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Two heavy rainfall events occurred in Sanming City in Fujian Province, China, on May 16 and June 10, 2019. Many small-scale, shallow earthen landslides were triggered by these two rainfall events. Aerial photographic interpretation and field investigations were conducted to identify the shallow landslides characteristics. A total of 150 shallow landslides were investigated during the field survey, and a total of 28 shallow landslides were studied using aerial photographic interpretation. The total number of shallow landslides was 178. We analyzed the characteristics of these shallow landslides, such as the thickness, area, volume, plan curvature, profile curvature, slope angle, lithology, elevation, and vegetation. The survey results showed that more than half of the shallow landslides (103 out of 178, 57.9%) were along the roads and the urban greenway, showing the characteristics of development along the engineering activities. We also tested a model of the probability thresholds for the occurrence of shallow landslides. Four classes regarding the probability and frequency of shallow landslides were identified by the model. The warming levels were defined as "Null" (below 5%), "Watch" (5–20%), "Attention" (20–50%), and "Alarm" (above 50%). The probability and frequency of shallow landslides increase as the thresholds increase, which is expressed through a percentage. The rainfall thresholds of the model describing the probability of the occurrence of shallow earthen landslides may decrease when the triggering event is fairly closely preceded by another heavy rainfall. [ABSTRACT FROM AUTHOR]

Background: Regorafenib is the first oral targeted drug as a second-line agent in patients with advanced hepatocellular carcinoma (HCC) who progressed on sorafenib treatment. Recently, several studies demonstrated that the combination of regorafenib and PD-1 inhibitors showed a synergistic effect. Our study aimed to evaluate the efficacy of regorafenib with PD-1 inhibitors (RP) and regorafenib alone (R) as second-line treatment for advanced HCC. Methods: From October 2018 to January 2022, our retrospective study evaluated advanced HCC patients who received regorafenib with PD-1 inhibitors or regorafenib alone as a second-line treatment at the Second Affiliated Hospital of Nanchang University, China. The efficacy and safety were compared between RP and R groups. Results: In total, 78 patients were enrolled in our study and were separated into two groups – RP group (48) and R group (30) – according to the criteria. The ORR of RP group and R group was 18.8% and 10%, respectively, and the DCR was 66.7% and 43.3%, respectively. The RP group had a longer mPFS (5.9 months vs 3.0 months, P< 0.001) and mOS (12.9 months vs 10.3 months, P=0.010) than the R group. Regorafenib monotherapy is an independent prognostic factor for OS and PFS. In OS, subgroup analysis showed that patients with AFP ≥ 400ng/mL, BCLC C stage and extrahepatic metastasis may benefit from RP, while in PFS, subgroup analysis showed that patients with BCLC C stage, AFP ≥ 400ng/mL, extrahepatic metastasis, ALBI ≥-2.60 and first-line treatment of sorafenib may benefit from RP. The incidence of grade 3/4 adverse reaction in the two groups was 22.9% and 23.3%, respectively, with no significant statistically difference (P=0.966). Conclusion: In the second-line therapy of advanced HCC, compared to regorafenib alone, the combination of regorafenib and PD-1 inhibitors showed promising efficacy and tolerable drug toxicity. [ABSTRACT FROM AUTHOR]

The rainfall can contribute significantly to landslide events, especially in hilly areas. The landslide susceptibility map (LSM) usually helps to mitigate disasters. However, how to accurately predict the susceptibility of landslides is still a difficult point in the field of disaster research. In this study, five advanced machine learning technologies (MLTs), including the Light Gradient Boosting Machine, extreme gradient boost, categorical boosting (CatBoost), support vector machine, and random forest, are utilized to landslide susceptibility modeling and their capabilities are compared through evaluation indicators. The northern part of Yanping, Fujian Province, China, is selected as the research object, because this area experienced mass landslide events due to extremely heavy rainfall in June 2010, resulting in many casualties and a large number of public facilities destroyed. The influencing factors for landslides, namely topographic, hydrological, geologic and human activities, are prepared from various data sources based on the availability. Through the analysis of the actual situation in the study area, 13 suitable landslide condition factors are considered and the availability of relevant factors is checked according to the multicollinearity test. The landslide inventory including 631 samples in this study area is obtained from historical information, satellite data in Google earth and performed field surveys. The landslide inventory is randomly divided into two datasets for model training and testing with a 7:3 ratio. The area under the curve of ROC, accuracy rate, Kappa index and F1 score are applied to compare the MLTs capabilities. In this paper, the results of factor importance analysis show that the first three important condition factors are the distance to faults, the distance to drainages and the slope. According to the LSMs, in the study area, the central and western regions are at high and very high landslide susceptibility levels, while almost all the eastern and northeastern regions are at medium and low landslide susceptibility levels. The CatBoost model is a very promising technology in landslide research according to the evaluation results, which means that for landslide susceptibility research, gradient boosting algorithms may get more accurate results and show better prospects in the future. Finally, the results of this paper will contribute to environmental protection to a certain extent. [ABSTRACT FROM AUTHOR]

Two tapeworm specimens collected in northeast China in 2009 and 2011 were identified as Diphyllobothrium latum based on morphological criteria. Molecular methods were used to confirm their identity and analyze genetic variations compared with published data for this species. Species identity was confirmed by molecular characterization of the 18S rDNA partial sequence, complete sequences of internal transcribed spacers (ITSs) and 5.8S rDNA, and partial sequences of mitochondrial cytochrome c oxidase subunit 1 ( cox1) and mitochondrial NADH dehydrogenase subunit 5 ( nad5). PCR amplification and sequence analysis of 18S rDNA (1472 bp), ITS regions (1218 bp), cox1 (885 bp), and nad5 (1028 bp) revealed that these four sequences showed more than 99% identity to reference sequences for D. latum, confirming that this species is D. latum. To date, a total of 12 diphyllobothriosis cases have been documented in China. This study represents the first molecular characterization of D. latum in China, providing molecular evidence of human diphyllobothriosis in China. [ABSTRACT FROM AUTHOR]

Objectives: Investigate short- and long-term effect of multifactorial intervention on endothelial dysfunction in patients with newly diagnosed type 2 diabetes. Background: Whether multifactorial intervention reduces cardiovascular risk in type 2 diabetes is largely controversial, partially because of lack of reliable method for endothelial dysfunction detection. Using high-resolution ultrasonographical flow-mediated vasodilatation (FMD), we completed a 5-year randomized prospective intervention trial in patients with newly diagnosed type 2 diabetes. We have studied the effect of multifactorial intervention therapy on their endothelial dysfunction. Methods: One hundred eight patients with newly diagnosed type 2 diabetes, and 83 healthy subjects received measurement of brachial artery FMD and endothelium-independent dilatation (EID). Diabetic patients were assigned into four groups, treated with: (A) hypoglycemic and antihypertensive agents, (B) hypoglycemic, antihypertensive and lipid-lowering agents, (C) hypoglycemic, antihypertensive and lipid-lowering agents, and vitamin E, and (D) hypoglycemic, antihypertensive and lipid-lowering agents, and compound salvia tablets. Both FMD and EID were remeasured after 24- and 60-month treatment. Results: FMD in diabetic patients was significantly lower than those in healthy subjects. After 24-month treatment, there was no FMD change. However, FMD improved significantly after 60-month treatment. The differences between 24- and 60-month are also significant. EID did not change significantly after both 24- and 60-month treatments. Conclusions: (1) FMD-detectable endothelial dysfunction exists in newly diagnosed type 2 diabetic patients. (2) Reverse of endothelial function occurs only after long-term (60-month) multifactorial intervention. (3) FMD could potentially help early identification, stratification, and treatment of endothelial dysfunction in type 2 diabetic patients. (Echocardiography 2011;28:1133-1140) [ABSTRACT FROM AUTHOR]

• Fish assemblages in the Zhougong River increased from upstream to downstream. • Significant spatial differences and no seasonal change in fish community were found. • Spatial variations of fish community were significantly correlated with V, TP and WD. • Fish assemblages have been impacted by damming, water pollution and overfishing. • Pollution prevention, dam removal, dam operation, fishery control are recommended. The Zhougong River is one of the most important tributaries of the Qingyi River in upper Yangtze River drainage, Sichuan Province, southwest China. The river has been dammed in several places by hydroelectric stations and thus, we aimed to characterize the longitudinal and seasonal patterns of fish assemblage structure in it and whether anthropogenic perturbations have impacted fish assemblages. An extensive survey of fish was conducted in spring (April), summer (August) and autumn (November) of 2015, and winter (February) of 2016 at a total of 18 sampling locations across the river's watershed. It was found that fish abundance, richness and Shannon-Wiener diversity all increased from upstream to downstream. Fish assemblage showed significant spatial differences between the upstream, midstream and downstream, while there were no differences between seasons as was expected. The spatial variation in the abundance of Rhodeus sinensis , Schizothorax prenanti , Pseudorasbora parva , Zacco platypus and Abbottina obtusirostris were considered to contribute most to the spatial pattern in fish assemblage. The canonical correspondence analysis (CCA) results revealed that spatial variations of fish community in the Zhougonng River were significantly correlated with water velocity, total phosphorus and water depth. Our findings indicate that spatial differences and no seasonal change in fish assemblage were partially attributed to the physicochemical changes caused by cascade hydroelectric dams (e.g., channel blocking, hydrological alterations) and water pollution (e.g., phosphorus) and it is also likely that overfishing has exacerbated impacts. We recommend that pollution prevention, dam removal, modifying dam ecological operations and fishery control may effectively lessen the impacts on fish biodiversity in the Zhougong River. [ABSTRACT FROM AUTHOR]

Purpose: Our previous studies have suggested that the first trimester fasting plasma glucose (FPG) level is associated with gestational diabetes mellitus (GDM) and is a predictor of GDM. The aim of the present study was to provide valuable insights into the accuracy of the first trimester FPG level in the screening and diagnosis of GDM in southern China., Methods: This retrospective study included pregnant women who had their first trimester FPG level recorded at 9-13 +6  weeks and underwent screening for GDM using the 2-h 75 g oral glucose tolerance test (OGTT) between the 24th and 28th gestational weeks. Differences between the GDM and non-GDM groups were assessed by Student's t test and the chi-squared test according to the nature of the variables. A restricted cubic spine was used to explore the relationship between the first trimester FPG level and the odds ratio (OR) of GDM in pregnant women. Cut-off values of first trimester FPG were determined using receiver operating characteristic (ROC) curves and the area under the curve (AUC), and 95% confidence intervals (CIs), the positive predictive value (PPV) and the negative predictive value (NPV) were calculated., Results: The medical records of 28,030 pregnant women were analysed, and 4,669 (16.66%) of them were diagnosed with GDM. The average first trimester FPG level was 4.62 ± 0.37 mmol/L. The OR of GDM increased with increasing first trimester FPG levels and with a value of first trimester FPG of approximately 4.6 mmol/L, which was equal to 1 (Chi-Square = 665.79, P < 0.001), and then started to increase rapidly afterwards. The ROC curve for fasting plasma glucose in the first trimester (4.735 mmol/L) for predicting gestational diabetes mellitus in pregnant women was 0.608 (95% CI: 0.598-0.617), with a sensitivity of 0.490 and a specificity of 0.676., Conclusion: Based on the research, we recommend that all pregnant women undergo FPG testing in the first trimester, particularly at the first antenatal visit. Furthermore, we suggest that the risks of GDM should be given increased attention and management as soon as the first trimester FPG value is more than 4.7 mmol/L. First trimester FPG levels should be considered a screening marker when diagnosing GDM in pregnant women but this needs to be confirmed by more prospective studies. These factors may have a significant impact on the clinical treatment of pregnant women., (© 2022. The Author(s).)

Background: Gestational weight gain (GWG) is associated with the risk of gestational diabetes mellitus (GDM). However, the effect of weight gain in different trimesters on the risk of GDM is unclear. This study aimed to evaluate the effect of GWG on GDM during different trimesters., Methods: A birth cohort study was conducted from 2017 to 2020 in Shenzhen, China. In total, 51,205 participants were included comprising two models (early pregnancy model and middle pregnancy model). Gestational weight (kg) was measured at each prenatal clinical visit using a standardized weight scale. Logistic regression analysis was used to assess the risk of GDM. Interaction analysis and mediation effect analysis were performed in the middle pregnancy model., Results: In the early pregnancy model, the risk of GDM was 0.858 times lower (95% confidence interval [CI]: 0.786, 0.937) with insufficient GWG (iGWG) and 1.201 times higher (95% CI: 1.097, 1.316) with excessive GWG after adjustment. In the middle pregnancy model, the risk of GDM associated with iGWG increased 1.595 times (95% CI: 1.418, 1.794) after adjustment; for excessive GWG, no significant difference was found ( P  = 0.223). Interaction analysis showed no interaction between GWG in early pregnancy (GWG-E) and GWG in middle pregnancy (GWG-M) ( F  = 1.268; P  = 0.280). The mediation effect analysis indicated that GWG-M plays a partial mediating role, with an effect proportion of 14.9%., Conclusions: eGWG-E and iGWG-M are associated with an increased risk of GDM. Strict control of weight gain in early pregnancy is needed, and sufficient nutrition should be provided in middle pregnancy., (Copyright © 2022 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.)

BACKGROUND This article presents our experience in managing a rare kidney tumor - reninoma - by analyzing a relatively large series of cases from a single center. MATERIAL AND METHODS Nine cases of reninoma were reviewed. Clinical manifestations, imaging examinations, laboratory examinations, perioperative data, and pathological findings were summarized. A 58.8-month follow-up was performed to evaluate patient survival and recrudescence. RESULTS The main clinical manifestations were hypertension, hypokalemia, headache, dizziness, nausea, vomiting, palpation, and sweating. Three patients had hypertensive end-organ damage, including brain hemorrhage, gestation termination, and grade III ocular fundus changes. All patients underwent retroperitoneal laparoscopic partial nephrectomy successfully. The mean warm ischemic time was 23.4 min. The median operation time was 95.1 min, with a median estimated blood loss of 60 ml. The median hospital stay was 6 days. No serious intraoperative or postoperative complications occurred. The histology and electron microscopy findings confirmed the diagnosis of reninoma in all cases. After 58.8 months of follow-up, symptoms involving hypertension were relieved in all patients, and no tumor recurrence or metastasis was detected. CONCLUSIONS Reninoma may have severe consequences despite being a benign tumor. Retroperitoneal laparoscopic partial nephrectomy is a feasible and effective method for the surgical removal of reninoma. Multidisciplinary cooperation plays an important role in improving the diagnosis and enabling the early surgical treatment of reninoma. Especially in cases of reninoma with moderate and high RENAL scores, an accurate diagnosis of reninoma based on multidisciplinary cooperation facilitates the selection of less invasive surgical approaches.

Background: Robot-assisted retrohepatic inferior vena cava (IVC) thrombectomy (RA-R-IVCTE) has been reported only for limited series., Objective: To describe in detail the techniques for RA-R-IVCTE with regard to the relationship of a proximal thrombus to either the first porta hepatis (FPH) or second porta hepatis (SPH)., Design, Setting, and Participants: From May 2013 to July 2016, 22 patients with R-IVC tumor thrombi were admitted to our hospital., Surgical Procedure: RA-R-IVCTE was performed using the Rummel tourniquet technique. For a proximal thrombus inferior to the FPH, we ligated some short hepatic veins (SHVs; typically 1-3). For a thrombus between the FPH and SPH, we mobilized the right lobe of the liver from the IVC by ligating additional SHVs. For a thrombus near or above the SPH but below the diaphragm, we mobilized both the right and left lobes of the liver to obtain high proximal control of the suprahepatic and infradiaphragmatic IVC, and simultaneously clamped the FPH., Measurements: Detailed techniques were described for various scenarios and perioperative outcomes were recorded., Results and Limitations: The median operation time was 285min (interquartile range [IQR] 191-390). Intraoperative estimated blood loss was 1350ml (IQR 1000-2075ml). Some 63.6% of patients required an intraoperative blood transfusion and 68% were transferred to the intensive care unit after surgery. Grade IV complications developed in five cases. Vascular injuries (4 cases) were treated with intraoperative endoscopic sutures. An intestinal fistula was found on postoperative day 7 in one case; treatment with gastrointestinal decompression and drainage resolved the condition by 1 mo., Conclusions: Even though the risks involved are high, RA-R-IVCTE is feasible for selected patients. The FPH/SPH is an important boundary landmark for RA-R-IVCTE. The location of proximal IVC tumor thrombi in relation to the FPH or SPH should determine the technique used., Patient Summary: Robot-assisted thrombectomy for retrohepatic inferior vena cava tumor thrombus is feasible in selected patients., (Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.)