Risk Factors and Risk Assessment for Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis.

OBJECTIVE: To analyse the pertinent risk factors associated with post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) and develop a predictive scoring system for assessing the risk of PEP in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) procedures. STUDY DESIGN: Descriptive study. Place and Duration of the Study: Department of Gastroenterology, Nantong First People's Hospital, Jiangsu, China, from January 2022 to January 2023. METHODOLOGY: Clinical data of 375 patients who underwent successful ERCP treatment were collected and organised. Relevant risk factors for PEP were analysed, and a scoring system was established to predict the risk of PEP. RESULTS: Among the 375 patients who underwent ERCP, the incidence of PEP was 9.07% (34/375). Univariate analysis revealed that female gender, pancreatic duct opacification, difficult cannulation, operation time ≥45 minutes, sphincter of Oddi dysfunction (SOD), and biliary stenting were risk factors for PEP. Multivariate analysis showed that female gender, pancreatic duct opacification, difficult cannulation, operation time ≥45 minutes, and SOD were independent risk factors for PEP. A scoring system was developed, and the receiver operating characteristic (ROC) curve analysis determined a cut-off value of 1.5 points. Patients with a score less than 1.5 points had a low probability of developing PEP, while those with a score greater than 1.5 points had a significantly higher probability of PEP. CONCLUSION: Female gender, pancreatic duct opacification, difficult cannulation, operation time ≥45 minutes, and SOD were independent risk factors for PEP. Additionally, a reliable scoring system was established to predict the risk of PEP. Clinicians can use this scoring system to assess the risk of PEP in patients and implement preventive measures to reduce the incidence of PEP. KEY WORDS: Endoscopic retrograde cholangiopancreatography, Post-ERCP pancreatitis, Risk factors, Risk assessment, Preventive measure.

Circular RNA circWNK1 inhibits the progression of gastric cancer via regulating the miR-21-3p/SMAD7 axis.

Gastric cancer (GC) is a highly aggressive malignancy with limited treatment options for advanced-stage patients. Recent studies have highlighted the role of circular RNA (circRNA) as a novel regulator of cancer progression in various malignancies. However, the underlying mechanisms by which circRNA contributes to the development and progression of GC remain poorly understood. In this study, we utilized microarrays and real-time quantitative polymerase chain reaction (qRT-PCR) to identify and validate a downregulated circRNA, hsa_circ_0003251 (referred to as circWNK1), in paired GC and normal tissues. Through a series of in vitro and in vivo gain-of-function and loss-of-function assays, we demonstrated that circWNK1 exerts inhibitory effects on the proliferation, migration, invasion, and epithelial-mesenchymal transition (EMT) of GC cells. Additionally, we discovered that circWNK1 acts as a competitive endogenous RNA (ceRNA) for SMAD7 by sequestering miR-21-3p. Our findings were supported by comprehensive biological information analysis, as well as RNA pull-down, luciferase reporter gene, and western blot assays. Notably, the downregulation of circWNK1 in GC cells resulted in reduced SMAD7 expression, subsequently activating the TGF-ß signaling pathway. Collectively, our study reveals that circWNK1 functions as a tumor suppressor in GC by regulating the miR-21-3p/SMAD7-mediated TGF-ß signaling pathway. Furthermore, circWNK1 holds promise as a potential biomarker for the diagnosis and treatment of GC.

Effects of Mesalamine Combined with Live Combined Bifidobacterium, Lactobacillus and Enterococcus Capsules on Intestinal Mucosa Barrier Function and Intestinal Microbiota in Mildly Active Crohn's Disease Patients.

Objective: This study is aimed at investigating the impact of mesalamine combined with Live combined Bifidobacterium, Lactobacillus and Enterococcus capsules on intestinal mucosa barrier function and intestinal microbiota in mildly active Crohn's disease patients.Methods: Ninety-six Crohn's disease patients in mild activity period were randomized into the control group (treated with mesalamine) and the observation group (treated with mesalamine combined with Live combined Bifidobacterium, Lactobacillus and Enterococcus capsules) (n = 48). After 4 wk of treatment, the patients were evaluated for their clinical efficacy. Intestinal microbiota counts, serum inflammatory factors, T lymphocyte subsets, and mucosal barrier function indicators in both groups were assessed.Results: After 4 wk of treatment, the total clinical effective rate of the observation group was higher than that of the control group. The number of Lactobacillus acidophilus (L. acidophilus) and Bifidobacterium Longum (B. longum) in the intestinal tract, serum IL-10 levels, and peripheral blood CD4+ and CD4+/CD8+ levels were higher, and the number of Bacteroides vulgatus (B. vulgatus), the levels of TNF-α, IL-6, CRP, CD8+, ET, D-lactate, DAO, and urine L/M ratio were lower in the observation group in comparison to those in the control group (all p < 0.05).Conclusion: Mesalamine combined with Live combined Bifidobacterium, Lactobacillus and Enterococcus capsules are more effective in treating mildly active Crohn's disease.

Clinical value of BISAP score combined with CRP and NLR in evaluating the severity of acute pancreatitis.

To investigate the clinical value of bedside index for severity in acute pancreatitis (BISAP) score combined with serum C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR) in predicting the severity of early acute pancreatitis. A total of 113 patients with acute pancreatitis admitted to the Department of Gastroenterology, Second Affiliated Hospital of Nantong University from September 2019 to September 2022 were retrospectively collected and divided into mild acute pancreatitis group (51 cases), moderately severe acute pancreatitis group (32 cases) and severe acute pancreatitis group (30 cases) according to the severity of the disease. The general clinical data, laboratory test indicators, and imaging data within 72 hours were collected and compared among the 3 groups. The sensitivity, specificity, and accuracy of BISAP score, BISAP combined with CRP, BISAP combined with NLR, and BISAP combined with CRP and NLR in predicting the severity of acute pancreatitis were analyzed by receiver operating characteristic curve. 1. BISAP score (0.9608 ± 0.1119, 1.688 ± 0.1225, 2.6 ± 0.1135), CRP (74.77 ± 8.336, 142.9 ± 11.44, 187.6 ± 13.04), and NLR (8.063 ± 0.7781, 13.69 ± 1.023, 18.06 ± 1.685) increased sequentially in mild acute pancreatitis group, moderately severe acute pancreatitis group, and severe acute pancreatitis group, and the differences in BISAP score, CRP and NLR among the 3 groups were statistically significant (P < .05). BISAP score was positively correlated with CRP and NLR (R = 0.5062, 0.5247, P < .05). The area under the receiver operating characteristic curve of BISAP score, CRP, NLR, BISAP combined with NLR, and BISAP combined with CRP in predicting the severity of acute pancreatitis were 0.885, 0.814, 0.714, 0.953, respectively. The specificity and sensitivity of combined diagnosis were higher than those of BISAP score or CRP and NLR alone. BISAP score combined with CRP and NLR can effectively evaluate the severity of acute pancreatitis, and their combination has a higher predictive value for early severity assessment.

Effects of plastic contamination on carbon fluxes in a subtropical coastal wetland of East China.

Coastal wetlands are recognized as carbon sinks that play an important role in mitigating global climate change because of the strong carbon uptake by vegetation and high carbon sequestration in the soil. Over the last few decades, plastic waste pollution in coastal zones has become increasingly serious owing to high-intensity anthropogenic activities. However, the influence of plastic waste (including foam waste) accumulation in coastal wetlands on carbon flux remains unclear. In the Yangtze Estuary, we investigated the variabilities of vegetation growth, carbon dioxide (CO2) and methane (CH4) fluxes, and soil properties in a clean Phragmites australis marsh and mudflat and a plastic-polluted marsh during summer and autumn. The clean marsh showed a strong CO2 uptake capacity (a carbon sink), and the clean mudflat showed a weak CO2 sink during the measurement period. However, polluted marshes are a significant source of CO2 emissions. Regardless of the season, the gross primary production and vegetation biomass of the polluted marshes were on average 9.5 and 1.1 times lower than those in the clean marshes, respectively. Ecosystem respiration and CH4 emissions in polluted marshes were significantly higher than those in clean marshes and mudflats. Generally, the soil bulk density and salinity in polluted marshes were lower, whereas the median particle size was higher at the polluted sites than at the clean sites. Increased soil porosity and decreased salinity may favor CO2 and CH4 emissions through gas diffusion pathways and microbiological behavior. Moreover, the concentrations of heavy metals in the soil of plastic-polluted marshes were 1.24-1.49 times higher than those in the clean marshes, which probably limited vegetation growth and CO2 uptake. Our study highlights the adverse effects of plastic pollution on the carbon sink functions of coastal ecosystems, which should receive global attention in coastal environmental management.

Impacts of land-use change on carbon dynamics in China's coastal wetlands.

The impact of land-use and land-cover change (LULCC) on ecosystem carbon (C) dynamics has been previously documented at local and global scales, but uncertainty persists for coastal wetlands due to geographical variability and field data limitations. Field-based assessments of plant and soil C contents and stocks of various LULCC types were conducted in nine regions along the coastline of China (21°-40°N). These regions cover natural coastal wetlands (NWs, including salt marshes and mangroves) and former wetlands converted to different LULCC types, including reclaimed wetlands (RWs), dry farmlands (DFs), paddy fields (PFs) and aquaculture ponds (APs). The results showed that LULCC generally decreased the C contents and stocks of the plant-soil system by 29.6 % ± 2.5 % and 40.4 % ± 9.2 %, respectively, while it slightly increased the soil inorganic C contents and stocks. Wetlands converted to APs and RWs lost greater ecosystem organic C stocks (EOC, sum of plants and top 30 cm of soil organic C stocks) than other LULCC types. The annual potential CO2 emissions estimated from EOC loss depended on the LULCC type, with an average emission of 7.92 ± 2.94 Mg CO2-eq ha-1 yr-1. The change rate of EOC in all LULCC types showed a significantly deceasing trend with increasing latitude (p < 0.05). The loss of EOC due to LULCC was larger in mangroves than in salt marshes. The results showed that the response of plant and soil C variables to LULCC was mainly related to differences in plant biomass, median grain size, soil water content and soil NH4+-N content. This study emphasized the importance of LULCC in triggering C loss in natural coastal wetlands, which strengthens the greenhouse effect. We suggest that the current land-based climate models and climate mitigation policies must account for specific land-use types and their associated land management practices to achieve more effective emission reduction.

Quantifying seaweed and seagrass beach deposits using high-resolution UAV imagery.

Macroalgae and seagrass wash ashore by tidal waters and episodic events and create an ocean-to-land transport of carbon and nutrients. On land, these deposits (beach wrack) are consumed by macrofauna, remineralized by microorganisms, or washed back to the sea, during which recycling of carbon and nitrogen affect the biochemical cycles in coastal zones. Manual quantification of beach wracks is time-consuming and often difficult due to complex topography and remote locations. Here, we present a novel method using Unoccupied Aerial Vehicle (UAV) photogrammetry combined with in situ measurements of carbon and nitrogen contents of wrack to quantify marine carbon and nutrient deposits in beach zones. The UAV method was tested against placed cubes ranging from 125 to 88,218 cm3 and demonstrated a high accuracy (R2 > 0.99) for volume acquisition when compared to manual measurements. Also, the UAV-based assessments of the cross-sectional area of beach deposits demonstrated a high accuracy when compared to manual and high-precision GNSS (Global Navigation Satellite System) measurements without significant differences between the methods. This demonstrated that UAVs can provide detailed spatial maps, three-dimensional (3D) surface models, and accurate volumetric assessments of beach wrack deposits. In three case studies, combined with carbon and nitrogen measures, total organic carbon and nitrogen deposits in beach wracks were quantified ranging from 4.3 to 9.7 and from 0.3 to 0.5 kg per meter coastline, respectively. In conclusion, this UAV method demonstrated an effective tool to quantify ecosystem carbon and nitrogen deposits relevant to ecosystem assessments and quantification of blue carbon stocks. The method is optimal when the terrain below beach wrack deposits is known, as in the case with before-and-after or repeated surveys. Further, UAVs display strong time- and cost-effective advantages over manual methods which is amplified with increasing project scale. We propose it as a valuable method for multiple scientific and commercial applications related to environmental monitoring and management, including marine resource exploration and exploitation.

Reclamation-induced tidal restriction increases dissolved carbon and greenhouse gases diffusive fluxes in salt marsh creeks.

Intertidal creeks play an important role in transporting nutrients between coastal ecosystems and ocean. Reclamation is a predominant anthropogenic disturbance in coastal regions; however, the influence of reclamation on carbon and nitrogen species and greenhouse gas (GHG) fluxes in creek remains unclear. In a subtropical salt marsh of eastern China, the seasonal patterns of dissolved carbon (DOC, DIC, CO2, and CH4) and inorganic nitrogen (NH4+-N, NO2--N, and NO3--N and N2O) species, and the diffusive fluxes of CO2, CH4, and N2O, were compared between the natural tidal creeks and the reclaimed creeks. Due to notably changed hydrological and biological conditions in the reclaimed creeks, concentrations of all dissolved carbon species, NH4+-N and NO2--N increased significantly by 60.2-288.2%, while NO3--N and N2O decreased slightly, compared to the natural tidal creeks. DIC and NO3--N were the primary components of the total dissolved carbon and inorganic nitrogen in both creek types; however, their proportions decreased as a result of elevated DOC, CO2, CH4, NH4+-N, and NO2--N following reclamation. Significantly higher global warming potential (0.58 ± 0.15 g CO2-eq m-2 d-1) was found in the reclaimed creeks, making them hotspot of greenhouse effects, compared to the natural tidal creeks. Our results indicated that changes in flow velocity, salinity, Chlorophyll a, and pH were the main factors controlling the dissolved carbon and nitrogen and consequent GHG emissions, due to reclamation. This study is helpful in understanding of carbon and nitrogen sink-source shifts resulting from land use changes in coastal wetlands.

Sea-level rise will reduce net CO2 uptake in subtropical coastal marshes.

Coastal marshes have a significant capacity to sequester carbon; however, sea-level rise (SLR) is expected to result in prolonged flooding and saltwater intrusion in coastal regions. To explore the effects of SLR projections on net CO2 uptake in coastal marshes, we conducted a "double-check" investigation, including the eddy covariance (EC) measurements of the CO2 fluxes in subtropical coastal marshes along inundation and salinity gradients, in combination with a mesocosm experiment for analyzing CO2 flux components under waterlogging and increased salinity conditions. During the same measurement periods, the net ecosystem CO2 exchange (NEEEC based on the EC dataset) in an oligohaline marsh was higher than that in a low-elevation mesohaline marsh, whereas the NEEEC was lower than that in a high-elevation freshwater marsh. The declines in NEEEC between the marshes could be attributed to a greater decrease in gross primary production relative to ecosystem respiration. Waterlogging slightly increased the NEEms (NEE based on the mesocosms) because of inhibited soil respiration and slight changes in plant photosynthesis and shoot respiration. However, the NEEms measured during the drainage period decreased significantly due to the stimulated soil respiration. The NEEms decreased with increasing salinity (except under mild salinity), and waterlogging exacerbated the adverse impacts of salinity. The amplificatory effect of decreases in both leaf photosynthesis and growth under hydrological stresses contributed more to reduce the NEEms than to respiratory effluxes. Both waterlogging and increased salinity reduced the root biomass, soil microbial biomass, and activities of assayed soil enzymes (except for cellulase under waterlogging conditions), leading to limited soil respiration. The declines in plant growth, photosynthesis, and soil respiration could also be attributed to the decrease in soil nutrients under waterlogging and increased salinity conditions. We propose that the coupling of SLR-driven hydrological effects lowers the capacity of CO2 uptake in subtropical coastal marshes.

Conversion of coastal wetlands, riparian wetlands, and peatlands increases greenhouse gas emissions: A global meta-analysis.

Land-use/land-cover change (LULCC) often results in degradation of natural wetlands and affects the dynamics of greenhouse gases (GHGs). However, the magnitude of changes in GHG emissions from wetlands undergoing various LULCC types remains unclear. We conducted a global meta-analysis with a database of 209 sites to examine the effects of LULCC types of constructed wetlands (CWs), croplands (CLs), aquaculture ponds (APs), drained wetlands (DWs), and pastures (PASs) on the variability in CO2 , CH4 , and N2 O emissions from the natural coastal wetlands, riparian wetlands, and peatlands. Our results showed that the natural wetlands were net sinks of atmospheric CO2 and net sources of CH4 and N2 O, exhibiting the capacity to mitigate greenhouse effects due to negative comprehensive global warming potentials (GWPs; -0.9 to -8.7 t CO2 -eq ha-1  year-1 ). Relative to the natural wetlands, all LULCC types (except CWs from coastal wetlands) decreased the net CO2 uptake by 69.7%-456.6%, due to a higher increase in ecosystem respiration relative to slight changes in gross primary production. The CWs and APs significantly increased the CH4 emissions compared to those of the coastal wetlands. All LULCC types associated with the riparian wetlands significantly decreased the CH4 emissions. When the peatlands were converted to the PASs, the CH4 emissions significantly increased. The CLs, as well as DWs from peatlands, significantly increased the N2 O emissions in the natural wetlands. As a result, all LULCC types (except PASs from riparian wetlands) led to remarkably higher GWPs by 65.4%-2,948.8%, compared to those of the natural wetlands. The variability in GHG fluxes with LULCC was mainly sensitive to changes in soil water content, water table, salinity, soil nitrogen content, soil pH, and bulk density. This study highlights the significant role of LULCC in increasing comprehensive GHG emissions from global natural wetlands, and our results are useful for improving future models and manipulative experiments.

The importance of the propagule-sediment-tide "power balance" for revegetation at the coastal frontier.

Revegetation of pioneer plants is a critical phase in community establishment for mudflats in seriously degraded coastal wetlands. We tested a hypothesis of the importance of a "power balance" among propagule resilience and sedimentary and tidal disturbances for vegetation reestablishment. Our experiment used three types of propagules (seeds, seedlings, and corms) of native Scirpus species in the fringing flats with similar tidal flows and varying sedimentary intensities in the Yangtze Estuary. Regardless of the initial planting densities, the seed germination rate was extremely low in the field situation. Although the incubated seedlings were planted directly on the bare flat, the wave movement easily flushed the seedlings, even at the site with moderate sedimentary accretion. Failure of the revegetation practice using the seed and seedling materials indicated that the combined "growing and anchoring power" of young seedlings and "stabilizing power" of the sediment were insufficient to withstand the "dislodging power" of the tidal energy. In contrast, the planting approach with underground propagules (corms) proved to be feasible for vegetation establishment at the sites with moderate and low-level sedimentary intensities. The successful practice improved the tipping point of plant survival and tussock formation could be surpassed when the combined growing and anchoring power of seedlings that developed from corms with the stabilizing power of the sediment was greater than the dislodging power of the wave energy. However, at the site with high-level sedimentary intensity, the excessive sediment converted to the burying stress power as seedlings developed from the corms, revealing a burial threshold for seedling survival. The risk of seedling establishment was high when the burying stress power of the sediment far outweighed the combination of the growing power of the seedlings and the sediment removal power of the tidal current and surpassed the tipping point of vegetation die-off. Additionally, we checked the practice cost of the different approaches to ensure a highly cost-effective revegetation planning based on site suitability. This study highlights that understanding of the propagule-sediment-tide power balance offers a tool for improvement of the revegetation and management of site-specific sedimentary and hydrological environments for many degraded coastal ecosystems.

The shaping role of self-organization: linking vegetation patterning, plant traits and ecosystem functioning.

Self-organized spatial patterns are increasingly recognized for their contribution to ecosystem functioning, in terms of enhanced productivity, ecosystem stability, and species diversity in terrestrial as well as marine ecosystems. Most studies on the impact of spatial self-organization have focused on systems that exhibit regular patterns. However, there is an abundance of patterns in many ecosystems which are not strictly regular. Understanding of how these patterns are formed and how they affect ecosystem function is crucial for the broad acceptance of self-organization as a keystone process in ecological theory. Here, using transplantation experiments in salt marsh ecosystems dominated by Scirpus mariqueter, we demonstrate that scale-dependent feedback is driving irregular spatial pattern formation of vegetation. Field observations and experiments have revealed that this self-organization process affects a range of plant traits, including shoot-to-root ratio, rhizome orientation, rhizome node number, and rhizome length, and enhances vegetation productivity. Moreover, patchiness in self-organized salt marsh vegetation can support a better microhabitat for macrobenthos, promoting their total abundance and spatial heterogeneity of species richness. Our results extend existing concepts of self-organization and its effects on productivity and biodiversity to the spatial irregular patterns that are observed in many systems. Our work also helps to link between the so-far largely unconnected fields of self-organization theory and trait-based, functional ecology.

Wine consumption and colorectal cancer risk: a meta-analysis of observational studies.

There were inconsistent results with respect to the correlation between consumption of wine and the development of colorectal cancer (CRC). We carried out a meta-analysis to investigate this issue. We included observational studies on the aforementioned relationship according to a literature search of Embase and Pubmed from inception till 28 February 2017. The summary relative risk (SRR) and 95% confidence intervals (CI) were calculated using a random-effects model. A total of eight case-control and nine cohort studies were identified, involving 12 110 CRC cases. The study showed that wine drinking was not associated with any greater risk for CRC (SRR=0.99, 95% CI: 0.89-1.10; Pheterogeneity<0.001) compared with nondrinkers. The subgroup analyses indicated that null associations were observed in men and women for colon and rectal cancer. Neither light to moderate (<2 drinks/day; SRR=0.93, 95% CI: 0.80-1.08, I= 69.2%) nor heavy (≥2 drinks/day; SRR=1.00, 95% CI: 0.86-1.16, I= 39.9%) consumption of wine was associated statistically with CRC risk. This meta-analysis suggests that any wine consumption was not associated with the risk of CRC. Null associations were shown in men and women for colon and rectal cancer.

Double-stranded RNA-dependent kinase PKR activates NF-κB pathway in acute pancreatitis.

The activation of transcription factor nuclear factor kappa B (NF-κB) occurs early in acute pancreatitis (AP) simultaneously with intracellular trypsinogen activation. Double-stranded RNA-dependent kinase (PKR) promotes the activation of NF-κB and the production of pro-inflammatory factors including tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6). The rat and rat pancreatic AR42J cells were treated by cerulein to establish AP models, showing PKR increased. TNF-α, IL-6 and lactate dehydrogenase (LDH) in AP pancreatic tissues and cerulein-treated AR42J cells increased, while PKR knockdown in AR42J cells reversed cerulein-induced inflammatory response and pancreatic cell injury. In addition, inhibitor of kappa B kinase α (IKKα), phosphorylated P65 (p-P65), P65 increased in cerulein-treated AR42J cells. Meanwhile, in cerulein-treated AR42J cells, interaction between PKR and IKKα, as well as the co-localization and nuclear accumulation of PKR and P65, were detected. Furthermore, cerulein induced the phosphorylation and nuclear translocation of P65, which indicated the activation of NF-κB, while PKR knockdown hindered NF-κB activation to alleviate pancreatic cell injury. In summary, PKR might promote NF-κB activation via facilitating its phosphorylation and nuclear translocation, thus accelerated inflammatory response and pancreatic cell injury in AP, implying a novel molecular target for the treatment of AP.

Activating transcription factor 3 promotes intestinal epithelial cell apoptosis in Crohn's disease.

Intestinal epithelial cell (IEC) apoptosis plays a vital role in the pathogenesis of Crohn's disease (CD), which is an inflammatory bowel disease (IBD). Activating transcription factor 3 (ATF3) modulates apoptosis under stress via regulating the p53 pathway. However, the expression and function of ATF3 in CD are unclear. In the present study, ATF3, p53, and p53 target gene Bax expression increased in CD patients; a mouse 2, 4, 6-trinitrobenzenesulfonic acid (TNBS)-induced CD model; and a TNF-α-treated HT29 cell colitis model. ATF3 knockdown effectively decreased TNF-α-induced p53 and Bax expression, as well as inhibited the apoptosis of HT29 cells. Additionally, ATF3 enhanced the stability and transcription activity of p53 via interacting with p53. In summary, these data indicated that ATF3 might promote IEC apoptosis in CD via up-regulating the stability and transcription activity of p53, implying a novel molecular target for CD therapy.

Ecophysiological response of native and exotic salt marsh vegetation to waterlogging and salinity: Implications for the effects of sea-level rise.

The ecophysiological characteristics of native Phragmites australis and exotic Spartina alterniflora grown under waterlogging and salinity were investigated to explore their adaptation potential to sea level rise. The seasonal course of phenotypic traits, photosynthetic activity and chlorophyll fluorescence parameters of P. australis did not change remarkably under shallow flooding, whereas these variables were sensitive to increasing salinity. Waterlogging exacerbated the negative effects of salinity on shoot growth and photosynthetic activity of P. australis, and the combined stresses led to an absence of tassel and reproductive organs. By contrast, S. alterniflora performed well under both stresses and showed an obvious adaptation of salt secretion with increasing salinity. Light salinity was the optimal condition for S. alterniflora, and the tassel growth, chlorophyll content and fluorescence characters under moderate stresses did not differ notably. The Na+ and Cl- concentrations in leaves of both species increased, and the K+ content decreased in response to salinity. Under moderate and high saline levels, the ion concentrations in S. alterniflora were maintained at relatively consistent levels with increased salt secretion. We expect the degradation of P. australis and further colonization of S. alterniflora under prolonged flooding and saltwater intrusion from sea level rise on the coastline of China.

Responses of eastern Chinese coastal salt marshes to sea-level rise combined with vegetative and sedimentary processes.

The impacts of sea-level rise (SLR) on coastal ecosystems have attracted worldwide attention in relation to global change. In this study, the salt marsh model for the Yangtze Estuary (SMM-YE, developed in China) and the Sea Level Affecting Marshes Model (SLAMM, developed in the U.S.) were used to simulate the effects of SLR on the coastal salt marshes in eastern China. The changes in the dominant species in the plant community were also considered. Predictions based on the SLAMM indicated a trend of habitat degradation up to 2100; total salt marsh habitat area continued to decline (4-16%) based on the low-level scenario, with greater losses (6-25%) predicted under the high-level scenario. The SMM-YE showed that the salt marshes could be resilient to threats of SLR through the processes of accretion of mudflats, vegetation expansion and sediment trapping by plants. This model predicted that salt marsh areas increased (3-6%) under the low-level scenario. The decrease in the total habitat area with the SMM-YE under the high-level scenario was much lower than the SLAMM prediction. Nevertheless, SLR might negatively affect the salt marsh species that are not adapted to prolonged inundation. An adaptive strategy for responding to changes in sediment resources is necessary in the Yangtze Estuary.

[Vulnerability assessment on the coastal wetlands in the Yangtze Estuary under sea-level rise].

To study the response of coastal wetlands to climate change, assess the impacts of climate change on the coastal wetlands and formulate feasible and practical mitigation strategies are the important prerequisite for securing coastal ecosystems. In this paper, the possible impacts of sea level rise caused by climate change on the coastal wetlands in the Yangtze Estuary were analyzed by the Source-Pathway-Receptor-Consequence (SPRC) model and IPCC definition on the vulnerability. An indicator system for vulnerability assessment was established, in which sea-level rise rate, subsidence rate, habitat elevation, inundation threshold of habitat and sedimentation rate were selected as the key indicators. A quantitatively spatial assessment method based on the GIS platform was established by quantifying each indicator, calculating the vulnerability index and grading the vulnerability index for the assessment of coastal wetlands in the Yangtze Estuary under the scenarios of sea-level rise. The vulnerability assessments on the coastal wetlands in the Yangtze Estuary in 2030 and 2050 were performed under two sea-level rise scenarios (the present sea-level rise trend over recent 30 years and IPCC A1F1 scenario). The results showed that with the projection in 2030 under the present trend of sea-level rise (0.26 cm x a(-1)), 6.6% and 0.1% of the coastal wetlands were in the low and moderate vulnerabilities, respectively; and in 2050, 9.8% and 0.2% of the coastal wetlands were in low and moderate vulnerabilities, respectively. With the projection in 2030 under the A1F1 scenario (0.59 cm x a(-1)), 9.0% and 0.1% of the coastal wetlands were in the low and moderate vulnerabilities, respectively; and in 2050, 9.5%, 1.0% and 0.3% of the coastal wetlands were in the low, moderate and high vulnerabilities, respectively.

[Distribution of soil carbon storage in different saltmarsh plant communities in Chongming Dongtan wetland].

Abstract: The high productivity of saltmarsh vegetation in coastal wetlands plays an important role on the formation of soil carbon pool. This paper studied the biomass difference, the spatiotemporal dynamics and vertical distribution of soil carbon storage in three dominant saltmarsh plant communities, i. e., Phragmites australis, Spartina alterniflora and Scirpus mariqueter in the Chongming Dongtan wetland, in the Yangtze Estuary. The results indicated that the gross biomass in the three saltmarsh plant communities was in the order of S. alterniflora (5750.7 g x m(-2)) > P. australis (4655.1 g x m(-2)) > S. mariqueter (812.7 g x m(-2)). The aboveground biomass was the highest in summer and autumn, and the underground biomass was the highest in winter. The soil carbon storage (0-50 cm) was the lowest in spring, gradually increased, and was the highest in winter. The annual increment of soil carbon storage decreased from the high tidal zone to the low tidal zone, and was in the order of P. australis community (711. 8 g x m(-2)) > S. alterniflora community (646.2 g x m(-2)) > S. mariqueter community (185.3 g x m(-2)) > bare mudflat (65.6 g x m(-2)). The highest value was in the 25-30 cm, 10-15 cm, 30-35 cm and 30-40 cm soil layers for bare mudflat and the S. mariqueter, S. alterniflora and P. australis communities, respectively. There was a significant linear relationship between the soil carbon storage and the underground biomass in the different saltmarsh communities.

Cholecystectomy and the risk of esophageal and gastric cancer.

OBJECTIVE: To conduct a meta-analysis of observational studies to explore the relationships between cholecystectomy and the risk of esophageal and gastric cancer (GC). METHODS: The study design was retrospective, and carried out in the First People's Hospital of Nantong, Jiangsu, China from January 2012 to April 2012. Studies were identified by a literature search of MEDLINE and EMBASE through March 31, 2012, and by manually searching the reference lists of pertinent articles. The summary relative risks (SRRs) with their 95% confidence intervals (CIs) were calculated with a random-effects model. RESULTS: A total of 12 estimates from 6 independent studies (including 1,622 esophageal cancer [EC] cases and 2,314 GC cases) were included in this meta-analysis. We found that cholecystectomy was not associated with risk of EC and GC (EC: SRRs--1.03; 95% CI: 0.94-1.13; heterogeneity: p=0.496; I2=0; n=4 studies; [GC: SRRs--1.03; 95% CI: 0.93-1.13; heterogeneity: p=0.652; I2=0; n=5 studies]). Sub-grouped analyses revealed that these null associations were independent of geographic location and study design. Based on 2 studies, we found patients undergoing cholecystectomy at least 10 years before had an elevated risk of esophageal adenocarcinoma (EAC). CONCLUSION: The results of this meta-analysis suggest that cholecystectomy does not increase the risk of esophageal squamous cell carcinoma and GC development, but may increase EAC risk. More epidemiological research of a prospective design is needed to further clarify these associations in the future.