Functional constipation（FC）refers to constipation that is not caused by organic diseases of the intestines or systemic conditions，nor by medication-related factors. It is typically characterized by a prolonged course and a tendency for symptoms to recur. When constipation symptoms persist despite standardized treatment and significantly impact daily life，it may be termed refractory FC. In recent years，some novel treatment approaches for refractory FC have begun to be applied in children. These include new medications such as prucalopride，lubiprostone，and linaclotide，as well as fecal microbiota transplantation（FMT），neuromodulation，biofeedback therapy，and antegrade continence enema（ACE）. This article reviews the current advances in the treatment of refractory FC in children，aiming to provide insights and directions for the application of new therapeutic methods in clinical practice in the future.

Crohn's disease（CD）is a chronic non-specific inflammatory bowel disease with unclear etiology and pathogenesis. Endoscopy combined with pathological examination remains the gold standard for diagnosing and monitoring CD activity. However，endoscopy is limited to the mucosal surface and intestinal lumen，making it difficult to assess the full thickness of the intestinal wall and extraintestinal conditions，and it cannot reach the proximal end of a narrowed intestinal segment. Additionally，endoscopic biopsy is invasive，requires thorough bowel preparation，and is poorly tolerated by infants and young children.This article reviews recent research advances in non-invasive examination methods for CD patients，including non-invasive biomarkers in blood and stool，as well as non-invasive imaging techniques，and their potential applications in the diagnosis and treatment of CD. By integrating these biomarkers with clinical parameters，it is possible to reduce reliance on invasive testing，optimize personalized treatment strategies，and enable early identification of disease activity and remission status. This comprehensive approach allows for more accurate assessment of disease progression，adjustment of treatment plans，and the delivery of more precise and individualized care for CD patients，ultimately improving their prognosis and quality of life.

Wilson disease（WD）is an inherited disorder caused by mutations in the ATP7B gene.It is characterized by pathological accumulation of copper in the organs throughout the body，especially the liver and brain. This article reviews the latest progress of existing and emerging therapies. At present，the most commonly used treatment methods are oral chelators of copper and zinc agents. Liver transplantation can be used as a treatment for end-stage patients. However，these treatment methods have some shortcomings：many side effects of drugs，poor treatment effect，lifelong treatment，poor patient compliance and so on. At present，the choice of drugs is still in the exploratory stage，and there are no guidelines to specify which patients should receive which treatment. In addition，there are many emerging therapies in different experimental stages，such as new chelators of copper，targeted molecular therapy，gene therapy and cell transplantation. The old methods have many disadvantages and lack large controlled clinical trials，and emerging research is still in its infancy，which are urgent questions.

Coagulopathy in patients with liver disease is considered to be a fragile "rebalancing" state.Conventional coagulation test commonly used in clinic can not reflect the whole process of coagulation, so its application is limited.In recent years, thromboelastography has developed rapidly as a rapid and real-time detection method to evaluate the coagulation status of whole blood, and has unique advantages in the application of liver disease.The article reviews the application in transfusion guidance of thromboelastography and its association with severity of liver disease, bleeding, thrombosis, mortality and conventional coagulation testing.Although thromboelastography has some shortcomings, it can better reflect the real coagulation state of patients with liver disease and help reduce the use of blood products.Pediatric data are scarce, but the use of thromboelastography alone or in combination with conventional coagulation test will have broad prospects.

Inflammatory bowel disease (IBD) is a type of recurrent chronic non-specific inflammatory disease of the intestinal tract with unclear etiology. The pathological features of IBD patients are the dysfunction of intestinal epithelial barrier and destruction of crypt. More and more evidences show the importance of epithelial barrier integrity in intestinal homeostasis. Barrier dysfunction in IBD patients occurs earlier than clinical symptoms, and accelerates the progression of the disease. This article mainly reviews the relationship between intestinal epithelial barrier and IBD from the composition and development of intestinal epithelium, and the progress of developmental signaling pathways in the pathogenesis of IBD, in order to provide the new ideas for the treatment of IBD.

Inflammatory bowel disease (IBD) is a type of recurrent chronic non-specific inflammatory disease of the intestinal tract with unclear etiology. The pathological features of IBD patients are the dysfunction of intestinal epithelial barrier and destruction of crypt. More and more evidences show the importance of epithelial barrier integrity in intestinal homeostasis. Barrier dysfunction in IBD patients occurs earlier than clinical symptoms, and accelerates the progression of the disease. This article mainly reviews the relationship between intestinal epithelial barrier and IBD from the composition and development of intestinal epithelium, and the progress of developmental signaling pathways in the pathogenesis of IBD, in order to provide the new ideas for the treatment of IBD.

Objective To establish and evaluate intestinal epithelial barrier model using Caco-2 cell so as to play a foundation for next study of barrier permeability.Methods Caco-2 cells were cultured in vitro then seeded into Transwell cell culture inserts.The permeability of the intestinal epithelial barrier was detected by transepithelial electrical resistance(TEER)and lucifer yellow flux,and verified by transmission electron micro-scope.Different concentrations of PAF(0,50,100,and 200 nmol /L)were exposed for 24 hours to Caco-2 mono-layer when cultured 21 days.The tight junction was observed under transmission electron microscope.Assess-ment of ZO-1 protein localization and expression were detected by immunofluorescence and Western blot analy-sis.Results Cultured Caco-2 cell confluencd as monolayer with time passed.From 5th day,TEER increased, then reached 600Ω?cm2 at 15th day and lasted to 21 st day,there was little flux of lucifer yellow,transmission e-lectron microscopy also found cells differentiated better,had well-arranged villi and polarity alined as monolayer, forming completed tight junction which was the marker of intestinal epithelial barrier model in vitro.TEER de-creased and lucifer yellow flux increased in cells exposed to PAF.The permeability reached the peak when ex-posed to 100 nmol /L PAF(P <0.01 ),tight junction disrupted,ZO-1 protein expression downregulated,abnor-mal localization and distribution was assessed by immunofluorescence staining.Conclusion Cultured Caco-2 cells for 2-3w can be used to study intestinal epithelial barrier as a model in vitro.PAF increased intestinal epi-thelial permeability,which would correlate to the decreased protein expression and abnormal distribution of ZO-1.

Objective:To investigate the clinicopathological characteristics, treatments, and survival of patients with esophageal adeno-squamous carcinoma (EASC). Methods:A total of 494 patients with EASC were selected from the clinical information databases of 500, 000 cases with esophageal and gastric cardiac carcinomas in the Henan Key Laboratory for Esophageal Cancer Research. Among the 494 EASC cases, 361 were males with an average age of 61.47 ± 8.32 years, and 133 were females with an average age of 65.56 ± 8.06 years. SPSS 21.0 software was applied to determine the statistical differences among the different groups. A life-table method was also used to calculate the five-year survival rate. A linear regression model was used to analyze the correlation of changes at different peri-ods. Results:The incidence of EASC in our database was 0.196%(494/251707). EASC occurred predominantly in male patients (male:female=2.71:1.00). The peak age was within 60-69 years in both males and females (39.6%vs. 40.6%). Notably, the incidence of male patients showed a downward trend (R2=0.063), whereas that of female patients showed an upward trend (R2=0.004). The prevalence of EASC was obviously higher in low-incidence areas for esophageal cancer than in high-incidence areas (53.1%vs. 46.9%, P<0.001). Ac-cording to the TNM staging criteria for esophageal cancer, phases II and III patients comprised the majority of cases, which accounted for 40.8%(173/424). The positive lymph node metastasis rate was 47.0%(206/438), and the number of positive lymph node metasta-ses ranged within 1-2 (48.5%, 100/206). In addition, preoperative biopsy was performed in 467 cases, and more than half of the pa-tients (53.96%, 252/467) were diagnosed before the operation. Surgical resection was the predominant treatment method for EASC (88.8%, 419/472). Only 1.9%patients (9/472) underwent radiotherapy and chemotherapy. The five-year survival rate of male patients who were neither smoking nor drinking of alcohol was higher than that of male smokers (26.5%vs. 12.1%). In patients with stagesⅠ,Ⅱ, andⅢ+Ⅳcarcinomas with surgery as lone treatment, the three-year survival rates were 64.7%, 50.9%, and 48.5%, respectively. Correspondingly, these rates were 51.7%, 47.8%, and 33.1%after adjuvant radiotherapy and chemotherapy. Conclusion:EASC is a rare type of esophageal malignant tumor. The preoperative biopsy pathological diagnosis has high misdiagnosis rate. Smoking and drinking of alcohol can influence the prognosis of patients. In EASC patients, lymph node metastasis easily occurs, and a simple surgery is bet-ter than other cancer treatments.

Objective T o investigate the m ain point of long backbone fracture caused by blunt force in forensic clinical identification and to provide a reference for the inspection and appraisal practices of such injury. Methods N inety-nine cases of adult long backbone fractures were collected from January 2006 to D ecem ber 2013 in G utian C ounty of Fujian Province. A ccording to the term s of fracture loca-tion, m ode of injury, type, the data were sum m arized. Results In the 99 cases, there were 36 cases caused by hitting, kicking, and falling and 63 cases caused by vehicle collision. T he m ajority of the for-m er was ulna, and those of the latter were tibia and fibula. T he types of fracture were transverse one, short oblique one, long oblique one, and spiral one. Conclusion D ifferent types of long backbone frac-ture, not only causing stress load of fractures as well as structural differences related to each segm ent.