Objective: To determine the prevalence and risk factors of constipation in Hangzhou urban areas by analyzing data from a recent epidemiological survey. Methods: From August 2022 to June 2023, a cross-sectional survey was conducted on 43 communities on eight streets in suburbs of Hangzhou, including Wangjiang, Sijiqing, Puyan, Changhe, Ziyang, Xiaoshanchengxiang, Zhuantang, and Banshan. Written questionnaires were filled out face to face by community doctors. The prevalence of constipation was investigated using a combination of the Bristol stool typing method and the Rome IV criteria. The risk factors for constipation were analyzed using multivariate logistic regression analysis. Results: The study cohort comprised 10,479 participants, 5551 of whom were male (53.0%) and 4928 female (47.0%). The overall prevalence of constipation was 10.6% (1107/10,479). The prevalence was 11.0% (613/5551) for male and 10.0% (494/4928) for female participants; this difference is not statistically significant (P>0.05).There were no significant differences in the prevalence of constipation between different categories of body mass index (P>0.05). The prevalence of constipation was highest in individuals aged 70 years and above, accounting for 15.4% (264/1717) of all cases. There were significant differences in the prevalence of constipation between different occupations, marital statuses, and educational levels (P<0.001). Patients with hypertension or diabetes mellitus had a higher prevalence of constipation than those without these conditions, those who had been taking long-term medication had a higher prevalence of constipation than those who did not, parents of children with constipation had a higher prevalence of constipation than those with children who did not have constipation, and there were other significant differences in various variables (P<0.001). Multivariate logistic regression analysis of modifiable factors revealed that eating less fruit (OR=1.284, 95%CI: 1.061-1.553, P=0.010), liking spicy and salty food (OR=1.234, 95%CI: 1.039-1.466, P=0.016), sleeping for too long (OR=1.644, 95%CI: 1.260-2.144, P<0.001), irregular sleep patterns (OR=1.370, 95%CI: 1.127-1.665, P=0.002) and minimal exercise (OR=1.388, 95% CI: 1.168-1.649, P<0.001) were all risk factors for constipation; whereas mix diets (OR=0.709,95%CI:0.608-0.826, P<0.001), meat diets (OR=0.604,95%CI: 0.495-0.736, P<0.001), moderate alcohol consumption (OR=0.659, 95% CI: 0.534-0.812, P<0.001), less or no drinking (OR=0.523, 95% CI: 0.428-0.638, P<0.001), and non-smoking (OR=0.819, 95%CI:0.674-0.995, P<0.001) protected against constipation. We found no association between dietary preferences and the risk of constipation (refined grains: OR=1.147, 95%CI:0.944-1.393, P=0.167; no specific preference: OR=0.935, 95%CI:0.783-1.117, P=0.459). The rate of agreement between self-evaluation of constipation by the respondents and objective criteria was higher for negatives (95.8%) than for positives (38.0%). Conclusion: The prevalence of constipation is relatively high in the urban population of Hangzhou. A good lifestyle and diet can significantly reduce its incidence. There should be more emphasis on preventive education, promotion of prevention of constipation, and advocacy for a healthy lifestyle.

目的:探讨复方沙棘籽油加速大鼠肛周脓肿术后创面修复的作用机制.方法:取制备成功肛周脓肿术后创面SD模型鼠共50只,随机分为5组,分别为模型组(G1,给予蒸馏水);阳性对照组(G2,给予高锰酸钾);复方沙棘籽油纳米乳化液低剂量治疗组(G3);复方沙棘籽油纳米乳化液中剂量治疗组(G4);复方沙棘籽油纳米乳化液高剂量治疗组(G5);造模后各组实验大鼠创面用相应实验药物均匀涂抹,2次/d,连续给药14d.观察治疗5d、8d、14d后各组大鼠创面愈合情况,计算各组大鼠创面愈合率,分别取各组大鼠创面组织,应用免疫组化S-P法检测创面表皮生长因子(EGF)、磷酸化细胞外调节蛋白激酶(ERK)1/2、白细胞介素-8(IL-8)、前列腺素E2(PGE2)表达情况.结果:创面处理后5 d、8 d、14 d,G5组、G4组、G3组、G2组、G1组大鼠创面愈合率依次升高(均P＜0.05).术后14 d,大鼠创面IL-8表达水平为G2组＜G5组＜G4组＜G3组＜G1组(P＜0.05);PEG2表达水平为G5组＜G2组＜G4组＜G3组＜G1组(P＜0.05).术后14 d,大鼠创面EGF、ERK1/2表达为G5组＞G4组＞G3组＞G2组＞G1组(均P＜0.05).结论:复方沙棘籽油纳米乳化液可有效促进大鼠肛周脓肿术后创面愈合,这可能与IL-8及PEG2炎症介质有关,还可能与EGF-ERK通路活化促进创面角质形成细胞、成纤维细胞生长、增殖、分化有关.

目的:观察淫羊藿对大鼠溃疡性结肠炎的治疗效果以及对结肠组织中相关炎症因子表达的影响.方法:雄性SD大鼠84只,随机分为空白对照组、模型组、淫羊藿高、中、低剂量组、柳氮磺吡啶(SASP)组及联合治疗组,每组12只.采用疾病活动指数(DAI)、结肠大体损伤评分、结肠组织病理学评分、结肠组织TNF-α、IFN-γ和IL-6免疫组化表达情况评价其治疗作用.结果:在实验处理第4天开始,各实验组大鼠与模型组比较体重增加,实验第7天联合组大鼠与SASP组比较体重增加,且差异均有统计学意义(P<0.05);第5天开始各实验组与模型组比较,DAI评分升高,差异有统计学意义(P<0.05);各实验组结肠损伤程度与模型组比较,联合组的结肠溃疡面积及结肠重量与长度比减小,淫羊藿高、中、低剂量组及联合组的结肠损伤程度减轻,联合组的结肠溃疡面积小于SASP组,差异均有统计学意义(P<0.05);与模型组比较,淫羊藿高剂量组结肠组织病理学评分显著降低(P<0.01);各实验组大鼠结肠组织中TNF-α、IFN-γ和IL-6表达水平,联合组及SASP组与模型组比较显著降低(P<0.01),联合组较SASP组显著降低(P<0.01).结论:淫羊藿可改善溃疡性结肠炎大鼠的精神状态、减轻结肠损伤程度,其治疗作用可能与其减少TNF-α、IFN-γ和IL-6细胞因子表达有关.

Objective To observe the effect of Modified Dachengqi Decoction on recovery of gastrointestinal function after closure of protective ileostomy of rectal cancer. Methods Seventy pa- tients with rectal cancer, scheduled to receive protective ileostomy were enrolled and randomized into treatment group (35 cases) and control group (35 cases). The treatment group was subjected to ante-grade enema with Modified Dachengqi Decoction (500 mL) once a day before ileostomy, the therapeutic course was 2 weeks ,and the control group received ileostomy alone. The oral feeding time, anal exhaust time, ileus rate and length of hospital stay were observed. Results Compared with the control group, the oral feeding time(h,22 ±6 vs.41 ±8), anal exhaust time(h,27 ±5 vs.48 ±8), ileus rate(2. 85% vs. 14. 29%) and length of hospital stay ( d,5. 5 ± 1. 0 vs.7. 6 ± 1. 2) were decreased in the treatment group (P <0. 01 , P <0. 05).Conclusion Modified Dachengqi Decoction could promote the recovery of gastroin- testinal function after surgery in patients with rectal cancer.

为探讨肠造口患者术后性生活质量及其影响因素,本研究通过问卷调查及电话随访的方式对50例肠造口患者进行手术前后性生活频率、性生活满意度调查,并进行相关因素分析.结果显示,肠造口患者术后性生活质量较治疗前明显降低,其与患者年龄和文化程度密切相关.

结直肠癌是常见的消化道恶性肿瘤,死亡率非常高,主要治疗手段为手术切除.但大部分患者术后易发生复发和转移,因此,术后辅助化疔作为减少复发和转移、延长患者生存时间的主要综合治疗手段之一日益受到重视.

总结7例直肠绒毛状腺瘤患者行经肛门内镜显微手术的护理。护理重点为术前加强心理护理,做好术前检查和肠道准备,术后指导患者早期活动,加强饮食护理和并发症的观察及护理。7例患者术后恢复良好,康复出院。

目的:探讨藻酸钙敷料用于混合痔术后促进创面愈合的疗效和机理.方法:将40例混合痔手术患者分治疗组(术后用藻酸钙换药)和对照组(术后用马应龙痔疮膏换药)各20例.结果:治疗组在减轻创面疼痛、缩短创面愈合时间方面均明显优于对照组(P＜0.01).结论:藻酸钙伤口敷料可明显减轻创面疼痛、缩短愈合时间,具有临床应用价值.

便秘可由多种因素引起,长期便秘可使全身各器官系统的功能发生改变,导致许多疾病的发生.本调查旨在了解杭州市城区便秘的患病率和危险因素.