Biochar and nano-hydroxyapatite combined remediation of soil surrounding tailings area: Multi-metal(loid)s fixation and soybean rhizosphere soil microbial improvement

The soil near tailings areas is relatively barren and contaminated by multi-metal(loid)s, seriously threatening the safety of crop production. Here, biochar and nano-hydroxyapatite (nHAP) were combined to improve the sterilized and unsterilized polymetallic contaminated soil, and soil incubation and soybean pot experiments were designed. Results showed that biochar and nHAP not only increased soil C, N, and P but also effectively reduced multi-metal bioavailability, wherein the combined application of the two amendments had the best effect on metal immobilization. The synergistic effect of the two amendments decreased the acid-soluble contents of Co, Cu, Fe, and Pb in rhizosphere soils up to 86.75%, 80.69%, 89.09%, and 96.70%, respectively. The ameliorant reduced the accumulation of metal(loid)s in soybean plants, and rhizosphere microorganisms inhibited the migration of soil metals to plants. Additionally, biochar and nHAP regulated the rhizosphere soil microbial community. The rhizosphere soil of the sterilization group tended to prioritize the restoration of the original dominant bacteria. As, Pb, Fe, Urease, OM, TN, and TP were the critical environmental variables affecting rhizosphere soil bacterial communities. Therefore, combining biochar and nHAP is an environmentally friendly strategy to reduce polymetallic mobility in tailings soil and crops and improve soil microbial community structure.

CT radiomics can predict disease progression within 6 months after chimeric antigen receptor-modified T-cell therapy in relapsed/refractory B-cell non-Hodgkin's lymphoma patients

AIM

To predict progression within 6 months after chimeric antigen receptor-modified (CAR) T-cell therapy for relapsed/refractory (R/R) B-cell non-Hodgkin's lymphoma (B-NHL) patients by radiomic indexes derived from contrast-enhanced computed tomography (CECT) examinations.

MATERIALS AND METHODS

Seventy R/R B-NHL patients who underwent CECT before treatment with CAR T-cells were examined retrospectively. In total, 297 volumes of interest for lesions were segmented from CECT images. Patients without and with disease progression were assigned to groups 1 and 2, respectively. Radiomic and combined predictive models were constructed by three machine-learning algorithms using features from the training set, respectively. Furthermore, predictive models were constructed based on multi-lesion-based and largest-lesion-based radiomic features, respectively.

RESULTS

In the test set, no marked differences were observed between the areas under the curves (AUCs) of the combined and radiomic models for all three machine-learning algorithms (all p>0.05). Differences in machine-learning algorithms did not significantly affect the predictive performances of the models. Radiomics and combined models constructed with multi-lesion-based radiomic features showed better predictive performances than those applying largest-lesion-based radiomic features (all p<0.05 for comparisons between combined models).

CONCLUSION

CECT-based radiomic features may be applied to predict disease progression in R/R B-NHL patients within 6 months after CAR T-cell treatment, and radiomic features from multiple lesions may have better predictive efficacy. Different machine-learning algorithms may not show significant differences in prediction performance.

Analysis of the relationship between mild cognitive impairment and serum klotho protein and insulin-like growth factor-1 in the elderly

BACKGROUND

Mild cognitive impairment (MCI) is a mild memory or cognitive impairment.

OBJECTIVE

To explore the relationship between serum klotho (K1) protein and insulin-like growth factor-1 and mild cognitive impairment in the elderly in order to provide accurate and appropriate indicators for clinical diagnosis and treatment of MCI.

METHODS

This randomized stratified study adopted a multistage cluster sampling method. 161 elderly patients with mild cognitive impairment were included as the MCI group, and 161 healthy people matched with the MCI group in gender, age and education were selected as the control group.

RESULTS

The levels of serum K1 protein and insulin-like growth factor-1 in the MCI group were lower than those in the control group (P< 0.05). Both IGF-1 and K1 had predictive value for MCI (P< 0.05). The area under the curve (AUC) of IGF-1 for predicting MCI was 0.859 (95% CI: 0.790∼0.929), and the AUC of K1 for predicting MCI was 0.793 (95% CI: 0.694∼0.892). The value of joint prediction of the two indicators was the highest, with an AUC of 0.939 (95% CI: 0.896-0.993).

CONCLUSION

High serum K1 and insulin-like growth factor-1 are the protective factors of cognitive impairment in MCI patients. Both IGF-1 and serum K1 proteins have predictive value for MCI, and the combination of the two indicators has the highest predictive value.

Nanoparticles and antibiotics stress proliferated antibiotic resistance genes in microalgae-bacteria symbiotic systems

The comprehensive effect of exogenous pollutants on the dispersal and abundance of antibiotic-resistance genes (ARGs) in the phycosphere, bacterial community and algae-bacteria interaction remains poorly understood. We investigated community structure and abundance of ARGs in free-living (FL) and particle-attached (PA) bacteria in the phycosphere under nanoparticles (silver nanoparticles (AgNPs) and hematite nanoparticles (HemNPs)) and antibiotics (tetracycline and sulfadiazine) stress using high-throughput sequencing and real-time quantitative PCR. Meanwhile, the intrinsic connection of algae-bacteria interaction was explored by transcriptome and metabolome. The results showed that the relative abundance of sulfonamide and tetracycline ARGs in PA and FL bacteria increased 103-129 % and 112-134 %, respectively, under combined stress of nanoparticles and antibiotics. Antibiotics have a greater effect on ARGs than nanoparticles at environmentally relevant concentrations. Proteobacteria, Firmicutes, and Bacteroidetes, as the primary potential hosts of ARGs, were the dominant phyla. Lifestyle, i.e., PA and FL, significantly determined the abundance of ARGs and bacterial communities. Moreover, algae can provide bacteria with nutrients (carbohydrates and amino acids), and can also produce antibacterial substances (fatty acids). This algal-bacterial interaction may indirectly affect the distribution and abundance of ARGs. These findings provide new insights into the distribution and dispersal of ARGs in microalgae-bacteria symbiotic systems.

Current advances in the application of nanomedicine in bladder cancer

Bladder cancer is the most common malignant tumor of the urinary system, however there are several shortcomings in current diagnostic and therapeutic measures. In terms of diagnosis, the diagnostic tools currently available are not sufficiently sensitive and specific, and imaging is poor, leading to misdiagnosis and missed diagnoses, which can delay treatment. In terms of treatment, current treatment options include surgery, chemotherapy, immunotherapy, gene therapy, and other emerging treatments, as well as combination therapies. However, the main reasons for poor efficacy and side effects during treatment are the lack of specificity and targeting, improper dose control of drugs and photosensitizers, damage to normal cells while attacking cancer cells, and difficulty in delivering siRNA to cancer cells. Nanomedicine is an emerging approach. Among the many nanotechnologies applied in the medical field, nanocarrier-assisted drug delivery systems have attracted extensive research interest due to their great translational value. Well-designed nanoparticles can deliver agents or drugs to specific cell types within target organs through active targeting or passive targeting (enhanced permeability and retention), which allows for imaging, diagnosis, as well as treatment of cancer. This paper reviews advances in the application of various nanocarriers and their advantages and drawbacks, with a focus on their use in the diagnosis and treatment of bladder cancer.

Nutrient dynamics and microbial community response in macrophyte-dominated lakes: Implications for improved restoration strategies

Although lakes dominated by macrophytes are conducive to ecological balance, this balance is easily disrupted by excessive nutrients flowing into the lake. However, knowledge of whether excessive nutrients lead to different microbial environmental vulnerabilities in the lake sediment between macrophyte-dominated areas and macrophyte-free areas is a prerequisite for the implementation of targeted protection measures. In this study, we investigated bacterial communities in sediments using high-throughput sequencing of 16S rRNA genes. Our results showed that the sources of total nitrogen (TN) and organic matter (OM) were related to the macrophytes. The structure, drivers, and interspecific associations of bacterial community, which were more susceptible to increased changes in TN and OM, differed significantly between macrophyte-dominated areas and macrophyte-free areas. More precisely, the lake edge, where was occupied by macrophytes, had a higher proportion of deterministic phylogenetic turnover (88.89%) than other sites, as well as a wider ecological niche and a tighter network structure. Further, as the difference in TN increased, the main assembly processes in surface sediments changed from stochastic to deterministic. However, the majority of phyla from the lake edge showed a greater correlation with excessive nutrients, and the selection of the community by excessive nutrients was more obvious at the edge of the lake. In addition, our results demonstrated that the stability of the bacterial community in macrophyte-free areas is greater than in macrophyte-dominated areas, while an excessively high deterministic process ratio and nutrient (TN and OM) concentration significantly reduced bacterial community stability at macrophyte-dominated areas. Taken together, these results provide a better understanding of the effects of excessive nutrients derived from macrophytes on bacterial community patterns, and highlight the importance of avoiding the accumulation of TN and OM in macrophyte-dominated areas to enhance the sustainability of the ecosystem after restoration of lakes with macrophytes.

The behavior, transport, and positive regulation mechanism of ZnO nanoparticles in a plant-soil-microbe environment

ZnO nanoparticles (ZnO NPs) have been widely used in several fields, and they have the potential to be a novel fertilizer to promote plant growth. For the effective use of ZnO NPs, it is necessary to understand their influence mechanisms and key interactions with the soil physical and biological environment. In this review, we summarize the fate and transport of ZnO NPs applied via soil treatment or foliar spray in plant-soil systems and discuss their positive regulation mechanisms in plants and microbes. The latest research shows that the formation, bioavailability, and location of ZnO NPs experience complicated changes during the transport in soil-plant systems and that this depends on many factors. ZnO NPs can improve plant photosynthesis, nutrient element uptake, enzyme activity, and the related gene expression as well as modulate carbon/nitrogen metabolism, secondary metabolites, and the antioxidant systems in plants. Several microbial groups related to plant growth, disease biocontrol, and nutrient cycling in soil can be altered with ZnO NP treatment. In this work, we present a systematic comparison between ZnO NP fertilizer and conventional zinc salt fertilizer. We also fill several knowledge gaps in current studies with the hope of providing guidance for future research.

SrB4O7:Sm2+ fluorescence improves the accuracy of temperature measurements in externally heated diamond anvil cells

The sample temperature in an externally heated diamond anvil cell (EHDAC) is generally measured by a thermocouple fixed to the pavilions of diamond anvils, ignoring the temperature difference between the thermocouple and the sample. However, the measured temperature depends strongly on the placement of the thermocouple, thus seriously reducing the accuracy of the temperature measurement and hindering the use of EHDAC in experiments requiring precise temperature measurements, such as high-pressure melting and phase-diagram investigations. In this study, the full width at half maximum (FWHM) of the 0-0 fluorescence line of strontium borate doped with bivalent samarium ions (SrBO₄:Sm²⁺, SBO) is found to be highly sensitive to temperature and responds extremely rapidly to small temperature fluctuations, which makes it an excellent temperature indicator. We propose herein a precise method to measure temperature that involves measuring the FWHM of the 0-0 fluorescence line of SBO. This method is used to correct the temperature discrepancy between the thermocouple and the sample in an EHDAC. These corrections significantly improve the accuracy of temperature measurements in EHDACs. The accuracy of this method is verified by measuring the melting point of tin at ambient pressure. We also use this method to produce a tentative elementary phase diagram of tin up to 109 GPa and 495 K. This method facilitates high-pressure, high-temperature experiments demanding accurate temperature measurements in various disciplines. The study also discusses, in general, the experimental approach to measuring temperature.

["Identifying forms and verifying quality" in materia medica]

The thinking of "identifying forms and verifying quality'' in materia medica research came from the theory of "treatment based on syndrome differentiation" in traditional Chinese medicine. It refers to an approach to evaluate the quality of materia medica based on their characteristics and external properties in order to clarify the nature of medicinal materials. This paper examined the historical development of "identifying forms and verifying quality'' from the pre-Qin Dynasty up to today and analysed the connotation of this thinking. It is believed that this thinking has advantages such as scientific, holistic, practical, and universal considerations. However, it still needs to be developed in terms of philosophical thinking and practical application.

Rhizosphere microbial community composition and survival strategies in oligotrophic and metal(loid) contaminated iron tailings areas

In this study, the metal(loid) fractions in two alkaline iron tailings areas with similar physico-chemical properties and the enrichment ability of dominant plants in these areas were investigated. Additionally, high-throughput sequencing and metagenome analysis were used to examine the rhizosphere microbial community structures and their strategies and potential for carbon fixation, nitrogen metabolism, and metal(loid) resistance in mining areas. Results showed that Salsola collina, Setaria viridis, and Xanthium sibiricum have strong enrichment capacity for As, and the maximum transport factor for Mn can reach 4.01. The richness and diversity of bacteria were the highest in rhizosphere tailings, and the dominant phyla were Proteobacteria, Actinobacteria, Ascomycota, and Thaumarchaeota. The key taxa present in rhizosphere tailings were generally metal(loid) resistant, especially Sphingomonas, Pseudomonas, Nocardioides, and Microbacterium. The reductive citrate cycle was the main carbon fixation pathway of microorganisms in tailings. Rhizosphere microorganisms have evolved a series of survival strategies and can adapt to oligotrophic and metal(loid) polluted mining environments. The results of this study provide a basis for the potential application of plant-microbial in situ remediation of alkaline tailings.

[The illustrations in the works of traditional Chinese medicine in the period of the Republic of China: indicating the integrated thinking of Chinese and western medicine]

Some works of traditional Chinese medicine in the period of the Republic of China were influenced by the integrated thinking of Chinese and Western medicine to some extent. This was reflected in the illustrations in the works of the time. A total of 1,932 illustrations or diagrams found in sixteen institution's book collections in China illustrated the integration of medical thinking. The illustrations and diagrams were classified into eleven categories. The categories were theoretical illustration, medical charts, viscera diagrams, disease diagrams, acupoint diagrams, apparatus diagrams, human body diagrams, fetal birth charts, drug diagrams, figure pictures, and experimental diagrams. It was found that these illustrations or diagrams had their own characteristics at the time and greatly influenced anatomy. However, the author has argued that most of the influence was on the surface.

Engineering topological states in atom-based semiconductor quantum dots

The realization of controllable fermionic quantum systems via quantum simulation is instrumental for exploring many of the most intriguing effects in condensed-matter physics^1–3. Semiconductor quantum dots are particularly promising for quantum simulation as they can be engineered to achieve strong quantum correlations. However, although simulation of the Fermi–Hubbard model⁴ and Nagaoka ferromagnetism⁵ have been reported before, the simplest one-dimensional model of strongly correlated topological matter, the many-body Su–Schrieffer–Heeger (SSH) model^6–11, has so far remained elusive—mostly owing to the challenge of precisely engineering long-range interactions between electrons to reproduce the chosen Hamiltonian. Here we show that for precision-placed atoms in silicon with strong Coulomb confinement, we can engineer a minimum of six all-epitaxial in-plane gates to tune the energy levels across a linear array of ten quantum dots to realize both the trivial and the topological phases of the many-body SSH model. The strong on-site energies (about 25 millielectronvolts) and the ability to engineer gates with subnanometre precision in a unique staggered design allow us to tune the ratio between intercell and intracell electron transport to observe clear signatures of a topological phase with two conductance peaks at quarter-filling, compared with the ten conductance peaks of the trivial phase. The demonstration of the SSH model in a fermionic system isomorphic to qubits showcases our highly controllable quantum system and its usefulness for future simulations of strongly interacting electrons.

Precision-engineered devices consisting of a linear array of ten quantum dots are used to realize both the trivial and topological phases of the many-body Su–Schrieffer–Heeger model.

Radiotherapy Standardisation and Artificial Intelligence within the National Cancer Institute's Clinical Trials Network

Artificial intelligence in healthcare refers to the use of complex algorithms designed to conduct certain tasks in an automated manner. Artificial intelligence has a transformative power in radiation oncology to improve the quality and efficiency of patient care, given the increase in volume and complexity of digital data, as well as the multi-faceted and highly technical nature of this field of medicine. However, artificial intelligence alone will not be able to fix healthcare's problem, because new technologies bring unexpected and potentially underappreciated obstacles. The inclusion of multicentre datasets, the incorporation of time-varying data, the assessment of missing data as well as informative censoring and the addition of clinical utility could significantly improve artificial intelligence models. Standardisation plays a crucial, supportive and leading role in artificial intelligence. Clinical trials are the most reliable method of demonstrating the efficacy and safety of a treatment or clinical approach, as well as providing high-level evidence to justify artificial intelligence. The National Surgical Adjuvant Breast and Bowel Project, the Radiation Therapy Oncology Group and the Gynecologic Oncology Group collaborated to form NRG Oncology (acronym NRG derived from the names of the parental groups). NRG Oncology is one of the adult cancer clinical trial groups containing radiotherapy specialty of the National Cancer Institute's Clinical Trials Network (NCTN). Standardisation from NRG/NCTN has the potential to reduce variation in clinical treatment and patient outcome by eliminating potential errors, enabling broader application of artificial intelligence tools. NCTN, NRG and Imaging and Radiation Oncology Core are in a unique position to help with standards development, advocacy and enforcement, all of which can benefit from artificial intelligence, as artificial intelligence has the ability to improve trial success rates by transforming crucial phases in clinical trial design, from study planning through to execution. Here we will examine: (i) how to conduct technical and clinical evaluations before adopting artificial intelligence technologies, (ii) how to obtain high-quality data for artificial intelligence, (iii) the NCTN infrastructure and standards, (iv) radiotherapy standardisation for clinical trials and (v) artificial intelligence applications in standardisation.

[Effects of regional citrate anticoagulation in continuous veno-venous hemofiltration of severe burn patients]

Objective: To investigate the effects of regional citrate anticoagulation in continuous veno-venous hemofiltration (CVVH) of severe burn patients. Methods: A retrospective non-randomized controlled study was conducted. From January 2017 to August 2020, sixty-eight severe burn patients who met the inclusion criteria were treated with CVVH in Affiliated Hospital of Nankai University. According to the different methods of blood anticoagulation in CVVH treatment, patients were divided into citrate group (n=40) and heparin group (n=28). In the citrate group, 32 males and 8 females were (40±18) years old with total burn area of (62±14)% total body surface area (TBSA); in the heparin group, 22 males and 6 females were (38±16) years old with total burn area of (57±20)%TBSA. Creatinine level, C-reactive protein (CRP) value, and urea nitrogen level in serum of patients were recorded at 0 (immediately), 48, and 96 h after CVVH treatment in 2 groups, urea clearance index was calculated based on urea nitrogen level at 0, 48, and 96 h after CVVH treatment in 2 groups, platelet count (PLT), prothrombin time (PT), and activated partial thromboplastin time (APTT) in total coagulation of patients were recorded. The frequency of forced hemofiltration termination caused by adverse reactions such as severe hypocalcemia, aggravated wound bleeding, and new bleeding on non-wound surface of patients was recorded within 96 h of CVVH treatment. The duration of daily CVVH use from the beginning to the end was recorded. Data were statistically analyzed with chi-square test, analysis of variance for repeated measurement, independent samples t test, and Bonferroni correction. Results: There were no significant differences in urea nitrogen level, creatinine level, and CRP value in serum of patients between 2 groups at 0 h after treatment (P>0.05). At 48 and 96 h after treatment, urea nitrogen level, creatinine level, and CRP value in serum of patients in citrate group were significantly lower than those in heparin group (t=3.366, -2.315, 2.942, -2.657, 2.011, -2.441, P<0.05), and urea clearance index of patients in citrate group was significantly higher than that in heparin group (t=1.017, 2.233, P<0.05). There were no statistically significant differences in PLT, PT, and APTT of patients between 2 groups at 0 h after treatment (P>0.05). At 48 and 96 h, PLT of patients in citrate group was significantly higher than that in heparin group (t=-3.417, -4.143, P<0.05 or P<0.01), PT of patients in citrate group was significantly shorter than that in heparin group (t=2.760, -3.655, P<0.01), APTT of patients in citrate group was significantly shorter than that in heparin group (t=3.719, 5.146, P<0.05 or P<0.01). Within 96 h of treatment, there was 1 case of hypocalcemia and 1 case of aggravated wound bleeding resulting in forced hemofiltration termination in citrate group, but there was no new bleeding on non-wound surface; in heparin group, there was no hypocalcemia, but 7 cases of aggravated wound bleeding and 2 cases of new bleeding on non-wound surface (both at the tracheotomy site) resulting in forced hemofiltration termination. The use time of blood purification filter of patients in citrate group was (11.7±4.8) h, obviously longer than (6.6±2.5) h in heparin group (t=3.310, P<0.01). Conclusions: The use of regional citrate anticoagulation in CVVH treatment of severe burn patients has the advantages including little effect on coagulation function and high safety, can effectively prolong the use time of filter and improve the therapeutic effect, but this conclusion still needs to be further verified in clinical application.

Transcriptomics and Metabolomics Revealed the Biological Response of Chlorella pyrenoidesa to Single and Repeated Exposures of AgNPs at Different Concentrations

Increased release of engineered nanoparticles (ENPs) from widely used commercial products has threatened environmental health and safety, particularly the repeated exposures to ENPs with relatively low concentration. Herein, we studied the response of Chlorella pyrenoidesa (C. pyrenoidesa) to single and repeated exposures to silver nanoparticles (AgNPs). Repeated exposures to AgNPs promoted chlorophyll a and carotenoid production, and increased silver accumulation, thus enhancing the risk of AgNPs entering the food chain. Notably, the extracellular polymeric substances (EPS) content of the 1-AgNPs and 3-AgNPs groups were dramatically increased by 119.1% and 151.5%, respectively. We found that C. pyrenoidesa cells exposed to AgNPs had several significant alterations in metabolic process and cellular transcription. Most of the genes and metabolites are altered in a dose-dependent manner. Compared with the control group, single exposure had more differential genes and metabolites than repeated exposures. 562, 1341, 4014, 227, 483, and 2409 unigenes were differentially expressed by 1-0.5-AgNPs, 1-5-AgNPs, 1-10-AgNPs, 3-0.5-AgNPs, 3-5-AgNPs, and 3-10-AgNPs treatment groups compared with the control. Metabolomic analyses revealed that AgNPs altered the levels of sugars and amino acids, suggesting that AgNPs reprogrammed carbon/nitrogen metabolism. The changes of genes related to carbohydrate and amino acid metabolism, such as citrate synthase (CS), isocitrate dehydrogenase (IDH1), and malate dehydrogenase (MDH), further supported these results. These findings elucidated the mechanism of biological responses to repeated exposures to AgNPs, providing a new perspective on the risk assessment of nanomaterials.

Potentially Toxic Element Contaminations and Lead Isotopic Fingerprinting in Soils and Sediments from a Historical Gold Mining Site

Lead (Pb) isotopes have been widely used to identify and quantify Pb contamination in the environment. Here, the Pb isotopes, as well as the current contamination levels of Cu, Pb, Zn, Cr, Ni, Cd, As, and Hg, were investigated in soil and sediment from the historical gold mining area upstream of Miyun Reservoir, Beijing, China. The sediment had higher ²⁰⁶Pb/²⁰⁷Pb ratios (1.137 ± 0.0111) than unpolluted soil did (1.167 ± 0.0029), while the soil samples inside the mining area were much more variable (1.121 ± 0.0175). The mean concentrations (soil/sediment in mg·kg⁻¹) of Pb (2470/42.5), Zn (181/113), Cu (199/36.7), Cr (117/68.8), Ni (40.4/28.9), Cd (0.791/0.336), As (8.52/5.10), and Hg (0.168/0.000343) characterized the soil/sediment of the studied area with mean I_geo values of the potentially toxic element (PTE) ranging from −4.71 to 9.59 for soil and from −3.39 to 2.43 for sediment. Meanwhile, principal component analysis (PCA) and hierarchical cluster analysis (HCA) coupled with Pearson’s correlation coefficient among PTEs indicated that the major source of the Cu, Zn, Pb, and Cd contamination was likely the mining activities. Evidence from Pb isotopic fingerprinting and a binary mixing model further confirmed that Pb contamination in soil and sediment came from mixed sources that are dominated by mining activity. These results highlight the persistence of PTE contamination in the historical mining site and the usefulness of Pb isotopes combined with multivariate statistical analysis to quantify contamination from mining activities.

[A new classification of intrahepatic cholangiocarcinoma based on actual anatomy:a series of 135 cases]

Objective: To explore the feasibility and clinical value of a new classification for resectable intrahepatic cholangiocarcinoma (IHCC) according to the actual anatomy. Methods: The data of 135 patients with IHCC who were admitted to the Department of Hepatopancreatobiliary Surgery,Second Affiliated Hospital of Zhejiang University School of Medicine from November 2011 to November 2020 after discussion by a multidisciplinary team and planned to undergo radical resection were analyzed retrospectively. There were 77 males and 58 females,with a median age of 61 years (range:26 to 86 years),of which 38 cases had vascular invasion. This new classification was carried out independently by two hepatobiliary surgeons. First,a preliminary classification was made based on the location of the tumor,and then the final classification was based on vascular invasion. All patients were followed up by telephone,and the follow-up was as of November 2020. Survival time is defined as the time after surgery to follow-up or death. Log-rank test was used to compare patients' median recurrence-free survival and overall survival time. The Cox proportional hazard model was used to analyze the prognosis factors of the overall survival time of patients with IHCC. Results: Among the 135 patients,129 underwent R0 resection and 6 underwent R1 resection. According to the actual anatomy,28 cases (20.7%) belonged to segmental type, 43 cases (31.9%) belonged to branch type, 64 cases (47.4%). The median survival time of all patients was 35.2 months(95%CI:21.3 to 70.5 months),the 1-year cumulative survival rate was 75.1%,the 3-year cumulative survival rate was 45.8%,and the 5-year cumulative survival rate was 39.0%. After grouping according to the classification,the median survival time of segmental patients was 36.9 months (more than 50% of patients reached the median survival time),and the median survival time of branched patients was 33.8 months (95%CI:16.8 to 38.5);The median survival time of lobe patients was 25.0 months (95%CI:13.6 to 58.7). The result of Log-rank test between groups indicated that the median survival time of patients with segmental type was better than that of patients with branch and lobe type(HR=2.03,95%CI:1.24 to 3.64,P=0.006);There was no significant difference in survival time between patients with branch type and lobe type (P=0.685). The results of the multivariate analysis of the Cox risk ratio model suggested that the actual anatomical location classification (HR=2.32,95%CI:1.10 to 4.92,P=0.028) and the postoperative lymph node metastasis rate (HR=2.06,95%CI:1.24 to 3.45,P=0.005) were independent factors related to survival after radical resection of IHCC patients. Conclusion: It is simple and convenient to classify resectable IHCC by actual anatomy,which can be used to preliminarily judge the prognosis of patients and provide a feasible classification scheme for the clinic.

Comparison of modeling accuracy between Radixact®and CyberKnife®Synchrony®respiratory tracking system

Synchrony Respiratory Tracking system adapted from CyberKnife has been introduced in Radixact to compensate the tumor motion caused by respiration. This study aims to compare the modeling accuracy of the Synchrony system between Radixact and CyberKnife. Two Synchrony plans based on fiducial phantoms were created for CyberKnife and Radixact, respectively. Different respiratory motion traces were used to drive a motion platform to move along the superoinferior and left-right direction. The cycle time and the amplitude of target/surrogate motion of one selected motion trace were scaled to investigate the dependence of modeling accuracy on the motion characteristic. The predicted target position, the correlation error, potential difference (Radixact only) and standard error (CyberKnife only) were extracted from raw data or log files of the two systems. The modeling accuracy was evaluated by calculating the root-mean-square (RMS) error between the predicted target positions and the input motion trace. A threshold T95 within which 95% of the potential difference or the standard error lay was defined and evaluated. Except for the motion trace with a small amplitude and a good (linear) correlation between target and surrogate motion, Radixact showed smaller RMS errors than CyberKnife. The RMS error of both systems increased with the motion amplitude and showed a decreasing trend with the increasing cycle time. No correlation was found between the RMS error and the amplitude of surrogate motion. T95 could be a good estimator of modeling accuracy for CyberKnife rather than Radixact. The correlation error defined in Radixact were largely affected by the number of fiducial markers and the setup error. In general, the modeling accuracy of the Radixact Synchrony system is better than that of the CyberKnife Synchrony system under unfavorable conditions.

Initial clinical experience of patient-specific QA of treatment delivery in online adaptive radiotherapy using a 1.5 T MR-Linac

Purpose. This study aims to evaluate the performance of a commercial 1.5 T MR-Linac by analyzing its patient-specific quality assurance (QA) data collected during one full year of clinical operation.Methods and Materials. The patient-specific QA system consisted of offline delivery QA (DQA) and online calculation-based QA. Offline DQA was based on ArcCHECK-MR combined with an ionization chamber. Online QA was performed using RadCalc that calculated and compared the point dose calculation with the treatment planning system (TPS). A total of 24 patients with 189 treatment fractions were enrolled in this study. Gamma analysis was performed and the threshold that encompassed 95% of QA results (T95) was reported. The plan complexity metric was calculated for each plan and compared with the dose measurements to determine whether any correlation existed.Results. All point dose measurements were within 5% deviation. The mean gamma passing rates of the group data were found to be 96.8 ± 4.0% and 99.6 ± 0.7% with criteria of 2%/2mm and 3%/3mm, respectively. T95 of 87.4% and 98.2% was reported for the overall group with the two passing criteria, respectively. No statistically significant difference was found between adaptive treatments with adapt-to-position (ATP) and adapt-to-shape (ATS), whilst the category of pelvis data showed a better passing rate than other sites. Online QA gave a mean deviation of 0.2 ± 2.2%. The plan complexity metric was positively correlated with the mean dose difference whilst the complexity of the ATS cohort had larger variations than the ATP cohort.Conclusions. A patient-specific QA system based on ArcCHECK-MR, solid phantom and ionization chamber has been well established and implemented for validation of treatment delivery of a 1.5 T MR-Linac. Our QA data obtained over one year confirms that good agreement between TPS calculation and treatment delivery was achieved.

Deciphering the toxic effects of metals in gold mining area: Microbial community tolerance mechanism and change of antibiotic resistance genes

Mine tailing dumps represent significant threats to ecological environments due to the presence of toxic substances. The present work investigated the relationship among microbial activity, the community, antibiotic resistance genes (ARGs) and trace metals in soil surrounding gold mine tailings. Using microbial metabolic activity and high-throughput sequencing analysis, we found the trace metals Cd and Hg could be main factors influencing the microbial community. According to bacterial co-occurrence pattern analysis, the effects of total cadmium and total mercury on bacterial diversity are potentially mediated by influencing bacteria community in the keystone module II. Additionally, most of metal-resistant bacteria belong to Actinobacteria and Proteobacteria, and the metal tolerance suggested to be linked with various functions including replication, recombination and repair, as well as inorganic ion transport and metabolism based on PICRUSt2 analysis. We also found that metals generated by mining activity may trigger the co-selection of antibiotic resistance in the phyla Actinobacteria and Proteobacteria due to co-resistance or cross resistance. Additionally, PLS-PM analysis revealed that metals could indirectly affect ARGs by influencing bacterial diversity in gold mining areas.

Molecular characteristics of leonardite humic acid and the effect of its fractionations on sulfamethoxazole photodegradation

The widespread occurrence of synthetic antibiotic sulfamethoxazole (SMX)- poses a potential risk to aquatic ecosystems where dissolved organic matter (DOM) may affect its photolysis. In this study, the elimination of SMX by solar photolysis was investigated in the presence of leonardite humic acid (LHA) and its fractions. Fourier transform ion cyclotron resonance mass (FT-ICR-MS) spectra showed that LHA has high aromaticity. van Krevelen diagrams demonstrated highly unsaturated and phenolic compounds. The photolytic degradation of SMX was impeded by all DOM, mainly due to the competition of photons and scavenging or quenching of reactive oxygen species (ROS). The evaluation of isolated fractions of LHA suggested that fractions with MW < 3500, 14000-25,000 and > 100,000 had the greatest negative effects on sulfamethoxazole photodegradation; their inhibitory activities could reach up to 56.2%, 52.9% and 50.5%, respectively. The characterization of DOM at the molecular level will provide further insights into the assessment of photolysis for antibiotic elimination in natural waters where DOM exists ubiquitously.

Integrating high-throughput sequencing and metagenome analysis to reveal the characteristic and resistance mechanism of microbial community in metal contaminated sediments

Some metallic tailings from closed mines were scattered in upstream of the Miyun Reservoir, Beijing, threatening the ecological environment of rivers due to trace metals. The Liuli River, one of the main rivers affected, was investigated as a typical model in this work. In this study, we selected eight sites to assess interactions among the various geochemical factors especially between trace metals and sediment microbiota. Random forest predicted that low concentrations of Cu, Cd, Cr and Ni (lower than 61.8 mg/kg, 3.2 mg/kg, 173.2 mg/kg and 34.1 mg/kg, respectively) were able to enhance community diversity but generally, trace metals contamination impaired microbial diversity. Environmental factor correlation analysis showed that As, pH and available P were the major factors that shifted the distribution of the microbial communities. Metagenome sequencing revealed that Proteobacteria harbored the vast majority of heavy metal resistance genes followed by Actinobacteria and Bacteroidetes. Metal tolerance of Proteobacteria were achieved by exportation of metals by the corresponding transporters, by pumps and ion channels, or by their reduction via redox reactions. In addition, Proteobacteria harbored a greater ability to repair DNA damage via DNA recombination.

Leaching behavior of metals from iron tailings under varying pH and low-molecular-weight organic acids

The migration of metals (e.g., Fe, Cd, Co, Cr, Cu, Mn, Ni, and Zn) in both of iron tailings under different pH leachates was studied by laboratory static leaching experiments. The results indicated that Fe showed the highest leaching concentration at an initial pH of 2, reaching 16.19 and 51.72 mg L^-1 in the Qian'anling (Q0) and Majuanzi (M0) iron tailings, respectively. Metal ions manifested a strong pH dependence. In addition, the leaching behavior of Cd, Cr, Fe, and Cu for the two tailings was also evaluated under leaching by three low-molecular-weight organic acids (LMWOAs). The results indicated the leaching of Cd and Fe followed the order of citric acid > malic acid > oxalic acid and that the leaching order for Cr and Cu was citric acid > oxalic acid > malic acid. The concentration of Fe was low in 5 mM oxalic acid leaching for 20 days because of the hydrolysis precipitation of iron ions and the complexation with organic ligand. The crystal lattice on the tailings was significantly damaged after leaching. The CO₃^2- peak appeared in M0 with different treatments, and the proportion of COO- fitting peak areas increased markedly after leaching with LMWOAs.

Mechanism of methylphosphonic acid photo-degradation based on phosphate oxygen isotopes and density functional theory

Methylphosphonic acid (MPn) is an intermediate in the synthesis of the phosphorus-containing nerve agents, such as sarin and VX, and a biosynthesis product of marine microbes with ramifications to global climate change and eutrophication. Here, we applied the multi-labeled water isotope probing (MLWIP) approach to investigate the C-P bond cleavage mechanism of MPn under UV irradiation and density functional theory (DFT) to simulate the photo-oxidation reaction process involving reactive oxygen species (ROS). The results contrasted with those of the addition of the ROS-quenching compounds, 2-propanol and NaN3. The degradation kinetics results indicated that the extent of MPn degradation was more under alkaline conditions and that the degradation process was more rapid at the initial stage of the reaction. The phosphate oxygen isotope data confirmed that one exogenous oxygen atom was incorporated into the product orthophosphate (PO4) following the C-P bond cleavage, and the oxygen isotopic composition of this free PO4 was found to vary with pH. The combined results of the ROS-quenching experiments and DFT indicate that the C-P bond was cleaved by OH-/˙OH and not by other reactive oxygen species. Based on these results, we have established a mechanistic model for the photolysis of MPn, which provides new insights into the fate of MPn and other phosphonate/organophosphate compounds in the environment.

[The expression of VHL/HIF signaling pathway in the erythroid progenitor cells with chronic mountain sickness]

Objective: To investigate the expression and interaction of VHL/HIF-α pathways including HIF-1α, HIF-2α as well as VHL in erythroid progenitor cells of bone marrow from chronic mountain sickness (CMS) patients. Methods: A total of 25 patients with CMS and 21 healthy controls were recruited for this study. The CD71(+)CD235a(+) cells in bone marrow mononuclear cells, marked as erythroid progenitor cells, were isolated using MACS separation technology. The expression levels of HIF-1α, HIF-2α and VHL in erythroid progenitor cells were detected by Western blotting and real-time fluorescence quantitative PCR. Results: The mRNA levels of HIF-2α were higher in erythroid progenitor cells of CMS than in healthy controls [1.68 (0.81, 2.22) vs 0.98 (0.60, 1.19), P<0.05], while HIF-1α and VHL mRNA levels were similar between the two groups (P>0.05). Spearman analyses indicated that HIF-2α mRNA was positively associated with hemoglobin (Hb) levels in the erythroid progenitor cells of CMS (ρ=0.504, P<0.05). Furthermore, the mRNA level of HIF-2α was correlated with the mRNA level of VHL in the erythroid progenitor cells of CMS (ρ=0.647, P<0.05).The protein levels of HIF-2α in the erythroid progenitor cells of CMS were higher than that of healthy controls [0.94(0.68, 3.30) vs 0.59(0.30, 0.88), P<0.05], but the protein levels of HIF-1α and VHL were similar between the two groups (P>0.05). Conclusions: The abnormal increased expression of HIF-2α in the erythroid progenitor cells of CMS patients leads to the abnormal expression of hypoxia sensitive genes downstream, participating in the occurrence and development of CMS.

[Influence of directed restrictive fluid management strategy on patients with serious burns complicated by severe inhalation injury]

Objective: To explore the influence of directed restrictive fluid management strategy (RFMS) on patients with serious burns complicated by severe inhalation injury. Methods: Sixteen patients with serious burns complicated by severe inhalation injury hospitalized in our department from December 2014 to December 2017, meeting the inclusion criteria and treated with RFMS, were enrolled in directed treatment group. Thirty-four patients with serious burns complicated by severe inhalation injury hospitalized in our department from December 2012 to December 2017, meeting the inclusion criteria and without RFMS, were enrolled in routine treatment group. Medical records of patients in 2 groups were retrospectively analyzed. Within post injury day 2, mean arterial pressure (MAP), central venous pressure (CVP), extravascular lung water index (ELWI), global end-diastolic volume index, and pulmonary vascular permeability index of patients in directed treatment group were monitored by pulse contour cardiac output monitoring technology, while MAP and CVP of patients in routine treatment group were monitored by routine method. On post injury day 3 to 7, patients in 2 groups were treated with routine fluid supplement therapy of our Department to maintain hemodynamic stability, and patients in directed treatment group were treated according to RFMS directed with goal of ELWI≤7 mL·kg(-1)·m(-2). On post injury day 3 to 7, total fluid intake, total fluid output, and total fluid difference between fluid intake and output within 24 h, value of blood lactic acid, and oxygenation index of patients in 2 groups were recorded. Occurrence of acute respiratory distress syndrome (ARDS) on post injury day 3 to 7 and 8 to 28, mechanical ventilation time within post injury day 28, and occurrence of death of patients in 2 groups were counted. Data were processed with chi-square test, t test, and analysis of variance for repeated measurement. Results: The total fluid intakes within 24 h of patients in directed treatment group were close to those in routine treatment group on post injury day 3, 4, 5, 6, 7 (t=-0.835, -1.618, -2.463, -1.244, -2.552, P>0.05). The total fluid outputs and total fluid differences between fluid intake and output within 24 h of patients in 2 groups on post injury day 3 were close (t=0.931, -2.274, P>0.05). The total fluid outputs within 24 h of patients in directed treatment group were significantly higher than those in routine treatment group on post injury day 4, 5, 6, 7 (t=2.645, 2.352, 1.847, 1.152, P<0.05). The total fluid differences between fluid intake and output within 24 h of patients in directed treatment group were (2 928±768), (2 028±1 001), (2 186±815), and (2 071±963) mL, significantly lower than (4 455±960), (3 434±819), (3 233±1 022), and (3 453±829) mL in routine treatment group (t=-4.331, -3.882, -3.211, -4.024, P<0.05). The values of blood lactic acid of patients in directed treatment group and routine treatment group on post injury day 3, 4, 5, 6, 7 were close (t=0.847, 1.221, 0.994, 1.873, 1.948, P>0.05). The oxygenation indexes of patients in directed treatment group on post injury day 3 and 4 were (298±78) and (324±85) mmHg (1 mmHg=0.133 kPa ), which were close to (270±110) and (291±90) mmHg in routine treatment group (t=-1.574, 2.011, P>0.05). The oxygenation indexes of patients in directed treatment group on post injury day 5, 6, 7 were (372±88), (369±65), and (377±39) mmHg, significantly higher than (302±103), (313±89), and (336±78) mmHg in routine treatment group (t=3.657, 3.223, 2.441, P<0.05). On post injury day 3, 4, 5, 6, 7, patients with ARDS in directed treatment group were less than those in routine treatment group, but with no significantly statistical difference between the 2 groups (χ(2)=0.105, P>0.05). On post injury day 8 to 28, patients with ARDS in directed treatment group were significantly less than those in routine treatment group (χ(2)=0.827, P<0.05). The mechanical ventilation time within post injury day 28 of patients in directed treatment group was apparently shorter than that in routine treatment group (t=-2.895, P<0.05). Death of patients in directed treatment group within post injury day 28 was less than that in routine treatment group, but with no significantly statistical difference between the 2 groups (χ(2)=0.002, P>0.05). Conclusions: Under the circumstance of hemodynamics stability, RFMS directed with goal of ELWI≤7 mL·kg(-1)·m(-2) on post injury day 3 to 7 is an useful strategy, which can reduce occurrence rate of ADRS and shorten mechanical ventilation time of patients with serious burns complicated by severe inhalation injury at late stage of burns.

[Analysis on the characteristics of postural blood pressure changes recorded with continuous non-invasive arterial pressure monitoring system and the correlative factors in elderly hospitalized patients]

Objective: To explore the characteristics of postural blood pressure changes in elderly inpatients and the related factors of orthostatic hypotension (OH). Methods: This study was a clinical case control study. Two hundred and sixty-six elderly patients (≥60 years old), who were hospitalized between April 2016 and November 2017 in Geriatric Department of Peking University First Hospital, were included. They were divided into direct standing group and indirect standing group. Direct standing group involved 102 patients, they changed posture from supine directly to standing position, and the blood pressures at the moments of supine, immediately after standing and the first, second, and third minute after standing were recorded by continuous noninvasive arterial pressure (CNAP) system. Indirect standing group involved 164 patients, and they changed posture from supine to sitting for 3 minutes, and then changed to standing position. Blood pressures at the moments of supine, immediately after sitting, the third minute after sitting, immediately after standing and the third minute after standing was recorded by CNAP. Blood pressure changes after different postural changes mode and the rates of OH were compared. The related factors of OH was analyzed by binary logistic regression analysis. Results: The lowest systolic blood pressures (SBP) mostly occurred immediately after postural change: immediately after standing for direct standing group (86.3%(88/102)), and immediately after sitting for indirect standing group (59.1%(97/164)). The lowest diastolic blood pressures (DBP) mostly occurred immediately after standing in the two groups: 87.3%(89/102) for direct standing group and 43.3% (71/164) for indirect standing group. The maximum SBP drop (SBP of supine minus the lowest SBP during postural changes) of direct standing group was significantly higher than indirect standing group (median 20.5(14.0, 29.3) vs. 18.0(11.0, 26.0) mmHg (1 mmHg=0.133 kPa, P<0.05). The rates of OH occurred immediately and within 3 minutes from supine to standing position were significantly higher in direct standing group than in indirect standing group (65.7% (67/102) vs. 43.9% (72/164), and 70.6% (72/102) vs. 49.4% (81/164), both P<0.05). Binary logistic regression analysis showed that brachial-ankle pulse wave velocity was positively associated with OH after a transition from supine to standing position (immediately and within 3 minutes, OR=1.002 (95%CI 1.000-1.004), 1.003 (95%CI 1.001-1.006), P=0.014, 0.006) in direct standing group. Conclusions: OH is common in elderly hospitalized patients. The most obvious blood pressure changes are likely to occur immediately after position changes. Adding a sitting position during the transition of supine to standing position may decrease the amplitude of SBP drop. Brachial-ankle pulse wave velocity is associated with OH after the transition from the supine to standing position in the elderly inpatients.

Environmental behavior and associated plant accumulation of silver nanoparticles in the presence of dissolved humic and fulvic acid

This work investigated the role of natural organic matter (NOM) in the environmental processes of silver nanoparticles (AgNP) and the uptake and accumulation of AgNP in wheat. Different NOMs (Suwannee River humic acids [SRHA], fulvic acid [FA]) and Ag elements (Ag⁽⁰⁾ and Ag⁺) were incubated in a hydroponic media for 15 days. The results showed that the NOM (10 mg C L^-1) altered the dissolution, stabilization, uptake and accumulation of AgNP. The dissolution of AgNP declined in the presence of NOM. Compared with FA, the dissolved Ag⁺ decreased much more from 0.30 mg L^-1 to 0.10 mg L^-1 in the presence of SRHA. The fluorescence quenching results indicated that SRHA exhibited stronger binding to Ag⁺ than that of FA, and the quenching constants Ksv were 0.1309 (SRHA) and 0.0074 (FA), respectively. CO, CH, COC, and MeOH were involved in the interaction between NOM and AgNP. The NOM decreased the accumulated content of Ag in wheat. Hence, NOM alleviated the inhibition of AgNP to wheat growth. SRHA reduced the Ag content of wheat roots approximately 3-fold. These results clearly indicated the importance of NOM on altering the behavior, fate and toxicity of AgNP in an environment.

[Types and characteristics of advertising images in Chinese medicine works during the Republic of China]

The emergence of advertising images in Chinese medicine works during the period of China is the inevitable outcome of the development of commercial society. In the 237 advertising images, there are 106 pictures, 130 ink lines and 1 color photograph. It can be divided into 8 categories: chemist's shop, hospital, medical products, Chinese medicine school and organizations, book, book publishers, commodity and public service. It can reflect the popular themes of the society and social atmosphere at that time, having vivid characteristics of the times and artistry. Advertising image is a unique phenomenon in the books of the Republic of China.

[The expressions of VEGF and VEGFR signaling pathway in the bone marrow mononuclear cells with chronic mountain sickness]

Objective: This study was aimed at investigating the levels and relationships of vascular endothelial growth factor (VEGF) and its receptor(VEGFR) in the bone marrow mononuclear cells (MNC) of chronic mountain sickness (CMS). Methods: A total of 34 patients with CMS and 30 controls residing at altitudes of 3 000-4 500 m were recruited for this study. The levels of VEGF, VEGFR1 and VEGFR2 in bone marrow MNC were detected by flow cytometry technique and RT-qPCR. Results: The percentage of VEGFR2 positive cells in the bone marrow MNC of CMS were higher than that of the controls[20.7% (8.1%, 67.6%) vs 8.1% (2.2%, 14.9%), P<0.05], but that of VEGFR1-positive and VEGF-positive were similar in CMS and controls. The mRNA levels of VEGFR2 were higher in the bone marrow MNC of CMS than in the controls[1.7(1.0, 5.1) vs 1.0(0.4, 2.7), P<0.05], while VEGF and VEGFR1 mRNA levels were similar between the two groups. The percentage of VEGFR2 positive cells in CMS were significantly correlated with hemoglobin (r=0.453, P=0.007) and the percentage of VEGF-positive cells (r=0.373, P=0.030). Conclusions: Bone marrow MNC of CMS may show enhanced activity of the VEGF-VEGFR2 pathway, and it appears to be involved in the pathogenesis of CMS.