关键词： 结肠镜   体检   结直肠息肉   结直肠肿瘤  

摘要： 目的:分析1 719例健康体检人群结肠镜检出结直肠疾病的分布情况。方法:通过对1 719例行电子结肠镜体检的无症状患者进行分析,统计结直肠疾病总检出率及各类结直肠疾病检出率,按性别分为男性、女性组,按年龄分为<30岁、30~44岁、45~59岁、60~74岁、75岁以上(包括75岁)组,按BMI分为非肥胖、超重、肥胖组,比较不同性别、年龄、BMI体检者结直肠疾病检出率的差异。结果:健康体检人群结直肠疾病总检出率较高,达63.53%,各类疾病检出率由高至低依次为非特异性结直肠炎(42.76%)、结直肠息肉(17.16%)、结直肠癌(0.93%)、结直肠黑变病(0.81%)、大肠憩室(0.76%)、结直肠血管畸形(0.47%)等;男体检者结直肠疾病检出率高于女性体检者,年龄45岁以上体检者结直肠疾病检出率高于45岁以下体检者,且差异有统计学意义(P<0.05),不同体质量指数(BMI)体检者结直肠疾病总检出率比较,差异无统计学意义(P>0.05)。结论:无症状体检者结直肠疾病总检出率较高,疾病检出类型以非特异性结直肠炎、结直肠息肉多见;结直肠疾病与性别、年龄相关。

关键词： 肛肠疾病   穴位贴敷   按摩   舒尿通煎剂  

摘要： 目的:探讨舒尿通煎剂配合穴位贴敷按摩的应用效果以及预防尿潴留情况。方法:选取2016年1月—2016年6月于我院住院的肛肠疾病术后患者共720例,分为对照组(舒尿通煎剂)370例与观察组(舒尿通煎剂配合穴位贴敷按摩)350例,其中比较两组治疗方式对肛肠疾病术后患者的应用效果。结果:观察组总有效率97.71%高于对照组85.67%,差异有统计学意义(P<0.001)。结论:通过对肛肠疾病术后患者采用舒尿通煎剂配合穴位贴敷按摩,能有效预防术后发生尿潴留的概率,具有使用价值。

关键词： 肠疾病   寄生虫性   感染   危险因素   学生  

摘要： 目的了解岳阳市部分大中小学生肠道寄生虫病感染现状,为进一步制定防治策略提供依据。方法分层随机抽查岳阳市大中小学校5所,每年级随机抽查2个班,采用改良加藤厚涂片(Kato-Katz)法,粪便检查虫卵。钩虫培养采用试管滤纸培养法。采用问卷调查法调查学生卫生知识和健康行为情况。结果共调查1 545名大中小学生,肠道寄生虫感染率小学(3.27%)>中学(2.42%)>大学(1.91%),随学生学段增高而降低(χ~2=2.54,P>0.05)。肠道寄生虫虫种感染率蛔虫(2.65%)>钩虫(1.49%)>鞭虫(0.13%)及姜片虫(0.13%)>华支睾吸虫(0.06%)。城市学生感染率(2.21%)低于农村学生(3.28%),男生感染率(2.65%)略低于女生(2.66%)(χ~2值分别为1.67,0.00,P值均>0.05)。小学、中学与大学肠道寄生虫病防治知识知晓率分别为87.07%,95.00%,97.13%,健康行为形成率分别为84.94%,94.03%,94.90%,且均随学生学段增高而增高,学段间差异均有统计学意义(χ~2值分别为40.12,39.58,P值均<0.01)。肠道寄生虫病防治知识知晓率与健康行为形成率之间呈正相关(r=0.99,P<0.05)。经常吃未洗瓜果、经常喝生水、经常饭前便后不洗手、经常生熟食物共用砧板、经常光脚旱地干活是肠道寄生虫病感染的危险因素[OR值(OR值95%CI)分别为6.14(3.22~11.73),4.13(2.10~8.14),3.74(1.95~7.18),2.64(1.41~4.93),2.45(1.32~4.57),P值均<0.01]。结论蛔虫与钩虫是岳阳市在校学生肠道感染的主要寄生虫种,小学生是重点防治对象。要继续坚持驱虫治疗,加强水及粪便管理,加强健康教育及培养个人良好文明卫生习惯的多种综合防治措施。

关键词： Inflammatory bowel disease   Incidence   Children   Czech Republic   Pilsen region   Projections   Crohn’s disease   Ulcerative colitis  

摘要： AIM To examine the incidence and trends in pediatric inflammatory bowel diseases(IBDs) over 2000-2015 and project the incidence to 2018. METHODS A 16-year prospective study of IBD patients < 19 years of age was conducted in the Czech Republic(the Pilsen region). All incident IBD cases within a well-defined geographical area were retrieved from a prospectively collected computerized clinical database. Historical Czech data were used for comparison(1990-2001). Our catchment population was determined from the census data. We calculated the incidence by relating the number of newly diagnosed cases to the size of thepediatric population-at-risk in each calendar year. Age/sex, disease type, place of residence, and race/ethnicity were identified. RESULTS In total, 170 new IBD cases [105 Crohn's disease(CD), 48 ulcerative colitis(UC), and 17 IBD-unclassified(IBD-U)] were identified. The median age at IBD diagnosis was 14.2 years, 59.4% were males, and 97.1% were Caucasians. A male preponderance of IBD(P = 0.026) and CD(P = 0.016) was observed. With 109209 person-years in the catchment area, the average incidence of IBD per 100000 person-years was 10.0(6.2 for CD, 2.8 for UC, and 1.0 for IBD-U) for children aged 0 to 19 years; for those aged 0 to 15 years, the incidence rate was 7.3(4.6 for CD, 2.0 for UC, and 0.7 for IBD-U). An increase in incidence with age was observed(P = 0.0003). Over the 16-year period, the incidence increased for IBD patients(P = 0.01) and CD in particular(P < 0.0001), whereas the incidence for UC(P = 0.09) and IBD-U(P = 0.339) remained unchanged. IBD-projected data from 2016 to 2018 were 12.1, 12.3 and 12.6 per 100000 personyears, *** Pediatric-onset IBD incidence is around its highest point. The increase, which is particularly pronounced for CD, may be challenging to relate to causes of pediatric disease.

关键词： 胃十二指肠疾病   诊断   胃肠超声造影   胃镜  

摘要： 目的探讨口服胃肠超声造影检查在胃十二指肠疾病诊断中的临床价值。方法选取2013年9月至2016年9月广东省东莞市人民医院收治的200例疑似胃十二指肠疾病的受检者为研究对象,对所有患者实施口服胃肠超声造影检查,其中阳性发现者行胃镜检查和胃镜下病理活检,以病理检查结果为金标准。分析口服胃肠超声造影检查诊断正确率、特异性、漏诊率、误诊率、敏感性。结果口服胃肠超声造影检测在胃溃疡患者中诊断正确率为84.62%,胃炎100.00%,复合性溃疡80.00%,十二指肠球炎60.00%,十二指肠球部溃疡83.33%,胃癌81.82%,胃息肉85.71,黏膜下肿物90.00%。同时口服胃肠超声造影检测在胃十二指肠患者中敏感性、特异性、漏诊率、误诊率分别为98.63%、96.30%、1.37%、3.70%。结论口服胃肠超声造影检查在胃十二指肠疾病中有良好的诊断价值,适合于难以耐受胃镜检查或对胃镜检查有恐惧患者,但如果口服胃肠超声造影检查发现病变或有明显临床报警症状,仍建议进一步胃镜检查明确。

关键词： 肛肠疾病   护理干预   热秘   症状积分   气机郁滞   润肠汤   麻子仁丸   临床护理经验   肝气不舒   术后饮食  

摘要： 由于多种因素的影响,肛肠疾病患者手术后容易发生便秘。一旦发生便秘,不仅会给患者带来生理痛苦,而且排便困难、大便干燥等可使患者产生焦虑、烦躁不安等消极情绪,还会对患者术后的饮食、睡眠造成影响。如果发生便秘后没有及时给予有效的处理,干燥的粪便还有可能擦破患者的伤口,导致局部疼痛,并增加出血、感染的发生率,

关键词： Treatment   Calcineurin Inhibitors   Infliximab   Immunocompromised  

摘要： BACKGROUND & AIMS: Use of immunosuppressants and inflammatory bowel disease (IBD) may increase the risk of pneumonia caused by Pneumocystis jirovecii (PJP). We assessed the risk of PJP in a population-based cohort of patients with IBD treated with corticosteroids, immune-suppressive medications, and biologics. METHODS: We performed a population-based cohort study of residents of Olmsted County, Minnesota, diagnosed with Crohn's disease (n = 427) or ulcerative colitis (n = 510) from 1970 through 2011. Records of patients were reviewed to identify all episodes of immunosuppressive therapies and concomitant PJP prophylaxis through February 2016. We reviewed charts to identify cases of PJP, cross-referenced with the Rochester Epidemiology Project database (using diagnostic codes for PJP) and the Mayo Clinic and Olmsted Medical Center databases. The primary outcome was risk of PJP associated with the use of corticosteroids, immune-suppressive medications, and biologics by patients with IBD. RESULTS: Our analysis included 937 patients and 6066 patient-years of follow-up evaluation (median, 14.8 y per patient). Medications used included corticosteroids (520 patients;55.5%;555.4 patient-years of exposure), immunosuppressants (304 patients;32.4%;1555.7 patient-years of exposure), and biologics (193 patients;20.5%;670 patient-years of exposure). Double therapy (corticosteroids and either immunosuppressants and biologics) was used by 236 patients (25.2%), with 173 patient-years of exposure. Triple therapy (corticosteroids, immunosuppressants, and biologics) was used by 70 patients (7.5%) with 18.9 patient-years of exposure. There were 3 cases of PJP, conferring a risk of 0.2 (95% CI, 0.01-1.0) to corticosteroids, 0.1 (95% CI, 0.02-0.5) cases per 100 patient-years of exposure to immunosuppressants, 0.3 (95% CI, 0.04-1.1) cases per 100 patient-years of exposure to biologics, 0.6 (95% CI, 0.01-3.2) cases per 100 patient-years of exposure to double therapy, and 0 (95% CI, 0.0-19.5

关键词： Inflammatory bowel disease   Ulcerative colitis   Crohn's disease   Trace elements  

摘要： The relationship of minerals and trace elements with inflammatory bowel disease (IBD) is complex. Alterations in their metabolism can be induced by the diseases and their complications. To study the role of trace elements in IBD patients' serum zinc and copper and their related enzymes, including superoxide dismutase (SOD), activity were measured in patients with IBD patients as well as in healthy subjects. In addition, the correlation between serum trace element levels, albumin, total protein, urea level, copper/zinc ratio, and disease activity (DA) was determined in these subjects. Serum samples were obtained from 35 patients (19 ulcerative colitis (UC) and 16 Crohn's disease (CD)) in the active phase of the disease and 30 healthy control subjects. Serum levels of zinc, copper, SOD activity, albumin, total protein, and urea were measured. The results were compared between the two groups using independent Student's t test in statistical analysis. Serum levels of zinc, SOD activity, albumin, and total protein were significantly lower (P < 0.05) in patients than controls, while serum urea level was significantly higher in patients compared to controls. Copper concentrations did not differ between patients with IBD (mean +/- SD, 58.8 +/- 20.7 mu g/d) and controls (55.57 +/- 12.6 mu g/d). Decreased levels of zinc and SOD activity are associated with increased inflammatory processes indicating inappropriate antioxidant system in patients with IBD. Additionally, lower levels of albumin and total protein with higher level of urea reflect metabolic problems in liver system.

关键词： Inflammatory bowel diseases   Inflammatory cytokine   Naïve T-cell   Vitamin D3   dendritic cell   inhibitory cytokine  

摘要： Inflammatory bowel disease (IBD) is a group of idiopathic, chronic and relapsing inflammatory conditions of the gastrointestinal tract, caused by an aberrant and exaggerated immunological response in the gut. Supplementation of vitamin D3 in patients with IBD exerts both direct and indirect regulatory roles on the naive T cells, thereby maintaining a balance between inflammatory and inhibitory cytokines. The direct actions of vitamin D3 on naive T cells result in the proliferation of more regulatory T cells and inhibitory cytokines such as IL-4, IL-10 and IL-5. The binding of vitamin D to dendritic cells (DCs) through vitamin D receptors inhibits the action of IL-12 on DCs, resulting in the downregulation of Th1 and Th17. On the other hand, this interaction favours Th2 and Treg upregulation and facilitates the maintenance of immune homoeostasis between inflammatory and inhibitory cytokines which is essentially significant in the management of patients with IBD. The aim of this review was to explore the current and mounting scientific evidence on the roles of vitamin D3 in immunoregulation of inflammatory and inhibitory cytokines in patients with IBDs. An extensive literature search was conducted using keywords such as Vitamin D3*, IBD*, inflammatory cytokines*, inhibitory cytokines*, naive-T-cells* and antigen presenting cells* through PubMed, SCOPUS and MEDLINE search engines. The results of the accumulated bodies of research that have been conducted demonstrate that vitamin D3 plays a major role not only in the immunoregulation of cytokines involved in the pathogenesis of IBDs but also in many other inflammatory disorders.