关键词： 多层螺旋CT   小肠造影   小肠疾病   价值评价  

摘要： 目的:研究多层螺旋CT小肠造影用于小肠疾病诊断的价值评价。方法:对我院2016年1月—12月118例诊断不明并怀疑存在小肠疾病的患者进行多层螺旋CT造影检查,并行多平面重建和最大密度投影,通过检查结果做出评价。结果:118例患者中存在小肠病变的有103例,占比为85.83%,不明原因消化道出血学检出率50.00%(23/46),腹痛病变检出率52.63%(30/57)。与MSCTE检查前阳性病灶检出率25.42%(30/118)差异明显,具有统计学意义(P<0.05)。结论:多层螺旋CT小肠造影对诊断小肠疾病效果显著,值得临床推广。

关键词： INTESTINAL ischemia   ATRIAL fibrillation   PATIENTS   PREDICTION models   PUBLIC health   EPIDEMIOLOGY  

关键词： 16层螺旋CT   结肠透明化   诊断  

摘要： 目的探究16层24排螺旋CT透明化技术在结直肠疾病诊断中的应用。方法选取医院2015年12月至2016年6月收治的71例表现出消化道症状的患者作为研究对象,对比其透明化处理后CT检查结果与手术病理检查结果。结果 69例患者的CT检查结果同手术病理检查结果相同,螺旋CT检查的准确率为97.2%,漏诊2例,1例为阑尾炎,1例为结肠息肉。结论 16层24排螺旋CT透明化技术在诊断结直肠疾病时,诊断准确率高,给患者造成的痛苦少,简单有效。

关键词： 尿潴留   肛肠疾病   整体护理  

摘要： 目的:探讨整体护理干预对于降低肛肠疾病术后潴留的发生。方法:本组病例均来自我院肛肠科2013年4月—2015年6月收治的114例行手术治疗的患者的临床资料,根据数字随机分配的原则,将患者分为观察组57例与对照组57例,对照组给予常规护理,包括用药护理、术后疼痛护理、环境护理、心理干预等,观察组采用整体护理模式加强护理干预。结果:2组疼痛VAS评分比较,结果具有明显差异(P<0.05)。观察组患者术后各时间段尿潴留发生率均明显低于对照组(P<0.05)。结论:肛肠疾病术后易因各种因素发生尿潴留,给予整体护理干预,采取各种预防措施,可有效降低疼痛感,降低尿潴留发生,改善预后。

关键词： 肛肠疾病   肛门疾病   陈硕   妊娠月份   胎儿发育   功能锻炼   宠物主人   急诊手术   血液循环   肠蠕动  

摘要： 28岁的小于已经怀孕25周,因为怀的是双胞胎,她的肚子明显比同孕龄产妇要大。小于有轻度的便秘和痔疮,随着孕龄的增加越来越明显。一次用力排便后,小于感觉肛门疼痛,马桶中有很多鲜血,立刻到医院就诊。

关键词： INTESTINAL diseases   TUMOR necrosis factor receptors   MICE   CRYSTALS   MURIDAE  

摘要： TNF plays an integral role in inflammatory bowel disease (IBD), as evidenced by the dramatic therapeutic responses in Crohn's disease (CD) patients induced by chimeric anti-TNF mAbs. However, treatment of CD patients with etanercept, a decoy receptor that binds soluble TNF, fails to improve disease. To explore this discrepancy, we investigated the role of TNF signaling in Wnt/beta-catenin-mediated intestinal stem cell and progenitor cell expansion in CD patients, human cells, and preclinical mouse models. We hypothesized that TNF exerts beneficial effects on intestinal epithelial cell (IEC) responses to injury. In CD patients, intestinal stem cell and progenitor cell Wnt/beta-catenin signaling correlates with inflammation status. TNF-deficient (Tnf(-/-)) mice exhibited increased apoptosis, less IEC proliferation, and less Wnt signaling when stimulated with anti-CD3 mAb. Bone marrow (BM) chimera mice revealed that mucosal repair depended on TNF production by BM-derived cells and TNFR expression by radioresistant IECs. Wild-type -> Tnfr1/2(-/-) BM chimera mice with chronic dextran sodium sulfate colitis exhibited delayed ulcer healing, more mucosal inflammation, and impaired Wnt/beta-catenin signaling, consistent with the hypothesis that epithelial TNFR signaling participates in mucosal healing. The direct effect of TNF on stem cells was demonstrated by studies of TNF-induced Wnt/beta-catenin target gene expression in murine enteroids and colonoid cultures and TNF-induced beta-catenin activation in non-transformed human NCM460 cells (TOPFlash) and mice (TOP-GAL). Together, these data support the hypothesis that TNF plays a beneficial role in enhancing Wnt/beta-catenin signaling during ulcer healing in IBD. These novel findings will inform clinicians and therapeutic chemists alike as they strive to develop novel therapies for IBD patients.

关键词： 肛肠疾病   尿潴留   新斯的明   VitB1  

摘要： 目的观察评价小剂量新斯的明联用VitB．穴位注射治疗肛肠疾病术后尿潴留（UR）的临床效果。方法选择2015年8月至2017年2月期间佛山市禅城区朝阳医院及佛山市中医院普外科收治的肛肠疾病术后尿潴留患者98例，随机对照试验分为两组，对照组49例给予新斯的明穴位注射治疗并采取常规护理方法；观察组49例给予小剂量新斯的明联用VitB，穴位注射治疗并采取优质综合护理干预，并比较两组的临床效果及护理满意度。结果观察组总有效率为97．96％，明显高于对照组的79．59％（P〈0．05），观察组膀胱残存尿量明显低于对照组（P〈0．05），观察组自行排尿时间、术后进食时间、排便时间和住院时间均显著短于对照组（均P〈0．05），观察组总满意度为100．00％，明显高于对照组的83．67％（P〈0．05）。结论小剂量新斯的明联用VitB．穴位注射治疗肛肠疾病术后尿潴留疗效显著，有效地降低了患者的膀胱残留尿量，大大缩短了自行排尿时间、术后进食时间、排便时间和住院时间，显著提高了护理满意度。

关键词： 肛肠疾病   从脾论治   中医理论  

摘要： 脾与大肠在生理功能和病理变化过程中相互协调、感应和影响,肛肠病的发生、发病与脾的功能关系密切。因此,临床上针对痔疮、直肠脱垂、肛肠病术后创面愈合、泄泻、便秘、溃疡性结肠炎等肛肠疾病,需重点培补后天之本,使脾土健运,气血调和,升清有常,促进疾病向愈。

关键词： VASCULITIS   INFLAMMATORY bowel diseases   PATIENTS   ABDOMINAL pain in children   IMMUNOGLOBULIN A   LEUKOCYTOCLASTIC vasculitis   ULCERATIVE colitis in children   SCHOENLEIN-Henoch purpura   SKIN biopsy   CASE studies  

摘要： Cutaneous small-vessel vasculitis (CSVV) is an infrequent manifestation of pediatric inflammatory bowel disease (IBD). We report two cases of CSVV associated with ulcerative colitis, review the literature, and discuss the diagnostic evaluation of children who present with CSVV and abdominal pain. After excluding more common causes of CSVV and abdominal pain in children, including immunoglobulin A vasculitis (previously Henoch-Schonlein purpura), infectious colitis, and drug-induced vasculitis, alternative diagnoses such as CSVV secondary to IBD or systemic vasculitis with gastrointestinal involvement must be considered.

关键词： clinical trial   inflammatory bowel diseases   remission   thioguanine   treatment  

摘要： OBJECTIVEThe potential therapeutic effect of thioguanine in the management of inflammatory bowel disease (IBD) is hindered due to association with vascular hepatotoxicity. The study aimed to assess the evidence for efficacy of thioguanine in IBD management and the association with nodular regenerative hyperplasia (NRH) and other thioguanine-related hepatotoxicities. METHODSPreferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used for literature search. Due to the lack of randomized controlled trials (RCTs), the search was extended to observational studies. Quality of the included studies were graded A to C based on evaluation tools used to determine efficacy (subjective and objective grading tools) and nodular regenerative hyperplasia safety (liver biopsy and imaging tools). RESULTSTwo hundred and ninety studies were identified, but following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines only 13 studies were evaluated for efficacy and safety of thioguanine. Outcome measures were consistent across the included studies. Thioguanine appeared efficacious and well-tolerated in patients who were intolerant/non-responsive to existing immunomodulators. There was a trend toward a positive association between dose of thioguanine and NRH but not with other adverse events such as liver biochemical abnormalities or with portal hypertension. CONCLUSIONSThe evidence to support thioguanine treatment is limited to observational studies. While encouraging, there is a need for prospective RCTs to determine the role of thioguanine in the management of IBD.