BRBNS in children presents atypical symptom and systemic complications. It should be dealt with seriously if gastrointestinal bleeding or orthopedic complication occurs. Treatment includes conservative, endoscopic and surgical options. Its recurrence with new angioma in the gastrointestinal tract needs laser-steroid therapy.

AIM:To determine whether recombinant human epidermal growth factor (rhEGF) can protect gastric mucosa against ethanol induced injury in rats.METHOD: Fifty-four SD rats weighing 200g-500g each were divided into six groups after fasting for 24 hours.Three groups received different doses of oral rhEGF (30, 60 and 120&mgr;gcenter dotkg(-1)center dotd(-1)), one group was given cimetidine,one subcutaneous rhEGF (rhEGF IV) and one received saline as control.RESULTS:Acute gastric dilatation developed in the control and cimetidine groups and bloody gastric juice was found in the control group. The ulcer index was 58 in control group, 53 in rhEGF I, 46 in rhEGF II (P < 0.01), 11 in rhEGFIII (P < 0.01), 19 in rhEGF IV (P < 0.01), and 39 in cimetidine group (P < 0.05).CONCLUSION: rhEGF protected gastric mucosa against ethanol induced damage. The effect was dose-dependent with blood levels of epidermal growth factor (EGF) at a dosage range of 60&mgr;gcenter dotkg(-1)center dotd(-1)-120&mgr;gcenter dot kg(-1)center dotd(-1). It was more effective by injection than via oral route at the same dosage.

The objective of the present randomized, double-blind trial was to evaluate the efficacy and safety of daily topical washing procedure with miconazole nitrate-containing soap for candidiasis at diaper-covered sites in elderly subjects under long-term inpatient care. We initially enrolled 75 elderly patients with a constant use of diapers, and of this cohort, 55 patients (32 male and 23 female) who randomly assigned to receive treatment with either miconazole soap (n¼28) or miconazole-free placebo soap (n¼27) were assessed microscopically for the existence of the pseudohyphae and/or blastoconidia of Candida spp. up to 4 weeks. Although washing with miconazole soap did not affect the baseline frequency of pseudohyphae/blastoconidia-positive patients, it significantly inhibited the positive conversion of pseudohyphae/blastoconidia compared with the placebo group (17.3% vs. 44.0%, respectively; p<0.05). Moreover, the frequency of patients positive for pseudohyphae/blastoconidia at 4 week was significantly lower in the miconazole group than in the control group (17.9% vs. 44.4%, respectively; p<0.01). These anti-Candida effects were not different between both sexes, and neither clinically-apparent diaper candidiasis nor severe adverse effects developed in either group. Patients with diarrhea and heart failure tended to be associated with the positive rate of pseudohyphae/blastoconidia. A daily washing with miconazole soap is easy and quick to perform, as a paramedical stuff work, and well-tolerated for anogenital skin in elderly. This prophylactic approach can inhibit the progressive conversion activity of genital Candida flora, enabling to maintain satisfactory genital hygiene in patients wearing diapers.

BACKGROUND Interleukin 10 receptor alpha subunit (IL10RA) dysfunction is the main cause of very early-onset inflammatory bowel disease (VEO-IBD) in East Asians. AIM To identify disease-causing gene mutations in four patients with VEO-IBD and verify functional changes related to the disease-causing mutations. METHODS From May 2016 to September 2020, four young patients with clinically diagnosed VEO-IBD were recruited. Before hospitalization, using targeted gene panel sequencing and trio-whole-exome sequencing (WES), three patients were found to harbor a IL10RA mutation (c.301C>T, p.R101W in one patient; c.537G>A, p.T179T in two patients), but WES results of the fourth patient were not conclusive. We performed whole-genome sequencing (WGS) on patients A and B and reanalyzed the data from patients C and D. Peripheral blood mononuclear cells (PBMCs) from patient D were isolated and stimulated with lipopolysaccharide (LPS), interleukin 10 (IL-10), and LPS + IL-10. Serum IL-10 levels in four patients and tumor necrosis factor-α (TNF-α) in the cell supernatant were determined by enzyme-linked immunosorbent assay. Phosphorylation of signal transducer and activator of transcription 3 (STAT3) at Tyr705 and Ser727 in PBMCs was determined by western blot analysis. RESULTS The four children in our study consisted of two males and two females. The age at disease onset ranged from 18 d to 9 mo. After hospitalization, a novel 333-bp deletion encompassing exon 1 of IL10RA was found in patients A and B using WGS and was found in patients C and D after reanalysis of their WES data. Patient D was homozygous for the 333 bp deletion. All four patients had elevated serum IL-10 levels. In vitro , IL-10-stimulated PBMCs from patient D failed to induce STAT3 phosphorylation at Tyr705 and only minimally suppressed TNF-α production induced by LPS. Phosphorylation at Ser727 in PBMCs was not affected by LPS or LPS + IL-10 in both healthy subjects and in patient D. CONCLUSION WGS revealed a novel 333-bp deletion of IL10RA in four patients with VEO-IBD, whereas the WES results were inconclusive.

Background: Previous studies have suggested that Helicobacter pylori (H. pylori, Hp) infection has a protective function in inflammatory bowel disease (IBD); Exosomes (Exo) are novel cell-cell communication mediators and their association with inflammatory immune responses has received great attention. however the mechanisms regarding the role of exosomes between Hp infection and IBD are limited.Methods: Human intestinal epithelial cells were treated with serum exosomes derived from Hp-positive chronic gastritis patients (Exo(Hp)), the expression of cytokines, inflammasome and signal pathway genes were detected by antibody microarray or PCR array. Furthermore, DSS-induced colitis mice were treated with exosomes by intraperitoneally injection to study the effect of Exo(Hp) in IBD.Results: Serum exosomes derived from Hp-positive chronic gastritis patients promoted NLRP12 expression in intestinal epithelial cells, and NLRP12 decreased chemokine MCP-1 and MIP-1α expression by inhibiting the Notch signaling pathway. In vivo, Exo(Hp) could attenuated inflammatory responses in DSS-induced colitis and improved colitis symptoms, which was associated with the increase in NLRP12 expression. Furthermore, the immunohistochemistry results showed that NLRP12 was negatively correlated with the disease activity of pediatric IBD patients. Conclusions: Exo(Hp) inhibited the Notch signaling pathway through the promotion of NLRP12 expression to further down-regulate MCP-1 and MIP-1α expression in intestinal epithelial cells and thereby attenuate DSS-induced colitis in mice. These results provide new theoretical bases for further elucidation of the intestinal protection mechanisms of Hp infection in IBD, and provide new targets for explorations of effective interventional strategies for IBD.