关键词： microplastics   inflammatory bowel disease   feces   health risk   source of exposure  

摘要： Human ingestion of microplastics (MPs) is inevitable due to the ubiquity of MPs in various foods and drinking water. Whether the ingestion of MPs poses a substantial risk to human health is far from understood. Here, by analyzing the characteristics of MPs in the feces of patients with inflammatory bowel disease (IBD) and healthy people, for the first time, we found that the fecal MP concentration in IBD patients (41.8 items/g dm) was significantly higher than that in healthy people (28.0 items/g dm). In total, 15 types of MPs were detected in feces, with poly(ethylene terephthalate) (22.3-34.0%) and polyamide (8.9-12.4%) being dominant, and their primary shapes were sheets and fibers, respectively. We present evidence indicating that a positive correlation exists between the concentration of fecal MPs and the severity of IBD. Combining a questionnaire survey and the characteristics of fecal MPs, we conclude that the plastic packaging of drinking water and food and dust exposure are important sources of human exposure to MPs. Furthermore, the positive correlation between fecal MPs and IBD status suggests that MP exposure may be related to the disease process or that IBD exacerbates the retention of MPs. The relative mechanisms deserve further studies. Our results also highlight that fecal MPs are useful for assessing human MP exposure and potential health risks.

关键词： Infectious Diseases   Parasitology   Medical Microbiology   Tropical Medicine   Internal Medicine  

摘要： Background: Patients with Inflammatory Bowel Disease (IBD) are at increased risk of serious infections, including vaccine preventable diseases. Current evidence suggests uptake of additional recommended special risk vaccinations is low. Identification of IBD patients prior to commencing immunosuppressive therapy allows for optimisation of vaccination, including timely administration of live-attenuated and additional recommended vaccines, such as influenza and pneumococcal vaccines. Methods: Paediatric patients (0-18 years) seen at the tertiary Royal Children's Hospital, Melbourne, Australia, with a recent diagnosis of IBD were referred by the Gastroenterology Unit to our Specialist Immunisation Clinic (SIC) for assessment and provision of routine and special risk vaccines. Data was collected via a standardised REDCap questionnaire completed in or post attendance at the SIC and included serology results where available. Results: Sixty-nine paediatric patients were recruited to the study between 2014 and 2017. Median age at IBD diagnosis was 11.25 years (IQR 4.64 years), with median time between diagnosis and SIC review of 0.88 years (IQR 2.84 years). At initial review 84.1% (58/69) of patients were up to date with vaccines on the Australian National Immunisation Program (NIP) schedule. Of those who were tested, serological evidence of immunity was demonstrated in 38.3% (23/60) of patients for Hepatitis B, 66.7% (36/54) for measles, 51.9% (28/54) for rubella and 41.9% (26/62) for Varicella Zoster Virus. Prior to SIC review 47.8% (33/69) had additional vaccinations and 92.8% (64/69) had vaccinations administered in the 12 months following SIC assessment. The Pneumococcal conjugate vaccine (76.8%, 53/69) was the most commonly administered vaccine after SIC review, followed by influenza vaccine (69.6%, 48/69). Within 12 months of SIC review 43.5% (30/69) of patients had completed the schedule and were up-to-date as recommended by the SIC. Conclusions: Children with IBD a

关键词： Inflammatory bowel disease   Crohn's disease   Ulcerative colitis   Zonulin   Zonulin-related proteins (ZRP)  

摘要： Background Current evidence regarding the association of serum zonulin-related proteins (ZRP) levels with prevalent inflammatory bowel disease (IBD) is contradictory. Moreover, the association with the subsequent risk of incident IBD is still unexplored. This study aimed to investigate the association of serum ZRP levels with both prevalent and incident IBD. Method The study included a total of 130 women (51-61 years) from the Women's Health in Lund Area (WHILA) study, which included 18 prevalent IBD (diagnosed before baseline) and 47 incident IBD diagnosed during the 17 years (median) follow-up and age- and sampling time-matched controls. Serum ZRP was tested in all participants by ELISA. Results The serum ZRP levels were significantly higher in prevalent IBD compared to their matched controls (63.2 ng/ml vs 57.0 ng/ml, p = 0.02), however, no evidence of a difference in ZRP levels was found between the women who developed IBD during the follow-up period and their matched controls (61.2 ng/ml vs 59.7 ng/ml, p = 0.34). Using linear mixed models, we found that the association between serum ZRP levels and prevalent IBD (beta = 6.2, p = 0.01), remained after adjusting for potential confounders. Conditional logistic regression models showed no evidence of an association between ZRP level and incident IBD (OR 1.03, p = 0.34). Conclusion Higher serum ZRP levels were associated with prevalent IBD, but not with incident IBD in our study samples.

关键词： 高蛋白食物   脏腑娇嫩   人体营养   消化系统症状   精神焦虑   身体发育   课业压力   搬运工  

摘要： 消化系统是人体重要的一部分,是人体营养的搬运工,对于儿童来说,更是身体发育的根源,肠胃一旦出现问题,会对孩子从身体到智力等各个方面的发育带来不良的影响。孩子脏腑娇嫩,胃肠功能尚未发育完全,然而随着生活水平的提高,家长对孩子的饮食十分重视,总怕孩子营养跟不上,给孩子吃的过多过精,高蛋白食物多,粮食蔬菜少,加上丰富的零食、冷饮,难以消化,给孩子娇嫩的肠胃造成负担。同时繁重的课业压力,老师、家长的高要求,造成孩子精神焦虑、紧张,加重消化系统症状。

关键词： 单气囊小肠镜   小肠疾病   老年患者  

摘要： 目的评价单气囊小肠镜(single balloon enteroscopy,SBE)对老年患者小肠疾病的诊断价值。方法回顾性分析首都医科大学附属北京友谊医院消化分中心2017年1月至2019年12月行全身静脉麻醉SBE检查老年患者60例,与同期检查的146例非老年患者进行比较。结果60例老年患者均能耐受检查,检出阳性率为46.7%(28/60),老年患者SBE检查时间为22~172 min,平均检查时间为76.9 min。老年患者主要受检原因为不明原因消化道出血56.7%(34/60),老年患者因腹痛受检比例16.7%(10/60)显著低于非老年组患者34.2%(50/146)(P=0.018)。老年患者检出主要疾病为小肠肿瘤28.6%(8/28)及血管病变28.6%(8/28),在检出疾病中老年患者小肠炎症、溃疡的发生比例25.0%(7/28)显著低于非老年患者48.4%(30/62)(P=0.037)。老年患者的小肠病变检出率、操作时间、并发症发生率与同期检查的非老年患者相同,差异无统计学意义(P>0.05)。结论SBE对老年患者小肠疾病的诊断是一种安全、可靠的手段。

关键词： 肛肠疾病   术后疼痛   治疗  

摘要： 随着现代胜过节奏的加快、工作压力增大,久坐、暴饮暴食等不良生活习惯,使得痔疮、肛周脓肿等肛肠疾病发病率不断升高,正如《内经》言:“因而饱食,筋脉横解,肠癖为痔”,对于肛肠疾病处理大都以手术治疗为主,且手术治疗因其疗效快,治疗病程短为大众所接受。手术治疗方案也在不断优化,但由于多种因素的影响,术后疼痛不仅是肛肠科医生面临的常见难题,也会给患者带来神经、内分泌、胃肠道等多方面的不良影响,本文主要从中医外治法角度论述肛肠疾病术后疼痛的常见治疗方案以及简述其发生的机理。

关键词： 护理干预   肛肠疾病   术后尿潴留  

摘要： 分析护理干预对预防和护理肛肠疾病术后尿潴留的效果。方法:选取2019年1月~2021年9月我院收治的57例肛肠疾病手术患者,按照随机数字表法将其分为2组,对照组(28例)给予常规护理,观察组(29例)给予综合护理干预,分析护理效果。结果:观察组泌尿系统感染率、尿潴留发生率明显比对照组低,差异具有统计学意义(P<0.05);观察组护理满意度明显高于对照组,差异具有统计学意义(P<0.05);观察组患者留置尿管时间、排尿时间、残余尿量均比对照组低,排尿量明显高于对照组,差异具有统计学意义(P<0.05)。结论:肛肠疾病患者术后加强护理干预,可缩短患者导尿时间,促进患者正常排尿,有效避免泌尿系统感染、尿潴留发生,且患者满意度更高。

关键词： 大肠疾病   人工智能   深度学习   辅助诊疗  

摘要： 在我国,大肠疾病尤其是结直肠癌的发病率和病死率均逐年增高,但现有检查方法和技术的诊断效率和准确性仍有待提高。人工智能正处于高速发展阶段,其中深度学习是当下最先进、最流行的机器学习算法,已开始应用于医学领域,在辅助疾病诊疗中显示出良好的应用前景。新近研究表明,人工智能辅助系统的应用有助于提高大肠疾病诊断的效率和准确率。本文综述了人工智能尤其是深度学习算法在各类大肠疾病诊疗中的应用现状与价值,以及所面临的问题和挑战。

关键词： 肛肠疾病   中西医结合   外科   疗效  

摘要： 本次研究主要是针对肛肠疾病,通过中西医结合外科治疗方式所收获到的临床疗效进行总结和深度的探寻。方法:随机选择在我院接受治疗的,存在有肛肠疾病的患者总计数量有76名,通过随机均匀分组手段将此76名肛肠疾病患者均匀分配成观察组38名肛肠疾病患者,以及对照组38名肛肠疾病患者,通过采取不同治疗方式以及不同时段的疼痛评分比较,对于本次研究两组肛肠疾病所收获到的临床效果进行比较分析。结果:在本次研究当中,对于疼痛评分进行比较来看,观察组38名肛肠疾病患者的疼痛评分,明显比对照组其余38名肛肠疾病患者的疼痛评分相对更低,而且在组间的数据比较方面是明显有统计学差异存在的,P<0.05;而在针对两组患者住院平均时间、手术后有无感染、脓肿等并发症情况来看,也是观察组38名肛肠疾病患者的数据指标更加出色、更加优秀,而且组间数据比较明显,有统计学差异存在,P<0.05。结论:在临床上相对于肛肠疾病患者来说,通过中西医结合外科治疗,能够让肛肠疾病患者的疼痛症状得到有效的减轻,并且让患者住院时间有效缩短,全面减少手术之后所存在的不良感染和肛周脓肿等不良并发症,让患者的临床治疗疗效得以全面提升。因此,相对于肛肠疾病治疗来说,应该积极的开展中西医结合外科的临床治疗手段,并将此治疗方式在临床上进行有效推广和全面应用。

关键词： 刘德山   胃肠疾病   慢性胃炎   小儿急性胃肠炎   援药理论  

摘要： 通过对刘德山小儿急性胃肠炎、慢性胃炎等典型案例的总结,指出脾胃虚弱是胃肠疾病发生的根本病机,胃肠疾病的性质多为本虚标实,其病位虽在胃、肠,但与脾、肝的关系密切;在治疗方面,刘德山强调健运脾胃、调和肝脾、疏肝和胃的重要性,并且刘德山善用援药对因对症治疗。本文记录了刘德山治疗胃肠疾病的经验及典型医案。