Application and development of suture-dragging therapy for anal fistula / 中华胃肠外科杂志

Traditional Chinese surgical treatment "suture-dragging" therapy is based on medical thread therapy and tight seton drainage in combination of minimal invasive surgical principle. It can preserve the integrity of anal sphincter musculature involved in fistulous tract or abscess and maintain anal function. This article not only describes in detail about the operation points and mechanisms of "suture-dragging" therapy of anorectal fistula, but also reviews the application and modification of anorectal disease.

Analysis on mental health status of health system staffs in a district of Chongqing municipality / 重庆医学

Objective To investigate the mental health states of health system staffs in a district of Chongqing municipality. Methods Seven hundred and seventy-three health system staffs were taken as the research subjects for conducting the investigation by the Symptoms Checklist-90 (SCL-90).With the total SCL-90 score >160 as the positive psychological symptom,the total mean scores of SCL-90 and the 9 items of factor score of somatization,obsession,personal relations,depression,anxiety,hostility,dread, paranoid and psychotics were performed the statistical analysis.Results The positive rate of psychological symptoms in 773 health system staffs was 17.46% (135/773),among them which in the clinical nurses,clinicians and nonclinical staffs were 23.20%(58/250),15.63%(50/320)and 13.30%(27/203)respectively.The somatization and obsession scores of the health system staffs in this district were obviously higher than those of the national norm (P 0.05).The total mean scores of the clinical nurses were higher than those of the non-clinical staffs(P <0.05).Conclusion The scores of multiple factors had significant differences between the health system staffs in this district and the national norm.The psychological health status in the clinicians was poorer than that in the non-clinical staffs,especially the psychological health status in the clinical nurses were much poorer.

Risk factors for early postoperative cognitive dysfunction in elderly patients undergoing spinal surgery / 中华麻醉学杂志

Objective To identify the risk factors for early postoperative cognitive dysfunction (POCD) in the elderly patients undergoing spinal surgery.Methods One hundred and fifty ASA Ⅱ or Ⅲ patients,aged ≥65 yr,undergoing elective spinal surgery under general anesthesia,were studied.Venous blood samples were taken at 1 day before operation and 7 days after operation to determine the concentration of serum S-100B protein.Cognitive function was assessed by Mini-Mental State Examination (MMSE) at 1 day before operation and 7 days after operation.The patients were diagnosed as having POCD if MMSEpre-MMSEpost ≥ 3.The patients were divided into POCD group and non-POCD group.Age,body weight,sex,education,type of operations,complications,preoperative TCM syndrome type,MMSE score at 1 day before operation and 7 days after operation,duration of operation,emergence time,and intraoperative blood loss,cardiovascular events,and amount of fluid infused per hour were recorded.The risk factors for POCD were analyzed using multivariate logistic regression analysis.Results Thirty-eight patients developed early POCD (25.3％).The resuhs of logistic regression analysis showed that age ≥ 70 yr,elementary education or below,duration of operation ≥5 b,and the number of hypotension occurred during operation≥3 were the risk factors for early POCD.Conclusion Age≥70 yr,elementary education or below,duration of operation ≥ 5 h,and the number of hypotension occurred during operation ≥ 3 are the risk factors for early POCD in the elderly patients undergoing spinal surgery.