AIM To compare the efficacy,improved quality of life,and prognosis in patients undergoing either subtotal colonic bypass with antiperistaltic cecoproctostomy(SCBAC) or subtotal colonic bypass plus colostomy with antip...AIM To compare the efficacy,improved quality of life,and prognosis in patients undergoing either subtotal colonic bypass with antiperistaltic cecoproctostomy(SCBAC) or subtotal colonic bypass plus colostomy with antiperistaltic cecoproctostomy(SCBCAC) for the treatment of slow transit constipation.METHODS Between October 2010 and October 2014,aged patients with slow transit constipation who were hospitalized and underwent laparoscopic surgery in our institute weredivided into two groups: the bypass group,15 patients underwent SCBAC,and the bypass plus colostomy group,14 patients underwent SCBCAC. The following preoperative and postoperative clinical data were collected: gender,age,body mass index,operative time,first flatus time,length of hospital stay,bowel movements(BMs),Wexner fecal incontinence scale,Wexner constipation scale(WCS),gastrointestinal quality of life index(GIQLI),numerical rating scale for pain intensity(NRS),abdominal bloating score(ABS),and ClavienDindo classification of surgical complications(CD) before surgery and at 3,6,12,and 24 mo after surgery.RESULTS All patients successfully underwent laparoscopic surgery without open surgery conversion or surgeryrelated death. The operative time and blood loss were significantly less in the bypass group than in the bypass plus colostomy group(P = 0.007). No significant differences were observed in first flatus time,length of hospital stay,or complications with CD > 1 between the two groups. No patients had fecal incontinence after surgery. At 3,6,and 12 mo after surgery,the number of BMs was significantly less in the bypass plus colostomy group than in the bypass group. The parameters at 3,6,12,and 24 mo after surgery in both groups significantly improved compared with the preoperative conditions(P < 0.05),except NRS at 3,6 mo after surgery in both groups,ABS at 12,24 mo after surgery and NRS at 12,24 mo after surgery in the bypass group. WCS,GIQLI,NRS,and ABS significantly improved in the bypass plus colostomy group compared with the bypass group at 3,6,12,and 24 mo after surgery(P < 0.05) except WCS,NRS at 3,6 mo after surgery and ABS at 3 mo after surgery. At 1 year after surgery,a barium enema examination showed that the emptying time was significantly better in the bypass plus colostomy group than in the bypass group(P = 0.007).CONCLUSION Laparoscopic SCBCAC is an effective and safe procedure for the treatment of slow transit constipation in an aged population and can significantly improve the prognosis. Its clinical efficacy is more favorable compared with that of SCBAC. Laparoscopic SCBCAC is a better procedure for the treatment of slow transit constipation in an aged population.展开更多
BACKGROUND We previously identified miR-10b-5p as a key regulator of gastrointestinal(GI)motility through its essential role in the development and function of interstitial cells of Cajal(ICC),the pacemaker cells of t...BACKGROUND We previously identified miR-10b-5p as a key regulator of gastrointestinal(GI)motility through its essential role in the development and function of interstitial cells of Cajal(ICC),the pacemaker cells of the gut.Loss of miR-10b-5p in ICC im-pairs intestinal motility and contributes to constipation,a common condition in the elderly.Notably,miR-10b-5p is co-expressed with its paralog,miR-10a-5p,in ICC.AIM To investigate the roles of miR-10a-5p and miR-10b-5p in age-associated intestinal dysmotility and assess the therapeutic potential of restoring their expression.METHODS We employed aged mice,mir-10a and mir-10b single and double knockout(KO)models,and human plasma and colon samples across age groups.GI and colonic transit,ICC network integrity,and expression levels of miR-10a/b-5p were eva-luated.Additionally,we tested whether treatment with their microRNA mimics could restore GI motility in aged mice.RESULTS Aged mice exhibited delayed GI and colonic transit,reduced fecal output,and diminished expression of miR-10a-5p and miR-10b-5p,which peaked during late embryonic and early postnatal stages and declined with age.This decline para-lleled ICC network deterioration in the colon.All KO models exhibited impaired motility and ICC loss,with mir-10a KO mice displaying more severe phenotypes than mir-10b KO mice.Double KO mice demonstrated growth retardation and reduced survival,with homozygous mutants living only up to 3 months.Treatment of aged mice with miR-10a-5p and miR-10b-5p mimics encapsu-lated in jetPEI significantly improved GI and colonic motility.Successful delivery to the gut,including the colon,was confirmed.In human samples,both miR-10a/b-5p and KIT expression decreased with age.CONCLUSION miR-10a-5p and miR-10b-5p are essential for ICC maintenance and colonic motility,and their age-related decline contributes to GI dysmotility in both mice and humans.Restoring their levels offers a promising therapeutic stra-tegy for treating age-related constipation and other motility disorders.展开更多
Thirty-six cases of constipation due to spasmodic syndrome of the pelvic floor were treated by electroacupuncture, with satisfactory therapeutic results reported as follows.Clinical DataThere were 36 cases in this ser...Thirty-six cases of constipation due to spasmodic syndrome of the pelvic floor were treated by electroacupuncture, with satisfactory therapeutic results reported as follows.Clinical DataThere were 36 cases in this series, 12 males and 24 females, ranging in age from 25 to 76 years, averaging 42 years. The course of disease ranged from 6 months to 22 years, with an average of 6 years. All the 36 cases were previously treated by purgative and emollient cathartic for promoting the bowl movement.展开更多
目的回顾性分析乳果糖口服液和便通片对精神分裂症患者服用氯氮平所致顽固性便秘的临床疗效和安全性。方法收集2022年11月~2023年4月间120名服用氯氮平的精神分裂症便秘患者,随机分为对照组、便通片组、乳果糖口服液组各40例。对照组进...目的回顾性分析乳果糖口服液和便通片对精神分裂症患者服用氯氮平所致顽固性便秘的临床疗效和安全性。方法收集2022年11月~2023年4月间120名服用氯氮平的精神分裂症便秘患者,随机分为对照组、便通片组、乳果糖口服液组各40例。对照组进行宣教和膳食调整;便通片组口服便通片每日2次每次3片;乳果糖口服液组每日口服乳果糖15 mL。治疗2周后,观察三组治疗前的排便情况(首次排便时间、排便间隔时间、每次排便时间),及治疗前后的主症积分、Bristol大便分型量表(Bristol Stool Classification Scale,BSFS)评分、心理状态评估用正性负性情绪量表(Positive and Negative Affect Scale,PANAS)评分、生活质量评估量表(Quality of Life Assessment Scale,PAC-QOL)评分、不良反应及肝肾功能。结果治疗前,便通片组和乳果糖口服液组与对照组相比,排便情况、主症积分、BSFS评分、PANAS评分、PAC-QOL评分、肝肾功能和不良反应无显著性差异(P>0.05);便通片组与乳果糖口服液组间也无显著性差异(P>0.05)。治疗后,便通片组和乳果糖口服液组的总胆红素、谷丙转氨酶、肌酐及不良反应无显著性差异(P>0.05),但主症积分、BSFS评分、PANAS评分、PAC-QOL评分、谷草转氨酶和尿素氮显著改善(P<0.05),且两组间无显著性差异(P>0.05)。干预前后比较显示,对照组的PANAS评分、PAC-QOL评分、谷草转氨酶、肌酐、尿素氮无显著性差异(P>0.05);干预前后便通片组和乳果糖口服液组的主症积分、BSFS评分、PANAS评分、PAC-QOL评分显著改善(P<0.05);便通片组总胆红素、尿素氮有显著性差异(P<0.05),乳果糖口服液组谷草转氨酶、肌酐有显著性差异(P<0.05)。便通片组治疗总有效率87.5%(35/40),乳果糖口服液组为90%(36/40),均高于对照组的32.5%(13/40)(P<0.05)。结论乳果糖口服液和便通片对精神分裂症患者服用氯氮平所致的顽固性便秘具有良好的疗效和安全性,能显著改善患者的便秘症状、排便情况、心理状态及生活质量。展开更多
Clinical observation on 48 cases of stomach carcinoma pain indicated that acupuncture including filiform needle group and point-injection group had better therapeutic effects in treatment of stomach carcinoma pain whe...Clinical observation on 48 cases of stomach carcinoma pain indicated that acupuncture including filiform needle group and point-injection group had better therapeutic effects in treatment of stomach carcinoma pain when patient's mind was concentrated at the site of disease. After treatment for 2 months, the long-term effective rates of analgesia in both the filiform needle group and the point-injection group were similar to that in the western medicine group, all being about 81%. While the long-term markedly effective rates in the two groups were superior to that in the western medicine group. Life quality of the patients in all the groups were improved. The toxic action and side effects caused by chemotherapy were prevented, the high viscous state showed by indexes of blood rheology was improved, and the lowered Cu-Zu-SOD activity in erythrocytes in patients of stomach carcinoma was increased in the filiform needle group and the point-injection group. Based on the results of clinical study, we consider that acupuncture analgesic effect on stomach carcinoma is related to the increase of PLEK, improvement of cellular immune function and the elevation of life quality after acupuncture.展开更多
基金the Medical Science and technology Project of Henan Province,No.2011030031
文摘AIM To compare the efficacy,improved quality of life,and prognosis in patients undergoing either subtotal colonic bypass with antiperistaltic cecoproctostomy(SCBAC) or subtotal colonic bypass plus colostomy with antiperistaltic cecoproctostomy(SCBCAC) for the treatment of slow transit constipation.METHODS Between October 2010 and October 2014,aged patients with slow transit constipation who were hospitalized and underwent laparoscopic surgery in our institute weredivided into two groups: the bypass group,15 patients underwent SCBAC,and the bypass plus colostomy group,14 patients underwent SCBCAC. The following preoperative and postoperative clinical data were collected: gender,age,body mass index,operative time,first flatus time,length of hospital stay,bowel movements(BMs),Wexner fecal incontinence scale,Wexner constipation scale(WCS),gastrointestinal quality of life index(GIQLI),numerical rating scale for pain intensity(NRS),abdominal bloating score(ABS),and ClavienDindo classification of surgical complications(CD) before surgery and at 3,6,12,and 24 mo after surgery.RESULTS All patients successfully underwent laparoscopic surgery without open surgery conversion or surgeryrelated death. The operative time and blood loss were significantly less in the bypass group than in the bypass plus colostomy group(P = 0.007). No significant differences were observed in first flatus time,length of hospital stay,or complications with CD > 1 between the two groups. No patients had fecal incontinence after surgery. At 3,6,and 12 mo after surgery,the number of BMs was significantly less in the bypass plus colostomy group than in the bypass group. The parameters at 3,6,12,and 24 mo after surgery in both groups significantly improved compared with the preoperative conditions(P < 0.05),except NRS at 3,6 mo after surgery in both groups,ABS at 12,24 mo after surgery and NRS at 12,24 mo after surgery in the bypass group. WCS,GIQLI,NRS,and ABS significantly improved in the bypass plus colostomy group compared with the bypass group at 3,6,12,and 24 mo after surgery(P < 0.05) except WCS,NRS at 3,6 mo after surgery and ABS at 3 mo after surgery. At 1 year after surgery,a barium enema examination showed that the emptying time was significantly better in the bypass plus colostomy group than in the bypass group(P = 0.007).CONCLUSION Laparoscopic SCBCAC is an effective and safe procedure for the treatment of slow transit constipation in an aged population and can significantly improve the prognosis. Its clinical efficacy is more favorable compared with that of SCBAC. Laparoscopic SCBCAC is a better procedure for the treatment of slow transit constipation in an aged population.
基金Supported by National Institutes of Health Grants,No.R01DK103055(to Ro S)RosVivo Therapeutics,No.AWD-01-00003158(to Ro S)the National Research Foundation of Korea Grant Funded by the Korean Government(MSIT),No.NRF-2021R1C1C2006743(to Kim MS)and No.NRF-2021R1A2C1095311(to Lee MY).
文摘BACKGROUND We previously identified miR-10b-5p as a key regulator of gastrointestinal(GI)motility through its essential role in the development and function of interstitial cells of Cajal(ICC),the pacemaker cells of the gut.Loss of miR-10b-5p in ICC im-pairs intestinal motility and contributes to constipation,a common condition in the elderly.Notably,miR-10b-5p is co-expressed with its paralog,miR-10a-5p,in ICC.AIM To investigate the roles of miR-10a-5p and miR-10b-5p in age-associated intestinal dysmotility and assess the therapeutic potential of restoring their expression.METHODS We employed aged mice,mir-10a and mir-10b single and double knockout(KO)models,and human plasma and colon samples across age groups.GI and colonic transit,ICC network integrity,and expression levels of miR-10a/b-5p were eva-luated.Additionally,we tested whether treatment with their microRNA mimics could restore GI motility in aged mice.RESULTS Aged mice exhibited delayed GI and colonic transit,reduced fecal output,and diminished expression of miR-10a-5p and miR-10b-5p,which peaked during late embryonic and early postnatal stages and declined with age.This decline para-lleled ICC network deterioration in the colon.All KO models exhibited impaired motility and ICC loss,with mir-10a KO mice displaying more severe phenotypes than mir-10b KO mice.Double KO mice demonstrated growth retardation and reduced survival,with homozygous mutants living only up to 3 months.Treatment of aged mice with miR-10a-5p and miR-10b-5p mimics encapsu-lated in jetPEI significantly improved GI and colonic motility.Successful delivery to the gut,including the colon,was confirmed.In human samples,both miR-10a/b-5p and KIT expression decreased with age.CONCLUSION miR-10a-5p and miR-10b-5p are essential for ICC maintenance and colonic motility,and their age-related decline contributes to GI dysmotility in both mice and humans.Restoring their levels offers a promising therapeutic stra-tegy for treating age-related constipation and other motility disorders.
文摘Thirty-six cases of constipation due to spasmodic syndrome of the pelvic floor were treated by electroacupuncture, with satisfactory therapeutic results reported as follows.Clinical DataThere were 36 cases in this series, 12 males and 24 females, ranging in age from 25 to 76 years, averaging 42 years. The course of disease ranged from 6 months to 22 years, with an average of 6 years. All the 36 cases were previously treated by purgative and emollient cathartic for promoting the bowl movement.
文摘目的回顾性分析乳果糖口服液和便通片对精神分裂症患者服用氯氮平所致顽固性便秘的临床疗效和安全性。方法收集2022年11月~2023年4月间120名服用氯氮平的精神分裂症便秘患者,随机分为对照组、便通片组、乳果糖口服液组各40例。对照组进行宣教和膳食调整;便通片组口服便通片每日2次每次3片;乳果糖口服液组每日口服乳果糖15 mL。治疗2周后,观察三组治疗前的排便情况(首次排便时间、排便间隔时间、每次排便时间),及治疗前后的主症积分、Bristol大便分型量表(Bristol Stool Classification Scale,BSFS)评分、心理状态评估用正性负性情绪量表(Positive and Negative Affect Scale,PANAS)评分、生活质量评估量表(Quality of Life Assessment Scale,PAC-QOL)评分、不良反应及肝肾功能。结果治疗前,便通片组和乳果糖口服液组与对照组相比,排便情况、主症积分、BSFS评分、PANAS评分、PAC-QOL评分、肝肾功能和不良反应无显著性差异(P>0.05);便通片组与乳果糖口服液组间也无显著性差异(P>0.05)。治疗后,便通片组和乳果糖口服液组的总胆红素、谷丙转氨酶、肌酐及不良反应无显著性差异(P>0.05),但主症积分、BSFS评分、PANAS评分、PAC-QOL评分、谷草转氨酶和尿素氮显著改善(P<0.05),且两组间无显著性差异(P>0.05)。干预前后比较显示,对照组的PANAS评分、PAC-QOL评分、谷草转氨酶、肌酐、尿素氮无显著性差异(P>0.05);干预前后便通片组和乳果糖口服液组的主症积分、BSFS评分、PANAS评分、PAC-QOL评分显著改善(P<0.05);便通片组总胆红素、尿素氮有显著性差异(P<0.05),乳果糖口服液组谷草转氨酶、肌酐有显著性差异(P<0.05)。便通片组治疗总有效率87.5%(35/40),乳果糖口服液组为90%(36/40),均高于对照组的32.5%(13/40)(P<0.05)。结论乳果糖口服液和便通片对精神分裂症患者服用氯氮平所致的顽固性便秘具有良好的疗效和安全性,能显著改善患者的便秘症状、排便情况、心理状态及生活质量。
文摘Clinical observation on 48 cases of stomach carcinoma pain indicated that acupuncture including filiform needle group and point-injection group had better therapeutic effects in treatment of stomach carcinoma pain when patient's mind was concentrated at the site of disease. After treatment for 2 months, the long-term effective rates of analgesia in both the filiform needle group and the point-injection group were similar to that in the western medicine group, all being about 81%. While the long-term markedly effective rates in the two groups were superior to that in the western medicine group. Life quality of the patients in all the groups were improved. The toxic action and side effects caused by chemotherapy were prevented, the high viscous state showed by indexes of blood rheology was improved, and the lowered Cu-Zu-SOD activity in erythrocytes in patients of stomach carcinoma was increased in the filiform needle group and the point-injection group. Based on the results of clinical study, we consider that acupuncture analgesic effect on stomach carcinoma is related to the increase of PLEK, improvement of cellular immune function and the elevation of life quality after acupuncture.
