Cold or Hot Snare with Endoscopic Mucosal Resection for 6-9 mm Colorectal Polyps: A Propensity Score Matching Analysis.

Objective: To investigate the efficacy and safety of cold snare endoscopic mucosal resection (CS-EMR) and hot snare endoscopic mucosal resection (HS-EMR) for colorectal polyps with diameters of 6-9 mm. Methods: Retrospective analysis was performed on the clinical data of 485 patients with colorectal polyps (6-9 mm in size) who were treated with CS-EMR or HS-EMR in the endoscopy center of Hangzhou Third People's Hospital from January 2017 to December 2019. Colorectal polyps were lifted by submucosal injection of normal saline. The CS-EMR group used a cold snare to remove the lifting polyps, while the HS-EMR group used a hot snare. Propensity score matching analysis with 1:1 matching and the nearest neighbor matching method were performed to ensure well-balanced characteristics of the CS-EMR and HS-EMR groups. Matching factors included age, gender, body mass index, blood routine, coagulation indicators, polyp site, size, number, and morphology. This resulted in a balanced cohort of 128 patients per group. Polyp recovery, complications, clipping for disclosure, and length of hospital stay were compared after matching. t-Tests, χ2 tests, McNemar's tests, and Fisher's exact test were used for comparison between the two groups before and after matching. Results: There were no differences between the two groups of intraoperative and postoperative bleeding (P > .05), but the CS-EMR clipping rate was lower than the HS-EMR group (P < .01). There was a higher incidence of post-polypectomy syndrome (PPS) (P = .03) and longer hospital stays (P < .01) in the HS-EMR group than the CS-EMR group. Conclusions: Compared with HS-EMR, CS-EMR is more convenient to operate, with a low incidence of PPS, clipping rates, and short hospital stays. It is a safe and effective removal method for 6-9 mm colorectal polyps.

Role of Helicobacter pylori Eradication in Chronic Spontaneous Urticaria: A Propensity Score Matching Analysis.

OBJECTIVE: To investigate the role of Helicobacter pylori (HP) eradication in chronic spontaneous urticaria (CSU) treatment. METHODS: Retrospective analysis was performed on the clinical data of 522 patients with CSU who underwent a HP breath test in Hangzhou Third People's Hospital between January 2018 and December 2019. The CSU-HP(+) group consisted of patients with CSU and HP infection, who were treated with antihistamines combined with HP eradication therapy. The CSU-HP(-) group consisted of patients with CSU alone, who were treated with antihistamines. Propensity score matching (PSM) analysis, using the nearest neighbor matching method on a 1:1 basis, was performed to ensure the characteristics of the CSU-HP(+) and CSU-HP(-) groups were similar. Factors, including age, gender, white blood cells, red blood cells, platelets, alanine transaminase, creatinine, immunoglobulin E, and pre-treatment urticaria activity score (UAS), were matched to obtain a balanced cohort of patients in each group. Therapeutic effects were compared after matching. t-tests, Χ 2 test, and McNemar's test were used for comparison between the two groups before and after matching. RESULTS: Patients in the CSU-HP(+) group reported significantly more gastrointestinal symptoms than those in the CSU-HP(-) group. UAS scores in the second week of treatment were significantly different between the two groups. After 3 months, the recurrence rate in the CSU-HP(+) group was lower than in the CSU-HP(-) group. CONCLUSION: Eradication of HP infection in patients with CSU helps relieve gastrointestinal symptoms, improves the therapeutic effect of CSU within 2 weeks, and reduces the recurrence rate 3 months after treatment.

Microbial community evolution and fate of antibiotic resistance genes in anammox process under oxytetracycline and sulfamethoxazole stresses.

The microbial community characteristics, functional and antibiotic resistance genes (ARGs), anammox performance under individual and combined oxytetracycline (OTC) and sulfamethoxazole (SMX) were tested under environmentally relevant levels. The results showed that anammox performance was inhibited when the OTC or SMX concentration increased from 0.5 to 1.0 mg L-1. The absolute abundance of tetX in OTC (3.03 × 106 copies mg-1), SMX (2.80 × 106 copies mg-1) and OTC + SMX (2.03 × 106 copies mg-1) was the highest and one more order of magnitude higher than that of tetG, tetM, intI1, or sul2. The anammox performance in the presence of OTC or SMX was lower than that sum of their independent effects. The enrichment of sludge resistomes with prolonged exposure time and increasing OTC and SMX doses might be due to succession of bacterial hosts and potential elevation of ARGs by horizontal transfer.

The performance and microbial community in response to MnO2 nanoparticles in anammox granular sludge.

The response of anaerobic ammonium oxidation (anammox) process and granular sludge in the upflow anaerobic sludge blanket reactor was analyzed under long-term exposure to MnO2 nanoparticles (NPs) (1-200 mg L-1). The addition of 200 mg L-1 MnO2 NPs had a significantly positive effect on nitrogen removal and this system exhibited excellent performance, with a total nitrogen removal efficiency of 93.1%. Moreover, the specific anammox activity enhanced with increasing concentrations of MnO2 NPs up to the maximum value of 657.3 ±â€¯9.3 mg TN g-1 VSS d-1 under MnO2 NPs concentration of 200 mg L-1. This value was approximately 1.6-fold higher than that of the reactor in the absence of MnO2 NPs. The extracellular polymeric substances and settling velocity were both increased with MnO2 NPs addition. Meanwhile, the high-throughput sequencing results revealed that MnO2 NPs increased the relative abundance of dominant bacteria (Candidatus Kuenenia) from 17.3% at the absence of MnO2 NPs to 23.9% at 200 mg L-1 MnO2 NPs, which resulted in a higher efficiency of biological nitrogen removal on the anammox system. These results indicated that MnO2 NPs enhanced nitrogen removal performance of anammox process.

Effects of ZnO nanoparticles on high-rate denitrifying granular sludge and the role of phosphate in toxicity attenuation.

The increasing release of engineered nanoparticles (NPs) from consumer products has raised great concerns about their impacts on biological wastewater treatment. In this study, the widely-used ZnO NP was selected as a model NP to investigate its impact on high-rate denitrifying granular sludge in terms of sludge properties and community structure. A hormesis effect was observed during short-term exposure, in which the specific denitrification activity (SDA) was stimulated by 10% at 1 mg L-1 ZnO NPs, but inhibited by 23% at 5.0 mg L-1 ZnO NPs. When continuously exposed to 2.5 mg L-1 ZnO NPs, the nitrogen removal capacity of the denitrification reactor was nearly deprived within 15 days, and the relative abundance of the dominant denitrifying bacterium (Castellaniella) was decreased from 51.0 to 8.0%. Meanwhile, the dehydrogenase activity (DHA) and the content of extracellular polymeric substance (EPS) significantly decreased to 22.3 and 61.1%, respectively. Nevertheless, the presence of phosphate substantially weakened the adverse effects of ZnO NPs on the SDA, EPS, DHA and the relative abundance of functional genes even exposed to 6.25 mg L-1 ZnO NPs, which was associated with the fact that the level of Zn(II) released from ZnO NPs was significantly reduced in the presence of phosphate. Therefore, the toxicity of ZnO NPs may be mainly attributed to the release of toxic Zn(II) and could be attenuated in the presence of phosphate. Overall, this study provided further reference and meaningful insights into the impact of engineered NPs on biological wastewater treatment.

Acetaminophen-induced acute pancreatitis: A case report and literature review.

Acute pancreatitis is rarely associated with drugs. Acetaminophen overdose is a well-known cause of hepatic toxicity, but drug-induced pancreatitis is rarely reported, especially after mild overdose. A 32-year-old woman presented with nausea and vomiting for 12 h, but no abdominal pain following an overdose of eight Tylenol tablets containing acetaminophen (325 mg acetaminophen per tablet). Laboratory results on admission showed abnormal amylase and lipase levels but completely normal liver function. Magnetic resonance cholangiopancreatography revealed mild swelling of the pancreas without fluid collection around the pancreas. The patient complained of severe abdominal pain five days after admission when attempting to drink water and liquids. Eight days after admission, fluid around the pancreas was observed by computed tomography. The patient was subsequently diagnosed with acetaminophen-induced acute pancreatitis after exclusion of common causes. Routine treatment for pancreatitis and N-acetylcysteine were administered to prevent disease progression. The patient was discharged in good condition.

Effect of chromium on granule-based anammox processes.

In this study, the feasibility of application of anaerobic ammonium oxidation (anammox) to teat wastewater containing chromium was assessed. Anammox granule activity decreased with increasing Cr(VI) concentration and pre-exposure time in batch tests, and the 50% inhibition concentration of Cr(VI) on anammox biomass was 296.5 mg L-1. Approximately 93.9% chromium was absorbed by loosely bound-extracellular polymeric substances and tightly bound-extracellular polymeric substances when less than 60 mg L-1 Cr(VI) was added. During long-term operation in up-flow anaerobic sludge blanket reactor, significant inhibitory effects anammox performance were observed for Cr(VI) concentrations up to 2 mg L-1. The nitrogen removal rate (NRR) rapidly decreased to 1.49 ±â€¯0.89 kg N m-3 d-1, whereas the NRR was 11.37 ±â€¯1.30 kg N m-3 d-1 in a control reactor. Compared with initial levels, specific anammox granule activity was 22%. The tolerance of the anammox process to Cr(VI) can be enhanced after a long-term adaptive phase.

[Adsorption of Pb2+ and Cd2+ from Aqueous Solution Using Vermicompost Derived from Cow Manure and Its Biochar].

Using vermicompost (CV) as raw material, its biochar (CVC350) was prepared at 350℃ and then their physio-biochemical properties were characterized. Furthermore, adsorption studies were performed in a batch system for removing Pb2+ and Cd2+ ions from solution. The characterization results revealed much higher surface area, smaller pore size, greater aromaticity and nonpolarity of CVC350 as compared to CV. Batch adsorption experiments revealed that both the adsorption of Pb2+ and Cd2+ onto CV or CVC350 fitted Langmuir isotherm model very well, and the maximum adsorption capacity of Pb2+ was in the order of CVC350>CV, but no difference was observed for the adsorption capacity of Cd2+ between CV and CVC350. The desorption studies showed that both CV and CVC350 had much higher adsorption rate for Pb2+ than that for Cd2+, and the Cd2+ adsorbed could be more easily desorbed from CV and CVC350 compared with that for the Pb2+ adsorbed. Both the dynamic adsorption process of Pb2+ onto CV and CVC350 was a rapid process, however, the adsorption process of Cd2+ onto CV and CVC350 could be separated into the first rapid step and the second slower step. The adsorption capacity of Pb2+ or Cd2+ onto CV and CVC350 was only affected by the much lower initial pH of the solution, besides, the adsorption capacity of Cd2+ onto CV and CVC350 was relatively more influenced by the initial pH compared with that of Pb2+. Moreover, FTIR analysis showed that the adsorption of Pb2+ and Cd2+on CV depended on the active sites such as aliphatic alcohol, aliphatic acid,carbonates as well as phosphate while that on CVC350 mainly relied on aromatic alcohol, aromatic acid and carbonates.

[Evaluation on Heavy Metal Pollution and Its Risk in Soils from Vegetable Bases of Hangzhou].

With the purpose of investigation on heavy metal contamination in soils from vegetable bases of Hangzhou, adopting field investigation and indoor analysis methods, the contents of heavy metals as Cu, Zn, Pb, Cd, Cr, As and Ni, together with their relevance to the physicochemical properties of the 203 soils from 30 vegetable bases in 10 districts of Hangzhou were studied. The results showed that the contents of heavy metals such as Zn,Cr,As,Ni generally didn't exceed the standard, while the contents of heavy metals such as Cu, Pb, Cd exceeded it. The results from synthetic pollution evaluation showed that the soils were slightly polluted in soils from vegetable bases of Hangzhou, which were mainly caused by Cd pollution. Furthermore, there was slight potential ecological hazard for Cu, Zn, Pb, Cr, As and Ni but strong potential ecological hazard for Cd, and medium comprehensive ecological hazard as a whole for all the heavy metals in soils from vegetable bases of Hangzhou. The correlation analysis indicated that the contents of Cu, Zn, Pb, As, Cd were greatly influenced by the soil physicochemical property. Thus, measures must be taken for the prevention and controlling of heavy metal pollution in the soils from vegetable bases in Hangzhou, especially for that of Cd.

[Effect of Chinese drugs for strengthening Pi, harmonizing Wei, and dispersing blood stasis on the expression of gastric mucosal heat shock protein 70 in chronic atrophic gastritis patients].

OBJECTIVE: To observe the effect of Chinese drugs for strengthening Pi, harmonizing Wei, and dispersing blood stasis (CDSPHWDBS) on the expression of gastric mucosal heat shock protein 70 (HSP70) in chronic atrophic gastritis (CAG) patients. METHODS: A total of 100 CAG patients were assigned to the control group and the treatment group by random digit table, 50 in each group. Patients in the control group took Folic Acid Tablet 10 mg each time, 3 times per day. Those in the treatment group took CDSPHWDBS, 100 mL each time, once per day. The treatment course was 6 months for all. Clinical symptoms and signs, endoscopic and histopathological changes were observed before and after treatment in the two groups. The expression of gastric mucosal HSP70 in CAG patients was determined using SP immunohistochemistry. Data were collected by HPIAS-1 000 pathological graphic analysis system, and its expression semi-quantitatively analyzed. RESULTS: The total effective rate of clinical Chinese medical symptoms and signs was 88. 0% (44/50 cases) in the treatment group and 56. 0% (28/50 cases) in the control group, with significant difference between the two groups (P <0. 01). The improvement rate of endoscopic manifestations such as congestion and edema, erosion, bile regurgitation, pale gastric mucosa, exposed blood vessels, particles proliferation in the treatment group were superior to those in the control group (P <0. 05). The total effective rate of atrophy was 80. 0% (40/50 cases) in the treatment group and 54. 0% (27/50 cases) in the control group, with significant difference between the two groups (P<0. 01). The effective rate of intestinal metaplasia was 75. 0% (12/16 cases) in the treatment group and 33.3% (5/15 cases) in the control group, with significant difference between the two groups (P < 0. 05). The optical density value of gastric mucosal HSP70 was significantly elevated in the two groups after treatment (both P <0. 05). It was higher in the treatment group than in the control group after treatment with significant difference (P <0. 01). CONCLUSION: CDSPHWDBS had obvious effect in treatment of CAG and could improve pathological changes of precancerous lesions possibly by promoting the expression of gastric mucosal HSP70 in CAG patients.

[Comparative studies on the characteristics for Cu2+ or Zn2+ adsorption onto different landfilled sludge].

In this paper, it was comparatively studied about the adsorption or desorption behaviour for Cu2+ or Zn2+ ion onto different landfilled sludge. The results showed that Cu2+ or Zn2+ adsorption isotherm could significantly conform to Freundlich and Henry equations both for the directly landfilled sludge (SSA) and the solidifying landfilled sludge (SSB). Moreover, much higher adsorption capacities were found for Cu2+ on SSA but for Zn2+ on SSB, and the removal efficiency could reach 95% for Cu2+ by SSA with dosage being 10-20 g/L or Zn2+ by SSB with dosage being 5 g/L when the initial CU2+ or Zn2+ concentration was 128 mg/L. However, the desorption ratio of Cu2+, Zn2+ decreased with their increasing adsorption amount, with the same initial concentration, it was much more difficult for Cu2+ to release from SSA while for Zn2+ to release from SSB. Relatively, first-order dynamic equation was the optimal model to describe the kinetics of Cu2+, Zn2+ adsorption by the two sludges, the rates for Cu2+ adsorbed onto SSA and for Zn2+ adsorbed onto SSB were much higher at the same adsorption time. FTIR analysis showed that, the site for Cu2+ adsorption onto SSA is the Si-O group from silicate and carboxy groups from aromatic acids or fatty acids which making stable complex compound with CU2+, while it was specific adsorption by Me--O group from metal oxide and hydroxyl group or carboxy groups from fatty acids for Zn2+ adsorption onto SSB.