The objective of this review is to examine whether a redundant colon gives rise to symptoms like constipation and volvulus. In 1820, Monterossi made drawings of colons with displacements and elongation of the colon fo...The objective of this review is to examine whether a redundant colon gives rise to symptoms like constipation and volvulus. In 1820, Monterossi made drawings of colons with displacements and elongation of the colon found during autopsy. In 1912, Kienb?eck first visualized a redundant colon using bismuth, and Lardennois and Auborg named the anatomic variant dolichocolon in 1914. The criteria were later: A sigmoid loop rising over the line between the iliac crests, a transverse colon below the same line and extra loops at the flexures. The incidence of dolichocolon is 1.9%-28.5%. Dolichocolon seems to be congenital, as fetuses, newborns, and infants exhibit colonic redundancies. Studies have identified a triade of constipation, abdominal pain, and distension. Colon transit time was recently shown to increase significantly with increased number of redundancies, which increases abdominal pain, bloating and infrequent defecation. The diagnosis of dolichocolon is established by barium enema or CT-colonography. Treatment is conservative, or surgical in case of volvulus or refractory constipation.展开更多
Functional gastrointestinal disorders(FGID) are heterogeneous disorders with a variety of clinical manifestations, primarily defined by signs and symptoms rather than a definite underlying cause. Their pathophysiology...Functional gastrointestinal disorders(FGID) are heterogeneous disorders with a variety of clinical manifestations, primarily defined by signs and symptoms rather than a definite underlying cause. Their pathophysiology remains obscure and, although it is expected to differ according to the specific FGID, disruptions in the brain-gut axis are now thought to be a common denominator in their pathogenesis. The hormone ghrelin is an important component of this axis,exerting a wide repertoire of physiological actions, including regulation of gastrointestinal motility and protection of mucosal tissue. Ghrelin's gene shows genetic polymorphism, while its protein product undergoes complex regulation and metabolism in the human body. Numerous studies have studied ghrelin's relation to the emergence of FGIDs, its potential value as an index of disease severity and as a predictive marker for symptom relief during attempted treatment. Despite the mixed results currently available in scientific literature, the plethora of statistically significant findings shows that disruptions in ghrelin genetics and expression are plausibly related to FGID pathogenesis. The aim of this paper is to review current literature studying these associations, in an effort to uncover certain patterns of alterations in both genetics and expression, which could delineate its true contribution to FGID emergence, either as a causative agent or as a pathogenetic intermediate.展开更多
Objective: Liver metastasis,which contributes substantially to high mortality,is the most common recurrent mode of colon carcinoma.Thus,it is necessary to identify genes implicated in metastatic colonization of the li...Objective: Liver metastasis,which contributes substantially to high mortality,is the most common recurrent mode of colon carcinoma.Thus,it is necessary to identify genes implicated in metastatic colonization of the liver in colon carcinoma.Methods: We compared mRNA profiling in 18 normal colon mucosa(N),20 primary tumors(T) and 19 liver metastases(M) samples from the dataset GSE49355 and GSE62321 of Gene Expression Omnibus(GEO) database.Gene ontology(GO) and pathways of the identified genes were analyzed.Co-expression network and proteinprotein interaction(PPI) network were employed to identify the interaction relationship.Survival analyses based on The Cancer Genome Atlas(TCGA) database were used to further screening.Then,the candidate genes were validated by our data.Results: We identified 22 specific genes related to liver metastasis and they were strongly associated with cell migration,adhesion,proliferation and immune response.Simultaneously,the results showed that C-X-C motif chemokine ligand 14(CXCL14) might be a favorable prediction factor for survival of patients with colon carcinoma.Importantly,our validated data further suggested that lower CXCL14 represented poorer outcome and contributed to metastasis.Gene set enrichment analysis(GSEA) showed that CXCL14 was negatively related to the regulation of stem cell proliferation and epithelial to mesenchymal transition(EMT).Conclusions: CXCL14 was identified as a crucial anti-metastasis regulator of colon carcinoma for the first time,and might provide novel therapeutic strategies for colon carcinoma patients to improve prognosis and prevent metastasis.展开更多
AIM: To determine the mortality associated with functional bowel disorders (FBDs) and their possible relationship with organic bowel disease. METHODS: Patients who satisfied the Rome Ⅲ criteria for FBD (retrospective...AIM: To determine the mortality associated with functional bowel disorders (FBDs) and their possible relationship with organic bowel disease. METHODS: Patients who satisfied the Rome Ⅲ criteria for FBD (retrospective diagnosis) were followed up by telephone interview and/or outpatient review at 5 years after their first attendance. The patients were divided into the following groups: irritable bowel syndrome, functional abdominal bloating, functional constipation, functional diarrhea and unspecified FBD. The survival of the FBD patients overall and of those with each FBD were compared with data obtained from the Guangzhou population in 2005. The incidences of colonic cancer overall and for each FBD were compared with data from the Chinese population obtained from 56 cancer registries in 19 provinces of the country in 2008. RESULTS: Two hundred and sixty-three patients were followed-up. Five patients died, which was not significantly different from the expected survival rate. No differences in mortality among the FBDs were found. There were nine cases of organic bowel disease: three colonic cancers and six colonic polyps. The incidence of colonic cancer in FBD patients was higher than that in the general Chinese population (0.23% vs 0.03%, P < 0.05). There were significant differences in the incidence of colonic cancer among the FBDs (0/134, 0/24, 2/29, 1/66, 0/10, respectively, P<0.05); functional constipation was the most common. The incidence of colonic polyps was similar among the FBDs. The baseline age of patients who died was greater than that of those who survived (66.60±6.84 years vs 45.14±10.34 years, P<0.05). The baseline age of patients who had colonic cancer or polyps during follow-up was greater than that of those without colonic cancer or polyps (60.33±1.53 years vs 45.38±10.62 years; 54.50±6.47 years vs 45.34±10.68 years, P<0.05). CONCLUSION: FBDs do not increase the risk of death. The incidence of colonic cancer in patients with FBDs may be increased, especially in those with functional constipation and in the elderly.展开更多
文摘The objective of this review is to examine whether a redundant colon gives rise to symptoms like constipation and volvulus. In 1820, Monterossi made drawings of colons with displacements and elongation of the colon found during autopsy. In 1912, Kienb?eck first visualized a redundant colon using bismuth, and Lardennois and Auborg named the anatomic variant dolichocolon in 1914. The criteria were later: A sigmoid loop rising over the line between the iliac crests, a transverse colon below the same line and extra loops at the flexures. The incidence of dolichocolon is 1.9%-28.5%. Dolichocolon seems to be congenital, as fetuses, newborns, and infants exhibit colonic redundancies. Studies have identified a triade of constipation, abdominal pain, and distension. Colon transit time was recently shown to increase significantly with increased number of redundancies, which increases abdominal pain, bloating and infrequent defecation. The diagnosis of dolichocolon is established by barium enema or CT-colonography. Treatment is conservative, or surgical in case of volvulus or refractory constipation.
文摘Functional gastrointestinal disorders(FGID) are heterogeneous disorders with a variety of clinical manifestations, primarily defined by signs and symptoms rather than a definite underlying cause. Their pathophysiology remains obscure and, although it is expected to differ according to the specific FGID, disruptions in the brain-gut axis are now thought to be a common denominator in their pathogenesis. The hormone ghrelin is an important component of this axis,exerting a wide repertoire of physiological actions, including regulation of gastrointestinal motility and protection of mucosal tissue. Ghrelin's gene shows genetic polymorphism, while its protein product undergoes complex regulation and metabolism in the human body. Numerous studies have studied ghrelin's relation to the emergence of FGIDs, its potential value as an index of disease severity and as a predictive marker for symptom relief during attempted treatment. Despite the mixed results currently available in scientific literature, the plethora of statistically significant findings shows that disruptions in ghrelin genetics and expression are plausibly related to FGID pathogenesis. The aim of this paper is to review current literature studying these associations, in an effort to uncover certain patterns of alterations in both genetics and expression, which could delineate its true contribution to FGID emergence, either as a causative agent or as a pathogenetic intermediate.
基金supported by grants from the National Natural Science Foundation of China(No.8177061284)
文摘Objective: Liver metastasis,which contributes substantially to high mortality,is the most common recurrent mode of colon carcinoma.Thus,it is necessary to identify genes implicated in metastatic colonization of the liver in colon carcinoma.Methods: We compared mRNA profiling in 18 normal colon mucosa(N),20 primary tumors(T) and 19 liver metastases(M) samples from the dataset GSE49355 and GSE62321 of Gene Expression Omnibus(GEO) database.Gene ontology(GO) and pathways of the identified genes were analyzed.Co-expression network and proteinprotein interaction(PPI) network were employed to identify the interaction relationship.Survival analyses based on The Cancer Genome Atlas(TCGA) database were used to further screening.Then,the candidate genes were validated by our data.Results: We identified 22 specific genes related to liver metastasis and they were strongly associated with cell migration,adhesion,proliferation and immune response.Simultaneously,the results showed that C-X-C motif chemokine ligand 14(CXCL14) might be a favorable prediction factor for survival of patients with colon carcinoma.Importantly,our validated data further suggested that lower CXCL14 represented poorer outcome and contributed to metastasis.Gene set enrichment analysis(GSEA) showed that CXCL14 was negatively related to the regulation of stem cell proliferation and epithelial to mesenchymal transition(EMT).Conclusions: CXCL14 was identified as a crucial anti-metastasis regulator of colon carcinoma for the first time,and might provide novel therapeutic strategies for colon carcinoma patients to improve prognosis and prevent metastasis.
基金Supported by The Open Project Program of the Jiangsu Key Laboratory of Molecular and Functional Imaging, No. PYZX2011016the Medical Science and Technology Development Foundation of Nanjing Department of Health, No.YKK11199
文摘AIM: To determine the mortality associated with functional bowel disorders (FBDs) and their possible relationship with organic bowel disease. METHODS: Patients who satisfied the Rome Ⅲ criteria for FBD (retrospective diagnosis) were followed up by telephone interview and/or outpatient review at 5 years after their first attendance. The patients were divided into the following groups: irritable bowel syndrome, functional abdominal bloating, functional constipation, functional diarrhea and unspecified FBD. The survival of the FBD patients overall and of those with each FBD were compared with data obtained from the Guangzhou population in 2005. The incidences of colonic cancer overall and for each FBD were compared with data from the Chinese population obtained from 56 cancer registries in 19 provinces of the country in 2008. RESULTS: Two hundred and sixty-three patients were followed-up. Five patients died, which was not significantly different from the expected survival rate. No differences in mortality among the FBDs were found. There were nine cases of organic bowel disease: three colonic cancers and six colonic polyps. The incidence of colonic cancer in FBD patients was higher than that in the general Chinese population (0.23% vs 0.03%, P < 0.05). There were significant differences in the incidence of colonic cancer among the FBDs (0/134, 0/24, 2/29, 1/66, 0/10, respectively, P<0.05); functional constipation was the most common. The incidence of colonic polyps was similar among the FBDs. The baseline age of patients who died was greater than that of those who survived (66.60±6.84 years vs 45.14±10.34 years, P<0.05). The baseline age of patients who had colonic cancer or polyps during follow-up was greater than that of those without colonic cancer or polyps (60.33±1.53 years vs 45.38±10.62 years; 54.50±6.47 years vs 45.34±10.68 years, P<0.05). CONCLUSION: FBDs do not increase the risk of death. The incidence of colonic cancer in patients with FBDs may be increased, especially in those with functional constipation and in the elderly.
