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Significance Igneous rocks are well-developed in the southern Pinghu slope zone, Xihu Sag, East China Sea Shelf Basin. In this zone, the increased local geotemperature caused by magmatic activity produced significant impacts on the thermal evolution of source rocks and the formation of secondary pores in sandstone reservoirs and also serves as a significant indicator of regional tectonic movements, thus holding great significance for understanding the regional geological history. Objective and Methods This study aims to determine the formation stages and distribution patterns of igneous rocks as the cap rocks in the southern Pinghu slope zone. Using previous study results and the data of adjacent areas, as well as 3D seismic data and related attributes, and data from drilling and logs, this study analyzed the types, corresponding strata, and distribution ranges of volcanic rocks in the southern Pinghu slope zone. Furthermore, the formation stages of igneous rocks in the slope zone were explored based on the stratigraphic chronology, the morphologies of volcanic edifices, and the contact relationship between volcanic edifices and surrounding rocks. Results and Conclusions The results indicate that the seismic facies of igneous rocks in the Pingnan area can be divided into volcanic vent facies, along with explosive, overflow, and intrusive facies, with mounded and shield volcanic edifices proving the most developed. The magmatic activity in the Xihu Sag can be divided into three stages. Specifically, magmatic activity during the regional Longjing Movement, occurring in the late Miocene, exhibits the highest intensity and widest influence range. Besides, local small-scale tectonic movements occurred in the late depositional stage of the Yuquan Formation and the early depositional stage of the Santan Formation, corresponding to weak magmatic activity with minimal impacts. The Pingnan area contains five lithologic, low-amplitude drape anticline/fault combination traps associated with magmatic activity. The results of this study will provide a reference for future hydrocarbon exploration and production in the southern Pinghu slope zone of the Xihu Sag.

Summary: Background: Existing studies have not provided robust evidence about the CVD risk of non-smoking patients with restrictive spirometric pattern (RSP) or airflow obstruction (AFO), and how the risk is modified by body shape. We aimed to bridge the gap. Methods: We used never-smokers' data from the China Kadoorie Biobank (CKB) and performed Cox models by sex (278,953 females and 50,845 males). Spirometry was used to assess the baseline spirometric pattern. CVD outcomes were captured through multiple sources. Findings: Females’ results were presented primarily, though males' results were similar. During a median 12-year (maximum 14.5 years) follow-up, both RSP and AFO patients had increased risks of acute myocardial infarction (AMI), other ischaemic heart disease (other IHD), heart failure, pulmonary heart disease, arrhythmia, and intracerebral haemorrhage (ICH). RSP was also associated with ischaemic stroke (IS). The HRs (95% CIs) for AFO in females ranged from 1.29 (1.15–1.45) for ICH to 8.84 (7.79–10.03) for pulmonary heart disease, while those for RSP ranged from 1.11 (1.08–1.15) for IS to 3.17 (2.80–3.59) for pulmonary heart disease. These risks increased with the severity of AFO and reduced FVC. RSP/AFO was more strongly associated with other IHD, heart failure, and pulmonary heart disease in underweight females than in normal and obese counterparts, respectively. Interpretation: With the confounding of smoking fully controlled, both RSP and AFO were associated with higher risks of various CVD outcomes, which further increased with the severity of AFO and reduced FVC. These associations were even stronger in underweight individuals. Funding: National Natural Science Foundation of China, National Key Research and Development Program of China, Ministry of Science and Technology of the People's Republic of China, Kadoorie Charitable Foundation, UK Wellcome Trust, UK Medical Research Council, Cancer Research UK, and British Heart Foundation.

Abstract Diabetic cardiomyopathy (DCM) represents a unique myocardial disease originating from diabetic metabolic disturbances that is characterized by myocardial fibrosis and diastolic dysfunction. While recent research regarding the pathogenesis and treatment of DCM has focused primarily on myocardial cells, nonmyocardial cells—including fibroblasts, vascular smooth muscle cells (VSMCs), endothelial cells (ECs), and immune cells—also contribute significantly to the pathogenesis of DCM. Among various therapeutic targets, fibroblast growth factor 21 (FGF21) has been identified as a promising agent because of its cardioprotective effects that extend to nonmyocardial cells. In this review, we aim to elucidate the role of nonmyocardial cells in DCM and underscore the potential of FGF21 as a therapeutic strategy for these cells.

The sub-instability refers to a stress state that exists between the maximum stress the rock can withstand and its final failure. This stress state should be an indicator of impending large earthquakes, as it occurs in the final stage of earthquake nucleation. We apply the Load/Unload Response Ratio (LURR) method to explore sub-instability in the source media before large earthquakes. The earthquake-related observation data such as the groundwater, crustal deformation, electromagnetism and so on were adopted as data input. The load and unload phases at each observation station are discriminated by the change of Coulomb failure stress caused by earth tides along the tectonically optimal sliding direction. Retrospective studies of this approach on the 2020 Mw6.0 Jiashi, Xinjiang, 2022 Mw6.6 Menyuan, Qinghai, and Mw6.6 Luding, Sichuan earthquakes show that the LURR time series derived from the observation stations near the epicenter exceed 2 standard deviations of the mean within several days to years before the mainshocks. Additionally, as the time of mainshock approaches, the distance between the stations detecting LURR anomaly and epicenter decreases. The LURR anomalies indicate the presence of sub-instability prior to a large earthquake, and their spatio-temporal evolution may suggest the weakening processes in the source media.

Summary: Background: In non-high-risk individuals, risk-category-based atherosclerotic cardiovascular disease (ASCVD) screening strategies may be more cost-effective than one-size-fits-all approaches. However, current decisions are constrained by a lack of research evidence. We aimed to explore appropriate risk-category-based screening interval strategies for non-high-risk individuals in ASCVD primary prevention in the Chinese population. Methods: We used data from 28,624 participants in the China Kadoorie Biobank (CKB) who had completed at least two field surveys. The risk assessment tools were the 10-year ASCVD risk prediction models developed based on the CKB cohort. We constructed multistate Markov models to model disease progression and estimate transition probabilities between different risk categories. The total person-years spent unidentified in the high-risk state over a 10-year period were calculated for each screening interval protocol. We also estimated the number of ASCVD events prevented, quality-adjusted life years (QALYs) gained, and costs saved when compared to the 3-yearly screening protocol. Findings: When compared to the uniform 3-yearly protocol, most risk-category-based screening interval protocols would identify more high-risk individuals timely, thus preventing more ASCVD events and gaining QALYs. A few of them would reduce total health-care costs. The protocol, which used 6-year, 3-year, and 2-year screening intervals for low-risk, intermediate-low-risk, and intermediate-high risk individuals, was optimal, and would reduce the person-years spent unidentified in the high-risk category by 17.9% (95% CI: 13.1%–21.9%), thus preventing an estimated 113 thousand (95% CI: 83–138) hard ASCVD events for Chinese adults aged 30–79 over a 10-year period. When using a lower cost of statin therapy, more screening protocols would gain QALYs while saving costs. Interpretation: For the primary prevention of ASCVD, risk-category-based screening protocols outperformed the one-size-fits-all approach in the Chinese population. Funding: This work was supported by National Natural Science Foundation of China (82192904, 82388102, 82192900) and grants (2023YFC2509400) from the National Key R&D Program of China. The CKB baseline survey and the first re-survey were supported by a grant from the Kadoorie Charitable Foundation in Hong Kong. The long-term follow-up is supported by grants from the UK Wellcome Trust (212946/Z/18/Z, 202922/Z/16/Z, 104085/Z/14/Z, 088158/Z/09/Z), grants (2016YFC0900500) from the National Key R&D Program of China, National Natural Science Foundation of China (81390540, 91846303, 81941018), and Chinese Ministry of Science and Technology (2011BAI09B01).

Background: Neoadjuvant therapy improves survival benefits in patients with locally advanced non-small cell lung cancer but increases tissue density, presenting challenges for surgeons. Objectives: To compare the differences in surgical complexity and short-term prognostic outcomes between neoadjuvant targeted therapy (NTT) and neoadjuvant chemoimmunotherapy (NCI). Design/methods: This study enrolled 106 patients underwent curative surgery after neoadjuvant therapy between January 2020 and December 2023 at the National Cancer Center of China. Differences in surgical complexity and short-term prognostic outcomes between the two neoadjuvant therapy cohorts were evaluated. The pathological indicators such as pathological response rate and lymph node upstaging/downstaging were then analyzed. Results: In total, 33 patients underwent NTT and 73 underwent NCI preoperatively. Patients who received NTT showed a higher minimally invasive surgery rate (84.8% versus 53.4%, p < 0.01), shorter operative time (144 versus 184 min, p < 0.01), lower conversion rate (3.3% versus 17.8%, p = 0.03), less postoperative drainage (day 3: 140 versus 200 mL, p = 0.03), and lower incidence of postoperative complications including arrhythmias (6.1% versus 26%, p = 0.02). The pathological response rate in the NTT and NCI groups was 70% and 75%, respectively, with the latter group showing a higher complete pathological response rate. The two groups had no significant differences in major pathological response and lymph node pathological response rate. Conclusion: Patients who received NTT presented fewer surgical challenges for surgeons and had better surgical outcomes than those who received NCI therapy, with comparable pathological response rates between the two cohorts. Accordingly, NTT is the preferred induction regimen for patients harboring mutation status.

Biogenic amine is one of the main categories of hazardous compounds in meat and meat products, making its detection methods vital for the assurance of edible safety. In this sense, many biogenic amine detection techniques such as chromatographic, electrophoretic, and electrochemical methods have been developed, which play an irreplaceable role in ensuring the safety of meat and meat products. Due to the increasing demand for fast and on-site detection techniques, visual detection methods have been gradually developed compared with non-visual methods such as chromatography and electrophoresis. Herein, we comprehensively review the mechanism and the latest progress of these biogenic amine detection methods; besides, we put forward the prospects for the future development of biogenic amine detection techniques, with a view to providing support for the establishment of more accurate and efficient detection, prevention and control strategies of biogenic amines.

Frequent tectonic activity in rift basins has led to complex fault zones, which have led to extensive hydrocarbon distributions and tremendous resource potential. This study investigated the hydrocarbon potential in the southern Pinghu structural belt, focusing on fault traps in complex fault zones. Through fault sealing analysis and gas detection attenuation methods, this study aims to improve exploration success rates. The application outcomes demonstrate that the Shale Gouge Ratio (SGR) threshold for achieving the lateral sealing of faults in the southern Pinghu structural belt is 34%, with a critical fault throw of 100 m. Regions where the fault’s lateral sealing zone corresponds with areas exhibiting anomalous gas responses are deemed promising for hydrocarbon accumulation. Additional analysis indicates that favorable fault trap development occurs along the foot walls of significant faults, particularly in the eastern sector of the study area. The findings are corroborated by actual drilling data, affirming the efficacy of these methods in pinpointing hydrocarbon traps within complex fault zones and offering valuable insights for their broader global application.

Abstract Background The primary pathophysiological process of sepsis is to stimulate a massive release of inflammatory mediators to trigger systemic inflammatory response syndrome (SIRS), the major cause of multi-organ dysfunction and death. Like other helminths, Echinococcus granulosus induces host immunomodulation. We sought to determine whether E. granulosus cyst fluid (EgCF) displays a therapeutic effect on sepsis-induced inflammation and tissue damage in a mouse model. Methods The anti-inflammatory effects of EgCF were determined by in vitro culture with bone marrow-derived macrophages (BMDMs) and in vivo treatment of BALB/C mice with cecal ligation and puncture (CLP)-induced sepsis. The macrophage phenotypes were determined by flow cytometry, and the levels of cytokines in cell supernatants or in sera of mice were measured (ELISA). The therapeutic effect of EgCF on sepsis was evaluated by observing the survival rates of mice for 72 h after CLP, and the pathological injury to the liver, kidney, and lung was measured under a microscope. The expression of TLR-2/MyD88 in tissues was measured by western blot to determine whether TLR-2/MyD88 is involved in the sepsis-induced inflammatory signaling pathway. Results In vitro culture with BMDMs showed that EgCF promoted macrophage polarization to M2 type and inhibited lipopolysaccharide (LPS)-induced M1 macrophages. EgCF treatment provided significant therapeutic effects on CLP-induced sepsis in mice, with increased survival rates and alleviation of tissue injury. The EgCF conferred therapeutic efficacy was associated with upregulated anti-inflammatory cytokines (IL-10 and TGF-β) and reduced pro-inflammatory cytokines (TNF-α and INF-γ). Treatment with EgCF induced Arg-1-expressed M2, and inhibited iNOS-expressed M1 macrophages. The expression of TLR-2 and MyD88 in EgCF-treated mice was reduced. Conclusions The results demonstrated that EgCF confers a therapeutic effect on sepsis by inhibiting the production of pro-inflammatory cytokines and inducing regulatory cytokines. The anti-inflammatory effect of EgCF is carried out possibly through inducing macrophage polarization from pro-inflammatory M1 to regulatory M2 phenotype to reduce excessive inflammation of sepsis and subsequent multi-organ damage. The role of EgCF in regulating macrophage polarization may be achieved by inhibiting the TLR2/MyD88 signaling pathway. Graphical Abstract

Fruit is a major source of vitamins, minerals, and dietary fiber in people’s daily lives. Leaf diseases caused by climate change and other factors have significantly reduced fruit production. Deep learning methods for segmenting leaf diseases can effectively mitigate this issue. However, challenges such as leaf folding, jaggedness, and light shading make edge feature extraction difficult, affecting segmentation accuracy. To address these problems, this paper proposes a method based on EFS-Former. The expanded local detail (ELD) module extends the model’s receptive field by expanding the convolution, better handling fine spots and effectively reducing information loss. H-attention reduces computational redundancy by superimposing multi-layer convolutions, significantly improving feature filtering. The parallel fusion architecture effectively utilizes the different feature extraction intervals of the convolutional neural network (CNN) and Transformer encoders, achieving comprehensive feature extraction and effectively fusing detailed and semantic information in the channel and spatial dimensions within the feature fusion module (FFM). Experiments show that, compared to DeepLabV3+, this method achieves 10.78%, 9.51%, 0.72%, and 8.00% higher scores for mean intersection over union (mIoU), mean pixel accuracy (mPA), accuracy (Acc), and F_score, respectively, while having 1.78 M fewer total parameters and 0.32 G lower floating point operations per second (FLOPS). Additionally, it effectively calculates the ratio of leaf area occupied by spots. This method is also effective in calculating the disease period by analyzing the ratio of leaf area occupied by diseased spots. The method’s overall performance is evaluated using mIoU, mPA, Acc, and F_score metrics, achieving 88.60%, 93.49%, 98.60%, and 95.90%, respectively. In summary, this study offers an efficient and accurate method for fruit tree leaf spot segmentation, providing a solid foundation for the precise analysis of fruit tree leaves and spots, and supporting smart agriculture for precision pesticide spraying.

Soil, a non-renewable resource, requires continuous monitoring to prevent degradation and support sustainable agriculture. Visible-near-infrared (Vis-NIR) spectroscopy is a rapid and cost-effective method for predicting soil properties. While traditional machine learning methods are commonly used for modeling Vis-NIR spectral data, large datasets may benefit more from advanced deep learning techniques. In this study, based on the large soil spectral library LUCAS, we aimed to enhance regression model performance in soil property estimation by combining Transformer and convolutional neural network (CNN) techniques to predict 11 soil properties (clay, silt, pH in CaCl2, pH in H2O, CEC, OC, CaCO3, N, P, and K). The Transformer-CNN model accurately predicted most soil properties, outperforming other methods (partial least squares regression (PLSR), random forest regression (RFR), support vector machine regression (SVR), Long Short-Term Memory (LSTM), ResNet18) with a 10–24 percentage point improvement in the coefficient of determination (R2). The Transformer-CNN model excelled in predicting pH in CaCl2, pH in H2O, OC, CaCO3, and N (R2 = 0.94–0.96, RPD > 3) and performed well for clay, sand, CEC, P, and K (R2 = 0.77–0.85, 2 < RPD < 3). This study demonstrates the potential of Transformer-CNN in enhancing soil property prediction, although future work should aim to optimize computational efficiency and explore a wider range of applications to ensure its utility in different agricultural settings.

Summary: Background: Previous observational studies established a positive relationship between snoring and stroke. We aimed to investigate the causal effect of snoring on stroke. Methods: Based on 82,339 unrelated individuals with qualified genotyping data of Asian descent from the China Kadoorie Biobank (CKB), we conducted a Mendelian randomization (MR) analysis of snoring and stroke. Genetic variants identified in the genome-wide association analysis (GWAS) of snoring in CKB and UK Biobank (UKB) were selected for constructing genetic risk scores (GRS). A two-stage method was applied to estimate the associations of the genetically predicted snoring with stroke and its subtypes. Besides, MR analysis among the non-obese group (body mass index, BMI

BackgroundAir pollution is a major public health concern. Air Quality Health Index (AQHI) is a very important air quality risk communication tool. However, AQHI is usually constructed by single-pollutant model, which has obvious disadvantages.ObjectiveTo construct an AQHI based on the joint effects of multiple air pollutants (J-AQHI), and to provide a scientific tool for health risk warning and risk communication of air pollution.MethodsData on non-accidental deaths in Yunnan, Guangdong, Hunan, Zhejiang, and Jilin provinces from January 1, 2013 to December 31, 2018 were obtained from the corresponding provincial disease surveillance points systems (DSPS), including date of death, age, gender, and cause of death. Daily meteorological (temperature and relative humidity) and air pollution data (SO2, NO2, CO, PM2.5, PM10, and maximum 8 h O3 concentrations) at the same period were respectively derived from China Meteorological Data Sharing Service System and National Urban Air Quality Real-time Publishing Platform. Lasso regression was first applied to select air pollutants, then a time-stratified case-crossover design was applied. Each case was matched to 3 or 4 control days which were selected on the same days of the week in the same calendar month. Then a distributed lag nonlinear model (DLNM) was used to estimate the exposure-response relationship between selected air pollutants and mortality, which was used to construct the AQHI. Finally, AQHI was classified into four levels according to the air pollutant guidance limit values from World Health Organization Global Air Quality Guidelines (AQG 2021), and the excess risks (ERs) were calculated to compare the AQHI based on single-pollutant model and the J-AQHI based on multi-pollutant model.ResultsPM2.5, NO2, SO2, and O3 were selected by Lasso regression to establish DLNM model. The ERs for an interquartile range (IQR) increase and 95% confidence intervals (CI) for PM2.5, NO2, SO2 and O3 were 0.71% (0.34%–1.09%), 2.46% (1.78%–3.15%), 1.25% (0.9%–1.6%), and 0.27% (−0.11%–0.65%) respectively. The distribution of J-AQHI was right-skewed, and it was divided into four levels, with ranges of 0-1 for low risk, 2-3 for moderate risk, 4-5 for high health risk, and ≥6 for severe risk, and the corresponding proportions were 11.25%, 64.61%, 19.33%, and 4.81%, respectively. The ER (95%CI) of mortality risk increased by 3.61% (2.93–4.29) for each IQR increase of the multi-pollutant based J-AQHI , while it was 3.39% (2.68–4.11) for the single-pollutant based AQHI .ConclusionThe J-AQHI generated by multi-pollutant model demonstrates the actual exposure health risk of air pollution in the population and provides new ideas for further improvement of AQHI calculation methods.

Injury poses heavy burden on public health, but little evidence on the potential role of climate change on injury exists. Here, the authors collect data during 2013-2019 in six provinces of China to estimate the associations between temperature and injury mortality, and to project future mortality burden attributable to temperature change driven by climate change.

Objectives To explore the association between non-high-density lipoprotein (non-HDL) and mortality risk, both short-term and long-term, in Chinese people.Design A prospective cohort study.Setting The National Basic Public Health Service (BPHS) in China.Participants Including 621 164 elderly individuals around Hunan Province who underwent healthcare management receiving check-ups in China BPHS from 2010 to 2020. Exclusion criteria: (1) missing information on gender; (2) missing records of lipid screening; (3) missing information on key covariates; and (4) missing records of comorbidities (cardiovascular disease, hypertension, diabetes, cancer.)Primary and secondary outcome measures The study’s primary endpoint was all-cause and cause-specific mortality, sourced from Hunan’s CDC(Center for Disease Control and Prevention)-operated National Mortality Surveillance System, tracking participants until 24 February 2021.Results 26 758 (4.3%) deaths were recorded, with a median follow-up of 0.83 years. Association between non-HDL and mortality was non-linear after multivariable adjustment, with the optimum concentration (OC) being 3.29 and 4.85 mmol/L. Compared with OC, the risk increased by 1.12-fold for non-HDL

Although studies have estimated the associations of PM2.5 with total mortality or cardiopulmonary mortality, few have comprehensively examined cause-specific mortality risk and burden caused by ambient PM2.5. Thus, this study investigated the association of short-term exposure to PM2.5 with cause-specific mortality using a death-spectrum wide association study (DWAS). Individual information of 5,450,764 deaths during 2013–2018 were collected from six provinces in China. Daily PM2.5 concentration in the case and control days were estimated by a random forest model. A time-stratified case-crossover study design was applied to estimate the associations (access risk, ER) of PM2.5 with cause-specific mortality, which was then used to calculate the population-attributable fraction (PAF) of mortality and the corresponding mortality burden caused by PM2.5. Each 10 μg/m3 increase in PM2.5 concentration (lag03) was associated with a 0.80 % [95 % confidence interval (CI): 0.73 %, 0.86 %] rise in total mortality. We found greater mortality effect at PM2.5 concentrations

BackgroundDrowning is a serious public health problem worldwide. Previous epidemiological studies on the association between meteorological factors and drowning mainly focused on individual weather factors, and the combined effect of mixed exposure to multiple meteorological factors on drowning is unclear. ObjectiveWe aimed to investigate the combined effects of multiple meteorological factors on unintentional drowning mortality in China and to identify the important meteorological factors contributing to drowning mortality. MethodsUnintentional drowning death data (based on International Classification of Diseases, 10th Edition, codes W65-74) from January 1, 2013, to December 31, 2018, were collected from the Disease Surveillance Points System for Guangdong, Hunan, Zhejiang, Yunnan, and Jilin Provinces, China. Daily meteorological data, including daily mean temperature, relative humidity, sunlight duration, and rainfall in the same period were obtained from the Chinese Academy of Meteorological Science Data Center. We constructed a time-stratified case-crossover design and applied a generalized additive model to examine the effect of individual weather factors on drowning mortality, and then used quantile g-computation to estimate the joint effect of the mixed exposure to meteorological factors. ResultsA total of 46,179 drowning deaths were reported in the 5 provinces in China from 2013 to 2018. In an effect analysis of individual exposure, we observed a positive effect for sunlight duration, a negative effect for relative humidity, and U-shaped associations for temperature and rainfall with drowning mortality. In a joint effect analysis of the above 4 meteorological factors, a 2.99% (95% CI 0.26%-5.80%) increase in drowning mortality was observed per quartile rise in exposure mixture. For the total population, sunlight duration was the most important weather factor for drowning mortality, with a 93.1% positive contribution to the overall effects, while rainfall was mainly a negative factor for drowning deaths (90.5%) and temperature and relative humidity contributed 6.9% and –9.5% to the overall effects, respectively. ConclusionsThis study found that mixed exposure to temperature, relative humidity, sunlight duration, and rainfall was positively associated with drowning mortality and that sunlight duration, rather than temperature, may be the most important meteorological factor for drowning mortality. These findings imply that it is necessary to incorporate sunshine hours and temperature into early warning systems for drowning prevention in the future.

Abstract Associations of circulating metabolic biomarkers with type 2 diabetes (T2D) and their added value for risk prediction are uncertain among Chinese adults. A case-cohort study included 882 T2D cases diagnosed during 8-years’ follow-up and a subcohort of 789 participants. NMR-metabolomic profiling quantified 225 plasma biomarkers in stored samples taken at recruitment into the study. Cox regression yielded adjusted hazard ratios (HRs) for T2D associated with individual biomarkers, with a set of biomarkers incorporated into an established T2D risk prediction model to assess improvement in discriminatory ability. Mean baseline BMI (SD) was higher in T2D cases than in the subcohort (25.7 [3.6] vs. 23.9 [3.6] kg/m2). Overall, 163 biomarkers were significantly and independently associated with T2D at false discovery rate (FDR) controlled p

With continued progress of exploration degree on the western slope of Xihu Sag of East China Sea Shelf Basin, exploration strategy has gradually changed from structural reservoirs to structural-lithological composite ones. Through the systematic evaluation of the hydrocarbon-generating potential of coal-measure source rocks, it was concluded that coal seams and carbonaceous mudstone are the main source rocks in this area. According to the study of sedimentary system based on the "Source-to-Sink" system, 8 types of structural-lithological composite trap were proposed. Furthermore, the accumulation conditions and distribution characteristics of oil and gas were studied, it is then confirmed that effectiveness of trap is the main controlling factor for oil-and-gas accumulation in the upper and middle members of Pinghu Formation, while the hydrocarbon-supplying capacity and physical properties of reservoir are the main controlling factor in the lower member of Pinghu Formation. Consequently, a comprehensive evaluation system was established. By the means of the comprehensive evaluation of structural-lithological composite reservoirs, the Eocene-Paleocene delta in Yingcuixuan area of the northern segment of the western slope belt, the Eocene tidal flat-delta in Pingnan, Chuyang and Baoshi areas, and the inner zone of Pinghu slope are large-scale reserve areas, which is valuable and favorable for further exploration.

The Xihu Sag has huge exploration potential and is the main target for oil and gas exploration in the East China Sea Shelf Basin. At present, it has been known that the Xihu Sag has a transitional facies with sedimentary system mainly composed of tidal flat deposits, and the provenance of which is dominated by western and northern uplift area. However, the transport process of sands from source area to deposit area, namely "source-channel-sink" system, has not been well studied. In this study, we take the Pinghu Formation of Baochu slope belt in the Xihu Sag as research object, and use borehole and seismic data to preform high-precision restoration of palaeo-geomorphology. Moreover, on the basis of palaeo-geomorphology restoration, we make qualitative and quantitative analyses of palaeo-water-system and palaeo-break. Results show that the location of sink zone is controlled by palaeo-geomorphology, the distribution of sand transporting channel is controlled by palaeo-water-system, and the development of sedimentary facies is controlled by palaeo-break. Through comprehensive analysis, we suppose that the combination of "palaeo-geomorphology, palaeo-water-system and palaeo-break" restricts the process of sand body deposition from provenance to convergence area through river transportation, and controls the distribution of the sedimentary system of Baochu slope belt.

Abstract Background Immunotherapy using immune checkpoint inhibitors (ICIs), such as antibody of programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) has showed as a promising treatment for esophageal squamous cell carcinoma (ESCC), but resistance is unavoidable. This study aimed to find more immune-related genes to promote the efficiency of immunotherapy. Materials and methods Three datasets were downloaded from Gene Expression Omnibus (GEO) database. Gene differential analysis was performed to identify differentially expressed genes (DEGs), then ceRNA network was constructed based on differentially expressed lncRNAs and mRNAs. Next, Functional enrichment analysis and protein–protein interaction (PPI) network were built to reveal the potential function of mRNAs in ceRNA network. Survival analysis and immune cell infiltration level analysis were utilized to identify prognostic immune-related genes. Finally, pan-cancer analysis was performed to show the role of immune-related genes in other cancers. Results The data of 215 samples in total were obtained from GEO database (98 normal tissues and 117 tumor tissues), and 1685 differentially expressed mRNAs (176 downregulated and 1509 upregulated) and 3 upregulated lncRNAs (MCM3AP-AS1, HCP5 and GUSBP11, all upregulated) were found. ceRNA network was constructed to reveal some special correlation. Function enrichment showed some potential functions of mRNAs in ceRNA network such as mitotic cell cycle process, negative regulation of DNA-binding transcription factor activity, ossification, VEGFA-VEGFR2 signaling pathway, epithelial to mesenchymal transition, embryonic morphogenesis and so on. PPI network showed the physical interactions between each mRNA in ceRNA network. Through survival analysis and immune cell infiltration level analysis, GINS4 was confirmed as an immune-related prognostic gene in ESCC. GSEA showed some potential functions such as negative regulation of monocyte chemotaxis, antigen processing and presentation of endogenous peptide antigen via MHC class I via ER pathway, positive regulation of antigen processing and presentation, dendritic cell antigen processing and presentation and so on. Finally, pan-cancer analysis revealed that GINS4 might be a novel immune-related prognostic gene in ESCC and other cancers. Conclusion Our study suggested that GINS4 was correlated with prognosis and immune cell infiltration level of ESCC and other cancers. It may deserve further investigation as a potential immune-related prognostic biomarker of ESCC and other cancers.

BackgroundThe United Nations Sustainable Development Goals for 2030 include reducing premature mortality from noncommunicable diseases by one-third. Although previous modeling studies have predicted premature mortality from noncommunicable diseases, the predictions for cancer and its subcategories are less well understood in China. ObjectiveThe aim of this study was to project premature cancer mortality of 10 leading cancers in Hunan Province, China, based on various scenarios of risk factor control so as to establish the priority for future interventions. MethodsWe used data collected between 2009 and 2017 from the Hunan cancer registry annual report as empirical data for projections. The population-attributable fraction was used to disaggregate cancer deaths into parts attributable and unattributable to 10 risk factors: smoking, alcohol use, high BMI, diabetes, physical inactivity, low vegetable and fruit intake, high red meat intake, high salt intake, and high ambient fine particulate matter (PM2.5) levels. The unattributable deaths and the risk factors in the baseline scenario were projected using the proportional change model, assuming constant annual change rates through 2030. The comparative risk assessment theory was used in simulated scenarios to reflect how premature mortality would be affected if the targets for risk factor control were achieved by 2030. ResultsThe cancer burden in Hunan significantly increased during 2009-2017. If current trends for each risk factor continued to 2030, the total premature deaths from cancers in 2030 would increase to 97,787 in Hunan Province, and the premature mortality (9.74%) would be 44.47% higher than that in 2013 (6.74%). In the combined scenario where all risk factor control targets were achieved, 14.41% of premature cancer mortality among those aged 30-70 years would be avoided compared with the business-as-usual scenario in 2030. Reductions in the prevalence of diabetes, high BMI, ambient PM2.5 levels, and insufficient fruit intake played relatively important roles in decreasing cancer premature mortality. However, the one-third reduction goal would not be achieved for most cancers except gastric cancer. ConclusionsExisting targets on cancer-related risk factors may have important roles in cancer prevention and control. However, they are not sufficient to achieve the one-third reduction goal in premature cancer mortality in Hunan Province. More aggressive risk control targets should be adopted based on local conditions.

BackgroundSolid predominant adenocarcinoma (SPA) has been reported to be a subtype with poor prognosis and unsatisfactory response to chemotherapy and targeted therapy in lung adenocarcinoma (LUAD). However, the underlying mechanisms remain largely unknown and the suitability of immunotherapy for SPA has not been investigated.MethodsWe conducted a multi-omics analysis of 1078 untreated LUAD patients with clinicopathologic, genomic, transcriptomic, and proteomic data from both public and internal cohorts to determine the underlying mechanisms of poor prognosis and differential therapeutic responses of SPA and to investigate the potential of immunotherapy for SPA. The suitability of immunotherapy for SPA was further confirmed in a cohort of LUAD patients who received neoadjuvant immunotherapy in our center.ResultsAlong with its aggressive clinicopathologic behaviors, SPA had significantly higher tumor mutation burden (TMB) and number of pathways altered, lower TTF-1 and Napsin-A expression, higher proliferation score and a more immunoresistant microenvironment than non-solid predominant adenocarcinoma (Non-SPA), accounting for its worse prognosis. Additionally, SPA had significantly lower frequency of therapeutically targetable driver mutations and higher frequency of EGFR/TP53 co-mutation which was related to resistance to EGFR tyrosine kinase inhibitors, indicating a lower potential for targeted therapy. Meanwhile, SPA was enriched for molecular features associated with poor response to chemotherapy (higher chemoresistence signature score, lower chemotherapy response signature score, hypoxic microenvironment, and higher frequency of TP53 mutation). Instead, muti-omics profiling revealed that SPA had stronger immunogenicity and was enriched for positive biomarkers for immunotherapy (higher TMB and T cell receptor diversity; higher PD-L1 expression and more immune cell infiltration; higher frequency of gene mutations predicting efficacious immunotherapy, and elevated expression of immunotherapy-related gene signatures). Furthermore, in the cohort of LUAD patients who received neoadjuvant immunotherapy, SPA had higher pathological regression rates than Non-SPA and patients with major pathological response were enriched in SPA, confirming that SPA was more prone to respond to immunotherapy.ConclusionsCompared with Non-SPA, SPA was enriched for molecular features associated with poor prognosis, unsatisfactory response to chemotherapy and targeted therapy, and good response to immunotherapy, indicating more suitability for immunotherapy while less suitability for chemotherapy and targeted therapy.

Background: In China, there are few studies that have reported future estimations for cancer mortality. Therefore, this study aimed to assess cancer mortality in China and identify priorities for future cancer control strategies. Methods: Based on the Global Burden of Disease 2019 study, we extracted data on cancer-related deaths from 1990 to 2019 in Hunan Province, China. Under the current trends evaluated using a joinpoint regression model, we fitted a linear regression model for cancer mortality projections by 2025. Results: The age-standardized mortality rate of total cancer in Hunan, China, declined slowly and is projected to be 140.80 (95% confidence interval [CI]: 140.12–141.48) by 2025, with the mortality rate in men approximately twice that in women. In 2025, the top five causes of cancer-related deaths in males are projected to be lung, liver, colorectal, stomach, and esophageal cancers, with the corresponding causes in females being lung, breast, colorectal, liver, and cervical cancers. Between 2019 and 2025, male mortality rates due to liver and pancreatic cancer are expected to increase, while those due to the six leading female cancers will increase. Excess male deaths were associated with liver and esophageal cancers, while all main cancers in females will have excess mortality, except for colorectal cancer. Conclusion: A comprehensive cancer spectrum characteristic of both developing and developed countries will remain in Hunan, China. Lung cancer remains the most common cause of cancer-related deaths, and tobacco control efforts are urgently required. Additional efforts should be made to promote universal screening, improve access to cancer healthcare services, optimize medical payment models, and enhance access to valuable anticancer drugs.

Background: Although many studies have reported the mortality effect of temperature, there were few studies on the mortality risk of humidity, let alone the joint effect of temperature and humidity. This study aimed to investigate the joint and interaction effect of high temperature and relative humidity on mortality in China, which will deepen understanding the health risk of mixture climate exposure. Methods: The mortality and meteorological data were collected from 353 locations in China (2013–2017 in Jilin, Hunan, Guangdong and Yunnan provinces, 2009–2017 in Zhejiang province, and 2006–2011 in other Provinces). We defined location-specific daily mean temperature ≥ 75th percentile of distribution as high temperature, while minimum mortality relative humidity as the threshold of high relative humidity. A time-series model with a distributed lag non-linear model was first employed to estimate the location-specific associations between humid-hot events and mortality, then we conducted meta-analysis to pool the mortality effect of humid-hot events. Finally, an additive interaction model was used to examine the interactive effect between high temperature and relative humidity. Results: The excess rate (ER) of non-accidental mortality attributed to dry-hot events was 10.18% (95% confidence interval (CI): 8.93%, 11.45%), which was higher than that of wet-hot events (ER = 3.21%, 95% CI: 0.59%, 5.89%). The attributable fraction (AF) of mortality attributed to dry-hot events was 10.00% (95% CI: 9.50%, 10.72%) with higher burden for females, older people, central China, cardiovascular diseases and urban city. While for wet-hot events, AF was much lower (3.31%, 95% CI: 2.60%, 4.30%). We also found that high temperature and low relative humidity had synergistic additive interaction on mortality risk. Conclusion: Dry-hot events may have a higher risk of mortality than wet-hot events, and the joint effect of high temperature and low relative humidity may be greater than the sum of their individual effects.

BackgroundLittle is known about the effect of histology on the efficacy of immune checkpoint inhibitors (ICI) in non-small-cell lung cancer (NSCLC). We conducted a systematic review and meta-analysis to assess the potential differences in the efficacy of ICIs between squamous NSCLC (SQ-NSCLC) and non-squamous NSCLC (non-SQ-NSCLC).MethodsSystematic searches of PubMed, Embase, Scopus, and Cochrane Library databases were conducted. All randomized clinical trials of ICIs with available hazard ratios (HR) for progression-free survival (PFS) or overall survival (OS) according to histology were included. The primary endpoint was to assess the difference in the efficacy of ICIs between SQ-NSCLC and non-SQ-NSCLC, measured by the ratio of the HR in SQ-NSCLC to the HR in non-SQ-NSCLC (RHR).ResultsA total of 40 trials were included in the meta-analysis. ICI monotherapy could improve OS in both SQ-NSCLC (OS-HR 0.71, 95% CI 0.65-0.77) and non-SQ-NSCLC (OS-HR 0.80, 95% CI 0.73-0.87) while OS benefit was larger in SQ-NSCLC (OS-RHR 0.89, 95% CI 0.80-0.99). In terms of PFS, ICI monotherapy could reduce the risk of progression by 35% (PFS-HR 0.65, 95% CI 0.56-0.77) in SQ-NSCLC while the PFS benefit was smaller (10%) and not statistically significant in non-SQ-NSCLC (PFS-HR 0.90, 95% CI 0.76-1.07). Similarly, ICI-based combination treatments could reduce the risk of both progression and death in SQ-NSCLC (OS-HR 0.70, 95% CI 0.61-0.80; PFS-HR 0.56, 95% CI 0.48-0.65) and non-SQ-NSCLC (OS-HR 0.78, 95% CI 0.74-0.83; PFS-HR 0.63, 95% CI 0.57-0.69) while the survival benefits were larger in SQ-NSCLC (OS-RHR 0.83, 95% CI 0.70-0.99; PFS-RHR 0.82, 95% CI 0.70-0.96).ConclusionsICIs could deliver survival benefits in both SQ-NSCLC and non-SQ-NSCLC while the magnitude of survival benefits was histology-dependent. Future researches should consider the effect of histology on the efficacy of ICIs.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier [CRD42022299603].

Abstract Background Here, by using the lipopolysaccharide (LPS)‐induced mice sepsis model, we treated septic wild‐type (WT) mice or MEK1DD mice with rigosertib to evaluate its prospective effects on sepsis. Methods We also generated macrophages derived from bone marrow from WT or MEK1DD mice. These macrophages were pretreated with rigosertib and then induced with LPS or poly I:C. Results Rigosertib suppressed LPS or poly I:C‐induced expression of inflammatory cytokines (tumor necrosis factor‐alpha [TNF‐α] and interleukin‐6 [IL‐6], and IL‐23) in WT bone marrow–derived macrophages while failed to affect the upregulation of TNF‐α and IL‐6 in LPS‐treated bone marrow–derived macrophages from MEK1DD mice. Rigosertib promoted survival rate, ameliorated lung injury, and reduced inflammatory cytokine levels in serum of WT septic mice. Conclusion In contrast, the effects of rigosertib on sepsis were abrogated in septic MEK1DD mice, which had inducible constitutive activation of MEK1 signaling. Rigosertib alleviated LPS‐induced sepsis inhibits MEK1/ERK signaling pathway.

Abstract Background Several studies have investigated the associations between ambient temperature and years of life lost (YLLs), but few focused on the difference of life loss attributable to temperature among different socioeconomic development levels. Objectives We investigated the disparity in temperature-YLL rate relationships and life loss per death attributable to nonoptimal temperature in regions with various development levels. Methods Three hundred sixty-four Chinese counties or districts were classified into 92 high-development regions (HDRs) and 272 low-development regions (LDRs) according to socioeconomic factors of each location using K-means clustering approach. We used distributed lag non-linear models (DLNM) and multivariate meta-analysis to estimate the temperature-YLL rate relationships. We calculated attributable fraction (AF) of YLL and temperature-related average life loss per death to compare mortality burden of temperature between HDRs and LDRs. Stratified analyses were conducted by region, age, sex and cause of death. Results We found that non-optimal temperatures increased YLL rates in both HDRs and LDRs, but all subgroups in LDRs were more vulnerable. The disparity of cold effects between HDRs and LDRs was significant, while the difference in heat effect was insignificant. The overall AF of non-optimal temperature in LDRs [AF = 12.2, 95% empirical confidence interval (eCI):11.0–13.5%] was higher than that in HDRs (AF = 8.9, 95% eCI: 8.3–9.5%). Subgroups analyses found that most groups in LDRs had greater AFs than that in HDRs. The average life loss per death due to non-optimal temperature in LDRs (1.91 years, 95% eCI: 1.72–2.10) was also higher than that in HDRs (1.32 years, 95% eCI: 1.23–1.41). Most of AFs and life loss per death were caused by moderate cold in both HDRs and LDRs. Conclusions Mortality burden caused by temperature was more significant in LDRs than that in HDRs, which means that more attention should be paid to vulnerable populations in LDRs in planning adaptive strategies.

A low exploration success ratio on the Baochu Slope of Xihu Sag of East China Sea has been inferred, and the ratio in the Central Anticline Belt varies significantly in different sub structures. To solve this issue, the petroleum geologic conditions of the sag were systematically reviewed in light of new basin analysis methodologies, and new understanding have been achieved. Due to the differences in tectonic features and evolution histories, the Baochu Slope and Central Anticline Belt developed different petroleum systems and play types. Only those areas with overlapping favorable fairways of all petroleum system elements promise the formation of large oil and gas fields. The Baochu Slope is featured by tectonic rifting, with weak later compression and early structure formation. Its favorable conditions for hydrocarbon accumulation include: short distance to the main source kitchen; multiple, overlapping, large-scale reservoirs; multiple structural-stratigraphic trap types; good vertical sealing zones; and effective lattice pattern migration pathways. The large to medium structural-stratigraphic fields are concentrated in fairways with a large scale source kitchen and updip pinchout of tide-dominated delta sands controlled by paleo slope break which in turn were induced by either faulting or paleo morphology. The Central Anticline Belt has experienced strong inversion and compression during the late depression stage, and developed inverted compressional slip faults and large scale anticlines. Hydrocarbon accumulation is controlled by four major factors: preexisting structural highs before the compressional event, large scale structural-lithological traps, excellent timing of hydrocarbon charging during deformation, and highly effective reservoir-seal combinations. The areas with good congruence of these contro-lling factors promise the occurrence of large-scale deposits such Longjing, Guzhenzhu, Huxinting fields.

BackgroundProstate cancer (PCa) is the most common malignant tumor in men. Although clinical treatments of PCa have made great progress in recent decades, once tolerance to treatments occurs, the disease progresses rapidly after recurrence. PCa exhibits a unique metabolic rewriting that changes from initial neoplasia to advanced neoplasia. However, systematic and comprehensive studies on the relationship of changes in the metabolic landscape of PCa with tumor recurrence and treatment response are lacking. We aimed to construct a metabolism-related gene landscape that predicts PCa recurrence and treatment response.MethodsIn the present study, we used differentially expressed gene analysis, protein–protein interaction (PPI) networks, univariate and multivariate Cox regression, and least absolute shrinkage and selection operator (LASSO) regression to construct and verify a metabolism-related risk model (MRM) to predict the disease-free survival (DFS) and response to treatment for PCa patients.ResultsThe MRM predicted patient survival more accurately than the current clinical prognostic indicators. By using two independent PCa datasets (International Cancer Genome Consortium (ICGC) PCa and Taylor) and actual patients to test the model, we also confirmed that the metabolism-related risk score (MRS) was strongly related to PCa progression. Notably, patients in different MRS subgroups had significant differences in metabolic activity, mutant landscape, immune microenvironment, and drug sensitivity. Patients in the high-MRS group were more sensitive to immunotherapy and endocrine therapy, while patients in the low-MRS group were more sensitive to chemotherapy.ConclusionsWe developed an MRM, which might act as a clinical feature to more accurately assess prognosis and guide the selection of appropriate treatment for PCa patients. It is promising for further application in clinical practice.

BackgroundThe Spring Festival is one of the most important traditional festivals in China. This study aimed to estimate the mortality risk attributable to the Spring Festival.MethodsBetween 2013 and 2017, daily meteorological, air pollution, and mortality data were collected from 285 locations in China. The Spring Festival was divided into three periods: pre-Spring Festival (16 days before Lunar New Year's Eve), mid-Spring Festival (16 days from Lunar New Year's Eve to Lantern Festival), and post-Spring Festival (16 days after Lantern Festival). The mortality risk attributed to the Spring Festival in each location was first evaluated using a distributed lag nonlinear model (DLNM), and then it was pooled using a meta-analysis model.ResultsWe observed a dip/rise mortality pattern during the Spring Festival. Pre-Spring Festival was significantly associated with decreased mortality risk (ER: −1.58%, 95%CI: −3.09% to −0.05%), and mid-Spring Festival was unrelated to mortality risks, while post-Spring Festival was significantly associated with increased mortality risk (ER: 3.63%, 95%CI: 2.15–5.12%). Overall, a 48-day Spring Festival period was associated with a 2.11% (95%CI: 0.91–3.33%) increased mortality. We also found that the elderly aged over 64 years old, women, people with cardiovascular disease (CVD), and people living in urban areas were more vulnerable to the Spring Festival.ConclusionOur study found that the Spring Festival significantly increased the mortality risk in China. These findings suggest that it is necessary to develop clinical and public health policies to alleviate the mortality burden associated with the Spring Festival.

This study aimed to investigate the mismatch between the preferred and actual roles in the medical decision-making of intensive care unit (ICU) patients’ family members and the relationship between the role mismatch of family members’ decisions and anxiety and depression syndromes. A total of 223 family members of ICU patients in the Affiliated Hospital of Jiangnan University in China were enrolled. The simple Chinese version of the Control Preference Scale was used to complete the surveys to assess the preferred and actual roles, and anxiety and depression syndromes were measured using the Generalized Anxiety Disorder-7 scale and Patient Health Questionnaire-9, respectively. For the preferred and actual roles, the active role rates were 16.1% and 8.1%, the cooperative role rates were 49.3% and 31.4%, and the passive role rates were 34.5% and 60.5%, respectively. The incidence of mismatch was 43.0% between the preferred and actual roles, and the consistency between their preferred and actual decision-making roles was poor (kappa = 0.309, P

Rock temperature reflects the adjustment in crustal stress, and the fluctuation of ionospheric electron concentration is closely related to short-term disturbances of the stress field. Their coupling may reveal short-term effects before strong earthquakes. This study explores the rock temperature changes and mechanical-electrical coupling in the lithosphere–ionosphere before the Jiashi Ms6.4 earthquake on 19 January 2020. The observed data were detrended by general polynomial piecewise fitting; three observation points within 150 km of the epicenter were found to show significant temperature fluctuations in the 15 days before the earthquake. The peak occurred synchronously five days before the earthquake, and the variation range was approximately 10−3 orders of magnitude. Five days before the earthquake, the electromagnetic satellite Zhangheng-1 synchronously observed an anomalous electron concentration in orbit near the epicenter, with a maximum value of 2.01 × 1010 m−3. The loading/unloading response ratio (LURR) was calculated using small earthquakes within 100 km of the epicenter; it showed that the large changes in rock temperature and the ionosphere occurred at high LURR, indicating high-stress accumulation in the region. Various anomalies appeared simultaneously and may indicate fault rupture, which may be caused by an acoustic-gravity wave, indicating a synchronous coupling between the lithosphere atmosphere and the ionosphere.

Summary: Although numerous studies have investigated premature deaths attributable to temperature, effects of temperature on years of life lost (YLL) remain unclear. We estimated the relationship between temperatures and YLL, and quantified the YLL per death caused by temperature in China. We collected daily meteorological and mortality data, and calculated the daily YLL values for 364 locations (2013–2017 in Yunnan, Guangdong, Hunan, Zhejiang, and Jilin provinces, and 2006–2011 in other locations) in China. A time-series design with a distributed lag nonlinear model was first employed to estimate the location-specific associations between temperature and YLL rates (YLL/100,000 population), and a multivariate meta-analysis model was used to pool location-specific associations. Then, YLL per death caused by temperatures was calculated. The temperature and YLL rates consistently showed U-shaped associations. A mean of 1.02 (95% confidence interval: 0.67, 1.37) YLL per death was attributable to temperature. Cold temperature caused 0.98 YLL per death with most from moderate cold (0.84). The mean YLL per death was higher in those with cardiovascular diseases (1.14), males (1.15), younger age categories (1.31 in people aged 65–74 years), and in central China (1.34) than in those with respiratory diseases (0.47), females (0.87), older people (0.85 in people ≥75 years old), and northern China (0.64) or southern China (1.19). The mortality burden was modified by annual temperature and temperature variability, relative humidity, latitude, longitude, altitude, education attainment, and central heating use. Temperatures caused substantial YLL per death in China, which was modified by demographic and regional characteristics.

BackgroundTo investigate the effects of short-term exposure to sulfur dioxide (SO2) and carbon monoxide (CO) in the central and southern China areas on ischemic heart disease (IHD) and non-accidental deaths.MethodWe investigated the associations between short-term exposure to SO2 and CO in a city in south-central China and IHD and non-accidental death using a time-series design and generalized additive models with up to a 5-day lag adjusting for day of the week, temperature, air pressure, wind speed, and relative humidity. The relative risks of IHD and non-accidental death per 10-unit increase in SO2 and CO were derived from zero to five days in single-pollutant models.ResultsBetween 2016 and 2018, a total of 10,507 IHD and 44,070 non-accidental deaths were identified. The largest significant relative risk for IHD death was lag 02 for both SO2 (1.080; 95% confidence interval: 1.075-1.084) and CO (5.297; 95% confidence interval: 5.177-5.418) in single-pollutants models. A significant association was shown at all lag multiple-day moving averages. Two-pollutant models identified an association between SO2 and mortality when adjusting for CO. In stratified analyses, SO2 exhibited a stronger association with death during the cold season, while CO exhibited a stronger association with mortality from IHD during the warm season. The risk of death was more robust in the elderly for both pollutants, but was greater in men for CO and in women for SO2.ConclusionsOverall, we found an association between short-term exposure to low-level SO2 and CO and the risk of IHD and non-accidental death.

Background In 2011, the United Nations set a target to reduce premature mortality from non-communicable diseases (NCDs) by 25% by 2025. While studies have reported the target in some countries, no studies have been done in China. This study aims to project the ability to reach the target in Hunan Province, China, and establish the priority for future interventions. Methods We conducted the study during 2019–2020. From the Global Burden of Disease Study 2016, we extracted death data for Hunan during 1990–2016 for four main NCDs, namely cancer, cardiovascular disease (CVD), chronic respiratory diseases, and diabetes. We generated estimates for 2025 by fitting a linear regression to the premature mortality over the most recent trend identified by a joinpoint regression model. We also estimated excess premature mortality attributable to unfavorable changes over time. Results The rate of premature mortality from all NCDs in Hunan will be 19.5% (95% CI [19.0%–20.1%]) by 2025, with the main contributions being from CVD (8.2%, 95% CI [7.9%–8.5%]) and cancer (7.9%, 95% CI [7.8%–8.1%]). Overall, it will be impossible to achieve the target, with a relative reduction of 16.4%. Women may be able to meet the target except with respect to cancer, and men will not except with respect to chronic respiratory diseases. Most of the unfavorable changes have occurred since 2008–2009. Discussion More urgent efforts, especially for men, should be exerted in Hunan by integrating population-wide interventions into a stronger health-care system. In the post lock-down COVID-19 era in China, reducing the NCD risk factors can also lower the risk of death from COVID-19.

The coseismic geothermal changes of ground temperature observed at observatories near the epicenter of the 2020 Jiashi Ms = 6.4 earthquake in China, provide a unique opportunity to study heat generation and conduction in rock. Here, evolutions of rock temperature at the Xikeer, Jiashizongchang, and Gedaliang observatories, which are located at epicentral distances of 1.4, 27.42, and 50 km respectively, were analyzed. Significant coseismic geothermal changes of 0.0432 °C were observed at the Xikeer observatory at the depth of 33.38 m, at which clear diurnal variations can be observed. Smaller changes of ~0.0001 °C were observed at the depths of 12.3 and 22.8 m at the Xikeer observatory and 22.3 m at the Jiashizongchang observatory. The stress transfer induced by the coseismic rupture induced a rise in local ground temperature, but the magnitude of the change was relatively small. The larger amplitude change at the Xikeer observatory was caused by fluid infiltration. We note that diurnal variation has been recorded at the Gedaliang observatory, but the coseismic response is no longer in existence. The temperature increases at the hypocentral area were higher than expected in the ground due to the coseismic stress transfer, but the change attenuated rapidly with distance.

Stress may induce apparent resistivity changes. Clarifying the deformation process of the source media is critical for determining the correlations between resistivity variations and earthquake occurrence. In this study, the stress state of a medium was analyzed by integrating GPS measurements, the spatiotemporal evolution of the load/unload response ratio (LURR), geochemical monitoring, and synchronous apparent resistivity changes preceding the 2020 Mw 6.0 Jiashi earthquake. The medium hosting the Kalpin Observatory underwent elastic deformation before 2019, and the synchronous decreases in the E–W and N–S apparent resistivities from 2015 can be attributed to N–S-dominated compressive stress. The microdamage stage occurred in 2019, with subsequent E–W apparent resistivity variation amplitudes that were ~0.4 Ωm higher than those in previous years. This difference is a result of microdamage to the medium owing to tensile stress during the seismogenic process. The spatiotemporal evolution of the LURR and gas seepage monitoring data also indicate that the medium was damaged prior to the earthquake. Variations in the apparent resistivity measured at the Kalpin Observatory indicate that the medium underwent elastic deformation, followed by microdamage, until stress triggered the earthquake.

Abstract Background Urbanization is associated with an increased risk for a number of diseases, including obesity, diabetes, and cancer, which all also show associations with the microbiome. While microbial community composition has been shown to vary across continents and in traditional versus Westernized societies, few studies have examined urban-rural differences in neighboring communities within a single country undergoing rapid urbanization. In this study, we compared the gut microbiome, plasma metabolome, dietary habits, and health biomarkers of rural and urban people from a single Chinese province. Results We identified significant differences in the microbiota and microbiota-related plasma metabolites in rural versus recently urban subjects from the Hunan province of China. Microbes with higher relative abundance in Chinese urban samples have been associated with disease in other studies and were substantially more prevalent in the Human Microbiome Project cohort of American subjects. Furthermore, using whole metagenome sequencing, we found that urbanization was associated with a loss of microbial diversity and changes in the relative abundances of Viruses, Archaea, and Bacteria. Gene diversity, however, increased with urbanization, along with the proportion of reads associated with antibiotic resistance and virulence, which were strongly correlated with the presence of Escherichia and Shigella. Conclusions Our data suggest that urbanization has produced convergent evolution of the gut microbial composition in American and urban Chinese populations, resulting in similar compositional patterns of abundant microbes through similar lifestyles on different continents, including a loss of potentially beneficial bacteria and an increase in potentially harmful genes via increased relative abundance of Escherichia and Shigella.

Diaphragmatic injury is a common clinical condition, and it may be difficult to avoid diaphragmatic hernia if detection and treatment is not timely. Parasternal hernia is mostly congenital. It is relatively rare in adults, and intestinal obstruction as a complication of intrathoracic intestinal herniation occurs only rarely. We treated a patient in whom parasternal hernia occurred 2 years after thoracic injuries. We present the plain radiography and computed tomography findings of this adult patient with acute abdomen symptoms caused by parasternal hernia. Keywords: Parasternal hernia, Obstruction, Jejunal necrosis

Bladder urothelial carcinoma (BC) has been identified as one of the most common malignant neoplasm worldwide. High-grade bladder urothelial carcinoma (HGBC) is aggressive with a high risk of recurrence, progression, metastasis, and poor prognosis. Therefore, HGBC clinical management is still a challenge. We performed the present study to seek new urine biomarkers for HGBC and investigate how they promote HGBC progression and thus affect the prognosis based on large-scale sequencing data. We identified the overlapped differentially expressed genes (DEGs) by combining GSE68020 and The Cancer Genome Atlas (TCGA) datasets. Subsequent receiver operating characteristic (ROC) curves, Kaplan-Meier (KM) curves, and Cox regression were conducted to test the diagnostic and prognostic role of the hub genes. Chi-square test and logistic regression were carried out to analyze the associations between clinicopathologic characteristics and the hub genes. Ultimately, we performed gene set enrichment analysis (GSEA), protein-protein interaction (PPI) networks, and Bayesian networks (BNs) to explore the underlying mechanisms by which ECM1, CRYAB, CGNL1, and GPX3 are involved in tumor progression. Immunohistochemistry based on The Human Protein Atlas and quantitative real-time polymerase chain reaction based on urine samples confirmed the downregulation and diagnostic values of the hub genes in HGBC. In conclusion, our study indicated that CRYAB, CGNL1, ECM1, and GPX3 are potential urine biomarkers of HGBC. These four novel urine biomarkers will have attractive applications to provide new diagnostic methods, prognostic predictors and treatment targets for HGBC, which could improve the prognosis of HGBC patients, if validated by further experiments and larger prospective clinical trials.

Introduction Salt intake in China (≈12 g/day) is more than twice the upper limit recommended by the WHO (5 g/day). To reduce salt intake, Action on Salt China (ASC) was launched in 2017. As one of four randomised controlled trials (RCTs) in the ASC programme, a comprehensive intervention study was designed to test whether all the components of the interventions adopted by other RCTs are acceptable, scalable and effective when provided to a region in the real world.Methods and analysis Using a cluster RCT design, 2688 participants were selected from 48 towns (clusters) in 12 counties in 6 provinces and assigned to the intervention group or the control group. Randomisation was performed after the baseline survey was completed. Information on salt-related knowledge, attitude and practice (KAP), blood pressure and 24-hour urinary sodium were collected. The intervention includes government engagement, health education and other intervention components targeting restaurants, home cooks and primary school students and their families that have been used in other RCTs. The control group will not receive the intervention. The project will be followed up for 2 years, with the intervention being carried out for the first year only. The primary outcome is salt intake measured by 24-hour urinary sodium excretion after 1 year. The secondary outcomes are the long-lasting effectiveness on salt intake and blood pressure measured by the same method, as well as salt-related KAP and blood pressure at the 1-year and 2-year follow-ups. Process evaluation and health economics analysis will be conducted as well.Ethics and dissemination The study was reviewed and approved by the Institutional Review Board of the National Center for Chronic and Noncommunicable Disease Control and Prevention, the Chinese Center for Disease Control and Prevention, and Queen Mary Research Ethics Committee. Results will be disseminated through presentations, publications and social media.Trial registration number ChiCTR1800018119

Many studies have linked temperature with respiratory deaths, but epidemiological evidence of temperature-attributable years of life lost (YLL) from respiratory diseases is limited. Daily respiratory YLL rates were calculated using mortality data from 364 locations of China during 2006–2017, and meteorological data were collected for the same period. First, the distributed lag non-linear model (DLNM) was applied to estimate specific temperature-respiratory YLL rate associations in each location. Then multivariable meta-analysis was conducted to pool the location-specific estimates. Finally, we calculated the average life loss per death (LLD) to quantify the respiratory mortality burden of non-optimal temperature. Subgroup analyses were conducted by gender, age, region and cause of death. Inversely J-shaped association was observed between non-optimal temperature and respiratory YLL rate in China. The minimum YLL-rate temperature was 26.9 °C nationwide. An average of 1.37 years (95% CI: 1.06–1.65) LLD was attributable to non-optimal temperatures with 2.06 years (95% CI: 1.57–2.60) for pneumonia, 2.03 years (95% CI: 1.76–2.31) for chronic lower respiratory infections (LRTI), 0.88 years (95% CI: 0.65–1.09) for chronic obstructive pulmonary disease (COPD), most of which was attributed to moderate cold (0.73 years, 95% CI: 0.65–0.80). LLD caused by non-optimal temperature was higher in males, the young, and north China. Exposure to non-optimal temperature increases respiratory YLL rate in China, most of which were attributed to moderate cold. People with respiratory diseases including pneumonia, chronic LRTI and COPD are vulnerable to non-optimal temperature exposure. The result of this study provides useful information to reduce temperature-related respiratory disease burden.

Background Cost-effective strategies of chronic disease control, integrated health education and health promotion play important roles in the programs of chronic disease demonstration districts in China. The performance of these districts can be directly assessed by their health education and promotion work. However, there have been only a few performance assessments done on these programs, most of which made without the inclusion of proper quality indicators. This study was designed to establish a framework of indicators for outcome evaluation of health education and promotion efforts in Chinese districts, and explore the factors involved in promoting these efforts. Methods A modified two-round Delphi survey was first used to construct quality indicators on a nine-point Likert scale. With those indicators, the rank sum ratio (RSR) method was then conducted through rank conversion and parametric statistics, to assess and classify the performance of ten districts or counties randomly chosen both from demonstration and non-demonstration districts in the Hunan province. Results The Delphi process produced seven themes and 25 sub-themes as quality indicators. The seven themes included organizational management, financial support, professional personnel, health education and promotion, residents’ health awareness and behaviors, residents’ satisfaction, and residents’ health literacy. The districts were classified into four levels by RSR as follows: One demonstration district at the first-ranked level, five other demonstration districts at the second-ranked level, all non-demonstration districts at the third-ranked level. None were at the fourth-qualified level. Discussion Chronic disease demonstration districts performed better on the work of health education and health promotion than the non-demonstration districts. The work should be focused on the following measures of chronic diseases: organizational management, financial support, media-related broadcasting, technical support, community-based promotion and supportive environment, and people’s enhanced awareness and health literacy.

Previous studies have shown that Hunan Province has a high incidence of stroke and a high proportion of intracerebral hemorrhage (ICH). Considering the changes over the past three decades, little is known about the current epidemiological characteristics of stroke in Hunan Province. In 2013, a cross-sectional study was conducted at seven national disease surveillance points (DSPs) in Hunan Province. A multistage cluster sampling method was used to select a representative sample. A total of 21,156 participants aged 20 years and older were examined. Among the 21,156 participants, the number of prevalent strokes, incident strokes and deaths was 307, 87, and 36, respectively. The 2010 China census-standardized prevalence, incidence and mortality were 1191.0 per 100,000 people [95% confidence interval (CI) 1044.8–1337.2], 333.6 per 100,000 person-years (95% CI 255.7–411.5) and 129.7 per 100,000 person-years (95% CI 81.1–178.3), respectively. Ischemic stroke (IS), ICH, subarachnoid hemorrhage (SAH), and stroke of undetermined type (UND) constituted 50.6, 41.4, 5.7, and 2.3% of all incident stroke cases, respectively. Tianxin, Liuyang, Wuling, and Hongjiang have high proportions of ICH (61.5, 58.3, 60, and 50%, respectively). Hypertension is the most common risk factor for prevalent stroke (71.34%), followed by smoking (30.62%) and alcohol use (25.73%). In conclusion, Hunan Province has an extremely heavy stroke burden. The high proportion of ICH is not limited to the Changsha community; it represents an important issue for all of Hunan Province.

Summary: Background: The age-specific association between blood pressure and vascular disease has been studied mostly in high-income countries, and before the widespread use of brain imaging for diagnosis of the main stroke types (ischaemic stroke and intracerebral haemorrhage). We aimed to investigate this relationship among adults in China. Methods: 512 891 adults (59% women) aged 30–79 years were recruited into a prospective study from ten areas of China between June 25, 2004, and July 15, 2008. Participants attended assessment centres where they were interviewed about demographic and lifestyle characteristics, and their blood pressure, height, and weight were measured. Incident disease was identified through linkage to local mortality records, chronic disease registries, and claims to the national health insurance system. We used Cox regression analysis to produce adjusted hazard ratios (HRs) relating systolic blood pressure to disease incidence. HRs were corrected for regression dilution to estimate associations with long-term average (usual) systolic blood pressure. Findings: During a median follow-up of 9 years (IQR 8–10), there were 88 105 incident vascular and non-vascular chronic disease events (about 90% of strokes events were diagnosed using brain imaging). At ages 40–79 years (mean age at event 64 years [SD 9]), usual systolic blood pressure was continuously and positively associated with incident major vascular disease throughout the range 120–180 mm Hg: each 10 mm Hg higher usual systolic blood pressure was associated with an approximately 30% higher risk of ischaemic heart disease (HR 1·31 [95% CI 1·28–1·34]) and ischaemic stroke (1·30 [1·29–1·31]), but the association with intracerebral haemorrhage was about twice as steep (1·68 [1·65–1·71]). HRs for vascular disease were twice as steep at ages 40–49 years than at ages 70–79 years. Usual systolic blood pressure was also positively associated with incident chronic kidney disease (1·40 [1·35–1·44]) and diabetes (1·14 [1·12–1·15]). About half of all vascular deaths in China were attributable to elevated blood pressure (ie, systolic blood pressure >120 mm Hg), accounting for approximately 1 million deaths (