Development of a Multifaceted Perspective for Systematic Analysis, Assessment, and Performance for Environmental Standards of Contaminated Sites.

Contaminated soil and groundwater can pose significant risks to human health and ecological environments, making the remediation of contaminated sites a pressing and sustained challenge. It is significant to identify key performance indicators and advance environmental management standards of contaminated sites. The traditional study currently focuses on the inflexible collection of related files and displays configurable limitations regarding integrated assessment and in-depth analysis of published standards. In addition, there is a relative lack of research focusing on the analysis of different types of standard documents. Herein, we introduce a cross-systematic retrospective and review for the development of standards of the contaminated sites, including the comprehensive framework, multifaceted analysis, and improved suggestion of soil and groundwater standards related to the environment. The classification and structural characteristics of different types of files are systematically analyzed of over 300 national, trade, local, and group standards for the contaminated sites. It exhibits that trade standards are the main types and testing methods are the important format within numerical considerations of soil standards. The guide standard serves as a crucial component in environmental management for investigating, assessing, and remediating of contaminated sites. Future improvement plans and development directions are proposed for advancing robust technical support for effective soil contamination prevention and control. This multidimensional analysis and the accompanying suggestions can provide improved guidance for Chinese environmental management of contaminated sites and sparkle the application of standards in a wide range of countries.

A critical application of different methods for the vulnerability assessment of shallow aquifers in Zhengzhou City.

Groundwater vulnerability can partially reflect the possibility of groundwater contamination, which is crucial for ensuring human health and a good ecological environment. The current study seeks to assess the groundwater vulnerability of Zhengzhou City by adopting an amended version of the traditional DRASTIC model, i.e., the DRASTICL model, which incorporates land use type indicators. More specifically, the AHP-DRASTICL, entropy-DRASTICL, and AE-DRASTICL models were established by optimizing weights using the analytic hierarchy process (AHP) and entropy weight method. The evaluation results for these five models were divided into five levels: very low, low, medium, high, and very high. Using Spearman's rank correlation coefficient, the nitrate concentration was used to verify the groundwater vulnerability assessment results. The AE-DRASTICL model was found to perform the best, with a Spearman correlation coefficient of 0.78. However, the AHP and entropy weight method effectively improved the accuracy of vulnerability assessment results, making it more suitable for the study area. This study provides important insights to inform the design of strategies to protect groundwater in Zhengzhou.

Association between Three Therapeutic Strategies and Clinical Outcomes of 2009 FIGO Stage IB2/IIA2 Cervical Cancer.

Objective: The aim of this study was to compare clinical outcomes of three therapeutic strategies in patients with stage IB2/IIA2 cervical cancer. Methods: This is a retrospective cohort study. Patients diagnosed with stage IB2/IIA2 cervical cancer between April 2010 and December 2015 at First Affiliated Hospital of Guangxi Medical University were included and classed into three groups. The primary outcomes were overall survival (OS) and progression-free survival (PFS). The secondary outcomes included toxicity, hospitalization costs, clinical value, and length of stay. Results: 206 patients were included: 104 used primary surgical treatment (PST), 53 used neoadjuvant chemotherapy followed by radical surgery (NAC + RS), and 49 used concurrent chemoradiotherapy (CCRT). Fewer patients with NAC + RS had deep cervical stromal invasion than primary surgical treatment (PST) (P=0.024). 70.2% of PST and 77.4% in NAC + RS required postoperative radiotherapy or chemoradiotherapy (P=0.634). Median follow-up was 57 months and the 3-year OS and PFS in PST, NAC + RS, and CCRT group were 87.5%, 84.9%, 85.7% and 85.6%, 79.2%, 85.7% (P=0.856 and P=0.424, respectively). Three therapeutic strategies were not associated with OS and PFS. Hospitalization costs were significantly higher in NAC + RS compared to PST (P < 0.001) and CCRT (P < 0.001). Length of stay in NAC + RS was longer than PST (P < 0.001) and CCRT group (P=0.07). Conclusion: The results of this study tend to suggest that the three therapeutic strategies were equivalent treatment options for patients with 2009 FIGO stage IB2/IIA2 cervical cancer. However, prospective larger studies are needed to confirm this. In addition, we did find that concurrent chemoradiotherapy needed shorter treatment time and less cost.

A sustainability assessment-based methodology for the prioritization of contaminated site risk management options.

Contaminated site management is a multiple objective decision-making that generally involves different factors, such as performance of technology, environmental effects, cost, and social influence. In this study, we developed a sustainability assessment-based methodology for the prioritization of contaminated site risk management options. We integrate remediation sustainable assessment and redevelopment sustainable assessment in one framework and allow the optimization of indicators. The framework started with the definition of site management type, then investigating site characterization, screening indicators, quantifying of indicator, selecting assessment model, selecting primary options, assessment with uncertainty analysis, and determining of preferred options. To demonstrate the utility of the framework, results are presented in a contaminate site in southwest China for two risk management decisions, site remediation and site redevelopment. We used different approaches to evaluate the stability and robustness of assessment results, including Monte Carlo simulation, scenario analysis, and sensitivity analysis. The demonstration showed that attention has to be paid to the proper description of the site, the principles of the procedure, and the decision criteria.

Cardiac Rehabilitation with Targeted Intensity Improves Cardiopulmonary Functions Accompanying with Reduced Copeptin Level in Patients with Coronary Artery Disease.

Cardiac rehabilitation (CR) plays an important role in cardiovascular disease prevention. Understanding the key component of CR such as training intensity and biomarkers reflecting cardiopulmonary functions may help to better target the rehabilitation program. Thirty-four consecutive patients with coronary artery disease after percutaneous coronary intervention participated in the CR program. The difference between intervention group and control group was mainly the training intensity. Cardiopulmonary exercise testing (CPET) and blood biomarker measurements were performed before and after CR. The results demonstrated that it was safe and feasible to perform CR, while sufficient training intensity was required to significantly ameliorate CPET parameters. Among numerous biomarkers tested, vasopressin surrogate marker copeptin (CPP) improved significantly after CR. Moreover, improved CPP was correlated with exercise intensity and peak oxygen uptake, two most important indicators of cardiopulmonary exercise capacities. Therefore, CR may have a novel role in maintaining plasma osmolality and cardiovascular homeostasis. Graphical Abstract Cardiac rehabilitation training improves cardiopulmonary exercise parameters El and PVO2 which are correlated with reduced CPP level. CPP, copeptin; El, exercise intensity; POV2, peak oxygen uptake.

Effects of radial extracorporeal shockwave therapy on spasticity of upper-limb agonist/antagonist muscles in patients affected by stroke: a randomized, single-blind clinical trial.

BACKGROUND: the effects of radial extracorporeal shock wave therapy (rESWT) were assessed on agonist/antagonist muscles in stroke patients with elbow spasticity, the duration of effects and influence on function. METHODS: patients were randomly assigned into groups: control (A, n = 25), rESWT on agonist muscles (B, n = 27) and rESWT on antagonist muscles (C, n = 30) groups. Conventional physical therapy was given to three groups for 3 weeks, six times a week, and besides, rESWT was given at 4-day intervals for five consecutive treatments, B received rESWT on agonist muscles and C received rESWT on antagonist muscles. The primary outcome was Modified Ashworth Scale (MAS) scores. Modified Tardieu Scale, Visual Analogue Scale (VAS), Fugl-Meyer Assessment and swelling scale (SS) scores were secondary outcomes. Indicators were assessed at baseline, after five treatments and after 4 weeks follow-up. RESULTS: the rate of treatment was determined by changes in MAS, which was 16.0 (A), 70.4 (B) and 63.3% (C) after rESWT treatments, and was 24.0 (A), 74.1 (B) and 66.7% (C) after 4 weeks follow-up. Improvements were achieved for R1 (P < 0.01), R2 (P < 0.01) and VAS (P < 0.01) after five rESWT interventions. At 4 weeks, significant improvements were achieved for R1 (P < 0.01) and VAS (P < 0.01). CONCLUSIONS: rESWT is an effective therapy for spasticity after stroke, with lasting effects on both agonist and antagonist muscles after 4 weeks. rESWT relieved pain but had no effect on active function or swelling of the upper limbs.

Aerobic exercise-based cardiac rehabilitation in Chinese patients with coronary heart disease: study protocol for a pilot randomized controlled trial.

BACKGROUND: Cardiovascular disease is the leading cause of morbidity and mortality in the world, including China. Cardiac rehabilitation (CR) has been demonstrated to be beneficial in reducing cardiovascular mortality, myocardial infarction, and cerebrovascular events. This pilot study seeks to assess the feasibility of aerobic-exercise-based CR in Chinese patients with coronary heart disease (CHD) and outcomes of aerobic metabolism capacity and molecular biomarkers. METHODS/DESIGN: This study is a single-center, pilot, randomized, controlled study that is currently being carried out at a regional hospital in Shanghai. Forty patients with CHD who underwent percutaneous coronary intervention will be randomly allocated into either the intervention group or control group. Participants in the intervention group will undergo 8 weeks of aerobic exercise with targeted intensity and participants in the control group will undergo 8 weeks of leisure exercise. The primary measurement is the feasibility of the trial; the secondary measurement is the capacity of aerobic metabolism and the exploratory measurement includes additional molecular biomarkers underlying cardiovascular function. DISCUSSION: This is the first prospective randomized and controlled clinical study in China that assesses the parameters of aerobic metabolism and comprehensively screens for substantial blood biomarkers to reveal the molecular mechanisms underlying changes in cardiovascular function after aerobic exercise with targeted intensity in participants with CHD. The success of this study will contribute to guide the design of future CR studies in patients with CHD in China. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR-IPR-17010556 . Registered on 1 June 2016.

Bu-Shen-Tong-Luo decoction prevents bone loss via inhibition of bone resorption and enhancement of angiogenesis in ovariectomy-induced osteoporosis of rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Gathering three ancient formulas, traditional Chinese medicine Bu-Shen-Tong-Luo decoction (BSTLD) has been used to treat postmenopausal osteoporosis (PMO) at the Jiangsu Province Hospital of Chinese Medicine for decades. However, the effect of BSTLD on angiogenesis and bone resorption as well as its possible mechanism are still unknown. AIM OF THE STUDY: This study was aimed to evaluate the preventive effect of BSTLD on ovariectomy-induced bone loss and vasculature disorder, and to investigate the possible bone protection mechanism of BSTLD in inhibiting bone resorption by enhancing angiogenesis signaling in ovariectomy-induced osteoporosis of rats. MATERIALS AND METHODS: The animal experiment was divided into five groups. Rats underwent either sham surgery with intact ovaries (SHAM, n = 10) or bilateral ovariectomy (OVX, n = 40). OVX rats were randomly divided into four groups and gavaged by water (vehicle, 12 mL/kg, n = 10), BSTLD (6 g/kg, n = 10), BSTLD (12 g/kg, n = 10) and 17ß-estradiol (E2, 100 µg/kg, n = 10) daily for 12 weeks, respectively. The bone loss and microstructure of the distal femur were observed using micro-computed tomography (µCT). The biomechanical parameters of the femur were detected using three-point bending tests. The distribution of osteoclasts and endothelial cells were analyzed by immunohistochemistry. The mRNA and protein levels of angiogenesis-related hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF), as well as osteoclast activation-related signaling calcitonin receptor (CALCR), cathepsin K (CTSK), receptor activator of NF-κB ligand (RANKL), osteoprotegerin (OPG), and ß-catenin were assayed by RT-PCR or Western blot. RESULTS: BSTLD protected trabecular bone mass density and trabecular bone microstructure from ovariectomy-induced osteoporosis in rats. BSTLD significantly reduced mRNA and protein levels of calcitonin receptor and CTSK in femoral metaphysis and inhibited bone resorption in ovariectomized rats. Furthermore, BSTLD stabilized HIF-1α activity and subsequently increased VEGF expression to enhance angiogenesis and modulated RANKL/OPG signaling in this animal model. CONCLUSIONS: These results demonstrated that BSTLD reduced osteoclasts activation and bone resorption in ovariectomy-induced osteoporosis. Bone protection by BSTLD may be associated with its stimulation of HIF-1α/VEGF angiogenesis signaling and suppression of RANKL/OPG ratio. This study may provide evidence that BSTLD treats postmenopausal osteoporosis, especially with micro-circulation complication.

Responses of the electron transfer capacity of soil humic substances to agricultural land-use types.

Humic substances (HS) are redox-active organic compounds that constitute a major fraction of natural organic matter in soils. The electron transfer capacity (ETC) of soil HS is mainly dependent on the type and abundance of redox-active functional groups in their structure. It is unclear whether or not agricultural land-use types can affect the ETC of HS in soils. In the present study, we evaluate the responses of ETCs of soil humic acids (HA) and fulvic acids (FA) to different agricultural land-use types. Our results show that both HA and FA of paddy soil showed the highest ETCs, followed by tomato soil, celery cabbage soil, grapevine soil, and myrica rubra soil, respectively. Agricultural land-use types could affect the transformation and decomposition of HS in soils, and thus further change the intrinsic chemical structures associated with ETC. Consequently, the ETC of soil HS exerts a significant difference among different agricultural land-use types. The results of this study could give insight into the roles of HS redox properties on the transport, fate, and redox conversion of organic and inorganic pollutants in different agricultural soils.

The Emerging Role of MicroRNA-155 in Cardiovascular Diseases.

MicroRNAs have been demonstrated to be involved in human diseases, including cardiovascular diseases. Growing evidences suggest that microRNA-155, a typical multifunctional microRNA, plays a crucial role in hematopoietic lineage differentiation, immunity, inflammation, viral infections, and vascular remodeling, which is linked to cardiovascular diseases such as coronary artery disease, abdominal aortic aneurysm, heart failure, and diabetic heart disease. The effects of microRNA-155 in different cell types through different target genes result in different mechanisms in diseases. MicroRNA-155 has been intensively studied in atherosclerosis and coronary artery disease. Contradictory results of microRNA-155 either promoting or preventing the pathophysiological process of atherosclerosis illustrate the complexity of this pleiotropic molecule. Therefore, more comprehensive studies of the underlying mechanisms of microRNA-155 involvement in cardiovascular diseases are required. Furthermore, a recent clinical trial of Miravirsen targeting microRNA-122 sheds light on exploiting microRNA-155 as a novel target to develop effective therapeutic strategies for cardiovascular diseases in the near future.