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.

Trace elements and vitamins are essential micronutrients for metabolism.Micronutrients deficiency results in adverse effects on human body,and brings huge challenge to clinical nutrition therapy.To normalize micronutrients application in clinical practice,European Society for Clinical Nutrition and Metabolism(ESPEN)published ESPENpractical short micronutrient guideline on January 2024.Based on previous version published in 2022,current guideline shortens the interpretation of biochemical and physical mechanisms,focuses on micronutrients deficiency and inflammation,recommends the methods of micronutrients assessment and supplementation in different statuses during clinical practices.This paper summarizes specific recommendations and comments for domestic peers to communicate,and provides reference for the management of micronutrient therapy in China.

Objective:To investigate the influence of nutritional therapy on short-term efficacy of gastric cancer patients with malnutrition after radical gastrectomy.Methods:The prospec-tive randomized control study was conducted. The clinicopathological data of patients with malnutri-tion after radical resection of gastric cancer who were admitted to the Zhongshan Hospital of Fudan University from December 2020 to December 2022 were selected. Based on random number table, all patients were allocated into the nutritional therapy group and the control group. Patients in the nutritional therapy group were given dietary guidance and daily oral nutrition supplements for 90 days after discharge, while patients in the control group were only given the same dietary guidance. Observation indicators: (1) grouping situations of the enrolled patients; (2) follow-up; (3) comparison of nutritional indicators at 90 days after discharge; (4) comparison of inflammation and physical function indicators at 90 days after discharge; (5) comparison of clinical outcome indicators at 90 days after discharge. Measurement data with normal distribution were expressed as Mean± SD, and independent sample t test was used for comparison between groups. Measurement data with skewed distribution were expressed as M(IQR), and non-parameter rank sum test was used for comparison between groups. Count data were expressed as absolute numbers or percentages, and chi-square test was used for comparison between groups. Comparison of ordinal data was conducted using the chi-square test. Results:(1) Grouping situations of the enrolled patients. A total of 187 patients were selected for eligibility. There were 131 males and 56 females, aged (65±12)years. Of the 187 patients, there were 95 patients in the nutritional therapy group and 92 patients in the control group, respectively. The gender (male, female), age, cases with cardiovascular complications, cases with respiratory complications, cases with diabetes, surgical methods (partial gastrectomy, total gastrectomy), tumor staging (Ⅰ stage, Ⅱ stage, Ⅲ stage), body mass, body mass index (BMI), skeletal muscle index, albumin (Alb), hemoglobin (Hb), neutrophil-to-lymphocyte ratio (NLR), 6-minutes walking distance, grip strength were 68, 27, (64±12)years, 21, 4, 7, 59, 36, 17, 27, 51, (59±11)kg, (21.5±3.1)kg/m 2, (42±7)cm 2/m 2, (39±5)g/L, (112±25)g/L, 2.3(8.0), (456±97)m, (29±8)kg in patients of the nutritional therapy group, versus 63, 29, (66±13)years, 22, 3, 9, 56, 36, 14, 24, 54, (58±11)kg, (21.1±2.9)kg/m 2, (42±7)cm 2/m 2, (39±4)g/L, (111±26)g/L, 2.2(8.4), (459±98)m, (29±8)kg in patients of the control group, showing no significant difference in the above indicators between the two groups ( χ2=0.21, t=-1.29, χ2=0.09, 0, 0.35, 0.03, 0.51, t=0.80, 0.85, 0.19, 0.14, 0.16, Z=-0.28, t=-0.17, 0.43, P>0.05). (2) Follow-up. All 187 patients were followed up for 90 days after surgery. During the follow-up period, all patients had good compliance and were able to follow the dietary guidance. Five patients in the nutrition therapy group experienced diarrhea and nausea adverse reactions, which were relieved after symptomatic treatment. No adverse reactions were found in the control group. (3) Comparison of nutritional indicators at 90 days after discharge. The body mass, body mass loss, BMI, skeletal muscle index, Alb, Hb were (58±10)kg, 2(6)kg, (21.0±2.9)kg/m 2, (41±7)cm 2/m 2, (41±4)g/L, (125±18)g/L in patients of the nutritional therapy group, versus (56±10)kg, 3(6)kg, (20.4±2.7)kg/m 2, (39±7)cm 2/m 2, (41±4)g/L, (121±21)g/L in patients of the control group. There were significant differences in body mass loss and skeletal muscle index between the two groups ( Z=-4.70, t=2.39, P<0.05), and there was no significant difference in body mass, BMI, Alb, and Hb ( t=1.30, 1.51, 0.80, 1.32, P>0.05). (4) Comparison of inflammation and body function indicators at 90 days after discharge. The NLR, 6-minutes walking distance, grip strength were 2.1(5.1), (478±99)m, and (33±9)kg in patients of the nutritional therapy group, versus 2.2(5.7), (465±96)m, (30±8)kg in patients of the control group. There was a significant difference in grip strength between the two groups ( t=2.08, P<0.05), and there were no significant difference in NLR and 6-minutes walking distance ( Z=-1.28, t=0.91, P>0.05). (5) Comparison of clinical outcome indicators at 90 days after discharge. The quality of life score and readmission rate were (79±14)points, 4.2%(4/95) in patients of the nutritional therapy group, versus (78±16)points, 6.5%(6/92) in patients of the control group, showing no significant difference in the above indicators between the two groups ( t=0.58, χ2=0.14, P>0.05). Conclusion:Nutritional therapy with daily oral nutrition supplements can improve the short-term nutritional status and body function of patients with malnutrition after radical gastrectomy for gastric cancer.

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.

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.

Urothelial carcinoma associated 1 (UCA1) is a kind of long non-coding RNA (lncRNA),which has no capacities for coding proteins.UCA1 over-expresses in diverse tumors,and plays a pivotal role in initiation and progression of tumors.Researches indicate that UCA1 may function as an oncogene in gastrointestinal tumors,such as gastric cancer,colorectal cancer and hepatocellular cancer,and participate in regulating cell proliferation,metastasis and chemo-resistance.

Biliary tract infection is the most commonly seen severe complication of malignant obstructive jaundice (MOJ)with a high mortality rate. Bile bacterial infection in MOJ patients is related with a variety of clinical factors and the therapeutic approaches including surgical operation,ERCP and percutaneous transhepatic cholangial drainage( PTCD). Bile bacterial culture combined with drug sensitivity test is of great importance for selection of optimal antibacterial agents. In this article,the related factors,current status of therapeutics,biliary bacterial spectrum and drug sensitivity in MOJ with biliary tract infection were reviewed for defining the clinical indicators and guiding the use of antibacterial agents.

AIM:To investigate the effect of atorvastatin on myocardial apoptosis , ventricular remodeling and cardiac function after acute myocardial infarction (AMI) in diabetic rats, and to explore whether the effect is mediated by hepatocyte growth factor ( HGF)/c-Met signaling pathway .METHODS:Diabetes in 70 male SD rats was induced by in-traperitoneal injection of streptozotocin (STZ, 65 mg/kg).After 8 weeks, AMI was induced by the ligation of the left ante-rior descending coronary artery in the diabetic rats , and 32 surviving rats were divided into AMI group (n=16) and AMI+atorvastatin group ( n=16, 20 mg· kg -1 · d-1 ) at random.The similar surgical procedure was completed in sham group (n=11) without coronary ligation.Atorvastatin was given daily by gavage from the first day after AMI .Two weeks later, the cardiac function , pathological changes of myocardial tissues , myocardial apoptosis , and the expression of HGF and c-Met were compared among groups .RESULTS: AMI significantly reduced cardiac function , increased collagen volume fraction ( CVF) and myocardial apoptotic index , and up-regulated the expression of HGF and c-Met at mRNA and protein levels in AMI control group (P<0.05).The cardiac function was improved , and CVF and myocardial apoptotic index were reduced by the treatment with atorvastatin , which also up-regulated the expression of HGF and c-Met (P<0.05).CON-CLUSION:Atorvastatin significantly attenuates myocardial apoptosis and cardiac remodeling , and improves cardiac func-tion after AMI in diabetic rats by further enhancing the activation of HGF /c-Met pathway .

Objective: To investigate the expression of microRNA-100 (miR-100) in the serum of gastric cancer patients and its clinical significance. Methods: At The First Affiliated Hospital of Bengbu Medical College, 40 gastric cancer patients who underwent surgery with complete follow-up data and 40 healthy controls were selected as research subjects. Total miRNA was isolated from the se-rum samples of the cancer patients. A stable and sensitive detection method for the absolute quantification of miR-100 was established. The serum levels of miR-100 in the patients and healthy controls were tested according to this novel method. Differences of the miR-100 expression in the serum samples of the patients and healthy controls were analyzed using statistical analysis. The correlation between miR-100 expression levels and the clinicopathological features of gastric cancer was also analyzed. Results: The expression level of miR-100 in the serum was significantly higher in cancer patients[(2.78±1.92) fmol/L]than in the healthy controls[(0.19± 0.15) fmol/L, P<0.01]. The receiver operating characteristic curve of miR-100 indicated that serum miR-100 has satisfactory specificity and sensitivity for the diagnosis of gastric cancer (AUC=0.985). Further analytical results indicated that no significant differences were found among the expression levels of serum miR-100 with respect to the gender, age, tumor diameter, infiltrating depth, differentiation degree, frequency of lymph-node metastasis, and TNM stage (P>0.05). Conclusion: Serum miR-100 testing may be helpful in the diag-nosis of gastric cancer.

Objective To investigate the diagnostic value of detection of protein SP70 in differentiating benign and malignant pleural effusion.Methods A case-control study was conducted from July 2011 to February 2012.108 cases of pleural effusion from patients with clinically proven lung cancers and 122 cases of benign pleural effusion were collected.SP70 was detected by Sandwich ELISA,while CEA,CYFRA21-1,NSE were measured by electrochemiluminescence immunoassay for comparison.Meanwhile,protein SP70 on exfoliated cells in pleural effusion was detected by direct immunofluorescence,and was compared with the results of HE staining.The differences between the groups were evaluated by the chisquare test Fisher' s exact test.Results Positive rates of SP70,CEA,CYFRA21-1,NSE were 72.2％,58.3％,52.8％ and 30.6％ in malignant pleural effusion,obviously higher than benign pleural effusio (9.8％,13.1％,23.0％ and 19.7％).The specificity of SP70,CEA,CYFRA21-1,NSE were 90.2％,86.9％,77.0％ and 80.3％,NSCLC had significantly higher positive rate than SCLC(74.3％ ＞0.0％,P =0.02 ＜ 0.05),detection of protein SP70 in malignant pleural effusion had significantly higher coincidence rate than HE staining(72.2％ vs 47.2％,x2 =14.03,P ＜ 0.05).Conclusion Determination of the protein SP70 in pleural effusion and in exfoliated cells,can improve the sensitivity and specificity of the diagnosis of malignant pleural effusion.