Magnifying image-enhanced endoscopy-only mode boosted early cancer diagnostic efficiency: a multicenter randomized controlled trial.

BACKGROUND AND AIMS: Magnifying image-enhanced endoscopy (MIEE) is an advanced endoscopy with image enhancement and magnification used in preoperative examination. However, its impact on the detection rate is unknown. METHODS: We conducted an open-label, randomized, parallel (1:1:1), controlled trial in 6 hospitals in China. Patients were recruited between February 14, 2022 and July 30, 2022. Eligible patients were aged ≥18 years and undergoing gastroscopy in outpatient departments. Participants were randomly assigned to the MIEE-only mode (o-MIEE) group, white-light endoscopy-only mode (o-WLE) group, and MIEE when necessary mode (n-MIEE) group (initial WLE followed by switching to another endoscope with MIEE if necessary). Biopsy sampling of suspicious lesions of the lesser curvature of the gastric antrum was performed. Primary and secondary aims were to compare detection rates and positive predictive value (PPV) of early cancer and precancerous lesions in these 3 modes, respectively. RESULTS: A total of 5100 recruited patients were randomly assigned to the o-MIEE (n = 1700), o-WLE (n = 1700), and n-MIEE (n = 1700) groups. In the o-MIEE, o-WLE, and n-MIEE groups, 29 (1.51%; 95% confidence interval [CI], 1.05-2.16), 4 (.21%; 95% CI, .08-.54), and 8 (.43%; 95% CI, .22-.85) early cancers were found, respectively (P < .001). The PPV for early cancer was higher in the o-MIEE group compared with the o-WLE and n-MIEE groups (63.04%, 33.33%, and 38.1%, respectively; P = .062). The same trend was seen for precancerous lesions (36.67%, 10.00%, and 21.74%, respectively). CONCLUSIONS: The o-MIEE mode resulted in a significant improvement in diagnosing early upper GI cancer and precancerous lesions; thus, it could be used for opportunistic screening. (Clinical trial registration number: ChiCTR2200064174.).

Plasma VWF: Ag levels predict long-term clinical outcomes in patients with acute myocardial infarction.

Background: A vital role in coronary artery disease is played by Von Willebrand factor (VWF), which serves as a bridge between platelets and the subendothelial matrix after vessel damage. The purpose of the study was to assess the validity of plasma VWF antigen (VWF: Ag) levels as a predictor of clinical outcomes after acute myocardial infarction (AMI). Methods: Three hundred and seventy-four patients were studied following coronary angiography, including 209 patients suffering from acute myocardial infarction and 165 healthy participants. Coronary angiography was followed by measurement of plasma VWF: Ag levels. Over a 2-year follow-up period, major adverse cardiopulmonary and cerebrovascular events (MACEs) were the primary endpoint. All-cause mortality was investigated as a secondary endpoint. Results: When compared to controls, patients with AMI had mean plasma VWF: Ag levels that were ~1.63 times higher (0.860 ± 0.309 vs. 0.529 ± 0.258 IU/ml; P < 0.001). The plasma VWF: Ag levels were substantially higher in patients who experienced MACEs after myocardial infarction vs. those without MACEs (1.088 ± 0.253 vs. 0.731 ± 0.252 IU/ml; P < 0.001). For predicting long-term MACEs using the optimal cut-off value (0.7884 IU/ml) of VWF: Ag, ROC curve area for VWF: Ag was 0.847, with a sensitivity of 87.2% and a specificity of 66.3% (95%CI: 0.792-0.902; P = 0.001). Two-year follow-up revealed a strong link between higher plasma VWF: Ag levels and long-term MACEs. At the 2-year follow-up, multivariate regression analysis revealed an independent relationship between plasma VWF: Ag levels and MACEs (HR = 6.004, 95%CI: 2.987-12.070). Conclusion: We found evidence that plasma VWF: Ag levels were independent risk factors for AMI. Meanwhile, higher plasma VWF: Ag levels are associated with long-term MACEs in people with AMI.

Investigation on the zoonotic trematode species and their natural infection status in Huainan areas of China.

BACKGROUND: To investigate the species of zoonotic trematodes and the endemic infection status in the domestic animals in Huainan areas, north Anhui province of China, we intent to provide evidences for prevention of the parasitic zoonoses. METHODS: The livestock and poultry (definitive hosts) were purchased from the farmers living in the water areas, including South Luohe, Yaohe, Jiaogang and Gaotang Lakes, and dissected the viscera of these collected hosts to obtain the parasitic samples. Then the specimens were microscopically identified, with reference to the descriptions in previous literatures for counting the zoonotic species found in these areas. RESULTS: A total of 41 species were detected in the domestic samples, in which 23 were zoonotic trematodes, and 18 were internal trematodes of animals. Of the 41 species, 38 were novel records in Huainan areas, and 12 were newly detected in Anhui province, including Metorchis anatinus, Echinostoma hortense, E. cinetorchis, E. angustitestis, E. lindoensis, E. nordiana, E. ilocanum, Metagonimus yokogawai, Prosthogonimus gracilis, P. skrjabini, P. anatinusand Trichobilharzia sp. which generally occurred in definitive hosts of chicken, ducks, geese, dogs, cattle, buffaloes, sheep, goats and pigs, respectively. CONCLUSION: A large quantity of livestock and poultry are fed by the local farmers living along the river banks in Huainan area, suggesting that the population in that area are at higher risks of natural focus of zoonotic infections, since these animals are favorable definitive hosts to the zoonotic trematodes.

Investigation on the zoonotic trematode species and their natural infection status in Huainan areas of China / Investigación sobre las especies de trematodos zoonóticos y su estado natural de infección en las zonas de Huainan en China

Background: To investigate the species of zoonotic trematodes and the endemic infection status in the domestic animals in Huainan areas, north Anhui province of China, we intent to provide evidences for prevention of the parasitic zoonoses. Methods: The livestock and poultry (definitive hosts) were purchased from the farmers living in the water areas, including South Luohe, Yaohe, Jiaogang and Gaotang Lakes, and dissected the viscera of these collected hosts to obtain the parasitic samples. Then the specimens were microscopically identified, with reference to the descriptions in previous literatures for counting the zoonotic species found in these areas. Results: A total of 41 species were detected in the domestic samples, in which 23 were zoonotic trematodes, and 18 were internal trematodes of animals. Of the 41 species, 38 were novel records in Huainan areas, and 12 were newly detected in Anhui province, including Metorchis anatinus, Echinostoma hortense, E. cinetorchis, E. angustitestis, E. lindoensis, E. nordiana, E. ilocanum, Metagonimus yokogawai, Prosthogonimus gracilis, P. skrjabini, P. anatinus and Trichobilharzia sp. which generally occurred in definitive hosts of chicken, ducks, geese, dogs, cattle, buffaloes, sheep, goats and pigs, respectively. Conclusion: A large quantity of livestock and poultry are fed by the local farmers living along the river banks in Huainan area, suggesting that the population in that area are at higher risks of natural focus of zoonotic infections, since these animals are favorable definitive hosts to the zoonotic trematodes (AU)

Introducción: para investigar las especies de trematodos zoonóticos y el estado de infección endémica en los animales domésticos en áreas de Huainan, al norte de la provincia de Anhui, China, tenemos la intención de proporcionar evidencias para la prevención de enfermedades zoonóticas. Métodos: el ganado y las aves (hospedadores definitivos) fueron adquiridos a los campesinos que viven en las zonas con agua, incluyendo el sur de Luohe, Yaohe, Jiaogang y Gaotang Lagos, y se diseccionaron las vísceras de estos anfitriones recogidos para obtener las muestras parasitarias. Las muestras fueron identificadas microscópicamente, con referencia a las descripciones de la literatura revisada para contar las especies zoonóticas que se encuentran en estas áreas. Resultados: se detectaron un total de 41 especies en las muestras nacionales, de las que 23 eran trematodos zoonóticos y 18 eran trematodos internos de los animales. Estas especies representaron 22 géneros en 12 familias de 4 órdenes. De las 41 especies, 38 fueron registros nuevos en las áreas de Huainan y 12 fueron detectadas recientemente en la provincia de Anhui, incluyendo Metorchis anatinus, Echinostoma hortense, E. cinetorchis, E. angustitestis, E. lindoensis, E. nordiana, Euparyphium ilocanum, Metagonimus yokogawai, Prosthogonimus gracilis, P. skrjabini, P. anatinus y Trichobilharzia sp., generalmente producidos en huéspedes definitivos de pollo, patos, gansos, perros, vacas, búfalos, ovejas, cabras y cerdos, respectivamente. Conclusión: los agricultores locales que viven a lo largo de las orillas del río se alimentan de gran cantidad de ganado y aves de corral de la zona de Huainan, lo que sugiere que la población en esa área tiene mayor riesgo ante el foco natural de las infecciones zoonóticas, ya que estos animales son huéspedes definitivos favorables a los trematodos zoonóticos (AU)

Health-related quality of life as measured with the Short-Form 36 (SF-36) questionnaire in patients with recurrent vulvovaginal candidiasis.

BACKGROUND: Recurrent vulvovaginal candidiasis (RVVC) has a poor therapeutic outcome and a severe impact on women and their partners, both physically and psychologically. Health-related quality of life (HRQOL) is significantly affected in patients with RVVC; however, little is known about HRQOL in patients with this disease. In this study, we aim to identify the clinical and mycological characteristics of women with RVVC and the effects of RVVC on women's HRQOL. METHODS: We designed this study as a comparative cross-sectional study. The Short-Form Health Survey (SF-36) was used to measure HRQOL in 102 patients with RVVC and 101 women seeking general health care (controls). RVVC was defined as four or more episodes of proven VVC in the previous 12-month period. VVC was defined as vulvar itching, burning, erythema, vaginal discharge, pseudohyphae or blastoconidia on a wet 10 % potassium hydroxide (KOH)-treated vaginal slide and a positive Candida culture. Group comparisons were conducted with independent samples t test. Correlation analysis was performed on the variables. RESULTS: The mean age at first diagnosis of the patients with RVVC was 30.96 years (SD 5.38), and the mean age of the controls was 29.75 years (SD 5.83; p > 0.05). The duration of the patients' complaints varied from 6 months to 10 years, with a mean duration of 22.28 (±21.75) months. The most common complaints were increased vaginal discharge (102 cases, 100 %), itching (97 cases, 95.1 %), dyspareunia (65 cases, 63.7 %), burning (79 cases, 77.5 %) and erythema (25 cases, 24.5 %). C. albicans was the predominant Candida species (86 strains, 84.3 %) in the patients, followed by C. glabrata (12 strains, 11.8 %). C. parapsilosis (1 strain, 0.9 %), C. tropicalis (1 strain, 0.9 %), C. krusei (1 strain, 0.9 %) and C. lusitaniae (1 strain, 0.9 %). The mean SF-36 dimension scores for physical function, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health were significantly lower in the patients with RVVC than in the controls (85.20, 61.39, 77.79, 54.95, 53.17, 67.89, 52.48 and 59.17 vs. 90.20, 80.87, 87.08, 67.38, 59.69, 79.86, 68.01 and 65.38). The physical composite and mental composite scores of the patients with RVVC were 63.06 and 64.87, respectively, which were lower than those of the controls (75.01 and 74.87; p < 0.05). CONCLUSIONS: Nearly all of the patients with RVVC had clinical symptoms. In our sample, RVVC was mainly caused by C. albicans. RVVC has negative effects on women's HRQOL, as indicated by lower physical and mental composite scores among the RVVC group compared with controls.

Developing multi-cellular tumor spheroid model (MCTS) in the chitosan/collagen/alginate (CCA) fibrous scaffold for anticancer drug screening.

In this work, a 3D MCTS-CCA system was constructed by culturing multi-cellular tumor spheroid (MCTS) in the chitosan/collagen/alginate (CCA) fibrous scaffold for anticancer drug screening. The CCA scaffolds were fabricated by spray-spinning. The interactions between the components of the spray-spun fibers were evidenced by methods of Coomassie Blue stain, X-ray diffraction (XRD) and Fourier transform-infrared spectroscopy (FTIR). Co-culture indicated that MCF-7 cells showed a spatial growth pattern of multi-cellular tumor spheroid (MCTS) in the CCA fibrous scaffold with increased proliferation rate and drug-resistance to MMC, ADM and 5-Aza comparing with the 2D culture cells. Significant increases of total viable cells were found in 3D MCTS groups after drug administration by method of apoptotic analysis. Glucose-lactate analysis indicated that the metabolism of MCTS in CCA scaffold was closer to the tumor issue in vivo than the monolayer cells. In addition, MCTS showed the characteristic of epithelial mesenchymal transition (EMT) which is subverted by carcinoma cells to facilitate metastatic spread. These results demonstrated that MCTS in CCA scaffold possessed a more conservative phenotype of tumor than monolayer cells, and anticancer drug screening in 3D MCTS-CCA system might be superior to the 2D culture system.

[Traditional Chinese Medicine Treatment of Gouty Arthritis Based on Syndrome Differentiation].

OBJECTIVE: To observe the clinical effect and safety of traditional Chinese medicine (TCM) treatment in gouty arthritis (GA) based on syndrome differentiation. METHODS: 81 patients of GA were enrolled from August 2013 to August 2014. They were divided into syndrome differentiation treatment group (27 cases), disease differentiation treatment group (27 cases) and basic treatment group (27 cases). The patients in syndrome differentiation treatment group were given corresponding TCM drug granules prescription by dialectical syndromes classification. The patients in disease differentiation treatment group were given TCM drug granules prescription. The patients in basic treatment group.were only given Diclofenac Sodium sustained-release tablets in acute phase, and Benzbromarone tablets in chronic phase. After 12 weeks treatments, all the patients received the measurements of serum uric acid (SUA), serum creatinine (SCr), blood urea nitrogen (BUN), triacylglycerol (TG), cholesterol (TC). The clinical efficacy, recurrence rate and adverse reactions were recorded and analyzed. RESULTS: Syndrome differentiation treatment group achieved higher clinical efficacy than basic treatment group and disease differentiation treatment group (P<0. 05). Moreover, syndrome differentiation treatment were superior to disease differentiation treatment in improving of recurrence rate (P<0. 05). There were no obvious adverse reactions occurred. There were no clinical significant changes in blood, urine routine analysis, and electrocardiogram examination before and 3 months after the treatments. CONCLUSION: The treatment of TCM in patients with GA based on syndrome differentiation showed definite therapeutic effects.

[Trematode Aspidogastrea found in Huaihe River].

OBJECTIVE: To investigate the epidemic situation of trematode Aspidogastrea in the Huaihe River. METHODS: The mussels in the Huaihe River were collected, numbered and dissected to detect the trematode; and the species of trematodes were identified after dyeing. RESULTS: Totally 79 mussels were collected, and the trematode Aspidogastrea were found from 23 mussels with the infection rate of 29.11%; 209 trematode Aspidogastrea were collected and the average infectiosity of mussels was 9.09. CONCLUSION: Trematode Aspidogastrea is endemic in the Huaihe River and the species is Aspidogaster sp.

[Zoonotic trematode species identified in domestic animals from Huainan area].

OBJECTIVE: To understand the zoonotic trematode species identified in domestic animals from Huainan area, Anhui Province, so as to supply the evidence for the prevention of zoonoses. METHODS: The livestock/definitive hosts were commercially available on category basis, and sacrificed for obtaining the parasitic samples via dissecting the viscera. The specimens were microscopically identified, with reference to the descriptions in the previous literature. RESULTS: By identification, sorting and classification, 41 species of internal trematodes were found so far in the domestic animals fed in Huainan areas, in which 23 species were zoonotic trematodes and 18 were internally parasitic in livestock, belonging to 4 orders, 12 families and 21 genera, and occurred in 9 definitive hosts including chicken, ducks, geese, pigs, cattle, buffaloes, sheep, goats and dogs, respectively. CONCLUSION: The findings suggest that the zoonotic trematodes belong to many kinds and prevalent in the domestic animals in Huainan areas, and such prevalence should call for high attention since it is urgent risk factors for zoonoses in this geographic area.

[Optimization of the ultrasound assisted extraction of saikosaponins from Bupleurum falcatum using response surface methodology].

OBJECTIVE: To investigate the optimization of extraction conditions of saikosaponins a, c and d from Bupleurum falcatum. METHODS: Experimental factors and levels were firstly selected by one-factor test. According to the central composite experimental design principle, the response surface methodology with 3 factors and 3 levels was adopted. Used HPLC to determine the contents of saikosaponins a, c and d. Used column symmetry C18 (150 mm x 4.6 mm, 5 microm); Mobile phase was acetonitrile-water gradient elution, flow rate was 1.0 mL/min, the detection wavelength was 200 nm, detecting temperature was 25 degrees C. RESULTS: The optimum conditions of aikosaponins extraction were as follows:extraction time was 93 min, power was 150 W, solvent to solid ratio was 60. The predicted total saikosaponin extraction yield was 13.66 mg/g,while the actual extraction yield was 13.64 mg/g, with relative error of 0.15%. CONCLUSION: The optimum extraction process is reasonable, reliable and high yield of extracting effective content.

[Survey on natural nidus of Metorchis orientalis in Huaihe River Basin].

Parafossarulus striatulus, Pseudorasbora parva and brood ducks are involved in the lifecycle of Metorchis orientalis. Natural nidi of M. orientalis are confirmed in Huaihe River Basin.

Chronic liver fluke disease with dyspepsia: a case report.

BACKGROUND: Chronic liver fluke disease with dyspepsia is rarely seen clinically. In this study, we assessed the etiological factors, symptoms, physical signs and diadynamic methods in a case of chronic liver fluke disease with dyspepsia. METHODS: Physical examination, laboratory studies, ultrasonography and CT scan were performed before pathogen examination. The eggs of fluke found with the inverted sedimentation method were also observed under a microscopy. They were diagnosed as the eggs of Clonorchis sinensis. RESULTS: The patient was diagnosed as having chronic liver fluke disease, and his appetite recovered after three courses of treatment with praziquantel. CONCLUSION: Eating fresh fish and shrimp might cause liver fluke disease. The symptoms of this disease with dyspepsia can be anorexia, abdominal distention, bellyache, and loose stools.

Extraction of protoporphyrin disodium and its inhibitory effects on HBV-DNA.

AIM: To explore an ideal method for extracting protoporphyrin disodium (PPN) from unanticoagulated animal blood, and to study the inhibitory effects of PPN on HBV-DNA duplication and its cytotoxicity to 2.2.15 cell strain. METHODS: Protoporphyrin methyl ester and other intermediate products were prepared with protoheme separated from protein hydrolysates of coagulated animal blood, which were finally made into PPN and detected quantitatively with an ultraviolet fluorescent analyzer. Ten microg/ml, 20 microg/ml, 40 microg/ml, 80 microg/ml and 160 microg/ml of PPN-aqueous solution were added into culture medium for 2.2.15 cells respectively. Eight days later, the drug concentration in supernatant from the culture medium was detected when inhibition rate of HBeAg, cell survival rate when inhibition rate of HBeAg was 50% (ID50), and when survival cells in experimental group were 50% of those in control group (CD50), and the therapeutic index (TI) was also detected. PPN with different concentration of 10 microg/ml, 20 microg/ml, 40 microg/ml, 80 microg/ml and 160 microg/ml was respectively mixed and cultivated with HepG2 2.2.15 cell suspension, and then the inhibition of PPN against HBV-DNA was judged by PCR. RESULTS: The extract of henna crystal was identified to be PPN. When the concentrations of PPN were 160 microg/ml and 80 microg/ml, the inhibition rates of HBeAg were 89.8% and 82.4%, and the cell survival rates were 98.7% and 99.2%. CONCLUSION: It is suggested that PPN can be extracted from unanticoagulated animal blood. PPN can inhibit HBV-DNA expression and duplication in vitro, and has no cytotoxicity to liver cells. Further study and application of PPN are warranted.