关键词： 复方紫草油   地奈德乳膏   肛周继发性湿疹  

摘要： 目的:探讨复方紫草油局部外用治疗肛肠疾病术后湿疹的临床疗效与安全性。方法:将86例肛肠疾病术后继发肛周湿疹的患者随机分成治疗组和对照组,两组均予基础治疗,治疗组加用复方紫草油外敷皮损局部,对照组加用地奈德乳膏外涂。观察两组治疗1～2周的效果及停药1周的复发情况及住院时间。结果:经过1～2周治疗,两组患者肛周皮损、瘙痒感和渗出均有不同程度消退,两组的治愈率和总有效率差异无明显统计学意义(P>0.05)。停药1周后,对照组11例出现不同程度的肛周皮肤红肿、皮疹、渗出或瘙痒,治疗组1例出现肛周皮肤红肿,差异有统计学意义(P<0.05)。与对照组相比,治疗组住院时间明显缩短(P<0.05)。结论:复方紫草油外敷治疗肛周继发性湿疹疗效确切,不良反应少、复发率较低且能有效缩短住院时间,值得在临床中推广应用。

关键词： apparent diffusion coefficient cut-off   apparent diffusion coefficient quantitative analysis   diffusion weighted imaging   inflammatory bowel disease   magnetic resonance enterography  

摘要： Objective: The aim of the study was to establish an apparent diffusion coefficient (ADC) cut-off value to classify active and non-active lesions in inflammatory bowel disease. Methods: We reviewed 167 paediatric magnetic resonance enterographies executed for suspected inflammatory bowel disease by using a 1.5- and 3-T scanner. We assessed the presence and activity of the disease by using morphologic and functional parameters such as the ADC. Each patient could have more than 1 examinations. Quantitative assessment of disease activity in the ADC map was measured placing 3 regions of interest in the areas of highest inflammation and the mean value was calculated, patients without sign of inflammation were assessed at 2 standardised site. Ileocolonoscopy, esophagogastroduodenoscopy, surgery, and video-capsule endoscopy were used as standards of reference. Results: We enrolled 34 patients and 35 examinations: radiological findings of disease were identified in 29 examinations and 44 lesions were detected. Six patients had negative results and ADC assessment was taken at the terminal ileum and cecum. A total of 56 bowel segments were included in the study. Image analysis revealed 39 active lesions (69.6%) and their ADC values were lower compared to the ones of non-active segments. For each scanner a cut-off value was found (sensitivity: 0.91, specificity: 0.89 for 1.5 T and 0.81 for 3 T). Inter-rater agreement on disease activity between ADC values and magnetic resonance enterography results and between ADC values and the standard of reference were very good. Conclusions: ADC can provide a scanner-based quantitative measurement of disease activity.

关键词： bacterial overgrowth   breath tests   Crohn's disease   inflammatory bowel disease   prevalence   SIBO   ulcerative colitis  

摘要： Background Current data on small intestinal bacterial overgrowth (SIBO) in patients with inflammatory bowel diseases (IBD) are controversial. Aim To conduct a systematic review and meta-analysis to determine the prevalence of SIBO in patients with ulcerative colitis (UC) and Crohn's disease (CD). Methods Electronic databases were searched up to May 2018 for studies reporting prevalence of SIBO in IBD patients. The prevalence rate of SIBO among IBD patients and the odds ratio (OR) and 95% CI of SIBO in IBD patients compared with controls were calculated. Results The final dataset included 11 studies (1175 adult patients with IBD and 407 controls), all utilising breath test for diagnosis of SIBO. The proportion of SIBO in IBD patients was 22.3% (95% CI 19.92-24.68). The OR for SIBO in IBD patients was 9.51 (95% CI 3.39-26.68) compared to non-IBD controls, and high in both CD (OR = 10.86;95% CI 2.76-42.69) and UC (OR = 7.96;95% CI 1.66-38.35). In patients with CD, subgroup analysis showed the presence of fibrostenosing disease (OR = 7.47;95% CI 2.51-22.20) and prior bowel surgery (OR = 2.38;95% CI 1.65-3.44), especially resection of the ileocecal valve, increased the odds of SIBO. Individual studies suggest that combined small and large bowel disease but not disease activity may be associated with SIBO. Conclusions Overall, there is a substantial increase in the prevalence of SIBO in IBD patients compared to controls. Prior surgery and the presence of fibrostenosing disease are risk factors for SIBO in IBD.

关键词： Immune checkpoint inhibitors   Metformin   Adverse event   FAERS   Inflammatory bowel disease  

摘要： PurposePD-1/PD-L1 inhibitors have demonstrated unparalleled therapeutic efficacy in multiple tumor types. Additionally, metformin has been linked to favorable outcomes in tumors. Many researchers have reported immune-mediated adverse events induced by immune checkpoint inhibitors (ICI) single agent. However, little is documented on the adverse events of the combined use of ICI and *** address this question, we used the Food and Drug Administration Adverse Event Reporting System (FAERS) to display the landscape of adverse events associated with the combined use of ICI and metformin. We identified 38 adverse event cases about the combination treatment between January 1, 2015 and June 30, *** are 36 cases in patients receiving nivolumab plus metformin (NM) therapy, and the other 2 cases were pembrolizumab plus metformin (PM). Among the 36 patients receiving NM therapy, the most common indication was for treatment of malignant lung cancer (20, 55.56%), Notably, 9 cases of inflammatory bowel disease (IBD) and diarrhea were *** findings revealed that higher risk of IBD might occur in lung cancer patients during the combined therapy of nivolumab plus metformin. Further studies are needed to verify our findings.

关键词： Inflammatory bowel diseases   Therapeutic drug monitoring   Thiopurines   Azathioprine   Linear and logistic regression models  

摘要： PurposeThe thiopurines azathioprine and 6-mercaptopurine are frequently used for remission maintenance in patients with inflammatory bowel diseases. However, there are therapy failures, and it is unclear whether clinical and laboratory parameters can be used to predict thiopurine metabolite concentrations (as a surrogate for adequate remission maintenance therapy) and clinical outcome in these *** this retrospective analysis of clinical routine patient data, multivariate statistical models based on Linear Mixed Models regression and Generalized Estimating Equations logistic regression were developed. The adequacy of the models was assessed using Pearson's correlation and a receiver operating characteristic *** study included 273 patients and 1158 thiopurine metabolite measurements as well as routine laboratory and clinical data. In the statistical models, thiopurine metabolite concentrations and the odds of non-remission based on different clinical and laboratory parameters were computed. Correlation (r(2)) between predicted and measured thiopurine metabolites were 0.40 (p<0.001) for 6-thioguanine nucleotides and 0.53 (p<0.001) for 6-methyl-mercaptopurine nucleotides, respectively. The model for remission classified data sets in remission and non-remission with a sensitivity of 63% and a specificity of 73%. The area under the receiver operating characteristic curve of the model was *** the models are not yet accurate enough to be used in clinical routine, model-based prediction of thiopurine metabolite concentrations and of outcome is feasible. Until more accurate models are developed and validated, traditional therapeutic drug monitoring of thiopurine metabolites in patients with inflammatory bowel diseases under thiopurine therapy stays the best tool to individualize therapy.

关键词： INFLIXIMAB   INFLAMMATORY bowel diseases   DRUG monitoring   INFLAMMATION   DISEASE remission  

摘要： Linked Content This article is linked to Lucidarme et al and Gibson and Ward *** view these articles, and .

关键词： Colitis   ulcerative   Crohn disease   Endoscopic index   Colonoscopy  

摘要： Inflammatory bowel disease (IBD) is considered a chronic condition characterized by mucosal or transmural inflammation in the gastrointestinal tract. Endoscopic diagnosis and surveillance in patients with IBD have become crucial. In addition, endoscopy is a useful modality in estimation and evaluation of the disease, treatment results, and efficacy of treatment delivery and surveillance. In relation to these aspects, endoscopic disease activity has been commonly estimated in clinical practices and trials. At present, many endoscopic indices of ulcerative colitis have been introduced, including the Truelove and Witts Endoscopy Index, Baron Index, Powell-Tuck Index, Sutherland Index, Mayo Clinic Endoscopic Sub-Score, Rachmilewitz Index, Modified Baron Index, Endoscopic Activity Index, Ulcerative Colitis Endoscopic Index of Severity, Ulcerative Colitis Colonoscopic Index of Severity, and Modified Mayo Endoscopic Score. Endoscopic indices have been also suggested for Crohn's disease, such as the Crohn's Disease Endoscopic Index of Severity, Simple Endoscopic Score for Crohn's Disease, and Rutgeerts Postoperative Endoscopic Index. However, most endoscopic indices have not been validated owing to the complexity of their parameters and inter-observer variations. Therefore, a chronological approach for understanding the various endoscopic indices relating to IBD is needed to improve the management.

关键词： Metastatic Malignant Neoplasm to the Peritoneum   Intestinal Diseases   Inflammatory Bowel Diseases