Crohn's disease with involvement of the esophagus, stomach and duodenum has a prevalence of 0.5% to 4% in symptomatic adult patients, but some studies have shown that these results may be underestimated, since upp...Crohn's disease with involvement of the esophagus, stomach and duodenum has a prevalence of 0.5% to 4% in symptomatic adult patients, but some studies have shown that these results may be underestimated, since upper gastrointestinal endoscopy is not performed routinely in the initial evaluation of the disease in adult patients, as it is in the pediatric population. In general, involvement of the upper gastrointestinal tract in Crohn's disease occurs concomitantly with involvement of the lower gastrointestinal tract. The diagnosis depends on clinical,endoscopic, histological and radiological evaluation. The presence of aphthoid ulcers, longitudinal ulcers, bamboo-joint-like appearance, stenoses and fistulas are endoscopic findings suggestive of the disease, and it is important to exclude the presence of Helicobacter pylori infection. The primary histological findings,which facilitate the diagnosis, are the presence of a chronic inflammatory process with a predominance of lymphoplasmacytic cells and active focal gastritis. The presence of epithelioid granuloma, although less frequent, is highly suggestive of the disease in the absence of chronic granulomatous disease. Treatment should include the use of proton pump inhibitors associated with corticosteroids,immunomodulators and biological therapy according to the severity of the disease.展开更多
目的:探讨吗啡依赖胃肠损伤的多巴胺(dopamine,DA)能作用机制.方法:吗啡剂量递增皮下注射训练10 d,建立大鼠吗啡条件性位置偏爱(conditioned place preference,CPP)模型,生理盐水对照组(normal saline,NS)组和吗啡模型组(模型组)各取10...目的:探讨吗啡依赖胃肠损伤的多巴胺(dopamine,DA)能作用机制.方法:吗啡剂量递增皮下注射训练10 d,建立大鼠吗啡条件性位置偏爱(conditioned place preference,CPP)模型,生理盐水对照组(normal saline,NS)组和吗啡模型组(模型组)各取10只断头处死,取胃和十二指肠黏膜,荧光分光光度法检测其DA含量;另再取10只,采用Western blot检测其胃(胃贲门、胃体和幽门)和十二指肠组织多巴胺受体亚型2(dopamine D2 receptor,D2R)蛋白的表达.两组计量资料比较采用t检验.结果:模型组大鼠胃、十二指肠D A含量(18.41 n g/g±0.62 n g/g、9.01 n g/g±2.37ng/g)较NS组(32.01 ng/g±0.61 ng/g、17.31ng/g±2.58 ng/g)显著减少(胃:t=49.765,P=0.000;十二指肠:t=7.485,P=0.000);而模型组胃贲门、胃体和十二指肠的D2R平均光密度值(0.67±0.05、0.53±0.08和0.61±0.07)较NS组(0.43±0.08、0.33±0.07和0.44±0.05)明显升高(胃贲门:t=7.557,P=0.001;胃体:t=6.859,P=0.000;十二指肠:t=6.188,P=0.001);胃幽门变化差异无统计学意义(t=0.84,P=0.43).结论:吗啡依赖胃肠的损伤与胃肠DA系统的改变(递质和D2R受体)具有一定的相关性.展开更多
文摘Crohn's disease with involvement of the esophagus, stomach and duodenum has a prevalence of 0.5% to 4% in symptomatic adult patients, but some studies have shown that these results may be underestimated, since upper gastrointestinal endoscopy is not performed routinely in the initial evaluation of the disease in adult patients, as it is in the pediatric population. In general, involvement of the upper gastrointestinal tract in Crohn's disease occurs concomitantly with involvement of the lower gastrointestinal tract. The diagnosis depends on clinical,endoscopic, histological and radiological evaluation. The presence of aphthoid ulcers, longitudinal ulcers, bamboo-joint-like appearance, stenoses and fistulas are endoscopic findings suggestive of the disease, and it is important to exclude the presence of Helicobacter pylori infection. The primary histological findings,which facilitate the diagnosis, are the presence of a chronic inflammatory process with a predominance of lymphoplasmacytic cells and active focal gastritis. The presence of epithelioid granuloma, although less frequent, is highly suggestive of the disease in the absence of chronic granulomatous disease. Treatment should include the use of proton pump inhibitors associated with corticosteroids,immunomodulators and biological therapy according to the severity of the disease.
文摘目的:探讨吗啡依赖胃肠损伤的多巴胺(dopamine,DA)能作用机制.方法:吗啡剂量递增皮下注射训练10 d,建立大鼠吗啡条件性位置偏爱(conditioned place preference,CPP)模型,生理盐水对照组(normal saline,NS)组和吗啡模型组(模型组)各取10只断头处死,取胃和十二指肠黏膜,荧光分光光度法检测其DA含量;另再取10只,采用Western blot检测其胃(胃贲门、胃体和幽门)和十二指肠组织多巴胺受体亚型2(dopamine D2 receptor,D2R)蛋白的表达.两组计量资料比较采用t检验.结果:模型组大鼠胃、十二指肠D A含量(18.41 n g/g±0.62 n g/g、9.01 n g/g±2.37ng/g)较NS组(32.01 ng/g±0.61 ng/g、17.31ng/g±2.58 ng/g)显著减少(胃:t=49.765,P=0.000;十二指肠:t=7.485,P=0.000);而模型组胃贲门、胃体和十二指肠的D2R平均光密度值(0.67±0.05、0.53±0.08和0.61±0.07)较NS组(0.43±0.08、0.33±0.07和0.44±0.05)明显升高(胃贲门:t=7.557,P=0.001;胃体:t=6.859,P=0.000;十二指肠:t=6.188,P=0.001);胃幽门变化差异无统计学意义(t=0.84,P=0.43).结论:吗啡依赖胃肠的损伤与胃肠DA系统的改变(递质和D2R受体)具有一定的相关性.
