The incidence of Crohn disease has gradually increased in recent years. The diagnosis and treatment of Crohn disease has gained more and more attention from clinicians. This article is to propose solutions to problems in the diagnosis and treatment of Crohn disease, based on evidence from clinical trials, including the diagnosis, differential diagnosis, management of steroid-refractory disease and anal fistula, and timing of surgery.
Crohn Disease ; diagnosis ; therapy ; Humans

Pharmacological activities of the effective constituents: essential oils, flavonoids andalkaloids, in fruit of Citrus aurantium L. were compared. Blood pressure was increased markedly by transfusion of the alkaloids. Contractions of isolated intestines were iuhibited byflavonoids. Essential oils significantly decreased the rate and frequency of writhing syndromeinduced by ip acetie acid and spontaneous locomotor activities in the mice with the exceptionfexciting at first followed by inhibiting the isolated intestines,which displayed analgesia andoceutral inhibition to a certain extent.

Objective To investigate the differential expression of mitochondrial genome and apoptosis-related genes in human lung adenocarcinoma A549 cell line induced by cisplatin. Methods A549 cells were cultured in RPMI 1640 medium supplemented with 10% fetal bovine serum (FBS; Hyclone) in 150-mm dishes, and the test cells were exposed to 0.5?g/ml cisplatin continuously for 20h. Same volume PBS solution was added to culture of control cells instead of cisplatin. Human mitochondrial genome oligonucletide micoarray was used to detect the differential expression of 26 target genes. The apoptosis status was analyzed by the flow cytometry technique. Results Compared with the control cells, the expression levels of tRNA-Cys, tRNA-Asn, 12S rRNA and cytochrome oxidase subunit I were remarkably elevated in test cells. The expression levels of bax, NADH dehydrogenase subunit I, NADH dehydrogenase subunit Ⅱ and tRNA-Ser, tRNA-Asp, tRNA-Arg and tRNA-Ala also were elevated to some extent. Apoptosis rate of test cells was 8.5%?0.78%(n=5), which was remarkably higher than that of control cells 1.3%?0.56%(n=5,P

Objective To study the expresion and significance of CXCR4 in gastric cancer(GC) and intra-abdominal metastasis.Methods Immunohistochemistry and PT-PCR were used to detecte the expresion of CXCR4 protein and CXCR4 mRNA in GC,lynph node metastasis(LNM),peritoneal metastasis(PM) and normal stomach(NM) tissues.Results There was no CXCR4 expression in normal gastric mucosa cell.The expression rate of CXCR4 in GC and PM was 59.4%,100% respectively(P

Objective To investigate the clinical efficacy of surgical treatment for stage Ⅳ gastric cancer after conversion therapy.Methods The retrospective cohort study was conducted.The clinicopathological data of 50 stage Ⅳ gastric cancer patients who were admitted to the First Affiliated Hospital of Dalian Medical University between January 2012 and June 2016 were collected.All the 50 patients who were diagnosed with single distal metastasis underwent chemotherapy.After chemotherapy,21 patients with operation indication receiving gastrectomy (R0 or R1 resection) were allocated into the conversion surgery group and 29 without operation indication continuing to chemotherapy were allocated into the chenotherapy group.Patients received S-1 + oxaliplatin or S-1 + docetaxel regimen.Patients underwent open distal or total gastrectomy.Observation indicators:(1) response assessment of chemotherapy (complete remission,partial remission,stable disease and progressive disease),grading of of adverse reactions;(2) intra-and post-operative situations of conversion surgery group:operation procedures,intraoperative situations (operation time,volume of blood loss,number of lymph node dissected and surgical margin) and postoperative situations (complications and duration of hospital stay);(3)comparison of follow-up and survival between the 2 groups;(4) prognostic factors analysis affecting stage Ⅳ gastric cancer patients.Follow-up using outpatient examination,correspondence and telephone interview was performed to detect postoperative survival of patients up to September 2016.Survival time was from operation to the last follow-up or death.Measurement data with normal distribution were represented as x±s.Comparison of count data and univariate analysis were done using the chi-square test.Ordinal data were analyzed by the nonparametric test.The survival rate was calculated by the Kaplan-Meier method,and the Log-rank test was used for survival analysis.Multivariate analysis was done using the COX regression model.Results (1) Response assessment of chemotherapy:of 50 patients,24 received S-1 + oxaliplatin regimen and 26 received S-1 + docetaxel regimen.Twenty-one patients in the conversion surgery group underwent chemotherapy,with negative peritoneal metastasis,N2 and below of lymph node metastasis (No.16 lymph node disappeared or reduced),invasive depth ＜T4b and narrowing or disappeared hepatic metastasis.A median preoperative chemotherapy cycle was 4.2 cycles (range,2.0-9.0 cycles).Chemotherapy reaction of 21 patients:15 had partial remission and 6 had stable disease.Twenty-nine patients without operation indication in the chemotherapy group didn't receive surgery.The median cycle of first-line chemotherapy was 5.5 cycles (range,2.0-10.0 cycles).Chemotherapy reaction of 29 patients:13 had partial remission,11 had stable disease and 5 patient had progressive disease.Chemotherapy adverse reactions of 50 patients:26 had reduced white blood cells (WBCs),including 6 with grade Ⅲ-Ⅳ of adverse reactions;29 had reduced neutrophils,including 12 with grade Ⅲ-Ⅳ of adverse reactions;18 had anemia,including 6 with grade Ⅲ-Ⅳ of adverse reactions;12 had reduced platelets,including 2 with grade Ⅲ-Ⅳ of adverse reactions;27 had apositia,including 5 with grade Ⅲ-Ⅳ of adverse reactions;7 had stomatitis;9 had diarrhea;3 had elevated serum creatinin;4 had hand-foot syndrome;3 had abnormal sensory nerve.There was no chemotherapy-related death.(2) Intra-and post-operative situations of conversion surgery group:of 21 patients in the conversion surgery group,8 underwent radical total gastrectomy + D3 lymph node dissection,6 underwent radical distal gastrectomy + D3 lymph node dissection and 7 underwent radical distal gastrectomy + D2 lymph node dissection (including 4 combined with resection of hepatic metastatic tumors and 1 combined with radiofrequency ablation of hepatic metastatic tumor).Operation time,volume of blood loss,number of lymph node dissected and recovery time of gastrointestinal function of 21 patients were (216±31)minutes,(128±52)mL,31±8 and (3.0± 0.7)days,respectively.There were 17 patients receiving R0 resection and 4 receiving R1 resection (3 with positive gastric margin and 1 with positive hepatic margin).There was no death.Seven of 21 patients with complications were cured by conservative treatment,including 2 with pancreatic fistula,1 with intra-abdominal hemorrhage,1 with intestinal obstruction,1 with pneumonia,1 with intra-abdominal infection and 1 with wound infection.Duration of hospital stay of 21 patients was (13.0±3.0) days.(3) Comparison of follow-up and survival between the 2 groups:50 patients were followed up for 6-46 months,with a median time of 24 months.The 3-year cumulative survival rates in the conversion surgery and chemotherapy groups were respectively 33.3％ and 6.9％,with a statistically significant difference between the 2 groups (x2 =7.678,P＜0.05).Results of further analysis showed that R0 resection of 17 patients and R1 resection of 4 patients in the conversion surgery group were respecgtively (25.3±2.8)months and (8.3±0.9)months,with a statistically significant difference between the 2 groups (X2=16.242,P＜0.05).(4) Prognostic factors analysis affecting stage Ⅳ gastric cancer patients:results of univariate analysis showed that T stage,N stage,response assessment of chemotherapy,surgery after chemotherapy and degree of tumor radical resection were related factors affecting prognosis of stage Ⅳ gastric cancer patients (X2 =5.288,12.645,25.581,8.372,12.001,P＜0.05).Results of multivariate analysis showed that R1 resection after conversion therapy was an independent risk factor affecting prognosis of stage Ⅳ gastric cancer patients (HR=14.021,95％ confidence interval:1.928-10.938,P＜0.05).Conclusion Radical resection after conversion therapy can increase survival rate of stage Ⅳ gastric cancer patients,and R1 resection after conversion therapy is an independent risk factor affecting poor prognosis of stage Ⅳ gastric cancer patients.

Objective:To investigate the potential pro-apoptotic activity of arsenic trioxide (ATO) in human leukemia HL-60 cells,as well as the potential mechanism with focus on mitochondrial pathway.Methods:After treatment with different concentrations of ATO (1 μg/mL,5 μg/mL or 10 μg/mL) for 24 h,apoptotic cell death was detected by flow cytometry,oxidative stress was determined by measuring MDA and GSH levels,the expression of apoptotic factors was detected by western blot,and mitochondrial membrane potential (MMP) was determined by immunofluorescence staining.Results:ATO at the concentrations of 5 μg/mL or 10 μg/mL induces apoptotic cell death and increases oxidative stress in human leukemia HL-60 cells.ATO significantly increases the expression of pro-apoptotic factors (Bax and Caspase-3),whereas decreases the expression of anti-apoptotic factor Bcl-2.Compared with the control group,ATO treatment significantly decreases the MMP level in HL-60 ceils.Conclusions:Arsenic trioxide induces apoptotic cell death through mitochondrial pathway in human leukemia HL-60 cells.

Colonic Diseases, Functional ; diagnosis ; drug therapy ; Dyspepsia ; diagnosis ; drug therapy ; Gastrointestinal Diseases ; diagnosis ; drug therapy ; Humans ; Medicine, Chinese Traditional ; Research Design ; standards

Aged ; Aged, 80 and over ; Corynebacterium ; isolation & purification ; Cross Infection ; epidemiology ; microbiology ; Female ; Humans ; Male ; Random Amplified Polymorphic DNA Technique

Objective To analyze the clinicopathologic features,effect of surgical treatment and prognosis of elderly patients with gastric cancer.Methods The records of 84 elderly patients(aged 80 years or above) with gastric cancer who underwent operation in our hospital from 2000-2008 were analyzed retrospectively.Results Ten patients had early gastric cancer(1a,8 cases,1b,2cases),stage II 12 cases,stage III 45 cases(53.6%) and stage IV 17 cases.Among them,81% patients had one or more co-morbidities.Cardiovascular disease was present in 43 cases(51.2%).Resection rate was 85.7%(72/84).Radical resection rate was 60.7%(51/84).Limited nodal dissection(

Objective To study the clinical significance of the gene protein expression of p16,nm23 and PTEN in bile duct carcinoma.Methods The expression of p16,PTEN and nm23 gene protein in tissues of 63 cases of malignant tumors of biliary system(33 cases of bile duct carcinoma,30 cases of carcinoma of gallbladder) and 20 cases of benign bile duct lesion were studied by SP immunohistochemical technique and analyzed together with clinicopathologic data.Results The positive expression of p16,PTEN and nm23 in bile duct carcinoma tissue was low to medium,their expression rate was 36.5%,38.1% and 23.8%,(respectively),and was significantly lower than that of bile duct benign lesions(P