Objective To investigate the association between fecal incontinence and the risk of postoperative recurrence in patients with complete rectal prolapse(CRP).Methods A retrospective cohort study design was employed,CRP patients who underwent surgical treatment in the Guang'an-men Hospital of China Academy of Chinese Medical Sciences from January 2013 to June 2024 were selected as the study subjects.Two sequential survival analysis models were used to explore the rela-tionship between fecal incontinence and postoperative recurrence of rectal prolapse;restricted cubic spline regression was utilized to examine the linear relationship between the two indexes;survival curves were generated to illustrate the postoperative recurrence-free survival probabilities among patients with varying degrees of incontinence.Results A total of 180 CRP patients were included in this study,among whom 44 patients had severe fecal incontinence.The results of the multivariate sur-vival analysis model revealed a significant correlation between fecal incontinence and the risk of post-operative recurrence after controlling for covariates(P＜0.05).Considering a Wexner fecal inconti-nence score ≤ 5 as reference group,the recurrence risk in the group with a score≥16 was 4.26 times than that of the reference group[unadjusted model:HR=4.3(1.62 to 11.41);model 1:HR=3.37(1.27 to 8.94);model 2:HR=4.26(1.48 to 12.24);P＜0.05],indicating a significantly elevated recurrence risk in patients with high scores.A linear positive correlation was observed be-tween fecal incontinence and recurrence risk(Pnon-linearity＞0.05).The survival curves demonstrated significant differences in recurrence-free survival rates among different fecal incontinence groups.The survival probability in the group with a score ≥ 16 declined sharply(with only 3 cases remaining recurrence-free at 9 years),indicating the highest recurrence risk in this group.Conclusion Fecal incontinence is an important predictor of postoperative recurrence in rectal prolapse,with severe fe-cal incontinence serving as an independent high-risk factor.The severity of fecal incontinence should be incorporated into the preoperative risk assessment system in clinical practice to provide evidence-based support for optimizing surgical plans,stratified postoperative management,and preventing postoperative recurrence.

Objective To distinguish Khat from its similar plants,such as white tea and Houttuynia cordata,so as to identity Khat and its camouflage and confusing products in smuggling crime and public security anti-drug work.Methods FTIR is used to collect the infrared spectral data of plant samples,and the data are analyzed by chemometrics.The original data were preprocessed by three data processing methods,namely,SG smoothing,baseline and normalization,then the processed data were classified and reduced by PCA,finally the mathematical model was constructed by three methods:KNN,RF and SVM for classification and prediction.Results The results were expressed by confusion matrix,and the accuracy of the RF model is 96.51%.The accuracy of the SVM model is 98.84%;The accuracy of the KNN model is 93.02%.Conclusion In this experiment,FTIR was used to establish a model for rapid identification of Khat grass,the SVM model has the highest correct recognition rate and good parameters,which can be used to distinguish dry khat from its similar plants.

ObjectiveTo investigate the clinical value of transgastrie endoscopic surgery for the treatment of pancreatic abscess or pancreatic cyst and infection.MethodsThe clinical data of 22 patients with pancreatic abscess or pancreatic cyst and infection who underwent transgastric puncture and drainage or transgastric debridement under the guidance of endoscopic ultrasonography (EUS) at the Xinqiao Hospital of Third Military Medical University from July 2008 to August 2011 were retrospectively analyzed.All patients were comfirmed with bacteria infection after liquid aspiration culture. Patients with pancreatic abscess underwent endoscopic transgastric debridement,and for patients with pancreatic cyst and infection,10 F double pigtail stent and 8.5 F nasal bile duct were placed for drainage.ResultsThe results of liquid aspiration culture confirmed that 2 patients were infected by staphylococcus aureus,3 by proteus mirabilis,4 by pseudomonas aeruginosa,4 by klebsiella and 9 by escherichia coli bacilli.The double pigtail stent and nasal bile duct were installed under EUS (16 patients) or duodenoscope (6 patients).The lesions of 9 patients with pancreatic abscess were healed after endoscopic transgastric debridement with an average period of (6.5 + 1.8 )weeks,and the lesions of 13 patients with pancreatic cyst and infection were healed after transgastric puncture and drainage under the guidance of EUS with an average period of ( 8.3 ± 2.1 ) weeks.All patients were followed up for 2 years,and no recurrence of pancreatic abscess or pancreatic cyst was observed.ConclusionThe effect of transgastric endoscopic surgery for the treatment of pancreatic abscess or pancreatic cyst and infection is satisfactory.

Objective To study the diagnostic and therapeutic value of 1.4-metre colonoscope for upper jejunum lesions. Methods From 2008 to 2009, patients with suspected upper jejunum lesions, who presented as obscure gastrointestinal bleeding or other digestive symptoms and got no definite diagnosis from gastroscopy and entire digestive tract barium meal, were recruited as experimental group (n = 115) and underwent an examination with 1.4-metre endoscope. The endoscope was inserted into proximal jejunum, biopsy or treatment was performed according to the found lesions. Another 115 patients from 2004 to 2007, who presented with similar situation but were examined with gastroscope, were recruited as control group. Results Descending duodenum was accessed successfully in all cases from 2 groups. Horizontal duodenum was accessed in 112 and 107 cases of experimental group and control, respectively (97. 39% vs. 93.04%, P ＞0. 05), while the ascending part was accessed in 109 and 72 cases, respectively (94.78% vs. 62.61%, P＜0.005), and the proximal jejunum was accessed in 102 and 35 cases, respectively (88.70% vs. 30. 43%, P ＜ 0. 005). A total of 31 (26. 96%) lesions were found in experimental group, which was significantly higher than that in control group (6/115, 5.22%, P ＜0.005). Biopsy or endoscopic management was performed in 20 cases from experimental group, in which 12 occupying lesions were confirmed by pathology and surgery. In control group, 1 case of stromal tumor, 1 adenocarcinma, 1 P-J syndrome and 3 ancylostomiasis at horizontal duodenum were confirmed. Conclusion 1.4-metre endoscope can be inserted deeper than gastroscope, and is of better diagnostic value for bleeding in descending duodenum, especially in upper jejunum.

Achalasia is an esophageal motility disorder involving the smooth muscle layer of the esophagus and the lower esophageal sphincter. It is characterized by difficulty swallowing, regurgitation, and sometimes chest pain. Peroral endoscopic myotomy (POEM) was developed by Inoue to provide a less invasive permanent treatment for esophageal achalasia. We applied this method to cure successfully a 47-year-old female with achalasia. The procedure was as follows: after creating submucosal tunnel, endoscopic myotomy of circular muscle bundles was carried out at approximately 16 cm in total length ( 15 cm in distal esophagus and 1 cm in cardia). Smooth passing of endoscope through gastroesophageal junction was confirmed at the end of the procedure. The third day after POEM, the barium meal examination revealed the barium smoothly passed though the cardia. The short-term outcome of POEM for achalasia was excellent, and further studies on long-term efficacy and on comparison of POEM with other interventional therapies are awaited.