Advancing higher education and its implication towards sustainable development: Moderate role of green innovation in BRI economies.

Environmental deterioration is one of the major problems the globe is facing in the modern period. On the other hand, several groups around the world have endeavored to launch efforts to protect the planet, such as the Sustainable Development Goals. Therefore, the proposed objectives' primary duty is to strike a balance between development and environmental concerns. This study looked at 65 Belt and Road Initiative (BRI) economies to see how factors, including the economic complexity index, urbanization, ICT, higher education, and green innovation, affected carbon emissions in the presence of sustainable development. Annual time series data from 2000 to 2020 have been used in the analysis. This study employs the CC-EMG to determine the durability of the association between the variables. AMG and quantile GMM regression estimations were used to test the robustness and reproducibility of the results. The results reveal that higher education and green innovation help lower carbon emissions, whereas the economic complexity index and urbanization are beneficial for increasing economic activity and advancing information and communication technologies. The economic complexity index, ICT, and higher education are all negatively impacted by green innovation. Important policy implications of the computed coefficients for the selected and other developing markets in planning a suitable path forward to a sustainable environment are also provided.

Multifunctional CaF2: Yb3+, Ho3+, Gd3+ Nanocrystals: Insight into Crystal Growth and Properties of Upconversion Luminescence, Magnetic, and Temperature Sensing Properties.

The upconversion (UC) emission intensity of Ln3+-doped CaF2 nanomaterials is not ideal, which limits their application in some advanced scientific fields. Hence, it is extremely imperative to enhance the emission intensity of UC nanocrystals. In this work, an ionic-liquid-assisted hydrothermal method based on an ethylene glycol (EG) and ionic liquid (IL) two-phase system was used to synthesize CaF2 doped with Yb3+ and Ho3+. The influence of the amount of IL and the reaction time as well as the concentration of Gd3+ doping on morphology and size was studied in detail, and the growth mechanism was proposed. Green UC luminescence materials were obtained through co-doping Yb3+ and Ho3+ ions. Furthermore, the luminescence of UC was increased monotonically with the introduction of Gd3+ ions. The effect mechanism of Gd3+ doping on the UC luminescence was put forward, which might provide a new method for the promotion of UC luminescence. In addition, the temperature sensing of CaF2: Yb3+/Ho3+/Gd3+ was investigated, which demonstrated that the phosphor has a potential application prospect in thermal sensing. Meanwhile, CaF2: Yb3+/Ho3+/Gd3+ also exhibited a paramagnetic property at room temperature. Therefore, these multifunctional nanocrystals may have prospective applications in optical bioimaging, magnetic resonance imaging, and temperature sensing.

Systematic Study on the Luminescent Properties, Thermal Stability, and Magnetic Behavior of GdOF: RE3+ (RE = Eu, Yb, and Er) Red Phosphors with Various Morphologies.

In this work, GdOF:RE3+ (RE = Eu, Yb, and Er) phosphors with high thermally stable luminescence were reported, which were synthesized by an ionic liquid-assisted two-phase system and subsequent calcination technique for the first time. Nanodisks, nanorod aggregates, nanoneedles, and stubby nanorods were obtained by simply regulating the pH value. The luminescent properties of precursors and products were discussed in detail. By carefully adjusting the calcination temperature and the pH value of the initial system, pure red emission was achieved in both GdOF:Eu3+ and GdOF:Yb3+, Er3+ phosphors. The reason for distinct luminescent properties of different products was discussed from various perspectives. Moreover, the temperature-dependent spectra were measured and the GdOF:Eu3+ and GdOF:Yb3+, Er3+ products both exhibited outstanding thermal stability. In addition, the as-prepared nanomaterials presented paramagnetic properties, indicating their potential application in both field-emission displays and magnetic resonance imaging technology.

MicroRNA-133a suppresses colorectal cancer cell invasion by targeting Fascin1.

[This retracts the article DOI: 10.3892/ol.2014.2753.].

Luminescence and Energy Transfer of Color-Tunable Y2Mg2Al2Si2O12:Eu2+,Ce3+ Phosphors.

Color-tunable phosphors can be obtained through codoping strategies and energy transfer regulation. Ce3+ and Eu2+ are the most common and effective activator ions used in phosphor materials. However, the energy transfer from Eu2+ to Ce3+ is rarely reported. In this work, Y2Mg2Al2Si2O12(YMAS):Eu2+,Ce3+ phosphors were successfully synthesized, which was confirmed by X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), Rietveld refinement, scanning electron microscopy (SEM) and element mapping images, and spectral information. The luminescent color of YMAS:Eu2+,Ce3+ phosphors could be tuned from blue to cyan to light green to yellow-green and finally to green-yellow, which was achieved by adjusting the energy transfer between different dopants. The energy transfer from Eu2+ to Ce3+ was confirmed by photoluminescence spectra and fluorescence decay curves. Within the experimental gradient, the energy transfer efficiency could reach up to 48%. At 373 K, the Y1.99Mg1.99Al2Si2O12:0.01Eu2+,0.01Ce3+ (YMAS:0.01Eu2+,0.01Ce3+) phosphor exhibited a total integral emission loss of only 8%, and the emission peak intensity decreased to 95%, indicating the excellent thermal stability. The white light-emitting diode (WLED) fabricated by the YMAS:0.01Eu2+,0.01Ce3+ phosphor has the same level correlated color temperature (CCT = 5841 K), greatly improved color rendering index (Ra = 87.8), and higher quality white light color (CIE = (0.3258, 0.3214)) than the WLED made by the YMAS:0.01Eu2+ phosphor, indicating that the performance of the phosphor was significantly improved by introducing Ce3+. This work provides an effective guide for the design and development of highly efficient color-tunable phosphors involving energy transfer from Eu2+ to Ce3+ in some specific materials, such as garnet structures.

A single-phase full-visible-spectrum phosphor for white light-emitting diodes with ultra-high color rendering.

Excellent luminous performance and high color rendering are the keys to white light-emitting diode (WLED) illumination. This work reports a single-phase full-visible-spectrum Y2Mg2Al2Si2O12(YMAS):Eu2+,Mn2+ phosphor for WLEDs with ultra-high color rendering. The luminescence of a single Mn2+ doped YMAS phosphor is very weak due to the spin-forbidden transition of Mn2+, while it can be dramatically enhanced in the YMAS:Eu2+,Mn2+ system through efficient energy transfer from the sensitizer Eu2+. Meanwhile, the luminescent color of this phosphor can be tuned from cyan to cold white, to warm white, and finally close to the yellow region by controlling the activator concentration and energy transfer process. Its good thermal and chromaticity stability meet the requirements of application in WLEDs. Its stable photochromic performance at different excitation wavelengths (365-395 nm) indicates that it can be used in different ultraviolet chips. The YMAS:0.03Eu2+,0.30Mn2+ phosphor-converted WLED achieves an ultra-high color rendering index (Ra = 93.3), near-standard chromaticity coordinates (CIE = (0.3343, 0.3388)) and a suitable correlated color temperature (CCT = 5417 K).

Study on the Local Structure and Luminescence Properties of a Y2Mg2Al2Si2O12:Eu3+ Red Phosphor for White-Light-Emitting Diodes.

Structure determines properties, and properties determine applications, which is an important ideology of natural sciences. For optical materials, it is vital to lucubrate the corresponding relationship between the local crystal structure and luminescence properties for their design, synthesis, and application. This work reports a newly designed Y2Mg2Al2Si2O12(YMAS):Eu3+ red phosphor, in which difunctional Eu3+ ion is used as a red-light activator and spectroscopic probe. The qualitative and quantitative studies on the relationship between the local crystal structure and the luminescence properties of YMAS:Eu3+ are performed experimentally and computationally, using the Y3Al5O12 (YAG):Eu3+ as contrast. Moreover, compared with YAG:Eu3+, the newly designed YMAS:Eu3+ has stronger luminescence, superior Commission Internationale de L'Eclairage chromaticity coordinates, a lower optimal doping concentration, and equally excellent thermal stability. The satisfactory color-rendering index of packaged white-light-emitting diodes demonstrates its potential performance as a red phosphor. Briefly, this work provides not only a new case for the study of the local crystal structure and luminescence properties but also a new possibility for the application of a red phosphor in solid-state lighting.

Synthesis and characterization of a flexible fluorescent magnetic Fe3O4@SiO2/CdTe-NH2 nanoprobe.

In this study, we designed and synthesized two novel fluorescent magnetic nanoparticles. Fe3O4@SiO2-NH-GSH-CdTe (FSGC) (GSH = glutathione) nanoparticles were synthesized using amino-functionalized Fe3O4@SiO2 nanoparticles and GSH-stabilized CdTe quantum dots (CdTe QDs), while flexible Fe3O4@SiO2-NH-GSH-CdTe-NH-NH2 (FSGCN) nanoparticles were synthesized using the FSGC precursor and 1,6-hexamethylenediamine. These two kinds of nanoprobes exhibited excellent magnetic and fluorescent properties. By comparing the fluorescence quenching effect of folic acid (FA) on FSGC and FSGCN, we found that the quenching effect of FA on FSGC was acute and the process was too fast to determine the FA content. However, the quenching effect of FA on flexible FSGCN was mild and hence it could be used as a nanoprobe to determine FA concentration. At physiological pH, the fluorescence quenching effect of FA on the FSGCN nanoprobes was fitted according to the Stern-Volmer equation with a linear response in the concentration range of 0.14 to 4.20 µg mL-1 with a detection limit of 15.1 × 10-9 g mL-1 (S/N = 3) under optimized experimental conditions. The proposed flexible nanoprobe was successfully used to determine the content of FA in folic acid tablets. Recovery was found to be in the range of 92.7%-105.6% with a relative standard deviation of 1.12%-3.84%. Owing to their good stability, environment-friendly characteristics, high selectivity, and good optical properties and biocompatibility, these nanoprobes have potential for usage in practical applications.

The effect of nano-TiO2 photocatalysis on the antioxidant activities of Cu, Zn-SOD at physiological pH.

Security issues of nanoparticles on biological toxicity and potential environmental risk have attracted more and more attention with the rapid development and wide applications of nanotechnology. In this work, we explored the effect and probable mechanism of nano-TiO2 on antioxidant activity of copper, zinc superoxide dismutase (Cu, Zn-SOD) under natural light and mixed light at physiological pH. Nano-TiO2 was prepared by sol-hydrothermal method, and then characterized by X-ray Diffraction (XRD) and Transmission electron micrographs (TEM). The Cu, Zn-SOD was purified by sephadex G75 chromatography and qualitatively analyzed by sodium dodecyl sulfate polypropylene amide gel electrophoresis (SDS-PAGE). The effect and mechanism were elucidated base on Fourier Transform Infrared Spectrometer (FT-IR), Circular Dichroism (CD), zeta potential, and electron spin resonance (ESR) methods. Accompanying the results of FT-IR, CD and zeta potential, it could be concluded that nano-TiO2 had no effect on the antioxidant activity of Cu, Zn-SOD by comparing the relative activity under natural light at physiological pH. But the relative activity of Cu, Zn-SOD significantly decreased along with the increase of nano-TiO2 concentration under the mixed light. The results of ESR showed the cause of this phenomenon was the Cu(II) in the active site of Cu, Zn-SOD was reduced to Cu(I) by H2O2 and decreased the content of active Cu, Zn-SOD. The reduction can be inhibited by catalase. Excess O2·- produced by nano-TiO2 photocatalysis under mixed light accumulated a mass of H2O2 through disproportionation reaction in this experimental condition. The results show that nano-TiO2 cannot affect the antioxidant activity of Cu, Zn-SOD in daily life. The study on the effect of nano-TiO2 on Cu, Zn-SOD will provide a valid theory support for biological safety and the toxicological effect mechanism of nanomaterials on enzyme.

[Clinical efficacy of partial resection of puborectalis combined with mutilation of internal anal sphincter in the treatment of puborectalis syndrome with high anal pressure].

OBJECTIVE: To explore the efficacy of partial resection of puborectalis combined with mutilation of internal anal sphincter(IAS) in the treatment of puborectalis syndrome with high anal pressure. METHODS: Twenty-five cases of puborectalis syndrome with high anal resting pressure in the preoperative examination received the operation of partial resection of puborectalis combined with mutilation of IAS in Zhongnan Hospital of Wuhan University between January 2013 and May 2015. The position of puborectalis was confirmed by touching with the exposure under the transfixion device, and a transverse incision was made by electrotome between 3 and 5 o'clock direction of puborectalis, then partial puborectalis was lifted by vessel clamp at 5 o'clock direction, and about 0.5 cm of muscular tissue was resected. Between 8 to 10 o'clock direction of anal tube, about 1 cm length of transverse incision was made by electrotome, then partial IAS was lifted by vessel clamp and cut off. Preoperative and postoperative 3-month anorectal manometry and defecography were carried out. Wexner constipation score and Cleveland Clinic incontinence score were implemented before surgery and 3, 6, 12 months after operation. This study was registered in the Chinese Clinical Trial Registry (registration number: ChiCTR-ORB-16007695). RESULTS: Of the 25 cases, 18 were male and 7 were female, the average age was 55 years old and the average course of disease was 9 years. Compared with pre-operation, the postoperative 3-month anal resting pressure and maximal squeeze pressure were significantly decreased [(53.56±9.05) mmHg vs. (92.44±7.06) mmHg, (142.80±20.35) mmHg vs. (210.88±20.56) mmHg, respectively, both P=0.000]; anorectal angulation at resting state and forced defecation state increased significantly [(102.32±4.96)degree vs. (95.88±4.01)degree, (117.88±5.95)degree vs. (89.52±3.25)degree, respectively, both P=0.000]. Wexner constipation score of postoperative 3-month, 6-month, 12-month (8.28±3.91, 7.40±3.64 and 8.04±4.74) was significantly lower than the preoperative score (16.00±3.69, all P<0.05), while the score was not significantly different among 3 time points after operation (P>0.05). Cleveland Clinic incontinence score was 0 at postoperative 6 and 12 months, and revealed 20 cases were effective among all the surgical patients(80%). CONCLUSION: Partial resection of puborectalis combined with mutilation of internal anal sphincter can effectively reduce anal pressure and improve symptoms of outlet obstruction, which is an effective method in the treatment of puborectalis syndrome with high anal pressure.

Facile synthesis and color-tunable properties of BaLuF5:Ce,Tb,Eu(Sm) submicrospheres via a facile ionic liquid/EG two-phase system.

BaLuF5:Ce,Tb,Eu(Sm) submicrospheres were synthesized via an ILs/ethylene glycol(EG) two-phase system. The crystalline phase, size, morphology, and luminescence properties were characterized using powder X-ray diffraction (XRD), field emission-scanning electron microscopy (FE-SEM), transmission electron microscopy (TEM), photoluminescence (PL) spectra. The results show that 1-methyl-3-octylimidazolium hexafluorophosphate ([Omim]PF6) was used as fluoride source and capping agent to tune morphology and size of the crystals. The formation mechanism has been supposed. Under the excitation of ultraviolet, the BaLuF5:5%Ce3+,5%Tb3+, BaLuF5:Eu3+, and BaLuF5:5%Ce3+,5%Sm3+ exhibit green and red emission, which was derived from Tb3+, Eu3+, and Sm3+ emission. When codoping Ce3+, Tb3+, Sm3+ or Eu3+ together, multi-color emission can be realized. Furthermore, this synthetic route may have potential applications for fabricating other lanthanide fluorides.

BaGdF5:Dy(3+),Tb(3+),Eu(3+) multifunctional nanospheres: paramagnetic, luminescence, energy transfer, and tunable color.

A series of Dy(3+),Tb(3+) and Eu(3+) singly, doubly or triply doped BaGdF5 phosphors were synthesized by a one-step hydrothermal method with l-arginine, and their energy transfer, migrations and multicolored luminescence properties were investigated in detail. The as-prepared Dy(3+),Tb(3+) or Eu(3+) doped samples showed strong blue, green and red emission, respectively. Different hues of green and red light were obtained by co-doped Dy(3+),Tb(3+) and Tb(3+),Eu(3+) in the BaGdF5 host, respectively. More significantly, in the Dy(3+),Tb(3+),Eu(3+) tri-doped BaGdF5 phosphors, colors changed from yellow green to orange red by adjusting the doping concentration of Eu(3+). Energy migrations from Dy(3+) to Tb(3+) and from Tb(3+) to Eu(3+) are reported in detail. Furthermore, the obtained samples exhibit paramagnetic properties at room temperature and low temperature. It is obvious that these Dy(3+), Tb(3+), Eu(3+) singly or doubly or triply doped BaGdF5 nanomaterials with tunable multicolored luminescence properties may have potential applications in the fields of full-color displays, biological labels and bio-separation.

Luminescence and energy-transfer properties of color-tunable Ca2Mg0.25Al1.5Si1.25O7:Ce(3+)/Eu(2+)/Tb(3+) phosphors for ultraviolet light-emitting diodes.

A series of Ca2Mg0.25Al1.5Si1.25O7:Ce(3+)/Eu(2+)/Tb(3+) phosphors was been prepared via a conventional high temperature solid-state reaction and their luminescence properties were studied. The emission spectra of Ca2Mg0.25Al1.5Si1.25O7:Ce(3+),Eu(2+) and Ca2Mg0.25Al1.5Si1.25O7:Ce(3+),Tb(3+) phosphors show not only a band due to Ce(3+) ions (409 nm) but also as a band due to Eu(2+) (520 nm) and Tb(3+) (542 nm) ions. More importantly, the effective energy transfer from Ce(3+) to Eu(2+) and Tb(3+) ions was confirmed and investigated by emission/excitation spectra and luminescent decay behaviors. Furthermore, the energy level scheme and energy transfer mechanism were investigated and were demonstrated to be of resonant type via dipole-dipole (Ce(3+) to Eu(2+)) and dipole-quadrupole (Ce(3+) to Tb(3+)) reactions, respectively. Under excitation at 350 nm, the emitting color could be changed from blue to green by adjusting the relative doping concentration of Ce(3+) and Eu(2+) ions as well as Ce(3+) and Tb(3+) ions. The above results indicate that Ca2Mg0.25Al1.5Si1.25O7:Ce(3+),Eu(2+)/Tb(3+) are promising single-phase blue-to-green phosphors for application in phosphor conversion white-light-emitting diodes.

[Application of ileal D-pouch anal anastomosis in the treatment of ulcerative colitis and familial adenomatous polyposis].

OBJECTIVE: To evaluate the clinical outcomes of ileal D-pouch anal anastomosis in the treatment of ulcerative colitis (UC) and familial adenomatous polyposis (FAP). METHODS: Clinical and follow-up data of 6 UC patients and 5 FAP patients undergoing proctocolectomy and D-ileum pouch anal anastomosis between October 2014 and March 2015 were retrospectively analyzed. End-to-side anastomosis was firstly performed in ileal cutting end and ileum, then side-to-side anastomosis was operated in closing amphi-loop to construct the D-ileum pouch. RESULTS: The mean age of the patients was 42 years (range 18 to 61 years), 5 patients were female. The duration of surgery was (225±23) min, the operation time to D-ileum pouch was (18±4) min, the volume of D-ileum pouch was (175±15) ml, the blood loss was (110±30) ml. There was no procedure-related death, however rectum perforation occurred in 1 male UC patient during operation. The postoperative hospital stay was 8 to 11 days (mean 8.5 days). The follow-up period was 2 to 7 months (median 3 months). One female FAP patient suffered from anal anastomosis vagina fistula 21 days after operation. No pouch-related fistula, anastomosis or input loop stricture fecal incontinence, and severe pouchitis were recorded. The defecation frequency was 4 to 6 times per day (UC) and 3 to 5 times per day (FAP) 6 months after operation. No night-time fecal leakage was complained in those patients. Wexner incontinence score was 3±2 and GQLI was 114±11 one month after operation. Clinical outcome in the first month was excellent in 10 patients and good in 1 patient. CONCLUSIONS: After total colorectal resection for UC and FAP patients, application of D-ileum pouch can clear ileal stump of pouch and avoid the pouch-associated complications effectively.

MicroRNA-133a suppresses colorectal cancer cell invasion by targeting Fascin1.

MicroRNAs (miRs) are a type of small non-coding RNA molecule that are involved in gene silencing and the regulation of cancer progression; miR-133a in particular has been implicated in colorectal cancer, although its specific role and underlying mechanism have yet to be determined. In the present study, the expression level of miR-133a was significantly downregulated in a number of colorectal cancer cell lines, as well as in colorectal cancer tissues compared with the normal adjacent tissues. Furthermore, the Fascin1 (FSCN1) gene was identified as a direct target of miR-133a, and the protein expression level of FSCN1 was negatively regulated by miR-133a in colorectal cancer cells. Additionally, restoration of miR-133a expression and downregulation of FSCN1 protein expression suppressed colorectal cancer cell invasion, while overexpression of FSCN1 reversed the inhibitory effect of miR-133a upregulation on colorectal cancer cell invasion. Thus, the present data indicates that miR-133a may at least partially suppress colorectal cancer cell invasion, possibly via the inhibition of FSCN1 expression. The present study highlights the important role of miR-133a in the progression of colorectal cancer.

[Total colonic exclusion plus side to side ileorectal antiperistaltic anastomosis in the treatment for elderly patients with slow transit constipation].

OBJECTIVE: To evaluate the feasibility and safety of total colonic exclusion plus side to side antiperistaltic ileorectal anastomosis in the treatment for elderly patients with slow transit constipation (STC). METHODS: Clinical data of 13 patients with severe idiopathic STC undergoing the above novel procedure in Zhongnan Hospital of Wuhan University between May 2009 and September 2012 were retrospectively analyzed. The Wexner constipation score and gastrointestinal quality of life index (GIQLI) before and 6 months after operation were compared. RESULTS: There were 8 female and 5 male patients, with a mean age of 74 years (range 63-82 years). No procedure-related deaths or any serious complication occurred. The length of follow-up ranged from 6 to 29 months (median,12 months). The duration of surgery was (55±4) min. Blood loss was (30±2) ml. The postoperative hospital stay ranged 10 to 16 days (mean 11.4 days). The first bowel movement occurred in the 4th day (range 2nd-8th day) after operation. There was no intestinal occlusion and anastomotic leakage that required surgery in all the patients. No fecal incontinence or constipation recurrence was found. One patient developed blind loop syndrome 14 months after operation. Postoperative complications included incision fat liquefaction in 2 cases, anorectal bearing-down while bowel movement in 2 cases, and minor defecate difficulty needed glycerin enema in 1 case. Wexner scores was significantly improved from 22.8±3.3 before operation to 5.4±2.1 six months after operation (P<0.05). GQLI was significantly increased from 93.6±20.5 before operation to 120.8±13.0 six months after operation (P<0.05). At 6 months after operation, the outcome was excellent in 11 patients and good in 2 patients. CONCLUSION: Total colonic exclusion plus side to side antiperistaltic ileorectal anastomosis is easy, safe and effective in the treatment for selected elderly patients with STC.

[Use of antiperistaltic cecoproctostomy in colorectal reconstruction].

OBJECTIVE: To explore the feasibility and functional outcome of antiperistaltic cecoproctostomy in colorectal reconstruction. METHODS: Fifty-six patients who underwent antiperistaltic cecoproctostomy were retrospectively studied. Indications for antiperistaltic cecoproctostomy included slow transit constipation(n=44), synchronous colon cancer or colonic polyps(n=5), acute obstructing left colon carcinoma(n=4), and adult megacolon(n=3). RESULTS: Short-term postoperative complications included wound infections(n=5), 3 lymphatic leakages(n=3), and inflammatory small bowel obstruction(n=1). One month after antiperistaltic cecoproctostomy, the median frequency of daily bowel movement was 4.0(range, 2-6). After a median follow-up of 4 years(range, 1 month to 7 years), the median daily bowel frequency was 2.5(range, 0.5-4.0). Five patients suffered from long-term postoperative complications including small bowel obstruction(n=3), incision hernia(n=1), and mild cecal dilatation(n=1). The mean Wexner incontinence score was 4.2±1.1. CONCLUSION: Antiperistaltic cecoproctostomy is safe and effective for colorectal reconstruction.

[Comparison of subtotal colectomy with antiperistaltic cecoproctostomy and total colectomy with ileoproctostomy in treating slow transit constipation].

OBJECTIVE: To compare clinical outcome and quality of life of subtotal colectomy with antiperistaltic cecoproctostomy and total colectomy with ileorectal anastomosis (TAC-IRA) in patients with severe slow transit constipation (STC). METHODS: Of the 56 patients enrolled in this study from January 1999 to June 2008, 32 cases underwent subtotal colectomy with antiperistaltic cecoproctostomy, and 20 patients underwent TAC-IRA. The patients' clinical characteristics, operative data, postoperative outcome, functional result and gastrointestinal quality of life index (GIQLI) survey were compared between the two groups. RESULTS: All patients were followed up for 1-7 years (median, 4 years). The basic clinical characteristics between the two groups was comparable. During the follow-up period, the number of daily bowel movements in the subtotal colectomy group was significantly fewer than that in TAC-IRA group (2.5+/-0.8 vs. 3.4+/-0.8; P=0.000). The Wexner continence score was significantly lower in subtotal colectomy group (4.4+/-1.6 vs. 5.8+/-1.9; P=0.011), and the GIQLI score in subtotal colectomy group was significantly higher than that in the TAC-IRA group (120.7+/-7.5 vs. 111.1+/-12.0; P=0.005). CONCLUSION: Subtotal colectomy with antiperistaltic cecoproctostomy appeared to be the superior treatment than the TAC-IRA for selected patients with slow transit constipation for improved functional outcomes and quality of life.

[Efficacy comparison of subtotal colectomy with antiperistaltic cecoproctostomy and total colectomy with ileorectal anastomosis for patients with slow transit constipation].

OBJECTIVE: To compare the efficacy between subtotal colectomy with antiperistaltic cecoproctostomy and total colectomy with ileorectal anastomosis (TAC-IRA) for patients with severe refractory slow transit constipation(STC). METHODS: During 1999 to 2002, TAC-IRA was the preferred procedure for 20 STC patients in our department. From 2003 to 2005, 17 STC patients underwent subtotal colectomy plus antiperistaltic cecoproctostomy. Clinical data of the two groups were collected and compared retrospectively. RESULTS: There were no significant differences in basic preoperative clinical data between the two groups. During the follow-up period, the time of daily defecation in the antiperistaltic cecoproctostomy group was less than that of TAC-IRA group (2.4+/-0.9 vs 3.4+/-0.8, P=0.0014), meanwhile the Wexner continence score was significantly lower in the antiperistaltic cecoproctostomy group (4.3+/-1.8 vs 5.8+/-1.9, P=0.0223). Barium enema after subtotal colectomy showed that residual ascending colon and cecum presented a sign of "reservoir". CONCLUSION: Subtotal colectomy with antiperistaltic cecoproctostomy is a better method for appropriately selected patients with STC than TAC-IRA.