AIM： To evaluate the prevalent topical therapeutic modalities available for the treatment of acute radiation proctitis compared to formalin. METHODS： A total of 120 rats were used. Four groups （n = 30） were analyz...AIM： To evaluate the prevalent topical therapeutic modalities available for the treatment of acute radiation proctitis compared to formalin. METHODS： A total of 120 rats were used. Four groups （n = 30） were analyzed with one group for each of the following applied therapy modalities： control, mesalazine, formalin, betamethasone, and misoprostol. A single fraction of 17.5 Gy was delivered to each rat. The rats in control group rats were given saline, and the rats in the other three groups received appropriate enemas twice a day beginning on the first day after the irradiation until the day of euthanasia. On d 5, 10, and 15, ten rats from each group were euthanized and a pathologist who was unaware of treatment assignment examined the rectums using a scoring system. RESULTS： The histopathologic scores for surface epithelium, glands （crypts） and lamina propria stroma of the rectums reached their maximum level on d 10. The control and formalin groups had the highest and mesalazine had the lowest, respectively on d 10. On the 15^th d, mesalazine, betamethasone, and misoprostol had the lowest scores of betamethasone. CONCLUSION： Mesalazine, betamethasone, and misoprostol are the best topical agents for radiation proctitis and formalin has an inflammatory effect and should not be used.展开更多
Chronic haemorrhagic radiation proctitis(CHRP) is a difficult problem faced by the patients following radiation for pelvic malignancy. There is no standardtreatment for this condition, but many methods of treatment ar...Chronic haemorrhagic radiation proctitis(CHRP) is a difficult problem faced by the patients following radiation for pelvic malignancy. There is no standardtreatment for this condition, but many methods of treatment are available. The aim of this study was to review the literature to see whether there is an improvement in the available evidence in comparison with previously published systematic reviews in treating patients with CHRP. The Pub Med/Medline database and Google Scholar search was selectively searched. Studies, which treated patients with rectal bleeding due to chronic radiation proctitis or CHRP, were included. Seventy studies were finally selected out of which 14 were randomized controlled clinical trials. Though these studies could not be compared, it could be seen that there was an improvement in the methodology of the studies. There was an objective assessment of symptoms, signs and an objective assessment of outcomes. But, still, there were only a few studies that looked into the quality of life following treatment of CHRP. To increase recruitment to trials, a national registry of cases with established late radiation toxicity would facilitate the further improvement of such studies. Some of the conclusions that could be reached based on the available evidence are 4% formalin should be the first line treatment for patients with CHRP. Formalin and argon plasma coagulation(APC) are equally effective, but formalin is better for severe disease. Refractory patients, not responding to formalin or APC, need to be referred for hyperbaric oxygen therapy or surgery. Radio-frequency ablation is a promising modality that needs to be studied further in randomized trials.展开更多
本试验选取4只体重约35 kg、2岁龄装置了永久性瘤胃瘘管和十二指肠瘘管的新疆美利奴羯羊,采用4×4拉丁方设计,研究口服福尔马林对饲喂玉米秸秆日粮绵羊瘤胃消化代谢的影响。结果表明,给绵羊分别喂给0(对照)、0.5、1.0、1.5m l/d.只...本试验选取4只体重约35 kg、2岁龄装置了永久性瘤胃瘘管和十二指肠瘘管的新疆美利奴羯羊,采用4×4拉丁方设计,研究口服福尔马林对饲喂玉米秸秆日粮绵羊瘤胃消化代谢的影响。结果表明,给绵羊分别喂给0(对照)、0.5、1.0、1.5m l/d.只福尔马林,各处理组羊的玉米秸秆采食量分别为637.1、692.9、744.8和760.3 g/d.只,瘤胃液氨态氮平均浓度分别为26.1、24.4、23.6和21.8 m g/100 m l,乙酸平均浓度分别为64.92、65.21、66.17和66.46 mm o l/L,丙酸平均浓度分别为15.29、16.21、17.61和17.98 mm o l/L,丁酸平均浓度分别为10.43、10.64、11.30和11.52 mm o l/L,总VFA平均浓度分别为90.64、92.06、94.66和95.95 mm o l/L,原虫平均数量分别为71.7、52.9、47.5和40.3(×104个/m l)。前胃有机物消失量分别为510.1、594.1、628.3和634.4 g/d.只,前胃纤维素消化率分别为53.1%、61.1%、66.2%和64.5%,到达十二指肠的粗蛋白质量分别为82.3、87.3、96.1和97.8 g/d.只,微生物蛋白质量分别为64.8、64.6、61.3和60.2 g/d.只,过瘤胃饲料蛋白质量分别为16.1、20.5、32.9和35.6 g/d.只。试验结果表明,给绵羊口服福尔马林可提高动物对玉米秸秆的采食量,降低瘤胃液氨态氮的浓度,具有增加乙酸和丙酸浓度从而增加总挥发性脂肪酸浓度的趋势,增加前胃有机物的消失量和纤维素的消化量,增加到达十二指肠的粗蛋白质总量和过瘤胃饲料蛋白质量,并有减少到达十二指肠的微生物蛋白质量的趋势。福尔马林以上这些作用均随剂量的增加而提高,然而,从总体看,绵羊每天口服1 m l福尔马林(分2次喂给)比较适于改善瘤胃消化代谢状况。展开更多
Chronic radiation proctopathy(CRP) is a troublesome complication of pelvic radiotherapy. The most common presentation is rectal bleeding. CRP symptoms interfere with daily activities and decrease quality of life. Rect...Chronic radiation proctopathy(CRP) is a troublesome complication of pelvic radiotherapy. The most common presentation is rectal bleeding. CRP symptoms interfere with daily activities and decrease quality of life. Rectal bleeding management in patients with CRP represents a conundrum for practitioners. Medical therapy is ineffective in general and surgical approach has a high morbidmortality. Endoscopy has a role in the diagnosis,staging and treatment of this disease. Currently available endoscopic modalities are formalin,potassium titanyl phosphate laser,neodymium:yttrium-aluminum-garnet laser,argon laser,bipolar electrocoagulation(BiCAP),heater probe,band ligation,cryotherapy,radiofrequency ablation and argon plasma coagulation(APC). Among these options,APC is the most promising.展开更多
Chronic radiation proctitis is a complication that occurs in patients who receive radiation therapy for pelvic malignancies. The common presentation is with rectal bleeding, but also rectal pain, diarrhea, tenesmus an...Chronic radiation proctitis is a complication that occurs in patients who receive radiation therapy for pelvic malignancies. The common presentation is with rectal bleeding, but also rectal pain, diarrhea, tenesmus and even passage of mucus can occur. The optimal treatment of bleeding due to radiation proctitis remains unclear. Among various therapeutic options, medical management is generally ineffective and surgical intervention has a high incidence of morbidity. Promising advances have been made in endoscopic therapy, including argon plasma coagulation (APC), formalin application as well as new techniques such as radio-frequency ablation and cryoablation. APC is a safe, highly effective and long-lasting therapy in patients with rectal bleeding associated with radiation proctitis. It has been shown that several sessions of APC reduce the rate of bleeding and therefore the blood transfusion requirements. Moreover, the effect of treatment is long lasting. However, best results are achieved in patients with mild to moderate radiation proctitis, leaving space for alternative treatments for patients with more severe disease. In patients with severe or refractoryradiation proctitis intra rectal formalin application is an appropriate treatment option. Radiofrequency ablation and cryoablation have shown efficacy as alternative methods in a limited number of patients with refractory chronic radiation proctitis.展开更多
文摘AIM： To evaluate the prevalent topical therapeutic modalities available for the treatment of acute radiation proctitis compared to formalin. METHODS： A total of 120 rats were used. Four groups （n = 30） were analyzed with one group for each of the following applied therapy modalities： control, mesalazine, formalin, betamethasone, and misoprostol. A single fraction of 17.5 Gy was delivered to each rat. The rats in control group rats were given saline, and the rats in the other three groups received appropriate enemas twice a day beginning on the first day after the irradiation until the day of euthanasia. On d 5, 10, and 15, ten rats from each group were euthanized and a pathologist who was unaware of treatment assignment examined the rectums using a scoring system. RESULTS： The histopathologic scores for surface epithelium, glands （crypts） and lamina propria stroma of the rectums reached their maximum level on d 10. The control and formalin groups had the highest and mesalazine had the lowest, respectively on d 10. On the 15^th d, mesalazine, betamethasone, and misoprostol had the lowest scores of betamethasone. CONCLUSION： Mesalazine, betamethasone, and misoprostol are the best topical agents for radiation proctitis and formalin has an inflammatory effect and should not be used.
文摘Chronic haemorrhagic radiation proctitis(CHRP) is a difficult problem faced by the patients following radiation for pelvic malignancy. There is no standardtreatment for this condition, but many methods of treatment are available. The aim of this study was to review the literature to see whether there is an improvement in the available evidence in comparison with previously published systematic reviews in treating patients with CHRP. The Pub Med/Medline database and Google Scholar search was selectively searched. Studies, which treated patients with rectal bleeding due to chronic radiation proctitis or CHRP, were included. Seventy studies were finally selected out of which 14 were randomized controlled clinical trials. Though these studies could not be compared, it could be seen that there was an improvement in the methodology of the studies. There was an objective assessment of symptoms, signs and an objective assessment of outcomes. But, still, there were only a few studies that looked into the quality of life following treatment of CHRP. To increase recruitment to trials, a national registry of cases with established late radiation toxicity would facilitate the further improvement of such studies. Some of the conclusions that could be reached based on the available evidence are 4% formalin should be the first line treatment for patients with CHRP. Formalin and argon plasma coagulation(APC) are equally effective, but formalin is better for severe disease. Refractory patients, not responding to formalin or APC, need to be referred for hyperbaric oxygen therapy or surgery. Radio-frequency ablation is a promising modality that needs to be studied further in randomized trials.
文摘本试验选取4只体重约35 kg、2岁龄装置了永久性瘤胃瘘管和十二指肠瘘管的新疆美利奴羯羊,采用4×4拉丁方设计,研究口服福尔马林对饲喂玉米秸秆日粮绵羊瘤胃消化代谢的影响。结果表明,给绵羊分别喂给0(对照)、0.5、1.0、1.5m l/d.只福尔马林,各处理组羊的玉米秸秆采食量分别为637.1、692.9、744.8和760.3 g/d.只,瘤胃液氨态氮平均浓度分别为26.1、24.4、23.6和21.8 m g/100 m l,乙酸平均浓度分别为64.92、65.21、66.17和66.46 mm o l/L,丙酸平均浓度分别为15.29、16.21、17.61和17.98 mm o l/L,丁酸平均浓度分别为10.43、10.64、11.30和11.52 mm o l/L,总VFA平均浓度分别为90.64、92.06、94.66和95.95 mm o l/L,原虫平均数量分别为71.7、52.9、47.5和40.3(×104个/m l)。前胃有机物消失量分别为510.1、594.1、628.3和634.4 g/d.只,前胃纤维素消化率分别为53.1%、61.1%、66.2%和64.5%,到达十二指肠的粗蛋白质量分别为82.3、87.3、96.1和97.8 g/d.只,微生物蛋白质量分别为64.8、64.6、61.3和60.2 g/d.只,过瘤胃饲料蛋白质量分别为16.1、20.5、32.9和35.6 g/d.只。试验结果表明,给绵羊口服福尔马林可提高动物对玉米秸秆的采食量,降低瘤胃液氨态氮的浓度,具有增加乙酸和丙酸浓度从而增加总挥发性脂肪酸浓度的趋势,增加前胃有机物的消失量和纤维素的消化量,增加到达十二指肠的粗蛋白质总量和过瘤胃饲料蛋白质量,并有减少到达十二指肠的微生物蛋白质量的趋势。福尔马林以上这些作用均随剂量的增加而提高,然而,从总体看,绵羊每天口服1 m l福尔马林(分2次喂给)比较适于改善瘤胃消化代谢状况。
文摘Chronic radiation proctopathy(CRP) is a troublesome complication of pelvic radiotherapy. The most common presentation is rectal bleeding. CRP symptoms interfere with daily activities and decrease quality of life. Rectal bleeding management in patients with CRP represents a conundrum for practitioners. Medical therapy is ineffective in general and surgical approach has a high morbidmortality. Endoscopy has a role in the diagnosis,staging and treatment of this disease. Currently available endoscopic modalities are formalin,potassium titanyl phosphate laser,neodymium:yttrium-aluminum-garnet laser,argon laser,bipolar electrocoagulation(BiCAP),heater probe,band ligation,cryotherapy,radiofrequency ablation and argon plasma coagulation(APC). Among these options,APC is the most promising.
文摘Chronic radiation proctitis is a complication that occurs in patients who receive radiation therapy for pelvic malignancies. The common presentation is with rectal bleeding, but also rectal pain, diarrhea, tenesmus and even passage of mucus can occur. The optimal treatment of bleeding due to radiation proctitis remains unclear. Among various therapeutic options, medical management is generally ineffective and surgical intervention has a high incidence of morbidity. Promising advances have been made in endoscopic therapy, including argon plasma coagulation (APC), formalin application as well as new techniques such as radio-frequency ablation and cryoablation. APC is a safe, highly effective and long-lasting therapy in patients with rectal bleeding associated with radiation proctitis. It has been shown that several sessions of APC reduce the rate of bleeding and therefore the blood transfusion requirements. Moreover, the effect of treatment is long lasting. However, best results are achieved in patients with mild to moderate radiation proctitis, leaving space for alternative treatments for patients with more severe disease. In patients with severe or refractoryradiation proctitis intra rectal formalin application is an appropriate treatment option. Radiofrequency ablation and cryoablation have shown efficacy as alternative methods in a limited number of patients with refractory chronic radiation proctitis.
