No abstract

Background Pulmonary rehabilitation is a crucial part of the nonpharmacological treatment of stable chronic obstructive pulmonary disease (COPD), but management remains problematic. WeChat could serve as a useful tool in patient management. Baduanjin is a popular exercise in China that is usually applied in pulmonary rehabilitation, which has been confirmed to be effective in improving lung function and life quality. Objective This study aimed to explore the efficiency of WeChat in the management of Baduanjin exercise in COPD patients. Methods A total of 200 patients from the respiratory department of Putuo Hospital participated in the Baduanjin rehabilitation project from September 2018 to October 2019, and were randomly assigned to the WeChat and control groups and followed up using the WeChat platform or telephone for 12 weeks. The frequency of Baduanjin exercise, lung function (percentage of forced expiratory volume in 1 second predicted, FEV1% predicted), and COPD assessment test (CAT) scores were collected and compared between the two groups. The number of message exchanges and a satisfaction survey on the WeChat platform were used to assess the feasibility of WeChat management outside the hospital. Results The Baduanjin exercise frequency significantly differed between the control group and WeChat group (F=33.82, P<.001) and across various time points (F=214.87, P<.001). After the follow-up on WeChat, there were fewer patients not performing Baduanjin exercise. The FEV1% predicted value significantly differed before and after Baduanjin exercise in the control group (Z=−3.686, P<.001) and the WeChat group (Z=−6.985, P<.001). A significant difference in the FEV1% predicted value was observed after Baduanjin exercise between the two groups (Z=−3.679, P<.001). The CAT score significantly differed before and after Baduanjin exercise in the control group (Z=−4.937, P<.001) and the WeChat group (Z=−5.246, P<.001). A significant difference in the CAT score was observed after Baduanjin exercise between the two groups (Z=−5.246, P<.001). The number of completed Baduanjin exercises, lung function, and CAT scores in active patients were higher than those in nonactive patients. All satisfaction survey items were scored with more than 4 points. Among the items, the highest score (mean 4.54, SD 0.77) was for continued WeChat management, followed by the effective management of Baduanjin exercise (mean 4.46, SD 0.87). The patients in the WeChat group showed much higher enthusiasm for and compliance with Baduanjin exercise, resulting in better life quality and lung function. The patients were very satisfied with the WeChat management because of the obvious curative effect and home feeling. Conclusions The WeChat platform provided a feasible, effective, and sustainable management plan for Baduanjin rehabilitation. Trial Registration Chinese Clinical Trial Registry ChiCTR1900028248; http://www.chictr.org.cn/showprojen.aspx?proj=46995

Procedure for Prolapse and Hemorrhoids (PPH), also known as circular stapled hemorrhoidectomy, is a common method of treating hemorrhoids due to its low risk of complications and minimal postoperative pain. Several complications have appeared alongside the rise of treated cases, however, and this has led to a progressive slowing of the clinical use of PPH in recent years. Anastomotic stenosis is one of the most common complications of PPH, but the greater amount of tissue removed and the speed with which it can heal make it the best choice for patients with severe prolapsed annular hemorrhoids or rectal mucosal prolapse. Therefore, academics continue to comprehensively study PPH to take advantage of annular resection and reduce complications. In this paper, we analyzed the causes, intraoperative warnings, and postoperative therapy of anastomotic stenosis induced by PPH, with an eye toward scientific application in the anorectal field, based on the experience of clinical applications.

BACKGROUND Pulmonary rehabilitation is a crucial part of the nonpharmacological treatment of stable chronic obstructive pulmonary disease (COPD), but management remains problematic. WeChat could serve as a useful tool in patient management. Baduanjin is a popular exercise in China that is usually applied in pulmonary rehabilitation, which has been confirmed to be effective in improving lung function and life quality. OBJECTIVE This study aimed to explore the efficiency of WeChat in the management of Baduanjin exercise in COPD patients. METHODS A total of 200 patients from the respiratory department of Putuo Hospital participated in the Baduanjin rehabilitation project from September 2018 to October 2019, and were randomly assigned to the WeChat and control groups and followed up using the WeChat platform or telephone for 12 weeks. The frequency of Baduanjin exercise, lung function (percentage of forced expiratory volume in 1 second predicted, FEV1% predicted), and COPD assessment test (CAT) scores were collected and compared between the two groups. The number of message exchanges and a satisfaction survey on the WeChat platform were used to assess the feasibility of WeChat management outside the hospital. RESULTS The Baduanjin exercise frequency significantly differed between the control group and WeChat group (<i>F</i>=33.82, <i>P&lt;</i>.001) and across various time points (<i>F</i>=214.87, <i>P&lt;</i>.001). After the follow-up on WeChat, there were fewer patients not performing Baduanjin exercise. The FEV1% predicted value significantly differed before and after Baduanjin exercise in the control group (<i>Z</i>=−3.686, <i>P</i>&lt;.001) and the WeChat group (<i>Z</i>=−6.985, <i>P&lt;</i>.001). A significant difference in the FEV1% predicted value was observed after Baduanjin exercise between the two groups (<i>Z</i>=−3.679, <i>P</i>&lt;.001). The CAT score significantly differed before and after Baduanjin exercise in the control group (<i>Z</i>=−4.937, <i>P&lt;</i>.001) and the WeChat group (<i>Z</i>=−5.246, <i>P</i>&lt;.001). A significant difference in the CAT score was observed after Baduanjin exercise between the two groups (<i>Z</i>=−5.246, <i>P&lt;</i>.001). The number of completed Baduanjin exercises, lung function, and CAT scores in active patients were higher than those in nonactive patients. All satisfaction survey items were scored with more than 4 points. Among the items, the highest score (mean 4.54, SD 0.77) was for continued WeChat management, followed by the effective management of Baduanjin exercise (mean 4.46, SD 0.87). The patients in the WeChat group showed much higher enthusiasm for and compliance with Baduanjin exercise, resulting in better life quality and lung function. The patients were very satisfied with the WeChat management because of the obvious curative effect and home feeling. CONCLUSIONS The WeChat platform provided a feasible, effective, and sustainable management plan for Baduanjin rehabilitation. CLINICALTRIAL Chinese Clinical Trial Registry ChiCTR1900028248; http://www.chictr.org.cn/showprojen.aspx?proj=46995

Purpose to investigate preventive measures of rectal stricture after procedure for prolapse and hemorrhoids (PPH) and to intervene early. Methods A total of 400 patients with severe mixed hemorrhoids hospitalized in the [anonymous hospital] from January 2018 to February 2022 were randomly divided into the experimental group and control group A, B, and C, with 100 patients in each group. Experimental group: Thread-drawing during operation and anal enlargement after PPH. Group A: Thread-drawing during PPH surgery, group B: Anal enlargement after PPH, and group C: PPH alone. The anastomotic sites of the 4 groups were observed for 1-2 months and followed up for 1-3 years. Results The effective rate of mixed hemorrhoid treatment in the 4 groups was 100%. There was no rectal stenosis in the experimental group, 11% in group A, 7% in group B, and 14% in group C. Conclusion Multipoint thread-drawing and anal enlargement after PPH can avoid postoperative rectal stenosis and can strengthen anastomosis and reduce bleeding, while being a simple procedure that can be easily popularized.