1.The value of transabdominal bowel ultrasonography in evaluating active Crohn′s disease and the clinical diagnostic efficacy of different imaging scoring systems
Xingyun LONG ; Li GONG ; Chunyan PENG ; Xiaoqi ZHANG ; Wentao KONG
Chinese Journal of Digestion 2025;45(5):331-337
Objective:To investigate the value of transabdominal bowel ultrasonography (TBUS) in evaluating the active phase of Crohn′s disease (CD) and its complications, and to compare the diagnostic efficacy of the international bowel ultrasound segmental activity score (IBUS-SAS) and the multidetector computed tomography enterography (MDCTE) score in the active phase.Methods:A totle of 103 CD patients who were admitted to the Nanjing Drum Tower Hospital from March 2021 to May 2023 were retrospectively analyzed. All patients underwent TBUS and MDCTE examinations. TBU parameters such as bowel wall thickness (BWT), color Doppler imaging signal (CDS), inflammatory fat (i-fat), and bowel wall stratification (BWS) were recorded. The patients were divided into the remission group and the active group based on the Crohn′s disease activity index. The latter group was further divided into the mild active group and the moderate-to-severe active group.Receiver operating characteristic curves (ROC) were plotted, and the diagnostic efficacy of TBUS parameters and two scoring systems in assessment of the active phase of CD was evaluated by sensitivity, specificity, area under the curve (AUC), and optimal cut-off values. Endoscopic or histopathological results were served as the gold standard for the diagnosis of intestinal strictures. The diagnostic efficacy of TBUS and MDCTE in CD complicated with intestinal stenosis were evaluated by ROC analysis. Spearman correlation analysis was performed to analyze the correlation between TBUS parameters, imaging scores, and clinical laboratory indicators such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and faecal calprotectin (FC).Results:In distinguishing the active phase and the remission phase of CD, BWT (a sensitivity of 85.7%, specificity of 90.9%, and cut-off value of 4.4 mm), CDS (a sensitivity of 95.7%, and specificity of 63.6%), IBUS-SAS (a sensitivity of 91.4%, specificity of 84.8%, and cut-off value of 23.8), and MDCTE score (a sensitivity of 77.1%, specificity of 75.8%, and cut-off value of 6.5) had high diagnostic efficacies. In distinguishing mild and moderate-severe active phases of CD, BWT, CDS and i-fat demonstrated high sensitivity (81.4%, 69.8% and 62.8%) and specificity (81.5%, 77.8% and 100.0%); IBUS-SAS (a sensitivity of 83.7%, specificity of 88.9%, and cut-off value of 40.0) and MDCTE score (a sensitivity of 83.7%, specificity of 85.2%, and cut-off value of8.5) had high diagnostic efficacy. In the diagnosis of CD complicated with intestinal stenosis, the AUC, sensitivity, specificity, and accuracy of MDCTE was 0.942, 94.0%, 94.3%, and 94.2%, respectively. The AUC, sensitivity, specificity, and accuracy of TBUS in the diagnosis of CD complicated with intestinal stenosis was 0.952, 96.0%, 94.3%, and 95.1%, respectively. The results of Spearman correlation analysis revealed that BWT, CDS, and i-fat have positively correlated with ESR, CRP, and FC ( r value: 0.252 to 0.451, all P<0.05). Conclusions:TBUS demonstrates good application value in evaluating the activity of CD and intestinal stenosis. IBUS-SAS has the potential application for precise assessment of CD activity.
2.The value of transabdominal bowel ultrasonography in evaluating active Crohn′s disease and the clinical diagnostic efficacy of different imaging scoring systems
Xingyun LONG ; Li GONG ; Chunyan PENG ; Xiaoqi ZHANG ; Wentao KONG
Chinese Journal of Digestion 2025;45(5):331-337
Objective:To investigate the value of transabdominal bowel ultrasonography (TBUS) in evaluating the active phase of Crohn′s disease (CD) and its complications, and to compare the diagnostic efficacy of the international bowel ultrasound segmental activity score (IBUS-SAS) and the multidetector computed tomography enterography (MDCTE) score in the active phase.Methods:A totle of 103 CD patients who were admitted to the Nanjing Drum Tower Hospital from March 2021 to May 2023 were retrospectively analyzed. All patients underwent TBUS and MDCTE examinations. TBU parameters such as bowel wall thickness (BWT), color Doppler imaging signal (CDS), inflammatory fat (i-fat), and bowel wall stratification (BWS) were recorded. The patients were divided into the remission group and the active group based on the Crohn′s disease activity index. The latter group was further divided into the mild active group and the moderate-to-severe active group.Receiver operating characteristic curves (ROC) were plotted, and the diagnostic efficacy of TBUS parameters and two scoring systems in assessment of the active phase of CD was evaluated by sensitivity, specificity, area under the curve (AUC), and optimal cut-off values. Endoscopic or histopathological results were served as the gold standard for the diagnosis of intestinal strictures. The diagnostic efficacy of TBUS and MDCTE in CD complicated with intestinal stenosis were evaluated by ROC analysis. Spearman correlation analysis was performed to analyze the correlation between TBUS parameters, imaging scores, and clinical laboratory indicators such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and faecal calprotectin (FC).Results:In distinguishing the active phase and the remission phase of CD, BWT (a sensitivity of 85.7%, specificity of 90.9%, and cut-off value of 4.4 mm), CDS (a sensitivity of 95.7%, and specificity of 63.6%), IBUS-SAS (a sensitivity of 91.4%, specificity of 84.8%, and cut-off value of 23.8), and MDCTE score (a sensitivity of 77.1%, specificity of 75.8%, and cut-off value of 6.5) had high diagnostic efficacies. In distinguishing mild and moderate-severe active phases of CD, BWT, CDS and i-fat demonstrated high sensitivity (81.4%, 69.8% and 62.8%) and specificity (81.5%, 77.8% and 100.0%); IBUS-SAS (a sensitivity of 83.7%, specificity of 88.9%, and cut-off value of 40.0) and MDCTE score (a sensitivity of 83.7%, specificity of 85.2%, and cut-off value of8.5) had high diagnostic efficacy. In the diagnosis of CD complicated with intestinal stenosis, the AUC, sensitivity, specificity, and accuracy of MDCTE was 0.942, 94.0%, 94.3%, and 94.2%, respectively. The AUC, sensitivity, specificity, and accuracy of TBUS in the diagnosis of CD complicated with intestinal stenosis was 0.952, 96.0%, 94.3%, and 95.1%, respectively. The results of Spearman correlation analysis revealed that BWT, CDS, and i-fat have positively correlated with ESR, CRP, and FC ( r value: 0.252 to 0.451, all P<0.05). Conclusions:TBUS demonstrates good application value in evaluating the activity of CD and intestinal stenosis. IBUS-SAS has the potential application for precise assessment of CD activity.
3.Correlation between interleukin 1β-511C/T polymorphism and essential hypertension in the Yi ethnic group of Yunnan province
Tong YANG ; Yuan XU ; Xingyun PU ; Yiting MA ; Jing YANG ; Xin SHU ; Hongyu PENG ; Yanrui WU ; Li LONG
Basic & Clinical Medicine 2024;44(12):1651-1655
Objective To investigate the correlation between interleukin 1β gene-511C/T polymorphism of and essential hypertension in the Yi ethnic group of Yunnan province.Methods-511C/T polymorphism of interleukin 1β gene was detected by PCR-RFLP in 85 Yi patients with essential hypertension(EH group)and 106 Yi healthy people(control group)in Shuanghe Township,Jinning County,Yunnan Province.Genotype and allele frequencies were analyzed by SPSS 27.0 software,and association analysis was performed.Results The frequency distribution of CC,CT and TT genotypes at the mutation site 511 of the IL-1βgene in EH group was 18.82%,44.71%and 36.47%,respectively,and it was 5.66%,26.42%and 67.92%in the control group.The difference in genotype frequency between the two groups was statistically significant(P<0.05).The allele frequency of C and T in EH group was 41.18%and 58.82%,respectively,and the allele frequency of C and T in control group was 18.87%and 81.13%.The frequency difference of alleles between the two groups was statistically significant(P<0.05).Both genotype frequency and allele frequency found in males and females had statistical differences(P<0.05).Conclusions The distribution of IL-1β gene-511C/T polymorphism is related to the incident of essential hyper-tension among the Yi ethnic group Yunnan Province,and is the susceptibility gene of the Yi ethnic group to essen-tial hypertension.
4.Effect of exercise under blood flow restriction on risk of fragility fractures in postmenopausal patients with chronic obstructive pulmonary disease
Chinese Journal of Rehabilitation Theory and Practice 2023;29(7):761-769
ObjectiveTo explore the effect of blood flow restriction (BFR)-based aerobic exercise and low-intensity resistance program on bone strength, hormone secretion, lung function and exercise capacity in postmenopausal patients with chronic obstructive pulmonary disease (COPD), to relieve the risk of fragility fractures and mortality. MethodsFrom June, 2020 to January, 2021, 67 postmenopausal patients with COPD were selected from seven community hospitals such as Chongqing Yuxi Hospital, etc. The patients were randomly divided into control group (n = 33) and experimental group (n = 34). Both groups received conventional treatment and implemented a pulmonary rehabilitation program consisting of aerobic exercise and low-intensity resistance, while the experimental group finished the low-intensity resistance under BFR, for 24 weeks. Before and after intervention, the femoral neck bone mineral density (BMD) was measured with dual-energy X-ray; the interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), 25-hydroxyvitamin D3 [25(OH)D3], estradiol (E2), bone-specific alkaline phosphatase (BALP), tartrate-resistant acid phosphatase (TRACP), osteocalcin (BGP), β-I collagen cross-linked C-terminal peptide (β-CTX), growth hormone (GH) and insulin-like growth factor-1 (IGF-1) levels were measured with ELISA; the forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) were measured with lung function test; the maximum oxygen uptake (VO2max) and anaerobic threshold (AT) were measured with cardiopulmonary exercise test; the body mass index (BMI) and muscle mass were measured with bioelectrical impedance; the peak torque of knee flexion and extension, and fatigue index were measured with isokinetic muscle strength test; and they were also assessed with distance of 6-minute walk test (6MWT), modified Falls Efficacy Scale (MFES), Timed Up and Go Test (TUGT), and Tinetti Performance Oriented Mobility Assessment (Tinetti). ResultsFour cases dropped down in the control group, and five in the experimental group. All the indexes improved in the experimental group after intervention (|t| > 2.208, P < 0.05), and most of the indexes improved in the control group (|t| > 2.052, P < 0.05); while the E2, GH, IGF-1, IL-6, TNF-α, TRACP, β-CTX, BALP, FEV1, AT, distance of 6MWT, muscle mass, peak torque of knee flexion and extension, fatigue index, time of TUGT, and scores of Tinetti and MFES were better in the experimental group than in the control group (|t| > 2.141, P < 0.05). ConclusionExercise under BFR may improve the bone strength, lung function, estrogen secretion and exercise ability of postmenopausal patients with COPD, which may help to relieve the risk of fragility fractures.
5.Effect of hyperbaric oxygen on the incidence of complications following decompressive cranioectomy in severe traumatic brain injury
Chunni CAO ; Zuofu ZHANG ; Chunhua LIN ; Xiuyu ZHAO ; Yusong BIAN ; Xingyun WU ; Hongxing ZHANG ; Zhengrong PENG
Chinese journal of nautical medicine and hyperbaric medicine 2017;24(1):50-55
Objective To explore the effects of hyperbaric oxygen (HBO) on the incidence of complications and treatment efficacy following decompressive craniectomy(DC) in severe traumatic brain injury.Methods A total of 160 patients who underwent DC for severe traumatic brain injury from January 2010 to December 2014 in the Neurosurgery Department of Yantai Yuhuangding Hospital were chosen for the study.The subjects were divided into the HBO group (86 Patients) and the routine treatment group (74 patients) in accordance with different treatment methods.Incidence of complications,changes in EEG at different time points after surgery,the levels of transforming factor-β1 (TGF-β1) and myelin basic protein (MBP) in cerebrospinal fluid,scores of Glasgow Coma Scale as well as scores of Modified Rankin Scale 6 months after surgery were compared between the two groups.Results Following DC in severe traumatic brain injury,the rates of cerebral herniation (31.4%),postsurgical epilepsy (10.5%) and hydrocrania (11.6%) in the HBO group were all obviously decreased(47.3%,23.0%,24.3%),as compared with those of the control group,and statistical significance could be seen,when comparisons were made between the 2 groups (P < 0.05).The incidence of subdural effusion in the HBO group was 32.6%,while that of the routine treatment group was 41.9%,and there was no statistical significance,when comparisons were made between the 2 groups (P > 0.05).In the HBO group,the levels of TGF-β 1 and MBP in the cerebrospinal fluid 14 and 21 days after surgery were significantly decreased,as compared with those of the routine treatment group.The EEG and GCS scores in the HBO group were significantly improved,1 and 3 months after surgery,as compared with those of the routine treatment group.The scores of the modified Rankin Scale of the HBO group,which were obtained 6 months after surgery,were significantly higher than those of the routine treatment group,and statistical significance could be noted,when comparisons were made between the 2 groups (P < 0.05).Conclusions Following decompressive cranioectomyin,HBO in the treatment of severe traumatic brain injury could obviously decrease the rates of cerebral herniation,postsurgical epilepsy and hydrocrania.HBO could also substantially improve EEG and decrease levels of TGF-β 1 and MBP,14 and 21 days after surgery,and improve the prognosis of the patients.
6.Effect of hyperbaric oxygen on the incidence of complications following decompressive cranioectomy in severe traumatic brain injury
Chunni CAO ; Zuofu ZHANG ; Chunhua LIN ; Xiuyu ZHAO ; Yusong BIAN ; Xingyun WU ; Hongxing ZHANG ; Zhengrong PENG
Chinese journal of nautical medicine and hyperbaric medicine 2017;24(1):50-55
Objective To explore the effects of hyperbaric oxygen (HBO) on the incidence of complications and treatment efficacy following decompressive craniectomy(DC) in severe traumatic brain injury.Methods A total of 160 patients who underwent DC for severe traumatic brain injury from January 2010 to December 2014 in the Neurosurgery Department of Yantai Yuhuangding Hospital were chosen for the study.The subjects were divided into the HBO group (86 Patients) and the routine treatment group (74 patients) in accordance with different treatment methods.Incidence of complications,changes in EEG at different time points after surgery,the levels of transforming factor-β1 (TGF-β1) and myelin basic protein (MBP) in cerebrospinal fluid,scores of Glasgow Coma Scale as well as scores of Modified Rankin Scale 6 months after surgery were compared between the two groups.Results Following DC in severe traumatic brain injury,the rates of cerebral herniation (31.4%),postsurgical epilepsy (10.5%) and hydrocrania (11.6%) in the HBO group were all obviously decreased(47.3%,23.0%,24.3%),as compared with those of the control group,and statistical significance could be seen,when comparisons were made between the 2 groups (P < 0.05).The incidence of subdural effusion in the HBO group was 32.6%,while that of the routine treatment group was 41.9%,and there was no statistical significance,when comparisons were made between the 2 groups (P > 0.05).In the HBO group,the levels of TGF-β 1 and MBP in the cerebrospinal fluid 14 and 21 days after surgery were significantly decreased,as compared with those of the routine treatment group.The EEG and GCS scores in the HBO group were significantly improved,1 and 3 months after surgery,as compared with those of the routine treatment group.The scores of the modified Rankin Scale of the HBO group,which were obtained 6 months after surgery,were significantly higher than those of the routine treatment group,and statistical significance could be noted,when comparisons were made between the 2 groups (P < 0.05).Conclusions Following decompressive cranioectomyin,HBO in the treatment of severe traumatic brain injury could obviously decrease the rates of cerebral herniation,postsurgical epilepsy and hydrocrania.HBO could also substantially improve EEG and decrease levels of TGF-β 1 and MBP,14 and 21 days after surgery,and improve the prognosis of the patients.
7.Mechanism of dexamethasone inhibiting U937 cell adhesion and phagocytose function
Dong LIU ; Xingyun CHEN ; Renping XIONG ; Ping LI ; Yalei NING ; Yan PENG ; Yan ZHAO ; Nan YANG ; Yuanguo ZHOU
Chinese Journal of Trauma 2012;28(5):466-469
ObjectiveTo investigate the mechanism of dexamethasone (Dex) in inhibiting monocyte adhesion and phagocytose function.Methods Under the stimulation of phorbo1-12-myristate-13-acetate (PMA),U937 monocytes cultured in vitro were treated with Dex and Fasudil respectively.The adhesion rate of U937 monocles to human umbilical vein endothelial cells (HUVECs) and their phagocytic ability of India ink were studied.The protein content and activity of rho-associated coiled-coil protein kinase 1 ( ROCK1 ) as well as the effects of mifepristone and cycloheximide on Dex were determined.ResultsBoth DEX and Fasudil could significantly inhibit the adhesion tate and phagocytosis of U937 cells stimulated by PMA and suppressed the activity of ROCK1.While mifepristone and cycloheximide could not alter these effects of DEX.ConclusionDEX interferes with the adhesion and phagocytosis function of U937 cells by inhibiting ROCKI activity.

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