Flow diagram of studies identified, included, and excluded.

<p>Flow diagram of studies identified, included, and excluded.</p

CO₂ insufflation versus air insufflation for endoscopic submucosal dissection: A meta-analysis of randomized controlled trials

<div><p>Background</p><p>Carbon dioxide (CO₂) insufflation is increasingly used for endoscopic submucosal dissection (ESD) owing to the faster absorption of CO₂ as compared to that of air. Studies comparing CO₂ insufflation and air insufflation have reported conflicting results.</p><p>Objectives</p><p>This meta-analysis is aimed to assess the efficacy and safety of use of CO₂ insufflation for ESD.</p><p>Methods</p><p>Clinical trials of CO₂ insufflation versus air insufflation for ESD were searched in PubMed, Embase, the Cochrane Library and Chinese Biomedical Literature Database. We performed a meta-analysis of all randomized controlled trials (RCTs).</p><p>Results</p><p>Eleven studies which compared the use of CO₂ insufflation and air insufflation, with a combined study population of 1026 patients, were included in the meta-analysis (n = 506 for CO₂ insufflation; n = 522 for air insufflation). Abdominal pain and VAS scores at 6h and 24h post-procedure in the CO₂ insufflation group were significantly lower than those in the air insufflation group, but not at 1h and 3h after ESD. The percentage of patients who experienced pain 1h and 24h post-procedure was obviously decreased. Use of CO₂ insufflation was associated with lower VAS scores for abdominal distention at 1h after ESD, but not at 24h after ESD. However, no significant differences were observed with respect to postoperative transcutaneous partial pressure carbon dioxide (PtcCO₂), arterial blood carbon dioxide partial pressure (PaCO₂), oxygen saturation (SpO₂%), abdominal circumference, hospital stay, white blood cell (WBC) counts, C-Reactive protein (CRP) level, dosage of sedatives used, incidence of dysphagia and other complications.</p><p>Conclusion</p><p>Use of CO₂ insufflation for ESD was safe and effective with regard to abdominal discomfort, procedure time, and the residual gas volume. However, there appeared no significant differences with respect to other parameters namely, PtcCO₂, PaCO₂, SpO₂%, abdominal circumference, hospital stay, sedation dosage, complications, WBC, CRP, and dysphagia.</p></div

Forest plot of primary outcomes of ESD with CO₂ insufflation and air insufflation.

<p>A: post-procedural abdominal pain VAS score; SMD with 95% CI; B: Percentage of patients without pain; RR with 95% CI; C: mean PtcCO₂ levels; SMD with 95% CI; D: post-procedural PaCO₂; SMD with 95% CI.</p

Results of quality assessment by Cochrane risk of bias.

<p>a. each risk of bias item presented as percentages across all included studies. b. each risk of bias item for each included study.</p

Characteristics of the included studies.

<p>Characteristics of the included studies.</p

Changes in the heterogeneity of abdominal pain VAS score at 24h post-procedure after sequential exclusion of one study at a time.

<p>Changes in the heterogeneity of abdominal pain VAS score at 24h post-procedure after sequential exclusion of one study at a time.</p

Isomer Profiles of Perfluoroalkyl Substances in Water and Soil Surrounding a Chinese Fluorochemical Manufacturing Park

Despite that China is the largest global manufacturer of perfluoroalkyl substances (PFASs), the manufacturing methods and isomer purity of these chemicals are generally unknown. Here, sampling was conducted around a major fluorochemical manufacturing park in China in 2012, including soil and water collection inside the park, including from a wastewater treatment plant (WWTP), as well as in surrounding rivers and soil (∼15 km radius). Perfluoroalkyl sulfonates (PFSAs) were lower than perfluoroalkyl carboxylates (PFCAs) in all samples, and short-chain (C₄–C₆) PFCAs were predominant. Perfluoroalkyl phosphonates and phosphate diesters were occasionally detected, but at low detection frequency. Branched isomers of perfluorobutanesulfonate (PFBS) are reported for the first time, accounting for 15–27% of total PFBS in water. An enrichment of isopropyl-PFOA (28%) was found in WWTP influent, suggesting its manufacturing primarily by isopropyl telomerization. More numerous branched isomers were observed for the longer C₉–C₁₃ PFCAs (e.g., C₁₂ PFCA had 16 branched isomers), including high proportions of one major branched isomer (likely isopropyl), possibly as impurities from isopropyl-PFOA manufacturing. Overall, short-chain perfluorinated acids were the predominant PFASs being released, but PFOA was still a major chemical in use at this site, primarily from isopropyl telomerization

Biomonitoring of Perfluoroalkyl Acids in Human Urine and Estimates of Biological Half-Life

Perfluoroalkyl acids (PFAAs) are persistent and bioaccumulative compounds that have been associated with adverse health outcomes. In human blood, PFAAs exist as both linear and branched isomers, yet for most linear homologues, and for all branched isomers, elimination rates are unknown. Paired blood and urine samples (<i>n</i> = 86) were collected from adults in China. They were analyzed by a sensitive isomer-specific method that permitted the detection of many PFAAs in human urine for the first time. For all PFAAs except perfluoroundecanoate (PFUnA), levels in urine correlated positively with levels in blood. Perfluoroalkyl carboxylates (PFCAs) were excreted more efficiently than perfluoroalkane sulfonates (PFSAs) of the same carbon chain-length. In general, shorter PFCAs were excreted more efficiently than longer ones, but for PFSAs, perfluorooctanesulfonate (PFOS, a C8 compound) was excreted more efficiently than perfluorohexanesulfonate (PFHxS, a C6 compound). Among PFOS and perfluorooctanoate (PFOA) isomers, major branched isomers were more efficiently excreted than the corresponding linear isomer. A one-compartment model was used to estimate the biological elimination half-lives of PFAAs. Among all PFAAs, the estimated arithmetic mean elimination half-lives ranged from 0.5 ± 0.1 years (for one branched PFOA isomer, 5<i>m</i>-PFOA) to 90 ± 11 years (for one branched PFOS isomer, 1<i>m</i>-PFOS). Urinary excretion was the major elimination route for short PFCAs (C ≤ 8), but for longer PFCAs, PFOS and PFHxS, other routes of excretion likely contribute to overall elimination. Urinary concentrations are good biomarkers of the internal dose, and this less invasive strategy can therefore be used in future epidemiological and biomonitoring studies. The very long half-lives of long-chain PFCAs, PFHxS, and PFOS isomers in humans stress the importance of global and domestic exposure mitigation strategies

Additional file 1: Figure S1. of The fate of systemically administrated allogeneic mesenchymal stem cells in mouse femoral fracture healing

Cell surface markers and differentiation capacities of mouse MSCs. (A) Flow cytometry analysis results confirmed that isolated BM-MSCs were negative for hematopoietic marker CD45. (B) Cells were negative for endothelial cell marker CD31. (C, D) Cells were positive for MSC markers CD44 and CD90. (E) The Alizarin red staining demonstrated that mineralized nodules formed after 4 weeks of the osteogenic induction. (F) Intracellular Oil red O-stained lipid-rich vacuoles appeared after 2 weeks of the adipogenic induction. BM-MSC bone marrow-derived mesenchymal stem cell, MSC mesenchymal stem cell. (TIFF 468 kb

Athabasca Oil Sands Petcoke Extract Elicits Biochemical and Transcriptomic Effects in Avian Hepatocytes

Petroleum coke or “petcoke” is a granular carbonaceous material produced during the upgrading of heavy crude oils, including bitumen. Petcoke dust was recently reported as an environmental contaminant in the Athabasca oil sands region, but the ecotoxicological hazards posed by this complex bitumen-derived materialincluding those to avian specieshave not been characterized. In this study, solvent extracts (x) of delayed and fluid petcoke (xDP and xFP) were prepared and dissolved in dimethyl sulfoxide. A water-accommodated fraction of delayed petcoke (waDP) was also prepared. Graded concentrations of xDP, xFP, and waDP were administered to chicken and double-crested cormorant hepatocytes to determine effects on 7-ethoxyresorufin-<i>O</i>-deethylase (EROD) activity, porphyrin accumulation, and mRNA expression. Polycyclic aromatic compounds (PACs) were characterized, and xDP, xFP, and waDP had total PAC concentrations of 93 000, 270, and 5.3 ng/mL. The rank order of biochemical and transcriptomic responses was xDP > xFP > waDP (e.g., EROD EC_50s were lower for xDP compared to xFP and waDP). A total of 22, 18, and 4 genes were altered following exposure to the highest concentrations of xDP, xFP, and waDP, respectively, using a chicken PCR array comprising 27 AhR-related genes. To provide more exhaustive coverage of potential toxicity pathways being impacted, two avian ToxChip PCR arrayschicken and double-crested cormorantwere utilized, and xDP altered the expression of more genes than xFP. Traditional PAC-related toxicity pathways and novel mechanisms of action were identified in two avian species following petcoke extract exposure. Extrapolation to real-world exposure scenarios must consider the bioavailability of the extracted PACs compared to those in exposed organisms