Association of sleep duration with chronic constipation among adult men and women: Findings from the National Health and Nutrition Examination Survey (2005-2010).

Background: Previous studies suggested that unhealthy sleep patterns were closely associated with gastrointestinal diseases, but the impact of unhealthy sleep duration on chronic constipation has not been well studied until now. In this study, we aim to explore the association between sleep duration and constipation among males and females. Methods: We utilized the US National Health and Nutrition Examination Surveys data from 2005 to 2010, and adults (≥20 years old) who completed the sleep and bowel health questionnaires were enrolled in this observational study. Sleep duration was categorized into four groups: very short sleep (<5 h/night), short sleep (5-6 h/night), normal sleep (7-8 h/night), and long sleep (≥9 h/night). Chronic constipation was defined as Bristol Stool Scale Type 1(separate hard lumps, like nuts) or Type 2(sausage-like but lumpy). Controlling demographic, lifestyle, and dietary factors, the logistic regression model in Generalized Linear Model (GLM) function was used to estimate the correlation of sleep duration with constipation among men and women. Results: Of the 11,785 individuals (51.2% males and 48.8% females), 4.3% of men and 10.2% of women had constipation, respectively. More than half of patients with constipation did not adopt the recommended sleep duration. Compared with normal individuals, male participants with constipation had a higher proportion of shorter sleep duration (41.0 vs. 32.3% in the short sleep group and 6.3 vs. 4.7% in the very short sleep group), and female individuals with constipation had a higher proportion of long sleep duration (12.7 vs. 8.2%). After covariates adjustment, men with short sleep duration (5-6 h/night) correlated with increased odds for constipation (OR:1.54, 95%CI:1.05-2.25), and women with long sleep duration (≥9 h/night) linked to the higher constipation risk (OR:1.58, 95%CI:1.10-2.29). Excessive sleep duration in males or insufficient sleep duration in females was neither linked to increased nor decreased constipation risk. Conclusions: In this observational study of a nationally representative sample of adults, we demonstrate a differential impact of unhealthy sleep duration on constipation among men and women. Short sleep duration poses a higher risk of constipation in men, and excessive sleep duration correlates with higher constipation risk in women.

A Refined Theory for Characterizing Adhesion of Elastic Coatings on Rigid Substrates Based on Pressurized Blister Test Methods: Closed-Form Solution and Energy Release Rate.

Adhesion between coatings and substrates is an important parameter determining the integrity and reliability of film/substrate systems. In this paper, a new and more refined theory for characterizing adhesion between elastic coatings and rigid substrates is developed based on a previously proposed pressurized blister method. A compressed air driven by liquid potential energy is applied to the suspended circular coating film through a circular hole in the substrate, forcing the suspended film to bulge, and then to debond slowly from the edge of the hole as the air pressure intensifies, and finally to form a blister with a certain circular delamination area. The problem from the initially flat coating to the stable blistering film under a prescribed pressure is simplified as a problem of axisymmetric deformation of peripherally fixed and transversely uniformly loaded circular membranes. The adhesion strength depends on the delamination area and is quantified in terms of the energy released on per unit delamination area, the so-called energy release rate. In the present work, the problem of axisymmetric deformation is reformulated with out-of-plane and in-plane equilibrium equations and geometric equations, simultaneously improved, and a new closed-form solution is presented, resulting in the new and more refined adhesion characterization theory.

Solitary metastasis to the skin and colon from gastric cancer after curative gastrectomy and chemotherapy: A case report.

RATIONALE: Gastric cancer usually spread via blood circulation to liver, lung, bone, and kidney after recurrence, but it is extremely rare in clinical practice that gastric carcinoma metastasizes to the skin and colon without metastasis to common sites like liver or lung. PATIENT CONCERNS: A 57-year-old man was admitted to the hospital with altered bowel habit and hematochezia for 2 weeks. DIAGNOSES: The patient was diagnosed with advanced gastric cancer at stage IIIA (pT3N2M0) two and a half years ago. Cutaneous metastasis from gastric cancer was confirmed by cutaneous biopsy 2 years following curative gastrectomy. Unfortunately, colonic metastasis from gastric cancer was found by PET-CT 6 months after the diagnosis of cutaneous metastasis. INTERVENTIONS: The patient was given chemotherapy with docetaxel, cisplatin, and 5-fluorouracil for the skin metastasis. Right hemicolectomy was performed when the malignant tumor of the colon was found, in order to relieve the symptom, and improve the quality of life. OUTCOMES: The patient was treated with chemoradiotherapy in a local hospital, the peritoneal carcinomatosis occurred 5 months after the second operation, and died 9 months after the diagnosis of colonic metastasis. LESSONS: Our case represents a rare condition that solitary cutaneous and colonic metastasis from gastric cancer can occur after surgical resection and systemic chemotherapy. Its unique clinicopathological features can extend our insights on gastric cancer, and it may provide clinicians with some positive clinical experience for identifying and treating this disease.

Enhanced recovery after surgery with laparoscopic radical gastrectomy for stomach carcinomas.

AIM: To study the efficacy of the enhanced recovery after surgery (ERAS) program in laparoscopic radical gastrectomy for stomach carcinomas. METHODS: From June 2010 to December 2012, 61 gastric cancer patients who underwent laparoscopic-assisted radical gastrectomy with D2 lymphadenectomy at First Hospital of Jilin University were enrolled in this randomized controlled trial. (Clinical Trials.gov, registration ID: NCT01955096). The subjects were divided into the ERAS program group and the conventional control group. The clinical characteristics, recovery variables, and complications of patients were analyzed. RESULTS: The time to first ambulation, oral food intake, and time to defecation were significantly shorter in the ERAS group (n = 30), compared to the conventional group (n = 31; P = 0.04, 0.003, and 0.01, respectively). The postoperative hospital stay was less in the ERAS group (6.8 ± 1.1 d) compared to the conventional group (7.7 ± 1.1 d) (P = 0.002). There was no significant difference in postoperative complications between the ERAS (1/30) and conventional care groups (2/31) (P = 1.00). There were no readmissions or mortality during the 30-d follow-up period. CONCLUSION: The ERAS program is associated with a shorter hospital stay in gastric cancer patients undergoing laparoscopic radical gastrectomy. The ERAS protocol is useful in the treatment of gastric cancer.