Objective:To investigate the correlation between leucine-rich α2 glycoprotein (LRG) and endoscopic activity in patients with Crohn′s disease (CD), based on the assessment of inflammation in small intestinal lesion by double-balloon enteroscope (DBE).Methods:From 15 August 2022 to 22 August 2023, the clinical data of 139 patients with small bowel CD diagnosed by DBE at the First Affiliated Hospital of Anhui Medical University were prospectively collected, which included fecal calprotectin (FC), C-reactive protein (CRP), white blood cell count, hemoglobin, albumin, Crohn′s disease activity index (CDAI), and simple endoscopic score for Crohn′s disease (SES-CD). According to the SES-CD, endoscopic activity was classified as mucosal healing (0), endoscopic remission (0 to 2), mild activity (3 to 6), moderate activity (7 to 15), and severe activity (≥16). LRG levels were detected in all patients. Spearman rank correlation was used to analyze the correlation between LRG, clinical biochemical parameters and endoscopic scores. Receiver operating characteristic curve (ROC) was performed to determine the optimal cut-off value of LRG for evaluating endoscopic mucosal healing. Mann-Whitney U test, Kruskal-Wallis H test, and Bonferroni corrected test were used for statistical analysis. Results:Among 139 patients with small bowel CD, the LRG level was 17.3 (13.0, 25.2) mg/L, and SES-CD was 5 (1, 9); 32 patients achieved mucosal healing, 50 patients achieved endoscopic remission; 39 patients had mild activity, 40 patients had moderate activity, and 10 patients had severe activity. The SES-CD was negatively correlated with both hemoglobin and albumin ( r=-0.177 (95% confidence interval, 95% CI: -0.334 to -0.011), -0.293 (95% CI: -0.438 to -0.133)), with statistical significance ( P=0.037, <0.001). The SES-CD was positively correlated with CRP, CDAI, LRG and FC ( r=0.344 (95% CI: 0.188 to 0.482), 0.429 (95% CI: 0.282 to 0.556), 0.525 (95% CI: 0.393 to 0.636), 0.661 (95% CI: 0.556 to 0.745)), with statistical significant (all P<0.001). For the 64 small bowel CD patients with CRP in the normal reference value, SES-CD was positively correlated with CDAI, LRG and FC ( r=0.296 (95% CI: 0.054 to 0.505), 0.364 (95% CI: 0.129 to 0.559), 0.547 (95% CI: 0.348 to 0.699)), with statistical significance ( P=0.017, =0.003, <0.001). The LRG level of patients with endoscopic mucosal healing was significantly lower than that of patients with endoscopic remission (11.5 (10.1, 17.2) mg/L vs. 17.3 (13.4, 23.5) mg/L), with statistical significance ( Z=-3.25, P<0.001). ROC analysis showed that the area under the curve (AUC) of LRG in predicting endoscopic mucosal healing was 0.81 (95% CI: 0.73 to 0.89), with an optimal cut-off value of 15.27 mg/L. The sensitivity, specificity, positive predictive value and negative predictive value were 0.757, 0.718, 0.900 and 0.469, respectively. The accuracy of the combination of LRG and FC (AUC was 0.88, 95% CI: 0.82 to 0.94) in predicting endoscopic mucosal healing was higher than that of LRG alone (AUC was 0.81, 95% CI: 0.73 to 0.89), and the difference was statistically significant ( P=0.011). Conclusion:Based on the results of DBE, LRG may be a reliable biomarker for predicting endoscopic remission and mucosal healing in patients with small bowel CD.

Objective:To investigate the correlation between leucine-rich α2 glycoprotein (LRG) and endoscopic activity in patients with Crohn′s disease (CD), based on the assessment of inflammation in small intestinal lesion by double-balloon enteroscope (DBE).Methods:From 15 August 2022 to 22 August 2023, the clinical data of 139 patients with small bowel CD diagnosed by DBE at the First Affiliated Hospital of Anhui Medical University were prospectively collected, which included fecal calprotectin (FC), C-reactive protein (CRP), white blood cell count, hemoglobin, albumin, Crohn′s disease activity index (CDAI), and simple endoscopic score for Crohn′s disease (SES-CD). According to the SES-CD, endoscopic activity was classified as mucosal healing (0), endoscopic remission (0 to 2), mild activity (3 to 6), moderate activity (7 to 15), and severe activity (≥16). LRG levels were detected in all patients. Spearman rank correlation was used to analyze the correlation between LRG, clinical biochemical parameters and endoscopic scores. Receiver operating characteristic curve (ROC) was performed to determine the optimal cut-off value of LRG for evaluating endoscopic mucosal healing. Mann-Whitney U test, Kruskal-Wallis H test, and Bonferroni corrected test were used for statistical analysis. Results:Among 139 patients with small bowel CD, the LRG level was 17.3 (13.0, 25.2) mg/L, and SES-CD was 5 (1, 9); 32 patients achieved mucosal healing, 50 patients achieved endoscopic remission; 39 patients had mild activity, 40 patients had moderate activity, and 10 patients had severe activity. The SES-CD was negatively correlated with both hemoglobin and albumin ( r=-0.177 (95% confidence interval, 95% CI: -0.334 to -0.011), -0.293 (95% CI: -0.438 to -0.133)), with statistical significance ( P=0.037, <0.001). The SES-CD was positively correlated with CRP, CDAI, LRG and FC ( r=0.344 (95% CI: 0.188 to 0.482), 0.429 (95% CI: 0.282 to 0.556), 0.525 (95% CI: 0.393 to 0.636), 0.661 (95% CI: 0.556 to 0.745)), with statistical significant (all P<0.001). For the 64 small bowel CD patients with CRP in the normal reference value, SES-CD was positively correlated with CDAI, LRG and FC ( r=0.296 (95% CI: 0.054 to 0.505), 0.364 (95% CI: 0.129 to 0.559), 0.547 (95% CI: 0.348 to 0.699)), with statistical significance ( P=0.017, =0.003, <0.001). The LRG level of patients with endoscopic mucosal healing was significantly lower than that of patients with endoscopic remission (11.5 (10.1, 17.2) mg/L vs. 17.3 (13.4, 23.5) mg/L), with statistical significance ( Z=-3.25, P<0.001). ROC analysis showed that the area under the curve (AUC) of LRG in predicting endoscopic mucosal healing was 0.81 (95% CI: 0.73 to 0.89), with an optimal cut-off value of 15.27 mg/L. The sensitivity, specificity, positive predictive value and negative predictive value were 0.757, 0.718, 0.900 and 0.469, respectively. The accuracy of the combination of LRG and FC (AUC was 0.88, 95% CI: 0.82 to 0.94) in predicting endoscopic mucosal healing was higher than that of LRG alone (AUC was 0.81, 95% CI: 0.73 to 0.89), and the difference was statistically significant ( P=0.011). Conclusion:Based on the results of DBE, LRG may be a reliable biomarker for predicting endoscopic remission and mucosal healing in patients with small bowel CD.

Objective:To explore the expression level and clinical significance of low-density granulocytes (LDGs) in peripheral blood of patients with inflammatory bowel disease (IBD) .Methods:A cross-sectional survey was conducted. Clinical data of IBD patients admitted to the Department of Gastroenterology, the First Affiliated Hospital of Anhui Medical University from August 2022 to January 2023 were collected. A total of 45 healthy people were enrolled as the normal control group. Simple endoscopic score for Crohn′s disease (SES-CD) was used to evaluate the activity of Crohn′s disease (CD) and Mayo endoscopic score (MES) was used to evaluate the activity of ulcerative colitis (UC). Laboratory indicators included LDGs, white blood cell count (WBC), hemoglobin (HB), platelet count (PLT), C-reactive protein (CRP), neutrophil to lymphocyte ratio (NLR), and fecal calprotectin (FC). The difference in LDGs level between IBD patients and the normal control group was statistically analyzed and the relationship between LDGs level and clinical characteristics of IBD patients was analyzed. Receiver operating characteristic (ROC) curve was used to calculate the predictive value of LDGs for the disease activity of IBD.Results:A total of 130 IBD patients were included, including 83 CD patients and 47 UC. Compared with the normal control group, the LDGs levels of patients in the CD group and UC group were respectively higher[CD: 0.53% (0.32%, 1.41%) vs. 0.19% (0.12%, 0.29%), H= 57.71, P<0.001; UC: 0.87% (0.43%, 1.90%) vs. 0.19% (0.12%, 0.29%), H= 73.23, P<0.001]. Compared with the CD patients in remission phase, the level of LDGs in active CD patients was higher ( P<0.001). Compared with the CD patients in mild activity phase, the LDGs levels of CD patients in moderate and severe activity phases were higher (all P<0.05). In terms of different disease behaviours, the level of LDGs in stricturing CD patients was the highest [1.37% (0.91%, 3.06%), all P<0.05]. Compared with the UC patients in remission phase, the level of LDGs in active UC patients was higher ( P<0.001). Compared with the UC patients in mild activity phase, the LDGs levels of UC patients in moderate and severe activity phases were higher (all P<0.05). In the CD group, LDGs level was positively correlated with CRP, FC, NLR, PLT, simple Crohn′s disease activity index (CDAI), and SES-CD ( r= 0.374, 0.548, 0.345, 0.284, 0.764, 0.721, all P<0.05). In the UC group, LDG levels was positively correlated with CRP, FC, NLR, Sutherland disease activity index (DAI), and MES ( r= 0.325, 0.666, 0.474, 0.638, 0.740, all P<0.05). In CD patients, the cut-off value of LDGs was 0.565%, with the area under curve (AUC) of 0.873, sensitivity of 73.50%, and specificity of 99.30%. In UC patients, the cut-off value of LDGs was 0.545%, with the AUC of 0.877, sensitivity of 76.90%, and specificity of 100.00%. Conclusion:The expression of LDGs in IBD patients is significantly high, which correlates with the disease activity and may be used as a biological marker for the clinical evaluation of IBD patients.

Objective:To explore the expression level and clinical significance of low-density granulocytes (LDGs) in peripheral blood of patients with inflammatory bowel disease (IBD) .Methods:A cross-sectional survey was conducted. Clinical data of IBD patients admitted to the Department of Gastroenterology, the First Affiliated Hospital of Anhui Medical University from August 2022 to January 2023 were collected. A total of 45 healthy people were enrolled as the normal control group. Simple endoscopic score for Crohn′s disease (SES-CD) was used to evaluate the activity of Crohn′s disease (CD) and Mayo endoscopic score (MES) was used to evaluate the activity of ulcerative colitis (UC). Laboratory indicators included LDGs, white blood cell count (WBC), hemoglobin (HB), platelet count (PLT), C-reactive protein (CRP), neutrophil to lymphocyte ratio (NLR), and fecal calprotectin (FC). The difference in LDGs level between IBD patients and the normal control group was statistically analyzed and the relationship between LDGs level and clinical characteristics of IBD patients was analyzed. Receiver operating characteristic (ROC) curve was used to calculate the predictive value of LDGs for the disease activity of IBD.Results:A total of 130 IBD patients were included, including 83 CD patients and 47 UC. Compared with the normal control group, the LDGs levels of patients in the CD group and UC group were respectively higher[CD: 0.53% (0.32%, 1.41%) vs. 0.19% (0.12%, 0.29%), H= 57.71, P<0.001; UC: 0.87% (0.43%, 1.90%) vs. 0.19% (0.12%, 0.29%), H= 73.23, P<0.001]. Compared with the CD patients in remission phase, the level of LDGs in active CD patients was higher ( P<0.001). Compared with the CD patients in mild activity phase, the LDGs levels of CD patients in moderate and severe activity phases were higher (all P<0.05). In terms of different disease behaviours, the level of LDGs in stricturing CD patients was the highest [1.37% (0.91%, 3.06%), all P<0.05]. Compared with the UC patients in remission phase, the level of LDGs in active UC patients was higher ( P<0.001). Compared with the UC patients in mild activity phase, the LDGs levels of UC patients in moderate and severe activity phases were higher (all P<0.05). In the CD group, LDGs level was positively correlated with CRP, FC, NLR, PLT, simple Crohn′s disease activity index (CDAI), and SES-CD ( r= 0.374, 0.548, 0.345, 0.284, 0.764, 0.721, all P<0.05). In the UC group, LDG levels was positively correlated with CRP, FC, NLR, Sutherland disease activity index (DAI), and MES ( r= 0.325, 0.666, 0.474, 0.638, 0.740, all P<0.05). In CD patients, the cut-off value of LDGs was 0.565%, with the area under curve (AUC) of 0.873, sensitivity of 73.50%, and specificity of 99.30%. In UC patients, the cut-off value of LDGs was 0.545%, with the AUC of 0.877, sensitivity of 76.90%, and specificity of 100.00%. Conclusion:The expression of LDGs in IBD patients is significantly high, which correlates with the disease activity and may be used as a biological marker for the clinical evaluation of IBD patients.

Objective : To investigate the effect of platelet particles on the extent of intestinal inflammation and in⁃ testinal mucosal permeability in mice with dextran sodium sulfate induced colitis. Methods : The experiment was divided into four groups : normal control group ( n = 10 , drinking sterile distilled water + intraperitoneal injection of 0. 9% sodium chloride solution) , PMPs group ( n = 10 , drinking sterile distilled water + intraperitoneal injection of PMPs) , DSS model group ( n = 10 , drinking DSS solution + intraperitoneal injection of 0. 9% sodium chloride solution) , and experimental group ( n = 15 , drinking DSS solution + intraperitoneal injection of PMPs) . Peripheral blood⁃derived PMPs suspension was collected from inflammatory bowel disease ( IBD) patients. A colitis model was constructed in mice by allowing them to freely drink a 5% DSS solution for 1 week , followed by continuous intraperitoneal injection of PMPs for 7 days. Disease activity index (DAI) scores was recorded daily and the severity of intestinal inflammation with histopathological scores (HI) was assessed by HE staining of colon samples at the end of the experiment. Myeloperoxidase (MPO) , neutrophil elastase (NE) , citrullinated histone H3 (citH3) , and free DNA levels were measured in colon homogenate , observe intestinal mucosal structure by transmission electron microscopy , and intestinal permeability was tested using fluorescein isothiocyanate⁃dextran (FITC⁃D) . Results: Compared with the normal control group , the colonic mucosa of mice in the PMPs group showed edema , severe destruction of epithelial structure , extensive aggregation of inflammatory cells , and increased overall HI score (P < 0. 01) ; the levels of inflammatory factors such as IL⁃1β and TNF⁃α in colonic tissue homogenates of mice in the PMPs group increased (P < 0. 05) , and the expression of NETs increased (P < 0. 05) ; the plasma FITC⁃D level of mice in the PMPs group significantly increased (P < 0. 05) , and the permeability of intestinal mucosa increased. Compared with the DSS group , the experimental group mice had higher plasma FITC⁃D levels ( P < 0. 05 ) and more electron microscopic colonic epithelial damage. Conclusion PMPs induces NETs formation in mice , promotes colonic inflammation in mice , increases intestinal mucosal permeability and aggravates intestinal inflammation in mice with DSS colitis.

Objective:To investigate the clinical effect of early bronchoalveolar lavage on patients with aspiration pneumonia.Methods:A retrospective study was conducted on 55 patients with aspiration pneumonia who met inclusion criteria but not exclusion criteria in the Intensive Care Department of our hospital from January 2020 to April 2021. The patients were divided into the control group (32 cases) and the bronchoscopic lavage group (23 cases) according to whether they received bronchoscopic lavage within 24 h after aspiration. Basic information (sex, age, body mass index, chest X-ray score, oxidation index, temperature, heart rate, respiratory rate, white blood cells, PCT, IL-6, CPR and APACHE Ⅱ score), etiology changes at the early stage (≤ 3 d) and later stage (4-7 d after admission), and changes in prognostic indexes (mechanical ventilation time, length of ICU stay, length of stay and mortality) were compared between the two groups. The clinical efficacy of early endoscopy lavage for aspiration pneumonia was evaluated.Results:The positive rate of early etiological culture was 85.2%, the bacterial positive rate was 72.9% and the fungal positive rate was 14.6%. Pseudomonas aeruginosa accounted for 20.8%, Klebsiella pneumoniae accounted for 14.6%, Staphylococcus aureus and Streptococcus accounted for 12.5%, and there was no significant difference in the distribution between the bronchoscopic lavage group and the control group (all P>0.05). The positive rate of late etiological culture was 88.6%, the bacterial positive rate was 85.7% and the fungal positive rate was 2.9%. The positive rate of late bacterial culture was significantly decreased in the bronchoscopic lavage group ( P < 0.05), and the other results were not significantly different from the control group (all P>0.05). After early bronchoscopic lavage, the duration of mechanical ventilation, length of ICU stay and length of stay were significantly shortened, and the fifth day CPIS score was significantly decreased (all P< 0.05). Conclusions:Early endotracheal lavage can reduce mechanical ventilation time, length of ICU stay and length of stay of aspiration pneumonia, and reduce the positive rate of bacterial culture in the lung at the later stage, which needs to be further verified by a large randomized controlled study.

Objective:To explore the clinical strategies to improve the clinical outcomes of patients with thin endometrium.Methods:A retrospective cohort study was conducted to analyze 1924 frozen-thawed embryo transfer (FET) cycles of 2452 patients with thin endometrium at the Reproductive Medicine Center of Henan Provincial People's Hospital from January 2013 to December 2019. According to the type of embryos transferred, they were divided into the embryo group at cleavage stage (cleavage embryo group) and embryo group at blastocyst stage (blastocyst group). Univariate analysis, multivariate regression analysis, curve fitting and threshold effect analysis were used to compare the clinical outcomes of the cycles transferring cleavage stage embryo and blastocyst.Results:The percentage of cycles with two embryos transferred [87.17% (1298/1489)], the rate of ectopic pregnancy [3.35% (16/477)] and the rate of multiple births [23.32% (73/313)] in cleavage embryo transfer cycle were higher than those of blastocyst transfer cycle [40.71% (392/963), P<0.001; 0.76% (4/524), P=0.003; 16.27% (55/338), P=0.024]. The clinical pregnancy rate [54.41% (524/963)] and the live birth rate [35.10% (338/963)] in blastocyst transfer cycle were significantly higher than those of cleavage embryo transfer cycle [32.03% (477/1489), P<0.001; 21.02% (313/1489), P<0.001]. After adjusting for confounders, the clinical pregnancy rate ( OR=3.42, 95% CI=2.71-4.31, P<0.001) and the live birth rate ( OR=2.35, 95% CI=1.84-3.00, P<0.001) of blastocyst transfer cycle were higher than those of cleavage stage embryo transfer cycle. The results of stratified analysis showed that the clinical pregnancy rate (<6 mm: OR=2.94, 95% CI=1.32-6.51, P=0.008; 6-7 mm: OR=3.41; 95% CI=2.13-5.45, P<0.001; >7 mm: OR=3.56, 95% CI=2.67-4.74, P<0.001) and the live birth rate (<6 mm: OR=2.50, 95% CI=1.01-6.22, P=0.049; 6-7 mm: OR=2.56, 95% CI=1.56-4.21, P<0.001; >7 mm: OR=2.30, 95% CI=1.71-3.10, P<0.001) of blastocyst transfer cycle in different endometrial thickness stratifications were higher than those of cleavage stage embryo transfer cycle. The results of stratified curve fitting analysis showed that with increasing endometrial thickness among patients with thin endometrium, the clinical pregnancy rate and the live birth rate of both cleavage stage embryo cycle and blastocyst transfer cycle increased, and in all of the different endometrial thickness stratifications, the clinical pregnancy rate and the live birth rate in blastocyst transfer cycle were higher than those of cleavage embryo transfer cycle. Compared with the blastocyst transfer cycle, the slope of curve fitting between endometrial thickness and clinical pregnancy rate was larger in cleavage embryo transfer cycle. Conclusion:The clinical pregnancy rate and the live birth rate of the blastocyst transfer cycle in FET were higher than those of cleavage stage embryo transfer cycle. The increasement of endometrial thickness on the first day of progesterone administration can improve the clinical pregnancy rate and the live birth rate in patients with thin endometrium.

Objective:To explore the clinical strategies to improve the clinical outcomes of patients with thin endometrium.Methods:A retrospective cohort study was conducted to analyze 1924 frozen-thawed embryo transfer (FET) cycles of 2452 patients with thin endometrium at the Reproductive Medicine Center of Henan Provincial People's Hospital from January 2013 to December 2019. According to the type of embryos transferred, they were divided into the embryo group at cleavage stage (cleavage embryo group) and embryo group at blastocyst stage (blastocyst group). Univariate analysis, multivariate regression analysis, curve fitting and threshold effect analysis were used to compare the clinical outcomes of the cycles transferring cleavage stage embryo and blastocyst.Results:The percentage of cycles with two embryos transferred [87.17% (1298/1489)], the rate of ectopic pregnancy [3.35% (16/477)] and the rate of multiple births [23.32% (73/313)] in cleavage embryo transfer cycle were higher than those of blastocyst transfer cycle [40.71% (392/963), P<0.001; 0.76% (4/524), P=0.003; 16.27% (55/338), P=0.024]. The clinical pregnancy rate [54.41% (524/963)] and the live birth rate [35.10% (338/963)] in blastocyst transfer cycle were significantly higher than those of cleavage embryo transfer cycle [32.03% (477/1489), P<0.001; 21.02% (313/1489), P<0.001]. After adjusting for confounders, the clinical pregnancy rate ( OR=3.42, 95% CI=2.71-4.31, P<0.001) and the live birth rate ( OR=2.35, 95% CI=1.84-3.00, P<0.001) of blastocyst transfer cycle were higher than those of cleavage stage embryo transfer cycle. The results of stratified analysis showed that the clinical pregnancy rate (<6 mm: OR=2.94, 95% CI=1.32-6.51, P=0.008; 6-7 mm: OR=3.41; 95% CI=2.13-5.45, P<0.001; >7 mm: OR=3.56, 95% CI=2.67-4.74, P<0.001) and the live birth rate (<6 mm: OR=2.50, 95% CI=1.01-6.22, P=0.049; 6-7 mm: OR=2.56, 95% CI=1.56-4.21, P<0.001; >7 mm: OR=2.30, 95% CI=1.71-3.10, P<0.001) of blastocyst transfer cycle in different endometrial thickness stratifications were higher than those of cleavage stage embryo transfer cycle. The results of stratified curve fitting analysis showed that with increasing endometrial thickness among patients with thin endometrium, the clinical pregnancy rate and the live birth rate of both cleavage stage embryo cycle and blastocyst transfer cycle increased, and in all of the different endometrial thickness stratifications, the clinical pregnancy rate and the live birth rate in blastocyst transfer cycle were higher than those of cleavage embryo transfer cycle. Compared with the blastocyst transfer cycle, the slope of curve fitting between endometrial thickness and clinical pregnancy rate was larger in cleavage embryo transfer cycle. Conclusion:The clinical pregnancy rate and the live birth rate of the blastocyst transfer cycle in FET were higher than those of cleavage stage embryo transfer cycle. The increasement of endometrial thickness on the first day of progesterone administration can improve the clinical pregnancy rate and the live birth rate in patients with thin endometrium.

Objective:To investigate the expression of Piezo1 in small intestinal mucosal epithelial cells of patients with Crohn′s disease (CD) and its clinical correlation with CD.Methods:From January 1st 2010 to November 30th 2020, the clinical data including age, gender, disease location and biological behavior, etc of 57 patients with CD (CD group) who underwent surgery at The First Affiliated Hospital of Anhui Medical University were retrospectively. And at same time the normal samll intestinal epithelial tissues of 10 healthy individuals who underwent colonoscopy were collected as the healthy control group. The expression of Piezo1 in small intestinal epithelial cells of CD patients with different disease sites, biological behavior and disease activity were detected by immunofluorescence staining and hematoxylin-eosin staining. The histological score system and intestinal fibrosis score were used to analyze the inflammation and fibrosis of the intestinal tissues of patients with CD. Semi-quantitative analysis of Piezo1 in small intestinal epithelial cells was analyzed by ImageJ software. And the correlation between Piezo1 expression and clinical characteristics and pathological features of small intestine was also analyzed. Independent sample t test and analysis of variance were used for statistical analysis. Results:In CD group, there were 37 males (64.9%) and 20 females (35.1%). The age was (39.1±14.2) years old, ranged from 18 to 71 years old, and the average duration of the disease was (26.5±24.1) months. There were 29 cases (50.9%)of ileal type, 26 cases (45.6%) of ileocolonin type and 2 cases (3.5%) of colonic type. There were 12 cases (21.1%) of non-penetrating non-stenotic type, 31 cases (54.4%) of stenotic type and 14 cases (24.6%) of penetrating type. There were 47 cases (82.5%) with moderate activity and 10 cases (17.5%) with severe activity. There were 17 cases (29.8%) of moderate intestinal inflammation, 40 cases (70.2%) of severe intestinal inflammation. The score of intestinal fibrosis in six cases (10.5%) was 1, 28 cases (49.1%) was 2, 18 cases (31.6%) was 3, five cases was 4. The relative expression level of Piezo1 in intestinal mucosal epithelial cells of CD group was higher than that of healthy control group (12.9±4.6 vs. 8.5±1.1), the relative expression of Piezo1 in intestinal mucosal epithelia cells of stenotic type and penetrating type CD patients were both higher than that of non-penetrating and non-stenotic CD patients (12.6±3.8 and 9.8±2.4 vs. 6.0±1.3), and the differences were all statistically significant ( t=3.00, -3.66 and -3.32, all P<0.01). The relative expression of Piezo1 in small intestinal epithelial cells of CD patients with severe intestinal inflammation was higher than that of CD patients with moderate intestinal inflammation (13.1±4.0 vs. 9.7±3.1), and the difference was statistically significant ( t=-2.65, P<0.05). The relative expression levels of Piezo1 in small intestinal epithelial cells of patients with intestinal fibrosis score of 4, 3, 2 and 1 were 17.6±5.2, 12.6±1.7, 9.1±2.1 and 5.8±1.1, respectively; the relative expression levels of Piezo1 in intestinal epithelial cells of patients scored 4 were higher than that of patients scored 3, 2 and 1, and that of patients scored 3 was higher than patients scored 2 and 1, and that of patients scored 2 was higher than that of patients scored 1, and the differences were all statistically significant ( t=-2.98, -5.10, -3.84, 4.60, 6.55 and 2.56, all P<0.05). The relative expression of Piezo1 in intestinal mucosal epithelial cells was related to the severity of intestinal inflammation and fibrosis. The more severe the intestinal inflammation and fibrosis, the higher the relative expression of Piezo1 in intestinal mucosal epithelial cells. Conclusions:The relative expression of Piezo1 in small intestinal epithelial cells is related to the biological behavior and the severity of intestinal inflammation and fibrosis of CD. It is speculated that the expression of Piezo1 in small intestinal epithelial cells may be clinically related to the process of intestinal wall fibrosis in CD to some extent, however whether it plays an important role in the process of intestinal wall fibrosis in CD and its specific mechanism need to be further studied.

A 61-year-old man developed nausea, vomiting, unconsciousness, and limb convulsions after 1 hour of mistaken ingestion of European waterhemlock ( Radix Archangeliae Decurrentis). Laboratory tests showed white blood cell count (WBC) 21.5×10 9/L, alanine aminotransferase (ALT) 246 U/L, total bilirubin (TBil) 35.3 μmol/L, creatine kinase MB (CK-MB) 20.8 μg/L, lactate dehydrogenase (LDH) 525 U/L, serum creatinine (Scr)143 μmol/L, uric acid 1 338 μmol/L, and blood ammonia 45 μmol/L. Chest computed tomography showed multiple ground glass density lesions in bilateral lungs. The patient was diagnosed as having acute and severe European waterhemlock poisoning, toxic encephalopathy, aspiration pneumonia, and pulmonary edema. The treatments including ventilator assisted breathing, analgesia and sedation, anti-infection, expectorant and antiasthmatic, inhibition of gastric acid secretion, rehydration hydration, promotion of awakening, liver protection, and myocardial nutrition were given. In addition, the patient received 2 times of hemoperfusion. Five days later, the patient′s condition was improved. Laboratory tests showed WBC 12.0×10 9/L, ALT 94 U/L, TBil 28.2 μmol/L, CK-MB 2.7 μg/L, LDH 452 U/L, Scr 61 μmol/L, uric acid 514 μmol/L, blood ammonia 38.0 μmol/L. Then the patient was transferred to the Department of Emergency Internal Medicine for further treatment.