2017年 · 第37卷第04期

IBD is a chronic non-specific intestinal disease that mainly includes CD and UC. IBD is chronic and persistent, which seriously affects the quality of life of patients. The treatment of IBD has gone through three periods of evolution. Glucocorticoids were introduced in the 1950s, and immunosuppressants began to be used in the 1960s. Today, it has entered the era of biologics. With the progress and standardization of treatment, the treatment effect of IBD has made great progress, and the complications and mortality rate of patients have decreased significantly. However, these drugs alone or in combination can alter the immune status of the patient, thereby creating corresponding problems, especially increasing the risk of opportunistic infection.

IBS is a common digestive system disease with gastrointestinal dysfunction. The main symptoms are abdominal pain or abdominal discomfort, abdominal distension, and changes in defecation habits. According to the Bristol Fecal Character Scale, it is divided into constipation, diarrhea, mixed and indefinite IBS^[1]。 At present, the etiology and mechanism of IBS are still unclear, and intestinal flora may play an important role in its pathogenesis^[2]。 In this study, real-time fluorescence quantitative PCR was used to analyze and compare the levels of faecal Bacteroides, Bifidobacterium, Lactobacillus and Escherichia coli in IBS patients and healthy controls, and to investigate the correlation between IBS and intestinal flora.

Colorectal cancer is one of the common malignant tumors of the digestive tract. In recent years, with the change of living environment and diet structure, the incidence and mortality of colorectal cancer in China are on the rise^[1]。 Colorectal adenomas are common precancerous lesions of colorectal cancer, and about 80% of colorectal cancers originate from adenomas. In this study, the expression of gastrin releasing peptide (GRP) and gastrin releasing peptide receptor (GRPR) in colorectal adenoma and colorectal cancer tissues was detected by immunohistochemistry, and the expression significance of GRP and GRPP was analyzed.

epithelial mesenchymal transition (EMT) refers to epithelial cells losing the characteristics of epithelial cells and acquiring the phenotype of mesenchymal cells, which is manifested by cadherin conversion and upregulation of transcription factor expression, which plays an important role in the pathogenesis of IBD. Saccharomyces boulardii (Saccharomyces boulardii, Sb), as a probiotic preparation that has received more and more attention in clinical application in recent years, has been used to protect small intestinal inflammatory reaction and injury, but its effect on IBD is still being studied and discussed. The purpose of this study was to investigate the effect of Sb on the inflammatory response of colon in mice with experimental colitis induced by dextran sulfate sodium salt (DSS), the score of disease activity index (DAI), the degree of colon mucosal tissue damage, and the expression of E-cadherin and vimentin in colon tissue.

Flexible gastrointestinal (GI) endoscopy was first reported in the late 1960s^[1],and for the first 20-30 years, evidence as largely a diagnostic test with the obvious benefit of its ability to visualize the GI lumen. At that time, there were very few requirements for based medical decision making other than physicians' experience combined with the theoretical benefit of procedures and treatments. As the use and cost of GI endoscopy rapidly expanded in the 1990s and into the 21^stcentury, demand grew for high-level evidence to support endoscopy. The first major areas of study were colonoscopy and its benefit on colorectal cancer prevention^[2],management of upper GI bleeding^[3],and in Asia use of flexible upper endoscopy for detection of early gastric cancer^[4,5,6]．

Endometriosis refers to a disease caused by the existence of endometrial tissue with growth function outside the uterine cavity. The lesions can spread to pelvic tissues and organs, and can also occur in the abdominal cavity, chest cavity, limbs, etc. Its clinical manifestations are sometimes very inconsistent with the degree of the lesion. A case of sigmoid endometriosis admitted to the Tenth People's Hospital of Tongji University in Shanghai was retrospectively analyzed, and its diagnosis and treatment were discussed.

IBS is a common functional bowel disease characterized by abdominal discomfort, abdominal pain and changes in defecation habits. The pathogenesis may be related to psychological and brain-intestinal axis dysfunction, gastrointestinal motility disorder, visceral hypersensitivity, impaired mucosal barrier and low-grade intestinal inflammatory reaction. Refractory IBS is not well defined^[1]Foreign studies have defined it as, after health education, dietary guidance, antispasmodics, laxatives, antidiarrheal drugs and other standardized treatment for at least 3 months, the visual analogue scale (VAS) is still ≥59 points; It is also defined as meeting the Rome III criteria and having an IBS symptom severity score (IBS-SSS) ≥75 points. Conventional empirical treatment has little effect on patients with refractory IBS, and repeated visits to the doctor seriously affect the quality of life of patients and consume a lot of medical resources.

At present, most of the researches on pregnancy in patients with autoimmune hepatitis focus on childbirth complications, and there is still a lack of systematic discussion on the activity of liver disease, disease control and treatment of patients with autoimmune hepatitis before, during and after pregnancy. This paper summarizes the research progress of pregnancy in patients with autoimmune hepatitis, in order to provide assistance to the education and management of patients with autoimmune hepatitis complicated with pregnancy.

randomized controlled trials (RCTs) provide the best evidence for evidence-based medicine and are the basis for developing clinical guidelines. The results of a study show that increasing students' extracurricular activities can reduce the occurrence of myopia. The study was randomized according to schools as cohorts. Twelve schools were selected for cluster randomization, 6 schools in each group, received regular activities or increased outdoor activities respectively, and the incidence of myopia and its related objective indicators were evaluated after 1 to 3 years^[1]。 In this study, it is not suitable to use parallel control randomization for each individual (student). Even if the same school is randomized according to class, there will be ethical and implementation problems. The cluster randomization design well addresses the implementation difficulty of outdoor activities in different comparison groups.