The potential value of serum GP73 in the ancillary diagnosis and grading of liver cirrhosis.

This study is to evaluate the potential value of serum GP73 in ancillary cirrhosis diagnosis. 150 cirrhotic subjects and healthy subjects were retrospectively analyzed, and the two groups were compared in terms of Child‒Pugh grade. Serum GP73 was detected by enzyme-linked immunosorbent assay. Receiver operating characteristic curves were drawn to evaluate the diagnostic value of GP73, and the quantitative relationship between cirrhosis and GP73 was verified by logistic regression. The result showed in regard to serum biomarkers related to cirrhosis, the serum levels of GP73, TBIL, DBIL, and PT were higher and the ALB and PLT were lower in the cirrhosis group than in the control group (p = 0.000), and the area under the ROC curve of GP73 for diagnosing cirrhosis was 0.823 (p = 0.000), the cutoff value was 135 ng/ml, the sensitivity was 60.0%, and the specificity was 88.67%. Logistic regression analysis showed that GP73 > 135 ng/ml had an odds ratio of 11.735 (ß= 2.463, 95% CI: 6.432-21.411, p = 0.000) for diagnosing cirrhosis. Additionally, the Child‒Pugh A, B, and C groups had different levels of GP73 (χ2 =17.840, p = 0.000). A pairwise comparison between the groups showed that there was a significant difference between grades A and B (p = 0.004) and between grades A and C (p = 0.002), but there was no significant difference between grades B and C (p = 1.000). We found serum GP73 levels were elevated in patients with cirrhosis. When the GP73 level was >135 ng/ml, the potential risk of a cirrhosis diagnosis increased approximately 12-fold.

Leakage of soluble microbial products from biological activated carbon filtration in drinking water treatment plants and its influence on health risks.

The application of ozone-biological activated carbon (O3-BAC) as an advanced treatment method in drinking water treatment plants (DWTPs) can help to remove organic micropollutants and further decrease the dissolved organic carbon (DOC) level in finished water. With the increase attention to microbial safety of drinking water, a pre-positioned O3-BAC followed by a sand filter has been implanted into DWTP located in Shanghai, China to increase the biostability of effluents. The results showed that BAC had high removal efficiencies of UV254, DOC and disinfection by-product formation potential (DBPFP). The removal efficiencies between pre- and post-positioned BAC filtrations were similar. Based on the analyses of fluorescence excitation-emission matrix spectrophotometry (FEEM), the generation and leakage of soluble microbial products (SMPs) were found in both two BAC filtrations on account of the increased fluorescence intensities and fluorescence regional integration (FRI) distribution of protein-like organics, as well as the enhanced biological index (BIX). The leakage of SMPs produced by metabolism of microbes during BAC process resulted in increased DBPFP yield and carcinogenic factor per unit of DOC (CF/DOC). Although BAC filtration reduced the DBPFP and CF, there still was high health risk of effluents for the production of SMPs. Therefore, the health risks for SMPs generated by BAC filtration in drinking water advanced treatment process should be addressed, especially with that at high temperature.

Randomized controlled trial of cholestyramine and hydrotalcite to eliminate bile for capsule endoscopy.

BACKGROUND/AIMS: Bile is the main cause of poor bowel preparation for capsule endoscopy (CE). We aimed to determine whether cholestyramine and hydrotalcite can eliminate bile in the bowel. PATIENTS AND METHODS: Patients undergoing CE were randomized into two groups. Group A patients (n = 75) received 250 mL 20% mannitol and 1 L 0.9% saline orally at 20:00 hours on the day before and at 05:00 hours on the day of CE and 20 mL simethicone 30 min before CE. Group B patients (n = 73) were treated identically, except for taking oral cholestyramine and hydrotalcite, starting 3 days before CE. Greenish luminal contents were assessed by four tissue color bar segments using Color Area Statistics software. Bowel cleanliness was evaluated by visualized area percentage assessment of cleansing (AAC) score. RESULT: Bowel cleanliness (82.7% [62/75] vs 46.6% [34/73]; χ2 = 14.596, P = 0.000). and detected greenish luminal contents (20.0% [15/75] vs 8.2% [6/73]; χ2 = 4.217, P = 0.040) were significantly greater in Group A than in Group B. Greenish luminal contents in the two groups differed significantly in the captured small-bowel (t = -13.74, P = 0.000) segments and proximal small-bowel (t = -0.7365, P = 0.000) segments, but not for the distal small-bowel (t = -0.552, P = 0.581) segments. CONCLUSIONS: Cholestyramine and hydrotalcite were ineffective in eliminating bile and improving small-bowel preparation.

Evaluation of visualized area percentage assessment of cleansing score and computed assessment of cleansing score for capsule endoscopy.

BACKGROUND/AIM: The purpose of this study was to evaluate the clinical significance of visualized area percentage assessment of cleansing score (AAC) and computed assessment of cleansing score (CAC) of these two small bowel cleanliness scores systems for capsule endoscopy (CE). MATERIALS AND METHODS: The reliability and consistency of the AAC and CAC scores were evaluated by comparing the scores by two examiners (one expert, one without any training in CE). Reliability was determined using the intraclass correlation coefficient (ICC) and consistency was determined using the kappa statistic. RESULTS: The inter-observer agreement was excellent for both the AAC and CAC scores. For AAC, the ICC was 0.791 (95% confidence interval: 0.677-0.868), and for CAC the ICC was 1.000. Using 1.5 as the cutoff, there was no significant difference between AAC and CAC results by the expert examiner (kappa = 0.756, P = 0.000) or the non-expert examiner (kappa = 0.831, P = 0.000). Evaluation of small bowel cleanliness using AAC took 15-30 min, and evaluation using CAC took about 2-3 min. The overall adequacy assessment (OAA) using the AAC was not significantly different between the two examiners (χ2 = 0.586, P = 0.444). There were also no significant differences between the OAA using the AAC and the OAA using the CAC by the expert examiner (χ2 = 1.730, P = 0.188) or the non-expert examiner (χ2 = 1.124, P = 0.289). CONCLUSION: Both of these scores for assessment of small bowel cleanliness can be useful in clinical practice, but the CAC is simpler to use.