保留括约肌术治疗高位单纯性肛瘘的临床研究

目的：探讨保留括约肌术治疗高位单纯性肛瘘的临床疗效。方法：将67例高位单纯性肛瘘患者随机分为治疗组（34例）和对照组（33例），治疗组行保留括约肌术，对照组行切开挂线术。观察比较两组术后疼痛、创面愈合时间、肛门瘢痕大小、肛门畸形、肛门功能状况、术后复发情况以及患者满意率。结果：治疗组术后疼痛持续时间短，创面愈合时间短，肛门瘢痕小，肛门畸形发生率低，肛门部分失禁发生率低；与对照组比较，差异均有统计学意义（P均〈0．05）。术后复发率两组差异无统计学意义（P〉0．05）。结论：保留括约肌术治疗高位单纯性肛瘘效果较切开挂线术为佳。     

定向挂线法治疗36例高位复杂性肛瘘的疗效分析

目的：探讨定向挂线法与传统切开挂线法治疗高位复杂性肛瘘之疗效对比。方法将该院肛肠中心2013年1月至2013年12月收治的高位复杂性肛瘘患者72例分为对照组和治疗组,每组36例。对照组采用传统切开挂线法,治疗组采取定向挂线法,比较两组术后创面完全愈合时间、住院天数、复发率、疼痛及手术对肛门括约功能的影响情况。结果两组创面完全愈合时间、住院天数和复发情况比较,差异无统计学意义（P＞0．05）;治疗组术后2 d视觉模拟疼痛评分（VAS）与肛门括约功能指标检测,与对照组比较,差异有统计学意义（P＜0．05）。结论定向挂线法相比于传统切开挂线法治疗高位复杂性肛瘘,具有对肛门括约功能影响小和减轻术后疼痛的优势。     

高位肛瘘微创术式与传统术式对肛门损伤的对比研究

目的研究高位肛瘘微创术式和传统术式对肛门功能和肛门外形损伤程度的差异。方法采用单盲随机相互对照的研究方法,治疗组施行高位肛瘘微创术式（内口切除低位小切口高位挂线引流,不紧线,保留肛管直肠环）,对照组施行传统术式（低位切开高位挂线,内口不切除,紧线,破坏肛管直肠环）,术后对两组病人的肛管静息压、肛管最大收缩压、漏气漏液和肛管锁眼畸形等指标进行对比分析。结果两组患者所有指标治疗组均优于对照组。结论高位肛瘘微创术式比传统高位肛瘘治疗术式对肛门功能和肛门外形的损伤小,因此高位肛瘘微创术式在肛门功能和肛门外形的保护方面优于传统术式。     

对口引流保留皮桥术治疗复杂性肛瘘的临床观察

目的：探讨对口引流保留皮桥术治疗复杂性肛瘘的临床效果。方法：选取我院2013年9月－2015年9月64例复杂性肛瘘患者,数字抽取分成观察组与对照组,对照组采取传统肛瘘切开术治疗,观察组采取对口引流保留皮桥术治疗,对比两组总有效率、治愈时间,且以 Wexner 肛门失禁评分表评价术后肛门功能。结果：观察组手术后、痊愈后及6个月随访 Wexner 评分均明显低于对照组（P＜0．05）;观察组总有效率96．88％明显高于对照组97．50％（P＜0．05）;观察组治愈时间短于对照组（P＜0．05）;观察组手术后、痊愈后、6个月随访时的 Wexner 评分均低于对照组（P＜0．05）。结论：对口引流保留皮桥术治疗复杂性肛瘘效果显著,有效保留肛门功能,减少治愈时间,值得临床推广。     

括约肌间瘘管结扎术结合脱细胞异体真皮基质 填塞治疗经括约肌肛瘘的疗效分析

目的 探讨括约肌间瘘管结扎术（LIFT）结合瘘管脱细胞异体真皮基质（AEM）填塞治疗经括 约肌肛瘘的临床疗效。方法 选取2013 年10 月-2016 年10 月该院收治的66 例经括约肌肛瘘患者。采用随 机数字表法将患者分为治疗组（行LIFT 和AEM）和对照组（行肛瘘切开术或切开挂线术）,每组各33 例。 主要观察指标：创面愈合时间,术前、术后1、3、6、12 个月肛门失禁评分和总有效率。患者术后1 个月至 门诊复诊,术后3、6、12 个月采用门诊、问卷及电话方式进行随访,了解创面愈合情况、肛门控便能力及 治愈情况。结果 筛选出符合研究条件的患者61 例,治疗组31 例,对照组30 例,两组患者术前均无肛门失 禁。对照组30 例患者中,21 例行肛瘘切开术,9 例行切开挂线术。两组创面愈合时间比较,差异有统计学意 义（P <0.05）,治疗组少于对照组。肛门失禁评分两组术前比较差异无统计学意义（P >0.05）,两组术后肛门 失禁评分比较,差异有统计学意义（P <0.05）,治疗组术后1、3、6、12 个月肛门失禁评分均低于对照组。治 疗组和对照组总有效率分别为90.32% 和93.33%,两组比较,差异无统计学意义（P >0.05）。结论 LIFT 结合 AEM 治疗经括约肌肛瘘与传统肛瘘切开术疗效相当,而且创面愈合时间短,肛门功能保护良好,无肛门失禁 的发生。     

2种手术方式治疗高位肛瘘的疗效比较

目的 比较切开挂线选择性缝合术与切开挂线治疗高位复杂性肛瘘的临床疗效,探讨治疗高位肛瘘较为可靠有效的手术方法。 方法 选择2010年10月—2014年10月在淮南市第一人民医院治疗的高位复杂性肛瘘患者60例,采用数字表法随机分为2组,观察组(30例)采用切开挂线选择性缝合术治疗,对照组(30例)采用切开挂线治疗,比较2组治愈时间、治愈率、肛门功能评分及并发症发生情况。 结果 观察组治愈时间为(22±4) d,对照组治愈时间为(24±5) d,2组治愈时间比较差异有统计学意义(t=3.240,P＜0.01);观察组治愈率为96.7%,对照组治愈率为86.7%,2组治愈率比较差异有统计学意义(χ2=3.857,P＜0.05);观察组术后肛门功能评分为(4.8±1.2)分,对照组术后肛门功能评分为(6.8±1.3)分,2组术后肛门功能评分比较差异有统计学意义(t=2.671,P＜0.01);随访半年,对照组复发4例,观察组无复发,2组均无肛门失禁者。 结论 切开挂线选择性缝合术与切开挂线均可有效治疗高位复杂性肛瘘,与切开挂线比较,切开挂线选择性缝合术治疗高位肛瘘治愈时间短、治愈率高、肛门功能恢复好,是治疗高位肛瘘较好的手术方法之一。肛瘘管道切除缝合加肛瘘主管挂线法用于高位复杂性肛瘘的治疗可获得较好的效果。      

内口黏膜瓣推移修补瘘道部分剥除治疗高位肛瘘的疗效评价

【摘要】目的 探究内口黏膜瓣推移修补辅助瘘道部分剥除治疗高位肛瘘的临床疗效。方法 选取2015年1月～2016年7月我院收治的86例高位肛瘘患者,根据抽签法分为观察组和对照组,每组43例。观察组采取内口黏膜瓣推移修补辅助瘘道部分剥除术,对照组根据传统方式完成肛瘘切开挂线术。比较两组患者临床疗效,肛门直肠压力情况,肛门功能情况,术后疼痛情况,后遗症情况。结果 手术后,观察组临床总有效率和对照组比较差异无统计学意义（P＞0.05）。观察组肛管静息压、直肠静息压、肛管收缩压高于对照组（P＜0.05）。观察组的肛门功能主观评分、肛门指诊评分低于对照组（P＜0.05）。观察组的VAS评分低于对照组（P＜0.05）。观察组的肛门变形、肛门部分失禁、肛门潮湿并发症发生率低于对照组（P＜0.05）。结论 内口黏膜瓣推移修补辅助瘘道部分剥除治疗高位肛瘘,给患者带来的痛苦较轻,刺激反应小,有利于患者肛门功能的恢复,并发症发生率低,临床疗效良好。     

肛瘘切开联合肛门内外括约肌修补术治疗括约肌间瘘的疗效研究

目的观察肛瘘切开联合肛门内外括约肌修补术治疗括约肌间肛瘘的疗效。方法选取杭州市第三人民医院2020年1月1日至2021年6月30日接受手术治疗的300例括约肌间肛瘘患者为研究对象,其中采取肛瘘切开联合肛门内外括约肌修补术治疗150例,为观察组;单纯肛瘘切开150例,为对照组。比较两组患者手术情况、手术前后肛肠动力学指标以及随访半年后肛门失禁、锁孔畸形发生率及肛瘘复发率。结果与对照组比较,观察组患者创口愈合时间明显缩短（P＜0.05）;两组患者术中出血量、手术时间、疼痛评分、住院时间比较,差异均无统计学意义（均P＞0.05）。术前两组患者肛管静息压、肛管最大收缩压、肛管最长收缩时间比较,差异均无统计学意义（均P＞0.05）;术后对照组患者上述肛肠动力学指标均明显降低（均P＜0.05）,而观察组变化不明显（均P＞0.05）,其中观察组上述肛肠动力学指标均明显高于对照组（均P＜0.05）。与对照组比较,观察组患者肛门失禁、锁孔畸形发生率均明显降低（均P＜0.05）;两组患者肛瘘复发率比较,差异无统计学意义（P＞0.05）。结论肛瘘切开联合肛门内外括约肌修补术治疗括约肌间肛瘘的有效性及安全性均较好,可在临床推广应用。     

保留肛门括约肌治疗高位肛瘘

目的 :探讨高位肛瘘的治疗方法。方法 :采用内口扩大 ,内括约肌切开 ,主管挂线引流保留肛门括约肌方式治疗 14例高位肛瘘。结果 :13例患者一次治愈 ,1例需再次挂线而治愈 ,术后无肛门失禁 ,随访 1～ 2年 ,无复发。结论 :此术式能达到根治高位肛瘘 ,又有效保护肛门括约肌正常功能目的     

挂线引流法治疗高位肛管直肠周围脓肿的临床观察

目的：研究挂线引流法治疗高位肛管直肠周围脓肿的临床疗效及其对术后疼痛、肛管缺损和肛门功能评分的影响。方法：对高位肛管直肠周围脓肿采用挂线引流疗法和一次性切开挂线疗法进行治疗,分别观察两组的疗效、创面愈合时间、术后疼痛、肛管缺损、肛门功能评分。结果：试验组和对照组的近期治愈率均为100％,经半年以上随访,试验组远期治愈率为96．2％（25/26）,对照组远期治愈率为100％（23/23）,但两组间并无显著性差异（χ2＝0．004, P＞0．05）;试验组创面愈合时间为（24．20±1．97）d,对照组创面愈合时间为（26．20±2．30） d。试验组显著短于对照组（ t＝4．667, P ＜0．01）;术后试验组疼痛积分平均为1．94±0．71,对照组疼痛积分平均为2．72±0．81,试验组积分明显优于对照组（t＝5．118,P＜0．01）;术后试验组患者均未发现明显漏气漏液和肛管锁眼畸形,对照组有16例患者出现肛管锁眼畸形,两组间有显著性差异（χ2＝51．515, P＜0．01）;按照Wexner的肛门功能评分法对患者术后肛门功能进行了评价,试验组的肛门功能评分为0．56±0．50,对照组的肛门功能评分为1．34±0．63,以试验组的肛门功能为优（ t＝6．935,P＜0．01）。结论：挂线引流法治疗高位肛管直肠周围脓肿与一次性切开挂线术的临床治愈率、疗程相近,但在术后疼痛、术后肛管缺损、肛门功能评分方面较一次性切开挂线组为优。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.