Ulcerative colitis （UC） is a chronic nonspecific inflammatory intestinal disease with a complex pathogenesis. Its recurrent attacks easily lead to persistent intestinal mucosal damage， resulting in a year-by-year increase in incidence and imposing a heavy burden on patients. Currently， the treatment of UC mainly relies on corticosteroids， immunosuppressants， and aminosalicylate preparations. However， these therapies are limited by significant side effects， strong drug resistance， and poor long-term prognosis. As one of the important inflammatory pathways， the Janus kinase 2 （JAK2）/signal transducer and activator of transcription 3 （STAT3） signaling pathway can regulate the occurrence and development of UC through multiple pathways by modulating multiple downstream targets. Therefore， the JAK2/STAT3 signaling pathway offers a new research direction for the treatment of UC. Numerous studies have shown that the JAK2/STAT3 signaling pathway plays an important role in intestinal inflammatory responses， intestinal mucosal barrier damage， T helper cell 17 （Th17）/regulatory T cell （Treg） immune imbalance， intestinal epithelial cell apoptosis， and oxidative stress. Chinese medicine has attracted increasing attention because of its unique advantages， including fewer side effects， individualized diagnosis and treatment， and enhancement of efficacy with reduction of toxicity. In addition to traditional Chinese herbal formulas， more Chinese medicine monomers and extracts have played key roles because of their more precise therapeutic targets. In recent years， many studies have confirmed that Chinese medicine can exert therapeutic effects on UC by interfering with the JAK2/STAT3 signaling pathway， thereby alleviating intestinal inflammatory responses， repairing the intestinal mucosal barrier， regulating the balance of Th17/Treg immune cells， inhibiting intestinal epithelial cell apoptosis， and suppressing oxidative stress. This article summarizes and reviews recent research progress in this field from three aspects， including an overview of the JAK2/STAT3 signaling pathway， the relationship between the JAK2/STAT3 signaling pathway and UC， and the regulatory mechanisms of traditional Chinese medicine， with the aim of providing a theoretical basis for the future clinical treatment of UC and drug development.

Ulcerative colitis （UC） is a chronic nonspecific inflammatory intestinal disease with a complex pathogenesis. Its recurrent attacks easily lead to persistent intestinal mucosal damage， resulting in a year-by-year increase in incidence and imposing a heavy burden on patients. Currently， the treatment of UC mainly relies on corticosteroids， immunosuppressants， and aminosalicylate preparations. However， these therapies are limited by significant side effects， strong drug resistance， and poor long-term prognosis. As one of the important inflammatory pathways， the Janus kinase 2 （JAK2）/signal transducer and activator of transcription 3 （STAT3） signaling pathway can regulate the occurrence and development of UC through multiple pathways by modulating multiple downstream targets. Therefore， the JAK2/STAT3 signaling pathway offers a new research direction for the treatment of UC. Numerous studies have shown that the JAK2/STAT3 signaling pathway plays an important role in intestinal inflammatory responses， intestinal mucosal barrier damage， T helper cell 17 （Th17）/regulatory T cell （Treg） immune imbalance， intestinal epithelial cell apoptosis， and oxidative stress. Chinese medicine has attracted increasing attention because of its unique advantages， including fewer side effects， individualized diagnosis and treatment， and enhancement of efficacy with reduction of toxicity. In addition to traditional Chinese herbal formulas， more Chinese medicine monomers and extracts have played key roles because of their more precise therapeutic targets. In recent years， many studies have confirmed that Chinese medicine can exert therapeutic effects on UC by interfering with the JAK2/STAT3 signaling pathway， thereby alleviating intestinal inflammatory responses， repairing the intestinal mucosal barrier， regulating the balance of Th17/Treg immune cells， inhibiting intestinal epithelial cell apoptosis， and suppressing oxidative stress. This article summarizes and reviews recent research progress in this field from three aspects， including an overview of the JAK2/STAT3 signaling pathway， the relationship between the JAK2/STAT3 signaling pathway and UC， and the regulatory mechanisms of traditional Chinese medicine， with the aim of providing a theoretical basis for the future clinical treatment of UC and drug development.

Objective To observe the impact of ultrasonic image quality on the consistency of artificial intelligence(Al)assisted diagnosis system and manual measurements of biological indicators of developmental dysplasia of hip(DDH).Methods Hip ultrasonic data of 75 DDH and 345 non-DDH children were retrospectively analyzed,and the quality of ultrasonic images were subjectively scored.An evaluation model of ultrasonic image quality was constructed based on 140 ultrasonic images acquired from 140 cases(group A,containing 25 DDH and 115 non-DDH)using entropy weighting method,the weight of anatomic structures and impact factors related to DDH were obtained.The comprehensive image quality scores of other ultrasonic images acquired from 280 cases(group B,including 50 DDH and 230 non-DDH)were calculated,and the images in group B were classified into grade A,B and C in descending order.The consistency of AI and manual measurements of DDH biological indicators in group B was assessed.Results The weight of each anatomic structure and impact factors of DDH obtained with the model were as follows:The lower edge of iliac branch＞ilium＞glenoid labrum＞bony margin＞femoral head＞motion artifacts.In group B,grade A was observed in 67(9 DDH and 58 non-DDH),grade B was found in 160(26 DDH and 134 non-DDH),while grade C was noticed in 53(15 DDH and 38 non DDH)images.Except for β,femoral head coverage(FHC)and femoral head length diameter,the consistencies between AI and manual measurements of other indicators of DDH were grade A＞B＞C.In group B,AI and manual measurements were more consistent in DDH than in non-DDH cases.Conclusion Ultrasonic image quality affected the consistency between AI and manual measurements of biological indicators of DDH.When image quality was not good enough,further attention should be paid to measurement of FHC and sizes of femoral head.

Purpose To explore the value of contrast-enhanced ultrasound(CEUS)in the differential diagnosis of gallbladder polypoid lesions(GPLs)(diameter≥10 mm).Materials and Methods A prospective enrollment of 229 patients with GPLs who underwent cholecystectomy in 17 hospitals from December 1 2021 to June 30 2024 was conducted to analyze the relationship between general data,conventional ultrasound,CEUS characteristics and the nature of GPLs.Multivariate Logistic regression was employed to identify independent risk factors for neoplastic polyps,the differential diagnostic value of different indicators was compared.Results Among 229 patients with GPLs,there were 108 cases of cholesterol polyps,102 cases of adenoma and 19 cases of gallbladder cancer.Age(Z=-4.476,P<0.001),polyp number(χ2=15.561,P<0.001),diameter(Z=-8.149,P<0.001),echogenicity(χ2=9.241,P=0.010),vascularity(χ2=23.107,P<0.001),enhancement intensity(χ2=47.610,P<0.001),enhancement pattern(χ2=6.468,P=0.011),vascular type(χ2=84.470,P<0.001),integrity of gallbladder wall(χ2=7.662,P=0.006)and stalk width(Z=-9.831,P<0.001)between cholesterol polyps and neoplastic polyps were statistically significant.Age,location,diameter,echogenicity,enhancement pattern,vascular type and stalk width between adenoma and gallbladder cancer were statistically significant(Z=-4.333,-3.902,-5.042,all P<0.05).Multivariate Logistic regression analysis showed that hyper-enhancement,branched vascular type and stalk width were independent risk factors for neoplastic polyps(OR=4.563,5.770,3.075,all P<0.001).The combination of independent risk factors was better than single factor and diameter in the differential diagnosis of cholesterol polyps and neoplastic polyps(all P<0.01).Conclusion CEUS can effectively identify the nature of GPLs and provide a valuable imaging reference for the selection of treatment methods.

Background:Gastric adenocarcinoma of the fundic gland type(GA-FG)and oxyntic gland adenoma(OGA)are rare variants of the gastric neoplasms exhibiting fundic differentiation.However,their endoscopic recognition and diagnosis is difficult in clinical practice.Aims:To explore the endoscopic and clinicopathological features of GA-FG and OGA,and to discuss the surgical methods and clinical outcomes.Methods:A retrospective analysis was conducted on 19 cases with a total of 22 lesions diagnosed as GA-FG or OGA through histopathology at the Shanghai Sixth People′s Hospital,Shanghai Jiao Tong University School of Medicine from January 2020 to May 2023.Data on the diagnosis,treatment and follow-up among these patients were collected and analyzed.Results:Females were slightly more than males(12:7),with an average age of 54 years.Eighteen patients had single lesions,while one had 4 synchronous multifocal lesions.All the lesions located in the non-atrophic gastric fundic area of the upper and middle third of the stomach.Nine lesions were misdiagnosed as gastric fundic gland polyps initially.The tumors were small,with the average diameter of 7.4 mm.Most of the lesions(77.3%)showed fading or whitening changes under white light endoscopy.While under magnifying endoscopy with narrow-band imaging,obscure demarcation line,and dilated intervening part and crypt-opening could be observed in over half of the lesions,but irregular microvascular pattern was absent.Six lesions exhibited submucosal infiltration(GA-FG)without lymphovascular invasions.Eighteen lesions were diagnosed as chief cell predominant type,one was parietal cell predominant type,and three were mixed type.Endoscopic submucosal dissection and endoscopic mucosal resection were performed in 17 cases.No severe perioperative complications occurred,and no local recurrence and metastasis were detected during follow-up period.Conclusions:GA-FG and OGA mainly occur in the non-atrophic gastric fundic area,with small lesions exhibiting fading changes under endoscopy.The pathological type is primarily chief cell predominant type.This kind of lesion can be easily misdiagnosed as gastric fundic gland polyps.Endoscopic therapy appears to be effective and safe for them with a favorable prognosis.

Background:Gastric adenocarcinoma of the fundic gland type(GA-FG)and oxyntic gland adenoma(OGA)are rare variants of the gastric neoplasms exhibiting fundic differentiation.However,their endoscopic recognition and diagnosis is difficult in clinical practice.Aims:To explore the endoscopic and clinicopathological features of GA-FG and OGA,and to discuss the surgical methods and clinical outcomes.Methods:A retrospective analysis was conducted on 19 cases with a total of 22 lesions diagnosed as GA-FG or OGA through histopathology at the Shanghai Sixth People′s Hospital,Shanghai Jiao Tong University School of Medicine from January 2020 to May 2023.Data on the diagnosis,treatment and follow-up among these patients were collected and analyzed.Results:Females were slightly more than males(12:7),with an average age of 54 years.Eighteen patients had single lesions,while one had 4 synchronous multifocal lesions.All the lesions located in the non-atrophic gastric fundic area of the upper and middle third of the stomach.Nine lesions were misdiagnosed as gastric fundic gland polyps initially.The tumors were small,with the average diameter of 7.4 mm.Most of the lesions(77.3%)showed fading or whitening changes under white light endoscopy.While under magnifying endoscopy with narrow-band imaging,obscure demarcation line,and dilated intervening part and crypt-opening could be observed in over half of the lesions,but irregular microvascular pattern was absent.Six lesions exhibited submucosal infiltration(GA-FG)without lymphovascular invasions.Eighteen lesions were diagnosed as chief cell predominant type,one was parietal cell predominant type,and three were mixed type.Endoscopic submucosal dissection and endoscopic mucosal resection were performed in 17 cases.No severe perioperative complications occurred,and no local recurrence and metastasis were detected during follow-up period.Conclusions:GA-FG and OGA mainly occur in the non-atrophic gastric fundic area,with small lesions exhibiting fading changes under endoscopy.The pathological type is primarily chief cell predominant type.This kind of lesion can be easily misdiagnosed as gastric fundic gland polyps.Endoscopic therapy appears to be effective and safe for them with a favorable prognosis.

Objective:To analyze the endoscopic characteristics of early gastric cancer and precancerous lesions after Helicobacter pylori ( H. pylori) eradication. Methods:From May 2019 to June 2022, at Shanghai Sixth People′s Hospital affiliated to Shanghai Jiaotong University School of Medicine, the medical data of patients diagnosed with differentiated early gastric cancer and precancerous lesions were collected. A total of 93 patients with early gastric cancer and precancerous lesions who had previous history of H. pylori infection and had undergone standardized eradication treatment were selected, and their endoscopic characteristics were retrospectively analyzed. Independent sample t-test, chi-square test, and Fisher′s exact test were used for statistical analysis. Results:Among 93 patients with early gastric cancer and precancerous lesions after H. pylori eradication, there were 56 males and 37 females, with an average age of (66.9±8.2) years old. The time after H. pylori eradication was 3.4 years (range 1.0 to 7.0 years). A total of 109 early gastric cancer and precancerous lesions were found, including 79 patients with single lesion and 14 patients with multiple lesions (30 lesions). There were 60 cases with 73 lesions in the early gastric cancer group and 33 cases with 36 lesions in the precancerous group. Among 93 patients, 89 cases (95.7%) were diagnosed with atrophy level above C-2 according to Kimura-Takemoto classification under endoscopy. The long diameter of 109 lesions was (1.38±0.70) cm and the short diameter was (1.04±0.53) cm. A total of 80 lesions (73.4%) were located in the lower 1/3 part of the stomach, and 53 lesions (48.6%) were located in the lesser curvature. A total of 106 lesions (97.2%) were superficial type (0-Ⅱ) under the endoscopy. The long diameter and short diameter in the early gastric cancer group after H. pylori eradication were both greater than those in the precancerous lesion group ((1.54±0.78) cm vs. (1.06±0.35) cm, (1.16±0.58) cm vs. (0.78±0.33) cm), and the differences were statistically significant ( t=3.53 and 3.73, both P<0.001). There was statistically significant difference in the morphological types between early gastric cancer group after H. pylori eradication and precancerous lesion group ( χ2=11.01, P=0.012). The main morphological type of early gastric cancer after H. pylori eradication was superficial depression type (0-Ⅱc), accounting for 45.2% (33/73), while the precancerous lesions were mainly superficial protruded and flat type, both accounting for 38.9% (14/36). Conclusions:After H. pylori eradication, the endoscopic atrophy range of early gastric cancer and precancerous lesions is mostly above C-2. And the lesions are mostly located in the middle and lower 1/3 part of the stomach, long diameter of lesions <20 mm. The main morphological type is superficial type, especially superficial depression type.

Objective:To compare the effect and biotoxicity of tert-butyl acetate (TBA) and ethyl butyrate (EB) on stone dissolution in vitro.Methods:Ten gallstone samples from patients with multiple gallbladder stones were selected and the cholesterol content was analyzed by HPLC. Stone dissolution tests of TBA and EB were performed on cholesterol gallstone in vitro, and the weight of stone at each time point was recorded, meanwhile, methyl tert-butyl ether (MTBE) was used as the control. The inhibitory effects of MTBE, TBA and EB on proliferation of human normal liver cell line LO2 were analyzed by cell proliferation inhibition assay. Flow cytometry was used to analyze the effects of MTBE, TBA and EB on the early and late apoptosis of LO2 cells, and the changes of reactive oxygen species level in LO2 cells were also analyzed.Results:Of the 10 gallbladder gallstones, 6 were cholesterol gallstones and 4 were non-cholesterol gallstones. Stone dissolution experiment showed that the remaining stones of MTBE, TBA and EB groups were (47.83±3.84)%, (58.12±4.53)% and (75.75±4.61)% 30 minutes later. The remaining stones were (18.38±6.47)%, (33.82±6.22)% and (56.38±3.91)% 90 minutes later. MTBE had the best stone dissolution effect in vitro, the stone dissolution effect of TBA was slightly weaker than MTBE, and the stone dissolution effect of EB was relatively weak in all ( P<0.05). The cell proliferation inhibition experiment showed that the cell viability of the control group, MTBE group and TBA group were (100.00±4.46)%, (96.79±4.32)% and (93.72±3.51)%, respectively, and there were no significant differences among the three groups ( P>0.05). However, the cell viability of EB group (87.57±5.29)% was lower than the above three groups, and the differences were statistically significant ( P<0.001). The early apoptosis and late apoptosis of the control group were (1.67±0.15)% and (1.27±0.06)%, respectively. EB induced early apoptosis (15.90±0.53)% ( P<0.001) and late apoptosis (5.13±0.76)% ( P<0.05). However, MTBE and TBA had no significant effect on cell apoptosis ( P>0.05). Compared with control group, MTBE, TBA and EB all significantly inhibited the level of reactive oxygen species ( P<0.05), and the inhibitory effect of EB was the most obvious. Conclusions:TBA has good stone dissolution effect and biosafety for gallbladder cholesterol stones in vitro, while EB has relatively poor performance. TBA is a potential drug for gallstone dissolution.

Objective:To study the effect of diabetes mellitus (DM) on sepsis in patients with pyogenic liver abscess (PLA).Methods:The clinical data of 116 patients with PLA treated in the Affiliated Hospital of Jiangnan University from January 2021 to May 2022 were retrospectively analyzed, including 64 males and 52 females, aged (62.3±12.6) years old. Patients were divided into DM group ( n=56) and non-DM group ( n=60), which were also divided into the sepsis group ( n=29) and the non-sepsis group ( n=87). The clinical features were compared among the groups, the risk factors of PLA complicated with sepsis were analyzed by multivariate logistic regression. Mediation model was used to analyze how DM affects the development of sepsis. Results:Compared with the non-DM group, patients in DM group had higher incidences of hypertension and acute physiology and chronic health evaluation II, a higher proportion of blood neutrophil count, a higher serum levels of triglyceride, urea nitrogen, fasting blood glucose and glycated hemoglobin at admission. The DM group also higher incidences of hypoproteinemia, pleural effusion, and sepsis, with longer hospital stay and higher hospitalization cost (all P<0.05). The levels of hemoglobin, albumin and hematocrit were lower in DM group (all P<0.05). Multivariate logistic regression analysis showed that comorbidity of DM ( OR=3.431, 95% CI: 1.245-9.455) and abscess with a larger diameter ( OR=1.664, 95% CI: 1.258-2.220) were associated with a higher risk of developing sepsis (all P<0.05). Mediation model showed that neutrophil count and triglyceride were the mediating variables of sepsis in patients with PLA. Conclusion:Comorbidity of diabetes is an independent risk factor of developing sepsis in patients with pyogenic liver abscess. Diabetes may induce sepsis by affecting the neutrophils and triglyceride.

Objective:To analyze and compare the features of undifferentiated-typed early gastric cancer (UD-EGC) and gastric mucosa-associated lymphoid tissue(MALT) lymphoma under white light endoscopy (WLE) and magnifying endoscopy-narrow band imaging (ME-NBI).Methods:Data of patients with complete endoscopic images of WLE and ME-NBI in Shanghai General Hospital, Shanghai Jiao Tong University from March 2015 to July 2019 were retrospectively analyzed.Twenty-six UD-EGC patients and seven gastric MALT lymphoma patients in ⅠE1 stage were included, and the characteristics of the two diseases under WLE and ME-NBI were compared and summarized.Results:There were no significant differences in age, sex or infiltration depth of lesions between the two groups.Under WLE, UD-EGC was often manifested as a single lesion located in the lower part of the stomach, with unclear lesion boundaries. While MALT lymphoma lesions were mostly multifocal with clear boundaries, located in the middle of the stomach. Under ME-NBI, the microsurface pattern of UD-EGC showed dilation or disappearance of areas between the recesses, and the spiral microvascular pattern. However, the microsurface pattern of MALT lymphomas were characterized by " cross-road traffic sign" , " pebble sign" , and the presentation of residual glandular duct at the lesion was similar to that of Helicobacter pylori ( HP)-related gastritis. Furthermore, the microvascular pattern of MALT lymphomas often showed " tree like appearance (TLA)" . After HP eradication therapy, the morphology of microsurface pattern and microvascular pattern in the original lesion area gradually returned to normal. Conclusion:UD-EGC and gastric MALT lymphoma showed particular features in the number, site and boundary under WLE, and they showed significantly different microsurface pattern and microvascular pattern under ME-NBI. Differentiation of the two diseases will help reduce the risk of missed diagnosis and misdiagnosis.