ObjectiveTo explore the protective effect and mechanism of Gegen Qianliantang （GQT） on intestinal mucosal barrier function in dextran sulfate sodium （DSS）-induced ulcerative colitis （UC） model mice. MethodsA UC model was established in C57BL/6 mice using a 2.5% DSS solution. Mice were randomly divided into five groups （n=8 per group）： blank group， model group， mesalazine sustained-release granule group （0.52 g·kg^-1）， high-dose GQT group （2.23 g·kg^-1）， and low-dose GQT group （1.12 g·kg^-1）. Fecal characteristics and body weight changes were observed before and after treatment. The body weight loss and disease activity index （DAI） of UC mice were calculated to evaluate symptom severity. Hematoxylin-eosin （HE） staining and Alizarin blue-periodic acid-Schiff （AB-PAS） staining were used to detect histological changes in colon tissue. Immunohistochemistry was used to detect the expression of zonula occludens-1 （ZO-1） and mucin 2 （MUC2）. Enzyme-linked immunosorbent assay （ELISA） was used to detect serum levels of pro-inflammatory cytokines interferon-γ （IFN-γ）， interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， IL-17A， and anti-inflammatory cytokine IL-10. Flow cytometry was used to detect the activation of helper T lymphocyte subsets （Th1， Th17）， regulatory T cells （Treg）， and regulatory B cells （Breg） in spleen and colon tissues. Western blot was used to detect the expression levels of T-bet， forkhead box protein P3（FoxP3）， nuclear transcription factor（NF）-κB p65， phosphorylated NF-κB p65 （p-NF-κB p65）， signal transducer and activator of transcription 3（STAT3）， and phosphorylated STAT3 （p-STAT3）. ResultsCompared with the model group， both high- and low-dose GQT groups significantly improved the body weight loss and DAI scores （P<0.05）， alleviated colonic inflammation， and showed optimal efficacy in the high-dose group. AB-PAS staining showed that compared with the model group， both the high- and low-dose GQT groups significantly increased goblet cell proliferation and mucin secretion， indicating improved mucosal barrier function. GQT upregulated the expression of ZO-1 and MUC2 in colon tissue （P<0.05）， suppressed IFN-γ， IL-6， and TNF-α secretion （P<0.05）， elevated IL-10 secretion （P<0.05）， but had no significant effect on IL-17A. At the same time， high- and low-dose GQT intervention increased the activation of CD4⁺ FoxP3⁺ Treg cells （P<0.05） and suppressed activation of CD4⁺ IFN-γ⁺ Th1 cells （P<0.05）. Western blot showed that GQT downregulated T-bet， NF-κB p65， and STAT3 protein expression （P<0.05）， upregulated FoxP3 （P<0.05）， and also reduced phosphorylation levels of p-NF-κB p65 and p-STAT3 （P<0.05）. ConclusionGQT can upregulate the activation of CD4⁺ FoxP3⁺ Treg cells， reduce the activation of CD4⁺ IFN-γ⁺ Th1 cells， inhibit the secretion of IFN-γ， IL-6， and TNF-α， and increase the secretion of IL-10. It enhances the expression of MUC2 and ZO-1 in colon tissue， thereby alleviating inflammatory damage to the intestinal mucosa and restoring mucosal barrier integrity. These effects may be related to its regulation of NF-κB p65 and STAT3 signaling pathways， ultimately regulating the activation of transcription factors T-bet and FoxP3.

The development of ulcerative colitis(UC)is closely related to genetic and environmental factors,impaired intestinal mucosal barrier function,intestinal immunological disorders and dysbiosis of intestinal bacterial flora.Acupuncture and moxibustion treatment has been emphasized for improving intestinal inflammation in UC.In this article,the mechanism of acupuncture and moxibustion in alleviating UC was reviewed from the aspects of immune cells,inflammatory factors and intestinal flora,and believed that acupuncture may exert therapeutic effects by improving the immune homeostasis among T-lymphocytes,inhibiting the expression of pro-inflammatory factors including IL-1β,IL-6 and IL-8,regulating the abundance of different species of intestinal flora,modulating macrophage polarization,and inhibiting oxidative stress.The possible mechanism of acupuncture and moxibustion in the treatment of UC was summarized to provide reference for the related research of inflammatory bowel disease.

The development of ulcerative colitis(UC)is closely related to genetic and environmental factors,impaired intestinal mucosal barrier function,intestinal immunological disorders and dysbiosis of intestinal bacterial flora.Acupuncture and moxibustion treatment has been emphasized for improving intestinal inflammation in UC.In this article,the mechanism of acupuncture and moxibustion in alleviating UC was reviewed from the aspects of immune cells,inflammatory factors and intestinal flora,and believed that acupuncture may exert therapeutic effects by improving the immune homeostasis among T-lymphocytes,inhibiting the expression of pro-inflammatory factors including IL-1β,IL-6 and IL-8,regulating the abundance of different species of intestinal flora,modulating macrophage polarization,and inhibiting oxidative stress.The possible mechanism of acupuncture and moxibustion in the treatment of UC was summarized to provide reference for the related research of inflammatory bowel disease.

Objective To explore the mechanism underlying the anti-hemorrhoid effects of Qingji Liangxue mixture(QLM).Methods Models of acute hemorrhoid in rats were established using a croton oil preparation(COP)and glacial acetic acid.A total of 80 SD female rats were randomly divided into two major groups:the COP group and the glacial acetic acid group,each consisting of 40 rats.In the COP group,rats were further randomly assigned to the following subgroups:control group 1(group CA),model group 1(group CB),low-dose QLM group 1-1(group CC),high-dose QLM group 1-2(group CD),and diosmin group 1(group CE),with eight rats in each subgroup.In the glacial acetic acid group,rats were randomly divided into the following subgroups:control group 2(group GA),model group 2(group GB),low-dose QLM group 2-1(group GC),high-dose QLM group 2-2(group GD),and diosmin group 2(group GE),with eight rats in each subgroup.Except for the control groups,all other subgroups were treated with COP or glacial acetic acid then treated with various drugs for 7 days.HE staining was used to observe anorectal histomorphology induced by COP and glacial acetic acid.ELIS As were used to measure serum levels of IL-6 and TNF-α induced by COP.Additionally,the area of perianal ulcers induced by glacial acetic acid was recorded.Twenty-four C57 mice were randomly divided into a control group(group A),low-dose QLM group(group B),high-dose QLM group(group C),and adrenal chromazone tablet group(group D).Results QLM significantly improved the pathological injury of animal models with similar hemorrhoids,reduced the score of pathological changes induced by COP(P＜0.05),reduced the serum levels of IL-6 and TNF-α(P＜0.05),reduced the area of perianal ulcers induced by glacial acetic acid(P＜0.05),and shortened the time of coagulation and bleeding(P＜0.05).Conclusions QLM has a good anti-hemorrhoid activity,which may be achieved by anti-inflammatory effects,hemostasis,and reducing tissue damage.

Objective To observe the effect of electroacupuncture(EA)on the immune balance between helper T cell 17(Th 17)/regulatory T cells(Treg)in the spleens of mice with dextran sulfate sodium(DSS)-induced ulcerative colitis(UC)by modulating the interleukin-6(IL-6)/signal transducer and activator of transcription 3(STAT3)signaling pathway,and to explore part of the mechanism of EA on treating UC.Methods Male C57BL/6N mice were randomly divided into UC model group,EA group,and sham acupuncture(SA)group,with 10 mice in each group,and 10 mice in the blank control group.After establishing the UC model mice by DSS free-drinking method,bilateral"Tianshu(ST25)"and"Shangjiuxu(ST37)"were selected for EA or SA treatment for 20 min each time,with a total of 10 times.The general condition and disease activity index(DAI)of the mice in each group were observed,the pathological changes of colon tissue were observed by HE staining,the levels of IL-6,IL-10 and IL-17 in serum were detected by ELISA,and the protein expression levels of IL-6,STAT3,retinoic acid-related orphan receptor gamma t(RORγt)and Forkhead box protein P3(FoxP3)were detected by Western blot in the colon tissue.Results Compared with the blank group,mice in the model group had significantly higher DAI scores(P＜0.01),with colonic mucosal rupture and massive inflammatory cell infiltration.Significant increases were detected in serum IL-6 and IL-17 levels(P＜0.01),with significant reductions in IL-10 levels(P＜0.01).Significant increases were detected in the expression of IL-6,STAT3,and RORγt in colonic tissues(P＜0.01),with the decreased expression of FoxP3(P＜0.05).The percentage of Th17 cells in the spleen was increased and the percentage of Treg cells was decreased(P＜0.05).Compared with the model group,mice in the EA group had lower DAI scores(P＜0.05),with reduced colonic injury,decreased inflammatory infiltration.Decreased serum IL-6 and IL-17 levels,with increased IL-10 levels(P＜0.05)were detected.Significantly lower IL-6,STAT3,and RORγt expression in the colonic tissues(P＜0.01),and increased FoxP3 expression(P＜0.05)were detected,as well as the decreased percentage of Th17 cells and increased percentage of Treg cells in spleen(P＜0.05).However,the colonic injury of mice in the SA group did not show any improvement,and no statistical difference was observed in these indexes compared with the model group.Conclusion EA may exert a therapeutic effect on UC by down-regulating the IL-6/STAT3 signaling pathway and promoting the restoration of immune balance by Th17/Treg,thereby diminishing intestinal inflammation in UC mice.

Objective To observe the effect of electroacupuncture(EA)on the immune balance between helper T cell 17(Th 17)/regulatory T cells(Treg)in the spleens of mice with dextran sulfate sodium(DSS)-induced ulcerative colitis(UC)by modulating the interleukin-6(IL-6)/signal transducer and activator of transcription 3(STAT3)signaling pathway,and to explore part of the mechanism of EA on treating UC.Methods Male C57BL/6N mice were randomly divided into UC model group,EA group,and sham acupuncture(SA)group,with 10 mice in each group,and 10 mice in the blank control group.After establishing the UC model mice by DSS free-drinking method,bilateral"Tianshu(ST25)"and"Shangjiuxu(ST37)"were selected for EA or SA treatment for 20 min each time,with a total of 10 times.The general condition and disease activity index(DAI)of the mice in each group were observed,the pathological changes of colon tissue were observed by HE staining,the levels of IL-6,IL-10 and IL-17 in serum were detected by ELISA,and the protein expression levels of IL-6,STAT3,retinoic acid-related orphan receptor gamma t(RORγt)and Forkhead box protein P3(FoxP3)were detected by Western blot in the colon tissue.Results Compared with the blank group,mice in the model group had significantly higher DAI scores(P＜0.01),with colonic mucosal rupture and massive inflammatory cell infiltration.Significant increases were detected in serum IL-6 and IL-17 levels(P＜0.01),with significant reductions in IL-10 levels(P＜0.01).Significant increases were detected in the expression of IL-6,STAT3,and RORγt in colonic tissues(P＜0.01),with the decreased expression of FoxP3(P＜0.05).The percentage of Th17 cells in the spleen was increased and the percentage of Treg cells was decreased(P＜0.05).Compared with the model group,mice in the EA group had lower DAI scores(P＜0.05),with reduced colonic injury,decreased inflammatory infiltration.Decreased serum IL-6 and IL-17 levels,with increased IL-10 levels(P＜0.05)were detected.Significantly lower IL-6,STAT3,and RORγt expression in the colonic tissues(P＜0.01),and increased FoxP3 expression(P＜0.05)were detected,as well as the decreased percentage of Th17 cells and increased percentage of Treg cells in spleen(P＜0.05).However,the colonic injury of mice in the SA group did not show any improvement,and no statistical difference was observed in these indexes compared with the model group.Conclusion EA may exert a therapeutic effect on UC by down-regulating the IL-6/STAT3 signaling pathway and promoting the restoration of immune balance by Th17/Treg,thereby diminishing intestinal inflammation in UC mice.

The incidence of severe mixed hemorrhoids is increasing year by year, and its surgical method has always been the focus in the study of anoenterology. On the basis of anal cushion downward movement theory, anal cushion suspension surgery moves up prolapsed anal cushion by suturing or ligating the mucosa above the dentate line. This not only ensures the effect of surgical treatment, but also protects the structure and function of the canal and anus in the most fine, which is in line with the minimally invasive treatment idea of severe mixed hemorrhoids, and is gradually widely used in clinical practice. As a new surgical method, anal cushion suspension surgery has unique advantages in treating severe mixed hemorrhoids, especially in severe prolapsed hemorrhoids. This paper will analyse the key points of anal cushion suspension surgery combined with procedure for prolapse and hemorrhoids, milligan morgan, hemorrhoidal artery ligation, automatic ligation of hemorrhoids, injection sclerotherapy, laser ablation and mixed surgeries respectively, in order to provide reference for clinicians to operate on severe mixed hemorrhoids.

Traditional Chinese surgical treatment "suture-dragging" therapy is based on medical thread therapy and tight seton drainage in combination of minimal invasive surgical principle. It can preserve the integrity of anal sphincter musculature involved in fistulous tract or abscess and maintain anal function. This article not only describes in detail about the operation points and mechanisms of "suture-dragging" therapy of anorectal fistula, but also reviews the application and modification of anorectal disease.
Abscess ; Drainage ; Humans ; Rectal Fistula ; Suture Techniques ; Sutures

Objective: To observe the effects of mild moxibustion on angiogenesis and microcirculation in wound repair after operation of anal fistula, and to explore the mechanism of action. Methods: Seventy-two SD male rats were made to bear an "acute, open, bleeding, infected" wound surface and were divided randomly into mild moxibustion group, microwave group and control group (24 rats per group). The wound surfaces of the treatment groups were treated for 15 min with mild moxibustion or microwave medical instrument from the first day after operation, and the control group was not given any treatment. At the first, third, seventh and fourteenth days after operation (1, 3, 7 and 14 days of treatment), six rats in each group were sacrificed after examining the blood flow of the wound surface, and the samples of granulation tissues were collected. The numbers of CD34 and positive expression of vascular endothelial growth factor (VEGF) in granulation tissues were detected. Results: In the early and middle stages of wound healing, mild moxibustion could obviously increase the expression of VEGF, the number of CD34, and the blood flow of the wound surface. And the expression of VEGF, the number of CD34, and the blood flow of the wound surface began to increase at the third day, and reached the peak level at the seventh day, and then began to decrease. In the late stage of wound healing (day 14), mild moxibustion could decrease the expression of VEGF, the number of CD34, and decrease the blood flow of the wound surface. There were significant differences between the mild moxibustion group and the control group in the blood flow of the wound surface, the expression of VEGF and the numbers of CD34 in granulation tissues (P<0.05) after treatment, and except the number of CD34 at 14-day treatment, there were also differences between the mild moxibustion group and the microwave group. Conclusion: Mild moxibustion has better regulative actions on blood flow of the wound surface and the number of CD34 and positive expression of VEGF in granulation tissues, and can regulate microcirculation in wound surface and promote the wound healing.