BACKGROUND Premonitory urges (PUs) was defined as the uncomfortable physical sensations of inner tension that can be relieved by producing movement responses. Nearly 70%-90% patients with Tourette syndrome reported ex...BACKGROUND Premonitory urges (PUs) was defined as the uncomfortable physical sensations of inner tension that can be relieved by producing movement responses. Nearly 70%-90% patients with Tourette syndrome reported experiences of PUs. CASE SUMMARY In this paper, we present two cases of young patients with PUs located in their tongue, which is very rare and easily misdiagnosed in clinical work. Both two young patients complained of an itchy tongue and cannot help biting their tongue. These two cases were worth reporting because it was rare that PUs was the initial symptom and located in the tongue. The results indicated that PUs seem to play an important role in the generation of tics. CONCLUSION Thus, PUs may be the first process, and an essential part, of the formation of tics.展开更多
he government of an HIV/AIDS ravaged province in southwestern China has recently completed an innovative new research report entitied ＂To get NGOs involved in national lawmaking for HIV control work.＂
本文对儿童体育运动提出了警告,很有现实意义。儿童不宜过早地投入某专项体育运动。为什么?本文有一句话,说得委婉,却值得深思: Those who participate in a variety of sports and specialize only after reachingthe age of pubergy(...本文对儿童体育运动提出了警告,很有现实意义。儿童不宜过早地投入某专项体育运动。为什么?本文有一句话,说得委婉,却值得深思: Those who participate in a variety of sports and specialize only after reachingthe age of pubergy(青春期)tend to be more consistent performers,have fewerinjuries and adhere to sports play longer than those who specialize early. 为什么会强迫儿童从事某项专门的体育训练?文章透露的原因令人悲从中来: Children and their parents are motivated to commit to such training by thelure(诱惑)of college scholarships and professional careers,the report said. 本文的另一精彩处是对为何儿童不宜过早投入专项体育训练作了生理原因的分析,令人信服。读者不妨细读。 Children need to be children.此话说得何等好啊！展开更多
Importance Tics usually start around 4–6 years old and affect about 1%of school‐age children.Premonitory urges(PUs)are sensory phenomena that precede tics and are often described as unpleasant feelings.Recent eviden...Importance Tics usually start around 4–6 years old and affect about 1%of school‐age children.Premonitory urges(PUs)are sensory phenomena that precede tics and are often described as unpleasant feelings.Recent evidence supports a relationship between PUs and tic severity,but reports are conflicting.In addition,there is no report of PUs in the Chinese population.Objective To investigate the correlation between PUs and tic symptoms in the Chinese population with tic disorders.Methods We recruited 252 Chinese individuals with chronic tic disorders(age 5–16 years).The Yale Global Tic Severity Scale(YGTSS)was used to assess tic symptoms,and the Premonitory Urge for Tics Scale(PUTS)was used to assess PUs.We calculated Spearman correlations between PUTS and YGTSS scores,and constructed a linear regression model to predict the tic symptom severity by PUs.Results There was a significant positive correlation between PU severity(PUTS scores)and motor tic severity,total tic severity,tic‐caused impairment(YGTSS scores)(P<0.05).PU severity was a significant positive predictor of tic symptom severity(standardized beta coefficient=0.174,t=2.786,P=0.006).Interpretation We provide evidence for a correlation between PUs and tic symptoms.PU severity predicts tic symptom severity.Further research on PUs is needed to clarify the shared brain mechanism with tics,and their role in tic expression.A suitable tool to assess PUs in younger children is also needed.展开更多
We aim to evaluate the incidence of incontinence following laser endoscopic enucleation of the prostate(EEP)comparing en-bloc(Group 1)versus 2-lobe/3-lobe techniques(Group 2).We performed a retrospective review of pat...We aim to evaluate the incidence of incontinence following laser endoscopic enucleation of the prostate(EEP)comparing en-bloc(Group 1)versus 2-lobe/3-lobe techniques(Group 2).We performed a retrospective review of patients undergoing EEP for benign prostaticenlargement in 12 centers between January 2020 and January 2022.Data were presented as median and interquartile range(IQR).Univariable and multivariable logistic regression analysis was performed to evaluate factors associated with stress urinary incontinence(SUI)and mixed urinary incontinence(MUI).There were 1711 patients in Group 1 and 3357 patients in Group 2.Patients in Group 2were significantly younger(68[62–73]years vs 69[63–74]years,P=0.002).Median(interquartile range)prostate volume(PV)wassimilar between the groups(70[52–92]ml in Group 1 vs 70[54–90]ml in Group 2,P=0.774).There was no difference in preoperativeInternational Prostate Symptom Score,quality of life,or maximum flow rate.Enucleation,morcellation,and total surgical time weresignificantly shorter in Group 1.Within 1 month,overall incontinence rate was 6.3%in Group 1 versus 5.3%in Group 2(P=0.12),and urge incontinence was significantly higher in Group 1(55.1%vs 37.3%in Group 2,P<0.001).After 3 months,the overall rate ofincontinence was 1.7%in Group 1 versus 2.3%in Group 2(P=0.06),and SUI was significantly higher in Group 2(55.6%vs 24.1%in Group 1,P=0.002).At multivariable analysis,PV and IPSS were factors significantly associated with higher odds of transient SUI/MUI.PV,surgical time,and no early apical release technique were factors associated with higher odds of persistent SUI/MUI.展开更多
Objective:Urinary incontinence (UI) is a prevalent condition with a negative impact on women's quality of life. Data about UI among Jordanian women are lacking;therefore, we aimed to investigate the prevalence, ty...Objective:Urinary incontinence (UI) is a prevalent condition with a negative impact on women's quality of life. Data about UI among Jordanian women are lacking;therefore, we aimed to investigate the prevalence, types, and associated factors.Methods:A cross sectional nationwide survey was conducted between 1 March 2020 and 15 April 2020. Women were included if they were 18 years of age or more and had access to the internet. Data collected included women's characteristics, UI types, and associated factors. UI was inventoried by asking women if they have UI (yes/no), and the Arabic language validated International Consultation on Incontinence Questionnaire Urinary Incontinence-Short Form was used. Age-group specific prevalence rates of UI were estimated, and associated factors were studied using logistic regression analyses.Results:Data from 2118 women were analysed. The median age was 40 (range 18–85) years;58.3% gave birth three or more times;and 64.1% consistently reported having UI. Limited mobility and being multiparous increased the likelihood of reporting UI. Compared to women with normal body mass index, overweight and obese women were 1.9 times and 4.4 times more likely to report UI, respectively.Conclusion:The prevalence of UI among Jordanian women is 64.1%, with mixed UI and stress UI being the more prevalent types in women younger than 60 years old. Age, parity body mass index, and limited mobility are all associated factors with UI. The results of this study provide healthcare policy makers with the necessary information to increase awareness and knowledge regarding UI.展开更多
The main aim of this opinion review is to comment on the recent article published by Garg et al in the World Journal of Gastroenterology 2023;29:4593–4603.The authors in the published article developed a new scoring ...The main aim of this opinion review is to comment on the recent article published by Garg et al in the World Journal of Gastroenterology 2023;29:4593–4603.The authors in the published article developed a new scoring system,Garg incon-tinence scores(GIS),for fecal incontinence(FI).FI is a chronic debilitating disease that has a severe negative impact on the quality of life of the patients.Rome IV criteria define FI as multiple episodes of solid or liquid stool passed into the clothes at least twice a month.The associated social stigmatization often leads to significant under-reporting of the condition,which further impairs management.An important point is that the complexity and vagueness of the disease make it difficult for the patients to properly define and report the magnitude of the problem to their physicians.Due to this,the management becomes even more difficult.This issue is resolved up to a considerable extent by a scoring ques-tionnaire.There were several scoring systems in use for the last three decades.The prominent of them were the Cleveland Clinic scoring system or the Wexner scoring system,St.Marks Hospital or Vaizey’s scores,and the FI severity index.However,there were several shortcomings in these scoring systems.In the opinion review,we tried to analyze the strength of GIS and compare it to the existing scoring systems.The main pitfalls in the existing scoring systems were that most of them gave equal weightage to different types of FI(solid,liquid,flatus,etc.),were not comprehensive,and took only the surgeon’s perception of FI into view.In GIS,almost all shortcomings of previous scoring systems had been addressed:different weights were assigned to different types of FI by a robust statistical methodology;the scoring system was made comprehensive by including all types of FI that were previously omitted(urge,stress and mucus FI)and gave priority to patients’rather than the physicians’perceptions while developing the scoring system.Due to this,GIS indeed looked like a paradigm shift in the evaluation of FI.However,it is too early to conclude this,as GIS needs to be validated for accuracy and simplicity in future studies.展开更多
应用基因芯片技术获取以稳定转染HBx基因的肝癌细胞Hep G(Hep G22-X)Y,以及非转染的肝癌细胞Hep G 2的差异表达基因,利用生物信息学方法对其进行初步分析表明,该蛋白基因编码673个氨基酸,预测分子量为17.06 k D,理论等电点为4.83,定位...应用基因芯片技术获取以稳定转染HBx基因的肝癌细胞Hep G(Hep G22-X)Y,以及非转染的肝癌细胞Hep G 2的差异表达基因,利用生物信息学方法对其进行初步分析表明,该蛋白基因编码673个氨基酸,预测分子量为17.06 k D,理论等电点为4.83,定位于细胞核,具有转录调控、生长因子、信号传导的功能,同源性分析结果表明,其碱基序列与已经报道的其他12个物种的相似率为76%-97%,且符合种属之间的进化关系。展开更多
BACKGROUND The transanal opening of intersphincteric space(TROPIS)procedure,performed to treat complex anal fistulas,preserves the external anal sphincter(EAS)but involves partial incision of the internal anal sphinct...BACKGROUND The transanal opening of intersphincteric space(TROPIS)procedure,performed to treat complex anal fistulas,preserves the external anal sphincter(EAS)but involves partial incision of the internal anal sphincter(IAS).AIM To ascertain the incidence of incontinence after the division of the IAS as is done in TROPIS and to evaluate whether regular Kegel exercises(KE)in the postoperative period can prevent incontinence due to IAS division.METHODS Patients operated on for high complex fistulas and having no preoperative continence problem(score=0)were included in the study.All patients were operated on by the TROPIS procedure and were recommended KE(pelvic contraction exercises)50 times/day.KE were commenced on the 10^(th)postoperative day and continued for 1 year.Incontinence was evaluated objectively(by modified Vaizey’s scores)in the immediate postoperative period(Pre-KE group)and on long-term follow-up(Post-KE group).The incontinence scores in both groups were compared to evaluate the efficacy of KE.RESULTS Of 102 anal fistula patients operated on between July 2018 and July 2020 were included in this study.There were 90 males,the mean age was 42.3±12.8,and the median follow-up was 30 mo(18-42 mo).Three patients were lost to follow-up.There were 65 recurrent fistulas,92 had multiple tracts,42 had associated abscess,46 had horseshoe fistula and 34 were supralevator fistulas.All were magnetic resonance imaging-documented high fistulas(>1/3 EAS involved).Overall incontinence occurred in 31%patients(Pre-KE group)with urge and gas incontinence accounting for the majority of cases(28.3%).The mean incontinence scores in the Pre-KE group were 1.19±1.96(in 31 patients,solid=0,liquid=7,gas=8,urge=24)and in the Post-KE group were 0.26±0.77(in 13 patients,solid=0,liquid=2,gas=3,urge=10)(P=0.00001,t-test).CONCLUSION Division of the IAS led to incontinence,mainly urge incontinence,and also to a mild degree of gas and liquid incontinence.However,regular KE led to a significant reduction in incontinence(both in the number of affected patients and the severity of scores in these patients).展开更多
BACKGROUND Several scoring systems are used to assess fecal incontinence(FI),among which,the most commonly used are Wexner and Vaizey’s scoring systems.However,there are significant lacunae in these scoring systems,d...BACKGROUND Several scoring systems are used to assess fecal incontinence(FI),among which,the most commonly used are Wexner and Vaizey’s scoring systems.However,there are significant lacunae in these scoring systems,due to which they are neither accurate nor comprehensive.AIM To develop a new scoring system for FI that is accurate,comprehensive,and easy to use.METHODS A pro forma was made in which six types of FI were included:solid,liquid,flatus,mucous,stress,and urge.The weight for each FI was determined by asking a group of patients and laypersons to give a disability score to each type of FI from 0 to 100(0-least,100-maximum disability).The disability was assessed on a modified EQ-5D+(EuroQol)description system,4D3L(4 dimensions and 3 levels)for each FI.The average score of each FI was calculated,divided by 10,and rounded off to determine the weight of each FI type.The scores for the three levels of frequency of each FI were assigned as never=0(No episode of FI ever),occasional=1(≤1 episode of FI/wk),and common=2(>1 episode of FI/wk),and was termed as frequency score.The score for each FI would be derived by multiplying the frequency score and the weight for that FI type.In the second phase of the study,a group of colorectal surgeons was asked to rank the six FI types in order of severity,and their ranking was compared with the patient and laypersons’rankings.RESULTS Fifty patients and 50 laypersons participated in the study.The weight was assigned to each FI(solid-8,liquid-8,urge-7,flatus-6,mucus-6,and stress-5),and an new scoring system was formulated.The maximum possible score was 80(total incontinence),and the least 0(no incontinence).The surgeons’ranking of FI severity did not correlate well with patients’and laypersons’rankings of FI,highlighting that surgeons and patients may perceive the severity of FI differently.CONCLUSION A new scoring system for FI was formulated,which was simple,logical,comprehensive,and easy to use,and eliminated previous shortcomings.Patients’and surgeons’perceptions of FI severity of FI did not correlate well.展开更多
BACKGROUND Tourette syndrome(TS)is a complex neurodevelopmental condition marked by tics,as well as a variety of psychiatric comorbidities,such as obsessivecompulsive disorders(OCDs),attention deficit hyperactivity di...BACKGROUND Tourette syndrome(TS)is a complex neurodevelopmental condition marked by tics,as well as a variety of psychiatric comorbidities,such as obsessivecompulsive disorders(OCDs),attention deficit hyperactivity disorder(ADHD),anxiety,and self-injurious behavior.TS might progress to treatment-refractory Tourette syndrome(TRTS)in some patients.However,there is no confirmed evidence in pediatric patients with TRTS.AIM To investigate the clinical characteristics of TRTS in a Chinese pediatric sample.METHODS A total of 126 pediatric patients aged 6-12 years with TS were identified,including 64 TRTS and 62 non-TRTS patients.The Yale Global Tic Severity Scale(YGTSS),Premonitory Urge for Tics Scale(PUTS),and Child Behavior Checklist(CBCL)were used to assess these two groups and compared the difference between the TRTS and non-TRTS patients.RESULTS When compared with the non-TRTS group,we found that the age of onset for TRTS was younger(P<0.001),and the duration of illness was longer(P<0.001).TRTS was more often caused by psychosocial(P<0.001)than physiological factors,and coprolalia and inappropriate parenting style were more often present in the TRTS group(P<0.001).The TRTS group showed a higher level of premonitory urge(P<0.001),a lower intelligence quotient(IQ)(P<0.001),and a higher percentage of family history of TS.The TRTS patients demonstrated more problems(P<0.01)in the“Uncommunicative”,“Obsessive-Compulsive”,“Social-Withdrawal”,“Hyperactive”,“Aggressive”,and“Delinquent”subscales in the boys group,and“Social-Withdrawal”(P=0.02)subscale in the girls group.CONCLUSION Pediatric TRTS might show an earlier age of onset age,longer duration of illness,lower IQ,higher premonitory urge,and higher comorbidities with ADHD-related symptoms and OCD-related symptoms.We need to pay more attention to the social communication deficits of TRTS.展开更多
目的探讨URG11基因介导的Wnt/β-Catenin信号通路调控EMT参与非小细胞肺癌转移的分子机制。方法非小细胞肺癌细胞系A549经shRNA质粒转染48h,敲除URG11后收集细胞行后续实验。实验共分两组,分别为敲除URG11的A549细胞组(实验组)和未敲除U...目的探讨URG11基因介导的Wnt/β-Catenin信号通路调控EMT参与非小细胞肺癌转移的分子机制。方法非小细胞肺癌细胞系A549经shRNA质粒转染48h,敲除URG11后收集细胞行后续实验。实验共分两组,分别为敲除URG11的A549细胞组(实验组)和未敲除URG11的A549细胞组(空白对照组)。采用Western blott测定β-Catenin及其下游基因cyclinD1、c-myc的蛋白表达,同时用RT-qPCR检测β-Catenin、cyclinD1和c-myc的mRNA表达。并用裸鼠成瘤模型评估URG11基因对NSCLC侵袭性生长的影响。结果①敲除URG11显著抑制Wnt/β-Catenin信号通路在NSCLC细胞中激活。Western blot蛋白质印迹分析显示β-Catenin、cyclin D1和c-myc的蛋白水平在敲除实验组中的表达显著低于对照组(DPI值分别为0.22±0.06 VS 0.77±0.21,0.61±0.09 VS 1.52±0.23,0.42±0.07 VS 0.84±0.14,P<0.05)。RT-qPCR结果显示β-Catenin、cyclinD1和c-myc的mRNA在对照组中的表达显著高于实验组(分别为3.52倍,2.58倍和2.19倍,P<0.05)。②敲除URG11显著减少异种移植肿瘤体在裸鼠体内侵袭性生长。通过裸鼠异种移植肿瘤模型动态观察了URG11对肿瘤的体内生长作用。与对照组相比,敲除URG11能显著抑制Balb/C裸鼠体内新生肿瘤的重量,第35天实验组VS对照组(0.21±0.04)g VS(0.58±0.08)g,P<0.05,平均抑瘤率为63.79%;同时敲除URG11能显著减少异种移植肿瘤的体积:第21、28、35天的新生瘤体体积,实验组VS对照组(258.33±0.24)mm^(3)VS(512.86±0.18)mm^(3),(414.59±0.17)mm^(3)VS(685.78±0.23)mm^(3),(423.21±0.36)mm^(3)VS(986.73±0.14)mm^(3),P<0.05。结论URG11导致的EMT与NSCLC的发生和进展密切相关。展开更多
文摘BACKGROUND Premonitory urges (PUs) was defined as the uncomfortable physical sensations of inner tension that can be relieved by producing movement responses. Nearly 70%-90% patients with Tourette syndrome reported experiences of PUs. CASE SUMMARY In this paper, we present two cases of young patients with PUs located in their tongue, which is very rare and easily misdiagnosed in clinical work. Both two young patients complained of an itchy tongue and cannot help biting their tongue. These two cases were worth reporting because it was rare that PUs was the initial symptom and located in the tongue. The results indicated that PUs seem to play an important role in the generation of tics. CONCLUSION Thus, PUs may be the first process, and an essential part, of the formation of tics.
文摘he government of an HIV/AIDS ravaged province in southwestern China has recently completed an innovative new research report entitied ＂To get NGOs involved in national lawmaking for HIV control work.＂
文摘本文对儿童体育运动提出了警告,很有现实意义。儿童不宜过早地投入某专项体育运动。为什么?本文有一句话,说得委婉,却值得深思: Those who participate in a variety of sports and specialize only after reachingthe age of pubergy(青春期)tend to be more consistent performers,have fewerinjuries and adhere to sports play longer than those who specialize early. 为什么会强迫儿童从事某项专门的体育训练?文章透露的原因令人悲从中来: Children and their parents are motivated to commit to such training by thelure(诱惑)of college scholarships and professional careers,the report said. 本文的另一精彩处是对为何儿童不宜过早投入专项体育训练作了生理原因的分析,令人信服。读者不妨细读。 Children need to be children.此话说得何等好啊！
文摘Importance Tics usually start around 4–6 years old and affect about 1%of school‐age children.Premonitory urges(PUs)are sensory phenomena that precede tics and are often described as unpleasant feelings.Recent evidence supports a relationship between PUs and tic severity,but reports are conflicting.In addition,there is no report of PUs in the Chinese population.Objective To investigate the correlation between PUs and tic symptoms in the Chinese population with tic disorders.Methods We recruited 252 Chinese individuals with chronic tic disorders(age 5–16 years).The Yale Global Tic Severity Scale(YGTSS)was used to assess tic symptoms,and the Premonitory Urge for Tics Scale(PUTS)was used to assess PUs.We calculated Spearman correlations between PUTS and YGTSS scores,and constructed a linear regression model to predict the tic symptom severity by PUs.Results There was a significant positive correlation between PU severity(PUTS scores)and motor tic severity,total tic severity,tic‐caused impairment(YGTSS scores)(P<0.05).PU severity was a significant positive predictor of tic symptom severity(standardized beta coefficient=0.174,t=2.786,P=0.006).Interpretation We provide evidence for a correlation between PUs and tic symptoms.PU severity predicts tic symptom severity.Further research on PUs is needed to clarify the shared brain mechanism with tics,and their role in tic expression.A suitable tool to assess PUs in younger children is also needed.
文摘We aim to evaluate the incidence of incontinence following laser endoscopic enucleation of the prostate(EEP)comparing en-bloc(Group 1)versus 2-lobe/3-lobe techniques(Group 2).We performed a retrospective review of patients undergoing EEP for benign prostaticenlargement in 12 centers between January 2020 and January 2022.Data were presented as median and interquartile range(IQR).Univariable and multivariable logistic regression analysis was performed to evaluate factors associated with stress urinary incontinence(SUI)and mixed urinary incontinence(MUI).There were 1711 patients in Group 1 and 3357 patients in Group 2.Patients in Group 2were significantly younger(68[62–73]years vs 69[63–74]years,P=0.002).Median(interquartile range)prostate volume(PV)wassimilar between the groups(70[52–92]ml in Group 1 vs 70[54–90]ml in Group 2,P=0.774).There was no difference in preoperativeInternational Prostate Symptom Score,quality of life,or maximum flow rate.Enucleation,morcellation,and total surgical time weresignificantly shorter in Group 1.Within 1 month,overall incontinence rate was 6.3%in Group 1 versus 5.3%in Group 2(P=0.12),and urge incontinence was significantly higher in Group 1(55.1%vs 37.3%in Group 2,P<0.001).After 3 months,the overall rate ofincontinence was 1.7%in Group 1 versus 2.3%in Group 2(P=0.06),and SUI was significantly higher in Group 2(55.6%vs 24.1%in Group 1,P=0.002).At multivariable analysis,PV and IPSS were factors significantly associated with higher odds of transient SUI/MUI.PV,surgical time,and no early apical release technique were factors associated with higher odds of persistent SUI/MUI.
文摘Objective:Urinary incontinence (UI) is a prevalent condition with a negative impact on women's quality of life. Data about UI among Jordanian women are lacking;therefore, we aimed to investigate the prevalence, types, and associated factors.Methods:A cross sectional nationwide survey was conducted between 1 March 2020 and 15 April 2020. Women were included if they were 18 years of age or more and had access to the internet. Data collected included women's characteristics, UI types, and associated factors. UI was inventoried by asking women if they have UI (yes/no), and the Arabic language validated International Consultation on Incontinence Questionnaire Urinary Incontinence-Short Form was used. Age-group specific prevalence rates of UI were estimated, and associated factors were studied using logistic regression analyses.Results:Data from 2118 women were analysed. The median age was 40 (range 18–85) years;58.3% gave birth three or more times;and 64.1% consistently reported having UI. Limited mobility and being multiparous increased the likelihood of reporting UI. Compared to women with normal body mass index, overweight and obese women were 1.9 times and 4.4 times more likely to report UI, respectively.Conclusion:The prevalence of UI among Jordanian women is 64.1%, with mixed UI and stress UI being the more prevalent types in women younger than 60 years old. Age, parity body mass index, and limited mobility are all associated factors with UI. The results of this study provide healthcare policy makers with the necessary information to increase awareness and knowledge regarding UI.
文摘The main aim of this opinion review is to comment on the recent article published by Garg et al in the World Journal of Gastroenterology 2023;29:4593–4603.The authors in the published article developed a new scoring system,Garg incon-tinence scores(GIS),for fecal incontinence(FI).FI is a chronic debilitating disease that has a severe negative impact on the quality of life of the patients.Rome IV criteria define FI as multiple episodes of solid or liquid stool passed into the clothes at least twice a month.The associated social stigmatization often leads to significant under-reporting of the condition,which further impairs management.An important point is that the complexity and vagueness of the disease make it difficult for the patients to properly define and report the magnitude of the problem to their physicians.Due to this,the management becomes even more difficult.This issue is resolved up to a considerable extent by a scoring ques-tionnaire.There were several scoring systems in use for the last three decades.The prominent of them were the Cleveland Clinic scoring system or the Wexner scoring system,St.Marks Hospital or Vaizey’s scores,and the FI severity index.However,there were several shortcomings in these scoring systems.In the opinion review,we tried to analyze the strength of GIS and compare it to the existing scoring systems.The main pitfalls in the existing scoring systems were that most of them gave equal weightage to different types of FI(solid,liquid,flatus,etc.),were not comprehensive,and took only the surgeon’s perception of FI into view.In GIS,almost all shortcomings of previous scoring systems had been addressed:different weights were assigned to different types of FI by a robust statistical methodology;the scoring system was made comprehensive by including all types of FI that were previously omitted(urge,stress and mucus FI)and gave priority to patients’rather than the physicians’perceptions while developing the scoring system.Due to this,GIS indeed looked like a paradigm shift in the evaluation of FI.However,it is too early to conclude this,as GIS needs to be validated for accuracy and simplicity in future studies.
文摘应用基因芯片技术获取以稳定转染HBx基因的肝癌细胞Hep G(Hep G22-X)Y,以及非转染的肝癌细胞Hep G 2的差异表达基因,利用生物信息学方法对其进行初步分析表明,该蛋白基因编码673个氨基酸,预测分子量为17.06 k D,理论等电点为4.83,定位于细胞核,具有转录调控、生长因子、信号传导的功能,同源性分析结果表明,其碱基序列与已经报道的其他12个物种的相似率为76%-97%,且符合种属之间的进化关系。
文摘BACKGROUND The transanal opening of intersphincteric space(TROPIS)procedure,performed to treat complex anal fistulas,preserves the external anal sphincter(EAS)but involves partial incision of the internal anal sphincter(IAS).AIM To ascertain the incidence of incontinence after the division of the IAS as is done in TROPIS and to evaluate whether regular Kegel exercises(KE)in the postoperative period can prevent incontinence due to IAS division.METHODS Patients operated on for high complex fistulas and having no preoperative continence problem(score=0)were included in the study.All patients were operated on by the TROPIS procedure and were recommended KE(pelvic contraction exercises)50 times/day.KE were commenced on the 10^(th)postoperative day and continued for 1 year.Incontinence was evaluated objectively(by modified Vaizey’s scores)in the immediate postoperative period(Pre-KE group)and on long-term follow-up(Post-KE group).The incontinence scores in both groups were compared to evaluate the efficacy of KE.RESULTS Of 102 anal fistula patients operated on between July 2018 and July 2020 were included in this study.There were 90 males,the mean age was 42.3±12.8,and the median follow-up was 30 mo(18-42 mo).Three patients were lost to follow-up.There were 65 recurrent fistulas,92 had multiple tracts,42 had associated abscess,46 had horseshoe fistula and 34 were supralevator fistulas.All were magnetic resonance imaging-documented high fistulas(>1/3 EAS involved).Overall incontinence occurred in 31%patients(Pre-KE group)with urge and gas incontinence accounting for the majority of cases(28.3%).The mean incontinence scores in the Pre-KE group were 1.19±1.96(in 31 patients,solid=0,liquid=7,gas=8,urge=24)and in the Post-KE group were 0.26±0.77(in 13 patients,solid=0,liquid=2,gas=3,urge=10)(P=0.00001,t-test).CONCLUSION Division of the IAS led to incontinence,mainly urge incontinence,and also to a mild degree of gas and liquid incontinence.However,regular KE led to a significant reduction in incontinence(both in the number of affected patients and the severity of scores in these patients).
文摘BACKGROUND Several scoring systems are used to assess fecal incontinence(FI),among which,the most commonly used are Wexner and Vaizey’s scoring systems.However,there are significant lacunae in these scoring systems,due to which they are neither accurate nor comprehensive.AIM To develop a new scoring system for FI that is accurate,comprehensive,and easy to use.METHODS A pro forma was made in which six types of FI were included:solid,liquid,flatus,mucous,stress,and urge.The weight for each FI was determined by asking a group of patients and laypersons to give a disability score to each type of FI from 0 to 100(0-least,100-maximum disability).The disability was assessed on a modified EQ-5D+(EuroQol)description system,4D3L(4 dimensions and 3 levels)for each FI.The average score of each FI was calculated,divided by 10,and rounded off to determine the weight of each FI type.The scores for the three levels of frequency of each FI were assigned as never=0(No episode of FI ever),occasional=1(≤1 episode of FI/wk),and common=2(>1 episode of FI/wk),and was termed as frequency score.The score for each FI would be derived by multiplying the frequency score and the weight for that FI type.In the second phase of the study,a group of colorectal surgeons was asked to rank the six FI types in order of severity,and their ranking was compared with the patient and laypersons’rankings.RESULTS Fifty patients and 50 laypersons participated in the study.The weight was assigned to each FI(solid-8,liquid-8,urge-7,flatus-6,mucus-6,and stress-5),and an new scoring system was formulated.The maximum possible score was 80(total incontinence),and the least 0(no incontinence).The surgeons’ranking of FI severity did not correlate well with patients’and laypersons’rankings of FI,highlighting that surgeons and patients may perceive the severity of FI differently.CONCLUSION A new scoring system for FI was formulated,which was simple,logical,comprehensive,and easy to use,and eliminated previous shortcomings.Patients’and surgeons’perceptions of FI severity of FI did not correlate well.
基金the National Natural Science Foundation of China(NSFC),No.82171538the Beijing Natural Science Foundation,No.7212035.
文摘BACKGROUND Tourette syndrome(TS)is a complex neurodevelopmental condition marked by tics,as well as a variety of psychiatric comorbidities,such as obsessivecompulsive disorders(OCDs),attention deficit hyperactivity disorder(ADHD),anxiety,and self-injurious behavior.TS might progress to treatment-refractory Tourette syndrome(TRTS)in some patients.However,there is no confirmed evidence in pediatric patients with TRTS.AIM To investigate the clinical characteristics of TRTS in a Chinese pediatric sample.METHODS A total of 126 pediatric patients aged 6-12 years with TS were identified,including 64 TRTS and 62 non-TRTS patients.The Yale Global Tic Severity Scale(YGTSS),Premonitory Urge for Tics Scale(PUTS),and Child Behavior Checklist(CBCL)were used to assess these two groups and compared the difference between the TRTS and non-TRTS patients.RESULTS When compared with the non-TRTS group,we found that the age of onset for TRTS was younger(P<0.001),and the duration of illness was longer(P<0.001).TRTS was more often caused by psychosocial(P<0.001)than physiological factors,and coprolalia and inappropriate parenting style were more often present in the TRTS group(P<0.001).The TRTS group showed a higher level of premonitory urge(P<0.001),a lower intelligence quotient(IQ)(P<0.001),and a higher percentage of family history of TS.The TRTS patients demonstrated more problems(P<0.01)in the“Uncommunicative”,“Obsessive-Compulsive”,“Social-Withdrawal”,“Hyperactive”,“Aggressive”,and“Delinquent”subscales in the boys group,and“Social-Withdrawal”(P=0.02)subscale in the girls group.CONCLUSION Pediatric TRTS might show an earlier age of onset age,longer duration of illness,lower IQ,higher premonitory urge,and higher comorbidities with ADHD-related symptoms and OCD-related symptoms.We need to pay more attention to the social communication deficits of TRTS.
文摘目的探讨URG11基因介导的Wnt/β-Catenin信号通路调控EMT参与非小细胞肺癌转移的分子机制。方法非小细胞肺癌细胞系A549经shRNA质粒转染48h,敲除URG11后收集细胞行后续实验。实验共分两组,分别为敲除URG11的A549细胞组(实验组)和未敲除URG11的A549细胞组(空白对照组)。采用Western blott测定β-Catenin及其下游基因cyclinD1、c-myc的蛋白表达,同时用RT-qPCR检测β-Catenin、cyclinD1和c-myc的mRNA表达。并用裸鼠成瘤模型评估URG11基因对NSCLC侵袭性生长的影响。结果①敲除URG11显著抑制Wnt/β-Catenin信号通路在NSCLC细胞中激活。Western blot蛋白质印迹分析显示β-Catenin、cyclin D1和c-myc的蛋白水平在敲除实验组中的表达显著低于对照组(DPI值分别为0.22±0.06 VS 0.77±0.21,0.61±0.09 VS 1.52±0.23,0.42±0.07 VS 0.84±0.14,P<0.05)。RT-qPCR结果显示β-Catenin、cyclinD1和c-myc的mRNA在对照组中的表达显著高于实验组(分别为3.52倍,2.58倍和2.19倍,P<0.05)。②敲除URG11显著减少异种移植肿瘤体在裸鼠体内侵袭性生长。通过裸鼠异种移植肿瘤模型动态观察了URG11对肿瘤的体内生长作用。与对照组相比,敲除URG11能显著抑制Balb/C裸鼠体内新生肿瘤的重量,第35天实验组VS对照组(0.21±0.04)g VS(0.58±0.08)g,P<0.05,平均抑瘤率为63.79%;同时敲除URG11能显著减少异种移植肿瘤的体积:第21、28、35天的新生瘤体体积,实验组VS对照组(258.33±0.24)mm^(3)VS(512.86±0.18)mm^(3),(414.59±0.17)mm^(3)VS(685.78±0.23)mm^(3),(423.21±0.36)mm^(3)VS(986.73±0.14)mm^(3),P<0.05。结论URG11导致的EMT与NSCLC的发生和进展密切相关。
