This article reports the diagnosis and treatment process of a case of iron deficiency anemia in a patient with Crohn's disease who has a poor response to iron supplementation therapy. It reviews relevant literature reports to enhance clinicians' understanding of iron deficiency anemia in patients with inflammatory bowel disease who have a poor response to iron supplementation therapy, and to provide timely effective treatment and regular follow-up and monitoring for the patient after analyzing the causes of anemia.

Cap polyposis is a rare benign gastrointestinal disorder characterized by distinctive endoscopic and pathological manifestions. It primarily affects the rectum and sigmoid colon, with diverse clinical manifestations that often lead to misdiagnosis and delayed treatment. This article reports a case of cap polyposis successfully treated with infliximab. Through the literature review, we aim to enhance clinicians' understanding and capabilities of diagnosis and treatmet for this rare disease.

Staphylococcus aureus is a Gram-positive bacterium with strong pathogenicity. With the widespread use of antibiotics， its multi-drug resistance has gradually increased. Among them， methicillin-resistant S. aureus （MRSA） is one of the main pathogens of hospital and community infections. Antimicrobial peptides are short-chain peptides with good antibacterial effects and low drug resistance， which have been widely studied in recent years. This study summarizes the mechanism of action of antimicrobial peptides and related study on antimicrobial peptides against MRSA from different sources. It is found that the mechanisms of action of antimicrobial peptides include targeting bacterial cell membranes， bacterial cells， and bacterial cell walls， etc. Besides isolating antimicrobial peptides with anti-MRSA activity from animals， plants， and microorganisms， antimicrobial peptides can also be obtained through synthetic methods. Among them， GHa-derived peptides from animal sources， Ib-AMP4 from plant sources， Ph-SA from microbial sources， the synthetic peptide LLKLLLKLL-NH2， and so on， due to their effective antibacterial activity， rapid bactericidal speed， and low toxicity， are promising candidates for anti-MRSA drugs.

Gastric cancer is one of the most common malignant tumors of the digestive tract worldwide,and its early diagnosis and treatment have always been the focus of clinical research.In recent years,the rapid progress and wide application of proteomics technology have opened up a new perspective for the early screening,diagnosis,prognosis assessment,and mechanism exploration of gastric cancer.With the rapid development of bioinformatics,a series of innovative methods and cutting-edge results based on proteomics related to gastric cancer have emerged.This article reviewed the application progress of proteomics in gastric cancer from three dimensions:experimental techniques,analysis strategies,and major achievements,and discussed the challenges and opportunities in this field.In the future,with the integration of technologies and the deepening of interdisciplinary research,proteomics of gastric cancer is expected to make more breakthroughs,achieve clinical transformation,and provide more precise diagnosis and treatment plans for patients.

Background:Th9 cells are a newly identified subpopulation of CD4+helper T cells.Immune checkpoint inhibitors have emerged as a central focus in the realm of gastric cancer immunotherapy.However,the comprehension of the alterations within Th9 cells and the expression patterns of immune checkpoint molecules on their surface among gastric cancer patients remain limited.Aims:To investigate the expression and clinical significance of immune checkpoint molecules on Th9 cells in the peripheral blood of gastric cancer patients.Methods:A total of 74 patients diagnosed with gastric cancer and initially treated at the First Affiliated Hospital of Soochow University between June 2021 and September 2022 constituted the case group,while 34 healthy individuals who underwent physical examination during the same period served as the control group.The proportion of Th9 cells in the peripheral blood mononuclear cells(PBMCs)and the surface expression of PD-1,TIM-3,B7-H3 and B7-H4 were assessed using flow cytometry.Subsequently,correlations of their expression levels and the clinicopathological characteristics and prognosis of gastric cancer patients were preliminarily analyzed.Results:When compared to the control group,the proportion of Th9 cells in PBMCs of gastric cancer patients was significantly decreased,while the surface expression levels of PD-1,TIM-3,B7-H3,and B7-H4 were notably elevated(all P<0.05).Positive correlations were observed between TIM-3 and B7-H3,TIM-3 and B7-H4,as well as B7-H3 and B7-H4 on Th9 cells(all P<0.05).Gastric cancer patients aged 70 years or older demonstrated significantly higher levels of PD-1 expression on Th9 cells(P<0.05).Furthermore,low PD-1 expression was associated with a significantly prolonged progression-free survival compared to high expression(27.55 months vs.19.17 months,P<0.05).Univariate and multivariate Cox regression analysis confirmed that high PD-1 expression was an independent risk factor for postoperative disease progression in gastric cancer patients(HR=3.398,95%CI:1.278-9.033,P=0.014).Conclusions:Peripheral blood Th9 cells,along with their surface immune checkpoint molecules,are hypothesized to exert a significant influence on the initiation and progression of gastric cancer.Alterations in PD-1 expression on Th9 cells might be intricately linked with the prognosis of gastric cancer patients.

Background:Th9 cells are a newly identified subpopulation of CD4+helper T cells.Immune checkpoint inhibitors have emerged as a central focus in the realm of gastric cancer immunotherapy.However,the comprehension of the alterations within Th9 cells and the expression patterns of immune checkpoint molecules on their surface among gastric cancer patients remain limited.Aims:To investigate the expression and clinical significance of immune checkpoint molecules on Th9 cells in the peripheral blood of gastric cancer patients.Methods:A total of 74 patients diagnosed with gastric cancer and initially treated at the First Affiliated Hospital of Soochow University between June 2021 and September 2022 constituted the case group,while 34 healthy individuals who underwent physical examination during the same period served as the control group.The proportion of Th9 cells in the peripheral blood mononuclear cells(PBMCs)and the surface expression of PD-1,TIM-3,B7-H3 and B7-H4 were assessed using flow cytometry.Subsequently,correlations of their expression levels and the clinicopathological characteristics and prognosis of gastric cancer patients were preliminarily analyzed.Results:When compared to the control group,the proportion of Th9 cells in PBMCs of gastric cancer patients was significantly decreased,while the surface expression levels of PD-1,TIM-3,B7-H3,and B7-H4 were notably elevated(all P<0.05).Positive correlations were observed between TIM-3 and B7-H3,TIM-3 and B7-H4,as well as B7-H3 and B7-H4 on Th9 cells(all P<0.05).Gastric cancer patients aged 70 years or older demonstrated significantly higher levels of PD-1 expression on Th9 cells(P<0.05).Furthermore,low PD-1 expression was associated with a significantly prolonged progression-free survival compared to high expression(27.55 months vs.19.17 months,P<0.05).Univariate and multivariate Cox regression analysis confirmed that high PD-1 expression was an independent risk factor for postoperative disease progression in gastric cancer patients(HR=3.398,95%CI:1.278-9.033,P=0.014).Conclusions:Peripheral blood Th9 cells,along with their surface immune checkpoint molecules,are hypothesized to exert a significant influence on the initiation and progression of gastric cancer.Alterations in PD-1 expression on Th9 cells might be intricately linked with the prognosis of gastric cancer patients.

Objective:To comparatively evaluate the efficacy of anti-tumor necrosis factor (TNF)-α and anti-interleukin (IL)-12/23 biologics as the first-line treatment in Crohn′s disease (CD).Methods:From January 1, 2016 to December 31, 2024, at the Department of Gastroenterology of the First Affiliated Hospital of Soochow University, the clinical data of patients with CD treated with anti-TNF-α (infliximab or adalimumab) or anti-IL-12/23 biologics (ustekinumab) as first-line treatment were retrospectively collected. All the patients were followed up for 1 year since the initiation of first-line biologic treatment, with the follow-up concluding on December 31, 2024. The primary outcomes were the clinical efficacy (including clinical response rate and clinical remission rate) of anti-TNF-α or anti-IL-12/23 treatment at week 24 and week 48, and the endoscopic efficacy(including endoscopic response rate and endoscopic remission rate) at week 48. The clinical efficacy was assessed based on Crohn′s disease activity index(CDAI). The clinical response was defined as a reduction in CDAI by ≥ 70 from baseline (week 0), and clinical remission was defined as CDAI < 150. The endoscopic efficacy was assessed based on simple endoscopic score for Crohn′s disease (SES-CD), the endoscopic response was defined as a reduction in SES-CD by ≥50% from baseline (week 0), and endoscopic remission was defined as SES-CD ≤2. Chi-square test or Fisher′s exact test was used for statistical analysis.Results:A total of 215 CD patients were enrolled, including 160 males and 55 females, with the age of (31.88±11.55) years old. Among them, 179 patients completed the clinical efficacy evaluation, 110 cases were treated with anti-TNF-α, 69 cases were treated with anti-IL-12/23. The clinical response rates of patients treated with anti-TNF-α and anti-IL-12/23 at week 24 were 95.5%(105/110) and 95.7%(66/69), respectively, and the clinical remission rates at week 24 were 86.4%(95/110) and 85.5%(59/69), respectively; the clinical response rates at week 48 were 95.5%(105/110) and 97.1%(67/69), respectively, and the clinical remission rates at week 48 were 89.1%(98/110) and 88.4%(61/69), respectively; and the differences were not statistically significant(Fisher′s exact test, χ2=0.03, Fisher′s exact test, χ2=0.02; P=1.000, 0.708, 0.872, and 0.887). A total of 76 patients completed endoscopic efficacy evaluation, among which 55 cases were treated with anti-TNF-α, and 21 cases were treated with anti-IL-12/23. The endoscopic response rates of patients treated with anti-TNF-α and anti-IL-12/23 were 74.5%(41/55) and 66.7%(14/21), respectively, and the endoscopic remission rates at week 48 were 49.1%(27/55) and 28.6%(6/21), respectively; and the differences were not statistically significant( χ2=0.47 and 2.60, P=0.492 and 0.107). Conclusion:Both anti-TNF-α and anti-IL-12/23 are effective as first-line biological therapies for CD, and there are no significant differences in both clinical and endoscopic efficacy between these 2 biologics.

Objective:To compare the role of double-balloon enteroscopy (DBE) and dual-energy CT enterography (DCTE) in evaluating the clinical characteristics of Crohn′s disease (CD).Methods:From July 1, 2016 to November 1, 2023, 72 patients with CD who underwent both DBE and DCTE (with an interval of less than 3 months) in the First Affiliated Hospital of Soochow University were enrolled in this retropective study. Among them, 4 patients underwent both DBE and DCTE twice (a total of 76 cases). The data of DBE and DCTE in the diagnosis of 76 CD cases were analyzed, including the diagnostic rate of CD, the consistency of the 2 methods in detecting the lesion location (ileocecal, colonic, ileocolonic, and upper gastrointestinal tract involvement), and the detection rates of stenosis, ulcer and the location, long ulcer (long-diameter≥2 cm), and fistula. Kappa test was performed for the consistency analysis, and Chi-square test was used for statistical analysis.Results:The diagnostic rate of CD by DBE was higher than that by DCTE (80.3% (61/76) vs. 65.8% (50/76)), and the diagnostic rate of combination of the 2 methods (89.5% (68/76)) was higher than that by DCTE alone, and the differences were statistically significant ( χ2=4.04 and 12.28, P=0.044 and <0.001). The result of Kappa consistency test showed that the consistency of CD lesion location detected by DBE and DCTE was poor (Kappa value=0.29, t=3.17, P=0.002). The detection rate of stenosis by DBE was higher than that by DCTE (46.1% (35/76) vs. 13.2% (10/76)), the detection rate of stenosis by combination of the 2 methods (52.6% (40/76)) was higher than that by DCTE alone, and the differences were statistically significant ( χ2=19.73 and 26.82, both P<0.001). There were no statistically significant differences in the detection rates of fistula among DBE, DCTE, and the combination of the 2 methods (3.9%(3/76), 2.6% (2/76), 5.3% (4/76); all P>0.05). The detection rate of ulcer by DBE was higher than that by DCTE(73.7% (56/76) vs. 7.9% (6/76)), the detection rate of ulcer by combination of the 2 methods (76.3%(58/56)) was higher than that by DCTE alone, and the differences were statistically significant ( χ2=68.10 and 72.98, both P<0.001). The detection rates of long ulcer and non-terminal ileum ulcer by DBE were both 17.9% (10/56). All the 6 cases with ulcer detected by DCTE were located in the terminal ileum, and no long ulcers were observed. Conclusions:In the diagnosis of CD, as well as in the detection of stenosis and ulcer, DBE and the combination of DBE and DCTE have more advantages over DCTE alone. The consistency between DBE and DCTE in identifying the location of lesion is poor. DBE has advantages in detecting long ulcer and non-terminal ileum ulcer.

This article reports the diagnosis and treatment process of a case of iron deficiency anemia in a patient with Crohn's disease who has a poor response to iron supplementation therapy. It reviews relevant literature reports to enhance clinicians' understanding of iron deficiency anemia in patients with inflammatory bowel disease who have a poor response to iron supplementation therapy, and to provide timely effective treatment and regular follow-up and monitoring for the patient after analyzing the causes of anemia.

Cap polyposis is a rare benign gastrointestinal disorder characterized by distinctive endoscopic and pathological manifestions. It primarily affects the rectum and sigmoid colon, with diverse clinical manifestations that often lead to misdiagnosis and delayed treatment. This article reports a case of cap polyposis successfully treated with infliximab. Through the literature review, we aim to enhance clinicians' understanding and capabilities of diagnosis and treatmet for this rare disease.