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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

Pulmonary cryptococcosis after immunomodulator treatment in patients with Crohn’s disease:Three case reports

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World Journal of Gastroenterology 2023年第4期29卷 758-765页

作者： Yan-Fei Fang Xiang-Han Cao Ling-Ya Yao Qian Cao Department of Gastroenterology Inflammatory Bowel Disease CenterSir Run Shaw HospitalCollege of Medicine Zhejiang UniversityHangzhou 310016Zhejiang ProvinceChina

BACKGROUND Corticosteroids and anti-tumor necrosis factorαmAbs are widely used to treat Crohn's disease(CD).However,one disadvantage of this treatment is impairment of normal immune function,leading to an increased risk of *** infection is an opportunistic infection that occurs mainly in immunocompromised patients and poses a significant diagnostic challenge in patients with *** SUMMARY Here,we report three cases of pulmonary cryptococcosis in patients with CD after receiving immunomodulatory *** patients presented with no or mild respiratory *** computed tomography scans revealed pulmonary nodules in the unilateral or bilateral *** were made using pathological examination and metagenomic *** patients were treated with fluconazole 400 mg once daily for 1 to 6 mo,and symptoms were *** searches were conducted in PubMed,Web of Science,and Embase to retrieve previously reported cases and summarize patient *** The incidence of cryptococcus infection has increased along with immunomodulator *** vigilance is required for early identification and standardized treatment.

关键词： Crohn’s disease Immunomodulator Infliximab Opportunistic infections Pulmonary cryptococcosis Case report

Spinal anesthesia alleviates dextran sodium sulfate-induced colitis by modulating the gut microbiota

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World Journal of Gastroenterology 2022年第12期28卷 1239-1256页

作者： Yu Hong Jie Zhao Ye-Ru Chen Zi-Hao Huang Li-Dan Hou Bo Shen Yu Xin Department of General Surgery Sir Run Run Shaw Hospital of Zhejiang UniversityHangzhou 310012Zhejiang ProvinceChina Department of Anaesthesiology Sir Run Run Shaw Hospital of Zhejiang UniversityHangzhou 310012Zhejiang ProvinceChina College of Medicine Zhejiang UniversityHangzhou 310012Zhejiang ProvinceChina Biomedical Research center Sir Run Run Shaw Hospital of Medical SchoolZhejiang UniversityHangzhou 310012Zhejiang ProvinceChina Department of Anesthesiology Sir Run Run Shaw Hospital of Zhejiang UniversityHangzhou 310012Zhejiang ProvinceChina

BACKGROUND Inflammatory bowel disease(IBD)is a chronic disease with recurrent intestinal *** the exact etiology of IBD remains unknown,the accepted hypothesis of the pathogenesis to date is that abnormal immune responses to the gut microbiota are caused by environmental *** role of the gut microbiota,particularly the bidirectional interaction between the brain and gut microbiota,has gradually attracted more *** To investigate the potential effect of spinal anesthesia on dextran sodium sulfate(DSS)-induced colitis mice and to detect whether alterations in the gut microbiota would be crucial for *** A DSS-induced colitis mice model was *** anesthesia was administered on colitis mice in combination with the methods of cohousing and fecal microbiota transplantation(FMT)to explore the role of spinal anesthesia in IBD and identify the potential mechanisms *** We demonstrated that spinal anesthesia had protective effects against DSS-induced colitis by alleviating clinical symptoms,including reduced body weight loss,decreased disease activity index score,improved intestinal permeability and colonic morphology,decreased inflammatory response,and enhanced intestinal barrier ***,spinal anesthesia significantly increased the abundance of Bacteroidetes,which was suppressed in the gut microbiota of colitis ***,cohousing with spinal anesthetic mice and FMT from spinal anesthetic mice can also alleviate DSS-induced colitis by upregulating the abundance of *** further showed that spinal anesthesia can reduce the increase in noradrenaline levels induced by DSS,which might affect the gut *** These data suggest that microbiota dysbiosis may contribute to IBD and provide evidence supporting the protective effects of spinal anesthesia on IBD by modulating the gut microbiota,which highlights a novel approach for the treatment of IBD.

关键词： Spinal anesthesia Inflammatory bowel disease Gut microbiota Intestinal barrier Intestinal inflammation Intestinal immune

A 10-Year Retrospective Cohort Study of Real-World Effectiveness of Sofosbuvir-Based Regimens for Hepatitis C in a Single center in China

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Infectious Microbes & diseases 2023年第4期5卷 180-185页

作者： Qiao Yang Fangping Xu Yi Shen Borui Pi Fangfang Lv Department of Infectious diseases Sir Run Run Shaw Alar HospitalSchool of MedicineZhejiang UniversityAlarChina Department of Infectious diseases Sir Run Run Shaw HospitalSchool of MedicineZhejiang UniversityHangzhouChina Biomedical Research center Sir Run Run Shaw HospitalSchool of MedicineZhejiang UniversityHangzhouChina

This study aimed to review the trends of hepatitis C virus(HCV)treatment over the past decade and to analyze the effectiveness of sofosbuvir(SOF)–based direct-acting antiviral regimens in the heterogeneous population of patients with chronic hepatitis C(CHC)in clinical *** retrospective cohort study included CHC patients attending the sir run run shaw hospital between January 1,2012,and December 31,*** of the 194 patients treatedwith SOF-based regimens completed 12weeks of treatment and were followed up for at least 12 weeks after completion of the *** virologic response(SVR)12 weeks after the end of treatment was the primary endpoint.A total of 194 patients treated with SOF-based regimens were included,among which 121,56,10 and 7 patients received SOF+velpatasvir±ribavirin,SOF+daclatasvir,SOF+ledipasvir or SOF+ribavirin,*** 36.1%,HCV Genotype 1 predominated in CHC patients treated with SOF-based regimens,followed by Genotype 2a with 17.5%and Genotype 3 with 14.9%.Comorbidities among patients included hypertension(4.1%),diabetes(2.1%),depression(1.0%)and neoplastic disease(2.6%).All patients treated with SOF-based regimens achieved *** was no association between SVR and factors such as HCV genotype,sex,age,presence of cirrhosis or previous treatment *** were no reports of any serious adverse events in the *** single-center retrospective study represented the latest 10-year treatment trends for HCV in real-world clinical practice and provided useful information on the excellent efficacy of SOF-based direct-acting antiviral regimens for treatment of CHC patients in Eastern China.

关键词： hepatitis C virus sofosbuvir direct-acting antiviral agent China

Investigation of iodine concentration in salt,water and soil along the coast of Zhejiang,China

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2005年第12期6卷 1200-1205页

作者：陆颖理王宁荐朱岚王国兴吴晖匡琳朱文明 Department of Endocrinology Sir Run Run Shaw Hospital School of Medicine Zhejiang University Hangzhou 310016 China disease Control center Hangzhou 310006China

Objective: We aim to describe the environment iodine concentration in salt, water and soil along Zhejiang Province coast in the China foreland. It will be helpful for us to judge whether this area is insufficient in iodine and universal iodized salt is necessary or not. Methods: We collected iodized salt samples, drinking water samples (tap water in the towns, and well water or spring water in the villages), water samples from different sources (ditches, lakes, rivers) and soil samples through random sampling in June, 2005. Salt, water and soil iodine was detected by arsenic-cerium redox method. Statistical analysis was expressed as mean±SEMby Windows SPSS 13.0. Results: (1) The iodine concentration in salt was 27.9±4.33 mg/kg (n=108). (2) Seventy-five water samples were collected. The water iodine value was 0.6～84.8 μg/L (mean of 11.66 μg/L). The watershed along the Qiantang River has significantly higher iodine content than the water in Lin'an in mountain area (P＜0.01). The iodine content and mean iodine content of tap water, well or spring water and natural water sources were 4.30±2.43 μg/L (n=34), 23.59±27.74 μg/L (n=19)and 12.72±10.72 μg/L (n=22) respectively. This indicated that among environmental water sources, the ditch iodine content was the highest with river water iodine being the lowest (P＜0.01). (3) Soil iodine value was 0.11～2.93 mg/kg (mean of 1.32 mg/kg).Though there was no statistical difference of soil iodine in different districts (P=0.131), soil iodine content correlated positively with water iodine content. Conclusion: Iodine concentration in salt accords with national policy of adding iodine in salt. Foreland has more iodine in water than mountain area. The data reflected that water and soil iodine in foreland area was not high, which suggests universal iodized salt should be necessary. Environment iodine has relatively close association with pollution.

关键词： Iodine Salt Water Soil Coast

Real-world cost-effectiveness associated with infliximab maintenance therapy for moderate to severe Crohn's disease in China

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World Journal of Gastroenterology 2020年第41期26卷 6455-6474页

作者： Ji-Hao Shi Liang Luo Xiao-Li Chen Yi-Peng Pan Zhou Zhang Hao Fang Ying Chen Wen-Dong Chen Qian Cao Department of Gastroenterology Sir Run Run Shaw HospitalCollege of MedicineZhejiang UniversityHangzhou 310016Zhejiang ProvinceChina Department of Project Changsha Normin Health Technology LtdChangsha 410013Hunan ProvinceChina Department of HEOR Normin Health Consulting LtdToronto L5R 0E9OntarioCanada Inflammatory bowel disease center Sir Run Run Shaw HospitalHangzhou 310016Zhejiang ProvinceChina

BACKGROUND Infliximab was the first approved biologic treatment for moderate to severe Crohn's disease(MS-CD) in China. However, the cost-effectiveness of infliximab maintenance therapy(IMT) for MS-CD relative to conventional maintenance therapy remained *** To assess the cost-effectiveness of IMT for MS-CD in Chinese patients from the perspective of Chinese public insurance *** A cohort of MS-CD patients managed in a Chinese tertiary care hospital was created to compare IMT with conventional maintenance therapy(CMT) for clinical outcomes and direct medical costs over a 1-year observation time using conventional regression analyses. A decision-analytic model with the generated evidence was constructed to assess the cost-effectiveness of IMT relative to CMT using reimbursed medical *** Based on the included 389 patients, IMT was associated with significantly higher disease remission chance [odds ratio: 4.060, P = 0.003], lower risk of developing new complications(odds ratio: 0.527, P = 0.010), higher utility value for quality of life(coefficient 0.822, P = 0.008), and lower total hospital costs related to disease management(coefficient-0.378, P = 0.008) than CMT. Base-case cost-effectiveness analysis estimated that IMT could cost Chinese health insurance payers $55260 to gain one quality-adjusted life year(QALY). The cost-effectiveness of IMT was mainly driven by the estimate of quality of life, treatment efficacy of maintenance therapy, mortality risk associated with active disease, and unit price of infliximab. The probability that IMT was cost-effective at a willingness-to-pay threshold of three times gross domestic product [2018 Chinese gross domestic product per capita(GDPPC)] was 86.4%.CONCLUSION IMT significantly improved real-world health outcomes and cost the Chinese public health insurance payers less than one GDPPC to gain one QALY in Chinese MS-CD patients.

关键词： Infliximab Crohn's disease Maintenance therapy Cost-effectiveness Outcomes Direct medical costs

Mannose metabolism normalizes gut homeostasis by blocking the TNF-α-mediated proinflammatory circuit

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Cellular & Molecular Immunology 2023年第2期20卷 119-130页

作者： Peng Xiao Ziwei Hu Jiaheng Lang Tianyuan Pan Randall Tyler Mertens Huilun Zhang Ke Guo Manlu Shen Hongqiang Cheng Xue Zhang Qian Cao Yuehai Ke Department of Gastroenterology Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhouChina Department of Pathology and Pathophysiology and Department of Gastroenterology at Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhouChina Immunological disease Research center Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhouChina Key Laboratory for Immunity and Inflammatory diseases of Zhejiang Province HangzhouChina Department of Pathology and Pathophysiology Zhejiang University School of MedicineHangzhouChina Department of General Medicine The First Affiliated HospitalZhejiang University School of MedicineHangzhouChina Department of Immunology Harvard Medical SchoolBostonMAUSA Zhejiang Laboratory for Systems and Precision Medicine Zhejiang University Medical CenterHangzhouChina

Mannose is a naturally occurring sugar widely consumed in the daily diet;however,mechanistic insights into how mannose metabolism affects intestinal inflammation remain ***,we reported that mannose supplementation ameliorated colitis development and promoted colitis ***-secreted inflammatory cytokines,particularly TNF-α,induced pathological endoplasmic reticulum stress(ERS)in intestinal epithelial cells(IECs),which was prevented by mannose via normalization of protein *** preserving epithelial integrity,mannose reduced the inflammatory activation of colonic *** the other hand,mannose directly suppressed macrophage TNF-αproduction translationally by reducing the glyceraldehyde 3-phosphate level,thus promoting GAPDH binding to TNF-α***,we found dysregulated mannose metabolism in the colonic mucosa of patients with inflammatory bowel ***,we revealed that activating PMM2 activity with epalrestat,a clinically approved drug for the treatment of diabetic neuropathy,elicited further sensitization to the therapeutic effect of ***,mannose metabolism prevents TNF-α-mediated pathogenic crosstalk between IECs and intestinal macrophages,thereby normalizing aberrant immunometabolism in the gut.

关键词： Colitis Mannose Macrophages Intestinal epithelial cells TNF-alpha Endoplasmic reticulum stress

Knockdown of insulin-like growth factor 2 gene disrupts mitochondrial functions in the liver

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Journal of Molecular Cell Biology 2021年第8期13卷 543-555页

作者： Weiwei Gui Yiyi Zhu Shuiya Sun Weifen Zhu Bowen Tan Hanxin Zhao Chengxin Shang Fenping Zheng Xihua Lin Hong Li Department of Endocrinology The Affiliated Sir Run Run Shaw HospitalSchool of MedicineZhejiang UniversityHangzhouChina Peking Union Medical College Chinese Academy of Medical SciencesBeijingChina College of Medicine Zhejiang UniversityHangzhouChina Biomedical Research center and Key Laboratory of Biotherapy of Zhejiang Province The Affiliated Sir Run Run Shaw HospitalZhejiang UniversityHangzhouChina

Even though insulin-like growth factor 2(IGF2)has been reported to be overexpressed in nonalcoholic fatty liver disease(NAFLD),its role in the progression of NAFLD and the potential mechanism remain largely *** in vitro models,we found that IGF2 was the key overexpressed gene in steatosis,suggesting a possible association between IGF2 and ***,loss-of-function experiments revealed that inhibition of IGF2 protein impaired mitochondrial biogenesis and *** additionally disrupted the expression changes of mitochondrial fusion and fission-related proteins necessary in maintaining mitochondrial ***,IGF2 knockdown reduced the mitochondrial membrane potential and increased the production of reactive oxygen ***,IGF2 regulates mitochondrial functions by modulating the expression of sirT1 and its downstream gene *** research opens a new frontier on the role of IGF2 in energy metabolism,which potentially participates in the development of *** such,IGF2 is a potential therapeutic target against NAFLD.

关键词： insulin-like growth factor 2 mitochondrial function nonalcoholic fatty liver

Hemorrhagic fever with renal syndrome complicated with aortic dissection:A case report

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World Journal of Clinical Cases 2020年第22期8卷 5795-5801页

作者： Feng-Qi Qiu Cong-Cong Li Jian-Ya Zhou Department of Respiratory disease Thoracic Disease CenterThe First Affiliated HospitalCollege of MedicineZhejiang UniversityHangzhou 310000Zhejiang ProvinceChina Department of Critical Care Medicine Sir Run Run Shaw HospitalSchool of MedicineZhejiang UniversityHangzhou 310000Zhejiang ProvinceChina

BACKGROUND Hemorrhagic fever with renal syndrome is caused by hantaviruses presenting with high fever,hemorrhage,and acute kidney *** injury and hemorrhage in mucus were often observed in patients with hantavirus *** with bacterial and virus related aortic aneurysm or dissection occurs ***,we report a previously unreported case of hemorrhagic fever with concurrent aortic *** SUMMARY A 56-year-old man complained of high fever and generalized body ache,with decreased platelet counts of 10×10^9/L and acute kidney *** enzymelinked immunosorbent assays test for immunoglobulin M and immunoglobulin G hantavirus-specific antibodies were both *** the convalescent period,he complained sudden onset acute chest pain radiating to the back,and the computed tomography angiography revealed an aortic dissection of the descending aorta extending to iliac *** was diagnosed with hemorrhagic fever with renal syndrome and Stanford B aortic *** patient recovered completely after surgery with other support *** Hemorrhagic fever with renal syndrome complicated with aortic dissection is rare and a difficult clinical *** infection not only causes microvascular damage presenting with hemorrhage but may be risk factor for acute macrovascular detriment.A causal relationship has yet to be confirmed.

关键词： Hantavirus Hemorrhagic fever with renal syndrome Aortic dissection Infection Acute kidney injury Case report