Re-intensification of flash drought in western China over the past decade: Implications of fluctuating wetting trend.

Climate changes and human activities have led to a rise of frequency and intensity of the global flash droughts, resulting in severe consequences for ecosystems, agriculture, and human societies. However, research dedicated to flash droughts in the dryland of western China is relatively limited, leaving their evolutionary characteristics and development processes of these phenomena unclear. To bridge this gap, this study analyzed the spatiotemporal characteristics of flash droughts in western China from 1981 to 2020, based on the standardized evapotranspiration stress index. Additionally, we investigated the development mechanisms by taking meteorological conditions and soil moisture into account. The findings revealed that the northern Qinghai-Tibet Plateau, western Qilian Mountains, and western and southern Loess Plateau are hotspots of flash droughts, characterized by rapid development rates. Across most of the study area, flash drought events persisted between 25 and 30 days. Adequate precipitation is necessary before the onset of flash droughts in western China, while water scarcity and high temperatures played crucial roles in driving the mid-stage of flash droughts. Within the context of the observed "warming and wetting" trend, the average flash droughts occurrence from 2011 to 2020 was approximately 16 % lower than that from 1981 to 1990, and there was a significant annual decrease in spatial coverage of 0.01 % per year. However, in the "wetting in west, drying in east" trend, the spatial coverage of flash droughts has shifted from a declining trend to an insignificant increasing trend since 2000 in the study area, with significant regional differences between the western and eastern regions. Over the past decade, flash droughts had once again intensified in the central Qinghai-Tibet Plateau and the Loess Plateau due to warming and fluctuating wetting trends, raising significant concerns for future ecosystem and agricultural water management in these regions.

miR-1-3p Inhibits Osteosarcoma Cell Proliferation and Cell Cycle Progression While Promoting Cell Apoptosis by Targeting CDK14 to Inactivate Wnt/Beta-Catenin Signaling.

Osteosarcoma (OS) is a common bone malignancy and is diagnosed frequently in children and young adults. According to previous RNA sequencing, miR-1-3p is downregulated in OS clinical samples. Nevertheless, the functions of miR-1-3p in OS cell process and the related mechanism have not been revealed yet. In the current study, miR-1-3p expression in OS tissues and cells were evaluated using quantitative polymerase chain reaction. CCK-8 assays were conducted to measure OS cell viability in response to miR-1-3p overexpression. Colony forming assays and EdU staining were conducted for measurement of cell proliferation, and flow cytometry analysis was performed to determine cell apoptosis and cell cycle progression. Protein levels of apoptotic markers, beta-catenin, and Wnt downstream targets were quantified using western blotting. The binding relation between miR-1-3p and cyclin dependent kinase 14 (CDK14) was validated utilizing luciferase reporter assays. Experimental results revealed that miR-1-3p expression was decreased in OS tissues and cells. Additionally, miR-1-3p inhibited cell proliferation and cell cycle progression while enhancing OS cell apoptosis. Moreover, miR-1-3p directly targeted CDK14 and inversely regulated CDK14 expression in OS cells. Furthermore, miR-1-3p inactivated the Wnt/beta-catenin signaling. CDK14 overexpression partially rescued the inhibitory impact of miR-1-3p on OS cell growth. Overall, miR-1-3p inhibits OS cell proliferation and cell cycle progression while promoting cell apoptosis by targeting CDK14 and inactivating the Wnt/beta-catenin signaling.

Predicting the recurrence-free survival of phyllodes tumor of the breast: a nomogram based on clinicopathology features, treatment, and surgical margin.

Background: Grading based on histopathologic indicators cannot accurately assess the prognosis of phyllodes tumor (PT) of the breast. This article aimed to investigate the correlation between PT prognosis and clinicopathological features, treatment, and surgical margin. Methods: The clinicopathological data of patients with pathologically confirmed PT at our institution were retrospectively collected. Univariate and multivariate Cox proportional risk models were employed to test the effects of different variables on the prognosis of PT. A nomogram to predict the 1-, 3-, 5-, and 10-year recurrence-free survival (RFS) of PT was proposed, and its discriminative ability and calibration were tested using the concordance index (C-index), area under the curve (AUC), and calibration plots. All statistical analyses were performed using R. Results: A total of 342 PT patients were included, including 242 benign (70.8%), 75 borderline (21.9%) and 25 malignant (7.3%) cases. The median follow-up period was 64.5 months (range, 3-179 months), 66 PT patients had local recurrence (LR), and four patients had distant metastasis. The 1-, 3-, 5-, and 10-year RFS of the PT patients were 90.8%, 81.8%, 78%, and 76.7%, respectively. Age, fibroadenoma (FA) surgery history, treatment, mitotic activity, and surgical margin were selected as the independent factors for PT prognosis. The nomogram showed good discriminative ability and calibration, as indicated by the C-index [0.78, 95% confidence interval (CI): 0.75-0.11]. Conclusions: Independent predictors related to PT prognosis were selected to establish a nomogram for predicting the RFS of PT. This nomogram was able to objectively stratify PT patients into prognostic groups and performed well in the internal validation.

Simulation of future land use/cover change (LUCC) in typical watersheds of arid regions under multiple scenarios.

The rapid development of the social economy has promoted a continuous increase in the intensity and scale of land use by humans, which has seriously affected the sustainable development of the region. It is important to understand the land use/cover change (LUCC) in the arid region and its future development trends and to make reasonable planning recommendations for the sustainable development of the ecological environment. This study validates the patch-generating land use simulation (PLUS) model in a typical arid region, the Shiyang River Basin (SRB), and analyzes the applicability of the model in arid regions. On this basis, the PLUS model is combined with the scenario analysis method to design four scenarios including no policy intervention, farmland protection, ecological protection and sustainable development to analyze the dynamic changes in past and future land use in the SRB and to make corresponding planning recommendations for the development of each type of land use in the arid region. The results showed that the PLUS model had a better simulation effect in the SRB (its overall accuracy reached 0.97). Coupled models obtain better simulation results than quantitative and spatial models by comparing the mainstream models, with PLUS model that combines CA model and patch generation strategy showing better simulation results in the same category. From 1987 to 2017, the spatial centroid of each LUCC in the SRB moved to varying degrees due to a continuous increase in human activities. The spatial centroid of water bodies had the most obvious change, with a moving speed of 1.49 km/a, while the moving speed of built-up land increased year by year. The spatial centroid of farmland, built-up land and unused land all shifted toward the middle and lower plains, which is a further indication of increased human activity. Due to different government policies, the development trend of land use was also different under different scenarios. However, the four scenarios all showed that the area of built-up land will be increasing exponentially from 2017 to 2037, which would seriously affect the surrounding ecological land and have a negative impact on the local agro-ecological environment. Therefore, we proposed the following planning recommendations: (1) Land leveling work should be carried out on scattered farmland located at high altitudes and with slopes over 25°. Additionally, the land use of low-altitude areas should strictly adhere to basic farmland, increase the diversification of cropping patterns and improve the efficiency of agricultural water. (2) The relationship between ecology, farmland and cities should be reasonably coordinated and the existing idle built-up land should be efficiently used. (3) Forestland and grassland resources should be strictly protected and the ecological redline should be strictly observed. This study can provide new ideas for LUCC modeling and prediction in other parts of the world and provide a strong basis for ecological management and sustainable development in arid areas.

A Monte Carlo simulation-based health risk assessment of heavy metals in soils of an oasis agricultural region in northwest China.

In recent years, heavy metal contamination of soils has been increasing, posing a major threat to food security, human health, and soil ecosystems. This study analyzed the spatial characteristics, contamination sources, risks of heavy metals by collecting topsoil samples from farmland in an oasis agricultural region in northwest China. The results found that soil heavy metals in farmland were at a moderate contamination level. The PMF model classifies soil heavy metals as fertilizer and pesticide sources dominated by As and Mn with 27.8 %, mixed sources of transport and agricultural sources dominated by Cu, Zn, Cd and Pb with 26.9 %, metal processing sources dominated by Cr and Ni with 22.6 %, and the combined pollution sources of Ti, V, Cr, Mn, Fe, As, Pb dominated by natural sources and fuel combustion. The noncarcinogenic and carcinogenic risks values from the ingestion route were higher for children than for adults. The non-carcinogenic risk of heavy metals to adults in the southwestern and central regions of the study area was >1 × 10-4. The carcinogenic risk was >1 in all adults, but >1 in children in the central and southwestern study areas. Monte Carlo simulation takes into account the parameters and their distributions that affect the health risk assessment model by combining the uncertainty assessment with the health risk, which will reduce the uncertainty of the health risk assessment. The results showed that conventional deterministic risk assessment may overestimate health risk outcomes. In addition, As has a 1.85 % probability of non-carcinogenic risk to children, and an 85.3 % probability of total non-carcinogenic risk for children for all heavy metals. 69.5 % and 11.4 % probability of carcinogenic risk for children and adults respectively for Ni, and 96.4 % and 52.1 % probability of total carcinogenic risk, suggesting that Ni is a priority control heavy metal.

Contralateral prophylactic mastectomy for unilateral breast cancer in Chinese female population: a retrospective cohort study.

Background: Due to differences in socioeconomic and cultural backgrounds, the characteristics and prognosis of Asian female patients choosing contralateral prophylactic mastectomy (CPM) are likely to be different from Western patients. To fill the research gap of CPM in Asian populations, this study aims to explore the application trend, survival benefits, decision-making factors, and satisfaction of CPM based on the Chinese patients undergoing CPM. Methods: The 0-III stage unilateral breast cancer (UBC) patients who received breast surgery in the Chinese PLA General Hospital from 2005 to 2017 were selected. The surgical procedures included simple mastectomy (SM), nipple-sparing mastectomy (NSM), breast conserving surgery (BCS), and CPM. Cox proportional regression analyses and Kaplan-Meier (KM) curve were performed to compare the overall survival (OS) and disease-free survival (DFS) rates between CPM group and unilateral mastectomy (UM) group. Proportional propensity score matching (PSM) with a 1:1 ratio was used to match the two groups and secondary survival analysis was performed. Logistic regression models were used to test predictive factors related to patients' CPM surgical decision-making. Results: Four thousand two hundred and seventy-six patients were included in the study, with 73 patients receiving CPM, 3,567 receiving SM, 151 receiving NSM, and 485 receiving BCS. CPM surgery was first used in 2007, with a peak application rate of 3.02% in 2016. Three thousand seven hundred and ninety-one patients were included in the survival analysis, with a median follow-up time of 66.60 months. Compared to UM patients, neither the KM survival curve nor Cox regression hazard analyses of CPM showed better OS (P=0.963; P=0.834). After PSM, CPM also did not exhibit significant survival benefits in OS (P=0.335) and DFS (P=0.409). The logistic regression analyses showed that NSM surgery and lower tumor-node-metastasis (TNM) stage were independent factors to promote the CPM decision-making of patients. The CPM group showed high overall satisfaction (84.9%) and relatively low appearance satisfaction (69.9%). Conclusions: CPM was practiced for the first time since 2007 in our hospital. CPM does not provide any OS and DFS benefits compared to UM and the appearance satisfaction procedure was relatively low. Therefore, clinicians should fully communicate with patients before surgery and be more cautious in giving CPM recommendations.

Smoke analysis of a new surgical system that applies low-temperature plasma.

Background: The high-frequency electrotome (ES), which is widely used in surgical procedures, generates surgical smoke that is potentially hazardous to operating personnel. Previous research shows that the PlasmaBlade (PB) may be able to overcome this problem. The present study set out to analyze potentially hazardous surgical smoke generated during electrosurgery by the ES, the PB, and. a new surgical system that applies low-temperature plasma, the NTS-100. Methods: In vitro and in vivo healthy porcine models were used to compare volatile organic compounds (VOCs) and particulate matter (PM) in smoke generated by the NTS-100, the PB, and the conventional ES when cutting liver, muscle, and skin and subcutaneous tissues. The detected indexes included the VOCs in surgical smoke, the concentration and percentage of each part, the PM2.5 concentration, the mass of particles, and the diameter distribution of particles. Results: The smoke generated by the NTS-100 contained fewer hazardous components than that generated by the ES (P<0.05) and a comparable amount to that generated by the PB (P>0.05). The PM2.5 concentration and mass of particles in the smoke generated by the NTS-100 were lower than those with the ES (P<0.05 and P<0.01, respectively) and similar to those with the PB (P>0.05). The NTS-100 generated larger particles than did the ES and the PB (P<0.05). Conclusions: Surgical smoke contains harmful VOCs and PM, but the NTS-100 generated less hazardous surgical smoke than did the conventional ES and performed comparably to the PB. Therefore, using the NTS-100 may reduce the potential hazard of surgical smoke to operating room personnel.

Clinicopathological features and prognosis of bilateral breast cancer: a single-center cohort study based on Chinese data.

Background: The incidence of bilateral breast cancer (BBC) is low, accounting for 5% of patients with breast cancer. This study aimed to investigate the clinicopathological features and prognosis of synchronous bilateral breast cancer (SBBC) and metachronous bilateral breast cancer (MBBC) in the Chinese population. Methods: Patients with BBC, including SBBC and MBBC, were selected from 6,162 breast cancer patients who underwent surgery at the Chinese People's Liberation Army (PLA) General Hospital between January 2007 and December 2019. Furthermore, patients with unilateral breast cancer (UBC) who underwent surgery at the same time were randomly selected at a ratio of 1:2 as the control group. Clinicopathological features and prognosis were compared between the groups. Results: In all, 123 (2.0%) patients with BBC were enrolled in this study, including 98 (1.6%) SBBC and 25 (0.4%) MBBC patients. A total of 280 patients with UBC were selected for the control group. Compared with patients with UBC, patients with SBBC were more likely to be older and have a family history of breast cancer, non-infiltrative carcinoma, lower pathological tumor-node-metastasis (pTNM) stage, and luminal A type breast cancer as their first tumor. Patients with MBBC were more likely to be postmenopausal and have hormone receptor [estrogen receptor (ER)/progesterone receptor (PR)] negativity, a higher pTNM stage, and a triple-negative first tumor. Patients with UBC with ER/PR (-) were more likely to develop contralateral breast cancer (CBC) than those with ER/PR (+). There was no significant difference in overall survival (OS) and disease-free survival (DFS) between patients with SBBC and patients with UBC. Patients with MBBC had worse DFS than those with UBC, but OS was similar for both types of patients. Patients with MBBC <55 years at first diagnosis had significantly shorter DFS compared to those with SBBC and UBC. A multivariate Cox proportional hazards model revealed that age ≥55 years and ER/PR negativity of the first tumor were independent risk factors for OS. Independent risk factors for DFS included MBBC, age <55 years, family history of other malignant tumors, ER/PR (-), lymphovascular invasion, and N stage ≥2 of the first tumor. Conclusions: The OS and DFS of patients with SBBC and UBC were similar. The MBBC patients, especially those <55 years old at first diagnosis, had shorter DFS than patients with UBC.

Surgical management and prognosis of phyllodes tumors of the breast.

Background: Regardless of histological grade, phyllodes tumors (PTs) exhibit the potential of local recurrence. The National Comprehensive Cancer Network (NCCN) recommends wide local excision (WLE) with a 1 cm margin or more for borderline/malignant PTs but excisional biopsy for benign PTs. However, the treatment of benign PTs remains controversial and the clinicopathologic risk factors for the local recurrence is still unclear. Methods: We retrospectively analyzed 238 patients with PTs who underwent surgery at the Chinese PLA General Hospital from January 1, 2006 and April 30, 2020. We stratified our analysis according to histologic grade and explored the clinicopathologic factors to influence local recurrence (LR), including age, histologic grade, history of fibroadenoma, type of surgery [vacuum-assisted biopsy system (VABS), local excision (LE), wide local excision (WLE) and mastectomy]. Results: All 238 cases were categorized as benign (171, 71.8%), borderline (38, 16.0%), or malignant (29, 12.2%). The median follow-up was 50.2 months. In multivariate analysis, histologic grade (P<0.01) and history of fibroadenoma (P<0.01) were independent prognostic factors for LR. No difference existed in the recurrence rate of BPT treated with different surgical procedures (P=0.397), whereas a higher recurrence rate was found in VABS and LE subgroups than in WLE and mastectomy subgroups for borderline/malignant tumors (P<0.01). Conclusions: No association found between surgical modalities and LR rate for BPT. We suggested a "wait-and-watch" policy for patients with unexpected benign subtypes, instead of unnecessary re-excision. In addition, VABS or LE can be treated for BPT with small mass, whereas WLE or even mastectomy should be conducted for borderline/malignant PTs with large mass.

The association between platelet-lymphocyte ratio and the risk of all-cause mortality in chronic kidney disease: a systematic review and meta-analysis.

BACKGROUND: Chronic kidney disease (CKD) patients have high levels of inflammatory mediators. These inflammatory mediators contribute to the increased risk of cardiovascular events and all-cause mortality. Platelet-lymphocyte ratio (PLR) has recently been recognized as a novel inflammatory marker and has been shown to be associated with the prognosis in CKD patients. However, the quality of these studies varies and their results are controversial. The purpose of this meta-analysis was to investigate the relationship between PLR and all-cause mortality in CKD patients. METHODS: A systematic literature search of PubMed, EMBASE, CENTRAL and ISI Web of Science was conducted. The databases were searched from their inception dates up to the latest issue (31 October 2021). Two reviewers independently searched the databases and screened studies. Data were extracted using a standardized collection form. Meta-analysis was performed to compare PLR values between CKD and non-CKD patients, and to investigate the association between PLR and all-cause mortality in CKD patients. This meta-analysis is reported in adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). RESULTS: A total of 11 studies involving 4244 participants were selected. The pooled data indicated that PLR values were significantly higher in CKD patients than non-CKD controls (weighted mean difference = 21.6, 95% CI 17.39-25.81, p < 0.01), and PLR is associated with an increased risk of all-cause mortality in CKD patients (hazard ratio = 2.49, 95% CI 1.78-3.49, p < 0.01). CONCLUSIONS: Patients with CKD have higher PLR values compared to non-CKD patients. Meanwhile, PLR values were highly associated with all-cause mortality in CKD patients. PLR is a valid predictor as a clinically accessible indicator for patients with CKD.

Probabilistic risk assessment of heavy metals in urban farmland soils of a typical oasis city in northwest China.

Previous studies lacked quantitative evaluation studies of the probability of ecology and human health risks from soil heavy metals. This study assessed heavy metal risk level by collecting topsoil samples from a typical oasis city (Wuwei) in northwest China and then quantitatively evaluating the ecological risk from heavy metals by incorporating the uncertainty of health risk model parameters into the risk assessment. This study found that anthropogenic activities have influenced the accumulation of heavy metals in the study area and that the risk of contamination of soil heavy metals was characterized as light to moderate contamination and low ecological risk. On this basis, the species sensitivity distribution curves of heavy metals were constructed using species acute toxicity data, the predicted no effect concentrations of heavy metals were derived, and a probabilistic ecological risk evaluation was conducted. The results show that the current soil environmental quality standards in China are not effective in protecting species diversity. In addition, the probability of ecological risk for Cr, Ni and As in the study area was 63.3%, 23.8% and 7.1%, however, traditional pollution assessment methods underestimate the hazard of Cr. Monte Carlo simulations have shown that the probability of the carcinogenic risk of Cr (adults: 79.4%; children: 94.5%) and As (adults: 78.9%; children: 94.0%) is high, the probability of the total carcinogenic risk exceeding 1E-06 is 99.0%, the probability of the non-carcinogenic risk is low, and the slope factor and reference dose can significantly affect the evaluation of human health risks.

Surgical management in phyllodes tumors of the breast: a systematic review and meta-analysis.

Background: Information is still controversial in the studies regarding the current optimal surgical management of phyllodes tumors (PTs) of the breast. Local recurrence (LR) may occur with an upgraded in the pathological grade, influencing the prognosis of patients with PT. This systematic review and meta-analysis aimed to investigate the association of LR risk with margin status and margin width which could have significant implications on the surgical management of PT. Methods: Independent and comprehensive searches were performed by two authors through five databases including PubMed, Medline, Embase, ScienceDirect and Cochrane Library from January 1990 to October 2021. Studies investigating the association between margin width, margin status and LR rates were considered for inclusion. Study quality was evaluated using the Newcastle-Ottawa Scale (NOS). Meta-analysis was performed using RevMan5.3 software, and statistical heterogeneity was assessed using the Chi-square test and quantified using the I2 statistic. Visual inspection of funnel plots was used to judge publication bias. Results: A total of 34 articles were included in this article, all of which with NOS scores above 5. Regardless of the PT grade, positive margin significantly increased the risk of LR [odds ratio (OR) 3.64, 95% confidence interval (CI): 2.60-5.12]. No significant difference was found in the risk of LR between the margins <1 and ≥1 cm (OR 1.39, 95% CI: 0.67-2.92). For benign and borderline PTs, there were no significant differences of the LR risk between breast-conserving surgery (BCS) and mastectomy (benign OR 0.68, 95% CI: 0.12-3.78; borderline OR 1.14, 95% CI: 0.29-4.51). While the LR risk was significantly increased by BCS for malignant PT (OR 2.77, 95% CI: 1.33-5.74). Discussion: Different surgical management strategies should be considered for different PT grades. BCS was a feasible option and margins <1 cm was not significantly associated with LR risk for all grade of PT. After BCS, benign PT with positive margin could adopt the "wait and watch" strategy with regular follow-up, while borderline and malignant PTs were expected to underwent re-excision to ensure negative margins. More studies are still needed to clarify and update the existing conclusions and improve the prognosis of PT patients.

Distribution of soil available nutrients and their response to environmental factors based on path analysis model in arid and semi-arid area of northwest China.

The study on the distribution of soil available nutrients and their response to the natural environment can provide valuable data and theoretical guidance for supporting human agricultural activities, especially in arid and semi-arid area where the ecological environment is extremely fragile. Based on the soil sampling and survey data set, this study established the path analysis model of SANs (soil available nutrients, including ammonium nitrogen (AN), available phosphorus (AP) and available potassium (AK)) with topography, climate and vegetation in order to explore how environmental factors interact to affect the content of SANs. Then, we combined Pearson correlation analysis and statistical analysis to explore the distribution of SANs under different environmental conditions and the response of vegetation growth to climate changes, in order to further reveal the availability of soil nutrients. The results showed that vegetation was the most important direct factor affecting AN and AP, and AK was the most sensitive to climate changes. The indirect effects of topography and climate on SANs were much greater than their direct effects. Elevation largely predicted the change of climate environment, and the regional climate directly controlled the growth of vegetation. These indirect effects strengthened the connection between topography as well as climate factors and SANs. It is worth noting that the response of vegetation to temperature and precipitation had time lag, which would have a certain impact on the content of SANs response to the environmental changes. This study is of great significance for improved understanding of soil nutrients supply and how ecosystems respond to soil nutrients availability in arid and semi-arid area.

Assessing the sustainability of ecosystems over fourteen years of cultivation in Longnan City of China based on emergy analysis method.

Currently, the contradiction between the limited resources of China's cultivated ecosystems and population growth is becoming increasingly evident, and the negative impacts on the environment and human activities need to be curbed. Therefore, it is crucial to quantify the sustainability of cultivated ecosystems and determine these driving factors that affect their development. This study used the emergy method to quantify the input/output flow and sustainable development of the cultivated land ecosystem in Longnan City, combined with the logarithmic mean divisia index decomposition analysis (LMDI) method to evaluate the driving factors of sustainable development in the region. The results demonstrate that from 2004 to 2017, the total emergy input and output of Longnan City showed an upward trend, and non-renewable resources (N) were always in a dominant state in the total emergy (T) input, and their proportion rose from 59.69% to 66.92%. The emergy sustainability index (ESI) is less than 1, and the environmental pressure of the system is relatively higher. Comprehensive emergy production ratio (EPR), emergy investment ratio (EIR), the renewable fraction (R%), emergy yield ratio (EYR) and environmental load ratio (ELR), showed that the agricultural ecological economy in Longnan still has great development potential, and clean energy should be developed as far as possible to replace fossil fuels in future planning. LMDI results showed that the intensity factor ΔY'A is the main driving factor for the positive development of ESI. The government's ecological protection requirements can reduce waste emissions through reasonable farming system and advocating the use of organic fertilizer, so as to achieve the purpose of improving crop yield. Vigorous development of green ecological agricultural production patterns can improve the sustainability of arable ecosystems. This study can provide a theoretical basis for the sustainable development of cultivated ecosystems and the formulation of related agricultural production measures.

Heavy metal pollution levels, source apportionment and risk assessment in dust storms in key cities in Northwest China.

In this study, the potential hazards of heavy metals in dust storms were investigated by collecting dust storm samples, measuring their heavy metal concentrations, and using index evaluation, spatial analysis, positive matrix factorization (PMF) model and risk assessment model. Heavy metals in dust storms were contaminated by anthropogenic sources leading to their concentrations being higher than the background values. The enrichment factors and geoaccumulation indices showed that the heavy metals came from both natural and anthropogenic sources, Cu, Ni, Zn and Pb are strongly influenced by anthropogenic sources. Heavy metals in dust storms were divided into four sources: Cu and Ni were attributed to industrial sources mainly from local mining and metal processing; Cr was mainly contributed by industrial sources related to industrial production such as coal combustion; Pb and Zn were mainly contributed by transportation sources; and Ti, V, Mn, Fe, and As were from natural and agricultural sources. The level of comprehensive ecological risk of heavy metals in dust storms were low, but there were moderate and above risks at individual sites. Both adults and children had the highest carcinogenic and non-carcinogenic risks from the ingestion route, and the risk for children was higher than that for adults.

Tall cell carcinoma with reversed polarity: case report with gene sequencing and literature review.

Tall cell carcinoma with reversed polarity (TCCRP) is an extremely rare type of invasive breast cancer with only 17 literatures and 75 cases reported. Knowledge on TCCRP is still scanty. The present study reported 2 cases of TCCRP, analyzed their clinicopathological characteristics, and used whole exome sequencing to perform genetic testing. Both two cases were proved to have typical clinicopathological manifestations (solid and papillary architectures lined by tall columnar cells with nuclei displaying "reverse polarization") and hotspot mutations (IDH2 and PIK3CA mutations) of TCCRP. Furthermore, positive expression of TTF-1 was found in a small number of tumor cells nuclei and normal ductal epithelial cells, while the negative rate of TTF-1 in previous case reports was 100%. Attention should be paid in core needle biopsy to avoid misdiagnosis. In addition, this article also reviewed all previous cases and demonstrated that the positive expression of calretinin might have an indicative significance for TCCRP, which could be used as one of the auxiliary diagnosis tools. The diagnosis of TCCRP requires comprehensive analysis of clinical pathology and genetic testing results. There is no clear treatment standard for TCCRP currently, further research should be reported to characterize and deeply investigate the diagnosis and treatment criteria of TCCRP.

Comparative healing of swine skin following incisions with different surgical devices.

BACKGROUND: Electrosurgical technology is widely used in surgical dissection and hemostasis, but the generated heat creates thermal injury to adjacent tissues and delays wound healing. The plasma blade (PB) applies pulsed radiofrequency (RF) to generate electrical plasma along the edge of a thin, flat, insulated electrode, minimizing collateral tissue damage. This study aimed to evaluate wound healing in swine skin following incision with a new surgical system that applies low-temperature plasma (NTS-100), a foreign PB, conventional electrosurgery (ES), and a scalpel blade. METHODS: In vitro porcine skin and an in vivo porcine skin model were used in this study. Full-thickness skin incisions 3 cm in length were made on the dorsum of each animal for each of the 5 surgical procedures at 0, 21, 28, 35, and 42 days. The timing of the surgical procedures allowed for wound-healing data points at 1, 2, 3, and 6 weeks accordingly. Local operating temperature and blood loss were quantified. Wounds were harvested at designated time points, tested for wound tensile strength, and examined histologically for scar formation and tissue damage. RESULTS: Local operating temperature was reduced significantly with NTS-100 (cut mode 83.12±23.55 °C; coagulation mode 90.07±10.6 °C) compared with PB (cut mode 94.46±11.48 °C; coagulation mode 100.23±6.58 °C, P<0.05) and ES (cut mode 208.99±34.33 °C, P<0.01; coagulation mode 233.37±28.69 °C, P<0.01) in vitro. Acute thermal damage from NTS-100 was significantly less than ES incisions (cut mode: 247.345±42.274 versus 495.295±103.525 µm, P<0.01; coagulation mode: 351.419±127.948 versus 584.516±31.708 µm, P<0.05). Bleeding, histological scoring of injury, and wound strength were equivalent for the NTS-100 and PB incisions. CONCLUSIONS: The local operating temperature of NTS-100 was lower than PB, and NTS-100 had similarly reliable safety and efficacy.

Inverted-T pattern reduction mammoplasty in bilateral breast ptosis: cosmetic and oncological outcomes.

BACKGROUND: Breast ptosis is directly caused by Cooper's ligament laxity, with the decline of nipple areola complex (NAC) and mammary parenchyma. Breast cancer with ptosis is always a knotty problem that can hardly be repaired by classic breast conservation surgery (BCS) ending up with a pleasing appearance. We analyzed our 12 years' experience of performing inverted-T pattern techniques to treat bilateral breast ptosis, with or without breast cancer. METHODS: One hundred forty-eight breasts in 74 patients undergoing inverted-T pattern reduction mammoplasty were included in this study. Information about patients' clinical and surgical characteristics, complications, NAC sensitivity, cosmetic and oncological outcomes were collected and retrospectively analyzed. RESULTS: In the cohort of 57 patients with pure breast ptosis, the mean body mass index (BMI) was 25.2 kg/m2, and the mean weight of resected tissue from the left and right breast reductions were 744.9 and 756.7 g. In the cohort of 17 patients diagnosed as breast cancer with ptosis, the mean BMI was 25.1 kg/m2, and the mean weight of resected tissue were 504.1 g for left and 535.6 g for right side. The majority of repairs were performed for tumors located in the upper outer (58.8%), mostly with inferior or superomedial pedicles (90%). All the upper inner tumors were repaired with inferior pedicles. Minor complications such as seroma (8.1%), NAC epidermolysis (8.1%), delayed wound healing (4.1%) were detected postoperatively. Partial NAC necrosis occurred in one patient (1.4%). 82.4% of all the patients rated "very satisfied" or "satisfied" as the final cosmetic outcomes. NAC sensitivity was "very high" and "high" in 82.4% patients. No local occurrence, distant metastasis and mortality occurred in tumor patients. CONCLUSIONS: The inverted-T pattern reduction mammoplasty is a reliable technique to treat bilateral breast ptosis with a low complication rate. For cases with breast cancer, this technique can achieve both satisfying cosmetic outcomes and oncological safety.

Predicting the spatial pollution of soil heavy metals by using the distance determination coefficient method.

Identifying the spatial distribution of heavy metal concentrations is a prerequisite for soil contamination assessment and control. In this study, soil surface samples (0-20 cm) were collected in Wuwei, China, and heavy metal concentrations were determined. The LUR (land use regression) model was used to simulate the spatial distribution of seven heavy metal concentrations in the study area, considering various factors, and the results were compared with ordinary kriging (OK) interpolation. Based on A Distance Decay REgression Selection Strategy (ADDRESS), the distance-coefficient of determination (DCD) was proposed to more easily and accurately select the optimal buffer of the relevant covariates. The simulation results showed that the adj R2 values of the LUR models of the remaining heavy metals were all above 0.6, and the empirical comparison showed that LUR was better than OK. The variables that showed a more significant impact on soil heavy metal concentrations in the research area included road length, normalized difference vegetation index (NDVI), and soil sample nutrients around the sample site. In the research area, the concentration of heavy metals in the soil was greatly affected by motorway, primary roads, and secondary roads in the range of 1.2-2.1 km (r > 0.5), while building and As, Cu, Pb and Zn in the range of 3.6-4.8 km had a significant correlation (r > 0.5). This study provides scientific evidence and basic information for the prevention and control of heavy metal contamination and human health risk assessment management in arid zones.

PIK3CA mutation confers resistance to chemotherapy in triple-negative breast cancer by inhibiting apoptosis and activating the PI3K/AKT/mTOR signaling pathway.

BACKGROUND: Triple-negative breast cancer (TNBC) is a malignant subtype of breast cancer, the main treatments for which are chemotherapy and surgery. PIK3CA is an oncogene that encodes the p110α subunit of class IA PI3K to regulate cell proliferation and apoptosis. Some reports have observed neoadjuvant chemotherapy (NAC) to have poor pathological complete response (pCR) rates in TNBC with PIK3CA mutation. This study aimed to explore the mechanism of how mutant PIK3CA alters chemotherapeutic susceptibility in TNBC. METHODS: TNBC cell lines (MDA-MB-231 and MDA-MB-468) with PIK3CA gene mutations (E545K and H1047R regions) and overexpression were established by transfection. NOD/SCID mice were used for in vivo experiments. Epirubicin was used as the chemotherapeutic agent. Cell viability, cell cycle, apoptosis, and Transwell assays were conducted for phenotype analysis. Western blot, quantitative reverse transcription-polymerase chain reaction, and immunohistochemistry were used to detect gene and protein expression levels. A clinical analysis of 50 patients with TNBC was also performed. RESULTS: Cell viability and Transwell assays showed that PIK3CA mutation promoted TNBC cell growth and conferred an enhanced migratory phenotype. Cell cycle and apoptosis assays showed that PIK3CA mutation moderately improved the proliferation ability of TNBC cells and remarkably inhibited their apoptosis. After epirubicin therapy, the proportion of early apoptotic cells decreased among cells with PIK3CA mutation. Further, xenograft tumors grew faster in NOD/SCID mice injected with mutated cell lines than in control group, suggesting that PIK3CA mutation caused chemotherapy resistance. Importantly, western blot and immunohistochemical analysis showed that cells and mouse tumors in the PIK3CA mutation groups exhibited different expression levels of apoptosis-related markers (Xiap, Bcl-2, and Caspase 3) and proteins associated with the PI3K/AKT/mTOR pathway (p110α, AKT, p-AKT, mTOR, p-mTOR, p-4E-BP1, p-p70S6K, and Pten). Moreover, prognostic analysis of 50 patients with TNBC indicated that PIK3CA mutation might be linked with relapse and death. CONCLUSIONS: PIK3CA mutation confers resistance to chemotherapy in TNBC by inhibiting apoptosis and activating the PI3K/AKT/mTOR signaling pathway.