RESUMEN
Organizational coordination has been regarded as a vital factor to determine the environmental governance efficiency of local authority, while existing empirical studies mainly discuss the vertical decentralization but largely ignore the horizontal cross-departmental interaction within single government. Based on the data of 31 Chinese provinces from 2003 to 2017, this paper uses a panel vector autoregression (PVAR) approach, two-way fixed-effect models and dynamic panel regression with system generalized method of moments estimation (SYS-GMM) to investigate the environmental strategic interaction between two representative departments (finance department and environmental protection department) within local governments. The results indicate, on the whole, their environmental governance strategies show a significantly co-directional coordination. However, the cross-departmental interaction obviously varied in different periods and regions (even showed as conflict sometimes), and was synchronized with the dynamic trade-off between economic and environmental targets of China. This research helps understand the inner logic of environmental governance of Chinese government, and can be valuable guidance for other countries to accomplish multi-departmental sustainable development goal.
RESUMEN
The combination of thoracic radiotherapy and immune checkpoint inhibitors (ICIs) has emerged as a novel treatment approach for malignant tumors. However, it is important to consider the potential exacerbation of lung injury associated with this treatment modality. The neutrophil-to-lymphocyte ratio (NLR), an inflammatory marker, holds promise as a non-invasive indicator for assessing the toxicity of this combination therapy. To investigate this further, a study involving 80 patients who underwent thoracic radiotherapy in conjunction with ICIs was conducted. These patients were divided into two groups: The concurrent therapy group and the sequential therapy group. A logistic regression analysis was conducted to ascertain risk factors for grade ≥2 pneumonitis. Following propensity score matching, the NLR values were examined between the concurrent group and the sequential group to evaluate any disparity. A mouse model of radiation pneumonitis was established, and ICIs were administered at varying time points. The morphological evaluation of lung injury was conducted using H&E staining, while the NLR values of peripheral blood were detected through flow cytometry. Logistic regression analysis revealed that radiation dosimetric parameters (mean lung dose, total dose and V20), the inflammatory index NLR at the onset of pneumonitis, and treatment sequences (concurrent or sequential) were identified as independent predictors of grade ≥2 treatment-related pneumonitis. The results of the morphological evaluation indicated that the severity of lung tissue injury was greater in cases where programmed cell death protein 1 (PD-1) blockade was administered during thoracic radiotherapy, compared with cases where PD-1 blockade was administered 14 days after radiotherapy. Moreover, the present study demonstrated that the non-invasive indicator known as the NLR has the potential to accurately reflect the aforementioned injury.