基于网络药理学及实验验证探讨三七治疗骨折的作用机制

目的 基于网络药理学方法预测三七治疗骨折的作用机制,并通过动物实验进行验证。方法 通过中药系统药理学数据库分析平台（TCMSP）、文献报道以及Swiss Target Prediction筛选三七主要活性成分及靶点,利用GeneCards数据库收集骨折靶点,再使用String数据库和Cystoscope 3.7.2软件构建蛋白相互作用（PPI）网络,同时筛选核心靶点,建立“三七-活性成分-骨折-靶点”网络,并对潜在核心靶点进行基因本体（gene ontology,GO）功能富集分析和京都基因与基因组百科全书（Kyoto encyclopedia of genes and genomes,KEGG）通路富集分析。最后通过动物实验对三七治疗骨折进行疗效分析,对部分靶点进行验证。结果 共筛选获得三七活性成分20个及其相应靶点356个,骨折靶点5 235个,两者交集靶点205个。三七治疗骨折潜在核心靶点包括蛋白激酶（AKT1）、白细胞介素6(IL-6)、血管内皮生长因子A(VEGFA)、表皮生长因子受体（EGFR）、信号转导与转录激活因子3(STAT3)、表皮生长因子（EGF）、丝裂原活化蛋白...     

磁共振成像在复杂性肛瘘诊断中的应用

目的 探讨磁共振成像(MRI)在复杂性肛瘘诊断中的应用价值.方法 28例临床诊断为复杂性肛瘘的患者,术前进行磁共振相控阵列线圈检查.以手术结果为标准,比较术前指诊和MRI的诊断结果.结果 有25例患者诊断为复杂性肛瘘,1例为骶前囊肿合并与直肠相通的瘘道,2例肛瘘伴癌变.25例肛瘘Parks分类显示:经括约肌肛瘘3例,括约肌间肛瘘10例,括约肌外肛瘘5例,括约肌上肛瘘7例;MRI与术前指诊检查结果比较,内口检出符合率为84%比48%:原发主管、支管或脓腔检出准确率为100%比76%、94.7%比57.9%;两种检查方法比较,差异有统计学意义(P<0.01).结论 应用MRI相控阵列线圈能准确定位复杂性肛瘘的内口、瘘管的走向及其与肛管直肠括约肌复合体之间的复杂关系,对排除肛瘘伴其他肛管直肠周围病变具有确切意义.     

复杂性肛瘘手术治疗的现存问题及对策

针对目前复杂性肛瘘治疗中普遍存在的复发率高、肛门功能保护不足的现状,为解决临床医生忽视术前诊断,功能保护意识薄弱以及缺乏规范的临床诊治指南等问题,本文提出建立术前诊断“金标准”及医疗转诊机制,确立切断肛门括约肌新原则,收集高级别循证医学证据等对策,从而制订出具有中国特色的肛瘘临床诊治指南,以期提高该病的治愈率并大幅减少术后肛门失禁。     

磁共振成像在挂线治疗复发性肛瘘中的应用

目的 探讨磁共振成像(Mill)在挂线治疗复发性肛瘘中的应用价值.方法 对22例复发性肛瘘患者,术前进行磁共振相控阵列线圈检查,将删检查结果 与术前指诊结果 进行比较,最终以挂线手术结果 为标准验证其准确性,同时观察挂线后患者肛门功能、复发情况.结果 22例患者中19例确诊为复发性肛瘘,1例为骶前囊肿合并直肠瘘,2例肛瘘伴癌变.MRI对肛瘘内口、原发主管、支管/脓腔检查准确率明显优于直肠指诊,差异有统计学意义(P<0.01).19例患者均行挂线治疗,近期治愈率100%.平均随访13个月,其中2例患者复发(10.5%),再次手术后痊愈.5名患者术前已有肛门功能改变,肛门漏气3例,漏液2例,挂线后8名患者有肛门功能改变,肛门漏气5例,漏液3例,未见有发生完全性肛门失禁的病例.结论 应用删相控阵列线圈能准确定位复发性肛瘘的内口、瘘管及潜在脓腔的位置,同时排除其它肛管直肠周围病变,在其引导下行中医挂线治疗可大大提高该疗法的疗效.     

浅挂线疗法治疗肛周脓肿40例临床研究

目的：探讨浅挂线疗法在肛周脓肿手术治疗中对保护肛门功能的意义。方法：采用以适当降低挂线高度为特征的“浅挂线”新技术，同时改进挂线紧线技术。结果：浅挂线在保持高治愈率基础上，在肛门功能保护方面优于传统挂线组（P〈O．05）。结论：浅挂线新疗法疗效满意，并能有效地避免现流行挂线技术肛门功能保护不够的不足。     

磁共振成像在深部肛周脓肿诊断中的应用

Objective To evaluate magnetic resonance imaging (MRI) in the diagnosis of deep anorectal abscess. Methods Twenty-one patients who were suspected of having deep anorectal abscess were admitted to the Affiliated Hospital of Nanjing University of Chinese Medicine from January 2006 to December 2007, and their clinical data were retrospectively analyzed. Phased-array coil MRI was applied to all patients before the operation. We compared the efficacy of MRI and rectal digital examination in the classification of deep anorectal abscess and the diagnosis rate of internal opening according to the postoperative results. All data were analyzed using the chi-square test. Results Nineteen patients were diagnosed with deep anorectal abscess, one patient had presacral cyst combined with infection and one patient had perianal mucinous adenocarcinoma. A total of 25 lesions were identified, including 14 ischiorectal abscesses, five pelvirectal abscesses, and six high intersphincteric abscesses. Thirteen patients had single space abscesses and six had multiple space abscesses. There were no significant differences in the diagnosis rate between MRI (12/19) and rectal digital examination for internal opening (13/19) (χ2 =0. 116, P>0.05). The accuracy rate was significantly different between MRI (25/25) and rectal digital examination (16/25) in the classification of deep anorectal abscess (χ2 = 10.970, P <0.05). Operative exploration revealed that there were 13 patients with single space abscesses and six with multiple space abscesses. The accuracy rate was significantly different between MRI (19/19) and the rectal digital examination (13/19) for detecting multiple space abscesses (χ2 =7. 125, P <0. 05). Conclusions MRI with a phased-array coil can accurately detect the extent of deep anorectal abscess and its relationship with anorectal sphincters. MRI examination is helpful in excluding potential lesions in the anorectal region.