关键词： 肠疾病   囊肿/病因学   囊肿/治疗   综述  

摘要： 尾肠囊肿是一种临床上较为罕见的疾病,但其恶变率较高,最高可达30%,且由于其临床症状缺乏特异性,早期诊断较困难。近年来,国内也鲜有关于尾肠囊肿的系统报道,且随着医学的进步,微创手术越来越占据主流。因此有必要对该病的病因、临床表现、影像学特征、病理表现、诊断及治疗等进行详细阐述,有助于临床的诊治。

关键词： Inflammatory bowel disease   Obesity   Body mass index   Antibiotics   Risk factor   Corticosteroids  

摘要： BACKGROUND In recent years,an increasing prevalence of obesity in inflammatory bowel disease(IBD)has been ***,moreover,has been directly correlated with a more severe clinical course and loss of response to *** To assess the prevalence and associated factors of obesity in *** We collected data about IBD disease pattern and activity,drugs and laboratory investigations in our *** measures were retrieved and obesity defined as a body mass index(BMI)>***,we compared characteristics of obese vs non obese patients,and Chi-squared test and Student’s t test were used for discrete and continuous variables,respectively,at univariate *** multivariate analysis,we used binomial logistic regression and estimated odd ratios(OR)and 95%confidence intervals(CI)to ascertain factors associated with *** We enrolled 807 patients with IBD,either ulcerative colitis(UC)or Crohn’s disease(CD).Four hundred seventy-four patients were male(58.7%);the average age was 46.2±13.2 years;438(54.2%)patients had CD and 369(45.8%)*** enrolled 378 controls,who were comparable to IBD group for age,sex,BMI,obesity,diabetes and abdominal circumference,while more smokers and more subjects with hypertension were observed among *** prevalence of obesity was 6.9%in IBD and 7.9%in controls(not statistically different;P=0.38).In the comparison of obese IBD patients and obese controls,we did not find any difference regarding diabetes and hypertension prevalence,nor in sex or smoking *** IBD patients were younger than obese controls(51.2±14.9 years vs 60.7±12.1 years,P=0.03).At univariate analysis,obese IBD were older than normal weight ones(51.2±14.9 vs 44.5±15.8,P=0.002).IBD onset age was earlier in obese population(44.8±13.6 vs 35.6±15.6,P=0.004).We did not detect any difference in disease *** subjects had consumed more frequently long course of systemic steroids(66.6%vs 12.5%,P=0.02)as well as antibiotics s

关键词： 幽门螺杆菌   分离培养   耐药性   药敏试验   双重耐药   三重耐药  

摘要： 目的观察西安地区胃十二指肠疾病患者幽门螺杆菌(***)感染及抗生素耐药情况,指导今后临床用药。方法对320例Hp阳性胃十二指肠疾病患者的胃黏膜样本进行***分离培养、鉴定,对所得***菌株进行甲硝唑、克拉霉素、左氧氟沙星、阿莫西林、呋喃唑酮、四环素的药敏检测。结果共获得有药敏结果***菌株121株。将患者分为慢性非萎缩性胃炎组、慢性萎缩性胃炎组、胃溃疡组、十二指肠溃疡组、复合性溃疡组及胃癌组,各组的***培养检出率之间有显著差异,胃、十二指肠溃疡组的***培养检出率及药敏培养检出率显著高于萎缩性胃炎及胃癌组(P<0.05)。***药敏结果显示甲硝唑的耐药率为80.17%,克拉霉素的耐药率为24.79%,左氧氟沙星的耐药率为30.58%,对阿莫西林、四环素与呋喃唑酮耐药率均为0.0%。对所有抗生素均敏感的***菌株占9.09%(11/121),单药耐药占56.20%(68/121),双重耐药占24.79%(30/121),三重耐药占9.92%(12/121)。各组***对不同抗生素的耐药情况无明显差异。结论不同类型疾病的***培养检出率之间有显著差异。西安地区***对克拉霉素、左氧氟沙星和甲硝唑耐药率高,对阿莫西林、四环素与呋喃唑酮耐药率低,推荐使用。

摘要： The inflammatory bowel diseases (IBDs) are chronic immune-mediated inflammatory disorders, including ulcerative colitis (UC) and Crohn's disease (CD). IBD results from a complex interplay between environmental, microbial, and genetic factors to create an abnormal immunological response leading to intestinal inflammation. Many pathways driving inflammation have been described, and different pathways may predominate in an individual patient. The interleukin (IL)-23 pathway plays a key role in IBD pathogenesis through promoting a pathological Th17 response. Targeting IL-23 is effective in the treatment of IBD. Ustekinumab, a monoclonal antibody targeting the shared p40 subunit of IL-12/23, is approved for treatment of moderate-to-severe CD and UC. Specific IL-23p19 antagonists are in development and promising results from phase II trials of mirikizumab and risankizumab underscore the potential for this class of treatment. In this review, we summarize the mechanisms of action and the evidence from clinical trials supporting the efficacy and safety of different IL-23 antagonists for IBD.

关键词： a-FMT   CD   CDI   CI   FMT   hGM   h-FMT   IBD   IBS   RCT   UC  

摘要： The termautologous fecal microbiota transplantation (a-FMT) refers herein to the use of one's feces during a healthy state for later use to restore gut microbial communities after perturbations. Generally, heterologous fecal microbiota transplantation (h-FMT), where feces from a "healthy" donor is transplanted into a person with illness, has been used to treat infectious diseases such as recurrent Clostridioides difficile infection (CDI), with cure rates of up to 90%. In humans, due to limited response to medicines, h-FMT has become a hallmark intervention to treat CDI. Extrapolating the benefits from CDI, h-FMT has been attempted in various diseases, including inflammatory bowel disease (IBD), but clinical response has been variable and less effective (ranging between 24% and 50%). Differences in h-FMT clinical response could be because CDI is caused by a Clostridial infection, whereas IBD is a complex, microbiome-driven immunological inflammatory disorder that presents predominantly within the gut wall of geneticallysusceptible hosts. FMT response variability could also be due to differences in microbiome composition between donors, recipients, and within individuals, which vary with diet, and environments, across regions. While donor selection has emerged as a key factor in FMT success, the use of heterologous donor stool still places the recipient at risk of exposure to infectious/pathogenic microorganisms. As an implementable solution, herein we review the available literature on a-FMT, and list some considerations on the benefits of a-FMT for IBD.

关键词： Inflammatory bowel disease   Preclinical   Histology  

摘要： Background: The immune response involved in the pathogenesis of Inflammatory Bowel Disease (IBD) may be present years before the diagnosis, but the characteristics of the disease during the preclinical period have been scarcely investigated. Aim: To describe the microscopic findings of preclinical IBD and its relationship with the natural history of the disease. Methods: Medical records from all patients with an incidental diagnosis of IBD during a screening colonoscopy were included in this multicentric and retrospective study. We assessed 15 histologic items in the biopsy samples at diagnosis, and the Geboes score was calculated in patients with Ulcerative Colitis (UC). The main outcome was the development of gastrointestinal symptoms during follow-up. Results: We included 110 patients (79 UC, 24 Crohn's Disease (CD) and 7 with unclassified disease). In UC the most common histologic findings were acute or chronic inflammatory infiltrate and crypt epithelial polymorphs, while in CD we observed acute or chronic neutrophilic infiltrate and epithelial irregularity. Granuloma were only observed in 4% of CD patients. Crypt distortion and the infiltration of neutrophils in the epithelium were associated with a higher risk of developing symptomatic disease. Conclusions: Preclinical IBD shows specific microscopic findings and they are associated with the progression to symptomatic disease. (C) 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.