关键词： United States   Inflammatory Bowel Diseases   Intestinal Diseases   Perspective   Biological Therapy   Europe   Patients  

关键词： gut bacteria   leaky gut   short-chain fatty acid  

摘要： New Findings What is the central question of this study?'Leaky gut' has been found in intestinal and extra-intestinal diseases. However, functional evaluation of intestinal permeability is not widely used as a diagnostic marker, possibly owing to significant limitations of currently used permeability assays. There is an unmet need for development of a new, non-invasive test to assess intestinal function. What is the main finding and its importance?We show that an increased blood-to-stool ratio of the concentration of gut bacteria-produced short-chain fatty acids may be used as a marker of gut permeability. Our findings lay the groundwork for establishing a new, non-invasive, risk-free diagnostic tool in diseases associated with intestinal barrier malfunction, such as inflammatory bowel disease. Intestinal diseases, such as inflammatory bowel disease (IBD), are characterized by an impaired gut-blood barrier commonly referred to as 'leaky gut'. Therefore, functional evaluation of the gut-blood barrier is a promising diagnostic marker. We hypothesized that short-chain fatty acids (SCFAs) produced by gut bacteria might serve as a marker in IBD. Animal experiments were performed on male Sprague-Dawley rats with acetic acid-induced colitis and in sham control animals. The gut-blood barrier permeability was determined by assessing the ratios of the following: (i) portal blood concentration of SCFAs (C-p) to faecal concentration of SCFAs (C-f);(ii) systemic blood concentration of SCFAs (C-s) to faecal concentration of SCFAs (C-f);and (iii) C-p and C-s of fluorescein isothiocyanate (FITC)-dextran administered into the colon. As a clinical study, we evaluated C-s, C-f and the C-s/C-f ratio of SCFAs in six paediatric patients with IBD, assessed as mild/moderate/severe by the Paediatric Ulcerative Colitis Activity Index (PUCAI) and the Paediatric Crohn's Disease Activity Index (PCDAI) at the time of sample collection, and nine age-matched healthy control subjects. Rats with his

关键词： Colorectal cancer   Inflammation   Crohn disease   Ulcerative colitis   IBD   Inflammatory bowel disease  

摘要： BackgroundColorectal cancer (CRC) and inflammatory bowel disease (IBD) are the most prevalent diseases of the digestive system, and their association is unequivocal. A long-standing inflammatory process is one of the causes of sporadic as well as inherited cancers as it impacts on malignant transformation in a wide variety of neoplastic diseases, including colorectal *** extensive publication search was performed in Medline and PubMed database. The keywords: colorectal carcinoma, inflammation, Crohn disease, ulcerative colitis and inflammatory bowel disease were *** nucleotide-binding oligomerization domain-containing protein 2 (NOD2) and toll like receptor (TLR) signaling pathways are clearly involved in the inflammatory process and are therefore implicated in the transformation of normal colonic mucosa to premalignant and malignant disease. Focal sites of inflammation could significantly increase the risk of initiation and development of cancer. Altered inflammatory activity is likely to be a result of either a disturbance of intestinal bacterial flora or an inadequate cellular response to it. Additionally, increasing the level of inflammation-related factors may also interfere with the control of cellular *** review shows an overview of the genetic and environmental factors that appear to influence both the occurrence of IBD and CRC with particular reference to NOD2 and TLRs as well as pro- and anti-inflammatory cytokines associated with tumor initiation and progression (encompassing both tumor invasion and metastases), as they constitute potential targets for therapeutic intervention.

关键词： Inflammation   non-motor symptoms   alpha-synuclein   Parkinson's disease   inflammatory bowel disease  

摘要： Gastrointestinal (GI) symptoms can precede by many years the motor symptoms of Parkinson's disease (PD) and these patients can show some degree of inflammation associated with abnormal aggregates of alpha-synuclein in the GI tract. The abnormal accumulation of alpha-synuclein and the spreading of the aggregates from the gut to the brain might be promoted by inflammation, rising the hypothesis of a possible relationship between inflammatory bowel disease and PD. Many population-based studies have explored this association, but they have found conflicting results. It is essential to clarify this hypothesis and to try to elucidate the milestones of this relationship. There is no clear concordance between the results and the interpretation of different previous findings, probably due to many confounding factors such as drugs with anti-inflammatory activity, surgery, genetic predisposition and also selection bias. If there is a real association between both diseases, gastroenterologists and neurologists should be able to detect possible triggers of the disease or on the other hand, protective factors, that may be considered in clinical practice.

关键词： Crohn ' s disease   fecal calprotectin   disease activity   ulcerative colitis  

摘要： Objectives: The aim of this prospective study was to evaluate the home monitoring with a rapid fecal calprotectin test combined with a symptom questionnaire in patients with colonic IBD in real-life setting. Methods: We randomized 180 patients with colonic IBD in a study or a control group. The home monitoring patients performed the fecal calprotectin test and filled in a symptom questionnaire every second month and in cases with increasing symptoms. The control patients filled in the symptom questionnaire at baseline and at 6 and 12 months as well as for the appointment at the outpatient clinic. The study duration was 12 months. Results: The patient adherence to the self-monitoring program was low. Patients with a higher disease burden were more adherent than patients with better health-related quality of life, but otherwise, there were no significant factors predicting the adherence. The home monitoring patients had fewer contacts with the outpatient clinic, but otherwise, the disease course between the home monitoring and the control group were similar. Conclusions: The self-monitoring of IBD activity with a combination of a rapid fecal calprotectin home test and a symptom questionnaire provides an option for individualized care for IBD patients. However, adherence to the self-monitoring program remains a challenge.

关键词： Birth weight   childhood growth   height   inflammatory bowel disease  

摘要： Background: Growth in childhood is associated with later development of autoimmune diseases and cancer, but the impact of growth on risk of inflammatory bowel disease (IBD) remains unknown. We conducted a population-based cohort study to examine whether birth weight, childhood height, or changes in height associated with later risk of IBD. Methods: Our cohort consisted of 317,030 children from the Copenhagen School Health Records Register (born 1930-1989) with height repeatedly measured from age 7 to 13 and with data on birth weight on a subset. Through linkage to the Danish National Patients Register, cases of IBD were identified. Cox proportional hazard regression was used to examine associations between measures of childhood growth and risk of IBD. Results: During more than 9 million years of follow-up, 1612 individuals were diagnosed with Crohn's disease (CD) and 2,640 with ulcerative colitis (UC). Birth weight and childhood heights were not associated with subsequent risk of CD or UC (HRs close to 1.00). Childhood growth from 7 to 10 years (CD: HR, 1.00;95% CI, 0.85-1.18;UC: HR, 0.92;95% CI, 0.81-1.05) and 10 to 13 years (CD: HR, 1.02;95% CI, 0.89-1.17;UC: HR, 0.95;0.85-1.05) did not associate with risk of IBD either. Conclusion: In this large population-based cohort study, birth weight and childhood growth did not influence risk of IBD, which contrasts with observations in other chronic diseases. Thereby, the study also suggests that pre-clinical effects of adult IBD are not measurable in childhood and that childhood risk factors for IBD do not influence growth.

关键词： 不同浓度   罗哌卡因   右美托咪定   肛肠疾病   麻醉效果  

摘要： 目的:研究不同浓度罗哌卡因复合右美托咪定在肛肠疾病日间手术中的麻醉效果。方法:选取2016年5月~2018年5月期间于我院行肛肠疾病日间手术的患者123例为研究对象。根据随机数字表将患者分成A、B、C三组,每组各41例,其中A组麻醉时注入右美托咪定复合0.375%罗哌卡因20 m L,B组麻醉时注入右美托咪定复合0.5%罗哌卡因20 m L,C组注入右美托咪定复合0.75%罗哌卡因20 m L。比较三组患者麻醉后镇痛效果,比较三组麻醉前、麻醉30 min后的呼吸循环指标,比较三组患者感觉神经、运动神经阻滞情况,记录三组患者术后不良反应发生情况。结果:B组、C组镇痛优良率显著高于A组(P<0.05),但B组、C组镇痛优良率组间比较差异无统计学意义(P>0.05)。三组患者麻醉前、麻醉30 min后心率(HR)、收缩压(SBP)、舒张压(DBP)、血氧饱和度(SPO2)整体比较差异均无统计学意义(P>0.05)。B组、C组感觉神经阻滞起效时间均较A组短,且C组短于B组(P<0.05),而B组、C组感觉神经阻滞持续时间均较长,且C组长于B组(P<0.05);B组、C组Bromage评分1分人数均较A组少,且C组少于B组(P<0.05),B组、C组Bromage评分2分人数均较A组多,但C组较B组少(P<0.05),C组Bromage评分3分人数较A组和B组多(P<0.05),三组Bromage评分4分人数整体比较差异均无统计学意义(P>0.05)。C组患者术后不良反应总发生率高于A组、B组(P<0.05),但A组、B组不良反应总发生率组间比较差异无统计学意义(P>0.05)。结论:0.5%、0.75%罗哌卡因复合右美托咪定应用于肛肠疾病日间手术的镇痛效果、麻醉效果优于0.375%罗哌卡因复合右美托咪定,但是0.75%罗哌卡因复合右美托咪定的不良反应发生率偏高,0.5%罗哌卡因复合右美托咪定是肛肠疾病日间手术中更为合适的麻醉方案。

关键词： Inflammatory   bowel   disease   Metabolite   Microbiota  

摘要： Objective:The metabolites produced by the gut microbiota are of interest to *** objective of this review was to provide an updated summary of progress regarding the microbiota and their metabolites and influences on the pathogenesis of inflammatory bowel disease(IBD).Data sources:The author retrieved information from the PubMed database up to January 2018,using various combinations of search terms,including IBD,microbiota,and *** selection:Both clinical studies and animal studies of intestinal microbiota and metabolites in IBD were *** information explaining the possible pathogenesis of microbiota in IBD was ***:In IBD patients,the biodiversity of feces/mucosa-associated microbiota is decreased,and the probiotic microbiota is also decreased,whereas the pathogenic microbiota are *** gut microbiota may be a target for diagnosis and treatment of *** amounts of data support the view that the microbiota and their metabolites play pivotal roles in IBD by affecting intestinal permeability and the immune ***:This review highlights the advances in recent gut microbiota research and clarifies the importance of the gut microbiota in IBD *** research is needed to study the function of altered bacterial community compositions and the roles of metabolites.

关键词： dihydroartemisinin   CD4+T subsets   heme oxygenase-1   ulcerative colitis   Crohn's disease  

摘要： Dihydroartemisinin (DHA) is a derivative of the herb Artemisia annua L. that has prominent immunomodulatory activity;however, its underlying mechanism remains elusive. Inflammatory bowel disease (IBD) is an idiopathic inflammatory condition characterized as an autoimmune disorder that includes dysfunctions in the T helper (Th)/T regulatory cell (Treg) balance, which normally plays pivotal roles in immune homeostasis. The aim of this study was to explore the potential of DHA to ameliorate IBD by restoring the Th/Treg cell balance. To this end, we established mouse models of colitis induced by oxazolone (OXA) and 2,4,6-trinitro-benzene sulfonic acid (TNBS). We then treated mice with DHA at 4, 8, or 16 mg/kg/day. DHA treatment ameliorated colitis signs and reduced lymphocyte infiltration and tissue fibrosis. Moreover, DHA decreased the numbers of Th1 and Th17 cells and Th9 and Th22 cells in TNBS- or OXA-induced colitis, respectively, and increased Tregs in both models. DHA (0.8 mg/mL) also inhibited activated CD4+ T lymphocytes, which was accompanied by apoptosis induction. Moreover, it promoted heme oxygenase-1 (HO-1) production in vitro and in vivo, concomitant with CD4+ T cell apoptosis and restoration of the Th/Treg balance, and these effects were blocked by treatment with the HO-1 inhibitor Sn-protoporphyrin IX. Overall, these results suggest that DHA is a novel and valuable candidate for IBD therapy or Th/Treg immunoregulation.

关键词： 肛肠疾病   硬膜外麻醉   急性尿潴留   针刺   麦粒灸  

摘要： 目的:观察针刺联合麦粒灸疗法与针刺疗法对肛肠疾病硬膜外麻醉术后急性尿潴留的疗效差异。方法:62例患者随机分为针刺联合麦粒灸组和针刺组,各31例。针刺组穴取中极、关元、气海、水道、膀胱俞、三阴交、阴陵泉进行针刺治疗;针刺联合麦粒灸组在针刺治疗基础上予麦粒灸中极、关元、气海、水道穴治疗。第1次治疗结束60 min后仍不能排尿者进行第2次治疗。第2次治疗结束后30 min比较两组患者治疗前后小腹症状评分,治疗后首次排尿后膀胱残余尿量,并比较两组临床疗效及安全性。结果:治疗后,两组症状评分均较治疗前降低(P<0.05),针刺联合麦粒灸组症状评分低于针刺组(P<0.05);针刺联合麦粒灸组膀胱残余尿量为(26.71±17.01)mL,低于针刺组的(35.32±20.76)mL,差异有统计学意义(P<0.05);针刺联合麦粒灸组总有效率为93.5%(29/31),高于对照组的71.0%(22/31,P<0.05)。结论:针刺联合麦粒灸治疗肛肠疾病硬膜外麻醉术后急性尿潴留疗效优于单纯针刺,且安全可靠。