[Effects of humic acid water-soluble fertilizer on growth and physiological characteristics of Bupleurum chinense seedlings].

The effects of humic acid water-soluble fertilizer on the growth and physiological characteristics of Bupleurum chinense seedlings(Zhongchai No.1) were studied by using a single factor experiment design. When the seedling age was 60 days, the humic acid water-soluble fertilizer was diluted 1 200 times(T1), 1 500 times(T2), 1 800 times(T3), and 2 100 times(T4) for seedling treatment, respectively, and water was used as the control(CK). The effects of different treatments on growth indexes, biomass accumulation, root activity, antioxidant enzyme activity, membrane lipid peroxidation, and photosynthetic characteristics of B. chinense seedlings were analyzed after 30 days. The results showed that compared with CK, stem height, leaf number, root diameter, and root length of the B. chinense seedlings under T3 treatment were significantly increased by 36.82%, 37.03%, 42.78%, and 22.38%, respectively. Root fresh weight, leaf fresh weight, root dry weight, and leaf dry weight under T3 treatment were significantly increased by 90.36%, 98.68%, 123.84%, and 104.38%, respectively. In addition, humic acid water-soluble fertilizer also enhanced TTC reducing activity of the root of B. chinense seedlings, inhibited malonaldehyde(MDA) content, increased superoxide dismutase(SOD), peroxidase(POD), and catalase(CAT) enzyme activities, improved chlorophyll content, and enhanced P_n, G_s, T_r, and other photosynthetic parameters. In conclusion, the application of humic acid water-soluble fertilizer diluted 1 800 times can significantly promote the growth of B. chinense seedlings, enhance root vitality, improve seedling stress resistance, and enhance photosynthesis. The results of this study can provide a theoretical basis for fertilization of B. chinense seedlings.

The erythromycin sorption removal at environmentally relevant concentration based on molecular imprinted polymer: Performance and mechanism.

The antibiotic pollution emerged in different environments has raised a great concern. Adsorption is an effective method to solve the problem. However, conventional adsorbents are not always efficient for antibiotic removal with interferences. Therefore, in this study, molecularly imprinted polymer (EMIP) with selective adsorption ability was prepared to remove a typical antibiotic-erythromycin (ERY) at environmentally relevant concentration. The specific surface area of EMIP was 265.62 m2/g with large pore volume, small pore size and hydrophobic surface. The adsorption capacity of EMIP was increased from 211.08 to 4015.51 µg/g when the concentration of ERY was increased from 5.00 to 100.00 µg/L. The isothermal adsorption process was fitted well with the Langmuir model. The adsorption kinetic could be well described by the pseudo-second-order model. With co-existing of interferences, the imprinting factor for ERY was 2.57, which demonstrated EMIP had good adsorption selectivity. After five consecutive adsorption-desorption experiments, the adsorption capacity of EMIP was still over 80%. The results of molecular dynamic simulation showed the adsorption energy between ERY and EMIP was high, which was favorable for ERY adsorption removal. Hopefully, the results of this study could provide new insights for trace antibiotic removal by molecular imprinting polymers in different aqueous environments.

Comparing the effectiveness and safety of Sorafenib plus TACE with Apatinib plus TACE for treating patients with unresectable hepatocellular carcinoma: a multicentre propensity score matching study.

OBJECTIVE: Local combined systemic therapy has been an important method for the treatment of unresectable hepatocellular carcinoma (HCC).The purpose of this study was to compare the effectiveness and safety of transarterial chemoembolization (TACE) plus Sorafenib versus TACE plus Apatinib for treating patients with unresectable HCC. METHODS: The clinical data of patients with unresectable HCC who were treated with TACE plus Sorafenib or TACE plus Apatinib at 5 Chinese medical centers between January 2016 and December 2020 were retrospectively analyzed. Propensity score matching (PSM) was applied to reduce the bias from confounding factors. RESULTS: A total of 380 patients were enrolled, of whom 129 cases were treated with TACE plus Sorafenib and 251 cases with TACE plus Apatinib. After the 1:1 PSM, 116 pairs of patients were involved in this study. The results showed that the PFS and OS in the TACE-Sorafenib group were significantly longer than those in the TACE-Apatinib group (PFS: 16.79 ± 6.45 vs. 14.76 ± 6.98 months, P = 0.049; OS: 20.66 ± 6.98 vs. 17.69 ± 6.72 months, P = 0.013). However, the ORR in the TACE-Apatinib group was markedly higher than that in the TACE-Sorafenib group (70.69% vs. 56.03%, P = 0.021). There were more patients with adverse events (AEs) in the TACE-Apatinib group than those in the TACE-Sorafenib group before dose adjustment (87 vs. 63, P = 0.001); however, the number of patients who suffered from AEs was not significantly different between the two groups after the dose adjustment (62 vs. 55, P = 0.148). No treatment-related death was found in the two groups. Subgroup analysis revealed that patients with unresectable HCC could better benefit from regular doses than reduced doses (Sorafenib, 22.59 vs. 18.02, P < 0.001; Apatinib, 19.75 vs. 16.86, P = 0.005). CONCLUSION: TACE plus either Sorafenib or Apatinib could effectively treat patients with unresectable HCC, the safety of TACE plus Sorafenib was better. and the ORR of TACE plus Apatinib was higher.

A series of two-dimensional carbon allotropes with Dirac cone structure.

By combining a hexagon and square carbon ring, a series of two-dimensional (2D) carbon allotropes, named (HS)nm-graphene, can be obtained. Based on the first-principles calculations, the energetic, dynamical and mechanical stability were evaluated. Importantly, we predicted that some carbon allotropes possess the Dirac cone structure. A pair of Dirac points can be found for (HS)52-graphene and (HS)72-graphene in the first Brillouin zone. With varying the number of four- and six-membered rings, a distorted Dirac cone can be observed for (HS)41-graphene and (HS)71-graphene. To get insight into the features of the Dirac cone, the orbital decomposed band structure, the corresponding density of states, the projection map of the three-dimensional bands and Fermi velocity were investigated. Interestingly, the Fermi velocity of (HS)52-graphene is up to 8.8 × 105 m s-1 along the kx direction, which is higher than that of graphene, indicating higher potential application in electronic transport. Finally, we discuss the mechanical properties of (HS)nm-graphene. Our work provides a new way to design the stable 2D carbon allotropes with a Dirac cone.

The contradictory roles of tightly bound and loosely bound extracellular polymeric substances of activated sludge in trimethoprim adsorption process.

Extracellular polymeric substances (EPS) of activated sludge are a mixture of high molecular weight polymers secreted by microorganisms, which have the double structure of tightly-bound EPS (TB-EPS) in inner layer and loosely-bound EPS (LB-EPS) in outer layer. The characteristic of LB- and TB-EPS were different, which would affect their adsorption of antibiotics. However, the adsorption process of antibiotics on LB- and TB-EPS was still unclear yet. Therefore, in this work, the roles of LB-EPS and TB-EPS in adsorption of a typical antibiotic-trimethoprim (TMP) at environmentally relevant concentration (25.0 µg/L) were investigated. The results showed the content of TB-EPS was higher than that of LB-EPS, which was 17.08 and 10.36 mg/g VSS, respectively. The adsorption capacity of raw, LB-EPS extracted and both LB- and TB-EPS extracted activated sludges for TMP were 5.31, 4.65 and 9.51 µg/g VSS, respectively, which indicated LB-EPS had positive effect on TMP removal, while TB-EPS had negative effect. The adsorption process can be well described by a pseudo-second-order kinetic model (R2 > 0.980). The ratio of different functional groups was calculated and the CO and C-O bond might be responsible for the adsorption capacity difference between LB- and TB-EPS. The fluorescence quenching results indicated that tryptophan protein-like substances in LB-EPS provided more binding sites (n = 0.36) than that of tryptophan amino acid in TB-EPS (n = 0.1). Furthermore, the extend DLVO results also demonstrated that LB-EPS promoted the adsorption of TMP, while TB-EPS inhibited the process. We hope the results of this study were helpful for understanding the fate of antibiotics in wastewater treatment systems.

Submucosal Tunneling Endoscopic Resection for Submucosal Tumors in the Proximal Esophagus.

BACKGROUND: Submucosal tunneling endoscopic resection (STER) is widely applied for treatment of gastrointestinal submucosal tumors (SMTs) originating from the muscularis propria layer. However, the tumor location within the proximal esophagus makes STER a challenge for the endoscopists. The aim of this study was to summarize the technique skill and evaluate the outcomes of proximal esophageal STER. STUDY DESIGN: A total of 72 patients with SMTs in the proximal esophagus undergoing STER were included from February 2019 to March 2021. Imaging 3-dimensional reconstruction was used for patients with large SMTs. Clinicopathological, endoscopic, and follow-up data were collected and analyzed. RESULTS: In this study, all the tumors were removed completely and no gross disease was remaining. The en bloc resection was achieved in 90.28% of patients, and the complications rate was 6.95%. Three-dimensional reconstruction was used for 30 patients (41.67%) with large SMTs (transverse diameter >2.0 cm). Based on statistical analysis, tumors with irregular shape and larger size were the significant contributors to piecemeal resection. Larger tumors increase the risk of long operation time, and irregular tumor shapes increase the risk of complications. The median hospitalization time was 4 days. All of the complications were cured by conservative treatment. A median follow-up of 12 months was available, and all patients were free from local recurrence or distant metastasis during the study period. CONCLUSIONS: STER is an effective and safe methodology for the resection of proximal esophageal SMTs. Tumor size and shape mainly impact the piecemeal resection rate, STER-related complications, and procedural difficulty.

Topological insulators on the square-hexagon lattice driven by next-nearest-neighbor hopping.

We investigate the topological phase transition of the square-hexagon lattice driven by the next-nearest-neighbor (NNN) hopping. By means of the Fukui-Hatsugai method, the topological invariantZ2can be determined. The phase diagrams in the (t1,t2) plane for different filling fractions are displayed, together with the size of the bulk band gap. We find the competition betweent1andt2can drive the system into topological nontrivial phase, withZ2= 1. Interestingly, for 2/5 and 3/5 filling fractions, topological nontrivial phase can be easily realized when the NNN hoppings are turned on. Besides, the phase diagrams in the plane oft2andλso2(t1andλso1) are also investigated. By numerically diagonalizing the Hamiltonian, the bulk band structures are calculated. And the topological trivial and nontrivial phase are also distinguished in terms of helical edge state. In experiments, these topological phase transitions may be realized by shaking optical lattice.

Insight into the role of different extracellular polymeric substances components on trimethoprim adsorption by activated sludge.

Adsorption is the primary mechanism of antibiotic removal in wastewater treatment plants, wherein the extracellular polymeric substances (EPS) of the activated sludge play an important role. Due to their complex characteristics, the effect of EPS components on antibiotic adsorption is unknown. Therefore, in this study, the role of main components of EPS in antibiotic adsorption was explored using enzymatic treatment. The results revealed that proteinase K and α-amylase can efficiently hydrolyse the proteins and polysaccharides of EPS. The protein content of EPS reduced from 31.25 mg/g VSS to 21.53, 18.75, and 10.76 mg/g VSS, after treatment with proteinase K, α-amylase and their combination, respectively; the polysaccharides content also observed a similar decrease from 15.20 mg/g VSS to 8.22, 7.83, and 6.03 mg/g VSS, respectively. The humic substance in EPS was stable during enzymatic treatment. The equilibrium adsorption capacity of activated sludge treated by enzyme for trimethoprim (TMP)- a typical antibiotic, was significantly increased from 2.19 µg/g VSS to 4.68, 5.34, and 8.36 µg/g VSS after treatment with proteinase K, α-amylase and their mixture. The adsorption process was adequately described by pseudo-second-order kinetic model. A multivariable linear regression model was subsequently used to quantify the adsorption capacity of activated sludge for TMP considering the concentration of EPS components. The modelling and validated results showed that the model could satisfactorily predict the TMP adsorption capacity. The results of this study can provide new insights into the role of EPS on antibiotic transformation in biological wastewater treatment systems.

Pulmonary Artery Catheter in Patients with Severe Acute Pancreatitis: A Single-Center Retrospective Study.

OBJECTIVE: It is still uncertain what effects pulmonary artery catheter (PAC)-guided resuscitation has on outcomes for patients with severe acute pancreatitis (SAP). Therefore, we aimed to investigate the effect of PAC on hospital mortality in patients with SAP. METHODS: We collected the data of patients with a diagnosis of SAP from January 10, 2017, to July 30, 2019. Patients were divided into a PAC group and a control group. The primary outcome measured was the day-28 mortality. Secondary outcomes included day-90 mortality, duration of ICU and hospital stay, ventilation days, usage of renal support and vasoactive agents, incidences of acute abdominal compartment syndrome, infusion volumes, and fluid balance and hemodynamic characteristics measured by the PAC. Kaplan-Meier analysis was applied to estimate survival outcomes. Complications related to PAC were also analyzed. RESULTS: There was no significant difference between the PAC group and the control group for day-28 mortality (22.7% vs. 30%, odds ratio, 0.69; 95% CI 0.31-1.52; P = 0.35). The duration of ICU stay in the PAC group was shorter (P = 0.00), and the rate of dependence on renal support treatment was lower in the PAC group than in the control group (P = 0.03). There was no difference in other secondary outcomes and no significant difference in the survival curve between the two groups (log-rank P = 0.72, X2 = 0.13). However, SAP patients inserted PAC within 24 h ICU admission showed that duration of renal support therapy in PAC patients within 24 h ICU admission (mean days, 1.60; standard deviation, 0.14) was shorter than those with 24-72 h ICU admission (mean days, 2.94; standard deviation, 0.73; P = 0.03). The organ failure rates (1 organ, 2 organs and 3 organs) were all lower in PAC patients within 24 h ICU admission than with 24-72 h ICU admission (P = 0.02, P = 0.02, P = 0.048, respectively). CONCLUSION: In patients with severe acute pancreatitis, PAC-guided fluid resuscitation shortened the duration of ICU stay, and patients in the PAC group had a lower rate of dependence on renal support, while no benefit in terms of mortality was observed. However, SAP patients inserted PAC within 24 h ICU admission showed shorter duration of renal support therapy and lower organ failure rates than those with 24-72 h ICU admission, indicating that early use of PAC, especially within 24 h, might be better for SAP patients.

The Efficacy and Prognostic Factors of the Combination of TACE and Apatinib for the Treatment of BCLC Stage C Hepatocellular Carcinoma.

Objective: Apatinib is a inhibitor of vascular endothelial growth factor receptor-2. To explore the efficacy and prognostic factors of transarterial chemoembolization (TACE) combined with apatinib in the treatment of Barcelona Clinic Liver Cancer stage C (BCLC C) hepatocellular carcinoma (HCC). Methods: Clinical data of 146 HCC patients with BCLC stage C admitted to our hospital were collected and analyzed retrospectively, of which 76 cases were treated with TACE combined with apatinib (TACE-apatinib) and 70 with TACE alone. The tumor response, survival time, and adverse events were compared between the two groups, and the factors affecting the prognosis were analyzed. Results: The objective response rate (ORR) and disease control rate (DCR) in the TACE-apatinib group were higher than in the TACE-alone group (ORR: 42.10 vs. 25.71%, P = 0.03; DCR: 84.21 vs. 55.71%, P = 0.001). The median time to progression (TTP) and overall survival (OS) in the TACE-apatinib group were longer than in the TACE-alone group (TTP: 5.5 vs. 3.7 months, P = 0.02; OS: 10.0 vs. 6.2 months, P = 0.01). Univariate and multivariate Cox regression analysis showed that tumor size, Child-Pugh class, and the presence of the portal vein tumor thrombus affect the prognosis of patients. Subgroup analysis revealed that TACE-apatinib therapy resulted in a higher OS in patients with tumor size <10 cm, without portal vein tumor thrombus, and with Child-Pugh class A (P < 0.05). The likelihood of adverse events (hand-foot syndrome, hypertension, oral ulcer) was significantly higher in the increased in the TACE-apatinib group than in the TACE alone group (P < 0.05). Conclusion: TACE-apatinib is an effective and safe method for the treatment of BCLC stage C HCC. Tumor size, Child-Pugh class, and portal vein tumor thrombus affect survival time in HCC patients with BCLC stage C.

Direct interaction between Rab5a and Rab4a enhanced epidermal growth factor-stimulated proliferation of gastric cancer cells.

BACKGROUND: Gastric cancer (GC) is one of the leading causes of cancer-related death worldwide. Although targeted therapies such as antibodies against human epidermal growth factor receptor 2 or vascular endothelial growth factor receptor 2 have been widely used in the treatment of metastatic cancer, the overall outcomes are poor. Therefore, elucidation of the mechanism underlying cancer progression is important to improve prognosis. Overexpression of the Rab5a gene has been confirmed to correlate with tumorigenesis of many cancers, but the mechanism underling, especially of GC, is still unclear. AIM: To investigate the effects of Rab5a overexpression on the tumorigenesis of GC. METHODS: First, the expression levels of Rab5a and Rab4a in primary tumorous tissues of GC patients diagnosed between 2015 and 2018 were analyzed. Then we constructed HGC-27 cell lines overexpressing green fluorescent protein-Rab5a or red fluorescent protein-Rab4a and investigated the interaction between Rab5a or Rab4a using Western blotting, co-immunoprecipitation, confocal microscopy, and colocalization analysis. Finally, epidermal growth factor-stimulated proliferation of these cell lines was analyzed using cell counting kit-8 cell viability assay. RESULTS: Compared with normal gastric tissues, the expression levels of Rab5a and Rab4a increased progressively both in paracancerous tissues and in advanced cancerous tissues. Epidermal growth factor could promote the proliferation of HGC-27 cells, especially Rab5a-overexpressing HGC-27 cells. Notably, Rab5a and Rab4a co-overexpression promoted the proliferation of HGC-27 cells to the greatest extent. Further analysis identified a direct interaction between Rab5a and Rab4a in HGC-27 cells. CONCLUSION: Co-overexpression of Rab5a and Rab4a in GC may promote the endosomal recycling of epidermal growth factor receptor, which in turn contributes to poor prognosis and tumor progression in GC patients. Inhibition of Rab5a or Rab4a expression might be a promising therapy for refractory GC.

[Characteristics of Dissolved Organic Matter in Overlying Water During Algal Bloom Decay].

In this study, indoor simulation experiments were performed to elucidate the effects of migration and transformation of dissolving organic matter (DOM) during the decay of algal blooms. Based on ultraviolet-visible spectra (UV-vis) and excitation-emission matrix spectroscopy (EEMs), spectral characterizations of dissolved organic matter (DOM) in overlying water were evaluated with analyses of the physical and chemical indexes, variation in dissolved organic carbon (DOC), and variation in dissolved inorganic carbon (DIC). Results showed that at the early stage of decay, a large amount of organic matter was released, and dissolved oxygen (DO) decreased sharply. With the extension of reaction time, DOC gradually changed into DIC, which further changed the oxidation-reduction and acid-base characteristics of the water. UV-vis spectra showed that a large amount of DOM was released with high aromaticity and a high degree of humification, and the released DOM was gradually degraded. With the application of parallel factor analysis in excitation-emission matrix spectroscopy (EEM-PARAFAC), three fluorescence components were analyzed:refractory humic-like substances (C1), protein-like tryptophan substances (C2) produced by algae, and fulvic-like substances (C3) related to microbial activities. Most protein-like tryptophan substances were degraded into fulvic-like substances by microorganisms during the decaying process. Heterotrophic microorganisms promoted the release of algae-derived DOM and accelerated the degradation of DOM. The DOM born during algae blooms decaying process was eventually converted into humic-like substance, which was difficult to be degraded. We analyzed correlations of water quality, UV-vis spectrum, and EEMs parameters. Results showed that ORP was positively correlated (P<0.05) with DO. There was a significant negative correlation (P<0.05) between pH and DOC, which was consistent with the trend of the transformation to from DOC to DIC; C1 was positively correlated (P<0.05) with Fn355; and C2 was significantly positively correlated (P<0.05) with DOC and Fn280; C3 was positively correlated (P<0.05) with FI, BIX and ß:α. The variation trend of these spectral parameters was consistent with that of DOM components. In summary, with the analyses of water quality characteristics and spectral characteristics of DOM in overlying water during algae blooms decaying process, it was expected that our results could contribute to the further exploration of the dynamic migration and transformation of lake DOM and the changes of carbon cycling.

The inhibitory effect of in situ extracellular polymeric substances on trimethoprim adsorption by activated sludge.

The extracellular polymeric substances (EPS) of activated sludge are a mixture of high molecular weight polymers secreted by microorganisms, which are mainly composed of proteins, polysaccharides and humic substances. It is widely accepted that EPS have a good adsorption ability for pollutants with different functional groups. However, recent studies showed the EPS had an inhibitory effect on pollutant sorption, which is contradictory to previous viewpoint. Therefore, in this study, three types of activated sludge with different EPS contents and compositions were used to investigate the role of EPS in an antibiotic-trimethoprim (TMP) sorption process at environmentally relevant concentration. The in situ experiments results showed the adsorption capacity of activated sludge for TMP were increased from 2.98, 5.37 and 28.33 µg/g VSS to 7.87, 12.93 and 150.24 µg/g VSS in nitrifying activated sludge, wastewater treatment plant activated sludge and anaerobic ammonia-oxidized activated sludge, respectively after EPS extracted. The adsorption process can be well described by the pseudo-second-order kinetic model. Results of zeta potential, contact angles and infrared spectrum showed TMP replacing proteins embedded into the cell membrane enhancing the TMP adsorption capacity of activated sludge after EPS extraction. Our results demonstrated that less proteins in EPS of activated sludge is more beneficial for TMP adsorption removal.

[Effect of hysteretic acupuncture on joint function and related cytokines in articular fluid in patients with knee osteoarthritis].

OBJECTIVE: To observe the difference of therapeutic effect between hysteretic acupuncture and Celecoxib capsules for knee osteoarthritis(KOA), and to investigate their effects on levels of interleukin 6(IL-6) and tumor necrosis factor α(TNF-α) in articular fluid. METHODS: Seventy-two patients with KOA were randomly divided into hysteretic acupuncture and me-dication groups, with 36 cases in each group. The patients of the hysteretic acupuncture group received hysteretic acupuncture stimulation at Dubi (ST35), Neixiyan (EX-LE4), Zusanli (ST36), Yanglingquan (GB34), Yinlingquan (SP9), Xuehai (SP10), Liangqiu (ST34) and Heding (EX-LE2) as the main acupoints for 30 min once daily. The patients of the medication group received oral administration of Celecoxib capsules(200 mg) once daily. Both of the two groups were treated with 14 days as a course of treatment, with a 2-day rest between each course of treatment, and the treatments were conducted for 2 courses. The visual analogue scale(VAS) score of pain, Lequesne index score, IL-6 and TNF-α level in joint fluid and the change of traditional Chinese medicine(TCM) syndrome score were observed before and after treatment. RESULTS: Compared with pre-treatment, the VAS score, Lequesne index score, IL-6 and TNF-α level, and total TCM syndrome score decreased significantly after treatment in both of the two groups (P<0.05). Hysteretic acupuncture was more effective in reducing VAS score, Lequesne index score, IL-6 and TNF-α level than Celecoxib capsules (P<0.05), and there was no significant difference in total TCM syndrome score and total effective rate between the two groups(P>0.05). No adverse events occurred in both groups during the treatment. CONCLUSION: Hysteretic acupuncture can effectively relieve pain symptoms and improve joint function in KOA patients. Its effect is comparable to that of oral administration of Celecoxib capsules.

The clinical application of microincision vein harvesting of the great saphenous vein in coronary artery bypass grafting.

BACKGROUND: The present study aimed to summarize the clinical application of microincision vein harvesting (MVH) of the great saphenous vein in coronary artery bypass grafting (CABG). METHODS: From July 2014 to October 2017, 160 patients underwent coronary artery bypass grafting. Among them, 80 patients received MVH of the great saphenous vein, and 80 received open venous harvesting (OVH). The results of the sampling operation, complications during hospitalization, and the long-term patency of the great saphenous vein were compared between the two groups. RESULTS: All the patients in both groups received successful operations. The difference in the length of the veins obtained and the injury of the veins was not statistically significant (P > 0.05). The difference in the long-term patency rate of the graft vessels between the two groups was not statistically significant. The in-hospital mortality rate was the same in both groups. The MVH group had noticeable advantages over the OVH group in terms of the vein collection times, the incision length, and the complications experienced when performing the leg incisions (P < 0.01). The time relating to the patients' observed early out-of-bed activity was significantly longer in the MVH group. Furthermore, the patients' hospitalization length was significantly shorter in the MVH group compared to the OVH group (P < 0.05). The MVH group had significant advantages in pain score and patient satisfaction, and this difference was also statistically significant (P < 0.05). CONCLUSIONS: The MVH procedure met the requirements of CABG in vein grafting. When compared with OVH, MVH can significantly reduce leg incision complications and improve patients' overall satisfaction with their hospital experience.

An Indole Alkaloid Extracted from Evodia rutaecarpa Inhibits Colonic Motility of Rats In Vitro.

Evodiamine (Evo) is an indole alkaloid extracted from the traditional Chinese medicinal herb Evodia rutaecarpa. Evo may regulate gastrointestinal motility, but the evidence is insufficient, and the mechanisms remain unknown. The aim of this study was to investigate the effect of Evo on colonic motility of rats and the underlying mechanisms in vitro. Rat colonic muscle was exposed to Evo (10 and 100 µM) followed by immunohistochemistry of cholecystokinin receptor 1 (CCK1R). Muscle contractions were studied in an organ bath system to determine whether CCK1R, nitric oxide (NO), and enteric neurons are involved in the relaxant effect of Evo. Whole-cell patch-clamp was used to detect L-type calcium currents (I Ca,L) in isolated colonic smooth muscle cells (SMCs). CCK1R was observed in SMCs, intermuscular neurons, and mucosa of rat colon. Evo could inhibit spontaneous muscle contractions; NO synthase, inhibitor L-NAME CCK1R antagonist, could partly block this effect, while the enteric neurons may not play a major role. Evo inhibited the peak I Ca,L in colonic SMCs at a membrane potential of 0 mV. The current-voltage (I-V) relationship of L-type calcium channels was modified by Evo, while the peak of the I-V curve remained at 0 mV. Furthermore, Evo inhibited the activation of L-type calcium channels and decreased the peak I Ca,L. The relaxant effect of Evo on colonic muscle is associated with the inhibition of L-type calcium channels. The enteric neurons, NO, and CCK1R may be partly related to the inhibitory effect of Evo on colonic motility. This study provides the first evidence that evodiamine can regulate colonic motility in rats by mediating calcium homeostasis in smooth muscle cells. These data form a theoretical basis for the clinical application of evodiamine for treatment of gastrointestinal motility diseases.

Submucosal tunneling endoscopic resection for large symptomatic submucosal tumors of the esophagus: A clinical analysis of 24 cases.

BACKGROUND/AIMS: Studies evaluating submucosal tunneling endoscopic resection (STER) for the treatment of upper gastrointestinal submucosal tumors (SMTs) have recently increased. However, the efficacy and safety of STER for the treatment of large symptomatic SMTs in the esophagus have not been well investigated. The aim of the present study was to evaluate the efficacy and safety of STER for the treatment of large symptomatic SMTs in the esophagus. METHODS: A total of 24 patients with large symptomatic SMTs in the esophagus who underwent STER in our hospitals between January 2015 and May 2018 were included in the study. The tumors were confirmed to be of muscularis propria layer origin. Treatment outcomes, complications, and follow-up results were retrospectively analyzed. RESULTS: All 24 lesions were resected en bloc with STER. The mean maximum transverse diameter of the lesions was 4.7 (3.5-6.5) cm. The mean maximum longitudinal diameter of the lesions was 2.1 (1.5-3.0) cm. The mean duration from mucosal incision to complete mucosal closure was 65 (50-115) min. Postoperative pathological diagnosis confirmed 18 cases with leiomyomas, 4 cases with stromal tumors, and 2 cases with schwannomas. There were no major complications. There were no residual lesions or disease recurrence during follow-up. CONCLUSION: STER is safe and effective for the treatment of large symptomatic SMTs of muscularis propria layer origin in the esophagus.

Critical process parameter identification of manufacturing processes of Astragali Radix extract with a weighted determination coefficient method.

Objective: Critical process parameters (CPPs) identification is an important step of the implementation of quality by design (QbD) concept. There are many CPP identification methods, such as risk analysis method, sensitivity analysis method, multiple linear regression method, standard partial regression coefficient (SPRC) method, and so on. The SPRC method can consider multiple process critical quality attributes (CQAs) simultaneously, but the determination of CPP number is subjective. Therefore, new CPP identification method is still required. Methods: The manufacturing process of Astragali Radix extract, which contained water reflux extraction, concentration, and ethanol precipitation, was used as an example. First, the multiple process CQAs were determined to be the yield of pigment, dry matter, sugars, and active ingredients. Second, the potential CPPs were determined by a knowledge organization method. Plackett-Burman designed experiments were then performed. A weighted determination coefficient ( R w 2 ) method was presented to identify CPPs. In this method, the importance of different CQAs was considered. Process parameters were removed one-by-one according to their importance index. The decrease in R w 2 was used to characterize the importance of the removed parameter. If the decrease of R w 2 was less than a preset threshold, the removed parameter was not a CPP. Results: During the manufacturing process of Astragali Radix extract, the potential CPPs determined by the knowledge organization method were water consumption, reflux extraction time, extraction frequency, ethanol content, ethanol consumption, and concentration endpoint. Reflux extraction time, the first ethanol consumption, the second ethanol consumption, and the second ethanol precipitation refrigeration temperature were found to be CPPs using the weighted determination coefficient method with the threshold of 10%. Conclusion: Using the weighted determination coefficient method, CPPs can be determined with all the CQAs considered based on their importance. The determination of CPP number is more objective compared with the SPRC method.

Quantitatively ranking the influencing factors of ammonia volatilization from paddy soils by grey relational entropy.

Ammonia (NH3) volatilization from paddy soils is a main source of atmospheric NH3 and the magnitude is affected by many factors. Because of the complex field condition, it is difficult to identify the relative importance of individual factor on NH3 volatilization process in different locations and at different times. In this study, the grey relational entropy method was used to evaluate the relative impact of four main factors (i.e., nitrogen fertilizer application rate, NH4-N concentration, pH, and temperature of the floodwater) on NH3 volatilization loss from three different field experiments. The results demonstrated that floodwater NH4-N concentration was the most important factor governing NH3 volatilization process. Floodwater pH was the second most important factor, followed by temperature of the floodwater and nitrogen fertilizer application rate. We further validated the grey relational entropy method with NH3 volatilization loss data from other published study and confirmed the order of importance for the four factors. We hope the findings of this study will be helpful for guiding design to reduce paddy soil NH3 emission.