Celiac disease(CD)is a chronic immune-mediated intestinal disease with genetic susceptibility.It is characterized by inflammatory damage to the small intestine after ingestion of cereals and products containing gluten...Celiac disease(CD)is a chronic immune-mediated intestinal disease with genetic susceptibility.It is characterized by inflammatory damage to the small intestine after ingestion of cereals and products containing gluten protein.In recent years,the global prevalence rate of CD has been approximately 1%,and is gradually increasing.CD patients adhere to a gluten-free diet(GFD)throughout their entire life.However,it is difficult to adhere strictly to a GFD.Untreated CD may be accompanied by gastrointestinal symptoms,such as diarrhea,abdominal pain,and extraintestinal symptoms caused by secondary malnutrition.Many studies have suggested that CD is associated with intestinal tumors such as enteropathyassociated T-cell lymphoma(EATL),small bowel cancer(SBC),and colorectal cancer.In this study,we reviewed related studies published in the literature to provide a reference for the prevention and treatment of intestinal tumors in patients with CD.Compared with the general population,CD patients had a high total risk of SBC and EATL,but not colorectal cancer.The protective effect of GFD on CD-related malignancies is controversial.Further studies are needed to confirm whether GFD treatment can reduce the risk of intestinal neoplasms in CD.展开更多
BACKGROUND Research on celiac disease(CD)in northwest China is still in its infancy.At present,large-sample data on the epidemiological,clinical,and pathological characteristics of CD are limited.AIM To investigate th...BACKGROUND Research on celiac disease(CD)in northwest China is still in its infancy.At present,large-sample data on the epidemiological,clinical,and pathological characteristics of CD are limited.AIM To investigate the epidemiological,clinical,and pathological characteristics of CD in northwest China.METHODS The clinical data of 2884 patients with gastrointestinal(GI)symptoms were retrospectively analyzed.Total immunoglobulin A(IgA)and anti-tissue transglutaminase(tTG)IgA levels were examined in all patients.Gastroscopy and colonoscopy were performed in patients with positive anti-tTG IgA and deficient total IgA levels.Atrophy of the duodenal and ileal villi was examined and histopathological examinations were performed.The modified Marsh–Oberhuber classification system was used to grade villous atrophy in the duodenum or distal ileum.The patients’Helicobacter pylori(H.pylori)infection status was compared in terms of clinical presentation and Marsh grade.Statistical analyses were performed using the t-test or chi-square test.RESULTS Among the 2884 patients,73 were positive for serum anti-tTG IgA,and 50 were diagnosed with CD.The CD detection rate was significantly higher in Kazakhs(4.39%)than in Uyghurs(2.19%),Huis(0.71%),and Hans(0.55%).The main symptoms of CD were chronic diarrhea,anorexia,anemia,fatigue,weight loss,sleep disorders,osteopenia,and osteoporosis.The body mass index of patients with CD was significantly lower than that of patients without CD.A total of 69 patients with positive serum anti-tTG IgA and two patients with deficient total IgA levels underwent GI endoscopy.Endoscopy revealed crypt hyperplasia and/or duodenal villous atrophy,mainly manifested as nodular mucosal atrophy,grooves,and fissures.The difference in H.pylori infection rates was not statistically significant between CD and non-CD patients but was significantly different among CD patients with different Marsh grades.CONCLUSION Among the patients with GI symptoms in northwestern China,the prevalence of CD was more in the Uyghur and Kazakh populations.H.pylori infection may be associated with CD severity.展开更多
Cardiovascular health metrics are now widely recognized as modifable risk factors for cognitive decline and dementia.Metabolic perturbations might play roles in the linkage of cardiovascular diseases and dementia.Circ...Cardiovascular health metrics are now widely recognized as modifable risk factors for cognitive decline and dementia.Metabolic perturbations might play roles in the linkage of cardiovascular diseases and dementia.Circulating metabolites profling by metabolomics may improve understanding of the potential mechanism by which cardiovascular risk factors contribute to cognitive decline.In a prospective community-based cohort in China(n=725),312 serum metabolic phenotypes were quantifed,and cardiovascular health score was calculated including smoking,exercise,sleep,diet,body mass index,blood pressure,and blood glucose.Cognitive function assessments were conducted in baseline and follow-up visits to identify longitudinal cognitive decline.A better cardiovascular health was signifcantly associated with lower risk of concentration decline and orientation decline(hazard ratio(HR):0.84–0.90;p<0.05).Apolipoprotein-A1,high-density lipoprotein(HDL)cholesterol,cholesterol ester,and phospholipid concentrations were signifcantly associated with a lower risk of longitudinal memory and orientation decline(p<0.05 and adjusted-p<0.20).Mediation analysis suggested that the negative association between health status and the risk of orientation decline was partly mediated by cholesterol ester and total lipids in HDL-2 and-3(proportion of mediation:7.68–8.21%,both p<0.05).Cardiovascular risk factors were associated with greater risks of cognitive decline,which were found to be mediated by circulating lipoproteins,particularly the medium-size HDL components.These fndings underscore the potential of utilizing lipoproteins as targets for early stage dementia screening and intervention.展开更多
background and purpose Clinical features of epileptic seizures after cerebral venous sinus thrombosis(CVST)among Chinese patients are not known,and it is still controversial whether seizures would affect the outcome o...background and purpose Clinical features of epileptic seizures after cerebral venous sinus thrombosis(CVST)among Chinese patients are not known,and it is still controversial whether seizures would affect the outcome of CVST.Methods In a Chinese hospital-based study of consecutive patients with CVST between 2003 and 2015,we described the clinical features of seizures and determined the predictors of seizure onset using multivariable logistic regression analysis.We also compared the in-hospital case-fatality and short-term functional outcome(modified Rankin Scale(mRS)at discharge)in patients with versus without seizures using ordinal regression analysis.results Among 151 patients with CVST,52(34.4%)presented seizures,of which 42(80.8%)were generalised seizures.Male gender(OR 6.32,95% CI 2.06 to 19.35,p=0.001),motor deficits(OR 4.89,95% CI 1.52 to 15.68,p=0.008),intracerebral haemorrhage(OR 3.93,95% CI 1.16 to 13.26,p=0.027),cerebral infarction(OR 3.78,95% CI 1.15 to 12.36,p=0.029)and superior sagittal sinus thrombosis(OR 3.38,95% CI 91.16 to 9.86,p=0.026)were independent predictors for seizures.The overall in-hospital case-fatality rate was 2.0%(3/151),and 21(13.9%)had mRS>2 at discharge.Compared with patients without seizures,patients with seizures were more likely to have a worse outcome(p=0.02)at discharge,independent of age,gender,clinical presentation,clot burden and presence of parenchymal lesions.conclusions In Chinese Han patients,compared with patients without seizures,patients with seizures after CVST had a worse outcome.Risk factors such as male gender,paresis,parenchymal lesion and superior sagittal sinus thrombosis were independently associated with seizure onset after CVST.Generalised seizure was the main form of seizures after CVST,which was obviously different to seizures after strokes of arterial origin.展开更多
基金Supported by The National Natural Science Foundation of China,No.81760101.
文摘Celiac disease(CD)is a chronic immune-mediated intestinal disease with genetic susceptibility.It is characterized by inflammatory damage to the small intestine after ingestion of cereals and products containing gluten protein.In recent years,the global prevalence rate of CD has been approximately 1%,and is gradually increasing.CD patients adhere to a gluten-free diet(GFD)throughout their entire life.However,it is difficult to adhere strictly to a GFD.Untreated CD may be accompanied by gastrointestinal symptoms,such as diarrhea,abdominal pain,and extraintestinal symptoms caused by secondary malnutrition.Many studies have suggested that CD is associated with intestinal tumors such as enteropathyassociated T-cell lymphoma(EATL),small bowel cancer(SBC),and colorectal cancer.In this study,we reviewed related studies published in the literature to provide a reference for the prevention and treatment of intestinal tumors in patients with CD.Compared with the general population,CD patients had a high total risk of SBC and EATL,but not colorectal cancer.The protective effect of GFD on CD-related malignancies is controversial.Further studies are needed to confirm whether GFD treatment can reduce the risk of intestinal neoplasms in CD.
基金Supported by National Natural Science Foundation of China,No.81760101Natural Science Foundation of Xinjiang Uygur Autonomous Region,No.2021D01C149。
文摘BACKGROUND Research on celiac disease(CD)in northwest China is still in its infancy.At present,large-sample data on the epidemiological,clinical,and pathological characteristics of CD are limited.AIM To investigate the epidemiological,clinical,and pathological characteristics of CD in northwest China.METHODS The clinical data of 2884 patients with gastrointestinal(GI)symptoms were retrospectively analyzed.Total immunoglobulin A(IgA)and anti-tissue transglutaminase(tTG)IgA levels were examined in all patients.Gastroscopy and colonoscopy were performed in patients with positive anti-tTG IgA and deficient total IgA levels.Atrophy of the duodenal and ileal villi was examined and histopathological examinations were performed.The modified Marsh–Oberhuber classification system was used to grade villous atrophy in the duodenum or distal ileum.The patients’Helicobacter pylori(H.pylori)infection status was compared in terms of clinical presentation and Marsh grade.Statistical analyses were performed using the t-test or chi-square test.RESULTS Among the 2884 patients,73 were positive for serum anti-tTG IgA,and 50 were diagnosed with CD.The CD detection rate was significantly higher in Kazakhs(4.39%)than in Uyghurs(2.19%),Huis(0.71%),and Hans(0.55%).The main symptoms of CD were chronic diarrhea,anorexia,anemia,fatigue,weight loss,sleep disorders,osteopenia,and osteoporosis.The body mass index of patients with CD was significantly lower than that of patients without CD.A total of 69 patients with positive serum anti-tTG IgA and two patients with deficient total IgA levels underwent GI endoscopy.Endoscopy revealed crypt hyperplasia and/or duodenal villous atrophy,mainly manifested as nodular mucosal atrophy,grooves,and fissures.The difference in H.pylori infection rates was not statistically significant between CD and non-CD patients but was significantly different among CD patients with different Marsh grades.CONCLUSION Among the patients with GI symptoms in northwestern China,the prevalence of CD was more in the Uyghur and Kazakh populations.H.pylori infection may be associated with CD severity.
基金the National Key Research and Development program of China(2022YFC3400700,2022YFA0806400,2021YFC2500100,2020YFE0201600)the Science and Technology Innovation 2030 Major Projects(2022ZD0211600)+5 种基金the Shanghai Rising-Star Program(22QA1404000)Shanghai Municipal Science and Technology Major Project(2017SHZDZX01)the Natural Science Foundation of Shanghai,China(22ZR1405300)the National Natural Science Foundation of China(31821002)the Key Research and Development Plans of Jiangsu Province,China(BE2021696)the Greater Bay Area Institute of Precision Medicine(Guangzhou).
文摘Cardiovascular health metrics are now widely recognized as modifable risk factors for cognitive decline and dementia.Metabolic perturbations might play roles in the linkage of cardiovascular diseases and dementia.Circulating metabolites profling by metabolomics may improve understanding of the potential mechanism by which cardiovascular risk factors contribute to cognitive decline.In a prospective community-based cohort in China(n=725),312 serum metabolic phenotypes were quantifed,and cardiovascular health score was calculated including smoking,exercise,sleep,diet,body mass index,blood pressure,and blood glucose.Cognitive function assessments were conducted in baseline and follow-up visits to identify longitudinal cognitive decline.A better cardiovascular health was signifcantly associated with lower risk of concentration decline and orientation decline(hazard ratio(HR):0.84–0.90;p<0.05).Apolipoprotein-A1,high-density lipoprotein(HDL)cholesterol,cholesterol ester,and phospholipid concentrations were signifcantly associated with a lower risk of longitudinal memory and orientation decline(p<0.05 and adjusted-p<0.20).Mediation analysis suggested that the negative association between health status and the risk of orientation decline was partly mediated by cholesterol ester and total lipids in HDL-2 and-3(proportion of mediation:7.68–8.21%,both p<0.05).Cardiovascular risk factors were associated with greater risks of cognitive decline,which were found to be mediated by circulating lipoproteins,particularly the medium-size HDL components.These fndings underscore the potential of utilizing lipoproteins as targets for early stage dementia screening and intervention.
文摘background and purpose Clinical features of epileptic seizures after cerebral venous sinus thrombosis(CVST)among Chinese patients are not known,and it is still controversial whether seizures would affect the outcome of CVST.Methods In a Chinese hospital-based study of consecutive patients with CVST between 2003 and 2015,we described the clinical features of seizures and determined the predictors of seizure onset using multivariable logistic regression analysis.We also compared the in-hospital case-fatality and short-term functional outcome(modified Rankin Scale(mRS)at discharge)in patients with versus without seizures using ordinal regression analysis.results Among 151 patients with CVST,52(34.4%)presented seizures,of which 42(80.8%)were generalised seizures.Male gender(OR 6.32,95% CI 2.06 to 19.35,p=0.001),motor deficits(OR 4.89,95% CI 1.52 to 15.68,p=0.008),intracerebral haemorrhage(OR 3.93,95% CI 1.16 to 13.26,p=0.027),cerebral infarction(OR 3.78,95% CI 1.15 to 12.36,p=0.029)and superior sagittal sinus thrombosis(OR 3.38,95% CI 91.16 to 9.86,p=0.026)were independent predictors for seizures.The overall in-hospital case-fatality rate was 2.0%(3/151),and 21(13.9%)had mRS>2 at discharge.Compared with patients without seizures,patients with seizures were more likely to have a worse outcome(p=0.02)at discharge,independent of age,gender,clinical presentation,clot burden and presence of parenchymal lesions.conclusions In Chinese Han patients,compared with patients without seizures,patients with seizures after CVST had a worse outcome.Risk factors such as male gender,paresis,parenchymal lesion and superior sagittal sinus thrombosis were independently associated with seizure onset after CVST.Generalised seizure was the main form of seizures after CVST,which was obviously different to seizures after strokes of arterial origin.
