Objective:To investigate the changes in symptoms of inflammatory bowel disease (IBD) patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the coronavirus disease 2019 (COVID-19) pandemic, as well as the situation of IBD treatment medication use.Methods:A cross-sectional survey study method was used. A questionnaire survey was conducted on a voluntary sampling basis for IBD patients of multiple centers nationwide from December 1st to 31st 2022, collecting clinical data of patients diagnosed with COVID-19 through nucleic acid/antigen testing. Patients were divided into symptomatic exacerbation group and asymptomatic exacerbation group based on whether they felt an exacerbation of IBD symptoms including abdominal discomfort, increased bloody stool or the appearance of purulent bloody stool, increased frequency of diarrhea, etc. And the differences in age, gender, body mass index (BMI) , underlying disease conditions, SARS-CoV-2 vaccination status, IBD type, disease activity, COVID-19 symptoms, and treatment medication between the two groups were compared.Results:A total of 497 patients were included, 317 males and 180 females; age (35.27±11.54) years; 355 CD patients and 142 UC patients; more than 50% of patients exhibited respiratory system symptoms such as fever, muscle soreness, fatigue, cough, expectoration, nasal congestion, and some IBD patients exhibited digestive system symptoms and nervous system symptoms. The symptomatic exacerbation group consisted of 104 patients (20.93%) , and the asymptomatic exacerbation group consisted of 393 (79.07%) . There were no statistically significant differences in gender, age, BMI, underlying diseases, IBD type, and SARS-CoV-2 vaccine doses between the two groups (all P>0.05) . Compared with the asymptomatic exacerbation group, the proportion of patients in the disease active phase was higher [47.12% (49/104) vs. 24.68% (97/393) , P<0.001], and the proportion of patients using mesalazine/sulfasalazine was higher (35.58% vs. 23.41%, P = 0.012) , and the proportions of COVID-19 symptoms such as diarrhea, headache, and dizziness were all higher (all P<0.05) in the symptomatic exacerbation group. Among the 237 IBD patients using biologics, there was a statistically significant difference in the types of biologics used between the symptomatic and asymptomatic exacerbation groups (χ 2 = 9.351, P = 0.031) . Among the 240 patients using biologics, the proportion of delaying or interrupting the use of biologics was higher in symptomatic exacerbation group than that of the asymptomatic exacerbation group, and the difference was statistically significant [45.45% (20/44) vs. 23.98% (47/196) , χ 2 = 8.235, P = 0.004]. Among the 47 patients using immunosuppressants, there was no statistically significant difference in the proportion of stopping immunosuppressants between the symptomatic and asymptomatic exacerbation groups ( P = 0.263) . Conclusion:The main symptoms of IBD patients infected with COVID-19 are respiratory and systemic symptoms, and those in the active phase of the disease or those delaying or withdrawing biologics are more likely to experience an exacerbation of IBD symptoms during the infection.

Objective:To evaluate the efficacy and safety of oliceridine for treatment of moderate to severe pain after surgery with general anesthesia in patients.Methods:The patients with moderate to severe pain (numeric pain rating scale ≥4) after abdominal surgery with general anesthesia from 14 hospitals between July 6, 2021 and November 9, 2021 were included in this study. The patients were assigned to either experiment group or control group using a random number table method. Experiment group received oliceridine, while control group received morphine, and both groups were treated with a loading dose plus patient-controlled analgesia and supplemental doses for 24 h. The primary efficacy endpoint was the drug response rate within 24 h after giving the loading dose. Secondary efficacy endpoints included early (within 1 h after giving the loading dose) drug response rates and use of rescue medication. Safety endpoints encompassed the development of respiratory depression and other adverse reactions during treatment.Results:After randomization, both the full analysis set and safety analysis set comprised 180 cases, with 92 in experiment group and 88 in control group. The per-protocol set included 170 cases, with 86 in experiment group and 84 in control group. There were no statistically significant differences between the two groups in 24-h drug response rates, rescue analgesia rates, respiratory depression, and incidence of other adverse reactions ( P>0.05). The analysis of full analysis set showed that the experiment group had a higher drug response rate at 5-30 min after giving the loading dose compared to control group ( P<0.05). The per-protocol set analysis indicated that experiment group had a higher drug response rate at 5-15 min after giving the loading dose than control group ( P<0.05). Conclusions:When used for treatment of moderate to severe pain after surgery with general anesthesia in patients, oliceridine provides comparable analgesic efficacy to morphine, with a faster onset.

Objective:To investigate the changes in symptoms of inflammatory bowel disease (IBD) patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the coronavirus disease 2019 (COVID-19) pandemic, as well as the situation of IBD treatment medication use.Methods:A cross-sectional survey study method was used. A questionnaire survey was conducted on a voluntary sampling basis for IBD patients of multiple centers nationwide from December 1st to 31st 2022, collecting clinical data of patients diagnosed with COVID-19 through nucleic acid/antigen testing. Patients were divided into symptomatic exacerbation group and asymptomatic exacerbation group based on whether they felt an exacerbation of IBD symptoms including abdominal discomfort, increased bloody stool or the appearance of purulent bloody stool, increased frequency of diarrhea, etc. And the differences in age, gender, body mass index (BMI) , underlying disease conditions, SARS-CoV-2 vaccination status, IBD type, disease activity, COVID-19 symptoms, and treatment medication between the two groups were compared.Results:A total of 497 patients were included, 317 males and 180 females; age (35.27±11.54) years; 355 CD patients and 142 UC patients; more than 50% of patients exhibited respiratory system symptoms such as fever, muscle soreness, fatigue, cough, expectoration, nasal congestion, and some IBD patients exhibited digestive system symptoms and nervous system symptoms. The symptomatic exacerbation group consisted of 104 patients (20.93%) , and the asymptomatic exacerbation group consisted of 393 (79.07%) . There were no statistically significant differences in gender, age, BMI, underlying diseases, IBD type, and SARS-CoV-2 vaccine doses between the two groups (all P>0.05) . Compared with the asymptomatic exacerbation group, the proportion of patients in the disease active phase was higher [47.12% (49/104) vs. 24.68% (97/393) , P<0.001], and the proportion of patients using mesalazine/sulfasalazine was higher (35.58% vs. 23.41%, P = 0.012) , and the proportions of COVID-19 symptoms such as diarrhea, headache, and dizziness were all higher (all P<0.05) in the symptomatic exacerbation group. Among the 237 IBD patients using biologics, there was a statistically significant difference in the types of biologics used between the symptomatic and asymptomatic exacerbation groups (χ 2 = 9.351, P = 0.031) . Among the 240 patients using biologics, the proportion of delaying or interrupting the use of biologics was higher in symptomatic exacerbation group than that of the asymptomatic exacerbation group, and the difference was statistically significant [45.45% (20/44) vs. 23.98% (47/196) , χ 2 = 8.235, P = 0.004]. Among the 47 patients using immunosuppressants, there was no statistically significant difference in the proportion of stopping immunosuppressants between the symptomatic and asymptomatic exacerbation groups ( P = 0.263) . Conclusion:The main symptoms of IBD patients infected with COVID-19 are respiratory and systemic symptoms, and those in the active phase of the disease or those delaying or withdrawing biologics are more likely to experience an exacerbation of IBD symptoms during the infection.

Crohn′s disease (CD) is a chronic, progressive and destructive inflammatory disease affecting the entire digestive tract. Changes in the intestinal microbiota, particularly a decrease in gut microbiome diversity, are thought to be associated with chronic intestinal inflammation of CD. As for the mechanism of antibiotics in CD treatment, some scholars believe that antibiotics can affect the course of disease by reducing the concentration of intestinal bacteria and changing the composition of intestinal microbiota. Different antibiotics, including ciprofloxacin, metronidazole and rifaximin, have been proved to have certain therapeutic effect on some patients with CD in clinical practice, but there are still limitations in the use of antibiotics.In this review, the relationship between intestinal flora and the incidence of CD and the application of antibiotics in CD were reviewed, providing reference and help for the standardized application of antibiotics in CD.

The Ly-6 and uPAR (LU) domain-containing proteins represent a large family of cell-surface markers. In particular, mouse Ly-6A/Sca-1 is a widely used marker for various stem cells; however, its human ortholog is missing. In this study, based on a systematic survey and comparative genomic study of mouse and human LU domain-containing proteins, we identified a previously unannotated human gene encoding the candidate ortholog of mouse Ly-6A/Sca-1. This gene, hereby named LY6A, reversely overlaps with a lncRNA gene in the majority of exonic sequences. We found that LY6A is aberrantly expressed in pituitary tumors, but not in normal pituitary tissues, and may contribute to tumorigenesis. Similar to mouse Ly-6A/Sca-1, human LY6A is also upregulated by interferon, suggesting a conserved transcriptional regulatory mechanism between humans and mice. We cloned the full-length LY6A cDNA, whose encoded protein sequence, domain architecture, and exon-intron structures are all well conserved with mouse Ly-6A/Sca-1. Ectopic expression of the LY6A protein in cells demonstrates that it acts the same as mouse Ly-6A/Sca-1 in their processing and glycosylphosphatidylinositol anchoring to the cell membrane. Collectively, these studies unveil a novel human gene encoding a candidate biomarker and provide an interesting model gene for studying gene regulatory and evolutionary mechanisms.
Humans ; Membrane Proteins/genetics* ; Pituitary Neoplasms/genetics* ; Biomarkers

Objective:To investigate the incidence, clinical characteristics and risk factors of growth retardation in pediatric onset IBD patients.Methods:A cross-sectional study was conducted. IBD patients with the age at diagnosis younger than 18 years old were recruited and screened in the Wechat group of patients in 8 IBD medical centers across the country. Demographic, clinical and growth-related data were collected through questionnaire survey, and the incidences of growth retardation at the time of diagnosis and investigation were calculated. According to whether there was growth retardation at the time of investigation, the patients were divided into growth retardation group and non-growth retardation group. The influencing factors of growth retardation were analyzed by the univariate analysis and multivariate Logistic regression analysis.Results:A total of 97 patients were involved including 8 ulcerative colitis (UC) and 89 Crohn′s disease (CD). There was no growth retardation in UC patients. Among 89 patients with CD, there were 48 males and 41 females, and the age was 15.5 (1.0, 21.0) years old. At the time of investigation, 14 patients (15.7%) with growth retardation were set as the growth retardation group, and 75 without growth retardation were set as the non-growth retardation group. The incidence of growth retardation was 19.0% (16/84) at the time of diagnosis. Univariate analysis results showed that compared with non-growth retardation group, patients in growth retardation group had lower diagnostic age [5.0 (1.0, 13.8) years old vs. 14.0 (12.0, 16.0) years old, P = 0.003], severer disease activity ( P = 0.006), higher proportion of acute gastrointestinal perforation [28.6% (4/14) vs. 2.7% (2/75), P = 0.005], higher proportion of patients in using glucocorticoids [64.3% (9/14) vs. 33.3% (25/75), P = 0.029), and longer time of using glucocorticoids [1.5 (0, 6.5) months vs. 0 (0, 3.0) months, P = 0.040], while the proportion of patients using biological agents was lower [42.9% (6/14) vs. 80.0% (60/75), P = 0.010], and the time of using biological agents was shorter [0 (0, 6.3) months vs. 7.0 (1.0, 12.0) months, P = 0.006]. Logistic regression analysis revealed that the age at diagnosis of CD was still a risk factor for growth retardation after correcting other factors ( OR = 6.909, 95% CI: 1.250-38.195, P = 0.027) . Conclusion:The pediatric onset IBD patients with low diagnostic age are prone to growth retardation, which should be paid attention to.

Crohn′s disease (CD) is a chronic transmural inflammation disease which may affect the whole gastrointestinal tract. It is known that ileal and colonic involvement of CD is common. Capsule endoscopy (CE) is widely used for CD because of its noninvasiveness and convenience, especially for diagnosis of early-onset and atypical small bowel CD. CE also plays an important role in improving and modifying disease extent and assessment of disease activity. However, CE has its limitations. We mainly summarize the efficacy of CE for early-onset diagnosis and evaluation of extent and activity in small bowel CD. The retention risks are also reviewed to give some references for clinical practice.

Objective:To investigate the incidence, clinical characteristics and risk factors of growth retardation in pediatric onset IBD patients.Methods:A cross-sectional study was conducted. IBD patients with the age at diagnosis younger than 18 years old were recruited and screened in the Wechat group of patients in 8 IBD medical centers across the country. Demographic, clinical and growth-related data were collected through questionnaire survey, and the incidences of growth retardation at the time of diagnosis and investigation were calculated. According to whether there was growth retardation at the time of investigation, the patients were divided into growth retardation group and non-growth retardation group. The influencing factors of growth retardation were analyzed by the univariate analysis and multivariate Logistic regression analysis.Results:A total of 97 patients were involved including 8 ulcerative colitis (UC) and 89 Crohn′s disease (CD). There was no growth retardation in UC patients. Among 89 patients with CD, there were 48 males and 41 females, and the age was 15.5 (1.0, 21.0) years old. At the time of investigation, 14 patients (15.7%) with growth retardation were set as the growth retardation group, and 75 without growth retardation were set as the non-growth retardation group. The incidence of growth retardation was 19.0% (16/84) at the time of diagnosis. Univariate analysis results showed that compared with non-growth retardation group, patients in growth retardation group had lower diagnostic age [5.0 (1.0, 13.8) years old vs. 14.0 (12.0, 16.0) years old, P = 0.003], severer disease activity ( P = 0.006), higher proportion of acute gastrointestinal perforation [28.6% (4/14) vs. 2.7% (2/75), P = 0.005], higher proportion of patients in using glucocorticoids [64.3% (9/14) vs. 33.3% (25/75), P = 0.029), and longer time of using glucocorticoids [1.5 (0, 6.5) months vs. 0 (0, 3.0) months, P = 0.040], while the proportion of patients using biological agents was lower [42.9% (6/14) vs. 80.0% (60/75), P = 0.010], and the time of using biological agents was shorter [0 (0, 6.3) months vs. 7.0 (1.0, 12.0) months, P = 0.006]. Logistic regression analysis revealed that the age at diagnosis of CD was still a risk factor for growth retardation after correcting other factors ( OR = 6.909, 95% CI: 1.250-38.195, P = 0.027) . Conclusion:The pediatric onset IBD patients with low diagnostic age are prone to growth retardation, which should be paid attention to.

Crohn′s disease (CD) is a chronic transmural inflammation disease which may affect the whole gastrointestinal tract. It is known that ileal and colonic involvement of CD is common. Capsule endoscopy (CE) is widely used for CD because of its noninvasiveness and convenience, especially for diagnosis of early-onset and atypical small bowel CD. CE also plays an important role in improving and modifying disease extent and assessment of disease activity. However, CE has its limitations. We mainly summarize the efficacy of CE for early-onset diagnosis and evaluation of extent and activity in small bowel CD. The retention risks are also reviewed to give some references for clinical practice.

Crohn′s disease (CD) that affects the gastrointestinal tract is a chronic, non-specific transmural inflammatory disease, and its pathogenesis is not clear at present. Traditional drug therapy includes glucocorticoids and immunosuppressive agents and so on. In nearly two decades, biological agents represented by anti-tumor necrosis factor (TNF) -α monoclonal antibodies have greatly changed the prognosis of CD. However, its clinical application still faces challenges, such as primary non-response or secondary non-response. With the in-depth study of the pathophysiology of CD, novel therapeutic targets drugs are emerging continuously. This article summarizes and discusses the research progress of these novel drugs to provide references for clinical treatment.