Objective:To observe and explore the clinical effect and mechanism of Tongxie Yaofang formula combined with hyperbaric oxygen (HBO) in the treatment of ulcerative colitis (UC) with liver stagnation and spleen deficiency syndrome.Methods:A total of 98 patients diagnosed as ulcerative colitis at the Department of Anorectal Medicine of the Affiliated Hospital of Qingdao University from March 2019 to September 2019 were selected as the research subjects and divided into observation group ( n=52) and control group ( n=46) according to treatment methods. The observation group was treated with Tongxie Yaofang formula combined with HBO, while the control group was treated with mesalazine sustained-release granules. The clinical efficacy and Mayo scores were evaluated after 28 days of treatment. The serum levels of tumor necrosis factor α (TNF-α) and interleukin-17 (IL-17) were detected by enzyme-linked immunosorbent assay (ELISA). The contents of prostaglandin endoperoxide synthase 2 (PTGS2) and B-cell lymphoma 2 (Bcl-2) proteins were detected by Western blotting. Fresh colon tissues before and after treatment were taken with biopsy forceps, and the contents of Yes-associated protein 1 (Yap1) and Phospho-Yes-associated protein 1 (PYap1) (Ser127) in colon tissue before and after treatment were detected by Western blotting. The healing of colonic mucosal edema and ulcer was observed by endoscope. The counts of neutrophilic granulocytes in the diffuse inflammatory infiltration of lamina propria of colonic mucosa, colonic mucosal surface ulcer, and crypt epithelium were observed microscopically before and after treatment. Results:After 28 days of treatment, the clinical effective rate in the observation group (80.8%) was significantly higher than that in the control group (60.9%) ( P<0.05). Compared with those before treatment, the Mayo scores after treatment were significantly lower in both groups ( P<0.05). The Mayo score in the observation group was lower than that in the control group ( P<0.05). After treatment, the colonic mucosal edema and ulcer were improved, and the conditions of the observation group were better than those of the control group. Pathological observations showed that the patients in the two groups, before treatment, had diffuse inflammatory infiltration of the lamina propria of the colonic mucosa, irregular glands, destruction of the crypt epithelium, abscess, and surface ulcer. After treatment, the counts of neutrophilic granulocytes in the lamina propria and the crypt epithelium were significantly reduced, and the diffuse inflammatory infiltration turned into focal infiltration. The serum levels of TNF-α and IL-17 in both groups were significantly lower than those before treatment ( P<0.05). However, there was no significant difference in serum levels of TNF-α and IL-17 between the two groups after treatment ( P>0.05). The expressions of PTGS2 and Yap1 in colon tissues of the two groups were significantly down-regulated compared with those before treatment, and the expressions of anti-apoptotic proteins Bcl-2 and PYap1 were up-regulated( P<0.05). There was no statistically significant difference in PTGS2, Yap1, Bcl-2, and P-Yap1 levels between the two groups after treatment ( P>0.05). Conclusion:Tongxie Yaofang formula combined with HBO in the treatment of UC with liver stagnation and spleen deficiency syndrome can achieve a better clinical remission rate than that of mesalazine sustained-release granule alone, and it more strengths in reducing the modified Mayo score, reducing the level of inflammatory factors, and effectively promoting mucosal ulcer healing.

Objective:To observe and explore the clinical effect and mechanism of Tongxie Yaofang formula combined with hyperbaric oxygen (HBO) in the treatment of ulcerative colitis (UC) with liver stagnation and spleen deficiency syndrome.Methods:A total of 98 patients diagnosed as ulcerative colitis at the Department of Anorectal Medicine of the Affiliated Hospital of Qingdao University from March 2019 to September 2019 were selected as the research subjects and divided into observation group ( n=52) and control group ( n=46) according to treatment methods. The observation group was treated with Tongxie Yaofang formula combined with HBO, while the control group was treated with mesalazine sustained-release granules. The clinical efficacy and Mayo scores were evaluated after 28 days of treatment. The serum levels of tumor necrosis factor α (TNF-α) and interleukin-17 (IL-17) were detected by enzyme-linked immunosorbent assay (ELISA). The contents of prostaglandin endoperoxide synthase 2 (PTGS2) and B-cell lymphoma 2 (Bcl-2) proteins were detected by Western blotting. Fresh colon tissues before and after treatment were taken with biopsy forceps, and the contents of Yes-associated protein 1 (Yap1) and Phospho-Yes-associated protein 1 (PYap1) (Ser127) in colon tissue before and after treatment were detected by Western blotting. The healing of colonic mucosal edema and ulcer was observed by endoscope. The counts of neutrophilic granulocytes in the diffuse inflammatory infiltration of lamina propria of colonic mucosa, colonic mucosal surface ulcer, and crypt epithelium were observed microscopically before and after treatment. Results:After 28 days of treatment, the clinical effective rate in the observation group (80.8%) was significantly higher than that in the control group (60.9%) ( P<0.05). Compared with those before treatment, the Mayo scores after treatment were significantly lower in both groups ( P<0.05). The Mayo score in the observation group was lower than that in the control group ( P<0.05). After treatment, the colonic mucosal edema and ulcer were improved, and the conditions of the observation group were better than those of the control group. Pathological observations showed that the patients in the two groups, before treatment, had diffuse inflammatory infiltration of the lamina propria of the colonic mucosa, irregular glands, destruction of the crypt epithelium, abscess, and surface ulcer. After treatment, the counts of neutrophilic granulocytes in the lamina propria and the crypt epithelium were significantly reduced, and the diffuse inflammatory infiltration turned into focal infiltration. The serum levels of TNF-α and IL-17 in both groups were significantly lower than those before treatment ( P<0.05). However, there was no significant difference in serum levels of TNF-α and IL-17 between the two groups after treatment ( P>0.05). The expressions of PTGS2 and Yap1 in colon tissues of the two groups were significantly down-regulated compared with those before treatment, and the expressions of anti-apoptotic proteins Bcl-2 and PYap1 were up-regulated( P<0.05). There was no statistically significant difference in PTGS2, Yap1, Bcl-2, and P-Yap1 levels between the two groups after treatment ( P>0.05). Conclusion:Tongxie Yaofang formula combined with HBO in the treatment of UC with liver stagnation and spleen deficiency syndrome can achieve a better clinical remission rate than that of mesalazine sustained-release granule alone, and it more strengths in reducing the modified Mayo score, reducing the level of inflammatory factors, and effectively promoting mucosal ulcer healing.

Objective:To explore the detection rate, missed diagnosis rate, and clinical significance of incidental extra-hip findings (IEHFs) in hip joint MRI.Methods:The data of 1 734 cases who underwent MRI examination of hip joint from September 2014 to September 2018 at the First Central Hospital of Baoding City were retrospectively analyzed. According to the revised CT colonography reporting and data system (C-RADS), the IEHFs were divided into 4 types using structural imaging reading method. E1 type was anatomical variation; E2 type was sign without clinical significance; E3 type was sign with little clinical significance; E4 type was sign with important clinical significance. The types and distributions of IEHFs were analyzed, and the results of structural imaging reading were compared with those of the initial MRI reports. The missed diagnosis rate was calculated in this group.Results:Among the 1 734 patients, 1 651 of IEHFs were found in 1 064 patients. There were 1 080 E2 type IEHFs (65.4%, 1 080/1 651), with cervical cysts (26.0%, 281/1 080) accounting for the largest number. There were 354 IEHFs of E3 type (21.4%, 354/1 651), with most cases were prostatic hyperplasia (47.2%, 167/354). There were 217 IEHFs of E4 type (13.1%, 217/1 651), most of which were the enlarged lymph nodes in the inguinal region (30.9%, 67/217). E2 and E3 IEHFs accounted for a great proportion in male patients. The proportion of E2 IEHFs was the largest in female patients. There was significant difference in IEHFs composition between male and female patients (χ2=294.080, P<0.001). The IEHFs of patients under 60 years old were mainly E2 type, while those of over 60 years old patients were mainly E3 type. There was significant difference in IEHFs composition among different age groups (χ2=206.702, P<0.001). The overall missed diagnosis rate of IEHFs was 85.2% (1 406/1 651). The missed diagnosis rate of E2 was the highest (91.1%, 984/1 080), and that of E4 was the lowest (63.1%, 137/217). Conclusion:The incidence of IEHFs in patients undergoing hip joint MRI are prevalent. The structural imaging reading method can increase the detection of IEHFs. Therefore, it is suggested that revised C-RADS be used to grade IEHFs to reduce the rate of missed diagnosis.