Oral sulfate solution benefits polyp and adenoma detection during colonoscopy: Meta-analysis of randomized controlled trials.

OBJECTIVES: Although oral sulfate solution (OSS) has been revealed to be not only safe and efficacious but also noninferior to polyethylene glycol with ascorbic acid (PEG + ASC), it is unclear whether OSS can ultimately increase the polyp detection rate (PDR) and adenoma detection rate (ADR). We performed this meta-analysis to estimate the effect of OSS on PDR and ADR during colonoscopy. METHODS: We searched PubMed, EMBASE, and the Cochrane Library to identify relevant randomized controlled trials (RCTs) investigating the comparative effect of OSS versus PEG + ASC on the PDR and ADR during colonoscopy. Cecal intubation time (CIT), cecal intubation rate (CIR), and bowel preparation score were also evaluated. Review Manager (RevMan) version 5.3.0 was used to perform statistical analysis. RESULTS: Eight RCTs involving 2059 patients fulfilled the selection criteria. Meta-analysis suggested that OSS significantly increased the PDR (47.34% vs. 40.14%, risk ratio [RR] 1.13, 95% confidence interval [CI] 1.03-1.24, P = 0.01) and ADR (44.60% vs. 38.14%, RR 1.17, 95% CI 1.03-1.33, P = 0.01) during colonoscopy. Subgroup analysis showed that the beneficial effects of OSS on PDR and ADR were consistent among patients with mean age >55 years and with body mass index <25 kg/m2 receiving outpatient colonoscopy, morning colonoscopy, and the 2-L bowel preparation protocol. Meanwhile, patients receiving OSS had a beneficial bowel preparation score. CONCLUSION: Compared with polyethylene glycol-based regimens, the OSS bowel preparation regimen significantly increased the PDR and ADR in patients undergoing colonoscopy.

Fabrication and application of a continuously regenerated cationic impurity removal device for ion chromatography.

A continuously regenerated cationic impurity removal device (CR-CRD) has been fabricated and applied for ion chromatography (IC). The removal of cationic impurities is realized by electrodialytically replacing the cationic impurities with hydronium ions. The device is configured in a sandwich structure and the central eluent channel is respectively isolated from both electrodes by stacked cation exchange membranes and a bipolar membrane (BPM) plus stacked anion exchange membranes. The eluent channel is packed with cation exchange resins in hydronium form and their continuous regeneration can be achieved by electrodialysis. A desirable feature of the device is gas-free, and no degasser is required. It showed sufficient ability to remove cationic impurities, as indicated by > 99.9 % removal of 10 mL of 1 mM LiOH solution injected (∼10 µmol) or continuous removal of 1 mM LiOH solution at the flow rate of 1 mL/min (1 µmol/min). A useful application was for sample pretreatment in nuclear power industry, by eliminating strong matrix interference of the sample containing LiOH (1 mM) and boric acid (2000 mg/L) with trace anion analysis.

Comparative efficacy of combination of 1 L polyethylene glycol, castor oil and ascorbic acid versus 2 L polyethylene glycol plus castor oil versus 3 L polyethylene glycol for colon cleansing before colonoscopy: Study protocol of a randomized, double-blind, single-center study.

Colonoscopy has been regarded as an important method of early diagnosing and treating gastrointestinal lesions; however adequate bowel preparation is critical one of many factors needed for successful colonoscopy. Although several modified or novel regimes have been developed, desired quality of bowel preparation has not yet been generated. Scattered evidences revealed that castor oil may have potential of effectively cleansing colon. It is noted that, however, prospective trial of exploring the value of castor oil in preparing bowel before colonoscopy is lacking. The aims of this study are to test the hypotheses that low dose castor oil (30 mL) may enhance potential of polyethylene glycol (PEG) and combination of low castor oil and ascorbic acid may halve the volume of PEG.This is a randomized, double-blind (endoscopist and assessor), single center trial with three-arm design. We will randomly assign 282 adult patients (≥18 years but < 75 years), who are scheduled to undergo colonoscopy, to receive either 3 L PEG alone, 2 L PEG plus 30 mL castor oil or combination of 1 L PEG, 30 mL castor oil and 5 g ascorbic acid. The bowel preparation quality based on Boston Bowel Preparation Scale (BBPS) is the primary outcome. The secondary outcomes include the first defecation time, total number of defecation, time of cecal intubation, detection rate of polyp and adenoma, willing to repeat the same regime, tolerance to regime, and adverse events.The study protocol has been approved by the Clinical Research Ethics Committees of Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital & Chongqing Cancer Center (2017[107]). The results from this trial will be submitted for publication in peer-reviewed journals, and will be presented at national and international conferences.

Comparative efficacy of low volume versus traditional standard volume PEG on bowel preparation before colonoscopy: Protocol for an updated meta-analysis with trial sequential analysis.

INTRODUCTION: Polyethylene glycol (PEG) has been considered as the first recommendation for bowel preparation prior to colonoscopy. A previous meta-analysis suggested that low volume PEG may improve the acceptability of ingesting bowel preparation solution. However, several limitations impaired the power of findings from this published meta-analysis, such as the variation in study design of included trials and adjuvant prescriptions. Moreover, some studies related to this topic have been published recently. And thus, the aim of this updated meta-analysis is to further assess the comparative efficacy of low volume versus standard volume of PEG on bowel preparation before colonoscopy with trial sequential analysis (TSA). METHODS AND ANALYSIS: Systematic searches will be performed to capture any potential randomized controlled trials (RCTs) investigated the comparative efficacy of low volume versus traditional standard volume PEG on bowel preparation prior to colonoscopy in PubMed, EMBASE, and Cochrane Central Register of Controlled Trials. Moreover, we will also manually check the bibliographies of related studies and reviews so as to get additional studies. Two reviewers will independently screen the citation records, extract essential information, and appraise the risk of bias of each RCT in sequence. Finally, we will used the STATA software version 12.0 and TSA software version beta 0.9 to statistically analyze all data and test the robust of each pooled result, respectively. RESULTS: We will submit the full-text of systematic review to a peer-review journal for publication. CONCLUSION: This updated systematic review and meta-analysis with TSA will further assess the comparative efficacy and safety of low-volume versus traditional standard volume PEG for bowel preparation prior to colonoscopy. And then, a more comprehensive evidence body on low-volume compared to standard volume PEG in bowel preparation will be constructed.

Effects of polyethylene glycol 2 L alone or with ascorbic acid compared with polyethylene glycol 4 L alone for bowel preparation before colonoscopy: protocol for a systematic review and network meta-analysis.

INTRODUCTION: Colonoscopy has been regarded as a standard method of detecting and removing gastrointestinal lesions early, while adequate bowel preparation is the prerequisite of determining the diagnostic accuracy and treatment safety of this process. Polyethylene glycol (PEG) based bowel preparation regimens remain the first recommendation, but the optimal option is still uncertain. The aim of this systematic review and network meta-analysis of randomised controlled trials (RCTs) is to determine the optimal PEG based bowel preparation regimen before colonoscopy. METHODS AND ANALYSIS: We will assign two investigators to independently search all potential citations, screen records, abstract essential information and appraise the risk of bias accordingly. Then, random effects pairwise and network meta-analyses of RCTs comparing PEG 2 L alone or with ascorbic acid with PEG 4 L alone will be performed using RevMan 5.3 (Copenhagen, Denmark: The Nordic Cochrane Centre, The Cochrane Collaboration, 2013), Stata 14 (StataCorp, Texas, USA) and WinBUGS 1.4 (Imperial College School of Medicine, St Mary's, London, UK) from January 2000 to April 2017. The surface under the cumulative ranking curve will also be calculated in order to rank the regimens. ETHICS AND DISSEMINATION: Ethics approval and patient written informed consent will not be required because all of the analyses in the present study will be performed based on data from published studies. We will submit our systematic review and network meta-analysis to a peer reviewed scientific journal for publication. SYSTEMATIC REVIEW REGISTRATION: PROSPERO: CRD42017068957.

Nickel-based (Ni-Cr and Ni-Cr-Be) alloys used in dental restorations may be a potential cause for immune-mediated hypersensitivity.

Although nickel-based (Ni-Cr and Ni-Cr-Be) alloy prothesis is widely used in orthodontics, its potential biologic hazards, hypersensitivity in particular, are still uncertain as yet. And only a few studies in vivo have considered the biocompatibility. However, several case reports show adverse effects of immunologic alterations, such as urticaria, respiratory disease, nickel contact dermatitis, microscopic hematuria and proteinuria, and even exacerbated to hepatocyte injury and renal injury. So nickel-based alloy used in dental restorations may be a potential cause for immune-mediated hypersensitivity. The metal surface would occur electrochemical corrosion as metal edge of porcelain-fused-to-nichrome crown exposed to oral cavity rich in electrolytes after restoration, and metal ion would release to oral cavity then come into contact with cells and tissues in the immediate environment, or be distributed throughout the body, mainly to the intestine canal. Once these ions are not biocompatible, the human system may be injured (toxicity and risk of sensitization) if they are absorbed in sufficient quantity. Thus, it is necessary to determine the long-term biocompatibility properties of nickel-based alloy, reduce sensitization, and grasp the information of individual differences in the appearance of adverse reactions in further research.