1.Normative values and its clinical significance of the anorectal manometry in Chinese from multi-center study
Xiaohong SUN ; Zhifeng WANG ; Haiwei XIN ; Youling ZHU ; Xueqin WANG ; Jinyan LUO ; Xiaoping XIE ; Xiaohua HOU ; Duowu ZUO ; Meiyun KE
Chinese Journal of Digestion 2014;(9):597-602
Objective To acquire normative values of anorectal manometry and sensation in population of our country with different gender and age.Methods Healthy individuals from four medical centers were collected and divided into three group according to their age,group Ⅰ 18 - 39 years old, group Ⅱ 40-59 years old and group Ⅲ ≥60 years old.The parameters of anal of subjects at resting status was examined by pneumohydraulic capillary perfusion system and high resolution PC Polygraf HR desktop gastrointestinal dynamic monitoring system.Subjects were asked to simulate defecation and then the defecation related indexes were recorded.In the end rectoanal inhibitory reflexes (RAIR)and rectal sensation were assessed by aired balloon.One-way analysis of variance and independent sample test were performed to compare indexes among three groups with different age and between different genders. Results A total of 166 healthy subjects were enrolled,79 in group Ⅰ with 40 male,68 in group Ⅱ with 29 male and 19 in group Ⅲ with 11 male.There was no significant difference in anal sphincter length (ASL),valid anal sphincter length (VASL),resting anal sphincter pressure (RASP),squeeze anal sphincter pressure (SASP)and duration of valid squeeze anal sphincter pressure (VSASP)among three groups with different age (all P > 0.05 ).Compared between male and female,only SASP of male ((180.13±8.10)mmHg,1 mmHg=0.133 kPa)was significantly higher than that of female ((143.93± 6.59)mmHg,t = -3.489,P <0.001 ),no difference in other parameters was found (all P >0.05 ). There was no significant difference in rectal pressure (RP),rectoanal pressure gradient (RAPG),anal sphincter relaxation rate (ASRR),and rectoanal coordination (RAC)among three groups (all P >0.05). During simulated defecation,RP and RAPG of men ((61 .23±3.46)mmHg and (40.04±4.08)mmHg) were significantly higher than those of women ((44.47 ± 2.32)mmHg and (24.00 ± 2.59 )mmHg, t=-4.075 ,-3.367,both P <0.01 ).There was no significant difference in other parameters between men and women (all P >0.05).All participants had RAIR,and there was no significant difference neither among three groups nor between men and women (both P >0.05).There was no significant difference in first rectal sensation (FRS)and constant rectal sensation (CRS)among three groups with different age (all P >0.05).However,the maximum rectal tolerable sensation (MRTS)of group Ⅱ and group Ⅲ was significantly higher than that of group Ⅰ ((194.41 ±6.32)mL and (200.00±12.75)mL vs (167.80 ± 5 .00)mL,F = 6.698,P = 0.002).There was no significant difference in rectal sensation between different gender (all P >0.05 ).Conclusions In our country,SASP,RP and RAPG during simulated defecation of male are higher than those of female.The value of MRTS increases along with the age.
2.Dynamic change of depression in diabetic patients based on the latent growth curve model
Haiwei HOU ; Yaling ZHAO ; Fangyao CHEN ; Lingxia ZENG ; Leilei PEI
Journal of Xi'an Jiaotong University(Medical Sciences) 2022;43(4):588-593
【Objective】 To explore the dynamic change of depression in diabetic patients so as to provide evidence for early detection and warning of psychological problems in diabetic patients. 【Methods】 Based on the data from the China Health and Retirement Longitudinal Study (CHARLS), the propensity score matching method was used to eliminate confounding factors in the study. The linear growth model, the nonlinear quadratic growth model, and the growth model without defined curve type were fitted respectively. According to the fitting indices of the models, the optimal solution of the growth function was determined to explore the changes of depression development in the diabetic patients. 【Results】 A total of 5 711 cases (5 380 cases in the non-diabetic group and 331 cases in the diabetic group) were included in the study. After propensity score matching, 1 621 cases (1 291 cases in the non-diabetic group and 330 cases in the diabetic group) were included and all confounding factors were balanced between the two groups. By fitting three growth curve models with latent variables, the results showed that the model without defined curve type was better than the other two models. The mean depression score for initial status in the non-diabetic and diabetic groups was 9.640 and 10.097, respectively, with significant inter-individual differences. During the follow-up period, the depression status of both groups showed a trend of decrease first and then increase, but the depression score was always lower in the non-diabetic group than in the diabetic group. At the same time, there was no individual difference in the rate of change between the two groups, and there was no statistical difference between the initial depression score and the subsequent slope of change. 【Conclusion】 Exploring the change track of depression status over time in diabetic patients, understanding the individual psychological change trend and further explaining the differences between individuals are of great significance for intervention on psychological status at different stages.