Alterations and Significance of Computed Tomography Pulmonary Angiography-Derived Parameters in Older Patients With Acute Pulmonary Embolism.

OBJECTIVE: This study aimed to investigate changes of computed tomography pulmonary angiography (CTPA)-derived parameters in older adults with acute pulmonary embolism (APE). METHODS: According to the pulmonary artery obstruction index (PAOI), patients with APE were divided into the A1 (PAOI ≥30%, n = 57) and A2 (PAOI <30%, n = 40) groups. Participants without APE were placed in group B (n = 170). The left atrial (LA) and left ventricular (LV) parameters among the three groups were compared, and the parameter changes in the 44 patients with APE were analyzed before and after treatment. The correlation between APE severity and the parameters was analyzed using correlation analysis. RESULTS: The left-to-right diameters (LR) of LA, and LR × anteroposterior diameters (AP) of LA and LV: A1 < A2 < B; LR of LV: A1 < A2, B; AP of LA and LV: A1, A2 < B. After treatment, LR and LR × AP of the LA and LV were significantly increased in the group A1 and LR of the LV and LR × AP of the LA and LV were elevated in the group A2. Acute pulmonary embolism severity was closely associated with LR × AP ( r = -0.557) and LR ( r = -0.477) of LA. CONCLUSIONS: With an increase in the degree of obstruction, older adults had a smaller LA and LV. Furthermore, the LR and LR × AP values of the LA were significantly decreased. These results contribute to in-time risk stratification.

Spatiotemporal response of the optical characteristics of dissolved organic matter to seasonality and land use in tropical island rivers.

Dissolved organic matter (DOM), a pivotal component in the global carbon cycle, plays a crucial role in maintaining the productivity and functionality of aquatic ecosystems. However, the driving factors of variations in the properties of riverine DOM in tropical islands still remain unclear. In this study, the spatiotemporal response of the optical characteristics of riverine DOM to seasonality and land use on Hainan Island in southern China was investigated. Our results revealed that DOM in the rivers of Hainan Island exhibited a relatively high proportion of fulvic acid and demonstrated strong terrestrial sources. The optical properties of DOM exhibited significant variations both seasonally and spatially. Land use exerted a dominant influence on riverine DOM. Specifically, during the wet season, riverine DOM exhibited larger molecular weight, increased chromophoric DOM (CDOM) abundance, and higher Fmax compared to the dry season. Furthermore, riverine DOM influenced by grassland and farmland showed higher CDOM abundance, Fmax, and humification degree in contrast to those impacted by forest and urban. Random forest and correlation analysis results indicated that grassland and farmland enhanced the Fmax of DOM by increasing levels of TP, NO3--N, Chl a, and NH4+-N in the dry season. However, during the wet season, the increased Fmax of DOM induced by grassland and farmland relied on the increments of Chl a and TP concentrations. This study improves our understanding of the spatiotemporal fluctuations of DOM in the rivers of Hainan Island, highlighting the effects of season and land use on DOM. It offers valuable support for improving water quality and contributes to enhancing human comprehension of the global carbon cycle.

Cervicocerebral Computed Tomography Angiography for Older Patients Based on Time to Peak and Number of Time Points to Peak in the Test Bolus Technique.

OBJECTIVE: This study sought to optimize image quality and reduce the contrast dose by adjusting contrast agent and normal saline doses used in cervicocerebral computed tomography angiography (CTA) of older patients. METHODS: Older patients who underwent cervicocerebral CTA were divided into group A (n = 110) and group B (n = 124). In the angiography scan, patients in group A were injected with 1.0 mL/kg contrast agent, followed by 40 mL saline chaser. In group B, contrast agent and normal saline doses were adjusted based on time to peak and number of time points to peak in the test bolus technique. The CT attenuation values, noise, signal-to-noise ratio, and contrast-to-noise ratio of target arteries and the right transverse sinus were objectively compared. RESULTS: Compared with group A, the contrast retention and artifacts in the right subclavian vein, right brachiocephalic veins, and superior vena cava were significantly decreased in group B. Furthermore, in group B, the noise at the bifurcation of the right common carotid artery increased by 1.7%, and the signal-to-noise ratio of the left middle cerebral artery M1 segment decreased by 6.6%. The contrast dose in group B decreased significantly (18.2%) as compared with group A. CONCLUSION: Based on time to peak and number of time points to peak with the test bolus, adjusting contrast and normal saline doses in cervicocerebral CTA for older people reduces contrast retention and artifacts in the veins of the injection side. Further, it also decreases the contrast dose needed to obtain image quality that satisfies diagnostic requirements.

Development and Validation of a Prediction Model of the Risk of Pneumonia in Patients with SARS-CoV-2 Infection.

Objective: To establish a prediction model of pneumonia risk in SARS-CoV-2-infected patients to reduce unnecessary chest CT scans. Materials and Methods: The model was constructed based on a retrospective cohort study. We selected SARS-CoV-2 test-positive patients and collected their clinical data and chest CT images from the outpatient and emergency departments of Hunan Provincial People's Hospital, China. Univariate and multivariate logistic regression and least absolute shrinkage and selection operator (LASSO) regression were utilized to identify predictors of pneumonia risk for patients infected with SARS-CoV-2. These predictors were then incorporated into a nomogram to establish the model. To ensure its performance, the model was evaluated from the aspects of discrimination, calibration, and clinical validity. In addition, a smoothed curve was fitted using a generalized additive model (GAM) to explore the association between the pneumonia grade and the model's predicted probability of pneumonia. Results: We selected 299 SARS-CoV-2 test-positive patients, of whom 205 cases were in the training cohort and 94 cases were in the validation cohort. Age, CRP natural log-transformed value (InCRP), and monocyte percentage (%Mon) were found to be valid predictors of pneumonia risk. This predictive model achieved good discrimination of AUC in the training and validation cohorts which was 0.7820 (95% CI: 0.7254-0.8439) and 0.8432 (95% CI: 0.7588-0.9151), respectively. At the cut-off value of 0.5, it had a sensitivity and specificity of 70.75% and 66.33% in the training cohort and 76.09% and 73.91% in the validation cohort, respectively. With suitable calibration accuracy shown in calibration curves, decision curve analysis indicated high clinical value in predicting pneumonia probability in SARS-CoV-2-infected patients. The probability of pneumonia predicted by the model was positively correlated with the actual pneumonia classification. Conclusion: This study has developed a pneumonia risk prediction model that can be utilized for diagnostic purposes in predicting the probability of pneumonia in patients infected with SARS-CoV-2.

LncRNA MAFG-AS1 Upregulates Polo-Like Kinase-1 by Sponging miR-505 to Promote Gastric Adenocarcinoma Cell Proliferation.

Gastric cancer is a commonly diagnosed, often fatal malignancy and requires novel anticancer therapies and preventative approaches. This study described the involvement of MAFG-AS1, a lncRNA with important functions in cancer biology, in gastric adenocarcinoma (GA). Thirty-six male and forty-two female GA patients with an average age of 51.9 ± 5.7 years in the range of 35 to 68 years were enrolled. Paired gastric cancer (GC) and non-tumor tissues were collected from each patient. MAFG-AS1 expression was determined. RNA interaction prediction, dual luciferase reporter assay, RT-qPCR assay, Western blot, and CCK-8 assay were conducted. The results indicated that MAFG-AS1 was highly expressed in GA and closely correlated with poor survival. MAFG-AS1 interacted with miR-505, but MAFG-AS1 and miR-505 overexpression showed no significant effects on each other's expression. In addition, MAFG-AS1 increased the expression of PLK1, a miR-505 target. MAFG-AS1 and PLK1 overexpression increased GC cell proliferation rate. MiR-505 overexpression reduced the effects of MAFG-AS1 and PLK1 overexpression on cell proliferation. Therefore, MAFG-AS1 might upregulate PLK1 by sponging miR-505 to promote GA cell proliferation.

Producing more grain with lower environmental costs.

Agriculture faces great challenges to ensure global food security by increasing yields while reducing environmental costs. Here we address this challenge by conducting a total of 153 site-year field experiments covering the main agro-ecological areas for rice, wheat and maize production in China. A set of integrated soil-crop system management practices based on a modern understanding of crop ecophysiology and soil biogeochemistry increases average yields for rice, wheat and maize from 7.2 million grams per hectare (Mg ha(-1)), 7.2 Mg ha(-1) and 10.5 Mg ha(-1) to 8.5 Mg ha(-1), 8.9 Mg ha(-1) and 14.2 Mg ha(-1), respectively, without any increase in nitrogen fertilizer. Model simulation and life-cycle assessment show that reactive nitrogen losses and greenhouse gas emissions are reduced substantially by integrated soil-crop system management. If farmers in China could achieve average grain yields equivalent to 80% of this treatment by 2030, over the same planting area as in 2012, total production of rice, wheat and maize in China would be more than enough to meet the demand for direct human consumption and a substantially increased demand for animal feed, while decreasing the environmental costs of intensive agriculture.

Effect of somatostatin on prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis and hyperamylasemia: A systematic review and meta-analysis.

OBJECTIVE: To perform a meta-analysis of all available studies on the effect of prophylactic somatostatin administration on prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) and post-ERCP hyperamylasemia (PEHA). METHODS: Electronic databases, including PubMed, EMBASE, the Cochrane library, and the Science Citation Index were searched to retrieve relevant trials. Randomized, placebo-controlled trials in adult patients that compared somatostatin versus placebo in prevention of PEP were included. Meta-analysis was performed using a random-effects model to assess the ratios of PEP, PEHA and post-ERCP abdominal pain. RESULTS: Total ratio of PEP of somatostatin group was significantly lower than that of placebo group. For the short-term injection or bolus injection there were no heterogeneity and no significance between the ratio of PEP of somatostatin group and placebo group. For the long-term injection subgroup there was heterogeneity, and the ratio of PEP of somatostatin group was significantly lower than that of placebo group. There was no significance between the ratio of PEP of somatostatin group and placebo group for the low-risk PEP subgroup, while the ratio of PEP of somatostatin group was significantly lower than that of placebo group for the high-risk PEP subgroup. The ratio of PEP of somatostatin group was significantly lower than that of placebo group for the long-term injection high-risk PEP subgroup. There was no significance between the ratio of PEHA of somatostatin group and placebo group for the short-term injection subgroup or bolus injection subgroup. The ratio of PEHA of somatostatin group was significantly lower than that of placebo group for the long-term injection subgroup. The total ratio of post-ERCP abdominal pain of somatostatin group was significantly lower than that of placebo group. The funnel plot of incidence of PEP and PEHA showed no asymmetry with a negative slope. CONCLUSION: Prophylactic use of long-term injection of somatostatin can significantly reduce the incidence of PEP, PEHA and post-ERCP abdominal pain for the high-risk PEP patients, while it is not necessary to be used for the low-risk PEP patients.

Closing the N-use efficiency gap to achieve food and environmental security.

To achieve food and environmental security, closing the gap between actual and attainable N-use efficiency should be as important as closing yield gaps. Using a meta-analysis of 205 published studies from 317 study sites, including 1332 observations from rice, wheat, and maize system in China, reactive N (Nr) losses, and total N2O emissions from N fertilization both increased exponentially with increasing N application rate. On the basis of the N loss response curves from the literature meta-analysis, the direct N2O emission, NH3 volatilization, N leaching, and N runoff, and total N2O emission (direct + indirect) were calculated using information from the survey of farmers. The PFP-N (kilogram of harvested product per kilogram of N applied (kg (kg of N)(-1))) for 6259 farmers were relative low with only 37, 23, and 32 kg (kg of N)(-1) for rice, wheat, and maize systems, respectively. In comparison, the PFP-N for highest yield and PFP-N group (refers to fields where the PFP-N was within the 80-100th percentile among those fields that achieved yields within the 80-100th percentile) averaged 62, 42, and 53 kg (kg of N)(-1) for rice, wheat, and maize systems, respectively. The corresponding grain yield would increase by 1.6-2.3 Mg ha(-1), while the N application rate would be reduced by 56-100 kg of N ha(-1) from average farmer field to highest yield and PFP-N group. In return, the Nr loss intensity (4-11 kg of N (Mg of grain)(-1)) and total N2O emission intensity (0.15-0.29 kg of N (Mg of grain)(-1)) would both be reduced significantly as compared to current agricultural practices. In many circumstances, closing the PFP-N gap in intensive cropping systems is compatible with increased crop productivity and reductions in both Nr losses and total N2O emissions.

Mipu1 protects H9c2 myogenic cells from hydrogen peroxide-induced apoptosis through inhibition of the expression of the death receptor Fas.

Mipu1 (myocardial ischemic preconditioning upregulated protein 1), a novel rat gene recently identified in our lab, was expressed abundantly and predominantly in the brain and heart and upregulated in myocardium during myocardial ischemia/reperfusion in rats. In our previous study we found that Mipu1 was an evolutionarily conserved zinc finger-containing transcription factor. However, whether Mipu1 confers myocardial protection remains unknown. In this study, H9c2 myogenic cells were treated with hydrogen peroxide (H2O2) to simulate oxidative stress during myocardial ischemia-reperfusion injury. The expression of Mipu1 at mRNA and protein levels was detected by RT-PCR and Western blotting analysis. To study the effect of Mipu1 on apoptosis and expression of Fas induced by H2O2, full-length Mipu1 cDNA and Mipu1-RNAi plasmids were transiently transfected into H9c2 myogenic cells, and flow cytometry was used to quantitate the percentage of apoptotic cells. The expression of Fas was analyzed by Western blotting assay. The DNA binding and transcription activities of Mipu1 to the Fas promoter were detected by chromatin immunoprecipitation and luciferase reporter assays. The results showed that exposure of H9c2 myogenic cells to H2O2 resulted in a dose- and time-dependent increase in Mipu1 mRNA and protein levels; Mipu1 over-expression inhibited H2O2-induced apoptosis and upregulation of Fas induced by H2O2 in H9c2 myogenic cells; and knockdown of Mipu1 by RNAi promoted apoptosis and upregulation of Fas induced by H2O2. The chromatin immunoprecipition and reporter assays showed the DNA binding and transcription suppressor activities of Mipu1 to Fas promoter region. These results indicate that Mipu1 protected H9c2 myogenic cells from H2O2-induced apoptosis through inhibiting the expression of Fas.

Development and Validation of a Diagnostic Model for Enhancing Lesions on Breast MRI: Based on Kaiser Score.

RATIONALE AND OBJECTIVES: This study aims to develop and validate a new diagnostic model based on the Kaiser score for preoperative diagnosis of the malignancy probability of enhancing lesions on breast MRI. MATERIALS AND METHODS: This study collected consecutive inpatient data (including imaging data, clinical data, and pathological data) from two different institutions. All patients underwent preoperative breast Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) examinations and were found to have enhancing lesions. These lesions were confirmed as benign or malignant by surgical resection or biopsy pathology (all carcinomas in situ were confirmed by pathology after surgical resection). Data from one institution were used as the training set(284 cases), and data from the other institution were used as the validation set(107 cases). The Kaiser score was directly incorporated into the diagnostic model as a single predictive variable. Other predictive variables were screened using Least Absolute Shrinkage and Selection Operator (LASSO) regression. Multivariate logistic regression was employed to integrate the Kaiser score and other selected predictive variables to construct a new diagnostic model, presented in the form of a nomogram. Receiver operating characteristic (ROC) curve, DeLong test, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were adopted to evaluate and compare the discrimination of the diagnostic model for breast enhancing lesions based on Kaiser score (hereinafter referred to as the "breast lesion diagnostic model") and the Kaiser score alone. Calibration curves were used to assess the calibration of the breast lesion diagnostic model, and decision curve analysis (DCA) was used to evaluate the clinical efficacy of the diagnostic model and the Kaiser score. RESULTS: LASSO regression indicated that, besides the indicators already included in the Kaiser score system, "age", "MIP sign", "associated imaging features", and "clinical breast examination (CBE) results" were other valuable diagnostic parameters for breast enhancing lesions. In the training set, the AUCs of the breast lesion diagnostic model and the Kaiser score were 0.948 and 0.869, respectively, with a statistically significant difference (p < 0.05). In the validation set, the AUCs of the breast lesion diagnostic model and the Kaiser score were 0.956 and 0.879, respectively, with a statistically significant difference (p < 0.05). The DeLong test, NRI, and IDI showed that the breast lesion diagnostic model had a higher discrimination ability for breast enhancing lesions compared to the Kaiser score alone, with statistically significant differences (p < 0.05). The calibration curves indicated good calibration of the breast lesion diagnostic model. DCA demonstrated that the breast lesion diagnostic model had higher clinical application value, with greater net clinical benefit over a wide range of diagnostic thresholds compared to the Kaiser score. CONCLUSION: The Kaiser score-based breast lesion diagnostic model, which integrates "age," "MIP sign", "associated imaging features", and "CBE results", can be used for the preoperative diagnosis of the malignancy probability of breast enhancing lesions, and it outperforms the classic Kaiser score in terms of diagnostic performance for such lesions.

The predictive value of neurally adjusted ventilatory assist indexes for the prognosis of patients with severe cerebral hemorrhage.

OBJECTIVE: This study assessed the predictive value of electrical activity of the diaphragm (EAdi) and the EAdi-derived monitoring index in the prognosis of patients with severe cerebral hemorrhage. METHODS: Ninety patients with severe cerebral hemorrhage were admitted to the Neurosurgery Intensive Care Unit of Yijishan Hospital from April 2019 to June 2021 and were divided into the good prognosis group (Glasgow Outcome Scale [GOS] ≥ 4) and poor prognosis group (GOS ≤ 3). The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate prediction accuracy. RESULTS: EAdi, neuro-ventilatory efficiency (NVE), and neuro-muscular efficiency (NME) in patients with good prognosis were significantly higher than those in patients with poor prognosis (4.707 µV vs 2.80 µV, P < 0.001; 141.85 ml/µV vs 66.01 ml/µV, P = 0.000; 2.57 cm H2O/µV vs 1.37 cm H2O/µV, P = 0.000). The area under the ROC curve for the EAdi score was 0.719, with sensitivity of 69.70% and specificity of 68.42% when EAdi was 3.6 µV. The AUC for NVE score was 0.793, with sensitivity of 75.76% and specificity of 75.44% when the NVE value was 95.32 ml/µV. The AUC for NME score was 0.792, with sensitivity of 69.70% and specificity of 78.95% when the NME value was 2.06 H2O/µV. The 6-month survival time of patients with higher EAdi, NVE, and NME was significantly longer than that of patients with lower EAdi, NVE, and NME CONCLUSION: EAdi, NVE, and NME can be used as indices for predicting the prognosis of patients with severe cerebral hemorrhage. TRIAL REGISTRATION NO: ChiCTR1900022861. Registered April 28, 2019, http://www.chictr.org.cn .

HSP70 promotes pancreatic cancer cell epithelial-mesenchymal transformation and growth via the NF-κB signaling pathway.

OBJECTIVE: To study the effects of HSP70 on proliferation, migration, invasion, and epithelial-mesenchymal transformation (EMT) of pancreatic cancer cells and explore its underlying mechanisms. METHODS: Pancreatic cancer cell models with either reduced HSP70 or increased HSP70 expression were established. RT-qPCR and Western blot assays were used to determine mRNA and protein levels of HSP70, IKK/IκBa/NF-κB signaling pathway-related genes, and EMT markers. The CCK-8 and cell cloning assays were used to evaluate cell proliferation and cloning abilities. Transwell and wound healing assays were used to assess the invasive and migratory properties of the cells. Effects of NF-κB signaling modulation were explored using an IKK inhibitor (BAY11-7082) and an IKK overexpression vector (pCMV-IKK). Electrophoretic mobility shift assay (EMSA) and luciferase reporter assays were conducted to analyze NF-κB's promoter binding and transcriptional activities. RESULTS: HSP70 knockdown inhibited p-p65 nuclear translocation and reduced the expression of p-p65, p-IKKα/ß, p-IκBα, N-cadherin, Vimentin, and Twist. It also decreased NF-κB's promoter binding and transcriptional activities, increased E-cadherin levels, and suppressed pancreatic cancer cell proliferation, cloning, migration, and invasion. In contrast, HSP70 overexpression led to increased expression of p-p65, p-IKKα/ß, p-IκBα, N-cadherin, Vimentin, and Twist, decreased E-cadherin levels, and enhanced cell proliferation, cloning, migration, and invasion capabilities. NF-κB signaling pathway modulation reversed EMT changes induced by altered HSP70 expression levels. rhHSP70 also increased p-IKKα/ß and p-IκBα protein levels. CONCLUSION: HSP70 promotes the EMT and enhances pancreatic cancer cell proliferation, migration, and invasion by activating the NF-κB pathway.

Serum HSP70 and VEGF Levels Are Effective Predictive Factors of Chemoradiosensitivity and Prognosis of Pancreatic Cancer Patients.

AIM: The study is to evaluate serum HSP70 and VEGF for predicting the chemoradiosensitivity of the pancreatic cancer patients. MATERIALS AND METHODS: 255 pancreatic cancer patients and 60 healthy subjects were measured for serum HSP70 and VEGF using ELISA for the pretreatment, during treatment, and postchemoradiotherapy timepoints. RESULTS: The serum HSP70 and VEGF were found to be elevated in pancreatic cancer patients as compared to healthy subjects. After chemoradiotherapy treatment, 179 patients showed effective clinical response while 76 patients showed ineffective clinical response. Serum HSP70 and VEGF were higher during chemoradiotherapy, and lower posttreatment in the effective group. However, serum HSP70 and VEGF were higher during and after treatment in the ineffective group. At any given timepoint, serum HSP70 and VEGF were higher in the ineffective group compared with the effective group. The overall survival and progression-free survival trends were as follows: HSP70 High /VEGF High < HSP70 High /VEGF Low or HSP70 Low /VEGF High < HSP70 Low /VEGF Low . Serum HSP70 and VEGF were individually effective, and their combination was even more effective in predicting the chemoradiosensitivity of pancreatic cancer patients. HSP70 and VEGF were independent risk factors for overall survival and progression-free survival of pancreatic cancer patients. CONCLUSIONS: Low levels of serum HSP70 and VEGF were associated with improved radiosensitivity and better prognosis of pancreatic cancer patients.

Effect of enteral nutrition and ecoimmunonutrition on bacterial translocation and cytokine production in patients with severe acute pancreatitis.

BACKGROUND: Severe acute pancreatitis (SAP) with severe complications such as multiple organ failure, necrosis, abscess, and formation of pancreatic pseudocysts often gives rise to a high mortality despite intensive treatment. Parenteral nutrition (PN), elemental enteral nutrition, and ecoimmunonutrition (EIN) hastened the recovery of SAP patients, stimulated gastrointestinal motility, and alleviated the degree of systemic inflammatory response syndrome. This study aimed to examine the effects of enteral nutrition (EN) and EIN on bacterial translocation and cytokine production in patients with SAP. METHODS: One hundred eighty-three SAP patients were randomly divided into three groups receiving PN, EN, or EN + EIN. Acute Physiology and Chronic Health Evaluation II scores, complications (systemic inflammatory response syndrome, multiorgan failure, and infections), intestinal bacterial strains of stool, and plasma concentrations of endotoxin, tumor necrosis factor α (TNF-α), and interleukin (IL) 6 and IL-10 were evaluated. RESULTS: The percentage of pancreatic sepsis, multiple organ dysfunction syndrome, and mortality was significantly lower in the EN group and was further lower in the EN + EIN group than that in the PN group. The plasma concentrations of TNF-α and IL-6 and APACHE II scores were significantly decreased in the EN group and were further lowered in the EN + EIN group than those in the PN group. The plasma concentration of IL-10 was higher in the EN group and was further increased in the EN + EIN group than that in the PN group. CONCLUSIONS: EN plays effective roles in the treatment of SAP by decreasing the expression of endotoxin, TNF-α, and IL-6 and the bacterial translocation, enhancing the expression of IL-10, and the combination of EIN with EN results in more therapeutic benefits than EN alone.

In-season root-zone N management for mitigating greenhouse gas emission and reactive N losses in intensive wheat production.

Although both the grain yields and environmental costs of nitrogen (N) fertilization are gaining more public and scientific debate, the complex linkages among crop productivity, N application rate, environmental footprints, and the consequences of improved N management are not well understood. We considered the concept of linking greenhouse gas (GHG) emission, reactive N losses, and N fertilizer application rates with crop productivity to determine the response of the GHG emission and reactive N losses to N surplus and further evaluated the potential to reduce these N environmental footprints by in-season root-zone N management. A meta-analysis suggested an exponential increase in the response of direct N2O emissions and nitrate leaching to an increasing N surplus, while NH3 volatilization increased linearly with an increasing N application rate for intensive wheat production in north China. The GHG emission and reactive N losses during N fertilizer application increased exponentially with an increasing N surplus. By pooling all 121 on-farm experimental sites, an in-season root-zone N management strategy was shown to reduce the N application rate by 61% from 325 kg N ha(-1) to 128 kg N ha(-1) compared to the farmers' N practice, with no loss in wheat grain yield. As a result, the intensity of GHG emission and reactive N losses were reduced by 77% and 80%, respectively. The intensity of GHG emission and reactive N losses can be further reduced due to the improved N recovery and increased grain yield achieved by best crop management. In conclusion, N recovery efficiency and yield improvements should be used to reduce future agricultural N environmental footprints, rather than reducing the N application rate.

CEBPB promotes gastrointestinal motility dysfunction after severe acute pancreatitis via the MALAT1/CIRBP/ERK axis.

Severe acute pancreatitis (SAP) is a kind of reversible inflammatory process of the exocrine pancreas with gastrointestinal motility dysfunction involved. Studies have highlighted the role of long noncoding RNA metastasis associated lung adenocarcinoma transcript 1 (MALAT1) in AP. However, the mechanism underlying its role in the gastrointestinal motility dysfunction remains undefined. Hence, we explored the regulatory role of MALAT1 in gastrointestinal motility dysfunction following SAP. Then, the expression of CCAAT/enhancer-binding protein beta (CEBPB), MALAT1 and cold-inducible RNA binding protein (CIRBP) was detected in plasma of SAP patients and pancreatic and intestinal tissues of SAP mouse models with their correlation analyzed also. Additionally, the effect of MALAT1 on the pancreatic and intestinal injury, expression of inflammatory factors and the ERK pathway-related genes as well as gastrointestinal motility dysfunction was assessed using ectopic expression and depletion experiments. CEBPB, MALAT1 and CIRBP were highly expressed in plasma of SAP patients and pancreatic and intestinal tissues of SAP mice. Further analysis showed that knockdown of MALAT1 could alleviate pancreatic and intestinal injury, reduce inflammation, and prevent gastrointestinal motility dysfunction in SAP mice. The transcription factor CEBPB could bind to the promoter region of MALAT1, thus activating the transcription of MALAT1. MALAT1 interacted with CIRBP and inhibited the degradation of CIRBP, leading to activated extracellular signal-regulated kinase (ERK) pathway and the resultant gastrointestinal motility dysfunction. In conclusion, CEBPB exhibits a promoting activity towards gastrointestinal motility dysfunction in SAP by pumping up MALAT1 expression and activating the CIRBP-dependent ERK pathway.

Effects of Somatostatin and Indomethacin Mono or Combination Therapy on High-risk Hyperamylasemia and Post-pancreatitis Endoscopic Retrograde Cholangiopancreatography Patients: A Randomized Study.

BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a minimally invasive technique widely used to diagnose and treat pancreatic and biliary diseases; however, it is linked with imminent hyperamylasemia and post-ERCP pancreatitis (PEP). Somatostatin and indomethacin are the classic recommended drugs used for PEP prevention. OBJECTIVE: To elucidate the effects of somatostatin and indomethacin mono or in combination to prevent hyperamylasemia and PEP in high-risk individuals. METHODS: Altogether 1458 patients who underwent ERCP in our hospital from January 2016 to May 2022 were included in this investigation and categorized into 4 groups based on the treatment regimen: placebo, indomethacin, somatostatin, and indomethacin + somatostatin. The pre operation and post operation (at 6, 12, and 24 h) hospitalization cost, length of stay, the occurrence of hyperamylasemia and PEP, levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-8, and VAS pain score were determined in the 4 groups. In all the groups, VAS and IL-6, TNF-α, and IL-8 levels substantially increased in the pretreatment and decreased sequentially from 6 to 24 h post operation. The individuals in the indomethacin revealed substantially reduced hyperamylasemia, VAS, and levels of IL-6, TNF-α, and IL-8, 6 h post operation, whereas the hospitalization fee, length of stay, PEP incidence, VAS, levels of IL-6, TNF-α, and IL-8, 12 and 24 h post operation were not statistically important in comparison with the individuals who received placebo therapy. The somatostatin and the indomethacin + somatostatin groups indicated markedly alleviated hospitalization fee, length of stay, the occurrence of hyperamylasemia and PEP, VAS, and the levels of IL-6, TNF-α, and IL-8 at 6, 12, and 24 h post operation compared with the placebo cohort. Furthermore, compared with the indomethacin group, the above-determined factors notably reduced at 6, 12, and 24 h post operation in somatostatin and indomethacin + somatostatin groups. It was also observed that the indomethacin + somatostatin group has substantially decreased the occurrence of hyperamylasemia, VAS score, and levels of IL-6, TNF-α, and IL-8, 6 hours post operation, while at 12 and 24 h post operation, the hospitalization fee, length of stay and incidence of PEP, VAS, levels of IL-6, TNF-α, and IL-8 were not statistically important compared with the somatostatin group. It is also worth noting that the side effects of both drugs are rare and mild. RESULTS: For high-risk PEP patients, indomethacin and somatostatin can efficiently alleviate post-operative hyperamylasemia and improve their life standard within 6 hours and 24 hours, respectively. Indomethacin is suitable for individuals who underwent simple, short-duration ERCP with expected mild post-operative abdominal pain, whereas somatostatin is given to patients with complicated, long-duration ERCP and expected severe post-operative abdominal pain. Their combinational therapy produces a synergistic effect and can reduce the incidence of hyperamylasemia, thereby improving patients' quality of life within 6 h and is also effective against individuals who received a more complicated, longer-duration ERCP and were expected to have severer and longer post-operative abdominal pain.

SPI1 Mediates N-Myristoyltransferase 1 to Advance Gastric Cancer Progression via PI3K/AKT/mTOR Pathway.

Gastric cancer (GC) is a common digestive tract malignancy worldwide. N-myristoyltransferase 1 (NMT1) has been implicated in many cancers, but its association with gastric cancer remains to be clarified. Thus, this paper elucidated the role of NMT1 in GC. The NMT1 expression level in GC and normal tissue samples as well as the relationship between NMT1 high or low expression and overall survival in GC was analyzed via GEPIA. GC cells were transfected with NMT1 or SPI1 overexpression plasmid and short hairpin RNA against NMT1 (shNMT1) or shSPI1. NMT1, SPI1, p-PI3K, PI3K, p-AKT, AKT, p-mTOR, and mTOR levels were detected through qRT-PCR and western blot. MTT, wound healing, and transwell assays were applied to test cell viability, migration, and invasion. The binding relationship of SPI1 and NMT1 was determined through a dual-luciferase reporter assay and chromatin immunoprecipitation. NMT1 was upregulated in GC, the high level of which connected with a poor prognosis. Overexpressed NMT1 elevated viability, migration rate, and invasion rate of GC cells, whereas NMT1 knockdown leads to the opposite results. Besides, SPI1 could bind to NMT1. Overexpressed NMT1 reversed the effects of shSPI1 on decreasing viability, migration, invasion, p-PI3K/PI3K, p-AKT/AKT, and p-mTOR/mTOR in GC cells, and NMT1 knockdown reversed the effects of SPI1 overexpression on increasing viability, migration, invasion, p-PI3K/PI3K, p-AKT/AKT, and p-mTOR/mTOR. SPI1 upregulated NMT1 to facilitate the malignant behaviors of GC cells through the PI3K/AKT/mTOR pathway.

[Effect of neurally adjusted ventilatory assist ventilation in severe neurological cerebrovascular diseases patients undergoing mechanical ventilation].

OBJECTIVE: To explore the prognostic effect and safety of neurally adjusted ventilatory assist (NAVA) mode on the patients with severe neurological cerebrovascular disease undergoing mechanical ventilation. METHODS: A prospective study was conducted. Fifty-four patients with cerebrovascular disease undergoing mechanical ventilation admitted to the neurosurgery intensive care unit (NSICU) of the First Affiliated Hospital of Wannan Medical College (Yijishan Hospital) from December 2020 to May 2022 were enrolled. They were divided into NAVA group and pressure support ventilation (PSV) group by computer random number generator with 27 patients in each group. The ventilation time of the two groups was ≥ 72 hours. The general basic data of the two groups were recorded. The time without mechanical ventilation 28 days after enrollment, total length of mechanical ventilation, survival rate of 90 days after enrollment, length of NSICU stay, total length of hospital stay, NSICU mortality, in-hospital mortality, Glasgow outcome score (GOS), complications related to mechanical ventilation, and changes of respiratory mechanics indexes, arterial blood gases, vital signs, and diaphragm function indexes were observed. RESULTS: The time without mechanical ventilation 28 days after enrollment in the NAVA group was significantly longer than that in the PSV group [days: 22 (15, 26) vs. 6 (0, 23), P < 0.05]. However, there were no significant differences in the total length of mechanical ventilation, 90-day survival rate, length of NSICU stay, total length of hospital stay, NSICU mortality, in-hospital mortality, GOS score, and incidence of mechanical ventilator-related complications between the two groups. In terms of respiratory mechanics parameters, the expiratory tidal volume (VTe) on 3 days after mechanical ventilation of patients in the NAVA group was significantly lower than that on 1 day and 2 days, and significantly lower than that in the PSV group [mL: 411.0 (385.2, 492.6) vs. 489.0 (451.8, 529.4), P < 0.01]. Minute ventilation (MV) at 2 days and 3 days in the NAVA group was significantly higher than that at 1 day, and significantly higher than that in the PSV group at 2 days [L/min: 9.8 (8.4, 10.9) vs. 7.8 (6.5, 9.8), P < 0.01], while there was no significant change of MV in the PSV group. At 1 day, peak airway pressure (Ppeak) and mean airway pressure (Pmean) in the NAVA group were significantly lower than those in the PSV group [Ppeak (cmH2O, 1 cmH2O ≈ 0.098 kPa): 14.0 (12.2, 17.0) vs. 16.6 (15.0, 17.4), Pmean (cmH2O): 7.0 (6.2, 7.9) vs. 8.0 (7.0, 8.2), both P < 0.05]. However, there was no significant difference in the Ppeak or Pmean at 2 days and 3 days between the two groups. In terms of arterial blood gas, there was no significant difference in pH value between the two groups, but with the extension of mechanical ventilation time, the pH value at 3 days of the two groups was significantly higher than that at 1 day. Arterial partial pressure of oxygen (PaO2) at 1 day in the NAVA group was significantly lower than that in the PSV group [mmHg (1 mmHg ≈ 0.133 kPa): 122.01±37.77 vs. 144.10±40.39, P < 0.05], but there was no significant difference in PaO2 at 2 days and 3 days between the two groups. There was no significant difference in arterial partial pressure of carbon dioxide (PaCO2) or oxygenation index (PaO2/FiO2) between the two groups. In terms of vital signs, the respiratory rate (RR) at 1, 2, and 3 days of the NAVA group was significantly higher than that of the PSV group [times/min: 19.2 (16.0, 25.2) vs. 15.0 (14.4, 17.0) at 1 day, 21.4 (16.4, 26.0) vs. 15.8 (14.0, 18.6) at 2 days, 20.6 (17.0, 23.0) vs. 16.7 (15.0, 19.0) at 3 days, all P < 0.01]. In terms of diaphragm function, end-inspiratory diaphragm thickness (DTei) at 3 days in the NAVA group was significantly higher than that in the PSV group [cm: 0.26 (0.22, 0.29) vs. 0.22 (0.19, 0.26), P < 0.05]. There was no significant difference in end-expiratory diaphragm thickness (DTee) between the two groups. The diaphragm thickening fraction (DTF) at 2 days and 3 days in the NAVA group was significantly higher than that in the PSV group [(35.18±12.09)% vs. (26.88±8.33)% at 2 days, (35.54±13.40)% vs. (24.39±9.16)% at 3 days, both P < 0.05]. CONCLUSIONS: NAVA mode can be applied in patients with neuro-severe cerebrovascular disease, which can prolong the time without mechanical ventilation support and make patients obtain better lung protective ventilation. At the same time, it has certain advantages in avoiding ventilator-associated diaphragm dysfunction and improving diaphragm function.