关键词： 肛肠疾病   肛肠专科   诊疗方案   医师协会   痔病   湖南省长沙市   中医药   诊疗新技术  

摘要： 各位专家、同仁:为更好地继承和发扬祖国中医药肛肠学科的特色和优势,规范肛肠疾病诊疗方案,推进肛肠疾病诊疗新技术普及,加强中医药人才队伍建设,提高肛肠专科医师的能力和水平,促进肛肠专业可持续发展。由湖南省女医师协会肛肠疾病防治专业委员会、南华大学第一附属医院、《结直肠肛门外科》杂志联合主办的省级中医药继续教育项目“湘中医联盟肛肠疾病高峰论坛”(项目编号:Q21270212108),将于2021年7月16—18日在湖南省长沙市隆重召开。

关键词： 胃肠超声造影   诊断   胃十二指肠   价值  

摘要： 目的:探讨胃十二指肠疾病应用胃肠超声造影诊断的价值。方法:选取84例某院在2018年7月~2019年7月期间收治的胃十二指肠疾病患者作为研究对象,根据诊断方法将84例患者平均分为对照组和研究组各42例,胃镜检查患者为对照组,胃肠超声造影检查患者为研究组,以病理诊断为准,对比研究组与对照组胃十二指肠良性病变检查结果与胃十二指肠恶性病变检查结果。结果:研究组患者应用胃肠超声造影检查,可以清晰显示病变位置以及病变周围情况,胃十二指肠良性病变检查结果与对照组患者相比无显著差异(P>0.05);研究组患者胃十二指肠恶性病变检查结果与对照组相比差异无统计学意义(P>0.05);研究组患者检查结果与病理学检查结果无显著差异(P>0.05)。结论:胃十二指肠患者应用胃肠超声造影检查具有显著效果,可以有效提高诊断准确率,可为患者治疗提供可靠依据。

关键词： Mesalamine   Coumarin   Inflammatory bowel diseases   Molecular docking   Molecular dynamic studies  

摘要： Inflammatory bowel diseases (IBD) are continuous idiopathic inflammation of GIT. Ulcerative colitis, inflammation of the colonic or rectal mucosa has no known medical cure and its treatment is aimed at reducing the signs and symptoms associated with the disorders, induction and maintenance of remission. In this study, we have reported the synthesis of mesalamine and coumarin linked together by a diazo group. The compound was characterized by various spectroscopic methods. Therapeutic potential of the synthesized compound was investigated through acetic acid induced ulcerative rat model. Pharmacokinetic properties were predicted for the compounds by ADMET related descriptors. Molecular docking studies were conducted with four proteins (COX-2, MMP-9, TNF-? and MPO) to examine the interaction of mesalamine (MS) and mesalamine coumarin derivative (MS-CU). Moreover, molecular dynamic simulations were carried out to study the dynamics and stability of the complexes in solvent system. The binding energy of MS-CU with MPO, COX-2, MMP-9 and TNF-? was found to be -9.5, -10.4, -9.2 and -8.4 kcal/mol respectively. MS-CU exhibited higher binding affinity towards all tested proteins than MS. Molecular dynamic simulation reveals that both MS and MS-CU formed a stable complex with all test proteins in aqueous system. Overall binding energy of MS-CU was more than MS showing stronger affinity towards the test portions. In conclusion, Mesalamine-coumarin derivative reduces colonic damage in acetic acid induced ulcerative colitis in rat model, and therefore may prove to be effective in the management of IBD.

摘要： LINKED CONTENT This article is linked to El-Matary et al papers. To view these articles, visit and

关键词： children   inflammatory bowel disease   sarcopenia  

摘要： Objectives: Inflammatory bowel disease (IBD) has a high impact on nutritional status. Sarcopenia is related to higher risk of surgery and rescue therapy in adults with IBD;however, comparable data in pediatric populations are scarce. We evaluated muscle mass as a predictor of disease outcome in pediatric IBD. Methods: All pediatric IBD patients who underwent magnetic resonance enterography (MRE) during 2008 to 2019 were included. Muscle mass was assessed by measuring the area of the psoas muscle at the upper level of L3 on MRE. The psoas area divided by the body surface area (BSA) yielded the psoas index. Clinical and radiological data, including disease location, activity, course, and medications were documented. The control group included non-IBD children who underwent an MR imaging study. Results: We enrolled 101 IBD patients, 69 (68.3%) with Crohn disease (CD) and 32 (31.7%) with ulcerative colitis (UC) (mean age 15.03 +/- 3.27 years). The psoas index was significantly lower in the IBD patients compared with the 87 controls (326 vs 528, respectively, P < 0.001). Patients with a psoas index in the lowest quartile had significantly higher risk for biologic therapy (multivariate analysis, hazard ratio [HR] = 12.1, P = 0.046) and disease exacerbation (HR = 9, P = 0.047) independently of body mass index, compared with patients with a psoas index in the uppermost quartile. Conclusions: Sarcopenia correlates with the radiological severity of pediatric IBD and serves as a predictor for adverse clinical disease outcome. Muscle mass measurement in MRE studies may serve as a possible marker for disease outcome in this population.

关键词： CD   IBD   ICI   UC  

摘要： The etiology of inflammatory bowel disease (IBD) has yet to be fully understood; however, it is thought to be a result of genetic, immunologic, and environmental factors, including changes in the gut microbiome.1,2 Immune checkpoint inhibitors (ICI) have revolutionized treatment of advanced cancer. They activate the immune system by promoting cytotoxic T-cell survival and antitumor effects. A total of 7 ICIs currently are approved by the United States Food and Drug Administration, and target cytotoxic T lymphocyte–associated protein 4 (ipilimumab); anti–programmed cell death 1 (PD-1) (nivolumab, pembrolizumab, and cemiplimab), or anti–PD-ligand 1 (atezolizumab, durvalumab, and avelumab). However, by activating the immune system, these medications also can lead to off-target inflammation and autoimmunity, including ICI-induced colitis, which has been reported in up to 13.6% of patients.3

关键词： Crohn's Disease   Ulcerative colitis   Thiopurines   Calcineurin inhibitors   Biologics   Combination therapy  

摘要： Background: Combining immunosuppressors has been proposed as a strategy to enhance treatment efficacy in Inflammatory Bowel Disease (IBD). Aim: To summarize current evidence on combinations of targeted therapies with traditional immunosuppressors or with other targeted therapies. Methods: A literature search on PubMed and Medline databases was performed to identify relevant articles. Results: Current evidence supports that the combination of infliximab and thiopurines is more effective than monotherapy with both agents in inducing remission in Crohn's Disease and Ulcerative colitis. Data on other combinations of other biologics and traditional immunosuppressors is lacking or show conflicting results. Vedolizumab seems a potentially effective maintenance regimen after calcineurin inhibitors-based rescue therapy in acute severe ulcerative colitis, as an alternative to thiopurines. Dual Targeted Therapy, which is the combination of 2 targeted therapies, might be a reasonable choice in patients with concomitant IBD and extraintestinal manifestations, or in patients with medical-refractory IBD who lack valid alternatives. Combinations with thiopurines are associated with an increased risk of infections and lymphoma. Data on other combinations is scarcer, but no specific safety issue has emerged so far. Conclusions: Combination therapies seem to be effective in selected patients, with an overall acceptable safety profile.

关键词： Crohn's disease   CT-P13   Infliximab   Subcutaneous   Ulcerative Colitis  

摘要： BACKGROUND & AIMS: This study compared pharmacokinetics, symptomatic and endoscopic efficacy, safety, and immunogenicity of a subcutaneous formulation of the infliximab biosimilar CT-P13 (CT-P13 SC) vs intravenous CT-P13 (CT-P13 IV) in patients with inflammatory bowel disease (IBD). METHODS: This randomized, multicenter, open-label, parallel-group, phase 1 study enrolled tumor necrosis factor inhibitor-naive patients with active ulcerative colitis (total Mayo score 6-12 points with endoscopic subscore >2) or Crohn's disease (Crohn's Disease Activity Index 220-450 points) at 50 centers. After CT-P13 IV induction at Week (W) 0/ W2, patients were randomized (1:1) to receive CT-P13 SC every 2 weeks (q2w) from W6 to W54 or CT-P13 IV every 8 weeks from W6 to W22. At W30, all patients receiving CT-P13 IV switched to CT-P13 SC q2w until W54. The primary endpoint was noninferiority of CT-P13 SC to CT-P13 IV for observed predose CT-P13 concentration at W22 (Ctrough,W22), concluded if the lower bound of the 2-sided 90% confidence interval (CI) for the ratio of geometric least-squares means exceeded 80%. RESULTS: Overall, 66 and 65 patients were randomized to CT-P13 SC and CT-P13 IV, respectively. The primary endpoint of noninferiority was met with a geometric least-squares means ratio for Ctrough, W22 of 1154.17% (90% CI 786.37-1694.00;n = 59 [CT-P13 SC];n = 57 [CT-P13 IV]). W30/W54 clinical remission rates were comparable between arms. Other efficacy, safety, and immunogenicity assessments were also broadly comparable between arms, including after switching. CONCLUSIONS: The pharmacokinetic noninferiority of CT-P13 SC to CT-P13 IV, and the comparable efficacy, safety, and immunogenicity profiles, support the potential suitability of CTP13 SC treatment in IBD.

关键词： Inflammatory Bowel Disease   Extraintestinal Cancer   Crohn's Disease   Ulcerative Colitis   Population-Based  

摘要： BACKGROUND & AIMS: Patients with Crohn's disease (CD) and ulcerative colitis (UC) are at increased risk of developing intestinal cancer. However, less is known about the risk of extraintestinal cancers (EICs). The aim of this study was to conduct a systematic review and meta-analysis of population-based cohorts assessing the risk of EICs in inflammatory bowel disease (IBD) patients. METHODS: Only population-based studies reporting on the prevalence or incidence of EICs were included. In total, 884 studies were screened and those included were assessed for quality. Eligible studies were pooled for length of follow-up evaluation, events in the IBD population, and events or expected events in a control population for the meta-analyses. RESULTS: In total, 40 studies were included in the systematic review and 15 studies were included in the meta-analysis. The overall risk of EICs was found to be increased in both CD (incidence rate ratio [IRR]: 1.43 [CI, 1.26, 1.63]) and UC (IRR: 1.15 [1.02, 1.31]) patients. Both CD and UC patients presented with an increased risk of skin (IRR: CD, 2.22 [1.41-3.48];UC, 1.38 [1.12-1.71]) and hepatobiliary (IRR: CD, 2.31 [1.25-4.28];UC, 2.05 [1.52-2.76]) malignancies. Furthermore, CD patients showed an increased risk of hematologic (IRR, 2.40 [1.81-3.18]) and lung (IRR, 1.53 [1.23-1.91]) cancers. These increased risks were present despite treatment with immunosuppressives. CONCLUSIONS: This systematic review and meta-analysis shows that both CD and UC patients are at an increased risk of developing EICs, both overall and at specific sites. However, additional studies with longer follow-up evaluation are needed to assess the true risk of EICs posed by IBD.