The transcription factor WRKY22 modulates ethylene biosynthesis and root development through transactivating the transcription of ACS5 and ACO5 in Arabidopsis.

The WRKY transcription factor (TF) genes form a large family in higher plants, with 72 members in Arabidopsis (Arabidopsis thaliana). The gaseous phytohormone ethylene (ET) regulates multiple physiological processes in plants. It is known that 1-aminocyclopropane-1-carboxylic acid (ACC) synthases (ACSs, EC 4.4.1.14) limit the enzymatic reaction rate of ethylene synthesis. However, whether WRKY TFs regulate the expression of ACSs and/or ACC oxidases (ACOs, EC 1.14.17.4) remains largely elusive. Here, we demonstrated that Arabidopsis WRKY22 positively regulated the expression of a few ACS and ACO genes, thus promoting ethylene production. Inducible overexpression of WRKY22 caused shorter hypocotyls without ACC treatment. A qRT-PCR screening demonstrated that overexpression of WRKY22 activates the expression of several ACS and ACO genes. The promoter regions of ACS5, ACS11, and ACO5 were also activated by WRKY22, which was revealed by a dual luciferase reporter assay. A follow-up chromatin immunoprecipitation coupled with quantitative PCR (ChIP-qPCR) and electrophoretic mobility shift assay (EMSA) showed that the promoter regions of ACS5 and ACO5 could be bound by WRKY22 directly. Moreover, wrky22 mutants had longer primary roots and more lateral roots than wild type, while WRKY22-overexpressing lines showed the opposite phenotype. In conclusion, this study revealed that WRKY22 acts as a novel TF activating, at least, the expression of ACS5 and ACO5 to increase ethylene synthesis and modulate root development.

Synergetic regulation of SEI mechanics and crystallographic orientation for stable lithium metal pouch cells.

The advancement of Li-metal batteries is significantly impeded by the presence of unstable solid electrolyte interphase and Li dendrites upon cycling. Herein, we present an innovative approach to address these issues through the synergetic regulation of solid electrolyte interphase mechanics and Li crystallography using yttrium fluoride/polymethyl methacrylate composite layer. Specifically, we demonstrate the in-situ generation of Y-doped lithium metal through the reaction of composite layer with Li metal, which reduces the surface energy of the (200) plane, and tunes the preferential crystallographic orientation to (200) plane from conventional (110) plane during Li plating. These changes effectively passivate Li metal, thereby significantly reducing undesired side reactions between Li and electrolytes by 4 times. Meanwhile, the composite layer with suitable modulus (~1.02 GPa) can enhance mechanical stability and maintain structural stability of SEI. Consequently, a 4.2 Ah pouch cell with high energy density of 468 Wh kg-1 and remarkable capacity stability of 0.08% decay/cycle is demonstrated under harsh condition, such as high-areal-capacity cathode (6 mAh cm-2), lean electrolyte (1.98 g Ah-1), and high current density (3 mA cm-2). Our findings highlight the potential of reactive composite layer as a promising strategy for the development of stable Li-metal batteries.

The Clinical Effect of Octreotide Combined with Upper Endoscopy in the Treatment of Peptic Ulcer Complicated with Upper Gastrointestinal Hemorrhage.

Background: With the development of endoscopic technology, the application of upper endoscopy can quickly target the lesion site of patients with peptic ulcer complicated with upper gastrointestinal bleeding. Objective: This study aims to discuss the clinical effect of octreotide combined with upper endoscopy in treating peptic ulcer complicated with upper gastrointestinal hemorrhage. Methods: A total of 82 patients diagnosed with peptic ulcer complicated with upper gastrointestinal hemorrhage were recruited as study objects in the researchers' hospital. According to the treatment method, this retrospective study divided the patients into a control group (n=41, receiving adrenaline injection under upper endoscopy only) and a treatment group (n=41, receiving adrenaline injection under upper endoscopy and Octreotide intravenously). Results: After treatment, the volume of blood loss, average hemostasis time, hospital stay, and time of occult blood turning negative in the treatment group were shorter than those in the control group (P < .05). After treatment, the clinical efficacy of the treatment group was better than that of the control group (P < .05). The levels of prothrombin time (PT), activated partial thromboplastin time (APTT), and thrombin time (TT) levels in the treatment group were lower than those in the control group, with significant differences (P < .05). Conclusion and Relevance: Combining octreotide and upper endoscopy has affirmative efficacy and good hemostatic effect on treating peptic ulcer complicated with upper gastrointestinal hemorrhage with less pain and short recovery time, which is worthy of clinical application.

WRKY6 transcription factor modulates root potassium acquisition through promoting expression of AKT1 in Arabidopsis.

Potassium (K+), being an essential macronutrient in plants, plays a central role in many aspects. Root growth is highly plastic and is affected by many different abiotic stresses including nutrient deficiency. The Shaker-type K+ channel Arabidopsis (Arabidopsis thaliana) K+ Transporter 1 (AKT1) is responsible for K+ uptake under both low and high external K+ conditions. However, the upstream transcription factor of AKT1 is not clear. Here, we demonstrated that the WRKY6 transcription factor modulates root growth to low potassium (LK) stress in Arabidopsis. WRKY6 showed a quick response to LK stress and also to many other abiotic stress treatments. The two wrky6 T-DNA insertion mutants were highly sensitive to LK treatment, whose primary root lengths were much shorter, less biomass and lower K+ content in roots than those of wild-type plants, while WRKY6-overexpression lines showed opposite phenotypes. A further investigation showed that WRKY6 regulated the expression of the AKT1 gene via directly binding to the W-box elements in its promoter through EMSA and ChIP-qPCR assays. A dual luciferase reporter analysis further demonstrated that WRKY6 enhanced the transcription of AKT1. Genetic analysis further revealed that the overexpression of AKT1 greatly rescued the short root phenotype of the wrky6 mutant under LK stress, suggesting AKT1 is epistatic to WRKY6 in the control of LK response. Further transcriptome profiling suggested that WRKY6 modulates LK response through a complex regulatory network. Thus, this study unveils a transcription factor that modulates root growth under potassium deficiency conditions by affecting the potassium channel gene AKT1 expression.

Baduanjin exercise intervention trial: research protocol of a randomised controlled trial for frail kidney transplant recipients.

INTRODUCTION: Frailty is one of the most common comorbidities in kidney transplant recipients (KTRs). Physical, psychological and social frailty could be improved by exercise intervention. Baduanjin, also known as Eight-section Brocades, is a type of traditional Chinese medicine exercise characterised by the interplay between physical postures and movements, breathing and mind. It can help frail patients strengthen their upper and lower body muscles, improve their mood, quality of life and frailty. However, the effectiveness of Baduanjin on frail KTRs remains unknown. Therefore, we will conduct a randomised controlled trial (RCT) to evaluate the effectiveness of Baduanjin on frail KTRs. METHODS AND ANALYSIS: This protocol describes an assessor and analyst blinded, parallel RCT for frail KTRs comparing Baduanjin group (n=72) with care-as-usual group (n=72). The primary outcomes are frailty assessed by Frailty Phenotype scale and Tilburg Frailty Indicator scale, and muscle strength assessed by a grip strength metre. The secondary outcomes are quality of life assessed by Medical Outcomes Study 36-Item Short-Form Health Survey (MOS SF-36) and depression assessed by the Hospital Anxiety and Depression Scale. All these data will be collected at the baseline, after 3, 6, 9 and 12 months, respectively. Two-way mixed analysis of variance (ANOVA) will be used to test the effectiveness of Baduanjin exercise. Qualitative interviews with participants in the intervention group will also be performed after 6 months. Themes will be extracted from interview transcripts using NVivo software. ETHICS AND DISSEMINATION: The Ethics Committees of Beijing University of Chinese Medicine (2022BZYLL1018) and China-Japan Friendship Hospital (2022-KY-250) had approved the study. The organ donors were all from China-Japan Friendship Hospital. They provided informed consent and they were not executed prisoners. We have provided BMJ Open with documentation from the hospital that indicates that the organs will be harvested ethically. The findings of this study will be disseminated through peer-reviewed journals, international conferences, media reports and briefings. TRIAL REGISTRATION NUMBER: ChiCTR2100041730.

Development and validation of the Chinese version of the self-management support scale for kidney transplant recipients.

BACKGROUND: Providing self-management support to kidney transplant recipients is essential. However, a scale to identify the self-management support they have received is lacking. The purpose of this study is to develop a Self-management Support Scale for Kidney Transplant Recipients (SMSSKTR) and test its psychometric properties. METHODS: This is an instrument development and validation study, which has a three-stage cross-sectional design. In Stage 1, a preliminary item pool was formed using a literature review, semi-structured interviews, and the Delphi method. In Stage 2, six experts were invited to assess content validity. A convenience sample of 313 participants was used to explore the factor structure by using exploratory factor analysis. The test-retest reliability was assessed using the intra-class correlation coefficient (ICC). In Stage 3, two hundred and sixty-five participants were recruited to validate the factor structure by using confirmatory factor analysis. Convergent validity was examined using Spearman's correlation coefficient. Cronbach's alpha coefficient and corrected item-total correlation coefficient were used to test the reliability of the entire scale and its dimensions. The study was reported according to the STARD and GRRAS checklists. RESULTS: An initial 40-item scale was developed in Stage 1. In Stage 2, three factors with 22 items emerged from the exploratory factor analysis: instrumental support, psychosocial support, and relational support. The content validity index of the scale was 0.97. The intra-class correlation coefficient for the entire scale and the subscales were 0.915, 0.771, 0.896, and 0.832, respectively. In Stage 3, the confirmatory factor analysis indicated that the three-factor model had a good fit. The score of the scale was positively associated with that of the Self-Management Scale of Renal Transplant Recipients (r = 0.532). Cronbach's alpha was 0.959 for the entire scale and 0.956-0.958 for the three subscales. The corrected item-total correlation coefficient ranged from 0.62 to 0.82. CONCLUSION: The 22-item SMSSKTR has sufficient psychometric properties to assess the self-management support they have received, which has not been measured before.

Enabling 420 Wh kg-1 Stable Lithium-Metal Pouch Cells by Lanthanum Doping.

Lithium (Li) metal, a promising anode for high-energy-density rechargeable batteries, typically grows along the low-surface energy (110) plane in the plating process, resulting in uncontrollable dendrite growth and unstable interface. Herein, an unexpected Li growth behavior by lanthanum (La) doping is reported: the preferred orientation turns to (200) from (110) plane, enabling 2D nuclei rather than the usual 1D nuclei upon Li deposition and thus forming a dense and dendrite-free morphology even at an ultrahigh areal capacity of 10 mAh cm-2 . Noticeably, La doping further decreases the reactivity of Li metal toward electrolytes, thereby establishing a stable interface. The dendrite-free, stable Li anode enables a high average Coulombic efficiency of 99.30% at 8 mAh cm-2 for asymmetric Li||LaF3 -Cu cells. A 3.1 Ah LaF3 -Li||LiNi0.8 Co0.1 Mn0.1 O2 pouch cell at a high energy density (425.73 Wh kg-1 ) with impressive cycling stability (0.0989% decay per cycle) under lean electrolyte (1.76 g Ah-1 ) and high cathode loading (5.77 mAh cm-2 ) using this doped Li anode is further demonstrated.

Factors associated with frailty in kidney transplant recipients: A cross-sectional study.

BACKGROUND: Frailty is prevalent in kidney transplant recipients and associated with multiple health care challenges. The association between frailty and outcomes has been extensively studied in kidney transplant recipients, but the status of frailty and its associated factors are not well studied, hindering efforts to develop strategies to improve care and reduce frailty. OBJECTIVES: To identify the factors that are associated with frailty in kidney transplant recipients comprehensively. DESIGN AND PARTICIPANTS: The associated factors of frailty were explored by a cross-sectional study of 185 kidney transplant recipients. MEASUREMENTS: Data were collected using the general information questionnaire, the Charlson comorbidity index, the Pittsburgh Sleep Quality Index, the Hospital Anxiety and Depression Scale, the Connor-Davidson Resilience Scale, the Perceived Social Support Scale and the Tilburg Frailty Indicator. Data were analyzed using the multiple linear regression analysis. RESULTS: A total of 75 (40.5%) kidney transplant recipients were assessed as frail by Chinese TFI. Age (ß = 0.228), time post-transplant (ß = 0.055), sleep quality (ß = 0.224) and psychological resilience (ß = -0.038) entered the final multiple regression equation and accounted for 41.8% of the total frailty variation (R2 = 0.418, F = 21.31, p < 0.05). CONCLUSIONS: Frailty was common among kidney transplant recipients. Old age, long time after transplantation, poor sleep quality and low psychological resilience were main associated factors for frailty. Integrated care interventions are therefore needed for this vulnerable population to prevent or delay frailty.

ANAC087 transcription factor positively regulates age-dependent leaf senescence through modulating the expression of multiple target genes in Arabidopsis.

Leaf senescence is the final stage of leaf development and appropriate onset and progression of leaf senescence are critical for reproductive success and fitness. Although great progress has been made in identifying key genes regulating leaf senescence and elucidating the underlining mechanisms in the model plant Arabidopsis, there is still a gap to understanding the complex regulatory network. In this study, we discovered that Arabidopsis ANAC087 transcription factor (TF) positively modulated leaf senescence. Expression of ANAC087 was induced in senescing leaves and the encoded protein acted as a transcriptional activator. Both constitutive and inducible overexpression lines of ANAC087 showed earlier senescence than control plants, whereas T-DNA insertion mutation and dominant repression of the ANAC087 delayed senescence rate. A quantitative reverse transcription-polymerase chain reaction (qRT-PCR) profiling showed that the expression of an array of senescence-associated genes was upregulated in inducible ANAC087 overexpression plants including BFN1, NYE1, CEP1, RbohD, SAG13, SAG15, and VPEs, which are involved in programmed cell death (PCD), chlorophyll degradation and reactive oxygen species (ROS) accumulation. In addition, electrophoretic mobility shift assay (EMSA) and chromatin immunoprecipitation-quantitative polymerase chain reaction (ChIP-qPCR) assays demonstrated that ANAC087 directly bound to the canonical NAC recognition sequence (NACRS) motif in promoters of its target genes. Moreover, mutation of two representative target genes, BFN1 or NYE1 alleviated the senescence rate of ANAC087-overexpression plants, suggesting their genetic regulatory relationship. Taken together, this study indicates that ANAC087 serves as an important regulator linking PCD, ROS, and chlorophyll degradation to leaf senescence.

WRKY29 transcription factor regulates ethylene biosynthesis and response in arabidopsis.

The gaseous phytohormone ethylene participates in a lot of physiological processes in plants. 1-aminocyclopropane-1-carboxylic acid (ACC) synthase (ACS, EC 4.4.1.14) and the ACC oxidase (ACO, EC 1.14.17.4) are key enzymes in ethylene biosynthesis. However, how ACSs and ACOs are regulated at the transcriptional level is largely unknown. In the present study, we showed that an Arabidopsis (Arabidopsis thaliana) WRKY-type transcription factor (TF), WRKY29 positively regulated the expression of ACS5, ACS6, ACS8, ACS11 and ACO5 genes and thus promoted basal ethylene production. WRKY29 protein was localized in nuclei and was a transcriptional activator. Overexpression of WRKY29 caused pleiotropic effect on plant growth, development and showed obvious response even without ACC treatment. Inducible overexpression of WRKY29 also reduced primary root elongation and lateral root growth. A triple response assay of overexpression and mutant seedlings of WRKY29 showed that overexpression seedlings had shorter hypocotyls than the transgenic GFP (Green Fluorescence Protein) control, while mutants had no difference from wild-type. A qRT-PCR assay demonstrated that expression of multiple ACSs and ACO5 was up-regulated in WRKY29 overexpression plants. A transactivation assay through dual luciferase reporter system confirmed the regulation of promoters of ACS5, ACS6, ACS8, ACS11 and ACO5 by WRKY29. Both in vivo chromatin immunoprecipitation (ChIP)- quantitative PCR and in vitro electrophoretic mobility shift assay (EMSA) revealed that WRKY29 directly bound to the promoter regions of its target genes. Taken together, these results suggest that WRKY29 is a novel TF positively regulating ethylene production by modulating the expression of ACS and ACO genes.

Primary ectopic meningiomas: Report of 6 cases with emphasis on atypical morphology and exploratory immunohistochemistry.

AIMS: To investigate the histological and immunohistochemical features of primary ectopic meningiomas (PEMs), especially those of primary ectopic atypical meningiomas (PEAMs). METHODS AND RESULTS: We examined 6 cases of PEM, including 2 PEAM cases, which occurred separately in left nasal cavity, left lower lung, right neck, left orbit, right upper lung, and left upper lung by histological and immunohistochemical analysis. In general, of the 6 PEM cases analyzed, 4 cases exhibited morphology of Grade Ⅰ, including 1 fibrous, 1 meningothelial, and 2 transitional variant. The remaining 2 cases shared similar atypical morphology of Grade Ⅱ. The tumors were distributed in sheet-like patterns with loss of architecture of classic meningiomas. Significant hypercellularity, multi-focal necrosis, and thin-walled blood vessels were identified. The mitotic figures were estimated at 6 per 10 high-power fields in one case, and 8 mitotic figures in another. Immunohistochemically, the 6 PEM cases were all positive for Vimentin and EMA, while none showed immunostaining for CKpan, S-100, CD34, STAT6, SMA, Syn or Bcl-2. 4 PEM cases of Grade Ⅰ were immunoreactive for PR but negative for P53, while the 2 PEAM cases displayed negative staining for PR but positivity for P53. As for Ki-67, the positive staining of 4 Grade Ⅰ cases was no greater than 2%, while the positive rates of the 2 PEAM cases were 10% and 20%. CONCLUSIONS: Our study has expanded cases of PEMs, especially the 2 PEAM cases in rare sites. Our study has also further summarized the pathological features of PEMs, focusing on the histological features of PEAMs, and the immunohistochemical features worthy of further investigations.

Rapeseed NAM transcription factor positively regulates leaf senescence via controlling senescence-associated gene expression.

Leaf senescence is one of the most visible forms of programmed cell death in plants. It can be a seasonal adaptation in trees or the final stage in crops ensuring efficient translocation of nutrients to seeds. Along with developmental cues, various environmental factors could also trigger the onset of senescence through transcriptional cascades. Rapeseed (Brassica napus L.) is an important oil crop with its yielding affected by significant falling leaves as a result of leaf senescence, compared to many other crops. Therefore, a better understanding of leaf senescence and developing strategies controlling the progress of leaf senescence in rapeseed is necessary for warranting vegetable oil security. Here we functionally characterized the gene BnaNAM encoding No Apical Meristem (NAM) homologue to identify transcriptional regulation of leaf senescence in rapeseed. A combination of transient and stable expression techniques revealed overexpression of BnaNAM induced ROS production and leaf chlorosis. Quantitative evaluation of up-regulated genes in BnaNAM overexpression lines identified genes related to ROS production (RbohD, RbohF), proteases (ßVPE, γVPE, SAG12, SAG15), chlorophyll catabolism (PaO, PPH) and nucleic acid degradation (BFN1) as the putative downstream targets. A dual luciferase-based transcriptional activation assay of selected promoters further confirmed BnaNAM mediated transactivation of promoters of the downstream genes. Finally, an electrophoretic mobility shift assay further confirmed direct binding of BnaNAM to promoters of ßVPE, γVPE, SAG12, SAG15 and BFN1. Our results therefore demonstrate a novel role of BnaNAM in leaf senescence.

Calcium-dependent Protein Kinase 5 (CPK5) positively modulates drought tolerance through phosphorylating ABA-Responsive Element Binding Factors in oilseed rape (Brassica napus L.).

Drought is an environmental stress that causes severe crop loss. Drought stress can induce abscisic acid (ABA) accumulation and cytoplasmic calcium oscillation. Calcium-dependent protein kinases (CPKs) constitute a group of Ser/Thr protein kinases decoding calcium signals. However, the function and molecular mechanisms of most CPKs in oilseed rape (Brassica napus) remain unknown. Here, we report the functional characterization of BnaCPK5 in drought stress tolerance. BnaCPK5 belongs to Group I of the CPK family and was localized at the plasma membrane and nuclei. Overexpression of BnaCPK5 enhanced drought stress tolerance compared with the control. A screening of interacting proteins identified that BnaCPK5 interacted strongly with two ABA-Responsive Element Binding Factors (ABF/AREBs), BnaABF3 and BnaABF4. BnaCPK5 was shown to phosphorylate both BnaABF3 and BnaABF4 in a kinase assay. Further, it was found that the phosphorylation of BnaABF3 and BnaABF4 by BnaCPK5 increased their transcriptional activities against the famous drought stress marker gene, Responsive to Dehydration (RD) 29B and protein stability. Taken together, these data demonstrate that BnaCPK5 acts as a positive regulator of drought tolerance by, at least in part, phosphorylating two core ABA-signaling components to modulate Late-Embryogenesis Abundant (LEA)-like RD29B expression.

Boron Modified Bifunctional Cu/SiO2 Catalysts with Enhanced Metal Dispersion and Surface Acid Sites for Selective Hydrogenation of Dimethyl Oxalate to Ethylene Glycol and Ethanol.

Boron (B) promoter modified Cu/SiO2 bifunctional catalysts were synthesized by sol-gel method and used to produce ethylene glycol (EG) and ethanol (EtOH) through efficient hydrogenation of dimethyl oxalate (DMO). Experimental results showed that boron promoter could significantly improve the catalytic performance by improving the structural characteristics of the Cu/SiO2 catalysts. The optimized 2B-Cu/SiO2 catalyst exhibited excellent low temperature catalytic activity and long-term stability, maintaining the average EG selectivity (Sel.EG) of 95% at 190 °C, and maintaining the average EtOH selectivity (Sel.EtOH) of 88% at 260 °C, with no decrease even after reaction of 150 h, respectively. Characterization results revealed that doping with boron promoter could significantly increase the copper dispersion, enhance the metal-support interaction, maintain suitable Cu+/(Cu+ + Cu0) ratio, and diminish metallic copper particles during the hydrogenation of DMO. Thus, this work introduced a bifunctional boron promoter, which could not only improve the copper dispersion, reduce the formation of bulk copper oxide, but also properly enhance the acidity of the sample surface, so that the Cu/SiO2 sample could exhibit superior EG selectivity at low temperature, as well as improving the EtOH selectivity at high temperature.

Gradient H-Bonding Binder Enables Stable High-Areal-Capacity Si-Based Anodes in Pouch Cells.

Alleviating large stress is critical for high-energy batteries with large volume change upon cycling, yet this still presents a challenge. Here, a gradient hydrogen-bonding binder is reported for high-capacity silicon-based anodes that are highly desirable for the next-generation lithium-ion batteries. The well-defined gradient hydrogen bonds, with a successive bond energy of -2.88- -10.04 kcal mol-1 , can effectively release the large stress of silicon via the sequential bonding cleavage. This can avoid recurrently abrupt structure fracture of traditional binder due to lack of gradient energy dissipation. Certainly, this regulated binder endows stable high-areal-capacity silicon-based electrodes >4 mAh cm-2 . Beyond proof of concept, this work demonstrates a 2 Ah silicon-based pouch cell with an impressive capacity retention of 80.2% after 700 cycles (0.028% decay/cycle) based on this gradient hydrogen-bonding binder, making it more promising for practical application.

Intermolecular hydrogen bond ruptured by graphite with different lamellar number.

Intermolecular hydrogen bonds are formed through the electrostatic attraction between the hydrogen nucleus on a strong polar bond and high electronegative atom with an unshared pair of electrons and a partial negative charge. It affects the physical and chemical properties of substances. Based on this, we presented a physical method to modulate intermolecular hydrogen bonds for not changing the physical-chemical properties of materials. The graphite and graphene are added into the glycerol, respectively, by being used as a viscosity reducer in this paper. The samples are characterized by Raman and 1H-nuclear magnetic resonance. Results show that intermolecular hydrogen bonds are adjusted by graphite or graphene. The rheology of glycerol is reduced to varying degrees. Transmission electron microscopes and computer simulation show that the spatial limiting action of graphite or graphene is the main cause of breaking the intermolecular hydrogen bond network structure. We hope this work reveals the potential interplay between nanomaterials and hydroxyl liquids, which will contribute to the field of solid-liquid coupling lubrication.

The effect of care transition pathway implementation on patients undergoing joint replacement during the COVID-19 pandemic: a quasi-experimental study from a tertiary care hospital orthopedic department in Beijing, China.

BACKGROUND: The coronavirus disease (COVID-19) pandemic has had a massive impact on individuals globally. The Chinese government has formulated effective response measures, and medical personnel have been actively responding to challenges associated with the epidemic prevention and control strategies. This study aimed to evaluate the effect of the implementation of a care transition pathway on patients that underwent joint replacement during the COVID-19 pandemic. METHODS: A quasi-experimental study was designed to evaluate the effect of implementing a care transition pathway for patients who underwent joint replacement during the COVID-19 pandemic in the orthopedic department of a tertiary care hospital in Beijing, China. Using a convenient sampling method, a total of 96 patients were selected. Of these, 51 patients who had undergone joint replacement in 2019 and received treatment via the routine nursing path were included in the control group. The remaining 45 patients who underwent joint replacement during the COVID-19 epidemic in 2020 and received therapy via the care transition pathway due to the implementation of epidemic prevention and control measures were included in the observation group. The quality of care transition was assessed by the Care Transition Measure (CTM), and patients were followed up 1 week after discharge. RESULTS: The observation group was determined to have better general self-care preparation, written planning materials, doctor-patient communication, health monitoring, and quality of care transition than the control group. CONCLUSIONS: A care transition pathway was developed to provide patients with care while transitioning through periods of treatment. It improved the patient perceptions of nursing quality. The COVID-19 pandemic is a huge challenge for health professionals, but we have the ability to improve features of workflows to provide the best possible patient care.

Membrane-Bound Transcriptional Activator NTL1 from Rapeseed Positively Modulates Leaf Senescence through Targeting Genes Involved in Reactive Oxygen Species Production and Programmed Cell Death.

Leaf senescence is the last stage of leaf development and is determined by various environmental and endogenous signals. Leaf senescence can determine plant productivity and fitness. Transcription factors (TFs) with the transmembrane domain constitute a special group of regulatory proteins that can translocate from the membrane system into nuclei to exert the transcriptional function upon endogenous or exogenous stimuli. Reactive oxygen species (ROSs) play an important role in numerous processes throughout the life cycle of plants including leaf senescence. Leaf senescence is characterized by massive programmed cell death (PCD) and is a type of developmental PCD. The transcriptional regulatory relationships between membrane-bound TFs and leaf senescence remain largely uncharacterized, especially in rapeseed (Brassica napus L.), an important oil crop. Here, we show that BnaNTL1 is a membrane-bound NAC (NAM, ATAF, and CUC) TF, which is predominantly expressed in senescent leaves. Expression of BnaNTL1ΔTM, a form of BnaNTL1 devoid of the transmembrane domain, can induce serious HR-like cell death symptoms and ROS accumulation in cells. Plants overexpressing BnaNTL1ΔTM show earlier leaf senescence compared with the control, accompanied by chlorophyll degradation and electrolyte leakage. Genes involved in ROS production (RbohD), PCD (VPEs and CEP1), and leaf senescence (BFN1) are significantly induced and activated by BnaNTL1ΔTM according to the quantitative reverse transcription PCR (qRT-PCR) analysis and dual luciferase reporter (Dual-LUC) assay. Moreover, electrophoretic mobility shift assay revealed that BnaNTL1 directly bound to the NTLBS elements in promoters of RbohD, γVPE, and BFN1. In conclusion, these results demonstrate that BnaNTL1 positively modulates ROS production and HR-like cell death to induce leaf senescence.

The Predictive and Guidance Value of Signet Ring Cell Histology for Stage II/III Colon Cancer Response to Chemotherapy.

PURPOSE: To evaluate the predictive and guidance value of signet-ring cell carcinoma for chemotherapy response in stage II/III colon cancer. METHODS: Eligible patients were recruited from the Surveillance, Epidemiology and End Results (SEER) database. The differences between adenocarcinoma (AD) and SRCC groups in the incidence of patients' demographic and clinical characteristics were analyzed by Pearson's chi-squared (×2) test. Survival was analyzed using the Kaplan-Meier method, and the differences were determined by the log-rank test. Some Cox regression models were built to assess hazard ratios (HRs) of different variables with 95% confidence intervals (95% CIs). RESULTS: In stage II AD, it was found that the receipt of chemotherapy had significantly 12.6% decreased risk of cancer-specific mortality (HR = 0.874, 95% CI = 0.825-0.927, P < 0.001). In stage II SRCC, however, the receipt of chemotherapy had significantly 70.00% increased risk of cancer-specific mortality (HR = 1.700, 95% CI = 1.032-2.801, P = 0.037). In stage III AD, it was found that the receipt of chemotherapy had significantly 45.3% decreased risk of cancer-specific mortality (HR = 0.547, 95% CI = 0.530-0.564, P < 0.001). In stage III SRCC, the receipt of chemotherapy had significantly 24.6% decreased risk of cancer-specific mortality (HR = 0.754, 95% CI = 0.632-0.900, P = 0.002). CONCLUSIONS: The cancer-specific survival (CSS) difference between AD and SRCC was not statistically significant in stage II colon cancer. We provided the first compelling evidence that chemotherapy should not be treated in stage II SRCC, while stage III SRCC should be treated with chemotherapy.

Ectopic overexpression of a membrane-tethered transcription factor gene NAC60 from oilseed rape positively modulates programmed cell death and age-triggered leaf senescence.

Senescence is an integrative final stage of plant development that is governed by internal and external cues. The NAM, ATAF1/2, CUC2 (NAC) transcription factor (TF) family is specific to plants and membrane-tethered NAC TFs (MTTFs) constitute a unique and sophisticated mechanism in stress responses and development. However, the function of MTTFs in oilseed rape (Brassica napus L.) remains unknown. Here, we report that BnaNAC60 is an MTTF associated with the endoplasmic reticulum (ER) membrane. Expression of BnaNAC60 was induced during the progression of leaf senescence. Translocation of BnaNAC60 into nuclei was induced by ER stress and oxidative stress treatments. It binds to the NTLBS motif, rather than the canonical NAC recognition site. Overexpression of BnaNAC60 devoid of the transmembrane domain, but not the full-length BnaNAC60, induces significant reactive oxygen species (ROS) accumulation and hypersensitive response-like cell death in both tobacco (Nicotiana benthamiana) and oilseed rape protoplasts. Moreover, ectopic overexpression of BnaNAC60 devoid of the transmembrane domain, but not the full-length BnaNAC60, in Arabidopsis also induces precocious leaf senescence. Furthermore, screening and expression profiling identified an array of functional genes that are significantly induced by BnaNAC60 expression. Further it was found that BnaNAC60 can activate the promoter activities of BnaNYC1, BnaRbohD, BnaBFN1, BnaZAT12, and multiple BnaVPEs in a dual-luciferase reporter assay. Electrophoretic mobility shift assay and chromatin immunoprecipitation coupled to quantitative PCR assays revealed that BnaNAC60 directly binds to the promoter regions of these downstream target genes. To summarize, our data show that BnaNAC60 is an MTTF that modulates cell death, ROS accumulation, and leaf senescence.