The lack of exposure to helminth infections,as a result of improved living standards and medical conditions,may have contributed to the increased incidence of inflammatory bowel disease (IBD) as an important environmental factor.Basically the increasing experimental data and clinical studies support the protective potential of helminth infection in IBD.The helminth or its product is expected to become an important biological agent in the treatment of IBD.

Objective To investigate the clinical features of small bowel Crohn's disease(CD).Methods From January 2009 to September 2012,a total of 138 patients diagnosed as CD who underwent examinations of colonoscopy,digestive tract radiography,capsule endoscopy,double-balloon enteroscopy and computed tomography (CT) enterography were enrolled.According to the Montreal Classification criteria,the disease was typed by the age at diagnosis,location of the lesions and behavior of the disease.The clinical symptoms,laboratory examinations,diagnostic methods and recurrence condition were also evaluated.Through the comparison of the clinical features of ileocolonic and colonic CD,the clinical features of small bowel CD were analyzed.Measurement data were analyzed with t-test,analysis of variance or non parametric test.Chi square test was performed for count data.Spearman's correlation analysis was used for correlation analysis and multivariate Logistic regression analysis was used for risk factors screening.Results A total of 62 (44.9％) cases were simple small bowel CD.Fifty-three patients (85.5％) were male,and the mean age at diagnosis was 35.3 years old.The age of 67.7％(42/62) of small bowel CD patients were less than 40 years old when diagnosed.The ratio of stricture in small bowel CD group (35.5％,22/62) was significantly higher than that of ileocolonic (18.8％,6/32) and colonic CD group (13.9％,5/36) (x2=6.594,P=0.037).Jejunal involvement was an independent risk factor for structure in CD (OR=3.481,95％ CI:1.250 to 9.693).The patients with obstructive symptoms as primary symptom in small bowel CD (38.7％,24/62) were more than those with colonic CD (16.7％,6/36) (x2 =5.210,P=0.022).However,patients with diarrhea as primary symptom in small bowel CD (21.0％,13/62) were less than those with ileocolonic (37.5％,12/32) and colonic CD (44.4％,16/36) (x2=6.512,P=0.039).Patients with two or more extraintestinal manifestations in small bowel CD (3.2％,2/62) were also significantly less than those with ileocolonic (15.6％,5/32) and colonic CD (19.4％,7/36) (x2=7.957,P=0.019).The score of CD activity index was generally low,and with no statistical correlation to serum inflammation markers such as C reaction protein.The average time duration between induction of remission and clinical recurrence of small bowel CD ((23.64 ± 17.08) months) was shorter than that of ileocolonic type ((35.07±29.84) months,t=-4.285,P=0.002) and colonic CD ((32.35 ± 28.46) months,t =-3.700,P =0.004).However,there was no significant difference in the rate of clinical recurrence between small bowel CD and ileocolonic,colonic CD.Conclusions Patients with small bowel CD account for a large proportion in patients with CD,especially in males.Stricture is more common in jejunum CD.The time duration between induction of remission and clinical recurrence of small bowel CD is short.

The increasing prevalence of metabolic diseases poses a significant threat to public health,high-lighting the urgent need to identify effective therapeutic targets.Humanin(HN),a 24-amino acid linear peptide synthe-sized from mitochondrial DNA,has been previously acknowledged for its neuroprotective properties.Recent research indi-cates that HN can regulate glucose and lipid metabolism and has shown promise in treating metabolic disorders in animal models using either HN or its analogs.This review outlines the fundamental biological functions and signal transduction mechanisms of HN,and comprehensively evaluates its role and therapeutic potential in type 2 diabetes mellitus,nonalco-holic fatty liver disease,atherosclerosis and polycystic ovary syndrome,aiming to examine the potential of HN as a target for the prevention and treatment of metabolic diseases.

Objective To observe the efficacy of mesalazine combined with probiotics in the treatment of ulcerative colitis. Methods 60 patients with ulcerative colitis who were admitted to our hospital from May 2015 to May 2017 were selected randomly. These patients were divided into two groups according to the treatment method: mesalamine com bined with probiotic group(combination therapy group, n=30) and mesalamine alone treatment group (n=30). The clinical symptom score, endoscopic score, serum CRPlevel, clinical efficacy, incidence of adverse reactions and recurrence in both groups were statistically analyzed. Results Compared with those before treatment, the clinical symptom score, en doscopic score and serum CRPlevel were significantly lower in both groups after treatment(P＜0. 05); After treatment, clinical symptom score, endoscopic score and serum CRPlevel were significantly lower in the combination therapy group than those in the treatment alone group(P＜0. 05). The total effective rate in the combination therapy group was 93. 3％(28/30), significantly higher than 63. 3％(19/30) in the treatment alone group(P＜0. 05). The recurrence rate was 13. 3％ (4/30), significantly lower than that of 33. 3％(10/30) in the treatment alone group(P＜0. 05). However, the incidence rates of adverse reactions in the two groups was 6. 7％(2/30) and 10. 0％(3/30) respectively, which were not significantly different(P＞0. 05). Conclusion The efficacy of mesalazine combined with probiotics in the treatment of ulcerative colitis is more significant than that of mesalazine alone. At the same time, it is also more effective in improving the clinical symptoms, reducing the serum CRPlevel and recurrence rate in the patients, and will not increase the patients' adverse reactions to a great extent, so it is worthy of promotion and application in clinical settings.

Objective To explore the hemodynamic assessment after radical surgery in children with tetralogy of Fallot (TOF) by both echocardiography and Mostcare monitor. Methods Clinical data of 63 children with TOF who underwent radical surgery in our hospital from February 2016 to June 2018 were retrospectively analyzed, including 34 males and 29 females, aged 6-24 (9.82±5.77) months. There were 19 patients undergoing transannular patch reconstruction of the right ventricular outflow tract (a transannular patch group) while 44 patients retained the pulmonary valve annulus (a non-transannular patch group) . The echocardiography and Mostcare monitor parameters were recorded and brain natriuretic peptide was tested at the time points of 0, 8, 12, 24 and 48 hours after operation (T 0, T 1, T 2, T 4) to analyze their correlations and the change trend at different time points after radical surgery. Results The left ventricular ejection fraction at T 1 (43.49%±3.82%) was lower than that at T 0 (48.29%±4.55%), T 2 (45.83%±3.69%), T 3 (53.76%±4.43%) and T 4 (60.54%±3.23%, P<0.05). The cardiac index at T 1 (1.85±0.35 L·min−1·m−2) was lower than that at T 0 (2.11±0.38 L·min−1·m−2), T 2 (2.07±0.36 L·min−1·m−2), T 3 (2.42±0.37 L·min−1·m−2) and T 4 (2.82±0.42 L·min−1·m−2, P<0.05). The cardiac circulation efficiency at T1 (0.19±0.05) was lower than that at T 0 (0.22±0.06), T 2 (0.22±0.05), T 3 (0.28±0.06) and T 4 (0.34±0.06, P<0.05). The right ventricular two-chambers view fraction area change at T 1 (23.17%±3.11%) was lower than that at T 0 (25.81%±3.74%), T 2 (25.38%±3.43%), T 3 (30.60%±4.50%) and T 4 (36.94%±5.85%, P<0.05). The pulse pressure variability was the highest at T 0 (18.76%±3.58%), followed by T 1 (14.81%±3.32%), T 2 (12.44%±2.94%), T 3 (10.39%±2.96%) and T 4 (9.18%±1.92%, P<0.05). The blood brain natriuretic peptide was higher at T 1 (846.67±362.95 pg/ml) than that at T 0 (42.60±18.06 pg/ml), T 2 (730.95±351.09 pg/ml), T 3 (510.98±290.39 pg/ml) and T 4 (364.41±243.56 pg/ml, P<0.05). There was no significant difference in left ventricular ejection fraction, cardiac circulation efficiency and heart index between the two groups (P>0.05). The right ventricular two-chambers view fraction area change of the transannular patch group was significantly lower than that of the nontransannular patch group at each time point (P<0.05). The blood brain natriuretic peptide and pulse pressure variability of the transannular patch group were significantly higher than those of the non-transannular patch group (P<0.05). Left ventricular ejection fraction was positively correlated with cardiac index (r=0.637, P=0.001) and cardiac circulation efficiency (r=0.462, P=0.001) while was significantly negatively correlated with blood brain natriuretic peptide (r=–0.419, P=0.001). Conclusion Both methods can accurately reflect the state of cardiac function. Mostcare monitor has a good consistency with echocardiography. Using transannular patch to recontribute right ventricular outflow tract in operation has more influence on right ventricular systolic function. The Mostcare monitor can guide the hemodynamic management after surgery in real time, continuously and accurately.