Ulcerative colitis (UC) is a chronic immune-mediated gastrointestinal inflammatory disease, the etiology has not been fully clarified. As a developing and emerging industrialized country, China is about to enter or has entered the stage of ' accelerated incidence rate and compound epidemic' of UC. Evaluate the clinical condition of refractory ulcerative colitis (RUC) at its early stage and select appropriate treatment is important. Although the kinds of drug become more and more, the rate of colon resection remains unchanged. When drug therapy cannot improve the symptoms of patient, surgical treatment should be considered. This article reviewed the progress in studies on diagnosis and surgical treatment of RUC.

Ulcerative colitis （UC）is a chronic inflammatory bowel disease caused by multiple factors ，and its etiology and pathogenesis remain unclear . Tofacitinib，a small molecule rapidly absorbed by oral administration ，treats UC primarily by inhibiting Janus kinase （JAK）. Tofacitinib has been approved by the FDA and the European Medicines Agency for the treatment of moderate to severe UC . Many clinical studies on tofacitinib in the treatment of UC have been carried out abroad ，but there is no relevant report on its use in UC in China . This paper summarizes the relevant research advances of tofacitinib in the treatment of UC from its mechanism ，clinical application and safety . The results show that tefatinib mainly treats UC by inhibiting the expression of JAK and proinflammatory factors , regulating the overexpressed signaling transducers and activators of transcription , and repairing the intestinal mucosal barrier . Tofacitinib has good clinical efficacy ，but safety studies have shown that the risks of herpes zoster and thrombosis should not be ignored ，and the drug should be used with caution in pregnant ，children，adolescents， and elderly patients . The efficacy and safety of tofacitinib in Chinese population should be further studied in the future ，since it has not been used in UC patients in China .