Background and study aims Endoscopic resection for esophageal squamous high-grade intraepithelial neoplasia (HGIN) or intramucosal cancer (esophageal squamous cell carcinoma [ESCC]) with the endoscopic resection cap technique is technically difficult, and requires submucosal lifting and multiple snares for piecemeal resections. Multiband mucosectomy (MBM) is an easy-to-use endoscopic resection technique and may be the modality of choice in China, where ESCC is extremely prevalent. The aim of the current study was to prospectively evaluate MBM for piecemeal endoscopic resection of squamous neoplasia of the esophagus. Methods Patients with HGIN/ESCC and no signs of submucosal invasion or metastatic disease were included in the study. Lesions were delineated using electrocoagulation and resected using the MBM technique. Endpoints were procedure time, endoscopic radicality, complications, histology of the endoscopic resection specimens, and absence of HGIN/ESCC at the endoscopic resection scar during follow-up. Results a total of 41 patients (26 male; mean age 61 years) underwent MBM; all lesions were visible with white light endoscopy (median length 5 cm, interquartile range [IQR] 4–6 cm; median circumferential extent 42%, IQR 25%–50%). Median procedure time was 12 minutes (IQR 8–24 minutes). Median number of resections was 5 (IQR 3–6). Endoscopic complete resection was achieved in all lesions. There was one perforation, which was treated by application of clips. No other complications were observed. The worst histology was ESCC (n = 19), HGIN (n = 17), middle grade intraepithelial neoplasia (n = 4), and normal squamous epithelium (n = 1). Endoscopic follow-up at 3 months showed HGIN at the endoscopic resection scar in two patients, which was effectively treated endoscopically, and showed normal squamous epithelium in all patients at final follow-up (median 15 months, IQR 12–24 months). Conclusion This first prospective study on MBM for piecemeal endoscopic resection of early esophageal squamous neoplasia showed that MBM was effective for the complete removal of lesions with short procedure time, few complications, effective histological assessment of resected specimens, and durable treatment effect.

Background: Most of the studies regarding air pollution and preterm birth (PTB) in highly polluted areas have estimated the exposure level based on fixed-site monitoring. However, exposure assessment methods relying on monitors have the potential to cause exposure misclassification due to a lack of spatial variation. In this study, we utilized a land use regression (LUR) model to assess individual exposure, and explored the association between PM 2.5 exposure during each time window and the risk of preterm birth in Wuhan city, China.

Objectives: To explore the health effects of indoor/outdoor carbonaceous compositions in PM2.5 on pulmonary function among healthy students living in the local university campus. Methods: Daily peak expiratory flow (PEF) and forced expiratory volume in 1 second (FEV1) were measured among 37 healthy students in the morning and evening for four two-week periods. Concurrent concentrations of indoor and outdoor PM2.5 (particulate matter with an aerodynamic diameter ≤ 2.5m), carbonaceous components in PM2.5, ambient temperature, and relative humidity in the study area were also obtained. Mixed-effects model was applied to evaluate the associations between carbonaceous components and lung function. Different lags for the carbonaceous components were investigated. Results: In single-pollutant model, a 10 g/m3 increase of indoor and outdoor EC (elemental carbon) associated with −3.93 (95%CI: −6.89, −0.97) L/min and −3.21 (95%CI: −5.67, −0.75) L/min change in evening PEF at lag 0 day, respectively. Also, a 10 g/m3 increase of indoor and outdoor POC (primary organic carbon) concentration was significantly associated with −5.82 (95%CI: −10.82, −0.81) L/min and −7.32 (95%CI: −12.93, −1.71) L/min change of evening PEF at lag 0 day. After adjusting total mass of PM2.5, indoor EC consistently had a significant adverse impact on evening PEF and FEV1 at lag3 day and a cumulative effect at lag0-3 day. Conclusions: This study suggests that carbonaceous components in PM2.5 indeed have impacts on pulmonary function among healthy young adults especially on evening PEF. Thus, the local mitigation strategies on pollution are needed.

Background:Intraoperative blood salvage (IBS) recovers most lost blood, and is widely used in the clinic. It is unclear why IBS does not reduce long-term postoperative requirements for red blood cells (RBCs), and 1 possibility is that IBS affects RBC lifespan.Methods:Prospectively enrolled patients who underwent spine, pelvic, or femur surgery not involving allogeneic RBC transfusion were grouped based on whether they received IBS or not. Volumes of blood lost and of RBCs salvaged during surgery were recorded. Total blood cell counts, levels of plasma-free hemoglobin, and CD235a-positive granulocytes were determined perioperatively.Results:Although intraoperative blood loss was higher in the IBS group (n = 45) than in the non-IBS group (n = 52) (P < .001), hemoglobin levels were similar between groups (P = .125) at the end of surgery. Hemoglobin levels increased in non-IBS patients (4 ± 11 g/L), but decreased in IBS patients (−7 ± 12 g/L) over the first 3 postoperative days. Nadir hemoglobin levels after surgery were higher in the non-IBS group (107 ± 12 g/L) than in the IBS group (91 ± 12 g/L). Salvaged RBC volume correlated with hemoglobin decrease (r = 0.422, P = .004). In multivariate analysis, salvaged RBC volume was an independent risk factor for hemoglobin decrease (adjusted odds ratio 1.002, 95% confidence interval 1.001–1.004, P = .008). Flow cytometry showed the numbers of CD235a-positive granulocytes after surgery to be higher in the IBS group than in the non-IBS group (P < .05).Conclusion:IBS may shorten the lifespan of RBCs by triggering their engulfment upon re-infusion (China Clinical Trial Registry ChiCTR-OCH-14005140).

Colorectal cancer (CRC) currently leads to many deaths worldwide. The regulatory mechanism, however, remains largely unclear. In the present study, bioinformatics methods were used to identify genes associated with CRC prognosis and to detect the molecular signals regulating the cell cycle in two CRC cell lines. It was revealed that BNIPL-2 expression was higher in CRC tissues than in adjacent tissue samples. Upregulation of BNIPL-2 was correlated with poor prognosis and the adverse malignant stages T and M. BNIPL-2 was also associated with signaling pathways involved in cancer cell growth. BNIPL-2 overexpression promoted cell proliferation and increased the proportion of cells in the G2/M phase. Knockdown of BNIPL-2 inhibited cell proliferation. CD44 was regulated by BNIPL-2 and promoted cell proliferation. Downregulation of CD44 suppressed cell proliferation and rescued the cell proliferation promoted by BNIPL-2. Overexpression of CD44 restored the cell proliferation suppressed by BNIPL-2 knockdown. The present study not only suggested that BNIPL-2 may be a potential biomarker of CRC but also indicated that BNIPL-2 regulates CRC cancer proliferation via CD44, which could be a diagnostic and clinical treatment target.