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This paper assesses the emergency capacity of rain-flood disaster in provinces along the Yangtze River Economic Belt (YREB), China, from 2013 to 2017. In this study, the evaluation index system of emergency capacity on rain-flood disaster was built from the economic-social and environmental-natural aspects, and spatial auto-correlation analysis was used to analyze spatial differentiation characteristics of the emergency capacity. Then, the Spatial Durbin Model (SDM) was used to analyze the influence mechanism of the development level of economic-social factors (ESF) subsystem, environmental-natural factors (ENF) subsystem and the coupling level of these two subsystems on the emergency capacity of rain-flood disaster in provinces. The findings show that the emergency capacity distribution of rain-flood disaster in the YREB presented a “decreasing” spatial pattern of eastern, central and western regions. The development of two subsystems has produced spatial spillover effect and diffusion effect on the neighboring areas. There was a high coupling degree between these two subsystems in the YREB. Although spillover effect existed in space, the spillover did not depend on economic distance.

The coupling and coordination development of the environment and economy (CC2E) is one of the most vital issues to sustainable development. This paper adopted the coupling coordination model, projection pursuit algorithm, and random forest model to explore the spatial-temporal evolution and influencing factors of the CC2E in the Yangtze River Delta from 2015 to 2019, respectively. The results showed that: (1) The degree of coupling coordination (DCC) of the CC2E in most cities of the Yangtze River Delta has risen from primary coordination to intermediate coordination. (2) In the spatial perspective, the distribution of DCC is correlated with geographical location. The value of DCC in the western region was significantly lower than that of the eastern cities. (3) The influencing factors results showed that the GDP in the economic subsystem and the annual average concentration of PM2.5 in the environmental subsystem were the most influencing factors of DCC in the Yangtze River Delta. The established index system of CC2E and the measurements of CC2E provide a new idea for how to achieve sustainable development. Meanwhile, this study can provide recommendations for formulating the environmental protection and economic development policy.

Objectives: The study objective is to assess personality traits as predictors of mental symptoms in university volunteers in China. Methods: We carried out a cross-sectional study. The study sample consisted of volunteers from sixteen main universities in the city of Hangzhou. The OQ-45 scale was used to evaluate mental symptoms and the PHI was used for the measurement of personality traits. Multiple linear regression analysis was used to study relationships between personality factors and mental symptoms. Results: Estimation of personality traits revealed higher scores on subscales of hypomania, depression, and psychopathic deviance. The OQ-45 scale identified 1.4% of volunteers as having psychological disorders. PHI scores were positively correlated with scores on the OQ-45 scale ( P < 0.01). Anxiety was correlated particularly strongly with interpersonal relationship score and total OQ-45 score ( r = 0.6, P < 0.05). Furthermore, we found that personality traits could influence the explicit mental symptoms of the volunteers. Volunteers with traits of anxiety and depression reported a significant impact on their mental symptoms. Conclusions: The OQ-45 and PHI scales can be used to screen volunteers with mental symptoms. Inner personality traits could be used to predict the mental symptoms of volunteers in China. Our results might assist organizers of future conferences and games in selecting appropriate university volunteers. Funding: This study was supported by the Health Commission of Zhejiang Province (2019RC142, OO20190435). Declaration of Interest: The authors declare no competing interest. Ethical Approval: All participants provided written informed consent. This study was carried out according to the Declaration of Helsinki and was approved by the Ethics Committee of Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine (Code No. 10; date of approval: August 8, 2018).

Chimeric antigen receptor (CAR)-T-cell therapy has resulted in remarkable responses in patients with certain hematological malignancies. However, its efficacy in solid tumors is disappointing. Many factors can limit the effect of CAR-T-cell therapy on solid tumors. CAR-T-cell infiltration, survival, and persistence face numerous challenges in solid tumors. Vasculature and stromal barriers, hypoxia and high metabolism of solid tumors, tumor microenvironment immunosuppression, and high numbers of heterogeneous tumor cells all are closely related to cancer progression and immune escape. These factors usually contribute to form an environment wherein tumor cells have an advantage over CAR-T cells for survival. It is thus necessary to improve immune CAR-T-cell function in solid tumors by developing strategies to reconstruct the environment or modify the CAR-T cells. In this review, we outline major obstacles of CAR-T-cell therapy for solid tumors. We also propose strategies to overcome the above challenges and barriers against CAR-T antitumor efficacy.

Transportation infrastructure, which has always been regarded as an important element to promote regional innovation, accelerates factor flows and productivity spillovers. In February 2021, the State Council of China issued the outline of national integrated multidimensional transportation network planning (2021–2050), which proposed that during the 14th Five-Year Plan period, the Yangtze River Delta would speed up the construction of an integrated transport network to serve the dual circulation development pattern in China. However, few studies have systematically investigated the development of integrated transport in the Yangtze River Delta, especially the relationship between transport operating efficiency and regional innovation based on the theory of flow space. This study aims to calculate the integrated transport efficiency of 26 cities in the Yangtze River Delta and analyse the spillover effect of efficiency improvement on urban innovation. The results reveal that integrated transport efficiency is relatively stable at approximately 0.92. We find that the local innovation value would increase by 0.119% with every 1% increase in transport efficiency, and it would exceed 0.26% after introducing spatial factors. The spillover effect on the surrounding cities is significantly higher than that in the cities themselves, and the result is 0.292 under the economic spatial distance weight matrix. These findings will support the construction of the integrated transport network and provide useful references for government decision makers in the Yangtze River Delta.

With the increase in the elderly population, people pay more and more attention to the harm caused by falls. When people reach old age, various functions of the body will degrade to a certain extent. If the elderly fall down, it may endanger their physical and mental health. In view of the above problems, this system designed a elderly fall detection and alarm system based on the reverse neural network algorithm, specifically using MPU6050 sensor to detect human posture data, the control module using the algorithm for real-time judgment, if the fall behavior, the control alarm module to send alarm messages. This system can be used in nursing home health monitoring system, intelligent home system in the detection subsystem and other intelligent medical aspects, can be used in various aspects to protect the health of the elderly, reduce the risk of accidental injury.

TP53 mutation is one of the most common genetic changes in hepatocellular carcinoma (HCC). It is of great clinical significance to tailor specialized prognostication approach and to explore more therapeutic options for TP53-mutant HCCs. In this study, a total of 1135 HCC patients were retrospectively analyzed. We developed a random forest-based prediction model to estimate TP53 mutational status, tackling the problem of limited sample size in TP53-mutant HCCs. A multi-step process was performed to develop robust poor prognosis-associated signature (PPS). Compared with previous established population-based signatures, PPS manifested superior ability to predict survival in TP53-mutant patients. After in silico screening of 2249 drug targets and 1770 compounds, we found that three targets (CANT1, CBFB and PKM) and two agents (irinotecan and YM-155) might have potential therapeutic implications in high-PPS patients. The results of drug targets prediction and compounds prediction complemented each other, presenting a comprehensive view of potential treatment strategy. Overall, our study has not only provided new insights into personalized prognostication approaches, but also thrown light on integrating tailored risk stratification with precision therapy.

Almost all currently approved systemic therapies for hepatocellular carcinoma (HCC) failed to achieve satisfactory therapeutic effect. Exploring tailored treatment strategies for different individuals provides an approach with the potential to maximize clinical benefit. Previously, multiple studies have reported that hepatoma cell lines belonging to different molecular subtypes respond differently to the same treatment. However, these studies only focused on a small number of typical chemotherapy or targeted drugs across limited cell lines due to time and cost constraints. To compensate for the deficiency of previous experimental researches as well as link molecular classification with therapeutic response, we conducted a comprehensive in silico screening, comprising nearly 2000 compounds, to identify compounds with subclass-specific efficacy. Here, we first identified two transcriptome-based HCC subclasses (AS1 and AS2) and then made comparison of drug response between two subclasses. As a result, we not only found that some agents previously considered to have low efficacy in HCC treatment might have promising therapeutic effects for certain subclass, but also identified novel therapeutic compounds that were not routinely used as anti-tumor drugs in clinic. Discovery of agents with subclass-specific efficacy has potential in changing the status quo of population-based therapies in HCC and providing new insights into precision oncology.

In China, the adjuvant epirubicin and docetaxel (ED) regimen is widely used as a substitute for the epirubicin and cyclophosphamide followed by docetaxel (EC-D) regimen in patients with operable breast cancer. However, their equivalence has not yet been demonstrated. This retrospective study compared these two adjuvant regimens as regards feasibility, safety and efficacy. Data on consecutive patients who received either ED (70/75 mg/m2 every 3 weeks for 6 cycles) or EC-D (70/600 mg/m2 epirubicin/cyclophosphamide followed by 75 mg/m2 docetaxel every 3 weeks for 4 cycles each) as their adjuvant chemotherapy in our center from January 2009 to January 2014, were analyzed. A total of 374 patients was enrolled, among whom 250 patients received the ED regimen, and 124 patients received the EC-D regimen. The overall median follow-up time was 38.6 months. In total, 90 and 94.4% of patients in the ED and EC-D groups, respectively, completed full cycles of chemotherapy (P=0.174). There was no difference in efficacy in terms of disease-free survival (DFS) and overall survival (OS) (DFS, P=0.919; OS, P=0.069). The incidence of neutropenia in the ED group was similar to that in the EC-D group (81.2 vs. 78.9%, P=0.660) with a similar utilization rate of granulocyte-colony stimulating factor (G-CSF; 76.9 vs. 75.2%, P=0.850). However, grade 3/4 gastrointestinal reactions were more frequently observed in the patients who received the EC-D regimen (42.0 vs. 29.2%, P=0.058). The findings of our study indicate that with similar feasibility, safety and mid-term efficacy, the adjuvant ED regimen for 6 cycles may be an alternative to the EC-D regimen in operable breast cancer.

Hexavalent chromium [Cr (Ⅵ)] has extensive applications in industries, and long-term occupational exposure to Cr (Ⅵ) may lead to lung carcinoma and other cancers. While microRNA (miRNA) can take part in carcinogenesis, little is known about its expression profile in the population with Cr (Ⅵ) exposure. Thus, this study aimed to explore miRNA expression profiles in Cr (Ⅵ) exposed workers and to identify the potential biological function of differentially expressed miRNAs. A total of 45 significant differentially expressed miRNAs were identified by the miRNA array. The results of validation showed that miR-19a-3p, miR-19b-3p, and miR-142-3p were downregulated and miR-590-3p and miR-941 were upregulated in the exposure group. Multivariate analysis demonstrated that age, exposure duration and urinary chromium level were associated with one or more miRNAs expression. Target gene analysis indicated that these miRNAs might participate in the regulation of DNA damage-related signaling pathways. Taken together, Cr (Ⅵ) exposure can result in differential expression of miRNAs in occupational workers, and the expression of these miRNAs is correlated with the level and duration of Cr (Ⅵ) exposure, and the differentially expressed miRNAs may participate in DNA damage response.

This study aimed to investigate the characteristics of insulin resistance and β-cell secretion in healthy adolescents. A total of 124 adolescents with normal glucose tolerance (NGT) were divided according to BMI into normal weight (n=31; control), overweight (n=52) and obese (n=41) groups. Oral glucose tolerance tests were performed, and blood glucose (G0, G30 and G120) and insulin (I0, I30 and I120) levels at 0, 30 and 120 min, respectively, were measured. The homeostasis model assessment estimate of insulin resistance (HOMA-IR) and early insulin release index (IRI) were calculated to evaluate insulin sensitivity and early β-cell secretion. The G0, G120 levels and the natural logarithm (Ln) of I30 and ΔI30/ΔG30 were similar in the overweight and obese groups, but significantly higher compared with those of the normal weight group (P

// Wenwen Qi 1 , Mingjuan Sun 2 , Xiangnan Kong 3 , Yaming Li 1 , Xiaolong Wang 1 , Shangge Lv 1 , Xia Ding 4 , Sumei Gao 1 , Jinjing Cun 1 , Chang Cai 1 , Xiaoting Wang 1 , Junfei Chen 1 , Aijun Yin 5 , Qifeng Yang 1, 6 1 Department of Breast Surgery, Qilu Hospital, Shandong University, Jinan, P.R. China 2 Shandong Cancer Hospital and Institute, Jinan, P.R. China 3 Laboratory Medicine Center, Qilu Hospital of Shandong University, Qingdao, P.R. China 4 Department of Oncology, Qilu Hospital, Shandong University, Jinan, P.R. China 5 Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Jinan, P.R. China 6 Pathology Tissue Bank, Qilu Hospital, Shandong University, Jinan, P.R. China Correspondence to: Qifeng Yang, email: qifengy_sdu@163.com Keywords: Huaier extract, tamoxifen, ER-positive breast cancer, autophagy, apoptosis Received: December 09, 2015 Accepted: March 02, 2016 Published: March 23, 2016 ABSTRACT Tamoxifen (TAM) is the most widely used endocrine therapy for estrogen receptor (ER)-positive breast cancer patients, but side effects and the gradual development of insensitivity limit its application. We investigated whether Huaier extract, a traditional Chinese medicine, in combination with TAM would improve treatment efficacy in ER-positive breast cancers. MTT, colony formation, and invasion and migration assays revealed that the combined treatment had stronger anticancer effects than either treatment alone. Huaier extract enhanced TAM-induced autophagy, apoptosis, and G0/G1 cell cycle arrest, as measured by acidic vesicular organelle (AVO) staining, TUNEL, flow cytometry, and western blot. Additionally, combined treatment inhibited tumorigenesis and metastasis by suppressing the AKT/mTOR signaling pathway. Huaier extract also enhanced the inhibitory effects of TAM on tumor growth in vivo in a xenograft mouse model. These results show that Huaier extract synergizes with TAM to induce autophagy and apoptosis in ER-positive breast cancer cells by suppressing the AKT/mTOR pathway.