Objective: To analyze the characteristics and safety risks of preservatives and sweeteners in beverages sold near schools in Anshun City, so as to provide a evidence for formulating targeted regulatory strategies in campus. Methods: From December 2023 to July 2024, 834 beverage samples were collected from sales points near primary and secondary schools in Xixiu District and four surrounding townships of Anshun City by a stratified random sampling method. High performance liquid chromatography was used to detect three preservatives (sorbic acid, benzoic acid and dehydroacetic acid) and four sweeteners (sodium saccharin, acesulfame-K, aspartame, and neotame). Differences were analyzed using the Chi-square test. Results: The overall exceedance rate of preservative was 8.6% (72 samples), with dehydroacetic acid showing the highest exceedance rate (7.0%, 58 samples), significantly higher than sorbic acid (0.6%, 5 samples) and benzoic acid (0.4%, 3 samples) ( χ 2=90.85, P <0.01). The overall exceedance rate of sweetener was 10.4% (87 samples), with sodium saccharin having the highest exceedance rate ( 6.2 %, 52 samples),significantly higher than neotame (2.8%, 23 samples), acesulfame-K (0) and aspartame (0) ( χ 2=262.04, P <0.01). Potential risks were identified due to the co occurrence of multiple additive exceedances, including 0.7% (6 samples) for mixed preservatives and 1.6% (13 samples) for mixed sweetener. No statistically significant differences were found in preservative (7.2%, 26 samples) or sweetener (12.3%, 44 samples) exceedance rates between micro enterprises and large, medium and small enterprises ( χ 2=2.67, 5.16, both P >0.05). Conclusion Systemic misuse risk of food additives in beverages sold near school necessitates a risk traceability based regulatory framework, with emphasis on standardizing enterprise production practices and strengthening oversight of sales outlets near campuses.

Objective To investigate the short- and long-term prognoses and the risk factors affecting “textbook outcome” (TO) after laparoscopic pancreaticoduodenectomy (LPD) for pancreatic ductal adenocarcinoma (PDAC). Methods The clinical and follow-up data of patients diagnosed with PDAC and treated with LPD from January 2019 to December 2022 were retrospectively analyzed. The prognosis was compared between TO and non-TO groups, and univariate and multivariate logistic regression analyses were used to identify independent prognostic factors for TO. Results A total of 284 patients were enrolled in this study, including 185 cases in the TO group and 99 cases in the non-TO group. The 1-, 3- and 5-year overall survival (OS) rates of the TO and non-TO groups with PDAC were 87.3% vs. 85.9%, 52.5% vs. 38.4%, and 18.0% vs. 4.5%, respectively (P=0.020); the recurrence-free survival (RFS) rates were 74.1% vs. 65.7%, 27.1% vs. 21.0%, and 10.0% vs. 0%, respectively (P=0.042). Multivariate logistic regression analysis showed that operation time >360 min (OR=0.561, 95%CI: 0.321-0.979, P=0.042), intraoperative blood loss >400 ml (OR=0.392, 95%CI: 0.175-0.879, P=0.023), hard or tough texture of pancreas (OR=2.240, 95%CI: 1.247-4.022, P=0.007), and main pancreatic duct diameter >3 mm (OR=1.931, 95%CI: 1.126-3.312, P=0.017) were independent prognostic factors for TO. Conclusion After the learning curve, more than 60% of patients with PDAC can achieve TO after LPD. The chances of achieving TO are significantly reduced when the operation time >360 min, the intraoperative blood loss >400 ml, the texture of pancreas was soft, and the diameter of the main pancreatic duct >3 mm.

Objective To develop a predictive model for pulmonary embolism(PE)based on the related clinical symptoms,signs,and the labo-ratory index,so as to improve the positive rate of CTPA. Methods The model was developed from a database of 119 patients with suspected PE. The risk factors of suspected PE were analyzed by logistic regression analysis ,which included significant differences in the prevalence of PE be-tween non-diseased and non-diseased groups. Receiver operating characteristic(ROC)curves was draw to determine the cut-off value of the clini-cal probability. It was validated in an independent sample of 106 patients with suspected PE. Results According to the univariate analysis ,17 of 51 variables show a significant difference between PE and non-PE patients. The model comprised 4 variables:age,dyspnea,D-dimer and unilater-al leg swelling. The area under the ROC curve is 0.776,and the cut-off value is supposed to be 0.38. In the validation sample,27% patients had PE confirmed by CTPA. The prevalence of PE was 54%when the clinical probability was above 0.38. Conclusion The proposed predictive mod-el in this study can improve the positive rate of CTPA ,simplify the diagnosis process of suspected PE patients.

Consensus ; Hirschsprung Disease ; diagnosis ; Humans

Objective To observe the effect of RNA interference binding immunoglobulin protein (BiP) on expression of bone markers and keytranscription factors in osteoblast exposed to fluoride.Methods MC3T3-E1 cells were used as osteoblast model in vitro.The cell viability was test with cell counting Kit-8 after cells were administrated with varying concentrations of fluoride [0.0 (control),0.1,1.0,2.0,4.0,8.0,16.0,20.0,32.0 and 64.0 mg/L] for different duration.Cells transfected with small interfering RNA (siRNA) BiP were exposed to fluoride (2.0,8.0 and 20.0 mg/L) for 2 days.Real-time PCR and Western blotting technique were used to determine the gene and protein levels of BiP.Meantime,the mRNA expression of bone markers and key transcription factors was investigated by real-time PCR.Results The difference of all viability in fluoride-dose groups was statistically significant exposed for 1,3,7 and 14 days (F =46.7,118.6,214.6,325.6,all P ＜ 0.05).Expression of BiP significantly increased in cells exposed to 20.0 mg/L compared to that of control (11.22 ± 3.25 vs.7.94 ± 1.31,P ＜ 0.05).The expression of alkaline phosphatase (ALP) elevated in cells exposed to 2.0 mg/L of fluoride (12.81 ± 3.62 vs.6.86 ± 2.13,P ＜ 0.01);conversely,it significantly reduced in cells exposed to 20.0 mg/L of fluoride (0.89 ± 0.17 vs.6.87 ± 2.14,P ＜ 0.01).Cells transfected with siRNA BiP significantly decreased the ALP expression in cells exposed to fluoride compared to that of cells only exposed to the same concentration of fluorine (12.81 ± 3.62 vs.7.43 ± 2.06;5.92 ± 2.38 vs.3.96 ± 0.21,all P ＜ 0.05).Cells transfected with siRNA BiP and administrated with 2.0 mg/L significantly reduced the osteocalcin expression (4.29 ± 0.99 vs.1.29 ± 0.86,P ＜ 0.01).Similarly,expression of runt-related transcription factor 2 (Runx2) significantly increased in cells exposed to 2.0 mg/L.However,expression of Runx2 significantly decreased in cells transfected with siRNA BiP and administrated with fluoride.Cells transfected with siRNA BiP significantly decreased the Runx2 expression in cells exposed to 2.0 mg/L and 20.0 mg/L compared to that of cells only exposed to the same concentration of fluorine (1.13 ± 0.22 vs.6.61 ± 0.48;0.02 ± 0.02 vs.1.50 ± 0.38,all P ＜ 0.01).As the downstream of Runx2,the expression of osterix in cells treated with different concentrations of fluoride was similar to that of Runx2.Conclusion BiP is not directly involved in the process of osteoblast differentiation induced by fluoride;instead,it affects the expression of bone markers and key transcription factors in osteoblast exposed to fluoride.

Anemia, Aplastic ; drug therapy ; immunology ; Animals ; Antilymphocyte Serum ; immunology ; therapeutic use ; Calcineurin Inhibitors ; immunology ; therapeutic use ; Humans ; Immunoglobulins ; immunology ; therapeutic use ; Lymphocytes ; drug effects ; immunology ; Swine

Adult ; Female ; Humans ; Male ; Middle Aged ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; Rhabdomyolysis ; chemically induced ; diagnosis ; Vindesine ; adverse effects ; therapeutic use

Objective To discuss interventional procedures before feeding tube placed in the DSA guidance,influence postoperative enteral nutrition support for the presence of nutritional risk of clinical outcomes in elderly patients with hepatocellular carcinoma. Methods 33 patients acquired with interventional therapy of hepatic carcinoma were selected as the study group.All of patients un-derwent preoperatively the nutritional risk screening and insertion of nasogastric feeding tube under DSA.Enteral nutritional support by the nasogastric feeding tube was used after interventional therapy.33 similar patients underwent parenteral nutritional support af-ter international therapy were selected as the control group.The change of the nutritional indexes,the incidence of the systemic in-flammatory response syndrome,the incidence of infection,and the length of hospital stay after operation were compared between the two groups.Results There were no significant differences in the plasma albumin levels and body weight changes compared between the two groups (P >0.05).However,the incidence of infection and the length of hospital stay were lower significantly in the study group than in the control group (P >0.05).Conclusion The nutritional risk screening before interventional treatment is necessary for the elder patients with hepatic carcinoma.The patients with nutritional risk can be placed the nasogastric feeding tube preopera-tively under DSA,and perform combined nutritional support to promote the recovery of nutritional state after operation.

Objective To evaluate the safety and efficacy of combined transcatheter intraarterial chemoembolization with 350-560 μm gelatin sponge particles and lobaplatin (GSPs-TACE) and oral Chinese herb medication Huaier granules in patients with hepatocellular carcinoma (HCC).Methods This is a case-control,single-institution clinical trial.31 HCC patients receiving GSPs-TACE (group A) were matched with 31 patients receiving GSPs-TACE and Huaier granules (group B).Tumor response was evaluated by CECT using response evaluation criteria in solid tumors at 1 month after initial GSPs-TACE.The overall survival was calculated from the data of initial GSPs-TACE using the Kaplan-Meier method.Results The overall mean follow-up period was 28.7 (range 12-42) months.The overall 6-and 12-month survival rates in group A and group B were 90.3％ and 80.6％ vs 100％ and 93.5％,respectively.There was statistically significant difference in 12-month survival rates (x2 =5.213,P ＜0.05).Median survival time respectively was 17.1 and 20.6 months(x2 =0.745,P ＞0.05).The average TACE times were (4.1 ±7.3) and (2.9 ±8.7) respectively in group A and group B (P =0.01).Tumor objective response rate was statistically different in 6-and 12-month in two arms(x2 =5.945,6.384,P ＜0.05).There was no statistically significant difference in complications (respectively x2 =0.435,0.485,2.037,0.137,0.325,all P ＞ 0.05).Conclusions Huaier granules combined with transcatheter intraarterial chemoembolization with 350-560 μm gelatin sponge particles and carboplatin for HCC is safe and effectively prolongs patients' survival.