Objective To compare the effects of biofeedback (BF) training on clinical symptoms , psychological status and quality of life in different subtypes of patients with functional defecation disorders (FDD) .Methods According to Rome Ⅲ criteria ,50 FDD patients were divided into non coordinated defecation (F3a) and the lack of promoting defecation (F3b) two subtypes .The patients of these two subtypes received BF training three times every week ,five to ten times each course ,two to three times training at home were required during and after treatment .The changes ,of clinical symptoms scores ,self‐rating anxiety scale (SAS) ,self‐rating depressive scale (SDS) and the patient assessment of constipation quality of life question naire (PAC‐QOL ) were compared between before and after BF training in the patients of two subtypes .The difference between two subtypes were also analyzed as well .Paired t‐test or Wilcoxon signed‐rank test was performed for comparison between before and after treatment ,and group t‐test or Wilcoxon rank sum test was for comparison between groups .Results Among 50 FDD patients , there were 13 cases of F3a type and 37 cases of F3b type .After BF training ,the clinical symptoms scores of two subtypes patients were both lower than those before BF training (5 .62 ± 3 .91 vs 8 .77 ± 3 .59 , 5 .89 ± 3 .67 vs 9 .35 ± 3 .22 ,t = 3 .264 and 6 .272 ,both P< 0 .01) .There were no statistically significant differences in the scores of clinical symptoms between two subtypes at before and after BF training (t =- 0 .545 and - 0 .230 ,both P > 0 .05) .After BF training ,the SAS scores of two subtypes patients were both lower than those before BF training (30 .85 ± 6 .67 vs 42 .46 ± 8 .37 ,30 .65 ± 7 .51 vs 38 .59 ± 8 .38 , t= 4 .536 and 6 .402 ,both P< 0 .01) ,and the scores of SDS were both lower than those before BF training (42 .85 ± 8 .30 vs 53 .92 ± 7 .98 ,43 .95 ± 12 .17 vs 55 .39 ± 10 .83 ,t = 4 .788 and 6 .830 ,both P< 0 .01) . There were no statistically significant differences in the scores of SAS and SDS between two subtypes at before and after BF training (t= 1 .431 ,0 .084 ,- 0 .447 and - 0 .301 ,all P> 0 .05) .After BF training ,the PAC‐QOL scores of two subtypes [0 .54 (0 .15 ,0 .88) 、0 .98 (0 .51 ,1 .34)] were both lower than those before BF training [2 .08(1 .18 ,2 .34) 、1 .86(1 .34 ,2 .29)] ,Z= - 2 .903 、- 4 .825 ,both P < 0 .01) .There were no statistically significant differences in the PAC‐QOL scores between two subtypes at before and after BF training (Z= 0 .409 ,1 .891 ,both P > 0 .05) .Conclusions BF training is both effective on two subtypes of FDD ,which can improve clinical symptoms ,psychological status and quality of life ,and with There is no difference in efficacy between the two subtypes .

Objective To evaluate the long-term efficacy and the influencing factors of biofeedback (BF) treatment in functional constipation (FC).Methods Totally 120 BF treated FC patients were retrospectively followed up.The clinical symptom score,the use of laxatives,the result of colonic transit test and anorectal manometry were compared before BF treatment and during follow-up.The long-term efficacy of biofeedback treatment was evaluated.Thirty-two possible influencing factors of long-term efficacy were selected and univariate and multivariate analysis were conducted.The groups were compared with t test,rank-sum test and x2 test.The influencing factors of long-term efficacy were analyzed with a stepwise multiple regression analysis.Results The median score of clinical symptoms in follow-up period (3) was significantly lower than that before BF treatment (10,Z=-7.900,P＜0.01).The total long-term efficacy rate was 70.6％ (77/109).During follow-up,the rate of laxatives use [39.4 ％ (43/109)] was lower than that before BF treatment [83.5％ (91/109),x2 =44.623,P＜0.01].During follow-up,the 48 hour median colonic emptying rate (30.0％)was higher than that before BF treatment (0,Z=-2.298,P=0.022).During follow-up,the proportion of patients with uncoordinated defecation (51.4％) was lower than that before BF treatment (77.1％,x2 =5.040,P=0.025).The results of univariate and multivariate analysis showed that the long-term efficacy of BF treatment was positively correlated with the compliance for home training and utilization of social support,negatively correlated with the course of disease.Conclusions BF therapy can improve clinical symptoms of FC patients,correct physiological dysfunction and have a satisfactory lon~term efficacy.Compliance for home training,utilization of social support and the course of disease were independent influencing factors.

Objective To investigate whether stem cell factor(SCF)was responsible for the diabetesassociated depletion of interstitial cells of Cajal in colon(ICC)in diabetic mice.Methods Forty male C57/BL6 mice were randomly divided into the control group(n=10),the diabetic group(n=10),the normal group with immunoneutralization of endogenous SCF(n=10)and the diabetic group with exogenous SCF (n=10).All mice were sacrificed 6 weeks after modeling.The ICC in the proximal colon tissues were investigated by flow cytometry,transmission electron microscopy and Western blot.The SCF in colon tissues and serum were analyzed by Western blot and ELISA.Results The SCF in the serum and proximal colon muscle was significantly reduced in diabetic group compared with the control group(P＜0.05).The changes were accompanied with the depletion of ICC and the uhrastructure damage of ICC.The expression of SCF was significantly decreased in the serum and proximal colon tissues in the normal group after immunoneutralization of SCF.Meanwhile,the depletion of ICC and the ultrastructure damage of ICC was similar to the diabetic group.The expression of SCF in the serum and proximal colon tissues of the diabetic group with exogenous SCF was significantly increased,and which was along with the quantity of ICC and the ultrastructure improved dramatically compared with the diabetic group.Conclusions The decrease of SCF in the serum and colon of the diabetic mice may be responsible for the diabetes-associated depletion of ICC in colon.Exogenous SCF may improve the ICC lesions in diabetic gastroimestinal tract.

Objective To assess the effects of zinc protoporphyrin (ZnPP), an inhibitor of the heme oxygenase (HO), on the colonic interstitial cells of Cajal (ICC) of diabetic rats with colonic slow transit. Methods Diabetes mellitus (DM) model was induced by intraperitoneal injection of streptozotocin (STZ) in Sprague-Dawley rats. Twenty four successfully established DM rats were selected, and 16 healthy rats were served as controls. Six weeks later, gastrointestional (GI) dysfunction was observed by charcoal propulsion experiment in 8 DM rats and 8 controls. The rest rats in DM group were divided into 2 groups: DM rats intraperitoneal injected with PBS (n=8) or with 10 μmol/kg of ZnPP (n = 8) every other day for 3 weeks. The rats in control group (n = 8) were intraperitoneally injected with PBS. The levels of HO and c-kit (the special receptor of ICC) expression were detected by Western blotting. The distribution of ICC was observed by immunohistochemistry and the area of c-kit positive cells was counted. Results The GI propulsion rate in DM rats interfered with PBS was significantly declined compared to that in the controls (63.0%± 1.2% vs 71.8%±2.0%, P<0.05). But it was improved in DM rats interfered with ZnPP (72.5± 2.6%, P<0.05), which showed no significant differentee with that in control group (P>0.05). The expression of HO-1 in close and distant colon of DM rats interfered with ZnPP was decreased (P< 0.05). The expression of HO-2 in close colon and the area of c-kit positive cells of DM rats interfered with PBS was reduced compared with that in controls (P<0.05), but both were improved in DM rats interfered with ZnPP (P<0. 05). Conclusion Administration of ZnPP might be able to protect ICC by its blockage of HO-1 in DM rats with gastrointestinal dysfunction.

Objective:To establish an animal model of slow transit constipation and the pathobiological changes in interstitial cell of Cajal in colon. Methods:The mouse model was established by subcutaneous administration of morphine. Fecal weight was recorded daily. Transit functions of intestinal movement were examined by activated charcoal suspension pushing test and the changes of interstitial cell of Cajal were observed by immunohistochemical methods. Results:Compared with the controlled mice, there was a significant decrease in fecal weight daily(P

OBJECTIVE:To explore the effect of prophylactic use of vitamin B6 with chlorpheniramine on the adverse reactions in fundus fluorescein angiography (FFA). METHODS:326 patients with FFA were randomly divided into observation group and control group. Observation group was orally given Vitamin B6 tablet 10 mg 30 min before angiography+Chlorpheniramine maleate tablet 4 mg;control group was orally given Metoclopramide tablet 10 mg+Chlorpheniramine maleate tablet 4 mg. The occurrence time and incidence of adverse reactions in 2 groups were observed and correlation analysis was conducted. RESULTS:There was no significant difference in the occurrence time of adverse reactions between 2 groups(P>0.05);the incidence of adverse reactions in observation group was significantly lower than control group,the difference was statistically significant(P<0.05). The correlation analysis of adverse reactions in control group showed the occurrence of adverse reactions had no correlation with age and gender of patients(P>0.05). CONCLUSIONS:Prophylactic use of vitamin B6 with chlorphenir arnine can reduce the occurrence of adverse reactions in FFA.

Objective To explore the relationship between health?related quality of life and resili?ence of patients with inflammatory bowel disease( IBD) ,and provide a new entry point to improve the quality of life. Methods The general information questionnaire,the Chinese version of inflammatory bowel disease questionnaire ( IBDQ) and the Chinese version of Connor?Davidson mental resilience scale ( CD?RISC) were used to investigate 102 patients with IBD. Results The average scores of IBDQ and CD?RISC of IBD pa?tients were (157.6±31.7) and (62.5±15.0). Except for the correlation between the score of optimistic di?mension and the social function dimension,the total score and the scores of other dimensions of IBDQ were significantly correlated with the total score and the scores of dimensions of CD?RISC( r=0.200?0.490, P<0.05). Multiple regression analysis showed that tenacity,residence,moderate and severe disease severity,and disease duration with more than 10 years could significantly predict the level of health?related quality of life (β=0.319,0.268,-0.218,-0.373,-0.260, P<0.05) . Conclusion The health?related quality of life of IBD patients has a strong relationship with resilience. Health care workers can help improve health?related quality of life of the patients through fostering resilience.

Objective To assess the psychometric properties of the Chinese Heartburn Version of Quality of Life in Reflux and Dyspepsia Questionnaire (QOLRAD) in patients with gastroesophageal reflux disease.Methods 130 patients with symptoms of heartburn completed the Chinese version of QOLRAD,the Short-Form-36 (SF-36).30 of them received proton pump inhibitors (PPI) for 8 weeks,which was used to test responsiveness of the Chinese heartburn version of QOLRAD.Results The Chinese version of QOLRAD had acceptable internal consistency.The overall Cronbach's alpha was 0.89 and the internal consistency of dimensions ranged from 0.70～0.90.Content validity index (CVI) was 0.82.Confirmation factor analysis revealed a 5 factor solutions accounting for 62.02％ and most of items in their dimensions had acceptable loads (＞0.4).There was acceptable concurrent validity with correlations between the Chinese heartburn version of QOLRAD and Short Form-36 health survey ranging from 0.172～0.613.As to responsiveness,after therapy of PPI for 8 weeks,except the dimension of sleep disturbance,scores for dimensions of vitality,food/drink problems,physical/social functioning,emotional distress had significant changes.Conclusions The Chinese version of QOLRAD has a good reliability,validity and responsiveness to therapy,which can be used to assess the quality of life in patients with gastroesophageal reflux disease.

Objective To investigate the effect of silencing Notch1 gene by RNA interference on the proliferation,apoptosis and Akt/mTOR signaling pathway in clear renal cell carcinoma.Methods The optimal segment targeting Notch1 gene was designed and transfected into 786-O cells by Lipofectamine TM2000.The Notch1 mRNA and protein were detected by RT-PCR and Western blot.The proliferation rate of 786-O cells was evaluated by MTT and the variation of apoptosis was measured by TUNEL.The protein expression level of apoptosis-related protein Bcl-2,caspase-3,caspase-9,and signaling pathway protein Akt,p-Akt,p-mTOR,p-P70S6K were detected by Western blott.Results Notchl mRNA and protein was markedly suppressed by the siRNA targeting Notch1.Treated with 0,40,60,80,100 and 120 nmol/L of Notch1 siRNA for 24 hours,cell proliferation rates were (98.51 ± 1.33) ％,(87.34 ± 2.26) ％,(64.72 ± 3.24)％,(57.68 ±3.32)％,(31.91 ± 1.85)％ and (19.27 ±2.73)％,and the difference was statistically significant (P ＜ 0.01).Treated with 0,40,80,and 120 nmol/L of Notchl siRNA for 24 hours,apoptosis rates were (7.6 ± 3.8) ％,(21.5 ± 4.8) ％,(32.3 ± 3.5) ％,and (46.3 ± 4.7％),the difference was statistically significant (P ＜ 0.05).Decreased expression of Akt signaling pathway proteins p-Akt,p-mTOR,p-70S6K and apoptosis-related protein Bcl-2,procaspase-3 was detected,but no change in the total protein of Akt.Conclusions Depletion of Notch1 gene could inhibit cell growth and induce apoptosis in 786-O cell line.It inhibits Akt/mTOR signaling pathway by dephosphorylated.