OBJECTIVETo study the anti-halitosis effect of sugar-free chewing gum through their influence on odor induced by cysteine.

METHODSTen volunteers were randomly divided into the treatment group and the untreated group; each group consisted of five volunteers. All volunteers consented to participate in a test in which breath odor was induced by cysteine. After the test, the treatment group chewed sugar-free chewing gum for 1 min, whereas the untreated group did not undergo any treatment. The effectiveness was determined by the percent reduction of H2S, CH3SH, and (CH3)2S response after the volunteers chewed gum for 1, 10, and 20 min.

RESULTSAt 1, 10, and 20 min, H2S of the treatment group was reduced by 82.68%, 92.27%, 97.47%, respectively, CH3SH was reduced by 65.49%, 73.79%, and 82.89%, respectively, and (CH3)2S was reduced by 60.45%, 73.82%, and 59.72%, respectively. The differences between the two groups at different times were significant (P < 0.05).

CONCLUSIONChewing gum can effectively inhibit cysteine-induced odor.

Objective: To investigate the second-hand smoke behavior at home among smokers, so as to provide the reference for developing home tobacco control strategies. Methods: Permanent residents who were smokers and at the ages of 15 years and above were sampled from 10 streets (townships) in Xuhui District, Shanghai Municipality using the multi-stage random sampling and population-size proportional sampling methods in 2022. Demographic information, smoking status, awareness of second-hand smoke hazards and second-hand smoke behavior at home were collected by questionnaire surveys. Factors affecting second-hand smoke behavior at home were identified using a multivariable logistic regression model. Results: A total of 1 024 smokers were surveyed, including 769 males (75.10%) and 255 females (24.90%). The awareness of hazards of second-hand smoke was 33.59%; the awareness rate of second-hand smoke causing lung cancer in adults was the highest at 76.76%, while the awareness rate of second-hand smoke leading to premature birth and low birth weight in newborns was the lowest at 39.45%. There were 459 smokers with second-hand smoke behavior at home, accounting for 44.82%. Multivariable logistic regression analysis showed that occupation (the retired, OR=2.320, 95%CI: 1.276-4.218), frequency of smoking (often, OR=5.722, 95%CI: 3.977-8.231), smoking duration (a year and above, OR=10.089, 95%CI: 5.508-18.480), electronic cigarette use (occasionally, OR=2.994, 95%CI: 1.283-6.986), living with pregnant women or infants (no, OR=2.171, 95%CI: 1.367-3.448), family indoor smoking restrictions (no restriction, OR=13.926, 95%CI: 7.538-25.727) and awareness of second-hand smoke hazards (unknown, OR=1.562, 95%CI: 1.067-2.287) were the influencing factors for second-hand smoke behavior at home. Conclusion There were 44.82% smokers in Xuhui District with second-hand smoke behavior at home, which was influenced by occupation, living situation, smoking status, family indoor smoking restriction and awareness of second-hand smoke hazards.

Objective To evaluate the safety, indications and clinical efficacy of single balloon enteroscopy (SBE) for diagnosis of small bowel diseases. Methods Data of 30 patients (21 males and 9 females) with suspected small bowel diseases, who underwent SBE from June to September 2009, were retrospectively studied to analyze the access, procedure time and complications of SBE. Results A total of 35 SBE procedures were performed on 30 patients. Procedures were performed via oral, anal and the combined routes in 15, 10 and 5 cases, respectively, and definite diagnosis was made in26 cases (86. 7% ). The average access times via oral and anal routes were 49.7 min and 48. 6 min, respectively. Patietns showed normal vital signs during the procedures. No such procedure-related complications as cadiovascular events, severe abdominal pain, bleeding or perforation, were observed. Conclusion SBE is a safe and reliable diagnostic modality of high clinical value for small bowel diseases.

Objective To assess the effectiveness and safety of the technique of endoscopic submucosal dissection (ESD) in upper gastrointestinal lesions. Methods The patients with mucosal or submucosal lesions of upper gastrointestinal tract detected by gastroscopy were enrolled. Endoscopic ultrasonography and/ or biopsy were applied to confirm the size, location, and nature of the lesions. The procedure of ESD, involving the use of hook knife, insulation-tipped diathermic knife ( IT knife), and high-frequency electric coagulation, was as follows : first, identified the lesions by gastroscopy or mucosal staining and marked it with needle knife or argon plasma coagulation (APC) ; second, raised the submucosa through submucosal injection of indigo carmine and diluted epinephrine. Then, pre-cut the circumferential mucosa of the target lesion; finally, completely dissected along the submucosal layer. Acid-suppressing and mucosal protection agents were administered postoperatively. Follow-up endoscopy was taken at 1, 2, 6 months after ESD to evaluate the progression of the lesions. Results A total of 153 cases were enrolled from August 2006 to January 2008, of which 85 were mucosal lesions and 68 were submucosal ones. The mucosal lesions included 2 cases of ulcerating type, 48 of protruding type, and 35 of erosive type, with the diameter ranging from 0. 4 to 5. 0 cm (mean 2. 0 era). All the mucosal lesions were dissected through endoscopy, with the operation time ranging from 15 to 210 minutes (mean 55 minutes). One patient received emergency endoscopic hemostaais becauseof delayed hemorrhage, seven others were treated conservatively because of perforation. All the wound surfaces healed during the follow-up, including 4 cases of recurrence, of which 3 received second ESD, and 1 was referred to surgery. Among the submucosal lesions, 52 cases underwent endoscopic ultrasonography before ESD, and the others were diagnosed by postoperative histology. The diameter of the lesion ranged from 0. 4 to 4. 0 cm ( mean 1.2 cm). All the submucosal lesions were removed completely in 10 to 182 minutes(mean 41 min), except one patient was treated by endoscopic nylon ligation. Eleven patients were treated conservatively because of perforation, and one received surgery because of the uncontrolled bleeding. Conclusion As a minimally invasive method, ESD may present a novel and promising procedure in treating mucosal or submucosal lesions of upper gastrointestinal tract, with the advantage of achieving large en-bloc resections, low recurrence rate, and few complications.

Objective To evaluate the clinical efficacy and safety of 4 types of endoscopic nylon ligation in the treatment of submucosal tumors in upper gastrointestinal tract. Methods Those with submucosal tumors located in esophagus, stomach or duodenum were enrolled in the study. All patients were treated with endoscopic nylon ligation, which included direct ligation, ligation with a transparent cap, ligation with dual-channel endoscope, and ligation in combination with endoscopic submucosal dissection (ESD).The patients were followed up endoscopically for evaluation of efficacy and safety of the procedures. Results A total of 128 patients were recruited into the present study from June 2006 to December 2008. The tumors were in esophagus in 28 patients, in stomach in 82 and in duodenum in 18. Direct ligation was applied in 3 patients, ligation with a transparent cap in 105, ligation with a dual-channel endoscope in 8, and ligation plus ESD in 12. Endoscopic follow-up was completed in 111 patients. Reduced lesion size was observed in 16 patients ( 14. 4% ), residue nylon in 16 ( 14. 4% ) and no lesion in 71 others (63.9%). The overall effective rate was 92.8%. No delayed perforation or bleeding occurred. Conclusion Endoscopic ligation with nylon thread in combination with other assistant approaches is effective and safe for the treatment of submucosal tumors in upper gastrointestinal tract.

Objective To evaluate the efficacy of a new endoscopic suturing device(OverStitchTM, Apollo Endosurgery, USA)for gastrointestinal wall defect after endoscopic full?thickness resection (EFTR). Methods Clinical data of the patients with submucosal tumors who underwent endoscopic suturing closure of gastrointestinal wall defect at the Endoscopy Center of Zhongshan Hospital from April 2015 to June 2015 were retrospectively analyzed. Results Five patients were included in this research with 4 lesions located in stom?ach and 1 lesion located in descendent duodenum. The mean diameter of lesions was 3?? 2 cm (ranging 2?? 0?5?? 0 cm). All patients underwent complete closure and none of them was converted to laparoscopic surgery or laparotomy. The mean repairing time was 16?? 6 min (ranging 11?? 0?22?? 0 min). The mean postoperative hospi?talization time was 5 days ( ranging 4?6 d). Two patients complained about slight abdominal pain and elevated body temperature. CT showed minor pleural effusion in one case. These patients received antibiotics, were on gastrointestinal decompression and asked to maintain the semi?supine position and discharged after 3 to 4 days. Conclusion Endoscopic suturing closure of gastrointestinal wall defect with the OverStitchTM en?doscopic suturing device is technically fast, feasible and safe.

Objective??To?study?the?anti-halitosis?effect?of?sugar-free?chewing?gum?through?their?influence?on?odor?induced?by?cysteine.?Methods??Ten?volunteers?were?randomly?divided?into?the?treatment?group?and?the?untreated?group;?each?group?consisted?of?five?volunteers.?All?volunteers?consented?to?participate?in?a?test?in?which?breath?odor?was?induced?by?cysteine.?After?the?test,?the?treatment?group?chewed?sugar-free?chewing?gum?for?1?min,?whereas?the?untreated?group?did?not?undergo?any?treatment.?The?effectiveness?was?determined?by?the?percent?reduction?of?H2S,?CH3SH,?and?(CH3)2S?response?after?the?volunteers?chewed?gum?for?1,?10,?and?20?min.?Results??At?1,?10,?and?20?min,?H2S?of?the?treatment?group?was?reduced?by?82.68%,?92.27%,?97.47%,?respectively,?CH3SH?was?reduced?by?65.49%,?73.79%,?and?82.89%,?respectively,?and?(CH3)2S?was?reduced?by?60.45%,?73.82%,?and?59.72%,?respectively.?The?differences?between?the?two?groups?at?different?times?were?significant?(P<0.05).?Conclusion??Chewing?gum?can?effectively?inhibit?cysteine-induced?odor.

ObjectiveTo evaluate the efficacy and safety of submucosal tunneling endoscopic resection (STER) for upper gastrointestinal (GI) submucosal tumors (SMTs) originating from the muscularis propria (MP) layer.MethodsA total of 26 upper GI-SMTs originating from the MP layer were treated by STER after endoscopic ultrasonography (EUS) and CT examination.The lesions were localized endoscopically and a submucosal tunnel was created to expose the tumor.The lesion was then resected under direct endoscopic view and the mucosal incision site was closed with hemostatic clips.ResultsOf the 26 SMTs,14 were located at esophagus,7 at cardia and 5 at stomach,with 11 originated from superficial MP layer and 15 from deep MP layer ( including 2 gastric SMTs adherent with serosa).All lesions were successfully resected by STER with an en bloc resection rate of 100％.The average operation time was 68.5 min ( range 25-145min).Four to six (mean five) hemostatic clips were used to close the mucosal incision site.The average lesion size was 1.8 cm ( range 1.0-3.2 cm).The pathology results were 17 leiomyomas,7 stromal tumors (GISTs),1 glomus tumor and 1 Schwannoma.All resected lesions showed both lateral and vertical tumorfree margins.Subcutaneous emphysema occurred in 2 patients (7.7％ ).One patient (3.8％ ) developed left pneumothorax and subcutaneous emphysema,and 2 others (7.7％) pneumoperitoneum.All of them recovered uneventfully on conservative treatments.No delayed bleeding,GI tract leakage or secondary peritoneal/thoracial infection occurred.None of the 26 cases developed submucosal hematoma or infection.No tumor residual or recurrence was found during follow-up period (range 3-9 months).ConclusionSTER is a safe,efficacious and feasible new method for providing accurate histopathological evaluations,as well as radical treatments for upper GI-SMTs from the MP layer.It can regain the mucosal integrity of the GI tract,preventing leakage and secondary infection.

Objective:To investigate the association between estradiol on the day of human chorionic gonadotropin (HCG) administration and birth outcomes among singleton live births following fresh embryo transfers.Methods:Based on the clinical reproduction medicine management system of the First Affiliated Hospital of Nanjing Medical University, this retrospective cohort study collected data of fresh embryo transfer cycles during January 2013 and December 2016, including pregnant women’s age, body mass index (BMI), type and cause of infertility, assisted reproductive therapy indicators (fertilization mode, ovulation stimulation protocol, estradiol levels on HCG administration day), adverse birth outcomes[small for gestational age (SGA), premature and low birth weight (LBW)], etc.. A total of 2 060 women with singleton pregnancy (2 061 fresh embryo transfer cycles) were enrolled. Multivariate logistic regression was used to analyze the association between estradiol on HCG administration day and singletons’ adverse birth outcomes.Results:The age and BMI of the 2 060 pregnant women were (29.63±3.92) years old and (22.29±2.86) kg/m 2. Incidences of SGA, premature and LBW were 9.8% (201/2 061), 6.9% (143/2 061) and 3.5% (73/2 061), respectively. After adjusting for confounders, the risk of LBW in 4 000-4 499 pg/ml group was significantly elevated when compared to estradiol<1 500 pg/ml group [ OR (95% CI): 4.42 (1.13-17.24)]. A protective effect of premature was observed in estradiol≥4 500 pg/ml group [ OR (95% CI): 0.50 (0.25-0.97)]. Conclusion:The high level of estradiol on HCG administration day might be a risk factor for LBW, but a protective factor for premature.

Objective:To investigate the association between estradiol on the day of human chorionic gonadotropin (HCG) administration and birth outcomes among singleton live births following fresh embryo transfers.Methods:Based on the clinical reproduction medicine management system of the First Affiliated Hospital of Nanjing Medical University, this retrospective cohort study collected data of fresh embryo transfer cycles during January 2013 and December 2016, including pregnant women’s age, body mass index (BMI), type and cause of infertility, assisted reproductive therapy indicators (fertilization mode, ovulation stimulation protocol, estradiol levels on HCG administration day), adverse birth outcomes[small for gestational age (SGA), premature and low birth weight (LBW)], etc.. A total of 2 060 women with singleton pregnancy (2 061 fresh embryo transfer cycles) were enrolled. Multivariate logistic regression was used to analyze the association between estradiol on HCG administration day and singletons’ adverse birth outcomes.Results:The age and BMI of the 2 060 pregnant women were (29.63±3.92) years old and (22.29±2.86) kg/m 2. Incidences of SGA, premature and LBW were 9.8% (201/2 061), 6.9% (143/2 061) and 3.5% (73/2 061), respectively. After adjusting for confounders, the risk of LBW in 4 000-4 499 pg/ml group was significantly elevated when compared to estradiol<1 500 pg/ml group [ OR (95% CI): 4.42 (1.13-17.24)]. A protective effect of premature was observed in estradiol≥4 500 pg/ml group [ OR (95% CI): 0.50 (0.25-0.97)]. Conclusion:The high level of estradiol on HCG administration day might be a risk factor for LBW, but a protective factor for premature.