Objective To investigate the clinical effect of hemorrhoidal artery ligation combined with ultrasonic knife resection,suture,ligature and suspension in the treatment of mixed hemorrhoids with annular prolapse.Methods A retrospective analysis was conducted to select 80 patients with annular prolapse mixed hemorrhoids admitted to the anorectal Department of our hospital from January 2022 to April 2023.According to different treatment plans,they were divided into control group(n=40 cases)who received external stripping and internal ligation combined with tape ligation,and study group(n=40 cases)who received hemorrhoidal artery ligation combined with ultrasonic knife resection,suture,ligation and suspension.The operative effect,operative status,postoperative anal pain,anal edema,stool blood score and quality of life were evaluated.Results The effective rate of the study group was 97.50％,which was higher than that of the control group(77.50％)(P＜0.05).The operation time,intraoperative blood loss,hospital stay and wound healing time of the research group were(25.03±10.00)minutes,(10.00±5.32)ml,(7.25±1.54)days and(12.21±2.00)days respectively.[is better than that of control group(29.85±14.00)minutes,ml(17.85±10.25),(11.87±2.35),(18.89±4.85)days],two groups of comparison,the difference was statistically significant(P＜0.05).The VAS scores of anal pain in the study group on 1 day,3 days and 7 days after the operation were(4.25±0.85)points,(2.89±0.54)points and(2.00±0.30)points,respectively.The scores of perianal edema were(1.87±0.36)points,(1.41±0.30)points,and(1.00±0.20)points,respectively.The hematochezia scores were(1.85±0.21)points,(1.34±0.18)points,and(0.85±0.13)points,respectively.Which were better than that of control group[(7.56±1.10),(6.54±1.03),(4.87±1.00)][(2.40±0.58),(2.03±0.49),(1.87±0.45)][(2.45±0.55),(2.03±0.47),(1.88±0.25)],and the differences were statistically significant(P＜0.05).The recurrence rate was 2.50％in the study group and 17.50％in the control group(P＜0.05).The scores of SF,MH,PF and GH of the Modified Health Survey Summary Form(SF-36)in the study group were(88.54±10.22,87.87±10.58,88.97±10.00,89.95±10.05)higher than those of the control group(67.52±10.00,70.10±11.25,71.10±9.85,70.00±10.00)(P＜0.05).Conclusion Hemorrhoidal artery ligation combined with ultrasonic knife resection,suture,ligature and suspension in the treatment of patients with annular prolapse mixed hemorrhoids has ideal surgical effect and little trauma,which is beneficial to promoting postoperative rehabilitation,alleviating anal pain,improving anal edema and hematostoecium,and improving quality of life.

Objective To investigate the clinical effect of hemorrhoidal artery ligation combined with ultrasonic knife resection,suture,ligature and suspension in the treatment of mixed hemorrhoids with annular prolapse.Methods A retrospective analysis was conducted to select 80 patients with annular prolapse mixed hemorrhoids admitted to the anorectal Department of our hospital from January 2022 to April 2023.According to different treatment plans,they were divided into control group(n=40 cases)who received external stripping and internal ligation combined with tape ligation,and study group(n=40 cases)who received hemorrhoidal artery ligation combined with ultrasonic knife resection,suture,ligation and suspension.The operative effect,operative status,postoperative anal pain,anal edema,stool blood score and quality of life were evaluated.Results The effective rate of the study group was 97.50％,which was higher than that of the control group(77.50％)(P＜0.05).The operation time,intraoperative blood loss,hospital stay and wound healing time of the research group were(25.03±10.00)minutes,(10.00±5.32)ml,(7.25±1.54)days and(12.21±2.00)days respectively.[is better than that of control group(29.85±14.00)minutes,ml(17.85±10.25),(11.87±2.35),(18.89±4.85)days],two groups of comparison,the difference was statistically significant(P＜0.05).The VAS scores of anal pain in the study group on 1 day,3 days and 7 days after the operation were(4.25±0.85)points,(2.89±0.54)points and(2.00±0.30)points,respectively.The scores of perianal edema were(1.87±0.36)points,(1.41±0.30)points,and(1.00±0.20)points,respectively.The hematochezia scores were(1.85±0.21)points,(1.34±0.18)points,and(0.85±0.13)points,respectively.Which were better than that of control group[(7.56±1.10),(6.54±1.03),(4.87±1.00)][(2.40±0.58),(2.03±0.49),(1.87±0.45)][(2.45±0.55),(2.03±0.47),(1.88±0.25)],and the differences were statistically significant(P＜0.05).The recurrence rate was 2.50％in the study group and 17.50％in the control group(P＜0.05).The scores of SF,MH,PF and GH of the Modified Health Survey Summary Form(SF-36)in the study group were(88.54±10.22,87.87±10.58,88.97±10.00,89.95±10.05)higher than those of the control group(67.52±10.00,70.10±11.25,71.10±9.85,70.00±10.00)(P＜0.05).Conclusion Hemorrhoidal artery ligation combined with ultrasonic knife resection,suture,ligature and suspension in the treatment of patients with annular prolapse mixed hemorrhoids has ideal surgical effect and little trauma,which is beneficial to promoting postoperative rehabilitation,alleviating anal pain,improving anal edema and hematostoecium,and improving quality of life.

Purpose/Significance To investigate the status quo and influencing factors of self-management level of elderly diabetic mellitus patients in Dongcheng District of Beijing,and to provide references for further development of community diabetes health educa-tion and health management.Method/Process The survey is conducted on 1 962 cases of elderly patients with type 2 diabetes mellitus who are randomly selected from community-level health service institutions in Dongcheng District of Beijing and are investigated by self-made questionnaires and the summary of diabetes self-care activities.Multiple stepwise regression and logistic regression are used to analyze the influencing factors of patients'self-management level.Result/Conclusion The self-management level of elderly diabetic mellitus patients is affected by many factors,among which the awareness of disease-related knowledge,the form of medical security and the use of health-related software to manage chronic diseases are the main influencing factors(P＜0.05).Local management depart-ments can take targeted health interventions to further improve the self-management ability of elderly diabetic mellitus patients.

Purpose/Significance The paper systematically reviews relevant research on infectious disease prediction models based on internet data,helps to realize the advancement of infectious disease surveillance,and provides references for the construction of intelli-gent three-dimensional prevention and treatment system of infectious diseases.Method/Process The development history and research direction of infectious disease surveillance and early warning based on internet data collected in the core database of Web of Science and CNKI in the past 20 years are reviewed,major existing problems and challenges are analyzed,and common prediction models and their optimization directions are summarized.Result/Conclusion The study on internet infectious disease surveillance shows the trend of diver-sification of monitoring diseases,refinement and specialization of data sources.Due to the complexity and uncertainty of internet data,most of the existing models are only suitable for short-term or real-time prediction.By constructing a combination model,strengthening multi-source data fusion,improving the selection of keywords and influencing factors,the model can be further optimized and the fitting effect and prediction capacity can be strengthened.

Objective:To examine the effect of brown midle borosilicate glass ampoules on the drug safety of ambr-oxol hydrochloride injection.Methods:By simulating the storage conditions of ambroxol hydrochloride injection,experimental studies were designed using inductively coupled plasma emission spectroscopy(ICP-OES)and scan-ning electron microscopy(SEM)to investigate element migration and internal surface detachment.Results:The Si content in the injections increased over time,and after 0 to 48 months of various stages of testing,the inner surface of the glass was intact,with no detachment or erosion;the migration of various target elements,such as Cd,Pb,As,Hg,etc.,into the injections took place,but the contents were in accordance with the limits set by the relevant regulations.Conclusion:Brown middle borosilicate glass ampoule packaging for ambroxol hydrochloride injection is safe and stable for 48 months.Brown middle borosilicate glass ampoule can be used as a good container for ambr-oxol hydrochloride injection.

Objective To observe the effects of massage along meridians based on different stages of Brunnstrom on lower extremity function in patients with convalescent stroke. Methods Ninety patients with convalescent stroke and lower limb dysfunction who were hospitalized in our hospital's brain center from September 2016 to August 2018 were selected. They were randomly assigned to an observation group of 45 patients and a control group of 45 patients. Both groups were given basic rehabilitation therapy. The control group was given conventional exercise therapy, and the observation group was given additional massage based on different stages of Brunnstrom. The two groups were treated for6 weeks, and the FMA-L, MAS and BBS scores before and after treatment were evaluated. Results There were no significant differences in FMA-L, MAS and BBS scores between the two groups (P>0.05). After 6 weeks of treatment, the FMA-L and BBS scores of the two groups were significantly higher than the pre-treatment scores, while the MAS scores were lower than the pre-treatment scores (P<0.05 or P<0.01). Compared with the control group, the improvement of FMA-L and BBS scores and the reduction of MAS score in the observation group was more significant (P<0.05 or P<0.01). Conclusion On the basis of conventional treatment methods, the application of massage therapy based on different stages of Brunnstrom is more helpful to improve the balance function of patients during stroke recovery, reduce muscle tension of lower limbs and to improve functional activities of lower limbs.

Objective To study the influence of traction on the blood circulation of femur head and its evaluation by DSA. Methods Using micro-catheter, transfemoral selective femoral circumflex arteriography in 22 healthy dogs was performed in unilateral hip before (Group A,n =22) and immediately (Group B,n=22) ,30( Group D,n =22) ,60(Group E,n=20) ,90( Group F,n = 10),120 (Group G,n=10) minutes during 2 kg skin hip traction, and immediately after traction removal (Group H,I,J,L and 0), and 30 minutes after traction removal with 60,90 and 120 minutes continuous traction(Group K,M and P),and 60 minutes after traction removal with 90 and 120 minutes continuous traction(Group N and Q). DSA was also performed immediately during 4 kg weight traction before continuous traction in 12 hips( Group C).Blood circulation of the femoral head was evaluated mainly by observing its perfusion and time of circulation. Femur head perfusion was assessed as good scoring 3,poor scoring 2 and extremely poor scoring 1. Femur head circulation time was assessed as normal scoring 3 .prolonged scoring 2 and remarkably prolonged scoring 1. Analysis of variance was employed for analysis of the angiographic findings between different groups.Results Good femoral head perfusion in Group A to Q was 22,0,0,0,0,0,0,22,22,1,18,0,0,8,0,0 and 1 hips respectively, poor one was 0,22,8,22,15,4,1,0,0,15,2,4,6,2,1,3 and 8 hips, respectively,extremely poor one was 0,0,4,0,5,6,9,0,0,4,0,6,4,0,9,7 and 1 hips, respectively; and normal femoral head blood circulation time was 22,0,0,0,0,0,0,22,22,1,18,0,0,8,0,0 and 1 hips, respectively, prolonged one was 0,22,9,22,15,4,2,0,0, 15,2,5,7,2,2,4 and 8 hips, respectively, remarkably prolonged one was 0,0,3,0,5,6,8,0,0,4,0,5,3,0,8,6 and 1 hips, respectively. F value of femoral head perfusion among group A and B,group B and C,group B,D,E,F and G,Group H,I,J,L and O,group K,M and P,Group N and Q was 437. 48,30. 25,29. 04,132. 69,143. 73,25.20, respectively, and their P value was all <0. 01. F value of femoral head circulation time among group A and B,group B and C,group B,D,E,F and G,Group H,I,J,L and O,group K,M and P,Group N and Q was 386. 26,31. 83,22.43,141. 94,119.69,21.68, respectively, and their P value was all < 0.01. Conclusions Traction could lead to ischemic response and circulation disorder of canine femoral head. The longer the traction time or the bigger the traction weight was, the poorer the femoral head perfusion and the longer the femoral head circulation time were, and the slower they recovered. DSA could directly reflect these changes in the femoral head with these angioarchitectural and hemodynamic indexes.

Objective To investigate the technical protocols and feasibility of subtraction computed tomography perfusion imaging (sCTP) on observation of ischemic necrosis of femoral head (ANFH) on dog. Methods Sixteen laboratory canines underwent CT perfusion imaging (CTP) of femoral head before and after selective femoral circumflex artery embolization, and ANFH were observed. Then new sequence imaging data, created by sources imaging of CT perfusion scan using subtraction software, were analyzed at workstation (AW 4.2) with CT perfusion 3 analysis program, and data of sCTP were obtained. The parametric maps and indexes of capillary-level hemodynamics including blood volume (BV), blood flow (BF) and mean transit time (MTT) of CTP and sCTP were compared. Results ①The technical success rate of sCTP post-processing created from CTP sources imaging data was 100%. The values and mappings of BF, BV and MTT of region of interest (ROI) were all obtained from subtraction sequence images data. The post-processing time of sCTP was about 1-5 h. ② sCTP depicted ANFH well, though the values and mappings of BF, BV and MTT were different from those obtained with conventional bone CTP. Conclusion sCTP can be generated with subtraction and perfusion analysis program and techniques. It can be applied to bone CT perfusion imaging and early quantitative diagnosis of necrosis.