Effects of salinity on nitrogen reduction pathways in estuarine wetland sediments.

Denitrification, anammox, and DNRA are three important nitrogen (N) reduction pathways in estuarine sediments. Although salinity is an important variables controlling microbial growth and activities, knowledge about the effects of changing salinity on those three processes in estuarine and coastal wetland sediments are not well understood. Herein, we performed a 60-d microcosms experiment with different salinities (0, 5, 15, 25 and 35 ‰) to explore the vital role of salinity in controlling N-loss and N retention in estuarine wetland sediments. The results showed that sediment organic matter, sulfide, and nitrate (NO3-) were profoundly decreased with increasing salinity, while sediment ammonium (NH4+) and ferrous (Fe2+) varied in reverse patterns. Meanwhile, N-loss and N retention rates and associated gene abundances were differentially inhibited with increasing salinity, while the contributions of denitrification, anammox, and DNRA to total nitrate reduction were apparently unaffected. Moreover, denitrification rate was the most sensitive to salinity, and then followed by DNRA, while anammox was the weakest among these three processes. In other words, anammox bacteria showed a wide range of salinity tolerance, while both denitrification and DNRA reflected a relatively limited dynamic range of it. Our findings could provide insights into temporal interactive effects of salinity on sediment physico-chemical properties, N reduction rates and associated gene abundances. Our findings can improve understanding of the effects of saltwater incursion on the N fate and N balance in estuarine and coastal sediments.

Real-world experience of arbidol for Omicron variant of SARS-CoV-2.

Background: At a crucial time with the rapid spread of Omicron severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus variant globally, we conducted a study to evaluate the efficacy and safety of arbidol tablets in the treatment of this variant. Methods: From Mar 26 to April 26, 2022, we conducted a prospective, open-labeled, controlled, and investigator-initiated trial involving adult patients with confirmed Omicron variant infection. Patients with asymptomatic or mild clinical status were stratified 1:2 to receive either standard-of-care (SOC) or SOC plus arbidol tablets (oral administration of 200 mg per time, three times a day for 5 days). The primary endpoint was the negative conversion rate within the first week. Results: A total of 367 patients were enrolled in the study; 246 received arbidol tablet treatment, and 121 were in the control group. The negative conversion rate of SARS-CoV-2 within the first week in patients receiving arbidol tablets was significantly higher than that of the SOC group [47.2% (116/246) vs. 35.5% (43/121); odds ratio (OR), 1.619; 95% confidence interval (CI): 1.034-2.535; P=0.035]. Compared to those in the SOC group, patients receiving arbidol tablets had a shorter negative conversion time [median 8.3 vs. 10.0 days; hazard ratio (HR), 0.645; 95% CI: 0.516-0.808; P<0.001], and a shorter duration of hospitalization (median 11.4 vs. 13.7 days; HR, 1.214; 95% CI: 0.966-1.526; P<0.001). Moreover, the addition of arbidol tablets led to better recovery of declined blood lymphocytes, CD3+, CD4+, and CD8+ cell counts. The most common adverse event (AE) was transaminase elevation in patients treated with arbidol tablets (3/246, 1.2%). No one withdrew from the study due to AEs or disease progression. Conclusions: As a whole, arbidol may represent an effective and safe treatment in asymptomatic-mild patients suffering from Omicron variant during the pandemic of coronavirus disease 2019 (COVID-19).

Distribution and Genesis of Organic Carbon Storage on the Northern Shelf of the South China Sea.

The sediments distributed in the marginal seas of the continental shelf are important burial materials for global organic carbon (OC). There have been many estimates of the global continental shelf OC reserves, but due to the limited acquisition of measured data, the estimated results have great uncertainty. The vast continental shelf in the northern part of the South China Sea (SCS) provides a good place for the storage of OC. Based on a large amount of sediment OC data obtained from the northern coast of the SCS, the OC storage in the surface sediment (0~10 cm) in the study area (approximately 8.63 × 104 km2) was accurately calculated as 51 Tg. The study area covers different regions, such as estuaries, open seas, strait areas and upwelling development areas, and the OC content of each area is quite different. According to provenance analysis, the source of OC in sediments is mainly from the input of Pearl River runoff. The OC content is significantly higher and less affected by sediment particle size in the Pearl River Estuary and the surrounding areas; meanwhile, the OC content gradually decreases with the distance from the Pearl River Estuary. Far from the western Pearl River Estuary, the sediment OC content is mainly controlled by the particle size of the sediments and is significantly correlated with silt and clay content. The deposition rate is also an important factor affecting the burial of OC, for the high deposition rates correspond to the high levels of OC in the nearshore estuarine areas, as well as the low deposition rate region having low OC content in the sediments even though it has a high productivity of OC, such in as the upwelling sea area on the eastern side of Hainan.

Single-port combined subsegment resection (RS3b + S1bi) with a rare branching segment pattern of the bronchi and vessels: case report and literature review.

Background: Video-assisted thoracoscopic surgery segmentectomy is increasingly being used to resect peripheral small lung cancer. However, to manage some lesions which locate between segment deep inside the parenchyma is still challenging. Generally, wedge resection and segmentectomy are optional for peripheral small lung cancer. However, it is hard to achieve safe surgical margins if the lesion is located in the segment plane deep inside the parenchyma, especially close to the segment hilum. In that situation, lobectomy and bi-segmentectomy are usually performed for the sake of safe margins with the price of excessive normal lung tissue lost. To ensure safe surgical margins and preserve normal lung tissue as far as possible, combined subsegmentectomy is feasible and it is required precise preoperative plan including surgical margin delineation, bronchi and vessels variation and surgical procedure. The variation of bronchi and segment vein in our current case are rare and the branching pattern of pulmonary artery-inferior trunk (Tr.inf) is firstly reported in our case. Case Description: In 2019, a 41-year-old female presented to the Thoracic Clinic with a history of a 7-mm sized, mixed-density ground-glass opacity (GGO) in the right upper lobe. The lesion located in the segmental plane between S3b and S1b deep inside the parenchyma. We performed precise preoperative planning with 3-dimension pulmonary bronchi and vessels reconstruction and resected RS3b + S1bi via single-port approach. The patient was discharged from hospital on the 5th postoperative day without any complications. Chest computed tomography (CT) scans in the 12th and 24th months after surgery showed good lung recovery, and no atelectasis or pulmonary congestion was observed. Notably, we observed a new branching pattern of A1b, which came from the inferior trunk, combined with A3a. Additionally, we performed a literature review to analyze the variation patterns of segmental structures in the right upper lobe, and the indications, effects, and safety of combined subsegmentectomy. Conclusions: Our case and review of literature showed that combined subsegmentectomy was feasible for lesion deep inside parenchyma if a detailed preoperative plan and delicate procedures during surgery were implemented.

Robotic versus thoracoscopic combined anatomic subsegmentectomy for early-stage lung cancer: early results of a cohort study.

Background: Combined anatomic subsegmentectomy performed by video-assisted thoracic surgery or robot-assisted thoracic surgery is an emerging minimally invasive surgical technique for patients with early-stage non-small cell lung cancer (NSCLC). However, the early results of these two methods have barely been studied. Methods: A retrospective analysis of medical records from Shanghai Ruijin Hospital between July 2017 and August 2021 included 62 patients, 32 of whom underwent video-assisted combined anatomic pulmonary subsegmentectomy and 30 underwent robot-assisted combined anatomic pulmonary subsegmentectomy. Perioperative outcomes were compared. Results: Sixty-two patients with comparable baseline characteristics were included in this study. No significant difference was found in the length of postoperative hospital stay, operation duration, intraoperative blood loss and the rate of overall complications between the robot-assisted and video-assisted groups. A higher cost was observed in the robot-assisted group compared to the video-assisted group. There were more N1 lymph nodes and N1 stations dissected in the robot-assisted group compared with the video-assisted group; the same results were observed with regard to the number of N2 lymph nodes and N2 stations dissected. Conclusions: It is safe and feasible for the patients with early-stage NSCLC to be treated with combined anatomic subsegmentectomy performed via robot-assisted or video-assisted thoracic surgery. The robotic approach may contribute to the potential improvements in N1 and N2 lymph node retrieval.

Management of middle lobe veins during single-portal video-assisted thoracoscopic surgery lobectomy via the fifth intercostal approach (case series): why the subcarinal triangular right base angle is helpful.

Background: The fifth intercostal space is the preferred approach during uniportal video-assisted thoracoscopic surgery (VATS) lobectomy. However, managing the right middle lobe pulmonary vein (RML PV) through this approach is technically challenging for inexperienced surgeons. To facilitate the surgical procedure, we describe our surgical strategy for managing the middle lobe vein via the fifth intercostal space and define the approach [subcarinal triangular right base angle (SCT-RBA)] utilized to manage the middle lobe vein. Case Description: Based on the characteristics of uniportal surgery, we designed a new method of managing middle lobar veins via the fifth intercostal approach, which also facilitates the dissection of the subcarinal lymph nodes. We described the short-term surgical outcomes of 7 patients who underwent single-port middle lobe resection from January 2021 to January 2022 in the Department of Thoracic Surgery, Ruijin Hospital North Campus, Shanghai Jiaotong University School of Medicine. No conversion and mortality were observed in 7 patients who underwent single-port VATS middle lobe resection. One patient had bronchial asthma and air leakage, which led to delayed drainage and hospitalization. There were no complications or delayed discharge reported among the other patients. Conclusions: Our initial results indicate that this new technique is a feasible strategy to manage the middle lobe veins and facilitate the dissection of subcarinal lymph nodes.