Exploring the impact of acute viral exposure on clinical characteristics and antibody profiles in antiphospholipid syndrome: a study in CAPSTONE.

The relationship between antiphospholipid syndrome (APS) and acute viral infection, such as SARS-CoV-2, is unclear. This study aims to assess symptoms, antiphospholipid antibody (aPL) fluctuations, and complication risks in APS patients infected with SARS-CoV-2. APS patients from Peking Union Medical College Hospital during the COVID-19 outbreak (October-December 2022) were included. Age- and gender-matched APS patients without infection served as controls. Data on demographics, symptoms, treatments, and serum aPL levels were analyzed. Of 234 APS patients, 107 (45.7%) were infected with SARS-CoV-2. Typical symptoms included high fever (81.3%), cough/expectoration (70.1%), and pharyngalgia (52.3%). Age- and gender-based matching selected 97 patients in either infected or uninfected group. After infection, anti-ß-2-glycoprotein I-IgG (aß2GP1-IgG) increased from 4.14 to 4.18 AU/ml, aß2GP1-IgM decreased from 9.85 to 7.38 AU/ml, and anticardiolipin-IgA (aCL-IgA) significantly increased with a median remaining at 2.50 APLU/ml. Lupus anticoagulants and other aPLs remained stable. Arterial thrombosis incidence increased from 18 (18.6%) to 21 (21.6%), while venous thrombosis incidence did not change. Additionally, 7 (6.5%) patients presented either new-onset or worsening thrombocytopenia, characterized by a significant decline in platelet count (no less than 10 × 109/L) within two weeks of SARS-CoV-2 infection, all of which recovered within 2 weeks. Acute SARS-CoV-2 infection may induce or worsen thrombocytopenia but does not substantially increase thrombotic events in APS. The process of SARS-CoV-2 infection was related to mild titer fluctuation of aß2GP1-IgG, aß2GP1-IgM and aCL-IgA in APS patients, necessitating careful monitoring and management.

Optimized treatment for severe ulcerative colitis: A case report. / é‡åº¦æºƒç–¡æ€§ç»“è‚ ç‚Ž1ä¾‹å† ç§‘ä¼˜åŒ–æ²»ç–—.

Severe ulcerative colitis is usually severe and rapidly progressive, with a particularly high risk of life-threatening complications and colectomy. For ulcerative colitis, surgical treatment may be considered when medical treatment fails. A case of severe ulcerative colitis failed to be treated with conventional drugs, resulting in complications such as hypotension shock, which met the indication of surgery. Since the patient was a young unmarried female, there were risks of life quality, sexual dysfunction, and infertility after surgery. Therefore, after analyzing the reasons for the poor curative effect of internal medicine, taking standardized treatment schemes, fully enhancing nutritional support, regulation of intestinal microecology, and other individualized treatments were taken. The patients changed from severe to mild. It is suggested that nutritional support is as important as drug therapy in ulcerative colitis.

Changes in the intestinal microecology induced by bacillus subtilis inhibit the occurrence of ulcerative colitis and associated cancers: a study on the mechanisms.

This study aimed to explore how changes in intestinal floras caused by Bacillus subtilis (Bs) inhibited occurrence of ulcerative colitis (UC) and associated cancers. Bs was used as an intervention in an azoxymethane (AOM)/dextran sodium sulfate sodium (DSS) animal model. Stool specimens were analyzed for changes in intestinal floras. Disease activity index (DAI) scores, body mass indices, cancer counts, and other indices were calculated, while changes in the colon mucosa were observed. Compared with AOM/DSS group, carcinogenesis significantly reduced and intestinal inflammations and DAI score alleviated; diversity, evenness, and number of species of floras significantly increased; and relative abundances of Rikenellaceae and Lactobacillus increased when UC developed into cancers in the AOM/DSS + Bs group. Colon epitheliums in the mice were severely damaged in the AOM/DSS group, while mucosae were repaired in the AOM/DSS + Bs group. The mRNA expression levels of IL-6 and IL-17a were lower while those of IL-10 and TGF-ß1 were higher, and the expression level of Ki-67 decreased while that of caspase 3 increased in the AOM/DSS + Bs group. Bs intervention could alter the structure of intestinal floras, repair the mucosal barrier, adjust immunity, and reduce the incidence of cancer in the AOM/DSS animal model.

[Small fugal enteritis manifestation with intestinal obstruction and hematochezia: a case report].

Fungal enteritis was rarely reported. A case of fungal enteritis manifestation with jejunum multiple ulcers and obstruction was treated by Department of Gastroenterology, Third Xiangya Hospital, Central South University. After antifungal treatment, the clinical symptoms were relieved, and the ulcers in jejunal and upper gastrointestinal tract were healed completely. Clinical manifestation for small fungal enteritis is special, and the small intestine ulcer is easily to be misdiagnosed. It is helpful to prevent the misdiagnose for small fungal enteritis if we can tell the clinical features for this disease.