Systemic immune-inflammation index,neutrophilto-lymphocyte ratio,and platelet-to-lymphocyte ratio in patients with type 2 diabetes at different stages of diabetic retinopathy

AIM:To investigate systemic immune-inflammation index(SII),neutrophil-to-lymphocyte ratio(NLR),and plateletto-lymphocyte ratio(PLR)levels in patients with type 2 diabetes at different stages of diabetic retinopathy(DR).METHODS:This retrospective study included 141 patients with type 2 diabetes mellitus(DM):45 without diabetic retinopathy(NDR),47 with non-proliferative diabetic retinopathy(NPDR),and 49 with proliferative diabetic retinopathy(PDR).Complete blood counts were obtained,and NLR,PLR,and SII were calculated.The study analysed the ability of inflammatory markers to predict DR using receiver operating characteristic(ROC)curves.The relationships between DR stages and SII,PLR,and NLP were assessed using multivariate logistic regression.RESULTS:The average NLR,PLR,and SII were higher in the PDR group than in the NPDR group(P=0.011,0.043,0.009,respectively);higher in the NPDR group than in the NDR group(P<0.001 for all);and higher in the PDR group than in the NDR group(P<0.001 for all).In the ROC curve analysis,the NLR,PLR,and SII were significant predictors of DR(P<0.001 for all).The highest area under the curve(AUC)was for the PLR(0.929 for PLR,0.925 for SII,and 0.821 for NLR).Multivariate regression analysis indicated that NLR,PLR,and SII were statistically significantly positive and independent predictors for the DR stages in patients with DM[odds ratio(OR)=1.122,95%confidence interval(CI):0.200–2.043,P<0.05;OR=0.038,95%CI:0.018–0.058,P<0.05;OR=0.007,95%CI:0.001–0.01,P<0.05,respectively).CONCLUSION:The NLR,PLR,and SII may be used as predictors of DR.

Rotating tank experiments for the study of geophysical fluid dynamics

Geophysical fluid dynamics(GFD)is an interdisciplinary field that studies the large-scale motion of fluids in the natural world.With a wide range of applications such as weather forecasts and climate prediction,GFD employs various research approaches including in-situ observations,satellite measurements,numerical simulations,theoretical analysis,artificial intelligence,and physical model experiments in laboratory.Among these approaches,rotating tank experiments provide a valuable tool for simulating naturally-occurring fluid motions in laboratories.With proportional scaling and proper techniques,scientists can reproduce multi-scale physical processes of stratified fluids in the rotation system,which allows for the simulation of essential characteristics of fluid motions in the atmosphere and oceans.In this review,rotating tanks of various scales in the world are introduced,as these tanks have been actively used to explore fundamental scientific questions in ocean and atmosphere dynamics.To illustrate the GFD experiments,three representative cases are presented to demonstrate the frontier achievements in the the GFD study by using rotating tank experiments:mesoscale eddies in the ocean,convection processes,and plume dynamics.Detailed references for the experimental procedures are provided.Future studies are encouraged to further explore the utilization of rotating tanks with improvements in experimental design and integration of other research methods.This is a promising direction of GFD to help enhance our understanding of the complex nature of fluid motions in the natural world and to address the challenges posed by global environmental changes.

Robust free-space optical frequency transfer in time-varying link distances conditions

Future inter-satellite clock comparison on high orbit will require optical time and frequency transmission technology between moving objects.Here,we demonstrate robust optical frequency transmission under the condition of variable link distance.This variable link is accomplished by the relative motion of a single telescope fixed on the experimental platform to a corner-cube reflector(CCR)installed on a sliding guide.Two acousto–optic modulators with different frequencies are used to separate forward signal from backward signal.With active phase noise suppression,when the CCR moves back and forth at a constant velocity of 20 cm/s and an acceleration of 20 cm/s^(2),we achieve the best frequency stability of 1.9×10^(-16) at 1 s and 7.9×10^(-19) at 1000 s indoors.This work paves the way for future studying optical frequency transfer between ultra-high-orbit satellites.

FasL抑制剂对大鼠角膜移植术后角膜细胞凋亡及Treg的影响

目的:探索大鼠角膜移植术后玻璃体腔内注射FasL抑制剂对角膜细胞凋亡,角膜Fas、FasL表达,全血和颈部淋巴结中Treg数量及排斥反应指数的影响。方法:将24只SD大鼠24眼行穿透性角膜移植术,术后随机分为玻璃体腔内注射PBS组(12只12眼)、FasL抑制剂组(12只12眼),每周记录角膜排斥反应指数,术后1、3、5wk取全血、颈部淋巴结检测Treg数量,取角膜组织测Fas、FasL表达及凋亡细胞数量。结果:FasL抑制剂组角膜Fas、FasL表达较PBS组明显下降(均P<0.05);FasL抑制剂组角膜细胞凋亡较PBS组明显减少,FasL抑制剂组术后5wk凋亡最少;术后3wk开始FasL抑制剂组Treg数量较PBS组明显升高(均P<0.05),FasL抑制剂组角膜移植排斥反应评分明显低于PBS组(均P<0.05)。结论:大鼠角膜移植术后玻璃体腔内注射FasL抑制剂可减少角膜各层细胞凋亡,增加全血、颈部淋巴结中Treg的数量,减轻排斥反应。

Pulmonary cryptococcosis after immunomodulator treatment in patients with Crohn’s disease:Three case reports

BACKGROUND Corticosteroids and anti-tumor necrosis factorαmAbs are widely used to treat Crohn's disease(CD).However,one disadvantage of this treatment is impairment of normal immune function,leading to an increased risk of infection.Cryptococcus infection is an opportunistic infection that occurs mainly in immunocompromised patients and poses a significant diagnostic challenge in patients with CD.CASE SUMMARY Here,we report three cases of pulmonary cryptococcosis in patients with CD after receiving immunomodulatory treatment.The patients presented with no or mild respiratory symptoms.Chest computed tomography scans revealed pulmonary nodules in the unilateral or bilateral lobes.Diagnoses were made using pathological examination and metagenomic sequencing.The patients were treated with fluconazole 400 mg once daily for 1 to 6 mo,and symptoms were resolved.Literature searches were conducted in PubMed,Web of Science,and Embase to retrieve previously reported cases and summarize patient characteristics.CONCLUSION The incidence of cryptococcus infection has increased along with immunomodulator use.Clinical vigilance is required for early identification and standardized treatment.

Characteristics of geothermal field and evaluation of geothermal resource potential in the Yingjiang Basin

Geothermal resource,a green and sustainable energy resource,plays an important role in achieving‘emission peak’and‘carbon neutrality’targets.The Yingjiang Basin is located in the eastern branch of the Mediterranean-Himalayan high-temperature geothermal belt and exhibits considerable potential for geothermal resources.However,current investigations into the distribution of deep geothermal resources in this region are somewhat limited.In this paper,the transient plane source(TPS)method is used to measure the thermal conductivity parameters of 31 rock samples within the study area.Additionally,the one-dimensional steady-state heat conduction equation is employed to calculate the deep geothermal field,considering the constraints of rock thermal properties and terrestrial heat flow in the study area.Furthermore,the“stripping method”is used to determine the contribution rate of sedimentary layer to terrestrial heat flow,while the volume method is applied to estimate the geothermal resources at burial depths of 3000-5000 m.The results show that(1)The heat generation rate of granite is the highest with an average value of 4.52 mW/m^(3),followed by gneiss with an average value in the range of 2.0-3.5 W/(m·K),mudstone and sandstone being the lowest with an average value between 1.0 and 2.0 W/(m·K).(2)The main contributor of terrestrial heat flow in the study area is mantle heat flow,and the contribution of sedimentary layers to terrestrial heat flow only accounts for about 2%.(3)The geothermal resources in Yingjiang Basin within the depth range of 3000-5000 m is 93.6×10^(15)kJ,or 3.2×10^(9)tonnes standard coal equivalent(SCE).

Protective effects of ferulic acid against ionizing radiation-induced oxidative damage in rat lens through activating Nrf2 signal pathway

AIM: To examine the protection of ferulic acid(FA) against ionizing radiation(IR)-induced lens injury in rats, as well as the underlying mechanisms.METHODS: FA(50 mg/kg) was administered to rats for 4 consecutive days before they were given 10 Gy γ-radiation, as well as for 3 consecutive days afterward. Two weeks after radiation, the eye tissues were collected. Histological alterations were evaluated by hematoxylineosin staining. Enzyme linked immunosorbent assay(ELISA) was utilized to assess the activities of glutathione reductase(GR) and superoxide dismutase(SOD), as well as the levels of glutathione(GSH) and malondialdehyde(MDA) in the lenses. The protein and m RNA levels of Bcl-2, caspase-3, Bax, heme oxygenase-1(HO-1), and glutamatecysteine ligase catalytic subunit(GCLC) were quantified using Western blot and quantitative reverse transcription polymerase chain reaction, respectively. With nuclear extracts, the nuclear factor erythroid-2 related factor(Nrf2) protein expressions in the nuclei were also measured.RESULTS: Rats exposed to IR showed lens histological alterations which could be alleviated by FA. FA treatment reversed apoptosis-related markers in IR-induced lens, as evidenced by lower levels of Bax and caspase-3 and higher level of Bcl-2. Furthermore, IR induced oxidative damage manifested by decreased GSH level, increased MDA level, and decreased SOD and GR activities. FA boosted nuclear translocation of Nrf2 and increased the expressions of HO-1 and GCLC to inhibit oxidative stress, as evidenced by an increase in GSH, a decrease in MDA, and an increase in GR and SOD activities.CONCLUSION: FA may work well in preventing and treating IR-induced cataract through promoting the Nrf2 signal pathway to attenuate oxidative damage and cell apoptosis.

DCD角膜移植术后角膜内皮细胞与排斥反应的相关性分析

目的:探讨心脏死亡供体器官捐献(donation after cardiac death,DCD)来源角膜植片术后排斥反应与角膜内皮细胞的相关性。方法:用角膜内皮显微镜对心脏死亡供体来源角膜植片行穿透性角膜移植术后发生排斥反应的28例28眼角膜植片分别于术后<1、2~3、4~6、7~12mo行角膜内皮镜检查。结果:28例患者术后<1、2~3、4~6、7~12mo的角膜内皮细胞变异系数分别为38.23%、49.56%、57.18%、65.04%;角膜内皮细胞密度分别为2071.15±311.47、1771.33±348.18、1626.59±353.92、1553.14±307.31个/mm2;角膜内皮细胞变异系数与排斥反应呈正相关关系(r=0.95,P<0.05);术后角膜内皮细胞密度与排斥反应呈负相关关系(r=-0.93,P<0.05)。结论:DCD穿透性角膜移植术后发生排斥反应时有角膜内皮细胞变异系数逐步增高,角膜内皮细胞密度逐步降低的趋势;角膜内皮细胞变异系数、角膜内皮细胞密度可作为早期检测术后排斥反应的指标。

The role of mechanical stretch and TGF-β2 in epithelial-mesenchymal transition of retinal pigment epithelial cells

AIM: To explore the effects and mechanisms of mechanical stress and transforming growth factor-beta2(TGF-β2) on epithelial-mesenchymal transition(EMT) in cultured human retinal pigment epithelial(RPE) cells. METHODS: Human RPE cells were inoculated on BioF ex 6-well plates and RPE cells received 0, 1, 2, 3, or 4 mild stretch injuries delivered 3h apart after 24h of culture. The device of mechanical stress parameters were set to sine wave, frequency 1 Hz, stretch strength 20%. For treatment with TGF-β2, when the inoculated RPE cells in 6-well plates were around 60% confluent, serum was reduced to 0 for 12h and recombinant human TGF-β2(0, 1, 5, 10 ng/mL)was added for 48h. α-SMA, Vimentin and N-Cadherin, fibronectin proteins expressions were detected by Western blotting, confocal cell immunofluorescence and quantitative real-time polymerase chain reaction(q RT-PCR). Then we detected the change of mi RNA-29b and ascertained the changes of phosphatidylinositol 3-kinase-serine threonine protein kinase(PI3K/Akt) pathway after RPE cells were stretched by the device of mechanical stress and induced by TGF-β2 by Western blotting, confocal cell immunofluorescence and qR T-PCR. RESULTS: Mechanical stress induce EMT and activate the PI3K/Akt pathway in ways that lead to the EMT process. TGF-β2 induce RPE cells EMT and in a certain range and TGF-β2 decrease the miR NA-29b expression in RPE cells, and the inhibitory effect is more obvious with the increase of TGF-β2 concentration. CONCLUSION: Our findings are crucial steps in determining the critical roles of the PI3K/Akt signaling pathway and mi RNA-29b in pathogenesis of proliferative vitreoretinopathy(PVR) which may be a potential target for preventing or treating PVR.

Corticosteroid therapy in ulcerative colitis:Clinical response and predictors

AIM:To evaluate clinical response to initial corticosteroid(CS) treatment in Chinese ulcerative colitis patients(UC) and identify predictors of clinical response.METHODS:Four hundred and twenty-three UC patients who were initially treated with oral or intravenous CS from 2007 to 2011 were retrospectively reviewed at eight inflammatory bowel disease centers in China,and 101 consecutive cases with one-year follow-up were analyzed further for clinical response and predictors.Short-term outcomes within one month were classified as primary response and primary non-response.Longterm outcomes within one year were classified as prolonged CS response,CS dependence and secondary non-response.CS refractoriness included primary and secondary non-response.Multivariate analyses were performed to identify predictors associated with clinical response.RESULTS:Within one month,95.0%and 5.0%of the cases were classified into primary response andnon-response,respectively.Within one year,41.6%of cases were assessed as prolonged CS response,while49.5%as CS dependence and 4.0%as secondary nonresponse.The rate of CS refractoriness was 8.9%,while the cumulative rate of surgery was 6.9%within one year.After multivariate analysis of all the variables,tenesmus was found to be a negative predictor of CS dependence(OR=0.336;95%CI:0.147-0.768;P=0.013)and weight loss as a predictor of CS refractoriness(OR=5.662;95%CI:1.111-28.857;P=0.040).After one-month treatment,sustained high Sutherland score(≥6)also predicted CS dependence(OR=2.347;95%CI:0.935-5.890;P=0.014).CONCLUSION:Tenesmus was a negative predictor of CS dependence,while weight loss and sustained high Sutherland score were strongly associated with poor CS response.

Tertiary hydrothermal activity and its effect on reservoir properties in the Xihu Depression, East China Sea

Three large-scale episodes of volcanic activity occurred during the Tertiary in the Xihu Depression, located in the East China Sea. Intermediate-felsic magmas intruded along faults and the associated hydrothermal fluids resulted in the hydrothermal alteration of the clastic country rock. To better describe reservoir characteristics, reservoir samples were subjected to the following investigations: thin section examination, scanning electron microscope-energy dispersive spectrometer analysis(SEM–EDS), fluid inclusion homogenization temperature tests, vitrinite reflectance measurements, and X-ray di raction. The results of this study provide evidence of the following hydrothermal alteration phenomena: brittle fracturing, clastic particle alteration, precipitation of unique hydrothermal minerals(celestite, zircon, apatite, barite, and cerous phosphate). The presence of abnormally high temperatures is indicated by fluid inclusion analysis, the precipitation of high-temperature authigenic minerals such as quartz, illite alteration, and anomalous vitrinite reflectance. Two aspects related to hydrothermal effects on reservoir properties have been investigated in this study:(1) Deep magmatic hydrothermal fluids carry large amounts of dissolved carbon dioxide and sulfur dioxide gas. These fluids percolate into the country rocks along fault zones, resulting in dissolution within the sandstone reservoirs and the development of significant secondary porosity.(2) Magma intrusions increase the temperature of the surrounding rocks and accelerate the thermal evolution of hydrocarbon source rocks. This results in the release of large amounts of organic acids and carbon dioxide, leading the dissolution of the aluminosilicate minerals and volcanic fragments in the reservoirs, and the generation of significant secondary porosity.

Current use of immunosuppressive agents in inflammatory bowel disease patients in East China

AIM:To investigate immunosuppressive agents used to treat inflammatory bowel disease(IBD)in East China. METHODS:A retrospective review was conducted, involving 227 patients with IBD admitted to Sir Run Run Shaw Hospital,College of Medicine,Zhejiang University from June 2000 to December 2007.Data regarding demographic,clinical characteristics and immunosuppressants usage were analyzed. RESULTS:A total of 227 eligible patients were evaluated in this study,including 104 patients with Crohn’s disease and 123 with ulcerative colitis.Among the patients,61 had indications for immunosuppressive agents use.However,only 21 (34.4%)received immunosuppressive agents.Among the 21 patients,6(37.5%)received a subtherapeutic dose of azathioprine with no attempt to increase the dosage.Of the 20 patients that received immunosuppressive agent treatment longer than 6 mo,15 patients went into remission,four patients were not affected and one relapsed.Among these 20 patients,four patients suffered from myelotoxicity and one suffered from hepatotoxicity.CONCLUSION:Immunosuppressive agents are used less frequently to treat IBD patients from East China compared with Western countries.Monitoring immunosuppressive agent use is recommended to optimize dispensation of drugs for IBD in China.

Real-world cost-effectiveness associated with infliximab maintenance therapy for moderate to severe Crohn's disease in China

BACKGROUND Infliximab was the first approved biologic treatment for moderate to severe Crohn's disease(MS-CD) in China. However, the cost-effectiveness of infliximab maintenance therapy(IMT) for MS-CD relative to conventional maintenance therapy remained unclarified.AIM To assess the cost-effectiveness of IMT for MS-CD in Chinese patients from the perspective of Chinese public insurance payer.METHODS A cohort of MS-CD patients managed in a Chinese tertiary care hospital was created to compare IMT with conventional maintenance therapy(CMT) for clinical outcomes and direct medical costs over a 1-year observation time using conventional regression analyses. A decision-analytic model with the generated evidence was constructed to assess the cost-effectiveness of IMT relative to CMT using reimbursed medical costs.RESULTS Based on the included 389 patients, IMT was associated with significantly higher disease remission chance [odds ratio: 4.060, P = 0.003], lower risk of developing new complications(odds ratio: 0.527, P = 0.010), higher utility value for quality of life(coefficient 0.822, P = 0.008), and lower total hospital costs related to disease management(coefficient-0.378, P = 0.008) than CMT. Base-case cost-effectiveness analysis estimated that IMT could cost Chinese health insurance payers $55260 to gain one quality-adjusted life year(QALY). The cost-effectiveness of IMT was mainly driven by the estimate of quality of life, treatment efficacy of maintenance therapy, mortality risk associated with active disease, and unit price of infliximab. The probability that IMT was cost-effective at a willingness-to-pay threshold of three times gross domestic product [2018 Chinese gross domestic product per capita(GDPPC)] was 86.4%.CONCLUSION IMT significantly improved real-world health outcomes and cost the Chinese public health insurance payers less than one GDPPC to gain one QALY in Chinese MS-CD patients.

分子间相互作用对复合固态聚合物电解质离子电导率的影响机制

以聚氧化乙烯(PEO)为基体、埃洛石纳米管(HNTs)为填料,采用溶液浇铸法制备了系列聚氧化乙烯/高氯酸锂/埃洛石(PEO/LiClO4/HNTs)固态聚合物电解质。系统研究了HNTs经表面改性前后对PEO结晶性能、锂盐解离度及离子电导率的影响机制。透射电子显微镜和比表面积表征结果表明,HNTs经硫酸处理后(A-HNTs),可在保持纳米管形貌的基础上使其比表面积从33.15 m^(2)/g增加到104.73 m^(2)/g;X射线衍射和差示扫描量热法分析结果表明,HNTs经表面改性处理,可增加分子间的相互作用,进一步降低PEO的结晶度;光学显微镜结果证明,HNTs的加入可使PEO球晶尺寸减小,表面改性处理可进一步使PEO结晶细化;傅里叶变换红外光谱和离子电导率测试结果表明,通过对HNTs纳米管表面基团的控制,可以提高LiClO4解离程度,获得的电解质膜在40℃的离子电导率高达1.35×10^(-4) S/cm。

Quality of care for patients with inflammatory bowel disease in East China

AIM： To investigate the quality of care for a hospital based-cohort of patients with inflammatory bowel disease （IBD） from East China according to the current practice guidelines, METHODS： A retrospective review was conducted, involving 177 patients with IBD admitted to Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University between June 2000 and June 2006. Data regarding demographic and clinical characteristics as well as medical therapy including use of oral aminosalisylates, topical therapy, corticosteroid agents, immunomodulatory agents （such as azathioprine） at admission and outpatient clinic visit were analyzed. RESULTS： A total of 177 eligible patients were evaluated in this study, including 71 patients with Crohn＇s disease （CD） and 106 with ulcerative colitis （UC）. All were the Han nationality Chinese with active disease at baseline. All the 106 patients with ulcerative colitis received optimal doses of aminosalisylate while 27 of 68 （39.7%） patients with ileal or colonic CD received the suboptimal doses of aminosalisylate. The incidence of suboptimal dose of aminosalisylate was significantly higher in CD patients with small intestine involvement only （52.8% vs 25.0%, P = 0.019）. Thirty-one （54.4%） patients with active distal or left-sided ulcerative colitis received topical therapy, and 27.8% of patients suffering from severe inflammatory bowel disease did not receive oral or intravenous steroid therapy. Among the 51 patients for whom thiopurine was indicated, only 10 （19.6%） received immunomodulatory agents, and more thanhalf of the 8 patients received a suboptimal dose of azathiopurine with no attempt to increase its dosage. CONCLUSION： The quality of care for IBD patients can be further improved. A suboptimal dose of aminosalicylate is used in treatment of patients with CD, especially in those with small intestine involved only. Topical mesalazine is inadequately used in patients with distal or left-sided colitis. Oral or intravenous steroid therapy is not used in some patients with severe IBD. Use of immunomodulatory medication is limited. Larger prospective studies are needed to investigate the quality of care for patients with IBD to establish our own evidence-based guidelines.

Trends in medication use and treatment patterns in Chinese patients with inflammatory bowel disease

BACKGROUND Medications for inflammatory bowel disease(IBD)have changed dramatically over time.However,no study on long-term medication profiles has been conducted in the Chinese population.AIM To evaluate temporal changes in medication use and treatment patterns for Chinese patients with IBD.METHODS A multicenter retrospective cohort study was conducted among Chinese patients newly diagnosed with Crohn’s disease(CD)and ulcerative colitis(UC)between January 1999 and December 2019.Baseline characteristics and drug prescriptions were collected.Trends in medication use and therapeutic patterns were analyzed.RESULTS In total,3610 patients were analyzed.During follow-up,5-aminosalicylates(5-ASA)and corticosteroids(CS)prescriptions gradually decreased,accompanied by a notable increase in immunosuppressants(IMS)and infliximab(IFX)prescriptions in patients with CD.Prescription rates of 5-ASA and CS were stable,whereas IMS and IFX slightly increased since 2007 in patients with UC.Subgroup(n=957)analyses showed a switch from conventional medications to IFX in patients with CD,while 5-ASA and CS were still steadily prescribed in patients with UC.Logistic regression analyses revealed that surgical history,disease behavior,and disease location were associated with initial therapeutic strategies in patients with CD.However,medications before diagnosis,disease location,and diagnostic year might affect initial strategies in patients with UC.CONCLUSION Long-term treatment strategies analyses has provided unique insight into the switch from conventional drugs to IFX in Chinese patients with CD.

Design of Implant Prosthesis for Bone Injury Repair Considering Stress Shielding Effect

The failure of bone injury repair surgery is mostly due to the stress shielding effect caused by the difference of elastic modulus between the implant prosthesis and human bone,result-ing in a great damage to patients.To solve this problem,in this study,the influencing factors of the elastic modulus of implant prosthesis were investigated,the relationship between the elastic modulus of the implanted prosthesis and the influencing factors was analyzed,and then a design method of the implant prosthesis to reduce the stress shielding effect by adjusting the unit module to control the elastic modulus was established.This method was used for the biomechanical simula-tion to simulate the displacement and stress distribution between the implant prosthesis and the surrounding bone tissue,and then the reliability of the method was verified.The implant prosthe-sis with an elastic modulus consistent with that of the experimental dog bone was made by this method,and used for the animal experiments.The effects of implant prosthesis with different mod-ulus on the growth of surrounding bone tissue were observed,and at the same time,the reliability of the implant design method and the results of biomechanical simulation were verified.It is con-firmed that this method can effectively reduce the stress concentration of implant prosthesis by more than 15.4%and increase the growth of bone tissue by more than 21%.

A Survey of Pregnancy Outcomes for Women of Childbearing Age with Inflammatory Bowel Disease in South China

Purpose: Women of childbearing age with inflammatory bowel disease (IBD) in South China were studied to understand the effects of IBD on pregnancy outcomes. Materials and Methods: One hundred thirty-nine women treated at two large IBD centers participated. Pregnancy outcome data were collected by telephone interviews. Results: Ninety patients (90/139;64.7%) did not pursue pregnancy after IBD diagnosis because of concerns regarding adverse effects. Fifteen Crohn’s disease (CD) and 12 ulcerative colitis (UC) patients pursued pregnancy and achieved successful conception. Twenty-five patients were treated with drugs before pregnancy;however, 15 (15/25;60%) discontinued the use of all drugs 3 months before pregnancy. The other 10 patients continued mesalazine and one continued azathioprine during pregnancy. Four CD and five UC patients had mild disease at conception;the others were in remission. Two CD patients and one UC patient experienced mild disease relapse during pregnancy. They refused all drugs except mesalazine. One UC patient with mild disease during pregnancy had pregnancy-induced hypertension. All newborns were healthy. There was no difference between pregnancy outcomes of CD and UC patients (P > 0.05). No relationship was found between disease activity and pregnancy outcomes (P > 0.05). Patients with active disease during pregnancy tended to choose cesarean delivery, especially in CD patients with active disease (P = 0.028). Conclusion: Many female IBD patients may not pursue pregnancy because of concerns regarding adverse effects on the pregnancy. Patients were more willing to conceive during disease remission. Some refused all IBD medications except mesalazine. Relapse was uncommon or mild during pregnancy. Disease activity had an obvious effect on the delivery mode of CD patients.

Use of the ulcerative colitis endoscopic index of severity and Mayo endoscopic score for predicting the therapeutic effect of mesalazine in patients with ulcerative colitis

Objective:The ulcerative colitis endoscopic index of severity(UCEIS)and the Mayo endoscopic score(MES)are developed as objective methods of evaluating endoscopic severity in patients with ulcerative colitis(UC).The aim of this study is to investigate the diagnostic accuracy of the UCEIS and MES in predicting the patient's response to mesalazine.Methods:Consecutive patients with UC who had undergone colonoscopy within 1 month before starting mesalazine between October 2011 and July 2016 were retrospectively collected at the Department of Gastroenterology,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine.The median follow-up was 81 months,and all the data were analyzed in January 2021.The primary outcome was the need for step-up treatment,which included the use of corticosteroids,immunomodulatory,or surgery during admission and follow-up.Data were analyzed using the c2 or Fisher exact test,Spearman test,t-test,and ManneWhitney U test.Results:Totally,65 patients were enrolled,of whom 12(18.5%)needed step-up treatment due to nonresponse to mesalazine.The UCEIS score,MES,and the ulcerative colitis disease activity index(UCDAI)score were significantly higher in patients who had nonresponse to mesalazine(UCEIS score:6.92±0.69 vs.4.45±1.17,p<0.001;MES:2.67±0.49 vs.2.15±0.69,p=0.024;UCDAI score:9.33±1.87 vs.6.70±2.38,p=0.002).In the multivariate analysis,the UCEIS score(OR=25.65,95%CI:3.048 e45.985,p=0.003),UCDAI score(OR=1.605,95%CI:1.144e2.254,p=0.006),and C-reactive protein level(OR=1.056,95%CI:1.006e1.108,p=0.026)were independent risk factors of nonresponse.The area under the ROC curve of UCEIS was 0.95,with a sensitivity of 100%and specificity of 84.6%,a cut-off value of 6,which outperformed the MES with an area under the ROC curve of 0.70.When the UCEIS score≥6,60%of patients eventually needed step-up treatment.Conclusions:The UCEIS is a useful instrument for predicting the therapeutic effect in patients with UC treated with mesalazine.The high probability of mesalazine treatment failure and benefits of other therapies should be discussed in patients with baseline UCEIS score≥6.

镧-钛氧簇闪烁体中无机簇核和有机配体的协同作用实现高性能X射线成像

随着对X射线成像,特别是对弯曲和不规则物体的三维成像的需求不断增加,高性能柔性闪烁膜的开发引起了人们的极大关注.镧系(Ⅲ)-有机闪烁体由于其在结构设计和光学可调谐方面的巨大灵活性,最近成为一类新的有前途的X射线闪烁体.然而,设计具有高光产额和良好溶液分散性的镧系元素(Ⅲ)-有机闪烁体仍然具有挑战性.本文报道了一种具有高效X射线激发发光(XEL)和良好溶液分散性的铕-钛氧簇合物(Eu-TiOCs)闪烁体.笼状镧-钛氧原子簇核作为X射线吸收剂,产生高能电子并引发二次电子热弛豫.有机配体作为能量转移桥和天线,通过级联能量转移来敏化Ln^(3+);离子的发光.Eu-TiOCs闪烁体表现出高的稳态X射线光产额(高达26,816±2000 photons MeV^(-1)).此外,EuTiOCs闪烁体和聚合物的羟基之间的弱氢键相互作用增强了Eu-TiOCs的溶液分散性,有利于制备低光散射和均匀闪烁膜.铕-钛氧簇与聚合物之间的通过无机簇笼和有机配体之间的协同作用,所得到的柔性闪烁膜对平面和非平面物体都表现出的高空间分辨率和低剂量X射线成像.本工作为进一步设计和制备高性能X射线闪烁体和高分辨率柔性闪烁膜提供了新思路.