[Enrichment Factors, Health Risk, and Source Identification of Heavy Metals in Agricultural Soils in Semi-arid Region of Hainan Island].

To understand the enrichment factors and pollution levels of heavy metals in agricultural soils in the semi-arid region of Hainan island, 1818 surface soil samples were collected in Gancheng Town and analyzed for their heavy metal contents and physicochemical composition. Correlation analysis was used to determine the heavy metal enrichment factors. The geo-accumulation index (Igeo), comprehensive ecological risk index (RI), and hazard index (HI), as well as carcinogenic risk (CR), were used to assess the degree of pollution and health risk. Positive matrix factorization (PMF) was used to determine the primary sources of pollution and priority sources. The average values of heavy metal contents in the topsoil were 22.7, 0.128, 33.4, 14.5, 0.032, 9.32, 32.5, and 43.3 mg·kg-1 for As, Cd, Cr, Cu, Hg, Ni, Pb, and Zn, respectively. With the exception of Zn, the concentrations of other heavy metals in the topsoil were higher than the soil background values of Hainan, showing different degrees of heavy metal accumulation effect. The Igeo revealed that the major pollutant element in soils was As, followed by Cd and Cu. The RI showed that the proportion of soil samples that were high-risk level or worse was 29.4% of the total number of samples, among which As was the major source of risk. The health risk assessment results indicated that As, Cr, and Ni exposure presented carcinogenic risk for children with high CR values. Based on PMF, four major sources of heavy metals were identified in the study area. Hg was derived mainly from industrial sources, and As was closely associated with agricultural activities. Ni, Cu, Cr, and Zn were related to soil parent materials. Pb and Cd were associated with agricultural activities and traffic emissions. The PMF models combined with correlation analysis were useful for estimating the source apportionment of heavy metals in soils.

Endophthalmitis diagnosis supported by bedside ultrasound.

Endophthalmitis is a bacterial or fungal infection in the deep spaces of the eye. The diagnosis of endophthalmitis has traditionally been made by vitreous humor culture and is commonly missed on initial presentation. In this case report, we emphasize the role of ocular point-of-care ultrasound (POCUS) in revealing endophthalmitis as a primary differential diagnosis for a patient presenting with unilateral eye pain and significant swelling that limited physical examination of the eye. Here, the patient's initial clinical examination was more suggestive of an alternative diagnosis, orbital cellulitis, which could have delayed the highly morbid and time-sensitive diagnosis of endophthalmitis. Although POCUS is traditionally enlisted for other posterior ophthalmic pathologies, including retinal detachment, vitreous detachment, vitreous hemorrhage, and papilledema, this rare case of endophthalmitis secondary to hepatic abscess demonstrates the utility of bedside ocular ultrasound as a tool to distinguish endophthalmitis from mimicking differentials when physical examination is unable to do so.

Translator use not associated with longer time to pain medication in initial evaluation of low-severity geriatric trauma.

OBJECTIVES: Determine whether geriatric victims of blunt trauma who preferred to communicate in a language other than English waited longer for pain medication or received more imaging studies than English-speaking patients with the same age and injuries. Secondary outcomes were the type of medication administered and number of imaging studies. METHODS: We conducted a retrospective analysis of all trauma activations to a single academic urban medical center from January 2019 to October 2019. We included all hemodynamically stable patients older than 65, with head or torso trauma after a low energy injury, and on at least one medication that was an anti-coagulant, anti-platelet, or chemotherapeutic. RESULTS: We identified 1,153 unique patients (17, 379 radiologic studies) performed from January 2019 to October 2019, with a median of 5 (4-6) radiologic studies per patient. We excluded 419 patients for whom the language used was not reported (n = 7), no imaging was not reported (n = 16), or no medication was recorded as given (n = 409), leaving 734 patients for further analysis. Of those 734 patients, 460 preferred to communicate in English, 84 in Mandarin Chinese, 64 in Spanish, 37 in Cantonese Chinese, and 35 in Korean, and 29 in Russian. Across all languages patient age and Injury Severity Score (ISS) were comparable. Those who preferred to communicate in Spanish, Russian, or Korean were more likely to be female than those who preferred English, Mandarin, or Cantonese, but this tendency was not statistically significant (χ2-test; p = 0.051, 0.15 after Bonferroni correction). We did not find a statistically significant association between preferred language and time to medication, fraction of opioids used as first-line pain medication, or number of imaging studies performed. Across all patients, the most common medications administered were acetaminophen (524/734, 71%), any opioid (111/734, 15%), followed by local infiltration or nerve block with lidocaine (49/734, 6.7%). CONCLUSIONS: A retrospective analysis of patients with low-risk blunt trauma found no relationship between preferred language, time to pain medication, use of opioids or number of imaging studies.

[Accumulation and Health Risk of Heavy Metals in Cereals, Vegetables, and Fruits of Intensive Plantations in Hainan Province].

The accumulation of some harmful elements in plants from intensive production systems pose a serious threat to human health. In this study, seven heavy metals(Cu, Pb, Zn, Cr, Cd, As, and Hg) and their distribution characteristics in the crops, vegetables, and fruits were analyzed alongside single factor evaluation and Nemero index analysis. Combined with dietary recommended consumption data from the Chinese Nutrition Society, the dietary exposure of heavy metals were further analyzed, and a consequent safety risk assessment was conducted. A total of 673 crop, vegetable, and fruit samples were collected from typical intensive production systems in Hainan Province. The results showed that the content of Cu, As, and Hg in the 673 plant samples was below the value of the national food standard. The exceed rates of Pb, Zn, Cr, and Cd were 2.67%, 3.71%, 2.53%, and 3.71%, respectively. The heavy metal comprehensive pollution degree of six species of plants showed the trend of leafy vegetables > tuber crops > non-leafy vegetables > legume crops > fruits > cereals. In particular, Cr in leafy vegetables showed significantly higher hazard quotients(HQ) than that in other types, and exceeded 1, suggesting a high potential health risk via the ingestion of heavy metals through leafy vegetables. The relatively lower hazard index(HI) values of tuber crops, non-leafy vegetables, legume crops, fruits, and cereals suggest that these types of plants are more suitable for intensive production systems.

The impact of leucoaraiosis on neurological function recovery in elderly patients with acute cerebral infarction: Clinical study involving 279 Chinese patients.

OBJECTIVE: To explore the link between leucoaraiosis and recovery of neurological function in elderly patients with acute cerebral infarction. METHODS: The study included elderly patients, hospitalized with acute cerebral infarction. Magnetic resonance imaging examinations were performed before or within 5 days after admission; T1-weighted, T2-weighted, fluid-attenuated inversion recovery and diffusion-weighted imaging sequence data were collected. Using the Fazekas scale, leucoaraiosis (white matter hyperintensity [WMH]) was graded as 0 (absent), 1 (mild), 2 (moderate) or 3 (severe) for all participants. RESULTS: The study included 279 patients. WMH grades of 0, 1, 2 and 3 were seen in 27 (9.67%), 90 (32.26%), 104 (37.28%) and 58 cases (20.79%) respectively. Improvement on the National Institutes of Health Stroke Scale for neurological impairment was negatively associated with WMH grade. Patients with severe leucoaraiosis at hospital admission had worse neurological functional recovery and a higher rate of self-care incapability compared with those with mild or no leucoaraiosis. CONCLUSIONS: The results suggest that severe leucoaraiosis in elderly patients with acute cerebral infarction is associated with poor prognosis and poor recovery of neurological function.

[Angiotensin-converting enzyme 2 gene transfer attenuates neointimal formation after carotid artery ischemia-reperfusion injury in rats].

OBJECTIVE: To explore the effects of lentiviral recombinant angiotensin-converting enzyme 2 (LV-ACE2) gene transfer on the neointimal formation after carotid artery ischemia-reperfusion injury (IRI) and related mechanisms. METHODS: IRI was induced in SD rats through the carotid artery clipping and rats were divided into IRI, IRI+LV-GFP, IRI+LV-ACE2, IRI+ paclitaxel groups (n = 10 each). Sham operated rats serve as normal control. Four weeks later, neointimal formation was observed on HE stained carotid artery sections. The protein expression of ACE2, α-SM-actin, CD31, AT1R and P-ERK were detected by immunohistochemistry. RESULTS: (1) Carotid artery neointimal hyperplasia was readily shown in IRI group [I/M: 1.517 ± 0.151 (4 weeks later) vs. 0.011 ± 0.004 (Sham), P < 0.01], which was significantly reduced in IRI+LV-ACE2 (0.71 ± 0.17) and IRI+ paclitaxel (0.89 ± 0.21) groups. (2) The growth of vascular smooth muscle cells and neovascularization were also significantly inhibited in IRI+LV-ACE2 group and the expression of α-SM-actin (5 843 ± 839 vs. 12 648 ± 1 760, P < 0.01) and CD31 [(12.40 ± 4.01)/mm(2) vs. (96.20 ± 17.79)/mm(2), P < 0.01], AT1R (1 219 ± 175 vs. 4 861 ± 545, P < 0.01) and P-ERK1/2 phosphorylation (1 040 ± 215 vs. 2 938 ± 286, P < 0.01) in the neointimal of the injury arteries in IRI+LV-ACE2 group were significantly downregulated compared to IRI group. CONCLUSION: This data suggest that ACE2 gene overexpression is able to attenuate neointimal formation after ischemia-reperfusion injury possibly through downregulating AT1 receptor expression and signal pathway of ERK1/2 phosphorylation.

SIRT1 suppresses the epithelial-to-mesenchymal transition in cancer metastasis and organ fibrosis.

The epithelial-to-mesenchymal transition (EMT) is important for the development of cancer metastases and organ fibrosis, conditions prevalent in aging. Because sirtuins affect the pathology of aging, we tested the effect of SirT1 on EMT. Reduced SIRT1 levels in HMLER breast cancer cells led to increased metastases in nude mice, and the loss of SIRT1 in kidney tubular epithelial cells exacerbated injury-induced kidney fibrosis. SIRT1 reduces EMT in cancer and fibrosis by deacetylating Smad4 and repressing the effect of TGF-ß signaling on MMP7, a Smad4 target gene. Consequently, less E-cadherin is cleaved from the cell surface and ß-catenin remains bound to E-cadherin at the cell-cell junctions. Our findings suggest that the SIRT1/Smad4/ß-catenin axis may be a target for diseases driven by EMT.

[The stability of the atherosclerotic plaque depends on the extent of injured endothelium:results from a novel model of ischemia/reperfusion induced atherosclerosis in carotid artery of rats].

OBJECTIVE: To observe the atherogenic lesion progress in a novel ischemia/reperfusion induced atherosclerosis model in the carotid artery of rats. METHODS: Rats were divided into normal control, sham-operated control and ischemia-reperfusion injury (IRI) groups (n = 10 each). IRI was induced by 30 min carotid artery occlusion with a 2 cm long artery clips in anesthetized rats. Four weeks later, hematoxylin and eosin (HE) and immunohistochemical stain were performed on carotid arteries of various groups. The ratio of neointima area/media area (I/M) and expression of platelet endothelial cell adhesion molecule (PECAM-1/CD31) were compared among groups. RESULTS: (1) Neointimal hyperplasia was detected in carotid artery of IRI group and the I/M ratio was significantly higher than in normal control and sham-operated groups (1.328 ± 0.301 vs. 0.011 ± 0.004 and 0.017 ± 0.008, all P < 0.01). (2) Small to large-sized neointima were found in the IRI group and the small sized intima was stable while large sized intima which covered the whole cavity was instable and underwent spontaneous rupture and thrombosis formation. (3) CD31 expression was significantly upregulated in carotid artery of IRI group corresponding to the instability of neointima in this group. CONCLUSION: Ischemia-reperfusion injury of carotid artery could result in atheroma in rats, this model could be used for future research on the pathogenesis of atherosclerosis. Our results show that endothelium injury of the arteries is the key factor to trigger atheroma and responsible for the disruption of the plaque.

[Overexpression of angiotensin-converting enzyme 2 inhibits angiotensin II type 1 receptor expression and signal transducer and activator of transcription 3 phosphorylation in cultured smooth muscle cells].

OBJECTIVE: To explore the effects of recombinated lentiviral angiotensin-converting enzyme 2 (ACE2) vector transfer on the expression of angiotensin II type 1 (AT1) receptor in cultured vascular smooth muscle cells (VSMCs). METHODS: VSMCs were divided into 7 groups: (1) CONTROL: serum-free culture medium; (2) Lentiviral-GFP vector group: Lentiviral-GFP vector (MOI = 10); (3) Ang II group (10(-7) mol/L); (4) Ang II (10(-7) mol/L) + Lentiviral-ACE2 (MOI = 10) group; (5) Ang II (10(-7) mol/L) + Irbesartan (10(-7) mol/L) group ; (6) Ang II (10(-7) mol/L) + irbesartan (10(-7) mol/L) + Lentiviral-ACE2 (MOI = 10) group ; (7) Lentiviral-ACE2 (MOI = 10) group. Ninety-six hours later, the proliferation of VSMCs was determined with CCK-8 Kit. AT1 receptor mRNA and protein expressions were detected with quantitative real-time PCR and Western blot, the signaling pathway of signal transducer and activator of transcription 3 (STAT3) was also detected. RESULTS: ACE2 gene transfer significantly inhibited the VSMCs proliferation in the absence or presence of Ang II. AT1 receptor mRNA and protein expressions were also significantly downregulated in the absence or presence of Ang II. Similar to AT1 receptor mRNA and protein expression changes, STAT3 phosphorylation was also significantly inhibited by ACE2 overexpression. CONCLUSION: Our results suggest that overexpression of ACE2 gene could inhibit the VSMCs proliferation by downregulating AT1 receptor expression and STAT3 phosphorylation. ACE2 could also directly inhibit AT1 receptor in cultured VSMCs.

Enantioselective intramolecular Rauhut-Currier reaction catalyzed by chiral phosphinothiourea.

Chiral organophosphine-catalyzed enantioselective Rauhut-Currier reaction has been disclosed for the first time. With L-valine-derived phosphinothiourea, the intramolecular Rauhut-Currier reaction of bis(enones) was achieved in good yields (up to 99%) with excellent enantioselectivities (up to 99.4% ee).

[Study on microwave-assisted extraction technology for active ingredients in different parts of traditional Chinese medicine].

OBJECTIVE: To study the optimization process of microwave-assisted extraction for active ingredients in different parts of TMC. METHOD: Using the uniform design, the optimization processes of microwave-assisted extraction for Flavonoids and Paneonolum in Bidens and Cortex Moutan were gained. RESULT: The optimization process of extraction for Flavonoids in Bidens can be described as following: microwave power was 850 W, radiation time was 30 min, solvent concentration was 40%, solvent volume was 13 times as the proportion of raw material, and dipping time was 60 min. The optimization process of extraction for Paneonolum in Cortex Moutan has also been gained which could be shown as following: 340 W as microwave power, 20 min as radiation time, 85% as solvent concentration, 1:5 as the proportion of raw material to solvent, and 30 min as the dipping time. CONCLUSION: These can prove it reasonable to get active ingredients in Bidens and Cortex Moutan with microwave-assisted extraction technology.