Toremifene, an Alternative Adjuvant Endocrine Therapy, Is Better Than Tamoxifen in Breast Cancer Patients with CYP2D6*10 Mutant Genotypes.

PURPOSE: Tamoxifen showed individual differences in efficacy under different CYP2D6*10 genotypes. Our study evaluated the prognosis of tamoxifen or toremifene in hormone receptor (HR)-positive breast cancer patients under different genotypes. MATERIALS AND METHODS: CYP2D6*10 genotypes of HR-positive breast cancer patients were determined by Sanger sequencing, and all the patients were divided into tamoxifen group or toremifene group. RESULTS: A total of 268 patients with HR-positive breast cancer were studied. The median follow-up time was 72.0 months (range, 5.0 to 88.0 months). Of these, 88 (32.9%), 114 (42.5%), and 66 (24.6%) patients had C/C, C/T, and T/T genotypes, respectively. Among patients who received tamoxifen (n=176), the 5-year disease-free survival (DFS) rate in patients with C/C and C/T genotype was better than that in patients with T/T genotype, and the difference was statistically significant (p < 0.001 and p=0.030, respectively). In patients receiving toremifene, CYP2D6*10 genotype was not significantly associated with DFS (p=0.325). Regardless of genotypes, the 5-year DFS rate was higher in patients treated with toremifene than in patients with tamoxifen (91.3% vs. 80.0%, p=0.011). Compared with tamoxifen, toremifene remained an independent prognostic marker of DFS in multivariate analysis (hazard ratio, 0.422; p=0.021). For all the 180 patients with CYP2D6*10 C/T and T/T genotypes, the 5-year DFS rate was significantly higher in the toremifene group than in the tamoxifen group (90.8% vs. 70.1%, p=0.003). CONCLUSION: Toremifene may be an alternative adjuvant endocrine therapy for patients with CYP2D6*10 mutant genotypes.

Global distributions of foliar nitrogen and phosphorus resorption in forest ecosystems.

Nutrient resorption is an important mechanism for nutrient conservation and can maintain ecosystem stoichiometry. Here, we examined the global-scale variation of nitrogen resorption efficiency (NRE) and phosphorus resorption efficiency (PRE) by analyzing observations from 218 published papers. We used Pagel's λ to test the phylogenetic limitation on NRE and PRE and applied the random forest model to assess biotic and abiotic drivers, which included climate, soil, species characteristics, and topographical factors, and predicted the global NRE and PRE distributions. We found that NRE and PRE had oppositing trends among climatic zones, plant functional groups, and foliar nitrogen (N) to phosphorus (P) ratios. Nutrient resorption was higher in ectomycorrhizal trees than in arbuscular mycorrhizal trees. Moreover, foliar NRE and PRE were not linked to phylogeny. On average, the random forest overall explained 38 % (21 %-55 %) variation in NRE and 36 % (16 %-55 %) variation in PRE. Both NRE and PRE varied greatly with climate and soil organic carbon (SOC). The spatial variation of NRE and PRE was coupled to N-limitation and P-limitation, respectively. Our evaluation of the factors that influenced NRE and PRE and their global distributions, and our novel approach for evaluating plant utilization of nutrients, advances our understanding of the relative stability of ecosystem randomness in forest ecosystems and the global forest nutrient cycle.

Harmless Treatment of High Arsenic Tin Tailings and Environmental Durability Assessment.

The treatment of arsenic (As) in tin tailings (TT) has been an urgent environmental problem, and stabilization/solidification (S/S) treatment is considered an effective technology to eliminate contamination of As. In this study, we developed a low-carbon and low-alkalinity material to S/S of As, and the results showed that the leaching concentration of As after treatment was lower than the Chinese soil environmental quality standard (0.1 mg/L). Based on a series of characterization tests, we found that OH- promoted the dissolution of As(III)-S, Fe-As(V), and amorphous As(III)-O species and formed Ca-As(III) and Ca-(V) species with Ca2+. Simultaneously, hydration produces calcium silicate hydrate (C-S-H) gel and ettringite by the form of adsorption and ion exchange to achieve S/S of As. We also assessed the durability of this material to acidity and temperature, and showed that the leaching concentration of As was below 0.1 mg/L at pH = 1-5 and temperature 20-60 °C. The method proposed in this study, S/S of As, has excellent effect and environmental durability, providing a new solution for harmless treatment of TT and its practical application.

Dryness weakens the positive effects of plant and fungal ß diversities on above- and belowground biomass.

Plant and microbial diversity are key to determine ecosystem functioning. Despite the well-known role of local-scale α diversity in affecting vegetation biomass, the effects of community heterogeneity (ß diversity) of plants and soil microbes on above- and belowground biomass (AGB and BGB) across contrasting environments still remain unclear. Here, we conducted a dryness-gradient transect survey over 3000 km across grasslands on the Tibetan Plateau. We found that plant ß diversity was more dominant than α diversity in maintaining higher levels of AGB, while soil fungal ß diversity was the key driver in enhancing BGB. However, these positive effects of plant and microbial ß diversity on AGB and BGB were strongly weakened by increasing climatic dryness, mainly because higher soil available phosphorus caused by increasing dryness reduced both plant and soil fungal ß diversities. Overall, these new findings highlight the critical role of above- and belowground ß diversity in sustaining grassland biomass, raising our awareness to the ecological risks of large-scale biotic homogenization under future climate change.

Exploring organic micropollutant biodegradation under dynamic substrate loading in rapid sand filters.

Microbial removal of trace organic micropollutants (OMPs) from drinking water sources remains challenging. Nitrifying and heterotrophic bacteria in rapid sand filters (RSFs) are capable of biodegrading OMPs while growing on ammonia and dissolved organic matter (DOM). The loading patterns of ammonia and DOM may therefore affect microbial activities as well as OMP biodegradation. So far, there is very limited information on the effect of substrate loading on OMP biodegradation at environmentally relevant concentrations (∼ 1 µg/L) in RSFs. We investigated the biodegradation rates of 16 OMPs at various substrate loading rates and/or empty bed contact times (EBCT). The presence of DOM improved the biodegradation of paracetamol (41.8%) by functioning as supplementary carbon source for the heterotrophic degrader, while hindering the biodegradation of 2,4-D, mecoprop and benzotriazole due to substrate competition. Lower loading ratios of DOM/benzotriazole benefited benzotriazole biodegradation by reducing substrate competition. Higher ammonia loading rates enhanced benzotriazole removal by stimulating nitrification-based co-metabolism. However, stimulating nitrification inhibited heterotrophic activity, which in turn inhibited the biodegradation of paracetamol, 2,4-D and mecoprop. A longer EBCT promoted metformin biodegradation as it is a slowly biodegradable compound, but suppressed the biodegradation of paracetamol and benzotriazole due to limited substrate supply. Therefore, the optimal substrate loading pattern is contingent on the type of OMP, which can be chosen based on the priority compounds in practice. The overall results contribute to understanding OMP biodegradation mechanisms at trace concentrations and offer a step towards enhancing microbial removal of OMPs from drinking water by optimally using RSFs.

Prognostic Prediction Using the Clinical Data and Ultrasomics-Based Model in Acute Respiratory Distress Syndrome (ARDS) Combined with Acute Kidney Injury (AKI).

Objective: A model was constructed based on clinical and ultrasomics features to predict the prognosis of patients in the respiratory intensive unit (RICU) who had acute respiratory distress syndrome (ARDS) combined with acute kidney injury (AKI). AKI ensues after ARDS in RICU ordinarily. The prognostic prediction tool was further developed on this basis. Methods: We collected clinical and ultrasonic data from 145 patients who had ARDS combined with AKI and received continuous renal replacement therapy (CRRT) in the RICU of Xiangyang Hospital of Traditional Chinese Medicine from March 2016 to November 2019. The patients were divided into the survival group (n = 51) and the death group (n = 94), depending on the treatment outcome. The training set (n = 102) and the testing set (n = 43) were established based on patient data. The clinical and ultrasomics features and the CRRT parameters were compared between the two groups. The influence factors of death were analyzed by logistic regression, and four predictive models were established. The predictive performance of 4 models was compared using the R Software 4.1.3. The decision curve analysis graphs were drawn using the R language to determine the net benefit of each. Result: Univariate analysis was conducted in the training set. The following risk factors for poor prognosis were identified: age, concurrent cancers, sequential organ failure assessment score (SOFA), number of organ dysfunctions, positive cumulative fluid balance at 72 h, time from ICU admission to CRRT, mean arterial pressure, oxygenation index, and gray-level size zone matrix, GLSZM (SumEntropy.239/SmallDependenceHighGrayLevelEmphasis.314/Maximum.327/Variance.338) (P < 0.05). Four models were built based on the above factors: clinical model, CRRT model, ultrasomics-based model, and combination model. Comparison using the MedCalc software indicated that the best predictive performance achieved with the combination model. The decision curve analysis also suggested that the combination model had the highest net benefit. Similar results were reported after validation on the testing set. Conclusion: The prognosis of ARDS patients combined with AKI is usually poor. The combination model based on clinical and ultrasomics features had the highest predictive performance. This model can be used to improve the clinical outcome and prognosis.

Tea plant roots respond to aluminum-induced mineral nutrient imbalances by transcriptional regulation of multiple cation and anion transporters.

BACKGROUND: Tea is one of the most popular non-alcoholic beverages in the world for its flavors and numerous health benefits. The tea tree (Camellia sinensis L.) is a well-known aluminum (Al) hyperaccumulator. However, it is not fully understood how tea plants have adapted to tolerate high concentrations of Al, which causes an imbalance of mineral nutrition in the roots. RESULTS: Here, we combined ionomic and transcriptomic profiling alongside biochemical characterization, to probe the changes of metal nutrients and Al responsive genes in tea roots grown under increasing concentrations of Al. It was found that a low level of Al (~ 0.4 mM) maintains proper nutrient balance, whereas a higher Al concentration (2.5 mM) compromised tea plants by altering micro- and macro-nutrient accumulation into roots, including a decrease in calcium (Ca), manganese (Mn), and magnesium (Mg) and an increase in iron (Fe), which corresponded with oxidative stress, cellular damage, and retarded root growth. Transcriptome analysis revealed more than 1000 transporter genes that were significantly changed in expression upon Al exposure compared to control (no Al) treatments. These included transporters related to Ca and Fe uptake and translocation, while genes required for N, P, and S nutrition in roots did not significantly alter. Transporters related to organic acid secretion, together with other putative Al-tolerance genes also significantly changed in response to Al. Two of these transporters, CsALMT1 and CsALS8, were functionally tested by yeast heterologous expression and confirmed to provide Al tolerance. CONCLUSION: This study shows that tea plant roots respond to high Al-induced mineral nutrient imbalances by transcriptional regulation of both cation and anion transporters, and therefore provides new insights into Al tolerance mechanism of tea plants. The altered transporter gene expression profiles partly explain the imbalanced metal ion accumulation that occurred in the Al-stressed roots, while increases to organic acid and Al tolerance gene expression partly explains the ability of tea plants to be able to grow in high Al containing soils. The improved transcriptomic understanding of Al exposure gained here has highlighted potential gene targets for breeding or genetic engineering approaches to develop safer tea products.

Strategy for treating vascular emergencies during the COVID-19 pandemic in China.

Coronavirus-caused pneumonia (COVID-19) broke out in December 2019. The virus soon proved to be extremely contagious and caused an international pandemic. Clinicians treating COVID-19 patients face considerable danger of occupational exposure because of the highly infectious nature of the virus, and precautions must be taken to prevent medical staff infections. This article lists important measures that may save the lives of patients and medical staff during the COVID-19 pandemic and help stop the transmission of COVID-19 on hospital grounds. The suggestions include establishing detailed infection control and prevention protocols in the operating room; expediting testing procedures and patient screening for COVID-19; using case-specific treatment planning for vascular patients with COVID-19, favoring minimally invasive methods; and establishing and reinforcing protective awareness of medical personnel.

Selection of cost-effective magnesium sources for fluidized struvite crystallization.

Struvite crystallization has been considered a promising approach to recover phosphorus from wastewater. However, its practical application is limited, probably because of the high cost of magnesium (Mg). In this study, a comprehensive economic analysis was conducted using five Mg sources (MgCl2, MgSO4, MgO, Mg(OH)2, and bittern) during the operation of a pilot-scale fluidized bed reactor (FBR), using swine wastewater as the case matrix. First, the economic operating conditions were investigated, and subsequently, the performance and the costs of the five Mg sources were compared. The results indicated that the FBR could be operated most economically at pH of 8.5 and Mg to phosphorus (Mg/P) molar ratio of 1.5. Under these conditions, no significant differences in phosphorus removal and product quality could be found between the five Mg sources. Selecting the most economical Mg source was thus highly dependent on the prices of the reagents and Mg sources. Low-solubility Mg sources were preferable when NaOH was priced higher, while high-solubility Mg sources proved more economical when HNO3 was expensive. The bittern was the most economical choice only when the distances for total inorganic orthophosphate removal and struvite recovery were shorter than 40 and 270km, respectively. The current study provides an overview of the economic selection of an Mg source, which can help reduce the cost of struvite crystallization.

Inorganic nitrate alleviates the senescence-related decline in liver function.

Senescence-related decline in liver function is a common complication in the elderly that can lead to impaired health in older individuals. Dietary nitrate supplements have physiological and therapeutic effects on organ function by nitrate (NO3-)-nitrite (NO2-)-nitric oxide (NO) pathway. However, the role of dietary nitrate on the senescence-related decline in liver function is unclear. The findings of the present study showed that nitrate levels in the serum and liver decreased, whereas the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in serum increased in ageing mice. Consistently, cell senescence, decreased glycogen levels and increased lipid deposition were found in the liver of aged mice, both glucokinase (GCK) and phosphoenolpyruvate carboxykinase (PCK) were down-regulated (n=10). Daily nitrate intake (0.5 mmol L-1) restored nitrate levels, decreased ALT and AST levels, and prevented cell senescence and structural and glucose and lipid metabolism degeneration in liver tissue both in D-galactose (D-gal)-induced ageing mice (n=10) and in natural aged mice (n=10). In conclusion, the present study demonstrated that the reduction of nitrate levels was correlated with liver degeneration in ageing individuals and that dietary supplement of nitrate could restore the nitrate levels in serum and the liver and prevent ageing-related liver degeneration.

Effect of PDIA3 gene silence on colonic mast cells and visceral sensitivity of rats with irritable bowel syndrome.

This study aimed to elucidate the role of PDIA3 in visceral hypersensitivity of rats with irritable bowel syndrome (IBS). Fourty eight SD rats were randomly divided into four groups (n=12): control group, IBS-empty virus group (IBS-1), IBS-PDIA3 silence group (IBS-2), and IBS-the control group (IBS-3). Visceral hypersensitivity models were established by using acetic acid enema combined with restraint stress, and assayed by abdominal withdrawal reflexes (AWR). Mast cells (MCs) in ileocecal mucosa were counted with toluidine blue staining. Degranulation of MCs was observed under electron microscopy. Serum and mucosal levels of IL-4 and IL-9 were measured with ELISA and QT-PCR. Intestinal tryptase and PAR-2 expression was examined with ELISA and Western blot. The Results showed that PDIA3 plays an important role in the formation of visceral hypersensitivity by increasing systemic and colon mucosal expressions of IL-4 and IL-9, activating mast cells and upregulating PAR-2 expression of target organs.

[Kangle Decoction for erectile dysfunction with liver-qi stagnation and kidney deficiency].

OBJECTIVE: To observe the clinical efficacy of Kangle Decoction in the treatment of erectile dysfunction (ED) with liver-qi stagnation and kidney deficiency. METHODS: A total of 79 ED patients with liver-qi stagnation and kidney deficiency were randomly assigned to an experimental group (aged ï¼»36.62±8.05ï¼½ yr and with a disease course of ï¼»18.15±6.41ï¼½ mo) and a control group (aged ï¼»37.44±8.10ï¼½ yr and with a disease course of ï¼»17.51±6.79ï¼½ mo), the former treated orally with Kangle Decoction at 0.5 dose bid while the latter with Cialis at 10 mg qd alt, both for 8 weeks. Before treatment, after 4 and 8 weeks of medication, and at 4 weeks after drug withdrawal, we obtained the scores of the patients in the International Index of Erectile Function-5 (IIEF-5), Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS), and Short-Form Psychological and Interpersonal Relationship Scales (SF-PAIRS), and compared the indexes between the two groups of patients. RESULTS: The IIEF-5 score was dramatically increased in both the treatment and control groups after 4 weeks (13.40±2.42 and 16.00±2.68) and 8 weeks of medication (18.60±3.50 and 18.59±3.80) and at 4 weeks after drug withdrawal (17.00±3.05 and 13.95±2.61) as compared with the baseline (10.78±2.28 and 10.77±2.33) (P<0.05 ), even higher in the treatment than in the control group after drug withdrawal (P<0.05 ). The EDITS scores in the treatment and control groups were (28.88±3.31 and 28.90±3.31) after 4 weeks of intervention, (29.68±3.30 and 29.13±3.32) after 8 weeks of intervention, and (29.20±2.92 and 26.82±3.23) at 4 weeks after drug withdrawal, all significantly higher in the former than in the latter group after drug withdrawal (P<0.05 ). The sexual self-confidence score (SSCS), sexual spontaneity score (SSS), and sexual time-concern score (STCS) were all improved in the treatment and control groups after medication as compared with the baseline (P<0.05 ), even higher in the former than in the latter group after drug withdrawal (P<0.05 ). CONCLUSIONS: Kangle Decoction has a definite efficacy in the treatment of ED with liver-qi stagnation and kidney deficiency, with few adverse reactions and long-term post-withdrawal effect, and therefore deserves a wide clinical application.

[Atmospheric Particle Retaining Function of Common Deciduous Tree Species Leaves in Beijing].

In order to explore the atmospheric particle-retaining function of common deciduous tree species leaves in Beijing, six typical tree species (Populus, Robinia pseudoacacia, Koelreuteria paniculata, Salix babylonica, Acer truncatum, Ginkgo biloba) were chosen to measure retaining amount of unit leaf area of air total suspended particles (TSP), coarse particles and fine particulate with aerosol generator (QRJZFSQ-I). The results showed that (1) All six tree species leaves had a certain level of retaining ability to different sizes of atmospheric particles, and different species exhibited some differences. For different sizes of atmospheric particle, retaining amounts of unit leaf area were higher in Koelreuteria paniculata and Robinia pseudoacacia than those of other four species, and the amount of Populus was the lowest among all tree species; (2) The retaining amount of unit leaf area for different tree species was not entirely increased with sampling time. The retaining amounts of TSP and coarse particles for all tree species on the eighth day after rain were significantly higher than those on the fifth day after rain, however, the retaining amount of fine particles was not significantly different under different sampling times. In order to select deciduous tree species for ecological management of air pollution in Beijing, Koelreuteria paniculata should be considered as the priority, followed by Robinia pseudoacacia, compared with Ginkgo biloba, Salix babylonica, Acer truncatum and Populus.

[Distribution, combination, and evolution of syndromic etiologies of erectile dysfunction].

OBJECTIVE: To explore the distribution, combination and evolution of various syndromic etiologies of erectile dysfunction (ED) based on the syndrome etiology theory. METHODS: Using the ED Syndromic Etiology Scale, we collected the clinical data on the Chinese medicine diagnoses of 297 cases of ED, extracted the core syndromic etiologies by analysis of principal components and factors, and analyzed the patterns of distribution, combination, and evolution of ED syndromic etiologies according to the general information of the patients. RESULTS: Through analysis of principal components and factors, 9 core syndromic etiologies were extracted, i. e. , liver constraint with qi stagnation, kidney yin deficiency, damp-heat, liver constraint transforming into liver-fire, blood stasis, kidney yang deficiency, heart-spleen paired deficiency, qi-yin paired deficiency, and phlegm-damp. Each of these syndrome etiologies exhibited its own specific distribution patterns. Of the total number of cases studied, 51.52% had 2 or 3 core syndromic etiologies and 36.03% had only one. CONCLUSION: In the early stage of ED, its syndromic etiologies are usually liver constraint with qi stagnation, kidney yin deficiency, damp-heat, liver constraint transforming into liver-fire, and blood stasis. With the natural progres- sion of the disease, its syndromic etiologies gradually evolve into kidney yang deficiency, heart-spleen paired deficiency, qi-yin paired deficiency, phlegm-damp, and blood stasis, and finally into yin-yang deficiency of the heart, spleen and kidneys, combined with phlegm-damp and blood stasis.

[Efficiency and mechanism on reduction of U(VI) by sulfate reducing bacteria].

Under anaerobic conditions, the characteristics of sulfate reducing bacteria (SRB) were applied to reduce U(VI) under different temperature, pH values, U(VI) concentrations and coexisting ions. The results showed that the optimum reduction condition was the temperature 35 degrees C, pH 7.0 and U(VI) concentration 25 mg x L(-1). The maximum reduction capacity of SRB was 179.1 mg x g(-1). Mo(VI) or Ca2+ did not affect SRB on the reduction process of U(VI) under the concentration less than 5 g x L(-1), but they strongly inhibited the process under the concentration more than 20 g x L(-1). The main inhibition of Mo (VI) was physiological inhibition and the inhibition of Ca2+ was competitive inhibition through the stable complex formation, Ca-UO2-CO3. The results also showed that lag phase did not appear on the concentration of Ca2+ less than 5 g x L(-1), but the lag phase of 24 hours appeared on the concentration of Ca2+ more than 20 g x L(-1).

[Surgical treatment for patients with primary hyperparathyroidism].

OBJECTIVE: To evaluate the feasibility and efficacy of surgical treatment for patients with primary hyperparathyroidism (pHPT). METHODS: The studies were analyzed for 55 patients with pHPT who underwent parathyroidectomy in our hospital from 1985 to 2002. RESULTS: Eight patients were asymptomatic. The skeletal manifestations were found in 24 cases, urinary stones in 10 cases, and both skeletal manifestations and urinary stones in 13 cases. Pathological bone fractures occurred in 16 cases. Hypercalcemia was discovered in all patients with the average value of (3.1 +/- 0.4) mmol/L, ranging from 2.7 to 3.9 mmol/L and. Fifty patients showed elevated parathyroid hormone (PTH) with the average value of (489.2 +/- 69.2) pg/ml, ranging from 102 to 2,000 pg/ml. Preoperatively all patients underwent sonography, CT and/or scintigraphy. The overall preoperative image-directed localization rate was 90.9%. Follow-up was done from 6 months to 2 years after surgery. The symptoms and signs of all patients relieved postoperatively with the improving of osteoporosis and healing of bone fracture. Of all cases, 39 presented with temporary hypocalcemia, 37 showed circumoral paresthesia in whom 10 showed tetany, 15 showed eucalcemia and one had mild hypercalcemia after operation. The serum calcium was normal in all cases with hypocalcemia by Rocaltrol and calcium supplementation for 1 - 3 weeks. PTH level decreased to normal fro 2 weeks to 2 months in 47 cases and was still mildly higher than normal in 3 cases. CONCLUSIONS: Parathyroidectomy is an effective approach to patients with pHPT. With preoperative image-directed localization techniques, minimally invasive parathyroidectomy is a valid surgical strategy.