[Meta Analysis of Stabilization Effect of Phosphorus on Soil Lead and Its Influencing Factors].

Phosphorus exerts a good stabilization effect on soil lead. In this study, the findings of 90 papers were summarized using the Meta-analysis method. These papers described the immobilization of soil lead using phosphorus from 1997 to 2022. The effects of phosphorus materials on the stabilization rate and speciation transformation of soil Pb and soil pH were quantitatively analyzed based on soil properties, stabilization process conditions, and types of phosphorus materials. The results revealed that the stronger the soil alkalinity (pH ≥ 7.5), the lower is the content of lead (≤ 500 mg·kg-1), and the higher the content of soil organic matter (>0.5%), the more conducive it is to the phosphorus-based stabilization of soil lead; the stabilization rates are 75.21%, 34.97% and 93.12%, respectively. In terms of stabilization process conditions, the higher the addition amount of phosphorus (≥ 10%), the higher is the water content (>50%)and longer is the curing time (≥ 30 days), and the higher the curing temperature (≥ 40℃), the more conducive it is to the stabilization of soil lead, and the stabilization rates are 80.65%, 84.98%, 79.39%, and 41.44%, respectively. According to the types of phosphorus, soluble phosphorus had a high stabilization rate of soil lead (96.24%). The conversion rate of exchangeable lead and carbonate-bound lead to residual lead was 95.93%. Soluble phosphorus was majorly acidic, reducing the soil pH by 7.27%, whereas insoluble phosphorus was majorly alkaline, increasing the soil pH by 3.63%. In conclusion, when the soil pH ≥ 7.5, soil lead content ≤ 500 mg·kg-1, soil organic matter content >0.5%, soluble phosphorus addition ≥ 10%, water content >50%, curing time ≥ 30 days, and curing temperature ≥ 40℃, phosphorus had a better effect on soil Pb stabilization. In the actual remediation process of lead-contaminated soil, to improve the lead stabilization rate, it is necessary to comprehensively consider the effects of soil properties, stabilization process conditions, phosphorus, and other factors.

Cost-effectiveness of active surveillance versus early surgery for thyroid micropapillary carcinoma based on diagnostic and treatment norms in China.

Objectives: In this study, we compared the cost-effectiveness comparison of the active surveillance (AS) and early surgery (ES) approaches for papillary thyroid microcarcinoma (PTMC) from the perspective of the Chinese healthcare system. Methods: We performed a cost-effectiveness analysis using a Markov model of PTMC we developed to evaluate the incremental cost-effectiveness ratio of AS and ES. Our reference case was of a 40-year-old woman diagnosed with unifocal (<10 mm) PTMC. Relevant data were extracted after an extensive literature review, and the cost incurred in each state was determined using China Medicare data on payments for ES and AS. The willingness-to-pay threshold was set at ¥242,928/quality-adjusted life-year (QALY) gained. Sensitivity analyses were performed to account for any uncertainty in the model's variables. Additional subgroup analyses were performed to determine whether AS was cost-effective when different initial monitoring ages were used. Results: ES exhibited an effectiveness of 5.2 QALYs, whereas AS showed an effectiveness of 25.8 QALYs. Furthermore, the incremental cost-effectiveness ratio for ES versus AS was ¥1,009/QALY. The findings of all sensitivity analyses were robust. Compared with ES, AS was found to be the cost-effective strategy at initial monitoring ages of 20 and 60 years, with an incremental cost-effectiveness ratio of ¥3,431/QALY and -¥1,316/QALY at 20 and 60 years, respectively. AS was a more cost-effective strategy in patients with PTMC aged more than 60. Conclusions: With respect to the norms of the Chinese healthcare system, AS was more cost-effective for PTMC over lifetime surveillance than ES. Furthermore, it was cost-effective even when the initial monitoring ages were different. In addition, if AS is incorporated into the management plan for PTMC in China at the earliest possible stage, a predicted savings of ¥10 × 108/year could be enabled for every 50,000 cases of PTMC, which indicates a good economic return for future management programs. The identification of such nuances can help physicians and patients determine the best and most individualized long-term management strategy for low-risk PTMC.

Resistin Regulates Fatty Acid Β Oxidation by Suppressing Expression of Peroxisome Proliferator Activator Receptor Gamma-Coactivator 1α (PGC-1α).

BACKGROUND/AIMS: Abnormal fatty acid ß oxidation has been associated with obesity and type 2 diabetes. Resistin is an adipokine that has been considered as a potential factor in obesity-mediated insulin resistance and type 2 diabetes. However, the effect of resistin on fatty acid ß oxidation needs to be elucidated. METHODS: We detected the effects of resistin on the expression of fatty acid oxidation (FAO) transcriptional regulatory genes, the fatty acid transport gene, and mitochondrial ß-oxidation genes using real-time PCR. The rate of FAO was measured using 14C-palmitate. Immunofluorescence assay and western blot analysis were used to explore the underlying molecular mechanisms. RESULTS: Resistin leads to a reduction in expression of the FAO transcriptional regulatory genes ERRα and NOR1, the fatty acid transport gene CD36, and the mitochondrial ß-oxidation genes CPT1, MCAD, and ACO. Importantly, treatment with resistin led to a reduction in the rate of cellular fatty acid oxidation. In addition, treatment with resistin reduced phosphorylation of acetyl CoA carboxylase (ACC) (inhibitory). Mechanistically, resistin inhibited the activation of CREB, resulting in suppression of PGC-1α. Importantly, overexpressing PGC-1α can rescue the inhibitory effects of resistin on fatty acid ß oxidation. CONCLUSIONS: Activating the transcriptional activity of CREB using small molecular chemicals is a potential pharmacological strategy for preventing the inhibitory effects of resistin on fatty acid ß oxidation.