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1.
Nat Commun ; 15(1): 6706, 2024 Aug 07.
Article in English | MEDLINE | ID: mdl-39112545

ABSTRACT

A typical El Niño event often results in suppressed tropical cyclone (TC) genesis frequency (TCGF) over the North Atlantic (NA) and a distinct northwest-southeast dipole pattern in TCGF anomaly over the western North Pacific (WNP). The 2023 saw a strong El Niño event but surprisingly active NA and suppressed WNP TC activities. Here, we present that these unprecedented deviations were driven by the record-warm NA, a record-breaking negative phase of the Pacific Meridional Mode (PMM), and background global warming. Results from high-resolution global model experiments demonstrate that extraordinary Atlantic warming dominated the increased NA TCGF and contributed equally with the PMM to the suppressed WNP TCGF, overshadowing El Niño's impact. Global warming also contributed to the observed TCGF anomalies. Our findings demonstrate that the typical influence of strong El Niño events on regional TC activity could be markedly altered by other climate modes, highlighting the complexity of TC genesis in a warming world.

2.
Nat Commun ; 15(1): 7401, 2024 Aug 27.
Article in English | MEDLINE | ID: mdl-39191781

ABSTRACT

The East Asian summer monsoon (EASM) supplies vital rainfall for over one billion people. El Niño-Southern Oscillation (ENSO) markedly affects the EASM, but its impacts are more robust following El Niño than La Niña. Here, we show that this asymmetry arises from the asymmetry in ENSO evolution: though most El Niño events last for one year, La Niña events often persist for 2-3 years. In the summers between consecutive La Niña events, the concurrent La Niña opposes the delayed effect of the preceding winter La Niña on the EASM, causing a reduction in the magnitude and coherence of climate anomalies. Results from a large ensemble climate model experiment corroborate and strengthen the observational analysis with an order of magnitude increase in sample size. The apparent asymmetry in the impacts of the ENSO on the EASM can be reduced by considering the concurrent ENSO, in addition to the ENSO state in the preceding winter. This has important implications for seasonal climate forecasts.

3.
Nat Commun ; 15(1): 6425, 2024 Jul 30.
Article in English | MEDLINE | ID: mdl-39080287

ABSTRACT

Skillful subseasonal forecasts are crucial for various sectors of society but pose a grand scientific challenge. Recently, machine learning-based weather forecasting models outperform the most successful numerical weather predictions generated by the European Centre for Medium-Range Weather Forecasts (ECMWF), but have not yet surpassed conventional models at subseasonal timescales. This paper introduces FuXi Subseasonal-to-Seasonal (FuXi-S2S), a machine learning model that provides global daily mean forecasts up to 42 days, encompassing five upper-air atmospheric variables at 13 pressure levels and 11 surface variables. FuXi-S2S, trained on 72 years of daily statistics from ECMWF ERA5 reanalysis data, outperforms the ECMWF's state-of-the-art Subseasonal-to-Seasonal model in ensemble mean and ensemble forecasts for total precipitation and outgoing longwave radiation, notably enhancing global precipitation forecast. The improved performance of FuXi-S2S can be primarily attributed to its superior capability to capture forecast uncertainty and accurately predict the Madden-Julian Oscillation (MJO), extending the skillful MJO prediction from 30 days to 36 days. Moreover, FuXi-S2S not only captures realistic teleconnections associated with the MJO but also emerges as a valuable tool for discovering precursor signals, offering researchers insights and potentially establishing a new paradigm in Earth system science research.

4.
Oral Dis ; 2024 Jun 18.
Article in English | MEDLINE | ID: mdl-38887128

ABSTRACT

OBJECTIVE: Patient-derived organoids are potent pre-chemotherapy models. Due to limited research on diverse types of oral squamous cell carcinoma (OSCC) and construction efficiency, our goal was to optimize OSCC organoid models from various sites and assess drug responsiveness. METHODS: We screened and optimized culture media, employing three-dimensional techniques to construct human-derived oral squamous cell carcinoma (OSCC) organoid models in vitro. Morphological validation, immunofluorescence analysis, tissue origin verification, and Short Tandem Repeat (STR) sequencing confirmed the consistency between organoids and source tissues. These organoid models were then subjected to varying concentrations of anticancer drugs, with subsequent assessment of cell viability to calculate IC50 values. RESULTS: Twenty-nine surgical specimens yielded an 86.2% success rate in culturing 25 organoids in vitro. Morphological consistency confirmed nuclear atypia and positive expression of K5, P40, and E-cadherin, indicating squamous epithelial origin. Cultured complex organoids included α-SMA+ tumour-associated fibroblasts and tumour stem cells expressing CD44 and Ki67. STR sequencing affirmed genomic homogeneity between cultured organoids and source tissues. Drug sensitivity testing revealed diverse responses among organoids, highlighting their value for assessing drug sensitivity. CONCLUSIONS: An efficient OSCC organoid culture system for personalized in vitro drug sensitivity screening was established, laying the foundation for precise treatment development.

5.
Nat Commun ; 15(1): 5060, 2024 Jun 13.
Article in English | MEDLINE | ID: mdl-38871686

ABSTRACT

Arctic Amplification (AA), the amplified surface warming in the Arctic relative to the globe, is a salient feature of climate change. While the basic physical picture of AA has been depicted, how its degree is determined has not been clearly understood. Here, by deciphering atmospheric heat transport (AHT), we build a two-box energy-balance model of AA and derive that the degree of AA is a simple nonlinear function of the Arctic and global feedbacks, the meridional heterogeneity in radiative forcing, and the partial sensitivities of AHT to global mean and meridional gradient of warming. The formula captures the varying AA in climate models and attributes the spread to models' feedback parameters and AHT physics. The formula clearly illustrates how essential physics mutually determine the degree of AA and limits its range within 1.5-3.5. Our results articulate AHT as both forcing and feedback to AA, highlight its fundamental role in forming a baseline AA that exists even with uniform feedbacks, and underscore its partial sensitivities instead of its total change as key parameters of AA. The lapse-rate feedback has been widely recognized as a major contributor to AA but its effect is fully offset by the water-vapor feedback.

6.
Nat Commun ; 15(1): 4221, 2024 May 17.
Article in English | MEDLINE | ID: mdl-38760333

ABSTRACT

Decadal variability in the North Atlantic Ocean impacts regional and global climate, yet changes in internal decadal variability under anthropogenic radiative forcing remain largely unexplored. Here we use the Community Earth System Model 2 Large Ensemble under historical and the Shared Socioeconomic Pathway 3-7.0 future radiative forcing scenarios and show that the ensemble spread in northern North Atlantic sea surface temperature (SST) more than doubles during the mid-twenty-first century, highlighting an exceptionally wide range of possible climate states. Furthermore, there are strikingly distinct trajectories in these SSTs, arising from differences in the North Atlantic deep convection among ensemble members starting by 2030. We propose that these are stochastically triggered and subsequently amplified by positive feedbacks involving coupled ocean-atmosphere-sea ice interactions. Freshwater forcing associated with global warming seems necessary for activating these feedbacks, accentuating the impact of external forcing on internal variability. Further investigation on seven additional large ensembles affirms the robustness of our findings. By monitoring these mechanisms in real time and extending dynamical model predictions after positive feedbacks activate, we may achieve skillful long-lead North Atlantic decadal predictions that are effective for multiple decades.

7.
Proc Natl Acad Sci U S A ; 121(21): e2313797121, 2024 May 21.
Article in English | MEDLINE | ID: mdl-38709948

ABSTRACT

During 2010 to 2020, Northeast Pacific (NEP) sea surface temperature (SST) experienced the warmest decade ever recorded, manifested in several extreme marine heatwaves, referred to as "warm blob" events, which severely affect marine ecosystems and extreme weather along the west coast of North America. While year-to-year internal climate variability has been suggested as a cause of individual events, the causes of the continuous dramatic NEP SST warming remain elusive. Here, we show that other than the greenhouse gas (GHG) forcing, rapid aerosol abatement in China over the period likely plays an important role. Anomalous tropospheric warming induced by declining aerosols in China generated atmospheric teleconnections from East Asia to the NEP, featuring an intensified and southward-shifted Aleutian Low. The associated atmospheric circulation anomaly weakens the climatological westerlies in the NEP and warms the SST there by suppressing the evaporative cooling. The aerosol-induced mean warming of the NEP SST, along with internal climate variability and the GHG-induced warming, made the warm blob events more frequent and intense during 2010 to 2020. As anthropogenic aerosol emissions continue to decrease, there is likely to be an increase in NEP warm blob events, disproportionately large beyond the direct radiative effects.

8.
Oral Oncol ; 154: 106860, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38801787

ABSTRACT

OBJECTIVES: The deep circumflex iliac artery flap (DCIA) and vascularized fibular free flap (FFF) are mainstay flaps for maxillary defect reconstruction. This study compared the functional outcomes and success rates of these flaps to provide midface reconstruction strategies. MATERIALS AND METHODS: Maxillary defects reconstructed with DCIA or FFF at the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology between May 2016 and May 2023 were retrospectively analyzed. The length, width, and height of the grafted bone segments; intermaxillary distance; buttress reconstruction rate (BRR); dental arch reconstruction rate (DAR); success rate; and dental implantation rate were compared. RESULTS: The DCIA and FFF groups had 33 and 27 patients, respectively. Success rate in the DCIA group was 93.94 % and 100 % in the FFF group. The DCIA length was less than that of FFF; however, the width and height were significantly larger. 87.10 % of cases in the DCIA group were classified as Brown class b and c, 51.85 % of cases in the FFF group were classified as Brown class d. The average BRR in the DCIA group was 69.89 % ± 16.05 %, which was significantly higher than that in the FFF group. A total of 38.7 % and 11.1 % patients in the DCIA and FFF groups, respectively, had completed implantation. CONCLUSION: DCIA has a greater width and height, and is more suitable for repairing Brown class b and c defects, providing sufficient bone for implantation, while the FFF is longer and more suitable for Brown class d defect reconstruction.


Subject(s)
Fibula , Free Tissue Flaps , Iliac Artery , Maxilla , Plastic Surgery Procedures , Humans , Male , Female , Retrospective Studies , Middle Aged , Iliac Artery/surgery , Iliac Artery/transplantation , Fibula/transplantation , Plastic Surgery Procedures/methods , Maxilla/surgery , Adult , Aged
9.
Biofabrication ; 16(3)2024 May 07.
Article in English | MEDLINE | ID: mdl-38604162

ABSTRACT

Peripheral nerve injuries can lead to sensory or motor deficits that have a serious impact on a patient's mental health and quality of life. Nevertheless, it remains a major clinical challenge to develop functional nerve conduits as an alternative to autologous grafts. We applied reduced graphene oxide (rGO) as a bioactive conductive material to impart electrophysiological properties to a 3D printed scaffold and the application of a pulsed magnetic field to excite the formation of microcurrents and induce nerve regeneration.In vitrostudies showed that the nerve scaffold and the pulsed magnetic field made no effect on cell survival, increased S-100ßprotein expression, enhanced cell adhesion, and increased the expression level of nerve regeneration-related mRNAs.In vivoexperiments suggested that the protocol was effective in promoting nerve regeneration, resulting in functional recovery of sciatic nerves in rats, when they were damaged close to that of the autologous nerve graft, and increased expression of S-100ß, NF200, and GAP43. These results indicate that rGO composite nerve scaffolds combined with pulsed magnetic field stimulation have great potential for peripheral nerve rehabilitation.


Subject(s)
Electromagnetic Fields , Graphite , Nerve Regeneration , Printing, Three-Dimensional , Rats, Sprague-Dawley , Sciatic Nerve , Tissue Scaffolds , Animals , Graphite/chemistry , Sciatic Nerve/physiology , Sciatic Nerve/injuries , Nerve Regeneration/drug effects , Tissue Scaffolds/chemistry , Rats , Male
10.
Sci Adv ; 10(17): eadk9250, 2024 Apr 26.
Article in English | MEDLINE | ID: mdl-38657060

ABSTRACT

In July to August 2022, Pakistan suffered historic flooding while record-breaking heatwaves swept southern China, causing severe socioeconomic impacts. Similar extreme events have frequently coincided between two regions during the past 44 years, but the underlying mechanisms remain unclear. Using observations and a suite of model experiments, here, we show that the upper-tropospheric divergent wind induced by convective heating over Pakistan excites a barotropic anomalous anticyclone over eastern China, which further leads to persistent heatwaves. Atmospheric model ensemble simulation indicates that this dynamic pathway linking Pakistan flooding and East Asian heatwaves is intrinsic to the climate system, largely independent of global sea surface temperature forcing. This dynamic connection is most active during July to August when convective variability is large over Pakistan and the associated divergent flow excites barotropic Rossby waves that propagate eastward along the upper troposphere westerly waveguide. This robust waveguide and the time delay offer hopes for improved subseasonal prediction of extreme events in East Asia.

11.
Sci Adv ; 10(12): eadk8646, 2024 Mar 22.
Article in English | MEDLINE | ID: mdl-38517959

ABSTRACT

In the boreal spring of 2023, an extreme coastal El Niño struck the coastal regions of Peru and Ecuador, causing devastating rainfalls, flooding, and record dengue outbreaks. Observations and ocean model experiments reveal that northerly alongshore winds and westerly wind anomalies in the eastern equatorial Pacific, initially associated with a record-strong Madden-Julian Oscillation and cyclonic disturbance off Peru in March, drove the coastal warming through suppressed coastal upwelling and downwelling Kelvin waves. Atmospheric model simulations indicate that the coastal warming in turn favors the observed wind anomalies over the far eastern tropical Pacific by triggering atmospheric deep convection. This implies a positive feedback between the coastal warming and the winds, which further amplifies the coastal warming. In May, the seasonal background cooling precludes deep convection and the coastal Bjerknes feedback, leading to the weakening of the coastal El Niño. This coastal El Niño is rare but predictable at 1 month lead, which is useful to protect lives and properties.

12.
Cell Genom ; 4(2): 100474, 2024 Feb 14.
Article in English | MEDLINE | ID: mdl-38359790

ABSTRACT

Epstein-Barr virus (EBV) and human leukocyte antigen (HLA) polymorphisms are well-known risk factors for nasopharyngeal carcinoma (NPC). However, the combined effects between HLA and EBV on the risk of NPC are unknown. We applied a causal inference framework to disentangle interaction and mediation effects between two host HLA SNPs, rs2860580 and rs2894207, and EBV variant 163364 with a population-based case-control study in NPC-endemic southern China. We discovered the strong interaction effects between the high-risk EBV subtype and both HLA SNPs on NPC risk (rs2860580, relative excess risk due to interaction [RERI] = 4.08, 95% confidence interval [CI] = 2.03-6.14; rs2894207, RERI = 3.37, 95% CI = 1.59-5.15), accounting for the majority of genetic risk effects. These results indicate that HLA genes and the high-risk EBV have joint effects on NPC risk. Prevention strategies targeting the high-risk EBV subtype would largely reduce NPC risk associated with EBV and host genetic susceptibility.


Subject(s)
Epstein-Barr Virus Infections , Nasopharyngeal Neoplasms , Humans , Nasopharyngeal Carcinoma/genetics , Herpesvirus 4, Human/genetics , Epstein-Barr Virus Infections/genetics , Nasopharyngeal Neoplasms/epidemiology , Case-Control Studies , Polymorphism, Single Nucleotide/genetics
13.
Breast ; 74: 103679, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38367283

ABSTRACT

BACKGROUND: In those with one to three positive lymph nodes (N1) breast cancer (BC), the 21-gene recurrence score (RS) classification can be referred for decision-making on adjuvant chemotherapy. This study aimed to investigate the effect of RS in predicting the survival benefit of postoperative radiotherapy (PORT) in T1-2N1 BC with estrogen receptor-positive and human epidermal growth factor receptor 2-negative disease after breast-conserving surgery (BCS). METHODS: We included patients with BC and available RS data from the Surveillance, Epidemiology, and End Results Oncotype DX database. The chi-square test, Kaplan-Meier method, propensity score matching (PSM) as well as multivariable Cox proportional hazard analyses were used for statistical analyses. RESULTS: We included 6509 patients in the analysis. Of these patients, 5302 (85.5%) were treated with BCS + PORT, and 207 (15.5%) had BCS alone. There were 1419 (21.8%), 4319 (66.4%), and 771 (11.8%) patients being low-, intermediate-, and high-risk RS, respectively. After PSM, PORT was significantly associated with a 5-year overall survival (OS) advantage (95.1% vs. 90.5%, P < 0.001) compared to those without PORT, which similar breast cancer-specific survival (BCSS) was found between the treatment arms (P = 0.126). The sensitivity analyses showed that PORT was not associated with a better BCSS (P = 0.472) and OS (P = 0.650) than those without PORT in the low-risk RS cohort. However, PORT was associated with a better BCSS (P = 0.031) and OS (P < 0.001) compared to those without PORT in the intermediate/high-risk RS cohorts. CONCLUSIONS: Our study highlights the possible role of the RS in predicting the outcome of PORT in T1-2N1 luminal BC patients undergoing BCS.


Subject(s)
Breast Neoplasms , Humans , Female , Breast Neoplasms/genetics , Breast Neoplasms/radiotherapy , Breast Neoplasms/surgery , Mastectomy, Segmental , Neoplasm Staging , Chemotherapy, Adjuvant
14.
Proc Natl Acad Sci U S A ; 121(5): e2315124121, 2024 Jan 30.
Article in English | MEDLINE | ID: mdl-38252827

ABSTRACT

The discrepancy between the observed lack of surface warming in the eastern equatorial Pacific and climate model projections of an El Niño-like warming pattern confronts the climate research community. While anthropogenic aerosols have been suggested as a cause, the prolonged cooling trend over the equatorial Pacific appears in conflict with Northern Hemisphere aerosol emission reduction since the 1980s. Here, using CESM, we show that the superposition of fast and slow responses to aerosol emission change-an increase followed by a decrease-can sustain the La Niña-like condition for a longer time than expected. The rapid adjustment of Hadley Cell to aerosol reduction triggers joint feedback between low clouds, wind, evaporation, and sea surface temperature in the Southeast Pacific, leading to a wedge-shaped cooling that extends to the central equatorial Pacific. Meanwhile, the northern subtropical cell gradually intensifies, resulting in equatorial subsurface cooling that lasts for decades.

16.
Clin Chem Lab Med ; 62(1): 187-198, 2024 01 26.
Article in English | MEDLINE | ID: mdl-37531579

ABSTRACT

OBJECTIVES: Epstein-Barr virus (EBV) C promoter (Cp) hypermethylation, a crucial factor for EBV latent infection of nasopharyngeal epithelial cells, has been recognized as a promising biomarker for nasopharyngeal carcinoma (NPC) detection. In this study, we develop a novel EBV Cp methylation quantification (E-CpMQ) assay and evaluate its diagnostic performance for NPC detection. METHODS: A novel qPCR assay for simultaneous quantification of methylated- and unmethylated EBV Cp was developed by the combinational modification of MethyLight and QASM, with an innovative calibrator to improve the detection accuracy and consistency. The NP swab samples and synthetic standards were used for the analytical validation of the E-CpMQ. The diagnostic efficacy of the developed E-CpMQ assay was validated in 137 NPC patients and 137 non-NPC controls. RESULTS: The E-CpMQ assay can detect the EBV Cp methylation ratio in one reaction system under 10 copies with 100 % recognition specificity, which is highly correlated to pyrosequencing with a correlation coefficient over 0.99. The calibrated E-CpMQ assay reduces the coefficient of variation by an average of 55.5 % with a total variance of less than 0.06 units standard deviation (SD). Linear methylation ratio detection range from 4.76 to 99.01 %. The sensitivity and specificity of the E-CpMQ respectively are 96.4 % (95 % CI: 91.7-98.8 %), 89.8 % (95 % CI: 83.5-94.3 %). CONCLUSIONS: The developed E-CpMQ assay with a calibrator enables accurate and reproducible EBV Cp methylation ratio quantification and offers a sensitive, specific, cost-effective method for NPC early detection.


Subject(s)
Epstein-Barr Virus Infections , Nasopharyngeal Neoplasms , Humans , Nasopharyngeal Carcinoma/diagnosis , Herpesvirus 4, Human/genetics , Epstein-Barr Virus Infections/diagnosis , Epstein-Barr Virus Infections/genetics , Nasopharyngeal Neoplasms/diagnosis , Nasopharyngeal Neoplasms/genetics , DNA, Viral/genetics , Nasopharynx , DNA Methylation
17.
Nat Commun ; 14(1): 7189, 2023 Nov 08.
Article in English | MEDLINE | ID: mdl-37938565

ABSTRACT

In the latter half of the twentieth century, a significant climate phenomenon "diurnal asymmetric warming" emerged, wherein global land surface temperatures increased more rapidly during the night than during the day. However, recent episodes of global brightening and regional droughts and heatwaves have brought notable alterations to this asymmetric warming trend. Here, we re-evaluate sub-diurnal temperature patterns, revealing a substantial increase in the warming rates of daily maximum temperatures (Tmax), while daily minimum temperatures have remained relatively stable. This shift has resulted in a reversal of the diurnal warming trend, expanding the diurnal temperature range over recent decades. The intensified Tmax warming is attributed to a widespread reduction in cloud cover, which has led to increased solar irradiance at the surface. Our findings underscore the urgent need for enhanced scrutiny of recent temperature trends and their implications for the wider earth system.

18.
Nat Commun ; 14(1): 5099, 2023 Aug 28.
Article in English | MEDLINE | ID: mdl-37640712

ABSTRACT

Tropical cyclones do not form easily near the equator but can intensify rapidly, leaving little time for preparation. We investigate the number of near-equatorial (originating between 5°N and 11°N) tropical cyclones over the north Indian Ocean during post-monsoon season (October to December) over the past 60 years. The study reveals a marked 43% decline in the number of such cyclones in recent decades (1981-2010) compared to earlier (1951-1980). Here, we show this decline in tropical cyclone frequency is primarily due to the weakened low-level vorticity modulated by the Pacific Decadal Oscillation (PDO) and increased vertical wind shear. In the presence of low-latitude basin-wide warming and a favorable phase of the PDO, both the intensity and frequency of such cyclones are expected to increase. Such dramatic and unique changes in tropical cyclonic activity due to the interplay between natural variability and climate change call for appropriate planning and mitigation strategies.

19.
Head Neck ; 45(10): 2544-2554, 2023 10.
Article in English | MEDLINE | ID: mdl-37530710

ABSTRACT

BACKGROUND: The purpose of this study was to investigate the effect of anterior superior iliac spine (ASIS) preservation on donor site morbidity and function after harvesting a vascularized iliac bone flap (VIBF). METHODS: Patients who underwent jaws reconstruction with VIBF were divided into a maintaining the anterior superior iliac spine (MASIS) group and a not maintaining the anterior superior iliac spine (NMASIS) group. Pain, tenderness, sensory deficit, gait disturbance, and function of the donor site were evaluated before and after the operation. RESULTS: Thirty-three patients were included in this study, of which 18 were in the MASIS group. The incidence of sensory deficit in the MASIS group was significantly lower than that in the NMASIS group (50.0% vs. 86.7%, p = 0.010). Pain, tenderness, gait disturbance, and function did not differ statistically between the two groups. CONCLUSION: Except for sensory deficit, ASIS preservation has minimal impact on donor site morbidity and function.


Subject(s)
Ilium , Surgical Flaps , Humans , Morbidity , Incidence , Ilium/surgery , Pain , Bone Transplantation/adverse effects
20.
Front Nutr ; 10: 1142861, 2023.
Article in English | MEDLINE | ID: mdl-37465140

ABSTRACT

Background: Associations between trace elements and nasopharyngeal carcinoma (NPC) have been speculated but not thoroughly examined. Methods: This study registered a total of 225 newly diagnosed patients with NPC and 225 healthy controls matched by sex and age from three municipal hospitals in Guangdong Province, southern China between 2011 and 2015. Information was collected by questionnaire on the demographic characteristics and other possibly confounding lifestyle factors. Eight trace elements and the level of Epstein-Barr virus (EBV) antibody were measured in casual (spot) serum specimens by inductively coupled plasma-mass spectrometry (ICP-MS) and enzyme-linked immunosorbent assay (ELISA), respectively. Restricted cubic splines and conditional logistic regression were applied to assess the relationship between trace elements and NPC risk through single-and multiple-elements models. Results: Serum levels of chromium (Cr), cobalt (Co), nickel (Ni), arsenic (As), strontium (Sr) and molybdenum (Mo) were not associated with NPC risk. Manganese (Mn) and cadmium (Cd) were positively associated with NPC risk in both single-and multiple-element models, with ORs of the highest tertile compared with the reference categories 3.90 (95% CI, 1.27 to 7.34) for Mn and 2.30 (95% CI, 1.26 to 3.38) for Cd. Restricted cubic splines showed that there was a linear increasing trend between Mn and NPC risk, while for Cd there was a J-type correlation. Conclusion: Serum levels of Cd and Mn was positively related with NPC risk. Prospective researches on the associations of the two trace elements with NPC ought to be taken into account within the future.

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