Reduced magnitude and shifted seasonality of CO2 sink by experimental warming in a coastal wetland

Coastal wetlands have the highest carbon sequestration rate per unit area among all unmanaged natural ecosystems. However, how the magnitude and seasonality of the CO₂ sink in coastal wetlands will respond to future climate warming remains unclear. Here, based on measurements of ecosystem CO₂ fluxes in a field experiment in the Yellow River Delta, we found that experimental warming (i.e., a 2.4°C increase in soil temperature) reduced net ecosystem productivity (NEP) by 23.7% across two growing seasons of 2017-2018. Such a reduction in NEP resulted from the greater decrease in gross primary productivity (GPP) than ecosystem respiration (ER) under warming. The negative warming effect on NEP mainly occurred in summer (-43.9%) but not in autumn (+61.3%), leading to a shifted NEP seasonality under warming. Further analyses showed that the warming effects on ecosystem CO₂ exchange were mainly controlled by soil salinity and its corresponding impacts on species composition. For example, warming increased soil salinity (+35.0%), reduced total aboveground biomass (-9.9%), and benefited the growth of plant species with high salt tolerance and late peak growth. To the best of our knowledge, this study provides the first experimental evidence on the reduced magnitude and shifted seasonality of CO₂ exchange under climate warming in coastal wetlands. These findings underscore the high vulnerability of wetland CO₂ sink in coastal regions under future climate change.

[Analysis of treatment modalities and prognosis of patients with gallbladder cancer in China from 2010 to 2017]

Objective: To evaluate the clinical characteristics and prognosis of gallbladder cancer (GBC) patients in China. Methods: This retrospective multicenter cohort study enrolled 3 528 consecutive GBC patients diagnosed between January 2010 to December 2017 in 15 hospitals from 10 provinces. There were 1 345 (38.12%) males and 2 183 (61.88%) females.The age of diagnosis was (63.7±10.8) years old (range: 26 to 99 years old) .There were 213 patients (6.04%) in stage 0 to Ⅰ, whereas 1 059 (30.02%) in stage Ⅱ to Ⅲ, 1 874 (53.12%) in stage Ⅳ, and 382 (10.83%) unavailable. Surgery was performed on 2 255 patients (63.92%) . Three hundred and thirty-six patients received chemotherapy or radiotherapy (9.52%; of which 172 were palliative); 1 101 (31.21%) received only supportive treatment.The patient source, treatment and surgery, pathology, concomitant gallstone, and prognosis were analyzed. Results: Among the 3 528 GBC patients, 959 (27.18%) were from East China, 603 (17.09%) from East-North China, 1 533 (43.45%) from Central China, and 433(12.27%) from West China. Among the 1 578 resectable tumor, 665 (42.14%) underwent radical surgery, 913 (57.86%) underwent surgery that failed to follow the guidelines.Eight hundred and ninety-one (56.46%) patients were diagnosed before surgery, 254 (16.10%) during surgery, and 381 (24.14%) after surgery (time point of diagnosis couldn't be determined in 52 patients) .Among the 1 578 patients with resectable tumor, 759 (48.10%) had concomitant gallstone.Among the 665 patients underwent radical surgery, 69 (10.4%) showed positive resection margin, 510 (76.7%) showed negative resection margin, and 86 (12.9%) unreported margin status.The 5-year overall survival rate (5yOS) for the 3 528-patient cohort was 23.0%.The 5yOS for patients with resectable tumor was 39.6%, for patients with stage ⅣB tumor without surgery was 5.4%, and for patients with stage ⅣB tumor underwent palliative surgery was 4.7%. Conclusions: More than half GBC patients in China are diagnosed in stage Ⅳ.Curative intent surgery is valuable in improving prognosis of resectable GBC.The treatment of GBC needs further standardization.Effective comprehensive treatment for GBC is in urgent need.

Unraveling the Promotion Effects of a Soluble Cobaltocene Catalyst with Respect to Li-O2 Battery Discharge

The discharge process of a nonaqueous Li-O₂ battery at the cathode is the direct oxygen reduction reaction (ORR) with the formation of discharge product, e.g., Li₂O₂, deposits on the cathode surface. The aggressive superoxide intermediate generated during the ORR severely degrades the organic electrolyte and carbon-based cathodes. To avoid the formation of superoxide species and promote the growth of Li₂O₂ in the electrolyte solution, we employ a soluble cobaltocene [Co(C₅H₅)₂, Cp₂Co] as a homogeneous molecule catalyst to boost the discharge performance of Li-O₂ batteries. Owing to the unique chemical reactivity of Cp₂Co with molecular oxygen, the electrochemistry of the discharge process at the cathode is the (Cp₂Co)₂^II-O₂^2- adduct-mediated process rather than direct electrochemical oxygen reduction, thereby avoiding the formation of aggressive superoxide intermediate. In addition, the strong intermolecular attraction between Cp₂Co and the newly formed Li₂O₂ promotes the solution phase growth of Li₂O₂, which effectively suppresses electrode passivation.

Characteristics and roles of severe acute respiratory syndrome coronavirus 2-specific antibodies in patients with different severities of coronavirus 19

The diagnosis of coronavirus 19 (COVID-19) relies mainly upon viral nucleic acid detection, but false negatives can lead to missed diagnosis and misdiagnosis; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific antibody detection is convenient, safe and highly sensitive. Immunoglobulin (Ig)M and IgG are commonly used to serologically diagnose COVID-19; however, the role of IgA is not well known. We aimed to quantify the levels of SARS-CoV-2-specific IgM, IgA and IgG antibodies, identify changes in them based on COVID-19 severity, and establish the significance of combined antibody detection. COVID-19 patients, divided into a severe and critical group and a moderate group, and non-COVID-19 patients with respiratory disease were included in this study. A chemiluminescence method was used to detect the levels of SARS-CoV-2-specific IgM, IgA and IgG in the blood samples from the three groups. Epidemiological characteristics, symptoms, blood test results and other data were recorded for all patients. Compared to the traditional IgM-IgG combined antibodies, IgA-IgG combined antibodies are more effective for diagnosing COVID-19. During the disease process, IgA appeared first and disappeared last. All three antibodies had significantly higher levels in COVID-19 patients than in non-COVID-19 patients. IgA and IgG were also higher for severe and critical disease than for moderate disease. All antibodies were at or near low levels at the time of tracheal extubation in critical patients. Detection of SARS-CoV-2-specific combined IgA-IgG antibodies is advantageous in diagnosing COVID-19. IgA detection is suitable during early and late stages of the disease. IgA and IgG levels correspond to disease severity.

[Severe community-acquired pneumonia caused by Legionella pneumophila with acute respiratory failure: clinical characteristics and prognosis of 34 cases]

Objective: To describe the clinical characteristics and treatment of severe community-acquired pneumonia(SCAP) caused by Legionella pneumophila with acute respiratory failure and to analyze the risk factors for mortality. Methods: From October 2011 to October 2019, 34 patients were diagnosed with SCAP caused by Legionella pneumophila with acute respiratory failure.There were 25 males and 9 females, aged from 17 to 82 years, with a median age of 61 (48, 69) years. According to the prognosis, the patients were divided into a survival group and a death group for comparative analysis.The survival group included 24 patients, 17 males and 7 females, with a median age of 65 (55, 70) years. There were 10 cases in the death group, 8 males and 2 females, with a median age of 53 (50, 58) years. Multivariable logistic regression analysis was used for risk factors of ICU mortality. Results: The median time of admission to ICU was 7 (5, 11) days, the median time of stay in RICU was 12 (7, 22) days, and the PaO(2)/FiO(2) was 134 (91, 216) mmHg(1 mmHg=0.133 kPa). Ten patients died during ICU hospitalization, with a mortality of 29%. Sequential organ failure assessment (SOFA) of death group was 9 (7, 12), which was significantly higher than that of the survival group [4 (3, 8)], P=0.018. The time from onset of pneumonia symptoms to initiation of targeted treatment of the death group was 10 (7, 14) d, which was significantly longer than that of the survival group of [4 (3, 7) d], P=0.019. Multivariable logistic regression analysis showed that SOFA score (OR=1.461, 95%CI 1.041-2.051, P=0.028) and the time from onset of pneumonia symptoms to initiation of targeted treatment (OR=1.293, 95%CI 1.029-1.625, P=0.027) were independent risk factors for hospital mortality. Conclusions: The ICU mortality of severe legionella pneumonia was high. Critical organ dysfunctions and delayed initial targeted treatment were related with the increase of ICU mortality.

Bifunctional LaMn0.3Co0.7O3 Perovskite Oxide Catalyst for Oxygen Reduction and Evolution Reactions: The Optimized eg Electronic Structures by Manganese Dopant

Perovskite oxides as bifunctional electrocatalysts toward oxygen reduction (ORR) and oxygen evolution reactions (OER) have been investigated for decades because of the flexible and adjustable electronic structures. For example, by optimizing the strength of the Co-O bond, the ORR and OER activity of a typical perovskite oxide, LaCoO₃, can be improved, but they are still unsatisfying. The insufficient insights into the effects of secondary metal dopants at the B-site on the electronic structure and activity, especially for ORR, significantly limit the R&D of bifunctional perovskite oxide catalysts. In this work, a series of LaMn_xCo_1-xO₃ (x = 0, 0.25, 0.3, 0.35, 0.5, 1) catalysts are prepared by a polyol-assisted solvothermal method to investigate the structure-property relationships between the B-site metal substitution and the electrochemical performance of perovskite oxides catalysts. The optimized LaMn_0.3Co_0.7O₃ catalyst demonstrates an enhanced half-wave potential of 0.72 V for ORR, 52 mV higher than that of the pristine LaCoO₃ (0.668 V). Meanwhile, the OER overpotential of LaMn_0.3Co_0.7O₃ catalyst is 416 mV, which is reduced by 64 mV compared to LaCoO₃ (480 mV). It is revealed that the appropriate Mn dopant efficiently optimizes the covalency of Co-O bonds and significantly reduces the e_g orbit-filling electron from 1.23 of pristine LaCoO₃ to 1.02 in LaMn_0.3Co_0.7O₃ (very close to theoretical value 1). This work paves a new way to design and synthesize bifunctional perovskite oxide electrocatalyst for ORR and OER.

[The keypoints in treatment of the critical coronavirus disease 2019 patient(1)]

COVID-19 has been prevalent in Wuhan and spread rapidly to all of our country. Some cases can develop into ARDS, or even death. We will share the treatment experience of severe COVID-19 with the first-line treatment experience. The best respiratory support mode should be selected, but the timing of intubation and protection during intubation are two difficulties; patients with high level peep and poor effect in prone position can be given ECMO support. For COVID-19 patients with mechanical ventilation, reasonable sedation and analgesia strategies should be formulated; delirium should not be ignored. In addition, there is up regulation of inflammatory factors in patients with severe COVID-19, but the effect of renal replacement therapy needs to be further confirmed by clinical research.

[The keypoints in treatment of the critical coronavirus disease 2019 patient(2)]

The treatment of critically ill patients with coronavirus disease 2019(COVID-19) faces compelling challenges. In this issue, we'd like to share our first-line treatment experience in treating COVID-19. Hemodynamics need be closely monitored and different types of shock should be distinguished. Vasoconstrictor drugs should be used rationally and alerting of complications is of the same importance. The risk of venous thromboembolism (VTE) needs to be assessed, and effective prevention should be carried out for high-risk patients. It is necessary to consider the possibility of pulmonary thromboembolism (PTE) in patients with sudden onset of oxygenation deterioration, respiratory distress, reduced blood pressure. However, comprehensive analysis of disease state should be taken into the interpretation of abnormally elevated D-Dimer. Nutritional support is the basis of treatment. It's important to establish individual therapy regimens and to evaluate, monitor and adjust dynamically. Under the current epidemic situation, convalescent plasma can only be used empirically, indications need to be strictly screened, the blood transfusion process should be closely monitored and the curative effect should be dynamically evaluated.

[Pharmacotherapeutics for the new coronavirus pneumonia]

The new coronavirus pneumonia (NCP), also named as COVID-19 by WHO on Feb 11 2020, is now causing a severe public health emergency in China since. The number of diagnosed cases is more than 40,000 until the submission of this manuscript. Coronavirus has caused several epidemic situations world widely, but the present contagious disease caused by 2019 new coronavirus is unprecedentedly fulminating. The published cohorts of 2019 new coronavirus (n-Cov) are single-center studies, or retrospective studies. We here share the therapeutic experiences of NCP treatment with literature review. Combination of Ribavirin and interferon-α is recommended by the 5(th) edition National Health Commission's Regimen (Revised Edition) because of the effect on Middle East respiratory syndrome (MERS), and the effectiveness of Lopinavir/Ritonavir and Remdisivir needs to be confirmed by randomized controlled trial (RCT), given the situation of no specific antivirus drug on NCP is unavailable. Systemic glucocorticosteroid is recommended as a short term use (1~2 mg·kg(-1)·d(-1), 3~5 d) by the 5(th) edition National Health Commission's Regimen (Revised Edition) yet RCTs are expected to confirm the effectiveness. Inappropriate application of antibiotics should be avoided, especially the combination of broad-spectrum antibiotics, for the NCP is not often complicated with bacterial infection.

Perovskite LaCoxMn1-xO3-σ with Tunable Defect and Surface Structures as Cathode Catalysts for Li-O2 Batteries

Rechargeable lithium-oxygen batteries have shown great potential as next-generation sustainable and green energy storage systems. The bifunctional catalyst plays an important role in accelerating the cathode kinetics for practical realization of the batteries. Herein, we employ the surface structure and defect engineering to introduce surface-roughened nanolayers and oxygen vacancies on the mesoporous hollow LaCo_xMn_1-xO_3-σ perovskite catalyst by in situ cation substitution. The experimental results show that the O₂-electrode with the LaCo_0.75Mn_0.25O_3-σ catalyst exhibits an extremely high discharge capacity of 10,301 mA h g^-1 at 200 mA g^-1 for the initial cycle and superior cycling stability under a capacity limit of 500 mA h g^-1 together with a low voltage gap of 1.12 V. Good electrochemical performance of LaCo_0.75Mn_0.25O_3-σ can be attributed to the synergistic effect of the hierarchical mesoporous hollow structure and the abundant oxygen vacancies all over the catalyst surface. We reveal that the modified surface structure can provide more accessibility of active sites to promote electrochemical reactions, and the introduced oxygen vacancy can serve as an efficient substrate for binding intermediate products and decomposition reactions of Li₂O₂ during discharge and charge processes. Our methodology provides meaningful insights into the rational design of highly active perovskite catalysts in energy storage/conversion systems.

[Pharmacotherapeutics for the New Coronavirus Pneumonia]

The New Coronavirus Pneumonia (NCP, also named as COVID-19 by WHO on Feb 11 2020, is now causing a severe public health emergency in China since. The number of diagnosed cases is more than 40,000 until the submission of this manuscript. Coronavirus has caused several epidemic situations world widely, but the present contagious disease caused by 2019 new Coronavirus is unprecedentedly fulminating. The published cohorts of 2019 new Coronavirus (n-Cov) are single-center studies, or retrospective studies. We here share the therapeutic experiences of NCP treatment with literature review. Combination of Ribavirin and Interferon-α is recommended by the 5(th) edition National Health Commission's Regimen (Revised Edition) because of the effect on MERS (Middle East Respiratory Syndrome), and the effectiveness of Lopinavir/Ritonavir and Remdisivir needs to be confirmed by randomized controlled trial (RCT), given the situation of no specific antivirus drug on NCP is unavailable. Systemic glucocorticosteroid is recommended as a short term use (1~2 mg.kg(-1).d(-1), 3~5d ) by the 5(th) edition National Health Commission's Regimen (Revised Edition) yet RCTs are expected to confirm the effectiveness. Inappropriate application of antibiotics should be avoided, especially the combination of broad-spectrum antibiotics, for the NCP is not often complicated with bacterial infection.

[Evaluation of menopause and treatment choice of breast cancer patients before endocrine therapy]

Aromatase inhibitors (AIs) directly applies to postmenopausal breast cancer patients. Patients underwent bilateral ovariectomy or ≥60 years were acknowledged as postmenopausal.Alternatively, for <60 years breast cancer patients, sex hormone detection to evaluate menopause is recommended by National Comprehensive Cancer Network (NCCN) guideline, textbooks, and AIs clinical trials.However, series of clinical trial found that, a broad overlap region of follicle stimulating hormone and estradiol appeared between premenopausal and postmenopausal patients, which unable to determine the menopause even with sensitivity promotion of detection equipment or manners.We have abandon this detection in clinical treatment, and decision making was only according to the relapse risk and disease status. We recommend bilateral ovariectomy resection accompanied with AIs for breast cancer patients with high recurrence risk (e.g. T3-4 or LNM≥4) or patients with advanced metastatic disease.However, patients with low or moderate recurrence risk can be treated with tamoxifen.

Clinical impact of serum miR-661 in diagnosis and prognosis of non-small cell lung cancer

OBJECTIVE

The aim of this study was to evaluate whether serum miR-661 could serve as a biomarker for the diagnosis and prognosis of non-small cell lung cancer (NSCLC).

PATIENTS AND METHODS

  The expression of serum miR-661 was detected in 150 cases of NSCLC and 114 cases of normal healthy controls by Real-time PCR. Receiver-operating characteristic (ROC) curve analysis was applied to analyze diagnostic value of serum miR-661. The relationship between serum miR-661 expression and clinicopathological characteristics was investigated. Overall survival was analyzed using Kaplan-Meier method. Moreover, Cox proportional-hazards regression analyses were performed to determine the prognostic value of serum miR-661 in NSCLC patients.

RESULTS

We found that the expression of serum miR-661 was significantly upregulated in NSCLC compared with healthy controls (p < 0.01). The expression level of serum miR-661 was positively correlated with histological grade (p = 0.011), lymph node metastasis (p = 0.003), distant metastasis (p = 0.021) and clinical stage (p = 0.005). Then, ROC curve analysis showed that serum miR-661 has considerable diagnostic accuracy, with an area under the ROC curve (AUC) of 0.726 (p = 0.001). Moreover, NSCLC patients with serum miR-661 higher expression have shown significantly poorer overall survival than those with lower serum miR-661 expression (p = 0.004). Furthermore, multivariate analyses showed that serum miR-661 expression levels were an independent prognostic factor for survival in NSCLC patients.

CONCLUSIONS

Overall, these findings indicate that serum miR-661 may be a potential biomarker for the diagnosis and prognosis of NSCLC.

[Suggestions on environmental and health work from Health Environment Promotion Campaigns]

The Health Environment Promotion Campaigns (HEPCs) focus on the major environmental health issues and relevant factors of concern among the general public, and promote the achievement of the national health goal. Based on the summary and analysis of the background, key indicators, specific actions in different domains of the HEPCs, this paper proposes suggestions for scientifically implementing HEPCs from five aspects, namely, formulating implementation plans, establishing pilot areas, building comprehensive service platforms, improving the health literacy of residents and strengthening the development of protection technologies and standards.

Evaluating the diagnostic and prognostic value of serum miR-770 in non-small cell lung cancer

OBJECTIVE

Serum miRNAs are promising biomarkers for the diagnosis and prognostication of many diseases. Our present study aimed at assessing the usefulness of serum miR-770 expression as a diagnostic and prognostic tool for non-small-cell lung cancer (NSCLC).

PATIENTS AND METHODS

Quantitative Real-time PCR (qRT-PCR) was used to measure expression level of serum miR-770 in 196 NSCLC patients and 77 healthy controls. The associations of serum miR-770 expression with clinicopathologic variables were analyzed. Receiver operating characteristic analysis (ROC) was used to determine the value of serum miR-770 as a biomarker for diagnosis of NSCLC. Kaplan-Meier and Cox regression analyses were performed to examine the relationship between serum miR-770 expression and prognosis of NSCLC patients.

RESULTS

We found that serum miR-770 levels were significantly decreased in NSCLC patients compared to healthy controls (p < 0.01). Decreasing serum miR-770 expression was significantly correlated with poorer histological grade (p = 0.015), positive lymph node metastasis (p = 0.007), and advanced tumor stage (p = 0.002). Moreover, we found that the diagnostic value of serum miR-770 for NSCLC patients from healthy controls resulted in an AUC of 0.835 (95 % CI, 0.751-0.919) with a sensitivity of 68% and a specificity of 89%, based on a cut-off value of 5.723. Kaplan-Meier analysis showed that decreased serum miR-770 expression was associated with poor overall survival of NSCLC patients (p = 0.000). Multivariate analysis confirmed that serum miR-770 was an independent prognostic factor in patients with NSCLC.

CONCLUSIONS

Our findings suggested that serum miR-770 may represent a novel diagnostic, prognostic biomarker and a potential therapeutic target for NSCLC.

[Computational investigation of Artemisia pollen deposition in realistic nasal cavities of residents in northwest China]

Objective: To investigate the deposition rate of Artemisia pollen in different nasal cavity regions and its influence factors in residents of northwest China. Methods: Thirty healthy adults from northwest China were enrolled. The computational fluid dynamics (CFD) and discrete phase model (DPM) were used for numerical simulation of nasal structures. The pollen deposition fraction in each anatomical part was counted and the effects of pollen density and breathing rate on deposition were analyzed. SPSS 19.0 software was used for statistical analysis. Results: The hottest deposition parts of Artemisia pollen were nasal septum (30.70%±12.27%), vestibule (27.45%±8.21%), middle turbinate area (13.59%±8.98%) and nasopharynx (7.14%±5.90%). When the inspiratory flow rate increased to 30 L/min, the deposition rates of pollen in nasal vestibule and nasal septum were significantly higher than that at the rate of 15 L/min (43.20%±11.14% vs 27.45%±8.21%, 51.48%±9.77% vs 30.70%±12.27%, t value was -8.126,-5.264, respectively, all P<0.05), which indicated that with the increase of the inspiratory flow rate, the deposition hotspot moved forward. Compared with the wet Artemisia pollen, the deposition rate of the dry pollen in nasal vestibule and nasal septum decreased significantly (16.55%±4.33% vs 27.45%±8.21%, 7.09%±3.69% vs 30.70%±12.27%, t value was 8.669, 9.173, respectively, all P<0.05). The escape rate at outlet increased from 17.00%±9.57% to 43.48%±13.43% (t=-9.282, P<0.05). Conclusions: The deposition of Artemisia pollen in nasal cavity is highly concentrated. The inhalation velocity and the dry-wet degree of pollen are the main determinants of the deposition site.

[Research advances on the value of preoperative systemic inflammatory response index in predicting the prognosis of patients with resectable pancreatic cancer]

Pancreatic cancer is a highly malignant gastrointestinal tumor with high invasiveness, easy metastasis, and poor chemoresistance. Surgery is still the preferred treatment for resectable pancreatic cancer. At present, inflammatory scoring systems based on serological indicators in patients with resectable pancreatic cancer can be divided into two types: the inflammatory scoring system based on c-reactive protein albumin and the inflammatory scoring system based on peripheral blood cell count. However, the specific mechanism between these inflammatory markers and the prognostic value of resectable pancreatic cancer remains unclear. This article reviews the correlation between systemic inflammatory response indexes and prognosis of patients with resectable pancreatic cancer, so as to provide help for the comprehensive treatment of pancreatic cancer.

Oral vaccination with the porcine circovirus type 2 (PCV-2) capsid protein expressed by Lactococcus lactis induces a specific immune response against PCV-2 in mice

AIMS

Porcine circovirus type 2 (PCV2) can cause postweaning, multisystemic wasting syndrome in pigs, which leads to enormous losses in the swine industry worldwide. Here, a genetically engineered Lactococcus strain expressing the main protective antigen of PCV2, the Cap protein, was developed to act against PCV2 infection as an oral vaccine.

METHODS AND RESULTS

Expression of the Cap protein was confirmed via western blot, ELISA and fluorescence microscopy. Over 90% of the recombinant pAMJ399-Cap/MG1363 survived a simulated gastrointestinal transit. It also survived the murine intestinal tract for at least 11 days. Then, the safety and immunogenicity of pAMJ399-Cap/MG1363 in orally immunized mice was evaluated. The levels of the sIgA, IgG and cytokines (IL-4 and IFN-γ) obtained from the mice immunized with pAMJ399-Cap/MG1363 were significantly higher than those in the control groups.

CONCLUSIONS

pAMJ399-Cap/MG1363 can survive in the gastrointestinal transit and effectively induce mucosal, cellular and humoral immune response against PCV2 infection via oral administration.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study demonstrates the potential of the genetically engineered Lactococcus lactis as a candidate for an oral vaccine against PCV2.