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Rural evolution is a multifaceted combination of social, economic and ecological changes. Existing research about rural evolution focused on the socioeconomic transformation but paid inadequate attention to the ecological aspects and the links to external settings. In this research, we structured the cognition of rural evolution with a social-ecological framework, evaluated the sustainability of rural evolution with multisource data, and analyzed its external driving forces. Taking Jiangsu Province as a case study, we found that, (1) Rural evolution showed spatial heterogeneity in Jiangsu Province. From 2000 to 2015, rural evolution in South Jiangsu demonstrated a sustainable trend, while the rural system in North and Central Jiangsu was on the decline. (2) Population, social outcomes and ecological environment were predominant internal variables that determined the trend of rural evolution. With developed economy, good human well beings and large immigration, South Jiangsu surpassed North and Central Jiangsu in terms of rural sustainability. Although North and Central Jiangsu got higher scores on ecological environment, it was not sufficient to offset the negative effects of population loss and economic depression on rural sustainability. (3) Both the socioeconomic and ecological settings at larger scale had effects on rural evolution. Flat terrain, mild climate, advantageous location, good socioeconomic base as well as progress in infrastructures, globalization and marketization provided favorable conditions for rural development. However, over rapid urbanization had negative impacts on rural sustainability due to the urban-biased policy. Based on the results, we proposed to develop small towns and promote bottom-up urbanization to reconcile the conflicts between rural development and urbanization. To pursuit rural sustainability, a problem-driven, solution-oriented approach was also needed to avoid one-size-fits-all implementation of policy design.

Previously, urban planning approaches have tended to convert local agglomeration into network connections to advance urban development. However, is this successful experience learned from developed counties appropriate for developing countries? Scholars hold different opinions on this debate. To answer this question, we need to examine the effects of urban agglomeration in developing countries with a quantitative method. In this paper, we introduced a method of examining network connections from a geospatial perspective to explore the practice and spatial consequences of regional integration using a new concept of “coupling distance” based on metal valence bond theory. Then we applied this method to conduct an empirical case study of the urban agglomeration in the middle reaches of the Yangtze River region in China. We found that: (1) the real integration scale of the investigated urban areas was less than one-fourth the planned area, as most of interactions between cities are local, although we see the positive facilitation of urban networks on cross-provincial integration. (2) In terms of spatial consequences, the study area demonstrated phenomena of “agglomeration shadows”, “enclaves” and “inverse integration”. Specifically, these “agglomeration shadows” were all in their province’s geometric centers, which seemed to have suffered a “central position curse”. (3) Both “enclaves” and “inverse integration” call for a readjustment of government-led regional integration planning. Differently, the former has a positive attitude towards integration while the latter holds the opposite attitude. This study hopes to provide operationalizing methods and guidelines for planners and decision makers in the field of regional integration planning.

The urban-rural transformation from dichotomy to integration is a gradual process. Like rural areas in many countries, Chinese rural society is experiencing a decline in all spheres due to depopulation, aging, lack of economic opportunity, and so on. Aiming at solving the serious rural issues, China proposed the implementation of a rural revitalization strategy and the promotion of an integrated urban-rural development for the first time in 2017. This proposal marks the transformation of the urban-rural relationship, and the integrated urban-rural development reflects a significant conceptual change. Researches on issues of rural decline are urgently needed to determine the most effective method for rural revitalization and development from the perspective of the urban-rural dynamics. In this context, this paper focuses on studying the theory, technology and management of rural revitalization and development. We construct a theoretical framework for urban-rural integration based on population-land-industry-right between the urban and rural systems, regarding land engineering for land capacity building as the technical support and the rural land system reform and reconstruction as the policy support for management. This research will provide theoretical support for the implementation of China’s rural revitalization strategy.

Introduction The purpose of this study was to explore the outcomes of all-trans-retinoic acid (ATRA) and arsenic trioxide (ATO) plus idarubicin (IDA) as a frontline treatment in adult patients with acute promyelocytic leukemia (APL). Patients and Methods We analyzed the outcomes of ATRA and intravenous ATO plus IDA as a frontline induction therapy in 118 patients with APL with high-risk (HR) and standard-risk (SR) disease from January 2008 to December 2017. The medical records of 118 patients with APL (HR, n = 45; SR, n = 73) who received the frontline triple combination regimen at Henan Provincial People’s Hospital and Tongji Hospital were retrospectively reviewed. Consolidation therapy comprised 6 cycles of ATO and ATRA plus IDA, and IDA was administered in 1 to 4 cycles of consolidation therapy based on the comparable clinical efficacy compared with 6 cycles and fewer side effects to myocardium without subsequent maintenance therapy. Results Of 118 patients, there were 3 (2.5%) early deaths and 115 (97.5%) hematologic complete remissions; 102 (88.7%) of 115 patients achieved molecular complete remission following induction therapy, and all patients were polymerase chain reaction-negative for promyelocytic leukemia-retinoic acid receptor alpha after the first cycle of consolidation therapy. The 5-year overall survival (OS) and event-free survival (EFS) were 93.0% ± 2.9% and 92.4% ± 3.0%, respectively. Early death, hematologic complete remissions, molecular complete remissions, and toxicities were comparable between the HR and SR groups. The cumulative incidence of relapse in the HR group was 4.7% (n = 2), and the cumulative incidence of relapse in the SR group was 0. The OS and EFS of the SR and HR groups were comparable (92.3% ± 4.5% vs. 92.8% ± 4.0%; X2 = 0.263; P = .608; 92.3% ± 4.5% vs. 91.1% ± 4.2%, X2 = 0.917; P = .338). The total dosage of IDA was approximately 181 to 258 mg, and no patient experienced cardiotoxicity. OS and EFS were not influenced by fms-related tyrosine kinase 3 internal tandem duplication mutation status (P = .405 and P = .528, respectively). Conclusion The triple combination of ATRA and ATO plus IDA as both an induction and consolidation therapy for the HR and SR groups attained excellent outcomes, and this regimen was effective, safe, and easy, without maintenance therapy. The triple combination treatment might be a preferred frontline therapy for patients with APL, especially for those with HR or the APL fms-related tyrosine kinase 3 internal tandem duplication mutation.

Purpose This study screened serum proteins to identify potential biomarkers for childhood B-cell and T-cell acute lymphoblastic leukemia (ALL). Patients and methods Serum collected from 20 newly diagnosed B-cell ALL, 20 T-cell ALL and 20 healthy children. The peptides from these samples were subjected to iTRAQ. Differentially expressed proteins (DEPs) were further validated by ELISA in 24 B-ALL, 24 T-ALL, and 24 healthy children. Results Bioinformatics analysis revealed several pathways, including atherosclerosis signaling, interleukin signaling and production in macrophages and clathrin-mediated endocytosis signaling, that were closely related to childhood T-cell ALL. Furthermore, four selected proteins, namely LRG1, S100A8, SPARC and sL-selectin, were verified by ELISA. These results were consistent with the results of the proteomics analysis. Conclusion Serum S100A8 may serve as new diagnostic biomarkers in childhood B-cell ALL and T-cell ALL.

We compared the outcomes of immunosuppressive therapy (IST) with those of T cell-replete haploidentical donor hematopoietic stem cell transplantation (haplo-HSCT) in children and adolescents with severe aplastic anemia (SAA). The medical records of 49 patients with SAA who received frontline IST (n = 29) or frontline haplo-HSCT (n = 20) between 2012 and 2016 were analyzed retrospectively. Fourteen patients responded after the first IST, and 1 patient responded after the second IST in the frontline IST group; 12 patients underwent salvage HSCT after IST failure. Sixteen of the 20 patients who underwent frontline haplo-HSCT survived without treatment failure. The 3-year overall survival of the frontline IST group was comparable to that of the frontline haplo-HSCT group (79.3 ± 7.5% versus 85.0 ± 8.0%; χ2 = 0.110; P = .740). The 3-year failure-free survival was lower in the frontline IST group compared with the frontline haplo-HSCT group (35.9 ± 10.9% versus 80.0 ± 8.9%; χ2 = 4.089; P = .043). Five patients of the IST group who underwent salvage HSCT achieved long survival without event. The event-free survival was lower in the salvage HSCT group compared with the haplo-HSCT group (41.7 ± 14.2% versus 80.0 ± 8.9%; χ2 = 3.992; P = .046), and the incidences of acute GVHD, grade II-IV acute GVHD, chronic GVHD, and severe infection were comparable between the 2 groups. Our results suggest that frontline haplo-HSCT may be a better treatment than IST for children and adolescents with SAA who lack an HLA age-matched familial donor.

Land consolidation, as a sustainability-oriented policy design, has been implemented worldwide for promoting agricultural production and rural development. Although there has been a large number of publications on land consolidation, few attempts have been made to systematically assess the existing research. To fill this gap, here we present a comprehensive literature review of land consolidation based on materials collected from Web of Science. Through applying quantitative and qualitative analysis to the collected literature, including statistical analysis, cluster analysis and main path analysis, we found: (1) Land consolidation has formed an interdisciplinary research field with more than one century’s history, with scientists from developing countries more active than those from developed countries. (2) The hot topics of rural sustainability, impacts evaluation, land fragmentation and land reallocation are closely related to the theme of land consolidation. (3) Research of land consolidation mainly covers three knowledge domains: origins of land consolidation, operation process of land consolidation, and impacts of land consolidation. To advance land consolidation to better serve the pursuit of sustainability, we suggest to take a diagnostic approach to assessing the suitability and feasibility of land consolidation before launching a project, and to adopt a transdisciplinary approach to linking science with knowledge through involving both scientists and stakeholders into the knowledge production and application process.

Although Indoleamine 2,3-dioxygenase (IDO), tryptophan-2,3-dioxygenase (TDO), and aryl hydrocarbon receptor (AHR) are involved in cancer immune escape, their prognostic impact on diffuse large B-cell lymphoma (DLBCL) is unknown. To examine the prognostic impact of IDO, TDO, and AHR on patients with DLBCL. This was a retrospective study on treatment-naïve patients with newly diagnosed DLBCL at the Henan Province People's Hospital between 01/2012 and 06/2015. Patients with inflammatory reactive lymph nodes were included as controls. All cases were reviewed by 2 pathologists. IDO, TDO, and AHR positivity was determined through immunochemistry. Survival was examined using the Kaplan-Meier method and multivariable Cox analyses. The positive expression of TDO (50.0% vs 16.7%, P = .005) and AHR (60.0% vs 8.3%, P

With the increase in climate change and increasing social concerns about environmental deterioration, sustainability has become a hot topic in both natural and social research. Nowadays, sustainable cities are one of the focal points, while rural areas have been disregarded. In fact, rural areas have been suffering from environmental degradation for decades. Thus, sustainability transitions in both urban and rural areas should be given commensurate emphasis. In this paper, we provide an overview of rural evolution worldwide and attempt to explore alternative approaches for enhancing rural sustainability. As depicted in the literature, rural evolution is multifaceted. For a long time, depopulation and demographic aging have been like chronic diseases torturing rural areas. Although there were some bright spots of rural repopulation and economic restructuring, they were not mainstream of rural development. Based on the existing research, we established a conceptual framework and analyzed the rural evolution paradigm from a geographic perspective. We found that rural composition determined rural architecture, while rural architecture affected rural functioning. Changes in rural functioning formed the rural evolution trend. Since rural development was also influenced by external factors, both self-organization and governmental intervention were found to be alternative approaches to guiding rural transitions. We took the case study of Tengtou village to exemplify the sustainable pathways of a rural transition. The case study indicated that national policies were the fundamental impetus for rural transformation, while self-organization played a more important role. We hope that our study will shed new light on policy orientations and rural transitions.

Acute lymphoblastic leukemia (ALL) is one of the most common and most malign childhood cancers. In this work, we investigated the expression and function of human mature microRNA-9 (miR-9) in ALL. In ALL in vitro cell lines and in situ clinical specimens, gene expression of miR-9 was tested by qRT-PCR. MiR-9 was overexpressed in CEM/C1 and Molt-3 cells to investigate its possible anti-cancer effects on ALL in vitro proliferation, cell-cycle progression, and in vivo explant growth. The possible downstream target of miR-9, neuropilin-1 (NRP1), was examined by dual-luciferase activity assay, qRT-PCR, and Western blot. NRP1was upregulated in miR-9-overexpressed CEM/C1 and Molt-3 cells to investigate the functional involvement of NRP1 in miR-9-mediated regulation on ALL in vitro proliferation and cell-cycle progression. MiR-9 was downregulated in ALL cell lines and leukemic T-cells of ALL patients. Lentivirus-mediated miR-9 overexpression inhibited ALL in vitro proliferation, cell-cycle progression, and in vivo explant growth. NRP1 was confirmed be the downstream target of miR-9, and inversely modulated by miR-9 in ALL. NRP1 upregulation reversed the anti-cancer regulations of miR-9 on ALL in vitro proliferation and cell-cycle progression. MiR-9 is downregulated in ALL. Overexpressing miR-9 may inhibit ALL development, possible through its downstream target of NRP1.

Objective: To investigate the role of DR4 gene in the occurrence, development and prognosis of acute myeloid leukemia (AML), find a new regulatory gene of Decitabine for the treatment of AML, namely DR4 gene, and explore the molecular mechanism of AML in the treatment of AML. Methods: The methylation level and the mRNA expression level of DR4 gene promoters of bone marrow mononuclear cells in 122 patients with newly diagnosed AML and 24 patients with iron deficiency anemia (IDA) were detected using Methylation specific PCR (MS-PCR) and Q-RT-PCR, respectively, and a correlation analysis of them was conducted. The effects of Decitabine on the proliferation of K562 cells were detected using CCK-8 assay. Then, the effects of Decitabine on the methylation level and the mRNA expression level of DR4 genes of K562 cells treated with Decitabine were detected using MS-PCR and Q-RT-PCR, respectively. The effects of Decitabine on the cell cycle and apoptosis of K562 cells were detected using flow cytometry. Results: Compared with the control group, the methylation level (P = .002) of DR4 genes of bone marrow mononuclear cells in patients with newly diagnosed AML was high. The methylation level (P = .01) of DR4 genes of bone marrow mononuclear cells in patients of the positive group of enlargement of liver, spleen and lymph node was lower than that of the negative group, and the methylation level (P = .006) of DR4 genes in patients of the high risk group of clinical stage was lower than that of the low risk group, and the methylation level (P = .03) of DR4 genes in patients of the group where patients did not achieve complete remission (CR1) after a course of induction chemotherapy was lower than that of the group where patients achieved complete remission (CR1) after a course of induction chemotherapy. There was a significant negative correlation (P

Hemorrhage is the usual manifestation of acute promyelocytic leukemia (APL) related coagulopathy while thrombosis is uncommonly reported. APL-associated thrombosis, although low incidence, is one of the most critical cause of early death in this otherwise curable leukemia. Therefore, an understanding of potential factors predict fatal thrombotic complications in patients with APL might be useful for designing more appropriately risk-adapted treatment protocols or personalized therapy aimed at reducing the considerable problem of induction mortality in APL. According to NCCN guidelines, high-risk APL patients in our study defined bythe presence of WBC≥10×109/L. We retrospectively analyzed the clinical data of 22 patients newly diagnosed with high-risk APL at Zhengzhou University People's hospital from January 2013 to January 2018. Based on the clinical data, the 22 patients were divided into two groups (5 patients developed high-risk APL-related thrombosis and 17 patients developed high-risk APL-related hemorrhage) (Table 1). In the high-risk APL patients who developed thrombosis, 4/5 patients were confirmed for life-threatening cerebrovascular accidents before or after induction therapy with all-trans retinoic acid (ATRA) and 1 patient developed lower limb vein thrombosis. Notably, in this study, we observed a close relationship between some coagulative-fibrinolytic abnormalities and development of thrombotic events in patients with high-risk APL--FDP/FIB and D-dimer/FIB showed higher ratio than the normal range (P In order to emphasized the role of FDP/FIB and D-dimer/FIB ratios in predicting thrombosis in high-risk APL, we highlighted a case of high-risk APL patient with thrombosis showing the continuously monitored dynamic coagulation profile and illuminated the personalized treatment strategy for this patient. The 45-year-old male patient was given ATRA, arsenic trioxide (ATO), hydroxycarbamide and idarubicin for therapy. 3rd day after ATRA administration, he began to complain of swelling and severe pain in the lower extremities with walking difficulty. Routine blood tests on that day showed WBC 88.5×109/L, Hb 80g/L and PLT 70×109/L. The coagulation parameters revealed: PT 15.2s, APTT 37.2s, FIB 2.9g/L, FDP 30.53mg/L, D-dimer 12.79mg/L, FDP/FIB ratio 10.53 and D-dimer/FIB ratio 4.41. The patient was confirmed bilateral calf muscle venous thrombosis and coagulation profile reflected the tendency of thrombosis rather than hemorrhage and DIC during the initial course of induction therapy (Figure 2). Leukapheresis was applied daily for 3 successive days at the physician's discretion, which resulted in a striking decrease in the WBC count (31×109/L) (Figure 3). Finally, the patient achieved morphologic complete remission (CR) after 1 month of therapy and later molecular CR with PML-RARα documented to be negative. In conclusion, our data/results demonstrated that (1) A few high-risk APL patients present with thrombosis rather than hemorrhage. (2) The value of FDP/FIB and D-dimer/FIB ratios could predict high-risk APL related thrombosis. (3) Leukapheresis, which is currently not recommended for the treatment of high-risk APL, could be used for this special subtype of high-risk APL associated with predisposing factors to thrombosis. (4) ATRA has a profound impact on the hemostatic system, and it can rapidly correct fibrinolysis and reverse coagulopathy with prothrombotic function. For this small distinct subtype of high-risk APL trending to thrombosis rather than hemorrhage, the clinical entity which have been an overlooked, the dose and timing of ATRA administration might need to be adjusted. Disclosures No relevant conflicts of interest to declare.