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Cytomegalovirus (CMV) colitis brings great obstacles for treatment of ulcerative colitis (UC). We aimed to assess the impact of CMV colitis on prognostic outcomes and associated risk factors for UC patients. A consecutive 77 inpatients diagnosed as UC were collected retrospectively from January 2012 to December 2015. About 33 patients were defined with CMV colitis by histological tests of colon mucosa. Clinical characteristics and outcomes were compared between patients with CMV colitis or those without. The primary outcomes were UC-related colectomy or the first time of disease relapse after discharge. 33 CMV colitis patients had higher frequency of recent steroid treatment (81.8% vs. 31.8%, p <.001), older age of onset (45.3 ± 13.0 vs. 44.5 ± 15.7 years, p =.028) and more severe colitis (p <.001) characterized by lower hemoglobin (99.0 ± 23.2 vs. 114.6 ± 22.6 g/L, p =.004), albumin (29.7 ± 4.6 vs. 35.4 ± 6.5 g/L, p <.001), immunoglobulin G [8.8 (5.9–10.6) vs. 12.3 (9.3–16.2) g/L, p =.003] and higher C reactive protein [48.5 (21.6–73.8) vs. 9.1 (3.6–35.0) mg/L, p <.001]. The occurrence of UC-related colectomy in patients with CMV colitis was more frequent (48.5% vs 20.5%, p<.01) and CMV colitis was proved to be one of risk factors of colectomy with a hazard ratio of 3.15 (95%CI 1.387–7.171, p =.006), mainly in a short term period. UC-related complications almost occurred within 1 year since CMV colitis diagnosis. And UC patients with CMV colitis always experienced early relapse. CMV colitis increases the colectomy risk mainly in a short term due to severe inflammatory response, early-onset complications or medication treatment failure. There is also potential correlation between CMV colitis and early relapse. Short-term therapy for UC patients with CMV colitis should be more concerned on controlling systemic inflammation and reducing complications whereas long-term maintenance therapy may not require more aggressive intervention. [ABSTRACT FROM AUTHOR]

Whether patients with myelodysplastic syndrome (MDS) undergoing allogeneic hematopoietic stem cell transplantation (allo‐HSCT) benefit from pretransplant cytoreductive therapy remains controversial. Our study compared the outcomes of upfront transplantation with those of pretransplant cytoreductive therapy in the patients who received transplantation and those who dropped out due to cytoreductive therapy‐related adverse effects. Patients with MDS‐EB‐1 or MDS‐EB‐2 were enrolled and divided into three groups based on therapy pretransplantation: upfront transplantation (upfront, n = 54), induction chemotherapy (CT, n = 66) and hypomethylating agents (HMA, n = 37) alone. One hundred fifty‐seven patients were enrolled and 124 received allo‐HSCT, with 5.6%, 28.8% and 29.7% of drop‐out rate of transplantation in upfront, CT and HMA groups (P =.030), respectively. Overall therapy‐related mortality (TRM), cytoreductive therapy and transplant‐related mortality was 13.0%, 32.4% and 28.4% (P =.028), and 5‐year overall survival (OS) was 73.6%, 43.4% and 46.9% (P =.033). Multivariate analysis showed that CT and HMA were risk factors for TRM and OS, and transplantation was a protective factor for OS. In transplant patients, 3‐year cumulative incidence of relapse was 10.6%, 20.4% and 20.3% (P =.033), 5‐year TRM was 14.5%, 20.0% and 17.6% (P =.651), OS was 77.3%, 64.3% and 68.8% (P =.047) and DFS was 74.0%, 63.0% and 65.8% (P =.042). Multivariate analysis showed that CT was a risk factor for DFS, while CT, HMA and poor karyotype were risk factors for relapse. Results suggested that pretransplant cytoreductive therapy was not associated with better outcomes in the patients who had undergone transplantation. Therefore, upfront transplantation may be preferable for MDS patients. What's new? Whether patients with myelodysplastic syndrome undergoing allogeneic hematopoietic stem cell transplantation benefit from pre‐transplant cytoreductive therapy remains controversial. This study comparing the outcomes of upfront transplantation with those of pre‐transplant cytoreductive therapy includes both patients who ultimately received transplantation and those who dropped out due to cytoreductive therapy‐related adverse effects. The results suggest that pre‐transplant cytoreductive therapy did not improve survival because adverse effects led a proportion of patients to drop out of transplantation. Moreover, pre‐transplant cytoreductive therapy may increase relapse compared to upfront transplantation. Therefore, upfront transplantation may be preferable for myelodysplastic syndrome patients. [ABSTRACT FROM AUTHOR]

Introduction: Chronic gastritis is a common disease worldwide. Studies have consistently shown that chronic gastritis is usually associated with gastric microbial dysbiosis, especially the infection of Helicobacter pylori . However, the interaction between H. pylori and non- H. pylori bacteria in patients with chronic gastritis has not been clearly identified yet. Consequently, we designed a protocol for a systematic review and meta-analysis, which focused on identifying the changes in gastrointestinal microbiota composition between patients with H. pylori -infective and non-infective chronic gastritis., Method and Analysis: We will search PubMed, EMBASE and Cochrane Library databases to retrieve observational studies on humans. The eligible studies must include data about the relative abundance of the gastrointestinal microbiome in patients with H. pylori -infective or non-infective chronic gastritis. Only the data of adults aged over 18 years will be analysed. Two researchers will extract the data independently, and Newcastle-Ottawa Scale will be used to assess the risk of bias. Random-effects model will be performed in quantitative analyses. Correlation analysis, bioinformatics analysis and function analysis will be performed., Discussion: Currently, numerous studies have revealed the role of H. pylori in chronic gastritis. However, the alterations of non- H. pylori bacteria in patients with chronic gastritis remain an open question. The results of our study might provide new insights into future diagnosis and treatments., Ethics and Dissemination: This study is based on published documents, unrelated to personal data, so ethical approval is not in need. The results of this study are expected to be published in journals or conference proceedings., Prospero Registration Number: CRD42020205260; Pre-results., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)