Combination treatment of inflammatory bowel disease:Present status and future perspectives

The treatment of patients with inflammatory bowel disease(IBD),especially those with severe or refractory disease,represents an important challenge for the clinical gastroenterologist.It seems to be no exaggeration to say that in these patients,not only the scientific background of the gastroenterologist is tested,but also the abundance of“gifts”that he should possess(insight,intuition,determ-ination,ability to take initiative,etc.)for the successful outcome of the treatment.In daily clinical practice,depending on the severity of the attack,IBD is treated with one or a combination of two or more pharmaceutical agents.These combin-ations include not only the first-line drugs(e.g.,mesalazine,corticosteroids,antibiotics,etc)but also second-and third-line drugs(immunosuppressants and biologic agents).It is a fact that despite the significant therapeutic advances there is still a significant percentage of patients who do not satisfactorily respond to the treatment applied.Therefore,a part of these patients are going to surgery.In recent years,several small-size clinical studies,reviews,and case reports have been published combining not only biological agents with other drugs(e.g.,immunosuppressants or corticosteroids)but also the combination of two biologi-cal agents simultaneously,especially in severe cases.In our opinion,it is at least a strange(and largely unexplained)fact that we often use combinations of drugs in a given patient although studies comparing the simultaneous administration of two or more drugs with monotherapy are very few.As mentioned above,there is a timid tendency in the literature to combine two biological agents in severe cases unresponsive to the applied treatment or patients with severe extraintestinal manifestations.The appropriate dosage,the duration of the administration,the suitable timing for checking the clinical and laboratory outcome,as well as the treatment side-effects,should be the subject of intense clinical research shortly.In this editorial,we attempt to summarize the existing data regarding the already applied combination therapies and to humbly formulate thoughts and suggestions for the future application of the combination treatment of biological agents in a well-defined category of patients.We suggest that the application of biomarkers and artificial intelligence could help in establishing new forms of treatment using the available modern drugs in patients with IBD resistant to treatment.

Hybrid argon plasma coagulation for the treatment of Barrett’s esophagus:A prospective,multicenter study

BACKGROUND The incidence of Barrett’s esophagus(BE)in China is lower compared to the Western populations.Hence,studies conducted in the Chinese population has been limited.The current treatment options available for BE treatment includes argon plasma coagulation(APC),radiofrequency ablation and cryoablation,all with varying degrees of success.AIM To determine the efficacy and safety of HybridAPC in the treatment of BE.METHODS The study cohort consisted of patients with BE who underwent HybridAPC ablation treatment.These procedures were performed by seven endoscopists from different tertiary hospitals.The duration of the procedure,curative rate,complications and recurrent rate by 1-year follow-up were recorded.RESULTS Eighty individuals were enrolled for treatment from July 2017 to June 2020,comprising of 39 males and 41 females with a median age of 54 years(range,30 to 83 years).The technical success rate of HybridAPC was 100%and the overall curative rate was 98.15%.No severe complications occurred during the operation.BE cases were classified as short-segment BE and long-segment BE.Patients with short-segment BE were all considered cured without complications.Thirty-six patients completed the one-year follow-up without recurrence.Twenty-four percent had mild dysplasia which were all resolved with one post-procedural treatment.The mean duration of the procedure was 10.94±6.52 min.CONCLUSION Treatment of BE with HybridAPC was found to be a simple and quick procedure that is safe and effective during the short-term follow-up,especially in cases of short-segment BE.This technique could be considered as a feasible alternative ablation therapy for BE.

Surgical treatment of inflammatory bowel disease:From the gastroenterologist’s stand-point

Treatment of ulcerative colitis(UC)and Crohn’s disease(CD)represents,in the majority of cases,a real challenge to the gastroenterologist’s abilities and skills as well as a clinical test concerning his/her levels of medical knowledge and experience.During the last two decades,our pharmaceutical arsenal was significantly strengthened,especially after the introduction of the so-called biological agents,drugs which to a large extent not only improved the results of conservative treatment but also changed the natural history of the disease.However,colectomy is still necessary for some patients with severe UC although smaller compared to the past,precisely because of the improvements achieved in the available conservative treatment.Nevertheless,surgeries to treat colon dysplasia and cancer are increasing to some extent.At the same time,satisfactory improvements in surgical techniques,the pre-and post-operative care of patients,as well as the selection of the appropriate time for performing the surgery have been noticed.Regarding patients with CD,the improvement of conservative treatment did not significantly change the need for surgical treatment since two-thirds of patients need to undergo surgery at some point in the course of their disease.On the other hand,the outcome of the operation has improved through good preoperative care as well as the wide application of more conservative surgical techniques aimed at keeping as much of the bowel in situ as possible.This article discusses the indications for surgical management of UC patients from the gastroenterologist’s point of view,the results of the emerging new techniques such as transanal surgery and robotics,as well as alternative operations to the classic ileo-anal-pouch anastomosis.The author also discusses the basic principles of surgical management of patients with CD based on the results of the relevant literature.The self-evident is emphasized,that is,to achieve an excellent therapeutic result in patients with severe inflammatory bowel disease in today’s era;the close cooperation of gastroenterologists with surgeons,pathologists,imaging,and nutritionists is of paramount importance.

Effectiveness of anti-psychiatric treatment on visual and haptic perceptual disorder for a patient with Alzheimer’s disease: A case report

BACKGROUND Perception is frequently impaired in patients with Alzheimer’s disease(AD).Several patients exhibit visual or haptic hallucinations.CASE SUMMARY A 71-year-old Chinese man presented with visual and haptic hallucinations he had been experiencing for 2 weeks.The clinical manifestations were the feeling of insects crawling and biting the limbs and geison.He looked for the insects while itching and scratching,which led to skin breakage on the limbs.He was treated with topical and anti-allergic drugs in several dermatology departments without any significant improvement.After admission,the patient was administered risperidone(0.5 mg)and duloxetine(2 mg/day).One week later,the dose of risperidone was increased to 2 mg/day,and that of duloxetine was increased to 60 mg/day.After 2 weeks of treatment,the patient’s sensation of insects crawling and biting disappeared,and his mood stabilized.CONCLUSION This patient manifested psychiatric behavioral symptoms caused by AD brain atrophy.It was important to re-evaluate the patient’s cognitive-psychological status when the patient repeatedly went to the hospital for treatment.Follow-up attention to cognitive function and the consideration of perceptual deficits as early manifestations of AD should be considered.

Effect of substrate temperature and oxygen plasma treatment on the properties of magnetron-sputtered CdS for solar cell applications

Cadmium sulfide(CdS)is an n-type semiconductor with excellent electrical conductivity that is widely used as an electron transport material(ETM)in solar cells.At present,numerous methods for preparing CdS thin films have emerged,among which magnetron sputtering(MS)is one of the most commonly used vacuum techniques.For this type of technique,the substrate temperature is one of the key deposition parameters that affects the interfacial properties between the target film and substrate,determining the specific growth habits of the films.Herein,the effect of substrate temperature on the microstructure and electrical properties of magnetron-sputtered CdS(MS-CdS)films was studied and applied for the first time in hydrothermally deposited antimony selenosulfide(Sb_(2)(S,Se)_(3))solar cells.Adjusting the substrate temperature not only results in the design of the flat and dense film with enhanced crystallinity but also leads to the formation of an energy level arrangement with a Sb_(2)(S,Se)_(3)layer that is more favorable for electron transfer.In addition,we developed an oxygen plasma treatment for CdS,reducing the parasitic absorption of the device and resulting in an increase in the short-circuit current density of the solar cell.This study demonstrates the feasibility of MS-CdS in the fabrication of hydrothermal Sb_(2)(S,Se)_(3)solar cells and provides interface optimization strategies to improve device performance.

COVID-19 mortality paradox(United States vs Africa):Mass vaccination vs early treatment

The coronavirus disease 2019(COVID-19)mortality rate in 55 African countries is almost 4.5 times lower than in the coronavirus disease 2019(COVID-19)despite Africa having over 4.2 times more people.This mortality paradox is also evident when comparing Nigeria,a heavily populated,poorly vaccinated and weakly mandated country to Israel,a small,highly vaccinated and strictly mandated country.Nigeria has almost 4 times lower COVID mortality than Israel.In this Field of Vision perspective,I explain how this paradox has evolved drawing upon my academic,clinical and social experience.Since April 2020,I’ve developed and been using the Egyptian immune-modulatory Kelleni’s protocol to manage COVID-19 patients including pediatric,geriatric,pregnant,immune-compromised and other individuals suffering from multiple comorbidities.It’s unfortunate that severe acute respiratory syndrome coronavirus 2 is still evolving accompanied by more deaths.However in Africa,we’ve been able to live without anxiety or mandates throughout the pandemic because we trust science and adopted early treatment using safe,and effective repurposed drugs that have saved the majority of COVID-19 patients.This article represents an African and Egyptian tale of honor.

Clinical Study on the Treatment of Senile Alzheimer’s Dementia with Sodium Oligomannate Combined with Memantine Hydrochloride

Objective:To analyze the clinical effects of sodium oligomannate combined with memantine hydrochloride in the treatment of senile Alzheimer’s dementia.Methods:Sixty-eight cases of Alzheimer’s dementia treated at the Second People’s Hospital of Fujian University of Traditional Chinese Medicine from March 2020 to March 2022 were selected as the study subjects.The patients were divided into two groups based on different treatment methods:the control group(treated with memantine hydrochloride,34 cases)and the treatment group(treated with sodium oligomannate+memantine hydrochloride,34 cases).Cognitive function,activities of daily living,neurotransmitters,serum intestinal flora metabolic markers,inflammatory factors,neurotrophic factors,and adverse reactions were compared between the two groups.Results:The treatment group showed better cognitive function,quality of life scores,and levels of relevant metabolic markers in the body compared to the control group,with statistically significant differences(P<0.05).The incidence of adverse reactions between the two groups(treatment group:2%;control group:4%)was not statistically significant(χ^(2)=0.731,P=0.393).Conclusion:Sodium oligomannate combined with memantine hydrochloride has better efficacy than the control group for treating senile Alzheimer’s dementia.It significantly improves and restores cognitive function and daily living abilities,benefits neurotransmitter secretion and internal regulation,upregulates the expression of neurotrophic factors,and has fewer adverse reactions,making it a treatment worthy of further clinical promotion and application.

从协同到求异:指向教师专业发展的U-S合作优化研究

U-S合作是教师专业发展的重要举措。审视U-S合作的历程可知,U-S合作致力于多方位促进教师专业发展,协同逐渐成为U-S合作促进教师专业发展的底层逻辑。随着合作的持续推进,这一底层逻辑在促进教师专业发展方面所潜在的矛盾也逐渐暴露出来。一方面,大学与中小学的文化差异阻碍了协同的深度发生;另一方面,为了实现大学与中小学的协同,双方不得不做出诸多的妥协,在妥协的语境下,中小学教师往往面临着主体性丧失的风险。与之相对,在求异这一核心理念的引领下,跨界学习旗帜鲜明地提出了“差异即资源”的主张,并通过互动场域的营造和互动系统的建构,为“差异即资源”提供了现实可能,也为优化U-S合作提供了新的思路。

How Teachers' Attitudes During Error Treatment May Influence Students' Oral English Competence

Usually, Chinese EFL students make satisfactory progress in reading, grammar and writing. However, it is very difficult for them to transmit messages, exchange thoughts in English. I conducted a questionnaire in Inner Mongolia Teachers’ University and found out that when the students come to speak English, they tend to appear frustrated, lack confidence on the grounds of fear of making errors, which may be closely related to the teachers’ attitudes towards students’ errors. Therefore, it is essential for English teachers to have proper attitudes to errors in English teaching. The paper discusses some important strategies on whether, when and how speaking errors should be corrected based on some researchers’ views and on a small scale of experiment for the purpose of helping teachers deal with students’ errors effectively in communication.

On the Reconstruction of Teachers’Role of Business English Reading Classroom Teaching Based on Literature Circle

Business English reading teaching under the mode of“literature circles”focuses on cultivating students’autonomy in reading,group cooperation,and the exchange of ideas among group members.In this teaching mode,teachers are no longer the masters of the reading classroom,but the helpers,participants,and researchers in the process of students’reading.The reconstruction of teachers’role can promote the benign development of relationship not only between teachers and students,but also between students and students,inject new impetus and vitality into the classroom,and improve students’reading literacy.

Exploring exosomes to provide evidence for the treatment and prediction of Alzheimer’s disease

Exosomes are extracellular vesicles with a 30–150 nm diameter originating from endosomes.In recent years,scientists have regarded exosomes as an ideal small molecule carrier for the targeted treatment of Alzheimer’s disease(AD)across the blood-brain barrier due to their nanoscale size and low immunogenicity.A large amount of evidence shows that exosomes are rich in biomarkers,and it has been found that the changes in biomarker content in blood,cerebrospinal fluid,and urine are often associated with the onset of AD patients.In this paper,some recent advances in the use of exosomes in the treatment of AD are reviewed,and various exosome markers and some latest detection methods are summarized to provide some evidence for the detection or treatment of AD by exosomes.

Assessment of the Elastic-Wave Well Treatment in Oil-Bearing Clastic and Carbonate Reservoirs

A set of techniques for well treatment aimed to enhance oil recovery are considered in the present study.These are based on the application of elastic waves of various types(dilation-wave,vibro-wave,or other acoustically induced effects).In such a context,a new technique is proposed to predict the effectiveness of the elastic-wave well treatment using the rank distribution according to Zipf’s law.It is revealed that,when the results of elastic wave well treatments are analyzed,groups of wells exploiting various geological deposits can differ in terms of their slope coefficients and free members.As the slope coefficient increases,the average increase in the well oil production rate(after the well treatment)becomes larger.An equation is obtained accordingly for estimating the slope coefficient in the Zipf’s equation from the frequency of the elastic wave.The obtained results demonstrate the applicability of the Zipf’s law in the analysis of the technological efficiency of elastic-wave well treatment methods.

Multi-national observational study to assess quality of life and treatment preferences in patients with Crohn’s perianal fistulas

BACKGROUND Patients with Crohn’s disease(CD)are at risk of developing complications such as perianal fistulas.Patients with Crohn’s perianal fistulas(CPF)are affected by fecal incontinence(FI),bleeding,pain,swelling,and purulent perianal discharge,and METHODS This cross-sectional observational study was conducted in patients with CD aged 21-90 years via a web-enabled questionnaire in seven countries(April-August 2021).Patients were recruited into three cohorts:Cohort 1 included patients without perianal fistulas;cohort 2 included patients with perianal fistulas without fistula-related surgery;and cohort 3 included patients with perianal fistulas and fistula-related surgery.Validated patient-reported outcome measures were used to assess quality of life.Drivers of treatment preferences were measured using a discrete choice experiment(DCE).RESULTS In total,929 patients were recruited(cohort 1,n=620;cohort 2,n=174;cohort 3,n=135).Short Inflammatory Bowel Disease Questionnaire scores were worse for patients with CPF(cohorts 2 and 3)than for those with CD without CPF(cohort 1):Mean score 3.8 and 3.7 vs 4.1,respectively,(P<0.001).Similarly,mean Revised FI and FI Quality of Life scores were worse for patients with CPF than for those with CD without CPF.Quality of Life with Anal Fistula scores were similar in patients with CPF with or without CPF-related surgery(cohorts 2 and 3):Mean score 41 and 42,respectively.In the DCE,postoperative discomfort and fistula healing rate were the most important treatment attributes influencing treatment choice:Mean relative importance 35.7 and 24.7,respectively.CONCLUSION The burden of illness in CD is significantly higher for patients with CPF and patients rate lower postoperative discomfort and higher healing rates as the most desirable treatment attributes.

师范生U-G-S培养模式实践探索与路径优化——基于“优师计划”背景

师范生U-G-S培养模式实践已取得诸多成效,如多方配合助力师范生培养,促进区域均衡,提升基层教学水平等。但师范生U-G-S培养模式在实践中也存在突出问题,如高校一方主导、其他方参与度低,难以高效协同,培育方案与实际岗位需求存在适配偏差等。剖析“优师计划”对优化师范生U-G-S培养模式的启发,探索以当地政府为统筹、师范院校为关键、中小学校为导向、师范生为主体的“四位一体”优化路径,有助于提高师范生培育成效。

热处理对电沉积Ni-S合金微观组织和析氢性能的影响

电解水制氢是目前最有望替代矿石燃料制氢的技术,低成本且高效的析氢电极是限制电解水制氢大规模应用的瓶颈问题,而Ni-S合金具有易制备和高活性等优点,作为电解水的阴极材料具有极大的潜力。通过电沉积法在泡沫镍表面制备了非晶Ni-S合金,研究了Ni-S合金的晶化行为对其析氢性能的影响,热处理促使非晶Ni-S合金镀层再结晶转变为以Ni_(3)S_(2)和Ni为主的结晶层,电化学分析结果表明热处理减少非晶Ni-S合金镀层的析氢活性位点,增大氢气从Ni-S合金表面脱附难度,显著削弱Ni-S/NF电极的电化学析氢性能。

Emotional Value Care to Promote Emotional Communication Between Teachers and Students Under the New Era of Education Mode

With the development of the times and the progress of the society,the ancient education mode can no longer meet the requirements of the times.The concept of educating people must keep pace with the times.The way teachers and students get along is no longer like in ancient times,where teachers teach students to listen.In the new era,it is necessary to build a new model of interaction between teachers and students.If educators pay attention and come to understand students’psychology,listen to students’aspirations,tend to students’emotions,grow in love for education,and treat students from their hearts,they would be able to win the favor of students.Paying attention to students’emotional value can promote emotional communication between teachers and students.It is possible to adapt to the requirements of the new era for the construction of morality and ethics among teachers by caring for students’emotional value.

Perianal Crohn’s disease:Still more questions than answers

In this editorial we comment on the article by Pacheco et al published in a recent issue of the World Journal of Gastroenterology.We focus specifically on the burden of illness associated with perianal fistulizing Crohn’s disease(PFCD)and the diagnostic and therapeutic challenges in the management of this condition.Evol-ving evidence has shifted the diagnostic framework for PFCD from anatomical classification systems,to one that is more nuanced and patient-focused to drive ongoing decision making.This editorial aims to reflect on these aspects to help clinicians face the challenge of PFCD in day-to-day clinical practice.

Recent advances on vaccines against malaria: A review

This review aims to summarize the currently viable vaccine strategies including the approved vaccines and the those in trials for next-generation malaria vaccines.Data on malaria vaccine development was collected through a comprehensive review.The literature search was performed using databases including Google Scholar,PubMed,NIH,and Web of Science.Various novel approaches of vaccination are being developed,including those based on radiation-attenuated strategies,monoclonal antibodies,targeted immunogenic peptides,RNA and DNA vaccines,nanoparticle-based vaccines,protein-based vaccination protocols,and whole organism-based vaccination strategies.Trials on RTS,S have entered phase Ⅲtesting,and those based on blood-stage vaccines and vaccines to interrupt malarial transmission have advanced to higher stages of trials.Mathematical modeling,combined drug and vaccine strategies,mass drug administration,polyvalent vaccine formulations,and targeted vaccination campaigns is playing an important role in malarial prevention.Furthermore,assessing coverage,accessibility,acceptability,deployment,compilation,and adherence to specific vaccination strategies in endemic regions is essential for vaccination drives against malaria.

老年慢性阻塞性肺疾病患者应用Swanson关怀理论的健康教育实践研究

目的观察基于Swanson关怀理论的健康教育对老年慢阻肺患者治疗依从性和生活质量的影响。方法回顾性选取2021年6月—2023年6月间在亳州市人民医院接受治疗的老年COPD稳定期患者104例,依据不同干预措施将患者分为对照组和观察组,每组52例。对照组患者行常规健康教育,观察组采用基于Swanson关怀理论的健康教育。观察并比较2组干预前后患者治疗依从性、生活质量和肺功能指标值变化情况。结果干预后,观察组和对照组患者吸入药物治疗依从性量表(TAI)评分均较同组干预前升高,且观察组TAI评分高于对照组(均P<0.05);观察组和对照组患者活动能力、胸闷、精力和日常活动能力评分较同组干预前降低,且观察组上述评分均低于对照组(均P<0.05)。干预后,观察组和对照组患者FVC、FEV 1/FVC较干预前升高,且观察组高于对照组(P<0.05)。结论应用基于Swanson关怀理论的健康教育可显著改善老年慢阻肺患者的治疗依从性,提高患者的生活质量和肺功能。

“优师计划”背景下师范生U-G-S培养模式价值、问题及对策

从“优师计划”背景下师范生U-G-S培养模式价值分析入手,剖析“优师计划”背景下师范生U-G-S培养模式中地方政府、师范院校、中小学校、师范生四个基本要素各自存在问题,提出“四位一体”师范生U-G-S培养模式提升对策,以当地政府为主导、以师范院校为引领、以中小学校为核心、以师范生为主体,统筹各方培养资源和优势力量,激活多方利益主体意愿,助力乡村卓越教师的培养。