[Fraction Characteristic and Risk Assessment of Heavy Metals in Surface Sediments of the Yellow River Mainstream].

Heavy metals(HMs) are highly toxic and do not easily degrade in the environment. They can accumulate in the human body through the food chain, with serious impacts on the ecological environment and human health. In this study, 14 sampling sites along the mainstream of the Yellow River were investigated, and the total content and chemical fractions of six heavy metals(As, Cd, Cr, Cu, Pb, and Zn) in sediments were analyzed. The geo-accumulation index, potential ecological risk index, and risk assessment coding were used to assess the contamination level and bioavailability of HMs in sediment. Principal component analysis and redundancy analysis were used to identify the main sources of HMs. The results showed that the average content of heavy metals was in the order of Cr>Zn>Cu>Pb>As>Cd. Cd had the highest excess rate relative to the background value of each reach, reaching 85.7%. In the sediments, As, Zn, Pb, and Cu were predominantly in the oxidizable fraction(F3:sulfide and organic matter-bound), Cd was mainly occupied by the acid-soluble(F1:exchangeable and carbonate-bound) and a residual fraction(F4:mineral matrix-bound), and Cr was predominantly in the residual fraction. As, Cr, Cu, Pb, and Zn showed the lowest bioavailability in the upstream, increased in the midstream, and finally decreased in the downstream. The risk assessment showed that Cd, the element with the highest pollution risk level in the Yellow River, was prone to pose a serious threat to the ecological environment and should be prevented and controlled first. The PCA and RDA analyses revealed that fine sediment and total organic matter controlled HMs contamination. Therefore, the prevention and control of soil erosion and sediment migration should be emphasized to control HMs pollution in the Yellow River Basin.

The effect of Saccharomyces boulardii supplementation on Helicobacter pylori eradication in children: a systematic review and meta-analysis of Randomized controlled trials.

BACKGROUND: It is unclear whether Saccharomyces boulardii (S. boulardii) supplementation in standard triple therapy (STT) is effective in eradicating Helicobacter pylori (H. pylori) infection in children. We therefore conducted a meta-analysis of randomized controlled trials (RCTs) to assess the effect of S. boulardii supplementation on H. pylori eradication in children. METHODS: We conducted electronic searches in PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure and Wanfang database from the beginning up to September 2023. A random-effects model was employed to calculate the pooled relative risk (RR) with 95% confidence intervals (CI) through a meta-analysis. RESULTS: Fifteen RCTs (involving 2156 patients) were included in our meta-analysis. Results of the meta-analysis indicated that S. boulardii in combination with STT was more effective than STT alone (intention-to-treat analysis : 87.7% vs. 75.9%, RR = 1.14, 95% CI: 1.10-1.19, P < 0.00001; per-protocol analysis : 88.5% vs. 76.3%, RR = 1.15, 95% CI: 1.10-1.19, P < 0.00001). The S. boulardii supplementation group had a significantly lower incidence of total adverse events (n = 6 RCTs, 9.2% vs. 29.2%, RR = 0.32, 95% CI: 0.21-0.48, P < 0.00001), diarrhea (n = 13 RCTs, 14.7% vs. 32.4%, RR = 0.46, 95% CI: 0.37-0.56, P < 0.00001), and nausea (n = 11 RCTs, 12.7% vs. 21.3%, RR = 0.53, 95% CI: 0.40-0.72, P < 0.0001) than STT group alone. Similar results were also observed in the incidence of vomiting, constipation, abdominal pain, abdominal distention, epigastric discomfort, poor appetite and stomatitis. CONCLUSIONS: Current evidence indicated that S. boulardii supplementing with STT could improve the eradication rate of H. pylori, and concurrently decrease the incidence of total adverse events and gastrointestinal adverse events in children.

Diagnostic value of Kaiser score combined with breast vascular assessment from breast MRI for the characterization of breast lesions.

Objectives: The Kaiser scoring system for breast magnetic resonance imaging is a clinical decision-making tool for diagnosing breast lesions. However, the Kaiser score (KS) did not include the evaluation of breast vascularity. Therefore, this study aimed to use KS combined with breast vascular assessment, defined as KS*, and investigate the effectiveness of KS* in differentiating benign from malignant breast lesions. Methods: This retrospective study included 223 patients with suspicious breast lesions and pathologically verified results. The histopathological diagnostic criteria were according to the fifth edition of the WHO classification of breast tumors. The KS* was obtained after a joint evaluation combining the original KS and breast vasculature assessment. The receiver operating characteristic (ROC) curve was used for comparing differences in the diagnostic performance between KS* and KS, and the area under the receiver operating characteristic (AUC) was compared. Results: There were 119 (53.4%) benign and 104 (46.6%) malignant lesions in total. The overall sensitivity, specificity, and accuracy of increased ipsilateral breast vascularity were 69.2%, 76.5%, and 73.1%, respectively. The overall sensitivity, specificity, and accuracy of AVS were 82.7%, 76.5%, and 79.4%, respectively. For all lesions included the AUC of KS* was greater than that of KS (0.877 vs. 0.858, P = 0.016). The largest difference in AUC was observed in the non-mass subgroup (0.793 vs. 0.725, P = 0.029). Conclusion: Ipsilaterally increased breast vascularity and a positive AVS sign were significantly associated with malignancy. KS combined with breast vascular assessment can effectively improve the diagnostic ability of KS for breast lesions, especially for non-mass lesions.

Combined 3D rapid prototyping and computer navigation facilitate surgical treatment of congenital scoliosis: A case report and description of technique.

RATIONALE: This study describes the technique of combined Orbic 3D navigation (O3DN) and 3D rapid prototyping (3DRP) to assist surgical correction of congenital scoliosis. PATIENT CONCERNS: A 12-year-old boy with congenital scoliosis. His father brought him to our hospital upon noticing the boy's asymmetry of the trunk. DIAGNOSES: Congenital scoliosis. INTERVENTIONS: O3DN and 3DRP were used to assist correction surgery in this patient. OUTCOMES: The Cobb angle of segmental scoliosis (T8-L2) was 46.9° preoperatively and 2.3° at the last postoperative follow-up; correction was 95.1%. The average segmental kyphosis (T5-T12) was 45.2° preoperatively and 18.6° at the postoperative follow-up; correction was 58.9%. The preoperative sagittal imbalance of 56.2 mm was improved to 9.7 mm. The mean distance between the center sacral vertical line and the C7 plumb line was reduced from 5.7 to 4.1 mm. Operative time and bleeding volume was impressively little, with no misplacement of pedicle screws or other surgical complications. LESSONS: Combined 3DRP and O3DN helped achieve satisfactory correction for this case of congenital scoliosis. The application of 3DRP aided by O3DN in surgical treatment of congenital scoliosis can reduce operative time, lessen blood loss, reduce screw misplacement, and avoid neurovascular damage. However, patients' hospital costs were greater. Our lessons learnt are that the relative position between the tracker and the pedicle must be static to ensure the accuracy of the whole system during the entire operation.

Prevertebral space effusion caused by the breaking of swollen lymphonodi retropharynici in nasopharyngeal carcinoma: A case report.

A 20-year-old male presented to hospital with blood in the mucus, which had occurred for 6 months, and was diagnosed with nasopharyngeal carcinoma (NPC). Due to passive smoking, the patient developed a constant and violent cough, pain behind the right ear and swelling of the retropharynx. The results of a computed tomography scan, which was performed during re-examination of the patient, revealed that the right lymphonodi retropharynici had decreased in size and the hypodense shadow of the prevertebral space had become clear. Therefore, the retropharyngeal pressure was suspected to be increased due to the violent cough. Consequently, the increased pressure may have caused the swollen lymph nodes on the right side of the pharynx to break, which allowed the necrotic liquid to seep into the prevertebral space and result in effusion. Subsequent to 5 days of treatment with methylprednisolone (40 mg ivgtt qd, d1-5), the results from the cone bean computed tomography examination, which had been performed prior to radiotherapy, indicated that the retropharyngeal swelling had improved and the prevertebral space had returned to normal. To the best of our knowledge, the present study is the first reported case of effusion in the prevertebral space caused by the breaking of swollen lymphonodi retropharynici in NPC. The present study acts as a reminder of the possible delays in the treatments for head and neck tumor patients that demonstrate swollen retropharyngeal lymph nodes due to the occurrence of effusion in the prevertebral space.

[Accuracy evaluation of mammography in the breast cancer screening in Asian women: a community-based follow-up study and meta analysis].

OBJECTIVE: To evaluate the accuracy of mammography in breast cancer screening in Asian women. METHODS: 8718 community women in Chengdu were examined by mammography during the routine physical examination from Mar. 2002 to Sep. 2007. Pathological diagnosis and following up results were used as the gold standards for X-ray-positive and -negative findings. The sensitivity, specificity and diagnosis odds ratio were calculated as accuracy indexes. Large scale follow-up studies of breast cancer screening in community in Asian women were collected to evaluate the pooled accuracy of mammography. Diagnosis meta-analysis was conducted with Meta-Disc software to estimate the pooled sensitivity, specificity and DOR, and draw the summary receiver operating characteristic (SROC). RESULTS: The data of seven studies were included with a total of 223 619 women received mammography for screening breast cancer. The sensitivity (95%CI) and specificity (95%CI) of mammography of community-based follow-up study in Chengdu were 0.889 (0.741 - 0.970) and 0.991 (0.987 - 0.993), respectively. Referring to meta-analysis, random effects models were adopted due to existed heterogeneity among studies. The pooled sensitivity, specificity, DOR with their 95% confidence intervals were 0.845 (0.821 - 0.870), 0.930 (0.929 - 0.931) and 117.271 (65.060 - 211.412), respectively. The Area Under the Curve (AUC) of SROC was 0.9144. CONCLUSION: Due to its high accuracy, mammography deserves to be recommend in breast cancer screening in Asian women.