穴位埋线对实验性大鼠溃疡性结肠炎粘附分子CD44，CD54及白细胞介素2的影响

目的：探讨穴位埋线治疗溃疡性结肠炎（UC）的机理。方法：采用流式细胞仪测定各组UC大鼠组织中粘附分子CD44、CD54含量以及用酶免法测定血清中白细胞介素2（IL－2）的含量。结果：模型大鼠结肠组织中CD44、CD54及血清中IL－2含量较正常鼠低（P＜0．01）；埋线后能显著提高组织中CD44、CD54含量，且优于SASP组，在提高血清中IL－2含量上，两组间差异无显著性意义，但埋线性与模型组间比较，差异有显著性意义（P＜0．05）。结论：穴位埋线具有明显的免疫调节作用，对UC的治疗有较好的疗效。     

美沙拉嗪口服联合灌肠治疗溃疡性结肠炎剂量选择

目的在控制美沙拉嗪总给药量不变的情况下通过改变口服和灌肠联合用药的剂量来选择治疗溃疡性结肠炎的最佳给药剂量。方法120例活动期溃疡性结肠炎患者随机分为A、B、C3组,各40例。每组分别给予不同剂量的口服美沙拉嗪缓释片(艾迪莎)和美沙拉嗪灌肠剂(莎尔福灌肠剂)。比较治疗8周后3组患者的疗效和不良反应发生率。结果治疗8周后,3组患者的疗效间差别有统计学意义(P<0.01);且3组患者疗效间两两比较,差别均有统计学意义(P<0.01)。3组患者不良反应发生率间差别无统计学意义(P>0.05)。结论小剂量多次联合给药可以增加药物的治疗效果。在总用药量不变的情况下,最佳的治疗剂量为口服美沙拉嗪缓释片1g,4次/d,灌肠1g/100ml,2次/d,联合治疗不少于8周。     

血清C反应蛋白和D-二聚体联合检测在溃疡性结肠炎病情活动性判断中的价值

目的通过检测溃疡性结肠炎(UC)患者的血清C反应蛋白(CRP)及D-二聚体水平,探讨二者在UC患者病情活动及严重程度判断中的应用价值。方法分别采用胶乳增强免疫比浊法与免疫扩散比浊法检测64例活动期UC患者、45例缓解期UC患者及40例健康对照者血清CRP及D-二聚体水平,并对活动期患者行肠镜及病理组织学检查,评价病情程度。结果(1)活动期UC组患者血清CRP及D-二聚体水平与缓解期UC组及对照组比较,差异均有统计学意义(P<0.01);缓解期UC组CRP水平与对照组比较,差异有统计学意义(P<0.05),而D-二聚体水平与对照组比较,差异无统计学意义(P>0.05)。(2)重型UC患者血清CPR及D-二聚体水平与轻、中型患者比较,差异有统计学意义(P<0.05)。结论血清CRP及D-二聚体水平可作为评价UC患者病情活动性及严重程度的良好指标。     

5-Aminoisoquinolinone reduces colon injury by experimental colitis

Poly (ADP-ribose) polymerase (PARP), a nuclear enzyme activated by strand breaks in DNA, plays an important role in the colon injury associated with experimental colitis. The aim of the present study was to examine the effects of 5-aminoisoquinolinone (5-AIQ), a novel and potent inhibitor of PARP activity, in the development of experimental colitis. To address this question, we used an experimental model of colitis, induced by dinitrobenzene sulfonic acid (DNBS). Compared with DNBS-treated mice, mice treated with 5-AIQ (3 mg/kg i.p.) or 3-aminobenzamide (3-AB; 10 mg/kg i.p. twice a day) and subjected to DNBS-induced colitis experienced a significantly lower rate in the extent and severity of the histological signs of colon injury. DNBS-treated mice experienced diarrhea and weight loss. Four days after administration of DNBS, the mucosa of the colon exhibited large areas of necrosis. Neutrophil infiltration (determined by histology as well as an increase in myeloperoxidase [MPO] activity in the mucosa) was associated with an up-regulation of intercellular adhesion molecule-1 (ICAM-1). Immunohistochemistry for PAR showed an intense staining in the inflamed colon. On the contrary, the treatment of DNBS-treated mice with 5-AIQ or with 3-AB significantly reduced the degree of hemorrhagic diarrhea and weight loss caused by administration of DNBS. 5-AIQ also caused a substantial reduction in the degree of colon injury, in the rise in MPO activity (mucosa), in the increase in staining (immunohistochemistry) for PAR, as well as in the up-regulation of ICAM-1 caused by DNBS in the colon. Thus, 5-AIQ treatment reduces the degree of colitis caused by DNBS. We propose that 5-AIQ treatment may be useful in the treatment of inflammatory bowel disease.     

Antigranulocyte monoclonal antibody immunoscintigraphy in inflammatory bowel disease in children and young adolescents

Aim: Diagnostic delay for inflammatory bowel disease (IBD) is frequent, especially in paediatric patients. Scintigraphy with labelled leucocytes has been proposed as a very sensitive diagnostic tool for detecting bowel inflammation. The aim of this study was to evaluate the sensitivity and specificity of immunoscintigraphy in the diagnosis and follow-up of children with IBD and to compare this technique with other diagnostic techniques.

Methods: Sixty-six children with histologically confirmed IBD were enrolled in the study. Twenty-one children in whom IBD was suspected but subsequently not confirmed were used as controls. A total of 138 immunoscintigraphies were performed using 99m Technetium-labelled monoclonal anti-granulocyte antibodies. Immunoscintigraphy was also compared with other diagnostic techniques.

Results: Overall sensitivity of monoclonal antibody immunoscintigraphy (MoAb-IS) in patients with clinically active disease was 94% for Crohn's disease (CD) and 85% for ulcerative Ultrasonography, endoscopy and radiology were carried out at the same time in 29 patients with CD and in 6 patients with UC: sensitivity of IS was 90% compared with 76% of colonoscopy, 75% for enemas, and 55% for sonography. IS was negative (specificity) in 24% of patients with CD and in 67% of patients with UC during remission, and in 64% of controls with other causes of intestinal inflammation. Diagnostic delay was significantly shorter when compared with a historical cohort of patients.

Conclusion: Immunoscintigraphy is a highly sensitive detector of intestinal inflammation in young patients with IBD and can be useful for reducing diagnostic delay. However, its specificity is low and all positive cases must be confirmed histologically. colitis (UC).     

The adenosine A3 receptor agonist,N6-(3-iodobenzyl)-adenosine-5'-N-methyluronamide,is protective in two murine models of colitis

This study evaluated the effects of the adenosine A(3) receptor agonist, N(6)-(3-iodobenzyl)-adenosine-5'-N-methyluronamide (IB-MECA), in two murine models of colitis, the dextran sodium sulphate-induced colitis and the spontaneous colitis found in interleukin-10 gene deficient mice. IB-MECA was given orally twice a day at a dose of either 1 or 3 mg/kg/day. Evaluation of colon damage and inflammation was determined grossly (body weight, rectal bleeding) and biochemically (colon levels of myeloperoxidase, malondialdehyde, chemokines and cytokines). There was significantly increased inflammatory cell infiltration into the colon associated with an increase in colon levels of cytokines and chemokines; with subsequent free radical related damage in both dextran sodium sulphate-induced colitis and 10-week-old interleukin-10(-/-) mice. IB-MECA protected in both models against the colitis induced inflammatory cell infiltration and damage and attenuated the increases in colon inflammatory cytokine and chemokine levels. Thus activation of the adenosine A(3) receptor is effective in protecting against colitis.     

介入治疗溃疡性结肠炎的临床观察

目的：观察介入疗法治疗溃疡性结肠炎的临床疗效。方法：溃疡性结肠炎患者52例，分为两组。介入组32例，常规美沙拉嗪治疗基础上行介入治疗，经肠系膜上、下动脉药物灌注治疗；对照组20例，常规美沙拉嗪治疗。观察其临床症状和结肠镜下病变改善情况。结果：治疗后两组症状均有明显的改善（P〈0．05），且介入组患者治疗后1d，排便次数即明显减少，随访4～8周观察各项临床症状改善情况均较对照组治疗效果明显。介入组结肠镜下病变明显改善，且优于对照组；其治疗后的完全缓解率和总有效率也高于对照组。结论：肠系膜上、下动脉药物灌注是一种溃疡性结肠炎切实有效的治疗方法．     

血液病并发急性盲肠升结肠炎的外科处理

目的急性盲肠升结肠炎是儿童血液病的严重并发症，本文讨论其诊断和处理。方法总结我院的临床病例资料，并行文献复习。结果过去5年间诊断血液病并发急性盲肠炎的病例共7例，主要症状是在血液粒细胞严重减低的基础上，出现右下腹痛伴高热和腹泻，CT、B超可提示盲升结肠壁增厚，保守治疗可获明显疗效。结论血液病治疗中出现急性腹痛的患儿，除了考虑阑尾炎外应注意盲升结肠炎的可能。高热、腹泻和CT检查中出现结肠和盲肠壁增厚或壁内积气常是盲肠炎的依据。治疗上以保守治疗为主。     

Gibt es Neues in der Standardtherapie der CED?

Zum Thema Trotz der Fortschritte in der Erfassung genetischer Grundlagen und im Verst?ndnis der Mechanismen der Entzündungsreaktion in der intestinalen Mukosa ist die Behandlung der chronisch entzündlichen Darmerkrankungen auch am Ende dieses Jahrhunderts noch eine symptomatische Therapie, die keine Heilung, sondern nur eine Behandlung der Schübe der Erkrankung und den Versuch einer Erhaltung einer einmal erreichten Remission beinhaltet. Eine Ausnahme bildet die chirurgische Therapie der Colitis ulcerosa, die die Krankheit heilt, aber mit dem Verlust des Kolons und der Reservoirfunktion im Rektum ihrerseits wieder Beschwerden hervorrufen kann. Angesicht dieser Situation ist ein optimales Verh?ltnis von Wirkung und Nebenwirkungen besonders wichtig. Einer Verbesserung dieses Verh?ltnisses waren viele Bemühungen der letzten Jahre gewidmet.     

Detergent enema: A cause of caustic colitis

A 5-year-old boy developed acute colitis followed by stricture formation as a result of a detergent enema. The acute phase of the caustic induced colitis was reproduced in the dog and the rat using full strength and diluted detergent enemas. The severity of the experimental colitis was shown to be directly related to the concentration of the detergent.