目的 分析经结肠镜检查确诊的6410例结直肠病患者临床资料,为疾病防治提供依据.方法 对6410例结直肠病患者的临床资料作回顾性分析.结果 6410例结直肠病患者均经结肠镜检查确诊,其中结直肠息肉患者5412例、结直肠憩室患者393例、结直肠炎患者356例、溃疡性结肠炎患者294例、结直肠癌患者255例、大肠黑变病患者252例.临床表现主要为腹痛、腹泻、便秘及便血等,其中结直肠息肉、结直肠炎、结直肠憩室患者的临床表现主要为腹痛,结直肠癌患者的临床表现主要为便血,大肠黑变病患者的临床表现主要为便秘,溃疡性结肠炎患者的临床表现主要为便血、黏液脓血便.溃疡性结肠炎患者中男性占比显著高于女性(P<0.05);≤40岁的结直肠病患者中溃疡性结肠炎占比最高,60～70岁间为结直肠息肉、大肠黑变病、结直肠憩室的检出高峰,≥71岁患者中以结直肠癌占比最高.结直肠癌发病部位以直肠为主,溃疡性结肠炎发病部位以直乙状结肠为主,结直肠憩室发病部位以结肠为主,结直肠息肉发病部位以左半结肠为主.结直肠息肉病理类型以管状腺瘤为主,形态以山田Ⅰ型、Ⅱ型为主.5412例结直肠息肉患者中,息肉癌变130例,癌变部位以直肠、乙状结肠为主.结论 结直肠病以结直肠息肉多见,临床表现主要为腹痛、腹泻、便秘及便血,其中≤40岁男性患者中溃疡性结肠炎占比较高,≥71岁患者中结直肠癌占比最高.部分结直肠息肉患者出现息肉癌变,癌变部位以直肠、乙状结肠为主.

Metabolic syndrome (MetS) is a pathological state of metabolic disorders that primarily occur in human proteins, fats, and carbohydrates. It is a complex cluster of core metabolic disorder syndromes including obesity, hyperglycemia, dyslipidemia, and hypertension, and vascular endothelial injury, occurring over time. The currently available treatment options cannot effectively manage MetS. In our previous research, we revealed ChaiQi decoction (CQD) as an effective prescription for improving MetS; however, the specific mechanism remains unclear. Herein, we assessed the efficacy and mechanism of CQD in ApoE gene knockout (ApoE-) mice. Mice were administered with CQD daily for 12 weeks, and the measurement of their body weight was taken monthly. To evaluate the metabolic levels of mice, we determined the fasting blood glucose (FBG), fasting serum insulin (FINS), insulin resistance index (IRI), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels. Furthermore, immunohistochemical analysis was adopted to determine the expression of ICAM-1 and VCAM-1 in vascular endothelium, while an optical microscope was adopted to observe the pathological morphology of abdominal aorta in mice. Tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), intercellular cell adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1) levels were determined using the ELISA method, whereas Western blotting was used to determine nuclear factor- (NF-) κB p65. Of note, intragastric CQD administration ameliorated ApoE-model mice, as evidenced by reduced levels of FBG, FINS, IRI, TG, TC, and LDL-C. Furthermore, CQD alleviated vascular endothelial injury and regularized the structure of the abdominal aorta by downregulating the expressions of proinflammatory cytokines TNF-α, IL-6, ICAM-1, VCAM-1, and NF-κB p65. Overall, these findings advocated that CQD ameliorates metabolic levels and vascular endothelial injury in mice by downregulating the inflammatory response and thus may be utilized as a novel MetS therapy.

目的 探讨复查胃镜的中年人群上消化道疾病的内镜及病理学特征,为临床诊治提供依据.方法 回顾性分析2015年1月1日至2020年12月31日在北京中医药大学东方医院胃镜中心复查电子胃镜的中年人群,收集其性别、胃镜诊断、病理结果及H.pylori结果等数据,对首查及复查结果进行分析比较.结果 共有397例年龄为35～55岁复查胃镜的受检者,首次检查中慢性萎缩性胃炎、胃溃疡、胃息肉、十二指肠溃疡、食管溃疡、胃癌例数分别为:86例(21.66％)、49例(12.34％)、73例(18.38％)、41例(10.33％)、5例(1.26％)、2例(0.50％),复查例数分别为:93例(23.43％)、19例(4.79％)、89例(22.42％)、20例(5.04％)、1例(0.25％)、1例(0.25％),其中复查胃溃疡、十二指肠溃疡检出率低于首查,差异有统计学意义(P<0.05).十二指肠溃疡、胃息肉的例数在性别分布上差异有统计学意义(P<0.05),H.pylori阳性例数首查、复查分别为:264例(88.29％)、161例(78.92％),差异有统计学意义(P<0.05).慢性萎缩性胃炎、胃溃疡、胃息肉中H.pylori阳性例数高于阴性例数,差异有统计学意义(P<0.05).胃癌前病变首查例数为215例,复查为250例,其中首查胃黏膜萎缩、肠上皮化生、异型增生、上皮内瘤变检出例数分别为:86例(21.66％)、205例(51.64％)、45例(11.34％)、42例(10.58％),复查分别为:93例(23.43％)、226例(56.93％)、89例(22.42％)、37例(9.32％),复查异型增生检出率高于首查(P<0.05).癌前病变发病部位在胃窦、胃角、胃体、贲门、幽门的分布,差异有统计学意义(P<0.05),以胃窦、胃角最为常见.两次检查癌前病变的H.pylori阳性例数高于H.pylori阴性例数,差异有统计学意义(P<0.05).结论 复查胃镜的中年人群中慢性萎缩性胃炎、胃息肉及H.pylori阳性检出率较高;癌前病变中肠上皮化生检出率最高,而异型增生例数复查增加最多;癌前病变部位以胃窦、胃角最为常见.

探讨肝郁脾虚型与腹泻型肠易激综合征的相关联性及在中医药方面的诊疗进展,通过从中医体质与腹泻型肠易激综合征的相关联性、中医药治疗方法 等方面对近年来相关文献进行分析、概括与总结.应用中医辨证论治可以提高腹泻型肠易激综合征的治愈率,降低病情复发率;推断肝郁脾虚的患者可能会增加对腹泻型肠易激综合征染的易感性,将中医辨证-辨病-辨体模式应用于该病能更好地提高疗效.

[Objective] To observe the effects of Chaiqi decoction on intestinal injury of metabolic syndrome rats mode. [Methods] The forty SDF male SD rats were randomly divided into normal group, model group, traditional Chinese medicine group, western medicine group. The rat model was established by feeding high fat, high sugar and high salt diet. The Chinese medicine, Western medicine group were respectively given Chaiqi decoction, pioglitazone hydrochloride suspension from the beginning of modeling. Normal and model groups were given Physiological saline for 16 weeks. The blood glucose, blood lipids and insulin were detected at 16th week, evaluation the insulin resistance. At the same time, measure blood pressure in rats. Measure and calculate the small intestine propulsion rate. HE staining was used to observe the pathological changes of intestinal tract, to assess the degree of intestinal injury. The expression of NF-κB protein in small intestine was detected by Western blot. [Results] The blood glucose, blood lipids, insulin, insulin resistance index, IL-6, TNF-α, blood pressure in Chinese medicine Chaiqi decoction group were significantly lower than the model group, higher than the normal group (P<0.05). Chaiqi decoction can improve the rate of small intestine, improve intestinal pathological damage. [Conclusion] Chaiqi decoction can improve metabolic syndrome in rats with glucose and lipid metabolism disorders, reduce metabolic syndrome, the extent of intestinal damage, delay its progress.