摘要:目的:探讨量子血液疗法在胃溃疡治疗中的作用。方法:114例胃溃疡患者随机分为治疗组和对照组。治疗组60例,对照组54例。疗程均为4周。结果:经临床症状缓解,HP阴转及胃镜和病理复查的比较,治疗组总有效率99%,对照组总有效率为78%。经统计学处理,治疗组效果明显优于对照组(Plt;001)。结论:量子血液疗法对胃溃疡有肯定的辅助治疗作用。
One hundred and ten patients with gastric ulcer underwent Roux-en-Y gastroentestinal reconstruction. The results of follow up from 1 to 14 years are as follows: Visick’s grade Ⅰ 89 cases (80.90%), grade Ⅱ 17 cases (15.45%), grade Ⅲ 3 cases (2.70%), and grade Ⅳ 1 case (0.90%). Two patients (1.80%) complicated with superficial marginal ulcer, and 7 cases (6.30%) with mild gastric retention. Neither alkaline reflux gastritis nor gastric remnant cancer was found in all this patients. The authors consider that Roux-en-Y gastroentestinal reconstruction could effectively prevent and treat alkaline gastritis, and there was no afferent loop complication in this series. The rate of recurrence and gastric retention was not higher than that of the Billroth operation.
ObjectiveTo study the serum transforming growth factorβ1 (TGF-β1) and interleukin-23 (IL-23) expression in the patients with chronic gastric ulcer or gastric cancer, and to investigate the clinical value of TGF-β1 and IL-23 on the prevention and treatment of gastric cancer. MethodsThe serum levels of TGF-β1 and IL-23 in cancer group (83 cases), gastric ulcer group (184 cases), and control group (58 cases) were detected by using ELISA assay method. The difference of serum TGF-β1 and IL-23 levels in patients with gastric cancer with different pathological parameters were compared. ResultsThe serum levels of TGF-β1〔(15.96±3.92) ng/mL〕and IL-23〔(645.25±234.18) ng/mL〕in gastric cancer group were higher than those of the gastric ulcer group〔(10.10±3.58) ng/mL, (496.10±108.32) ng/mL〕and normal control group〔(9.87±2.86) ng/mL, (372.75±89.27) ng/mL〕, the difference were statistically significant (P < 0.05). The levels of serum TGF-β1 in gastric cancer patients of stageⅠ-Ⅱ, ⅢandⅣwere successively increased, and the differences were statistically significant (P < 0.05). The levels of serum TGF-β1 in poorly differentiated gastric cancer or with lymph node metastasis patients were higher than those in high-middle differentiation or without lymph node metastasis patients, the difference were statistically significant (P < 0.05). There were no significant difference in the levels of serum TGF-β1 between different tumor diameter and different location (P > 0.05). The level of serum IL-23 in patients with stageⅠ-Ⅱwas higher than that in stageⅢandⅣ, the difference was statistically significant (P < 0.05). Ther were no significant difference in serum IL-23 levels between the different degree of differentiation, lymph node metastasis or not, different tumor diameter and different location of the tumor (P > 0.05). ConclusionTGF-β1 and IL-23 have important reference value in judging the stage and malignancy degree of gastric cancer.
ObjectiveTo summarize the recent progress in studies of intestinal immunity in inflammatory bowel disease (IBD). MethodsThe literatures on studying the intestinal immunity in IBD, including ulcerative colitis and Crohn disease were reviewed and analyzed. ResultsIBD comprised two main diseases that cause inflammation of the intestines: ulcerative colitis and Crohn disease. Although the diseases had some features in common, there were some important differences in clinical symptoms and pathological features. Accumulating evidence suggested that IBD results from an inappropriate inflammatory response to intestinal microbes in a genetically susceptible host. Immunity studies highlighted the importance of host-microbe interactions in the pathogenesis of these diseases. Prominent among these findings were genomic regions containing nucleotide oligomerization domain 2 (NOD2), autophagy genes, miRNAs, and components of the interleukin-23/type 17 helper T-cell (Th17) pathway. The disfunction of the intestinal microbiome, intestinal epithelium, intestinal immune cells, and the intestinal vasculature played a key role in the process of IBD. The treatment with monoclonal antibody had been introduced to treat IBD and had been certificated effective. ConclusionThe study of basic intestinal immunity and regulation network of molecules in pathogenic process of IBD provides theory basis on prevention of IBD, while related genes of IBD can offer more gene therapy targets.
ObjectiveTo explore the clinical efficacy of ultrasound debridement combined with autolytic debridement in the treatment of diabetic foot ulcers.MethodsA total of 60 diabetic foot ulcers patients who were diagnosed and treated in Jinshan Hospital of Fudan University from April 2019 to April 2020 were enrolled in the study and randomly divided into two groups, with 30 cases in each group. The trial group received autolytic cleansing combined with ultrasound debridement treatment, and the control group only received autolytic debridement treatment. The baseline conditions, wound treatment efficacy, number of dressing changes, length of hospital stay, treatment cost, wound healing time, wound shrinkage rate, and the time required for the wound to turn into 100% red granulation were compared between the two groups.ResultsThere was no statistically significant difference in gender, age, duration of diabetes or Wagner grade of diabetic foot between the two groups (P>0.05). The efficacy of wound healing in the trial group was better than that in the control group (Z=−2.146, P=0.032). The number of dressing changes [(11.76±2.23) vs. (17.34±4.43) times] and the length of stay [(18.03±3.73) vs. (25.43±4.43) d] in the trial group were lower than those in the control group, and the differences were statistically significant (P<0.05). The difference in treatment cost between the two groups was not statistically significant (P>0.05). The wound healing time of the trial group [(48.43±18.34) vs. (65.24±19.62) d], the wound shrinkage rate [(78.35±8.34)% vs. (56.53±6.54)%] and the time required for the wound to turn into 100% red granulation [(16.34±2.42) vs. (24.55±3.23) d] were better than those of the control group, and the differences were statistically significant (P<0.05). During the treatment process, no patient in the trial group had wound bleeding and had difficulty in stopping bleeding during ultrasonic debridement, and no patient had intolerable pain related to ultrasonic debridement. No patients in either group withdrew early.ConclusionsUltrasound debridement combined with autolytic debridement can effectively improve the curative effect of patients with diabetic foot ulcers and shorten the wound healing time. Therefore, it is worthy of promotion and application in the wound care of patients with diabetic foot ulcers.
目的:通过对61例重型脑伤合并消化道应激性溃疡出血的内科综合治疗,评价其疗效在治疗中的地位。方法:对61例重型脑伤合并消化道应激性溃疡出血的患者进行内科综合治疗,分析其疗效。结果:消化道应激性溃疡出血一般发生在入院的2～6 d,占观察例数的86.9%(53例),出血后,在治疗的两周内痊愈42例(占68.9%)。结论:重型脑伤合并消化道应激性溃疡出血是临床危急重症,积极的了解和祛除病因,持续监控,积极的、有效的综合治疗,能取得满意的疗效,提高痊愈率和患者的生存质量。
Objective To analyze the clinical characteristics of scar cancer ulcer wound of head and face, and to investigate its diagnosis and treatment. MethodsThe clinical data of 14 patients with head and facial scar cancer ulcer wounds who met the selection criteria and admitted between January 2021 and March 2022 were retrospectively analyzed. There were 8 males and 6 females. The age of onset ranged from 21 to 81 years with an average age of 61.6 years. The incubation period ranged from 1 month to 70 years, with a median of 4 years. Site of the disease included 7 cases of head, 6 cases of maxillofacial region, and 1 case of neck region. Injury factors included trauma in 5 cases, scratch in 5 cases, scalding in 2 cases, burn in 1 case, and needle puncture in 1 case. Pathological results showed squamous cell carcinoma in 9 cases, basal cell carcinoma in 3 cases, sebaceous adenocarcinoma in 1 case, papillary sweat duct cystadenoma combined with tubular apocrine sweat gland adenoma in 1 case. There was 1 case of simple extensive tumor resection, 1 case of extensive tumor resection and skin grafting repair, 7 cases of extensive tumor resection and local flap repair, and 5 cases of extensive tumor resection and free flap repair. ResultsAll the 14 patients were followed up 16-33 months (mean, 27.8 months). Two patients (14.29%) had scar cancer ulcer wound recurrence, of which 1 patient recurred at 2 years after 2 courses of postoperative chemotherapy, and was still alive after oral traditional Chinese medicine treatment. One patient relapsed at 1 year after operation and died after 2 courses of chemotherapy. One patient underwent extensive resection of the left eye and periocular tumor and the transfer and repair of the chimaeric muscle axial flap with the perforating branch of the descending branch of the left lateral circumflex femoral artery, but the incision healing was poor after operation, and healed well after anti-infection and debridement suture. The wounds of other patients with scar cancer ulcer did not recur, and the wounds healed well. ConclusionScar cancer ulcer wound of the head and face is common in the middle-aged and elderly male, and the main pathological type is squamous cell carcinoma. Local extensive resection, skin grafting, or flap transfer repair are the main treatment methods. Early active treatment of wounds after various injuries to avoid scar repeated rupture and infection is the foundamental prevention of scar cancer.