Interleukin-10 (IL10)/interleukin-10 receptor (IL10R) deficiency is a rare disease with life-threatening infantile-onset colitis. We sought to accurately phenotype this disorder based on a large cohort of patients with a proven defect of IL10 signaling and to clarify the effects of allogeneic hematopoietic stem cell transplantation (HSCT). We analyzed the phenotypes of our 61 patients and reviewed 78 other previously reported cases with identified mutations in the genes encoding IL10 or IL10R. We also compared the clinical features of patients with interleukin-10 receptor B (IL10RB), interleukin-10 receptor A (IL10RA), and IL10 mutations. The therapeutic effects of allogeneic HSCT were evaluated. We found that the disease onset time was extremely early: 70.3% within 30 days postnatal and 94.9% within the first 6 months of life. In addition, 94.2% of patients typically presented with perianal lesions. Oral ulcers and skin rash were common extra-intestinal manifestations (33.8% and 51.8%, respectively). There was no statistically significant difference in disease onset time, perianal lesion involvement, or mortality rate among patients with IL10RB, IL10RA, or IL10 deficiency. However, the surgery rate was higher in patients with IL10RB mutations than in those with IL10 or IL10RA mutations (P < 0.05). Compared with those with IL10RA deficiency, a higher percentage (32%, 9 of 28) of patients with IL10RB mutations developed B-cell lymphoma (P < 0.01). Compared with other regions, a higher percentage (98.7%) of IL10RA mutations was detected among patients in East Asia countries (P < 0.01), with hot-spot mutation sites of c.C301T and c.G537A. Allogeneic HSCT is efficacious but has a high mortality rate (17.5%, 7 of 40). Our study expands the current knowledge on the genotype-correlated phenotypes with a defect of IL10 signaling. B-cell lymphoma was more frequent than would be expected in patients with IL10RB mutations. There may be a unique genetic architecture among Eastern Asia compared with other populations. Although allogeneic HSCT represents a causal therapeutic approach for IL10-and IL10R-deficient patients, a word of caution is warranted.

Background: Penicillin‐allergic children who are infected with Helicobacter pylori constitute a relatively common subgroup. We aimed to study the short‐term and long‐term effects of bismuth quadruple therapy on gut microbiota in penicillin‐allergic children.Methods: We prospectively recruited treatment‐naive children with H pylori infection and H pylori‐negative asymptomatic children as healthy controls. Patients received 14‐day bismuth quadruple therapy consisting of omeprazole, clarithromycin, metronidazole, and bismuth. Fecal samples were collected at weeks 0, 2, 6, and 52. Alterations in the gut microbiota were analyzed by 16S rRNA gene sequencing.Results: Twenty‐two subjects (14 gastritis patients, 8 duodenal ulcer patients) and 23 controls participated in this study. At week 2, alpha diversity was reduced in both gastritis (P < .05) and ulcer (except P = .16 with Chao 1 index) patients compared with baseline. Some changes persisted at week 6, and all were restored at week 52. Beta diversity was significantly altered 2 weeks after treatment in the gastritis and duodenal ulcer groups (P = .001, P = .002, respectively) and restored at weeks 6 and 52. The mean relative abundance of Bacteroidetes (P < .001, P = .005, respectively) decreased and that of Proteobacteria increased (P < .001, P = .03, respectively). All alterations recovered at week 6 and 52. In both the gastritis and ulcer groups at week 2, some beneficial bacteria were decreased including Bacteroides (P < .001 and P = .003), Faecalibacterium (P < .001 and P = .02), Phascolarctobacterium (P = .002 and P = .004), Roseburia ( P < .001 and P = .13), Bifidobacterium (P = .08 and P = .04), and Blautia (P < .001 and P = .002). Some detrimental bacteria were increased including Escherichia‐Shigella (P < .001 and P = .19), Klebsiella (P < .001, and P = .09), Enterococcus (P < .001 and P = .007), and Streptococcus (P = .002 and P = .004). The changes returned to almost the pre‐eradication level 1 year after therapy.Conclusion: Bismuth quadruple therapy causes short‐term dysbiosis of the gut microbiota. Most changes recovered 1‐year post‐eradication, indicating the long‐term safety of H pylori therapy.

Human–AI collaboration (H + AI) using large language models (LLMs) offers a promising approach to enhance clinical reasoning, documentation, and interpretation tasks. Following PRISMA 2020 (PROSPERO registration: CRD420251068272), we systematically compared H + AI with human-only (H) workflows, searching four databases through June 28, 2025. Ten peer-reviewed studies met eligibility criteria, with three preprints informing sensitivity analyses only. Diagnostic/interpretation accuracy (k = 2) showed a positive trend for H + AI (Risk Ratio [RR] 1.59), but was statistically imprecise and non-significant (95% CI 0.08 to 32.74), with 95% prediction intervals (PI) crossing the null. Composite diagnostic/management scores (k = 2) showed a statistically significant improvement (Mean Difference [MD] +4.88 percentage points, 95% CI + 0.65 to +9.12), yet the PI (–31.65 to 41.42) indicates high real-world uncertainty. Time efficiency (k = 3) showed no overall difference (MD + 0.4 min, 95%CI −4.18 to +4.97; I² = 70.1%). While documentation quality improved, but factual error rates remained high (~26–36%), undermining quality gains. In three-arm settings, H + AI did not universally outperform AI-only. Evidence remains preliminary yet highly uncertain and context-dependent. We recommend preregistered, pragmatic, multicenter trials embedded in real workflows, with harmonized core outcomes that prioritize safety/error metrics and interfaces that surface uncertainty and support verification.