White Matter Microstructural Similarity and Diversity of Functional Constipation and Constipation-predominant Irritable Bowel Syndrome

BACKGROUND/AIMS: The Rome III criteria separated chronic constipation into functional constipation (FC) and constipation-predominant irritable bowel syndrome (IBS-C), but some researchers questioned the partitioning and treated both as distinct parts of a continuum. The study aims to explore the similarity and diversity of brain white matter between FC and IBS-C. METHODS: The voxel-wise analysis of the diffusion parameters was used to quantify the white matter changes of female brains in 18 FC patients and 20 IBS-C patients compared with a comparison group with 19 healthy controls by tract-based spatial statistics. The correlations between diffusive parameters and clinical symptoms were evaluated using a Pearson’s correlation. RESULTS: In comparison to healthy controls, FC patients showed a decrease of fractional anisotropy (FA) and an increase of radial diffusivity (RD) in multiple major fibers encompassing the corpus callosum (CC, P = 0.001 at peak), external capsule (P = 0.002 at peak), corona radiata (CR, P = 0.001 at peak), and superior longitudinal fasciculus (SLF, P = 0.002 at peak). In contrast, IBS-C patients showed FA and RD aberrations in the CC (P = 0.048 at peak). Moreover, the direct comparison between FC and IBS-C showed only RD differences in the CR and SLF. In addition, FA and RD in the CC were significantly associated with abdominal pain for all patients, whereas FA in CR (P = 0.016) and SLF (P = 0.040) were significantly associated with the length of time per attempt and incomplete evacuation separately for FC patients. CONCLUSION: These results may improve our understanding of the pathophysiological mechanisms underlying different types of constipation.

Therapeutic effect of different dosages of metoprolol combined amiodarone on tachyarrhythmia / 心血管康复医学杂志

Objective:To compare clinical therapeutic effects of different dosages of metoprolol combined amioda-rone on patients with tachyarrhythmia.Methods:A total of 120 patients with tachyarrhythmia were randomly divid-ed into small-dose group (n=40,received 5mg/d metoprolol),medium-dose group (n=40,received 10mg/d meto-prolol)and large-dose group (n=40,received 15mg/d metoprolol)according to number table method.Each group received combined amiodarone therapy.Clinical indexes such as acting time,sinus rhythm conversion rate and left ventricular ejection fraction (LVEF)were compared among three groups.After three-month follow up,recurrence rate of tachyarrhythmia was compared among three groups.Results:Compared with small-dose group,there was significant reduction in acting time [(7.2±1.1)h vs.(3.4±1.0)h,(2.9±0.8)h],and significant rise in sinus rhythm conversion rate (57.5% vs.85.0%,90.0%)and effective rate (62.5% vs.90.0%,95.0%)in medium-dose group and large-dose group,P0.05 all).There were no significant differences in mean blood pressure and heart rate,LVEF and incidence rates of all kinds of adverse reactions among three groups (P>0.05).After three-month follow-up,recurrence rate of medium-dose group (2.5%)was significantly lower than those of large-dose group (10.0%)and small-dose group (20.0%),P<0.05. Conclusion:Medium dosage of metoprolol combined with amio-darone possesses more clinical therapeutic effect than small-dose and large-dose in patients with tachyarrhythmia;it is worth extending in clinic.