中华消化杂志最新文献

{"title":"Mechanism of infliximab in preventing autoimmune hepatitis in mice model","authors":"Mengyu Sun, C. Wan, Mengnan Lyu, Yan Song, R. Ma, Wen-tian Liu","doi":"10.3760/CMA.J.ISSN.0254-1432.2020.03.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2020.03.011","url":null,"abstract":"Objective \u0000To observe the preventive effects of infliximab in autoimmune hepatitis (AIH) and to explore its mechanism. \u0000 \u0000 \u0000Methods \u0000The mice AIH model was established by injecting concanavalin A (Con-A) into the caudal vein. Forty mice were divided into prevention group and control group, with 20 mice in each group. The mice of prevention group were injected intravenously with infliximab (20 mg/kg) one hour before Con-A injection and the mice of control group were administrated with 200 μL phosphate buffered saline (PBS). Serum was collected 3, 8, 12 and 24 h after Con-A/PBS injection. The serum level of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) was detected by colorimetry. The level of cytokine interleukin (IL)-6, IL-1β, interferon gamma (IFN-γ), IL-4, IL-17A, IL-10 and chemokine C-X-C motif ligand 10 (CXCL10) was measured by enzyme-linked immunosorbent assay (ELISA). Liver samples were taken 12 h after Con-A/PBS injection for hematoxylin-eosin staining. Liver infiltrated lymphocytes were assessed by flow cytometry. The expression of T-box transcription factor 21 (TBX21), GATA binding protein 3 (GATA3), RAR related orphan receptor C (RORC) and CXCL10 at mRNA level was evaluated by quantitative real-time polymerase chain reaction (qRT-PCR). The expression of CXCL10 in liver was detected by Western blotting. Paired t test and one-way analysis of variance were used for statistic analysis. \u0000 \u0000 \u0000Results \u0000At 8, 12, and 24 h after Con-A injection, the serum ALT level, AST level, IL-1β and IFN-γ of prevention group were all lower than those of control group ((545.8±190.3) U/L vs. (865.8±237.7) U/L, (947.6±267.9) U/L vs. (1 448.0±403.5) U/L, (508.6±131.1) U/L vs. (976.6±207.6) U/L; (620.7±132.0) U/L vs. (952.9±106.8) U/L, (801.6±212.0) U/L vs. (1 424.8±236.0) U/L, (632.1±117.8) U/L vs. (1 008.3±187.5) U/L; (31.38±10.12) ng/L vs. (48.12±11.53) ng/L, (39.34±11.40) ng/L vs. (60.00±14.17) ng/L, (29.49±8.22) ng/L vs. (46.89±5.50) ng/L; and (432.93±66.82) ng/L vs. (674.66±97.88) ng/L, (655.09±169.17) ng/L vs. (937.90±166.36) ng/L, (263.40±54.97) ng/L vs. (410.74±86.64) ng/L), and the differences were statistically significant (t = 2.350, 2.308, 4.263, 4.374, 4.860, 3.806, 2.440, 2.541, 3.939, 4.560, 2.660 and 3.210; all P 0.05). \u0000 \u0000 \u0000Conclusions \u0000Infliximab has certain preventive effects in mice AIH model, which may be achieved by antagonizing TNF-α and decreasing the expression of CXCL10 in liver, reducing the infiltration of T-helper 1 cells and CD8+ T cells into liver, and by reducing T lymphocyte activation induced by inflammatory cytokines thus alleviating the damage of T lymphocytes to hepatocytes. \u0000 \u0000 \u0000Key words: \u0000Hepatitis, autoimmune; Infliximab; C-X-C motif chemokine ligand 10; Mice","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"25 1","pages":"192-198"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82851542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and risk factors of gastrointestinal symptoms in patients with novel coronavirus pneumonia in Xinyang, Henan province","authors":"Ye-ting Zhao, S. Zhong, Fang Li, Gang Liu, Xinfang Wang, Zhanju Liu","doi":"10.3760/CMA.J.ISSN.0254-1432.2020.0011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2020.0011","url":null,"abstract":"回顾性分析信阳市第五人民医院106例成人新型冠状病毒肺炎（COVID-19）患者的临床特征，了解河南省信阳地区COVID-19患者消化道症状临床特征和危险因素。筛选合并消化道症状8例患者为病例组，无消化道症状16例患者为对照组，结果发现病例组与对照组的临床症状、基础疾病和流行病学特征比较差异均无统计学意义（P均>0.05）。病例组中性粒细胞计数、C反应蛋白（CRP）、直接胆红素和肌红蛋白水平均高于对照组，差异均有统计学意义，OR值（95% CI）分别为2.021（1.012~2.123）、1.015（1.002~1.028）、1.062（1.008~1.357）和1.091（1.000~1.921），P均<0.05）。CRP水平升高是COVID-19患者出现消化道症状的独立危险因素（P < 0.05）。COVID-19患者合并消化道症状发生率为7.55%（8/106），有消化道症状者炎症活动和器官受累情况比无消化道症状者严重。","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81310457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manifestations of liver injury in 333 hospitalized patients with coronavirus disease 2019","authors":"Shuhui Wang, P. Han, Fang Xiao, Xiaofen Huang, Liping Cao, Zhenzhen Zhou, Shuai Xing, Jian Han, Liping Chen, Mi Wang, J. Dai, Q. Ding, S. Xiong, Wang Wei, Nan Meng, D. Tian, Wei Yan","doi":"10.3760/CMA.J.ISSN.0254-1432.2020.03.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2020.03.004","url":null,"abstract":"Objective \u0000To investigate the manifestations of liver injury in hospitalized patients with coronavirus disease 2019 (COVID-19), to investigate the prognosis indicators of the disease, and to provide the reference for clinical diagnosis and treatment. \u0000 \u0000 \u0000Methods \u0000From January 10 to February 14, 2020, at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, the data of 333 hospitalized patients with COVID-19 were collected. The changes of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), direct bilirubin (DBil), indirect bilirubin (IBil) and albumin of the first liver function test after admission and the reexaminations of liver function test during hospitalization period in patients with liver injury were retrospectively analyzed. Student t test and Chi-square test were used for statistical analysis. \u0000 \u0000 \u0000Results \u0000Liver injury occurred in 39.6% (132/333) of COVID-19 patients. There was no statistically significant difference in the rate of liver injury between patients in intensive care unit (ICU) and in general ward (45.6%, 26/57 vs. 38.4%, 106/276; χ2=1.026, P>0.05). 67.4% (89/132) of COVID-19 patients with liver injury presented with increased ALT or AST level on admission. During hospitalization, the level of ALT was higher than that of the first examination after admission ((60.28±50.44) U/L vs. (42.25±32.21) U/L), and the difference was statistically significant (t=-3.230, P<0.05). The levels of ALT and AST of 71.2% (94/132) patients were both <80 U/L, which indicated that most of the patients showed mild liver injury. The patients with elevated level of TBil, DBil and IBil accounted for 3.9% (13/333), 5.4% (18/333) and 2.4% (8/333) of the COVID-19 patients, respectively. The albumin level of COVID-19 patients with liver injury during hospitalization was lower than that of the first examination after admission ((31.8±5.1) g/L vs. (33.7±5.4) g/L), and the difference was statistically significant (t=2.712, P<0.05). The albumin levels at first examination on admission and reexamination during hospitalization of patients in ICU were both significantly lower than those of patients in general ward ((29.3±3.7) g/L vs. (34.8±5.1) g/L and (27.6±2.8) g/L vs. (32.9±5.1) g/L), and the differences were statistically significant (t=4.928 and 4.783, both P<0.05). \u0000 \u0000 \u0000Conclusions \u0000The incidence of liver injury in COVID-19 patients is high. A slight increase in aminotransferase levels is particularly common. Bilirubin abnormality is relatively rare and mild. The level of albumin may be one of the indicators for the severity and prognosis of COVID-19. \u0000 \u0000 \u0000Key words: \u00002019-nCoV; COVID-19; Liver injury; Albumin","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"15 1","pages":"157-161"},"PeriodicalIF":0.0,"publicationDate":"2020-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87370036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A survey on awareness of digestive system injury caused by corona virus disease 2019 in gastroenterologists/ 中华消化杂志","authors":"Hui Liu, Bin Wang, Kaijun Liu, Liangzhi Wen, Xing-wei Wang, Qin Li, Huiru Zhang, Dongfeng Chen, Yanling Wei, Hongli Cui, Yanmei Zhang","doi":"10.3760/CMA.J.ISSN.0254-1432.2020.03.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2020.03.005","url":null,"abstract":"Objective@#To investigate awareness of digestive system injury caused by corona virus disease 2019 (COVID-19) in gastroenterologists.@*Methods@#From February 21 to 23 in 2020, the electronic questionnaire was sent out to explore the condition of the basic knowledge of COVID-19 and knowledge of digestive system injury caused by COVID-19 grasped by gastroenterologists. Chi-square test was used for statistical analysis.@*Results@#A total of 2 216 gastroenterologists from 31 provinces, autonomous regions and municipalities nationwide completed the survey. 99.7% (2 209/2 216) of gastroenterologists stated that they had read the COVID-19 diagnosis and treatment guidelines. The percentage of physicians who well knew the diagnostic criteria of suspected and confirmed cases of COVID-19 was 34.9% (774/2 216) and 39.4% (874/2 216), respectively. The percentage of physician who gave the right answer of COVID-19 detectable methods and lung imaging was 68.4% (1 516/2 216) and 71.6% (1 586/2 216), respectively. The percentage of correct answer of digestive system injury caused by COVID-19 in residents, attending physicians, associate chief physicians and chief physicians was 30.9% (134/433), 33.9% (234/691), 32.4% (213/657) and 34.9% (152/435), respectively, however there were no statistically significant differences among physicians of different level (χ2=6.60, P> 0.05). 95.6% (2 119/2 216) of gastroenterologists believed that probiotics could effectively improve bowel function, and 94.0% (2 082/2 216) of gastroenterologists considered that enteral nutrition support could improve patients’ prognosis.@*Conclusions@#The knowledge and dynamic progress of the digestive system injury caused of COVID-19 are still insufficiently grasped by gastroenterologists in China. So it is necessary to carry out systematic and pertinent training for them.","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"44 1","pages":"162-166"},"PeriodicalIF":0.0,"publicationDate":"2020-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74956117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attention to the damage of 2019 novel coronavirus to digestive system and the possibility of fecal-oral transmission","authors":"X. Hou","doi":"10.3760/CMA.J.CN311367-20200225-00090","DOIUrl":"https://doi.org/10.3760/CMA.J.CN311367-20200225-00090","url":null,"abstract":"Since the end of December 2019, new coronavirus pneumonia (COVID-19) gradually rapid spread to all over the country, which with strong infectious and had become a major public health event concerned by the whole country. Although scientists devote to the research of COVID-19, however so far some public health related key factors such as the mode of virus transmission and infection route, are just known little. Current researches suggest that in addition to respiratory transmission, 2019 novel coronaviruses (2019-nCoV) may also have fecal-oral transmission. In clinical practice, it was found that part of patients initially present with gastrointestinal symptoms, and not a few patients are with digestive system injury. These findings put forward new requirements of COVID-19 prevention and therapeutic strategy. \u0000 \u0000 \u0000Key words: \u0000COVID-19; SARS-CoV-2; Digestive system damage; fecal-oral transmission","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72716073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manifestations of Digestive system in hospitalized patients with novel coronavirus pneumonia in Wuhan, China: a single-center, descriptive study/ 中华消化杂志","authors":"Dan Fang, Jingdong Ma, Jia-Lun Guan, Mu-ru Wang, Yang Song, D. Tian, Pei-Yuan Li","doi":"10.3760/CMA.J.ISSN.0254-1432.2020.0005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2020.0005","url":null,"abstract":"Objective@#To study the manifestations of digestive system of hospitalized patients with novel coronavirus pneumonia (NCP) in Wuhan, China, and to provide reference for disease control and treatment.@*Methods@#The data of hospitalized patients with NCP in the Sino-French Branch of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology was retrospectively analyzed, which included general information, nucleic acid test, severity degree of disease, incubation period, initial symptoms and manifestations of digestive system. The general information, positive rate of nucleic acid detection, and manifestations of digestive system were compared between critical patients who required non-invasive or invasive assisted ventilation (critical group) and non-critical patients without assisted ventilation (non-critical group). Continuous corrected chi-square test and independent sample median test were performed for statistical analysis.@*Results@#Among the 305 patients there were 146 males (47.9%) and 159 females (52.1%), median age 57 years old. Nucleic acid assay of nasopharynx swab or pharynx swab of 84.1% (228/271) patients were positive. Forty-six patients (15.1%) were in critical group and 259 patients (84.9%) were in non-critical group. The incubation period was one to fifteen days, and the median period was six days. The initial symptoms mainly were fever (81.1%, 163/201), cough (39.3%, 79/201), fatigue (54.7%, 110/201), and loss of appetite (50.2%, 101/201). In one to ten days after the disease onset, 79.1% (159/201) of patients developed gastrointestinal symptoms including nausea (29.4%, 59/201), vomiting (15.9%, 32/201), or abdominal pain (6.0%, 12/201). 49.5% (146/295) of patients had diarrhea, median time was 3.3 days, (3.3±1.6) times per day, and a duration of (4.1±2.5) days. Excluding possible drug-related diarrhea, the incidence of diarrhea still was 22.2%. Only 6.9% (4/58) of patients were found leukocytes or fecal occult blood positive in regular stool test. ALT, AST, or bilirubin increased in 39.1% (119/304) of patients at admission. Patients with ALT or AST ≥ 80 U/L only accounted for 7.9% (24/304) and 6.3% (19/304), respectively. About 2.0% (6/304) of patients also had increased bilirubin level, average level was (37.4 ± 21.1) μmol/L. The median age of critical group was older than that of non-critical group (65.5 years vs. 56 years), at admission the rates of abnormal liver function test abnormal and slightly increased AST (40~80 U/L) of critical group were both higher than those of non-critical group (67.4% (31/46) vs. 34.1% (88/258) and 47.8% (22/46) vs. 21.7% (56/228)), and the differences were statistically significant (x2=5.885, 18.154 and 15.723;all P 0.05).@*Conclusions@#The manifestation of digestive system of hospitalized NCP patients in Wuhan is significant, the ratio of patients with diarrhea and abnormal aminotransferase level is high. And at admission the rate of patients with abnormal liver fu","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89240816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in the digestive system of coronavirus infected patients","authors":"Liping Chen, Weixia Li, Cheng Tian, Jilin Cheng","doi":"10.3760/CMA.J.ISSN.0254-1432.2020.02.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2020.02.003","url":null,"abstract":"目前可感染人类的冠状病毒（HCoV）共有7种，其中严重急性呼吸综合征冠状病毒（SARS-CoV）、中东呼吸综合征冠状病毒（MERS-CoV）和正在流行的2019新型冠状病毒（2019-nCoV）的危害性大、传染性强，这3种冠状病毒感染的患者多存在消化系统表现，故除呼吸系统外，消化系统可能是冠状病毒又一潜在的感染靶标。本文就SARS-CoV、MERS-CoV和2019-nCoV感染引发的消化系统症状及其相关研究进展加以综述，以加深临床医师对冠状病毒感染所致消化系统损害的认识，从而做到快速有效的诊疗。","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"76 1","pages":"80-82"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86071140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and change trend of patients with Crohn′s disease at different onset times of perianal lesions","authors":"Haichao Wang, C. Ye, Yaling Wu, Pengyu Yang, Zhanju Liu, Xiaolei Wang","doi":"10.3760/CMA.J.ISSN.0254-1432.2020.02.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2020.02.007","url":null,"abstract":"Objective \u0000To investigate the clinical characteristics and change trend of patients with perianal lesions before or after Crohn′s disease (CD) diagnosed. \u0000 \u0000 \u0000Methods \u0000From January 2008 to September 2018, at The Tenth People′s Hospital Affiliated to Tongji University, the clinical data of 747 hospitalized CD patients were retrospectively collected, 293 patients were PCD patients. The clinical characteristics of PCD patients before or after CD diagnosed were analyzed and the change trend was followed. T test, Mann-Whitney U test, and Chi-square test were performed for statistical analysis. Multivariate logistic regression analysis was used to analyze factors associated with perianal lesions onset time. Spearman correlation analysis was used to analyze the change trend of clinical characteristics. \u0000 \u0000 \u0000Results \u0000Before CD diagnosis, 86.3% (253/293) PCD patients had perianal lesions. The median follow-up time (range) was 72 months (36 to 108 months). Compared with the patients presented with perianal lesions after CD diagnosis, the onset age of patients with perianal lesions before CD diagnosis was younger ((36.0±12.6) years vs. (24.2±10.2) years), and the rates of male (62.5%, 25/40 vs. 77.9%, 197/253), non-structuring and non-penetrating type (32.5%, 13/40 vs. 56.9%, 144/253) and perianal surgery (55.0%, 22/40 vs.76.7%, 194/253) were high, but low rate of abdominal surgery (37.5%, 15/40 vs. 13.0%, 33/253), and the differences were statistically significant (t=2.630, χ2=4.442, 8.379, 8.379 and 15.081; all P<0.05). The results of logistic multivariate analysis showed that before CD diagnosis, non-structuring and non-penetrating type was more common than structuring type (odds ratio (OR)=0.447, 95% confidence interval (CI) 0.207 to 0.962, P=0.039) and penetrating type (OR=0.264, 95%CI 0.089 to 0.780, P=0.016). The short disease duration of CD (OR=0.981, 95%CI 0.968 to 0.995, P=0.008), structuring type (OR=2.239, 95%CI 1.040 to 4.822, P=0.039) and penetrating type (OR=3.788, 95%CI 1.281 to 11.198, P=0.016) were the risk factors of perianal lesions after CD diagnosed. The number of PCD patients (r=0.964, P<0.01) and the proportion of biological agents (r=0.879, P<0.01) increased with years, while PCD duration (r=-0.828, P<0.01) and the rate of abdominal surgery significantly decreased with years (r=-0.882, P<0.01). The proportion of biological agents was negatively correlated with the rate of abdominal surgery (r=-0.770, P=0.006). \u0000 \u0000 \u0000Conclusions \u0000The perianal lesions should be closely monitored in adult CD patients with short disease duration, structuring type and penetrating type for early diagnosis and treatment. Biological agents can improve the clinical outcomes of PCD. \u0000 \u0000 \u0000Key words: \u0000Crohn disease; Perianal disease; Characteristics; Onset time; Trend","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"298 1","pages":"99-104"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80626833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics of patients with autoimmune liver disease complicated with gallbladder stone","authors":"Man Liu, Zhong-qing Zheng, Simin Zhou, Hongxia Zhang, H. Chu, Xiaoyi Wang, Jie Zhang, Lu Zhou, Bangmao Wang","doi":"10.3760/CMA.J.ISSN.0254-1432.2020.02.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2020.02.008","url":null,"abstract":"Objective \u0000To explore the clinical characteristics of liver function of patients with autoimmune liver disease (AILD) complicated with gallbladder stone (GS), so as to guide clinical practice. \u0000 \u0000 \u0000Methods \u0000From November 2009 to October 2018, at General Hospital of Tianjin Medical University, the clinical data of 386 patients with AILD were retrospectively analyzed. According to the relevant diagnostic criteria, 208 cases of autoimmune hepatitis (AIH), 129 cases of primary biliary cholangitis (PBC) and 49 cases of PBC-AIH overlap syndrome were screened out. The incidence, clinical characteristics and the changes of laboratory indicators including albumin, alkaline phosphatase (ALP) and γ-glutamyl transferase (GGT) of AILD patients complicated with GS were analyzed. Chi-square test, t test and rank sum test were performed for statistical analysis. \u0000 \u0000 \u0000Results \u0000There was no significant difference in the incidence between AILD, AIH, PBC and PBC-AIH overlap syndrome patients complicated with GS (32.9%, 127/386; 28.8%, 60/208; 36.4%, 47/129 and 40.8%, 20/49; respectively; P>0.05). Gallstones of AILD patients complicated with GS mostly were multiple and small stones with maximum diameter <1 cm (45.7%, 58/127 and 57.7%, 60/104, respectively). The age of initial diagnosis, the proportion of liver cirrhosis at inital diagnosis and the levels of ALP and GGT were higher in AILD patients complicated with GS than those of AILD patients without GS ((60.5±11.5) years vs. (57.6±11.5) years; 53.5%, 68/127 vs. 42.1%, 109/259; 154.00 U/L (89.00 U/L, 257.00 U/L) vs. 125.00 U/L (86.00 U/L, 212.00 U/L); 169.00 U/L (79.00 U/L, 343.00 U/L) vs. 128.60 U/L (48.00 U/L, 284.00 U/L); respectively); however the albumin level was lower than that of AILD patients without GS ((36.46±7.30) g/L vs. (38.34±7.58) g/L), and the differences were statistically significant (t=-2.361, χ2=4.506, Z=-2.192, -2.443, t=2.322; all P<0.05). The incidence of GS in AILD patients≥60 years old was higher than that AILD patients<60 years old (37.6%, 73/194 vs. 28.1%, 54/192), and the difference was statistically significant (χ2=3.948, P=0.047). The incidence of GS in AILD patients and AIH patients complicated with liver cirrhosis was higher than that in patients without liver cirrhosis (38.4%, 68/177 vs. 28.2%, 59/209; 35.7%, 35/98 vs. 22.7%, 25/110; respectively), and the differences were statistically significant (χ2=4.506 and 4.259, P=0.034 and 0.039). \u0000 \u0000 \u0000Conclusions \u0000AILD patients complicated with GS are common, most are multiple and small stones. When complicated with GS, the initial diagnosis may be delayed and the rate of liver cirrhosis at initial diagnosis may increase. The incidence of GS is high in AILD patients with older age and liver cirrhosis. \u0000 \u0000 \u0000Key words: \u0000Liver cirrhosis; Autoimmune liver disease; Gallbladder stone; Liver function; Age","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"13 5 1","pages":"105-109"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78398774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical value of sequential organ failure assessment score in evaluating organ function in acute pancreatitis","authors":"Xi Zheng, Lei Li, Yin Zhu, N. Lyu, W. He","doi":"10.3760/CMA.J.ISSN.0254-1432.2020.02.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2020.02.009","url":null,"abstract":"Objective \u0000To compare the clinical value of sequential organ failure assessment (SOFA) score and revised Marshall score in evaluating organ function in acute pancreatitis (AP). \u0000 \u0000 \u0000Methods \u0000From January 2013 to December 2017, at the Department of Gastroenterology of The First Affiliated Hospital of Nanchang University, the clinical data of 3 957 hospitalized AP patients were collected through the AP electronic database. AP was diagnosed and the severity of the disease was classified according to the revised Atlanta classification criteria. Organ function was evaluated by modified Marshall score and SOFA score. The correlation between SOFA score and mortality, pancreatic necrosis were analyzed. Chi-square test and Spearman correlation analysis were performed for statistical analysis. \u0000 \u0000 \u0000Results \u0000The incidences of circulatory failure and renal failure determined by the SOFA score were higher than those of the modified Marshall score (4.80%, 190/3 957 vs. 3.03%, 120/3 957; 10.11%, 400/3 957 vs. 6.44%, 255/3 957), and the differences were statistically significant (χ2=1 599.54 and 2 237.19, both P<0.01). Two score systems were consistent in determining the incidence of respiratory failure, which were 32.22% (1 275/3 957). The incidences of persistent circulatory failure (≥48 h) and persistent renal failure (≥48 h) determined by the SOFA score were higher than those of the modified Marshall score (1.64%, 65/3 957 vs. 0.76%, 30/3 957; 4.78%, 189/3 957 vs. 3.69%, 146/3 957), and the differences were statistically significant (χ2=1 458.37 and 2 398.01, both P<0.01). The incidence of persistent respiratory failure (≥48 h) was same determined by two score systems, which were 10.24% (405/3 957). The proportion of patients with severe AP determined by SOFA score was higher than that of the modified Marshall score (25.30%, 1 001/3 957 vs. 18.83%, 745/3 957), and the difference was statistically significant (χ2=718.216, P<0.01). The results of Spearman correlation analysis showed that SOFA total score was positively correlated with the overall mortality and the incidence of pancreatic necrosis (correlation coefficients r were 0.540 and 0.211, respectively), and the differences were statistically significant (both P<0.01). \u0000 \u0000 \u0000Conclusion \u0000SOFA score can comprehensively evaluate organ function in AP and is an important approach in determining prognosis. \u0000 \u0000 \u0000Key words: \u0000Sequential organ failure assessment score; Acute pancreatitis; Revised Marshall score; Organ function","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"26 1","pages":"110-114"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90360266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}