关键词： 双气囊小肠镜   小肠CT成像   诊断   安全性  

摘要： 目的探讨双气囊小肠镜(DBE)及多层螺旋CT小肠成像(MDCTE)在不同年龄患者小肠疾病诊断中的价值及安全性。方法收集2015年1月~2017年12月武汉大学人民医院疑诊小肠疾病且行DBE及MDCTE的患者病例资料,应用McNemar检验对两种诊断方法在不同年龄患者中的检出率进行比较。结果本研究纳入106例患者,中老年组(≥45岁)62例,青少年组(<45岁)44例。中老年患者中,MDCTE及DBE的总检出率分别为46.8%和66.1%,青少年患者中为56.8%及84.1%。在不明原因消化道出血患者中,各年龄组DBE的检出率均高于MDCTE,差异均有统计学意义(P<0.05)。对于慢性腹痛患者,各年龄组DBE检出率高于MDCTE,但差异无统计学意义(P>0.05),因此对主要适应证各年龄段两种检查效能比较,差异无统计学意义。中老年组最常见的小肠疾病依次为血管畸形、肿瘤;青少年组则以炎性疾病居多。DBE对各常见疾病的检出率均高于MDCTE,在炎性疾病(P=0.039)和肿瘤(P=0.039)中比较,差异有统计学意义,对于血管畸形的检出二者比较,差异无统计学意义。结论MDCTE及DBE均为小肠有效且安全的检查方式,需根据二者优缺点以及不同年龄患者的小肠疾病特点确定诊断方案。对于中老年患者,以血管畸形及肿瘤性病变多见,行MDCTE联合DBE检查可进行较全面的评估;对于青少年患者,根据病情怀疑炎性病变时可直接行DBE检查,必要时行MDCTE检查。

关键词： inflammatory bowel diseases   Crohn's disease   ulcerative colitis   estrogen receptors   GPER   ER alpha   ER beta   ER alpha 36   ER alpha 46  

摘要： The pathogenesis of inflammatory bowel diseases (IBD) seems to be associated with alterations of immunoregulation. Several lines of evidence suggest that estrogens play a role in the modulation of immune responses and may be related to the etiology of IBD. The purpose of this work was to examine the involvement of G protein-coupled estrogen receptor (GPER), estrogen receptor alpha (ER alpha), estrogen receptor beta (ER beta) and ER alpha spliced variants ER alpha 36 and ER alpha 46 in Crohn's disease (CD) and ulcerative colitis (UC). The studied group included 73 patients with IBD and 31 sex and age-related controls. No differences in serum levels of 17 beta-estradiol nor of CYP1A1 and SULT1E1 enzymes involved in estrogen catabolism were stated. The expression pattern of estrogen receptors in tissue samples was quantified using real-time PCR and Western blotting. Statistically significant up-regulation of GPER and ER alpha in both CD and UC as well as down-regulation of ER beta in CD patients was found. However, differences in the expression of estrogen receptors in CD and UC have been identified, depending on the sex and age of patients. In men, up-regulation of GPER, ER alpha and ER alpha 46 expression was shown in CD and UC patients. In women under 50 years of age, GPER protein level increased in UC whereas ER beta expression tended to decrease in CD and UC patients. In turn, in women over 50 the protein level of ER alpha increased in UC while ER beta expression decreased in CD patients. Dysregulation of estrogen receptors in the intestinal mucosa of patients with CD and UC indicates that estrogen signaling may play a role in the local immune response and maintain epithelial homeostasis in a gender- and age-dependent manner.

关键词： Gastroenterology   Inflammatory bowel disease  

摘要： Impaired intestinal epithelial barrier (IEB) function with loss of desmosomal junctional protein desmoglein 2 (DSG2) is a hallmark in the pathogenesis of inflammatory bowel disease (IBD). While previous studies have reported that glial cell line-derived neurotrophic factor (GDNF) promotes IEB function, the mechanisms are poorly understood. We hypothesized that GDNF is involved in the loss of DSG2, resulting in impaired IEB function as seen in IBD. In the inflamed intestine of patients with IBD, there was a decrease in GDNF concentrations accompanied by a loss of DSG2, changes of the intermediate filament system, and increased phosphorylation of p38 MAPK and cytokeratins. DSG2-deficient and RET-deficient Caco2 cells revealed that GDNF specifically recruits DSG2 to the cell borders, resulting in increased DSG2-mediated intercellular adhesion via the RET receptor. Challenge of Caco2 cells and enteroids with proinflammatory cytokines as well as dextran sulfate sodium-induced (DSS-induced) colitis in C57Bl/6 mice led to impaired IEB function with reduced DSG2 mediated by p38 MAPK-dependent phosphorylation of cytokeratins. GDNF blocked all inflammation-induced changes in the IEB. GDNF attenuates inflammation-induced impairment of IEB function caused by the loss of DSG2 through p38 MAPK-dependent phosphorylation of cytokeratin. The reduced GDNF in patients with IBD indicates a disease-relevant contribution to the development of IEB dysfunction.

关键词： 肛肠疾病   流行病学调查   山西省   流行病学抽样调查   中华中医药学会   成人   农村居民   城镇社区  

摘要： 肛肠疾病是临床常见的人类特有的疾病,本研究于2014—2016年对山西省18岁以上的城镇社区及农村居民中常驻人口(在当地居住≥6个月)常见肛肠疾病进行调查,旨在分析新形势下导致肛肠疾病的危险因素,从而为制定相关卫生政策和策略、加强人群防治提供科学依据。1对象与方法1.1调查对象:该调查为中华中医药学会肛肠分会发起的《全国常见肛肠疾病流行病学抽样调查》的一部分。

关键词： 胃肠超声充盈法   胃肠超声   胃十二指肠疾病  

摘要： 目的:研究胃肠超声充盈法对胃十二指肠疾病诊断效果.方法:选取胃十二指肠患者56例用胃肠超声充盈法进行检查,并对比和纤维胃镜检测结果有无不同.结果:胃肠超声充盈法对胃十二指肠疾病的诊断和纤维胃镜检查结果无统计学差异,P>0.05.结论:利用胃肠超声充盈法胃十二指肠疾病诊断效果准确率较高,值得推广.

关键词： 胃十二指肠疾病   诊断   胃肠超声造影  

摘要： 目的:分析胃十二指肠疾病诊断中胃肠超声造影的作用。方法:以2017年4月—2019年5月间入本院治疗的68例胃十二指肠疾病患者为研究主体。分成A组和B组,均是34例。A组行胃肠超声造影诊断,B组行胃镜诊断。对比诊断效果。结果:A组对于胃十二指肠良性与恶性病变的检出率接近于B组(P> 0.05)。A组的诊断准确率为97.06%,敏感度为96.88%,特异度为100.00%,B组分别为76.47%,80.65%和33.33%(P <0.05)。结论:为胃十二指肠疾病患者行胃肠超声造影诊断的痛苦性较低,疾病检出率较高,且诊断效果佳,可作为该病的首选诊断方式加以推广。

关键词： 肛肠疾病   尿潴留   针灸   疗效  

摘要： 尿潴留是肛肠病术后常见并发症,发生率高达52%,中医称为'癃闭','癃'者点滴而出也;'闭'者点滴不出也。临床常采用导尿术治疗,但导尿术为有创操作,不仅增加患者痛苦,而且加大了尿路感染的风险。近年来,针灸在肛肠疾病中的运用越来越广泛,在尿潴留中的治疗作用尤其明显,现将相关文献综述如下。

关键词： dietary products   fibrosis   inflammatory bowel disease   inflammatory cytokine   oxidative stress  

摘要： Dietary products may protect against inflammatory bowel disease (IBD) through mechanisms such as forming gut microbiota structures and providing substrates for microbial metabolism. Recently, many studies have been conducted on diets that potentially alleviate or suppress IBD development. To assess the efficacy of dietary oils in treating IBD, we examined the protective effects of olive oil, coconut oil, corn oil, and cottonseed oil in a dextran sodium sulfate (DSS)-induced colitis mouse model. Treatment with cottonseed oil or corn oil ameliorated the severity of DSS-induced colitis, alleviating weight loss and preventing the shortening of the intestine. Moreover, cottonseed oil or corn oil treatment significantly reduced the expression of inflammatory cytokines such as tumor necrosis factor-alpha, interleukin (IL)-1 beta, IL-6, and IL-17, as well as the expression of oxidative stress markers, including 8-hydroxyguanosine and nitrotyrosine in colon sections, compared with vehicle treatment. Cottonseed oil treatment inhibited intestinal fibrosis by reducing the expression of alpha-smooth muscle actin and type I collagen, compared with vehicle treatment in mice with DSS-induced colitis. Cottonseed oil protects against intestinal inflammation and the development of intestinal fibrosis by reducing inflammatory cytokines and oxidative stress markers, and may therefore be useful as a dietary product with therapeutic benefits for IBD.

关键词： 羔羊   胃肠疾病   防治   措施  

摘要： 改革开放以来,我国的社会经济得到了蓬勃的发展,人民的生活水平不断提高,对肉类食品的需求量也在迅速增加。随着羊肉需求量的不断上升,羊场的饲养规模进一步扩大,促进了我国畜牧业的发展,同时规模化羊场的饲养方式逐渐兴盛起来,但是这也增加了羔羊患病的风险。其中羔羊胃肠疾病的发病率逐渐上升,严重影响了羔羊的健康,为养殖者带来了较大的经济损失。本文分析了几种常见的羔羊胃肠疾病,并提出相应的防治措施,以便降低羔羊患病的风险。

关键词： agreement   congruence   disease activity index   Likert scale   participant report   symptom self-report  

摘要： Objectives: Clinical symptom evaluation for children with inflammatory bowel disease (IBD) is typically done using composite tools: the Pediatric Crohn's Disease Activity Index (PCDAI) and Pediatric Ulcerative Colitis Activity Index (PUCAI). Both rely on clinician interpretation of child or parent symptom recall. No universal self-report tool has yet been developed for children with IBD to assess and report their symptoms. The research objective was to develop a self-report tool that produced information congruent with that obtained by clinicians using the PUCAI or PCDAI. Methods: A children's symptom self-report tool (IBDnow) was developed with picture and text Likert symptom scales. The clinician and child completed their reports during the same outpatient consultation. Agreement levels were calculated at the individual level (identical child and clinician answers), category level (symptom severity), and aggregate level (cohort scores). Internal consistency was measured with Cronbach alpha. Results: One hundred children from Christchurch (New Zealand) (n = 65), and Sydney (Australia) (n = 35) completed the study (Crohn's Disease (CD):88, ulcerative colitis (UC):12), mean age 13.9 years (+/- 3.6). Mean individual agreement was 0.76 (+/- 0.19). Category severity had very good or good inter-rater reliability for 5 of the 7 symptom scales and overall severity agreement of 76%. Aggregate mean scores were significantly different between clinicians (14.9, +/- 18.8), and participants (21.6, +/- 19.4), (P <0.005, confidence interval -9.0, -4.4), but 60 pairs had scores within a 10% margin. Cronbach alpha was 0.74. Conclusions: This self-report tool had good proportionate agreement between raters, and good crude agreement for symptom categories. Assigning PUCAI or PCDAI scores caused inter-rater discrepancies to be misleadingly magnified. Pediatric gastroenterologists may consider utilizing IBDnow to elicit symptom self-reports from children with IBD to enable them to commu