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Objective We aim to develop and validate a clinical scoring system to predict the risks of colorectal neoplasia to better inform screening participants and facilitate their screening test choice. Design We recruited 5220 Chinese asymptomatic screening participants who underwent colonoscopy in Hong Kong during 2008-2012. From random sampling of 2000 participants, independent risk factors were evaluated for colorectal neoplasia, defined as adenoma, advanced neoplasia, colorectal cancer or any combination thereof using binary regression analysis. The ORs for significant risk factors were used to develop a scoring system ranging from 0 to 6: 0-2 'average risk' (AR) and 3-6 'high risk' (HR). The other 3220 screening participants prospectively enrolled between 2008 and 2012 for screening colonoscopy formed an independent validation cohort. The performance of the scoring system for predicting colorectal neoplasia was evaluated. Results The prevalence of colorectal neoplasia in the derivation and validation cohorts was 31.4% and 30.8%, respectively. Using the scoring system developed, 78.9% and 21.1% in the validation cohort were classified as AR and HR, respectively. The prevalence of colorectal neoplasia in the AR and HR groups was 27.1% and 44.6%, respectively. The subjects in the HR group had 1.65-fold (95% CI 1.49 to 1.83) increased prevalence of colorectal neoplasia than the AR group. Conclusions The scoring system based on age, gender, smoking, family history, Body Mass Index and self-reported diabetes is useful in predicting the risk of colorectal neoplasia. [ABSTRACT FROM AUTHOR]

Bulbus Fritillariae is the most commonly used antitussive herb in China. Eleven species of Fritillaria are recorded as Bulbus Fritillariae in the Chinese Pharmacopoeia. Bulbus Fritillariae Cirrhosae is a group of six Fritillaria species with higher efficiency and lower toxicity derived mainly from wild sources. Because of their higher market price, five other Fritillaria species are often sold deceptively as Bulbus Fritillariae Cirrhosae in the herbal market. To ensure the efficacy and safety of medicinal herbs, the authentication of botanical resources is the first step in quality control. Here, a DNA based identification method was developed to authenticate the commercial sources of Bulbus Fritillariae Cirrhosae. A putative DNA marker (0.65 kb) specific for Bulbus Fritillariae Cirrhosae was identified using the Random Amplified Polymorphic DNA (RAPD) technique. A DNA marker representing a Sequence Characterized Amplified Region (SCAR) was developed from a RAPD amplicon. The SCAR marker was successfully applied to differentiate Bulbus Fritillariae Cirrhosae from different species of Fritillaria. Additionally, the SCAR marker was also useful in identifying the commercial samples of Bulbus Fritillariae Cirrhosae. Our results indicated that the RAPD-SCAR method was rapid, accurate and applicable in identifying Bulbus Fritillariae Cirrhosae at the DNA level. [ABSTRACT FROM AUTHOR]

Background and study aims: Capsule endoscopy may play a role in the evaluation of patients presenting with acute upper gastrointestinal hemorrhage in the emergency department. Patients and methods: We evaluated adults with acute upper gastrointestinal hemorrhage presenting to the emergency departments of two academic centers. Patients ingested a wireless video capsule, which was followed immediately by a nasogastric tube aspiration and later by esophagogastroduodenoscopy (EGD).We compared capsule endoscopy with nasogastric tube aspiration for determination of the presence of blood, and with EGD for discrimination of the source of bleeding, identification of peptic/inflammatory lesions, safety, and patient satisfaction. Results: The study enrolled 49 patients (32 men, 17 women; mean age 58.3 ± 19 years), but three patients did not complete the capsule endoscopy and five were intolerant of the nasogastric tube. Blood was detected in the upper gastrointestinal tract significantly more often by capsule endoscopy (15 /18 [83.3 %]) than by nasogastric tube aspiration (6 /18 [33.3 %]; P=0.035). There was no significant difference in the identification of peptic/ inflammatory lesions between capsule endoscopy (27 /40 [67.5 %]) and EGD (35 /40 [87.5 %]; P= 0.10, OR 0.39 95%CI 0.11-1.15). Capsule endoscopy reached the duodenum in 45/46 patients (98 %). One patient (2.2 %) had self-limited shortness of breath and one (2.2 %) had coughing on capsule ingestion. Conclusions: In an emergency department setting, capsule endoscopy appears feasible and safe in people presenting with acute upper gastrointestinal hemorrhage. Capsule endoscopy identifies gross blood in the upper gastrointestinal tract, including the duodenum, significantly more often than nasogastric tube aspiration and identifies inflammatory lesions, as well as EGD. Capsule endoscopy may facilitate patient triage and earlier endoscopy, but should not be considered a substitute for EGD. [ABSTRACT FROM AUTHOR]

Hydrogen sulfide (H2S) is a gaseous bacterial metabolite that reaches high levels in the large intestine. In the present study, the effect of H2S on the proliferation of normal and cancerous colon epithelial cells was investigated. An immortalized colon epithelial cell line (YAMC) and a panel of colon cancer cell lines (HT-29, SW1116, HCT116) were exposed to H2S at concentrations similar to those found in the human colon. H2S inhibited normal and cancerous colon epithelial cell proliferation as measured by MTT assay. The anti-mitogenic effect of H2S was accompanied by G1-phase cell cycle arrest and the induction of the cyclin-dependent kinase inhibitor p21Cip. Moreover, exposure to H2S led to features characteristic of autophagy, including increased formation of LC3B+ autophagic vacuoles and acidic vesicular organelles as determined by immunofluorescence and acridine orange staining, respectively. Abolition of autophagy by RNA interference targeting Vps34 or Atg7 enhanced the anti-proliferative effect of H2S. Further mechanistic investigation revealed that H2S stimulated the phosphorylation of AMP-activated protein kinase (AMPK) and inhibited the phosphorylation of mammalian target of rapamycin (mTOR) and S6 kinase. Inhibition of AMPK significantly reversed H2S-induced autophagy and inhibition of cell proliferation. Collectively, we demonstrate that H2S inhibits colon epithelial cell proliferation and induces protective autophagy via the AMPK pathway. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC) is rapidly increasing in Asia, but screening guidelines are lacking. Through reviewing the literature and regional data, and using the modified Delphi process, the Asia Pacific Working Group on Colorectal Cancer and international experts launch consensus recommendations aiming to improve the awareness of healthcare providers of the changing epidemiology and screening tests available. The incidence, anatomical distribution and mortality of CRC among Asian populations are not different compared with Western countries. There is a trend of proximal migration of colonic polyps. Flat or depressed lesions are not uncommon. Screening for CRC should be started at the age of 50 years. Male gender, smoking, obesity and family history are risk factors for colorectal neoplasia. Faecal occult blood test (FOBT, guaiac-based and immunochemical tests), flexible sigmoidoscopy and colonoscopy are recommended for CRC screening. Double-contrast barium enema and CT colonography are not preferred. In resource-limited countries, FOBT is the first choice for CRC screening. Polyps 5-9 mm in diameter should be removed endoscopically and, following a negative colonoscopy, a repeat examination should be performed in 10 years. Screening for CRC should be a national health priority in most Asian countries. Studies on barriers to CRC screening, education for the public and engagement of primary care physicians should be undertaken. There is no consensus on whether nurses should be trained to perform endoscopic procedures for screening of colorectal neoplasia. [ABSTRACT FROM AUTHOR]

To investigate the clinical and immunologic significance of autoantibodies to RNA helicase A (RHA) in patients with systemic rheumatic diseases.The study group comprised 1,119 individuals enrolled in the University of Florida Center for Autoimmune Diseases registry from 2000 to 2005. Diagnoses were based on standard criteria. Autoantibodies were analyzed by immunoprecipitation and Western blot assays.Anti‐RHA was observed in 17 (6.2%) of 276 patients with systemic lupus erythematosus (SLE), 2 patients with antiphospholipid antibodies, and 3 other patients, but anti‐RHA was not observed in any patient with polymyositis/dermatomyositis, systemic sclerosis, rheumatoid arthritis, or Sjögren''s syndrome. Anti‐RHA was present in only 2.9% of African American patients, compared with 6.0% of white patients and 12–25% of patients of other races; this was in striking contrast to the frequency of anti‐Sm in African American patients (27.2%). Among patients with SLE, anti‐RHA was common in young patients (26% of those whose initial visit was at an age younger than 20 years versus 3–4% of those who were initially seen at ages 20–49 years) and at an early stage of disease (23% of those whose first clinic visit was within 1 year of disease onset versus 2–8% of those whose first visit was at least 1 year after disease onset). In 9 of 11 patients, levels of anti‐RHA decreased to <10% of the initial value within 9–37 months, while levels of coexisting anti‐Ro or anti‐Su remained the same. New specificities developed in 2 patients (anti–nuclear RNP and anti‐Sm, and anti–ribosomal P, respectively). These data suggest that the level of anti‐RHA diminishes over time, and that anti‐RHA is regulated via a mechanism different from that for other lupus‐related autoantibodies.Anti‐RHA is a new serologic marker for SLE. It is produced mainly in young non–African Americans at an early stage of their disease. Anti‐RHA has a unique tendency to diminish over time. The production of anti‐RHA may depend on a process restricted to early SLE, or it may be highly sensitive to treatment. [ABSTRACT FROM AUTHOR]

Two-dimensional (2D) hybrid materials have drawn enormous attention in thermoelectric applications. In this work, we apply a molecular dynamics (MD) simulation to investigate the phonon thermal transport in silicene-germanene superlattice. A non-monotonic thermal conductivity of silicene-germanene superlattice with period length is revealed, which is due to the coherent–incoherent phonon conversion and phonon confinement mechanisms. We also calculate the thermal conductivity of a Si-Ge random mixing monolayer, showing a U-shaped trend. Because of the phonon mode localizations at Ge concentration of <20% and >80%, thermal conductivity varies dramatically at low doping regions. By changing the total length (Ltotal), the infinite-length thermal conductivities of pure silicene, pure germanene, silicene-germanene superlattice, and Si-Ge random mixing monolayer are extracted as 16.08, 15.95, 5.60 and 4.47 W/m-K, respectively. The thermal boundary conductance (TBC) of the silicene-germanene is also evaluated, showing a small thermal rectification. At Ltotal = 274.7 nm, the TBC of silicene to germanene is 620.49 MW/m2-K, while that of germanene to silicene is 528.76 MW/m2-K. [ABSTRACT FROM AUTHOR]

To identify a finer level of antibody specificity for risk of congenital heart block (CHB) than reactivity to 52‐kd SSA/Ro (Ro 52).Serum from mothers enrolled in the Research Registry for Neonatal Lupus and the observational PR Interval and Dexamethasone Evaluation (PRIDE) study was evaluated for reactivity against peptide aa200‐239 of Ro 52 (p200), recently reported to be associated with a higher risk of CHB.The majority of 156 Ro 52–positive sera tested were reactive with p200 (>3 SD above control), irrespective of the clinical status of the child. Optical density (OD) values of p200 did not differ significantly among mothers of children with CHB (mean ± SD 0.187 ± 0.363), mothers of children with rash (mean ± SD 0.176 ± 0.356), and mothers of children without neonatal lupus (mean ± SD 0.229 ± 0.315). Reactivity against p200 was found in 80 of 104 mothers of children with CHB (77%), 24 of 30 mothers of children with rash (80%), and 21 of 22 mothers who delivered healthy children and had no children with neonatal lupus (95%) (P not significant for all comparisons). Sera from 4 mothers of children with CHB with varied p200 titers (OD range 0.025–1.818) bound to the surface of nonpermeabilized apoptotic, but not proliferating, human fetal cardiocytes. In 32 Ro 52–positive women who completed the PRIDE study (22 with no child with neonatal lupus, 7 with a child with CHB, and 3 with a child with rash) in whom p200 levels were determined during pregnancy, the correlation between level of p200 (OD range 0.000–1.170) and maximal fetal PR interval (range 115–168 msec) was not significant (ρ = 0.107, P = 0.58).Reactivity to p200 is a dominant but not uniform anti–Ro 52 response in women whose children have CHB. Since exposure to this antibody specificity was observed with a similar frequency in children without CHB born to mothers with anti–Ro 52, additional factors are necessary to convert risk to disease expression. [ABSTRACT FROM AUTHOR]