Remote Ischemic Preconditioning Before Drug-Coated Balloon Implantation can Improve the Long-Term Prognosis of Patients with CAD.

Background: Drug-coated balloons (DCBs) have become increasingly vital to percutaneous coronary intervention, offering many advantages. However, a significant challenge is that many patients are intolerant to the myocardial ischemia caused by DCB dilation. Remote ischemic preconditioning (RIPC) is known to enhance heart's tolerance to ischemia and hypoxia. This study investigated whether preoperative RIPC could extend the tolerated DCB inflation time and improve the long-term prognosis of patients with coronary artery disease (CAD). Methods: A total of 653 patients with CAD were recruited and randomized into a RIPC group (n = 323) and a control (n = 330) group. The RIPC group underwent RIPC on the left upper limb twice daily, starting three days before the DCB implantation. The patients were followed up for one year after the operation, and 197 patients returned for coronary angiography (CAG) examination where the quantitative flow ratio (QFR) of the target vessels was measured. The primary endpoint of the study was the incidence of target lesion failure (TLF), which included target lesion revascularization (TLR), target vessel myocardial infarction, and cardiac death. The secondary endpoint was the rate of QFR loss in the target vessels. Results: The findings revealed a significantly lower incidence of TLR in the RIPC group compared to the control group. Additionally, at the one-year follow-up, the rate of QFR loss in target vessels was lower in the RIPC group than in the control group. Conclusions: The preoperative application of RIPC effectively extended the duration patients could tolerate DCB inflation. Furthermore, this approach positively impacted the long-term prognosis of CAD patients undergoing DCB treatment. Clinical Trial Registration Information: NCT04766749.

DNMT3B activates FGFR3-mediated endoplasmic reticulum stress by regulating PTPN2 promoter methylation to promote the development of atherosclerosis.

Endoplasmic reticulum (ER) stress is closely associated with atherosclerosis (AS). Nevertheless, the regulatory mechanism of ER stress in endothelial cells during AS progression is unclear. Here, the role and regulatory mechanism of DNA (cytosine-5-)- methyltransferase 3 beta (DNMT3B) in ER stress during AS progression were investigated. ApoE-/- mice were fed with high fat diet to construct AS model in vivo. HE and Masson staining were performed to analyze histopathological changes and collagen deposition. HUVECs stimulated by ox-LDL were used as AS cellular model. Cell apoptosis was examined using flow cytometry. DCFH-DA staining was performed to examine ROS level. The levels of pro-inflammatory cytokines were assessed using ELISA. In addition, MSP was employed to detect PTPN2 promoter methylation level. Our results revealed that DNMT3B and FGFR3 were significantly upregulated in AS patient tissues, whereas PTPN2 was downregulated. PTPN2 overexpression attenuate ox-LDL-induced ER stress, inflammation and apoptosis in HUVECs and ameliorated AS symptoms in vivo. PTPN2 could suppress FGFR3 expression in ox-LDL-treated HUVECs, and FGFR3 knockdown inhibited ER stress to attenuate ox-LDL-induced endothelial cell apoptosis. DNMT3B could negatively regulate PTPN2 expression and positively FGFR2 expression in ox-LDL-treated HUVECs; DNMT3B activated FGFR2 expression by increasing PTPN2 promoter methylation level. DNMT3B downregulation repressed ox-LDL-induced ER stress, inflammation and cell apoptosis in endothelial cells, which was reversed by PTPN2 silencing. DNMT3B activated FGFR3-mediated ER stress by increasing PTPN2 promoter methylation level and suppressed its expression, thereby boosting ER stress to facilitate AS progression.

Predictive value of the early postoperative hemoglobin-to-red blood cell distribution width ratio for acute kidney injury in elderly intertrochanteric fracture patients.

BACKGROUND: Hemoglobin-to-red blood cell distribution width ratio (HRR) had great predictive value for the prognosis of malignant tumors and cardiovascular disease. However, its predictive value for the occurrence of acute kidney injury (AKI) in elderly intertrochanteric fracture patients remains unclear. This study aims to analyze the correlation between the early postoperative HRR and the risk of postoperative AKI in elderly intertrochanteric fracture patients. METHODS: We reviewed the medical records of 307 elderly intertrochanteric fracture patients in this single-center retrospective cohort study. We performed univariate analysis on the relevant parameters, and parameters with significant differences were included in the following logistic regression model for multivariate analysis. Then, we used a receiver operating characteristic (ROC) curve to evaluate the predictive value of the early postoperative HRR level for AKI in elderly intertrochanteric fracture patients. Patients were divided into a high HRR group and a low HRR group according to the cutoff point determined by ROC curve analysis. Subsequently, the relevance between postoperative HRR and AKI was further determined using propensity score matching (PSM) and inverse probability of treatment weighting (IPTW). RESULTS: The area under the curve of the early postoperative HRR for predicting postoperative AKI was 0.714 (95% CI: 0.618-0.809). The cutoff value was 5.44. The sensitivity was 72.7%, and the specificity was 70.8%. Patients were divided into low HRR (⩽ 5.44) and high HRR (> 5.44) groups according to the cutoff value. PSM and IPTW analysis indicated that the risk of AKI in the low HRR group was significantly higher than that in the high HRR group in both the matched cohort (OR = 6.914, 95% CI: 1.714-46.603, p = 0.016) and the weighted group (OR = 2.784, 95% CI: 1.415-5.811, p = 0.040). CONCLUSIONS: Early postoperative HRR is an accurate, accessible, and economical blood test parameter that can predict the risk of postoperative AKI in elderly patients with femoral intertrochanteric fracture.

Convergence of carbon sink magnitude and water table depth in global wetlands.

Wetlands are strategic areas for carbon uptake, but accurate assessments of their sequestration ability are limited by the uncertainty and variability in their carbon balances. Based on 2385 observations of annual net ecosystem production from global wetlands, we show that the mean net carbon sinks of inland wetlands, peatlands and coastal wetlands are 0.57, 0.29 and 1.88 tons of carbon per hectare per year, respectively, with a mean value of 0.57 tons of carbon per hectare per year weighted by the distribution area of different wetland types. Carbon sinks are mainly in Asia and North America. Within and across wetland types, we find that water table depth (WTD) exerts greater control than climate- and ecosystem-related variables, and an increase in WTD results in a stronger carbon sink. Our results highlight an urgent need to sustain wetland hydrology under global change; otherwise, wetlands are at high risk of becoming carbon sources to the atmosphere.

Thermal adaptation of microbial respiration persists throughout long-term soil carbon decomposition.

Soil microbial respiration is expected to show adaptations to changing temperatures, greatly weakening the magnitude of feedback over time, as shown in labile carbon substrates. However, whether such thermal adaptation persists during long-term soil carbon decomposition as carbon substrates decrease in decomposability remains unknown. Here, we conducted a 6-year incubation experiment in natural and arable soils with distinct properties under three temperatures (10, 20 and 30°C). Mass-specific microbial respiration was consistently lower under higher long-term incubation temperatures, suggesting the occurrence and persistence of microbial thermal adaptation in long-term soil carbon decomposition. Furthermore, changes in microbial community composition and function largely explained the persistence of microbial respiratory thermal adaptation. If such thermal adaptation generally occurs in large low-decomposability carbon pools, warming-induced soil carbon losses may be lower than previously predicted and thus may not contribute as much as expected to greenhouse warming.

Opposing seasonal temperature dependencies of CO2 and CH4 emissions from wetlands.

Wetlands are critically important to global climate change because of their role in modulating the release of atmospheric greenhouse gases (GHGs) carbon dioxide (CO2 ) and methane (CH4 ). Temperature plays a crucial role in wetland GHG emissions, while the general pattern for seasonal temperature dependencies of wetland CO2 and CH4 emissions is poorly understood. Here we show opposite seasonal temperature dependencies of CO2 and CH4 emissions by using 36,663 daily observations of simultaneous measurements of ecosystem-scale CO2 and CH4 emissions in 42 widely distributed wetlands from the FLUXNET-CH4 database. Specifically, the temperature dependence of CO2 emissions decreased with increasing monthly mean temperature, but the opposite was true for that of CH4 emissions. Neglecting seasonal temperature dependencies may overestimate wetland CO2 and CH4 emissions compared to the use of a year-based static and consistent temperature dependence parameter when only considering temperature effects. Our findings highlight the importance of incorporating the remarkable seasonality in temperature dependence into process-based biogeochemical models to predict feedbacks of wetland GHG emissions to climate warming.

Low soil moisture suppresses the thermal compensatory response of microbial respiration.

The thermal compensatory response of microbial respiration contributes to a decrease in warming-induced enhancement of soil respiration over time, which could weaken the positive feedback between the carbon cycle and climate warming. Climate warming is also predicted to cause a worldwide decrease in soil moisture, which has an effect on the microbial metabolism of soil carbon. However, whether and how changes in moisture affect the thermal compensatory response of microbial respiration are unexplored. Here, using soils from an 8-year warming experiment in an alpine grassland, we assayed the thermal response of microbial respiration rates at different soil moisture levels. The results showed that relatively low soil moisture suppressed the thermal compensatory response of microbial respiration, leading to an enhanced response to warming. A subsequent moisture incubation experiment involving off-plot soils also showed that the response of microbial respiration to 100 d warming shifted from a slight compensatory response to an enhanced response with decreasing incubation moisture. Further analysis revealed that such respiration regulation by moisture was associated with shifts in enzymatic activities and carbon use efficiency. Our findings suggest that future drought induced by climate warming might weaken the thermal compensatory capacity of microbial respiration, with important consequences for carbon-climate feedback.

Efficacy and safety of super-mini percutaneous nephrolithotomy in the treatment of urinary calculi: a systematic review and meta-analysis.

BACKGROUND: Super-mini-percutaneous nephrolithotomy (SMP) is feasible and safe in adults and children with moderate-size renal calculi, but the use of SMP to remove larger calculi has yet to be determined. This study aimed to review the efficacy (stone-free rate, SFR) and safety of SMP in treating urinary calculi. METHODS: PubMed, the Cochrane Library, and Embase were searched for eligible studies published up to May 2021. The primary outcome was the SFR. The secondary outcomes were the complications (using the Clavien-Dindo grading system), pain score, hospitalization days, and mean hemoglobin decline. All analyses were performed using the random-effects model. Nine studies (2433 patients with SMP and 2178 controls) were included. RESULTS: SMP was not associated with an improved SFR in patients with calculi (RR = 1.05, 95%CI: 0.99-1.11). There were no differences in the occurrence of Clavien-Dindo I (RR = 0.95, 95%CI: 0.67-1.35) and Clavien-Dindo II (RR = 0.91, 95%CI: 0.58-1.42) complications between SMP and the control procedures. There were more Clavien-Dindo III complications with SMP than with the control procedures (RR = 0.71, 95%CI: 0.55-0.91), but none of the individual complications significantly differed between the two groups. Clavien-Dindo I fever appeared to be higher with SMP than with the control procedure (RR = 0.64, 95%CI: 0.50-0.83). CONCLUSION: In terms of efficacy, there were no differences between SMP and other procedures in treating urinary calculi. Clavien-Dindo I fever and Clavien-Dindo III complications might be more frequent with SMP than other procedures.

Microbial respiratory thermal adaptation is regulated by r-/K-strategy dominance.

Microbial thermal adaptation is considered to be one of the core mechanisms affecting soil carbon cycling. However, the role of microbial community composition in controlling thermal adaptation is poorly understood. Using microbial communities from the rhizosphere and bulk soils in an 8-year warming experiment as a model, we experimentally demonstrate that respiratory thermal adaptation was much stronger in microbial K-strategist-dominated bulk soils than in microbial r-strategist-dominated rhizosphere soils. Soil carbon availability exerted strong selection on the dominant ecological strategy of the microbial community, indirectly influencing respiratory thermal adaptation. Our findings shed light on the linchpin of the dominant ecological strategy exhibited by the microbial community in determining its respiratory thermal adaptation, with implications for understanding soil carbon losses under warming.

Thermal adaptation occurs in the respiration and growth of widely distributed bacteria.

Soil microbial respiration is an important factor in regulating carbon (C) exchange between the soil and atmosphere. Thermal adaptation of soil microorganisms will lead to a weakening of the positive feedback between climate warming and soil respiration. The thermal adaptation of microbial communities and fungal species has been proven. However, studies on the thermal adaptation of bacterial species, the most important decomposers in the soil, are still lacking. Here, we isolated six species of widely distributed dominant bacteria and studied the effects of constant warming and temperature fluctuations on those species. The results showed that constant warming caused a downregulation of respiratory temperature sensitivity (Q10 ) of the bacterial species, accompanied by an elevation of the minimum temperature (Tmin ) required for growth. Similar results were seen with the addition of temperature fluctuations, suggesting that both scenarios caused a significant thermal adaptation among the bacterial species. Fluctuating and increasing temperatures are considered an important component of future warming. Therefore, the inclusion of physiological responses of bacteria to these changes is essential to understand relationships between microbiota and temperature and enhance the prediction of global soil-atmosphere C feedbacks.

Sexual Activity and Related Factors of Older Women in Hunan, China: A Cross-Sectional Study.

BACKGROUND: Sexuality has an important impact on people's physical and mental health, but current research on the sexual activity of older Chinese women has many limitations and more detailed studies are needed. AIM: The objective was to determine the prevalence of sexual activity and related factors in women aged 55 to 85 years in Hunan, China. METHODS: Based on the data from the Hunan Provincial Women Health Needs Survey in 2018, we conducted a secondary analysis of 2,401 older women aged 55 and above. The dependent variable was sexual activity, and independent variables included sociodemographic characteristics, health behaviors, reproductive and chronic medical history, and psychological characteristics. All statistical analyses were performed using SPSS 26.0. Chi-square test was used to assess the association between categorical variables, and binary logistic regression was used to examine factors related to sexual activity. OUTCOMES: Sexual activity and related factors. RESULTS: The prevalence of sexual activity among older women was 12.5% (301/2401) in the past month. Having a partner (OR = 1.484; 95% CI, 1.048-2.101; P = .026), jogging (OR = 2.061; 95% CI, 1.391-3.054; P < .001), dancing (OR = 1.477; 95% CI, 1.106-1.974; P = .008), vegetarian-based diet (OR = 2.197; 95% CI, 1.334-3.618; P = .002), meat-based diet (OR = 2.196; 95% CI, 1.144-4.216; P = .018) were positively associated with being sexually active. Whereas, aging (OR = 0.781; 95% CI, 0.647-0.942; P = .010), living in the urban (OR = 0.628; 95% CI, 0.488-0.808; P < .001), hypertension (OR = 0.702; 95% CI, 0.520-0.949; P = .021), and anxiety (OR = 0.680; 95% CI, 0.475-0.972; P = .034) were negatively associated with being sexually active. CLINICAL IMPLICATIONS: Health care workers need to be aware that older women still have sexual activity and understand the needs of older women for sex education, take the initiative to discuss safe sex with them, and solve their sexual problems. STRENGTHS AND LIMITATIONS: This is one of the largest studies to determine the prevalence of sexual activity among older women in China and its related factors. In addition, new factors such as exercise types and eating habits related to sexual activity were discovered. The limitation of this study is that it did not use a specific questionnaire to assess the sexual activity and did not consider physical tenderness other than sexual intercourse. CONCLUSIONS: Some older women still have had sexual activity in the past month and factors such as lifestyles that can be changed and chronic diseases that can be self-managed were found to predict sexual activity. Li T, LuoY, Meng Y, et al. Sexual Activity and Related Factors of Older Women in Hunan, China: A Cross-Sectional Study. J Sex Med 2022;19:302-310.

Improved LDTW Algorithm Based on the Alternating Matrix and the Evolutionary Chain Tree.

Dynamic time warping under limited warping path length (LDTW) is a state-of-the-art time series similarity evaluation method. However, it suffers from high space-time complexity, which makes some large-scale series evaluations impossible. In this paper, an alternating matrix with a concise structure is proposed to replace the complex three-dimensional matrix in LDTW and reduce the high complexity. Furthermore, an evolutionary chain tree is proposed to represent the warping paths and ensure an effective retrieval of the optimal one. Experiments using the benchmark platform offered by the University of California-Riverside show that our method uses 1.33% of the space, 82.7% of the time used by LDTW on average, which proves the efficiency of the proposed method.

Cross-phytogroup assessment of foliar epiphytic mycobiomes.

The foliar surface forms one of the largest aboveground habitats on Earth and maintains plant-fungus relationships that greatly affect ecosystem functioning. Despite many studies with particular plant species, the foliar epiphytic mycobiome has not been studied across a large number of plant species from different taxa. Using high-throughput sequencing, we assessed epiphytic mycobiomes on leaf surfaces of 592 plant species in a botanical garden. Plants of angiosperms, gymnosperms, and pteridophytes were involved. Plant taxonomy, leaf side, growing environment, and evolutionary relationships were considered. We found that pteridophytes showed the higher fungal species diversity, stronger mutualistic fungal interactions, and a greater percentage of putative pathogens than gymnosperms and angiosperms. Plant taxonomic group, leaf side, and growing environment were significantly associated with the foliar epiphytic mycobiome, but the similarity of the mycobiomes among plants was not directly related to the distance of the host evolutionary tree. Our results provide a general understanding of the foliar fungal mycobiomes from pteridophytes to angiosperms. These findings will facilitate our understanding of foliar fungal epiphytes and their roles in plant communities and ecosystems.

Temperature adaptation of soil microbial respiration in alpine, boreal and tropical soils: An application of the square root (Ratkowsky) model.

Warming is expected to stimulate soil microbial respiration triggering a positive soil carbon-climate feedback loop while a consensus remains elusive regarding the magnitude of this feedback. This is partly due to our limited understanding of the temperature-adaptive response of soil microbial respiration, especially over broad climatic scales. We used the square root (Ratkowsky) model to calculate the minimum temperature for soil microbial respiration (Tmin , which describes the temperature adaptation of soil microbial respiration) of 298 soil samples from alpine grasslands on the Tibetan Plateau and forest ecosystems across China with a mean annual temperature (MAT) range from -6°C to +25°C. The instantaneous soil microbial respiration was determined between 4°C and 28°C. The square root model could well fit the temperature effect on soil microbial respiration for each individual soil, with R2 higher than 0.98 for all soils. Tmin ranged from -8.1°C to -0.1°C and increased linearly with increasing MAT (R2  = 0.68). MAT dominantly regulated Tmin variation when accounting simultaneously for multiple other drivers (mean annual precipitation, soil pH and carbon quality); an independent experiment showed that carbon availability had no significant effect on Tmin . Using the relationship between Tmin and MAT, soil microbial respiration after an increased MAT could be estimated, resulting in a relative increase in respiration with decreasing MAT. Thus, soil microbial respiration responses are adapted to long-term temperature differences in MAT. We suggest that Tmin  = -5 + 0.2 × MAT, that is, every 1°C rise in MAT is estimated to increase Tmin of respiration by approximately 0.2°C, could be used as a first approximation to incorporate temperature adaptation of soil microbial respiration in model predictions. Our results can be used to predict future changes in the response of soil microbial respiration to temperature over different levels of warming and across broad geographic scales with different MAT.

Spatiotemporal variability of fire effects on soil carbon and nitrogen: A global meta-analysis.

A consensus about the fire-related soil carbon (C) and nitrogen (N) impacts that determine soil health and ecosystem services at the global scale remains elusive. Here, we conducted a global meta-analysis of 3173 observations with 1444, 1334, 228, and 167 observations for soil C, N, pyrogenic C (PyC), and the percent of PyC to total organic C (PyC/TOC) from 296 field studies. Results showed that fire significantly decreased soil C (-15.2%) and N (-14.6%) but increased soil PyC (40.6%) and PyC/TOC (30.3%). Stronger negative fire impacts on soil C and N were found in tropical and temperate climates than in Mediterranean and subtropical climates; stronger effects were found in forest ecosystems than in non-forest ecosystems. Wildfire and high-severity fire led to greater soil C and N losses than prescribed and low-severity fires, respectively, while they promoted greater increases in soil PyC and PyC/TOC than prescribed and low-severity fires, respectively. However, soil C and N recovered to control levels approximately 10 years after fire, which is a shorter period than previously determined. These results suggest that fire-induced PyC production should be accounted for in the C budget under global change. These results will improve our knowledge of the spatiotemporal variability of fire effects on soil C and N storage and have implications for fire management and ecosystem recovery.

Multiple gene integration to promote erythritol production on glycerol in Yarrowia lipolytica.

OBJECTIVE: Erythritol (1,2,3,4-butanetetrol) is a 4-carbon sugar alcohol that occurs in nature as a metabolite or storage compound. In this study, a multiple gene integration strategy was employed to enhance erythritol production in Y. lipolytica. RESULTS: The effects on the production of erythritol in Y. lipolytica of seven key genes involved in the erythritol synthesis pathway were evaluated individually, among which transketolase (TKL1) and transaldolase (TAL1) showed important roles in enhancing erythritol production. The combined overexpression of four genes (GUT1, TPI1, TKL1, TAL1) and disruption of the EYD1 gene (encoding erythritol dehydrogenase), resulted in produce approximately 40 g/L erythritol production from glycerol. Further enhanced erythritol synthesis was obtained by overexpressing the RKI1 gene (encoding ribose 5-phosphate isomerase) and the AMPD gene (encoding AMP deaminase), indicating for the first time that these two genes are also related to the enhancement of erythritol production in Y. lipolytica. CONCLUSIONS: A combined gene overexpression strategy was developed to efficiently improve the production of erythritol in Y. lipolytica, suggesting a great capacity and promising potential of this non-conventional yeast in converting glycerol into erythritol.

Biogeographic variation in temperature sensitivity of decomposition in forest soils.

Determining soil carbon (C) responses to rising temperature is critical for projections of the feedbacks between terrestrial ecosystems, C cycle, and climate change. However, the direction and magnitude of this feedback remain highly uncertain due largely to our limited understanding of the spatial heterogeneity of soil C decomposition and its temperature sensitivity. Here we quantified C decomposition and its response to temperature change with an incubation study of soils from 203 sites across tropical to boreal forests in China spanning a wide range of latitudes (18°16' to 51°37'N) and longitudes (81°01' to 129°28'E). Mean annual temperature (MAT) and mean annual precipitation primarily explained the biogeographic variation in the decomposition rate and temperature sensitivity of soils: soil C decomposition rate decreased from warm and wet forests to cold and dry forests, while Q10-MAT (standardized to the MAT of each site) values displayed the opposite pattern. In contrast, biological factors (i.e. plant productivity and soil bacterial diversity) and soil factors (e.g. clay, pH, and C availability of microbial biomass C and dissolved organic C) played relatively small roles in the biogeographic patterns. Moreover, no significant relationship was found between Q10-MAT and soil C quality, challenging the current C quality-temperature hypothesis. Using a single, fixed Q10-MAT value (the mean across all forests), as is usually done in model predictions, would bias the estimated soil CO2 emissions at a temperature increase of 3.0°C. This would lead to overestimation of emissions in warm biomes, underestimation in cold biomes, and likely significant overestimation of overall C release from soil to the atmosphere. Our results highlight that climate-related biogeographic variation in soil C responses to temperature needs to be included in next-generation C cycle models to improve predictions of C-climate feedbacks.

Human eutrophication drives biogeographic salt marsh productivity patterns in China.

Salt marshes are important natural carbon sinks with a large capacity to absorb exogenous nutrient inputs. The effects of nutrients on biogeographic productivity patterns, however, have been poorly explored in salt marshes. We conducted field surveys to examine how complex environments affect productivity of two common salt marsh plants, invasive Spartina alterniflora and native Phragmites australis, along an 18,000-km latitudinal gradient on the Chinese coastline. We harvested peak aboveground biomass as a proxy for productivity, and measured leaf functional traits (e.g., leaf area, specific leaf area [SLA], leaf nitrogen [N] and phosphorus [P]), soil nutrients (dissolved inorganic N [DIN] and available P [AP]), and salinity. We compiled data on mean annual temperature (MAT) and exogenous nutrients (both N and P). Then, we examined how these abiotic factors affect salt marsh productivity using both linear mixed effect models and structural equation modeling. Using a trait-based approach, we also examined how salt marsh productivity responds to changing environments across latitude. Exogenous nutrients (both N and P), compared with temperature and other variables (e.g., DIN, AP, salinity), were the dominant factors in explaining the biogeographic productivity patterns of both S. alterniflora and P. australis. Leaf size-related traits (e.g., leaf area), rather than leaf economic traits (e.g., SLA, leaf N and P), can be used to indicate the positive effects of exogenous nutrients on the productivity of these two species. Our results demonstrated that human eutrophication surpassed temperature as the major driver of biogeographic salt marsh productivity pattern, challenging current models in which biogeographic productivity pattern is primarily controlled by temperature. Our findings have potential broad implications for the management of S. alterniflora, which is a global invader, as it has benefited from coastal eutrophication. Furthermore, exogenous nutrient availability and leaf size need to be integrated into earth system models that are used to predict global plant productivity in salt marshes.

Analysis of risk factors and prevention strategies for functional delayed gastric emptying in 1243 patients with distal gastric cancer.

BACKGROUND: Analysis of the risk factors associated with functional delayed gastric emptying after distal gastric cancer surgery to provide a basis for further reduction of the incidence of this complication. METHODS: Total of 1382 patients with distal gastric cancer from January 2016 to October 2018 were enrolled. Correlation analysis was performed in 53 patients with FDGE by logistic regression. Subgroup risk analysis was performed in 114 patients with preoperative pyloric obstruction. A Pearson Chi-square analysis was used to compare categorical variables between normal distribution groups. Meanwhile, a t test was used to compare continuous variables between groups. Odds ratio (OR) was used for comparison of the two groups, and it was summarized with its 95% confidence interval (CI) and p value using logistic regression. RESULT: In multivariable analysis, age (OR 1.081, 95% CI, 1.047-1.117), BMI (OR 1.233, 95% CI, 1.116-1.363), preoperative pyloric obstruction (OR 3.831, 95% CI, 1.829-8.023), smaller volume of residual stomach (OR 1.838, 95% CI, 1.325-6.080), and anastomosis in greater curvature perpendicular (OR 3.385, 95% CI, 1.632-7.019) and in greater curvature parallel (OR 2.375, 95% CI, 0.963-5.861) were independent risk factors of FDGE. In the preoperative pyloric obstruction group, higher BMI (OR 1.309, 95% CI, 1.086-1.579) and preoperative obstruction time (OR 1.054, 95% CI, 1.003-1.108) were independent risk factors of FDGE and preoperative gastrointestinal decompression (OR 0.231, 95% CI, 0.068-0.785) was independent protective factor of FDGE. CONCLUSION: Adequate gastrointestinal decompression should be performed before the operation to reduce the incidence of postoperative gastroparesis in patients with preoperative pyloric obstruction. We also could improve the surgical methods to reduce the occurrence of FDGE, such as controlling the size of the residual stomach, ensuring blood supply. Especially selecting an appropriate stapler and anastomosis during the anastomosis process, the occurrence of FDGE can be reduced.

Nitrosporeusine A attenuates sepsis-associated acute kidney injury through the downregulation of IL-6/sIL-6R axis activation-mediated PGC-1α suppression.

Nitrosporeusine A (NA) has been recently reported to exert anti-inflammatory and renal protective effects, but whether NA can attenuate sepsis-associated acute kidney injury (AKI) has not yet been reported. In this study, our results found that cecal ligation and puncture (CLP) reduced renal PGC-1α expression and induced oxidative stress in C57BL/6 mice. PGC-1α overexpression attenuated CLP-induced AKI with decreased oxidative stress, whereas worsened AKI with excessive reactive oxygen species (ROS) production was observed in renal specific PGC-1α knockout (NiPKO) mice. In addition, PGC-1α expression is retained in IL-6-/- mice and wild-type (WT) C57BL/6 mice received JAK2/STAT3 inhibition. Finally, administration of NA attenuated CLP-induced AKI with decreased IL-6/sIL-6R axis activation, increased PGC-1α expression, and diminished ROS production in injured kidneys. However, NA failed to attenuate CLP-induced AKI in NiPKO mice. Together, these results suggested that NA attenuates sepsis-associated AKI through the downregulation of IL-6/sIL-6R axis activation-mediated renal PGC-1α suppression.