Objective:Summarize the clinical efficacy of using a disposable decomposed soft injection probe under propofol induced local infiltration anesthesia for the treatment of complex anal fistula.Methods:This technology is applied to patients with complex anal fistulas with clear diagnosis and no surgical contraindications. Using propofol to induce local infiltration anesthesia, a disposable decomposed soft injection probe (invention patent number: ZL 2014 1 0173127.3) soft catheter is gently introduced from the outer opening, passing through a cord like hard structure that can be touched on the surface of the body, and exiting through the rectum and anal canal. According to preoperative identification, each probe is explored one by one. If the inner opening and fistula are below the anorectal ring, a "V" - shaped incision is made to the skin and mucosal transition area between the inner and outer openings, and the fistula and inner opening are removed; If the exploration of the internal opening and fistula is above the anorectal ring, the internal opening should be enlarged and trimmed, and the skin of the external opening should be cut off in a shuttle shape. A soft catheter should be used to pull out a rubber strip for loose floating drainage. The two ends of the drainage rubber strip should be tied and fixed with 1 # silk thread. Connect a disposable decomposed soft injection probe with extracted methylene blue mixture (methylene blue 0.5 ml+0.9% sodium chloride 9.5 ml), press the external opening of the anal fistula to form a blind tube that seals the external opening, inject methylene blue mixture, implant an anal hook, explore the remaining blue anal sinus area, and inject methylene blue mixture again to determine the accurate position of the internal opening. Trim and enlarge the inner openings that have been accurately detected one by one. For the main fistula that runs below the anorectal ring, perform a "V" incision to cut open the soft tissue in the skin and mucosal transition area between the inner and outer openings, and remove the inner opening and fistula at once; For anal fistulas with fistulas above the anorectal ring, internal incision trimming and enlargement, sinus scraping, and floating bridge drainage surgery should be performed; For a complex anal fistula with multiple internal and external openings, the main lesion should be incised and treated with branch drainage. Record the successful time of internal port exploration, intraoperative and postoperative pain score (VAS), degree of fecal incontinence (Wexner incontinence score), wound healing time, and 3-month postoperative recurrence rate.Results:From January 2020 to December 2023, the Proctology Department of Zaozhuang Fourth Hospital and the Proctology Department of Tengzhou Traditional Chinese Medicine Hospital (Workers' Hospital) treated 54 patients with complex anal fistula using a disposable decomposed soft injection probe under propofol induced local infiltration anesthesia. The average successful internal exploration time was 2.80 minutes, and the average healing time was (22.3±2.6) days. The VAS scores (points) during surgery, 2 days after surgery, 4 days after surgery, and 6 days after surgery were 0.9±0.2, 1.5±0.2, 1.2±0.1, and 0.6±0.2, respectively. The Wexner score at 1 month after surgery was 0.80±0.20, All patients were followed up until April 2024, and the recurrence rate at 3 months after surgery was 5.6%.Conclusion:The use of disposable decomposed soft injection probes under propofol induced local infiltration anesthesia for the diagnosis and treatment of complex anal fistulas has shortened exploration and surgical time, improved treatment comfort and cure rate, and is safe and effective.

Objective:Summarize the clinical efficacy of using a disposable decomposed soft injection probe under propofol induced local infiltration anesthesia for the treatment of complex anal fistula.Methods:This technology is applied to patients with complex anal fistulas with clear diagnosis and no surgical contraindications. Using propofol to induce local infiltration anesthesia, a disposable decomposed soft injection probe (invention patent number: ZL 2014 1 0173127.3) soft catheter is gently introduced from the outer opening, passing through a cord like hard structure that can be touched on the surface of the body, and exiting through the rectum and anal canal. According to preoperative identification, each probe is explored one by one. If the inner opening and fistula are below the anorectal ring, a "V" - shaped incision is made to the skin and mucosal transition area between the inner and outer openings, and the fistula and inner opening are removed; If the exploration of the internal opening and fistula is above the anorectal ring, the internal opening should be enlarged and trimmed, and the skin of the external opening should be cut off in a shuttle shape. A soft catheter should be used to pull out a rubber strip for loose floating drainage. The two ends of the drainage rubber strip should be tied and fixed with 1 # silk thread. Connect a disposable decomposed soft injection probe with extracted methylene blue mixture (methylene blue 0.5 ml+0.9% sodium chloride 9.5 ml), press the external opening of the anal fistula to form a blind tube that seals the external opening, inject methylene blue mixture, implant an anal hook, explore the remaining blue anal sinus area, and inject methylene blue mixture again to determine the accurate position of the internal opening. Trim and enlarge the inner openings that have been accurately detected one by one. For the main fistula that runs below the anorectal ring, perform a "V" incision to cut open the soft tissue in the skin and mucosal transition area between the inner and outer openings, and remove the inner opening and fistula at once; For anal fistulas with fistulas above the anorectal ring, internal incision trimming and enlargement, sinus scraping, and floating bridge drainage surgery should be performed; For a complex anal fistula with multiple internal and external openings, the main lesion should be incised and treated with branch drainage. Record the successful time of internal port exploration, intraoperative and postoperative pain score (VAS), degree of fecal incontinence (Wexner incontinence score), wound healing time, and 3-month postoperative recurrence rate.Results:From January 2020 to December 2023, the Proctology Department of Zaozhuang Fourth Hospital and the Proctology Department of Tengzhou Traditional Chinese Medicine Hospital (Workers' Hospital) treated 54 patients with complex anal fistula using a disposable decomposed soft injection probe under propofol induced local infiltration anesthesia. The average successful internal exploration time was 2.80 minutes, and the average healing time was (22.3±2.6) days. The VAS scores (points) during surgery, 2 days after surgery, 4 days after surgery, and 6 days after surgery were 0.9±0.2, 1.5±0.2, 1.2±0.1, and 0.6±0.2, respectively. The Wexner score at 1 month after surgery was 0.80±0.20, All patients were followed up until April 2024, and the recurrence rate at 3 months after surgery was 5.6%.Conclusion:The use of disposable decomposed soft injection probes under propofol induced local infiltration anesthesia for the diagnosis and treatment of complex anal fistulas has shortened exploration and surgical time, improved treatment comfort and cure rate, and is safe and effective.

OBJECTIVE: To assess the value of using flat-sided culture tubes for preparing chromosomes through chorionic villi (CV) and amniotic fluid (AF) cell cultures during prenatal diagnosis. METHODS: From February to March 2020, 157 CV samples and 147 AF samples subjected to prenatal diagnosis at the Maternal and Child Health Care Hospital of Guangxi Zhuang Autonomous Region were selected as the study subjects. For each sample, one flat-sided tube and one flask culture were set up by following the standard protocols. The methods were evaluated by comparing the cell growth, experimental process, quality of chromosome preparation and costs. RESULTS: The success rates for the culturing of CV and AF samples by the flat-sided culture tube method were 97.45% (153/157) and 97.96% (144/147), respectively. By contrast, the success rates for the conventional flask method were 98.72% (155/157) for CV and 98.64% (145/147) for AF samples. No significant difference was found between the two methods (P > 0.05). The average harvest time required by the flat-sided culture tube method was 8.45 days for CV and 9.43 days for AF cultures, whilst the average harvest time for conventional flask method was 9.05 days and 9.54 days, respectively. The flat-sided culture tube method for CV had required significantly shorter average harvest time than the conventional method (P < 0.001). No statistical significant difference was found in the average harvest time for AF by the two methods (P > 0.05). The conventional culturing method had required three containers with two sample transfers. By contrast, the flat-sided culture tube method was carried out in one tube without any sample transfer. The average total amount of medium used was 3.91 mL for each flat-sided culture tube and 6.26 mL for each conventional flask. CONCLUSION The flat-sided culture tube method can provide a simple, cost-effective and error-reducing procedure for the CV and AF samples culture during prenatal diagnosis.
Child ; Female ; Pregnancy ; Humans ; China ; Prenatal Diagnosis ; Chorionic Villi Sampling ; Amniotic Fluid ; Cell Proliferation

Periarticular fracture of the shoulder is a common type of fractures in the elderly. Postoperative adverse events such as internal fixation failure, humeral head ischemic necrosis and upper limb dysfunction occur frequently, which seriously endangers the exercise and health of the elderly. Compared with the fracture with normal bone mass, the osteoporotic periarticular fracture of the shoulder is complicated with slow healing and poor rehabilitation, so the clinical management becomes more difficult. At present, there is no targeted guideline or consensus for this type of fracture in China. In such context, experts from Youth Osteoporosis Group of Chinese Orthopedic Association, Orthopedic Expert Committee of Geriatrics Branch of Chinese Association of Gerontology and Geriatrics, Osteoporosis Group of Youth Committee of Chinese Association of Orthopedic Surgeons and Osteoporosis Committee of Shanghai Association of Chinese Integrative Medicine developed the Chinese expert consensus on the diagnosis and treatment of osteoporotic periarticular fracture of the shoulder in the elderly ( version 2023). Nine recommendations were put forward from the aspects of diagnosis, treatment strategies and rehabilitation of osteoporotic periarticular fracture of the shoulder, hoping to promote the standardized, systematic and personalized diagnosis and treatment concept and improve functional outcomes and quality of life in elderly patients with osteoporotic periarticular fracture of the shoulder.

With continuous improvement of people's living standards, great efforts have been paid to environmental protection. Among those environmental issues, soil contamination by petroleum hydrocarbons has received widespread concerns due to the persistence and the degradation difficulty of the pollutants. Among the various remediation technologies, in-situ microbial remediation enhancement technologies have become the current hotspot because of its low cost, environmental friendliness, and in-situ availability. This review summarizes several in-situ microbial remediation technologies such as bioaugmentation, biostimulation, and integrated remediation, as well as their engineering applications, providing references for the selection of in-situ bioremediation technologies in engineering applications. Moreover, this review discusses future research directions in this area.
Biodegradation, Environmental ; Humans ; Hydrocarbons ; Petroleum ; Soil ; Soil Microbiology ; Soil Pollutants

Objective: To evaluate effect of screening of esophageal cancer though comparing difference of survival level between screening and non-screening patients in Linzhou city. Methods: The records pathologically diagnosed as serious hyperplasia/carcinoma and esophageal cancer were drawn from database of first round screening in Linzhou city from 2005-2013 and were assigned to the screening group. The records of new esophageal cancer cases which diagnosed within 2 years before, screening from the same village aged from 40 to 69, were drawn from database of cancer registry in Linzhou city and were assigned to the non-screening group. Five or 10 year survival rate with 95%CI of patients with different malignant degree diseases in the screening group and the patients with esophageal cancer in the non-screening group was calculated respectively. The survival curves between the screening and non-screening group were compared by Log rank method. Results: All 26 908 persons were examined in first round screening in Linzhou city from 2005 to 2013. There were 374 persons with serious hyperplasia/carcinoma in situ, 157 persons with esophageal cancer (141 intramucosal carcinomas/submucosal cancers, 16 invasive cancers). The 5 year survival rate of serious hyperplasia/carcinoma, intramucosal carcinoma/submucosal cancer and invasive cancer were 95.0% (95%CI: 91.7%-97.0%) , 72.0% (95%CI: 62.7%-79.3%) and 41.7% (95%CI: 17.4%-64.6%) separately. The 5 year survival rate of esophageal cancer in screening and non-screening group were 68.7% (95%CI:59.9%-75.9%) and 40.8% (95%CI: 36.4%-45.2%). The 10 year survival rate of esophageal cancer in screening and non-screening group were 58.0% (95% CI: 44.6%-69.3%) and 34.3% (95% CI:29.1%-39.5%). The 5 or 10 year survival rate of esophageal cancer in the screening group were higher than that in the non-screening group in whatever sex or age. The survival distribution of the screening group was better than non-screening group (χ²=38.88, P<0.001). Conclusion More precancerous lesions and early esophageal cancer can be detected and patients' survival level was improved through organized esophageal cancer screening, which provided support to evaluate value of organized screening.

Objective To establish a simple and rapid detection technique for Oncomelania infected with Schistosoma japonicum(SJ), with high sensitivity and good specificity .Methods The gene fragment of SJ was amplified by PCR , and cloned into the T-vector to construct positive-reference.An isothermal nucleic acid amplification reaction system for detecting Oncomelania infected with SJ was set up , and its sensitivity was analyzed by detecting positive-reference diluted according to geometric proportion , and its specificity by detecting the genomic DNA of relative samples .Then, a corresponding means of purifying nucleic acid was designed to assemble a reagent detecting Oncomelania infected with SJ . This reagent was validated by detecting Oncomelania samples.Results The 213 bp amplified products were obtained and used to construct recombination T-vector for positive reference .An isothermal nucleic acid amplification reaction system was set up for detecting Oncomelania infected with SJ , and the amplification results could be simply determined by color change, with better sensitivity and specificity .The reagents for detecting Oncomelania infected with SJ were assembled , which could detect samples containing only 1% infected Oncomelania.Conclusion A visible detection method for Oncomelania infected with SJ is successfully established and validated .

This paper is a follow-up study of 329 children in factory-run nurseries in urban Shanghai. The investigation lasted for a period of one year for each index-child, focusing on the conditions of nutrition, development and diseases of the children of various ages.Comparison between nutritionl findings and RDA of China disclosed that calorie intake of most of the index-child groups were 80-85% of RDA, the only exception being the 6-12 months group where the average calorie intake showed 90%. Protein intake of all groups was over 80% of RDA. Fe intake was lower than RDA, except for 18-month-old and over.Weight and height of the children were compared with the anthropo-metric data established in 1985 (1985 data) for Shanghai children under six years of age. It was found that the average weight and height appeared differently according to their age. Average weight of children under one year old was slightly higher than 1985 data, while average height was lower than 1985 data once the children reached 10 months old. Average weight, however, became lower than the 1985 data after the children were two years old. Over 60% of the index between 6-18 months old suffered from anemia (IDA).Accordingly, it is requested that calorie and iron intake should be supplemented.