Dicamba Resistance Enlarging and Preserving

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解读2014年新版芝加哥食管动力障碍分类标准

解读2014年新版芝加哥食管动力障碍分类标准

解读2014年新版芝加哥食管动力障碍分类标准更新时间:2015-05-03•作者:北京协和医院消化科孙晓红以往应用传统水灌注线性方法对临床表现为非机械梗阻性吞咽困难、非心源性胸痛以及胃食管反流症状的患者进行食管动力功能评估。

与传统测压方法比较,高分辨食管压力地形图(HRM-EPT)能更全面、客观地评估食管动力功能。

HRM-EPT是将高分辨食管测压(HRM)和压力地形图绘制相结合应用于临床评价食管动力的检测技术。

芝加哥国际HRM工作组于2007年首次拟定了芝加哥食管动力障碍分类标准;在2014年工作组结合近年来的临床实践,在2011版芝加哥分类标准基础上进行了调整和更新,主要对胃食管交界处(EGJ)流出道、食管动力障碍程度的定义和诊断标准进行了修订。

本文将就2014年新版芝加哥食管动力障碍分类标准的重点内容进行解读。

解读1:常用技术参数综合松弛压(IRP)指自上食管括约肌吞咽开始10s时间窗内,EGJ连续或不连续4s的最低松弛压。

IRP相当于传统测压技术中的LES松弛残余压,用于评价流出道是否梗阻。

食管远端收缩积分(DCI)指近端食管与远端食管形成的低压槽至EGJ近端之间的食管长度、食管收缩幅度和时间的乘积,用于评价食管蠕动收缩的力度。

收缩减速点(CDP)指远端食管推进性蠕动收缩速度减低点,为远端食管S2段和S3段之间的交点。

远端潜伏期(DL)指上食管括约肌松弛至CDP的时限。

DCI、CDP和DL用于评价食管体部蠕动收缩功能。

与旧版相比,新版芝加哥标准中不再应用收缩前沿速度(CFV)这个参数。

解读2:EGJ流出道分型EGJ主要是由下食管括约肌(LES)和膈脚(CD)两部分组成。

新版芝加哥分类标准分别阐述了EGJ的形态和压力。

EGJ形态分为3种类型(图):类型Ⅰ,LES和CD重叠,表现为单峰;类型Ⅱ,LES和CD不重叠,表现为双峰,纵向距离1~2cm;类型Ⅲ,LES和CD不重叠,表现为双峰,纵向距离大于2cm。

【医脉通-指南】“免疫功能异常患儿的预防接种专家共识(试行稿

【医脉通-指南】“免疫功能异常患儿的预防接种专家共识(试行稿

主堡』L型苤查!!!!生!!旦笙!!鲞笙!!塑坠也』壁i堕!:旦竺!竺!堕!!!!:∑尘:i!:盟!:!! “免疫功能异常患儿的预防接种专家共识 (试行稿:原发性免疫缺陷病"解读宋红梅疫苗接种是预防和控制感染性疾病的最有效手段,目前世界各国都有非常完善的针对健康儿童和成人的免疫接种程序,也因此预防了多种传染病的发生。

但是对于免疫功能异常的患儿,是否可以按照常规的计划免疫接种程序进行、谁负责判断这些患儿是否可以进行预防接种、有无特殊的适应证和禁忌证、对这些患儿是否应该给予二类疫苗的接种等问题,是经常困扰儿童保健医生和免疫专科医生的临床决策难点。

免疫功能异常的患儿是各种病原菌感染的易感和高发人群,更需要疫苗接种对其进行预防,同时,不恰当接种疫苗的风险更高,这些都是疫苗接种程序中亟待解决的。

近年来国内外学者非常重视这部分患儿的预防接种问题,免疫学者也一直关注这些人群的疫苗接种问题-l“,但是尚未形成全国统一的规范或实践指南。

为此中华医学会儿科学分会免疫学组联合《中华儿科杂志》编辑委员会,对有关免疫接种的国内外文献进行了收集和分析整理,参考国际其他专业委员会的建议或指南,经相关专家多次讨论达成本试行稿的共识,力争为我国儿科临床医生提供符合我国国情、具有可操作性的免疫功能低下患儿免疫接种的实践依据,但需强调本共识不是法律或法规性文件,不具备法律法规的约束性,仅作为临床医生在处理免疫功能异常患儿预防接种时的参考。

共识尽可能做到参考国内外一些高质量研究的数据,但是国内可用的高质量的文献有限,所以重点检索了PubMed的英文文献。

根据国外文献中应用的广泛程度,证据水平和推荐分级参考了美国感染病学会所推荐的系统。

检索时分别应用在共识中定义的免疫功能异常人群[包括primary/congenitalimmune deficiency、secondary immune deficiency、DOI:10.3760/cma.j.issn.0578-1310.2015.12.007基金项目:国家卫生计生委公益性行业科研项目(201402012 作者单位:100730中国医学科学院北京协和医学院北京协和医院儿科,Email:songhml021@hotmail.corn .指南解读.human immunode{iciency virus (HIV infected patients、chronic inflammatory diseases、rheumatoid diseases、glucocorticoid、immunosuppressive therapies、chronic kidney diseases? asplenic patients、 hepersensitivity/allergy和acute severe illness l和“vaccination”或“immunization”或“vaccine”,筛选相关文献。

肠外肠内营养指南汇总

肠外肠内营养指南汇总

附录1肠外肠内营养学临床指南中华医学会肠外肠内营养学分会(2006 版)第一章制定指南的“指南”引言制定指南的初级阶段中华医学会肠外肠内营养学分会(Chinese Society of Parenteral and Enteral Nutrition, CSPEN)于2004年12月在京成立。

作为一个多学科学术组织,CSPEN的愿景(vision)是倡导循证营养支持的实践,促进我国肠外肠内营养的合理应用,为患者提供安全、有效和具有良好效价比的营养治疗。

编写、制定与推广临床指南是实现上述目标的重要途径。

指南定义为:按照循证医学原则,以当前最佳证据为依据,按照系统和规范方法,在多学科专家、各级医院的临床医师和护理人员合作下达成的共识。

本指南的宗旨是为临床医师、护理工作者、营养师、药剂师和患者在特定临床条件下,制定和/或接受肠外肠内营养支持方案提供帮助,并为卫生政策的制定者提供决策依据。

2005年1月- 9月,是我们分会制定指南的初级阶段。

CSPEN常委们在中华医学会的直接指导下,组织了我国肠外肠内营养学工作者及儿科、外科、内科等多学科专家成立了第一届《肠外肠内营养指南》编写委员会。

按照循证医学原则,经过参比国内国外的临床研究报告,制定的肠外肠内营养支持的适应症指南。

在2005年9月在北京召开的的“第一届全国临床营养周”大会上公开征求意见后,又做了大范围的修正和大范围的补充,于当年12月完成了第2005版《肠外肠内营养学临床―指南‖系列一:住院患者肠外营养支持的适应证》。

虽然该指南范围窄,仅是住院患者肠外肠内营养支持的适应证的内容,但仍然受到业者的重视。

已经先后在《中国临床营养杂志》、《中华医学杂志》和《中华外科杂志》等三本核心期刊杂志登载。

发表后受到国内同行的关注,也为2006年完善方法学和扩大内容打下了基础。

一、2006年版指南制订过程在2005年适应症指南的基础上,2006年1月CSPEN《肠外和肠内营养临床指南》编委会和支持小组就启动了文献复习工作,在不同场合广泛听取和收集国内同行意见和建议。

有氧运动结合渐进性抗阻训练对住院老年肌少症患者的干预效果研究

有氧运动结合渐进性抗阻训练对住院老年肌少症患者的干预效果研究

有氧运动结合渐进性抗阻训练对住院老年肌少症患者的干预效果研究王磊1,陈松1,段江泽琰1,姜文扬1,姜敏敏2上海市杨浦区控江医院康复医学科1、老年医学科2,上海200093【摘要】目的探讨有氧运动结合渐进性抗阻训练对住院老年肌少症患者的干预效果。

方法选取2022年8月至2023年3月于上海市杨浦区控江医院住院治疗的60例老年肌少症患者作为研究对象,按照随机数表法分为观察组和对照组各30例。

对照组患者使用常规有氧运动干预,观察组患者在对照组基础上联合渐进性抗阻训练,均持续干预12周。

比较两组患者干预前后的握力、骨骼肌质量指数、大腿周径、Barthel 指数(BI)、Berg 平衡量表(BBS)评分、6min 步行测试(6MWT)距离和生活质量综合量表-74(GQOLI74)评分的变化。

结果干预后,观察组患者的握力、骨骼肌质量指数、大腿周径分别为(21.32±2.08)kg 、(6.58±0.41)kg/m 2、(52.87±1.46)cm ,明显高(长)于对照组的(19.88±1.72)kg 、(6.27±0.46)kg/m 2、(51.84±1.98)cm ,差异均有统计学意义(P <0.05);干预后,观察组患者的BI 评分、BBS 评分、6MWT 分别为(59.30±4.52)分、(48.25±3.76)分、(441.66±31.42)m ,明显高于(长)于对照组的(53.07±4.70)分、(45.81±3.71)分、(417.59±32.85)m ,差异均有统计学意义(P <0.05);GQOLI74评分中,观察组患者的躯体功能、心理功能、社会功能评分分别为(78.23±6.52)分、(73.24±6.85)分、(77.26±6.13)分,明显高于对照组的(72.67±6.88)分、(66.72±6.91)分、(73.05±6.66)分,差异均有统计学意义(P <0.05)。

Degradation of multidrug-resistant E. coli by low

Degradation of multidrug-resistant E. coli by low

Degradation of multidrug-resistant E. coli by lowpressure plasma期刊名称: International Journal of Food Properties作者: Irfan Qasim,Habib Bukhari,Muhammad Shafiq,Muhammad WaqarAhmed,Zobia Noreen,Syeda Masooma Naqvi作者机构: Department of Physics, Riphah International University, Islamabad, Pakistan,Vice chancellor, Kohsar University, Murree, Pakistan,Department of physics, Quaid-I-Azam University, Islamabad, Pakistan,Department ofBioinformatics, COMSATS University, Islamabad, Pakistan年份: 2021年期号: 第1期关键词: LTP;E.coli;Sterilization;OES;SEM摘要:Owing to its nontoxicity and better efficiency, low-temperature plasma (LTP) has been proposed to be a strong antibacterial agent against multidrug-resistant bactericidal pathogens. On the other hand, previously several food-borne pathogens were treated by chemically hazardous and least-efficient irradiation techniques. Because of its superior efficiency, in the current study, we implemented LTP protective mechanism against Escherichia coli (E.coli) . In particular, we investigated the sterilization effects of plasma on the degradation of pure samples of E.coli strain ( colony forming units) in the presence and absence of fumes. Interestingly, the proposed mechanism improved considerably the microbial reduction, inactivation efficiency and kill rate of the plasma-treated E.coli samples. The decrease in bactericidal cell viability was...内容由中国教育图书进出口有限公司引进。

大脑前动脉阻力指数升高的原因

大脑前动脉阻力指数升高的原因

大脑前动脉阻力指数升高的原因英文回答:Increased Resistance Index (RI) of the Anterior Cerebral Artery.The resistance index (RI) of the anterior cerebral artery (ACA) is a measure of the resistance to blood flow in the artery. An increased RI can indicate a number of underlying conditions, including:Atherosclerosis: Atherosclerosis is a condition in which plaque builds up in the arteries, narrowing them and reducing blood flow. Atherosclerosis can increase the RI of the ACA.Vasospasm: Vasospasm is a condition in which the arteries narrow, reducing blood flow. Vasospasm can be caused by a number of factors, including subarachnoid hemorrhage (SAH), head trauma, and certain medications.Hypertension: Hypertension is a condition in which blood pressure is abnormally high. Hypertension can damage the arteries and increase the RI of the ACA.Diabetes: Diabetes is a condition in which blood sugar levels are abnormally high. Diabetes can damage the blood vessels and increase the RI of the ACA.Sickle cell anemia: Sickle cell anemia is a condition in which the red blood cells are deformed, causing them to clog the blood vessels. Sickle cell anemia can increase the RI of the ACA.中文回答:大脑前动脉阻力指数升高的原因。

强直性肌营养不良基因CTG重复数与SEP、MEP对比分析

强直性肌营养不良基因CTG重复数与SEP、MEP对比分析崔毅;谢惠君;郑惠民;倪利英;刘莹【期刊名称】《第二军医大学学报》【年(卷),期】1999(20)9【摘要】目的:探讨强直性肌营养不良(DM)患者及其家系成员基因CTG重复数的变化与体感诱发电位(SEP)、经颅刺激运动诱发电位(MEP)的比较。

方法:用聚合酶链反应(PCR)扩增及DNA杂交法对5例临床诊断DM患者及其中3个家系16名成员进行DM基因CTG重复数和SEP、MEP测定。

结果:10名正常人CTG重复数19~30个,SEP、MEP正常5例。

DM患者CTG重复数均在80个以上,其中2例在1605个以上,明显高于正常人;16名家系成员中除4例正常,余12例CTG重复数均超过正常基因。

CTG重复数与临床症状、SEP、MEP有关。

结论:DM基因诊断与其临床诊断、SEP、ME【总页数】4页(P686-689)【关键词】强直性;肌营养不良;CTG重复数;SEP;MEP【作者】崔毅;谢惠君;郑惠民;倪利英;刘莹【作者单位】第二军医大学长海医院神经内科【正文语种】中文【中图分类】R746.2【相关文献】1.强直性肌营养不良患者基因CTG重复数与BAEP、TCD、ECG对比分析 [J], 崔毅;谢惠君;刘莹2.强直性肌营养不良基因CTG重复数与BAEP,TCD和ECG对比分析 [J], 崔毅;郑惠民3.强直性肌营养不良的不同组织基因中CTG重复数比较研究 [J], 谢惠君;郑惠民;张社卿;邓本强;许金明;崔毅;王晔;许谆;任大明4.DM基因CTG重复数与BAEP、SEP、VEP对比分析 [J], 崔毅;谢惠君;刘莹5.强直性肌营养不良基因CTG重复数与EMG,NCV对比分析 [J], 崔毅;吕如锋因版权原因,仅展示原文概要,查看原文内容请购买。

2023下英语教资科三考试真题及答案

2023下英语教资科三考试真题及答案全文共3篇示例,供读者参考篇12023下英语教资科三考试真题及答案Part I Multiple Choice Questions1. What is the main purpose of a teacher evaluation system?A. To reward teachers for their hard workB. To punish teachers for underperformingC. To provide feedback for professional growthD. To compare teachers' salariesAnswer: C. To provide feedback for professional growth2. Which of the following is NOT a characteristic of effective feedback?A. SpecificB. Well-timedC. EncouragingD. JudgmentalAnswer: D. Judgmental3. What does the term "differentiated instruction" mean?A. Teaching the same way to all studentsB. Adapting instruction to meet the needs of individual studentsC. Ignoring students' diverse learning stylesD. Using only one instructional strategyAnswer: B. Adapting instruction to meet the needs of individual students4. In a classroom setting, what is the teacher's role in promoting student engagement?A. Sitting back and observing silentlyB. Acting as a facilitator and guideC. Controlling every aspect of the lessonD. Ignoring student participationAnswer: B. Acting as a facilitator and guide5. How can teachers create a positive classroom environment?A. By having strict rules and consequencesB. By showing favoritism to certain studentsC. By building positive relationships with studentsD. By focusing only on academic contentAnswer: C. By building positive relationships with studentsPart II Short Answer Questions1. Describe how you would use technology to enhance your teaching practice.Answer: I would use technology such as interactive whiteboards, educational apps, and online resources to create engaging lessons, provide personalized learning opportunities, and facilitate collaboration among students.2. How would you handle a student who is consistently disruptive in class?Answer: I would first try to understand the underlying reasons for the student's behavior, communicate with them calmly and respectfully, and implement strategies such as positive reinforcement, behavior contracts, and individualized support to address their disruptive behavior.3. What are the benefits of incorporating real-world examples in your lessons?Answer: Incorporating real-world examples helps students connect abstract concepts to their everyday lives, enhances their understanding and retention of information, and fosters critical thinking and problem-solving skills.4. How can you support students with diverse learning needs in your classroom?Answer: I would differentiate instruction by modifying assignments, providing additional support, and implementing inclusive teaching practices to address the diverse learning needs of all students in my classroom.Part III Essay QuestionDiscuss the importance of ongoing professional development for teachers and how it contributes to their effectiveness in the classroom.Answer: Ongoing professional development is essential for teachers to stay current with educational trends, refine their teaching practices, and improve student learning outcomes. Continuous learning opportunities such as workshops, conferences, and advanced certifications provide teachers withnew knowledge, skills, and strategies to enhance their instructional practice and address the diverse needs of their students. Additionally, ongoing professional development fosters a growth mindset, encourages reflection andself-assessment, and promotes a culture of collaboration and innovation among educators. Ultimately, investing in professional development not only benefits teachers in their own professional growth but also positively impacts the quality of education and student success in the classroom.In conclusion, the 2023 English teaching qualification examination for secondary education includes multiple-choice, short-answer, and essay questions that assess candidates' knowledge, skills, and competencies in effective teaching practices. By successfully completing this examination, aspiring educators demonstrate their readiness to fulfill the responsibilities of a teacher and make a positive impact on student learning and development.篇22023下英语教资科三考试真题及答案Part A: Reading Comprehension (60 points)Read the following passage and answer the questions.The planet Mars has fascinated scientists and astronomers for centuries. Its reddish hue and mysterious surface have captivated the human imagination, leading to countless works of science fiction and speculation about the possibility of life on Mars. In recent years, technological advancements have allowed for more detailed study of the planet, revealing some surprising discoveries.1. What has fascinated scientists and astronomers about Mars?A. Its sizeB. Its red colorC. Its distance from EarthD. Its moons2. What has technology allowed scientists to do in recent years?A. Land on MarsB. Study the planet in more detailC. Determine the exact temperature of MarsD. Discover life on Mars3. What have scientists discovered about Mars?A. It is uninhabitableB. It has a blue surfaceC. It has no atmosphereD. It may have once had water4. Which of the following is NOT mentioned as a reason for the fascination with Mars?A. Its mysterious surfaceB. Its green colorC. its possibility of lifeD. its reddish hue5. What has led to more detailed study of Mars in recent years?A. Scientific curiosityB. Technological advancementsC. Political pressureD. Financial supportAnswer Key:1. B2. B3. D4. B5. BPart B: Essay Writing (40 points)Choose one of the following topics and write awell-organized essay of at least 300 words.1. Discuss the potential implications of discovering life on Mars.2. Analyze the role of technological advancements in the study of outer space.3. Debate the ethical considerations of colonizing Mars.Answer Key:I. IntroductionII. Body ParagraphsIII. ConclusionThat concludes the 2023 English Teaching Certification Exam (Secondary Level) Part Three: English Proficiency Test. Good luck to all test-takers!篇32023下英语教资科三考试真题及答案英语教育从事者是培养下一代的重要工作。

2018.8成人肺高压的分类和预后

成人肺高压的分类和预后Authors:Lewis J Rubin, MDWilliam Hopkins, MDSection Editor:Jess Mandel, MDDeputy Editor:Geraldine Finlay, MD翻译:丁永杰, 主治医师Contributor Disclosures我们的所有专题都会依据新发表的证据和同行评议过程而更新。

文献评审有效期至: 2018-07. | 专题最后更新日期: 2018-07-13.There is a newer version of this topic available in English.该主题有一个新的英文版本。

引言—肺高压是指肺动脉压升高,休息状态下平均肺动脉压≥25mmHg[1,2]。

肺高压有多种病因,如不治疗可进展至致死。

本文将总结肺高压的分类和预后。

肺高压的流行病学、发病机制、临床特征、诊断性评估和治疗将单独讨论。

(参见“肺动脉高压的发病机制”和“成人肺高压的临床特征和诊断”和“成人肺高压的治疗”)分类— WHO按病因将肺高压分为以下5型(表1)[1,2]:●1型–肺动脉高压(pulmonary arterial hypertension, PAH)●2型–左心疾病引起的肺高压●3型–慢性肺疾病和/或低氧血症引起的肺高压●4型–慢性血栓栓塞性肺高压(chronic thromboembolic pulmonary hypertension, CTEPH) ●5型–不明的多因素机制引起的肺高压PAH指1型肺高压。

肺高压指2-5型肺高压,也用于泛指以上5种类型。

肺高压还可按毛细血管前和毛细血管后分型。

毛细血管前肺高压是由于单纯肺动脉系统的原发性压力升高(如PAH),而毛细血管后肺高压是肺静脉和肺毛细血管系统压力升高所致(肺静脉高压;例如2型)。

(表2)实际上,部分患者兼有毛细血管前、后肺高压的特征。

1型PAH—该型PAH的原因包括:●特发性与遗传性PAH–不明机制引起的PAH(特发性PAH,IPAH)与遗传性基因缺陷引起的PAH(遗传性PAH,HPAH)在临床上往往无法区分。

重度胰岛素抵抗标准

重度胰岛素抵抗标准英文回答:Severe insulin resistance is a condition in which the body's cells become resistant to the effects of insulin, leading to high blood sugar levels. It is often associated with obesity, physical inactivity, and genetic factors. The standard for diagnosing severe insulin resistance is typically based on the level of insulin in the blood and the body's response to insulin.One common standard for diagnosing severe insulin resistance is the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). This test measures both fasting insulin and fasting glucose levels to assess insulin resistance. A HOMA-IR score above 2.5 is considered indicative of insulin resistance, while a score above 5 may indicate severe insulin resistance.Another standard for diagnosing severe insulinresistance is the Quantitative Insulin Sensitivity Check Index (QUICKI). This test also uses fasting insulin and glucose levels to calculate insulin sensitivity. A QUICKI score below 0.33 is considered indicative of insulin resistance.In addition to these tests, healthcare providers may also consider other factors such as the patient's medical history, family history of diabetes, and presence of other metabolic conditions. It's important to note that the diagnosis of severe insulin resistance is not based on a single test result, but rather a combination of factors.中文回答:重度胰岛素抵抗是一种病症,指的是人体细胞对胰岛素的作用产生抵抗,导致血糖水平升高。

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University of Nebraska - Lincoln DigitalCommons@University of Nebraska - LincolnFaculty Publications from the Center for PlantScience InnovationPlant Science Innovation, Center for5-25-2007Dicamba Resistance: Enlarging and Preserving Biotechnology-Based Weed Management StrategiesMark BehrensUniversity of Nebraska - LincolnNedim MutluUniversity of Nebraska - Lincoln , nmutlu2@Sarbani ChakrabortyUniversity of Nebraska - LincolnRazvan DumitruUniversity of Nebraska - LincolnWen Zhi JiangUniversity of Nebraska - Lincoln , wjiang2@ See next page for additional authorsThis Article is brought to you for free and open access by the Plant Science Innovation, Center for at DigitalCommons@University of Nebraska -Lincoln. It has been accepted for inclusion in Faculty Publications from the Center for Plant Science Innovation by an authorized administrator of DigitalCommons@University of Nebraska - Lincoln.Behrens, Mark; Mutlu, Nedim; Chakraborty, Sarbani; Dumitru, Razvan; Jiang, Wen Zhi; LaVallee, Bradley J.; Herman, Patricia L.;Clemente, Thomas E.; and Weeks, Donald, "Dicamba Resistance: Enlarging and Preserving Biotechnology-Based Weed Management Strategies" (2007).Faculty Publications from the Center for Plant Science Innovation.Paper 31./plantscifacpub/31AuthorsMark Behrens, Nedim Mutlu, Sarbani Chakraborty, Razvan Dumitru, Wen Zhi Jiang, Bradley J. LaVallee, Patricia L. Herman, Thomas E. Clemente, and Donald WeeksThis article is available at DigitalCommons@University of Nebraska - Lincoln:/plantscifacpub/31I n the past decade, the availability of biotechnology-derived herbicide-resis-tant and insect-resistant traits has led to striking advancements in agricultural crop management systems throughout the world. These “input traits” have contrib-uted to greater productivity per hectare, de-creased production costs, greater flexibility and efficiencies in production regimes, re -duced pesticide use, and improved farmer health (1–3). In 2006, more than 100 mil-lion hectares worldwide were planted with crops having biotechnology-derived traits (4). In the United States, for example, Roundup (glyphosate)–resistant crops were planted on almost 90% of the soybean acre-age and 60% of the cotton acreage in 2005, along with about 18% of the corn crop (3). The recent emergence of weeds resistant to the herbicides used year after year for weed control in fields of herbicide-resistant crops has prompted serious concerns regard-ing the long-term availability of the fac-ile and economically important weed con-trol provided by current herbicide-resistant crop plants. Also at risk is the greatly ex -panded use of no-till or reduced-till plant-ing procedures that are made possible by “burndown” of weeds before planting of herbicide-resistant crops. These integrated practices minimize soil loss due to water and wind erosion resulting from traditional methods of soil tillage (3).Among the glyphosate-tolerant weed spe-cies currently posing the greatest danger to agricultural productivity are several broad-leaf plants such as giant ragweed (Ambrosia trifida ), horseweed (Conyza canadenis ), water-hemp (Amaranthus rudis ), Palmer amaranth (Amaranthus palmeri ), and common rag-weed (Ambrosia artemisifolia ) (3, 5). To com-bat these pernicious weeds and to address the potential emergence of other herbicide-resistant broadleaf weeds, we have tar-geted the development of crop plants resis-tant to treatment with dicamba. Dicamba is a widely used, low-cost, environmentally friendly herbicide that does not persist in soils and shows little or no toxicity to wild -life and humans (6–10). Use of the dicamba resistance trait alone or in combination with other herbicide resistance traits will allow rotation of herbicides or use of mixtures of herbicides that will greatly suppress several present or future herbicide-resistant weeds. Here, we describe the use of a genetically engineered bacterial gene, DMO (dicamba monooxygenase), that encodes a Rieske nonheme monooxygenase capable of inacti -vating dicamba when expressed from either the nuclear genome or chloroplast genome of transgenic plants. The DMO enzyme acts to destroy the herbicidal activity of dicamba before the herbicide can build to toxic lev -els in dicamba-treated transgenic plants, as shown below.As the first step in the complete min -eralization of dicamba, the soil bacterium Pseudomonas maltophilia (strain DI-6) con-verts dicamba to 3,6-dichlorosalicylic acid (DCSA) (11, 12) (Figure 1A), a compound that lacks appreciable herbicidal activity. The enzyme system responsible for this conversion in the bacterium is the three-component enzyme dicamba O -demethyl-ase. This enzyme system serves as an elec-tron transfer chain in which electrons from NADH (the reduced form of nicotinamide adenine dinucleotide) are shuttled through a reductase to a ferredoxin and finally to the terminal component DMO (13–15). The ferredoxin component of dicamba O -de-methylase closely resembles the ferredoxin found in plant chloroplasts. Thus, to poten-tially take advantage of a source of reduced ferredoxin in chloroplasts of transgenic plants to supply electrons for the DMO re-action (and to eliminate the need for the bacterial reductase and ferredoxin genes), we included a chloroplast transit peptide–coding region upstream of the DMO gene to allow targeting of DMO to the chloro-plast. The DMO expression cassette (Figure 1B) contained the strong peanut chlorotic streak virus gene promoter FLt36 (16) and a terminator region from the pea Rubisco (ri-bulose-1,5-bisphosphate carboxylase-oxy -genase) small subunit gene. The goal then was to determine whether expression of DMO from this expression vector in trans -genic broadleaf plants could provide pro-tection against the normally lethal effects of dicamba.Because of ease of transformation and regeneration, Arabidopsis thaliana, tomato, and tobacco were used as model systems to test whether expression of the DMO gene alone (i.e., without the ferredoxin and reduc -tase components of dicamba O -demethyl-ase) could impart herbicide resistance after application of dicamba. Agrobacterium -me-diated gene transfer was used to introduce the DMO expression cassette into the nu -clear genome of the respective plant spe-cies. In regard to tobacco, we used DNA, RNA, and protein blot analyses to test sev-eral independently derived T 1-generation Published in Science 316 (May 25, 2007), pp. 1185–1188; doi 10.1126/science.1141596 Copyright © 2007 American Association for the Advancement of Science. Used by permission. /cgi/content/full/316/5828/1185/DC1Submitted February 21, 2007; accepted April 23, 2007.Dicamba Resistance: Enlarging and Preserving Biotechnology-Based Weed Management StrategiesMark R. Behrens,1* Nedim Mutlu,1* Sarbani Chakraborty,1 Razvan Dumitru,1 Wen Zhi Jiang,1 Bradley J. LaVallee,2† Patricia L. Herman,1‡ Thomas E. Clemente,2,3,4 Donald P. Weeks 1,41 Department of Biochemistry,2 Center for Biotechnology,3 Department of Agronomy and Horti-culture,4 Plant Science Initiative, University of Nebraska–Lincoln, Lincoln, NE 68588, USA.* These authors contributed equally to this work. † Present address: Monsanto Company, St. Louis, MO U.S.A. ‡ Present address: School of Biological Sciences, University of Nebraska–Lin-coln, Lincoln, NE 68588, USA. Corresponding author — D. Weeks, dweeks1@Abstract: The advent of biotechnology-derived, herbicide-resistant crops has revolutionized farm-ing practices in many countries. Facile, highly effective, environmentally sound, and profitable weed control methods have been rapidly adopted by crop producers who value the benefits as -sociated with biotechnology-derived weed management traits. But a rapid rise in the populations of several troublesome weeds that are tolerant or resistant to herbicides currently used in con-junction with herbicide-resistant crops may signify that the useful lifetime of these economically important weed management traits will be cut short. We describe the development of soybean and other broadleaf plant species resistant to dicamba, a widely used, inexpensive, and environ-mentally safe herbicide. The dicamba resistance technology will augment current herbicide re-sistance technologies and extend their effective lifetime. Attributes of both nuclear- and chloro-plast-encoded dicamba resistance genes that affect the potency and expected durability of the herbicide resistance trait are examined.Figure 1. Dicamba inacti-vation. (A) Conversion of di-camba to DCSA by DMO. (B) Genetically engineered ver-sion of the DMO gene for ex-pression in higher plants, us-ing the FLt36 promoter from peanut chlorotic streak virus, a translational enhancer from the tobacco etch virus (TEV), a chloroplast transit peptide– coding region from the pea Rubisco small subunit gene for chloroplast localization of DMO, and a terminator region from the pea Rubisco small subunit gene (rbcS3′).1186 B e h r e n s e t a l. i n S c i e n c e 316 (2007)plants for the presence and expression of the DMO gene (Figure S2). RNA blots demon-strated highly variable levels of DMO mRNA in individual transformants that, in general, did not correlate closely with the amount of DMO enzyme produced. We noted (most easily in lanes 2 and 6, Figure S2) that al-though most of the precursor DMO mole-cule containing the chloroplast transit pep-tide was cleaved to the mature form, not all of the precursor was processed.Most dicotyledonous plants, such as to-bacco, are quite sensitive to treatment with dicamba, an auxin-type herbicide. Figure 2A illustrates this point by showing non-transgenic tobacco plants not treated (left-most plant) and treated with increasing amounts of dicamba. Herbicide damage symptoms are pronounced after spraying dicamba even at the low level of 0.017 kg/ ha. Symptoms are quite severe at 0.28 kg/ ha and 0.56 kg/ha, the levels normally used for weed control in agricultural applica-tions.Treatment of transgenic tobacco plants containing the DMO gene with 5.6 kg/ha (10 to 20 times the recommended application rate) caused few if any symptoms, whereas a nontransgenic plant suffered severe dam-age (Figure 2B). Damage to the lower leaves of the transgenic plants could be duplicated by spraying plants with the surfactant-con-taining solvent solution used as the vehicle for dicamba application. Leaves produced after treatment of the transgenic plants with dicamba exhibited no visible signs of dam-age (Figure 2C). Transgenic tomato plants carrying the genetically engineered DMO gene, likewise, showed no damage to newly emerged leaves (Figure S2B) after spraying with dicamba at concentrations as high as 5.6 kg/ha. Arabidopsis expressing the DMO gene also displayed strong resistance to treatment with dicamba at 1.12 kg/ha, the highest level tested (Figure S3). Over a range of dicamba concentrations tested, an unexpected finding was the observation that tobacco plants trans-formed with a DMO expression cassette lack-ing a transit peptide–coding region were re-sistant to treatments with dicamba at levels on average only slightly below that of plants containing DMO genes bearing transit pep-tide–coding regions (Figure S4; see below).To determine whether DMO could func-tion exclusively inside chloroplasts, we cre-ated the pDMO1 vector bearing the DMO gene coding region (Figure S5). This vec-tor allows integration of the DMO gene into the chloroplast genome of tobacco by homologous recombination and the isola-tion of transformants through selection for antibiotic resistance. The DMO gene cod-ing region was driven by the strong psbA chloroplast gene promoter, containing the complete psbA5′-untranslated region se-quence, to obtain high levels of DMO ex-pression. Initial DNA blot analyses of an-tibiotic-resistant transgenic plants (Figure S6A) demonstrated the presence in chloro-plast genomes of both the DMO transgene (5.6-kb band) and the native psbA gene re-gion (3.3-kb band). Repeated regenerationand selection of transgenic plants on antibi-otic-containing medium resulted in appar-ently homoplastidic chloroplasts bearingthe DMO gene fragment but not the en-dogenous native gene region (Figure S6B).Only chloroplast transformants expressingthe DMO enzyme were resistant to treat-ment with dicamba (Figure S7). T1, T2, andT3generations of progeny from two inde-pendently derived chloroplast transfor-mants were tested for resistance to treat-ment with dicamba at various doses. Allexhibited high levels of resistance. Indeed,chloroplast genome transformants dis-played no apparent amage (other than “sol-vent-only damage” to lower leaves) whensprayed with dicamba at a rate of 28 kg/ha (Figure S8). Only transitory damage wasobserved when plants were treated with ex-tremely high dicamba applications of 112and 224 kg/ha. At these extremely highlevels, initial damage was caused primar-ily by surfactants and other componentsof the solvent in which dicamba was deliv-ered. New apex tissues and leaves growingfrom the damaged plants displayed nearlynormal to normal phenotypes, showed nodecrease in growth rates, and retained theability to produce usual numbers and qual-ity of seeds.The above results were consistent withthe hypothesis that reduced ferredoxin intobacco chloroplasts could be the donor toDMO of electrons needed for oxidation ofdicamba to DCSA. As a direct test of thishypothesis, we examined the ability of pu-rified spinach ferredoxin to support theconversion of dicamba to DCSA in the pres-ence and absence of DMO purified from P.maltophilia (strain DI-6) or overproducedand purified from Escherichia coli (table S1).Results of these experiments demonstratedthat reduced ferredoxin from spinach orClostridium pasteurianum was fully capableof donating electrons to DMO in vitro, asmeasured either by dicamba degradation orby DCSA appearance.The exceptionally high levels of resis-tance to dicamba displayed by tobaccoplants carrying the DMO gene in the chloro-plast genome, relative to plants bearing theDMO gene as a nuclear gene, suggested thepossibility that chloroplast-encoded DMOwas produced in greater abundance. Com-parison of the amounts of oxygenase as per-centage of total soluble protein, fraction offresh weight, or fraction of dry weight (tableS2) showed that chloroplast transformantsproduced about 20 times as much DMOas did nuclear transformants synthesizingDMO with a chloroplast transit peptide, andabout 40 times as much DMO as did nucleartransformants synthesizing DMO withoutthe peptide. The ability to achieve high lev-els of herbicide resistance and the ability toblock gene dissemination through “pollenflow” are attractive features of incorporatingthe DMO gene into the chloroplast genomesof important crop plants as soon as the tech-niques for such approaches prove practical(17, 18).Genetic studies of the inheritance of theDMO gene in chloroplast transformants re-vealed that inheritance was maternal, as ex-pected, and was mostly Mendelian intheFigure 2. Effects of dicamba treat-ment on nontransgenic tobaccoplants and plants transformedwith a genetically engineeredDMO gene. (A) Demonstration ofthe sensitivity of nontransgenic to-bacco plants to treatment with in-creasing doses of dicamba (left toright: 0, 0.017, 0.034, 0.07, 0.14,0.28, and 0.56 kg/ha). (B) Threeindependently derived T1-gener-ation tobacco plants carrying thedicamba resistance gene (threeplants at left) and a nontransgenicplant (right) treated with dicambaat a level of 5.6 kg/ha. (C) Top viewof plants in (B).D i c a m B a r e s i s ta n c e: B i ot e c h n o l o gy-B a s e D W e e D m a n ag e m e n t s t r at e g i e s 1187case of plants carrying DMO as a nuclear gene (Table S3). Most plants examined by DNA blot analysis contained a single DMO gene insert. Moreover, T3and T4progeny maintained the original levels of expression in regard to herbicide resistance whether they contained single or multiple copies of the DMO gene.The prime value of the dicamba resis-tance technology is related to its use in ma-jor field crops in which management of broadleaf weeds is essential to maximize production. Because soybean is one such crop, we transformed the soybean vari-eties Thorne (Ohio State University) and NE3001 (University of Nebraska) with the same DMO expression cassette (Figure 1B) used to transform tobacco, tomato, and Ara-bidopsis. As a means to derive marker-free soybean transformants, a two–T-DNA bi-nary plasmid was assembled. In this plas-mid, the marker-gene T-DNA element car-ried a bar gene cassette under the control of the Agrobacterium tumefaciens nopaline syn-thase promoter (nos), and the second, sep-arate, T-DNA element carried the DMO ex-pression cassette. More than 50 transgenic soybean events were produced, and seeds from the T1, T2, and T3generations were collected. Among the population of pri-mary transformants generated, one marker-free event was identified that harbored only the DMO cassette. Most transgenic soybean events showed resistance to treatment with dicamba at 2.8 kg/ha and 5.6 kg/ ha un-der greenhouse conditions (Figure S9) and complete resistance to dicamba at 2.8 kg/ ha (the highest level tested in field trials) (Figure 3). Initial field studies with five in-dependent soybean events on University of Nebraska farms over the past 3 years re-vealed no compromise in agronomic per-formance—including yield, date to flower-ing, height, and lodging—in the transgenic plots treated with dicamba application (1.5 kg/ha) at preplant, V3 stage, or dual pre-plant spray treatment coupled with post-emergence treatments at the V3 stage of plant development when compared with non–herbicide-treated, weed-free plots of the parental soybean variety Thorne.Dicamba resistance in all of the plants tested did not require cotransformation with either ferredoxin or reductase genes from P. maltophilia(strain DI-6). These re-sults showed that the plants contained one or more molecules that could transfer the requisite electrons to DMO to allow conver-sion of dicamba to DCSA. The initial target-ing of DMO to the chloroplasts by means ofa transit peptide sequence was aimed at us-ing reduced ferredoxin abundantly avail-able in the chloroplasts. However, trans-formation of tobacco plants with a DMOgene construct lacking a chloroplast transitpeptide–coding sequence unexpectedly re-sulted in plants that were highly resistantto treatment with dicamba. Results fromour limited trials with a small number ofT1-generation plants indicated that the levelof resistance obtained with these transgenicplants was only slightly lower on averagethan that obtained with tobacco plants pro-ducing DMO containing a transit peptide.These observations raise importantquestions in regard to the molecules intransgenic plants that can productively do-nate electrons to DMO. The fact that homo-plastidic chloroplasts producing DMO in-ternally from a DMO gene integrated intothe chloroplast genome show resistanceto extremely high levels of dicamba (Fig-ure S8) and the fact that purified DMOcan function in vitro with reduced spinachchloroplast ferredoxin (Table S2) both sug-gest that chloroplast ferredoxin can produc-tively interact with DMO to allow electrontransfer. However, the source of electronsfor DMO produced from nuclear geneslacking a chloroplast transit peptide–cod-ing sequence remains unknown. Presumingthat ferredoxins do not reside outside of theplant chloroplasts, one must consider thepossibility that an unknown cytoplasmicprotein can provide DMO with a steadysupply of electrons. Alternatively, DMO it-self might contain a gratuitous chloroplasttransit peptide that allows sufficient DMOto enter the chloroplasts to provide protec-tion from dicamba moving into the cell af-ter dicamba treatment. Further studies,such as microscopic localizations in situ ofDMO with and without a chloroplast tran-sit peptide and/or isolation and identifica-tion of cytoplasmic proteins that can inter-act “indiscriminately” with DMO to supplyelectrons, will be needed to resolve thequestions emanating from the present ob-servations.It is illuminating to consider that dicotplants like tobacco display distinct injurysymptoms even at levels of dicamba treat-ment as low as 0.001 to 0.01 kg/ha (Fig-ure 2A). Many transgenic tobacco, tomato,Arabidopsis, and soybean plants containinga nuclear-encoded DMO gene were fullyresistant to treatments with dicamba at orabove 5.8 kg/ha. This demonstrates that theDMO gene, present even in a single copyand expressed at relatively moderate rates(table S2), is capable of decreasing the sen-sitivity of dicot plants to applications of di-camba by at least a factor of 5000.Dicamba is an “auxin”-type herbicidethat mimics the effects of excess quantitiesof the natural plant hormone indole-3-ace-tic acid (IAA) when applied to dicotyledon-ous plants. It has been used for more than40 years to efficiently control most broad-leaf weeds. Yet despite its widespread use,no new noxious and economically impor-tant dicamba-resistant weed species haveappeared (5). One possible reason for sucha situation may be that dicamba may act onsome, if not all, of the IAA receptors that areessential in controlling normal growth anddevelopment of all plants. If so, the appear-ance of new dicamba-resistant weeds maynot happen rapidly. This is especially trueif the dicamba resistance gene is “stacked,”for example, with the widely used glypho-sate resistance gene to allow farmers to al-ternate herbicide applications between di-camba and glyphosate or to use mixtures ofthe two herbicides together. In either case,appearance of weeds resistant to either di-camba or glyphosate will be greatly sup-pressed. Moreover, the ability to use eitheror both herbicides before planting or at avariety of points during crop developmentwill allow producers excellent weed controlwith greater flexibility in their crop man-agement practices. This may be particularlyimportant in the control of existing glypho-sate-resistant weeds, such as horseweed,in which application of dicamba beforeplanting can control emerged or emergingglyphosate-resistant weeds. Thus, dicamba-resistant crops can be a valuable asset instrategies to control currently existing her-bicide-resistant weeds and to suppress theappearance of additional herbicide-resis-tant weeds that ultimately could threatenthe long-term use and value of current her-bicides and herbicide-resistant crops. Like-wise, dicamba-resistant crops should fur-ther encourage the use of conservationtillage practices that greatly decrease soilerosion and foster more sustainable and en-vironmentally friendly farming.References and Notes1. F. Hossain et al.,Int. J. Occup. Environ.Health 10, 296 (2004).2. J. Huang, R. Hu, S. Rozelle, C. Pray, Science308, 688 (2005).3. A. L. Cerdeira, S. O. Duke, J. Environ. Qual.35, 1633 (2006).4. International Service for the Acquisition ofAgri-biotech Applications, Global Statusof Commercialized Biotech/ GM Crops: Figure 3. Effects of dicamba treatments onnontransgenic soybean plants and trans-genic plants containing the genetically en-gineered DMO gene. Nontransgenic (1)and transgenic soybean plants (2) treatedunder field conditions with dicamba at alevel of 2.8 kg/ha are pictured 8 days af-ter spraying.1188 B e h r e n s e t a l. i n S c i e n c e 316 (2007)2006; see executive summary at http:// /resources/publications/ briefs/35/executivesummary/default.html 5. International Survey of Herbicide Resis-tant Weeds; / in.asp6. J. T. Stevens, D. D. Sumner, in Handbookof Pesticide Toxicology,W. J. Hayes, E. R.Laws Jr., Eds. (Academic Press, New York, 1991), pp. 1317–1408.7. Herbicide Handbook (Weed Science Societyof America, Champaign, IL, ed. 7, 1994).8. Hazardous Substance Databank(U.S. Na-tional Library of Medicine, Bethesda, MD, 1995).9. Health Advisory Summary: Dicamba (Officeof Drinking Water, U.S. Environmental Pro-tection Agency, Washington, DC, 1988). 10. Extoxnet Pesticide Information Profiles: Di-camba; /pips/di-camba.htm .11. D. J. Cork, J. Kreuger, Adv. Appl. Microbiol.36, 1 (1991).12. J. Yang, X.-Z. Wang, D. Hage, P. Herman,D. Weeks, Anal. Biochem.219, 37 (1994).13. P. L. Herman et al., J. Biol. Chem. 280,24759 (2005).14. S. Chakraborty et al., Arch. Biochem. Bio-phys. 437, 20 (2005).15. X. Wang, B. Li, P. L. Herman, D. Weeks,Appl. Environ. Microbiol.63, 1623 (1997).16. I. B. Maiti, R. Shepherd, Biochem. Biophys.Res. Commun.244, 440 (1998).17. P. Maliga, Photochem. Photobiol. Sci.4,971 (2005).18. N. Dufourmantel et al., Plant Mol. Biol.55,479 (2004).19. We thank M. Fromm for helpful sugges-tions regarding the manuscript; L. Allisonfor the kind gift of the chloroplast trans-formation vector pFMDV1 and for assis-tance with chloroplast transformationtechniques; G. Graef for seeds of the soy-bean variety NE3001; and K. Horkey forprecise applications of dicamba to green-house-grown plants. Dicamba monooxy-genase (DMO; oxygenaseDIC) is GenBankaccession number AY786442 (ddmC).Supported by the Consortium for PlantBiotechnology Research, United AgriProd-ucts, the Monsanto Company, and the Uni-versity of Nebraska Agricultural ResearchDivision. D.P. Weeks and P.L. Herman holda patent entitled “Methods and Materialsfor Making and Using Transgenic Dicamba-Degrading Organisms.” D.P. Weeks, T.E.Clemente, M. Behrens, P.L. Herman, andN. Mutlu will receive royalties from themarketing of dicamba-resistant technol-ogy if crop seeds containing the resistancegene are marketed by Monsanto, the li-censee of this technology from the Univer-sity of Nebraska.Supplemental and Supporting Material follows.Supporting MaterialMATERIALS AND METHODS:Reagents and Standard Methods: Restriction and other enzymes were obtained from either Fermentas or Invitrogen. DIG-11-dUTP (alkali-labeled), CSPD (ready-to-use), DIG III molecular weight markers, anti-digoxigenin-AP (Fab fragments) and blocking reagent were obtained from Roche. Prehybridization solution, ULTRAhyb was obtained from Ambion. The molecular weight marker DIG-RNA molecular weight marker I, was obtained from Roche. Anti-rabbit IgG, peroxidase-linked antibody (donkey) and Hybond ECL (nitrocellulose) membrane were obtained from Amersham Biosciences.DNA, RNA and Protein blots, recombinant DNA techniques, and other molecular biology procedures were carried out using standard protocols (13).Cloned Genes, Existing Vectors and New Vector Construction: Dicamba monooxygenase (DMO; oxygenase DIC) is GenBank accession number AY786442(ddmC). Vectors pRTL2 (12) and pKLP36 were used in creating a DMO gene construct with and without a DNA sequence encoding an upstream Rubisco small subunit transit peptide from pea. The pKLP36 binary vector (9) was obtained from Dr. Indu Maiti from the University of Kentucky. A DMOW112C variant coding sequence (DMOc) was initially generated by PCR amplification from a wild-type DMO gene (DMOw) template. In this amplification, the coding region of DMOw was amplified from the plasmid pPLH1, which contained the DMOw gene as a 3.5 kbp Xho I/Sst I fragment of P. maltophilia, strain DI-6, DNA (6). For DNA amplification, a 5' primer was employed that inserted an Nco I restriction site near the 5' end of the PCR product and a codon for alanine immediately following the ATG initiation codon. A 3' primer was used that created an Xba I restriction site at the 3' end of the PCR product (primer sequences provided below). The 112W to 112C change in the resulting DMOc gene was subsequently identified by nucleic acid sequencing.For creation of the plant transformation vector, pKLP36-TEV-TP-DMOc, the DMOc gene was inserted using Nco I and Xba I sites added to the 5' and 3' ends, respectively, of the coding region into the pRTL2 vector (12) thereby fusing the transit peptide coding region to the vector’s tobacco etch virus (TEV leader) translation enhancer element. As noted above, the 5’ Nco I site was introduced along with the addition of a GCC codon (alanine) following the ATG start codon and an Xba I restriction site was created at the 3’ end of the codon region using PCR primers (Oxy-Nco I 5’- ggagcagcccatggccttcgtccgcaatg –3’; Oxy-Xba I 5’ –atgccccagtctagaatatcgccgggaca –3’).To allow potential delivery of DMOc to the chloroplast, the chloroplast transit peptide coding region from the pea Rubisco small subunit gene (14) was placed upstream of the DMO coding region. The transit peptide coding sequence carried on a Bgl II and EcoR I fragment was cloned into the BamH I and EcoR I sites of the pBluescript II KS+ vector. This construct was used as the template in a PCR reaction that inserted an Nco I site。

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