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Backgrounds The evaluation of liver fibrosis stages is essential for the clinical management of chronic hepatitis B (CHB). Aims To develop and validate a novel noninvasive index for moderate to severe fibrosis (≥S2) in CHB patients. Methods A total of 401 CHB patients who underwent liver biopsy were divided into the training (n = 300) and validation (n = 101) cohort. Histological severity was scored using a modified Scheuer system. Clinical and laboratory assessments were collected. Results In the training cohort, PACG, a novel index combining the quantitative hepatitis B core antibody (qAnti-HBc), platelet count (PLT), and albumin globulin ratio (A/G), presented better diagnostic performance (AUROC = 0.814) than that of APRI (0.735, p  = 0.007) and FIB-4 (0.749, p  = 0.014). In the validation cohort, the AUROC of the PACG, APRI, FIB-4 and Fibroscan were 0.834, 0.806, 0.791 and 0.810, respectively. More importantly, a higher and lower cutoff of PACG for predicting ≥S2 fibrosis or not had a >90% sensitivity and specificity, with a diagnostic accuracy of 85.9%. Conclusion PACG is a promising noninvasive alternative to liver biopsy in CHB patients for the evaluation of moderate to severe fibrosis. [ABSTRACT FROM AUTHOR]

Abstract: Approaches to reduce N2O emission from crop ecosystems deserves urgent need for climate change mitigation in world agriculture. Yet, unique ecological measures to depress N emission while conserving crop productivity have not yet been well developed for wide ranges of crop ecosystems. In order to establish an ecological engineering option to mitigate N2O emission in rice ecosystems, we conducted a field experiment with biochar amendment on N2O emission from rice paddies in three sites across South China in 2010. This experiment was performed with 6 treatments of biochar rates of 0, 20, and 40tha−1 with and without N fertilization respectively. The rice ecosystem was managed with conventional crop production practices as seasonally man-managed wetlands, which were under flooding after seedling transplantation till panicling and drainage during spiking followed by a subsequent moist condition (F-D-M) till harvest across sites. Emission of N2O from rice soil was monitored with closed chambers at 7 days interval throughout the whole rice growing season (WRGS) and the gas samples analyzed with a gas chromatograph (Agilent 7890D) equipped with an electron capture detector (ECD). Total emission of N2O-N ranged from 1.5kgN2O-Nha−1 to 1.9kgN2O-Nha−1 without biochar, and from 0.8kgN2O-Nha−1 to 1.3kgN2O-Nha−1 and from 0.7kgN2O-Nha−1 to 0.9kgN2O-Nha−1 with biochar amendment at 20tha−1 and 40tha−1, respectively. Thus, biochar amendment depressed total N2O emission from chemical N fertilizer, as the calculated EF of N2O-N emission was reduced from 0.57±0.15% under chemical N fertilizer only to 0.36±0.08% and 0.22±0.04% under biochar amendment at 20tha−1 and 40tha−1 respectively. The value under biochar amendment at 40tha−1 was found even much smaller than that of a continuously flooding rice ecosystem. As soil pH (H2O), content of soil organic carbon and total N were all upraised significantly, biochar amendment improved rice ecosystem functioning by decreasing N2O-N emission per metric ton of rice production from 0.17±0.02kgN2O-N without biochar to 0.10±0.02 and 0.07±0.03kgN2O-N under biochar respectively at 20tha−1 and 40tha−1. Thus, soil amendment of biochar from crop straw could be adopted as a unique ecological engineering measure to reduce N2O emission while enhancing soil fertility and sustaining rice productivity in rice ecosystems. [Copyright &y& Elsevier]