Dyssynergic defecation is one of the most common forms of functional constipation both in children and adults; it is defined by incomplete evacuation of fecal material from the rectum due to paradoxical contraction or...Dyssynergic defecation is one of the most common forms of functional constipation both in children and adults; it is defined by incomplete evacuation of fecal material from the rectum due to paradoxical contraction or failure to relax pelvic floor muscles when straining to defecate. This is believed to be a behavioral disorder because there.are no associated morphological or neurological abnormalities, and consequently biofeedback training has been recommended for treatment. Biofeedback involves the use of pressure measurements or averaged electromyographic activity within the anal canal to teach patients how to relax pelvic floor muscles when straining to defecate. This is often combined with teaching the patient more appropriate techniques for straining （increasing intra-abdominal pressure） and having the patient practice defecating a water filled balloon. Tn adults, randomized controlled trials show that this form of biofeedback is more effective than laxatives, general muscle relaxation exercises （described as sham biofeedback）, and drugs to relax skeletal muscles. Moreover, its effectiveness is specific to patients who have dyssynergic defecation and not slow transit constipation. However, in children, no clear superiority for biofeedback compared to laxatives has been demonstrated. Based on three randomized controlled studies in the last two years, biofeedback appears to be the preferred treatment for dyssynergic defecation in adults.展开更多
Fecal incontinence is a disabling disease, often observed in young subjects, that may have devastating psycho-social consequences. In the last years, numerous evidences have been reported on the efficacy of bio-feedba...Fecal incontinence is a disabling disease, often observed in young subjects, that may have devastating psycho-social consequences. In the last years, numerous evidences have been reported on the efficacy of bio-feedback techniques for the treatment of this disorder. Overall, the literature data claim a success rate in more than 70% of cases in the short term. However, recent controlled trials have not confirmed this optimistic view, thus emphasizing the role of standard care. Nonetheless, many authors believe that this should be the first therapeutic approach for fecal incontinence due to the efficacy, lack of side-effects,and scarce invasiveness. Well-designed randomized,controlled trial are eagerly awaited to solve this therapeutic dilemma.展开更多
AIM: Chronic constipation is a frequent finding in children. In this age range, the concomitant occurrence of megarectum is not uncommon. However, the definition of megarectum is variable, and a few data exist for Ita...AIM: Chronic constipation is a frequent finding in children. In this age range, the concomitant occurrence of megarectum is not uncommon. However, the definition of megarectum is variable, and a few data exist for Italy.We studied anorectal manometric variables and sensation in a group of constipated children with megarectum defined by radiologic criteria. Data from this group were compared with those obtained in a similar group of children with recurrent abdominal pain.METHODS: Anorectal testing was carried out in both groups by standard manometric technique and rectal balloon expulsion test.RESULTS: Megarectum patients displayed discrete abnormalities of anorectal variables and sensation with respect to controls. In particular, the pelvic floor function appeared to be impaired in most patients.CONCLUSION: Constipated children with megarectum have abnormal anorectal function and sensation. These findings may be helpful for a better understanding of the pathophysiological basis of this condition.展开更多
Objective This cross-sectional study aimed to investigate the current attention and intervention of oncologists on oxaliplatin(OXA)-induced adverse reactions(ADRs).Methods In 31 provinces or administrative regions acr...Objective This cross-sectional study aimed to investigate the current attention and intervention of oncologists on oxaliplatin(OXA)-induced adverse reactions(ADRs).Methods In 31 provinces or administrative regions across China,401 oncologists were surveyed through a self-designed questionnaire.The survey queried the basic information of respondents,clinical use of OXA,OXA-induced ADRs,and relative interventions.Chi-square tests and multiple logistic regression were used to explore the sociodemographic factors influencing the safety perception of OXA and the relevant interventions.Results The survey showed that the age of respondents was mainly distributed between 30 and 40 years and the working period for most oncologists was no more than 5 years.Oncologists with long working years were more willing to conduct patient education and inquire about ADRs than those with short working years.The rate of ADRs reported by oncologists with intermediate professional titles was significantly higher than that reported by oncologists with junior and senior professional titles.Conclusion Our findings indicate that oncologists in China's Mainland are concerned about OXA-induced ADRs,but the reporting of ADRs still needs to be strengthened.Therefore,training and educational programs are urgently needed to improve the risk management of OXA-induced ADRs among oncologists.展开更多
Collecting cervical MSCT thin layer scanning image data of 52 cases of pediatric specimen from three hospitals, and 16 cases of childpediatric specimen and using Mimics to measure morphological indicators to make stat...Collecting cervical MSCT thin layer scanning image data of 52 cases of pediatric specimen from three hospitals, and 16 cases of childpediatric specimen and using Mimics to measure morphological indicators to make statistical analysis according to side sexand age, to provide the anatomical basis for clinical diagnosis and treatment of related diseases, internal fixationmode selection, auxiliary orthopaedic equipment designing and manufacturing and so on, The width, height andlength of the C_(3)-C_(7) pedicle, lateral mass pedicle length, pedicle axis length and the interpediculate distance ofchildren aged 0-6 years showed an overall increasing trend with the increase of age, but the range of theanteroposterior cervical spinal canal diameter was different.展开更多
OBJECTIVE:To compare and observe the effects of three kinds of cephalic acupuncture therapies commonly used in the clinic on promoting nerve function rehabilitation in the brain microenvironment of rats with cerebral ...OBJECTIVE:To compare and observe the effects of three kinds of cephalic acupuncture therapies commonly used in the clinic on promoting nerve function rehabilitation in the brain microenvironment of rats with cerebral palsy.METHODS:A negative control group,positive control group,and three cephalic acupuncture groups based on the administration of three cephalic acupuncture therapies were established.Ten experimental rats were selected from each group at 1,2,and 3 weeks after modeling.Neuromotor function after treatment was rated according to the Basso,Beattie,and Bresnahan method.White matter fiber bundles were evaluated by head diffusion tensor imaging.The expression levels of neuron-specific enolase,microtubule-associated protein 2,and myelin basic protein in the brain tissue extract were detected by Western blot analysis and the activities of ATPases were determined using a fixed phosphorus method.RESULTS:The pathological changes in brain tissue were restored and motor function scores were increased in the mice in each cephalic acupuncture group,and the expression of neuronal growth-related proteins in the brain tissue extract was significantly increased.Additionally,the activities of ATPases in the lesion area were significant enhanced(P<0.05).Diffusion tensor imaging revealed that the white matter fiber bundles of mice in each cephalic acupuncture group gradually increased and recovered.The nervous system structure was significantly improved.CONCLUSIONS:All three acupuncture methods promoted the rehabilitation of nerve function damaged by cerebral palsy.These effects are likely related to the improved expression of nerve growth-related proteins,enhancement of ATPase activities,and regulation of the brain microenvironment.展开更多
Background： Resection of sacral chordomas is challenging. The anatomy is complex, and there are often no bony landmarks to guide the resection. Achieving adequate surgical margins is, therefore, difficult, and the re...Background： Resection of sacral chordomas is challenging. The anatomy is complex, and there are often no bony landmarks to guide the resection. Achieving adequate surgical margins is, therefore, difficult, and the recurrence rate is high. Use of computer navigation may allow optimal preoperative planning and improve precision in tumor resection. The purpose of this study was to evaluate the safety and feasibility of computer navigation-aided resection of sacral chordomas. Methods： Between 2007 and 2013, a total of 26 patients with sacral chordoma underwent computer navigation-aided surgery were included and followed for a minimum of 18 months. There were 21 primary cases and 5 recurrent cases, with a mean age of 55.8 years old （range： 35 84 years old）. Tumors were located above the level of the $3 neural foramen in 23 patients and below the level of the $3 neural foramen in 3 patients. Three-dimensional images were reconstructed with a computed tomography-based navigation system combined with the magnetic resonance images using the navigation software. Tumors were resected via a posterior approach assisted by the computer navigation. Mean follow-up was 38.6 months （range： 18-84 months）. Results： Mean operative time was 307 min. Mean intraoperative blood loss was 3065 ml. For computer navigation, the mean registration deviation during surgery was 1.7 ram. There were 18 wide resections, 4 marginal resections, and 4 intralesional resections. All patients were alive at the final follow-up, with 2 （7.7%） exhibiting tumor recurrence. The other 24 patients were tumor-free. The mean Musculoskeletal Tumor Society Score was 27.3 （range： 19-30）. Conclusions： Computer-assisted navigation can be safely applied to the resection of the sacral chordomas, allowing execution of preoperative plans, and achieving good oncological outcomes. Nevertheless, this needs to be accomplished by surgeons with adequate experience and skill.展开更多
Background Juvenile Fibromyalgia Syndrome （JFMS） is a chronic health condition characterized by widespread musculoskeletal pain and multiple tender points （TP）.The objective of this study was to determine the prev...Background Juvenile Fibromyalgia Syndrome （JFMS） is a chronic health condition characterized by widespread musculoskeletal pain and multiple tender points （TP）.The objective of this study was to determine the prevalence of JFMS in the urban population of Samsun and to determine the impact of JFMS on depression symptoms,school performance and quality of life （QOL）.Methods A cross-sectional study was conducted in 1109 children （mean age （14.8±2.0） years old）.A questionnaire was applied to the children and a medical examination including TP was performed.Yunus and Masi＇s criteria were used for diagnosis of JFMS.The children with JFMS were compared with an age and sex matched non-JFMS group.Depression was assessed with Children＇s Depression Inventory （CDI） and QOL was evaluated with Pediatric Quality of Life Inventory 4.0 （PedsQL4.0）.Results Sixty-one （5.5%） （13 boys and 48 girls） of 1109 children met the diagnostic criteria of JFMS.While PedsQL scores of children with JFMS were lower than the non-JFMS group for physical,emotional,social,school functioning and total score （P=0.001）,CDI total score was higher in the JFMS group than in the non-JFMS group （P=0.001）.The JFMS group reported more school absences （P=0.001） and the average school grade was lower in the JFMS group than in the non-JFMS group （P=0.03）.Conclusion The prevalence of JFMS is high in school age children.Since JFMS is a common problem of childhood,early diagnosis and identification of the disorder and more comprehensive and successful treatment approaches with appropriate psychological assistance may prevent more complex and severe problems in adulthood.展开更多
文摘Dyssynergic defecation is one of the most common forms of functional constipation both in children and adults; it is defined by incomplete evacuation of fecal material from the rectum due to paradoxical contraction or failure to relax pelvic floor muscles when straining to defecate. This is believed to be a behavioral disorder because there.are no associated morphological or neurological abnormalities, and consequently biofeedback training has been recommended for treatment. Biofeedback involves the use of pressure measurements or averaged electromyographic activity within the anal canal to teach patients how to relax pelvic floor muscles when straining to defecate. This is often combined with teaching the patient more appropriate techniques for straining （increasing intra-abdominal pressure） and having the patient practice defecating a water filled balloon. Tn adults, randomized controlled trials show that this form of biofeedback is more effective than laxatives, general muscle relaxation exercises （described as sham biofeedback）, and drugs to relax skeletal muscles. Moreover, its effectiveness is specific to patients who have dyssynergic defecation and not slow transit constipation. However, in children, no clear superiority for biofeedback compared to laxatives has been demonstrated. Based on three randomized controlled studies in the last two years, biofeedback appears to be the preferred treatment for dyssynergic defecation in adults.
文摘Fecal incontinence is a disabling disease, often observed in young subjects, that may have devastating psycho-social consequences. In the last years, numerous evidences have been reported on the efficacy of bio-feedback techniques for the treatment of this disorder. Overall, the literature data claim a success rate in more than 70% of cases in the short term. However, recent controlled trials have not confirmed this optimistic view, thus emphasizing the role of standard care. Nonetheless, many authors believe that this should be the first therapeutic approach for fecal incontinence due to the efficacy, lack of side-effects,and scarce invasiveness. Well-designed randomized,controlled trial are eagerly awaited to solve this therapeutic dilemma.
文摘AIM: Chronic constipation is a frequent finding in children. In this age range, the concomitant occurrence of megarectum is not uncommon. However, the definition of megarectum is variable, and a few data exist for Italy.We studied anorectal manometric variables and sensation in a group of constipated children with megarectum defined by radiologic criteria. Data from this group were compared with those obtained in a similar group of children with recurrent abdominal pain.METHODS: Anorectal testing was carried out in both groups by standard manometric technique and rectal balloon expulsion test.RESULTS: Megarectum patients displayed discrete abnormalities of anorectal variables and sensation with respect to controls. In particular, the pelvic floor function appeared to be impaired in most patients.CONCLUSION: Constipated children with megarectum have abnormal anorectal function and sensation. These findings may be helpful for a better understanding of the pathophysiological basis of this condition.
基金supported by the Clinical Toxicology Foundation of the Chinese Society of Toxicology(No.CST2020CT107)the Research Project of the Drug Clinical Evaluation Professional Committee of the China Pharmaceutical Association(No.CPA-Z06-ZC-2021-004).
文摘Objective This cross-sectional study aimed to investigate the current attention and intervention of oncologists on oxaliplatin(OXA)-induced adverse reactions(ADRs).Methods In 31 provinces or administrative regions across China,401 oncologists were surveyed through a self-designed questionnaire.The survey queried the basic information of respondents,clinical use of OXA,OXA-induced ADRs,and relative interventions.Chi-square tests and multiple logistic regression were used to explore the sociodemographic factors influencing the safety perception of OXA and the relevant interventions.Results The survey showed that the age of respondents was mainly distributed between 30 and 40 years and the working period for most oncologists was no more than 5 years.Oncologists with long working years were more willing to conduct patient education and inquire about ADRs than those with short working years.The rate of ADRs reported by oncologists with intermediate professional titles was significantly higher than that reported by oncologists with junior and senior professional titles.Conclusion Our findings indicate that oncologists in China's Mainland are concerned about OXA-induced ADRs,but the reporting of ADRs still needs to be strengthened.Therefore,training and educational programs are urgently needed to improve the risk management of OXA-induced ADRs among oncologists.
文摘Collecting cervical MSCT thin layer scanning image data of 52 cases of pediatric specimen from three hospitals, and 16 cases of childpediatric specimen and using Mimics to measure morphological indicators to make statistical analysis according to side sexand age, to provide the anatomical basis for clinical diagnosis and treatment of related diseases, internal fixationmode selection, auxiliary orthopaedic equipment designing and manufacturing and so on, The width, height andlength of the C_(3)-C_(7) pedicle, lateral mass pedicle length, pedicle axis length and the interpediculate distance ofchildren aged 0-6 years showed an overall increasing trend with the increase of age, but the range of theanteroposterior cervical spinal canal diameter was different.
基金Supported by National Natural Science Foundation of China:Study on the Mechanism of Microenvironment in Cerebral Palsy Induced by Scalp Acupuncture based on Metabonomics Technique(No.81560795)Study on the Effect of Electroacupuncture Stimulation of Head Motor area on PI3K/AKT Signaling Pathway on Neural Behavior in Neonatal Cerebral Palsy Rats(No.81303035)。
文摘OBJECTIVE:To compare and observe the effects of three kinds of cephalic acupuncture therapies commonly used in the clinic on promoting nerve function rehabilitation in the brain microenvironment of rats with cerebral palsy.METHODS:A negative control group,positive control group,and three cephalic acupuncture groups based on the administration of three cephalic acupuncture therapies were established.Ten experimental rats were selected from each group at 1,2,and 3 weeks after modeling.Neuromotor function after treatment was rated according to the Basso,Beattie,and Bresnahan method.White matter fiber bundles were evaluated by head diffusion tensor imaging.The expression levels of neuron-specific enolase,microtubule-associated protein 2,and myelin basic protein in the brain tissue extract were detected by Western blot analysis and the activities of ATPases were determined using a fixed phosphorus method.RESULTS:The pathological changes in brain tissue were restored and motor function scores were increased in the mice in each cephalic acupuncture group,and the expression of neuronal growth-related proteins in the brain tissue extract was significantly increased.Additionally,the activities of ATPases in the lesion area were significant enhanced(P<0.05).Diffusion tensor imaging revealed that the white matter fiber bundles of mice in each cephalic acupuncture group gradually increased and recovered.The nervous system structure was significantly improved.CONCLUSIONS:All three acupuncture methods promoted the rehabilitation of nerve function damaged by cerebral palsy.These effects are likely related to the improved expression of nerve growth-related proteins,enhancement of ATPase activities,and regulation of the brain microenvironment.
文摘Background： Resection of sacral chordomas is challenging. The anatomy is complex, and there are often no bony landmarks to guide the resection. Achieving adequate surgical margins is, therefore, difficult, and the recurrence rate is high. Use of computer navigation may allow optimal preoperative planning and improve precision in tumor resection. The purpose of this study was to evaluate the safety and feasibility of computer navigation-aided resection of sacral chordomas. Methods： Between 2007 and 2013, a total of 26 patients with sacral chordoma underwent computer navigation-aided surgery were included and followed for a minimum of 18 months. There were 21 primary cases and 5 recurrent cases, with a mean age of 55.8 years old （range： 35 84 years old）. Tumors were located above the level of the $3 neural foramen in 23 patients and below the level of the $3 neural foramen in 3 patients. Three-dimensional images were reconstructed with a computed tomography-based navigation system combined with the magnetic resonance images using the navigation software. Tumors were resected via a posterior approach assisted by the computer navigation. Mean follow-up was 38.6 months （range： 18-84 months）. Results： Mean operative time was 307 min. Mean intraoperative blood loss was 3065 ml. For computer navigation, the mean registration deviation during surgery was 1.7 ram. There were 18 wide resections, 4 marginal resections, and 4 intralesional resections. All patients were alive at the final follow-up, with 2 （7.7%） exhibiting tumor recurrence. The other 24 patients were tumor-free. The mean Musculoskeletal Tumor Society Score was 27.3 （range： 19-30）. Conclusions： Computer-assisted navigation can be safely applied to the resection of the sacral chordomas, allowing execution of preoperative plans, and achieving good oncological outcomes. Nevertheless, this needs to be accomplished by surgeons with adequate experience and skill.
文摘Background Juvenile Fibromyalgia Syndrome （JFMS） is a chronic health condition characterized by widespread musculoskeletal pain and multiple tender points （TP）.The objective of this study was to determine the prevalence of JFMS in the urban population of Samsun and to determine the impact of JFMS on depression symptoms,school performance and quality of life （QOL）.Methods A cross-sectional study was conducted in 1109 children （mean age （14.8±2.0） years old）.A questionnaire was applied to the children and a medical examination including TP was performed.Yunus and Masi＇s criteria were used for diagnosis of JFMS.The children with JFMS were compared with an age and sex matched non-JFMS group.Depression was assessed with Children＇s Depression Inventory （CDI） and QOL was evaluated with Pediatric Quality of Life Inventory 4.0 （PedsQL4.0）.Results Sixty-one （5.5%） （13 boys and 48 girls） of 1109 children met the diagnostic criteria of JFMS.While PedsQL scores of children with JFMS were lower than the non-JFMS group for physical,emotional,social,school functioning and total score （P=0.001）,CDI total score was higher in the JFMS group than in the non-JFMS group （P=0.001）.The JFMS group reported more school absences （P=0.001） and the average school grade was lower in the JFMS group than in the non-JFMS group （P=0.03）.Conclusion The prevalence of JFMS is high in school age children.Since JFMS is a common problem of childhood,early diagnosis and identification of the disorder and more comprehensive and successful treatment approaches with appropriate psychological assistance may prevent more complex and severe problems in adulthood.
