期刊文献+
共找到8,889篇文章
< 1 2 250 >
每页显示 20 50 100
Preoperative bowel preparation does not favor the management of colorectal anastomotic leak 预览
1
作者 Konstantinos A Zorbas Daohai Yu +2 位作者 Aruj Choudhry Howard M Ross Matthew Philp 《世界胃肠外科杂志:英文版(电子版)》 2019年第4期218-228,共11页
BACKGROUND Controversy exists regarding the impact of preoperative bowel preparation on patients undergoing colorectal surgery. This is due to previous research studies, which fail to demonstrate protective effects of... BACKGROUND Controversy exists regarding the impact of preoperative bowel preparation on patients undergoing colorectal surgery. This is due to previous research studies, which fail to demonstrate protective effects of mechanical bowel preparation against postoperative complications. However, in recent studies, combination therapy with oral antibiotics (OAB) and mechanical bowel preparation seems to be beneficial for patients undergoing an elective colorectal operation. AIM To determine the association between preoperative bowel preparation and postoperative anastomotic leak management (surgical vs non-surgical). METHODS Patients with anastomotic leak after colorectal surgery were identified from the 2013 and 2014 Colectomy Targeted American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database and were employed for analysis. Every patient was assigned to one of three following groups based on the type of preoperative bowel preparation: first groupmechanical bowel preparation in combination with OAB, second groupmechanical bowel preparation alone, and third group-no preparation. RESULTS A total of 652 patients had anastomotic leak after a colectomy from January 1, 2013 through December 31, 2014. Baseline characteristics were assessed andfound that there were no statistically significant differences between the three groups in terms of age, gender, race, American Society of Anesthesiologists score, and other preoperative characteristics. A χ2 test of homogeneity was conducted and there was no statistically/clinically significant difference between the three categories of bowel preparation in terms of reoperation. CONCLUSION The implementation of mechanical bowel preparation and antibiotic use in patients who are going to undergo a colon resection does not influence the treatment of any possible anastomotic leakage. 展开更多
关键词 PREOPERATIVE BOWEL PREPARATION PREOPERATIVE mechanical BOWEL PREPARATION PREOPERATIVE oral antibiotics COLORECTAL anastomotic LEAK Anastomotic LEAK BOWEL PREPARATION COLORECTAL surgery National Surgical Quality Improvement Program
在线阅读 免费下载
Understanding the importance of autophagy in human diseases using Drosophila
2
作者 Arindam Bhattachaijee Aron Szabo +2 位作者 Tamas Csizmadia Hajnalka Laczko-Dobos Gabor Juhasz 《遗传学报:英文版》 SCIE CAS CSCD 2019年第4期157-169,共13页
Autophagy is a lysosome-dependent intracellular degradation pathway that has been implicated in the pathogenesis of various human diseases, either positively or negatively impacting disease outcomes depending on the s... Autophagy is a lysosome-dependent intracellular degradation pathway that has been implicated in the pathogenesis of various human diseases, either positively or negatively impacting disease outcomes depending on the specific context. The majority of medical conditions including cancer, neurodegenerative diseases, infections and immune system disorders and inflammatory bowel disease could probably benefit from therapeutic modulation of the autophagy machinery. Drosophila represents an excellent model animal to study disease mechanisms thanks to its sophisticated genetic toolkit, and the conservation of human disease genes and autophagic processes. Here, we provide an overview of the various autophagy pathways observed both in flies and human cells(macroautophagy, microautophagy and chaperone-mediated autophagy), and discuss Drosophila models of the above-mentioned diseases where fly research has already helped to understand how defects in autophagy genes and pathways contribute to the relevant pathomechanisms. 展开更多
关键词 DROSOPHILA NEURODEGENERATION Alzheimer’s DISEASE Parkinson’s DISEASE Cancer Inflammatory bowel DISEASE AUTOPHAGY
Functional gastrointestinal disorders and gut-brain axis:What does the future hold? 预览
3
作者 Kashif Mukhtar Hasham Nawaz Shahab Abid 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第5期552-566,共15页
Despite their high prevalence,lack of understanding of the exact pathophysiology of the functional gastrointestinal disorders has restricted us to symptomatic diagnostic tools and therapies.Complex mechanisms underlyi... Despite their high prevalence,lack of understanding of the exact pathophysiology of the functional gastrointestinal disorders has restricted us to symptomatic diagnostic tools and therapies.Complex mechanisms underlying the disturbances in the bidirectional communication between the gastrointestinal tract and the brain have a vital role in the pathogenesis and are key to our understanding of the disease phenomenon.Although we have come a long way in our understanding of these complex disorders with the help of studies on animals especially rodents,there need to be more studies in humans,especially to identify the therapeutic targets.This review study looks at the anatomical features of the gut-brain axis in order to discuss the different factors and underlying molecular mechanisms that may have a role in the pathogenesis of functional gastrointestinal disorders.These molecules and their receptors can be targeted in future for further studies and possible therapeutic interventions.The article also discusses the potential role of artificial intelligence and machine learning and its possible role in our understanding of these scientifically challenging disorders. 展开更多
关键词 Functional gastrointestinal disorders IDIOPATHIC bowel syndrome Gut-brain AXIS Microbiome-gut-brain AXIS Machine learning Artificial intelligence
在线阅读 免费下载
Fatigue in children and adolescents with inflammatory bowel disease 预览
4
作者 Els Van de Vijver Ann Van Gils +3 位作者 Laura Beckers Yannick Van Driessche Nicolette Dorien Moes Patrick Ferry van Rheenen 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第5期632-643,共12页
AIM To identify factors other than active disease and anemia that contribute to fatigue in pediatric inflammatory bowel disease(IBD).METHODS We performed an electronic search in Medline and EMBASE from their inception... AIM To identify factors other than active disease and anemia that contribute to fatigue in pediatric inflammatory bowel disease(IBD).METHODS We performed an electronic search in Medline and EMBASE from their inception to May 2017 using the search term"fatigue"or the related keywords"physical impairment"and"inflammatory bowel disease"with the filter"child"(age 0-18 years).Cross-sectional and case-control studies were included.We restricted our search to studies published in English.We used the PRISMA checklist and flow diagram.Duplicate articles were manually deleted in End Note.To identify further relevant studies,we checked the reference lists of the selected articles.RESULTS We identified 149 papers,of which 19 were retrieved for full text review.Eleven studies were subsequently excluded because fatigue was not evaluated as an outcome measure.Eight papers focused on the desired topic and were discussed in the final analysis.A lack of uniformity of outcome measures made the pooling of data impossible.In all but one study,questionnaires were used to evaluate fatigue.In the remaining study,an accelerometer was used to measure daily activities,sleeping time and their relationships with fatigue in a more quantifiable manner.Adolescents with IBD are significantly more fatigued than healthy controls.In addition to active disease,increased anxiety or depression and disturbed family relationships were frequently reported predictors of fatigue.Quantitative measurement of physical activity in patients with Crohn's disease showed a reduction in the number of steps per day,and patients with ulcerative colitis had a shorter duration of physical activity during the day.CONCLUSION Fatigue in pediatric IBD is related to a combination of biological,functional and behavioral factors,which should all be taken into account when managing fatigue. 展开更多
关键词 Adolescents Children FATIGUE INFLAMMATORY BOWEL disease PHYSICAL IMPAIRMENT SLEEP
在线阅读 免费下载
Personalized medicine in functional gastrointestinal disorders:Understanding pathogenesis to increase diagnostic and treatment efficacy 预览
5
作者 Xiao Jing Wang Michael Camilleri 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第10期1185-1196,共12页
There is overwhelming evidence that functional gastrointestinal disorders(FGIDs) are associated with specific mechanisms that constitute important targets for personalized treatment. There are specific mechanisms in p... There is overwhelming evidence that functional gastrointestinal disorders(FGIDs) are associated with specific mechanisms that constitute important targets for personalized treatment. There are specific mechanisms in patients presenting with functional upper gastrointestinal symptoms(UGI Sx). Among patients with UGI Sx, approximately equal proportions(25%) of patients have delayed gastric emptying(GE), reduced gastric accommodation(GA), both impaired GE and GA,or neither, presumably due to increased gastric or duodenal sensitivity.Treatments targeted to the underlying pathophysiology utilize prokinetics,gastric relaxants, or central neuromodulators. Similarly, specific mechanisms in patients presenting with functional lower gastrointestinal symptoms, especially with diarrhea or constipation, are recognized, including at least 30% of patients with functional constipation pelvic floor dyssynergia and 5% has colonic inertia(with neural or interstitial cells of Cajal loss in myenteric plexus);25% of patients with diarrhea-predominant irritable bowel syndrome(IBSD) has evidence of bile acid diarrhea;and, depending on ethnicity, a varying proportion of patients has disaccharidase deficiency, and less often sucrose-isomaltase deficiency. Among patients with predominant pain or bloating, the role of fermentable oligosaccharides, disaccharides, monosaccharides and polyols should be considered. Personalization is applied through pharmacogenomics related to drug pharmacokinetics, specifically the role of CYP2 D6, 2 C19 and 3 A4 in the use of drugs for treatment of patients with FGIDs. Single mutations or multiple genetic variants are relatively rare, with limited impact to date on the understanding or treatment of FGIDs. The role of mucosal gene expression in FGIDs, particularly in IBS-D, is the subject of ongoing research. In summary, the time for personalization of FGIDs, based on deep phenotyping, is here;pharmacogenomics is relevant in the use of central neuromodulators. There is still unclear impact of the role of genet 展开更多
关键词 Gastrointestinal symptoms GASTRIC EMPTYING GASTRIC accommodation DIARRHEA CONSTIPATION Irritable bowel syndrome Bile acid DIARRHEA Phenotypes PHARMACOGENOMICS PROKINETICS Neuromodulators
在线阅读 免费下载
Higher dose of simethicone decreases colonic bubbles and increases prep tolerance and quality of bowel prep: Meta-analysis of randomized controlled trials 预览
6
作者 Mohammad F Madhoun Maham Hayat Ijlal Akbar Ali 《世界荟萃分析杂志》 2019年第3期110-119,共10页
BACKGROUND Antifoaming agents, such as simethicone, may facilitate mucosal inspection during colonoscopy. However, conflicting results have been reported with regard to the impact of simethicone on quality of bowel pr... BACKGROUND Antifoaming agents, such as simethicone, may facilitate mucosal inspection during colonoscopy. However, conflicting results have been reported with regard to the impact of simethicone on quality of bowel preparation and adenoma detection rate (ADR). AIM To perform a meta-analysis of trials that have compared simethicone vs placebo during colonoscopy. METHODS A reproducible literature search of multiple medical databases yielded eleven studies (n = 2605) for inclusion. Studies were compared for quality of bowel preparation, bubbles quality, ADR, and tolerability. Two reviewers independently scored the identified studies for methodology and abstracted pertinent data. Pooling was conducted by both fixed-effects and random-effects models. Relative risk (RR) estimates with a 95% confidence interval (CI) were calculated. Heterogeneity was assessed by I-squared index (I2) statistics. RESULTS Patients’ demographic characteristics were comparable in all studies. Of the 2605 patients, 1300 were in the simethicone group, whereas 1305 were in the placebo group. Inadequate bowel preparation was much lower in the simethicone group than in the placebo group [13% vs 24.6%;RR = 0.51 (0.31-0.82);P < 0.0001]. The placebo group was more likely to have significant colonic bubbles than was the simethicone group [35% vs 8%;RR = 1.49 (1.25-1.76);P = 0.0001]. Use of simethicone resulted in a slight, statistically significant increase in ADR compared with the placebo group [26.6% vs 21.6%, RR = 1.07 (1.01-1.13);P = 0.02]. Higher doses of simethicone (> 478 mg) were more likely to result in significant reduction of inadequate bowel preparation, colonic bubbles, and to improve ADR. CONCLUSION Adding simethicone improved the quality of bowel preparation, visualization, tolerability, and, eventually, ADR. 展开更多
关键词 SIMETHICONE Colonoscopy BUBBLES BOWEL preparation Adenoma detection rate
在线阅读 免费下载
Comparison of decompression tubes with metallic stents for the management of right-sided malignant colonic obstruction 预览
7
作者 Yoshiyuki Suzuki Konosuke Moritani +2 位作者 Yuki Seo Takayuki Takahashi 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第16期1975-1985,共11页
BACKGROUND Emergency surgical resection is a standard treatment for right-sided malignant colonic obstruction;however, the procedure is associated with high rates of mortality and morbidity. Although a bridge to surge... BACKGROUND Emergency surgical resection is a standard treatment for right-sided malignant colonic obstruction;however, the procedure is associated with high rates of mortality and morbidity. Although a bridge to surgery can be created to obviate the need for emergency surgery, its effects on long-term outcomes and the most practical management strategies for right-sided malignant colonic obstruction remain unclear. AIM To determine the appropriate management approach for right-sided malignant colonic obstruction. METHODS Forty patients with right-sided malignant colonic obstruction who underwent curative resection from January 2007 to April 2017 were included in the study. We compared the perioperative and long-term outcomes of patients who received bridges to surgery established using decompression tubes and those created using self-expandable metallic stents (SEMS). The primary outcome was the overall survival duration (OS) and the secondary endpoints were the diseasefree survival (DFS) duration and the preoperative and postoperative morbidity rates. Analysis was performed on an intention-to-treat basis. RESULTS There were 21 patients in the decompression tube group and 19 in the SEMS group. There were no significant differences in the perioperative morbidity rates of the two groups. The OS rate was significantly higher in the decompression tube group than in the SEMS group (5-year OS rate;decompression tube 79.5%, SEMS 32%, P = 0.043). Multivariate analysis revealed that the bridge to surgery using a decompression tube was significantly associated with the OS (hazard ratio, 17.41;P = 0.004). The 3-year DFS rate was significantly higher in the decompression tube group than in the SEMS group (68.9% vs 45.9%;log-rank test, P = 0.032). A propensity score–adjusted analysis also demonstrated that the prognosis was significantly better in the decompression tube group than in the SEMS group. CONCLUSION The bridge to surgery using trans-nasal and trans-anal decompression tubes for right-sided malignant colonic obstru 展开更多
关键词 Right-sided colon cancer Large bowel OBSTRUCTION Self-expandable metallic stent Trans-anal TUBE Trans-nasal TUBE
在线阅读 免费下载
Contribution of ghrelin to functional gastrointestinal disorders’pathogenesis 预览
8
作者 Tilemachos Koutouratsas Theodora Kalli +1 位作者 Georgios Karamanolis Maria Gazouli 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第5期539-551,共13页
Functional gastrointestinal disorders(FGID)are heterogeneous disorders with a variety of clinical manifestations,primarily defined by signs and symptoms rather than a definite underlying cause.Their pathophysiology re... Functional gastrointestinal disorders(FGID)are heterogeneous disorders with a variety of clinical manifestations,primarily defined by signs and symptoms rather than a definite underlying cause.Their pathophysiology remains obscure and,although it is expected to differ according to the specific FGID,disruptions in the brain-gut axis are now thought to be a common denominator in their pathogenesis.The hormone ghrelin is an important component of this axis,exerting a wide repertoire of physiological actions,including regulation of gastrointestinal motility and protection of mucosal tissue.Ghrelin’s gene shows genetic polymorphism,while its protein product undergoes complex regulation and metabolism in the human body.Numerous studies have studied ghrelin’s relation to the emergence of FGIDs,its potential value as an index of disease severity and as a predictive marker for symptom relief during attempted treatment.Despite the mixed results currently available in scientific literature,the plethora of statistically significant findings shows that disruptions in ghrelin genetics and expression are plausibly related to FGID pathogenesis.The aim of this paper is to review current literature studying these associations,in an effort to uncover certain patterns of alterations in both genetics and expression,which could delineate its true contribution to FGID emergence,either as a causative agent or as a pathogenetic intermediate. 展开更多
关键词 FUNCTIONAL GASTROINTESTINAL disorders FUNCTIONAL colonic diseases Irritable bowel SYNDROME Cyclic VOMITING SYNDROME Infantile COLIC GASTROINTESTINAL disease GHRELIN Genetics Epigenetic processes
在线阅读 免费下载
Efficacy of 0.5-L vs 1-L polyethylene glycol containing ascorbic acid as additional colon cleansing methods for inadequate bowel preparation as expected by last stool examination before colonoscopy 预览
9
作者 Joon Hyun Cho Eun Joo Goo +3 位作者 Kyeong Ok Kim Si Hyung Lee Byung Ik Jang Tae Nyeun Kim 《世界临床病例杂志》 2019年第1期39-48,共10页
BACKGROUND No consensus has been reached in patients suspected of having inadequate bowel preparation regarding optimal salvage methods,which negatively affects the efficacy and quality of colonoscopy.The most ideal a... BACKGROUND No consensus has been reached in patients suspected of having inadequate bowel preparation regarding optimal salvage methods,which negatively affects the efficacy and quality of colonoscopy.The most ideal and reasonable rescue option involves early suspicion and identification of patients with inadequate preparation before sedation,additional oral ingestion of a suitable preparation formulation,and same-day colonoscopy.AIM To compare 0.5-L and 1-L polyethylene glycol containing ascorbic acid(PEG+Asc)as additional bowel cleansing methods after a 2-L split-dose PEG+Asc regimen in patients with expected inadequate bowel preparation before colonoscopy.METHODS Individuals with expected inadequate bowel preparation based on last stool form,such as turbid liquid,particulate liquid,or liquid with small amounts of feces,were randomized to either a 0.5-L PEG+Asc group or a 1-L PEG+Asc group.The primary endpoint was bowel preparation as assessed using the Aronchick bowel preparation scale(ABPS)and Boston bowel preparation scale(BBPS)scores.The secondary endpoints were cecal intubation time,withdrawal time,polyp detection rate(PDR),adenoma detection rate(ADR),individual compliance with additional PEG+Asc,and patient satisfaction.RESULTS Initially,98 patients were included,but 8 were later excluded due to withdrawal of consent to participate in the study.Adequate bowel preparation(as assessed by ABPS)was observed in 80.9%(38/47)of subjects in the 0.5-L group and in 88.4%(38/43)of subjects in the 1-L group(P=0.617).Mean total BBPS was 6.7 points in the 0.5-L group and 7.0 points in the 1-L group(P=0.458).ADRs and PDRs were similar in the two groups,and cecal intubation and withdrawal times were not significantly different.However,mean patient satisfaction score was significantly higher in the 0.5-L group(P=0.041).CONCLUSION The bowel cleaning efficacy of additional 0.5-L PEG+Asc was not inferior to that of 1-L PEG+Asc.Additional 0.5-L PEG+Asc is worthwhile when inadequate bowel preparation is expected before colonos 展开更多
关键词 INADEQUATE bowel preparation Additional COLON CLEANSING COLONOSCOPY Polyethylene GLYCOL
在线阅读 免费下载
Close association between abnormal expressed enzymes of energy metabolism and diarrhea-predominant irritable bowel syndrome
10
作者 Chun-Yan Zhang Xin Yao +1 位作者 Gang Sun Yun-Sheng Yang 《中华医学杂志:英文版》 SCIE CAS CSCD 2019年第2期135-144,共10页
Background:Irritable bowel syndrome (IBS) is one of the most common functional intestinal diseases, but its pathogenesis is still unknown.The present study aimed to screen the differentially expressed proteins in the ... Background:Irritable bowel syndrome (IBS) is one of the most common functional intestinal diseases, but its pathogenesis is still unknown.The present study aimed to screen the differentially expressed proteins in the mucosa of colon between IBS with diarrhea (IBS-D) patients and the healthy controls.Methods:Forty-two IBS-D patients meeting the Rome III diagnostic criteria and 40 control subjects from July 2007 to June 2009 in Chinese PLA General Hospital were enrolled in the present study.We examined the protein expression profiles in mucosa of colon corresponding to IBS-D patients (n=5) and controls (n=5) using 2-dimensional gel electrophoresis (2-DE) and mass spectrometry (MS).Secondly, Western blot and immunohistochemical analysis were carried out to validate the screened proteins in 27 IBS-D patients and 27 controls.Thirdly, high-performance liquid chromatography (HPLC) was further carried out to determine ATP concentration in the mucosa of colon between 10 IBS-D patients and 8 controls.Comparisons between 2 groups were performed by Student's t-test or Mann-Whitney U-test.Results:Twelve differentially expressed proteins were screened out.The α-enolase (ENOA) in the sigmoid colon (0.917 ± 0.007 vs.1.310 ± 0.100, t=2.643, P=0.017) and caecum (0.765 ± 0.060 vs.1.212 ± 0.122, t=2.225, P=0.023), Isobutyryl-CoA dehydrogenase (ACAD8) in the sigmoid colon (1.127 ± 0.201 vs.1.497 ± 0.392, t=7.093, P=0.008) of the IBS-D group were significantly lower while acetyl-CoA acetyltransferase (CT) in the caecum (2.453 ± 0.422 vs.0.931 ± 0.652, t=8.363, P=0.015) and ATP synthase subunit d (ATP5H) in the sigmoid (0.843 ± 0.042 vs.0.631 ± 0.042, t=8.613,P=0.007) of the IBS-D group was significantly higher, compared with the controls.The ATP concentration in the mucosa of the sigmoid colon in IBS-D group was significantly lower than that of control group (0.470 [0.180, 1.360] vs.5.350 [2.230, 7.900], U=55, P<0.001).Conclusions:Many proteins related to energy metabolism presented differential expression patterns in the m 展开更多
关键词 ATP IRRITABLE BOWEL syndrome Metabolism PROTEOME
Transitions of care across hospital settings in patients with inflammatory bowel disease 预览
11
作者 Leigh R Warren Jonathan M Clarke +3 位作者 Sonal Arora Mauricio Barahona Naila Arebi Ara Darzi 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第17期2122-2132,共11页
BACKGROUND Inflammatory bowel disease (IBD) is a chronic, inflammatory disorder characterised by both intestinal and extra-intestinal pathology. Patients may receive both emergency and elective care from several provi... BACKGROUND Inflammatory bowel disease (IBD) is a chronic, inflammatory disorder characterised by both intestinal and extra-intestinal pathology. Patients may receive both emergency and elective care from several providers, often in different hospital settings. Poorly managed transitions of care between providers can lead to inefficiencies in care and patient safety issues. To ensure that the sharing of patient information between providers is appropriate, timely, accurate and secure, effective data-sharing infrastructure needs to be developed. To optimise inter-hospital data-sharing for IBD patients, we need to better understand patterns of hospital encounters in this group. AIM To determine the type and location of hospital services accessed by IBD patients in England. METHODS This was a retrospective observational study using Hospital Episode Statistics, a large administrative patient data set from the National Health Service in England. Adult patients with a diagnosis of IBD following admission to hospital were followed over a 2-year period to determine the proportion of care accessed at the same hospital providing their outpatient IBD care, defined as their ‘home provider’. Secondary outcome measures included the geographic distribution of patient-sharing, regional and age-related differences in accessing services, and type and frequency of outpatient encounters. RESULTS 95055 patients accessed hospital services on 1760156 occasions over a 2-year follow-up period. The proportion of these encounters with their identified IBD ‘home provider’ was 73.3%, 87.8% and 83.1% for accident and emergency, inpatient and outpatient encounters respectively. Patients living in metropolitan centres and younger patients were less likely to attend their ‘home provider’ for hospital services. The most commonly attended specialty services were gastroenterology, general surgery and ophthalmology. CONCLUSION Transitions of care between secondary care settings are common for patients with IBD. Effective systems of data-s 展开更多
关键词 Inflammatory bowel DISEASE Crohn's DISEASE Ulcerative colitis TRANSITIONS of CARE Continuity of CARE FRAGMENTATION Multi-morbidity
在线阅读 免费下载
Characteristic dysbiosis of gut microbiota of Chinese patients with diarrhea-predominant irritable bowel syndrome by an insight into the pan-microbiome
12
作者 Zhe Wang Cong-Min Xu +8 位作者 Yi-Xuan Liu Xiao-Qi Wang Lu Zhang Mo Li Shi-Wei Zhu Zhong-Jie Xie Pei-Hong Wang Li-Ping Duan Huai-Qiu Zhu 《中华医学杂志:英文版》 SCIE CAS CSCD 2019年第8期889-904,共16页
Background:Irritable bowel syndrome(IBS)is reported associated with the alteration of gut microbial composition termed as dysbiosis.However,the pathogenic mechanism of IBS remains unclear,while the studies of Chinese ... Background:Irritable bowel syndrome(IBS)is reported associated with the alteration of gut microbial composition termed as dysbiosis.However,the pathogenic mechanism of IBS remains unclear,while the studies of Chinese individuals are scarce.This study aimed to understand the concept of dysbiosis among patients with Chinese diarrhea-predominant IBS(IBS-D),as a degree of variance between the gut microbiomes of IBS-D population and that of a healthy population.Methods:The patients with IBS-D were recruited(assessed according to the Rome III criteria,by IBS symptom severity score)from the Outpatient Department of Gastroenterology of Peking University Third Hosp让al,and volunteers as healthy controls(HCs)were enrolled,during 2013.The 16S rRNA sequences were extracted from fecal samples.Ribosomal database project resources,basic local alignment search tool,and SparCC software were used to obtain the phylotype composition of samples and the internal interactions of the microbial community.Herein,the non-parametric test,Wilcoxon rank-sum test was carried out to find the statistical significance between HC and IBS-D groups.All the P values were adjusted to q values to decrease the error rate.Results:The study characterized the gut microbiomes of Chinese patients with IBS-D,and demonstrated that the dysbiosis could be characterized as directed alteration of the microbiome composition leading to greater disparity between relative abundance of two phyla,Bacteroidetes(Z=4.77,q=1.59×10^-5)and Firmicutes(Z=-3.87,q=5.83×10^-4).Moreover,it indicated that the IBS symptom features were associated with the dysbiosis of whole gut microbiome,instead of one or several certain genera even they were dominating.Two genera,Bacteroides and Lachnospiracea incertae sedis,were identified as the core genera,meanwhile,the non-core genera contribute to a larger pan-microbiome of the gut microbiome.Furthermore,the dysbiosis in patients with IBS-D was associated with a reduction of network complexity of the interacted microbial community(HC us.IB 展开更多
关键词 IRRITABLE bowel syndrome GUT MICROBIOME DYSBIOSIS MICROBIAL diversity Community network COMPLEXITY
Conventional therapy for moderate to severe inflammatory bowel disease:A systematic literature review 预览
13
作者 Aderson Omar Mourao Cintra Damiao Matheus Freitas Cardoso de Azevedo +3 位作者 Alexandre de Sousa Carlos Marcela Yumi Wada Taciana Valéria Marcolino Silva Flávio de Castro Feitosa 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第9期1142-1157,共16页
BACKGROUND Despite the advent of biological drugs,conventional therapy continues to be used in moderate to severe inflammatory bowel disease(MS-IBD).This study hypothesized that as a standard of treatment and the prim... BACKGROUND Despite the advent of biological drugs,conventional therapy continues to be used in moderate to severe inflammatory bowel disease(MS-IBD).This study hypothesized that as a standard of treatment and the primary alternative to biologics,conventional therapy should present robust effectiveness results in IBD outcomes.AIM To investigate the effectiveness of conventional therapy for MS-IBD.METHODS A systematic review with no time limit was conducted in July 2017 through the Cochrane Collaboration,MEDLINE,and LILACS databases.The inclusion criteria encompassed meta-analyses,systematic reviews,randomized clinical trials,observational and case-control studies concerning conventional therapy in adult patients with MS-IBD,including Crohn’s disease(CD)and ulcerative colitis(UC).Corticosteroids(prednisone,hydrocortisone,budesonide,prednisolone,dexamethasone),5-aminosalicylic acid(5-ASA)derivatives(mesalazine and sulfasalazine)and immunosuppressants[azathioprine(AZA),methotrexate(MTX),mycophenolate,cyclosporine,tacrolimus,6-mercaptopurine(6-MP)]were considered conventional therapy.The exclusion criteria were sample size below 50;narrative reviews;specific subpopulations(e.g.,pregnant women,comorbidities);studies on postoperative IBD;and languages other than English,Spanish,French or Portuguese.The primary outcome measures were clinical remission(induction or maintenance),clinical response and mucosal healing.As secondary outcomes,fecal calprotectin,hospitalization,death,and surgeries were analyzed.The quality of the evidence was assessed using the Grading of Recommendations Assessment,Development and Evaluation criteria.RESULTS The search strategy identified 1995 citations,of which 27 were considered eligible(7 meta-analyses,20 individual studies).For induction of clinical remission,four meta-analyses were selected(AZA and 6-MP showed no advantage over placebo,MTX or 5-ASA in CD;MTX showed no statistically significant difference versus placebo,6-MP,or 5-ASA in UC;tacrolimus was superior to placebo for UC in two m 展开更多
关键词 Inflammatory bowel diseases STEROIDS SULFASALAZINE MESALAMINE AZATHIOPRINE Methotrexate Mycophenolic acid CYCLOSPORINE Tacrolimus 6-MERCAPTOPURINE
在线阅读 免费下载
Crohn’s-like acute severe colitis associated with Hermansky-Pudlak syndrome:A case report 预览
14
作者 Paul Girot Catherine Le Berre +3 位作者 Astrid De Maissin Marie Freyssinet Caroline Trang-Poisson Arnaud Bourreille 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第8期1031-1036,共6页
BACKGROUND Hermansky-Pudlak syndrome(HPS)is a rare autosomal recessive disorder characterized by oculocutaneous albinism,platelet storage pool deficiency and systemic complications associated with ceroid deposition in... BACKGROUND Hermansky-Pudlak syndrome(HPS)is a rare autosomal recessive disorder characterized by oculocutaneous albinism,platelet storage pool deficiency and systemic complications associated with ceroid deposition in the reticuloendothelial system.HPS types 1 and 4 are associated with Crohn’s disease(CD)-like gastrointestinal disorders,such as granulomatous enterocolitis or perianal disease.Cases of colitis can be particularly severe and,before the use of anti-tumor necrosis factor alpha(TNFα)therapy had become common,were reported as showing poor responsiveness to medical treatment.CASE SUMMARY We present the case of a 51-year-old albino woman who presented with acute severe colitis that led to the diagnosis of HPS.Histologic findings of biopsy samples showed chronic inflammation with deep ulcerations,and granulomas without caseous necrosis.Molecular genetic analysis confirmed HPS type 1,with a homozygous 27 base-pair deletion in exon 20 of the HPS1 gene.Once the patient’s bleeding diathesis was corrected by platelet transfusion,the granulomatous colitis responded dramatically to a medical treatment regimen that included corticosteroids,azathioprine and infliximab;this regimen is similar to that used in CD treatment.Although it remains unclear if the granulomatous enterocolitis in HPS is due to ceroid deposition or reflects the co-existence of CD and HPS,the fact that this case of HPS-related granulomatous colitis responded to the same therapeutic approach used in CD suggests that this type of colitis may result from HPS patients’genetic susceptibility to CD.CONCLUSION We report a case of severe colitis that led to the diagnosis of HPS,which was responsive to azathioprine and infliximab. 展开更多
关键词 Hermansky-Pudlak SYNDROME Acute severe COLITIS INFLIXIMAB AZATHIOPRINE Inflammatory BOWEL disease Case report
在线阅读 免费下载
Clinical characteristic and fecal microbiota responses to probiotic or antidepressant in patients with diarrhea-predominant irritable bowel syndrome with depression comorbidity: a pilot study
15
作者 Lu Zhang Yi-Xuan Liu +9 位作者 Zhe Wang Xiao-Qi Wang Jing-Jing Zhang Rong-Huan Jiang Xiang-Qun Wang Shi-Wei Zhu Kun Wang Zuo-Jing Liu Huai-Qiu Zhu Li-Ping Duan 《中华医学杂志:英文版》 SCIE CAS CSCD 2019年第3期346-351,共6页
To the Editor: Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder that presents as abdominal pain with altered bowel habits. The pathophysiologic mechanism of IBS is not well understood... To the Editor: Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder that presents as abdominal pain with altered bowel habits. The pathophysiologic mechanism of IBS is not well understood, although many hypotheses have been proposed, including visceral hypersensitivity, gastrointestinal dysmotility, lowgrade inflammation of the intestinal mucosa, and dysfunction of the brain-gut interaction. Dysfunction of the braingut interaction is thought to be involved in IBS because a considerable proportion of patients with IBS have some form of psychologic comorbidity, such as depression or anxiety. In addition, mental and psychologic problems increase the risk for IBS and the symptom severity of IBS. Recently, changes in the gut microbiota have also been suggested to contribute to both IBS and depression. Our previous study demonstrated significant altered gut microbiota profiles in patients with diarrhea-predominant IBS (IBS-D) and depression. 展开更多
关键词 FECAL microbiota RESPONSES DEPRESSION COMORBIDITY diarrhea-predominant IRRITABLE bowel syndrome
Upper gastrointestinal tract involvement of pediatric inflammatory bowel disease: A pathological review 预览
16
作者 Dua Abuquteish Juan Putra 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第16期1928-1935,共8页
Upper gastrointestinal (UGI) tract involvement of inflammatory bowel disease (IBD) is commonly seen in pediatric patients. Upper endoscopy is included in the routine workup of children with suspected IBD to enhance th... Upper gastrointestinal (UGI) tract involvement of inflammatory bowel disease (IBD) is commonly seen in pediatric patients. Upper endoscopy is included in the routine workup of children with suspected IBD to enhance the diagnosis and management of these patients. Currently, childhood IBD is classified into ulcerative colitis (UC), atypical UC, Crohn’s disease (CD) and IBD unclassified. Histologic confirmation of UGI tract involvement, in particular the presence of epithelioid (non-caseating) granulomas, is helpful in confirming the diagnosis of IBD and its classification. Herein, we reviewed selected IBD-associated UGI tract manifestations in children. Lymphocytic esophagitis, seen predominantly in CD, is histologically characterized by increased intraepithelial lymphocytes (> 20 in one high-power field) in a background of mucosal injury with absence of granulocytes. Focally enhanced gastritis is a form of gastric inflammation in pediatric IBD marked by a focal lymphohistiocytic pit inflammation with or without granulocytes and plasma cells in a relatively normal background gastric mucosa. Duodenal inflammation seen in children with IBD includes cryptitis, villous flattening, increased intraepithelial lymphocytes, and lamina propria eosinophilia. Finally, epithelioid granulomas not associated with ruptured gland/crypt are a diagnostic feature of CD. The clinicopathologic correlation and differential diagnosis of each microscopic finding are discussed. Clinicians and pathologists should be cognizant of the utility and limitations of these histologic features. 展开更多
关键词 PEDIATRIC Inflammatory bowel DISEASE LYMPHOCYTIC ESOPHAGITIS Focally enhanced gastritis EPITHELIOID GRANULOMA Crohn’s DISEASE Ulcerative colitis
在线阅读 免费下载
Performance of tacrolimus in hospitalized patients with steroidrefractory acute severe ulcerative colitis 预览
17
作者 Peter Hoffmann Cyrill Wehling +3 位作者 Johannes Krisam Jan Pfeiffenberger Nina Belling Annika Gauss 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第13期1603-1617,共15页
BACKGROUND Acute severe ulcerative colitis unresponsive to systemic steroid treatment is a lifethreatening medical condition requiring hospitalization and often colectomy. Despite the increasing choice of medical ther... BACKGROUND Acute severe ulcerative colitis unresponsive to systemic steroid treatment is a lifethreatening medical condition requiring hospitalization and often colectomy. Despite the increasing choice of medical therapy options for ulcerative colitis, the condition remains a great challenge in the field of inflammatory bowel diseases (IBD). The performance of the calcineurin inhibitor tacrolimus in this clinical setting is insufficiently elucidated. AIM To evaluate the short and long-term outcomes of tacrolimus therapy in adult inpatients with steroid-refractory acute severe ulcerative colitis. METHODS We conducted a retrospective monocentric study enrolling 22 patients at a tertiary care center for the treatment of IBD. All patients who were admitted to one of the wards of the Department of Gastroenterology and Hepatology of the Heidelberg University Hospital with acute severe ulcerative colitis between 2007 and 2018, and who received oral or intravenous tacrolimus for steroid-refractory disease were included. Baseline characteristics and data on the disease courses were retrieved from entirely computerized patient charts. The primary study endpoint was clinical response to tacrolimus therapy, resulting in discharge from the hospital. Secondary study endpoints were colectomy rate and time to colectomy, achievement of clinical remission under tacrolimus therapy, and the occurrence of side effects. RESULTS In the majority of the 22 included patients (68.2%), tacrolimus therapy was initiated intravenously and subsequently converted to oral administration. The treatment duration was 128 ± 28.5 d (mean ± SEM), and the patients were followed up for 705 ± 110 d after treatment initiation. Among all patients, 86.4% were discharged from the hospital under continued oral tacrolimus therapy. In 36.4% of the patients, the administration of tacrolimus resulted in clinical remission at some point during the treatment. Thirty-two percent of the patients underwent colectomy between 5 and 194 d after the initiation of tacrol 展开更多
关键词 Acute severe ULCERATIVE colitis STEROID-REFRACTORY TACROLIMUS Rescue therapy CALCINEURIN inhibitor Inflammatory bowel disease HOSPITALIZED
在线阅读 免费下载
Neonatal Maternal Deprivation Followed by Adult Stress Enhances Adrenergic Signaling to Advance Visceral Hypersensitivity
18
作者 Wan-Jie Du Shufen Hu +4 位作者 Xin Li Ping-An Zhang Xinghong Jiang Shan-Ping Yu Guang-Yin Xu 《神经科学通报:英文版》 SCIE CAS CSCD 2019年第1期4-14,共11页
The pathophysiology of visceral pain in patients with irritable bowel syndrome remains largely unknown.Our previous study showed that neonatal maternal deprivation(NMD) does not induce visceral hypersensitivity at the... The pathophysiology of visceral pain in patients with irritable bowel syndrome remains largely unknown.Our previous study showed that neonatal maternal deprivation(NMD) does not induce visceral hypersensitivity at the age of 6 weeks in rats. The aim of this study was to determine whether NMD followed by adult stress at the age of 6 weeks induces visceral pain in rats and to investigate the roles of adrenergic signaling in visceral pain. Here we showed that NMD rats exhibited visceral hypersensitivity 6 h and 24 h after the termination of adult multiple stressors(AMSs). The plasma level of norepinephrine was significantly increased in NMD rats after AMSs. Whole-cell patch-clamp recording showed that the excitability of dorsal root ganglion(DRG) neurons from NMD rats with AMSs was remarkably increased. The expression of β2 adrenergic receptors at the protein and mRNA levels was markedly higher in NMD rats with AMSs than in rats with NMD alone. Inhibition of β2 adrenergic receptors with propranolol or butoxamine enhanced the colorectal distention threshold and application of butoxamine also reversed the enhanced hypersensitivity of DRG neurons. Overall,our data demonstrate that AMS induces visceral hypersensitivity in NMD rats, in part due to enhanced NE-β2 adrenergic signaling in DRGs. 展开更多
关键词 IRRITABLE bowel syndrome DORSAL root GANGLION NOREPINEPHRINE VISCERAL pain STRESS
Nutrient drink test:A promising new tool for irritable bowel syndrome diagnosis 预览
19
作者 Fermin Estremera-Arevalo Marta Barcelo +1 位作者 Blanca Serrano Enrique Rey 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第7期837-847,共11页
BACKGROUND Irritable bowel syndrome(IBS)is a highly prevalent condition.It is diagnosed on the basis of chronic symptoms after the clinical and/or investigative exclusion of organic diseases that can cause similar sym... BACKGROUND Irritable bowel syndrome(IBS)is a highly prevalent condition.It is diagnosed on the basis of chronic symptoms after the clinical and/or investigative exclusion of organic diseases that can cause similar symptoms.There is no reproducible noninvasive test for the diagnosis of IBS,and this raises diagnostic uncertainty among physicians and hinders acceptance of the diagnosis by patients.Functional gastrointestinal(GI)syndromes often present with overlapping upper and lower GI tract symptoms,now believed to be generated by visceral hypersensitivity.This study examines the possibility that,in IBS,a nutrient drink test(NDT)provokes GI symptoms that allow a positive differentiation of these patients from healthy subjects.AIM To evaluate the NDT for the diagnosis of IBS.METHODS This prospective case-control study compared the effect of two different nutrient drinks on GI symptoms in 10 IBS patients(patients)and 10 healthy controls(controls).The 500 kcal high nutrient drink and the low nutrient 250 kcal drink were given in randomized order on separate days.Symptoms were assessed just before and at several time points after drink ingestion.Global dyspepsia and abdominal scores were derived from individual symptom data recorded by two questionnaires designed by our group,the upper and the general GI symptom questionnaires,respectively.Psycho-social morbidity and quality of life were also formally assessed.The scores of patients and controls were compared using single factor analysis of variance test.RESULTS At baseline,IBS patients compared to controls had significantly higher levels of GI symptoms such as gastro-esophageal reflux(P=0.05),abdominal pain(P=0.001),dyspepsia(P=0.001),diarrhea(P=0.001),and constipation(P=0.001)as well as higher psycho-social morbidity and lower quality of life.The very low incidence of GI symptoms reported by control subjects did not differ significantly for the two test drinks.Compared with the low nutrient drink,IBS patients with the high nutrient drink had significantly more dyspe 展开更多
关键词 IRRITABLE bowel syndrome NUTRIENT DRINK TEST NON-INVASIVE DYSPEPSIA Screening
在线阅读 免费下载
Peritonitis and pneumoperitoneum after successful emergency pericardiocentesis in the case of a Chilaiditi syndrome 预览
20
作者 Michael Schulte-Hermes Oliver Klein-Wiele +1 位作者 Marc Vorpahl Melchoir Seyfarth 《老年心脏病学杂志:英文版》 SCIE CAS CSCD 2019年第1期60-62,共3页
Pericardiocentesis is a common therapeutic procedure for pericardial tamponade due to pericardial effusion as well as a diagnostic procedure to obtain fluid for cytopathologic examination.Standard methods include ultr... Pericardiocentesis is a common therapeutic procedure for pericardial tamponade due to pericardial effusion as well as a diagnostic procedure to obtain fluid for cytopathologic examination.Standard methods include ultrasound or fluoroscopic guidance,which generally result in high success rates(over 95%).[1,2].The complication rate of pericardiocentesis is low with reported incidences of l%-2%.[3]In the past,the most common indications for pericardiocentesis include uremia,tuberculous pericarditis or malignant pericardial effusions.However,with the increasing number of catheter-based interventional cardiac procedures,iatrogenic pericardial effusions are becoming more frequent[4-6]. 展开更多
关键词 BOWEL PERFORATION Chilaiditi SYNDROME Pericardiocentesis Peri to nitis
在线阅读 下载PDF
上一页 1 2 250 下一页 到第
使用帮助 返回顶部 意见反馈