Case report: EGFR fusion mutation combined with EGFR amplification responds to EGFR-TKI therapy.

Given their good antitumor effects, epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are standard first-line therapy for EGFR-sensitive mutations, including exon 19 deletions and exon 21 L858R mutations. EGFR fusion mutations and EGFR amplification are very rare in non-small cell lung cancer (NSCLC). We describe 2 patients with NSCLC harboring EGFR fusion mutations (EGFR-MACF1 and EGFR-GNAT3) combined with EGFR amplification. Both patients received EGFR-TKI treatment, and 1 of them showed an antitumor response.

Efficient utilization of photoelectron-hole at semiconductor-microbe interface for pyridine degradation with assistance of external electric field.

In this study, enhanced pyridine bio-photodegradation with assistance of electricity was achieved. Meanwhile, photoelectron-hole played a vital role in accelerating pyridine biomineralization. The significant separation of photoelectron-hole was achieved with an external electric field, which provided sufficient electron donors and acceptors for pyridine biodegradation. The enhanced electron transport system activity also revealed the full utilization of photoelectron-hole by microbes at semiconductor-microbe interface with assistance of electricity. Microbial community analysis confirmed the enrichment of functional species related to pyridine biodegradation and electron transfer. Microbial function analysis and microbial co-occurrence networks analysis indicated that upregulated functional genes and positive interactions of different species were the important reasons for enhanced pyridine bio-photodegradation with external electric field. A possible mechanism of enhanced pyridine biodegradation was proposed, i.e., more photoelectrons and holes of semiconductors were utilized by microbes to accelerate reduction and oxidation of pyridine with the assistance of electrical stimulation. The excellent performance of the photoelectrical biodegradation system showed a potential alternative for recalcitrant organic wastewater treatment.

Multi-scenario PM2.5 distribution and dynamic exposure assessment of university community residents: Development and application of intelligent health risk management system integrated low-cost sensors.

Exposure scenario and receptor behavior significantly affect PM2.5 exposure quantity of persons and resident groups, which in turn influenced indoor or outdoor air quality & health management. An Internet of Things (IoT) system, EnvironMax+, was developed to accurately and conveniently assess residential dynamic PM2.5 exposure state. A university community "QC", as the application area, was divided into four exposure scenarios and five groups of residents. Low-cost mobile sensors and indoor/outdoor pollution migration (IOP) models jointly estimated multi-scenario real-time PM2.5 concentrations. Questionnaire was used to investigate residents' indoor activity characteristics. Mobile application (app) "Air health management (AHM)" could automatic collect residents' activity trajectory. At last, multi-scenario daily exposure concentrations of each residents-group were obtained. The results showed that residential exposure scenario was the most important one, where residents spend about 60 % of their daily time. Closing window was the most significant behavior affecting indoor contamination. The annual average PM2.5 concentration in the studied scenarios: residential scenario (RS) < public scenario (PS) < outdoor scenario (OS) < catering scenario (CS). Except for CS, the outdoor PM2.5 in other scenarios was higher than indoor by 5-10 µg/m3. The multi-scenario population weighted annual average exposure concentration was 37.1 µg/m3, which was 78 % of the annual average outdoor concentration. The exposure concentration of 5 groups: cooks > outdoor workers > indoor workers > students > the elderly, related to their daily activity time proportion in different exposure scenario.

Unveiling the Synergy of Architecture and Anion Vacancy on Bi2Te3-x@NPCNFs for Fast and Stable Potassium Ion Storage.

Large volume strain and slow kinetics are the main obstacles to the application of high-specific-capacity alloy-type metal tellurides in potassium-ion storage systems. Herein, Bi2Te3-x nanocrystals with abundant Te-vacancies embedded in nitrogen-doped porous carbon nanofibers (Bi2Te3-x@NPCNFs) are proposed to address these challenges. In particular, a hierarchical porous fiber structure can be achieved by the polyvinylpyrrolidone-etching method and is conducive to increasing the Te-vacancy concentration. The unique porous structure together with defect engineering modulates the potassium storage mechanism of Bi2Te3, suppresses structural distortion, and accelerates K+ diffusion capacity. The meticulously designed Bi2Te3-x@NPCNFs electrode exhibits ultrastable cycling stability (over 3500 stable cycles at 1.0 A g-1 with a capacity degradation of only 0.01% per cycle) and outstanding rate capability (109.5 mAh g-1 at 2.0 A g-1). Furthermore, the systematic ex situ characterization confirms that the Bi2Te3-x@NPCNFs electrode undergoes an "intercalation-conversion-step alloying" mechanism for potassium storage. Kinetic analysis and density functional theory calculations reveal the excellent pseudocapacitive performance, attractive K+ adsorption, and fast K+ diffusion ability of the Bi2Te3-x@NPCNFs electrode, which is essential for fast potassium-ion storage. Impressively, the assembled Bi2Te3-x@NPCNFs//activated-carbon potassium-ion hybrid capacitors achieve considerable energy/power density (energy density up to 112 Wh kg-1 at a power density of 1000 W kg-1) and excellent cycling stability (1600 cycles at 10.0 A g-1), indicating their potential practical applications.

Resourceful application and mechanism of oyster shell-microalgae synergistic system：Sustainable treatment of harsh low carbon nitrogen ratio actual wastewater.

Microalgal technology holds great promise for both low C/N wastewater treatment and resource recovery simultaneously. Nevertheless, the advancement of microalgal technology is hindered by its reduced nitrogen removal efficiency in low C/N ratio wastewater. In this work, microalgae and waste oyster shells were combined to achieve a total inorganic nitrogen removal efficiency of 93.85% at a rate of 2.05 mg L-1 h-1 in low C/N wastewater. Notably, over four cycles of oyster shell reuse, the reactor achieved an average 85% ammonia nitrogen removal extent, with a wastewater treatment cost of only $0.092/ton. Moreover, microbial community analysis during the reuse of oyster shells revealed the critical importance of timely replacement in inhibiting the growth of non-functional bacteria (Poterioochromonas_malhamensi). The work demonstrated that the oyster shell - microalgae system provides a time- and cost-saving, environmental approach for the resourceful treatment of harsh low C/N wastewater.

Icariside II protects dopaminergic neurons from 1­methyl­4­phenylpyridinium­induced neurotoxicity by downregulating HDAC2 to restore mitochondrial function.

Parkinson's disease (PD) is the second most common neurodegenerative disease after Alzheimer's disease (AD). Icariside II (ICS II) is known to confer notable therapeutic effects against a variety of neurodegenerative diseases, such as AD. Therefore, the present study aimed to evaluate the possible effects of ICS II on 1-methyl-4-phenylpyridinium (MPP+)-induced SK-N-SH cell injury, in addition to understanding the underlying mechanism of action. The MPP+-induced SK-N-SH cell model was used to simulate PD in vitro. The viability and mitochondrial membrane potential of SK-N-SH cells were detected by MTT assay and JC-1 staining, respectively. Lactate dehydrogenase (LDH) release, ATP levels and complex I activity in treated SK-N-SH cells were measured using LDH activity, ATP and Complex I assay kits, respectively. The protein expression levels of histone deacetylase 2 (HDAC2) and γ-H2A histone family member X and the copy number of mitochondrial DNA were measured by western blotting or reverse transcription-quantitative PCR, respectively. Autodock 4.2 was used to predict the molecular docking site of ICS II on HDAC2. The results of the present study demonstrated that ICS II mitigated SK-N-SH cytotoxicity induced by MPP+. Specifically, ICS II alleviated DNA damage and restored mitochondrial function in SK-N-SH cells treated with MPP+. In addition, ICS II reduced the HDAC2 protein expression levels in MPP+-induced SK-N-SH cells. However, overexpression of HDAC2 reversed the protective effects of ICS II on DNA damage and mitochondrial dysfunction in MPP+-induced SK-N-SH cells. In conclusion, the results of the present study suggest that ICS II can protect dopaminergic neurons from MPP+-induced neurotoxicity by downregulating HDAC2 expression to restore mitochondrial function.

Experimental Study on the Compressive Strength and Fatigue Life of Cement Concrete under Temperature Differential Cycling.

Concrete, as an engineering material with extremely wide applications, is widely used in various infrastructure projects such as bridges, highways, and large buildings. However, structures such as highways and bridges often need to be situated in variable and harsh service environments for long periods. They not only face cyclic reciprocating vehicle loads but also have to contend with the effects of temperature cycling. Therefore, studying the impact and mechanism of temperature differential cycling on the compressive strength and fatigue life of cement concrete has certain theoretical significance and practical value. This study employed a comprehensive experimental design to investigate cement concrete specimens subjected to typical temperature variations (20-60 °C) and different numbers of temperature differential cycling (0, 60, 120, 180, 240, 300). Axial compressive strength tests, ultrasonic tests, and compressive fatigue tests were conducted. The axial compressive strength test measured the compressive strength of the cement concrete. It was found that with an increase in the number of temperature differential cycling, the compressive strength exhibited a trend of an initial increase followed by a decrease: at 60 cycles, the strength increased by 10.8%, gradually declined; returned to near-initial strength at 120 cycles, and continued decreasing, reaching a decline of 19.4% at 300 cycles. The ultrasonic test measured the ultrasound velocity of the concrete specimens after different temperature differential cycling. It revealed a decreasing trend in ultrasound velocity with an increase in times of temperature differential cycling, showing a strong linear relationship between the ultrasound velocity loss and strength loss, confirming the correlation between the degree of concrete strength degradation and internal damage. The compressive fatigue test analyzed the fatigue life variation in cement concrete under different times of temperature differential cycling and stress levels, showing good adherence to the Weibull distribution pattern. Based on the approximation assumptions of log-normal distribution and the Weibull distribution, the Weibull distribution parameters for the compressive fatigue life of cement concrete under temperature differential cycling were obtained.

Icariside II suppresses ferroptosis to protect against MPP+-Induced Parkinson's disease through Keap1/Nrf2/GPX4 signaling.

Parkinson's disease (PD) is recognized as a degenerative and debilitating neurodegenerative disorder. The novel protective role of icariside II (ICS II) as a plant-derived flavonoid compound in neurodegenerative diseases has aroused much attention. Herein, the definite impacts of ICS II on the process of PD and the relevant action mechanism were studied. Human neuroblastoma SK-N-SH cells were challenged with 1-methyl-4-phenylpyridinium ion (MPP+) to construct the PD cell model. MTT assay and flow cytometry analysis, respectively, appraised cell viability and apoptosis. Caspase 3 Activity Assay examined caspase 3 activity. Corresponding kits examined oxidative stress levels. BODIPY 581/591 C11 assay evaluated lipid reactive oxygen species. Iron Assay Kit assessed iron content. Western blot tested the expression of apoptosis-, ferroptosis- and Kelch-like ECH-associated protein 1 (Keap1)/nuclear factor erythroid 2-related factor 2 (Nrf2)/glutathione peroxidase 4 (GPX4) signaling-associated proteins. Molecular docking verified the binding of ICS II with Keap1. The existing experimental results unveiled that ICS II elevated the viability whereas reduced the apoptosis, oxidative stress, and ferroptosis in MPP+-treated SK-N-SH cells in a concentration-dependent manner. Furthermore, ICS II declined Keap1 expression while raised Nrf2, heme oxygenase 1, and GPX4 expression. In addition, ICS II had a strong binding with Keap1 and Nrf2 inhibitor ML385 partially abolished the suppressive role of ICS II in MPP+-triggered apoptosis, oxidative stress, and ferroptosis in SK-N-SH cells. To summarize, ICS II might inhibit apoptosis, oxidative stress, and ferroptosis in the MPP+-stimulated PD cell model, which might be due to the activation of Keap1/Nrf2/GPX4 signaling.

Different gastric tubes in esophageal reconstruction during esophagectomy.

Esophagectomy is currently the mainstay of treatment for resectable esophageal carcinoma. Gastric grafts are the first substitutes in esophageal reconstruction. According to the different tailoring methods applied to the stomach, gastric grafts can be classified as whole stomach, subtotal stomach and gastric tube. Gastric-tube placement has been proven to be the preferred method, with advantages in terms of postoperative complications and long-term survival. In recent years, several novel methods involving special-shaped gastric tubes have been proposed, which have further decreased the incidence of perioperative complications. This article will review the progress and clinical application status of different types of gastric grafts from the perspectives of preparation methods, studies of anatomy and perioperative outcomes, existing problems and future outlook.

Dynamics and control mechanisms of inorganic nitrogen removal during wetting-drying cycles: A simulated managed aquifer recharge experiment.

Managed aquifer recharge (MAR) systems can be operated intermittently through wetting-drying cycles to simultaneously improve the water supply and quality. Although MAR can naturally attenuate considerable amounts of nitrogen, the dynamic processes and control mechanisms of nitrogen removal by intermittent MAR remain unclear. This study was conducted in laboratory sandy columns and lasted for 23 d, including four wetting periods and three drying periods. The hydraulic conductivity, oxidation reduction potential (ORP), and leaching concentrations of ammonia nitrogen and nitrate nitrogen of MAR systems were intensively measured to test the hypothesis that hydrological and biogeochemical controls play an essential role in regulating nitrogen dynamics at different stages of wetting-drying cycles. Intermittent MAR functioned as a sink for nitrogen while providing a carbon source to support nitrogen transformations; however, it occasionally became a source of nitrogen under intense flushes of preferential flow. Nitrogen dynamics were primarily controlled by hydrological processes in the initial wetting phase and were further regulated by biogeochemical processes during the subsequent wetting period, supporting our hypothesis. We also observed that a saturated zone could mediate nitrogen dynamics by creating anaerobic conditions for denitrification and buffering the flush effect of preferential flow. The drying duration can also affect the occurrence of preferential flow and nitrogen transformations, which should be balanced when determining the optimal drying duration for intermittent MAR systems.

Delta-radiomics based on CT predicts pathologic complete response in ESCC treated with neoadjuvant immunochemotherapy and surgery.

Background and purpose: Unnecessary surgery can be avoided, and more appropriate treatment plans can be developed for patients if the efficacy of neoadjuvant immunochemotherapy for esophageal cancer (EC) can be predicted before surgery. The purpose of this study was to evaluate the ability of machine learning models based on delta features of immunochemotherapy CT images to predict the efficacy of neoadjuvant immunochemotherapy in patients with esophageal squamous cell carcinoma (ESCC) compared with machine learning models based solely on postimmunochemotherapy CT images. Materials and methods: A total of 95 patients were enrolled in our study and randomly divided into a training group (n = 66) and test group (n = 29). We extracted preimmunochemotherapy radiomics features from preimmunochemotherapy enhanced CT images in the preimmunochemotherapy group (pregroup) and postimmunochemotherapy radiomics features from postimmunochemotherapy enhanced CT images in the postimmunochemotherapy group (postgroup). We then subtracted the preimmunochemotherapy features from the postimmunochemotherapy features and obtained a series of new radiomics features that were included in the delta group. The reduction and screening of radiomics features were carried out by using the Mann-Whitney U test and LASSO regression. Five pairwise machine learning models were established, the performance of which was evaluated by receiver operating characteristic (ROC) curve and decision curve analyses. Results: The radiomics signature of the postgroup was composed of 6 radiomics features; that of the delta-group was composed of 8 radiomics features. The area under the ROC curve (AUC) of the machine learning model with the best efficacy was 0.824 (0.706-0.917) in the postgroup and 0.848 (0.765-0.917) in the delta group. The decision curve showed that our machine learning models had good predictive performance. The delta group performed better than the postgroup for each corresponding machine learning model. Conclusion: We established machine learning models that have good predictive efficacy and can provide certain reference values for clinical treatment decision-making. Our machine learning models based on delta imaging features performed better than those based on single time-stage postimmunochemotherapy imaging features.

Intraspecific variation in microhabitat selection in reintroduced Chinese giant salamanders.

Reintroduction of captive-bred Chinese giant salamanders is a primary approach for restoring wild populations. Despite previous studies have investigated the habitat preferences of reintroduced Chinese giant salamanders, the intraspecific variation in their habitat selection has been neglected. In the present study, 30 captive-bred Chinese giant salamanders belonging to 3 groups (i.e., 10 males, 10 females, and 10 juveniles) were released into a montane stream to explore whether intraspecific variation in habitat selection occurred in this species using radiotelemetry. Our results indicated that linear home range and daily movement of males were significantly higher than those of females and juveniles. Male sedentariness was significantly lower than that of females and juveniles. No significant differences were detected between females and juveniles in these measures. Importantly, we found that males preferred microhabitats with low water conductivity and deep water depth. Females preferred microhabitats with high water conductivity, low dissolved oxygen and ammonium-nitrogen, and slow current velocity, while juveniles occupied microhabitats with low ammonium-nitrogen. In addition, males and juveniles exhibited higher niche breadth than females. Niche overlap was high between adults and juveniles but low between males and females. Our study revealed the presence of spatial segregation in reintroduced Chinese giant salamanders. Males, females, and juveniles exhibited variation in microhabitat selection. These results provide important information for use when planning strategies for conservation of Chinese giant salamanders.

Complete mitochondrial genome of Mastigias papua (Scyphozoa: Rhizostomeae: Mastigiidae) based on next-generation sequencing and phylogenetic analysis.

We assembled the complete mitochondrial genome (mitogenome) of Mastigias papua (Scyphozoa: Rhizostomeae: Mastigiidae) by the data generated from the next-generation sequencing platform. The complete mitogenome of M. papua was 16,560 bp in length, containing 14 protein-coding genes, two transfer RNA genes, and two ribosomal RNA genes. The base compositions were A 30.65%, C 15.16%, G 16.34%, and T 37.86%, with a gene arrangement similar to the mitogenomes derived from other representatives of Scyphozoa. Based on the 13 common protein-coding genes of 16 species within Scyphozoa, we constructed the phylogenetic tree and found that M. papua has a close relationship with Cassiopea andromeda and Cassiopea xamachana. All these species belong to an order of jellyfish Rhizostomeae, which have similar morphological characteristics. This is agreement with the conclusion we got by the phylogenetic relationship analysis using molecular data. This research has practical implications for advancing understanding of the phylogenetic relationships, taxonomic classifications, and phylogeography within Scyphozoa.

Characteristics and source-pathway of microplastics in freshwater system of China: A review.

China plays a key role in global plastic production, consumption and disposal, which arouses growing concern about microplastics (MPs) contamination in Chinese freshwater systems. However, few reviews have discussed the characteristics of MP pollution in whole freshwater systems at a national scale. In this review, we summarized the characteristics, sources and transport pathways of MPs in Chinese freshwater systems including surface water and sediment. Results showed that current research mainly focused on the middle and lower reaches of the Yangtze River and its tributaries, as well as lakes and reservoirs along the Yangtze River. Large-scale reservoirs, rivers and lakes located in densely populated areas usually showed higher abundances of MPs. The majority of MPs in Chinese surface water and sediment mainly consisted of polyethylene and polypropylene, and the most common morphologies were fibers and fragments. To identify the sources and pathways, we introduced the source-sink-pathway model, and found that sewage system, farmland and aquaculture area were the three most prevalent sinks in freshwater systems in China. The source-sink-pathway model will help to further identify the migration of MPs from sources to freshwater systems.

Dual-Type Carbon Confinement Strategy: Improving the Stability of CoTe2 Nanocrystals for Sodium-Ion Batteries with a Long Lifespan.

Sodium-ion batteries have great potential to become large-scale energy storage devices due to their abundant and low-cost resources. However, the lack of anode and cathode materials with both high energy density and long-term cycling performance significantly affects their commercial applications. In this work, uniform CoTe2 nanoparticles are generated from the tellurization of Co nanoparticles, which were coated with polyvinylpyrrolidone in a three-dimensional (3D) porous carbon matrix (CoTe2@3DPNC). Finally, a dual-type carbon confinement structure is formed after tellurization during which citric acid is adopted as the source of the inner carbon scaffold. The hierarchical carbon matrix not only builds a robust and fast ion/electronic conductive 3D architecture but also mitigates the volume expansion and aggregation of CoTe2 during sodium insertion/extraction. Remarkably, the CoTe2@3DPNC electrode displays a high reversible capacity (216.5 mAh g-1/627.9 mAh cm-3 at 0.2 A g-1 after 200 cycles) and outstanding long-term cycling performance (118.1 mAh g-1/342.5 mAh cm-3 even at 5.0 A g-1 after 2500 cycles). Kinetics tests and capacitance calculations clearly reveal a battery-capacitive dual-model Na-storage mechanism. Furthermore, ex situ XRD/SEM/TEM demonstrate superior stability during sodium insertion/extraction. This work provides a valuable strategy for the rational structural design of long-life electrodes for advanced rechargeable batteries.

2D shape reconstruction of irregular particles with deep learning based on interferometric particle imaging.

Interferometric particle imaging (IPI) technology is widely used in the measurement of various particles. Obtaining particle shape information directly by IPI is challenging because of the complex relationship between the speckle distribution of interference-defocused speckle patterns and the shape of the corresponding irregular particles. Considering this challenge, we implement a deep learning method based on the convolutional neural network (CNN) to reconstruct defocused images of sand particles with sparse features. We also introduce the negative Pearson correlation coefficient as the loss function. To verify the feasibility of our method, we implemented it to reconstruct defocused images obtained from IPI experiments. Finally, compared with another common CNN-based structure, we confirmed that our network structure has good performance in the shape reconstruction of irregular particles.

Spatiotemporal patterns of anuran functional diversity in temperate montane forests.

Functional diversity is an integrative approach to better understand biodiversity across space and time. In the present study, we investigated the spatiotemporal patterns (i.e., elevation and season) and environmental determinants of anuran functional diversity on Tianping Mountain, northwest Hunan, China. Specifically, 10 transects were established from low (300 m a.s.l.) to high (1 492 m a.s.l.) elevations, and anuran communities were sampled in spring, early summer, midsummer, and autumn in 2017. Four functional diversity indices were computed for each transect in each season using ecomorphological functional traits. Our results demonstrated that these indices had contrasting responses to increasing elevations. However, they did not differ significantly among seasons in terms of temporal patterns. Interestingly, the unique spatiotemporal functional diversity patterns were impacted by distinct environmental variables, such as leaf litter cover, water temperature, number of trees, and water conductivity.

Comparison of aspect ratios of ellipsoidal particles through interferometric out-of-focus images.

Based on the interferometric particle imaging (IPI) technology, we present a method for comparison of aspect ratios of ellipsoidal particles. By simulating the interference in-focus and out-of-focus images of transparent ellipsoidal particles with different aspect ratios, we find that, under the same orientation angle, the larger the particle aspect ratio is, the higher the spatial frequency of the out-of-focus image. The IPI system is established to experimentally acquire the out-of-focus images of the transparent ellipsoidal particles. Because the experimental results agree with the simulation, we propose a method to compare the aspect ratios of ellipsoidal particles using out-of-focus images. The method features potential applications in particle measurements.

Bayesian networks for imbalance data to investigate the contributing factors to fatal injury crashes on the Ghanaian highways.

The crash data are often predominantly imbalanced, among which the fatal injury (or minority) crashes are significantly underrepresented relative to the non-fatal injury (or majority) ones. This unbalanced phenomenon poses a huge challenge to most of the statistical learning methods and needs to be addressed in the data preprocessing. To this end, we comparatively apply three data balance methods, i.e., the Synthetic Minority Oversampling Technique (SMOTE), the Borderline SMOTE (BL-SMOTE), and the Majority Weighted Minority Oversampling (MWMOTE). Then, we examine different Bayesian networks (BNs) to explore the contributing factors of fatal injury crashes. The 2016 highway crash data of Ghana are retrieved for the case study. The results show that the accuracy of the injury severity classification is improved by using the preprocessed data. Highest improvement is observed on the data preprocessed by the MWMOTE technique. Statistical verification is done by the Wilcoxon signed-rank test. The inference results of the best BNs show the significant factors of fatal crashes which include off-peak time, non-intersection area, pedestrian involved collisions, rural road environment, good tarred road, roads without shoulders, and multiple vehicles involved crash.

Hazardous alcohol consumption and aging synergistically increase the risk of death in patients with severe fever with thrombocytopenia syndrome.

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease with high case fatality rate (CFR). Alcohol consumption which impairs host immunity and contributes to tissue damage in a variety of organs may be a predisposing factor of fatal outcome in SFTS. We aimed to determine the role of alcohol consumption on the fatal outcome of SFTS. Patients with laboratory-diagnosed SFTS who were admitted to the Jinan Infectious Disease Hospital, Jinan, China, between January 2011 and November 2018 were evaluated. Demographic, clinical, and laboratory data were recorded. Alcohol consumption was evaluated. The association between a fatal outcome and each demographic, clinical, and laboratory variable with alcohol consumption was assessed. A total of 694 patients with SFTS were identified during the study period. The overall CFR was 20.9 % (95 % CI: 17.9 %-23.9 %). The CFR in non/light drinkers (0-98 g/week) and moderate/heavy drinkers (>98 g/week) was 18.3 % and 35.6 %, respectively (P < 0.001). In age>60 years patients, the overall CFR in moderate/heavy drinker groups were as high as 53.4 % (95 % CI:40.2 %-66.7 %). Comparing to the age≤60y and non/light drinkers, age>60y and moderate/heavy drinkers was associated with increased risk of death with an odds ratio (95 % CI) of 9.9 (5.1-19.1). The interaction between age>60 and alcohol consumption was a significant determinant for death in both genders (F=10.18, P = 0.001). The clinical manifestation, laboratory parameters, and organ injury were significantly extensive and severe in moderate and heavy drinkers. In conclusion, hazardous alcohol consumption and aging synergistically increase the risk of death in patients with SFTS. In SFTS endemic areas, it is important for older individuals to minimize the exposure risks and abstain from alcohol.