Impact of Smoking on Anal Abscess and Anal Fistula Diseases

Background：Several studies have investigated the association between smoking and anal abscess and anal fistula （AA/F） diseases.However,the relationship between cigarette smoking and AA/F remains unclear.This study sought to assess the role of smoking in anorectal male patients in a Chinese population.Methods：In this retrospective study,a questionnaire,including smoking history,was completed over a 3-month period by male inpatients in the Proctology Department of China-Japan Friendship Hospital.＂Cases＂ were patients who had AA/F,and ＂controls＂ were patients with other anorectal complaints.Mann-Whitney U-test and Chi-square test were carried out to examine differences in baseline characteristics between groups.Subsequently,multivariate logistic regression was used to explore any related factors.Results：A total of 977 patients aged from 18 to 80 years were included,excluding those diagnosed with inflammatory bowel disease or diabetes mellitus.Out of this total,805 patients （82.4％） completed the entire questionnaire.Among the 805 patients,334 （41.5％） were cases and 471 （58.5％） were controls.Results showed significant differences between cases and controls （x2 =205.2,P ＜ 0.001）,with smoking found to be associated with the development of AA/F diseases （odds ratio：12.331,95％ confidence interval：8.364-18.179,P ＜ 0.001）.Conclusions：This study suggested smoking to be a potential risk factor for the development of AA/F diseases in a Chinese population.Consequently,current smoking patients should be informed of this relationship,and further research should be conducted to explore and investigate this further.

Acupotomy combined with fire needle for sacral nerve dysfunction syndrome:A randomized,single-blind clinical trial

Objective： To provide the clinical evidence to evaluate the feasibility and refine the protocol for acupotomy combined with fire needle and pudendal nerve block therapy in treatment of sacral nerve dysfunction syndrome（SNDS）. Methods： Seventy-five patients with SNDS were randomized into the treatment group（acupotomy and fire needle and pudendal nerve block therapy） and the control group（pudendal nerve block therapy）. After a course of treatment, Visual Analogue Scales（VAS） of anorectal pain, defecation disorders, anal incontinence, VAS of lumbar pain or soreness, VAS of abdominal distension and pain were compared before and after the treatment. Result： Scores of defecation disorders, including defecation interval time index, defecation time index, fecal property index and defecation difficulty index, of patients with SNDS in the two groups were statistically different before and after the treatment in the same group（all P〈0.05）, but the differences of those indexes between two groups were not statistically significant（all P〈0.05） after the treatment,. Scores of anal incontinence, VAS scores of lumbar pain or soreness, VAS scores of abdominal pain and distension in the two groups were statistically different before and after the treatment（all P〈0.05）. However, after treatment, the differences between two groups were not statistically significant（all P〈0.05）. VAS scores of anorectal pain in the two groups were statistically different before and after the treatment（both P〈0.05）, and that of the treatment group was statistically lower than control group after the treatment（1.61 ± 0.95 vs. 3.04 ± 1.81, P〈0.01）, the total effective rate of the treatment group was higher than that of the control group, and the difference was statistically significant（94.74% vs. 81.08%, P〈0.01）, there was no difference in self-evaluation between the two groups（P〈0.05）. Conclusion： In treating SNDS, acupotomy combined with fire needle and pudendal nerve block therapy can more effectively alleviate anorectal pain and improve the total effective rate.