Two-way Relationship Between Inflammatory Bowel Disease and Sleep Disorder / 胃肠病学

Inflammatory bowel disease (IBD) is an idiopathic inflammatory disease of gastrointestinal tract, which mainly includes Crohn’s disease (CD) and ulcerative colitis (UC). The existence of chronic diseases is an important influencing factor of sleep quality, and sleep quality is a key index to evaluate the quality of life. Sleep disorder can lead to fatigue, anxiety and stress. The incidence of sleep disorder in patients with active IBD is higher than that in remission IBD. When patients with IBD get worse, the sleep disorder is more serious, while sleep disorder can aggravate intestinal inflammation and injury recovery. This article summarized the research on the correlation between sleep disorder and IBD, and clarified their two - way interaction, so as to provide reference for the clinical management and treatment of sleep disorder associated with IBD.

Bidirectional Relationship Between Inflammatory Bowel Disease and Physical Activity / 胃肠病学

There is a bidirectional relationship between patients with inflammatory bowel disease (IBD) and physical activity. Physical activity may be associated with a reduced risk of IBD, especially Crohn’s disease. Long⁃term prolongation and recurrence of IBD not only affect the quality of life of patients, but also make many patients ignore the impact of exercise on IBD. Moderate exercise can reduce the level of proinflammatory factors in IBD patients, which can play an anti⁃inflammatory role, but acute high⁃intensity exercise may cause a local inflammatory response. IBD symptoms, especially active symptoms, can impair the ability to exercise and participate in physical activity. Exercise may worsen the symptoms such as fatigue, abdominal pain, diarrhea, and urgency of bowel movements in patients with active IBD. This review presented the level of physical activity in adults with IBD, summarized the evidence for benefits of physical activity for IBD and the challenges faced by patients with IBD in physical activity, and provided recommendations for physical activity in patients with IBD based on the latest evidence, so as to provide references for further research in this area.

Fecal Microbiota Transplantation for Treatment of Inflammatory Bowel Disease: From Immune Response to Mechanism / 胃肠病学

Inflammatory bowel disease (IBD) is a chronic, recurrent, nonspecific inflammatory disease of gastrointestinal tract, and includes ulcerative colitis (UC) and Crohn's disease (CD). Many studies have shown that gut microbiota and its mediated immune responses are the key factors driving the development of IBD. Fecal microbiota transplantation (FMT) is widely recognized as a new and potentially effective method for the treatment of IBD, but the mechanism is unclear. This article reviewed the current application of FMT in IBD, the immune response and the microbiota-immune interaction mechanism after FMT for the treatment of IBD, so as to discuss the potential mechanism of FMT in IBD.

Effect of multi-channel health education model by professional team on self-management of patients with inflammatory bowel disease / 中华消化杂志

Objective:To explore the effect of multi-channel health education model by professional team on drug compliance, disease knowledge and recurrence in rate of inflammatory bowel disease (IBD) patients, so as to provide basis for formulating scientific health education measures.Methods:From February 2016 to February 2019, IBD patients visited First Affiliated Hospital of Kunming Medical University were selected. According to whether they received health education, the patients were divided into intervention group (100 cases) and control group (138 cases). Morisky medication adherence scale-8 (MMAS-8) and Chinese version of Crohn′s and colitis knowledge score (CCKNOW) were used to evaluate treatment compliance and disease knowledge. The score of MMAS-8, the proportion of poor drug compliance, CCKNOW score and recurrence rate at 48 weeks of follow-up were compared between the intervention group and control group. Two sample t test and chi-square test were used for statistical analysis. Results:The total scores of MMAS-8 and CCKNOW of the intervention group were both higher than those of the control group (5.58±1.96 vs. 4.47±1.44, 10.87±4.21 vs. 9.23±4.65), and the differences were statistically significant ( t=-5.06 and -2.79, both P<0.05). The proportion of patients with poor drug compliance and recurrence rate at 48 weeks of follow up of the intervention group were both lower than those of the control group (56.0%, 56/100 vs. 86.2%, 119/138; 20.0%, 20/100 vs. 31.9%, 44/138), and the differences were statistically significant ( χ2=38.18 and 4.17, both P<0.05). Conclusions:Multi-channel health education by professional team can effectively improve the drug compliance and disease knowledge in IBD patients, improve patient self-management ability, and reduce the recurrence rate.

Value of Colonoscopy and Endoscopic Ultrasonography in Diagnosis and Evaluation of Disease Severity of Inflammatory Bowel Disease / 胃肠病学

Background: Endoscopic ultrasonography (EUS) can display the different layers and structures of the intestinal wall, however, its value in diagnosis and assessment of disease activity of inflammatory bowel disease (IBD) is still in exploration. Aims: To investigate the value of colonoscopy and EUS in diagnosis and evaluation of disease severity of IBD. Methods: A retrospective study was conducted in patients with active IBD admitted at the First Affiliated Hospital of Kunming Medical University from September 2017 to September 2019. The results and characteristics of colonoscopy and EUS were analyzed. Results: One hundred and five active IBD patients were enrolled, including 68 cases of ulcerative colitis (UC) and 37 cases of Crohn's disease (CD). Spearman correlation coefficient analysis revealed that the endoscopic score of UC (ulcerative colitis endoscopic index of severity, UCEIS) and CD (simple endoscopic score for Crohn's disease, SES-CD) were both positively correlated with the disease severity (r

Analysis of Deanxit-combined Treatment of Functional Dyspepsia / 昆明医科大学学报

Objective To investigate the improvement and safety of the conventional treatment combined with Deanxit in the treatment of digestive adverse (FD) of gastrointestinal symptoms and sleep efficacy.Methods Ninety cases of patients with FD were randomly divided into the control group (pantoprazole capsule and Mosapride will + Capsule associated with sleep disorders with estazolam tablets) and observation group (pantoprazole capsule and Mosapride will + capsule with sleep disorders and estazolam tablets plus Deanxit).Both groups were treated for 4 weeks.After the course of treatment,the improvement degree and adverse reaction of digestive tract symptoms and sleep were compared between the two groups.Results After 4 weeks of treatment in the observation group with gastrointestinal symptoms were improved and the total effective rate was 86.7％,higher than that of the control group (66.7％).The difference was statistically gigmificart (P ＜ 0.05).The total effective rate of was sleep disorders improvement 83.3％,higher than that of control group (61.9％),but the difference was not statistically significant (P ＞ 0.05).Adverse reaction rates were not significantly different between the two groups.Conclusion On the basis of conventional therapy,treatment of functional dyspepsia (FD) with Deanxit can significantly alleviate gastrointestinal symptoms.Medication after 3-7 days can relieve the symptoms.After 4 weeks,the total efficiency is the highest with fewer adverse reactions.Clinical application is recommended.

Clinical analysis of inflammatory bowel disease in ten general hospitals of Kunming city / 重庆医学

Objective To retrospectively investigate hospitalized patients with inflammatory bowel disease (IBD) in Kun-ming ,to understand their characteristics of clinical data in recent years .Methods Ten three-tertiary general hospitals in Kunming were selected and clinical information of 1 029 patients diagnosed IBD from January 2007 to December 2013 were reviewed ,inclu-ding gender ,age ,course of disease ,symptoms ,diagnosis ,treatment and outcomes .Results This study showed that there was an up-ward tendency of IBD patients in recent 7 years in Kunming .Among the 1 029 IBD patients ,853 patients had ulcerative colitis (UC) ,157 patients had Crohn disease(CD) and 19 patients had undifferentiated IBD .The ratio of male to female was 1 .23 ∶ 1 .00 , and the average onset age of IBD was (47 .93 ± 16 .78)years old .The peak onset age of UC was from 40 to 60 years old ,while CD was more prevalent from 20 to 40 years old .Most of these patients had IBD less than 5 years .Cases from urban areas were more than from the country side .The majority of these hospitalised cases were moderate IBD patients and more UC cases than CD . 64 .4% of the UC cases were chronic and relapsing ;while in the CD cases ,51 .0% were inflammatory and 41 .2% were stenotic type .The main symptoms of IBD were diarrhea (91 .0% ) ,abdominal pain (84 .6% ) ,bloody stool (79 .4% ) and so on .About 6 .1%IBD patients had extraintestinal manifestations and 10 .6% of IBD patients had complications .The auxiliary diagnosis methods were colonoscopy (97 .7% ) and pathology (29 .2% ) .Colonoscopy revealed that UC lesions were in the rectum and sigmoid colon ,and CD lesions were in ileocecal and terminal ileum .Aminosaliccylic acid and steroids were the main medications and immunosupressant was much less used .The effective rate of medical treatment alone was 92 .4% with a mortality rate of 0 .4% .Conclusion The number of hospitalized IBD patients increased in recent years and most of them are young and middle aged .The lesions are mainly moderate . The majority UC cases are chronic and recurrent ;while CD cases belong to inflammatory type and stenotic type predominantly .Par-enteral lesions and complications are rare .Sulphasalazine (SASP)/5-ASA and steroids are still the mainstay agents used for the treatment of IBD .This disease need for long-term maintenance treatment .

A stereological analysis of ginsenoside Rg1 in inhibiting hepatic fibrosis / 重庆医学

Objective To investigate the effect of Panax notoginsenosides monomers ginsenoside Rg 1 in inhibiting hepatic fibro-sis .Methods The rat model of hepatic fibrosis was established by using 50% Ccl4 ,total 35 d .The different doses of Rg1was ad-ministered by hypodermical injection .At the end of the treatment ,the pathological changes of hepatic tissue were observed by light and transmission electron microscope .The stereological method was adopted to measure the volume density (Vvm) ,area density (Svm) ,specific surface(Qm) and surface number density (Nam) of liver cell mitochondria in various groups .Results The stereo-logical data of liver cell mitochondria showed that the statistical differences existed among various groups .Vvm in the Panax Notog-insenosides ,low dose Rg1 and isotonic saline groups were significantly increased compared with the normal control group with sta-tistical difference(P0 .05);Vvm in the high ,middle and low dose Rg1 ,Panax No-toginsenosides and colchicine groups showed the decreasing trend compared with the isotonic saline group without statistical differ-ence(P>0 .05) .Svm in the low dose Rg1 ,Panax Notoginsenosides ,colchicine and isotonic saline groups were significantly increased compared with the normal group with statistical difference (P0 .05) .Conclu-sion Rg1 has antifibrosis effects of Panax notoginsenosides ,even exceeds Panax notoginsenosides in some aspects ,and the above-mentioned effect is positively correlated with dose .Rg1 is an ideal drug for preventing and treating liver fibrosis .

Inflammatory Bowel Disease and Fertility / 昆明医科大学学报

Inflammatory bowel disease (IBD) patients have a young age incidence,which overlaps with the childbearing time. So,with the increasing morbidity of IBD,it will greatly influence the fertility process,treatment effect and reproductive problems like delivery mode and lactation. The purpose of this review is to explain the relationship between IBD and fertility,and enable clinicians to fully recognize the problem,and give scientific and reasonable birth guide to IBD patients.

Expression of HSF2 in ulcerative colitis and other intestinal diseases / 中华消化内镜杂志

Objective To investigate the expression of HSF2 in colonic mucosa of patients with ulcerative colitis (UC),Crohn's disease (CD),intestinal tuberculosis (ITB),intestinal lymphoma (IL),infectious enteritis,Behcet's disease and normal control.Methods Intestinal tissue samples were retrieved from 2003-2011 archived specimen at the Department of Pathology,and assigned to UC group (n =38),CD group (n =29),ITB group (n =31),IL group (n =32),infectious enteritis group (n =32) and Behcet's disease group (n =28).10 cases were recruited as normal control group.The expression of HSF2 in colonic mucosa were detected by immunohistochemistry.Positive cells were counted by Image Analysis.Results The expression rate of HSF2 in intestinal mucosa of UC patients (64.64 ± 15.17) was significantly higher than that of CD (32.44 ± 5.94),ITB (36.93 ± 6.32),IL (36.16 ± 6.55),infectious enteritis (37.86 ±7.76),Behcet's disease (34.90 ±5.92) and normal control (35.54 ±6.76) (P ＜0.05),while there was no significant difference among the latter six groups (P ＞ 0.05).Conclusion HSF2 is closely related with UC,and may play an important role in the pathogenesis,diagnosis and differential diagnosis of UC.

Multicenter clinical study on patients with inflammatory bowel disease in Kunming city / 中华消化杂志

Objective To retrospectively investigate the characteristics of patients with inflammatory bowel disease (IBD)in last 10 years in Kunming city. Methods Four hundred and thirty consecutive patients with IBD, who had hospitalized in 7 hospitals between January 1998 to March 2007, were investigated. Among them, 379 patinets had ulcerative colitis (UC) and 51 had Crohn's disease (CD). The patients who received coloscopy, histopathological and bariam enema examination accunted for 98.2%, 56.2% and 2.6% in UC group,respectively, and 72.5%,78.4% and 31.4% in CD group,respectively. The gender, age, occupation and the clinical manifestation of the patients, and the results of the colonoscopy and pathological examination were analyzed. Results Most of the UC patients were aged 30 to 39 years and 50 to 59 years with average age of (46.9±15.8) years, whereas CD patients were aged 20 to 29 years with average age of (41.6±17.2)years. The male and urban patients were predominat in both UC and CD groups. Mental workers were common in UC group. The symptoms of diarrhea (302,79.7%), abdominal pain (285,75.2%) and bloody stools (290,76.5%) were major events in UC patients, and those of abdominal pain (44,86.3%), diarrhea (28,54.9%) and weight loss (28,54.9%) were major events in CD patients. The coincidence ratio among colonoseopy, histopathology and bariam enema examinations was 88.4 % ( 329/372 ), 24.4 % ( 52/213 ) and 4/10 in UC patients, respectively, and 86.5%(32/37), 27.5%(11/40) and 75%(12/16) in CD patients, respectively. All of the UC patients were in active stage of disease,including 38.3 % in mild,42.2% in moderate and 19.5% in severe. In CD group, 7.8% was in relief stage and 92.2% in active stage,including 15.7% in mild,43.1% in morderate and 41.2% in severe.Conclusion The understanding of prevalence and clinical characteristics of IBD in last 10 years in Kunming city will be helpful in diagnosis and treatment of the disease.

Clinical value of endoscopy and histopathology in differential diagnosis of intestinal tuberculosis and Crohn's disease / 中华消化内镜杂志

Objective Clinical values of endoscopy and histopathology in differential diagnosis of Crohn's disease(CD) and intestinal tuberculosis were evaluated by characterising the distinctive diagnostic features of CD and intestinal tuberculosis in surgically resected specimens.Methods To review retrospectively the surgical enterocolonic specimens and to compare the clinical,endoscopic and morphologic features of CD or intestinal tuberculosis.Selected histological parameters were evaluated retrospectively in both 30 cases of CD and intestinal tuberculosis.Results The sensitivity,specificity and accuracy of endoscopy in diagnosis of CD and intestinal tuberculosis were 80.0%,25.6% 49.3% and 86.7%,46.2% 63.8% respectively.The histological characteristic parameters of intestinal tuberculosis were confluent granulomas often with caseous necrosis and thinning submucosa;the features of CD were granulomas without caseous necrosis ,submucosal hyperplasia fissure like ulceration and prominent lymphoid aggregates.Some histopathology similarities of CD and intestinal tuberculosis were found,such as chronic non-specific inflammation of intestinal wall,ulceration,collections of epithelioid histocytes,microgranulomas and transmural inflammation.Conclusions Although distinctive diagnostic features of CD and intestinal tuberculosis were found in their clinical,endoscopical and pathological study.The final differential diagnosis depends largely upon pathology.