关键词： 肛肠疾病术后   创面止痛   蒙药冲-5   护理效果  

摘要： 目的:探究肛肠疾病术后创面止痛的临床护理方法。方法:选取我科2016年11月份收治的肛肠疾病术后患者120例,随机分为两组各60例。对照组采用常规肛肠科术后护理。观察组采用患者术后蒙药嘎日迪-5味栓纳肛创面止痛,治疗10天观察肛肠术后患者创面止痛效果及满意度情况。结果:观察组患者止痛效果总有效率明显高于对照组(P﹤0.05),观察组患者总满意率明显高于对照组(P﹤0.05)。结论:肛肠疾病患者术后用蒙药嘎日迪-5味能有提高创面止痛的护理效果,增加患者的满意度,值得推广。

关键词： SELENIUM   IBD   INFLAMMATION   OXIDATIVE STRESS  

摘要： This study aims to investigate the protective effect of p-chloro-phenyl-selenoesterol [PCS;0,2mg/kg;10ml/kg i.g.)in colitis induced by 2,4,6-trinitrobenzene sulfonic acid [TNBS;2 mg/100 mu l 50% ethanol;intrarectally) in mice. Several parameters including weight, length, histological analyses determination, thiobarbituric acid reactive species, reactive species levels, superoxide dismutase, catalase, and myeloperoxidase (MPO) activity of colon were evaluated. The serum levels of tumor necrosis factor alpha [TNF-alpha) and interleukin 6 [IL-6) were also assessed. Treatment with PCS reduced the clinical and histopathologic severity of TNBS-induced colitis, characterized by colon length reduction and increased colon weight and microscopic intestinal inflammation. The therapeutic effects of PCS in this model were associated with significant decrease in proinflammatory cytokines TNF-alpha and IL-6 and decrease in MPO activity. Furthermore, combined with improvements in inflammatory parameters, treatment with the PCS was able to decrease oxidative stress and to prevent the decrease in antioxidant defenses in animals with TNBS-induced colitis. This finding suggests that PCS can improve experimental colitis in mice and it could be a potential therapeutic agent for the treatment of patients with IBD. (C) 2016 Wiley Periodicals, Inc.

关键词： inflammatory bowel disease   sphingosine-1-phosphate   cancer  

摘要： Beyond their role as structural molecules, sphingolipids are involved in many important cellular processes including cell proliferation, apoptosis, inflammation, and migration. Altered sphingolipid metabolism is observed in many pathological conditions including gastrointestinal diseases. Inflammatory bowel disease (IBD) represents a state of complex, unpredictable, and destructive inflammation of unknown origin within the gastrointestinal tract. The mechanisms explaining the pathophysiology of IBD involve signal transduction pathways regulating gastro-intestinal system's immunity. Progressive intestinal tissue destruction observed in chronic inflammation may be associated with an increased risk of colon cancer. Sphingosine-1-phosphate (S1P), a sphingolipid metabolite, functions as a cofactor in inflammatory signaling and becomes a target in the treatment of IBD, which might prevent its conversion to cancer. This paper summarizes new findings indicating the impact of (S1P) on IBD development and IBD-associated carcinogenesis.

关键词： Cytokines   FoxP3   IL-17   Immunosuppressive therapy   Inflammatory Bowel Disease   Th17   Tregs  

摘要： Inflammatory bowel disease (IBD) is assumed to be caused by genetic and environmental factors that interact together in promoting intestinal immune dysregulation where cytokines have validated role. However, the underlying intimate mechanisms in the human IBD involving cytokines still needs to be supplemented especially in the clinical context. The aim of this study was to investigate the expression of some inflammatory and regulatory cytokines (IL-17A, IL-23, IL-6, TGFβ1, and IL-10) as well as of the transcription factor FoxP3 in mucosal samples of IBD and non-IBD patients. We assessed the mRNA relative quantities (RQ) of the above-mentioned cytokines and the transcription factor FoxP3 in paired colonic samples (inflamed and adjacent normal mucosa) from 37 patients with IBD and in normal mucosal tissue in 12 persons without IBD by performing a qRT-PCR assay and tested the protein levels of target cytokines in serum samples. The patients were divided into three groups: without any therapy (n = 10), on 5-ASA (n = 11) and on immunosuppressants (Azathioprine ± 5-ASA/corticosteroids) (n = 16) in order to compare the RQ values for each therapeutic group. All investigated genes were found upregulated in the inflamed mucosa of IBD patients in the following order: IL-6 > FoxP3 > TGFβ1 > IL-23 > IL-17A > IL-10. We also observed that the gene expression of FoxP3 and IL-6 were substantially higher in the inflamed mucosal tissue of the IBD patients than the adjacent normal mucosa (p = 0.035, p = 0.03 respectively). Differences between higher mRNA expression of FoxP3 and IL-6 in inflamed tissue were considered significant in patients with ulcerative colitis (UC) (p = 0.011, p = 0.000 respectively) and with Crohn’s disease (CD) (p = 0.008, p = 0.000 respectively) in comparison to the normal mucosa of non-IBD persons and we found increased TGFβ1 in CD patients alone (p = 0.041). Furthermore, IL-6 and TGFβ1 were overexpressed (RQ > 10) in non-inflamed mucosa from IBD patients compa

关键词： Crohn's disease   inflammatory bowel disease   meta-analysis   oral health   periodontal disease   systematic review   ulcerative colitis  

摘要： BackgroundThe objective of this systematic review was to systematically investigate whether there is an association between inflammatory bowel disease (IBD) and oral health. MethodsLiterature searches for randomized and non-randomized studies were performed up to January 2017. Risk of bias within studies was assessed with the Downs and Black checklist. Across-studies risk of bias was assessed with the GRADE framework. Quantitative synthesis was conducted with random-effects meta-analyses. ResultsA total of 9 cross-sectional studies including 1297 patients were included. IBD was associated with increased risk of periodontitis (332 more patients per 1000 patients;95% confidence interval (CI): 257-388 patients;p<0.001) compared to non-IBD patients. Additionally, the Decayed-Missing-Filled-Teeth index of IBD patients was significantly worse than non-IBD patients (mean difference: 3.85;95% CI: 2.36-5.34;p=0.005). Patients with ulcerative colitis had considerably worse oral health for most of the assessed factors, while the quality of overall evidence ranged from high to low, due to the observational nature of contributing studies. ConclusionsInflammatory bowel disease was associated with significantly higher risk of periodontitis and worse oral health compared to non-IBD patients. However, longitudinal studies are needed in order to establish a causality link between IBD and periodontal disease.

摘要： Background and aims Patients with inflammatory bowel disease (IBD) report increased mental health issues, poorer sleep quality and less engagement in physical activity (PA). Standard treatment consists of immune modulating pharmaceuticals, though evidence is growing that aerobic exercise training (AET) might serve as adjuvant option to reduce disease symptoms and improve mental health. The aim of the present study was to investigate possible AET effects on psychological functioning, depressive symptoms, sleep and PA behavior in paediatric patients with IBD. Methods Twenty-one paediatric patients with IBD and 23 gender and age-matched healthy controls (HC) were assessed. The IBD group was split into a “remission-group” (IBD-RE; n = 14) and an “active disease group” (IBD-AD; n = 7). All participants completed an 8-week AET exergame intervention reaching 60–80% of maximal heart rate for 5 days per week. At baseline and after 8 weeks, psychological functioning, depressive symptoms, objective sleep EEG, subjective sleep and objective and subjective PA were assessed. Results AET significantly improved the exercise capacity of all participants. Self-reported fitness and daily PA behavior significantly increased in IBD-AD, but not in IBD-RE and HC. No improvements were observed for psychological functioning, depressive symptoms and subjective or objective sleep dimensions. Descriptively, the IBD-AD group reported lower psychological functioning and poorer subjective sleep quality. Conclusions Results suggest that children and adolescents in an active disease state were at increased risk to descriptively report lower scores of psychological functioning and sleep. Further, an exergaming intervention has the potential to improve exercise capacity, self-reported fitness and daily PA. Disclosure of interest The authors have not supplied their declaration of competing interest.

关键词： CCHS   Ulcerative Colitis   Crohn's Disease   Marriage   Occupation   Long-term Effect  

摘要： BACKGROUND & AIMS: We aimed to assess levels of education attained, employment, and marital status of adults diagnosed with inflammatory bowel diseases (IBD) during childhood or adolescence, compared with healthy individuals in Canada. METHODS: We performed a cross-sectional study of adults diagnosed with IBD in childhood or adolescence at Children's Hospital in Winnipeg, Manitoba from January 1978 through December 2007. Participants (n = 112) answered a semi-structured questionnaire on educational achievements, employment, and marital status. Patients were matched for age and sex with random healthy individuals from the 2012 Canadian Community Health Survey (controls, 5 per patient). Conditional binary logistic regression and random-effects ordinal logistic regression models were used for analysis. RESULTS: Patients were followed for a mean duration of 14.3 years (range, 3.1-34.5 years). Persons with IBD were more likely to earn more money per annum and attain a post-secondary school degree or receive a diploma than controls (odds ratio, 1.72;95% confidence interval, 1.13-2.60;P < .01 and odds ratio, 2.73;95% confidence interval, 1.48-5.04;P < .01, respectively). There was no significant difference between patients and controls in employment or marital status. CONCLUSIONS: Adults diagnosed with IBD during childhood seem to achieve higher education levels than individuals without IBD. This observation should provide reassurance to children with IBD and their parents.

关键词： INTESTINAL diseases   TUMOR necrosis factor   BONE density   ULCERATIVE colitis   CROHN'S disease  

关键词： INFLAMMATION   INFLAMMATORY bowel diseases   CROHN'S disease   DISEASE remission   DISEASE relapse  

摘要： BackgroundReliable data on inflammatory biomarkers for predicting relapse of paediatric inflammatory bowel disease (IBD) are lacking. AimTo investigate the predictive value of faecal calprotectin (FC) and CRP for symptomatic relapse in pediatric IBD in clinical remission. MethodsIn this cross-sectional cohort study, patients <18 years with Crohn's disease or ulcerative colitis in clinical remission 3 months were included. At baseline, clinical and biochemical disease activity were assessed using the abbreviated-Pediatric Crohn's Disease Activity Index or Pediatric Ulcerative Colitis Activity Index, and FC and CRP respectively. Disease course over the subsequent 12 months was retrospectively assessed. ResultsIn total, 114 patients (56% males;median age 14.9 years) were included. Baseline FC was higher in patients that developed symptomatic relapse [median (IQR), relapse 370 g/g (86-1100) vs. remission 122 g/g (40-344), P = 0.003]. Baseline FC was predictive of symptomatic relapse within 6 months [HR per 250 g/g (95% CI): 1.46 (1.21-1.77), P < 0.001], with good predictive accuracy (AUC: 0.82). Optimal FC cut-off was 350 g/g, with positive and negative predictive value of 41% and 96%. Baseline CRP was higher in patients that developed symptomatic relapse [median (IQR), relapse 1.0 g/g (0.6-5.0) vs. remission 1.0 g/g (0.4-2.0), P = 0.033]. Baseline CRP was predictive of symptomatic relapse within 6 months from baseline [HR per 1 mg/L (95% CI): 1.10 (1.02-1.19), P = 0.011], with fair predictive accuracy (AUC: 0.72). Optimal CRP cut-off was 1.0 mg/L, with positive and negative predictive value of 21% and 94%. ConclusionsFaecal calprotectin and CRP are predictive of symptomatic relapse and may be valuable in management of paediatric IBD in clinical remission.