微小RNA在肿瘤坏死因子α介导的急性肝功能衰竭小鼠体内的表达谱及其作用

目的 了解微小RNA(miRNA)在急性肝功能衰竭小鼠模型中的表达谱及对其发病机制的调控作用.方法 将BALB/c小鼠85只分为4组,模型组40只用D-氨基半乳糖(D-GalN)联合脂多糖(LPS)腹腔注射建立肝功能衰竭模型,D-GalN单药组20只、LPS单药组20只和对照组5只分别予D-GalN、LPS和0.9%NaCl溶液腹腔注射.在给药后0、5和7 h观察小鼠肝脏组织学变化,0、1、3、5、7和9 h留取小鼠血清和肝脏组织标本.采用实时定量PCR方法检测小鼠血清及肝组织中炎性细胞因子(TNF-α和IL-6)表达水平;采用miRNA微阵列(microarray)检测小鼠肝脏中miRNA的表达谱,实时定量PCR验证其表达.体外LPS诱导小鼠巨噬细胞Raw264.7活化,诱导不同时间点收集细胞检测细胞miRNA的表达情况.组间均数比较用单因素方差分析,相关性分析采用Pearson和Spearman相关分析.结果 miRNA微阵列发现小鼠急性肝功能衰竭发病过程中miRNA的表达谱发生了明显变化,与对照组相比,模型组有97个miRNA表达变化显著(P＜0.01),其中21个miRNA在给药后5 h和7 h均表达上调,27个miRNA均表达下调,进一步PCR验证得到miR-146a和miR-155随给药时间延长表现为持续性上调,且miR-155表达与TNF-α和IL-6表达均具有良好的相关性.体外实验进一步发现miR-146a和miR-155在活化的巨噬细胞中表达上调.结论 在小鼠急性肝功能衰竭发病过程中,伴随着miRNA表达谱的变化,炎性反应相关miR-146a和miR-155明显上调,可能在急性肝功能衰竭的免疫发病机制中发挥重要的调控作用.     

miR-122在D-氨基半乳糖联合脂多糖诱导急性肝衰竭小鼠体内的表达及其意义

目的 通过监测急性肝功能衰竭小鼠体内miR-122的表达,探讨miR-122与小鼠急性肝衰竭疾病程度和进展之间的关系,为肝功能衰竭的早期诊断提供新的生物学标志物. 方法将BALB/C小鼠随机分为4组,实验组用D-氨基半乳糖(D-GalN,900 mg/kg)联合脂多糖(LPS,10 μg/kg)腹腔注射建立肝衰竭模型,对照组3组,分别予以D-GalN(900 mg/kg),LPS(10 μg/kg)和等渗盐水腹腔注射,在不同时间点观察小鼠病死率、肝脏组织学变化,给药后0、1、3、5、7、9 h分别留取血清、肝脏组织标本,实时定量逆转录多聚酶链反应检测小鼠体内miRNA-122和炎症因子的表达,LNA(锁核酸)-Northern blot验证miRNA-122的表达,生化分析仪检测血清中ALT、AST水平,酶联免疫吸附法检测血清中炎症因子水平.组间均数比较用two-WayANOVA方差分析,相关性分析采用Pearson和Spearman相关分析.结果 D-GalN/LPS给药24 h,小鼠病死率率达80%以上,而3个对照组则无一只小鼠死亡;肝脏特异性miR-122在正常小鼠肝脏内含量丰富(ct≈14),D-GalN/LPS诱导后1 h,miR-122即发生了明显的变化(P=0.013),表现为上调,之后随疾病的进展,miR-122表达进行性下降,9 h下调最为明显(ct≈15,P=0.002);ALT/AST于给药1 h无明显变化,3 h后呈明显上升趋势,7 h达高峰,之后ALT/AST急剧下降;对miR-122和ALT的表达对比,发现在该模型中miR-122比ALT变化快,且持久;肝衰竭相关炎症因子肿瘤坏死因子(TNF)α和白细胞介素(IL)-6在肝组织和血清中的变化一致,均上调(P<0.05); miR-122和ALT、TNFα和IL-6的相关性分析显示miR-122与以上三项指标均呈良好的相关性(相关系数分别为-0.505、0.493和0.674、).结论 肝衰竭小鼠体内肝脏特异性miR-122和ALT呈负相关关系,但又较ALT更敏感,更持久地反映肝细胞损伤程度,且miR-122表达变化与肝脏炎症损伤相关因素TNF α、IL-6均具良好的相关性,推测miR-122有望成为判断急性肝衰竭肝细胞损伤程度的一个新的分子生物学标志物.     

微小RNA-1187对半胱天冬氨酸蛋白酶-8介导的肝细胞凋亡调控的作用

目的 通过微小RNA-1187(miR-1187)靶向调节半胱天冬氨酸蛋白酶-8(caspase-8)mRNA的表达,观察miR-1187对肝细胞凋亡的调控作用.方法 应用D-氨基半乳糖联合脂多糖构建BALB/c小鼠急性肝功能衰竭模型,取肝组织进行锁核酸(LNA)-miRNA微阵列分析和miRNA靶基因功能分析.体外培...     

高脂饮食诱导非酒精性脂肪性肝病小鼠模型肝脏microRNA表达谱的变化分析

目的研究microRNA(miRNA)-384的表达对高脂饮食诱导非酒精性脂肪性肝病(NAFLD)小鼠肝脂肪变性的影响。方法将30只雄性C57BL/6J小鼠适应性喂养7 d,然后随机分成2组,每组15只。对照组中的15只小鼠给予普通饮食,模型组15只小鼠给予HFD,喂养8周后获取肝组织。进行HE和尼罗红染色观察肝组织病理改变。采用微阵序列测序肝组织的全基因组miRNA表达谱,PCR法测定miRNA-384的相对表达水平。计量资料2组间比较采用t检验。结果对照组小鼠肝脏呈红色,边缘锐利,肝小叶结构清晰,肝细胞无脂肪变性;模型组小鼠肝脏呈黄色,边缘变钝,肝细胞明显肿胀,细胞质内可见大量脂肪空泡,脂滴相互融合导致细胞核偏位。与正常小鼠相比,在NAFLD小鼠的肝组织中发现了12个上调和18个下调的miRNA。筛查了对照组和模型组间的一些差异表达的miRNA,获得同样的聚类分析图。在这8个明显改变的miRNA中,miRNA-384具有显著的倍数变化。结论 miRNA-384表达的上调与肝脏脂肪变性有着密切关系,但是其作用机制仍需进一步研究。     

小鼠感染肝毛细线虫肝脏microRNA的差异表达分析

目的 分析小鼠感染肝毛细线虫后肝脏microRNA (miRNA)的表达谱,筛选差异表达miRNA,为肝毛细线虫感染致肝纤维化机制研究提供资料。方法 6只雄性BABL/c小鼠随机分为肝毛细线虫感染组和对照组,每组3只。感染组小鼠经灌胃感染肝毛细线虫感染期虫卵（20个卵/鼠）,对照组灌胃等量生理盐水。感染后35 d分别取感染组和对照组小鼠的肝组织,进行组织切片、苏木精-伊红（HE）染色后,镜下观察肝组织病变情况。提取和纯化小鼠肝组织总RNA进行文库构建和miRNA高通量测序。通过生物信息学分析筛选差异表达的mi RNA,预测其靶基因并进行基因本体论（GO）和京都基因与基因组百科全书（KEGG）富集分析。采用实时荧光定量PCR (qRT-PCR)对部分差异表达miRNA进行验证分析。结果 肝组织切片的HE染色结果显示,感染组小鼠肝组织呈虫卵肉芽肿性病变,伴有明显的炎性细胞浸润;对照组肝细胞形态完整,未见炎性细胞浸润、变性坏死和纤维化。通过miRNA测序,筛选出差异表达的miRNA共16条,4条表达上调,且均上调2倍以上,其中mmu-miR-129-5p上调4倍以上;12条表达下调,均下调0...     

下调miR-122对非酒精性脂肪性肝炎小鼠的炎症发生及肝细胞凋亡的影响

目的探讨下调miR-122对非酒精性脂肪性肝炎(non-alcoholic steatohepatitis, NASH)小鼠的炎症发生及肝细胞凋亡的影响。方法 qRT-PCR检测各组小鼠肝组织中miR-122的表达情况;HE染色观察各组小鼠肝组织病理损伤情况;油红O染色观察各组小鼠肝组织脂肪堆积情况;ELISA检测各组小鼠血清中甘油三脂(TG)、丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)和白细胞介素-6(IL-6)的表达情况;TUNEL荧光染色观察各组小鼠肝细胞凋亡情况;Western blotting检测各组小鼠肝组织中Bax、Bcl-2蛋白表达水平。结果 miR-122 mRNA的表达水平在MCD组和MCD+miR-NC组小鼠肝组织中表达水平上调(P均0.01),在MCD+miR-122 inhibitor组小鼠肝组织中表达水平下调(P0.001);MCD组和MCD+miR-NC组小鼠的肝脏出现中度至重度肝细胞空泡化和大量脂质滴(P均0.001),MCD+miR-122 inhibitor组小鼠的肝脏组织表现出轻度至中度的肝细胞空泡和脂质滴也减少(P0.05);MCD组和MCD+miR-NC组小鼠血清中TG、ALT、AST、TNF-α、IL-1β和IL-6表达水平上调(P均0.01),MCD+miR-122 inhibitor组小鼠血清中TG、ALT、AST、TNF-α、IL-1β和IL-6表达水平下调(P均0.05);MCD组和MCD+miR-NC组肝细胞凋亡指数升高(P均0.001),MCD+miR-122 inhibitor组肝细胞凋亡指数下降(P0.05);MCD组和MCD+miR-NC组小鼠肝组织中Bax蛋白表达水平上调(P0.01),Bcl-2蛋白表达下调(P均0.001),MCD+miR-122 inhibitor组小鼠肝组织中Bax蛋白表达水平下调(P0.05),Bcl-2蛋白表达上调(P0.05)。结论下调miR-122可抑制炎症的发生、抑制肝细胞凋亡,对NASH有一定的治疗作用。     

乙型肝炎患者外周血单个核细胞中微小RNA的表达变化

目的 探讨乙型肝炎患者外周血单个核细胞(PBMC)中微小RNA(miRNA)和细胞因子的变化及其与炎性反应的相互关系.方法 收集健康对照者17例,急性乙型肝炎发作期、病毒清除期和恢复期患者各20例,慢性乙型肝炎轻度、中度和重度患者各20例和乙型肝炎后肝硬化患者20例.分离PBMC,采用反转录-荧光定量PCR方法检测miRNA146、miRNA155、miRNA181、IFN-α、IFN-β、IFN诱导基因54(ISG54)、IFN调节因子5(IRF5)的表达.多组间比较采用单因素方差分析.结果 急性乙型肝炎患者PBMC中miRNA155的表达水平在急性发作期(2.386±1.835)较高,明显高于健康对照组(1.498±1.276),差异有统计学意义(F=1.137,P=0.045),随疾病进入发作期、病毒清除期(1.633±2.291)、恢复期(0.642±0.836),其表达逐渐降低(F=2.122,P=0.022).同时IFN-α、IFN-β随急性发作期(7.059±9.594、4.767±6.725)、病毒清除期(2.216±2.148、1.750±1.403)和恢复期(0.642±0.836、1.201±0.779)其表达也逐渐降低(F=1.880,P=0.038;F=1.835,P=0.048).相关性分析发现,miRNA155与IFN-α、IFN-β均具有良好的正相关性(r=0.483,P=0.004;r=0.660,P=0.0002).在急性HBV感染患者中,miRNA155的表达与ALT、Tbil均呈正相关(r=0.342,P=0.006;r=0.322,P=0.011),但与血清HBV DNA载量无相关性.miRNA181在HBV感染者PBMC中的表达,除急性乙型肝炎恢复期(1.873±0.998)外,均高于健康对照组(1.307±0.935)(F=2.072,P=0.045),但HBV感染各组间差异无统计学意义.miRNA146的表达水平变化不明显.结论 在HBV感染过程中,miRNAs参与了宿主的抗HBV免疫反应,并与细胞因子表达相关.     

内毒素预适应减轻急性肝功能衰竭中热休克蛋白27的作用

目的研究热休克蛋白27（HSP27）介导内毒素（LPS）预适应减轻急性肝功能衰竭（ALF）的作用机制。方法实验动物为雄性C57BL/6小鼠。将小鼠分为5组,对照组为正常C57BL/6小鼠;肝功能衰竭组小鼠以LPS10μg/kg＋D-半乳糖胺700 mg/kg,用1 mL0.9%氯化钠溶液溶解后腹腔内注射,建立急性肝功能衰竭的模型;LPS预处理组小鼠经LPS预适应24 h后,建立急性肝功能衰竭的模型;HSP27干扰组小鼠和转染对照组小鼠分别以尾静脉注射包装有干扰HSP27表达的短发夹RNA的重组腺病毒以及对照空病毒,成功干扰HSP27表达后,经LPS预处理,建立急性肝功能衰竭模型。通过比较各组ALT和AST水平,评价肝组织病理损伤程度,以及检测肝组织内TNF-α、IL-6mRNA水平,观察HSP27对LPS预适应减轻急性肝功能衰竭的影响。结果 LPS预适应可明显减轻Galn/LPS所致的肝损伤,干扰HSP27的表达后,小鼠血清ALT和AST明显升高,肝组织病理损伤和炎性反应加重（P〈0.05）。下调HSP27的表达水平后,LPS预适应的保护作用几乎完全消失。结论 LPS预适应可以减轻小鼠的急性肝损伤,HSP27在这一效应中发挥重要作用。     

高迁移率族蛋白B1在急性肝功能衰竭小鼠中的表达变化

目的 阐明高迁移率族蛋白B1(HMGB1)在小鼠急性肝功能衰竭模型肝组织中的表达模式、动态变化及其与TNF-α、IL-1β的相互作用.方法 D-氨基半乳糖和脂多糖制备小鼠急性肝功能衰竭模型,免疫组织化学SABC法检测肝组织内HMGB1在6个时间点的表达变化,ELISA测定血清中TNF-α、IL-1β的含量.配对t检验分析数据差异.结果 造模后2 h肝内即可观察到HMGB1的表达,并随时间的延长而呈现出明显的增长趋势,直至24 h;血清中TNF-α、IL-1β造模后即出现上升,分别于8 h、2 h达到峰值,TNF-α 8 h为(473.42±22.99)pg/mL,IL-1β2 h为(724.49士34.24)pg/mL.后缓慢下降,其中IL-1β于24 h恢复正常为(51.49士36.87)pg/mL.结论 HMGB1是急性肝功能衰竭的重要参与因子,早期可促进TNF-α、IL-1β的分泌,中晚期则在炎性因子的作用下大量表达,加速肝脏损伤,并与肝功能衰竭的发展及严重程度存在正相关.     

急性肝功能衰竭大鼠模型中程序性死亡-1及其配体的表达

目的 探讨程序性死亡-1(PD-1)/程序性死亡配体-1(PD-L1)在急性肝功能衰竭大鼠模型中的表达变化及其在肝脏急性炎性损伤中的作用.方法 SD大鼠分为2组:正常组6只,模型组30只,以D-氨基半乳糖(D-Gal)诱导急性肝功能衰竭大鼠模型.造模后分别在12、24、48、72和120 h取大鼠血及肝脏标本,采用RT-PCR法检测肝组织中PD-1 mRNA、PD-L1 mRNA的表达.计量资料组间比较用t检验,相关性检验用Pearson直线相关分析.结果 造模后12 h,大鼠血ALT、AST明显升高,分别为(217.3±33.7)U/L和(397.2±101.3)U/L,显著高于正常组的(30.5±3.1)U/L和(78.6±4.2)U/L,差异有统计学意义(t=-8.921,-6.121,均P＜0.01),至48 h达高峰.造模后12 h,模型组大鼠PD-1 mRNA表达(0.385±0.074)高于正常组(0.097±0.009),差异有统计学意义(t=-7.725,P＜0.01),48 h达高峰(0.927±0.132),72 h则明显下降.PD-L1mRNA在正常大鼠肝组织中表达很少,模型组PD-L1 mRNA水平逐渐升高,48 h达高峰(0.593±0.105)(t=-10.076,P＜0.01).造模后大鼠PD-1、PD-L1表达水平与血清ALT水平呈正相关(r=0.807,0.792,P＜0.01).结论 PD-1/PD-L1表达在急性肝功能衰竭大鼠肝脏炎性损伤中可能起重要作用.     

A Call to Action to Enhance Filovirus Disease Outbreak Preparedness and Response

The frequency and magnitude of recognized and declared filovirus-disease outbreaks have increased in recent years, while pathogenic filoviruses are potentially ubiquitous throughout sub-Saharan Africa. Meanwhile, the efficiency and effectiveness of filovirus-disease outbreak preparedness and response efforts are currently limited by inherent challenges and persistent shortcomings. This paper delineates some of these challenges and shortcomings and provides a proposal for enhancing future filovirus-disease outbreak preparedness and response. The proposal serves as a call for prompt action by the organizations that comprise filovirus-disease outbreak response teams, namely, Ministries of Health of outbreak-prone countries, the World Health Organization, Médecins Sans Frontières, the Centers for Disease Control and Prevention—Atlanta, and others.     

Control of intraabdominal hemorrhage and shock: a comparison of fluid resuscitation, MAST, and balloon occlusion

Our study examined the efficacy of four treatment modalities in controlling hemorrhage and achieving hemodynamic stabilization in hemorrhagic shock: intravenous fluid replacement (IV); military antishock trousers used concomitantly with fluids (MAST); balloon occlusion at the level of the diaphragm with concomitant fluid replacement (balloon); and a combination of MAST inflation, balloon occlusion, and fluid resuscitation (MAST and balloon). Twenty-eight mongrel dogs were anesthetized, and the spleen was exposed and completely crushed. The abdomen was closed, and treatment was initiated and continued for four hours or until the dog died. For all conditions the hematocrit dropped during the course of the experiment; balloon occlusion was effective at slowing this drop (P less than .0001), but MAST had no statistically significant effect. Animals with balloons bled more slowly into the abdominal cavity than did animals in the other two groups (P less than .0001). MAST also were effective at slowing the bleeding (P less than .05). Of the balloon and the MAST and balloon dogs, all except one survived the entire four hours; this difference between balloon and nonballoon dogs is significant (P = .002). MAST did not have a statistically significant effect on survival. Perfusion pressure (PP) declined during the course of the experiment, and the balloon was effective at slowing this decline (P less than .0001); none of the other comparisons was statistically significant.     

Interplay between interferon-mediated innate immunity and porcine reproductive and respiratory syndrome virus

Innate immunity is the first line of defense against viral infection, and in turn, viruses have evolved to evade host immune surveillance. As a result, viruses may persist in host and develop chronic infections. Type I interferons (IFN-α/β) are among the most potent antiviral cytokines triggered by viral infections. Porcine reproductive and respiratory syndrome (PRRS) is a disease of pigs that is characterized by negligible induction of type I IFNs and viral persistence for an extended period. For IFN production, RIG-I/MDA5 and JAK-STAT pathways are two major signaling pathways, and recent studies indicate that PRRS virus is armed to modulate type I IFN responses during infection. This review describes the viral strategies for modulation of type I IFN responses. At least three non-structural proteins (Nsp1, Nsp2, and Nsp11) and a structural protein (N nucleocapsid protein) have been identified and characterized to play roles in the IFN suppression and NF-κB pathways. Nsp's are early proteins while N is a late protein, suggesting that additional signaling pathways may be involved in addition to the IFN pathway. The understanding of molecular bases for virus-mediated modulation of host innate immune signaling will help us design new generation vaccines and control PRRS.     

Disease Pandemics and Major Epidemics Arising From New Encounters between Indigenous Viruses and Introduced Crops

Virus disease pandemics and epidemics that occur in the world’s staple food crops pose a major threat to global food security, especially in developing countries with tropical or subtropical climates. Moreover, this threat is escalating rapidly due to increasing difficulties in controlling virus diseases as climate change accelerates and the need to feed the burgeoning global population escalates. One of the main causes of these pandemics and epidemics is the introduction to a new continent of food crops domesticated elsewhere, and their subsequent invasion by damaging virus diseases they never encountered before. This review focusses on providing historical and up-to-date information about pandemics and major epidemics initiated by spillover of indigenous viruses from infected alternative hosts into introduced crops. This spillover requires new encounters at the managed and natural vegetation interface. The principal virus disease pandemic examples described are two (cassava mosaic, cassava brown streak) that threaten food security in sub-Saharan Africa (SSA), and one (tomato yellow leaf curl) doing so globally. A further example describes a virus disease pandemic threatening a major plantation crop producing a vital food export for West Africa (cacao swollen shoot). Also described are two examples of major virus disease epidemics that threaten SSA’s food security (rice yellow mottle, groundnut rosette). In addition, brief accounts are provided of two major maize virus disease epidemics (maize streak in SSA, maize rough dwarf in Mediterranean and Middle Eastern regions), a major rice disease epidemic (rice hoja blanca in the Americas), and damaging tomato tospovirus and begomovirus disease epidemics of tomato that impair food security in different world regions. For each pandemic or major epidemic, the factors involved in driving its initial emergence, and its subsequent increase in importance and geographical distribution, are explained. Finally, clarification is provided over what needs to be done globally to achieve effective management of severe virus disease pandemics and epidemics initiated by spillover events.     

岳阳市城区小学生血吸虫病防治健康教育现状调查

目的 调查湖南省岳阳市城区小学生血吸虫病防治知识、行为现状及健康教育需求情况,为制定科学有效的小学生血吸虫病健康教育方案提供参考依据。方法 采用分层整群抽样方法,抽取岳阳市城区洞庭湖湖畔学校和中心城区学校各2所,每所再从五、六年级分别抽取2个班的学生,通过调查问卷了解小学生血吸虫病相关知识、预防行为及健康教育需求,并进行统计分析。结果 共调查湖畔小学353人、中心城区小学363人,两组学校小学生年龄、性别、年级构成差异无统计学意义（t=-0.494,χ²_性别=1.615,χ²_年级=2.152;P均>0.05）。学生血吸虫病防治知识总知晓率为42.60%（305/716）,其中,湖畔学校小学生血防知识知晓率（52.97%）高于中心城区（32.51%）,差异有统计学意义（χ²=30.661,P<0.05）;学生行为正确率为76.68%（549/716）,血防知识知晓组行为正确率（81.31%）高于不知晓组（71.24%）,差异有统计学意义（χ²=6.384,P<0.05）。学生血防知识主要来源于老师（47.49%）;91.90%的学生愿意了解更多的血防知识,最喜欢的血防知识学习方式是参加课外活动（50.42%）。结论 岳阳市城区小学生的血防知识知晓率及行为正确率偏低,对血吸虫病防治健康教育需求较高。建议针对学生开展形式多样的血防健康教育,以增强学生的血吸虫病防护意识,提高自我防护能力。     

Barrett's Esophagus: Where Do We Stand?

Barrett''s esophagus (BE) is a precursor for esophageal adenocarcinoma, which has an increased incidence rate over the last few decades. Its importance stems from the poor five-year survival of esophageal adenocarcinoma and current data that suggest a survival benefit when surveillance programs are implemented. In this review, we will cover the pathophysiology and natural history of BE and the different endoscopic findings. The prevalence of BE in different geographic areas and the incidence of high-grade dysplasia and adenocarcinoma in this patient population is reviewed. Recent recommendation for screening and surveillance of BE has been covered in this review as well as the efficacy of nonconventional imaging modalities and endoscopic ablation therapies.     

Routine diagnosis of intestinal tuberculosis and Crohn’s disease in Southern India

AIM:To investigate whether routinely measured clinical variables could aid in differentiating intestinal tuberculosis(ITB)from Crohn’s disease(CD).METHODS:ITB and CD patients were prospectively included at four South Indian medical centres from October 2009 to July 2012.Routine investigations included case history,physical examination,blood biochemistry,ileocolonoscopy and histopathological examination of biopsies.Patients were followed-up after 2 and 6 mo of treatment.The diagnosis of ITB or CD was re-evaluated after 2 mo of antituberculous chemotherapy or immune suppressive therapy respectively,based on improvement in signs,symptoms and laboratory variables.This study was considered to be an exploratory analysis.Clinical,endoscopic and histopathological features recorded at the time of inclusion were subject to univariate analyses.Disease variables with sufficient number of recordings and P<0.05 were entered into logistic regression models,adjusted for known confounders.Finally,we calculated the odds ratios with respective confidence intervals for variables associated with either ITB or CD.RESULTS:This study included 38 ITB and 37 CD patients.Overall,ITB patients had the lowest body mass index(19.6 vs 22.7,P=0.01)and more commonly reported weight loss(73%vs 38%,P<0.01),watery diarrhoea(64%vs 33%,P=0.01)and rural domicile(58%vs 35%,P<0.05).Endoscopy typically showed mucosal nodularity(17/31 vs 2/37,P<0.01)and histopathology more frequently showed granulomas(10/30vs 2/35,P<0.01).The CD patients more frequently reported malaise(87%vs 64%,P=0.03),nausea(84%vs 56%,P=0.01),pain in the right lower abdominal quadrant on examination(90%vs 54%,P<0.01)and urban domicile(65%vs 42%,P<0.05).In CD,endoscopy typically showed involvement of multiple intestinal segments(27/37 vs 9/31,P<0.01).Using logistic regression analysis we found weight loss and nodularity of the mucosa were independently associated with ITB,with adjusted odds ratios of 8.6(95%CI:2.1-35.6)and 18.9(95%CI:3.5-102.8)respectively.Right lower abdominal quadrant pain on examination and involvement of≥3 intestinal segments were independently associated with CD with adjusted odds ratios of 10.1(95%CI:2.0-51.3)and 5.9(95%CI:1.7-20.6),respectively.CONCLUSION:Weight loss and mucosal nodularity were associated with ITB.Abdominal pain and excessive intestinal involvement were associated with CD.ITB and CD were equally common.