护理干预对肠易激综合征患者临床症状和生活质量的影响

目的探讨护理干预对肠易激综合征患者临床症状和生活质量的影响。方法对34例肠易激综合征患者进行食物过敏原皮肤试验,对19例试验阳性者进行食物激发试验,对13例食物激发试验阳性患者采取剔除过敏食物、记录日志等针对性护理干预,并观察其效果。结果护理干预4周、8周后,患者症状频率、严重程度评分显著低于干预前。生活质量总体健康评分和7个维度评分(除挑食外)显著高于干预前(均P0.05)。结论针对性护理干预措施能有效改善IBS患者的临床症状和生活质量。     

护理干预对肠易激综合征患者临床症状和生活质量的影响

目的探讨护理干预对肠易激综合征患者临床症状和生活质量的影响。方法对34例肠易激综合征患者进行食物过敏原皮肤试验,对19例试验阳性者进行食物激发试验,对13例食物激发试验阳性患者采取剔除过敏食物、记录日志等针对性护理干预,并观察其效果。结果护理干预4周、8周后,患者症状频率、严重程度评分显著低于干预前。生活质量总体健康评分和7个维度评分（除挑食外）显著高于干预前（均P〈0．05）。结论针对性护理干预措施能有效改善IBS患者的临床症状和生活质量。     

益生菌治疗肠易激综合征的可能机制

肠易激综合征（irritable bowel syndrome．IBS）是常见的功能性胃肠病的一种，以反复发作的腹痛或腹部不适为特点，伴有大便性状和排便习惯的改变。据文献报道，IBS在欧美的发病率达到了20％，     

肠易激综合征动力异常及其机制

肠易激综合征(irritable bowel syndrome，IBS)是一种以肠道功能异常为主要表现的功能性疾病，其功能异常的表现可有多方面，动力异常是其中的重要表现形式之一。动力异常可表现为结肠动力异常、小肠动力异常、其他消化道动力异常，甚至消化道外动力异常。IBS一般据其症状分为便秘型(IBS—C)、腹泻型(IBS—D)、交替型(IBS—A)。此外，有人根据动力异常的形式分为痉挛性结肠综合征(SCS)、功能性腹泻(FD)、腹泻为主的痉挛性结肠综合征(DPSCS)和小肠动力异常(MGD)四种^[1]。兹将IBS动力异常及其机制研究简单回顾如下。     

器官移植后食物过敏的研究进展

移植后食物过敏（TAFA）是实体器官移植术后的一种少见并发症。TAFA的发病原因目前尚未完全阐明,其发生机制包括供者免疫球蛋白E传递介导的食物过敏和移植后食物不耐受引起的食物过敏。目前,器官移植科医师对TAFA的认识尚不充分。笔者通过系统复习相关文献,对TAFA的相关研究进展进行总结,内容包括TAFA的发病机制、临床特...     

30例肠易激综合征患者的辨证施护

选择肠易激综合征患者６０例，随机分为两组，在接受治疗的同时，治疗组３０例采用辨证施护；对照组３０例按腹泻、便秘症的护理。结果治疗组疗效明显高于对照组（Ｐ〈０．０５）；复发率明显低于对照组（Ｐ〈０．０５）。     

中西医结合治疗肠道易激综合征

中西医结合治疗肠道易激综合征吕文增１吕贵英２蔡润喜２１．山东省聊城地区人民医院（山东２５２０００）２．山东省聊城市人民医院近年来我们探索中西医结合方法治疗本病，疗效满意。１资料与方法１．１一般资料本组８６例，男６８例，女１８例；年龄３２～５４岁；病程...     

肠易激，有话好好说

肠易激综合征不是大病，但是发作起来令人抓狂。 年轻女子的情绪很容易激动——这一点几乎是大家公认的事实．但如果连你的肠胃同样都容易激动。该怎么办呢？     

便秘型肠易激综合征的肠道微生态学研究

目的 了解便秘型肠易激综合征患者与健康人肠道菌群的变化情况。方法 研究组42例，对照组38例，取当日首次定量大便作活性菌培养，检测两组相同菌种进行比较。结果 研究实验数据显示，研究组肠杆菌和梭杆菌差异有高度统计学意义（P〈0．01），类杆菌和双歧杆菌差异有高度统计学意义（P〈0．01），而健康人群对照组以双歧杆菌、类杆菌差异有高度统计学意义（P〈0．01），梭杆菌极显著性降低（P〈0．01）。结论 便秘型肠易激综合征肠道菌群结构的变化可能与梭状芽胞杆菌类致病菌增高，双歧杆菌类有益菌的降低有密切关系。     

Adverse reactions to food and clinical expressions of food allergy

Adverse reactions to foods are frequent in everyday life. They are divided into toxic and immunologic food reactions. The awareness of toxic food reactions among adverse reactions to food is essential for correct diagnosis. Enzymatic food intolerance, adverse reactions to food or food additives, pharmacologic food intolerance, psychosomatic factors, food allergy with classic symptoms (anaphylaxis, urticaria-angioedema), atopic dermatitis, contact dermatitis (protein), upper and lower respiratory symptoms like rhinitis or asthma, and gastrointestinal disorders (oral allergy syndrome, colic, nausea, vomiting, diarrhea, abdominal pain) are discussed. Target organs throughout the body-ear, eye, pharynx, skin, lung, joints, and muscles-can be involved. The gold standard in diagnosis is a double-blind, placebo-controlled food challenge test. The diagnostic tools available for most food-related disorders are the skin-prick test and radioallergosorbent test. The treatment of food-induced urticaria consists of elimination of the offending food or substance from the diet, use of antihistamines, and immunotherapy.     

A closer look at food allergy and intolerance

Food allergy is a condition prevalent in over 2 percent of the world's population. The topic has been subject to research from ancient Greek times and continues to attract modern scientific and medical communities. In susceptible individuals certain foods produce a wide spectrum of unwanted effects like eczema, asthma, and urticaria. The management of food allergy and intolerance chiefly involves elimination diets, accurate diagnosis and detecting the causative mechanism providing us with ample food for thought. In this article, we have attempted to summarize and simplify the research on the various aspects of food allergy and intolerance, and discuss the natural history, manifestations, mechanisms, diagnosis, and management of this condition affecting countless worldwide.     

The development of food allergy after liver transplantation.

The acquisition of new food allergy after orthotopic liver transplantation is now a well described phenomenon, mainly reported in children. The etiology of this phenomenon is at present unclear, but has been ascribed by some to tacrolimus treatment. Here we report a case of liver transplant acquired food allergy (LTAFA) in a child who received a split liver graft. The case is remarkable for the absence of new food allergy in the adult recipient of the same graft. This suggests that host-specific factors play an important role in the development of food allergy after liver transplantation, and emphasizes the predisposition that children have toward this phenomenon. Possible mechanisms underlying the development of food allergy after liver transplantation are discussed. In conclusion, tacrolimus treatment alone cannot account for LTAFA. Host factors such as the maturity of immune regulatory mechanisms are likely to play a critical role in the development of new food allergy after a liver transplant.     

The role of food allergy in otitis media with effusion

OBJECTIVE: To detect the relationship between food allergy and otitis media with effusion (OME). MATERIALS AND METHODS: This study was performed on three different groups. The patient group was made up of 56 patients with OME (group I). There were 28 patients with food allergy in group II and these patients were investigated for OME. The control group consisted of 28 patients without any complaints concerning food allergy or OME (group III). RESULTS: Food allergy was detected in 25 patients with OME (44.6%) (group I). In patients with food allergy (group II), OME was detected in 7 patients (25%). In the control group (group III) food allergy was diagnosed in 5 patients (18%) and OME in 1 patient (3%). The incidence of food allergy in OME group was statistically significant when compared to the normal group (P > 0.05). CONCLUSIONS: This study demonstrates that food allergy may play a role in the etiopathogenesis of OME.     

Is adult idiopathic nephrotic syndrome food allergy? Value of oligoantigenic diets

To evaluate the prevalence of food hypersensitivity in idiopathic nephrotic syndrome (INS), an oligoantigenic diet was given for 10 days to 13 patients with INS who had not steadily responded to corticosteroids; 5 of these patients were corticodependent, 3 were corticoresistant and 5 had multiple relapses. A history of allergy was present in 8 cases and an increase in total serum IgE levels in 6. Sensitivity to food antigens was documented by skin tests in 5, by the radioallergosarbent test (RAST) in 5 and by the human basophil degranulation test (HBDT) in 11. At the end of the oligoantigenic diet, proteinuria was significantly reduced in the 13 patients as compared to the initial level. It decreased by more than 50% in 9 patients and disappeared completely in 5. It seems that an oligoantigenic diet is helpful in cases of INS that do not respond to corticosteroids. This argues for a role of food hypersensitivity in this disease and suggests that avoidance of specific foods on the longer term may be of benefit. This diet must be tried in INS before the initiation of immunosuppressive therapy.     

椎间盘退变机制研究进展

椎间盘退变（intervertebral disc degeneration,IVDD）是一系列脊柱退行性疾病的前提和基础病理过程,临床上往往表现为椎管狭窄、脊柱节段不稳、腰腿痛、颈椎病、椎间盘突出等病症,患者相关的神经根、脊髓受压并产生一系列相应症状。目前引起椎间盘退变的确切机制尚无定论,国内外学者从不同角度（如分子生物学、生物化学、生物力学、免疫学等等）进行了深入的探讨,现将研究的进展简述如下。     

Aggressive gastrointestinal food allergy in neonates and its possible relationship to necrotizing enterocolitis

IntroductionThe incidence of gastrointestinal food allergy (FA) in neonates is increasing. Despite this, cases of patients with gastrointestinal FA who develop necrotizing enterocolitis (NEC) requiring laparotomy are extremely rare.Presentation of caseWe describe two cases that presented with bloody stool with a probable diagnosis of FA as eosinophils were positive in the stool at onset. Both cases failed conservative treatment. Jejunostomy and ileostomy were performed in both cases due to secondary NEC with underlying acute FA. Post-surgery, raised peripheral blood eosinophil count, presence of cow’s milk-specific IgE antibody and positive allergen-specific lymphocyte stimulation test were found. Stoma closure were performed 3 and 1 months later in both cases. Postoperative recovery was uneventful.DiscussionA few reports have not identified risk factors for NEC secondary to FA. Thrombocytopenia and rise in C-reactive protein (CRP) levels 2 days after the development of FA may be suggestive of FA with NEC. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in the fecal culture of both patients at the time of the onset of NEC. The toxic antigen produced by MRSA may cause activation of milk-protein-primed T cells and exacerbate FA.ConclusionThe decrease of platelet levels and rise in CRP may indicate the development of secondary NEC in patients with FA. Additionally, MRSA detected in the fecal culture also may be a risk factor for NEC through the activation of cellular immunity reaction pathways.     

良性胆管狭窄形成机制的研究

目的 探讨良性胆管狭窄的形成机制。方法 用28只犬建立犬胆总管损伤修复的动物模型,分别于术后3d、1周、3周、3月、6月取材行光镜、电镜观察及免疫纵化观察巨噬细胞、转化生长因子（TGF-β1）、平滑肌肌动蛋白（α-SMA）在胆管愈合过程不同时期组织中的表达强度、阳性细胞数和组织分布。结果 光镜及电镜显示:在整个胆管修复过程中炎性渗出期较长,胆道粘膜上皮愈合较慢,瘢痕组织细胞持续增生活跃,细胞外基质过度沉积,胶原纤维排列致密杂乱。肌成纤维细胞（MFB）功能活跃,持续存在于整个愈合过程中。免疫组化:巨噬细胞、TGF-β1、α-SMA在胆管愈合过程中表达较强,且持续较长时间。MΦ阳性主要表达于胆道粘膜下固有层;TGF-β1主要表达于肉芽组织、成纤维细胞、MΦ由及血管内皮细胞胞浆和细胞膜;α-SMA表达于MFB胞浆、平滑肌组织。MΦ、TGF-β1及α-SMA的表达呈正相关。结论 ①胆管愈合方式属于过度愈合。②肌成纤维细胞功能活跃,持续存在,是导致胆管瘢痕性挛缩的重要原因。③MΦ、TGF-β1及α-SMA高表达是造成胆管愈合过程中成纤维细胞增殖旺盛、细胞外基质过度沉积、胆管瘢痕性挛缩的重要因素。