Lysis-Free Isolation and Direct Amplification of Pathogenic Bacterial DNA Using Diatom Frustules.

DNA has been implicated as an important biomarker for the diagnosis of bacterial infections. Herein, we developed a streamlined methodology that uses diatom frustules (DFs) to liberate and capture bacterial DNA and allows direct downstream amplification tests without any lysis, washing, or elution steps. Unlike most conventional DNA isolation methods that rely on cell lysis to release bacterial DNA, DFs can trigger the oxidative stress response of bacterial cells to promote bacterial membrane vesicle formation and DNA release by generating reactive oxygen species in aqueous solutions. Due to the hierarchical porous structure, DFs provided high DNA capture efficiency exceeding 80% over a wide range of DNA amounts from 10 pg to 10 ng, making only 10 µg DFs sufficient for each test. Since laborious liquid handling steps are not required, the entire DNA sample preparation process using DFs can be completed within 3 min. The diagnostic use of this DF-based methodology was illustrated, which showed that the DNA of the pathogenic bacteria in serum samples was isolated by DFs and directly detected using polymerase chain reaction (PCR) at concentrations as low as 102 CFU/mL, outperforming the most used approaches based on solid-phase DNA extraction. Furthermore, most of the bacterial cells were still alive after DNA isolation using DFs, providing the possibility of recycling samples for storage and further diagnosis. The proposed DF-based methodology is anticipated to simplify bacterial infection diagnosis and be broadly applied to various medical diagnoses and biological research.

Occurrence, dietary influence and risks of selected trace metals in different coastal predatory species.

The global issue of ongoing trace metal emissions and legacy accumulation from diverse sources is posing threats to coastal wildlife. This study characterized the distribution of five metals in relation to dietary ecology (carbon and nitrogen stable isotopes: δ15N and δ13C) in representative predatory species (starfish, fish, and seabird) collected from the coast of Qingdao, northeastern China. Zinc (Zn) was the most abundant metal across species, followed by copper (Cu), chromium (Cr), cadmium (Cd), total and methylated mercury (THg and MeHg). Among the studied species, black-tailed gulls (Larus crassirostris) occupied the highest trophic position, followed by three predatory fish species, whereas the northern Pacific seastar (Asterias amurensis) had the lowest trophic position. The starfish exhibited high capacity to accumulate Cd, Cr and Cu. Conversely, black-tailed gulls exhibited high levels of Zn, while Hg was highest in predatory fishes. Across species, Cr, MeHg, THg and MeHg:THg showed significant positive correlations with δ13C, suggesting the influence of inshore food sources on their accumulation. Both MeHg and THg were significantly and positively correlated with δ15N, with MeHg demonstrating a greater slope, indicating their potential trophic magnification. We assessed health risks from the studied metals using established toxicity reference thresholds. Elevated risks of Hg were identified in three predatory fish species, while other metals and species remain within safe limits. These findings emphasize the significance of foraging patterns in influencing trace metal accumulation in coastal predators and highlight the importance of further monitoring.

Tissue damage, antioxidant capacity, transcriptional and metabolic regulation of red drum Sciaenops ocellatus in response to nanoplastics exposure and subsequent recovery.

Nanoplastics are recognized as emerging contaminants that can cause severe toxicity to marine fishes. However, limited researches were focusing on the toxic effects of nanoplastics on marine fish, especially the post-exposure resilience. In this study, red drum (Sciaenops ocellatus) were exposed to 5 mg/L polystyrene nanoplastics (100 nm, PS-NPs) for a 7-day exposure experiment, and a 14-day recovery experiment that followed. The aim was to evaluate the dynamic alterations in hepatic and branchial tissue damage, hepatic antioxidant capacity, as well as hepatic transcriptional and metabolic regulation in the red drum during exposure and post-exposure to PS-NPs. Histopathological observation found that PS-NPs primarily triggered hepatic lipid droplets and branchial epithelial liftings, a phenomenon persistently discernible up to the 14 days of recovery. Although antioxidant capacity partially recovered during recovery periods, PS-NPs resulted in a sustained reduction in hepatic antioxidant activity, causing oxidative damage throughout the entire exposure and recovery phases, as evidenced by decreased total superoxide dismutase activities and increased malondialdehyde content. At the transcriptional and metabolic level, PS-NPs primarily induced lipid metabolism disorders, DNA damage, biofilm disruption, and mitochondrial dysfunction. In the gene-metabolite correlation interaction network, numerous CcO (cytochrome c oxidase) family genes and lipid metabolites were identified as key regulatory genes and metabolites in detoxification processes. Among them, the red drum possesses one additional CcO6B in comparison to human and zebrafish, which potentially contributes to its enhanced capacity for maintaining a stable and positive regulatory function in detoxification. This study revealed that nanoplastics cause severe biotoxicity to red drum, which may be detrimental to the survival of wild populations and affect the economics of farmed populations.

Endoscopic treatment for a huge self-inserted foreign body impacted in colon.

A 37-year-old male suffered from abdominal pain and distention for 8 hours after a huge long foreign body was inserted through anorectum by self-masturbation. The colonoscope with the polypectomy snare griped the foreign body was pulled out slowly along with the dragged foreign body. However, when we reached at 20 cm from the anal margin, it got stuck because of the turn point in the sigmoid colon. Different methods were tried to remove the foreign body. At last, We asked the patient to turn to supine position, take deep breath and defecation. More air was insufflated to make the colon cavity larger to facilitate removal, and slowly the colonoscope dragged the foreign body (35 cm in length) out from the anus successfully. No bleeding or perforation occurred during the procedure. Although the foreign body was huge, effort was made to help the patient avoid taking operation.

Ulcerative colitis complicated with hypermucinous dysplasia.

Patients with ulcerative colitis are at increased risk for colorectal neoplasia compared to the general population. The risk factors include family history of colorectal cancer, wide extent of colitis, disease duration, cumulative inflammatory burden, and primary sclerosing cholangitis. Here, we report a case of colorectal neoplasia developed in a patient with ulcerative colitis.

Mapping and Functional Analysis of QTL for Kernel Number per Row in Tropical and Temperate-Tropical Introgression Lines of Maize (Zea mays L.).

Kernel number per row (KNR) is an essential component of maize (Zea mays L.) grain yield (GY), and understanding its genetic mechanism is crucial to improve GY. In this study, two F7 recombinant inbred line (RIL) populations were created using a temperate-tropical introgression line TML418 and a tropical inbred line CML312 as female parents and a backbone maize inbred line Ye107 as the common male parent. Bi-parental quantitative trait locus (QTL) mapping and genome-wide association analysis (GWAS) were then performed on 399 lines of the two maize RIL populations for KNR in two different environments using 4118 validated single nucleotide polymorphism (SNP) markers. This study aimed to: (1) detect molecular markers and/or the genomic regions associated with KNR; (2) identify the candidate genes controlling KNR; and (3) analyze whether the candidate genes are useful in improving GY. The authors reported a total of 7 QTLs tightly linked to KNR through bi-parental QTL mapping and identified 21 SNPs significantly associated with KNR through GWAS. Among these, a highly confident locus qKNR7-1 was detected at two locations, Dehong and Baoshan, with both mapping approaches. At this locus, three novel candidate genes (Zm00001d022202, Zm00001d022168, Zm00001d022169) were identified to be associated with KNR. These candidate genes were primarily involved in the processes related to compound metabolism, biosynthesis, protein modification, degradation, and denaturation, all of which were related to the inflorescence development affecting KNR. These three candidate genes were not reported previously and are considered new candidate genes for KNR. The progeny of the hybrid Ye107 × TML418 exhibited strong heterosis for KNR, which the authors believe might be related to qKNR7-1. This study provides a theoretical foundation for future research on the genetic mechanism underlying KNR in maize and the use of heterotic patterns to develop high-yielding hybrids.

A retrospective investigation of feather corticosterone in a highly contaminated white-tailed eagle (Haliaeetus albicilla) population.

Exposure to persistent organic pollutants (POPs), such as organochlorines (OCs) and polybrominated diphenyl ethers (PBDEs), is associated with adverse health effects in wildlife. Many POPs have been banned and consequently their environmental concentrations have declined. To assess both temporal trends of POPs and their detrimental impacts, raptors are extensively used as biomonitors due to their high food web position and high contaminant levels. White-tailed eagles (WTEs; Haliaeetus albicilla) in the Baltic ecosystem represent a sentinel species of environmental pollution, as they have suffered population declines due to reproductive failure caused by severe exposure to dichlorodiphenyltrichloroethane (DDT) and polychlorinated biphenyls (PCB) during the 1960s through 1980s. However, there is a lack of long-term studies that cover a wide range of environmental contaminants and their effects at the individual level. In this study, we used 135 pooled samples of shed body feathers collected in 1968-2012 from breeding WTE pairs in Sweden. Feathers constitute a temporal archive for substances incorporated into the feather during growth, including corticosterone, which is the primary avian glucocorticoid and a stress-associated hormone. Here, we analysed the WTE feather pools to investigate annual variations in feather corticosterone (fCORT), POPs (OCs and PBDEs), and stable carbon and nitrogen isotopes (SIs; dietary proxies). We examined whether the expected fluctuations in POPs affected fCORT (8-94 pg. mm-1) in the WTE pairs. Despite clear temporal declining trends in POP concentrations (p < 0.01), we found no significant associations between fCORT and POPs or SIs (p > 0.05 in all cases). Our results do not support fCORT as a relevant biomarker of contaminant-mediated effects in WTEs despite studying a highly contaminated population. However, although not detecting a relationship between fCORT, POP contamination and diet, fCORT represents a non-destructive and retrospective assessment of long-term stress physiology in wild raptors otherwise not readily available.

Large-scale assessment of exposure to legacy and emerging per- and polyfluoroalkyl substances in China's shorebirds.

Emerging per- and polyfluoroalkyl substances (PFAS) have become more widely applied, whereas legacy PFAS such as PFOS continue to distribute ubiquitously in the environment. Large-scale assessment of wildlife exposure to both emerging and legacy PFAS plays a key role in effective biomonitoring to better discriminate regional contamination patterns and provide early warnings. Using eggs of two closely-related shorebird species collected across China during the breeding season in 2021, we constructed contrasting PFAS levels and profiles in coastal versus inland populations. The highest ∑PFAS concentrations were found in two Kentish plover (Charadrius alexandrinus) populations from the Bohai Sea, a semi-enclosed shallow bay located in northeast China. These two populations showed exceptionally high PFOA concentrations (mean: 94 and 121 ng/g wet weight; West and North Bohai Sea, respectively) dominating the overall PFAS profile (66% for both). This pattern is characteristic, compared to that of other seabird eggs worldwide. By comparison, PFAS profile in the white-faced plover (Charadrius dealbatus) population at the South China Sea coast was dominated by PFOS (46%), which showed similar levels to those at the North Bohai Sea coast (mean: 29 and 20 ng/g, respectively). PFAS concentrations of Kentish plovers from the remote Qinghai Lake were lower compared to the three coastal populations, and were dominated by PFNA (mean: 2.6 ng/g, 29%) and PFOS (mean: 2.5 ng/g, 27%). None of the eggs analyzed in the present study exceeded estimated toxicity reference values for PFOS or PFOA. Additionally, the emerging 6:2 Cl-PFESA was detected in eggs from all regions, while its concentrations were highest in the Bohai Sea populations, and short-chain PFBS was only detected in the North Bohai Sea population. Our results indicate intensive local emissions of PFOA and emerging PFAS at the Bohai Sea region, and warrant further investigation and monitoring.

Management and outcome of patients with femoral head fractures: the mid-term follow-up with injuries and associated prognostic factors.

BACKGROUND: Femoral head fractures are rare injuries often associated with poor functional outcomes and complications. The purpose of this study was to evaluate the incidence, treatment methods and approaches, complications, and functional outcomes of femoral head fractures. METHODS: We retrospectively reviewed 50 patients who sustained femoral head fractures between January 2011 and December 2018. There were thirty-seven (74%) males and thirteen (26%) females with a median age of 40 years. According to Pipkin's classification, there were eighteen (36%) Pipkin I, ten (20%) Pipkin II, eight (16%) Pipkin III, and fourteen (28%) Pipkin IV patients. Treatment methods were categorized into non-operative, operative by open reduction and internal fixation (ORIF), and immediate total hip replacement (THR). The recorded surgical approach consists of an anterior(S-P) approach, posterior(K-L) approach, lateral stab, and combined anterior + lateral stab approach for fixation. The patients were also stratified by the Injury Severity Score (ISS), associated injuries, and, mechanism of injuries. The modified harris hip score (MHHS) was used to evaluate the ongoing complications with the clinical outcome of patients with two years or greater follow-up. RESULTS: Eight (16%) patients were managed successfully with closed reduction without surgery and thirty-seven (74%) patients required operative reduction and internal fixation (ORIF) of the femoral head and acetabulum, and 5 (10%) patients required immediate THR. Six (12%) patients developed AVN, and four (8%) required a secondary THR. Sixteen patients (33%) developed post-traumatic osteoarthritis (PTOA), eight (16%) developed heterotopic ossification (HO) and six patients (12%) had sciatic nerve injury, none requiring operative treatment. Overall functional results according to MHHS were, excellent in two (4%) patients, good in sixteen (32%) patients, fair in twenty-two (44%) patients, and poor in ten (20%) patients. A statistically significant difference in outcome was observed among four pipkin subtypes. CONCLUSION: Femoral head fractures are rare injuries often associated with poor outcomes. In this study, we report the functional outcomes and complications of all treatment approaches for femoral head fracture based on the Pipkin classification. The treatment aim should always be the anatomical reduction of the fragments. This study, adds to the growing literature on femoral head fracture and provides a reference for the clinical treatment to guide patient management. TRIAL REGISTRATION: Our study was approved by the Clinical Research and Biomedical Ethical Committee of West China Hospital, Sichuan University, and was performed in accordance with the Declaration of Helsinki. All participants provided written informed consent to participate in this study.

Machine-Learning Algorithms for Process Condition Data-Based Inclusion Prediction in Continuous-Casting Process: A Case Study.

Quality-related prediction in the continuous-casting process is important for the quality and process control of casting slabs. As intelligent manufacturing technologies continue to evolve, numerous data-driven techniques have been available for industrial applications. This case study was aimed at developing a machine-learning algorithm, capable of predicting slag inclusion defects in continuous-casting slabs, based on process condition sensor data. A large dataset consisting of sensor data from nearly 7300 casting samples has been analyzed, with the empirical mode decomposition (EMD) algorithm utilized to process the multi-modal time series. The following machine-learning algorithms have been examined: K-Nearest neighbors, support vector classifier (linear and nonlinear kernels), decision trees, random forests, AdaBoost, and Artificial Neural Networks. Four over-sampling or under-sampling algorithms have been adopted to solve imbalanced data distribution. In the experiment, the optimized random forest outperformed other machine-learning algorithms in terms of recall and ROC AUC, which could provide valuable insights for quality control.

Federated Transfer Learning Strategy: A Novel Cross-Device Fault Diagnosis Method Based on Repaired Data.

Federated learning has attracted much attention in fault diagnosis since it can effectively protect data privacy. However, efficient fault diagnosis performance relies on the uninterrupted training of model parameters with massive amounts of perfect data. To solve the problems of model training difficulty and parameter negative transfer caused by data corruption, a novel cross-device fault diagnosis method based on repaired data is proposed. Specifically, the local model training link in each source client performs random forest regression fitting on the fault samples with missing fragments, and then the repaired data is used for network training. To avoid inpainting fragments to produce the wrong characteristics of faulty samples, joint domain discrepancy loss is introduced to correct the phenomenon of parameter bias during local model training. Considering the randomness of the overall performance change brought about by the local model update, an adaptive update is proposed for each round of global model download and local model update. Finally, the experimental verification was carried out in various industrial scenarios established by three sets of bearing data sets, and the effectiveness of the proposed method in terms of fault diagnosis performance and data privacy protection was verified by comparison with various currently popular federated transfer learning methods.

A Width Measurement Method of Line Shape Based on Second Harmonic Peak and Modulation Amplitude.

The line width of different line shapes is a very important parameter in absorption spectroscopy sensing techniques. Based on the high sensitivity and low noise properties of wavelength modulation spectroscopy, we report a novel line width measurement method. After theoretically proving the relationship between line width, modulation amplitude and the amplitude of the second harmonic at the center frequency, the absorption lines of CH4 near 6046.96 cm-1 and CO2 4989.97 cm-1 were chosen for simulation, and the relative errors of the line width between our method and theoretical data were kept at about 1%. A distributed feedback laser diode operating near 1653 nm with three different concentrations of CH4 was used for experimental validation, and the results were consistent with the numerical simulation. Additionally, since only the peaks of second harmonic need to be measured, the advantages of wavelength modulation can be utilized while reducing the difficulty of data acquisition.

An Approach to Integrated Scheduling of Flexible Job-Shop Considering Conflict-Free Routing Problems.

This study proposes an approach to minimize the maximum makespan of the integrated scheduling problem in flexible job-shop environments, taking into account conflict-free routing problems. A hybrid genetic algorithm is developed for production scheduling, and the optimal ranges of crossover and mutation probabilities are also discussed. The study applies the proposed algorithm to 82 test problems and demonstrates its superior performance over the Sliding Time Window (STW) heuristic proposed by Bilge and the Genetic Algorithm proposed by Ulusoy (UGA). For conflict-free routing problems of Automated Guided Vehicles (AGVs), the genetic algorithm based on AGV coding is used to study the AGV scheduling problem, and specific solutions are proposed to solve different conflicts. In addition, sensors on the AGVs provide real-time data to ensure that the AGVs can navigate through the environment safely and efficiently without causing any conflicts or collisions with other AGVs or objects in the environment. The Dijkstra algorithm based on a time window is used to calculate the shortest paths for all AGVs. Empirical evidence on the feasibility of the proposed approach is presented in a study of a real flexible job-shop. This approach can provide a highly efficient and accurate scheduling method for manufacturing enterprises.

Explainable machine learning via intra-tumoral radiomics feature mapping for patient stratification in adjuvant chemotherapy for locoregionally advanced nasopharyngeal carcinoma.

PURPOSE: This study aimed to discover intra-tumor heterogeneity signature and validate its predictive value for adjuvant chemotherapy (ACT) following concurrent chemoradiotherapy (CCRT) in locoregionally advanced nasopharyngeal carcinoma (LA-NPC). MATERIALS AND METHODS: 397 LA-NPC patients were retrospectively enrolled. Pre-treatment contrast-enhanced T1-weighted (CET1-w) MR images, clinical variables, and follow-up were retrospectively collected. We identified single predictive radiomic feature from primary gross tumor volume (GTVnp) and defined predicted subvolume by calculating voxel-wised feature mapping and within GTVnp. We independently validate predictive value of identified feature and associated predicted subvolume. RESULTS: Only one radiomic feature, gldm_DependenceVariance in 3 mm-sigma LoG-filtered image, was discovered as a signature. In the high-risk group determined by the signature, patients received CCRT + ACT achieved 3-year disease free survival (DFS) rate of 90% versus 57% (HR, 0.20; 95%CI, 0.05-0.94; P = 0.007) for CCRT alone. The multivariate analysis showed patients receiving CCRT + ACT had a HR of 0.21 (95%CI: 0.06-0.68, P = 0.009) for DFS compared to those receiving CCRT alone. The predictive value can also be generalized to the subvolume with multivariate HR of 0.27 (P = 0.017) for DFS. CONCLUSION: The signature with its heterogeneity mapping could be a reliable and explainable ACT decision-making tool in clinical practice.

Comparative proteomic analysis reveals novel insights into the continuous cropping induced response in Scrophularia ningpoensis.

BACKGROUND: Scrophularia ningpoensis is a well-known medicinal crop. Continuous cropping seriously affects the yield and quality, but little is known about the influence of continuous cropping on metabolic pathways. In this study, the difference in protein abundance between continuous cropping and non-continuous cropping of S. ningpoensis roots was studied by proteomics, and the molecular mechanism that protects S. ningpoensis against continuous cropping was explored. RESULTS: The results suggested that continuous cropping in S, ningpoensis altered the expression of proteins related to starch and sucrose metabolism, glycolysis/gluconeogenesis, pentose phosphate pathway, citric acid cycle, phenylalanine, tyrosine and tryptophan biosynthesis, phenylpropanoid biosynthesis, terpenoid backbone biosynthesis, monoterpenoid biosynthesis, sesquiterpenoid and triterpenoid biosynthesis, and steroid biosynthesis. Among these processes, the most affected were phenylpropanoid biosynthesis and starch and sucrose metabolism, which may be important for continuous cropping resistance. CONCLUSION: The effect of continuous cropping on S. ningpoensis was demonstrated at the proteome level in this work, and identified candidate proteins that may cause continuous cropping reactions. The paper provides the theoretical foundation and scientific reference for enhancing the continuous cropping resistance of S. ningpoensis. © 2022 Society of Chemical Industry.

Early-life risk factors for food allergy: Dietary and environmental factors revisited.

There appears a steep increase in the prevalence of food allergy worldwide in the past few decades. It is believed that, rather than genetic factors, the recently altered dietary and environmental factors are the driving forces behind the rapid increase of this disease. Accumulating evidence has implied that external exposures that occurred in prenatal and postnatal periods could affect the development of oral tolerance in later life. Understanding the potential risk factors for food allergy would greatly benefit the progress of intervention and therapy. In this review, we present updated knowledge on the dietary and environmental risk factors in early life that have been shown to impact the development of food allergy. These predominantly include dietary habits, microbial exposures, allergen exposure routes, environmental pollutants, and so on. The key evidence, conflicts, and potential research topics of each theory are discussed, and associated interventional strategies to prevent the disease development and ameliorate treatment burden are included. Accumulating evidence has supported the causative role of certain dietary and environmental factors in the establishment of oral tolerance in early life, especially the time of introducing allergenic foods, skin barrier function, and microbial exposures. In addition to certain immunomodulatory factors, increasing interest is raised toward modern dietary patterns, where adequately powered studies are required to identify contributions of those modifiable risk factors. This review broadens our understanding of the connections between diet, environment, and early-life immunity, thus benefiting the progress of intervention and therapy of food allergy.

Gastric peroral endoscopic pyloromyotomy for the treatment of congenital hypertrophic pyloric stricture in an infant with a self-made bite block.

Gastric per-oral endoscopic myotomy (G-POEM) is reported to be a promising treatment for refractory gastroparesis, on the other hand, it is also an effective treatment for congenital hypertrophic pyloric stenosis (CHPS). Here, we want to report a case in which G-POEM was performed in an infant with CHPS.

Convolutional neural network models for automatic diagnosis and graduation in skin frostbite.

The study aimed to develop and validate a convolutional neural network (CNN)-based deep learning method for automatic diagnosis and graduation of skin frostbite. A dataset of 71 annotated images was used for the training, the validation, and the testing based on ResNet-50 model. The performances were evaluated with the test set. The diagnosis and graduation performance of our approach was compared with two residents from burns department. The approach correctly identified all the frostbite of IV (18/18, 100%), but with respectively 1 mistake in the diagnosis of degree I (29/30, 96.67%), II (28/29, 96.55%) and III (37/38, 97.37%). The accuracy of the approach on the whole test set was 97.39% (112/115). The accuracy of the two residents were respectively 77.39% and 73.04%. Weighted Kappa of 0.583 indicates good reliability between the two residents (P = .445). Kendall's coefficient of concordance is 0.326 (P = .548), indicating differences in accuracy between the approach and the two residents. Our approach based on CNNs demonstrated an encouraging performance for the automatic diagnosis and graduation of skin frostbite, with higher accuracy and efficiency.

Within-patient randomised clinical trial exploring the development of microskin implantation in the treatment of pressure ulcers.

Pressure injury often seriously affects the life quality of aged patients, especially the long-term bedridden casualties. Widely adopted by different disciplines, negative pressure suction has its role in pressure injury. Microskin implantation has been demonstrated powerful in increasing the expansion ratio of donor area-derived skin and accelerating wound healing by forming "skin islands". The study was designed to evaluate the efficacy and safety of additional use of bedside microskin implantation in the palliative care of pressure injury of aged patients who cannot tolerate surgical treatment as a supplement for standard negative pressure suction. An open-label within-patient RCT was conducted in aged patients with pressure injury. Sixteen patients were enrolled. After granulation tissues formed, half of a pressure injury was randomised to receive the negative pressure suction as the control group, and the other half exposed to additional bedside microskin implantation as the experimental group. Efficacy was evaluated within 1 month after treatment, and the primary endpoints included the wound healing rate and pressure ulcer scale for healing (PUSH) scores. The secondary outcomes included survival rate of implanted microskin, pain intensity assessment, satisfaction surveys from patients or their family, and pressure ulcer healing complications. Sixteen patients completed the study. After 14 days of operation, 5.63 ± 1.78 out of 10 pieces of implanted microskin survived and formed neonatal epithelium. The wound healing rates of the control group and the experimental group at 1 month were (26.17 ± 9.03%) and (35.95 ± 16.02%), respectively (P < .01). The mean PUSH score before the surgery was 12.38 ± 2.23. At 1 month after surgery, the mean difference of PUSH score from baseline was 2.13 ± 0.96 in the control group and 2.81 ± 0.83 in the experimental group (P < .01). The treatment of microskin implantation did not cause additional pain or complications to the patients. Accompanied by a better ulcer status, the majority of patients or their guardians have a high degree of acceptance towards the microskin implantation. Bedside microskin implantation could accelerate wound healing with lower PUSH scores. As a complementary palliative treatment, supplementary microskin implantation is effective and well tolerated.

Graphical education and appropriate time before elective colonoscopy make better bowel preparation.

Background: Inadequate bowel preparation leads to lower polyp detection rates, longer procedure times and lower cecal intubation rates. However, there is no consensus about high-quality bowel preparation, so our study evaluated graphical education and appropriate time before elective colonoscopy. Patients and Methods: We performed a secondary analysis of a national colorectal cancer screening programme of 738 patients. The patients were divided into a group given a graphical information manual (n = 242) or a word-only one (n = 496). They were also divided into groups according to the interval between bowel preparation and colonoscopy: 6-8 h (Group 1, n = 106), 9-12 h (Group 2, n = 228) and 13-17 h (Group 3, n = 402). All patients were scored according to the Boston Bowel Preparation Scale (BBPS) during the examination. Results: The bowel preparation of the graphical group was significantly better than the text group (P < 0.001). After adjustment, the bowel preparation score of Group 1 and Group 2 were both significantly higher than that of Group 3 (P = 0.012 and P = 0.032). Maximum BBPS was 6.31 when the interval time was 6.52 h (95% confidence interval: 5.95-6.66), and when the interval was <10 h, the BBPS was ≥6. Conclusion: High-quality bowel preparation was linked to graphical education and appropriate time before colonoscopy. We suggest that the interval between taking the first laxative and colonoscopy should be <10 h, preferably 6.5 h. Prospective multicentre research is needed to give more evidence of high-quality bowel preparation methods.