关键词： 双气囊小肠镜   小肠疾病   诊断   治疗   安全性  

摘要： 目的:分析探讨双气囊小肠镜(double balloon enteroscopy,DBE)在小肠疾病诊治中的应用价值和安全性。方法:回顾性分析2019年1月—2020年7月因疑似小肠疾病在南京医科大学第一附属医院住院行DBE检查的244例患者的临床资料。依据进镜方式的不同分为经口组和经肛组,分析其年龄、性别、临床表现、进镜方式、进镜深度、内镜阳性发现、诊断、治疗性操作、并发症等。结果:经口组与经肛组之间进镜深度差异有统计学意义(P<0.001),阳性发现率差异无统计学意义(P>0.05)。治疗性操作包括活检(36例次)、息肉切除(16例次)、止血(2例次)和胶囊内镜取出(1例次)。并发症发生率为2.5%,均为轻~中度。结论:DBE在小肠疾病的诊治中具有重要作用,显著提升了小肠疾病的检出率,是治疗小肠疾病安全有效的方法,值得临床进一步推广。

关键词： Pouchitis   Proctitis   Stoma   Short-bowel   Ileo-rectal anastomosis   Biologics  

摘要： Inflammatory bowel disease(IBD)is a chronic condition that requires continuous medical *** date,the medical management of patients with moderatelyto-severely active IBD who develop dependence or resistance to corticosteroids is based on immunomodulator *** therapies are licenced after passing through three phases of randomized controlled trials(RCTs),and are subsequently adopted in clinical ***,the real-life population of IBD patients who require these therapies can significantly differ from those included in *** a matter of fact,there is a number of exclusion criteria–nearly ubiquitous in all RCTs–that prevent the enrolment of specific patients:Chronic refractory pouchitis or isolated proctitis in ulcerative colitis,short-bowel syndrome and stomas in Crohn’s disease,ileorectal anastomosis in both ulcerative colitis and Crohn’s disease,and elderly age are some representative *** this frontier article,we aim to give an overview of current literature on this topic,in order to address the main knowledge gaps that need to be filled in the upcoming years.

关键词： Inflammatory bowel diseases   COVID-19   Transmembrane serine protease 2   Inflammation   Pro-inflammatory   Immunological responses  

摘要： long-term,and relapsing inflammatory *** may spontaneously grow in the colon,and in severe cases may result in tumor lesions such as invasive carcinoma in inflamed regions of the *** epidemiological reports indicate that old age and underlying diseases such as IBD contribute to severity and mortality in patients with coronavirus disease 2019(COVID-19).Currently,the ongoing COVID-19 pandemic caused serious morbidity and mortality *** has also been shown that the transmembrane serine protease 2 is an essential factor for viral activation and viral ***,viral entry causes a'cytokine storm'that induces excessive generation of proinflammatory cytokines/chemokines including interleukin(IL)-6,IL-2,IL-7,tumor necrosis factor-α,and interferon-γ.Future research could concentrate on developing inflammatory immunological responses that are efficient to encounter *** analysis elucidates the role of inflammation and immune responses during IBD infection with COVID-19 and provides a list of possible targets for IBD-regulated therapies in *** from clinical,in vitro,and in vivo studies were collected in English from PubMed,Google Scholar,Scopus,and the Cochrane library until May 2021.

关键词： local drug delivery   nanoparticles   antioxidant enzymes   inflammatory bowel disease   superoxide dismutase  

摘要： The local treatment of inflammatory bowel disease (IBD) by enzyme therapeutics is challenging owing to hostile environments in the gastrointestinal tract, leading to the hydrolysis and enzymatic degradation of labile proteins. In this study, safe and efficient local drug delivery systems were developed by antioxidant superoxide dismutase (SOD) sequestered within lipid-polymer hybrid nanoparticles through sequential self-assembly processes. Interestingly, we found that the sequestered SOD exhibited long-term enzymatic stability and comparable biological activity to the enzymes in the native form, probably owing to particle encapsulation providing a physical barrier to prevent the enzymolysis of proteins. We demonstrated that nanoparticle-based local drug delivery systems showed excellent mucu-spenetrating ability and inflammation-targeting properties, owing to the particle surface with a poly(ethylene glycol) (PEG) coating and folate functionalization, thus improving mucosal retention time and drug delivery efficiency within the colorectal region. Furthermore, SOD-containing lipid-polymer hybrid nanoparticles could effectively mitigate inflammatory responses by regulating the secretion of inflammationassociated cytokines, thus increasing therapeutic outcomes in colitis mice through intrarectal administration. The findings indicated that antioxidant enzymes sequestered within lipid-polymer hybrid nanoparticles might be potential enzyme therapeutics for the local treatment of some inflammatory diseases in the near future.

关键词： 脾功能亢进   门脉高压性胃病   门静脉高压   继发性病变   肠疾病   支架置入术   血运障碍   生长发育迟缓  

摘要： 门静脉海绵样变性(CTPV)是由于肝门或肝内门静脉系统血管先天性或继发性病变,导致门静脉全部或部分阻塞,从而在肝门区代偿性地形成大量侧枝血管丛,因这些侧枝血管形态酷似海绵而得名。该病成人少见,多见于儿童,发病原因尚不明确,早期无明显症状,当门静脉高压失代偿后,会出现食管-胃底静脉曲张甚至破裂出血、脾功能亢进、腹水、门脉高压性胃病、门脉高压性胆病、肠系膜回流血运障碍性肠疾病等一系列症候群[1],也有可能会导致患者生长发育迟缓[2]。

关键词： 肛肠疾病   拔除导尿管   尿潴留   负性情绪  

摘要： 目的:探讨导尿管不同拔除时机对肛肠疾病患者的影响。方法:将2016年4月1日~2020年10月31日收治的100例肛肠疾病术后留置导尿管患者随机分为实验组和对照组各50例。对照组在术后72 h拔除导尿管,实验组在肛肠术后24 h或术后肛周切口换药后拔除导尿管,比较两组尿潴留发生率、拔管至首次排尿时间、负性情绪[采用焦虑自评量表(SAS)和抑郁自评量表(SDS)]及生活质量[采用生命质量测定量表(QCQ-C30)]。结果:实验组尿潴留发生率低于对照组(P<0.05);实验组拔管至首次排尿时间短于对照组(P<0.05);导尿管拔除后两组SAS、SDS评分均低于拔除前(P<0.05),且导尿管拔除后实验组SAS评分、SDS评分均低于对照组(P<0.05);实验组躯体健康、心理健康和社会功能的生活质量评分高于对照组(P<0.01)。结论:肛肠疾病患者术后早期拔除导尿管能有效降低尿潴留发生率,改善患者焦虑和抑郁情绪,提升患者拔管后的生活质量。

关键词： 肛肠疾病术后尿潴留   针灸   防治   研究进展   综述  

摘要： 尿潴留是肛肠疾病术后常见的并发症,发生率约52%,以排尿困难,排尿不畅,小便量少或仅点滴排尿为主要表现,严重影响了患者的生活质量及术后疾病的恢复。针灸因独特优势广泛应用于临床,本研究通过总结近5年相关文献,包括针刺、电针、艾灸、耳针、穴位贴敷等方面,探析针灸防治肛肠疾病术后尿潴留的临床应用,并提出不足,以期为临床研究提供参考。

关键词： muciniphila   homeostasis   mucosal  

摘要： Akkermansia muciniphila(***),a type of Gram-negative anaerobe,was first isolated and identified from the feces of a healthy Caucasian woman at Wageningen University in 2004.[1]It can stably colonize the human gut 1 year after birth and accounts for 1%–4%of the total gut *** specializes in the degradation of mucin(the glycoprotein in mucus)and uses the mucin as the sole source of carbon and *** is abundant in the host intestinal mucosal layer,with the greatest abundance in the cecum,where most mucin is produced.[2]Although degradation of mucin is a pathogen-like behavior;*** does not show any pathogenicity,it resides only in the outer mucosal layer and does not reach the inner mucosal ***,several studies have revealed that *** has important regulatory effects on gut homeostasis.

关键词： Inflammatory bowel disease   Review   Emerging   Treatment   Ulcerative colitis   Crohn's disease  

摘要： Inflammatory bowel disease(IBD)is a chronic disease that requires chronic treatment throughout the evolution of the disease,with a complex physiopathology that entails great challenges for the development of new and specific treatments for ulcerative colitis and Crohn's *** anti-tumor necrosis factor alpha therapy has impacted the clinical course of IBD in those patients who do not respond to conventional treatment,so there is a need to develop new therapies and markers of treatment *** pathways involved in the development of the disease are known and the new therapies have focused on blocking the inflammatory process at the gastrointestinal level by oral,intravenous,subcutaneous,and topical *** these new therapies can lead to more personalized treatments with higher success rates and fewer *** treatments have not only focused on clinical remission,but also on achieving macroscopic changes at the endoscopic level and microscopic changes by achieving mucosal *** treatments are mainly based on modifying signaling pathways,by blocking receptors or ligands,reducing cell migration and maintaining the integrity of the epithelial ***,this review presents the efficacy and safety of the new treatments that are currently under study and the advances that have been made in this area in recent years.

关键词： Thiopurines   Inflammatory bowel disease   Crohn's disease   Ulcerative colitis   Precision medicine  

摘要： Background and aims: The role of thiopurines in therapeutic algorithms of Crohn's disease (CD) and Ulcerative colitis (UC) is being questioned. This work aimed to investigate current practice and future perspectives of Inflammatory Bowel Disease (IBD) physicians regarding the efficacy, safety, and role of precision medicine with thiopurines in IBD. Methods: A 29-questions web-based survey was developed and distributed to IBD physicians worldwide. Results: We collected the complete answers of 408 physicians from 50 countries. Most participants were experienced physicians in IBD;26.0% met our definition of "IBD expert". Four physicians reported to not use thiopurines in clinical practice. Most respondents used thiopurines in monotherapy and in combination therapy, both in CD and UC. Respondents tended to consider thiopurines as drugs with a good safety profile, with the agreement of 61.5% of the overall cohort. A minority of physicians (similar to 6%) considered that thiopurines will not be used in the future in IBD patients, while 57.8% believed that these drugs will still be used, in mono and combination therapy. Conclusion: Despite the many emerging treatments in IBD, according to the beliefs of most physicians surveyed, thiopurines will still be an important part of the treatment algorithm of both CD and UC. (C) 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.