Harmonia sedecimnotata (F.) was studied in biology, life table, consumption rates, molecular characterization, and field evaluation. The net reproductive rate (R0), based on the age-stage and two-sex life table, was 43.2 eggs/individual. The female adults lived longer (68.1 d) than the male adults (62.9 d). The rate of consumption increased with progress in each stage of development. Compared to the other larval stages of the predator, the fourth stadium consumed most quantities of Aphis gossypii Glover nymphs (Hemiptera: Aphididae) (200.4). Both female (2214.6) and male (1792.4) consumed more prey (nymphs) than larvae. The net rate of consumption was 1458.92 nymphs of melon aphids. There was no variation in the sequences of the two nucleotides out of 583 bp, H sedecimnotata China (EU392410) and India (MG720024). Our investigations demonstrated that inoculative release of 30 or 40 or 50 adults per 100 m2 attained high reduction of aphids (>90%). Thus, it may be recommended the release rate of 40 adults per 100 m2 to suppress the eggplant aphid population. H. sedecimnotata is therefore one of the most promising biological control agents for cotton aphids that can be achieved for instant control through an inoculative release of adults.The ladybird beetle,  In both field and protected conditions, they are economically important insect pests4. The aphid is one of the most important sucking pests and in many ways lower yields of agricultural and horticultural crops. High population densities may damage plants by removing plant nutrients to cause withering and death. Aphids inject toxins from their salivary secretion that cause curling, crinkling and malformations of the plant. They cause secondary plant injury by transmitting many plant diseases. Farmers rely on a variety of insecticides to control these pests5. Most of them adversely affect natural enemies such as predators, parasitoids, entomopathogens and have also resulted in residue, resurgence, resistance, and unwanted effects on human and non-target organisms7. Biological control is a good substitute for toxic insecticides that can protect plants, human beings and the environment11. Among the most important beneficial insects that feed on sucking insect pests are coccinellid predators12. There are several habitats where the coccinellid beetles are found13. They feed on sap-sucking insects like aphids, mealybugs, scales, thrips and mites14, as well as other soft-body insects15.Many of the sucking insect pests cause severe damage to the crop by injecting toxins through their salivary secretions14. Around 4,000 predatory ladybird beetle species have been reported from the Indo-Pak subcontinent, including >300 species16. The harlequin lady beetle, Harmonia axyridis Pallas (Coleoptera: Coccinellidae) in the genus Harmonia Mulsant is one of the most popular biocontrol agents for greenhouse pest that has become a dangerous invader17. Very few studies have been carried out in the other species of the Harmonia genus. The sporadic occurrence of Harmonia sedecimnotata (F.) (Coleoptera: Coccinellidae) from India has recently been reported18. Most of the H. sedecimnotata occurs in okra, eggplant, chili, tomato, guava, ornamental, etc.18. Polyphagous ladybird predators who feed on various aphid prey species on crop plants exhibit biological fitness variations and are therefore likely to vary in their genotypes20. An important source for biocontrol agents will be the most effective genotypes of a predator species with higher predation potential21. In comparison to other insect species, limited molecular studies were carried out in the members of the Coccinellinae subfamily of the Coccinellidae22. A partial COI gene was identified and the taxonomic relationship of 16 species was analyzed through four subfamilies23. The 5′ region of the COI gene is considered informative and has also been commonly used to detect molecular genetic variation within and between species24. For assessing the host-associated variations for insect species, the COI gene has also been effectively employed25. In this investigation, we used the COI gene for molecular characterization of H. sedecimnotata. The purpose of this study is to select aspects of the consumption rate, biology, life table studies of the H. sedecimnotata fed on Aphis gossypii Glover (Hemiptera: Aphididae), field evaluation and its molecular characterization. Hopefully, this study would help to enhance Integrated Pest Management (IPM) strategies by using this predator as a potential biological control agent for aphid management.More than 5,200 species have been described worldwide in the Coccinellidae familyA. gossypii. The age-specific consumption rate, kx (mean number of aphids fed by H. sedecimnotata age x) and age-specific net consumption rate, qx (weighted number of prey fed by H. sedecimnotata age x) were formulated by considering sex and stage differentiation , the transformation rate (Qp) and the total consumption of the cohort were 1458.92, 33.77 and 36473 nymphs of melon aphids respectively   Fig. . In the 01) Fig. . Fourth During the 4th day and the 6th day the first stadium consumed more and least prey respectively Fig. . At 3rd F = 77.429; df = 5, 54; P < 0.001) was significantly different  for eggs was 1.0. The probability of Sxj was differed between larval stadia and also differed between adults. The overlap between different stages showed that more variability was found among individuals in the developmental rates , age - specific survival (lx), and age - specific maternity (lxmx) ranged from 0.04 to 0.88, 1.62 to 10.71 and 0.84 to 6.00, respectively , the finite rate of increase (λ), the net rate of reproduction (R0) and the mean time of generation (T) for all individuals were 0.1096 day, 1.1159 day, 43.20 eggs/individual and 34.35 day, respectively.The probability of age-stage survival rate  trees contributed low as well as high bootstrap values of COX gene region. Alignment of the sequences H. sedecimnotata China (EU392410) and India (MG720024) shows that there was no variation in two nucleotides outs of 583 bp  on the eggplant  could reproduce. Both larvae and adults were voracious feeders on all stages of cotton aphids. The prey consumption values were significantly higher with the advancement in each larval stage except the second stadium, which consumed fewer aphids. An increase in feeding potential with age of the larvae was demonstrated in Cryptolaemus montrouzieri Mulsant (Coleoptera: Coccinellidae)26 which is in accordance with our findings. Compared to the other larval stages of the predator, the fourth stadium consumed most aphids. These results are consistent with earlier findings that reported more than 653.25 Cervaphis quercus (Takahashi) (Hemiptera: Aphididae)27, 88.75 Brevicoryne brassicae (L.) (Hemiptera: Aphididae)28 and 92.13 Tuberculatus nervatus Chakrabarti and Raychaudhuri (Hemiptera: Aphididae)29 were consumed in the fourth stadium of Harmonia dimidiata (F.) (Coleoptera: Coccinellidae). In the later larval stadia, the consumption rate increased and continued in the adult stage, resulting in one individual being able to kill 4338.6 aphids throughout life.By feeding on F = 77.429; df = 5, 54; P < 0.001) compared to male and larval stages. This is in line with the earlier finding that Cheilomenes sexmaculata (F.) (Coleoptera: Coccinellidae) female killed a maximum of 1624, Aphis craccivora Koch (Hemiptera: Aphididae) than larval stages and male30. The consumption rate of adults in the current investigation was higher than the larval stages. Similarly, when fed on A. craccivora, the feeding effectiveness of C. sexmaculata adults was higher than that of larvae30. Using the life tables due to non-predatory stages (eggs and pupae), two gaps in consumption rate were depicted. This will determine the life tables’ significance and also helped to determine the release time in a biocontrol program.Most aphids were consumed by the females (C. sexmaculata adults had a higher consumption rate than larvae fed on A. craccivora30. The release of coccinellid adults (@ 10 adults/tree or 1500 adults/ha) could suppress the populations of sucking pests31. Thus, adults have the potential to be used to suppress sucking pests in biocontrol programs.An overall adult consumption rate was higher than the larva feeding rate because adults were able to live longer in the ecosystems and search for their prey. In addition, more eggs were laid by the female beetles and emerged larvae could search for their prey. H. dimidiata was demonstrated when reared on B. brassicae28 than our results indicate shorter lifespans fed on A. gossypii by H. sedecimnotata. Our study showed that H. sedecimnotata could reproduce a lifelong fecundity of 1080 eggs. The age-specific fecundity (mx) and age-specific maternity (lxmx) showed irregular peaks in female fecundity similar to those shown by Lemnia biplagiata (Swartz) (Coleoptera: Coccinellidae), another coccinellid32. The first emerged adult’s survival rate (la) was 0.65. Since its most important hypothesis, this will help in further statistical analysis.The female adults lived longer than the male adults in our investigation. A longer female longevity (81.0 d) and male longevity (73.0 d) of 21. The stage survival rates and overlaps would not have been found if traditional life tables were used in this study. The life table of Tamarixia radiata Waterson (Hymenoptera: Eulophidae) was recorded using the female age-specific life table33. Since the female age-specific life table avoids the male population and could not adequately explain the stage difference, it is possible to obtain ‘adult age’ in measuring population parameters and no clear F and R0 relationship. Problems were addressed in adapting female life tables to insect populations34. It was possible to observe the stage differentiation of H. sedecimnotata by using the age-stage, two-sex life table and the emergence and termination of various stages. Nevertheless, this gives a single age-specific survival rate when the survival rates from different stages are combined. At an older age, the survival rate can only be equal or lower than at an earlier age (x). It is also possible to observe certain monotonous properties of the lx curve in all studies focused on age-specific life table.The development rate among individuals and the role of male individuals in a population is ignored by traditional female age-specific life tablesAdalia bipunctata L. (Coleoptera: Coccinellidae) can be grown massively on Encallipterus tillae (L.) and Euceraphis betulae (L.) (Hemiptera: Aphididae) as they were more suitable prey for A. bipunctata based on their rates of development and survival and more abundance in ecosystems35. Based on data from the life table, Scymnus apetzi Mulsant (Coleoptera: Coccinellidae), S. subvillosus (Goeze), and Exochomus nigromaculatus (Goeze) (Coleoptera: Coccinellidae) have the potential to be used in the IPM program to manage Hyalopterus pruni (Geoffer) (Hemiptera: Aphididae)36.Different methods and parameters were used to estimate population growth potential and insect mass rearing efficiencies. For example, 37. The mitochondrial genes provide support throughout the topology below the genus level and this will help confirm the species’ current positions in coccinellid evolution. In this investigation, 100 percent similarity was found between the sequences of the two nucleotides, H. sedecimnotata China (EU392410) and India (MG720024) out of 583 bp. These patterns might be controlled by the function of the gene and might also be caused by mitochondrial genes38. The 16 S rDNA was used to investigate higher taxonomic levels of Anisoptera and Odonata groups39. Most important to know about the entire phylogeny of ladybird beetles is the incorporation of morphological characteristics, ecological characteristics and DNA sequence.The mitochondrial genes and the 16 S rDNA gene were used to investigate the insect relationships between the genus level and the level of the speciesHarmonia sedecimnotata is suitable for mass rear in the laboratory, which is an essential requirement for inoculative releases. The most important considerations for inoculation are the number of beetles to be released and the timing of releases. Inoculative releases of H. sedecimnotata showed a higher reduction in the aphid population in the eggplant. Earlier, Rodolia iceryae Janson (Coleoptera: Coccinellidae) was reintroduced as an inoculative release into a plantation where the beetle was absent, and within one year the population of lcerya pattersoni Newstead (Hemiptera: Monophlebidae) was reduced to below the economic threshold40. Ladybird beetle predation can slow population growth and reduce aphid densities in the early growing season and the growth of a crop41. After 3 releases of 30 Hippodamia varigata (Goeze) (Coleoptera: Coccinellidae) larvae on rose leaves and flower buds, more than 95% aphid reduction was achieved42. In this study, the release rates of 30 or 40 or 50 adults on eggplant achieved a high reduction in aphid (>90%). Thus, to suppress the aphid population on eggplant, we recommend the release rate of 40 adults per 100 m2.H. sedecimnotata fed on A. gossypii in our investigations, and this predator also had higher consumption rates. In order to know the complete phylogeny of the ladybird beetles, research on ecological character, morphological character and character in the DNA sequence is essential. H. sedecimnotata is a good biocontrol agent that can be used in an inoculative release (40 beetles/100 m2) to control A. gossypii. This biological information revealed that H. sedecimnotata has the potential to be exploited on various crops in India to control sucking insects.The life tables and consumption rates were the most important parameters for predator-prey dynamics models, but most pest management based biocontrol programs do not use these life tables. We determined the development rate, survival rate, life tables, and biology of A. gossypii culture was maintained at a temperature of 25 ± 5 °C and 75 ± 5% RH on potted okra plants in a polyhouse of 20 mesh cm−2. In the experimental field of the ICAR Research Complex for NEH Region, Mizoram Centre, Kolasib, Mizoram, India, Okra (cv. Parbhani Kranti) was grown on a plot sized 10 × 10 m. Okra plants were exposed to natural aphids infestation and on okra plants the aphids began colonizing.An Adult beetles were obtained from various host plants and grown on aphids at 23 ± 5 °C temperature and 70 ± 5% RH in the Biological Control Laboratory, ICAR Research Complex for the NEH Region, Mizoram Centre, Kolasib, Mizoram, India. The beetles were fed daily with aphids in plastic containers (7 cm in diameter and 10 cm height) covered by a fine nylon netting for ventilation.H. sedecimnotata.The 10 pairs of males and females that emerged freshly were kept in a plastic container. The plastic containers were secured for ventilation by fine nylon netting and kept at a temperature of 23 ± 1 °C at 70 ± 1% RH. These pairs fed nymphs of melon aphids along with okra leave as food for the nymphs. For the biology and life tables, 85 freshly laid eggs were collected and held in a plastic container under the same conditions. Newly emerging larvae were kept for individual rearing in a new plastic container. The first stadium, second stadium, third stadium, fourth stadium, and adults were provided with 30, 40, 50, 75, and 100 nymphs of melon aphids per cup daily. The observations on prey consumption were recorded daily in all larval stages until the stadium changes and in the case of adult beetles until death. Small plastic pipette tubes were kept for oviposition . The time taken from egg laying to hatching was recorded as well as the duration of larval and pupal stages. Also calculated were the total life cycle, pre-oviposition, oviposition, post-oviposition, fecundity, and adult longevity. The experiment was repeated twice (November to February 2013 and 2014) under laboratory conditions and the mean of both experiments was used to determine life table and consumption rate of 44 were shown using the TWOSEX-MSChart computer program45. It calculated the age-stage-specific survival rate (Sxj), the age-stage-specific fecundity (fxj), the age-specific survival rate (lx), the age-specific fecundity (mx), the net reproductive rate (R0), the intrinsic rate of increase (r), the finite rate of increase (λ), and the mean generation time (T)43.Based on raw data, the age-stage and two-sex life tables46. It calculated the age-specific consumption rate (kx), the age-stage-specific consumption (Cxj), the age-specific net consumption rate (qx), the net consumption rate (C0), the cumulative consumption rate (Cy) and the transformation rate (Qp)47.Total, per-day and percentage of aphid consumption was calculated for each stage of life of predatory beetle. The daily consumption rates were calculated using the CONSUME-MSChart computer program48. In a sterile microcentrifuge, the female of H. sedecimnotata were grounded by adding 200 μL of preheated CTAB buffer. The samples were kept for 45 minutes at 65 °C. The tubes were centrifuged at 4 °C for 15 min at 16,000 g after adding an equal volume of chloroform: isoamyl alcohol mixture (24:1). A one-third volume of ice-cold isopropanol was added in the clear aqueous phase and the tubes were incubated at −20 °C overnight. The tubes were then centrifuged at 16,000 g at 4 °C for 20 minutes. It was dissolved in 20 μL of 1X TE buffer (pH 8.0) after washing the DNA pellet with 70% ethanol.The DNA was extracted with a slight modification using the cetyl trimethylammonium bromide (CTAB) method49. In a thermocycler  polymerase chain reactions (PCR) were performed. PCR reactions were conducted with a volume of 25.0 μL containing a buffer , 200 µM dNTPs, 1.5 mM MgCl2, 10 pmol of both forward and reverse primers, 1 unit Taq DNA polymerase, and 4 ng of the extracted DNA. The PCR cycle included pre-denaturation at 94 °C for 2.0 min, 40 amplification cycles . A co-migrating 100 bp DNA ladder (MBI Fermentas) was compared to the size of the DNA fragment.A set of COI primers [(F: C1-J-2183): CAA CAT TTT TTT TTT TTT GG and R (TL-2-N-3014-ANT): TGA AGT TTA AGT TCA ATG CAC] was used to amplify the DNA samplesH. sedecimnotata Indian isolate was deposited in the NCBI database and the accession number was MG720024. Homology searches conducted using the Basic Local Alignment Search Tool (BLAST) and differences in H. sedecimnotata COX-1 sequences were determined using the BioEdit version 7.0.5.3 sequence alignment editor.Sequences for 50. The statistics of molecular character, pairwise nucleotide sequence divergence, and base frequencies for each gene fragment were estimated using MEGA 4.0 software. Neighbor-Joining (NJ) and Minimum-Evolution (ME) for phylogenetic construction implemented in MEGA 4.0.The Clustal W program (a MEGA 4.0 sub-program) has been used to align the sequence and where necessary the alignment has been refinedThis study was conducted on an experimental farm located in the ICAR Research Complex for NEH Region, Mizoram Centre, Kolasib, Mizoram, India at an altitude of 650 m, 24.12°N latitude and 92.40°E longitude and has a mild-tropical agroclimate. For the seasons 2013–2014 (season 1) and 2014–2015 (season 2), field experiments were conducted in eggplant (var. Pusa Purple Round). Treatment of 5 replicates arranged in a randomized complete block design (RCBD) has been applied. During two seasons, average daily temperatures in the open field ranged from 20.8 to 32.3 °C with relative humidity ranging from 74 to 85.0%; low rainfall during the observation period.2). The first release was made during the vegetative stage when the aphid population was above the economic threshold (10–29% affected plants). The second release covered new leaves and shoots and increased populations in newly emerging aphids nymphs and adults, making it 30 days after the first release. In the same plants/plots, both releases were made. During the study, the control was free to release coccinellids. In order to avoid the movement of predators from one treatment to another, each treatment was separated by a distance of 25 m and no insecticide spray was given throughout the experimental period.The predator’s two releases were made at 30 days apart. Each release was released at five rates of 10, 20, 30, 40, and 50 adults (1 F: 1 M) per plot  by selecting ten plants from each replication. The plants were randomly examined on each sample date for nymph and adult stages of melon aphids in each plot. Mean aphid population per leaf was estimated by an average of three leaves . The aphid population was recorded with the aid of a magnifying glass . Data were estimated weekly in the canopy area between 8.0 and 10.0 h. For each release, the percentage reduction in aphids over control was calculated.51 for biology, and consumption rate with completely randomized design (CRD) and field assessment with RCBD. Data on total, per-day, and percentage consumption for larvae or adults were analyzed using analysis of variance (ANOVA) and the ANOVA was performed on the original values and the means were analyzed by least squares means (LSD) and the mean separated using Tukey’s HSD test at P ≤ 0.001. Field assessment data were transformed into square root and arc sine wherever required, as described by Poisson for statistical analysis52. ANOVA was done on the transformed values of field evaluation data and the same values were analyzed by least squares means (LSD) and separated using Tukey’s HSD test at P ≤ 0.001.Data were analyzed using SAS Software Version 9.3


Transcatheter closure (TCC) and surgical closure (SC) are the two main approaches for congenital coronary artery fistula (CCAF), but data on the comparisons of the efficacy and safety of these two approaches are limited.We retrospectively reviewed pediatric patients with CCAF in Guangdong Cardiovascular Institute between January 2002 and December 2017. Patients who were qualified into our criteria were included into final analysis. The rate of successful closure and complications during hospitalization and at follow-up were compared between SC and TCC groups.In total, 121 pediatric patients  with CCAF were divided to TCC (n = 63) and SC groups (n = 58) according to the indications. The mean age was 5.3 ± 1.4 years. The baseline characteristics of these two groups were similar except for the fistula anatomic feature. After adjusted for the fistula anatomy, compared to SC, TCC was associated with higher risk of major complications (p = 0.013). Proportions of patients requiring blood transfusion and intra-operative blood loss were higher in SC versus TCC groups, as were longer duration of hospital and ICU stay during hospitalization. In contrast, myocardial ischemia , residual shunts  and new-onset moderate-to-severe valve regurgitation  were higher in TCC group versus SC groups during follow-up.TCC has less invasive and faster recovery. However, SC had a higher successful rate and lower risk of major complications in pediatric patients. Congenital coronary artery fistula (CCAF) is a rare congenital anomaly with a connection between coronary arteries and a cardiac chamber or intrathoracic great vessel. Some reports have shown that CCAF was detected in approximately 0.2–0.6% of patients undergoing angiographic examination, and the overall incidence in the general populations is 0.002% , 2. AlthSurgical closure (SC) and transcatheter closure (TCC) are the two main approaches for CCAF therapy. Compared to TCC, SC has a historically higher successful rate for fistula closure. Nonetheless, SC requires cardiopulmonary bypass and median sternotomy, and these invasive procedures are associated with increased risk of complications such as infection and bleeding –8. ReidyWe retrospectively reviewed the medical records of all pediatric patients with CCAF receiving therapy in Guangdong Cardiovascular Institute  from January 2002 to December 2017. The inclusion criteria were as follows: (1) < 18 years old; and (2) data on in-hospital examination and therapy were available during hospitalization. The exclusion criteria were as follows: (1) asymptomatic patient with small fistula size (< 2 mm); (2) with concomitant other congenital cardiac abnormalities; (3) prior cardiac surgery history; (4) with coexistent coronary artery diseases or severe comorbidities (e.g. Marfan syndrome); and (5) iatrogenic or traumatic coronary artery fistula.CCAF diagnosis was confirmed by preoperative transthoracic echocardiography (TTE), coronary computed tomographic angiography (CCTA) or selective coronary angiography (SCAG) as appropriate. CCTA or SCAG was performed if TTE was unable to provide a clear depiction of the fistula anatomy. All patients received routine clinical examination including standard 12-lead electrocardiogram, chest X-ray, TTE and laboratory tests. Selection of TCC for isolated CCAF was dependent on two key factors: optimal occlusion site and applicable catheter and device , 11. TheIn SC group (n = 58), 8 (13.8%) patients were diagnosed and measured by CCTA, 43 (74.1%) patients by SCAG, and 712.1%) patients by TTE. After general anesthesia, all patients in the SC group underwent median sternotomy. CCAF was identified by the presence of palpable vibrations and expansion at the fistula site. Aortic and bicaval cannulation was used for cardiopulmonary bypass. CCAF was closed by epicardial or endocardial correction. In 22(37.9%) patients, surgical correction of proximal region of the fistula would be performed if the fistula and coronary artery was enlarged exceedingly. In 29(50.0%) patients, the fistula drainage was completely closed. In 3(5.2%) patients, the fistula was closed by simple ligation, and another 46.9%) patients were treated by closing proximal and distal orifices. No anti-platelet or anticoagulation therapy was used after surgery [.9% patie.1% patieIn TCC group (n = 63), all patients were diagnosed and measured by SCAG, and 57 (90.5%) received TCC procedure under general anesthesia and 6 (9.5%) patients received local anesthesia. Heparin was infused intravenously at a dose of 100 units per kilogram of body weight. Femoral artery and/or femoral vein were used as access site. The anatomic and hemodynamic data of CCAF was evaluated by aortic root angiography. Fistula course, coronary artery branches and drainage were evaluated with multiple views as presented in Fig. Data on medical history, physical examination, laboratory examination, radiography reports, electrocardiogram, TTE, catheterization images and surgical notes were extracted from In-patient Management Information System. After closure, patients were followed from the day of intervention until death or end of study on December 31, 2017. At least three examinations of TTE and electrocardiogram were performed at the 3rd, 6th and 12th month after discharge, and then annually thereafter.The major complications were the rates of re-intervention, postoperative infective endocarditis, medium-sized or above residual fistula, coronary artery thrombosis, ischemic changes on electrocardiogram, and new-onset moderate or severe valvular regurgitation. The definition of medium-sized or above residual fistula was a ≥ 2 mm shunt in TTE during follow-up . New-onsContinuous variables were expressed as mean ± standard deviation or median  as appropriate. Categorical data were presented as number and percentage. Continuous variables with normal distribution were compared using Student’s t-test, and categorical variables were compared using Chi-square test or Fisher's exact test.This study was analyzed as intention-to-treat. The Cox proportional hazards regression models was used to examine time to the major complications for all available follow-up patients, of using hazard ratios (HR) and 95% confidence intervals (CI). Baseline variables that were considered clinically relevant with major complications were entered into multivariate Cox proportional-hazards regression model. Candidate variables with a p value < 0.1 on univariate analysis were included in multivariable model. Statistical tests were considered significant when p < 0.05. All statistical analyses were performed using SPSS software version 25.0 .Of the 121 pediatric patients undergoing CCAF closure between January 2002 and December 2017, 63(52.1%) underwent TCC, and 58(47.9%) underwent SC. 114 (94.2%) patients completed at least 1 year follow-up and the median follow-up duration was 6.9 years (IQR 3.4–10.6 years).Baseline characteristics were presented in Table As presented in Table Of Cox regression analysis, SC was associated with lower major complications Fig. . The numAs presented in Table There were 5 re-intervention cases during hospitalization and 4 re-intervention cases at follow-up. Clinical characteristics of patients undergoing re-intervention were summarized in Table The incidence of CCAF is increasing gradually, which is partly due to a broader use of echocardiography and other imaging modalities . PreviouThe indications of surgical closure and transcatheter closure in pediatric patients is controversial and has not been done systematically. The American Heart Association guideline 2011) in adults suggested that transcatheter occlusion should be considered in CCAF patients (class I) . However011 in adThis study shows that TCC entails shorter hospitalization time and intensive care unit stays, and fewer intra-operative blood loss. The major complications analysis was adjusted for confounding variables by Cox proportional hazards regression models. The fistula drainage (left atrium) was adjusted because it was a significant risk factor for complications after CCAF closure in previous research  and its TCC had a total of 9 (15.3%) re-intervention cases during hospitalization and follow-up when there was zero in SC group. Three prior studies also reported a similar or higher failure rate of TCC for CCAF therapy, with a rate of 13.0%, 16.7% and 25.0% respectively –28. SeveIn our study, the reasons for re-intervention included myocardial ischemia, incomplete occlusion, occluder embolization and valves injury. Of note, myocardial ischemia was the main reason, which was caused by occluder displacement, coronary artery thrombosis or postoperative coronary artery spasm. Therefore, monitoring electrocardiogram changes at first 24–48 h post-TCC is important to identify this severe complication timely. And careful evaluation of coronary artery anatomical structure may be also helpful to select suitable cases for TCC therapy so as to prevent this complication. In addition, we observed that 5(9.1%) patients in SC group developed coronary artery thrombosis, and whether anti-platelet therapy should be used to these patients needs to be further investigated. Notably, among the TCC groups, during the study period, 4 different kinds of devices were used to manage the fistula. One might argue that the outcomes of patients might be related to the selection of different devices. However, since the number of patients managed with each kind of device were small and there was insufficient power to compare the outcomes between these devices.Our data also showed that TCC had a higher rate of residual shunt. At follow-up, 10 (6.9%) patients in TCC group had a residual shunt versus 2 (3.6%) patients in SC group, suggesting that SC had a better long-term efficacy, as was better long-term safety. Our results showed that no patients in SC group had moderate or severe valve regurgitation, while 7 (11.9%) patients in TCC group had new onset or worsening of valve regurgitation, which might be due to wire loop caused cusps injury or valve geometry distortion.Angiograms were available for review in only 87.6% of the patients studied, and there were no standard methods to evaluate the length and tortuosity of the fistula, therefore, the angiographic features of fistula length and degree of tortuosity were not included in the current analyses. This is a single-center retrospective study, where there is potential for inherent bias such as missing data, referral and selection bias. Our current study has recruited a relatively larger sample of pediatric CCAF patients undergoing fistula closure, however, findings from our current report still needs to be corroborated in prospective and multi-center study in the future.Transcatheter closure has less invasive and faster recovery. However, our study suggests that compared to transcatheter closure, surgical closure has higher successful rate and lower risk of complications in pediatric CCAF patients.


Previous genome-wide association studies have identified a link between the rs13041247 single nucleotide polymorphisms (SNPs) in the chromosome 20q12 locus and the development of the congenital malformation known as nonsyndromic cleft lip with or without cleft palate (NSCL/P). The present meta-analysis was therefore designed to formally assess the relationship between rs13041247 and NSCL/P.2 statistic was used to compare heterogeneity among studies.We searched Embase, Web of Science, PubMed, the China National Knowledge Internet (CNKI), and the China Wanfang database in order to identify relevant published through 25 June 2019. This allowed us to identify 13 studies incorporating 4914 patients and 5981 controls for whom rs13041247 genotyping had been conducted, with STATA 12.0 then being used to conduct a meta-analysis of these pooled results. The IP = 0.048; CT vs TT: OR = 0.839, 95% CI: 0.734–0.959, P = 0.01; CC + CT vs TT: OR = 0.824, 95% CI: 0.701–0.968, P = 0.019).In total this analysis incorporated 13 case-control studies. No association between the rs13041247 polymorphism and NSCL/P risk was detected in individuals of Asian ethnicity  or Caucasian ethnicity . However, an overall analysis of all participants in these studies revealed the rs13041247 C allele, the CT genotype, and the CC + CT model to be linked to a reduced NSCL/P risk (C vs T: OR = 0.897, 95% CI: 0.723–1.114, These results suggest that the rs13041247 SNP located at the 20q12 chromosomal locus is associated with NSCL/P risk in an overall pooled study population, although this association was not significant in East Asian or Caucasian populations. Non-syndromic cleft lip with or without cleft palate (NSCL/P) is a congenital birth defect that affects a relatively high percentage of individuals in a manner that is linked to ethnicity , with raBoth environmental and genetic factors can regulate the development of NSCL/P, but the underlying mechanisms are not fully understood at present. Recent genome-wide association studies have revealed that polymorphisms in the genomic region encoding the v-maf musculoaponeurotic fibrosarcoma oncogene homolog B (MAFB) are strongly associated with the risk of NSCL/P . In lineResearch regarding the rs13041247 polymorphism within the 20q12 chromosomal locus has provided strong evidence for the relevance of this single nucleotide polymorphism (SNP) to NSCL/P incidence Indian, Brazilian, Mesoamerican, and Chinese populations –8. HowevIn order to fully explore the role of the rs1304127 in NSCL/P, the present meta-analysis of previously published case-control studies was conducted. This approach was employed in order to attain additional statistical power, allowing for the thorough examination of the relationship between this SNP and this congenital malformation in different populations. The results of this study have the potential to guide genetic counseling efforts in families at risk of or affected by NSCL/P.Embase, Web of Science, PubMed, the China National Knowledge Internet (CNKI) and the China Wanfang database were searched for articles published through 25 June 2019. Search terms used were as follows:  and (“MAFB” or “20q12” or “v-maf musculoaponeurotic fibrosarcoma oncogene homolog B”) and . No restrictions were imposed upon the language in which articles were published.In order to be included in this meta-analysis, studies had to meet the following inclusion criteria: (1) Studies were case-control studies; (2) Studies were focused on NSCL/P; (3) Polymorphisms analyzed in the study included rs13041247 at the 20q12 locus; (4) Studies provided sufficient data necessary for the calculation of odds ratios (ORs) and 95% confidence intervals (CIs); (5) All necessary data was either available or was obtained within two attempts to contact the study authors. When multiple articles included overlapping patient cohorts, only the study with the most comprehensive information was included in the present meta-analysis (i.e. the study with the largest population or the most complete dataset). In addition, studies meeting the following criteria were excluded from this analysis: (1) Animals studies; (2) Reviews, letters, or abstracts lacking original data; (3) Case-reports; (4) Studies focused only on other SNPs or which lacked a control group. No language restrictions were imposed on these studies.p-values, genotyping methodology, and case/control genotype distributions (Table Two authors (Liheng Huang and Yangzhan Ou), independently reviewed identified studies in order to exclude those which were either clearly irrelevant or which were duplicates, after which a full text review was performed to identify studies meeting the inclusion criteria for this analysis. Any discrepancies were resolved via discussion with the third author (Yunpu He).The following pieces of data were extracted from these studies: Name of the first author, year of publication, country, population ethnicities, control source, study design, samples size, control Hardy-Weinberg equilibrium (HWE) ns Table  5–17]. –17. p-vaP > 0.05). Ethnicity-based subgroup analyses were also conducted. Five different genetic models were used to examine the rs13041247 and NSCL/P risk according to ORs and 95% CIs: an allele model (C vs T), a homozygote model (CC vs TT), a heterozygote model (CC vs CT), a dominant model (CT + TT vs CC), and a recessive model (CC + CT vs TT). Z-tests were used to assess the significance of pooled ORs, P < 0.05 as the significance threshold. The I2 statistic was used to assess heterogeneity among studies, with I2 > 50% being consistent with significant heterogeneity, leading to the use of a random effect model, and I2 < 50% leading to the use of a fixed effect model. Sensitivity analyses were conducted by iteratively omitting individual studies from the overall analysis, while funnel plots were used to examine the risk of publication bias.STATA 12.0 was used to obtain crude ORs and 95% CIs for each of the included articles as a means of assessing the relationship between the rs13041247 SNP and NSCL/P risk. Chi-squared tests were used to assess the HWE in the control group, revealing it not to differ significantly from HWE . Significantly heterogeneity was detected in all models for both the overall and Asian analysis groups (I2 > 50%), whereas the heterogeneity in the Caucasian subgroup analysis was not significant. The results of this meta-analysis of the relationship between rs13041247 and NSCL/P risk for the allele model (C vs T), the heterozygote model (CC vs CT), the homozygote model (CC vs TT), the recessive model (CC + CT vs TT), and the dominant model (CT + TT vs CC) are shown in Figs. P = 0.253, Caucasian P = 0.239, and Overall population P = 0.124). Similarly, no funnel plot asymmetry was detected . The molecular basis for NSCL/P remains poorly characterized, with both genetic and environmental factors being thought to drive the development of this disease. Risk factors such as maternal drinking, smoking, and poor nutrition prior to conception may influence this risk of this birth defect. Several meta-analyses have recently highlight a number of genetic and environmental risk factors associated with NSCL/P development [This meta-analysis incorporated 13 total articles examining the relationship between rs13041247 and NSCL/P risk, with data available for 4914 patients and 5981 controls. In a subgroup analysis of different ethnic groups, we observed no significant association between rs13041247 and NSCL/P risk. However, in an analysis of the overall study population we found the C allele, the CT genotype and the CC + CT model to be significantly linked with reduced NSCL/P risk (C vs T: OR = 0.897, 95% CI: 0.723–1.114, elopment .The MAFB gene is a transcription factor with a basic leucine zipper structure encoded in the 20q12 region . MAFB isThe present meta-analysis has several limitations. For one, the sample size in this analysis was relatively small, limiting our ability to precisely assess the relationship between rs13041247 and NSCL/P risk. Secondly, these analyses were based upon one-way estimates. Furthermore, there was significantly heterogeneity among studies. In addition, we were unable to adjust for maternal risk factors such as alcohol intake or smoking as this information was unavailable in the majority of the included studies. Lastly, we were unable to assess gene-environment and gene-gene interactions for the same reason.In summary, the present meta-analysis revealed that the rs13041247 SNP located in the 20q12 region is significantly linked to NSCL/P risk, which the C allele, the CT genotype and the CC + CT model for this SNP being associated with reduced NSCL/P risk in an overall study population. However, subgroup analyses in individual ethnic groups failed to detect any significant relationship between rs13041247 and NSCL/P risk. Future large-scale well-designed studies will therefore be essential to accurately assess the relationship between rs13041247 SNP and NSCL/P risk in order to better understand the etiology of this complex disorder.


Liparis nervosa is a plant of the family Orchidaceae and mainly distributed in subtropical and tropical regions of the world. In Chinese traditional medicine, it has been used for the treatment of hemostasis, carbuncle, and furuncle for centuries. The chloroplast (cp) genome of L. nervosa, sequenced based on next-generation platform (NEOSAT), is 157,274 bp in size. The cp genome encodes 130 genes, including eight rRNA genes, 85 protein-coding genes (PCGs), and 37 tRNA genes. Phylogenetic relationship analysis based on complete cp genome sequences exhibited that both of L. nervosa and L. loeselii were phylogenetically closer to Dendrobium officinale. Liparis nervosa is a species of flowering herbaceous plant of the family Orchidaceae and mainly distributed in subtropical and tropical regions of the world. It grows on rocks and in the shade of trees beside valleys at an altitude of 1000–2100 m . It was chilled with dry ice and deposited in a chest freezer at the herbarium of Hunan Academy of Forestry (HAF). The total genomic DNA (gDNA) was isolated from 300 mg of young leaves by CTAB protocol. An Illumina Hiseq 2500 platform was utilised to conduct 2 × 150 bp paired-end sequencing. After trimming, around 5.7 Gb clean data were used to map to the on-line published cp genome of L. loeselii  was harvested from an individual L. nervosa (GenBank no. MN480463) is a circular DNA molecule with 157,274 bp in size having 36.97% of total GC content. There are 130 genes annotated in the cp genome, containing eight rRNA genes, 85 PCGs and 37 tRNA genes. Eight tRNA genes, seven PCGs, and four rRNA genes were duplicated in the inverted repeat regions (IRs). Two PCGs (ycf3 and clpP) harbour two introns each while six of them , harbour one intron each.The complete cp genome of L. nervosa and L. loeselii were phylogenetically closer to Dendrobium officinale than others (For phylogenetic maximum-likelihood (ML) analysis, multiple alignment was carried using MAFFT v7.2 with 15 published cp genomes downloaded from Genbank (Katoh and Standley n others , which wn others .


Soil degradation due to global warming, water scarcity and diminishing natural resources negatively impacts food security. Soil fertility deterioration, particularly phosphorus (P) deficiency, remains a challenge in the arid and semi-arid regions. In this study, field experiments were conducted in different geographical locations to investigate the effects of organic amendments coupled with P fertilization and irrigation on soil physical-chemical properties, and the growth, yield and quality of wheat. Application of P fertilizers combined with organic amendments mitigated soil salinity, increased organic matter content, available water, hydraulic conductivity and available macronutrients, but decreased soil bulk density. Application of organic amendments slightly increased total Cd, Ni and Pb in soil, but Cd and Ni concentration was below allowable limits whilst Pb reached a hazardous level. Soil P fractions were significantly increased with the combined application of mineral P and organic amendments irrespective of salinity and irrigation. Crop growth yield and quality of wheat improved significantly in response to the integrated application of mineral P and organic amendments. In conclusion, the combination of mineral P sources with organic amendments could be successfully used as a cost-effective management practice to enhance soil fertility and crop production in the arid and semi-arid regions stressed with water scarcity and natural resource constraints. This problem may be solved through a targeted remediation program of such soils. Deficit irrigation (DI) is also projected to increase soil salinity and sodicity, particularly in the arid and semi-arid climatic regions3, requiring proper management strategies to alleviate soil degradation. Contamination of soils with heavy metals has become a global concern, due to potential hazardous impacts of these elements on soil quality, crop yield and quality4, and food safety and human health5. Application of organic amendments was reported to remediate saline soils, alleviate salinity and sodicity stress on crops6, and reduce toxicity of heavy metals4. Some organic amendments contain heavy metals, and their application benefits require further studies7. Organic amendments could improve soil properties by accelerating leaching of sodium and other salts and reducing exchangeable sodium percentage (ESP)8. Moreover, organic amendments enhance soil biological and enzyme activities and increase organism abundance, thus improving soil fertility and crop production9. However, more research is needed to explore effect of organic amendments combined with irrigation regimes on saline and alkaline soils. Phosphorus (P) is a major essential element for plant growth and production10. Due to rapid population expansion worldwide, the projected amount of P fertilizers will be doubled to enable sustainable food production2. Arid soils contain much less available P, as compared to humid regions, due to low total P and high fixation of P in soils11. In the arid region low water inputs limit salt leaching, resulting in accumulation of calcium (Ca) minerals12. Most of water soluble P applied in fertilizers to soils is rapidly converted to other forms with less availability13. Chemical fractionation of soil P could provide further information about P mobility and availability in soils14. However, there is no further investigation for determining the effect of P fertilizers on soil P fractionation at a field scale, particularly in the arid and semi-arid ecosystems. Given this situation, there is an urgent need for more efficient use of P, while reducing the environmental impacts of mineral fertilizers15. This could be achieved through the integration between P mineral fertilizers and organic amendments, which requires more attention. Various types of organic amendments have been used to remediate saline soils, some of them untreated and inexpensive such as poultry manure16, crop straw and factory residues17, farmyard manure (FYM)18, and sewage sludge (SS)8. The SS is reported as a valuable fertilizer for wheat, increasing soil organic matter content7, which requires further evaluation in field. Furthermore, integration between soil amendments and irrigation in saline soils is not well studied. Unequivocally, phosphate fertilizers could improve crop production19 and soil microbial activity15, but limited studies focused on saline alkaline soils. Exploring the integrated effects of phosphate fertilizers, deficit irrigation and organic amendments on saline soil quality and crop production is imperative for managing soils in the arid and semiarid regions. The main objectives of this study were: (I) to explore the combined effect of phosphate fertilizers (superphosphate and ammonium phosphate), organic amendments (farmyard manure and sewage sludge) and irrigation regime (full and deficit) on soil properties, P fractionation, and heavy metal accumulation , (II) to explore the relationship between soil salinity, organic matter, available P, applied irrigation water and soil P fractionation, and (III) to investigate the effect of different treatments on wheat productivity and quality traits on three typical soil types .Saline soils are an important natural resource but the area of degraded saline soils worldwide has rapidly increased due to climate change and limited rainfall, which poses a great challenge to global food securitySoil in three locations differed in salinity content, which in turn, caused variations in other physical, chemical and nutritional properties such as pH, ESP, OM, bulk density (Bd), HC and available macronutrients  significantly increased due to organic amendments and P fertilization Fig. . The incChanges in soil P fractions in response to different amendments, soil salinity and irrigation regime are shown in Fig. 2, number of grains per spike and grain weight) were also significantly enhanced due to P fertilization and organic amendment, despite adverse effects of salinity and deficit irrigation (Supplementary Table Wheat phenology (anthesis and maturity dates) and plant height parameters were significantly promoted in response to application of amendments in all the studied soils Table . DeficitIn addition, the interactions between SS and FYM either added solely or combined with P fertilizer were non-significant. On the other hand, the interaction between all the treatments  was significant for wheat grain and straw yield. Beside wheat growth and yield components, application of P fertilizers (i.e. Ps and Pa) and organic amendments (i.e. SS and FYM) and combinations of them, significantly improved quality traits (i.e. protein and carbohydrates), indicating the importance of these treatments in food security and nutrition value Table . Applica20, such as increased water holding capacity and available water, even in the highly saline soil. Consequently, the hazard effect of DI was alleviated. Conversely, application of SS resulted in the highest values of soil bulk density and lower values of hydraulic conductivity, due to higher SAR content in SS , particularly SS, due to high content of such metals in SS. Nevertheless, total contents of Cd and Ni in the soils received SS combined with P fertilizers were lower than the threshold values according to limits described by Tóth et al.25. In comparison, total content of Pb in all the studied soils was above the threshold limit regardless of amendments application or not. This contamination problem requires a proper remediation program. These findings highlight the importance of P fertilization and organic amendments for improving soil quality and crop production in this region.Deficit irrigation and salinity are the critical factors that negatively affect soil fertility and crop production in the arid and semiarid regions. They significantly decreased soil available macro nutrients , due to higher salinity caused by less irrigation than evapotranspiration, particularly in the highly saline soil. Consequently, highly saline soils occur frequently in combination with DI and drought, thus causing negative impacts on microbial activity27. This may be due to low levels of P in the soils and inputs from both organic and inorganic P sources28. Available P fraction in the studied soils represents only 0.89, 0.76 and 0.74% of the total P in non-saline, saline and highly saline soils, respectively , Ca-P (R2 = 0.93), Fe/Al-P (R2 = 0.64) and residual-P fraction (R2 = 0.98). This may be due to the negative effect of salinity on soil physical, chemical and biological properties. By contrast, increasing soil organic matter showed a significant positive relationship with total P (R2 = 0.32), Fe/Al-P (R2 = 0.54) and residual-P (R2 = 0.07), whilst Ca-P fraction showed a negative relationship with soil organic matter (R2 = 0.28),  organic amendments mobilize native soil P34.The combined application of P fertilizers and organic amendments significantly increased P accumulation, which is in agreement with previous studies applied with cattle manure and P fertilizersns Figs. . Soil EC8), Fig. . Soil av8), Fig. . By cont8), Fig. , despite6. Similarly, water deficit during the sensitive growth stages (flowering and grain filling) caused a considerable reduction in wheat yield, and quality. This is mainly due to the negative effect of DI on plant physiological features such as accelerated leaf senescence, assimilate translocation, sink capacity, reduced grain set, as well as the oxidative damage to assimilatory machinery36. Consequently, the combined application of P fertilizers and organic amendments could alleviate the negative impacts of salinity and DI, improved soil physical and chemical properties, and thus enhanced wheat yield and quality. These treatments increased soil organic matter, available macronutrients and available water, and alleviated the hazardous impacts of salinity and deficit irrigation. Furthermore, soil P in the arid and semi-arid regions has very low availability due to high fixation, and slow diffusion, thus limiting plant growth and crop yield. Application of P fertilizers combined with organic amendments can significantly enhance soil P availability and increase wheat yield and quality.Soil salinity decreased yield and quality of wheat, due to its negative impact on soil available water and nutrientsTriticum aestivum L., cv Sakha 95) was selected for the experiments carried out in the three different locations, i.e. Kafrelsheikh (31.0N and 30.9 E), El-Riad (31.3N and 31.2 E), and Hamoul (31.4 N and 31.5 E), with non-saline (NS), saline (S) and highly saline (HS) soil, respectively (Supplementary Table 37. The average range of ground water table recorded (1.8–2.0 m), (1.6–1.8 m) and (1.2–1.4 m) for locations Kafrelsheikh (N-S), El-Riad (S) and Hamoul (HS) respectively38.The locations show a limited variation in climatic data through last three decades (1980–2010) as they were all located in the first agroclimatic zone in Egypt  for two successive winter growing seasons 2016/2017 and 2017/2018. A new and high yielding wheat cultivar (2 (8 m × 5 m), with 0.5 m alley surrounding each plot. The main treatments included irrigation scheduling at different levels of depletion from soil available water to be 50%  and 70% . Soil moisture content was monitored daily using time-domain reflectometry (TDR), to specify the irrigation timing in both treatments. The main bases of FI and DI treatments had been defined according to the change in depletion of soil available water for each soil type. The FI represents the optimum irrigation design in clay soil and could be achieved by triggered irrigation at 50% depletion from soil available water (readily available water). At this point, crop could not expose to deficit irrigation, as irrigation triggered at readily available water. As the available water content differs between soil types, Supplementary Table 3, SM1 = Soil moisture at field capacity (%), SM2 = Soil moisture before next irrigation based on the required depletion (%), BD = Soil bulk density (Mg m−3), D = Soil depth of the effective root zone (m), and A = Irrigated area (m2)The experiment in each location was laid out in a split plot design with three replicates. The tillage system included ploughing the soil up to 30 cm depth using a country plough. The plot size was 40 m3 S−1), C = Empirical coefficient determined from discharge measurement, 0.3, L = Length of the crest (m), H = Head above the weir (m)For controlling in water applied to each treatment and soil, a rectangular sharp crested weir had been used through the following equation:The same procedures of irrigation scheduling (timing and quantity) were used with deficit irrigation, considering the required depletion to be 70% from soil available water.−1), ammonium phosphate , farmyard manure , sewage sludge , Ps + FYM, Ps + SS, Pa + FYM and Pa + SS. Phosphorus fertilizers and organic amendments were applied to soil with tillage. The chemical characteristics and heavy metal content of FYM and SS are shown in Supplementary Table 2O ha−1 as potassium sulphate (containing 48% K2O). Nitrogen fertilizer as urea was added to all the experiments in two equal doses (180 kg N ha−1), the first dose was applied with the first irrigation and the second dose was added with the second irrigation. The experiments in the three locations, irrigated with good quality water from canals branched from the River Nile with EC values  for Kafrelsheikh, El-Riad and Hamoul locations, respectively. Detailed information of irrigation water scheduling (timing and quota) and subsequent total irrigation water amount for each irrigation regime are explained in Supplementary Table −1 and applied at 25 days after sowing (DAS), as well as Topic 15% WP (Clodinafop-propargyl) at rate of 350 g ha−1, applied at 45 DAS.The sub main treatments consisted of control (without addition), superphosphate  and permanent wilting point (PWP) were measured using pressure membrane apparatus at the pressures of 0.3 and 15 bar, respectively. Saturated hydraulic conductivity was determined in field using Guelph permeameter apparatus43. Soil available N, P and K were extracted and determined with the standard methods46. Additional part of soil samples was digested for total heavy metal analysis  using inductively coupled plasma-optical emission spectrometry 47. In subsamples soil P fractionation was determined following the modified sequential extraction method49. Specifically, air dried soil (1 g) was extracted with NaHCO3, giving the available fraction of P. The soil residue was then treated with NaOH and shaken for 16 h and the extract was analyzed for Fe/Al-P fraction. The soil residue was then extracted with HCl for 16 h to obtain Ca-P fraction. Finally, the residual P fraction was obtained by digesting the remaining soil with concentrated HNO3. Following each extraction, soil residues were separated from extraction solution, through centrifuging and filtering the supernatant with filter papers and determining P by the ascorbic acid reduction-molybdenum colorimetric method.Soil chemical properties before cultivation and after harvesting from all the locations were analyzed using the classical methods2, number of grains per spike, 1000-grain weight, grain yield (dried in oven at 70 °C for 24 h), and straw yield were measured in all the experiments. Plant grains of ten wheat plants from each experimental plot, were oven dried at 70 °C for 48 h, then ground to fine powder for quality analysis. Protein in wheat grains was calculated by multiplying the N content determined in grains50 by 5.7, meanwhile, total carbohydrate was measured in the ground powder as described by51.Phenology parameters such as anthesis and maturity dates, plant height, number of spikes per m52, using PASW statistics 21.0 . Treatment means were compared using the least significant difference test (LSD) at P < 0.05. Combined analysis for the two seasons and all three locations was performed using the homogeneity test.The obtained data were statistically analyzed using the analysis of variance (ANOVA) according toApplication of P fertilizers and organic amendments to soils resulted in significant improvement in soil physical and chemical properties, enhanced wheat yield and quality traits. The combined treatments of P fertilizers with sewage sludge or farmyard manure decreased soil salinity, soil bulk density, whilst increased organic matter content, hydraulic conductivity, available water and macronutrients. Environmentally, application of sewage sludge and/or farmyard manure increased total content of heavy metals  in soil. Notwithstanding, the levels of total Cd and Ni in soil are generally below the critical limits for ecological and health risk. However, the levels of total Pb in soil exceeded the hazardous limits, which requires additional program for remediation. Although P is a very important element for plant growth, the soils in the arid and semi-arid regions are generally low in available P. Combination of different sources of mineral P with organic amendments can significantly increase soil available P regardless of soil types and irrigation regimes.Supplemental Information.


P < 0.05). K-M plots revealed significantly better OS of adjuvant chemotherapy group than no chemotherapy group (P < 0.001). Meanwhile, there was no significantly different in CSS between the two groups (P = 0.93). However, after adjusting for confounding factors by multivariable Cox regression analysis, receipt of postoperative chemotherapy was still associated with better CSS and OS  ; . Patients with stage II/III colorectal SRCC could receive survival benefit from postoperative adjuvant chemotherapy.This study aimed to assess the benefit of postoperative adjuvant chemotherapy in stage II–III colorectal signet ring cell carcinoma (SRCC). Qualified postoperative patients were extracted from Surveillance, Epidemiology, and End Results (SEER) database from 2004 until 2015. We collected 1675 patients in the research, and 936 patients were subjected to adjuvant chemotherapy group. The proportions of married status, male, rectal cancer, grade III/IV, AJCC stage III and radiotherapy were higher; While, the rates of white race, ≥ 65 years old and located in cecum–transverse colon were lower in patients of chemotherapy group compared to no chemotherapy group (all  The diverse pathological types of CRC have been uncovered to be having correlation with various clinical parameters and patient survival, with adenocarcinoma being most prevalent type3. Signet-ring cell carcinoma (SRCC) is a relatively rare histological subtype, consisting of 0.1–2.6% of CRC patients5, defined as the abundant presence of intracellular mucin in over 50% cells according to WHO7.Colorectal cancer (CRC) ranks the third of cancer-associated death, causing great health burden globally9. In addition, massive lymphatic involvement, higher frequency of multiple metastatic organs and greater risks of peritoneal metastases are more commonly seen in SRCC9.SRCC is considered as a distinct pathological subtype in CRCs. A series of differences among colorectal SRCC, mucinous adenocarcinoma (MC) and non-mucinous adenocarcinoma (NMC) have been consistently reported. To be specific, SRCC has been reported to be associated with younger age at diagnosis, more advanced stage and poorer clinical outcomes than MC and NMC5. At present, surgical intervention is still the optimal option for colorectal SRCC patients. Moreover, the combined application of other therapeutics has been increasing, especially chemotherapy10. Hugen et al. have assessed the efficacy of adjuvant chemotherapy in colorectal SRCC, who further indicated the benefit of adjuvant chemotherapy in stage III SRCC patients11. Meanwhile, by analyzing the distinct metastatic patterns of colorectal SRCC toward different sites, Tao et al. have demonstrated better survival of received chemotherapy in metastatic colorectal SRCC patients12. However, there were still some studies showed that colorectal SRCC responded poorly to chemotherapy14. Thus, clear elucidation of the efficacy of postoperative chemotherapy in colorectal SRCC patients is of great significance.Because SRCC is relatively rare, there is a lack of consensus on therapeutic guidelines due to the difficulty in conducting large randomized controlled trials15, records tumor data by covering almost 30% of population in the USA from diverse geographic regions, which could readily represent the population diversity16. Therefore, SEER is widely acknowledged as a valuable database for investigation into rare tumors20. Herein, in the present study, we collected eligible non-metastatic colorectal SRCC patients from SEER database to investigate the influence of adjuvant chemotherapy.The SEER database, the most authoritative and largest cancer dataset in North AmericaSEER*Stat v8.3.6 tool  was adopted for selecting qualified subjects. Colorectal SRCC patients who were diagnosed from January 1, 2004 to December 31, 2015 were selected from the Incidence-SEER 18 Registries Custom Data . Eligible patients were collected accordingly: (1) primary colorectal SRCC patients; (2) the diagnosis of SRCC was based on . Patients were eliminated if they had: (1) more than one primary malignancies; (2) reported diagnosis source from autopsy or death certificate or no pathological diagnosis; (3) no AJCC stage; (4) no surgery; (5) AJCC stage I/IV; (6) no prognostic information. The remaining qualified populations were included, followed by assignment of patients into adjuvant chemotherapy group and no chemotherapy group according to whether they had chemotherapy or not.The following clinicopathological parameters were analyzed: year of diagnosis ; insured status ; age ; marital status ; gender ; race ; primary site; grade ; tumor size ; AJCC stage ; lymph node dissection ; chemotherapy  and radiotherapy . The widowed or single (never married or having a domestic partner) or divorced or separated patients were classified as unmarried. The primary tumor site was classified as cecum–transverse colon , descending colon–sigmoid (including the splenic flexure and descending and sigmoid colons), multiple, rectum and unknown. In addition, the staging of cancer is based on the 6th edition of AJCC stage system, which adapted to patients in the SEER database with a diagnosis time of 2004–2015.The endpoint of this study was cancer‐specific survival (CSS) and overall survival (OS). CSS was defined as the period from diagnosis to death attributed to colorectal SRCC. OS was defined as the period from diagnosis to death from any cause.P values lower than 0.1 in univariate analysis were incorporated into the multivariate Cox proportional hazard model. SPSS software (version 19.0)  was employed for statistical analysis, and Graph Pad Prism 5 was utilized for generating survival curve. A two-sided P < 0.05 indicated statistical significance.Categorical data were compared by Chi‐square test between chemotherapy and no chemotherapy groups. Kaplan–Meier (K-M) method was adopted for univariate analysis to evaluate whether CSS and OS were different between two groups (log-rank test). Variables with In order to obtain relevant data from the database, we signed the SEER Research Data Agreement (No.19817-Nov2018) and further searched for data according to the approved guidelines. The extracted data were publicly accessible and de-identified, and the data analysis was considered as non-human subjects by Office for Human Research Protection, therefore, no approval was demanded from institutional review board.P < 0.05). There were more patients with married (57.59% vs. 48.44%), male (54.81% vs. 47.36%), located in rectum (29.38% vs. 9.47%), grade III/IV (84.08% vs. 82.41%), AJCC stage III (83.01% vs. 59.27%); less often white race (78.31% vs. 85.66%), ≥ 65 years old (36.65% vs. 73.88%) and located in cecum–transverse colon (52.56% vs. 76.45%) in chemotherapy group compared with no chemotherapy group. Furthermore, more subjects received radiotherapy in adjuvant chemotherapy group (28.31% vs. 2.71%).In total, 1675 eligible patients were included in this research, and 936 patients received adjuvant chemotherapy while 739 patients did not. The process of patient selection was displayed in Fig. P < 0.001). Meanwhile, there was no significantly different in CSS between the two groups (P = 0.93).The survival curves of CSS as well as OS were displayed in Fig. The median survival time of all included patients was 25.0 months (0–155 months). The 3-, 5- and 10-year CSS rate was 53.47%, 46.14% and 39.53%, respectively. In addition, the 3-, 5- and 10-year OS rate was 47.93%, 39.06% and 26.75%, respectively. K-M plots revealed significantly better OS of adjuvant chemotherapy group than no chemotherapy group (P < 0.05), which were later incorporated into the multivariate Cox analysis. As a results, adjuvant chemotherapy was a significantly protective factor for survival ; . The concrete results of univariate analysis and multivariate analysis were listed in Tables In univariate analysis of CSS and OS, age, marital status, race, primary site, grade, tumor size, AJCC stage, lymph node dissection, chemotherapy and radiotherapy were risk factors for survival  and weak positivity for thymidylate synthase (key enzyme for DNA synthesis pathways targeted by 5-FU)24.The multidisciplinary management of colorectal SRCC is required to select the optimal therapeutic strategies based on both natural history of tumor and tumor-associated prognostic factors. According to the present international guidelines, no specific therapy is recommended for SRCC histology in clinical practice12. Additionally, the clinical significance of chemotherapy on colorectal SRCC was evaluated in a population-based study involving 1972 patients from 1989 to 2010. The study found that patients with stage III colon SRCC receiving adjuvant chemotherapy had better survival compared to those without chemotherapy 11. In the present study, we analyzed 1675 stage II/III colorectal SRCC patients and found that chemotherapy could significantly prolong survival in CSS and OS. This is similar to the previous study. Unfortunately, we were not able to analyze the benefit of adjuvant chemotherapy in high-risk stage II patients specially, due to the low number of patients who received chemotherapy in this group and because the motivation for administration of chemotherapy was not registered.Conversely, in several large sample-based retrospective studies, we have found that chemotherapy provides significant survival benefits for certain colorectal SRCC populations. Tao Shi et al. found that chemotherapy was related to better survival in metastatic colorectal SRCC20. Furthermore, the effects of other adjuvant therapy are not assessed, and the specific type of chemotherapeutic regimen is unclear (single agent or doublet). Thus, we are unable to precisely elucidate whether differences exist in terms of adjuvant therapy throughout the study. Thirdly, therapeutic responses as well as recurrence rates are inaccessible from SEER database. Finally, several important prognostic information are unavailable from SEER database, such as: specific number of lymph node dissection ,extramural vascular invasion or obstruction/occlusion status, and Microsatellite stability/Microsatellite instability (MSS/MSI) status .Although it is better to obtain more details, we believed that the present available data from SEER database could fit our research objectives very well. The above concerns should be investigated in future studies.As a large population based dataset, SEER could be used for cross-sectional assessment in a large number of tumor patients and simultaneously provide long-term follow-up data without inherent institutional bias. Nevertheless, several limitations are unavoidable in our research. First of all, as a retrospective study, the intrinsic selection bias exists in this studyIn conclusion, our results have shown that stage II/III colorectal SRCC can gain survival benefit from postoperative adjuvant chemotherapy. This is a large population-based study to discuss adjuvant chemotherapy for patients with localized colorectal SRCC, and our present findings might be of significance for disease management and future prospective researches.


Mollitrichosiphum tenuicorpus. The M. tenuicorpus mitogenome is 15,727 bp in length and comprising 37 genes typically present in insect mitogenomes, a control region, and a unique repeat region. All protein-coding genes (PCGs) terminate with TAA or TAG except for cox1, which is terminated with T—. The secondary structure of trnS (AGN) loses the dihydrouridine (DHU) arm, but all the other transfer RNAs show the typical clover-leaf secondary structure. The repeat region between trnE and trnF is 458 bp, with a 217-bp repeat unit repeating 2.11 times. Phylogenetic analysis of the M. tenuicorpus mitogenome using the maximum-likelihood optimality criterion places it in a strongly supported sister position to Eutrichosiphum pasaniae. These data show that mitogenome sequences could be useful in resolving phylogenetic relationships of the Greenideinae.Here we report the complete mitochondrial genome of the aphid species  Mollitrichosiphum tenuicorpus  (Aphididae: Greenideinae: Greenideini) is widely distributed in southeastern Asia. It is monoecious and holocyclic, mainly feeding on young shoots of the plants of Castanopsis, Litsea, and Lithocarpus  and deposited in the National Zoological Museum of China, Institute of Zoology, Chinese Academy of Sciences, Beijing, China . The sequencing was performed on an Illumina platform. The mitogenome was assembled using SPAdes version 3.10.1 . The mitogenome contains 13 protein-coding genes (PCGs), 22 transfer RNA genes (tRNAs), 2 ribosomal RNA genes (rRNAs), a control region, and a special non-coding repeat region. The gene order is identical to the inferred ancestral arrangement of insects (Clary and Wolstenholme cox1 uses the incomplete T— as the stop codon. The tRNA genes range from 62 to 73 bp in length. All tRNAs except for trnS (AGN) display the typical clover-leaf secondary structure. The dihydrouridine (DHU) arm is lost in the secondary structure of trnS (AGN). The rrnL and rrnS genes are located on the minority strand. The rrnL gene is 1271 bp long, with an A + T content of 85.7%. The rrnS gene is 769 bp in length, with an A + T content of 83.2%. The control region resides between rrnS and trnI. It is 680 bp long with an A + T content of 90.5%, including an AT-rich zone, a poly-thymidine stretch, and a stem-loop region. In the mitogenome of M. tenuicorpus, the repeat region located between trnE and trnF is 458 bp in length with an A + T content of 87.2%. Within this non-coding repeat region, a 217-bp repeat unit repeats 2.11 times. Up to now, this aphid-specific repeat region has been found in all reported mitogenomes of Greenideinae species except for Cervaphis quercus Takahashi, 1918.The mitochondrial genome of M. tenuicorpus and 26 other aphid species. The phylogenetic analysis was performed using RAxML version 8.2.10 (Stamatakis M. tenuicorpus and Eutrichosiphum pasaniae formed a sister group with strong support (We built a maximum-likelihood tree of aphids using the whole mitogenome sequences of  support .


Falls (44.9%) and road traffic accidents (46.6%) were the commonest mechanisms of injury with an average presentation GCS of 9.2 . GCS on admission of ≤ 13.1 and contusion volume at day 2 post-injury of ≥ 62.9cm3 were associated with increased risk of deterioration needing surgical interventions . The majority of patients underwent surgery; the average GOS was 4, at an average follow-up duration of 11.7 months . The currently available evidence on the management of TBC is scarce. Larger multicentre well-designed studies are needed to further delineate the factors behind acute deterioration, the effectiveness of management options. Once in place, this can be used to develop and test an algorithmic approach to management of TBC resulting in consistently improved outcomes.Traumatic bifrontal contusions (TBC) form a recognised clinical entity among patients with traumatic brain injury (TBI). This study aims to systematically review current literature on demographics, management, and predictors of outcomes of patients with TBC. A multi-database literature search  was performed using PRISMA as a search strategy. Studies were selected by predefined selection criteria (PROSPERO: CRD42018055390), and risk of bias was assessed using an adapted form of ROBINS-I tool. Of the 275 studies yielded by the literature search, seven articles met the criteria for inclusion, all of which were level III evidence. Total cohort consisted of 468 patients; predominantly male ( Traumatic brain injury (TBI) is a leading cause of mortality and morbidity worldwide . VariousThe structure of the search strategy for this literature review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines . The proA multi-database literature search  was performed to identify relevant full text articles in English from January 1947 to January 2018 by authors NZ and SM , 72.7% (303/417) were male and 27.3% (114/417) were female. In studies reporting age , average age of patients was 44.3 years (range 7–81). One study did not report age [A total of 468 patients were found across all included studies. Of studies specifying gender  and road traffic accidents . Other causes included accidental injury , assault , and explosions . The remaining 14 patients (3.1%) were reported as “Other”. One study  consistin = 7). Two studies reported GCS on an individual basis [GCS on admission was reported by all included studies . Various surgical interventions were described. Three studies only considered patients undergoing surgery 12–14). Of those, one study  utilised–14. Of t3, (iii) deterioration took place on day 4.4 post injury, and (iv) oedema volume at time of deterioration was 69.7cm3. The third study [Three studies , 9, 12 en = 7, 368 patients) was 13 months. Except one study [n = 6, 356 patients). Peterson et al. 2011 [A total of 368 patients 75.4%) across all studies were followed up, and 100 patients (24.6%) had no follow-up data  GCS ≥ 10 on admission, and (iii) no evidence of other intracranial traumatic lesions. Contusion volumes used to screen for inclusion were measured on day 2. Authors chose this time point to account for “blossoming” of contusions from initial admission. Initial contusions “blossomed” in nine patients (69%) by day 2. Only six of the nine patients experienced acute deterioration at some stage post admission within the first week, but this did not necessarily go hand-in-hand with radiological progression. It follows that the relationship between clinical and imaging parameters warrants further study. The shortcomings of this study include (i) rationale behind the decision for ICP monitoring was not given, (ii) inclusion criteria state GCS ≥ 11 on admission, yet subsequent discussion reveals two patients presenting with GCS 10, and one patient presenting 3-day post-injury with GCS 3, and (iv) despite investigating several relevant parameters, the study prevents any quantitative evaluation of deteriorating and non-deteriorating subgroups due to the small sample size and lack of statistical comparison.The subsequent study  was perfAcross all studies, BDC and BC were the predominant surgical approaches reported. One study  comparedp = 0.013) and overall hospital stay (p = 0.001), as well as fewer days of osmotic therapy (p = 0.008) for patients belonging to the ICP subgroup. Interestingly, of surgical patients followed up at 6 months, the ICP cohort also had a significantly higher GOS at 6 months compared to non-ICP cohort (p = 0.025). However, the indications for ICP monitoring in this study were not clearly defined. Superior outcomes in the ICP group suggest a potentially useful role in TBC management, although further evidence is required. Despite multiple data points, the effects of only a few of these on GOS scores were calculated: age, progression to surgery, and ICP monitoring. Only the latter was accompanied by statistical comparisons. Similar to Peterson et al. [The remaining included studies were published over the subsequent few years. Gao et al.  collecten et al. , deterioWu et al.  performeSimilarly, another retrospective study  evaluateThe most recent study  retrospeIn conclusion, there is currently a lack of evidence on many aspects of the management of TBC. The stringency of our inclusion criteria further limited widespread appraisal of evidence. However, based on available evidence, some consistent themes emerge Fig. : (i) ini


The principal function of iodine acts on thyroid function, but in recent years, the role of iodine deficiency in metabolism has also been gradually revealed. We aimed to investigate the current status of iodized salt consumption and urinary iodine concentration (UIC) in an urban Chinese population with type 2 diabetes, and to further explore whether UIC was associated with diabetic microvascular complications.2. Diabetic retinopathy (DR) was evaluated by high-quality fundus photographs and was remotely read by ophthalmologist.Four thousand five hundred fifty-nine subjects with diabetes from 7 communities in downtown Shanghai were enrolled in the cross-sectional Metal Study in 2018. UIC was detected using an inductively coupled plasma-mass spectrometer. Diabetic kidney disease (DKD) was defined as urinary albumin-to-creatinine ratio (UACR) > 30 mg/g or estimated glomerular filtration rate < 60 mL/min/1.73 mThe median UIC of subjects with diabetes was 115.4 μg/L (78.9–170.8) in downtown Shanghai. Among all the subjects, 52.7% consumed non-iodized salt and 40.4% were iodine deficient. Iodine deficiency (UIC < 100 μg/L) was associated with an increased odds of DKD  after adjustment for age, sex, education, current smokers, BMI, HbA1c, duration of diabetes, dyslipidemia, thyroid-stimulating hormone and free thyroxine. No association was observed between UIC and DR after multivariable adjustment.A concerning number of subjects with diabetes consumed non-iodized salt and suffered from iodine deficiency in coastal regions of China. Low UIC might be a risk factor for DKD, which should be further confirmed by longitudinal prospective studies. Type 2 Diabetes Mellitus (T2DM) has become a serious global health care burden, causing microvascular complications which are associated with increased disability, reduced quality of life and life expectancy , 2. It wIodine is an indispensible micronutrient for the synthesis of thyroid hormones. Iodine deficiency (ID) in early life impairs neurodevelopment, and also has many adverse effects throughout various life stages . Over thThe principal function of iodine acts on thyroid function, but in recent years, the role of ID in metabolism has also been gradually revealed. Analysis of data from the National Health and Nutrition Survey (NHANES) 2007–2012 found that in US adults, low urinary iodine concentration (UIC) was associated with dyslipidemia . MoreoveThe aim of this study was to investigate the current status of iodized salt consumption and UICs in an urban Chinese population with T2DM, and additionally whether UIC is associated with diabetic microvascular complications including DKD and DR.mental Pollutant Exposure and Metabolic Diseases in Shanghai, www.chictr.org.cn, ChiCTR1800017573) was launched to investigate the association between iodine nutrition and microvascular complications in Chinese adults with diabetes. We recruited study participants from seven communities in Huangpu and Pudong new district, Shanghai, China. Huangpu district, located in downtown Shanghai, is the administrative, economic and cultural center of the metropolitan coastal city [n = 254) were excluded. Finally, 4559 participants were involved in the present analysis.The cross-sectional METAL study  was measured by high-performance liquid chromatography . Fasting plasma glucose, serum creatinine, triglycerides, total cholesterol, high (HDL) and low-density lipoprotein (LDL) were performed with a Beckman Coulter AU 680 . Serum thyroid-stimulating hormone (TSH) and free thyroxine (FT4) were measured by electrochemiluminescence .Morning fasting spot urine samples collected were refrigerated immediately and frozen at − 20 °C in 2 hours. UIC was detected using an inductively coupled plasma-mass spectrometer . The concentrations of urine albumin and creatinine were determined with a Beckman Coulter AU 680  using a turbidimetric immunoassay and an enzymatic method, respectively. Urinary albumin-to-creatinine ratio (UACR) was calculated as the urinary albumin concentrations divided by the urinary creatinine concentrations and expressed in mg/g.DR screening was evaluated by mydriatic binocular indirect ophthalmoscopy . Fundus photographs were read by an experienced ophthalmologist specialized in retina.Dyslipidemia was defined as total cholesterol ≥6.22 mmol/L (240 mg/dL), triglycerides ≥2.26 mmol/L (200 mg/dL), LDL ≥ 4.14 mmol/L (160 mg/dL), HDL < 1.04 mmol/L (40 mg/dL), or self-reported previous diagnosis of hyperlipidemia by physicians, according to the modified National Cholesterol Education Program-Adult Treatment Panel III.2, and DKD as UACR > 30 mg/g or eGFR < 60 mL/min/1.73 m2 [The estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation for “Asian origin” . As sugg/1.73 m2 .The internationally accepted DR classification by the “Global Diabetic Retinopathy Project Group” in 2003 was applied [Statistical analysis was run with SPSS 24.0 . General characteristics are presented as median with the interquartile range (IQR) for continuous variables or as proportion for categorical variables. Mann-Whitney U test and the Kruskal-Wallis test were used for comparison of two or more groups of non-normally distributed data. Pearson’s χ2 tests were performed to compare categorical variables.The associations of UIC with elevation of UACR, reduction of eGFR, DKD and DR were analyzed with logistic regression analyses. The results are presented as odds ratio (OR) and 95% confidence intervals (CIs). Model 1 was unadjusted. Model 2 was adjusted for age, sex, education, current smokers, BMI, HbA1C, duration of diabetes, dyslipidemia, TSH and FT4.2), and 17.9% were current smokers. The percentage of an educational level beyond high school was 50.9% and the average duration of diabetes was 9 years.The general characteristics are presented in Table Compared to those with adequate iodine nutrition, subjects with ID were slightly older and were more likely to be women. These subjects also had higher TSH, lower BMI and a lower percentage of current smokers. In addition, subjects with more than adequate and excess iodine nutrition were slightly younger and had higher BMI, but comparable TSH.The distribution of UICs in the study population is presented in Fig. The distribution of type of salt intake is presented in Fig. The association of UIC with elevation of UACR, reduction of eGFR and DKD is shown in Table Table In this study among over 4500 community-dwelling Chinese adults with diabetes, we found that 52.7% of the subjects consumed non-iodized salt, and 40.4% had ID. Iodine deficiency was significantly associated with a higher prevalence of elevated UACR and DKD, independently of age, sex, education, current smokers, BMI, HbA1C, duration of diabetes, dyslipidemia, TSH and FT4. To the best of our knowledge, this is the first study to investigate the current status of iodized salt consumption and iodine nutrition status in a relatively large population with diabetes, and further investigate the association between UIC and diabetic microvascular complications.China was once severely affected by IDD, and hence, a mandatory Universal Salt Iodization (USI) program was introduced in 1996, and was successful in eliminating IDD. However, since the prevalence of thyroid diseases has markedly increased in recent years, some concerns about the USI have circulated, especially among coastal residents in urban areas . In the thyroid abnormalities were found to be much higher in females than males [The present study indicates that an increasing number of urban residents in downtown Shanghai prefer to use non-iodized salt in recent years and suffer from ID. Women and those with a higher educational level were more tended to consume non-iodized salt. Why? Changes in the reported spectrum and growing incidence of thyroid disorders have been linked to the increased iodine intake resulting from USI in the local media and international medical literature . Those wan males , it is rConsidering that Shanghai is a coastal city, local residents believe that they should never suffer from IDD with high iodine-enriched aquatic products consumption. However, it may not be true to rely on consumption of seafood alone to provide sufficient iodine. Actually, the environmental levels of iodine in Shanghai are deficient (< 10 μg/L) . Further2” [DKD was commonly defined by ADA as “UACR≥30mg/g or eGFR<60 ml/min per 1.73 m2” . We foun2” , 33. Mor2” . Recent 2” . TherefoIn view of the ever-growing prevalence of T2DM and DKD all over the world, successive intervention in this large population can have important impact on public health. ID, unlike most micronutrient deficiencies, is not restricted to people in developing countries with poor diets. Since salt iodization is simple, effective and inexpensive, the best strategy to control ID is addition of iodine into salt in nearly all countries . MonitorOur study benefited from its well-defined community-based participants with a relatively large sample size. Second, regarding the novelty, our study is the first to provide iodine status, and linked iodine insufficiency to an increased risk of albuminuria in people with diabetes. Third, we used ICP-MS to detect UIC in the present analysis, which was considered as the gold-standard method . There wA large proportion of diabetic patients in downtown Shanghai consumed non-iodized salt and had ID. ID may increase the risk of DKD independent of thyroid function in diabetic patients. Maintaining USI at an appropriate level is indispensable for diabetic patients. Cohort and intervention studies as well as basic research exploring the effect and mechanism of iodine supplementation on renal function are warranted.