炎症性肠病是一种慢性复发性疾病, 患者希望水平较低, 可能加剧疾病活动度、降低治疗依从性并降低其生活质量。文章从炎症性肠病患者希望水平的现状、评估工具、影响因素及干预方法四方面进行综述, 剖析现存挑战并提出未来研究方向, 旨在提升医护人员对希望水平管理的重视,为进一步构建科学、合理的炎症性肠病患者希望水平规范化管理方案提供参考。

        Inflammatory bowel disease（IBD）is a chronic and frequently recurring disease, and low level of hope in patients may exacerbate disease activity, reduce treatment adherence,and lower their quality of life．This article reviews the current situation of hope level, assessment tools, influencing factors and intervention methods, to analyze the existing challenges and proposes future research directions, aiming to raise the attention of hope level management among healthcare professionals, and to provide reference for the construction of a scientific, reasonable and standardized management plan for hope level of patients with inflammatory bowel disease．

      目的   免疫球蛋白A肾病（IgAN）与炎症性肠病（IBD）的相互作用机制尚未阐明。本研究旨在解析IBD与IgAN共病的关键特征基因及核心信号通路，以揭示肠－肾轴的分子调控网络。方法   于GEO数据库获取IBD（GSE75214）和IgAN（GSE93798）基因表达谱，筛选差异表达基因（DEGs）。通过蛋白互作网络（PPI）和拓扑算法（MCC、MNC、Degree、EPC等）识别核心特征基因，并结合公共数据库（CTD、DISEASES和GeneCards）和单细胞转录组测序（GSE171314）进行验证。通过Nephroseq数据库验证基因表达与临床表型的相关性。结果   共筛选出17个IBD-IgAN共病DEGs，PPI网络分析等确定以FOS、EGR1、CXCL2和JUNB为核心特征基因。功能富集分析显示白细胞介素-17（IL-17）信号通路显著激活。单细胞测序验证FOS、EGR1、CXCL2和JUNB基因在IgAN特异性高表达，并通过Nephroseq数据库验证其与尿蛋白和估算的肾小球滤过率下降（eGFR）显著相关。结论  本研究揭示IBD与IgAN共享IL-17通路异常激活及FOS、EGR1、CXCL2和JUNB的基因网络，为开发基于肠－肾轴调控的靶向治疗策略提供理论依据。

       Objective  The complex interplay between immunoglobulin A nephropathy（IgAN）and inflammatory bowel disease（IBD）remains poorly understood．This  study  aimed to identify  key  cross-talk  genes  and  pivotal  signaling pathways shared between IBD and IgAN，thereby elucidating the molecular regulatory network underlying the gut-kidney axis．Methods  Transcriptomic datasets for IBD（GSE75214）and IgAN（GSE93798）were retrieved from the GEO database．Differentially expressed genes（DEGs）were screened，and shared DEGs were intersected．Protein-protein interaction（PPI）networks were constructed using STRING and Cytoscape，with topological algorithms applied to identify hub genes．Gene expression profiles were validated through（CTD，DISEASES and GeneCards）and single-cell RNA sequencing（GSE171314）and the Nephroseq database，focusing on clinical correlations with proteinuria and estimated glomerular filtration rate（eGFR）．Results  Seventeen shared DEGs were identified between IBD and IgAN．PPI network analysis revealed FOS，EGR1，CXCL2 and JUNB as core hub genes．Functional enrichment analysis demonstrated significant activation of the interleukin-17（IL-17）signaling pathway．Single-cell sequencing confirmed the specific upregulation of these genes in renal tubular epithelial cells of IgAN patients，which was further validated to correlate with proteinuria and eGFR decline．Conclusions  IBD and  IgAN share aberrant activation of the IL-17 pathway and a co-regulatory gene network involving FOS，EGR1，CXCL2 and JUNB，providing a theoretical foundation for developing therapeutic strategies centered on the gut-kidney axis．

炎症性肠病（IBD）作为一种慢性、易复发的炎症性疾病,被世界卫生组织归类为现代医疗领域的难治性疾病之一。其确切发病机制尚不清晰,目前主要认为与肠菌失衡触发宿主过度的肠黏膜免疫反应,进而在遗传易感性的个体中引发肠黏膜的损伤有关。目前,尚无特效的靶点能治愈IBD。过氧化物酶体增殖物激活受体（PPARs）作为核受体超家族的一员,在机体的生长发育、炎症调控以及代谢过程中扮演着重要角色,且被视为治疗包括IBD在内的多种疾病的重要潜在靶点,并被认为与肠道菌群关系密切。文章旨在探讨PPARs与肠道菌群的关系在IBD中的作用,从而挖掘IBD新的潜在诊疗靶点,开发新的治疗策略,为临床上IBD的诊断和治疗提供新的思路和方法。

Inflammatory bowel disease（IBD）,characterized as a chronic and recurrent inflammatory condition,is classified by the World Health Organization as one of the intractable diseases in modern medicine．The precise pathogenesis of IBD remains unclear,but current research widely believes that it is closely related to dysbiosis of the gut microbiota．Imbalance in the gut flora triggers an excessive immune response in the host’s intestinal mucosa,leading to mucosal damage in genetically susceptible individuals．To date,no specific targets have been identified that can cure IBD．Peroxisome proliferator-activated receptors（PPARs）,as members of the nuclear receptor superfamily,play significant roles in growth and development,inflammation regulation,and metabolic processes．They are regarded as potential effective targets for treating various diseases,including IBD,and are closely related to the gut microbiota．This review aims to discuss the progress in understanding the role of the relationship between PPARs and gut microbiota in IBD,so as to find new potential targets for the diagnosis and treatment of IBD,develop new treatment strategies,provide new ideas and methods for the diagnosis and treatment of IBD in clinical practice．

目的 建立针对炎症性肠病患者的运动锻炼方案。方法 通过系统检索Web of Science、Embase、Cochrane Library等数据库,综合相关文献并由两名研究者独立提取信息,制定出指导患者运动锻炼的方案。检索时间从建库截至2023年9月1日。结果 共筛选出12篇文献,包括指南、专家共识、Meta分析以及RCT试验。最终总结出运动的必要性、作用、适合人群、评估及筛选、运动方式选择、监测以及限制因素等7个方面,共计37条证据。结论 这些证据为轻中度炎症性肠病患者提供了有氧运动联合抗阻运动的最佳实践依据,可指导临床实践,规范运动训练,从而延缓疾病进展。

Objective To establish an exercise program for patients with inflammatory bowel disease（IBD）．Methods A systematic search was conducted in databases such as Web of Science,Cochrane Library,and Embase,with relevant literature being comprehensively reviewed．Information was independently extracted by two researchers to develop a program guiding patients' exercise．Searching terms included both Chinese and English keywords,with the searching period covering from the inception of the databases to September 1,2023．Results A total of 12 articles were screened,including guidelines,expert consensuses,Meta-analyses,and randomized controlled trials．Ultimately,37 pieces of evidence were summarized across seven aspects：the importance of exercise,suitable populations,assessment and screening,choice of exercise modes,monitoring and limiting factors．Conclusions These evidences provide the best practice basis for aerobic and resistance exercises in patients with mild to moderate IBD,guiding clinical practice,standardizing exercise training,and thus delaying disease progression．

目的 分析闽西南地区在院炎症性肠病患者流行病学资料,从而加强对炎症性肠病的认识。方法 回顾性研究炎症性肠病患者临床特点及用药情况。结果 纳入317例炎症性肠病,克罗恩病占212例,男女之比 2.07:1,溃疡性结肠炎占105例,男女比例1.84:1。克罗恩病患者确诊平均年龄29岁,以患A2型为主,溃疡性结肠炎者确诊平均年龄44岁。女性B2型比例明显高于男性。溃疡性结肠炎患者的病变部位主要为E3型(44.8%)。结论 炎症性肠病患者临床表现多样。克罗恩病确诊年龄主要是A2型, L3型是主要病变部位分型,B2型是疾病行为主要分型。E3型是溃疡性结肠炎患者的主要病变部位。克罗恩病多以免疫抑制剂和生物制剂治疗,糖皮质激素和5-ASA类制剂是轻中度的UC患者主要治疗措施。生物制剂、糖皮质激素治疗多用于重度UC患者。

Objective To analyze the epidemiological data of inflammatory bowel disease (IBD)patients in southwest Fujian Province, so as to improve the understanding of IBD. Methods To retrospectively study the clinical characteristics and medication of inflammatory bowel disease patients. Results A total of 317 IBD patients were included.Crohn's disease accounted for 212 cases, with a male-to-female ratio of 2.07:1, and ulcerative colitis accounted for 105 cases, with a male-to-female ratio of 1.84:1.Patients with Crohn's disease were diagnosed at an average age of 29, mainly with type A2, while patients with ulcerative colitis were diagnosed at an average age of 44. The proportion of female with type B2 was significantly higher than that of male.The lesions of ulcerative colitis patients were mainly type E3 (44.8%).Conclusions Patients with IBD had diverse clinical manifestations.The age of diagnosis of Crohn's disease was mainly type A2, type L3 was the main lesion, type B2 was the main disease classification.Crohn's disease was mainly treated with immunosuppressive and biological therapy. Glucocorticoids and 5-ASA were the main treatment for patients with mild-to-moderate ulcerative colitis. Biological agents and glucocorticoid therapy were mostly used in severe patients.

目的 通过比较炎症性肠病(IBD)患者的血脂水平,探讨炎症性肠病疾病活动程度与血脂的相关性。方法 收集2013年1月—2018年5月在南方医科大学附属南海医院住院的159例IBD患者和159例健康对照为研究对象,检测分析两组的血浆TG、TC、LDL-C、HDL-C、脂蛋白a、白蛋白和超敏C反应蛋白(hCRP)水平差异,分析IBD患者疾病活动程度与血脂异常的关系。结果 与对照组比较,IBD患者的TG、TC、LDL-C、HDL-C和白蛋白均下降,但脂蛋白a升高(P＜0.05),且CD组的TC、LDL-C、HDL-C、白蛋白均较UC组更低(P＜0.05)。TC、LDL-C、HDL-C等胆固醇水平随IBD疾病活动程度加重而逐渐下降,且与hCPR呈负相关,脂蛋白a与hCRP呈正相关性,但未见TG水平与疾病活动相关。结论 IBD患者的胆固醇水平下降,脂蛋白a升高,CD患者更明显,胆固醇水平随IBD病情加重逐渐下降,且与hCRP呈负相关。

Objective To explore the correlations between disease activity of inflammatory bowel disease(IBD) and lipid profiles levels by compare the levels of plasma lipids in patients with IBD. Methods A total of 159 IBD patients admitted to Nanhai Hospital of Southern Medical University from January 2013 to May 2018 were included in the study and the clinical data were collected. There were 159 healthy people recruited in the control group. The differences of plasma levels of triglycerides(TG), total cholesterol(TC), low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C), lipoprotein(a), albumin and high-sensitivity C-reactive protein(hCRP) between these two groups were analyzed respectively. The relationships between lipids levels and the severity of IBD were analyzed. Results Plasma levels of TG,TC,LDL-C,HDL-C and albumin were lower in IBD group than those in control group,but lipoprotein(a) was higher than control group(P＜0.05). The levels of TC,LDL-C,HDL-C and albumin were lower in CD patients compared to those of UC(P＜0.05). Plasma levels of TC,LDL-C,HDL-C gradually decreased with the severity of IBD. TC,LDL-C,HDL-C values were negatively correlated with hCRP levels in IBD patients. And lipoprotein(a) values was positively correlated with hCRP levels in IBD patient. However, there was no association between TG levels and the severity of IBD. Conclusion TG、TC、LDL-C、HDL-C levels are decreased and lipoprotein(a) is increased in IBD patients, especially CD patients, compared with healthy controls. Moreover, the cholesterol levels are negatively associated with more severe disease activity.

目的 水解乳清蛋白对炎症性肠病大鼠的抗炎作用及机制。方法 将40只雄性大鼠随机分为实验组和对照组,并建立炎症性肠病动物模型,分别喂食添加了水解乳清蛋白及普通蛋白的饲料,喂养4周后处死大鼠,每周检测体重,血清ALB、TNF-α、IL-2、IL-6等。结果 二组间体重及血清白蛋白无区别(P>0.05),实验组与对照组的TNF-α、IL-2及IL-6无区别(P>0.05),从第二周到第四周,实验组的炎症因子水平低于对照组(P<0.05)。结论 水解乳清蛋白具有抗炎作用,能够减少炎症性肠病大鼠动物模型的炎症因子的释放,并改善其营养状况。

Objective To evaluate the anti-inflammatory effects of whey protein on SD rats model of inflammatory bowel disease. Methods 40 SD rats model of inflammatory bowel disease were established and randomly divided into experimental and control groups equally. Experimental and control groups were fed whey protein and ordinary protein respectively. After 4 weeks, TNF-α, IL-2 and IL-6 were detected. Results There were no significant difference between the two groups of weights and the level of ALB. The level of TNF-α, IL-2 and IL-6 between groups were not significantly different in the first week(P>0.05). However, thelevels of TNF-α, IL-2 and IL-6 in experimental group were significantly lower than those of the control group in the follow weeks. Conclusion The whey protein could reduce the production of inflammatory cytokines.

       人工智能（AI）这一新兴技术的出现和应用给炎症性肠病（IBD）的诊断带来了巨大的变革。越来越多的研究着手于开发基于机器学习（ML）和深度学习（DL）的诊断模型，并获得了良好的诊断性能，尤其是在IBD的图像诊断，卷积神经网络（CNN）等模型由于其出色的图像分析能力，在内镜检查和组织病理检查等方面具有十分可观的发展前景。近年来AI诊断模型的应用越发广泛，但与此同时，关于算法、数据库及其应用方面仍存在一些难以忽视的局限性。本文将主要就图像识别方面对AI在IBD诊断中的应用进行综述，以期为IBD精准图像诊断领域下步研究提供参考。

        As an emerging technology，artificial intelligence（AI）has brought great changes to the precise diagnosis of inflammatory bowel disease（IBD）．More and more  researches have developed diagnostic models which are based on machine learning（ML）and deep learning（DL）and obtained satisfactory diagnostic performance．Especially in the image  diagnosis of IBD，convolutional neural network（CNN）and  other models  have  considerable  development  prospects in  endoscopy  and histopathology due to their excellent image analysis capabilities．In recent years，the application of AI diagnostic models has become more and more widespread，but at the same time，there are still some limitations about algorithms，databases and their applications that cannot be ignored．This review mainly focused on the application of AI in IBD diagnosis from the aspect of image recognition，to provide a reference for IBD diagnosis towards precision medicine．

       炎症性肠病（IBD）是一种以反复腹痛、腹泻、血便和体重降低为主要表现的慢性特发性性疾病，主要分为溃疡性结肠炎与克罗恩病两种类型。近年来，IBD的患病率随着城市化和工业化进展迅速升高，给中国和全球的公共健康带来沉重的负担。随着人类基因组技术的发展，越来越多的证据表明，遗传学因素在IBD发病过程中起着不可或缺的作用。在亚欧人群中，通过大规模全基因组关联研究现已明确了320个IBD易感基因位点。IBD易感基因在影响机体的细胞代谢、免疫功能调节、肠道上皮屏障和微生物清除等多个方面发挥着重要作用。本文就IBD相关易感基因及其多态性的研究进展进行综述，从基因层面揭示IBD发病的分子机制，并对探索IBD因人而异的个性化治疗方案提供帮助。

    Inflammatory bowel disease（IBD）is a chronic idiopathic disease characterized by recurrent abdominal pain，diarrhea，bloody stools，and weight loss．Ulcerative colitis and Crohn’s disease represent the two main types of IBD．In recent years，the prevalence of IBD has increased rapidly with the advancement of industrialization，imposing a heavy burden on public health in China and globally．Currently，with the development of genomics，a growing body of evidence suggests that genetic factors play an indispensable role in the pathogenesis of IBD．In the Eurasian population，320 IBD susceptibility gene loci have been identified through large-scale genome-wide association studies．IBD susceptibility genes play a crucial role in various aspects affecting cellular metabolism，immune function regulation，intestinal epithelial barrier，and microbial clearance．This article reviews the susceptibility genes and their polymorphisms associated with IBD，revealing the molecule mechanisms of IBD from gene perspectives and contributing to the development of personalized treatment strategies tailored to individual IBD patients．