Idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV) is often misdiagnosed as inflammatory bowel disease due to the similarity of clinical symptoms and endoscopic presentation. This paper reports a female patient who was misdiagnosed as Crohn′s disease with poor treatment outcome and later treated with surgical resection. The diagnosis was confirmed by postoperative pathology to be IMHMV of the cecum, with a view to improve the awareness of the disease and reduce misdiagnosis and mistreatment.

Objective:To evaluate the long-term efficacy and safety of vedolizumab (VDZ) in the treatment of patients with moderate to severe ulcerative colitis (UC) .Methods:Clinical data of patients with moderate to severe active UC receiving VDZ treatment for more than 52 weeks at the Department of Gastroenterology of the Second Affiliated Hospital of Xi′an Jiaotong University from February 2021 to April 2023 were retrospectively collected. The observation indexes were clinical response rate, clinical remission rate, endoscopic mucosal healing rate and adverse events after 52 weeks of treatment.Results:A total of 21 patients with moderate to severe UC with complete data were included in this study, including 17 moderate and 4 severe patients with a mean age of (44.2±14.3) years, 17 males and 4 females, and a disease duration of 60 (36, 103) months. The clinical response rate, clinical remission rate, and endoscopic mucosal healing rate at week 52 were 85.7% (18/21) , 76.2% (16/21) and 71.4% (15/21) respectively. Of the 21 patients, 2 (9.5%) had increased transaminases, 5 (23.8%) had clostridium difficile infection and 1 (4.8%) had intestinal EBV infection, with no other adverse effects. Conclusion:VDZ has favorable long-term efficacy and safety in patients with moderate to severe active UC.

Idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV) is often misdiagnosed as inflammatory bowel disease due to the similarity of clinical symptoms and endoscopic presentation. This paper reports a female patient who was misdiagnosed as Crohn′s disease with poor treatment outcome and later treated with surgical resection. The diagnosis was confirmed by postoperative pathology to be IMHMV of the cecum, with a view to improve the awareness of the disease and reduce misdiagnosis and mistreatment.

Objective:To evaluate the long-term efficacy and safety of vedolizumab (VDZ) in the treatment of patients with moderate to severe ulcerative colitis (UC) .Methods:Clinical data of patients with moderate to severe active UC receiving VDZ treatment for more than 52 weeks at the Department of Gastroenterology of the Second Affiliated Hospital of Xi′an Jiaotong University from February 2021 to April 2023 were retrospectively collected. The observation indexes were clinical response rate, clinical remission rate, endoscopic mucosal healing rate and adverse events after 52 weeks of treatment.Results:A total of 21 patients with moderate to severe UC with complete data were included in this study, including 17 moderate and 4 severe patients with a mean age of (44.2±14.3) years, 17 males and 4 females, and a disease duration of 60 (36, 103) months. The clinical response rate, clinical remission rate, and endoscopic mucosal healing rate at week 52 were 85.7% (18/21) , 76.2% (16/21) and 71.4% (15/21) respectively. Of the 21 patients, 2 (9.5%) had increased transaminases, 5 (23.8%) had clostridium difficile infection and 1 (4.8%) had intestinal EBV infection, with no other adverse effects. Conclusion:VDZ has favorable long-term efficacy and safety in patients with moderate to severe active UC.

Objective:To investigate the effects of adherent-invasive Escherichia coli ( E. coli) LF82 on the structure and function of intestinal barrier in mice with ulcerative colitis (UC). Methods:Twenty-four specific pathogen free (SPF) C57BL/6 mice were divided into UC with E. coli LF82 group, UC group and healthy control group with eight mice in each group. The UC mice model was induced by dextran sulfate sodium (DSS). One week before modeling, the mice of UC with E. coli LF82 group were intragastric administrated with 1×10 9 colony-forming unit (CFU) E. coli LF82 to colonize the bacteria strain. The effects of E. coli LF82 on colitis of mice with UC were evaluated by disease activity index (DAI), gross morphological injury score, colonic mucosal injury index (CMDI), myeoloperoxidase (MPO) activity and pathological features. The ultrastructure and the changes of cytoskeleton F-actin of mice colonic tissues were detected by transmission electron microscope (TEM) and direct immunofluorescence. The ability of colonic mucin production and degree of fibrosis were estimated by periodic acid Schiff reaction (PAS) stain and sirius red stain. T test, least significant difference, repeated measurement analysis of variance and one-way analysis of variance were used for statistical analysis. Results:On the fourth, fifth, sixth and seventh day after the modeling, the DAI scores of UC with E. coli LF82 group were all higher than those of UC group ((2.53±0.38) points vs. (2.01±0.53) points, (3.02±0.62) points vs. (2.67±0.24) points, (3.13±0.61) points vs. (2.20±0.24) points, (3.27±0.28) points vs. (2.20±0.69) points, respectively), and the differences were statistically significant ( t=3.37, 2.25, 9.56 and 10.24, all P<0.05). The gross morphological injury score of mice colon of UC with E. coli LF82 group was higher than that of UC group ((6.17±1.94) points vs. (2.83±0.98) points), and the difference was statistically significant ( t=-3.75, P<0.05). The CMDI and MPO activity of UC with E. coli LF82 group were both higher than those of UC group ((16.80±2.79) points vs. (11.80±3.11) points, (729.3±77.5) U/mg vs. (594.4±31.9) U/mg), and the differences were statistically significant ( t=-2.83; mean difference=134.82, 95% confidence interval ( CI) 72.12 to 197.51; both P<0.05). The results of TEM showed that the E. coli LF82 could invade the submucosa of colon and caused further injury of colonic tissues in mice. The distribution of cytoskeleton F-actin of mice colonic tissues changed. The results of PAS staining showed that the percentages of PAS positive cells of UC with E. coli LF82 group and UC group were both lower than that of healthy control group ((32.40±8.02)% and (41.90±8.99)% vs. (57.70±11.52)%), and the difference was statistically significant ( F=17.63, P<0.01). The percentage of PAS positive cells of UC with E. coli LF82 group was lower than that of UC group, and the difference was statistically significant (mean difference=-9.50, 95% CI -18.33 to -0.67, P<0.05). The results of sirius red staining showed that the villous epithelium of colon mucosa of UC with E. coli LF82 group was partially injured and collagen fibers hyperplasia was serious. The area ratios of collagen fiber of UC with E. coli LF82 group and UC group were both higher than that of healthy control group ((51.83±5.78)% and (37.11±5.59)% vs. (15.41±2.25) %), and the difference was statistically significant ( F=86.72, P<0.01). The area ratio of collagen fiber of UC with E. coli LF82 group was higher than that of UC group, the difference was statistically significant (mean difference=14.83, 95% CI 8.91 to 20.76, P<0.05). Conclusions:E. coli LF82 can aggravate DSS-induced colitis in UC mice, leading to changes in colon ultrastructure and cytoskeleton, it can also reduce the ability of mucus secretion of colon of mice and increase the degree of colonic tissues fibrosis.

Many drugs and diseases can damage the intestine and induce the intestinal strictures and nonsteroidal anti-inflammatory drugs (NSAIDs) is a kind of the most common drugs. This article reports a rare case with gastrointestinal diaphragm disease induced by indometacin, a NSAID, which aims to remind the clinical doctors of the rare adverse reaction of these drugs.

Many drugs and diseases can damage the intestine and induce the intestinal strictures and nonsteroidal anti-inflammatory drugs (NSAIDs) is a kind of the most common drugs. This article reports a rare case with gastrointestinal diaphragm disease induced by indometacin, a NSAID, which aims to remind the clinical doctors of the rare adverse reaction of these drugs.