Background: Venous thromboembolic (VTE) disease burden is increasing worldwide, representing a major cause of cardiovascular death and public health problem. Pulmonary embolism (PE) is the most serious clinical presen...Background: Venous thromboembolic (VTE) disease burden is increasing worldwide, representing a major cause of cardiovascular death and public health problem. Pulmonary embolism (PE) is the most serious clinical presentation of VTE. Epidemiological and clinical data on PE are still lacking in Africa, particularly in Cameroon. This study aimed at determining the clinical features as well as imaging presentation and outcome of pulmonary embolism. Methods: A cross-sectional study was carried out in three hospitals in Douala. We retrospectively reviewed patient records admitted for PE from January 2009 to May 2017. We collected data on epidemiology, clinical presentation, venous Doppler/pulmonary computed tomographic angiography (CTA), and outcome. Results: We included 103 patients (56 males) with PE. Their median age was 52 years. The main risk factors were obesity (49.5%), hypertension (35.0%), long trip (24.3%) and cancer (18.4%). The most frequent clinical presentations were dyspnoea (83.4%), chest pain (78.6%), and cough (40.8%). Additionally, pleural effusion (32.8%), atelectasis (25.7%) and pulmonary hyperlucency (20.0%) were the most frequent findings on chest X-ray. The main abnormalities found in electrocardiogram were sinus tachycardia (63.4%), S1Q3T3 aspect (37.6%) and right axial deviation (28.7%). Moreover, right cavities dilatation (26.0%), pulmonary artery hypertension (35.0%) and pulmonary artery dilatation (21.0%) were the main echocardiographic findings. Low-molecular-weight heparin (LMWH) was the initial anticoagulant in all cases. There were 19 (18.4%) in-hospital deaths, and the mean hospital stay was 8.5 ± 5 days. Conclusion: PE is not rare in our setting. Obesity, long trip and cancer are the main risk factors, while dyspnoea, chest pain and respiratory distress are the main clinical presentation for PE. LMWH remains the therapeutic agent of choice. Lastly, in-hospital mortality is very high.展开更多
BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has become a major health concern worldwide.In that context,the understanding of epidemiological and clinical features associated with the disease and its seve...BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has become a major health concern worldwide.In that context,the understanding of epidemiological and clinical features associated with the disease and its severity is crucial for the establishment of strategies aimed at disease control and remedy.AIM To describe epidemiological features,signs,symptoms,and laboratory findings among severely ill COVID-19 patients from an inten-sive care unit in northeastern Brazil as well as to evaluate predictor factors for disease outcomes.METHODS This is a prospective single-center study that evaluated 115 patients admitted to the intensive care unit in a northeastern Brazilian hospital.RESULTS The patients had a median age of 65.60±15.78 years.Dyspnea was the most frequent symptom,affecting 73.9%of the patients,followed by cough(54.7%).Fever was reported in approximately one-third of patients and myalgia in 20.8%of the patients.At least two comorbidities were found in 41.7%of the patients,and hypertension was the most prevalent(57.3%).In addition,having two or more comorbidities was a predictor of mortality,and lower platelet count was positively associated with death.Nausea and vomiting were two symptoms that were predictors of death,and the presence of a cough was a protective factor.CONCLUSION This is the first report of a negative correlation between cough and death in severely ill severe acute respiratory syndrome coronavirus 2-infected individuals.The associations between comorbidities,advanced age,and low platelet count and the outcomes of the infection were similar to the results of previous studies,highlighting the relevance of these features.展开更多
BACKGROUND Healthcare workers(HCWs)are at increased risk of contracting coronavirus disease 2019(COVID-19)as well as worsening mental health problems and insomnia.These problems can persist for a long period,even afte...BACKGROUND Healthcare workers(HCWs)are at increased risk of contracting coronavirus disease 2019(COVID-19)as well as worsening mental health problems and insomnia.These problems can persist for a long period,even after the pandemic.However,less is known about this topic.AIM To analyze mental health,insomnia problems,and their influencing factors in HCWs after the COVID-19 pandemic.METHODS This multicenter cross-sectional,hospital-based study was conducted from June 1,2023 to June 30,2023,which was a half-year after the end of the COVID-19 emergency.Region-stratified population-based cluster sampling was applied at the provincial level for Chinese HCWs.Symptoms such as anxiety,depression,and insomnia were evaluated by the Generalized Anxiety Disorder-7,Patient Health Questionnaire-9,and Insomnia Severity Index.Factors influencing the symptoms were identified by multivariable logistic regression.RESULTS A total of 2000 participants were invited,for a response rate of 70.6%.A total of 1412 HCWs[618(43.8%)doctors,583(41.3%)nurses and 211(14.9%)nonfrontline],254(18.0%),231(16.4%),and 289(20.5%)had symptoms of anxiety,depression,and insomnia,respectively;severe symptoms were found in 58(4.1%),49(3.5%),and 111(7.9%)of the participants.Nurses,female sex,and hospitalization for COVID-19 were risk factors for anxiety,depression,and insomnia symptoms;moreover,death from family or friends was a risk factor for insomnia symptoms.During the COVID-19 outbreak,most[1086(76.9%)]of the participating HCWs received psychological interventions,while nearly all[994(70.4%)]of them had received public psychological education.Only 102(7.2%)of the HCWs received individual counseling from COVID-19.CONCLUSION Although the mental health and sleep problems of HCWs were relieved after the COVID-19 pandemic,they still faced challenges and greater risks than did the general population.Identifying risk factors would help in providing targeted interventions.In addition,although a major proportion of HCWs have received public psychological education,individual interventions are still insufficient.展开更多
Objective: Hyperlipidemia is a representative nutritional metabolic disease in clinic, which is easy to induce atherosclerotic cardiovascular and cerebrovascular diseases, with complex classification. Traditional Chin...Objective: Hyperlipidemia is a representative nutritional metabolic disease in clinic, which is easy to induce atherosclerotic cardiovascular and cerebrovascular diseases, with complex classification. Traditional Chinese Medicine (TCM) syndrome aims to reflect the characteristics of diseases and is the basic principle of TCM treatment of diseases. This study aimed to summarize the distribution pattern of TCM syndromes in patients with hyperlipidemia. Methods: The frequency, characteristics and distribution of all TCM syndromes of 1012 patients with hyperlipidemia were analyzed. Results: The main disease types determined by frequency of 1012 patients included hypertriglyceridemia combined with hypo high-density lipoprotein cholesterolemia (19.76%), hypo high-density lipoprotein cholesterolemia (18.58%), hypercholesterolemia (16.50%), mixed hyperlipidemia (16.40%), and hypertriglyceridemia (15.12%). The distribution of TCM syndromes, in order of frequency, was as follows: Qi-deficiency and blood stasis syndrome (23.52%), liver depression and spleen deficiency (9.88%), syndrome of qi stagnation and blood stasis (9.29%), phlegm stasis syndrome (7.41%), and syndrome of yang deficiency of spleen and kidney (6.92%). Conclusion: Qi-deficiency and blood stasis syndrome and liver depression and spleen deficiency are the most common TCM syndromes in patients with hyperlipidemia.展开更多
AIM To systematically review the literature on epidemiology,disease burden, and treatment outcomes for Crohn's disease(CD) patients with complex perianal fistulas.METHODS PubMed, Embase, and Cochrane were searched...AIM To systematically review the literature on epidemiology,disease burden, and treatment outcomes for Crohn's disease(CD) patients with complex perianal fistulas.METHODS PubMed, Embase, and Cochrane were searched for relevant articles(published 2000-November 2016) and congress abstracts(published 2011-November 2016).RESULTS Of 535 records reviewed, 62 relevant sources were identified(mostly small observational studies). The cumulative incidence of complex perianal fistulas in CD from two referral-centre studies was 12%-14%(follow-up time, 12 years in one study; not reported in the second study). Complex perianal fistulas result in greatly diminished quality of life; up to 59% of patients are at risk of faecal incontinence. Treatments include combinations of medical and surgical interventions and expanded allogeneic adipose-derived stem cells. High proportions of patients experience lack of or inadequate response to treatment(failure and relapse rates,respectively: medical, 12%-73% and 0%-41%; surgical:0%-100% and 11%.20%; combined medical/surgical:0%-80% and 0%-50%; stem cells: 29%-47% and not reported). Few studies(1 of infliximab; 3 of surgical interventions)have been conducted in treatment-refractory patients, a population with high unmet needs. Limited data exist on the clinical value of anti-tumour necrosis factor-α dose escalation in patients with complex perianal fistulas in CD.CONCLUSION Complex perianal fistulas in CD pose substantial clinical and humanistic burden. There is a need for effective treatments, especially for patients refractory to antitumour necrosis factor-α agents, as evidenced by high failure and relapse rates.展开更多
Irritable bowel syndrome(IBS) is a chronic gastrointestinal disorder, common in clinic and in the community. It has a significant impact on both society and patients' quality of life. The epidemiology, clinical pr...Irritable bowel syndrome(IBS) is a chronic gastrointestinal disorder, common in clinic and in the community. It has a significant impact on both society and patients' quality of life. The epidemiology, clinical presentation, and management of IBS may vary in different geographical regions due to differences in diet, gastrointestinal infection, socio-cultural and psychosocial factors, religious and illness beliefs, symptom perception and reporting. Although previous reviews and consensus reports on IBS in Asia have been published, Asia is quite diverse socio-demographically. In this context, India, Bangladesh and Malaysia share some similarities, including:(1) large proportion of the population living in rural areas;(2) rapid development and associated lifestyle changes in urban areas; and(3) dietary, cultural and religious practices. The present review explores the clinical and epidemiological data on IBS from these three major nations in South and South-East Asia. In-depth review of the literature revealed important differences between IBS in the East, as revealed by studies from these three countries, and the West; these include a predominantly rural profile, differences in bowel habit and symptom profile, raising concern with regards to diagnostic criteria and subtyping of IBS, higher dietary fiber consumption, frequent lactose malabsorption, parasitosis, and possible overlap between post-infectious IBS and tropical sprue. Moreover, the current perception on difference in prevalence of the disorder in these countries, as compared to the West, might be related to variation in survey methods.展开更多
The International Consultation on Urological Disease have recently published comprehensive conclusions, based on evidence reviewed by eight committees, on aspects of male lower urinary tract symptoms(LUTS). In this re...The International Consultation on Urological Disease have recently published comprehensive conclusions, based on evidence reviewed by eight committees, on aspects of male lower urinary tract symptoms(LUTS). In this review, we summarise the conclusions from fourof the committees, namely, the evidence regarding the epidemiology of male LUTS, patient assessment, nocturia and medical management. It is indisputable that with an expanding and ageing global population the prevalence of male LUTS is likely to increase. Therefore symptom prevention and preservation of quality of life(Qo L) feature highly in the guidelines. There are now a number of different medical options, proven to lead to significant improvements in symptom scores, flow rate and Qo L available to men with LUTS. Metaanalyses have shown the benefits for alpha blockers, antimuscarinics, 5-α reductase and phosphodiesterase-5 inhibitors. High level evidence also exists for combinations of all of the above with alpha blockers and so men with concomitant storage symptoms, prostate volume > 30 mL, PSA > 1.4 or erectile dysfunction may be considered for combination treatment of an alpha blocker with an antimuscarinic, 5-α reductase inhibitor or phosphodiesterase-5 inhibitor respectively. In an era of personalised medicine, appropriate patient selection is likely to provide the key to the most effective clinical management strategy.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
文摘Background: Venous thromboembolic (VTE) disease burden is increasing worldwide, representing a major cause of cardiovascular death and public health problem. Pulmonary embolism (PE) is the most serious clinical presentation of VTE. Epidemiological and clinical data on PE are still lacking in Africa, particularly in Cameroon. This study aimed at determining the clinical features as well as imaging presentation and outcome of pulmonary embolism. Methods: A cross-sectional study was carried out in three hospitals in Douala. We retrospectively reviewed patient records admitted for PE from January 2009 to May 2017. We collected data on epidemiology, clinical presentation, venous Doppler/pulmonary computed tomographic angiography (CTA), and outcome. Results: We included 103 patients (56 males) with PE. Their median age was 52 years. The main risk factors were obesity (49.5%), hypertension (35.0%), long trip (24.3%) and cancer (18.4%). The most frequent clinical presentations were dyspnoea (83.4%), chest pain (78.6%), and cough (40.8%). Additionally, pleural effusion (32.8%), atelectasis (25.7%) and pulmonary hyperlucency (20.0%) were the most frequent findings on chest X-ray. The main abnormalities found in electrocardiogram were sinus tachycardia (63.4%), S1Q3T3 aspect (37.6%) and right axial deviation (28.7%). Moreover, right cavities dilatation (26.0%), pulmonary artery hypertension (35.0%) and pulmonary artery dilatation (21.0%) were the main echocardiographic findings. Low-molecular-weight heparin (LMWH) was the initial anticoagulant in all cases. There were 19 (18.4%) in-hospital deaths, and the mean hospital stay was 8.5 ± 5 days. Conclusion: PE is not rare in our setting. Obesity, long trip and cancer are the main risk factors, while dyspnoea, chest pain and respiratory distress are the main clinical presentation for PE. LMWH remains the therapeutic agent of choice. Lastly, in-hospital mortality is very high.
基金Supported by FAPEMIG Edital 001/2020-Programa Emergencial de Apoio a Ações de Enfrentamento da Pandemia Causada pelo Novo Coronavírus.FUNDAÇÃO DE AMPAROÀPESQUISA DO ESTADO DA BAHIA–FAPESB,PPSUS-Programa Pesquisa para o SUS-Headline 02/2020,Term of Grant nºSUS0025/2021Magalhães Queiroz DM,Freire de Melo F,are research fellows of the Conselho Nacional de Desenvolvimento Científico e Tecnológico(CNPq-)–Brazil.Programa Permanecer da Universidade Federal da Bahia.Programa Institucional de Bolsas de Iniciação Científica da Universidade Federal da Bahia(PIBIC-UFBA).
文摘BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has become a major health concern worldwide.In that context,the understanding of epidemiological and clinical features associated with the disease and its severity is crucial for the establishment of strategies aimed at disease control and remedy.AIM To describe epidemiological features,signs,symptoms,and laboratory findings among severely ill COVID-19 patients from an inten-sive care unit in northeastern Brazil as well as to evaluate predictor factors for disease outcomes.METHODS This is a prospective single-center study that evaluated 115 patients admitted to the intensive care unit in a northeastern Brazilian hospital.RESULTS The patients had a median age of 65.60±15.78 years.Dyspnea was the most frequent symptom,affecting 73.9%of the patients,followed by cough(54.7%).Fever was reported in approximately one-third of patients and myalgia in 20.8%of the patients.At least two comorbidities were found in 41.7%of the patients,and hypertension was the most prevalent(57.3%).In addition,having two or more comorbidities was a predictor of mortality,and lower platelet count was positively associated with death.Nausea and vomiting were two symptoms that were predictors of death,and the presence of a cough was a protective factor.CONCLUSION This is the first report of a negative correlation between cough and death in severely ill severe acute respiratory syndrome coronavirus 2-infected individuals.The associations between comorbidities,advanced age,and low platelet count and the outcomes of the infection were similar to the results of previous studies,highlighting the relevance of these features.
文摘BACKGROUND Healthcare workers(HCWs)are at increased risk of contracting coronavirus disease 2019(COVID-19)as well as worsening mental health problems and insomnia.These problems can persist for a long period,even after the pandemic.However,less is known about this topic.AIM To analyze mental health,insomnia problems,and their influencing factors in HCWs after the COVID-19 pandemic.METHODS This multicenter cross-sectional,hospital-based study was conducted from June 1,2023 to June 30,2023,which was a half-year after the end of the COVID-19 emergency.Region-stratified population-based cluster sampling was applied at the provincial level for Chinese HCWs.Symptoms such as anxiety,depression,and insomnia were evaluated by the Generalized Anxiety Disorder-7,Patient Health Questionnaire-9,and Insomnia Severity Index.Factors influencing the symptoms were identified by multivariable logistic regression.RESULTS A total of 2000 participants were invited,for a response rate of 70.6%.A total of 1412 HCWs[618(43.8%)doctors,583(41.3%)nurses and 211(14.9%)nonfrontline],254(18.0%),231(16.4%),and 289(20.5%)had symptoms of anxiety,depression,and insomnia,respectively;severe symptoms were found in 58(4.1%),49(3.5%),and 111(7.9%)of the participants.Nurses,female sex,and hospitalization for COVID-19 were risk factors for anxiety,depression,and insomnia symptoms;moreover,death from family or friends was a risk factor for insomnia symptoms.During the COVID-19 outbreak,most[1086(76.9%)]of the participating HCWs received psychological interventions,while nearly all[994(70.4%)]of them had received public psychological education.Only 102(7.2%)of the HCWs received individual counseling from COVID-19.CONCLUSION Although the mental health and sleep problems of HCWs were relieved after the COVID-19 pandemic,they still faced challenges and greater risks than did the general population.Identifying risk factors would help in providing targeted interventions.In addition,although a major proportion of HCWs have received public psychological education,individual interventions are still insufficient.
文摘Objective: Hyperlipidemia is a representative nutritional metabolic disease in clinic, which is easy to induce atherosclerotic cardiovascular and cerebrovascular diseases, with complex classification. Traditional Chinese Medicine (TCM) syndrome aims to reflect the characteristics of diseases and is the basic principle of TCM treatment of diseases. This study aimed to summarize the distribution pattern of TCM syndromes in patients with hyperlipidemia. Methods: The frequency, characteristics and distribution of all TCM syndromes of 1012 patients with hyperlipidemia were analyzed. Results: The main disease types determined by frequency of 1012 patients included hypertriglyceridemia combined with hypo high-density lipoprotein cholesterolemia (19.76%), hypo high-density lipoprotein cholesterolemia (18.58%), hypercholesterolemia (16.50%), mixed hyperlipidemia (16.40%), and hypertriglyceridemia (15.12%). The distribution of TCM syndromes, in order of frequency, was as follows: Qi-deficiency and blood stasis syndrome (23.52%), liver depression and spleen deficiency (9.88%), syndrome of qi stagnation and blood stasis (9.29%), phlegm stasis syndrome (7.41%), and syndrome of yang deficiency of spleen and kidney (6.92%). Conclusion: Qi-deficiency and blood stasis syndrome and liver depression and spleen deficiency are the most common TCM syndromes in patients with hyperlipidemia.
基金Kate Lothman of RTI Health Solutions provided medical writing services,which were funded by Takeda
文摘AIM To systematically review the literature on epidemiology,disease burden, and treatment outcomes for Crohn's disease(CD) patients with complex perianal fistulas.METHODS PubMed, Embase, and Cochrane were searched for relevant articles(published 2000-November 2016) and congress abstracts(published 2011-November 2016).RESULTS Of 535 records reviewed, 62 relevant sources were identified(mostly small observational studies). The cumulative incidence of complex perianal fistulas in CD from two referral-centre studies was 12%-14%(follow-up time, 12 years in one study; not reported in the second study). Complex perianal fistulas result in greatly diminished quality of life; up to 59% of patients are at risk of faecal incontinence. Treatments include combinations of medical and surgical interventions and expanded allogeneic adipose-derived stem cells. High proportions of patients experience lack of or inadequate response to treatment(failure and relapse rates,respectively: medical, 12%-73% and 0%-41%; surgical:0%-100% and 11%.20%; combined medical/surgical:0%-80% and 0%-50%; stem cells: 29%-47% and not reported). Few studies(1 of infliximab; 3 of surgical interventions)have been conducted in treatment-refractory patients, a population with high unmet needs. Limited data exist on the clinical value of anti-tumour necrosis factor-α dose escalation in patients with complex perianal fistulas in CD.CONCLUSION Complex perianal fistulas in CD pose substantial clinical and humanistic burden. There is a need for effective treatments, especially for patients refractory to antitumour necrosis factor-α agents, as evidenced by high failure and relapse rates.
文摘Irritable bowel syndrome(IBS) is a chronic gastrointestinal disorder, common in clinic and in the community. It has a significant impact on both society and patients' quality of life. The epidemiology, clinical presentation, and management of IBS may vary in different geographical regions due to differences in diet, gastrointestinal infection, socio-cultural and psychosocial factors, religious and illness beliefs, symptom perception and reporting. Although previous reviews and consensus reports on IBS in Asia have been published, Asia is quite diverse socio-demographically. In this context, India, Bangladesh and Malaysia share some similarities, including:(1) large proportion of the population living in rural areas;(2) rapid development and associated lifestyle changes in urban areas; and(3) dietary, cultural and religious practices. The present review explores the clinical and epidemiological data on IBS from these three major nations in South and South-East Asia. In-depth review of the literature revealed important differences between IBS in the East, as revealed by studies from these three countries, and the West; these include a predominantly rural profile, differences in bowel habit and symptom profile, raising concern with regards to diagnostic criteria and subtyping of IBS, higher dietary fiber consumption, frequent lactose malabsorption, parasitosis, and possible overlap between post-infectious IBS and tropical sprue. Moreover, the current perception on difference in prevalence of the disorder in these countries, as compared to the West, might be related to variation in survey methods.
文摘The International Consultation on Urological Disease have recently published comprehensive conclusions, based on evidence reviewed by eight committees, on aspects of male lower urinary tract symptoms(LUTS). In this review, we summarise the conclusions from fourof the committees, namely, the evidence regarding the epidemiology of male LUTS, patient assessment, nocturia and medical management. It is indisputable that with an expanding and ageing global population the prevalence of male LUTS is likely to increase. Therefore symptom prevention and preservation of quality of life(Qo L) feature highly in the guidelines. There are now a number of different medical options, proven to lead to significant improvements in symptom scores, flow rate and Qo L available to men with LUTS. Metaanalyses have shown the benefits for alpha blockers, antimuscarinics, 5-α reductase and phosphodiesterase-5 inhibitors. High level evidence also exists for combinations of all of the above with alpha blockers and so men with concomitant storage symptoms, prostate volume > 30 mL, PSA > 1.4 or erectile dysfunction may be considered for combination treatment of an alpha blocker with an antimuscarinic, 5-α reductase inhibitor or phosphodiesterase-5 inhibitor respectively. In an era of personalised medicine, appropriate patient selection is likely to provide the key to the most effective clinical management strategy.
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.
