关键词： 功能性胃肠疾病   FGID   发病机制  

摘要： 功能性胃肠疾病(FGID)是一种以慢性或反复出现的腹部疼痛症为特征的临床综合征。近年来国内外学者对其发病机制的研究不断深入,现从肠-脑轴紊乱、饮食、环境因素、遗传因素、感染、轻度黏膜炎症、免疫激活、肠道通透性改变、胆汁酸代谢紊乱及5-羟色胺代谢异常等机制方面进行综述。

关键词： glycol chitosan   quercetin   nanomicelles   dual responsive   drug delivery   IBD  

摘要： The incidence and progression of inflammatory bowel disease are closely related to oxidative stress caused by excessive production of reactive oxygen species (ROS). To develop an efficacious and safe nanotherapy against inflammatory bowel diseases (IBD), we designed a novel pH/ROS dual-responsive prodrug micelle GC-B-Que as an inflammatory-targeted drug, which was comprised by active quercetin (Que) covalently linked to biocompatible glycol chitosan (GC) by aryl boronic ester as a responsive linker. The optimized micelles exhibited well-controlled physiochemical properties and stability in a physiological environment. Time-dependent NMR spectra traced the changes in the polymer structure in the presence of H2O2, confirming the release of the drug. The in vitro drug release studies indicated a low release rate (<20 wt %) in physiological conditions, but nearly complete release (>95 wt % after 72 h incubation) in a pH 5.8 medium containing 10 mu M H2O2, exhibiting a pH/ROS dualresponsive property and sustained release behavior. Importantly, the negligible drug release in a simulated gastric environment in 1 h allowed us to perform intragastric administration, which has potential to achieve the oral delivery by mature enteric-coating modification in future. Further in vivo activities and biodistribution experiments found that the GC-B-Que micelles tended to accumulate in intestinal inflammation sites and showed better therapeutic efficacy than the free drugs (quercetin and mesalazine) in a colitis mice model. Typical inflammatory cytokines including TNF-alpha, IL-6, and iNOS were significantly suppressed by GC-B-Que micelle treatment. Our work promoted inflammatory-targeted delivery and intestinal drug accumulation for active single drug quercetin and improved the therapeutic effect of IBD. The current study also provided an alternative strategy for designing a smart responsive nanocarrier for a catechol-based drug to better achieve the target drug delivery.

关键词： Bowel preparation   Inflammatory bowel disease   Tolerability   Efficacy   Moviprep   Prep Kit-C  

摘要： BACKGROUND Colonoscopy remains the gold standard for detection of colonic *** optimal evaluation depends on adequate bowel *** with inflammatory bowel disease(IBD),require frequent endoscopic assessment for both activity and dysplasia *** commonly used bowel preparations in Australia are Prep Kit-C(Pc)and Moviprep(Mp).Little is known about tolerability,efficacy and safety of split protocols of Mp and Pc in both IBD and non-IBD *** To primary aim was to compare the tolerability,efficacy and safety of split protocols of Mp and Pc in patients having a *** secondary aim was to compare the efficacy,tolerability and safety of either preparation in patients with or without *** Patients were randomized to Pc or Mp bowel *** completed a questionnaire to assess *** was assessed using the Ottawa Bowel Preparation *** electrolytes and renal function were collected one week prior to colonoscopy and on the day of *** Of 338 patients met the inclusion *** 168 patients randomized to Mp and 170 to *** efficacy of bowel preparation(mean Ottawa Bowel Preparation Score)was similar between Mp(5.4±2.4)and Pc(5.1±2.1)(P=0.3).Mean tolerability scores were similar in Mp(11.84±5.4)and Pc(10.99±5.2;P=0.17).125 patients had IBD(73 had Crohn’s Disease and 52 had Ulcerative colitis).Sixtyfour IBD patients were allocated to Mp and 61 to *** non-IBD patients,104 were allocated to Mp and 109 to *** mean tolerability score in the IBD group was lower than the non-IBD group(mean tolerability scores:IBD:10.3±5.1 and non-IBD:12.0±5.3;P=0.01).IBD patients described more abdominal pain with Mp when compared with Pc;(Mp:5.7±4.4 vs Pc:3.6±2.6,P=0.046).Serum magnesium level increased with Pc compared with Mp in all patients(mean increase in mmol/L:Mp:0.03±0.117 and Pc:0.11±0.106;P<0.0001).CONCLUSION In this study,the efficacy,tolerability and safety of Mp and Pc were simila

关键词： 复方阿嗪米特   莫沙必利   老年胃肠疾病相关性消化不良   效果   安全性  

摘要： 目的探讨复方阿嗪米特结合莫沙必利治疗老年胃肠疾病相关性消化不良的效果及安全性。方法选取2018年1月~2020年1月赣州市人民医院老年病科收治的老年胃肠疾病相关性消化不良患者100例,按照随机数字表法分为联合组(50例)和对照组(50例),联合组应用复方阿嗪米特结合莫沙必利治疗,对照组单独应用莫沙必利治疗。比较两组患者的症状积分、生活质量评分、临床疗效、症状消失时间、住院时间及不良反应发生情况。结果治疗后,两组严重程度积分、症状出现频率均低于治疗前,且联合组低于对照组,差异有统计学意义(P<0.05)。治疗后两组生活质量评分高于治疗前,联合组高于对照组,差异有统计学意义(P<0.05)。联合组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。联合组症状消失时间、住院时间短于对照组,差异有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论复方阿嗪米特结合莫沙必利治疗老年胃肠疾病相关性消化不良的疗效显著,安全性较高。

关键词： 胃十二指肠疾病   幽门螺杆菌   抗体分型   相关性  

摘要： 目的分析幽门螺杆菌(Hp)抗体分型与袁州区居民胃十二指肠疾病的关系。方法回顾性分析2019年6月—2020年6月因上腹不适阳性征于宜春市第二人民医院消化内科就诊的袁州区患者的临床资料,将接受胃镜检查与14C尿素呼气试验检查阳性的胃十二指肠疾病患者200例纳入观察组,将同期200例健康体检者纳入对照组,均进行Hp抗体检测。比较2组HpⅠ型、HpⅡ型、HpⅠ+Ⅱ型抗体阳性率及与胃十二指肠疾病的关系。结果观察组HpⅠ型抗体阳性率高于对照组,HpⅡ型抗体阳性率低于对照组,差异有统计学意义(P<0.05);2组HpⅠ+Ⅱ型抗体阳性率比较,差异无统计学意义(P>0.05)。在胃溃疡、胃癌中HpⅠ型抗体阳性率较高,单纯慢性胃炎中HpⅡ型抗体阳性率较高。结论通过检测Hp抗体分型,可评估胃十二指肠疾病病情程度、预后情况,且可及时规范根除Hp感染,减少耐药发生。

关键词： Inflammatory bowel disease   Biological blood concentration   Endoscopic inactivity   Infliximab   Adalimumab   Vedolizumab  

摘要： BACKGROUND Although blood concentration of biologics is an important composition of disease management in inflammatory bowel disease(IBD)patients,complexity and uncertainty of biological management encourage many disputes in predicting the outcome of IBD patients through blood concentration of *** To verify the predictive value of blood concentration of biologics on endoscopic inactivity in IBD patients under different *** We searched PubMed/MEDLINE,Embase,and Web of Science up to May 2020 and identified IBD patients as the research cohort as well as the correlations between blood concentration of biologics and endoscopic inactivity in IBD patients as the research *** A total of 23 articles with 30 clinical studies and 1939 IBD patients were *** predictive cut-off value of blood concentration of infliximab on mucosal healing should be 2.7-10.6μg/mL in *** concentration of infliximab reaching 5.0-12.7μg/mL or more increased the probability of fistula healing/closure in perianal fistulizing Crohn's *** concentration of adalimumab reaching 7.2-16.2μg/mL or more could predict mucosal healing in *** predictive cut-off value of blood concentration of adalimumab on fistula healing/closure should be 5.9-9.8μg/mL in perianal fistulizing Crohn's *** concentration of vedolizumab surpassing 25.0μg/mL indicated mucosal healing in ulcerative colitis patients under maintenance therapy and the predictive cut-off value of blood concentration on mucosal healing or endoscopic remission under induction therapy in IBD could be 8.0-28.9μg/*** Blood concentration of biologics should not be utilized to predict endoscopic inactivity of IBD independently due to discrepancies in clinical studies,whereas conducting therapeutic drug monitoring intensively contributes to precise therapy.

摘要： Recent studies suggest an important role for RNA, especially noncoding RNA, in inflammatory bowel disease (IBD) and colon cancer. Drug development based on regulating RNA rather than protein is a promising new area. Phytochemicals are naturally occurring plant-derived compounds with chemical diversity, biologic activity, easy availability, and low toxicity. Many phytochemicals have been shown to exert protective effects on IBD and colon cancer through modulation of RNAs. The aim of this study was to summarize the advancements of phytochemicals in regulating RNA for the treatment of IBD and colon cancer. This review involves many phytochemicals, including polyphenols, flavones, and alkaloids, which can influence various types of RNAs, including microRNA, long noncoding RNA, as well as messenger RNA, by influencing a variety of upstream molecules or regulating epigenetic processes. The limitation for many current studies is that the specific mechanisms of phytochemicals regulating RNA have not been fully uncovered. Accompanied by more identified functions of RNAs, especially noncoding RNA functions, the screening of RNA-regulating phytochemicals has presented challenges as well as opportunities for the prevention and treatment of IBD and colon cancer. SIGNIFICANCE STATEMENT Noncoding RNAs, which constitute the majority of the human transcriptional genome, play a key role in the disease state and are considered as important therapeutic targets in inflammatory bowel disease (IBD) and colon cancer. Recent studies have shown that phytochemicals regulate the expression of many noncoding RNAs involved in IBD and colon cancer. Therefore, identifying the specific molecular mechanism of phytochemicals regulating noncoding RNA in disease models may result in novel and effective therapeutic opportunities.

关键词： Crohn’s disease   Colitis,Ulcerative   COVID-19   Inflammatory bowel disease   Brazil  

摘要： BACKGROUND Coronavirus disease 2019(COVID-19)pandemic is still evolving globally,and Brazil is currently one of the most affected *** is still debated whether patients with inflammatory bowel disease(IBD)are at a higher risk for developing COVID-19 or its *** To assess geographical distribution of IBD patients at the highest risk and correlate these data with COVID-19 mortality rates in *** The Brazilian IBD Study Group(Grupo de Estudos da Doença Inflamatória Intestinal do Brasil)developed a web-based survey adapted from the British Society of Gastroenterology *** included categories were demographic data and inquiries related to risk factors for complications from *** were categorized as highest,moderate or lowest individual *** Spearman correlation test was used to identify any association between highest risk and mortality rates for each state of the *** A total of 3568 patients(65.3%females)were *** participants were from the southeastern and southern regions of Brazil,and 84.1%were using immunomodulators and/or *** patients(55.1%)were at moderate risk,23.4%were at highest risk and 21.5%were at lowest risk of COVID-19 *** association between the proportion of IBD patients at highest risk for COVID-19 complications and higher mortality rates was identified in different Brazilian states(r=0.146,P=0.467).CONCLUSION This study indicates a distinct geographical distribution of IBD patients at highest risk for COVID-19 complications in different states of the country,which may reflect contrasting socioeconomic,educational and healthcare *** association between high risk of IBD and COVID-related mortality rates was identified.

关键词： BM   CD   CD-PRO/SS   IBD   TNF   UC  

摘要： The global incidence of inflammatory bowel disease (IBD) has increased considerably during the past few decades.1 IBDs, composed of Crohn’s disease (CD) and ulcerative colitis (UC), are characterized by heterogeneous presentation and widely variable clinical course. The therapeutic goals are to induce and maintain remission. Despite the current treatments available, many patients do not achieve this goal.

关键词： Crohn's   Hematologic malignancy   Hepatosplenic T-cell lymphoma   Complication