Biological treatment of gastrointestinal diseases

Biological methods are widely used in the treatment of intestinal inflammation (II). The TNFalpha inhibitor infliximab can quickly correct recurrence, provide long-term remission and reduce hormone need in many patients with hormone-resistant and hormone-dependent forms of Crohn's disease (CD) and ulcerative colitis (UC). However, almost half of II patients fail anticytokine therapy. Some clinical trials of biological medicines were stopped because of toxicity and complications. One of promising approaches to II treatment is now transplantation of mesenchymal stromal cells (MSC). The trial with participation of 85 CD and UC patients demonstrates that intravenous injection of allogenic MSC significantly prolongs duration of remission, reduces recurrence risk and is indicated for patients with hormone-resistant, hormone-dependent forms of II. Cell therapy can be also used in combined treatment of other gastrointestinal diseases, hepatic cirrhosis, in particular. A clinical trial is initiated of efficacy of transplantation of bone marrow autologous cells CD133+ for stimulation of regeneration of the liver in its extensive resection and cirrhosis. The future of this method depends on the results of controlled, randomized clinical trials.     

Evolving molecular targets in the treatment of nonmalignant gastrointestinal diseases

Novel treatments for gastrointestinal (GI) diseases are based on molecular targets. Novel pharmacologic and biological agents with greater selectivity and specificity are being developed for a variety of epithelial diseases, including eosinophilic esophagitis (EoE), gastroesophageal reflux disease (GERD), celiac disease, short bowel syndrome (SBS), and inflammatory bowel diseases (IBDs; Crohn's disease and ulcerative colitis). Motility and secretory agents are being developed for gastroparesis, irritable bowel syndrome (IBS), functional constipation, and diarrhea. Here we focus on data from clinical trials involving validated pharmacodynamic or patient response outcomes.     

乳腺疾病的微创与功能治疗

随着我国改革开放和经济水平的提高 ,审美观念正发生巨大转变。现代社交活动的日益丰富、服装服饰的不断更新 ,西方美学观念的强烈冲击 ,女性乳房作为美的体现和美的象征而受到前所未有的重视 ,人们已不再单纯满足于乳房疾病的医治 ,更要求在形体、功能及心理上得到康复。今天 ,腔镜技术在外科的广泛应用 ,美容手术、整形手术与外科手术的结合 ,外科已进入了一个微创与功能时代。1　乳腺良性疾病的微创功能治疗1 1　乳腔镜 (Mastoscopy)手术切除乳房肿块是乳房疾病中最常见的临床表现 ,门诊就诊的乳腺疾病患者 2 /3以上主诉乳腺肿块 ,以良…     

内镜超声检查对消化道疾病诊治价值的认识

超声内镜（endoscopic ultrasound）开始时为机械环扫探头，主要用于消化道腔内疾病的诊断；而今内镜超声检查（endoscopic ultrasonography，EUSl）技术已进展至电子环扫、扇形扫描、前视探头和多普勒技术相结合的多系列、全面发展阶段，其临床功能也已从单纯的诊断进展至诊断与EUS引导下微创治疗相结合并以治疗为主的阶段。     

在校大学生功能性胃肠疾病调查及影响因素分析

目的探讨在校大学生功能性胃肠疾病发病情况及其影响因素。方法采取分层整群抽样方法抽取2015-2018年本校在校的大学生1200名,发放问卷1200份,收回有效问卷1138份,统计功能性胃肠疾病患病情况,比较功能性胃肠疾病和正常对照者一般资料(性别、年龄、体质量指数、民族、年级)、饮食情况(暴饮暴食、辛辣生冷等刺激饮食、每日饮水量、蔬菜水果频次)、作息情况(每日学习时间、每日睡眠时间、每周体育锻炼次数、每周娱乐时间)、心理因素(焦虑、抑郁)以及既往应激史(肠道感染史、过敏史、经常用药史、外伤史),有统计学意义的因素进行多因素logistic回归分析确定功能性胃肠疾病的影响因素。结果 1138名学生中功能性胃肠疾病发病率为26. 80%(305/1138),发病率前3位的是功能性便秘119名、功能性消化不良91名、功能性腹胀70名,主要临床症状有便秘、腹胀、腹部疼痛、恶心呕吐、腹泻等。多因素logistic回归分析显示,性别、年级、暴饮暴食、辛辣生冷等刺激饮食、每日睡眠时间、焦虑、抑郁、肠道感染史、经常用药史是在校大学生功能性胃肠疾病发病的独立危险因素(P <0. 05)。结论在校大学生功能性胃肠疾病发病受到多种因素影响,应采取相应干预措施降低发病率。     

伽玛刀治疗脑功能性疾病疗效分析

目的分析伽玛刀治疗脑功能性疾病的有效性.方法对111例脑功能性疾病患者采用不同的靶点及剂量实施治疗,统计及分析疗效.结果随访6～40个月,平均26个月,三叉神经痛有效率88.6%,癫痫87.5%,帕金森氏病60%,精神病75%,药物依赖57.1%,丘脑痛例数较少,近期疗效令人满意.结论伽玛刀治疗脑功能性疾病是相对安全、有效的可供选择的方法之一.     

超声内镜在上消化道疾病诊断与治疗中的应用

超声内镜检查的应用价值正在不断地扩展.本文就其在上消化道中的应用,对相关疾病的诊断与治疗进展作一综述.     

Immune dysregulation in the functional gastrointestinal disorders

Gastrointestinal conditions may be broadly classified into two: organic and functional disease, with functional disorders accounting for the majority of patients with chronic gastrointestinal symptoms. Functional gastrointestinal disorders (FGIDs) present with no obvious pathology or well‐accepted biochemical mechanism and, as such, treatment strategies are limited and focus on symptoms rather than cure. Irritable bowel syndrome and functional dyspepsia are the most widely recognised FGIDs, and there is a growing body of evidence to suggest an underlying inflammatory phenotype in subsets with these conditions. Here, we discuss the current knowledge of immune involvement in FGIDs and the commonalities between the different manifestations of FGIDs and propose a new hypothesis, potentially defining an underlying immunopathological basis of these conditions.     

Proteases in gastrointestinal neoplastic diseases

Cysteine and serine proteases are involved in cancer invasion and metastasis. In the past few years we investigated the tissue levels of these proteases in gastric cancer (GC), gastric precancerous changes (CAG), colorectal cancer (CRC) and the plasma and serum levels of proteases in several gastrointestinal tumours, using ELISA methods. Significantly higher antigen levels were found not only in GC tissue but also in CAG with respect to the levels found normal tissue; with respect to CAG, patients with dysplasia had higher levels than patients without dysplasia. The same findings were obtained in CRC. In general protease levels correlated with the major histomorphological parameters, such as grading and histotype in GC as well as in CRC. Tissue protease levels had a strong prognostic impact in GC, in which UPA was singled out by multivariate analysis as the major prognostic factor, and CRC. The plasma levels of urokinase-type plasminogen activator (UPA) and the serum levels of cathepsin B were significantly increased in patients with gastrointestinal tumours. In conclusions, cysteine and serine proteases may have a part not only in GC and CRC invasion and metastasis, but also in the progression of gastric precancerous changes into cancer. They are strong prognostic factors in GC and CRC. These proteases may also have a role as tumour markers in the early diagnosis of gastrointestinal tract tumours.