目的 評估倒“V”字皮瓣修復加內括約肌切斷術治療陳舊性肛裂的效果及合理性。方法 回顧性分析2000～2010年期間我院采用肛門后倒“V”字皮瓣修復加內括約肌切斷治療的62例陳舊性肛裂患者的臨床資料，并對其效果進行評價。結果 62例患者經過該手術治療，均痊愈出院。發生切口血腫4例，切口感染1例，暫時性大便滲漏4例。住院時間平均8.6d，術中出血量平均13ml，創口愈合時間平均8d。術后隨訪6～15個月（平均12個月），均未出現復發，排便情況滿意。結論 該術式治愈率高，并發癥少，是治療陳舊性肛裂有效而可行的一種手術方式。
目的 探討小兒結腸系膜淋巴管瘤的診斷與治療方法。方法 回顧性分析我院2006年1月至2011年12月期間手術治療的5例小兒結腸系膜淋巴管瘤的臨床資料。結果 3例診斷為腹腔包塊性質待查的患兒，術中發現腹腔腫塊來源于乙狀結腸系膜，其中1例腫塊侵犯到降結腸系膜達結腸脾曲而行左半結腸切除＋腸吻合術，另外2例行乙狀結腸系膜淋巴管瘤切除＋部分乙狀結腸切除＋腸吻合術；1例患兒診斷為急性化膿性闌尾炎合并乙狀結腸系膜淋巴管瘤，行闌尾切除＋乙狀結腸系膜淋巴管瘤切除＋腸吻合術，1例患兒診斷為乙狀結腸系膜淋巴管瘤破裂并彌漫性腹膜炎，行乙狀結腸系膜淋巴管瘤切除＋乙狀結腸造瘺術，術后6個月后再行二期手術。5例患兒手術后恢復良好，未發生吻合口漏等并發癥。術后隨訪5個月～5年， （2.3±1.1）年，1例失訪，余均存活，仍在隨訪中，所有病例均未復發。結論 日常行闌尾手術中，應常規探查小腸、結腸；未進行腸道準備的結腸一期吻合手術中結腸灌洗可減少吻合口漏等并發癥的發生率；腹腔感染嚴重的患兒結腸一期吻合不可取，結腸造瘺安全；小兒結腸系膜淋巴管瘤術前確診困難，反復出現腹痛、腹部包塊的患兒應想到結腸系膜淋巴管瘤的可能性，行充分的腸道準備后擇期手術，手術是腸系膜淋巴管瘤唯一的治療方法。
Objective To assess the influence of different digestive tract reconstruction on the blood glucose of gastric antral cancer patients with type 2 diabetes. Methods The clinical data of 51 cases of gastric antral cancer with type 2 diabetes treated radical surgery in this hospital from January 2006 to January 2012 were analyzed retrospectively. The patients were divided into three groups according to the different digestive tract reconstruction methods：BillrothⅠ anastomosis group （n=14）， BillrothⅡ anastomosis group （n=28）， and Roux-en-Y anastomosis group （n=9）. The indexes were analyzed and compared among three groups：① The levels of fast blood glucose （FBG） and 2h postprandial blood glucose （PG2h） were detected before operation and on 1 month and 6 months after the operation；② The level of glycated hemoglobin （HbA1c） was detected before operation and 6 months after the operation；③ The diabetes control was observed. Results The FBG and PG2h levels in the BillrothⅠ anastomosis group detected on 1 month and 6 months after the operation were not statistically different from those detected before the operation （P＞0.05）. The FBG and PG2h levels in the BillrothⅡanastomosis group and Roux-en-Y anastomosis group detected on 1 month and 6 months after the operation were significantly lower than those before the operation respectively （P＜0.05）. The FBG and PG2h levels in the BillrothⅡ anastomosis group detected on 1 month and 6 months after the operation were not statistically different from those in the Roux-en-Y anastomosis group respectively （P＞0.05）， but which were markedly lower than those in the BillrothⅠ anastomosis group， the differences were statistically significant （P＜0.05）. The HbA1c levels in the BillrothⅠ anastomosis group detected before the operation and on 6 months after the operation were not statistically different from each other （P＞0.05）. The HbA1c levels in the BillrothⅡ anastomosis group and Roux-en-Y anastomosis group detected on 6 months after the operation were markedly lower than those before the operation and the difference was statistically significant （P＜0.05）. On 6 months after the operation， the HbA1c levels in the BillrothⅡanastomosis group and Roux-en-Y anastomosis group were markedly lower than those in the BillrothⅠ anastomosis group and the differences were statistically significant （P＜0.05）；the HbA1c level was not statistically different between the BillrothⅡ anastomosis group and the Roux-en-Y anastomosis group （P＞0.05）. The total curative effects in the BillrothⅡ anastomosis and Roux-en-Y anastomosis groups were significantly better than those in the BillrothⅠ anastomosis group （P＜0.05）. Conclusion According to our limited clinical data， BillrothⅡ anastomosis and Roux-en-Y anastomosis for gastric antral cancer patients with type 2 diabetes may be the best surgical approach.
The full process information management of daytime surgery can help medical staff complete centralized patient management, improve the closed-loop quality of daytime surgery, and maximize the efficiency and management level of hospital daytime surgery operation. Since 2021, the First Hospital of Lanzhou University has integrated internal information exchange resources, big data, and artificial intelligence, created a full process management platform for daytime surgery, and explored the intelligent management of daytime surgery processes. This article shares the experience of building an intelligent daytime surgery full process management model based on interactive design information system from the aspects of platform interaction design, intelligent management mode, application effectiveness, in order to provide a reference for optimizing intelligent closed-loop management of daytime surgery.