Treatment of different sites or types of ulcerative colitis: ① Ulcerative proctitis: A. Starting treatment: lesions confined to the rectum, symptoms are mostly mild, may use mesalachin (5-aminosalicylic acid) suppositories, 2-3 times/d, or cortisone foam 1 to 2 times/d, 1 suppository each time. If suppository intolerance occurs, such as lower abdominal discomfort and rectal irritation, it can be switched to salazosulfapyridine (azosulfapyridine) tablets or mesalachine (5-ASA) orally, which is often effective within 2 weeks and later changed to maintenance doses. B. Maintenance therapy: Mesalachin (5-ASA) suppositories are better used as long-term maintenance therapy, 1 capsule per night, to reduce recurrence. The recommended maintenance dose is 2g/d of salazosulfapyridine (SASP ). Monitor blood levels, hemoglobin and reticulocytes. ②Left-sided semi-ulcerative colitis: The starting treatment is usually mesalazine (5-ASA) enema, 4g per night, and if there is no symptomatic relief after 3-4 weeks, the dose can be increased to 1 in the morning and 1 in the evening. Or add hydrocortisone 100mg/100ml enema, if it is still ineffective or difficult to be tolerated by the patient, add or switch to salazosulfapyridine (SASP) or mesalachine (5-ASA) orally, starting with a small dose and gradually increasing if tolerated, such as salazosulfapyridine (SASP) 1g/d or mesalachine (5-ASA) 1~1.2g/d, gradually increasing to salazosulfapyridine ( Once the symptoms are relieved, the dose should be gradually reduced. Maintenance therapy is commonly used with 5-ASA enemas of 4g each, once a night or once every 3 nights, or oral maintenance with SASP 1 to 2g/d and 5-ASA 1.2 to 2.4g/d. For long-term use of SASP, folic acid should be supplemented. ③ Right hemi-ulcerative colitis and total colitis: The starting treatment is commonly used with salazosulfapyridine (SASP) 4-6g/d or mesalazine 2.0-4.8g/d orally, with the addition of mesalazine (5-ASA) enemas or corticosteroid enemas during acute exacerbations. Once symptoms are relieved, enemas should be gradually discontinued and oral salazosulfapyridine (SASP) or mesalazine (5-ASA) should be reduced to maintenance doses. If ineffective, switch to prednisone 40-60 mg/d orally. Take care of iron supplementation and add antidiarrheal agents to relieve symptoms as appropriate. Maintenance treatment with salazosulfapyridine (SASP) 1~2g/d or mesalazine (5-ASA) 1.2~2.4g/d. ④ Heavy or fulminant ulcerative colitis: Patients with this type often have systemic symptoms and are prone to complications such as toxic megacolon and intestinal perforation, requiring hospitalization for observation and treatment. The main therapeutic drug so far is corticosteroids, and in severe cases, immunosuppressive drugs can be administered or colonic resection can be performed, and the main measures are parenteral nutrition for intestinal rest and intravenous corticosteroids. Intravenous nutrition with conventional methods, corticosteroids can be hydrocortisone 100mg intravenous infusion every 8 hours, or prednisolone 30mg intravenous infusion every 12 hours or methylprednisolone (methylprednisolone) 16-20mg intravenous infusion every 8 hours. The latter two drugs are less likely to have side effects of sodium retention and potassium loss. If the effect is not obvious, mesalamine (5-ASA) enema or hydrocortisone enema can be used twice/d, and antibiotics can also be used in combination. If corticosteroids are ineffective, a small dose of cyclosporine 2mg/(kg・d) can be used as a continuous drip to relieve the disease and avoid emergency colectomy, and the dosage of corticosteroids can be reduced appropriately. In addition, granulocyte adsorption therapy has been used to achieve better results. Granulocyte adsorption therapy refers to the removal of activated leukocytes such as granulocytes, monocytes, and killer T lymphocytes from the blood, thereby suppressing inflammation. Granulocyte adsorber is a blood filter with small beads filled with cellulose acetate inside, and after the patient’s venous blood flows through it, about 60% of activated granulocytes and monocytes are adsorbed. The therapy is administered once a week for 1h for a course of 5 sessions, and as it is allopathic, regular maintenance therapy is required. Granulocyte adsorption therapy can be applied to a variety of inflammatory disorders, and its efficiency is 58.5%, which is higher than that of corticosteroids at 44.2%, and the incidence of adverse effects is only 8.5%, compared with 42.9% for corticosteroids. ⑤ Chronic active ulcerative colitis: some patients are ineffective with salazosulfapyridine (SASP), mesalazine (5-ASA) and corticosteroids, but are unwilling to undergo surgery, they can be treated with azathioprine, starting with 50 mg/d and gradually increasing the amount to a maximum of 2 mg/(kg・d). Although the effective rate is 60% to 70%, it takes 3-6 months for the treatment to take effect, so it is often necessary to maintain treatment with prednisone for at least 2 months before reducing the dose. If mercaptopurine (6-mercaptopurine) or azathioprine is not effective after 6 months, methotrexate (methotrexate) 2.5mg/week orally, gradually increase to 10-15mg/week, or 25mg/week intramuscularly. It takes 8 to 10 weeks to see the effect.