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Aims Oesophageal fistula represents a rare but dreadful complication of atrial fibrillation catheter ablation. Data on its incidence, management and outcome are sparse. Methods and results This international multicenter registry investigates the characteristics of oesophageal fistulae after treatment of atrial fibrillation by catheter ablation. A total of 553,729 catheter ablation procedures (radiofrequency: 62.9%, cryoballoon: 36.2%, other modalities: 0.9%) were performed at 214 centers in 35 countries. In 78 centers 138 patients (0.025%, radiofrequency: 0.038%, cryoballoon: 0.0015% (p<0.0001)) were diagnosed with an oesophageal fistula. Periprocedural data were available for 118 patients (85.5%). Following catheter ablation, the median time to symptoms and the median time to diagnosis were 18 (7.75, 25; range: 0-60) days and 21 (15, 29.5; range: 2-63) days, respectively. The median time from symptom onset to oesophageal fistula diagnosis was 3 (1, 9; range: 0-42) days. The most common initial symptom was fever (59.3%). The diagnosis was established by chest computed tomography in 80.2% of patients. Oesophageal surgery was performed in 47.4% and direct endoscopic treatment in 19.8%, and conservative treatment in 32.8% of patients. The overall mortality was 65.8%. Mortality following surgical (51.9%) or endoscopic treatment (56.5%) was significantly lower as compared to conservative management (89.5%) (odds ratio 7.463 (2.414, 23.072) p<0.001). Conclusions Oesophageal fistula after catheter ablation of atrial fibrillation is rare and occurs mostly with the use of radiofrequency energy rather than cryoenergy. Mortality without surgical or endoscopic intervention is exceedingly high.

To develop an effective phytoremediation approach to purify soils polluted by decabromodiphenyl ether (BDE-209) in e-waste recycling area, pot experiments were conducted through greenhouse growth of seven plant species in BDE-209-polluted soils. The hygrocolous rice (Oryza sativa L.) cultivars (XiuS and HuangHZ) and the xerophyte ryegrass (Lolium perenne L.) were found to be as the most effective functional plants for facilitating BDE-209 dissipation, with the removal of 52.9, 41.9, and 38.7% in field-contaminated soils (collected directly from field, with an average pollution concentration of 394.6 μg BDE-209 kg(-1) soil), as well as 21.7, 27.6, and 28.1% in freshly spiked soils (an average pollution concentration of 4413.57 μg BDE-209 kg(-1) soil, with additional BDE-209 added to field-contaminated soils), respectively. Changes in soil phospholipid fatty acid (PLFA) profiles revealed that different selective enrichments of functional microbial groups (e.g., arbuscular mycorrhizal fungi and gram-positive bacteria) were induced due to plant growth under contrasting water management (flooded-drained sequentially, flooded only, and drained only, respectively). The abundance of available electron donors and acceptors and the activities of soil oxido-reductases were also correspondingly modified, with the activity of catalase, and the content of NO3(-) and Fe(3+) increased generally toward most of the xerophyte treatments, while the activity of dehydrogenase and the content of dissolved organic carbon (DOC) and NH4(+) increased toward the hygrophyte treatments. This differentiated dissipation of BDE-209 in soils as function of plant species, pollution doses and time, and water-dependent redox condition. This study illustrates a possibility of phytoremediation for BDE-209-polluted soils by successive cultivation of rice followed by ryegrass coupling with suitable water management, possibly through dissipation pathway of microbial reductive debromination and subsequent aerobic oxidative cleavage of benzene ring.

Gynura divaricata (L.) DC and G. bicolor DC are used as secret recipes to treat diabetes mellitus in some parts of China. Pharmacological tests were performed to prove the anti-hyperglycemic effect of these two plants of genus Gynura Cass. in this study. Both water and 95% ethanol extracts of fresh G. divaricata had significant effects on lowering blood glucose level in normal mice, in which the dose of 0.4 g (crude drug)/kg of 95% ethanol extract was more effective than 50 mg/kg glyburide. The ethyl acetate and n-butanol extracts of dried G. divaricata had significant effects on lowering blood glucose level in normal and alloxan diabetic mice too. Both ethyl acetate and n-butanol extracts of dried G. bicolor showed very significant effect on lowering blood glucose level to normal and alloxan-diabetic mice, and the dose 4.0 g (crude drug)/kg had a more hypoglycemic effect than 50 mg/kg glyburide in normal mice.