A novel risk score model of esophageal stricture for patients undergoing endoscopic submucosal dissection.

BACKGROUND AND PURPOSE: Endoscopic submucosal dissection (ESD) is a promising technique for superficial esophageal lesions. However, stricture is a frequent adverse complication. This study was performed to develop a precise and convenient score prediction model for esophageal strictures after ESD, and compare its efficacy with a previously published predictive model. METHODS: This study enrolled clinical data of patients who underwent esophageal ESD for superficial esophageal lesions. Possible risk factors for esophageal stricture were identified by univariate and multivariate logistic regression analysis. Then we developed a prediction model according to the Framingham system for the first time and presented a convenient table containing the risk probability for each patient. In addition, we validated our score model and the previously published model in our center. RESULTS: A total of 838 patients were enrolled in this study and 6 variables, including age, surgery time, location of the lesion, circumference of the lesion, longitudinal resection length, and depth of infiltration were comprised in the score model. The total score ranged from 0 to 16 points and the risk probability was presented in one concise table for each patient. Areas under receiver-operator characteristic curves for the prediction model were 0.715 in derivation group and 0.804 in validation group. CONCLUSION: We designed and validated a prediction score model for esophageal stricture after ESD, which can be applied conveniently to stratify the stricture risk after esophageal ESD and may facilitate appropriate clinical decision-making for these patients.

Difference Analysis of the Composition of Iron (Hydr)Oxides and Dissolved Organic Matter in Pit Mud of Different Pit Ages in Luzhou Laojiao and Its Implications for the Ripening Process of Pit Mud.

Long-term production practice proves that good liquor comes out of the old cellar, and the aged pit mud is very important to the quality of Luzhou-flavor liquor. X-ray diffraction, Fourier transform ion cyclotron resonance mass spectrometry, and infrared spectroscopy were used to investigate the composition characteristics of iron-bearing minerals and dissolved organic matter (DOM) in 2-year, 40-year, and 100-year pit mud and yellow soil (raw materials for making pit mud) of Luzhou Laojiao distillery. The results showed that the contents of total iron and crystalline iron minerals decreased significantly, while the ratio of Fe(II)/Fe(III) and the content of amorphous iron (hydr)oxides increased significantly with increasing cellar age. DOM richness, unsaturation, and aromaticity, as well as lignin/phenolics, polyphenols, and polycyclic aromatics ratios, were enhanced in pit mud. The results of the principal component analysis indicate that changes in the morphology and content of iron-bearing minerals in pit mud were significantly correlated with the changes in DOM molecular components, which is mainly attributed to the different affinities of amorphous iron (hydr)oxides and crystalline iron minerals for the DOM components. The study is important for understanding the evolution pattern of iron-bearing minerals and DOM and their interactions during the aging of pit mud and provides a new way to further understand the influence of aged pit mud on Luzhou-flavor liquor production.

Prevalence of poor psychiatric status and sleep quality among frontline healthcare workers during and after the COVID-19 outbreak: a longitudinal study.

Poor psychiatric status and sleep quality were common among frontline healthcare workers (FHWs) during the outbreak of the 2019 novel coronavirus disease (COVID-19), but the change in these mental health outcomes overtime remained unknown. This study compared the psychiatric status and sleep quality of FHWs during and after the COVID-19 outbreak in China. FHWs who volunteered to work in Hubei province (the COVID-19 epicenter) were assessed at baseline during the COVID-19 outbreak and re-assessed when they returned to their place of origin (Liaoning province) after the COVID-19 outbreak. Participants' psychiatric status and sleep quality were measured with the Symptom CheckList-90 (SCL-90) and the Pittsburgh Sleep Quality Index (PSQI), respectively. A total of 494 FHWs was assessed at baseline and 462 at follow-up assessments. The prevalence of poor psychiatric status was 10.5% at baseline and increased to 14.9% at the follow-up assessment (P = 0.04). The corresponding figures of poor sleep quality at baseline and follow-up assessment were 16.4% and 27.9%, respectively (P < 0.001). Multiple logistic regression analysis found that severe fatigue (p = 0.003, OR = 1.266, 95% CI = 1.081-1.483), poor sleep quality (p < 0.001, OR = 1.283, 95% CI = 1.171-1.405), and history of pre-existing psychiatric disorders (p < 0.001, OR = 5.085, 95% CI = 2.144-12.06) were independently associated with higher odds of poor psychiatric status among the FHWs. Poor psychiatric status and sleep quality were common among FHWs during the COVID-19 outbreak, and the prevalence increased following their volunteer experiences. This suggests a critical need for longer-term psychological support for this subpopulation.

Photonic crystal enhanced laser desorption and ionization substrate for detection of stress biomarkers under atmospheric pressure.

Enhanced efficiency for generating molecular ions is essential for high-throughput and sensitive detection using mass spectrometry in clinical diagnostics and biomarker discovery. In this study, we developed a novel strategy to promote laser desorption and ionization by using photonic crystals as substrates. The WO3-TiO2 inverse opal photonic crystal, with a coupling stop band and laser wavelength, significantly enhanced the efficiency of laser desorption and ionization owing to the slow light effect and the porous structure of the inverse opal, which increased the interaction between the laser and WO3-TiO2. Furthermore, stress biomarkers were conveniently measured under atmospheric pressure by using WO3-TiO2 inverse opal as an enhanced substrate to evaluate the impact of chronic unpredictable mild stress. The universal and highly sensitive substrate has promised for application in the highly sensitive detection and quantification of biomarkers.

Self-Reporting Colorimetric Analysis of Drug Release by Molecular Imprinted Structural Color Contact Lens.

As a prospective ophthalmic drug delivery device, contact lenses attract a lot of attention because of the improved drug residence time and bioavailability. Herein, we proposed and fabricated a molecular imprinted structural color contact lens for sustained timolol release which could self-report the release process by color change. The specific recognition of target timolol by molecular imprinted sites can not only increase the loading amount and the residence time of the drug but also endow the structure color of lens remarkable blue shift with the accumulative release of timolol. The fascinating contact lens can be further used for controlling release of a large number of ophthalmic drugs and has high potential to be a new generation of functional contact lenses.

Evaluation of the development of the fetal anal sphincter with tomography ultrasonography imaging.

The aim of the study described here was to examine the potential of tomography ultrasonography imaging (TUI) in evaluation of the fetal anal sphincter. In this prospective cross-sectional study of the fetal anal sphincter with TUI, 326 singleton pregnancies (mean age = 28 y, range: 22-38 y) were scanned at 19-40 wk of gestation. The fetal anal region and ischium were revealed in 320 of 326 patients (98.2%). The normal fetal anal sphincter diameter and ischial space reached maximums of 15 and 39 mm, respectively. The normal fetal anal sphincter diameter and the ischial space were plotted as a function of gestational age (GA) on a linear curve, and the regression equations for normal fetal anal sphincter diameter and ischial space as a function of GA in weeks were obtained. A scatterplot was also created that revealed a significant positive relationship between normal fetal anal sphincter diameter and ischial space. On the basis of these criteria, imperforate anus was diagnosed in one fetus. Ultrasonographic assessment of the fetal anal sphincter and the ischium with TUI is feasible. The reference values reported in this article may be useful in prenatal diagnosis of fetal anal sphincter abnormalities.

Diagnosis value of focal liver lesions with SonoVue®-enhanced ultrasound compared with contrast-enhanced computed tomography and contrast-enhanced MRI: a meta-analysis.

PURPOSES: This study is aimed at evaluating diagnostic value of focal liver lesions (FLLs) with SonoVue(®)-enhanced ultrasound compared with contrast-enhanced computed tomography (CECT) and contrast-enhanced magnetic resonance imaging (CEMRI). METHODS: PubMed, EMBASE, and the Cochrane Central Register were searched for English language articles published from January 2000 to May 2011. Histopathologic analysis and/or close clinical and imaging follow-up (except CECT or CEMRI) for at least 6 months were used as golden reference. Sensitivity, specificity, summary receiver operating characteristic (SROC) curves, and area under the curve (AUC) were extracted to test heterogeneity. RESULTS: In 21 included studies, for the SonoVue(®)-enhanced ultrasound studies, sensitivity was 88% (95% CI 87-90), specificity was 81% (95% CI 79-84), and 38.62 (95% CI 13.64-109.35) for diagnostic odds ratio (DOR); for the CECT studies, sensitivity was 90% (95% CI 88-92), specificity was 77% (95% CI 71-82), and 30.84 (95% CI 11.11-85.61) for DOR; for the CEMRI studies, sensitivity was 86% (95% CI 83-88), specificity was 81% (95% CI 76-85), and 27.63 (95% CI 11.28-67.70) for DOR. CONCLUSIONS: In comparison, SonoVue(®)-enhanced ultrasound had high pooled sensitivity and pooled specificity. SROC analysis showed the diagnostic value of FLLs with SonoVue(®)-enhanced ultrasound has no significant difference compared with CECT and CEMRI. SonoVue(®)-enhanced ultrasound is highly sensitive and specific in the characterization of FLLs to support an effective diagnostic method.

Diagnostic value of contrast-enhanced ultrasound, computed tomography and magnetic resonance imaging for focal liver lesions: a meta-analysis.

The diagnostic performance of contrast-enhanced ultrasound (CEUS), contrast-enhanced computed tomography (CECT) and contrast-enhanced magnetic resonance imaging (CEMRI) was determined in patients with focal liver lesions (FLLs) in a meta-analysis. Meta-Disc version 1.4 was used to describe and calculate sensitivity, specificity, summary receiver operating characteristic (SROC) curves and area under the curve (AUC). In the 25 included studies, the pooled estimate of CEUS studies for sensitivity, specificity and diagnostic odds ratio (DOR) was 87% (95% CI 85-88), 89% (95% CI 87-91) and 78.84 (95% CI 29.40-211.40), respectively. Sensitivity, specificity and DOR were 86% (95% CI 84-88), 82% (95% CI 77-86) and 26.34 (95% CI 8.32-83.39), respectively, for the CECT studies. Sensitivity, specificity and DOR were 85% (95% CI 82-88), 87% (95% CI 83-91) and 48.37 (95% CI 15.87-147.45), respectively, for the CEMRI studies. SROC analysis indicated that the diagnostic value of CEUS for FLLs is not significantly different from that of CECT and CEMRI.

Housing characteristics, home environmental factors and respiratory health in 3945 pre-school children in China.

The objective of the study was to assess the effects of housing characteristics and home environmental factors on respiratory symptoms of Chinese children. A cross-sectional study of 3945 children aged 1-6-years-old was conducted at 24 randomly selected kindergartens in Liaoning province, northeast China during April 2007. Information on respiratory symptoms (persistent cough, persistent phlegm, doctor-diagnosed asthma, current asthma, current wheeze and allergic rhinitis) and exposures to home environmental factors was obtained by a standard questionnaire from the American Thoracic Society. We used Chi-square tests, multivariate logistic regression models and adjusted odds ratios (ORs) with 95% confidence intervals (95% CI) for estimates of the risk of respiratory symptoms. Results suggested that the prevalence of asthma-related symptoms was higher for those who lived along the main stem of traffic, and houses near a pollution source. Lower prevalence rates of respiratory morbidity were associated with households with a larger area of residence and more rooms. Pet keeping was associated with doctor-diagnosed asthma (OR = 1.45; 95% CI, 1.03-2.06). Among boys, home decorations significantly increased the risk of doctor-diagnosed asthma (OR = 1.71; 95% CI, 1.21-2.41), current asthma (OR = 1.80; 95% CI, 1.10-2.94) and current wheeze (OR = 1.81; 95% CI, 1.31-2.50). Environmental tobacco smoke, pests and visible mold on walls were associated with the occurrence of asthma symptoms, especially in boys. Based upon the findings of this study, it is concluded that home environmental factors are particularly important for the development of respiratory morbidity among children. Boys may be more susceptible to home environmental factors than girls.

Asthma and asthma-related symptoms in 16 789 Chinese children in relation to pet keeping and parental atopy.

BACKGROUND: The relationship between exposure to animals and allergic respiratory diseases in childhood is controversial, and there is little information about how exposure to pets affects the respiratory health of Chinese children, who have lower rates of asthma. OBJECTIVE: To study the association between exposure to pets and doctor-diagnosed asthma and asthma-related symptoms in Chinese children. We also investigated whether genetic propensity as a result of parental atopy modifies these relations. METHODS: A cross-sectional study of 16 789 children was conducted at 24 randomly selected kindergartens and 12 elementary schools in Liaoning province, China. Information on respiratory health and exposure to indoor allergens was obtained by a standard questionnaire from the American Thoracic Society. RESULTS: In children, exposure to animals was associated with a diagnosis of asthma (adjusted odds ratio [OR], 1.49; 95% confidence interval [CI], 1.30-1.70), wheezing (adjusted OR, 1.37; 95% CI, 1.18-1.60), persistent cough (adjusted OR, 1.71; 95% CI, 1.52-1.91), and persistent phlegm (adjusted OR, 2.26; 95% CI, 1.94-2.64). Parental atopy increased the risk of a diagnosis of asthma (adjusted OR, 3.12; 95% CI, 2.61-3.73) and asthma-related symptoms. There was an interaction between parental atopy and pet exposure in persistent cough and persistent phlegm, but not in doctor-diagnosed asthma. CONCLUSIONS: Pet keeping and parental atopy increased the risk of asthma and allergic respiratory diseases in children. Parental atopy modified the effect of pet exposure in persistent cough and persistent phlegm but not in doctor-diagnosed asthma.

Housing characteristics, home environmental factors and respiratory health in 14,729 Chinese children.

BACKGROUND: Very few studies have assessed the relative impact of housing characteristics and home environmental factors on asthma and asthma-related symptoms in Chinese children who have lower rates of asthma. To our knowledge few studies have assessed respiratory symptoms and allergies in this context. METHODS: To assess the effects of housing characteristics, pet keeping, home decorations and other indoor environmental factors on respiratory health of Chinese children. We studied a population of 14,729 children (1-13 years old) from 12 districts in Liaoning province, Northeast China. Information on respiratory health, housing characteristics, and environmental pollutions were obtained by a standard questionnaire from the American Thoracic Society. RESULTS: Housing conditions, house adjacent to traffic or not, house with or without pollution source nearby, pet keeping, presence of pests and mold/water damage in the home, home decorations and exposure to environmental tobacco smoke (ETS) were associated with doctor-diagnosed asthma and asthma-related symptoms both in boys and girls. The vulnerability towards exposure to housing conditions and environmental factors differed between males and females. Among boys, the risk of respiratory morbidity appeared to be reduced in households with larger surface areas and more rooms; use of a ventilation device was strongly protective against persistent phlegm (OR=0.68; 95%CI: 0.48, 0.96). Asthma-related symptoms were more associated with different pets among girls than among boys. The presence of a cat in the household was associated with doctor-diagnosed asthma (OR=1.89; 95% CI, 1.11-3.20), current wheeze (OR=2.64; 95% CI, 1.52-4.59), persistent cough (OR=1.84; 95% CI, 1.18-2.87) and persistent phlegm (OR=2.17; 95% CI, 1.21-3.87) only among girls. CONCLUSION: Living within the vicinity of a source of pollution, traffic, pet keeping, home decorations, pests, mold and ETS are important determinants of children's respiratory health in China.

Effects of housing characteristics and home environmental factors on respiratory symptoms of 10,784 elementary school children from northeast china.

BACKGROUND: Only few studies have assessed the relative impact of housing characteristics and home environmental factors on asthma and asthma-related symptoms in Chinese children, and to our knowledge, few studies have elaborated respiratory symptoms and allergies in this context. OBJECTIVE: It was the aim of this study to assess the effects of housing characteristics, pet keeping, home decorations and other indoor environmental factors on respiratory health of Chinese children. METHODS: We studied 10,784 children (6-13 years old) from 12 districts in Liaoning province, Northeast China. Information on respiratory health, housing characteristics and environmental pollution was obtained by a standard questionnaire from the American Thoracic Society. RESULTS: Prevalence of asthma-related symptoms was higher for those living along the main stem of traffic, and for those with a house nearby a pollution source. Lower prevalence rates of respiratory morbidity were associated with households with a bigger area of residence and more rooms. Pet keeping was associated with doctor-diagnosed asthma (OR = 1.52; 95% CI 1.25-1.84). Home decorations also increased the risk of doctor-diagnosed asthma (OR = 1.72; 95% CI 1.45-2.04) and current asthma (OR = 1.43; 95% CI 1.06-1.93). Environmental tobacco smoke, pests and visible mold on walls were associated with the occurrence of asthma symptoms. CONCLUSION: Home environmental factors are particularly important for the development of respiratory morbidity among children.