Repair of coronary artery ostium with a ring-shaped bovine pericardial patch.

As an approach to coronary artery ostial injury in type A aortic dissection and infective endocarditis, we describe a technique of coronary ostial repair using a ring-shaped bovine pericardial patch. The inner and outer rims of the patch were sutured to the involved coronary ostium (to close the ostial tear) and to the aortic wall (to cover the sinus), respectively. Four patients were successfully managed and computed tomographic coronary arteriogram at follow-up showed patent coronary ostia and arteries. The favourable preliminary results imply that this technique is a simple, safe and effective approach to coronary ostial repair in patients with type A aortic dissection or infective endocarditis.

Spatiotemporal variations and structural characteristics of carbon emissions at the county scale: a case study of Wu'an City.

In China, the county is not only an important component of industrial areas and a large contributor of carbon emissions, but also a key administrative unit for the implementation of carbon peak and carbon neutrality goals and policies. The spatiotemporal variations and structural characteristics of carbon emissions at the county scale are of great significance to China's dual goals of regional carbon policy implementation and low carbon spatial planning. Thus, it is important and insightful to conduct an in-depth and detailed examination of these characteristics while focusing on a typical iron and steel industry county-level city in North China. This study systematically calculated the carbon emissions of the county-level city of Wu'an from 2008 to 2017, and explored their structural characteristics and spatiotemporal variations. The results showed that (1) under the influence of macroeconomic and national policies, the carbon emissions of county-level cities dominated by the iron and steel industry show obvious phased characteristics; (2) there is a significant negative correlation between industry carbon emission concentrations and industrial carbon emissions; (3) within the steel industry system, sintering, iron smelting, steelmaking, and metal product processing are the main sources of carbon emissions, and the coal-based production process of the iron and steel industry needs a fundamental reformation; and (4) the carbon emission of Wu'an City shows obvious spatial differentiation characteristics. The geographic distribution of carbon emissions in Wu'an City is very unbalanced and tended to cluster together in urban areas, industrial and mining areas, and major towns. Taking 2014 as the turning point, the spatial pattern of carbon emissions in Wu'an City presents different variation characteristics.

Has the Sudden Health Emergency Impacted Public Awareness? Survey-Based Evidence from China.

Public environmental cognition is an important basis for optimizing environmental management and reducing tensions between humans and land. Although the level of environmental cognition is a gradual process under normal conditions, it often changes qualitatively because of major public emergencies. During the 2019 new coronavirus epidemic (COVID-19), the most significant public health event in recent years, 24,188 national samples were obtained based on a network survey. The comprehensive evaluation method was used to assess the impact of major public events on public environmental cognition and the characteristics of spatial and temporal distribution. The findings are as follows. (1) During the epidemic period, sudden public health emergencies effectively promoted the national residents' environmental awareness, whether urban residents or rural; most respondents generally agreed with the concept of "respect nature and cherish life". (2) The environmental cognition of national residents was higher in the northwest and lower in the northeast of China, which is suitable for economic and social development and humanistic tradition. (3) There was a clear positive correlation between environmental awareness and education level. (4) During the epidemic, nervousness of respondents had a negative effect on environmental cognition. This study provides scientific support and a basis for decision making for the government to carry out environmental management optimization and improve the ecological and environmental cognition of the public, as well as devise effective intervention mechanisms with different time and space dimensions for similar future public health emergencies.

Comparison between dexmedetomidine and propofol on outcomes after coronary artery bypass graft surgery: a retrospective study.

BACKGROUND: Dexmedetomidine (DEX) has a pharmacological profile that should allow rapid recovery and prevent undesirable outcomes such as pulmonary complications. METHODS: This large retrospective study compared the beneficial effects of perioperative infusion of DEX with propofol on the postoperative outcome after coronary artery bypass graft surgery. We reviewed patients' medical notes at Luoyang Central Hospital from 1st January 2012 to 31st December 2019. All continuous variables, if normally distributed, were presented as mean ± SD; Otherwise, the non-normally distributed data and categorical data were presented as median (25-75 IQR) or number (percentage). The Mann-Whitney U test and Chi-square test were used to evaluate the difference of variables between the DEX and propofol groups. Multivariate logistic regression analysis was performed on the main related and differential factors in the perioperative period. RESULTS: A total of 1388 patients were included in the study; of those, 557 patients received propofol infusion, and 831 patients received dexmedetomidine. DEX significantly reduced postoperative pulmonary complications compared with propofol, 7.82% vs 13.29%; P < 0.01, respectively. When compared with propofol, DEX significantly shortened the duration of mechanical lung ventilation, 18 (13,25) hours vs 21 (16,37) hours; P < 0.001, the length of stay in the intensive care unit, 51 (42,90) vs 59 (46,94.5) hours; P = 0.001 and hospital stay, 20 (17,24) vs 22 (17,28) days; P < 0.001, respectively. The incidences of postoperative wound dehiscence and infection were significantly reduced with DEX compared with propofol groups, 2.53% vs 6.64%; P < 0.001, respectively. Interestingly, patients receiving DEX had significantly shorter surgical time compared to propofol; 275 (240,310) vs 280 (250,320) minutes respectively (P = 0.005) and less estimated blood loss (P = 0.001). CONCLUSION: Perioperative infusion of dexmedetomidine improved the desirable outcomes in patients who had coronary artery bypass graft surgery compared with propofol.

Spatiotemporal Characteristics of Coupling and Coordination of Cultural Tourism and Objective Well-Being in Western China.

A supply of high-quality cultural tourism products effectively promotes people's happiness. This study takes the coupling and coordination relationship between cultural tourism (CT) and objective well-being (OWB) in western China as the research object and constructs an index evaluation system for the development levels of cultural tourism and objective welfare, which are divided into three development stages of dysfunctional, transitional, and coordinated development and 10 coordination levels, including high-quality coordination. The entropy weight method, coupled coordination model, Thiel index, standard deviation, and coefficient of variation were used to calculate the comprehensive development index and coupling coordination degree of the CT and OWB systems in western China from 2007 to 2020, and then their evolution characteristics were analyzed from the perspectives of time and space. The results show the following: (1) The comprehensive development capacity of the CT and OWB systems in the western region shows a relatively consistent growth trend except for 2020, the overall development capacity of objective welfare was relatively high, and the development capacity of cultural tourism was relatively low. (2) The CT and OWB systems were in a state of transition from high coupling and low coordination to high coupling and high coordination, which were divided into three development stages: imbalanced stage (2007-2008), transitional stage (2009-2011), and coordinated development (2012-2020). The coordination degree has developed steadily from moderate misalignment to good coordination over time, and the diversified characteristics of coupling coordination levels are obvious. (3) The spatial equilibrium of the CT and OWB systems is obvious, and the spatial difference in the western region is getting smaller, but the relative gap is widening significantly. (4) The comprehensive development capacity of the cultural tourism system should be enhanced, the spiritual needs of residents based on objective well-being should be met, and the sustainable development of the CT and OWB systems.

Impact of Economic Development Level and Agricultural Water Use on Agricultural Production Scale in China.

The change of agricultural production scale is directly related to food security and the stable development of social economy. Particularly, the influence of economic development level and agricultural water use on agricultural production scale cannot be ignored. Therefore, this paper uses the fully modified ordinary least squares (FMOLS) and the Dumitrescu-Hurlin panel causality test models to discuss the effects of the level of economic development, agricultural water use, the level of urbanization, and the market price of agricultural products on the scale of agricultural production in China. The analysis results indicated that agricultural water use, the level of urbanization, and the market price of agricultural products promoted an increase of the scale of agricultural production at the total sample level; a 1% increase for these three variables will result in an increase of the scale of agricultural production of 0.634%, 0.377%, and 0.292%, respectively. The influence of economic development level on agricultural production scale accords with Kuznets curve. However, at the regional level, the influence of each variable on the eastern region is consistent with the trend of the total sample. In the central region, the impact of economic development on agricultural production scale shows a U-shaped curve, and the improvement of urbanization level inhibits the expansion of agricultural production scale. In the western region, all variables failed to pass the significance test. The results of the FMOLS model were validated by the fixed effects model. The results of causality tests showed that bidirectional causality existed between the scale of agricultural production and the level of economic development, the scale of agricultural production and agricultural water use, the level of economic development and the market price of agricultural products, and the level of urbanization and the market price of agricultural products. In different regions, there were differences in causality between variables. Therefore, based on the empirical results, we put forward some policy suggestions to maintain the scale of agricultural production.

Microwave-accelerated and efficient synthesis of structurally diverse N-(2,2-diphenylvinyl)-ß-oxoamides.

N-(2,2-Diphenylvinyl)-ß-oxoamides are both the structural moiety of biologically active compounds and important synthetic intermediates. Structurally diverse N-(2,2-diphenylvinyl)-ß-oxoamides are prepared efficiently from 2-diazo-1,3-dicarbonyl compounds and N-alkyl-2,2-diphenylaziridines via an electrophilic ring opening reaction under two different reaction conditions of reflux and microwave irradiation. 2-Diazo-1,3-dicarbonyl compounds undergo the Wolff rearrangement under heating to generate α-oxoketenes, which electrophilically react with N-alkylaziridines to directly produce structurally diverse N-(2,2-diphenylvinyl)-ß-oxoamides in good to excellent yields under microwave irradiation. Microwave irradiation accelerates the reaction obviously and efficiently. Both 2-diazo-1,3-diketones and alkyl 2-diazo-3-oxoalkanoates work well. The reaction is catalyst-free and highly atom economical, involves only loss of nitrogen and does not require additives. The products are useful synthons for the convenient preparation of multisubstituted ß-lactam derivatives.

Simultaneous Determination of Celecoxib, Dezocine and Dexmedetomidine in Beagle Plasma Using UPLC-MS/MS Method and the Application in Pharmacokinetics.

BACKGROUND: An efficient, fast and sensitive ultra high-performance liquid chromatography-mass spectrometry (UPLC-MS/MS) method for simultaneous determination of celecoxib (CEL), dezocine (DEZ) and dexmedetomidine (DEX) in beagle plasma were established. METHODS: The beagle dogs plasmawas precipitated by acetonitrile. The column was Acquity UPLC BEH C18 column and the mobile phase was acetonitrile-formic acid with gradient mode, and the flow rate was set at 0.4 mL/min. Under the positive ion mode, CEL, DEZ, DEX and Midazolam (internal standard, IS) were monitored by multiple reaction monitoring (MRM) as the following mass transition pairs: m/z 381.10→282.10 for CEL, m/z 246.20→147.00 for DEZ, m/z 201.10→94.90 for DEX, and m/z 326.10→291.10 for IS. RESULTS: This UPLC-MS/MS method had good linearity for CEL, DEZ and DEX. The RSDs of inter-day and intra-day precision were the values of 0.31-7.66% and 0.11-9.63%, respectively; the RE values were from -6.05% to 10.98%. The extraction recovery was more than 79%, and the matrix effect was around 100%. The RSDs of stability were less than 8.96%. All of them met the acceptance standard of biological analysis method recommended by FDA. CONCLUSION: This UPLC-MS/MS method is an effective tool for the simultaneous determination of CEL, DEX and DEX, and has been successfully applied to the study of pharmacokinetics in beagle dogs.

Regional Differences and Dynamic Evolution of Carbon Emission Intensity of Agriculture Production in China.

The study of the carbon emission intensity of agricultural production is of great significance for the formulation of a rational agricultural carbon reduction policy. This paper examines the regional differences, spatial-temporal pattern and dynamic evolution of the carbon emission intensity of agriculture production from 1991 to 2018 through the Theil index and spatial data analysis. The results are shown as follows: The overall differences in carbon emission intensity of agriculture production presents a slightly enlarging trend, while the inter-regional differences in carbon emissions intensity is decreasing, but the intra-regional difference of carbon emissions intensity presented an expanding trend. The difference in carbon emission intensity between the eastern and central regions is not obvious, and the difference in carbon emission intensity in the western region shows a fluctuating and increasing trend. The overall differences caused by intra-regional differences; the average annual contribution of intra-regional differences is 67.84%, of which the average annual contribution of western region differences is 64.24%. The carbon emission intensity of agricultural production in China shows a downward trend, with provinces with high carbon emission intensity remaining stable, while provinces with low intensity are expanding. The Global Moran's I index indicates that China's carbon emission intensity of agricultural production shows a clear trend of spatial aggregation. The agglomeration trend of high agricultural carbon emission remains stable, and the overall pattern of agricultural carbon emission intensity shows a pattern of increasing differentiation from east to west.

Effects of Dexmedetomidine on the Pharmacokinetics of Parecoxib and Its Metabolite Valdecoxib in Beagles by UPLC-MS/MS.

A sensitive and reliable ultraperformance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) method was developed for the simultaneous determination of parecoxib and its metabolite valdecoxib in beagles. The effects of dexmedetomidine on the pharmacokinetics of parecoxib and valdecoxib in beagles were studied. The plasma was precipitated by acetonitrile, and the two analytes were separated on an Acquity UPLC BEH C18 column (2.1 mm × 50 mm, 1.7 µm); the mobile phase was acetonitrile and 0.1% formic acid with gradient mode, and the flow rate was 0.4 mL/min. In the negative ion mode, the two analytes and internal standard (IS) were monitored by multiple reaction monitoring (MRM), and the mass transition pairs were as follows: m/z 369.1 → 119.1 for parecoxib, m/z 313.0 → 118.0 for valdecoxib, and m/z 380.0 → 316.0 for celecoxib (IS). Six beagles were designed as a double cycle self-control experiment. In the first cycle, after intramuscular injection of parecoxib 1.33 mg/kg, 1.0 mL blood samples were collected at different times (group A). In the second cycle, the same six beagles were intravenously injected with 2 µg/kg dexmedetomidine for 7 days after one week of washing period. On day 7, after intravenous injection of 2 µg/kg dexmedetomidine for 0.5 hours, 6 beagle dogs were intramuscularly injected with 1.33 mg/kg parecoxib, and blood samples were collected at different time points (group A). The concentration of parecoxib and valdecoxib was detected by UPLC-MS/MS, and the main pharmacokinetic parameters were calculated by DAS 2.0 software. Under the experimental conditions, the method has a good linear relationship for both analytes. The interday and intraday precision was less than 8.07%; the accuracy values were from -1.20% to 2.76%. C max of parecoxib in group A and group B was 2148.59 ± 406.13 ng/mL and 2100.49 ± 356.94 ng/mL, t 1/2 was 0.85 ± 0.36 h and 0.85 ± 0.36 h, and AUC(0-t) was 2429.96 ± 323.22 ng·h/mL and 2506.38 ± 544.83 ng·h/mL, respectively. C max of valdecoxib in group A and group B was 2059.15 ± 281.86 ng/mL and 2837.39 ± 276.78 ng/mL, t 1/2 was 2.44 ± 1.55 h and 2.91 ± 1.27 h, and AUC(0-t) was 4971.61 ± 696.56 ng·h/mL and 6770.65 ± 453.25 ng·h/mL, respectively. There was no significant change in the pharmacokinetics of parecoxib in groups A and B. C max and AUC(0 - ∞) of valdecoxib in group A were 37.79% and 36.19% higher than those in group B, respectively, and t 1/2 was increased from 2.44 h to 2.91 h. V z /F and CL z /F were correspondingly reduced, respectively. The developed UPLC-MS/MS method for simultaneous determination of parecoxib and valdecoxib in beagle plasma was specific, accurate, rapid, and suitable for the pharmacokinetics and drug-drug interactions of parecoxib and valdecoxib. Dexmedetomidine can inhibit the metabolism of valdecoxib in beagles and increase the exposure of valdecoxib, but it does not affect the pharmacokinetics of parecoxib.

Measuring Regional Eco-Efficiency in China (2003-2016): A "Full World" Perspective and Network Data Envelopment Analysis.

Eco-efficiency enhancement is an inherent requirement of green development and an important indicator of high-quality development in general. It aims to achieve the coordinated development of nature, the economy, and society. Therefore, eco-efficiency measurements should focus on not only total factor input, but also process analysis. Based on the "full world" model in ecological economic theory, this study constructed a theoretical framework for a composite economic-environmental-social system that reflects human welfare and sustainability. To this end, using network data envelopment analysis (DEA), this study established a staged eco-efficiency evaluation model that uses economic, environmental, and social factors to measure the overall and staged eco-efficiency of China's provinces from 2003 to 2016 and analyze its spatiotemporal characteristics. A geographically weighted regression (GWR) model was also used to analyze the influencing factors of eco-efficiency changes and the spatial differentiation in their effect intensity. The findings were as follows: (1) China's overall eco-efficiency is still at a low level. It varies significantly from region to region, and only three regions are at the frontier of production. The eastern region has the highest eco-efficiency, followed by the central region, and the gap between the central and western regions has gradually narrowed. In terms of staged efficiency, the level of eco-efficiency in the production stage is less than in the environmental governance stage, which is less than that in the social input stage. (2) In terms of the efficiency of each stage, the efficiency level of the production stage showed a downward trend throughout the entire process, and the decline in the central and western regions was more obvious. The social input stage and the environmental governance stage both showed upward trends. The social input stage showed a higher level, and the increase was relatively flat during the period of study. Efficiency continued to rise during the environmental governance stage from 2003 to 2010 and rose overall, but with some fluctuations from 2011 to 2016. (3) Geographically weighted regression showed that the effects of the influencing factors on eco-efficiency had obvious spatial heterogeneity. The factors affecting overall, production stage, and social input eco-efficiency were, in order of effect intensity from high to low, economic growth level, marketization level, and social input level. In terms of environmental governance, social input level had the greatest impact, followed by economic growth; marketization level did not show a significant impact.

Machinability: Zirconia-reinforced lithium silicate glass ceramic versus lithium disilicate glass ceramic.

Diamond grinding used in dental adjustment of high-strength zirconia-reinforced lithium silicate glass ceramic (ZLS) and lithium disilicate glass ceramic (LDGC) is challenging in restorative dentistry. This study aimed to compare the machinability of ZLS and LDGC in diamond grinding in terms of machining forces and energy, debris, surface and edge chipping damage. Grinding experiments in simulation of dental adjustment were conducted using a computer-assisted high-speed dental handpiece and coarse diamond burs. A piezoelectric force dynamometer and a high-speed data acquisition system were used for on-processing monitoring for assessment of grinding forces and energy. Grinding debris and grinding-induced surface and edge chipping damage were examined using scanning electron microscopy. The results show that grinding of ZLS required higher tangential and normal forces and energy than LDGC (p < 0.05). ZLS was ranked the most difficult to machine among dental glass ceramics based on a machinability index associated with the material mechanical properties. The higher machinability indices of ZLS and LDGC pose a challenge for clinicians to conduct high-efficient material removal for dental adjustment and repair. Both ZLS and LDGC debris were micro fractured particles but the former were smaller than the latter due to the finer microstructure of ZLS. Ground ZLS surfaces contained more irregular microchipping and microfracture in comparison with LDGC surfaces with intergranular fracture or grain dislodgement. Grinding-induced edge chipping damage remained a serious issue for both ZLS and LDGC, which depths ranged approximately 20-100 µm and significantly increased with the material removal rate (p < 0.01). As the zirconia-reinforcement in ZLS only slightly reduced edge chipping damage (p > 0.05), continued efforts are required to explore new reinforcement technologies for optimized LDGC.

Carbon emissions, energy consumption and economic growth: Evidence from the agricultural sector of China's main grain-producing areas.

China is currently the world's largest carbon emitter. As a large agricultural country, understanding the relationship between carbon emissions, economic growth and energy consumption in the agricultural sector can contribute to achieving the sustainable development of agriculture. Hence, this paper aims to investigate the relationship between carbon emissions, energy consumption and economic growth in the agricultural sector using a time series of data from China's main grain-producing areas during the period between 1996 and 2015. We first estimate the agricultural carbon emissions. And then based on the estimated results, we employ the autoregressive distributed lag (ARDL) model, the Granger causality test based on the vector error correction model (VECM), and impulse response and variance decomposition to test the relationship between carbon emissions, energy consumption and economic growth in the agricultural sector. The estimated results support the environmental Kuznets curve (EKC) hypothesis for agricultural carbon emissions in China's main grain-producing areas. Furthermore, agricultural energy consumption has both the short-run and the long-run negative impacts on agricultural carbon emissions. In addition, we find that there is a bidirectional causality between agricultural carbon emissions and agricultural economic growth in both the short-run and the long-run, and the unidirectional causalities are found to exist from agricultural energy consumption to agricultural carbon emissions and agricultural economic growth. Finally, several policy recommendations are offered to promote the sustainable development of agriculture in China's main grain-producing areas.

Valve surgery in combination with cryoablation in the treatment of atrial fibrillation.

OBJECTIVE: To investigate the effectiveness and safety of valve surgery in combination with cryoablation in the treatment of atrial fibrillation. METHODS: Fifty patients who needed to undergo valve surgery because of heart valve disease and sixty-five patients who needed to undergo valve surgery in combination with cryoablation were selected as the research subjects. The perioperative technical characteristics, postoperative curative effect and complications were compared between the two different treatment modalities in our hospital between October 2013 and November 2015. RESULTS: No significant differences were observed between the two groups in valve surgery mode, valve type and postoperative length of hospital stay (P>0.05), but the duration of extracorporeal bypass and aorta occlusion of the observation group was longer than that of the control group (P<0.05). The 3-month, 6-month and one-year atrial fibrillation cardioversion rates of patients in the observation group were superior to those of the control group, and the differences were notable (P<0.05). The improvement of left atrial diameter of the observation group was also superior to that of the control group (P<0.05). The incidence of postoperative complications of the two groups had no significant difference (P>0.05). CONCLUSION: Valve surgery in combination with cryoablation has favorable short-term clinical effect in the treatment of heart valve disease in combination with atrial fibrillation, which is worth promotion.

MicroRNA-30b protects myocardial cell function in patients with acute myocardial ischemia by targeting plasminogen activator inhibitor-1.

The aim of the present study was to determine the expression of plasminogen activator inhibitor-1 (PAI-1) and microRNA (miR)-30b in the blood of patients with acute myocardial ischemia (AMI) and in the blood and myocardial tissue of mice with AMI. In addition, the present study aimed to identify the mechanism of action of miR-30b in AMI. A total of 36 patients with AMI were included in the present study and 28 healthy subjects were included as a control. Peripheral blood was collected from all subjects. For animal experiments, mice in the AMI group received an intraperitoneal injection of pituitrin (20 U/kg), whereas mice in the negative control group received an intraperitoneal injection of the same volume of saline. Blood and myocardial tissue was collected from all mice for analysis. Reverse transcription-quantitative polymerase chain reaction was performed to determine the expression of PAI-1 mRNA and miR-30b in the serum and myocardial tissue. An enzyme-linked immunosorbent assay was performed to measure the expression of PAI-1 protein in the serum of humans and mice, whereas western blotting was performed to determine the expression of PAI-1 protein in mouse myocardial tissue. Catalase, glutathione peroxidase and superoxide dismutase activity was measured using an automatic biochemical analyzer. A dual luciferase assay was performed to identify the interactions between PAI-1 mRNA and miR-30b. The results indicated that patients with AMI have higher PAI-1 levels and lower miR-30b expression in the peripheral blood compared with healthy subjects. AMI damaged the myocardium tissue of mice and reduced catalase, glutathione peroxidase and superoxide dismutase activity. Mice that have undergone AMI exhibit increased PAI-1 levels but decreased miR-30b expression in the peripheral blood and myocardial tissues. It was also demonstrated that miR-30b is able to bind to the 3'-untranslated region of PAI-1 mRNA to regulate its expression. The present study demonstrates that patients with AMI exhibit decreased miR-30b expression and elevated PAI-1 expression in the peripheral blood. miR-30b may therefore inhibit the damage to myocardial cells that occurs following AMI and protect myocardial cell function by targeting PAI-1 expression.

Quantitative Whole Genome Sequencing of Circulating Tumor Cells Enables Personalized Combination Therapy of Metastatic Cancer.

Much effort has been dedicated to developing circulating tumor cells (CTC) as a noninvasive cancer biopsy, but with limited success as yet. In this study, we combine a method for isolation of highly pure CTCs using immunomagnetic enrichment/fluorescence-activated cell sorting with advanced whole genome sequencing (WGS), based on long fragment read technology, to illustrate the utility of an accurate, comprehensive, phased, and quantitative genomic analysis platform for CTCs. Whole genomes of 34 CTCs from a patient with metastatic breast cancer were analyzed as 3,072 barcoded subgenomic compartments of long DNA. WGS resulted in a read coverage of 23× per cell and an ensemble call rate of >95%. These barcoded reads enabled accurate detection of somatic mutations present in as few as 12% of CTCs. We found in CTCs a total of 2,766 somatic single-nucleotide variants and 543 indels and multi-base substitutions, 23 of which altered amino acid sequences. Another 16,961 somatic single nucleotide variant and 8,408 indels and multi-base substitutions, 77 of which were nonsynonymous, were detected with varying degrees of prevalence across the 34 CTCs. On the basis of our whole genome data of mutations found in all CTCs, we identified driver mutations and the tissue of origin of these cells, suggesting personalized combination therapies beyond the scope of most gene panels. Taken together, our results show how advanced WGS of CTCs can lead to high-resolution analyses of cancers that can reliably guide personalized therapy. Cancer Res; 77(16); 4530-41. ©2017 AACR.

Greenhouse cultivation mitigates metal-ingestion-associated health risks from vegetables in wastewater-irrigated agroecosystems.

Wastewater irrigation can elevate metal concentrations in soils and crops and increase the metal-associated health risks via vegetable ingestion in arid and semiarid northwestern China. Here, we investigated the As, Cd, Cr, Cu, Ni, Pb, and Zn concentrations in four vegetable species from Dongdagou and Xidagou farmlands in Baiyin, Gansu, China. We evaluated the effects of irrigation type (Dongdagou: industrial wastewater; Xidagou: domestic wastewater) and cultivation mode (open field and greenhouse) on the vegetable metal concentration, metal partitioning, soil-to-plant bioconcentration factor (BCF), and the health risk index. All stream waters, soils, and vegetables were found most severely polluted by As and Cd, with higher severity in the industrial-wastewater-irrigated Dongdagou than the domestic-wastewater-irrigated Xidagou. All vegetables had higher or, at least, comparable metal mass allocated in the shoot than in the root. Greenhouse cultivation could reduce metal-ingestion-associated health risks from edible vegetable biomass by decreasing the soil to plant bioaccumulation (BCF) and the metal concentration. This effect was always significant for all vegetables within Xidagou, and for carrot within Dongdagou. This mitigation effect of greenhouse cultivation could be attributed to the metal sorption by a higher level of soil organic matter and faster growth rate over metal uptake rate in greenhouses compared to open fields. Such mitigation effect was, however, insignificant for leafy vegetables within Dongdagou, when much more severely polluted water for irrigation was applied in greenhouses compared to open fields within Dongdagou. The present study highlights greenhouse cultivation as a potential mitigating approach to providing less-polluted vegetables for residents in the severely polluted area in addition to the source pollution control.

The Effect of Silibinin on the Pharmacokinetics of Ivabradine and N-Desmethylivabradine in Rats.

The objective of this work was to investigate the effect of orally administered silibinin on the pharmacokinetics of ivabradine and its active metabolite N-desmethylivabradine in rats. Twelve healthy male Sprague-Dawley rats were randomly divided into 2 groups: the control group (received oral 1.0 mg/kg ivabradine alone) and the combination group (1.0 mg/kg ivabradine orally coadministered with 30 mg/kg silibinin). The plasma concentration of ivabradine and N-desmethylivabradine were estimated by ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) and different pharmacokinetic parameters were calculated using the DAS 2.0 software. The pharmacokinetic parameters of t1/2, Cmax, AUC(0-t) and AUC(0-∞) of ivabradine in the combination group were significantly higher than those in the control group (p < 0.01). However, silibinin has no effect on the pharmacokinetics of N-desmethylivabradine. This study demonstrates that silibinin increase plasma concentration of ivabradine. Henceforth, the pharmacodynamic influence of this interaction should be taken into consideration while prescribing ivabradine to patients already taking silibinin.

[Dynamic changes of the relationships between economic growth and environmental pressure in Gansu Province: a structural decomposition analysis].

Based on the ideology of macro environmental economics, a function of environmental pressure represented by pollutant emission was built, and the relative importance of the driving factors in the dynamic changes of the relationships between economic growth and environmental pressure in Gansu Province in 1990 - 2005 was analyzed by using structural decomposition analysis (SDA) model combining with 'refined Laspeyres' method. In the study period, the environmental pressure in the Province was mainly caused by the emission of waste gases and solids in the process of economic growth, and showed a rapid increasing trend at the late stage of the period. Population factor had less impact on the increase of this environmental pressure, while economic growth factor had obvious impact on it. Technological progress did mitigate, but could not offset the impact of economic growth factor, and the impacts of economic growth and technological factors on the environmental pressure differed with the kinds of pollutants.

[Staged total cavopulmonary connection for complex congenital heart diseases].

OBJECTIVE: To review the experience of staged total cavopulmonary connection (TCPC) in complex congenital heart diseases. METHODS: From June 1998 to March 2008, 22 patients underwent staged TCPC for complex congenital heart diseases. Among them, 9 were univentricular and pulmonary artery valve stenosis; 3 were univentricular and pulmonary artery atresia; 1 was transposition of great arteries, crisscross heart and pulmonary artery valve stenosis; 1 was complete atrioventricular canal defects, left ventricular hypoplasia, pulmonary artery atresia and atrioventricular valvular regurgitation; 1 was complete atrioventricular canal defects, left ventricular hypoplasia, pulmonary artery valve stenosis and atrioventricular valvular regurgitation after Glenn procedure; 1 was mirror image dextrocardia, single ventricle, pulmonary artery atresia, major aortopulmonary collateral arteries (MAPCAs) and right pulmonary arteriovenous fistula after Glenn procedure; 4 were tricuspid atresia and pulmonary artery valve stenosis; 1 was tricuspid atresia and pulmonary atresia; 1 was mirror image dextrocardia, double-outlet of right ventricle, left ventricular hypoplasia, pulmonary artery valve stenosis, tricuspid incompetence, and MAPCAs. Among them, 5 patients received systemic-to-pulmonary artery shunt, bidirectional Glenn procedure and TCPC. Seventeen patients received bidirectional Glenn procedure, the mean age was (5.9+/-4.4) years old. Pulmonary artery pressure pre-Glenn procedure was 17 to 20 mm Hg (1 mm Hg=0.133 kPa). Atrioventricular valve incompetence in 3 patients. Nakata index was less than 200 mm2/m2 in 4 patients before the first stage operation. The age of TCPC procedure was (9.6+/-4.9) years old, the interval time was (3.7+/-1.2) years. RESULTS: There was one in-hospital death, the mortality was 4.5%. The patient with univentricular and pulmonary atresia, received systemic-to-pulmonary artery shunt, bidirectional Glenn procedure and TCPC and died of pneumorrhagia. Other patients were recovered well, postoperative central venous pressure was 12 to 18 mm Hg, percutaneous oxygen saturation was 90% to 96%. The cardiac function were in NYHA class I to II. CONCLUSIONS: The staged TCPC was a good procedure in high-risk Fontan candidates. The results were satisfactory for those patients. This staged strategy may extend the operative indications for the Fontan procedure.