Primary hepatoid adenocarcinoma of the lung with extremely elevated serum AFP: a case report and literature review.

Primary hepatoid adenocarcinoma of the lung (HAL) is an exceptionally rare subtype of lung cancer that mimics the morphology and biological behavior of hepatocellular carcinoma. Although reports in the literature are limited, HAL is known for its high malignancy and poor prognosis, thus drawing increasing attention. We present the case of a patient with a mass-like consolidation with central necrosis initially misdiagnosed as inflammation at another medical institution despite a percutaneous lung biopsy. After ineffective anti-inflammatory treatment, she was referred to our hospital. We performed another lung biopsy, obtaining five samples from different angles, and eventually diagnosed her with HAL. Surprisingly, her serum alpha-fetoprotein (AFP) levels were extraordinarily high, leading to the successful diagnosis of HAL. Here, we present a case report and a related literature review.

Impacts of February climate conditions in the Gobi Desert on March dust activities in the northern East Asia.

Amid ongoing global warming, intense dust storms continue to plague regions despite efforts to understand and mitigate their impacts. This study explores the connection between surface temperature (ST) and precipitation (PRE) in the Gobi Desert (GD) during February and their subsequent effects on March dust concentrations across northern East Asia. Our analysis reveals a clear pattern: higher February ST combined with lower PRE in GD correlates with increased dust levels in March, with ST effects predominantly in northern areas of dust sources compared to PRE. The warming of the ST in February facilitates surface thawing, and the concurrently reduced PRE decreases soil moisture in GD. These conditions both contribute to the loosening of the soil, thereby creating favorable lower boundary conditions for the onset of dust activities in the subsequent March. Atmospheric dynamics play a pivotal role in the changes of ST and PRE. The preceding ST warming is closely tied to the weakening of the East Asian winter monsoon. Furthermore, the Eurasia teleconnection (EU) pattern is identified as a key circulation factor driving the changes of February PRE in GD. Additionally, sea surface temperature anomalies in the Barents Sea and the North Atlantic appear to influence these atmospheric circulation changes, altering ST and PRE in GD, and consequently, impacting March dust dynamics in northern East Asia. This study provides crucial insights into the climatic precursors that drive dust storm activities, which are essential for improving the accuracy of dust storm forecasting.

Analysis of the spatiotemporal changes in global tropospheric ozone concentrations from 1980 to 2020.

Tropospheric ozone affects human health, ecosystems, and climate change. Previous studies on Tropospheric Column Ozone (TCO) have primarily concentrated on specific regions or global geographic divisions. This has led to insufficient exploration of the spatiotemporal characteristics and influencing factors of TCO in global and rational subregions. In this study, TCO is calculated using the Modern Era Retrospective analysis for Research and Applications version 2 (MERRA-2) reanalysis data and corrected using satellite data. Cluster analysis is conducted to explore the temporal characteristics of TCO variations in different regions. The results show that the global TCO is basically distributed latitudinally, with higher TCO in the northern hemisphere, which is related to atmospheric circulation, radiation, stratospheric transport, and the distribution of ozone precursors. Between 1980 and 2020, the global average annual TCO showed an increasing trend at 0.09 DU yr-1 due to rising anthropogenic emissions of ozone precursors (NOx at 589547.86 t yr-1 and NMVOC at 1070818.24 t yr-1), increasing tropopause height (-0.10 hPa yr-1), and the enhanced ozone flux at the tropopause (0.22 ppbv m s-2 yr-1). Cluster analysis reveals different trends in TCO changes across regions. The ocean south of 60°S and parts of West Antarctica (Region 2), the region from 30°N to 60°N and the western oceanic region of 30°S (Region 3), and the region from the equator to 60°S and the region north of 60°N (Region 5) exhibit increasing trends (with rates of 0.08 DU yr-1, 0.07 DU yr-1, and 0.11 DU yr-1, respectively), linked to the enhanced ozone flux at the tropopause, the rising tropopause height and increasing ozone p precursors. Conversely, the decreasing TCO trends in the equatorial Pacific (Region 1) and East Antarctica (Region 4) (with rates of -0.01 DU yr-1 and -0.02 DU yr-1) may be related to increased cloudiness and weakened photochemical reactions.

Novel Halogenated Curcumin-Mediated Photodynamic Inactivation for the Preservation of Small Yellow Croaker (Larimichthys polyactis).

A novel class of halogenated curcumin, X-Cur (X = F, Cl, or Br), was synthesized, and its photosensitivity was evaluated. The results showed that Br-Cur with the highest singlet oxygen (1O2) generation capacity exhibited a better photodynamic inactivation (PDI) effect on the small yellow croaker (Larimichthys polyactis) than curcumin. This was attributed to the heavy atom effect of Br, which resulted in Br-Cur having the smallest singlet-triplet energy difference ΔEst(S1-T3) (0.140 eV) and the largest spin-orbit coupling value (0.642262 cm-1). When L. polyactis was treated with 0.025 wt % Br-Cur and exposed to blue LED irradiation (450 nm, 20 mW/cm2) for 20 min, the increase in the total volatile basic nitrogen content (28.23 ± 2.38 mg/100 g on day 6), pH, and total viable count (6.13 ± 0.06 log CFU/g on day 6) could be effectively controlled. Accordingly, Br-Cur is a promising photosensitizer for PDI preservation.

Involvement of a rice mutation in storage protein biogenesis in endosperm and its genomic location.

MAIN CONCLUSION: A mutation was first found to cause the great generation of glutelin precursors (proglutelins) in rice (Oryza sativa L.) endosperm, and thus referred to as GPGG1. The GPGG1 was involved in synthesis and compartmentation of storage proteins. The PPR-like gene in GPGG1-mapped region was determined as its candidate gene. In the wild type rice, glutelins and prolamins are synthesized on respective subdomains of rough endoplasmic reticulum (ER) and intracellularly compartmentalized into different storage protein bodies. In this study, a storage protein mutant was obtained and characterized by the great generation of proglutelins combining with the lacking of 13 kD prolamins. A dominant genic-mutation, referred to as GPGG1, was clarified to result in the proteinous alteration. Novel saccular composite-ER was shown to act in the synthesis of proglutelins and 14 kD prolamins in the mutant. Additionally, a series of organelles including newly occurring several compartments were shown to function in the transfer, trans-plasmalemmal transport, delivery, deposition and degradation of storage proteins in the mutant. The GPGG1 gene was mapped to a 67.256 kb region of chromosome 12, the pentatricopeptide repeat (PPR)-like gene in this region was detected to contain mutational sites.

Curcumin-loaded food-grade nano-silica hybrid material exhibiting improved photodynamic effect and its application for the preservation of small yellow croaker (Larimichthys polyactis).

Two types of curcumin-loaded food-grade nano-silica (F-SiO2) hybrid materials were successfully synthesized using the rotary evaporation method (F-SiO2@Cur) and the adsorption method (Cur@F-SiO2). The microstructure and spectral analyses confirmed that the curcumin in F-SiO2@Cur was loaded within the nanopores in a non-aggregate form rather than being adsorbed onto the surface (Cur@F-SiO2). Additionally, F-SiO2@Cur exhibited remarkable water solubility (1510 ± 50.33 µg/mL) and photostability (a photodegradation ratio of only 59.22 %). Importantly, F-SiO2@Cur obtained a higher capacity for the generation of singlet oxygen (1O2) compared to control groups. Consequently, F-SiO2@Cur-mediated photodynamic inactivation (PDI) group attained the highest score in sensory evaluation and the best color protection effect in PDI experiment of small yellow croaker (Larimichthys polyactis) at 4 °C. Moreover, F-SiO2@Cur could effectively controlled total volatile basic nitrogen (TVB-N) content, pH, and total viable count (TVC), thereby prolonging the shelf life. Therefore, F-SiO2@Cur-mediated PDI is an effective fresh-keeping technology for aquatic products.

Clinicopathological features, prognostic factor analysis, and survival nomogram of patients with double primary cancers involving lung cancer.

BACKGROUND: Although the incidence of double primary cancers (DPCs) involving lung cancer is rising, they have not been studied sufficiently. This study retrospectively analyzed the clinicopathological and prognostic characteristics of DPC patients with lung cancer and developed a survival nomogram to predict the individual OS rates. METHODS: We included 103 DPC patients with lung cancer from Shengjing Hospital between 2016 and 2021. Based on the 6-month cancer occurrence interval, the cases were categorized as synchronous DPCs (sDPCs) or metachronous DPCs (mDPCs). Furthermore, the mDPCs were subdivided based on whether the lung cancer occurred first (LCF cohort) or the other cancer occurred first (OCF cohort). RESULTS: Among the patients, 35 (33.98%) and 68 (66.02%) had sDPCs and mDPCs, respectively. In the mDPCs cohort, 18 (26.47%) belonged to the LCF cohort and 50 (73.53%) to the OCF cohort. The most frequent primary cancer sites were the breast (27.18%), colorectum (22.33%), and urinary system (18.45%). Independent risk factors for progression-free survival were Stage IV lung cancer (p = 0.008) and failure to undergo radical lung cancer surgery (p = 0.028). The risk factors for OS included squamous carcinoma (p = 0.048), Stage IV lung cancer (p = 0.001), single cancer resection plus drug therapy (p < 0.001), drug therapy alone (p = 0.002), failure to undergo radical lung cancer surgery (p = 0.014), and chemotherapy (p = 0.042). The median OS was 37 months, with 3- and 5-year rates of 50.9% and 35.9%, respectively. CONCLUSION: DPCs involving lung cancer account for 1.11% of cases. The breast, colorectum, and urinary system were the most common extra-pulmonary sites, and mDPCs were more frequent than sDPCs. Radical lung cancer surgery significantly affects prognosis, and drug therapy alone may be preferable when only one tumor is operable. The developed nomogram can accurately predict individual 3-year and 5-year OS rates.

Invert global and China's terrestrial carbon fluxes over 2019-2021 based on assimilating richer atmospheric CO2 observations.

With China's commitment to reach carbon peak by 2030 and achieve carbon neutrality by 2060, it is particularly important to obtain terrestrial ecosystem carbon fluxes with low uncertainty both globally and in China. The use of more observation data may help reduce the uncertainty of inverting carbon fluxes. This study uses the observation data from global stations, background stations and provincial stations in China, as well as the OCO-2 satellite, and uses the China Carbon Monitoring, Verification and Supporting System for Global (CCMVS-G) to estimate the carbon fluxes of global and Chinese terrestrial ecosystems from 2019 to 2021. The results revealed that the global terrestrial ecosystem carbon sink was approximately -3.40 Pg C/yr from 2019 to 2021. The carbon sinks in the Northern Hemisphere are large, especially in Asia, North America, and Europe. From 2019 to 2021, the carbon sink of China's terrestrial ecosystem was approximately -0.44 Pg C/yr. Carbon sinks exhibit significant seasonal and interannual variations in China. After assimilating the observation data, the uncertainty of the posterior flux is smaller than that of the prior flux, a more reasonable distribution of carbon sources and sinks can be obtained, and more accurate boundary conditions can be provided for the China Carbon Monitoring, Verification and Supporting System for Regional (CCMVS-R). In the future, it is important to establish a well-designed CO2 ground-based observation network.

Impacts of emissions and meteorological conditions in three different phases of aerosol pollution during 2013-2022 in Anhui, China.

The PM2.5 concentrations in Anhui, which links the Yangtze River Delta region, China's fastest growing economy area, with the Beijing-Tianjin-Hebei (BTH) region, China's most polluted region, are influenced not only by emissions, but also by variation of meteorological conditions. A comprehensive understanding of the relative impacts of meteorology and emissions on heavy pollution in Anhui at three phases (i.e., phase1: from 2013 to 2017; phase2: from 2018 to 2020; phase 3: from 2021 to 2022) from 2013 to 2022, which can provide suggestions for pollution prevention and control in the future. The decrease in pollutant concentrations from 2013 to 2022 is mainly attributed to the continued reduction in emissions, while the year-to-year fluctuations in pollutant concentrations are largely influenced by meteorological conditions. Although emissions are decreasing, the proportions of residential biofuel combustion and cement are increasing. In addition to the effects of prevailing northeasterly and northwesterly winds (i.e., Type1 and Type2), there is also concern about the influences of static weather and neighboring regional transport (i.e., Type5 and Type6), especially in 2016. The contribution of emissions is greater in phase 2 and phase 3, with a 17 % increase compared to phase 1. Overall, approximately 57 % of explosive growth in PM2.5 concentration during the cumulative stage (CS) can be regarded as the feedback effect of the deteriorating meteorological conditions. Therefore, statistical analyses show that limiting PM2.5 concentrations below about 73 µg m-3 would weaken the feedback effects, which in turn would avoid most of the explosive growth processes in the CS of the 60 heavy pollution processes, which can provide a reference for the government to set a target for sustained emission reduction.

Aerosol forcing regulating recent decadal change of summer water vapor budget over the Tibetan Plateau.

The Tibetan Plateau (TP), known as the Asian water tower, has been getting wetter since the 1970s. However, the primary drivers behind this phenomenon are still highly controversial. Here, we isolate the impacts of greenhouse gases (GHG), aerosols, natural forcings and internal climate variability on the decadal change of summer water vapor budget (WVB) over the TP using multi-model ensemble simulations. We show that an anomalous Rossby wave train in the upper troposphere travelling eastward from central Europe and equatorward temperature gradient in eastern China due to the inhomogeneous aerosol forcing in Eurasia jointly contribute to anomalous easterly winds over the eastern TP. Such anomalous easterly winds result in a significant decrease in water vapor export from the eastern boundary of the TP and dominate the enhanced summer WVB over the TP during 1979-2014. Our results highlight that spatial variation of aerosol forcing can be used as an important indicator to project future WVB over the TP.

Bronchopulmonary foregut malformation with severe hemoptysis in advanced age: a case report and literature review.

Bronchopulmonary foregut malformation (BPFM) is a rare developmental malformation disease due to embryonic defects, with an even rarer occurrence in adults. We report a diagnosed case in an adult patient, and notably, this is the first reported case of such advanced age. Additionally, she experienced coughing up approximately 1 liter of blood and partial lung tissue, accompanied by respiratory failure and shock. Following treatment with transcatheter arterial embolization, her condition improved, and she has remained stable during follow-up. We present a case report and conducted a systematic review on this particular case.

Food-grade silica-loaded gallic acid nanocomposites: Synthesis and mechanism for enhancing water-based biological activity.

As the low water solubility of gallic acid (GA), its biological activities such as water-based antioxidant effect may be greatly reduced. Therefore, GA-loaded nanocomposites (F-SiO2@GA) with high water solubility were synthesized via solvent evaporation using food-grade silica (F-SiO2) as carriers in this work. The assessment of antioxidant capacity revealed that F-SiO2@GA exhibited considerably greater free-radical scavenging ability than free GA and the physical mixture of F-SiO2 and GA. In the photooxidation experiment of food-grade gardenia yellow pigment (GYP), F-SiO2@GA showed a notable antioxidant effect on GYP solution. Additionally, in the storage experiment on chilled whiteleg shrimp (Litopenaeus vannamei) treated with F-SiO2@GA, pH, total volatile basic nitrogen (TVBN), and thiobarbituric acid reactive substance (TBARS) values were effectively inhibited. In conclusion, the internal encapsulation of GA effectively prevented the self-aggregation phenomenon, thereby facilitating the exposure of its active phenolic hydroxyl group and significantly enhancing its water-based biological activity.

Spatially resolved land and grid model of carbon neutrality in China.

China has committed to achieve net carbon neutrality by 2060 to combat global climate change, which will require unprecedented deployment of negative emissions technologies, renewable energies (RE), and complementary infrastructure. At terawatt-scale deployment, land use limitations interact with operational and economic features of power systems. To address this, we developed a spatially resolved resource assessment and power systems planning optimization that models a full year of power system operations, sub-provincial RE siting criteria, and transmission connections. Our modeling results show that wind and solar must be expanded to 2,000 to 3,900 GW each, with one plausible pathway leading to 300 GW/yr combined annual additions in 2046 to 2060, a three-fold increase from today. Over 80% of solar and 55% of wind is constructed within 100 km of major load centers when accounting for current policies regarding land use. Large-scale low-carbon systems must balance key trade-offs in land use, RE resource quality, grid integration, and costs. Under more restrictive RE siting policies, at least 740 GW of distributed solar would become economically feasible in regions with high demand, where utility-scale deployment is limited by competition with agricultural land. Effective planning and policy formulation are necessary to achieve China's climate goals.

Columnar optical-radiative properties and components of aerosols in the Arctic summer from long-term AERONET measurements.

Aerosols as an external factor have an important role in the amplification of Arctic warming, yet the geography of this harsh region has led to a paucity of observations, which has limited our understanding of the Arctic climate. We synthesized the latest decade (2010-2021) of data on the microphysical-optical-radiative properties of aerosols and their multi-component evolution during the Arctic summer, taking into consideration the important role of wildfire burning. Our results are based on continuous observations from eight AERONET sites across the Arctic region, together with a meteorological reanalysis dataset and satellite observations of fires, and utilize a back-trajectory model to track the source of the aerosols. The summer climatological characteristics within the Arctic Circle showed that the aerosols are mainly fine-mode aerosols (fraction >0.95) with a radius of 0.15-0.20 µm, a slight extinction ability (aerosol optical depth âˆ¼ 0.11) with strong scattering (single scattering albedo ∼0.95) and dominant forward scattering (asymmetry factor âˆ¼ 0.68). These optical properties result in significant cooling at the Earth's surface (∼-13 W m-2) and a weak cooling effect at the top of the atmosphere (∼-5 W m-2). Further, we found that Arctic region is severely impacted by wildfire burning events in July and August, which primarily occur in central and eastern Siberia and followed in subpolar North America. The plumes from wildfire transport aerosols to the Arctic atmosphere with the westerly circulation, leading to an increase in fine-mode aerosols containing large amounts of organic carbon, with fraction as high as 97-98 %. Absorptive carbonaceous aerosols also increase synergistically, which could convert the instantaneous direct aerosol radiative effect into a heating effect on the Earth-atmosphere system. This study provides insights into the complex sources of aerosol loading in the Arctic atmosphere in summer and emphasizes the important impacts of the increasingly frequent occurrence of wildfire burning events in recent years.

A Review of Recent Advances in the Molecular Mechanisms Underlying Brain Metastasis in Lung Cancer.

Brain metastasis from lung cancer is a prevalent mode of treatment failure associated with a poor prognosis. The incidence of brain metastasis has recently shown a dramatic increase. The early detection and risk stratification of lung cancer-related brain metastasis would be highly advantageous for patients. However, our current knowledge and comprehension of the underlying mechanisms driving brain metastasis in lung cancer pose significant challenges. This review summarizes the mechanisms underlying brain metastasis, focusing on the intricate interplay between lung cancer-derived tumor cells and the unique characteristics of the brain, recent advancements in the identification of driver genes, concomitant genes, epigenetic features, including miRNAs and long noncoding RNAs, as well as the molecular characterization of brain metastasis originating from other organs, which may further enhance risk stratification and facilitate precise treatment strategies.

Evaluation of MERRA-2 and CAMS reanalysis for black carbon aerosol in China.

Black carbon (BC) constitutes a pivotal component of atmospheric aerosols, significantly impacting regional and global radiation balance, climate, and human health. In this study, we evaluated BC data in two prominent atmospheric composition reanalysis datasets: the Modern-Era Retrospective analysis for Research and Applications, Version 2 (MERRA-2) and the Copernicus Atmosphere Monitoring Service (CAMS), and analyzed the causes of their deviations. This assessment is based on observational data collected from 34 monitoring stations across China from 2006 to 2022. Our research reveals a significant and consistent decline in BC concentrations within China, amounting to a reduction exceeding 67.33%. However, both MERRA-2 and CAMS reanalysis data fail to capture this declining trend. The average annual decrease of BC in MERRA-2 from 2006 to 2022 is only 0.06 µg/m3 per year, while the BC concentration in CAMS even increased with an average annual value of 0.014 µg/m3 per year. In 2022, MERRA-2 had overestimated BC concentration by 20% compared to observational data, while CAMS had overestimated it by approximately 66%. In the regional BC concentration analysis, the data quality of the reanalysis data is better in the South China (RM = 0.59, RC = 0.53), followed by the North China (RM = 0.50, RC = 0.42). Reanalysis BC data in Northwest China and the Tibetan Plateau are difficult to use for practical analysis due to their big difference with observation. In a comparison of the anthropogenic BC emissions inventory used in the two atmospheric composition reanalysis datasets with the Multi-resolution Emission Inventory model for Climate and air pollution research (MEIC) emissions inventory, we found that: Despite the significant decline in China's BC emissions, MERRA-2 still relies on the 2006 emissions inventory, while CAMS utilizes emission inventories that even show an increasing trend. These factors will undoubtedly lead to greater deviations between reanalysis and observational data.

Nomograms integrating CT radiomic and deep learning signatures to predict overall survival and progression-free survival in NSCLC patients treated with chemotherapy.

OBJECTIVES: This study aims to establish nomograms to accurately predict the overall survival (OS) and progression-free survival (PFS) in patients with non-small cell lung cancer (NSCLC) who received chemotherapy alone as the first-line treatment. MATERIALS AND METHODS: In a training cohort of 121 NSCLC patients, radiomic features were extracted, selected from intra- and peri-tumoral regions, and used to build signatures (S1 and S2) using a Cox regression model. Deep learning features were obtained from three convolutional neural networks and utilized to build signatures (S3, S4, and S5) that were stratified into over- and under-expression subgroups for survival risk using X-tile. After univariate and multivariate Cox regression analyses, a nomogram incorporating the tumor, node, and metastasis (TNM) stages, radiomic signature, and deep learning signature was established to predict OS and PFS, respectively. The performance was validated using an independent cohort (61 patients). RESULTS: TNM stages, S2 and S3 were identified as the significant prognosis factors for both OS and PFS; S2 (OS: (HR (95%), 2.26 (1.40-3.67); PFS: (HR (95%), 2.23 (1.36-3.65)) demonstrated the best ability in discriminating patients with over- and under-expression. For the OS nomogram, the C-index (95% CI) was 0.74 (0.70-0.79) and 0.72 (0.67-0.78) in the training and validation cohorts, respectively; for the PFS nomogram, the C-index (95% CI) was 0.71 (0.68-0.81) and 0.72 (0.66-0.79). The calibration curves for the 3- and 5-year OS and PFS were in acceptable agreement between the predicted and observed survival. The established nomogram presented a higher overall net benefit than the TNM stage for predicting both OS and PFS. CONCLUSION: By integrating the TNM stage, CT radiomic signature, and deep learning signatures, the established nomograms can predict the individual prognosis of NSCLC patients who received chemotherapy. The integrated nomogram has the potential to improve the individualized treatment and precise management of NSCLC patients.

Ongoing CO2 monitoring verify CO2 emissions and sinks in China during 2018-2021.

Accurate estimating CO2 emissions and sinks is crucial in achieving carbon neutrality in China. However, CO2 emissions from bottom-up inventories are uncertain at regional scales and lack independent verification from atmospheric perspectives. Here we integrated 39 high-precision CO2 stations in China to top-down invert emission-sink variations at 45 km × 45 km and achieved a full range of inventories verification. The results show that China's CO2 emissions are 15% higher than those of five bottom-up inventories, to an annual total of 3.40 Pg C a-1 for 2018-2021. After deducting human and livestock respiration, the annual CO2 emissions were 3.13 Pg C a-1 (11.48 Pg CO2 a-1). The annual increase in emissions slowed from 3.7% in 2019 to 1.1% in 2020 and resumed growth to 4.0% in 2021, consistent with observed CO2 growth rates in China. China's land CO2 sink, deducting farmland sinks and lateral fluxes, was 0.57 Pg C a-1 (2.09 Pg CO2 a-1) for 2018-2021 (higher than most global inverse models), accounting for ∼16.9% of anthropogenic CO2 emissions. The land sink in China decreased by -19.3% in 2019 due to a weak El Niño event and increased by 3.2% in 2020 and 13.7% in 2021. It is worth noting that inverse CO2 emissions and sinks in western China still face large uncertainty due to limited CO2 monitoring. Overall, our top-down estimates demonstrate spatiotemporal variations in CO2 emissions and sinks from atmospheric perspectives and highlight challenges for different provinces in achieving 2060 carbon neutrality with verified estimates.

Complexity of carbon dioxide flux in urban areas: A comparison with natural surfaces.

The characteristics of turbulent CO2 transport and its dissimilarity with heat and water vapor are investigated over both natural and urban areas. A novel index TS is proposed to effectively quantify the transport similarity between two scalars. By comparison, it is found that the transport of CO2 shows great complexity in urban areas. It is ideal in natural areas that heat, water vapor, and CO2 are efficiently transported by thermal plumes (i.e., the dominant coherent structures under unstable conditions), and that the transport similarity among them becomes increasingly evident with the increase of atmospheric instability. However, in urban areas, the transport of CO2 shows significant dissimilarity from that of heat and water vapor, and it is hard to detect the role of thermal plumes. Furthermore, it is observed that the sector-average CO2 flux in urban areas changes largely with the wind blowing from different urban functional areas. Specially, for a given direction, there might be contrasting characteristics in CO2 transport under different unstable conditions. These features can be explained by the flux footprint. Since the CO2 sources and sinks are distributed heterogeneously in urban areas, the variation of footprint areas with wind direction or atmospheric instability, causes the alternation between source-dominated (i.e., upward) and sink-dominated (i.e., downward) CO2 transport. Therefore, the role of coherent structures in CO2 transport is substantially confused by spatially-confined sources/sinks in urban areas, leading to significant transport dissimilarity between CO2 and heat or water vapor and thus the great complexity in CO2 transport. The findings in this study are helpful to promote the understanding of the global carbon cycle in depth.

Mallory-Weiss syndrome in four hemodialysis patients: a case study.

BACKGROUND: Hemodialysis patients are prone to gastrointestinal bleeding, and Mallory-Weiss syndrome (MWS) is one of the causes. Mallory-Weiss syndrome is often induced by severe vomiting, manifests as upper gastrointestinal bleeding, and is self-limited with a good prognosis. However, mild vomiting in hemodialysis patients can lead to the occurrence of MWS, and the mild early symptoms are easy to misdiagnose, leading to the aggravation of the disease. CASE PRESENTATION: In this paper, we report four hemodialysis patients with MWS. All patients displayed symptoms of upper gastrointestinal bleeding. The diagnosis of MWS was confirmed by gastroscopy. One patient had a history of severe vomiting; however, the other three reported histories of mild vomiting. Three patients received the conservative hemostasis treatment, and the gastrointestinal bleeding stopped. One patient underwent the gastroscopic and interventional hemostasis treatments. The conditions of three of the patients improved. Unfortunately, one of the patients died due to the cardia insufficiency. CONCLUSIONS: We think that the mild symptoms of MWS are easily covered up by other symptoms. This may lead to delays in diagnosis and treatment. For patients with severe symptoms, gastroscopic hemostasis is still the first choice, and interventional hemostasis can also be considered. For patients with mild symptoms, drug hemostasis is the first consideration.