Regional differences in mucosal hemodynamics in experimental colonic injury in rats

In rat colon damaged by 10% acetic acid and by dinitrochlorobenzene, we test the following hypotheses: (1) mucosal hemodynamic changes are significantly different at the ulcer base, the ulcer margin, and the inflamed non-ulcer-bearing mucosa; and (2) these mucosal hemodynamic changes also vary with time after induction of the colonic injury. Mucosal hemodynamic changes were documented by reflectance spectrophotometry, and variations in gross mucosal morphology were confirmed by hematoxylin and eosin histologic sections. Results revealed that in the acute stage, the ulcer base, which was covered by necrotic debris, showed ischemia without congestion. The ulcer margin at the edge of the ulcer base showed ischemia with congestion. The nonulcerated mucosa, which appeared erythematous, showed increased perfusion. In the convalescent stage, all the altered perfusion patterns returned to normal. These observations offer plausible explanations for the variability in colonic perfusion observed in experimentally damaged colons.     

Sympathetic Input to Multiple Cell Types in Mouse and Human Colon Produces Region-Specific Responses

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Chemotherapeutic studies on N-nitrosoacetoxymethyl-methylamine-and 1,2-dimethylhydrazine-induced colonic tumors in rats: Monotherapy with 5-fluorouracil,ftorafur, CGP 6809, and CGP 15'720A

Summary Colonic tumors were induced in male Sprague-Dawley rats by ten applications of 2 mg/kg/week N-nitrosoacetoxymethyl-methylamine (AMMN) or by three applications of 100 mg/kg/month 1,2-dimethylhydrazine (1,2-DMH). Application of AMMN and 1,2-DMH induced selective colonic tumors in 97% and 29–42% of the initial animals, respectively. Colonic-tumor-bearing animals were subjected to monotherapy with 5-fluorouracil, ftorafur, CGP 6809, and CGP 15'720A. No cures were achieved. The different therapies did not exert any clear influence on the survival time of animals, except for animals pretreated with AMMN and then subjected to ftorafur therapy.     

结肠灌洗脱落细胞端粒酶活性诊断结肠癌的价值

目的端粒酶作为核糖核酸蛋白酶能使端粒延长而克服细胞衰老，与细胞永生和癌变密切相关，正常的躯体细胞无端粒酶活性，大多人类原发肿瘤均可探及端粒酶阳性．本研究旨在探讨结肠脱落细胞端粒酶检测对结肠癌的临床诊断价值．方法采用端粒重复序列扩增法（ＴＲＡＰ）检测１６例结肠癌外科手术新鲜标本、相邻的正常组织及其肠腔灌洗物，６例ＩＢＳ患者的结肠镜抽取物的端粒酶活性．结果结肠癌组织１６例，端粒酶强阳性１０例，弱阳性３例和阴性３例，阳性率为８１３％；结肠癌远端正常肠粘膜组织的端粒酶强阳性、弱阳性和阴性分别为０，２和１４例，阳性率为１２５％，两组Ｐ＜００１．结肠癌结肠灌洗液１６例中有５例端粒酶阳性，而６例ＩＢＳ结肠镜抽取液全部为端粒酶阴性，其诊断的敏感性和特异性分别为３１３％和１００％，阳性预测值和阴性预测值分别为１００％和６４７％．结论结肠灌洗脱落细胞的端粒酶检测对结肠癌有良好的诊断价值．     

不同冲洗方法清除根管内氢氧化钙的体外研究

目的比较不同冲洗方法对根管内氢氧化钙的清除效果,为临床治疗提供参考。方法收集160颗下颌单根管恒前磨牙,截冠后ProTaper预备至F4。将牙纵向劈为两半,分别在根管壁上制备标准化凹槽和凹陷模型并填入氢氧化钙。根据不同冲洗方法将样本随机分为4组(n=40):注射器组、超声组、XPendo finisher(XPF)组、M3Max组;每组根据冲洗液再分为2个亚组(n=20):次氯酸钠组、次氯酸钠+乙二胺四乙酸(ethylene diamine tetraacetic acid,EDTA)组。冲洗结束后显微镜下拍摄凹槽和凹陷照片,并对残余氢氧化钙进行评分,比较不同冲洗方法和冲洗液对氢氧化钙的清除效果。结果在凹槽和凹陷模型中,使用次氯酸钠作为冲洗液时,超声、XPF和M3Max清除氢氧化钙的效果均优于注射器冲洗(P<0.05);当使用次氯酸钠联合EDTA冲洗时,超声、XPF和M3Max清除氢氧化钙的效果也均优于注射器冲洗(P<0.05);但超声、XPF和M3Max三者之间的差异均无统计学意义(P>0.05);与使用次氯酸钠作为冲洗液时相比,次氯酸钠联用EDTA冲洗可增强超声、XPF和M3Max清除氢氧化钙的效果(P<0.05),但不能增强注射器冲洗效果(P>0.05)。结论次氯酸钠联用EDTA冲洗可增强超声、XPF和M3Max清除氢氧化钙的效果,三者间无明显差异,均优于注射器冲洗。     

Perforation of the rectum and sigmoid colon during barium-enema examination

Perforation of the rectum or sigmoid colon complicated 5 of 2200 barium-enema examinations performed during a 4-year period. Three patients with rectal perforations manifested by air extravasation were successfully treated with intravenous antibiotics and complete bowel rest. Two patients with barium extravasation were treated with immediate operation and colostomy. All five patients recovered. Perforation was found to be associated with a rectal stricture due to ulcerative colitis, a rectal cancer, an incarcerated inguinal hernia, fulminant ulcerative colitis, and a normal colon in an elderly patient. To determine the pressure in the rectum that could potentially be generated during a barium-enema examination, the pressures created by a standard barium delivery set were measured, using 1-meter columns of water, 25 percent diatrizoate sodium (Hypaque^®), 20 percent barium, and 80 percent barium. The columns generated pressures of 70, 85, 95, and 120 mm Hg respectively. Squeezing the delivery bag increased the pressure 21 to 79 percent or a maximum of 55 mm Hg. Colorectal perforation during barium-enema examination that was not accompanied by barium extravasation could be successfully treated nonoperatively. The associated pathology and our studies of pressures generated during a barium-enema examination allow us to suggest that the incidence of colorectal perforation during barium-enema radiography can be reduced by 1) performing proctoscopy prior to barium enema, 2) avoiding the use of the rectal balloon in patients with known rectal lesions, 3) avoiding barium studies in patients with active colitis, 4) avoiding generation of pressure greater than that created by a column of barium suspension of one meter, and 5) using a lower concentration of barium when possible.     

经尿道前列腺电切术后失血量评估方法的研究进展

综述良性前列腺增生行经尿道前列腺电切术(TURP)病人术后失血量评估方法的研究进展,比较各种方法的优缺点,指出目前临床尚无失血量估计统一客观方法,泌尿外科医护人员可以对目视比色法,尤其是血尿比色卡的临床应用开展进一步研究,以便对 TURP 术后病人膀胱冲洗液中失血量评估提供更科学、准确和直观的方法。     

Ⅰ期手术治疗结肠穿孔的疗效研究

目的研究Ⅰ期手术治疗结肠穿孔的有效性及安全性。方法将綦江区人民医院胃肠外科2011年9月至2014年4月收治的37例结肠穿孔患者分为观察组与对照组。观察组行Ⅰ期穿孔修补术或肠切除吻合术;对照组行分期手术,Ⅰ期行穿孔修补术或肠管切除术,Ⅱ期行近端肠管造瘘术。比较两组患者的疗效及安全性。结果两组患者术中出血量、切口感染发生率、心肺并发症发生率及住院时间比较,差异无统计学意义(P0.05);观察组患者术后肛门排气、排便时间大于对照组,住院费用高于对照组,组间比较差异均有统计学意义(P0.05)。所有患者均安全度过围术期,无严重并发症发生,观察组19例患者中发生术后吻合口瘘1例、切口感染3例、无腹腔感染发生。结论对部分结肠穿孔患者行Ⅰ期手术治疗安全有效,值得临床推广。