[Integrative medicine for fecal incontinence: reflections on eastern and western experiences].

Fecal incontinence has emerged as a global health concern. This article explores an integrative medical model for fecal incontinence by illustrating its conceptual framework and scope, drawing from multidisciplinary consensus and guidelines developed over the past three decades, both internationally and through personal reflection. This integrative medical model is patient-centered, emphasizes the patient's role in treatment decision-making, and recognizes the value of patient-reported outcomes measure. The incorporation of multidisciplinary assessment tools such as the IMPACT scale promises to enhance the standards of clinical practice and research. Furthermore, learning from international guidelines provides insights into interdisciplinary forces, including acupuncture, to formulate consensus guidelines that align with the unique healthcare landscape in China.

[Morphological characteristic of anal canal in patients with dyssynergic defecation and its correlation with anorectal manometry].

Objective: To evaluate the diagnostic value of three-dimensional endoanal ultrasound (3D-EAUS) for dyssynergic defecation (DD). Methods: A case-control study was performed to retrospectively collectclinical data of 46 DD patients, including 16 males and 30 females with median age of 51 (20 to 70) years, at Nanjing Hospital of Chinese Medicine from February 2012 to April 2015.All the patients met the diagnostic criteria of functional constipation of Rome III. The paradoxical contraction of puborectalis (PR) muscle was found by both rectal examination and anorectal manometry. In the same period,45 healthy volunteers, including 22 males and 23 females with median age of 48 (21 to 72) years, without pelvic operation history, and with normal defecation in recent 6 months, were enrolled as the control group. No significant differences were observed in age and gender between two groups (both P>0.05). Cleveland constipation score of DD group was higher than that of control group [15(8-24) vs. 5(1-9), t=15.720, P<0.001]. 3D-EAUS examination was performed in all the subjects. Thickness and length of internal anal sphincter (IAS) (anterior side and posterior side), thickness of PR muscle, length of external anal sphincter (EAS) plus PR muscle, and puborectalis angle were measured and compared by using student t test between two groups. Correlation between these ultrasound parameters and anorectal manometry was examined by Pearson correlation analysis. Results: Both male and female in the DD group had the greater thickness of IAS, as compared to those in the control group [male: (1.7±0.5) mm vs.(1.5±0.2) mm, t=2.516, P=0.016; female: (1.9±0.4) mm vs.(1.6±0.5) mm, t=2.034,P=0.047]. No significant differences between the two groups were observed with respect to the posterior length of IAS, length of EAS plus PR muscle, and thickness of PR muscle (all P>0.05). Compared to the control group, male in the DD group had smaller puborectalis angle during straining [(87.0±3.6)° vs. (90.5±1.8)°,t=3.502,P=0.002];female in the DD group had smaller puborectalis angle both in resting and straining [resting:(86.5±3.8)° vs. (90.1±2.1)°,t=4.047, P<0.001;straining: (84.1±4.5)° vs. (90.2±2.3)°, t=5.938, P<0.001]. Correlation analysis showed that anterior length of IAS was positively correlated with anal resting pressure (r=0.321, P=0.030); the length of EAS plus PR muscle was positively correlated with anal squeeze pressure (r=0.415, P=0.004). There were no correlations between the thickness and the posterior length of IAS and the anal resting pressure, or between the thickness of PR muscle and the anal squeeze pressure (all P>0.05). Conclusions: The 3D-EAUS can accurately assess the morphological features of anal canal in DD patients. There is a certain positive correlation between 3D-EAUS and anorectal manometry.

LncRNA LINC01116 competes with miR-145 for the regulation of ESR1 expression in breast cancer.

OBJECTIVE: To investigate the biological role and clinical significance of long non-coding RNAs (lncRNA) LINC01116 in breast cancer. MATERIALS AND METHODS: In the public database Gene Expression Omnibus (GEO), the breast cancer data set GSE54002 was screened for differentially expressed lncRNA LINC01116 in breast cancer tissues and paracancerous tissues. Quantitative Real-time polymerase chain reaction (qRT-PCR) was used to detect the expression of LINC01116 in 64 breast cancer tissues and 30 normal breast tissues. Level of LINC01116 and clinicopathological parameters of breast cancer were statistically analyzed. The effect of LINC01116 in breast cancer cells was investigated after knockdown of LINC01116. Luciferase reporter gene was further used to investigate the mechanism of endogenous RNA (ceRNA). RESULTS: Results of GSE54002 showed that the expression of LINC01116 in breast cancer tissues was significantly increased. In clinical samples, the level of LINC01116 in patients with breast cancer was significantly increased, which was correlated with the overall survival, tumor size and tumor node metastasis (TNM) stage in patients, but not correlated with the age, sex and lymph node metastasis (p>0.05). LINC01116 can act as an endogenous sponge and bind directly to miR-145, resulting in the up-regulation of estrogen receptor 1 (ESR1), a target gene of miR-145. CONCLUSIONS: LncRNA LINC01116 is highly expressed in breast cancer and is a new prognostic biomarker in breast cancer. Our study establishes a new link between LINC01116, miR-145 and ESR1.

The polymorphism of HLA antigens in the Chinese.

Remarkable differences were observed in antigen frequencies (AF), gene frequencies (GF) and haplotype frequencies (HF) when 2441 healthy Chinese individuals representing nine different ethnic groups and living in 14 different geographic locations were examined for the genetic distribution of the various HLA Class I and II markers. A sizable number of individuals of each ethnic group within each of the three major categories of the Chinese population, namely, Hans, Mongols, and Southern minorities, have been studied here, providing useful population statistics for applications such as determination of probabilities of paternity, comparisons for HLA and disease associations, and anthropologic studies.