目的 探讨个体化肠内营养支持在胃肠术后早期应用的可行性及安全性。方法 选取2022年1月—12月安徽省亳州市中医院普通外科收治的胃肠手术患者100例。使用随机数字表法将患者随机为观察组和对照组,每组各50例。观察组在常规治疗基础上实施个体化肠内营养,持续7 d。对照组则接受术后常规处理。术后第7天测定实验室指标,并比较两组胃肠功能的恢复情况。结果 观察组术后肛门首次排气时间短于对照组[（55.41±19.63）h vs （81.46±19.39） h],前白蛋白水平高于对照组[（241.14±65.73）g/L vs（217.35±51.63）g/L],组间比较差异有统计学意义（P<0.05）。血清总蛋白水平[（70.55±18.89）g/L vs （68.16±20.05）g/L]、血清白蛋白水平[（53.22±17.76）g/L vs（50.76±18.54）g/L]、淋巴细胞计数[（1.60±0.54）×10⁹/L vs （1.56±0.55）×10⁹/L]以及肛门排便时间[（89.67±22.31）h vs （97.77±21.27）h ]在组间比较差异无统计学意义（P>0.05）。结论 根据个体情况在胃肠术后早期实施个体化的肠内营养支持是安全可行的,能够促进胃肠功能的快速恢复,从而改善患者的营养状况。

Objective To investigate the feasibility and safety of personalized enteral nutrition support during the early postoperative period of gastrointestinal surgery．Methods A total of 100 patients who underwent gastrointestinal surgery at the Department of General Surgery,Bozhou Hospital of Traditional Chinese Medicine,who were enrolled in this study during January 2022 to December 2022．Patients were randomly allocated into either the observational or control group,with 50 patients in each group．The randomization was performed using a random number table．The observational group received personalized enteral nutrition support in addition to routine treatment for 7 days．The control group received standard postoperative care．Laboratory indicators were measured on the 7th postoperative day to compare recovery of gastrointestinal function between the two groups．Results The observational group exhibited a significantly shorter time to the first passage of flatus from the anus compared to the control group（55.41±19.63 h vs 81.46±19.39 h,P<0.05）,as well as higher prealbumin levels（241.14±65.73 g/L vs 217.35±51.63 g/L,P<0.05）．However,there were no significant differences between the two groups in terms of serum total protein levels（70.55±18.89 g/L vs 68.16±20.05 g/L）,serum albumin levels（53.22±17.76 g/L vs 50.76±18.54 g/L）,lymphocyte counts[（1.60±0.54）×10⁹/L vs （1.56±0.55）×10⁹/L],and time to the first defecation from the anus（89.67±22.31 h vs 97.77±21.27 h）（all P>0.05）．Conclusions Personalized enteral nutrition support based on individual conditions is safe and feasible in the early postoperative period of gastrointestinal surgery．It can promote the rapid recovery of gastrointestinal function and improve patients' nutritional status．

目的 探讨学生实验室安全知识盲区,以提高高校实验室安全管理工作的成效。方法 考试人数192人,共计235次考试,根据考试系统的统计分析结果,观察各题目错误率和各选项构成比;结合统计描述和χ²检验,探讨影响学生实验室安全考试成绩的原因和所存在的知识盲区。结果 41%的考生身份为在读硕士研究生,59%的考生为在读本科生,男生占48%,女生占52%,且比较不同身份的性别构成比,差异无统计学意义;题目被归纳分为“行为规范”“应急自救技能”和“事故防范能力”三大部分,比较“行为规范”和“应急自救技能”类题目的错误率,差异存在统计学意义（χ²=7.570,P=0.006）,“应急自救技能”类题目的错误率为3.14%,高于其余两类。结论 高校学生对应急自救技能类可能存在较多的知识盲区,应以之作为实验室安全管理工作关键控制点,加强应急自救技能培训可以极大地降低事故的严重程度。

Objective To enhance the efficiency of laboratory safety management in colleges,we analyzed the insufficiency of students in the knowledge about laboratory safety. Methods A total of 192 college students had attended the education tests of laboratory safety and totally 235 tests had been successfully recorded．According to the statistical analysis results,we observed the error ratio and the and the composition of the options for each question in the tests．With statistical description and Chi-square test,the impact of the test scores and the main insufficiency in the knowledge about laboratory safety were discussed. Results 41% of the students were pursuing master's degree,59% of them were pursuing bachelor's degree,48% are males and 52% are females,there was no significant difference in gender composition among different identities．All the questions had been categorized into three types,which were principle for conduct in laboratory,the skills of self rescue and the capability to prevent accidence．There was statistical significance between types of questions on principle for conduct in laboratory and the skills of self rescue（χ²=7.570,P=0.006）,the error ratio of the question type of skills of self rescue was 3.14%,which was higher than the other types. Conclusions The insufficiency in the knowledge of skills of self rescue might probably be the critical control point in laboratory safety management,which should set as the key point of lab security,improve the self rescue skill of students may decrease thu severity accidence．

目的 初步探讨无创产前基因检测（NIPT）筛查胎儿患猫叫综合征临床性能。方法 收集2018年4月—2019年3月行NIPT提示胎儿患猫叫综合征高风险的孕妇,并收集其羊水细胞培养染色体核型分析或微阵列芯片检测结果,分析NIPT与羊水产前诊断结果的符合率。结果 NIPT提示猫叫综合征病例11例,孕妇均接受了羊水穿刺,染色体核型分析或微阵列芯片检测出胎儿染色体异常6例,符合率为54.5%。结论 NIPT对胎儿猫叫综合征的筛查具有临床价值,当提示高风险时必须行有创性产前诊断。

Objective To investigate the value of non-invasive prenatal testing（NIPT）for the screening of fetal Cri du Chat Syndrome（CdCS）. Methods Pregnant women who accepted NIPT with the results with high risk of fetal CdCS were selected in the study from April 2018 to March 2019．They were also accepted prenatal genetic counseling and the chromosome karyotype analysis or CMA detection of amniotic fluid cell culture．The coincidence rate of NIPT with chromosome karyotype and microarray analysis results were conducted. Results There were 11 cases with high risk of fetal CdCS in NIPT．All of them had received amniocentesis chromosome karyotype or microarray analysis,6（54.5%）cases were confirmed. Conclusions NIPT has some clinical value in screening fetal CdCS from maternal blood．Therefore,it was suggested to perform the invasive chromosomal karyotyping and CMA for high risk of fetal CdCS．

在过去的几十年中,随着RNA生物学的深入研究,越来越多的证据表明,非编码RNA（ncRNA）对包括癌症在内的多种疾病进展起着关键作用,同时在作为生物标志物和治疗靶点方面表现出了巨大的潜力。在全球范围内,消化道（GI）肿瘤是肿瘤相关死亡的主要原因,目前消化道肿瘤晚期患者的生存率依然很低。既往大量研究报道了ncRNA中,特别是长链非编码RNA（lncRNA）在消化道肿瘤发生发展中发挥重要作用。本文将着重阐述lncRNA在消化道肿瘤分子生物学中的作用,旨在为深入理解lncRNA在消化道肿瘤发生发展机制以及临床转化应用提供新的思路和线索。

In recent decades,an increasing body of evidence has pointed to the pivotal roles of non-coding RNAs（ncRNAs）,particularly long non-coding RNAs（lncRNAs）,in the development of various diseases,including cancer．Meanwhile,ncRNAs have been shown great potential as biomarker and therapeutic target．Gastrointestinal（GI）cancers are a leading cause of cancer-related mortality globally and the survival rate of advanced GI cancer patients is still very low．Extensive research has underscored the significant involvement of lncRNAs in the initiation and progression of GI cancers．This review aims to offer a comprehensive overview of lncRNAs,shedding light on their roles in the molecular biology of GI cancers．By synthesizing previous studies,this review seeks to provide new insights into the mechanisms underlying lncRNAs' contribution to GI cancer development and their potential clinical applications．

目的 探讨高频超声对小儿梅克尔憩室所致肠梗阻的诊断价值。方法 选取广州市妇女儿童医疗中心2018年1月—2023年12月经手术证实的由梅克尔憩室引起的肠梗阻患儿41例作为研究对象,回顾性分析患儿临床资料及超声表现,并与术中所见和病理结果进行对照。结果 41例患儿,发病平均年龄为（3.97±3.69）岁,其中男32例、女9例。术前超声诊断肠梗阻38例,诊断符合率为92.7%;诊断梅克尔憩室所致肠梗阻9例,诊断符合率为21.9%。术中诊断梅克尔憩室索带卡压肠管24例,腹内疝8例,肠扭转1例;肠套叠10例;梅克尔憩室炎症、粘连6例,粘连穿孔1例;憩室内异物并穿孔1例。结论 高频超声对小儿肠梗阻有重要的诊断价值,仔细探查可以明显提高梅克尔憩室所致肠梗阻的临床诊断率,为临床尽早手术提供重要依据。

Objective To investigate the diagnostic value of high frequency ultrasound for intestinal obstruction caused by Meckel's diverticulum in children．Methods From January 2018 to December 2023,41 children with intestinal obstruction caused by Meckel's diverticulum were selected as the study objects．The clinical data and ultrasound images of the children were analyzed retrospectively,and compared with the intraoperative and pathological results．Results In 41 patients,the average age of onset was（3.97±3.69）years ,including 32 males and 9 females．Preoperative ultrasonic diagnosis of intestinal obstruction in 38 cases,diagnosis coincidence rate was 92.7%．Intestinal obstruction caused by Meckel's diverticulum was diagnosed in 9 cases,the diagnosis coincidence rate was 21.9%．During the operation,24 cases of Meckel's diverticulum intestinal compression were diagnosed,8 cases of abdominal hernia,1 case of intestinal torsion,and intussusception of 10 cases．Meckel's diverticulum had inflammation and adhesion in 6 cases and adhesion perforation in 1 case．A case of foreign body in diverticulum with perforation．Conclusions High-frequency ultrasound has an important diagnostic value for intestinal obstruction in children．Careful exploration can significantly improve the clinical diagnosis rate of intestinal obstruction caused by Meckel's diverticulum,and provide an important basis for early clinical operation．

临床研究中,我们会经常遇到多重检验的问题。当同时检验多个假设时,如何控制犯Ⅰ类错误的概率,保证结果的准确性,是研究者面对的首要问题。然而未对多重检验进行校正的文章比例仍较大。本文从简单的单个检验假设出发,回答为什么需要进行多重校正,何时进行多重校正,同时介绍总体错误率(FWER)和错误发现率(FDR)两种重要的错误率以及在此基础上的Bonferroni和Benjamini-Hochberg校正方法,从而避免因多重检验问题带来的混乱。

In clinical research, we often encounter the problem of multiple testing. When testing many hypotheses at the same time, how to control the type I error to ensure the accuracy of the results is the primary problem faced by researchers. However, the proportion of articles that didn't correct the multiple testing remains substantial. Starting with the simple hypothesis of a single test, this article provides an introduction to multiple testing issues, answers why and when multiple corrections are needed, introduces two important error rates which are family-wise error rate (FWER) and false discovery rate (FDR), and the Bonferroni and Benjamini-Hochberg correction methods based on them, thereby avoiding confusion caused by multiple testing.

消化系统疾病诊治与组织病理诊断密切相关,高效、规范获取组织样本是关键,对此2021年欧洲胃肠内镜学会制定了消化道及肝胰腺胆道的内镜下组织活检的指南,分为上消化道（含肝、胰腺、胆道）和下消化道两部分,提供了规范活检的指导及建议。笔者对指南就上消化道内镜下组织活检的部分内容进行解读,解读内容为个人观点。

The diagnosis and treatment of digestive system diseases are closely related to histopathological diagnosis．Efficient and standardized acquisition of tissue samples plays a key role．In 2021,European Society of Gastrointestinal Endoscopy（ESGE）had developed guidelines for endoscopic tissue biopsy of the digestive tract and hepatopancreatic biliary tract,which divided into upper gastrointestinal tract（including liver,pancreas,biliary tract）and lower gastrointestinal tract．This guideline provided guidance and recommendations for standardizing biopsies．We interprets some of the contents of the guideline on tissue biopsy under endoscopy of the upper gastrointestinal tract,which are personal opinions．

目的 从炎症反应和肠道屏障两个方面探究五味苦参肠溶胶囊对葡聚糖硫酸钠（DSS）诱导的小鼠结肠炎的治疗作用。方法 6~8周龄雄性BALB/c小鼠被随机分为3组,分别为正常组、急性肠炎模型组和五味苦参组。急性肠炎模型组和五味苦参组小鼠予含有3% DSS的饮用水1周诱导急性结肠炎,其后急性肠炎模型组予PBS灌肠,五味苦参组予五味苦参肠溶胶囊制备为灌肠液灌肠。每天称量小鼠体质量,观察大便性状及血便情况,第8天处死小鼠,取结肠组织检测炎症细胞因子和肠屏障因子。结果 与正常组相比,急性肠炎模型组肠道炎症明显,五味苦参组有效缓解肠道炎症和有利于肠上皮屏障修复。表现为五味苦参灌肠液有效缓解小鼠体质量下降,具有较低的DAI评分,有较好的组织学表现,其结肠组织IL-1β,IL-6和TNF-α的相对表达下降,Occludin和ZO-1的相对表达增加（P<0.05）。结论 五味苦参肠溶胶囊制备的灌肠液可减轻DSS诱导的小鼠急性结肠炎。

Objective To explore the therapeutic effect of five-flavor sophora flavescens enteric-coated capsules（FSEC）on dextran sulphate sodium（DSS）-induced colitis in mice from inflammatory response and intestinal barrier．Methods Male BALB/c mice aged 6-8 weeks were randomly divided into three groups,namely normal group,acute colitis group and FSEC group．The mice in acute colitis group and FSEC group were given drinking water containing 3% DSS for one week to induce acute colitis,and then they were given PBS enema or FSEC enema respectively．The mice were administered daily,including weight loss,the stool properties and bloody feces．The mice were sacrificed on the 8th day,and the colon tissue was collected to detect inflammatory cytokines and intestinal barrier cytokines．Results Compared with the normal group,the intestinal inflammation in the acute colitis group was obvious,however the FSEC effectively relieved intestinal inflammation and facilitated the intestinal epithelial barrier repair．It showed that FSEC enema effectively relieved weight loss and had a lower disease activity index score．In addition,FSEC enema group had better histological appearance．Compared to acute colitis group,the relative expression of IL-1β,IL-6 and TNF-α in colon tissue decreased,and the relative expression of Occludin and ZO-1 significantly increased in FSEC group（P<0.05）．Conclusions FSEC enema can alleviate DSS-induced acute colitis in mice．

目的 探讨功能性消化不良（FD）患者应用乳果糖联合莫沙必利治疗的临床疗效及药物对肠道菌群的影响。方法 选取2019年1月—2021年12月来院诊治的180例FD患者作为研究对象,随机分为2组,每组90例,对照组口服莫沙必利片,观察组服用莫沙必利片+乳果糖口服液,4周后观察2组患者治疗后临床症状改善率及肠道菌群数量的情况。结果 治疗4周后,观察组的总有效率（86.67%）高于对照组（72.22%）,P<0.05;观察组的乳杆菌菌群数多于对照组,肠球菌、肠杆菌菌群数少于对照组,P<0.05。结论 乳果糖联合莫沙必利用于FD患者临床治疗,总有效率高于单用莫沙必利,患者症状获得有效改善,明显改善FD患者肠道菌群水平。

Objective To explore the clinical efficacy and effect on intestinal flora of lactulose combined with mosapride in patients with functional dyspepsia（FD）．Methods A total of 180 FD patients admitted to the hospital in January 2019 and December 2021 were selected as the study subjects and randomly divided into two groups,90 cases in each group．The control group took oxapride orally and the observation group took lactulose oral solution additionally．After 4 weeks,the improvement rate of clinical symptoms and the number of intestinal flora of patients were observed．Results After 4 weeks of treatment,the total effective rate of the observation group（86.67%）was obviously higher than that of the control group（76.67%）,P<0.05;the number of Lactobacillus in the observation group was higher than that of the control group,and the numbers of Enterococcus and Enterobacteria were less than that of the control group,P<0.05．Conclusions The total effective rate of lactulose combined with mosalabin for FD patients is higher than that of mossalapride alone．The symptoms are effectively improved,and the intestinal flora level of FD patients is significantly improved．

目的 上消化道出血发作急、变化快,具有较高的危险性,本研究目的在于分析急性上消化道出血患者的临床特征及危险因素,为临床诊治提供参考。方法 将2019年1月—2021年2月年我院的242例疑似急性上消化道出血患者作为研究对象,收集患者的年龄、性别、是否有长期抽烟史、饮酒史,是否有合并症以及并发症等一般资料,运用单因素分析其临床特征,运用多因素Logistic回归分析其独立危险因素。结果 患者年龄、长期饮酒史、消化性溃疡、门脉高压、急性胃黏膜病变、服用阿司匹林(ASA药物)、Hp感染等临床特征与急性上消化道出血具有相关性,与患者的性别、长期抽烟史不具有相关性;年龄、消化性溃疡、门脉高压、服用ASA药物、Hp感染是急性上消化道出血的危险性因素。结论 急性上消化道出血病势程度较重,死亡率高,出血需及时针对性治疗;对于急性上消化道出血高危患者,严密监测病情变化,评估其风险系数。

Objective Upper gastrointestinal bleeding has a high risk because of its rapid change. The purpose of this study is to analyze the clinical characteristics and risk factors of patients with acute upper gastrointestinal bleeding, so as to provide reference for clinical diagnosis and treatment. Methods A total of 242 patients with suspected acute upper gastrointestinal bleeding in our hospital from January 2019 to February 2021 were selected as the research objects. The general data such as patients' age, gender, whether they had a long-term history of smoking or drinking, whether they had complications and data of complications were collected. The clinical characteristics were analyzed by univariate analysis, and the independent risk factors were analyzed by multivariate Logistic regression analysis. Results Age, long-term drinking history, peptic ulcer, portal hypertension, acute gastric mucosal lesions, taking aspirin (ASA drugs), Hp infection and other clinical characteristics were correlated with acute upper gastrointestinal bleeding, but gender and long-term smoking history were not. Age, peptic ulcer, portal hypertension, taking ASA drugs and Hp infection were the risk factors of acute upper gastrointestinal bleeding. Conclusion The acute upper gastrointestinal bleeding is a serious disease, with high mortality, and the bleeding needs timely targeted treatment. For patients with high-risk acute upper gastrointestinal bleeding, closely monitor the changes of the disease and evaluate the risk coefficient are needed.