Effectiveness of digestive endoscopy and surgery in the treatment of necrotizing pancreatitis: a meta-analysis and systematic review.

BACKGROUND: Digestive endoscopy and surgery are the primary invasive methods for the clinical treatment of necrotizing pancreatitis. However, there are relatively few studies evaluating the effectiveness and safety of these two methods. METHODS: Randomized controlled trials (RCTs) on endoscopic and surgical treatment of necrotizing pancreatitis published from January 2000 to December 2020 were searched in the PubMed, Medline, Embase, China Biology Medicine Disc (CBM), and WanFang databases. The Cochrane System Review Manual was adopted to evaluate the quality of the included literature, and Review Manager 5.3 was used for data analysis. RESULTS: Ten articles were included in this meta-analysis, involving a total of 401 patients, including 188 in the endoscopy group and 213 in the surgery group. Meta-analysis results revealed that the clinical remission rate (CRR) [odds ratio (OR) =1.30, 95% confidence interval (CI): 0.58-2.92, P=0.52], new organ failure rate (OFR) (OR =0.53, 95% CI: 0.26-1.09, P=0.08), abdominal bleeding rate (ABR) (OR =0.62, 95% CI: 0.33-1.15, P=0.13), and intensive care unit (ICU) stay time (IST) [mean deviation (MD) =-7.33, 95% CI: -16.76 to 2.11, P=0.13] were not significantly different between the endoscopy and surgery groups. In the endoscopy group, the mortality rate (OR =0.56, 95% CI: 0.31-1.02, P=0.05), intestinal fistula rate (IFR) or gastrointestinal perforation rate (GPR) (OR =0.50, 95% CI: 0.26-0.99, P=0.05), and pancreatic fistula rate (PFR) (OR =0.09, 95% CI: 0.04-0.23, P<0.00001) were markedly lower compared to the surgery group. DISCUSSION: There was no obvious difference in the clinical efficacy of endoscopic and surgical treatment of necrotizing pancreatitis. However, endoscopy can greatly reduce the incidence of postoperative death and major complications in patients.

Antibiotics: An overview on the environmental occurrence, toxicity, degradation, and removal methods.

Antibiotics, as antimicrobial drugs, have been widely applied as human and veterinary medicines. Recently, many antibiotics have been detected in the environments due to their mass production, widespread use, but a lack of adequate treatment processes. The environmental occurrence of antibiotics has received worldwide attention due to their potential harm to the ecosystem and human health. Research status of antibiotics in the environment field is presented by bibliometrics. Herein, we provided a comprehensive overview on the following important issues: (1) occurrence of antibiotics in different environmental compartments, such as wastewater, surface water, and soil; (2) toxicity of antibiotics toward non-target organisms, including aquatic and terrestrial organisms; (3) current treatment technologies for the degradation and removal of antibiotics, including adsorption, hydrolysis, photodegradation and oxidation, and biodegradation. It was found that macrolides, fluoroquinolones, tetracyclines, and sulfonamides were most frequently detected in the environment. Compared to surface and groundwaters, wastewater contained a high concentration of antibiotic residues. Both antibiotics and their metabolites exhibited toxicity to non-target organisms, especially aquatic organisms (e.g., algae and fish). Fluoroquinolones, tetracyclines, and sulfonamides can be removed through abiotic process, such as adsorption, photodegradation, and oxidation. Fluoroquinolones and sulfonamides can directly undergo biodegradation. Further studies on the chronic effects of antibiotics at environmentally relevant concentrations on the ecosystem were urgently needed to fully understand the hazards of antibiotics and help the government to establish the permissible limits. Biodegradation is a promising technology; it has numerous advantages such as cost-effectiveness and environmental friendliness.

Evaluating the application of antibiotic treatment using algae-algae/activated sludge system.

Biological methods are promising treatment methods to remove pollutants from wastewater. Recently, microalgae have been proved to be of strong application potential in wastewater treatment. In this study, a microalga - antibiotic treatment system was built to evaluate the treatment capacity of microalgae in antibiotic wastewater. In the group with Chlorella pyrenoidosa, the removal rate of cefradine was 41.47 ± 0.62% after 24 h of treatment, which was 3.4 times higher than that without microalgae (12.37 ± 2.30%). Algal decomposition was the main removal mechanism. Meanwhile, the effect of multiple microalgae species on antibiotic treatment was studied. The removal rates of cefradine by C. pyrenoidosa cultivated in the filtered fluid of Microcystis aeruginosa were 75.48 ± 0.29%, which was significantly higher than those by C. pyrenoidosa only. Those indicated that multiple microalgae species strategy was a potential enhancement strategy for algae-based antibiotic treatment. Finally, amoxicillin and norfloxacin were used to study the treatment potential of this technology for more different kinds antibiotics and the integration of microalgae with activated sludge was also investigated. Amoxicillin can be quickly removed by microalgae, but the removal effect of norfloxacin by microalgae is poor. The refractory antibiotic norfloxacin can be treated by co-culturing microalgae and activated sludge. Those showed the good expansibility of microalgae-based technology. The findings indicated that with microalgae-based antibiotic removal method has good application potential, and combined with other technologies, it can effectively remove the refractory antibiotics.

Evaluation of the novel nanoparticle material - CdSe quantum dots on Chlorella pyrenoidosa and Scenedesmus obliquus: Concentration-time-dependent responses.

Quantum dots (QDs), as a kind of novel nanomaterial, have the extensive applications in various fields, inevitably leading to increasing risks for the ecological environment. The mobilization of cadmium including metal smelting and subsequent machining for multifarious applications has caused the release of cadmium element into the environment. In this study, we evaluated the potential toxicity of a novel nanoparticle material CdSe QDs, using two green algae Chlorella pyrenoidosa and Scenedesmus obliquus. The impact of CdSe QDs and cadmium ions on algae and the sensitivity of the two algae on target compounds were also considered and compared. Our results showed the algal growth rates and chlorophyll content decreased with increasing exposure concentrations and durations. Moreover, the glutathione levels were decreased while the activities of superoxide dismutase increased, exhibiting their pivotal functions in defeating toxic stress. The increment of malondialdehyde levels revealed that the stresses of CdSe QDs and cadmium ions were contributed to the occurrence of oxidative damage. Our study also indicated that the impact of CdSe QDs was stronger than that of cadmium nitrate and the algal response was also species-specific. In addition, the TEM photographs of the algal ultrastructure showed the presence of surface attachment and uptake of QDs.

Correlation between antibiotic-induced feeding depression and body size reduction in zooplankton (rotifer, Brachionus calyciflorus): Neural response and digestive enzyme inhibition.

The study analyzed the correlation between the antibiotic-induced feeding depression and body size reduction in rotifer, Brachionus calyciflorus, involving exposure, post-exposure and re-exposure periods. The filtration and ingestion rates of the rotifers were inhibited in these three exposure periods at any given concentration of the antibiotic sulfamethazine (SMZ). As food for rotifer, the cell size of the green algae was unchanged, which indicated that it could not drive feeding depression. Secondly, several corresponding physiological responses were considered. Reactive oxygen species (ROS) levels increased in the post-exposure and the re-exposure; acetylcholinesterase (AChE) activity was significantly decreased in the exposure and the re-exposure, whereas it was induced in the post-exposure. The activities of amylase and lipase were always inhibited in these three exposure periods. Additionally, significant decreases in lorica length, width and biovolume of rotifers occurred after the feeding depression. Statistical analysis indicated a positive correlation between the activity of the digestive enzyme and the body size. Our results demonstrated that SMZ could influence the neurotransmission, inhibit the activity of the digestive enzyme, and finally result in body size reduction. These results provided an integrated perspective on assessing the toxicity effects of antibiotic in non-lethal dosage on the feeding behavior of non-target aquatic organisms.

Integrated toxic evaluation of sulfamethazine on zebrafish: Including two lifespan stages (embryo-larval and adult) and three exposure periods (exposure, post-exposure and re-exposure).

Persistence of antibiotics in aquatic environment may pose a risk to the non-target aquatic organisms. This study provided an integrated evaluation to analyze the toxic stress of sulfamethazine (SMZ) on zebrafish in two lifespan stages (embryo-larval and adult) and three exposure periods (exposure, post-exposure and re-exposure). Zebrafish embryos and adult zebrafish were exposed to SMZ at 0.2, 20 and 2000 µg/L, respectively. The results showed that SMZ at any given concentration inhibited the hatching of embryos at 58-96 hpf (hours post-fertilization). Our result also indicated that two major kinds of the malformation, which was induced by the antibiotic, were edema and spinal curvature. Additionally, the antibiotic stimulated the heartbeat while reduced the body length of the embryo at 72 hpf. Superoxide dismutase (SOD) activities and malondialdehyde (MDA) contents significantly increased at 120 hpf when the embryos were exposed to the lowest concentration (0.2 µg/L) of the antibiotic. On the other hand, the antibiotic induced SOD activities and MDA contents in adult zebrafish in the exposure and re-exposure periods. The MDA contents could recover while SOD activities still increased in 2 d after the exposure. Both SOD activities and MDA contents could recover in 7 d after the exposure. Levels of SOD and MDA in the re-exposure were higher than those in the first exposure. Our results suggested that SMZ had toxic effects on both embryos and adult zebrafish, and provided an integrated evaluation of the toxic effects of SMZ on zebrafish at a new perspective.

Bisphenol analogues in surface water and sediment from the shallow Chinese freshwater lakes: Occurrence, distribution, source apportionment, and ecological and human health risk.

Compared to Bisphenol A (BPA), current knowledge on the spatial distribution, potential sources and environmental risk assessment of other bisphenol analogues (BPs) remains limited. The occurrence, distribution and sources of seven BPs were investigated in the surface water and sediment from Taihu Lake and Luoma Lake, which are the Chinese shallow freshwater lakes. Because there are many industries and living areas around Taihu Lake, the total concentrations of ∑BPs were much higher than that in Luoma Lake, which is away from the industry-intensive areas. For the two lakes, BPA was still the dominant BPs in both surface water and sediment, followed by BPF and BPS. The spatial distribution and principal component analysis showed that BPs in Luoma Lake was relatively homogeneous and the potential sources were relatively simple than that in Taihu Lake. The spatial distribution of BPs in sediment of Taihu Lake indicated that ∑BPs positively correlated with the TOC content. For both Taihu Lake and Luoma Lake, the risk assessment at the sampling sites showed that no high risk in surface water and sediment (RQt < 1.0, and EEQt < 1.0 ng E2/L).

One-pot synthesis of fluorescent nitrogen-doped carbon dots with good biocompatibility for cell labeling.

Here we report an easy and economical hydrothermal carbonization approach to synthesize the fluorescent nitrogen-doped carbon dots (N-CDs) that was developed using citric acid and triethanolamine as the precursors. The synthesis conditions were optimized to obtain the N-CDs with superior fluorescence performances. The as-prepared N-CDs are monodispersed sphere nanoparticles with good water solubility, and exhibited strong fluorescence, favourable photostability and excitation wavelength-dependent behavior. Furthermore, the in vitro cytotoxicity and cellular labeling of N-CDs were investigated using the rat glomerular mesangial cells. The results showed the N-CDs have more inconspicuous cytotoxicity and better biosafety in comparison with ZnSe quantum dots, although both targeted the cells successfully. Considering their admirable photostability, low toxicity and good compatibility, the as-obtained N-CDs could have potential applications in biosensors, cellular imaging, and other fields.