Adenoma Detection Rate in Average-Risk Population: An Observational Consecutive Retrospective Study.

BACKGROUND: Although colonoscopy is considered the most effective tool for reducing colorectal cancer-related morbidity, the age at which average-risk individuals begin colonoscopic screening is undetermined. This study aimed to compare the adenoma and advanced adenoma detection rates according to age and sex in a large average-risk population in the rural areas of Eastern China. METHODS: This observational, single-center, retrospective study included patients with average colorectal cancer risk and examined the adenoma and advanced adenoma detection rates using age intervals of 5 years. We also compared the size and age of patients with and without advanced adenoma. RESULTS: We included 18 928 patients with a median age of 54 years (range 15-90 years), including 10 143 men and 8785 women. The adenoma and advanced adenoma detection rates were 17.08% and 5.24%, respectively, and increased with age in the whole population. The adenoma detection rates increased from 8.97% (aged 40-44) to 14.98% (aged 45-49) and 6.24% (aged 45-49) to 11.00% (aged 50-54) in men and women (both P < .001), respectively. The advanced adenoma detection rates increased from 2.19% (aged 40-44) to 4.76% (aged 45-49) and 1.89% (aged 45-49) to 3.13% (aged 50-54) in men (P = .002) and women (P = .056), respectively. Patients with advanced adenomas were significantly older than those with non-advanced adenomas (P < .001). The tumors in the advanced adenoma group were significantly larger than those in the non-advanced adenoma group (P < .001). CONCLUSION: The adenoma and advanced adenoma detection rates increased significantly in average-risk population aged 45 years and older, especially in men.

Construction of Dual-Shell Mo2C/C Microsphere towards Efficient Electromagnetic Wave Absorption.

Carbon-based carbides have attracted tremendous attention for electromagnetic energy attenuation due to their adjustable dielectric properties, oxidation resistance, and good chemical stability. Herein, we reasonably regulate the growth of dopamine hydrochloride on the surface of the Mo-glycerate (Mo-GL) microsphere and then transform the resultant Mo-polydopamine (Mo-PD) microsphere into a dual-shell Mo2C/C (DS-Mo2C/C) microsphere in a high-temperature pyrolysis process under an inert atmosphere. It is found that the pyrolysis temperature plays an important role in the graphitization degree of the carbon matrix and internal architecture. The fabrication of a dual-shell structure can be propitious to the optimization of impedance matching, and the introduction of Mo2C nanoparticles also prompts the accumulation of polarization loss. When the pyrolysis temperature reaches 800 °C, the optimized composite of DS-Mo2C/C-800 exhibits good EM absorption performance in the frequency range of 2.0-18.0 GHz. DS-Mo2C/C-800's qualified bandwidth can reach 4.4 GHz at a matching thickness of 1.5 mm, and the integrated qualified bandwidth (QBW) even exceeds 14.5 GHz with a thickness range of 1.5-5.0 mm. The positive effects of the dual-shell structure and Mo2C nanoparticles on EM energy attenuation may render the DS-Mo2C/C microsphere as a promising candidate for lightweight and broad bandwidth EM absorption materials in the future.

Rare spontaneous extensive annular intramural esophageal dissection with endoscopic treatment: A case report.

BACKGROUND: Intramural esophageal dissection (IED) is a rare disease that should be considered in patients with chest pain, dysphagia, and hematemesis. Although it occurs most frequently in older adult women with impaired coagulation or as a sequela of endoscopy, the incidence of spontaneous IED without an obvious causative agent has risen gradually. CASE SUMMARY: This report describes a case of extensive annular IED in a 75-year-old male patient who presented with dysphagia for the past month. Esophageal barium meal radiography revealed slow passage of diluted iohexol through the esophagus after swallowing, prominent luminal dilation, obstruction of the lower segment with only a small amount of contrast medium entering the gastric cavity, and no obvious extravasation. Gastroscopy revealed smooth esophageal mucosa; several esophageal mucosal bridges and webbed mucosa were observed approximately 22 cm from the incisor. The mucosal surface was occasionally rough and uneven, and the length of the esophageal mucosal defect exceeded 10 cm. The anatomy was considered to be annular because the mucosal bridge connecting the proximal and distal tube was not attached to the surrounding myotubes. The final diagnosis was spontaneous extensive annular IED. We treated the patient successfully using endoscopic esophagotomy, which completely relieved the symptoms without complications. CONCLUSION: Spontaneous annular IED can be treated successfully by endoscopic resection of the mucosal septum between the true and false lumen.

Melatonin inhibits the endoplasmic reticulum stress­induced, C/EBP homologous protein­mediated pathway in acute pancreatitis.

Melatonin, which is mainly secreted by the pineal gland, appears to have anti­inflammatory activities. Acute pancreatitis (AP) is characterized by inflammation and acinar cell death, and is associated with a high mortality rate. It has been reported that melatonin can alleviate cerulein (Cer) or Cer + lipopolysaccharide (LPS)­induced inflammatory responses in AR42J rat pancreatic acinar cells (AR42J cells). CCAAT/enhancer binding protein homologous protein (CHOP) is a specific transcription factor involved in endoplasmic reticulum (ER) stress­induced apoptosis, and regulates ER stress responses. However, the mechanisms of the anti­inflammatory effects of melatonin' are unknown, particularly the relationship between melatonin and ER stress. Therefore, the present study aimed to investigate the anti­inflammatory activity of melatonin in AR42J cells and analyze its molecular mechanisms during ER stress. The RNA interference method was used to determine the potential role of CHOP in AR42J cells during AP. In vitro models of AP were induced by treating AR42J cells with Cer + LPS, and pre­treatment with melatonin was used to identify the potential anti­inflammatory mechanisms. The cells also underwent Cell Counting Kit­8, western blotting and reverse transcription­quantitative PCR analyses. The expression levels of ER stress­related molecules were rapidly activated in the early stage and increased over time in the AR42J AP models, with significant pancreatic inflammation and apoptosis. However, knockdown of CHOP expression significantly reduced apoptosis, the activation of NF­κB and the downstream signal pathway. Moreover, cells treated with melatonin exhibited attenuated inflammation, decreased expression levels of ER stress­associated proteins and inhibition of apoptosis. Thus, the present results suggested that melatonin may attenuate the inflammatory response by inhibiting the activation of the CHOP­mediated pathway in AR42J cells.