Colonoscopy-assisted removal of an impaction foreign body at the rectosigmoid junction: A case report.

BACKGROUND: When an anorectal foreign body is found, its composition and shape should be evaluated, and a timely and effective treatment plan should be developed based on the patient's symptoms to avoid serious complications such as intestinal perforation caused by displacement of the foreign body. CASE SUMMARY: A 54-year-old male was admitted to our outpatient clinic on June 3, 2023, due to a rectal foreign body that had been embedded for more than 24 h. The patient reported using a glass electrode tube to assist in the recovery of prolapsed hemorrhoids, however, the electrode tube was inadvertently inserted into the anus and could not be removed by the patient. During hospitalization, the patient underwent surgery, and the foreign body was dragged into the rectum with the aid of colonoscopy. The anus was dilated with a comb-type pulling hook and an anal fistula pulling hook to widen the anus and remove the foreign body, and the local anal symptoms were then relieved with topical drugs. The patient was allowed to eat and drink, and an entire abdominal Computed tomography (CT) and colonoscopy were reviewed 3 d after surgery. CT revealed no foreign body residue and colonoscopy showed no metal or other residues in the colon and rectum, and no apparent intestinal tract damage. CONCLUSION: The timeliness and rationality of the surgical and therapeutic options for this patient were based on a literature review of the clinical signs and conceivable conditions in such cases. The type, material and the potential risks of rectal foreign bodies should be considered.

Antimicrobial Substances and Mechanisms of Lactobacillus rhamnosus against Gardnerella vaginalis.

Bacterial vaginosis (BV) is a common vaginal disease associated with abnormal changes in the vaginal microbiome. Our previous study found that Lactobacillus rhamnosus has a good therapeutic effect on bacterial vaginosis by inhibiting the most prominent bacterium associated with BV, Gardnerella vaginalis. In this study, we show that acetic acid and lactic acid are the main substances in the cell-free supernatant (CFS) of L. rhamnosus that inhibit the growth of G. vaginalis. Further study on the mechanism showed that acetic acid and lactic acid alter the morphology of the G. vaginalis cells, eventually causing the cells to shrink or burst, resulting in exudation of their intracellular contents. In addition, these two organic acids also dissipate the membrane potential of bacterial cells, affecting their synthesis of ATP. A reduced activity of the Na+/K+-ATPase leads to abnormal ATP metabolism, and ultimately inhibits the growth and reproduction of G. vaginalis. Our study provides valuable information for the widespread application of L. rhamnosus in the treatment of bacterial vaginosis.

Interpreting Infrared Thermography with Deep Learning to Assess the Mortality Risk of Critically Ill Patients at Risk of Hypoperfusion.

Background: Hypoperfusion, a common manifestation of many critical illnesses, could lead to abnormalities in body surface thermal distribution. However, the interpretation of thermal images is difficult. Our aim was to assess the mortality risk of critically ill patients at risk of hypoperfusion in a prospective cohort by infrared thermography combined with deep learning methods. Methods: This post-hoc study was based on a cohort at high-risk of hypoperfusion. Patients' legs were selected as the region of interest. Thermal images and conventional hypoperfusion parameters were collected. Six deep learning models were attempted to derive the risk of mortality (range: 0 to 100%) for each patient. The area under the receiver operating characteristic curve (AUROC) was used to evaluate predictive accuracy. Results: Fifty-five hospital deaths occurred in a cohort consisting of 373 patients. The conventional hypoperfusion (capillary refill time and diastolic blood pressure) and thermal (low temperature area rate and standard deviation) parameters demonstrated similar predictive accuracies for hospital mortality (AUROC 0.73 and 0.77). The deep learning methods, especially the ResNet (18), could further improve the accuracy. The AUROC of ResNet (18) was 0.94 with a sensitivity of 84% and a specificity of 91% when using a cutoff of 36%. ResNet (18) presented a significantly increasing trend in the risk of mortality in patients with normotension (13 [7 to 26]), hypotension (18 [8 to 32]) and shock (28 [14 to 62]). Conclusions: Interpreting infrared thermography with deep learning enables accurate and non-invasive assessment of the severity of patients at risk of hypoperfusion.

INFRARED THERMOGRAPHY-BASED BODY-SURFACE THERMAL INHOMOGENEITY MONITORING TO ASSESS THE SEVERITY OF HYPOPERFUSION IN CRITICALLY ILL PATIENTS.

ABSTRACT: Background: Uneven body-surface thermal distribution is a manifestation of hypoperfusion and can be quantified by infrared thermography. Our aim was to investigate whether body-surface thermal inhomogeneity could accurately evaluate the severity of patients at risk of hypoperfusion. Methods: This was a prospective cohort study in which infrared thermography images were taken from unilateral legs of critically ill patients at high risk of hypoperfusion in a cardiac surgical intensive care unit. For each patient, five body-surface thermal inhomogeneity parameters, including standard deviation (SD), kurtosis, skewness, entropy, and low-temperature area rate (LTAR), were calculated. Demographic, clinical, and thermal characteristics of deceased and living patients were compared. The risk of mortality and capillary refill time (CRT) were chosen as the primary outcome and benchmarking parameter for hypoperfusion, respectively. The area under the receiver operating characteristic curve (AUROC) was used to evaluate predictive accuracy. Results: Three hundred seventy-three patients were included, and 55 (14.7%) died during hospital stay. Of inhomogeneity parameters, SD (0.738) and LTAR (0.768) had similar AUROC to CRT (0.757) for assessing mortality risk. Besides, there was a tendency for LTAR (1%-3%-7%) and SD (0.81°C-0.88°C-0.94°C) to increase in normotensive, hypotensive, and shock patients. These thermal parameters are associated with CRT, lactate, and blood pressure. The AUROC of a combined prediction incorporating three thermal inhomogeneity parameters (SD, kurtosis, and entropy) was considerably higher at 0.866. Conclusions: Body-surface thermal inhomogeneity provided a noninvasive and accurate assessment of the severity of critically ill patients at high risk of hypoperfusion.

3D NiO nanoflakes/carbon fiber meshwork: Facile preparation and utilization as general platform for photocathodic bioanalysis.

Herein, we describe a customized approach for facile preparation of three-dimensional (3D) NiO nanoflakes (NFs)/carbon fiber meshwork (CFM) and its validation as a common photocathode matrix for photoelectrochemical (PEC) bioanalysis, which to our knowledge has not been reported. Specifically, 3D NiO NFs/CFM was fabricated by a sequential liquid phase deposition and annealing process, which was then characterized by scanning electron microscopy, X-ray photoelectron spectrum, UV-vis absorption spectra and N2 adsorption-desorption measurement. Sensitized by BiOI and incorporated with an alkaline phosphatase (ALP)/tyrosinase (TYR) bi-enzyme cascade system, a sensitive split-type cathodic PEC bioanalysis for the determination of ALP was achieved. This method can detect ALP concentrations down to 3 × 10-5 U L-1 with a linear response range of 0.001-10 U L-1. Moreover, this proposed system exhibited good selectivity, stability and excellent performance for real sample analysis. This research features the facile preparation of 3D NiO NFs/CFM that could acts as a universal matrix for photocathodic analysis, and is envisioned to stimulate more effort for advanced 3D photocathode for PEC bioanalysis and beyond.

Enhanced organic-inorganic heterojunction of polypyrrole@Bi2WO6: Fabrication and application for sensitive photoelectrochemical immunoassay of creatine kinase-MB.

In this report, enhanced organic-inorganic heterojunction of polypyrrole@Bi2WO6 was fabricated and applied for sensitive photoelectrochemical (PEC) immunoassay of creatine kinase-MB (CK-MB). Specifically, heterostructured polypyrrole@Bi2WO6 photoelectrode was prepared and sandwich immunorecognition were integrated for the CK-MB immunoassay. In the detection, with the aid of alkaline phosphate (ALP)-induced biocatalytic precipitation (BCP), the precipitation-dependent suppression of the photocurrent can be recorded due to the impediment of the interfacial mass and electron transfer. On the basis of target-controlled BCP formation, a novel PEC immunoassay could be developed for the sensitive and specific CK-MB detection. This work manifested the great potential of polypyrrole@Bi2WO6 heterojunction as a novel platform for PEC bioanalysis development and also a PEC method for CK-MB detection. This work is expected to stimulate more interest in the design and implementation of numerous other organic-inorganic heterojunction for advanced PEC bioanalysis development.

Direct Observation of Oxidation Reaction via Closed Bipolar Electrode-Anodic Electrochemiluminescence Protocol: Structural Property and Sensing Applications.

In this work, we developed an innovative closed bipolar electrode (BPE)-electrochemiluminescence (ECL) sensing strategy with generality for target detection. Based on charge balance and 100% current efficiency between the closed BPE poles and the driving electrodes, one of the driving electrodes in one cell of the closed BPE system was employed as ECL sensing surface to reflect the target on the BPE pole in the opposite cell. Compared with traditional BPE-ECL sensing method, which in general adopted the anodic ECL reagents such as Ru(bpy)32+ and its coreactant on one pole (anode) to reflect the target (occurring reduction reaction) on the other pole (cathode), the difference was that the targets occurring oxidation reaction could be detected by the anodic ECL reagents based on this strategy. To verify the feasibility of this strategy, the detection principle was stated first, and Fe(CN)64- as model target at anodic BPE pole were detected by anodic ECL reagents (Ru(bpy)32+ and TprA) on the driving electrode first. The ECL signals showed good performance for target detection. By changing the size and the material of the BPE pole where the targets were located, the detection of l-ascorbic acid (AA), uric acid (UA), and dopamine (DA) as other model targets with higher detection limit were accomplished. Visual and high-throughput detection of AA, UA, and DA were also successfully realized by an array of the closed BPE system. This closed BPE (array) system is an effective supplement of traditional BPE-ECL sensing and could greatly expand the scope of the detection target.

Integration of DNA bio-gates and duplex-specific nuclease signal amplification: towards electrochemiluminescence detection of survivin mRNA.

Using the DNA bio-gate and duplex-specific nuclease assisted target recycling, a facile electrochemiluminescence assay was developed for the sensitive detection of survivin mRNA.

Lobeline shows protective effects against MPTP-induced dopaminergic neuron death and attenuates behavior deficits in animals.

We previously demonstrated that lobeline effectively inhibited dopamine transporter (DAT)-mediated dopamine (DA) transportation. Therefore, the present study aimed to investigate whether lobeline shows protective effects against neurotoxin-induced cell death in vivo. Mice were administered 30 mg/kg 1-methyl-4-phenyl-1,2,3,6-tetra-hydropyridine (MPTP) and treated with 80 mg/kg L-dopa, 10 mg/kg GBR12935 or 1 or 3 mg/kg lobeline, respectively, via injection. Rotarod and swim tests as well as tyrosine hydroxylase (TH) immunohistochemistry were carried out to evaluate the effects of these drugs. Compared with L-DA and GBR12935, lobeline (3 mg/kg administered via intraperitoneal injection) on behavior and dopaminergic neurons. Compared with L-DA and GBR12935, lobeline (3 mg/kg injected subcutaneously) significantly reduced MPTP induced locomotive deficits detected in behavioral tests. In addition, TH immunostaining showed that lobeline (3 mg/kg) markedly decreased the neurotoxin-induced immunoreactivity loss in the substantia nigra and striatum. Lobeline may be useful in the protection of dopaminergic neurons and may alleviate the symptoms of Parkinson's disease.

Portable thermo-powered high-throughput visual electrochemiluminescence sensor.

This paper describes a portable thermo-powered high-throughput visual electrochemiluminescence (ECL) sensor for the first time. This sensor is composed of a tiny power supply device based on thermal-electrical conversion and a facile prepared array electrode. The ECL detection could be conducted with thermo-power, which is easily accessible. For example, hot water, a bonfire, or a lighted candle enables the detection to be conducted. And the assay can be directly monitored by the naked eye semiquantitatively or smart phones quantitatively. Combined with transparent electrode and array microreactors, a portable high-throughput sensor was achieved. The portable device, avoiding the use of an electrochemical workstation to generate potential and a photomultiplier tube to receive the signal, is not only a valuable addition for traditional methods but also a suitable device for field operation or point-of-care testing.

Glucose microfluidic biosensors based on reversible enzyme immobilization on photopatterned stimuli-responsive polymer.

In this paper, we demonstrate a new strategy for replaceable enzymatic microreactor based on a switchable wettability interface of poly(N-isopropylacrylamide) (PNIPAAm). PNIPAAm porous polymer monolith (PPM) with 3D macroporous framework is photopolymerized in glass microchip within 30 s. The PNIPAAm PPM not only shows its reversible swelling/shrinking property at the different temperature around the lower critical solution temperature (LCST), but also shows reversible hydrophilicity/hydrophobicity corresponding to its swelling/shrinking status. Based on these properties, a biocompatible and replaceable on-chip enzymatic microreactor has been successfully built by means of the reversible adsorption and release of glucose oxidase (GOx) on the robust and stable matrix. Coupled with a carbon fiber microelectrode as electrochemical detector, the microreactor has been successfully employed for detection of glucose with a linear range from 0.05 to 5 mM. This approach may provide a promising way for high efficient and renewable microreactors that will find wide application in clinical diagnosis, biochemical synthesis/analysis, and proteomic research.

Glass etching to bridge micro- and nanofluidics.

In this study, a simple and economical fabrication technique bridging micro- and nanostructures is proposed. Glass molds with micro-nanostructures are fabricated by glass microlithography. The microlithography provides flexibility for structure design, and the glass etching contributes to transform the micro glass ridge to the nanoscale. Glass ridge structures with triangular cross sections are generated by undercutting, which coupled the isotropic character of glass and the shield effect of the top Cr layer upon HF etching. Further etching induced the height of the glass ridges to shrink from micro- to nanometres due to the edge effects. At the late etching stage, the geometrical change of the glass greatly slows down, which gives better control over the size of the glass ridge. By glass structure mold-copy, well repeatable, mechanically stable and tunable polydimethylsiloxane (PDMS) channels and cones are fabricated. Scanning electron microscopy (SEM) and laser interferometry (LI) are carried out to characterize the micro-nanostructures. To demonstrate their workability, sample preconcentration to a single nanochannel level is carried out.

[Study on needling depth and direction from different acupoints to sphenopalatine ganglion].

OBJECTIVE: To observe and survey the location of Xiaguan (ST 7), "Die'e" and Quanliao (SI 18) on the surface, and the needling depth and direction from the 3 points to sphenopalatine ganglion. METHODS: Fifteen corpses (30 sides) of adult male were fixed by 10% formalin. The lateral areas of face were dissected from the surface to the deep on the 3 acupoints: the electric drill with the kirschner wire punctured towards the sphenopalatine ganglion and extended to the contralateral areas according to different directions of puncturing sphenopalatine ganglion from the 3 acupoints. The corresponding puncturing points of the 3 acupoints were measured by the coordinate location method. RESULTS: (1) Surface location: the distance between Quanliao (SI 18) and "Die'e" was 21 mm and the distance between Xiaguan (ST 7) and "Die'e" was 17 mm; (2) Inserting depth of each point to sphenopalatine ganglion: the depths of Xiaguan (ST 7), "Die'e" and Quanliao (SI 18) were 49.9 mm, 46.9 mm and 46.6 mm, respectively; (3) The coordinate location of the corresponding puncturing points: the puncturing direction of Xiaguan (ST 7) was anterointernal upper corresponding to the area of connecting center between contralateral Taiyang (EX-HN 5) and Tongziliao (GB 1), the distance between the corresponding inserting point of Xiaguan (ST 7) and Sizhukong (TE 23) was 17.6 mm; the puncturing direction of "Die'e" point was posterointernal upper, and the horizontal distance from the corresponding puncture point to the zygomatic arch was 33 mm and the vertical distance from the corresponding puncture point to the eyes' outer canthus was 42 mm; the puncturing direction of Quanliao (SI 18) was posteriointernal upper and the distance between the corresponding inserting point and the area of contralateral parietal tuber, the distance between the corresponding inserting point of Quanliao (SI 18) and the connecting line of bilateral external acoustic pore was 28 mm, the distance between the corresponding inserting point of Quan-liao (SI 18) and the medial line of the head was 62 mm. CONCLUSION: Understanding the surface location, inserting depths and the general puncturing directions of the 3 points can provide basis for puncturing the sphenopalatine ganglion in clinical practice.

[Clinical anatomy study on the acupuncture safety of tiantu (CV 22) and qishe (ST 11)].

OBJECTIVE: To study on the relation between the regional anatomy and safety of acupuncture at Tiantu (CV 22) and Qishe (ST 11). METHODS: In forty-six adult corpses, 92 sides were dissected to observe the partial anatomy structure of acupuncture path of Tiantu (CV 22) and Qishe (ST 11) and structure characteristics by the steel needle marked method and lay-by-lay dissection method. RESULTS: The bilateral the pleura returning lines behind the manubrium sterni interacted at the sternal angle plane accounted for 50.0% of the total specimens and at the first ribs plane accounted for 6.5% of the specimens; for needling the point Tiantu (CV 22), left brachiocephalic vein was at the same level or close to the manubrium sterni upper fringe in 43.5% of the specimens, the left brachiocephalic vein and the middle of manubrium sterni were at the same level in 56.5% of the specimens; for needling the point Qishe (ST 11), in 68 sides of the specimens, internal jugular vein were pierced, accounting for 73.9%, and in 24 sides of the specimens the left common carotid artery were pierced, accounting for 26.1%; in 50 sides of specimens the vagus nerve were touched by the steel needle, accounting for 54.3. CONCLUSION: In acupuncture of Tiantu (CV 22) and Qishe (ST 11), the needle not only easily injure the upper pleural cavity, but also damage the big blood vessel and the vagus nerve in the mediastinum and the cervical root.

[Clinically anatomic study on the relation between the form of pleural cupula and its surrounding commonly-used acupoints].

OBJECTIVE: To explore the relation of the form of pleural cupula of the normal adult with safety of acupuncture at commonly-used acupoints around the pleural cupula. METHODS: The safe depth for the commonly-used acupoints around the pleural cupula and the relation with the form of pleural cupula were investigated in 46 adult corpses with small Kirschner wire location and arrangement dissection. RESULTS: The width of the pleural cupula projection equal to clavicle medial 1/3 accounted for 32. 6% of all the corpses, and the width of the pleural cupula projection more than clavicle medial 1/3 accounted for 59. 8% of all the corpses, the width of the pleural cupula projection less than clavicle medial 1/3 and pleural cupula medial margin located at the sternoclavicular joint medial accounted for 7.6% of all the corpses. The observed points such as Tiantu (CV 22), Qishe (ST 11), Jianjing (GB 21), Dingchuan (EX-B1), Dazhu (BL 11) which were considered be not related to the pleural cupula. When acupuncture is carried out according to criteria of acupoint location and needling direction, and the needle exceeded a limit, the pleural menbrane will be broken and induce destruction. CONCLUSION: Position and form of the pleural cupula have anatomical relation to acupuncture accident for needling the points around the superior pleural cupula, which should be played attention to.

Prognostic analysis and complications of traumatic carotid cavernous fistulas after treatment with detachable balloon and/or coil embolization.

OBJECTIVE: To explore the causes of the formation of traumatic carotid-cavernous fistulas and the therapeutic effect of detachable balloon and/or coil embolization and the prevention of its complications. METHODS: From October, 1992 to March, 2002, 17 patients with traumatic carotid-cavernous fistulas were treated with detachable balloon and/or coil embolization in our hospital. The clinical data and imaging features of CT, MR and selective angiogram of these patients were analyzed. RESULTS: One week after treatment with embolization, the clinical symptoms of the 17 patients were remitted, and optic cacophony, nystagmus, exophthalmos and dropsy of conjunctiva disappeared. Two patients manifested surgical complications, one patient died. Sixteen patients survived. They were all followed up for more than 2 years, which showed one patient had handicap in movement, and in one patient the signs and symptoms of traumatic carotid-cavernous fistulas reoccurred 2 months after treatment. CONCLUSIONS: The detachable balloon and/or coil embolization is safe and reliable. It is a good method to treat traumatic carotid-cavernous fistulas.