Life-Threatening Enterovirus 71 Encephalitis in Unrelated Children with Autosomal Dominant TLR3 Deficiency.

PURPOSE: Enterovirus A71 (EV71) causes a broad spectrum of childhood diseases, ranging from asymptomatic infection or self-limited hand-foot-and-mouth disease (HFMD) to life-threatening encephalitis. The molecular mechanisms underlying these different clinical presentations remain unknown. We hypothesized that EV71 encephalitis in children might reflect an intrinsic host single-gene defect of antiviral immunity. We searched for mutations in the toll-like receptor 3 (TLR3) gene. Such mutations have already been identified in children with herpes simplex virus encephalitis (HSE). METHODS: We sequenced TLR3 and assessed the impact of the mutations identified. We tested dermal fibroblasts from a patient with EV71 encephalitis and a TLR3 mutation and other patients with known genetic defects of TLR3 or related genes, assessing the response of these cells to TLR3 agonist poly(I:C) stimulation and EV71 infection. RESULTS: Three children with EV71 encephalitis were heterozygous for rare mutations-TLR3 W769X, E211K, and R867Q-all of which were shown to affect TLR3 function. Furthermore, fibroblasts from the patient heterozygous for the W769X mutation displayed an impaired, but not abolished, response to poly(I:C). We found that TLR3-deficient and TLR3-heterozygous W769X fibroblasts were highly susceptible to EV71 infection. CONCLUSIONS: Autosomal dominant TLR3 deficiency may underlie severe EV71 infection with encephalitis. Human TLR3 immunity is essential to protect the central nervous system against HSV-1 and EV71. Children with severe EV71 infections, such as encephalitis in particular, should be tested for inborn errors of TLR3 immunity.

ThePreparation of Electrospun PVDF/TBAC Multimorphology Nanofiber Membrane and Its Application in Direct Contact Membrane Distillation.

Microporous membrane with a hydrophobic surface, high porosity, and narrow pore size distribution is the ideal membrane distillation (MD) membrane. The electrospun membranes for MD are a new type and effective way to seawater desalination. Herein, a novel polyvinylidene fluoride (PVDF)/tetrabutylammonium chloride (TBAC) electrospun nanofiber membrane (ENMs) fabricated apply to for direct contact membrane distillation (DCMD). Combine with the spinning condition, the characteristic and content of TBAC significant effect on the multimorphology structure of nanofiber. Therefore, the porous structure and morphology of PVDF/TBAC ENMs can be well-designed by optimizing relative humidity and TBAC concentration in spinning process, three different structure nanofiber membranes are obtained. Lab-scale setup is used to test membrane separation performance. The result indicates that the ultrafine ENMs with 0.025 mol L-1 TBAC presented a steady water flux of about 20.6 L m-2 h-1 and a high-efficiency salt rejection rate of over 99%. PVDF/TBAC ENMs are expected to provide a solution for development of efficient water treatment membrane.

Novel biallelic loss-of-function variants in CEP290 cause Joubert syndrome in two siblings.

BACKGROUND: Joubert syndrome (JS) is a rare genetic disorder, which can be defined by brain stem malformation, cerebellar vermis hypoplasia, and consequent "molar tooth sign" (MTS). JS always shares variety of phenotypes in development defects. With the development of next-generation sequencing, dozens of causative genes have been identified to JS so far. Here, we investigated two male siblings with JS and uncovered a novel pathogenesis through combined methods. RESULTS: The siblings shared similar features of nystagmus, disorders of intellectual development, typical MTS, and abnormal morphology in fourth ventricle. Whole-exome sequencing (WES) and chromosome comparative genomic hybridization (CGH) were then performed on the proband. Strikingly, a maternal inherited nonsense variant (NM_025114.3: c.5953G>T [p.E1985*]) in CEP290 gene and a paternal inherited deletion in 12q21.32 including exons 1 to 10 of CEP290 gene were identified in the two affected siblings. We further confirmed the two variants by in vitro experiments: quantitative PCR and PCR sequencing. CONCLUSIONS: In this study, we first reported a novel causative mechanism of Joubert syndrome: a copy number variation (CNV) combined with a single-nucleotide variant in CEP290 gene, which can be helpful in the genetic diagnosis of this disease.

Involvement of Differentially Expressed microRNAs in the PEGylated Liposome Encapsulated 188Rhenium-Mediated Suppression of Orthotopic Hypopharyngeal Tumor.

Hypopharyngeal cancer (HPC) accounts for the lowest survival rate among all types of head and neck cancers (HNSCC). However, the therapeutic approach for HPC still needs to be investigated. In this study, a theranostic 188Re-liposome was prepared to treat orthotopic HPC tumors and analyze the deregulated microRNA expressive profiles. The therapeutic efficacy of 188Re-liposome on HPC tumors was evaluated using bioluminescent imaging followed by next generation sequencing (NGS) analysis, in order to address the deregulated microRNAs and associated signaling pathways. The differentially expressed microRNAs were also confirmed using clinical HNSCC samples and clinical information from The Cancer Genome Atlas (TCGA) database. Repeated doses of 188Re-liposome were administrated to tumor-bearing mice, and the tumor growth was apparently suppressed after treatment. For NGS analysis, 13 and 9 microRNAs were respectively up-regulated and down-regulated when the cutoffs of fold change were set to 5. Additionally, miR-206-3p and miR-142-5p represented the highest fold of up-regulation and down-regulation by 188Re-liposome, respectively. According to Differentially Expressed MiRNAs in human Cancers (dbDEMC) analysis, most of 188Re-liposome up-regulated microRNAs were categorized as tumor suppressors, while down-regulated microRNAs were oncogenic. The KEGG pathway analysis showed that cancer-related pathways and olfactory and taste transduction accounted for the top pathways affected by 188Re-liposome. 188Re-liposome down-regulated microRNAs, including miR-143, miR-6723, miR-944, and miR-136 were associated with lower survival rates at a high expressive level. 188Re-liposome could suppress the HPC tumors in vivo, and the therapeutic efficacy was associated with the deregulation of microRNAs that could be considered as a prognostic factor.

Enhanced oral delivery and anti-gastroesophageal reflux activity of curcumin by binary mixed micelles.

The aim of this study was to improve the solubility, oral bioavailability, and anti-gastroesophageal reflux activity of curcumin (CM) by preparing two CM-loaded, novel, binary mixed micelles (CM-M). The two CM-M were prepared by ethanol thin-film hydration method. One (CM-T) was prepared using D-alpha-tocopheryl polyethylene glycol 1000 succinate and Solutol®HS15, and the other (CM-F) was prepared using Pluronic®F127 and Solutol®HS15. The entrapment efficiency and drug loading of CM-T were 83.61 ± 0.54% and 2.20 ± 0.65%, respectively, which were lower than those of CM-F (88.66 ± 0.12% and 1.47 ± 0.26%, respectively). TEM results demonstrated that CM-T and CM-F were homogeneous and spherical. The permeability of CM delivered via CM-T and CM-F was enhanced across a Caco-2 cell monolayer, and CM-T and CM-F showed a 5.24- and 4.76-fold increase in relative oral bioavailability, respectively compared with free CM. In addition, the in vivo anti-gastroesophageal reflux study showed that CM-T and CM-F achieved higher anti-gastroesophageal reflux efficacy compared with free CM. Collectively, these findings were indicative of an oral micelle formulation of CM with increased solubility, oral bioavailability, and anti-gastroesophageal reflux activity.

Preparation of a novel polymer monolith with functional polymer brushes by two-step atom-transfer radical polymerization for trypsin immobilization.

Novel porous polymer monoliths grafted with poly{oligo[(ethylene glycol) methacrylate]-co-glycidyl methacrylate} brushes were fabricated via two-step atom-transfer radical polymerization and used as a trypsin-based reactor in a continuous flow system. This is the first time that atom-transfer radical polymerization technique was utilized to design and construct polymer monolith bioreactor. The prepared monoliths possessed excellent permeability, providing fast mass transfer for enzymatic reaction. More importantly, surface properties, which were modulated via surface-initiated atom-transfer radical polymerization, were found to have a great effect on bioreactor activities based on Michaelis-Menten studies. Furthermore, three model proteins were digested by the monolith bioreactor to a larger degree within dramatically reduced time (50 s), about 900 times faster than that by free trypsin (12 h). The proposed method provided a platform to prepare porous monoliths with desired surface properties for immobilizing various enzymes.

Clinical value of 99Tcm-MDP SPECT bone scintigraphy in the diagnosis of unilateral condylar hyperplasia.

PURPOSE: To investigate the clinical value of (99)Tc(m)-MDP SPECT for the diagnosis of unilateral condylar hyperplasia (UCH). METHODS: One hundred forty-nine patients who underwent mandibular (99)Tc(m)-MDP SPECT between January 2009 and December 2012 were studied, including 105 cases that were clinically suspected of UCH and 44 comparable cases without UCH as a control group. RESULTS: Increased bone activity was observed in the affected condyles for all UCH patients. In the UCH group, the relative percentage uptake on the affected side was 59% (SD ± 4.3%), significantly higher than the 41% (SD ± 4.1%) uptake on the contralateral side (P<0.001). Similarly, the condyle/skull ratio was significantly higher for the affected side (1.66 ± 0.63) than for the contralateral side (1.34 ± 0.34, P < 0.01. No significant difference was found in the control group between the left and right condyles. Values for the sensitivity (95%), specificity (61%), positive (84.4%) and negative (84.6%) predictive values, and accuracy (84.5%) for (99)Tc(m)-MDP SPECT in the diagnosis of UCH were calculated. However, for the hyperplastic condyle, no correlation was observed between the thickness of each cartilage layer and the relative uptake in the SPECT image. CONCLUSION: (99)Tc(m)-MDP SPECT is accurate for diagnosing UCH and can provide a reference for treatment options.

[Analysis of clinical features of traditional Chinese medicine symptoms and syndromes of 220 patients with chronic aplastic anemia].

OBJECTIVE: To study Chinese medicine (CM) syndrome types of chronic aplastic anemia (CAA) patients and the distribution laws of typical CM symptoms in different genders. METHODS: From June 2002 to June 2012, 220 CAA outpatients/inpatients at Department of Hematology, Zhejiang Chinese Medical Hospital were recruited. Patients' symptoms and signs, as well as four diagnostic information at the first onset were collected. CM syndrome differentiation was performed. The syndrome types and typical symptoms were analyzed. RESULTS: (1) In the 220 CAA patients, there were 121 cases of Shen yang deficiency syndrome (55.0%), 18 of Shen yin deficiency syndrome type (8.18%), 81 cases of Shen yin-yang deficiency syndrome (36.82%). (2) The distribution of typical symptoms: fatigue and shortness of breath (77.12% males and 73.53% females), pale complexion (64.41% males and 57.84% females), low temperature of four limbs (12.71% males and 26.47% females), spontaneous perspiration and night sweating (32.20% males and 26.47% females), dry mouth and throat (6.78% males and 6.86% females), feverish feelings in palms and soles (14.41% males and 20.59% females), loose stool (6.78% males and 2.94% females), petechiae and ecchymosis (42.37% males and 43.14% females). CONCLUSIONS: Shen yang deficiency syndrome was most often seen in CAA patients at the initial diagnosis, followed by Shen yin-yang deficiency syndrome. Shen yin deficiency syndrome was the least seen. In CM symptoms, fatigue and shortness of breath were most common seen, followed by pale complexion, skin petechia and ecchymosis.

Cone-beam CT evaluation of post-extraction alveolar bone changes at the maxillary incisor sites in an East Asian population: A cross-sectional study.

Objective: Understanding the characteristics of alveolar bone resorption in an East Asian population after maxillary incisor extraction and providing a reference for implant treatment plans. Study design: Cone-beam computerized tomography (CBCT) data of 125 East Asian patients with unilateral extraction of maxillary incisors for 3 months were collected. The alveolar bone width and height in the extraction sites were measured and compared with the corresponding contralateral sites. Results: The differences in alveolar bone width between the extraction site and contralateral site were as follows: 4.11 mm, 2.68 mm, and 2.09 mm (3 mm, 5 mm, 7 mm apical from CEJ of the contralateral tooth). Data are expressed as the median. The horizontal resorption ratio of alveolar bone was 49.94 %, 31.5 %, and 24.46 %. The difference in alveolar bone height was 0.78 mm. The vertical resorption ratio was 7.78 %. The resorption did not differ significantly between sexes and was not significantly affected by tooth positions. Conclusions: In the studied East Asian population, significant horizontal and vertical alveolar bone resorption occurs after natural healing of maxillary incisor extraction for 3 months. The closer to the alveolar ridge crest, the more significant the horizontal resorption, resulting in an "inverted triangle" shape residual alveolar bone.

A generalizable sensing platform based on molecularly imprinted polymer-aptamer double recognition and nanoenzyme assisted photoelectrochemical-colorimetric dual-mode detection.

Developing highly sensitive and selective methods that incorporate specific recognition elements is crucial for detecting small molecules because of the limited availability of small molecule antibodies and the challenges in obtaining sensitive signals. In this study, a generalizable photoelectrochemical-colorimetric dual-mode sensing platform was constructed based on the synergistic effects of a molecularly imprinted polymer (MIP)-aptamer sandwich structure and nanoenzymes. The MIP functionalized peroxidase-like Fe3O4 (Fe3O4@MIPs) and alkaline phosphatase mimic Zr-MOF labeled aptamer (Zr-mof@Apt) were used as the recognition elements. By selectively accumulating dibutyl phthalate (DBP), a small molecule target model, on Fe3O4@MIPs, the formation of Zr-MOF@Apt-DBP- Fe3O4@MIPs sandwich structure was triggered. Fe3O4@MIPs oxidized TMB to form blue-colored oxTMB. However, upon selective accumulation of DBP, the catalytic activity of Fe3O4@MIPs was inhibited, resulting in a lighter color that was detectable by the colorimetric method. Additionally, Zr-mof@Apt effectively catalyzed the hydrolysis of L-Ascorbic acid 2-phosphate sesquimagnesium salt hydrate (AAPS), generating ascorbic acid (AA) that could neutralize the photogenerated holes to decrease the photocurrent signals for PEC sensing and reduce oxTMB for colorimetric testing. The dual-mode platform showed strong linearity for different concentrations of DBP from 1.0 pM to 10 µM (PEC) and 0.1 nM to 0.5 µM (colorimetry). The detection limits were 0.263 nM (PEC) and 30.1 nM (colorimetry) (S/N = 3), respectively. The integration of dual-signal measurement mode and sandwich recognition strategy provided a sensitive and accurate platform for the detection of small molecules.

Effectiveness and safety of n-butyl-2-cyanoacrylate medical adhesive for noninvasive patch fixation in laparoscopic inguinal hernia repair.

BACKGROUND: Our purpose was to compare the recurrence rate and other clinical outcomes of laparoscopic (LS) transabdominal preperitoneal (TAPP) inguinal hernia repair using n-butyl-2-cyanoacrylate (NBCA) for mesh fixation with those of no mesh fixation and mesh fixation with titanium spiral tacks (ST). METHODS: The medical records of patients who received LS TAPP inguinal hernia repair between 2009 and 2012 at our institution were reviewed. Patients were included if the received LS TAPP with either no mesh fixation, mesh fixation with NBCA only, fixation with ST only, or fixation with NBCA + ST. Outcome measures were operation time, postoperative length of stay, visual analogue scale (VAS) pain score 24 h after surgery, postoperative complications, and hernia recurrence. RESULTS: A total of 1,027 TAPP cases were included. In 552 cases, meshes were fixed with NBCA only, in 89 cases only ST were used, in 47 cases ST and NBCA were used, and in 339 cases meshes were not fixed. The groups were comparable with respect to demographic and clinical characteristics. No surgical complications occurred in any group. VAS pain scores were significantly lower in the nonfixation and NBCA only groups (1.4 ± 0.6 and 1.3 ± 0.6, respectively) than in the ST and NBCA + ST groups (2.2 ± 0.9 and 2.2 ± 0.7, respectively; P = 0.001). The mean follow-up duration was ~19 months. At the final follow-up, no wound infections or hernia recurrences had occurred in any of the groups. No occurrence of chronic pain was noted in the nonfixation and NBCA only groups, whereas two cases (2.2%) were noted in the ST group and one case (2.1%) in the NBCA + ST group (P = 0.005). CONCLUSIONS: The use of NBCA medical adhesive for noninvasive patch fixation in laparoscopic hernia repair (TAPP) is effective and safe.

Economic Burden of Hand, Foot, and Mouth Disease - Beijing Municipality, China, 2016-2019.

What is already known about this topic?: Current research regarding hand, foot, and mouth disease (HFMD) has primarily concentrated on the economic impacts, drawing from retrospective or sentinel hospital-based data. This approach often overlooks cases that were either not consulted or were misdiagnosed. What is added by this report?: This research systematically examined the iceberg phenomenon of HFMD and its economic implications in Beijing. Our findings indicate that each confirmed case represents 9.1 actual infections, imposing financial burdens of 25.58 United States dollars (USD) per unconsulted individual, 265.75 USD per misdiagnosed individual, 366.50 USD per individual with mild cases, and 2355.89 USD per individual with severe cases. The annual economic losses attributed to HFMD in the area range from 7.03 million USD to 13.31 million USD. What are the implications for public health practice?: This study offers insight into the actual prevalence of HFMD in Beijing, as well as conducting an economic burden analysis on a per-case, per-category basis. This could facilitate a cost-effectiveness analysis of prevention and control strategies for HFMD.

A well-defined block copolymer serving as surfactants in separation of 1,4-dihydropyridines by open-tubular capillary eletrochromatography.

A novel series of diblock copolymers, poly(butyl methacrylate)(n) -block-poly(glycidyl methacrylate)(m) [P(BMA)(n) -b-P(GMA)(m) ], were synthesized by atom transfer radical polymerization and developed as covalent coating of capillaries. The excellent performance of this coating in separation of three 1,4-dihydropyridines (DHPs) derivatives (amlodipine, nicardipine, nitrendipine) was achieved when the diblock copolymers self-assembled into micelles, which was confirmed by transmission electron microscopy, dynamic light scattering, and atom force microscopy. Meanwhile, the effects of block ratio n/m, pH value, buffer concentration, and organic solvents on the separation of 1,4-DHPs were investigated in detail. Then, the relationship between the morphologies of copolymers and the separation resolutions of 1,4-DHPs was discussed. Furthermore, the proposed method exhibited good run-to-run and column-to-column precision with relative standard deviations of electroosmotic flow less than 3.0%. It was also validated with linearity of three 1,4-DHPs in the range of 0.01-1.80 mM (r(2) ≥ 99.7%), efficient recovery (94-103%), and good repeatability (≤ 3.8%). In addition, three 1,4-DHPs were successfully separated in the spiked human serum sample, which indicated the potential utility of this method in biological sample analysis.

Reactive polymer as a versatile toolbox for construction of multifunctional superparamagnetic nanocomposites.

The development of magnetic nanoparticles with multiple functions has been an ever-growing field because of their diverse applications in drug delivery, biosensing, cell labeling, and so on. In this study, a facile method was developed to construct multifunctional magnetic nanocomposites. The approach is based on the use of poly(glycidyl methacrylate), PGMA, with numerous epoxy groups as reactive polymer to combine with fluorescent dye, the surface of magnetic nanoparticles, and targeting ligands directly without expatiatory functionality design. The resultant nanocomposites with good superparamagnetic and fluorescent properties could be exploited for bioimaging. Moreover, after conjugation with a model protein, namely, transferrin, which specifically targets cells overexpressing transferrin receptors, the nanocomposites could be used selectively to recognize Hela cells in comparison with nonconjugated ones. These results indicate that the newly designed magnetic nanocomposites with PGMA as functional polymer could serve as a novel versatile platform to conjugate with various molecules for construction of diverse multifunctional magnetic nanocomposites to meet different requirements and potential uses in nanomedicine and biological chemistry.

Diagnostic performance of initial salivary alpha-amylase activity for acute myocardial infarction in patients with acute chest pain.

BACKGROUND: To rule out acute myocardial infarction (AMI) in chest pain patients constitutes a diagnostic challenge to emergency department (ED) physicians. STUDY OBJECTIVES: To evaluate the diagnostic value of measuring salivary alpha-amylase (sAA) activity for detecting AMI in patients presenting to the ED with acute chest pain. METHODS: sAA activity was measured in a prospective cohort of 473 consecutive adult patients within 4 h of onset of chest pain. Comparisons were made between patients with a final diagnosis of AMI and those with non-AMI. Univariate analysis and multiple logistic regression model were used to identify independent clinical predictors of AMI. RESULTS: Initial sAA activity in the AMI group (n = 85; 266 ± 127.6 U/mL) was significantly higher than in the non-AMI group (n = 388; 130 ± 92.8 U/mL, p < 0.001). sAA activity levels were also significantly higher in patients with ST elevation AMI (n = 53) compared to in those with non-ST elevation AMI (n = 32) (300 ± 141.1 vs. 210 ± 74.1 U/mL, p < 0.001). The area under the receiver operating characteristic curve of sAA activity for predicting AMI in patients with acute chest pain was 0.826 (95% confidence interval [CI] 0.782-0.869), with diagnostic odds ratio 10.87 (95% CI 6.16-19.18). With a best cutoff value of 197.7 U/mL, the sAA activity revealed moderate sensitivity and specificity as an independent predictor of AMI (78.8% and 74.5%). CONCLUSIONS: High initial sAA activity is an independent predictor of AMI in patients presenting to the ED with chest pain.

Oxidized sodium alginate crosslinked silk fibroin composite scaffold for skin tissue engineering.

Engineering skin substitutes represent a prospective source of advanced therapy in repairing severe traumatic wounds. Sodium alginate (SA) and silk fibroin (SF) are natural biomaterials, which are widely used in tissue engineering and other fields because of their low price, high safety, and good biocompatibility. However, SA itself degrades slowly, its degradation mode is difficult to control, and the degradation products are difficult to remove from the body because of its high molecular weight. Therefore, the composite scaffolds were prepared by freeze-drying composite technology by using the Schiff base reaction between biocompatible SF and permeable oxidized sodium alginate (OSA). Sodium periodate was used as oxidant to modify SA. The results showed that higher oxidation degree of OSA could be obtained by increasing the proportion of oxidant, and the relative molecular weight of the oxidized products could also be reduced. The composite scaffolds were prepared by using sodium tetraborate as a crosslinking accelerator of the Schiff base reaction between OSA and SF. FT-IR confirmed that the Schiff base group appeared in the material. In vitro biodegradation experiments showed that the biodegradation of the composite scaffolds was controllable, and the cytocompatibility experiment showed that the composite scaffolds had good biocompatibility.

Preparation of Centella asiatica loaded gelatin/chitosan/nonwoven fabric composite hydrogel wound dressing with antibacterial property.

Antibiotics abuse and the emergence of massive drug-resistant bacteria have become the major obstacles in the medical system. Thus, designing an antibiotic-free wound dressing with antibacterial activity and decent biocompatibility is urgently desired. Herein, the sandwich-like composite hydrogel wound dressings were developed by intercalating nonwoven fabrics (NF) as the middle layer, gelatin and chitosan (Gel-CS) hydrogel loaded with Centella asiatica (CA) as the base materials. In addition, soaking strategy was employed to improve the mechanical properties of hydrogels. The hydrogels exhibited uniform microporous structure, stable mechanical property, high water absorbency, as well as water vapor transmission rate. After loading with CA, the composite wound dressing showed the sustained drug release properties in vitro and excellent antibacterial activity against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli). The cytotoxicity results demonstrated that the composite hydrogels had good biocompatibility. This work indicates that the nonwoven composite hydrogels have broad application prospects in the field of medical care in the future.

Soil pH has a stronger effect than arsenic content on shaping plastisphere bacterial communities in soil.

Microplastic (MP) pollution is widespread in various ecosystems and is colonized by microbes that form biofilms with compositions and functions. However, compared with aquatic environments, the soil environment has been poorly studied in terms of the taxonomic composition of microbial communities and the factors influencing the community structure of microbes in the plastisphere. In the present study, a microcosm experiment was conducted to investigate the plastisphere bacterial communities of MP (polyvinyl chloride, PVC) in soils with different pH (4.62, 6.5, and 7.46) and arsenic (As) contents (13 and 74 mg kg-1). Bacterial communities in the plastisphere were dominated by Proteobacteria and Firmicutes, with distinct compositions and structures compared with soil bacterial communities. Soil pH and As content significantly affected the plastisphere bacterial communities. Constrained analysis of principal coordinates and a structural equation model demonstrated that soil pH had a stronger influence on the dissimilarity and diversity of bacterial communities than did soil As content. Soil pH affected As speciation in soil and on MP. The concentration of dimethylarsinic acid (DMA) was significantly higher on MP than that in soil, indicating that As methylation occurred on MP. These results suggest that environmental fluctuations govern plastisphere bacterial communities with cascading effects on biogeochemical cycling of As in the soil ecosystems.

Polylactide-caprolactone composite mesh for ventral hernia repair: a prospective, randomized, single-blind controlled trial.

BACKGROUND: Although composite surgical meshes are widely used in laparoscopic repair of ventral hernia, the risk of postoperative complications associated with these type of mesh is relatively high. In this report, we demonstrated the safety as well as the effectiveness of a new composite polypropylene mesh coated with poly L-lactide-co-ε-caprolactone (EasyProsthes™) for the repair of ventral hernia. METHODS: This study was a randomized, controlled trial designed to compare EasyProsthes composite mesh (EPM) with Parietex™ Composite (PCO) in patients undergoing laparoscopic ventral hernia repair. Hernia recurrence, chronic pain, seroma formation, intestinal fistula or obstruction, wound or abdominal infection, and viscera adhesion were evaluated. 80 patients who needed repair surgery for primary or secondary ventral hernias were enrolled in this study. Patients were divided into two groups: the EPM group (N.=40) and the PCO group (N.=40). Patients completed 12 months of follow-up. RESULTS: Our results revealed that one patient in the EPM group (2.5%) and two patients in the PCO group (5%) developed mesh-viscera adhesions after surgery (P=1.000). We had no case of intestinal fistulas or obstruction. Seventeen patients in EPM group (42.5%) and 21 in PCO group (52.2%) developed post-surgical seromas in the surgery area (P=0.370). One patient from each group developed postoperative wound infection. There was no case of abdominal infection, chronic pain or hernia recurrence. The incidence of postoperative complications in the EPM group was similar to that observed in the PCO group. CONCLUSIONS: EPM is a safe and effective method to be used in ventral hernia repair surgeries.