Objective: The treatment of trans-sphincteric fistulas is a surgical challenge since eradicating the fistula tract while maintaining the anal continence is vitally important. In this study we documented the outcomes o...Objective: The treatment of trans-sphincteric fistulas is a surgical challenge since eradicating the fistula tract while maintaining the anal continence is vitally important. In this study we documented the outcomes of the patients with one or more fistulas treated at the same operation with a new type of seton. Patients and Methods: The study included 78 patients with 107 high anal fistulas who were treated with seton between 2007 and 2011. Fifty seven patients had only one fistula, 13 patients had two isolated fistulas and 8 patients had three isolated fistulas. Group I was the patients with one fistula and Group II was the patients having more than one fistula. Postoperative complications, hospital stay, cutting through the sphincter and healing times and Wexner’s scores were compared between the two groups. Results: In Group I, there were 57 patients and in Group II, 21 patients were operated for 50 fistulas. No postoperative complications were observed except urinary retentions (4 patients in Group I, 3 patients in Group II). No infection on the operation site was documented in both groups, in Group I none of the patients needed extra dose of narcotic analgesic but in Group II two of the patients who had 3 fistulas were discharged on the second postoperative day because of pain on the operation site. The median for the cutting seton to cut through the sphincter was 31 days and complete healing was achieved with a median of 40 days in Group I, whereas it was 56 and 65 days respectively for Group II. There were no recurrences in our patients in both groups. Although the Wexner scores of the both groups were low, the difference between the groups was statistically significant. Conclusion: It seems to be feasible to perform seton by using a cheap, effective, easily inserted material, also in treatment of patients with more than one fistula while preserving anal continence.展开更多
We reported a 30 years old man who suffered a bite wound of the right hand in a fight. Two days after the injury, he was admitted in emergency because of stab wound above the head of the third metacarpal bone. He pres...We reported a 30 years old man who suffered a bite wound of the right hand in a fight. Two days after the injury, he was admitted in emergency because of stab wound above the head of the third metacarpal bone. He presented the swelling, redness, pain and fever. Primary revision confirmed only partial lesion of the extensor apparatus. During the following days, we recorded a deterioration of local findings and magnetic resonance imaging revealed osteomyelitis and septic arthritis of the third metacarpophalangeal joint. The wound was then revised several times using negative pressure wound therapy in combination with intravenous antibiotics. After resolution of clinical and laboratory findings, the wound was finally closed by delayed primary suture. Clenched fist injury is a medical emergency that requires immediate surgical revision. We treated clenched fist injury with the development of septic arthritis and osteo- myelitis with negative pressure wound therapy and obtained good outcomes.展开更多
IN the summer of 1997, during the opening ceremony of China’s Eighth National Games, a thousand women performed an elegant demonstration of Mulan Fist to the accompaniment of sweet-sounding folk music and thunderous ...IN the summer of 1997, during the opening ceremony of China’s Eighth National Games, a thousand women performed an elegant demonstration of Mulan Fist to the accompaniment of sweet-sounding folk music and thunderous applause from the audience. They were led by Ying Meifeng, the creator of Mulan Fist.展开更多
200多年前英国经济学家亚当·史密斯曾提出“自由放任”的经济发展观点。他认为“不干涉主义”就如一只“无形巨手”促使企业在为社会服务中求得自身发展。 本文作者认为,如今由于信息技术革命,新型企业雨后春笋般地涌现,政府职能...200多年前英国经济学家亚当·史密斯曾提出“自由放任”的经济发展观点。他认为“不干涉主义”就如一只“无形巨手”促使企业在为社会服务中求得自身发展。 本文作者认为,如今由于信息技术革命,新型企业雨后春笋般地涌现,政府职能减弱等因素驱使“无形巨手”演变成“无形拳头”——即无情的竞争。这只拳头正在重重地锤击或无情地摧毁竞争不力者的过程中创造未来新市场(the newmarketplace of the future)。作者随后指出:欲在市场上求得生存与发展的企业除了应提高产品质量,改进服务态度,用笼络等手段与顾客建立良好关系外,还应设法建立不让顾客流失的屏障(barriers to exit)以及控制顾客的先行权。展开更多
Apopular saying goes,“Seventy-twoof the 108 outlaws of the marsh arefrom Yuncheng.”Located inShandong Province with Liangshan Hill onits east,the Huanghe River to the north andthe Beijing-Kowloon Railway runningthro...Apopular saying goes,“Seventy-twoof the 108 outlaws of the marsh arefrom Yuncheng.”Located inShandong Province with Liangshan Hill onits east,the Huanghe River to the north andthe Beijing-Kowloon Railway runningthrough,Yuncheng has given birth to manyheroes.Sun Bin,also called Sunzi,famousmilitarist in the Warring States Period(475-221 BC)and Song Jiang,leader of afarmers uprising in the Northern SongDynasty(960-1127 AD)were both bornthere.Wushu has prevailed there forgenerations in past dynasties.Now展开更多
文摘Objective: The treatment of trans-sphincteric fistulas is a surgical challenge since eradicating the fistula tract while maintaining the anal continence is vitally important. In this study we documented the outcomes of the patients with one or more fistulas treated at the same operation with a new type of seton. Patients and Methods: The study included 78 patients with 107 high anal fistulas who were treated with seton between 2007 and 2011. Fifty seven patients had only one fistula, 13 patients had two isolated fistulas and 8 patients had three isolated fistulas. Group I was the patients with one fistula and Group II was the patients having more than one fistula. Postoperative complications, hospital stay, cutting through the sphincter and healing times and Wexner’s scores were compared between the two groups. Results: In Group I, there were 57 patients and in Group II, 21 patients were operated for 50 fistulas. No postoperative complications were observed except urinary retentions (4 patients in Group I, 3 patients in Group II). No infection on the operation site was documented in both groups, in Group I none of the patients needed extra dose of narcotic analgesic but in Group II two of the patients who had 3 fistulas were discharged on the second postoperative day because of pain on the operation site. The median for the cutting seton to cut through the sphincter was 31 days and complete healing was achieved with a median of 40 days in Group I, whereas it was 56 and 65 days respectively for Group II. There were no recurrences in our patients in both groups. Although the Wexner scores of the both groups were low, the difference between the groups was statistically significant. Conclusion: It seems to be feasible to perform seton by using a cheap, effective, easily inserted material, also in treatment of patients with more than one fistula while preserving anal continence.
文摘We reported a 30 years old man who suffered a bite wound of the right hand in a fight. Two days after the injury, he was admitted in emergency because of stab wound above the head of the third metacarpal bone. He presented the swelling, redness, pain and fever. Primary revision confirmed only partial lesion of the extensor apparatus. During the following days, we recorded a deterioration of local findings and magnetic resonance imaging revealed osteomyelitis and septic arthritis of the third metacarpophalangeal joint. The wound was then revised several times using negative pressure wound therapy in combination with intravenous antibiotics. After resolution of clinical and laboratory findings, the wound was finally closed by delayed primary suture. Clenched fist injury is a medical emergency that requires immediate surgical revision. We treated clenched fist injury with the development of septic arthritis and osteo- myelitis with negative pressure wound therapy and obtained good outcomes.
文摘IN the summer of 1997, during the opening ceremony of China’s Eighth National Games, a thousand women performed an elegant demonstration of Mulan Fist to the accompaniment of sweet-sounding folk music and thunderous applause from the audience. They were led by Ying Meifeng, the creator of Mulan Fist.
文摘200多年前英国经济学家亚当·史密斯曾提出“自由放任”的经济发展观点。他认为“不干涉主义”就如一只“无形巨手”促使企业在为社会服务中求得自身发展。 本文作者认为,如今由于信息技术革命,新型企业雨后春笋般地涌现,政府职能减弱等因素驱使“无形巨手”演变成“无形拳头”——即无情的竞争。这只拳头正在重重地锤击或无情地摧毁竞争不力者的过程中创造未来新市场(the newmarketplace of the future)。作者随后指出:欲在市场上求得生存与发展的企业除了应提高产品质量,改进服务态度,用笼络等手段与顾客建立良好关系外,还应设法建立不让顾客流失的屏障(barriers to exit)以及控制顾客的先行权。
文摘Apopular saying goes,“Seventy-twoof the 108 outlaws of the marsh arefrom Yuncheng.”Located inShandong Province with Liangshan Hill onits east,the Huanghe River to the north andthe Beijing-Kowloon Railway runningthrough,Yuncheng has given birth to manyheroes.Sun Bin,also called Sunzi,famousmilitarist in the Warring States Period(475-221 BC)and Song Jiang,leader of afarmers uprising in the Northern SongDynasty(960-1127 AD)were both bornthere.Wushu has prevailed there forgenerations in past dynasties.Now
