Objective:To evaluate the efficacy and safety of vedolizumab (VDZ) monoclonal antibody in maintenance therapy for ulcerative colitis (UC) .Methods:A retrospective case control study was conducted, including 84 patients with active UC undergoing VDZ therapy for an average of (22±8) weeks in the Department of Gastroenterology, the Second Affiliated Hospital of Zhejiang University School of Medicine from December 2020 to September 2023. These patients achieved a response or remission by (22±8) weeks and continued follow-up until (54±8) weeks. They were divided into effective and ineffective groups based on whether they achieved clinical remission by (54±8) weeks after using VDZ; those who required optimized treatment with shortened injection intervals were included in the ineffective group. Baseline clinical data, medication history and endoscopic imaging data were recorded. The clinically modified Mayo score, Mayo endoscopic score, and other assessments were used to evaluate UC disease activity. Adverse reactions related to treatment were also recorded to assess the efficacy of VDZ treatment up to (54±8) weeks was assessed and key factors affecting clinical remission of the disease were analyzed.Results:Among the 84 UC patients with followed up to (54±8) weeks, 47 cases (55.95%) achieved clinical remission and were classified as the effective group, while 37 cases (44.05%) did not achieve clinical remission and were classified as the ineffective group. The endoscopic remission rate in the effective group was 68.09% (32/47), and the mucosal healing rate was 36.17% (17/47). Joint pain occurred in 2.38% of patients, hepatic dysfunction in 3.57%, and one patient died from leukemia following a COVID-19 infection during the maintenance therapy period.Conclusion:VDZ has a certain efficacy in the continuous treatment of UC patients and in maintaining clinical and endoscopic remission, with generally high overall safety and a low incidence of adverse reactions.

Objective:To evaluate the efficacy and safety of vedolizumab (VDZ) monoclonal antibody in maintenance therapy for ulcerative colitis (UC) .Methods:A retrospective case control study was conducted, including 84 patients with active UC undergoing VDZ therapy for an average of (22±8) weeks in the Department of Gastroenterology, the Second Affiliated Hospital of Zhejiang University School of Medicine from December 2020 to September 2023. These patients achieved a response or remission by (22±8) weeks and continued follow-up until (54±8) weeks. They were divided into effective and ineffective groups based on whether they achieved clinical remission by (54±8) weeks after using VDZ; those who required optimized treatment with shortened injection intervals were included in the ineffective group. Baseline clinical data, medication history and endoscopic imaging data were recorded. The clinically modified Mayo score, Mayo endoscopic score, and other assessments were used to evaluate UC disease activity. Adverse reactions related to treatment were also recorded to assess the efficacy of VDZ treatment up to (54±8) weeks was assessed and key factors affecting clinical remission of the disease were analyzed.Results:Among the 84 UC patients with followed up to (54±8) weeks, 47 cases (55.95%) achieved clinical remission and were classified as the effective group, while 37 cases (44.05%) did not achieve clinical remission and were classified as the ineffective group. The endoscopic remission rate in the effective group was 68.09% (32/47), and the mucosal healing rate was 36.17% (17/47). Joint pain occurred in 2.38% of patients, hepatic dysfunction in 3.57%, and one patient died from leukemia following a COVID-19 infection during the maintenance therapy period.Conclusion:VDZ has a certain efficacy in the continuous treatment of UC patients and in maintaining clinical and endoscopic remission, with generally high overall safety and a low incidence of adverse reactions.

Malnutrition is highly prevalent in patients with inflammatory bowel disease, which can be life-threatening when refeeding syndrome occurs. This article reports a patient with Crohn′s disease admitted to the Second Affiliated Hospital of Zhejiang University School of Medicine who developed refeeding syndrome due to long-term malnutrition and complicating lymph node tuberculosis. After the discussion, diagnosis and treatment of multidisciplinary team including Departments of Gastroenterology, Nutrition, Colorectal Surgery and Oncology, and Pathology, the patient was improved significantly.

Malnutrition is highly prevalent in patients with inflammatory bowel disease, which can be life-threatening when refeeding syndrome occurs. This article reports a patient with Crohn′s disease admitted to the Second Affiliated Hospital of Zhejiang University School of Medicine who developed refeeding syndrome due to long-term malnutrition and complicating lymph node tuberculosis. After the discussion, diagnosis and treatment of multidisciplinary team including Departments of Gastroenterology, Nutrition, Colorectal Surgery and Oncology, and Pathology, the patient was improved significantly.

Background::The potential impact of β cell function and insulin sensitivity on adverse pregnancy outcomes in women with gestational diabetes mellitus (GDM) remains uncertain. We aimed to investigate the association between β cell dysfunction, insulin resistance, and the composite adverse pregnancy outcomes.Methods::This observational study included 482 women diagnosed with GDM during pregnancy. Quantitative metrics on β cell function and insulin sensitivity during pregnancy were calculated using traditional equations. The association of β cell dysfunction and insulin resistance with the risk of the composite adverse pregnancy outcomes was investigated using multivariable-adjusted logistic regression models.Results::Multivariable-adjusted odds ratios (ORs) of adverse pregnancy outcomes across quartiles of homeostatic model assessment for insulin resistance (HOMA-IR) were 1.00, 0.95, 1.34, and 2.25, respectively ( P for trend = 0.011). When HOMA-IR was considered as a continuous variable, the multivariable-adjusted OR of adverse pregnancy outcomes was 1.34 (95% confidence interval 1.16-1.56) for each 1-unit increase in HOMA-IR. Multivariable-adjusted ORs of adverse pregnancy outcomes across quartiles of homeostatic model assessment for β cell function (HOMA-β) were 1.00, 0.51, 0.60, and 0.53, respectively ( P for trend = 0.068). When HOMA-β was considered as a continuous variable, the multivariable-adjusted OR of adverse pregnancy outcomes was 0.57 (95% CI 0.24-0.90) for each 1-unit increase in HOMA-β. However, other quantitative metrics were not associated with the composite adverse pregnancy outcomes. Conclusions::We demonstrated a significant association of β cell function and insulin sensitivity with the risk of adverse pregnancy outcomes. We have provided additional evidence on the early identification of adverse pregnancy outcomes besides the glycemic values.

Objective:To investigate the impact of menopause hormone therapy (MHT) on life quality improvement in women aged 40-65 years who suffered from menopausal syndrome.Methods:A retrospective cohort study was performed to analyze the clinical data of patients aged 40-65 years attending the menopause clinic of the Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, between April 2010 and November 2019. The menopause rating scale (MRS) was implemented to evaluate the scale and severity of menopausal syndrome.Results:The total MRS scores were 9.25, 5.25, 4.67 and 4.25 before and 3, 6 and 12 months after menopausal hormone therapy, respectively. Compared with baseline, MRS score decreased significantly after menopausal hormone therapy (all P<0.001). Furthermore, After treatment, the decrease of MRS score in 50-54 years old group was significantly higher than that in 40-44 years old group ( P=0.043). Other characteristics such as marriage, income and body mass index, were not associated with the decrease of MRS score (all P>0.05). Conclusion:MHT can significantly improve menopausal syndrome in women aged 40 to 65 years, and the effect in 50-54 years old group is better than that in 40-44 years old group.

Objective:To evaluate the relationship between menopausal symptoms and everyday cognition in perimenopausal and postmenopausal women.Methods:A cross-sectional study was used to analyze the clinical data of 314 women who first visited the menopausal clinic of Department of Gynecology and Obstetrics of Shanghai Jiao Tong University Affiliated Sixth People's Hospital from October 2018 to October 2020. The modified Kupperman menopausal index (KMI) scale was used to assess the prevalence and severity of menopausal symptoms, and a short version of everyday cognition (ECog) scale was used to evaluate everyday cognition. Multiple linear regression was used to analyze the relationship between menopausal symptoms and everyday cognition in perimenopausal and postmenopausal women.Results:The ECog score of 314 patients was 1.50±0.49. The score of KMI was 12.67±7.88, 74.8% (235/314) of the patients had menopausal symptoms, and 34.7% (109/314) had moderate to severe menopausal symptoms. Compared with asymptomatic patients (ECog scores: 1.27±0.29), symptomatic patients had higher ECog scores (mild symptoms group: 1.48±0.47, P=0.005; moderate to severe symptoms group: 1.69±0.55, P<0.001) . Correlation analysis showed that the five symptoms of KMI (hot flashes/sweating, insomnia, irritability, melancholia and fatigue) were associated with the decline of everyday cognition ( P<0.001). Multiple linear regression analysis showed that the symptoms of hot flashes/sweating [ β=0.060, 95% confidence interval ( CI) =0.002-0.117, P=0.043], melancholia ( β=0.163, 95% CI=0.073-0.253, P<0.001 ) and fatigue ( β=0.138, 95% CI=0.071-0.205, P<0.001) were still associated with the decline of everyday cognition. Conclusion:The symptoms of hot flashes/sweating, melancholia and fatigue are independent risk factors for the decline of everyday cognition in perimenopausal and postmenopausal women.

Objective:To investigate the impact of menopause hormone therapy (MHT) on life quality improvement in women aged 40-65 years who suffered from menopausal syndrome.Methods:A retrospective cohort study was performed to analyze the clinical data of patients aged 40-65 years attending the menopause clinic of the Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, between April 2010 and November 2019. The menopause rating scale (MRS) was implemented to evaluate the scale and severity of menopausal syndrome.Results:The total MRS scores were 9.25, 5.25, 4.67 and 4.25 before and 3, 6 and 12 months after menopausal hormone therapy, respectively. Compared with baseline, MRS score decreased significantly after menopausal hormone therapy (all P<0.001). Furthermore, After treatment, the decrease of MRS score in 50-54 years old group was significantly higher than that in 40-44 years old group ( P=0.043). Other characteristics such as marriage, income and body mass index, were not associated with the decrease of MRS score (all P>0.05). Conclusion:MHT can significantly improve menopausal syndrome in women aged 40 to 65 years, and the effect in 50-54 years old group is better than that in 40-44 years old group.

Objective:To evaluate the relationship between menopausal symptoms and everyday cognition in perimenopausal and postmenopausal women.Methods:A cross-sectional study was used to analyze the clinical data of 314 women who first visited the menopausal clinic of Department of Gynecology and Obstetrics of Shanghai Jiao Tong University Affiliated Sixth People's Hospital from October 2018 to October 2020. The modified Kupperman menopausal index (KMI) scale was used to assess the prevalence and severity of menopausal symptoms, and a short version of everyday cognition (ECog) scale was used to evaluate everyday cognition. Multiple linear regression was used to analyze the relationship between menopausal symptoms and everyday cognition in perimenopausal and postmenopausal women.Results:The ECog score of 314 patients was 1.50±0.49. The score of KMI was 12.67±7.88, 74.8% (235/314) of the patients had menopausal symptoms, and 34.7% (109/314) had moderate to severe menopausal symptoms. Compared with asymptomatic patients (ECog scores: 1.27±0.29), symptomatic patients had higher ECog scores (mild symptoms group: 1.48±0.47, P=0.005; moderate to severe symptoms group: 1.69±0.55, P<0.001) . Correlation analysis showed that the five symptoms of KMI (hot flashes/sweating, insomnia, irritability, melancholia and fatigue) were associated with the decline of everyday cognition ( P<0.001). Multiple linear regression analysis showed that the symptoms of hot flashes/sweating [ β=0.060, 95% confidence interval ( CI) =0.002-0.117, P=0.043], melancholia ( β=0.163, 95% CI=0.073-0.253, P<0.001 ) and fatigue ( β=0.138, 95% CI=0.071-0.205, P<0.001) were still associated with the decline of everyday cognition. Conclusion:The symptoms of hot flashes/sweating, melancholia and fatigue are independent risk factors for the decline of everyday cognition in perimenopausal and postmenopausal women.

Objective To control study the treatment effect of functional dyspepsia of stagnation of liver-qi type treated by liver-coursing depression-resolving decoction added psychological counseling.Methods130 patients with functional dyspepsia of liver-qi stagnation type who were treated in the inpatients and outpatients in our hospital from January 2015 to January 2016 were selected, to randomLy grouping.The 65 cases of the control group was given the conventional therapy, and the another 65 cases of the treatment group was given liver-coursing depression-resolving decoction added psychological counseling at the the same term based on the control.After the continue treatment for 4 weeks, to compared the clinical curative effect of them.ResultsThe treatment effective rate of the treatment group was 94%, he treatment effective rate of the control group was 78%, there was statistical significance (P<0.05).To compared with the grade of traditional Chinese medicine symptom (distending pain in the stomach, satiation, belching, inhibited defecation) and discovered that the grades of them were lower after treatment, and there has the significant improvements that compared with that before the treatment, there was statistical significance (P<0.05), and the treatment group was significantly lower than the control group, there was statistical significance (P<0.05).The Hp Infection and the bile regurgitation of them after treatment was significantly improved, the treatment group was significantly better than the control group, there was statistical significance (P<0.05), the treatment group was significantly better than the control, there was statistical significance (P<0.05).To compared the 71% of the negative conversion ratio of Hp urease detection of the treatment group that was significantly greater than the 40% of the control group after detection, there was statistical significance (P<0.05).The gastric emptying time of them was significant improved after treatment, and compared with that before the treatment, there was statistical significance (P<0.05).For the gastric emptying time, to compared with the control group, the improvement effect of the treatment group was outstanding, there was statistical significance (P<0.05).After treatment, the grade of anxiety and depression was significantly decreased of them, and to compared with the control group after treatment, the grade of anxiety and depression of the treatment group was significantly improved, there was statistical significance (P<0.05).There was no obvious untoward effects of them, there was no statistical significance.ConclusionThat has an exact effect of functional dyspepsia of stagnation of liver-qi type treated by liver-coursing depression-resolving decoction added psychological counseling, to provide an effective way for the clinic treatment of the functional dyspepsia (stagnation of liver-qi type).Meanwhile, to provide the new theoretical foundation for the traditional chinese medicine therapy of functional dyspepsia.