Objective:To investigate the efficacy of infliximab in the treatment of small intestinal Crohn's disease and its effects on simple endoscopic score for Crohn's disease (SES-CD), routine blood test and nutritional indexes.Methods:Eighty-four patients with small intestinal Crohn's disease who received treatment in Zhejiang Xin'an International Hospital between November 2019 and March 2021 were included in this study. They were randomly divided into control and observation groups with 42 patients each. The control group was treated with azathioprine. The observation group was treated with azathioprine and infliximab. Clinical efficacy, SES-CD score, hemoglobin (Hb) level, white blood cell (WBC) count, platelet (PLT), albumin (ALB), pre-albumin (PA) and total protein (TP) levels pre- and post-treatment were compared between the two groups.Results:Response rate in the observation group was significantly higher than that in the control group [92.8% (39/42) vs. 73.8% (31/42), χ2 = 5.48, P < 0.05]. There was no significant difference in SES-CD score pre-treatment between the control and observation groups [(7.24 ± 1.30) points vs. (7.33 ± 1.27) points, t = -0.34, P > 0.05]. After treatment, SES-CD scores in the control and observation groups were (5.12 ± 1.17) points and (4.22 ± 0.98) points, respectively, which were significantly decreased compared with those before treatment ( t = 11.01, 14.66, both P < 0.001). After treatment, SES-CD score in the observation group was significantly lower than that in the control group ( t = 4.19, P < 0.001). Before treatment, there were no significant differences in Hb level [(110.23 ± 16.19) g/L vs. (112.27 ± 15.98) g/L], WBC count [(7.61 ± 2.54) × 10 9 g/L vs. (7.47 ± 2.61) × 10 9 g/L] and PLT level [(420.14 ± 130.27) × 10 9 g/L vs. (419.23 ± 131.15) × 10 9 g/L] between the control and observation groups ( t = -0.58, 0.25, 0.03, all P > 0.05). After treatment, Hb level [(120.25 ± 14.36) g/L and (130.17 ± 12.24) g/L ], WBC count [(6.01 ± 1.88)× 10 9 g/L, (5.13 ± 1.96) × 10 9 g/L) and PLT level [(321.79 ± 110.21) × 10 9 g/L, (267.25 ± 100.23) × 10 9 g/L] in the control and observation groups were significantly decreased compared with those before treatment ( tcontrol group = -4.70, 6.60, 8.02, tobservaton group = -7.91, 3.50, 4.99, all P < 0.05). Hb level post-treatment in the observation group was significantly higher than that in control group ( t = -3.41, P < 0.05) . WBC count and PLT level in the observation group were significantly lower than those in the control group ( t = 2.10, 2.37, both P < 0.05). Before treatment, there were no significant differences in ALB level [(33.14 ± 5.66) g/L vs. (32.98 ± 5.73) g/L], PA level [(220.17 ± 71.14) mg/L vs. (219.89 ± 70.26) mg/L], TP level [(61.23 ± 8.21) g/L vs. (60.95 ± 8.17) g/L] between control and observation groups ( t = 0.12, 0.01, 0.15, all P > 0.05). After treatment, ALB level [(38.29 ± 6.13) g/L, (44.23 ± 6.07) g/L], PA level [(281.14 ± 85.23) mg/L, (320.27 ± 82.01) mg/L], TP level [(67.23 ± 7.22) g/L, (73.28 ± 6.97) g/L] in the control and observation groups were significantly increased compared with those before treatment ( tcontrol group = -7.90, -4.30, -5.08, tobservation group = -13.76, -7.52, -11.45, all P < 0.05). After treatment, ALB, PA and TP levels in the observation group were significantly higher than those in the control group ( t = -4.46, -2.14, -3.89, all P < 0.05). Conclusion:Infliximab is highly effective on small intestinal Crohn's disease. It can effectively decrease SES-CD score, improve routine blood parameters and nutritional indexes, alleviate azathioprine-induced myelosuppression, and reduce gastrointestinal reactions.

Background:Understanding the local epidemiologic features of Helicobacter pylori (Hp)infection might be helpful for formulating a targeted disease control strategy. Aims:To study the current status of Hp infection and its influencing factors in health examination subjects and outpatients in Xiuzhou District,Jiaxing,Zhejiang Province. Methods:Local residents who visited the health examination center or outpatient service for Hp test from Jan. 2016 to Jun. 2017 at Zhejiang Shin-an International Hospital were enrolled. Demographic data,life style,dietary habit,drug history and history of gastroscopy and dental treatment were collected to analyze the influencing factors of Hp infection. Positive for any of the three Hp tests:13 C/ 14C-UBT,biopsy pathology and bacterial culture was defined as Hp infection. Results:A total of 4 220 adults, including 2 002 males and 2 218 females with age ranged from 18 to 80 years were enrolled. The overall detection rate of Hp infection was 38. 1%. The detection rate in males was significantly higher than that in females (45. 0% vs. 32. 0%, P＜0. 05). Also,the detection rate of middle-aged subjects (41-65 years)was significantly higher than those of young (18-40 years)and elderly subjects (66-80 years)(45. 0% vs. 31. 2% and 32. 0%,P ＜0. 05). Cigarette smoking, alcohol drinking,as well as dinner party were associated with higher detection rate of Hp infection (P＜0. 05),while long-term use of non-steroidal anti-inflammatory drugs (NSAIDs)was associated with lower Hp detection rate (P＜0. 05). No associations were found between gastroscopic procedure and dental treatment with the detection rate of Hp infection (P＞0. 05). Conclusions:The detection rate of Hp infection in health examination subjects and outpatients in Xiuzhou District, Jiaxing,Zhejiang Province is relatively low when compared with the mean level in general population. Unhealthy life style is associated with the increased risk of Hp infection.

Objective:To investigate the efficacy of probiotics, mesalazine and Kangfuxin liquid in combination on ulcerative colitis and its effects on inflammatory factors. Methods:A total of 106 patients with ulcerative colitis admitted to Zhejiang Sian International Hospital from November 2021 to May 2022 were included in this study. They were randomly assigned to receive treatment with either probiotics, mesalazine and Kangfuxin liquid in combination (combined therapy group, n = 53) or mesalazine alone (monotherapy group, n = 53) for 30 days. Clinical efficacy, inflammatory factor level and Rachmilewitz endoscopic score pre- and post-treatment as well as the incidence of adverse reactions were compared between the two groups. Results:Total response rate in the combined therapy group was significantly higher than that in the monotherapy group [98.1% (52/53) vs. 79.3% (42/53), χ2 = 9.40, P < 0.05]. After treatment, tumor necrosis factor-a, interleukin-8, and interleukin-17 levels were significantly decreased, and interleukin-10 level was significantly increased (all P < 0.05). Tumor necrosis factor-a, interleukin-8, and interleukin-17 levels as well as Rachmilewitz endoscopic score in the combined therapy group were significantly lower than those in the monotherapy group ( t = -2.22, -5.85, -14.08, -2.62, all P < 0.05). The interleukin-10 level in the combined therapy group was significantly higher than that in the monotherapy group ( t = 3.91, P < 0.05). The incidence of clinical symptoms in the combined therapy group was significantly lower than that in the monotherapy group [11.3% (6/53) vs. 54.7% (29/53), χ2 = 22.57, P < 0.001]. There was no significant difference in the incidence of adverse reactions between the two groups ( P = 0.540). Conclusion:Probiotics, mesalazine and Kangfuxin liquid in combination for the treatment of ulcerative colitis can improve clinical efficacy, decrease inflammatory factor levels, reduce clinical symptoms, and have a few adverse reactions.

Mandibular defects caused by injuries, tumors, and infections are common and can severely affect mandibular function and the patient's appearance. However, mandible reconstruction with a mandibular bionic structure remains challenging. Inspired by the process of intramembranous ossification in mandibular development, a hierarchical vascularized engineered bone consisting of angiogenesis and osteogenesis modules has been produced. Moreover, the hierarchical vascular network and bone structure generated by these hierarchical vascularized engineered bone modules match the particular anatomical structure of the mandible. The ultra-tough polyion complex has been used as the basic scaffold for hierarchical vascularized engineered bone for ensuring better reconstruction of mandible function. According to the results of in vivo experiments, the bone regenerated using hierarchical vascularized engineered bone is similar to the natural mandibular bone in terms of morphology and genomics. The sonic hedgehog signaling pathway is specifically activated in hierarchical vascularized engineered bone, indicating that the new bone in hierarchical vascularized engineered bone underwent a process of intramembranous ossification identical to that of mandible development. Thus, hierarchical vascularized engineered bone has a high potential for clinical application in mandibular defect reconstruction. Moreover, the concept based on developmental processes and bionic structures provides an effective strategy for tissue regeneration.
Bone Regeneration ; Bone Transplantation/methods* ; Hedgehog Proteins ; Humans ; Mandible/surgery* ; Osteogenesis