Distribution characteristics of basic syndromes of chronic functional constipation and its related factors analysis / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the distribution characteristics of basic syndromes and its related factors in patients with chronic functional constipation (CFC).</p><p><b>METHODS</b>The complete data of 538 patients with CFC were collected and initial database was established with Epidata 3. 0. TCM syndrome typing was performed. The distribution characteristics of basic syndromes were analyzed using SPSS 17. 0 Software. The univariate and multivariate Logistic regression analyses were performed with SPSS 17. 0 Software to determine basic syndrome related factors such as age, engaged professionals, sleep quality, depression, mental stress, interpersonal relations, work fatigue, stimulating beverage, exercise conditions, Western medicine type of constipation, and so on.</p><p><b>RESULTS</b>The TCM syndrome frequency of CFC patients was sequenced from high to low as qi deficiency syndrome (380 cases, 70.6%), qi stagnation syndrome (337 cases, 62.6%), blood deficiency syndrome (234 cases, 43.5%), yin deficiency syndrome (220 cases, 40.9%), yang deficiency syndrome (197 cases, 36.6%), and others(58 cases, 10. 8%) . Most patients were complicated with complex syndromes, and the most common complex syndromes were qi deficiency complicated qi stagnation syndrome (275 cases, 51.1%) and qi deficiency complicated blood deficiency syndrome (222 cases, 41.3%). Aging, work fatigue, and exercise conditions were main related factors for qi deficiency syndrome (P <0. 01, P <0. 05). Poor emotional (depression and anxiety tendencies), mental stress, interpersonal relations, defecation barriers constipation were main related factors for qi stagnation syndrome (P <0.01). Sleep quality and poor emotional (depression and anxiety tendencies) were main related factors for blood deficiency syndrome (P <0. 01, P < 0.05). Stimulating beverages were main related factor for yin deficiency syndrome (P <0.05). Engaged in mental work and slow transit constipation were main related factors for yang deficiency syndrome (P < 0. 01, P <0. 05).</p><p><b>CONCLUSIONS</b>CFC is featured as complex syndromes. The most common complex syndromes were qi deficiency complicated qi stagnation syndrome and qi deficiency complicated blood deficiency syndrome. Basic syndrome related factors such as age, engaged professionals, sleep quality, poor emotional (depression and anxiety tendencies), mental stress, interpersonal relations, work fatigue, stimulating beverage, exercise conditions, Western medicine type of constipation were associated with the distribution of CFC syndromes.</p>

Multi-gene methylation detection increases positive methylation rate in colorectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study whether combined detection of the methylation status of vimentin, sFRP1, and HPP1 gene can increase the positive methylation rate in colorectal cancer.</p><p><b>METHODS</b>Tissue samples were collected from 90 patients with colorectal cancer, 60 patients with adenomatous polyp, and 20 healthy controls. DNA was extracted and the methylation status of vimentin, sFRP1, and HPP1 gene was detected by Methylation-specific PCR (MSP). The relationship between clinicopathologic features of colorectal cancer and gene methylation was analyzed.</p><p><b>RESULTS</b>The methylation rates of vimentin, sFRP1, and HPP1 were 66.7%, 68.9%, and 72.2% in colorectal cancer, 53.3%, 55.0%, and 50.0% in colorectal adenomas, and 0, 0, and 5.0% in healthy controls, respectively. The methylation of each of the three genes in colorectal cancer tissues was higher than colorectal adenomas and healthy controls(P<0.05). The diagnostic sensitivity by combining three methylation markers was 93.3% in colorectal cancer, 76.7% in colorectal adenomas, which was higher than the sensitivity using single gene testing(P<0.05). No significant associations existed between the methylation status of the three genes and clinical characteristics including sex, age, tumor location, lymph node metastases, distant metastasis, and TNM stage(P>0.05).</p><p><b>CONCLUSIONS</b>DNA methylation levels of vimentin, sFRP1 and HPP1 are significantly higher in colorectal cancer tissue. Combined detection significantly improves the positive rate of methylation, and may be used as early diagnosis method for colorectal cancer.</p>

Transsacral resection for presacral tumors / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the operation indication and safety of presacral tumor.</p><p><b>METHODS</b>Clinical data of 36 patients with presacral tumor from November 1990 to May 2006 treated in our hospital, in whom 23 patients underwent trans-sacral operation, were analyzed retrospectively.</p><p><b>RESULTS</b>The operation time was from 43 to 210 min (average 94 min). The volume of blood loss was from 30 to 2000 ml (average 350 ml). Hospital stay was from 8 to 16 days (average 10.7 days). There were 13 different pathology types of tumors in the 36 patients including 26.4% of malignancy. Complications of trans-sacral operation included 1 case of ureteral damage, 1 case of sacral wound hernia, 1 case of presacral abscess who was healed by sigmoid stoma and wound drainage.</p><p><b>CONCLUSION</b>Trans-sacral resection of low presacral tumor is safe and effective with less trauma, less bleeding and quick recovery.</p>

Bowel preparation with sodium phosphate versus polyethylene glycol: a prospective, randomized, controlled clinical trial / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the efficacy, tolerance and safety between oral sodium phosphate(NaP) and polyethylene glycol(PEG) on bowel preparation.</p><p><b>METHODS</b>One hundred and fifteen inpatients were randomly divided into NaP group and PEG group. The questionnaire was designed for scoring by patients and doctors regarding to tolerance, taste, side effects and cleaning degree etc.</p><p><b>RESULTS</b>Compared with PEG group, NaP presented better tolerance, lower side effects and higher rate of adequate cleaning quality(P<0.05). NaP could cause electrolytic alterations, such as hyperphosphatemia, hypernatremia, hypocalcemia and hypopotassemia, but these changes were transient and without clinical significance.</p><p><b>CONCLUSION</b>Sodium phosphate is safe and effective for bowel preparation, and is better than polyethylene glycol in tolerance.</p>

Efficacy of the procedure for prolapse and hemorrhoids combined with external hemorrhoids excision in the treatment of III or IV mixed hemorrhoids / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the efficacy of the procedure for prolapse and hemorrhoids (PPH) combined with external hemorrhoids excision in the treatment of III or IV mixed hemorrhoids.</p><p><b>METHODS</b>One hundred and twelve patients with III or IV mixed hemorrhoids admitted for surgical treatment were randomly divided into three groups: PPH 1 group (34 cases), PPH2 group (36 cases), and Milligan-Morgan group (42 cases). PPH1 group received the standard PPH operation, PPH2 received PPH and external hemorrhoids excision, and Milligan-Morgan group received Milligan-Morgan hemorrhoidectomy. Postoperative 24 h-pain index, pain index when defecating, bleeding, anal discomfort feeling , wound edema, the ability of controlling feces, operating time, hospitalization time and charges were recorded. The change of anal dynamics was detected by anorectal manometry. All the patients were followed-up for 0.5-1 year.</p><p><b>RESULTS</b>There were no significant differences among the three groups in bleeding, anal discomfort feeling, the ability of controlling feces (P>0.05). The postoperative 24 h-pain index of PPH1 group was lower than those of the other two groups (P<0.05). PPH1 group and PPH2 group were better than Milligan-Morgan group in pain index when defecating, wound edema, operating time, and hospitalization time (P<0.05). Milligan-Morgan group was better than the other two groups in postoperative urinary retention and hospital charges (P<0.05). The change of anal duct pressure of Milligan-Morgan group was less than those of the other two groups (P<0.05). Within 0.5-1.0 year follow-up, 3 patients got thrombosed external hemorrhoid in PPH1 group, 2 patients recurred and 1 patient got thrombosed external hemorrhoid in Milligan-Morgan group, no recurred patients in PPH2 group.</p><p><b>CONCLUSION</b>PPH combined with external hemorrhoid excision is a safe and effective treatment for mixed hemorrhoids, which is suitable for mixed hemorrhoids with severe external hemorrhoids.</p>

Prophylactic use of antibiotics in selective colorectal operation: a randomized controlled trial / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the reasonable proposal of prophylactic antibiotics use in selective colorectal operation.</p><p><b>METHODS</b>One hundred and sixty-five patients underwent colorectal surgery were randomized to Treatment 1 (55 cases), Treatment 2 (50 cases) and Control (60 cases) group. The Treatment 1 group was given oral MgSO4 solution at the night before operation, and Cefradine 2.0 g (I.V.) during the induction of anesthesia, continued with tow times of intravenous Cefradine 2.0 g and 0.5% Metronidazole 100 ml at an interval of 12 hours in 24 hours after the operation. The Treatment 2 group was given the same treatment as Treatment 1, but the antibiotics would not be withdrawn until 3-5 d after operation. On the basis of the treatment of Treatment 2 group, the Control group was given oral antibiotics 2-3 days before operation. Postoperative complications including surgical site infection, stoma leakage, dysbacteriosis, and WBC, body temperature, days of hospitalization and antibiotic expenses in the three groups were observed and compared.</p><p><b>RESULTS</b>There was no significant differences in surgical site infection, stoma leakage, WBC counting and its change, body temperature and hospital stay among the three groups (P > 0.05). The incidence rate of dysbacteriosis in Control group was significantly higher than that in Treatment 1 group (P < 0.05). The antibiotic expenses in the Treatment 1 group was significantly lower than those of the other two groups (P < 0.05).</p><p><b>CONCLUSIONS</b>Prophylactic antibiotic use during the induction of anesthesia and 24 hours after operation was reasonable in selective colorectal operation, it can prevent the surgical site infection effectively with good social-economic effects and fewer side effects.</p>