关键词： 中药坐浴   微波理疗   肛肠疾病  

摘要： 观察中药坐浴配合微波理疗对于肛肠疾病患者术后护理干预的效果,方法:选取2015年11月-2020年11月5年内在南充市中心医院接受肛肠疾病手术治疗的患者200例,将着200例患者按照随机抽签法分为对照组和观察组,各100例患者,对照组采用医院常规护理,观察组采用中药坐浴配合微波理疗护理,对比两组患者的疗效。结果:采用中药坐浴配合微波理疗护理的观察组总有效率在97%,显著高于对照组的78%,治疗效果具有明显治疗优势。差异具有统计学意义(P<0.05),结论:中药坐浴配合微波理疗护理可以提高患者的术后治疗效果,有助于患者恢复,具有临床推广价值。

关键词： 健康教育   肛肠疾病   护理   应用  

摘要： 探究健康教育路径在肛肠疾病护理中的应用。方法:选取我院2019年上半年肛肠科收治的患者100人,分组,对照组患者采用的是常规的护理方法,实验组患者采用的是健康教育路径的护理模式,需要记录两组患者对于疾病知识的掌握程度以及对于实验的满意度。结果:实验组患者对于知识的掌握程度要好于对照组,实验组患者对于本次的健康教育感到非常满意,数据分析结果显示P<0.05,实验有意义。结论:采取必要的健康教育,对肛肠疾病有很好的治疗效果,值得临床推广。

关键词： 肛肠疾病术   肛肠疾病术   效果  

摘要： 探讨肛肠疾病术后换药时配合心理护理的效果,方法:本次研究选取南充市中心医院2017年12月-2020年12月近三年内接受肛肠疾病术后换药患者150例为研究对象,将这150例患者采用随机抽签法,分为对照组和观察组,两组各75例患者,对照组采用医院常规护理,观察组采用心理护理,本次研究对象150例患者均对本研究知情同意,基本资料无差异性,对比两组患者的术后换药效果、护理满意度、不良情绪发生率数据差异。结果对比两组患者换药时VAS评分对比,发现观察组患者分值明显低于对照组,P<0.05为差异有统计学意义。观察组患者的不良情绪发生率在焦虑、紧张、恐慌指标上的发生率明显低于对照组,两组数据对比,P<0.05为差异有统计学意义。观察组患者在术后换药护理中,满意程度达到了95%,明显优于采用常规护理的对照组,在非常满意指标上,观察组患者的30%,也明显高于对照组的15%。两组数据对比,P<0.05为差异有统计学意义。结论:肛肠疾病术后换药时配合心理护理能够提高患者换药效果,缓解患者术后负面情绪,提高患者护理满意度。值得在临床大力推广。

关键词： inflammatory bowel disease   biologics   multi-omics   microbiome   Crohn's disease   infliximab   vedolizumab   metabolomics   proteomics   remission  

摘要： The intestinal microbiome is a key determinant of responses to biologic therapy in inflammatory bowel disease (IBD). However, diverse therapeutics and variable responses among IBD patients have posed challenges in predicting clinical therapeutic success, In this prospective study, we profiled baseline stool and blood in patients with moderate-to-severe Crohn's disease or ulcerative colitis initiating anti-cytokine therapy (anti-TNF or -IL12/23) or anti-integrin therapy. Patients were assessed at 14 weeks for clinical remission and 52 weeks for clinical and endoscopic remission. Baseline microbial richness indicated preferential responses to anti-cytokine therapy and correlated with the abundance of microbial species capable of 7 alpha/beta-dehydroxylation of primary to secondary bile acids. Serum signatures of immune proteins reflecting microbial diversity identified patients more likely to achieve remission with anti-cytokine therapy. Remission-associated multi-omic profiles were unique to each therapeutic class. These profiles may facilitate a priori determination of optimal therapeutics for patients and serve as targets for newer therapies.

摘要： Inflammatory bowel disease (IBD) is a group of immune-mediated conditions. Immune activity is varied by age and gender. The present study is aimed at investigating the effect of age and gender on the positive rates of anti-Saccharomyces cerevisiae antibodies (ASCA), anti-neutrophil cytoplasmic antibodies (ANCA), anti-intestinal goblet cell antibodies (GAB), and antibodies to exocrine pancreas (PAB) in IBD patients. A total of 1871 hospitalized patients with confirmed IBD were included in this study. Sera were obtained from each subject for antibody measurement by indirect immunofluorescence assay. The positive rates of ANCA IgG and IgA were higher in female patients than those in male patients (P < 0.001) while the positive rate of PAB IgG was just reversed (P < 0.001). Moreover, the median ages of patients with positive ANCA IgG and IgA were higher than patients with negative antibodies (P = 0.0019 and P = 0.0110, respectively), while the median ages of patients with positive PAB IgG and IgA were significantly lower than patients with negative PAB (P < 0.0001). The serum levels of ANCA IgG and IgA were potentiated in old female patients, while serum PAB IgG was easy to be detected in the young male patients with IBD.

关键词： Steroidal compounds   NF-kappa B signaling   DSS-Induced mouse colitis   Anti-inflammatory bowel diseases  

摘要： A series of steroidal compounds based on 3-hydroxyandrosta-5,7-diene-17-carboxylic acid core structure were designed, synthesized and bio-evaluated for their anti-inflammatory potency. Among them, compound 5c, 6f, and 6q effectively inhibited the production of nitric oxide (NO) in lipopolysaccharide (LPS) stimulated RAW 264.7 macrophages. They inhibited the expression of inducible NO synthase (iNOS) and prostaglandin synthase-2 (COX-2) at mRNA level. Compound 6q displayed inhibitory effects on both iNOS and COX-2 expression in a concentration-dependent manner. Furthermore, 6q was found to effectively decrease the mRNA and protein levels of interleukin 6 (IL-6). Mechanically, 6q could potently downregulate NF-kappa B signaling via suppression of the Akt/PI3K pathway. Moreover, 6q demonstrated high in vivo anti-inflammatory activities in a mouse colitis model induced by dextran sulfate sodium (DSS). Taken together, these data indicate that 6q represents a novel and promising anti-inflammatory bowel diseases (IBD) agent worthy of further investigation. (C) 2021 Elsevier Masson SAS. All rights reserved.

关键词： 中药熏洗   肛肠疾病   中医特色   肛周脓肿   肛肠术后   外治法   肛瘘   肛裂  

摘要： 手术是治疗痔疮、肛周脓肿、肛裂、肛瘘等肛肠疾病的常用手段,其对于缓解病情、控制疾病发展有着重要的意义[1]。肛肠组织神经末梢丰富,结构及功能具有一定的特殊性,肛肠术后容易出现水肿、渗血等,患者多伴随疼痛,一方面影响术后愈合,另一方面增加了患者身心痛苦,降低了患者生活质量。因此寻找一种能够缓解肛肠术后疼痛的方法尤为重要。中药熏洗作为中医特色外治法之一,在肛肠疾病的治疗上具有疗效显著、不良反应少的优势[2]。笔者采用中药熏洗联合针刺痔疮穴方案用于肛肠疾病术后患者治疗,现总结如下。

关键词： 肠道菌群   肠易激综合征   炎症性肠病   结直肠癌   靶向菌群疗法  

摘要： 近年来,越来越多的疾病被发现与肠道菌群失调相关,特别是近5年来一些颠覆性的发现使得肠道菌群成为健康、疾病领域的热点问题.作为机体生物过程的重要协调者以及多种疾病发生发展过程中的共同参与者,加之其组成和功能的可塑性,肠道菌群逐渐成为一个极富吸引力的预防和治疗疾病的靶标而引起研究者的高度重视.本文就肠道菌群与肠易激综合征、IBD和结直肠癌的关系进行了整理,并介绍了在胃肠病中以肠道菌群为靶向的治疗策略的现状,以期为靶向肠道菌群治疗策略的应用提供借鉴.

关键词： 儿童   功能性胃肠病   流行病学   门诊  

摘要： 目的了解儿科消化门诊功能性胃肠疾病(FGIDs)的诊疗现状,加深对儿童FGIDs的认知。方法应用儿童FGIDs ROMEⅣ标准对2016年6月至2019年12月在重庆医科大学附属儿童医院消化门诊就诊的0~18岁患者的临床资料进行回顾性分析。结果儿科消化门诊共纳入11810例患者,FGIDs患者2788例(23.61%),婴/幼儿组FGIDs比例为19.48%(1664/8541),儿童/青少年组FGIDs比例为34.38%(1124/3269),儿童/青少年FGIDs比例明显高于婴/幼儿FGIDs(χ^(2)=291.08,P<0.01);而在婴/幼儿(χ^(2)=24.19)、儿童/青少年(χ^(2)=12.64)及消化门诊全体患者(χ^(2)=28.86)中均发现女性FGIDs比例较男性高(P<0.01)。婴/幼儿FGIDs中最常见的为功能性便秘(49.04%);其次为婴儿排便困难(22.96%)、婴儿反流(14.00%)、功能性腹泻(10.76%)、婴儿腹绞痛(2.58%);而周期性呕吐(0.48%)、反刍综合征(0.18%)则少见。儿童/青少年FGIDs最常见的为功能性消化不良(58.98%),其次为功能性便秘(21.17%)、肠易激综合征(9.25%)、功能性恶心/呕吐(6.05%)、周期性呕吐(1.78%)、功能性腹痛(非特指,1.51%),而吞气症(0.45%)、反刍综合征(0.09%)、腹型偏头痛(0.35%)、非潴留性大便失禁(0.35%)则少见。在婴/幼儿FGIDs中,56例(3.37%,56/1664)患者有疾病重叠现象,主要为婴儿反胃(G1)、婴儿腹绞痛(G4)及婴儿排便困难(G7);儿童/青少年FGIDs中,78例(6.93%,78/1124)患者有共病现象,主要为周期性呕吐综合征、功能性恶心/呕吐、功能性消化不良、腹型偏头痛、功能性便秘。结论儿科消化门诊中,约1/4的患者实为FGIDs,儿童/青少年FGIDs更为常见。部分FGIDs具年龄、性别相关性,且存在FGIDs的重叠现象。临床医师应当重视儿童FGIDs的诊治,避免误诊误治及过度医疗。