AIM:To investigate the role of anal cushions in hemorrhoidectomy and its effect on anal continence of the patients.METHODS:Seventy-six consecutive patients(33 men and 43 women) with a mean age of 44 years were include...AIM:To investigate the role of anal cushions in hemorrhoidectomy and its effect on anal continence of the patients.METHODS:Seventy-six consecutive patients(33 men and 43 women) with a mean age of 44 years were included.They underwent Milligan-Morgan hemorrhoidectomy because of symptomatic third-and fourth-degree hemorrhoids and failure in conservative treatment for years.Wexner score was recorded and liquid continence test was performed for each patient before and two months after operation using the techniques described in our previous work.The speed-constant rectal lavage apparatus was prepared in our laboratory.The device could output a pulsed and speed-constant saline stream with a high pressure,which is capable of overcoming any rectal resistance change.The patients were divided into three groups,group A(< 900 mL),group B(900-1200 mL) and group C(> 1200 mL) according to the results of the preoperative liquid continence test.RESULTS:All the patients completed the study.The average number of hemorrhoidal masses excised was 2.4.Most patients presented with hemorrhoidal symptoms for more than one year,including a mean duration of incontinence of 5.2 years.The most common symptoms before surgery were anal bleeding(n = 55),prolapsed lesion(n = 34),anal pain(n = 12) and constipation(n = 17).There were grade Ⅲ hemorrhoids in 39(51.3%) patients,and grade Ⅳ in 37(48.7%) patients according to Goligher classification.Five patients had experienced hemorrhoid surgery at least once.Compared with postoperative results,the retained volume in the preoperative liquid continence test was higher in 40 patients,lower in 27 patients,and similar in the other 9 patients.The overall preoperative retained volume in the liquid continence test was 1130.61 ± 78.35 mL,and postoperative volume was slightly decreased(991.27 ± 42.77 mL),but there was no significant difference(P = 0.057).Difference was significant in the test value before and after hemorrhoidectomy in group A(858.24 ± 32.01 mL vs 574.18 ± 60.28 mL,P = 0.011),but no obvious difference was noted in group B or group C.There was no significant difference in Wexner score before and after operation(1.68 ± 0.13 vs 2.10 ± 0.17,P = 0.064).By further stratified analysis,there was significant difference before and 2 months after operation in group A(2.71 ± 0.30 vs 3.58 ± 0.40,P = 0.003).In contrast,there were no significant differences in group B or group C(1.89 ± 0.15 vs 2.11 ± 0.19,P = 0.179;0.98 ± 0.11 vs 1.34 ± 0.19,P = 0.123).CONCLUSION:There is no difference in the continence status of patients before and after Milligan-Morgan hemorrhoidectomy.However,patients with preoperative compromised continence may have further deterioration of their continence,hence Milligan-Morgan hemorrhoidectomy should be avoided in such patients.展开更多
Whether or not Grenvillian orogeny occurred in South China still remains highly controversial because high-quality,discriminating data are lacking,and therefore,the key to resolve this matter is to find datable volcan...Whether or not Grenvillian orogeny occurred in South China still remains highly controversial because high-quality,discriminating data are lacking,and therefore,the key to resolve this matter is to find datable volcanic and/or sedimentary rocks related to Grenvillian orogeny. Such rocks are apparently present in the Fuliangpeng Member from the lower-middle part of Kunyang Group in central Yunnan; here the unit is more than 100 m thick and consists of andesitic ignimbrite,tuffite,terrigeous clastic rocks and carbonates. These volcanic rocks,developed south of the Sibao fold-thrust belts,represent the earliest calc-alkaline volcanic activity in late Precambrian time from central Yunnan and are coeval with both a change in sedimentary facies from detritus to carbonates and the beginning of seismite development elsewhere. Two samples for SHRIMP analysis were collected from this volcanic unit. Sample G3-29-2,from the bottom of Fuliangpeng Member,is an ignimbrite,and about 100 zircon crys-tals recovered from it have euhedral shapes and display relatively simple sector zonation under cathodoluminescent (CL) imaging,suggesting a magmatogenic origin. Twenty-five of the zircons were analyzed and a weighed-mean U-Pb age of 1032±9 Ma was obtained. Sample G3-29-3 from uppermost part of Fuliangpeng Member is a tuffite,and many rounded,evidently detrital zircons were recovered. Nine of these zircons were analyzed,and the oldest single-grain U-Pb zircon age is 1938±26 Ma,im-plying that Paleoproterozoic basement developed in Cathaysia. The dating result,combined with the geotectonic research on the Fuliangpeng Member,leads us to conclude that late Mesoproterozoic orogenic volcanic activity occurred in the western part of South China,and that the related collision of Yangtze and Cathaysian cratons was an integral part of the assembly of Rodinia.展开更多
文摘AIM:To investigate the role of anal cushions in hemorrhoidectomy and its effect on anal continence of the patients.METHODS:Seventy-six consecutive patients(33 men and 43 women) with a mean age of 44 years were included.They underwent Milligan-Morgan hemorrhoidectomy because of symptomatic third-and fourth-degree hemorrhoids and failure in conservative treatment for years.Wexner score was recorded and liquid continence test was performed for each patient before and two months after operation using the techniques described in our previous work.The speed-constant rectal lavage apparatus was prepared in our laboratory.The device could output a pulsed and speed-constant saline stream with a high pressure,which is capable of overcoming any rectal resistance change.The patients were divided into three groups,group A(< 900 mL),group B(900-1200 mL) and group C(> 1200 mL) according to the results of the preoperative liquid continence test.RESULTS:All the patients completed the study.The average number of hemorrhoidal masses excised was 2.4.Most patients presented with hemorrhoidal symptoms for more than one year,including a mean duration of incontinence of 5.2 years.The most common symptoms before surgery were anal bleeding(n = 55),prolapsed lesion(n = 34),anal pain(n = 12) and constipation(n = 17).There were grade Ⅲ hemorrhoids in 39(51.3%) patients,and grade Ⅳ in 37(48.7%) patients according to Goligher classification.Five patients had experienced hemorrhoid surgery at least once.Compared with postoperative results,the retained volume in the preoperative liquid continence test was higher in 40 patients,lower in 27 patients,and similar in the other 9 patients.The overall preoperative retained volume in the liquid continence test was 1130.61 ± 78.35 mL,and postoperative volume was slightly decreased(991.27 ± 42.77 mL),but there was no significant difference(P = 0.057).Difference was significant in the test value before and after hemorrhoidectomy in group A(858.24 ± 32.01 mL vs 574.18 ± 60.28 mL,P = 0.011),but no obvious difference was noted in group B or group C.There was no significant difference in Wexner score before and after operation(1.68 ± 0.13 vs 2.10 ± 0.17,P = 0.064).By further stratified analysis,there was significant difference before and 2 months after operation in group A(2.71 ± 0.30 vs 3.58 ± 0.40,P = 0.003).In contrast,there were no significant differences in group B or group C(1.89 ± 0.15 vs 2.11 ± 0.19,P = 0.179;0.98 ± 0.11 vs 1.34 ± 0.19,P = 0.123).CONCLUSION:There is no difference in the continence status of patients before and after Milligan-Morgan hemorrhoidectomy.However,patients with preoperative compromised continence may have further deterioration of their continence,hence Milligan-Morgan hemorrhoidectomy should be avoided in such patients.
基金Supported by China Geological Survey (Grant No. 200313000055)Program for Changjiang Scholars and Innovative Research Team in University (Grant No. IRT0546)the National Natural Science Foundation of China (Grant No. 40621002)
文摘Whether or not Grenvillian orogeny occurred in South China still remains highly controversial because high-quality,discriminating data are lacking,and therefore,the key to resolve this matter is to find datable volcanic and/or sedimentary rocks related to Grenvillian orogeny. Such rocks are apparently present in the Fuliangpeng Member from the lower-middle part of Kunyang Group in central Yunnan; here the unit is more than 100 m thick and consists of andesitic ignimbrite,tuffite,terrigeous clastic rocks and carbonates. These volcanic rocks,developed south of the Sibao fold-thrust belts,represent the earliest calc-alkaline volcanic activity in late Precambrian time from central Yunnan and are coeval with both a change in sedimentary facies from detritus to carbonates and the beginning of seismite development elsewhere. Two samples for SHRIMP analysis were collected from this volcanic unit. Sample G3-29-2,from the bottom of Fuliangpeng Member,is an ignimbrite,and about 100 zircon crys-tals recovered from it have euhedral shapes and display relatively simple sector zonation under cathodoluminescent (CL) imaging,suggesting a magmatogenic origin. Twenty-five of the zircons were analyzed and a weighed-mean U-Pb age of 1032±9 Ma was obtained. Sample G3-29-3 from uppermost part of Fuliangpeng Member is a tuffite,and many rounded,evidently detrital zircons were recovered. Nine of these zircons were analyzed,and the oldest single-grain U-Pb zircon age is 1938±26 Ma,im-plying that Paleoproterozoic basement developed in Cathaysia. The dating result,combined with the geotectonic research on the Fuliangpeng Member,leads us to conclude that late Mesoproterozoic orogenic volcanic activity occurred in the western part of South China,and that the related collision of Yangtze and Cathaysian cratons was an integral part of the assembly of Rodinia.
