Phosphate fertilizers facilitated the Cd contaminated soil remediation by sepiolite: Cd mobilization, plant toxicity, and soil microbial community.

In-situ immobilization does not remove Cd from the contaminated soil. It is vital to investigate the effects of fertilizers on soil Cd mobility during remediation with amendments. In the current study, a pot experiment was conducted to investigate the effects of calcium magnesium phosphate (CMP) and calcium superphosphate (SSP) on the remediation of Cd-contaminated soil by sepiolite. We mainly focused on changes in soil Cd immobilization, plant toxicity, and soil microbial communities after applying two phosphates during Cd-contaminated soil remediation by sepiolite. The results demonstrated that sepiolite decreased Cd concentration in brown rice, straw, and roots by 32.66%, 38.89%, and 30.94%, respectively. During soil remediation by sepiolite, the Cd concentrations of brown rice and straw were not affected by CMP or SSP, except for the treatment with sepiolite plus high-dose CMP. Sepiolite significantly decreased HCl-extractable Cd and DTPA-extractable Cd by 32.21% and 10.50%, respectively. During soil remediation by sepiolite, the HCl-extractable and DTPA-extractable Cd further decreased with CMP or SSP. The decreasing amplitude with CMP was 40.57-72.60% and 7.05-14.53%, and that of SSP was 37.68-59.66% and 20.71-25.07%, respectively. The superoxide dismutase, peroxidase, catalase activities, and malondialdehyde concentration in rice roots decreased inordinately with the addition of sepiolite, CMP, and SSP, indicating that the application of sepiolite, CMP, or SSP alleviated Cd-induced rice root stress and protected rice roots from Cd toxicity. Alpha diversity estimators (including the Chao, ACE, and Shannon indices) indicated that sepiolite, CMP, or SSP applications had no adverse effects on soil bacterial richness and diversity. Hierarchical clustering analysis revealed that the two phosphate fertilizers and sepiolite were the main factors affecting changes in the bacterial communities structure. Redundancy analysis revealed that soil pH, Eh, and soil-extractable Cd were critical factors affecting the structure of the bacterial communities.

Pfaffia glomerata is a hyperaccumulator candidate: Cd and Zn tolerance, absorption, transfer, and distribution.

Pfaffia glomerata is a candidate for phytoremediation due to its high biomass and high bioaccumulation efficiency of multiple heavy metals. It is essential to further evaluate its tolerance, absorption, transfer, and distribution to multiple heavy metals. In the current study, we evaluated the tolerance, absorption, transfer, and distribution of P. glomerata in a Cd/Pb/Cu/Zn combined-contaminated environment by two hydroponic experiments. The results demonstrated that P. glomerata was not affected by Cd/Pb/Cu/Zn exposure, except for the 50 µM Cd/Pb/Cu/Zn treatment, which significantly decreased the stem biomass. In a single Cd, Pb, Cu, and Zn exposure, the root of P. glomerata absorbed Cd/Pb/Cu/Zn in the order of Cd > Zn > Pb > Cu. Almost all Pb and Cu accumulated in the plant roots and were hardly transferred to the aboveground parts. Therefore, the order of total Cd/Pb/Cu/Zn extraction of a single plant in multiple Cd/Pb/Cu/Zn exposures at the same concentration was Cd > Zn > Pb > Cu. The bioconcentration factor (BCF) of Cd and Zn in roots, stems, and leaves increased with the concentration of Cd and Zn in the solution, and was > 1. In contrast with Cd and Zn, the BCFs of Cu and Pb in the stems and leaves were < 1. The element distribution of Pb, Cu, Zn, and Mn in the stem of P. glomerata was dispersed, indicating that the stem of P. glomerata does not have a detoxification mechanism for distributing metals to the area of low biological activity. The total amount of tartaric acid, critic acid, and DOC secreted by P. glomerata roots decreased with the increase in Cd/Pb/Cu/Zn exposure. However, further investigation is needed to unravel the interaction between the LMWOAs secreted by the root of P. glomerata and heavy metals.

Faster recovery of soil biodiversity in native species mixture than in Eucalyptus monoculture after 60 years afforestation in tropical degraded coastal terraces.

Afforestation is an effective method to restore degraded land. Afforestation methods vary in their effects on ecosystem multifunctionality, but their effects on soil biodiversity have been largely overlooked. Here, we mapped the biodiversity and functioning of multiple soil organism groups resulting from diverse afforestation methods in tropical coastal terraces. Sixty years after afforestation from bare land (BL), plant species richness and the abundance of plant litter (398 ± 85 g m-2 ) and plant biomass (179 ± 3.7 t ha-1 ) in native tree species mixtures (MF) were restored to the level of native forests (NF; 287 ± 21 g m-2 and 243.0 ± 33 t ha-1 , respectively), while Eucalyptus monoculture (EP) only successfully restored the litter mass (388 ± 43 g m-2 ) to the level of NF. Soil fertility in EP and MF was increased but remained lower than in NF. For example, soil nitrogen and phosphorus concentrations in MF (1.2 ± 0.2 g kg-1 and 408 ± 49 mg kg-1 , respectively; p < 0.05) were lower than in NF (1.8 ± 0.2 g kg-1 and 523 ± 24 mg kg-1 , respectively; p < 0.05). Soil biodiversity, abundance (except for nematodes), and community composition in MF were similar or greater than those in NF. In contrast, restoration with EP only enhanced the diversity of microbes and mites to the level of NF, but not for other soil biota. Together, afforestation with native species mixtures can end up restoring vegetation and most aspects of the taxonomic and functional biodiversity in soil whereas monoculture using fast-growing non-native species cannot. Native species mixtures show a greater potential to reach completely similar levels of soil biodiversity in local natural forests if they are received some more decades of afforestation. Multifunctionality of soil biotic community should be considered to accelerate such processes in future restoration practices.

Phosphorus addition decreases microbial residual contribution to soil organic carbon pool in a tropical coastal forest.

The soil nitrogen (N) and phosphorus (P) availability often constrains soil carbon (C) pool, and elevated N deposition could further intensify soil P limitation, which may affect soil C cycling in these N-rich and P-poor ecosystems. Soil microbial residues may not only affect soil organic carbon (SOC) pool but also impact SOC stability through soil aggregation. However, how soil nutrient availability and aggregate fractions affect microbial residues and the microbial residue contribution to SOC is still not well understood. We took advantage of a 10-year field fertilization experiment to investigate the effects of nutrient additions, soil aggregate fractions, and their interactions on the concentrations of soil microbial residues and their contribution to SOC accumulation in a tropical coastal forest. We found that continuous P addition greatly decreased the concentrations of microbial residues and their contribution to SOC, whereas N addition had no significant effect. The P-stimulated decreases in microbial residues and their contribution to SOC were presumably due to enhanced recycling of microbial residues via increased activity of residue-decomposing enzymes. The interactive effects between soil aggregate fraction and nutrient addition were not significant, suggesting a weak role of physical protection by soil aggregates in mediating microbial responses to altered soil nutrient availability. Our data suggest that the mechanisms driving microbial residue responses to increased N and P availability might be different, and the P-induced decrease in the contribution of microbial residues might be unfavorable for the stability of SOC in N-rich and P-poor tropical forests. Such information is critical for understanding the role of tropical forests in the global carbon cycle.

Contrasting impacts of mobilisation and immobilisation amendments on soil health and heavy metal transfer to food chain.

Heavy metal mobilisation or immobilisation have been widely applied in situ for soil remediation. However, the consequences of the mobilisation or immobilisation amendments on soil health and heavy metal transfer are rarely compared. In this study, four mobilisation additives (EDTA, humic acid, oxalic acid and citric acid) and four immobilisation additives (calcium silicate, lime, biochar and pig manure) were applied in soils contaminated with Cd, Zn, and Pb to investigate their effects on soil microbial and nematode communities, chemical speciation of metals in Amaranthus tricolour L., and metal food chain transfer in soil-plant-insect system. We found that mobilisation amendments inhibited plant growth and EDTA reduced microbial biomass indicated by phospholipid fatty acids. In contrast, immobilisation amendments promoted plant growth. However, abundances of microbe and nematode were reduced by calcium silicate and lime, while they were substantially increased by biochar and pig manure. We also realised that the immobilisation amendments shifted the water-soluble and pectate-/protein-associated fractions to phosphate-/oxalate-associated fractions of metals in plant leaves, enhanced detoxification ability of Prodenia litura larvae, and reduced metal transfer along food chain. However, opposite changes were observed in mobilisation treatments. According to redundancy analysis, we found that the addition of biochar or pig manure improved soil health and function by reducing metal availability and increasing soil available N and P concentrations. Our results indicate that organic immobilisation amendments most effectively improve soil health and reduce metal transfer, and should be recommended for remediation of heavy metal-contaminated soils.

Efficacy and toxicity of extended aromatase inhibitors after adjuvant aromatase inhibitors-containing therapy for hormone-receptor-positive breast cancer: a literature-based meta-analysis of randomized trials.

BACKGROUND: Endocrine therapy with aromatase inhibitors (AIs) is the cornerstone of adjuvant systemic treatment for postmenopausal patients with hormone receptor-positive breast cancer. It has become clear that hormone receptor-positive breast cancer carries a consistent risk of relapse up to 15 years after diagnosis. Extended duration of adjuvant AIs therapy after completing initial standard adjuvant AIs-containing therapy may prevent late recurrence and death. We performed a meta-analysis to assess the real impact of the extended adjuvant therapy with AIs. METHODS: A literature-based meta-analysis of the randomized controlled trials (RCTs) was undertaken. Relevant publications from PubMed, Embase, Cochrane Library, and abstracts from American Society of Clinical Oncology (ASCO) and San Antonio Breast Cancer (SABCS) symposia were searched. The endpoints were disease-free survival (DFS), overall survival (OS), local recurrence, distant recurrence, contralateral breast cancer, non-breast cancer-related death, and toxicity. RESULTS: Eight trials comprising 15,966 patients met the inclusion criteria. The pooled analysis revealed a significant improvement in DFS (RR = 0.79; 95% CI 0.68-0.91), distant recurrence (RR = 0.75; 95% CI 0.58-0.96), and contralateral breast cancer (RR = 0.53; 95% CI 0.40-0.70) in the extended AIs group. While there was not significant improvement in OS (RR = 1.00, 95% CI 0.99-1.01), non-breast cancer-related death (RR = 1.16, 95% CI 0.96-1.41), and local recurrence (RR = 0.82; 95% CI 0.64-1.06), the subgroup analysis showed that the patient with tumor size > 2 cm (HR = 0.74, RD = - 0.31, P = 0.05 vs. HR = 0.85, RD = - 0.16, P = 0.20), node positive status (HR = 0.77, RD = - 0.27, P = < 0.0001 vs. HR = 0.89, RD = -0.12, P = 0.19) and previous chemotherapy use (HR = 0.75, RD = - 0.29, P = 0.003 vs. HR = 0.91, RD = -0.10, P = 0.44) would get a greater DFS benefit with extended AIs. Longer treatment with AIs was associated with an increased risk ratio of bone pain (RR = 1.26, RD = 0.04, P = 0.003), bone fractures (RR = 1.59, RD = 0.02, P = 0.002), osteoporosis (RR = 1.53, RD = 0.07, P = 0.005), myalgia (RR = 1.26, RD = 0.04, P = 0.02), and treatment discontinuation for adverse events (RR = 1.51, RD = 0.06, P = 0.0009). CONCLUSION: After initial standard AIs-containing adjuvant therapy, extended AIs therapy could further bring a DFS benefit for postmenopausal patients with early breast cancer, especially in the patients with high-risk characteristics.

Simultaneous quantification of N2 , NH3 and N2 O emissions from a flooded paddy field under different N fertilization regimes.

Gaseous nitrogen (N) emissions, especially emissions of dinitrogen (N2 ) and ammonia (NH3 ), have long been considered as the major pathways of N loss from flooded rice paddies. However, no studies have simultaneously evaluated the overall response of gaseous N losses to improved N fertilization practices due to the difficulties to directly measure N2 emissions from paddy soils. We simultaneously quantified emissions of N2 (using membrane inlet mass spectrometry), NH3 and nitrous oxide (N2 O) from a flooded paddy field in southern China over an entire rice-growing season. Our field experiment included three treatments: a control treatment (no N addition) and two N fertilizer (220 kg N/ha) application methods, the traditional surface application of N fertilizer and the incorporation of N fertilizer into the soil. Our results show that over the rice-growing season, the cumulative gaseous N losses from the surface application treatment accounted for 13.5% (N2 ), 19.1% (NH3 ), 0.2% (N2 O) and 32.8% (total gaseous N loss) of the applied N fertilizer. Compared with the surface application treatment, the incorporation of N fertilizer into the soil decreased the emissions of NH3 , N2 and N2 O by 14.2%, 13.3% and 42.5%, respectively. Overall, the incorporation of N fertilizer into the soil significantly reduced the total gaseous N loss by 13.8%, improved the fertilizer N use efficiency by 14.4%, increased the rice yield by 13.9% and reduced the gaseous N loss intensity (gaseous N loss/rice yield) by 24.3%. Our results indicate that the incorporation of N fertilizer into the soil is an effective agricultural management practice in ensuring food security and environmental sustainability in flooded paddy ecosystems.

Quantification and influencing factors of perioperative hidden blood loss during intramedullary fixation for intertrochanteric fractures in the elderly.

INTRODUCTION: We aimed to quantify perioperative hidden blood loss (HBL) and investigate its influencing factors in elderly patients with intertrochanteric fractures (IFs) undergoing intramedullary fixation surgery. MATERIALS AND METHODS: We prospectively collected the clinical data of 200 elderly patients with IFs treated with intramedullary fixation surgery in our hospital between December 1, 2014 and August 31, 2018. The intraoperative visible blood loss, blood transfusion rate, and pre- and postoperative hemoglobin (Hb) levels as well as the general characteristics of the enrolled patients were recorded. A multiple linear regression analysis model (stepwise) was used to identify independent factors affecting perioperative HBL. RESULTS: The mean perioperative HBL was 614.72 ± 368.14 mL, which accounted for 84.05% of the mean total perioperative blood loss (731.37 ± 391.50 mL). The mean preoperative HBL was 368.33 ± 325.57 mL, which accounted for 50.36% of the mean total perioperative blood loss. Patients with fracture types AO/OTA 31-A2.2 to A3.3 had more severe preoperative HBL (median 580.10 mL), and most of them developed mild-to-moderate anemia before the operation, and 27.63% of them received preoperative blood transfusion. Compared with patients operated within 5 days after injury, patients operated over 5 days had lower Hb value at admission (101.56 ± 19.49 vs. 107.28 ± 16.53; P = 0.026) and higher preoperative transfusion rate (25.84% vs. 9.01%; P = 0.001). Multiple linear regression analysis revealed that fracture types AO/OTA 31-A2.2 to A3.3, male sex, right-sided injury, and operation time > 60 min were independently associated with increased perioperative HBL. Tranexamic acid treatment was negatively correlated with perioperative HBL. CONCLUSION: IFs in elderly patients undergoing intramedullary fixation surgery were associated with significant perioperative HBL and anemia. Persistent HBL occurred before the operation and on the first few postoperative days. Surgeons should pay more attention to preoperative HBL in patients with fracture types AO/OTA 31-A2.2 to A3.3 and regularly measure Hb levels preoperatively to avoid anemia. Shortening preoperative time may helps to reduce preoperative blood loss.

Responses of soil microbial community and enzymes during plant-assisted biodegradation of di-(2-ethylhexyl) phthalate and pyrene.

A pot experiment was conducted to explore the plant-assisted degradation efficiency of di-(2-ethylhexyl) phthalate (DEHP) and pyrene. Three plant species: Ceylon spinach, sunflower, and leaf mustard were cultivated in co-contaminated soils under three contamination levels: control (T0), 20 mg kg-1 (T20), and 50 mg kg-1 (T50). The results showed that a higher DEHP and pyrene degradation efficiency was observed evidently in planted cases, increasing from 42 to 53-59% (T0), 61 to 65-76% (T20) and 52 to 68-78% (T50) for DEHP, and from 22 to 30-49% (T0), 58 to 62-72% (T20), and 54 to 57-70% (T50) for pyrene. Under T20 contamination level, soil phospholipid fatty-acid analysis depicted the increased microbial biomass in rhizosphere, especially the arbuscular mycorrhizal fungus that is effective for the degradation of organic pollutants. The study also revealed that the activities of dehydrogenase, acid phosphomonoesterase, urease, and phenol oxidase negatively correlated with pollutant concentration. In general, the removal rate of DEHP and pyrene was highest in the soil planted with leaf mustard for each contamination level considered. For soils at T20 level, sunflower and leaf mustard appeared as interesting phytoremediation plants due to the improved removal rates of organic pollutants and the soil microbial activity.

Expression of TBX3 in Hepatocellular Carcinoma and Its Clinical Implication.

BACKGROUND Hepatocellular carcinoma (HCC) is the fifth most common malignancy in China, and China's annual number of new cases accounts for about 45% of the world total. This research was aimed to study the expression of TBX3 protein in HCC and exploring its clinical significance. MATERIAL AND METHODS We collected tumor tissues and adjacent non-tumoral tissues of 174 patients with HCC undergoing surgical resection. The expression of TBX3 protein in different tissues and cell lines in vitro (LO2, HHL-5, MHC97-L, MHC97-H) was detected by immunohistochemistry or Western blotting, and the relationship between TBX3 expression and clinical data of patients with HCC was analyzed. RESULTS The expression of TBX3 protein in HCC was significantly correlated with histological grade, tumor size, cancer cell metastasis, hepatitis B surface antigen, and the expression of Ki-67 in tumor tissues (P<0.05), and it was positively correlated with serum AFP level (r=0.766, P<0.05). The expression of TBX3 increased with increased histological grade in HCC (P<0.05). Cox regression analysis showed that the expression of TBX3 protein in HCC was an independent risk factor for prognosis (OR=0.524, 95% CI=0.283-0.964). The 5-year survival rate of patients with HCC that highly expressed TBX3 protein was 20.83%, which was significantly lower than the 40.20% rate in patients with low expression (P<0.05). CONCLUSIONS The expression of TBX3 in HCC patients undergoing surgical resection is high, and its expression increases with the degree of tumor differentiation. It is related to the metastasis of tumor cells and is positively correlated with the serum level of AFP and may affect the survival time of HCC patients undergoing surgical resection.

Natural attenuation of toxic metal phytoavailability in 35-year-old sewage sludge-amended soil.

Toxic heavy metals persist in agricultural soils and ecosystem for many decades after their application as contaminants in sewage sludge and fertilizer products This study assessed the potential long-term risk of cadmium (Cd), lead (Pb), zinc (Zn), and copper (Cu) in land-applied sewage sludge to food crop contamination. A sewage sludge-amended soil (SAS) aged in the field more than 35 years was used in a greenhouse pot experiment with leafy vegetables (lettuce and amaranth) having strong Cd and Zn accumulation tendencies. Soil media with variable levels of available Cd, Zn, and Cu (measured using 0.01 M CaCl2 extraction) were prepared by diluting SAS with several levels of uncontaminated control soil. Despite long-term aging in the field, the sludge site soil still retains large reserves of heavy metals, residual organic matter, phosphorus, and other nutrients, but its characteristics appear to have stabilized over time. Nevertheless, lettuce and amaranth harvested from the sludge-treated soil had undesirable contents of Cd and Zn. The high plant uptake efficiency for Cd and Zn raises a concern regarding the quality and safety of leafy vegetables in particular, when these crops are grown on soils that have been amended heavily with sewage sludge products at any time in their past.

Clinicopathological differences and survival benefit in ER+/PR+/HER2+ vs ER+/PR-/HER2+ breast cancer subtypes.

INTRODUCTION: Breast cancer subtypes based on estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) expression have significant implications for prognosis. HER2-positive tumors historically demonstrated poorer survival, but anti-HER2 targeted therapy improved outcomes. However, hormone receptor (HR)-positive patients may experience reduced benefit due to HER2-HR signaling crosstalk. METHODS: Data from two databases, the Shanghai Jiao Tong University Breast Cancer Data Base (SJTUBCDB) and the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database, were analyzed. Propensity score adjustments were used to balance patient characteristics between ER+/PR+/HER2+ and ER+/PR-/HER2+ subtypes. Kaplan-Meier survival curves estimated disease-free survival (DFS), breast cancer-specific survival (BCSS), overall survival (OS) for these subtypes in the SJTUBCDB, while subgroup analyses using multivariable models were performed based on menstruation, pN stage, HER2-targeted therapy, and endocrinotherapy. RESULTS: The ER+/PR+/HER2+ group showed significantly better DFS and BCSS than the ER+/PR-/HER2+ group, particularly in postmenopausal and pN0 stage patients. Survival outcomes were similar after anti-HER2 therapy or endocrine aromatase inhibitor (AI) therapy in both groups. However, among patients receiving selective estrogen receptor modulator (SERM) treatment, those in the ER+/PR-/HER2+ group had a significantly worse prognosis compared to ER+/PR+/HER2+ patients. CONCLUSIONS: HER2-positive breast cancers with different HR statuses exhibit distinct clinicopathological features and survival outcomes. Patients in the ER+/PR+/HER2+ group generally experience better survival, particularly in postmenopausal and pN0 stage patients. Treatment strategies should consider HR status and specific modalities for better personalized management.

Phytoremediation and environmental effects of three Amaranthaceae plants in contaminated soil under intercropping systems.

Intercropping is a widely used agricultural system; however, the effect of intercropping between accumulator plants on phytoextraction in heavy metal-contaminated soils remains unknown. Here, a field experiment was conducted to investigate the phytoextraction efficiency and related environmental effects of three Amaranthaceae plants (Amaranthus hypochondriacus, Celosia argentea, and Pfaffia glomerata) using mono- and intercropping models. In monocropping, the total biomass of A. hypochondriacus was only 51.2 % of that of C. argentea. Compared with monocropping, intercropping reduced the fresh weight per plant of A. hypochondriacus by 53.0 % (intercropping with C. argentea) and 40.5 % (intercropping with P. glomerata) but increased the biomass per plant of C. argentea and P. glomerata by 128.2 and 14.2 %, respectively. The Cd uptake of the three plants in the monocropping models showed the following trend: C. argentea > P. glomerata > A. hypochondriacus. Interplanting A. hypochondriacus and C. argentea further increased the phytoextraction efficiency by 361.2 % (compared with A. hypochondriacus monocropping) and 52.0 % (compared with C. argentea monocropping). Soil exchangeable Cd, Pb, Cu, Zn, K, and P, soil N-NO3- and N-NH4+, soil common bacteria and arbuscular mycorrhiza (AM) fungi, and soil total organic carbon (TOC) play key roles in Cd and Pb uptake by the three accumulator plants (p < 0.05). The biomass of common bacteria, Gm+, Gm- bacteria, fungi, AM fungi, and actinomycetes increased with the three accumulators planted in the mono- and intercropping models. Compared with C. argentea monocropping, the biomass of soil microbes in the rhizosphere soil was obviously increased in the intercropping A. hypochondriacus and C. argentea models. These results suggest that interplanting A. hypochondriacus and C. argentea can increase Cd removal efficiency from Cd-contaminated soils, and this model could be recommended to remediate Cd-contaminated soils on a field scale.

Development and validation of a nomogram for predicting lymph node metastasis in ductal carcinoma in situ with microinvasion: A SEER population-based study.

BACKGROUND: Ductal carcinoma in situ with microinvasion (DCIS-MI) is a special type of breast cancer. It is an invasive lesion less than 1.0 mm in size related to simple ductal carcinoma in situ (DCIS). Lymph node metastasis (LNM) in DCIS-MI often indicates a poor prognosis. Therefore, the management of lymph nodes plays a vital role in the treatment strategy of DCIS-MI. Since DCIS-MI is often diagnosed by postoperative paraffin section and immunohistochemical detection, to obtain the best clinical benefits for such patients, we aim to establish and verify a nomogram to predict the possibility of lymph node metastasis in DCIS-MI patients and help preoperative or intraoperative clinical decision-making. METHODS: A retrospective analysis of patients with DCIS-MI in the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2019 was performed. The study cohort was randomly divided into a training cohort and a validation cohort at a ratio of 7:3. The risk factors were determined by univariate and multivariate logistic regression analyses in the training cohort, and a nomogram was constructed. The receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) were used to evaluate the nomogram in the training set and validation set. An independent data cohort was obtained from the Shanghai Jiao Tong University Breast Cancer Database (SJTU-BCDB) for external validation. RESULTS: This study included 3951 female patients from SEER with DCIS-MI, including 244 patients with regional lymph node metastasis, accounting for 6.18% of the total. An independent test set of 323 patients from SJTU-BCDB was used for external validation. According to the multifactorial logistic regression analysis results, age at diagnosis, ethnicity, grade, and surgical modality were included in the prediction model. The areas under the ROC curves (AUCs) were 0.739 (95% CI: 0.702~0.775), 0.732 (95% CI: 0.675~0.788), and 0.707 (95%CI: 0.607-0.807) in the training, validation and external test groups, suggesting that the column line graphs had excellent differentiation. The calibration curves slope was close to 1, and the model's predicted values were in good agreement with the actual values. The DCA curves showed good clinical utility. CONCLUSION: In this study, we constructed accurate and practical columnar maps with some clinical benefit to predict the likelihood of lymph node metastasis in patients with postoperatively diagnosed DCIS-MI and provide a reference value for specifying treatment strategies.

Premature closure or restriction of the foramen ovale: prenatal diagnosis by directional enhanced flow imaging.

Premature closure or restriction of the foramen ovale may occur at any time during pregnancy and may be due to various causes. We describe 2 patients with premature closure or restriction of the foramen ovale during the third trimester. In both patients the foramen ovale was detected by directional enhanced flow imaging technology (DeFLOW; Hitachi-Aloka Medical, Ltd, Tokyo, Japan), a novel method of imaging blood flow dynamics. Our findings indicate that D-eFLOW can display blood flow information with higher sensitivity and resolution than conventional methods, helping obstetricians and pregnant women make timely decisions about delivery.

Analysis of coronary flow haemodynamics in homozygous familial hypercholesterolaemic adolescents with aortic supravalvular stenosis.

OBJECTIVE: To study coronary artery haemodynamics in adolescents with homozygous familial hypercholesterolaemia and aortic supravalvular stenosis. METHODS: Patients diagnosed with familial hypercholesterolaemia who were younger than 16 years and who had undergone transthoracic echocardiography from 2007 to 2010 were included in this study. We included patients with homozygous familial hypercholesterolaemia and aortic supravalvular stenosis and those with heterozygous familial hypercholesterolaemia. All patients underwent stress echocardiography, and left anterior descending coronary artery flow was successfully detected. Coronary flow velocity reserve was calculated as the ratio of hyperaemic mean diastolic flow velocity after injection of adenosine to basal mean diastolic flow velocity. Changes in coronary haemodynamics and the relationship between lipid concentrations were determined. RESULTS: A total of 11 patients with homozygous familial hypercholesterolaemia were enrolled in this study. Lipid concentrations were measured, and the mean coronary flow velocity reserve was 1.97 plus or minus 0.51. Seven children were included in the group of patients with heterozygous familial hypercholesterolaemia. In these children, the mean coronary flow velocity reserve was 3.08 plus or minus 0.84. CONCLUSION: The coronary flow velocity reserve of homozygous familial hypercholesterolaemic patients is lower than that of heterozygous familial hypercholesterolaemic patients, and it is associated with a high concentration of low-density lipoprotein cholesterol. Aortic stenosis and plaques compromised the ostia of the coronary artery and caused increased basal mean diastolic coronary velocity with blunted increase in peak velocity, which decreased the coronary flow velocity reserve.

Effect of prescribed fire on soil properties and N transformation in two vegetation types in South China.

Prescribed fire is a common site preparation practice in forest management in southern China. However, the effect of fire on soil properties and N transformations is still poorly understood in this region. In this study, soil properties and N transformations in burned and unburned site of two vegetation types (Eucalyptus plantation and shrubland) were compared in rainy and dry seasons after 2 years' prescribed fire. Soil pH and soil NH4-N were all higher in the burned site compared to the unburned control. Furthermore, burned sites had 30-40 % lower of soil total phosphorus than conspecific unburned sites. There was no difference in soil organic matter, total N, soil exchangeable cations, available P or NO3-N. Nitrogen mineralization rate of 0-5 cm soil in the unburned site ranged from 8.24 to 11.6 mg N kg(-1) soil month(-1) in the rainy season, compared to a lower level of 4.82-5.25 mg N kg(-1) soil month(-1) in the burned sites. In contrast, 0-5 cm layer nitrification rate was overall 2.47 mg N kg(-1) soil month(-1) in the rainy season, and was not significantly affected by burning. The reduced understory vegetation coverage after burning may be responsible for the higher soil NH4-N in the burned site. This study highlights that a better understanding the effect of prescribed burning on soil nutrients cycling would provide a critical foundation for management decision and be beneficial to afforestation in southern China.

Purification of contaminated paddy fields by clean water irrigation over two decades.

Paddy fields near a mining site in north part of Guangdong Province, PR China, were severely contaminated by heavy metals as a result of wastewater irrigation from the tailing pond. The following clean water irrigation for 2 decades produced marked rinsing effect, especially on Pb and Zn. Paddy fields continuously irrigated with wastewater ever since mining started (50 years) had 1,050.0 mg kg−1 of Pb and 810.3 mg kg−1 of Zn for upper 20 cm soil, in comparison with 215.9 mg kg−1 of Pb and 525.4 mg kg−1 of Zn, respectively, with clean water irrigation for 20 years. Rinsing effect mainly occurred to a depth of upper 40 cm, of which the soil contained highest metals. Copper and Cd in the farmlands were also reduced due to clean water irrigation. Higher availability of Pb might partly account for more Pb transferred from the tailing pond to the farmland and also more Pb removal from the farmland as a result of clean water irrigation. Neither rice in the paddy field nor dense weeds in the uncultivated field largely took up the metals. However, they might contribute to activate metals differently, leading to a different purification extent. Rotation of rice and weed reduced metal retention in the farmland soil, in comparison with sole rice growth. Harvesting of rice grain (and partially rice stalk) only contributed small fraction of total amount of removed metal. In summary, heavy metal in paddy field resulting from irrigation of mining wastewater could be largely removed by clean water irrigation for sufficient time.