Chronic constipation is a common clinical disorder,which has different influences on patients’quality of life and work. With the increase in pressure and pace of modern life,the aging of population,the changes in dietary pattern and the challenge of social psychological problems,the overall prevalence of chronic constipation in general population is increasing in recent decades. However,the therapeutic efficacy of chronic constipation is still not satisfactory. This article reviewed the advances in study on treatment of chronic constipation.

Objective To investigate the confocal laser scanning microscopic (CLSM) features of several hypopigmented diseases, including vitiligo, nevus depigmentosus, progressive macular hypomelanosis and amelanotic nevus. Methods A total of 131 patients with hypopigmented diseases were recruited in this study. CLSM was performed on depigmented lesions, adjacent normal appearing skin and lesion borders at the dermoepidermal junction level in these patients. Results CLSM showed that in progressive vitiligo, melanin was completely absent from some areas in vitiliginous skin, while some areas were present with residual dermal papillary rings which were less intact with decreased melanin content; the border of lesions was obscure; some dermal papillary rings lost integrity in normal appearing skin adjacent to the vitiliginous skin. There was a complete disappearance of pigment in vitiliginous skin, clear border of lesions and intact dermal papillary rings with bright reflected light in adjacent normal appearing skin in stable vitiligo. Dendrite-like melanocytes with bright reflected light were noted in recovery-stage vitiligo. The CLSM imaging of nevus depigmentosus and progressive macular hypomelanosis was similar: dermal papillary rings were intact with decreased melanin content and weak reflected light in depigmented lesions. No significant difference was observed in the structure of dermal papillary rings or melanin content between vitiliginous skin and adjacent normal-appearing skin of nevus anemicus. Conclusion Combined with clinical manifestations, CLSM may serve as an auxiliary tool to discriminate vitiligo, nevus depigmentosus, progressive macular hypomelanosis and amelanotic nevus.

The ability to feed on vertebrate blood has evolved many times in various arthropod clades. Consequently, saliva of blood-feeding arthropods has proven to be a rich source of antihemostatic molecules. A variety of platelet aggregation inhibitors antagonize platelet responses to wound-generated signals, including ADP, thrombin, and collagen. Anticoagulants disrupt elements of both the intrinsic and extrinsic pathways. Vasodilators include nitrophorins (nitric oxide storage and transport heme proteins), a variety of peptides that mimic endogenous vasodilatory neuropeptides, and proteins that catabolize or sequester endogenous vasoconstrictors. Multiple salivary proteins may be directed against each component of hemostasis, resulting in both redundancy and in some cases cooperative interactions between antihemostatic proteins. The complexity and redundancy of saliva ensures an efficient blood meal for the arthropod, but it also provides a diverse array of novel antihemostatic molecules for the pharmacologist.

OBJECTIVE:To provide suggestions for pharmaceutical manufacturers to improve medicine package in China. METHODS:The problems of some Chinese patent medicine package were summed up and analyzed,and improvement suggestions were put forward. RESULTS & CONCLUSIONS:At present,many defects are observed in Chinese patent drug package,such as large package increasing patients’burden;various package material aggravating resource waste and environmental pollution;indi-vidual package and multilayered package increasing unpacking and peeling time,and bringing risk;non-standard medicine informa-tion carrier easily resulting in medical errors. Pharmaceutical manufacturers are suggested to simplify drug package,increase pack-age capacity,adopt ordinary packagdized,highlight key information and other measures. Through these measures,Chinese patent medicine package could to be more standard,humanized and be convenient for clinical use.

Long noncoding RNA (lncRNA) refers to RNA transcripts with more than 200 nucleotides in length, which plays regulatory roles directly in the form of RNA. Their functions are affected by their secondary structures, post transcriptional modification and so on. LncRNA can be classified to various subtypes with complicated mechanisms. In human-induced-pluripotent stem cells (iPSCs) and embryonic stem cells (ESCs), dynamic expression of some lncRNAs is detected during the neuronal differentiation, and a series of lncRNAs associated closely with the development process of the central nervous system (CNS) are found. This review summarizes the molecular biological properties of lncRNA and their regulatory functions in the development of the CNS, which is helpful to reveal the mechanisms of the pathogenesis and progression of certain neurological diseases and results in innovation of their diagnosis and treatment.

Objective To investigate the effects of different preoperative fasting water time on body temperature in preoperative children. Methods Divided 350 children into A, B and C group randomly and apply 4 hours preoperative fasting water, 4 hours fasting water added 250～500 ml fluid infusion and 2 hours fasting water respectively. Observe the condition of body temperature, thirst, fidget, crying and vomiting in these 3 groups. Results The incidence rate of preoperative fever in group A was significant higher than that of in the other two groups. The incidence rate of thirst, fidget and crying were significant higher in group A and B than those of in group C, while there was no significant difference among three groups in the incidence rate of vomiting during the course of operation. Conclusion It is a safe method of 8 hours preoperative fasting food and 2 hours fasting water for children, which can effective reduce the incidence rate of preoperative fever and then guarantee the operation.

In spite of the fact that rectal stromal tumor accounts for only 4.2％ of the gastrointestinal stromal tumor,its surgical treatment is still very difficult and challenging due to the special anatomical position of rectum,its complicated anatomical relationship with adjacent organs,and whether the anus be preserved.Local resection of rectal stromal tumor is feasible and reasonable owing to its biological characteristics.However,there are many approaches and methods for local resection and no consensus has been reached.The clinical data of 18 patients with rectal stromal tumor who were treated by local resection via transposterior approach at the Peking Union Hospital from March 2003 to September 2012 were retrospectively analyzed.The surgery not only applies with the oncology treatment principle,but also preserves anus and limits the surgical injury to a large extent.Therefore,it is one of the most ideal surgical methods for the treatment of rectal stromal tumor.

0.05). Follow-up of 14 patients was from 1 to 60 months (the mean value is 26. 8 months). There was no late death and re-operation. The average mitral annulus area is (3.00?0.57) cm~2. The transmitral pressure gradient decreased from (8.13?4.49) mmHg to (6.25?3.82) mmHg after operation (P=0.050). There were eight cases with minimal reflux and 6 cases with slight reflux. In all patients, the heart function returned to NYHA I～II grade. Conclusion The “edge-to-edge” technique is a feasible and effective operation for treatment of the mitral regurgitation caused by Barlow's disease.

Objective The research aimed to probe into the complications of the treatment that endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy (ERCP/EST) combined with laparoscopic cholecystectomy (LC) for the patients suffered from gallstone disease combined with common bile duct stones and investigate the nursing methods.Methods One hundred and twenty-four patients suffered from gallstone disease combined with common bile duct stones were included in this retrospective analysis.At first,they underwent the treatment of ERCP/EST,and underwent LC in 1 to 5 days later.All the clinical data were collected and analyzed.Results Of all the patients,104 patients successfully underwent the treatment of ERCP/EST.And of the 104 patients,100 patients successfully underwent LC,the other 4 patients underwent open cholecystectomy.Nineteen complicated with acute pancreatitises,one with hemorrhage and two suffered from infections of bile duct were observed in this study.Conclusions Combination of ERCP/EST with LC is a safe and effective treatment for gallstone disease combined with common bile duct stones.The preoperative psychological counseling,and the surveillance and nursing of complications play significant roles in the successful treatment.

Objective To study the association between cytotoxin-associated gene A of Helicobacter pylori (Hp-CagA) and the expressions of mtp53 and c-myc protein in different subtypes of intestinal metaplasia.Methods One hundred and sixty-five patients with gastroscopy included 125 cases with chronic atrophic gastritis with intestinal metaplasia,40 cases with non-atrophic gastritis.Intestinal metaplasia included complete intestinal metaplasia,incompletetype intestinal metaplasia,complete colonic epithelial metaplasia and incomplete colonic epithelial metaplasia.The carbon-14-urea breath test was used to determine Helicobacter pylori (Hp);AB-PAS and HID-AB mucinous staining was used to distinguish intestinal metaplasia subtypes; the immunohistochemical Elivision method was used to determine the expressions ofmtp53 and c-myc protein;indirect ELISA was used to determine Hp-CagA.Results Forty-five cases with incomplete colonic epithelial metaplasia,47 cases with incomplete type intestinal metaplasta,17 cases with complete colonic epithelial metaplasia,16 cases with complete intestinal metaplasia.The positive rate of Hp-CagA in all intestinal metaplasia subtypes was higher than that in non-atrophic gastritis,but there was no significant difference (P ＞ 0.05).The expression of mtp53 protein in incomplete colonic type of intestinal metaplasia with Hp-CagA positive was higher than that in incomplete colonic type of intestinal metaplasia with Hp-CagA negative (x2 =5.494,P ＜ 0.05).The expression of c-myc protein in incomplete colonic type of intestinal metaplasia with Hp-CagA positive was higher than that in incomplete colonic type of intestinal metaplasia with Hp-CagA negative (x2 =13.950,P ＜ 0.01).Conclusion Hp-CagA is a sort of highly virulent strain,and Hp-CagA may do a strong role in the promotion of gastric atrophy and intestinal metaplasia.