Rectal administration of d-alpha tocopherol for active ulcerative colitis： A preliminary report

AIM： To investigate the anti-oxidant and antineutrophil recruitment effects of rectal d-alpha （d-α） tocopherol administration on mild and moderately active ulcerative colitis （UC）.
METHODS： Fifteen patients with mild and moderately active ulcerative colitis were enrolled in an openlabel study of d-α tocopherol enema （8000 U/d） for 12 wk. All patients were receiving concomitant therapy with 5-aminosalicylic acid derivatives （5-ASA） and/or immunomodulator medications. Endoscopic evaluation was performed at baseline and after 4th and 12th weeks. Disease activity was measured with the Mayo disease activity index （DAI） and remission was defined as DAI of ≤ 2 with no blood in stool. Clinical response was defined as a DAI reduction of ≥ 2.
RESULTS： At the end of 12th week, the average DAI score significantly decreased compared to the beginning of the study （2.3 ± 0.37 vs 8 ± 0.48, P 〈 0.0001）. One patient was withdrawn after 3 wk for being unavailable to follow-up. On the 4th week of therapy, 12 patients showed clinical response, 3 of whom （21.4%） achieving remission. After 12 wk, all 14 patients responded clinically to the therapy and remission was induced in 9 of them （64%）. No patient reported adverse events or was hospitalized due to worsened disease activity.
CONCLUSION： This preliminary report suggests that rectal d-α tocopherol may represent a novel therapy for mild and moderately active UC. The observed results might be due to the anti-inflammatory and anti-oxidative properties of vitamin E.     

Elevated plasma von Willebrand factor levels in patients with active ulcerative colitis reflect endothelial perturbation due to systemic inflammation

AIM: To evaluate the plasma von Willebrand factor (vWF) levels in patients with ulcerative colitis (UC) and to investigate their relationship with disease activity, systemic inflammation and coagulation activation. METHODS: In 46 patients with ulcerative colitis (active in 34 patients), clinical data were gathered and plasma vWF levels, markers of inflammation (ESR, CRP, and fibrinogen) and thrombin generation (TAT, F1+2, and D-dimers) were measured at baseline and after 12 wk of treatment. Plasma vWF levels were also determined in 52 healthy controls (HC). The relationship of plasma vWF levels with disease activity, disease extent, response to therapy, acute-phase reactants (APRs) and coagulation markers (COAGs) was assessed. RESULTS: The mean plasma vWF concentrations were significantly higher in active UC patients (143.38±63.73%) than in HC (100.75±29.65%, P = 0.001) and inactive UC patients (98.92±43.6%, P = 0.031). ESR, CRP and fibrinogen mean levels were significantly higher in active UC patients than in inactive UC patients, whereas there were no significant differences in plasma levels of D-dimers, F1+2, and TAT. UC patients with raised APRs had significantly higher mean plasma vWF levels than those with normal APRs (144.3% vs 96.2%, P = 0.019), regardless of disease activity. Although the mean plasma vWF levels were higher in UC patients with raised COAGs than in those with normal COAGs, irrespective of disease activity, the difference was not significant (141.3% vs 118.2%, P = 0.216). No correlation was noted between plasma vWF levels and disease extent. After 12 wk of treatment, significant decreases of fibrinogen, ESR, F1+2, D-dimers and vWF levels were noted only in UC patients with clinical and endoscopic improvement. CONCLUSION: Our data indicate that increased plasma vWF levels correlate with active ulcerative colitis and increased acute-phase proteins. Elevated plasma vWF levels in ulcerative colitis possibly reflect an acute-phase response of the perturbed endothelium due to inflammation. In UC patients, plasma vWF levels may be another useful marker of disease activity or response to therapy.     

法莫替丁与羟氨卞青霉素及果腔铋合用治疗Hp阳性的十二指肠溃疡

CombinedthefamotidineandamoxicillinandpecticbismuthforduodenalulcerwithpositiveHp我们应用国产法莫替丁与羟氨卞青霉素及果胶铋治疗幽门螺杆菌（Hp）阳性的十二指肠溃疡48例，现报告如下。1材料与方法1．1一般资料经胃镜确诊的活动性十二指肠溃疡，活组织尿素酶试验和活组织切片染色Hp均阳性者，且除外复合性溃疡、活动性出血、幽门梗阻、胃手术史、艾一单综合症，1mo内应用抗Hp药物者。男38例，女周例，年龄19～71岁。1．2治疗方法所有病人给予法莫替丁20mg，每日2次；羟氨卞青霉素5009，每日3次；果腔铋1509，每日4次；疗程14d。…     

Hp相关性十二指肠溃疡患者胃泌素,生长抑素变化及其意义

目的：探讨幽门螺杆菌（Ｈｐ）相关性十二指肠溃疡（ＤＵ）患者的胃粘膜及血浆中胃泌素（ＳＳ）、生长抑素（ＧＡＳ）的变化及其意义。方法：对４５例证实为Ｈｐ感染的ＤＵ患者，采用ＰＰＩ三联疗法，１月后胃镜复查。同时采用放射免疫法检测治疗前后血浆和胃粘膜中ＧＡＳ、ＳＳ的表达，并与对照组比较，结果：治疗后①溃疡愈合率为８６．７％，Ｈｐ根除率达９１．１％；②血浆和胃粘膜中ＧＡＳ、ＳＳ含量与对照组差异无显著性（Ｐ〉     

穿刺引流治疗胃十二指肠溃疡急性穿孔的效果观察

目的 探讨穿刺引流治疗胃十二指肠溃疡急性穿孔的临床疗效.方法 2010年1月至2011年12月我院共收治胃十二指肠溃疡急性穿孔患者65例,其中24例患者选择穿刺引流治疗(穿刺组),41例患者选择手术治疗(手术组),比较两组患者的治疗效果.结果 穿刺组手术时间明显低于手术组(P<0.05),两组在住院时间和肛门排气时间方面差异无统计学意义(P>0.05);穿刺组患者术后无并发症出现,无患者中转手术,手术组患者有1例出现术后感染,1例吻合口瘘,并发症发生率为0.49%.结论 穿刺引流治疗胃十二指肠溃疡急性穿孔操作简单、创伤小、疗效可靠,值得推广应用.     

扩大壁细胞迷走神经切断术治疗十二指肠溃疡及并发症的效果观察

目的 观察扩大壁细胞迷走神经切断术治疗十二指肠溃疡并发穿孔、出血和狭窄的近、远期效果.方法 观察50例十二指肠溃疡并发穿孔、出血和狭窄病人扩大壁细胞迷走神经切断术的治疗效果,46例病人得到随访和观察,随访期为3.0～10 a,平均6 a,其中穿孔28例,出血6例和狭窄12例.结果 总的溃疡复发率为2.2%,狭窄复发率占...     

十二指肠溃疡症状再发的内镜诊断分析：—附120例报告

由于不断有新药出现，对十二指肠球部溃疡(DU)的治疗，如使用H_2受体阻滞剂或质子泵抑制剂(PPI)药物，4周的愈合率可达95％，但本病又具有容易复发的特点，据有关报道，本病一年后的复发率高达80％。溃疡复发……     

双气囊小肠镜在小肠溃疡诊断中的价值

目的 探讨双气囊小肠镜在小肠溃疡诊断中的临床价值.方法 19例小肠溃疡的病人经双气囊小肠镜检查并行镜下描述,与其病理诊断对照分析,从而论证双气囊小肠镜检查在小肠溃疡诊断中具有重要价值.结果 小肠克罗恩病9例(47.3%),小肠结核4例(21.0%),小肠非特异性溃疡2例(10.5%),小肠肿瘤1例(5.3%),非何杰金淋巴瘤1例(5.3%),过敏性紫癜1例(5.3%),不明原因的溃疡1例(5.3%).结论 小肠溃疡以克罗恩氏病为多见,其次为肠结核.而结合其他部位的病变有助于对病因的判断.