Characterization of Patients With Obstructed Defecation and Slow Transit Constipation With a Simulated Stool.

INTRODUCTION: Defecatory disorders including obstructed defecation (OD) are currently diagnosed using specialized investigations including anorectal manometry and the balloon expulsion test. Recently, we developed a simulated stool named Fecobionics that provides a novel type of pressure measurements and analysis. The aim was to study OD phenotypes compared with slow transit constipation (STC) patients and normal subjects (NS). METHODS: Fecobionics expulsion parameters were assessed in an interventional study design. The Fecobionics device contained pressure sensors at the front, rear, and inside a bag. All constipation patients had colon transit study, defecography, anorectal manometry, and balloon expulsion test performed. The Fecobionics bag was distended in the rectum until desire-to-defecate in 26 OD compared with 8 STC patients and 10 NS. Rear-front pressures (preload-afterload parameters) and defecation indices (DIs) were compared between groups. RESULTS: The Wexner constipation scoring system score was 13.8 ± 0.9 and 14.6 ± 1.5 in the OD and STC patients (P > 0.5). The median desire-to-defecate volume was 80 (quartiles 56-80), 60 (54-80), and 45 (23-60) mL in OD, STC, and NS, respectively (P < 0.01). The median expulsion duration was 37 (quartiles 15-120), 6 (3-11), and 11 (8-11) seconds for the 3 groups (P < 0.03). Fecobionics rear-front pressure diagrams demonstrated clockwise loops with distinct phenotype differences between OD and the other groups. Most DIs differed between OD and the other groups, especially those based on the anal afterload reflecting the nature of OD constipation. Several OD subtypes were identified. DISCUSSION: Fecobionics obtained novel pressure phenotypes in OD patients. DIs showed pronounced differences between groups. Larger studies are needed on OD subtyping.

Effects of mechanical vibration on micoRNA-214-3p and serum interleukin-1β in ovariectomized rats with a fracture / 中华物理医学与康复杂志

Objective:To observe the effect of mechanical vibration on the expression of microRNA-214-3p and serum interleukin-1β (IL-1β) in the broken ends of fractured bones in ovariectomized rats.Methods:Thirty 3-month-old female Wistar rats were randomly divided into a control group, a model group, and a vibration group, each of 10. An operation of ovariotomy was performed in those of the model and vibration groups to establish osteoporosis model. Five months later a model of mid femur fracture was made with animals in all the groups. Five days after their fracture, the vibration group received 20 minutes of whole-body vibration treatment at 35Hz for 5 days a week, while the control group and the model group received natural rearing without any additional intervention At 2 and 6 weeks after the operation, the Lane-Sandhu X-ray scoring system was used to evaluate the quality of fracture healing, and reverse-transcription polymerase chain reactions and enzyme-linked immunosorbent assays were used to detect miR-214-3p in the fractured bones and the serum levels of IL-1β.Results:At 2 weeks and 6 weeks after the operation the average growth score of the broken ends in the model group was significantly lower than that of the control group, while that of the vibration group was significantly higher than the model group′s average. Compared with the control group at the same time point, the average miR-214-3p content of the model and vibration groups was significantly higher 2 and 6 weeks after the surgery. Compared with the model group, the average level of miR-214-3p of the fractured ends of the vibration group was significantly lower at 6 weeks. Two and six weeks after the surgery, the average IL-1β of the model group was significantly higher than the control group′s average, and that of the vibration group was significantly lower.Conclusion:Mechanical vibration can promote osteoporotic fracture healing by inhibiting the expression of miR-214-3p and reducing the level of IL-1β at the broken ends of fractured bones.

The scanning techniques of 64-slice spiral CT on pulmonary artery and aorta angiography at a time / 实用放射学杂志

Objective To investigate the CT angiography techniques of the pulmonary artery and aorta at a time.Methods Twenty-three patients who underwent the 64-slice spiral CT examinations of pulmonary and aortic angiography at a time were analyzed retrospec-tively (Group A).Also,13 cases whose pulmonary angiography showed normal (Group B)and 13 cases whose aortic angiography showed normal (Group C)enrolled in this study as control groups.The contrast media dose and the radiation dose were analyzed among three groups.The abnormal blood vessels were observed,and the CT values of the normal pulmonary artery and aorta and the number of the pulmonary 4,5 grade were compared among all groups.Results The contrast media dose in Group A was more than that in Group B or Group C,but less than the sum of that in Group B and Group C.The radiation dose in Group A was equivalent to that in Group C,which was obviously less than the sum of that in Group B and Group C.Six of 23 cases were accurately diagnosed as pul-monary embolism,1 case as pulmonary malformation,4 cases as aortic dissection whose true and false lumens clearly showed with contrast,5 cases as aortitis,and 10 cases as aortic atherosclerosis.For the cases whose angiography showed normal,there was no statistically significance of the number of the 4,5 grade of pulmonary artery and the CT values of pulmonary artery and the aorta compared with those of the control group (P >0.05 ).Conclusion The 64-slice spiral CT can be used to complete pulmonary and aortic angiography at a time,and the contrast media dose and the radiation dose can be reduced obviously.

Radiographic study of maxillary sinus associated with molars in adult / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#to explore the relationship between the maxillary sinus volume and the amount of alveolar bone, and the effect of molar loss upon the maxillary sinus was further analyzed,by measuring adult maxillary sinus volume, sinus ridge distance, and calculating the gasification coefficient of maxillary sinus.@*METHOD@#One hundred and ninety cases (361 maxillary sinus) with CT examinations were collected, they were divided into group A and group B, 121 cases (242 maxillary sinus) of normal subjects served as group A, 42 cases (65 maxillary sinus) with molar part off were B group, in which 31 maxillary sinus with a molar loss were group B1,22 maxillary sinus with two molar loss were B2 group,12 maxillary sinus with three molar loss (one molar remains) were B3 group, 27 cases (54 maxillary sinus) with upper teeth off were C group. Bymeasureing the maxillary sinus volume, sinus ridge distance and the size of the maxillary sinus, calculating the gasification coefficient, we analyzed the relationship between maxillary volume and sinus ridge distance, and comparatively analyzed the differences among the three groups in the size, gasification coefficient, volume of maxillary sinus and sinus ridge distance.@*RESULT@#In the normal group,the volume of maxillary sinus and sinus ridge distance had a correlation coefficient of -0. 63,(P< 0.05); Sinus ridge distance in group A was larger than the other two groups (P<0.05), and larger in B group than in C group (P<0. 05), anteroposterior maxillary sinus diameter and reft-right diameter in C group was greater than in A group and B group(P<0.05), group C gasification coeffiecent was less than A group and B group (P<0. 05).@*CONCLUSION@#The volume of maxillary sinus is negatively correlated with the amont of alveolar bone; Upper teeth's shedding promotes maxillary sinus deformation; Maxiuary sinus volume has a tendency to decrease.

Diagnosis and conservative treatment of transient osteoporosis of the hip / 中华骨科杂志

Objective To investigate clinical diagnosis and clinical outcome of conservative treatment for transient osteoporosis of the hip. Methods Between October 2006 and July 2009, 10 patients with transient osteoporosis of the hip were treated in out-patient clinic. The clinical and radiologic characteristics were studied retrospectively. There were 4 males and 6 females with an average age of 35 years (range, 22-43). All female patients were not in the period of pregnancy. The diagnosis was made based upon detailed X-ray and MRI evaluations. X-ray revealed osseous demineralization of the femoral head at 8 patients and showed normal at 2 patients. All patients showed the characteristic MRI pattern of transient osteoporosis of the hip. The involved hip had a diffuse and homogeneous area of low signal intensity on T1-weighted images and high signal intensity on T2-weighted images in the head, neck and the intertrochanteric region in 7 patients. Non-operative management, consisting of symptomatic therapy and reduction of weight bearing was performed in all patients. Symptomatic therapy included nonsteroidal anti-inflammatory drug and bisphosphonate administration. Verbal pain rating scale and Harris hip score were used to assess the results of the treatment. Results All 10 patients have been followed up at 3, 6 and 12 months interval after they received treatments. The last follow-up duration of all 10 patients was 2.5 years (range, 1.0-3.5). All patients had pain relief in varying degrees at 1 day after the therapy. The pain scale level had diminished in all patients, while the Harris hip score had increased from 74.5 pre-therapy to 96 post-therapy. X-ray and MRI showed complete recovery after 6 months. No complications were found among them. Conclusion Transient osteoporosis of the hip was considered to be a distinct, self-limiting, and transient disease, which had specific clinical and radiologic characters. Non-operative management should be the first choice to treat this disease.

Effect of jog stress at fracture site on local basic fibroblast growth factor / 中国组织工程研究

BACKGROUND: Some researches demonstrate that jog stress at fracture part can promote formation of callus, but molecular biological mechanism of jog stress on fracture healing is still unclear.OBJECTIVE:To study the effect of jog stress at fracture site on basic fibroblast growth factor(bFGF)at broken parts.DESIGN:Randomized controlled animal study.SETTING:Department of Orthopaedics,General Hospital of the Second Artilleryman of Chinese PLA;Departments of Orthopaedics and Pharmacy,the First Affiliated Hospital of General Hospital of Chinese PLA.MATERIALS:The experiment was carried out in the Animal Laboratory,the First Affiliated Hospital of General Hospital of Chinese PLA and the 8th Laboratory,Academy of Military Medical Sciences of Chinese PLA from March 2003 to April 2004.A total of 72 healthy purebred New Zealand rabbits,of general grade,5-6 months old,weighing 2.5-3.0 kg,were provided by Animal Center of Academy of Military Medical Sciences of Chinese PLA.All rabbits were randomly divided into jog group and fixation group with 36 rabbits in each group.And then,every 6 rabbits in both groups were respectively observed at 6 time points,including 7,14,21,28,42 and 56 days.METHODS:All animals were anesthetized with ketamine and sumian xinji.Fixation needle was rotated into 3,3.5,5.5 and 6 cm below platform of tibia,respectively,and then external fixators were installed.Chuck which was located at 1.5 cm from internal cortical bone and 4.5 cm below platform of tibia crossly cut off tibia.Fracture space was 2.0 mm and 2.5 mm in the fixation group and jog group,respectively.Animals in the fixation group were fixed with unilateral external fixator to dissect replace fracture part.In addition,animals in the jog group cut off their bone,fixed,and moved 0.5 mm to axis along central staff of external fixator.Animals were able to freely walk and external fixator was slightly shaken based on body mass of animal.Furthermore,all animals were sacrificed at 7,14,21,28,42 and 56 days after operation.According to the center of fracture part,samples in 1 cm length were cut,divided and fixed for 12 hours.Quantitative analysis of bFGF and colorized intensity were detected with immunohistochemical stain and JVC imaging analytic system at 7,14,21,28,42 and 56 days after operation.MAIN OUTCOME MEASURES:①Detecting colored intensity of bFGF;②quantitative analysis of bFGF.RESULTS:A total of 72 rabbits were involved in the final analysis bFGF could express in interstitial cells,vascular endothelial cell,osteoblast,chondroblast and osteocyte plasma.At 14,21 and 28 days after operation,positive indexes of bFGF protein in the jog group were 1.98±0.14,2.04±0.12 and 2.13±0.17,respectively,which were obviously higher than those in fixation group(1.59±0.14,1.68±0.15,1.63±0.27,P＜0.05).CONCLUSION:Jog stress can increase numbers of bFGF at fracture part and promote fracture healing.

Pathological study of bone lengthening for bone defect resulted from gunshot wound / 中华骨科杂志

Objective To investigate the pathological changes of bone in situ lengthening for the gunshot bone defect, and to discuss the practical feasibility and biological basis of bone lengthening in the conditions of periosteum damage. Methods The 38 canines were randomly distributed into two groups and sustained the same gunshot bone defect in the mid femoral diaphysis. In one group, the femur were stabilized with Bastiani external fixator and 2 weeks later the fractured limb with fixation were lengthened 2-4 times per day at a speed of 0.5-1 mm/d until the normal length was reached. The control group only had external fixation without lengthening. 3, 6 and 12 weeks after injury, the canines were given 99mTc MDP and got radionuclide examination under SPECT (ADAC company, USA.). Pathological and X ray observation were carried out at 1, 2 ,3 ,6 and 12 weeks respectively after injury for comparison between two groups. Results The X ray measurement showed that the length of callus distraction in the bone lengthening group increased by (2.82?0.94)cm and the relative lengthening of bone is 19.3% (15.8%-21.4% ), compared with normal femur on the same X ray film. The count of radionuclide increased gradually at the region of bone defect in the lengthening group. While in the fracture ends, no significant difference was found in the development pattern through each radionuclide observation phase between two groups. The main mode of osteogenesis was endochondral ossification and the bone defect area was enriched by chondrocyte in the bone lengthening group. Conclusion There are no obvious negative influence on bone turnover and local blood flow in the bone lengthening for gunshot bone defect. The remained periosteum and bone fragment under gunshot injury may have important role in the progression of osteogenesis. The neogenetic capillary provided not only blood supply for healing of bone but also source of osteocyte for bone lengthening in the case of the periosteum and blood circulation damaged with gunshot wound.

CONSTRUCTION OF TGF-?_1 MATURE PEPTIDE GENE AND ITS EXPRESSION IN ESCHERICHIA COLI / 解放军医学杂志

To further understand the function and biological activity of TGF ? 1, and to provide the basis for the production of biologically active TGF ? 1 protein, TGF ? 1 cDNA was cloned into procaryotic expression vectors--pBV220 and pQE30, and the monomeric form of the recombinant TGF ? 1expressed in E.coli DH5? and M15. Sephacryl S 100 HR and Ni + NTA agarose column were used to purify the TGF ? 1 protein. With digestion of the enzymes and sequencing, TGF ? 1 mature peptide gene was inserted into procaryotic expression vectors--pBV220 and pQE30. After purified, the expressed products of two plasmids in E.coli showed a single protein on SDS--PAGE, and their expression levels were about 15% and 20% of the total bacterial protein. The construction of recombinant plasmids and preparation of the monomeric protein of TGF ? 1 lay a solid foundation for further studying the function of TGF ? 1 and producing biologically active TGF ? 1 protein.

TREATMENT OF THE LOCAL MICROCIRCULATION CHANGES IN PRIMARY BONE LENGTHENING FOR GUNSHOT BONE DEFECT BY EXTERNAL FIXATOR / 解放军医学杂志

To observe the local microcirculation changes in primary bone lengthening for gunshot bone defect treated by external fixators, the experimental study was carried out by using canine model of gunshot bone defect of extremities. 16 mongrel dogs were randomly divided into 2 groups, external fixators were used to distract early callus in one group and plaster was used for immobilization in the other group. The local microcirculation in the two groups was measured. The results showed: (1) Different from the normal fractures, the local blood flow of gunshot fractures was reduced in the first 3 days and then increased, at the 6th week it was close to the normal level. (2) There was no significant difference in the restoration of blood flow between the groups of external fixation and plaster immobilization. It is suggested that primary bone lengthening for gunshot bone defect by external fixators has no adverse effect on the restoration of the local blood flow.