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This study focuses on improving environmental protection and facilitating coordinated economic and social development in the Yangtze River Economic Belt (YREB). Examining the progress of green development in 11 provinces and cities within the YREB. The Super SBM model and the GML index model were utilized to assess the green development efficiency of these regions from 2008 to 2021. Additionally, the spatial distribution, evolutionary trends, and determinants of green development were explored through hot and cold spot analysis, kernel density estimation, the random forest RF method, and the Tobit model.Findings indicate that the overall green development efficiency in these provinces and cities is relatively notable, with the upstream and downstream areas exhibiting higher efficiency compared to the midstream regions. Shanghai and Zhejiang have emerged as frontrunners in green development. Analysis of hot and cold spots revealed that hot spots are predominantly located in the Yangtze River Delta, while sub-cold spots extend upstream, forming concentrated and contiguous cold spot areas in the midstream reaches. Kernel densities show that green development is more efficient overall and in particular in upstream and downstream areas. In contrast, the midstream regions have witnessed a decline in this efficiency. Regarding influencing factors, ecological environmental protection is identified as a direct influence on the efficiency of green development. Furthermore, the degrees of economic advancement, governmental support, and investment in pioneering science and technology exert substantial influence on green development..

Dark-field microscopy offers several advantages, including high image contrast, minimal cell damage, and the absence of photobleaching of nanoprobes, which make it highly advantageous for cell imaging. The NIR-II window has emerged as a prominent research focus in optical imaging in recent years, with its low autofluorescence background in biological samples and high imaging SBR. In this study, we initially compared dark-field imaging results of colorectal cancer cells in both visible and NIR-II wavelengths, confirming the superior performance of NIR-II imaging. Subsequently, we synthesized gold nanorods with localized surface plasmon resonance (LSPR) absorption peaks in the NIR-II window. After bio-compatible modification, we non-specifically labeled colorectal cancer cells for NIR-II dark-field scattering imaging. The imaging results revealed a sixfold increase in SBR, especially in the 1425–1475 nm wavelength range. Finally, we applied this imaging system to perform dark-field imaging of cell nuclei in the NIR-II region and used GNRs for specific nuclear labeling in colorectal cancer cells. The resulting images exhibited higher SBR than non-specifically-labeled cell imaging, and the probe’s labeling was precise, confirming the potential application of this system in photothermal therapy and drug delivery for cancer cells.

Routine PCR, Sanger sequencing, and specially designed GAP-PCR are often used in the genetic analysis of thalassemia, but all these methods have limitations. In this study, we evaluated a new third-generation sequencing-based approach termed comprehensive analysis of thalassemia alleles (CATSA) in subjects with no variants identified by routine PCR, Sanger sequencing, and specially designed GAP-PCR. Hemoglobin testing and routine PCR tests for 23 common variants were performed for 3,033 subjects. Then, Sanger sequencing and specially designed GAP-PCR were performed for a subject with no variants identified by routine PCR, no iron deficiency, and positive hemoglobin testing. Finally, the new CATSA method was conducted for the subjects with no variants identified by Sanger sequencing and specially designed GAP-PCR. In the 49 subjects tested by CATSA, eight subjects had variants identified. Sanger sequencing and independent PCR confirmed the CATSA result. In addition, it is the first time that Hb Lepore was identified in Hunan Province. In total, traditional methods identified variants in 759 of the 3,033 subjects, while CATSA identified additional variants in eight subjects. CATSA showed great advantages compared to the other genetic testing methods.

BackgroundClinical target delineation is a primary focus in the field of radiotherapy. This study aimed to investigate whether high-risk clinical target volume can be removed in nasopharyngeal carcinoma patients with different T stages.Materials and methodsWe designed a test plan without the high-risk clinical target volume for 111 nasopharyngeal carcinoma patients and further compared the test plans with the treatment plans in the parameters of planning target volumes and the radiation dose to normal organs.ResultsOur data showed that when high-risk clinical target volume was abnegated, target coverage, conformity indices, and homogeneity indices of planning target volumes and doses of normal organs were not influenced in the T4 nasopharyngeal carcinoma patients, and more than 95% of the high-risk planning target volume area could still be covered by the 60 Gy dose line. However, only some T1–3 patients achieved the ideal dose coverage, and even fewer after induction chemotherapy (62.8% vs. 41.2%, p = 0.018). Gross tumor volume was positively correlated with the target coverage of the original high-risk planning target volume in the test-plan (p = 0.0001). Gross tumor volume can be used to predict whether the target coverage of high-risk planning target volume is more than 95% (area under the curve = 0.868).ConclusionOmitting high risk clinical target volume can be considered in patients with T4 nasopharyngeal carcinoma according to physical evaluations. However, this approach is only suitable for a specific subset of T1–3 patients.

IntroductionTo compare efficacy and safety of the levonorgestrel-releasing intrauterine system (LNG-IUS) with medical treatments for women with heavy menstrual bleeding.Materials and methodsWe searched PubMed, Embase, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure (CNKI), and Wanfang databases for relevant randomized controlled trials (RCTs) in November 2021. All meta-analyses were performed using the random-effects model. PROSPERO registration number: CRD42021295379.ResultsA total of trials (with 14 references) reporting on 1,677 women were included in this systematic review. The majority of the included RCTs were rated with low-to-unclear risk of bias in selection, detection, attrition, reporting, and other bias. All RCTs were rated as high risk in performance bias because blinding was difficult to ensure in the compared groups. Results of meta-analyses revealed that the number of clinical responders was greater in the LNG-IUS group than that in the medical treatments group at both 6-month (steroidal: five RCTs; n = 490; risk ratio [RR]: 1.72 [1.13, 2.62]; I2 = 92%; nonsteroidal: one RCT; n = 42; RR: 2.34 [1.31, 4.19]) and 12-month (steroidal: three RCTs; n = 261; RR: 1.31 [1.01, 1.71]; I2 = 74%) endpoints, with no clear differences on number of dropouts, and the incidence of adverse events.ConclusionEvidence indicates that LNG-IUS is superior to the medical treatments in short-term and medium-term clinical responses, blood loss control, compliance, and satisfaction. Meanwhile, frequency of adverse events related to LNG-IUS is acceptable.Systematic review registrationPROSPERO, identifier CRD42021259335, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021295379.

Abstract Background The optimal treatment volume for Glioblastoma multiforme (GBM) is still a subject of debate worldwide. The current study was aimed to determine the distances between recurring tumors and the edge of primary lesions, and thereby provide evidence for accurate target area delineation. Methods Between October 2007 and March 2019, 68 recurrent patients with GBM were included in our study. We measured the distance from the initial tumor to the recurrent lesion of GBM patients by expanding the initial gross tumor volume (GTV) to overlap the center of recurrent lesion, with the help of the Pinnacle Treatment Planning System. Results Recurrences were local in 47(69.1%) patients, distant in 12(17.7%) patients, and both in 9(13.2%) patients. Factors significantly influencing local recurrence were age (P = 0.049), sex (P = 0.049), and the size of peritumoral edema (P = 0.00). A total number of 91 recurrent tumors were analyzed. All local recurrences occurred within 2 cm and 94.8% (55/58) occurred within 1 cm of the original GTV based on T1 enhanced imaging. All local recurrences occurred within 1.5 cm and 98.3%(57/58) occurred within 0.5 cm of the original GTV based on T2-FLAIR imaging. 90.9% (30/33) and 81.8% (27/33) distant recurrences occurred >3 cm of T1 enhanced and T2-Flair primary tumor margins, respectively. Conclusions The 1 cm margin from T1 enhanced lesions and 0.5 cm margin from T2-Flair abnormal lesions could cover 94.8 and 98.3% local recurrences respectively, which deserves further prospective study as a limited but effective target area.

BackgroundNowadays, lymphadenectomy could be performed by the transperitoneal or extraperitoneal approach. Nevertheless, each approach has its own advantages and disadvantages. Under these circumstances, we developed a transumbilical laparoendoscopic single-site (TU-LESS) extraperitoneal approach for lymphadenectomy. In this research, the primary goal is to demonstrate the feasibility of the novel approach in systematic lymphadenectomy and present the surgical process step-by-step.MethodsBetween May 2020 and June 2021, patients who had the indications of systematic lymphadenectomy underwent lymphadenectomy via the TU-LESS extraperitoneal approach. This new approach was described in detail, and the clinical characteristics and surgical outcomes were collected and analyzed.ResultsEight patients with gynecological carcinoma were included in the research, including four with high-risk endometrial cancer and four with early-stage ovarian cancer. The TU-LESS extraperitoneal approach for pelvic and para-aortic lymphadenectomy was successfully performed in all patients without conversion. In all, a median of 26.5 pelvic lymph nodes (range 18–35) and 18.0 para-aortic lymph nodes (range 7–43) were retrieved. There was a median of 166.5 min of surgical time (range 123–205). Patients had speedy recoveries without complications. All patients had positive pain responses after surgery, as well as satisfactory cosmetic and body image outcomes.ConclusionOur initial experience showed that it is feasible to perform systematic lymphadenectomy with the TU-LESS extraperitoneal approach. And this new approach may provide a new measure or a beneficial supplement for lymphadenectomy in gynecologic cancer.

Focusing on the shortage of mechanical defect detection and diagnosis technology for disconnectors, a wireless monitoring method for the mechanical state of disconnectors is proposed. The split-core current sensors and improved voltage sensors are used to measure the motor currents and voltages of the disconnector under typical mechanical states at different working voltages. The wireless communication network is used to upload the acquisition data to the cloud server quickly, and the received data are processed by the software system. By comparing and analyzing the curves of current, input power, and output power under different states, it is concluded that the motor output power can adequately reflect the mechanical state of the disconnector. Twenty-three time-domain features of the output power time curve are extracted to form the original feature vector. Kernel principal component analysis (KPCA) method is used to reduce the dimension of the nonlinear features, and the Fisher's criterion function is constructed to determine the width parameter of the kernel function in the feature optimization. Grid search algorithm is used to optimize the kernel parameters of the support vector machine (SVM), and the trained SVM model is used to classify the mechanical state data whose working voltage part is known, and part is unknown, with a classification accuracy of 100%. The results show that the proposed wireless monitoring method can effectively diagnose the mechanical state of the disconnector and has a good generalization ability.

Due to global warming and urbanization, high-temperature events—which frequently occur in cities—are presenting an increasing threat to the daily lives of human beings. In coastal cities, sea breezes can cool the near surface and improve the urban environment to some extent. Understanding the cooling characteristics of sea breeze on the urban environment is informative for improving and mitigating the urban heat island (UHI) effect. In this paper, we analyze the basic characteristics of the timing of the cooling effect of sea breeze in urban summer based on the long-term multi-point measurements of air temperatures. Additionally, the Weather Research and Forecasting (WRF) model is used to show the influence of sea breeze on cities in terms of the cooling action time. The whole process is reproduced based on a time distribution map created using the results of the WRF simulation. The measured temperature and WRF simulation results are also evaluated with observations. The results show little difference between the two. The analysis of the distribution map shows that the sea breeze gradually penetrates inland from coastal areas. It can therefore be concluded that the sea breeze blows at different speeds in different areas. Our results show that the sea breeze is weak in places near the coast, while it is significantly stronger around inland rivers. Moreover, in urban areas that are far from inland rivers, the speed of the sea breeze is evenly distributed in space. The spatial pattern of sea breeze retreat time and arrival time is reversed: retreats happen earlier in inland areas. The duration of the sea breeze shows a significantly decreasing trend from the coast to inland, with the longest duration at the southern end of the urban area near the coast.

PurposePost-radiation nasopharyngeal necrosis (PRNN) is one of the most serious late effects of nasopharyngeal carcinoma (NPC) after radiotherapy. Standard conservative treatments are not always effective, and this study sought to investigate the feasibility of modified nasopharyngeal irrigation in the treatment of PRNN.MethodsBetween September 2011 and September 2018, 113 NPC patients with pathologically or radiologically diagnosed PRNN were analyzed retrospectively. All patients received the traditional conservative treatments of debridement of the necrotic tissues guided by an endoscope and systematic antibiotic therapy partly guided by culture results. The patients were divided into two groups according to the irrigation method used: traditional and modified groups. Modified irrigation used an irrigation device made by our hospital, guided by endoscopy, while the patients in the traditional irrigation group used a nasopharyngeal irrigation pot to wash the nasopharynx by themselves each day.ResultsSurvival was affected by ICA (internal carotid artery) exposure, necrosis grade, and re-irradiation, but only ICA exposure and re-irradiation were found to be independent prognostic factors. The modified irrigation had a significantly more positive effect on the recovery rates of patients with mild- and moderate-grade PRNN than did traditional irrigation. The 2-year overall survival (OS) of the 113 patients was 68.4%. The modified irrigation was associated with better OS in the mild- and moderate-grade groups, in the one-course radiotherapy group, and in the low-risk group (according to the 2017 system).ConclusionsMore intense modified irrigation under the physician’s control may be an effective treatment for PRNN, especially mild- and moderate-grade, one-course radiotherapy, or low-risk PRNN.

Hot-band absorption (HBA)-induced anti-Stokes fluorescence (ASF) with longer-wavelength excitation is one effective pathway to deep penetration and low autofluorescence in intravital fluorescence imaging, raising demands for fluorophores with broad spectra, high absorption, and strong emission. However, typical fluorescent dyes display some emission quenching when their concentration is increased in order to obtain brighter fluorescence. In this work, the HBA-induced ASF of aggregation-induced emission (AIE) dots is reported. BPN-BBTD dots were synthesized and confirmed with a fluorescence enhancement and a considerable ASF intensity. In addition, the mechanism of ASF and the HBA process of BPN-BBTD dots were carefully validated and discussed. To obtain the full advantages of the long-wavelength excitation and the short fluorescence lifetime in deep-tissue bioimaging, a large-depth ASF confocal microscopic imaging of in vivo cerebral vasculature was conducted under the excitation of a 980 nm continuous wave laser after intravenous injection of BPN-BBTD dots. Meanwhile, the 3D structure of the cerebrovascular network was successfully reconstructed.