRF01_AE (37.95%), CRF07_BC (37.65%) and CRF105_0107 (10.24%). There were 890 sequences in the regional molecular transmission network, of which 21.80% were infected students in Nanjing City, 39.89% were non-student-infected individuals in Nanjing City, and 38.31% were non-Nanjing-infected individuals. In the CRF105_0107 transmission cluster, non-student-infected individuals from Nanjing accounted for 66.95% (81/121), while in the CRF07_BC transmission cluster, non-Nanjing-infected individuals accounted for 56.66% (200/353). There were 1 644 edges connected to infected students within the regional molecular transmission network, with local transmission accounting for 64.72% and regional transmission accounting for 35.28%. Regional transmission was mainly in Guangdong Province (19.83%) and other cities in Jiangsu Province (4.50%). The HIV-1 subtypes of newly reported HIV-infected students aged≥18 years in Nanjing City are mainly CRF01_AE, CRF07_BC and CRF105_0107, with local transmission as the main transmission characteristics. There is transmission between students and non-students.

To analyze the transmission characteristics of newly reported HIV-infected students aged ≥18 years in Nanjing City from 2016 to 2022 and provide evidence for AIDS publicity and intervention among young students. The pol region sequences of newly reported HIV-infected students and non-student HIV-infected individuals in Nanjing City from 2016 to 2022 were collected, and the BLAST tool was used to search the published global non-Nanjing reported HIV infection sequences in the LANL HIV database. The basic molecular transmission network and regional molecular transmission network were constructed using the HIV-TRACE in a pairwise genetic distance threshold of 1.0%. 332 sequences of infected students aged≥18 years in Nanjing City, 1 904 sequences of non-student-infected individuals in Nanjing City and 1 698 non-Nanjing-infected individuals were obtained. Among the 332 infected students, the main route of infection was homosexual (96.39%), and the subtypes were CRF01_AE (37.95%), CRF07_BC (37.65%) and CRF105_0107 (10.24%). There were 890 sequences in the regional molecular transmission network, of which 21.80% were infected students in Nanjing City, 39.89% were non-student-infected individuals in Nanjing City, and 38.31% were non-Nanjing-infected individuals. In the CRF105_0107 transmission cluster, non-student-infected individuals from Nanjing accounted for 66.95% (81/121), while in the CRF07_BC transmission cluster, non-Nanjing-infected individuals accounted for 56.66% (200/353). There were 1 644 edges connected to infected students within the regional molecular transmission network, with local transmission accounting for 64.72% and regional transmission accounting for 35.28%. Regional transmission was mainly in Guangdong Province (19.83%) and other cities in Jiangsu Province (4.50%). The HIV-1 subtypes of newly reported HIV-infected students aged≥18 years in Nanjing City are mainly CRF01_AE, CRF07_BC and CRF105_0107, with local transmission as the main transmission characteristics. There is transmission between students and non-students.

ObjectiveTo investigate the short-term knee function recovery of patients undergoing total knee arthroplasty (TKA) after discharge and analyze its related factors. MethodsFrom December, 2022 to April, 2023, 140 adult patients who underwent TKA in Nanjing Drum Tower Hospital and being about to be discharged were selected as the survey subjects using convenient sampling. Potential influencing factors were selected based on a literature review. They were investigated with general information questionnaire, Rehabilitation Exercise Compliance Scale, Self-Efficacy Scale for Rehabilitation Exercise (SER), Visual Analog Scale for pain (VAS), and joint range of motion measurements before discharge, and were investigated with the Hospital for Special Surgery Knee Score (HSS) one month after discharge. ResultsA total of 130 patients finished follow-up. One month after discharge, the HSS score ranged from 40 to 82, with an average of (70.89±6.26). Multiple linear regression analysis revealed that Body Mass Index (B = -0.423, 95%CI -0.622 to -0.224, P < 0.001), pre-discharge VAS (B = -1.016, 95%CI -1.198 to -0.113, P = 0.028), rehabilitation exercise compliance (B = 0.267, 95%CI 0.121 to 0.413, P < 0.001), SER (B = 0.478, 95%CI 0.315 to 0.642, P < 0.001), and knee joint flexion contracture angle (B = -0.251, 95%CI -0.414 to -0.088, P = 0.003) could influence HSS score one month after discharge (R² = 0.615, F =17.106, P < 0.001). ConclusionPatients after TKA have recovered well in short time after discharge, however, there is still significant room for improvement. Clinical healthcare providers should design and implement appropriate interventions based on related factors to improve the function.

Objective:To explore the occurrence of alexithymia in patients with functional constipation (FC) and its influence on the symptoms, anorectal function and treatment efficacy.Methods:From July 4, 2022 to September 30, 2023, a total of 118 FC patients who visited the outpatient Department of Gastroenterology, the First Affiliated Hospital of Nanjing Medical University and underwent high-resolution anorectal manometry (HR-ARM) were selected. According to twenty-item Toronto alexithymia scale, a total score of <51 was classified as without alexithymia, and a total score of ≥51 was classified as with alexithymia. The combination of osmotic laxatives and probiotic agents was used for the treatment for 4 weeks. The efficacy of the medication was compared before and after treatment in FC patients with and without alexithymia, as well as the scores of patient assessment of constipation-symptom (PAC-SYM), patient assessment of constipation-quality of life (PAC-QoL), self-rating anxiety scale (SAS), self-rating depression scale (SDS) and HR-ARM results.Independent sample t-test, Mann-Whitney U test and chi-square test were used for statistical analysis. Multivariate logistic regression analysis was performed to analyze the related factors affecting the efficacy of FC treatment. Results:Among the 118 FC patients, 43.2% (51/118) of FC patients had alexithymia, and 56.8% (67/118) of FC patients had no alexithymia. Among them, 43 patients without alexithymia and 32 patients with alexithymia completed the evaluation of treatment efficacy, respectively. There was no statistically significant difference in the frequency of spontaneous defecation before and after treatment in patients with alexithymia ( P>0.05). The frequency of complete spontaneous defecation after treatment was higher than that before treatment in FC patients without alexithymia (5.0 (3.0, 7.0) vs. 3.0 (2.0, 3.0)), and the increased times of total spontaneous defecation after treatment compared to before treatment in patients with alexithymia was less than that in patients without alexithymia (0.0 (0.0, 0.0) vs. -2.0 (-3.0, 0.0)), and the differences were statistically significant ( Z=-4.49 and -3.79, both P < 0.001). The scores of PAC-SYM, PAC-QoL, SAS and SDS in FC patients without alexithymia after treatment were all lower than those before treatment (2.0 (0.0, 8.0) vs. 14.0 (11.0, 16.0), 9.0 (1.1, 16.0) vs. 22.0 (18.0, 40.0), 26.0 (25.0, 30.0) vs. 29.0 (25.0, 34.0), 28.0 (26.0, 30.0) vs. 30.0 (29.0, 35.0)), and the differences were statistically significant ( Z=-5.24, -5.08, -3.60, and -5.21, all P<0.001). Among all the scores, only the PAC-SYM score after treatment was lower than that before treatment in FC patients with alexithymia (14.0 (9.5, 19.0) vs. 17.0 (12.5, 21.0)), and the difference was statistically significant ( Z=-2.66, P=0.008). The effective rate of FC patients without alexithymia was higher than that of patients with alexithymia (72.1%, 31/43 vs. 18.8%, 6/32), and the difference was significant ( χ2=22.09, P<0.001). The reduction of PAC-SYM, PAC-QoL, SAS and SDS scores in FC patients with alexithymia after treatment were all lower than those of FC patients without alexithymia (0.0 (0.0, 2.8) vs. 9.0 (2.0, 14.0), 0.0 (0.0, 0.8) vs. 15.0 (2.0, 19.0), 0.0 (-1.0, 1.0) vs. 0.0 (0.0, 4.0), 0.0 (0.0, 1.0) vs. 3.0 (1.0, 5.0)), and the differences were statistically significant ( Z=-4.24, -4.31, -2.59, and -4.60, all P<0.05). The results of multivariate logistic regression analysis showed that alexithymia was an independent risk factor of ineffective medication treatment of constipation in FC patients ( OR=8.930, 95% confidence interval 2.011 to 39.658, P=0.004). Conclusions:There is a high incidence of alexithymia in FC patients. Alexithymia affects the perception of symptoms and the efficacy of medication treatment of constipation in FC patients.

Objective:To explore the occurrence of alexithymia in patients with functional constipation (FC) and its influence on the symptoms, anorectal function and treatment efficacy.Methods:From July 4, 2022 to September 30, 2023, a total of 118 FC patients who visited the outpatient Department of Gastroenterology, the First Affiliated Hospital of Nanjing Medical University and underwent high-resolution anorectal manometry (HR-ARM) were selected. According to twenty-item Toronto alexithymia scale, a total score of <51 was classified as without alexithymia, and a total score of ≥51 was classified as with alexithymia. The combination of osmotic laxatives and probiotic agents was used for the treatment for 4 weeks. The efficacy of the medication was compared before and after treatment in FC patients with and without alexithymia, as well as the scores of patient assessment of constipation-symptom (PAC-SYM), patient assessment of constipation-quality of life (PAC-QoL), self-rating anxiety scale (SAS), self-rating depression scale (SDS) and HR-ARM results.Independent sample t-test, Mann-Whitney U test and chi-square test were used for statistical analysis. Multivariate logistic regression analysis was performed to analyze the related factors affecting the efficacy of FC treatment. Results:Among the 118 FC patients, 43.2% (51/118) of FC patients had alexithymia, and 56.8% (67/118) of FC patients had no alexithymia. Among them, 43 patients without alexithymia and 32 patients with alexithymia completed the evaluation of treatment efficacy, respectively. There was no statistically significant difference in the frequency of spontaneous defecation before and after treatment in patients with alexithymia ( P>0.05). The frequency of complete spontaneous defecation after treatment was higher than that before treatment in FC patients without alexithymia (5.0 (3.0, 7.0) vs. 3.0 (2.0, 3.0)), and the increased times of total spontaneous defecation after treatment compared to before treatment in patients with alexithymia was less than that in patients without alexithymia (0.0 (0.0, 0.0) vs. -2.0 (-3.0, 0.0)), and the differences were statistically significant ( Z=-4.49 and -3.79, both P < 0.001). The scores of PAC-SYM, PAC-QoL, SAS and SDS in FC patients without alexithymia after treatment were all lower than those before treatment (2.0 (0.0, 8.0) vs. 14.0 (11.0, 16.0), 9.0 (1.1, 16.0) vs. 22.0 (18.0, 40.0), 26.0 (25.0, 30.0) vs. 29.0 (25.0, 34.0), 28.0 (26.0, 30.0) vs. 30.0 (29.0, 35.0)), and the differences were statistically significant ( Z=-5.24, -5.08, -3.60, and -5.21, all P<0.001). Among all the scores, only the PAC-SYM score after treatment was lower than that before treatment in FC patients with alexithymia (14.0 (9.5, 19.0) vs. 17.0 (12.5, 21.0)), and the difference was statistically significant ( Z=-2.66, P=0.008). The effective rate of FC patients without alexithymia was higher than that of patients with alexithymia (72.1%, 31/43 vs. 18.8%, 6/32), and the difference was significant ( χ2=22.09, P<0.001). The reduction of PAC-SYM, PAC-QoL, SAS and SDS scores in FC patients with alexithymia after treatment were all lower than those of FC patients without alexithymia (0.0 (0.0, 2.8) vs. 9.0 (2.0, 14.0), 0.0 (0.0, 0.8) vs. 15.0 (2.0, 19.0), 0.0 (-1.0, 1.0) vs. 0.0 (0.0, 4.0), 0.0 (0.0, 1.0) vs. 3.0 (1.0, 5.0)), and the differences were statistically significant ( Z=-4.24, -4.31, -2.59, and -4.60, all P<0.05). The results of multivariate logistic regression analysis showed that alexithymia was an independent risk factor of ineffective medication treatment of constipation in FC patients ( OR=8.930, 95% confidence interval 2.011 to 39.658, P=0.004). Conclusions:There is a high incidence of alexithymia in FC patients. Alexithymia affects the perception of symptoms and the efficacy of medication treatment of constipation in FC patients.

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by repeated abdominal pain and changes in defecation habits, which seriously affects the quality of life of patients. The occurrence and development of IBS are affected by many factors. As an inherent component of the gastrointestinal tract, eosinophils play a role in maintaining the local homeostasis of intestine. The activation of intestinal eosinophils plays a direct or indirect role in the occurrence and development of IBS. This article reviewed the progress of research on the potential role of eosinophils in IBS.

Objective: To analyze the clinical epidemiological characteristics including composition of pathogens , clinical characteristics, and disease prognosis acute bacterial meningitis (ABM) in Chinese children. Methods: A retrospective analysis was performed on the clinical and laboratory data of 1 610 children <15 years of age with ABM in 33 tertiary hospitals in China from January 2019 to December 2020. Patients were divided into different groups according to age,<28 days group, 28 days to <3 months group, 3 months to <1 year group, 1-<5 years of age group, 5-<15 years of age group; etiology confirmed group and clinically diagnosed group according to etiology diagnosis. Non-numeric variables were analyzed with the Chi-square test or Fisher's exact test, while non-normal distrituction numeric variables were compared with nonparametric test. Results: Among 1 610 children with ABM, 955 were male and 650 were female (5 cases were not provided with gender information), and the age of onset was 1.5 (0.5, 5.5) months. There were 588 cases age from <28 days, 462 cases age from 28 days to <3 months, 302 cases age from 3 months to <1 year of age group, 156 cases in the 1-<5 years of age and 101 cases in the 5-<15 years of age. The detection rates were 38.8% (95/245) and 31.5% (70/222) of Escherichia coli and 27.8% (68/245) and 35.1% (78/222) of Streptococcus agalactiae in infants younger than 28 days of age and 28 days to 3 months of age; the detection rates of Streptococcus pneumonia, Escherichia coli, and Streptococcus agalactiae were 34.3% (61/178), 14.0% (25/178) and 13.5% (24/178) in the 3 months of age to <1 year of age group; the dominant pathogens were Streptococcus pneumoniae and the detection rate were 67.9% (74/109) and 44.4% (16/36) in the 1-<5 years of age and 5-<15 years of age . There were 9.7% (19/195) strains of Escherichia coli producing ultra-broad-spectrum β-lactamases. The positive rates of cerebrospinal fluid (CSF) culture and blood culture were 32.2% (515/1 598) and 25.0% (400/1 598), while 38.2% (126/330)and 25.3% (21/83) in CSF metagenomics next generation sequencing and Streptococcus pneumoniae antigen detection. There were 4.3% (32/790) cases of which CSF white blood cell counts were normal in etiology confirmed group. Among 1 610 children with ABM, main intracranial imaging complications were subdural effusion and (or) empyema in 349 cases (21.7%), hydrocephalus in 233 cases (14.5%), brain abscess in 178 cases (11.1%), and other cerebrovascular diseases, including encephalomalacia, cerebral infarction, and encephalatrophy, in 174 cases (10.8%). Among the 166 cases (10.3%) with unfavorable outcome, 32 cases (2.0%) died among whom 24 cases died before 1 year of age, and 37 cases (2.3%) had recurrence among whom 25 cases had recurrence within 3 weeks. The incidences of subdural effusion and (or) empyema, brain abscess and ependymitis in the etiology confirmed group were significantly higher than those in the clinically diagnosed group (26.2% (207/790) vs. 17.3% (142/820), 13.0% (103/790) vs. 9.1% (75/820), 4.6% (36/790) vs. 2.7% (22/820), χ²=18.71, 6.20, 4.07, all P<0.05), but there was no significant difference in the unfavorable outcomes, mortility, and recurrence between these 2 groups (all P>0.05). Conclusions: The onset age of ABM in children is usually within 1 year of age, especially <3 months. The common pathogens in infants <3 months of age are Escherichia coli and Streptococcus agalactiae, and the dominant pathogen in infant ≥3 months is Streptococcus pneumoniae. Subdural effusion and (or) empyema and hydrocephalus are common complications. ABM should not be excluded even if CSF white blood cell counts is within normal range. Standardized bacteriological examination should be paid more attention to increase the pathogenic detection rate. Non-culture CSF detection methods may facilitate the pathogenic diagnosis.
Adolescent ; Brain Abscess ; Child ; Child, Preschool ; Escherichia coli ; Female ; Humans ; Hydrocephalus ; Infant ; Infant, Newborn ; Male ; Meningitis, Bacterial/epidemiology* ; Retrospective Studies ; Streptococcus agalactiae ; Streptococcus pneumoniae ; Subdural Effusion ; beta-Lactamases

Objective:To investigate the nutritional status of elderly inpatients in China, and to assess its relationship with clinical outcomes.Methods:A prospective, multicenter, parallel investigation was organized and conducted by the Chinese Medical Association's Group of Geriatric Nutrition Support.Patients aged ≥65 years from 30 major hospitals of 14 cities in China were evaluated by the Nutritional Risk Screening 2002(NRS2002)and the Mini-Nutritional Assessment-Short Form(MNA-SF), in order to understand the nutritional status and nutritional risk of elderly inpatients in China.The indicators of clinical outcomes were summarized, and the correlation between nutritional status and clinical outcomes was analyzed.Results:A total of 10 184 elderly patients who met the inclusion criteria were enrolled in this study, aged 65-112(74.81±7.01)years, with a body mass index(BMI)of 17.80-35.50(23.32±3.83)kg/m 2.Grip strength of the dominant hand was(16.95±18.42)kg, upper arm circumference was(25.68±3.70)cm, and calf circumference was(32.07±3.89)cm.BMI, grip strength, upper arm circumference and calf circumference decreased significantly with age( F=13.74, 97.47, 28.31 and 88.68, all P<0.001). NRS2002 was conducted on 10 182 patients.Of them, 10.14%(895/10 182)suffered malnutrition(BMI≤18.5 kg/m 2), and 46.42%(4 726/10 182)were at nutritional risk(NRS2002 score≥3). Nutrition deficiency and nutritional risk showed upward trends with age( F=43.41 and 177.05, both P<0.001). A total of 9 755 patients(95.79%, 9 755/10 182)completed the MNA-SF.Of them, 14.67%(1 431/9 755)had malnutrition, 35.04%(3 418/9 755)were at risk of malnutrition, and 50.29%(4 906/9 755)had normal nutritional status.The incidence of malnutrition and the risk of malnutrition significantly increased with age( F=172.79, 12.10 and 152.42, all P<0.05). Nutritional risk(NRS2002 score≥3)was related to age, BMI, mortality, infectious complications, length of hospital stay and total hospital cost(all P<0.05). Conclusions:The incidence of malnutrition and the risk of malnutrition are high in elderly inpatients in China.Nutritional risk is an influencing factor for adverse clinical outcomes.

Objective:To investigate the clinical efficacy, safety and tolerance of different enteral nutritional therapy in the treatment of moderately severe acute pancreatitis (MSAP).Methods:From January 2018 to January 2019, 65 patients with MSAP who were hospitalized in Beijing Chao-Yang Hospital, Capital Medical University were prospectively enrolled. According to random number table, the patients were divided into the nasogastric tube enteral nutrition (NGEN) group (35 cases) and the nasojejunal tube enteral nutrition (NJEN) group (30 cases). All the patients received enteral nutrition solution through continuously pumping at a constant speed for 24 h. The two groups were compared in the relief time of abdominal pain, time from admission to receiving enteral nutrition treatment, time to resume oral feeding, computed tomography severity index (CTSI) score 1 week after enteral nutrition, nutrition status, infection parameters, hospitalization time, hospitalization expenses and complications. Independent sample t test and rank sum test of two independent samples were used for statistical analysis. Results:There were no significant differences in age, gender, body mass index (BMI), CTSI score and Ranson score at admission, relief time of abdominal pain, time from admission to receiving enteral nutrition treatment, time to resume oral feeding, CTSI score one week after enteral nutrition or hospitalization time between NGEN group and NJEN group (all P>0.05), and there was no death in both groups. The cost of hospitalization, catheterization time, cost of catheterization of NGEN group were all lower than those of NJEN group ((40.0±10.0) thousand yuan vs. (40.4±9.0) thousand yuan; 2.00 min (1.50 min, 2.50 min) vs. 11.50 min (9.50 min, 12.75 min); 135.42 yuan (135.42 yuan, 135.42 yuan) vs. 1 313.30 yuan (1231.20 yuan, 1 823.72 yuan)), and the differences were statistically significant ( t=2.342, Z=6.737 and 7.687, all P<0.01). The albumin levels of MSAP patients of the NGEN group at admission and 1 week after enteral nutrition were both higher than those of NJEN group ((43.5±5.1) g/L vs. (41.0±4.0) g/L, (42.1±4.1) g/L vs. (39.5±4.4) g/L), and the differences were statistically significant ( t=2.135 and 2.486, P=0.04 and 0.02), however there was no statistically significant difference in the decrease of albumin level between the two groups ( P>0.05). There were no statistically significant differences in the incidence of nutrition-related complications (abdominal distension, diarrhea, gastric retention and lumen obstruction) or the incidence of severe complications (transient organ failure and pancreatic necrosis complicated with infection) between NGEN group and NJEN group (all P>0.05). Conclusions:The efficacy and safety of NGEN are equivalent to NJEN in MSAP. Moreover, it can reduce the medical expenses of patients, and it is convenient to carry out in primary hospitals because of its easy operation.