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Background Infliximab (IFX) is effective at inducing and maintaining clinical remission and mucosal healing in patients with Crohn's disease (CD); however, 9%–40% of patients do not respond to primary IFX treatment. This study aimed to construct and validate nomograms to predict IFX response in CD patients. Methods A total of 343 patients diagnosed with CD who had received IFX induction from four tertiary centers between September 2008 and September 2019 were enrolled in this study and randomly classified into a training cohort (n  = 240) and a validation cohort (n  = 103). The primary outcome was primary non-response (PNR) and the secondary outcome was mucosal healing (MH). Nomograms were constructed from the training cohort using multivariate logistic regression. Performance of nomograms was evaluated by area under the receiver-operating characteristic curve (AUC) and calibration curve. The clinical usefulness of nomograms was evaluated by decision-curve analysis. Results The nomogram for PNR was developed based on four independent predictors: age, C-reactive protein (CRP) at week 2, body mass index, and non-stricturing, non-penetrating behavior (B1). AUC was 0.77 in the training cohort and 0.76 in the validation cohort. The nomogram for MH included four independent factors: baseline Crohn's Disease Endoscopic Index of Severity, CRP at week 2, B1, and disease duration. AUC was 0.79 and 0.72 in the training and validation cohorts, respectively. The two nomograms showed good calibration in both cohorts and were superior to single factors and an existing matrix model. The decision curve indicated the clinical usefulness of the PNR nomogram. Conclusions We established and validated nomograms for the prediction of PNR to IFX and MH in CD patients. This graphical tool is easy to use and will assist physicians in therapeutic decision-making. [ABSTRACT FROM AUTHOR]

Objective: To observe the efficacy of early treatment of suspension moxibustion for Bell's palsy and its influence on the prognosis, and to explore whether the early treatment of suspension moxibustion has non-inferiority effect to hormone treatment and whether suspension moxibustion combined with hormone treatment has the synergistic effect., Methods: A total of 132 patients with acute-stage Bell's palsy were divided into a hormone group (94 cases) and a moxibustion group (38 cases) by non-random method, and the hormone group was further randomly divided into a hormone with moxibustion group (48 cases) and a hormone without moxibustion group (46 cases). The acupuncture and oral administration of mecobalamin capsule were used as basic treatment. Acupuncture was applied at Yangbai (GB 14), Sibai (ST 2), Quanliao (SI 18), Dicang (ST 4), Jiache (ST 6), Yifeng (TE 17), etc., with the needles retained for 30 min, once a day, 5 consecutive days per week; there was an interval of 2 days between two weeks, and a total of 4-week treatment was given. The oral administration of mecobalamin capsule was given 0.5 mg each time, 3 times a day for 4 weeks. The patients in the moxibustion group, on the basis of basic treatment, were treated with the suspension moxibustion at Yangbai (GB 14), Sibai (ST 2), Dicang (ST 4), Jiache (ST 6), Wangu (GB 12), Yifeng (TE 17) of affected side, 5 min per acupoint, once a day, 5 consecutive days per week; there was an interval of 2 days between two weeks, and a total of 4-week treatment was given. The patients in the hormone without moxibustion group, on the basis of basic treatment, were treated with prednisone acetate tablets. The patients in the hormone with moxibustion group, on the basis of basic treatment, were treated with suspension moxibustion and prednisone acetate tablets. All the treatment was given for 4 weeks. The House-Brcackmann facial nerve grading (H-B) global score and facial disability index (FDI) scale were used to evaluate the curative effect in the three groups before treatment, 2 weeks and 4 weeks into treatment and 4 weeks after treatment; the efficacy was compared among the three groups., Results: Compared before treatment, the H-B grading and FDI scores were significantly improved 2 weeks and 4 weeks into treatment and 4 weeks after treatment ( P <0.05). The various indexs of each group 2 weeks into treatment were not statistically significant in the three groups ( P >0.05); the H-B grading and FDI scores in the hormone with moxibustion group were superior to those in the moxibustion group and the hormone without moxibustion group 4 weeks into treatment and 4 weeks after treatment ( P <0.05), while there was no significant difference between the moxibustion group and the hormone without moxibustion group ( P >0.05). At the end of follow-up, the cured rate in the hormone with moxibustion group was 81.3% (39/48), which was superior to 68.4% (26/38) in the moxibustion group and 60.9% (28/46) in the hormone without moxibustion group ( P <0.05). However, there was no significant difference between the moxibustion group and the hormone without moxibustion group ( P >0.05)., Conclusion: The three treatment methods are all safe and effective for acute-stage Bell's palsy. The suspension moxibustion combined with hormone therapy are superior to suspension moxibustion or hormone therapy alone. Early treatment of suspension moxibustion is safe and effective for Bell's palsy, and has obvious synergistic effect with hormone. For the patients who cannot use hormone, suspension moxibustion could replace hormone, which is non-inferior to hormone.

Wetlands litter decomposition affects wetlands nutrient cycling. The decomposition progress of standing litter was monitored and the litterbag simulation experiment was carried out in order to analyze dynamics of litter decomposition and phosphorus release in Phragmites australis (PA), Spartina alterniflora (SA) and Scirpus mariqueter (SM) marshes of Hangzhou Bay coastal wetland. Results show that the dry mass of standing litter and P concentration decrease gradually and the litter drops to the sediment surface after 180 d. There are distinctive stages of the plant litter decomposition in litterbag simulation experiments. The loss rate is faster during 0- 15 d than that of later days. The loss rate in root decomposition of three plants are SM > PA > SA, while the trend is opposite for that of aboveground tissues. The time needed for 95% of dry mass decomposition in the plant tissues is between 1. 2- 8. 3 a. The P concentration in litters decreases rapidly in the initial stage and then increases slowly while the net P pools decreases all the time. Pearson's correlation coefficient shows that there is no significant correlation between the litter decomposition rate and C/N ratio. However, the litter C/P ratio affects greatly on plant decomposition rate. Environmental factors in the atmospheric temperature also have an impact on the decomposition rate of leaves. The different decomposition progresses between standing litter and litterbag are caused by environmental factors.

Salt marshes perform important ecosystem functions in carbon, nitrogen and phosphorus recycling. The plant biomass, content and pools of C, N and P were measured seasonally in three marsh species Phragmites australis, Spartina alterniflora and Scirpus mariquezer in Hangzhou Bay coastal wetland for the dynamics of C, N and P storage. The results showed that seasonal variation of aboveground biomass displayed a unimodal curve. The seasonal variability of plant OC content in the aboveground part of the plants was not significant, while the TN and TP content decreased significantly from spring to winter. The seasonal variability of plant C, N and P pools was significant. And there was a significant relationship between plant C/N/P pools and biomass. The pools among plant species were significantly different. S. mariqueter had the lowest C/N/P pools. TN pool in the aboveground part of P. australis was higher than that of S. aterniflora, but its TP pool was lower than that of S. alterniflora, and there was no significant difference for OC pools between P. australis and S. alterniflora. C fixation of the three marsh species was 380%, 376% and 55.5% of the average C fixation of terrestrial vegetations in China, and 463%, 458% and 67.7% of the average C fixation of terrestrial vegetations of the world. Considering the purification capacity of N and P, July would be the best harvest time of the study area for three plants. And the harvest of S. alterniflora could remove the biggest amount of P, since P was a limiting nutrient for phytoplankton growth. In conclusion, the marsh plants had strong C fixation and N/P purification ability.