Quantitation of Atmospheric Suspended Polystyrene Nanoplastics by Active Sampling Prior to Pyrolysis-Gas Chromatography-Mass Spectrometry.

Plastic has been demonstrated to release nanoplastics (NPs) into the atmosphere under sunlight irradiation, posing a continuous health risk to the respiratory system. However, due to lack of reliable quantification methods, the occurrence and distribution of NPs in the atmosphere remain unclear. Polystyrene (PS) micro- and nanoplastics (MNPs) represent a crucial component of atmospheric MNPs. In this study, we proposed a simple and robust method for determining the concentration of atmospheric PS NPs using pyrolysis-gas chromatography-mass spectrometry (Py-GC/MS). Following active sampling, the filter membrane is directly ground and introduced into the Py-GC/MS system to quantify PS NPs. The proposed method demonstrates excellent reproducibility and high sensitivity, with a detection limit as low as down to 15 pg/m3 for PS NPs. By using this method, the occurrence of PS NPs in both indoor and outdoor atmospheres has been confirmed. Furthermore, the results showed that the abundance of outdoor PS NPs was significantly higher than that of indoor samples, and there was no significant difference in NP vertical distribution within a height of 28.6 m. This method can be applied for the routine monitoring of atmospheric PS NPs and for evaluating their risk to human health.

Removal of iodide anions in water by silver nanoparticles supported on polystyrene anion exchanger.

The removal of iodide (I-) from source waters is an effective strategy to minimize the formation of iodinated disinfection by-products (DBPs), which are more toxic than their brominated and chlorinated analogues. In this work, a nanocomposite Ag-D201 was synthesized by multiple in situ reduction of Ag-complex in D201 polymer matrix, to achieve highly efficient removal of iodide from water. Scanning electron microscope /energy dispersive spectrometer characterization showed that uniform cubic silver nanoparticles (AgNPs) evenly dispersed in the D201 pores. The equilibrium isotherms data for iodide adsorption onto Ag-D201 was well fitted with Langmuir isotherm with the adsorption capacity of 533 mg/g at neutral pH. The adsorption capacity of Ag-D201 increased with the decrease of pH in acidic aqueous solution, and reached the maximum value of 802 mg/g at pH 2. This was attributed to the oxidization of I-, by dissolved oxygen under the catalysis of AgNPs, to I2 which was finally adsorbed as AgI3. However, the aqueous solutions at pH 7 - 11 could hardly affect the iodide adsorption. The adsorption of I- was barely affected by real water matrixes such as competitive anions (SO42-, NO3-, HCO3-, Cl-) and natural organic matter, of which interference of NOM was offset by the presence of Ca2+. The proposed synergistic mechanism for the excellent performance of iodide adsorption by the absorbent was ascribed to the Donnan membrane effect caused by the D201 resin, the chemisorption of I- by AgNPs, and the catalytic effect of AgNPs.

Gaseous Arsenic Capture in Flue Gas by CuCl2-Modified Halloysite Nanotube Composites with High-Temperature NOx and SOx Resistance.

Gaseous arsenic emitted from coal combustion flue gas (CCFG) causes not only severe contamination of the environment but also the failure of selective catalytic reduction (SCR) catalysts in power plants. Development of inexpensive and effective adsorbents or techniques for the removal of arsenic from high-temperature CCFG is crucial. In this study, halloysite nanotubes (HNTs) at low price were modified with CuCl2 (CuCl2-HNTs) through ultrasound assistance and applied for capturing As2O3(g) in simulated flue gas (SFG). Experiments on arsenic adsorption performance, adsorption mechanism, and adsorption energy based on density functional theory were performed. Modification with CuCl2 clearly enhanced the arsenic uptake capacity (approximately 12.3 mg/g) at 600 °C for SFG. The adsorbent exhibited favorable tolerance to high concentrations of NOx and SOx. The As2O3(III) was oxidized and transformed into As2O5(V) on the CuCl2-HNTs. The Al-O bridge had the highest adsorption energy for the O end of the As-O group (-2.986 eV), and the combination formed between arsenic-containing groups and aluminum was stable. In addition, the captured arsenic could be stabilized in the sorbent at high temperature, making it possible to use the sorbent before the SCR system. This demonstrates that CuCl2-HNTs is a promising sorbent for arsenic oxidation and removal from CCFG.

Sequential Isolation of Microplastics and Nanoplastics in Environmental Waters by Membrane Filtration, Followed by Cloud-Point Extraction.

Respective detection of microplastics (MPs) and nanoplastics (NPs) is of great importance for their different environmental behaviors and toxicities. Using spherical polystyrene (PS) and poly(methyl methacrylate) (PMMA) plastics as models, the efficiency for sequential isolation of MPs and NPs by membrane filtration and cloud-point extraction was evaluated. After filtering through a glass membrane (1 µm pore size), over 90.7% of MPs were trapped on the membrane, whereas above 93.0% of NPs remained in the filtrate. The collected MPs together with the glass membrane were frozen in liquid nitrogen, ground, and suspended in water (1 mL) and subjected to pyrolysis-gas chromatography-mass spectrometry (Py-GC/MS) determination. The NPs in the filtrate were concentrated by cloud-point extraction, heated at 190 °C to degrade the extractant, and then determined by Py-GC/MS. For MPs and NPs spiked in pure water, the method detection limits are in the range of 0.05-1.9 µg/L. The proposed method is applied to analyze four real water samples, with the detection of 1.6-7.6 µg/L PS MPs and 0.6 µg/L PMMA MPs in three samples, and spiked recoveries of 75.0-102% for MPs and 67.8-87.2% for NPs. Our method offers a novel sample pretreatment approach for the respective determination of MPs and NPs.

Distribution and chemical speciation of arsenic in different sized atmospheric particulate matters.

The distribution and chemical speciation of arsenic (As) in different sized atmospheric particulate matters (PMs), including total suspended particles (TSP), PM10, and PM2.5, collected from Baoding, China were analyzed. The average total mass concentrations of As in TSP, PM10, and PM2.5 were 31.5, 35.3, and 54.1 µg/g, respectively, with an order of PM2.5 >PM 10 > TSP, revealing that As is prone to accumulate on fine particles. Due to the divergent toxicities of different As species, speciation analysis of As in PMs is further conducted. Most of previous studies mainly focused on inorganic arsenite (iAsIII), inorganic arsenate (iAsV), monomethylarsonate (MMA), and dimethylarsinate (DMA) in PMs, while the identification and sensitive quantification of trimethylarsine oxide (TMAO) were rarely reported. In this study, a high-performance liquid chromatography coupled to inductively coupled plasma mass spectrometry system was optimized for As speciation including TMAO in PMs. An anion exchange column was used to separate MMA, DMA and iAsV, while a cation exchange column to separate TMAO and iAsIII. Results showed that iAsV was the dominate component in all the samples, corresponding to a portion of 79.2% ± 9.3% of the total extractable species, while iAsIII, TMAO and DMA made up the remaining 21%. Our study demonstrated that iAsIII accounted for about 14.4% ± 11.4% of the total extracted species, with an average concentration of 1.7 ± 1.6 ng/m3. It is worth noting that TMAO was widely present in the samples (84 out of 97 samples), which supported the assumption that TMAO was ubiquitous in atmospheric particles.

Speciation Analysis of the Uptake and Biodistribution of Nanoparticulate and Ionic Silver in Escherichia coli.

A new method was developed to determine the nanoparticulate and ionic silver (Ag) species in bacteria (Escherichia coli, E. coli). By removal of the cell wall with lysozyme, the cell surface-adsorbed Ag species were separated from the intracellular Ag species, which were extracted by tetramethylammonium hydroxide and determined by size-exclusion chromatography coupled with inductively coupled plasma mass spectrometry (SEC-ICP-MS). The detection limit is 3 ng/107 CFU/mL (where CFU is colony-forming unit) for both silver nanoparticles (AgNPs) and ionic Ag(I) species. The cell wall-adsorbed Ag was calculated by subtracting the contents of the intra- and extracellular Ag from the total exposure dose of Ag, and therefore the biodistribution of Ag species was profiled. We then applied this strategy to quantitatively analyze extra- and intracellular Ag species in E. coli after respective exposure to Ag+ and 10 and 30 nm AgNPs at different effective concentrations (EC10, EC50, and EC90). Results showed that the intracellular and cell wall-bound Ag account for 5.98-15.21% and 25.13-64.43% of the exposed dose, respectively, and AgNPs could transform into complexed or free Ag+. Our method opens new avenues for the quantitative analysis of the uptake and biodistribution of nanoparticles and their transformation species in bacteria.

Intracellular Dissolution of Silver Nanoparticles: Evidence from Double Stable Isotope Tracing.

To track transformations of silver nanoparticles (AgNPs) in vivo, HepG2 and A549 cells were cocultured with two enriched stable Ag isotopes (107AgNPs and 109AgNO3) at nontoxic doses. After enzymatic digestion, 107AgNPs, ionic 107Ag+ and 109Ag+ in exposed cells could be separated and quantified by liquid chromatography combined with ICP-MS. We found that ratios of 107Ag+ to total 107Ag and proportions of 107Ag+/ 109Ag+ in cells increased gradually after exposure, proving that the Trojan-horse mechanism occurred, i.e., AgNPs released high contents of Ag+ after internalization. While the presence of 109Ag+ (5 and 100 µg/L) has little influence on the uptake of 107AgNPs (0.1 and 2 mg/L), the presence of 107AgNPs at a high dose (2 mg/L) dramatically increases the ingestion of 109Ag+, even though 107AgNPs at a low dose (100 µg/L) showed negligible effects on the internalization of 109Ag+. Cellular homeostasis may be perturbed under sublethal exposure of 107AgNPs, and thus enhanced uptake of 109Ag+. Our findings suggest that the widely adopted control experiments in toxicology studies, culturing organisms with AgNO3 at the same concentration of Ag+ in the AgNP exposure medium, may underestimate uptake of Ag+ and thus cannot exclude suspected toxic effects of Ag+ at high AgNP exposure doses.

An Ultraviolet Nonlinear Optic Borate with 13-Ring Channels Constructed from Different Building Units.

Under solvothermal conditions, a chair open-framework borate, Na2B9O15(H2O)(H3O) (1), has been synthesized. Compound 1 shows regular pores of zeolites as well as nonlinear optical (NLO) properties of borates. The large 13-ring channels of the boron oxide framework are constructed from different cluster units of B3O7 and B6O13 with three-ring units. The second harmonic generation (SHG) signal intensity of 1 is similar to that of KH2PO4 (KDP) and gradually increased with larger particle size. Compound 1 is a potential UV NLO material for its short wavelength absorption edge.

Centrosymmetric (Hdima)2[Ge5B3O15(OH)] and Noncentrosymmetric Na4Ga3B4O12(OH): Solvothermal/Surfactant-Thermal Synthesis of Open-Framework Borogermanate and Galloborate.

Under solvothermal/surfactant-thermal conditions, two new open-framework borogermanate and galloborate, centrosymmetric (Hdima)2[Ge5B3O15(OH)] (1; dima = dimethylamine) and noncentrosymmetric Na4Ga3B4O12(OH) (2), were obtained and characterized. Compound 1 contains an unusual basket-shaped Ge5B3O18(OH) cluster and displays a 3D open-framework layered structure. Compound 2 shows an interrupted 3,4-connected network constructed by alternately linked BO3 units and Ga3+ ions and displays weak second-harmonic-generation response.

Speciation Analysis of Labile and Total Silver(I) in Nanosilver Dispersions and Environmental Waters by Hollow Fiber Supported Liquid Membrane Extraction.

Hollow fiber supported liquid membrane (HFSLM) extraction was coupled with ICP-MS for speciation analysis of labile Ag(I) and total Ag(I) in dispersions of silver nanoparticles (AgNPs) and environmental waters. Ag(I) in aqueous samples was extracted into the HFSLM of 5%(m/v) tri-n-octylphosphine oxide in n-undecane, and stripped in the acceptor of 10 mM Na2S2O3 and 1 mM Cu(NO3)2 prepared in 5 mM NaH2PO4-Na2HPO4 buffer (pH 7.5). Negligible depletion and exhaustive extraction were conducted under static and 250 rpm shaking to extract the labile Ag(I) and total Ag(I), respectively. The extraction equilibration was reached in 8 h for both extraction modes. The extraction efficiency and detection limit were (2.97 ± 0.25)% and 0.1 µg/L for labile Ag(I), and (82.3 ± 2.0)% and 0.5 µg/L for total Ag(I) detection, respectively. The proposed method was applied to determine labile Ag(I) and total Ag(I) in different sized AgNP dispersions and real environmental waters, with spiked recoveries of total Ag(I) in the range of 74.0-98.1%. With the capability of distinguishing labile and total Ag(I), our method offers a new approach for evaluating the bioavailability and understanding the fate and toxicity of AgNPs in aquatic systems.

Highly dynamic PVP-coated silver nanoparticles in aquatic environments: chemical and morphology change induced by oxidation of Ag(0) and reduction of Ag(+).

The fast growing and abundant use of silver nanoparticles (AgNPs) in commercial products alerts us to be cautious of their unknown health and environmental risks. Because of the inherent redox instability of silver, AgNPs are highly dynamic in the aquatic system, and the cycle of chemical oxidation of AgNPs to release Ag(+) and reconstitution to form AgNPs is expected to occur in aquatic environments. This study investigated how inevitable environmentally relevant factors like sunlight, dissolved organic matter (DOM), pH, Ca(2+)/Mg(2+), Cl(-), and S(2-) individually or in combination affect the chemical transformation of AgNPs. It was demonstrated that simulated sunlight induced the aggregation of AgNPs, causing particle fusion or self-assembly to form larger structures and aggregates. Meanwhile, AgNPs were significantly stabilized by DOM, indicating that AgNPs may exist as single particles and be suspended in natural water for a long time or delivered far distances. Dissolution (ion release) kinetics of AgNPs in sunlit DOM-rich water showed that dissolved Ag concentration increased gradually first and then suddenly decreased with external light irradiation, along with the regeneration of new tiny AgNPs. pH variation and addition of Ca(2+) and Mg(2+) within environmental levels did not affect the tendency, showing that this phenomenon was general in real aquatic systems. Given that a great number of studies have proven the toxicity of dissolved Ag (commonly regarded as the source of AgNP toxicity) to many aquatic organisms, our finding that the effect of DOM and sunlight on AgNP dissolution can regulate AgNP toxicity under these conditions is important. The fact that the release of Ag(+) and regeneration of AgNPs could both happen in sunlit DOM-rich water implies that previous results of toxicity studies gained by focusing on the original nature of AgNPs should be reconsidered and highlights the necessity to monitor the fate and toxicity of AgNPs under more environmentally relevant conditions.

Quantification of the uptake of silver nanoparticles and ions to HepG2 cells.

The toxic mechanism of silver nanoparticles (AgNPs) is still debating, partially because of the common co-occurrence and the lack of methods for separation of AgNPs and Ag(+) in biological matrices. For the first time, Triton-X 114-based cloud point extraction (CPE) was proposed to separate AgNPs and Ag(+) in the cell lysates of exposed HepG2 cells. Cell lysates were subjected to CPE after adding Na2S2O3, which facilitated the transfer of AgNPs into the nether Triton X-114-rich phase by salt effect and the preserve of Ag(+) in the upper aqueous phase through the formation of hydrophilic complex. Then the AgNP and Ag(+) contents in the exposed cells were determined by ICP-MS after microwave digestion of the two phases, respectively. Under the optimized conditions, over 67% of AgNPs in cell lysates were extracted into the Triton X-114-rich phase while 94% of Ag(+) remained in the aqueous phase, and the limits of detection for AgNPs and Ag(+) were 2.94 µg/L and 2.40 µg/L, respectively. This developed analytical method was applied to quantify the uptake of AgNPs to the HepG2 cells. After exposure to 10 mg/L AgNPs for 24 h, about 67.8 ng Ag were assimilated per 10(4) cells, in which about 10.3% silver existed as Ag(+). Compared to the pristine AgNPs (with 5.2% Ag(+)) for exposure, the higher ratio of Ag(+) to AgNPs in the exposed cells (10.3% Ag(+)) suggests the transformation of AgNPs into Ag(+) in the cells and/or the higher uptake rate of Ag(+) than that of AgNPs. Given that the toxicity of Ag(+) is much higher than that of AgNPs, the substantial content of Ag(+) in the exposed cells suggests that the contribution of Ag(+) should be taken into account in evaluating the toxicity of AgNPs to organisms, and previous results obtained by regarding the total Ag content in organisms as AgNPs should be reconsidered.

Speciation analysis of silver nanoparticles and silver ions in antibacterial products and environmental waters via cloud point extraction-based separation.

The rapid growth in commercial use of silver nanoparticles (AgNPs) will inevitably increase silver exposure in the environment and the general population. As the fate and toxic effects of AgNPs is related to the Ag(+) released from AgNPs and the transformation of Ag(+) into AgNPs, it is of great importance to develop methods for speciation analysis of AgNPs and Ag(+). This study reports the use of Triton X-114-based cloud point extraction as an efficient separation approach for the speciation analysis of AgNPs and Ag(+) in antibacterial products and environmental waters. AgNPs were quantified by determining the Ag content in the Triton X-114-rich phase with inductively coupled plasma mass spectrometry (ICPMS) after microwave digestion. The concentration of total Ag(+), which consists of the AgNP adsorbed, the matrix associated, and the freely dissolved, was obtained by subtracting the AgNP content from the total silver content that was determined by ICPMS after digestion. The limits of quantification (S/N = 10) for antibacterial products were 0.4 µg/kg and 0.2 µg/kg for AgNPs and total silver, respectively. The reliable quantification limit was 3 µg/kg for total Ag(+). The presence of Ag(+) at concentrations up to 2-fold that of AgNPs caused no effects on the determination of AgNPs. In the cloud point extraction of AgNPs in antibacterial products, the spiked recoveries of AgNPs were in the range of 71.7-103% while the extraction efficiencies of Ag(+) were in the range of 1.2-10%. The possible coextracted other silver containing nanoparticles in the cloud point extraction of AgNPs were distinguished by transmission electron microscopy (TEM), scanning electron microscopy (SEM)- energy dispersive spectroscopy (EDS), and UV-vis spectrum. Real sample analysis indicated that even though the manufacturers claimed nanosilver products, AgNPs were detected only in three of the six tested antibacterial products.

Heteroaggregation of different surface-modified polystyrene nanoparticles with model natural colloids.

This study investigated heteroaggregation of three surface-functionalized polystyrene nanoparticles (PSNPs), i.e. negatively charged unfunctionalized nanoparticles (Bare-PS) and carboxylated nanoparticles (COOH-PS), and positively charged amino-functionalized nanoparticles (NH2-PS), with two model natural colloids, positively charged hematite and negatively charged kaolin, respectively. Heteroaggregation was conducted at a constant natural colloid concentration and variable NP/colloid concentration ratios. Electrostatic interaction was the main mechanism driving the formation of heteroaggregates. In binary systems containing hematite and Bare-PS/COOH-PS, a charge neutralization - charge inverse mechanism was observed with the increase of PSNP concentration. At NP/hemetite concentration ratios much smaller or larger than the full charge neutralization point, the primary heteroaggregates were stable, while full charge neutralization induced the formation of large secondary heteroaggregates. Large aggregates were not observed in suspensions containing kaolin and NH2-PS, as highly positively charged NH2-PS reversed surface charges of kaolin at extremely low concentrations. Heteroaggregation between PSNPs and natural colloids with the same charge is unfavorable due to strong electrostatic repulsion. In the presence of electrolytes, homoaggregation and heteroaggregation both occurred, and homoaggregation of hematite played a key role when the concentration of PSNPs was low. The presence of Suwannee River natural organic matter (SRNOM) could modify surface charges of nanoparticles, and thus affect heteroaggregation behaviors of the binary suspension. When SRNOM and electrolytes were both present, whether SRNOM inducing or hindering the stability of the binary system was a combined effect of NP/colloid concentration ratios, SRNOM concentrations, electrolyte types and ionic strength. Mechanisms extensively reported in homoaggregation such as steric hindrance and cation bridging effects between SRNOM and Ca2+ also stand for heteroaggregation. These results highlight the critical role of surface modification on the environmental behaviors of NPs, and will underpin our understanding of the fate and transport of NPs in the aquatic environment.

Fractions of arsenic and selenium in fly ash by ultrasound-assisted sequential extraction.

Sequential extraction has been validated as an effective method to assess the fractions of elements in fly ash. However, the time consumption and high labor costs limit the application of the conventional sequential extraction (CSE) for fast screening of elemental fractions in fly ash. In this study, two ultrasound-assisted sequential extraction (UASE) methods were developed for fast analysis of arsenic (As) and selenium (Se) fractions in fly ash (FA). The parameters of UASE were optimized by comparing the results of As and Se obtained from UASE with those values observed via CSE. The operation time of sequential extraction procedures for As and Se were shortened from 24.5 h to less than 90 min. A certified reference material (CRM, GBW08401) and real fly ash samples were applied to validate the developed UASE. The recoveries of As and Se were found in the range of 82.3% to 114%. For all fractions, the performance of UASE was faster than CSE with the acceptable uncertainties. The analytical results demonstrated that the concentration of As in F3 was found to be higher than other fractions, while the main forms of Se were found to be in F1 and F3 in the fly ash samples. Based on the advantages of high efficiency and easy operation, the developed UASE procedures can be applied for fast screening of the mobility and bioavailability of As and Se in FA from coal fired power plants.

Removal of arsenic from water by silver nanoparticles and Fe-Ce mixed oxide supported on polymeric anion exchanger.

By encapsulating nanoscale particles of goethite (α-FeO(OH)), hydrous ceric oxide (CeO2·H2O, HCO) and silver nanoparticles (AgNPs) in the pores of polystyrene anion exchanger D201, a novel nanocomposite FeO(OH)-HCO-Ag-D201 was prepared for the effective removal of arsenic from water. The isotherm study shows that FeO(OH)-HCO-Ag-D201 has excellent adsorption performance for As(III) and As(V), with an increased adsorption capacity of As(III) to 40.12 mg/g compared to that of 22.03 mg/g by the composite adsorbent without AgNPs (FeO(OH)-HCO-D201). The adsorption kinetics data showed that the sorption rate of FeO(OH)-HCO-Ag-D201 for As(III) is less than that for As(V), and the adsorption of As(III) and As(V) were consistent with the pseudo-second-order model and the pseudo-first-order model, respectively. Neutral or basic conditions are favored for the adsorption of As(III/V) by FeO(OH)-HCO-Ag-D201. Compared with nitrate/chloride/bicarbonate, sulfate/silicate/phosphate showed more remarkable inhibition of arsenic removal by FeO(OH)-HCO-Ag-D201, whereas natural organic matter showed no interference to the arsenic removal. The As(V) adsorption involved different interactions such as electrostatic attraction and surface complexation, while the adsorption of As(III) involved the part oxidization of As(III) to As(V) and the simultaneous adsorption of As(III) and As(V). In addition to the Ce(IV) in CeO2·H2O acted as an oxidant, the synergistic effect of α-FeO(OH) and AgNPs also contributed to the oxidization of As(III) to As(V). Moreover, the reusable property suggested that this FeO(OH)-HCO-Ag-D201 nanocomposite has great potential for arsenic-contaminated water purification.

Silver nanoparticles in the environment.

Silver nanoparticles (AgNPs) are well known for their excellent antibacterial ability and superior physical properties, and are widely used in a growing number of applications ranging from home disinfectants and medical devices to water purificants. However, with the accelerating production and introduction of AgNPs into commercial products, there is likelihood of release into the environment, which raises health and environmental concerns. This article provides a critical review of the state-of-knowledge about AgNPs, involving the history, analysis, source, fate and transport, and potential risks of AgNPs. Although great efforts have been made in each of these aspects, there are still many questions to be answered to reach a comprehensive understanding of the positive and negative effects of AgNPs. In order to fully investigate the fate and transport of AgNPs in the environment, appropriate methods for the preconcentration, separation and speciation of AgNPs should be developed, and analytical tools for the characterization and detection of AgNPs in complicated environmental samples are also urgently needed. To elucidate the environmental transformation of AgNPs, the behavior of AgNPs should be thoroughly monitored in complex environmental relevant conditions. Furthermore, additional in vivo toxicity studies should be carried out to understand the exact toxicity mechanism of AgNPs, and to predict the health effects to humans.

Capping agent replacement induced self-organization of ultrathin nanowires: a new and general approach for fabricating noble metal nanoporous films with small ligament sizes.

Ultrafine ligament noble metal nanoporous films are successfully fabricated by self-organization of ultrathin nanowires. The replacement of weak binding capping agent Triton X-114, used for stabilizing nanowires, by Cl(-) is claimed for this self-organization. Our method is also applicable for synthesizing other hierarchical nanostructure-like hybrid nanoporous films.

[Study of gastric function after esophagectomy and cardiectomy with vagus nerve preserved and reconstruction of gastric funds in patients with esophageal and cardiac cancer].

OBJECTIVE: To study the gastric function after esophagectomy and cardiectomy with vagus nerve preserved and reconstruction of gastric funds (VPRG)in patients with esophageal cancer (EC) and cardiac cancer (CC). METHODS: Sixty-eight patients with early or middle staged EC or CC received esophagectomy and cardiectomy with vagus nerve preserved and reconstruction of gastric funds (VPRG),while other 68 patients esophagectomy and cardiectomy with vagus nerve severed and no reconstruction of gastric funds (VSNG) as control. The symptoms,the pressure of the residual esophagus and thoracic stomach, 24-hour pH monitoring, mean basic gastric acid output, gastric emptying time of the intrathoracic stomach,fasting serum gastrin level, fibreoptic endoscopic results were compared before and after operation between the two groups. RESULTS: The patients with VPRG had less symptoms after operation than those with VSNG such as anorexia, belch, reflux, heartburn, nausea, diarrhea, postcibal satiety (P< 0.01). In VPRG group,compared with the results before operation,there were no significant differences in 24-hour pH monitoring,the mean basic gastric acid output, the fasting serum gastrin level,the gastric emptying time of intrathoracic stomach one month and one year after operation (both P > 0.05). The pressure of the residual esophagus above the anastomosis in VPRG group was significantly higher than that in VSNG group (both P< 0.05). Fibreoptic endoscopic examination revealed higher incidences of postoperative atrophic gastritis and reflux esophagitis in VPRG group one month and one year after operation than those in VSNG group (P< 0.01). CONCLUSION: Preservation of the vagus nerve and reconstruction of gastric funds after esophagectomy and cardiectomy for esophageal and cardiac cancer can prevent digestive disorder and improve the life quality of the patients.