New technologies reduce greenhouse gas emissions from nitrogenous fertilizer in China.

Synthetic nitrogen (N) fertilizer has played a key role in enhancing food production and keeping half of the world's population adequately fed. However, decades of N fertilizer overuse in many parts of the world have contributed to soil, water, and air pollution; reducing excessive N losses and emissions is a central environmental challenge in the 21st century. China's participation is essential to global efforts in reducing N-related greenhouse gas (GHG) emissions because China is the largest producer and consumer of fertilizer N. To evaluate the impact of China's use of N fertilizer, we quantify the carbon footprint of China's N fertilizer production and consumption chain using life cycle analysis. For every ton of N fertilizer manufactured and used, 13.5 tons of CO2-equivalent (eq) (t CO2-eq) is emitted, compared with 9.7 t CO2-eq in Europe. Emissions in China tripled from 1980 [131 terrogram (Tg) of CO2-eq (Tg CO2-eq)] to 2010 (452 Tg CO2-eq). N fertilizer-related emissions constitute about 7% of GHG emissions from the entire Chinese economy and exceed soil carbon gain resulting from N fertilizer use by several-fold. We identified potential emission reductions by comparing prevailing technologies and management practices in China with more advanced options worldwide. Mitigation opportunities include improving methane recovery during coal mining, enhancing energy efficiency in fertilizer manufacture, and minimizing N overuse in field-level crop production. We find that use of advanced technologies could cut N fertilizer-related emissions by 20-63%, amounting to 102-357 Tg CO2-eq annually. Such reduction would decrease China's total GHG emissions by 2-6%, which is significant on a global scale.

Treatment strategies and long-term outcomes for primary intramedullary spinal germinomas: an institutional experience.

Primary intramedullary germinomas are very rare tumors in the spinal cord. This study presented a series of 11 patients with histologically proven primary intramedullary spinal germinomas. Their clinical and radiological findings, treatment records and long-term outcomes were reviewed. There were four male and seven female patients with a mean age of 27.1 years. Because germ cell tumors were suspected by frozen-section biopsy, gross total resection was unattempted. Partial resection was performed in four cases, while biopsy was performed in seven cases. Postoperatively, carboplatin and etoposide chemotherapy combined with low dose radiotherapy (30.6 Gy) to local spine was performed in seven cases, followed by radiotherapy alone (40 Gy) in four cases. All 11 patients had a complete response to either combination treatment or single radiotherapy, and the mass effect on the spinal cord vanished. The mean follow-up period was 75.4 months. At the last follow-up, the symptoms were improved in 10 cases and the current status of one patient was unchanged. The postoperative follow-up magnetic resonance imaging showed no recurrence or dissemination in any of the patients. Primary intramedullary germinomas are amenable to adjuvant radiochemotherapy and low dose radiation with etoposide and carboplatin chemotherapy is recommended. When combination therapy cannot be performed, relatively high doses of radiotherapy are advised, and radiation to the craniospinal axis may be unnecessary. A good clinical outcome after combination therapy or radiotherapy alone can be expected, and the risk of long-term recurrence and dissemination is low.

Surgical versus nonsurgical treatment of displaced intra-articular calcaneal fracture: a meta-analysis of current evidence base.

PURPOSE: Controversy still surrounds the optimal treatment for patients with displaced intra-articular calcaneal fractures (DIACF). An up-to-date meta-analysis was performed to evaluate clinical effectiveness of surgical treatment for DIACF compared with nonsurgical treatment. METHODS: We systematically searched four electronic databases (Medline, BIOSIS, Cochrane library and Google Scholar) to identify randomised controlled trials (RCTs) and clinical controlled trials (CCTs) in which surgical treatment was compared with nonsurgical treatment of DIACF from 1980 to 2011. Trial quality was assessed using the modified Jadad scale and effective data were pooled for meta-analysis. RESULTS: Ten studies (six RCTs and four CCTs) with a total of 891 participants were screened. Results showed that surgical treatment was superior to nonsurgical treatment in better recovery of the Böhler angle (P < 0.0001), more stable calcaneal height (P = 0.0009) and width (P < 0.00001). Moreover, fewer surgically treated patients needed increased shoe size (P = 0.0004) and more were able to resume pre-injury work (P = 0.004) than the nonsurgical patients. No significant difference was identified between the two methods regarding the incidence of residual pain (P = 0.49). However, operative management was associated with a higher risk of complications (P = 0.008). CONCLUSIONS: Although surgical repair may increase the complication probability, it is the price that has to be paid for better reconstruction of the calcaneus and better functional results. Taken as a whole, surgery is probably the optimal choice in DIACF treatment.

Swimming Suppresses Cognitive Decline of HFD-Induced Obese Mice through Reversing Hippocampal Inflammation, Insulin Resistance, and BDNF Level.

Obesity is an important public health problem nowadays. Long-term obesity can trigger a series of chronic diseases and impair the learning and memory function of the brain. Current studies show that scientific exercise can effectively improve learning and memory capacity, which also can provide benefits for obese people. However, the underlying mechanisms for the improvement of cognitive capacity under the status of obesity still need to be further explored. In the present study, the obesity-induced cognition-declined model was established using 4-week-old mice continuously fed with a high-fat diet (HFD) for 12 weeks, and then the model mice were subjected to an 8-week swimming intervention and corresponding evaluation of relevant indicators, including cognitive capacity, inflammation, insulin signal pathway, brain-derived neurotrophic factor (BNDF), and apoptosis, for exploring potential regulatory mechanisms. Compared with the mice fed with regular diets, the obese mice revealed the impairment of cognitive capacity; in contrast, swimming intervention ameliorated the decline in cognitive capacity of obese mice by reducing inflammatory factors, inhibiting the JNK/IRS-1/PI3K/Akt signal pathway, and activating the PGC-1α/BDNF signal pathway, thereby suppressing the apoptosis of neurons. Therefore, swimming may be an important interventional strategy to compensate for obesity-induced cognitive impairment.

Acral persistent papular mucinosis: a case report and literature review.

Acral persistent papular mucinosis is a rare subtype of localized lichen myxedematosus. It shows symmetric, asymptomatic, chronic, ivory to flesh-colored, 2-5 mm sized papules arranged on the dorsa of the hands and extensor aspects of the distal forearms. Thirty-two cases including two from China, appear to fit the proposed diagnostic criteria. We report a 31-year-old Chinese woman who presented with papules on the extensor aspects of her hands and distal forearms. Histopathology revealed a circumscribed area in the upper and mid reticular dermis with splaying of collagen fibers caused by amorphous deposits. The material was mucin, as it stained positively with alcian blue at pH 2.5. The thyroid profile was normal, and there was no evidence for lupus erythematous. The lesions were treated with electrofulguration and resolved leaving mild scars; there has been no recurrence at follow-up after one year. We also review the literature on this rare form of mucinosis.

Clinical characteristics and outcomes of chronic subdural hematoma in patients with a history of antiplatelet therapy.

OBJECTIVE: Chronic subdural hematoma (CSDH) is a common neurosurgical disease. Many patients with CSDH take antiplatelet (AP) drugs. Several studies have focused merely on the relationship between AP drug use and recurrence without deeply analyzing the specific clinical features of these patients. The primary objective of this study was to investigate the detailed clinical characteristics and outcomes of CSDH patients with a history of AP therapy. METHODS: A total of 1181 CSDH patients over 40 years of age who received burr-hole craniostomy were enrolled. Clinical information, computed tomographic findings, and data on long-term outcomes and recurrence among these patients were gathered. We divided these patients into two groups according to whether they had a history of AP therapy. Percentages and χ2 tests were applied for categorical variables. Standard deviations and 2-sided unpaired t-tests were applied for continuous variables. Univariate and multivariate logistic regression analyses were performed to identify independent factors of the outcomes (6 months after discharge). RESULTS: AP therapy was not related to the outcomes of patients with CSDH (P = 0.48), and there were no differences in recurrence between the AP and non-AP group. Only Bender grade (P < 0.01, B = -3.14, Exp (B) = 0.04, 95% CI 0.01-0.29) was associated with the outcomes of patients in the AP group. The incidence of complications in the AP group was higher than that in the non-AP group (P < 0.01). Postoperative thrombotic events may be more likely to occur in the AP group than in the non-AP group (P = 0.02). Patients in the AP group were older (P < 0.01) and had more comorbidities (P < 0.01). CONCLUSIONS: Patients treated with AP therapy had more complications. The outcomes of patients treated with AP therapy were associated with their status of admission. Patients treated with AP therapy were at greater risk for postoperative thrombotic events. The recurrence rate of CSDH did not appear to be affected by AP therapy.

The effects of Intensive Supervision Mechanism on air quality improvement in China.

The Intensive Supervision Mechanism (hereafter referred to as ISM) is one of the most important institutional management innovations for air pollution control in China, but there is currently no consensus on the effects of the ISM on air quality improvement. In this study, a reliable quantitative model based on the Difference-in-Differences (DID) analysis was designed to evaluate the impacts of ISM on air quality (as indicated by good air quality days (hereafter referred to as GAD) and the concentrations of six major air pollutants (i.e. PM2.5, PM10, O3_8H, NO2, SO2, and CO)), in China with focuses on the implementation cities of Henan Province. To optimize the model design, six meteorological factors, five socio-economic indicators, and VIIRS (Visible Infrared Imaging Radiometer Suite) data were also considered as alternative control variables for more comprehensive and effective results. In addition, the redundancy analysis (RDA) and Monte Carlo simulation were conducted to determine the optimal combination of those control variables which can best reflect the changes in explanatory variables. The main findings are as follows: (1) the statistical model applied in this study can well evaluate the impacts of ISM; (2) the implementation of ISM can significantly reduce the concentrations of SO2, CO, and NO2, but the improvements for PM2.5, PM10, GAD and O3_8H were not significant. (3) the potential for air quality improvement due to ISM tends to be reduced over time, and thus the positive effects of ISM at its second stage were not increased significantly compared with those observed during its first stage. In general, those results not only demonstrate the effectiveness of ISM on air quality improvement, but also provide insights into how the ISM can be optimized to gain a sustained improvement of the ambient air quality in the future.Implications: As a policy measure implemented by the Chinese government, the Intensive Supervision Mechanism (ISM) has significantly contributed to the improvement of air quality since its execution. However, the potential for air quality improvement due to ISM tends to be reduced over time, and thus the positive effects of ISM at its second stage were not increased significantly compared with those observed during its first stage. In addition, the implementation of ISM requires a large amount of financial investment, and thus has limited sustainability. Considering the increased difficulty of this policy instrument, whether to insist on the ISM warrants further analyses on its cost and effectiveness. More importantly, more targeted measures of ISM should be applied to decrease the ozone concentration in the future.

The relationship of neutrophil elastase and proteinase 3 with risk factors, and chronic complications in type 2 diabetes: A Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) sub-study.

INTRODUCTION: Neutrophil elastase (NE) and proteinase 3 (PR3) are novel inflammation biomarkers. We investigated their associations with chronic complications, determinants of biomarker levels and effects of fenofibrate in patients with type 2 diabetes mellitus (T2DM) from Fenofibrate Intervention and Event Lowering in Diabetes study. METHODS: Plasma NE and PR3 levels were quantified at baseline (n = 2000), and relationships with complications over 5-years assessed. Effects of fenofibrate on biomarker levels (n = 200) were determined at four follow-up visits. RESULTS: Higher waist-to-hip ratio, homocysteine and C-reactive protein and lower apoA-II were determinants of higher NE and PR3 levels. Higher NE levels were associated with on-trial stroke and cardiovascular mortality, and higher PR3 levels with on-trial stroke, but associations were not significant after adjustment for confounding factors. Although higher NE and PR3 levels were associated with baseline total microvascular disease, only NE levels were associated with on-trial neuropathy or amputation. These associations were not significant after adjusting for multiple comparisons. NE and PR3 levels did not change with fenofibrate. CONCLUSIONS: In T2DM plasma NE and PR3 levels are associated with vascular risk factors, and total microvascular disease at baseline, but on rigorous analyses were not associated with on-trial complications. Levels were not changed by fenofibrate.

Effects of a new nitrification inhibitor 3,4-dimethylpyrazole phosphate (DMPP) on nitrate and potassium leaching in two soils.

In this study, soil column was used to study the new nitrification inhibitor 3,4-dimethylpyrazole phosphate (DMPP) on nitrate (NO3(-)-N) and potassium (K) leaching in the sandy loam soil and clay loam soil. The results showed that DMPP with ammonium sulphate nitrate (ASN) ((NH4)2SO4 and NH4NO3) or urea could reduce NO3(-)-N leaching significantly, whereas ammonium (NH4(+)-N) leaching increased slightly. In case of total N (NO3(-)-N+NH4(+)-N), losses by leaching during the experimental period (40 d) were 37.93 mg (urea), 31.61 mg (urea+DMPP), 108.10 mg (ASN), 60.70 mg (ASN+DMPP) in the sandy loam soil, and 30.54 mg (urea), 21.05 mg (urea+DMPP), 37.86 mg (ASN), 31.09 mg (ASN+DMPP) in the clay loam soil, respectively. DMPP-amended soil led to the maintenance of relatively high levels of NH4(+)-N and low levels of NO3(-)-N in soil, and nitrification was slower. DMPP supplementation also resulted in less potassium leached, but the difference was not significant except the treatment of ASN and ASN+DMPP in the sandy loam soil. Above results indicate that DMPP is a good nitrification inhibitor, the efficiency of DMPP seems better in the sandy loam soil than in the clay loam soil and lasts longer.

[Comparison of immediate therapeutic effects of endovenous laser treatment and conventional therapy for lower extremity varicose veins].

OBJECTIVE: To compare the immediate therapeutic effects of endovenous laser treatment (ELT) and conventional surgery for lower extremity varicosity (LEV). METHODS: Twenty-two limbs of 20 patients with ELT and 36 limbs of 30 patients with traditional surgery were analyzed in terms of operation time, number of the incision, postoperative pain, complications, postoperative hospital stay and one-year recurrence rate. RESULTS: ELT group had shorter operation time, fewer incisions, less postoperative pain and shorter hospital stay than conventional surgery group, but the two groups showed no significant difference in complications and one-year recurrence rate. CONCLUSIONS: As a safe and effective new treatment of LEV with minimal invasiveness and leaving no scars ELT has the potential to replace conventional surgery and extends the surgical indications for LEV treatment.

[The clinical study of the epithelial flap of painless LASEK and Epi-LASIK].

OBJECTIVE: To protect epithelial flap and improve the rate of painless LASEK and Epi-LASIK surgery. METHODS: 285 eyes of 285 cases of LASEK, 39 eyes of 39 cases of Epi-LASIK were involved in the study. Laser machines used in the study included Mel 80, lasersight LSX, NIDEK EC5000, VISX 4star, AOV (66 vision) and 217Z. The Epi-LASIK hinge position was routinely at 11-12 o'clock. The application time of alcohol for LASEK was 10-20 seconds. The hinge was routinely at 12-1 o'clock by the way of epithelial-CCC. RESULTS: Postoperative pain: 269 cases (91.23%) in LASEK and 36 cases (92.31%) in Epi-LASIK were quiet (patients did not complain pain and open the eyes in a nature way), There was no significant difference in the ration of postoperative pain between two groups. LASEK: CLs were taken off in 10 cases (3.51%) in 7-11 days. Epi-LASIK: CLs were taken off in 2 cases (5.13%) in 7-10 days. The main reason of delayed taking of the CLs was irregular edema of epithelium. CONCLUSIONS: The LASEK and Epi-LASIK are able to be a painless procedure. LASEK/Epi-LASIK can get quiet situation postoperatively with quickly recovery of effective vision by LASIK. Delayed taking off CLs is safe and effective to protect the survival epithelium in case of the epithelial flap delayed healing.

Intraspinal hemangioblastomas: analysis of 92 cases in a single institution: clinical article.

OBJECT: Intraspinal hemangioblastomas are relatively uncommon benign tumors. The surgical strategies remain controversial, and the risk factors with regard to clinical outcome are unclear. The purpose of this study was to analyze the clinical characteristics, imaging findings, surgical strategies, and functional outcomes associated with intraspinal hemangioblastomas. METHODS: A series of 92 patients who underwent 102 operations for resection of 116 intraspinal hemangioblastomas at a single institution during 2007-2011 were consecutively enrolled in this study. Of these, 60 patients (65.2%) had sporadic hemangioblastomas and 32 (34.8%) had von Hippel-Lindau disease. Preoperatively, 13 patients underwent digital subtraction angiography (DSA), 15 patients underwent 3D CT angiography (3D CTA), and none underwent preoperative embolization. Clinical characteristics, imaging findings, and operative records were analyzed. The advantages and disadvantages of DSA and 3D CTA were compared. For identification of risk factors that affect prognosis, logistic analysis was performed. RESULTS: The male/female patient ratio was 1.8:1.0 (59 male and 33 female patients). Of the tumors, 41% were intramedullary, 37% were intramedullary-extramedullary, and 22% were primarily extramedullary. Three-dimensional CTA and DSA did not differ significantly in the ability to identify the feeding arteries (p = 1.000) and image qualities (p = 0.367). However, compared with 3D CTA, the effective x-ray dose of spinal DSA was 2.73 times higher and the mean amount of contrast media injected was 1.88 times higher. Spinal DSA was more time consuming (mean 120 minutes) than 3D CTA (scanning time < 1 minute). No complications were observed after 3D CTA; acute paraparesis developed in 1 patient after DSA. Gross-total resection was achieved for 109 tumors (94.0%), and resection was subtotal for 7 tumors. Mean duration of follow-up was 50 months (range 24-78 months). At the most recent follow-up visit, the functional outcome was improved for 38 patients (41.3%), remained stable for 40 (43.5%), and deteriorated for 14 (15.2%). Logistic analysis showed that subtotal resection was a risk factor affecting prognosis (p = 0.003, OR 12.833, 95% CI 2.429-67.806). CONCLUSIONS: The authors' study suggests that safe and effective treatment of intraspinal hemangioblastomas can be achieved for most patients, even without preoperative embolization. Gross-total resection, when safe to perform, leads to better outcomes. Compared with spinal DSA, 3D CTA is a promising technique because it is noninvasive, takes less time to perform, requires lower x-ray doses and less contrast media, results in fewer complications, and offers high accuracy for delineating the feeding arteries.