Objective To investigate the gender differences and psychological influencing factors for anal rectal function in senile patients with functional constipation (FC) .Methods The gender differences and correlation of anal rectal function and psychological factors were compared in elderly patients and control group by anorectal manometry and psychological testing methods .Results The anal pressure drops of analog defecation of elderly female and male patients were attenuated and the rectal sensation thresholds increased compared with that of control group ,and the maximal squeezing pressure ,the rectal defecation pressure and anorectal pressure difference of elderly female patients were attenuated compared with that of elderly male patients .The SAS and SDS stand‐ard score of elderly female and male patients were significantly higher than that of control group .The SAS standard score of elderly female patients were higher than elderly male patients .SAS and SDS were negatively correlated with anorectal pressure difference and positively correlated with rectal first sensation volume (FSV) .Conclusion Anorectal dysfunction and psychological factors were involved in the elderly FC pathogenesy ,and they were related .Elderly female patients suffered more severe anxiety and anorectal motility disorders than male patients .

Objective To investigate the gender differences of anal rectal function and depression and/or anxiety in elderly patients with functional constipation (FC).Methods Twenty-seven elder female FC patients (elder female patients group),20 elder male FC patients (elder male FC patients group),28 elder healthy female (elder healthy female group) and 24 elder healthy male (elder healthy male group) were selected.The gender differences and correlation of anal rectal function and psychological factors were compared in elderly patients and control group,by using anorectal manometry and psychological testing methods.Results Compared with elder healthy female group,maximum squeeze pressure (MSP),anorectal pressure decreased in elder healthy male group(P ＜ 0.05 or ＜ 0.01),anal canal overpressure,first sensation volume(FSV),defecating sensation volume(DSV),maximum tolerable volume(MTV) increased in elder female patients group (P＜ 0.01).Compared with elder male healthy group,anal canal excess pressure increased,anorectal pressure decreased (P＜ 0.05),and FSV,DSV,MTV increased in elder male patients group (P ＜ 0.01 or ＜ 0.05).MSP,rectum systolic pressure,anorectal pressure in elder female patients group was lower than that in elder male patients group (P ＜ 0.05 or ＜ 0.01),rectal tube excess pressure and rectal sensation threshold was higher than that in elder male patients group,but there was no significant difference (P ＞ 0.05).RRP,rectum systolic pressure,anorectal pressure in elder female healthy group was lower than that in elder male healthy group (P ＜ 0.01).FSV was higher than that in elder male healthy group (P ＜ 0.01).SAS score and SDS score was higher in elder female patients group was higher than that in elder female healthy group (P＜ 0.01),SAS score and SDS score was higher in elder male patients group was higher than that in elder male healthy group(P＜ 0.05 or ＜ 0.01).SAS score was negatively correlated with MSP,rectum systolic pressure,anorectal pressure(P ＜ 0.01),was positively correlated with FSV(P ＜ 0.05).SDS score was negatively correlated with anorectal pressure (P ＜ 0.01),was positively correlated with FSV,DSV,MTV (P ＜0.01).Conclusions Anorectal dys function and psychological factors are involved in the elderly FC pathogenesy,and the two are related.Elderly female patients exist more severe anxiety and anorectal motility disorders than male patients.

Objective To evaluate the effect of surgery combined with aminolevulinic acid (ALA)-based photodynamic therapy (PDT) on the prognosis of extramammary Paget's disease.Methods A prospective open-labelled controlled trial was conducted.A total of 38 patients with pathologically comfirmed extramammary Paget's disease were enrolled from Shanghai Dermatology Hospital,and divided into 2 groups to be treated with surgery alone (surgery alone group,n =21) or surgery combined with ALA-PDT (combination group,n =17).Patients in the combination group received ALA-PDT after the surgery once every two weeks for 3 sessions.All the patients were followed up once every three months for more than 12 months,and the incidence of relapse was evaluated and compared between the 2 groups after the treatment.Results During the follow-up of 12-58 months (mean,35.45 ± 16.98 months),7 patients in the surgery alone group experienced relapse,and the median time to relapse was 9 months,with an upper quartile of 18 months and a lower quartile of 6 months.However,relapse only occurred in 1 patient in the combination group,and the time to relapse was 18 months after the end of treatment.The recurrence rate was significantly lower in the combination group than in the surgery alone group (P ＜ 0.05),and the time to relapse was also longer in the combination group than in the surgery alone group.Furthermore,ALA-PDT after the surgery was well tolerated in all the patients.Conclusion Surgery combined with ALA-PDT can reduce the recurrence rate of extramammary Paget's disease,and improve its prognosis.

Adaptation, Psychological ; Adolescent ; COVID-19 ; Child ; China ; Cross-Sectional Studies ; Female ; Humans ; Male ; SARS-CoV-2