Objective:To analyze the clinical and prognostic characteristics of patients with immune checkpoint inhibitor (ICI) -related colitis.Methods:A retrospective observational research method was conducted. Clinical data from patients diagnosed with ICI-related colitis at Beijing Friendship Hospital between January 2016 and May 2024 were collected. Clinical severity was assessed using the common terminology criteria for adverse event (CTCAE) grading, Mayo Score, Truelove & Witts Score, and endoscopic severity was assessed using Mayo endoscopic score (MES), ulcerative colitis endoscopic index of severity (UCEIS), and MD Anderson Cancer Center endoscopic inflammation grading (MD grading). Spearman rank correlation analysis was performed to evaluate the correlation between different scoring systems.Results:A total of 15 patients were included, with 10 males and 5 females, and the median age was 64.0 (55.5, 71.0) years. Thirteen patients were treated with programmed cell death protein 1 (PD-1) monoclonal antibodies, and 2 patients were treated with programmed cell death-ligand 1 (PD-L1) monoclonal antibodies. The median onset time of the 15 patients was 66.5 (41.0, 168.0) days after ICI treatment. All patients had diarrhea, only 25% patients presented with abdominal pain, and 20%-33% patients had fever, abdominal distension, nausea, and vomiting. Most of the inflammatory indicators were non-specific. Among the 14 patients who underwent CT examinations, 2 patients had no abnormal manifestations, 10 patients had left colon involvement, mainly manifested as thickening of the colon wall, and 6 of these patients had full-thickness involvement. Among the 12 patients who underwent colonoscopy examination, except for one patient with no abnormalities, 11 patients had rectal and sigmoid colon involvement, the proportions of the descending colon, ascending colon, and terminal ileum involvement decreased successively, and the involved mucosa was mainly manifested as disappearance of vascular texture, mucosal congestion and edema, erosion to shallow ulcers, and lumen stenosis. The lesions in 5 patients were distributed continuously similar to ulcerative colitis, and the lesions in 6 patients were distributed segmentally, 1 of them had an isolated deep ulcer in the rectum under endoscopy. Correlation analysis revealed significant correlations between endoscopic scores (MES, UCEIS, and MD grading; all P < 0.001). Truelove & Witts score strongly correlated with the Mayo score ( ρ = 0.88, P < 0.001). Among clinical-endoscopic comparisons, the Mayo score exhibited the strong positive correlation with endoscopic scores (all P < 0.05), followed by the Truelove & Witts score (all P < 0.05), and CTCAE diarrhea grading only had positive correlation with MD grading ( P = 0.034). However, CTCAE colitis grading showed no significant correlation with endoscopic scores (all P > 0.05). During a mean follow-up of 13.5 months, 10 patients received corticosteroid therapy, and 5 received alternative treatments. Corticosteroid-treated patients showed favorable clinical responses, and rapid tapering feasible occurred in parts of mild-to-moderate patients without relapse. However, perforation occurred in 2 patients with small bowel involvement. Conclusions:The main clinical manifestations of patients with ICI-related colitis are diarrhea. Imaging studies suggest thickening of the colonic wall. Endoscopic findings show the highest involvement in the left colon. Truelove&Witts score and Mayo score is strongly correlated. Corticosteroid therapy exhibits a rapid response, and the prognosis of patients with small intestine involvement is poor.

Objective:To analyze the clinical and prognostic characteristics of patients with immune checkpoint inhibitor (ICI) -related colitis.Methods:A retrospective observational research method was conducted. Clinical data from patients diagnosed with ICI-related colitis at Beijing Friendship Hospital between January 2016 and May 2024 were collected. Clinical severity was assessed using the common terminology criteria for adverse event (CTCAE) grading, Mayo Score, Truelove & Witts Score, and endoscopic severity was assessed using Mayo endoscopic score (MES), ulcerative colitis endoscopic index of severity (UCEIS), and MD Anderson Cancer Center endoscopic inflammation grading (MD grading). Spearman rank correlation analysis was performed to evaluate the correlation between different scoring systems.Results:A total of 15 patients were included, with 10 males and 5 females, and the median age was 64.0 (55.5, 71.0) years. Thirteen patients were treated with programmed cell death protein 1 (PD-1) monoclonal antibodies, and 2 patients were treated with programmed cell death-ligand 1 (PD-L1) monoclonal antibodies. The median onset time of the 15 patients was 66.5 (41.0, 168.0) days after ICI treatment. All patients had diarrhea, only 25% patients presented with abdominal pain, and 20%-33% patients had fever, abdominal distension, nausea, and vomiting. Most of the inflammatory indicators were non-specific. Among the 14 patients who underwent CT examinations, 2 patients had no abnormal manifestations, 10 patients had left colon involvement, mainly manifested as thickening of the colon wall, and 6 of these patients had full-thickness involvement. Among the 12 patients who underwent colonoscopy examination, except for one patient with no abnormalities, 11 patients had rectal and sigmoid colon involvement, the proportions of the descending colon, ascending colon, and terminal ileum involvement decreased successively, and the involved mucosa was mainly manifested as disappearance of vascular texture, mucosal congestion and edema, erosion to shallow ulcers, and lumen stenosis. The lesions in 5 patients were distributed continuously similar to ulcerative colitis, and the lesions in 6 patients were distributed segmentally, 1 of them had an isolated deep ulcer in the rectum under endoscopy. Correlation analysis revealed significant correlations between endoscopic scores (MES, UCEIS, and MD grading; all P < 0.001). Truelove & Witts score strongly correlated with the Mayo score ( ρ = 0.88, P < 0.001). Among clinical-endoscopic comparisons, the Mayo score exhibited the strong positive correlation with endoscopic scores (all P < 0.05), followed by the Truelove & Witts score (all P < 0.05), and CTCAE diarrhea grading only had positive correlation with MD grading ( P = 0.034). However, CTCAE colitis grading showed no significant correlation with endoscopic scores (all P > 0.05). During a mean follow-up of 13.5 months, 10 patients received corticosteroid therapy, and 5 received alternative treatments. Corticosteroid-treated patients showed favorable clinical responses, and rapid tapering feasible occurred in parts of mild-to-moderate patients without relapse. However, perforation occurred in 2 patients with small bowel involvement. Conclusions:The main clinical manifestations of patients with ICI-related colitis are diarrhea. Imaging studies suggest thickening of the colonic wall. Endoscopic findings show the highest involvement in the left colon. Truelove&Witts score and Mayo score is strongly correlated. Corticosteroid therapy exhibits a rapid response, and the prognosis of patients with small intestine involvement is poor.

Background::Non-alcoholic fatty liver disease (NAFLD) and inflammatory bowel disease (IBD) have shown similar worsening epidemic patterns globally and shared various overlapping pathophysiological mechanisms. However, evidence on the relationship between NAFLD and IBD risk is lacking. We aimed to investigate the associations between long-term risk of incident IBD and NAFLD in a large prospective cohort.Methods::Participants from the United Kingdom Biobank cohort (https://biobank.ndph.ox.ac.uk/) who were free of IBD and alcoholic liver disease at baseline were enrolled. Baseline non-alcoholic fatty liver degree was measured by the well-established fatty liver index (FLI). The outcomes of interest included incident IBD, ulcerative colitis (UC), and Crohn’s disease (CD). Multivariable Cox proportional hazard regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs).Results::Among 418,721 participants (mean FLI: 48.11 ± 30.11), 160,807 (38.40%) participants were diagnosed as NAFLD at baseline. During a median of 12.4 years’ follow-up, 2346 incident IBD cases (1545 UC, 653 CD, and 148 IBD-unclassified) were identified. Due to limited events, those IBD-unclassified were combined in UC or CD when examining the associated risk of UC or CD, separately. Compared with the lowest quartile of FLI, the highest quartile showed a separately 36.00%, 25.00%, and 58.00% higher risk of incident IBD (HR Q4 vs. Q1 =1.36, 95% CI: 1.19-1.55, Ptrend <0.001), UC (HR Q4 vs. Q1 =1.25, 95% CI: 1.07-1.46, Ptrend=0.047), and CD (HR Q4 vs. Q1 =1.58, 95% CI: 1.26-1.97, Ptrend <0.001) after multivariable adjustment. Compared with non-NAFLD, NAFLD participants had a significantly higher risk of incident IBD (HR=1.13, 95% CI: 1.04-1.24) and CD (HR =1.36, 95% CI: 1.17-1.58). Conclusions::Higher degree of non-alcoholic fatty liver is associated with increased risk of incident IBD. Interventions aimed at improving NAFLD may be a potential targeted strategy for the detection and treatment of IBD.

AIM: To investigate the mechanism of baicalin-induced apoptosis in human laryngeal cancer cells. METHODS: AMC-HN-8 cells were selected for the study, and baicalin was applied to the cells at different concentrations (0, 10, 30, 100, and 300 μmol/L), and the half-inhibitory concentration (IC50) was measured by the CCK-8 method. Bax, cleaved-caspase-3, Cyto-c, IRF4 protein expression by protein blotting (Western blot); miR-125b-5p and IRF4 expression by RT-qPCR. Dual-luciferase reporter gene validation of Targetscan prediction (binding of miR-125b-5p to IRF4-3'UTR); apoptosis and necrosis inhibitors explore the way baicalein induces death in laryngeal cancer cells. AMC-HN-8 was then divided into blank group, baicalein (IC50), miR-125b-5p inhibitor group, baicalein + inhibitor NC group, baicalein+miR-125b-5p inhibitor group, and cell invasion and clone formation assays to detect cell invasion and proliferation ability, respectively. Apoptosis was detected by flow cytometry. RESULTS: Baicalein inhibited the proliferation of AMC-HN-8 cells in a dose-dependent manner with an IC50 value of 47.31 μmol/L. Compared with the blank group, 47.31 μmol/L baicalin induced apoptosis and inhibited cell invasion, while upregulating the expression of miR-125b-5p and suppressing the mRNA and protein levels of IRF4. The luciferase results showed that the miR-125b-5p mimic was able to inhibit the activity of the IRF4-3'UTR promoter relative to the NC mimic (mimic) group. Baicalein induces laryngeal cancer cell death in an apoptotic manner. In addition, the combination of 47.31 μmol/L baicalin and miR-125b-5p inhibitor affected the behavior of AMC-HN-8 cells, showing that compared with the blank group, the baicalin group showed a decrease in the number of cell clones, weakened invasion ability, and increased apoptosis; the miR - 125b-5p inhibitor group showed an increase in the number of cell clones, enhanced invasion ability and decreased apoptosis. The baicalin+ inhibitor NC group was consistent with baicalin, with no significant effect of inhibitor NC on cell behavior. The cloning, invasion, and apoptosis of cells in the baicalin+miR-125b-5p inhibitor group were intermediate between the baicalin and miR-125b-5p inhibitor groups. CONCLUSION: Baicalin inhibits the proliferation of AMC-HN-8 cells, and the mechanism may be related to miR-125b-5p targeting to inhibit the expression of IRF4, inducing the pro-apoptotic proteins Bax, cleaved-caspase3, and Cyto-c, and inhibiting the apoptosis suppressor protein Bcl-2 thereby inducing apoptosis.

Objective:To investigate the relationships between the expression level of human epidermal growth factor receptor 2 (HER2) in HER2-positive breast cancer and the characteristics of ultrasound imaging and mammography.Methods:The imaging data of 486 patients with HER2-positive breast cancer treated in the Harbin Medical University Cancer Hospital from January 2014 to December 2021 were retrospectively collected. The relationships between the expression level of HER2 and the imaging features of breast ultrasound and mammography were analyzed.Results:49.38% (240/486) of HER2-positive breast cancer patients were HER2 2+, and 50.62% (246/486) of HER2-positive breast cancer patients were HER2 3+. The age of HER2 2+ patients [ (52.88±1.16) years] was older than the age of HER2 3+ patients [ (49.59±1.00) years], and there was a statistically significant difference ( t=18.07, P<0.001) . There was a statistically significant difference of menstrual status between HER2 2+ patients and HER2 3+ patients ( χ2=4.42, P=0.036) . There were statistically significant differences in the ultrasonography showed burr sign ( χ2=8.37, P=0.010) , posterior echo ( χ2=9.68, P=0.017) , axillary lymph node enlargement ( χ2=15.77, P<0.001) between HER2 2+ patients and HER2 3+ patients. There was a statistically significant difference in the mammography showed whether there were lumps between HER2 2+ patients and HER2 3+ patients ( χ2=15.81, P<0.001) . Conclusion:The expression level of HER2 in HER2-positive breast cancer patients is related to burr sign, posterior echo, and axillary lymph node enlargement shown by ultrasound, as well as lumps shown by mammography, which can provide certain information for clinical prediction of malignant degree of breast cancer, prognosis and individualized treatment plan.

Objective:To study the macrolides resistance of Mycoplasma pneumoniae(MP) in Suzhou area, and try to explore the relationship between drug resistance and refractory Mycoplasma pneumoniae pneumonia (RMPP). Methods:From a series of hospitalized children who were diagnosed as Mycoplasma pneumoniae pneumonia (MPP) from October 2013 to September 2014 in Suzhou area, 48 children were treated with Azithromycin (10 mg/kg, once a day, intravenous drip for 5-7 days), and the clinical symptoms and chest imaging were still progressing so they were clinically diagnosed as RMPP, and 34 children who were successfully treated with macrolides antibiotics (MA) were clinically diagnosed as general MPP (GMPP). MP DNA was extracted from the airway secretion of children in the two groups, and the point mutations of 2063 and 2064 of 23S rRNA were sequenced, and according to the MP 23S rRNA sequencing results, the children were divided into macrolides antibiotic resistant MP group (MRMP) and macrolides antibiotic sensitive MP group (MSMP). The clinical characteristics of the two groups were compared. Results:In the MRMP group, the incidence of RMPP was 62.2% (46/74 cases), while in MSMP group, the incidence of RMPP was 25.0% (2/8 cases). The point mutation of MP 23S rRNA had no significant effect on the occurrence of RMPP ( χ2=2.719, P=0.099). Compared with MRMP group, MSMP group presented shorter fever time and less glucocorticoid use.No significant differences between the two groups were found in chest imaging examination, as well as some laboratory results, including the total number and classification of white blood cell (WBC), C-reactive protein (CRP), alanine aminotransferase (ALT), lactate dehydrogenase (LDH) and creatine kinase isoenzyme (CK-MB). Conclusions:The fever duration of MPP lasted more than 1 week, suggesting the possibility of macrolides resistance of MP, but macrolides resistance did not aggravate the occurrence of RMPP.It is unreliable to judge the MRMP by chest imaging features and laboratory results.

Objective To investigate the effects of single i.v. subanesthetic dose of ketamine on heart rate, blood pressure and oxygen saturation for antidepressant treatment. Methods Patients with severe depressive disorder were randomized to ketamine group (n=13) and control group (n=14). Ketamine group received ketamine (0.5mg/kg) single injection whereas control group received saline single injection. Escitalopram (10 mg/d) were orally administered for 4 weeks simultaneously. Comparisons were made on the heart rate, blood pressure and oxygen saturation at baseline, 40 min, 100 min, and 280 min after injection between the two groups. Results The main effects of time but not group were significant for all parameters including heart rate, systolic blood pressure and diastolic blood pressure, (P＜0.05). Interaction of time×group was significant (P＜0.05). All parameters including heart rate (F=16.85, P＜0.01), systolic blood pressure (F=15.82, P＜0.01) and diastolic blood pressure (F=8.63, P＜0.01) with time were significant in ketamine group. The heart rate, systolic blood pressure and diastolic blood pressure in ketamine group were significantly higher at 40 min than at other time points (P＜0.05), while were no significant difference among other time points (P＞0.05). There was no statistical significance of main effect of time, group and interaction of time×group in oxygen saturation between the two groups (P＞0.05). Conclusion Single subanesthetic dose ketamine intravenous drip for antidepressant therapy may cause a transient increase in heart rate and blood pressure.

Objective To investigate the risk factors of single and multiple bronchoscopic lavage therapy in children with refractory Mycoplasma pneumoniae pneumonia(RMPP).Methods Retrospective analysis was conducted of the clinical data of 332 RMPP children at Department of Respiratory Disease,Children's Hospital of Soochow University from January 2011 to December 2016.The patients were divided into the single group and the multiple group (≥2 times),and the correlative index were compared between the 2 groups.Logistic regression analysis was performed to analyze the risk factors of multiple bronchoscopic lavage therapy in RMPP patients.Results Among 332 children,223 cases were in the single group and 109 cases in the multiple group.Children undergoing multiple bronchoscopy had the fever duration ≥ 10 days before the bronchoscopy and course of disease ≥ 10 days before the bronchoscopy,more than those in the single group [118 cases (52.9％) vs.71 cases (65.1％),69 cases (29.6％) vs.45 cases(41.3％)],and the differences were statistically significant(all P ＜ 0.05).At the same time,the use of glucocorticoid,macrolide,glucocorticoid combined with macrolide antibiotics in the first week of illness were significantly lower in the multiple groups than those in the single group,and the differences were statistically significant (all P ＜ 0.05).In the multiple group,the percentage of neutrophils (N),C-reactive protein (CRP),CRP ＞ 44 mg/L,lactate dehydrogenase (LDH) and LDH ＞ 480 U/L were higher than those in the single group,and the differences were significant (all P ＜ 0.05).In addition,the mixed infection and pleural effusion of multiple group were higher than those of the single group.The proportion of bronchoscopy in the multiple group was higher than that of the single group.In bronchoscopy,the mucus plug blocking and mucosal erosion were more than those of the single group,and the differences were statistically significant (x2 =5.397,13.31,all P ＜ 0.05).After adjusted by multiple regression analysis,6 factors were independent risk factors for multiple bronchoscopic procedures.They were the fever duration before the bronchoscopy ≥ 10 days[odds ratio (OR) =19.504,95 ％ confidence interval (CI):7.350-51.754,P =0.000],the unuse of macrolide antibiotics in the first week of illness (OR =5.072,95％ CI:2.230-11.537,P =0.000),the unuse of glucocorticoid in the first week of illness (OR =14.051,95 ％ CI:4.755-41.522,P =0.000),CRP ＞ 44 mg/L (OR =2.638,95 ％ CI:1.356-5.133,P =0.004),LDH ＞ 480 U/L(OR =2.326,95％ CI:1.302-4.157,P =0.004) and mucosal erosion (OR =11.15,95％ CI:2.503-49.715,P =0.002).Conclusion Severe inflammatory reaction and whether or not to actively resist infection and inflammation in the early stage,were important risk factors for multiple bronchoscopic procedures.

Objective To analyze the epidemiological characteristics of Streptococcus pneumonia (SP) in children with respiratory tract infection in Suzhou area,and the correlation between the air pollutants and the epidemiological characteristics of SP.Methods The real-time air quality test data of Suzhou in Jiangsu province was recorded from January 2012 to December 2014,and sputum specimens of 6 653 cases of hospitalized children with respiratory tract diseases in the same period were collected.The SP detection content and the correlation between SP and the concentration level of PM2.5,PM 10,nitrogen dioxide (NO2),sulfur dioxide (SO2),carbon monoxide (CO),ozone (O3) in Suzhou were analyzed.Results The SP detection rate was 9.94％ in 6 653 children.The SP detection rates were respoctively 7.69％ (183/2 381 cases),10.87％ (235/2 161 cases),11.51％ (243/2 111 cases) between 2012 and 2014.The SP detection rates of children at the age of ≤ 1 year old,＞ 1-3 years old,＞ 3-＜ 7 years old and ≥ 7 years old more respectively were 7.11％ (227/3 192 cases),13.48％ (244/1 810 cases),13.76％ (168/1 221 cases),5.12％ (22/430 cases).The SP detection rate of children at the age of ＞ 1-3 years old and ＞3-＜7 years old was higher than that of ≤ 1 years old and ≥7 years old,and the difference was significant (x2 =84.980,P ＜ 0.001).The SP detection rates in spring,summer,antumn and winter respectively were 9.79％ (173/1 768 cases),7.66％ (130/ 1 697 cases),11.76％ (187/1 590 cases),10.70％ (171/1 598 cases).The SP detection rate of children in summer was the lowest (x2 =4.897,15.839,9.165,all P ＜ 0.05).The concentrations of PM2.5,PM 10,SO2,NO2,CO and O3 were in a state of fluctuation during the survey period.The SP detection rate had positive correlation with the concentration of PM2.5,PM10,SO2,NO2,CO and O3 (r =0.650,0.586,0.680,0.467,all P ＜ 0.005),and there was no obvious correlation between the SP detection rate and the concentration of CO,O3 (all P ＞ 0.05).Conclusions SP is one of the important pathogens of respiratory tract infection in children in Suzhou area,and the detection rate in infants and preschoolers is higher but the detection rate in summer is lower.The SP detection rate is closely correlated with the concentration of PM2.5,PM10,SO2,NO2.

Objective To investigate the application value of mini-nutritional assessment short-form(MNA-SF) in screening and evaluating nutritional status in elderly hospitalized patients with malignant tumor.Methods 1472 elderly hospitalized patients(≥65 years old)with malignant tumor were enrolled and prospectively studied for evaluating the nutritional status by nutritional risk screening 2002 (NRS 2002)assessment.Indicators of clinical outcomes were summarized.The consistencies of MNA-SF with body mass index(BMI),grip and results of NRS 2002 assessment,and the relationship between the different nutritional status and clinical outcomes were analyzed.Results The patients meeting the inclusion/exclusion criteria were aged(72.1±5.9)years,with BMI of(22.3 ±3.7)kg/m2 and grip of(21.7± 19.0)kg.Among 16.7％ of the malnourished patients with malignant tumors,pancreatic cancer (30.9 ％),bile duct cancer (24.1％) and esophageal cancer (21.2 ％) occupied the top three incidence of malnutrition,with the lowest (5.4％)incidence in breast cancer.Among 59.2％ of patients being malnourished (16.7％)or at risk(42.5％)of malnutrition,the highest incidence was in bile duct cancer(82.8％),and lowest one was in breast cancer(28.6 ％).MNA-SF-discriminated malnutrition(0～ 7 points)showed a great agreement with malnutrition evaluation by BMI(＜18.5),but had a poor agreement with grip in screening malnutrition.MNA-SF-discriminated nutrition problem(malnourishment plus at risk of malnutrition)showed a great agreement with NRS 2002-discovered nutrition problem (score≥3).Under-nourished patients had a higher infection complication(9.29％ vs.5.14％,P =0.006)and longer hospital stays(15.4 d vs.12.8 d,P＜0.01)as compared with patients with normal nutrition status.Conclusions The prevalence and risk factors for malnutrition are higher in elderly patients with malignant tumor.Poor nutritional status is correlated with poor clinical outcomes.MNA-SF can be used as a tool for evaluating the nutritional status of elderly patients with malignant tumor.