Objective To study the value of preoperative MRI in diagnosing and typing anal fistula.Methods The clinical data and MRI findings of 36 operated patients with anal fistula were analyzed retrospectively, and compared with pathological results of the operations, the manifestation and application value of MRI in anal fistula were summarized.Results 36 cases of anal fistula showed 42 internal openings,45 primary tracts,15 small tracts,42 external openings,16 abscesses.Compared with surgical results, the accuracy of MRI was 90.5%(38/42) for internal openings,80%(12/15) for small tracts,100% for primary tracts, external openings and abscesses respectively.According to the Parks type, the coincidence of MRI classification was 88.9%(32/36).Conclusion MRI can accurately display the position of the internal and external openings, the number and form of the tracts, and type about anal fistula.

Aim To establish in vitro blood-brain barrier (BBB) model with characteristics of simulation of in vivo BBB by primi-tive co-culture of brain-microvessel endothelial cells (BMECs) with brain-microvessel pericytes (BMPC)and astrocytes (AS). Methods BMECs,BMPC and AS from SD rats were primitively isolated,purified and cultured,and then primitive culture cells were identified by cellular morphological and immunocytochemi-cal staining methods.Five types of in vitro BBB models were es-tablished by using Millicell culture insert (pore diameter 0.4μm)and their barrier functions were evaluated by detection of transendothelial electrical resistance (TEER),permeability of sodium fluorescent (Na-FLU ),expression of alkaline phospha-tase (AKP)and γ-glutamyl transpeptidase (γ-GT1 ),and simi-larity of permeation amount for positive drugs in vitro and in vivo BBB conditions.Results Primitive culture of BMECs presented typical pebbles-like structure,BMPC presented larger soma with branching property,AS presented slender synapse and shallower cytoplasm.Moreover,immunocytochemical staining results iden-tified primitive cells were targeted cells.TEER value for co-cul-ture of BMECs,BMPC and AS reached (478 ±25 )Ω· cm2 , permeability coefficients (Papp )value of Na-FLU was [(8.23 ± 0.78) ×10 -6 ]cm·s-1 ,expression of AKP and γ-GT1 were (6.90 ±0.27 )King unit · g-1 Pro and (4.39 ±0.32 )μg · g-1 Pro respectively.Moreover,good correlation could be found in Papp for positive controls in vitro and in vivo BBB models (R2=0.92).Conclusion The established in vitro BBB model by using primitive co-culture of BMECs with BMPC and AS posses-ses in vivo BBB properties in cell morphology,structures and barrier functions,and can be used as a powerful tool for studying physiology,pathology of BBB and screening candidate com-pounds.

Objective To investigate the impact of genetic and environmental factors on mental health status in adolescents twins. Methods A total of 52 pairs of twins aged 11 years were recruited with support from educational committees and school. After the guardians of these twins had signed an informed consent form,the Chinese version growth and the state of health evaluation (Development and Well-Bing Assessment,DAWBA) carries on twins' mental health growth condition investigation to the twins of Age greater than 11-year-old,and focus on a-nalysis of DAWBA youth-assessment version of more than 11-year-old twins. Buccal mucosa samples were collected from all twins for DNA extraction and zygosity identification test. Results The mood, the behavior symptom and the symptom produced the influence of the DAWBA and in the computer diagnosis' s result showed that the intra-pair correlation coefficience of the emotional disorder(rMZ=0, 200, P = 0. 28; r DZ = 0. 198, P = 0. 447) (MZ means was monozygotic,DZ means was dizygotie, r means was correlation), the special phobia symptom(r MZ = 0.440, P = 0.013;rDZ =0.419, P=0.094),the social phobia (rMZ =0.2%, P = 0. 106; r DZ = -0.119, P = 0.648),the depressive symptom (rMZ =0.556, P=0.001; rDZ = -0.254, P=0.325), and the oppositional/con-duct disorder(rMZ =0.503, P = 0.014; rDZ = -0.270, P = 0.295),eating disorder(r MZ =0.764, P=0.046; rDZ = -0.091, P=0.728) in Monozygotic twins was more remarkable than that in dizygotie twin. Conclusion The genetic factors play the vital role in affects in the child twins' mental health growth.

ObjectiveTo study the early diagnosis and prevention of fungal infection in severe acute pancreatitis(SAP). Method 1.SAP patients from July 1998 to June 2002 were prospectively randomized into 3 groups: garlicin prevention group, fluconazole (low dosage) prevention group and control group, the incidence of fungal infection in SAP was compared between the groups. For fungal infection patients, the fungal clearance and mortality rate were observed. 2.Clinical data of SAP patients with fungal infection and with simple bacterial infection was compared by multivariate logistic regression, and clinical characters and risk factors of fungal infection were evaluated. Results 1.There were lower incidences of fungal infection in garlicin group (16% vs. 30%,P

Objective:To investigate the effect of different solutions to prevent nasal intestinal blockage.Methods:Tottaly 199 cases of enteral nutrition treatment were selected from June 2018 to May 2019 and were randomly divided into three groups: warm boiled water group (67 cases), sugar-free cola group (67 cases), alpha-chymotrypsin group (65 cases). The rate of nasointestinal obstruction, the rate of nasointestinal obstruction, the rate of catheter patency maintenance, the rate of recanalization and the incidence of complications in three different enteral nutrition treatment cycles (< 7 days, 7-29 days, ≥ 30 days) were compared.Results:The catheter blockage rate in warm boiled water group was 20.9%(14/67) and in sugar-free cola group was 3.0%(2/67). The patency maintenance time in warm boiled water group was (8.83±1.84)days and in sugar-free cola group was (9.92±1.63) days ( t value was 2.182). The recanalization rate after blockage in warm boiled water group was 21.4%(3/14) and in sugar-free cola group was 100.0%( χ 2 value was 5.021, P < 0.05). The catheter blockage rate in sugar-free cola group was significantly lower than that in warm boiled water group, the catheter maintenance time and recanalization rate after blockage were significantly higher than that in warm boiled water group, the difference was significant ( P < 0.05). There was no significant difference between sugar-free cola group and alpha-chymotrypsin group in catheter blockage rate, catheter blockage rate, recanalization rate after blockage and incidence of complications( P > 0.05). The catheter blockage rate was 0 in patients with enteral nutrition treatment cycle < 7 days. The catheter blockage rate was 11.9%(8/67) (warm boiled water group) , 1.5%(8/67) (sugar-free cola group) and 1.5%(8/67) (alpha-chymotrypsin group) in patients with enteral nutrition treatment cycle 7-29 days. The catheter blockage rate was 9.0%(6/67) (warm boiled water group), 1.5%(1/65, sugar-free cola group) and 3.1%(2/67)(alpha-chymotrypsin group) in patients with enteral nutrition treatment cycle >30 days. The catheter blockage rate in sugar-free cola group and alpha-chymotrypsin group was significantly lower than that in warm boiled water group ( χ 2 values were 4.325-5.836, P<0.05) and there was no significant differences between the sugar-free cola group and the alpha-chymotrypsin group ( P>0.05). Conclusion:Sugar-free cola and alpha-chymotrypsin can effectively reduce the incidence of catheter blockage and complications, prolong the catheter patency and improve the recanalization rate after blockage, especially for patients with enteral nutrition treatment cycle longer than one week.

Objective To determine the prevention and therapy of fungal infection in patients with severe acute pancreatitis (SAP). Methods Seventy patients with SAP admitted from July,1998 to June,2002 were randomly divided into 3 groups: garlicin prevention group, fluconazole (low dosage) prevention group and control group.The incidence of fungal infection, the fungal clearance and mortality after the treatment were compared. Results The incidence of fungal infection in garlicin group and fluconazole group was lower than that in control group. (16%∶30%,P

Objective:To explore the feasibility of the newly developed micro‐irrigation tube in the application to fistula complicated with empyema after esophagectomy .Methods:From Jan 2012 to Dec 2014 ,5 patients with fistula complicated with empyema after esophagectomy ,admitted in Zhongshan Hospital ,Fudan University ,accepted the therapy with a new type of micro‐irrigation tube .Among them ,4 patients were male and the other 1 was female .Three patients accepted left transthoracic esophagectomy and the other 2 underwent right thoracoabdominal esophagectom .Four patients got anastomotic stoma fistula , and the other 1 patient got stump fistula .The micro‐irrigation tube was composed of anesthesia epidural catheter ,double pipe joint and bottle water seal joint .Along the chest dralnage tube ,the micro‐irrigation tube was placed into the empyema cavity . Results:There was no serious adverse reaction except for the symptoms of cough and acid reflux in 2 patients .All the 5 patients were discharged smoothly with fistula healed and chest tube drawn .Conclusions:The application of micro‐irrigation tube in fistula complicated with empyema after esophagectomy is safe and feasible .