Objectives: We developed a computer-aided diagnosis system called ECRC-CAD using standard white-light endoscopy (WLE) for predicting conventional adenomas with high-grade dysplasia (HGD) to optimise the patients' management decisions during colonoscopy. Methods: Pretraining model was used to fine-tune the model parameters by transfer learning. 2,397 images of HGD and 2,487 low-grade dysplasia (LGD) images were randomly assigned (8:1:1) to the training, optimising, and internal validation dataset. The prospective validation dataset is the frames accessed from colonoscope videoes. One independent rural hospital provided an external validation dataset. Histopathological diagnosis was used as the standard criterion. The capability of the ECRC-CAD to distinguish HGD was assessed and compared with two expert endoscopists. Results: The accuracy, sensitivity and specificity for diagnosis of HGD in the internal validation set were 90.5%, 93.2%, 87.9%, respectively. While 88.2%, 85.4%, 89.8%, respectively, for the external validation set. For the prospective validation set, ECRC-CAD achieved an AUC of 93.5% in diagnosing HGD. The performance of ECRC-CAD in diagnosing HGD was better than that of the expert endoscopist in the external validation set (88.2% vs. 71.5%, P < 0.0 001). Conclusion: ECRC-CAD had good diagnostic capability for HGD and enabled a more convenient and accurate diagnosis using WLE. (c) 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

背景肝癌干细胞样细胞（hepatocarcinoma stem cell-like cells,CSCs）具有较强的自我更新和肿瘤发生能力,在肝硬化进展至肝癌的进程发挥关键作用.我们将肝脏Axin2+CD90+细胞鉴定为肝硬化的CSCs,并观察了HGF/Met/JN信号通路介导的细胞自噬在肝硬化进展至肝癌期间的作用.目的明确肝细胞生长因子（hepatocyte growth factor, HGF）/Met/JNK信号通路介导的细胞自噬在肝硬化癌变进程中的作用.方法从肝血管瘤患者中共收集8例非肝硬化手术标本;2007-09,在本院收集了18例酒精相关,30例慢性乙型肝炎相关肝硬化活检样本.这些患者随访至2015-12.来自患者的3例外科肝癌样本与酒精相关的肝硬化,通过手术收集来自乙型肝炎相关肝硬化患者的8个肝癌样本. 8 wk龄雄性SD大鼠每周两次腹膜内注射50 mg/kg二乙基亚硝胺持续8 wk建立肝硬化模型.Western-blotting检测人和大鼠进行的组织自噬状态、HGF的水平及HGF/Met/JNK信号途径分子的变化.采用c-Met抑制剂EMD1214063治疗肝硬化大鼠并评估细胞增殖和凋亡,同时评估HGF/Met/JNK信号途径分子的变化.结果相较于正常肝组织对照,肝硬化患者的自噬水平显著升高（全部P ＜0.05）,而自噬水平的下降与肝硬化进展为肝癌有关;同时,这些肝硬化异常自噬样本中HGF的产生显著增加.肝硬化肝脏根据自噬状态和HGF表达首先分层后发现p-Met、t-Met及p-JNK水平在自噬增强的Axin2阳性细胞中显著升高（全部P＜0.05）.治疗8 wk和11 wk后细胞增殖显著减少（全部P＜0.05）,而TUNEL染色的结果显示细胞的c-Met抑制剂EMD1214063对肝细胞的凋亡并无明显影响.在第8周和第11周使用来自对照和EMD1214063处理组的全肝裂解物的Western印迹分析显示p-Met、p-JNK及HGF在11wk的大鼠中显著降低,而t-Met、p-JNK及HGF在8 wk的大鼠中显著降低.结论 HGF/Met/JNK信号通路介导的细胞自噬参与到肝硬化癌变进程中,并且c-Met抑制剂能够在肝硬化进程中发挥治疗作用.

背景 长基因间非编码RNA 152(long intergenic noncoding RNA 152,Linc00152)在胃癌组织中高表达,且其能促进胃癌细胞增殖、迁移与侵袭,而Linc00152对胃癌化疗耐药的影响和机制并不清楚.目的 探究Linc00152对人胃癌细胞系NCI-N87化疗耐药性的影响及相关的作用机制.方法 实时定量荧光聚合酶链式反应(real-time fluorescence quantitative polymerase chain reaction,Real-time PCR)检测人胃癌细胞系NCI-N87及其丝裂霉素(mitomycin,MMC)耐药细胞系NCI-N87/MMC 中Linc00152的表达情况.采用小分子RNA干扰技术敲除NCI-N87/MMC中Linc001 52的表达后,MTT法检测细胞对MMC和顺铂的敏感性,流式细胞术检测细胞凋亡,Western Blot检测B细胞淋巴瘤/白血病-2(B cell lymphoma/lewkmia-2,Bcl-2)、Bcl-2相关X蛋白(Bcl-2 associated X protein,Bax)、半胱氨酸天冬氨酸蛋白酶-3(cysteine aspartic acid proteinase 3,caspase3)和劈裂的caspase3(cleaved-caspase3)的蛋白表达水平.此外,Real-time PCR和Western blot检测多药耐药蛋白1/P-糖蛋白(multidrug resistant protein 1/P-glycoprotein,MDR1/P-gp)、层粘连蛋白受体1前体抗原(P37-kDa laminin receptor-l precursor antigen,Mgrl-Ag)以及多药耐药相关蛋白(multidrug resistance-associated protein,MRP)的表达.结果 NCI-N87/MMC细胞中Linc00152的表达水平明显高于其亲本细胞NCI-N87.在NCI-N87/MMC细胞中,敲除Linc00152可诱导细胞凋亡,并增加其对MMC和顺铂的敏感性.敲除Linc00152可抑制NCI-N87/MMC细胞中Bcl-2蛋白表达,促进Bax蛋白表达和caspase 3的活化.此外,敲除Linc00152还可下调NCI-N87/MMC细胞中多药耐药基因MDR1、Mgr1-Ag、MRP及其编码的蛋白的表达.结论 下调NCI-N87/MMC细胞中Linc00152的表达可提高细胞对MMC和顺铂的敏感性,其机制可能与调控细胞凋亡相关因子促进凋亡,同时下调细胞中多药耐药基因MDR1、Mgr1-Ag及MRP的表达有关.

PURPOSE:Colorectal cancer (CRC) can develop via a hypermutagenic pathway characterized by frequent somatic DNA base-pair mutations. Alternatively, the immunogenicity of tumor cells themselves may influence the anticancer activity of the immune effector cells. Impaired DNA repair mechanisms drive mutagenicity, which then increase the neoantigen load and immunogenicity. However, no studies have analyzed immune checkpoint protein expression, particularly programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1), in adenoma-carcinoma progression and its relationship with the emergence of other DNA repair gene mutation.MATERIALS AND METHODS:We investigated mutations of 10 genes involved in DNA repair function: XRCC1, TP53, MLH1, MSH, KRAS, GSTP, UMP, MTHF, DPYD, and ABCC2. We performed sequencing to determine mutations and immunohistochemistry of immune checkpoints in clinical samples and determined changes in XRCC1 expression during progression through the adenoma-carcinoma pathway. We further investigated the prognostic associations of gene XRCC1 according to the expression, mutational profile, and immune profile using The Cancer Genome Atlas-colon adenocarcinoma (TCGA-COAD) dataset.RESULTS:From clinical samples, XRCC1 mutation demonstrated the strongest association with adenomas with a mutation frequency of 56.2% in adenomas and 34% in CRCs (p =0.016). XRCC1 was abnormally expressed and altered by mutations contributing to adenoma carcinogenesis. High expression of XRCC1, CD4, FOXP3, and PD-1/PD-L1 showed an overall upward trend with increased lesion severity (all p < 0.01). PD-1/PD-L1 expression and CD4+ intraepithelial lymphocytes (IELs) correlated with cytological dysplasia progression, specifically in patients with wild-type XRCC1 (all p < 0.01), whereas FOXP3 expression was independently associated with adenoma-carcinoma progression. From TCGA-COAD analysis, XRCC1 expression was associated with patients survival, tumor-infiltrating lymphocytes and immune marker expression.CONCLUSION:Increased IEL density and PD-1/PD-L1 expression correlate with cytological dysplasia progression and specifically with the XRCC1 mutation status in CRC. Our findings support a stepwise dysplasia-carcinoma sequence of adenoma carcinogenesis and an XRCC1 hypermutated phenotypic mechanism of lesions.

Background: The 2019 novel coronavirus (COVID-19) has continuous outbreaks around the world. Lung is the main organ that be involved. There is a lack of clinical data on the respiratory sounds of COVID-19 infected pneumonia, which includes invaluable information concerning physiology and pathology. The medical resources are insufficient, which are now mainly supplied for the severe patients. The development of a convenient and effective screening method for mild or asymptomatic suspicious patients is highly demanded. Methods: This is a retrospective case series study. 10 patients with positive results of nucleic acid were enrolled in this study. Lung auscultation was performed by the same physician on admission using a hand-held portable electronic stethoscope delivered in real time via Bluetooth. The recorded audio was exported, and was analyzed by six physicians. Each physician individually described the abnormal breathing sounds that he heard. The results were analyzed in combination with clinical data. Signal analysis was used to quantitatively describe the most common abnormal respiratory sounds. Results: All patients were found abnormal breath sounds at least by 3 physicians, and one patient by all physicians. Cackles, asymmetrical vocal resonance and indistinguishable murmurs are the most common abnormal breath sounds. One asymptomatic patient was found vocal resonance, and the result was correspondence with radiographic computed tomography. Signal analysis verified the credibility of the above abnormal breath sounds. Conclusions: This study describes respiratory sounds of patients with COVID-19, which fills up for the lack of clinical data and provides a simple screening method for suspected patients.

ABSTRACTColorectal cancer (CRC) is the third in incidence and mortality1 of cancer. Screening with colonoscopy has been shown to reduce mortality by 40-60%2. Challenge for screening indistinguishable precancerous and noninvasive lesion using conventional colonoscopy was still existing3. We propose to establish a propagable artificial intelligence assisted high malignant potential early CRC characterization system (ECRC-CAD). 4,390 endoscopic images of early CRC were used to establish the model. The diagnostic accuracy of high malignant potential early CRC was 0.963 (95% CI, 0.941-0.978) in the internal validation set and 0.835 (95% CI, 0.805-0.862) in external datasets. It achieved better performance than the expert endoscopists. Spreading of ECRC-CAD to regions with different medical levels can assist in CRC screening and prevention.

ABSTRACTObjectiveArtificial intelligence (AI) has undeniable values in detection, characterization, and monitoring of tumors during cancer imaging. However, major AI explorations in digestive endoscopy have not been systematically planned, and more important, most AI productions are based on Single-center Studies (ScSs). ScSs result in data scarcity, redundancy as well as island effects, which leads to some limitations in applying it on endoscopy. We investigate the disadvantages of picture processing which may effect the AI detection, and make improvements in AI detection and image recognition accuracy.DesignCurrent investigation aggregates a total of 2,500 gastroenteroscopy samples from various hospitals in multiple regions and carries out deep learning.ResultsIt is found that factors inconducive to AI recognition are common such as: (a) the gastrointestinal tract is not cleaned up completely; (b) shooting angle (from left to right and the top of polyp are unexposed clearly), shooting distance (too close or too far to shoot causes the lump to be unclear), shooting light (insufficient light source or overexposed light source in mass) and unstable shooting lead to poor quality of pictures.ConclusionWe set standards for a multicenter cooperation involving three-level medical institutions from the provincial, municipal and county to improve the recognition accuracy as well as the diagnosis and treatment efficiency meanwhile.

目的 通过分组对比,探讨消化道早癌诊断中双重染色内镜的应用价值.方法 选取2015年5月-2017年6月接受胃肠镜检查的患者752例,根据不同检查方法对患者实施分组,对照组490例行常规内镜检查,发现可疑病灶予以活检,观察组262例行内镜下双重染色检查,对2组患者结直肠黏膜、胃黏膜、食道黏膜病变及早癌检出情况予以对比,采用SPSS 19.0统计软件对数据进行处理.结果 观察组结直肠黏膜病变共检出57例,检出率为80.28％,对照组结直肠黏膜病变共检出37例,检出率为25.52％,2组差异有统计学意义(P＜0.05);观察组结直肠早癌检出率为5.63％,对照组未检出结直肠早癌,2组差异有统计学意义(P＜0.05);观察组胃黏膜病变共检出56例,检出率为64.37％,对照组胃黏膜病变共检出24例,检出率为14.81％,2组差异有统计学意义(P＜0.05);观察组胃早癌检出率为4.60％,对照组未检出胃早癌,2组差异有统计学意义(P＜0.05);观察组食管黏膜病变共检出19例,检出率为18.27％,对照组食管黏膜病变共检出8例,检出率为4.37％,2组差异有统计学意义(P＜0.05);观察组食管早癌检出率为3.85％,对照组未检出食管早癌,2组差异有统计学意义(P＜0.05).结论 双重染色内镜可显著提高消化道早癌检出率,为疾病诊断及治疗方案制定提供有效指导,值得推广.

AIM To investigate alterations in the fecal microbiome using 16S rRNA amplicon sequencing in couples in the same cohabitation environment. METHODS Fecal samples were collected from eight ulcerative colitis (UC) patients and their healthy partners at Lishui People’s Hospital, Zhejiang Province, China. DNA was extracted and the variable regions V3 and V4 of the 16S rRNA genes were PCR amplified using a two-step protocol. Clear reads were clustered into operational taxonomic units (OTUs) at the 97% sequence similarity level using UCLUST v1.2.22. The Wilcoxon rank-sum test (R v3.1.2) was used to compare inter-individual differences. Differences with a P value < 0.05 were considered statistically significant. RESULTS Fecal microbial communities were more similar among UC patients than their healthy partners (P = 0.024). UC individuals had a lower relative abundance of bacteria belonging to the Firmicutes, especially Blautia, Clostridium, Coprococcus and Roseburia (P < 0.05). Microbiota dysbiosis was detected in UC patients and their healthy partners. Relevant genera included Akkermansiam, Bacteroides, Escherichia, Lactobacillales, Klebsiella and Parabacteroides. The enriched pathways in fecal samples of UC patients were related to lipid and nucleotide metabolism. Additionally, the pathways involved in membrane transport and metabolism of cofactors and vitamins were more abundant in the healthy partners. CONCLUSION Our results suggested that the microbial composition might be affected in healthy partners cohabiting with UC patients, especially in terms of microbiota dysbiosis.

ObjectiveTo investigate the diagnosis and treatment of the inflammatory bowel disease(IBD)hospitalized patients and provide a reference for clinical diagnosis and treatment.MethodsFrom January 2010 to September 2015 in our hospital clinical data of 67 newly diagnosed IBD patients were retrospectively analyzed. In all the patients the clinical features,laboratory tests,endoscopic features,medication and treatment were summarized.ResultsOf 67 cases of IBD patients 54 cases were ulcerative colitis(UC)and 13 cases were Crohn's disease(CD);After taking anti-inflammatory therapy(mesalazine),clinical manifestations,laboratory testing,and(or)endoscopic findings in 47 UC patients and 9 CD patients were effectively improved;The total efficiency of UC was 87.04%,CD 69.23%,with a total effective rate of 83.58%;Another 7 UC patients and 4 CD patients had no significant improvement;One CD patients transferred to surgery.Conclusion IBD patients all have the first treatment;After more scientific rules treatment of the disease patients can have effective relieve,Mesalazine combined therapy in clinical applications has good results.

目的 研究柳氮磺胺吡啶联合益生菌治疗炎症性结肠炎的临床意义.方法 选择2014-05/2015-05在浙江省丽水市人民医院治疗炎症性肠炎患者78例,随机数字分成研究组和对照组,各39例.对照组采用柳氮磺胺吡啶治疗,研究组采用柳氮磺胺吡啶联合益生菌共同治疗,观察2组临床疗效、内镜复查效果、炎症因子水平及疾病活动指数(disease activity index,DAI)变化.结果 治疗后,研究组临床疗效、内镜复查疗效均优于对照组(94.87％ vs 64.10％,89.74％ vs58.97％),差异有统计学意义(P＜0.05);研究组DAI评分低于对照组(3.13±1.08 vs 6.08±1.12),差异有统计学意义(P＜0.05);研究组炎症因子水平值低于对照组(肿瘤坏死因子-α:75.68±20.31 vs 96.24±20.64,白介素-6:95.56±23.74 vs 120.37±25.25),差异有统计学意义(P＜0.05).结果 对炎症性肠炎患者采用益生菌辅助柳氮磺胺吡啶治疗的疗效更好,能抵制炎症发生,降低DAI,可推广应用.

[目的]探讨KIAA1199基因在胃癌中的表达与临床病理特征及预后的相关性,以明确KIAA1199基因在胃癌中的临床意义.[方法]采用实时定量RT-PCR方法检测手术切除胃癌及癌旁正常组织中KIAA1199的mRNA表达;采用免疫组织化学染色方法检测胃癌组织中KIAA1199的蛋白原位表达;分析KIAA1199的mRNA表达水平与患者临床病理特征及预后的相关性.[结果]胃癌组织KIAA1199的mRNA水平明显高于癌旁正常组织(P＜0.05),胃癌组织中KIAA1199蛋白表达较癌旁正常组织亦升高.x2检验发现胃癌组织KIAA1199的mRNA水平与肿瘤分化程度、浆膜浸润、淋巴结转移及临床分期呈正相关(P＜0.05),与患者年龄、性别及远处转移无相关性.生存分析提示KIAA1199 mRNA高表达组生存率明显低于低表达组(P＜0.05).[结论]KIAA1199基因在胃癌中表达量升高,与胃癌的临床病理学及生存率密切相关,对评估胃癌病程进展及预后有一定指导意义.

ObjectiveTo study the infection status of Helicobacter pylori(H. pylori)and sensitivity for commonly used antibiotics and provide reference for improvement of eradication rate of HP infection.MethodsFrom March 2012 to February 2014,12834 patients from 6 hospitals in Lishui district underwent gastrointestinal endoscopy. Gastric mucosal specimens were collected and H. pylori strains were isolated and cultured. Resistance tests of all the H. pylori isolates were performed to 6 commonly used antibiotics:levofloxacin,metronidazole,clarithromycin,amoxicillin,gentamicin, and furazolidone with the agar dilution method.Results12834 cases were enrolled in this study and the overall infection rate of Hp was 54.7%. The resistance rate to metronidazole,levofloxacin and clarithromycin were 94.4%,19.76%,16.61% respectively. The resistant rates of amoxicillin, gentamicin and furazolidone were 0%. There were a large number of multi drug resistant strains in these HP clinical isolates. The resistance rates of isolates obtained during 2012 to 2014 were18.56%,7.35%,15.47%,6.92% to levofloxacin and metronidazole,levofloxacina and clarithromycin, metronidazole and clarithromycin,levofloxacin、metronidazole and clarithromycin,respectively.ConclusionThe metronidazole resistance rates have been maintained at a high level of 94.4 %,the rates of resistance to levofloxacin and clarithromycin also have reached a relative high level. The isolates obtained were sensitive to the following three drugs:amoxicillin,gentamicin,and furazolidone. In order to improve the HP eradication rate of currently accepted triple therapy. Amoxicillin,gentamicin and furazolidone should be applied as the preferred antibiotics for the treatment of HP in this area due to sensitivity to HP. Metronidazole should not be applied as the first-line antibiotic due to the higher resistance rate.

Objectives: Increasing evidence showed that microRNAs (miRNAs) were implicated in the chemical resistance of human cancers. We intended to investigate the role of miR-218 in cisplatin sensitivity of esophageal cancer cells. Methods: Quantitative real-time polymerase chain reaction (qRT-PCR) was carried out to analyze miR-218 expression in human esophageal cancer cell line Eca9706 and a cisplatin-resistant subline (ECa9706-CisR cells). The effects of miR-218 transfection on ECa9706 and ECa9706-CisR cell viability, including cell viability and apoptosis rate were confirmed using MTT assay, or flow cytometry, respectively. qRT-PCR was used to validate survivin as a direct target gene of miR-218 in our system. Results: We found that miR-218 was significantly decreased in ECa9706-CisR cells compared with parent Eca9706 cells. Overexpression of miR-218 by mimics transfection would enhance cisplatin sensitivity evaluated by cell viability inhibition and apoptosis promotion. We validated here survivin as a direct target of miR-218 in ECa9706 cells, which might contribute to the chemoresistance of esophageal cancer cells to cisplatin. Conclusions: In summary, our data suggest that miR-218 might represent as a promising sensitizer of cisplatin therapy in clinical esophageal cancer patients.

Objective To screen the EV71 virus inhibitors by using protein block code technology.Methods The complex crystal structures of EV71 virus were extracted from the PDB database.The binding sites areas of the EV71 complex crystal structures which hold 12 chemical compounds were analyzed by protein block code technology and Discovery Studio Visualizer software.Use of three classes of EV71 target fragments to scan total protein of one-dimensional codes database in order to find the new targets which were similar to the EV71 virus proteins.The chemical compound which interact with the new target may be the inhibitors of EV71 virus.Result The binding site structures of POLG proteins were similar to the EV71 virus proteins.The two inhibitors,CHEMBL216000 and CHEMBL222234,of the POLG protein may be the inhibitors of EV71 virus.Conclusion The article made an explanation of the interaction mechanism of the EV71 virus proteins and the chemical compounds from a drug-target view.It also provides useful clues for the development of new EV71 inhibitors.

>目前临床根除幽门螺杆菌主要采用经典的三联疗法或四联疗法。由于抗生素的大量使用已导致抗生素耐药率逐年升高。根除幽门螺杆菌的治疗方案本应以细菌药敏试验结果为客观依据,但临床目前对药敏试验结果往往产生异议,原因是药敏试验结果与临床药效有时出入较大。以笔者所在医院为例,药敏试验很多患者对克拉霉素敏感,但是体内疗效并不理想。有时会出现药敏试验敏感药无效,而药敏试验耐药的药

目的 探讨六味能消胶囊结合排便训练治疗青少年功能性便秘的疗效.方法 中重度青少年功能性便秘患者150例,随机分为A、B、C组各50例.A组口服六味能消胶0.9 g,tid,同时结合排便训练;B组单用六味能消胶囊,0.9 g,tid,饭后服;C组排便训练,配合饮食调节.疗程均为2周,疗程结束后随访3个月.观察便秘缓解总有效率和便秘复发率.结果 疗程结束后A组总有效率92.00%,随访3个月复发率23.91%;B组总有效率86.00%,随访3个月复发率60.46%;C组总有效率24.00%,随访3个月复发率25.00%.A组总有效率明显高于C组,复发率明显低于B组,差异有统计学意义(P＜0.01).结论 六味能消胶囊解除青少年功能性便秘疗效肯定,排便训练对预防便秘复发有重要意义.

Objective To observe the effects of clostridium butyricum in adjuvant treatment of patients with irritable bowel syndrome(IBS).Methods From february of 2011 to 2012,78 patients with IBS were recruited and were randomly divided into observation group and control group(both n=38).Two groups received food direct and common drugs treatment,and observation group was given clostridium butyricum 500 mg two a day for 4 weeks.The treatment effects were compared.Results In observation group control group,marked improvement and active treatment were seen in 20,14 and 17,17 cases,respectively.The total effective rate in two groups were 94.9 %,79.5%.A significant difference was seen in effective rate between two groups(P0.01),and no significant adverse reactions were seen in either group.Conclusion The adjuvant treatment of IBS with clostridium butyricum is successful and worthy of clinical use.

OBJECTIVE:To investigate the risk factors for anastomotic infectious complications after bowel resection in patients with Crohn disease.METHODS:Clinical data of 124 patients with Crohn disease undergoing bowel resection between January 1990 and October 2012 were analyzed retrospectively. The risk factors were identified by χ(2) test and Logistic regression.RESULTS:Fourteen patients (12.3%, 14/114) developed anastomotic infectious complications in the postoperative period, including anastomotic leak (n=7), intra-abdominal abscess (n=6), and enterocutaneous fistula (n=1). Crohn disease activity index (CDAI)>150 (OR=2.185, 95%CI:1.098-6.256, P=0.040), steroid usage (OR=2.674, 95%CI:1.118-8.786, P=0.027), and the presence of preoperative abscess/fistula (OR=3.447, 95%CI:1.254-10.462, P=0.014) were identified as independent risk factors of anastomotic infectious complications. In the absence of these 3 risk factors, the rate of anastomotic infectious complication was 5.7% (3/53), which increased to 11.4% (4/35) when one risk factor was present, 21.1% (4/19) when two risk factors were present, and 42.9% (3/7) when all the 3 risk factors were present.CONCLUSIONS:CDAI>150, steroid usage and preoperative abscess/fistula are associated with higher rates of anastomotic infectious complications following bowel resection for Crohn disease. A prudent management should be carried out if risk factors can not be eliminated preoperatively.

目的 观察及评价雷贝拉唑联合康复新液治疗消化性溃疡,对溃疡愈合质量的作用.方法 经胃镜及组织病理学确诊伴有(或不伴有)Helicobacter pylori(Hp)感染的活动性消化性溃疡患者,按就诊顺序分为治疗组和对照组.治疗组:雷贝拉唑胶囊20mg,每日1次,加康复新液10mL每日3次口服.对照组:雷贝拉唑胶囊20mg,每日1次口服.对Hp阳性者均另给予克拉霉素500mg+左氧氟沙星200mg,每日2次口服抗Hp治疗一周,十二指肠溃疡疗程为4周,胃溃疡为6周,疗程结束后复查胃镜,观察溃疡的临床愈合率,Hp根除率,瘢痕S2期占有率.结果 疗程结束后,两组病例中溃疡临床愈合率和Hp根除率比较差异无显著性(P＞0.05).治疗组瘢痕S2期占有率显著高于对照组(P＜0.05).结论 雷贝拉唑联合康复新液治疗消化性溃疡明显增加瘢痕S2期占有率,显著提高溃疡的愈合质量,提示康复新液在提高溃疡愈合质量中起重要作用.