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OBJECTIVE To systematically evaluate the real-world effectiveness and safety of belimumab in the treatment of lupus nephritis （LN） in Chinese adult patients. METHODS Retrieved from PubMed， Embase， Web of Science， Cochrane Library， Wanfang data， CNKI， VIP and CBM， real-world studies on belimumab in the treatment of LN in Chinese adult patients were collected from the inception to July 7th， 2023. Two reviewers independently screened the literature， extracted data， and assessed the quality of the included studies. Meta-analysis was then performed using RevMan 5.3 software. RESULTS A total of 10 real- world studies were included， involving 253 Chinese adult patients with LN. The results of the meta-analysis demonstrated that the complete renal response rate， partial renal response rate， and the incidence of adverse reaction rate in Chinese adult patients with LN treated with belimumab were 61% （95%CI was 46%-76%， P＜0.000 01）， 23%（95%CI was 2%-44%， P＝0.03）， and 30% （95%CI was 16%-43%， P＜0.000 01）， respectively. Belimumab could reduce the 24-hour urinary protein （MD＝－1.71， 95%CI was －3.02-－0.40， P＝0.01）， urine protein-creatinine ratio （MD＝－1.76，95%CI was －2.06-－1.46，P＜0.000 01）， the systemic lupus erythematosus disease activity index （MD＝－8.63， 95%CI was －12.12-－5.13， P＜0.000 01）， and glucocorticoids dosage （MD＝－18.65， 95%CI was －31.82-－5.48， P＝0.006）. In addition， it could elevate the levels of complement C3 （MD＝0.19， 95%CI was 0.08-0.30， P＝0.000 6） and complement C4 （MD＝0.06， 95%CI was 0.02-0.09， P＝0.001）. However， belimumab could not improve the levels of serum creatinine and estimated glomerular filtration rate （P＞0.05）. CONCLUSIONS Belimumab has good efficacy and safety in Chinese adult patients with LN.
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Background: Ankylosing spondylitis (AS) is a chronic inflammatory disease of the axial spine that can manifest with various clinical signs and symptoms. Chronic back pain and progressive spinal stiffness are the most common features of this disease. It is an autoimmune disease which also leads to the involvement of skeletal, cardiac, nervous tissues, and other systemic organs. Aim and Objectives: This study was conducted to assess the correlation between the Bath AS Disease Activity Index (BASDAI) score/visual analog scale (VAS) and various age groups in the patients suffering with AS using standard questionnaire. Materials and Methods: Forty-eight AS patients having BASDAI scores of ?4 were included in this study. The height and weight were taken and responses to the standard questionnaire were recorded. BASDAI Score, body mass index (BMI), and VAS were computed. The patients with history of chronic diseases such as hyper/hypothyroidism, diabetes mellitus, and hypertension or the use of any medication such as ?/? blockers, calcium channel blockers, and antiepileptics were excluded from the study. Results: The patients were divided into six different age groups, i.e., 15–20 years, 21–25 years, 26–30 years, 31–35 years, 36–40 years, and 41–45 years. The mean ± SEM values of the BASDAI score in various age groups were 6.8 ± 0.34, 6.3 ± 0.33, 6.2 ± 0.26, 7.1 ± 0.41, 6.5 ± 0.30, and 5.8 ± 0.48, respectively. The mean ± SEM values of VAS are shown in relation to the various age groups, i.e., 15–20 years, 21–25 years, 26–30 years, 31–35 years, 36–40 years, and 41–45 years and the values were 6.88 ± 0.312, 6.58 ± 0.22, 6.55 ± 0.66, 6.00 ± 0.23, 6.72 ± 0.25, and 6.0 ± 0.50, respectively. Conclusion: This study indicates that in the young age group, patients BASDAI score is higher and BMI is lower, and in the older age group, patients BASDAI score is lower and BMI is higher than each other indicating higher disease activity in the younger patients than older patients. An inverse correlation between VAS and age further substantiates our previous finding.
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Ulcerative colitis (UC) is one of the two types of inflammatory bowel disease (IBD) which is increasing worldover due to modern life style. Patients with UC are prone to develop colorectal cancer. While the disease severity decides the treatment option, researchers look towards herbal medicines with anti-inflammatory properties for minimal or nil side effects. Artemisia dracunculus L., commonly called Tarragon, is a medicinal herb used in traditional Asian medicine mainly in Iran, India, Pakistan and Azerbaijan due to its special compounds. In this study, we tried to elucidate the effects of aqueous extract of tarragon on acetic acid induced ulcerative colitis (UC) in rats. Male Wistar rats were grouped into four groups of eight each viz., control; experimental control (UC was induced via luminal instillation of 4% acetic acid); and UC induced + aqueous tarragon extract (100 mg/kg) or prednisolone (2 mg/kg) orally for ten consecutive days. Tissue specimens were collected after the experimental period for evaluation of caspase-3 and cyclooxygenase-2 (COX-2) expression by immunohistochemistry. Real-time PCR was used to monitor the levels of IL-1, IL-6 and TNF-? in colonic homogenates. Moreover, the levels of myeloperoxidase, nitric oxide and total antioxidant capacity were measured in colonic homogenates. The results showed that both treatment regimens could similarly reduce the severity of disease symptoms. Treatment with aqueous extract of tarragon caused a better improvement (P <0.05) in the levels of myeloperoxidase enzyme, and total antioxidant capacity of colonic homogenates compared to prednisolone. Nevertheless, the levels of the expression of caspase-3, and COX-2 and TNF-? were reduced in UC rats received prednisolone more than UC rats received aqueous extract of tarragon. The was no statistical difference in the levels of nitric oxide, IL-1 and IL-6 between UC rats received tarragon extract or prednisolone. Overall, these findings suggest that the aqueous extract of tarragon is a promising strategy to control ulcerative colitis. Aqueous extract can also be used as an anti-inflammatory and immune system stimulant in conditions where the immune system is damaged.
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Objective:To evaluate the diagnostic performance and clinical significance of SLE-DAS in the disease activity of SLE patients in China.Methods:The clinical data of 134 patients with SLE were collected. The disease activity was evaluated by SLE-DAS, SLEDAI-2000, BILAG-2004 and PGA scoring tools. Pearson test and Spearman test were used to analyze the correlation. The receiver operating characteristic curve (ROC curve) was used to evaluate SLE-DAS, and Kappa consistency test was adapted to assess the consistency of the two scoring methods.Results:One hundred and thirty-four patients with SLE, including 7 males and 127 females, aged 13-77 years, with an average of (35±13) years were included. Among them, renal involvement was 38.1%, skin mucosal involvement was 11.2%, musculoskeletal involvement was 8.2%, blood system involvement was 13.4%, heart and lung involvement was 2.2%, neuropsychiatric involvement was 1.5%, and multisystem involvement was 3.0%. SLE-DAS was positively correlated with CRP, ESR, anti-dsDNA antibody, urinary protein (24 h) level, SLEDAI-2000, BILAG-2004 and PGA ( r=0.25, 0.34, 0.47, 0.77, 0.93, 0.94, 0.95, P<0.01); SLE-DAS was negatively correlated with PLT, Hb, C3 and C4 ( r=-0.29, -0.43, -0.41, -0.32, P<0.01). When SLEDAI-2000>5 was used as a cut point for analyzing SLE-DAS, the results showed that the area under the curve (AUC) 95% CI of SLE-DAS was 0.961 (0.927,0.995), the Yoden index was 0.845. When the cut-off value was set up to 4.65( P<0.001), the sensitivity was 98.11%, the specificity was 86.42%, and the accuracy was 91.04%. Kappa consistency test showed that kappa value was 0.819( P<0.001). Conclusions:SLE-DAS can be used to evaluate the disease activity of SLE patients and can be used as the evidence to guide treatment plan in clinical practice.
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Objective:To investigate the expression and clinical significance of peptide/histidine transporter solute carrier family 15 member 4 (SLC15A4) in peripheral blood mononuclear cells (PBMCs) of patients with systemic lupus erythematosus (SLE).Methods:Fifty-five patients with SLE were divided into active SLE group and stable SLE group according to SLE disease activity index (SLEDAI) score, and 13 healthy volunteers were used as controls. The expression of SLC15A4 in PBMCs were detected by Western blot method. Moreover, the correlation between the expression of SLC15A4 and clinical and laboratory parameters of SLE patients were analyzed. The expression of SLC15a4 in the three groups was compared based on one-way analysis of variance (ANOVA), and the correlation between SLC15A4 expression level and clinical indicators was analyzed by Pearson correlation.Results:The expression levels of SLC15A4 in active SLE group, stable SLE group and healthy control group were (0.96±0.19), (0.88±0.14), (0.78±0.24), respectively. The expression level of SLC15A4 in SLE with active disease was higher than that in healthy controls ( F=4.47, P=0.015). In addition, the expression of SLC15A4 in PBMCs of SLE patients was positively correlated with the quantity of anti-double stranded DNA (anti-dsDNA) antibody, erythrocyte sedimentation rate (ESR) and systemic lupus erythematosus disease activity index (SLEDAI) ( r=0.29, P=0.031; r=0.36, P=0.007; r=0.32, P=0.017, respectively). However, the expression of SLC15A4 in PBMCs had no significant correlation with 24-h urinary protein ( r=0.45, P=0.127) and C3 ( r=0.20, P=0.133). Conclusion:SLC15A4 is involved in the pathogenesis of SLE and its expression in PBMCs of SLE patients can be used as an index to evaluate disease activity.
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Objective:To investigate the correlation between serum neutrophil to lymphocyte ratio (NLR), thrombospondin 1 (TSP-1), miR-210 and systemic lupus erythematosus disease activity index (SLEDAI) and the prognostic value of their combination.Methods:The medical records of 126 patients with systemic lupus erythematosus (SLE) in Haikou People′s Hospital (Haikou Hospital Affiliated to Xiangya Medical College of Central South University) from February 2018 to February 2020 were retrospectively analyzed. According to the recurrence of prognosis 6 months after treatment, they were divided into recurrence group ( n=23) and non recurrence group ( n=103). The general data, serum NLR, TSP-1, miR-210 levels and SLEDAI score before and after treatment of the two groups were compared. The relationship between the levels of serum indicators before and after treatment, SLEDAI score, prognosis and recurrence of SLE patients were analyzed, and the efficacy of single and combined serum indicators in predicting prognosis was explored. Results:The levels of serum NLR, TSP-1, miR-210 and SLEDAI score in the recurrence group were higher than those in the non recurrence group before and after treatment (all P<0.05); After treatment, the levels of serum NLR, TSP-1, miR-210 and SLEDAI score in the two groups were lower than those before treatment (all P<0.05). Pearson correlation analysis showed that the levels of serum NLR, TSP-1 and miR-210 in SLE patients were positively correlated with SLEDAI scores (all P<0.05); Cox regression analysis showed that after adjusting other factors such as complement C3, complement C4 levels and SLEDAI scores before and after treatment, serum NLR, TSP-1 and miR-210 before and after treatment were still significantly correlated with the risk of recurrence in SLE patients (all P<0.05); The receiver operating characteristic (ROC) curve showed that the area under curve (AUC) of serum NLR, TSP-1 and miR-210 combined to predict recurrence was 0.907 (95% CI: 0.842-0.951), the sensitivity was 86.96%, and the specificity was 83.50%, which was significantly higher than that of each index alone. Conclusions:Serum NLR, TSP-1, miR-210 levels in SLE patients are positively correlated with SLEDAI scores, and the combined detection of these indicators has a high predictive value for prognosis and recurrence, which can provide references for the diagnosis and treatment of SLE.
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OBJECTIVE: To observe the effect of medicated thread moxibustion of Zhuang Minority medicine on helper T cell 17 (Th17)/ Interleukin-17F(IL-17F) signaling pathway in ulcerative colitis (UC) rats, so as to explore its mechanisms underlying improvement of UC. METHODS: Forty male SD rats were randomly divided into normal control, model, medication and medicated thread moxibustion (MTM) groups, with 10 rats in each group. The UC model was induced by free drinking of 4% dextran sulfate sodium (DSS) for 10 d. After successful modeling, rats of the medication group were treated by gavage of salazosulfapyridine (SASP). Medicated thread moxibustion was applied to unilateral "Tianshu" (ST25) and "Qihai" (CV6) alternatively for rats of the MTM group, once daily for 14 d. The body mass, stool shape, and fecal occult test were recorded and conducted daily to perform disease activity index (DAI) score. H．E. staining was used to display pathological changes of the colon tissue. The Th17 cells and IL-17F and retinoic acid related orphan receptor γ t (ROR-γt) in the colon tissue were detected by flow cytometry, and enzyme-linked immunosorbent assay (ELISA), respectively, and the expression levels of RORγt and IL-17F mRNA in colon tissue were detected by quantitive real-time PCR. RESULTS: After modeling, the DAI score, colonic Th17 percentage, RORγt and IL-17F contents, and RORγt and IL-17F mRNA expression were significantly increased in the model group in contrast to the normal control group (P0.05, except RORγt and IL-17F mRNA expression). H．E. staining showed disappearance of goblet cells, infiltration of a large number of inflammatory cells, exfoliation of the epithelial tissue and edema of colonic mucosal in rats of the model group, which was relatively milder in both medication and MTM groups. CONCLUSION: Medicated thread moxibustion of Zhuang Minority medicine can reduce the inflammatory damage of colon tissue in UC rats, which is associated with its effects in suppressing the expression of RORγt, production of Th17 cells, and secretion of pro-inflammatory factor IL-17F in colon tissue.
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OBJECTIVE: To observe the effect of moxibustion and acupoint catgut embedding (ACE) at "Tianshu"(ST25) "Dachangshu"(BL25) and "Shangjuxu"(ST37) on changes of body mass, stool property, histopathological conditions and expression levels of interleukin 6 (IL-6) in colonic mucosa of ulcerative colitis (UC) rats, so as to reveal its anti-inflammatory mechanisms underlying improvement of UC. METHODS: SD rats were randomized into normal, model, moxibustion, ACE and moxibustion＋ACE groups (n＝6 in each group). The UC model was established by enema of trinitro-benzene-sulfonic acid and ethanol. Moxibustion was applied to bilateral ST25, BL25 and ST37 for 10 min, once daily for 14 days, and ACE applied to the same 3 acupoints, once a week for two weeks. After the treatment, the rats' general conditions were observed, and the severity of UC was assessed by using disease activity index (DAI) score. Colonic mucosal pathological changes were observed under microscope after hematoxylin eosin (H.E.) stain, and the expression levels of IL-6 in the colonic mucosa tissue detected by using immunohistochemical stain and Western blot, respectively. RESULTS: After modeling, the DAI score, and expression level of colonic IL-6 protein detected by immunohistochemistry and Western blot were obviously increased in the model group relevant to the normal group (P<0.01). Following the intervention, the increase of DAI score and IL-6 expression were reversed in moxibustion, ACE and moxibustion＋ACE groups (P<0.01, P<0.05). The therapeutic effects of moxibustion＋ACE were considerably superior to those of simple ACE and simple moxibustion in down-regulating the levels of DAI score and IL-6 expression (P<0.01). H．E. staining showed severe defect of the colonic mucosal epithelium with infiltration of a large number of inflammatory cells in the model group, which was milder in moxibustion, ACE and moxibustion＋ACE groups. CONCLUSION: Moxibustion combined with ACE is able to improve the inflammatory injury of colonic mucosa in UC rats, which may be related with its effect in suppressing the expression of colonic IL-6; and the efficacy of moxibustion＋ACE is apparently superior to that of moxibustion and ACE alone.
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Objective: To explore the expression levels of miR-23a-3p and miR-27a-3p in the sera of mice with ulcerative colitis (UC) and their potential action mechanisms. Methods: Twenty C57BL/6 mice were randomly divided into the control group and the model group with 10 mice in each group. The model group mice were induced orally by water with 5% dextran sulfate sodium (DSS) for 7 d. During the induction period, the general condition, fecal morphology and occult blood status of the mice were observed. After 7 d, the whole blood and colon tissues of mice were collected, and the colon lengths and wet weights were measured. The expressions of miR-23a-3p and miR-27a-3p in the sera were detected by qRT-PCR. The expressions of peroxisome proliferator-activated receptor γ, coactivator-1α (PPARGC1A), PH domain leucine-rich repeat protein phosphatase 2 (PHLPP2), B-cell lymphoma-2 (BCL-2), BCL-2 associated X protein (BAX), cytochrome c (CYT-C) and cleaved cysteine-containing aspartate-specific protease (cleaved-caspase-3) were detected by Western blotting. Results: After DSS induction, the model group mice showed mental depression, weight loss, diarrhea, and bloody stool, whose colon lengths were shortened and colon wet weights decreased. The UC model was constructed successfully. In the model group, the expressions of miR-23a-3p and miR-27a-3p in the sera decreased significantly (P<0.05), and the expressions of PPARGC1A, PHLPP2, BAX, CYT-C and cleavedcaspase- 3 in the colon tissues increased significantly (P<0.05), but BCL-2 decreased (P<0.05). Conclusion: The expressions of miR-23a-3p and miR- 27a-3p are low in the sera of UC mice, which may be involved in the occurrence and development of UC by up regulating the expressions of PPARGC1A and PHLPP2 in the colons and triggering mitochondrial pathway to induce apoptosis.
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Objective To investigate the expression of peripheral programmed death (PD)-1hiCXCR5-CD4+T cells and its clinical significance in systemic lupus erythematosus (SLE). Methods Peripheral blood PD-1hiCXCR5-CD4+ T cells from 21 SLE patients and 16 healthy controls were examined by flow cytometry. The levels of serum anti-double-stranded deoxyribonucleic acid (dsDNA) antibodies were determined using immunoradiometric as-say. Data were analyzed with t test and Pearson's correlation test. Results The per-centages of PD-1hiCXCR5- cells within CD4+ T cell were significantly higher in SLE patients [(2.1 ±2.0)％] compared to normal controls [(0.3±0.3)％] (t=2.959, P<0.01). The percentages of PD-1hiCXCR5-cells within CD4+T cells in moderate to severe active SLE patients (3.0 ±2.0)％ was significantly increased compared to patients with mild or inactive (1.0±1.4)％(t=2.574, P<0.05) and normal controls (0.3±0.3)％ (t=5.149, P<0.01). The percentages of PD-1hiCXCR5- cells within CD4+ T cells from SLE patients were positively related with systemic lupus erythematosus disease activity index (SLEDAI) (r=0.475, P=0.0297). SLE patients in serum anti-dsDNA antibodies positive group (2.7±2.1)％displayed a higher percentage of PD-1hiCXCR5-cells within CD4+T cells than patients in serum anti-dsDNA antibodies negative group (0.6 ±0.5)％ (t=2.303, P<0.05). The percentages of PD-1hiCXCR5-cells within CD4+T cells from SLE patients were positively correlated with anti-dsDNA antibody titers. Conclusion The percentages of PD-1hiCXCR5- cells within CD4+ T cells from SLE patients are increased and are positively correlated with SLEDAI and anti-dsDNA antibody levels. Increased percentage of PD-1hiCXCR5-cells within CD4+T cells might play an important role in the pathogenesis of SLE.
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Objective To observe the clinical efficacy of SHAO's five-needle therapy in treating active ulcerative colitis. Method By following a randomized controlled design, 57 patients with active ulcerative colitis were divided into a lung-intestine simultaneous treatment group of 28 cases and an intestine treatment group of 29 cases. The lung-intestine simultaneous treatment group was intervened by SHAO's five-needle therapy plus medications including oral administration of mesalazine, sulfasalazine suppositories via rectal insertion and Ge Gen Qin Lian decoction via enema; the intestine treatment group was intervened by medications. The two groups were both treated successively for4 weeks. The Sutherland Disease Activity Index (Sutherland DAI) was observed in the two groups and the release rate was also assessed; the main clinical symptom and sign scores of the two groups were recorded before and after treatment. Result The Sutherland DAI score dropped after treatment in both groups (P<0.05), and the between-group difference was statistically significant (P<0.05); the scores of abdominal pain, diarrhea and stool mixed with pus and blood declined after treatment in both groups (P<0.05), and the between-group differences were statistically significant (P<0.05); the lung-intestine simultaneous treatment group was superior to the intestine treatment group comparing plus medications the therapeutic efficacy regarding the symptoms and signs (P<0.05). Conclusion SHAO's five-needle therapy can rapidly release the clinical symptoms and body signs of active ulcerative colitis and enhance the clinical efficacy.
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Objective:To observe ulcer characteristics of Crohn's disease under double balloon enteroscopy,and to evaluate the correlation between endoscopic severity and clinical manifestations.Methods:A prospective,observational study from July 2015 to December 2016 in the Third Xiangya Hospital,Central South University,we selected 45 patients with positive double-balloon enteroscopy (DBE) and confirmed Crohn's disease.Two digestive internal physician observed the ulcer characteristics of Crohn's disease under double balloon enteroscopy,and gave a simple endoscopic score for CD (SES-CD).We analyzed the correlation between SES-CD and Crohn's disease activity index (CDAI).Results:DBE indicated 24 patient ulcers (53.33％) locating at the end of the ileum,5 (11.11％)locating at ileocolon,16 (35.56％) locating at upper gatrointestinal tract and they did not affect the end of the ileum.Among them,8 cases (17.78％) affected only jejunum.Thirty-two patients with longitudinal ulcers in Crohn's disease,accounting for 71.11％.There was no correlation between SES-CD score and CDAI score (r=0.237,P=0.136).Conclusion:The ulcerative appearance in Crohn's disease were diverse under double balloon enteroscopy.Crohn's disease could only affect the upper gastrointestinal tract or jejunum.The unwounded ileum and ileocecal valve couldn't be a sign to exclude Crohn's disease.CDAI score couldn't fully assess the prognosis of Crohn's disease.
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Objective To evaluate the value of CT enterography (CTE)imaging scores in assessing the clinical activity of Crohn's disease (CD).Methods Forty-eight patients with pathologically or clinically confirmed CD were collected retrospectively.The CTE findings associated with disease activity were analyzed and scored,and the well-known Crohn's disease activity index (CDAI)was also performed.The correlation between CTE score and CDAI score was analyzed by Pearson correlation method.The diagnostic efficacy and optimal diagnostic threshold of CTE score for clinical activity of CD were evaluated by ROC curve analysis.Results There was a good correlation between the CTE score and CDAI (r =0.790,P <0.001).ROC curve analysis showed the area under the curve (AUC)was 0.913 (P <0.001).The optimal diagnostic threshold was 5.5.A CTE score of 5.5 or above indicated the disease was active,with a sensitivity of 84.2％,specificity of 80％,positive predictive value of 94.1％,negative predictive value of 57.1％ and the Youden index of 0.642.Conclusion The CTE comprehensive score has high sensitivity and specificity for estimating clinical activity of CD.
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Objective To make a Meta-analysis of the effectiveness and safety of Shenling Baizhu Powder (SBP) for the treatment of ulcerative colitis(UC),thus to provide evidence for the clinical treatment of ulcerative colitis.Methods Randomized controlled trials (RCTs) of SBP combined with western medicine vs western medicine in treating ulcerative colitis were included.The quality of RCTs was assessed by the Cochrane scale.A Meta-analysis was performed for the clinical efficacy,improvement of disease activity index (DAI) levels of the included trials.Results A total of 19 RCTs were included,involving 1498 cases.The results of Metaanalysis showed that compared with the western medicine group,the combined risk ratio(RR) of clinical efficacy in the SBP combined group was 1.55,95％ confidence interval (CI) being (1.39,1.72).The subgroup analysis based on control medicine showed that the combined RR of combined use of sulfasalazine or mesalazine/Olsalazine was 1.46,1.59 [95％CI (1.19,1.77) vs 95％CI (1.40,1.80)].The subgroup analysis based on different treatment courses showed that the combined RR of 1-30 days,31-60 days,61-90 days was 1.42,1.69,1.47 [95％CI (1.18,1.70) vs 95％CI (1.44,1.97) vs 95％CI (1.15,1.88)] respectively.The differences were significant (P ＜ 0.05).(2) The differences of the two groups on the improvement of DAI and inflammatory factors levels of interlekin-17(IL-17),IL-23,tumor necrosis factor alpha(TNF-α),C-reactive protein(CRP) were statistically significant(P ＜ 0.05).(3)The sensitivity analysis of the primary outcomes showed a higher homogeneity in the literatures and the funnel plot analysis showed no evidence of publication bias.Conclusion Compared with western medicine,SBP combined with western medicine has better clinical efficacy for the treatment of UC,and the combined use of mesalazine/Olsalazine medicated for 30-60 days is more effective on improving DAI and inflammatory factors levels.However,for the low quality of the included literatures and insufficient experimental design,the conclusion needs more evidence from large sample-size randomized double-blind controlled trials.
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Fifty activity small intestinal Crohn's disease patients were enrolled in this study.Every patient was confirmed multidetector CT enterography (MDCTE) scanning.The CT imaging and scored accoeding to the CT findings were retrospectively analyzed.Patients were divided into mild,moderate,severe activities according to patients'Crohn's disease activity index(CDAI).The correlation between CT score and the CDAI was compared.Results showed that CT score and CDAI had significant correlation (r =0.825,P ＜ 0.825).The MDCTE score can be used for clinical evaluation of Crohn's disease activity.
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Objective To evaluate the value of CT enterography (CTE)imaging scores in assessing the clinical activity of Crohn's disease (CD).Methods Forty-eight patients with pathologically or clinically confirmed CD were collected retrospectively.The CTE findings associated with disease activity were analyzed and scored,and the well-known Crohn's disease activity index (CDAI)was also performed.The correlation between CTE score and CDAI score was analyzed by Pearson correlation method.The diagnostic efficacy and optimal diagnostic threshold of CTE score for clinical activity of CD were evaluated by ROC curve analysis.Results There was a good correlation between the CTE score and CDAI (r =0.790,P <0.001).ROC curve analysis showed the area under the curve (AUC)was 0.913 (P <0.001).The optimal diagnostic threshold was 5.5.A CTE score of 5.5 or above indicated the disease was active,with a sensitivity of 84.2％,specificity of 80％,positive predictive value of 94.1％,negative predictive value of 57.1％ and the Youden index of 0.642.Conclusion The CTE comprehensive score has high sensitivity and specificity for estimating clinical activity of CD.
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Intestinal Behçet's disease (BD), generally accepted as a type of inflammatory bowel disease (IBD), could be diagnosed when patients with BD have objectively documented gastrointestinal symptoms and intestinal ulcerations. Similar to IBD, intestinal BD has an unpredictable disease course with relapse and remission and is often related to a poor prognosis. However, there is no single gold standard for assessment of the disease activity of intestinal BD, and its diagnosis and management depend heavily on expert opinions. The Korean IBD Study Group recently developed novel diagnostic criteria based on colonoscopy findings and clinical manifestations using a modified Delphi process to overcome drawbacks of previously used consensus for the diagnosis of intestinal BD. In addition, the recently developed disease activity index for intestinal BD, consisting of a relatively simple 8-point index, could also help in determining treatment strategies and monitoring therapeutic responses. In this review, the progress in the diagnosis and disease activity measurement of intestinal BD will be discussed.
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Humans , Behcet Syndrome , Colonoscopy , Consensus , Diagnosis , Expert Testimony , Inflammatory Bowel Diseases , Prognosis , Recurrence , UlcerABSTRACT
Objective To investigate the percentage of CD177+ neutrophils in peripheral blood and inflamed mucosa of the intestine in patients with inflammatory bowel disease(IBD)and in healthy controls, and to investigate the correlation between CD177+ neutrophils and mucosal impairment as well as clinical characteristics. Methods A total of 54 patients with ulcerative colitis(UC),62 patients with Crohn disease (CD),and 48 healthy controls were enrolled. SYBR-green Realtime PCR was applied to determine the ex-pression proportion of CD177+ neutrophils in peripheral blood and in inflamed intestinal mucosa to investigate the correlation between CD177+ neutrophils and endoscopic and clinical disease activity. Results In periph-eral blood and inflamed mucosa of the intestine,the expression of CD177+ neutrophils was significantly higher than that in health controls or patients in remission stage(P< 0. 05),with higher proportion( P<0. 05). The expression of CD177+ neutrophils in peripheral blood and inflamed mucosa of the intestine was positively correlated with both endoscopic disease activity index and clinical severity of the disease( P <0. 05). Conclusion CD177+ neutrophils increase in peripheral blood and intestinal mucosa of patients with IBD. The percentage of CD177+ neutrophils is a favorable marker for both endoscopic disease activity and clinical severity of the disease. CD177+ neutrophils may play a vital role in the immune response in the intes-tinal mucosa,as a new subset of effector neutrophils.
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Objective To investigate whether expression quantity of HLA-B27 and its subtypes associated with incidence of AS,the gene expression of HLA-B27 and its subtypes were detected in patients with AS.Methods 120 cases patients sus-pected with AS and 50 healthy subjects were enrolled in the study.Main demographic and clinical characteristics of the sub-jects were collected.Meanwhile total RNA was isolated from peripheral blood and real time RT-PCR was used to measure the quantitative expression of HLA-B27 gene.Besides RT-PCR,sequence-based typing (SBT)method was used to confirm the HLA-B27 subtype.All experimental data were analyzed by SPSS17.0 software and P values <0.05 were considered to be significant.Results Firstly,there were 55 subjects were finally diagnosed as AS patients among the 120 patients suspec-ted with AS.There were 53 subjects whose HLA-B27 was positive (96.36%)in 55 patients with AS.It showed that there was a correlation between BASDAI and expression quantity of HLA-B27 gene (r=0.845,P =0.000).Five subtypes were found and which were HLA-B27∶04 subtype (29/53,54.72%),HLA-B27:05 subtype (20/53,37.74%),HLA-B27 ∶02 subtype (2/53,3.77%),HLA-B27∶03 subtype (1/53,1.89%)and HLA-B27∶07 subtype (1/53,1.89%),respectively. Among the 50 healthy subjects,there were only one kind of subtype (2/50,4%),which was HLA-B27∶04.There were no statistical difference in the age (t=0.711,P =0.480),sex (χ2 =0.880,P =0.348),family history (χ2 =0.011,P =0.916) and treatment (χ2 =0.113,P =0.736)between the HLA-B27∶04 and HLA-B27∶05 subtypes.Conclusion HLA-B27∶04 and HLA-B27∶05 were primary subtypes in AS patients which HLA-B27 positive.There was a correlation between gene expression quantity of HLA-B27 and AS disease activity index.
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The clinical manifestations and endoscopic changes of inflammatory bowel disease (IBD) are complex and vary greatly according to the severity of the problem.The activity of the inflammatory bowel disease,macroscopic and microscopic features are closely related to disease progression and treatment response.The activity and the severity of IBD can be defined by pediatric ulcerative colitis activity index (PUCAI) and pediatric Crohn's disease activity index(PCDAI).According to the Montreal standards and Paris consensus,the extent of the endoscopic intestinal involvement and the severity of the lesion can be determined.It reflects the local changes before and after the treatment and reactions as time goes on.It's helpful to evaluate the severity and the treatment efficacy of IBD,to carry out multi-center and large-scale research through the activity score,macroscopic and microscopic features evaluation.