[Simulation of land use and assessment of ecosystem service value in the eastern coastal cities of Zhejiang Province, China]. / 浙江东部沿海城市土地利用模拟及生态系统服务价值评估.

Simulating the change of ecosystem service values (ESV) caused by land use/cover change (LUCC) in the eastern coastal cities of Zhejiang Province is of great significance for regional sustainable development and ecological security. Based on remote sensing images of land use and Statistics Yearbook of 2000, 2010, and 2020, we analyzed the influence of LUCC on ESV in the study area during 2000-2020. We used the PLUS model to simulate land use change under three scenarios, including inertial development, ecological protection, and urban development in 2030, analyzed the spatial distribution and concentration degree of ESVs based on grid scale, and clarified the sensitivity characteristics of ESVs. The results showed that the construction land area showed an increasing trend during 2000-2020. The area of forest, cultivated land and water decreased significantly, resulting in a continuous downward trend of ESVs, which decreased by 160×108 yuan. Under the simulation of three scenarios of inertial development, ecological development, and urban development, the construction land area would increase by 93624, 54927, and 111966 hm2, respectively. The eastern plain would become the agglomeration area of construction land expansion. The ESVs of those three scenarios was 1693×108, 1729×108, and 1688×108 yuan, respectively, which were all lower than the ESVs of the study area in 2020. The decline rate of ESV in the ecological protection scenario slowed down. The spatial distribution of ESVs in the study area was high in the west and low in the east. Hot spots and cold spots of ESVs were distributed in a large range with strong agglomeration. Hot spots were mainly concentrated in the west, while cold spots were mainly distributed in the east and north.

A high-quality model for predicting the prognosis of breast neuroendocrine carcinoma to help clinicians decide on appropriate treatment methods: A population-based analysis.

BACKGROUND: Breast neuroendocrine carcinoma (NEC) is a rare malignancy with unclear treatment options and prognoses. This study aimed to construct a high-quality model to predict overall survival (OS) and breast cancer-specific survival (BCSS) and help clinicians choose appropriate breast NEC treatments. PATIENTS AND METHODS: A total of 378 patients with breast NEC and 349,736 patients with breast invasive ductal carcinoma (IDC) were enrolled in the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2018. Propensity score matching (PSM) was performed to balance the clinical baseline. Prognostic factors determined by multivariate Cox analysis were included in the nomogram. C-index and calibration curves were used to verify the performance of the nomogram. RESULTS: Nomograms were constructed for the breast NEC and breast IDC groups after PSM. The C-index of the nomograms ranged from 0.834 to 0.880 in the internal validation and 0.818-0.876 in the external validation, indicating that the nomogram had good discrimination. The risk stratification system showed that patients with breast NEC had worse prognoses than those with breast IDC in the low-risk and intermediate-risk groups but had a similar prognosis that those in the high-risk group. Moreover, patients with breast NEC may have a better prognosis when undergoing surgery plus chemotherapy than when undergoing surgery alone or chemotherapy alone. CONCLUSIONS: We established nomograms with a risk stratification system to predict OS and BCSS in patients with breast NEC. This model could help clinicians evaluate prognosis and provide individualized treatment recommendations for patients with breast NEC.

Predicting the survival benefit of local surgery in patients aged 70 years or older with stage IV breast cancer: A population-based analysis.

PURPOSE: The aim of this study was to establish individualized nomograms to predict survival outcomes in older female patients with stage IV breast cancer who did or did not undergo local surgery, and to determine which patients could benefit from surgery. METHODS: A total of 3,129 female patients with stage IV breast cancer aged ≥70 years between 2010 and 2015 were included in the Surveillance, Epidemiology, and End Results program. Multivariate Cox regression analysis was used to identify risk factors for overall survival (OS) and breast cancer-specific survival (BCSS). Survival analysis was performed using the Kaplan-Meier plot and log-rank test. Nomograms and risk stratification models were constructed. RESULTS: Patients who underwent surgery had better OS (HR = 0.751, 95% CI [0.668-0.843], P < 0.001) and BCSS (HR = 0.713, 95% CI [0.627-0.810], P < 0.001) than patients who did not undergo surgery. Patients with human epidermal growth factor receptor 2-positive, lung or liver metastases may not benefit from surgery. In the stratification model, low-risk patients benefited from surgery (OS, HR = 0.688, 95% CI [0.568-0.833], P < 0.001; BCSS, HR = 0.632, 95% CI [0.509-0.784], P < 0.001), while patients in the high-risk group had similar outcomes (OS, HR = 0.920, 95% CI [0.709-1.193], P = 0.509; BCSS, HR = 0.953, 95% CI [0.713-1.275], P = 0.737). CONCLUSION: Older female patients with stage IV breast cancer who underwent surgery had better OS and BCSS than those who did not in each specific subgroup. Patients in low- or intermediate-risk group benefit from surgery while those in the high-risk group do not.

[Effects of neoadjuvant chemotherapy of docetaxel combined with and epirubicin or pirarubicin on breast cancer: clinical analysis of 160 cases].

OBJECTIVE: To evaluate the effects and toxicity of the neoadjuvant chemotherapy of docetaxel combined with epirubicin or pirarubicin on breast cancer, and to investigate the influencing factors of the response to neoadjuvant chemotherapy. METHODS: 160 patients with stage II/III breast cancer, all females, aged 47 (22-66), were treated with docetaxel plus epirubicin or pirarubicin with 3 weeks as a cycle. Two to six cycles of treatment were given before surgery. The clinical efficacy and toxicity of the treatment were evaluated, and the correlation between the influencing factors and the clinical parameters with treatment response was analyzed. RESULTS: The clinical response rate (RR) was 90% (144/160), the complete response (CR) rate was 26% (41/160), the partial response (PR) rate was 64% (103/160). The stable disease (SD) rate was 8% (13/160). The progress disease (PD) rate was 2% (3/160), the pathologically complete remission (pCR) rate was 7% (11/160), and the tumor-pathological complete response (tpCR) rate was 2% (1.3/160). Univariate analysis showed that the tumor size, clinical stage, triple negative phenotype might be the meaningful parameters influencing the clinical response. The patients with smaller tumor size, low stage tumor, and being triple-negative were more likely to achieve CR (P = 0.0371, 0.0013, and 0.0019 respectively). Age, histological grading, ER/PR ratio, Her-2 status did not significantly influence the early response. Multivariate analysis showed that the disease stage might be the meaningful factors for better response (P = 0.0030). The major toxic reactions of the therapy included neutropenia, alopecia, nausea, and vomiting. CONCLUSION: The combination neoadjuvant chemotherapy with docetaxel and epirubicin or pirarubicin is an effective method to treat breast cancer with tolerable toxicity. The meaningful parameter influencing the early response is clinical stage.

[The clinical study on neoadjuvant chemotherapy with combination of docetaxel and pharmorubicin for locally advanced breast cancer].

OBJECTIVE: To evaluate the clinical efficacy and toxicity of combination neoadjuvant chemotherapy with docetaxel and pharmorubicin in the treatment of locally advanced breast cancer. METHODS: From June 2005 to March 2007, 94 breast cancer patients who have been pathologically confirmed by core needle biopsy were treated with neoadjuvant chemotherapy before operation. Docetaxel 75 mg/m(2) plus pharmorubicin 80 mg/m(2) were administered as intravenous infusion on the first day of each 3-week cycle. Accepted 2 to 4 cycles of the treatment, the patients were underwent surgery after 12 to 16 days. RESULTS: The overall response rate (RR) was 80% (76/94). The complete clinical response rate (CR) was 22% (21/94). The partial response rate (PR) was 58% (55/94). The stable disease (SD) rate was 17% (16/94). The progress disease (PD) rate was 2% (2/94). The pathological complete rate (pCR) was 3% (3/94). The major toxic reactions of the therapy were neutropenia, alopecia, nausea and vomit. 76 patients (80%) suffered with grade 3 to 4 neutropenia. 4 patients suffered with grade 3 to 4 thrombocytopenia. 84 patients suffered with severe alopecia. 90 patients (95%) accepted supportive treatment of G-CSF. Septicemia and death were not occurred in this study. CONCLUSION: The combination neoadjuvant chemotherapy with docetaxel and pharmorubicin is an effective method to treat breast cancer and the toxicities are tolerable.