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Development and validation of a novel criterion of histologic healing in ulcerative colitis defined by inflammatory cell enumeration in lamina propria mucosa:A multicenter retrospective cohort in China

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Chinese Medical Journal 2024年第11期137卷 1316-1323页

作者： Han Gao Kangsheng Peng Yadi Shi Shenshen Zhu Ruicong Sun Chunjin Xu Ping liu Zhi Pang Lanxiang Zhu Weichang Chen Baisui Feng Huili Wu Guangxi Zhou Mingsong Li Junxiang Li Baijing Ding zhanju liu Center for IBD Research and Department of Gastroenterology Shanghai Tenth People’s HospitalTongji University School of MedicineShanghai 200085China Clinical Medicine Sanquan College of Xinxiang Medical UniversityXinxiangHenan 453003China Department of Gastroenterology The First People’s Hospital of Shangqiu City Affiliated to Xinxiang Medical UniversityShangqiuHenan 476100China Department of Gastroenterology Wuhu First People’s HospitalWuhuAnhui 241000China Department of Gastroenterology Suzhou Municipal Hospital Affiliated to Nanjing Medical UniversitySuzhouJiangsu 215008China Department of Gastroenterology The First Affiliated Hospital of Soochow UniversitySuzhouJiangsu 251006China Department of Gastroenterology The Second Affiliated Hospital of Zhengzhou UniversityZhengzhouHenan 450014China Department of Gastroenterology Zhengzhou Central Hospital Affiliated to Zhengzhou UniversityZhengzhouHenan 450000China Department of Gastroenterology The Affiliated Hospital of Jining Medical CollegeJiningShandong 272004China Department of Gastroenterology The Third Affiliated Hospital of Guangzhou Medical UniversityGuangzhouGuangdong 510140China Department of Gastroenterology Dongfang Hospital of Beijing University of Chinese MedicineBeijing 100078China

Background:Histological healing is closely associated with improved long-term clinical outcomes and lowered relapses in patients with ulcerative colitis(UC).Here,we developed a novel diagnostic criterion for assessing histological healing in UC ***:We conducted a retrospective cohort study in UC patients,whose treatment was iteratively optimized to achieve mucosal healing at Shanghai Tenth People’s Hospital of Tongji University from January 2017 to May *** identified an inflammatory cell enumeration index(ICEI)for assessing histological healing based on the proportions of eosinophils,CD177^(+)neutrophils,and CD40L^(+)T cells in the colonic lamina propria under high power field(HPF),and the outcomes(risks of symptomatic relapses)of achieving histological remission *** histological inflammation using Kaplan-Meier *** reliability and inter-reader reliability were evaluated by each *** relationships to the changes in the Nancy index and the Geboes score were also assessed for *** ICEI was further validated in a new cohort of UC patients from other nine university ***:We developed an ICEI for clinical diagnosis of histological healing,i.e.,Y=1.701X_(1)+0.758X_(2)+1.347X_(3)-7.745(X_(1),X_(2),and X_(3)represent the proportions of CD177^(+)neutrophils,eosinophils,and CD40L^(+)T cells,respectively,in the colonic lamina propria under HPF).The receiver operating characteristics curve(ROC)analysis revealed that Y<-0.391 was the cutoff value for the diagnosis of histological healing and that an area under the curve(AUC)was 0.942(95%confidence interval[CI]:0.905-0.979)with a sensitivity of 92.5%and a specificity of 83.6%(P<0.001).The intraclass correlation coefficient(ICC)for the intrareader reliability was 0.855(95%CI:0.781-0.909),and ICEI had good inter-reader reliability of 0.832(95%CI:0.748-0.894).During an 18-month follow-up,patients with histological healing had a substantially better outcome com

关键词： Ulcerative colitis Histological healing Inflammatory cell enumeration index Prognosis

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炎症性肠病药物治疗优化策略

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中华消化杂志 2024年第1期44卷 3-7页

作者：刘占举同济大学附属第十人民医院消化内科

炎症性肠病(IBD)是原因不明的一组慢性非特异性胃肠道炎症性疾病, 主要包括克罗恩病和溃疡性结肠炎。随着对IBD病理生理发病机制的认识不断增进, 以及新药研发与临床试验优化, 消化内科医师在IBD的疾病分型、药物遴选、预防复发等方面... 详细信息

炎症性肠病(IBD)是原因不明的一组慢性非特异性胃肠道炎症性疾病, 主要包括克罗恩病和溃疡性结肠炎。随着对IBD病理生理发病机制的认识不断增进, 以及新药研发与临床试验优化, 消化内科医师在IBD的疾病分型、药物遴选、预防复发等方面都取得了长足进步。笔者对近年来国内外IBD药物治疗的最新治疗进展给予系统性总结, 以期对临床治疗提供帮助。

关键词：炎症性肠病药物疗法优化方案糖皮质激素类生物制剂

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英夫利西单抗治疗克罗恩病的临床疗效及影响因素

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中华消化病与影像杂志（电子版） 2024年第1期14卷 28-34页

作者：刘萍刘占举张萃芜湖市第一人民医院消化内科安徽省241000 同济大学附属第十人民医院消化内科上海200072

目的分析英夫利西单抗(IFX)治疗克罗恩病(CD)的有效性及其影响因素。方法回顾性纳入2018年1月1日至2022年7月1日于同济大学附属上海市第十人民医院的IFX治疗的CD住院患者375例,收集患者IFX治疗前基线资料及用药第54周随访资料,包括年龄... 详细信息

目的分析英夫利西单抗(IFX)治疗克罗恩病(CD)的有效性及其影响因素。方法回顾性纳入2018年1月1日至2022年7月1日于同济大学附属上海市第十人民医院的IFX治疗的CD住院患者375例,收集患者IFX治疗前基线资料及用药第54周随访资料,包括年龄、性别、病程、蒙特利尔分型、手术史、既往用药史、身高、体重、克罗恩病疾病活动度评分(CDAI)、简化克罗恩病内镜评分(SES-CD),评估IFX治疗1年CD患者的临床和内镜应答率、缓解率。利用卡方检验、单因素及多因素分析发现影响IFX治疗CD有效性的关键因素。结果375例CD有352例为IFX药物治疗,23例为回肠造口术后启用IFX治疗。352例CD患者中,72.7%患者治疗1年后达临床应答(ΔCDAI≥70),61.4%达临床缓解(第54周CDAI<150),56.3%达内镜应答(ΔSES-CD≥50%),37.6%达内镜缓解(SES-CD≤2)。23例回肠造口术后CD患者中,4.3%达内镜缓解(Rutgeert评分

关键词：克罗恩病:抗肿瘤坏死因子α单克隆抗体英夫利西单抗肛周克罗恩病临床疗效

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Dichotomous roles of neutrophils in modulating pathogenic and repair processes of inflammatory bowel diseases

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Precision Clinical Medicine 2021年第4期4卷 246-257页

作者： Huimin Chen Xiaohan Wu Chunjin Xu Jian Lin zhanju liu Center for Inflammatory Bowel Disease Research the Shanghai Tenth People’s HospitalTongji University School of MedicineShanghai 200072China Department of Gastroenterology the First People’s Hospital of Shangqiu City Affiliated to Xinxiang Medical UniversityShangqiu 476100China Department of Gastroenterology Affiliated Hospital of Putian UniversityPutian 351106China

Neutrophils are considered as complex innate immune cells and play a critical role in maintaining intestinal mucosal *** exert robust pro-inflammatory effects and recruit other immune cells in the acute phase of pathogen infection and intestinal inflammation,but paradoxically,they also limit exogenousmicrobial invasion and facilitate mucosal *** or dysfunction of neutrophils results in abnormal immune responses,leading to multiple autoimmune and inflammatory diseases including systemic lupus erythematosus,rheumatoid arthritis,and inflammatory bowel diseases(IBD).As a refractory intestinal inflammatory disease,the pathogenesis and progression of IBD are associated with complicated immune response processes in which neutrophils are profoundly ***,the consensus on potential roles of neutrophils in modulating pathogenic and repair processes of IBD remains not fully *** infiltrating neutrophils cross the epithelial barrier and contribute to microbial dysbiosis,aggravated intestinal architectural damage,compromised resolution of intestinal inflammation and increased risk of thrombosis during ***,activated neutrophils are also associated with effective elimination of invaded microbiota,promoted angiogenesis and tissue restoration of gutmucosa in ***,we discuss the beneficial and detrimental roles of neutrophils in the onset and resolution of intestinalmucosal inflammation,hoping to provide a precise overview of neutrophil functions in the pathogenesis of IBD.

关键词： neutrophil innate immune cell inflammatory bowel disease intestinal inflammation mucosal homeostasis immune response microbial dysbiosis

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乌司奴单克隆抗体治疗克罗恩病的短期临床疗效及影响因素

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实用医学杂志 2024年第7期40卷 989-995页

作者：王芮刘嫦钦张萃杨清露杨娇兰殷鹏云李晓辉孙永顺刘占举孙晓敏同济大学附属上海市第十人民医院上海200072 上海中医药大学附属市中医医院上海200071

目的探讨乌司奴单克隆抗体(UST)治疗克罗恩病(CD)的短期临床疗效及影响因素,为UST的临床应用提供更多的证据支持。方法采用回顾性队列研究方法,收集2020年12月至2022年10月在同济大学附属第十人民医院采用UST治疗的CD患者临床资料。主... 详细信息

目的探讨乌司奴单克隆抗体(UST)治疗克罗恩病(CD)的短期临床疗效及影响因素,为UST的临床应用提供更多的证据支持。方法采用回顾性队列研究方法,收集2020年12月至2022年10月在同济大学附属第十人民医院采用UST治疗的CD患者临床资料。主要分析UST治疗CD第8、16周的短期临床疗效和影响因素,并分析部分患者的内镜缓解率。结果共纳入91例初次使用UST的CD患者。UST治疗CD第8/16周的临床应答率分别为61.5%、71.4%,临床缓解率分别为45%、54.9%。单因素分析表明瘘(包括肛瘘、肛瘘个人史、肠皮瘘)与CD第8/16周的临床缓解有关。多因素COX分析提示,有肛瘘手术史相比于无瘘者是影响UST治疗CD第8周(HR=0.04,95%CI:0.00~0.38;P<0.01)和16周(HR=0.04,95%CI:0.01~0.34;P<0.01)临床缓解的独立保护性因素;狭窄型病变相较于非狭窄非穿透性病变,是CD患者16周临床缓解的独立危险因素(HR=1.75,95%CI:1.08~2.84;P<0.05)。56例于我院复查内镜,16周的内镜缓解率为41.1%。未发现有患者因严重不良反应停止用药。结论UST能够改善CD第8/16周的临床缓解与临床应答,具有较好的短期临床疗效。有肛瘘个人史的CD患者推荐应用UST单抗,具有狭窄型病变的患者需谨慎应用UST单抗。患者既往是否行手术治疗,以及UST一线或非一线应用,均对临床缓解无明显影响。

关键词：乌司奴单克隆抗体克罗恩病临床缓解临床应答

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Study of stimulated Raman and Brillouin scattering in a finite interaction region under the convective instability condition

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Chinese Science Bulletin 2012年第21期57卷 2747-2751页

作者： HAO Liang liu zhanju ZHENG ChunYang XIANG Jiang FENG Wu HU XiaoYan LI Bin Institute of Applied Physics and Computational Mathematics Beijing 100094China Center for Applied Physics and Technology Peking UniversityBeijing 100871China Graduate School of China Academy of Engineering Physics Beijing 100088China

We discuss stimulated Raman scattering (SRS) and stimulated Brillouin scattering (SBS) under the convective instability condition with a one-dimensional three-wave interaction (3WI) *** linear theory,we deduce the temporal growth rate,gain exponent,and reflectivity of the backward scattered wave in a finite interaction *** find that the growth rate is not only determined by the laser intensity and plasma density and temperature,but also related to the spatial *** length of the interaction region is important to the gain exponent and backscattering *** simulate the developments and evolutions of SRS and SBS based on the 3WI *** numerical results consist with the linear theory.

关键词：受激拉曼散射稳定条件对流受激布里渊散射等离子体密度线性理论相互作用计算结果

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The latest breakthrough on genetic characteristics ofinflammatory bowel disease in Chinese and other EastAsianancestries

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Precision Clinical Medicine 2023年第3期6卷 135-140页

作者： Han Gao zhanju liu Center for Inflammatory Bowel Disease Research and Department of Gastroenterology The Shanghai Tenth People's HospitalTongji UniversityShanghai 200072China

Inflammatory bowel diseases(IBDs)are complex chronic disorders of the gastrointestinal tract with the following two subtypes:Crohn's disease and ulcerative *** presentation and progression within and across IBDs,especially Crohn's disease,are highly heterogeneous in the location,severity of inflammation,intestinal stenosis and obstruction,and extraintestinal *** classifications fail to accurately predict the disease course and response to *** date,most IBD genetic associations are derived from individuals of European ancestries,leading to a limitation of the discovery and application of IBD genetics in the rest of the world *** this mini-review,we summarize the latest progress of genome-wide association studies of IBD across global ancestries especially the Chinese population,the similarities and differences in genetic architecture between European and East Asian ancestries,as well as,the clinical significances relevant to IBD genetic study.

关键词： Chinese population Crohn's disease East Asian infammatory bowel disease susceptible gene ulcerative colitis

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Regulatory role of defensins in inflammatory bowel disease

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Open Journal of Immunology 2012年第2期2卷 78-84页

作者： Chi Chen Praveen Kumar Yadav Xingpeng Wang zhanju liu Department of Gastroenterology The Shanghai Tenth People’s Hospital Tongji University School of Medicine Shanghai China

Defensins are endogenous antimicrobial peptides (AMPs) produced by professional phago- cytes, Paneth cells, and epithelial cells at mucosal surfaces, which mediate innate immunity through their potent antimicrobial activity in the intestinal tract. In addition, defensins also regulate the function of diverse host immune cells, thereby play an important role in both innate and adaptive immune responses against pathogenic microbes. Abundant evidences have proved that attenuated changes in defensins expression are observed in inflammatory bowel disease (IBD). Further studies have discovered the concentration of different defensins subgroups has the relationship with various clinical characteristics of IBD and that mucosal surface destruction causes defensins deficiency as a result of in- flammatory damage. This article is to review new current approaches on defensins expression in the intestinal mucosa, particularly in IBD and their potential roles in immune responses in the gut mucosa.

关键词： Defensins Inflammatory Bowel Disease

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我国炎症性肠病的基础研究现状和临床转化挑战

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中华内科杂志 2018年第2期57卷 81-83页

作者：刘占举同济大学附属第十人民医院消化内科上海200072

炎症性肠病（inflammatory bowel diseases,IBD）是发生在胃肠道原因不明的慢性非特异性炎症性疾病,主要包括溃疡性结肠炎（ulcerative colitis, UC）和克罗恩病（Crohn＇s disease,CD）.常表现为腹痛、腹泻、黏液脓血便、肠梗阻和肠穿... 详细信息

炎症性肠病（inflammatory bowel diseases,IBD）是发生在胃肠道原因不明的慢性非特异性炎症性疾病,主要包括溃疡性结肠炎（ulcerative colitis, UC）和克罗恩病（Crohn＇s disease,CD）.常表现为腹痛、腹泻、黏液脓血便、肠梗阻和肠穿孔,甚至癌变等.因病情反复、迁延,严重影响患者生活质量和日常工作.

关键词：炎症性肠病慢性非特异性炎症性疾病 diseases 转化临床溃疡性结肠炎原因不明病情反复

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炎症性肠病研究的热点和展望

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中华炎性肠病杂志（中英文） 2019年第1期3卷 2-4页

作者：刘占举同济大学附属第十人民医院消化内科上海200072

本文根据当前国内外炎症性肠病(IBD)基础研究和临床诊疗进展,从IBD病因、发病机制、诊断和鉴别诊断、肠壁损伤程度评估、内科和外科治疗6个方面对IBD研究当前的热点问题进行总结和述评.

关键词：热点问题进展肠壁临床肠病评估内科研究

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