Objective:To compare the clinical efficacies of seton sequential treatment with different drugs for perianal fistula of active Crohn′s disease (CD) .Methods:Clinical data of 42 active CD patients with anal fistula undergoing seton sequential treatment in Suzhou Hospital of Traditional Chinese Medicine and Suzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2017 to December 2018 were retrospectively analyzed. According to seton sequential drugs, patients were divided into IFX group ( n = 11) , azathioprine group ( n = 14) and mesalazine group ( n = 17) . The pre- and post-operative symptoms, laboratory tests, disease activity indexes (CDAI and PDAI) , anal self-control (Wexner) score were compared among 3 groups. Results:Forty-two patients were followed up with a median time of 24 months (12-34 months) . The proportions of healing and effectiveness of anal fistula patients were 90.9%, 71.4% and 35.3% in the IFX group, azathioprine group and mesalazine group respectively. There was a significant difference in anal fistula healing among 3 groups ( P = 0.020) . The CDAI scores after treatment in IFX group, azathioprine group and mesalazine group were lower than those scores before treatment [ (96.66 ± 51.23) points vs (170.12 ± 52.67) points, (142.11 ± 79.68) points vs (196.82 ± 81.10) points, (179.91 ± 42.06) points vs (208.02 ± 42.60) points, all P<0.05]. There was a significant general difference in CDAI score among the 3 groups ( P = 0.005) . And the CDAI score after treatment in mesalazine group was obviously higher than that in IFX group ( P<0.05) . The PDAI scores after treatment in IFX group and azathioprine group were lower than those scores before treatment [ (1.71 ± 0.91) points vs (9.91 ± 3.53) points, (3.81 ± 2.40) points vs (10.07 ± 2.67) points, both P<0.05]. There was a significant general difference in PDAI score among IFX group, azathioprine group and mesalazine group [ (1.71 ± 0.91) points vs (3.81 ± 2.40) points vs (10.45 ± 2.84) points, P<0.001] and the PDAI scores after treatment gradually increased (all P<0.05) . Conclusions:Seton sequential treatment with drug is an effective method for the treatment of perianal fistula of active Crohn′s disease. IFX and azathioprine are suitable for the choice of sequential drugs.

Objective:To compare the clinical efficacies of seton sequential treatment with different drugs for perianal fistula of active Crohn′s disease (CD) .Methods:Clinical data of 42 active CD patients with anal fistula undergoing seton sequential treatment in Suzhou Hospital of Traditional Chinese Medicine and Suzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2017 to December 2018 were retrospectively analyzed. According to seton sequential drugs, patients were divided into IFX group ( n = 11) , azathioprine group ( n = 14) and mesalazine group ( n = 17) . The pre- and post-operative symptoms, laboratory tests, disease activity indexes (CDAI and PDAI) , anal self-control (Wexner) score were compared among 3 groups. Results:Forty-two patients were followed up with a median time of 24 months (12-34 months) . The proportions of healing and effectiveness of anal fistula patients were 90.9%, 71.4% and 35.3% in the IFX group, azathioprine group and mesalazine group respectively. There was a significant difference in anal fistula healing among 3 groups ( P = 0.020) . The CDAI scores after treatment in IFX group, azathioprine group and mesalazine group were lower than those scores before treatment [ (96.66 ± 51.23) points vs (170.12 ± 52.67) points, (142.11 ± 79.68) points vs (196.82 ± 81.10) points, (179.91 ± 42.06) points vs (208.02 ± 42.60) points, all P<0.05]. There was a significant general difference in CDAI score among the 3 groups ( P = 0.005) . And the CDAI score after treatment in mesalazine group was obviously higher than that in IFX group ( P<0.05) . The PDAI scores after treatment in IFX group and azathioprine group were lower than those scores before treatment [ (1.71 ± 0.91) points vs (9.91 ± 3.53) points, (3.81 ± 2.40) points vs (10.07 ± 2.67) points, both P<0.05]. There was a significant general difference in PDAI score among IFX group, azathioprine group and mesalazine group [ (1.71 ± 0.91) points vs (3.81 ± 2.40) points vs (10.45 ± 2.84) points, P<0.001] and the PDAI scores after treatment gradually increased (all P<0.05) . Conclusions:Seton sequential treatment with drug is an effective method for the treatment of perianal fistula of active Crohn′s disease. IFX and azathioprine are suitable for the choice of sequential drugs.

Objective To observe the effect of magnetic stimulation of sacral roots on detrusor overactivity and urge incontinence after spinal cord disease.Methods 15 cases with detrusor overactivity and urge incontinence after spinal cord disease were treated with magnetic stimulation of sacral roots for 10 d.Voiding diary,quality of life scale and urodynamic investigation were applied to evaluate the effect.Results The mean frequency of voiding in 24 h after treatment decreased,urine volume increased,frequency of incontinence decreased and the quality of life score improved.Urge incontinence improved in 85.7% cases.The results of urodynamic investigation showed bladder capacity at first desire to void and maximum cystometric capacity significantly increased after stimulation,while the detrusor pressure at storage decreased.Conclusion Magnetic stimulation of sacral roots can improve urinary frequency and urge incontinence of patients with detrusor overactivity after spinal cord disease by inhibiting detrusor overactivity,increasing cystometric capacity.Magnetic stimulation of sacral roots may be an alternative promising rehabilitation technique.