On Diagnosis and Treatment of Constipation from Translational Medicine / 中国中西医结合杂志

Clinical diagnosis and treatment of constipation lags behind relatively with unsatisfactory efficacy. Pathogeneses and molecular mechanisms for different types of constipation are waiting to be further clarified. New biomarkers and therapeutic targets for clinical diagnosis of constipation are so urgent. As for current problems in diagnosis and treatment of constipation, it is necessary to use the concept of translational medicine to break existing imprisonment of thinking, and find out new thinking ways of research methods, diagnosis and treatment approaches, thereby improving diagnosis and treatment levels.

Diagnosis and treatment of slow transit constipation complicated with adult megacolon / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To summarize the experience in the management of slow transit constipation complicated with adult megacolon.</p><p><b>METHODS</b>The clinical data of 32 above patients admitted between October 2007 and June 2011 were retrospectively studied.</p><p><b>RESULTS</b>Thirty-two patients were diagnosed as slow transit constipation according to the Roman III criteria. There were 15 males and 17 females aging from 18 to 56 years old. Sitz marker study showed prolonged colon transit time. Barium enema and defecography suggested bowel stricture locating in the transverse colon (n=3), descending colon (n=4), rectum (n=20), and concurrent transverse colon or descending colon and rectum (n=5). Anal manometry showed that anorectal inhibitory reflex was absent in 23 patients, while the other 9 patients were normal. Procedures performed included segmental colectomy and side-to-side anastomosis (n=1), subtotal colectomy and modified Duhamel anastomosis (n=16), total colectomy and ileal J-pouch Duhamel anastomosis (n=9). There were no postoperative complications. During the follow-up ranging from 3 to 47 months, defacatory function was excellent in 18, good in 9, and moderate in 5 patients.</p><p><b>CONCLUSIONS</b>Adult megacolon should be considered differential diagnosis of slow transit constipation. Detailed history taking and thorough evaluation of testing is the key to obviate misdiagnosis. Extent of resection should include the diseased dilated colon and slow transit colon.</p>

Association between expressions of HSP70, HSP90 and efficacy of chemotherapy in colorectal cancer patients with unresectable liver metastasis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the association between expressions of HSP70, HSP90 and efficacy of chemotherapy in colorectal cancer patients with unresectable liver metastasis.</p><p><b>METHODS</b>Data of 52 colorectal cancer cases, whose primary colorectal focuses were resected but hepatic metastatic tumors were unresectable, were reviewed retrospectively. All the patients underwent FOLFOX4 regimen well. Immunohistochemistry assay was applied to determine the expressions of HSP70 and HSP90 in primary focus tissues. The number and size of hepatic metastatic tumors pre- and post-chemotherapy were compared by CT scanning.</p><p><b>RESULTS</b>Partial remission(PR) rate was 33.3% in cases with up-regulated expression of HSP70, while 64.5% in cases with down-regulated expression of HSP70, whose difference was significant. PR rate was 50% in cases with up-regulated expression of HSP90, and 53.1% in the others with down-regulated expression of HSP90, whose difference was not significant.</p><p><b>CONCLUSIONS</b>FOLFOX4 regimen has advantages in cases with lower HSP70 expression over those with higher HSP70 expression. HSP90 expression level is not associated with the efficacy of FOLFOX4 regimen.</p>