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Land and soil resources are scarce in the Tibetan Plateau, and the region is facing ecological pressure from climate warming and increasing human activities. As a major ecological problem, gully erosion is destroying land and soil resources on the Tibetan Plateau, but related research is limited, and susceptibility areas and influencing factors are unclear. Machine learning methods are often applied to study gully initiation susceptibility, but they require a programming foundation. Therefore, the Redui watershed on the southern Tibetan Plateau with severe gully erosion was selected to evaluate the susceptibility and influencing factors of gully initiation through 12 influencing factors including topography, human activity, and underlying surface conditions, and all 2310 gully headcut sites. Two non-code nonlinear modeling methods, the categorical Regression (CATREG) and geographical detector (Geodetector) methods, were first used in the spatial modeling of gully initiation susceptibility. The results showed that the gully initiation susceptibility of the hillslope around the alluvial fan was highest. The very high susceptibility areas of the CATREG model and Geodetector model account for 18.2% and 16% of the total, respectively. The main influencing factors of gully initiation were elevation, relief, and soil type recognized by CATREG, and elevation, human footprint, and soil type recognized by Geodetector. Elevation is the primary factor controlling downstream susceptibility in both models. The primary factors in the upper and middle reaches are soil type and relief identified by CATREG. Human footprint, soil type, and distance to road are primary factors in the upper and middle reaches identified by Geodetector. The explanatory power of elevation, elevation-relief interaction, Geodetector model and CATREG model were 39%, 54%, 46.4% and 73.8%, respectively, at extremely significant levels (P

Check dams are widely used throughout the world to tackle soil and water loss. However, the frequency of extreme rainfall events has increased owing to global climate change and the main structure of check dam is gradually aging, which lead to an increase in the failure risk of check dams. Thus, it is necessary to carry out the study on failure risk diagnosis and assessment of check dams. In the study, machine learning algorithms (ML), including random forests (RF), support vector machine (SVM), and logistic regression (LR), were used to integrate the environmental and engineering factors and then assess the risk of check dam failure due to the “7.26” rainstorm on July 26, 2017, in the Chabagou watershed, located in the hilly-gully region of the Loess Plateau, China. To verify the generalizability of the model in this study, these models were used for the Wangmaogou catchment north of the Loess Plateau. The accuracy assessment by the receiver operating characteristic (ROC) curve indicated that the RF model with an area under the ROC curve (AUC) greater than 0.89 was the most precise model and had a higher generalization ability. In addition, the model dataset was relatively small and easy to obtain, which make the risk modeling of check dam failure in the study has the potential for application in other regions. In the RF model, each factor selected was confirmed to be important, and the importance values for engineering factors were generally higher than those for the environmental factors. The risk map of check dam failure in the RF model indicated that 56.34% of check dams in the study area had very high and high risks of dam failure under high-intensity rainfall in 2017. Based on the importance of factors and the risk map of check dam failure, the prevention and control measures for reducing the risk of check dam failure and promoting the construction of check dam are proposed. These proposals provide a scientific basis for the reinforcement of check dams and the future layout of check dams in the Chinese Loess Plateau.

Background Huanglianjiedu decoction (HLJDD) is a classical Traditional Chinese Medicine (TCM) prescription with thousand years of clinical use against various malignancies, including pancreatic adenocarcinoma (PAAD). However, its potential bioactive component and molecular mechanism remains unclear. Aims This study is to inspect the HLJDD mechanisms of action against PAAD via integrated computational and pharmacochemistry strategy, in vivo and in vitro experiments to validate associated targets and pathways. Methods A PAAD xenograft model was established by subcutaneous injecting Panc02 cells into C57BL/6 mice. Ultra-high performance liquid chromatography with tandem mass spectrometry (UHPLC-MS/MS) was engaged to determine constituents of HLJDD and assessed for pharmacokinetic scheme using the TCM Systems Pharmacology Platform (TCM-SP). Differentially expressed genes (DEGs) of PAAD was retrieved from the transcriptome dataset GSE43795, followed by recognizing overlapping targets the oncogenes and target genes of PAAD and HLJDD, respectively. Putative signaling pathways of HLJDD in treating PAAD were enriched using KEGG and GO analyses. The anti-PAAD effects of HLJDD was assessed in vivo and in vitro , besides, the potential mechanism was validated using immunoblotting and immunohistochemical assays. Results HLJDD significantly suppressed the growth of transplanted PAAD tumors, constrained PAAD progression, and induced apoptosis and S-phase arrest. Seventy-five active components meeting the drug-likeness criteria and 278 target genes of HLJDD were identified. KEGG analysis indicated that the top three enriched pathways were cancer, AGE-RAGE signaling, and IL-17 signaling pathways. Disease enrichment analysis highlighted immune, pharmacological, and cancer-related diseases as the top three categories. A total of 47 potential target genes were identified. Immunoblotting revealed that HLJDD inhibited PI3K and MAPK-related signaling pathways, while immunohistochemical staining confirmed that HLJDD suppressed the expression of phosphorylated MAPK and ERK1/2. Conclusion HLJDD inhibited PAAD in vitro and in vivo via the modulation of multiple mechanisms, including regulation of PI3K/AKT/mTOR and MAPK/ERK1/2 signaling pathways.

Abstract Background To determine whether frailty can predict prolonged postoperative ileus (PPOI) in older abdominal surgical patients; and to compare predictive ability of the FRAIL scale, the five-point modified frailty index (mFI-5) and Groningen Frailty Indicator (GFI) for PPOI. Methods Patients (aged ≥ 65 years) undergoing major abdominal surgery at our institution between April 2022 to January 2023 were prospectively enrolled. Frailty was evaluated with FRAIL, mFI-5 and GFI before operation. Data on demographics, comorbidities, perioperative management, postoperative recovery of bowel function and PPOI occurrence were collected. Results The incidence of frailty assessed with FRAIL, mFI-5 and GFI was 18.2%, 38.4% and 32.5% in a total of 203 patients, respectively. Ninety-five (46.8%) patients experienced PPOI. Time to first soft diet intake was longer in patients with frailty assessed by the three scales than that in patients without frailty. Frailty diagnosed by mFI-5 [Odds ratio (OR) 3.230, 95% confidence interval (CI) 1.572–6.638, P = 0.001] or GFI (OR 2.627, 95% CI 1.307–5.281, P = 0.007) was related to a higher risk of PPOI. Both mFI-5 [Area under curve (AUC) 0.653, 95% CI 0.577–0.730] and GFI (OR 2.627, 95% CI 1.307–5.281, P = 0.007) had insufficient accuracy for the prediction of PPOI in patients undergoing major abdominal surgery. Conclusions Elderly patients diagnosed as frail on the mFI-5 or GFI are at an increased risk of PPOI after major abdominal surgery. However, neither mFI-5 nor GFI can accurately identify individuals who will develop PPOI. Trial registration This study was registered in Chinese Clinical Trial Registry (No. ChiCTR2200058178). The date of first registration, 31/03/2022, https://www.chictr.org.cn/ .

Abstract Early dysbiosis in the gut microbiota may contribute to the severity of acute pancreatitis (AP), however, a comprehensive understanding of the gut microbiome, potential pathobionts, and host metabolome in individuals with AP remains elusive. Hence, we employed fecal whole-metagenome shotgun sequencing in 82 AP patients and 115 matched healthy controls, complemented by untargeted serum metabolome and lipidome profiling in a subset of participants. Analyses of the gut microbiome in AP patients revealed reduced diversity, disrupted microbial functions, and altered abundance of 77 species, influenced by both etiology and severity. AP-enriched species, mostly potential pathobionts, correlated positively with host liver function and serum lipid indicators. Conversely, many AP-depleted species were short-chain fatty acid producers. Gut microflora changes were accompanied by shifts in the serum metabolome and lipidome. Specifically, certain gut species, like enriched Bilophila wadsworthia and depleted Bifidobacterium spp., appeared to contribute to elevated triglyceride levels in biliary or hyperlipidemic AP patients. Through culturing and whole-genome sequencing of bacterial isolates, we identified virulence factors and clinically relevant antibiotic resistance in patient-derived strains, suggesting a predisposition to opportunistic infections. Finally, our study demonstrated that gavage of specific pathobionts could exacerbate pancreatitis in a caerulein-treated mouse model. In conclusion, our comprehensive analysis sheds light on the gut microbiome and serum metabolome in AP, elucidating the role of pathobionts in disease progression. These insights offer valuable perspectives for etiologic diagnosis, prevention, and intervention in AP and related conditions.

AbstractContext Qingyi granules can be used to effectively treat patients with severe acute pancreatitis (SAP).Objective To elucidate the role of gut microbiota-mediated metabolism in the therapeutic effects of Qingyi granules.Materials and methods Sprague–Dawley rats were grouped into the sham operation, SAP model, Qingyi granule intervention (Q, 1.8 g/kg) and emodin intervention (E, 50 mg/kg) groups and observed for 24 h. H&E staining and ELISA were used for histopathological analysis and serum enzyme and cytokine assays. 16S rDNA sequencing and UHPLC-HRMS were used for gut microbiota analysis and untargeted metabolomics.Results In SAP rats, Qingyi granules decreased the pancreatic pathological score (Q, 7.4 ± 1.14; SAP, 11.6 ± 1.14, p

Abstract Background Due to the continued growth of surgical procedures in older adults and the significant impact of chronic postsurgical pain (CPSP), it is crucial to improve our understanding of the occurrence of CPSP as well as the appropriate prevention and treatment. We therefore conducted this study to determine the incidence, characteristics and risk factors of CPSP in elderly patients at both 3 and 6 months after surgery. Methods Elderly patients (aged ≥ 60 years) undergoing elective surgery in our institution between April 2018 and March 2020 were prospectively enrolled in this study. Data on demographics, preoperative psychological well-being, intraoperative surgical and anesthesia management, and acute postoperative pain intensity were collected. At 3 and 6 months after surgery, patients received telephone interview and completed the questionnaires regarding chronic pain characteristics, analgesic consumption, and interference of the pain with activities of daily living (ADL). Results A total of 1065 elderly patients were followed up for 6 postoperative months and included in final analysis. At 3 and 6 months after operation, the incidence of CPSP was 35.6% [95% confidence interval (95% CI) 32.7 − 38.8%] and 21.5% (95% CI 19.0% − 23.9%), respectively. CPSP cause negative impacts on patient’s ADL and most particularly on mood. Neuropathic features were found in 45.1% of the patients with CPSP at 3 months. At 6 months, 31.0% of those with CPSP reported that the pain had neuropathic features. Preoperative anxiety [3 months: Odds ratio (OR) 2.244, 95% CI 1.693 to 2.973; 6 months: OR 2.397, 95% CI 1.745 to 3.294], preoperative depression (3 months: OR 1.709, 95% CI 1.292 to 2.261; 6 months: OR 1.565, 95% CI 1.136–2.156), orthopedic surgery (3 months: OR 1.927, 95% CI 1.112 to 3.341; 6 months: OR 2.484, 95% CI 1.220 to 5.061), higher pain severity on movement within postoperative 24 h (3 months: OR 1.317, 95% CI 1.191 to 1.457; 6 months: OR 1.317, 95% CI 1.177 to 1.475) were associated with a higher risk for CPSP independently at both 3 and 6 months after surgery. Conclusions CPSP is a common postoperative complication in elderly surgical patients. Preoperative anxiety and depression, orthopedic surgery, and greater intensity of acute postoperative pain on movement are associated with an increased risk for CPSP. It should be kept in mind that developing psychological interventions to reduce anxiety and depression and optimizing the management of acute postoperative pain will be effective in reducing the development of CPSP in this population.

Alluvial fans have been proven to have great utilisation potential in QTP, but to what extent they are suitable for agricultural development is unknown. Therefore, using the alluvial fan in the Lhasa River Basin (LRB) as a case study, this paper established an evaluation system of land suitability for agriculture (LSA). Principal component analysis (PCA) and the exhaustive method (EM) were used to define the minimum dataset (MDS) and then the LSA of the alluvial fan in the LRB was evaluated using a comprehensive index of LSA. Two scientific approaches were implemented to improve the LSA using a scenario simulation. The results showed that the MDS assessed by the EA was more representative compared to the PCA. Alluvial fans with suitable grades are mainly distributed in the Lhasa River’s middle and lower reaches. Developing facility agriculture and repairing roads accessing the alluvial fans are effective approaches to improve the LSA, which can increase the suitable-grade area from 58.62% to 97.82% and 63.85%, respectively. Therefore, most alluvial fans in the LRB are suitable for developing agriculture, and under the influence of human activities, there will be more alluvial fans suitable for developing agriculture. Our research provides scientific methods for the sustainable development of land in alpine regions.

Abstract Background Protein kinases play a pivotal role in the malignant evolution of pancreatic cancer (PC) through mediating phosphorylation. Many kinase inhibitors have been developed and translated into clinical use, while the complex pathology of PC confounds their clinical efficacy and warrants the discovery of more effective therapeutic targets. Methods Here, we used the Gene Expression Omnibus (GEO) database and protein kinase datasets to map the PC-related protein kinase-encoding genes. Then, applying Gene Expression and Profiling Interactive Analysis (GEPIA), GEO and Human Protein Atlas, we evaluated gene correlation, gene expression at protein and mRNA levels, as well as survival significance. In addition, we performed protein kinase RIPK2 knockout and overexpression to observe effects of its expression on PC cell proliferation, migration and invasion in vitro, as well as cell apoptosis, reactive oxygen species (ROS) production and autophagy. We established PC subcutaneous xenograft and liver metastasis models to investigate the effects of RIPK2 knockout on PC growth and metastasis. Co-immunoprecipitation and immunofluorescence were utilized to explore the interaction between protein kinases RIPK2 and PRKCI. Polymerase chain reaction and immunoblotting were used to evaluate gene expression and protein phosphorylation level. Results We found fourteen kinases aberrantly expressed in human PC and nine kinases with prognosis significance. Among them, RIPK2 with both serine/threonine and tyrosine activities were validated to promote PC cells proliferation, migration and invasion. RIPK2 knockout could inhibit subcutaneous tumor growth and liver metastasis of PC. In addition, RIPK2 knockout suppressed autophagosome formation, increased ROS production and PC cell apoptosis. Importantly, another oncogenic kinase PRKCI could interact with RIPK2 to enhance the phosphorylation of downstream NF-κB, JNK and ERK. Conclusion Paired protein kinases PRKCI-RIPK2 with multiple phosphorylation activities represent a new pathological mechanism in PC and could provide potential targets for PC therapy.

In recent decades, the hydrological processes on the Loess Plateau have undergone significant changes due to the combined effects of climate change and human activities. This study investigates the Qin River basin, the core area of the Loess Plateau. Between 1971 and 2000, the hydrometeorology of the flood season in the Qin basin on the Loess Plateau in China changed abruptly in 1982 and 1992. This study uses distributed hydrologic modeling and statistical analysis to distinguish the spatial and temporal impacts of climate change and human activities. The fastest dynamic changes in land use occurred in grassland and construction land, accounting for 0.36% and −0.1%, respectively, from 1982 to 1991. From 1992 to 2000, it was 0.29% and 0.3%, respectively. The increase in basin area where the Normalized Difference Vegetation Index increased was 95%. However, except for significant changes in runoff from 1981 to 1992, there were no significant changes in precipitation, runoff, and temperature during other flood seasons. During the two studied variation periods, from 1982 to 1991 and from 1992 to 2000, the contribution rate of climate change to flood season runoff (CClimate) decreased from 83.26% to 74.47%, while the contribution rate of human activity disturbance to flood season runoff (Chuman) increased from 16.74% to 25.53%. In terms of spatial distribution, from 1982 to 1991, areas with a Chuman > 50% were primarily concentrated in the upper reaches of the basin, while from 1992–2000, these areas shifted to the lower reaches. This study offers valuable insights for water resource planning and soil conservation measures in the Loess Plateau and similar arid regions worldwide, aiming to ensure water resource safety and sustainability in response to climate change and human interference.

Background: Pancreatic adenocarcinoma (PAAD) is a highly malignant tumor in urgent need of novel diagnostics, prognostic markers, and treatments. Eukaryotic translation initiation factor 2 subunits (EIF2Ss), comprising Eukaryotic translation initiation factor 2 subunit alpha (EIF2S1), Eukaryotic translation initiation factor 2 subunit beta (EIF2S2), and Eukaryotic translation initiation factor 2 subunit gamma (EIF2S3), is a family of eukaryotic initiation factors that participate in early protein synthesis and are crucial for tumor initiation and progression. However, the role of EIF2Ss in PAAD has yet to be reported. The aim of this study was therefore to analyze EIF2Ss in relation to the diagnosis, prognosis, and treatment of PAAD. Methods: The cancer genome atlas (TCGA) database was used to investigate gene expression and patient survival. Gene alterations, immune cell infiltration, and immune checkpoints in PAAD were also evaluated. Univariate and multivariate analysis, nomograms, calibration curves, and Decision Curve Analysis (DCA) diagrams were used to develop and evaluate a prediction model for patient outcome. Single-cell RNA-seq (scRNA) analysis, functional enrichment, co-IP assay, mass spectrometry, and western blot were used to study the relationship between EIF2Ss and c-myc in PAAD. Results: EIF2Ss are over-expressed in PAAD tissue and are associated with poor prognosis. The frequency of EIF2S1, EIF2S2, and EIF2S3 gene alteration in PAAD was 0.2%, 0.4%, and 0.2%, respectively. High EIF2Ss expression was associated with Th2 cell infiltration, whereas low expression was associated with pDC infiltration. Moreover, EIF2Ss expression was positively correlated with the expression of the NT5E, ULBP1, PVR, CD44, IL10RB, and CD276 checkpoints. A prediction model developed using EIF2Ss and important clinicopathologic features showed good predictive value for the overall survival of PAAD patients. ScRNA-Seq data showed that EIF2Ss was associated with enrichment for endothelial cells, fibroblasts, malignant cells, and ductal cells. EIF2Ss expression was also correlated with adipogenesis, interferon-alpha response, epithelial-mesenchymal transition, myc targets, G2M checkpoint, oxidative phosphorylation, and hypoxia. Functional enrichment analysis of EIF2Ss showed a close correlation with the myc pathway, and interactions between EIF2Ss and c-myc were confirmed by co-IP assay and mass spectrometry. Importantly, knockdown of c-myc decreased the expression of EIF2S1, EIF2S2, and EIF2S3 in PAAD cells. Conclusions: EIF2Ss were found to have significant clinical implications for the prognosis and treatment of PAAD. Inhibition of c-myc caused the downregulation of EIF2S1, EIF2S2, and EIF2S3 expression.

Land degradation has become a catastrophic global environmental issue. The current status of land degradation and changing trends of land remain unclear on the Qinghai-Tibet Plateau (QTP). This study integrated an Optimal Land Degradation Index (OLDI) and spatial footprints of three land degradation pathways (i.e., salinization, desertification and soil erosion) to investigate changing trends and degradation risks from 2001 to 2021 on the QTP. The results showed that land improvements were the dominant changing trends on the QTP compared to land degradation, accounting for 18.83% of the whole plateau. The regions with land improvements were mainly distributed in the northeastern QTP. High-risk degraded land covered an area of 0.55 million km2, and low-risk degraded land covered 0.78 million km2. The spatial distribution of high-risk degraded land varied gradually from scattered small areas to increasingly frequent connected patches from southeast to northwest. Potential driving factor analysis illustrated that land degradation resulted from multidimensional driving forcings, including topography, climatic factors, and human activities. The findings in this study can provide great insight for alpine ecosystem development and make adaption to achieve carbon neutrality with global warming.

Study region: The Shejiagou catchment on the Loess Plateau, China Study focus: This study used CAESAR-lisflood to simulate the impacts on flood processes of fully-filled check dams with different numbers, silt land areas and connection modes. According to the model results, the protective measures of fully-filled check dams and recommendations for promoting the construction of check dams were proposed in the study. New hydrological insights for the region: CAESAR-lisflood model in the study obtained higher accuracy with both the Nash-Sutcliff coefficient of efficiency and the coefficient of determination greater than 0.8. Our results showed the presence of fully-filled check dams made the flood process tend to balance, and reduced the flood volume by 9.56–75.52%, peak discharge by 14.25–89.74%, runoff kinetic energy by 30.21–99.75% and runoff power by 20.17–95.23% under different layout scenarios. Meanwhile, the results indicated that the impacts of fully-filled check dams in main channel mainly manifested in the energy dissipation of silt land and energy increase at the outside slope of dam body, which was aggravated by downstream channel with steep slope. The combination of fully-filled check dams could amplify the flood control efficiency of individual dam. These results provide a scientific basis for reinforcement of fully-filled check dams and optimization of check dams layout in the future on the Chinese Loess Plateau.

Abstract Background Enhanced recovery after surgery (ERAS) pathways have been shown to improve clinical outcomes after surgery. Considering the importance of patient experience for patients with benign surgery, this study evaluated whether improved compliance with ERAS protocol modified for gynecological surgery which recommended by the ERAS Society is associated with better clinical outcomes and patient experience, and to determine the influence of compliance with each ERAS element on patients’ outcome after benign hysterectomy. Methods A prospective observational study was performed on the women who underwent hysterectomy between 2019 and 2020. A total of 475 women greater 18 years old were classified into three groups according to their per cent compliance with ERAS protocols: Group I:

Assessing the impact of land use and land cover change (LUCC) on soil erosion by wind and water is crucial for improving regional ecosystem services and sustainable development. In this study, the Revised Wind Erosion Equation (RWEQ) and Revised Universal Soil Loss Equation (RUSLE) were used to reveal changes in the extent of soil erosion by wind and water in the Qaidam Basin from 2000 to 2018 and the impact of LUCC on them. From 2000 to 2018, with global climate change, the areas and intensities of soil erosion by wind decreased, whereas those of soil erosion by water increased. With increased human activities, approximately 12.96% of the total area underwent conversion of the type of use: the areas of cropland, woodland, grassland, and construction land increased, whereas the areas of shrubbery, desert, and other unused land decreased. Land use/cover changes are positive to the soil erosion of water but negative to the soil erosion of wind. Among them, the changes in vegetation coverage of other unused land and grassland contributed to 83.19% of the total reduction in soil erosion by water. Converting other unused land to grassland reduced the total reductions in soil erosion by wind by 94.69%. These results indicate that the increase in vegetative cover and area of grasslands in the Qaidam Basin had a positive impact on the reduction in soil erosion. It is recommended that the arrangement of grasses, shrubs, and trees be optimized to prevent compound erosion by wind and water for protecting regional ecological environments.

When coronavirus disease 2019 (COVID-19) develops into the severe phase, lung injury, acute respiratory distress syndrome, and/or respiratory failure could develop within a few days. As a result of pulmonary tissue injury, pathomorphological changes usually present endothelial dysfunction, inflammatory cell infiltration of the lung interstitium, defective gas exchange, and wall leakage. Consequently, COVID-19 may progress to tremendous lung injury, ongoing lung failure, and death. Exploring the treatment drugs has important implications. Recently, the application of traditional Chinese medicine had better performance in reducing fatalities, relieving symptoms, and curtailing hospitalization. Through constant research and study, plant polysaccharides may emerge as a crucial resource against lung injury with high potency and low side effects. However, the absence of a comprehensive understanding of lung-protective mechanisms impedes further investigation of polysaccharides. In the present article, a comprehensive review of research into plant polysaccharides in the past 5 years was performed. In total, 30 types of polysaccharides from 19 kinds of plants have shown lung-protective effects through the pathological processes of inflammation, oxidative stress, apoptosis, autophagy, epithelial–mesenchymal transition, and immunomodulation by mediating mucin and aquaporins, macrophage, endoplasmic reticulum stress, neutrophil, TGF-β1 pathways, Nrf2 pathway, and other mechanisms. Moreover, the deficiencies of the current studies and the future research direction are also tentatively discussed. This research provides a comprehensive perspective for better understanding the mechanism and development of polysaccharides against lung injury for the treatment of COVID-19.

Grazing plays a critical role in the sustainable development of grassland. It has been convinced that grazing affects grassland productivity, however, researches on the relationship between grazing intensity and grassland soil quality remain inadequate in the alpine environment. This study compared ten soil quality indexes (SQIs) to quantitative assess the effect of different grazing intensities [no grazing (NG); light grazing (LG); moderate grazing (MG); heavy grazing (HG)] on the soil quality of alpine meadow in the 0–10 cm and 10–20 cm soil layers. Principal component analysis (PCA) and minimum data set (MDS) were applied to indicator selection and weight assignment. The fitting relationship and correlation between SQI-TDS and SQI-MDSs and the sensitivity index (SI) of ten SQIs were used to select the optimal SQI method. Our results showed that compared with NG and LG, HG and MG significantly decreased soil organic matter (SOM), total nitrogen (TN), available nitrogen (AN), total phosphorus (TP), and cation exchange capacity (CEC) (p

BackgroundDamp-heat syndrome is one of the most important syndrome types in the traditional Chinese medicine (TCM) syndrome differentiation and treatment system, as well as the core pathogenesis of pancreatic cancer (PC) which remains a challenge to medical researchers due to its insidious onset and poor prognosis. Great attention has been given to the impact of damp-heat syndrome on tumorigenesis and progression, but less attention has been given to damp-heat modeling per se. Studying PC in a proper damp-heat syndrome animal model can recapitulate the actual pathological process and contribute to treatment strategy improvement.MethodsHere, an optimized damp-heat syndrome mouse model was established based on our prior experience. The Fibonacci method was applied to determine the maximum tolerated dosage of alcohol for mice. Damp-heat syndrome modeling with the old and new methods was performed in parallel of comparative study about general appearance, food intake, water consumption and survival. Major organs, including the liver, kidneys, lungs, pancreas, spleen, intestines and testes, were collected for histological evaluation. Complete blood counts and biochemical tests were conducted to characterize changes in blood circulation. PC cells were subcutaneously inoculated into mice with damp-heat syndrome to explore the impact of damp-heat syndrome on PC growth. Hematoxylin-eosin staining, Masson staining and immunohistochemistry were performed for pathological evaluation. A chemokine microarray was applied to screen the cytokines mediating the proliferation-promoting effects of damp-heat syndrome, and quantitative polymerase chain reaction and Western blotting were conducted for results validation.ResultsThe new modeling method has the advantages of mouse-friendly features, easily accessible materials, simple operation, and good stability. More importantly, a set of systematic indicators was proposed for model evaluation. The new modeling method verified the pancreatic tumor-promoting role of damp-heat syndrome. Damp-heat syndrome induced the proliferation of cancer-associated fibroblasts and promoted desmoplasia. In addition, circulating and tumor-located chemokine levels were altered by damp-heat syndrome, characterized by tumor promotion and immune suppression.ConclusionsThis study established a stable and reproducible murine model of damp-heat syndrome in TCM with systematic evaluation methods. Cancer associated fibroblast-mediated desmoplasia and chemokine production contribute to the tumor-promoting effect of damp-heat syndrome on PC.

Impaired intestinal barrier function and gut microbiota dysbiosis are believed to be related to exacerbation of acute pancreatitis (AP). As a bacterial cell wall peptidoglycan component, diaminopimelic acid (DAP) is a specific ligand of NOD1 that regulates the NOD1/RIP2/NF-kB signaling pathway. Here, we investigated the role of DAP in the crosstalk between the gut microbiota and pancreas during the occurrence of AP. Upregulation of NOD1/RIP2/NF-kB and elevated serum DAP levels were found in severe AP (SAP) model rats. The accumulation of DAP in SAP patients corroborated its ability to serve as an indicator of disease severity. Subsequently, SAP rats were treated with oral administration of the traditional Chinese medicine Qingyi Keli (QYKL) as well as neomycin, which can widely eliminate DAP-containing bacteria. Both QYKL and neomycin intervention ameliorated intestinal and pancreatic damage and systemic inflammation in SAP rats. Through 16S rDNA sequencing, we found that QYKL could rehabilitate the gut microbiota structure and selectively inhibit the overgrowth of enteric bacteria, such as Helicobacter and Lactobacillus, in SAP rats without affecting some protective strains, including Romboutsia and Allobaculum. Interestingly, we demonstrated that the decrease in serum DAP was accompanied by suppression of the NOD1/RIP2/NF-kB signaling pathway in both the intestine and pancreas of the two intervention groups. Taken together, these results suggested that the gut microbiota-DAP-NOD1/RIP2 signaling pathway might play a critical role in the progression of AP and that SAP could be alleviated via intervention in the signaling pathway. Our work provides new potential early warning indicators of SAP and targets for intervention.

Pregnancies are rare in women with chronic renal failure requiring hemodialysis. Although a chance of successful pregnancy and delivery in hemodialysis women has increased over the years, it is still very low, and with high maternal and fetal mortality and morbidity rate compared to normal population. And cesarean section is usually used for delivery. The first case was a 32-year-old Chinese woman with chronic kidney disease stage V undergoing maintenance hemodialysis for six years. The second case was also a 32-year-old patient with a 6-year history of hemodialysis for chronic glomerulonephritis. And due to a history of atrial septal defect and hypertension she received intensive hemodialysis during pregnancy. Both cases were scheduled for cesarean delivery under epidural anesthesia. To help develop reasonable anesthetic methods and management objectives for such patients, we described our anesthetic management and performed a literature search on published cases of cesarean section with chronic renal failure undergoing hemodialysis.

Vegetation restoration is the primary method used to prevent soil erosion and improve the ecological environment. The objective of this study was to explore how vegetation and soil properties changed over time in natural and artificial vegetation types. We conducted vegetation surveys in four permanent plots over 12 years (2007–2018) and measured soil properties in 2007, 2013, and 2016. The results showed that the change in species composition in natural vegetation was a continuous and progressive process. After approximately ten years of natural herb restoration, trees began to appear and formed sparse forests. In artificial vegetation, the species composition of the undergrowth varied under Robinia pseudoacacia forests during restoration years, and was dominated by Poaceae and annual plants that could tolerate shade and drought. Species composition was stable under Caragana korshinskii shrubs, where the undergrowth was dominated by perennial plants that were similar to natural vegetation. In different vegetation types, species richness, diversity, and herb community cover fluctuated, while the succession rate decreased with the number of restoration years. The soil moisture condition was better in natural vegetation than in artificial vegetation, and could be maintained near the stable field capacity. The soil moisture was supplemented to 280 cm in R. pseudoacacia forests and 320 cm in C. korshinskii shrubs in a year with extreme rainfall, but the dry soil layer returned in the following years. Soil nutrients improved over time, especially in artificial vegetation, which appears to be better than natural vegetation. In general, natural vegetation improved plant community and soil properties. Artificial vegetation only improved soil nutrients, but caused soil desiccation which is difficult to recover. Therefore, the natural vegetation restoration model of sparse forest grassland was better than artificial vegetation model.

Alluvial fans are an important land resource with agricultural potential in Qinghai–Tibet Plateau. The spatiotemporal variation in land use/cover is an important indicator to understand the value of alluvial fans and protect and make scientific use of such fans. In this study, the spatiotemporal characteristics of land use/cover are determined by analysing the land use/cover changes of alluvial fans in the Lhasa River Basin (LRB) at different times, counties/districts, altitudes, and gradients. Results show that the area of cultivated land and the artificial land provided by alluvial fans for LRB has continuously increased. In 2000, 2010, and 2020, 17.72%, 21.84%, and 24.17% of cultivated land and 7.89%, 7.51%, and 25.24% of artificial land in LRB were provided by alluvial fans, respectively. At all altitudes and slopes, cultivated land and artificial land are increasing but the increasing part is basically due to the massive loss of grassland. The spatiotemporal changes in all land use/cover types of alluvial fans were dominated by human activities, although they were also influenced by natural factors to some degree.

Objectives: This study aimed to evaluate the level and factors affecting the perioperative exercise intention in China.Design: This study was a cross-sectional survey in Southwest China.Methods: Four hundred and ninety nine participants were randomly sampled in eight medical centers from November 23, 2020 to November 27, 2020. The survey included sociodemographic information and a 24-item modified questionnaire, which aimed to evaluate the attitude toward daily exercise, perception of perioperative exercise, social support and the perioperative exercise intention. A multivariable linear regression model was used to evaluate the effect of different items on the patients' intention for perioperative exercise.Results: A total of 523 responses (95.09%) were collected and 499 (95.41%) were analyzed. The level of exercise intention of the patients during the perioperative period was: 14.83% planned to exercise every day in the hospital, 21.04% planned to exercise every other day, and 35.87% planned to exercise every week. Intensity of daily exercise (P = 0.016), positive attitude of daily exercise (P < 0.001), positive attitude of perioperative exercise (P < 0.001) and social support (P < 0.001) were positively associated with the intention for perioperative exercise. Female (P = 0.012), non-tertiary center (P = 0.011), and preoperative anxiety (P = 0.023) was negatively associated with it.Conclusions: The intention for perioperative exercise was low in Southwest China. The authors aimed to relieve preoperative anxiety, promote the education of perioperative exercise, design perioperative exercise programs, and provide more social support from medical staff and family for inpatients undergoing elective surgery.

Abstract Background Several randomized controlled trials suggest that goal-directed fluid therapy (GDFT) may result in improved postoperative outcomes. The aim of this study was to assess the clinical and financial impact of the real-life implementation of intraoperative GDFT in patients undergoing elective gastrointestinal surgery in a Chinese tertiary medical center. Methods This Quality Improvement Program (QIP) study comprised three phases of 5, 1, and 5 months, respectively. During the first phase, we retrospectively collected perioperative data from patients who received standard intraoperative fluid management from January to May 2016. Then a 1-month training period allowed the clinical staff to become familiar with the GDFT protocol. After the training phase, GDFT was used from July to November 2016. In the GDFT group, stroke volume (SV) was continuously monitored and optimized towards the plateau of the Frank-Starling curve. The primary outcome measure was postoperative morbidity (the proportion of patients with one or more complications within 30 days after surgery). Secondary outcomes were total hospital cost, postoperative length of hospital stay, and 30-day mortality. Results Data from 200 patients before (control group) and 201 patients after the implementation of GDFT (GDFT group) were collected and compared. There was no significant difference in demographics and surgical procedures between the two groups. Postoperative morbidity was significantly lower in the GDFT group than in the control group (30.8% vs. 44.0%, p = 0.006). No significant differences were observed for mean total hospital cost (76,793 RMB vs. 74,444 RMB; p = 0.430), median postoperative length of hospital stay (10 days vs. 10 days; p = 0.104), and 30-day mortality (1% vs. 0.5%; p = 0.565). Conclusion In patients undergoing gastrointestinal surgery, the implementation of a GDFT protocol was associated with a reduction in postoperative morbidity without increasing costs. Trial registration clinicaltrials.gov, NCT02507557. Registered 13 July 2015.

Denitrification is a critical component of soil nitrogen (N) cycling, including its role in the production and loss of nitrous oxide (N2O) from the soil system. However, restoration effects on the contribution of denitrification to soil N2O emissions, the abundance and diversity of denitrifying bacteria, and relationships among N2O emissions, soil properties, and denitrifying bacterial community composition remains poorly known. This is particularly true for fragile semiarid ecosystems. In order to address this knowledge gap, we utilized 42-year chronosequence of Robinia pseudoacacia plantations in the Chinese hilly gullied Loess Plateau. Soil potential N2O emission rates were measured using anaerobic incubation experiments. Quantitative polymerase chain reaction (Q-PCR) and Illumina MiSeq high-throughput sequencing were used to reveal the abundance and community composition of denitrifying bacteria. In this study, the afforestation practices following farmland abandonment had a strong negative effect on soil potential N2O emission rates during the first 33 years. However, potential N2O emission rates steadily increased in 42 years of restoration, leading to enhanced potential risk of greenhouse gas emissions. Furthermore, active afforestation increased the abundance of denitrifying functional genes, and enhanced microbial biomass. Actinobacteria and Proteobacteria were the dominant denitrifying bacterial phyla in the 0 to 33-years old sites, while the 42-years sites were dominated by Planctomycetes and Actinobacteria, implying that the restoration performed at these sites promoted soil microbial succession. Finally, correlation analyses revealed that soil organic carbon concentrations had the strongest relationship with potential N2O emission rates, followed by the abundance of the nosZ functional gene, bulk density, and the abundance of Bradyrhizobium and Variovorax across restoration stages. Taken together, our data suggest above-ground restoration of plant communities results in microbial community succession, improved soil quality, and significantly altered N2O emissions.

Dietary plant sterols supplementation has been demonstrated in some studies to lower plasma total and LDL cholesterol in hypercholesterolemic subjects. The cholesterol lowering action of plant sterols remains to be investigated in subjects with the metabolic syndrome. In a randomized, crossover study of 2 x 4 week therapeutic periods with oral supplementation of plant sterols (2 g/day) or placebo, and two weeks placebo wash-out between therapeutic periods, we investigated the effects of dietary plant sterols on lipoprotein metabolism in nine men with the metabolic syndrome. Lipoprotein kinetics were measured using [D3]-leucine, gas chromatography-mass spectrometry and compartmental modeling. In men with the metabolic syndrome, dietary plant sterols did not have a significant effect on plasma concentrations of total cholesterol, triglycerides, LDL cholesterol, HDL cholesterol, apolipoprotein (apo) B, apoA-I or apoA-II. There were no significant changes to VLDL-, IDL-, LDLapoB or apoA-I fractional catabolic rates and production rates between therapeutic phases. Relative to placebo, plasma campesterol, a marker of cholesterol absorption was significantly increased (2.53 ± 0.35 vs. 4.64 ± 0.59 μg/ml, p<0.05), but there was no change in plasma lathosterol, a marker of endogenous cholesterol synthesis. In conclusion, supplementation with plant sterols did not appreciably influence plasma lipid or lipoprotein metabolism in men with the metabolic syndrome. Future studies with larger sample size, stratification to low and high cholesterol absorbers and cholesterol balance studies are warranted. [ABSTRACT FROM AUTHOR]