[Short-term clinical efficacy observation of lesion removal, bone graft fusion, and external brace treatment for late-stage wrist tuberculosis].

OBJECTIVE: To observe the clinical efficacy of lesion removal, bone grafting, fusion, and external fixation in the treatment of late-stage wrist tuberculosis. METHODS: From October 2015 to May 2019, 25 patients with late-stage wrist tuberculosis were treated using lesion removal, bone grafting, fusion, and external fixation. Among these patients, there were 14 males and 11 females, aged from 40 to 74 years old, with an average age of (60.72±8.45) years old. The duration of the disease ranged from 5 to 24 months, with an average of (11.52±7.61) months. There were 11 cases of left wrist tuberculosis and 14 cases of right wrist tuberculosis, with 5 cases accompanied by sinus formation. Postoperative regular anti-tuberculosis treatment was continued. Visual analogue score (VAS), inflammatory indicators, Gartland-Werley wrist function score, and upper limb function score were observed before and after treatment. RESULTS: All 25 patients were followed up for ranging from 12 to 36 months with an average of (19.7±6.3) months. At the latest follow-up, all wounds were healed satisfactorily, and there was no recurrence of tuberculosis or infection. VAS at one week before operation and three months after operation were (5.16±1.14) score and (1.68±0.80) score respectively. One week before operation and three months after operation, erythrocyte sedimentation rate (ESR) was (44.20±20.56) mm·h-1 and (14.44±1.14) mm·h-1, and C-reactive protein (CRP) was (12.37±7.95) mg·L-1 and (4.3±3.37) mg·L-1. The differences in all three data sets were statistically significant (P<0.01). According to Gartland-Werley wrist function scoring, the scores at one week before operation and one year after operation were (21.32±3.44) and (14.96±1.37) respectively, showed a statistically significant difference (P<0.01). According to the upper limb function score (disabilities of the arm, shoulder, and hand, DASH), the score was (70.52±7.95) at one week before operation and(28.84±2.30) at one year after operation. The difference was statistically significant (P<0.01). At the latest follow-up, no patient had a recurrence of tuberculosis. CONCLUSION: The short-term clinical efficacy of treating wrist tuberculosis with lesion removal, bone grafting, fusion, and external fixation is satisfactory.

Phthalate exposure and DNA oxidative damage in young people of takeaway food lovers.

Numerous studies have demonstrated the ubiquitous of phthalates in materials of food and food packaging, and the effects of regular eating takeaway food for a long time on human health and phthalate exposure levels were not fully investigated. A total of 288 college students who love eating takeaway food were recruited to explore phthalate exposure and oxidative stress, by measuring metabolites of traditional or alternative phthalates and 8-hydroxydeoxyguanosine (8-OHdG, a biomarker of DNA oxidative damage) in their urine samples. Both traditional and alternative phthalates were highly detected. Based on weekly frequency of takeaway eating collecting from questionnaire, the students were divided into four groups including level 1 (L1, < 3 times), level 2 (L2, 3-7 times), level 3 (L3, 8-12 times) and level 4 (L4, > 12 times). The total concentrations of all phthalate metabolites were 42.5-893 ng/mL in all students, which were significantly different among four groups, with the lowest level in L1 (p < 0.05). Checking with the generalized linear model (L1 as the reference), the concentrations of most phthalate metabolites increased 12.0-144% in L2 and L3 compared with those in L1. For each group increase, the concentrations of total metabolites, and metabolites of high and low molecular weight phthalates will increase by 0.156%, 0.128%, and 0.142%, respectively. Besides, levels of 8-OHdG (0.639-33.7 ng/mL) were positively correlated with phthalate daily exposure doses. The each increase of a percentage unit of daily exposure of phthalates, the concentrations of 8-OHdG will increase by 0.258-0.405%. However, levels of 8-OHdG were not significantly different among the four groups. The alternative phthalates have already entered the body of Chinese young people. Our results indicated the regular consumption of takeaway food (e.g., more than three times per week) may increase the chance of exposure to certain phthalates, and may not significantly increase the levels of DNA oxidative damage, unless exposed to other pollutants such as phthalates.

Microplastics: A review of analytical methods, occurrence and characteristics in food, and potential toxicities to biota.

Microplastics (MPs) are ubiquitous in various environment compartments, including food. Here, we collected research reports of MPs in food published during 2010-2020, and summarized the analytical methods developed and utilized by researchers (e.g., digestion, separation and identification, as well as related QA/QC measures implemented), the occurrence, and the characteristics of MPs in six kinds of food. The potential effects on biota from exposure to MPs were also reviewed. The results showed that most researchers digested food samples using chemical solutions such as HNO3, H2O2, KOH, or NaOH. FT-IR and Raman spectroscopy were the main technique for identifying MPs, and microscopes were used to count MP particles. The abundances MPs were in the ranges of 0-5860, 2.00-1100, 0-698, 4.00-18.7, 0-5.68 × 104 and 900-3000 particles/kg in beverages, condiments, honey, meat, seafood and vegetables, respectively. The "maximum" annual human intake of MPs from these foods is approximately 1.42 × 105-1.54 × 105 particles/capita, equivalent to the consumption of 50 plastic bags (size: 0.04 mm × 250 mm × 400 mm, density: 0.98 g/cm3) each year. Blue-colored and fiber-shaped MP particles were the most commonly observed in food, predominated by PA, PE, PES, PET and PP types. Toxicity studies indicated that MPs, additives of MPs and adsorbents or microorganisms on the surfaces of MPs were all somewhat toxic to cells or biota. Exposure to MPs may induce oxidative stress, inflammation, neurotoxicity, and reproductive toxicity, and change the structure of intestinal microflora in cells or biota. Therefore, we call for more investigation into the residual, excretion and bioavailability of MPs or related absorbents/additives in biota and humans.

Delayed postoperative radiotherapy might improve the long-term prognosis of locally advanced esophageal squamous cell carcinoma.

OBJECTIVE: There is no consensus on the optimal timing of postoperative radiotherapy (PORT) for locally advanced esophageal squamous cell carcinoma (ESCC). We aimed to determine whether the timing of PORT affects the long-term prognosis of ESCC, and plotted nomograms to predict survival. METHODS: We retrospectively analyzed 351 ESCC patients who underwent radical surgery and PORT. Receiver operating characteristic curves were used to estimate the optimal cutoff point of the time interval between surgery and PORT. Cox proportional hazards regression was used to identify prognostic predictors. Overall survival (OS) and progression-free survival (PFS) were predicted using nomograms. RESULTS: The median follow-up was 53 months (range: 3-179 months). Compared to early PORT, PORT at >48 days after surgery was associated with better OS (adjusted hazard ratio [HR]: 1.406, p = 0.037) and PFS (adjusted HR: 1.475, p = 0.018). In the chemotherapy subgroup, incorporation of chemotherapy timing into the analysis suggested that 2-4 chemotherapy cycles followed by PORT was the optimal treatment schedule as compared to 0-1 chemotherapy cycle followed by PORT and concurrent chemoradiotherapy (5-year PFS: 65.9% vs. 51.0% vs. 50.1%; p = 0.049). The nomograms for OS and PFS were superior to the TNM classification (concordance indices: 0.721 vs. 0.626 and 0.716 vs. 0.610, respectively). CONCLUSIONS: Delayed PORT (>48 days) provides better survival benefit than early PORT among ESCC patients. PORT following 2-4 chemotherapy cycles might lead to the best survival rate. The nomogram plotted in this study effectively predicted survival and may help guide treatment.