Enema Research Articles

Effects of Dai Huang Fu Zi Tang on ultrastructure and ion pump of mitochondria in intestinal epithelial cells of rats with severe acute pancreatitis

Objective To investigate the effects of Dai Huang Fu Zi Tang(DHFZT)on ultrastructure and ion pump of mitochondria in intestinal epithelial cells(IECs)of rats with severe acute pancreatitis(SAP). Methods Seventy-two SD rats were randomly divided into three groups:sham-operated group(No SAP with 0.9% NaCl enema), model group(SAP with 0.9% NaCl enema), and treatment group(SAP with DHFZT), and each group was then subdivided into 1, 3, 6, and 12 h subsets(n= 6 each).SAP models were established by retrograde injection of 5% sodium taurocholate(4 ml/kg)into the pancreatic bile duct in model group and treatment group.Serum intestinal fatty acid binding protein(iFABP)and diamine oxidase(DAO), and ATPase in mitochondria of IECs were determined.The structural changes of mitochondria in IECs were observed under electron microscope and light microscope. Results After treatmenting with DHFZT, the levels of mitochondrial Na+- K+-ATPase and Ca2+- ATPase in treatment group were significantly increased as compared with model group[for Na+- K+- ATPase,μmol Pi/mg(protein·h), 6.35±0.49 vs.6.24±0.46 at 1 h, 7.01±0.57 vs.5.45±0.39 at 3 h, 6.57±0.58 vs.4.81±0.32 at 6 h,P< 0.05, and 5.98± 0.39 vs.4.24±0.29 at 12 h,P<0.01; for Ca2+-ATPase,μmol Pi/mg(protein·h),5.25±0.46 vs. 4.46±0.39 at 3 h,P<0.05, 4.68±0.41 vs.3.49±0.30 at 6 h, and 4.85±0.35 vs.3.26±0.28 at 12 h,P<0.01], damage of mitochondrial ultrastructure was also reduced, and serum iFABP and DAO were significantly decreased[for iFABP(μmol/L):74.67±8.57 vs.132.46±16.43 at 6 h, and 121.48± 14.35 vs.243.43±35.91 at 12 h,P< 0.01; for DAO(g/L):100.03±16.99 vs.178.43±26.38 at 3 h,P<0.05; 135.58±20.86 vs.258.32±36.31 at 6 h, and 172.55±22.53 vs.288.49±40.29 at 12 h,P<0.01]. Conclusion DHFZT could protect IECs and mitochondrial normal structures and increase the levels of serum iFABP and DAO probably by regulating the levels of mitochondrial ion pump Na+-K+ ATPase and Ca2+-ATPase. Key words: Severe acute pancreatitis; Intestinal epithelial cells; Mitochondria; Dai Huang Fu Zi Tang

Firing at a fly with a shotgun.

The use of antibiotic prophylaxis during transrectal ultrasound-guided prostate biopsy is state of the art [1]. Currently, fluoroquinolones, cotrimoxazole and targeted antibiotic prophylaxis are the recommended approaches [2]. There is less consensus how long the drug administration should last. Unlike antibiotic prophylaxis, no method of bowel preparation has been agreed upon so far. It seems logical that some form of bowel cleansing can help to decrease the amount of bacteria present in the rectum before biopsy and lead to a lower rate of infectious complications. The present study by Yildirim et al. [3] aims to answer the question, which method of bowel preparation before prostate biopsy yields better outcomes in terms of infectious complications. A self-administered phosphate enema as well as sennasoid a-b laxatives were the forms of bowel preparation used. Phosphate enemas directly stimulate smooth muscles of the rectum in order to eliminate stool; sennasoid laxatives induce fluid secretion from the mucosa and colonic contractions. Additionally, a seven-day antibiotic course was used before and after prostate biopsy. Urosepsis occurred in 1.8% and 3.6% of the phosphate enema and sennasoid laxative group, respectively (p = 0.358). The study is retrospective, but despite the lack of formal randomisation, both groups were comparable (Table 1). Overall risk of infectious complications after prostate biopsy is 10.9% [4]. In a large, retrospective population-based study [5], 72% of all 30-day hospital admissions after biopsy were caused by infection and the odds of having an infectious complication after biopsy increased four-fold between 1996 and 2005. Therefore, it makes sense to look for new ways to make this widely performed procedure safer for the patient. However, there is no point in firing at a fly with a shotgun. More modest protocols of antibiotic prophylaxis and bowel preparation are in use with acceptable complication rates in many institutions including the author′s (ciprofloxacine 500 mg BID on the day of biopsy plus glycerin rectal suppository the night and morning before biopsy). Therefore, instead of comparing two extensive bowel cleansing and antibiotic protocols, future studies should try to establish a minimalist, yet efficient pre-biopsy preparation method.

Hemorrhoids and pregnancy. Current views of treatment and prevention. Experience with Enema Clin

Hemorrhoids and pregnancy. Current views of treatment and prevention. Experience with Enema Clin

Effect of compound dracorhodin enema on pulmonary and colonic expression of interleukin-6 in mice with distal ulcerative colitis

目的：探讨复方血竭制剂对远端型溃疡性结肠炎（ulcerative colitis,UC）小鼠模型肺与肠的保护作用.方法：60只♂BALB/c小鼠随机分成4组（n=15）,正常组、葡聚糖硫酸钠（dextran sulfate sodium,DSS）组、复方血竭制剂组、DSS＋复方血竭制剂组.全部小鼠适应环境喂养7 d,第8天,正常组、DSS组小鼠予以生理盐水1 mL灌胃,复方血竭制剂组、DSS＋复方血竭制剂组小鼠予以复方血竭制剂[0.075 g/（kg·d）]1 mL灌胃,每只小鼠自由觅食,继续喂养10 d.通过疾病活动指数（disease activity index,DAI）评分、结肠组织病理评分（histopathology score,HI）、肺HI评分、苏木精-伊红（hematoxylin-eosin,HE）染色评价炎症严重程度.通过酶联免疫吸附测定（enzyme-linked immunosorbent assay,ELISA）、免疫组织化学、实时荧光定量PCR（real-time quantitative PCR,RT-QPCR）测定结肠与肺组织中白介素（interleukin,IL）-6炎性因子的表达量.结果：与正常组、复方血竭制剂组比较,DSS组、DSS＋复方血竭制剂组小鼠一般情况、DAI评分、结肠HI评分、肺HI评分均升高（P〈0.05）;与DSS＋复方血竭制剂组比较,DSS组小鼠结肠与肺组织炎症程度更重（P〈0.05）;且小鼠肺与结肠组织中IL-6表达量显著升高（P〈0.05）.结论：复方血竭制剂可以下调炎性因子IL-6表达量,缓解小鼠实验性UC及UC肺损伤.

Effect of retention enema with Chinese Traditional Medicine at different hour on the patients with chronic renal failure

Objective To study the impact of medicine retention time and the therapeutic effect to the chronic renal failure by retention enema with Chinese traditional Medicine at different hour.Methods Totals of 60 patients with chronic renal failure disease were randomly divided into observation group （n=30）and control group （n=30）.The observation group adopted enema at 7：00-9：00, and the control group adopted enema at routine hour （ 19：00 -21：00 ） .Following items were observed and compared between two groups： subjective feeling, adverse reflection, defecating ratio before enema, the appetency of defecating after enema, medicine retention time after enema, the Scr before and after enema, the change of BUN and Ua.The observation period was 30 days （ one period of the treatment） .Results Compared with the control group, the adverse reflection, such as bellyache, abdominal distension, anus ache, downfallen pressure feeling at anus were significantly relieved in observation group （P〈0.05）.The times ＆amp; severity of the appetency of defecating after enema in observation group was reduced apparently than that in control group （P〈0.05）.The average defecating ratio before enema in observation group was significantly improved （83.3%vs 20.0%;χ2 =79.452,P〈0.01）.The retention time in observation group was （ 324.12 ±129.47 ） min, and that in control group was （ 225.32 ± 104.21）min,and the difference was statistically significant （t=4.605,P〈0.01）.The blood BUN, Scr, Ua were down after enema in both groups, but the improvement in observation group was significantly better than that in the control group （P 〈0.05）.Conclusions By practicing retention enema with Chinese traditional Medicine at 7：00-9：00, the medicine retention time in intestines can be extended, and the therapeutic effect to the chronic renal failure can be improved. Key words: Chronic renal failure disease; Chinese traditional medicine; Enema; Hour; Retention time; Nursing

Clinical diagnosis and surgical operation treatment of adult dolichocolon

Objective To analyze experience of clinical diagnosis and surgical operation in treatment of adult dolichocolon.Method The clinical data of 50 patients who had been diagnosed as adult dolichocolon were retrospectively analyzed.Results 41 patients appeared intractable constipation.18 patients had recurrent episodes of abdominal distention,abdominal pain,nausea,vomiting and other symptoms.6 patients had acute intestinal obstruction.Sigmoid volvulus occurred in 5 patients.After diagnosed by surgery and barium enema X-ray fluoroscopy,40 cases were Ⅰ type,3 cases were type Ⅱ,and 7 cases were Ⅲ type.6 cases were treated with emergency operation,after elective bowel preparation,4.4 cases were treated with operation.4.8 patients showed abnormal changes under microscope.42 cases were followed up after operation,and symptoms of 38 case disappeared.Conclusion Diagnosis of adult dolichocolon is mainly based on the clinical manifestation and barium enema X-ray fluoroscopy.The most common treatment method of this disease is surgical treatment,and the results are satisfactory. Key words: Adult dolichocolon; Diagnosis; Surgical operation

Curative effect observation on uremic clearance granule combined with colon dialysis in the treatment of chronic renal failure

Objective To observe the clinical efficacy of uremic clearance granule combined with colon dialysis in the treatment of chronic renal failure (CRF) at early and middle stages.Methods 76 cases of CRF in early and middle stage in our hospital were randomly divided into control group and treatment group,two groups underwent 3 courses of treatment.38 cases of the control group,were given routine colon dialysis,38 cases in the treatment group,based on the conventional colon dialysis therapy,were added with uremic clearance granule retention enema.We observed and analyzed the patients of two groups before the first treatment and after the last treatment,detecting the blood urea nitrogen (BUN),serum creatinine (SCr),blood uric acid (UA).Results In the treatment group and the control group after treatment,the BUN,SCr,UA significantly decreased compared with those before treatment,the treatment group decreased significantly compared with that of the control group,showing a significant difference between two groups (P ＜ 0.05).Conclusion Uremic clearance granule combined with colon dialysis in the treatment of CRF patients has better clinical curative effect than the conventional colon dialysis,uremic clearance granule retention enema on CRF treated with colon dialysis has its advantages. Key words: Uremic clearance granule; Chronic renal failure; Colon dialysis

Milk gargle and activated carbon retention enema in the application of the treatment of acute paraquat poisoning

目的 观察用牛奶漱口及活性炭保留灌肠在急性百草枯中毒的口腔黏膜及器官损伤救治中的效果.方法 对41例口服百草枯中毒患者随机分成清水洗胃+牛奶漱口及活性炭保留灌肠组(牛奶漱口组)(19例)和清水洗胃+活性炭及白陶土灌肠组(非牛奶漱口组)(22例),观察两组患者口腔黏膜破溃出现时间及多脏器功能损害发生的时间.结果 牛奶漱口组患者口腔黏膜破溃出现时间为(36±11.2)h,器官损伤出现时间为(42±15.2)h;非牛奶漱口组为口腔黏膜破溃(24±13.6)h,器官损伤出现时间为(30±10.3)h,两组比较,差异均有统计学意义(P＜0.01).牛奶漱口组器官损伤例数及构成比均明显低于非牛奶漱口组,差异有统计学意义(P＜0.05).结论 牛奶漱口和活性炭保留灌肠对急性百草枯中毒患者口腔黏膜及器官有保护作用,可延缓病情的进展。

The curative effect analysis of oralYiyuan-Guchangdecoctionand enema retention of Yuyangyein treating chronic ulcerative colitis

Objective To research the efficacy of oralYiyuan-Guchangdecoction and enema retention ofYuyangye in treating chronic ulcerative colitis（CUC）.Methods 70 patients of CUC were randomly divided into two groups： a control group of 34 patients, treated by mesalazine（etiasa） orally, 1g/twice daily; and a test group of 36 patients, treated byYuyangyedecoction for oral administration andYuyangyeenema retention. The treatment course of both groups was 8 weeks. The curative effect, clinical symptoms, endoscopic sign and pathology, and ESR, CRP, IL-8, and IL-13 after one course of treatment, were analyzed statistically.Results The total effect of the test group and the control group was 94.44%（34/36） and 64.71%（22/34）, and the difference was significant statistically（Z=-4.207,P〈0.05）. The effects of test group were superior than the control group in terms of the clinical symptoms, endoscopic sign, and histopathology（P〈0.05）. The ESR, CRP, IL-8, IL-13 of the test group were（13.5±3.3）mm/h,（8.26±1.54）mg/L,（0.85±0.17）ng/ml,（37.18± 14.58）pg/ml before the treament, and（7.0±2.4）mm/h, （3.56±1.03）mg/L,（0.38±0.08）ng/ml, （76.33± 23.74）pg/ml after the treatment; The ESR、CRP、IL-8、IL-13 of control group were（14.5±4.8）mm/h, （8.41 ±1.36）mg/L,（0.86±0.15）ng/ml,（40.46±14.47）pg/ml before the treatment and（7.5±3.5）mm/h,（3.63± 1.10）mg/L,（0.36±0.07）ng/ml,（55.84±17.52）pg/ml after the treatment. ESR, CRP and IL-8 of both groups decreased significantly（P〈0.05）, while IL-13 significantly increased（P〈0.05）. ESR, CRP, IL-8 had no obvious statistical significance（P〉0.05）between the two groups, while IL-13 of the test group was superior than the control group（P〈0.05）.Conclusion The therapeutic effect of oralYiyuan-Guchangdecoction and Yuyangyeenema retention is good in treating chronic ulcerative colitis. Key words: Yiyuan-Guchang decoction Yuyangye Ulcerative colitis Curative effect analysis

Optimum concentration and dose of ropivacaine for caudal block in neonates undergoing laparotomy under general anesthesia: evaluation of postoperative outcome

Objective To investigate the optimum concentration and dose of ropivacaine for caudal block in the neonates undergoing laparotomy under general anesthesia.Methods One hundred pediatric patients of both sexes,aged 9-30 days,weighing 2.5-4.5 kg,scheduled for elective pyloromyotomy,were randomly divided into 5 groups (n =20 each) using a random number table:control group (group C),0.10％ ropivacaine 1.0 ml/kg group (group 0.1％ L1),0.15 ％ ropivacaine 1.0 ml/kg group (group 0.15 ％ L1),0.10 ％ ropivacaine 1.2 ml/kg group (group 0.10 ％ L2),and 0.15 ％ ropivacaine 1.2 ml/kg group (group 0.15 ％ L2).Anesthesia was induced with sevoflurane and cisatracurium.The pediatric patients were tracheally intubated and mechanically ventilated.Remifentanil was infused intravenously at 0.2-0.3 μg· kg-1 · min-1 in group C.In 0.10 ％ L1,0.15 ％ L1,0.10 ％ L2 and 0.15％L2 groups,the corresponding concentrations and doses of ropivacaine were injected into the sacral canal under the guidance of ultrasound.The operation was started at 15 min after administration and sevoflurane was inhaled and the end-tidal concentration of sevoflurane was maintained at 0.8-1.0 MAC.Before induction (T1),at pyloric muscle retraction (T2),and at 4,8,12 and 24 h after operation (T3-6),blood samples were collected from the central vein for determination of plasma concentrations of cortisol and interleukin-6 (IL-6).Pain was assessed using CRIES score at T3-6.When CRIES scores ＞ 3,10％ chloral hydrate 0.5 ml/kg was given by retention enema for analgesia,and the requirement for chloral hydrate was recorded.The emergence time,extubation time,duration of stay in post-anesthesia care unit (PACU) and hospital discharge time were recorded.Bradycardia and hypotension during operation,and development of motor block of lower extremities,infection and dehiscence of incision,vomiting,and urinary retention after operation were also recorded.Results Compared with group C,no significant changes were found in the emergence time,extubation time,duration of stay in PACU,hospital discharge time,plasma concentrations of cortisol and IL-6,the requirement for chloral hydrate,and the incidence of bradycardia,hypotension,motor block of lower extremities,and infection and dehiscence of incision in 0.10％ L1 and 0.15 ％ L1 groups,the emergence time,extubation time,duration of stay in PACU,hospital discharge time were significantly shortened,and the plasma concentrations of cortisol and IL-6,requirement for chloral hydrate,and the incidence of hypotension and infection of incision were decreased in 0.10％ L2 and 0.15％ L2 groups,and the incidence of vomiting and urinary retention was increased in 0.15％ L1 and 0.15％ L2 groups.Compared with group 0.10％ L2,the incidence of vomiting and urinary retention was significantly decreased,and no significant changes were found in the other parameters mentioned above in 0.15％ L2 group.Conclusion The optimum concentration and dose of ropivacaine are 0.10％ and 1.2 ml/kg,respectively,for caudal block in the neonates undergoing laparotomy under general anesthesia. Key words: Amides ; Anesthesia, caudal ; Anesthesia, general; Infant, newborn

Effect observation of quality control circle to reduce the times of enema in patients with intestinal operation

Objective To explore the application effect of quality control circle （ QCC ） activities to reduce the number of operation clean bowel enema .Methods To set up QCC group , in order to reduce the number of preoperative cleaning enema .Thirty-six patients, from February to October, 2012 were included as the control group.After the application of QCC, thirty-six patients, from November, 2012 to April, 2013 were included as the observation group .Results After the application of QCC , the times of enema of patients in the control group and in the observation group were （8.11 ±0.950） and （5.06 ±0.984）, respectively.There was a significant difference between the two groups （t=13.407, P〈0.01）.The effective rates of patients in the control group and in the observation group were 77.8%and 94.4%.There was a significant difference between the two groups （χ2 =4.181, P〈0.05）.The satisfactions before and after the QCC were 91.7%and 100.0%, which had no significant difference （χ2 =3.130, P〉0.05）.Conclusions QCC can reduce the frequency of bowel preparation for enema and alleviate the suffering of patients . Key words: Enema Satisfaction Quality control circle Colon surgery

Influence of m-trihydroxybenzene on the recurrence rate in children with intussusception hydrostatic enema

Objective To explore the application value of m-trihydroxybenzene in pediatric intussusception in the course of treatment,to observe its curative effect and safety.Methods 200 cases of enema intussusception were selected and randomly divided into two groups by the method of random number table.100 cases in the observation group were given m-trihydroxybenzene injection (2mg/kg) 15 minutes before hydrostatic enema,and reduction of hydrostatic enema.If reduction,continued to give benzene three phenol intravenous drip,once a day.100 cases in the control group used atropine(0.02mg/kg) intramuscular injection before hydrostatic enema,after successful reduction did not continue to use the spasmolytic drug.The success rate,short-term recurrence rate,reduction time and adverse reaction were compared between the two groups.Results The hydrostatic pressure enema reduction success rate of the observation group was 99％,which was significantly higher than 87％ in the control group (x2 =4.38,P ＜ 0.05).The reduction time of the observation group was (7.56 ± 2.54) min,which was significantly shorter than (10.45 ± 3.03) min of the control group (t =-4.285,P ＜ 0.05).The short-term recurrence rate in 3 days of the observation group was 3％,which was significantly lower than 13％ in the control group (x2 =2.79,P ＜0.05).The observation group had no obvious adverse reaction.Conclusion m-Trihydroxybenzene in water enema intussusception reset before and after use is safe and effective,it can not only improve the success rate reduction,but also can significantly reduce the short-term recurrence of intestinal intussusception reduction rate. Key words: Phloroglucinol; Intussusception; Enema; Ultrasonography; Child

Role of bowel management program in pediatric patients with fecal incontinence

To investigate a new bowel management program for children patients with fecal incontinence. Clinical data of 19 children with fecal incontinence undergoing bowel management program in our center between January 2012 and January 2013 were retrospectively analyzed. The main outcome measure was clinical efficacy of this program. Fifteen out of 19 cases were genuine fecal incontinence and required continuous treatment by enema. The other 4 cases were false fecal incontinence. After treatment with this program, stool dirty and constipation were improved in genuine incontinence. Two cases of false continence could control defecation independently by oral administration of antispasmodic drug. Two cases of false continence were cured and did not need medical interference. Bowel management program is an effective treatment for pediatric patients with fecal incontinence. The key of success is maintenance of perianal hygiene for 24 hours by continual adjustment of the elements and volumes of enemas.

Perils of total colonic aganglionosis presenting in neonatal age.

The purpose of this study is to review the cases of total colonic aganglionosis seen in the span of ten years at a pediatric surgery unit of a tertiary care public hospital in New Delhi. Medical records of twelve patients with total colonic aganglionosis were retrieved. Ten out of the twelve patients were males; seven were of the Muslim community. Average recorded birth weight was 2.2 kg. Ten patients presented with features of intestinal obstruction, while two presented with perforation peritonitis. Among the cases of obstruction, Hirschsprung's disease was suspected in eight cases (one was associated with Shah-Waardenburg syndrome), one case each was preoperatively diagnosed as ileal atresia and meconium ileus. Abdominal X-rays at presentation of all the neonates except in one with Shah-Waardenburg syndrome showed multiple air fluid levels. Contrast enema was done in five patients. It showed micro-colon in two patients, and typical question mark sign, dilated small bowel with transition zone in hepatic flexure and normal caliber colon in one each. All the patients underwent exploratory laparotomy. Intra-operatively, the transition zone was seen at distal ileum in ten cases and at hepatic flexure and transverse colon in one each. Biopsies of all the twelve patients eventually showed absence of ganglion cells in entire colon. Ileostomy was done in nine cases, colostomy in two and primary Kimura's procedure in one (this patient was discharged and lost to follow up). Left colonic patch with Swenson's pull through with ileostomy was done for one patient on colostomy. His stoma was closed; he was eventually discharged and lost to follow up. In the other patient with colostomy, the stoma was closed and an ileostomy was created. Of all the patients on ileostomy, three expired in the immediate postoperative period. Four were lost to follow up. Two underwent Kimura's procedure; and expired few months later. One patient on ileostomy is awaiting further treatment. The outcomes for total colonic aganglionosis in those presenting in neonatal age tend to be unsatisfactory in the developing countries.

Observation of the efficacy of digital rectal enema on tumor patients with constipation during chemotherapy

Objective To explore the efficacy of digital rectal enema on tumor patients with constipation during chemotherapy .Methods Two hundred tumor patients with constipation during chemotherapy were divided into the control group and the experimental group according to stratified blocked randomization , each with 100 cases.The control group received the conventional enema , and the experimental group received the digital rectal enema .Results The incidence of successful intubation one time in the experimental group was 98.0%, and was higher than 85.0%in the control group , and the difference was statistically significant （χ2 =10.865,P〈0.01）.The incidence of adverse reactions in the process of intubation was 6% in the experimental group, and was lower than 17%in the control group, and the difference was statistically significant （χ2 =5.944, P〈0.05）.The incidence of severe pain in the experimental group was 5%, and was lower than 17% in the control group, and the difference was statistically significant （u=-3.505,P〈0.01）.Conclusions Compared with the conventional enema , the digital rectal enema is safer and more effective , and can reduce the patient ’ s suffering, and bears a great value in clinical practice . Key words: Tumor; Constipation; Enema; Finger probe; During chemotherapy

Value of water enema 18F-FDG PET/CT for diagnosis of rectal cancer

Objective To investigate the diagnostic value of delayed water enema 18F-FDG PET/ CT for rectal cancer.Methods Sixty-nine cases (52 males,17 females; average age 57.9 years) with clinically suspected rectal cancer underwent routine and delayed water enema 18F-FDG PET/CT.The imaging results were compared with colonoscopy and surgical pathology.The diagnostic efficiency of the two imaging methods was compared and so was the SUVmax of lesions.Paired t and McNemar test were used to analyze the data.Results There were 61 rectal cancer cases confirmed by pathology.The SUVmax of rectal cancer calculated from routine and delayed water enema 18F-FDG PET/CT was significantly different (13.17± 6.19 vs 14.25±6.63; t=-6.100,P＜0.01).The sensitivity,specificity and accuracy of routine 18F-FDG PET/CT and delayed water enema 18F-FDG PET/CT in diagnosis rectal cancer were 90.2％ (55/61) vs 98.4％(60/61),4/8 vs 6/8,85.6％(59/69) vs 95.7％(66/69).A statistically significant difference was found in diagnostic accuracy between the two imaging methods (x2=5.140,P＜0.05).Conclusion The delayed water enema 18F-FDG PET/CT has a complementary diagnostic value for routine 18F-FDG PET/CT in rectal cancer. Key words: Rectal neoplasms; Enema; Tomography, emission-computed; Tomography, X-ray computed; Deoxyglucose

Effect of percutaneous pulsedmagnetic stimulation of the sacral nerve for the treatment of paraplegic patients with constipation

Objective To observe the effect of percutaneous pulsedmagnetic stimulation of the preganglionic parasympathetic nervous system of spinal at T 12-L1 vertebral level （2-4 sacral spinal cord）, in order to promote gastrointestinal peristalsis paraplegics and relieve symptoms of constipation .Methods Totals of 52 patients were divided into two groups by their admission date .The control group were applied the routine nursing care, including the psychology nursing care , drug intervention, diet, water balance, lower abdominal massage therapy, enema, pelvic floor muscle training and hyperbaric oxygen therapy .Based on the routine care, the intervention group was given the early percutaneous spinal cord pulsed magnetic stimulation of the preganglionic parasympathetic nerves of the spine at T 12 -L1 vertebral level （ 2 -4 sacral spinal cord ） . Results In the intervention group , 1 patient had cervical fracture and dislocation;2 patients had tumor invasion of the primary caudaequina of spinal cord.88.46%（23/26） patients had regular bowel movements.In the control group, only 61.54% （16/26） patients had regular bowel movements.The difference was statistically significant （χ2 =5.026,P〈0.05）.The effective rate of the intervention group was 76.9%（20/26）, which was significantly higher than 50.0% （13/26） in the control group （χ2 =4.046,P〈0.05）.Conclusions Percutaneous pulsed magnetic stimulation of the parasympathetic preganglionic nerve can improve the recovery of neurological function and provide a simple , noninvasive and painless method to reduce the constipation and improve patients ’ quality of life. Key words: Constipation; Paraplegia; Percutaneous pulsed magnetic stimulation

Clinical outcome of transanal endorectal pull-through for neonatal hirschsprung's disease

Objective To analyze the diagnosis and treatment of neonatal Hirschsprung's disease (HD)and to evaluate the outcome of one-stage transanal endorectal pull-through in the treatment of neonatal HD.Methods The records of 48 newborns with HD from July 2004 to July 2013 were reviewed retrospectively.Base data,details of management,complications,and outcomes were examined.Results Totally 48 consecutive newborns with HD were identified,of which 32 were classical type,9 were long-segment type and 7 were short-segment type.All were successfully treated by one-stage transanal endorectal pull-through procedure,of which 39 were transanal only,7 were laparoscopic assisted,2 were open.The average preoperative preparation time was (7 ± 2) d.The operation time was (88 ± 15) min.The average intra-operative blood loss was (7 ± 2) ml.The average length of resected bowel was (18 ± 6) cm.The mean hospital stay was (10± 2) d.The follow-up period for all patients was in the range of 3 months to 8 years,and all grew well.Complications included anastomotic stricture (9 cases),constipation (8 cases),incontinence (8 cases),enterocolitis (10 cases),et al.All of them got better at last after treatment.Barium enema showed that the shape of colon had become normal.The score of bowel movement assessment was 4 for 38 cases,3 for 7 cases and 2 for 1 case.Conclusion It is suggested that one-stage transanal endorectal pull-through procedure for neonatal HD was safe,for its less complication good outcome and long term effect,which is worthy of further promotion. Key words: Neonatal Hirschsprung's disease; Operation; Treatment

Application and evaluation of pouch configuration in rectal surgery

Colonic pouch can improve fecal continence after low anterior resection in the short-term, but its superiority would disappear in the long-term (2 years after surgery), since fecal continence improves gradually with time in the non-pouch group. Furthermore, the incidence of incomplete defecation increases gradually with time, and a lot of patients would have difficulty in defecation and require long-term use of suppositories and enemas. Pouch enforcement will result in prolonged operation time and increased treatment cost. Therefore, the value of colonic pouch in low rectal anastomosis is being questioned, and its application diminishes gradually. For patients with ulcerative colitis (UC) or familial adenomatous polyposis (FAP) after total colectomy, ileal pouch anal anastomosis (IPAA) can reduce fecal frequency and improve patients' quality of life in both short-term and long-term, by increasing the volume of the neo-rectum and altering intestinal motility. For these reasons, IPAA is the first surgical choice for UC and FAP.

Study on vinegar retention enema combined with scopolamine in the treatment of hepatic encephalopathy

Objective To analyze the clinical efficacy of vinegar retention enema combined with scopolamine in the treatment of hepatic encephalopathy.Methods Patients with hepatic encephalopathy in our hospital were selected as research subjects,they received either the treatment of scopolamine alone or vinegar enema combined with scopolamine.Treatment effects,ammonia and MDA,SOD levels were compared between two groups.Results The efficiency was 94.9％,SOD level was (47.3 ± 8.6) U/mg in the observation group,significantly higher than those in the control group.Ammonia level was (211.4 ± 32.2) μ mol/L,MDA level was (4.4-± 0.8) μ mol/L,significantly lower than those in the control group (P ＜ 0.05).Conclusion Vinegar retention enema combined with scopolamine in the treatment of hepatic encephalopathy can effectively improve the outcomes of patients,and reduce their blood ammonia level. Key words: Hepatic encephalopathy; Vinegar; Retention enema; Scopolamine