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Use of the ulcerative colitis endoscopic index of severity and Mayo endoscopic score for predicting the therapeutic effect of mesalazine in patients with ulcerative colitis

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Laparoscopic, Endoscopic and Robotic Surgery 2021年第2期4卷 33-39页

作者： Haotian Chen Lexi Wu Mengyu Wang Bule Shao Lingna Ye Yu Zhang Qian Cao Department of Gastroenterology Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016China inflammatory bowel disease center Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016China

Objective:The ulcerative colitis endoscopic index of severity(UCEIS)and the Mayo endoscopic score(MES)are developed as objective methods of evaluating endoscopic severity in patients with ulcerative colitis(UC).The aim of this study is to investigate the diagnostic accuracy of the UCEIS and MES in predicting the patient's response to ***:Consecutive patients with UC who had undergone colonoscopy within 1 month before starting mesalazine between October 2011 and July 2016 were retrospectively collected at the Department of Gastroenterology,Sir Run Run Shaw Hospital,Zhejiang University School of *** median follow-up was 81 months,and all the data were analyzed in January *** primary outcome was the need for step-up treatment,which included the use of corticosteroids,immunomodulatory,or surgery during admission and *** were analyzed using the c2 or Fisher exact test,Spearman test,t-test,and ManneWhitney U ***:Totally,65 patients were enrolled,of whom 12(18.5%)needed step-up treatment due to nonresponse to *** UCEIS score,MES,and the ulcerative colitis disease activity index(UCDAI)score were significantly higher in patients who had nonresponse to mesalazine(UCEIS score:6.92±0.69 vs.4.45±1.17,p<0.001;MES:2.67±0.49 vs.2.15±0.69,p=0.024;UCDAI score:9.33±1.87 vs.6.70±2.38,p=0.002).In the multivariate analysis,the UCEIS score(OR=25.65,95%CI:3.048 e45.985,p=0.003),UCDAI score(OR=1.605,95%CI:1.144e2.254,p=0.006),and C-reactive protein level(OR=1.056,95%CI:1.006e1.108,p=0.026)were independent risk factors of *** area under the ROC curve of UCEIS was 0.95,with a sensitivity of 100%and specificity of 84.6%,a cut-off value of 6,which outperformed the MES with an area under the ROC curve of *** the UCEIS score≥6,60%of patients eventually needed step-up ***:The UCEIS is a useful instrument for predicting the therapeutic effect in patients with UC treated with *** high probabili

关键词： Mesalazine Ulcerative colitis Ulcerative colitis endoscopic index of severity Mayo endoscopic score Ulcerative colitis disease activity index

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Evolving roles of magnifying endoscopy and endoscopic resection for neoplasia in inflammatory bowel diseases

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World Journal of Gastrointestinal Oncology 2022年第3期14卷 646-653页

作者： Shintaro Akiyama Taku Sakamoto Joshua M Steinberg Yutaka Saito Kiichiro Tsuchiya Department of Gastroenterology University of TsukubaIbaraki 305-8575Japan Endoscopy Division National Cancer Center HospitalTokyo 104-0045Japan Department of inflammatory bowel disease Gastroenterology of the RockiesDenverCO 80218United States

Magnifying endoscopy is a useful technique to differentiate neoplasia from non-neoplastic lesions. Data regarding the clinical utility of magnifying endoscopy for neoplasia in patients with inflammatory bowel disease(IBD) has been *** Kudo’s pit pattern types Ⅲ-Ⅴ are findings suggestive of neoplasia in non-IBD patients, these pit patterns are predictive of IBD-associated neoplasia as ***, active chronic inflammatory processes, particularly regenerative changes, can mimic neoplastic pit patterns and may affect a meticulous evaluation of pit pattern diagnosis in patients with IBD. The clinical evidence regarding the utility of magnifying endoscopy with narrow band imaging or endocytoscopy has also been evolving in regard to the diagnosis of IBD-associated neoplasia. These advanced endoscopic techniques are promising for multiple reasons;not only for making an accurate diagnosis of neoplasia, but also in determining if endoscopic resection is appropriate for such lesions in patients with IBD. In this review, we discuss the diagnostic accuracy and limitations of magnifying endoscopy in assessing IBD-associated neoplasia and examine the feasibility and outcomes of endoscopic resection for these lesions.

关键词： Magnifying endoscopy Neoplasia Ulcerative colitis inflammatory bowel disease Endoscopic resection

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Temporal trends in the misdiagnosis rates between Crohn's disease and intestinal tuberculosis

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World Journal of Gastroenterology 2017年第34期23卷 6306-6314页

作者： Hyungil Seo Seohyun Lee Hoonsub So Donghoi Kim Seon-Ok Kim Jae Seung Soh Jung Ho Bae Sun-Ho Lee Sung Wook Hwang Sang Hyoung Park Dong-Hoon Yang Kyung-Jo Kim Jeong-Sik Byeon Seung-Jae Myung Suk-Kyun Yang Byong Duk Ye Department of Gastroenterology University of Ulsan College of MedicineAsan Medical Center Division of Gastroenterology Department of Internal MedicineCenter for Health PromotionSeoul National University Hospital Department of Clinical Epidemiology and Biostatistics University of Ulsan College of MedicineAsan Medical Center Division of Gastroenterology Department of Internal MedicineHallym University College of Medicine Hallym University Sacred Heart Hospital Department of Gastroenterology Seoul National University College of MedicineSeoul National University Hospital Gangnam Center inflammatory bowel disease center University of Ulsan College of MedicineAsan Medical Center

AIM To investigate the temporal trends in the misdiagnosis rate between Crohn's disease(CD) and intestinal tuberculosis(ITB) in South Korea. METHODS We retrospectively reviewed the medical records of patients managed for CD or ITB at Asan Medical center, a tertiary referral hospital, Seoul, Korea between 1996 and 2014. The temporal trends in the misdiagnosis rates between the two diseases were analyzed. The demographic and clinical characteristics were compared between CD patients who were initially misdiagnosed as ITB(final CD group) and vice versa(final ITB group). Final diagnostic criteria for ITB and medication for CD before definite diagnosis of TB were also analyzed in final ITB *** In total, 2760 patients were managed for CD and 772 patients for ITB between 1996 and 2014. As well, 494 of the 2760 CD patients(17.9%) were initially misdiagnosed as ITB and 83 of the 772 ITB patients(10.8%) as CD. The temporal trend in misdiagnosing CD as ITB showed a decrease(OR = 0.89, 95%CI: 0.87-0.91, P < 0.001), whereas the temporal trend in misdiagnosing ITB as CD showed an increase(OR = 1.06, 95%CI: 1.01-1.11, P = 0.013). Age at diagnosis, presenting symptoms, and proportion of patients with active/past perianal fistula and active/inactive pulmonary tuberculosis(TB) were significantly different between final CD group and final ITB group. Forty patients(48.2%) in final ITB group were diagnosed by favorable response to empirical anti-TB treatment. Seventeen patients(20.5%) in final ITB group had inappropriately received corticosteroids and/or thiopurines due to misdiagnosis as CD. However, there were no mortalities in both groups. CONCLUSION Cases of CD misdiagnosed as ITB have been decreasing, whereas cases of ITB misdiagnosed as CD have been increasing over the past two decades.

关键词： Crohn’s disease Intestinal tuberculosis Misdiagnosis

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Immune function, gastrointestinal hormone levels, and their clinical significance in patients with gastric ulcers complicated with depression

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World Journal of Psychiatry 2023年第9期13卷 665-674页

作者： Yun-Han Yang De-Jun Cui Zai-Li Yang Wen-Qiang Yuan Bo Huang Department of Gastroenterology Guizhou Inflammatory Bowel Disease Research CenterNational Institution of Drug Clinical TrialGuizhou Provincial People’s HospitalMedical College of Guizhou UniversityGuiyang 550002Guizhou ProvinceChina

BACKGROUND Gastric ulcer(GU)is a common digestive tract disease,and medical records of GU combined with depression are increasingly ***,the risk factors and pathogenesis of GU complicated with depression remain *** immune function and gastrointestinal hormone levels may also be significant risk ***,this study explored the immune function and gastrointestinal hormone levels in patients with GU combined with *** To explore the immune function,gastrointestinal hormone level,and clinical significance of patients with GU combined with *** A retrospective analysis was conducted on 300 patients with GU combined with depression admitted to Guizhou Provincial People’s Hospital from January 2021 to June 2022 as the study *** to the Hamilton Depression Scale(HAMD)score,patients were divided into mild-to-moderate(n=210)and heavy(n=90)*** data,immune function indices[immunoglobulin A(IgA),IgM,IgG,serum CD4+and CD8+percentage,and CD4+/CD8+ratio],and gastrointestinal hormone indices[serum gastrin(GAS),cholecystokinin(CCK),and motilin(MTL)levels]were *** basic data of the two groups were compared,and the immune function and gastrointestinal hormone indices were *** logistic regression was used to analyze the factors influencing the severity of GU complicated with *** receiver operating characteristic(ROC)curve and area under the ROC curve(AUC)were used to analyze the value of the immune function index,gastrointestinal hormone index,and combined index in predicting the severity of GU complicated with *** There were no marked differences in sex,age,body mass index,abdominal distension,abdominal pain,belching,nausea,vomiting,or sleep disorders between the heavy and mild-to-moderate groups(P>0.05).There was a marked difference in the family history of depression between the heavy and mild-to-moderate groups(P<0.05).There were significant differences

关键词： Gastric ulcer combined with depression Immune function Gastrointestinal hormones

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Real-world efficacy and safety of tofacitinib treatment in Asian patients with ulcerative colitis

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World Journal of Gastroenterology 2024年第13期30卷 1871-1886页

作者： Kentaro Kojima Kenji Watanabe Mikio Kawai Soichi Yagi Koji Kaku Maiko Ikenouchi Toshiyuki Sato Koji Kamikozuru Yoko Yokoyama Tetsuya Takagawa Masahito Shimizu Shinichiro Shinzaki Department of Gastroenterology Hyogo Medical UniversityNishinomiya 663-8501Japan Department of Gastroenterology Gifu University Graduate School of MedicineGifu 501-1194Japan Department of Internal medicine for inflammatory bowel disease The University of ToyamaToyama 930-0194Japan center for Clinical Research and Education Hyogo Medical UniversityNishinomiya 663-8501Japan

BACKGROUND Real-world data on tofacitinib(TOF)covering a period of more than 1 year for a sufficient number of Asian patients with ulcerative colitis(UC)are *** To investigate the long-term efficacy and safety of TOF treatment for UC,including clinical *** We performed a retrospective single-center observational analysis of 111 UC patients administered TOF at Hyogo Medical University as a tertiary inflammatory bowel disease *** consecutive UC patients who received TOF between May 2018 and February 2020 were *** were followed up until August *** primary outcome was the clinical response rate at week *** outcomes included clinical remission at week 8,cumulative persistence rate of TOF administration,colectomy-free survival,relapse after tapering of TOF and predictors of clinical response at week 8 and week *** The clinical response and remission rates were 66.3%and 50.5%at week 8,and 47.1%and 43.5%at week 48,*** overall cumulative clinical remission rate was 61.7%at week 48 and history of anti-tumor necrosis factor-alpha(TNF-α)agents use had no influence(P=0.25).The cumulative TOF persistence rate at week 48 was significantly lower in patients without clinical remission than in those with remission at week 8(30.9%vs 88.1%;P<0.001).Baseline partial Mayo Score was significantly lower in responders vs non-responders at week 8(odds ratio:0.61,95%confidence interval:0.45-0.82,P=0.001).Relapse occurred in 45.7%of patients after TOF tapering,and 85.7%of patients responded within 4 wk after *** 6 patients with herpes zoster(HZ)developed the infection after achieving remission by *** TOF was more effective in UC patients with mild activity at baseline and its efficacy was not affected by previous treatment with anti-TNF-α*** relapsed patients responded again after re-increase of TOF and nearly half relapsed after tapering off *** attention is needed for tapering and H

关键词： Ulcerative colitis Tofacitinib Janus kinase inhibitor Real-world Biologics

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FK506 contributes to peripheral nerve regeneration by inhibiting neuroinflammatory responses and promoting neuron survival

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Neural Regeneration Research 2025年第7期20卷 2108-2115页

作者： Yuhui Kou Zongxue Jin Yusong Yuan Bo Ma Wenyong Xie Na Han Department of Trauma and Orthopedics Peking University People’s HospitalBeijingChina National center for Trauma medicine Peking University People’s HospitalBeijingChina Key Laboratory of Trauma and Neural Regeneration(Peking University) Ministry of EducationBeijingChina Trauma medicine center Peking University People’s HospitalBeijingChina Department of Orthopedics China-Japan Friendship HospitalBeijingChina

FK506(Tacrolimus)is a systemic immunosuppressant approved by the *** and Drug ***506 has been shown to promote peripheral nerve regeneration,however,its precise mechanism of action and its pathways remain *** this study,we established a rat model of sciatic nerve injury and found that FK506 improved the morphology of the injured sciatic nerve,increased the numbers of motor and sensory neurons,reduced inflammatory responses,markedly improved the conduction function of the injured nerve,and promoted motor function *** findings suggest that FK506 promotes peripheral nerve structure recovery and functional regeneration by reducing the intensity of inflammation after neuronal injury and increasing the number of surviving neurons.

关键词： FK506 inflammation motor neurons nerve regeneration neuron peripheral nerve injury sensory neurons

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Ferric carboxymaltose for anemia in Crohn’s disease patients at a tertiary center:A retrospective observational cohort study

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World Journal of Clinical Cases 2023年第12期11卷 2740-2752页

作者： Natália Souza Nunes Siqueira Livia Bitencourt Pascoal Bruno Lima Rodrigues Marina Moreira de Castro Alan Sidnei Corrêa Martins Dante Orsetti Silva Araújo Luis Eduardo Miani Gomes Michel Gardere Camargo Maria de Lourdes Setsuko Ayrizono Raquel Franco Leal inflammatory bowel disease Research Laboratory GastrocenterColorectal Surgery UnitSchool of Medical SciencesUniversity of Campinas(Unicamp)Campinas 13083-878São PauloBrazil

BACKGROUND Although the gastrointestinal tract is the most affected by Crohn’s disease(CD),the condition triggers other consequent manifestations,and iron deficiency anemia(IDA)is one of the most ***(IV)iron replacement is currently available through several drugs,such as ferric hydroxide sucrose and ferric carboxymaltose(FCM).However,the clinical management of these conditions can be *** To elucidate the drug’s effectiveness,the present study analyzed,through medical records,the clinical and epidemiological data of a cohort of patients with active CD who received IV FCM for the IDA *** This retrospective observational study included 25 patients with active CD,severe anemia,and refractory to previous conventional *** were evaluated two times:During the last treatment with ferric hydroxide sucrose and treatment with *** After treatment with FCM,parameters of IDA assessment significantly improved,serum hemoglobin(Hb)levels increased in 93%of patients(P<0.0001),and in 44%,there was an increase of≥2 g/dL in a single *** addition,86%of the patients showed an increase in serum iron(P<0.0001)and ferritin(P=0.0008)and 50%in transferrin saturation(P=0.01).The serum iron levels at baseline showed a negative association with the ileal and colonic CD and use of biologics and a positive association with patients who developed CD later in life after the age of 40(A3)and with a stenosing(B2)and fistulizing(B3)*** values of Hb and hematocrit after ferric hydroxide sucrose treatment remained similar to those found before *** This study demonstrated that FCM is an important therapeutic strategy for treating IDA in CD patients,achieving satisfactory results in refractory cases.

关键词： Ferric carboxymaltose Iron deficiency anemia Crohn’s disease inflammatory bowel disease Anemia Clinical management

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Hepatobiliar manifestations in inflammatory bowel disease: A practical approach

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World Journal of Hepatology 2022年第2期14卷 319-337页

作者： Paulina Núñez F Fabiola Castro Gabriel Mezzano Rodrigo Quera Diego Diaz Lorena Castro Universidad de los Andes Inflammatory Bowel Disease ProgramDigestive Disease CenterSantiago 7600976RMChile inflammatory bowel disease Program Hospital San Juan de DiosUniversidad de ChileSantiago 7701230RMChile Universidad de los Andes Hepatology ProgramDigestive Disease CenterSantiago 7600976RMChile Department of Gastroenterology Hospital del Salvador/Universidad de ChileSantiago 7600976RMChile Universidad de los Andes Santiago 770976RMChile

inflammatory bowel diseases(IBD)are associated with various hepatobiliary *** can occur at any moment in the course of the disease or associated with the *** prevalence of liver dysfunction can reach up to 50%in different *** fatty liver disease is considered the most common hepatobiliary complication in IBD,while primary sclerosing cholangitis is the most *** of hepatic manifestations in IBD involves a multidisciplinary approach that includes a high index of suspicion and joint management with *** medical confrontation with abnormal liver tests must include an exhaustive study to determine if these patterns can be related to IBD,associated diseases or to the therapies used.

关键词： Extraintestinal manifestations inflammatory bowel disease Sclerosing primary cholangitis Hepatic steatosis Liver toxicity

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Medical consultation in ulcerative colitis:Key elements for improvement

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World Journal of Gastroenterology 2023年第6期29卷 917-925页

作者： Yago González-Lama Elena Ricart Ana Cábez Pilar Fortes Susana Gómez Francesc Casellas inflammatory bowel disease Unit Department of Gastroenterology and HepatologyHospital Universitario Puerta de Hierro-MajadahondaMadrid 28222Spain inflammatory bowel disease Unit Department of GastroenterologyHospital ClínicBarcelona 08036Spain Biomedical Research Networking center in Hepatic and Digestive diseases(CIBERehd) Barcelona 08036Spain Department of Medical Pfizer SpainMadrid 28108Spain Servicio de Reumatología Hospital Universitario de SalamancaSalamanca 37007Spain Department of Gastroenterology Vall d'Hebron Research InstituteBarcelona 08035Spain

Ulcerative colitis(UC)is a chronic inflammatory disease with a high *** order to improve patient outcomes,the clinician-patient relationship in daily practice is *** guidelines provide a framework for UC diagnosis and ***,standard procedures and the medical content focused upon medical consultations in UC patients has not yet been ***,UC is a complex disease,given that patient characteristics and patient needs have been proven to vary during clinical consultation since establishing the diagnosis and upon the course of the *** this article,we have discussed the key elements and specific objectives to consider in medical consultation,such as diagnosis,first visits,follow-up visits,active disease patients,patients on topical therapies,new treatment initiation,refractory patients,extra-intestinal manifestations,as well as challenging *** key elements have been mentioned to comprise effective communication techniques,motivational interviewing(MI),as well as information and educational aspects,or organizational *** key elements to be implemented in daily practice were reported to comprise several general principles like duly prepared consultations,in addition to honesty and empathy with patients,as well as effective communication techniques,MI,information and educational points,or organizational *** role of other healthcare professionals such as specialized nurses,psychologists,or the use of checklists was also discussed and commented on.

关键词： Ulcerative colitis Patient experience Shared decision making Medical consultation Motivational interviewing Patient education

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CP-25 reverses prostaglandin E4 receptor desensitization-induced fibroblast-like synoviocyte dysfunction via the G protein-coupled receptor kinase 2 in autoimmune arthritis

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Acta Pharmacologica Sinica 2019年第8期40卷 1029-1039页

作者： Xiao-yi Jia Yan Chang Fang Wei Xing Dai Yu-jing Wu Xiao-jing Sun Shu Xu Hua-xun Wu Chun Wang Xue-zhi Yang Wei Wei Institute of Clinical Pharmacology Anhui Medical University Key Laboratory of Anti-inflammatory and Immune Medicine Ministry of Education Anhui Collaborative Innovation Center of Anti-inflammatory and Immune Medicine School of Pharmacy Anhui University of Chinese Medicine

Paeoniflorin-6’-O-benzene sulfonate(CP-25)is a novel compound derived from paeoniflorin that has been demonstrated to have therapeutic effects in a rat model of rheumatoid arthritis(RA).However,the underlying mechanism has not been elucidated to *** explored this mechanism in the present study by treating rats with adjuvant arthritis(AA)with *** found that the membrane EP4 protein level was downregulated;whereas,GRK2 was upregulated,in fibroblast-like synoviocyte(FLS)s of AA ***(PGE)2 stimulated FLS proliferation and enhanced the membrane EP4 receptor protein level;the latter was reversed by the administration of an EP4 receptor agonist,whereas the membrane GRK2 protein level gradually *** changes in the EP4 receptor and GRK2 expression were enhanced by TNF-α,and the former was accompanied by an alteration in the cyclic(c)AMP *** EP4 receptor agonist stimulation increased the association between GRK2 and the EP4 ***2 knockdown abrogated the abnormalities in FLS *** CP-25 treatment(100 mg/kg)suppressed joint inflammation with an efficacy that was similar to that of *** finding was associated with EP4 upregulation and GRK2 downregulation in ***,GRK2 plays an important role in the abnormal FLS proliferation observed in AA possibly by promoting EP4 receptor desensitization and decreasing the cAMP *** results demonstrate that CP-25 has therapeutic potential for the treatment of human RA via GRK2 regulation.

关键词： adjuvant-induced arthritis paeoniflorin-6’-O-benzene sulfonate fibroblast-like synoviocytes G protein-coupled receptor kinase 2 prostaglandin E2

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