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World Journal of Gastroenterology 2022年第48期28卷 6888-6899页

作者： Yi-Han Xu wei-ming zhu Zhen Guo Department of General Surgery Affiliated Jinling HospitalMedical School of Nanjing UniversityNanjing 210002Jiangsu ProvinceChina

Treatment strategies for inflammatory bowel disease(IBD)are rapidly evolving with the development of biologics and small molecule drugs(SMDs).However,these drugs are not guaranteed to be effective in all patients,and a“ceiling effect”of biologic monotherapy may occur.This issue highlights an unmet need for optimizing the use of biologics and predicting therapeutic responses.Thus,the development of new drugs with novel mechanisms of action is urgently needed for patients with primary nonresponse and secondary loss of response to conventional biologics and SMDs.In addition,combining different biologics or SMDs has been proposed as a novel strategy to enhance treatment efficacy in IBD,which theoretically has multidimensional anti-inflammatory potential.Based on the current evidence available for IBD,dual targeted therapy may be a promising strategy for refractory IBD patients who have failed in multiple biologic treatments or who have extraintestinal manifestation.Additionally,identifying the subgroup of IBD patients who are responding to biological combination therapies is also equally important in stable disease remission.In this review,we summarize the newly developed biologics and SMDs and the current status of biologics/SMDs to highlight the development of individualized treatment in IBD.

关键词： Inflammatory bowel diseases Biologic Dual targeted therapy Therapeutic drug monitoring Bispecific antibodies

Postoperative diarrhea in Crohn's disease:Pathogenesis,diagnosis,and therapy

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World Journal of Clinical Cases 2023年第1期11卷 7-16页

作者： En-Hao Wu Zhen Guo wei-ming zhu Department of General Surgery Affiliated Jinling HospitalMedical School of Nanjing UniversityNanjing 210002Jiangsu ProvinceChina

Diarrhea is a frequent symptom in postoperative patients with Crohn’s diseases(CD),and several different mechanisms likely account for postoperative diarrhea in CD.A targeted strategy based on a comprehensive underst... 详细信息

关键词： Postoperative diarrhea Crohn’s disease Intestinal resection Bile acid malabsorption Treatment

Perforating and nonperforating indications in repeated surgeries for Crohn's disease

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World Journal of Clinical Cases 2022年第9期10卷 2733-2742页

作者： wei-Song Shen Xiao-Hui Huang Rui-Qing Liu Chen-Yang Li Yi Li wei-ming zhu Department of Gastrointestinal Surgery Peking University People’s HospitalBeijing 100044China Department of General Surgery Chinese PLA General Hospital First Medical CenterBeijing 100853China Department of General Surgery The affiliated Hospital of Qingdao UniversityQingdao 266000Shandong ProvinceChina Peking University School of Nursing Peking University School of NursingBeijing 100191China Department of General Surgery Jinling HospitalMedical School of Nanjing UniversityNanjing 210002Jiangsu ProvinceChina

BACKGROUND Despite advances in medical therapy for Crohn’s disease(CD),most patients with CD require repeated resection surgeries.AIM To analyze the perforating and nonperforating indications of repeated CD operations and identify the anastomosis characteristics for postoperative CD.METHODS We retrospectively reviewed 386 patients who underwent at least one resection for CD between 2003 and 2013.Clinical characteristics of each surgery were collected.Univariate and multivariate analyses were performed to determine risk factors for recurrence.RESULTS The indication for reoperation in CD tends to be the same as that for primary operation,i.e.,perforating disease tends to represent as perforating disease and nonperforating as nonperforating.Concordance was found between the first surgery and second surgery in terms of the indication for the operation(P=0.006),and the indication for the third surgery was also correlated with that for the second surgery(P=0.033).Even if the correlation of surgical indications between repeated operations,the rate of perforating indication for the second and third surgeries was significantly higher than that of the first surgery.In addition,the presence of perforating CD was a predictor of recurrence for both the first and second surgeries.Moreover,anastomotic lesions were the most common sites of recurrence after the operation.Based on the importance of anastomosis,anastomosis might be a new type of disease location for the classification of postoperative CD.CONCLUSION CD not only has stable characteristics but also progresses chronically.Perforation is a progressive surgical indication for Crohn’s disease.For CD after surgery,anastomosis may be a new classification of disease location.

关键词： Crohn’s Disease Anastomosis Perforation Nonperforating

Role of mesenteric component in Crohn’s disease:A friend or foe?

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World Journal of Gastrointestinal Surgery 2021年第12期13卷 1536-1549页

作者： Yi Yin Zhen-Xing zhu zhun Li Yu-Sheng Chen wei-ming zhu Department of General Surgery Jinling HospitalMedical School of Nanjing UniversityNanjing 210002Jiangsu ProvinceChina

Crohn’s disease(CD)is a complex and relapsing gastrointestinal disease with mesenteric alterations.The mesenteric neural,vascular,and endocrine systems actively take part in the gut dysbiosis-adaptive immunity-mesentery-body axis,and this axis has been proven to be bidirectional.The abnormalities of morphology and function of the mesenteric component are associated with intestinal inflammation and disease progress of CD via responses to afferent signals,neuropeptides,lymphatic drainage,adipokines,and functional cytokines.The hypertrophy of mesenteric adipose tissue plays important roles in the pathogenesis of CD by secreting large amounts of adipokines and representing a rich source of proinflammatory or profibrotic cytokines.The vascular alteration,including angiogenesis and lymphangiogenesis,is concomitant in the disease course of CD.Of note,the enlarged and obstructed lymphatic vessels,which have been described in CD patients,are likely related to the early onset submucosa edema and being a cause of CD.The function of mesenteric lymphatics is influenced by endocrine of mesenteric nerves and adipocytes.Meanwhile,the structure of the mesenteric lymphatic vessels in hypertrophic mesenteric adipose tissue is mispatterned and ruptured,which can lead to lymph leakage.Leaky lymph factors can in turn stimulate adipose tissue to proliferate and effectively elicit an immune response.The identification of the role of mesentery and the crosstalk between mesenteric tissues in intestinal inflammation may shed light on understanding the underlying mechanism of CD and help explore new therapeutic targets.

关键词： Crohn’s disease Mesenteric nerves Angiogenesis Lymphatic drainage Mesenteric adipose tissue

Endoscopic closure instead of surgery to close an ileal pouch fistula with the over-the-scope clip system

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World Journal of Gastrointestinal Endoscopy 2017年第2期9卷 95-98页

作者： Yao wei Jian-Feng Gong wei-ming zhu Institute of General Surgery Jinling HospitalMedical School of Nanjing UniversityNanjing 210002Jiangsu ProvinceChina

An ileal pouch fistula is an uncommon complication after an ileal pouch anal anastomosis. Most patients who suffer from an ileal pouch fistula will need surgical intervention. However, the surgery can be invasive and has a high risk compared to endoscopic treatment. The over-the-scope clip(OTSC) system was initially developed for hemostasis and leakage closure in the gastrointestinal tract during flexible endoscopy. There have been many successes in using this approach to apply perforations to the upper gastrointestinal tract. However, this approach has not been used for ileal pouch fistulas until currently. In this report, we describe one patient who suffered a leak from the tip of the "J" pouch and was successfully treated with endoscopic closure via the OTSC system. A 26-year-old male patient had an intestinal fistula at the tip of the "J" pouch after an ileal pouch anal anastomosis procedure. He received endoscopic treatment via OTSC under intravenous anesthesia, and the leak was closed successfully. Endoscopic closure of a pouch fistula could be a simpler alternative to surgery and could help avoid surgeryrelated complications.

关键词： Over-the-scope 片断系统内视镜的处理补药 proctocolectomy Ulcerative 大肠炎 Ileal 小袋管

New Diterpenoid Alkaloids from Spiraea japonica var. Ovalifolia

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Chinese Chemical Letters 2001年第2期12卷 147-150页

作者： Guo Ying ZUO Hong Ping HE Xin HONG wei ming zhu Yi ming HU Xiao Sheng YANG Xiao Jiang HAO Laboratory of Phytochemistry Kunming Institute of BotanyChinese Academy of SciencesKunming 650204 Kunming 43 Hospital PLAKunming 650032 The Key Laboratory of Chemistry for Natural Products ofGuizhou Province and Chinese Academy of Sciences Guiyang 550002

Five new diterpenoid alkaloids. 19-O-deethlyspiramine N (1), deacetylspiramine S (2), spiramidine A (3), spiramidine B (4) and deacetylspiramine F (5) were isolated from the aerial parts of Spirae japonica L. f. var o... 详细信息

关键词： Rosaceae Spireae japonica L. f. var. ovalifolia diterpenoid alkaloids

A cytotoxic pyrrolidinoindoline diketopiperazine dimer from the algal fungus Eurotium herbariorum HT-2

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Chinese Chemical Letters 2013年第12期24卷 1049-1052页

作者： Ye Li Kun-Lai Sun Yi Wang Peng Fu Pei-Pei Liu Chen Wang wei-ming zhu Key Laboratory of Marine Drugs Ministry of Education of ChinaSchool of Medicine and PharmacyOcean University of China

A new cytotoxic pyrrolidinoindoline diketopiperazine dimer, cristatumin E （1）, was isolated from the fermentation broth of the algal fungus Eurotium herbariorum HT-2 associated with the marine algae, Enteromorpha prolifera. The structure was determined by spectroscopic analyses and Marfey＇s amino acid analysis. Cristatumin E （1） showed cytotoxicity against K562 tumor cell line and antibacterial activity against Enterobacter aerogenes and Escherichia coli with IC50 and MIC values of 8.3, 44.0 and 44.0 μmol/L, respectively.

关键词： Cristatumin E Pyrrolidinoindoline diketopiperazine dimer Eurotium herbariorum Algal fungus Cytotoxicity Enteromorpha prolifera Marine algae

A New Cytotoxic Compound from Penicillium auratiogriseum, Symbiotic or Epiphytic Fungus of Sponge Mycale plumose

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Chinese Chemical Letters 2005年第9期16卷 1227-1229页

作者： Zhi Hong XIN wei ming zhu Qian Qun GU Yu Chun FANG Lin DUAN Cheng Bin CUI Key Laboratory of Marine Drugs of Chinese Ministry of Education Marine Drugs and Food Institute Ocean University of China Qingdao 266003

A new compound, （S）-2, 4-dihydroxy-1-butyl （4-hydroxy） benzoate （1）, and a known compound, fructigenines A （2）, were isolated from fungus Penicillium auratiogriseum derived from sponge Mycale plumose, by bioassay-guided fractionation. Their structures were established by spectroscopic and chemical methods. Both compounds show.ed cytotoxic activity against tsFT210 cells.

关键词： Penicillium auratiogriseum Mycale plumose aromatic ester alkaloid anti-tumoractivity

A New Benzosesquiterpenoid Dimer from Polyalthia cheliensis Hu

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Chinese Chemical Letters 2001年第7期12卷 617-618页

作者： wei ming zhu Xin HONG Yue Mao SHEN Bi Tao ZHAO Hong Ping HE Xiao Jiang HAO Laboratory of Phytochemistry Kunming Institute of BotanyChinese Academy of SciencesKunming 650204 Department of Chemistry Yunnan Normal UniversiteKunming 650092

A new benzosesquiterpenoid dimer, 3 ' ,3 ' ' ' -bispolycerasoidol (1), along with its monomer, polycerasoidol, were isolated from the dried leaves of Polyalthia cheliensis Hu. The structure of 1 was established by spe... 详细信息

关键词： Polyalthia cheliensis Annonaceae bispolycerasoidol benzosesquiterpenoid

Conservative treatment of early postoperative small bowel obstruction with obliterative peritonitis

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World Journal of Gastroenterology 2013年第46期19卷 8722-8730页

作者： Jian-Feng Gong wei-ming zhu Wen-Kui Yu Ning Li Jie-Shou Li Department of General Surgery Jinling Hospital Medical School of Nanjing University

AIM:To investigate the effect of somatostatin and dexamethasone on early postoperative small bowel obstruction with obliterative peritonitis(EPSBO-OP).METHODS:This prospective randomized study included 70 patients diagnosed with EPSBO-OP from June2002 to January 2009.Patients were randomized into two groups:a control group received total parenteral nutrition and nasogastric(NG)tube feeding;and an intervention group received,in addition,somatostatin and dexamethasone treatment.The primary endpoints were time to resolution of bowel obstruction and length of hospital stay,and the secondary endpoints were daily NG output and NG feeding duration,treatment-related complications,postoperative obstruction relapse,and patient satisfaction.RESULTS:Thirty-six patients were allocated to the intervention group and 34 to the control group.No patient needed to undergo surgery.Patients in the intervention group had an earlier resolution of bowel obstruction(22.4±9.1 vs 29.9±10.1 d,P=0.002).Lower daily NG output(583±208 vs 922±399 mL/d,P<0.001),shorter duration of NG tube use(16.7±8.8vs 27.7±9.9 d,P<0.001),and shorter length of hospital stay(25.8 vs 34.9 d,P=0.001)were observed in the intervention group.The rate of treatment-related complications(P=0.770)and relapse of obstruction(P=0.357)were comparable between the two groups.There were no significant differences in postoperative satisfaction at 1,2 and 3 years between the two groups.CONCLUSION:Somatostatin and dexamethasone for EPSBO-OP promote resolution of obstruction and shorten hospital stay,and are safe for symptom control without increasing obstruction relapse.

关键词： Dexamethasone Intestinal obstruction Parenteral nutrition Postoperative period Somatostatin