口腔微生物与免疫细胞及上皮屏障互作在口腔黏膜稳态维持及疾病发生中的作用研究进展

健康状态下,口腔微生物、黏膜免疫细胞及上皮屏障三者相互作用,维持口腔微生态稳定.疾病状态下,口腔微生态紊乱,各种致病菌及其毒力因子、代谢产物等激惹免疫系统,直接或间接破坏上皮屏障,促进口腔黏膜病的发生发展,产生免疫炎症反应或不可逆转的"炎-癌"转化.本文从口腔稳态维持与口腔黏膜病发生两个层面,针对口腔微生物与免疫细胞及...     

Four pathologies in one

Background  Acute appendicitis is a frequently encountered entity in emergency surgery. Incidental findings as Meckel’s diverticulum or Crohn’s disease during this operation are not uncommon. Methods  Laparotomy revealed a perforated appendix with an incidental Meckel’s diverticulum and thickened distal small bowel with fat encroaching the mesentery suggestive of active Crohn’s disease. A routine appendicectomy was done and pathology revealed inflamed perforated appendix with an incidental carcinoid within the appendix. Conclusions  Presence of active Crohn’s disease along with an incidental Meckel’s diverticulum or acute appendicitis raises controversies in their surgical management. We discuss the issues in managing patients with two or more of these co-existent pathologies.     

Laparoscopic assisted surgery for Crohn’s disease an initial experience and results

Summary The inflammatory process associated with Crohn’s disease often makes dissection difficult, even in open surgery. The aim of this study was to assess the technical feasibility, safety and indication of laparoscopic assisted procedures performed in patients with Crohn’s disease. Records of patients undergoing surgical operation for Crohn’s disease from 1993 to 1998 at our hospital were reviewed. Intestinal resection was performed laparoscopically in 24 patients (LAP) and by open technique in 23 patients (OPEN). No significant differences existed as to age, gender, body-mass-index and previous surgery. In the laparoscopic group, seven operations (CON) were converted to open laparotomy (29 %) because of large inflammatory mass and/or fistula. The mean intraoperative blood loss was significantly higher in CON- and OPEN-groups than in LAP-group (P < 0. 01). Major complications occurred only in one patient who underwent laparoscopic assisted high anterior resection. Patients who underwent laparoscopic operation tolerated p. o. liquids sooner than patients who underwent open surgery (median; 2 vs. 5 day,P < 0. 05). Compared with the CON- and OPEN-groups, patients in LAP-group had lower analgesic requirements (median: 3 vs. 6 and 5 day,P < 0. 01). The median postoperative length of stay was significantly shorter in LAP-group than in OPEN-group (median: 11 vs. 14 day,P < 0. 05). Our study showed that LAP is technically feasible for Crohn’s disease. The preoperative correct diagnosis and selection of indications are very important, because the laparoscopic mobilization and resection may be difficult or impossible in patients with large fixed masses, multiple complx fistulas, or recurrent Crohn’sdisease.     

Crohn’s disease in Dublin in the latter half of the nineteenth century

AT least 29 patients with Crohn’s disease were seen in hospitals in Dublin in the latter half of the last century. This retrospective study is additional epidemiological evidence that Crohn’s disease was present but unrecognised prior to this century and not as has been suggested a ‘new’ disease of this century.     

Probiotics and inflammatory bowel diseases

Enteric microflora profiles vary considerably between active inflammatory bowel diseases (IBD) and healthy conditions. Intestinal microflora may partake in the pathogenesis of IBD by one or some ways: specific pathogenic infection induces abnormal intestinal mucosal inflammation; aberrant microflora components trigger the onset of IBD; abnormal host immune response loses normal immune tolerance to luminal components; luminal antigens permeate through the defective mucosal barrier into mucosal lamina propria and induce abnormal inflammatory response. Preliminary studies suggest that administration of probiotics may be benefit for experimental colitis and clinical trials for IBD. Researches have been studying the function of probiotics. Introduction of probiotics can balance the aberrant enteric microflora in IBD patients, and reinforce the various lines of intestinal defence by inhibiting microbial pathogens growth, increasing intestinal epithelial tight junction and permeability, modulating immune response of intestinal epithelia and mucosal immune cells, secreting antimicrobial products, decomposing luminal pathogenic antigens.     

炎症与癫痫

炎症是具有血管系统的活体组织对致炎因子所发生的防御为主的反应。癫痫是一种脑部疾病,由癫痫发作所引起的脑内炎性反应是导致癫痫发作后脑组织病理改变,特别是海马结构损伤(包括海马内神经元脱失、神经元凋亡、胶质细胞增生、纤维发芽、海马硬化等)的主要原因之一。现就炎性反应在癫痫发生中的作用及其机制进行综述。     

Crohn’s disease of the terminal ileum: a cheap diagnosis

Background  A 29-year-old man was admitted with a 7-day history of progressive non-specific abdominal pain that progressed to small bowel obstruction following ingestion of a 20-pence coin 4-months previously. Colonoscopic retrieval was unsuccessful. A subsequent laparotomy revealed a chronically inflamed thickened terminal ileum with mesenteric fat encroachment necessitating a right hemicolectomy. Histopathological analysis confirmed Crohn’s disease with impaction of the 20-pence coin in a distal terminal ileum stricture near the ileo-caecal valve. Learning point  Gastrointestinal foreign body retention should alert the clinician to the presence of an undiagnosed bowel abnormality. Furthermore, failed endoscopic retrieval should be considered as a marker for potential underlying gastrointestinal pathology and a requirement for operative intervention. Conclusion  This case describes a rare presentation of Crohn’s disease and highlights the need to consider underlying gastrointestinal pathology in patients presenting with a deteriorating clinical condition in the presence of an incidental foreign body.     

溃疡性结肠炎发病相关的免疫机制

溃疡性结肠炎(UC)是一种慢性、非特异性炎症性肠病。多数学者认为,UC是由环境因素、微生物因素和肠道免疫系统之间复杂地相互作用于遗传易感人群,引起肠道异常免疫反应所致。本文拟对一些与UC发病关系密切的肠道免疫系统的相关因素予以综述。     

缺血性脑血管病与炎性免疫因子

免疫炎性反应在脑缺血后损伤中起重要作用,脑缺血的炎性免疫损伤是一个复杂的病理过程,免疫炎性因子是调节损伤过程免疫反应的关键因子。在炎性反应发生之前,可有细胞因子介导、参与免疫调节和趋化作用,促进白细胞黏附于血管内皮细胞,引起并加重脑缺血损伤,细胞因子产生后进一步诱导黏附分子和趋化因子的表达,促使炎性免疫细胞浸润到损伤组织,炎性免疫细胞及其产生的细胞因子又相互诱导激活,进一步加重组织损伤。     

TFF3和NF-κB在慢性胃炎诱导胃癌发生中的作用

TFF3分子是胃肠道黏膜的细胞保护因子,主要功能是维持其黏膜的完整性和促进损伤上皮的修复。NF-κB是一种多功能转录因子,参与体内免疫应答、炎症反应、细胞增殖、凋亡调节和肿瘤形成等过程。研究表明,在胃的炎性疾病诱导胃癌症形成过程中TFF3和NF-κB通过多种细胞因子（IL-8,血管内皮因子等）来发挥调控作用,此过程中TFF3和NF-κB相互影响、相互调节、共同发挥作用。进一步对TFF3和NF-κB在炎性肿瘤上及其相互关系的研究,可为指导临床炎性肿瘤相关疾病的诊断及治疗提供新的潜在靶点方向。     

Moxibustion treatment restoring the intestinal epithelium barrier in rats with Crohn’s disease by down-regulating tumor necrosis factor alpha, tumor necrosis factor receptor 1, and tumor necrosis factor receptor 2

Objective  

To investigate whether moxibustion regulates tumor necrosis factor alpha (TNF-α), tumor necrosis factor receptor 1 (TNFR1), and TNFR2 in the intestinal mucosa and to explore whether moxibustion could be used by means of this mechanism, to repair the intestinal epithelium barrier disruption in Crohn’s disease (CD).     

克罗恩病的血清学标记物

克罗恩病（CD）的病因仍不明确，但大量证据表明CD患者的免疫系统异常是造成炎症和组织损伤的内在因素，现已明确可以通过血清学标记来预测、监测、治疗许多免疫介导的疾病。寻找理想的非侵人性的炎性肠病（IBD）筛选方法的研究仍在进行，其目的是要找到一种高度特异性、敏感性及预测性的标记或标记物组合。作者就应用血清学标记物在CD发病机制中的作用及诊断的研究进展作一综述。     

Mesenteric panniculitis of the colon

Mesenteric panniculitis is a recently described, non-specific inflammatory disorder of the intestinal mesentery. The majority of cases reported concern the mesentery of the small intestine. We report a case of mesenteric panniculitis of the colon in a patient with Crohn’s disease and review 22 reported cases of mesenteric panniculitis of the colon. The clinical presentation of patients with colonic mesenteric panniculitis was variable, although different from that of small intestinal mesenteric panniculitis. The condition has been reported in all except two cases, and was aided by ultrasonography and computerised tomography. Mesenteric panniculitis of the colon would appear to carry a poorer prognosis than small intestinal mesenteric panniculitis as it presents at a more advanced stage and because of the dangers inherent in colonic obstruction secondary to the panniculitis. We recommend that surgical intervention should be restricted to biopsy to confirm diagnosis, and resection of obstructing mass lesions.     

Polymorphism of the second exon of human leukocyte antigen-DQA1, -DQB1 gene and genetic susceptibility to idiopathic dilated cardiomyopathy in people of the Han nationality in northern China

Idiopathic dilated cardiomyopathy (IDC) is characterized by dilation and impaired contraction of the left ventricle or both, and it is a relevant cause of heart failure and a common indication for heart transplantation. The major pathogenetic hypothesis in IDC involves autoimmune mediated damage to myocytes. The development of autoimmune inflammatory damage occurs only in patients with a predisposing genetic background.     

胃苏颗粒联合雷贝拉唑钠肠溶片治疗慢性胃炎的临床疗效和安全性

目的 分析胃苏颗粒联合雷贝拉唑钠肠溶片治疗慢性胃炎的临床疗效和安全性.方法 选取2018年2月至2020年2月本院收治的128例慢性胃炎患者作为研究对象,按照治疗方式不同分为两组,各64例.对照组采用雷贝拉唑钠肠溶片治疗,研究组采用胃苏颗粒联合雷贝拉唑钠肠溶片治疗,比较两组胃黏膜功能[胃泌素(GAS)、胃蛋白酶原Ⅰ(P...     

Enterocutaneous fistula: A reconstructive dilemma

Summary  Surgical repair of enterocutaneous fistulae in Crohn’s disease may result in large skin defects of the anterior abdominal wall. We present a case in which a large defect was managed with reconstruction using a pedicled rectus abdominis mycocutaneous flap in a single procedure. The case highlights the technical challenge of such a case and the value of a joint surgical approach between plastic and colorectal services.     

卒中、类风湿关节炎与同型半胱氨酸的关联因素

自从人们认识到同型半胱氨酸水平升高可独立引起动脉粥样硬化性血栓形成及血管内皮损伤并将其命名为高同型半胱氨酸血症,它一直都是研究的热点.不仅如此,同型半胱氨酸和类风湿关节炎的关系也尤为密切.同型半胱氨酸可以引起血管损伤并改变一些特定蛋白质的结构,造成新的可能会引起自身免疫反应的抗原的产生,因而同型半胱氨酸有可能是引起一些自身免疫疾病如类风湿关节炎的启动因素.这提示同型半胱氨酸和一些自身免疫疾病的相关性.同型半胱氨酸可以通过免疫-炎症作用引起心脑血管的损害.而免疫-炎症反应可能会增加同型半胱氨酸的水平,并损害特定的组织（心血管疾病中的血管内皮损伤、类风湿关节炎的滑膜损伤）.同型半胱氨酸和自身免疫疾病（免疫炎症反应）之间存在这样的双向作用.在本综述中,将阐述同型半胱氨酸作为卒中和类风湿关节炎之间的关联因素的合理解释,认为同型半胱氨酸是引起卒中和类风湿关节炎的因素之一,可以对这一点进行干预从而防控这两种不同的疾病.     

Prospects for research in inflammatory bowel disease

Inflammatory bowel disease is a chronic inflammatory condition of the gastrointestinal tract that manifests as ulcerative colitis and Crohn disease. Both these clinical entities result from interrelated genetic and environmental factors that may be channeled through an abnormality in mucosal immune function, possibly due to dysregulated or excessive T helper cell (T(H))1 (Crohn disease) or T(H)2 (ulcerative colitis) responses. This article reviews current knowledge of the role of immune factors in inflammatory bowel disease and the potential therapeutic strategies that target the pathways of T(H)1- or T(H)2-induced inflammation.     

浮针疗法对轻中度腹泻型肠易激综合征患者内脏敏感性、胃肠动力、肠道菌群及肠黏膜屏障功能的影响研究

背景　腹泻型肠易激综合征（IBS-D）是消化系统常见病、多发病之一，但目前单纯应用西药治疗尚不能取得满意疗效，且治疗后易复发。浮针疗法用于治疗IBS-D效果肯定，但其具体作用机制仍不明确。目的　探讨浮针疗法对轻中度IBS-D患者内脏敏感性、胃肠动力、肠道菌群及肠黏膜屏障功能的影响。方法　选取 2019年8月-2020 年3月在华北理工大学附属医院消化科门诊及针灸门诊就诊的轻中度IBS-D患者60例，采用随机数字表法分为对照组和观察组，每组30例。对照组患者在常规干预基础上给予复方谷氨酰胺肠溶胶囊治疗，观察组患者在常规干预基础上采用浮针疗法治疗；两组患者均连续治疗14 d。比较两组患者治疗前后肠易激综合征症状严重程度量表（IBS-SSS）评分、内脏敏感指数（VSI）评分、直肠容量刺激感觉指标、肠道菌群数量、生化指标，记录两组患者治疗期间不良反应/并发症发生情况。结果　对照组中1例患者被剔除，观察组中2例患者脱落，最终对照组、观察组分别纳入29例、28例患者。治疗后两组患者IBS-SSS、VSI评分及血清白介素6、白介素8、干扰素γ、血管活性肠肽、胃动素、D-乳酸、肿瘤坏死因子α（TNF-α）水平均低于治疗前，排便阈值、疼痛阈值、感觉阈值及血清P物质水平均高于治疗前，双歧杆菌、乳杆菌、拟杆菌数量均多于治疗前（P<0.05）；治疗后对照组患者肠杆菌数量少于治疗前（P<0.05）；治疗后观察组患者双歧杆菌数量少于对照组，肠杆菌数量多于对照组，血清干扰素γ水平高于对照组（P<0.05）。两组患者治疗期间均未出现明显不良反应/并发症。结论　浮针疗法可有效减轻轻中度IBS-D患者症状严重程度，降低患者内脏敏感性，提高患者直肠顺应性，有利于纠正患者肠道菌群失调，并可能通过调节炎性因子、胃肠激素及肠黏膜屏障相关因子而促进轻中度IBS-D患者肠黏膜屏障功能的恢复及胃肠激素的分泌，达到增强胃肠道免疫功能和减轻应激反应的目的，且安全性较高。     

Local proinflammatory effects of repeated skin exposure to warfarin, an anticoagulant rodenticide in rats

Objective: To evaluate the effects of epicutaneous application of anticoagulant warfarin, by examining the presence of tissue injury and immune/inflammatory activity in exposed skin. Methods: Rats were exposed to warfarin by applying 10 μg of warfarin‐sodium to 10‐12 cm 2 skin (range 0.8‐1 μg per 1 cm 2 ) for 3 consecutive days. Tissue injury was evaluated by lipid peroxidation, histomorphological changes and signs of reparative activity in skin. T cell infiltration and selected aspects of epidermal cell ac...