Enhancing soil ecological security through phytomanagement of tailings in erosion-prone areas

Revegetation is effective in improving soil quality in ecologically fragile areas. However, little is known about the impact of diverse phytomanagement strategies of tailings on soil quality and ecological security in erosion-prone areas. We investigated the water stability, soil aggregate nutrients, and the risk of heavy metal contamination of abandoned tailings under phytomanagement and in adjacent bare land on the Loess Plateau. The results showed that phytomanagement significantly enhanced soil aggregate stability, as demonstrated by higher contents of soil organic carbon (SOC), glomalin-related soil protein (GRSP), aromatic-C, and alkene-C in macro-aggregates. The pollution load index (PLI) and ecological risk index (RI) of soil heavy metals were lower in shrub/herbaceous mixed forests than in natural grasslands and planted forests. The risk of heavy metal contamination was higher in macro-aggregates (>0.25 mm) than in micro-aggregates (<0.25 mm) and was significantly and positively correlated with the SOC and GRSP contents of the aggregates. Our study demonstrates that soil aggregate quality is closely related to the fate of heavy metals. Diversified tailing revegetation measures can improve soil quality and ensure ecological security.

New perspectives on microbiome and nutrient sequestration in soil aggregates during long-term grazing exclusion

Grazing exclusion alters grassland soil aggregation, microbiome composition, and biogeochemical processes. However, the long-term effects of grazing exclusion on the microbial communities and nutrient dynamics within soil aggregates remain unclear. We conducted a 36-year exclusion experiment to investigate how grazing exclusion affects the soil microbial community and the associated soil functions within soil aggregates in a semiarid grassland. Long-term (36 years) grazing exclusion induced a shift in microbial communities, especially in the <2 mm aggregates, from high to low diversity compared to the grazing control. The reduced microbial diversity was accompanied by instability of fungal communities, extended distribution of fungal pathogens to >2 mm aggregates, and reduced carbon (C) sequestration potential thus revealing a negative impact of long-term GE. In contrast, 11-26 years of grazing exclusion greatly increased C sequestration and promoted nutrient cycling in soil aggregates and associated microbial functional genes. Moreover, the environmental characteristics of microhabitats (e.g., soil pH) altered the soil microbiome and strongly contributed to C sequestration. Our findings reveal new evidence from soil microbiology for optimizing grazing exclusion duration to maintain multiple belowground ecosystem functions, providing promising suggestions for climate-smart and resource-efficient grasslands.

[Clinical effects of free anterolateral thigh perforator flap pedicled with descending genicular artery in repairing wounds after lower leg limb-sparing surgery]

Objective: To explore the clinical effects of free anterolateral thigh perforator flap pedicled with descending genicular artery in repairing wounds after lower leg limb-sparing surgery. Methods: A retrospective observational study was conducted. From January 2019 to June 2021, 12 patients with wounds after lower leg limb-sparing surgery who met the inclusion criteria were admitted to Suzhou Ruihua Orthopedic Hospital, including 6 males and 6 females, aged 17 to 74 years, with original wound area ranging from 17 cm×9 cm to 40 cm×15 cm. Five patients had infection in wounds. The wounds were all repaired by free anterolateral thigh perforator flap from contralateral thigh, with area of 18 cm×10 cm to 37 cm×9 cm. The artery of flap was anastomosed with the descending genicular artery, and the wounds in donor areas were sutured directly. Seven patients were transplanted with split-thickness skin grafts from the contralateral thigh to cover the remaining wounds that can not be covered by flap and the wounds in donor areas were covered with gauze. During the operation, the types of perforating branch carried by flap and the types of arteries and veins in recipient areas were recorded. The survival and occurrence of vascular crisis of flap, the survival of skin graft, the wound healing in donor and recipient areas, and the length of hospital stay after flap transplant surgery were recorded. During follow-up, the color and texture of flap, reinfection in lower leg, and fracture healing were recorded. At the last follow-up, the limb salvage function of patients was evaluated according to the functional evaluation criteria of Chen Zhongwei's amputated limb replantation. Results: The types of perforating branches carried by flaps were as follows: 6 cases of only carrying the descending branch of the lateral circumflex femoral artery, 3 cases of only carrying the oblique branch of the lateral circumflex femoral artery, and 3 cases of carrying the descending branch of the lateral circumflex femoral artery and oblique branch of the lateral circumflex femoral artery after internal pressurization anastomosis. The types of arteries in the recipient area of flap were as follows: one case of main trunk of the descending genicular artery, 8 cases of the saphenous branch of the descending genicular artery, and 3 cases of the articular branch of the descending genicular artery. The types of veins in the recipient area of flap were as follows: 8 cases of one accompanying vein of the descending genicular artery and one branch of the great saphenous vein, and 4 cases of two branches of the great saphenous vein. All the flaps survived without vascular crisis, and all the skin grafts also survived. The wounds in the donor and recipient areas were all healed. The length of hospital stay of patient after flap transplant surgery ranged from 13 to 79 days. During the follow-up of 6 to 23 months, the color and texture of flap were both good, with no infection in lower leg wound. Internal or external fixation were removed after fracture healing in 5 patients, and bone graft internal fixation was performed in 7 patients whose fractures were not healed after surgery and all the incisions healed without infection. At the last follow-up, the limb salvage effect of patients was evaluated as followings: excellent in 7 patients, good in 4 patients, and fair in one patient. Conclusions: Free anterolateral thigh flap pedicled with descending genicular artery can effectively repair the wounds after lower leg limb-sparing surgery and control infection with short length of hospital stay, while not increasing the risk of secondary injury of distal limb vessels. Thus, it can obtain satisfactory limb salvage effect which is worthy of clinical promotion.

Microbial metabolic limitation of rhizosphere under heavy metal stress: Evidence from soil ecoenzymatic stoichiometry

Slow nutrient turnover and destructed soil function were the main factors causing low efficiency in phytoremediation of heavy metal (HM)-contaminated soil. Soil ecoenzymatic stoichiometry can reflect the ability of soil microorganisms to acquire energy and nutrients, and drive nutrient cycling and carbon (C) decomposition in HM-contaminated soil. Therefore, for the first time, we used the enzymatic stoichiometry modeling to examine the microbial nutrient limitation in rhizospheric and bulk soil of different plants (Medicago sativa, Halogeton arachnoideus and Agropyron cristatum) near the Baiyin Copper Mine. Results showed that the main pollutants in this area were Cu, Zn, Cd, and Pb, while Cd and Zn have the greatest contribution according to the analysis of pollution load index (PLI). The activities of soil C-, nitrogen (N)-, and phosphorus (P)-acquiring enzymes in the rhizosphere of plants were significantly greater than that in bulk soil. Moreover, microbial C and P limitations were observed in all plant treatments, while the lower limitation was generally in the rhizosphere compared to bulk soil. The HM stress significantly increased microbial C limitation and decreased microbial P limitation, especially in the rhizospheric soil. The partial least squares path modeling (PLS-PM) further indicated that HM concentration has the greatest effects on microbial P limitation (-0.64). In addition, the highest enzyme activities and the lowest P limitation were observed in the rhizospheric and bulk soil of M. sativa, thereby implying that soil microbial communities under the remediation of M. sativa were steadier and more efficient in terms of their metabolism. These findings are important for the elucidation of the nutrient cycling and microbial metabolism of rhizosphere under phytoremediation, and provide guidance for the restoration of HM-contaminated soil.

Reduction of Cu and nitrate leaching risk associated with EDDS-enhanced phytoextraction process by exogenous inoculation of plant growth promoting rhizobacteria

Biodegradable chelant (S,S)-N,N'-ethylenediaminedisuccinic acid (EDDS) has the more advantages of enhanced metal mobility, rapid degradation, environmental friendliness, and ammonium release. However, the risk of metal and/or nitrate residues and leaching within EDDS biodegradation remains as the bottleneck for the widespread application of EDDS-induced phytoremediation. This study aims to explore if the inoculation of plant growth-promoting rhizobacteria (PGPRs) can eliminate the risk associated with the short-term application of EDDS by investigating Cu phytoextraction and soil nitrate content. Results showed that EDDS application significantly increased the copper (Cu) concentration in shoots, soil total Cu, NH₄⁺-N and NO₃^--N content, but decreased plant biomass. The inoculation of PGPRs in the soil showed a strong ability to increase plant biomass, Cu phytoextraction and soil NH₄⁺-N content, and decrease soil Cu and NO₃^--N content. Moreover, bacterial dominant taxa were found to be the largest contributors to soil NH₄⁺-N and NO₃^--N variation, and the abundance of denitrifying bacteria (Bacteroidetes and Stenotrophomonas) decreased in the treatment with PGPRs. The risk of residual Cu and nitrate leaching was reduced by the inoculation of PGPRs without significantly changing the stability of the bacterial community. These new findings indicate that the exogenous application of beneficial rhizobacteria can provide an effective strategy to reduce the risk in metal-contaminated soils of chelant-assisted phytoextraction.

Associated soil aggregate nutrients and controlling factors on aggregate stability in semiarid grassland under different grazing prohibition timeframes

Grazing prohibition is an effective measure in improving soil stability and ecological quality. However, only a limited number of studies have been published on the dominant factors that impact soil aggregate stability and their associated effects on nutrient distribution for different size soil aggregates under long-term grazing prohibition management. In this study, we investigated variation in soil aggregate stability and nutrient distribution characteristics in semiarid grassland sites under different grazing prohibition timeframes (0 years [GP0], 11 years [GP11], 26 years [GP26], and 36 years [GP36]). Results showed that organic carbon (C) and total nitrogen (TN) concentrations in soil aggregates decreased at GP11 before progressively increasing and reaching its highest value at GP36, and the total phosphorus (TP) concentration did not change significantly. Most nutrients accumulated in macroaggregates (> 0.25 mm) under grazing prohibition, and the nutrient stoichiometry in soil aggregates increased after 26 years. Compared to the control (GP0), the mean weight diameter (MWD) value of the soil stability index increased at GP11 (21.7%) and decreased at GP26 (18.9%). Attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR) also showed that the proportion of stable organic C-related functional groups (i.e., alkene-C and aromatic-C) in macroaggregates were higher at GP11 and GP36 than at GP26. Furthermore, principal component analysis (PCA), partial least squares path modeling (PLS-PM), and the relative importance of regressors all showed that glomalin-related soil proteins (GRSP) and nutrients indirectly improved aggregate stability in semiarid grassland through their influence on the GRSP accumulation potential and nutrient stoichiometry. Generally, after 26 years grazing prohibition had a positive effect on soil aggregate stability and nutrient accumulation in the semiarid grassland sites investigated for this study. Results from this study provide a theoretical basis to select appropriate grazing prohibition timeframes under grassland management initiatives to optimize ecological quality measures in semiarid regions.

A novel extracellular enzyme stoichiometry method to evaluate soil heavy metal contamination: Evidence derived from microbial metabolic limitation

Heavy metal contaminates have become a significant threat to soil ecosystems due to their chronicity and universality in soil. Soil microbial metabolism plays a vital role in biogeochemical cycles and soil functions. However, the response of microbial metabolism to heavy metal contamination in soil remains elusive despite potentially offering important insight into the health and ecological consequences of soil ecosystems under such contamination. This study used extracellular enzyme stoichiometry models to identify the response of microbial metabolism to various heavy metal contaminants, while also revealing potential implications of heavy metal contaminates in soil ecosystems. Results showed that microbial metabolism was restricted by soil carbon (C) and phosphorus (P) within a heavy metal polluted area in Northwest China. Heavy metal stress significantly increased microbial C limitation while decreasing microbial P limitation. However, microbial C and P limitations both responded consistently to different heavy metals (i.e., Cd, Pb, Zn, and Cu). Heavy metals had the greatest effect on microbial C limitation (i.e., 0.720 of the total effects) compared to other soil properties, and soil with the lowest heavy metal concentration exhibited the lowest microbial C limitation, and vice versa. These results indicated that microbial metabolic limitation can robustly and sensitively reflect the degree of heavy metals pollution in soil. Additionally, increased microbial C limitation caused by heavy metal contaminants could potentially escalate C release by promoting soil C decomposition as well as increasing investments in enzyme production and the maintenance of metabolic processes. Consequently, potential C loss induced by heavy metal pollution on soil ecosystems may be extensive and significant. Generally, our results suggest the usefulness of extracellular enzyme stoichiometry as a new method from which to evaluate heavy metal soil pollution, while microbial metabolic limitation could potentially be a promising indicator.

Exogenous application of signaling molecules to enhance the resistance of legume-rhizobium symbiosis in Pb/Cd-contaminated soils

Being signaling molecules, nitric oxide (NO) and hydrogen sulfide (H₂S) can mediate a wide range of physiological processes caused by plant metal toxicity. Moreover, legume-rhizobium symbiosis has gained increasing attention in mitigating heavy metal stress. However, systematic regulatory mechanisms used for the exogenous application of signaling molecules to alter the resistance of legume-rhizobium symbiosis under metal stress are currently unknown. In this study, we examined the exogenous effects of sodium nitroprusside (SNP) as an NO donor additive and sodium hydrosulfide (NaHS) as a H₂S donor additive on the phytotoxicity and soil quality of alfalfa (Medicago sativa)-rhizobium symbiosis in lead/cadmium (Pb/Cd)-contaminated soils. Results showed that rhizobia inoculation markedly promoted alfalfa growth by increasing chlorophyll content, fresh weight, and plant height and biomass. Compared to the inoculated rhizobia treatment alone, the addition of NO and H₂S significantly reduced the bioaccumulation of Pb and Cd in alfalfa-rhizobium symbiosis, respectively, thus avoiding the phytotoxicity caused by the excessive presence of metals. The addition of signaling molecules also alleviated metal-induced phytotoxicity by increasing antioxidant enzyme activity and inhibiting the level of lipid peroxidation and reactive oxygen species (ROS) in legume-rhizobium symbiosis. Also, signaling molecules improved soil nutrient cycling, increased soil enzyme activities, and promoted rhizosphere bacterial community diversity. Both partial least squares path modeling (PLS-PM) and variation partitioning analysis (VPA) identified that using signaling molecules can improve plant growth by regulating major controlling variables (i.e., soil enzymes, soil nutrients, and microbial diversity/plant oxidative damage) in legume-rhizobium symbiosis. This study offers integrated insight that confirms that the exogenous application of signaling molecules can enhance the resistance of legume-rhizobium symbiosis under metal toxicity by regulating the biochemical response of the plant-soil system, thereby minimizing potential health risks.

Co-inoculation effect of plant-growth-promoting rhizobacteria and rhizobium on EDDS assisted phytoremediation of Cu contaminated soils

Chelants application can increase the bioavailability of metals, subsequently limiting plant growth and reducing the efficiency of phytoremediation. Plant growth-promoting rhizobacteria (PGPRs) and rhizobium have substantial potential to improve plant growth and plant tolerance to metal stress. We evaluated the effects of co-inoculation with a PGPR strain (Paenibacillus mucilaginosus) and a Cu-resistant rhizobium strain (Sinorhizobium meliloti) on the efficiency of biodegradable chelant (S,S-ethylenediaminedisuccinic acid; EDDS) assisted phytoremediation of a Cu contaminated soil using alfalfa. The highest total Cu extraction by alfalfa was observed in the EDDS-treated soil upon co-inoculation with the PGPR and rhizobium strains, which was 1.2 times higher than that without co-inoculation. Partial least squares path modeling identified plant oxidative damage and soil microbial biomass as the key variables influencing Cu uptake by alfalfa roots. Co-inoculation significantly reduced the oxidative damage to alfalfa by mitigating the accumulation of malondialdehyde and reactive oxygen species, and improving the antioxidation capacity of the plant in the presence of EDDS. EDDS application decreased microbial diversity in the rhizosphere, whereas co-inoculation increased microbial biomass carbon and nitrogen, and microbial community diversity. Increased relative abundances of Actinobacteria and Bacillus and the presence of Firmicutes taxa as potential biomarkers demonstrated that co-inoculation increased soil nutrient content, and improved plant growth. Co-inoculation with PGPR and rhizobium can be useful for altering plant-soil biochemical responses during EDDS-enhanced phytoremediation to alleviate phytotoxicity of heavy metals and improve soil biochemical activities. This study provides an effective strategy for improving phytoremediation efficiency and soil quality during chelant assisted phytoremediation of metal-contaminated soils.

Application of signaling molecules in reducing metal accumulation in alfalfa and alleviating metal-induced phytotoxicity in Pb/Cd-contaminated soil

The utilization of forages grown on metal-contaminated soil can increase the risk of heavy metals entering the food chain and affecting human health because of elevated toxic metal concentrations. Meanwhile, hydrogen sulfide (H₂S) and nitric oxide (NO) as signaling molecules are known to promote plant growth in metal-contaminated soils. However, the regulatory mechanisms of such molecules in plant physiology and soil biochemistry have not been well-documented. Hence, we investigate the role of the exogenous application of H₂S and NO on alfalfa growth in lead/cadmium (Pb/Cd)-contaminated soil. Our results indicate that the signaling molecules increase the alfalfa chlorophyll and biomass content and improve alfalfa growth. Further, H₂S and NO reduce the translocation and bioconcentration factors of Pb and Cd, potentially reducing the risk of heavy metals entering the food chain. These signaling molecules reduce metal-induced oxidative damage to alfalfa by mitigating reactive oxygen species accumulation and increasing antioxidant enzyme activities. Their exogenous application increases soil enzymatic activities, particularly of catalase and polyphenol oxidase, without significantly changing the composition and structure of rhizosphere bacterial communities. Interestingly, H₂S addition enriches the abundance of plant-growth-promoting rhizobacteria in soil, including Nocardioides, Rhizobium, and Glycomyces. H₂S is more effective than NO in improving alfalfa growth and reducing heavy-metal contamination of the food chain. These results provide new insights into the exogenous application of signaling molecules in alleviating metal-induced phytotoxicity, including an efficient strategy for the safe use of forages.

Impact of Urea Addition and Rhizobium Inoculation on Plant Resistance in Metal Contaminated Soil

Legume-rhizobium symbiosis has been heavily investigated for their potential to enhance plant metal resistance in contaminated soil. However, the extent to which plant resistance is associated with the nitrogen (N) supply in symbiont is still uncertain. This study investigates the effect of urea or/and rhizobium (Sinorhizobium meliloti) application on the growth of Medicago sativa and resistance in metals contaminated soil (mainly with Cu). The results show that Cu uptake in plant shoots increased by 41.7%, 69%, and 89.3% with urea treatment, rhizobium inoculation, and their combined treatment, respectively, compared to the control group level. In plant roots, the corresponding values were 1.9-, 1.7-, and 1.5-fold higher than the control group values, respectively. Statistical analysis identified that N content was the dominant variable contributing to Cu uptake in plants. Additionally, a negative correlation was observed between plant oxidative stress and N content, indicating that N plays a key role in plant resistance. Oxidative damage decreased after rhizobium inoculation as the activities of antioxidant enzymes (catalase and superoxide dismutase in roots and peroxidase in plant shoots) were stimulated, enhancing plant resistance and promoting plant growth. Our results suggest that individual rhizobium inoculation, without urea treatment, is the most recommended approach for effective phytoremediation of contaminated land.

Patterns of soil microbial nutrient limitations and their roles in the variation of soil organic carbon across a precipitation gradient in an arid and semi-arid region

The effects of precipitation patterns on the metabolism of soil microbes are poorly understood, especially in water-limited ecosystems where soil microorganisms play crucial roles in the turnover of soil organic carbon (SOC) and nutrients. We investigated the influence of the gradient levels of mean annual precipitation (MAP from 300 to 900 mm) on soil microbial metabolism in an arid and semi-arid grassland region located in Loess Plateau, China and identified relationships between microbial metabolic limitations and the variation of soil organic matter (SOM). Microbial metabolism in this arid and semi-arid region was limited by soil C and phosphorus (P) or nitrogen (N). Microbial C and P limitations decreased with the increase of MAP. Microbial C and P limitations were lowest in the areas with MAPs of 700-900 mm, whereas N limitation was observed in the areas with MAPs >700 mm. The results of a variation-partitioning analysis and partial least squares path modeling indicated that the microbial C and N/P limitations on regional scales were mainly determined by climate factors (MAP and mean annual temperature (MAT)), followed by vegetation biomass and soil properties. The extents of soil drying-rewetting processing caused by different MAPs directly affected microbial nutrient limitation. Our results suggested that the influence of precipitation variation on microbial metabolic limitation strongly governed SOM stability and that an increase in the rate of SOM decomposition with increasing precipitation could be caused by increased microbial nutrient limitation. SOM may be most stable at a MAP of 700 mm in the arid and semi-arid regions (300-900 mm MAP) where microbial nutrient limitation was lowest. This study provided novel insights into the responses of soil microbial metabolism to precipitation change and is an important step toward understanding the mechanisms of SOM stability in an arid and semi-arid grassland ecosystem under scenarios of precipitation variation.

Impact of co-inoculation with plant-growth-promoting rhizobacteria and rhizobium on the biochemical responses of alfalfa-soil system in copper contaminated soil

The effects and regulatory mechanisms of co-inoculation of plant-growth-promoting rhizobacteria (PGPRs) and rhizobium in plant-soil systems remain unclear, despite numerous reports that PGPRs or rhizobium can alleviate metal toxicity. We used the co-inoculation of the PGPR Paenibacillus mucilaginosus and the metal-resistant rhizobium Sinorhizobium meliloti for exploring the physiological and biochemical responses of the plant-soil system in metal-contaminated soil. The co-inoculation with the PGPR and rhizobium significantly increased the nutrient (N, P, and K) contents in plant tissues and promoted plant growth in soil contaminated with copper (Cu). Stress from Cu-induced reactive oxygen species and lipid peroxidation were largely attenuated by the co-inoculation by increasing the activities of antioxidant enzymes. The contents and uptake of Cu in plant tissues increased significantly in the co-inoculation treatment compared with the uninoculated control and individual inoculation treatment. Co-inoculation with PGPR and rhizobium significantly increased soil microbial biomass, enzymatic activities, total nitrogen, available phosphorus, and soil organic matter contents compared with the uninoculated control. Interestingly, co-inoculation also affected the composition of the rhizospheric microbial community, and slightly increased rhizospheric microbial diversity. These improvements of the soil fertility and biological activity also had a beneficial impact on plant growth under Cu stress. Our results suggested that alfalfa co-inoculated with PGPR and rhizobium could increase plant growth and Cu uptake in metal-contaminated soil by alleviating plant Cu stress and improving soil biochemical properties. These results indicate that the co-application of PGPR and rhizobium can have a positive effect on the biochemical responses of alfalfa-soil systems in soil contaminated by heavy metals and can provide an efficient strategy for the phytomanagement of metal-contaminated land.

Natural grassland as the optimal pattern of vegetation restoration in arid and semi-arid regions: Evidence from nutrient limitation of soil microbes

Soil microbial metabolism is vital for nutrient cycling and aboveground ecosystem stability. A general understanding of microbial metabolism and nutrient limitation under human disturbance in arid and semi-arid regions, which are the largest and most fragile oligotrophic ecosystems globally, however, is still limited. We quantified and compared the characteristics of nutrient limitation of soil microbes under natural/artificial grassland and shrubland, an ecological forest, an economic forest, and sloped cropland in typical arid and semi-arid ecosystems on the Loess Plateau, China. Vegetation restoration significantly affected the activities of extracellular enzymes and ecoenzymatic stoichiometry mainly by affecting soil nutrients and nutrient stoichiometry. A vector analysis of enzyme activity indicated that microbial communities were co-limited by carbon (C) and phosphorus (P) in all types of vegetation restoration. Linear regression indicated that microbial C and P limitations were significantly correlated with the stoichiometry of soil nutrient, suggesting that the balance of nutrient stoichiometry is an important factor maintaining microbial metabolism and elemental homeostasis. C and P limitations in the microbial communities were the lowest in the natural grassland. This implies that both vegetation and microbial communities under the restoration pattern of natural grassland were more stable under environmental stress, so the restoration of natural grassland should be recommended as the preferred option for ecosystem restoration in these arid and semi-arid regions.

The effect of selenium supplementation on coronary heart disease: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Selenium is a crucial mineral with antioxidant and immune functions, and selenium deficiency may increase the risk of coronary heart disease (CHD). However, the effect of selenium supplementation on CHD is still controversial according to numerous randomized controlled trials (RCTs). The aim of our meta-analysis study was to investigate the impact of selenium on CHD.

METHODS

PUBMED, EMBASE, MEDLINE, and the Cochrane Central Register of Controlled Trials databases were systematically searched to identify RCTs evaluating the effect of selenium supplementation on CHD mortality, blood lipid profile (high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and total cholesterol), serum C-reactive protein (CRP), and the level of glutathione peroxidase (GSH-PX) from inception until September 20, 2016. Odds ratio of CHD mortality and the associated 95% confidence intervals (CIs) were calculated using the fixed effect model. Weighted mean difference or standardized mean difference (SMD) and 95% confidence intervals (CIs) were calculated to determine the lipid profile, serum CRP, and GSH-PX using fixed effect or random effect models depending on the observed heterogeneity.

RESULTS

A total of 16 eligible RCTs with 43998 participants were included. Significant effects were observed for serum CRP (SMD=-0.48; 95% CI, -0.96 to 0; p=0.049) and GSH-PX (SMD=0.5; 95% CI, 0.36-0.64; p<0.001) after selenium supplementation. However, selenium supplementation was not statistically associated with CHD mortality and an aberrant lipid profile.

CONCLUSION

Selenium supplementation decreased serum CRP and increased the GSH-PX level, suggesting a positive effect on reducing oxidative stress and inflammation in CHD. However, selenium supplementation is not sufficient to reduce mortality and to improve the lipid status.

Multidisciplinary Cooperation in a Simultaneous Combined Liver and Kidney Transplantation Patient of Primary Hyperoxaluria 1

Primary hyperoxaluria type 1 is an autosomal recessive hereditary glyoxylate metabolism disorder characterized by excessive production of oxalate, caused by the deficiency of liver specific peroxisomal enzyme: alanineglyoxylate aminotransferase. For patients with end-stage renal disease, combined liver and kidney transplantation was needed. This report describes one patient, with a diagnosis of end-stage renal disease and primary hyperoxaluria 1 confirmed by PCR and direct sequencing with genomic DNA, received the simultaneous combined liver and kidney transplantation after seven months' waiting. However, there were several complications observed post surgery, such as protracted bleeding, common bile duct anastomotic stenosis, biliary calculi and recurrence of urolithiasis. All these were well solved by relevant department, and finally a satisfactory outcome was achieved. Multidisciplinary cooperation plays an important role on the PH1 patient management, especially when multiple complications are encountered.

Calpain 2-mediated autophagy defect increases susceptibility of fatty livers to ischemia-reperfusion injury

Hepatic steatosis is associated with significant morbidity and mortality after liver resection and transplantation. This study focuses on the role of autophagy in regulating sensitivity of fatty livers to ischemia and reperfusion (I/R) injury. Quantitative immunohistochemistry conducted on human liver allograft biopsies showed that, the reduction of autophagy markers LC3 and Beclin-1 at 1 h after reperfusion, was correlated with hepatic steatosis and poor survival of liver transplant recipients. In animal studies, western blotting and confocal imaging analysis associated the increase in sensitivity to I/R injury with low autophagy activity in fatty livers. Screening of autophagy-related proteins showed that Atg3 and Atg7 expression levels were marked decreased, whereas calpain 2 expression was upregulated during I/R in fatty livers. Calpain 2 inhibition or knockdown enhanced autophagy and suppressed cell death. Further point mutation experiments revealed that calpain 2 cleaved Atg3 and Atg7 at Atg3Δ92-97 and Atg7Δ344-349, respectively. In vivo and in vitro overexpression of Atg3 or Atg7 enhanced autophagy and suppressed cell death after I/R in fatty livers. Collectively, calpain 2-mediated degradation of Atg3 and Atg7 in fatty livers increases their sensitivity to I/R injury. Increasing autophagy may ameliorate fatty liver damage and represent a valuable method to expand the liver donor pool.

Gender Differences in the Toxicokinetics of Triptolide after Single- and Multiple-dose Administration in Rats

Triptolide is a natural compound extracted from the traditional Chinese medicine Tripterygium wilfordii Hook F with distinguishing pharmacological activities and evident toxicities. We reported previously that 28 continuous days of oral administration of triptolide in rats resulted in gender dimorphic profiles in toxicities. To better understand this issue, the toxicokinetics of triptolide was observed in this study. Rats of both sexes were administered 400 μg/kg triptolide either as a single dose or multiple doses for 28 days. Triptolide concentrations in rat plasma were determined using high performance liquid chromatography-tandem mass spectrometry (LC-MS/MS). The plasma concentration-time curve and toxicokinetic parameters revealed gender differences after single and repeated triptolide administration, including significantly higher area under the plasma concentration-time curve (AUC0-∞) and peak plasma concentration (Cmax), lower clearance rate (CL) and longer terminal elimination half-life (t1/2) of triptolide in females, and lower drug exposure levels and greater CL in males. The gender differential disposition of triptolide may be the cause of increased toxicity in females. Moreover, auto-inhibition of metabolism and the resulting increase in drug exposure were observed after repeated dosing. The AUC0-∞ of triptolide was increased 6-fold in females and 2-fold in males, while the CL of triptolide was significantly decreased by 84% in females and 55% in males. These results indicated that gender-related differences existed in the toxicokinetics of triptolide and long-term oral administration of triptolide resulted in drug accumulation, which might account for the gender differences in the toxicities of triptolide.

Augmented efficacy with the combination of blockade of the Notch-1 pathway, bortezomib and romidepsin in a murine MT-1 adult T-cell leukemia model

Adult T-cell leukemia (ATL) is an aggressive malignancy caused by human T-cell lymphotropic virus I (HTLV-1). There is no accepted curative therapy for ATL. We have reported that certain ATL patients have increased Notch-1 signaling along with constitutive activation of the NF-κB pathway. Physical and functional interaction between these two pathways provides the rationale to combine the γ-secretase inhibitor Compound E with the proteasome inhibitor Bortezomib. Moreover, Romidepsin, a histone deacetylase inhibitor, has demonstrated major antitumor action in leukemia/lymphoma. In this study, we investigated the therapeutic efficacy of the single agents and combinations of these agents in a murine model of human ATL, the MT-1 model. Single and double agents inhibited tumor growth as monitored by tumor size (P < .05), and prolonged survival of leukemia-bearing mice (P < .05) compared with the control group. The combination of three agents significantly enhanced the antitumor efficacy as assessed by tumor size, tumor markers in the serum (human sIL-2Rα and β₂M), and survival of the MT-1 tumor bearing mice, compared with all other treatment groups (P < .05). Improved therapeutic efficacy obtained by combining Compound E, Bortezomib and Romidepsin supports a clinical trial of this combination in the treatment of ATL.

A chiral HPLC-MS/MS method for simultaneous quantification of warfarin enantiomers and its major hydroxylation metabolites of CYP2C9 and CYP3A4 in human plasma

Warfarin is an oral anticoagulant that requires frequent therapeutic drug monitoring due to a narrow therapeutic window, considerable interindividual variability in drug response, and susceptibility to drug-drug and drug-diet interactions. Enantiomeric separation and quantification of warfarin enantiomers and clinically important major hydroxylation metabolites are essential for drug interaction studies and phenotypic characterization of CYP2C9 and CYP3A4, the major cytochrome P450 (CYP) enzymes involved in warfarin metabolism. Here, we describe the development and validation of a chiral high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS)-based quantification of R-warfarin, S-warfarin, S-7-hydroxywarfarin (the major CYP2C9 metabolite) and (9R;10S)-10-hydroxywarfarin (the CYP3A4 metabolite) in human plasma. Simple protein precipitation-based extraction showed good recovery of analytes (82.9 - 96.9%). The developed method exhibited satisfactory intra-day and inter-day accuracy and precision. The lower limits of detection were 0.25 nM (or ~0.08 ng/mL) for the warfarin enantiomers and 0.1 nM (or ~0.04 ng/mL) for S-7-hydroxywarfarin and (9R;10S)-10-hydroxywarfarin using only 50 µL plasma during extraction. The validated method was successfully applied to analyze plasma samples obtained from a healthy human subject who enrolled in a clinical drug interaction study involving warfarin.

Vitamin or antioxidant intake (or serum level) and risk of cervical neoplasm: a meta-analysis

BACKGROUND

Case-control studies have reported the preventive effect of vitamin or antioxidant intake on cervical neoplasms such as cervical intraepithelial neoplasia (CIN) and invasive cervical cancer. However, the findings are inconsistent.

OBJECTIVE

To investigate quantitative effects of vitamin or antioxidant intake on cervical neoplasm using meta-analysis.

SEARCH STRATEGY

We searched PubMed, EMBASE and the Cochrane Library in November 2008. All articles searched were independently reviewed and selected by two evaluators according to predetermined selection criteria.

SELECTION CRITERIA

We included case-control studies reporting an association between vitamin or antioxidant intake (or serum level) and cervical neoplasm risk and reporting the adjusted odds ratios (OR) and 95% confidence intervals (CI), whenever possible.

DATA COLLECTION AND ANALYSIS

After retrieval of data from selected articles, we performed a meta-analysis using both fixed-effects and random- effects models.

MAIN RESULTS

Of 274 articles meeting our initial criteria, we included 22 case-control studies involving a total of 10,073 participants. In meta-analyses by type of vitamin or antioxidant, a significant preventive effect on cervical neoplasm was found in intakes of vitamin B12 (OR 0.35, 95% CI 0.19-0.63; n=2), vitamin C (OR 0.67, 95% CI 0.55-0.82; n=8), vitamin E (OR 0.56, 95% CI 0.35-0.88; n=10), and beta-carotene (OR 0.68, 95% CI 0.55-0.84; n=9).

AUTHORS' CONCLUSIONS

The findings of this meta-analysis indicate that overall, there were preventive effects of vitamin or antioxidant intake on cervical neoplasms in case-control studies.

Effects of antioxidant supplements on cancer prevention: meta-analysis of randomized controlled trials

BACKGROUND

This meta-analysis aimed to investigate the effect of antioxidant supplements on the primary and secondary prevention of cancer as reported by randomized controlled trials.

METHODS

We searched Medline (PubMed), Excerpta Medica database, and the Cochrane Review in October 2007.

RESULTS

Among 3327 articles searched, 31 articles on 22 randomized controlled trials, which included 161 045 total subjects, 88 610 in antioxidant supplement groups and 72 435 in placebo or no-intervention groups, were included in the final analyses. In a fixed-effects meta-analysis of all 22 trials, antioxidant supplements were found to have no preventive effect on cancer [relative risk (RR) 0.99; 95% confidence interval (CI) 0.96-1.03). Similar findings were observed in 12 studies on primary prevention trials (RR 1.00; 95% CI 0.97-1.04) and in nine studies on secondary prevention trials (RR 0.97; 95% CI 0.83-1.13). Further, subgroup analyses revealed no preventive effect on cancer according to type of antioxidant, type of cancer, or the methodological quality of the studies. On the other hand, the use of antioxidant supplements significantly increased the risk of bladder cancer (RR 1.52; 95% CI 1.06-2.17) in a subgroup meta-analysis of four trials.

CONCLUSIONS

The meta-analysis of randomized controlled trials indicated that there is no clinical evidence to support an overall primary and secondary preventive effect of antioxidant supplements on cancer. The effects of antioxidant supplements on human health, particularly in relation to cancer, should not be overemphasized because the use of those might be harmful for some cancer.

The efficacy of systemic lymphadenectomy for overall survival in epithelial ovarian cancer: A systematic review and meta-analysis by KOGYMAG

e16509

Background: The role of systemic lymphadenectomy remains unclear for improving overall survival in epithelial ovarian cancer (EOC) till now. To evaluate the efficacy of systemic lymphadenectomy for survival in EOC, Korean Gynecologic Meta-analysis Group (KOGYMAG) performed a meta-analysis of all studies which compared systemic lymphadenectomy versus non-systemic lymphadenectomy (not performed or lymph node sampling). Methods: Studies were retrieved by searching PubMed, Embase, and Cochrane Controlled Trials Register (CENTRAL) electronic database. The literature search was conducted between 1995 and 2008. The meta-analysis was carried out on 11 studies (2 randomized controlled and 9 retrospective studies) and a total of 30,534 patients with EOC who underwent staging laparotomy including systemic lymphadenectomy or nonsystemic lymphadenectomy. The study endpoint was overall survival, and we extracted adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for overall survival from all studies and obtained pooled estimates using an inverse-variance model. Results: In all studies, systemic lymphadenectomy was a favorable factor for overall survival as compared to non-systemic lymphadenectomy (HR, 0.76, 95% CI, 0.65 to 0.88; random-effects model). When we performed sub-analysis according to disease status, patients treated with systemic lymphadenectomy showed improved overall survival compared to those with non-systemic lymphadenectomy in 3 studies where only patients with early-stage EOC (FIGO stage I-II) were included (HR, 0.70; 95% CI, 0.63 to 0.77; fixed-effects model). Furthermore, systemic lymphadenectomy was also a significant factor for improved overall survival in 5 studies where only patients with advanced-stage EOC (FIGO stage III-IV) were enrolled (HR, 0.91; 95% CI, 0.85–0.96; fixed-effects model). Conclusions: These results support that systemic lymphadnectomy may improve overall survival in patients with EOC. However, there are some limitaions including few randomized controlled studies and the deviation of weight in this meta-analysis. Thus, large-scale randomized controlled trials are required to evaluate the efficacy of systemic lymphadenectomy in EOC.

No significant financial relationships to disclose.