关键词： biomarker   calprotectin   Crohn's disease   diagnostic performance   extraction   feces   immunoassay   inflammatory bowel disease   likelihood ratio   ulcerative colitis  

摘要： Background: We evaluated the (pre-) analytical and diagnostic performance of two automated fecal calprotectin (FC) immunoassays, Liaison (R) Calprotectin (Diasorin) on Liaison (R) XL and fCAL (TM) turbo (Buhlmann laboratories AG) on Cobas C501 (Roche Diagnostics), and compared it with our established Buhlmann ELISA method. Methods: Our study comprised 229 consecutive patients with clinical suspicion of inflammatory bowel disease (IBD). Results: All assay related stool extraction procedures showed excellent correlation with the established method, but the new stool extraction devices tend to give higher results as compared with stool weight methods. Both automated assays demonstrated good performance in terms of precision (CVt <= 8.1%), accuracy (bias <= 6.7%) and total error (<= 16.4%). Method comparison with established enzyme linked immunosorbent assay (ELISA) showed good correlation (r(s) > 0.925), but regression analysis showed significant proportional differences. Diagnostic performance characteristics with regard to diagnosis of IBD were good and in line with other reports. In addition, we were able to show that optimization of manufacturer's cut-off and moreover, the introduction of a gray zone resulted in a significant increase of post-test probability. Conclusions: In conclusion, the newly developed stool extraction device protocols showed acceptable and comparable performance to the stool weight method. Overall,

关键词： Spondyloarthritis   T Cells   Treatment  

摘要： [...]6 out of the 14 patients with active SpA (46.2%)-all complaining of peripheral arthropathy-experienced a sharp clinical benefit after the initiation of VDZ. Even if we do not reject the possibility that VDZ may induce new onset or exacerbation of arthritis and/or sacroiliitis, the previous demonstration of [alpha]4[beta]7 in the joint 5 6 and the recent evidence of the upregulation of mucosal vascular address in cell adhesion molecule (MadCAM-1) in the high endothelial venules of bone marrow in patients with active axial SpA 7 seem to strengthen the hypothesis of a beneficial rather than a paradoxical effect of [alpha]4[beta]7 blockade on articular manifestations of IBD. Table 1 Variable n=53 Age (years), mean+-SD 51.5+-15.7 Male gender, n (%) 28 (52.8) Smokers, n (%) Never 50 (94.3) Current 2 (3.8) Ex 1 (1.9) Type of disease, n (%) Crohn's disease 34 (64.2) Ulcerative colitis 19 (35.8) Duration of disease (years), mean+-SD 13.6+-9.4 Localisation of the disease, n (%) Crohn's disease Ileal 3 (8.8) Ileocolic 26 (76.5) Colic 4 (11.8) Upper gastrointestinal tract* 1 (2.9) Perianal disease 7 (20.6) Ulcerative colitis Proctitis 0 (0.0) Left-sided 6 (31.6) Extensive 13 (68.4) Behaviour (Crohn's disease), n (%) Inflammatory 16 (47.1) Stricturing 17 (50.0) Fistulising 1 (2.9) Previous resections (Crohn's disease), n (%) 21 (61.8) Previous biological treatments Yes 43 (81.1) No (naïve to biologics) 10 (18.9) Steroid-dependent, n (%) 51 (96.2) IBD-associated SpA No history 31 (58.5) History (inactive at initiation of VDZ) 8 (15.1) Active at initiation of VDZ 14 (26.4) Peripheral arthropathy 12 (85.7) Axial and peripheral arthropathy 2 (14.3) Clinical benefit on SpA following initiation of VDZ (n=14) No clinical benefit 8/14 (57.1) Improvement 6/14 (42.9) New onset/exacerbation of SpA induced by VDZ 0 *In addition to an ileocolic localisation.

关键词： Non-alcoholic Fatty Liver Disease   Intestinal Diseases   Metabolic Syndrome X   Inflammatory Bowel Diseases  

关键词： 中医外治   肛肠疾病   创面愈合   疼痛  

摘要： 目的:探究中医外治综合疗法缓解肛肠疾病术后换药疼痛与创面愈合效果.方法:选取本院2016年10月-2016年12月间收治的300例肛肠病患者进行研究,分为实验组与对照组,实验组150例采用中医外治综合疗法,对照组采用西药治疗,观察两组术后换药疼痛度与创面愈合时间.结果:两组术后第1 ～ 3d、疼痛评分比较无统计学意义(P＞0.05),术后第5～ 7d,实验组疼痛评分低于对照组,具有统计学意义(P＜0.05);实验组创面愈合平均时间(20.14±2.36)d,对照组(32.25±3.20)d,差异具有统计学意义(P＜0.05).结论:肛肠病术后采用中医外治综合疗法可有效减轻换药疼痛,创面愈合时间缩短,减轻了患者痛苦,值得采用.

摘要： 药源性胃肠疾病是由药物引起的发生在胃肠系统的不良反应,2015年报告的药品不良反应/事件中,累及系统排名前三位的为皮肤及其附件损害占27.3％、胃肠系统损害占26.2％、全身性损害占10.8％[1].很多药物口服可引起胃肠系统不适,但有时候一些非口服给药,亦可引起恶心、呕吐、食欲减退、腹痛、腹泻、肠炎、肠绞痛、等胃肠不适.那些药物使用后可能发生在胃肠系统的不良反应,本文就此作一简述,以提高临床用药的安全性和有效性.

关键词： Intestinal Diseases   Inflammatory Bowel Diseases  

摘要： A type of microRNA known as miR-223, which inhibits a key component of the inflammasome, protects against colitis in a mouse model.

关键词： Adalimumab   Therapeutic drug monitoring   Inflammatory bowel diseases   Loss of response  

摘要： Background: Therapeutic drug monitoring (TDM) aid therapeutic decision making in patients with inflammatory bowel disease (IBD) who lose response to anti-TNF therapy. Our aim was to evaluate the frequency and predictive factors of loss of response (LOR) to adalimumab using TDM in IBD patients. Methods: One hundred twelve IBD patients (with 214 TDM measurements, CD/UC 84/28, male/female 50/62, mean age CD/UC: 36/35 years) were enrolled in this consecutive cohort from two referral centres in Hungary. Demographic data were comprehensively collected and harmonized monitoring strategy was applied. Previous and current therapy, laboratory data and clinical activity were recorded at the time of TDM. Patients were evaluated either at the time of suspected LOR or during follow-up. TDM measurements were determined by commercial ELISA (LISA TRACKER, Theradiag, France). Results: Among 112 IBD patients, LOR/drug persistence was 25.9%/74.1%. The cumulative ADA positivity (> 10 ng/mL) and low TL (< 5.0 mu g/mL) was 12.1% and 17.8% after 1 year and 17.3% and 29.5% after 2 years of adalimumab therapy. Dose intensification was needed in 29.5% of the patients. Female gender and ADA positivity were associated with LOR (female gender: p < 0.001, OR: 7.8 CI 95%: 2.5-24.3, ADA positivity: p = 0.007 OR: 3.6 CI 95%: 1.4-9.5). Conclusions: ADA development, low TL and need for dose intensification were frequent during adalimumab therapy and support the selective use of TDM in IBD patients treated with adalimumab. ADA positivity and gender were predictors of LOR.

关键词： 结肠镜检查   内镜磁性成像   肠疾病  

摘要： 近年兴起的内镜磁性成像(MEI)是一种能在结肠镜检查下实时显示患者体内结肠镜镜身三维图像的技术,具有安全无辐射的特点。与传统非可视化结肠镜检查相比,MEI具有进镜成功率高、帮助解除镜身成袢、减少成袢时间、辅助结肠镜训练等优点。本文就MEI的研究进展作一综述。

关键词： 护理风险   护理管理   胃肠疾病   护患纠纷  

摘要： 目的分析胃肠疾病急诊患者护理风险管理的实施价值。方法选择我院收治的胃肠疾病急诊患者作为研究对象,实施护理风险管理前收治的104例为对照组,实施护理风险管理后收治的113例为研究组。对照组患者实施常规护理,研究组患者行护理风险管理,对比两组患者的护理满意度及护理风险事件发生率。结果研究组患者护理风险事件发生率低于对照组(P<0.05),护理满意度高于对照组(P<0.01)。结论针对护理工作中的风险问题,实施干预性、预见性的风险护理干预,可以提高护理满意度,降低护患纠纷,改善患者的生活质量。

关键词： 梭杆菌   具核   结直肠疾病   具核梭杆菌黏附蛋白A   E-cadherin/β-catenin  

摘要： 肠道微生物在结直肠疾病发生发展过程中起着至关重要的作用,具核梭杆菌（Fn）作为肠道共生菌群与结直肠疾病具有密切关系,受到越来越多的关注.研究发现具核梭杆菌可促进肠道炎症及肿瘤的进展并且影响疾病的预后.本文就近年来具核梭杆菌致病机制及其对结直肠疾病影响的相关研究进展进行综述.