Objective To investigate the clinical efficacy of ligation of intersphincteric fistula tract (LIFT) for the treatment of high anal fistula.Methods The clinical data of 77 patients with high anal fistula who were admitted to the Puren Hospital and Chaoyang Hospital from January 2011 to June 2012 were retrospectively analyzed.All the patients were treated using the LIFT method (LIFT group,37 patients) or fistulectomy + threaddrawing therapy (thread-drawing group,40 patients).The operation time,healing time,time and severity of postoperative pain,recurrence and anal sphincter dysfunction were compared between the 2 groups.The measurement data,the count data and the rank data were analyzed using the t test,chi-square test,and the rank sum test,respectively.Results The operation time of the LIFT group and the thread-drawing group were (21.4 ± 2.0) minutes and (20.6 ± 1.9) minutes,with no significant difference between the 2 groups (t =1.911,P ＞ 0.05).In the LIFT group,17 patients felt low-grade pain,no patient felt medium-grade or severe pain.In the thread-drawing group,7 patients felt low-grade pain,14 patients felt medium-grade pain,19 patients felt severe pain.The duration of postoperative pain in the LIFT group and the thread-drawing group were (3.0 ± 1.3) days and (14.1 ± 1.5)days,respectively.The severity and duration of postoperative pain of the LIFT group were significant lower and shorter than those of the thread-drawing group (u =-7.189,t =34.534,P ＜ 0.05).The healing time,anal scar area and anal sphincter function score were (26.0 ± 1.9) days,(1.24 ± 0.20) cm2 and 1 in the LIFT group,and (40.7 ± 2.8) days,(2.64 ± 0.25) cm2 and 4 in the thread-drawing group,with no significant difference between the 2 groups (t =26.574,26.868,Z =-7.513,P ＜ 0.05).The effective rate of the 2 treatment methods were 100％.The cure rate and recurrence rate were 51.4％ (19/37) and 5.4％ (2/37) in the LIFT group,and 42.5％ (17/40) and 2.5％ (1/40) in the thread-drawing group.There were no significant differences in the cure rate and recurrence rate between the 2 groups (x2=0.605,0.433,P ＞ 0.05).Conclusion LIFF method has higher cure rate for high anal fistula with short time of postoperative pain and healing,good anal sphincter function and low recurrence rate.

Objective:To study the feasibility of a new composite mineralized collagen membrane in alveolar ridge preservation.Methods:The third mandibular premolars on both sides were extracted from 12 dogs,the 24 alveolar sockets were randomly assigned into A,B and C groups(n =8).The distal alveolar sockets of group A was immediately implanted with the new composite mineralized collagen membrane and bone graft material,those of group B with bone graft material,group C was the blank control.The healing of sockets was evaluated by gross observation,morphological measurements,X-ray microscope and photographs of spiral CT.Results:The horizontal width of the alveolar process of group A was bigger than that of group B (P ＜ 0.05),that of group B was bigger than that of group C (P ＜ 0.05).The region of extraction interest in spiral CT value was higher in group A than that in group B and C (P ＜ 0.05).The extraction sockets were generated new bone and the degree of reconstruction measurements was higher in group A than that in group B and C (P ＜ 0.05).Conclusion:The new composite mineralized collagen membrane can induce the regeneration of new bone,and preserve the alveolar.

Objective To investigate the expression variation of kidney OATP-3 in rats relating to rocuronium metabolism in anhepatic phase and to primarily explain the reason of extrahepatic metabolism characters of rocuronium. Methods Twelve rats were distributed to 2 groups randomly with 6 in each: Group A (control group) and Group B in which the hepatic portal devascularization was performed for 60 min. Kidney tissues of the rats were taken. oatp-3 mRNA was detected by RT-PCR and OATP-3 protein by Western blotting. Results The expression levels of kidney OATP-3 mRNA and protein in Group B were significantly higher than those in Group A(P

Objective: To observe the short-term effects of electroacupuncture at different acupoints on patients with hemiplegia after cerebral infarction. Methods: Patients with cerebral infarction were randomly allocated into a group of electroacupuncture nerve trunk and a group nerve trunk or routine acupoints, respectively, once a day, for 14 d. Results: Electroacupuncture at nerve trunk had better effects than at routine acupoints. The short-term improvement of electroencephalogram had significant differences (P＜0.05). Conclusion: Electroacupuncture at the nerve trunk could improve the neurologic impairment and brain function, and it has a better result than routine electroacupuncture.

Objective To understand the air microorganisms pollution and the community structure and distribution characteristics of outdoor airborne microbes in Xi'an in autumn.Methods Airborne microbes were sampled by fallen plates method in autumn,2006 in Xi'an at three typical sites,factories region,garden greenbelt region and main traffic region.Results The results showed that the total concentration of airborne microbes at the factories region and garden greenbelt region,main traffic region was 2 500 cfu/m~3,1 354 cfu/m~3 and 4 404 cfu/m~3 respectively.Bacteria and fungal genus were predominant.Gram positive bacteria were much more than Gram negative bacteria.There were 20 genera of bacteria and 8 fungal genus were detected. Micrococcui,Bacillus,Staphylococcus and Pseudornonus were predominant.The most frequently isolated fungal genus were Penicillium,Paecilomces,Cladosporium and Nonsporulatiny mycelia.The community structure of airborne fungal genus and the dominant genus in different function region was significantly different.The distribution characteristic of airborne microbe concentration in different function region was different.The concentration of airborne bacteria was significantly lower in garden greenbelt region than factories region and main traffic region,whereas the concentration of airborne fungi in garden greenbelt region was higher than that in factories region and main traffic region.Conclusion The distribution of the airbome microbes shows a characteristic of time and space,it is affected not only by the environment and pollution,but also by the other factors such as human activities,animals and plants.

It is particularly important to confirm that whether subjects were repeated to participate in the clinical trial, the time interval from the last dose in the recent clinical trial, whether the physical conditions of subjects accord with the clinical trial protocol in phase I clinical trials and so on.This paper will introduce two types of the subject database, one was established by our hospital, another one is subject networking database, and will introduce the operation mode, the present situation of subjects screening under the database management. To explore the existing problems, optimize the use of subject database and give long-term prospects of subject networking database.

Objective To summarize the clinical presentations, the findings of lab tests and procedures and the genetic investigation of collagen type Ⅵ related myopathy, and to help clinicians recognize and diagnose this rare disease.Methods Seven familiar or spontaneous collagen type Ⅵ related myopathy patients diagnosed by gene detection were analyzed.We emphasized on the features of clinical manifestations, serum creatine kinase level, electromyography, lower-limb muscle MRI, muscle biopsy and correlation between genotype and pZenotype.Results Among 7 patients, 3 were caused by COL6A1 mutation, 1 was caused by COL6A2 mutation and 3 were caused by COL6A3 mutation.Two patients were familiar wZile 5 were spontaneous.HigZligZted clinical presentations were proximal weakness in lower limbs and joint contrature.Serum creatine kinase level was sligZtly elevated.ElectromyograpZy sZowed sligZt myogenic damage.Muscle MRI of tZigZ sZowed distinct pattern of muscle involvement.Muscle patZology revealed dystropZic myogenic cZanges with proliferation of connective tissue between muscle fibers.Conclusions Neurologists should recognize the features of collagen type Ⅵ related myopathy, such as progressive weakness, early-onset joint contraetures, slightly elevated serum creatine kinase and selective muscle involvement on leg MRI scan, and then perform next-generation sequencing based genetic test on suspected patients.This approach would improve the diagnostic rate of the disease.

OBJECTIVETo discuss the treatment and diagnosis of congenital median perineal cleft in children.

METHODSBetween January 2009 to February 2013, 7 cases were diagnosed as congenital median perineal cleft according to the symptoms. Among them, 4 cases underwent surgery to correct cleft with double triangular perineal flaps. The other 3 cases with minor cleft did not receive surgery management.

RESULTSThere is an median cleft from the perineum to the anus with mucosa on the cleft surface. Primary healing was achieved in all the four patients with satisfactory appearance. The patients were followed up for 1-4 years with almost normal perineal appearance.

CONCLUSIONSCongenital perineal median cleft can be diagnosed according to the symptoms. Double triangular perineal flaps can be effectively correct the cleft to attain normal perineal appearance.

Adolescent ; Anal Canal ; Child ; Humans ; Perineum ; abnormalities ; surgery ; Surgical Flaps ; Treatment Outcome ; Wound Healing

OBJECTIVETo investigate the diagnosis and treatment of hypotelorism.

METHODSFrom Jan. 2000 to Jan. 2014, 6 cases with hypotelorism were retrospectively studied. Among them, 3 cases had craniosynostosis, 2 had holoprosencephaly, and 1 had cleft lip. All the cases were diagnosed and treated by bone graft or spring distraction to correct the hypotelorism.

RESULTS2 cases were treated by none graft and 4 cases were treated by external spring distraction. All the patients completed the treatment successfully with obvious improvement in appearance. No complication happened. 4 cases were followed up for 2 years with an average fronto-orbital axis angle as (50 ± 8) °.

CONCLUSIONSHypotelorism can be successfully corrected by bone graft as fronto-orbital bridge or spring distraction.

Bone Transplantation ; Cleft Lip ; Craniofacial Dysostosis ; diagnosis ; surgery ; Craniosynostoses ; complications ; Humans ; Osteogenesis, Distraction ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo investigate the clinical results of external fixation and AO titanium elastic intramedullary nailing for treatment of tibia-fibula comminuted closed fractures.

METHODSFrom June 2010 to June 2012,58 patients with tibia-fibula comminuted closed fractures were treated with external fixation and AO titanium elastic intramedullary nailing, including 31 males and 27 females with an average age of 38.5 years old ranging from 21 to 57 years old. According to the system of AO Classification, the fractures were classified as type B1 in 9 cases,type B2 in 7 cases, type B3 in 10 cases, type Cl in 14 cases, type C2 in 12 cases,and type C3 in 6 cases. According to the system of Winquist-Hanson,the fractures' comminuted were classified as grade 1 in 23 cases, grade 2 in 17 cases, grade 3 in 12 cases, and grade 4 in 6 cases. According to the system of Johner-Wruhs, clinical results were compared between different type and grade groups by the time of last followed-up.

RESULTSAll 58 patients were followed up with an average time of 6.8 months (ranged from 18 to 36 weeks). All fractures had clinical healing with an average time of 28 weeks (ranged from 24 to 32 weeks). The total rate of good to excellent results was 91.4%. The rate of good to excellent in the group of grade 1 was higher than that of other grades. The complication rates and fracture healing time would increase respectively with higher Winquist-Hanson's grade. The complication rates in the group of type C3 was higher than that of other types, but the rate of good to excellent was lower than that of other types. The complication rates in the group of type B1 was lower than that of other types,but the rate of good to excellent was higher than that of other types.

CONCLUSIONMinimal invasiveusing AO titanium elastic intramedullary nailing combined with external fixation for treatment of tibia-fibula fractures especially for the multiple-segment,long spiral mild-to-moderate comminuted with hidden fracture can get satisfactory reduction and reliable fixation,it conformes to the principle of BO completely, protects the fracture end blood supply,reduces the external fixation time, has less skin soft tissue complications, postoperative function recovered satisfactorily.

Adult ; Bone Nails ; Bone Plates ; External Fixators ; Female ; Fibula ; injuries ; surgery ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Fractures, Closed ; surgery ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Tibia ; injuries ; surgery ; Young Adult