Increased quality of bowel preparation via smartphone WeChat application: a multicenter randomized controlled trial.

Introduction: High-quality bowel preparation is an essential precondition for colonoscopy. Few studies have evaluated the smartphone WeChat application as a means of improving the quality of bowel preparation. Aim: To assess the effect of patient education by using smartphone WeChat application aids on the quality of bowel preparation. Material and methods: A multicenter prospective, endoscopist-blinded, randomized, controlled study was conducted. Patients were randomly assigned to three groups. A total of 478 patents in groups A were accepted for smartphone WeChat application, 477 in groups B were accepted for conventional education plus smartphone WeChat application while group C (473 patients) was a control group. The primary outcome was the quality of the bowel preparation according to the Boston Bowel Preparation Scale (BBPS). The secondary outcomes included polyp detection rate (PDR), cecal intubation rate, insertion and withdrawal time, anxiety score, self-rated sleep quality, and willingness to undergo another colonoscopy. Results: Total BBPS score was significantly higher in groups B and C than in the control group (7.5 ±1.2, 7.5 ±1.3 vs. 6.5 ±1.2, p < 0.001). PDR in group A (40.2%, 192/478) and group B (41.7%, 199/477) was higher than that in the control group (p = 0.003) and mean number of polyps per patient was higher too (p = 0.015). Moreover, a shorter cecal insertion time was recorded in group A and group B than in the control group (8.8 ±3.9, 8.9 ±3.8 vs. 10.5 ±4.2 min, p < 0.001). Intervention groups showed lower anxiety scores and better quality sleep and were more likely to be willing to repeat colonoscopy. Conclusions: Patient instruction via smartphone WeChat application efficiently improved bowel preparation for colonoscopy.

Pollution characteristics and health risk assessment of PM2.5-bound arsenic: a 7-year observation in the urban area of Jinan, China.

The aim of the study was to analyze the temporal trends, pollution sources, and carcinogenic health risks associated with PM2.5-bound arsenic (As). A total of 588 PM2.5 samples were collected in Jinan during January 2014-December 2020. The content and distribution characteristics were determined for As and Al in PM2.5, and the pollution sources were identified based on enrichment factors (EFs). The health risk of inhalation exposure to As was estimated using the risk assessment methods recommended by the United States Environmental Protection Agency (US EPA). The annual average concentration of As in PM2.5 was 4.5-17.5 ng m-3, which was 0.8-2.9 times higher than the limit ruled by the European Union and China's Ambient Air Quality Standards (6 ng m-3). From 2014 to 2020, the As concentration gradually decreased from 17.5 to 4.9 ng m-3. After 2017, the concentration was close to the level required by the atmospheric quality standard (6 ng m-3). The PM2.5 and arsenic concentrations in the heating season were significantly higher than those in the non-heating season. The EF of As ranged from 144 to 607, which was higher than 10. The cancer risk of As in PM2.5 decreased to the lowest values (heating season 1.0 × 10-5 and non-heating season 7.1 × 10-6, respectively) in 2019. As in Jinan mainly came from anthropogenic pollution. The level of As pollution has been significantly reduced in recent years, but there is still a high risk of carcinogenesis. Air pollution control strategies and guidelines need to be implemented in urban areas, especially during the heating season in winter and spring.

Pollution characteristics and chronic health risk assessment of metals and metalloids in ambient PM2.5 in Licheng District, Jinan, China.

PM2.5 samples were collected at the Wangsheren primary school site in Licheng District of Jinan, China, during 2016. Eleven metals and metalloids including Al, As, Be, Cd, Cr, Hg, Mn, Ni, Pb, Sb and Se in PM2.5 were measured by inductively coupled plasma-mass spectroscopy. The annual average mass concentration of PM2.5 was found to be 88.7 µg m-3. The highest PM2.5 concentrations were obtained during the heating seasons of winter and spring. The concentrations of metals and metalloids in PM2.5 were in a descending order of Al, Pb, Mn, As, Se, Cr, Sb, Ni, Cd, Hg and Be. The enrichment factors showed that Pb, Mn, As, Se, Cr, Sb, Ni, Cd, Hg originated from anthropogenic sources. Factor analysis indicated that the main sources of the metals were coal combustion dust, soil dust, metallurgical industry, brake abrasion of vehicles and other mixed sources. Coal combustion dust was the primary source of metal pollution in PM2.5. Non-carcinogenic risks associated with exposure through the respiratory system were between 6.30 × 10-4 and 7.62 × 10-1, which were lower than the safe limit (1). The carcinogenic risks of Cr, As and Cd were 3.17 × 10-5, 1.52 × 10-5, 2.22 × 10-6, respectively, which were higher than the precautionary criterion (10-6/year). This study indicates that the air pollution of PM2.5 is of public health concern in Licheng District of Jinan, particularly related to potential carcinogenic metals of As, Cr and Cd. Intervention action is needed to reduce the emission sources of these elements, especially coal combustion in winter heating season.

Multicenter surveillance study of surgical site infection and its risk factors in radical resection of colon or rectal carcinoma.

BACKGROUND: Colorectal surgery is associated with high rates of surgical site infection (SSI). We investigated SSI in radical resection of colon or rectal carcinoma and its epidemiological distribution in 26 hospitals in China. METHODS: We conducted prospective surveillance of patients who underwent radical resection of colon or rectal carcinoma in 26 selected hospitals from January 2015 to June 2016.An information system monitored all of the surgical inpatients. Infection control professionals observed the inpatients with suspected SSI who had been screened by the system at the bedside. The infection status of the incisions was followed up by telephone 1 month after the operation. RESULTS: In total, 5729 patients were enrolled for the two operations; SSIs occurred in 206 patients, and the infection rate was 3.60%. The incidence of SSI after radical resection of rectal carcinoma (5.12%; 119/2323) was 2.1 times higher than that after radical resection of colon carcinoma (2.55%; 87/3406) (P < 0.0001). Additionally, in the colon versus rectal groups, the rate of superficial incisional SSI was 0.94% versus 2.28% (P < 0.0001), the rate of deep incisional SSI was 0.56% versus 1.11% (P = 0.018), and the rate of organ space SSI was 1.06% versus 1.72% (P = 0.031), respectively. The most common pathogens causing SSIs after radical resection of colon carcinoma were Escherichia coli (21/38) and Pseudomonas aeruginosa (5/38). Escherichia coli (24/65) and Enterococcus spp. (14/65) were the two most common pathogens in the rectal group. The multivariate logistic regression analysis showed that only the operating time and number of hospital beds were common independent risk factors for SSIs after the two types of surgery. CONCLUSION: This multicenter study showed that there were significant differences in the incidence of SSIs, three types of SSIs, and some risk factors between radical resection of colon carcinoma and rectal carcinoma.

Twist Expression in Circulating Hepatocellular Carcinoma Cells Predicts Metastasis and Prognoses.

Hepatocellular carcinoma (HCC) is one of the leading malignancies worldwide. Enumeration of circulating tumor cells (CTCs) has been demonstrated to be a prognostic indicator in HCC. Twist plays a critical role in metastasis and has been proposed as a biomarker for epithelial-mesenchymal transition (EMT). However, links between the expression of Twist in CTCs and HCC clinical parameters are still unclear. This study aims to evaluate the relationship between Twist expression in CTCs and clinicohistopathological risk factors of HCC. Between June 2015 and July 2017, 80 HCC patients and 10 healthy volunteers were enrolled in this study. CTCs were isolated and analyzed by the optimized CanPatrol™ CTC-enrichment technique. Our analysis showed that Twist+ CTCs were detected in 54 of the 80 (67.5%) HCC patients. The positive ratios of Twist+ CTCs correlated with portal vein tumor thrombi, TNM staging, AFP, cirrhosis, tumor number, tumor size, and microvascular invasion. Meanwhile, the follow-up results of the 33 HCC patients who underwent hepatectomy showed that the positive ratios of Twist+ CTCs were closely correlated with the rate of metastasis or recurrence and the mortality rate. The ROC curve analyses suggested that the prognostic evaluation of Twist+ CTCs outperforms CTCs alone. Twist+ CTCs showed higher expression in Glypican-3 protein. In conclusion, Twist expression in CTCs could serve as a biomarker for evaluating HCC metastasis and prognosis.

TGF-α Overexpression in Breast Cancer Bone Metastasis and Primary Lesions and TGF-α Enhancement of Expression of Procancer Metastasis Cytokines in Bone Marrow Mesenchymal Stem Cells.

Bone metastasis (BM) is the advanced complication of breast cancer, while bone marrow-derived mesenchymal stem cells (BMSCs) in the microenvironment unclearly contribute to cancer metastasis. This study investigated potential roles of transforming growth factor- (TGF-) α in the interaction between breast cancer and BMSCs in BM. Clinical cases of breast cancer with bone metastasis (BMBC), breast cancer without bone metastasis (Non-BM-BC), and benign fibroadenoma (Benign) were enlisted in a retrospective study. TGF-α was found obviously overexpressed in BM lesion of BMBC compared to primary lesion of both BMBC and Non-BM-BC (P < 0.01), and TGF-α was higher in primary lesion of both BMBC and Non-BM-BC (P < 0.01) than Benign group. Interestingly, TGF-α in nontumor tissues of both BMBC and Non-BM-BC was at a higher level than Benign group (P < 0.01), and numbers of macrophages in nontumor tissues of both BMBC and Non-BM-BC (P < 0.01) were higher than Benign group. Furthermore, in cultured human BMSCs, TGF-α stimulated production of procancer cytokines including IL-6, VEGF, FGF10, FGF17, and TGF-ß1 in a dose-dependent manner. Thus, TGF-α in BC could potentially be an important signal of carcinogenesis and metastasis. Macrophages in the nontumor tissue of BC may not be protective but could promote cancer metastasis.

Photoreactivity of Metal-Organic Frameworks in Aqueous Solutions: Metal Dependence of Reactive Oxygen Species Production.

Promising applications of metal-organic frameworks (MOFs) in various fields have raised concern over their environmental fate and safety upon inevitable discharge into aqueous environments. Currently, no information regarding the transformation processes of MOFs is available. Due to the presence of repetitive π-bond structure and semiconductive property, photochemical transformations are an important fate process that affects the performance of MOFs in practical applications. In the current study, the generation of reactive oxygen species (ROS) in isoreticular MIL-53s was studied. Scavengers were employed to probe the production of (1)O2, O2(•-), and •OH, respectively. In general, MIL-53(Cr) and MIL-53(Fe) are dominated by type I and II photosensitization reactions, respectively, and MIL-53(Al) appears to be less photoreactive. The generation of ROS in MIL-53(Fe) may be underestimated due to dismutation. Further investigation of MIL-53(Fe) encapsulated diclofenac transformation revealed that diclofenac can be easily transformed by MIL-53(Fe) generated ROS. However, the cytotoxicity results implied that the ROS generated from MIL-53s have little effect on the viability of the human hepatocyte (HepG2) cell line. These results suggest that the photogeneration of ROS by MOFs may be metal-node dependent, and the application of MIL-53s as drug carriers needs to be carefully considered due to their high photoreactivity.