Long-term efficacy of bioprosthetic anal fistula plug in the treatment of transsphincteric anal fistula / 中华胃肠外科杂志

Objective@#To evaluate the long-term healing rate of transsphincteric anal fistula treated with anal fistula plug procedure and the risk factors affecting the healing of anal fistula.@*Methods@#A retrospective case-control study was conducted to analyze the clinical data of 207 patients with transsphincteric anal fistulas who received anal fistula plug procedure at the Department of General Surgery, Beijing Chaoyang Hospital of Capital Medical University from August 2008 to September 2012. Inclusion criteria: (1) consistent with the diagnosis of transsphincteric anal fistula: the anal fistula passed through the internal and external sphincter; (2) complete data; (3) initial treatment with anal fistula plug procedure. Exclusion criteria: (1) acute rectal or perianal infection or poorly controlled focal infection; (2) recent incision and drainage of perianal abscess or spontaneous rupture of abscess; (3) patients with malignant tumor; (4) patients with Crohn′s disease or ulcerative colitis; (5) patients with heart, liver, brain, lung or renal insufficiency; (6) cachexia due to various chronic wasting diseases; (7) patients could not tolerate surgery. Patients were followed up for anal fistula healing. The cumulative healing rate of patients with transsphincteric anal fistula was plotted using the Kaplan-Meier method, and the factors affecting anal fistula healing were explored by univariate and multivariate logistic regression analysis.@*Results@#There were 186 males and 21 females with age of 15 to 69 (mean 38) years. The duration of anal fistula was 3-60 (mean 15) months. Three patients had a history of previous episodes of perianal abscess and underwent incision and drainage of perianal abscess (all more than 3 months). During follow-up ending on October 31, 2018, 72 patients (34.8%) were lost to follow-up. Among 135 patients who were successfully followed up, the average follow-up period was 96 (75-124) months. Seventy-five patients had anal fistula healing, with healing rate of 55.6%. Kaplan-Meier survival curve showed that the healing time of anal fistula was prolonged and finally stabilized at 55.6%. In the patients who failed initial treatment with anal fistula plug packing, there were 6 cases whose anal fistula healed spontaneously without other treatment. Among them, 3 cases healed spontaneously 2 years and 3 cases 3 years after operation without recurrence. From 2008 to 2012, the annual healing rates of anal fistula plug treatment were 3/6, 61.5% (24/39), 42.1% (24/57), 12/15 and 12/18, respectively. Multivariate logistic regression analysis showed that the duration of anal fistula≥6 months (OR=3.187, 95% CI: 1.361-7.466, P=0.008) was an independent risk factor for anal fistula healing after treatment with anal fistula plug.@*Conclusion@#The long-term efficacy of anal fistula plug procedure in the treatment of transsphincteric anal fistula is positive, and this procedure should be implemented as soon as possible.

Diagnostic value of multi-slice spiral computerized tomographic fistulography in congenital fistula of neck / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the usefulness and effectiveness of multi-slice spiral computerized tomographic fistulography (MSCTF) in the diagnosis and treatment of congenital fistula of neck.@*Methods@#Thirty-four patients with thyroglossal fistulasor branchial cleft fistulas who were initial treated from July 2008 to August 2015 in Fujian Provincial Hospital were retrospectively analyses. Thirteen males and 21 females patients aging from 3 to 46 years old with a median age of 37 were included. There were thyroglossal fistula in 6 cases, the first branchialcleft fistula in 9 cases, the second branchialcleft fistula in 3 cases, the third branchialcleft fistula in 9 cases, and the fourth branchialcleft fistula in 7 cases. All the patients underwent preopeative MSCTF and the diagnoses were finally confirmed with surgery and histopathology. Multiplanar reconstruction(MPR), maximumintensity projection(MIP)and volume rendering(VR) were completed with AW Volume Share 4.2 image processing software after initial CT scanning.The internal openings, distribution, and neighboring relationship of the fistulas showed by MSCTF were analyzed and the surgical strategies were subsequently made.@*Results@#Except 2 cases, 32 patients had obtained successfully MSCTF image. The presence and location of the fistulas could be showed clearly on MSCTF. Based on the results of MSCTF examination, the surgical planes to treat the fistulas were made. The fistulas in all cases were successfully found and excised. Three cases underwent selective neck dissection. Postoperative infection occurred in 1 case. Unilateral vocal fold paralysis due to surgery recovered 3 months after surgery with follow-up. One case lost follow-up, the remaining 33 cases were followed up for 13-97 months with no the fistula recurrence.@*Conclusions@#MSCTF could provide valuable information and benefit surgical planning by demonstrating the coursesof congenital fistulas of neck in detail.

Female outlet obstruction constipation: assessment with MR defecography / 中华放射学杂志

Objective Using MR defecography to assess the morphological and functional anorectal anomalies related to female outlet obstruction constipation, and evaluate the joint disease of anterior and mid pelvic. Methods One hundred and seven female patients, aged 20 to 84 years ( average, 55 years), were diagnosed as outlet obstruction constipation based on clinical symptoms and signs. They all received MR defecography in our institution. The high compliance homemade balloon was inserted into rectum to simulate stool Then relevant measurements were obtained during rest, squeezing and straining, respectively. Results In all the 107 cases, 70 ( 65.4% ) presented rectocele on dynamic MRI; 28 ( 26. 2% ) presented anismus;60 (56. 1% ) presented cystocele; 59 presented vaginal or cervical prolapse(55. 1% ); and, 54 (50. 5% )presented descending perineum. In 85 females (79.4%) multiple disorders were detected, involving more than one pelvic compartment. Conclusion MR defecography allowed to accurately evaluate the morphological and functional anorectal anomalies related to female outlet obstruction constipation, and the joint disease of anterior and mid pelvic.

A novel capsule-style manometric system and its application on non-invasive measurement of pancolonic pressure / 生物医学工程学杂志

Pan-colonic motility was studied under normal conditions with a novel capsule-style system. A single use telemetry capsule embedded with one pressure sensor was ingested by subjects. It is capable of transmitting colonic pressure wirelessly greater than 130 h. Time of capsule entering segmental colon was determined by ultrasonic detection for tracing the batteries in capsule. The ultrasonic electrodes were mounted on the surface of subjects' ileocecum, navel as well as the junction of left colon and rectosigmoid colon in sequence. They were identified by abdominal X-rays with radiopaque markers. The confirming X-rays showed all telemetry capsules were detected successfully when passing through the key points in colon. A total of 613 h of colorectal recording was obtained from 20 healthy subjects. When compared with the parameters in the time of waking, the number of contractions and the area under contractions were significantly (P<0.05) decreased during sleep (21 +/- 5 vs 15 +/- 4 h(-1); 463 +/- 54 vs 342 +/- 45 mmHg x s x min(-1)). The colonic motility exhibited significant regional variation in the circadian behavior, as well as in its response to waking and meal. The clinical study proved the reliability and non-invasiveness of the system. It may represent a useful tool for the study on physiology and pathology of colonic motor disorders.

Application of video laryngoscope in diagnosis and treatment of laryngeal diseases / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the value of video laryngoscope in diagnosis of laryngeal diseases. To study the effect of video laryngoscope in treatment of laryngeal diseases.Method:Pentax VNL-1530T and Olympus BF-240T video laryngoscope were used in diagnosis of 3628 cases of laryngeal diseases and in treatment of 1221 cases of laryngeal diseases.Result:3628 cases were examined by video laryngoscope,and correct diagnosis was made.768 cases of vocal cord polyp and 249 cases of vocal cord node were excised, 113 cases of foreign bodies in hypopharynx or larynx were removed.91 cases of other laryngeal diseases were treated under video laryngoscope.Conclusion: Video laryngoscope is a new excellent instrument in diagnosis and treatment of laryngeal disease.

Comparative study of heat injury on vocal cord mucosa induced by different power semi conductor laser / 第二军医大学学报

Objective: To explore the heat injury level of vocal cord by different power of the Diomed 25 semi conductor laser so as to provide scientific evidence for clinical laser therapy of larynx diseases. Methods: Canine was used. The power of laser was set on 5, 10 and 20 W respectively, and the time of laser exposure was fixed on 2 s.When canine vocal cord was hit by laser in vivo , the depth and width of the tissue heat injury were measured. Results: When laser hit with 5, 10 and 20 W for 2 s exposure time, the corresponding depth of the tissue heat injury were 0.2 0.4,0.4 0.6,0.8 1.0 mm respectively, the corresponding width of the tissue heat injury were 1.0 1.7,1.7 2.0,2.0 2.6 mm respectively. There was significant difference between the tissue heat injury levels caused by different laser power under the same exposure time( P

Effect of basic fibroblast growth factor on nerve regeneration of posterior cricoarytenoid muscle in dogs / 第二军医大学学报

Objective: To investigate the effects of basic fibroblast growth factor(bFGF) on nerve regeneration of the posterior cricoarytenoid muscles(PCM) in dogs. Methods: After transection of the laryngeal recurrent nerves, the denervated PCM were reinnervated by nerve muscle pedicle implantation in 9 dogs. The animals were divided into 3 groups: bFGF and fibrin glue(FG) group(bFGF+FG), FG group and control group. Functional recovery of PCM was observed laryngoscopically. Electrophysiological acvitity and muscle contract strength were determined. Histochemical studies were demonstrated by Karnovsky and H E stain. Results: Six months after operation, functional recovery and nerve regeneration of the PCA in bFGF+FG group were the best in 3 groups (close to normal), and functional recovery in FG group was better than that in control group. The parameters of electrophysiological acvitity and muscle contract strength were different in bFGF+FG group , FG group, and control group( P

Electronic laryngoscopic diagnosis and therapy for laryngeal diseases / 第二军医大学学报

Objective: To study the diagnostic and therapeutic effects of electronic laryngoscope in treating laryngeal diseases and discuss some problems concerned. Methods: Follow up studies were conducted in 846 patients with laryngeal diseases who were treated electronic laryngoscopically in our department and sex, site of lesion and therapeutic effect were analyzed. Results: The incidence of vocal polyp and nodules in female was significantly higher than that in male, and vise versa in vocal cyst and leukoplakia. Vocal nodules could be located bilaterally, while vocal cyst unilaterally. The operative style applied showed good therapeutic effect. The effective rate for vocal polyp, nodule, and cyst was 99.84%~100%, and that for vocal leukoplakia, 66.67%. Conclusion: Operation under electronic laryngoscope has advantages of rapid performance, small dead angle, high accuracy, few complications, clear image, and little pain, and is beneficial to early diagnosis and treatment of laryngeal diseases. So it is worthy of wide application. [