Background The relationship between nutritional indices and treatment response in ulcerative colitis (UC) remains poorly characterized. Objectives To assess the discriminatory ability of Geriatric Nutritional Risk Index (GNRI), Malnutrition Universal Screening Tool (MUST), and Prognostic Nutritional Index (PNI) in evaluating the clinical efficacy of vedolizumab (VDZ) in patients with moderate-to-severe UC. Design A retrospective multicenter study. Methods This study enrolled moderate-to-severe UC patients receiving VDZ at three centers in northern China from 2021 to 2025. The relationship between baseline nutritional indices and clinical remission, alongside conventional biomarkers, was analyzed. Discriminatory performance was evaluated using receiver operating characteristic curves and area under the curve (AUC) analysis. Results A total of 184 patients were included. At week 14, multivariable logistic regression identified GNRI, PNI and MUST as factors significantly associated with clinical remission. GNRI showed the strongest correlation with clinical remission (r=0.340, p< 0.001), followed by HGB (r=0.316, p< 0.001), PNI (r=0.308, p< 0.001), PLR (r=-0.271, p< 0.001), MUST (r=-0.216, p= 0.003), and NLR (r=-0.163, p= 0.027). GNRI had the highest AUC (0.697), followed by HGB (0.683), PNI (0.678), Alb (0.660), PLR (0.657) and MUST (0.614). GNRI exhibited significantly greater discriminatory ability for 14-week clinical remission than Alb ( p =0.018) and MUST ( p= 0.041). No significant differences in diagnostic accuracy were found between GNRI, HGB, PNI, PLR, and NLR ( p> 0.05). At week 30 and 54, multivariate analysis showed that only baseline HGB remained independently associated with remission. Conclusions Patients with lower nutritional risk—as reflected by higher GNRI and PNI scores, alongside lower MUST scores-were significantly more likely to achieve clinical remission at week 14.

BackgroundVedolizumab (VDZ), a novel biologic targeting α4β7 integrin, is safe and effective for the treatment of patients with ulcerative colitis (UC). The objective of this study was to compare the potential of the Platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) in predicting clinical remission and treatment failure in patients with moderate-to-severe UC on VDZ therapy and to explore the risk factors for treatment failure.MethodsSeventy-four UC patients treated with VDZ at our institution between December 1, 2020, and October 1, 2023, who had medical records were included in this study. We retrospectively collected baseline NLR, PLR, and SII values and assessed the predictive ability of the three indices for clinical remission and treatment failure using the receiver operating characteristic (ROC) curves.ResultsPatients in the severe group (n = 47) had significantly higher baseline PLR and SII values than those in the moderate group (n = 27) (p < 0.05). Patients with MES3 had significantly higher PLR and SII values than patients with MES2 (p < 0.05). At 14 weeks after VDZ treatment, 28 patients obtained steroid-free clinical remission, whereas 46 did not. The area under the ROC curve (AUC) for SII was 0.659 for predicting clinical remission and exhibited the best predictive ability. Of the 52 patients who achieved long-term remission, 35 patients responded consistently to VDZ, whereas 17 patients experienced disease relapse. The SII, with an AUC of 0.793, showed the best predictive ability (sensitivity: 94.1%; specificity: 57.1%; cut-off value: 602.0). Cox regression analysis revealed that SII ≥602.0, was a potential predictor of relapse after VDZ treatment in UC patients (p = 0.048, hazard ratio: 8.651; 95% confidence interval: 1.017–73.593).ConclusionThe SII performed better than NLR and PLR in predicting clinical remission and relapse for UC patients on VDZ therapy. Moreover, patients with high SII may relapse after VDZ treatment and should be treated with caution.

This study aimed to delve deeper into the effects of CRLF3 on the immune microenvironment and the interaction between CRLF3 and ACTR2 in hepatocellular carcinoma (HCC). CRLF3 and ACTR2 in mouse tumor tissues and HepG2 cells were measured by RT-qPCR and Western Blot. The proliferative ability of HepG2 cells was assessed by MTT and colony formation assays, with apoptosis determined by flow cytometry, and migration and invasion quantified by Transwell assay. The apoptosis rate of CD8+ T cells was calculated by flow cytometry, as well as TNF-α and IFN-γ positivity in CD8+ T cells. TNF-α, IFN-γ, and IL-2 were assayed by ELISA. The interaction between CRLF3 and ACTR2 was examined using immunoprecipitation and Western Blot experiments. CRLF3 targeted binding to ACTR2 promoted the proliferative and migratory capacities of HepG2 cells and inhibited apoptosis. Lowering CRLF3 inhibited HCC cell immune escape, with a significant increase in TNF-α and IFN-γ-positive populations in CD8+ T cells, and enhancing ACTR2 significantly mitigated this effect. Lowering CRLF3 inhibited HCC xenografted tumor growth in nude mice. Through its targeted binding to ACTR2, CRLF3 aids in the growth and immune escape of HCC cells.

PURPOSE:To explore the factors influencing noncurative resection (NCR) in patients with rectal neuroendocrine neoplasms (R-NENs) on the basis of endoscopic ultrasonography (EUS) findings and to construct and validate a nomogram prediction model based on these factors. METHODS:This retrospective cohort study included 244 patients with pathologically confirmed R-NEN who underwent endoscopic submucosal dissection (ESD) at the Affiliated Hospital of Qingdao University between March 2016 and June 2023. The patients' EUS and clinical features were collected to identify independent factors influencing NCR following ESD. A nomogram prediction model was constructed, and its performance was evaluated with receiver operating characteristic (ROC) curve analysis. RESULTS:A larger tumor diameter, irregular borders, and submucosal involvement on EUS were identified as independent risk factors for NCR following ESD in patients with R-NENs. A nomogram model integrating these three predictors effectively predicted the occurrence of NCR. ROC curve analysis was used to compare the clinical predictive efficacy of the independent influencing factors and their combination. The results revealed that the area under the curve for the combination of factors was 0.791, with a sensitivity of 68.6% and specificity of 86.0%, indicating good clinical diagnostic value. The Hosmer-Lemeshow goodness-of-fit test ( P  = 0.178) indicated satisfactory model calibration. CONCLUSION:The nomogram model achieved good predictive performance. This model can assist endoscopists in dynamically assessing the risk of NCR in real time, but its clinical applicability requires verification.

We report a rare case of a 63-year-old man with ulcerative colitis (UC) who presented with hemoptysis and was diagnosed with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), evidenced by positivity for both cytoplasmic-ANCA (c-ANCA) and perinuclear-ANCA (p-ANCA). Imaging and bronchoscopy supported pulmonary involvement. Glucocorticoid therapy led to rapid resolution of respiratory symptoms; however, steroid tapering triggered a UC flare requiring biologic therapy and eventual total colectomy. At the 3-year follow-up, the patient remained free of pulmonary symptoms. This case underscores the importance of considering AAV in UC patients with hemoptysis to enable early diagnosis and appropriate management.

Elderly individuals with ulcerative colitis (UC) require specialized care given their prevalent multimorbidity, decreased physiologic reserves, and greater predisposition to adverse outcomes. Therefore, finding safe and effective treatments for this population is crucial. This study investigated whether probiotic mixtures of either Clostridium butyricum and Bifidobacterium infantis (hereinafter designated CB) or VSL#3 (a mixture of eight bacterial species) may reduce the severity of colitis and examined the pathogenesis of dextran sulfate sodium (DSS)-induced colitis in aged mice. Male C57BL/6 mice aged 14–18 months were treated with DSS to induce acute colitis. CB and VSL#3 were administered by gavage. Colitis severity was assessed quantitatively through disease activity index (DAI), histopathologic scores, and colon length. Intestinal epithelial cells were examined by transmission electron microscopy. Intestinal barrier Function was evaluated by Western blot assays of E-cadherin and occludin expressions. Microbiota of stool and colonic mucosa were characterized by 16S rRNA analysis. CB and VSL#3 alleviated colitis, evidenced by significantly lower DAI and histopathologic scores and increased colon lengths. CB- and VSL#3-treated mice exhibited the arrangement of epithelial cell surface microvilli in neat rows and clear and complete tight junction strands and desmosomes. CB increased E-cadherin and occludin expressions. CB-treated mice exhibited higher levels of beneficial bacteria (Clostridium_sensu_stricto, Ruminococcaceae_UCG-014, Rikenellaceae_RC9_gut_group). VSL#3-treated mice exhibited increased levels of Clostridium_sensu_stricto_1. In conclusion, both CB and VSL#3 reduced the severity of colitis in aged mice by enhancing intestinal barrier function and modulating gut microbiota. These findings underscore the potential therapeutic benefits of probiotics in elderly UC patients.

Background: The elderly ulcerative colitis (UC) patients pose unique challenges due to their comorbidities, diminished functional capacity, and heightened risk of treatment-related complications. Thus, finding a safe and effective treatment for this age group is crucial. Aim: This study investigates the role of autophagy in the pathogenesis of UC in young and elderly patients, and explores the therapeutic potential and mechanisms of autophagy modulators in aged mice with dextran sulfate sodium (DSS)-induced colitis. Methods: Colonic biopsies were collected from young and old UC patients as well as comparable healthy subjects. Young (6-8 weeks) and aged (56 weeks) C57BL/6 mice were treated with DSS to induce acute colitis model. The autophagy inhibitor 3-methyladenine was administered intraperitoneally to aged DSS-induced mice. The autophagy activity was detected by the protein expressions of LC3B-II, p62 and ATG5 by western blot and immunohistochemistry. The levels of TNF-alpha, IL-6, CCL4, CXCL12 and CD86 were measured by qRT-PCR. The transcriptional activity of NF-kappa B was measured by electrophoretic mobility shift assay (EMSA). Results: Increased autophagy activity was observed in aged DSS-induced mice. Treatment with 3-methyladenine suppressed autophagy in intestinal epithelial cells (IECs) and alleviated colitis severity. Additionally, 3-methyl- adenine reduced macrophage recruitment, decreased IL-6 levels, and inhibited NF-kappa B signaling, thereby mitigating inflammation. Conclusion: Significant differences in autophagy activity were identified between young and aged DSS-induced mice. These findings underscore the potential therapeutic benefits of autophagy inhibition in elderly UC patients.

BackgroundPOEMS syndrome is a rare hematologic disorder related to plasma cell dyscrasia. The Castleman disease variant of POEMS syndrome is extremely rare and often misdiagnosed. In this study, we aim to present a noteworthy case of POEMS syndrome mainly manifested as multiple pleural effusion and renal impairment without M protein.Case presentationA 47-year-old woman was admitted to the hospital with a 7-month history of lower extremity edema and 3 months of abdominal distension. Computed tomography revealed poly-serosal effusion and hepatosplenomegaly, while ultrasound showed multiple superficial lymphadenopathies. Serum protein electrophoresis and bone biopsy indicated no evidence of monoclonal plasma cell proliferation. Pathological results obtained from lymph node biopsy revealed Castleman disease (CD). The patient was ultimately diagnosed with the Castleman disease variant of POEMS syndrome without M protein. Renal function gradually declined in the later stages of the disease. After transferring to another hospital, the patient received a VPD chemotherapy regimen (Pomalidomide, Bortezomib, and Dexamethasone) and hemodialysis. Effusions in multiple serosal cavities were reduced, and renal function improved significantly following active treatment.ConclusionPOEMS syndrome without M protein is often misdiagnosed as other conditions. In patients presenting with multiple systemic manifestations, the possibility of POEMS syndrome or CD should be considered.

Limited data exist regarding the efficacy and safety of vedolizumab (VDZ) in China’s elderly adult population with ulcerative colitis (UC) in China. In this investigation, a comparative analysis of its efficacy and safety was performed between elderly and younger adult UC cohorts. Patients with moderate-to-severe UC and at least three VDZ infusions at our clinic between March 2021 and November 2024 were retrospectively recruited. The elderly adult patients (≥ 60 years at first VDZ dose) were matched clinically 1:2 to younger patients (18–59 years). This study included 30 elderly and 60 younger adult patients. There were no significant differences between the two groups regarding sex, body mass index, percentage of smokers, disease duration, disease extent, disease activity, Mayo endoscopic scores, extra-intestinal manifestations, perianal disease, history of bowel-related surgery, or previous and concomitant therapies. At week 6, the clinical remission and steroid-free clinical remission (SFCR) rates were significantly lower (10.00

Vedolizumab (VDZ), a monoclonal antibody to α4β7 integrin, is available for patients with moderate-to-severe ulcerative colitis (UC). This study planned to assess the real-world effectiveness and safety of VDZ for UC patients in Northern China. We enrolled patients with moderate-to-severe UC who underwent VDZ induction therapy from March 2021 to November 2022 at the Affiliated Hospital of Qingdao University. The primary outcome was clinical remission at weeks 14 and 52 after the initial VDZ therapy. Overall adverse events and risk factors associated with loss of response (LOR) were also evaluated. Seventy-three UC patients receiving VDZ therapy were included in this study. The rates of clinical response, clinical remission, and steroid-free clinical remission were 69.9%, 39.7%, and 34.2% at week 14 and 90.5%, 66.7%, and 64.4% at week 52, respectively. The mucosal remission rates were 37.5% (18/48) at week 14 ± 8 and 27.3% (9/33) at week 52 ± 16, while only 2 and 3 patients achieved mucosal healing at weeks 14 ± 8 and 52 ± 16, respectively. Of the UC patients, 23.3% experienced adverse events associated with VDZ, most of which were mild and self-limiting. Until the last follow-up, 37 of 73 UC patients experienced LOR during the maintenance period. Patients with a higher ulcerative colitis endoscopic severity index (UCEIS), partial Mayo scores (PMS), or hemoglobin below 120 g/L at baseline were more likely to experience LOR after VDZ induction therapy. VDZ is an effective and safe agent for patients with moderate-to-severe UC in Northern China. A high baseline UCEIS, PMS, or hemoglobin < 120 g/L may be an independent risk factor for LOR during the maintenance period.

Background: The efficacy of ustekinumab (UST) and infliximab (IFX) in Crohn’s disease (CD) patients with intestinal stenosis remains uncertain. Objective: This study aims to compare the efficacy of UST and IFX in the treatment of CD patients with intestinal stenosis. Design: This was a retrospective and multicenter cohort study. Methods: In this retrospective study, we included CD patients treated with IFX or UST at five centers. We assessed the clinical response rate at weeks 12 and 24, steroid-free clinical remission rate at weeks 24 and 52 for overall patients and those with stenosis, and objective examination (intestinal ultrasound and/or endoscopy) response rate at week 52 for stenosis patients. Results: A total of 211 CD patients (106 IFX and 105 UST) were included, with 119 (56 IFX and 63 UST) having intestinal stenosis. In the overall patient population, there were no significant differences in clinical response rate and steroid-free clinical remission rate at weeks 12, 24, and 52 between the IFX and UST groups. In patients with stenosis, the steroid-free clinical remission rate at week 52 was significantly lower in the IFX group compared to the UST group (51.79% IFX vs 69.84% UST, p = 0.044). The objective examination response rate did not significantly differ between the IFX and UST groups at week 52 (66.67% IFX vs 76.19% UST, p = 0.690). In the UST group, steroid-free clinical remission rate was higher in bio-naïve patients than bio-experienced patients at week 24 (75.00% bio-naïve vs 55.38% bio-experienced, p = 0.043). Conclusion: UST may be considered a more advantageous treatment option for those CD patients with intestinal stenosis, as it has better steroid-free clinical remission rates compared to IFX.

Rationale: The interstitial pneumonia (IP) linked to vedolizumab (VDZ) in patients with ulcerative colitis (UC) is rare. Prompt diagnosis and treatment can improve patient outcomes. Patient concerns: A 39-year-old man with UC who received VDZ as sole therapy developed symptoms such as chest tightness, cough, and suffocation. Diagnoses: IP was confirmed through pulmonary function tests, chest computed tomography, and bronchoscopic biopsy. Interventions: The patient was given methylprednisolone and VDZ cessation. Outcomes: The patient’s symptoms improved and remained symptom-free after nearly 2 years. Lessons: VDZ-induced IP should be considered when evaluating pulmonary infections in UC patients treated with VDZ.

BACKGROUND Endoscopic evaluation in diagnosing and managing ulcerative colitis (UC) is becoming increasingly important. Several endoscopic scoring systems have been established, including the Ulcerative Colitis Endoscopic Index of Severity (UCEIS) score and Mayo Endoscopic Subscore (MES). Furthermore, the Toronto Inflammatory Bowel Disease Global Endoscopic Reporting (TIGER) score for UC has recently been proposed; however, its clinical value remains unclear. AIM To investigate the clinical value of the TIGER score in UC by comparing it with the UCEIS score and MES. METHODS This retrospective study included 166 patients with UC who underwent total colonoscopy between January 2017 and March 2023 at the Affiliated Hospital of Qingdao University (Qingdao, China). We retrospectively analysed endoscopic scores, laboratory and clinical data, treatment, and readmissions within 1 year. Spearman’s rank correlation coefficient, receiver operating characteristic curve, and univariate and multivariable logistic regression analyses were performed using IBM SPSS Statistics for Windows, version 26.0 (IBM Corp., Armonk, NY, United States) and GraphPad Prism version 9.0.0 for Windows (GraphPad Software, Boston, Massachusetts, United States). RESULTS The TIGER score significantly correlated with the UCEIS score and MES (r = 0.721, 0.626, both P < 0.001), showed good differentiating values for clinical severity among mild, moderate, and severe UC [8 (4–112.75) vs 210 (109–219) vs 328 (219–426), all P < 0.001], and exhibited predictive value in diagnosing patients with severe UC [area under the curve (AUC) = 0.897, P < 0.001]. Additionally, the TIGER (r = 0.639, 0,551, 0.488, 0.376, all P < 0.001) and UCEIS scores (r = 0.622, 0,540, 0.494, and 0.375, all P < 0.001) showed stronger correlations with laboratory and clinical parameters, including C-reactive protein, erythrocyte sedimentation rate, length of hospitalisation, and hospitalisation costs, than MES (r = 0.509, 0,351, 0.339, and 0.270, all P < 0.001). The TIGER score showed the best predictability for patients' recent advanced treatment, including systemic corticosteroids, biologics, or immunomodulators (AUC = 0.848, P < 0.001) and 1-year readmission (AUC = 0.700, P < 0.001) compared with the UCEIS score (AUC = 0.762, P < 0.001; 0.627, P < 0.05) and MES (AUC = 0.684, P < 0.001; 0.578, P = 0.132). Furthermore, a TIGER score of ≥ 317 was identified as an independent risk factor for advanced UC treatment (P = 0.011). CONCLUSION The TIGER score may be superior to the UCIES score and MES in improving the accuracy of clinical disease severity assessment, guiding therapeutic decision-making, and predicting short-term prognosis.

目的 探讨外周血CD3+HLA-DR+活化T淋巴细胞(简称活化T细胞)对溃疡性结肠炎(ulcerative colitis,UC)患者疾病严重程度及药物疗效的预测价值.方法 纳入2013年8月至2022年1月就诊于青岛大学附属医院的96例UC患者,根据纳入患者活化T细胞水平分为活化T细胞升高组和活化T细胞正常组,回顾性分析两组患者活化T细胞水平与UC疾病严重程度及药物疗效的相关性及其预测价值.结果 活化T细胞升高组与活化T细胞正常组比较,重度UC患者更多(P<0.001),CRP和ESR水平更高(P<0.05);Spearman相关性分析显示,活化T细胞水平与UC疾病严重程度和CRP水平均呈高度相关(P<0.001).两组患者药物疗效分析,活化T细胞升高组的维得利珠单抗(Vedolizumab,VDZ)临床缓解率和糖皮质激素有效率更低(P<0.05),两组间英夫利西单抗(Infliximab,IFX)临床缓解率差异无统计学意义(P=0.449).ROC曲线分析,活化T细胞水平预测UC患者疾病严重程度(AUC=0.854,P<0.001)、VDZ(AUC=0.859,P=0.002)和糖皮质激素(AUC=0.699,P=0.027)疗效的cut-off值分别为5.35％、3.35％、4.55％.结论 外周血CD3+HLA-DR+活化T淋巴细胞水平升高能够初步预测UC疾病重度活动并提示VDZ可能疗效不佳.

The scoring systems commonly used to assess endoscopic disease severity of ulcerative colitis (UC) in clinical research and practice include the Mayo endoscopic score (MES), ulcerative colitis endoscopic severity index (UCEIS), and degree of ulcerative colitis burden of luminal inflammation (DUBLIN). We aimed to assess and compare the predictive efficacy of the MES, DUBLIN score and UCEIS score for prognosis in UC patients treated with vedolizumab (VDZ). Seventy-four UC patients who treated with VDZ from September 2021 to February 2023 were retrospectively enrolled. We used the MES, DUBLIN and UCEIS score to evaluate endoscopic findings. The predictive capability of these 3 scores for surgery or therapeutic escalation was assessed using the receiver operating characteristic curve. The mean MES, DUBLIN and UCEIS score significantly improved from 2.83 ± 0.38, 7.80 ± 1.82 and 6.24 ± 1.51 to 2.07 ± 0.88, 5.57 ± 2.68, and 3.72 ± 2.12, respectively (P < .001). Lower pre-therapeutic UCEIS scores were associated with favorable short-term outcomes. Importantly, the post-therapeutic UCEIS score showed the best predictive capability with an area under curve of 0.871 (95% confidence interval: 0.767-0.976), specificity of 0.654, sensitivity of 0.900, and cutoff value of 3.5. A UCEIS score of ≥ 4 after treatment was correlated with surgical operation or treatment escalation. The UCEIS score is superior to the MES and DUBLIN score in reflecting short-term outcomes and long-term prognosis in UC patients treated with VDZ, and clinical remission could be defined as a UCEIS score ≤ 3.

报道1例以Glu81Lys突变的转甲状腺素蛋白淀粉样变性（ATTR）老年患者的诊治过程，患者表现为腹泻、下肢无力、四肢肌肉萎缩、感觉异常、反复晕厥及体位性低血压，检查可见病变累及消化、周围和自主神经及心脏系统，口服氯苯唑酸效果不佳，最终因心力衰竭死亡。

BACKGROUND Smoldering multiple myeloma (SMM) is an asymptomatic plasma cell proliferative disorder that can progress to multiple myeloma (MM). Amyloidosis (light chain) (AL) is the most common form of systemic amyloidosis. There are few reports of SMM coexisting with AL involving the digestive tract. CASE SUMMARY A 63-year-old woman presented with lower limb edema, abdominal distension, abdominal pain, and hematochezia. Gastroscopy showed gastric retention, gastric angler mucosal coarseness, hyperemia, and mild oozing of blood. Colonoscopy showed hyperemic and edematous mucosa of the distal ascending colon and sigmoid colon with the presence of multiple round and irregular ulcers, submucosal ecchymosis, and hematoma. Gastric and colonic tissue biopsy confirmed the diagnosis of AL by positive Congo red staining. MM was confirmed by bone marrow biopsy and immunohistochemistry. The patient had no hypercalcemia, renal dysfunction, anemia, bone lesions or biomarkers of malignancy defined as plasma cells > 60% in bone marrow. Additionally, no elevated serum free light chain ratio, or presence of bone marrow lesions by magnetic resonance imaging (SLiM criteria) were detected. The patient was finally diagnosed with SMM coexisting with AL. She received chemotherapy and was discharged when the symptoms were relieved. She is doing well at nearly five years of follow up. CONCLUSION This case highlights that high index of suspicion is required to diagnose gastrointestinal AL. It should be suspected in elderly patients with endoscopic findings of granular-appearing mucosa, ecchymosis, and submucosal hematoma. Timely diagnosis and appropriate therapy can help to improve the prognosis of these patients.

BackgroundAcute pancreatitis (AP) damages the intestinal barrier, which aggravates AP. Butyrate exhibits anti-inflammatory effects in AP, but it is unknown if such a protective effect is associated with the regulation of gut microorganisms. We aim to investigate the effects of sodium butyrate (SB) on pancreatic inflammation, colonic barrier, and gut microorganisms.MethodsC57BL/6 mice were divided into groups of sham operation (Sham), AP, 200 mg/kg SB intervention (SB-200), and 500 mg/kg SB intervention group (SB-500). Samples were harvested 24 h after the model was established. The gut microbiota was analyzed using 16S rRNA gene sequencing.ResultsPancreatic infiltration of neutrophils, macrophages, and M2-type macrophages was significantly reduced in the SB-500 intervention group. Supplementation of SB-500 improved colon mucosal histology and the expression of ZO-1 and occluding. The relative abundance of Alloprevotella and Muribaculaceae was increased and that of Akkermansia was decreased in the SB-500 group compared with the AP group. Ruminococcaceae was the most significantly increased species and Prevotellaceae was the most significantly decreased species in the SB-500 group compared with the AP group.ConclusionHigh dose of SB inhibits pancreatic inflammation probably by maintaining the intestinal barrier and regulating gut microbiota in mice with AP.

Rationale: Intestinal stricture and obstruction are rare complications of ulcerative colitis (UC). Currently, there are only a few studies on the treatment of UC with intestinal stenosis, however there are no reports on the treatment of UC with benign intestinal stenosis with ustekinumab (UST). Patient concerns: A 22-year-old woman was admitted to our hospital due to a 3-year history of recurrent bloody mucous in stool with intermittent abdominal pain and distension developed in the past month. She was steroid-dependent and had developed a secondary loss of response to infliximab. Diagnoses: She was diagnosed with UC combined with incomplete intestinal obstruction due to stenosis. The stricture had a mixed pattern with both inflammatory and fibrotic components, with the former covering a larger section of the intestine. Interventions: The patient was given UST for 56 weeks. Outcomes: The patient’s symptoms subsided after treatment with UST. The ulcers healed, and the stenosis was reduced. Lessons: UST is effective against UC with benign intestinal stenosis. It is thought that UST inhibits the production of transforming growth factor-β and interleukin-17, leading to the suppression of myofibroblast proliferation, ultimately alleviating intestinal stenosis.