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.

Objective:To retrieve, evaluate and summarize the relevant evidence of subcutaneous injection in patients to reduce pain at the injection site, so as to provide reference for clinical practice.Methods:According to the evidence pyramid "6S" model, all evidence on subcutaneous injection and injection site pain, including guidelines, expert consensus, summary of evidence, clinical decision, systematic review, etc were retrieved from domestic and international guideline networks and databases. The search period was from database establishment to October 2, 2022. The literature quality evaluation and evidence grading system of Joanna Briggs Institute (JBI) Evidence-based Health Care Center was used to evaluate the literature quality and classify the evidence level.Results:A total of 12 articles were included, including 2 expert consensus, 6 systematic reviews, 2 best evidence summaries and 2 clinical guidelines. A total of 21 pieces of best evidence were summarized from 8 aspects, including pre-subcutaneous injection assessment, injection site, injection needle, injection position, injection method, precautions, personnel training and health education.Conclusions:This study summarized a comprehensive and practical subcutaneous injection method. Clinical practitioners can use evidence to administer subcutaneous injection to patients, reduce pain and improve patients ′ comfort.

With serious environmental problems and the aging of population， the incidence of cancers worldwide has increased dramatically. For modern medicine， cancer is an incurable malignant disease with a high metastasis rate and strong cell proliferation and invasion ability. At present， clinical anti-cancer therapies mainly include chemotherapy and radiotherapy， but most chemotherapy drugs can cause serious side effects. Therefore， Chinese medicine with high safety has been widely used in anti-cancer treatment， which can inhibit the proliferation of cancer cells， improve the quality of life， and prolong life. Ligustrazine is a pyrazine alkaloid isolated and purified from Chuanxiong Rhizoma， which has pharmacological effects， such as anti-fibrosis， anti-oxidation， and anti-tumor. In recent years， ligustrazine， as an index active component of Chuanxiong Rhizoma alkaloids， has gradually become one of the hot spots in clinical medical research due to its pharmacological actions， and its anti-tumor effect has attracted more attention from researchers. The present study mainly investigated the anti-cancer effect of ligustrazine from the induction of tumor cell apoptosis and autophagy， inhibition of cell proliferation and migration， reversal of multidrug resistance of cancer cells， and inhibition of angiogenesis， and the anti-tumor efficacy was observed in various malignancies such as gastric cancer， lung cancer， rectal cancer， bladder cancer， breast cancer， and ovarian cancer. In addition， ligustrazine can be combined with cisplatin， paclitaxel， podophyllotoxin， chalcone， curcumin， and other drugs to exert an anti-tumor effect. This study conducted a literature review based on the anti-tumor mechanism of ligustrazine to provide a reference for the treatment of clinical malignancies.

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) 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 explore the role of parental origin verification in chromosomal microarray analysis (CMA) on the determination of the clinical significance of copy number variations (CNVs).Methods:This retrospective study collected clinical information from 73 core families who underwent prenatal diagnosis at Peking University First Hospital from November 2017 to December 2019. Indications for prenatal diagnosis included ultrasound abnormality in 54 cases (including 12 with thickened nuchal translucency (≥2.5 mm), four with fetal growth restriction, seven with abnormal pregnancy history, and 31 with isolated ultrasound abnormality), NIPT indicated high-risk in four cases, advanced age in nine cases, abnormal pregnancy history alone in three cases, intrauterine death in two cases and one with maternal mental retardation. Genomic DNA of amniotic fluid sample, chorionic villi, cord blood, fetal tissues, and fetal heart blood were extracted using genomic DNA extraction kit. The CNVs of prenatal samples in 73 subjects were analyzed using array-based comparative genomic hybridization (array-CGH) analysis and single nucleotide polymorphism array (SNP-array). Peripheral blood DNA of the couples, and relevant families if necessary, were collected and analyzed in the same way. The results of parental origin detection in CMA were summarized.Results:A total of 76 CNVs were detected in these 73 samples, out of which nine were pathogenic and parental origin detection revealed that six were de novo, two were maternally, and one was paternally inherited; six CNVs were likely pathogenic, including three de novo, two maternally inherited and one paternally inherited; 20 CNVs were variants of uncertain significance, including five paternally inherited, three maternally inherited and 12 de novo; 41 CNVs were likely benign, among which 38 were inherited from parents with normal phenotype. Conclusions:Parental origin verification plays an important role in explaining the clinical significance of detected fetal CNVs and thereby can help to analyze its clinical effect and reproductive risk.

【Objective】 To investigate the clinical efficacy and safety of low-dose rituximab combined with dexamethasone in the treatment of refractory ITP (RITP) in children. 【Methods】 A total of 31 RITP children, admitted to the Hematology Department of Kunming Children′s Hospital from January 2016 to December 2019 and agreed to receive low-dose rituximab (100 mg/ time, once a week, for 4 successive weeks) combined with dexamethasone (0.6 mg/kg, once a day, for 4 successive days) were enrolled and studied. Blood routine was monitored every other day during treatment, and adverse drug reactions were recorded. The influence of gender, disease course and age on prognosis was compared by χ² test. 【Results】 1) Among the 31 cases, 11 (35.5%) had platelets >100×10⁹/L after 4 weeks and had no recurrence in 6 months; 9 (29%) had platelets >30×10⁹/L but <100×10⁹/L and had no recurrence in 6 months; 11 (35.5%) showed no recovery of platelets, which were consistently lower than 30×10⁹/L. 2) Rituximab was used in 4 cases (12.9%), 1 case (3.2%) presented with severe drug-induced rashes; Headache, vomiting and elevated blood pressure occurred in 2 cases (6.4%). 1 case (3.2%) presented with laryngeal edema. 3) There was no difference in the total effective rate among different gender, age and disease course (P >0.05). 【Conclusion】 The total effective rate of low-dose rituximab combined with dexamethasone for children with refractory ITP in 6 months is 64.5%, and the adverse reactions are tolerable, so it can be used as a treatment option for children with refractory ITP.

Objective:To investigate the clinicopathological differences in laterally spreading tumor (LST) from the rectum and colon.Methods:Clinicopathological records of 198 patients with LST (116 cases in rectum,82 cases in colon) from the Second Xiangya Hospital of Central South University between January 2012 and January 2017 were evaluated.Results:A total of 198 colorectal LST were included.According to the endoscopic classification,nodular mixed type (LST-GM),homogeneous type (LST-GH),flat elevated type(LST-FE) and pseudodepressed type (LST-PD) were 127(64.1％),13(6.6％),41(20.7％) and 17(8.6％),respectively.LST-GM was predominant in the rectum (71.7％),while LST-FE was predominant in the colon (78.0％),with significant difference (P＜0.01).The mean size of LST was (52.03±35.62) mm or (25.37±11.56) mm in the rectum or the colon,with significant difference between them (P＜0.01).High grade intraepithelial neoplasia frequency was higher in the rectum than that in the colon (31.0％ vs 18.3％),while the low grade intraepithelial neoplasia frequency was lower in the rectum than that in the colon (61.2％ vs 75.6％) (both P＜0.05).The mean size of LSTGM and LST-GH diameter were larger in the rectum than that in the colon,and the malignant potential of LST-GM was higher in the rectum than that in the colon.The percentage of high grade intraepithelial neoplasia + invasive carcinoma was 41.8％ and 22.2％,respectively (both P＜0.05).LST in colon was mostly treated with endoscopic mucosal resection,while LST in rectum was treated by endoscopic submucosal dissection predominantly.Conclu sion:LSTs from the rectum and colon show different clinicopathological characteristics to some extent.LST-GM is predominant in the rectum,while LST-FE is predominant in the colon.The malignant potential of LST-GM is higher in the rectum than that in the colon.

s:Apoptosis, also known as programmed cell death, is a gene controlled active cell suicide process in order to maintain balance of organisms. Apoptosis is mainly mediated through three signal pathways, including the endoplasmic reticulum, mitochondria, and death receptor. As a kind of naphthoquinone compounds and one of the main active ingredients of Lithospermum, shikonin has many biological activities, and its anti-cancer research is recent hot spot. The anti-cancer mechanism of shikonin is closely related with apoptosis and three kinds of signaling pathways. This article reviewed the research progress in apoptosis and signal pathways induced by shikonin.

Objective To study the clinical effect of psychological intervention combined with oral administration of aminoglucose hydrochloride capsules combined with intra-articular injection of sodium hyaluronate combined with functional exercise in the treatment of knee osteoarthritis.Methods Forty-eight patients with knee osteoarthritis were randomLy divided into control group and study group(n=39).The patients were randomLy divided into control group and study group.The control group was given intraperitoneal injection of sodium hyaluronate combined with functional exercise, the study group on the basis of the control group to give psychological intervention and oral administration of aminoglucose capsules combined therapy.Comparison of two groups of Lysholm knee function score and postoperative efficacy.Results The scores of Lysholm knee function were significantly improved after treatment, but the improvement rate of the study group was significantly better than that of the control group (P<0.05).The clinical effect of the study group was significantly better than that of the control group(94.87% vs 43.59%).The difference was statistically significant (P<0.05).Conclusion The combination of psychological intervention combined with oral administration of aminoglucose capsules with intraperitoneal injection of sodium hyaluronate combined with functional exercise in the treatment of knee osteoarthritis can significantly improve the clinical efficacy, improve the knee function and improve the prognosis, worthy of clinical application and promotion.