Objective To explore the clinical result and complications of noncyclic-PPH surgery in treating internal hemorrhoids.Methods In this study,we evaluate the clinical outcome,such as clinical efficacy,operation time,length of hospital stay,postoperative pain degree and incidence of complications in 120 hemorrhoid patients,randomly divided into control group (60 cases) and observation group (60 cases)based on digital table method,receiving respectively noncyclic-PPH,or PPH (procedure for prolapse and hemorrhoids).Results Two groups were similar in average operation time and average length of hospital stay (P ＞ 0.05).The postoperative VAS score at each time point,was significantly lower in noncyclic-PPH group than the control group (P ＜ 0.05).Non-cyclic PPH group were also significantly lower in postoperative complications than the control group (P ＜ 0.05).Conclusion Compared with PPH surgery,patients with noncyclic-PPH have fewer pain complications or trauma.

Objective To explore the intervention mechanism of Changzhou Tongbian Formula on functional constipation(FC)combined with depression in rats.Methods A rat model of FC combined with depressive-like behaviors was established by using gastric gavage of berberine hydrochloride and chronic unpredictable mild stress.The model rats were randomly divided into blank group,model group,lactulose group,and Changzhou Tongbian Formula high-,medium-,and low-dose groups,and the intervention was carried out for five weeks.The fecal water content was calculated before and after intervention.The small intestinal propulsion rate was calculated after intervention.The depressive-like behavior levels of rats were evaluated by forced swimming test and sucrose preference test before and after intervention.The colonic mucosal morphology was observed by HE staining.The morphology and number of pyramidal cells in the hippocampal CA1 and DG regions were observed by Nissl staining.The relative protein expression levels of the transient receptor potential vanilloid 4(TRPV4)in colonic tissue,as well as brain-derived neurotrophic factor(BDNF),tyrosine kinase receptor B(TrkB),mitogen-activated protein kinase(MAPK),and cAMP-response element binding protein(CREB)in the hippocampus of rats in each group were detected by Western Blot method.Results Compared with the blank group,the fecal water content of rats in the model group was significantly reduced(P＜0.001),the small intestinal propulsion rate was significantly lower(P＜0.01),the sucrose preference index was significantly decreased(P＜0.001),the number of pyramidal cells in the CA1 and DG regions of the hippocampus was significantly reduced(P＜0.001),and the TRPV4 in the colon and the BDNF,TrkB,MAPK,and CREB protein contents in the hippocampus were all significantly decreased(all P＜0.001).Compared with the model group,the fecal water content of the Changzhou Tongbian Formula high-,midium-,low-dose groups and the lactulose group were significantly increased(P＜0.001,P＜0.01).The small intestinal propulsion rate of the Changzhou Tongbian Formula high-,low-dose groups and lactulose group were significantly increased(P＜0.01,P＜0.05).The sucrose preference indices of the Changzhou Tongbian Formula high-,midium-,low-dose groups and lactulose group were significantly increased(P＜0.01,P＜0.05).There was no abnormality in the colonic histology.The numbers of pyramidal cells in the CA1 and DG regions of the hippocampus of the Changzhou Tongbian Formula high-,midium-,low-dose groups and lactulose group were significantly increased(P＜0.01,P＜0.001).The TRPV4 content in the colon of the Changzhou Tongbian Formula high-,midium-,low-dose groups and lactulose group were significantly increased(P＜0.001),and the BDNF,TrkB,MAPK,and CREB protein contents in the hippocampus were all significantly increased(P＜0.05,P＜0.01,P＜0.001).Conclusion After intervention,Changzhou Tongbian Formula can significantly improve the TRPV4 content in the colon of model rats with the comorbidity of FC with depression,increase the moisture content of feces,promote intestinal peristalsis and improve constipation.Meanwhile,TRPV4 can activate the BDNF/TrkB/MAPK pathway,trigger an increase in downstream CREB,improve neuroplasticity and thus alleviate some depressive-like behavior.

At present,external treatment of traditional Chinese medicine(TCM)has been wide-ly used in the treatment of intestinal obstruction,which is safe and effective.This study reported a case of recurrent intestinal obstruction after radiotherapy and chemotherapy for rectal cancer.After the implementation of external treatment of TCM on the basis of conventional western medicine treatment,the patient's condition improved significantly,and the patient was discharged smoothly.This case aimed to provide a reference for the diagnosis and treatment of this disease.

At present,external treatment of traditional Chinese medicine(TCM)has been wide-ly used in the treatment of intestinal obstruction,which is safe and effective.This study reported a case of recurrent intestinal obstruction after radiotherapy and chemotherapy for rectal cancer.After the implementation of external treatment of TCM on the basis of conventional western medicine treatment,the patient's condition improved significantly,and the patient was discharged smoothly.This case aimed to provide a reference for the diagnosis and treatment of this disease.