关键词： IBD   Non-biologic   Small molecule  

摘要： Purpose of Review: The biologic era revolutionized the medical management of inflammatory bowel disease (IBD) and allowed for a paradigm shift away from a therapeutic strategy that traditionally relied on corticosteroids and immunomodulators. IBD treatment has now further evolved to encompass novel non-biologic agents. Recent Findings: An electronic database search, spanning up to September 2018, was conducted using PubMed, Web of Science, Google Scholar, and Scopus. Abstracts were also reviewed from Digestive Diseases Week, European Crohn’s and Colitis Organization congress, Canadian Digestive Diseases Week, and United European Gastroenterology Week. Summary: The JAK1/3 inhibitor, tofacitinib, was shown to both induce and maintain clinical remission and mucosal healing in ulcerative colitis (UC). Also, the sphingosine-1-phosphate (SIP) S1P1/S1P5 receptor agonist ozanimod showed benefit with clinical remission and mucosal healing in UC. Anti-trafficking non-biologic therapies such as AJM300 and a phosphodiesterase (PDE) PDE4 inhibitor, apremilast, have shown benefit in terms of clinical response, clinical remission, and mucosal healing in UC. Upadacitinib and filgotinib have shown initial favorable outcomes in CD patients, with further ongoing trials. Non-biologic agents comprise a growing number of mechanisms of action with the promise of safe and effective oral therapy for patients with IBD. © 2019, Springer Science+Business Media, LLC, part of Springer Nature.

关键词： 肛肠疾病   手术   蛛网膜下腔阻滞   罗哌卡因   舒芬太尼   效果  

摘要： 为探讨罗哌卡因复合舒芬太尼蛛网膜下腔阻滞用于肛肠疾病手术的价值,将2016年7月至2018年4月于我院择期接受手术治疗的78例肛肠疾病患者随机分为观察组和对照组,各39例,对照组采用罗哌卡因蛛网膜下腔阻滞,观察组采用罗哌卡因复合舒芬太尼蛛网膜下腔阻滞,对比2组麻醉效果及不良反应。结果显示,2组肛门松弛优良率、牵拉反应阳性率及Bormage运动评分比较,差异均无统计学意义,P>0.05;观察组感觉阻滞时间短于对照组,不良反应发生率高于对照组,差异有统计学意义,P <0.05。结果表明,肛肠疾病手术单纯应用罗哌卡因进行蛛网膜下腔阻滞即可,复合舒芬太尼并未增强麻醉效果,反而不良反应增加,因此,无需复合舒芬太尼。