慢性溃疡性结肠炎中西医结合治疗分析

目的观察分析中西医结合治疗慢性溃疡性结肠炎的疗效.方法:临床病例分成西医治疗组、中医治疗组和中西医结合治疗组,观察各组的治愈数、好转数和复发数,统计分析各治疗方法的疗效.结果:中西医结合治疗组的总有效率显著高于西医组或中医治疗组(均P＜0.01);西医治疗组与中医治疗组的治疗总有效率无显著性差异(P＞0.05).对各组治愈患者追踪随防1年,西医治疗组与中医治疗组的复发率无显著差别(P＞0.05),而中西医结合治疗组复发率显著低于西医治疗组或中医治疗组(均P＜0.05).结论:采用辨证施治,以清热解毒利湿、导滞为主,结合西药的中西医结合方法治疗慢性溃疡性结肠炎优于单独的西医或中医治疗慢性溃疡性结肠炎.     

次全结肠切除治疗结肠慢转运型便秘 32例

由于饮食结构等方面的改变,近年来慢性顽固性便秘的发病有明显增多的趋势[1]。曾有报道,结肠次全切除加盲直肠吻合术治疗慢转运型便秘更为有效[2]。本文通过32例的临床疗效分析显示,掌握好手术适应证,结肠次全切除加盲直肠吻合术治疗结肠慢转运型便秘的效果良好。临床资料32例慢性顽固性便秘患者为我院1995年5月至2003年12月收治的。其中男性3例,女性29例;年龄31～82(平均47)岁。病程4～32(平均12)年,其中20年以上者6例,10～20年者7例,10年以下者19例。所有患者有大量泻药服用史,均存在慢性顽固性便秘,7～56d排便1次。多有腹胀及腹部隐痛症…     

生肌玉红膏联合硝硼散防治肛肠术后伤口感染的临床研究

目的探讨生肌玉红膏与硝硼散联合应用在防治肛肠术后伤口感染的临床效果,以降低伤口感染率。方法选取2010年2月-2013年12月行肛肠手术的患者386例,将其随机分为3组,分别于术后给予硝硼散、生肌玉红膏和硝硼散联合生肌玉红膏治疗;比较3组患者治疗效果以及术后感染率的差异。结果患者治疗后痊愈率和总有效率硝硼散组分别为65.6%和92.8%,生肌玉红膏组为67.7%和93.7%,硝硼散联合生肌玉红膏组为77.6%和98.5%,硝硼散联合生肌玉红膏组的痊愈率和总有效率均高于硝硼散组和生肌玉红膏组,差异均有统计学意义(P<0.05);硝硼散组与生肌玉红膏组差异无统计学意义;硝硼散联合生肌玉红膏组的总感染率为6.7%,硝硼散组为15.2%,生肌玉红膏组为14.2%,硝硼散联合生肌玉红膏组总感染率低于硝硼散组和生肌玉红膏组,差异均有统计学意义(P<0.05),硝硼散组与生肌玉红膏组差异无统计学意义;疾病种类之间比较,肛周脓肿、肛瘘以及混合痔的感染率较高。结论硝硼散联合生肌玉红膏能显著提高肛肠术后治疗效果,且能显著性降低术后感染率。     

杭州地区结肠慢转运型便秘患者遗传流行病学调查

[目的]探讨结肠慢转运型便秘(slow translate constipation,STC)可能的遗传模式和遗传因素在STC发病中的作用。[方法]通过调查表得到杭州地区66例STC患者及其一、二级亲属的数据。对有家族史与无家族史者进行比较,用SPSS 11.5软件包对资料进行分析。由于缺乏当地STC患病率普查数据,因此设立对照组(45例)以方便遗传模式及遗传度的计算。应用Penrose法、Falconer法对STC患者进行遗传方式分析、遗传度计算。[结果]①所调查的66例STC先证者中,有家族史者31例,无家族史者35例,遗传率46.97%。②Penrose法计算出同胞患病率(s)/人群患病率(q)为2.316,不接近1/2q(17.36),也不接近1/4q(8.68),而接近1/槡q(5.89),提示STC符合一种多基因遗传模式。③STC患者一级亲属遗传度为(23.68±9.56)%,二级亲属遗传度(1.315±6.73)%,由一级、二级亲属得出的遗传度估计值加权平均为(8.728±5.505)%。④与父母都不发病者比较,父亲患STC时,子女患STC的危险性为16.6倍,母亲患病时子女患病危险性为12.1倍。先证者各一级亲属病相对危险性为2.39～5.58倍。⑤性别、城乡差别在有家族史和无家族史中差异均无统计学意义;但有家族史的男性患者的发病年龄高于无家族史的男性患者。[结论]遗传因素在STC发病中占有重要作用,STC符合一种多基因或多因子遗传模式,存在主基因效应。     

结肠癌富伴侣分子疫苗的制备及其抗癌作用研究

Objective To prepare the anticolon carcinoma vaccine with rich chaperone peptide and to examine its anticancer immunological efficacy. Methods CT26 colon carcinoma cells were cultured in 1 mg/L Trichosanthin 1640 medium at different temperatures to induce the chaperone expression and promote the synthesis of antigen peptides. Groups of these cells treated under the different condition were lysed by the sonic disintegration, and the lysates were centrifuged. The rawpurified proteins were obtained from the supernatants by precipitating with saturated ammonium sulfate and removing the molecules below 50 000 and above 300 000 in molecular weight via dialysis. Furthermore, the proteins with the molecular weights in 70 000, 90 000, 95 000, 110 000 and 170 000 were collected through gel filtration and SDS-PAGE. The purified proteins were analysed by Western blotting, and inspected on the anticancer immunological effects including lymphocyte proliferation and the activities of NK and CTL. Results Major of the chaperone peptides of anticancer effects in CT26 cells, including antigen peptides joining with HSP70, HSP90, gp96, HSP110 and HSP170, was satisfactorily extracted and condensed, and rich chaperone peptide composites were successfully obtained. The composites prepared under various condition could all enhance lymphocyte proliferation and the activities of CTL and NK (P<0.01). Conclusions The rich chaperone peptide composites are successfully prepared via dialysis, salt fractionation and gel filtration combined with SDS-PAGE. Both the heat stress and Trichosanthin can increase the composites, which treated by 42℃ heat stress and Trichosanthin are found to possess the strongest anticancer efficacy.     

痔病PPH术后肛肠动力学变化

我院白2003年4月-2004年10月通过对60例痔病肛肠动力学的前瞻性研究，为临床选择术式及PPH术的进一步改进提供依据。     

结肠癌富伴侣分子疫苗的制备及其抗癌作用研究

Objective To prepare the anticolon carcinoma vaccine with rich chaperone peptide and to examine its anticancer immunological efficacy. Methods CT26 colon carcinoma cells were cultured in 1 mg/L Trichosanthin 1640 medium at different temperatures to induce the chaperone expression and promote the synthesis of antigen peptides. Groups of these cells treated under the different condition were lysed by the sonic disintegration, and the lysates were centrifuged. The rawpurified proteins were obtained from the supernatants by precipitating with saturated ammonium sulfate and removing the molecules below 50 000 and above 300 000 in molecular weight via dialysis. Furthermore, the proteins with the molecular weights in 70 000, 90 000, 95 000, 110 000 and 170 000 were collected through gel filtration and SDS-PAGE. The purified proteins were analysed by Western blotting, and inspected on the anticancer immunological effects including lymphocyte proliferation and the activities of NK and CTL. Results Major of the chaperone peptides of anticancer effects in CT26 cells, including antigen peptides joining with HSP70, HSP90, gp96, HSP110 and HSP170, was satisfactorily extracted and condensed, and rich chaperone peptide composites were successfully obtained. The composites prepared under various condition could all enhance lymphocyte proliferation and the activities of CTL and NK (P<0.01). Conclusions The rich chaperone peptide composites are successfully prepared via dialysis, salt fractionation and gel filtration combined with SDS-PAGE. Both the heat stress and Trichosanthin can increase the composites, which treated by 42℃ heat stress and Trichosanthin are found to possess the strongest anticancer efficacy.     

结肠癌富伴侣分子疫苗的制备及其抗癌作用研究

Objective To prepare the anticolon carcinoma vaccine with rich chaperone peptide and to examine its anticancer immunological efficacy. Methods CT26 colon carcinoma cells were cultured in 1 mg/L Trichosanthin 1640 medium at different temperatures to induce the chaperone expression and promote the synthesis of antigen peptides. Groups of these cells treated under the different condition were lysed by the sonic disintegration, and the lysates were centrifuged. The rawpurified proteins were obtained from the supernatants by precipitating with saturated ammonium sulfate and removing the molecules below 50 000 and above 300 000 in molecular weight via dialysis. Furthermore, the proteins with the molecular weights in 70 000, 90 000, 95 000, 110 000 and 170 000 were collected through gel filtration and SDS-PAGE. The purified proteins were analysed by Western blotting, and inspected on the anticancer immunological effects including lymphocyte proliferation and the activities of NK and CTL. Results Major of the chaperone peptides of anticancer effects in CT26 cells, including antigen peptides joining with HSP70, HSP90, gp96, HSP110 and HSP170, was satisfactorily extracted and condensed, and rich chaperone peptide composites were successfully obtained. The composites prepared under various condition could all enhance lymphocyte proliferation and the activities of CTL and NK (P<0.01). Conclusions The rich chaperone peptide composites are successfully prepared via dialysis, salt fractionation and gel filtration combined with SDS-PAGE. Both the heat stress and Trichosanthin can increase the composites, which treated by 42℃ heat stress and Trichosanthin are found to possess the strongest anticancer efficacy.     

结肠慢转运型便秘的外科治疗

我科 1995— 2 0 0 1年共收治结肠慢转运型便秘患者 18例 ,根据临床症状、体征 ,结合特殊检查取得确诊 ,行次全结肠切除、盲直肠吻合术 ,取得满意效果 ,现报告如下。1　临床资料本组 18例 ,男性 3例 ,女性 15例 ;年龄 31～ 6 5岁 ,平均 4 8 5岁。病史 7～ 32年 ,平均 17年。排便间隔 7～ 10d 10例 ,11～ 16d 5例 ,16d以上 3例 ,其中长期依赖泻剂协助排便 7例。主要临床表现为自然便次减少 ,便意缺乏 ,常 1～ 2周不排便 ,伴有腹胀、腹痛、纳差、烦燥等。长期依赖各种泻剂排便 ,对泻剂敏感度逐渐下降。结肠运输功能试验提示 :标记物排出 80 %…     

外剥内扎术联合荷包缝合术治疗Ⅲ、Ⅳ度混合痔的临床效果分析

目的 分析外剥内扎术联合荷包缝合术治疗Ⅲ、Ⅳ度混合痔的临床疗效。 方法 选择2015年12月—2017年12月间杭州市第三人民医院收治的Ⅲ、Ⅳ度混合痔患者136例作为研究对象，根据对患者采取手术方式的不同，将患者分为对照组与观察组，每组68例。对照组给予外剥内扎术，观察组给予外剥内扎术联合荷包缝合术，回顾性分析比较2组患者手术相关指标(手术时间、创面愈合时间、住院时间)、术后肛门疼痛(VAS评分)、术后肛缘水肿及术后并发症(排尿障碍、术后出血、肛门直肠狭窄、皮赘形成)发生情况及临床疗效。 结果 2组患者手术时间比较差异无统计学意义(P>0.05)，但观察组创面愈合时间与住院时间显著低于对照组(均P<0.05)。2组患者在术后7 d内肛门疼痛VAS评分与肛缘水肿评分依次降低，且观察组术后1、3、5、7 d肛门疼痛VAS评分与肛缘水肿评分明显低于对照组(均P<0.05)。观察组排尿障碍评分、术后出血评分明显低于对照组(均P<0.05)，肛门直肠狭窄与皮赘形成发生率显著低于对照组(均P<0.05)。观察组总有效率为98.53%，对照组总有效率为95.59%，2组临床总有效率差异无统计学意义(P>0.05)。 结论 外剥内扎术联合荷包缝合术治疗Ⅲ、Ⅳ度混合痔与外剥内扎术相比，临床疗效相当，但外剥内扎术联合荷包缝合术能够加快Ⅲ、Ⅳ度混合痔患者创面愈合，减轻术后疼痛，降低术后并发症的发生，值得临床推广应用。