简介：Agluten-freedietiscurrentlytheonlyeffectivemeansoftreatingindividualswithceliacdisease.Suchadietenablesceliacpatientstocontroltheirsymptomsandavoidvariouscomplicationsassociatedwiththiscondition.However,whilethequalityofgluten-freefoodshassignificantlyimprovedduringrecentdecades,maintenanceofagluten-freedietdoesnotnecessarilyensureadequatenutritionalintake.Becauseoatsareanimportantsourceofproteins,lipids,vitamins,minerals,andfibre,theirinclusioninagluten-freedietmightimprovethenutritionalstatusofaceliacpatient.AlthoughoatsareincludedinthelistofglutenfreeingredientsspecifiedinEuropeanregulations,theirsafetywhenconsumedbyceliacpatientsremainsdebatable.Somestudiesclaimthatpureoatsaresafeformostceliacpeople,andcontaminationwithothercerealsourcesisthemainproblemfacingpeoplewiththisdisease.However,itisnecessarytoconsiderthatoatsincludemanyvarieties,containingvariousaminoacidsequencesandshowingdifferentimmunoreactivitiesassociatedwithtoxicprolamins.Asaresult,severalstudieshaveshownthattheimmunogenicityofoatsvariesdependingonthecultivarconsumed.Thus,itisessentialtothoroughlystudythevarietyofoatsusedinafoodingredientbeforeincludingitinagluten-freediet.

简介：Airwaydiseasesarethemostcommonlydescribedlungmanifestationsofinflammatoryboweldisease(IBD).However,thesimilaritiesindiseasepathogenesisandthesharingofimportantenvironmentalriskfactorsandgeneticsusceptibilitysuggestthatthereisacomplexinterplaybetweenIBDandairwaydiseases.RecentevidenceofIBDoccurrenceamongpatientswithairwaydiseasesandthehigherthanestimatedprevalenceofsubclinicalairwayinjuriesamongIBDpatientssupportthehypothesisofatwo-wayassociation.Futureresearcheffortsshouldbedirectedtowardfurtherexplorationofthisassociation,asairwaydiseasesarehighlyprevalentconditionswithasubstantialpublichealthimpact.

简介：Acriticalfunctionoftheintestinalmucosaistoformabarrierthatseparatesluminalcontentsfromtheinterstitium.Thesinglelayerofintestinalepithelialcells(IECs)servesasadynamicinterfacebetweenthehostanditsenvironment.Cellpolarityandstructuralpropertiesoftheepitheliumiscomplexandisimportantinthedevelopmentofepithelialbarrierfunction.Epithelialcellsassociatewitheachotherviaaseriesofintercellularjunctions.TheapicalmostintercellularjunctionalcomplexreferredtoastheApicalJunctionComplex(AJC)isimportantinnotonlycell-cellrecognition,butalsointheregulationofparacellularmovementoffluidandsolutes.Defectsintheintestinalepithelialbarrierfunctionhavebeenobservedinanumberofintestinaldisorderssuchasinflammatoryboweldisease(IBD).ItisnowbecomingevidentthatanaberrantepithelialbarrierfunctionplaysacentralroleinthepathophysiologyofIBD.Thus,abetterunderstandingoftheintestinalepithelialbarrierstructureandfunctioninhealthyanddiseasestatessuchasIBDwillfosternewideasforthedevelopmentoftherapiesforsuchchronicdisorders.

简介：煽动性的肠疾病(IBD)经常与象眼的神经炎那样的extraintestinal表明(EIM)被联系(在上)尽管这到目前为止在仅仅一些成年病人被描述了，所有谁与Crohns疾病(CD)被影响。而且，在上并且demyelinating疾病比的被表明了在IBD病人更经常在控制人口。在我们的当前的案例报告，我们与活跃CD描述一个孩子开发了突然的盲目由于在那上双边不与任何已知的原因有关，并且那即时对类固醇的高剂量作出回应。调查和临床的后续到目前为止在这个病人排除了demyelinating疾病的发展。到我们的知识，这是第一份报告在上在有CD的一个小儿科的病人。对这个案例的可能的解释包括活跃的肠疾病的阵发性的EIM，联系自体免疫的混乱例如一周期性孤立在上，多重硬化的第一表明，或能出现在以后的后续的另一demyelinating疾病。

简介：

简介：Nonalcoholicfattyliverdisease(NAFLD),definedasabnormalaccumulation(>5%)ofhepatictriglyceridewithoutexcessalcoholintake,isthemostcommonformofchronicliverdiseaseinadultsandchildrenintheUnitedStates.NAFLDencompassesaspectrumofhistologicfindingsincludinguncomplicatedsteatosis,steatosiswithinflammationandsteatohepatitis[nonalcoholicsteatohepatitis(NASH)];thelattercanadvancetocirrhosisandhepatocellularcarcinoma.NASHiscurrentlyacceptedasthehepaticmanifestationofthesetofcardiovascularriskfactorscollectivelyknownasmetabolicsyndrome.In1999asystemforhistologicgradingandstagingforNASHwasproposed;thiswasrevisedbytheNASHClinicalResearchNetworkin2005fortheentirespectrumoflesionsinNAFLD,includingthelesionsandpatternsofpediatricNAFLD,andforapplicationinclinicalresearchtrials.Diagnosisremainsdistinctfromgradeandstage.ArecentEuropeanproposalseparatessteatosisfromactivitytoderiveanumericdiagnosisofNASH.Eventhoughtherehavebeenpromisingadvancementsinnon-invasivetesting,thesetestsarenotyetdetailedenoughtoreplacethefullrangeoffindingsprovidedbyliverbiopsyevaluation.Limitationsofbiopsyareacknowledged,butliverbiopsyremainsthe'goldstandard'fordiagnosisanddeterminationofamountsofnecroinflammatoryactivity,andlocationoffibrosis,aswellasremodelingoftheparenchymainNASH.ThisreviewfocusesonthespecifichistologiclesionsofNAFLDandNASH,gradingandstaging,differentialdiagnosestobeconsidered,andthecontinuingroleoftheliverbiopsyinthisimportantliverdisease.

简介：外科与ulcerative(UC)与Crohn的疾病(CD)并且在约三分之一个个病人在绝大多数病人被要求。类似于为IBD的麦克匪特斯氏疗法，重要进展发生在外科。在CD的进展在由更有限的切除术，苛评发育，和laparoscopic切除术例示的保守主义之上包括一个重音。在选择病人的职业人员生命学的使用为UC与pouchitis追随者补药proctocolectomy在病人改进了结果。在IBD的分子的基础的进行中的发现将接着识别将最好对外科作出回应的那些病人，这被期望。

简介：Theinflammatoryprocessplaysacentralroleinthedevelopmentandprogressionofnumerouspathologicalsituations,suchasinflammatoryboweldisease(IBD),autoimmuneandneurodegenerativediseases,metabolicsyndrome,andcardiovasculardisorders.IBDsinvolveinflammationofthegastrointestinalareaandmainlycompriseCrohn’sdisease(CD)andulcerativecolitis(UC).Bothpathologicalsituationsusuallyinvolverecurringorbloodydiarrhea,pain,fatigueandweightloss.ThereisatpresentnopharmacologicalcureforCDorUC.However,surgerymaybecurativeforUCpatients.Theprescribedtreatmentaimstoamelioratethesymptomsandpreventand/ordelaynewpainfulepisodes.Flavonoidcompoundsarealargefamilyofhydroxylatedpolyphenolicmoleculesabundantinplants,includingvegetablesandfruitswhicharethemajordietarysourcesofthesecompoundsforhumans,togetherwithwineandtea.Flavonoidsarebecomingverypopularbecausetheyhavemanyhealth-promotinganddisease-preventiveeffects.Mostinteresthasbeendirectedtowardstheantioxidantactivityofflavonoids,evidencingaremarkablefree-radicalscavengingcapacity.However,accumulatingevidencesuggeststhatflavonoidshavemanyotherbiologicalproperties,includinganti-inflammatory,antiviral,anticancer,andneuroprotectiveactivitiesthroughdifferentmechanismsofaction.ThepresentreviewanalyzestheavailabledataaboutthedifferenttypesofflavonoidsandtheirpotentialeffectivenessasadjuvanttherapyofIBDs.

简介：AIM:Toanalyzethepotentialrelationshipbetweengastroesophagealrefluxdisease(GERD)andthedevelopmentofatrialfibrillation(AF).METHODS:Usingthekeywords'atrialfibrillationandgastroesophagealreflux','atrialfibrillationandesophagitis,peptic','atrialfibrillationandhernia,hiatal'thePubMed,EMBASE,CochraneLibrary,OVIDSP,WILEYdatabaseswerescreenedforrelevantpublicationsonGERDandAFinadultsbetweenJanuary1972-December2013.StudieswritteninlanguagesotherthanEnglishorFrench,studiesnotperformedinhumans,reviews,casereports,abstracts,conferencepresentations,letterstotheeditor,editorials,commentsandopinionswerenottakenintoconsideration.ArticlestreatingthesubjectofradiofrequencyablationofAFandtheconsecutivedevelopmentofGERDwerealsoexcluded.RESULTS:Twothousandonehundredsixty-onetitleswerefoundofwhich8articlesmettheinclusioncriteria.ThepresenceofAFinpatientswithGERDwasreportedtobebetween0.62%-14%,highercomparedtothosewithoutGERD.EpidemiologicaldataprovidedbytheseobservationalstudiesshowedthatpatientswithGERD,especiallythosewithmoresevereGERD-relatedsymptoms,hadanincreasedriskofdevelopingAFcomparedwiththosewithoutGERD,butacausalrelationshipbetweenGERDandAFcouldnotbeestablishedbasedonthesestudies.ThemechanismsofAFasaconsequenceofGERDremainlargelyunknown,withinflammationandvagalstimulationplayingapossibleroleinthedevelopmentofthesedisorders.TreatmentwithprotonpompinhibitorsmayimprovesymptomsrelatedtoAFandfacilitateconversiontosinusrhythm.CONCLUSION:AlthoughlinksbetweenAFandGERDexist,largerandomizedclinicalstudiesarerequiredforabetterunderstandingoftherelationshipbetweenthesetwoentities.

简介：Hirschsprungs疾病是现场发生在1:5000的先天的混乱出生。它被伤寒神经原的缺席沿着胃肠的道的一个可变区域描述。Hirschsprungs疾病作为multigenic混乱被分类，因为一样的显型在多重不同基因与变化被联系。而且，Hirschsprungs疾病的遗传高度复杂、不严格地孟德尔。在Hirschsprungs疾病观察的phenotypic可变性和不完全的外显率也建议修饰词基因的参与。这里，我们总结基于人和动物研究位于Hirschsprungs疾病下面的遗传的当前的知识，集中于修饰词基因的主要原因的基因，他们的相互作用，和角色。

简介：瞄准：与胃肠的graft-versus-host疾病(官方补给的GVHD)在病人评估内视镜检查法的诊断价值。方法：我们与官方补给的GVHD后面的allogeneic识别了8个病人造血的干细胞移植(HSCT)。GVHD组织学地被定义为腺apoptosis的存在，没由另外的煽动性或传染的病原学解释。结果：官方补给的GVHD的症状包括了厌食，恶心，呕吐，水泻，腹的疼痛，官方补给的流血，等等。上面的内视镜的外观从微妙的粘膜浮肿变化了，充血，红斑到明显的侵蚀。Colonoscopic检查显示出弥漫的浮肿，充血，补缀的侵蚀，散布溃疡，腐肉形成并且活跃流血。在官方补给的GVHD的组织学的变化在上皮和薄板propria包括了地窟上皮细胞，地窟的退学学生，和淋巴球的渗入的apoptosis。胃和书籍的右页冒号的参与从diffuse变化了到焦点。结论：内视镜检查法可以在跟随allogeneicHSCT的官方补给的GVHD病人的早诊断起一个重要作用，并且胃肠的活体检视的histologic检查被需要证实最后的诊断。

简介：Historically,mastcellswereknownasakeycelltypeinvolvedintypeIhypersensitivity.Untillasttwodecades,thiscelltypewasrecognizedtobewidelyinvolvedinanumberofnon-allergicdiseasesincludinginflammatoryboweldisease(IBD).MarkedlyincreasednumbersofmastcellswereobservedinthemucosaoftheileumandcolonofpatientswithIBD,whichwasaccompaniedbygreatchangesofthecontentinmastcellssuchasdramaticallyincreasedexpressionofTNFα,IL-16andsubstanceP.TheevidenceofmastcelldegranulationwasfoundinthewallofintestinefrompatientswithIBDwithimmunohistochemistrytechnique.ThehighlyelevatedhistamineandtryptaselevelsweredetectedinmucosaofpatientswithIBD,stronglysuggestingthatmastcelldegranulationisinvolvedinthepathogenesisofIBD.However,littleisknownoftheactionsofhistamine,tryptase,chymaseandcarboxypeptidaseinIBD.Overthelastdecade,heparinhasbeenusedtotreatIBDinclinicalpractice.Thelowmolecularweightheparin(LMWH)waseffectiveasadjuvanttherapy,andthepatientsshowedgoodclinicalandlaboratoryresponsewithnoseriousadverseeffects.TherolesofPGD2,LTC4,PAFandmastcellcytokinesinIBDwerealsodiscussed.Recently,aseriesofexperimentswithdispersedcolonmastcellssuggestedthereshouldbeatleasttwopathwaysinmanformastcellstoamplifytheirownactivation-degranulationsignalsinanautocrineorparacrinemanner.Thehypothesisisthatmastcellsecretogoguesinducemastcelldegranulation,releasehistamine,thenstimulatetheadjacentmastcellsorpositivelyfeedbacktofurtherstimulateitshostmastcellsthroughH1receptor.Whereasreleasedtryptaseactssimilarlytohistamine,butactivatesmastcellsthroughitsreceptorPAR-2.Theconnectionsbetweencurrentanti-IBDtherapiesorpotentialtherapiesforIBDwithmastcellswerediscussed,implicatingfurtherthatmastcellisakeycelltypethatisinvolvedinthepathogenesisofIBD.Inconclusion,whilepathoge

简介：LongbeforethediscoveryofHelicobacterpylori,thereweremanyexcellentobservationalstudiesthatdocumenteddifferencesinthepatternsofgastroduodenaldisease.Itwasclearthatinthedevelopingworld,gastriculcerandgastriccancerweremorecommonthaninthedevelopedworldwhereduodenalulcerpredominated.Thiscorrelatedwiththedistributionofgastritisinduodenalulcerpatientswheretheinflammationwasantralpredominantwhileingastriculcerpatientsthegastritiswasmoreevenlydistributedthroughthestomach.Gastriculcersusuallyappearedinafairlyrestricteddistributioninthestomachneartheangulusandclosetothetransitionalzonebetweenantrumandbodymucosa.Asasocietydevelopedsothesepatternsofdiseasechanged.

简介：AIM:Toinvestigatewhetherliversteatosisreductionduetoasix-monthdietaryinterventionresultsinsignificantchangesintheconcentrationsoffattyacids.METHODS:Agroupof35Caucasianindividualsdiagnosedwithdifferentlevelsofsteatosiswereprospectivelyenrolledinthepresentstudy.Analysisofthefattyacidprofileswasperformedaccordingtochangesinliversteatosis(liversteatosisreductionbyoneortwodegrees)afterasix-monthdietaryintervention.Thediethelpedreducebodymassinobeseandoverweightpatients,andstabilizebothglycemiaanddyslipidemia.FattyacidswereextractedaccordingtotheFolchmethodandanalyzedbygaschromatography.RESULTS:Thisstudyshowedsignificantchangesinfattyacidprofilesinpatientswhohadreducedliversteatosisbyoneaswellastwodegrees.Areductioninliversteatosisbyonedegreecausedasignificantincreaseinthelevelofthen-3family:eicosapentaenoicacid(P<0.055),docosapentaenoicacid-C22:5(P<0.05)anddocosahexaenoicacid(P<0.05).Areductioninliversteatosisbytwodegreescausedasignificantdecreaseinserumpalmitoleicacid-C16:1(P<0.05).CONCLUSION:Liversteatosisreductionisassociatedwithchangesinfattyacidprofiles,andthesechangesmayreflectanalterationinfattyacidsynthesisandmetabolism.Thesefindingsmayhelpbetterunderstandregressionofnonalcoholicfattyliverdisease.

简介：煽动性的肠疾病(IBD)包括二个实体，Crohn的疾病和ulcerative。两个是有经常的复杂并发症和外科的过程的长期的条件，一个伟人影响病人生命的质量。thiopurine抗代谢物azathioprine和6-mercaptopurine广泛地在IBD病人被使用。当前的指示包括维护治疗，类固醇家属疾病，管闭合，infliximabimmunogenicity的预防和Crohn的疾病复发的预防。令人惊讶地，在最后十年的抑制免疫力的药的宽使用没减少外科的需要，可能因为这些治疗在疾病路线在太迟了的阶段被介绍。immunossupressants的更早的使用现在被一些作者倡导。合理包括：(1)修改现在的治疗学的途径的IBD自然科学的失败，(2)那个azathioprine罐头导致粘膜的愈合的示范，为Crohn的疾病和ulcerative的一个相关预示的因素，并且(3)早immunossupression有的示范很积极的影响在上小儿科，最近诊断的Crohn的疾病病人。我们现在正在等候新研究的结果，诊断了成年Crohn的疾病病人(阿兹台克人学习)，与infliximab(声音的学习)相比澄清azathioprine的贡献，并且在最近表明azathioprine的实用性。

简介：

简介：hepatocellular癌(HCC)的发展被归因于几个因素，包括长期的病毒的感染，白酒消费，到黄麴毒素B1的暴露和新陈代谢的混乱。几份最近的报告证明了HCC能当另外的内在的高风险的肝疾病不在时与长期的Crohns疾病(CD)发生在病人。然而，可以在CD和hepatocarcinogenesis之间有一个协会为这的精确机制要求进一步的调查。

简介：AIM:Toevaluatetherelationshipbetweenthiopu-rineS-methyltransferase(TPMT)polymorphismsandthiopurine-inducedadversedrugreactions(ADRs)ininflammatoryboweldisease(IBD).METHODS:EligiblearticlesthatcomparedthefrequencyofTPMTpolymorphismsamongthiopurine-tolerantand-intolerantadultIBDpatientswereincluded.StatisticalanalysiswasperformedwithReviewManager5.0.Sub-analysis/sensitivityanalysiswasalsoperformed.RESULTS:Ninestudiesthatinvestigatedatotalof1309participantsmetourinclusioncriteria.Theinci-denceofTPMTgenemutationwasincreased2.93-fold(95%CI:1.68-5.09,P=0.0001)and5.93-fold(95%CI:2.96-11.88,P<0.00001),respectively,inIBDpatientswiththiopurine-inducedoverallADRsandbonemarrowtoxicity(BMT),comparedwithcontrols.TheORforTPMTgenemutationinIBDpatientswiththiopurine-inducedhepatotoxicityandpancreatitiswas1.51(95%CI:0.54-4.19,P=0.43)and1.02(95%CI:0.26-3.99,P=0.98)vscontrols,respectively.CONCLUSION:Thismeta-analysissuggeststhattheTPMTpolymorphismsareassociatedwiththiopurine-inducedoverallADRsandBMT,butnotwithhepatotoxicityandpancreatitis.

简介：AIM:Toinvestigatetheproteinexpressionofphosphataseandtensinhomolog(PTEN)inhumanliverbiopsiesofpatientswithalcoholicandnon-alcoholicliverdisease.METHODS:PTENproteinexpressionwasassessedbyimmunohistochemistryinformalin-fixed,paraffinembeddedliversectionsofpatientswithnon-alcoholicfattyliverdisease(NAFLD)(n=44)oralcoholicliverdisease(ALD)(n=25).Liverresectionsobtainedfrom3healthysubjectscandidateforpartialliverdonationservedascontrols.Histologicalevaluationswereperformedbytwoexperiencedpathologists,anddiagnosesestablishedbasedoninternationalcriteria.TheintensityofthePTENstaininginnucleiwascomparedbetweensteatoticandnon-steatoticareasofeachliverfragmentanalyzed.Foreachliverspecimen,theantibody-stainedsectionswereexaminedandscoredblindlybythreeindependentobservers,whowereunawareofthepatients’clinicalhistory.RESULTS:Inhealthyindividuals,PTENimmunostainingwasintenseinboththecytoplasmandnucleiofallhepatocytes.However,PTENwasstronglydownregulatedinboththenucleusandthecytoplasmofhepatocytesfromsteatoticareasinpatientswithNAFLD,independentlyofthediseasestage.Incontrast,nochangesinPTENproteinexpressionwereobservedinpatientswithALD,regardlessofthepresenceofsteatosisorthestageofthedisease.ThedegreeofPTENdownregulationinhepatocytesofpatientswithNAFLDcorrelatedwiththepercentageofsteatosis(r=0.3061,P=0.0459)andtheBMI(r=0.4268,P=0.0043).Hovewer,inpatientswithALD,PTENexpressionwasnotcorrelatedwiththepercentageofsteatosiswithorwithoutobesityasaconfoundingfactor(P=0.5574).Finally,PTENexpressionlevelinsteatoticareasofALDpatientswassignificantlydifferentfromthatseeninsteatoticareasofNAFLDpatients(P<0.0001).CONCLUSION:PTENproteinexpressionisdownregulatedearlyinNAFLD,butnotinALD.PTENimmunohistochemicaldetectioncouldhelpinthedifferentialdiagnosisofN

简介：瞄准：评估影响多囊肝疾病的非侵略、侵略的治疗的结果的因素。方法：有到2006年6月的从1986年7月的完全的后续的病人的临床的文件的分析。结果：41个病人(男性，7；女性，34)，11.9年变老的47.8+/-，和5.7+/-6.7年后续，被学习。硷性磷酸酯酶(AP)举起(15%病人)与侵略治疗的要求被联系(信息技术，P=0.005)。信息技术率是更高的在比非征兆的病人征兆(65.4%对14.3%，P=0.002)，并且在拿神经质的代替治疗(HRT)的女人(P=0.001)。包囊复杂并发症(CC)是更经常的(22%)在征兆的病人组织(P=0.023)。有身体质量的病人索引(BMI)>(59%)25在它以后有一个趋势到复杂并发症(P=0.075)。腹的疼痛为信息技术(78%)是最普通的症状(56%)和指示。十九个病人(46%)要求了第一种信息技术：12开的开窗术()，4laparoscopic开窗术(LF)和有肝的切除术(FHR)的3开窗术。三要求了第二种信息技术，并且一个人要求了第三个过程。复杂并发症在32%由于第一种信息技术被发现(16.7%，LF25%，FHR66.7%)，并且在在66.7%的第二种信息技术(100%)。后续死亡率是0。结论：症状，提高的AP，和CC的存在与信息技术要求被联系。HRT与症状和信息技术要求的存在被联系。有BMI>的病人25有一个趋势产生信息技术复杂并发症。复杂并发症的比例在FHR和秒信息技术组是更高的。RS是更经常的在以后。