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In recent years, the range and impact of atmospheric rivers (ARs) landing in Greenland have been increasing. Extreme precipitation brought by ARs can cause a short-term surge in regional ice and snow mass, resulting in “transient” signal in the coordinate time series of Greenland GNSS stations. However, previous studies have mainly focused on ARs detection and corresponding climate impact factors, lacking research on the contribution of extreme AR precipitation to crustal deformation. This article utilizes MERRA-2 reanalysis data and the vIVT algorithm to statistically analyze the frequency, duration, and spatiotemporal distribution of ARs landings in Greenland from 2010 to 2019. We quantitatively analyze the extreme precipitation events caused by ARs and their spatiotemporal evolution characteristics across Greenland and its basins. Then, using coordinates time series from 46 GNSS stations in Greenland, we extract the transient crustal deformation signals caused by AR-induced precipitation based on the multichannel singular spectrum analysis method. The results show that from 2010 to 2019, ARs landed in Greenland a total of 186 times, with a duration of 3174 h, and they showed an overall increasing trend. AR-induced precipitation in Greenland accounted for approximately 13.42% of annual precipitation, with the western region contributing more than 16%. Overall, the contribution rate of AR-induced rainfall was lower than that of AR-induced snowfall. Transient crustal deformation signals caused by AR-induced precipitation were found in some GNSS stations, with vertical deformation reaching up to 1 mm. Coastal areas showed greater deformation than inland areas, and low-latitude areas showed greater deformation than high-latitude areas.

Brucellosis is a globally prevalent zoonotic disease caused by Brucella spp. posing significant threats to animal and human health. In this study, a novel lytic brucellaphage designated Y17 was isolated from sheep fecal samples collected in Ludian County, Yunnan Province, China. Transmission electron microscopy revealed that Y17 was composed of an icosahedral head (48.1 ± 2 nm) and a short tail (10.8 ± 1 nm), making it the smallest brucellaphage described so far. The optimal multiplicity of infection (MOI) for phage Y17 is 0.001, with a burst size of ~187 PFU/cell, the largest value reported for any brucellaphage, and it has a relatively short latent period. It exhibits broad pH and temperature stability, retaining activity even after 1 h of exposure to ultraviolet radiation and various ethanol concentrations. Y17 shows strong lytic activity against Brucella abortus and can also infect some Brucella melitensis strains. The Y17 genome spans 38,025 bp with a GC content of 48.2%, making it the smallest genome among brucellaphages to date. It lacks virulence, antibiotic resistance, or lysogenic genes, indicating its potential as a safe biocontrol agent. Whole-genome average nucleotide identity (ANI) analysis reveals high homology across all lytic brucellaphages, but Y17 exhibits relatively lower genome coverage compared to other lytic brucellaphages. Genomic collinearity comparison revealed that Y17 lacks some terminal fragments present in the genomes of other lytic brucellaphages. Furthermore, compared to brucellaphages with genomes larger than 40 kb, Y17 also lacks segments corresponding to ORF21 (amidase), ORF28 (hypothetical protein), and ORF29 (carbohydrate-binding protein). Phylogenetic analysis indicates that Y17 is closely related to phages Iz, Bk2, S708, Wb, R/C, Pr, and Bk. Moreover, the capsid gene shows significantly higher conservation in comparison with the tail collar and amidase genes. This study significantly enriches the brucellaphage database and highlights the potential of Y17 as a biocontrol agent for managing brucellosis in endemic regions.

Geothermal energy is a renewable energy with large scale and wide distribution. Geothermal resources are abundant in western Yunnan, China, but the work is less. In this study, a wide field electromagnetic method (WFEM) was applied to geothermal exploration in Sanying Basin, and six survey lines were deployed. On the basis of the inversion results, the paper conducts a progressive study on the four genetic factors of geothermal exploration, including “source, storage, channel, and circulation”. The Sanying Basin has three sets of intrusive rock masses, two kinds of lateral and vertical additional heating modes. Two sets of deep and shallow reservoir systems were identified. Two major strike-slip deep faults were identified as heat conduction channels. Two sets of water circulation systems were established, and the formation mechanism of hot springs was clarified. Anomaly 1 is a favorable target area for hydrothermal development, and invasion Ⅱ is a favorable target area for hot dry rock.

The liver is the main target organ for hematogenous metastases of colorectal cancer, and colorectal liver metastasis is one of the most difficult and challenging situations in the treatment of colorectal cancer. In order to improve the diagnosis and comprehensive treatment in China, the Guidelines have been edited and revised for several times since 2008, including the overall evaluation, personalized treatment goals and comprehensive treatments, to prevent the occurrence of liver metastases, increase the local damage rate of liver metastases, prolong long-term survival, and improve quality of life. The revised Guideline version 2023 includes the diagnosis and followup, prevention, multidisciplinary team (MDT), surgery and local ablative treatment, neoadjuvant and adjuvant therapy, and comprehensive treatment, with stateoftheart experience and findings, detailed content, and strong operability.

The effect of immunotherapy strategy has been affirmed in the treatment of various tumors. Nevertheless, the latent role of RNA 5-methylcytosine (m5C) modification in gastric cancer (GC) tumor microenvironment (TME) cell infiltration is still unclear. We systematically explore the m5C modification patterns of 2,122 GC patients from GEO and TCGA databases by 16 m5C regulators and related these patterns to TME characteristics. LASSO Cox regression was employed to construct the m5Cscore based on the expression of regulators and DEGs, which was used to evaluate the prognosis. All the GC patients were divided into three m5C modification clusters with distinct gene expression characteristics and TME patterns. GSVA, ssGSEA, and TME cell infiltration analysis showed that m5C clusters A, B, and C were classified as immune-desert, immune-inflamed, and immune-excluded phenotype, respectively. The m5Cscore system based on the expression of eight genes could effectively predict the prognosis of individual GC patients, with AUC 0.766. Patients with a lower m5Cscore were characterized by the activation of immunity and experienced significantly longer PFS and OS. Our study demonstrated the non-negligible role of m5C modification in the development of TME complexity and inhomogeneity. Assessing the m5C modification pattern for individual GC patients will help recognize the infiltration characterization and guide more effective immunotherapy treatment.

Abstract Background Long noncoding RNAs (lncRNAs), a type of pervasive genes that regulates various biological processes, are differentially expressed in different types of malignant tumors. The role of lncRNAs in the carcinogenesis of pancreatic ductal adenocarcinoma (PDAC) remains unclear. Here, we investigated the role of the lncRNA DKFZp434J0226 in PDAC. Methods Aberrantly expressed mRNAs and lncRNAs among six PDAC and paired non-tumorous tissues were profiled using microarray analysis. Quantitative real-time polymerase chain reaction was used to evaluate DKFZp434J0226 expression in PDAC tissues. CCK-8 assay, wound-healing assay, soft agar colony formation assay, and transwell assay were performed to assess the invasiveness and proliferation of PDAC cells. Furthermore, RNA pull-down, immunofluorescence, RNA immunoprecipitation, and western blotting assays were performed to investigate the association between DKFZp434J0226 and SF3B6. Tumor xenografts in mice were used to test for tumor formation in vivo. Results In our study, 222 mRNAs and 128 lncRNAs were aberrantly expressed (≥ twofold change). Of these, 66 mRNAs and 53 lncRNAs were upregulated, while 75 lncRNAs and 156 mRNAs were downregulated. KEGG pathway analysis and the Gene ontology category indicated that these genes were associated with the regulation of mRNA alternative splicing and metabolic balance. Clinical analyses revealed that overexpression of DKFZp434J0226 was associated with worse tumor grading, frequent perineural invasion, advanced tumor-node-metastasis stage, and decreased overall survival and time to progression. Functional assays demonstrated that DKFZp434J0226 promoted PDAC cell migration, invasion, and growth in vitro and accelerated tumor proliferation in vivo. Mechanistically, DKFZp434J0226 interacted with the splicing factor SF3B6 and promoted its phosphorylation, which further regulated the alternative splicing of pre-mRNA. Conclusions This study indicates that DKFZp434J0226 regulates alternative splicing through phosphorylation of SF3B6 in PDAC and leads to an oncogenic phenotype in PDAC.

Abstract Engineering cost‐effective catalysts with exceptional performance for the electrochemical oxygen evolution reaction (OER) remains crucial for the accelerated development of renewable energy techniques, and especially so, given the pivotal role of OER in water electrolysis. On the basis of the metal nodes (clusters) and organic linkers, metal‐organic frameworks (MOFs) and their derivatives are rapidly gaining ground in the fabrication of electrocatalysts, with promising catalytic activity and sound durability in OER, thanks to their controllable pore structures, abundant unsaturated active sites of metal ion, extensive specific surface area, as well as easily functionalized/modified surfaces. This review presents an in‐depth understanding of the established progress of MOFs‐derived materials for OER electrocatalysis. The material designing strategies of the pristine, monometallic, and multimetallic MOFs‐based catalysts are summarized to indicate the infinite possibilities of the morphology and the composition of MOF‐derived materials. While emphasis is laid on the essential features of MOF‐derived materials for the electrocatalysis of the corresponding reactions, insights about the applications in OER are discussed. Finally, this paper is concluded by presenting challenges and perspectives for MOF‐derived materials’ future applications in OER electrocatalysis.

PurposeImmunotherapy for gastrointestinal stromal tumors (GISTs) remains a clinical challenge. The present study aimed to explore the clinical and prognostic significance of immune cell infiltration and PD-L1 expression in GISTs.MethodsA total of 507 clinical tissue specimens of primary GISTs were collected for immunohistochemical analysis of immune cell infiltration and PD-L1 expression. Influencing factors of survival were evaluated by Kaplan–Meier analysis. Univariate and multivariate analyses were performed using the Cox regression model.ResultsThere were significant differences in sex, tumor location, size, mitotic index, NIH risk grade, and cell morphology between different gene mutation types of GISTs. Immune cell infiltration in GISTs mainly involved macrophages and T cells. PD-1 was expressed in 48.5% of the tissue specimens, and PD-L1 expression was detected in 46.0% of the samples. PD-L1 expression was negatively correlated with the tumor size and mitotic index but positively correlated with the number of CD8+ T cells. There were significant differences in the number of CD8+ T cells between different gene mutation types. Wild type-mutant GISTs were enriched with CD8+ T cells as compared with KIT- and PDGFRA-mutant GISTs. The number of CD8+ T cells was higher in non-gastric GISTs. PD-L1 and CD8+ T cells were independent predictors for better relapse-free survival of GISTs.ConclusionsPD-L1 expression is a predictive biomarker for better prognosis of GISTs. Non-gastric GIST patients with wild-type mutations may be the beneficiaries of PD-1/PD-L1 inhibitors.

Background: Venous thromboembolism (VTE) prophylaxis remains suboptimal in China due to the bleeding risk associated with pharmacologic prophylaxis. We used data from the DissolVE-2 study to report the risk factors for bleeding and validated the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) bleeding risk score (BRS). Methods: In-hospital major bleeding incidence in medical patients from the DissolVE-2 study were assessed by Kaplan-Meier method. Risk factors associated with clinically relevant bleeding (CRB) were analysed using Cox regression model. Sensitivity, specificity, positive predictive value, negative predictive value and receiver-operating characteristic (ROC) curve was used to compute the diagnostic accuracy of IMPROVE BRS in the study cohort. Findings: Of the 6623 medical patients, 5076 patients with all relevant clinical details were included for the validation cohort. Overall, 127 CRB events (38 major and 89 clinically relevant non-major bleeding events) occurred in this cohort, with a cumulative incidence rate of 2.6% (95% confidence interval [CI], 2.3–3.4). Application of IMPROVE BRS revealed significantly higher hazards of CRB (hazard ratio [HR]: 7.17, 95% CI, 5.05–10.18) and major bleeding (HR: 13.95, 95% CI, 7.28–26.73) in patients with IMPROVE BRS ≥7. Comparison of predictive parameters revealed higher sensitivity (44.1 vs 35.9) and positive predictive value (10.9 vs 2.6) for CRB in our study than the IMPROVE study, which was substantiated by the area under the curve (0.73, p

The novel coronavirus SARS-CoV-2 and the disease caused by it, COVID-19, have spread to virtually all countries worldwide within just a few months. The economic and sanitary impact has been enormous. In March 2020, the World Health Organization declared COVID-19 a pandemic. How to effectively prevent and control SARS-CoV-2 transmission while providing care to surgical patients during the pandemic is a crucial topic. In order to minimize the risk of cross-infection between patients and physicians, many hospitals have taken measures to limit outpatient services, elective hospitalizations, and the number of operations. Based on the prevention and control measures stipulated by major medical institutions in China, this overview provides recommendations for surgeons from three aspects: outpatient treatment, ward management and perioperative protection. Telemedicine should be encouraged as a means of social distancing. Outpatient examination should be selected. Reasonable spatial arrangement and effective environmental disinfection are important for ward management. Patient selection for surgery and timing of operations should be carefully discussed within multi-disciplinary teams. Appropriate personal protective equipment should be worn adapted to the situational risk.On December 31, 2019, China reported to the WHO Country Office a pneumonia of unknown cause detected in Wuhan [1,3]. Subsequently, the disease later named COVID-19 affected a substantial proportion of the population in Wuhan and spread to other areas of China. Relying on a nationwide shutdown and mandatory quarantine, China has effectively curtailed the domestic outbreak. However, due to the high transmissibility of SARS-Cov-2 and the mobility of people, COVID-19 spread to the rest of the world. Many hospitals worldwide were faced with confirmed and suspected SARS-Cov-2 infections, putting a huge strain on the safety of patients and employees. Consequently, surgical patients who seek medical care during the COVID-19 pandemic present significant challenges. This paper summarizes medical care and infection prevention and control in general surgery patients during the COVID-19, pandemic in the light of the current situation in China. It provides reference for surgeons and decision makers in health care in other countries suffering from the COVID-19 pandemic.

With the development of the EV industry, the growing demand for EV fast charging load has brought enormous impact on the power system. Due to the unbalance of charging time distribution and the high power of EV fast charging, the difference between peak and valley of the load curve will widen. In this paper, a hierarchical navigation strategy (HNS) based on dynamic traffic/temperature data is proposed to decrease the EV fast charging load at peak hours and the time and energy cost during the charging process. The upper layer of the HNS is charging time selection. The optimal selections of charging time, which is based on the habits of EV users, is proposed in this layer. It aims at providing efficient time slots for charging, which can decentralize the fast charging demand and decrease the EV users' time cost. The underlayer is the route selection layer, which is based on the priority coding genetic algorithm. It proposes the optimal charging routes to decrease EV users' energy cost and time cost. At the same time, the peak charging load can also be shaved due to the decline in energy cost. The case study under the scene with realistic traffic, temperature, and power grid information shows that the proposed HNS can shave the peak load of the power grid and decrease the energy/time cost during the EV fast charging process. Therefore, the effectiveness of the HNS is proved.

Abstract Background A new staging system recently proposed by the IGCA has demonstrated a better capacity of stratifying different prognoses for gastric cancer than the 7th edition AJCC staging system (AJCC7). The aim of this study was to evaluate the efficacy of the IGCA system in Chinese patients. Methods Medical records of patients with gastric cancer who received curative surgery in our center from January 2003 to December 2011 were reviewed retrospectively. All the lesions were staged according to both AJCC7 and IGCA staging systems. Overall survival (OS) of the patients was used as the observation endpoint. Results One thousand five hundred twenty-six cases were included in this study. By comparing the AJCC7 system with the IGCA systems, 395 cases were stratified into different stages, most of which were in stage III. The IGCA system could better stratify stage IIIB and IIIC patients (5-year OS, 38.1% vs. 29.0%; P = 0.005) than the AJCC7 system (5-year OS, 38.2% vs. 35.9%; P = 0.148). T3N3bM0, T4aN2M0 and T4aN3bM0 made up 97.5% (385/395) of the stage shift. T3N3bM0, which was stratified to stage IIIB in the AJCC7 system, showed a significant poorer prognosis than T4aN2M0 and T4aN3aM0, which were staged to IIIB and IIIC in the same system. The improper staging was revised in the IGCA staging system. Conclusions The IGCA staging system can stratify stage III gastric cancer patients more properly than the AJCC7 system.

The optimal timing of resection for synchronous colorectal liver metastases is still controversial. Retrospective cohort studies always had baseline imbalances in comparing simultaneous resection with staged strategy. Significantly more patients with mild conditions received simultaneous resections. Previous published meta-analyses based on these studies did not correct these biases, resulting in low reliability. Our meta-analysis was conducted to compensate for this deficiency and find candidates for each surgical strategy.A systemic search for major databases and relevant journals from January 2000 to April 2013 was performed. The primary outcomes were postoperative mortality, morbidity, overall survival and disease-free survival. Other outcomes such as number of patients need blood transfusion and length of hospital stay were also assessed. Baseline analyses were conducted to find and correct potential confounding factors.22 studies with a total of 4494 patients were finally included. After correction of baseline imbalance, simultaneous and staged resections were similar in postoperative mortality (RR = 1.14, P = 0.52), morbidity (RR = 1.02, P = 0.85), overall survival (HR = 0.96, P = 0.50) and disease-free survival (HR = 0.97, P = 0.87). Only in pulmonary complications, simultaneous resection took a significant advantage (RR = 0.23, P = 0.003). The number of liver metastases was the major factor interfering with selecting surgical strategies. With >3 metastases, simultaneous and staged strategies were almost the same in morbidity (49.4% vs. 50.9%). With ≤3 metastases, staged resection caused lower morbidity (13.8% vs. 17.2%), not statistically significant.The number of liver metastases was the major confounding factor for postoperative morbidity, especially in staged resections. Without baseline imbalances, simultaneous took no statistical significant advantage in safety and efficacy. Considering the inherent limitations of this meta-analysis, the results should be interpret and applied prudently.

BACKGROUND: Whether patients with resectable colorectal liver metastases (CRLM) receive survival benefit from neoadjuvant chemotherapy remains controversial. METHODS: We retrospectively analyzed 466 patients with resectable CRLM between 2000 and 2010. Patient characteristics and survival data were recorded. RESULTS: The patients were divided into one group with neoadjuvant chemotherapy (group NC, n = 121) and another without (group WN, n = 345). There was no difference in 5-year survival (52% vs. 48%) between the two groups. No significant differences were identified between the two groups in terms of 30-day mortality (1.7% vs. 1.2%) or morbidity (33.9% vs. 25.8%). A primary tumor at stage T4, ≥4 liver metastases, the largest liver metastasis ≥5 cm in diameter, and a serum CEA level ≥5 ng/ml were independent prognostic factors. By assigning one point to each, the patients were divided into a low-risk group (0-2) and a high-risk (3-4). The patients in the low-risk group received no survival benefit from neoadjuvant chemotherapy, whereas those in the high-risk group received survival benefit (5-year survival, 39% vs. 33%, P = 0.028). CONCLUSIONS: Preoperative neoadjuvant chemotherapy did not increase mortality or complications. Not all resectable patients, only those with >2 independent risk factors, received survival benefit from neoadjuvant chemotherapy.

To explore whether steroid therapy should be needed for autoimmune pancreatitis patients after operation, eight AIP patients receiving operation were enrolled in this study from January 2007 to July 2013. All patients underwent liver function, CA19-9, and contrast-enhanced CT and/or MRI. Tests of IgG and IgG4 were performed in some patients. Tests of serum TB/DB, γ-GT, and γ-globulin were undergone during the perioperative period. Six cases receiving resection were pathologically confirmed as AIP patients and two were confirmed by intraoperative biopsy. For seven patients, TB/DB level was transiently elevated 1 day or 4 days after operation but dropped below preoperative levels or to normal levels 7 days after operation, and serum γ-GT level presented a downward trend. Serum γ-globulin level exhibited a downward trend among six AIP patients after resection, while an upward trend was found in another two AIP patients receiving internal drainage. Steroid therapy was not given to all six AIP patients until two of them showed new lines of evidence of residual or extrapancreatic AIP lesion after operation, while another two cases without resection received steroid medication. Steroid therapy might not be recommended unless there are new lines of evidence of residual extrapancreatic AIP lesions after resection.

Aberrant chemokine (C-X-C motif) receptor CXCR4 expressions in malignant tissues have been reported, but its role in gastric cancer prognosis remains unknown. Our studies were designed to investigate the expression and prognostic significance of CXCR4 in patients with gastric cancer. CXCR4 expression was retrospectively analyzed by immunohistochemistry in 97 patients with gastric adenocarcinoma from China. Results were assessed for association with clinical features and overall survival by using Kaplan-Meier analysis. Prognostic values of CXCR4 expression and clinical outcomes were evaluated by Cox regression analysis. A molecular prognostic stratification scheme incorporating CXCR4 expression was determined by using receiver operating characteristic (ROC) analysis. The results show that CXCR4 predominantly localized in the cell membranes and cytoplasm. The protein level of CXCR4 was upregulation in gastric cancer tissues and upregulated expression of CXCR4 was only significantly associated with Lauren classification (P