目的 探讨肛周应用硝酸甘油软膏与肛周皮下组织注射复方亚甲蓝注射液联合情况下的肛肠疾病手术后镇痛的临床效果.方法 选取2019年5月 ～2020年2月在首都医科大学附属北京潞河医院住院行手术治疗的肛肠疾病患者60例,随机数表法将研究对象分成对照组和观察组各30例,对照组患者仅应用复方亚甲蓝注射液于肛周伤口周围皮下封闭注射;观察组肛周皮下组织注射复方亚甲蓝注射液同时联合肛周外用硝酸甘油软膏.观察两组患者术后第1天、第3天、第5天疼痛评分情况及术后恢复过程中的排便和排尿情况.结果 观察组在术后监测3d的疼痛评分和术后排便困难比例和尿潴留发生比例各方面指标均低于对照组,差异有统计学意义(P<0.01).结论 复方亚甲蓝注射液和硝酸甘油软膏联合应用在肛肠疾病术后镇痛的临床效果更加明显,是一种安全可行的肛肠疾病术后镇痛方法.

目的 探讨改良肌间瘘管结扎术治疗括约肌肛瘘的临床效果.方法 选取2015年7月至2017年6月首都医科大学附属北京潞河医院收治的120例括约肌肛瘘患者,采用随机数字表法分为改良组和对照组各60例,改良组采用改良肌间瘘管结扎术治疗,对照组采用常规肌间瘘管结扎术治疗;对比两组手术时间、住院时间、切口愈合时间、治愈率、手术后不同时间的疼痛程度评分、肛门失禁功能评估、肛肠动力学指标.结果 改良组的手术时间长于对照组,差异有显著性(P<0.05),改良组的治愈率高于对照组,差异有显著性(P<0.05),改良组和对照组患者的住院时间、切口愈合时间差异无显著性(P>0.05).两组患者在术后第1、3、7、14天,两组间VAS评分比较,差异无显著性(P>0.05);两组患者术前Wexner评分比较,差异无显著性(P>0.05),术后改良组患者Wexner评分低于对照组,差异有显著性(P<0.05).两组患者术前及术后的肛管最大收缩压、肛管静息压、直肠静息压组间比较,差异无显著性(P>0.05).结论 改良肌间瘘管结扎术治疗括约肌肛瘘患者较常规肌间瘘管结扎术具有更高的治愈率,同时对排便功能影响与常规肌间瘘管结扎术相差不大.

Oxaliplatin is one of the most common chemotherapy drugs for colorectal cancer (CRC), but its application is greatly limited owing to the drug resistance. Nobiletin is a natural flavonoid isolated from citrus peel and has many biological functions, including anti-inflammatory, antitumor and neuroprotective activities. However, little is known about the effect of nobiletin on the anti-tumor activities of other chemotherapy drugs. In this study, we examined the effect of nobiletin on the efficacy of oxaliplatin in treatment of CRC by using two CRC cell lines. In vitro experiments indicated that nobiletin enhanced the inhibitory effect of oxaliplatin on the proliferation of CRC cells. Meanwhile, nobiletin promoted oxaliplatin-induced apoptosis of CRC cells, as demonstrated by the increased expression of pro-apoptotic proteins (Bax and cleaved-caspse3) and the down-regulation of anti-apoptotic protein Bcl-2. Mechanically, nobiletin sensitized CRC to oxaliplatin chemotherapy by down-regulating the PI3K/Akt/mTOR pathway. Taken together, our study has demonstrated that nobiletin could enhance the sensitivity of CRC to oxaliplatin chemotherapy, and provided a molecular basis for nobiletin's potential applications in the chemosensitization of CRC.

Objective To compare the clinical efficacy of two surgical methods for the treatment of anal fissures in elderly patients.Methods A total of 138 elderly patients with anal fissures treated at our hospital from January to December 2016 were randomly divided into the conventional method group(69 cases) and the modified method group (69 cases).Patients in the conventional method group were treated with lateral sphincterotomy,while patients in the modified method group were treated with modified longitudinal sphincterotomy with transverse suture.Outcomes of treatment,VAS scores,incision wound infection rates,postoperative voiding dysfunction rates and recurrence rates were compared.Results There was no significant difference in overall effectiveness between the modified method group (98.6％)and the conventional method group(94.2％) (x2=1.8677,P=0.1717).The rates of incision wound infection,moderate postoperative urinary retention and recurrence in the conventional method group(8.7％,42.0％ and 10.1 ％,respectively)were significantly higher than those in the modified methods group(0.0 ％,15.9 ％ and 0.0％,respectively) (x2 =4.3561,11.4061 and 5.4177,respectively,P =0.0369,0.0007 and 0.0199,respectively).At 12 hours after operation,favorable VAS scores and incision healing times were observed in the modified method group,compared with the conventional method group,and the differences were statistically significant(each P＜0.05).Conclusions Modified longitudinal sphincterotomy with transverse suture produces about the same overall effectiveness as does lateral sphincterotomy in the treatment of elderly patients with anal fissures,but it is superior in reducing incision wound infection,moderate postoperative voiding dysfunction,recurrence and pain intensity,and in promoting incision healing.