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Free flap transplantation has become a mainstay for the restoration of oral and maxillofacial defects. However, the complexity of the surgical procedure and long hospitalization time result in high hospitalization costs. This study was performed to retrospectively analyse the composition of hospitalization expenses and factors influencing this for 507 patients who underwent oral and maxillofacial free flap transplantation at a representative medical institution in China. The aim was to provide evidence for the reasonable control of expenditure and effective utilization of medical resources, and to gain an indirect reflection of the healthcare model characteristics of public hospitals in China. The average hospitalization cost was found to be US$ 9265 ± 2284. Factors affecting hospitalization expenses were the type of free flap, tracheotomy, postoperative complications, and length of stay. The largest proportion of hospitalization expenses was the cost of materials (44.94%). Although the total hospitalization cost was lower than that in Western countries, the medical burden of patients was higher, and the corresponding medical charges do not fully reflect the value of medical services. We recommend reducing hospitalization expenses and the medical burden by shortening the hospital stay, selecting reasonably priced medical materials, strengthening airway management of patients undergoing tracheotomy, and enhancing the control and treatment of comorbidities in order to reduce the incidence of postoperative complications.

Permafrost soils store a large amount of nitrogen (N) which could be activated under the continuous climate warming. However, compared with carbon (C) stock, little is known about the size and spatial distribution of permafrost N stock. By combining measurements from 519 pedons with two machine learning models (supporting vector machine (SVM) and random forest (RF)), we estimated the size and spatial distribution of N stock across the Tibetan alpine permafrost region. We then compared these spatially-explicit N estimates with simulated N stocks from the Community Land Model (CLM). We found that N density (N amount per area) in the top three meters was 1.58 kg N m−2 (interquartile range: 1.40–1.76) across the study area, constituting a total of 1802 Tg N (interquartile range: 1605–2008), decreasing from the southeast to the northwest of the plateau. N stored below 1 m accounted for 48% of the total N stock in the top three meters. CLM4.5 significantly underestimated the N stock on the Tibetan Plateau, primarily in areas with arid/semi-arid climate. The process of biological N fixation played a key role in the underestimation of N stock prediction. Overall, our study highlights that it is imperative to improve the simulation of N processes and permafrost N stocks in land models to better predict ecological consequences induced by rapid and widespread permafrost degradation.

Permafrost thaw could lead to frozen carbon (C) being laterally transferred to aquatic systems as dissolved organic carbon (DOC). If this part of DOC has high biodegradability, it could be decomposed during the delivery process, release greenhouse gases to the atmosphere and trigger positive C-climate feedback. Thermokarst is an abrupt permafrost thaw process that can enhance DOC export and also impact DOC processing through increased inorganic nitrogen (N) and ultraviolet (UV) light exposure. Especially on the Tibetan Plateau, where thermokarst develops widely and suffers from serious UV radiation and N limitation. However, it remains unclear how thermokarst-impacted biodegradable DOC (BDOC) responds to inorganic N addition and UV radiation. Here, we explored the responses of DOC concentration, composition and its biodegradability to inorganic N and UV amendments in a typical thermokarst on the Tibetan Plateau, by using laboratory incubations with spectral analyses (UV-visible absorption and three-dimensional fluorescence spectra) and parallel factor analyses. Our results showed that BDOC in thermokarst outflows was significantly higher than in reference water. Our results also revealed that inorganic N addition had no influence on thermokarst-impacted BDOC, whereas exposure to UV light significantly increased BDOC by as much as 2.3 times higher than the dark-control. Moreover, N addition and UV radiation did not generate additive effects on BDOC. Our results further illustrated that dissolved organic matter (DOM) composition explained more of the variability in BDOC, while the nutrients and other physicochemical properties played a minor role. Overall, these results imply that UV light rather than inorganic N significantly increases thermokarst-derived BDOC, potentially strengthening the positive permafrost C-climate feedback.

Belowground microbial nitrogen (N) processes play key roles in regulating terrestrial ecosystem services such as vegetation production, however, our understanding of their responses to climate change remains limited. We determined patterns and controls of five gross N transformation processes along a typical aridity gradient on the Tibetan Plateau. Potential gross N transformation rates responded diversely to the changing aridity. Both mineralization (MN, average rate: 2.87 mg N kg−1 soil d−1) and ammonium immobilization (INH4, 3.35 mg N kg−1 soil d−1) declined as aridity increased. Autotrophic nitrification (ONH4, 1.72 mg N kg−1 soil d−1) exhibited a bell-shaped pattern along the gradient, with an optimum aridity of 0.53 (1- aridity index (AI)). By contrast, rates of nitrate immobilization (INO3, 0.46 mg N kg−1 soil d−1) and dissimilatory nitrate reduction to ammonium (DNRA, 0.10 mg N kg−1 soil d−1) did not respond to the changing aridity. These results suggest that predicted increases in aridity will exert different effects on various soil internal N cycling processes, and thus potentially have profound impact on structure and function of dryland ecosystems.

Paddy soils, a type of Hydragric Anthrosol, have much greater soil organic C (SOC) and total N (TN) contents than that in upland soils. However, this fact has never been generalized or mechanistically explained. We conducted a global meta-analysis on the organic C and total N contents and their stocks in continuous paddy soils (578 sites) and compared them with those in adjacent upland soils. Average C stocks up to depths of 35 cm in upland and paddy soils were 31 and 47 Mg C ha−1, respectively. The N stocks in upland and paddy soils were 2.2 and 3.2 Mg N ha−1, respectively. The combined effects of mean annual temperature and precipitation showed that C and N stocks in paddy and upland soils are generally the largest under cool and humid conditions and the smallest in warm and dry climates. Quantitative analysis of climatic, and soil physical and chemical factors showed that 1) climate effects are weakened by management such as puddling and flooding, thereby increasing the importance of soil physico-chemical properties, which control soil organic matter (SOM) stabilization, and 2) climate (e.g., mean annual precipitation) mainly affects C and N stocks in upland soils; the chemical properties (such as pH), on the other hand, primarily affect C and N stocks in paddy soils. Greater C and N stocks in paddy soils are the result of 1) a larger input of organic C by rice than by most upland cereals, 2) slower decomposition of plant residues and SOM under anoxic conditions, and 3) a greater importance of sesquioxides in the biochemical stabilization of SOM. We conclude that these man-made paddy soils store more organic C and N than their upland neighbors despite long-term and intensive management.

Accurate estimation of grassland biomass and its dynamics are crucial not only for the biogeochemical dynamics of terrestrial ecosystems, but also for the sustainable use of grassland resources. However, estimations of grassland biomass on large spatial scale usually suffer from large variability and mostly lack quantitative uncertainty analyses. In this study, the spatial grassland biomass estimation and its uncertainty were assessed based on 265 field measurements and remote sensing data across Northern China during 2001–2005. Potential sources of uncertainty, including remote sensing data sources (DATsrc), model forms (MODfrm) and model parameters (biomass allocation, BMallo, e.g. root:shoot ratio), were determined and their relative contribution was quantified. The results showed that the annual grassland biomass in Northern China was 1268.37 ± 180.84 Tg (i.e., 532.02 ± 99.71 g/m 2 ) during 2001–2005, increasing from western to eastern area, with a mean relative uncertainty of 19.8%. There were distinguishable differences among the uncertainty contributions of three sources (BMallo > DATsrc > MODfrm), which contributed 52%, 27% and 13%, respectively. This study highlighted the need to concern the uncertainty in grassland biomass estimation, especially for the uncertainty related to BMallo.

In a Co–Al–W base superalloy, two types of topologically close-packed (TCP) phases, μ and Laves phases, were investigated by high-resolution transmission electron microscopy, scanning transmission electron microscopy and energy dispersive X-ray spectroscopy. It is found that an intergrowth structure of Laves within μ phases can be formed and both have a completely coherent interface relationship. With the aid of image simulation, both μ and Laves phases are identified as the quaternary compounds containing Co, Cr, W and Mo. Compared to Co7W6-type μ phase, W1 and W3-sites are the preferred sites of substitution by Mo atoms and Co1-site is a preferred site of substitution by Cr atoms in the quaternary μ phase, leading to the atomic displacement and an alteration of lattice parameter. In contrast to Co2W-type Laves phase, the newly formed quaternary Laves phase can maintain the C14-type Laves structure although Co and W are substituted partially by Cr and Mo respectively.

Soil moisture plays a vital role in regulating the direction and magnitude of methane (CH4) fluxes. However, it remains unclear whether the responses of CH4 fluxes to climate warming exhibit difference between dry and moist ecosystems. Based on standardized manipulative experiments (i.e., consistent experimental design and measurement protocols), here we explored warming effects on growing season CH4 fluxes in two alpine grasslands with contrasting water status on the Tibetan Plateau. We observed that experimental warming enhanced CH4 uptake in the relatively arid alpine steppe, but had no significant effects on CH4 emission in the moist swamp meadow. The distinct responses of CH4 fluxes were associated with the different warming effects on biotic and abiotic factors related to CH4 oxidation and production processes. Warming decreased soil water-filled pore space (WFPS) and increased the pmoA gene abundance and CH4 oxidation potential in the alpine steppe, which together led to a significant increase in CH4 uptake at this alpine steppe site. However, warming-induced enhancement in CH4 oxidation potential might be counteracted by the simultaneously increased CH4 production potential in the swamp meadow, which could then result in insignificant warming effects on CH4 emission at this swamp meadow site. Based on a meta-analysis of warming effects on CH4 fluxes across the entire Tibetan Plateau, we found that the entire alpine grasslands could absorb an extra 0.042 Tg CH4 (1 Tg = 1012 g) per growing season if soil temperature increased by 1 °C. These findings demonstrate that warming effects on CH4 fluxes differ between two alpine grasslands with contrasting moisture conditions and the entire alpine grasslands may not trigger a positive CH4 feedback to climate system with moderate warming.

We conducted a field study in Danjiangkou Reservoir region of central China to evaluate soil C and N dynamics following afforestation by comparing soil organic C and N (SOC and SON), soil net N mineralization and nitrification, and inorganic N concentrations in the plant rhizosphere and open areas in the forest, shrubland and adjacent cropland. Afforestation increased SOC but did not significantly affect SON in the plant rhizosphere. Due to large quantity of low-quality litter (with high C:N ratios) inputs, afforestation enhanced soil C recalcitrant indexes (RIC) but decreased soil N recalcitrance indexes (RIN) in the plant rhizosphere. Both SON and RIN significantly decreased following afforestation in the open areas. Afforestation decreased inorganic N concentrations and net N mineralization. Soil net N mineralization were negatively correlated with soil C:N ratios across land use types. These results suggest that afforestation could increase SOC stocks resulting from large low-quality litter input, but over the long-term, this increase was likely limited due to decreased soil N availability.

Soil acidity is an important parameter that can regulate ecosystem structure and function. However, a quantitative understanding of the relationships between soil pH and environmental factors remains unavailable. In this study, relationships of soil pH with both climatic and edaphic factors in alpine grasslands on the Tibetan Plateau, China were quantified using data obtained from a regional soil survey during 2001-2004. Our results showed that soil pH decreased along the gradient of both mean annual temperature and precipitation. Likewise, soil pH exhibited consistent negative correlations with soil moisture and silt content. However, soil organic and inorganic carbon contents played opposite roles in shaping patterns of soil pH: the accumulation of soil organic matter led to higher soil acidity, while the existence of soil inorganic matter was favorable for maintaining higher soil alkalinity. The variation partitioning analysis indicated that the combination of climatic and edaphic variables explained 74.3% of the variation in soil acidity. These results suggest that soil pH could be predicted from routinely-measured variables, allowing a robust pedotransfer function to be developed. The pedotransfer function may facilitate land surface models to generate more reliable predictions on ecosystem structure and function around the world.

It is a well-established concept that nitrogen (N) limits plant growth and ecosystem production. However, whether N limits land carbon (C) sequestration – particularly in soil, the largest pool in the land – remains highly controversial. We conducted a meta-analysis to synthesize 257 studies published in the literature with 512 paired comparisons to quantify the changes of ecosystem C processes in response to N addition. Our results show that N addition significantly increased aboveground, belowground, and litter C pools by 35.7, 23.0, and 20.9%, respectively, across all the studies. Despite the substantial increases in C inputs from vegetation to soil system, N addition resulted in no significant change in C storage of both organic horizon and mineral soil in forests and grasslands, but a significant 3.5% increase in agricultural ecosystems, largely due to less contribution from aboveground production and increases in DOC and soil respiration. Thus, N stimulation of C storage primarily occurred in plant pools but little in soil pools. Moreover, N-induced change in soil C storage was positively related to changes in belowground production but not to those in aboveground growth. Our global synthesis also suggests that earth system models need to treat soil C inputs from aboveground and belowground sources differentially for soil C sequestration in response to N deposition and fertilization.

This study investigated spatial patterns and environmental controls of aboveground biomass (AGB) in alpine grasslands on the Tibetan Plateau by integrating AGB data collected from 135 sites during 2001– 2004 and concurrent enhanced vegetation index derived from MODIS data sets. The AGB was estimated at 68.8 g m �2 , with a larger value (90.8 g m �2 ) in alpine meadow than in alpine steppe (50.1 g m �2 ). It increased with growing season precipitation (GSP), but did not show a significant overall trend with growing season temperature (GST) although it was negatively correlated with GST at dry environments (

Soil holds the largest nitrogen (N) pool in terrestrial ecosystems, but estimates of soil N stock remain controversial. Storage and spatial distribution of soil N in China were estimated and the relationships between soil N density and environmental factors were explored using data from China's Second National Soil Survey and field investigation in northwest China and the Tibetan Plateau. China's soil N storage at a depth of one meter was estimated at 7.4 Pg, with an average density of 0.84 kg m−2. Soil N density appeared to be high in southwest and northeast China and low in the middle areas of the country. Soil N density increased from the arid to semi-arid zone in northern China, and decreased from cold-temperate to tropical zone in the eastern part of the country. An analysis of general linear model suggested that climate and vegetation determined the spatial pattern of soil N density for natural vegetation, which explained 75.4% of the total variance.