Objective:To explore the risk factors for short-term surgery in patients with acute severe ulcerative colitis (ASUC) .Methods:A retrospective case-control study was conducted. Consecutive patients with ASUC admitted to the Department of Gastroenterology at Zhongnan Hospital of Wuhan University from January 2019 to June 2023 were enrolled. Clinical data such as general information, clinical manifestations, laboratory tests, and colonoscopy examinations were analyzed. Based on whether the patients underwent surgery within 90 days after admission, the patients were divided into short-term surgery group and short-term non-surgery group, and the differences in clinical characteristics between the two groups were compared. Univariate and multivariate Logistic regression analyses were performed to identify the risk factors for short-term surgery.Results:A total of 90 patients were included, with 58 males and 32 females, age 42.0 (30.8, 54.3) years, disease duration 1.00 (0.15, 4.25) years, body mass index (21.4 ± 3.8) kg/m 2; according to the ulcerative colitis endoscopic index of severity (UCEIS) results of 83 patients, 31 were moderate activity, and 52 were severe activity. After a follow-up period of 8.4 (3.9, 14.7) months, a total of 15 patients (16.7%) underwent surgery. Ten patients undergoing surgery within 90 days after admission were set as the short-term surgery group ( n = 10), and 5 patients undergoing surgery more than 90 days after admission and 75 receiving drug treatment were set as the short-term non-surgery group ( n = 80). Compared with the short-term non-surgery group, patients in the short-term surgery group were older, and had a higher proportion of UCEIS 7-8 points and lower remission rates induced by glucocorticoids and biological agents, with all differences being statistically significant (all P < 0.05). Univariate and multivariate Logistic regression analyses found that age ≥55 years ( P = 0.009, OR = 13.266, 95% CI: 1.922-91.548) and high baseline CRP ( P = 0.014, OR = 1.010, 95% CI: 1.002-1.019) were independent risk factors for short-term surgery in ASUC patients. Postoperative complications occurred in 4 patients, including 1 of anastomotic ulceration, 1 of ileostomy infection, and 2 of pouchitis. Conclusion:The surgery rate in ASUC patients is high, and patients who are older or have elevated CRP are more likely to undergo short-term surgery.

Inflammatory bowel disease (IBD) is a kind of complex, chronic digestive disease with unclear etiology. This article systematically reviews the evolution of IBD, from early clinical descriptions to advancements in diagnostic techniques and significant developments in treatments, outlining the progression of the IBD diagnosis and treatment framework and highlighting how optimized approaches have impacted patients' quality of life. In the future, emerging technologies such as targeted immune modulation, microbiome intervention, stem cell therapy, and artificial intelligence-assisted diagnosis and treatment are expected to provide new directions and strategies for precise, personalized IBD management.

OBJECTIVES: To investigate the clinical features and prognosis of children with non-Down-syndrome-related acute megakaryoblastic leukemia (non-DS-AMKL). METHODS: A retrospective analysis was conducted on the medical data of 17 children with non-DS-AMKL who were admitted to Children's Hospital of The First Affiliated Hospital of Zhengzhou University from January 2013 to December 2023, and their clinical features, treatment, and prognosis were summarized. RESULTS: Among the 17 children with non-DS-AMKL, there were 8 boys and 9 girls. Fourteen patients had an onset age of less than 36 months, with a median age of 21 months (range:13-145 months). Immunophenotyping results showed that 16 children were positive for CD61 and 13 were positive for CD41. The karyotype analysis was performed on 16 children, with normal karyotype in 6 children and abnormal karyotype in 9 children, among whom 5 had complex karyotype and 1 had no mitotic figure. Detected fusion genes included EVI1, NUP98-KDM5A, KDM5A-MIS18BP1, C22orf34-BRD1, WT1, and MLL-AF9. Genetic alterations included TET2, D7S486 deletion (suggesting 7q-), CSF1R deletion, and PIM1. All 17 children received chemotherapy, among whom 16 (94%) achieved complete remission after one course of induction therapy, and 1 child underwent hematopoietic stem cell transplantation (HSCT) and remained alive and disease-free. Of all children, 7 experienced recurrence, among whom 1 child received HSCT and died of graft-versus-host disease. At the last follow-up, six patients remained alive and disease-free. CONCLUSIONS Non-DS-AMKL primarily occurs in children between 1 and 3 years of age. The patients with this disorder have a high incidence rate of chromosomal abnormalities, with complex karyotypes in most patients. Some patients harbor fusion genes or gene mutations. Although the initial remission rate is high, the long-term survival rate remains low.
Humans ; Male ; Female ; Leukemia, Megakaryoblastic, Acute/etiology* ; Child, Preschool ; Infant ; Child ; Retrospective Studies ; Prognosis ; Down Syndrome/complications*

Objective:To explore the risk factors for short-term surgery in patients with acute severe ulcerative colitis (ASUC) .Methods:A retrospective case-control study was conducted. Consecutive patients with ASUC admitted to the Department of Gastroenterology at Zhongnan Hospital of Wuhan University from January 2019 to June 2023 were enrolled. Clinical data such as general information, clinical manifestations, laboratory tests, and colonoscopy examinations were analyzed. Based on whether the patients underwent surgery within 90 days after admission, the patients were divided into short-term surgery group and short-term non-surgery group, and the differences in clinical characteristics between the two groups were compared. Univariate and multivariate Logistic regression analyses were performed to identify the risk factors for short-term surgery.Results:A total of 90 patients were included, with 58 males and 32 females, age 42.0 (30.8, 54.3) years, disease duration 1.00 (0.15, 4.25) years, body mass index (21.4 ± 3.8) kg/m 2; according to the ulcerative colitis endoscopic index of severity (UCEIS) results of 83 patients, 31 were moderate activity, and 52 were severe activity. After a follow-up period of 8.4 (3.9, 14.7) months, a total of 15 patients (16.7%) underwent surgery. Ten patients undergoing surgery within 90 days after admission were set as the short-term surgery group ( n = 10), and 5 patients undergoing surgery more than 90 days after admission and 75 receiving drug treatment were set as the short-term non-surgery group ( n = 80). Compared with the short-term non-surgery group, patients in the short-term surgery group were older, and had a higher proportion of UCEIS 7-8 points and lower remission rates induced by glucocorticoids and biological agents, with all differences being statistically significant (all P < 0.05). Univariate and multivariate Logistic regression analyses found that age ≥55 years ( P = 0.009, OR = 13.266, 95% CI: 1.922-91.548) and high baseline CRP ( P = 0.014, OR = 1.010, 95% CI: 1.002-1.019) were independent risk factors for short-term surgery in ASUC patients. Postoperative complications occurred in 4 patients, including 1 of anastomotic ulceration, 1 of ileostomy infection, and 2 of pouchitis. Conclusion:The surgery rate in ASUC patients is high, and patients who are older or have elevated CRP are more likely to undergo short-term surgery.

Inflammatory bowel disease (IBD) is a kind of complex, chronic digestive disease with unclear etiology. This article systematically reviews the evolution of IBD, from early clinical descriptions to advancements in diagnostic techniques and significant developments in treatments, outlining the progression of the IBD diagnosis and treatment framework and highlighting how optimized approaches have impacted patients' quality of life. In the future, emerging technologies such as targeted immune modulation, microbiome intervention, stem cell therapy, and artificial intelligence-assisted diagnosis and treatment are expected to provide new directions and strategies for precise, personalized IBD management.

Objective To investigate the clinical features and prognosis of childhood acute lymphoblastic leukemia (ALL) with CREBBP gene mutation. Methods A retrospective analysis was performed for the clinical data of 14 ALL children with CREBBP gene mutation who were admitted to Children's Hospital of the First Affiliated Hospital of Zhengzhou University from January 2016 to December 2023. Results The ALL patients with CREBBP gene mutation accounted for 1.5％ (14/963) among all children diagnosed with ALL during the same period of time,among whom there were 4 boys (29％) and 10 girls (71％),with a median age of 4 years and 3.5 months. All children had an immunological type of B-cell ALL and concurrent mutations in other genes including NRAS,KRAS,ETV6,FLT3,PAX5,SH2B3,CDKN2A,and CDKN2B,and 4 children had karyotype abnormality. All 14 children received induction therapy with the VDLP regimen,with a complete remission (CR) rate of 79％ (11/14) after the first course of treatment. Three children experienced bone marrow recurrence alone,with a recurrence rate of 21％ (3/14),among whom 1 child achieved CR after blinatumomab therapy and 2 received bridging hematopoietic stem cell transplantation after chemotherapy for recurrence. Among the 14 children,1 died due to treatment discontinuation and 13 achieved disease-free survival. The 5-year overall survival rate was 92％±7％,and the event-free survival rate was 73％±13％. Conclusions ALL with CREBBP gene mutation is more common in girls and has a low induction remission rate and a high recurrence rate,and it is often accompanied by other types of gene mutations and abnormal karyotypes. Most children with recurrence can achieve long-term survival after immunotherapy or hematopoietic stem cell transplantation.

Based on mass spectrometry(MS)-guided separation strategy, compound 1 was obtained from the roots of Rhus chinensis. By comprehensive analysis of high resolution-electrospray ionization-mass spectrometry(HR-ESI-MS), nuclear magnetic resonance(NMR) data, and quantum chemical calculation of NMR(qcc-NMR) parameters, compound 1 was elucidated as rhuslactone, a 17-epi-dammarane triterpenoid with a rare 17α-side chain. An HPLC-ELSD method for its quantification in R. chinensis was established and adopted for the quantification of rhuslactone in different batches of R. chinensis. Rhuslactone displayed a good linear relationship within the range of 0.021 3-1.07 μmol·mL~(-1 )(r=0.997 6), and the average recovery was 99.34% [relative standard deviation(RSD) 2.9%). Moreover, the results of the evaluation test of the preventive effects of rhusalctone on coronary heart disease(CHD) and thrombosis showed that rhuslactone(0.11 nmol·mL~(-1)) significantly alleviated heart enlargement and venous congestion and increased cardiac output(CO), blood flow velocity(BFV), and heart rate, thereby reducing thrombus formation in zebrafish with CHD. The effects of rhuslactone on CO and BFV were superior to that of digoxin(1.02 nmol·mL~(-1)), and its effect on improving heart rate was comparable to that of digoxin. This study provides experimental references for the isolation, identification, quality control, and application of rhuslactone from R. chinensis against CHD. It is worth mentioning that this study has discussed some omissions in the determination of the stereochemistry of C-17 in dammarane triterpenoids in the present coursebook Chemistry of Chinese Medicine and some research papers, that is, the compound may be 17-epi-dammarane triterpenoid. This paper has also proposed steps for the establishment of C-17 stereochemistry.
Animals ; Zebrafish ; Rhus/chemistry* ; Triterpenes/analysis* ; Coronary Disease ; Thrombosis

Humans ; Consensus ; Hypersensitivity ; Desensitization, Immunologic/adverse effects* ; Immunotherapy/adverse effects* ; Injections, Subcutaneous ; Allergens

Objectives:To investigate the clinical and genetic features of young Chinese patients with myeloproliferative neoplasms (MPN) .Methods:In this cross-sectional study, anonymous questionnaires were distributed to patients with MPN patients nationwide. The respondents were divided into 3 groups based on their age at diagnosis: young (≤40 years) , middle-aged (41-60 years) , and elderly (>60 years) . We compared the clinical and genetic characteristics of three groups of MPN patients.Results:1727 assessable questionnaires were collected. There were 453 (26.2%) young respondents with MPNs, including 274 with essential thrombocythemia (ET) , 80 with polycythemia vera (PV) , and 99 with myelofibrosis. Among the young group, 178 (39.3%) were male, and the median age was 31 (18-40) years. In comparison to middle-aged and elderly respondents, young respondents with MPN were more likely to present with a higher proportion of unmarried status (all P<0.001) , a higher education level (all P<0.001) , less comorbidity (ies) , fewer medications (all P<0.001) , and low-risk stratification (all P<0.001) . Younger respondents experienced headache (ET, P<0.001; PV, P=0.007; MF, P=0.001) at diagnosis, had splenomegaly at diagnosis (PV, P<0.001) , and survey (ET, P=0.052; PV, P=0.063) . Younger respondents had fewer thrombotic events at diagnosis (ET, P<0.001; PV, P=0.011) and during the survey (ET, P<0.001; PV, P=0.003) . JAK2 mutations were found in fewer young people (ET, P<0.001; PV, P<0.001; MF, P=0.013) ; however, CALR mutations were found in more young people (ET, P<0.001; MF, P=0.015) . Furthermore, mutations in non-driver genes (ET, P=0.042; PV, P=0.043; MF, P=0.004) and high-molecular risk mutations (ET, P=0.024; PV, P=0.023; MF, P=0.001) were found in fewer young respondents. Conclusion:Compared with middle-aged and elderly patients, young patients with MPN had unique clinical and genetic characteristics.

Objective: To observe the effect of lipid regulating therapy on carotid atherosclerotic plaque in diabetic patients. Methods: The REACH study, conducted between March 2009 and February 2012, enrolled asymptomatic patients with magnetic resonance imaging (MRI) confirmed carotid atherosclerotic plaque, who had never taken lipid-lowering drugs. Patients were treated with a moderate dose of rosuvastatin for 24 months. Blood lipid levels were measured and carotid MRI was performed at baseline, 3 and 24 months after treatment. The volume of carotid wall and lipid-rich necrotic core (LRNC) were measured by image analysis software. This study retrospectively analyzed patients in the REACH study. Patients were divided into diabetes group and non-diabetic group. The changes of blood lipid level and MRI parameters of carotid atherosclerotic plaque were compared between the two groups and their correlation was analyzed. Results: A total of 38 patients with carotid atherosclerotic plaque were included in this study, including 13 patients (34.2%) in the diabetic group and 25 patients (65.8%) in the non-diabetic group. Baseline parameters were comparable between the two groups, except higher HbA1c level in diabetes group (P<0.05). Compared with baseline, the total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and triglyceride (TG) levels were significantly decreased at 3 and 24 months in both two groups (P<0.05). The change of high-density lipoprotein cholesterol (HDL-C) in diabetes group was not obvious, while it was significantly increased in non-diabetic group at 24 months ((1.38±0.33) mmol/l vs. (1.26±0.26) mmol/l, P<0.05). MRI results showed that the volume and percentage of LRNC remained unchanged at 3 months, slightly decreased at 24 months (64.86 (45.37, 134.56) mm³ vs. 75.76 (48.20, 115.64) mm³, P>0.05) and (15.84% (11.47%, 24.85%) vs. 16.95% (11.64%, 22.91%), P>0.05) in diabetic group. In non-diabetic group, the volume and percentage of LRNC were significantly decreased at 3 months (63.01 (44.25, 188.64) mm³ vs. 72.49 (51.91, 199.59) mm³, P<0.05) and (13.76% (8.81%, 27.64%) vs. 16.04% (11.18%, 27.05%), P<0.05) respectively. Both parameters further decreased to (55.63 (27.18, 179.40) mm³) and (12.71% (8.39%, 24.41%)) at 24 months (both P<0.05). Wall volume, lumen volume and percent wall volume (PWV) were not affected post therapy in both two groups(P>0.05). There were no correlations between the changes of plaque parameters including volume and percentage of LRNC, wall volume, lumen volume, PWV and the changes of blood lipid parameters (TC, LDL-C, HDL-C and TG) in 3 and 24 months (P>0.05). Conclusion: Lipid-lowering therapy possesses different effects on carotid atherosclerotic plaque in diabetic and non-diabetic patients, and the LRNC improvement is more significant in non-diabetic patients as compared to diabetic patients.
Carotid Arteries/pathology* ; Carotid Artery Diseases/drug therapy* ; Cholesterol, HDL/therapeutic use* ; Cholesterol, LDL ; Diabetes Mellitus ; Humans ; Magnetic Resonance Imaging/methods* ; Necrosis/pathology* ; Plaque, Atherosclerotic/drug therapy* ; Retrospective Studies ; Rosuvastatin Calcium/therapeutic use*