Causal relationship between inflammatory cytokines and autoimmune thyroid disease: a bidirectional two-sample Mendelian randomization analysis.

Background: Autoimmune thyroid disease (AITD) ranks among the most prevalent thyroid diseases, with inflammatory cytokines playing a decisive role in its pathophysiological process. However, the causal relationship between the inflammatory cytokines and AITD remains elusive. Methods: A two-sample Mendelian randomization (MR) analysis was performed to elucidate the causal connection between AITD and 41 inflammatory cytokines. Genetic variations associated with inflammatory cytokines were sourced from the FinnGen biobank, whereas a comprehensive meta-analysis of genome-wide association studies (GWASs) yielded data on Graves' disease (GD) and Hashimoto thyroiditis. Regarding the MR analysis, the inverse variance-weighted, MR-Egger, and weighted median methods were utilized. Additionally, sensitivity analysis was conducted using MR-Egger regression, MR-pleiotropy residual sum, and outliers. Results: Seven causal associations were identified between inflammatory cytokines and AITD. High levels of tumor necrosis factor-ß and low levels of stem cell growth factor-ß were indicative of a higher risk of GD. In contrast, high levels of interleukin-12p70 (IL-12p70), IL-13, and interferon-γ and low levels of monocyte chemotactic protein-1 (MCP-1) and TNF-α suggested a higher risk of HD. Moreover, 14 causal associations were detected between AITD and inflammatory cytokines. GD increases the levels of macrophage inflammatory protein-1ß, MCP-1, monokine induced by interferon-γ (MIG), interferon γ-induced protein 10 (IP-10), stromal cell-derived factor-1α, platelet-derived growth factor BB, ß-nerve growth factor, IL-2ra, IL-4, and IL-17 in blood, whereas HD increases the levels of MIG, IL-2ra, IP-10, and IL-16 levels. Conclusion: Our bidirectional MR analysis revealed a causal relationship between inflammatory cytokines and AITD. These findings offer valuable insights into the pathophysiological mechanisms underlying AITD.

Short-term outcomes of deeper intubation technique of ileus tube for different types of acute intestinal obstruction patients: A retrospective multicenter study.

Background: Our previous research reported a novel deeper intubation technique (DIT) of the ileus tube for acute bowel obstruction patients. The present study was designed to evaluate the effect of this novel technique on the clinical outcomes of patients with obstruction using a large cohort. Methods: The detailed clinical data were analyzed retrospectively from 496 obstruction patients who underwent intubation technique from 2014 to 2019 in five hospitals. The patients were divided into either the DIT group or the traditional intubation technique (TIT) group. The groups were matched in a 1:1 ratio using propensity scores, and the primary outcome was the short-term clinical outcomes for patients. Results: The baseline characteristics were similar between the DIT group and the TIT group after matching. Compared with the TIT group, the DIT group had a significantly deeper intubation depth, with shorter hospital days, shorter time to first flatus and defecation, lower pain score, increased drainage volume, and lower emergency surgery rate. Importantly, the inflammatory factors such as white blood cell, C-reactive protein, and procalcitonin levels were significantly lower in the DIT group. In addition, the DIT treatment was significantly useful for adhesive obstruction patients. Conclusion: The DIT procedure led to better short-term clinical outcomes compared with the TIT procedure, indicating that DIT is a safe and feasible technique for the treatment of intestinal obstruction that is worthy of further popularization and clinical application.

Short-Term Clinical Outcomes after Using Novel Deeper Intubation Technique (DIT) of Ileus Tube for Acute Bowel Obstruction Patients.

BACKGROUND: The ileus tube has been widely used for the treatment of acute small bowel obstruction. However, it is difficult to get the tube sufficiently adjacent to the obstruction site due to various reasons. METHODS: We developed a novel intubation technique, named Deeper Intubation Technique (DIT), by using the Zebra Urological Guidewire and digital gastrointestinal fluoroscopy, where we deepened the catheter intubation, and further compared the effects of DIT with the Traditional Intubation Technique (TIT) on the short-term clinical outcomes of 183 patients. RESULTS: The average intubation depth of DIT apparently exceeds that of TIT (213.89 ± 31.11 vs. 134.67 ± 18.22 cm, P < 0.001). Compared with patients in the TIT group, patients in the DIT group got a lower pain score (P < 0.001), shorter recovery time for anal exhaust defecation (2.87 ± 1.50 vs. 3.37 ± 1.52 d, P = 0.040), higher recovery rate in anal exhaust defecation (24 h, 16.8% vs. 5.7%, P = 0.021; 48 h, 46.3% vs. 27.3%, P = 0.009), better symptomatic remission rate and imaging relief rate (P < 0.05), and increased drainage volume (1006.88 ± 583.45 vs. 821.02 ± 358.73 ml, P = 0.009). Importantly, the emergency surgery rate in the DIT group was lower than that in the TIT group (3.2% vs. 13.6%, P = 0.014). In addition, the DIT procedure was effective for patients with adhesive obstruction but not for cancerous and stercoral bowel obstruction. CONCLUSION: Compared to TIT, DIT produced better short-term clinical outcomes, indicating that DIT is a safe and feasible technique for the treatment of adhesive intestinal obstruction.