Health risk assessment of trace metal(loid)s in agricultural soils based on Monte Carlo simulation coupled with positive matrix factorization model in Chongqing, southwest China

This study aimed to investigate the pollution characteristics, source apportionment, and health risks associated with trace metal(loid)s(TMs) in the major agricultural producing areas in Chongqing, China. We analyzed the source apportionment and assessed the health risk of TMs in agricultural soils by using positive matrix factorization(PMF) model and health risk assessment(HRA) model based on Monte Carlo simulation. Meanwhile, we combined PMF and HRA models to explore the health risks of TMs in agricultural soils by different pollution sources to determine the priority control factors. Results showed that the average contents of cadmium(Cd), arsenic (As), lead(Pb), chromium(Cr), copper(Cu), nickel(Ni), and zinc(Zn) in the soil were found to be 0.26, 5.93, 27.14, 61.32, 23.81, 32.45, and 78.65 mg/kg, respectively. Spatial analysis and source apportionment analysis revealed that urban and industrial sources, agricultural sources, and natural sources accounted for 33.0%, 27.7%, and 39.3% of TM accumulation in the soil, respectively. In the HRA model based on Monte Carlo simulation, noncarcinogenic risks were deemed negligible(hazard index <1), the carcinogenic risks were at acceptable level(10^(-6)<total carcinogenic risk ≤ 10^(-4)), with higher risks observed for children compared to adults. The relationship between TMs, their sources, and health risks indicated that urban and industrial sources were primarily associated with As, contributing to 75.1% of carcinogenic risks and 55.7% of non-carcinogenic risks, making them the primary control factors. Meanwhile, agricultural sources were primarily linked to Cd and Pb, contributing to 13.1% of carcinogenic risks and 21.8% of non-carcinogenic risks, designating them as secondary control factors.

Prevalence and risk factors of depression among patients with perianal fistulizing Crohn’s disease

BACKGROUND Psychological distress,especially depression,associated with perianal fistulizing Crohn’s disease(PFCD)is widespread and refractory.However,there is a surprising paucity of studies to date that have sought to identify the prevalence and risk factors of depression associated with PFCD.AIM To estimate the prevalence of depressive symptoms and investigate the depression-related risk factors in patients with PFCD.METHODS The study was conducted in the form of survey and clinical data collection via questionnaire and specialized medical staff.Depressive symptoms,life quality,and fatigue severity of patients with PFCD were assessed by Patient Health Questionnaire-9,Inflammatory Bowel Disease Patient Quality of Life Questionnaire(IBDQ),and Inflammatory Bowel Disease(IBD)Fatigue Patient Self-assessment Scale.The basic demographic information,overall disease features,perianal clinical information,and laboratory inflammation indicators were also gathered.Multivariate regression analysis was ultimately used to ascertain the risk factors of depression associated with PFCD.RESULTS A total of 123 patients with PFCD were involved,and 56.91%were suffering from depression.According to multivariate logistic regression analysis,Perianal Disease Activity Index(PDAI)score[odds ratio(OR)=0.69,95%confidence interval(CI):0.50 to 0.95],IBDQ score(OR=0.93,95%CI:0.88 to 0.97),modified Van Assche index(OR=1.24,95%CI:1.01 to 1.53),and IBD Fatigue score(OR=1.72,95%CI:1.23 to 2.42)were independent risk factors of depression-related prevalence among patients with PFCD(P<0.05).Multiple linear regression analysis revealed that the increasing perianal modified Van Assche index(βvalue=0.166,95%CI:0.02 to 0.31)and decreasing IBDQ score(βvalue=-0.116,95%CI:-0.14 to-0.09)were independently associated with the severity of depression(P<0.05).CONCLUSION Depressive symptoms in PFCD patients have significantly high prevalence.PDAI score,modified Van Assche index,quality of life,and fatigue severity were the main independent risk factors.

Epidemiological Aspects of Obesity, Overweight and Cardiovascular Risk Factors at Associes in Semi-Urban Areas (Case of Sébikotane)

Introduction: Obesity and overweight are a public health problem. The general objective was to determine the epidemiological aspects of obesity, overweight and associated risk factors in a semi-urban environment. Patients and Methods: This was a cross-sectional, descriptive study conducted on November 28 and 29, 2023 in Sébikotane. It focused on volunteers for screening for chronic non-communicable diseases. Epidemiological and clinical data were evaluated. Results: One hundred and twenty-nine cases of obesity were recorded (28%). Two hundred and eighty-two cases were overweight or obese (61.3%). The mean age was 49.55 years, with a standard deviation of 12.41 years. The age group [40 - 49 years] was the most representative, with 85 cases (30.1%), and the majority were female, with 264 cases (93.6%). Primary education was the most common, with 75 cases (46.3%). Grade 1 obesity concerned ninety-seven cases (75.2%), and diabetes was present in thirty cases (23%). Hypertension was present in ninety-five cases (33.7%). Obesity was more marked in the age group [40 - 49 years] with 45 cases (36%). Conclusion: Obesity and overweight are a major cause of morbidity and mortality. The development and implementation of a prevention and management program is essential.

Surgical and non-surgical risk factors affecting the insufficiency of ileocolic anastomosis after first-time surgery in Crohn’s disease patients

BACKGROUND Crohn's disease(CD)often necessitates surgical intervention,particularly when it manifests in the terminal ileum and ileocecal valve.Despite undergoing radical surgery,a subset of patients experiences recurrent inflammation at the anasto-motic site,necessitating further medical attention.AIM To investigate the risk factors associated with anastomotic insufficiency following ileocecal resection in CD patients.METHODS This study enrolled 77 patients who underwent open ileocolic resection with pri-mary stapled anastomosis.Patients were stratified into two groups:Group I co-mprised individuals without anastomotic insufficiency,while Group II included patients exhibiting advanced anastomotic destruction observed endoscopically or those requiring additional surgery during the follow-up period.Surgical and non-surgical factors potentially influencing anastomotic failure were evaluated in both cohorts.RESULTS Anastomotic insufficiency was detected in 12 patients(15.6%),with a mean time interval of 30 months between the initial surgery and recurrence.The predomi-nant reasons for re-intervention included stenosis and excessive perianastomotic lesions.Factors associated with a heightened risk of anastomotic failure encompassed prolonged postoperative obstruction,anastomotic bleeding,and clinically confirmed micro-leakage.Additionally,patients in Group II exhibited preoperative malnutrition and early recurrence of symptoms related to CD.CONCLUSION Successful surgical outcomes hinge on the attainment of a fully functional anastomosis,optimal metabolic status,and clinical remission of the underlying disease.Vigilant endoscopic surveillance following primary resection facilitates the timely identification of anastomotic failure,thereby enabling noninvasive interventions.

Distribution, Mobility, and Health Risks Assessment of Trace Metals in River Sediments from Intense Agricultural Activity Areas in West Africa

The economy of West African countries is mainly based on agriculture. However, the trace metal(loid)s contamination status in rivers is relatively unknown in the region. In this work, 45 surface sediments collected from the Bandama, Comoé, and Bia Rivers in south and south eastern Côte d’Ivoire (West Africa), were analyzed for total metal concentrations and chemical speciation. The results showed that the river sediments were considerably contaminated by Cd and moderately contaminated by As, Cu, Pb, and Zn. Significant spatial variations were observed among the stations but not between the rivers. Metals Cd and Cu were likely to cause more ecological risks. The speciation analysis unravelled that the metal(loid)s partitioned mainly in the residual fraction, with the potential mobile fraction varying from 14% to 28%. The study calls for establishment of strict policies relative to the application of fertilizers and agrochemicals and mining activities to protect the environment and human health risks.

S-100β CysC和NF-κB对急性缺血性脑卒中患者静脉溶栓后出血转化的预测价值

目的 探讨急性缺血性脑卒中(AIS)外周血中S-100β、CysC和NF-κB水平对静脉溶栓后出血转化的影响及预测价值。方法 收集2019-03—2022-03接受溶栓治疗的AIS患者140例,根据溶栓后24 h是否发生出血转化(HT)将患者分为非HT组(n=112)和HT组(n=28)。比较2组一般临床资料,采用多因Logistic回归分析影响HT发生的危险因素,受试者工作特征(ROC)曲线评估S-100β、CysC和NF-κB预测HT发生的价值。结果 HT组与非HT组相比,患者年龄、发病至溶栓时间、房颤、TOAST分型、C反应蛋白、凝血酶原时间、S-100β、CysC、NF-κB、白质高信号和脑微出血等均有统计学差异(P<0.05)。Logistic多因素回归分析显示,房颤、S-100β、CysC和NF-κB为影响HT发生的危险因素。S-100β、CysC和NF-κB预测AIS患者静脉溶栓后出血转化的曲线下面积分别为0.915(0.902~0.923)、0.874(0.856~0.882)和0.789(0.771~0.796),均具有一定的预测价值。结论 S-100β、CysC和NF-κB为AIS患者静脉溶栓后HT发生的危险因素,对HT发生具有一定的预测价值。

Multiple assessments, source determination, and health risk apportionment of heavy metal(loid)s in the groundwater of the Shule River Basin in northwestern China

Global ecosystems and public health have been greatly impacted by the accumulation of heavy metal(loid)s in water.Source-specific risk apportionment is needed to prevent and manage potential groundwater contamination with heavy metal(loid)s.The heavy metal(loid)s contamination status,water quality,ecological risk,and health risk apportionment of the Shule River Basin groundwater are poorly understood.Therefore,field sampling was performed to explore the water quality and risk of heavy metal(loid)s in the groundwater of the Shule River Basin in northwestern China.A total of 96 samples were collected from the study area to acquire data for water quality and heavy metal(loid)s risk.There was noticeable accumulation of ferrum in the groundwater of the Shule River Basin.The levels of pollution were considered to be moderately low,as evaluated by the degree of contamination,heavy metal evaluation index,heavy metal pollution index,and Nemerow pollution index.The ecological risks were also low.However,an assessment of the water quality index revealed that only 58.34%of the groundwater samples had good water quality.The absolute principal component scores-multiple linear regression model was more suited for this study area than the positive matrix factorization model.There were no obvious noncarcinogenic or carcinogenic concerns for all types of receptors according to the values of the total hazard index and total carcinogenic risk.The human activities and the initial geological environment factor(65.85%)was the major source of noncarcinogenic risk(residential children:87.56%;residential adults:87.52%;recreational children:86.77%;and recreational adults:85.42%),while the industrial activity factor(16.36%)was the major source of carcinogenic risk(residential receptors:87.96%;and recreational receptors:68.73%).These findings provide fundamental and crucial information for reducing the health issues caused by heavy metal(loid)s contamination of groundwater in arid areas.

Contamination and human health risk assessment of heavy metal(loid)s in topsoil and groundwater around mining and dressing factories in Chifeng,North China

Chifeng is a concentrated mining area for non-ferrous metal minerals,as well as a key prevention and control area for heavyduty enterprises.This situation necessitates an efective ecological and human health risk assessment of heavy metal(loid)s driven by the wide distribution of metal ore processing,mining,and smelting factories in Hexigten Banner and Bairin Left Banner.We conducted surveys to assess the levels of heavy metal(loid)s(Cr,As,Pb,Cd,and Hg)in the topsoil and groundwater of the areas.The results indicated that the concentrations of As,Cd,and Pb in partial soil samples exceeded the environmental quality standards of Grade II.Based on contamination assessments,such as geoaccumulation indices and pollution indices,we inferred that Cd,Pb,and As were primary pollutants in topsoil.Potential ecological risks when considered as part of the average risk indices(RI)are up to 1626.40 and 2818.76,respectively,in the two areas.Comparative analysis revealed that Cd posed a very high potential ecological risk,followed by As.Moreover,the evaluation showed that the three exposure pathways of carcinogenic and non-carcinogenic risk followed a descending order:inhalation>ingestion>dermal contact,except for Pb.Arsenic in topsoil posed a potential non-carcinogenic risk to human health,while there were no adverse efects of As in groundwater.In addition,the average total carcinogenic risk for As in the two areas,as well as the risk of Pb in the topsoil of Bairin Left Banner and all the fve heavy metal(loid)s in groundwater,exceeded human tolerance.Pb–Zn mines caused higher human health risks.In addition,the tandem contamination of heavy metal(loid)s in soil and groundwater was not obvious.This research study provides a basis for pollution remediation to control heavy industry-induced ecological and health risks of heavy metal(loid)s.

黄土液化作用及其次生灾害风险评估方法初探——以积石山M_(S)6.2地震为例

2023年12月18日甘肃积石山6.2级地震引发的黄土液化泥石流地质灾害,造成了大量人员伤亡和财产损失。以此为背景,系统梳理了液化调查、风险评估和风险区划的工作思路:选定地区液化的内在和诱发因子,收集并分析资料,拟定调查工作底图,以调查问卷的形式开展液化影响因素摸底工作,开展针对性的外业调查或辅以物探和钻探工作,得到土壤液化发育潜势实际材料图;其后借用常规地质灾害的评估方法,开展调查区域的易发性、易损性评价和风险评价,得到调查区风险区划图。利用此方法对积石山地震诱发的泥石流灾害进行验证,分析其液化灾害的地质环境背景、形成机理和危害特征,并对其发生的风险进行评价。文章首次提出土的液化作用及其次生灾害区域调查因子的选择和风险评估的流程,可为开展土层液化作用及其次生灾害隐患区排查、国土空间规划,特别是高烈度山区集中居住点地质安全评估和选址建议提供参考。

滇西南1976年龙陵M_(S)7.3、M_(S)7.4双强震触发滑坡遥感解译及其构造意义

深入研究中国滇西南地区发育的龙陵-澜沧新生地震构造带对于合理划分活动地块边界及未来开展强震危险性评价工作具有重要意义。使用高分辨率卫星影像对已发生的双强震震例开展回溯研究是一种可行的技术手段。文中对震前、震后高分辨率Keyhole卫星影像进行遥感解译,结合野外验证和前人研究结果,获得了1976年M_(S)7.3、M_(S)7.4龙陵双强震触发滑坡较为完整的数据库。结果显示:1)共解译滑坡14448个,总面积为17.2km^(2),70.9%的滑坡分布在花岗岩质的岩体风化层中,单体滑坡面积集中在数百至1000m^(2)区间,多为表层风化层内的浅层滑坡,滑动距离较小;2)同震滑坡密集区与高烈度区不匹配,其空间分布显示破裂区规模约为30km,且均位于活动断裂的一侧,表明其发震构造并非为龙陵-瑞丽断裂或畹町断裂。滇西南地区共轭强震破裂可能局限了单次强震的空间规模,因此在确认未来强震危险区时应重点关注NE向与NW向构造的交会部位。

Ibrutinib and atrial fibrillation:An in-depth review of clinical implications and management strategies

Ibrutinib,a targeted therapy for B-cell malignancies,has shown remarkable efficacy in treating various hematologic cancers.However,its clinical use has raised concerns regarding cardiovascular complications,notably atrial fibrillation(AF).This comprehensive review critically evaluates the association between ibrutinib and AF by examining incidence,risk factors,mechanistic links,and management strategies.Through an extensive analysis of original research articles,this review elucidates the complex interplay between ibrutinib’s therapeutic benefits and cardiovascular risks.Moreover,it highlights the need for personalized treatment approaches,vigilant monitoring,and interdisciplinary collaboration to optimize patient outcomes and safety in the context of ibrutinib therapy.The review provides a valuable resource for healthcare professionals aiming to navigate the intricacies of ibrutinib’s therapeutic landscape while prioritizing patient well-being.

Gender disparities and woman-specific trends in Barrett’s esophagus in the United States:An 11-year nationwide populationbased study

BACKGROUND Barrett's esophagus(BE)is a known premalignant precursor to esophageal adenocarcinoma(EAC).The prevalence rates continue to rise in the United States,but many patients who are at risk of EAC are not screened.Current practice guidelines include male gender as a predisposing factor for BE and EAC.The population-based clinical evidence regarding female gender remains limited.AIM To study comparative trends of gender disparities in patients with BE in the United States.METHODS A nationwide retrospective study was conducted using the 2009-2019 National Inpatient Sample(NIS)database.Patients with a primary or secondary diagnosis code of BE were identified.The major outcome of interest was determining the gender disparities in patients with BE.Trend analysis for respective outcomes for females was also reported to ascertain any time-based shifts.RESULTS We identified 1204190 patients with BE for the study period.Among the included patients,717439(59.6%)were men and 486751(40.4%)were women.The mean age was higher in women than in men(67.1±0.4 vs 66.6±0.3 years,P<0.001).The rate of BE per 100000 total NIS hospitalizations for males increased from 144.6 in 2009 to 213.4 in 2019(P<0.001).The rate for females increased from 96.8 in 2009 to 148.7 in 2019(P<0.001).There was a higher frequency of obesity among women compared to men(17.4%vs 12.6%,P<0.001).Obesity prevalence among females increased from 12.3%in 2009 to 21.9%in 2019(P<0.001).A lower prevalence of smoking was noted in women than in men(20.8%vs 35.7%,P<0.001).However,trend analysis showed an increasing prevalence of smoking among women,from 12.9%in 2009 to 30.7%in 2019(P<0.001).Additionally,there was a lower prevalence of alcohol abuse,Helicobacter pylori(H.pylori),and diabetes mellitus among females than males(P<0.001).Trend analysis showed an increasing prevalence of alcohol use disorder and a decreasing prevalence of H.pylori and diabetes mellitus among women(P<0.001).CONCLUSION The prevalence of BE among women has steadily increased from 2009 to 2019.The existing knowledge concerning BE development has historically focused on men,but our findings show that the risk in women is not insignificant.

Fournier’s Gangrene: A Review of Fournier’s Gangrene Severity Index (FGSI) and Other Predictors of Mortality

Background: Fournier gangrene is an acute and rapidly progressive necrotizing fasciitis of the scrotum, perianal and perineal region of the body. It is a polymicrobial infection having an interplay of both anaerobic and aerobic orgasms in a soup of microbial disaster. Fournier’s gangrene was also initially thought to be an idiopathic condition but a lot of risk factors have been associated now with this condition, both systemic risk factors and local. Systemic risk factors include diabetes mellitus, HIV/AIDS, cancers, chronic liver disease, chronic steroid use etc. The local risk factors include perineal injuries, watering can perineum, perianal abscess, chronic perineal itching etc. Purpose: The swiftly flourishing bacteria orgasms cause a similar disruptive event in the body of the patients both clinically and biochemically and these can be used to create a predictive score or index for patients in order to assess the disease severity and guide in the management and prognostication of this condition. Materials and Method: Urology ward record books, clinic record books and operating theater records were used to identify patients managed for Fournier gangrene in ATBUTH Bauchi. A retrospective study of the medical files of all the patients managed from January 2011 to January 2024 was done. Folders were retrieved and the medical records were reviewed. Results: Of the 50 patients reviewed, Male to female ratio is 24:1. The mean age is 56 years (2 weeks to 97 years). Mortality rate was 34%. There is a significant difference between delayed presentation/initial use of unorthodox treatment with mortality (p = 0.002). Of the 17 patients that died, 15 had FGSI > 9 and of the 33 patients that survived 29 had FGSI 9 is 88.2% while the mortality rate for those with FGSI Conclusion: knowledge of the predictors of its mortality is necessary in other to help stratify patients and ensure the best response by the caregivers. FGSI, delayed presentation/initial patronage of unorthodox care, and polymicrobial infection are important predictors of mortality in this condition.

基于S-XGBoost融合模型的中国进境快件风险水平评价研究

党的二十大报告指出要增强维护国家安全能力,推进国家安全体系和能力现代化,坚决维护国家安全和社会稳定。随着互联网产业的发展壮大,以进境快件为代表的跨境个人消费进入发展的快车道,随之而来的安全准入风险也越来越高。为深入推进智慧海关建设,进一步提升进境快件风险防控能力,文章分析了现行监管模式下进境快件存在的问题,运用XGBoost算法和SMOTE技术构建了S-XGBoost进境快件风险评估模型,并对历史通关数据进行了仿真布控和评估。研究结果表明本文提出的S-XGBoost算法模型具有较好的预测效果,风险预测准确率达到了99.06%,能够为海关工作人员提升进境快件布控有效率提出切实参考建议。

血清组织蛋白酶S、颗粒蛋白前体及趋化因子配体12对慢性阻塞性肺疾病急性加重的预测价值

目的探讨血清组织蛋白酶S(CTSS)、颗粒蛋白前体(PGRN)及趋化因子配体12(CXCL12)对慢性阻塞性肺疾病(COPD)急性加重的预测价值。方法选择2020年1月至2023年2月铜陵市立医院收治的202例COPD患者为研究对象,根据是否发生急性加重分为急性加重组(n=64)和非急性加重组(n=138),收集2组患者的血清CTSS、PGRN、CXCL12水平及年龄、性别、体质量指数(BMI)、病程、吸烟史、第一秒呼气容积占预计值百分比(FEV1%)、稳定期慢性阻塞性肺疾病评估测试(CAT)评分等临床资料。采用单因素分析比较2组患者各指标的差异,多因素logistic回归分析COPD患者发生急性加重的独立危险因素,Pearson相关分析血清CTSS、PGRN及CXCL12水平与FEV1%和CAT评分的相关性,相对危险度分析不同水平CTSS、PGRN及CXCL12对COPD患者急性加重的影响,受试者操作特征(ROC)曲线评估血清CTSS、PGRN及CXCL12水平对COPD患者急性加重的预测效能。结果单因素分析结果显示,2组患者的年龄、性别、BMI、病程比较差异无统计学意义(P>0.05);2组患者吸烟者占比、FEV1%、CAT评分及血清CTSS、PGRN、CXCL12水平比较差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,血清CTSS、PGRN及CXCL12水平升高是COPD患者急性加重的危险因素(P<0.05)。不同FEV1%、CAT评分患者血清CTSS、PGRN、CXCL12水平比较差异有统计学意义(P<0.05)。相关性分析显示,血清CTSS、PGRN、CXCL12水平与FEV1%呈负相关,与CAT评分呈正相关(P<0.05)。危险度分析显示,血清CTSS、PGRN、CXCL12高水平COPD患者急性加重的风险分别是低水平患者的2.089倍(95%置信区间:1.341~3.253)、2.294倍(95%置信区间:1.363~3.862)、2.359倍(95%置信区间:1.459~3.815)。ROC曲线分析显示,血清CTSS、PGRN、CXCL12水平单独预测COPD患者急性加重风险的曲线下面积分别为0.780、0.811、0.775,三者联合预测COPD患者急性加重风险的曲线下面积为0.923。结论血清CTSS、PGRN及CXCL12水平是COPD急性加重的危险因素,血清CTSS、PGRN及CXCL12水平异常升高会显著增加COPD急性加重风险,血清CTSS、PGRN及CXCL12水平联合预测COPD急性加重风险的效能较优。

S Zorb装置转剂线腐蚀风险评估与磨损特性分析

催化裂化汽油吸附脱硫技术(S Zorb)是一种清洁汽油生产的核心技术,近年来,S Zorb装置中出现的转剂线磨损和泄漏等问题已成为石油化工行业内的共性难点问题。某公司2号S Zorb装置自2013年投用以来,转剂线频繁出现磨损和泄漏问题,以该案例为研究对象,对转剂线开展腐蚀风险评估以及气固两相流流态和磨损机理等综合特性分析,同时对弯管弯径比和气速对磨损的影响进行了讨论,为转剂线的设计优化以及运行可靠性的提升提供了参考。

基于D-S证据理论的危化品水路运输风险模糊综合评价

针对危险化学品水路运输风险因素的不确定性和模糊性,提出一种D-S证据理论与模糊综合评价法相结合的危化品水路安全运输风险评价方法。识别分析风险因素,建立危化品水路运输风险因素指标体系;引入距离函数,获取证据可信度后将可信度作为专家权重,结合D-S证据理论,融合专家信息,合理分配指标权重;构建危化品水路运输风险模糊综合评价模型,对危化品水路运输风险等级进行评价。结果表明,该案例的量化风险值为37.389,隶属于较低风险等级,人员、管理、货物因素为关键影响因素,二级指标中教育培训不足、违规操作、安全意识不足、货物敏感条件、通航环境复杂风险值相对较高,需要进行重点防控。

RISK信号通路在1-磷酸鞘氨醇后适应减轻心肌细胞缺氧/复氧损伤中的作用

目的研究再灌注损伤挽救激酶(reperfusion injury salvage kinase,RISK)信号通路在1-磷酸鞘氨醇(sphingosine-1-phosphate,S1P)后适应减轻H9c2心肌细胞缺氧/复氧损伤中的作用。方法将H9c2细胞随机分为7组,即(1)正常对照组(C);(2)缺氧/复氧组(H/R);(3)S1P组;(4)S1P+LY294002组(S1P+LY);(5)LY组;(6)S1P+PD98059组(S1P+PD);(7)PD组。采用MTT法测定各组细胞存活率;比色法测定丙二醛(MDA)含量、总超氧化物歧化酶(TSOD)和锰超氧化物歧化酶(Mn-SOD)活力;采用激光共聚焦显微镜技术检测细胞内游离钙离子浓度变化;流式细胞仪检测心肌细胞凋亡率;Western blot法测定Akt和ERK1/2蛋白的磷酸化水平。结果与H/R组比较,S1P组可明显增加H9c2细胞缺氧/复氧损伤后细胞存活率及凋亡率,增加TSOD及Mn-SOD活力,降低MDA含量,降低钙离子浓度,增加Akt和ERK1/2磷酸化水平,而PI3K/Akt信号通路阻断剂LY294002或ERK1/2阻断剂PD98059可阻断S1P对H9c2的上述作用。结论 S1P能够减轻H9c2细胞缺氧/复氧损伤,加入PI3K/Akt抑制剂LY294002和ERK1/2抑制剂PD98059均使S1P的保护作用被取消,表明S1P通过RISK信号通路发挥抗H9c2细胞缺氧/复氧损伤作用。

Has the risk of colorectal cancer in inflammatory bowel disease decreased?

The association between inflammatory bowel disease(IBD)and colorectal cancer(CRC)has been acknowledged for almost a century and is assumedly promoted by a chronic inflammation-driven carcinogenic process in the intestine in combination with a genetic predisposition.The magnitude of the risk of CRC in IBD remains a continuing subject of debate.The early,high risk estimates for CRC in IBD were most likely overestimated due to selected patient populations originating from tertiary referral centers with a disproportional high percentage of patients with severe disease.Later population-based studies calculating risk estimates from a broad spectrum of IBD patients have found the risk to be significantly lower.At present,there is evidence that IBD patients with longstanding and extensive disease with uncontrolled inflammation are those at increased risk.Additional,other recognized risk factors include early age at onset,family history of CRC,and concomitant primary sclerosing cholangitis.A significant amount of effort is put into identifying potential preventive factors of CRC in IBD,including surveillance programs and chemopreventive agents but the individual effect of these remains uncertain.Interestingly,recent studies have reported a decline in risk of CRC over time.Surveillance programs and the new treatment strategies,particular biological treatment might be part of the reason for the observed decline in risk of CRC in IBD over time but future studies will have investigate this assumption.

Risk factors and implications of anastomotic complications after surgery for Crohn's disease

Anastomotic complications occur more frequently in patients with Crohn's disease leading to postoperative intra-abdominal septic complications(IASC). Patients with IASC often require re-operation or drainage to controlthe sepsis and have an increased frequency of disease recurrence. The aim of this article was to examine the factors affecting postoperative IASC in Crohn's disease after anastomoses, since some risk factors remain controversial. Studies investigating IASC in Crohn's operations were included, and all risk factors associated with IASC were evaluated: nutritional status, presence of abdominal sepsis, medication use, Crohn's disease type, duration of disease, prior operations for Crohn's, anastomotic technique, extent of resection, operative timing, operative length, and perioperative bleeding. In this review, the factors associated with an increased risk of IASC are preoperative weight loss, abdominal abscess present at time of surgery, prior operation, and steroid use. To prevent IASC in Crohn's patients, preoperative optimization with nutritional supplementation or drainage of abscess should be performed, or a diverting stoma should be considered for patients with multiple risk factors.