Groundwater hydrochemical signatures, nitrate sources, and potential health risks in a typical karst catchment of North China using hydrochemistry and multiple stable isotopes.

Nitrate pollution in aquatic ecosystems has received growing concern, particularly in fragile karst basins. In this study, hydrochemical compositions, multiple stable isotopes (δ2H-H2O, δ18Ο-Η2Ο, δ15Ν-ΝΟ3-, and δ18Ο-ΝΟ3-), and Bayesian stable isotope mixing model (MixSIAR) were applied to elucidate nitrate pollution sources in groundwater of the Yangzhuang Basin. The Durov diagram identified the dominant groundwater chemical face as Ca-HCO3 type. The NO3- concentration ranged from 10.89 to 90.45 mg/L (average 47.34 mg/L), showing an increasing trend from the upstream forest and grassland to the downstream agricultural dominant area. It is worth noting that 47.2% of groundwater samples exceeded the NO3- threshold value of 50 mg/L for drinking water recommended by the World Health Organization. The relationship between NO3-/Cl- and Cl- ratios suggested that most groundwater samples were located in nitrate mixed endmember from agricultural input, soil organic nitrogen, and manure & sewage. The Self-Organizing Map (SOM) and Pearson correlations analysis further indicated that the application of calcium fertilizer, sodium fertilizer, and livestock and poultry excrement in farmland elevated NO3- level in groundwater. The output results of the MixSIAR model showed that the primary sources of NO3- in groundwater were soil organic nitrogen (55.3%), followed by chemical fertilizers (28.5%), sewage & manure (12.7%), and atmospheric deposition (3.4%). Microbial nitrification was a dominant nitrogen conversion pathway elevating NO3- levels in groundwater, while the denitrification can be neglectable across the study area. The human health risk assessment (HHRA) model identified that about 88.9%, 77.8%, 72.2%, and 50.0% of groundwater samples posing nitrate's non-carcinogenic health hazards (HQ > 1) through oral intake for infants, children, females, and males, respectively. The findings of this study can offer useful biogeochemical information on nitrogen pollution in karst groundwater to support sustainable groundwater management in similar human-affected karst regions.

Hydrogeochemical characterization, quality assessment, and potential nitrate health risk of shallow groundwater in Dongwen River Basin, North China.

Assessing groundwater geochemical formation processes and pollution circumstances is significant for sustainable watershed management. In the present study, 58 shallow groundwater samples were taken from the Dongwen River Basin (DRB) to comprehensively assess the hydrochemical sources, groundwater quality status, and potential risks of NO3- to human health. Based on the Box and Whisker plot, the cation's concentration followed the order of Ca2+ > Mg2+ > Na+ > K+, while anions' mean levels were HCO3- > SO42- > NO3- > Cl-. The NO3- level in groundwater samples fluctuated between 4.2 and 301.3 mg/L, with 67.2% of samples beyond the World Health Organization (WHO) criteria (50 mg/L) for drinking. The Piper diagram indicated the hydrochemical type of groundwater and surface water were characterized as Ca·Mg-HCO3 type. Combining ionic ratio analysis with principal component analysis (PCA) results, agricultural activities contributed a significant effect on groundwater NO3-, with soil nitrogen input and manure/sewage inputs also potential sources. However, geogenic processes (e.g., carbonates and evaporite dissolution/precipitation) controlled other ion compositions in the study area. The groundwater samples with higher NO3- values were mainly found in river valley regions with intense anthropogenic activities. The entropy weight water quality index (EWQI) model identified that the groundwater quality rank ranged from excellent (70.7%) and good (25.9%) to medium (3.4%). However, the hazard quotient (HQ) used in the human health risk assessment (HHRA) model showed that above 91.38% of groundwater samples have a NO3- non-carcinogenic health risk for infants, 84.48% for children, 82.76% for females, and 72.41% for males. The findings of this study could provide a scientific basis for the rational development and usage of groundwater resources as well as for the preservation of the inhabitants' health in DRB.

Electrospun fibers based anisotropic silk fibroin film with photodynamic antibacterial therapy for S. aureus infected wound healing.

Bacterial infection has been regarded as a life-threatening problem in clinic. In addition to screening of new antibiotics, it is important to develop highly effective antibacterial materials against antibiotic resistance with capacities on modulating chronic inflammation. Herein, aligned Chlorin e6 (Ce6) conjugated silk fibroin electrospun fibers were successfully fabricated on silk fibroin based film via electrospining to achieve effective photodynamic antibacterial activities under near infrared (NIR) irradiation. The aligned electrospun fiber based film composite (SFCF@Film) exhibited good mechanical properties and desirable hemocompatibility. SFCF@Film provided a promising guidance cue for directing cell orientation and promoting cell growth. Significantly, SFCF@Film effectively generated ROS under NIR irradiation to kill S. aureus for treating wound infections within 10 min and promoted M2 polarization of macrophages for wound healing at later stage. Therefore, we believed that this engineered bioscaffold can be a powerful strategy for handling wound infection.

Polydopamine Nanostructure-Enhanced Water Interaction with pH-Responsive Manganese Sulfide Nanoclusters for Tumor Magnetic Resonance Contrast Enhancement and Synergistic Ferroptosis-Photothermal Therapy.

Rational structure design benefits the development of efficient nanoplatforms for tumor theranostic application. In this work, a multifunctional polydopamine (PDA)-coated manganese sulfide (MnS) nanocluster was prepared. The polyhydroxy structure of PDA enhanced the water interaction with pH-responsive MnS nanoclusters via hydrogen bonds. At pH 5.5 conditions, the spin-lattice relaxation rate of MnS nanoclusters dramatically increased from 5.76 to 19.33 mM-1·s-1 after the PDA coating, which can be beneficial for efficient tumor magnetic resonance imaging. In addition, PDA endowed MnS nanoclusters with excellent biocompatibility and good photothermal conversion efficiency, which can be used for efficient tumor photothermal therapy (PTT). Furthermore, MnS nanoclusters possess the ability to release H2S in the acidic tumor microenvironment, effectively inhibiting mitochondrial respiration and adenosine triphosphate production. As a result, the expression of heat shock protein was obviously reduced, which can reduce the resistance of tumor cells to photothermal stimulation and enhance the efficacy of PTT. The released Mn2+ also displayed efficient peroxidase and glutathione oxidase-like activity, effectively inducing tumor cell ferroptosis and apoptosis at the same time. Therefore, this nanoplatform could be a potential nanotheranostic for magnetic resonance contrast enhancement and synergistic ferroptosis-PTT of tumors.

Identifying the hydrochemical features, driving factors, and associated human health risks of high-fluoride groundwater in a typical Yellow River floodplain, North China.

Fluoride enrichment (> 1.5 mg/L) in groundwater has become a global threat, particularly given the hazards to human health. This study collected 58 unconfined groundwater samples from Fengpei Plain in June 2022 for hydrochemical and stable isotope analyses combined with multiple methods to explore sources, influencing factors, and potential health hazards of groundwater F-. The results showed that groundwater F- concentration ranged from 0.08 to 8.14 mg/L, with an average of 1.91 mg/L; over 41.4% of them exceeded the acceptable level of 1.5 mg/L prescribed by the World Health Organization (WHO). The dominant hydrochemical facies changed from Ca·Mg-HCO3 and Ca·Mg-SO4·Cl type in low-F- groundwater to Na-HCO3 and Na-SO4·Cl water types in high-F- groundwater. The Self-Organizing Map (SOM) and ionic correlation analysis indicated that F- is positively correlated to pH, EC, Na+, K+, SO42-, and TDS, but negatively to Ca2+ and δ18O. Groundwater F- accumulation was primarily driven by F--bearing minerals dissolution such as fluorite. Simultaneously, the carbonates precipitation, positive cation exchange processes, and salt effect were conducive to groundwater F- enrichment. However, competitive adsorption between OH-/HCO3- and F-, evaporation, and anthropogenic activities only had a weak effect on the F- enrichment in groundwater. The hazard quotient (HQ) assessment results show that 67.2% of groundwater samples pose a non-carcinogenic risk (HQ > 1) for infants, followed by 53.4% for children, 32.8% for females, and 25.9% for males. The Monte Carlo simulation results agreed with those of the deterministic model that minors are more susceptible than adults. These findings are vital to providing insights into the geochemical behavior, driving factors, and drinking water safety of high-F- groundwater worldwide.

Biochar and Chlorella increase rice yield by improving saline-alkali soil physicochemical properties and regulating bacteria under aquaculture wastewater irrigation.

The combined effects of biochar and Chlorella under aquaculture wastewater irrigation in improving saline-alkali soil physicochemical properties, microbial communities, and rice yield, is not yet clear. This study utilized soil physicochemical indicators and gene sequencing to examine the effect of salinity stress, biochar and Chlorella under aquaculture wastewater irrigation on soil properties, bacterial community compositions, and rice production. Treatments included three factors in a randomized complete block design with three replications: (i) Biochar - 40 tons ha -1 (BW) versus no-biochar (BN); (ii) Salinity - 3‰ salinity (SH) versus 1‰ salinity (SL); and (iii) Chlorella - with 107 cells mL -1 Chlorella (CW) versus no-Chlorella (CN). The results revealed that increased salinity adversely affected the soil nutrients (TOC, NO3⁻-N, NH4+-N, Olsen-P), and enzyme activity (urease, sucrase, catalase), resulting in a 9.67% reduction in rice yield compared to SL treatment. However, the close correlation between alterations in soil bacterial communities, functions, and soil physicochemical properties, as well as rice yield, indicated that biochar and Chlorella promoted rice yield by enhancing the physicochemical properties of saline-alkali soil and bacterial community when irrigated with aquaculture wastewater: (1) addition of biochar increased the146.05% rice yield by increasing TOC content, the complexity of bacterial co-occurrence patterns, nitrogen fixation potential, and nitrification potential, (2) addition of Chlorella increased TOC, NO3⁻-N, NH4+-N, enhanced urease, sucrase, catalase activity, and nitrification potential to increased rice yield by 60.29%, and (3) compared with the treatment T3 (SHBNCN), the treatments with biochar (BW) and Chlorella (CW) increased the yield by 561.30% and 445.03% under 1‰ and 3‰ salinity, respectively. These findings provide novel perspectives on the capacity of biochar and Chlorella to improve saline-alkali soil properties and increase rice yield irrigated with aquaculture wastewater.

Using stable isotopes (δ2H and δ18O) and hydrochemistry to understand the genesis and hydrochemical processes of groundwater in Chongming Island, Yangtze Estuary.

Groundwater is an indispensable freshwater resource and its quality is significant in supporting sustainable social and economic development, particularly in estuarine islands where aquifers are complicated. In this study, a total of 19 groundwater and 4 surface water samples were collected in September 2022 to identify the origin and hydrogeochemical evolution processes of groundwater using stable isotopes and hydrochemistry in Chongming Island, which is the largest estuarine alluvial island in the world. The stable isotopic composition indicated that shallow groundwater and surface water are all derived from precipitation recharge under a humid climate, and the evaporative effect incurs the enrichment of isotopic compositions. The shallow groundwater and surface water were primarily of Ca-HCO3 type. Gibbs diagram, ionic correlation analysis, ionic ratios analysis, and mineral saturation indices suggested that water-rock interactions like carbonate and silicate weathering play a vital role in groundwater chemistry, but cation exchange reactions are weak. Revelle index (RI) result indicated that 10.5% of shallow groundwater samples were found to suffer seawater intrusion. The NO3- concentrations were between l2.0 and 180.8 mg/L with 31.6% of groundwater samples exceeding the World health organization (WHO) standards (50 mg/L). Agricultural activities and industrial activities were found to be mainly responsible for groundwater pollution in shallow groundwater. The findings of this study provide a scientific basis for better managing groundwater resources on coastal estuarine islands.

Hydrochemical evolution characteristics, controlling factors, and high nitrate hazards of shallow groundwater in a typical agricultural area of Nansi Lake Basin, North China.

Anthropogenic nitrate contamination in groundwater could not be neglected, which has been a global issue threatening public health, especially in agricultural fields where fertilizers were used intensively. The present study focused on evaluating the groundwater evolution process, quality, and associated health risks from nitrate pollution in Nansi Lake Basin (NLB), a typical intensive agricultural region of North China. For this purpose, fifty-two shallow groundwater samples were collected and analyzed major chemical parameters in June 2022. The groundwater samples are found to be mainly dominated by HCO3-Ca·Mg and SO4·Cl-Ca·Mg types. Water-rock interactions like minerals dissolution/precipitation and ion exchange were found to be the important processes influencing hydrochemistry. Nitrate content in groundwater fluctuated from 1.9 to 750.0 mg/L (average:148.7 mg/L), with about 75% of samples surprisingly exceeding the permissible limit (50 mg/L) set by the World Health Organization (WHO). Anthropogenic activities can be classified as excessive nitrogen fertilizer application, livestock manure, and industrial/domestic sewage, coupled with irrigation return flow, which brought significant hazards to human health. The calculation results of entropy weighted water quality index (EWQI) showed that about half of groundwater samples are unfit for drinking purposes. Most importantly, 88.5%, 88.5%, 73.1%, and 71.2% of the water samples had considerable NO3- health risks (HQ > 1) for infants, children, females, and males, respectively. It is suggested that the groundwater should be chemical and biological denitrification for nitrate removal before being used for drinking purposes. The findings of this work can help policymakers to solve groundwater pollution problems and ensure healthy drinking water in such intensive agricultural basins and other similar regions worldwide.

Identifying the geochemical evolution and controlling factors of the shallow groundwater in a high fluoride area, Feng County, China.

Understanding how groundwater is formed and evolves is critical for water resource exploitation and utilization. In this study, hydrochemistry and stable isotope tracing techniques were adopted to determine the key factors influencing groundwater chemical evolution in Feng County. A total of fourteen wells and five surface water samples were investigated in November 2021. The δD and δ18O compositions show that both surface water and groundwater are recharged from atmospheric precipitation. The dominating order of cations and anions in groundwater appears to be Na+ > Mg2+ > Ca2+ > K+ and HCO3- > SO42- > Cl- > NO3- > F-, respectively. The groundwater hydrochemical facies are mainly characterized by HCO3-Ca-Mg and SO4-Cl-Na types. The chemical evolution of groundwater is dominated by water-rock interaction and cation exchange reactions. The major ions in groundwater are mainly controlled by various geogenic processes including halite, gypsum, calcite, dolomite, Glauber's salt, feldspar, and fluorite dissolution/precipitation. Furthermore, the abundant fluoride-bearing sediments, together with low Ca2+, promote the formation of high F- groundwater. Approximately 85.7% and 28.6% of groundwater samples exceeded the permissible limit for F- and NO3- respectively. Apart from geogenic F-, human interventions (i.e., industrial fluoride-containing wastewater discharge and agricultural phosphate fertilizer uses) also regulate the F- enrichment in the shallow groundwater. Nitrate pollution of the groundwater may be attributed to domestic waste and animal feces. Our findings could provide valuable information for the sustainable exploitation of groundwater in the study area and the development of effective management strategies by the authorities.

Progress in methods for evaluating Schwann cell myelination and axonal growth in peripheral nerve regeneration via scaffolds.

Peripheral nerve injury (PNI) is a neurological disorder caused by trauma that is frequently induced by accidents, war, and surgical complications, which is of global significance. The severity of the injury determines the potential for lifelong disability in patients. Artificial nerve scaffolds have been investigated as a powerful tool for promoting optimal regeneration of nerve defects. Over the past few decades, bionic scaffolds have been successfully developed to provide guidance and biological cues to facilitate Schwann cell myelination and orientated axonal growth. Numerous assessment techniques have been employed to investigate the therapeutic efficacy of nerve scaffolds in promoting the growth of Schwann cells and axons upon the bioactivities of distinct scaffolds, which have encouraged a greater understanding of the biological mechanisms involved in peripheral nerve development and regeneration. However, it is still difficult to compare the results from different labs due to the diversity of protocols and the availability of innovative technologies when evaluating the effectiveness of novel artificial scaffolds. Meanwhile, due to the complicated process of peripheral nerve regeneration, several evaluation methods are usually combined in studies on peripheral nerve repair. Herein, we have provided an overview of the evaluation methods used to study the outcomes of scaffold-based therapies for PNI in experimental animal models and especially focus on Schwann cell functions and axonal growth within the regenerated nerve.

Arsenic Monolayers Formed by Zero-Dimensional Tetrahedral Clusters and One-Dimensional Armchair Nanochains.

One-dimensional (1D) arsenene nanostructures are predicted to host a variety of interesting physical properties including antiferromagnetic, semiconductor-semimetal transition and quantum spin Hall effect, which thus holds great promise for next-generation electronic and spintronic devices. Herein, we devised a surface template strategy in a combination with surface-catalyzed decomposition of molecular As4 cluster toward the synthesis of the superlattice of ultranarrow armchair arsenic nanochains in a large domain on Au(111). In the low annealing temperature window, zero-dimensional As4 nanoclusters are assembled into continuous films through intermolecular van der Waals and molecule-substrate interactions. At the elevated temperature, the subsequent surface-assisted decomposition of molecular As4 nanoclusters leads to the formation of a periodic array of 1D armchair arsenic nanochains that form a (2 × 3) superstructure on the Au(111) surface. These ultranarrow armchair arsenic nanochains are predicted to have a small bandgap of ∼0.50 eV, in contrast to metallic zigzag chains. In addition, the Au-supported arsenic nanochains can be flipped to form a bilayer structure through tip indentation and manipulation, suggesting the possible transfer of these nanochains from the substrate. The successful realization of arsenic nanostructures is expected to advance low-dimensional physics and infrared optoelectronic nanodevices.

Allocation of Flood Drainage Rights in Watershed Using a Hybrid FBWM-Grey-TOPSIS Method: A Case Study of the Jiangsu Section of the Sunan Canal, China.

In this study, an FDR allocation scheme based on synergetic theory was designed to alleviate the drainage conflicts caused by the grabbing of flood drainage rights (FDR) in each region of the basin. An FDR allocation index system was constructed by employing synergetic theory and following the principles of safety, equity, efficiency, and sustainability. A new multi-criteria decision-making method, called FBWM-Grey-TOPSIS, was developed, which is based on the integration of the fuzzy best-worst method (FBWM) and Grey-TOPSIS. Among them, the FBWM method was used to distinguish the importance of subsystems and order parameters, and the Grey-TOPSIS method is applied to obtain the optimal FDR assignment results. Taking the Jiangsu section of the Sunan Canal as an example, the FDRs of the four regions in the basin were allocated. The results reveal that the proportion of FDRs obtained in descending order is Changzhou (32.69%), Suzhou (24.88%), Wuxi (23.01%), and Zhenjiang (19.42%). In addition, the performance of the proposed method is demonstrated by sensitivity analysis and comparative analysis with the existing methods. The methodology and research results presented in this paper can help governments and agencies achieve a scientific allocation of FDR in watersheds, thus promoting harmonious watershed development.

Study on the Correlation between the Levels of HtrA3 and TGF-ß2 in Late Pregnancy and Preeclampsia.

Preeclampsia (PE) is a common and proprietary complication during pregnancy. The correlation was found between the levels of HtrA3 and TGF-ß 2 and preeclampsia (PE). This study aimed to detect the HtrA3 and TGF-ß2 in different parts of the third trimester (maternal serum, placenta). The 102 pregnant women who were eligible for enrollment in the obstetric examination at Tengzhou Maternity and Child Health Hospital from June 2020 to December 2020 were selected as the research objects. 28 cases diagnosed with PE were set up as the observation group 1, and 24 cases diagnosed with severe PE were set up as the observation group 2. Select 50 normal pregnant women as the control group and research the expressions of HtrA3 and TGF-ß2 in maternal blood and placental tissues of patients with PE. ELISA was used to measure the concentration of HtrA3 and TGF-ß2 in maternal blood. The distribution of HtrA3 and TGF-ß2 in the placenta was observed by immunohistochemical techniques (IHC) and mean optical density value (MOD). S/D was measured by using color Doppler ultrasonic. The concentration of HtrA3 and TGF-ß2 in the maternal blood and placenta tissue was higher in severe PE compared with PE and normotensive pregnancy, respectively (P < 0.05). There is a negative correlation between the level of HtrA3 and TGF-ß2 and the birthweight of newborns both in maternal plasma and placenta tissue in preeclampsia and positive correlation between HtrA3 and TGF-ß2 levels and S/D. HtrA3 and TGF-ß2 may correlate with severity of PE and their neonatal adverse outcomes.

Forkhead-box C1 attenuates high glucose-induced trophoblast cell injury during gestational diabetes mellitus via activating adenosine monophosphate-activated protein kinase through regulating fibroblast growth factor 19.

Gestational diabetes mellitus (GDM) is a complication developed during pregnancy and recover after childbirth. The purpose of this study was to investigate the protective role of FOXC1 during GDM and the underlying mechanism. FOXC1 was downregulated in GDM placental tissues and HG-treated HTR-8/SVneo cells. Overexpression of FOXC1 prevented HG-induced inhibition of cell proliferation, migration and invasion. FOXC1 suppressed HG-induced cell apoptosis in HTR-8/SVneo cells. The apoptosis-related proteins: cleaved caspase-3, cleaved caspase-9 and BAX, were also downregulated by FOXC1 overexpression. FOXC1 increased glucose uptake and improved insulin sensitivity. The expression of FOXC1 was positively correlated with FGF19 expression. FOXC1 regulated the expression of FGF19 and phosphorylation of AMPK. Inhibition of FGF19 attenuated the biological functions of FOXC1 through inactivation of AMPK. In conclusion, this study demonstrates that FOXC1 attenuates HG-induced trophoblast cell injury through upregulating FGF19 to activate the AMPK signaling pathway during GDM, suggesting that FOXC1 is a potential therapeutic target for drug discovery in the future.

Isolation, Characterization, and Application in Poultry Products of a Salmonella-Specific Bacteriophage, S55.

ABSTRACT: Salmonellosis occurs frequently worldwide, causing serious threats to public health. The abuse of antibiotics is increasing antibiotic resistance in bacteria, thereby making the prevention and control of Salmonella more difficult. A phage can help control the spread of bacteria. In this study, the lytic phage S55, whose host bacterium is Salmonella Pullorum, was isolated from fecal samples obtained from poultry farms. This phage belongs to the Siphoviridae and has a polyhedral head and a retraction-free tail. S55 lysed most cells of Salmonella Pullorum (58 of 60 strains, 96.67%) and Salmonella Enteritidis (97 of 104 strains, 93.27%). One-step growth kinetics revealed that the latent period was 10 min, the burst period was 80 min, and the burst size was 40 PFU per cell. The optimal multiplicity of infection was 0.01, and the phage was able to survive at pH values of 4 to 11 and temperatures of 40 to 60°C for 60 min. Complete genome sequence analysis revealed that the S55 genome consists of 42,781 bp (50.28% GC content) and 58 open reading frames, including 25 frames with known or assumed functions without tRNA genes. S55 does not carry genes that encode virulence or resistance factors. At 4 and 25°C, S55 reduced the populations of Salmonella Pullorum and Salmonella Enteritidis on chicken skin surfaces. S55 may be useful as a biological agent for the prevention and control of Salmonella infections.

Band Sharpening and Band Alignment Enable High Quality Factor to Enhance Thermoelectric Performance in n-Type PbS.

Low-cost and earth-abundant PbS-based thermoelectrics are expected to be an alternative for PbTe, and have attracted extensive attentions from thermoelectric community. Herein, a maximum ZT (ZTmax) ≈ 1.3 at 923 K in n-type PbS is obtained through synergistically optimizing quality factor with Sn alloying and PbTe phase incorporation. It is found that Sn alloying in PbS can sharpen the conduction band shape to balance the contradictory interrelationship between carrier mobility and effective mass, accordingly, a peak power factor of ∼19.8 µWcm-1K-2 is achieved. Besides band sharpening, Sn alloying can also narrow the band gap of PbS so as to make the conduction band position between Pb0.94Sn0.06S and PbTe well aligned, which can benefit high carrier mobility. Therefore, incorporating the PbTe phase into the Pb0.94Sn0.06S matrix can not only favorably maintain the carrier mobility at ∼150 cm2V-1s-1 but also suppress the lattice thermal conductivity to ∼0.61 Wm-1K-1 in Pb0.94Sn0.06S-8%PbTe, which contributes to a largely enhanced quality factor. Consequently, an average ZT (ZTave) ≈ 0.72 in 300-923 K is achieved in Pb0.94Sn0.06S-8%PbTe that outperforms other n-type PbS-based thermoelectric materials.

[Evaluation method of evidence body for acupuncture and moxibustion clinical practice guidelines: the stratified evidence evaluation method].

To explore the evaluation method of evidence body for acupuncture and moxibustion clinical practice guidelines (CPGs), and to provide methodological support for the development of acupuncture and moxibustion CPGs and to promote the establishment and application of acupuncture and moxibustion standard. Based on the academic characteristics of TCM acupuncture, the stratified evidence evaluation method was proposed. Firstly, evidences were collected from the ancient literature, modern literature and clinical experience, and were scientifically distinguished and evaluated. Secondly, all the evidences were integrated as body of evidence by analytic hierarchy process (AHP). Lastly, based on the general index (GI), the clinical recommendations for acupuncture were proposed. Based on the stratified evidence evaluation method, acupuncture and moxibustion CPGs were developed in a more scientific and objectiveway with the comprehensive and sufficient evidences.

Nuclear Magnetic Resonance-Assisted Metabolic Analysis of Plasma for Mild Gestational Diabetes Mellitus Patients.

AIMS: This study aimed at detecting the difference of metabolic profile in mild gestational diabetes mellitus (GDM) patients, and at identifying the correlation between the disturbed metabolites and insulin resistance pathway induced by the inflammation factors secreted by the placenta and adipocytes. MATERIALS AND METHODS: Blood samples were collected from 36 pregnant women diagnosed with mild GDM and 36 normal glucose-tolerant (NGT) pregnant women. Metabolic profiles were acquired by using proton nuclear magnetic resonance (1H-NMR) spectroscopy, and the data were analyzed by multivariate statistical data analysis. The messenger RNA (mRNA) expression of CX3CL1, CD14, and CD86 in placenta and omental adipose tissues was detected by quantitative real-time polymerase chain reaction. RESULTS: (1) Weight and body mass index in GDM group were remarkably higher at both pre-pregnancy and delivery than those in the NGT group. The levels of fasting blood glucose, insulin, and homeostasis model assessment-2 for insulin resistance in GDM group were also significantly higher than those in the NGT group. (2) The expression of mRNA of CD86 was significantly higher in placenta of GDM patients. However, the gene expression of CX3CL1 and CD86 in omental adipose tissues of GDM was markedly lower as compared with the control group. (3) The GDM group exhibited severely perturbed glucose metabolism, fatty acid metabolism, amino acid metabolism, and activated inflammatory response. CONCLUSIONS: The 1H-NMR-based metabonomics approach together with biochemical assay and the mRNA expression analysis provided metabolic information about mild GDM, which indicated disturbed glucose metabolism, fatty acid metabolism, amino acid metabolism, and activated inflammatory response in mild GDM patients. This integrated study provides a new idea and methods to understand underlying mechanisms of mild GDM in clinics.

Feed-forward Control Nursing Model in Expectant Treatment of Placenta Previa.

BACKGROUND: We studied the possible advantages of feed-forward control nursing model in the treatment of placenta previa. METHODS: We enrolled 60 pregnant women who were receiving treatment for expectant placenta previa between January 2010 and January 2016 and randomly divided them into the control group and the observation group with 30 cases in each group. In the control group, we offered specialist nursing which included examination, body positioning, vaginal bleeding record, psychological consultation and medication observation. Feed-forward control nursing was applied in the observation group which included establishing feed-forward control nursing improvement team, conducting quality control of nursing defects and putting forward ideas for improvements and verifying improvement outcomes. RESULTS: The observation group got significantly higher success rate and lower complication rate compared with control group. Gestational age and fetal weights improved apparently in the observation group. When we compared the amount of postpartum bleeding and pregnancy bleeding in two groups we did not find any statistically significant difference (P>0.05). Patients' satisfaction rate toward our nursing services was much higher in the observation group and the rate of nursing errors was significantly lower in this group. All differences were statistically significant (P<0.05). CONCLUSION: Application of feed-forward control nursing model in the expectant treatment of placenta previa can improve treatment success rate, decrease complications and upgrade nursing quality.