关键词： environmental risk factor   paediatric inflammatory bowel disease   Southeast Asia  

摘要： Aim Early-life environmental exposure, which has important implications in the pathogenesis of inflammatory bowel disease (IBD), is not well understood in Asian children. We examined environmental factors prior to the development of childhood IBD in a Southeast Asian population. Methods We conducted a case control study in IBD diagnosed before 18 years of age and controls matched by gender, age and ethnicity. A questionnaire recording medical, family, dietary and social histories, home environment, childhood diseases and immunisation status was used. Results In a multivariate analysis involving 70 children with IBD (Crohn's disease (CD) = 38;ulcerative colitis (UC) = 32) and 140 controls, childhood acute gastroenteritis (odds ratio (OR): IBD 6.9;CD 7.8;UC 5.8) and excessive antibiotic usage in early childhood (OR: IBD 5.3;CD 4.2;UC 4.8) were significantly associated with IBD, CD and UC. Having a fish or turtle aquarium (OR 6.0), major stressful life events (OR 5.6) and attending the same school concurrently with a sibling (OR 2.9) were significant risk factors for IBD. Duration of breastfeeding >6 months (OR: IBD 0.4;UC 0.2) and safe water consumption (OR: IBD 0.2;UC 0.2) reduced the odds of having IBD and UC, respectively. Being vaccinated for rotavirus reduced the odds of developing IBD (OR 0.1). Conclusions Several risk and protective factors were identified in this environmental risk study in Southeast Asian children with IBD. This knowledge has important implications in understanding disease aetiology and future prevention strategies to reduce the development of IBD in Southeast Asian children.

摘要： Introduction There are concerns regarding the effectiveness and safety of SARS-CoV-2 vaccine in inflammatory Bowel Disease (IBD) patients. This systematic review and meta-analysis comprehensively summarises the available literature regarding the safety and effectiveness of SARS-CoV-2 vaccine in IBD. Methods Three independent reviewers performed a comprehensive review of all original articles describing the response of SARS-CoV-2 vaccines in patients with IBD. Primary outcomes were (1) pooled seroconversion rate SARS-CoV-2 vaccination in IBD patients (2) comparison of breakthrough COVID-19 infection rate SARS-CoV-2 vaccination in IBD patients with control cohort and (3) pooled adverse event rate of SARS-CoV-2 vaccine. All outcomes were evaluated for one and two doses of SARS-CoV-2 vaccine. Meta-regression was performed. Probability of publication bias was assessed using funnel plots and with Egger's test. Results Twenty-one studies yielded a pooled seroconversion rate of 73.7% and 96.8% in IBD patients after one and two doses of SARS-CoV-2 vaccine respectively. Sub-group analysis revealed non-statistically significant differences between different immunosuppressive regimens for seroconversion. Meta-regression revealed that the vaccine type and study location independently influenced seroconversion rates. There was no statistically significant difference in breakthrough infection in IBD patients as compared to control after vaccination. Conclusion In summary, the systematic review and meta-analysis suggest that SARS-CoV-2 vaccine is safe and effective in IBD patients.

关键词： 中药熏洗   肛肠疾病   治疗效果  

摘要： 对将中药熏洗护理实施于接受肛肠疾病手术治疗的患者的应用效果进行分析探究。方法:本次研究选择时间为我院近1年开展的肛肠疾病治疗工作进行研究,研究对象类型为肛肠手术者,样本例数纳入66例,为了研究结果的客观性,分组方式为随机法。对不同方式下所产生的效果进行探究。结果:在通过治疗的积极干预下,通过整体治疗有效率的统计,两组中为观察组更高;且患者出现尿潴留、出血、排便失禁等并发症的几率明显更低;经过治疗后,观察组的情感职能、生理职能、情感职能、活力等多项指标均偏高,且不良情绪得分较对照组低,(p<0.05)。结论:患者在实施手术治疗后,对其采取中药熏洗治疗起到的效果和优势突出,能够促进患者的康复,减少其不良症状的发生,对患者的康复和预后有相当积极的效果,值得推广。

关键词： 综述   肛肠疾病   镇痛   临床研究  

摘要： 肛肠疾病是人类特有的常见病、多发病。从广义说,发生在肛门、大肠上的各种疾病都叫肛肠病,常用的治疗方法为手术治疗。疼痛是肛肠疾病术后常见的并发症,改善肛肠疾病术后疼痛是临床目前主要研究课题。中医学认为手术后疼痛症结为不通则痛,西医则认为疼痛是由组织出现损伤后使得致痛因子释放,出现神经痛觉超敏导致。现代医学镇痛药物效果良好,但是会产生相应的毒副作用,而中药方法能够一定程度上改善患者术后疼痛,因此可采用中西医结合疗法进行镇痛。本研究就肛肠疾病术后镇痛的临床研究进展进行综述。

关键词： 多糖   口服给药   药物制剂   药物递送体系   结肠疾病  

摘要： 多糖(polysaccharide)作为常见的药物递送材料,具有来源广泛、生物安全性好及功能丰富等优点,在医药及食品领域应用广泛,特别是在结肠疾病的口服靶向药物递送中具有重要的研究和应用价值。利用多糖的结构与理化特性优势,目前研究已构建出基于pH响应、微生物酶响应、活性氧响应、肠黏膜吸附和受体分子靶向等递送策略的交联型纳米粒、自组装型纳米粒及水凝胶,并在结肠炎与结肠癌等消化道疾病治疗中展现出优异效果。本文综述了基于多糖的口服靶向型药物递送体系在结肠疾病治疗中的研究进展,并对其研究和应用前景进行深入讨论。

关键词： 结直肠疾病   便秘   MSCT   低剂量  

摘要： 目的探讨分析结直肠疾病部分合并便秘患者疾病中低剂量多层螺旋CT结肠成像的应用及其临床意义研究。方法选取2015年1月至2018年1月期间我院收治的结直肠疾病部分合并便秘患者160例,行中、低剂量多层螺旋CT结肠成像和多重面重建,并与常规剂量多层螺旋CT、气钡双对比造影、电子肠镜或手术病理结果进行对比,观察并记录应用低剂量MSCT对于结直肠疾病的定性、定位的准确率及成像质量。结果通过电子肠镜及手术病理,160例患者中定性诊断结直肠癌、结肠息肉、多发性憩室、痔疮、结直肠炎症患病例数分别为65(40.625%)、38(23.750%)、26(16.250%)、7(4.375%)、24(15.000%),定位诊断乙状结肠、直肠、升结肠、盲肠患病例数分别为46(28.750%)、89(55.625%)、17(10.625%)、8(5.000%)。低剂量MSCT定性诊断结果的敏感性、特异性分别为87.474%、86.357%,定位诊断结果的敏感性、特异性分别为96.356%、95.382%,与电子肠镜以及手术病理结果比较差异无统计学意义(P>0.05)。常规剂量MSCT及低剂量MSCT,影像学评分差异无统计学意义(P>0.05),低剂量MSCT的影像学评分明显高于气钡双对比造影,差异有统计学意义(P<0.05)。结论低剂量多层螺旋CT结肠成像应用于结直肠疾病部分合并便秘患者,可有效定位和定性诊断疾病,多重面重建后成像质量高。

关键词： 磁控胶囊内镜   传统胶囊内镜   小肠病变   诊断价值  

摘要： 目的比较磁控胶囊内镜(MCE)与传统胶囊内镜(CE)在小肠疾病诊断中的应用价值。方法回顾性分析2016年3月至2020年3月在西安交通大学第一附属医院行CE及MCE的263例住院患者的资料,包括患者的一般信息、主诉、胶囊内镜检出结果等。结果MCE组与CE组的小肠主要疾病总检出率分别为73.81%和74.45%,各组最多见的前3种病变均为糜烂/溃疡病变、血管病变、淋巴管扩张;MCE组需要胃镜辅助明显低于CE组(0%vs.9.49%,P<0.001);MCE组与CE组的小肠检查不完全率分别为7.94%、13.87%,差异无统计学意义(P=0.185)。结论MCE对小肠疾病诊断价值与CE相似,可作为小肠检查的方法之一,但尚需进一步多中心、大样本的研究验证。

关键词： Inflammatory bowel disease   Ulcerative colitis   Crohn's disease   Clinical index   Endoscopic index  

摘要： Many clinical trials have been conducted for inflammatory bowel disease (IBD), so various clinical indices (CIs) and endoscopic indices (EIs) have also been evaluated. However, recently, with the progress of IBD management, review of established indices from previous studies, and establishment of new indices, the landscape of the use of indices in clinical trials have changed. We investigated the number and frequency of the indices adapted in recent clinical trials for ulcerative colitis (CI and EI) and Crohn's disease (CI, EI, index related to magnetic resonance imaging, index for evaluating patient-reported outcomes, and health-related quality of life). Based on the results, we selected representative indices and further reviewed their content and characteristics. Moreover, various definitions, including clinical and endoscopic response or remission, have been described by means of representative indices in clinical trials.