Magnesium metal and its corrosion products:Promising materials for tumor interventional therapy

Magnesium is generally known to degrade in aqueous environments by an electrochemical reaction.The corrosion products of magnesium include hydrogen gas,Mg^(2+),and Mg(OH)_(2).Here,we summarize the published literature describing the corrosion characteristics of magnesium,and the antitumor properties of magnesium-associated corrosion products,aiming to induce the therapeutic properties of magnesium and magnesium alloys in solid tumors.The therapeutic potential of corrosion products of magnesium is enormous.Hydrogen gas exhibits antioxidant and anti-inflammatory properties,which amount to potential anti-tumor characteristics.Mg(OH)_(2),which creates a localized alkaline microenvironment,represents a second approach for anti-tumor therapy with magnesium metal.Upregulated concentrations of Mg^(2+)ions in the local tumor microenvironment remodelling are considered a third approach for anti-tumor therapy.Therefore,we speculate about the different physical forms of magnesium that could create an anti-tumor microenvironment upon tumor interventional therapy,a technique that precisely places anti-tumor implants like particles and stents.Finally,we present our viewpoints on the potential use of magnesium in diverse solid tumor therapies to inhibit tumor progression.

Safety of high-carbohydrate fluid diet 2 h versus overnight fasting before non-emergency endoscopic retrograde cholangiopancreatography:A single-blind,multicenter,randomized controlled trial

Background:Although overnight fasting is recommended prior to endoscopic retrograde cholangiopancreatography(ERCP),the benefits and safety of high-carbohydrate fluid diet(CFD)intake 2 h before ERCP remain unclear.This study aimed to analyze whether high-CFD intake 2 h before ERCP can be safe and accelerate patients’recovery.Methods:This prospective,multicenter,randomized controlled trial involved 15 tertiary ERCP centers.A total of 1330 patients were randomized into CFD group(n=665)and fasting group(n=665).The CFD group received 400 mL of maltodextrin orally 2 h before ERCP,while the control group abstained from food/water overnight(>6 h)before ERCP.All ERCP procedures were performed using deep sedation with intravenous propofol.The investigators were blinded but not the patients.The primary outcomes included postoperative fatigue and abdominal pain score,and the secondary outcomes included complications and changes in metabolic indicators.The outcomes were analyzed according to a modified intention-to-treat principle.Results:The post-ERCP fatigue scores were significantly lower at 4 h(4.1±2.6 vs.4.8±2.8,t=4.23,P<0.001)and 20 h(2.4±2.1 vs.3.4±2.4,t=7.94,P<0.001)in the CFD group,with least-squares mean differences of 0.48(95%confidence interval[CI]:0.26-0.71,P<0.001)and 0.76(95%CI:0.57-0.95,P<0.001),respectively.The 4-h pain scores(2.1±1.7 vs.2.2±1.7,t=2.60,P=0.009,with a least-squares mean difference of 0.21[95%CI:0.05-0.37])and positive urine ketone levels(7.7%[39/509]vs.15.4%[82/533],χ^(2)=15.13,P<0.001)were lower in the CFD group.The CFD group had significantly less cholangitis(2.1%[13/634]vs.4.0%[26/658],χ^(2)=3.99,P=0.046)but not pancreatitis(5.5%[35/634]vs.6.5%[43/658],χ^(2)=0.59,P=0.444).Subgroup analysis revealed that CFD reduced the incidence of complications in patients with native papilla(odds ratio[OR]:0.61,95%CI:0.39-0.95,P=0.028)in the multivariable models.Conclusion:Ingesting 400 mL of CFD 2 h before ERCP is safe,with a reduction in post-ERCP fatigue,abdominal pain,and cholangitis during recovery.Trail Registration:ClinicalTrials.gov,No.NCT03075280.