Combined effects of high temperature and waterlogging on yield and stem development of summer maize

The purpose of this study was to identify the physiological mechanism underlying the effects of high temperature and waterlogging on summer maize.The stem development and yield of the maize hybrid Denghai 605 in response to high-temperature stress,waterlogging stress,and their combination applied for six days at the third-leaf,sixth-leaf,and tasseling stages were recorded.The combined stresses reduced lignin biosynthetic enzyme activity and lignin accumulation,leading to abnormal stem development.Reduction of the area and number of vascular bundles in stems led to reduced dry matter accumulation and allocation.Decreased grain dry weight at all three stages reduced grain yield relative to a control.In summary,high temperature,waterlogging,and their combined stress impaired stem development and grain yield of summer maize.The combined stresses were more damaging than either stress alone.

Application of Pelvic Peritoneum Closure Combined with Extraperitoneal Colostomy in Laparoscopic Surgery for Low Rectal Cancer

Background:In the treatment of colorectal cancer,laparoscopic surgery has seen a significant amount of success.Reducing the risk of postoperative complications and improving patients’quality of life can be accomplished by appropriately employing pelvic peritoneal repair and sigmoid colostomy when appropriate.Objective:To compare fusion closure of pelvic peritoneum combined with extraperitoneal colostomy with non-closure of pelvic peritoneum combined with intraperitoneal colostomy in patients with low rectal cancer who had permanent colostomy.Methods:Low rectal cancer patients admitted to Hengshui People’s Hospital for permanent colostomy were evaluated.The participants were divided into two groups:an observation and a control group.All 30 cases in the observation group underwent pelvic peritoneum closure and extraperitoneal colostomy,while the other 30 cases in the control group underwent intraperitoneal colostomy.The C-reactive protein(CRP)levels of the participants in both groups were evaluated for 6 months to 2 years(24 h before,24 h after,48 h after,96 h after surgery).Results:Comparing the colostomy operative time,time to first passage of flatus postoperatively,time to first defecation postoperatively,length of hospital stay,laboratory indicators,stoma-related complications,colostomy function,etc.,the colostomy operative time significantly differed between the two groups(P<0.05);the observation group did considerably better than the control group in terms of stoma-related complications and bowel movement control 6 months after surgery(P<0.05);and although serum CRP levels increased in both groups 48 h after surgery,the difference was significant(P<0.05).Conclusion:Extraperitoneal colostomy can improve the quality of life of patients with permanent stoma and reduce the occurrence of stoma-related complications.Thus,this technique is worthy of promotion in clinical practice.

Water and nitrogen footprint assessment of integrated agronomic practice management in a summer maize cropping system

The footprints of water and nitrogen(WF and NF)provide a comprehensive overview of the type and quantity of water consumption and reactive nitrogen(Nr)loss in crop production.In this study,a field experiment over two years(2019 and 2020)compared three integrated agronomic practice management(IAPM)systems:An improved management system(T2),a high-yield production system(T3),and an integrated soil-crop management system(ISCM)using a local smallholder farmer’s practice system(T1)as control,to investigate the responses of WF,Nr losses,water use efficiency(WUE),and nitrogen use efficiency(NUE)to IAPM.The results showed that IAPM optimized water distribution and promoted water use by summer maize.The evapotranspiration over the whole maize growth period of IAPM increased,but yield increased more,leading to a significant increase in WUE.The WUE of the T2,T3,and ISCM treatments was significantly greater than in the T1 treatment,in 2019 and 2020respectively,by 19.8-21.5,31.8-40.6,and 34.4-44.6%.The lowest WF was found in the ISCM treatment,which was 31.0%lower than that of the T1 treatment.In addition,the ISCM treatment optimized soil total nitrogen(TN)distribution and significantly increased TN in the cultivated layer.Excessive nitrogen fertilizer was applied in treatment T3,producing the highest maize yield,and resulting in the highest Nr losses.In contrast,the ISCM treatment used a reduced nitrogen fertilizer rate,sacrificing grain yield partly,which reduced Nr losses and eventually led to a significant increase in nitrogen use efficiency and nitrogen recovery.The Nr level in the ISCM treatment was34.8%lower than in the T1 treatment while NUE was significantly higher than in the T1 treatment by 56.8-63.1%in2019 and 2020,respectively.Considering yield,WUE,NUE,WF,and NF together,ISCM should be used as a more sustainable and clean system for sustainable production of summer maize.

Interfacial Electronic Modulation of Dual-Monodispersed Pt–Ni_(3)S_(2) as Efficacious Bi-Functional Electrocatalysts for Concurrent H_(2) Evolution and Methanol Selective Oxidation

Constructing the efficacious and applicable bifunctional electrocatalysts and establishing out the mechanisms of organic electro-oxidation by replacing anodic oxygen evolution reaction(OER) are critical to the development of electrochemicallydriven technologies for efficient hydrogen production and avoid CO_(2) emission. Herein, the hetero-nanocrystals between monodispersed Pt(~ 2 nm) and Ni_(3)S_(2)(~ 9.6 nm) are constructed as active electrocatalysts through interfacial electronic modulation, which exhibit superior bi-functional activities for methanol selective oxidation and H_(2) generation. The experimental and theoretical studies reveal that the asymmetrical charge distribution at Pt–Ni_(3)S_(2) could be modulated by the electronic interaction at the interface of dual-monodispersed heterojunctions, which thus promote the adsorption/desorption of the chemical intermediates at the interface. As a result, the selective conversion from CH_(3)OH to formate is accomplished at very low potentials(1.45 V) to attain 100 m A cm^(-2) with high electronic utilization rate(~ 98%) and without CO_(2) emission. Meanwhile, the Pt–Ni_(3)S_(2) can simultaneously exhibit a broad potential window with outstanding stability and large current densities for hydrogen evolution reaction(HER) at the cathode. Further, the excellent bi-functional performance is also indicated in the coupled methanol oxidation reaction(MOR)//HER reactor by only requiring a cell voltage of 1.60 V to achieve a current density of 50 m A cm^(-2) with good reusability.

The environment,especially the minimum temperature,affects summer maize grain yield by regulating ear differentiation and grain development

Ear differentiation,grain development and their interaction with factors in the growing environment,such as temperature,solar radiation and precipitation,greatly influence grain number and grain weight,and ultimately affect summer maize production.In this study,field experiments involving different sowing dates were conducted over three years to evaluate the effects of temperature factors,average solar radiation and total precipitation on the growth process,ear differentiation,fertilization characteristics,grain filling and yield of summer maize varieties with different growth durations.Four hybrids were evaluated in Huang-Huai-Hai Plain(HHHP),China from 2018 to 2020 with five different sowing dates.The results showed that the grain yield formation of summer maize was strongly impacted by the environment from the silking(R1)to milking(R3)stage.Average minimum temperature(AT_(min))was the key environmental factor that determined yield.Reductions in the length of the growing season(r=–0.556,P<0.01)and the total floret number on ear(R^(2)=0.200,P<0.001)were found when AT_(min) was elevated from the emerging(VE)to R1 stage.Both grain-filling rate(R^(2)=0.520,P<0.001)and the floret abortion rate on ear(R^(2)=0.437,P<0.001)showed quadratic relationships with AT_(min) from the R1 to physiological maturity(R6)stage,while the number of days after the R1 stage(r=–0.756,P<0.01)was negatively correlated with AT_(min).An increase in AT_(min) was beneficial for the promotion of yield when it did not exceeded a certain level(above 23°C during the R1–R3 stage and 20–21°C during the R1-R6 stage).Enhanced solar radiation and precipitation during R1–R6 increased the grain-filling rate(R^(2)=0.562,P<0.001 and R^(2)=0.229,P<0.05,respectively).Compared with short-season hybrids,full-season hybrids showed much greater suitability for a critical environment.The coordinated regulation of AT_(min),ear differentiation and grain development at the pre-and post-silking stages improved maize yield by increasing total floret number and grain-filling rate,and by reducing the floret abortion rate on ear.

Surface diffraction beamline at the SSRF

BL02U2 of the Shanghai Synchrotron Radiation Facility is a surface diffraction beamline with a photon flux of 5.5×10^(12) photons/s at 10 keV and a beam size of 160µm×80µm at the sample site.It is dedicated to studying surfaces(solid-vacuum,solid-gas)and interfaces(solid-solid,solid-liquid,and liquid-liquid)in nanoscience,condensed matter,and soft matter systems using various surface scattering techniques over an energy range of 4.8-28 keV with transmission and reflection modes.Moreover,BL02U2 has a high energy resolution,high angular resolution,and low beam divergence,which can provide excellent properties for X-ray diffraction experiments,such as grazing incident X-ray diffraction,X-ray reflectivity,crystal truncation rods,and liquid X-ray scattering.Diversity of in situ environments can also be provided for the samples studied.This paper describes the setup of the new beamline and its applications in various fields.

Therapeutic potential of urine-derived stem cells in renal regeneration following acute kidney injury:A comparative analysis with mesenchymal stem cells

BACKGROUND Acute kidney injury(AKI)is a common clinical syndrome with high morbidity and mortality rates.The use of pluripotent stem cells holds great promise for the treatment of AKI.Urine-derived stem cells(USCs)are a novel and versatile cell source in cell-based therapy and regenerative medicine that provide advantages of a noninvasive,simple,and low-cost approach and are induced with high multidifferentiation potential.Whether these cells could serve as a potential stem cell source for the treatment of AKI has not been determined.METHODS Stem cell markers with multidifferentiation potential were isolated from human amniotic fluid.AKI severe combined immune deficiency(SCID)mice models were induced by means of an intramuscular injection with glycerol.USCs isolated from human-voided urine were administered via tail veins.The functional changes in the kidney were assessed by the levels of blood urea nitrogen and serum creatinine.The histologic changes were evaluated by hematoxylin and eosin staining and transferase dUTP nick-end labeling staining.Meanwhile,we compared the regenerative potential of USCs with bone marrow-derived mesenchymal stem cells(MSCs).RESULTS Treatment with USCs significantly alleviated histological destruction and functional decline.The renal function was rapidly restored after intravenous injection of 5×105 human USCs into SCID mice with glycerol-induced AKI compared with injection of saline.Results from secretion assays conducted in vitro demonstrated that both stem cell varieties released a wide array of cytokines and growth factors.This suggests that a mixture of various mediators closely interacts with their biochemical functions.Two types of stem cells showed enhanced tubular cell prolif-eration and decreased tubular cell apoptosis,although USC treatment was not more effective than MSC treatment.We found that USC therapy significantly improved renal function and histological damage,inhibited inflammation and apoptosis processes in the kidney,and promoted tubular epithelial proliferation.CONCLUSION Our study demonstrated the potential of USCs for the treatment of AKI,representing a new clinical therapeutic strategy.

Hematochezia due to rectal invasion by an internal iliac artery aneurysm: A case report

BACKGROUND This case report presents the rare occurrence of hematochezia due to an internal iliac artery aneurysm leading to an arterioenteric fistula,expanding the differential diagnosis for gastrointestinal bleeding.It emphasizes the importance of considering vascular origins in cases of atypical hematochezia,particularly in the absence of common gastrointestinal causes,and highlights the role of imaging and multidisciplinary management in diagnosing and treating such unusual presentations.CASE SUMMARY A 75-year-old man with a history of hypertension presented with 12 d of hematochezia,experiencing bloody stools 7-8 times per day.Initial computed tomography(CT)scans revealed an aneurysmal rupture near the right internal iliac artery with suspected hematoma development.Hemoglobin levels progressively decreased to 7 g/dL.Emergency arterial angiography and iliac arterycovered stent placement were performed,followed by balloon angioplasty.Despite initial stabilization,minor rectal bleeding and abdominal pain persisted,leading to further diagnostic colonoscopy.This identified a neoplasm and potential perforation at the proximal rectum.An exploratory laparotomy confirmed the presence of a hematoma and an aneurysm invading the rectal wall,necessitating partial rectal resection,intestinal anastomosis,and ileostomy.Postoperative recovery was successful,with no further bleeding incidents and normal follow-up CT and colonoscopy results after six months.CONCLUSION In cases of unusual gastrointestinal bleeding,it is necessary to consider vascular causes for effective diagnosis and intervention.

Effect of potassium permanganate dosing position on the performance of coagulation/ultrafiltration combined process

The effects of potassium permanganate(KMnO_4)dosing position on the natural organic matter(NOM)removal as well as membrane fouling were investigated in the coagulation/ultrafiltration combined process.KMnO_4 oxidation altered the NOM characteristics in terms of hydrophobicity and molecular weight,and destroyed humic substances originated from terraneous organisms in raw water.The optimal KMnO_4 dosage was 0.5 mg·L^(-1) in the peroxidation enhanced coagulation process with respect to the dissolved organic carbon(DOC)removal.When KMnO_4 was dosed into both upstream and downstream of coagulation,namely in the proposed twoposition dosing mode,coagulation and KMnO_4 oxidation worked individually on the apparent DOC removal.However,compared to the KMnO_4 addition prior to or after coagulation,the two-position dosing mode dramatically alleviated membrane fouling and reduced fouling irreversibility.This was attributed to the change of NOM characteristics as a result of KMnO_4 addition prior to coagulation and the presence of MnO_2 on membrane surface as a result of KMnO_4 addition prior to ultrafiltration.This work may provide useful information for the application of KMnO_4 oxidation in the coagulation/ultrafiltration combined system.

帕博利珠单抗联合以铂类为基础的化疗治疗非小细胞肺癌合并稳定性脑转移患者的结局:KEYNOTE-021、-189和-407研究的汇总分析

背景与目的此项探索性分析回顾评价了晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的结局,旨在确定基线时合并脑转移是否会影响一线应用帕博利珠单抗联合化疗(pembrolizumab plus chemotherapy,PC)比对单用化疗的疗效。患者和方法对KEYNOTE-021队列G(非鳞癌)、KEYNOTE-189(非鳞癌)和KEYNOTE-407(鳞癌)三项研究晚期NSCLC患者的数据进行汇总分析。患者接受含铂两药化疗和/或35个周期帕博利珠单抗治疗(每3周200 mg)。所有研究均纳入了经治或初治的稳定性脑转移患者(KEYNOTE-189与KEYNOTE-407研究纳入初治脑转移患者)。经治的脑转移患者已处于病情稳定的状态≥2周(KEYNOTE-021队列G患者≥4周),无新发或脑转移病灶扩大的证据且入组前至少3天以上未使用激素。初治的无症状脑转移患者需定期接受脑部影像学检查。结果共纳入1298例患者,其中171例有基线脑转移,1127例无脑转移。两组的中位随访时间(范围)在数据截止时分别为10.9(0.1-35.1)个月和11.0(0.1-34.9)个月。合并脑转移和无脑转移患者的总生存期[0.48(95%CI:0.32-0.70)和0.63(95%CI:0.53-0.75)]和无进展生存期[0.44(95%CI:0.31-0.62)和0.55(95%CI:0.48-0.63)]的风险比(PC/化疗)相似。合并脑转移的患者中,PC组和单用化疗组患者的中位总生存期分别为18.8个月和7.6个月,中位无进展生存期分别为6.9个月和4.1个月。无论是否合并脑转移,PC组患者的客观缓解率都高于单用化疗组,且缓解持续时间有显著延长。合并脑转移的患者中,PC组与单用化疗组的治疗相关不良事件发生率分别为88.2%和82.8%;而无脑转移的患者中,两组治疗相关不良事件的发生率分别为94.5%和90.6%。结论无论是否合并脑转移,与单用化疗相比,帕博利珠单抗联合以铂类为基础的组织学特异性化疗可改善所有PD-L1亚组的临床结局,其中包括PD-L1肿瘤比例评分<1%的患者,并且在晚期NSCLC患者中安全性良好。该方案是晚期NSCLC初治患者的标准方案,并可用于合并稳定性脑转移的患者。

Exogenous SA or 6-BA maintains photosynthetic activity in maize leaves under high temperature stress

With global warming, high-temperature(HT) stress has become a major abiotic stress for crops, in particular summer maize in China. Photosynthesis is sensitive to HT. Salicylic acid(SA) and 6-benzyladenine(6-BA) can improve the adaptation of plants to various biotic and abiotic stresses. However, their contribution to maintaining photosynthetic activity and alleviating photoinhibition in maize leaves under HT stress is still unclear. The effects of exogenous SA or 6-BA on growth, photosynthesis capacity, photosystem Ⅱ(PSII) activity, subcellular ultrastructure, antioxidant system, and plant hormones in maize leaves under HT stress were investigated. Under HT conditions, application of SA or 6-BA up-regulated gibberellin and zeatin content in leaves, increasing leaf area index(LAI). It also expanded the stomata by reducing abscisic acid and jasmonic acid content in leaves, cooling them and increasing CO2supply to photosynthesis. A higher net photosynthetic rate, combined with increased activity of the antioxidant system, alleviated oxidative stress in maize plants sprayed with SA or 6-BA, allowing them to maintain their chloroplast ultrastructure and PSII activity, in particular electron transfer from QAto QB. The increased LAI and net photosynthetic rate per unit leaf area also resulted in the accumulation of more biomass.

Responses of photosynthetic characteristics and leaf senescence in summer maize to simultaneous stresses of waterlogging and shading

A field experiment was performed to investigate the physiological mechanism of the simultaneous stresses of waterlogging and shading on leaf photosynthetic and senescence during three growth stages of summer maize.The responses of leaf gas exchange parameters and antioxidant enzyme activities of the summer maize hybrids Denghai 605(DH605)to waterlogging(W),shading(S),and their combination(W+S)for 6 days at the third leaf stage(V3),the sixth leaf stage(V6),and the tasseling stage(VT)were recorded.Shading,waterlogging,and their combination disturbed the activities of protective enzymes and increased the contents of H2O2and O-2,accelerating leaf senescence and disordering photosynthetic characteristics.Under waterlogging,shading and their combination,leaf Pn,the photo-assimilates and grain yield was decreased.The greatest reduction for waterlogging and the combined stresses occurred at V3 and that for shading stress occurred at VT.The individual and combined stresses reduced the activities of protective enzymes and inhibited photosynthesis,reducing the accumulation of photosynthetic compounds and thereby yield.Waterlogging and the combined stresses at the V3 stage showed the greatest effect on leaf photosynthetic and senescence,followed by the V6 and VT stages.The greatest effect for shading stress occurred at VT,followed by the V6 and V3 stages,and the combined influence of shading and waterlogging was greater than that of either single stress.

Role of mitophagy in the hallmarks of aging

Aging, subjected to scientific scrutiny, is extensively defined as a time-dependent decline in functions that involves the majority of organisms. The time-dependent accretion of cellular lesions is generally a universal trigger of aging, while mitochondrial dysfunction is a sign of aging. Dysfunctional mitochondria are identified and removed by mitophagy, a selective form of macroautophagy. Increased mitochondrial damage resulting from reduced biogenesis and clearance may promote the aging process. The primary purpose of this paper is to illustrate in detail the effects of mitophagy on aging and emphasize the associations between mitophagy and other signs of aging, including dietary restriction, telomere shortening, epigenetic alterations, and protein imbalance.The evidence regarding the effects of these elements on aging is still limited. And although the understanding of relationship between mitophagy and aging has been long-awaited, to analyze details of such a relationship remains the main challenge in aging studies.

Evaporative Cooling Applied in Thermal Power Plants:A Review of the State-ofthe-Art and Typical Case Studies

A review is conducted about the application of the evaporative cooling technology in thermal power plants.Different case studies are considered,namely,evaporative air conditioners,evaporative cooling in direct air-cooled systems,gas turbine inlet cooling,wet cooling towers,and hybrid cooling towers with a crosswind effect.Some effort is provided to describe the advantages related to direct evaporative cooling when it is applied in thermal power plants and illustrate the research gaps,which have not been filled yet.In particular,typical case studies are intentionally used to compare the cooling performances when direct evaporative cooling is implemented in different types of cooling towers,including the natural draft wet cooling tower(NDWCT)and the pre-cooled natural draft dry cooling tower(NDDCT).It is shown that the NDWCT provides the best cooling performance in terms of power station cooling,followed by the pre-cooled NDDCT,and the NDDCT;moreover,the evaporative pre-cooling is able to enhance the cooling performance of NDDCT.Besides,on a yearly basis,better NDDCT cooling performances can be obtained by means of a spray-based pre-cooling approach with respect to wet media pre-cooling.Therefore,the use of nozzle spray is suggested for improvement in the performance of indirect/direct air-cooling systems with controlled water consumption.

Current Situation and Countermeasures of Antibiotic Pollu-tion in the Surface Water of the Yangtze River Basin in a Province of Central China

Antibiotics are widely used in the process of human medical treatment,livestock and poultry breeding,and aquaculture.With the excretion of urine and feces,they enter the water environment of human life and become an important source of water environment pollution.Antibiotic residues in the environment have high ecological and health risks.Through the pilot monitoring of antibiotics in the main stream of the Yangtze River,Chaohu Lake and the drinking water source of Hefei City,the current situation and impact of antibiotic pollution were analyzed.The results show that 32 kinds of antibiotics and their derivatives of the six major categories involved were detected to varying degrees,and the concentrations at some points reached 1.26μg/L.Finally,the prevention and control of antibiotic pollution in the surface water of the Yangtze River basin in a province of central China were summarized,and relevant suggestions were given.

A UV cross-linked gel polymer electrolyte enabling high-rate and high voltage window for quasi-solid-state supercapacitors

Serving as a promising alternative to liquid electrolyte in the application of portable and wearable devices,gel polymer electrolytes(GPEs)are expected to obtain more preferable properties rather than just be satisfied with the merits of high safety and deformability.Here,an easy-operated method is employed to fabricate cross-linked composite polymer membranes used for GPEs assisted by UV irradiation,in which N-doped carbon quantum dots(N-CQDs)and TiO2are introduced as photocatalysts and additives to improve the performances of GPEs.Specifically,N-CQDs participate as a cross-linker to construct the inner porous structure,and TiO2nanoparticles serve as a stabilizer to improve the electrochemical stability of GPEs under high voltage(3.5 V).The excellent thermal and mechanical stability of the membrane fabricated in this work guarantee the safety of the supercapacitors(SCs).This GPE based SC not only exhibits prominent rate performance(105%capacitance retention at the current density of 40A g^(-1))and cyclic stability(85%at 1 A g^(-1)under 3.5 V after 20,000 cycles),but also displays remarkable energy density(42.88 Wh kg^(-1))with high power density(19.3 k W kg^(-1)).Moreover,the superior rate and cycling performances of the as-prepared GPE based flexible SCs under flat and bending state confirm the feasibility of its application in flexible energy storage devices.

Simulations of hot electron transport in radiation-ablated plasma

The transport of hot electrons in inertial confinement fusion(ICF)is integrated issue due to the coupling of hydrodynamic evolution and many physical processes.A hot electron transport code is developed and coupled with the radiation hydrodynamic code MULTI1D in this study.Using the code,the slowing-down process and ablation process of the hot electron beam are simulated.The ablation pressure scaling law of hot electron beam is confirmed in our simulations.The hot electron transport is simulated in the radiation-ablated plasmas relevant to indirect-drive ICF,where the spatial profile of hot electron energy deposition is presented around the shock compressed region.It is shown that the hot electron can prominently increase the total ablation pressure in the early phase of radiation-ablated plasma.So,our study suggests that a potential-driven symmetric mechanism may occur under the irradiation of asymmetric hot electron beam.The possible degradation from the hot electron transport and preheating is also discussed.

Key elements and checklist of shared decisionmaking conversation on life-sustaining treatment in emergency:a multispecialty study from China

BACKGROUND:Shared decision-making(SDM)has broad application in emergencies.Most published studies have focused on SDM for a certain disease or expert opinions on future research gaps without revealing the full picture or detailed guidance for clinical practice.This study is to investigate the optimal application of SDM to guide life-sustaining treatment(LST)in emergencies.METHODS:This study was a prospective two-round Delphi consensus-seeking survey among multiple stakeholders at the China Consortium of Elite Teaching Hospitals for Residency Education.Participants were identified based on their expertise in medicine,law,administration,medical education,or patient advocacy.All individual items and questions in the questionnaire were scored using a 5-point Likert scale,with responses ranging from"very unimportant"(a score of 1)to"extremely important"(a score of 5).The percentages of the responses that had scores of 4-5on the 5-point Likert scale were calculated.A Kendall’s W coefficient was calculated to evaluate the consensus of experts.RESULTS:A two-level framework consisting of 4 domains and 22 items as well as a ready-touse checklist for the informed consent process for LST was established.An acceptable Kendall’s W coefficient was achieved.CONCLUSION:A consensus-based framework supporting SDM during LST in an emergency department can inform the implementation of guidelines for clinical interventions,research studies,medical education,and policy initiatives.

Rare synchronous colorectal carcinoma with three pathological subtypes: A case report and review of the literature

BACKGROUND Synchronous colorectal carcinomas(SCRC)are two or more primary colorectal carcinomas identified simultaneously or within 6 mo of the initial presentation in a single patient.Their incidence is low and the number of pathological types of SCRC is usually no more than two.It is very unusual that the pathological findings of a patient with SCRC show more than two different pathological subtypes.Here,we report a rare case of SCRC with three pathological subtypes.CASE SUMMARY A 75-year-old woman who had no previous medical history or family history was admitted to the hospital because of intermittent hematochezia for more than a month.Colonoscopy displayed an irregularly shaped neoplasm of the rectum,a tumor-like lesion causing intestinal stenosis in the descending colon,and a polypoidal neoplasm in the ileocecum.Subsequently,she underwent total colectomy,abdominoperineal resection for rectal cancer,and ileostomy.After operation,the pathological report showed three pathological subtypes including well-differentiated adenocarcinoma of the ascending colon,moderately differen-tiated adenocarcinoma of the descending colon,and mucinous adenocarcinoma of the rectum.She is now recovering well and continues to be closely monitored during follow-up.CONCLUSION Preoperative colonoscopy examination,imaging examination,and extensive intraoperative exploration play important roles in reducing the number of missed lesions.

Subchondral fatigue fracture of the femoral head in young military recruits:Potential risk factors

BACKGROUND Subchondral fatigue fracture of the femoral head(SFFFH)mainly occurs in young military recruits and might be confused with osteonecrosis of the femoral head.However,less research focuses on the risk factor for SFFFH.AIM To evaluate the intrinsic risk factors for SFFFH in young military recruits.METHODS X-ray and magnetic resonance imaging data were used for analysis.Acetabular anteversion of the superior acetabulum,acetabular anteversion of the center of the acetabulum(AVcen),anterior acetabular sector angle(AASA),posterior acetabular sector angle,superior acetabular sector angle,neck-shaft angle(NSA),inferior iliac angle(IIA),and ischiopubic angle were calculated.Then,logistic regression,receiver operating characteristic curve analysis,and independent samples t-test were performed to identify the risk factors for SFFFH.RESULTS Based on the results of logistic regression,age[odds ratio(OR):1.33;95%confidence interval(95%CI):1.12-1.65;P=0.0031]and treatment timing(OR:0.86;95%CI:0.75-0.96;P=0.015)could be considered as the indicators for SFFFH.AVcen(P=0.0334),AASA(P=0.0002),NSA(P=0.0007),and IIA(P=0.0316)were considered to have statistical significance.Further,AVcen(OR:1.41;95%CI:1.04-1.95)and AASA(OR:1.44;95%CI:1.21-1.77),especially AASA(area under curve:66.6%),should be paid much more attention due to the higher OR than other indicators.CONCLUSION We have for the first time unveiled that AASA and age could be key risk factors for SFFFH,which further verifies that deficient anterior coverage of the acetabulum might be the main cause of SFFFH.