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World Journal of Gastroenterology 2018年第45期24卷 5076-5080页

作者： Mark S Riddle Patrick Connor Chad K Porter Department of Preventive Medicine and Biostatistics Uniformed Services University Military Enteric Disease Group Department of Military Medicine Royal Centre for Defence Medicine Birmingham Research Park Department of Enteric Diseases Naval Medical Research Center

One-hundred years have passed since the original description of the commonly described phenomenon of persistent abdominal symptoms being triggered by an acute enteric infection. This first account was generated out of astute observations by Sir Arthur Hurst in World War I. Additional descriptions followed from military and non-military practitioners adding the evidence which has transitioned this recognized condition from association to causation. While mechanistic understanding is an area of active pursuit, this historical accounting of a centuries progress highlights important advances and contributions of military medicine and scientists to advances benefiting global populations.

关键词： post-infectious irritable bowel syndrome Medical history Military medicine Gastroenteritis Travelers’diarrhea Functional gastrointestinal disorder Bacterial diarrhea

Clinical features of postinfectious bronchiolitis obliterans in children undergoing long-term nebulization treatment

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World Journal of Pediatrics 2018年第5期14卷 498-503页

作者： Xiao-Mei Zhang Ai-Zhen Lu Hao-Wei Yang Li-Ling Qian Li-Bo Wang Xiao-Bo Zhang Respiratory Department Children's Hospital of Fudan University399 Wan Yuan RdShanghaiChina Radiology Department Children's Hospital of Fudan University399 Wan Yuan RdShanghaiChina

Background Limited data are available in relation to the clinical features of PIBO undergoing prolonged nebulization treat-ment with budesonide, terbutaline and ipratropium bromide. This retrospective study aimed to outline the features of clini-cal, high-resolution computed tomography (HRCT) and pulmonary function test (PFT) of PIBO, undergoing maintenance therapy utilizing a triple nebulization treatment and to determine the factors associated with prognosis. Methods Children diagnosed with PIBO were followed up between April 2014 and March 2017. The clinical features after maintenance nebulization treatment for 12 months were thereafter summarized. Results Thirty patients, 21 boys and 9 girls, were enrolled in the study. The median age of patients was 17.4 months, with a range between 3.0 and 33 months. Persistent coughing and wheezing were detected whilst wheezing and crackles were the common manifestations presented. HRCT scans revealed patchy ground and glass opacity, while PFT showed fixed airway obstruction in all patients. Four patients were lost during follow-up. After treatment, the clinical symptoms were improved greatly in all patients (P<0.01). The mean increase in the percentage of TPEF%TE and VPEF%VE were improved greatly (P < 0.01). Images of the HRCT scan indicated marked improvements in 18 patients (81.8%) in comparison with scans obtained pre-treatment. Conclusions Our data suggest a potential role of long-term nebulization treatment of budesonide, terbutaline, ipratropium bromide on PIBO, due to its efficacy as indicated in the improved clinical symptoms, pulmonary functions and CT manifesta-tions identified in the children. New prospective and controlled studies are required to confirm this proposition.

关键词： Clinical features Nebulization treatment post-infectious bronchiolitis obliterans Prognosis

Irritable bowel syndrome in children:Current knowledge, challenges and opportunities

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World Journal of Gastroenterology 2018年第21期24卷 2211-2235页

作者： Niranga Manjuri Devanarayana Shaman Rajindrajith Department of Physiology Faculty of MedicineUniversity of Kelaniya Department of Paediatrics Faculty of MedicineUniversity of Kelaniya

Irritable bowel syndrome(IBS) is a common and troublesome disorder in children with an increasing prevalence noted during the past two decades. It has a significant effect on the lives of affected children and their families and poses a significant burden on healthcare systems. Standard symptom-based criteria for diagnosis of pediatric IBS have changed several times during the past two decades and there are some differences in interpreting symptoms between different cultures. This has posed a problem when using them to diagnose IBS in clinical practice. A number of potential patho-physiological mechanisms have been described, but so far the exact underlying etiology of IBS is unclear. A few potential therapeutic modalities have been tested in children and only a small number of them have shown some benefit. In addition, most of the described patho-physiological mechanisms and treatment options are based on adult studies. These have surfaced as challenges when dealing with pediatric IBS and they need to be overcome for effective management of children with IBS. Recently suggested top-down and bottom-up models help integrating reported patho-physiological mechanisms and will provide an opportunity for better understanding of the diseases process. Treatment trials targeting single treatment modalities are unlikely to have clinically meaningful therapeutic effects on IBS with multiple integrating patho-physiologies. Trials focusing on multiple combined pharmacological and non-pharmacological therapies are likely to yield more benefit. In addition to treatment, in the future, attention should be paid for possible prevention strategies for IBS.

关键词： abdominal pain functional gastrointestinal disorder Irritable bowel syndrome management microbiota patho-physiology post-infectious

Preinduced intestinal HSP70 improves visceral hypersensitivity and abnormal intestinal motility in PI-IBS mouse model

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Asian Pacific Journal of Tropical Medicine 2016年第3期9卷 297-300页

作者： Cheng Lan Xiao-Ning Sun Xu-Chun Zhou Bo Yang Bai-Li Huang Tao-Zhi Deng Zhou-Tao He Xiang-Yang Han Department of Gastroenterology Hainan Provincial General Hospital Department of Gastroenterology 1st Affiliated Hospital of Chongqing Medical University

Objective:To investigate the impact of the preinduced intestinal heat shock protein 70(HSP70)on the visceral hypersensitivity and abnormal intestinal motility in a post-infectious irritable bowel syndrome(PI-IBS) mouse ***:Eighty-four female C57BL/6 mice were randomly assigned to four groups:control group(n=21) and induction+PI-IBS group(n=21),PI-IBS group(n=21) and induction group(n=21).The mice in PI-IBS group were infected in vivo with trichinella spiralis by oral *** visceral hypersensitivity and intestinal motility were evaluated respectively with abdominal withdrawal reflex and colon transportation *** intestinal HSP70 protein and mRNA level was measured by Western blot and realtime ***,the intestinal proinflammatory cytokines IL-10 and TNF-α level was detected by ***:Compared with their counterparts in PI-IBS group,the animals in the Induction+PI-IBS group show significantly increased intestinal level of HSP70 and obviously ameliorative clinical *** abdominal withdrawal reflex score,intestine transportation time and Bristol scores(Ppost-inflammatory cytokines remarkably changed,including increased IL-10 level and decreased TNF-αlevel(Ppost-inflammatory and anti-inflammatory cytokines in PI-IBS.

关键词： post-infectious irritable bowel syndrome Heat shock protein 70 Proinflammatory cytokine Visceral hypersensitivity Intestinal motility

Book Review: I-Cubed and <i>The Autoimmune Brain</i>, A Five-Step Plan

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World Journal of Neuroscience 2020年第1期10卷 29-36页

作者： David S. Younger

The Autoimmune Brain1 explains I-Cubed, a shorthand for post-infectious autoimmunity that results from the multiplier effect of infection, immunity and inflammation, when protective immunity becomes the source of autoimmunity, conditioned by applicable environmental and genetic predisposing factors. In keeping with the post-infectious autoimmune nature of I-Cubed, neurologic and psychiatric symptoms evolve beyond a standard of care course of antibiotic therapy. Extensive serologic, electrophysiological and neuroradiographic diagnostic testing provides clues to areas of central, peripheral and autonomic nervous system, and systemic involvement that guide therapy. A multimodality therapeutic approach employing immune modulatory (Ig) therapy that addresses the underlying mechanisms and not just the symptoms of Cubed disorders is most effective. Representative cases of post-infectious autoimmunity associated with Lyme disease and PANDAS are presented.

关键词： Neuropsychiatry Lyme Disease PANDAS I-Cubed post-infectious Autoimmunity

Extra-intestinal and long term consequences of Giardia duodenalis infections

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World Journal of Gastroenterology 2013年第47期19卷 8974-8985页

作者： Marie CM Halliez André G Buret Department of Biological Sciences Inflammation Research NetworkUniversity of CalgaryCalgaryAlbertaAB T2N 1N4Canada Parasitology Department Rouen University Hospital & EA 3800 Institute for Biomedical & Research University of RouenRouen76183France

Giardiasis is the most common waterborne parasitic infection of the human intestine *** etiological agent,Giardia duodenalis(***,***),is a flagellated,binucleated protozoan parasite which infects a wide array of mammalian *** giardiasis is a true cosmopolitan pathogen,with highest prevalence in developing *** can present with a broad range of clinical manifestations from asymptomatic,to acute or chronic diarrheal disease associated with abdominal pain and *** infections are self-limiting,although re-infection and chronic infection can *** evidence indicating that Giardia may cause chronic post-infectious gastrointestinal complications have made it a topic of intense *** causes of the post-infectious clinical manifestations due to Giardia,even after complete elimination of the parasite,remain *** review offers a state-of-the-art discussion on the long-term consequences of Giardia infections,from extra-intestinal manifestations,growth and cognitive deficiencies,to post-infectious irritable bowel *** discussion also sheds light on some of the novel mechanisms recently implicated in the production of these postinfectious manifestations.

关键词： Giardiasis Inflammatory disorders Extraintestinal manifestations of enteritis Failure to thrive post-infectious irritable bowel syndrome