Esophageal cancer is a prevalent malignant tumor of the digestive tract in China, and radical surgery remains the cornerstone of its comprehensive treatment. However, multifactorial challenges such as postoperative gastrointestinal tract reconstruction, traumatic stress, and tumor-related metabolic disturbances render esophageal cancer patients highly susceptible to malnutrition. Perioperative nutritional support therapy plays a crucial role in enhancing surgical safety, improving clinical outcomes, and elevating patients' quality of life by regulating metabolic homeostasis, preserving organ function, and optimizing the immune microenvironment. This article reviews the mechanisms underlying malnutrition in esophageal cancer, methods for nutritional status assessment, and precision intervention pathways based on multi-omics evaluations. The aim is to strengthen clinicians' awareness of standardized perioperative nutritional management for esophageal cancer patients and promote its clinical implementation, thereby facilitating postoperative recovery and improving long-term quality of life.

OBJECTIVE To compare the efficacy and safety of different classes of antibacterial agents in hospitalized adult patients with community-acquired pneumonia （CAP）.METHODS PubMed， Embase，the Cochrane Library，Web of Science，CNKI，and Wanfang data were searched from inception to January 1，2026，to identify randomized controlled trials that evaluated different classes of antibacterial agents in hospitalized adults with CAP.After screening the literature， extracting the data， and evaluating the quality of the literature， a network meta-analysis was performed using Stata 18.0.RESULTS A total of 25 studies were included，involving 7 863 patients. In terms of efficacy，compared with carbapenems，penicillins，cephalosporins，macrolides，and pleuromutilins were associated with significantly higher treatment failure rates （ P ＜0.05），carbapenems and traditional tetracyclines were ranked as the top two by the surface under the cumulative ranking curve area （SUCRA）. No statistically significant differences were observed in mortality among the interventions （ P ＞0.05），carbapenems and other quinolones were ranked as the top two by SUCRA. In terms of safety，no statistically significant differences were observed among the interventions in the incidence of adverse events or discontinuation rates （ P ＞0.05）；traditional tetracyclines and novel tetracyclines were ranked as the top two by SUCRA for the incidence of adverse events，while novel tetracyclines and pleuromutilins were ranked as the top two by SUCRA for discontinuation rates.CONCLUSIONS Carbapenems significantly reduced the treatment failure rate in hospitalized adults with CAP. The safety profiles of all antibacterial agents were comparable， with novel tetracyclines showing a more favorable safety profile.

Objective:To assess the levels and abnormal rates of trace elements and vitamins among older patients in Beijing Hospital, and to analyze the correlations between these measured indicators.Methods:This study selected 49 older individuals who underwent physical examinations at Beijing Hospital between May 2021 and March 2024.The participants were divided into two age groups: 60-79 years old(23 cases)and 80-100 years old(26 cases). Levels' differences of trace elements and vitamins between the two age groups were analyzed.Pearson correlation analysis was used to investigate the correlations among the tested indicators, and multivariate analysis was conducted using a generalized linear regression model.Results:Among the 49 older individuals, the overall abnormal rate for trace element test results was 8.16%(4 cases), with 2 cases of iron(Fe)deficiency(4.08%)and 2 cases of calcium(Ca)deficiency(4.08%). The overall abnormal rate for vitamin test results was 24.49%(12 cases), which included 5 cases of vitamin B2 deficiency(10.20%), 1 case of vitamin C deficiency(2.04%), and 6 cases of vitamin D deficiency(12.24%). Statistically significant differences were observed between the two age groups in zinc(Zn)and vitamin C levels( t=2.84, 2.83; P=0.007, 0.007). Pearson correlation analysis revealed correlations among 19 pairs of indicators.The top five correlations were between plumbum(Pb)and cadmium(Cd)( r=0.769, P<0.001), Fe and manganese(Mn)( r=0.685, P<0.001), Ca and magnesium(Mg)( r=0.677, P<0.001), vitamin B12 and vitamin C( r=0.455, P=0.001), and vitamin B9 and vitamin D( r=0.422, P=0.003), respectively.The results of the multivariate analysis indicated that, after adjusting for the effects of age group and gender, statistical differences in correlations remained among the remaining trace elements and vitamins, except for those between vitamin B1 and vitamin B12, vitamin B1 and vitamin C, and vitamin A and vitamin D (all P<0.05). Conclusions:The deficiency rates of trace elements and vitamins remain notably high among older patients in our hospital, underscoring the necessity for enhanced nutritional supplementation and regular monitoring of trace element and vitamin levels within this population.Furthermore, a correlation exists between trace elements and vitamins, which offers valuable insights for the diagnosis and treatment of related diseases.

Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T _NANC), time to symptom improvement (T _SI), and time of hospital stay (T _HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T _NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.

Quality marker (Q-Marker) is an innovative concept and model for quality control of Traditional Chinese medicines (TCMs), which will navigate the new direction of quality development of TCMs. Yet, how to characterize the overall quality attributes of TCMs and their biological effects is still debating. In view of this key scientific issue, this paper proposes a research method based on mass spectrometry imaging (MSI) technology for the discovery and confirmation of TCMs Q-Marker. MSI is powerful in investigating the spatial distribution of molecules in a variety of samples, and visualizing the information obtained from MS. On this basis, combine with the five principles of TCMs Q-Marker validation, i.e., specificity, transmission and traceability, testability, prescription compatibility, and validity, were applied to confirm the finalized Q-Marker. It will lead the new direction of quality development of TCMs.

Objective:To develop and validate a diagnostic model for pancreatic benign and malignant tumors using radiomics technology.Methods:A retrospective analysis was conducted on the clinical data of 113 patients with pancreatic tumors who underwent surgical treatment at the Hepatobiliary and Pancreatic Surgery Departments of the Second Hospital and the First Hospital of Hebei Medical University from January 2020 to December 2022. There were 59 male and 54 female patients, aged (55.3±16.8) years. Preoperative enhanced thin-slice computed tomography (CT) data and postoperative pathological diagnosis results were collected. Data from 74 patients at the Second Hospital were selected, and according to the random classification principle of 7∶3, the data of 52 patients were determined as the training set for model construction, while the remaining 22 patients' data served as the internal validation set. Data from 39 patients at the First Hospital of Hebei Medical University were used as the external validation set to assess the generali-zability of the established model. The region of interest in the lesions on CT images was analyzed using three-dimensional radiomics feature extraction, and the top 5 features were selected using feature selection methods. Radiomics models were established for the selected features using 17 classifiers. The performance of the models was evaluated using the area under curve (AUC) of the receiver operating characteristic (ROC).Results:Two hundred and fifty-five models were established with 15 feature selection methods and 17 classifiers. 7 models with the AUC greater than 0.7 were selected, among which the best one was LASSO-K neighbors classifier model, constructed using the LASSO feature selection method and the k-nearest neighbors algorithm, achieving AUC values of 0.933 (95% CI: 0.859-0.984) in the training set, 0.973 (95% CI: 0.896-1.000) in the validation set, and 0.774 (95% CI: 0.624-0.908) in the external validation set, with satisfactoryclassification and generalization ability. Conclusion:The radiomics-based diagnostic model for pancreatic benign and malignant tumors can effectively distinguish the benignancy and malignancy of tumors. The LASSO-K neighbors classifier model demonstrated high accuracy and reliability in this study.

Objective:To assess the levels and abnormal rates of trace elements and vitamins among older patients in Beijing Hospital, and to analyze the correlations between these measured indicators.Methods:This study selected 49 older individuals who underwent physical examinations at Beijing Hospital between May 2021 and March 2024.The participants were divided into two age groups: 60-79 years old(23 cases)and 80-100 years old(26 cases). Levels' differences of trace elements and vitamins between the two age groups were analyzed.Pearson correlation analysis was used to investigate the correlations among the tested indicators, and multivariate analysis was conducted using a generalized linear regression model.Results:Among the 49 older individuals, the overall abnormal rate for trace element test results was 8.16%(4 cases), with 2 cases of iron(Fe)deficiency(4.08%)and 2 cases of calcium(Ca)deficiency(4.08%). The overall abnormal rate for vitamin test results was 24.49%(12 cases), which included 5 cases of vitamin B2 deficiency(10.20%), 1 case of vitamin C deficiency(2.04%), and 6 cases of vitamin D deficiency(12.24%). Statistically significant differences were observed between the two age groups in zinc(Zn)and vitamin C levels( t=2.84, 2.83; P=0.007, 0.007). Pearson correlation analysis revealed correlations among 19 pairs of indicators.The top five correlations were between plumbum(Pb)and cadmium(Cd)( r=0.769, P<0.001), Fe and manganese(Mn)( r=0.685, P<0.001), Ca and magnesium(Mg)( r=0.677, P<0.001), vitamin B12 and vitamin C( r=0.455, P=0.001), and vitamin B9 and vitamin D( r=0.422, P=0.003), respectively.The results of the multivariate analysis indicated that, after adjusting for the effects of age group and gender, statistical differences in correlations remained among the remaining trace elements and vitamins, except for those between vitamin B1 and vitamin B12, vitamin B1 and vitamin C, and vitamin A and vitamin D (all P<0.05). Conclusions:The deficiency rates of trace elements and vitamins remain notably high among older patients in our hospital, underscoring the necessity for enhanced nutritional supplementation and regular monitoring of trace element and vitamin levels within this population.Furthermore, a correlation exists between trace elements and vitamins, which offers valuable insights for the diagnosis and treatment of related diseases.

Objective:To develop and validate a diagnostic model for pancreatic benign and malignant tumors using radiomics technology.Methods:A retrospective analysis was conducted on the clinical data of 113 patients with pancreatic tumors who underwent surgical treatment at the Hepatobiliary and Pancreatic Surgery Departments of the Second Hospital and the First Hospital of Hebei Medical University from January 2020 to December 2022. There were 59 male and 54 female patients, aged (55.3±16.8) years. Preoperative enhanced thin-slice computed tomography (CT) data and postoperative pathological diagnosis results were collected. Data from 74 patients at the Second Hospital were selected, and according to the random classification principle of 7∶3, the data of 52 patients were determined as the training set for model construction, while the remaining 22 patients' data served as the internal validation set. Data from 39 patients at the First Hospital of Hebei Medical University were used as the external validation set to assess the generali-zability of the established model. The region of interest in the lesions on CT images was analyzed using three-dimensional radiomics feature extraction, and the top 5 features were selected using feature selection methods. Radiomics models were established for the selected features using 17 classifiers. The performance of the models was evaluated using the area under curve (AUC) of the receiver operating characteristic (ROC).Results:Two hundred and fifty-five models were established with 15 feature selection methods and 17 classifiers. 7 models with the AUC greater than 0.7 were selected, among which the best one was LASSO-K neighbors classifier model, constructed using the LASSO feature selection method and the k-nearest neighbors algorithm, achieving AUC values of 0.933 (95% CI: 0.859-0.984) in the training set, 0.973 (95% CI: 0.896-1.000) in the validation set, and 0.774 (95% CI: 0.624-0.908) in the external validation set, with satisfactoryclassification and generalization ability. Conclusion:The radiomics-based diagnostic model for pancreatic benign and malignant tumors can effectively distinguish the benignancy and malignancy of tumors. The LASSO-K neighbors classifier model demonstrated high accuracy and reliability in this study.

Objective:To investigate the correlation between miR-137 gene polymorphism and genetic susceptibility to gestational diabetes mellitus.Methods:A total of 500 pregnant women with gestational diabetes who were admitted to Shunde Women and Childrens Hospital of Guangdong Medical University from January 2023 to September 2023 were selected as the observation group, and 500 healthy pregnant women with normal glucose metabolism and no pregnancy complications were selected as the control group. Polymerase chain reaction (PCR) was used to detect rs1625579 polymorphisms of miR-137 gene between the two groups, and the clinical data of the two groups were compared to analyze the influencing factors of the occurrence of gestational diabetes mellitus.Results:The frequencies of GT+ GG genotype and allele G at rs1625579 site of miR-137 gene in observation group were 13.20% and 7.00%, respectively, which were significantly higher than those in control group (all P<0.05). Fasting blood glucose (FPG), fasting insulin (FINS) and insulin resistance index (HOMA-IR) of miR-137 genotype GT+ GG pregnant women in the observation group were (7.92±0.81)mmol/L, (19.92±3.10)mmol/L and 6.60±1.02, respectively. It was significantly higher than genotypic TT pregnant women (all P<0.05), and islet β cell function index (HOMA-β) was significantly lower than genotypic TT pregnant women (188.84±43.34) ( P<0.05). Pre-pregnancy body mass index (BMI) and average weekly weight gain during pregnancy in the observation group were (23.81±1.92)kg/m 2 and (445.50±35.65)g, respectively, which were significantly higher than those in the control group (all P<0.05). The proportion of family history of diabetes in the observation group was 8.60%, which was significantly higher than that in the control group ( P<0.05). Logistic regression analysis showed that preconception BMI and average weekly weight gain during pregnancy were the influential factors for the occurrence of gestational diabetes (all P<0.05). Conclusions:The occurrence of gestational diabetes mellitus has no significant correlation with miR-137 gene polymorphism, but is related to pre-pregnancy BMI and average weekly weight gain during pregnancy. Compared with other miR-137 genotypes, GT+ GG patients were more likely to develop abnormal blood glucose.