摘要： Depression and anxiety are comorbidities of inflammatory bowel disease (IBD). Though previous studies have proposed a relationship between anxiety, depression, and IBD, causality and directionality are largely unknown. Current and future research in these areas is aimed at exploring the biological underpinnings of this relationship, specifically pertaining to small molecule metabolism, such as tryptophan. Tryptophan is acquired through the diet and is the precursor to several vital bioactive metabolites including the hormone melatonin, the neurotransmitter serotonin, and vitamin B3. In this review, we discuss previous findings relating mental health comorbidities with IBD and underline ongoing research of tryptophan catabolite analysis.

关键词： Probiotics  

摘要： Gut microbiota takes part in the pathogenesis of inflammatory bowel disease (IBD). Clinical research has found that probiotics have a beneficial effect on active ulcerative colitis, but to date, significant efficacy has rarely been found in the use of probiotics in the remission phase of ulcerative colitis and Crohn's disease. More studies are needed to assess the utilization of probiotics in IBD remission. In this study, we assessed the administration of Bacillus subtilis in remission and its possible mechanism in mice with IBD. Oral administration of B. subtilis was implemented for 6 weeks (dextran sulfate sodium (DSS)-P6w group), 2 weeks (DSS-P2w group) or 0 weeks (DSS-control(CT) group) in the remission phase in rodents with (DSS)-induced IBD. The body weight, colon length and disease activity index (DAI) were recorded, and colon H&E staining was performed. The expression of tight junction proteins (ZO-1 and occludin) mRNA and epithelium proliferation-related Ki67 was detected. Gut microbiota were tested by 16S rRNA sequencing. Administration of B. subtilis in remission effectively increased the body weight and colon length and decreased DAI in the DSS-P6w group compared with the DSS-CT group, but there is no significant difference between the DSS-P2w and DSS-CT groups. The epithelial integrity was improved, and the expression of ZO-1 and occludin increased due to administration of B. subtilis in remission, which was more evident in the DSS-P6w group. The expression of Ki67 increased in the DSS-CT group compared with that in the CT group. The administration of B. subtilis effectively down-regulated the expression of Ki67 in the DSS-P6w and DSS-P2w groups compared with the DSS-CT group. Furthermore, gut microbial structure was improved, with significantly decreased Escherichia/Shigella and Enterococcus, and increased Akkermansia and corresponding microbial function in the DSS-P6w group. Short-term administration of B. subtilis in the remission phase showed no sig

关键词： whole-genome sequencing of African Americans   rare variants   polygenic risk scores   differential genetic architecture   CALB2   PTGER4   understudied populations   trans-ethnic comparative analysis  

摘要： Whether or not populations diverge with respect to the genetic contribution to risk of specific complex diseases is relevant to understanding the evolution of susceptibility and origins of health disparities. Here, we describe a large-scale whole-genome sequencing study of inflammatory bowel disease encompassing 1,774 affected individuals and 1,644 healthy control Americans with African ancestry (African Americans). Although no new loci for inflammatory bowel disease are discovered at genome-wide significance levels, we identify numerous instances of differential effect sizes in combination with divergent allele frequencies. For example, the major effect at PTGER4 fine maps to a single credible interval of 22 SNPs corresponding to one of four independent associations at the locus in European ancestry individuals but with an elevated odds ratio for Crohn disease in African Americans. A rare variant aggregate analysis implicates Ca2+-binding neuro-immunomodulator CALB2 in ulcerative colitis. Highly significant overall overlap of common variant risk for inflammatory bowel disease susceptibility between individuals with African and European ancestries was observed, with 41 of 241 previously known lead variants replicated and overall correlations in effect sizes of 0.68 for combined inflammatory bowel disease. Nevertheless, subtle differences influence the performance of polygenic risk scores, and we show that ancestry-appropriate weights significantly improve polygenic prediction in the highest percentiles of risk. The median amount of variance explained per locus remains the same in African and European cohorts, providing evidence for compensation of effect sizes as allele frequencies diverge, as expected under a highly polygenic model of disease.

关键词： 肛肠疾病   术后护理:排便困难  

摘要： 伴随生活质量的日渐提升,大众对自身健康意识越来越重视。混合痔 、肛周脓肿、肛瘘等为临床中较为常见的肛肠疾病,对其最有效的治疗方式为手术,但是术后极易发生大便困难等相关并发症,不仅给患者带来极大的疼痛,同时延长住院治疗用时。为了促使患者在肛肠术后大便通畅,尽最大努力减轻其疼痛感以及出血量,并提升手术疗效,让患者满意。基于此,笔者将总结肛肠病术后发生大便困难患者为其进行相应的护理措施,旨在达到医患满意,相关护理体会如下,以供大家在实际工作中参考应用。

关键词： Inflammatory bowel disease   Fatigue   Quality of life   Work productivity   Risk factors   Eastern China  

摘要： BACKGROUND Fatigue is a very common but relatively neglected problem in patients with inflammatory bowel disease(IBD).The prevalence rate of IBD in China is the highest in Asia,but there is little research on fatigue in patients with *** the relationship between fatigue and quality of life(QoL)nor the relationship between fatigue and work productivity(WP)in Chinese IBD patients has been *** To investigate the prevalence of fatigue related to IBD in Eastern China,to identify the risk factors associated with fatigue,to assess the impact of fatigue on QoL,and to evaluate the relationship between fatigue and *** A cross-sectional study was conducted in a Regional Tertiary IBD Diagnostic and Treatment Center in Eastern *** data of patients were collected,and disease activity was *** samples were analyzed to assess anemia,albumin,and *** was assessed using the multidimensional fatigue *** and WP were measured using the short inflammatory bowel disease questionnaire and the work productivity and activity impairment general health questionnaire,*** patients also completed assessments of depression(Patient Health Questionnaire-9)and anxiety(Generalized Anxiety Disorder 7-item Scale).RESULTS A total of 311 IBD patients,comprising 168 Crohn's disease patients and 143 ulcerative colitis patients,were *** prevalence of fatigue in patients with IBD was 60.77%.In a univariate logistic regression analysis,factors such as disease activity,depression,anxiety,anemia,and IBD-related surgery were individually related to a significantly increased risk of fatigue in IBD *** logistic regression analysis indicated that depression[odds ratio(OR)=8.078,95%confidence interval(CI):4.113-15.865],anxiety(OR=2.373,95%CI:1.100-5.119),anemia(OR=2.498,95%CI:1.290-4.834),and IBD-related surgery(OR=2.035,95%CI:1.084-3.819)were related to fatigue in IBD *** was a negative correlat

关键词： 手术   肛肠疾病   中药熏洗   切口疼痛   愈合时间  

摘要： 目的:探讨并分析对接受手术治疗后的肛肠疾病患者进行中药熏洗治疗对其切口疼痛及愈合时间的影响。方法:选择2018年5月至2020年3月在江苏沭阳青伊湖农场职工医院进行手术治疗的36例肛肠疾病患者作为研究对象。按照随机双盲法将其分为中药熏洗组(n=18)与高锰酸钾组(n=18)。术后用高锰酸钾溶液对高锰酸钾组患者进行熏洗治疗,对中药熏洗组患者进行中药熏洗治疗,然后比较两组患者视觉模拟评分法(VAS)的评分、肛门坠胀感评分、便血症状消失的时间、切口疼痛消失的时间、住院的时间及切口愈合的时间。结果:术后3 d及术后7 d,中药熏洗组患者的VAS评分和肛门坠胀感评分均低于高锰酸钾组患者,差异有统计学意义(P<0.05)。中药熏洗组患者术后便血症状消失的时间、切口疼痛消失的时间、切口愈合的时间和住院的时间均短于高锰酸钾组患者,差异有统计学意义(P<0.05)。结论:对接受手术治疗后的肛肠疾病患者进行中药熏洗治疗能显著减轻其切口的疼痛感,促进其切口的愈合,缩短其住院的时间。

关键词： 糜烂性胃炎   幽门螺杆菌感染   慢性结肠炎症   清化湿热法   名医经验   单兆伟  

摘要： 通过1则验案探讨单兆伟教授运用清化湿热法治疗糜烂性胃炎、幽门螺杆菌感染、慢性结肠炎属湿热证的临床经验及用药特点,单兆伟教授认为化湿治标不忘扶正治本,清热解毒当防寒凉败胃,用药清灵醇正以达中正和平之效,使得正复本固则邪不复感,湿化热清则病邪自除。

关键词： Crohn’s disease   Ulcerative colitis   Inflammatory bowel disease   Beta-glucan   Histologic activity   Noninvasive test  

摘要： BACKGROUND 1,3-beta-D-glucan(BG)is a ubiquitous cell wall component of gut *** hypothesized that the serum levels of BG could reflect active intestinal inflammation in patients with inflammatory bowel *** To determine whether the serum BG concentrations correlate with intestinal *** A prospective observational study was performed in a tertiary referral center,from 2016 to 2019,in which serum BG was determined in 115 patients with Crohn’s disease(CD),51 with ulcerative colitis(UC),and 82 controls using a photometric detection *** activity was determined by ileocolonoscopy,histopathology,magnetic resonance enterography,and biomarkers,including fecal calprotectin(FC),C-reactive protein,and a panel of *** ability of BG to detect active vs inactive disease was assessed using the area under the receiver operating characteristic *** subgroup analysis,serial BG was used to assess the response to therapeutic *** The serum BG levels were higher in CD patients than in controls(P=0.0001).The BG levels paralleled the endoscopic activity in CD patients and histologic activity and combined endoscopic and histologic activity in both CD and UC *** area under the curve(AUC)in receiver operating characteristic analysis to predict endoscopic activity was 0.694[95%confidence interval(CI):0.60-0.79;P=0.001]in CD,and 0.662(95%CI:0.51-0.81;P=0.066)in UC *** AUC in receiver operating characteristic analysis to predict histologic activity was 0.860(95%CI:0.77-0.95;P<0.001)in CD,and 0.786(95%CI:0.57-0.99;P=0.015)in UC *** cut-off values of BG for both endoscopic and histologic activity were 60μg/mL in CD,and 40μg/mL in UC *** analysis showed that the results based on BG of 40 and 60μg/mL were more specific for predicting endoscopic activity(71.8%and 87.2%for CD;and 87.5%and 87.5%for UC,respectively)than FC(53.3%and 66.7%for CD;and 20%and 80%for UC,respectively);and

关键词： 无痛胃肠镜   胃肠疾病   全程护理   护理质量  

摘要： 目的:探究无痛胃肠镜诊疗胃肠疾病过程中应用全程护理的效果。方法:选取2019年1-12月应用无痛胃肠镜诊疗的胃肠疾病患者200例,随机分为两组,各100例。对照组给予传统护理干预;观察组接受全程护理干预。比较两组护理效果。结果:观察组护理后心理状态评分明显优于对照组,差异有统计学意义(P<0.05);观察组护理后心率、呼吸频率及血压水平的稳定性明显优于对照组,差异有统计学意义(P<0.05);观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:全程护理用于无痛胃肠镜诊疗的胃肠疾病患者,效果显著。

关键词： Inflammatory bowel disease   SARS-CoV-2   COVID-19   Crohn disease   Colitis ulcerative   Biological therapy  

摘要： Managing inflammatory bowel disease(IBD)during the coronavirus disease 2019(COVID-19)pandemic has been a challenge faced by clinicians and their patients,especially concerning whether to proceed with biologics and immunosuppressive agents in the background of a global outbreak of a highly contagious new coronavirus(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2).The knowledge about the impact of this virus on patients with IBD,although it is still scarce,is rapidly *** particular,concerns surrounding medications’impact for IBD on the risk of acquiring SARS-CoV-2 infection or developing COVID-19,and potentially exacerbate viral replication and the COVID-19 course,are a current thinking of both practicing clinicians and providers caring for patients with *** patients with IBD infected with SARS-CoV-2 depends on both the clinical activity of the IBD and the occasional development and severity of *** this review,we summarize the current data regarding gastrointestinal involvement by SARS-CoV-2 and pharmacologic and surgical management for IBD concerning this infection,and the COVID-19 impact on both the patient's psychological functioning and endoscopy services,and we concisely summarize the telemedicine roles during the COVID-19 pandemic.