Objective:To compare the results of high-resolution colonic manometry (HRCM) in patients with four subtypes of constipation: slow transit constipation(STC), outlet obstruction constipation (OOC), mixed STC and OOC, and normal transit constipation(NTC), and to explore the intestinal motility characteristics of patients with different subtypes of constipation.Methods:From 20th January 2017 to 20th September 2020, the HRCM results of 225 patients with functional constipation who visited the Department of Anorectal Surgery of Tianjin Union Medical Center were retrospectively analyzed. According to the results of colonic transit test, 225 patients were divided into STC group (108 cases), OOC group (36 cases), mixed group (28 cases) and NTC group (53 cases). General information such as Wexner constipation scores, clinical symptoms (decreased desire to defecate, sensation of anorectal blockage, hand-assisted defecation, spontaneous bowel movements frequency<3 times per week), the incidence, frequency within one day (hereinafter referred to as frequency), average velocity, average wave amplitude, average duration of contraction, average length of contraction, and the dynamic index (DI) of average pressure of high-amplitude propagating contraction (HAPC), as well as the frequency, average wave amplitude, average duration of contraction, and the DI of average pressure of low-amplitude propagating contraction (LAPC) were compared among the four groups. One-way ANOVA and multiple comparison, Kruskal-Wallis test and chi-square test were used for statistical analysis.Results:The Wexner constipation scores of the STC, OOC, mixed and NTC group were 13.17±4.04, 13.97±4.55, 11.36±4.03 and 11.58±4.06, respectively, and the difference was statistically significant ( F=3.879, P<0.05). The Wexner consipation scores of the STC and OOC group were both higher than the mixed and NTC group, and the difference were statistically significant (One-way ANOVA and multiple comparison, all P<0.05). The proportion of decreased desire to defecate, sensation of anorectal blockage, hand-assisted defecation, spontaneous bowel movements frequency<3 times per week of STC, OOC, mixed and NTC group were 47.2% (51/108), 36.1% (13/36), 14.3% (4/28), 20.8% (11/53); 42.6% (46/108), 75.0% (27/36), 46.4% (13/28), 64.2% (34/ 53); 31.5% (34/108), 38.9% (14/36), 3.6% (1/28), 18.9% (10/53); 90.7% (98/108), 77.8% (28/36), 82.1% (23/28) and 62.3% (33/53), and the differences were statistically significant ( χ2=17.093, 12.463, 13.437 and 18.927; all P<0.01). The proportion of decreased desire to defecate of STC group was higher than that of mixed and NTC group, and spontaneous bowel movements frequency<3 times per week was higher than that of OOC and NTC group, and the differences were statistically significant ( χ2=10.014, 10.518, 4.418 and 19.016; all P<0.05). The proportion of sensation of anorectal blockage of OOC group was higher than that of STC and mixed group, and the proportion of hand-assisted defecation was higher than that of the mixed and NTC group, and the differences were statistically significant ( χ2= 9.511, 5.486, 10.948 and 4.363, all P<0.05). The incidence of HAPC in STC, OOC, mixed and NTC groups was 39.8% (43/108), 36.1% (13/36), 57.1% (16/28), and 60.4% (32/53), respectively, and the difference was statistically significant ( χ2=8.880, P=0.031). The incidence of HAPC in STC group and OOC group were lower than that of NTC group, and the differences were statistically significant ( χ2=6.041 and 5.050, P=0.014 and 0.025). There were no statistically significant difference in the frequency, average velocity, average amplitude, average duration of contraction, average length of contraction and DI of pressure of HAPC in four groups, and there were no statistically significant difference in the frequency, average amplitude, average duration of contraction, and DI of pressure of LAPC in the four groups (all P>0.05). Conclusions:Doctors can more clearly and objectively observe the intestinal motility characteristics of patients with different subtypes of constipation through HRCM. HRCM provides a strong basis for the diagnosis and further treatment of functional constipation, and has a high clinical application value.

Juvenile myelomonocytic leukemia(JMML)is a rare hematopoietic malignant disease that occurs mostly in infants and young children.JMML is clinically heterogeneous, with most patients having rapid progression and a poor prognosis.A minority of patients have slow progression and may achieve spontaneous remission.Indicators affecting the prognosis of patients include clinical features, hematologic indicators, genetic mutations, acute myeloid leukemia-like gene expression profiles, and epigenetic alterations.Finding JMML prognostic indicators for risk grouping is of great significance for prognostic assessment and individualized therapy.This paper aims to review the advances in prognostic indicators of JMML.

In mammals, the piezoelectric protein, Prestin, endows the outer hair cells (OHCs) with electromotility (eM), which confers the capacity to change cellular length in response to alterations in membrane potential. Together with basilar membrane resonance and possible stereociliary motility, Prestin-based OHC eM lays the foundation for enhancing cochlear sensitivity and frequency selectivity. However, it remains debatable whether Prestin contributes to ultrahigh-frequency hearing due to the intrinsic nature of the cell's low-pass features. The low-pass property of mouse OHC eM is based on the finding that eM magnitude dissipates within the frequency bandwidth of human speech. In this study, we examined the role of Prestin in sensing broad-range frequencies (4-80 kHz) in mice that use ultrasonic hearing and vocalization (to >100 kHz) for social communication. The audiometric measurements in mice showed that ablation of Prestin did not abolish hearing at frequencies >40 kHz. Acoustic associative behavior tests confirmed that Prestin-knockout mice can learn ultrahigh-frequency sound-coupled tasks, similar to control mice. Ex vivo cochlear Ca²⁺ imaging experiments demonstrated that without Prestin, the OHCs still exhibit ultrahigh-frequency transduction, which in contrast, can be abolished by a universal cation channel blocker, Gadolinium. In vivo salicylate treatment disrupts hearing at frequencies <40 kHz but not ultrahigh-frequency hearing. By pharmacogenetic manipulation, we showed that specific ablation of the OHCs largely abolished hearing at frequencies >40 kHz. These findings demonstrate that cochlear OHCs are the target cells that support ultrahigh-frequency transduction, which does not require Prestin.
Animals ; Cochlea/metabolism* ; Hair Cells, Auditory, Outer/metabolism* ; Hearing ; Humans ; Mammals/metabolism* ; Mice ; Mice, Knockout ; Molecular Motor Proteins/metabolism*