1.Diagnostic value of fecal calprotectin for assessing endoscopic activity in ulcerative colitis: comparison with conventional inflammatory markers
Qianqian XIA ; Ye GUO ; Wei HAN ; Yuzhe ZHOU ; Xiaoyan TANG ; Hong LYU ; Huijun SHU ; Gechong RUAN ; Hong YANG ; Jiaming QIAN
Chinese Journal of Inflammatory Bowel Diseases 2025;09(6):448-455
Objective:To evaluate the diagnostic performance of fecal calprotectin (FC) in predicting endoscopic activity of ulcerative colitis (UC), and to compare it with high-sensitivity C reactive protein (hsCRP) and erythrocyte sedimentation rate (ESR) .Methods:A cross-sectional stydy was conducted. UC patients diagnosed at Peking Union Medical College Hospital between May 2023 and July 2025 were retrospective enrolled. Patients were divided into the endoscopically active group and endoscopic remission group according to endoscopic activity. FC levels were measured using latex-enhanced turbidimetric immunoassay (LETIA). Receiver operating characteristic (ROC) curves and logistic regression models were used to assess diagnostic efficacy. Subgroup analyses were conducted according to disease extent.Results:A total of 166 UC patients were enrolled, including 92 males and 74 females with the age of 40.00 (32.00, 52.00) years old and disease course 5.00 (2.00, 10.75) years. Forty-six patients were assigned to the active group, while the remaining 120 were assigned to the remission group. FC levels were significantly higher in the active group than in the remission group (620.72 μg/g vs. 29.00 μg/g, P < 0.001), with an AUC of 0.894 at a cutoff value of 122.54 μg/g. hsCRP and ESR had lower AUC (0.712 and 0.736, respectively). The combination of FC, hsCRP, and ESR slightly improved specificity (AUC 0.898). FC was strongly correlated with the endoscopic activity ( r =0.669, P < 0.001) but not with disease extent. Conclusions:FC measured by latex-enhanced turbidimetric immunoassay had comparable diagnostic accuracy to ELISA-based methods commonly used abroad, and provided a reference cutoff value of 122.54 μg/g. FC outperforms hsCRP and ESR in assessing intestinal inflammation in UC and it is less affected by disease extent, making it a reliable non-invasive biomarker for UC monitoring.
2.Cross-sectional study of fecal calprotectin in predicting endoscopic activity in patients with Crohn's disease
Yuzhe ZHOU ; Qianqian XIA ; Ye GUO ; Wei HAN ; Xiaoyan TANG ; Hong LYU ; Huijun SHU ; Gechong RUAN ; Hong YANG ; Jiaming QIAN
Chinese Journal of Inflammatory Bowel Diseases 2025;09(6):462-468
Objective:To evaluate the predictive efficacy of fecal calprotectin (FC) for endoscopic activity in patients with Crohn's disease (CD) .Methods:A cross-sectional study was conducted and patients diagnosed as CD at Peking Union Medical College Hospital from June 2023 to September 2025 were enrolled consecutively. Data was collected including general information, laboratory tests [hemoglobin (HGB), platelet (PLT), FC, high-sensitivity C-reactive protein (hsCRP), erythrocyte sedimentation rate (ESR) and so on], and endoscopic results. FC levels were measured by latex-enhanced turbidimetric immunoassay (LETIA). Endoscopic activity was defined as the simplified endoscopic score for Crohn's disease (SES-CD) > 2. Patients were divided into the endoscopically active group and endoscopic remission group according to endoscopic activity, and the differences in clinical data between the two groups were compared. Spearman correlation analysis was used to assess the correlation between FC and endoscopic activity, and receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy of FC, hsCRP and ESR for endoscopic activity, and the differences were compared.Results:A total of 90 CD patients were enrolled, including 65 males and 25 females with the age of 30 (22, 41) years old and disease course 4.0 (0.5, 8.0) years. Seventy-one patients (78.9%) had ileocolonic disease involvement (L3), and 55 patients (61.1%) were using biologics. Sixty-nine patients in endoscopic active phase were assigned to the endoscopically active group, while the remaining 21 were assigned to the endoscopic remission group. There were no statistically significant differences in general characteristics such as age and gender between the two groups (all P > 0.05). Compared with endoscopic remission group, HGB was significantly lower in the endoscopically active group, while PLT, hsCRP, ESR, and FC were moderataly higher (all P < 0.05). Among the 90 CD patients, FC levels were moderatly correlated with endoscopic activity (ρ = 0.494). ROC curve analysis indicated that the area under the curve for FC in predicting endoscopic activity was 0.836 (95% CI: 0.737-0.935), with a sensitivity of 0.725, specificity of 0.952, and accuracy of 0.778 at the optimal FC cutoff value of 153.8 μg/g. FC outperformed hsCRP and ESR. Conclusion:FC measured by LETIA demonstrates certain efficacy in predicting endoscopic activity in CD and will assist in efficient clinical monitoring of CD patients.
3.Diagnostic value of fecal calprotectin for assessing endoscopic activity in ulcerative colitis: comparison with conventional inflammatory markers
Qianqian XIA ; Ye GUO ; Wei HAN ; Yuzhe ZHOU ; Xiaoyan TANG ; Hong LYU ; Huijun SHU ; Gechong RUAN ; Hong YANG ; Jiaming QIAN
Chinese Journal of Inflammatory Bowel Diseases 2025;09(6):448-455
Objective:To evaluate the diagnostic performance of fecal calprotectin (FC) in predicting endoscopic activity of ulcerative colitis (UC), and to compare it with high-sensitivity C reactive protein (hsCRP) and erythrocyte sedimentation rate (ESR) .Methods:A cross-sectional stydy was conducted. UC patients diagnosed at Peking Union Medical College Hospital between May 2023 and July 2025 were retrospective enrolled. Patients were divided into the endoscopically active group and endoscopic remission group according to endoscopic activity. FC levels were measured using latex-enhanced turbidimetric immunoassay (LETIA). Receiver operating characteristic (ROC) curves and logistic regression models were used to assess diagnostic efficacy. Subgroup analyses were conducted according to disease extent.Results:A total of 166 UC patients were enrolled, including 92 males and 74 females with the age of 40.00 (32.00, 52.00) years old and disease course 5.00 (2.00, 10.75) years. Forty-six patients were assigned to the active group, while the remaining 120 were assigned to the remission group. FC levels were significantly higher in the active group than in the remission group (620.72 μg/g vs. 29.00 μg/g, P < 0.001), with an AUC of 0.894 at a cutoff value of 122.54 μg/g. hsCRP and ESR had lower AUC (0.712 and 0.736, respectively). The combination of FC, hsCRP, and ESR slightly improved specificity (AUC 0.898). FC was strongly correlated with the endoscopic activity ( r =0.669, P < 0.001) but not with disease extent. Conclusions:FC measured by latex-enhanced turbidimetric immunoassay had comparable diagnostic accuracy to ELISA-based methods commonly used abroad, and provided a reference cutoff value of 122.54 μg/g. FC outperforms hsCRP and ESR in assessing intestinal inflammation in UC and it is less affected by disease extent, making it a reliable non-invasive biomarker for UC monitoring.
4.Cross-sectional study of fecal calprotectin in predicting endoscopic activity in patients with Crohn's disease
Yuzhe ZHOU ; Qianqian XIA ; Ye GUO ; Wei HAN ; Xiaoyan TANG ; Hong LYU ; Huijun SHU ; Gechong RUAN ; Hong YANG ; Jiaming QIAN
Chinese Journal of Inflammatory Bowel Diseases 2025;09(6):462-468
Objective:To evaluate the predictive efficacy of fecal calprotectin (FC) for endoscopic activity in patients with Crohn's disease (CD) .Methods:A cross-sectional study was conducted and patients diagnosed as CD at Peking Union Medical College Hospital from June 2023 to September 2025 were enrolled consecutively. Data was collected including general information, laboratory tests [hemoglobin (HGB), platelet (PLT), FC, high-sensitivity C-reactive protein (hsCRP), erythrocyte sedimentation rate (ESR) and so on], and endoscopic results. FC levels were measured by latex-enhanced turbidimetric immunoassay (LETIA). Endoscopic activity was defined as the simplified endoscopic score for Crohn's disease (SES-CD) > 2. Patients were divided into the endoscopically active group and endoscopic remission group according to endoscopic activity, and the differences in clinical data between the two groups were compared. Spearman correlation analysis was used to assess the correlation between FC and endoscopic activity, and receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy of FC, hsCRP and ESR for endoscopic activity, and the differences were compared.Results:A total of 90 CD patients were enrolled, including 65 males and 25 females with the age of 30 (22, 41) years old and disease course 4.0 (0.5, 8.0) years. Seventy-one patients (78.9%) had ileocolonic disease involvement (L3), and 55 patients (61.1%) were using biologics. Sixty-nine patients in endoscopic active phase were assigned to the endoscopically active group, while the remaining 21 were assigned to the endoscopic remission group. There were no statistically significant differences in general characteristics such as age and gender between the two groups (all P > 0.05). Compared with endoscopic remission group, HGB was significantly lower in the endoscopically active group, while PLT, hsCRP, ESR, and FC were moderataly higher (all P < 0.05). Among the 90 CD patients, FC levels were moderatly correlated with endoscopic activity (ρ = 0.494). ROC curve analysis indicated that the area under the curve for FC in predicting endoscopic activity was 0.836 (95% CI: 0.737-0.935), with a sensitivity of 0.725, specificity of 0.952, and accuracy of 0.778 at the optimal FC cutoff value of 153.8 μg/g. FC outperformed hsCRP and ESR. Conclusion:FC measured by LETIA demonstrates certain efficacy in predicting endoscopic activity in CD and will assist in efficient clinical monitoring of CD patients.
5.Prediction of clinical risk factors for lymph node metastasis in central group of monofocal papillary thyroid carcinoma
Tong ZHANG ; Min TIAN ; Huijun CAO ; Zhijiang HAN ; Yanyan SHU ; Peiying WEI
Chinese Journal of Endocrine Surgery 2024;18(1):83-87
Objective:To determine the clinical factors affecting Central lymph node metastases (CLNM) of single Papillary thyroid carcinoma (PTC). To predict the value of age for CLNM under different genders and the status of Hashimoto’s thyroiditis (HT) .Methods:The clinical data of 4 115 patients with PTMC (≤10.0 mm) and 664 patients with PTC (> 10.0 mm) in Hangzhou First People’s Hospital affiliated to Westlake University Medical School from Jan. 2010 to Aug. 2023 were retrospectively analyzed, and the independent risk factors of PTMC and PTC CLNM were identified by univariate and multivariate logistic regression analysis. According to different gender and HT status, the patients were divided into male group, female group, HT group and non-HT group. The optimal age threshold and diagnostic efficacy of CLNM in each subgroup were determined by Receiver operating characteristic area under the curve (AUC) .Results:The proportion of CLNM in 3451 PTMCs and 664 PTCs was 27.2% (937/3451) and 58.9% (391/664) ( χ2=256.565, P<0.050), respectively. Univariate and multivariate regression analysis showed that larger tumor ( OR 1.230), male ( OR 2.085), older age ( OR 0.960) and HT ( OR 0.697) were independent predictors of the occurrence of CLNM in PTMC. Only male ( OR 1.460) and older ( OR 0.963) PTC were independently associated with CLNM. Subgroup analysis showed that the age-predicted AUC of CLNM in male, HT and non-HT patients in PTC were higher than that of PTMC, which were 0.642-0.689 and 0.635-0.659, respectively. The age thresholds of female, HT and non-HT subgroups in PTC were lower than those in PTMC, which were 38.5 to 39.5 years old and 41.5 to 42.5 years old, respectively. Conclusions:Larger tumor, male, older patients and HT can independently predict the risk of CLNM in PTMC, while only male and older people can independently predict the risk of CLNM in PTC. There are certain differences in the age of CLNM occurrence between PTMC and PTC patients with different genders and HT combination status. It is of great significance to correctly understand these differences for providing personalized clinical treatment.
6.Mesalamine-associated red-brown urine discoloration: a case report
Kunyu ZHENG ; Yue LI ; Yingzhen GU ; Yaozheng YANG ; Huijun SHU ; Lingyan ZUO
Chinese Journal of Inflammatory Bowel Diseases 2021;05(2):187-188
Mesalamine (5-aminosalicylic acid, 5-ASA) is used for ulcerative colitis, mild Crohn′s disease. The orally taken mesalamine is excreted primarily as N-acetyl-5-aminosalicylic acid (N-acetyl-5-ASA) via urine, renal damage and hematuria are rare. However, red-brown urine discoloration has been noted by some patients, which is associated with the reaction between N-acetyl-5-ASA and remaining hypochlorite in the disinfectant-containing water. This article reports a case of mesalamine-associated red-brown urine discoloration and reviews related literatures.
7.Mesalamine-associated red-brown urine discoloration: a case report
Kunyu ZHENG ; Yue LI ; Yingzhen GU ; Yaozheng YANG ; Huijun SHU ; Lingyan ZUO
Chinese Journal of Inflammatory Bowel Diseases 2021;05(2):187-188
Mesalamine (5-aminosalicylic acid, 5-ASA) is used for ulcerative colitis, mild Crohn′s disease. The orally taken mesalamine is excreted primarily as N-acetyl-5-aminosalicylic acid (N-acetyl-5-ASA) via urine, renal damage and hematuria are rare. However, red-brown urine discoloration has been noted by some patients, which is associated with the reaction between N-acetyl-5-ASA and remaining hypochlorite in the disinfectant-containing water. This article reports a case of mesalamine-associated red-brown urine discoloration and reviews related literatures.
8.Clinical analysis of alcoholic and non-alcoholic Wernicke′s encephalopathy
Xiaoqing LI ; Lili YANG ; Huijun SHU
Chinese Journal of General Practitioners 2020;19(5):419-423
Objective:To review the etiology, clinical manifestations, cranial MRI features and outcome of alcoholic and non-alcoholic Wernicke′s encephalopathy (WE).Methods:The clinical data of 51 WE patients admitted in Peking Union Medical College Hospital from May 1999 to May 2019 were retrospectively analyzed, including 10 cases of alcoholic WE (19.6%) and 41 cases of non-alcoholic WE (80.4%). The clinical manifestations, MRI results, treatment and efficacy of the two groups were compared.Results:The gastrointestinal surgery (17.1%, 7/41) , biliary and pancreatic diseases (14.6%, 6/41) , malignancy (12.2%, 5/41) were the common causes of non-alcoholic WE. Only 39.2% (20/51) of WE patients had typical triad syndrome of mental disorders, ocular symptoms and ataxia. There was no significant difference in the proportion of patients with typical triad syndrome between alcoholic WE and non-alcoholic WE groups [5/10 vs. 36.6% (15/41) , χ 2=0.959, P=0.619]. Mental disorders were more common in non-alcoholic WE [95.1% (39/41) vs. 70.0% χ 2=5.738, P=0.017]. In 45 WE patients undergoing cranial MRI, 53.3% (24/45) had typical symmetry abnormal signals in bilateral thalamus, periaqueductal region and paraventricular region of the third ventricle, in which non-alcoholic WE was more likely to have atypical lesions in comparison with alcoholic WE [66.7% (14/21) vs. 1/3, χ 2=10.578, P=0.001]. Forty-nine patients were treated with vitamin B 1 during hospitalization and symptoms were improved in 91.8% (45/49). The response to vitamin B 1 in non-alcoholic WE was better than that in alcoholic WE [97.4% (38/39) vs. 7/10, χ 2=8.128, P=0.017]. Conclusions:Non-alcoholic Wernicke′s encephalopathy deserves clinical attention. Compared with alcoholic WE, non-alcoholic WE may present mental disorders more frequently, and is more likely to have atypical lesions in cranial MRI, and has better response to vitamin B 1 treatment. Early identification, diagnosis and supplementation of vitamin B 1 can improve the prognosis of WE.
9.Expression of MAGE-A9 in colorectal cancer and its clinical significance
Jianping CHEN ; Qian CHEN ; Xiuying SHI ; Qian GUAN ; Jun KONG ; Shu ZHANG ; Huijun ZHU ; Xudong WANG
Chongqing Medicine 2018;47(9):1200-1203
Objective To observe the expression change of melanoma-associated antigen(MAGE)-A9 in colorectal cancer (CRC)tissue and to explore its significance.Methods The samples in 23 cases of initially diagnosed CRC in the Affiliated Hospital of Nantong University from January 2006 to December 2008 were collected.The quantitative real-time(qRT)-PCR was adopted to detect MAGE-A9 mRNA expression in cancer tissue and corresponding paracancerous tissue.Its correlation with the clinicopatho-logical features and prognosis was analyzed.Results The positive rate of MAGE-A9 in CRC tissue was significantly higher than that in paracancerous normal tissue(P<0.05).MAGE-A9 protein expression in CRC was related to the clinicopathological features such as tumor differentiation degree(P=0.011),TNM stage(P=0.003),tumor infiltration depth(P=0.001)and lymph node me-tastasis(P=0.003).The survival analysis showed that the expression of MAGE-A9 was closely related to the prognosis of CRC pa-tients.Conclusion MAGE-A9 expression is increased in CRC tissue,suggesting the poor prognosis.
10.Clinical characteristics of chronic intestinal pseudo-obstruction : an analysis of 43 cases
Xiaoqing LI ; Huijun SHU ; Guijun FEI ; Xiucai FANG
Chinese Journal of General Practitioners 2017;16(9):672-675
Objective To analyze the clinical characteristics of chronic intestinal pseudoobstruction (CIPO).Methods Clinical data of 43 patients with CIPO admitted in Peking Union Medical College Hospital from January 2012 to December 2016 were retrospectively reviewed.The clinical manifestations,laboratory examinations,images,treatment and prognosis of CIPO patients were analyzed.Results There were 14 males and 29 females with an mean age of (41.9 ± 16.1) years.Among 43 patients,32 were admitted in Gastroenterology Department,6 in General Medicine Department and 5 in Rheumatology Department.Twenty two cases were primary CIPO and 21 cases were secondary.The main clinical manifestations were abdominal distension (93.0%),abdominal pain (67.4%),vomiting (67.4%),diarrhea (46.5%) and constipation (41.9%).All 43 patients had decreased body weight and body mass index (BMI);23.3% (10/43) patients were complicated with anxiety and depression.53.5% (23/43) patients presented anemia and 55.8% (24/43) patients presented hypoalbuminemia.All patients with CIPO underwent abdominal X-ray,which showed intestinal obstruction;but there was no evidence of mechanical obstruction.The average length of hospital stay was (28.4 ± 13.9) d.Twenty three cases underwent gastric decompression;28 cases (65.1%) received parenteral nutrition,and 21 cases (48.8%) received enteral nutrition;and 9 abdominal operations were performed in 8 patients.Conclusion When clinical symptoms of intestinal obstruction appear without mechanical cause,CIPO should be considered and secondary factors should be screened.Unnecessary surgery should be avoided in CIPO patients.

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