Digital rectal examination(DRE)is essential for diagnosing anorectal diseases,yet its widespread adoption remains suboptimal among practitioners.While modalities such as anorectal manometry,rectal balloon expulsion te...Digital rectal examination(DRE)is essential for diagnosing anorectal diseases,yet its widespread adoption remains suboptimal among practitioners.While modalities such as anorectal manometry,rectal balloon expulsion tests,pelvic floor electromyography,and dynamic imaging(defecography/pelvic floor magnetic resonance imaging)enable comprehensive assessment of anorectal function,many healthcare facilities lack advanced diagnostic tools and specialized personnel.DRE has notable diagnostic value in the primary evaluation of functional defecation disorders(FDDs),particularly for detecting dyssynergic defecation and structural pelvic floor defects.Its cost efficiency and universal accessibility render it indispensable in resource-limited environments where high-resolution diagnostic technologies(e.g.,high-resolution manometry)are unavailable.This review delineates standardized DRE protocols for assessing FDDs and highlights characteristic imaging features of FDDs with the aim of improving the understanding of DRE.This review will hopefully encourage clinicians to perform DREs in diverse clinical settings.展开更多
BACKGROUND Xuanshen decoction(XSD)is a traditional Chinese medicine formulation that is often applied in treating slow transit constipation(STC).However,its specific therapeutic mechanism remains to be characterized.A...BACKGROUND Xuanshen decoction(XSD)is a traditional Chinese medicine formulation that is often applied in treating slow transit constipation(STC).However,its specific therapeutic mechanism remains to be characterized.AIM To investigate the mechanism of XSD for STC,we combined network pharmacology prediction,molecular docking analysis,and in vivo studies.METHODS The therapeutic effects of XSD on loperamide-induced STC in rats were assessed through 24-hour fecal number,fecal moisture content,and intestinal propelling rate.Hematoxylin–eosin and Alcian blue/periodic acid-Schiff staining were applied to analyze colonic mucosa for histopathological presentation and mucin production.Next,the mechanism of action of XSD for STC was elucidated through network pharmacology and molecular docking analyses,and the findings were validated by the animal experiments.RESULTS XSD significantly alleviated the symptoms of STC in rats.Relative to the STC rats,in the medium-dose XSD and high-dose XSD rats,stem cell factor,C-kit,phosphophosphoinositide 3-kinase/phosphoinositide 3-kinase,phospho-protein kinase B/protein kinase B,catalase,and superoxide dismutase were substantially upregulated(P<0.01);nuclear factor erythroid 2-related factor 2(nuclear/cytoplasmic)and B-cell lymphoma 2(Bcl-2)were increased(P<0.05),while cleaved caspase-3,Bcl-2-associated X protein(Bax)/Bcl-2,and malondialdehyde were significantly reduced(P<0.01).Heme oxygenase-1 and glutathione peroxidase in the high-dose XSD group were significantly increased(P<0.01),and Bax was statistically lowered(P<0.01);glutathione peroxidase in the medium-dose XSD group was increased(P<0.05),while Bax was reduced(P<0.05).CONCLUSION XSD may inhibit oxidative-stress-induced apoptosis in interstitial cells of Cajal by stimulating the phosphoinositide 3-kinase/protein kinase B/nuclear factor erythroid 2-related factor 2 pathway,thereby effectively treating STC.展开更多
Constipation is a common gastrointestinal disorder characterized by infrequentbowel movements and difficulty in passing stools.It can significantly affect anindividual's quality of life and overall well-being.Unde...Constipation is a common gastrointestinal disorder characterized by infrequentbowel movements and difficulty in passing stools.It can significantly affect anindividual's quality of life and overall well-being.Understanding the causes ofconstipation is important for its effective management and treatment.In thispaper,we have reviewed the primary causes of constipation or functional constipation.Primary constipation is a bowel disorder associated with colonic oranorectal sensorimotor or neuromuscular dysfunction.As per the literature,it ismultifactorial and involves factors such as decreased interstitial cells of Cajal,altered colonic motility,enteric nervous system dysfunction,intestinal flora disturbances,and psychological influences.Clinical symptoms include difficulty indefecation,decreased frequency of defecation,or a feeling of incomplete evacuation.A comprehensive evaluation and management of constipation require aninterdisciplinary approach incorporating dietary modifications,lifestyle changes,pharmacotherapy,and psychological interventions.Further research is imperativeto explain the intricate mechanisms underlying constipation and develop targetedtherapies for improved patient outcomes.展开更多
文摘Digital rectal examination(DRE)is essential for diagnosing anorectal diseases,yet its widespread adoption remains suboptimal among practitioners.While modalities such as anorectal manometry,rectal balloon expulsion tests,pelvic floor electromyography,and dynamic imaging(defecography/pelvic floor magnetic resonance imaging)enable comprehensive assessment of anorectal function,many healthcare facilities lack advanced diagnostic tools and specialized personnel.DRE has notable diagnostic value in the primary evaluation of functional defecation disorders(FDDs),particularly for detecting dyssynergic defecation and structural pelvic floor defects.Its cost efficiency and universal accessibility render it indispensable in resource-limited environments where high-resolution diagnostic technologies(e.g.,high-resolution manometry)are unavailable.This review delineates standardized DRE protocols for assessing FDDs and highlights characteristic imaging features of FDDs with the aim of improving the understanding of DRE.This review will hopefully encourage clinicians to perform DREs in diverse clinical settings.
基金Supported by the 2024 Hospital Innovation Talent Cultivation Fund Project,No.2024YGKT12.
文摘BACKGROUND Xuanshen decoction(XSD)is a traditional Chinese medicine formulation that is often applied in treating slow transit constipation(STC).However,its specific therapeutic mechanism remains to be characterized.AIM To investigate the mechanism of XSD for STC,we combined network pharmacology prediction,molecular docking analysis,and in vivo studies.METHODS The therapeutic effects of XSD on loperamide-induced STC in rats were assessed through 24-hour fecal number,fecal moisture content,and intestinal propelling rate.Hematoxylin–eosin and Alcian blue/periodic acid-Schiff staining were applied to analyze colonic mucosa for histopathological presentation and mucin production.Next,the mechanism of action of XSD for STC was elucidated through network pharmacology and molecular docking analyses,and the findings were validated by the animal experiments.RESULTS XSD significantly alleviated the symptoms of STC in rats.Relative to the STC rats,in the medium-dose XSD and high-dose XSD rats,stem cell factor,C-kit,phosphophosphoinositide 3-kinase/phosphoinositide 3-kinase,phospho-protein kinase B/protein kinase B,catalase,and superoxide dismutase were substantially upregulated(P<0.01);nuclear factor erythroid 2-related factor 2(nuclear/cytoplasmic)and B-cell lymphoma 2(Bcl-2)were increased(P<0.05),while cleaved caspase-3,Bcl-2-associated X protein(Bax)/Bcl-2,and malondialdehyde were significantly reduced(P<0.01).Heme oxygenase-1 and glutathione peroxidase in the high-dose XSD group were significantly increased(P<0.01),and Bax was statistically lowered(P<0.01);glutathione peroxidase in the medium-dose XSD group was increased(P<0.05),while Bax was reduced(P<0.05).CONCLUSION XSD may inhibit oxidative-stress-induced apoptosis in interstitial cells of Cajal by stimulating the phosphoinositide 3-kinase/protein kinase B/nuclear factor erythroid 2-related factor 2 pathway,thereby effectively treating STC.
文摘Constipation is a common gastrointestinal disorder characterized by infrequentbowel movements and difficulty in passing stools.It can significantly affect anindividual's quality of life and overall well-being.Understanding the causes ofconstipation is important for its effective management and treatment.In thispaper,we have reviewed the primary causes of constipation or functional constipation.Primary constipation is a bowel disorder associated with colonic oranorectal sensorimotor or neuromuscular dysfunction.As per the literature,it ismultifactorial and involves factors such as decreased interstitial cells of Cajal,altered colonic motility,enteric nervous system dysfunction,intestinal flora disturbances,and psychological influences.Clinical symptoms include difficulty indefecation,decreased frequency of defecation,or a feeling of incomplete evacuation.A comprehensive evaluation and management of constipation require aninterdisciplinary approach incorporating dietary modifications,lifestyle changes,pharmacotherapy,and psychological interventions.Further research is imperativeto explain the intricate mechanisms underlying constipation and develop targetedtherapies for improved patient outcomes.
