Investigation of the regulatory effects of water and nitrogen supply on nitrogen transport and distribution in wolfberry fields.

Resource-based water shortages, uncoordinated irrigation, and fertilization are prevalent challenges in agricultural production. The scientific selection of appropriate water and fertilizer management methods is important for improving the utilization efficiency of agricultural resources and alleviating agricultural non-point source pollution. This study focused on wolfberry and compared the effects of four irrigation levels [full irrigation (W0, 75%-85% θf), slight water deficit (W1, 65%-75% θf), moderate water deficit (W2, 55%-65% θf), and severe water deficit (W3, 45%-55% θf)] and four nitrogen application levels [no nitrogen application (N0, 0 kg·ha-1), low nitrogen application (N1, 150 kg·ha-1), medium nitrogen application (N2, 300 kg·ha-1), and high nitrogen application (N3, 450 kg·ha-1)] on soil nitrate nitrogen (NO3 --N) transport, plant nitrogen allocation, and soil nitrous oxide (N2O) emissions during the harvest period of wolfberry. And this study used CRITIC-entropy weights-TOPSIS model to evaluate 16 water and nitrogen regulation models comprehensively. The results revealed the following: (1) The NO3 --N content of the soil decreased with increasing horizontal distance from the wolfberry. It initially decreased, then increased, and finally decreased with an increase in soil depth. The average NO3 --N content in the 0-100 cm soil layer ranged from 3.95-13.29 mg·kg-1, indicating that W0 > W1, W2, W3, and N3 > N2 > N1 > N0. (2) The soil NO3 --N accumulation ranged from 64.45-215.27 kg·ha-1 under varying water and nitrogen levels, demonstrating a decreasing trend with increasing horizontal distance. The NO3 --N accumulation at each horizontal distance increased with increasing irrigation and nitrogen application. The NO3 --N accumulation of W0N3 treatment increased by 5.55%-57.60% compared with the other treatments. (3) The total nitrogen content and nitrogen uptake in all wolfberry organs were W1 > W0 > W2 > W3, and N2 > N3 > N1 > N0. The maximum total nitrogen content and nitrogen uptake in W1N2 treatment were 3.25% and 27.82 kg·ha-1 in the roots, 3.30% and 57.19 kg·ha-1 in the stems, 3.91% and 11.88 kg·ha-1 in the leaves, and 2.42% and 63.56 kg·ha-1 in the fruits, respectively. (4) The emission flux and total emission of N2O increased with increasing irrigation and nitrogen application. The emission flux exhibited a transient peak (116.39-177.91 ug·m-2·h-1) after irrigation. The intensity of N2O emissions initially decreased and then increased with an increase in the irrigation amount. It also initially increased with increasing nitrogen application amount, then decreased, and finally increased again. The maximum emission intensity was observed under the W3N3 treatment (0.23 kg·kg-1). The N2O emission coefficients ranged from 0.17%-0.39%, in the order of W0 > W1 > W2 > W3 (except for N1) and N1 > N2 > N3. (5) Under varying water and nitrogen concentrations, N2O emission flux showed a positive linear correlation with soil pore water content and NO3 --N content and a negative linear correlation with soil temperature. The comprehensive evaluation revealed that a slight water deficit (65%-75% θf) combined with medium nitrogen application (300 kg·ha-1) decreased soil NO3 --N leaching, increased nitrogen uptake, and reduced N2O emission. These findings can serve as a reference for improving the efficiency and reducing emissions of wolfberry in the Yellow River irrigation region of Gansu Province and in similar climate zones.

Exploration of lymph node recurrence patterns and delineation guidelines of radiation field in middle thoracic oesophageal carcinomas after radical surgery: a real-world study.

BACKGROUND: Oesophageal squamous cell carcinoma is one of the most commonly diagnosed carcinomas in China, and postoperative radiotherapy plays an important role in improving the prognosis of patients. Carcinomas in different locations of the oesophagus could have different patterns of lymph node metastasis after surgery. METHODS: In this multicentric retrospective study, we enrolled patients with middle thoracic oesophageal squamous cell carcinomas from 3 cancer centres, and none of the patients underwent radiotherapy before or after surgery. We analysed the lymph node recurrence rates in different stations to explore the postoperative lymphatic recurrence pattern. RESULTS: From January 1st, 2014, to December 31st, 2019, 132 patients met the criteria, and were included in this study. The lymphatic recurrence rate was 62.1%. Pathological stage (P = 0.032) and lymphadenectomy method (P = 0.006) were significant predictive factors of lymph node recurrence. The recurrence rates in the supraclavicular, upper and lower paratracheal stations of lymph nodes were 32.6%, 28.8% and 16.7%, respectively, showing a high incidence. The recurrence rate of the subcarinal node station was 9.8%, while 8.3% (upper, middle and lower) thoracic para-oesophageal nodes had recurrences. CONCLUSIONS: We recommend including the supraclavicular, upper and lower paratracheal stations of lymph nodes in the postoperative radiation field in middle thoracic oesophageal carcinomas. Subcarinal station is also potentially high-risk, while whether to include thoracic para-oesophageal or abdominal nodes needs careful consideration.

Effects of Water and Nitrogen Control on the Growth Physiology, Yields, and Economic Benefits of Lycium barbarum Plants in a Lycium barbarum + Alfalfa System.

In the production of economic forests, there are common issues such as excessive application of water and fertilizer, redundant plant growth, and low economic benefits. Reasonable water and fertilizer management can not only help address these problems but also improve the absorption and use efficiency of water and fertilizer resources by plants, promoting the green and efficient development of the fruit and forestry industry. In order to explore a suitable water and nitrogen management mode for Lycium barbarum, field experiments were conducted in this study from 2021 to 2022. Specifically, four irrigation modes (according to the proportion ratio of soil moisture content to field moisture capacity θf, 45-55% θf (W1, severe water deficiency), 55-65% θf (W2, moderate water deficiency), 65-75% θf (W3, mild water deficiency), and 75-85% θf (W4, sufficient irrigation)) and four nitrogen application levels (0 kg·ha-1 (N0, no nitrogen application), 150 kg·ha-1 (N1, low nitrogen application level), 300 kg·ha-1 (N2, medium nitrogen application level), and 450 kg·ha-1 (N3, high nitrogen application level)) were set up to analyze the influences of water and nitrogen control on the plant height, stem diameter, chlorophyll content, photosynthetic characteristics and yield, and economic benefits of Lycium barbarum in the Lycium barbarum + Alfalfa system. The study results show that the plant height and stem diameter increment of Lycium barbarum increase with the irrigation amount, increasing first and then decreasing with the increase in the nitrogen application level. Meanwhile, the chlorophyll contents in Lycium barbarum continuously increase throughout their growth periods, with Lycium barbarum treated with W4N2 during all growth periods presenting the highest contents of chlorophyll. In a Lycium barbarum + Alfalfa system, the daily variation curve of the Lycium barbarum net photosynthetic rate presents a unimodal pattern, with maximum values of the daily average net photosynthetic rate and daily carboxylation rate appearing among W4N2-treated plants (19.56 µmol·m-2·s-1 and 157.06 mmol·m-2·s-1). Meanwhile, the transpiration rates of Lycium barbarum plants continuously decrease with the increased degree of water deficiency and decreased nitrogen application level. W1N2-treated plants exhibit the highest leaf daily average water use efficiency (3.31 µmol·s-1), presenting an increase of 0.50-10.47% in efficiency compared with plants under other treatments. The coupling of water and nitrogen has significantly improved the yields and economic benefits of Lycium barbarum plants, with W4N2-treated and W3N2-treated plants presenting the highest dried fruit yield (2623.07 kg·ha-1) and net income (50,700 CNY·ha-1), respectively. Furthermore, compared with other treatment methods, these two treatment methods (W4N2 and W3N2) exhibit increases of 4.04-84.08% and 3.89-123.35% in dried fruit yield and net income indexes, respectively. Regression analysis shows that, in a Lycium barbarum + Alfalfa system, both high yields and economic benefits of Lycium barbarum plants can be achieved using an irrigation amount of 4367.33-4415.07 m3·ha-1 and a nitrogen application level of 339.80-367.35 kg·ha-1. This study can provide a reference for improving the productivity of Lycium barbarum plants and achieving a rational supply of water and nitrogen in Lyciun barbarum + Alfalfa systems in the Yellow River Irrigation Area of Gansu, China, and other similar ecological areas.

Role of 18F-FDG PET/CT in the detection of eosinophilic esophagitis.

Eosinophilic esophagitis (EoE) is a rare immune-mediated chronic inflammatory disease of the esophagus. The main symptoms are dysphagia, retrosternal pain, and repeated food impaction. Esophageal eosinophilic infiltration is seen on histopathological examination. Progressive esophageal stenosis and other complications may occur if not detected and treated. We report a patient with pathologically confirmed EoE whose disease was detected on fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). This case demonstrates the important role of 18F-FDG PET/CT in the diagnosis of eosinophilic esophagitis.

Development and validation of a nomogram model for predicting low muscle mass in patients undergoing hemodialysis.

BACKGROUND: Muscle mass is important in determining patients' nutritional status. However, measurement of muscle mass requires special equipment that is inconvenient for clinical use. We aimed to develop and validate a nomogram model for predicting low muscle mass in patients undergoing hemodialysis (HD). METHODS: A total of 346 patients undergoing HD were enrolled and randomly divided into a 70% training set and a 30% validation set. The training set was used to develop the nomogram model, and the validation set was used to validate the developed model. The performance of the nomogram was assessed using the receiver operating characteristic (ROC) curve, a calibration curve, and the Hosmer-Lemeshow test. A decision curve analysis (DCA) was used to evaluate the clinical practicality of the nomogram model. RESULTS: Age, sex, body mass index (BMI), handgrip strength (HGS), and gait speed (GS) were included in the nomogram for predicting low skeletal muscle mass index (LSMI). The diagnostic nomogram model exhibited good discrimination with an area under the ROC curve (AUC) of 0.906 (95% CI, 0.862-0.940) in the training set and 0.917 (95% CI, 0.846-0.962) in the validation set. The calibration analysis also showed excellent results. The nomogram demonstrated a high net benefit in the clinical decision curve for both sets. CONCLUSIONS: The prediction model included age, sex, BMI, HGS, and GS, and it can successfully predict the presence of LSMI in patients undergoing HD. This nomogram provides an accurate visual tool for medical staff for prediction, early intervention, and graded management.

Low-protein diet supplemented with inulin lowers protein-bound toxin levels in patients with stage 3b-5 chronic kidney disease: a randomized controlled study.

Introduction: Objective: this study aimed to evaluate whether low-salt low-protein diet (LPD) supplemented with 10 g of inulin could lower serum toxin levels in patients with chronic kidney disease (CKD), thereby providing evidence for adjusting dietary prescriptions of inhospital patients and outpatient nutrition consultants. Methods: we randomized 54 patients with CKD into two groups. Dietary protein intake compliance was evaluated using a 3-day dietary diary and 24-h urine nitrogen levels. The primary outcomes were indoxyl sulfate (IS) and p-cresyl sulfate (PCS), and secondary outcomes included inflammation marker levels, nutritional status, and renal function. We assessed 89 patients for eligibility, and a total of 45 patients completed the study, including 23 and 22 in the inulin-added and control groups, respectively. Results: PCS values decreased in both groups after intervention: inulin-added group, ∆PCS -1.33 (-4.88, -0.63) µg/mL vs. LPD group, -4.7 (-3.78, 3.69) µg/mL (p = 0.058). PCS values reduced from 7.52 to 4.02 µg/mL (p < 0.001) in the inulin-added group (p < 0.001). Moreover, IS decreased from 3.42 (2.53, 6.01) µg/mL to 2.83 (1.67, 4.74) µg/mL after adding inulin; ∆IS was -0.64 (-1.48, 0.00) µg/mL, and a significant difference was observed compared with the control group (p = 0.004). The inflammation index decreased after intervention. Conclusion: dietary fiber supplementation may reduce serum IS and PCS levels and modulate their inflammatory status in predialysis CKD patients.

Introducción: Objetivo: este ensayo aleatorizado doble ciego comparó el efecto de una dieta baja en proteínas (LPD) con o sin suplementos orales de 10 g de inulina en los niveles de PBUT en pacientes con ERC en prediálisis durante 12 semanas. Métodos: clasificamos aleatoriamente a 54 pacientes con ERC en dos grupos. El cumplimiento de la ingesta dietética de proteínas se evaluó utilizando un diario dietético de 3 días y nitrógeno en orina de 24 horas. Los resultados primarios fueron IS y PCS y los resultados secundarios incluyeron niveles de marcadores de inflamación, estado nutricional y función renal. Evaluamos la elegibilidad de 89 pacientes y 45 completaron la intervención, incluidos 23 y 22 en los grupos de inulina añadida y de control, respectivamente. Resultados: el sodio urinario promedio de 24 horas fue de 86 mmol/día y la ingesta promedio de proteínas fue de ~0,7 g/kg/día. Los valores de PCS exhibieron una tendencia decreciente en ambos grupos después de la intervención: grupo con inulina añadida, ∆PCS -1.33 (-4.88, -0.63) µg/mL vs. grupo LPD, -4.7 (-3.78, 3.69) µg/mL) (p =0,058). Los valores de PCS se redujeron de 7,52 a 4,02 µg/mL (p < 0,001) con inulina (p < 0,001). Además, IS disminuyó de 3,42 (2,53, 6,01) µg/mL a 2,83 (1,67, 4,74) µg/mL después de agregar inulina; El ∆IS fue -0,64 (-1,48; 0,00) µg/mL y se observó una diferencia significativa en comparación con el grupo control (p =0,004). Conclusión: la suplementación con fibra dietética puede reducir las toxinas de unión a proteínas séricas en pacientes con ERC en prediálisis y modular su estado inflamatorio.

Comparative study of encapsulated cannabidiol ternary solid dispersions prepared by different techniques: The application of a novel technique jet milling.

Jet milling is a common technique in ultrafine powder preparation field. It has never been used to design delivery systems. Cannabidiol (CBD) is an important cannabinoid of hemp but poor aqueous solubility limited its applications. In this study, solid dispersion (SD) technique was combined with cyclodextrin complexation technique, and jet milling was used for the first time to prepare SDs for improving CBD solubility. Different characterizations demonstrated that the dispersion effect and complexation structure of CBD SD3 prepared by jet milling were comparable to that of CBD SD2 prepared by spray drying (a common solution-based method), and were better than that of CBD SD1 prepared by cogrinding. The water solubility of CBD was increased to 20.902 µg/mL (909-fold) in CBD SD3. Besides, the antioxidant activity and cytotoxicity to tumor cells of CBD were enhanced by dispersion. This work indicated that jet milling, as a new technique with low cost and excellent applicability, could be further developed for the delivery of food functional factors or bioactive molecules.

Effects of irrigation and nitrogen application on soil water and nitrogen distribution and water-nitrogen utilization of wolfberry in the Yellow River Irrigation Region of Gansu Province, China.

To address the problems of extensive field management, low productivity, and inefficient water and fertilizer utilization in wolfberry (Lycium barbarum L.) production, an appropriate water and nitrogen regulation model was explored to promote the healthy and sustainable development of the wolfberry industry. Based on a field experiment conducted from 2021 to 2022, this study compared and analyzed the effects of four irrigation levels [75%-85% θf (W0, full irrigation), 65%-75% θf (W1, slight water deficit), 55%-65% θf (W2, moderate water deficit), and 45%-55% θf (W3, severe water deficit)] and four nitrogen application levels [0 kg·ha-1 (N0, no nitrogen application), 150 kg·ha-1 (N1, low nitrogen application), 300 kg·ha-1 (N2, medium nitrogen application), and 450 kg·ha-1 (N3, high nitrogen application)] on soil water distribution, soil nitrate nitrogen (NO3 --N) migration, yield, and water-nitrogen use efficiency of wolfberry. The soil moisture content of the 40-80 cm soil layer was higher than those of 0-40 cm and 80-120 cm soil layer. The average soil moisture content followed the order of W0 > W1 > W2 > W3 and N3 > N2 > N1 > N0. The NO3 --N content in the 0-80 cm soil layer was more sensitive to water and nitrogen regulation, and the cumulative amount of NO3 --N in the soil followed the order of W0 > W1> W2 > W3 and N3 > N2 > N1 > N0 during the vegetative growth period. There was no evidently change in soil NO3 --N accumulation between different treatments during the autumn fruit. The yield of wolfberry under the W1N2 treatment was the highest (2623.09 kg·ha-1), which was 18.04% higher than that under the W0N3 treatment. The average water consumption during each growth period of wolfberry was the highest during the full flowering period, followed by the vegetative growth and full fruit periods, and the lowest during the autumn fruit period. The water use efficiency reached a peak value of 6.83 kg·ha-1·mm-1 under the W1N2 treatment. The nitrogen uptake of fruit and nitrogen fertilizer recovery efficiency of fruit first increased and then decreased with increasing irrigation and nitrogen application. The treatment of W1N2 obtained the highest nitrogen uptake of fruit and nitrogen recovery efficiency of fruit, which were 63.56 kg·ha-1 and 8.17%, respectively. Regression analysis showed that the yield and water-nitrogen use efficiency of wolfberry improved when the irrigation amount ranged from 315.4 to 374.3 mm, combined with nitrogen application amounts of 300.0 to 308.3 kg·ha-1. Additionally, the soil NO3 --N residue was reduced, making it an optimal water and nitrogen management model for wolfberry planting. The present findings contribute novel insights into the production of wolfberry with saving water and reducing nitrogen, which helps to improve the level of wolfberry productivity in the Yellow River irrigation region of Gansu Province and other areas with similar climate.

Association of the modified creatinine index with muscle strength and mortality in patients undergoing hemodialysis.

BACKGROUND: In the updated consensus, low muscle strength overtook the role of low muscle mass, and probable sarcopenia was diagnosed once low muscle strength was detected. Whether the modified creatinine index (mCI) could identify persons with probable sarcopenia who may be at risk of adverse outcomes remains unknown. We aimed to evaluate the association of the mCI with probable sarcopenia and mortality in patients undergoing hemodialysis. METHODS: In the cross-sectional study (n = 346), univariate and multivariable logistic regression analyses were performed to study the association of mCI with probable sarcopenia. Modified Quantitative Subjective Global Assessment (MQSGA) was used to evaluate the nutritional status. The performance of the mCI value for identifying probable sarcopenia was analyzed using receiver operating characteristic (ROC) curve analysis. The appropriate cutoff points were determined using Youden's method. In the longitudinal cohort study composed of an independent hemodialysis cohort (n = 218), cox proportional regression models were used to evaluate crude and adjusted hazard ratios and 95% confidence intervals (CIs) of death by mCI and MQSGA. RESULTS: Cross-sectional results showed that after adjusting for confounders, the association of mCI with low muscle strength remained significant. The area under the curve (AUC) of the mCI to predict probable sarcopenia was 0.804 (95% CI, 0.744-0.863; p < 0.001) for men and 0.787 (95% CI, 0.711-0.864; p < 0.001) for women. The optimal mCI cutoff values were 21.07 mg/kg/d for men and 19.57 mg/kg/d for women, respectively. Longitudinal results showed that compared with those in the high mCI group, subjects in the low mCI group had a higher risk of death for all causes (adjusted HR, 2.51; 95% CI, 1.16-5.41; p = 0.019). Adding the mCI significantly improved the predictive accuracy for death with an increase in C-index from 0.785 to 0.805 (p = 0.026) and improved the net reclassification index (38.6%, p = 0.021), while adding MQSGA did not. CONCLUSION: The mCI is a predictor of muscle strength and survival in hemodialysis patients, and is preferable to the MQSGA for predicting death. Assessment of mCI could provide additional predictive and prognostic information to sarcopenia.

Ulex Europaeus Agglutinin-I-Based Magnetic Isolation for the Efficient and Specific Capture of SW480 Circulating Colorectal Tumor Cells.

The efficient and specific capture of circulating tumor cells (CTCs) from patients' peripheral blood is of significant value in precise cancer diagnosis and cancer therapy. As fine targeting molecules, lectins can recognize cancer cells specifically due to the abnormal glycosylation of molecules on the cancer cell membrane and the specific binding of lectin with glycoconjugates. Herein, a Ulex europaeus agglutinin-I (UEA-I)-based magnetic isolation strategy was developed to efficiently and specifically capture α-1,2-fucose overexpression CTCs from colorectal cancer (CRC) patients' peripheral blood. Using UEA-I-modified Fe3O4 magnetic beads (termed MB-UEA-I), up to 94 and 89% of target cells (i.e., SW480 CRC cells) were captured from the cell spiking complete cell culture medium and whole blood, respectively. More than 90% of captured cells show good viability and proliferation ability without detaching from MB-UEA-I. In combination with three-color immunocytochemistry (ICC) identification, MB-UEA-I has been successfully used to capture CTCs from CRC patients' peripheral blood. The experimental results indicate a correlation between CTC characterization and tumor metastasis. Specifically, MB-UEA-I can be applied to screen early CRC by capturing CTCs when served as a liquid biopsy. The presented work offers a new insight into developing cost-effective lectin-functionalized methods for biomedical applications.

The predictive value of bioimpedance-derived fluid parameters for cardiovascular events in patients undergoing hemodialysis.

BACKGROUND: It is becoming increasingly evident that the accurate assessment of fluid status is critical to ensure optimal care in patients undergoing hemodialysis (HD). Various fluid parameters, including overhydration (OH) and overhydration/extracellular water (OH/ECW%), which can be obtained using a bioimpedance spectroscopy device have been used to indicate the hydration status in such patients. This study aimed to explore the effect of these fluid parameters on cardiovascular events and determine which parameter was a better predictor of cardiovascular events (CVEs). METHODS: A total of 227 patients who underwent HD at the Hangzhou Hospital of Traditional Chinese Medicine were enrolled in this prospective study between December 2017 and August 2018. Clinical data were collected, and the fluid status of patients was assessed using a body composition monitor. The patients were followed up until December 2020. The primary outcomes were CVEs. The association between fluid parameters and CVEs was analyzed using Cox proportional hazards models. The areas under the curve (AUCs) of receiver operating characteristic analysis and improvement in the global chi-squared value were used to compare the predictive values of fluid parameters for CVEs. RESULTS: During a median follow-up of 31 months, 66 CVEs were recorded. The patients with a higher absolute hydration index (OH) and a relative hydration index (OH/ECW%) exhibited an increased risk of developing CVEs. After adjusting for confounding factors, both OH [hazard ratio (HR) 1.279 per L, 95% confidence interval (CI) 1.047-1.562; p = 0.016] and OH/ECW% (HR 1.061 per %, 95% CI 1.017-1.108; p = 0.006) were independently associated with CVEs. The predictive ability of the absolute hydration index was superior to the relative hydration index based on AUC calculations for CVEs. Furthermore, a greater change in χ2 in predicting CVEs was noted for the absolute hydration index. CONCLUSIONS: Both absolute hydration index and relative hydration index were found to be independent predictors of CVEs in univariate and multivariate analyses. Furthermore, the absolute hydration index had a better additive predictive value than the relative hydration index in predicting CVEs.

Efficacy and safety of a low-sodium diet and spironolactone in patients with stage 1-3a chronic kidney disease: a pilot study.

BACKGROUND: Excessive salt intake is associated with the deterioration of chronic kidney disease (CKD). Aldosterone is also known as an independent risk factor for kidney injury. Dietary sodium intake acts as a main stimulator in aldosterone-mediated kidney injury. Hence, this study aimed to further investigate the renal protective effects and safety of a low-sodium diet in combination with spironolactone (SPL) in stage 1-3a CKD. METHODS: This single-center, SPL-blinded randomized controlled trial recruited patients with stage 1-3a CKD, randomized into three groups, low-sodium (3 g/d salt) + placebo, medium-sodium (5 g/d salt) + SPL, and low-sodium (3 g/d salt) + SPL. Patients received 12 weeks of intervention. The primary and secondary endpoints were 24-h urine protein and estimated glomerular filtration rate (eGFR) at the end of the intervention, respectively. RESULTS: A total of 74 patients were analyzed eventually. Significantly decreased 24-h urine protein was found in all three groups, from 0.37 to 0.23 g/d (P = 0.004) in the low-sodium+placebo group, from 0.44 to 0.29 g/d (P = 0.020) in the medium-sodium+SPL group, and from 0.35 to 0.31 g/d (P = 0.013) in the low-sodium +SPL group. There were no significant differences among the three groups in 24-h urine protein amount change after intervention from pre-treatment values (P = 0.760, ITT set). The results of the 24-h urine protein by using PP set analysis was similar to the ITT set. No significant differences in eGFR, nutritional, metabolic, inflammatory, and other biomarkers were observed across all three groups (P > 0.05). No safety signal was observed. CONCLUSION: No additional benefit was observed when SPL was prescribed to patients already on a low-sodium diet (3.0 g/d). Still, small doses of SPL may benefit patients with poor sodium restriction. A combination of short-term low-dose SPL and ARB is safe for patients with stage 1-3a CKD, but blood potassium must be regularly monitored. TRIAL REGISTRATION: Name of the registry: Chinese clinical trial registry. TRIAL REGISTRATION NUMBER: ChiCTR1900026991. Date of registration: Retrospectively registered 28 October 2019. URL of trial registry record: http://www.chictr.org.cn/searchproj.aspx?title=&officialname=&subjectid=&secondaryid=&applier=&studyleader=ðicalcommitteesanction=&spo.

Postoperative lymphatic recurrence distribution and delineation of the radiation field in lower thoracic squamous cell esophageal carcinomas: a real-world study.

BACKGROUND: To study lymphatic recurrence distribution after radical surgery in the real world and guide clinical tumor volume delineation for regional lymph nodes during postoperative radiotherapy for lower thoracic squamous cell esophageal carcinomas. METHODS: We enrolled patients who underwent radical esophagectomy, without radiation before or after surgery, at 3 cancer hospitals. Patients were classified into groups according to tumor locations. We included patients with tumors in the lower thoracic segment and analyzed the postoperative lymph node recurrence mode. A cutoff value of 10% was used to differentiate high-risk lymph node drainage areas from others. RESULTS: We enrolled 1905 patients in the whole study series, including 652 thoracic esophageal carcinomas that met our inclusion criteria; there were 241 cases of lower thoracic esophageal carcinomas. 1st, 2nd, 4th, 7th, 8th groups of lymph nodes, according to the 8th edition of the AJCC classification, displayed as high-risk recurrence areas, representing 17.8%, 23.9%, 11.7%, 10.9% and 12.2% of lymph node recurrence. Stage III-IV tumors located in the lower segment of the thoracic esophagus showed a tendency to recur in the left gastric nodes (7.9%) and celiac nodes (10.6%). CONCLUSIONS: According to our results, we recommended including the 4th, 7th and 8th groups of lymph nodes in the radiation field, and for patients with stage III-IV disease, the 17th and 20th groups of nodes should be irradiated during postoperative treatment. Whether including 1st/2nd groups in preventive irradiation needed more proofs.

Research progress on intervention effect and mechanism of protocatechuic acid on nonalcoholic fatty liver disease.

Nonalcoholic fatty liver disease (NAFLD) has become a surge burden worldwide due to its high prevalence, with complicated deterioration symptoms such as liver fibrosis and cancer. No effective drugs are available for NALFD so far. The rapid growth of clinical demand has prompted the treatment of NAFLD to become a research hotspot. Protocatechuic acid (PCA) is a natural secondary metabolite commonly found in fruits, vegetables, grains, and herbal medicine. It is also the major internal metabolites of anthocyanins and other polyphenols. In the present manuscript, food sources, metabolic absorption, and efficacy of PCA were summarized while analyzing its role in improving NAFLD, as well as the mechanism involved. The results indicated that PCA could ameliorate NAFLD by regulating glucose and lipid metabolism, oxidative stress and inflammation, gut microbiota and metabolites. It was proposed for the first time that PCA might reduce NAFLD by enhancing the energy consumption of brown adipose tissue (BAT). However, the PCA administration mode and dose for NAFLD remain inconclusive. Fresh insights into the specific molecular mechanisms are required, while clinical trials are essential in the future. This review provides new targets and reasoning for the clinical application of PCA in the prevention and treatment of NAFLD.

Characterization and expression analysis of tandemly duplicated nicotinic acetylcholine receptors in pearl oysters after stimulation of pathogen-related molecular patterns.

Nicotinic acetylcholine receptors (nAChRs) are a class of ligand-gated ion channels that participate in signal transduction and are reported to play an important role in the immunomodulation of vertebrates and invertebrates. Previous studies have shown that the nAChRs in mollusks have undergone large-scale expansion after tandem repeats and retrotransposition, with the most expansion observed in bivalves. This study characterized the sequence of a tandem repeat nAChR unique to several bivalve mollusks and investigated its functions in Pinctada fucata martensii. Firstly, phylogenetic analysis revealed that the tandem arrays of nAChRs existed before bivalve differentiation and m ost tandem-replicated nAChR genes have a conserved genomic structure and domain combination. In present study, five tandemly duplicated nAChR genes were cloned from P. f. martensii and designated as PmnAChR-1 to PmnAChR-5. qRT-PCR analysis revealed that five PmnAChRs were specifically expressed in adult gills. In addition, after PAMP stimulation, the expression of PmnAChRs in hemocytes of P. f. martensii were strongly induced but exhibited different responses to different stimuli. PmnAChR-1, PmnAChR-4, and PmnAChR-5 exhibited strong and wide responsiveness to lipopolysaccharide (LPS) stimulation but had no response to peptidoglycan (PGN) stimulation. PmnAChR-2 expression was notably upregulated at 6 h after PGN challenge but had no response to LPS stimulation. Polyinosinic-polycytidylic acid challenge upregulated nearly all PmnAChRs, except for PmnAChR-5. Furthermore, Pm-miR-873-3p, Pm-miR-4577, Pm-miR-103a-3p, and Pm-miR-6753-3p were identified as the regulatory miRNA of PmnAChR-1, PmnAChR-3, PmnAChR-4, and PmnAChR-5, respectively. These findings suggested that these tandem arrays of nAChRs are unique to bivalves, and the tandem duplication of nAChR genes may be involved in the immune regulation process after pathogen stimulation.

Novel nicotinic acetylcholine receptor involved in immune regulation in pearl oyster (Pinctada fucata martensii).

The cholinergic anti-inflammatory pathway has been identified as a reflex monitoring system that contributes to the physiological and pathological regulation of cytokines. Nicotinic acetylcholine receptor (nAChR) plays an important role in immune regulation as a key molecule in neuronal communication. In this work, we investigated the characteristics and functions of a novel nAChR ß gene identified from the pearl oyster Pinctada fucata martensii (PmnAChR-ß). PmnAChR-ß displays structural similarities to nAChR molecules described in mammals, including a typical neurotransmitter-gated ion-channel ligand binding domain (LBD) and transmembrane (TM) domain. The result of phylogenetic analysis speculated that nAChR-ß in Mollusca, Chordata and Arthropoda were separated into three branches. The LBD of PmnAChR-ß was highly conserved, but its TM was variable. PmnAChR-ß was highly expressed in eggs and fertilized eggs and had the most abundant mRNA expression in the gills of pearl oyster. The expression of PmnAChR-ß mRNA was dramatically upregulated 12 h after lipopolysaccharide stimulation. Furthermore, PmnAChR-ß was highly expressed at 12 h and 6-18 d after transplantation in hemocytes. Pm-miR-516b-5p was identified as the regulatory microRNA of PmnAChR-ß. These results indicated that PmnAChR-ß may be an important component of the cholinergic anti-inflammatory pathway and participates in the immune regulation process of pearl oysters.

UCNP-Bi2 Se3 Upconverting Nanohybrid for Upconversion Luminescence and CT Imaging and Photothermal Therapy.

Non-invasive theranostics that integrate the advantages of multimodality imaging and therapeutics have great potential in the field of biomedicine. Herein, a new nanohybrid based on Bi2 Se3 -conjugated upconversion nanoparticles (UCNPs) has been successfully developed through a simple in situ growth strategy. Under 808 nm near-infrared laser irradiation, the UCNPs can emit bright visible light, whereas the Bi2 Se3 nanomaterial exhibits efficient photothermal conversion capacity. Moreover, the as-synthesized UCNP-Bi2 Se3 nanohybrid exhibits efficient cell upconversion luminescence (UCL), reasonable CT imaging, and admirable cancer cell ablation capacity, further emphasizing the efficiency of this strategy for simultaneous UCL imaging and photothermal therapy. The designed theranostic strategy guided by dual-modal imaging endowed with real-time dynamic monitoring, remote controllability, and non-invasiveness makes the UCNP-Bi2 Se3 nanohybrid an ideal candidate for non-invasive multimodal imaging-guided photothermal therapy for the precise diagnosis and treatment of cancer.

One-pot synthesis of Ln3+-doped porous BiF3@PAA nanospheres for temperature sensing and pH-responsive drug delivery guided by CT imaging.

The design and synthesis of responsive inorganic nanocapsules have attracted intensive research interest in cancer treatment. The combination of non-invasive diagnosis and chemotherapy into a single theranostic nanoplatform is prospective in the biomedical field. In this work, a polyacrylic acid (PAA)-functionalized porous BiF3:Yb,Er nanocarrier was constructed via a straightforward one-pot solvothermal strategy. Compared with the undoped BiF3 sub-microspheres, the lanthanide ion (Ln3+) doping endowed the BiF3 material with a smaller size and increased BET specific surface area and pore volume, which make it suitable as a drug carrier. It was found that the synthesized nanomaterial could effectively relieve the side effects of doxorubicin (DOX) and exhibited pH-dependent DOX loading and release. Its satisfactory biocompatibility and efficient tumor inhibition were emphasized by a series of in vitro/in vivo experiments. In addition, the synthesized nanomaterial exhibited favorable CT contrast efficacy due to the excellent X-ray attenuation coefficient of Bi. Moreover, characteristic upconversion luminescence and temperature sensing in a wide temperature range were realized over the synthesized BiF3:Yb,Er sample. Therefore, carboxyl-functionalized BiF3:Yb,Er can be expected to be an ideal candidate in the fabrication of temperature sensing and multifunctional theranostic nanoplatforms.

Risk Stratification Of Diffuse Large B-Cell Lymphoma With Interim PET/CT By Combining Deauville Scores And International Prognostic Index.

PURPOSE: Prognostic evaluation using interim positron emission tomography/computed tomography (interim PET/CT; I-PET) remains controversial. For any predictor, the prognosis of patients around its cutoff value is most uncertain. If the patients around the cutoff value could be subdivided by another factor, like the international prognostic index (IPI), it may improve the predictive power of I-PET. The combination of I-PET and IPI for risk stratification of patients was explored in this study. PATIENTS AND METHODS: One hundred and eleven diffuse large B-cell lymphoma (DLBCL) patients treated with R-CHOP therapy were included retrospectively, 59 of whom underwent PET/CT after three or four cycles of treatment (I-PET). Fifty-two patients underwent PET/CT after five or six cycles of treatment (end of treatment; E-PET). RESULTS: When Deauville 5-point scale (5-DS) scores of 4-5 were classified as a positive scan (denoted by DS [score 4]), there was no significant difference in progression-free survival (PFS) between I-PET positive and negative patients (P=0.151). Further, patients with 5-DS score 3 and high IPI were stratified into I-PET positive-, whereas those with 5-DS score 3 and low IPI were classified into I-PET negative scan groups. Under this stratification, there was a significant difference in PFS between I-PET positive and negative patients (P=0.001). The sensitivity, positive predictive value, and negative predictive value for 2-year PFS for the combination score were higher than DS (score 4) alone (66.7% vs 33.3%, 50.0%vs 37.5%, 93.6% vs 88.2%) whereas specificity was almost the same (90.0% vs 88.0%). CONCLUSION: Subdivision of patients with 5-DS score 3 by IPI improved prognostic prediction accuracy. The IPI adds strength to 5-DS in I-PET to detect patients with good or poor prognosis. Compared with other combinations of I-PET and IPI, dividing the patients around the cutoff value of 5-DS by IPI was easily accepted by clinicians and allowed them to decide on further treatment practically.

Rational synthesis of three-dimensional core-double shell upconversion nanodendrites with ultrabright luminescence for bioimaging application.

Engineering the morphology of rare-earth doped NaYF4-based upconversion nanoparticles (UCNPs) can effectively tune their upconversion luminescence emission (UCLE) properties. Herein, we rationally synthesized a new class of three-dimensional upconversion core-double-shell nanodendrites (UCNDs) including an active core (NaYF4:Yb,Er,Ca) capped by a transition layer (NaYF4:Yb,Ca) and an active outer shell (NaNdF4:Yb,Ca). The high concentration of the Nd3+ sensitizer in the outer dendritic shell enhances the luminescence intensity, while the transition layer enriched with Yb3+ acts as an efficient energy migration network between the outer shell and inner core along with preventing the undesired quenching effects resulting from Nd3+. These unique structural and compositional merits enhanced the UCLE of UCNDs by 5 and 15 times relative to NaYF4:Yb,Er,Ca@NaYF4:Yb,Ca truncated core-shell UCNPs and NaYF4:Yb,Er,Ca spherical core UCNPs, respectively, under excitation at 980 nm. The SiO2-COOH layer coated UCNDs (UCND@SiO2-COOH) were successfully used as efficient long-term luminescent probes for in vitro and in vivo bioimaging without any significant toxicity. The uptake and retention of UCND@SiO2-COOH were mostly found in the liver and spleen. This study may open the way towards the preparation of three-dimensional UCND nanostructures for biomedical applications.