Ulcerative colitis complicated with colonic necrosis, septic shock and venous thromboembolism: A case report

BACKGROUND Severe total colonic necrosis,septic shock and venous thromboembolism secondary to ulcerative colitis (UC) are rare and life-threatening.No such severe complications have been reported in the literature.CASE SUMMARY We report a 36-year-old woman who developed total colonic necrosis and septic shock secondary to UC.The patient was treated with emergency surgery because computed tomography showed suspicious perforations.Persistent massive ascites occurred after operation and computed tomography angiography demonstrated portal vein,mesenteric vein and splenic vein thrombosis.The patient was discharged from hospital after active treatment.CONCLUSION Clinicians should pay attention to venous thrombosis,colonic necrosis and septic shock in UC patients.Close observation of surgical indications and timely surgical intervention are the key to reduce mortality and complications in UC.

Impact of heart failure on outcomes in patients with sepsis:A systematic review and meta-analysis

BACKGROUND Heart failure(HF)often affects the progress of sepsis patients,although its impact on outcomes is inconsistent and inconclusive.AIM To conduct a systematic review and meta-analysis of the impact of HF on mortality in patients with sepsis.METHODS PubMed,Embase,Web of Science,and the Cochrane Library databases were searched to compare the outcomes of sepsis patients with HF.A random effect model was used to summarize the mortality data,and the odds ratio(OR)and 95%confidence interval(CI)were calculated as effect indicators.RESULTS Among 18001 records retrieved in the literature search,35712 patients from 10 separate studies were included.The results showed that sepsis patients with HF were associated with increased total mortality(OR=1.80,95%CI:1.34-2.43;I2=92.1%),with high heterogeneity between studies.Significant subgroup differences according to age,geographical location,and HF patient sample were observed.HF did not increase the 1-year mortality of patients(OR=1.11,95%CI:0.75-1.62;I2=93.2%),and the mortality of patients with isolated right ventricular dysfunction(OR=2.32,95%CI:1.29-4.14;I2=91.5%)increased significantly.CONCLUSION In patients with sepsis,HF is often associated with adverse outcomes and mortality.Our results call for more high-quality research and strategies to improve outcomes for sepsis patients with HF.

Mirids secrete a TOPLESS targeting protein to enhance JA-mediated defense and gossypol accumulation for antagonizing cotton bollworms on cotton plants

Most coexisting insect species exhibit stunted growth compared to individual species on plants.This phenomenon reflects an interspecific antagonism drawing extensive attention,while the underlying mechanisms remain largely uncharacterized.Mirids(Apolygus lucorum)and cotton bollworms(Helicoverpa armigera)are two common cotton pests.We identified a secretory protein,ASP1,from the oral secretion of mirids,found in the nucleus of mirid-infested cotton leaves.ASP1 specifically targets the transcriptional co-repressor TOPLESS(TPL)and inhibits NINJA-mediated recruitment of TPL,promoting plant defense response and gossypol accumulation in cotton glands.ASP1-enhanced defense inhibits the growth of cotton bollworms on cotton plants,while having limited impact on mirids.The mesophyll-feeding characteristic allows mirids to avoid most cotton glands,invalidating cotton defense.Our investigation reveals the molecular mechanism by which mirids employ cotton defense to selectively inhibit the feeding of cotton bollworms.