关键词： CI   COVID-19   IBD   IMT   mRNA   SARS-CoV-2  

关键词： Precision medicine   Inflammatory bowel disease   Crohn's disease   Ulcerative colitis   Pediatrics   Therapeutic drug monitoring   Prevention  

摘要： Inflammatory bowel disease (IBD) describes a heterogenous group of diseases characterized by chronic inflammation of the intestinal tract. The IBD subtypes, Crohn’s disease, ulcerative colitis, and IBD-Unspecified, each have characteristic features, but heterogeneity remains even among the subtypes. There has been an explosion of new knowledge on the possible pathogenesis of IBD over the last 2 decades mirroring innovation and refinement in technology, particularly the generation of large scale – “-omic” data. This knowledge has fostered a veritable renaissance of novel diagnostics, prognostics, and therapeutics, with patients with IBD seeing hope bloom in the increasingly large armamentarium of IBD therapies. However, while there are increased numbers of therapies and more pathways being targeted, the number of medications for IBD is still finite and the efficacy has reached a plateau. Precision medicine (PM) is much needed to rationally select and optimize IBD therapies in the new reality of wider but still limited choice with a concurrent, increasingly fine resolution on the significance and utility of clinical, genetic, microbial, and proteomic characteristics that define individual patients. PM is a rapidly changing art, but this review will strive to detail the current state and future directions of PM in pediatric IBD.

关键词： Ulcerative Colitis   Crohn's Disease   Spatial Proteomics   Immune Cell Composition  

摘要： BACKGROUND & AIMS: Significant progress has been made since the first report of inflammatory bowel disease (IBD) in 1859, after decades of research that have contributed to the understanding of the genetic and environmental factors involved in IBD pathogenesis. Today, a range of treatments is available for directed therapy, mostly targeting the overactive immune response. However, the mechanisms by which the immune system contributes to disease pathogenesis and progression are not fully understood. One challenge hindering IBD research is the heterogeneous nature of the disease and the lack of understanding of how immune cells interact with one another in the gut mucosa. Introduction of a technology that enables expansive characterization of the inflammatory environment of human IBD tissues may address this gap in knowledge. METHODS: We used the imaging mass cytometry platform to perform highly multiplex image analysis of IBD and healthy deidentified intestine sections (6 Crohn's disease compared to 6 control ileum;6 ulcerative colitis compared to 6 control colon). The acquired images were graded for inflammation severity by analysis of adjacent H&E tissue sections. We assigned more than 300,000 cells to unique cell types and performed analyses of tissue integrity, epithelial activity, and immune cell composition. RESULTS: The intestinal epithelia of patients with IBD exhibited increased proliferation rates and expression of HLA-DR compared to control tissues, and both features were positively correlated with the severity of inflammation. The neighborhood analysis determined enrichment of regulatory T cell interactions with CD68(+) macrophages, CD4(+) T cells, and plasma cells in both forms of IBD, whereas activated lysozyme C+ macrophages were preferred regulatory T cell neighbors in Crohn's disease but not ulcerative colitis. CONCLUSIONS: Altogether, our study shows the power of imaging mass cytometry and its ability to both quantify immune cell types and character

关键词： Cardiovascular diseases   Inflammatory bowel disease   Medicine/Public Health   general   Gastroenterology   Hepatology   Biomedicine  

摘要： Patients with inflammatory bowel disease (IBD) are at increased risk of thrombotic events. This Evidence-Based Guideline presents an international consensus on the prevention of venous and arterial thrombotic events in patients with IBD, and includes 19 recommendations for clinical practice. Patients with inflammatory bowel disease (IBD) are at increased risk of thrombotic events. Therapies for IBD have the potential to modulate this risk. The aims of this Evidence-Based Guideline were to summarize available evidence and to provide practical recommendations regarding epidemiological aspects, prevention and drug-related risks of venous and arterial thrombotic events in patients with IBD. A virtual meeting took place in May 2020 involving 14 international IBD experts and 3 thrombosis experts from 12 countries. Proposed statements were voted upon in an anonymous manner. Agreement was defined as at least 75% of participants voting as 'fully agree' or 'mostly agree' with each statement. For each statement, the level of evidence was graded according to the Scottish Intercollegiate Guidelines Network (SIGN) grading system. Consensus was reached for 19 statements. Patients with IBD harbour an increased risk of venous and arterial thrombotic events. Thromboprophylaxis is indicated during hospitalization of any cause in patients with IBD. Disease activity is a modifiable risk factor in patients with IBD, and physicians should aim to achieve deep remission to reduce the risk. Exposure to steroids should be limited. Antitumour necrosis factor agents might be associated with a reduced risk of thrombotic events.

关键词： central sensitization   chronic pain disorders   gastrointestinal symptoms   inflammatory bowel disease   irritable bowel syndrome  

摘要： Background Central sensitization has been suggested as an explanation of the wide range of gastrointestinal and extraintestinal symptoms commonly seen in irritable bowel syndrome (IBS). In this study, the presence and level of central sensitization, and its association to gastrointestinal (GI) symptoms were explored in IBS in comparison with control groups. Methods We investigated patients with IBS (n = 215), chronic pain disorders (n = 36), and inflammatory bowel disease (IBD) (n = 40) and volunteers without chronic diseases (n = 112). The Central Sensitization Inventory (CSI) was translated and validated in Swedish and used together with the Highly Sensitive Person (HSP) scale to measure the presence and level of central sensitization. Furthermore, severity of GI symptoms (GSRS-IBS and IBS-SSS), and anxiety and depression (HAD) were determined. Key results The Swedish translation of CSI demonstrated excellent validity. Central sensitization, defined by validated cut-off levels for CSI and HSP, was common in the whole cohort (40% and 28%) and in IBS (57% and 35%). Study participants with central sensitization had more severe GI symptoms, anxiety and depression, than participants without central sensitization. Strong associations were seen between CSI and GI symptom severity in the whole cohort (GSRS-IBS: partial eta(2) = 0.455, p < 0.001;IBS-SSS: partial eta(2) = 0.408, p < 0.001), with decreasing strength in patients with chronic pain, IBD, IBS, and volunteers. Conclusion and Inferences Central sensitization was common in IBS and associated with GI symptom severity, but with stronger associations in chronic pain disorders and IBD. This implies that other mechanisms may be of equal or greater importance for GI symptom severity in IBS.

关键词： adalimumab   Crohn disease   infliximab   ulcerative colitis  

摘要： Anti-tumor necrosis factor alpha (anti-TNF alpha) therapy is commonly used to treat refractory pediatric inflammatory bowel disease (IBD) and carry risks for adverse events. We aimed to assess the relationship between anti-TNF alpha trough concentrations and adverse events rate among pediatric patients with IBD. The medical records of pediatric patients with IBD who were treated with anti-TNF alpha agents from 2015 to 2020 and had sequential monitoring of trough concentration (TC) were reviewed retrospectively for the presence of adverse events. The study cohort included 135 eligible patients (59 [43.7%] girls, mean age at diagnosis 12.9 [+/- 3] years, 111 [82.2%] Crohn disease) who had 1589 measurements of TCs (1037 [63%] infliximab). During a median follow-up period of 1.7 years (IQR 1.1-2.7), we recorded 156 adverse events in 50 patients (37%). Higher TCs were not associated with higher rate of anti-TNF alpha-related adverse events whereas these events (excluding increase in liver transaminases) were associated with younger age.

关键词： 尿潴留   良性肛肠疾病术后   危险因素   护理进展  

摘要： 良性肛肠手术之后较常出现的并发症是尿潴留,患者的年龄大小、是否患有糖尿病以及麻醉方式的区别等等都是导致急性尿潴留发生的因素。本文针对可能导致尿潴留发生的相关因素进行了综合分析,旨在为患者提供肛肠疾病术后护理指导,最大限度避免尿潴留的发生。

关键词： 肉牛养殖   胃肠疾病   预防治疗  

摘要： 在现代畜牧业发展过程中,肉牛养殖对人类食品安全具有很大的影响,相关工作人员必须对其加强重视,强化肉牛养殖工作,科学预防常见胃肠疾病,并对其进行有效的治疗,确保能够有效保障养殖效果,对现代人食品安全进行更为有效的保障,本文首先分析肉牛养殖过程中预防胃肠疾病的具体策略,然后分别探究治疗感染性胃肠炎和病毒性腹泻两种常见胃肠疾病的具体策略,希望能够推进我国现代肉牛养殖行业的进一步发展,确保我国现代畜牧养殖业具有更高的经济效益和社会效益。

关键词： 肛肠疾病   术后疼痛   电热针灸   护理效果  

摘要： 探讨电热针灸在肛肠疾病术后疼痛的护理效果。方法:选取我院2019年12月-2020年12月收治的100例肛肠疾病术后疼痛的患者,随机分为2组各50例。对照组用西药缓解疼痛,观察组采用电热针灸治疗缓解疼痛,对比两组临床疗效、疼痛和生活质量评分及不良事件。结果:观察组临床疗效高于对照组;术后观察组疼痛评分低于对照组,而生活质量评分高于对照组;观察组不良反应发生率低于对照组(均P<0.05)。结论:电热针灸缓解肛肠疾病术后患者疼痛,提高患者的生活质量水平。

关键词： 中药熏洗   联合   针刺痔疮穴   肛肠疾病   术后应用  

摘要： 主要是研究利用中药熏洗联合针灸刺痔疮穴来缓解肛门直肠疾病术后痛苦程度以及创面愈合的临床效果。方法:在2020年3月至2021年3月这一年的时间段之内,在我院所有已经成功接受了肛肠外科手术和化学治疗的病例患者中,随机甄选出80例,并将这些病例患者分成两组与一组作为观察对照组,每组40例。对于一个观察组的病人,需要进行高锰酸钾水或钠溶液在坐浴中的熏洗,而对于另一个观察组病人,则可以通过联合肛疮穴的针刺治疗等方法来加以治疗。然后分别从两组病人的临床疗效出发,包括术后患者的疼痛舒适缓解程度、创面愈合所需要消耗的时间,以及术后并发症在哪里会有发生。结果:经过长期的研究和治疗之后,观察组总有效率比较高于对照组,差异在数据分析中具有重要性和科学意义(P<0.05);观察组的疼痛视觉模拟量表评分法( vas )明显优于对照组,差异在数据分析中具有重要性和科学意义(P<0.05);观察组水肿消失时间、疼痛性消失时间、渗出物消失时间和创面愈合时间均短于对照组,差异均具有统计学意义(P<0.05),观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:对于进行肛肠手术治疗后的病人,在术后采用了中药熏洗坐浴联合痔疮穴针刺治疗的方法,能够有效地改善和提升其临床疗效,有效地缓解患者的疼痛程度、促进症状的恢复、加速创面的愈合,并且能够很大的程度地减少术后并发症的发生概率,值得在本文中进行一些临床推广。