关键词： 肛肠疾病   中药制剂   雾化   熏洗  

摘要： 为观察自制中药制剂雾化熏洗对肛肠病患者术后的应用效果,将肛肠病手术患者100例随机分为对照组和观察组,每组50例。对照组患者术后采用高锰酸钾坐浴治疗,观察组患者术后采用自制中药制剂雾化熏洗,比较2组患者的临床疗效、一般指标以及创面疼痛、水肿、分泌物评分。结果显示,观察组患者临床总有效率高于对照组(P <0.05);观察组患者疼痛消失时间、肛缘水肿消失时间、便血消失时间、创口愈合时间和住院时间均短于对照组(P <0.05);术后1d2组患者创面疼痛、水肿和创面分泌物评分比较差异无统计学意义(P>0.05),术后7d观察组患者创面疼痛、水肿和创面分泌物评分均低于对照组(P <0.05)。结果表明,自制中药制剂雾化熏洗能促进肛肠病患者术后临床症状恢复,缩短创口愈合时间和住院时间,减轻疼痛和减少创面分泌物,改善创面水肿,值得临床推广应用。

关键词： Inflammatory bowel disease   Ulcerative colitis   Crohn’s disease   Biomarkers   Serum   Fecal   Mucosal healing  

摘要： Mucosal healing(MH)has emerged as a key therapeutic target in inflammatory bowel disease(IBD),and achievement of this goal is documented by endoscopy with ***,colonoscopy is burdensome and invasive,and substitution with an accurate noninvasive biomarker is *** To summarize published data regarding the performance of noninvasive biomarkers in assessing MH in IBD *** We conducted a systematic review of studies that reported the performance of biomarkers in diagnosing MH in patients with *** main outcome measure was to review the diagnostic accuracy of serum and fecal markers that showed promising utility in assessing *** We screened 1301 articles,retrieved 46 manuscripts and included 23 articles for full-text *** majority of the included manuscripts referred to fecal markers(12/23),followed by circulatory markers(8/23);only 3/23 of the included manuscripts investigated combined markers(serum and/or fecal markers).Fecal calprotectin(FC)was the most investigated fecal marker for assessing *** ulcerative colitis,for cutoff levels ranging between 58 mcg/g and 490 mcg/g,the sensitivity was 89.7%-100%and the specificity was 62%-93.3%.For Crohn’s disease,the cutoff levels of FC ranged from 71 mcg/g to 918 mcg/g(sensitivity 50%-95.9%and specificity 52.3%-100%).The best performance for a serum marker was observed for the endoscopic healing index,which showed a comparable accuracy to the measurement of FC and a higher accuracy than the measurement of serum C-reactive *** Several promising biomarkers of MH are emerging but cannot yet substitute for endoscopy with biopsy due to issues with reproducibility and standardization assessing *** ulcerative colitis,for cutoff levels ranging between 58 mcg/g and 490 mcg/g,the sensitivity was 89.7%-100%and the specificity was 62%-93.3%.For Crohn’s disease,the cutoff levels of FC ranged from 71 mcg/g to 918 mcg/g(sensitivity 50%-95.9%and specificity 52.3%-100%).The bes

关键词： Physical activity   Inflammatory bowel disease   Disease risk   Leisure time physical activity   Occupational physical activity   Cohort study  

摘要： BackgroundInflammatory bowel diseases (IBDs) are diseases of the immune system that share some genetic and lifestyle-related predisposing factors. Increasing incidences have been reported in all age groups. Based on experimental studies suggesting a role of physical activity on intestinal inflammation, this study aimed to investigate the association between leisure time physical activity and the risk of IBD in older *** study is a prospective cohort study using Danish registry data and questionnaire data from the Danish "Diet, Cancer and Health" cohort. The outcome IBD was defined as having at least two main diagnoses of Crohn's disease or ulcerative colitis registered in the National Patient Registry from the period between December 1993 and May 1997 with an average follow-up of 25years. Cox proportional hazard models were used to estimate hazard-ratios for IBD onset associated with being physically active and with levels of the metabolic equivalent of task (MET) hours/week of physical activity and hours/week spent on six types of physical activity. All analyses were adjusted for potential confounders. Furthermore, the analyses were stratified according to age-group, occupational physical activity, smoking, BMI and work status to test for effect *** total, 54,645 men and women aged between 50 and 64years were included, and of which there were 529 cases. When comparing physically active with inactive participants measured by MET hours/week there was no statistically significant difference in risk of IBD (0.89 [0.13;6.27]), regardless of how participation was measured. Results did not indicate any dose-response effect when comparing quartile groups of MET hours/week (HR=0.97 [0.76;1.22], HR=0.82 [0.64;1.05] and HR=0.83 [0.65;1.07] or whether five of the six types of activities were compared with the lowest quartile as reference. For do-it-yourself-work, the third quartile of hours/week was associated with a higher risk of IBD compared

关键词： Apolipoprotein E polymorphism   Crohn’s disease   Ulcerative colitis   Immunosuppression   Surgery   Disease severity  

摘要： BACKGROUND It has been suggested that apolipoprotein E(APOE)polymorphisms are associated with the risk of developing inflammatory bowel disease(IBD)and the early age of disease ***,there are no reports regarding the relationship with clinical characteristics and disease *** To summarise that APOE polymorphisms are associated with the risk of developing IBD and the early age of disease *** In total,406 patients aged 3-18 with IBD(192 had ulcerative colitis and 214 had Crohn’s disease)were genotyped using the TaqMan hydrolysis probe *** expression was described at diagnosis and the worst flare by disease activity scales,albumin and C-reactive protein levels,localisation and behaviour(Paris classification).Systemic steroid intake with the total number of courses,immunosuppressive,biological,and surgical treatment with the time and age of the first intervention were *** total number of exacerbation-caused hospitalisations,the number of days spent in hospital due to exacerbation,the number of relapses,and severe relapses were also *** Ulcerative colitis patients with the APOEε4 allele had lower C-reactive protein values at diagnosis(P=0.0435)and the worst flare(P=0.0013)compared to patients with the APOEε2 allele and genotype APOEε3/ε***’s disease patients with the APOEε2 allele scored lower on the Pediatric Crohn’s Disease Activity Index at diagnosis(P=0.0204).IBD patients with APOEε2 allele spent fewer days in the hospital due to relapse(P=0.0440).CONCLUSION APOE polymorphisms are associated with the risk of developing IBD and the clinical expression of ***,the clinical relevance of the differences identified is rather modest.

关键词： IBD   social media   rural population   telemedicine  

摘要： Background:Social media use is prevalent in our society and has become widely used in the health care community. Inflammatory bowel disease (IBD) patients constitute one of the patient populations that benefit from social media use to obtain information on their diseases. West Virginia (WV) is a rural Appalachian state with barriers to internet access and health care and we examined the role that social media plays in patients' lives in this state, which could be reflective of other rural states. Methods:Our patient population consisted of patients, 18-65 years old, who live in WV with a diagnosis of IBD. A 17-question survey was sent to 2,131 patients over a course of 4 weeks through an application called REDCap. Results:We received 624 responses with a 29% response rate. Approximately 30% of patients reported that they used Facebook for IBD-related information, while 4.3% used Instagram. While most (92%) patients preferred information coming from their physician, the majority judged information from the internet to be reliable (39.3%) or neutral (44.9%). Most patients believed that social media had no impact on their disease management (67%), while 30.3% believed it had a positive impact. Almost 45% of patients stated that they wished their physician had a social media account for IBD. Conclusions:Our study shows that patients are interested in obtaining health-related information from social media resources. As physicians, it is our job to point them in the right direction to be able to find reliable information.

摘要： Inflammatory bowel diseases (IBD) are chronic inflammatory diseases of the gastrointestinal tract arising from abnormal responses of the innate and adaptative immune systems. Interleukin (IL)-10-producing CD4(+)CD25(+) regulatory T (T-reg) cells play a protective role in the recovery phase of IBD. In the present study, the effects of the administration of the selective Ca2+-activated K+ channel K(Ca)3.1 inhibitor TRAM-34 on disease activities were examined in chemically induced IBD model mice. IBD disease severity, as assessed by diarrhea, visible fecal blood, inflammation, and crypt damage in the colon, was significantly lower in mice administered 1 mg/kg TRAM-34 than in vehicle-administered mice. Quantitative real-time polymerase chain reaction examinations showed that IL-10 expression levels in the recovery phase were markedly increased by the inhibition of K(Ca)3.1 in mesenteric lymph node (mLN) Treg cells of IBD model mice compared with vehicle-administered mice. Among several positive and negative transcriptional regulators (TRs) for IL-10, three positive TRs-E4BP4, KLF4, and Blimp1-were upregulated by the inhibition of K(Ca)3.1 in the mLN T-reg cells of IBD model mice. In mouse peripheral CD4(+)CD25(+) Treg cells induced by lectin stimulation, IL-10 expression and secretion were enhanced by the treatment with TRAM-34, together with the upregulation of E4BP4, KLF4, and Blimp1. Collectively, the present results demonstrated that the pharmacological inhibition of K(Ca)3.1 decreased IBD symptoms in the IBD model by increasing IL-10 production in peripheral T-reg cells and that IL-10(high) T-reg cells produced by the treatment with K(Ca)3.1 inhibitor may contribute to efficient T-reg therapy for chronic inflammatory disorders, including IBD. SIGNIFICANCE STATEMENT Pharmacological inhibition of Ca2+-activated K+ channel K(Ca)3.1 increased IL-10 expression in peripheral T-reg cells, together with the upregulation of the transcriptional regulators of IL-10: Kruppel-l

关键词： 胶囊内镜   小肠疾病   诊断   消化道出血   腹痛  

摘要： 目的分析小肠疾病诊断中应用胶囊内镜检查的临床价值和安全性。方法采用回顾性分析病例观察的方法搜集郑州大学第一附属医院2018年1月—2020年12月就诊的不明原因消化道的出血或腹部不适的患者329例,所有患者均行胶囊内镜检查。分析不同症状患者小肠疾病的检出率及检查过程中并发症的发生情况。结果所有应用胶囊内镜操作的患者中,有324例患者在有效工作时间内顺利进入小肠,余5例患者因出现胶囊内镜滞留,联合胃镜辅助下完成检查。应用胶囊内镜全小肠检查成功率为98.5%(324/329)。所有病例中不明原因消化道出血者病变检出率为70.4%(145/206),主要病变类型为血管畸形、小肠溃疡、非特异性炎症;慢性腹痛者检出率为40%(30/75),主要病变非特异性炎症、小肠溃疡、小肠淋巴管扩张;慢性腹泻者检出率为27.8%(10/36),主要病变为小肠糜烂、小肠溃疡和克罗恩病。腹胀者检出率为25%(3/12)。结论临床上对于小肠疾病诊断中采用胶囊内镜具有重要的临床价值,且操作简单、安全有效,特别是不明原因的消化道出血者。

关键词： 128层螺旋CT小肠造影   小肠疾病   小肠X线造影  

摘要： 目的:探讨在小肠疾病诊断中使用128层螺旋CT小肠造影扫描的临床价值。方法:研究于2018年12月—2020年10月收集我院诊治的患者资料,共45例,在手术之前实施疾病诊断观察,分别实施X线造影检查以及128层螺旋CT小肠造影检查,通过对45例患者的手术病理结果进行判断,分析这两种造影检查诊断的敏感性和特异性。结果:通过对患者的手术病理结果作为标准,其中使用128层螺旋CT小肠造影对患者小肠疾病的诊断敏感度为97.50%%,诊断特异度为80.00%,小肠X线造影分别为90.00%,20.00%,前一组数据明显优于后一组,组间差存意义(P<0.05);128层螺旋CT小肠造影的诊断准确性为97.50%,小肠X线造影为72.50%,两者差异性较为显著,组间差存意义(P<0.05)。结论:在小肠疾病患者的诊断中,使用128层螺旋CT小肠造影对患者疾病确诊具有积极意义,有利于患者的疾病的早发现和早治疗,具有临床推广价值。

关键词： 红外线理疗   耳穴埋豆   肛肠疾病   尿潴留   尿动力学指标  

摘要： 目的探讨红外线理疗联合耳穴埋豆干预对肛肠疾病术后尿潴留患者排尿情况、舒适度及生活质量的影响。方法选取2017年1月至2020年1月收治的400例肛肠疾病术后尿潴留患者作为研究对象,根据就诊顺序以随机数字表法将其分为对照组和观察组,各200例。对照组在常规护理基础上采用耳穴埋豆干预,观察组同步采用红外线理疗联合耳穴埋豆干预,比较两组的干预效果。结果观察组的首次排尿量多于对照组,恢复自主排尿时间短于对照组,干预2 h后残余尿量少于对照组(P<0.05)。干预后,观察组的最大尿流率、初尿感膀胱容量、最大逼尿肌压力均显著高于对照组(P<0.05)。观察组的尿潴留改善总有效率为97.50%,显著高于对照组的86.50%(P<0.05)。干预后,观察组的GCQ、WHOQOL-100评分均显著高于对照组(P<0.05)。结论红外线理疗结合耳穴埋豆干预能够有效改善肛肠疾病术后尿潴留患者排尿情况及尿动力学指标水平,也能提高患者舒适度及生活质量。

关键词： Capsule endoscopy   Crohn disease   Ulcerative colitis  

摘要： In Crohn disease (CD), the use of capsule endoscopy (CE) for suspected versus established disease is very different. Most patients with CD are diagnosed with ileocolonoscopy. In patients with a negative ileocolonoscopy, CE is the next best test in suspected CD. In patients with established CD, the potential benefits of CE are rating severity of disease, establishing extent and distribution, and following mucosal healing in a treat to target strategy. In those with proximal small bowel disease, CE can help in diagnosis and prognostication. In ulcerative colitis, CE has a limited role, but that may change with evolving technology. © 2020 Elsevier Inc.