Intestinal fibrosis in Crohn′s disease (CD) presents a significant clinical challenge, imposing a substantial burden on patients, their families and society. This article explores the histopathological and pathophysiological changes associated with intestinal fibrosis, providing a detailed summary of the related phenomena and processes. Additionally, we discuss the methods for detecting and assessing intestinal fibrosis, including radiological examinations, histopathological investigations, and the application of serum biomarkers. Finally, we delve into the therapeutic strategies for intestinal fibrosis in CD and the challenges faced in this realm, offering vital insights for further research and treatment of the disease.

Intestinal fibrosis in Crohn′s disease (CD) presents a significant clinical challenge, imposing a substantial burden on patients, their families and society. This article explores the histopathological and pathophysiological changes associated with intestinal fibrosis, providing a detailed summary of the related phenomena and processes. Additionally, we discuss the methods for detecting and assessing intestinal fibrosis, including radiological examinations, histopathological investigations, and the application of serum biomarkers. Finally, we delve into the therapeutic strategies for intestinal fibrosis in CD and the challenges faced in this realm, offering vital insights for further research and treatment of the disease.

Coronavirus disease 2019 (COVID-19) has become a worldwide pandemic. During the rapid spread time, it is a great challenge for patients with inflammatory bowel disease (IBD) who use immunosuppressive drugs from vaccination and drug application. This article is intended to supplement and revise the recommendations of the Inflammatory Bowel Disease Group of the Chinese Society of Gastroenterology in 2020 on the "Management of patients with inflammatory bowel disease during epidemic of novel coronavirus pneumonia", mainly including the treatment and vaccination of IBD patients complicated with COVID-19. It is expected to guide clinicians in drug use, vaccination of IBD patients at an appropriate time, also help patients getting through the epidemic period of COVID-19.

Innate lymphoid cells (ILC) are a type of innate immune cells with adaptive immune function, which can secrete a variety of cytokines and regulate immune response. In recent years, more and more studies have confirmed that there are abundant ILC in the lamina propria of the human intestinal mucosa, and are closely related to the occurrence and development of inflammatory bowel disease (IBD) . When intestinal inflammation occurs, the composition of ILC also appears abnormal. This article reviews the role of abnormal composition of ILC in the occurrence and development of IBD from the aspects of composition and function of ILC, the influence of its abnormal composition on IBD and possible mechanisms.

Patients with Crohn's disease (CD) are often complicated with malnutrition and enteral nutrition is the preferred option for nutritional support. Enteral nutrition is the first-line therapy to induce remission of CD in children, but its application in adults has not been well established. In recent years, studies have found that enteral nutrition can not only improve the nutritional status in adult CD patients, but also induce and maintain CD remission through various mechanisms. Given its favorable nutritional efficacy and safety, enteral nutrition has been considered as the basic treatment for adult CD patients and often used in combination with other treatment approaches. However, any combination therapy should be assessed in terms of benefit and risk. This review aims to describe the efficacy and safety of enteral nutrition combined with other treatment approaches in adult CD patients and enumerate common applicable clinical settings, so as to better inform clinical treatment.

Innate lymphoid cells (ILC) are a type of innate immune cells with adaptive immune function, which can secrete a variety of cytokines and regulate immune response. In recent years, more and more studies have confirmed that there are abundant ILC in the lamina propria of the human intestinal mucosa, and are closely related to the occurrence and development of inflammatory bowel disease (IBD) . When intestinal inflammation occurs, the composition of ILC also appears abnormal. This article reviews the role of abnormal composition of ILC in the occurrence and development of IBD from the aspects of composition and function of ILC, the influence of its abnormal composition on IBD and possible mechanisms.

Background/Aims: Risk of venous thrombosis is increased in patients with inflammatory bowel disease (IBD); data on Asian IBD patients is limited and status quo of thrombosis screening and prophylaxis are unknown. Therefore, we aimed to investigate the incidence, screening, prophylaxis, and risk factors for venous thrombosis among Asian IBD patients. Methods: Medical files of patients with Crohn’s disease (CD) and ulcerative colitis (UC) from 17 hospitals across China between 2011 and 2016 were reviewed for venous thrombosis, use of screening and prophylaxis. A case-control study was performed among hospitalized patients with venous thrombosis and their age-, sex-matched IBD controls hospitalized around the same period; disease characteristics and known provoking factors of venous thrombosis were recorded. Risk factors were analyzed in both univariate and logistic regression analyses. Results: A total of 8,459 IBD patients were followed for 12,373 person-year. Forty-six patients (0.54%) had venous thrombosis, yielding an incidence of 37.18 per 10,000 person-year. Incidence increased with age, especially among CD. Less than 20% of patients received screening tests and 35 patients (0.41%) received prophylaxis. Severe disease flare was an independent risk factor for venous thrombosis (odds ratio [95% confidence interval]: CD, 9.342 [1.813– 48.137]; UC, 5.198 [1.268–21.305]); past use of steroids and extensive involvement were 2 additional risk factors in CD and UC, respectively. Conclusions Incidence of venous thrombosis in China was 37.18 per 10,000 person-year (0.54%). Use of screening and prophylaxis were rare. Severe disease flare was an independent risk factor for thrombosis among hospitalized patients.

Objective:To analyze the clinical characteristics of solitary rectal ulcer syndrome (SRUS) .Methods:Retrospective analysis was performed on the data of 26 patients with SRUS diagnosed by pathology and admitted to Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from June 2015 to November 2019. A descriptive method was used to collect the general information, clinical manifestations, endoscopy, pathological examination, treatment and prognosis of patients.Results:A total of 26 patients were enrolled, including 11 males and 15 females, with average age of (41.96±13.83) years old and median duration of 21 (0.2-480) months from onset to diagnosis. The main clinical manifestations were rectal bleeding in 15 (57.69%) cases, rectal prolapse in 9 (34.62%) , perianal pain in 6 (23.08%) , body mass loss in 6 (23.08%) and rectal mucus in 5 (19.23%) . Seventeen patients underwent endoscopic examination, endoscopic features included ulcer in 6 (35.29%) cases, rectal polyp in 5 (29.41%) , protuberance in 4 (23.53%) , hyperplasia and swelling in 4 (23.53%) , erosion in 3 (17.65%) , either alone or in combination. Histological examination of rectal biopsies revealed that the characteristic features were mucosal surface erosion and ulcer in 11 (42.31%) cases, lamina propria fibrosis in 8 (30.77%) , mucosal gland deletion or decreased secretion in 6 (23.08%) , inflammatory cell infiltration in 5 (19.23%) , vascular changes in 5 (19.23%) , and crypts alteration in 4 (15.38%) . Five patients (19.23%) received medical treatment and 21 patients (80.77%) received surgery. Symptoms except rectal prolapse disappeared or were improved in all the patients after treatment.Conclusion:The clinical and endoscopic features of SRUS are variable. Pathology is crucial for diagnosis and differential diagnosis. Both the medical and surgical treatment are effective for SRUS.

Anti-tumor necrosis factor-α biologics have been widely used in the treatment of Crohn′s disease. A variety of new biological agents have been approved this year and entered clinical use.Clinical benefits and risks should be fully balanced according to the disease conditions for special population, and shared decision making should be conducted to select appropriate biological agents and develop individualized treatment regimen which will help to improve efficacy and safety of biologics.

The pathogenesis of inflammatory bowel disease (IBD) , especially mucosal immunity, has made rapid progress, and the emergence of cytokine targets has greatly promoted the treatment of IBD. According to the different effects, biological agents targeting cytokines can be divided into anti-inflammatory cytokine-derived biological agents and pro-inflammatory cytokine-derived biological agents, which are currently in different stages of research. This article reviews the application and prospect of cytokine-derived biological agents in maintaining intestinal immune balance, and provides some reference for clinical treatment of IBD.