Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in children and adolescents. The gut microbiota plays an important role in the pathophysiology of NAFLD through the gut–liver axis. Therefore, we aimed to investigate the genus and species of gut microbiota and their functions in children and adolescents with NAFLD. From May 2017 to July 2018, a total of 58 children and adolescents, including 27 abnormal weight (AW) (obese) NAFLD patients, 16 AW non-NAFLD children, and 15 healthy children, were enrolled in this study at Shenzhen Children’s Hospital. All of them underwent magnetic resonance spectroscopy (MRS) to quantify the liver fat fraction. Stool samples were collected and analysed with metagenomics. According to body mass index (BMI) and MRS proton density fat fraction (MRS-PDFF), we divided the participants into BMI groups, including the AW group (n = 43) and the Lean group (n = 15); MRS groups, including the NAFLD group (n = 27) and the Control group (n = 31); and BMI-MRS 3 groups, including NAFLD_AW (AW children with NAFLD) (n = 27), Ctrl_AW (n = 16) (AW children without NAFLD) and Ctrl_Lean (n = 15). There was no difference in sex or age among those groups (p > 0.05). In the BMI groups, at the genus level, Dialister, Akkermansia, Odoribacter, and Alistipes exhibited a significant decrease in AW children compared with the Lean group. At the species level, Megamonas hypermegale was increased in the AW group, while Akkermansia muciniphila, Dialister invisus, Alistipes putredinis, Bacteroides massiliensis, Odoribacter splanchnicus, and Bacteroides thetaiotaomicron were decreased in AW children, compared to the Lean group. Compared with the Control group, the genus Megamonas, the species of Megamonas hypermegale and Megamonas rupellensis, increased in the NAFLD group. Furthermore, the genus Megamonas was enriched in the NAFLD_AW group, while Odoribacter, Alistipes, Dialister, and Akkermansia were depleted compared with the Ctrl_Lean or Ctrl_AW group at the genus level. Megamonas hypermegale and Megamonas rupellensis exhibited a significant increase in NAFLD_AW children compared with the Ctrl_Lean or Ctrl_AW group at the species level. Compared with healthy children, the pathways of P461-PWY contributed by the genus Megamonas were significantly increased in NAFLD_AW. We found that compared to healthy children, the genus Megamonas was enriched, while Megamonas hypermegale and Megamonas rupellensis were enriched at the species level in children and adolescents with NAFLD. This indicates that the NAFLD status and/or diet associated with NAFLD patients might lead to the enrichment of the genus Megamonas or Megamonas species.

Inflammatory bowel disease (IBD) mainly includes Crohn’s disease and ulcerative colitis. These diseases have a progressive course of chronic relapse and remission and affect a large number of children and adults worldwide. The burden of IBD is rising worldwide, with levels and trends varying greatly in countries and regions. Like most chronic diseases, the costs associated with IBD are high, including hospitalizations, outpatient and emergency visits, surgeries, and pharmacotherapies. However, there is no radical cure for it yet, and its therapeutic targets still need further study. Currently, the pathogenesis of IBD remains unclear. It is generally assumed that the occurrence and development of IBD are related to the environmental factors, gut microbiota, immune imbalance, and genetic susceptibility. Alternative splicing contributes to a various diseases, such as spinal muscular atrophy, liver diseases, and cancers. In the past, it has been reported that alternative splicing events, splicing factors, and splicing mutations were associated with IBD, but there were no reports on the practical application for clinical diagnosis and treatment of IBD using splicing-related methods. Therefore, this article reviews research progress on alternative splicing events, splicing factors, and splicing mutations associated with IBD.

INTRODUCTION: Systemic inflammation and lipid metabolism disturbances are important hallmarks of the onset and progression of metabolic dysfunction-associated steatotic liver disease (MASLD). We aimed to explore the association of lymphocyte-high-density lipoprotein-cholesterol ratio (LHR), monocyte-HDL-C ratio (MHR), neutrophil-HDL-C ratio (NHR), and platelet-HDL-C ratio (PHR) with MASLD and significant liver fibrosis using NHANES 2017–2020 data. METHODS: LHR, MHR, NHR, and PHR were calculated based on complete blood count parameters and serum HDL-C. MASLD and liver fibrosis were diagnosed based on transient elastography. Multivariate logistic regression analyses were used to explore these associations, and receiver operating characteristic was used to compare the predictive power of these markers. RESULTS: A total of 8,341 participants were included, and the prevalence of MASLD and significant liver fibrosis was 45.1% and 11.57%, respectively. In fully adjusted models, log-transformed LHR, MHR, NHR, and PHR were positively associated with the odds of MASLD (odds ratio 1.853, 1.685, 1.470, and 1.879, respectively) and significant liver fibrosis (odds ratio 1.570, 1.425, 1.396, and 1.384, respectively) (all P < 0.05). Most of these associations were nonlinear, and significant positive correlations existed only after their respective inflection points. The association of LHR with significant liver fibrosis was more pronounced in men. Receiver operating characteristic analysis showed that LHR/NHR was superior in predicting MASLD, whereas MHR/NHR distinguished significant liver fibrosis better than other markers. DISCUSSION: LHR, MHR, NHR, and PHR were independently associated with MASLD and liver fibrosis in US adults and may serve as emerging predictors. Future cohort studies are needed to confirm these findings and explore clinical predictive value.

Colonoscopy screening is one of the most effective diagnostic tools for detecting intestinal diseases, such as bleeding, polyp, Meckel’s diverticulum, and ulcer. However, the missed rate of manual detection is high due to the lack of experience or fatigue among clinicians. To address this issue, this work proposed a novel autodiagnosis framework built on Internet of Medical Things (IoMT) systems, which can be deployed among multiple hospitals in a distributed fusion. This work presents a two-stage knowledge distillation (TSKD) method coupled with Bayesian optimization (BO) that can exploit distributed colonoscopy data to learn a compact diagnostic model achieving a good tradeoff between predictive performance and resource consumption (e.g., memory and computation). The proposed framework is extensively evaluated in real-world data sets in comparison with its counterparts. A prototype of on-site diagnostic device is implemented to demonstrate the potential for real-world deployment.

The diagnostic and treatment values and safety of preoperative double-balloon enteroscopy (DBE) for Meckel's diverticula (MD) bleeding in children by retrospective review and analyses. The clinical data were collected and analyzed from 10 cases of children with MD receiving preoperative DBE examination and postoperative pathological confirmation. The diagnostic and treatment values and safety were assessed through the comparison of the DBE results and intra-operative observations and subsequently postoperative pathological results. Total cases are 10, 7 males and 3 females. The male to female ratio is 2.3 to 1. The youngest patient is 3.3 years old and oldest 12.1, the average age is 7.4 ± 3.0. The lowest body weight is 12.6 kg and the average is 32.5 ± 18.9 kg. The hematochezia was the main clinical manifestation in all patients with anemia and moderate to severe anemia were common (9/10, 90%). All patients had and tolerated the DBE procedures via anal route with 100% success rate. There were no observable complications during the examinations and post operations. All patients were diagnosed with MD by DBE. Exploratory laparoscopy and surgical operations were subsequently performed. All surgical samples were confirmed by pathology as bleeding MD. The postoperative follow-ups up to April 2019 (from 3 to 12 months) do not show any bleeding sign. Pathological examinations found ectopic gastric mucosa in 9 patients (90%) and one case had both ectopic gastric mucosa pancreatic tissue (10%). The distance of MD to ileocecal valve was from 60 to 100 cm (average 81.0 ± 16.0 cm) by DBE examinations. Surgery showed similar findings from 30 to 100 cm (average 71.0 ± 18.5) consistently to DBE. There is no statistical significance between 2 methods (Ζ = 1.715, Ρ = .086). DBE examination proves to be a safe method for diagnosing children's MD disease and can reliably determine the bleeding lesions in children's MD, providing valuable guidance for surgical treatment of children's MD bleeding.