Validation of the iHealth Track upper-arm blood pressure monitor KN-550BT in general population according to the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018+AMD1:2020).

OBJECTIVE: To validate the iHealth Track KN-550BT oscillometric upper-arm blood pressure monitor in general population according to the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018+AMD1:2020). METHODS: Participants were recruited and the same left-arm sequential method was used for blood pressure measurement according to the ISO 81060-2:2018+AMD1:2020. The validation results were assessed following the protocol and the Bland-Altman scatterplot was used to show the difference between the test device and reference results. RESULTS: A total of 89 qualified participants were included in the final analysis. For the validation Criterion 1, the mean ± SD of the differences between the test device and reference readings was -1.22 ±â€…5.76 mmHg and -0.08 ±â€…4.40 mmHg for systolic and diastolic blood pressure, respectively. For Criterion 2, the mean ± SD of the differences between the test device and reference readings per participant was -1.22 ±â€…5.06 mmHg and -0.08 ±â€…3.84 mmHg for systolic and diastolic blood pressure, respectively. CONCLUSION: The iHealth Track KN-550BT upper-arm blood pressure monitor passed all the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018+AMD1:2020) and can be recommended for clinical use and self-measurement in general population.

Impacts of environmental flow regulation on survival of aquatic organisms: a case study of Cyprinus Carpio in Baiyangdian, China.

Decreasing water volume and increasing pollutants in wetlands pose challenges to aquatic life. While environmental flow regulation is widely applied to enhance aquatic habitats, its effectiveness needs to be evaluated. In this study, a hydrodynamic-water quality model was used to simulate the fields of flow, temperature, and pollutants. The Ecological Niche Modeling at the MetaLand EcologyLab (ENMTML) was utilized to evaluate the area of suitable habitats for aquatic organisms under both environmental flow regulation and no environmental flow regulation conditions. The typical Baiyangdian Wetland in northern China was taken as the study area, and the important economic fish, Cyprinus carpio, served as the indicator of aquatic species. The effectiveness of environmental flow regulation was evaluated from December 1, 2017, to June 30, 2018. The results indicated that the variables of water depth, dissolved oxygen (DO), ammonia nitrogen (NH4+-N) and Chlorophyll a (Chla) were the major environmental factors determining the variability of the suitable habitat area for Cyprinus carpio. The environmental flow regulation capacity of the Baiyangdian Wetland was 2.6 [Formula: see text] 108 m3, which produced a suitable habitat area of 135.538 km2 at the end of the water supply period. Compared with the no environmental flow regulation condition, the highly and moderately suitable habitat areas for Cyprinus carpio were enlarged by 56.30 km2 and 34.11 km2, respectively. The outcome provides not only a basic reference for wetland management, but also a scientific perspective for understanding the impact of environmental flow regulation on aquatic organisms. The proposed method demonstrates the important potential of evaluating the effectiveness of environmental flow regulation on aquatic organisms in wetlands.

Modeling the effect of fish migration on the horizontal distribution of microplastics in freshwater and ecological risks in the food web: Influence of habitat.

Microplastics (MPs < 5 mm) pollution is a widespread phenomenon in freshwater ecosystems. While the role of physiochemical factors in the migration and distribution of MPs is understood, the impact of biological migration remains less clear. The influence of nekton migration determined by habitat suitability on the distribution of MPs and the consequent ecological risks to the regional food web is investigated in the freshwater environment by using Baiyangdian Lake (China) as a case study. The key findings reveal that fish migration significantly alters the horizontal distribution of MPs in the water environment, with a higher degree of fish aggregation in high suitability habitats leading to an increased presence of MPs due to their ingestion and excretion behaviors. In both high and low suitability habitats, MPs are found to bioconcentrate in fish, suggesting a significant risk to aquatic ecosystems. Despite the lack of evidence supporting MPs biomagnification, the results indicate that MPs are more likely to be biomagnified within the food web of high suitability habitats due to the enhanced foraging capabilities of aquatic organisms. These findings highlight the critical need to consider biological factors, such as nekton migration, in understanding and addressing MPs pollution in freshwater ecosystems.

Virtual screening of novel mTOR inhibitors for the potential treatment of human colorectal cancer.

The abnormal activation of the mTOR pathway is closely related to the occurrence and progression of cancer, especially colorectal cancer. In this study, a rational virtual screening strategy has been established and MT-5, a novel mTOR inhibitor with a quinoline scaffold, was obtained from the ChemDiv database. MT-5 showed potent kinase inhibitory activity (IC50: 8.90 µM) and antiproliferative effects against various cancer cell lines, especially HCT-116 cells (IC50: 4.61 µM), and this was 2.2-fold more potent than that of the cisplatin control (IC50: 9.99 µM). Western blot, cell migration, cycle arrest, and apoptosis assays were performed with HCT-116 cells to investigate the potential anticancer mechanism of MT-5. Metabolic stability results in vitro indicated that MT-5 exhibited good stability profiles in artificial gastrointestinal fluids, rat plasma, and liver microsomes. In addition, the key contribution of the residues around the binding pocket of MT-5 in binding to the mTOR protein was also investigated from a computational perspective.

Microplastics in Tai lake food web: Trophic transfer and human health risk assessment.

Although microplastics (MPs) in marine organisms have been widely studied, the toxicity of MPs in freshwaters and human health is still a global challenge. To fill this gap, we implemented an Ecopath and food web accumulation model to simulate the Tai Lake ecosystem, a region dependent on the tourism and seafood industries. Our results suggested the accumulation of MPs throughout the food web and ultimately reach organisms at high trophic levels, including human-being, who consume MPs through seafood. The adults were prone to consume more MPs than adolescents and children. Unlike clams, fish biota magnification factors indicated that MPs accumulation between specific predator-prey interactions is not expected. The abundance of MPs within clams reveals a potential risk of MPs entering the food web. To better understand the MPs transfer, we recommend paying greater attention to species-specific mechanisms and the resources they rely on.

Periodontal Guided Tissue Regeneration Membranes: Limitations and Possible Solutions for the Bottleneck Analysis.

Guided tissue regeneration (GTR) is an important surgical method for periodontal regeneration. By placing barrier membrane on the root surface of the tooth to guide the adhesion and proliferation of periodontal ligament cells, periodontal tissue regeneration can be achieved. This review intends to analyze the current limitations of GTR membranes and to propose possible solutions for developing new ones. Limitations of current GTR membranes include nonabsorbable membranes and absorbable synthetic polymer membranes exhibit weak biocompatibility; when applying to a large defect wound, the natural collagen membrane with fast degradation rate have limited mechanical strength, and the barrier function may not be maintained well. Although the degradation time can be prolonged after cross-linking, it may cause foreign body reaction and affect tissue integration; The clinical operation of current barrier membranes is inconvenient. In addition, most of the barrier membranes lack bioactivity and will not actively promote periodontal tissue regeneration. Possible solutions include using electrospinning (ELS) techniques, nanofiber scaffolds, or developing functional gradient membranes to improve their biocompatibility; adding Mg, Zn, and/or other metal alloys, or using 3D printing technology to improve their mechanical strength; increasing the concentration of nanoparticles or using directional arrangement of membrane fibers to control the fiber diameter and porosity of the membrane, which can improve their barrier function; mixing natural and synthetic polymers as well as other biomaterials with different degradation rates in proportion to change the degradation rate and maintain barrier function; to improve the convenience of clinical operation, barrier membranes that meets personalized adhesion to the wound defect can be manufactured; developing local controlled release drug delivery systems to improve their bioactivity. Impact statement This review provides an up-to-date summary of commonly commercial periodontal guided tissue regeneration membranes, and analyze their limitations in clinical use. Using studies published recently to explore possible solutions from several perspectives and to raise possible strategies in the future. Several strategies have tested in vivo/in vitro, which will guide the way to propel clinical translation, meeting clinical needs.

Validation of the KANG KC-2850 oscillometric upper-arm ambulatory blood pressure monitor in general population according to the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization universal standard.

OBJECTIVE: To evaluate the accuracy of the KANG KC-2850 ambulatory blood pressure monitor (ABPM) for clinical blood pressure (BP) measurement according to the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (AAMI/ESH/ISO) universal standard (ISO 81060-2:2018). METHODS: BP was sequentially measured and compared with a standard mercury sphygmomanometer in 85 eligible participants. A standard adult cuff (22-3232 cm) was used for test device measurements. A total of 255 comparison pairs were obtained and analyzed according to the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (AAMI/ESH/ISO universal standard. RESULTS: The standard requirements were followed precisely. For the validation Criterion 1, the mean ± SD of the differences between the test device and reference BP readings was -1.12 ± 5.01 and -0.33 ± 4.52 mmHg for SBP and DBP, respectively. For Criterion 2, the SD of the averaged BP differences between the test device and reference BP per subject was 3.59 and 3.60 mmHg for SBP and DBP, respectively. CONCLUSION: The KANG KC-2850 ABPM met all the requirements for validation by the AAMI/ESH/ISO universal standard and can be recommended for clinical use in general population.

Association between urinary polycyclic aromatic hydrocarbons metabolites and high-normal blood pressure in coke oven workers / 中国职业医学

@#Objective （ ） To investigate the association between urinary polycyclic aromatic hydrocarbons PAHs metabolites - Methods and high normal blood pressure in coke oven workers. A total of 433 coke oven workers were selected as the study - subjects using convenient sampling method. They were divided into normal blood pressure group and high normal blood pressure group according to their blood pressure level. The levels of ten kinds of urinary hydroxylated PAHs metabolites were measured by - Results - high performance liquid chromatography mass spectrometry. Among the subjects,57.5% had high normal blood - ， - ， - pressure. The levels of 1 hydroxynathalene 2 hydroxyphenanthrene 1 hydroxyphenanthrene and the metabolite of total PAHs - （ P ） in the high normal blood pressure group were higher than those in the normal blood pressure group all <0.05 . The results of - ， - ， - ， the multivariate logistic regression analysis showed that urinary 1 hydroxynathalene 2 hydroxyfluorene 3 hydroxychrysene - （ P ）， and metabolite of total PAHs were all risk factors for high normal blood pressure in coke oven workers all <0.05 after ， ， ， ， ， adjusting for confounding factors such as gender length of service body mass index smoking index alcohol consumption tea ， ， ， Conclusion consumption night shift exercise frequency and other PAHs metabolites. Exposure to PAHs in coke oven plants may increase the risk of elevated blood pressure within the normal range among coke oven workers.

Inflammation-Immunity-Nutrition Score: A Novel Prognostic Score for Patients with Resectable Colorectal Cancer.

PURPOSE: This study was designed to investigate the prognostic value of the combination of high-sensitivity C-reactive protein, lymphocyte, and albumin in patients with resectable colorectal cancer. PATIENTS AND METHODS: Seven-hundred-and-nineteen patients who underwent colorectal cancer resection in Hubei Cancer Hospital were included. Inflammation-Immunity-Nutrition score (0-6) was constructed based on preoperative high-sensitivity C-reactive protein, lymphocyte, and albumin. Time-dependent receiver operating characteristic curve, decision curve, Kaplan-Meier survival curve, Cox regression, and C-index were conducted to detect the prognostic values of inflammation-immunity-nutrition score. The prognostic values of inflammation-immunity-nutrition score in different subgroups by sex, location of tumor, pathologic stage, and KRAS mutation were also explored. The prognostic performance of inflammation-immunity-nutrition score was further compared with that of other traditional prognostic indicators. RESULTS: The median follow-up time was 40 months. High inflammation-immunity-nutrition score (>2 scores) presented worse survival, with the adjusted hazard ratios (95% confidence intervals) of 3.106 (2.202-4.380) for overall survival and 2.105 (1.604-2.764) for disease-free survival. Besides, the associations of high inflammation-immunity-nutrition score with overall survival were even stronger in cases with wild type KRAS, with the adjusted hazard ratios (95% confidence intervals) of 4.018 (2.355-6.854). Considering the AUCs, C-indices, and hazard ratios estimates, inflammation-immunity-nutrition score presented better prognostic performance than high-sensitivity modified Glasgow prognostic score, high-sensitivity C-reactive protein to albumin ratio, prognostic nutrition index, carcinoembryonic antigen, and carbohydrate antigen 19-9 for overall survival. CONCLUSION: Inflammation-immunity-nutrition score might serve as a powerful prognostic score in patients with colorectal cancer for overall survival, particularly in patients with wild type KRAS.

An innovative approach to identify environmental variables with conservation priorities in habitat patches.

Conservation of habitat patches and the related environment benefits both the focal species and human well-being. Many indices use the dispersal range to identify habitat patches with conservation priorities. However, there lacks approaches to identify environmental variables with conservation priorities (noted as target variables) in those identified patches. Therefore, this paper proposes an approach to identify environmental variables with conservation priorities in habitat patches using perception range and introduces the related assumption. It is assumed the agents select habitats based on their prior preference and perceived information in their perception ranges, which avoids the omniscient assumption of agents. Based on such assumptions, the proposed approach identifies the target variables by approximating how animals identify their habitats. It highlights the use of perception range and identifies target variables using the maximum information gain. The variables that contribute the largest reduction of uncertainty are regarded as the target variables in the habitat patches. Taking the Common Moorhen (Gallinula chloropus) living in Tianjin, China as the case, different scenarios with 100 m, 250 m and 500 m perception ranges are designed to illustrate the feasibility of the proposed approach. The proposed approach identifies the normalized vegetation index, rather than the distance to water surface, is the target variable in 42.3%, 58.9% and 72.1% habitat patches with given perception ranges. Adjustments are made on areas within the given perception range of each patch. More grid cells that has increased suitability index can be found in scenarios given 250 m perception range, which indicates the conservation area is not always the large the better. Optimizations are expected on both a better approximation method and a more thorough hypothesis of using perception range.

Modelling of Corrosion-Induced Concrete Cover Cracking Due to Chloride Attacking.

The premature failure of reinforced concrete (RC) structures is significantly affected by chloride-induced corrosion of reinforcing steel. Although researchers have achieved many outstanding results in the structural capacity of RC structures in the past few decades, the topic of service life has gradually attracted researchers' attention. In this work, based on the stress intensity, two models are developed to predict the threshold expansive pressure, corrosion rate and cover cracking time of the corrosion-induced cracking process for RC structures. Specifically, in the proposed models, both the influence of initial defects and modified corrosion current density are taken into account. The results given by these models are in a good agreement with practical experience and laboratory studies, and the influence of each parameter on cover cracking is analyzed. In addition, considering the uncertainty existing in the deterioration process of RC structures, a methodology based on the third-moment method in regard to the stochastic process is proposed, which is able to evaluate the cracking risk of RC structures quantitatively and predict their service life. This method provides a good means to solve relevant problems and can prolong the service life of concrete infrastructures subjected to corrosion by applying timely inspection and repairs.

Operative and Conservative Management of Laryngeal Contact Granuloma: A Network Analysis and Systematic Review.

OBJECTIVE: Laryngeal contact granuloma is a disease of benign hypertrophic granulation tissue at the medial side of vocal process. Numerous studies of conservative and surgical management have reported effectiveness, yet optimal treatment has not been standardized. We compared primary and secondary outcomes of conservative and surgical treatment using endoscopic grading, Voice Handicap Index-10 (VHI-10), maximum phonation time (MPT), and recurrence rate. METHODS: We performed literature searches of MEDLINE, PubMed, and EMBASE from November 1985 to October 2017, with randomized controlled trials and case control studies of at least three months follow-up as the inclusion criteria. Outcomes included laryngoscopic findings, MPT, and VHI-10. Data regarding study design, outcome analysis, follow-up time, and disease remission were systematically collected. RESULTS: A total of 1069 patients were abstracted from 19 papers. With conservative treatment, 98% of patients' laryngeal granuloma resolved within three months, and 84% for the surgical group. There was a decrease in VHI-10 of 2.69 (95% credible interval (CI) -9.52 to 3.82) and 6.48 (95% CI -15.00 to 1.94) for conservative and surgical management, respectively. MPT improvement was 1.27 s (95% CI: 2.03-5.84) for conservative treatment and 5.02 s (95% CI: 0.78-8.07) for surgical. For all 19 studies, absolute recurrence risk for control, conservative, and surgical measures were respectively 4%, 16%, and 29%. CONCLUSIONS: Most patients treated conservatively or surgically alone responded to treatment, but conservative management was favored. VHI-10 and MPT improvement in surgical patients were noted, but only the latter was statistically significant. In regard to recurrence, conservative management had better outcome than surgical. Taken together, the results suggest that minimally symptomatic granulomas have higher response rate and lower recurrence risk when treated conservatively, while larger, symptomatic granulomas may favor surgical excision followed by medical management to reduce risk of recurrence.

Modelling the accumulation of microplastics through food webs with the example Baiyangdian Lake, China.

Microplastic plastics (MPs) is an increasingly widely serious global environment problem, which severely threats aquatic organisms and even human beings. However, the potential change trend of MPs abundance over time in natural aquatic ecosystems and the cumulative effects through food webs are unclear. In this research, the model of accumulation effect of MPs through aquatic food webs was established in the example Baiyangdian Lake (China) using the contaminant tracer module Ecotracer in the Ecopath modelling software. The results indicated that the MPs spread and accumulate throughout the food-web fast, and finally to the high trophic level aquatic organisms, Snakehead. The abundance of MPs in aquatic environment and organisms varies periodically with rainfall. The abundance of MPs in snakehead, mandarin fish, common carp, crucian carp, chub, fingerling, grass carp, mollusc, microzoobenthos, zooplankton increased about 3.97, 2.87, 2.35, 1.8, 1.48, 1.8, 1.86, 1.98, 1.99, 3.49 times of the initial abundance of MPs in them, respectively. Since snakehead exists in the highest trophic level in Baiyangdian Lake ecosystem, the cumulative effect of MPs is the most serious through food web. Furthermore, the accumulation of MPs in different trophic levels has a time delay effect, and the higher the nutrient level is, the more obvious the delay effect is. The results also showed that Ecotracer is a good model to explore the enrichment effect of MPs in food web, the accumulation of MPs through food webs is serious, and the phenomenon should arouse serious attention.

Plasma tissue factor and immune activation are associated with carotid intima-media thickness progression in treated HIV infection.

OBJECTIVES: We evaluated the roles of biomarkers of immune activation with carotid intima-media thickness (CIMT) progression in treated HIV infection. DESIGN: Longitudinal observational study of 118 treated and virologically suppressed individuals. METHODS: We measured biomarkers of immune activation at baseline using cryopreserved samples. CIMT was measured at baseline and longitudinally using high-resolution ultrasound. Linear regression was used to estimate biomarker associations with CIMT progression, and logistic regression was used to model plaque progression. RESULTS: The median duration of follow-up was 2.0 years. The median annual rate of change in mean CIMT was 6.0%. Rates of progression were more rapid in the bifurcation (5.6%/year, P = 0.006) and internal (6.5%/year, P = 0.0008) than common CIMT (4.3%/year). Incident plaque occurred in 13 of the 52 individuals without baseline plaque. In multivariable adjusted analysis, plasma tissue factor and monocyte chemoattractant protein-1 were associated with more rapid common CIMT progression (0.058 mm/year, P = 0.0004 and 0.067 mm/year, P = 0.017; all estimates per doubling). CD8 T-cell count and percentage of HLA-DRCD38CD8 T cells were associated with more rapid internal CIMT progression (0.10 mm/year, P = 0.008 and 0.054 mm/year, P = 0.045). CD8 T-cell count was also associated with 0.068 mm/year more rapid mean CIMT progression (P = 0.011). Each 10% increase in CD4 T-cell count at baseline was associated with a 34% reduced odds of plaque progression (P = 0.018). CONCLUSION: Residual immune activation and plasma tissue factor are independently associated with CIMT progression in treated HIV infection. Interventions targeting coagulation and inflammatory pathways to reduce cardiovascular disease risk in HIV merit additional investigations.

Prevalence, risk factors and genetic characterization of Toxoplasma gondii in sick pigs and stray cats in Jiangsu Province, eastern China.

Toxoplasma gondii is an obligate intracellular parasitic protozoan with a worldwide distribution. The parasites in edible tissues of pigs and oocysts from cats are the major sources of T. gondii infection in humans. However, there are no data from sick pigs in veterinary clinics or from stray cats in Jiangsu Province, eastern China. In total, biological samples from 141 sick pigs and 64 stray cats were collected from this region. The rate of T. gondii infection in sick pigs was 46.81% using a polymerase chain reaction (PCR), and the overall prevalence of toxoplasmosis in stray cats was 34.38% by PCR and an enzyme-linked immunosorbent assay (ELISA). T. gondii was significantly more prevalent in lungs and heart than in liver and spleen (P < 0.05). Age and geographic region were considered to be the main risk factors associated with T. gondii infection in these pigs. The DNA samples from 17 sick pigs and seven stray cats, were successfully genotyped by multilocus PCR-restriction fragment length polymorphism (PCR-RFLP) with 10 genetic markers [SAG1, SAG2 (5'-3'SAG2, alt. SAG2), SAG3, GRA6, PK1, c22-8, c29-2, BTUB, L358 and Apico]. Six distinct genotypes were found, which were designated ToxoDB PCR-RFLP genotypes #9 (Chinese I), #10 (Type I), #213, and #89, and New 1 and New 2. Chinese I is the most prevalent T. gondii genotype in this region. The two new genotypes (designated New 1 and New 2) are reported and the ToxoDB PCR-RFLP genotype #89 is found for the first time in China. Such information will be useful for the prevention, diagnosis and treatment of porcine toxoplasmosis in Jiangsu Province, eastern China.

The reason for the amelioration of N-methyl-N-nitrosourea-induced retinitis pigmentosa in rats by hydrogen-rich saline.

AIM: To investigate the effects of hydrogen-rich saline (HRS) on microglia activation and Sirtuin type 1 (Sirt1) in rats with N-methyl-N-nitrosourea (MNU)-induced retinitis pigmentosa (RP). METHODS: Rats were divided into norm (N) group, model (M) group and HRS (H) group. Rats in M and H groups were given saline and HRS respectively prior to and after administration of MNU. At one day (d1) and d3 afterwards, electroretinogram and histological examination were performed to confirm the effects of HRS on retinal function and structure of MNU-induced RP. Immunofluorescence staining of anti-ionized calcium-binding adapter molecule 1 (Iba1), a maker of microglia cells, was performed, with quantitative real-time polymerase chain reaction (qRT-PCR) for its mRNA quantification. Moreover, Sirt1 mRNA and protein expression in the retinas were detected by Western blot and qRT-PCR. RESULTS: HRS preserved the retinal function and mitigated the reduction of photoreceptor degeneration in MNU-treated retinas. The presence of microglia cells was somewhat more obvious in H group than that in M group at d1. HRS suppressed the further activation of microglia cells, with the number of microglia cells less than that of M group at d3. Results of qRT-PCR of Iba1 were consistent with those of immunofluorescence staining, with the mRNA expression of Iba1 in H group more intensive than that of M group at d1 (P<0.05), while less than that of M group at d3 (P<0.05). Furthermore, the Sirt1 mRNA and protein expression decreased after MNU administration, while HRS mitigated the MNU-induced downregulation of Sirt1. CONCLUSION: HRS can effectively keep microglia activation induced by MNU to an appropriate extent, while upregulate Sirt1 in MNU-induced RP.

Plasma IL-6 levels are independently associated with atherosclerosis and mortality in HIV-infected individuals on suppressive antiretroviral therapy.

OBJECTIVE: To determine the associations of markers of immune activation with atherosclerosis and mortality, in participants with treated and suppressed HIV infection. DESIGN: Observational study of 149 HIV-infected participants with virologic suppression on antiretroviral therapy. METHODS: Cryopreserved mononuclear cells and plasma were used to evaluate markers of T cell and monocyte activation, inflammation and coagulopathy. Carotid artery intima-media thickness (CIMT) was measured by high-resolution ultrasound at the common, bifurcation and internal carotid regions. Associations of immunologic markers with CIMT and all-cause mortality were assessed using multivariable linear regression and Cox proportional hazards regression. RESULTS: The majority of participants were men (93%) and white (67%), median age of 48.5 years and median CD4 T-cell count of 522 cells/µl. The median baseline IMT was 1.0 mm. Over a median of 8.3-year follow-up, 12 deaths occurred. In multivariate analysis, adjusted for traditional cardiovascular risk factors, higher monocyte C-C motif chemokine receptor 5 (CCR5) expression [5.4%, P = 0.001] was associated with greater common CIMT. Higher plasma IL-6 was associated with greater bifurcation [8.0%, P = 0.007] and overall mean IMT [5.2%, P = 0.026]. Finally, higher plasma IL-6 [hazard ratio 1.9, P = 0.030], internal carotid [hazard ratio 4.1, P = 0.022] and mean IMT [hazard ratio 5.2, P = 0.026] were individually associated with all-cause mortality. CONCLUSION: Higher monocyte CCR5 expression and plasma IL-6 were associated with atherosclerosis, independent of traditional cardiovascular risk factors. IL-6 and CIMT were individually associated with all-cause mortality. The impact of therapies targeting immune activation in cardiovascular disease in treated HIV infection merits additional investigation.

Colonoscopy Reduces Colorectal Cancer Incidence and Mortality in Patients With Non-Malignant Findings: A Meta-Analysis.

OBJECTIVES: Observational studies have shown that colonoscopy reduces colorectal cancer (CRC) incidence and mortality in the general population. We aimed to conduct a meta-analysis quantifying the magnitude of protection by colonoscopy, with screening and diagnostic indications, against CRC in patients with non-malignant findings and demonstrating the potentially more marked effect of screening over diagnostic colonoscopy. METHODS: PubMed, EMBASE, and conference abstracts were searched through 30 April 2015. The primary outcomes were overall CRC incidence and mortality. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated using random-effect models. RESULTS: Eleven observational studies with a total of 1,499,521 individuals were included. Pooled analysis showed that colonoscopy was associated with a 61% RR reduction in CRC incidence (RR: 0.39; 95% CI: 0.26-0.60; I(2)=93.6%) and a 61% reduction in CRC mortality (RR: 0.39; 95% CI: 0.35-0.43; I(2)=12.0%) in patients with non-malignant findings, although there was high heterogeneity for the outcome of CRC incidence. After excluding one outlier study, there was low heterogeneity for the outcome of incidence (I(2)=44.7%). Subgroup analysis showed that the effect of screening colonoscopy was more prominent, corresponding to an 89% reduction in CRC incidence (RR: 0.11; 95% CI: 0.08-0.15), in comparison with settings involving diagnostic colonoscopy (RR: 0.51; 95% CI: 0.43-0.59; P<0.001). CONCLUSIONS: On the basis of this meta-analysis of observational studies, CRC incidence and mortality in patients with non-malignant findings are significantly reduced after colonoscopy. The effect of screening colonoscopy on CRC incidence is more marked than diagnostic colonoscopy.