Effectiveness of transverse tibial bone transport in treatment of diabetic foot ulcer: A systematic review and meta-analysis.

Background: Diabetic foot ulcerations (DFUs) are a common but highly morbid complication of long-standing diabetes, carrying high rates of associated major amputation and mortality. Transverse tibial bone transport (TTT) has recently been applied for treatment of DFUs with the aim of accelerating wound healing. This study was performed to evaluate the effectiveness and safety of TTT in patients with DFUs. Methods: Two authors independently retrieved the platforms of PubMed, Embase and CENTRAL, to identify studies associated with treatment of DFUs with TTT. Quantitative meta-analyses were performed to pool all available outcomes about the effectiveness and complications of TTT operation, with fixed- (I2<50%) or random-effect (I2>50%) model according to I2. Results: A total of 7 studies, involving 818 participants, were included, with 661 participants treated with TTT operation. The pooled healing rate and limb salvage rate were 0.96 (95%CI: 0.93~0.98) and 0.98 (95%CI: 0.95~1.00) respectively after treatment with TTT. The pooled mean healing time was 15.03 (95%CI: 9.05~21.00) months. When compared with the pre-operative baseline values, the ankle-brachial index (ABI, MD: 0.23; 95%CI: 0.03~0.44; p<0.001), skin temperature (MD: 1.56; 95%CI: 0.30~2.81; p<0.001), and visual analogue scale (VAS, MD: 3.70; 95%CI: 1.97~5.44; p<0.001) were significantly improved at the final follow-up. When compared with non-TTT group, the TTT group was associated with higher healing rate (OR: 10.43; 95%CI: 3.96~27.43; p<0.001) and limb salvage rate (OR: 9.65; 95%CI: 3.30~28.20; p<0.001). Concerning the complications of the TTT process, the pooled risks of fracture at transportation site and pin-site infection were 0.02 (95%CI: 0.00~0.04) and 0.08 (95%CI: 0.00~0.22), respectively; and the DFU recurrence rate in TTT group was significantly lowered comparing to that of the non-TTT group (RR: 0.18; 95%CI: 0.06~0.49; p=0.001). Conclusions: TTT operation was associated with high healing rate and limb salvage rate, and could significantly improve the ABI, skin temperature, and VAS after operation. When compared with the control group, TTT group provided significantly higher healing rate and limb salvage rate. However, TTT operation should be conducted with caution concerning the incidences of fracture at tibia, infection at pin channels and necrosis of skin overlying the anterior tibia.

[Effects of Biochar and Straw on Soil N2O Emission from a Wheat Maize Rotation System].

The effects of biochar and straw return on soil N2O emissions were studied in the winter wheat-summer maize rotation system of intensively farmed land in North China to provide a theoretical basis for N2O emission reduction and the efficient straw utilization. The experiment included the following four treatments:① Control (CK); ② Biochar application at a rate of 9.0 t·(hm2·a)-1 (C); ③ Straw return (SR); and ④ Straw return plus biochar application at a rate of 9.0 t·(hm2·a)-1 (C+SR). The results showed that in the wheat season, the CK treatment showed a slight decrease in soil N2O emission while the SR and C+SR treatments promoted soil N2O emission by 47.4% and 71.8%, respectively. In the maize-growing season, the CK treatment reduced soil N2O emission by 29.8% while the SR and C+SR treatments increased soil N2O emission by 13.4% and 35.8%, respectively. During the wheat-growing season, the soil water, NH4+-N, and MBN content were the main environmental factors affecting N2O emissions; during the maize-growing season, NO3--N, NH4+-N, and MBC content were the main environmental factors affecting emissions. Based on our results, the application of biochar to cropland is an effective option for mitigating greenhouse gas emissions, whereas direct straw return to fields might not be an effective strategy. More research is now needed to examine the effect of the return of straw of different maturity on N2O emissions.

[Nitrogen uptake rate and use efficiency by rice under different levels of the controlled-release N fertilizers (CRF) in the Nansi Lake basin].

The nitrogen (N) fertilizers overused or misused are the main contributors for water eutrophication of the Nansi Lake in eastern China. A field experiment with different application levels of controlled-release N fertilizer (CRF) was carried out at a rice field in the Nansi lake basin to provide information on the nitrogen uptake rate and use efficiency by rice with CRF application at different growth stages of rice. The fertilization levels for the controlled fertilizer in this study were 0, 300, 337.5 and 375 kg/hm2, respectively, and 375 kg/hm2 for conventional urea (CU). We estimated the N uptake rate in different growing season and apparent recovery of fertilizer in root, stover and grain of rice. The result showed that grain yield increased by higher N rate. However, the N uptake rate did not increase linearly with the nitrogen application amount. The highest N uptake rate was 22.48 mg/(plant x d) under the fertilization amount of 337.5 kg/hm2 during the young panicle differentiation stage. Apparent N recovery efficiency for CU with traditional application amount of 375 kg/hm2 was 21.86%. Apparent N recovery efficiency for CRF with application amount of 337.5 kg/hm2 was highest with 37.17%. Based on the statistical data, with CU of traditional urea application amount of 375 kg/hm2, nitrogen loss and soil N residue at one growing season are 130.07 x 10(3) t for Jining city and 11.4 x 10(3) t for Yutai county of the Nansi Lake basin. If using CRF with the optimized application amount of 337.5 kg/hm2, nitrogen loss and soil residual at one growing season is 10.46 x 10(4) t for Jining city. It could reduce losses of 2.55 x 10(4) t N for Jining city and 2 235.26 t N for Yutai county per year. Because of releasing patterns more closely matched to crop N uptake patterns, controlled release N fertilizer could be a good way to prevent water eutrophication due to nitrogen fertilizer overused or misused in the Nansi Lake.

[Unspecified peripheral T cell lymphoma with distinct lymphoid follicules].

OBJECTIVE: To investigate the morphological features and immunophenotype of unspecified peripheral T cell lymphoma with distinct lymphoid follicular growth pattern. METHODS: Three cases of peripheral T cell lymphoma with special pathohistological features were collected. Morphologic analysis and immunohistochemical staining for CD3, CD45RO, CD43, CD20, CD79a, cyclinD1, bcl-2, CD4, CD8 and S-100 were performed. PCR was used to study TCR gamma gene rearrangements. RESULTS: The main symptoms of all the three patients with the primary sites of cervix and lower jaw. There were intermittent fever and skin rashes in the course of the disease. Morphological study showed lymphoid follicular reactive hyperplasia, mantle zone disappear, prominent infiltration of marginal zones by medium-sized tumor cells with clear cytoplasm and significant nuclear atypia. The immunophenotypic profile confirmed that they were T cell lymphomas. TCR gamma gene rearrangements were found in all the three patients. CONCLUSION: In some unspecified peripheral T cell lymphomas, the distinct follicular growth pattern and incomplete effacement of the lymph node architecture make it necessary to differentiate them from reactive hyperplasia, marginal zone B cell lymphoma, follicular B cell lymphoma and mantle cell lymphoma.