Effects of nitrogen addition and Bothriochloa ischaemum and Lespedeza davurica mixture on plant chlorophyll fluorescence and community production in semi-arid grassland.

Background: Grass-legume mixture can effectively improve productivity and stimulate overyielding in artificial grasslands, but may be N-limited in semi-arid regions. This study investigated the effects of N addition on chlorophyll fluorescence and production in the grass-legume mixtures community. Methods: An N addition experiment was conducted in the Bothriochloa ischaemum and Lespedeza davurica mixture community, with seven mixture ratios (B0L10, B2L8, B4L6, B5L5, B6L4, B8L2, and B10L0) according to the sowing abundance of B.ischaemum and L.davurica and four N addition levels, N0, N25, N50, and N75 (0,25,50,75kgNhm-2 a-1), respectively. We analyzed the response of chlorophyll fluorescence parameters of the two species, the rapid light-response curves of chlorophyll fluorescence, as well as aboveground biomass (AGB) and overyielding. Results: Our results showed that the two species showed different photosynthetic strategies, with L.davurica having significantly higher initial fluorescence (Fo), effective photochemical quantum yield of PSII (ΦPSII), and coefficient of photochemical fluorescence quenching (qP) than B. ischaemum, consisting with results of rapid light-response curves. N addition and mixture ratio both had significant effects on chlorophyll fluorescence and AGB (p<0.001). The ΦPSII and qP of L.davurica were significantly lowest in B5L5 and B6L4 under N addition, and the effect of N varied with mixture ratio. The photosynthetic efficiency of B. ischaemum was higher in mixture than in monoculture (B10L0), and ΦPSII was significantly higher in N50 than in N25 and N50 at mixture communities except at B5L5. The community AGB was significantly higher in mixture communities than in two monocultures and highest at B6L4. In the same mixture ratio, the AGB was highest under the N50. The overyielding effects were significantly highest under the N75 and B6L4 treatments, mainly attributed to L.davurica. The partial least squares path models demonstrated that adding N increased soil nutrient content, and complementary utilization by B.ischaemum and L.davurica increased the photosynthetic efficiency. However, as the different photosynthetic strategies of these two species, the effect on AGB was offset, and the mixture ratio's effects were larger than N. Our results proposed the B6L4 and N50 treatments were the optimal combination, with the highest AGB and overyielding, moderate grass-legume ratio, optimal community structure, and forage values.

Functional characterization of VrNAC15 for drought resistance in mung beans.

Drought stress has become an important limiting factor in mung bean production, and NAC(NAM/ATAF/CUC) transcription factors are crucial for plant growth under stress conditions, so it is important to study the regulatory role of NAC transcription factors in mung bean under drought stress. In this investigation, VrNAC15, along with its promoter, was cloned, and its structure was meticulously analyzed. Using qPCR, we examined the tissue-specific expression patterns of VrNAC15, particularly under drought stress and ABA exposure. Additionally, We performed ectopic expression of VrNAC15 in Arabidopsis to assess its function.. Gene sequence analysis revealed that VrNAC15 has a total length of 1014 bp, encoding 337 amino acids. It contains a NAM domain, localizes within the nucleus, and exhibits transcriptional activation. Promoter analysis of VrNAC15 identified essential core promoter elements and cis-acting elements related to abscisic acid, methyl jasmonate, gibberellin, adversity stress, light, and metabolism. Expression analysis demonstrated the concentration of VrNAC15 in leaves, with significant alterations following ABA and drought treatments in mung beans. Cluster analysis revealed that VrNAC15 may enhanced drought tolerance in transgenic plants through its expression. Transgenic experiments supported these findings, showing that heterologous expression of VrNAC15 led to enhanced antioxidant and osmotic adjustment capabilities in Arabidopsis plants. This resulted in the maintenance of cell membrane structural integrity during drought stress and normal physiological and biochemical metabolic reactions within cells. This research provides valuable insights into the structural and functional characteristics of the VrNAC15, setting the stage for future endeavors in molecular breeding for improved drought resistance in mung beans.

Comparison between Endoscopic Submucosal Dissection and Transanal Endoscopic Microsurgery in Early Rectal Neuroendocrine Tumor Patients: A Meta-Analysis.

PURPOSE: To compare the effectiveness, safety and cost-effectiveness of endoscopic submucosal dissection (ESD) with transanal endoscopic microsurgery (TEM) in early rectal neuroendocrine tumor (RNET) patients. This article will provide reliable evidence for surgeons in regards to clinical decision-making. METHODS: Systematic literature retrieval was performed in Pubmed, Embase and Cochrane database from 2013/4/30 to 2023/4/30. Methodology validation was performed by using the Newcastle-Ottawa Scale (NOS). Data-analysis was conducted by using the Review manager version 5.3 software. RESULTS: A total of three retrospective studies were included in our meta-analysis. All eligible studies were considered to be high quality. By comparing baseline characteristics between TEM and ESD, patients in the TEM group seemed to be characterized by a larger tumor size and lower tumor level, even though no statistical significance was found. Clear statistical significance favoring TEM was identified in terms of R0 resection rate, procedure time and hospital stay. No statistical significance was found in terms of recurrence rate, adverse events rate and additional treatment rate. CONCLUSIONS: Compared with ESD, TEM was a more effective treatment modality for early RNET patients; it was associated with a relatively higher R0 resection rate and a similar degree of safety. However, the relatively higher cost and complicated manipulation restricted the promotion of TEM. Surgeons should opt for TEM as a primary treatment in patients with a larger tumor size and deeper degree of tumorous infiltration if the financial condition and hospital facility permit.

Regioselective Cycloaddition of Alkenes with tert-butyl Nitrite: A Cascade Approach to the Formation of Δ2-Isoxazolines.

A route for cycloaddition reaction of alkenes and tert-butyl nitrite to synthesize Δ2-isoxazolines has been developed. The overall process involves the formation of multiple chemical bonds without the use of a catalyst. This methodology features mild reaction conditions and good functional group tolerance, providing a direct approach for the preparation of isoxazolines.

Health risk cause of water around landfill in hilly area and prevention and control countermeasures.

Evaluating the health risks of the groundwater and surface water in landfill areas is of great significance to the health and safety of local residents. The current practice of health risk assessment is based only on the analysis results of groundwater and surface water samples, which reflect the current situation of water security in landfill areas. However, due to the neglect of risk causes analysis, thus a health risk assessment is insufficient to provide rigorous scientific countermeasures for risk prevention and control. The health risks caused by groundwater and surface water is mainly controlled by the water quality, which is comprehensively controlled by the conditions of its formation and evolution. When a landfill site is located in a hilly area, the environmental characteristics, causes, main controlling factors, and evolution processes of the surface water and groundwater in different parts of the catchment are significantly different. This study used a municipal solid waste landfill area in a hilly area as an example and defined the causes and main controlling factors of regional health risks caused by water based on an analysis of the characteristics of natural and anthropogenic factors affecting the groundwater and surface water. Then, prevention and control countermeasures were proposed for health risks caused by water in different parts of the landfill area. This study provides a method for the causes analysis and prevention and control countermeasures of health risks caused by water in municipal solid waste landfills in hilly areas.

Cloning and expression analysis of VrNAC13 gene in mung bean.

To explore the role of NAC transcription factors in mung bean (Vigna ratiata), we here comprehensively analyzed VrNAC13 structure and expression patterns in the mung bean cultivar "Yulin No.1". The nucleotide sequence of VrNAC13 (GenBank accession number xp014518431.1) was determined by cloning and sequencing the gene. A predicted transcriptional activation domain in VrNAC13 was validated with a yeast one-hybrid assay. The composition and functional characteristics of VrNAC13 were analyzed using basic bioinformatics techniques, and the expression characteristics of VrNAC13 were analyzed via quantitative reverse transcription-PCR. The results showed that VrNAC13 was 1,068 bp in length and encoded a product of 355 amino acids. VrNAC13 was predicted to contain a NAM domain and to belong to the NAC transcription factor family. The protein was hydrophilic and contained several threonine phosphorylation sites. Phylogenetic analysis showed that VrNAC13 was highly similar in sequence to two Arabidopsis thaliana NAC proteins; we hypothesize that VrNAC13 may perform functions in mung bean similar to those of the two closely related proteins in Arabidopsis. Promoter analysis of VrNAC13 revealed cis-acting elements predicted to respond to abscisic acid (ABA), gibberellin, auxin, light, drought, low temperature, and other stressors. VrNAC13 was most highly expressed in the leaves and expressed at very low levels in the stem and root. It was experimentally determined to be induced by drought and ABA. Based on these results, VrNAC13 appears to regulate stress resistance in mung bean.

Effects of Danggui-Shaoyao-San on central neuroendocrine and pharmacokinetics in female ovariectomized rats.

ETHNOPHARMACOLOGICAL RELEVANCE: The traditional Chinese medicine formula Danggui-Shaoyao-San (DSS) has been reported to have estrogen-like effects and therapeutic effects on the symptoms of Alzheimer's disease (AD). AIM OF THE STUDY: To explore whether the central oxytocin and neuroendocrine system is involved in the modulating effects of DSS on the cognition and neuropsychiatric hebaviors in female AD rats, and to investigate the pharmacokinetics of paeoniflorin and ferulic acid in female AD rats with DSS treatment. MATERIAL AND METHODS: DSS (1.2, 3.2, 8.6 g/kg/day) was orally administered to ovariectomized (OVX) rats, and saline was orally administered to sham operation rats as control group. The Morris water maze test, novel object recognition test, and passive avoidance test were conducted for evaluation of learning and memory abilities, while elevated plus maze test and forced swim test were performed to assess anxiety- and depressive-like behaviors. ELISA kits were used to detect the levels of estrogen (E), estrogen receptor α (ERα), oxytocin (OT), oxytocin receptor (OTR), acetylcholine (Ach), acetylcholin esterase (AchE), and choline acetyl transferase (ChAT) in the cortex. The concentrations of Ach, glutamate (Glu), γ-aminobutyric acid (GABA), 5-hydroxytryptamine (5-HT), norepinephrine (NE) and dopamine (DA) in the hippocampus were assessed by HPLC-MS. The changes of neuronal morphology in the hippocampus were observed by Nissl staining. The pharmacokinetics of paeoniflorin and ferulic acid in OVX rats with DSS treatment were studied by HPLC. RESULTS: In the Morris water maze test, novel object recognition test, and passive avoidance test, OVX rats showed cognitive impairment. In the elevated plus maze test and forced swim test, the anxiety- and depressive-like behaviors of OVX rats were significant as compared to the control group. Treatment of DSS significantly imporved the cognitive deficits, and ameliorated anxiety- and depressive-like behaviors of OVX rats. The expression of E, ERα, OT, OTR, AchE and ChAT in the cortex of model group were significantly decreased, and DSS significantly reversed these changes. The concentrations of Ach, Glu, GABA, 5-HT and NE in the hippocampus of OVX rats were significantly decreased, whereas DSS significantly increased the levels of Ach, Glu, GABA, 5-HT and NE. There was no significant difference in the concentration of DA in the hippocampus among groups. Degenerating neurons in the hippocampal CA3 region were observed in OVX rats, and the number of neurons was decreased. DSS treatment reduced the degenerating neurons, and incresed the number of neurons. The MRT (0 - ∞), AUC (0 - ∞), Cmax and t1/2z values of paeoniflorin, and the AUC 0-∞ and Cmax value of ferulic acid were higher in DSS-treated OVX rats than those in the DSS-treated control rats. CONCLUSIONS: DSS improves the learning and memory ability, and attenuates anxiety- and depressive-like behaviors of OVX rats. The mechanism may be through increasing estrogen, reducing cholinergic damage, and modulating neurotransmitters. The increase in absorption and elimination time of paeoniflorin and ferulic acid in OVX rats may enhance the efficacy of DSS.

Morphological Features of Fractures Developed by Direct Shearing of Intact Granites after Water Cooling Cycles.

Rock fractures are considered as favorable objects for enhanced geothermal development. The fracture morphologies play an important role in enhanced geothermal development. Therefore, the study of fracture morphologies has a certain guiding significance for the geothermal reservoir. Water cooling and water cooling cycles can change the morphology of fracture surfaces formed by the shear failure of intact granites. To date, however, there is little work on the effect of water cooling and water cooling cycles on the morphology of fracture surfaces formed by direct shearing of intact granites. In this study, the direct shear tests of intact granites treated by water cooling cycles at different temperatures were conducted, and the variations in the laws of shear strength of intact granites and morphologies of fracture surfaces with temperature or cycle times were analyzed. Test results showed that the shear strength and shear stiffness of intact granites decreased nonlinearly with the increase of temperature or cycle times, but the height and apparent dip angle of asperities on the fracture surface increased with the increase of temperature or cycle times, and the overall uniformity of the fracture surface was improved. The height distribution frequency of asperities on fracture surfaces can be divided into four types: right-biased peak type, left-biased peak type, left-biased middle peak, and left-biased flat peak. The asperities on the fracture surface formed by the shearing of intact granites have asymmetric characteristics. The maximum apparent dip angle and average apparent dip angle in the reverse shear direction are larger than those in the shear direction, and the initial contact area ratio between the shear direction and reverse shear direction is in the range of fluctuation between 1.4 and 2.

The human health risk assessment and countermeasures study of groundwater quality.

Due to various geological, hydrogeological conditions and human activities, groundwater of different regions has distinct hydrochemical characteristics. The harmful chemical components of groundwater affect human health, and thus, the groundwater quality health risk assessment (GQHR) is important to local residents. It is vital to select GQHR factors combined with hydrochemical features, and to explore their formation, concentration characteristics and the prominent controlling role of influencing risk distribution from natural and human reasons. The factors of NO3-, NO2-, NH4+ and F- were extracted as assessment factors to evaluate the GQHR. The factors NO3-, NO2- and NH4+ are derived by human activities and F- stems from irrigation of geogenic high-fluoride groundwater and fertilizer use. The results of GQHR showed the risk order as children > adult females > adult males. The low- and medium-risk regions correspond to high groundwater levels, which are mainly controlled by natural factors. The high-risk regions located in eastern part of the study area, which were affected by both natural and human reasons. The targeted measures to prevent the increase of groundwater health risk caused by different dominant controlling effects were put forward. The research provides a scientific basis for the safety of groundwater supply and environmental exposure in this area. The research ideas and methods can be a reference for similar studies.

Multi-therapies Based on PARP Inhibition: Potential Therapeutic Approaches for Cancer Treatment.

The nuclear enzymes called poly(ADP-ribose)polymerases (PARPs) are known to catalyze the process of PARylation, which plays a vital role in various cellular functions. They have become important targets for the discovery of novel antitumor drugs since their inhibition can induce significant lethality in tumor cells. Therefore, researchers all over the world have been focusing on developing novel and potent PARP inhibitors for cancer therapy. Studies have shown that PARP inhibitors and other antitumor agents, such as EZH2 and EGFR inhibitors, play a synergistic role in cancer cells. The combined inhibition of PARP and the targets with synergistic effects may provide a rational strategy to improve the effectiveness of current anticancer regimens. In this Perspective, we sum up the recent advance of PARP-targeted agents, including single-target inhibitors/degraders and dual-target inhibitors/degraders, discuss the fundamental theory of developing these dual-target agents, and give insight into the corresponding structure-activity relationships of these agents.

Study on Regional Strata Movement during Deep Mining of Erdos Coal Field and Its Control.

Disasters such as rock bursts and mine earthquakes became increasingly serious with the increase in mining depth in Erdos Coal Field and became serious problems that restrict high-strength continuous mining of coal mines. In this study, strata movement and energy polling distribution of ultrathick weak-bonding sandstone layers were controlled by the local filling−caving multi-faces coordinated mining technique, which was based on the analysis of subsidence and overlying structural characteristics in the Yingpanhao mining area. Moreover, the influencing factors and the control effect laws were investigated. Surface subsidence and energy polling distribution control effects of different mining modes were compared, which confirmed the superiority of local filling based on the main key stratum. According to the results, the maximum surface subsidence velocity of the first mining face was 1.24 mm/d, which indicates the presence of a logistic functional relationship between the mining degree and subsidence factors. When the mining degree was close to full mining, the practical surface subsidence was smaller than the corresponding logistic functional value. The largest influencing factor for the strata movement control effect of partial filling mining based on the main key stratum was the width of the caving face, followed by the filling ratio, section pillar width, and width of the filling face, successively. With respect to the influencing degree on the energy polling distribution of partial filling mining based on the main key stratum, the order followed as section pillar width > filling ratio > caving working face > width of backfilling working face. Additionally, the comparative analysis from the perspectives of control effect, resource utilization, and cost-effectiveness demonstrated that partial filling mining based on the main key stratum was one of the techniques with high cost-effectiveness in controlling strata movement and relieving rock bursts, mining earthquakes, and subsidence disasters.

Effects of the mechanical response of low-permeability sandstone reservoirs on CO2 geological storage based on laboratory experiments and numerical simulations.

Carbon dioxide (CO2) geological storage (CGS) is an effective way for reducing greenhouse emissions. The injection of CO2 into the deep formation changes the pore pressure and effective stresses in the reservoir, thus leading to changes in stress-dependent porosity and permeability. These changes give feedback to the injection rate, migration, storage amount of CO2 in the target reservoir. In this study, we focus on the Liujiagou reservoir, one of the first demonstration CGS project in saline aquifers in the Ordos Basin, China. The mathematical model that defines the relationship between the permeability and the injection pressure (or effective stress) was obtained by laboratory experiments. On this basis, the permeability-stress law was successfully integrated into the thermo-hydro-mechanical (THM) coupled simulator TOUGH2Biot to simulate the feedback between the flow and mechanical response. The improved simulator was used to analyze the effects of reservoir mechanical response on CO2 geological storage efficiency. The modeling results indicated that the mechanical response of the reservoir had little effect on reservoir pore pressure and porosity, but it had a significant effect on reservoir permeability and the migration distance, injection rate, and total storage amount of CO2. The maximum increases in the lateral migration distance of CO2 caused by the reservoir mechanical response reached 13.1% using 5 MPa injection pressure. In addition, the total CO2 storage amount increased by 11.6% after 5 years of continuous CO2 injection. Furthermore, when the injection pressure was greater, the reservoir mechanical response had stronger enhancement effects on CGS. Overall, the results suggested that the reservoir mechanical response during CO2 injection was beneficial for increasing CGS efficiency and emphasized the importance of considering the mechanical response in CGS.

Development and placement accuracy evaluation of an MR conditional robot for prostate intervention.

Robot-assisted prostate intervention under magnetic resonance imaging (MRI) guidance is a promising method to improve the clinical performance compared with the manual method. An MR conditional 6-DOF prostate intervention serial robot is developed and a binocular vision system (BVS) is established to evaluate the needle placement accuracy and located the penetration point precisely. The robot is designed by the MR conditional criteria. The serial configuration of the robot provides adequate flexibility and large workspace and excellent friendliness to the physicians. The kinematics are deduced and the needle placement control flow is proposed according to the configuration of the robot. The robot-assisted prostate intervention is divided into two phases including needle placement and needle penetration. A custom-made robust BVS is developed to obtain the needle tip position automatically in the needle placement phase where the needle cannot be detected by the MRI for lack of hydrogen atom. A simple and general algorithm used for needle tip camera coordinate estimation is proposed. Experiments on the BVS validation and robot accuracy evaluation are performed. The experiment results show that the errors of the BVS are under 0.3621 mm and the position error of the proposed robot is 2.815 mm which indicate the adequate accuracy for the prostate intervention. Graphical abstract.

Reduced pests, improved grain quality and greater total income: benefits of intercropping rice with Pontederia cordata.

BACKGROUND: Intercropping, which is growing two or more different crops in the same field simultaneously, is an effective traditional agricultural practice for productivity, resource utilization, and pest control. However, study on intercropping in paddy fields is limited. So in this study, field experiments of 2 years/four seasons (early and late seasons in 2016 and 2017) were conducted to examine the effects of rice-Pontederia cordata intercropping on rice plant growth, pest control, yield, income, and grain quality. RESULTS: We found rice-P. cordata intercropping significantly decreased the occurrence of rice diseases and pests, with a 22.0-45.9% reduction in sheath blight and a 33.8-34.4% reduction in leaf folders. The mean land equivalent ratio (LER) (1.09) result indicates that intercropping rice and P. cordata generated positive yield effects. In addition, due to the economic profit from the replacement stripe of P. cordata in the rice paddy field, intercropping rice with P. cordata could greatly enhance farmer income. The average total income of rice intercropped with P. cordata was 2.5-fold higher than that of rice monoculture. Furthermore, intercropping significantly improved grain quality compared with the rice monoculture. It significantly increased the milled rice rate and whole milled rice rate by 11.2% and 12.8%, respectively, but decreased the chalky rice rate by 30.9-39.8% and chalkiness degree by 32.2%. CONCLUSIONS: We suggest that rice-P. cordata intercropping provides an environmentally effective way to control rice diseases and pests, results in higher overall productivity and total income, and improves grain quality. © 2021 Society of Chemical Industry.

GABAergic System in Stress: Implications of GABAergic Neuron Subpopulations and the Gut-Vagus-Brain Pathway.

Stress can cause a variety of central nervous system disorders, which are critically mediated by the γ-aminobutyric acid (GABA) system in various brain structures. GABAergic neurons have different subsets, some of which coexpress certain neuropeptides that can be found in the digestive system. Accumulating evidence demonstrates that the gut-brain axis, which is primarily regulated by the vagus nerve, is involved in stress, suggesting a communication between the "gut-vagus-brain" pathway and the GABAergic neuronal system. Here, we first summarize the evidence that the GABAergic system plays an essential role in stress responses. In addition, we review the effects of stress on different brain regions and GABAergic neuron subpopulations, including somatostatin, parvalbumin, ionotropic serotonin receptor 5-HT3a, cholecystokinin, neuropeptide Y, and vasoactive intestinal peptide, with regard to signaling events, behavioral changes, and pathobiology of neuropsychiatric diseases. Finally, we discuss the gut-brain bidirectional communications and the connection of the GABAergic system and the gut-vagus-brain pathway.

Short-Term Outcomes of Self-Expandable Metallic Stent versus Decompression Tube for Malignant Colorectal Obstruction: A Meta-Analysis of Clinical Data.

Purpose: To compare the short-term outcomes between self-expandable metallic stent (SEMS) and decompression tubes (DT) for malignant colorectal obstruction. Methods: A comprehensive literature search was performed from inception to 2018/12/6 covering Pubmed, Embase, and Cochrane library. Methodological assessments of eligible studies were performed by using Newcastle-Ottawa Scale (NOS). The Revman software (version 5.3) was used in our statistical analysis. Results: Totally 7 cohort studies were enrolled in our meta-analysis. All the 7 eligible studies proved to be high quality according to the NOS scale. Patients receiving SEMS had higher clinical success rates, higher laparoscopic surgery rates, and higher primary anastomosis rates compared with patients receiving DT. Conclusions: Based on evidence from eastern countries, SEMS placement is an effective procedure that treats malignant colorectal obstruction. Compared with DT placement, patients receiving SEMS may benefit from higher clinical success rates, higher laparoscopic surgery rates, and higher primary anastomosis rates.

Adjuvant therapy with Astragalus membranaceus for post-stroke fatigue: a systematic review.

Post-stroke fatigue (PSF) is a common symptom after stroke and interferes with the rehabilitation. There are limited pharmacological therapies for managing PSF. Astragalus membranaceus (Huangqi) is a frequently used Chinese herbal medicine (CHM) in the treatment of fatigue in China. The aim of this review was to summarize the efficacy of adjuvant therapy with CHM Huangqi (CHM-HQ) in managing fatigue after stroke. We searched the databases in both English and Chinese for randomized controlled trials (RCTs) on CHM-HQ for PSF till November 2016. The Cochrane risk of bias tool was used to assess the quality of included trials, and the Review Manager 5.3 software was used to conduct the data analysis. Sixteen RCTs with a total of 1222 participants were included. The evidence was poor in quality with unclear or high risks of bias. Compared to routine intervention, treatment with CHM-HQ decreased the fatigue severity based on the assessment of the Fatigue Severity Scale, Fugl-Meyer and Visual Analogue Scale, and improved the quality of life as measured by the Stroke Specific Quality of Life scale, the Barthel index, and the modified Barthel index, while the adverse effects were mild. In conclusions, adjuvant therapy with CHM-HQ may benefit in managing fatigue and quality of life in stroke patients. However, stronger evidence is needed for a promising conclusion and more rigorous designs of RCTs are merited in the future.

Is There Necessity for Oversewing the Staple Line During Laparoscopic Sleeve Gastrectomy? An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background: Laparoscopic sleeve gastrectomy (LSG) has become the current mainstream surgical treatment for obesity. With the development of clinical practice, surgeons realized the associated severity and danger of postoperative bleeding and leakage. Surgeons constantly explore different strategies to reduce the incidence of these complications. By reviewing previous clinical articles on the staple line reinforcement (SLR) in LSG, the conclusions were inconsistent regarding effectiveness. This article aims to discuss effectiveness of oversewing the staple line in LSG. Methods: From the start date of each database to September 27, 2018, a comprehensive search of published articles in English was conducted in PubMed, Embase, Central (Cochrane) databases and Scopus databases. We extracted and analyzed the main results on postoperative bleeding, staple line leakage, hospital stay and operative time of the final included articles. This review was compliant with PRISMA guidelines. Results: Finally, we extracted and analyzed 11 randomized controlled trials (RCTs) which contain 2411 patients (1219 patients as part of the oversewing (OS) group and 1192 patients in the no-oversewing (NOS) group). In the OS group, there were 15 cases (1.23%) of postoperative bleeding, and 8 cases (0.66%) of postoperative leakage. While in the NOS group, 35 patients (2.94%) had postoperative bleeding and 21 patients (1.76%) had postoperative leakage. By comparing and analyzing the OS group and the NOS group, the risk ratio (RR) for postoperative bleeding was 0.48 (95% confidence interval [CI], 0.27-0.83 p = 0.447). In addition, the RR for postoperative leakage was 0.44 (95% CI, 0.21-0.89 p = 0.835). The standardized mean difference (SMD) for hospital stay was -0.10 (95% CI, -0.25 to 0.04 p = 0.061) and 2.26 for operative time (95%CI, 0.82-3.69 p = 0.000). Conclusion: This study suggested that oversewing the staple line during LSG has a significant clinical value: it decreased the incidence of postoperative bleeding, postoperative leakage; moreover, it also significantly prolonged the operative time and but did not change hospital stay. More high-quality and large sample RCTs are expected to get more accurate results.

The effect of smoke-free legislation on the mortality rate of acute myocardial infarction: a meta-analysis.

BACKGROUND: Several studies have demonstrated that smoke-free legislation is associated with a reduced risk of mortality from acute myocardial infarction (AMI). This study aimed to examine and quantify the potential effect of smoke-free legislation on AMI mortality rate in different countries. METHODS: Studies were identified using a systematic search of the scientific literature from electronic databases, including PubMed, Web of Science, ScienceDirect, Embase, Google Scholar, and China National Knowledge Infrastructure (CNKI), from their inception through September 30, 2017. A random effects model was employed to estimate the overall effects of smoke-free legislation on the AMI mortality rate. Subgroup analysis was performed to explore the possible causes of heterogeneity in risk estimates based on sex and age. The results of meta-analysis after excluding the studies with a high risk of bias were reported in this study. RESULTS: A total of 10 eligible studies with 16 estimates of effect size were included in this meta-analysis. Significant heterogeneity in the risk estimates was identified (overall I2 = 94.6%, p < 0.001). Therefore, a random effects model was utilized to estimate the overall effect of smoke-free legislation. There was an 8% decline in AMI mortality after introducing smoke-free legislation (RR = 0.92, 95% confidence interval (CI): 0.90-0.94). The results of subgroup analyses showed that smoke-free legislation was significantly associated with lower rates of mortality for the following 5 diagnostic subgroups: smoke-free in workplaces, restaurants and bars (RR = 0.92, 95% CI: 0.90-0.95), smaller sample size (RR = 0.92, 95% CI: 0.89-0.95), study location in Europe (RR = 0.90, 95% CI: 0.85-0.94), regional study area (RR = 0.92, 95% CI: 0.89-0.94), and no previous local smoke-free legislation (RR = 0.91, 95% CI: 0.90-0.93). However, there was not much difference in AMI mortality rates after the legislation between the longer (RR = 0.92, 95% CI: 0.86-0.98) and shorter follow-up duration subgroups (RR = 0.92, 95% CI: 0.89-0.94). CONCLUSION: Smoke-free legislation could significantly reduce the AMI mortality rate by 8%. The reduction in the AMI mortality rate was more significant in studies with more comprehensive laws, without prior smoke-free bans, with a smaller sample size, at the regional level, and with a location in Europe.

Clinical Outcomes of Sleeve Gastrectomy Versus Roux-En-Y Gastric Bypass After Failed Adjustable Gastric Banding.

BACKGROUND: Over recent decades, laparoscopic adjustable gastric banding (LAGB) has been among the most common bariatric surgeries. Nowadays, many patients require revision surgery due to insufficient weight loss and band-related complications. Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are the two most common revision surgeries for failed LAGB, but the conclusions about their efficacy and safety have been inconsistent. This meta-analysis aimed to review the clinical outcomes of SG and RYGB after failed LAGB. METHODS: In accordance with the PRISMA guidelines, the PubMed, Embase, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were systematically searched for articles that had studied the efficacy and safety of SG and RYGB. The most appropriate effects model was chosen based on the heterogeneity of the articles included in this meta-analysis. Statistical analysis was conducted using Stata 14.0. RESULTS: Of 586 articles that were retrieved, 16 articles which examined 2141 SG and 2990 RYGB patients met the inclusion criteria. The patients in RYGB groups showed increased percent excess weight loss (%EWL) at 12 and 24 months after revision surgery but no statistically significant change was found about %EWL after 3, 6, or 36 months. In addition, RYGB was associated with a higher rate of complications, interventions, and readmission in addition to being of more operative time. CONCLUSIONS: This review suggested that RYGB was more effective at demonstrating weight loss after 12 and 24 months, but comparisons of the long-term efficacy of RYGB with that of SG remain inconclusive. In addition, RYGB was accompanied by a greater number of post-operative complications, interventions, and readmissions. Thus, surgeons should consider the overall status of the patients and their comorbidities as crucial factors when selecting a form of revision surgery. Additional high-quality randomized controlled studies are required to further compare the efficacy and safety of these treatments with longer follow-up times.