The Molecular Correlation Between Ulcerative Colitis And Colorectal Cancer & Clinical Observations On 14 Cases Of Refractory Anal Fistula Treated By Combined Chinese Traditional And Western Medicine

Objectives To examine the expression of the transcription factor NF-κB p65 in the colon mucosa of patients with ulcerative colitis (UC) and relative healthy volunteers.Methods Specimens were obtained from 12 healthy volunteers(6 male and 6 female patients,25-61 years old, mean 46.13±12.05 years) and 16 patients suffering from UC(10 male and 6 female patients,30-68 years old, mean 50.42±10.43 years). The duration of disease was less than 1 year for 3 patients while 13 patients had had UC for 3 years or more. Fresh colonic tissues from patients diagnosed with UC and healthy volunteers were obtained by endoscopic punch biopsies. The diagnosis was confirmed after further examination of histological sections obtained from these tissues. This study was approved by the Ethical Committee of Wuhan Union Hospital and the patients gave their informed consent. Real-time polymerase chain reaction and immumofluorescence method were used to examine the expression of NF-κB p65 at both mRNA and protein levels in the colon mucosa of patients with UC and healthy volunteers.Results The expression of NF-κB p65 in colon mucosa of patients with UC was significantly higher than that in normal controls at both mRNA and protein levels (5.19±3.37 vs0.53±0.24, P<0.01; 15.22%±3.16% vs2.10%±0.64%,P<0.01).Conclusions These data suggest that NF-κB p65 perhaps play an important role in the pathogenesis of UC and underscore the potential value of anti-UC strategies in the clinical management of this trouble disease. Objectives The molecular mechanism of ulcerative colitis-associated colorectal cancer remain largely unresolved, recently, Nuclear factor-κB p65(NF-K Bp65) has been shown to play an important part in the pathogenesis of human cancers. This study was designed to investigate the expression of NF-κB p65 in the colon mucosa of patients with ulcerative colitis(UC), colorectal adenocarcinoma and relative healthy volunteers.Methods Specimens were obtained from of 12 healthy volunteers,16 patients suffering from UC and 18 patients suffering from colorectal cancer. Fresh colonic tissues were obtained from all of them by endoscopic punch biopsies. The diagnosis was confirmed by an experienced pathologist and an expert on digest. This study was approved by the ethical committee of our Wuhan union hospital and all of the patients and healthy volunteers gave their informed consent. Reverse transcription-polymerase chain reaction(RT-PCR) and immunohistochemistry were used to examine the expression of NF-κB p65 at both mRNA and protein levels in the colon mucosa of three different groups.Results The expression of NF-κB p65 was obviously higher in colon mucosa of patients with UC in comparison with that in adenocarcinoma tissue and normal mucosa (P<0.01). Though the expression of NFκB p65 in colon mucosa of patients with colorectal cancer was higher than that in normal controls at both mRNA and protein levels, but the expression intensity were not as strong as other literature.Conclusions These data suggest that the increased expression of NF-κB p65 perhaps play an important role in the pathogenesis of UC, anti-NF-KB p65 therapy should be investigated further for use as a potential therapy target. We are also sure that NF-κB p65 is involved in the pathogenesis of colorectal cancer, but the significance of NF-κB p65 expression in colorectal cancer is not as big as other literature and we do not think the application of an inhibitor of NF-κB p65 may be a biologically based therapy for the treatment of colorectal cancer. Objectives Recent studies have suggested that angiotensin converting enzyme inhibitors (ACE-Ⅰ) and angiotensinⅡtypeⅠreceptor (AT1R) antagonists may exert an inhibitory effect on malignancy, for this reason, the aim of this study was to investigate the expression of angiotensinⅡ(ANGⅡ) and ATIR in the colon of patients with colorectal cancer.Methods Specimens were obtained from 6 healthy volunteers and 24 patients suffering from colorectal cancer (6 patients with poorly differentiated adenocarcinoma,9 patients with medium differentiated adenocarcinoma and 9 patients with well differentiated adenocarcinoma, The diagnosis was confirmed by two experts on pathologists). Fresh colonic tissues were obtained by endoscopic punch biopsies or surgery. Immunohis-tochemistry was used to examine the expression of angiotensinⅡand AT1R in the colon of patients with colorectal cancer and healthy volunteers.Results The expression of ANGⅡand ATIR in colon of patients with colorectal cancer were obviously higher than that in normal controls at protein level. The expression of ANGⅡhad no different in variant differentiation colorectal cancer tissues. Compared with medium differentiated adenocarcinoma and well differentiated adenocarcinoma, the expression of ATIR was more frequent in poorly differentiated histologic grade.Conclusions These data suggest that angiotensinⅡand ATIR perhaps play an important role in the pathogenesis of colorectal cancer and underscore the potential value of anti-colorectal cancer strategies in the clinical management of this disease. Further investigation is needed for us to identify this deduction. Objectives To the colorectal surgeon, the joint aims of eradication of the anal fistula and maintenance of continence still remain a challenging condition to manage. The purpose of this study is to report the authors'early experience in the treatment of anal fistula.Methods Forteen consecutive patients presenting with anal fistula were treated with combined western and traditional Chinese medicine. All surgery procedures were performed under spinal or local anesthesia at an appropriate position, and the anal area is exposed. After routine disinfection and identifying the internal orifice, a probe was gently passed through the external orifice and brought out of the anal canal through the internal opening. A V-shaped incision was made at about 1.5 cm from the anal margin and make sure the internal opening was eradicated. Along the line of the probe, the toolholder was introduced through the external orifice and progressed toward the V-shaped incision. Then remove the probe, the head protruding from the V-shaped incision was fixed with mill. The surgeon held the minisize electromotor, switched on the power (the device will generate an axial circular rotational movement by means of an electromotor rotating at 360 rpm) and pulling it, the non-healthy granulation tissue inside the fistula tract will be totally excised through its whole length. The elastic seton was then pulled through the remaining tube by a probe or hemostat, it was loosely tied with a silk suture. Patient had this draining seton at least 1 weeks. Follow-up was 6 months. Success was defined as complete closure of all external opening, absence of fistula seepage and no abscess formation; recurrence was defined as the presence of an obvious evidence of fistulation in the same area, or abscess arising in the same area. Results Recurrence occurred in one patient, whom did not insist on dressing change post operative. All other 13 patients had successful closure of their fistula tracts. None of our patients had any interference with the continence and there were no major intra or post operative complications too.Conclusions Combined western and traditional Chinese medicine for the management of anal fistula is a promising alternative to traditional methods that in the early experience.