高校作为我国科技创新的主力军,在我国的基础研究和重大原始性创新研究中具有举足轻重的地位.采用因子分析法,对我国各省高校的科技创新能力展开研究,不仅可以找出影响科技创新能力高低的因素,而且能根据科技创新能力的区域性差异提出针对性建议.

目的 探讨影响直肠癌前切除综合征(anterior resection syndrome,ARS)的危险因素.方法 选取第二炮兵总医院2013年8月至2014年10月期间收治的低位直肠癌并拟行直肠癌保肛术患者67例,其中行直肠癌低位前切除术(low anterior resection,LAR) 42例,经括约肌间切除术(intersPhincter resection,ISR)25例.术后随访1年,使用ARS评分系统评价ARS的严重程度,将患者年龄、性别、体质量指数(BMI)、TNM分期、手术方式、手术途径、吻合口高度、是否行预防性造口以及是否行辅助放化疗作为研究指标,评价其对ARS严重程度的影响.结果 单因素分析结果显示,手术方式、预防性造口、放疗、吻合口高度以及年龄对ARS程度有影响,差异有统计学意义(P＜0.05);多因素分析结果显示,手术方式(OR=4.506,95％ CI:1.220,16.640,P=0.024)和放疗(OR=14.688,95％ CI:3.200,67.429,P=0.001)对ARS程度影响的差异有统计学意义.结论 手术方式和放疗是ARS发生的独立危险因素.

OBJECTIVETo explore the value of preoperative evaluation with three-dimensional endoanal ultrasonography (3D-EAUS) for anal fistula in order to provide preoperative assessment for anal fistula.METHODSOne hundred patients diagnosed with anal fistula undergoing surgery between March 2012 and March 2013 in our department were prospectively enrolled. All the patients were randomly divided into the ultrasound group and the control group with fifty patients in each group. The ultrasound group received 3D-EAUS and the control group received routine examinations (digital examination and probe) to assess the position of the internal opening, the type of fistula and secondary tracks, respectively. The concordance rate of the preoperative assessment and intraoperative exploration was evaluated between the two groups.RESULTSThe accuracy of identifying internal opening was 96.0% for the ultrasound group and 82.0% for the control group with statistically significant difference (P=0.02). The accuracy of identifying internal opening for simple anal fistula was similar (95.0% vs. 91.3%, P=1). For complex anal fistula, the accuracy was also higher in the ultrasound group (96.7% vs. 74.1%, P=0.025). The accuracy of fistula classification was 78.0% for the ultrasound group and 96.0% for the control group with significant difference (P=0.01). The accuracy of identifying a second track was higher in the ultrasound group (96.0% vs. 82.0%, P=0.025).CONCLUSIONSIt is significantly superior for 3D-EAUS to detect the internal opening, fistula classification and identification of a second track in complex anal fistulas as compared to conventional examination. 3D-EAUS should be recommended as a preoperative assessment for anal fistula, especially for complex one.