Acute lung injury represents the most probable organ injury in the context of severe acute pancreatitis, with the exception of the pancreas, which is primarily distinguished by respiratory insufficiency, manifested as shortness of breath, cyanosis, and diminished lung compliance. Nevertheless, the precise pathogenesis remains incompletely elucidated. Despite the administration of protective measures, the quality of life of patients with severe acute pancreatitis complicated by acute lung injury remains adversely affected.

To systematically evaluate the risk factors of severe acute pancreatitis complicated with acute lung injury.

Computer searches were conducted on CNKI, Wanfang database, VIP, PubMed, Web of Science and EBSCO databases to search relevant studies on the risk factors of severe acute pancreatitis complicated with lung injury from the establishment of the database to October 2023. Two researchers independently screened literature, extracted data, evaluated literature quality and evidence level, and conducted meta-analysis using RevMan 5.3 software. Begg's test in Stata17.0 was used for publication bias analysis.

A total of 10 studies were included, all of which were case-control studies, including 1 053 patients with severe acute pancreatitis. The results of meta-analysis showed that increased age (SMD=0.58, 95%CI=0.03-1.14, P=0.04), elevated fasting blood glucose (SMD=0.45, 95%CI=0.27-0.64, P<0.000 01), and an elevated respiratory rate (>30 breaths/min) (OR=6.18, 95%CI=3.20-11.94, P<0.000 01), the occurrence of fever (OR=12.92, 95%CI=4.41-37.84, P<0.000 01), the occurrence of pleural effusion (OR=7.19, 95%CI=3.25-15.91, P<0.000 01), decreased albumin (SMD=-0.77, 95%CI=-0.98 to -0.56, P<0.000 01), combined with obesity (OR=3.11, 95%CI=1.94-4.98, P<0.000 01), decreased calcium ion (SMD=-0.63, 95%CI=-0.85 to -0.42, P<0.000 01), combined with acidosis (OR=2.15, 95%CI=1.03-4.49, P=0.04), elevated C-reactive protein (SMD=0.79, 95%CI=0.56-1.03, P<0.000 01), decreased hemoglobin (SMD=-0.77, 95%CI=-1.10 to -0.43, P<0.000 01), elevated blood amylase (SMD=0.21, 95%CI=0.01-0.42, P=0.04), increased urinary amylase (SMD=0.40, 95%CI=0.03-0.77, P=0.03), elevated Ranson score (SMD=0.87, 95%CI=0.66-1.08, P<0.000 01), a rise in APACHE Ⅱ score (SMD=0.77, 95%CI=0.58-0.96, P<0.000 01), increased CT severity index score (SMD=0.39, 95%CI=0.19-0.59, P<0.000 01), elevated BISAP (SMD=0.62, 95%CI=0.37-0.88, P<0.000 01), severe acute pancreatitis with hyperlipidemia (OR=1.68, 95%CI=1.05-2.67, P=0.03), combined with SIRS (OR=9.57, 95%CI=4.03-22.72, P<0.000 01), number of organ injury (≥2) (OR=6.94, 95%CI=3.34-12.59, P<0.000 01), the occurrence of infection (OR=4.59, 95%CI=2.42-8.71, P<0.000 01) were risk factors for severe acute pancreatitis complicated with acute lung injury. The results of the publication bias analysis demonstrated that no significant publication bias was observed for the 14 factors (age, obesity, glucose, albumin, calcium ions, C-reactive protein, serum amylase, respiratory rate, Ranson score, APACHE Ⅱ score, CT severity index score, BISAP, hyperlipidemicity and pleural effusion) for which the analyses were conducted (P>0.05). The GRADE evidence evaluation demonstrated that a total of 11 risk factors (age, respiratory rate, pleural effusion, obesity, hemoglobin, serum amylase, urinary amylase, Ranson score, BISAP, hyperlipidemicity and organ damage) exhibited moderate quality, while 10 (fasting blood glucose, fever, albumin, calcium ions, acidosis, C-reactive protein, APACHE Ⅱ score, CT severity Index score, SIRS and infection) demonstrated low quality.

Age increase, fasting blood glucose, amylase, C-reactive protein, urinary amylase increase, albumin, hemoglobin, calcium ion concentration decrease, respiratory rate (>30 breaths/min), Ranson score, APACHE Ⅱ score, CT severity index score, BISAP score high, SAP subtype - hyperlipidemia, fever, acidosis, obesity, pleural effusion, SIRS, organ involvement (≥2) and infection were the risk factors for ALI in SAP patients. In the future, it is necessary to carry out further high-level research to prove the above research results.

Frailty and metabolic syndrome (MetS) are both common geriatric conditions and may have potentially important links in terms of risk factors, body composition and metabolic mechanisms, which could jointly affect the prognosis of older patients with gastric cancer. Clearly distinguishing the characteristics of the two syndromes and elucidating their intrinsic relationship can help to develop precise and targeted preoperative management strategies.

To compare the characteristics of preoperative frailty and MetS in older patients with gastric cancer, focusing on general information, blood indicators and body compositions, then analyze their correlation.

A total of 286 patients aged 60 to 80 years who were admitted to the Gastrosurgery Department of the Jiangsu Province Hospital for gastric malignancy from August 2021 to August 2022 were included and divided into the four groups: the frailty group (n=45), the MetS group (n=58), the frailty+MetS group (n=12) and the normal group (n=171) based on the presence of frailty and MetS, and the clinical indicators of these groups were compared. With frailty as the dependent variable, Logistic regression analysis was conducted to investigate the correlation of MetS and the diagnostic indicators with preoperative frailty.

Statistically significant differences were observed among the four groups in terms of age, comorbidities, Nutritional Risk Screening 2002 (NRS2002) scores>3, fasting blood glucose, triglyceride, high-density lipoprotein cholesterol (HDL-C), C-reactive protein (CRP), hemoglobin, albumin, height, body mass, waist circumference, BMI, fat content, fat mass index, body fat percentage, visceral fat area, skeletal muscle content, skeletal muscle mass index, limb skeletal muscle mass index, muscle percentage, fat to muscle ratio and muscle to fat ratio (P<0.05). Multivariate Logistic regression analysis showed that age (OR=1.115, 95%CI=1.046-1.190), history of smoking (OR=2.156, 95%CI=1.134-4.096), NRS2002 score>3 (OR=2.359, 95%CI=1.159-4.802), CRP (OR=1.038, 95%CI=1.003-1.073) and central obesity (OR=0.405, 95%CI=0.183-0.896) were the risk factors for frailty in older patients with gastric cancer (P<0.05) .

The frailty group showed advanced age, elevated levels of inflammation and increased nutritional risk, along with an overall decline in fat and muscle composition. The MetS group showed increased comorbidities, elevated inflammation and albumin levels, abnormal markers of glycolipid metabolism, and overall increased fat and muscle composition. The frailty+MetS group had increased comorbidities, abnormal fasting blood glucose and HDL-C levels with increases only in fat-related components but no significant changes in muscle components. Thus, frailty was not significantly associated with MetS in this study.

The incidence of colorectal cancer ranks second among cancers in China and colorectal cancer is also one of the most common malignant tumors in the digestive system. With the development of medical research and technology, the diagnostic and therapeutic strategies of colorectal cancer are continuously evolving. The National Comprehensive Cancer Network (NCCN) is closely following the forefront and released the 2024 V1/V2 versions of the NCCN Clinical Practice Guidelines for Rectal Cancer on January 29 and April 4, 2024 respectively. The two revisions of the guidelines mainly focus on the latest research progress in molecular detection, immunotherapy, targeted therapy, neoadjuvant therapy and disease surveillance. This article analyzed the key updates of the 2024 V1/V2 NCCN guidelines, aiming to provide a more accurate reference for clinical rectal cancer diagnosis and treatment practice.

Inflammatory bowel disease (IBD) patients suffer from recurrent and prolonged disease episodes, resulting in a high disease burden, which seriously affects patients' quality of life. Different types of disease burden have different impacts on the health status of patients, however, the current distribution of disease burden types in IBD patients and their influencing factors are not clear and need to be further explored.

To explore the potential profiles of disease burden in patients with IBD, and to analyze the influencing factors of different potential profiles.

Convenience sampling method was used to select 241 IBD patients from Tenth People's Hospital, Tongji University from June to October 2023. General information questionnaire, Chinese version of the Inflammatory Bowel Disease Disk Scale, and Psychological Resilience Scale were used to conduct the survey. Potential profile analysis was categorized the burden of disease for IBD patients, and multiple Logistic regression was explored the differences in the characteristics of different categories of patients.

A total of 250 questionnaires were distributed in this study and 241 valid questionnaires were recovered, with a valid questionnaire recovery rate of 96.4%. The disease burden characteristics of IBD patients could be categorized into 3 potential profiles: high burden-disease coping difficulties type (n=147, 61.0%) , medium burden-perceived pain and image type (n=75, 31.1%) , and low burden-psycho-emotional type (n=19, 7.9%) . The results of multiple Logistic regression analysis showed that the high burden-disease coping difficulties type was compared with the low burden-psycho-emotional type, patients with unstable jobs and high education level were easily categorized into high burden-disease coping difficulties type, while patients with high annual income, long disease duration, no complications and favorable psychological resilience were easily categorized into low burden-psycho-emotional type. Comparing the medium burden-perceived pain and image type with the low burden-psycho-emotional type, the older the patients, the higher the literacy level, the higher the number of follow-ups, and the lack of surgical experience were easily categorized into the medium burden-perceived pain and image type, and the patients with high annual income, long disease duration, no complications, and favorable psychological resilience were easily categorized into the low burden-psycho-emotional type. Comparing the medium burden-perceived pain and image type with the high burden-disease coping difficulties type patients who were married, had no regular job, and had long disease duration were likely to be categorized in the high burden-disease coping difficulties type, whereas patients who had a high number of follow-ups and no surgical treatment were likely to be categorized in the medium burden-perceived pain and image type (P<0.05) .

The disease burden of IBD patients has a distinct categorical profile and is divided into three potential profiles: high burden-disease coping difficulties type, medium burden-perceived pain and image type, and low burden-psycho-emotional type, which are influenced by age, marital status, job status, education level, annual income, disease duration, frequency of follow-up, surgical experience, complications, and level of psychological resilience. Healthcare professionals should pay attention to identifying the disease burden levels of different patients, focusing on high-burden patients, strengthening IBD symptom management and psychological interventions, and improving patients' disease coping ability and psychological resilience levels to reduce their disease burden.

Diet plays a critical role in the development, progression and prognosis of inflammatory bowel disease (IBD) . Given that specific nutritional guidelines are limited, nutritional management for patients with IBD remains challenging and fraught with uncertainty. Although previous studies have demonstrated that artificial intelligence (AI) shows promising applications in the nutritional management of patients with chronic diseases, research specifically focused on its application in the nutritional management of patients with IBD remains limited.

To conduct a scoping review of studies on AI in nutrition management of patients with IBD.

Following the methodology of scoping reviews, the databases of PubMed, Web of Science, Embase, Cochrane Library, CINAHL, IEEE Xplore, Association for Computing Machinery Digital Library, SinoMed, CNKI, Wanfang Data, and VIP were systematically searched from inception to March 2024 for studies on the application of AI in the nutritional management of patients with IBD. According to the established inclusion and exclusion criteria, two investigators independently screened the literature, and the basic characteristics of the selected studies were extracted.

A total of 15 studies were included. The applications of AI in this field include exploring the relationship between diet and IBD, assisting in nutritional assessment, and aiding nutritional interventions. The majority of utilization AI technologies in the included studies are machine learning, with some also employing additional techniques such as natural language processing and deep neural networks.

AI is beneficial for exploring healthy dietary patterns for patients with IBD and providing personalized nutritional guidance. However, its application in the field of nutritional management in patients with IBD is still in its infancy. Future efforts should focus on strengthening multidisciplinary collaboration, emphasizing the integration of clinical guidelines, and assessing the effectiveness of AI applications in clinical settings to enhance the rigor and accuracy of the results.

The 2024.V4 of the NCCN Clinical Practice Guidelines for Colon Cancer provides important updates on pathological testing of systemic therapy for colon cancer, dose of chemoradiotherapy, and treatment and management of metastatic colon cancer. Firstly, the guidelines emphasize the importance of genomic testing in the systemic treatment of metastatic colon cancer. Secondly, the dose of chemoradiotherapy and targeted therapeutic targets of locally advanced colon cancer were modified. Finally, the new drug repitinib for the second-line treatment of metastatic colon cancer provides a new option for patients with positive neurotrophic tyrosine receptor kinase (NTRK) gene fusion. In terms of patient management, the importance of general practice to patients' quality of life and psychological support was emphasized. Through the interpretation of the above content, this paper is expected to provide references for the diagnosis, treatment and prognosis of colon cancer, ensure that patients receive timely specialized treatment, and provide references for the precision treatment of colon cancer.

In 2024, the National Comprehensive Cancer Network (NCCN) has updated three editions of the Clinical Practice Guidelines for Gastric Cancer. These updates encompass multiple crucial areas of diagnosis, treatment, and follow-up monitoring for gastric cancer. It elevates the significance of next-generation sequencing in precision therapy for gastric cancer, refines the limitations for Epstein-Barr virus (EBV) testing and first-line immunotherapy in advanced stages. Adjustments have been made to the preoperative medication cycle for neoadjuvant immunotherapy, a new NTRK-targeted therapy drug was added in the second-line therapy, and a more detailed approach to postoperative monitoring and supplementation for nutritional deficiencies has been introduced. Notably, this version marks the first inclusion of endoscopic treatment pathways for early-stage gastric cancer and diagnostic and treatment pathways for single peritoneal metastasis in advanced gastric cancer. Additionally, it provides a comprehensive elaboration on the application principles of several emerging surgical techniques combined with intraperitoneal treatments. The updated content fully embodies the trend towards precision, personalized, and multidisciplinary treatment. This article will focus on the diagnosis, surgical treatment, systemic treatment, follow-up monitoring and other aspects of the guideline, in order to provide guidance and help for clinical practice.

In recent years, the extensive application of transcriptome sequencing technology in the field of liver cancer has provided assistance in genomic and biological studies of liver cancer. Summarizing and analyzing the literature on RNA-seq applied to liver cancer research in the last two decades can help to provide researchers with a comprehensive understanding of the research hotspots and latest progress in this field, and provide reference for subsequent research.

To evaluate the application of RNA-seq in various aspects of liver cancer research, such as treatment, diagnosis, and pathogenesis as a whole by bibliometric analysis, so as to reveal the global distribution of research hotspots in the field of RNA-seq applied to liver cancer, and predict the development trend of this field in the future.

Web of Science database was searched for English literature related to the application of RNA-seq to liver cancer research from 2001 to 2022, and the number of publications was analyzed using Microsoft Excel 2016 software. CiteSpace software was used for visualization of authors, countries, institutions, and keywords.

A total of 1 397 documents on the application of RNA-seq to liver cancer research were retrieved in the database, and the analysis results showed that the core group of authors in this field had been formed; China has the largest number of publications, but the research depth is slightly lacking, the United States has the second largest number of publications after China, but with the highest centrality (0.44) ; most of the institutions with a high publication volume are located in China, and most of the institutions with greater influence are located in the United States; the keyword analysis showed that the research hotspots in the field include the molecular mechanism, gene expression and molecular markers related to the occurrence and development of liver cancer.

The molecular mechanism of liver cancer development, biomarkers and therapeutic targets of the disease are the current research hotspots in this field, and clinical precision medicine may be a key research direction in the future.

The gastric precancerous conditions includes gastric mucosal atrophy and intestinal metaplasia, which is key link in the occurrence and development of gastric cancer, and its prevalence is on the rise in China. This paper details the conceptual difference between gastric precancerous conditions and precancerous lesions, identifies the evaluation methods of patients with high risk of carcinogenesis in gastric precancerous conditions from the aspects of endoscopy, pathological histology, and biomarkers, and summarizes the pathogenesis of gastric precancerous conditions. This paper shows that the cancer risk of gastric precancerous conditions is related to various factors such as the degree, range and subtype of lesions. In the microenvironment of gastric mucosa, imbalance and disorder of oxidation and antioxidant effect, energy metabolism, immune homeostasis, cell proliferation and death are the pathogenesis of gastric precancerous conditions. A comprehensive and prudent assessment of the cancer risk of gastric precancerous conditions is needed in clinical practice, thus providing patients with appropriate surveillance and follow-up programs to improve the detection rate of early gastric cancer. This paper can provide powerful evidence-based medical evidence for high-risk screening and prevention measures of gastric precancerous conditions in China, provide a reference for the in-depth development of mechanism research and new drug development.

Deficiency of fluid and blood is the main clinical manifestation of middle- and advanced-stage patients with esophageal cancer, but there are few reports about the metabolomic characteristics of esophageal squamous cell carcinoma patients with TCM differentiation of deficiency of fluid and blood.

To investigate the metabolomic characteristics of esophageal squamous cell carcinoma patients with TCM differentiation of deficiency of fluid and blood.

From April to December 2022, 35 esophageal squamous cell carcinoma patients with TCM differentiation of deficiency of fluid and blood, were selected as the case group in the departments of TCM and Thoracic Surgery, the Fourth Hospital of Hebei Medical University, meanwhile 35 healthy volunteers were selected as the control group. Serum specimens were collected, and metabolomic characteristics was analyzed by ultra performance liquid chromatography-mass spectrometry, and then screened the differential metabolites metabolic pathways.

A total of 88 differential metabolites with substance secondary matching names were screened out; 5 key metabolic pathways with significant difference and 11 related differential metabolites were further screened out. The 5 key metabolic pathways were β-Alanine metabolism pathway, Sphingolipid metabolism pathway, Linoleic acid metabolism pathway, Glycine, serine and threonine metabolism pathway, and Arachidonic acid metabolism pathway. Of the 11 related differential metabolites, β-Alanine, Phosphatidylcholine, L-homoserine, and L-allothreonine were significantly down-regulated, whereas Carnosine, Linoleic acid, 9, 10-DHOME, Hydroxypyruvic acid, Arachidonic acid, Heparin B3, and Thromboxane B2 were significantly up-regulated.

There are metabolic pathways with significant difference and related differential metabolites in esophageal squamous cell carcinoma patients with TCM differentiation of deficiency of fluid and blood, which mainly involved in metabolic abnormality of energy, such as amino acids and fatty acids.

Camrelizumab is a PD-1 inhibitor independently developed in China, which has been approved for use in the treatment of esophageal cancer. However, its efficacy and safety data in clinical practice are still lacking.

This study is aimed at assessing the Camrelizumab-based regimens' safety and efficacy for locally advanced and metastatic esophageal cancer in the real world, and explore whether the reactive cutaneous capillary endothelial proliferation (RCCEP) could predict the efficacy of carrelizumab under different treatment modalities.

Cases of locally advanced and metastatic esophageal cancer treated with camrelizumab-based regimens in the Fourth Hospital of Hebei Medical University between 1 November 2019 and 31 May 2022 were retrospectively examined. Progression free survival (PFS), overall survival (OS), disease control rate (DCR), objective remission rate (ORR) and adverse events were evaluated. Using the Kaplan-Meier approach to compute the median and estimated 95% CI for PFS and OS. Comparing the survival function of patients in the RCCEP group and without RCCEP group.

A total of 70 patients were included in the study. In all patients, the efficacy was evaluated as CR 11 (15.7%), PR 35 (50.0%), SD 17 (24.3%), PD 7 (10%), ORR 65.7% (46/70) and DCR 90.0% (63/70). In the 47 patients who receiving first-line to third-line treatment, the median PFS was 8.1 months (95%CI=6.46 to 9.74 months) and the 1-year PFS rate was 34.0%. The median OS was not reached, the 1-year OS rate of 76.3%. In the 23 patients who receiving neoadjuvant therapy, all patients achieved R0 resection, and 6 patients (26.1%) achieved pCR. In terms of safety, the most observed TRAEs included RCCEP (65.7%), nausea/vomiting (42.8%), anemia (37.1%), fatigue (37.1%) and alopecia (34.2%). The incidence of adverse reactions≥grade 3 was 21.4% (15/70), mainly including leukopenia (5.7%), neutropenia (5.7%) and thrombocytopenia (4.3%). Four patients developed immune related adverse reactions≥grade 3, including one case of grade 3 myocarditis, one case of grade 3 pneumonia, one case of grade 3 rash and one case of grade 4 nephritis. All patients were relieved after symptomatic or glucocorticoid treatment and no drug-related deaths occurred. RCCEP was associated with the efficacy of camrelizumab. The ORR (76.1% vs 45.8%, P=0.010) and DCR (97.8% vs 75.0%, P=0.009) of patients with RCCEP were higher than those without RCCEP. The median PFS (18 months vs 7.4 months, P=0.015) and OS (not reaching vs 15.7 months, P<0.001) of patients with RCCEP were significantly longer than those without RCCEP.

In the real world, camrelizumab-based regimens achieved good disease control and tolerance for treating locally advanced and metastatic esophageal carcinoma. In different treatment modalities, RCCEP could predicts the efficacy of camrelizumab.

As the prevalence of insomnia is gradually increasing, it is seriously affecting the mental and work status of patients. The gut microbiota is considered to be a risk factor for insomnia, but there is a relative lack of evidence to accurately recognize the relationship between gut microbiota and insomnia.

Using two-sample Mendelian randomization as a research methodology to explore the causal relationship between gut microbiota and insomnia.

Single nucleotide polymorphisms (SNPs) significantly associated with the relative abundance of 196 gut microorganisms were extracted as instrumental variables (IVs) according to predefined thresholds using pooled statistics of the gut microbiota from the largest available genome-wide meta-analysis of association studies conducted by the MiBioGen consortium (n=18 340). Pooled statistics for insomnia were obtained from the UK Biobank (n=462 341). Inverse variance weighting (IVW), MR-Egger regression, weighted median (WME), and weighted multinomial (WM) were used to detect the causal relationship between gut microbiota and insomnia, with IVW being the predominant method, and the results were assessed according to the effect indicator dominance ratio (OR) and 95% confidence interval (CI). Sensitivity analysis, heterogeneity test, gene multiplicity test, MR multiplicity residual and outlier test (MR-PRESSO) were combined to verify the stability and reliability of the results. Reverse Mendelian randomization analysis was also performed on the colonies found to be causally associated with insomnia.

IVW results showed that genus_Roseburia (OR=0.787, 95%CI=0.671-0.923, P_FDR=0.016), genus_Erysipelatoclostridium (OR=0.880, 95%CI=0.794-0.976, P_FDR=0.077), genus_Paraprevotella (OR=0.891, 95%CI=0.801-0.991, P_FDR=0.083), genus_Ruminococcaceae UCG014 (OR=0.818, 95%CI=0.697-0.961, P_FDR=0.072), family_Pasteurellaceae (OR=0.897, 95%CI=0.814-0.988, P_FDR=0.081), order_Pasteurellales (OR=0.897, 95%CI=0.814-0.988, P_FDR=0.094) were associated with insomnia, and no genetic pleiotropy or significant heterogeneity of IVs was found. According to the results of reverse MR analysis, insomnia had no significant causal effect on gut microbiota.

The abundance of six species of GM from the genus_Roseburia, genus_Erysipelatoclostridium, genus_Paraprevotella, genus_Ruminococcaceae UCG014 group, family_Pasteurellaceae, and order_Pasteurellales is negatively correlated with the risk of developing insomnia, i.e., decreased abundance increased the risk of developing insomnia and is a protective factor against insomnia.

In recent years, the incidence of colorectal cancer has been on the rise in low- and middle-income countries. Early-onset colorectal cancer (EOCRC), defined as colorectal cancer occurring in patients under 50 years of age, continues to see an increasing incidence. However, there is currently a lack of relevant epidemiological trends, which may hinder precise prevention, control strategies, and resource allocation for EOCRC.

To analyze the trends in the disease burden of EOCRC and the major risk factors for EOCRC in China and Global across different genders from 1990 to 2021 and predict the incidence and mortality rates of EOCRC for different genders in China and global from 2022 to 2046.

The incidence, mortality and disability adjusted life year (DALY) rate of colorectal cancer diagnosed between the ages of 14 and 49 in China and Global from 1990 to 2021 were collected using the Global Burden of Disease Database 2021. Age-standardized incidence rates (ASIR), age-standardized mortality rates (ASMR), and age-standardized disability-adjusted life years (ASDR) were utilized to analyze the disease burden of EOCRC and its major risk factors by gender in China and global. The Joinpoint model was used to calculate the annual percentage change (APC) and the average annual percentage change (AAPC) to reflect the trends in disease burden changes. Furthermore, the Bayesian age-period-cohort (BAPC) model was used to predict the incidence and mortality rates of EOCRC for different genders in China and globally from 2022 to 2046.

In 2021, the ASIR, ASMR, ASDR for Chinese males in EOCRC were 13.39/100 000, 4.26/100 000, 220.59/100 000, the ASIR, ASMR, ASDR for Chinese females in EOCRC in were 5.75/100 000, 1.68/100 000, 87.29/100 000. In 2021, the ASIR, ASMR, ASDR for global males in EOCRC were 6.11/100 000, 2.29/100 000, and 115.58/100 000, the ASIR, ASMR, ASDR for Chinese females in EOCRC were 4.17/100 000, 1.57/100 000, and 79.49/100 000. The AAPC for ASIR of males in China and global was 2.09% (95%CI=1.76%-2.43%) and 0.73% (95%CI=0.61%-0.84%), while for females in China, it was 0.31% (95%CI=0.04%-0.59%), all indicating an upward trend (P<0.05). The AAPC for the ASMR for males in China and global was -0.28% (95%CI=-0.51% to -0.05%) and -0.54% (95%CI=-0.68% to -0.40%), the AAPC was -2.22% (95%CI=-2.47% to -1.97%) in Chinese female and -1.25% (95%CI=-1.37% to -1.13%) in global female, all indicating a downward trend (P<0.05). The trend of ASIR trend for global females exhibited fluctuations, with AAPC of -0.09% (95%CI=-0.22% to 0.04%) (P>0.05). The trend of ASDR for Chinese male showed an inverted "V" shape, with AAPC of -0.20% (95%CI=-0.45% to 0.04%) (P>0.05). By 2046, the predicted ASIR and ASMR for Chinese male are expected to be 28.46/100 000 and 4.80/100 000. For females in China, these rates are projected to be 7.41/100 000 and 1.23/100 000. Globally, the ASIR and ASMR for males are forecasted to be 5.90/100 000 and 1.62/100 000, while for females, the rates are expected to be 3.06/100 000 and 1.05/100 000.

The disease burden of EOCRC in both males and females in China is severe and exceeds the global average, exhibiting significant gender disparities. There is a need to deepen the focus on the gender disparities associated with EOCRC and to implement targeted prevention and control measures. Additionally, drawing on global prevention and treatment experiences can provide a valuable reference for policy formulation.

Intestinal infectious diseases are one of the common infectious diseases. Analysis and prediction of their epidemic status can provide certain reference for the prevention and treatment of intestinal infectious diseases.

To understand the incidence and mortality of three enteric infectious diseases, including diarrheal diseases, typhoid fever and paratyphoid fever, and invasive non-typhoidal Salmonella intestinal infections in China from 1990 to 2019, and to predict their morbidity and mortality from 2020 to 2030, so as to provide reference for the prevention and control of intestinal infectious diseases.

Based on the 2019 Global Burden of Disease Database (GBD), the incidence and mortality data of three enteric infectious diseases, including diarrheal diseases, typhoid fever and paratyphoid fever, and invasive non-typhoidal Salmonella intestinal infections in China from 1990 to 2019 were collected. The change rate (%) and estimated annual percentage change (EAPC) were used to describe the changing trends of the above three intestinal infectious diseases. The autoregressive integrated moving average model (ARIMA) was used to predict the morbidity and mortality of the above three enteric infectious diseases in China from 2020 to 2030.

There was no statistically significant change in the incidence of diarrheal diseases from 1990 to 2019 (EAPC=0.09, P>0.05), while the incidence of typhoid fever, paratyphoid fever and invasive non-typhoid salmonella intestinal infections showed a downward trend (EAPC were -4.0% and -0.64% respectively, P<0.05). The mortality rates of diarrheal diseases, typhoid fever and paratyphoid fever, and invasive non-typhoidal Salmonella intestinal infections all showed a downward trend from 1990 to 2019 (EAPC were -8.39%, -3.38%, and -1.87%, respectively, P<0.05). Among all age groups, the incidence of diarrheal disease among people aged ≥70 years in 2019 was the highest among all age groups, and it was on the rise (EAPC=0.27, P<0.05). The mortality rates of the above three intestinal infectious diseases in all age groups from 1990 to 2019 showed a downward trend (P<0.05). The ARIMA model prediction results show that the incidence of diarrheal diseases in China will be on an upward trend from 2020 to 2030, while the incidence of typhoid and paratyphoid fever and invasive non-typhoid Salmonella will be on a downward trend. The estimated incidence of the above three diseases was 58 793.04/10⁵, 5.26/10⁵, 0.447/10⁵, respectively. In addition, the mortality rates of diarrheal diseases, typhoid fever and paratyphoid fever, and invasive non-typhoid Salmonella in our country will all show a downward trend from 2020 to 2030. The mortality rates of the above three diseases in 2030 were expected to be 0.214/10⁵ and 0.039/10⁵, 0.026/10⁵, respectively.

The mortality rates of diarrheal diseases, typhoid fever and paratyphoid fever, and invasive non-typhoidal Salmonella intestinal infections in China will show a downward trend in 2030. Except for the incidence of diarrheal diseases, which will show an upward trend, the incidence of the other two diseases will show a downward trend. It reminds the government and relevant health departments to pay attention to diarrheal diseases and adopt different prevention and control measures for different groups of people.

Heart failure patients are prone to depression, and interact with each other, leading to lower quality of life and poor prognosis of patients. As the largest microecosystem in the human body, changes in the composition, structure and function of the gut microbiota are closely related to the physiological and pathological states of the host. Currently, the "gut-heart/brain axis" has been used to explain the link between gut microbiota, cardiovascular diseases, and mood states, which is an important comorbid basis for heart failure and depression. In this paper, we reviewed the mechanisms of gut microbiota, metabolites, and vagus nerve in the development of heart failure and depression, and propose that mediterranean diet, probiotics, and microbiota transplantation have the potential to improve the "microbiota-gut-heart/brain axis", providing a new perspective for the treatment of heart failure patients comorbid with depression.

Diarrhea-predominant irritable bowel syndrome (IBS-D) is a clinically common functional gastrointestinal disease, in which immune imbalance plays an important role. Related immune cells include innate immune cells and adaptive immune cells, and immune cytokines include immunoglobulin, interferon, interleukin, tumor necrosis factor, etc. Traditional Chinese medicine monomers/compounds or compound formulas can regulate immunotherapy for IBS-D through multi-pathway, multi-target. This article systematically reviews and sorts out relevant literature on targeted immunotherapy of IBS-D using traditional Chinese medicine monomers/compounds and compound therapies from the perspectives of immune imbalance and intestinal infection, dysbiosis of flora, brain-gut axis disorder, and endocrine disorders. At the same time, it confirms the similarities between the "spleen as the guard" and immunity, to provide ideas for traditional Chinese medicine to treat IBS-D and related diseases through immune-mediated pathways.

Hepatocellular carcinoma (HCC) is the leading cause of cancer-related deaths. The current prevention and treatment situation remains critical. It is of scientific significance to explore new therapeutic agents for HCC.

To analyze the mechanism of wogonin on HCC by network pharmacology and to verify it in vitro.

The drug targets of wogonin were searched in TCMSP database, and the disease targets of HCC were collected from TTD, GenCard, OMIM, DisGent databases. The collected drug targets and disease targets were intersected as potential targets for drug intervention in diseases. R software was used for enrichment analysis of intersection targets, STRING database and Cytoscape software were used to construct protein interaction network and screen core targets. The core targets were further analyzed in GIEPA database. Finally, the preliminary analysis results were verified by in vitro experiments, including cell activity determination using CCK-8 kit, cell proliferation determination using plate clone formation experiment, cell migration determination using scoring test, protein expression level determination using Western-blotting (WB) assay.

The AMDE characteristics of wogonin were found to be in accordance with the rules for small molecule drug formation and the toxicity analysis showed no toxicity. A total of 135 wogonin targets and 8 238 HCC targets were collected, and 113 targets were intersected. Through the analysis of the core genes of TOP10 screened by the constructed protein interaction network, it was found that the mRNA levels of CDK1 and SRC in liver cancer tissues were higher than those in normal liver tissues (P<0.05), and the high expression levels in liver cancer patients were related to poor prognosis (P<0.05). KEGG enrichment analysis showed that the intersection genes were enriched in the PI3K/AKT signaling pathway, and the molecular docking results showed that wogonin had strong binding configuration activity with CDK1 and SRC. The results of CCK-8 kit showed that the activity of HepG2 cells in the 75.0, 150.0, and 300.0 μmol/L wogonin groups was lower than that in the control group (P<0.05). The results of plate clone formation experiment showed that the number of colony formation of HepG2 cells in the 37.5, 75.0, 150.0 μmol/L wogonin groups was lower than that in the control group (P<0.05). The results of scoring test showed that the migration rate of HepG2 cells in the 37.5, 75.0 and 150.0 μmol/L wogonin groups was lower than that in the control group (P<0.05). The results of the WB assay showed that the expression levels of PI3K, P-AKT/AKT, CDK1 and SRC proteins in the 75.0 and 150.0 μmol/L wogonin groups were lower than those in the control group (P<0.05) .

Wogonin inhibits the proliferation and migration of HCC cells and induces apoptosis by down-regulating the expression of CDK1 and SRC proteins and attenuating the PI3K/AKT pathway signaling, to achieve the purpose of interfering with the occurrence and progression of HCC.

Hepatocellular carcinoma (HCC) is the third leading cause of common cancer-related mortality globally, accounting for approximately 90% of all primary liver cancer cases. Its recurrence and mortality rates are high, with the underlying molecular mechanisms remaining unclear.

To explore potential molecular mechanisms of HCC and explore novel biomarkers.

RNA-seq expression data and clinical information were retrieved from TCGA database, differential gene expression analysis was conducted between normal liver tissue and HCC tissue. Enrichment analysis on the differentially expressed genes was performed. Based on the gene expression data profiles of HCC in TCGA, a co-expression network was established using the WGCNA R package, and weighted gene co-expression network analysis (WGCNA) was performed to select clinically significant modules and screen candidate Hub genes; the candidate Hub genes were further analyzed for significant differential expression in HCC tissues and normal liver tissues, and whether they were significantly correlated with the overall survival and disease-free survival of HCC patients. The Hub genes were conclusively identified, and their protein expression was validated through the Human Protein Atlas database.

The genetic expression data in this study were obtained from 50 normal liver tissue samples and 373 HCC tissue samples. Through differential gene expression analysis, a total of 7 230 genes differential expression between HCC and normal hepatic tissue, comprising 3 691 up-regulated genes and 3 539 down-regulated genes in HCC were identified. Enrichment analysis showed that the up-regulated differentially expressed genes were mainly involved in cell cycle regulation and mitotic processes; the down-regulated differentially expressed genes were mainly involved in processes such as small molecule metabolism and organic acid metabolism. WGCNA identified 19 gene modules related to the clinical features of HCC patients, the cyan and purple modules were screened by analyzing the relationship between the modules and the clinical features. The first two genes in the cyan module genes that were strongly associated with both overall survival and disease-free survival of patients were VPS45 and FAM189B. In the purple module genes, first two genes that were strongly associated with both overall survival and disease-free survival of patients were CLEC1B and FCN3, respectively; therefore, VPS45, FAM189B, CLEC1B and FCN3 were identified as the final Hub genes. Immunohistochemical staining in the Human Protein Atlas database showed that VPS45 and FAM189B were expressed higher in HCC tissues than in normal liver tissues. FCN3 was expressed in HCC tissues lower than in normal liver tissues, the difference in the expression of CLEC1B between HCC tissues and normal liver tissues was not obvious.

VPS45, FAM189B, CLEC1B and FCN3 have been preliminary identified as possible novel potential biomarkers for HCC, which may provide a theoretical basis for targeted therapy of HCC.

The increasing incidence of childhood obesity has emerged as a novel challenge in the realm of global public health. Studies have demonstrated that alterations in the composition of intestinal flora during the early stages of life contribute to the development of obesity by influencing nutrient absorption and metabolism, triggering inflammatory responses, and regulating the communication between the gut and brain. Currently, Bifidobacterium and Akkermansia muciniphila have been found to reduce body fat content, exhibit anti-inflammatory properties, and enhance intestinal barrier function, whereas Prevotella is strongly associated with improvements in individual glucose metabolism induced by dietary fiber. Translational application of specific intestinal flora benefits to body glycolipid metabolism is helpful for the early prevention and therapy of pediatric obesity. This review elucidates the impact of early-life changes in intestinal flora composition on childhood obesity explores the mechanisms by which intestinal flora contributes to obesity pathogenesis, and specifically focuses on recent advances in utilizing short-chain fatty acids for the regulation of intestinal flora and the amelioration of obesity, aiming to provide a theoretical foundation for the intervention of childhood obesity from the perspective of intestinal flora.

Gastrointestinal symptoms in gastric cancer patients treated with postoperative chemotherapy are diverse and interconnected, without effective intervention targets. In recent years, network analysis has emerged as a prominent approach to identify intervention targets.

To construct a network of gastrointestinal symptoms in gastric cancer patients treated with postoperative chemotherapy, identify core symptoms and analyze the factors influencing core symptoms, so as to provide a reference for precise symptom management.

Postoperative chemotherapy patients with gastric cancer were selected in the medical oncology and surgical oncology department of four tertiary A-level Chinese medicine hospitals (Jiangsu Provincial Hospital of Traditional Chinese Medicine, Suzhou Hospital of Traditional Chinese Medicine, Wuxi Hospital of Traditional Chinese Medicine, and Xuzhou Hospital of Traditional Chinese Medicine) in South, Central, and North of Jiangsu Province, from March to December 2022 via convenience sampling method, as the study subjects. The MD Anderson Symptom Inventory Gastrointestinal Cancer (MDASI-GI) was used for evaluating gastrointestinal symptoms and their severity among patients receiving postoperative chemotherapy for gastric cancer, as well as assessing the classification of traditional Chinese medicine constitution among patients. The network of gastrointestinal symptoms was constructed using an R package to identify the centrality indexes. The univariate analysis and multiple linear regression analysis were conducted to investigate factors influencing core gastrointestinal symptoms in patients undergoing postoperative chemotherapy for gastric cancer.

A total of 362 electronic questionnaires were collected, 355 were valid, with a valid recovery rate of 98.1%. The highest incidence of gastrointestinal symptoms in patients with postoperative chemotherapy for gastric cancer was lack of appetite (83.1%), taste alteration (81.7%) and nausea (71.0%), and the top three in terms of severity were lack of appetite (2.77 points), taste alteration (2.50 points) and nausea (2.27 points). Network analysis showed that taste alteration had the highest intensity (r_S=1.27) and the highest tight centrality (r_C=1.50) ; vomiting had the highest betweenness centrality (r_B=1.76). The results of multiple linear regression analysis showed that gender (B=0.809, 95%CI=0.319-1.298), smoking history (B=0.706, 95%CI=0.185-1.228) and phlegm-damp constitution (B=1.703, 95%CI=0.538-2.868) were the factors influencing the severity of taste alteration symptoms in patients with gastric cancer after chemotherapy (P<0.05) .

Taste alteration is the core symptom of gastrointestinal symptoms in gastric cancer patients undergoing postoperative chemotherapy. Gender, smoking history, and phlegm-damp constitution are influential factors contributing to taste alteration. Nursing staff can develop intervention strategies based on these core symptoms and their influencing factors to enhance the efficacy of managing gastrointestinal symptoms during chemotherapy in gastric cancer patients.

Esophageal carcinoma is a common malignant tumor of the gastrointestinal tract in China and even globally, with a high incidence and mortality rate. As a traditional Chinese medicine, Salvia chinensia Benth (SJC) has the effects of clearing heat and detoxifying, promoting blood circulation and easing pain in the treatment of esophageal cancer. Pharmacological experimental studies have proved that SJC has anticancer properties and can effectively treat a variety of malignant tumors.

To explore the effect and mechanism of SJC in the inhibition of carcinoma in situ esophageal cancer development of C57 mice based on ferroptosis.

Ninety SPF grade C57BL/6 female mice were selected from February 2022 to February 2023 and randomly divided into Control group (n=15), simple 4-Nitroquinoline N-oxide (4NQO) -induced cancer group (4NQO group, n=25), 4NQO+ low-dose SJC group[4NQO/SJC (91 mg) group, n=25]and 4NQO+high dose SJC group[4NQO/SJC (182 mg) group, n=25]. The preparation of in situ model of esophageal cancer in C57 mice was carried out using 4NQO induction. The activities of the mice were observed, their mental state, food and water intake were recorded, and the body mass of the mice was measured and recorded at 8-week intervals. Hematoxylin-eosin (HE) staining and pathological analysis of esophageal tissue were performed after 32 weeks. The contents of Fe²⁺, glutathione (GSH) and malondialdehyde (MDA) in esophageal tissues were determined, and the expression levels of nuclear receptor coactivator 4 (NCOA4) and glutathione peroxidase 4 (GPX4) in esophageal tissues of mice were detected by western blot. Kaplan-Meier method was used to plot the survival curves of mice, and Breslow test was used to compare the survival curves.

The body mass of mice in 4NQO group, 4NQO/SJC (91 mg) group and 4NQO/SJC (182 mg) group at 8, 16, 24 and 32 weeks of modeling was lower than that in Control group. The body mass of 4NQO/SJC (91 mg) group and 4NQO/SJC (182 mg) group at 32 weeks was higher than that of 4NQO group (P<0.05). The results of Breslow test showed that there was significant difference in the survival curves of mice in the four groups (χ²=9.907, P=0.019). The results of HE staining showed that esophageal epithelial tissue of mice in 4NQO group showed abnormal proliferation, disordered cell arrangement, and abnormal pathological changes such as keratinized beads. Compared with 4NQO group, the esophageal epithelial histopathological changes in 4NQO/SJC (91 mg) and 4NQO/SJC (182 mg) groups were significantly improved. Fe²⁺ and MDA in 4NQO, 4NQO/SJC (91 mg) and 4NQO/SJC (182 mg) groups were lower than those in Control group, and GSH was higher than that in Control group (P<0.05). Fe²⁺ and MDA in 4NQO/SJC (91 mg) and 4NQO/SJC (182 mg) groups were higher than those in 4NQO group, and GSH was lower than that in 4NQO group (P<0.05). Fe²⁺ and MDA in 4NQO/SJC (182 mg) group were higher than those in 4NQO/SJC (91 mg) group, and GSH in 4NQO/SJC (91 mg) group was lower than that in 4NQO/SJC (91 mg) group (P<0.05). NCOA4 in 4NQO group was lower than that in Control group, 4NQO/SJC (91 mg) group and 4NQO/SJC (182 mg) group, and GPX4 was higher than that in Control group, 4NQO/SJC (91 mg) group and 4NQO/SJC (182 mg) group (P<0.05). The GPX4 of 4NQO/SJC (91 mg) group and 4NQO/SJC (182 mg) group was higher than that of Control group (P<0.05) .

It is proved that SJC can interfere with the development of esophageal cancer development by a mechanism that may be related to NCOA4-mediated ferritin phagocytosis.

Drug-induced liver injury is one of the most common adverse drug reactions, and atorvastatin is one of the widely used statin lipid-lowering drugs in clinical practice, which is susceptible to hepatic injury. Currently, there is limited research data on the clinical characteristics of liver injury induced by atorvastatin.

To investigate the clinical characteristics of liver injury induced by atorvastatin, so as to improve clinicians' understanding of liver injury induced by atorvastation.

The patients who were hospitalized and treated with atorvastatin in the First Affiliated Hospital of Guangxi Medical University from January 2012 to August 2022, developed liver injury and were evaluated as liver injury induced by atorvastation based on Roussel Uclaf Causality Assessment Method were selected, and analyzed on clinical characteristics.

A total of 84 cases of liver injury induced by atorvastation were diagnosed by Causality Assessment Method. The patients with liver injury induced by atorvastation were more male (72.6%), with an average age of (60.2±11.5) years, and all of them were comorbid with the underlying diseases (100.0%) ; two cases (2.4%) reached moderate liver injury, and the cure or improvement rate after treatment reached 100.0%. According to the stage of the disease, the main manifestation was an acute course (100.0%) ; according to the damaged target cells, the mixed type was the most frequent (60.7%), followed by the cholestasis type (26.2%) and the hepatocyte type (11.9%). The statistical results showed that 78.6% of the patients with liver injury occurred within 3 months after taking atorvastation and predominantly in the 1st to 2nd week; and 81.0% of the patients developed liver injuryat 80 defined daily dose (DDD) of cumulative atorvastation.

Liver injury induced by atorvastation occurs mostly in male, middle-aged and elderly patients patients with underlying diseases, mostly have mild liver injury and good prognosis, and the clinical types were mostly mixed type and cholestasis type. Liver injury occurs mainly within 3 months and the occurrence of liver injury induced by atorvastation was dose-dependent.

Surgery is one of the main means of treating colorectal cancer. However, patients with colorectal cancer need to face many physical and psychological problems after surgery, which seriously affects patients' treatment outcomes and quality of life, so how to carry out effective postoperative management is extremely important. Objective To investigate the effectiveness of an integrated hospital-community-patient chronic disease management pathway intervention for postoperative colorectal cancer patients. Methods Based on different postoperative interventions, colorectal cancer patients were divided into a control group (n=40) and a co-management group (n=36) , with the control group implementing conventional postoperative interventions and the co-management group following a constructed integrated chronic disease pathway for co-management. Changes in laboratory indices, recurrent metastasis, death, postoperative complications, quality of life, and anxiety were compared between the two groups before and after surgery. Results Retrospectively selected 80 patients with colorectal cancer who were discharged from the Department of General Surgery at Yangpu Hospital, affiliated with Tongji University, between January 2021 and April 2022, as study subjects. At 3 and 6 months postoperatively, patients in the co-management group had lower carcinoembryonic antigen levels than patients in the control group (P<0.001) . The incidence of recurrent metastases was not significantly different from that of the control group at 3 months postoperatively (P>0.05) , while at 6 months postoperatively, the incidence of recurrent metastases was lower in the co-management group than in the control group (5.6% vs. 22.5%, χ²=4.395, P=0.036) ; in addition, the incidence of complications was lower in the co-management group than in the control group at both 3 and 6 months postoperatively (0 vs. 16.2%, χ²=3.981, P=0.046; 5.6% vs. 25.0%, χ²=5.388, P=0.020) . However, the difference in mortality at 6 months postoperatively between the two groups was not significant (2.8% vs. 7.5%, χ²=0.165, P=0.685) . In quality of life scores at 6 months and 1 year postoperatively, the co-management group was higher than control patients (P<0.05) , and the anxiety scores were lower in the co-management group than in the control patients (P<0.05) . Conclusion The integrated hospital-community-patient chronic disease management pathway can reduce postoperative complications, decrease recurrence and metastasis of colorectal cancer, improve quality of life, and improve anxiety symptoms, and is of great value to the prognosis of postoperative colorectal cancer patients.

Intestinal stem cells are regulated by the intestinal nervous system, and both of them are closely related to intestinal inflammation. Relevant studies have shown the existence of intestinal nerve dysfunction in intestinal inflammation. By summarizing the relationship among intestinal stem cells, intestinal nervous system and intestinal inflammation, this paper discusses that intestinal nervous system injury related to intestinal inflammation may be the basis for persistent alteration of intestinal function, while enteric neurons provide feasible targets for improving intestinal nerve dysfunction in inflammatory bowel diseases, so as to apply various types of stem cells to the improvement of intestinal nerve dysfunction in intestinal inflammation.

Chronic atrophic gastritis is a common clinical precancerous lesion, which is prone to recurrent attacks and seriously affects the quality of life of patients. At present, Western medicine has limited effect in the treatment of chronic atrophic gastritis, while acupuncture has good results in the treatment of chronic atrophic gastritis, but which acupuncture therapy is the best still inconclusive.

To compare the clinical efficacy among different acupuncture and moxibustion therapies on chronic atrophic gastritis by network meta-analysis.

The articals of randomized controlled trials for chronic atrophic gastritis treated with acupuncture and moxibustion therapies were searched from CNKI, Wanfang Data, VIP, CBM, PubMed, Embase and Web of Science until April 30, 2023 according to the inclusion exclusion criteria. Literature quality assessment was based on ROB2 bias assessment tool, network meta-analysis was performed using RStudio software, and funnel plotting was used Stata software for publication bias risk assessment.

26 articles involving 10 interventions with a sample size of 2 068 cases were included. The results of network meta-analysis showed that in clinical efficacy, there were five acupuncture therapies were superior to conventional western medicines, including western medicine combined with acupoint injection, catgut embedment in acupoint therapy, western medicine combined with acupuncture, needle warming therapy and acupuncture (P<0.05). The SUCRA ranking result was western medicine combined with acupoint injection (0.86) >catgut embedment in acupoint therapy (0.80) >western medicine combined with acupuncture (0.67) >needle warming therapy and acupuncture (0.59) >western medicine combined with fire dragon moxibustion (0.58) >acupuncture (0.48) >western medicine combined with ginger separated moxibustion (0.40) >thunder-fire moxibustion (0.31) >western medicine combined with electroacupuncture (0.24) >conventional western medicine (0.06). In improving the efficacy of gastroscopy, five acupuncture therapies were superior to conventional western medicines, including catgut embedment in acupoint therapy, needle warming therapy, western medicine combined with acupuncture, acupuncture and western medicine combined with acupoint injection (P<0.05). The SUCRA ranking results show: catgut embedment in acupoint therapy (0.80) >needle warming therapy and acupuncture (0.72) >western medicine combined with acupuncture (0.58) >acupuncture (0.47) >western medicine combined with acupoint injection (0.41) >conventional western medicine (0.01). In terms of pathological efficacy, there were five acupuncture therapies that were superior to conventional western medicines, such as catgut embedment in acupoint therapy and needle warming therapy and acupuncture (P<0.05). The SUCRA ranking results show: catgut embedment in acupoint therapy (0.79) >western medicine combined with acupuncture (0.59) >needle warming therapy and acupuncture (0.53) >acupuncture (0.52) >western medicine combined with acupoint injection (0.51) >conventional western medicine (0.06) .

Western medicine combined with acupoint injection is preferred for patients with obvious clinical symptoms, while catgut embedment in acupoint therapy is preferred for patients with no obvious symptoms. Catgut embedment in acupoint therapy can not only improve the clinical efficacy, but also improve the efficacy of gastroscopy and pathological than other acupuncture treatments.

The elderly colorectal cancer population has a high prevalence and complex condition, and postoperative rehabilitation faces various challenges. It is of great significance to construct a scientific, practical and comprehensive postoperative health management program for colorectal cancer in the elderly to improve patients' health.

To construct a comprehensive health management program for elderly postoperative colorectal cancer patients, and provide reference for postoperative rehabilitation of elderly colorectal cancer patients.

Based on literature review and qualitative interviews, the management program for elderly postoperative colorectal cancer patients was initially formulated. The Delphi method was used to conduct 2 rounds of correspondence with 16 experts from tertiary hospitals in Nanjing and Shanghai. The motivation degree of the experts was evaluated based on questionnaire recovery rate and text revision rate. Furthermore, the authority coefficient was used to evaluate the degree of expert authority, while the coefficient of variation and Kendall's W coefficient were used to evaluate the coordination of expert opinions. Based on opinions and discussion of experts, the ultimate formation of the health management program for elderly postoperative colorectal cancer patients was constructed after adjusting the content of entries.

The recovery rates of the two rounds of expert correspondence were 94.12% and 100.00%, respectively. The text revision rates were 56.25%, and the authority coefficient was 0.91. The mean importance scores of items in the two rounds of the consultation ranged from 3.81 to 5.00 and 4.13 to 5.00, with the coefficients of variation from 0 to 0.24 and 0 to 0.20. The Kendall's W coefficients of expert opinions were 0.211 and 0.222, respectively (P<0.001), with an improvement observed in the second round compared to the first round. After two rounds of expert correspondence and the expert group discussion, the final management program for elderly postoperative colorectal cancer patients was determined, including 9 primary items (team building, psychological support, physical activity, stoma care, nutritional intervention, TCM rehabilitation techniques, peer education, treatment and follow-up, self-management) and 39 secondary items.

The health management program constructed in this study for elderly postoperative colorectal cancer patients is scientific, reliable, applicable and practical, and can provide guidance for rehabilitation of elderly patients after colorectal cancer surgery.

A large number of studies have confirmed that endoplasmic reticulum stress (ERS) is closely related to the development and progression of liver diseases, but the mechanism of the association between ERS and liver disease progression has not been clarified and needs to be further explored. Numerous studies have found that moderate ERS can activate the unfolded protein response (UPR) to protect cells, while severe or persistent ERS can induce apoptosis. Therefore, exploring the role of ERS in the pathogenesis of liver diseases may help to discover new therapeutic strategies. This paper describes the current research status and potential therapeutic strategies of ERS and UPR in various liver diseases.

Chronic atrophic gastritis (CAG) with intestinal metaplasia (IM) is an independent risk factor for gastric cancer. Long-term inflammation and oxidative stress response stimulate the physical and mental state of patients. Under the modern medical model, proton pump inhibitors and gastric mucosal protective agents are increasingly unable to meet the high drug resistance of patients. It is urgent to seek effective new Chinese medicine treatments and multiple methods to treat CAG and IM.

To evaluate the clinical efficacy and safety of modified Piwei Peiyuan Decoction combined with acupuncture in the treatment of CAG with IM.

From January 2022 to September 2023, 202 patients with CAG and IM diagnosed by gastroscopy and pathological examination in the Department of Spleen and Stomach, the Center for Preventive Treatment of Disease, the Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine and the Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine were selected. The patients were divided into control group (n=67), treatment group A (n=68) and treatment group B (n=67) by random number table method. All patients participated in 6 weeks of treatment: (1) Control group: aluminum magnesium suspension combined with folic acid tablets (3 times/d) ; (2) Treatment group A: to add and subtract syndrome types of Piwei Peiyuan Decoction (2 times/d) ; (3) Treatment group B: Piwei Peiyuan Decoction (the same as group A) combined with acupuncture (1 time/d), with Zusanli, Liangqiu, Gongsun, Neiguan, Zhongwan as the main points, according to the syndrome type selection of acupoints. Before and 6 weeks after treatment, OLGA, OLGIM staging, gastric mucosal pathological efficacy, gastric mucosal pathological score, clinical symptom score, PRO scale score, drug-related adverse events (AE) and adverse drug reactions (ADR) were recorded.

A total of 192 patients completed the 6-week course of treatment (62 in the control group, 66 in the treatment group A, and 64 in the treatment group B). The effective rate of the control group was 48.39% (30/62), the effective rate of the treatment group A was 69.70% (46/66), and the effective rate of the treatment group B was 71.88% (46/64). There was a statistically significant difference in the effective rate among the three groups (χ²=9.144, P=0.01). After treatment, the gastric mucosal pathological score, clinical symptom score and PRO scale score in the three groups were lower than those in the same group before treatment (P<0.05). Pathological score of gastric mucosa: the scores of chronic inflammation, atrophy and IM in treatment group A and treatment group B were lower than those in control group, and the scores of active inflammation and dysplasia were higher than those in control group (P<0.05). Clinical symptom score: the scores of epigastric fullness and epigastric pain in treatment group A and treatment group B were lower than those in control group (P<0.05). The PRO scale score: the treatment group A and the treatment group B were lower than the control group in acid reflux, dyspepsia, defecation, psychological state, systemic symptoms and total score (P<0.05). There was no significant difference in the incidence of AE and ADR among the three groups (P>0.05) .

The overall clinical efficacy of Piwei Peiyuan Decoction combined with acupuncture is better than that of aluminum magnesium suspension combined with folic acid tablets, which is better than that of traditional antacids and gastric mucosal protective agents.

Gastric cancer (GC) is one of the most heterogeneous and aggressive malignant tumors of the digestive system. Traditional chemotherapy drugs and epidermal growth factor receptor 2 (HER2) targeted drugs such as Trastuzumab still have the disadvantages of high incidence of drug resistance, high toxic side effects and poor tolerance of patients. Therefore, it is imperative to develop more effective anti GC drugs. Novel targeted drugs against HER2 are currently available, but are ineffective or resistance in some cases, which is related to the low expression of HER2 (HER2 IHC1+ or IHC2+/ISH-) in certain GC cells, accounting for about 40%-60% of all types. However, in clinical practice, these patients are still reported as HER2-negative GC. Therefore, accurate detection of HER2 expression is crucial to identify patients who may benefit from trastuzumab therapy. The emergence of antibody drug conjugates (ADC) provides a new therapeutic option for HER2-positive GC and it is expected to replace traditional GC chemotherapy in the future by its precise and efficient anti-tumor effect. Recent studies have found that ADC may have potential anti-tumor activity in HER2 low-expression GC, and related clinical studies are evaluating its effectiveness and safety in HER2 low-expression GC treatment. This article reviews the application and the latest research progress of ADC in HER2 low-expression GC patients in the era of targeted therapy and discusses the challenges faced in the application and development of HER2-targeted ADCs.

Ulcerative colitis (UC) is a persistent immune-mediated inflammatory bowel disease characterized by chronic relapses and remissions. The management of UC remains a subject of contention, particularly as approximately half of the patients experience a complex disease progression marked by chronic activity or frequent recurrence of common UC symptoms, significantly impacting their quality of life.

The current landscape presents a growing array of treatment modalities for UC. This study aims to systematically compare the relative efficacy and safety of biologics and small molecule drugs in treating patients with UC.

Two independent researchers meticulously conducted a search for randomized controlled trials involving biologics and small molecule drugs for UC. The search encompassed PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang Data, and VIP. The intervention group involved either biologics or small molecule drugs, while the control group received a placebo. The quality of the included studies was assessed using the Cochrane Risk of Bias tool and RevMan 5.4. Paired analyses and network meta-analyses were conducted using R Studio. The surface under the cumulative ranking curve (SUCRA) was employed to rank the included drugs based on each outcome indicator, providing a comparative assessment of the clinical efficacy of diverse treatments for UC.

A total of 25 studies including 9 546 patients with ulcerative colitis and 10 intervention regimens (Filgotinib 100 mg, Filgotinib 200 mg, Upadacitinib, Tofacitinib, Etrolizumab, Adalimumab, Vedolizumab, Golimumab 50 mg, Golimumab 100 mg, Infliximab). The results of SUCRA probability ranking of clinical remission effect of each drug showed that Upadacitinib (94.1%) >Vedolizumab (85.1%) >Tofacitinib (74.3%) >Infliximab (72.7%) >Filgotinib 200 mg (51.5%) >Golimumab 100 mg (44.3%) >Golimumab 50 mg (39.3%) >Etrolizumab (38.9%) >Adalimumab (29.8%) >Filgotinib 100 mg (18.7%) >Placebo (0.7%). The results of SUCRA probability ranking of the effect of each drug on clinical response showed that Upadacitinib (98.4%) >Infliximab (84.4%) >Tofacitinib (67.2%) >Vedolizumab (58.4%) >Golimumab 50 mg (53.3%) >Adalimumab (34.6%) >Golimumab 100 mg (30.1%) >Placebo (0.4%). The results of SUCRA probability ranking of the effect of each drug on endoscopic remission showed that Upadacitinib (98.7%) >Tofacitinib (68.6%) >Filgotinib 200 mg (59.6%) >Adalimumab (55.2%) >Etrolizumab (46.0%) >Vedolizumab (45.9%) >Filgotinib 100 mg (23.4%) >Placebo (2.2%). The results of SUCRA probability ranking of the effect of each drug on mucosal healing showed that Upadacitinib (99.7%) >Tofacitinib (77.2%) >Infliximab (65.2%) >Golimumab 50 mg (46.4%) >Vedolizumab (44.4%) >Adalimumab (33.8%) >Golimumab 100 mg (31.9%) >Placebo (1.0%). The results of the SUCRA probability ranking of the risk of adverse events for each drug showed that Golimumab 100 mg (96.7%) >Golimumab 50 mg (92.1%) >Placebo (68.7%) >Tofacitinib (60.8%) >Adalimumab (60.7%) >Etrolizumab (47.2%) >Upadacitinib (42.2%) >Vedolizumab (41.3%) >Infliximab (27.0%) >Filgotinib 200 mg (6.6%) >Filgotinib 100 mg (6.2%) .

Upadacitinib demonstrated optimal efficacy in clinical response, clinical remission, mucosal healing, and endoscopic remission, and Filgotinib 100 mg demonstrating safer outcomes in terms of adverse events.

Gastrointestinal dysfunction is a very common complication in peritoneal dialysis patients, which not only seriously affects the appetite and mood of patients, but also induces malnutrition, dehydration, electrolyte disorders, or systemic inflammatory reactions, and even leads to a decrease in the effectiveness of peritoneal dialysis, thus increasing the difficulty of medical treatment and lowering the patients' standard of living.

To analyse the clinical characteristics and influencing factors of patients with peritoneal dialysis-associated gastrointestinal dysfunction, and provide reference for the clinical diagnosis and treatment of peritoneal dialysis-associated gastrointestinal dysfunction.

A retrospective study was conducted to select 304 uremic patients who underwent continuous ambulatory peritoneal dialysis in the Department of Nephrology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from 2019-09-01 to 2021-09-01. The patients were divided into the gastrointestinal dysfunction group and non-gastrointestinal dysfunction according to the combination of gastrointestinal dysfunction. General data, comorbidities, laboratory test indexes, and dialysis adequacy-related indexes of the two groups of patients were collected and compared. SPSS 23.0 software was used to statistically analyze the clinical data, the clinical characteristics of peritoneal dialysis-associated gastrointestinal dysfunction, and multivariate Logistic regression analysis was used to explore the factors influencing the occurrence of peritoneal dialysis-associated gastrointestinal dysfunction in patients with uremia.

A total of 304 peritoneal dialysis patients were included, of which 189 (62.2%) were in the gastrointestinal dysfunction group, with the median age of 62 (52, 67) years. The differences in age, proportions of primary diabetic nephropathy and combined hypertension and coronary artery disease between the two groups were statistically significant (P<0.05) ; the levels of blood calcium, cholesterol, creatine kinase, C-reactive protein, total bilirubin, blood glucose, glycosylated hemoglobin, procalcitonin, and triglyceride were compared between the two groups, and the differences were statistically significant (P<0.05) ; standardized comparison of the levels of blood urea nitrogen, residual renal urea clearance index (Kt/V), peritoneal Kt/V, total creatinine clearance (Ccr), residual kidney Ccr, and total Ccr between the two groups showed statistically significant (P<0.05). The results of multivariate Logistic regression analysis showed that primary diabetic nephropathy (OR=7.471, 95%CI=1.161-48.061, P=0.034), elevated glycosylated hemoglobin (OR=1.367, 95%CI=1.080-1.731, P=0.009) were the independent risk factors for the occurrence of peritoneal dialysis-associated gastrointestinal function in uremic patients, and elevated residual kidney Ccr (OR=0.952, 95%CI=0.908-0.997, P=0.038) was an independent protective factor for the occurrence of peritoneal dialysis-associated gastrointestinal disorders in uremic patients.

The incidence of peritoneal dialysis-related gastrointestinal dysfunction was relatively high, with a clinical prevalence in the elderly. Diabetic nephropathy and elevated glycosylated hemoglobin may be independent risk factors for peritoneal dialysis-associated gastrointestinal dysfunction in patients with uremia. Elevated residual kidney Ccr may be an independent protective factor for peritoneal dialysis-associated gastrointestinal dysfunction in uremic patients.

Locally advanced gastric cancer mainly includes stage Ⅲ gastric cancer, which is mainly treated with comprehensive therapy. Postoperative recurrence is a key factor affecting the prognosis of patients.

To explore the influencing factors of long-term prognosis in patients with stage Ⅲ gastric cancer undergoing D2 radical surgery and adjuvant chemotherapy.

Gastric cancer patients who underwent D2 radical surgery and adjuvant chemoradiotherapy were collected from the Department of Radiotherapy at Zhongshan Hospital affiliated to Fudan University from 2009 to 2014. They were pathologically diagnosed with stage Ⅲ gastric cancer according to the International Union of Cancer (UICC) and American Cancer Federation (AJCC) 8th edition TNM staging system for gastric cancer. All postoperative patients were followed up every 3 months in the first year, every 6 months for the following 2 years, and once a year thereafter. The deadline for follow-up is December 15, 2021. Survival rates of subgroups were compared using Log-rank tests.The influencing factors of overall survival (OS) and disease-free survival (DFS) were compared using Cox proportional hazards regression analysis, and the prediction of clinicopathological features were analyzed by Nomogram. Comparison of survival differences among patients with different pTNM stagings, age, metastatic lymph node radios (LNR), and gastrectomy methods using Kaplan-Meier method.

A total of 135 qualified patients were included, with a median follow-up time of 10.48 years. Within 5 years, there were 70 cases of recurrence and 62 deaths. The 5-year DFS rate and OS rate were 48.1% (65/135) and 54.1% (73/135), respectively; Within 10 years, there were 74 cases of recurrence and 74 deaths. The 10-year DFS rate nd OS rate were both 45.2% (61/135). The Log-rank test results showed that there was a statistically significant difference in 5-year survival rates among patients with different pTNM stagings, pT stagings, LNRs, cancer nodules, tumor locations, and gastrectomy methods (P<0.05). The 10-year survival rates of patients with different pTNM stagings, pT stagings, LNRs, nerve infiltrations, and gastrectomy methods were compared, and the differences were statistically significant (P<0.05). The results of multivariate Cox proportional hazards regression analysis showed that pTNM staging (Stage ⅢA, OS: HR=0.40, 95%CI=0.19-0.83; DFS: HR=0.40, 95%CI=0.19-0.92), LNR (>50%, OS: HR=1.74, 95%CI=1.03-2.94; DFS: HR=1.73, 95%CI=1.02-2.94), and gastrectomy method (total gastrectomy, OS: HR=2.07, 95%CI=1.22-3.50; DFS: HR=2.02, 95%CI=1.20-3.41) were independent influencing factors for OS and DFS in patients with stageⅢ gastric cancer undergoing D2 radical surgery with adjuvant chemotherapy (P<0.05), while age (≤ 40 years, HR=2.19, 95%CI=1.06-4.53) was an independent influencing factor for OS. Moreover, nomogram indicated that age, pTNM staging, LNR, and gastrectomy method have good predictive effects on the prognosis. For recurrence, 10 cases (7.4%) experienced local recurrence (recurrence of anastomotic sites and lymph nodes within the radiation field), 35 cases (25.9%) experienced abdominal and pelvic dissemination of implants, and 37 cases (27.4%) experienced distant metastasis (including lung, liver, bone, brain and other organs) ; Some patients had two or more types of recurrence. The postoperative survival curves of stageⅢ gastric cancer patients with different pTNM stagings, age, LNRs, and gastrectomy methods were compared, and the differences were statistically significant (P<0.05) .

Most patients with stageⅢ gastric cancer who undergo adjuvant chemoradiotherapy after D2 radical surgery experience recurrence or death within 5 years. pTNM staging, LNR, and gastrectomy method are factors that affect the prognosis of these patients.

Acute pancreatitis (AP) is one of the common gastrointestinal emergencies, and the disease progression of moderately severe and severe AP is rapid. Early and accurate identification is crucial for effective intervention and prognosis assessment. there is still a lack of effective and simple predictive indicators.

To investigate the early dynamic changes and predictive value of the systemic inflammation response index (SIRI) in patients with AP.

A total of 221 AP patients who met the inclusion and exclusion criteria at the Department of Gastroenterology, Beijing Tiantan Hospital, Capital Medical University, were included as study subjects from August 2020 to March 2023. According to the revised 2012 Atlanta criteria, patients were categorized into mild group (MAP group, mild acute pancreatitis) and non-mild group (non-MAP group, including moderate severe and severe acute pancreatitis). The SIRI values (SIRI 0 h, SIRI 48 h) and C-reactive protein (CRP) levels (CRP 0 h, CRP 48 h) during admission and within 48 hours of admission for the patients were collected by reviewing cases. The receiver operating characteristic (ROC) curve was plotted, and the area under the curve (AUC) was calculated to analyze the predictive value of SIRI for non-MAP and compare it with CRP as a common clinical indicator of inflammation.

A total of 221 AP patients were finally included, 102 with MAP and 119 with non-MAP. SIRI 0 h and SIRI 48 h were higher in patients in the non-MAP group than in the MAP group (P<0.001). The ROC curve showed that the AUC for SIRI 0 h and SIRI 48 h in predicting non-MAP were 0.685 (95%CI=0.615-0.756) and 0.753 (95%CI=0.689-0.816), respectively, with no significant difference with CRP [0.607 (95%CI=0.533-0.681) and 0.752 (95%CI=0.687-0.817) ] during the corresponding time intervals (Z=1.67, P=0.095; Z=0.02, P=0.981). The optimal cut-off value for SIRI 48h to predict non-MAP was 2.49, with sensitivity, specificity, positive predictive value, and negative predictive value of 81.51%, 58.82%, 69.78%, and 73.17%, respectively.

SIRI is an affordable and readily available test that can be used as an indicator for assessing the severity of early-stage AP.

Gastroesophageal reflux disease (GERD) has a high incidence and a heavy disease burden in recent years, but there is a lack of data to understand the burden of GERD in China. This study describes and analyzes the disease burden of GERD in order to better understand the prevalence of GERD in China.

To analyze the disease burden and prevalence trend of GERD in China from 1990 to 2019, and to provide a reference for the prevention and treatment of GERD in China.

Crude and standardized incidence, prevalence, and DALY rates of GERD in China from 1990 to 2019 were obtained from the Global Burden of Disease Database 2019 (GBD 2019) ; the rate of change was calculated, and Joinpoint regression model was used to analyze the standardized incidence, prevalence, and DALY rates of GERD, and the annual percentage change (APC) was calculated.

In 2019, the crude rate and standardized rate of GERD incidence in China were 2 299.80 per 100 000 and 1 841.66 per 100 000, respectively. Compared with 1 761.59 per 100 000 and 1 849.31 per 100 000 in 1990, the crude rate increased by 30.55%, and the standardized rate decreased by 0.41%. In 2019, the crude rate and standardized rate of GERD prevalence in China were 5 739.55 per 100 000 and 4 509.32 per 100 000, respectively. Compared with 4 252.72 per 100 000 and 4 532.19 per 100 000 in 1990, the crude rate increased by 34.96%, and the standardized rate decreased by 0.51%. In 2019, the crude rate and standardized rate of GERD DALY rate in China were 44.37 per 100 000 and 34.94 per 100 000, respectively. Compared with 33.10 per 100 000 and 35.04 per 100 000 in 1990, the crude rate increased by 34.05%, and the standardized rate decreased by 0.29%. The standardized incidence, prevalence, and DALY rates were lower than crude rates after 1996. The standardized incidence, prevalence, and DALY rates of Chinese women were higher than those of men from 1990 to 2019. The results of Joinpoint regression analysis showed that the standardized incidence of GERD in China showed a downward trend from 1990 to 1994 (APC=-1.0%), a downward trend from 2005 to 2010 (APC=-1.4%), and an upward trend from 2014 to 2017 (APC=3.2%). The standardized prevalence of GERD in China showed a downward trend from 1990 to 1994 (APC=-1.2%), a downward trend from 2005 to 2009 (APC=-1.7%), and an upward trend from 2014 to 2017 (APC=3.7%). The standardized DALY rates of GERD in China showed a downward trend from 1990 to 1994 (APC=-1.1%), a downward trend from 2005 to 2009 (APC=-1.7%), and an upward trend from 2014 to 2017 (APC=3.6%). In 2019, the standardized incidence, prevalence, and DALY rates of GERD in China continued to increase with age, peaking at the age of 70 to 84 years. The number of new cases and cases of GERD in 2019 were respectively about 32.711 3 million and 81.636 5 million, and the populations were mainly concentrated in the age group of 45 to 59 years and 30 to 34 years.

From 1990 to 2019, the disease burden of GERD in China showed an upward trend in terms of crude rate and a slight decline in terms of standardized rate, indicating that aging had a great impact on the incidence, prevalence and DALY rate of GERD in China. In addition, it is important to pay attention to the middle-aged and young population, who account for a larger proportion of the population already suffering from GERD and may be closely related to overweight or obesity, alcohol consumption and dietary habits, etc.

Colorectal cancer has become the third most prevalent malignant tumor in Jiading district of Shanghai, and its disease burden is still increasing.

To analyze the epidemic trend of colorectal cancer in Jiading district of Shanghai from 2003 to 2019 and provide scientific basis for the prevention and treatment of colorectal cancer.

Based on the cancer registration data from 2003 to 2019 in Jiading district of Shanghai, the statistical indicators such as crude incidence rate, crude mortality rate, standardized incidence rate and standardized mortality rate were calculated (the rate was standardized using the Chinese standard population of 2010). Joinpoint Regression Program 4.9.1.0 software was used to analyze the trends of incidence rate and mortality rate.

From 2003 to 2019, there were 5 020 new cases of colorectal cancer in Jiading district of Shanghai, with a crude incidence rate of 52.12/100 000, a standardized incidence rate of 26.27/100 000; there were 2 419 deaths, with a crude mortality rate of 25.12/100 000, and a standardized mortality rate of 11.16/100 000; with males having higher crude incidence and crude mortality rates than females (P<0.05). There was an overall upward trend in the total population standardized incidence rate (APC=2.63%, P<0.05), with an increasing trend in the male standardized incidence rate (APC=3.48%, P<0.05), and no significant trend in the female standardized incidence rate (APC=1.39%, P=0.119), while no turning point was found. There was no significant trend in the total population standardized mortality rate (APC=-0.49%, P=0.250), of which there was no significant trend in the male standardized mortality rate (APC=0.34%, P=0.545), and a decreasing trend in the female standardized mortality rate (APC=-1.94%, P<0.05) .

From 2003 to 2019, the overall incidence rate of colorectal cancer in Jiading district of Shanghai still increased, among which there was an upward trend in males and no significant change in the trend for females. There was no significant trend in the overall mortality rate, among which there was no significant change in males and a downward trend in females. The prevention and control of colorectal cancer should continue to be strengthened, with a focus on the male population.

Dyslipidemia may be related to the occurrence and development of colorectal tumors. Numerous studies have confirmed that dyslipidemia increases the risk of colorectal adenomas at present; however, the association of dyslipidemia with colorectal serrated lesions and colorectal cancer is still controversial, and there are few relevant reviews in China. This article comprehensively explores the correlation of dyslipidemia with colorectal serrated lesions and colorectal cancer, analyzes the possible causes of controversy, identifies the directions of subsequent researches, and discusses the role of dyslipidemia in the occurrence and progression of colorectal tumors. This article indicates that dyslipidemia is associated with colorectal serrated lesions and colorectal cancer. Dyslipidemia may be involved in the development of colorectal tumors through the interaction of multiple mechanisms such as insulin resistance, inflammatory factors, oxidative stress, high-fat diet and immunosuppression. The incidence of colorectal cancer is increasing yearly with a relatively slower natural course and more definite precancerous lesions. Therefore, the clarification of correlation between lipid indexes and colorectal tumors can facilitate early prevention and targeted screening of colorectal tumors and provide a reference for formulating targeted prevention strategies for colorectal cancer.

Dietary over-restriction is common in patients with inflammatory bowel disease (IBD) and can lead to avoidant/restrictive food intake disorder (ARFID) in severe cases. Studies have shown that food literacy may influence patients' eating behavior to some extent, but whether it can directly affect ARFID in IBD patients has not been reported.

To understand the current status of food literacy and ARFID in patients with IBD, and analyse the correlation between the two.

This was a cross-sectional study, and convenience sampling method was used to select IBD patients who attended or were hospitalized in the outpatient clinics of gastroenterology and anorectal medicine in four general hospitals in Nanjing, including Jiangsu Province Hospital of Chinese Medicine (Affiliated Hospital of Nanjing University of Chinese Medicine), Nanjing Hospital of Chinese Medicine (Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine), Nanjing Drum Tower Hospital and Zhongda Hospital, Southeast University, from October 2022 to June 2023 as the study subjects. A self-made general information questionnaire, 9-item Avoidant/Restrictive Food Intake Disorder Screen (NIAS), and Food Literacy Scale were used to investigate the study subjects, to compare the NIAS and food literacy scores of IBD patients with different characteristics, and Pearson correlation analysis was used to explore the relationship.

A total of 438 questionnaires were distributed and 429 valid questionnaires were recovered, with a valid recovery rate of 97.95%. The NIAS score of IBD patients was (20.82±8.65), and the incidence of ARFID was 18.41% (79/429) ; the food literacy score was (32.72±9.68). Comparison of NIAS scores of patients with different disease types and disease activity showed statistically significant differences (P<0.05). Pearson correlation analysis showed that food literacy scores, planning and management dimensions of food literacy scale and the attitude towards making scores were negatively correlated with NIAS scores in patients with IBD (P<0.05) .

The level of food literacy in IBD patients needs to be improved. ARFID was common (18.41%), and food literacy was negatively associated with ARFID. Clinical medical staff should regularly evaluate patients' food literacy, monitor their eating behavior, and develop precise health education intervention paths to improve the level of food literacy, and reduce the incidence of ARFID.

Experiential effective prescription optimized Kuijie decoction can effectively improve the quality of life of patients with ulcerative colitis (UC), promote the intestinal mucosal healing and clinical remission, but its mechanism remains unclear now.

To investigate the effect and mechanism of optimized Kuijie decoction in UC rats with TCM syndrome differentiation of Qi stagnation and blood stasis.

From September to October 2023, 70 SPF-grade male SD rats were randomly divided into the blank-control, model, salicylazosulfapyridine, low-dose, standard-dose, Qi-enhancing and Blood-activating groups, with 10 rats in each group. UC model with TCM syndrome differentiation of Qi stagnation and blood stasis was established by trinitrobenzenesulfonic acid (TNBS) /ethanol secondary inflammation combined with restraint method. Rats in the blank-control group were enucleated with 0.9% sodium chloride solution at the time of modeling and were grasped and fixed synchronously with the rats in the other groups, and were given an equal volume of water by gavage once per day after the establishing for 14 days; rats in the model group were given an equal volume of water by gavage once per day after the establishing for 14 days; rats in the salicylazosulfapyridine, low-dose, standard-dose, Qi-enhancing and Blood-activating groups were given intragastric administration with salicylazosulfapyridine suspension (0.54 g/kg), low-dose optimized Kuijie decoction (0.837 g/kg), standard-dose optimized Kuijie decoction (1.674 g/kg), Astragalus suspension (1.8 g/kg) and Safflower suspension (0.9 g/kg) once per day after the establishing for 14 days, respectively. High-precision transmission electron microscope was used to observe the ultrastructural changes in the colonic tissues of the seven groups of rats after intervention, the expression levels of CXCR4, VEGFA, and TAK1 were compared among the seven groups of rats after intervention.

The ultrastructure of colonic tissue of rats in the low-dose and standard-dose groups tended to be normal after intervention. The gray ratios of proteins and relative mRNA expression quality of CXCR4, VEGFA and TAK1 in colonic tissues of rats in the model group were higher than the blank-control after intervention (P<0.05) ; the gray ratios of proteins and relative mRNA expression quality of CXCR4, VEGFA and TAK1 in the salicylazosulfapyridine, low-dose, standard-dose, Qi-enhancing and Blood-activating groups were significantly lower than those in the model group (P<0.05) ; the gray ratios of proteins of CXCR4, VEGFA and TAK1 in the standard-dose group were significantly lower than those in the salicylazosulfapyridine group, relative mRNA expression quality of VEGFA and TAK1 in the Blood-activating group was significantly lower than that in the salicylazosulfapyridine group, respectively (P<0.05) .

Optimized Kuijie decoction and its Qi-enhancing and Blood-activating components can effectively reduce the expression of CXCR4, VEGFA and TAK1 in colonic tissue in UC rats with TCM syndrome differentiation of Qi stagnation and blood stasis, its therapeutic effect may act through the coordinate regulating of the expression of CXCR4, VEGFA and TAK1 in colonic tissue by Qi-enhancing component and blood-activating component.

Due to economic development changes in domestic fertility policy, the incidence of acute pancreatitis in pregnancy (APIP) has been gradually increasing. The clinical characteristics of APIP of different etiologies are different, and there may be significant differences in the prognosis for mothers and infants, but previous studies on this are relatively few.

To analyze the clinical characteristics and maternal and neonatal outcomes in pregnancy complicated with acute pancreatitis patients of different etiologies.

A total of 48 inpatients with APIP in Beijing Friendship Hospital, Capital Medical University from 2016 to 2022 were collected, which were divided into the biliary group (n=27) and hyperlipidemic group (n=21). The laboratory indicators and maternal and infant outcomes in the two groups were compared.

The biliary group had a longer time of onset to visit, a smaller gestational week at admission, more previous pregnancies, and lower percentage of diarrhea and cessation of defecation than the hyperlipidemic group (P<0.05). There was no statistically significant difference in severity between the two groups of patients (P=0.912). The levels of hemoglobin, platelets, C-reactive protein, cholesterol, and triacylglycerol in the biliary group were lower than those in the hyperlipidemia group, while the levels of total bilirubin, direct bilirubin, alanine transaminase, alkaline phosphatase, glutamyltranspeptidase, creatinine, calcium, sodium, amylase, and N-terminal brain natriuretic peptide precursor were higher than those in the hyperlipidemia group (P<0.05). The gestational week at delivery of the biliary group was shorter than the hyperlipidemia group (P<0.05). There was no statistically significant difference in premature delivery rate, cesarean section rate, and artificial intervention termination of pregnancy rate between the biliary group and hyperlipidemia group (P>0.05). The birth weight of the biliary group was smaller than the hyperlipidemia group, while the birth length was shorter than the hyperlipidemia group. The incidence of neonatal jaundice, respiratory distress, and ventilator-assisted breathing was higher than the hyperlipidemia group (P<0.05) .

Biliary diseases are still the first cause of APIP patients, which can significantly shorten the maternal gestational week, cause low fetal body mass, increase the incidence of pathological jaundice, respiratory distress, and ventilator-assisted breathing in the fetus, leading to a more severe prognosis for the fetus.

In recent years, screening, early diagnosis and early treatment of upper gastrointestinal cancer have been successively carried out in various provinces and cities in China. At present, there are few studies on the screening results of upper gastrointestinal cancer and influencing factors of gastric cancer in coastal area of northern Jiangsu.

To analyze the influencing factors of gastric cancer based on the results of opportunistic screening for upper gastrointestinal cancer in rural population in coastal areas of northern Jiangsu, so as to provide a reference for the development of relevant prevention and control strategies.

A total of 8 564 rural subjects at high risk for upper gastrointestinal cancer admitted to the outpatient department of gastroenterology of the Affiliated Lianyungang Hospital of Xuzhou Medical University and received gastroscopy screening from January 2021 to December 2022 were selected, and divided into the gastric cancer group (n=183) and benign gastric disease group (n=366) after matching according to age (±2 years) and gender (1∶2) based on the screening results. The baseline data of the subjects were collected, the cancer detection rate and cancer early diagnosis rate were calculated. Multivariate Logistic regression analysis was used to explore the influencing factors of gastric cancer in rural population in coastal area of northern Jiangsu.

A total of 521 patients with upper gastrointestinal neoplastic lesions were detected, including 183 patients with gastric (including cardia) cancer, with a detection rate of 2.14% (183/8 564) ; and 46 patients with early gastric (including cardia) cancer, with the early diagnosis rate of 25.14% (46/183) . There was no significant difference in the distribution of different categories of gastric neoplastic lesions in different genders and ages (P>0.05) . The detection rate of gastric (including cardia) neoplastic lesions in males (5.14%, 195/3 795) was higher than females (2.05%, 98/4 769) , and the difference was statistically significant (χ²=60.807, P<0.001) . There were significant differences in the detection rate of gastric (including cardia) neoplastic lesions among different age groups (χ²=163.216, P<0.001) and early diagnosis rate of gastric cancer among different age groups (χ²=69.349, P<0.001) , among which the early diagnosis rate was the highest in the group of 40-49 years (37.50%) and the lowest in the group over 80 years (10.53%) . Multivariate Logistic regression analysis showed that junior high school education or below (OR=4.001, 95%CI=2.029-7.890, P<0.001) , smoking (OR=3.710, 95%CI=2.127-6.470, P<0.001) , salty taste (OR=1.777, 95%CI=1.067-2.957, P=0.027) , frequent spicy diet (OR=2.147, 95%CI=1.297-3.556, P=0.003) , preference for red meat (OR=1.787, 95%CI=1.018-3.139, P=0.043) , frequent consumption of leftovers (OR=2.452, 95%CI=1.538-3.912, P<0.001) , irregular diet (OR=2.420, 95%CI=1.420-4.124, P=0.001) and helicobacter pylori (H. pylori) positive/previously positive (OR=3.785, 95%CI=2.394-5.984, P<0.001) were risk factors for gastric cancer in rural population, while regular physical exercise (OR=0.598, 95%CI=0.359-0.996, P=0.048) and frequent consumption of fresh fruits (OR=0.531, 95%CI=0.328-0.860, P=0.010) were protective factors for gastric cancer in rural population.

Opportunistic screening of upper gastrointestinal cancer is beneficial for the detection of upper gastrointestinal cancer in Coastal Area of Northern Jiangsu. Junior high school education and below, smoking, multiple unhealthy food habits and H. pylori positive/previously positive are risk factors for gastric cancer in rural population. Future efforts should focus on improving the awareness of gastric cancer prevention among rural males and elderly population in the region.