关键词： inflammatory bowel disease   ulcerative colitis   cytomegalovirus  

摘要： Cytomegalovirus (CMV) infection can be a challenging clinical problem in patients with inflammatory bowel disease (IBD), particularly ulcerative colitis. Clinical presentation is difficult to distinguish from an underlying disease flare. Several diagnostic modalities are now available and when combined can aid clinicians in the identification of patients who are most likely to benefit from antiviral therapy. The aim of this article is to review the available literature and outline a practical approach to the diagnosis and management of CMV in patients with IBD.

摘要： Background Epidemiological studies have shown inconsistent incidence rates (IRs) for inflammatory bowel disease (IBD). Aim To assess the incidence and temporal trends of IBD in Sweden. Methods Nationwide cohort study based on diagnostic codes for IBD and biopsy reports registered through the ESPRESSO cohort in 1990-2014. Age-specific and age-standardised IRs and cumulative incidence were calculated. Results Overall, we identified 65 908 cases of incident IBD: ulcerative colitis (UC, n = 38 261, 58%), Crohn's disease (CD, n = 18 577, 28%) and IBD-U (n = 9070, 14%). During 1990-2014, the overall IRs per 100 000 person-years were 29.0 (95% CI: 27.3-30.7) for IBD, 16.9 (15.9-17.9) for UC, and 8.1 (7.7-8.6) for CD. For IBD-U, the IR was 5.2 (4.9-5.6) in 2002-2014. The annual incidence of IBD, UC and CD increased by approximately 7% per year between 1990 and 2001 (P < 0.001) and then decreased by 1%-2% per year from 2002 onwards (P < 0.001). IRs for IBD, UC and IBD-U were higher in males while the IR for CD was higher in females. The lifetime risk of IBD was about 2.5% for both sexes. Conclusions In Sweden, the incidence of IBD in all subtypes increased in 1990-2001 but has since declined. One in 40 individuals is expected to be diagnosed with IBD during their lifetime.

关键词： Anti-TNF-alpha   Chemotaxis   Diagnostic biomarkers   IL13RA2   Inflammatory bowel diseases  

摘要： Background and Aim: Anti-tumor necrosis factor-alpha (anti-TNF-alpha) agents have been used for inflammatory bowel disease;however, it has up to 30% nonresponse rate. Identifying molecular pathways and finding reliable diagnostic biomarkers for patient response to anti-TNF-alpha treatment are needed. Methods: Publicly available transcriptomic data from inflammatory bowel disease patients receiving anti-TNF-alpha therapy were systemically collected and integrated. In silico flow cytometry approaches and Metascape were applied to evaluate immune cell populations and to perform gene enrichment analysis, respectively. Genes identified within enrichment pathways validated in neutrophils were tracked in an anti-TNF-alpha-treated animal model (with lipopolysaccharide-induced inflammation). The receiver operating characteristic curve was applied to all genes to identify the best prediction biomarkers. Results: A total of 449 samples were retrieved from control, baseline, and after primary anti-TNF-alpha therapy or placebo. No statistically significant differences were observed between anti-TNF-alpha treatment responders and nonresponders at baseline in immune microenvironment scores. Neutrophil, endothelial cell, and B-cell populations were higher in baseline nonresponders, and chemotaxis pathways may contribute to the treatment resistance. Genes related to chemotaxis pathways were significantly upregulated in lipopolysaccharide-induced neutrophils, but no statistically significant changes were observed in neutrophils treated with anti-TNF-alpha. Interleukin 13 receptor subunit alpha 2 (IL13RA2) is the best predictor (receiver operating characteristic curve: 80.7%, 95% confidence interval: 73.8-87.5%), with a sensitivity of 68.13% and specificity of 84.93%, and significantly higher in nonresponders compared with responders (P < 0.0001). Conclusions: Hyperactive neutrophil chemotaxis influences responses to anti-TNF-alpha treatment, and IL13RA2 is a potential biomarker to pr

关键词： Branching crypts   Colon   Crohn colitis   Endoscopic biopsies   Ulcerative colitis  

摘要： Histologic sections from patients with inflammatory bowel disease (IBD) usually exhibit crypts with architectural distortions and branching crypts. It has been postulated that crypt branching should be assessed only in well-oriented, upright crypts. However, those crypts are mostly found in sections from colectomy specimens and colon mucosectomies. Sections from endoscopic biopsies are fortuitously cut in a horizontal plane, a procedure mostly revealing cross-cut crypt rings. In endoscopic biopsies from UC patients we previously detected cross-cut crypts heralding the crest domain of branching crypts. Recently, the scrutiny of biopsies from IBD patients revealed that branching-crest domains concurred either with crypts in symmetric branching, typified by twin, amalgamating back-to-back isometrics crypt-rings, or with crypts in asymmetric branching, characterized by >= 2 amalgamating anisometric crypt-rings;both symmetric and asymmetric branching-crest domains were encased by a thin muscularis mucosae. Quantitative studies in biopsies from Swedish and German patients with IBD showed that crypts in asymmetric branching outnumbered those in symmetric branching. Because crypt-branching seldom occurs in the normal colon in adults and considering that colon crypts typically divide once or twice during a lifetime, the accruing of asymmetric branching crypts in IBD biopsies emerges as a significant histologic parameter. Although the biological significance of asymmetric crypt-branching in IBD remains at present elusive, their occurrence deserves to be further investigated. The future policy will be to include in our pathologic reports, the number of crypts in asymmetric branching, in order to monitor their frequency in prospective surveillance biopsies in patients with IBD.

摘要： In this study, we described a series of 2,8-diazaspiro[4.5]decan-1-one derivatives as selective TYK2/JAK1 inhibitors. Systematic exploration of the structure-activity relationship through the introduction of spirocyclic scaffolds based on the reported selective TYK2 inhibitor 14l led to the discovery of the superior derivative compound 48. Compound 48 showed excellent potency on TYK2/JAK1 kinases with IC50 values of 6 and 37 nM, respectively, and exhibited more than 23-fold selectivity for JAK2. Compound 48 also demonstrated excellent metabolic stability and more potent anti-inflammatory efficacy than tofacitinib in acute ulcerative colitis models. Moreover, the excellent anti-inflammatory effect of compound 48 was mediated by regulating the expression of related TYK2/JAK1-regulated genes, as well as the formation of Th1, Th2, and Th17 cells. Taken together, these findings suggest that compound 48 is a selective dual TYK2/JAK inhibitor, deserving to be developed as a clinical candidate.

关键词： 肛肠疾病   中医外治综合疗法   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患者术后换药疼痛及创面愈合的效果。方法本次试验选取了本院2020年3月至2021年2月收治的60例肛肠疾病术后患者作为研究对象,根据随机、平均的分配方式分为对照组和观察组。对照组采用常规治疗,观察组则采用中医外治综合疗法,并针对两组的效果进行对比分析。结果观察组疼痛程度低于对照组疼痛程度(P<0.05);观察组患者在术后6 h以及术后5 d的疼痛度得分情况优于对照组(P<0.05);观察组创面愈合时间明显短于对照组(P<0.05)。结论采用中医外治综合疗法治疗肛肠疾病可有效缓解术后患者的疼痛程度,患者的创面愈合效果显著,且用药安全性较高,能够达到预期的治疗效果。

关键词： Resveratrol   Inflammatory bowel disease   Intestinal barrier   Gut microbiota   Inflammatory signaling pathways  

摘要： Inflammatory bowel disease(IBD)is a chronic inflammatory lesion of the intestine,mainly manifested by infiltration of intestinal inflammatory cells and imbalance of gut *** treatments for IBD include antibiotics,immunosuppressive agents,5-aminosalicylic acid,steroids and surgery,which have high toxic side *** is a natural polyphenol,and its various derivatives have anti-oxidation and anti-inflammatory *** this paper,we comprehensively review the mechanism of resveratrol and its derivates to alleviate IBD by improving intestinal barrier,regulating the unbalanced gut microbiota,and targeting various inflammatory signaling pathways.

关键词： 肛肠疾病   护理干预   术后疼痛  

摘要： 探究在肛肠疾病中应用护理干预对术后疼痛的影响。方法:选取我院在2019年6月-2021年6月所收治的肛肠疾病患者82例,按照干预形式分为对照组与研究组各41例,仅给予对照组常规护理,研究组实行综合护理,对比两组干预效果。结果:研究组各阶段的术后疼痛感均低于对照组(P<0.05);研究组相比对照组在干预后处于更低的PSQI评分与ISI评分(P<0.05)。结论:在肛肠疾病中应用护理干预,可减轻患者术后疼痛,保证睡眠质量,临床实践价值较高。

关键词： Polysaccharides   Inflammatory bowel disease   Intestinal flora   Structure-activity relationship  

摘要： Inflammatory bowel disease (IBD) is a long-term chronic disease, about 20% of IBD patients deteriorate to colorectal cancer. Currently, there is no radical cure for IBD. Natural plant polysaccharides (NPP) have low toxic and side effects, which have immune and prebiotic activities and possesses positive effect on alleviating IBD. In this review, we will focus on the alleviating effect of NPP on IBD in vitro and in vivo from three aspects: regulating intestinal flora imbalance, repairing intestinal barrier injury and improving immunity. The relationship between the chemical structure of natural plant polysaccharides and the therapeutic effect of IBD are highlighted. Finally, the synergistic role of NPP as a carrier of drugs or active molecules to reduce side effects and enhance targeting function are discussed, especially pectic polysaccharides. Broadly, this review provides a valuable reference for NPP to be developed as functional food or health products to alleviate IBD.