关键词： Inflammatory bowel disease   genetics   innate immunity   homeostasis   dysbiosis  

摘要： Inflammatory bowel diseases (IBD) comprise a distinct set of clinical symptoms resulting from chronic or relapsing immune activation and corresponding inflammation within the gastrointestinal (GI) tract. Diverse genetic mutations, encoding important aspects of innate immunity and mucosal homeostasis, combine with environmental triggers to create inappropriate, sustained inflammatory responses. Recently, significant advances have been made in understanding the interplay of the intestinal epithelium, mucosal immune system, and commensal bacteria as a foundation of the pathogenesis of inflammatory bowel disease. Complex interactions between specialized intestinal epithelial cells and mucosal immune cells determine different outcomes based on the environmental input: the development of tolerance in the presence of commensal bacterial or the promotion of inflammation upon recognition of pathogenic organisms. This article reviews key genetic abnormalities involved in inflammatory and homeostatic pathways that enhance susceptibility to immune dysregulation and combine with environmental triggers to trigger the development of chronic intestinal inflammation and IBD.

关键词： 小肠   肠疾病   影象诊断  

ISBN: (纸本)9787533179908

摘要： 本书重点讲述了小肠各种检查方式及其优缺点，是小肠气钡双对比检查的操作要点、正常影像学表现及异常影像学表现，然后分别讲述了小肠炎性疾病、小肠肿瘤、小肠功能障碍性疾病和小肠先天发育障碍性疾病的影像学表现，并简单介绍了相关疾病的病因病理及临床表现。

关键词： children   inflammatory bowel disease   knowledge   parents  

摘要： Aims: Disease-specific knowledge may influence disease outcome and quality of life in children with inflammatory bowel disease (IBD). This prospective study aimed to define IBD-related knowledge in a group of Australian children with IBD and their parents using a validated measure of disease-specific knowledge, the Inflammatory Bowel Disease Knowledge Inventory Device (IBD-KID). Methods: Children (less than 18 years) diagnosed with IBD who were members of the Australian patient support organisation were identified. Each family was sent copies of the IBD-KID. Children aged 10-18 years and all parents were asked to complete the IBD-KID and to also provide demographic details and disease characteristics. Results: Replies were received from 196 families: 262 parents and 128 children completed questionnaires. Most children had a diagnosis of Crohn disease (65%) and 51% were male. Children diagnosed in the preceding 6 years scored higher than those with longer time since diagnosis. Parents had better scores in the IBD-KID than the children (P < 0.0001). Overall, parents and children had poor understanding of key management issues for IBD (such as side effects of steroids), important outcomes (e.g. growth) and the use of complementary therapies. Conclusions: Consistent patterns of IBD-related knowledge were noted in this large group of Australian children with IBD and their parents. Measurement of disease-related knowledge with the IBD-KID can identify gaps in understanding, thereby permitting focused educational activities. Although these knowledge gaps may impact upon outcomes, further prospective studies are now required to elucidate the relationships between enhanced knowledge and specific outcomes.

摘要： The concept of remission for patients with inflammatory bowel diseases has recently evolved, and should also include histological healing of the mucosa, difficult to evaluate since there is no agreement on pathological scores and those available are quite complex to use in the daily routine. We evaluated the possible usefulness of a simplified pathological score to assess histological healing of the mucosa in inflammatory bowel diseases patients compared with four commonly proposed pathological scores. Slides from 24 patients (12 Crohn's disease, 12 ulcerative colitis, age range 24-62 years), pre-and post-treatment with biological agents and displaying endoscopic remission were assessed by two pathologists. Pre-and post-treatment results and the time employed to calculate the various scores were obtained. All scores were useful to document highly significant post-treatment decreases of histological activity. However, the simplified score needed significant less time to be calculated for each slide, had high inter-rater agreement, and avoided subjectivity from the pathologists. The simplified score is easy to calculate and seems apt to document histological healing of the mucosa, in a manner similar to the more complex scores. It remains to be established whether this score could simplify the daily routinary practice in this context.

关键词： 肛肠疾病术后   中药熏洗   高锰酸钾坐浴   创面愈合  

摘要： 对比分析中药熏药在肛肠疾病术后中的临床应用效果。方法:从2015年6月至2017年1月在我院肛肠外科手术治疗的112例患者按照数字随机表法分为对照组和实验组,各有56例患者;对照组采用高锰酸钾坐浴,实验组采用中药熏洗;对比分析两组患者临床效果。结果:实验组分泌物消失时间(5.18±2.04)d、水肿消失时间(4.26±2.02)d、创面愈合时间(14.24±4.25)d、疼痛消失时间(6.11±2.11)d,均显著的低于对照组(P<0.05);实验组VAS评分为(4.12±1.32)分显著的低于对照组(6.42±2.56)(P<0.05)。结论:中药熏洗治疗肛肠疾病术后患者,可以促进创面愈合,消除水肿,降低创面分泌物,缓解伤口疼痛,效果显著的优于高锰酸钾坐浴,具有推广应用价值。

关键词： Statistical methods   Genetic association study   Immunogenetics   Autoimmune diseases  

摘要： Inflammatory bowel diseases are chronic gastrointestinal inflammatory disorders that affect millions of people worldwide. Genome-wide association studies have identified 200 inflammatory bowel disease-associated loci, but few have been conclusively resolved to specific functional variants. Here we report fine-mapping of 94 inflammatory bowel disease loci using high-density genotyping in 67,852 individuals. We pinpoint 18 associations to a single causal variant with greater than 95% certainty, and an additional 27 associations to a single variant with greater than 50% certainty. These 45 variants are significantly enriched for protein-coding changes (n = 13), direct disruption of transcription-factor binding sites (n = 3), and tissue-specific epigenetic marks (n = 10), with the last category showing enrichment in specific immune cells among associations stronger in Crohn's disease and in gut mucosa among associations stronger in ulcerative colitis. The results of this study suggest that high-resolution fine-mapping in large samples can convert many discoveries from genome-wide association studies into statistically convincing causal variants, providing a powerful substrate for experimental elucidation of disease mechanisms.

关键词： microbiome   host-microbe interactions   microbiome intervention   immune development   microbial assemblage   dysbiosis   inflammatory bowel diseases   complex immune disorders   vertical transmission  

摘要： Factors affecting the developing neonatal gut microbiome and immune networks may increase the risk of developing complex immune disorders such as inflammatory bowel diseases (IBD). In particular, peripartum antibiotics have been suggested as risk factors for human IBD, although direct evidence is lacking. Therefore, we examined the temporal impact of the commonly used antibiotic cefoperazone on both maternal and offspring microbiota when administered to dams during the peripartum period in the IL-10-deficient murine colitis model. By rigorously controlling for cage, gender, generational, and murine pathobiont confounders, we observed that offspring from cefoperazone-exposed dams develop a persistent gut dysbiosis into adulthood associated with skewing of the host immune system and increased susceptibility to spontaneous and chemically dextran sodium sulfate (DSS)-induced colitis. Thus, early life exposure to antibiotic-induced maternal dysbiosis during a critical developmental window for gut microbial assemblage and immune programming elicits a lasting impact of increased IBD risk on genetically susceptible offspring.

关键词： Burden of disease   Inflammatory bowel disease   Japan   Unemployment  

摘要： Background: Inflammatory Bowel Disease (IBD) constitutes a huge burden for patients and studies show that IBD patients have difficulties remaining in employment. Because there is no data about the unemployment of IBD patients in Japan. Methods: We surveyed a representative sample of 1068 Japanese IBD patients regarding their employment status. Results: We found that the labor force participation rate is lower and unemployment higher for patients with IBD compared to the general population. Factors associated with unemployment in the IBD sample are older age, female gender, and the prevalence of depression. Discussion: IBD constitutes a high burden for patients in Japan regarding employment outcome.