Objective:To assess the differences in multidimensional clinical manifestations between patients with irritable bowel syndrome (IBS) matching the Rome Ⅲ criteria but not matching Rome Ⅳ and IBS patients matching the Rome Ⅳ criteria, among patients diagnosed with IBS according to Rome Ⅲ criteria.Methods:From November 2016 to October 2017, a total of 472 IBS patients admitted to six hospitals were selected, which included Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology (139 cases), Sir Run Run Shaw Hospital, School of Medicine of Zhejiang University (95 cases), the First Affiliated Hospital of Dalian Medical University (96 cases), the Affiliated Hospital of Guizhou Medical University (90 cases), the People′s Hospital of Guangxi Zhuang Autonomous Region (20 cases), and the Second Affiliated Hospital of Xi′an Jiaotong University (32 cases). The 472 IBS patients were divided into the group that matching the Rome Ⅳ criteria (Rome Ⅳ group), and the group that matching the Rome Ⅲ criteria but not matching the Rome Ⅳ criteria (Rome Ⅲ group). The basic characteristics (IBS course, post-infectious IBS, history of smoking or drinking, etc.), abdominal symptoms, and defecation-related symptoms of two groups were compared and analyzed by face-to-face questionnaires. Multi-dimensional clinical manifestations assessment was completed by questionnaires, which included gastrointestinal symptom rating scale (GSRS), irritable bowel syndrome-severity scoring system (IBS-SSS), irritable bowel syndrome-quality of life (IBS-QOL), and hospital anxiety and depression scale (HADS). Independent sample t-test, rank sum test, and chi-square test were used for statistical analysis. Results:There were 344 patients (72.9%) in Rome Ⅳ group and 128 patients (27.1%) in Rome Ⅲ group. The IBS course of patients in Rome Ⅳ group was longer than that in Rome Ⅲ group (3.0 years (7.0 years) vs. 2.0 years (5.7 years)), and the difference was statistically significant ( Z=-2.73, P=0.006). The GSRS scores of loose stools and abdominal pain of IBS patients in Rome Ⅳ group were higher than those in Rome Ⅲ group, and the GSRS scores of increased exhaust and abdominal distension of IBS patients in Rome Ⅳ group were lower than those in Rome Ⅲ group (3.0(2.0) vs. 2.0(4.0), 3.0(2.0) vs.1.0(2.0), 1.5(3.0) vs. 2.0(3.0), 1.0 (3.0) vs. 2.0(3.0)), and the differences were statistically significant ( Z=-2.48, -9.90, -2.11 and -2.06, P=0.013, <0.001, =0.035 and =0.040). The proportions of fatigue and dizziness of IBS patients in Rome Ⅳ group were higher than those in Rome Ⅲ group (58.4% (201/344) vs. 43.0% (55/128), 30.8% (106/344) vs. 29.7% (38/128)), and the differences were statistically significant ( χ2=8.37 and 12.36, P=0.004 and <0.001). The scores of anxiety and depression subscales of the HADS of IBS patients in Rome Ⅳ group were higher than those in Rome Ⅲ group (6.5 (6.8) vs. 6.0 (6.0), 5.0 (6.0) vs. 3.0 (5.0)), and the differences were statistically significant ( Z=-2.58 and -2.40, P=0.010 and 0.017). The scores of IBS-SSS scale, abdominal pain severity, abdominal pain frequency, and impact on quality of life of IBS patients in Rome Ⅳ group were all higher than those in Rome Ⅲ group (249.5 (108.0) vs. 177.0 (111.8), 50.0 (25.0) vs. 20.0 (30.0), 50.0 (70.0) vs. 10.0 (30.0), 66.0 (42.0) vs. 42.5 (34.0)), and the differences were statistically significant ( Z=-7.79, -9.64, -10.65 and -2.48, P<0.001, <0.001, <0.001 and =0.013). The score of IBS-QOL for behavioral disorder of IBS patients in Rome Ⅳ group was lower than that in Rome Ⅲ group (74.5±21.6 vs. 79.2±17.7), and the difference was statistically significant ( t=-2.22, P=0.027). Conclusion:The clinical symptoms of patients mathching the Rome Ⅳ criteria are more typical and severe, as compared with those of IBS patients matching the Rome Ⅲ criteria but not matching the Rome Ⅳ criteria.

目的 探讨含多西环素、呋喃唑酮四联方案10 d疗程根除幽门螺杆菌(Hp)的疗效、安全性和成本效益.方法 选取经 14C呼气试验检查确诊的Hp感染患者228例,采用随机数字表法将患者分为A组112例和B组116例,两组均采用胶体果胶铋、雷贝拉唑、呋喃唑酮、多西环素四联方案,餐前30 min口服胶体果胶铋胶囊200 mg、雷贝拉唑肠溶胶囊10 mg,餐后服用呋喃唑酮片0.1 g、多西环素片0.1 g,均2次/天.A组连续服药10 d,B组连续服药14 d.治疗后停药1个月,再次行 14C呼气试验检查,比较两组Hp根除率、不良反应和成本—效果比值.结果 Hp根除率按符合方案集分析和意向性治疗分析,A组分别为92.45%和87.50%,B组分别为91.67%和85.34%,两组根除率比较差异无统计学意义(P均>0.05).A组不良反应发生率为10.38%,B组为12.96%,两组比较差异无统计学意义(P>0.05).A组治疗费用为96.00元,成本—效果比值为103.84;B组治疗费用为134.40元,成本—效果比值为146.61,A组治疗费用和成本—效果比值均低于B组(P均<0.05).结论 含多西环素、呋喃唑酮四联方案10 d疗程的Hp根除率和安全性与14 d疗程方案相似,但10 d疗程方案治疗成本较低、性价比高.

Almost 50% of esophageal adenocarcinoma (EAC) patients progressed from Barrett's esophagus (BE). EAC is often diagnosed at late stages and is related to dismal prognosis. However, there are still no effective methods for stratification and therapy in BE and EAC. Two public datasets (GSE26886 and GSE37200) were analyzed to identify differentially expressed genes (DEGs) between BE and EAC. Then, a series of bioinformatics analyses were performed to explore potential biomarkers associated with BE-EAC. 27 up- and 104 down-regulated genes were observed between GSE26886 and GSE37200. The GO and KEGG enrichment analysis indicated that the DEGs were highly involved in tumorigenesis. Subsequently, Weighted Gene Co-Expression Network Analysis (WGCNA) were performed to explore the potential genes related to BE-EAC, which were validated in The Cancer Genome Atlas (TCGA) database, and 5 up-regulated genes (MYO1A, ACE2, COL1A1, LGALS4, and ADRA2A) and 3 down-regulated genes (AADAC, RAB27A, and P2RY14) were found in EAC. Meanwhile, ADRA2A and AADAC could contribute to EAC pathogenesis and progression. MYO1A, ACE2, COL1A1, LGALS4, ADRA2A, AADAC, RAB27A, and P2RY14 could be potential novel diagnostic and prognostic biomarkers in BE-EAC.

BACKGROUND:Natural orifice transluminal endoscopic surgery (NOTES) gallbladder-preserving surgery by flexible endoscopy is an emerging technology. However, the gallbladder fails to obtain traction and positioning functions during the operation.AIM:To evaluate the feasibility and safety of a new surgical method, "snare-assisted pure NOTES gallbladder-preserving surgery".METHODS:Eight miniature pigs were randomly divided into the experimental group [NOTES gallbladder-preserving surgery using the snare device, snare assisted (SA)] and the control group (NOTES gallbladder-preserving surgery without using the snare device, NC), with four cases in each group. The differences between the two groups of animals in operating time, operating workload, complications, adverse events, white blood cells, and liver function were determined.RESULTS:No differences were found in the surgical success rate, gallbladder incision closure, white blood cell count, or liver function between the two groups. The total operating time, gallbladder incision blood loss, gallbladder disorientation time, gallbladder incision closure time, and workload scores on the National Aeronautics and Space Administration-Task Load Index were significantly reduced in the SA group (P < 0.05).CONCLUSION:These results indicated that snare-assisted pure NOTES gallbladder-preservation surgery using standard endoscopic instruments reduced the difficulty of operation, shortened operation time, and did not increase complications in pigs. A new method for pure NOTES gallbladder-preservation surgery was provided.

Abstract Background Cholelithiasis is a common disease. It is worthy exploring the efficacy and safety of absorbable cllips in transumbilical gallbladder-preserving lithotomy via natural orifice transluminal endoscopic surgery. Method A retrospective analysis was performed on the clinical data of 7 patients undergoing transumbilical gallbladder-preserving lithotomy via natural orifice transluminal endoscopic surgery in Department of Gastroenterology, Guangxi Zhuang Autonomous Region People's Hospital from August 2020 to August 2021. Result The 7 patients were successfully operated. The operation time was 121 ~ 275min. The intraoperative blood loss was 0 ~ 25ml. The number of absorbable clips used during the operation was 4 ~ 10. The closure time of gallbladder was 29 ~ 93min. The time of first anal exhaust or defecation after operation was 24 ~ 36h. Slight postoperative pain occurred in 2 cases, which could be relieved by themselves. The length of patient stay was 6 ~ 10 days. No postoperative fever occurred in all patients and no complications such as bile leakage and poor closure occurred during hospitalization. The gallbladder function of 7 patients was evaluated by ultrasound or CT during six months follow-up. Among them, 1 case was found residual stones and 1 case was found stone recurrence. Conclusion Transumbilical gallbladder-preserving lithotomy via natural orifice transluminal endoscopic surgery is safe and feasible. Besides, the use of absorbable clips in gallbladder incision is innovative and effective in clinical practice.

目的 总结胃镜经胃保胆取石术治疗胆囊结石的手术技巧和临床经验.方法 对1例胆囊结石患者实施胃镜经胃保胆取石术治疗.于患者胃窦前壁做切口,建立经胃进入腹腔通道,将电子胃镜经通道置入腹腔,找到胆囊并于胆囊壁做一小切口,胃镜由胆囊切口进入胆囊内,取净胆囊内结石,夹闭胆囊切口并闭合胃壁切口.记录患者的手术情况和术后并发症发生情况.结果 手术顺利,手术用时166 min,术中出血约10 mL.术后无疼痛、出血、感染、胆漏、腹腔积液等并发症发生.术后复查胆囊B超提示胆囊形态尚正常,壁稍厚,较厚处厚约5 mm,壁毛糙,囊内未见明显结石及肿块回声,胆汁透声尚好,肝内胆管及胆总管无扩张.脂餐试验检测胆囊收缩功能恢复至50.7％.结论 采用胃镜经胃保胆取石术治疗胆囊结石患者的治疗效果较好,但应严格把握其适应证.

1 病例介绍 患者,女,58 岁,因"间断右上腹痛3 年余"于2020-08-22入院.既往在外院诊断胆囊结石并急性胆囊炎,经抗感染等治疗后好转出院.此后每年发病1～2次,近期复查B超提示胆囊结石明显增大,为求治疗入住内二科.患者无特殊不适,既往有结肠腺瘤行内镜下切除史.

目的 比较多西环素与四环素在四联方案根除幽门螺杆菌感染中的疗效和安全性.方法 选取经行14C呼气试验检查明确为幽门螺杆菌感染的患者110例,按随机数字表分为多西环素组(n=55)及四环素组(n=55),多西环素组给予雷贝拉唑10 mg,bid+胶体果胶铋200 mg,bid+呋喃唑酮0.1 g,bid+多西环素0.1 g,bid;四环素组给予雷贝拉唑10 mg,bid+胶体果胶铋200 mg,bid+呋喃唑酮0.1 g,bid+四环素0.5 g,tid;疗程均为14天.治疗结束后停药1个月,再次行14 C呼气试验检查确定治疗效果,比较两组幽门螺杆菌的根除率,记录两组病人的不良反应,并计算两组治疗的成本-效果比(C/E).结果 多西环素组根除率为92.16％,四环素组根除率为90.00％;多西环素组和四环素组不良反应发生率分别为7.3％(4/55)、9.1％(5/55),二者在根除率及不良反应方面比较差异无统计学意义(P>0.05).多西环素组C/E值为145.90,四环素C/E值为160.41,多西环素组的C/E值较低,性价比更高.结论 含多西环素的四联疗法在根除幽门螺杆菌感染上具有较理想的根除率、良好的安全性以及更好的性价比,尤其值得在基层医院推广.

[目的]探讨未分化型早期胃癌淋巴结转移的潜在危险因素.[方法]回顾性分析82例未分化型早期胃癌患者的临床病理资料,对影响未分化型早期胃癌淋巴结转移潜在危险因素进行单因素及多因素分析.[结果]未分化型早期胃癌淋巴结转移率为15.85％;单因素分析显示,淋巴结转移与肿瘤大小(P=0.046)及脉管癌栓(P=0.018)有关;多因素分析显示脉管浸润栓(P＜0.001)是淋巴结转移的危险因素.[结论]肿瘤直径＞2 cm或(和)有脉管癌栓的未分化型早期胃癌患者,淋巴结转移风险增加.

目的 探讨腹泻型肠易激综合征(IBS-D)患者体内CD4+T淋巴细胞亚群的分布及其对IBS-D的诊断效能.方法 选取30例IBS-D患者(IBS-D组)和20例同期健康体检者(对照组),比较两组研究对象肠黏膜中辅助性T细胞(Th)22的比例和白细胞介素(IL)-22水平,以及外周血中Th22细胞、Th17细胞、Th2细胞、Th1细胞的比例,并分析上述指标与IBS症状严重程度(IBS-SSS)评分、胃肠道症状分级评分量表(GSRS)评分的相关性,应用受试者工作特征曲线评价其对IBS-D的诊断效能.结果 IBS-D组患者肠黏膜Th22细胞比例及IL-22水平高于对照组,外周血Th17细胞比例高于对照组(均P<0.05).肠黏膜Th22细胞比例、IL-22水平和外周血Th22细胞、Th17细胞比例与IBS-SSS评分、GSRS评分均呈正相关(均P<0.05).肠黏膜Th22细胞比例、IL-22水平和外周血Th17细胞比例诊断IBS-D的曲线下面积分别为0.893、0.839、0.738,灵敏度分别为86.7％、83.3％、62.5％,特异度分别为80.0％、75.0％、53.3％.结论 IBS-D患者肠黏膜Th22细胞及其效应因子IL-22水平增高,两者均与IBS-D患者的肠道症状密切相关,且对IBS-D具有较高的诊断效能.

PURPOSE:The correlation between patatin-like phospholipase domain-containing protein 3 (PNPLA3) rs738409 polymorphism and hepatocellular carcinoma was investigated by several pilot studies, but the results of these studies were controversial. Therefore, we performed this study to better assess the relationship between PNPLA3 rs738409 polymorphism and the likelihood of hepatocellular carcinoma.METHODS:Eligible studies were searched in PubMed, Medline, EMBASE, and Web of Science. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the relationship between PNPLA3 rs738409 polymorphism and hepatocellular carcinoma.RESULTS:A total of 17 studies with 10,330 participants were analyzed. A significant association with the likelihood of hepatocellular carcinoma was detected for the PNPLA3 rs738409 polymorphism in dominant (P = 0.0001; OR 0.66; 95% CI 0.53, 0.82), recessive (P < 0.0001; OR 2.32; 95% CI 1.76, 3.06) and allele (P < 0.0001; OR 0.64; 95% CI 0.53, 0.77) comparisons. Further subgroup analyses revealed that the PNPLA3 rs738409 polymorphism was significantly associated with the likelihood of hepatocellular carcinoma in Caucasians (dominant model: P < 0.0001, OR 0.57, 95% CI 0.45, 0.71; recessive model: P < 0.0001, OR 2.74, 95% CI 2.02, 3.71; allele model: P < 0.0001, OR 0.56, 95% CI 0.46, 0.67). However, no positive results were detected in Asians.CONCLUSIONS:Our findings indicated that the PNPLA3 rs738409 polymorphism may serve as a potential biological marker of hepatocellular carcinoma in Caucasians.

背景 乙肝相关慢加急性肝衰竭(hepatitis-B-related acute-on-chronic liver failure,ACLF)是慢加急性肝衰竭中的常见类型,病情进展快,短期死亡率高.全身炎症反应是慢加急性肝衰竭重要的机制,而肠道通透性增加、内毒素移位增加是引起炎症反应的原因之一.肠道短链脂肪酸(short chain fatty acids,SCFAs)可减少肠道通透性、参与肝脏能量供应,可能在ACLF中起到一定保护作用.因此研究ACLF患者的肠道SCFAs水平变化,可能为该疾病的治疗提供新的方向.目的 探讨ACLF患者与正常人相比肠道SCFAs浓度的变化及其临床意义.方法 25名ACLF患者(病例组)、15名健康者(对照组).应用高效液相色谱法检测两组粪便SCFAs(乙酸、丙酸、丁酸、异丁酸、异戊酸及总SCFAs)的水平.根据病例组是否合并肝性脑病,Child-Pugh分级等不同病情分组,对SCFAs水平差别进行分析.结果 ACLF患者肠道丙酸、异戊酸、总SCFAs水平显著低于对照组(P＜0.05).病例组伴肝性脑病患者的肠道乙酸、丙酸、总SCFAs水平显著低于不伴肝性脑病患者(P＜0.05).Child-PughC级的患者乙酸水平低于Child-PughB级患者(P＜0.05).结论 ACLF患者肠道SCFAs水平下降;肠道乙酸、丙酸、总SCFAs水平下降,可能参与肝性脑病的发病;肠道乙酸水平可在一定程度上反映肝脏的储备功能.

Interleukin-10 (IL-10) is a key anti-inflammatory cytokine, and it is associated with the pathogenesis of inflammatory bowel disease (IBD). However, the relationship between serum IL-10 level and IBD remains controversial. In this study, a meta-analysis was performed using STATA 12.0 software. Articles were gathered by searching PubMed, Web of Science, Embase, and the Chinese Biomedical Database. Relevant studies were examined to identify their eligibility. Finally, eight studies met the inclusion criteria; these studies consisted of 211 patients diagnosed with ulcerative colitis (UC), 134 patients diagnosed with Crohn’s disease (CD), and 131 healthy control subjects. The IL-10 levels in the serum samples of UC patients significantly increased (pooled standardized mean difference (SMD) = 0.55, 95% confidence interval (CI): 0.08–1.03, P = 0.022). No significant association was observed in both adult (>17 years old) and pediatric (<17 years old) UC patients in a subgroup analysis performed in terms of age among all UC patients. The relationship between serum IL-10 concentration and UC patients did not differ as determined by enzyme-linked immunosorbent assay (ELISA), and no significant differences were observed when Bio-Plex technology and Luminex assay were used for analyses. There is no statistical difference of serum IL-10 levels between patients with UC and CD. Results suggest that the IL-10 levels increased in UC patients compared with the control group, and such increase contributes to the pathogenesis and progression of UC. Therefore, serum IL-10 level may be a noninvasive biomarker for UC patients.

目的 通过观察上消化道出血的痛风患者使用质子泵抑制剂(PPI)治疗前后临床症状及尿酸的变化,以探讨PPI治疗上消化道出血对痛风复发的影响.方法 选择我院上消化道出血合并原发性痛风患者37例为痛风组,同期37例上消化道出血且无痛风患者为对照组.两组患者在使用PPI前后分别监测尿酸、体温、关节肿痛等指标,并对相关指标进行统计学分析.结果 痛风组使用PPI后血尿酸较用药前升高(49.24±111.49)μmol/L,差异有统计学意义(<0.05);对照组PPI使用后血尿酸较用药前升高(2.89±47.87)μmol/L,但差异无统计学意义(>0.05).痛风组用药前后尿酸变化差值大于对照组,差异有统计学意义(<0.05).使用PPI治疗后,痛风组64.86％出现非感染性发热,75.68％出现新发关节疼痛,患者疼痛评分较用药前增加(<0.001),而对照组患者未出现关节痛及发热病例.结论 上消化道出血的痛风患者使用PPI可能诱发或加重痛风疾病的活动.

目的 探讨内镜下蓝激光成像(blue laser imaging,BLI)技术与碘染色对多原发食管癌的诊断价值.方法 选取2015-06～2018-08在广西壮族自治区人民医院消化内镜中心经病理诊断为食管癌的437例患者,对比内镜下BLI与碘染色对多原发食管癌的诊断价值.结果 经病理证实的多原发食管癌共47例,占所有食管癌患者的10.75％ (47/437);共检出癌灶99个,分布于食管上段24个,中段58个,下段17个;早期食管癌27个,进展期食管癌72个.BLI诊断多原发食管癌的灵敏度、特异度分别为89.36％、99.49％.碘染色诊断多原发食管癌的灵敏度、特异度分别为95.74％、98.97％.BLI和碘染色在诊断多原发食管癌上与病理诊断具有较高的一致性(Kappa=0.914;Kappa=0.930).但是BLI与碘染色对多原发食管癌的检出率比较差异无统计学意义(P＞0.05).结论 内镜下BLI与碘染色对多原发食管癌均有较高的诊断价值.

Objective To explore the clinical application value of double-balloon enteroscopy ( DBE) in diagnosis and treatment of Meckel's diverticulum ( MD) bleeding in young patients. Methods The clinical data of MD bleeding in 11 young patients who were diagnosed and treated with DBE in the hospital between July 2010 and April2018 were retrospectively analyzed. Results ( 1) The 11 patients came to the hospital for consultation because of repeated defecation of black stool or bloody stool. The small bowel bleeding or MD bleeding was considered by some examinations, while ileal diverticulum and bleeding lesions were found and MD bleeding was diagnosed by DBE. ( 2) One case of hemorrhagic diverticulitis was completed DBE microscopic hemostasis. One case of ileal artery hemorrhage underwent interventional therapy. Eleven patients eventually receiving laparoscopic surgery were improved and discharged. ( 3) DBE biopsy was performed in 6 cases and their diagnoses were consistent with the postoperative pathological results in 4 cases. ( 4) The patients were followed up untill April 2018. During the follow-up 2 cases were lost and 9 cases had no recurrent bleeding. Conclusion ( 1) MD bleeding can be directly detected and the size and shape of MD can be observed by DBE, and MD bleeding can be treated with microscopic hemostasis. ( 2) The radical treatment for MD bleeding is surgery, especially laparoscopic surgery, which has a good long-term effect.

目的 探讨内镜下逆行胰胆管造影术(ERCP)取石后胆总管结石复发的相关危险因素.方法 回顾性分析286例诊断为胆总管结石,并接受ERCP取石治疗患者的临床资料,其中取石后胆总管结石复发的42例患者为观察组,未复发的244例患者为对照组,对两组患者的基本资料进行单因素及多因素Logistic回归分析,分析胆总管结石复发的相关危险因素.结果 单因素分析显示,两组患者年龄、十二指肠乳头旁憩室发生率、胆总管直径、胆石直径、内镜取石术后胆囊切除率比较,差异均有统计学意义(均P＜0.05).Logistic回归分析显示,胆石直径为经ERCP取石后胆总管结石复发的独立危险因素(OR=1.107,95％ CI:1.037～1.182,P=0.002).结论 多种因素与ERCP取石后胆总管结石复发存在关联,术前须对相关危险因素加以评估,尽可能降低胆总管结石的术后复发率.

Background The role of miR-200c in gastric cancer remains controversial. This study is aimed at clarifying the diagnostic and prognostic value of miR-200c in gastric cancer through a meta-analysis. Methods A comprehensive literature search of PubMed, Embase, and Ovid library databases was conducted. The studies included were those conducted before December 2017. The sensitivity and specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under curve (AUC) were used to estimate the diagnostic value of miR-200c. Meanwhile, the pooled hazard ratio (HR) was used to estimate the prognostic value of miR-200c. Results For the diagnostic value of miR-200c, six studies that included 202 patients with gastric cancer and 250 normal controls were analyzed. The sensitivity, specificity, PLR, NLR, DOR, and AUC were 0.74, 0.66, 2.20, 0.40, 5.34, and 0.75, respectively. Subgroup analysis showed no significant difference in the type of the sample, method for testing miR-200c, and ethnicity among the patients. Meanwhile, for the prognostic value of miR-200c, seven studies comprising 935 patients with gastric cancer were analyzed. The pooled results showed that miR-200c expression was associated with overall survival (HR = 2.19) and disease-free survival (HR = 1.73), but not with progression-free survival (HR = 1.64) in patients with gastric cancer. There was no publication bias across the studies. Conclusions Both serum and tissue miR-200c have moderate diagnostic accuracy in gastric cancer. miR-200c could also be used as a valuable indicator for predicting the prognosis of gastric cancer patients.

慢性便秘是全球性问题,老年人因其体弱多病、机体老化、独居等因素使其发病率高于其他年龄阶段人群,精神心理因素是其中一个重要因素.本文阐述了快速识别便秘患者是否合并精神心理障碍的重要性,快速识别并及时治疗,对改善患者症状,提高生活质量具有重要意义.

辅助性T细胞9 (Thelper cell,Th9)是新发现的一种独立的不同于其他CD4+T细胞亚群(Th1、Th2、Th17)的T细胞,其特异性分泌白细胞介素(IL)-9发挥效应.近年来,大量研究表明,Th9细胞不仅参与了过敏性炎症、自身免疫性疾病、肿瘤等疾病的发生发展,而且在消化系统疾病的病理生理过程中也发挥着重要作用.现就Th9细胞及其相关因子、共刺激信号、生物学活性与消化系统疾病关系的研究进展进行综述.