Black hood assisted colonoscopy for detection of colorectal polyps: a prospective randomized controlled study

OBJECTIVE

Colonoscopy is considered as a standard method for detecting various kinds of colorectal polyps. However, conventional colonoscopy (CC) still has chances to miss some lesions. Some scholars have already reported that transparent hood assisted colonoscopy (THAC) can improve the detection rate of colorectal polyps. However, the efficacy of detection of colorectal polyps with black hood assisted colonoscopy (BHAC) is still unclear. In this study, BHAC was compared with CC for evaluating the efficacy of detection of colorectal polyps.

PATIENTS AND METHODS

Between Sep 2014 and Apr 2015, 542 patients underwent CC and meanwhile 534 patients underwent BHAC were enrolled into this prospective randomized controlled study. Comparison of baseline characteristics, cecal intubation time, withdrawal time, total number of detected polyps, detection rate of polyps, location, size, morphology and pathological diagnosis of polyps between these two groups was performed.

RESULTS

Cecal intubation time was significantly shorter in BHAC group than in CC group (6.31 ± 3.51 min vs. 7.05 ± 4.15 min, p = 0.002). The total number of detected polyps and detection rate of polyps were significantly higher in BHAC group than in CC group (349/65.36% vs. 264/48.71%, p = 0.004).

CONCLUSIONS

Compared with CC, BHAC could significantly improve the detection rate of colorectal polyps, and cecal intubation time was significantly reduced by BHAC.

DCD liver transplant infection: experience from a single centre in China

AIM

The purpose of our study was to evaluate the incidence, timing, location and risk factors for bacterial and fungal infections after donation after cardiac death (DCD) liver transplant and clearly delineate any relationship between infection and survival in DCD liver transplant recipients.

METHODS

We retrospectively reviewed 257 consecutive patients undergoing DCD liver transplant between October 2010 and May 2015 at our centre.

RESULTS

A total of 133 patients (51.8%) developed at least one bacterial or fungal infection episode. The predominant infection site was the respiratory tract, followed by the blood stream. Most of the infections occurred within the first week after liver transplant (61.9%). A recipient respiratory support time greater than 7 days (p = 0.041), post-transplant hospital time greater than 24 days (p = 0.002) and renal failure after DCD liver transplant (p = 0.039) were independent predictors of bacterial and fungal infection. The area under the receiver operating characteristic (ROC) curve (AUC) of the transplant infection risk assessment model was 0.788. The 1- and 3-year survival rates for recipients without infection were significantly increased compared with recipients with infection (96.1% and 89.0% vs. 81.5% and 75.9%, p = 0.007).

CONCLUSION

This is the first study that offers detailed data revealing the timing and incidence of bacterial and fungal infection among adult DCD liver transplant recipients. Bacterial and fungal infection occurs at a high rate during the first week after DCD liver transplant, especially in patients with prolonged respiratory support time and renal failure, and infection is related to increased hospital stay.

Efficacy of a quadruple therapy regimen for Helicobacter pylori eradication after partial gastrectomy

We aimed to evaluate the effectiveness and safety of bismuth-containing quadruple therapy plus postural change after dosing for Helicobacter pylori eradication in gastrectomized patients. We compared 76 gastric stump patients with H. pylori infection (GS group) with 50 non-gastrectomized H. pylori-positive patients who met the treatment indication (controls). The GS group was divided into GS group 1 and GS group 2. All groups were administered bismuth potassium citrate (220 mg), esomeprazole (20 mg), amoxicillin (1.0 g), and furazolidone (100 mg) twice daily for 14 days. GS group 1 maintained a left lateral horizontal position for 30 min after dosing. H. pylori was detected using rapid urease testing and histologic examination of gastric mucosa before and 3 months after therapy. Mucosal histologic manifestations were evaluated using visual analog scales of the updated Sydney System. GS group 1 had a higher prevalence of eradication than the GS group 2 (intention-to-treat [ITT]: P=0.025; per-protocol [PP]: P=0.030), and the control group had a similar prevalence. GS group 2 had a lower prevalence of eradication than controls (ITT: P=0.006; PP: P=0.626). Scores for chronic inflammation and activity declined significantly (P<0.001) 3 months after treatment, whereas those for atrophy and intestinal metaplasia showed no significant change. Prevalence of adverse reactions was similar among groups during therapy (P=0.939). A bismuth-containing quadruple therapy regimen plus postural change after dosing appears to be a relatively safe, effective, economical, and practical method for H. pylori eradication in gastrectomized patients.

Gastrointestinal stromal tumors: current translational research and management modalities

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract. In recent years, detection of these subepithelial lesions has improved due to advances in endoscopic imaging techniques. Furthermore, developments in immunohistochemical technologies, allowing for reliable differentiation of GISTs from other subepithelial tumors, have improved the understanding of these lesions significantly. Alongside the emergence of these new technologies, clinical management of GISTs has progressed greatly in the last decade. However, major controversies still exist in various aspects of GIST management, such as diagnosis, treatment, and prognosis. This review article provides the current overview of the research status in the management of GISTs.

SKLB-163, a new benzothiazole-2-thiol derivative, exhibits potent anticancer activity by affecting RhoGDI/JNK-1 signaling pathway

Small-molecule inhibitors are an attractive therapeutic approach for most types of human cancers. SKLB-163, a novel benzothiazole-2-thiol derivative, was developed via computer-aided drug design and de novo synthesis. MTT assay showed it had potent anti-proliferative activity on various human cancer cells. Treatment of cancer cells with SKLB-163 induced obvious apoptosis and inhibited proliferation in vitro. SKLB-163 administered p.o. showed a marked antitumor activity in vivo. Proteomic techniques were employed to identify possible drug target proteins. The data showed molecular mechanism of action might be involved in downregulation of RhoGDI, which finally contributed to increased apoptosis and inhibited proliferation. These findings provided the potential value of SKLB-163 as a novel candidate antitumor drug.

Combined folate gene MTHFD and TC polymorphisms as maternal risk factors for Down syndrome in China

We examined whether polymorphisms in the methylenetetrahydrofolate dehydrogenase (MTHFD) and transcobalamin (TC) genes, which are involved in folate metabolism, affect maternal risk for Down syndrome. We investigated 76 Down syndrome mothers and 115 control mothers from Bengbu, China. Genomic DNA was isolated from the peripheral lymphocytes. Polymerase chain reaction and restriction fragment length polymorphism were used to examine the polymorphisms of MTHFD G1958A and TC C776G. The frequencies of the polymorphic alleles were 24.3 and 19.1% for MTHFD 1958A, 53.9 and 54.2% for TC 776G, in the case and control groups, respectively. No significant differences were found between two groups in relation to either the allele or the genotype frequency for both polymorphisms. However, when gene-gene interactions between these two polymorphisms together with previous studied C677T and A1298C polymorphisms in the methylenetetrahydrofolate reductase (MTHFR) gene were analyzed, the combined MTHFR 677CT/TT and MTHFD 1958AA/GA genotype was found to be significantly associated with the risk of having a Down syndrome child [odds ratio (OR) = 3.11; 95% confidence interval (95%CI) = 1.07-9.02]. In addition, the combined TC 776CG and MTHFR 677TT genotype increased the risk of having a child with Down syndrome 3.64-fold (OR = 3.64; 95%CI = 1.28-10.31). In conclusion, neither MTHFD G1958A nor TC C776G polymorphisms are an independent risk factor for Down syndrome. However, the combined MTHFD/MTHFR, TC/MTHFR genotypes play a role in the risk of bearing a Down syndrome child in the Chinese population.

Embryonic-like stem cell derived from adult bone marrow: immature morphology, cell surface markers, ultramicrostructure and differentiation into multinucleated fibers in vitro

Embryonic-like stem cell (ELSC), expressing part of surface markers of human embryonic stem cells, may be a better candidate for cell therapy of degenerative muscular disease than mesenchymal stem cell (MSC). We isolated ELSC and MSC from bone marrow, respectively, and compared their differences in the characteristics and the capacity of myogenic differentiation. Results showed that ELSC could be isolated successfully from 3 adult bone marrow samples by using serum-free medium with 10ng/ml basic fibroblast growth factor (bFGF). At the same cell density, MSC could also be isolated from the same samples by using DMEM/F12 medium containing 10% new cattle serum. However, ELSC appeared as small, morphologically slenderer, upregulated expression of SSEA-4 and ultramicroscopically more immature than MSC derived from the same samples. Immunofluorescent staining and RT-PCR analysis showed ELSC weakly expressed Oct-4, Nanog-3 and Sox-2. Moreover, ELSC and MSC could be induced into long, multinucleated fibers expressing myogenin and myosin heavy chain (MHC) in myogenic differentiation medium, but by day 10, proportion of multinucleated fibers positive for MHC was respectively 25.0%+/-6.9% and 13.8%+/-7.6% in ELSC and MSC culture. These data suggest that bone marrow derived ELSC represent an ideal candidate for cell therapy of degenerative muscular disease.

[Abuse of "pheticol" and its interference to the analysis of methamphetamine]

The study was to eliminate interference from ephedrine in the analysis of methamphetamine. The extraction procedure for methamphetamine was modified to include an oxidation step (2 ml urine specimen was treated with 0.5 ml of 1 mol/L phosphate buffer (pH 6.8) and 0.5 ml 0.3 mol/L sodium periodate). Results showed that ephedrine could be oxidized in the presence of periodate ions into smaller fragments while leaving methamphetamine intact. It is recommended that specimens be treated with sodium periodate prior to extraction in order to eliminate any interference caused by ephedrine.

[Study of distribution and metabolism of methamphetamine in hair of guinea pig]

OBJECTIVE

To study the distribution and metabolism of methamphetamine in the hair of guinea pig.

METHODS

Determination of methamphetamine and its metabolite amphetamine in hair was performed by GC/MS and GC/NPD. Concentration-time course of methamphetamine and amphetamine in hair of guinea were recorded. Relationship between hair color, administrated dose and drug concentration in hair were also discussed.

RESULTS

The concentration of amphetamine is higher than the concentration of methamphetamine in the hair of guinea administrated a single dose or seven doses of methamphetamine. The concentration of methamphetamine and amphetamine were significantly related with administration dose and the incorporation rate into white and brown hair is much poorer than that of black hair.

CONCLUSION

Administration methods, dose and the color of hair affect the concentration of methamphetamine and amphetamine.

The stability of tetramine, morphine and meperidine in formalin solution

The stability of tetramine, morphine and meperidine in formalin solution is an important factor for drug analysis in forensic investigation. In this paper, the tissues (liver, kidney, lung and heart) from poisoned rabbits were immersed in 50 ml 10% formalin solutions for 4 months before examination. We compared the levels of tetramine, morphine, meperidine and the main metabolite normeperidine, measured by GC/NPD or GC-MS, in frozen rabbit tissues, formalin-fixed rabbit tissues, and formalin solution. There was a decrease in the levels of tetramine, morphine, meperidine in formalin-preserved tissues compared with the levels of these drugs in the frozen tissues. It is suggested that the formalin-fixed tissues and formalin solution should be analyzed at the same time to assure the accurate results.

[Detection of antidepressant and antipsychotic drugs in human hair and evaluation of the results]

The presence of therapeutic drugs in the hair of psychiatric patients was investigated, and the method for simultaneous determination of antidepressant and antipsychotic drugs by GC/NPD and GC/MS was also established. Eight different psychotroic drugs were detected from the hair of 32 subjects, and chlorpromazine and clozapine concentrations in the hair were found to be dependent on the dosage and the correlation coefficients were 0.8047 (P < 0.001, n = 16) and 0.7097 (P < 0.001, n = 16) respectively. Segmental analysis demonstrated that there was a correlation between the subject's drug exposure history and the distribution of drug along the hair shaft.

[Segmental analysis of hair from meperidine abusers and evaluation of the results]

Using meperidine abusers as subjects for this study, we detected in hair meperidine and its metabolites normeperidine, N-OCH3-meperidine and N-AC-meperidine. The content of meperidine and normeperidine of 60 abusers were 103 +/- 130 ng/mg and 117 +/- 143 ng/mg respectively. Meperidine was stably present in hair for at least 20 months. Normeperidine level decreased from hair root to tip. The segmental analysis of hair revealed that there were correlations between the drug abuse history and the distribution of drug along the hair shaft, and between the dose of meperidine and its content presented in hair.

[Determination of heroin metabolites in biological fluids, tissues and hair of heroin addicts using GC/MS-SIM]

Using GC/MS-SIM, we examined morphine distribution in human bodies of 2 delayed death cases and analyzed content of morphine and 6-acetylmorphine (MAM) in hair specimens of 7 cases. After hydrolysis and extraction, MOR and 6-MAM were derived with acetic anhydride or BSTFA and then the derivatives were qualitatively and quantitatively analyzed by GC/MS-SIM. The results indicated that urine, bile and liver were the best samples to reveal the heroin-related deaths. Hair analysis has its unique advantage for its long time of abusing monitor, compared to biological fluids.

[Study on the radioligand binding assay of cholecystokinin receptor in rat cerebral cortex]

A radioligand binding assay system for determining the characterization of CCK receptor is presented. Using Bolton-Hunter reagent, we prepared a biologically active, specific 125I-BH-CCK8. The iodination mixture was then transferred to a column of Sephadex G-25 and examined by silica thin layer chromatography. Its specific activity and radiochemical purity were 3.4 TBq/mmol and 96% respectively. Binding of 125I-BH-CCK8 to the membrane of rat cerebral cortex was rapid, reversible, time-temperature dependent, saturable and specific. The labeled CCK was shown to have biological activity as measured by the CCK receptor radioassay. Under our laboratorial conditions, the CCK binding required an hour to reach equilibrium at 4 degrees C. We chose polyethylene glycol 6,000 and gamma-globulin protein for the separation of B and F. Scatchard plot of CCK binding was linear with a Kd value of 1.098 nmol/L and Bmax of 197.5 fmol/mg protein. The results of this study support the stand-point that CCK may function as a regulatory peptide in brain and hence may be of use for clarifying the CCK receptor's function in central nervous system.

[Determination of metabolites of heroin in urine and discrimination of heroin abuse]

This article describes a sensitive method that detects morphine, 6-monoacetylmorphine, morphine-3-glucuronide and codeine in urine for qualifying the abuse of heroin. The analytes were extracted by solid phase C18. The limits of detection (LOD) for morphine and codeine were 50 ng/ml and 50 ng/ml, respectively. The RSD of morphine and codeine were 11.3% (n = 5), and 14.2% (n = 5) respectively. For urine, it does not need to be hydrolyzed before extracted, and for all analytes, also need not to be derivated. The difference ratio of morphine and codeine in the chromatography can be used to discriminate between the abuse of heroin and the administration of compound liquorice mixture.

[Analysis of penicillins in whole blood by reversed high-performance liquid chromatography]

A reversed-HPLC method was established to determinate penicillins in whole blood. Thiamphenicol as internal standard was added to 0.5 ml blood. Proteins in blood were precipitated with acetonitrile, then the separate supernatant was directly injected onto the chromatography column. The range of five penicillins' linearities was 0.9918 to 0.9996, their range of relative recovery was 91.75% to 107.33%, their CV was 3.56% to 9.85%. Effects of different storage temperatures on the stability of analytes and interference of other antibiotics were also studied.

[Zinc deficiency inhibited the proliferation and differentiation of rat osteoblast in vitro]

The effect of zinc deficiency on proliferation and differentiation of rat osteoblast was studied in vitro. The osteoblasts were isolated from the rat calvaria, and were subcultured in DMEM medium. Zinc deficiency model in cell culture was made by chelating zinc from the medium with a special chelator TPEN. Incorporation of 3H-thymidine was measured to show the DNA synthesis at different time point, and cell cycle was analyzed by flow cytometry. A histochemistry method was used to detect changes of osteoblast cytoskeleton. Incorporation of 3H-proline was measured to show the synthesis of collagen. Alkaline phosphatase activity (AKP) and osteocalcin content were measured by enzyme dynamics method and radioimmunoassay respectively. The results showed that the incorporation of 3H-thymidine in the zinc deficient group was significantly less than that in the control group at different time points. The cells were blocked at G2/M phase of cell cycle, which is related to the impairment of cytoskeleton. Collagen synthesis, osteocalcin content and AKP activity in the zinc deficient group were reduced significantly as compared with those in the control group. But no differences in all the measurements were observed between the control group and the group of zinc deficiency supplemented with zinc. Therefore, it was concluded that zinc deficiency inhibited the proliferation and differentiation of rat osteoblast in vitro.

The development of self-perceptions of ability and achievement goals and their relations in physical education

This study examined the development of self-perceptions of ability and achievement goals and their relationships in physical education. Three hundred and eight students in 4th, 8th, and 11th grades completed questionnaires assessing their goal orientations, conceptions of ability, and perceived competence in physical education. Analyses assessing grade-related changes in conceptions of ability and achievement goals showed that as the students progressed from grades 4 through 11, they were more likely to: (a) interpret ability as a stable capacity that may limit or increase the effect of effort on performance and (b) become ego-oriented. Analyses assessing relationships between variables of interest across grade level revealed that achievement goals were related to different conceptions of ability, students' self-ratings were significantly positively correlated to their teachers' ratings of their competence, and no consistent relationships emerged between achievement goals and perceived competence.

[Analysis and assessment of meperidine and normeperidine concentrations in urine]

In this study, urine concentrations of meperidine and normeperidine after a single therapeutic dose of meperidine in 5 healthy volunteers have been measured and compared the results to those in meperidine addicts. The results showed that there was a significant difference between two groups in the ratio of metabolite to parent drug. If can be concluded that the ratio should be aid in making a cause of meperidine injection.