肠道菌群调节肠道MicroRNA治疗骨质疏松症

骨质疏松症是以骨量减少,骨组织结构退化进而极易导致骨质疏松性骨折的一类疾病。严重影响患者生活质量,同时也带来了极大的经济负担。近年来有关调节肠道菌群进而干预骨质疏松症的研究逐渐兴起。炎症性肠病是由肠道菌群失调引起的炎症免疫变态反应,而炎症性肠病与骨量丢失密切相关。近来有研究表明肠道菌群与肠道MicroRNA直接的相互作用可以治疗炎症性肠病。为此,我们提出设想,肠道菌群可能调节肠道MicroRNA具有治疗骨质疏松症潜力,现从肠道菌群与骨质疏松症;MicroRNA与骨质疏松症;肠道菌群与MicroRNA;炎症性肠病与骨质疏松症四方面展开综述,支持肠道菌群通过调节肠道MicroRNA治疗骨质疏松症的观点,为骨质疏松症治疗提供新思路。     

酪酸梭菌联合阿仑膦酸钠治疗炎症性肠病合并骨质疏松症效果分析

目的探讨酪酸梭菌联合阿仑膦酸钠治疗炎症性肠病合并骨质疏松症近期疗效及对骨代谢、炎性因子和肠道菌群的影响。方法将80例炎症性肠病合并骨质疏松症患者随机分为对照组和观察组。除基础治疗外,对照组给予阿仑膦酸钠、观察组给予联合酪酸梭菌二联活菌胶囊治疗,持续3个月。比较两组临床疗效、骨密度(bone mineral density,BMD)、骨代谢指标、炎性因子及肠道菌群水平。结果与对照组相比,观察组治疗总有效率升高(95.0%vs 77.5%),腰椎、股骨颈及Ward三角区BMD水平升高;骨碱性磷酸酶(BALP)、骨钙素水平升高,1型胶原交联羧基末端肽(CTX)水平降低; IL-6、IL-17等炎性因子水平降低,粪便中大肠杆菌含量降低,双歧杆菌、乳酸杆菌含量增加,差异均有统计学意义(P均0.05)。结论酪酸梭菌联合阿仑膦酸钠治疗炎症性肠病合并骨质疏松症近期疗效好,能够增加BMD,改善骨代谢指标,减轻机体炎性反应,而且还能够调节肠道菌群,适于临床上应用。     

肠道微生态失衡为骨质疏松症发病的易感因素

本文通过综述人体肠道菌群和骨代谢的相关性研究,从衰老与胃肠道功能不足是老年性骨质疏松的危险因素、炎症性肠病是并发骨质疏松的危险因素、糖皮质激素是IBD诱发骨质疏松的重要因素、肠道菌群失调是绝经后骨质疏松发生的关键因素等方面探讨了肠道微生态失衡与骨质疏松发生发展的相关性,并从肠道微生态出发对老年性骨质疏松的危险因素和绝经后骨质疏松发生的关键因素做了深入探讨,通过综述国内外实验和临床研究,认为肠道微生态失衡是骨质疏松症发病的易感因素。     

消化系统疾病与骨质疏松症的研究进展

骨质疏松症是一种与多种因素有关的增龄性疾病，其病理改变主要是骨基质和骨矿物质含量减少。皮质骨变薄，松质骨的骨小梁变细、变小，骨小梁数量减少，骨髓腔扩大等。许多消化系统疾病与骨质疏松症之间有着密切的关系，如胃切除术后、慢性肝病、炎症性肠病等。近年来，随着研究的深入，其越来越受到人们的关注。     

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炎症性肠病的肠道并发症常见。虽然在大多数情况下外科治疗更为直接彻底,但对炎症性肠病来说并非治愈,术后并发症和复发均常见。内镜治疗炎症性肠病并发症是有效手段,可以延迟或避免手术治疗。内镜治疗瘘管、窦道、吻合口漏等疾病的新方法不断涌现。     

炎症性肠病规范化外科治疗值得注意的几个问题

近年来,由于药物尤其是生物制剂的不断开发和广泛应用,为炎症性肠病的治疗带来了新的希望和治疗选择。然而,手术仍然是治疗炎症性肠病不可或缺的重要手段,尤其对于复杂炎症性肠病,外科治疗起到核心作用。在外科治疗方面,炎症性肠病区别于胃肠道肿瘤等疾病的最大特点是其缺乏统一规范的围手术期处理方案及手术方式。炎症性肠病病人由于发病年龄、疾病表现、疾病部位及用药史不同,使其具有很强的个体化特点;由于合并肠道狭窄、瘘、腹腔脓肿等并发症,在围手术期处理和手术操作技巧等方面有许多值得研究和探索的空间。     

炎症性肠病的药物治疗

溃疡性结肠炎和克隆病的原因仍然没有完全清楚。近年来关于发病机制的研究集中在自身免疫学说、感染学说和遗传素质等。在炎症性肠病的病因弄清楚以前，炎症性肠病治疗药物的发展也受到限制。应用一些作用机制已知的药物治疗炎症性肠病，也帮助我     

炎症性肠病外科治疗国内外共识与指南主要内容介绍及解读

近年来,一系列炎症性肠病(IBD)诊治指南及共识相继发布,包括欧洲克罗恩病和结肠炎组织(ECCO)2015年发布的克罗恩病(UC)外科治疗共识及2016年发布的CD外科治疗共识、世界胃肠组织(WGO)2015年8月发布的WGO炎症性肠病环球指南、亚太消化学会炎症性肠病学组2016年发布的亚太CD诊治共识、美国结直肠外科医师学会临床实践指导委员会2015年发布的CD外科治疗指南,以及我国中华医学会消化病学分会炎症性肠病学组2012年发布的炎症性肠病诊断与治疗的共识意见等。学习和解读上述指南与共识有关IBD外科治疗的内容,有助于规范和提高IBD的外科治疗。     

炎症性肠病患儿基于云随访平台的延续护理

目的 基于云随访平台对炎症性肠病患儿实施延续护理并评价其应用效果.方法 在云随访平台扩增了炎症性肠病患儿随访相关的模块及功能,融合信息化技术与优质护理资源为炎症性肠病患儿提供以家庭为中心的居家延续护理.结果 66例患儿的家属注册使用患者App端,记录身高、体质量525次,饮食记录11095次,运动记录233次,睡眠记录119次.推送炎症性肠病专题知识14项,共2003次,已读1509次,已读率为75.34％.结论 云随访平台能为炎症性肠病患儿提供系统、规范、便利的以家庭为中心的居家延续护理服务,并为患儿提供便捷的疾病管理工具.     

炎症性肠病患者性功能障碍的研究进展

介绍炎症性肠病患者性功能障碍的影响因素、评测工具和干预措施,以期引起国内医护人员对炎症性肠病群体性功能问题的关注,为炎症性肠病患者性功能障碍的护理评估及干预提供参考。     

Inflammatory myofibroblastic tumor of the liver

Inflammatory myofibroblastic tumor is a rare benign entity formerly known as inflammatory pseudotumor. Involvement of the liver is extremely rare. There are controversies about the optimal treatment of this benign entity. Newer reports suggest an association with autoimmune sclerosing pancreatitis and primary sclerosing cholangitis. We present a case of an 18-year-old patient with biliary obstruction from a perihilar mass of the liver requiring hepatic resection. Division of the hepatic bile duct resulted in drainage of yellow, thick, gelatinous material in the presence of benign margins and absence of cholangitis. Histological examination showed a mass with fibroblastic and myofibroblastic cells set in a loose myxoid matrix containing scattered lymphocytes, consistent with an inflammatory myofibroblastic tumor. One-year recovery was uneventful. This report discusses the presentation, diagnosis, and controversies in management of this disease.     

Inflammatory Myofibroblastic Tumor of the Kidney in a Child: Report of a Case

Inflammatory myofibroblastic tumor (IMT), also known as inflammatory pseudotumor, is an uncommon benign tumor that has been reported in various locations throughout the body, but rarely in the kidney. To our knowledge, only 22 cases of renal IMT have been described in the literature. Renal IMT in children is difficult to differentiate from a malignancy such as Wilms' tumor. We report a case of a 9-year old girl with a left renal mass mimicking malignancy on preoperative diagnostic images, which was pathologically revealed to be an IMT. We review the literature and discuss the pathophysiology and clinical features of this unusual tumor.     

Seudotumor inflamatorio y tumor miofibroblástico inflamatorio. Criterios diagnósticos y diferencias pronósticas

IntroductionInflammatory pseudotumor (IPT) and inflammatory myofibroblastic tumor (IMT) are two very rare entities that were formerly included in the same category; however, today they are considered two different diseases due to the neoplastic origin of the IMT. Our objective is to share our experience in the management of these two types of tumors that we must take into account in the differential diagnosis of pulmonary masses or nodules.MethodsThirteen patients with a pathological diagnosis of IPT and IMT who underwent surgery between 2008 and 2019 were retrospectively studied. We recorded the pre and postoperative information of each one, as well as the survival analysis.ResultsOf the 13 patients, 8 were men and 5 women. The mean age of presentation was 53,5 years. An atypical segmentectomy was performed in 6 patients; a lobectomy was necessary in 6 and a pneumonectomy in 1 case. In all cases a complete resection was achieved. Diagnosis was possible thanks to histology, immunohistochemical (IHQ) and fluorescent in situ hybridization (FISH) techniques determining the expression of IgG4 and the rearrangement of ALK, respectively. After a median follow up of 49 months, we didńt find any loco-regional or distant recurrence in the patients studied.ConclusionIPT and IMT are rare tumors with a very good prognostic. The diagnosis of both entities is based mainly on specific anatomopathological techniques. Surgery has, in most cases, both a diagnostic and therapeutic role.     

Retroperitoneal inflammatory myofibroblastic tumor

Inflammatory myofibroblastic tumors are rare, and those located retroperitoneally are even rarer. The authors present the case of a 52-year-old male farmer with a lump in the lower abdomen of 2 months in duration that was retroperitoneal in location. It was excised, and histopathologic examination revealed an inflammatory myofibroblastic tumor. The present case is presented by virtue of its rare location.     

Inflammatory pseudotumor of the kidney: A case report

Inflammatory pseudotumor of the kidney is a very rare lesion. We report a patient who had a renal mass raising the suspicion of a malignant neoplasm and the pathologic examination revealed an inflammatory pseudotumor. Despite its rarity, inflammatory pseudotumor of kidney should be kept in mind in the differential diagnosis of a solitary renal mass.     

A rare lesion of the central nervous system: inflammatory pseudotumor

Inflammatory pseudotumor is an uncommon tumor, initially described in the lung, but which can involve various organs. It is a controversial entity. We report the case of a 19-year-old-man with an inflammatory pseudotumor localized in the central nervous system, revealed by epilepsy. Characteristically, the inflammatory pseudotumor is an inflammatory mass leading to manifestations related to its localization. Relatively ubiquitous, this tumor is seldom described in the central nervous system. This uncommon lesion is part of a heterogeneous group of entities which are difficult to diagnose for both surgical pathologists and clinicians.     

Abdominal inflammatory myofibroblastic tumor a clinicopathologic study with reappraisal of biologic behavior

Background and Purpose

Inflammatory myofibroblastic tumor (IMT) is a proliferative lesion of controversial nosology and uncertain prognosis. In an attempt to acquire further understanding of pathogenesis and biologic behavior, we surveyed abdominal IMTs managed over the last 12 years at a single institution.

Methods

Intra-abdominal IMTs treated between 1995 and 2007 were reviewed concerning demographic, clinical, and pathologic features as well as therapeutic management and outcome. All specimens were reevaluated by histologic examination and immunohistochemistry.

Results

There were 7 patients (4 males; age range, 28 days to 14 years). Five lesions were located in alimentary tract: 1 gastric presenting with bleeding, 1 hepatic presenting with a thoracic wall mass, 1 pancreatic and 2 colonic presenting with obstructive symptoms. One splenic IMT was found incidentally. The remaining case arose from the adrenal gland and presented with a palpable mass. The gastric and adrenal IMTs had evidence of a previous or concomitant infectious setting. Five lesions were excised. The pancreatic IMT underwent a drainage procedure followed by steroid administration, and the hepatic lesion received antibiotics. Histopathology revealed characteristic findings of IMT. Expression of anaplastic lymphoma kinase was negative in all cases. At a median follow-up of 6 years (range, 3-15), all children were asymptomatic with no recurrences. The hepatic and pancreatic IMT displayed complete and near total regression, respectively.

Conclusion

A benign behavior of abdominal IMTs was observed even in patients not undergoing surgical excision. Although IMT remains a surgical disease, a conservative approach may be reasonable in select cases.     

Inflammatory myofibroblastic tumor of the rectum in a 13-month-old girl: a case report

Inflammatory myofibroblastic tumor is a rare benign neoplasm. It is common in children and has been reported in various locations throughout the body but rarely in the rectum. A 13-month-old girl presented with a short history of a painless anal mass and no hematochezia. The mass was completely excised, and histologic examination of the initial biopsy showed fascicles of spindle cells in a mixed inflammatory background with predominance of plasma cells, typical of an inflammatory pseudotumor. The spindle cells were positive for smooth muscle actin and anaplastic lymphoma kinase staining. There is no evidence of recurrence or metastasis after a follow-up of 4.5 years.     

肝脏炎性假瘤12例诊治分析

目的探讨肝脏炎性假瘤的诊断和治疗方法。方法回顾性分析1998年6月至2004年10月收治的12例肝脏炎性假瘤的临床资料,结合文献对其临床症状、影像学特点、诊断和治疗方法进行了总结。结果12例病人中有右上腹不适者9例(75%),发热5例(41.6%),乏力消瘦5例(41.6%),呕吐和腹泻3例(25%)。B超检查肿块为低回声,CT检查肿块为低密度和周边强化或不均一强化,其中有3例门静脉分支穿过或包绕病灶呈闭塞性静脉炎改变。术前正确诊断4例(33.3%)。12例均行手术切除,经3个月至6年的随访无复发。结论结合临床特点和影像学表现的综合分析有助于术前诊断肝脏炎性假瘤。手术切除仍然是主要的治疗方法。