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A rare cause of acute abdomen after a Good Friday

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World Journal of Clinical Cases 2022年第26期10卷 9539-9541页

作者： Leticia Pante Luísa Gailhard Brito Miguel Franciscatto Eduardo Brambilla Jonathan Soldera School of Medicine Universidade de Caxias so SulCaxias do Sul 95070-560Brazil proctology Hospital Geral de Caxias do SulCaxias do Sul 95070-560Brazil Clinical gastroenterology Universidade de Caxias do SulCaxias do Sul 95070-560RSBrazil

Small bowel perforation caused by an ingested fish bone is rare but can involve the appendix or Meckel’s *** report the case of a 25-year-old man who presented to the emergency department with acute abdomen caused by... 详细信息

关键词： Fish bone Foreign body Small bowel perforation Meckel diverticulum

Network pharmacology and molecular docking reveal zedoary turmeric-trisomes in Inflammatory bowel disease with intestinal fibrosis

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World Journal of Clinical Cases 2022年第22期10卷 7674-7685页

作者： Lie Zheng Yong-Yi Ji Yan-Cheng Dai Xin-Li Wen Shi-Cheng Wu Department of gastroenterology Shaanxi Hospital of Traditional Chinese MedicineShaanxi Provincial Hospital of Traditional Chinese MedicineXi’an 730000Shaanxi ProvinceChina Department of Neurology Xi’an Hospital of Traditional Chinese MedicineXi’an 710021Shaanxi ProvinceChina Department of gastroenterology Shanghai Traditional Chinese Medicine Integrated HospitalShanghai University of Traditional Chinese MedicineShanghai 200082China Department of gastroenterology Shaanxi Hospital of Traditional Chinese MedicineXi’an 710003Shaanxi ProvinceChina Department of proctology Gansu Academy of Traditional Chinese MedicineGanSu Hospital of Traditional Chinese MedicineLanzhou 730050Gansu ProvinceChina

BACKGROUND Inflammatory bowel disease(IBD) is a complex chronic IBD that is closely associated with risk factors such as environment, diet, medications and lifestyle that may influence the host microbiome or immune response to antigens. At present, with the increasing incidence of IBD worldwide, it is of great significance to further study the pathogenesis of IBD and seek new therapeutic targets. Traditional Chinese medicine(TCM) treatment of diseases is characterized by multiple approaches and multiple targets and has a long history of clinical application in China. The mechanism underlying the effect of zedoary turmerictrisomes on inducing mucosal healing in IBD is not *** To explore the effective components and potential mechanism of zedoary turmeric-trisomes in the treatment of IBD with intestinal fibrosis using network pharmacology and molecular docking *** The chemical constituents and targets of Rhizoma zedoary and Rhizoma sanarum were screened using the TCMSP database. The GeneCards database was searched to identify targets associated with intestinal fibrosis in IBD. The intersection of chemical component targets and disease targets was obtained using the Venny 2.1 online analysis platform, and the common targets were imported into the STRING 11.0 database to construct a protein interaction regulatory network. A “zedoary turmeric-trisomes-chemical composition-target-disease” network diagram was subsequently constructed using Cytoscape 3.7.2 software, and the topological properties of the network were analyzed using the “Network Analysis” plug-in. Gene Ontology(GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG) enrichment analyses of the common targets were performed using the DAVID 6.8 database to elucidate the mechanism of zedoary turmeric-trisomes in the treatment of IBD. Subsequently, molecular docking of the compounds and targets with the highest intermediate values in the “zedoary turmeric-trisomes-chemical composition-target-dis

关键词： Network pharmacology Molecular docking Zedoary turmeric trisomes Inflammatory bowel disease Intestinal fibrosis

Stem cell injection for complex anal fistula in Crohn’s disease: A single-center experience

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World Journal of gastroenterology 2021年第24期27卷 3643-3653页

作者： Oliver Schwandner Department of proctology Krankenhaus Barmherzige BruederRegensburg 93049Germany

BACKGROUND Despite tremendous progress in medical therapy and optimization of surgical strategies,considerable failure rates after surgery for complex anal fistula in Crohn’s disease have been ***,stem cell therapy for the treatment of complex perianal fistula can be an innovative option with potential long-term *** To evaluate the results of local administration of allogenic,adipose-derived mesenchymal stem cells(darvadstrocel)for complex anal Crohn’s *** All patients with complex anal fistulas associated with Crohn’s disease who were amenable for definite fistula closure within a defined observation period were potential candidates for stem cell injection(darvadstrocel)if at least one conventional or surgical attempt to close the fistula had *** was only indicated in patients without active Crohn’s disease and without presence of anorectal *** injection of darvadstrocel was performed as a standardized procedure under general anesthesia including single-shot antibiotic prophylaxis,removal of seton drainage,fistula curettage,closure of the internal openings and local stem cell *** collection focusing on healing rates,occurrence of abscess and follow-up was performed on a regular basis of quality control and patient *** were retrospectively *** Between July 2018 and January 2021,12 patients(6 females,6 males)with a mean age of 42.5(range:26-61)years underwent stem cell *** patients had a minimum of one complex fistula,including patients with two complex fistulas in 58.3%(7/12).Two of the 12 patients had horse-shoe fistula and 3 had one complex *** to Parks classification,the majority of fistulas were transsphincteric(76%)or suprasphincteric(14%).All patients underwent removal of seton,fistula curettage,transanal closure of internal opening by suture(11/12)or mucosal flap(1/12)and stem cell *** a mean follow-up of 14.3(range:3-30)mo,a healing rate

关键词： Complex anal fistula Crohn’s disease Stem cell therapy Mesenchymal stem cells Darvadstrocel Treatment Surgery Outcomes

Relationship between clinical remission of perianal fistulas in Crohn’s disease and serum adalimumab concentrations:A multicenter cross-sectional study

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World Journal of gastroenterology 2022年第9期28卷 961-972页

作者： Laura Sirmai Anne-Laure Pelletier Nathalie Gault Camille Zallot Guillaume Bouguen Dominique Bouchard Pascale Roland Nicaise Marine Peyneau Sandrine Sironneau Marcelo De Carvalho Bittencourt Antoine Petitcollin Pedro Fernandez Xavier Roblin Laurent Siproudhis Laurent Abramowitz Division of Hepato-gastroenterology and Digestive Oncology Bichat Claude Bernard University HospitalParis 75018France Division of Hepato-gastroenterology Hospital Croix Saint SimonParis 75020France Division of Epidemiology Biostatistics and Clinical ResearchUniversity Hospital Center BichatParis 75018France National Institute of Health and Medical Research CIC-EC1425 University Hospital Center BichatParis 75018France Division of gastroenterology Nancy Regional and University Hospital CenterNancy 54035France Imphy CIC 1414 Group and Division of gastroenterology and Hepatology University Hospital of RennesPontchaillouRennes 35033France Division of proctology Hospital BagatelleTalence 33400France Division of Immunology University Hospital Center BichatParis 75018France Inflammation Microbiome and ImmunosurveillanceFaculty of PharmacyUniversitéParis-SaclayChâtenay-Malabry 92290France Division of Radiology Bagatelle Hospital CenterTalence 33400France Division of Immunology Nancy Regional and University Hospital CenterNancy 54000France University of Lorraine CNRS UMR 7365IMoPANancy 54000France Antoine Petitcol Department of Clinical and Biological Pharmacology and Pharmacovigilance Pharmacoepidemiology and Drug Information CenterRennes University HospitalRennes 35700France Division of Radiology University Hospital Center BichatParis 75018France Orangerie Center Le Perreux-sur-Marne 94170France Division of gastroenterology CHU Saint EtienneSaint-Priest-en-Jarez 42270France Division of gastroenterology and Hepatology and proctology University Hospital Center BichatParis 75018France Ramsay GDS Clinique Blomet Paris 75018France

BACKGROUND Crohn’s disease(CD)is complicated by perianal fistulas in approximately 20%of *** permanent fistula closure remains a challenge for *** association between serum anti-tumor necrosis factor-αconcentrations and clinical outcomes in patients with CD has been demonstrated;however,little information is available on serum adalimumab(ADA)concentrations and remission of perianal fistulas in such *** To study the relationship between serum ADA concentrations and clinical remission of CDassociated perianal *** This cross-sectional study of patients with CD-associated perianal fistulas treated with ADA was performed at four French hospitals between December 2013 and March *** the time of each serum ADA concentration measurement,we collected information about the patients and their *** primary study endpoint was clinical remission of fistulas defined as the absence of drainage(in accordance with Present’s criteria),with a PDAI≤4,absence of a seton and assessment of the overall evaluation as favorable by the proctologist at the relevant *** also assessed fistula healing[defined as being in clinical and radiological(magnetic resonance imaging,MRI)remission]and adverse *** The study cohort comprised 34 patients who underwent 56 evaluations(patients had between one and four evaluations).Fifteen patients had clinical remissions(44%),four of whom had healed fistulas on *** ADA concentrations were significantly higher at evaluations in which clinical remission was identified than at evaluations in which it was not[14(10-16)vs 10(2-15)μg/mL,P=0.01].Serum ADA concentrations were comparable at the times of evaluation of patients with and without healed fistulas[11(7-14)vs 10(4-16)μg/mL,P=0.69].The adverse event rate did not differ between different serum ADA *** We found a significant association between high serum ADA concentrations and clinical remission of CD-associated

关键词： Crohn’s disease Clinical pharmacology Peri-anal disorders Adalimumab

Can transcutaneous perianal ultrasonography be the first-line diagnostic instrument for evaluating pediatric perianal fistulas?

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gastroenterology Report 2022年第1期10卷 559-565页

作者： Yu-Wen Ding Hao-Qiang Yin Hong-Tao Liang Jin-Gen Lu Bo Wang Chen Wang Department of proctology Longhua Hospital affiliated to Shanghai University of TCMShanghaiP.R.China Department of Ultrasonic Longhua Hospital affiliated to Shanghai University of TCMShanghaiP.R.China Shanghai Shumiao Health Cloud Co.Ltd ShanghaiP.R.China

Background:Pediatric perianal fistula is a common *** is more difficult to detect the fistula tract and internal opening(IO)in children than in *** study aimed to evaluate the clinical diagnostic value of transcutaneous perianal ultrasound for children with perianal ***:A retrospective review was conducted by analysing the preoperative transcutaneous perianal ultrasound and intraoperative exploration results of 203 consecutive patients who were<3 years old and diagnosed with perianal *** were conducted to evaluate the accuracy and consistency of utilizing the transcutaneous perianal ultrasound in the diagnosis of the complexity and location of the IO of perianal ***:Compared with intraoperative exploration,the preoperative transcutaneous perianal ultrasonography has almost perfect agreement(Kappa=0.881,P<0.001)in the diagnosis of fistula tract complexity and IO with a sensitivity of 92%and a specificity of 97%.In addition,both intraoperative exploration and transcutaneous perianal ultrasound diagnosis showed high consistency in the identification of the IO of perianal fistulas(QuadrantⅠKappa=0.831,QuadrantⅡKappa=0.773,QuadrantⅢKappa=0.735,QuadrantⅣKappa=0.802,all P<0.01).The IOs were mainly distributed in QuadrantsⅣandⅡin both simple and complex ***:Transcutaneous perianal ultrasound,as a non-invasive and simple imaging technique,showed high accuracy in the diagnosis and identification of the fistula classification and IO *** could be considered a first-line diagnostic instrument for evaluating perianal fistulas among children.

关键词： pediatric perianal fistula transcutaneous perianal ultrasound surgical exploration consistency

Efficacy of Itopride in the Prevention of Lubiprostone-Induced Nausea

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Open Journal of gastroenterology 2014年第9期4卷 305-309页

作者： Tatsuya Abe Yoshikazu Hachiro Yoshiaki Ebisawa Houhei Hishiyama Masanori Murakami Masao Kunimoto Department of gastroenterology Kunimoto Hospital Asahikawa Japan Department of proctology Kunimoto Hospital Asahikawa Japan

Background: The efficacy of lubiprostone for chronic constipation has been established through phase III clinical trials. Nevertheless, the continuation of lubiprostone therapy is reportedly difficult due to the development of nausea. The objective of this study is to determine whether the administration of itopride hydrochloride can reduce lubiprostone-related nausea. Methods: Two hundred and thirty-five patients who were receiving lubiprostone (24 μg capsule twice daily) were enrolled. Seventy-one patients took a prophylactic dose of itopride (50 mg tablet twice daily) together with lubiprostone to prevent nausea. Thus, the patients were divided into 2 groups: lubiprostone alone (164;control group) and combination therapy with lubiprostone and itopride (71;itopride group). Efficacy measures included changes in constipation scoring system scores, the incidence of treatment-related adverse events including nausea, and the percentage of patients who discontinued treatment within two weeks after administration. Results: Of the 235 patients who were enrolled, 196 were available for analysis. Both treatment groups experienced statistically significant improvements in constipation scoring system scores. The percentage of patients who reported ≥1 adverse event was significantly higher in the control group (40.9%) than in the itopride group (21.9%). The percentage of patients experiencing nausea was statistically and significantly lower in the itopride group than in the control group (9.4% versus 22.7%). The itopride regimen was also statistically superior compared to the control regimen in terms of treatment discontinuation. Conclusion: The prophylactic administration of itopride can decrease the risk of nausea in patients receiving lubiprostone and consequently reduce the risk of treatment discontinuation.

关键词： Chronic Constipation Itopride Lubiprostone Nausea

Elaboration and validation of Crohn's disease anoperineal lesions consensual definitions

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World Journal of gastroenterology 2017年第29期23卷 5371-5378页

作者： Clémence Horaist Vincent de Parades Laurent Abramowitz Paul Benfredj Guillaume Bonnaud Dominique Bouchard Nadia Fathallah Agnès Sénéjoux Laurent Siproudhis Ghislain Staumont Manuelle Viguier Philippe Marteau Department of Digestive Disease Centre Hospitalier Intercommunal Le Raincy-Montfermeil Department of proctology Hopital Saint-Joseph Institut Léopold Bellan Department of proctology and Digestive Diseases University Hospital Bichat Department of Digestive Diseases Clinique des Cèdres Department of proctology Hopital Bagatelle Department of proctology Centre Hospitalier Privé Rennes de Saint-Grégoire Department of Digestive Diseases Pontchaillou University Hospital Department of proctology Clinique St Jean Languedoc AP-HP H0pital Saint Louis Dermatology and Denis Diderot-Paris 7 University Sorbonne Universités UPMC Univ Paris 06 75005 Paris France INSERM-ERL 1157 CHU Saint-Antoine 27 75012 Paris France CNRS UMR7203 75012 Paris France APHP Hépatologie et Gastroentérologie Hopital Saint Antoine

AIM To establish consensual definitions of anoperineal lesions of Crohn's(APLOC) disease and assess interobserver agreement on their diagnosis between *** A database of digitally recorded pictures of APLOC was examined by a coordinating group who selected two series of 20 pictures illustrating the various aspects of APLOC. A reading group comprised: eight experts from the Société Nationale Fran?aise de Colo Proctologie group of study and research in proctology and one academic dermatologist. All members of the coordinating and reading groups participated in dedicated meetings. The coordinating group initially conducted a literature review to analyse verbatim descriptions used to evaluate APLOC. The study included two phases: establishment of consensual definitions using a formal consensus method and later assessment of interobserver agreement on the diagnosis of APLOC using photos of APLOC, a standardised questionnaire and Fleiss' s kappa test or descriptive *** Terms used in literature to evaluate visible APLOC did not include precise definitions or reference to definitions. Most of the expert reports on the first set of photos agreed with the main diagnosis but their verbatim reporting contained substantial variation. The definitions of ulceration(entity, depth, extension), anal skin tags(entity, inflammatory activity, ulcerated aspect), fistula(complexity, quality of drainage, inflammatory activity of external openings), perianal skin lesions(abscess, papules, edema, erythema) and anoperineal scars were validated. For fistulae, they decided to follow the American gastroenterology Association's guidelines definitions. The diagnosis of ulceration(κ = 0.70), fistulae(κ = 0.75), inflammatory activity of external fistula openings(86.6% agreement), a b s c e s s e s( 8 4. 6 % a g r e e m e n t) a n d e r y t h e m a(100% agreement) achieved a substantial degree of interobserver reproducibility. CONCLUSION This study constructed consensual def

关键词： Crohn’s disease Anoperineal lesions Fistula Interobserver agreement

腹腔结核短程化疗的随机对照临床试验:5年报告

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国际结核病与肺部疾病杂志 1997年第1期 26-32页

作者： R.Balasubramanian M.Nagarajan R.Balambal S.P.Tripathy R.Sundararaman P.Venkatesan C.N.Paramasivam P.Rajasambandam N.Rangabashyam R.Prabhakar 杨枕旦 Tuberculosis Research Centre ChetputMadras National AIDS Research institute Pune Tamilanadu Hospital Madras Departments of Medical gastroenterology surgleal gastroenterology and proctology Government General HospitalMadrasIndia

目的:评价和比较腹腔结核6个月短程化疗与12个月标准疗程的治疗效果。设计和对象:共193名确诊腹腔结核的成年病人随机分配到2个不同的每日治疗方案中:1)6个月短程化疗组,前2个月使用利福平、异烟肼和吡嗪酰胺,后4个月使用利福平和异烟肼... 详细信息

目的:评价和比较腹腔结核6个月短程化疗与12个月标准疗程的治疗效果。设计和对象:共193名确诊腹腔结核的成年病人随机分配到2个不同的每日治疗方案中:1)6个月短程化疗组,前2个月使用利福平、异烟肼和吡嗪酰胺,后4个月使用利福平和异烟肼(简称6R组),2)12个月标准疗程组,使用乙胺丁醇和异烟肼以及为期2周的链霉素补充治疗(简称12E组)。仅对疑及肠梗阻和肠穿孔的病人施行手术。结果:除30人因各种原因退出外,总共对163人(6R组85人,12E组78人)进行了疗效分析。治疗结束时临床状态恢复正常者6R组有84人(99％),12E组有73人(94％)。其中147人随访5年,无一因腹腔结核复发而需要治疗。结论:在治疗各型腹腔结核中6个月短疗程化疗组的疗效与12个月标准疗程组同样有效。

关键词：短程化疗腹腔结核

Salvia miltiorrhiza extract may exert an anti-obesity effect in rats with high-fat diet-induced obesity by modulating gut microbiome and lipid metabolism

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World Journal of gastroenterology 2022年第43期28卷 6131-6156页

作者： Zi-Li Ai Xian Zhang Wei Ge You-Bao Zhong Hai-Yan Wang Zheng-Yun Zuo Duan-Yong Liu Department of Postgraduate Jiangxi University of Chinese MedicineNanchang 330004Jiangxi ProvinceChina Department of proctology Affiliated Hospital of Jiangxi University of Chinese MedicineNanchang 330006Jiangxi ProvinceChina Laboratory Animal Research Center for Science and Technology Jiangxi University of Chinese MedicineNanchang 330004Jiangxi ProvinceChina Formula-Pattern Research Center Jiangxi University of Chinese MedicineNanchang 330004Jiangxi ProvinceChina

BACKGROUND Studies have shown that a high-fat diet(HFD) can alter gut microbiota(GM)homeostasis and participate in lipid metabolism disorders associated with ***, regulating the construction of GM with the balance of lipid metabolism has become essential for treating obesity. Salvia miltiorrhiza extract(Sal), a common traditional Chinese medicine, has been proven effective against atherosclerosis, hyperlipidemia, obesity, and other dyslipidemia-related *** To investigate the anti-obesity effects of Sal in rats with HFD-induced obesity, and explore the underlying mechanism by focusing on GM and lipid *** Obesity was induced in rats with an HFD for 7 wk, and Sal(0.675 g/1.35 g/2.70g/kg/d) was administered to treat obese rats for 8 wk. The therapeutic effect was evaluated by body weight, body fat index, waistline, and serum lipid level. Lipid factors(cAMP, PKA, and HSL) in liver and fat homogenates were analyzed by ELISA. The effect of Sal on GM and lipid metabolism was assessed by 16S rRNAbased microbiota analysis and untargeted lipidomic analysis(LC-MS/MS),*** Sal treatment markedly reduced weight, body fat index, serum triglycerides(TG), total cholesterol(TC), low-density lipoprotein, glucose, free fatty acid, hepatic lipid accumulation, and adipocyte vacuolation, and increased serum high-density lipoprotein(HDL-C) in rats with HFD-induced obesity. These effects were associated with increased concentrations of lipid factors such as c AMP, PKA, and HSL in the liver and adipose tissues, enhanced gut integrity, and improved lipid metabolism. GM analysis revealed that Sal could reverse HFD-induced dysbacteriosis by promoting the abundance of Actinobacteriota and Proteobacteria, and decreasing the growth of Firmicutes and Desulfobacterita. Furthermore, LC-MS/MS analysis indicated that Sal decreased TGs(TG18:2/18:2/20:4, TG16:0/18:2/22:6), DGs(DG14:0/22:6, DG22:6/22:6), CL(18:2/18:1/18:1/20:0), and increased ceramides

关键词： Salvia miltiorrhiza extract Obesity Gut microbiota Lipid metabolism High fat diet