Abstract Background Behcet’s disease (BD) can involve any site of the alimentary canal. There has been research concerning intestinal BD. Nevertheless, the entire digestive tract not yet been studied extensively. Therefore, the purpose of study was to describe the prevalence, location, clinical features and possible risk factors of BD with gastrointestinal tract ulcer. Methods This was a cross-sectional observational study that included 1232 consecutive BD patients who routinely underwent endoscopy upon their wishes. The clinical symptoms, endoscopic findings, and histologic features of BD with gastrointestinal ulcer and negative Helicobacter pylori (Hp) were identified. Result We found that 22.16% (273/1232) Hp-negative BD patients had ulcers of the alimentary tract. At presentation, 61.54% (168/273) patients were asymptomatic. The numbers of BD patients with gastrointestinal ulcers isolated to upper gastrointestinal tract, small bowel, ileocecal region, ascending colon, transverse colon, descending colon, sigmoid colon and rectum were 84, 4, 106, 2, 3, 1, 2 and 8, respectively. The rest involved at least two of these intestinal segments. Only one patient suffered from total gastrointestinal tract involvement. Inflammation was the most common histopathologic feature 77.60% (142/183). The 273 BD patients with gastrointestinal ulcer were at greater risk of having archenteric symptoms (OR = 0.108, P ＜ 0.001), fever (OR = 0.235, P = 0.001) and high CRP level (OR = 0.991, P = 0.019). Uveitis may be a protective factor for gastrointestinal ulcer in patients with BD (OR = 2.480, P = 0.002). Conclusion BD could affect the upper gastrointestinal tract independently. Endoscopy should be conducted in all patients in whom a diagnosis of BD is entertained, especially in patients with higher CRP and fever. While, BD patients with uveitis correlates negatively with gastrointestinal involvement.
Abstract Background Cardiac Behçet’s syndrome (cardiac BS) is rare but lethal. And the influencing factors of prognoses in cardiac BS are not clear. This study was conducted to summarize the features of cardiac BS and find the predictors of unfavourable prognoses for cardiac BS patients. Methods Sixty-six cardiac BS patients were included from 1467 BS patients in the Shanghai Behçet’s syndrome database. The median follow-up duration was 4.0 (2.0–7.0) years. The unfavourable prognosis was defined as a compound event containing all-cause death and rehospitalization related to worsened cardiac lesions or postoperative complications. Logistic regression analyses were performed to evaluate the predictors of unfavourable prognoses. Results In this study, the mortality rate of cardiac BS patients was 10.61% (7/66), and 22 (33.33%) patients experienced two or more surgeries. Ninety-six cases were collected from 66 cardiac BS patients. The effective rates of postoperative biological agents and Janus kinases (JAK) inhibitors in cardiac BS patients were 88.89% (16/18) and 81.25% (13/16) respectively. Former smoking, valve replacement or repairment and poor compliance were found to be the independent risk factors of unfavourable prognoses; preoperative immunosuppressive therapies and postoperative immunosuppressive therapies were independent protective factors for unfavourable prognoses in total cardiac BS. In 65 cases of cardiac BS after aortic valve surgeries, former smoking was an independent risk factor for unfavourable prognoses. Bentall procedure, postoperative traditional DMARDs, postoperative JAK inhibitors or biological agents were independent protective factors for unfavourable prognoses in cardiac BS patients after aortic valve surgeries. Conclusion Both preoperative immunosuppressive therapies and postoperative immunosuppressive therapies are necessary for cardiac BS patients. Bentall procedure is recommended to be performed in BS patients with severe AR. Besides biological agents, JAK inhibitors can be used in cardiac BS patients after aortic valve surgeries for promoting favourable outcomes.
Abstract Background T lymphocytes are one of the major components of the adaptive immunity in Behçet’s syndrome (BS) pathology. To further understand of the role of T cells in Behçet’s syndrome (BS), we explore disease related T cell receptor (TCR) repertoires. Methods We performed a bulk sequencing of the TCR beta chain (TRB) of peripheral T-cells collected from 45 BS patients with panuveitis, intestinal involvement, and cardiovascular lesions and 10 cases of healthy controls (HC). Data analysis included peptide sequences, diversity analysis, variable (V)-joining (J) gene usage and K-nearest neighbor algorithm. Results We found significant differences in V, J and V-J combinations between the BS patients and HC. The decrease in TCR clone diversity indicates clonal expansion in BS. Although no significant difference in TCR clone diversity was observed among patient subgroups, the patients with panuveitis displayed the highest heterogeneous TCR distribution. In addition, a set of V-J genes could effectively discriminate between active and inactive BS patients with an area under the receiver operating characteristics (ROC) curve of 0.88 (95% CI: 0.77-1.00). Conclusions Clonal T cell expansion has been observed in BS patients. TCR profiles could help in the discrimination between active and inactive BS.
The panda burns incense case is a typical network criminal case.It involves the question of whether the criminal suspects of this case should sentenced and published by crime of destroying computer information system and larceny.So it is necessary for supreme judicial authority to make corresponding judicial interpretation about how to recognize consequence is serious and criminal law protection of network hypothesized property to effectively strike network criminal act.
Abstract Background Behçet’s syndrome (BS) is a rare variant vasculitis which can involve the eyes and gastrointestinal systems. However, ocular involvement rarely overlaps with intestinal lesions. This study aimed to compare the clinical characteristics and laboratory parameters of ocular BS and intestinal BS patients in China and analyze the differences between two key phenotypes to verify the heterogeneous conditions in BS patients. Methods A retrospective analysis was used to collect the demographic data, clinical characteristics, endoscopic findings, and laboratory parameters from 135 ocular BS and 174 intestinal BS patients. The Mann-Whitney U test and Pearson chi-square or continuity correction was used to analyze the differences between two groups. Results Among 916 BS patients enrolled in this study, ocular BS and intestinal BS accounted for 14.74% (135 cases) and 19.00% (174 cases), respectively. Ocular and intestinal involvements overlapped in only 7 cases (0.76%). Male gender (74.8% vs. 51.1%, P =0.00), erythema nodosum (45.9% vs. 32.2%, P =0.01), and vascular involvement (6.7% vs. 1.7%, P =0.03) were more frequent in the ocular BS group compared with the intestinal BS group. On the contrary, hematologic involvement (7.5% vs. 0.0%, P =0.00) and fever (17.8% vs. 4.4%, P =0.00) were more frequent in the intestinal BS group compared with the ocular BS group. Additionally, the inflammation markers including ESR [26.5 (16.0–41.5) vs. 9.0 (5.0–15.0) mm/H, P =0.00], CRP [14.8 (4.8–33.0) vs. 4.1 (1.6–8.3) mg/L, P =0.00], serum amyloid A [27.4 (10.8–92.3) vs. 11.3 (6.0–24.0) mg/L, P =0.00], and interleukin 6 [8.4 (1.7–18.7) vs. 1.7 (1.5–3.2) pg/mL, P =0.00] were higher in the intestinal BS group than those in the ocular BS group, respectively. Conclusions Ocular BS was more prevalent in male patients and more likely to manifest with erythema nodosum and vascular involvement, while intestinal BS tends to have fever and hematologic disorders with higher inflammation markers. Ocular BS and intestinal BS are two distinct clinical phenotypes and very rarely overlapped.
Kandelia obovata Sheue, H.Y.Liu & J.W.H.Yong is one of the most cold-resistant true mangrove species, and it is widely distributed from the South China Sea to southern Japan. In the current study, the complete mitochondrial genome sequence of K. obovata was assembled using Illumina reads. It is the first mitochondrial genome of the Kandelia genus within the family Rhizophoraceae to be sequenced. The mitochondrial genome size is 312,146 bp with a total of 49 predicted genes, including 29 protein-coding genes, 17 transfer RNA genes, and 3 ribosomal RNA genes. The overall GC content of the genome is 41.87%. A phylogenetic tree constructed using nine complete mitochondrial genomes revealed that K. obovata is more closely related to Bruguiera species. This study enriches the plastid genome of Kandelia, furnishing valuable genetic insights for the investigation of evolutionary and population genetics in Kandelia and other mangrove species.
This retrospective cohort study aimed to find out predictors and early biomarkers of Infliximab (IFX) refractory intestinal Behçet's syndrome (intestinal BS).We collected the baseline clinical characteristics, laboratory parameters, and concomitant therapies of intestinal BS patients treated by IFX from the Shanghai Behçet's syndrome database. After 1 year IFX therapy, intestinal BS patients with non-mucosal healing (NMH, intestinal ulcers detected by colonoscopy) and/or no clinical remission [NCR, scores of the disease activity index for intestinal Behçet's disease (DAIBD) ≥20] were defined as IFX refractory intestinal BS. Multivariate logistic regression analysis was performed to evaluate the predictors for NMH and NCR in IFX refractory intestinal BS.In 85 intestinal BS patients, NMH was identified in 29 (34.12%) patients, and NCR was confirmed in 20 (23.53%) patients. Erythrocyte sedimentation rate (ESR; ≥24 mm/h) and free triiodothyronine (fT3; ≤3.3pmol/L) were the independent risk factors of NMH in IFX refractory intestinal BS. Drinking alcohol and the fT3/free thyroxine ratio (fT3/fT4; ≤0.24) were independent risk factors, and thalidomide was an independent protective factor, for NCR in intestinal BS patients treated by IFX.This study may be applicable for adjusting the therapeutic strategy and sidestepping unnecessary exposure to IFX in intestinal BS patients. Routine assessments of ESR, fT3, and fT3/fT4 ratio are helpful to identify high-risk individuals of IFX refractory intestinal BS. Thalidomide is suggested to be a concomitant therapy with IFX for intestinal BS patients.
Abstract Background Behçet’s disease (BD) can involve any site of the alimentary canal. There has been research concerning intestinal BD. Nevertheless, the entire digestive tract not yet been studied extensively. Therefore, the purpose of study was to describe the prevalence, location, clinical features and possible risk factors of BD with gastrointestinal tract ulcer. Methods This was a cross-sectional observational study that included 1232 consecutive BD patients who routinely underwent endoscopy upon their wishes. The clinical symptoms, endoscopic findings, and histologic features of BD with gastrointestinal ulcer and negative Helicobacter pylori (Hp) were identified. Result We found that 22.16% (273/1232) BD patients had ulcers of the alimentary tract. At presentation, 61.54% (168/273) patients were asymptomatic. Isolated gastroduodenal involvement is an extremely usual event. The second was the pairwise combination between bowel segments, and 24 cases involved three segments at the same time. One patient suffered from total gastrointestinal tract involvement. Inflammation was the most common histopathologic feature 77.60% (142/183). The 273 BD patients with gastrointestinal ulcer were at greater risk of having archenteric symptoms (OR 0.070, P < 0.001), fever (OR 0.115, P = 0.047), high CRP (OR 0.994, P = 0.027) and BDCAF level (OR 0.590, P = 0.010). Uveitis correlates negatively with gastrointestinal involvement in BD patients (OR 3.738, P = 0.011). Conclusions BD could affect the upper gastrointestinal tract independently. Endoscopy should be conducted in all patients in whom a diagnosis of BD is entertained, especially in patients with higher CRP, disease activity and fever. While, BD patients with uveitis correlates negatively with gastrointestinal involvement.
'/%3e%3cuse xlink:href='%23a' transform='rotate(23.036 .093 25.536)'/%3e%3cuse xlink:href='%23a' transform='rotate(45.87 1.273 16.18)'/%3e%3cuse xlink:href='%23a' transform='rotate(69.945 .996 12.078)'/%3e%3cuse xlink:href='%23a' transform='rotate(20.66 -19.689 31.932)'/%3e%3c/svg%3e)
