Population genetic structure of Culex tritaeniorhynchus in different types of climatic zones in China.

BACKGROUND: Culex tritaeniorhynchus is widely distributed in China, from Hainan Island in the south to Heilongjiang in the north, covering tropical, subtropical, and temperate climate zones. Culex tritaeniorhynchus carries 19 types of arboviruses. It is the main vector of the Japanese encephalitis virus (JEV), posing a serious threat to human health. Understanding the effects of environmental factors on Culex tritaeniorhynchus can provide important insights into its population structure or isolation patterns, which is currently unclear. RESULTS: In total, 138 COI haplotypes were detected in the 552 amplified sequences, and the haplotype diversity (Hd) value increased from temperate (0.534) to tropical (0.979) regions. The haplotype phylogeny analysis revealed that the haplotypes were divided into two high-support evolutionary branches. Temperate populations were predominantly distributed in evolutionary branch II, showing some genetic isolation from tropical/subtropical populations and less gene flow between groups. The neutral test results of HNQH (Qionghai) and HNHK(Haikou) populations were negative (P < 0.05), indicating many low-frequency mutations in the populations and that the populations might be in the process of expansion. Moreover, Wolbachia infection was detected only in SDJN (Jining) (2.24%), and all Wolbachia genotypes belonged to supergroup B. To understand the influence of environmental factors on mosquito-borne viruses, we examined the prevalence of Culex tritaeniorhynchus infection in three ecological environments in Shandong Province. We discovered that the incidence of JEV infection was notably greater in Culex tritaeniorhynchus from lotus ponds compared to those from irrigation canal regions. In this study, the overall JEV infection rate was 15.27 per 1000, suggesting the current risk of Japanese encephalitis outbreaks in Shandong Province. CONCLUSIONS: Tropical and subtropical populations of Culex tritaeniorhynchus showed higher genetic diversity and those climatic conditions provide great advantages for the establishment and expansion of Culex tritaeniorhynchus. There are differences in JEV infection rates in wild populations of Culex tritaeniorhynchus under different ecological conditions. Our results suggest a complex interplay of genetic differentiation, population structure, and environmental factors in shaping the dynamics of Culex tritaeniorhynchus. The low prevalence of Wolbachia in wild populations may reflect the recent presence of Wolbachia invasion in Culex tritaeniorhynchus.

Interlayer Structure Manipulation of FeOCl/MXene with Soft/Hard Interface Design for Safe Water Production Using Dechlorination Battery Deionization.

Suffering from the susceptibility to decomposition, the potential electrochemical application of FeOCl has greatly been hindered. The rational design of the soft-hard material interface can effectively address the challenge of stress concentration and thus decomposition that may occur in the electrodes during charging and discharging. Herein, interlayer structure manipulation of FeOCl/MXene using soft-hard interface design method were conducted for electrochemical dechlorination. FeOCl was encapsulated in Ti3C2Tx MXene nanosheets by electrostatic self-assembly layer by layer to form a soft-hard mechanical hierarchical structure, in which Ti3C2Tx was used as flexible buffer layers to relieve the huge volume change of FeOCl during Cl- intercalation/deintercalation and constructed a conductive network for fast charge transfer. The CDI dechlorination system of FeOCl/Ti3C2Tx delivered outstanding Cl- adsorption capacity (158.47 ± 6.98 mg g-1), rate (6.07 ± 0.35 mg g-1 min-1), and stability (over 94.49 % in 30 cycles), and achieved considerable energy recovery (21.14 ± 0.25 %). The superior dechlorination performance was proved to originate from the Fe2+/Fe3+ topochemical transformation and the deformation constraint effect of Ti3C2Tx on FeOCl. Our interfacial design strategy enables a hard-to-soft integration capacity, which can serve as a universal technology for solving the traditional problem of electrode volume expansion.

Evaluation of the evolutionary genetics and population structure of Culex pipiens pallens in Shandong province, China based on knockdown resistance (kdr) mutations and the mtDNA-COI gene.

BACKGROUND: Mosquitoes are important vectors for a range of diseases, contributing to high rates of morbidity and mortality in the human population. Culex pipiens pallens is dominant species of Culex mosquito in northern China and a major vector for both West Nile virus and Bancroftian filariasis. Insecticide application were largely applied to control the mosquito-mediated spread of these diseases, contributing to increasing rates of resistance in the mosquito population. The voltage-gated sodium channel (Vgsc) gene is the target site of pyrethroids, and mutations in this gene cause knockdown resistance (kdr). While these kdr mutations are known to be critical to pyrethroid resistance, their evolutionary origins remain poorly understood. Clarifying the origins of these mutations is potential to guide further vector control and disease prevention efforts. Accordingly, the present study was designed to study the evolutionary genetics of kdr mutations and their association with the population structure of Cx. p. pallens in Shandong province, China. METHODS: Adult Culex females were collected from Shandong province and subjected to morphological identification under a dissection microscope. Genomic DNA were extracted from the collected mosquitoes, the Vgsc gene were amplified via PCR and sequenced to assess kdr allele frequencies, intron polymorphisms, and kdr codon evolution. In addition, population genetic diversity and related population characteristics were assessed by amplifying and sequencing the mitochondrial cytochrome C oxidase I (COI) gene. RESULTS: Totally, 263 Cx. p. pallens specimens were used for DNA barcoding and sequencing analyses to assess kdr allele frequencies in nine Culex populations. The kdr codon L1014 in the Vgsc gene identified two non-synonymous mutations (L1014F and L1014S) in the analyzed population. These mutations were present in the eastern hilly area and west plain region of Shandong Province. However, only L1014F mutation was detected in the southern mountainous area and Dongying city of Shandong Province, where the mutation frequency was low. Compared to other cities, population in Qingdao revealed significant genetic differentiation. Spatial kdr mutation patterns are likely attributable to some combination of prolonged insecticide-mediated selection coupled with the genetic isolation of these mosquito populations. CONCLUSIONS: These data suggest that multiple kdr alleles associated with insecticide resistance are present within the Cx. p. pallens populations of Shandong Province, China. The geographical distributions of kdr mutations in this province are likely that the result of prolonged and extensive insecticide application in agricultural contexts together with frequent mosquito population migrations. In contrast, the low-frequency kdr mutation detected in central Shandong Province populations may originate from the limited selection pressure in this area and the relative genetic isolation. Overall, the study compares the genetic patterns revealed by a functional gene with a neutral marker and demonstrates the combined impact of demographic and selection factors on population structure.

MoS2/MXene pillared nanocomposite for ultrafast photonics applications.

In this work, we used nanocomposite saturable absorbers (SAs) in order to precisely design and modulate the process of compositing the light absorption by band gap engineering. Due to the higher absorption intensity of our MoS2/MXene nanocomposite, we have successfully shortened the pulse duration (1.2µs) of SA with enhancing saturable absorption intensity (7.22 MW cm-2), and the ultra-fast fiber laser based on this nanocomposite SA has shown wider Q-switching stable range in the case of high pump power. This strategy can efficiently improve the performance of SA and shows the potential application prospect of nanocomposites in nonlinear optics.

Correlation between the Glasgow-Blatchford score, shock index, and Forrest classification in patients with peptic ulcer bleeding

Background/aim: To investigate the correlation between the Glasgow-Blatchford score, shock index, and Forrest classification in patients with peptic ulcer bleeding (PUB). Materials and methods: A total of 955 patients with PUB were assessed using the Glasgow-Blatchford score and shock index, as well as the Forrest classification based on their gastroscopy results. The correlation between the Glasgow-Blatchford score and shock index was determined using scatter plot analysis, and the correlation between the Glasgow-Blatchford score or shock index and Forrest classification was determined using Spearman's analysis. Results: Both the Glasgow-Blatchford score and shock index showed the highest values in patients with Forrest class IIa. The Glasgow- Blatchford score was significantly higher than patients with Forrest class Ib/IIc/III (P < 0.05), and the shock index was significantly higher than patients with Forrest class Ib/IIb/III (P < 0.05). A positive correlation was observed between the Glasgow-Blatchford score and shock index, at r = 0.427 (P < 0.001). A negative correlation was observed between the Glasgow-Blatchford score and Forrest classification, at r = ­0.111 (P < 0.01), and between the shock index and Forrest classification, at r = ­0.138 (P < 0.01). Conclusion: A moderate correlation was observed between the Glasgow-Blatchford score and shock index in patients with PUB, and the correlation between the Forrest classification and Glasgow-Blatchford score or shock index was relatively low.

Cold sub-mucosal injection versus traditional cold snare polypectomy for diminutive and small colorectal polyps: A systematic review and meta-analysis.

BACKGROUND: The guidelines recommend conventional cold snare polypectomy (C-CSP) for diminutive and small colorectal polyps (≤ 10 mm). However, it remains unclear whether CSP with sub-mucosal injection (SI-CSP) achieves comparable efficacy to C-CSP for managing these lesions. This study compares SI-CSP with C-CSP for patients with diminutive and small colorectal polyps. METHODS: An electronic literature search was conducted to retrieve articles comparing resection outcomes between SI-CSP and C-CSP in diminutive and small colorectal polyps (registration number INPLASY2023100096). Our primary outcomes of interest were the complete resection rate (CRR), complications (namely immediate bleeding, delayed bleeding and perforation) and polypectomy time. Mean differences with 95% confidence intervals (CI) were employed for continuous variables, while odds ratios (OR) with 95% CI were calculated for categorical variables. Data was analyzed using a random effects model and the I2 test was utilized to assess heterogeneity. RESULTS: Eight studies involving 1470 patients with 2223 polyps were included in our analysis. The CRR was not significantly higher in the SI-CSP group, with an OR of 95% CI 0.50 (0.22, 1.15). The incidences of immediate bleeding (OR 95% CI 0.60 [0.26-1.40]) and delayed bleeding (OR 95% CI 0.88 [0.32-2.42]) did not differ significantly between the two groups. On average, the mean polypectomy time was 64.75 seconds shorter in the C-CSP group (95% CI, - 102.96 to - 26.53). Notably, no perforation events were reported in the included studies. CONCLUSIONS: The use of SI-CSP was not superior to C-CSP in managing diminutive and small colorectal polyps and the procedure required significantly more time.

Ti3C2T x MXene/carbon nanofiber multifunctional electrode for electrode ionization with antifouling activity.

Scaling, corrosion, and biofouling have enormous economic impacts and potential safety hazards to circulating cooling water systems in industry. Capacitive deionization (CDI) technology, through the rational design and construction of electrodes, is expected to tackle these three problems simultaneously. Here, we report a flexible self-supporting Ti3C2T x MXene/carbon nanofiber film fabricated by electrospinning. It served as a multifunctional CDI electrode with high-performance antifouling and antibacterial activity. One-dimensional (1D) carbon nanofibers bridging two-dimensional (2D) Ti3C2T x nanosheets formed a three-dimensional (3D) interconnected conductive network, which expedited the transport and diffusion kinetics of electrons and ions. Meanwhile, the open-pore framework of carbon nanofibers anchored Ti3C2T x , which alleviated self-stacking and enlarged the interlayer space of Ti3C2T x nanosheets, thereby offering more sites for ion storage. The electrical double layer-pseudocapacitance coupled mechanism endowed the prepared Ti3C2T x /CNF-14 film with high desalination capacity (73.42 ± 4.57 mg g-1 at 60 mA g-1), rapid desalination rate (3.57 ± 0.15 mg g-1 min-1 at 100 mA g-1), and longish cycling life, and outperformed other carbon- and MXene-based electrode materials. More importantly, on account of the desirable hydrophilicity, good dispersion, and sufficient exposure of the sharp edges of Ti3C2T x nanosheets, Ti3C2T x /CNF-14 concurrently delivered an impressive inactivation efficiency against Escherichia coli, reaching 99.89% within 4 h. Our study draws attention to the simultaneous killing of microorganisms through the intrinsic characteristics of well-designed electrode materials. These data could aid application of high-performance multifunctional CDI electrode materials for treatment of circulating cooling water.

Preliminary Study on the Preparation of Conductive Nanosized Calcium Carbonate Utilizing Biogas Slurry by a Synchronous Double Decomposition Coating Method.

Nanosized calcium carbonate (NCC) plays a vital role in the rubber and plastic fields as a filler, but it cannot resolve the electrostatic problem. Humic-acid-based NCC (HA-NCC) was accidentally discovered in the reaction between biogas slurry and calcium chloride (CaCl2), based on nutrient recovery and gradient treatment technology to solve the biogas slurry problem. A preliminary study on the preparation of conductive nanosized calcium carbonate (CNCC) from the HA-NCC was implemented. Meanwhile, a synchronous double decomposition coating method was proposed to properly explain the formation of HA-NCC in the biogas slurry. The CNCC was further obtained through drying and carbonizing the HA-NCC sample. The morphology of CNCC was a square shape with aggregation, and its crystals were calcite. The C content of CNCC was 5% higher than that of the normal CaCO3, implying a synchronous coating effect of soluble HA in biogas slurry on NCC. The weight loss of CNCC was about 2.5% at 630 °C, explaining why the HA-NCC remained black at 550 °C for 4 h. The CNCC was partly ordered and graphitized. The resistivity of the CNCC reached 2.62 × 106 Ω·cm. It could be used as a conductive powder. In view of the favorable characteristics described above, CNCC would be expected to be a filler and antistatic agent for plastics and rubbers to enhance the tensile and bending resistance of polymer materials, while eliminating electrostatic hazards. The results are also of great significance for developing high-end products to realize resource utilization of biogas slurry.

Cold snare polypectomy compared to cold forceps polypectomy for endoscopic resection of guideline defined diminutive polyps: A systematic review and meta-analysis of randomized trials.

BACKGROUND: International guidelines recommend cold snare polypectomy (CSP) for polyps < 10 mm in size. However, recent randomized clinical trials (RCTs) showed conflicting results for the use of cold forceps polypectomy (CFP) vs. CSP for the resection of diminutive colorectal polyps (DCPs) (≤ 5 mm), especially for polyps ≤ 3 mm. Herein we compared CFP with CSP for patients with DCPs in this meta-analysis of RCTs. METHODS: We systematically searched the Cochrane Library, PubMed and EMBASE databases from inception to November 24, 2022, (Registration number INPLASY2022110135). The primary endpoint was DCP complete resection rate. The secondary endpoints were mean polypectomy time, polyp retrieval rate and complications. RESULTS: Seven RCTs involving 1023 DCPs were included. The complete resection rate (91.6% vs. 94.7%) for CFP was not significantly lower for polyps ≤ 5 mm (relative risk [RR] = 1.03; 95% confidence interval [CI]: 0.98-1.07). Sub-group analysis showed that the complete resection rate (88.7% vs. 92.4%) for CFP was not significantly lower for DCPs > 3 mm (RR = 1.04; 95% CI: 0.97-1.12). Another sub-group analysis showed that the complete resection rate (97.0% vs. 96.3%) was similar for polyps ≤ 3 mm for CFP vs. CSP (RR = 1.00; 95% CI: 0.98-1.03). The mean polypectomy time was not different between CFP and CSP (95% CI: -11.86-10.18). The polyp retrieval rate (100% vs. 96.9%) was not significantly higher for CFP (RR = 1.02; 95% CI: 0.98-1.07). There were no reported complications in the included studies. The overall study quality was moderate except for the removal of polyps ≤ 5 mm (low-quality evidence). CONCLUSION: CFP was comparable to CSP for the resection of polyps ≤ 3 mm; however, caution should be taken for DCPs > 3 mm because of the low complete resection rate (< 90%).

Red cell distribution width: A predictor of the severity of hypertriglyceridemia-induced acute pancreatitis.

BACKGROUND: Compared with patients with other causes of acute pancreatitis, those with hypertriglyceridemia-induced acute pancreatitis (HTG-AP) are more likely to develop persistent organ failure (POF). Therefore, recognizing the individuals at risk of developing POF early in the HTG-AP process is a vital for improving outcomes. Bedside index for severity in acute pancreatitis (BISAP), a simple parameter that is obtained 24 h after admission, is an ideal index to predict HTG-AP severity; however, the suboptimal sensitivity limits its clinical application. Hence, current clinical scoring systems and biochemical parameters are not sufficient for predicting HTG-AP severity. AIM: To elucidate the early predictive value of red cell distribution width (RDW) for POF in HTG-AP. METHODS: In total, 102 patients with HTG-AP were retrospectively enrolled. Demographic and clinical data, including RDW, were collected from all patients on admission. RESULTS: Based on the Revised Atlanta Classification, 37 (33%) of 102 patients with HTG-AP were diagnosed with POF. On admission, RDW was significantly higher in patients with HTG-AP and POF than in those without POF (14.4% vs 12.5%, P < 0.001). The receiver operating characteristic curve demonstrated a good discriminative power of RDW for POF with a cutoff of 13.1%, where the area under the curve (AUC), sensitivity, and specificity were 0.85, 82.4%, and 77.9%, respectively. When the RDW was ≥ 13.1% and one point was added to the original BISAP to obtain a new BISAP score, we achieved a higher AUC, sensitivity, and specificity of 0.89, 91.2%, and 67.6%, respectively. CONCLUSION: RDW is a promising predictor of POF in patients with HTG-AP, and the addition of RDW can promote the sensitivity of BISAP.

Interactions between the gut micro-community and transcriptome of Culex pipiens pallens under low-temperature stress.

BACKGROUND: Culex pipiens pallens (Diptera: Culicidae) can survive at low temperature for long periods. Understanding the effects of low-temperature stress on the gut microflora and gene expression levels in Cx. pipiens pallens, as well as their correlation, will contribute to the study of the overwintering mechanism of Cx. pipiens pallens. METHODS: The gut bacteria were removed by antibiotic treatment, and the survival of Cx. pipiens pallens under low-temperature stress was observed and compared with the control group. Then, full-length 16S rRNA sequencing and the Illumina HiSeq X Ten sequencing platform were used to evaluate the gut microflora and gene expression levels in Cx. pipiens pallens under low-temperature stress. RESULTS: Under the low-temperature stress of 7 °C, the median survival time of Cx. pipiens pallens in the antibiotic treatment group was significantly shortened by approximately 70% compared to that in the control group. The species diversity index (Shannon, Simpson, Ace, Chao1) of Cx. pipiens pallens decreased under low-temperature stress (7 °C). Non-metric multidimensional scaling (NMDS) analysis divided all the gut samples into two groups: control group and treatment group. Pseudomonas was the dominant taxon identified in the control group, followed by Elizabethkingia and Dyadobacter; in the treatment group, Pseudomonas was the dominant taxon, followed by Aeromonas and Comamonas. Of the 2417 differentially expressed genes (DEGs), 1316 were upregulated, and 1101 were downregulated. Functional GO terms were enriched in 23 biological processes, 20 cellular components and 21 molecular functions. KEGG annotation results showed that most of these genes were related to energy metabolism-related pathways. The results of Pearson's correlation analysis showed a significant correlation between the gut microcommunity at the genus level and several DEGs. CONCLUSIONS: These results suggest that the mechanism of adaptation of Cx. pipiens pallens to low-temperature stress may be the result of interactions between the gut bacterial community and transcriptome.

Accuracy of angiopoietin-2 for predicting organ failure in patients with acute pancreatitis: a systematic review and meta-analysis.

OBJECTIVE: Our aim was to assess the accuracy of angiopoietin-2 (Ang-2) as a prognostic marker for acute pancreatitis (AP) with organ failure (OF). METHODS: We undertook a systematic search of the PubMed, Cochrane Library, Embase, Chinese Journals Full-text, Wanfang, China Biology Medicine disc, and Weipu databases to identify eligible cohort studies on the predictive value of Ang-2 for AP with OF. The main outcome measures were sensitivity and specificity. The effects were pooled using a bivariate mixed-effects model. RESULTS: Six articles with seven case-control studies (n = 650) were included. Pooled sensitivity, specificity, and positive and negative likelihood ratios with 95% confidence intervals (CI) for AP with OF were 0.93 (95%CI: 0.75-0.99), 0.85 (95%CI: 0.75-0.92), 6.40 (95%CI: 3.36-12.19), and 0.08 (95%CI: 0.02-0.36), respectively. The area under the summary receiver operating characteristic curve was 0.95 (95%CI: 0.92-0.96), and the diagnostic odds ratio was 83.18 (95%CI: 11.50-623.17). Subgroup analysis showed that admission time of AP onset (< or ≥24 hours) was a source of overall heterogeneity. Sensitivity analysis supported this finding. CONCLUSION: Ang-2 had high diagnostic accuracy for AP with OF; the best prediction of Ang-2 may be 24 to 72 hours after onset of AP.

Antimicrobial activity of X zeolite exchanged with Cu2+ and Zn2+ on Escherichia coli and Staphylococcus aureus.

The biocidal cations of Cu2+ and Zn2+ were hosted on the surfaces and in the cavities of X zeolite via ion exchange. The microstructure and interface properties of the exchanged zeolite X samples were analyzed by XRD, SEM, XPS, and XRF. The as-prepared samples showed excellent antimicrobial activity towards gram-negative bacteria of Escherichia coli and gram-positive bacteria of Staphylococcus aureus. Furthermore, the batch antimicrobial experiments showed that the bacterial disinfection process fitted well with the first order model. The Cu2+-zeolite showed excellent and better antibacterial performance on S. aureus than on E. coli, and the mortalities of E. coli and S. aureus were almost 100% after 1 h with the initial Cu2+-zeolite concentrations of 1000 ppm and 100 ppm, respectively. However, the Zn2+-zeolites were found to be less effective on S. aureus than on E. coli, and the mortalities of E. coli and S. aureus were almost 100% after 1 h with the initial Zn2+-zeolite concentrations of 500 ppm and 1000 ppm, respectively. In addition, the relationships between the apparent rate constant (k) and reagent concentration (C) were also systematically investigated. The present results suggest that the as-prepared samples could be promising antibacterial materials for the efficient disinfection of contaminated water with bacteria.

One-Step Hydrothermal Synthesis of Zeolite X Powder from Natural Low-Grade Diatomite.

Zeolite X powder was synthesized using natural low-grade diatomite as the main source of Si but only as a partial source of Al via a simple and green hydrothermal method. The microstructure and surface properties of the obtained samples were characterized by powder X-ray diffraction (XRD), scanning electron microscopy (SEM), wavelength dispersive X-ray fluorescence (XRF), calcium ion exchange capacity (CEC), thermogravimetric-differential thermal (TG-DTA) analysis, and N2 adsorption-desorption technique. The influence of various synthesis factors, including aging time and temperature, crystallization time and temperature, Na2O/SiO2 and H2O/Na2O ratio on the CEC of zeolite, were systematically investigated. The as-synthesized zeolite X with binary meso-microporous structure possessed remarkable thermal stability, high calcium ion exchange capacity of 248 mg/g and large surface area of 453 m²/g. In addition, the calcium ion exchange capacity of zeolite X was found to be mainly determined by the crystallization degree. In conclusion, the synthesized zeolite X using diatomite as a cost-effective raw material in this study has great potential for industrial application such as catalyst support and adsorbent.

Can mean platelet volume play a role in evaluating the severity of acute pancreatitis?

AIM: To investigate serum mean platelet volume (MPV) levels in acute pancreatitis (AP) patients and assess whether MPV effectively predicts the disease severity of AP. METHODS: We included 117 consecutive patients with AP as the AP group and 34 consecutive patients with colorectal polyps (before endoscopic treatment) as the control group. Complete blood counts, liver function, platelet indices (MPV), coagulation parameters, lactate dehydrogenase (LDH) and C-reactive protein (CRP) were measured on days 1, 2, 3 and 7 after admission. Receiver operating characteristic curves were used to compare the sensitivity and specificity of MPV, white blood cell (WBC), LDH and CRP in predicting AP severity. The Modified Glasgow Prognostic Score (mGPS) and the 2012 revised Atlanta criteria were used to evaluate disease severity in AP. RESULTS: MPV levels were significantly lower in the AP group than in the control group on day 1 (P = 0.000), day 2 (P = 0.029) and day 3 (P = 0.001) after admission. In addition, MPV values were lower on day 1 after admission than on day 2 (P = 0.012), day 3 (P = 0.000) and day 7 (P = 0.002) in all AP patients. Based on the mGPS, 78 patients (66.7%) were diagnosed with mild and 39 patients (33.3%) with severe AP. There was no significant difference in mean MPV levels between patients diagnosed with mild and severe AP based on the mGPS (P = 0.424). According to the 2012 revised Atlanta criteria, there were 98 patients (83.8%) without persistent organ failure (OF) [non-severe acute pancreatitis (non-SAP) group] and 19 patients (16.2%) with persistent OF (SAP group). MPV levels were significantly lower in the SAP group than in the non-SAP group on day 1 after admission (P = 0.002). On day 1 after admission using a cut-off value of 6.65 fL, the overall accuracy of MPV for predicting SAP according to the 2012 revised Atlanta criteria (AUC = 0.716) had a sensitivity of 91.8% and a specificity of 47.4% and was superior to the accuracy of the traditional markers WBC (AUC = 0.700) and LDH (AUC = 0.697). CONCLUSION: MPV can be used at no additional cost as a useful, non-invasive biomarker that distinguishes AP with persistent OF from AP without persistent OF on day 1 of hospital admission.

Acquired double pylorus: Clinical and endoscopic characteristics and four-year follow-up observations.

Double pylorus (DP), or duplication of the pylorus, is an uncommon condition that can be either congenital or acquired. Acquired DP (ADP) occurs when a peptic ulcer erodes and creates a fistula between the duodenal bulb and the distal stomach. The clinical features and endoscopic characteristics of four patients with ADP were reviewed and compared with previously reported cases. An accessory channel connects the lesser curvature of the prepyloric antrum with the duodenal bulb, and in all cases, a peptic ulcer was located in or immediately adjacent to the accessory channel. In one of the patients, the bridge between the double-channel pylorus disappeared, resulting in a single large opening and duodenal kissing ulcer after two years and three months. Finally, nonsteroidal anti-inflammatory drugs, Helicobacter pylori and other risk factors associated with ADP are assessed.