简介：Azathioprine当前是在煽动性的肠疾病的维护治疗的关键药。然而，仍然有要决定的一些实际问题：一个人是我们多长必须维持这药。给疾病是标明日期长期的、非可医好的条件的那煽动性的肠，治疗应该是不定的，仅仅功效的损失或严肃的副作用的外观可以引起退却。关于到功效和他们的维护随着时间的过去，证据从长远的观点看支持这药的连续实用性：事实上，它的退却很实质地增加恶化的风险。关于副作用，azathioprine是一很好相对容忍了药和甚至不定的使用似乎安全。延长使用的主要理论风险将是癌症的骨髓中毒性，hepatotoxicity，和发展。事实上，严肃的骨髓抑制或严肃的肝损坏是不平常的，并且能与这药的合适的使用被最小化。最近的遇见的分析建议淋巴瘤的风险是真实的，但是单个风险是相当低的，并且决定分析从长远的观点看建议有利利益/风险比率。在有azathioprine谁有效、很好容忍的煽动性的肠疾病的病人，因此，这药不应该被停止。这个建议作为单个维护药使azathioprine的使用担心，并且对收到伴随物生物制品疗法的病人未必适用。

简介：Theperitonealstromaltissuewhichprovidesarichsourceofgrowthfactorsandchemokinesisafavorableenvironmentfortumorproliferation.Thepathophysiologicalmechanismofperitonealcarcinomatosisisanindividualsequenceconsistingofgeneticandenvironmentalfactorsandremainscontroversial.Thenaturalhistoryofthediseaserevealsapoormedianprognosisofapproximately6mo;howeveraggressivesurgeryandmultimodaltreatmentoptionscanimproveoncologicoutcomes.Consideringperitonealcarcinomatosisasthoughitisalocoregionaldiseasebutnotametastaticprocess,cytoreductivesurgeryandandintraperitonealchemotherapyhasbeenacurativeoptionduringrecentyears.Cytoreductivesurgeryimpliesaseriesofvisceralresectionsandperitonectomyprocedures.Althoughtheaimofcytoreductivesurgeryistoeliminateallmacroscopicdisease,viabletumorcellsmayremainintheperitonealcavity.Atthatpoint,intraperitonealchemotherapycanextendthemacroscopicdiseaseeliminationtomicroscopicdiseaseelimination.Thesuccessfultreatmentofperitonealcarcinomatosisrequiresacomprehensivemanagementplanincludingproperpatientselection,completeresectionofallvisibledisease,perioperativeintraperitonealchemotherapyandpostoperativesystemicchemotherapy.Surgicalandoncologicoutcomesarestrictlyassociatedwithextentofthetumor,completenessofcytoreductionandpatientrelatedfactorsaswellasmultidisciplinarymanagementandexperienceofthesurgicalteam.Inthisreview,pathophysiologyandcurrentmanagementofperitonealcarcinomatosisoriginatingfromgastrointestinaltumorsarediscussedaccordingtothelatestliterature.

简介：CorticosteroidsandimmunomodulatorshavebeenthemainstaytherapiesforCrohn’sdisease.Corticosteroidsarehighlyeffectivetocontrolsymptomsintheshort-term,buttheyarenoteffectiveinmaintainingremission,theyhealthemucosainareducedproportionofcases,andlong-timeexposureisassociatedwithanincreasedriskofinfectionsandmortality.Immunomodulators,azathioprineandmethotrexate,healthemucosainahigherproportionofpatientsthatcorticosteroidsbuttheironsetofactionisslowandtheybenefitlessthanhalfofpatientswithCrohn’sdisease.Inthelastdecade,medicaltherapyforCrohn’sdiseasehasexperiencedaremarkablechangeduetotheintroductionofbiologictherapy,andparticularlytheuseofanti-tumournecrosisfactor-alphaagents.Infliximab,adalimumab,andcertolizumabpegolhavedemonstratedefficacyforinductionandmaintenanceofremissioninactiveCrohn’sdisease.TheseagentshaveraisedthebarforwhatisasuitablesymptomaticresponseinCrohn’sdiseaseandmodificationofthenaturalhistoryofthediseasehasbecomeamajorgoalinthetreatmentofCrohn’sdisease.Thereareseveraldataintheliteraturethatsuggestthatearlyuseofbiologictherapyandachievementofmucosalhealingcontributetodiseasecoursemodification.However,manyquestionsonearlybiologicaltherapyforCrohn’sdiseaseremainstillunanswered.

简介：瞄准：调查怎么在老鼠orthotopic肝移植减少胆汁的复杂并发症的发生。方法：165只男Wistar老鼠的一个总数随机被划分成三个组：组A，有修改二手铐的技术的orthotropic肝移植；组B，没有移植，胆汁管被切并且重建；并且组织C，仅仅剖腹术被执行。基于为胆汁的重建使用的途径，组A被划分成二亚群:A1(n=30)，管管重建，和A2(n=30)，管十二指肠重建。在胆汁管复杂并发症上学习动脉重建的影响，组B被划分成四亚群：B1(n=10)，有肝的动脉结扎的管管重建，B2(n=10)，没有肝的动脉结扎的管管重建，B3(n=10)，有肝的动脉结扎的管十二指肠重建，和B4(n=10)，没有肝的动脉结扎的管十二指肠重建。样品被收获在操作以后或在重要胆汁的复杂并发症被发现的时间的14d。结果：在组A，anhepatic阶段是13.7??€?‥吗？？

简介：煽动性的肠疾病(IBD)包括二个实体，Crohn的疾病和ulcerative。两个是有经常的复杂并发症和外科的过程的长期的条件，一个伟人影响病人生命的质量。thiopurine抗代谢物azathioprine和6-mercaptopurine广泛地在IBD病人被使用。当前的指示包括维护治疗，类固醇家属疾病，管闭合，infliximabimmunogenicity的预防和Crohn的疾病复发的预防。令人惊讶地，在最后十年的抑制免疫力的药的宽使用没减少外科的需要，可能因为这些治疗在疾病路线在太迟了的阶段被介绍。immunossupressants的更早的使用现在被一些作者倡导。合理包括：(1)修改现在的治疗学的途径的IBD自然科学的失败，(2)那个azathioprine罐头导致粘膜的愈合的示范，为Crohn的疾病和ulcerative的一个相关预示的因素，并且(3)早immunossupression有的示范很积极的影响在上小儿科，最近诊断的Crohn的疾病病人。我们现在正在等候新研究的结果，诊断了成年Crohn的疾病病人(阿兹台克人学习)，与infliximab(声音的学习)相比澄清azathioprine的贡献，并且在最近表明azathioprine的实用性。

简介：HepatitisB(HB)virus(HBV)infection,whichcauseslivercirrhosisandhepatocellularcarcinoma,isendemicworldwide.HepatitisBvaccinesbecamecommerciallyavailableinthe1980s.TheWorldHealthOrganizationrecommendedtheintegrationoftheHBvaccineintothenationalimmunisationprogramsinallcountries.HBVpreventionstrategiesareclassifiedintothreegroups:(1)universalvaccinationalone;(2)universalvaccinationwithscreeningofpregnantwomenplusHBimmuneglobulin(HBIG)atbirth;and(3)selectivevaccinationwithscreeningofpregnantwomenplusHBIGatbirth.Mostlow-incomecountrieshaveadopteduniversalvaccineprogramswithoutscreeningofpregnantwomen.However,HBvaccinesarenotwidelyusedinlow-incomecountries.TheGlobalAllianceforVaccineandImmunizationwaslaunchedin2000,andby2012,theglobalcoverageofathree-doseHBvaccinehadincreasedto79%.Thenextchallengesaretofurtherincreasethecoveragerate,closethegapbetweenrecommendationsandroutinepractices,approachhighriskindividuals,screenandtreatchronicallyinfectedindividuals,andpreventbreakthroughinfections.ToeradicateHBVinfections,strenuouseffortsarerequiredtoovercomesocioeconomicbarrierstotheHBvaccine;thistaskisexpectedtotakeseveraldecadestocomplete.

简介：在最后十年期间是的胆汁分泌物的概念仅仅把净化的部件加到肠的混合便于胖消化/吸收并且消除方面产品的一个方法他我新陈代谢更加演变。在肠胃病学的世界杂志是在它“热点话题”的节出版的微型评论的系列，我们将打算在这块地里给我们的知识的简短却更新的概述。这封介绍的信被打算谢谢在肠胃病学贡献了知识的这个区域的发展的所有科学家。