Objective To investigate the clinical efficacy of sphincter preservation seton and fistula resection in the treatment of patients with complex anal fistula.Methods According to the stochastic indicator method, 96 patients with complex anal fistula admitted in department of anus bowel in our hospital from April 2013 to July 2015 were divided into control group and research group,48 patients in each group.The control group underwent tradi-tional fistula resection,while the research group underwent sphincter preservation seton surgery.The short -term and long -term efficacy,operation time,length of hospital stay,wound healing time,wound area and anal function were analyzed statistically.All patients were followed up more than half a year after surgery,and the incidence of complica-tions and the recurrence rate were recorded in detail.Results The short -term cure rate of two groups was 100.0%, with no statistical differences (P >0.05).While the long -term cure rate of the research group was 93.8%,which was significantly higher than 81.3% of the control group(χ2 =3.851,P =0.032).The operation time,length of hospital stay,wound healing time and wound area of the research group were significantly lower than the control group (t =4.417,6.496,2.693,3.944,P =0.025,0.017,0.041,0.028).Compared with before treatment,the anal func-tion scores of the two groups after treatment were significantly decreased(t =12.269,22.085,P =0.009,0.005),and the anal function score of the research group was significantly lower than the control group(t =3.155,P =0.035). The incidence rate of complications of the research group was 10.4%(5 /48),which was significantly lower than 22.9%(11 /48)of the control group(χ2 =4.510,P =0.044).Conclusion Compared with traditional fistula resec-tion,sphincter preservation seton has better long -term clinical efficacy in treatment of complex anal fistula,which can effectively improve the surgery indexes and prognosis,and significantly reduce the incidence of postoperative complica-tions.It is worth popularizing in clinic widely.

Objective To investigate whether pulse pressure variation (△PP) reflect the effects of PEEP and fluid resuscitation (FR) on hemodynamic effects.Methods Twenty critical patients with acute lung injury was ventilated with volume control (VT =8 mL/kg,Ti/Te = 1: 2) ,and PaCO2 was kept at 35 to 45 mm Hg.PEEP was setted as 5 cm H2O and 15 cm H2O in randomized order.Hemodynamic parameters including cardiac index, pulse pressure, central venous pressure, etc.were monitered by PiCCO system.Measurements were performed after the application of 5 cm H2O PEEP (PEEPs group)and 15 cm H2O PEEP (PEEP15 group) respectively.When the PEEP-induced decrease in cardiac index (CI) was > 10%, measurements were also performed after fluid resuscitation.Results Compared with PEEPs group, CI was decreased significantly in PEEP15 group(P < 0.05), and APP was increased significantly (P < 0.05).In 14 patients whose PEEP-induced decrease in CI was > 10%, fluid resuscitation increased CI from (3.01±0.57)L · min-1· m-1to (3.62±0.68)L · min-1 · m-2(P<0.01),and decreased △PP from (17±3)% to (10±2) % (P < 0.01).PEEP15-induced decrease in CI was correlated negatively with APP on PEEP5 (r =-0.91,P < 0.01) and with the PEEP15-induced increase in △PP (r =-0.79, P < 0.01).FR-induced changes in CI correlated with APP before FR (r = 0.96, P < 0.01) and with the FR-induced decrease in APP (r =-0.95, P < 0.01).Conclusions In ventilated patients with ALI, △PP may be a simple and useful parameter in predicting and assessing the hemodynamic effects of PEEP and FR.

Objective To explore the effect of 10％ and 25％ oral glucose on neonatal pain during blood sampling through radial artery.Methods 90 newborns were randomly divided into group A,B and C,each group with 30 cases.2 min before the blood sampling,group A was offered 2ml 10％ oral glucose,group B was offered 2ml 25％ oral glucose,and group C was offered 2ml plain boiled water by oral intake.Pain was evaluated based on Neonatal Facial Coding System (NFCS),Neonatal Infant Pain Scale(NIPS),raise of heart rate and crying cases.Results The scores of NIPS during puncture,the scores of NFCS and NIPS after puncture,the raise of heart rate and crying cases were significantly different between three groups.Group B were lower than group A and group C,while differences between group A and group C had no statistical significance.Conclusions During blood sampling through radial artery,offering newboms 2ml 25％ oral glucose can reduce the pain,while 2ml 10％ oral glucose was ineffective.

Objective To investigate the effects of congenital ptosis on refractive power of the corneal surface.Methods Forty-five patients (90 eyes) with congenital ptosis in the First Affiliated Hospital of Kunming Medical University were examined from October 2013 to June 2015.Corneal topographic analysis was performed in both the ptosis and the normal eyes.The comparison between the ptotic eye and the normal eye was done according to the topographic results.Results Among 90 eyes,55 were ptotic and 35 were normal.Amblyopia was detected in 21 ptotic eyes (38.2％).No correlation was found between amblyopia and the severity of ptosis (x 2=2.617,P＞0.05).Ptotic eye showed an asymmetrical bow tie pattern (23 eyes) and an irregular pattern (32 eyes) on corneal photography and the maximum refractive power occurred at the inferior quadrant of the corneal horizontal axis.Difference value of the average refractive power of the cornea between lower side and upper side in ptotic eyes was higher than that of the normal eyes at 5mm and 7mm diameter areas (P＜0.01) except for 3mm diameter area (P＞ 0.05).Conclusion Congenital ptosis may lead to the change of refractive power of the local corneal surface.Amblyopia has no correlation with the severity of ptosis.

Objective To investigate clinical features of lower motor neuron lesion (LMNL) caused by the single level lower thoracic disc protrusion (LTDP),and to observe clinical outcomes of surgical treatment.Methods Between January 1997 and December 2009,17 patients with LMNL caused by single level LTDP underwent en bloc resection of the superior articular process,Cave-in 360° circumferential decompression and internal fixation in our hospital.MRI and CT scans were taken to confirm lesion levels:T10-11 in 4 patients of whom 3 had patellar clonus and ankle clonus,T11-12 in 5 patients of whom 4 had ankle clonus,and T12L1 in 8 patients who only had positive Babinski sign.The neurologic status was assessed using the Japanese Orthopaedic Association (JOA) scoring system.The muscle strength of the tibialis anterior was assessed using the Manual Muscle Test (MMT).Sagittal Cobb angle and cross-sectional area of the dural sac at the level of maximal compression in MRI were also observed.Results All patients were followed up for 22 to 76 months (average,48.6 months).The mean JOA score increased from preoperative 5.88±1.11 to 9.53±0.94 at final follow-up (t=16.143,P＜0.05).The muscle strength of the tibialis anterior recovered to more than grade 4 in all patients.Postoperative Cobb angle was unchanged compared with that before operation.MRI indicated that the cross-sectional area of the dural sac at the level of maximum compression increased from preoperative 35.8±7.3 mm2 to postoperative 132.9±6.5 mm2 (t=70.78,P＜0.05).Conclusion LMNL can be caused by LTDP.The eu bloc resection of the superior articular process,Cave-in 360° circumferential decompression and internal fixation can provide a satisfactory decompression effect and marked recovery of neurological function.

Objective To determine the efficiency of microwave heating of the conjunctival sac flushing liquid combined with disposible blood transfusion device to prepare for laser-assisted in situ keratomileusis (LASIK).Methods A total of 150 healthy myopia patients undergoing LASIK in Myopia Treatment Center of our hospital from February to August 2013 were divided into two groups randomly according to operation date,75 patients in each group.The observation group used a microwave oven to heat the flushing liquid connected with a disposable blood transfusion device.The control group used a hot water bath to heat the flushing liquid,which was then connected to a disposable infusion device.The heated liquid by both methods was applied to conjunctival sac flushing before LASIK.The time required for liquid heating was recorded and the outcome of the conjunctival sac flushing was compared between the two groups.Results The time required by the observation group and the control group of heating flushing fluid from 5,10,15,20,25 and 30 ℃ to (36.0±1.0) ℃ was 124,104,84,64,44,24 s and 372,312,252,192,132,72 s,respectively.The conjunctival sac flushing effect comparison between the observation group and the control group was as follows:in four indicators such as the operation cooperation,conjunctiva congestion,spasm of eyelid,eye pain,there was no significant difference between two groups; for tear fat deposition,there was significant difference between two groups (4 cases vs.15 cases,x2=7.292,P ＜ 0.01).Conclusions Microwave heating of the conjunctival sac flushing liquid connected with a disposable blood transfusion device is efficient,safe and easy to operate.Therefore,it gains approvement and high opinion of medical workers and is worth being popularized in clinic.

Objective:To analyse ZHOU Zhong-ying’effective combination drugs in preventing and treating the systemic lupus erythematosus(SLE).Methods:Association rules based on Chi-squared analysis and influence degree was used.Results:73 Rules of TCM couples were selected in the high frequency drugs distribution,and the drugs were mainly those for heat clearing,antidote medicines and blood act stasis remove medicines,which was in accordance with the main pathological mechanism factor for SLE given by Professor Zhou.Conclusion:The new method could find out many significant TCM couples in the study of the compatibility of TCM.

Hand-foot-mouth disease (HFMD) is an acute infectious disease caused by various enteroviruses. Recently, large HFMD outbreaks caused by enterovirus type 71 (EV71) have been frequently reported in China, posing great threats on children's health. There is no specific antiviral therapy for severe HFMD, and patient management mainly depends on supportive and symptomatic treatment. Intravenous immunoglobulin (IVIG) is a pharmaceutical preparation of human IgG that is pooled from thousands of healthy blood donors, and contained neutralization antibodies against various enteroviruses, including EV71. IVIG therapy should be carefully administrated for severe HFMD considering its role on passive immunization against EV71 and immune regulation.
Antibodies, Neutralizing ; immunology ; therapeutic use ; Antibodies, Viral ; immunology ; therapeutic use ; Enterovirus A, Human ; immunology ; Hand, Foot and Mouth Disease ; therapy ; virology ; Humans ; Immunization, Passive ; Immunoglobulins, Intravenous ; immunology ; therapeutic use

Objective: To measure the body mass index (BMI) of secondary school students and analyze its association with the physical fitness index, so as to improve the physical health of middle school students. Methods: Using a randomized cluster stratified sampling method, 3 813 secondary school students from six cities (Ganzhou, Ji an, Fuzhou, Nanchang, Shangrao and Jiujiang) in Jiangxi Province, China, were selected in September 2022. Questionnaire survey was administered to obtain basic information and to assess the nutritional status and physical fitness tests were conducted among secondary school students. The study was stratified by gender and age, and the Kruskal Wallis H test was used to compare the differences in the mean values of grip strength, sit-ups, standing long jump performance and strength quality among secondary school students with different BMI levels, while the correlation between BMI and strength quality index was inferred by using curve regression analysis. Results: There was statistical significance in the strength quality index of middle school students with different BMI level ( H=56.79, 8.84, P <0.05). Except 13 years old group, the difference of physical fitness by BMI grade strength quality index of boys in other age groups was statistically significant ( H =22.21, 16.23, 17.98, 18.21, 8.08), while the difference of physical fitness by BMI of girls at 14 years old was statistically significant ( H =9.11)( P <0.05). The curve fitting using regression showed that the physical fitness index and BMI of middle school students (boys and girls) show an inverted U-shaped curve. The physical fitness index was higher in the middle region of BMI ( Z-score) and lower in the two end regions, while showing a decreasing trend from the middle to the two ends. Conclusion An association is found between BMI and physical fitness among secondary school students in Jiangxi Province, and wasting and overweight/obesity are negatively correlated with physical fitness. Greater attention should be paid to the nutritional status of secondary school students to ensure the normal development of physical fitness.

Objective To compare the trigger delay and work of trigger between neurally adjusted ventilatory assist (NAVA) and pressure support ventilation (PSV) in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients with intrinsic positive end-expiratory pressure (PEEP) during mechanical ventilation. Methods AECOPD patients with intrinsic PEEP (PEEPi) greater than or equal to 3 cmH2O (1 cmH2O=0.098 kPa) were enrolled during invasive mechanical ventilation. Subjects were ventilated with low, medium and high pressure under either NAVA or PSV mode. Servo Tracker software continuously recorded the waveform of ventilator and respiratory mechanics indexes (including respiratory frequency, inspiratory tidal volume (Vti), minute ventilation volume (VE), peak airway pressure (PIP), inspiratory time), and calculated trigger and expiratory conversion delay time, work of trigger and total work of breath. Results A total of 14 AECOPD patients were enrolled with the average PEEPi (4.3±1.3) cmH2O. PSV inspiratory trigger delay time was positively correlated with PEEPi (r=0.913, P<0.05). Compared with PSV, NAVA significantly decreased trigger delay time in low, medium and high pressure level groups [(48±17) ms vs. (167±86) ms, (63±65) ms vs. (247±240) ms, (63±49) ms vs. (342±192) ms,respectively all P<0.05]. Similar results were shown as to work of trigger [(0.92±0.36) μV?s vs. (1.22±0.70) μV?s, (1.08±0.51) μV?s vs. (1.62 ± 1.25) μV?s, (1.20 ± 0.96) μV?s vs. (2.29 ± 1.02) μV?s, all P<0.05]. Trigger delay time increased according to the increase of pressure level in PSV mode.Conclusion The presence of PEEPi in AECOPD patients leads to obvious trigger delay under PSV mode, which is positively correlated with PEEPi level. NAVA significantly reduces trigger delay time and work of trigger compared with PSV mode.