Background:Small bowel Crohn's disease (CD) is a chronic nonspecific inflammatory disease with unknown etiology.There is no clear criteria for assessing the progression of CD, and the endoscopic index for assessing disease activity in CD patients is limited to a single parameter.Aims:To investigate the clinical value of endoscopic index in evaluating disease activity in patients with CD and the correlation between different parameters.Methods:Sixty cases of CD patients form Jan.2008 to Dec.2012 at Affiliated Hospital of Yanan Uuiversity were collected, 60 healthy adults were served as control group.CECDAI score, CDAI score and Lewis score were used to evaluate disease activity in patients with CD, and their relationship with CRP and ESR were analyzed.Results:Levels of CRP and ESR were significantly increased in CD patients than in controls (P<0.05).CDAI score and Lewis score were statistically different in different CECDAI score groups (F=5.53, P<0.05;F=22.64, P<0.05).CECDAI score was statistically different in different CDAI score groups (F=3.55, P<0.05), and was statistically different in different Lewis score groups (F=4.26, P<0.05).CECDAI score was correlated with CDAI score, Lewis score, CRP, ESR (P<0.05);CDAI score was correlated with CRP, ESR (P<0.05) and not correlated with Lewis score (P>0.05);Lewis score was not correlated with CRP, ESR (P>0.05) in CD patients.Conclusions:CECDAI score, CDAI score, Lewis score, CRP, ESR can reflect disease activity of CD, and can be used together to assess disease activity of CD patients.

Objective To investigate the relationaship between liver cirrhosis patients comibined with infection or death and intestinal permeability (IP)test.Methods 48 patients with liver cirrhois and 16 healthy volunteers were enrolled in the Af-filiated Hospital of Yan’an University during 2 years from 2013 to 2014 in this prospective study.Clinical data of patients were analyzed.LMR (IP index)were caculated and dectected by HPLC differental method.Serum LBP,IL-6 and I-FABP were determined by ELISA.Patients were followed for 1 year and assessed fro survival and the occurrence of infections.Re-lated factors with IP index were analyzed by Spearman’s rho.ROC curve,kaplan-meiser curve,cox regression were used to analyze related factors with the infection-free survival.Results IP index were increased in 40 (83.3%)patients with liver cirrhosis,compared with 4 increased IP index in healthy controls (χ2=19.006,P=0.001).IP index were correlated with al-bumin,IL-6,INR,bilirubin and Child-Pugh (CTP)scores by Spearman’s rho anaylsis (rs=-0.339~0.485,all P<0.05). 20 (41.7%)liver cirrhosis patients developed infection in the one year follow-up.There were signigicant differences in asci-tes (14 vs 18),CTP scores [9(5~14)vs 10(7~14)],MELD scores [12(7~27)vs 17(9~25),IL-6 [40(10~1 200)vs 60 (10~1 800)pg/ml]and I-FABP [1 160(800~8 600)pg/ml vs 4 130(1 520~8 060)pg/ml]between non-infected cirrhosis and infected cirrhosis patients (χ2=8.400,Z=-3.310~-2.160,all P<0.05).It was found that MELD>9,acites,I-FABP>1 728 pg/ml were independent factors of infection-free survial in liver cirrhosis patients by COX regression (all P<0.05).Conclusion Although increased IP was higher in liver cirrhosis,and it failed to predict infection-free survial in liver cirrhosis patients.

Objective To investigate the correlation between serum amyloid A (SAA) and disease activity (DAS28) in patients with rheumatoid arthritis (RA). Methods Forty-four patients with RA, 35 patients with systemic lupus erythe-matosus (SLE), 18 patients with osteoarthritis (OA) and 30 healthy controls (HC) were enrolled in this study. The levels of SAA were measured by ELISA. Erythrocyte sedimentation rate (ESR) was measured by the Westergren method. The value of serum C reactive protein (CRP) was examined by immunonephelometry assay. The correlation between SAA and DAS 28, ESR and CRP was assessed, respectively. Results The SAA levels were significantly higher in RA group than those of SLE, OA, and HC groups (P<0.05). The serum ESR and CRP levels were both higher in RA group than those of OA and HC groups (P>0.05), but there was no significant difference between RA group and SLE group. There was positive correlation between SAA and DAS28, ESR, and CRP levels (rs=0.790, P<0.001;rs=0.674, P<0.001;rs=0.679, P=0.004), respective-ly. Conclusion SAA may be a new serological marker to assess disease activity in RA.

Objective Calreticulin (CRT)is a multifunctional protein of endoplasmic reticulum implicated in the pathogenesis of rheumatoid arthritis(RA). The present study was undertaken to determine whether CRT was involved in an?giogenesis events in RA. Methods Serum CRT levels were measured by enzyme-linked immnuosorbent assay(ELISA)in 106 patients with established RA, 75 osteoarthritis(OA)and 80 healthy controls(HC). CRT levels in synovial fluid were al?so measured in 25 RA and 22 OA patients. The expression of CRT in synovial tissue was examined by immunohistology. In order to investigate the role of CRT on angiogenesis, human umbilical vein endothelial cells(HUVECs)were isolated and cultured for in vitro experiments. The proliferation, migration and tube formation of HUVECs following CRT stimulation were examined in vitro by MTT assay, scratch wound healing assay and tube formation assay. Results Our results showed a sig?nificantly higher concentration of CRT in serum [(6.4±3.1) μg/L] of RA patients compared to that of OA [(3.7±0.9) μg/L, P<0.01] and HC [(3.4±1.0) μg/L, P<0.01];and significantly higher CRT in synovial fluid [(6.9±3.4) μg/L] of RA vs OA [(3.9± 0.7) μg/L, P<0.01]. Increased CRT expression predominantly localized to vascular endothelial cells, inflammatory cells and perivascular areas in both the lining and sublining layers of RA synovial tissue. Furthermore, CRT significantly promoted the proliferation, migration and tube formation of HUVECs, as showed by MTT assay, scratch wound healing assay and tube for?mation assay. Conclusion These findings suggested that CRT may be involved in synovitis and pannus formation events via promoting angiogenesis in RA.

Objective To investigate the role of scavenger receptor class B type 1 (SR-B1) signaling pathway in serum amyloid A (SAA)-induced angiogenesis in rheumatoid arthritis (RA).Methods The expression and location of SR-B1 in RA and osteoarthritis (OA) synovial tissues were observed by immunohistochemistry.And SR-B1 expression in the resting human umbilical vein endothelial cells (HUVECs) was detected by immunoflourescence.Wound repair assessement and tube formation assessement were employed to evaluate the effect on cell migration and tube formation stimulated by SAA and/or anti-SR-B1 antibody.The t-test and one-way analysis of variance (ANOVA) were used for statistical analysis.Results ① SR-B1 was significantly highly expressed in RA tissue samples (A=6 788±819) when compared to the minimal expression in OA (A =31 849±6 977,t=3.567,P＜0.01).Positive staining of SR-B1 was observed in RA synovial vascular endothelial cells and perivascular areas.② Strong staining for SR-B1 was observed in all HUVECs tested.③ Significant wound healing induced by SAA (MI=2.50±0.17) was found compared with the untreated controls (MI=1.00±0.09,q=14.38,P＜0.01),and the effects were inhibited in the presence of anti-SR-B1 antibody (MI=1.16±0.14,q=13.02,P＜0.01).④ Compared to the untreated group (branch point number:6.6±0.8),there was an enhanced formation of branched and capillary-hke tube structure followed by SAA stimulation (branch point number:19.0±1.1,q=25.04,P＜0.01) after culturing for 72 h,whereas,tube formation decreased markedly upon pre-treated with anti-SR-B1 antibody (branch point number:7.6±1.3,vs SAA,q =23.32,P＜0.01).Conclusion Our present study suggests that serum amyloid A may induce angiogenesis via SR-B1 signaling pathway in RA.

Objective To investigate the effect of neutrophil extracellular traps (NETs) on inflammation of rheumatoid arthritis (RA), especially angiogenesis. Methods The presence of NETs in synovial tissues of RA and osteoarthritis (OA) was observed by immunofluorescence assay. Neutrophils were isolated from peripheral blood of health volunteers. Neutrophils were cultured in vitro, the formation of NETs was observed. NETs were extracted as a stimulating agent. The effects of NETs on the proliferation of human umbilical vein endothelial cells (HUVECs) and synovial fibroblasts (RAFLS) were evaluated by MTT, and which were classified into two groups: HUVECs group and RAFLS group, with the following treatment: control and NETs (0.28 mg/L). Wound repair assay was employed to evaluate the effect on the cell migration stimulated with NETs. The experiment was divided into three groups:control, VEGF (40μg/L VEGF) and NETs (0.28 mg/L NETs). Results (1) Compared with OA, NETs were found more in the synovial tissue of RA. (2) NETs formation was induced by stimulator in vitro. The concentration of extracted NETs-DNA was 27.8 mg/L. (3) MTT assay showed that compared with the control groups, low concentration of NETs (0.28 mg/L) promoted the proliferation of HUVECs (0.499 ± 0.011 vs. 0.393 ± 0.009, P<0.05) and RAFLS (0.266 ± 0.007 vs. 0.192 ± 0.007, P<0.05). (4) It was showed that a significant wound closure induced by low concentration of NETs (0.28 mg/L) was found compared with control. Conclusion Our present study suggests that NETs are found more in the synovial tissue of RA, and low concentration of NETs can promote angiogenesis in RA.

Objective To explore whether serum amyloid A (SAA) can induce the formation of neutrophil extracellular traps(NETs)in neutrophils in vitro. Methods A stable method for inducing NETs formation in vitro was established, in-cluding isolation of peripheral blood neutrophils, cell culture, and NETs formation and observation. The neutrophils were iso-lated from peripheral blood of healthy volunteers. And cells were cultured in vitro and classified into three groups:negative control (NC) group, SAA group and lipopolysaccharide (LPS) group. Following the distinct stimulation in three groups, NETs formation was observed and its percentage was calculated. The concentration of hinstone (h) 3 in supernatant was detected by ELISA. Results The purification and vitality of isolated neutrophils were both more than 95%. The nuclei of neutrophils lost their shape and spread, NETs formation was found. More NETs formation was found in SAA group than that in NC group (P < 0.05). Moreover, the concentration of h3 in supernatant was significantly higher in SAA group than that in NC group (P<0.05). Conclusion SAA can induce the formation of NETs in vitro.

Objective To investigate the incidence of peptic ulcer (duodenal ulcer and gastric ulcer) and the development of Helicobacter pylori (Hp) infection in the population during 10 years after Hp eradication.Methods Subjects were chosen from general population and performed endoscopy.Among them,the individuals confirmed to be Hp positive were randomly divided into treatment group and placebo group.The patients in treatment group received OAC triple therapy (omeprazole 20 mg,clarithromycin 500 nag and amoxicillin 1000 re.g,twice daily) for one week.After that,both groups continuously followed up by endoscopy during at 1st,5th,8th and 10th year for incidence and relapse of peptic ulcer as well as status of Hp infection.The patients in treatment group were examined by 13C-UBT for Hp eradication one month after the completion of treatment.Results At the 1st year,the incidence of peptic ulcer between the treatment group and placebo group were 3.7% and 12.85% (P=0.0002),respectively.At the 5th year,they were 5.86% and 14.93% (P=0.0017),respectively.At the 8th year,they were 4.4% and 9.39% (P = 0.044),respectively.The incidence of peptic ulcer of the treatment group significantly decreased after the eradication therapy compared to the placebo group.After the eradication,at the 1st year,the recurrence rates were 3.70% and 38.1% between the treatment group and the placebo group (P=0.0027).At the 5th year,they were 14.81% and 42.86% (P=0.03).At 8th year,they were 14.81 and 47.62% (P=0.03),respectively.At the 10th year,they were 25.93% and 57.14% (P=0.028).Then the recurrence rates of the treatment group significantly decreased compared to the placebo group.During the 10-year follow up study,the rate of Hp reinfection after a successful eradication in the treatment group was high,and it was 46.4% at the 10th year.Conclusion Both the incidence and recurrence of peptic ulcer significantly decreased after Hp eradication.It is necessary of Hp eradication in patients with peptic ulcer.Hp reinfection after a successful eradication is more frequent.

Objectives To study the current prevalence and recent epidemiological changes of Helicobacter pylori (H. pylori) infection among children and adults residing in regions with high ( Muping, Shandong) and low (Yanqing, Beijing) incidence of gastric cancer in China. Methods A total of 2065 asymptomatic children aged 8-15 years and adults aged 40-79 years in the above two regions were examined from May to July 2006. The data obtained in early 1990s in the same two areas and those of 11 656 patients undergoing endoscopy in our hospital in 1991 and 2006 were also collected and studied. Results The prevalence ofH. pylori infection in Muping was significantly higher than that in Yanqing among both children (37.69% vs25.58%, P<0.001) and adults (50.95% vs41.35%, P < 0. 01 ). From 1991 to 2006 H. pylori prevalence among children aged 8-10 years decreased in Muping (60. 00% vs 32. 07% , P < 0.001), but not in Yanqing (24.06% vs 19.10%, P > 0. 05 ) . A significant decrease in H. pylori prevalence among adults in both regions was observed when the results of 2006 were compared with the data obtained in 1990 in Muping (50.95% vs 73.78% , P < 0. 001 ) and in 1992 inYanqing (41.35% vs 55. 35% , P < 0. 01 ) . The detected rate of H. pylori infection in patients undergoing endoscopy in our hospital decreased from 51. 88% in 1991 to 33. 59% in 2006 (P <0. 001). Conclusions The prevalence of H. pylori infection is significantly higher in areas with a high incidence of gastric cancer in China as compared with that in areas with a low incidence of gastric cancer among both children and adults. H. pylori infection may be a risk factor in gastric carcinogenesis. In the past decade or more, H.pylori infection rates have decreased in Chinese population.

Objective Based on"timing it right"framework,this study explored the dynamic changes of care dilemma in caregivers of adolescents with mood disorder and non-suicidal self-injury at different stages of disease development,and provided support for the construction of intervention programs.Methods This study adopted phenomenological research and purposive sampling method to select 11 caregivers of adolescents with mood disorders and non-suicidal self-injury behavior who were treated and hospitalized in a tertiary A psychiatric hospital in Henan Province from May 2022 to February 2023 as research subjects.According to the"timing it right"theory,5 semi-structured interviews were conducted with caregivers during the adolescent diagnostic period,hospitalization period,discharge preparation period,adjustment period,and adaptation period.The data was analyzed by the Colaizzi 7-step analysis method.Results The following themes were summarized.①Diagnostic period:complex emotional reactions,facing a dilemma at a loss.②Hospitalization period:lack of knowledge of disease and childcare,self-conscious care difficulties.③Discharge preparation period:lack of confidence in home care and lower expectations for the future of adolescents.④Adjustment period:lack of care skills and desire professional care support.⑤Adaptation period:negatively coping with diseases,with persistent care difficulties.Conclusion The care dilemma of caregivers of adolescents with mood disorders and non-suicidal self-injury behavior in different stages of disease development is dynamic.Medical staff should provide personalized professional support in a planned and continuous manner based on their different stages of care experience and needs,in order to improve the quality of their care and promote adolescent rehabilitation.