Objective:To investigate the effects of modified TROPIS surgery, incorporating both open and hanging stitches on the treatment of elevated anal fistula.Methods:For our study, 92 patients with high anal fistula, admitted between Jan. 2023 and Jun. 2024, were selected. They were divided into two categories: the observation group (45 modified TROPIS surgery) and the control group (47 cuts) ,to observe the clinical efficacy, postoperative recovery, quality of life and complications of the two groups.Results:Compared with the control group, the operation time, intraoperative blood loss and postoperative hospitalization time decreased in the observation group ( P<0.05) . Compared with the control group, the healing time of anal fistula in the observation group was (28.01±5.02) d, shorter than that in the control group (35.05±7.09) d, the healing rate was 97.78%, higher than that in the control group (80.85%) , and the recurrence rate was 4.44%, lower than that in the control group (19.14%) ( P<0.05) . The degree of postoperative pain and Wexner anal incontinence score in the observation group were lower than those in the control group ( P<0.05) . The life quality score of the observation group was higher than that of the control group ( P<0.05) . The complication rate of observation group was lower than that of control group ( P<0.05) . Conclusions:The modified TROPIS surgical method evidently provides advantages in anal fistula treatment. It can not only efficiently eliminate infections but also reduce anal movements and decrease the chances of post-surgical injuries and complications, presenting enhanced clinical options and suggesting a promising outlook for traditional anal fistula surgery.

Objective:To investigate the effects of modified TROPIS surgery, incorporating both open and hanging stitches on the treatment of elevated anal fistula.Methods:For our study, 92 patients with high anal fistula, admitted between Jan. 2023 and Jun. 2024, were selected. They were divided into two categories: the observation group (45 modified TROPIS surgery) and the control group (47 cuts) ,to observe the clinical efficacy, postoperative recovery, quality of life and complications of the two groups.Results:Compared with the control group, the operation time, intraoperative blood loss and postoperative hospitalization time decreased in the observation group ( P<0.05) . Compared with the control group, the healing time of anal fistula in the observation group was (28.01±5.02) d, shorter than that in the control group (35.05±7.09) d, the healing rate was 97.78%, higher than that in the control group (80.85%) , and the recurrence rate was 4.44%, lower than that in the control group (19.14%) ( P<0.05) . The degree of postoperative pain and Wexner anal incontinence score in the observation group were lower than those in the control group ( P<0.05) . The life quality score of the observation group was higher than that of the control group ( P<0.05) . The complication rate of observation group was lower than that of control group ( P<0.05) . Conclusions:The modified TROPIS surgical method evidently provides advantages in anal fistula treatment. It can not only efficiently eliminate infections but also reduce anal movements and decrease the chances of post-surgical injuries and complications, presenting enhanced clinical options and suggesting a promising outlook for traditional anal fistula surgery.

Objective:To establish a recurrence prediction model for perianal abscess after incision and drainage surgery based on Logistic regression.Methods:A total of 180 patients with perianal abscess admitted to our hospital from Jan. 2018 to Dec. 2023 were selected as the study objects, all of whom were treated with perianal abscess incision and drainage. According to the follow-up results, the subjects were divided into relapse group and non-recurrence group, and the clinical and follow-up data of the two groups were collected. Multivariate Logistic regression analysis was used to screen the risk factors of postoperative recurrence in patients with perianal abscess. A risk prediction nomogram model was constructed based on the selected risk factors, and the constructed model was evaluated.Results:Of the 180 patients, 35 relapsed during follow-up, with a recurrence rate of 19.44% (35/180). The proportion of patients with diabetes mellitus, abscess site (deep), BMI≥25 kg/m 2, history of chronic diarrhea, and surgical method (simple incision and drainage) in relapse group was higher than that in non-recurrence group ( P<0.05). Combined diabetes mellitus, abscess site (deep), BMI≥25 kg/m 2, history of chronic diarrhea, and surgical method (simple incision and drainage) were the main influencing factors for the recurrence of perianal abscess after incision and drainage. The area under ROC curve (AUC), 95%CI, sensitivity and specificity were 0.873, 0.649-0.996, 96.50% and 79.30% ( P<0.001), respectively, in the prediction of recurrence after incision and drainage of perianal abscess by the nomogram risk model. Calibration curve results showed that both predicted and actual predicted values were near the ideal curve, and the Hosmer-Lemeshow goodness of fit curve test χ 2=3.154, P=0.578. Conclusions:Combined diabetes mellitus, abscess site (deep), BMI≥25 kg/m 2, history of chronic diarrhea, and surgical method (simple incision and drainage) were the main influencing factors for the recurrence of perianal abscess after incision and drainage. The risk prediction model based on the above indexes has good differentiation, calibration and clinical practicability.

Objective:To establish a recurrence prediction model for perianal abscess after incision and drainage surgery based on Logistic regression.Methods:A total of 180 patients with perianal abscess admitted to our hospital from Jan. 2018 to Dec. 2023 were selected as the study objects, all of whom were treated with perianal abscess incision and drainage. According to the follow-up results, the subjects were divided into relapse group and non-recurrence group, and the clinical and follow-up data of the two groups were collected. Multivariate Logistic regression analysis was used to screen the risk factors of postoperative recurrence in patients with perianal abscess. A risk prediction nomogram model was constructed based on the selected risk factors, and the constructed model was evaluated.Results:Of the 180 patients, 35 relapsed during follow-up, with a recurrence rate of 19.44% (35/180). The proportion of patients with diabetes mellitus, abscess site (deep), BMI≥25 kg/m 2, history of chronic diarrhea, and surgical method (simple incision and drainage) in relapse group was higher than that in non-recurrence group ( P<0.05). Combined diabetes mellitus, abscess site (deep), BMI≥25 kg/m 2, history of chronic diarrhea, and surgical method (simple incision and drainage) were the main influencing factors for the recurrence of perianal abscess after incision and drainage. The area under ROC curve (AUC), 95%CI, sensitivity and specificity were 0.873, 0.649-0.996, 96.50% and 79.30% ( P<0.001), respectively, in the prediction of recurrence after incision and drainage of perianal abscess by the nomogram risk model. Calibration curve results showed that both predicted and actual predicted values were near the ideal curve, and the Hosmer-Lemeshow goodness of fit curve test χ 2=3.154, P=0.578. Conclusions:Combined diabetes mellitus, abscess site (deep), BMI≥25 kg/m 2, history of chronic diarrhea, and surgical method (simple incision and drainage) were the main influencing factors for the recurrence of perianal abscess after incision and drainage. The risk prediction model based on the above indexes has good differentiation, calibration and clinical practicability.

Objective:To explore the influencing factors of postoperative recurrence in patients with complex anal fistula, and to construct a nomogram model to predict the risk of postoperative recurrence and verify it.Methods:Clinical data of 310 patients with complex anal fistula who underwent fistulectomy in the hospital from Aug. 2019 to Mar. 2023 were retrospectively selected and divided into modeling group (93 cases) and validation group (217 cases) in a 3∶7 ratio according to system randomization method. Hospital electronic medical record system was used to collect patient baseline data and calculate the recurrence rate of patients 6 months after surgery. According to the data of the modeling group, multivariate Logistic regression was used to analyze the influencing factors of postoperative recurrence in patients with complex anal fistula. Based on the influencing factors, a nomogram model was established to predict the risk of postoperative recurrence, and external verification was performed based on the data of the validation group.Results:The recurrence rate at 6 months after operation was 20.43% (19/93) in the modeling group and 17.51% (38/217) in the validation group. There was no significant difference in recurrence rate between the two groups ( χ2=0.370, P=0.543) . The proportion of male, smoking history, diabetes mellitus, high anal fistula and unclear position of internal orifice in the recurrence group was higher than that in the non-recurrence group, and the body mass index and course of disease were higher than those in the non-recurrence group ( P<0.05) . Based on the above seven influencing factors, a nomogram model of the risk of recurrence of complex anal fistula after surgery was established. C index of the modeling group and the validation group was 0.984 and 0.798 respectively, the calibration curve was close to the ideal curve, and the Receiver operating characteristic AUC of the nomogram prediction model was>0.70, indicating that model consistency, prediction efficiency and differentiation were good. Conclusion:The nomogram prediction model based on gender, body mass index, smoking history, diabetes mellitus, course of disease, high anal fistula and internal orifice position can effectively predict the risk of postoperative recurrence in patients with complex anal fistula.

Objective: To establish colorectal cancer LoVo and SW620 cell lines that stably interfere with the expression of LINC01224, and to explore the effect of down-regulating the expression of LINC01224 on cell apoptosis. Methods: The GEPIA2 database was used to analyze the expression of LINC01224 in colorectal cancer tissues; qPCR method was used to detect the expression of LINC01224 in 10 human colorectal cancer cells. Three different LINC01224 siRNAs were respectively transfected into human colorectal cancer LoVo cells, and the LINC01224 shRNA lentiviral vector was constructed with the siRNA sequence with the most obvious inhibitory effect of LINC01224 expression. Recombinant lentiviral particles were packaged in HEK293 T cells and then infected with LoVo and SW620 cells. After selection by puromycin, the monoclonal cells that stably interfere with LINC01224 were obtained by limiting dilution method. MTS method detects cell proliferation ability, and flow cytometry detects cell apoptosis rate. Results: The expression of LINC01224 in colorectal cancer tissues was higher than that in normal colorectal tissues, and its expression in 10 types of colorectal cancer cells was also higher than that in normal colorectal epithelial cells HCOEPic. The inhibition rate of siRNA-3 on the expression of LINC01224 in LoVo cells was higher than that of siRNA-1 and siRNA-2. Therefore, siRNA-3 was chosen to design LINC01224 shRNA.Compared with the control group(sh-NC group), the expression level of LINC01224 in the LoVo and SW620 cells of the stable interference LINC01224 group(sh-LINC01224 group) was reduced(P<0.01), and the cell growth rate was slowed down(P<0.01), the rate of apoptosis also increased(P<0.01). Conclusion The shRNA lentiviral interference vector of LINC01224 is successfully constructed, which can stably infect LoVo and SW620 cells, down-regulate the expression of LINC01224 and induce cell apoptosis.

Objective:To investigate the risk factors of proteinuria in patients with hypertension in Qinghai-Tibet Plateau.Methods:From March 2019 to June 2020, prospective design was used to collect data of Qinghai-Tibet Plateau hypertension patients who were eligible for continuous enrollment in the Department of Cardiovascular Medicine in Hospital of Chengdu Office of People's Government of Tibet Autonomous Region. Questionnaire survey, physical examination and blood pressure measurement were performed on the selected patients. Fasting venous blood samples were collected for liver function test, blood lipid test, blood glucose test, and hemoglobin test, etc. Three times of morning urine samples were taken on different days, and urine protein creatinine ratio (UACR) was measured, UACR < 30 mg/g was negative for urinary protein, and UACR≥30 mg/g was positive for urinary protein. At the same time, the selected patients were examined by carotid artery color ultrasound and heart color ultrasound. The risk factors of proteinuria were analyzed.Results:A total of 588 patients with hypertension met the inclusion criteria, including 472 patients (80.3%) who received antihypertensive drug therapy, 239 patients (40.6%) had antihypertensive treatment compliance, and 252 patients (42.9%) reached the standard blood pressure after theropy. Hypertension was associated with diabetes mellitus in 150 patients (25.5%), and urinary protein was positive in 126 patients (21.4%). In univariate analysis, ethnic composition, systolic blood pressure [(138.19 ± 19.65) vs (133.16 ± 18.45) mmHg, 1 mmHg = 0.133 kPa], diastolic blood pressure [(85.80 ± 13.51) vs (83.17 ± 12.19) mmHg], uric acid [(411.79 ± 101.54) vs (379.96 ± 102.18) μmol/L], hemoglobin [(152.86 ± 30.70) vs (143.49 ± 21.15) g/L], pulmonary artery trunk width [(21.76 ± 3.94) vs (20.98 ± 3.34) mm], and ventricular septal thickness [(9.90 ± 1.70) vs (9.47 ± 1.60) mm] in the positive group ( n = 126) were significantly higher than those in the negative group ( n = 462, P < 0.01 or < 0.05). In multivariate logistic regression analysis, increased systolic blood pressure [odds ratio ( OR) = 1.015, 95% confidence interval (95% CI): 1.005 - 1.026], uric acid ( OR = 1.003, 95% CI: 1.001 - 1.005), and pulmonary artery trunk width ( OR = 1.058, 95% CI: 1.001 - 1.118) were risk factors for proteinuria; Tibetans had a decreased risk of proteinuria compared with Han ( OR = 0.505, 95% CI: 0.317 - 0.805), but increased hemoglobin had an increased risk of proteinuria compared with normal hemoglobin ( OR = 1.890, 95% CI: 1.231 - 2.903). Conclusion:In patients with hypertension at high altitude, increased hemoglobin, systolic blood pressure, uric acid, pulmonary artery trunk width, and Han nationality are risk factors for proteinuria.

Objective:To evaluate the clinical efficacy of Xuebijing combined with human immunoglobulin for the treatment of severe and critically ill patients with coronavirus disease 2019 (COVID-19).Methods:A retrospective study was conducted. The clinical data of 65 patients with severe and critical COVID-19 admitted to Chongqing Public Health Medical Center and Chongqing Three Gorges Central Hospital from January 2020 to March 2020 during the period of supporting to combat COVID-19 by the medical team of the Second Affiliated Hospital of Chongqing Medical University and Chongqing Hospital of Traditional Chinese Medicine were analyzed. According to different treatment regimens, patients were divided into conventional treatment group (conventional antivirus, anti-infection and symptomatic support treatments), Xuebijing group (Xuebijing was applied to patients with elevated inflammatory cytokines) and combination group (Xuebijing combined with human immunoglobulin, human immunoglobulin was applied to patients with low immunity indicated by monitoring results of lymphocytes and their subsets). The improvement of blood routine examination, blood gas analysis, myocardial enzyme spectrum, liver and kidney function, lymphocytes and their subsets and cytokines as well as severity score in three groups before and after treatment were observed. Kaplan-Meier method was used to draw the 28-day survival curve of each group, and the cumulative survival rate among the groups was compared.Results:Among the 65 severe and critically ill COVID-19 patients, only 20 patients received conventional treatment, 22 patients were treated with Xuebijing based on conventional treatment, and 23 patients were treated with Xuebijing combined with human immunoglobulin based on conventional treatment. Before treatment, CD4 + T cell count in combination group was higher than other two groups, and interleukin-6 (IL-6) was lower than other two groups, while other indicators showed no statistically significant differences among the three groups, suggesting that the baseline of the three groups was relatively balanced before treatment. The patients in the conventional treatment group were relieved after treatment, and it was characterized by that the acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score and lactate dehydrogenase (LDH) were significantly lower than those before treatment [APACHEⅡ score: 5.20±2.74 vs. 6.20±1.93, LDH (μmol·s -1·L -1): 4.1±1.0 vs. 4.7±0.9, both P < 0.01], but there was still liver damage, which was manifested as higher aspartate aminotransferase (AST) than that before treatment [U/L: 30.5 (23.8, 41.5) vs. 21.0 (17.0, 34.0), P < 0.05]. In Xuebijing group, the respiratory function and immunity of patients were improved after treatment, and the improvement degree of the ratio of CD4 + T cell was more significant than that in the conventional treatment group (4.86±6.31 vs. -0.95±12.38, P < 0.05). However, the patients still lived with an "inflammatory storm" and liver damage after treatment. It was shown that IL-4 was significantly higher than that before treatment (ng/L: 2.57±1.15 vs. 1.92±1.04, P < 0.05), while albumin (ALB) decreased significantly compared with before treatment [g/L: 33.0 (30.5, 35.6) vs. 36.2 (32.1, 41.4), P < 0.01]. While the treatment of Xuebijing combined with human immunoglobulin could improve patients' respiratory function and enhance their immunity more effectively, it was shown that arterial partial pressure of oxygen (PaO 2), oxygenation index (PaO 2/FiO 2), T lymphocyte count, ratio of CD4 + T cell, CD4 + T cell count, CD8 + T cell count and CD4 +/CD8 + ratio were significantly higher than those before treatment, while ALB, IL-6, APACHEⅡ score and sequential organ failure assessment (SOFA) score were significantly lower than those before treatment. T lymphocyte count, the ratio of CD4 + T cell and IL-6 in combination group were improved more significantly than those in conventional treatment group and Xuebijing group [T lymphocyte count (×10 9/L): 310.68±359.28 vs. 46.54±240.01, 81.59±256.76; ratio of CD4 + T cell: 14.53±14.49 vs. -0.95±12.38, 4.86±6.31; IL-6 (ng/L): -25.53±39.05 vs. -1.75±5.45, 12.78±44.81], PaO 2/FiO 2 was improved more significantly as compared with the Xuebijing group [mmHg (1 mmHg = 0.133 kPa): 146.31±109.73 vs. 59.41±87.70], and the differences were statistically different (all P < 0.05). Conclusion:The combination of Xuebijing and human immunoglobulin for the treatment of patients with COVID-19 can improve patients' respiratory function, reduce "inflammatory storm", enhance immunity, and alleviate severity of patients' condition.

Objectives To study application efficiencies of two types of intestinal ostomy in the treatment of elderly patients with obstructive sigmoid colon cancer and colorectal cancer.Methods 62 elderly patients with obstructive sigmoid colon cancer and rectal cancer from January 2013 to January 2016 in our hospital were chosen.The patients were divided into loop ileostomy group(n=32) and colostomy group(n=30)depending on the type of therapy.And the stage Ⅰ and Ⅱ operative time,hospital stay,postoperative fasting time and postoperative complication incidence rates were compared between the two groups.Results The postoperative fasting time was significantly shorter in loop ileostomy group than in colostomy group during stage Ⅰ surgery(2.5 ± 0.5)d vs.(4.6 ± 0.6)d(t=14.3644,P =0.0000).In stage Ⅱ surgery,the operative time,hospital stay,postoperative fasting time (2.9 ± 0.6)d vs.(4.9 ± 0.4)d,(1.4 ± 0.4)d vs.(2.5 ±± 0.3)d,(6.3± 1.4d)vs.(8.8±1.2)d were significantly lower in the loop ileostomy group than in the colostomy group(t=-15.2762、-10.9714、-7.6601,all P =0.0000).Conclusions Compared with colostomy technique,the loop ileostomy has advantages including shorter operation time,lower incidence of postoperative complications and quicker recovery after surgery for elderly patients with obstructive sigmoid colon cancer and colorectal cancer.