A Case of Giant Left Circumflex Coronary Fistula Aneurysm with Unidentified Fistula.

A coronary aneurysm is a rare type of cardiovascular disease. We report a case of a 53-year-old male patient who presented to our hospital with a giant left circumflex coronary fistula aneurysm (LCCA) (75 mm × 70 mm). Since coronary angiography and coronary computed tomography angiography failed to detect the fistula of the coronary aneurysm, interventional occlusion surgery could not be performed. We discovered the fistula in the right atrium by anterograde perfusion with blood-containing myocardial protective fluid after switching to intraoperative exploration during cardiac surgery. The coronary aneurysm's fistula and inlet were then sutured, and the aneurysm was resected. The patient recovered successfully after the operation. This case was instructive in managing LCCA, especially with an unidentified fistula.

Alternate Partial Root-Zone Drip Nitrogen Fertigation Reduces Residual Nitrate Loss While Improving the Water Use but Not Nitrogen Use Efficiency.

The efficient utilization of irrigation water and nitrogen is of great importance for sustainable agricultural production. Alternate partial root-zone drip irrigation (APRD) is an innovative water-saving drip irrigation technology. However, the coupling effects of water and nitrogen (N) supply under APRD on crop growth, water and N use efficiency, as well as the utilization and fate of residual nitrates accumulated in the soil profile are not clear. A simulated soil column experiment where 30-40 cm soil layer was 15NO3-labeled as residual nitrate was conducted to investigate the coupling effects of different water [sufficient irrigation (W1), two-thirds of the W1(W2)] and N [high level (N1), 50% of N1 (N2)] supplies under different irrigation modes [conventional irrigation (C), APRD (A)] on tomato growth, irrigation water (IWUE) and N use efficiencies (NUE), and the fate of residual N. The results showed that, compared with CW1N1, AW1N1 promoted root growth and nitrogen absorption, and increased tomato yield, while the N absorption and yield did not vary significantly in AW2N1. The N absorption in AW2N2 decreased by 16.1%, while the tomato yield decreased by only 8.8% compared with CW1N1. The highest IWUE appeared in AW2N1, whereas the highest NUE was observed in AW2N2, with no significant difference in NUE between AW2N1 and CW1N1 at the same N supply level. The 15N accumulation peak layer was almost the same as the originally labeled layer under APRD, whereas it moved 10-20 cm downwards under CW1N1. The amount of 15N accumulated in the 0-40 cm layer increased with the decreasing irrigation water and nitrogen supply, with an increase of 82.9-141.1% in APRD compared with that in CW1N1. The utilization of the 15N labeled soil profile by the tomato plants increased by 9-20.5%, whereas the loss rate of 15N from the plant-soil column system decreased by 21.3-50.1% in APRD compared with the CW1N1 treatment. Thus, APRD has great potential in saving irrigation water, facilitating water use while reducing the loss of residual nitrate accumulated in the soil profile, but has no significant effect on the NUE absorbed.

The pregnancy-associated spontaneous coronary artery dissection in a young woman with a novel missense mutation in NOTCH1: a case report.

BACKGROUND: Spontaneous coronary artery dissection (SCAD) is frequently reported as a disorder that primarily affects women without risk factors for cardiovascular disease. Although it has been recognized as one of the genetically mediated vascular disorders, the genetic pathogenesis of SCAD remains obscure to date. CASE PRESENTATION: In this report, we presented a rare case of pregnancy-associated SCAD in a young woman that occurred in multiple coronary arteries within a short period. The initial conservative management and then intravascular ultrasound-guided primary percutaneous coronary intervention (PCI) were adopted to achieve optimal results of revascularization in affected coronary arteries and avoid potential risks for PCI-associated complications. We further performed the whole-exome sequencing and Sanger sequencing and, for the first time, reported a novel heterozygous missense variant, c.4574 C > T (p.Arg1438Cys), in the NOTCH1 gene. This variant has never been documented in the medical literature and was predicted as being potentially damaging or disease-causing variant. CONCLUSIONS: We described a rare case of recurrent SCAD in a young woman after baby delivery. The initial conservative management and PCI with multiple stent implantations were successfully implemented to achieve optimal results of revascularization in coronary arteries. We, for the first time, identified a novel missense variant in the NOTCH1 gene, which appears to be a potential predisposing factor for artery fragility.

Effects of biochar amendment on bacterial and fungal communities in the reclaimed soil from a mining subsidence area.

Biochar amendment of soil is well known to improve soil fertility and microbial function. However, little is known about the effect of biochar addition to reclaimed soil in coal mining subsidence area on microbial community. A plant soil cultivation experiment was conducted with wheat grown and four treatments were included: P and K fertilizer (CK); NPK inorganic fertilizer (NPK); NPK inorganic fertilizer and straw (NPKS); and NPK inorganic fertilizer and biochar (NPKB). The results indicated that biochar amendment significantly increased the concentrations of NH4+-N, total N, and available P and K compared with the NPK. Biochar addition also significantly increased the grain yield and total biomass of wheat. Furthermore, biochar amendment treatment increased the absolute abundance and altered the community structure of soil bacteria and fungi in the reclaimed soil. Illumina MiSeq sequencing showed that the addition of biochar increased α-diversity of bacteria and relative abundances of Proteobacteria, Actinobacteria, and Bacteroidetes, whereas the relative abundance of Firmicutes were decreased by 61%. However, biochar addition did not change the relative abundance of dominant fungal phyla. Redundancy analysis (RDA) suggested that total N, available P, and K contents were the key factors correlated with changes in microbial community structure. Overall, our results suggest that biochar amendment in reclaimed soil in coal mine subsidence area could increase wheat yield and abundance and alter microbial community compositions.

Effects of biochar application on the abundance and community composition of denitrifying bacteria in a reclaimed soil from coal mining subsidence area.

As a new soil amendment, biochar has become an environmentally friendly material. The application of biochar is one of the most promising management practice to improve soil quality. Using a reclaimed soil from a coal mine subsidence area, the plat soil cultivation experiment in this study investigated the effects of biochar application at varying rates on soil properties, the abundance and composition of soil denitrifier communities. Biochar application significantly increased the crop yield which might be associated with the increased level of cation exchange capacity (CEC), total nitrogen (N), ammonium-N, available phosphorus (P) and potassium (K) in soil. In combination with N fertilizer, the abundance of both nirK and nirS genes significantly increased only at biochar application rate of 4% compared with the nil-biochar treatment. Biochar application significantly increased the community diversity of nirK gene, while not for nirS gene. Redundancy analysis showed that the level of nitrate-N (NO3--N), available P, and pH in soil significantly affected community structure of nirK gene, while the nirS community composition was only affected by soil NO3--N level. Our results indicate that biochar application to the reclaimed soil in coal mine subsidence area could influence the abundance and diversity of soil denitrifiers and improve soil nutrients thus crop yield.

[Preoperative high-dose chemotherapy with peripheral blood stem cell support in breast cancer: report of 3 cases].

OBJECTIVE: To investigate the possibility and short-term effect of high dose chemotherapy with peripheral blood stem cell support in the preoperative therapy of breast cancer, and-its influence on the following operation and would healing. METHODS: Three patients with T(3)N(1)M(0) (III(a)), T(4)N(1)M(0) (III(b)), T(4)N(1)M(1) (IV) of breast cancer were diagnosed histopathologically. After receiving HDC/APBSCT, the 3 patients were operated on. HDC/APBSCT process included 2 cycles of FEC induction chemotherapy; PBSC mobilization, APBSC collection and cryopreservation and PBSC infusion; and high-dose chemotherapy, APBSC infusion and supportive therapy. The therapy consisted of CTX2.5 g/m(2), VP-16 600 mg/m(2), and cerboplatin 600 mg/m(2) delivered on day 1, APBSC infusion 48 h later, rhG-CSF (150 microg, BID) was administered 4 h after infusion of APBSC until WBC was higher than 10 x 10(9)/L. During HDC/APBSCT, the patients were protected in the air laminar flow room with supportive therapy of antibiotics, anti-virus and anti-fungus drugs. They left the air laminar flow room after their WBC was greater than 2 x 10(9)/L. Case 1 was treated by radical mastectomy, Case 2 by improved radical mastectomy, Case 3 by improved radical mastectomy and transplantation of skin for the large area. RESULTS: Rapid recovery of bone marrow function was observed in all 3 patients. Operation was performed 4 weeks after HDC/PBSCT in Cases 1, 2 and 33 days in Case 3. No influence was seen on operative procedure and would healing, especially in Case 3 with a large area of skin transplantation. Two patients with stage III(a) and III(b) have been alive since the treatment for 30 months and the other with stage IV died of brain metastasis 16 months later. CONCLUSIONS: HDC/APBSCT as a preoperative therapy for breast cancer has no influence on the coming surgery and would healing, even on skin transplantation for a large area. It has a practical response in stage III(a) and III(b), but it is still controversial in stage IV. This method as a salvage therapy for patients with breast cancer of intemuediate or stage.