Objective To explore the effect of Endoanal advancement flap(ERAF)and transanal opening of interphincteric space(TROPIS)in the treatment of complex anal fistula and their impact on anorectal pressure,so as to provide a reference for clinical selection of surgical methods.Methods Eighty-four patients with complex anal fistula admitted from October 2018 to October 2022 were divided into group E received ERAF treatment(n=48)and group T received TROPIS treatment(n=36).The clinical efficacy,operation,wound surface and anorectal pressure of the two groups were compared.Results The effective rate of treatment in Group T was 97.22％,which was higher than that in Group E(87.50％),with no statistically significant difference(P＞0.05).The surgical time[(31.53 ±7.29)minutes],intraoperative bleeding volume[(29.56±7.37)ml],and wound area[(10.03± 0.96)cm2,(8.76±0.87)cm2,(6.20±0.77)cm2]on the day of surgery,7 and 14 days after surgery in Group T were all smaller than those in Group E[(35.36±8.54)min,(36.86±8.04)ml,(12.09± 1.23)cm2,(10.52±1.09)cm2 and(7.36±0.85)cm2](P＜0.05).After surgery,the VAS score and Wexner incontinence score of Group T were(1.38±0.27)and(0.21±0.08),respectively.Group E was(1.56±0.29)and(0.33±0.09),respectively.In group T,the anorectal systolic pressure at 20 mm and 30 mm and the anorectal resting pressure at 20 mm and 30 mm were(138.18±29.58)mmHg,(136.22±35.41)mmHg,(35.47±6.58)mmHg,and(32.97±8.01)mmHg,respectively.In Group E,the data was(152.78±31.53)mmHg,(156.29±32.74)mmHg,(38.29±7.62)mmHg and(36.41±7.63)mmHg,respectively.Both groups showed a decrease in score and anorectal pressure,and group T was lower than group E(P＜0.05).The incidence of adverse reactions in Group E was 20.83％,which was higher than that in Group T(11.11％),but the difference was not statistically significant(P＞0.05).Conclusion TROPIS has a better effect in the treatment of complex anal fistula,which can shorten the operation time,reduce intraoperative bleeding,reduce postoperative pain,and protect anal function.

Objective To investigate the anatomical features of aortic arch lesions in the Chinese population in order to provide anatomical reference for the development of domestic arch en-dografts.Methods Clinical data of 83 patients with aortic arch lesions were collected from a first prospective multi-center study of WeFlow-Arch stent system,which was carried out between June 1,2021 and January 1,2024 in 17 centers across China.According to their pathologic types,they were divided into an aneurysm group(67 patients)and an ulcer group(16 patients).Preoperative computed tomography angiography images were analyzed using three-dimensional reconstruction techniques to quantify the anatomical characteristics of the aorta.The resulting data were subse-quently compared to assess the anatomical suitability of the Zenith and Relay stents for use in Chinese patients.Results The anatomical feasibility of Zenith stent and Relay stent was 39.8％and 63.9％,respectively in this investigation.No significant differences were observed between the two groups in terms of anatomical features,including arch type,aortic diameter and length,di-mensions,orientation,and angulation of arch branch vessels,as well as diameters of the left and right femoral arteries,and proximal and total aortic tortuosity indices(P＞0.05).The tortuosity index of the ascending aorta was lower in the aneurysm group than the ulcer group(1.17±0.06 vs 1.22±0.08,P=0.010),but the index within the coverage region of the stent was higher in the aneurysm group than the ulcer group(2.97±0.46 vs 2.66±0.36,P=0.020).Conclusion There are significant variations in the tortuosity indexes of the ascending aorta and the coverage region of the stent among the patients with different aortic arch lesions,and thus,attention should be paid to the variations due to their prognostic implications.The anatomical suitability of foreign de-vices is not good enough for Chinese patients,so it is of great significance for developing en-dografts specifically designed for the patients of our own country.

Objective To investigate the anatomical features of aortic arch lesions in the Chinese population in order to provide anatomical reference for the development of domestic arch en-dografts.Methods Clinical data of 83 patients with aortic arch lesions were collected from a first prospective multi-center study of WeFlow-Arch stent system,which was carried out between June 1,2021 and January 1,2024 in 17 centers across China.According to their pathologic types,they were divided into an aneurysm group(67 patients)and an ulcer group(16 patients).Preoperative computed tomography angiography images were analyzed using three-dimensional reconstruction techniques to quantify the anatomical characteristics of the aorta.The resulting data were subse-quently compared to assess the anatomical suitability of the Zenith and Relay stents for use in Chinese patients.Results The anatomical feasibility of Zenith stent and Relay stent was 39.8％and 63.9％,respectively in this investigation.No significant differences were observed between the two groups in terms of anatomical features,including arch type,aortic diameter and length,di-mensions,orientation,and angulation of arch branch vessels,as well as diameters of the left and right femoral arteries,and proximal and total aortic tortuosity indices(P＞0.05).The tortuosity index of the ascending aorta was lower in the aneurysm group than the ulcer group(1.17±0.06 vs 1.22±0.08,P=0.010),but the index within the coverage region of the stent was higher in the aneurysm group than the ulcer group(2.97±0.46 vs 2.66±0.36,P=0.020).Conclusion There are significant variations in the tortuosity indexes of the ascending aorta and the coverage region of the stent among the patients with different aortic arch lesions,and thus,attention should be paid to the variations due to their prognostic implications.The anatomical suitability of foreign de-vices is not good enough for Chinese patients,so it is of great significance for developing en-dografts specifically designed for the patients of our own country.

Objective To investigate the physical fitness status of stationed on an island and the influence factors of military operational ability in order to take effective intervention measures to cope with the problems encountered by the garrison force.Methods The outdoor environment heat intensity of the island was monitored and evaluated by thermal environment monitors.The physical fitness of thirty-eight soldiers randomly selected was evaluated by measuring VO 2max. Ninety soldiers stationed on this island were selected by random sampling , for whom questionnaires and interviews were designed, involving the influence factors of military operational ability .Results This island was a typical humid-hot environment, with high temperature , high humidity and high radiation .The physical fitness of soldiers declined obviously because of the typical humid-hot environment.The top five working environmental factors were high temperature , humidity, solar radiation, wind and seasonal drying .The top five personal factors were physical fatigue , overtraining, injury, mental fatigue and lack of sleep .Conclusion Considering the obviously decreased physical fitness of soldiers caused by the typical humid-hot environment , how to assess military combat effectiveness and how to determine whether the level of combat effectiveness can meet the actual needs of tropical combat , requires scientific indicators and criteria of evaluation .

Objective To investigate the morbidity of soldiers stationed on an island ,analyze the relationship betweendiseases and the environment,and to provide an effective method for disease prevention and treatment .Method Data ofoutpatients from troops stationed on an island between September 2012 and August 2013 were statistically investigatedaccording to the classification of diseases.The cause of disease was analyzed .In addition,90 soldiers stationed on an islandwere randomly selected to investigate their response to heat and humidity and parts susceptible to skin diseases viaquestionnaires and talks.Results A total of 789 cases of disease were identified,including 226 cases of upper respiratorytract infection,118 cases of orthopedic-related diseases,90 cases of traumatic diseases,88 cases of oral diseases,74 casesof digestive system diseases,62 cases of skin diseases,53 cases of ENT diseases,41 cases of urinary tract infection,and37 cases of anorectal diseases.The top five responses to heat and humidity were sweating,thirst,body fatigue,dizzinessand profuse sweating.The most susceptible part to skin diseases was the feet ,followed by the cheek,crotch,back andneck.Conclusion The epidemiological characteristics of diseases on this island are significant,and medical supportshould be focused on improving the overall level of hospital treatment.