Objective:To compare the clinical features between inflammatory bowel disease (IBD) and Clostridium difficile infection (CDI) in children. Methods:A cross-sectional study was conducted. Clinical data of patients initially diagnosed IBD and CDI in the Affiliated Children′s Hospital of Xi′an Jiaotong University from August 2017 to August 2022 were collected retrospectively. The age, gender, symptom, laboratory test indexes of children in the two groups were analyzed and compared.Results:A total of 44 children [24 males, 20 females; median age, 9.04 (5.34, 12.50) years] were included in IBD group and there were 30 patients with Crohn′s disease (CD), 12 with ulcerative colitis (UC) and 2 with IBD unclassified (IBDU). A total of 45 children [28 males, 17 females; median age, 4.00 (2.38, 6.00) years] were included in CDI group. There was no significant difference in gender between the two groups (χ 2 = 0.54, P = 0.4625). The age of the CDI group was younger than that of the IBD group, and the difference was statistically significant ( U = 568.50, P = 0.0004). The incidences of diarrhea, hematochezia, abdominal pain and fever were high both in patients with IBD and CDI. The more common symptom in IBD group was abdominal pain, and its ratio was significantly higher than that of CDI group (61.36% vs. 40.00%, χ 2 = 4.06, P = 0.0439). The common clinical manifestations in CDI group were diarrhea and hematochezia, with a significantly higher proportion compared to the IBD group (diarrhea: 71.11% vs. 47.73%, χ 2 = 6.48, P = 0.0109; hematochezia: 75.56% vs. 50.00%, χ 2 = 6.23, P = 0.0126). The duration of symptoms in the IBD group was significantly longer than that in the CDI group ( U = 437.50, P<0.01). Compared with the CDI group, IBD patients had higher level of white blood cell count, neutrophil ratio, platelet count, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), while lower level of hemoglobin and albumin, and all the differences were statistically significant (all P<0.05) . Conclusions:IBD and CDI have similar symptoms, however abdominal pain is more common in the patients with IBD, diarrhea and hematochezia are more common in patients with CDI. The duration of symptoms in IBD patients is longer, and the level of CRP and ESR is higher. These clinical features can be used to differentiate the patients with initially diagnosed IBD from CDI.

Objective:To compare the clinical features between inflammatory bowel disease (IBD) and Clostridium difficile infection (CDI) in children. Methods:A cross-sectional study was conducted. Clinical data of patients initially diagnosed IBD and CDI in the Affiliated Children′s Hospital of Xi′an Jiaotong University from August 2017 to August 2022 were collected retrospectively. The age, gender, symptom, laboratory test indexes of children in the two groups were analyzed and compared.Results:A total of 44 children [24 males, 20 females; median age, 9.04 (5.34, 12.50) years] were included in IBD group and there were 30 patients with Crohn′s disease (CD), 12 with ulcerative colitis (UC) and 2 with IBD unclassified (IBDU). A total of 45 children [28 males, 17 females; median age, 4.00 (2.38, 6.00) years] were included in CDI group. There was no significant difference in gender between the two groups (χ 2 = 0.54, P = 0.4625). The age of the CDI group was younger than that of the IBD group, and the difference was statistically significant ( U = 568.50, P = 0.0004). The incidences of diarrhea, hematochezia, abdominal pain and fever were high both in patients with IBD and CDI. The more common symptom in IBD group was abdominal pain, and its ratio was significantly higher than that of CDI group (61.36% vs. 40.00%, χ 2 = 4.06, P = 0.0439). The common clinical manifestations in CDI group were diarrhea and hematochezia, with a significantly higher proportion compared to the IBD group (diarrhea: 71.11% vs. 47.73%, χ 2 = 6.48, P = 0.0109; hematochezia: 75.56% vs. 50.00%, χ 2 = 6.23, P = 0.0126). The duration of symptoms in the IBD group was significantly longer than that in the CDI group ( U = 437.50, P<0.01). Compared with the CDI group, IBD patients had higher level of white blood cell count, neutrophil ratio, platelet count, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), while lower level of hemoglobin and albumin, and all the differences were statistically significant (all P<0.05) . Conclusions:IBD and CDI have similar symptoms, however abdominal pain is more common in the patients with IBD, diarrhea and hematochezia are more common in patients with CDI. The duration of symptoms in IBD patients is longer, and the level of CRP and ESR is higher. These clinical features can be used to differentiate the patients with initially diagnosed IBD from CDI.

The occurrence of inflammatory bowel disease (IBD) may be related to a variety of cytokines, and the blocking of tumor necrosis factor (TNF) -α signaling pathway has been an important therapeutic target of IBD. Adalimumab is a fully humanized anti-TNF-α monoclonal antibody with low immunogenicity. It may be considered for better efficacy in children with IBD who failed infliximab therapy.

The occurrence of inflammatory bowel disease (IBD) may be related to a variety of cytokines, and the blocking of tumor necrosis factor (TNF) -α signaling pathway has been an important therapeutic target of IBD. Adalimumab is a fully humanized anti-TNF-α monoclonal antibody with low immunogenicity. It may be considered for better efficacy in children with IBD who failed infliximab therapy.

Objective To investigate the clinical efficacy of shoulder-three-points warm needling moxibustion plus conventional rehabilitation in recovery from arthroscopic rotator cuff repair.Method Seventy patients who had undergone arthroscopic rotator cuff repair for rotator cuff injury were enrolled and randomly allocated to groups A and B, 35 cases each. Group A received conventional rehabilitation and group B, shoulder-three-points warm needling moxibustion in addition. Functional activity and pain in the affected shoulder were scored using the American Shoulder Elbow Scale (ASES), the University of California at Los Angeles (UCLA) Shoulder Scale and the Constant-Murley Shoulder Outcome Score in the two groups before and after treatment.Result There were statistically significant pre-/post-treatment differences in the ASES, UCLA and Constant-Murley scores in the two groups (P<0.01). After treatment, the scores were higher in group B than in group A, but there was no significant difference in the UCLA function subscore (P>0.05) and a significant difference in the UCLA pain subscore (P<0.01) between groups A and B. Conclusion shoulder-three-points warm needling moxibustion plus conventional rehabilitation training can markedly promote postoperative rehabilitation and especially relieve postoperative pain in patients with rotator cuff injury. It provides a new idea for clinical shoulder rehabilitation in the future.