Search

Hepatocellular carcinoma (HCC) is a common and highly malignant tumor with poor outcomes, especially when it metastasizes. In this report, we present the case of a 64-year-old male patient diagnosed with recurrence and multiple metastases of HCC 7 years after surgery. As the tumor invaded the spinal canal and pressed on the spinal cord, the patient experienced paralysis in the lower limbs. After undergoing surgical resection for spinal decompression, the patient chose an innovative regimen: QL1604 200 mg every 3 weeks plus bevacizumab 675 mg every 3 weeks as first-line treatment. From July 2022 to February 2024, the patient has regularly received the treatment. During the treatment, the paralysis symptoms of the patient gradually improved, and the motor function of the lower limbs completely returned to normal. When re-evaluated his spinal cord injury, the Frankel grade of the patient was downgraded from C to E. The tumor shrank to reach a state of PR and lasted for one and a half years. QL1604 combined with bevacizumab demonstrated excellent efficacy and minimal side effects in this patient. This new combined therapy holds potential as a first-line treatment strategy.

Surface ozone (O3) increased by ∼20% in the Yangtze River Delta (YRD) region of China during 2014–2020, but the aggravating trend is highly variable on interannual time and city-level space scales. Here, we employed multiple air quality observations and numerical simulation to describe the increasing but variable trend of O3 and to reveal the main driving factors behind it. In 2014–2017, the governmental air pollution control action plan was mostly against PM2.5 (mainly to control the emissions of SO2, NOx, and primary PM2.5) and effectively reduced the PM2.5 concentration by 18%–45%. However, O3 pollution worsened in the same period with an increasing rate of 4.9 μg m−3 yr−1, especially in the Anhui province, where the growth rate even reached 14.7 μg m−3 yr−1. After 2018, owing to the coordinated prevention and control of both PM2.5 and O3, volatile organic compound (VOC) emissions in the YRD region has also been controlled with a great concern, and the O3 aggravating trend in the same period has been obviously alleviated (1.1 μg m−3 yr−1). We further combined the precursor concentration and the corresponding O3 formation regime to explain the observed trend of O3 in 2014–2020. The leading O3 formation regime in 2014–2017 is diagnosed as VOC-limited (21%) or mix-limited (58%), with the help of a simulated indicator HCHO/NOy. Under such condition, the decreasing NO2 (2.8% yr−1) and increasing VOCs (3.6% yr−1) in 2014–2017 led to a rapid increment of O3. With the continuous reduction in NOx emission and further in ambient NOx/VOCs, the O3 production regime along the Yangtze River has been shifting from VOC-limited to mix-limited, and after 2018, the mix-limited regime has become the dominant O3 formation regime for 55% of the YRD cities. Consequently, the decreases of both NOx (3.3% yr−1) and VOCs (7.7% yr−1) in 2018–2020 obviously slowed down the aggravating trend of O3. Our study argues that with the implementation of coordinated regional reduction of NOx and VOCs, an effective O3 control is emerging in the YRD region.

This study analyzed the effectiveness of temporary emission control measures on air quality of Nanjing, China during the Jiangsu Development Summit (JDS). We employed a regional chemistry model WRF-Chem to simulate air pollutants in Nanjing and compared the results to surface observations and satellite retrievals. During the JDS, air pollutant emissions from industry and transportation sectors largely decreased by 50–67% due to the short-term emission control measures such as reducing coal combustions, shutting down factories, and partially limiting traffic. Benefiting from the emission control, the simulated concentrations of PM2.5, NO2, SO2, CO and VOCs in Nanjing decreased by 17%, 20%, 20%, 19%, and 15% respectively, consistent with the surface and satellite observations. However, both the observed and simulated O3 increased by 3–48% during the JDS, which was mainly due to the remarkable NOx emission reduction (26%) in the downtown of Nanjing where the O3 production regime was mainly VOC-controlled. In addition, the atmospheric oxidation capacity and further the sulfur oxidation ratio, were facilitated by the elevated O3, which led to variable mitigation efficiencies of different secondary PM2.5 compositions. Our study offers an opportunity for understanding the coordinated control of PM2.5 and O3 in typical city clusters, and can provide implications for future mitigation actions.