生长抑素对溃疡性结肠炎患者炎症反应及氧化应激的调节作用

目的探讨生长抑素对溃疡性结肠炎(UC)患者炎症因子和氧化应激的改善作用。方法收集2019年1-12月法库县卫生健康服务中心收治的活动期UC患者40例,随机分为对照组和观察组各20例。对照组采用常规治疗方案,观察组在其基础上加用生长抑素,0.1mg/次,1次/8h,两组均治疗14d。比较两组治疗后炎症水平和氧化应激状态改善情况。结果两组治疗后各炎症和氧化应激指标差异均有统计学意义(P<0.05)。结论生长抑素能够进一.步改善活动期UC患者的炎症和氧化应激水平,值得推荐使用。     

超氧化物歧化酶对大鼠乙酸性结肠炎粘膜的保护作用

本文观察了超氧化物歧化酶（ＳＯＤ）对大鼠乙酸性结肠炎的粘膜保护作用。与生理盐水组对照，预防性静脉给予１万Ｕ ＳＯＤ能显著降低粘膜损伤指数以及肠粘连和狭窄的发生率。但是，腹腔注射与灌肠相同剂量的ＳＯＤ与各自生理盐水对照组比较，并无显著差别。ＳＯＤ的粘膜保护作用呈剂量效应。测定结肠粘膜ＳＯＤ、谷胱甘肽过氧化物酶、髓化氧化物酶活性以及过氧化脂质含量，提示ＳＯＤ的保护作用机理是减少炎症过程中的氧自由基。     

武汉市603例炎症性肠病并发症的临床调查

目的:分析武汉市炎症性肠病(IBD)并发症的临床特点,探讨其与病变程度、范围及治疗方式的关系。方法:回顾性收集1990-2005年武汉市5家医院经结肠镜及病理诊断为IBD病例共603例,其中溃疡性结肠炎(UC)521例,克罗恩病(CD)82例,分别观察各种并发症的发生频率及并发症与其他因素的关系。UC与CD间的差异及相关分析用χ2检验。结果:521例UC中,并发症34例(6.5%),82例CD中,并发症40例(48.8%)。重度UC和全结肠炎患者中并发症的发生率显著高于非重度和远端结肠炎患者(分别25.8%比3.9%,12.8%比4.9%,P<0.01)。有并发症的CD患者的手术史发生率显著高于无并发症患者(57.5%比14.3%,P<0.01),但CD病变范围与并发症的发生无相关性(P>0.05)。结论:CD并发症的发生率高于UC。UC的并发症与疾病病变程度和范围有关,而CD与手术方式有关。     

Colitis Cystica Profunda Simulating Rectal Carcinoma

Localized colitis cystica profunda is a rare, benign disease of the lower gastro-intestinal tract, usually presenting as a rectal mass and characterized microscopically by the presence of mucus-filled cysts in the submucosa. Knowledge of this particular pathological entity is important as it can mimic a well differentiated adenocarcinoma of the rectum and therefore could lead to unnecessary surgical resection. We present a case of colitis cystica profunda misdiagnosed as adenocarcinoma based on their similar clinical picture and histological features.     

Infliximab trough levels and persistent vs transient antibodies measured early after induction predict long-term clinical remission in patients with inflammatory bowel disease

BackgroundThe use of therapeutic drug monitoring has been proposed as a useful tool in the management of patients with loss of response to biological therapy in patients with inflammatory bowel disease.AimsTo evaluate whether early, post-induction anti-tumor necrosis factor trough levels and the presence of different types of anti-drug antibodies may impact long-term clinical remission in patients with inflammatory bowel disease.MethodsWe prospectively assessed anti-tumor necrosis factor trough levels and both persistent and transient anti-drug antibodies. The Harvey–Bradshaw Index and the partial Mayo score were evaluated at each visit or in case of relapse.ResultsAt week 14, median infliximab trough levels were significantly lower in patients who experienced loss of response at week 48 as compared to patients in stable remission (1.3 mcg/mL [range 0–10.2 mcg/mL] vs. 10.1 mcg/mL[range 0–42.8 mcg/mL], P < 0.0004). ROC curve identified an infliximab trough levels of 6.2 mcg/mL as the cut-off value with the highest accuracy (c-index = 0.864) for loss of response at week 48. At week 14 we observed a correlation between anti-drug antibodies concentration and infliximab trough levels (r_s = −0.513, P = 0.04).ConclusionsThe results highlight the usefulness of assessing early biological TL in order to predict patients’ long-term outcome.     

56例缺血性结肠炎临床回顾分析

目的 探讨缺血性结肠炎的临床特点、内镜特征及诊断和治疗方法.方法 对56例缺血性结肠炎患者的临床资料进行回顾性分析.结果 缺血性结肠炎多发生于老年患者,男女比例为1∶1.8.多伴有糖尿病（53.6％,30/56）、高血压（39.3％,22/56）、冠心病（32.1％,18/56）等基础疾病.腹痛（100.0％,56/56）及便血（89.3％,50/56）为主要临床表现.结肠镜检查以黏膜充血、水肿、糜烂、溃疡等非特异性表现为主,病变主要见于左半结肠,呈节段性分布.多数患者预后良好.结论 老年患者出现急性腹痛和便血时应警惕缺血性结肠炎可能,早期结肠镜检查可及时明确诊断和指导治疗.     

Comparison of Flow Cytometry and Histology with Mutational Screening for p53 and Ki-ras Mutations in Surveillance of Patients with Long-standing Ulcerative Colitis

Background: We evaluate the usefulness of screening for p53 and Ki-ras mutations in comparison with histological and flow cytometric findings. Methods: We analyzed 1486 biopsy samples from 769 locations of 83 patients with long-standing ulcerative colitis enrolled in a surveillance program by means of histology, flow cytometry and SSCP analysis. As a control we used 66 biopsy samples of 16 patients with irritable bowel disease. Results: With respect to all biopsy samples analyzed, DNA aneuploidy was found in 32.5% (27/83) of patients, dysplasia in 22.9% (15/83), p53 in 21.7% (18/83) and Ki-ras mutations in 18.1% (15/83) of patients. None of these markers was found in our control group. In 7 out of 10 patients who displayed dysplastic findings during endoscopic surveillance p53 and / or Ki-ras mutations were present in at least one colonoscopy. Statistically significant associations were observed between dysplasia and DNA aneuploidy ( P < 0.001), between dysplasia and p53 mutations ( P = 0.05) and between dysplasia and p53 and/or Ki-ras mutations ( P = 0.002). No significant associations were found between dysplasia and Ki-ras mutations alone. The results for the SSCP analysis showed a much broader variation than those for the flow cytometric analysis. Conclusions: These results show that screening for p53 and Ki-ras mutations can be a useful adjunct in surveillance of patients with longstanding ulcerative colitis.