Objective To assess the efficacy and safety of modified ligation of the intersphincteric fistula tract (LIFT) for low anal fistula.Methods We follow-up visited 20 patients with low anal fistula underwent modified LIFT procedures (Since the outer edge shape of anal fistula incision fistula and the branch into the intersphincteric groove,proximal lateral internal sphincterotomy ligation.The wound was closed to the whole layer of closed suture after removal of the pipe wall).Median follow-up duration was 10(range 3-15) months.To compile statistics on the wound healing time,the clinical healing rate,the recurrence rate and the fecal incontinence score (Wexner score) of those patients.Results The wound healing time was (15.3 ± 4.8) d.The prime success rate of fistula healing was 75 ％ (15/20) after the modified LIFT procedure.2 cases of low complex anal fistula presented with wound infection,and 3 cases (including 1 cases of simple low anal fistula,2 cases of low complex anal fistula)had fistula with infection.They were cured after appropriate treatment.During follow-up of 3 to 15 (median 10)months,1 cases of simple low anal fistula recurred in third months after surgery.To the end of the follow-up,the total clinical healing rate was 95％ (19/20),of which 12 cases of low complex anal fistula total cure rate was 100％ (12/12).Preoperative fecal incontinence scores (Wexner score)were all 0 points.At the final follow-up,18 (90％)cases of fecal incontinence score were 0 points,1 (5 ％) cases were 2 points and 1 (5 ％) cases were 1 points.Conclusion Modified LIFT is better balance the relationship between cure rate and anal function.The sphincter preservation is complete.The fistula is thoroughly cleared.The cure rate is high.The recurrence rate is low.Does not cause anal defects and deformities.It has little influence on the function of anal control,the operation is simple,and it is suitable to be popularized.

OBJECTIVE: Explore the affecting factors of mentally prisoner's competency to serve a sentence (CSS), establish the base of quantitative study of CSS. METHODS: Firstly, the researchers compile a questionnaire named legal-psycho ability of competency to serve a sentence questionnaire, then the researchers scaling the object with RTHD, and ask all object complete the questionnaire. there a hypothesis, that the object who are cured in cured ward is incompetent to serve a sentence (ISS), and the other who are stay in rehabilitated ward is competent to serve a sentence (CSS). RESULTS: There are 185 object admitted the study, the ISS group the CSS group have significance between psychiatric and legal aspects. CONCLUSION At the influence of psychiatric symptoms, the mentally prisoner's competency to serve a sentence had been impaired, and they should been transferred from prison to hospital.
Adult ; Expert Testimony/standards* ; Female ; Forensic Psychiatry ; Humans ; Male ; Mental Competency ; Mental Disorders/psychology* ; Mentally Ill Persons/psychology* ; Middle Aged ; Prisoners/psychology* ; Surveys and Questionnaires

Objective To study the effects of modified ligation of intersphincteric fistula tract (LITF)for low anal fistula.Methods A total of 40 consecutives were divided randomly into experiment and control groups(each 20 cases).The patients in experiment group received modified LITF and patients in control group adopted traditional anal fistula resection,then to compare the effects.Results The wound healing time in experiment group[(17.8 ± 4.5)d]was shorter than that in control group[(24.7 ± 5.8) d](P<0.05);the duration of pain in experiment group[(6.9 ± 1.5)d]was longer than that in control group[(4.0 ± 1.3)d](P<0.05);the postoperative anal function score in experiment group(3.7 ± 2.5)was better than that in control group(3.7 ± 2.5)(P<0.05).There were no significant differences in cure rate,pain at first day after operation and recurrence rate between two groups(P>0.05).Conclu-sion It is more effective,less injury,less pain,shorter course,less recurrence and better anal function of modified LITF.