Objective:To compare the efficacy and safety among traditional open suture, modified Kessler method, and minimally invasive suture with threaded rivets in acute closed Achilles tendon rupture.Methods:A total of 60 patients with acute closed Achilles tendon rupture diagnosed and treated in the Affiliated Hospital of Jining Medical College from January 2018 to August 2022 were selected retrospectively as the study subjects and divided into group A (20 patients with traditional open suture), group B (20 patients with modified Kessler method) and group C (20 patients with minimally invasive suture with threaded rivets) according to operative method. The clinical efficacy, perioperative indexes, Achilles tendon activity, postoperative recovery work and exercise time, visual analog scale (VAS) score and complications were compared among the three groups.Results:The total effective rate in the group C was higher than that in the group A : 18/20 vs. 12/20, there was statistical difference ( χ2 = 4.80, P<0.05). The total effective rate in the group B and group C had no statistical difference ( P>0.05). The operation time, intraoperative blood loss, incision length, hospitalization time, time to return to work, exercise and VAS scores in the group B and group C were lower than those in the group A: (49.32 ± 4.74), (48.12 ± 4.68) min vs. (66.71 ± 5.84) min; (15.32 ± 1.01), (15.62 ± 0.79) ml vs.(19.86 ± 1.20) ml; (7.69 ± 0.57), (3.76 ± 0.50) cm vs. (8.98 ± 0.62) cm; (7.01 ± 0.91), (6.82 ± 0.83) d vs.(8.74 ± 1.12) d; (56.32 ± 8.01), (55.17 ± 7.84) d vs. (63.17 ± 6.68) d; (6.13 ± 1.20), (5.94 ± 1.04) months vs. (8.21 ± 1.20) months; (2.76 ± 0.50), (2.55 ± 0.76) scores vs. (3.98 ± 0.62) scores, there were statistical differences ( P<0.05). At 1, 6 and 12 months after surgery, the American Society for Foot and Ankle Surgery (AOFAS) scores in the three groups were significantly increased, and the AOFAS scores in the group B and group C were higher than those in the group A, there were statistical differences ( P<0.05). The total incidence of complications in the group C was lower than that in the group A: 2/20 vs. 8/20, there was statistical difference ( χ2 = 4.80, P<0.05). The total incidence of complications in the group B and group C had no statistical difference ( P>0.05). Conclusions:Modified Kessler method and minimally invasive suture with threaded rivets have the advantages of high efficiency and safety in the treatment of acute closed Achilles tendon rupture, and their efficacy is higher than that of traditional open suture.

Tuberculosis is a zoonotic disease posing a substantial public health threat.Immunological diagnosis and vaccine im-munization are both necessary to control tuberculosis prevalence.However,the identical antigenic components in diagnostic reagents and vaccines hinder the use of animal vaccines and limit the specificity of clinical diagnosis in humans.Differentiating infected from vaccinated animals can overcome these problems.This article reviews the progress in differential diagnosis research from three as-pects:the diagnostic effects of antigens,methods for discovering new antigens,and screening of new host immune markers,to provide a theoretical basis for future research.

Tuberculosis is a zoonotic disease posing a substantial public health threat.Immunological diagnosis and vaccine im-munization are both necessary to control tuberculosis prevalence.However,the identical antigenic components in diagnostic reagents and vaccines hinder the use of animal vaccines and limit the specificity of clinical diagnosis in humans.Differentiating infected from vaccinated animals can overcome these problems.This article reviews the progress in differential diagnosis research from three as-pects:the diagnostic effects of antigens,methods for discovering new antigens,and screening of new host immune markers,to provide a theoretical basis for future research.

Objective:To compare the efficacy and safety among traditional open suture, modified Kessler method, and minimally invasive suture with threaded rivets in acute closed Achilles tendon rupture.Methods:A total of 60 patients with acute closed Achilles tendon rupture diagnosed and treated in the Affiliated Hospital of Jining Medical College from January 2018 to August 2022 were selected retrospectively as the study subjects and divided into group A (20 patients with traditional open suture), group B (20 patients with modified Kessler method) and group C (20 patients with minimally invasive suture with threaded rivets) according to operative method. The clinical efficacy, perioperative indexes, Achilles tendon activity, postoperative recovery work and exercise time, visual analog scale (VAS) score and complications were compared among the three groups.Results:The total effective rate in the group C was higher than that in the group A : 18/20 vs. 12/20, there was statistical difference ( χ2 = 4.80, P<0.05). The total effective rate in the group B and group C had no statistical difference ( P>0.05). The operation time, intraoperative blood loss, incision length, hospitalization time, time to return to work, exercise and VAS scores in the group B and group C were lower than those in the group A: (49.32 ± 4.74), (48.12 ± 4.68) min vs. (66.71 ± 5.84) min; (15.32 ± 1.01), (15.62 ± 0.79) ml vs.(19.86 ± 1.20) ml; (7.69 ± 0.57), (3.76 ± 0.50) cm vs. (8.98 ± 0.62) cm; (7.01 ± 0.91), (6.82 ± 0.83) d vs.(8.74 ± 1.12) d; (56.32 ± 8.01), (55.17 ± 7.84) d vs. (63.17 ± 6.68) d; (6.13 ± 1.20), (5.94 ± 1.04) months vs. (8.21 ± 1.20) months; (2.76 ± 0.50), (2.55 ± 0.76) scores vs. (3.98 ± 0.62) scores, there were statistical differences ( P<0.05). At 1, 6 and 12 months after surgery, the American Society for Foot and Ankle Surgery (AOFAS) scores in the three groups were significantly increased, and the AOFAS scores in the group B and group C were higher than those in the group A, there were statistical differences ( P<0.05). The total incidence of complications in the group C was lower than that in the group A: 2/20 vs. 8/20, there was statistical difference ( χ2 = 4.80, P<0.05). The total incidence of complications in the group B and group C had no statistical difference ( P>0.05). Conclusions:Modified Kessler method and minimally invasive suture with threaded rivets have the advantages of high efficiency and safety in the treatment of acute closed Achilles tendon rupture, and their efficacy is higher than that of traditional open suture.

OBJECTIVE To analyze the influential factors for rivaroxaban-induced bleeding events in patients with non- valvular atrial fibrillation （NVAF） and coronary heart disease. METHODS A total of 64 hospitalized patients with NVAF complicated with coronary heart disease who were treated with rivaroxaban and admitted to the Fuzhou University Affiliated Provincial Hospital from November 2021 to May 2023 were included in this retrospective study. The demographic data， laboratory test indexes and other general clinical data， and steady-state trough concentration of rivaroxaban were collected， and the dose- adjusted trough concentration was calculated. The occurrence of bleeding events within 6 months after discharge was recorded. The univariate analysis and binary Logistic regression analysis were adopted to determine the independent risk factors of rivaroxaban- related bleeding events. The binary Logistic regression equation was constructed to predict the probability of bleeding events. The area under the receiver operator characteristic （ROC） curve （AUC） was used to analyze the predictive value of the regression equation. RESULTS Among 64 patients， 19 patients had 24 case-times bleeding events， most of which were mild bleeding （19 case-times， 79.2%）， and mainly gastrointestinal bleeding （17 case-times， 70.8%）. After symptomatic treatment and adjustment of the anticoagulant regimen， most of them were improved or cured. In the univariate analysis， the proportion of patients with a history of anemia， platelet count， urea nitrogen content， steady-state trough concentration of rivaroxaban， dose-adjusted trough concentration and coagulation indexes [international normalized ratio， prothrombin time （PT）， activated partial thromboplastin time] in bleeding group were significantly more or higher than those in non-bleeding group， while the albumin level was significantly lower than that in non-bleeding group （P＜0.05）. In binary Logistics regression analysis， high PT level （odds ratio＝1.473， 95% confidence interval＝1.103-1.967， P＝ 0.009） and high rivaroxaban dose-adjusted trough concentration （odds ratio＝1.174， 95% confidence interval＝1.018-1.355， P＝ 0.027） were independent risk factors for rivaroxaban-related bleeding events. The binary Logistic regression equation of bleeding event prediction probability （P） was LogitP＝－6.975+0.387×PT level+0.161×dose-adjusted trough concentration， and the AUC of the ROC curve was 0.825 （95% confidence interval was 0.708-0.909， P＜0.001）. CONCLUSIONS The risk factors of rivaroxaban-related bleeding events in patients with NVAF and coronary heart disease include previous anemia history， high platelet count， high urea nitrogen content， high rivaroxaban steady-state trough concentration， high dose-adjusted trough concentration， high coagulation indexes and low albumin level. High PT level and high dose-adjusted trough concentration are independent risk factors that can be used to predict the risk of rivaroxaban-induced bleeding events. The regression equation has good predictive value.

In order to determine the changes of bacterial community structure and function in the early, middle and late stage of aerobic composting of chicken manure, high-throughput sequencing and bioinformatics methods were used to determine and analyze the 16S rRNA sequence of samples at different stages of composting. Wayne analysis showed that most of the bacterial OTUs in the three composting stages were the same, and only about 10% of the operational taxonomic units (OTUs) showed stage specificity. The diversity indexes including Ace, Chao1 and Simpson showed a trend of increasing at first, followed by decreasing. However, there was no significant difference among different composting stages (P < 0.05). The dominant bacteria groups in three composting stages were analyzed at the phylum and genus levels. The dominant bacteria phyla at three composting stages were the same, but the abundances were different. LEfSe (line discriminant analysis (LDA) effect size) method was used to analyze the bacterial biological markers with statistical differences among three stages of composting. From the phylum to genus level, there were 49 markers with significant differences among different groups. The markers included 12 species, 13 genera, 12 families, 8 orders, 1 boundary, and 1 phylum. The most biomarkers were detected at early stage while the least biomarkers were detected at late stage. The microbial diversity was analyzed at the functional pathway level. The function diversity was the highest in the early stage of composting. Following the composting, the microbial function was enriched relatively while the diversity decreased. This study provides theoretical support and technical guidance for the regulation of livestock manure aerobic composting process.
Animals ; Manure/microbiology* ; Chickens/genetics* ; Composting ; RNA, Ribosomal, 16S/genetics* ; Soil ; Bacteria/genetics*

Crohn′s disease (CD) -related rectovaginal fistula is a rare refractory disease in CD perianal lesions and its therapeutic strategy is not only to control intestinal inflammation but also to protect the anal and vaginal functions. It is also one of the treatment challenges for clinical surgeons. Clinically, medication and drug combined with surgery are mainly used for the treatment of CD-related rectovaginal fistula, but there is still lack of uniform standards. This article reviews the current treatment options for this disease in order to help clinical management.

Crohn′s disease (CD) -related rectovaginal fistula is a rare refractory disease in CD perianal lesions and its therapeutic strategy is not only to control intestinal inflammation but also to protect the anal and vaginal functions. It is also one of the treatment challenges for clinical surgeons. Clinically, medication and drug combined with surgery are mainly used for the treatment of CD-related rectovaginal fistula, but there is still lack of uniform standards. This article reviews the current treatment options for this disease in order to help clinical management.

Crohn′s disease is a chronic inflammatory disease of the digestive tract. The disease has the characteristics of progressive, lifelong and disabling. Some patients may be accompanied by perianal disease, especially the complex anal fistulas. The risk of surgery and the disability rate is higher than the general population. Many factors such as chronic intestinal inflammation and perianal disease may damage the patient′s anal function, causing frequent anal incontinence. This article will combine the clinical experience and relevant literature at home and abroad in recent years to discuss Crohn′s disease and anal incontinence, meanwhile the influencing factors associated with anal incontinence are reviewed.