Land use change affects the balance of organic carbon(C)reserves and the global C cycle.Microbial residues are essential constituents of stable soil organic C(SOC).However,it remains unclear how microbial residue chan...Land use change affects the balance of organic carbon(C)reserves and the global C cycle.Microbial residues are essential constituents of stable soil organic C(SOC).However,it remains unclear how microbial residue changes over time following afforestation.In this study,16-,23-,52-,and 62-year-old Mongolian pine stands and 16-year-old cropland were studied in the Horqin Sandy Land,China.We analyzed changes in SOC,amino sugar content,and microbial parameters to assess how microbial communities influence soil C transformation and preservation.The results showed that SOC storage increased with stand age in the early stage of afforestation but remained unchanged at about 1.27-1.29 kg/m2 after 52 a.Moreover,there were consistent increases in amino sugars and microbial residues with increasing stand age.As stand age increased from 16 to 62 a,soil pH decreased from 6.84 to 5.71,and the concentration of total amino sugars increased from 178.53 to 509.99 mg/kg.A significant negative correlation between soil pH and the concentration of specific and total amino sugars was observed,indicating that the effects of soil acidification promote amino sugar stabilization during afforestation.In contrast to the Mongolian pine plantation of the same age,the cropland accumulated more SOC and microbial residues because of fertilizer application.Across Mongolian pine plantation with different ages,there was no significant change in calculated contribution of bacterial or fungal residues to SOC,suggesting that fungi were consistently the dominant contributors to SOC with increasing time.Our results indicate that afforestation in the Horqin Sandy Land promotes efficient microbial growth and residue accumulation in SOC stocks and has a consistent positive impact on SOC persistence.展开更多
We are writing in response to the paper published in the World Journal of Gastroenterology by Zhou et al.The authors identified higher serum immunoglobulin(Ig)G4 levels and age over 55 years as independent risk factor...We are writing in response to the paper published in the World Journal of Gastroenterology by Zhou et al.The authors identified higher serum immunoglobulin(Ig)G4 levels and age over 55 years as independent risk factors for disease relapse.Despite notable strengths,it is crucial to address potential biases.Firstly,the cohort study included 189 patients with autoimmune pancreatitis(AIP)type 1(with higher IgG4 seropositivity and higher relapse)and 24 with type 2(with lower IgG4 seropositivity and lower relapse).Consequently,most,if not all,AIP type 2 patients were assigned to the normal group,possibly inflating the association of higher serum IgG4 levels with relapse and potentially exaggerating the association of older age with relapse.Secondly,the authors did not provide sufficient details regarding AIP diagnosis,such as the ratio of definitive vs probable cases and the proportion of biopsies.In cases where histological evidence is unavailable or indeterminate,AIP type 2 may be misdiagnosed as definitive type 1,and type 1 may also be misdiagnosed as probable type 2,particularly in cases with normal or mildly elevated serum IgG4 levels.Lastly,in this retrospective study,approximately one-third of the consecutive patients initially collected were excluded for various reasons.Accordingly,the impact of nonrandom exclusion on relapse outcomes should be carefully considered.In conclusion,the paper by Zhou et al offers plausible,though not entirely compelling,evidence suggesting a predictive role of elevated serum IgG4 levels and advanced age in AIP relapse.The foundation for future investigations lies in ensuring a reliable diagnosis and accurate disease subtyping,heavily dependent on obtaining histological specimens.In this regard,endoscopic ultrasound-guided fine-needle biopsy emerges as a pivotal component of the diagnostic process,contributing to mitigating biases in future explorations of the disease.展开更多
Identification and anatomy of oceanic arcs within ancient orogenic belt are significant for better understanding the tectonic framework and closure process of paleo-ocean basin.This article summarizes the geological,g...Identification and anatomy of oceanic arcs within ancient orogenic belt are significant for better understanding the tectonic framework and closure process of paleo-ocean basin.This article summarizes the geological,geochemical,and geochronological characteristics of upper crust of Proto-Tethyan Lajishan intra-oceanic arc and provides new data to constrain the subduction evolution of the South Qilian Ocean.The intra-oceanic arc volcanic rocks,including intermediate-mafic lava,breccia,tuff,and minor felsic rocks,are distributed along southern part of the Lajishan ophiolite belt.Geochemical and isotopic compositions indicate that the intermediate-mafic lava were originated from depleted mantle contaminated by sediment melts or hydrous fluids,whereas the felsic rocks were likely generated by partial melting of juvenile mafic crust in intra-oceanic arc setting.Zircons from felsic rocks yield consistent and concordant ages ranging from 506 to 523 Ma,suggesting these volcanic rocks represent the relicts of upper crust of the Cambrian intra-oceanic arc.Combined with the Cambrian forearc ophiolite and accretionary complex,we suggest that the Cambrian intra-oceanic arc in the Lajishan ophiolite belt is belonging to the intra-oceanic arc system which was generated by south-directed subduction in the South Qilian Ocean at a relatively short interval between approximately 530 and 480 Ma.展开更多
In this paper,the covert age of information(CAoI),which characterizes the timeliness and covertness performance of communication,is first investigated in the short-packet covert communication with time modulated retro...In this paper,the covert age of information(CAoI),which characterizes the timeliness and covertness performance of communication,is first investigated in the short-packet covert communication with time modulated retrodirective array(TMRDA).Specifically,the TMRDA is designed to maximize the antenna gain in the target direction while the side lobe is sufficiently suppressed.On this basis,the covertness constraint and CAoI are derived in closed form.To facilitate the covert transmission design,the transmit power and block-length are jointly optimized to minimize the CAoI,which demonstrates the trade-off between covertness and timelessness.Our results illustrate that there exists an optimal block-length that yields the minimum CAoI,and the presented optimization results can achieve enhanced performance compared with the fixed block-length case.Additionally,we observe that smaller beam pointing error at Bob leads to improvements in CAoI.展开更多
Objective This study aimed to determine the current epidemiological status of PLWHA aged≥50 years in China from 2018 to 2021.It also aimed to recommend targeted interventions for the prevention and treatment of HIV/A...Objective This study aimed to determine the current epidemiological status of PLWHA aged≥50 years in China from 2018 to 2021.It also aimed to recommend targeted interventions for the prevention and treatment of HIV/AIDS in elderly patients.Methods Data on newly reported cases of PLWHA,aged≥50 years in China from 2018 to 2021,were collected using the CRIMS.Trend tests and spatial analyses were also conducted.Results Between 2018 and 2021,237,724 HIV/AIDS cases were reported among patients aged≥50 years in China.The main transmission route was heterosexual transmission(91.24%).Commercial heterosexual transmission(CHC)was the primary mode of transmission among males,while non-marital non-CHC([NMNCHC];60.59%)was the prevalent route in women.The proportion of patients with CHC decreased over time(Z=67.716,P<0.01),while that of patients with NMNCHC increased(Z=153.05,P<0.01).The sex ratio varied among the different modes of infection,and it peaked at 17.65 for CHC.The spatial analysis indicated spatial clustering,and the high-high clustering areas were mainly distributed in the southwestern and central-southern provinces.Conclusion In China,PLWHA,aged≥50 years,were predominantly infected through heterosexual transmission.The primary modes of infection were CHC and NMNCHC.There were variations in the sex ratio among different age groups,infected through various sexual behaviors.HIV/AIDS cases exhibited spatial clustering.Based on these results,the expansion of HIV testing,treatment,and integrated behavioral interventions in high-risk populations is recommended to enhance disease detection in key regions.展开更多
Bone age assessment(BAA)helps doctors determine how a child’s bones grow and develop in clinical medicine.Traditional BAA methods rely on clinician expertise,leading to time-consuming predictions and inaccurate resul...Bone age assessment(BAA)helps doctors determine how a child’s bones grow and develop in clinical medicine.Traditional BAA methods rely on clinician expertise,leading to time-consuming predictions and inaccurate results.Most deep learning-based BAA methods feed the extracted critical points of images into the network by providing additional annotations.This operation is costly and subjective.To address these problems,we propose a multi-scale attentional densely connected network(MSADCN)in this paper.MSADCN constructs a multi-scale dense connectivity mechanism,which can avoid overfitting,obtain the local features effectively and prevent gradient vanishing even in limited training data.First,MSADCN designs multi-scale structures in the densely connected network to extract fine-grained features at different scales.Then,coordinate attention is embedded to focus on critical features and automatically locate the regions of interest(ROI)without additional annotation.In addition,to improve the model’s generalization,transfer learning is applied to train the proposed MSADCN on the public dataset IMDB-WIKI,and the obtained pre-trained weights are loaded onto the Radiological Society of North America(RSNA)dataset.Finally,label distribution learning(LDL)and expectation regression techniques are introduced into our model to exploit the correlation between hand bone images of different ages,which can obtain stable age estimates.Extensive experiments confirm that our model can converge more efficiently and obtain a mean absolute error(MAE)of 4.64 months,outperforming some state-of-the-art BAA methods.展开更多
BACKGROUND Cardiovascular disease(CVD)is a leading cause of morbidity and mortality worldwide,the global burden of which is rising.It is still unclear the extent to which prediabetes contributes to the risk of CVD in ...BACKGROUND Cardiovascular disease(CVD)is a leading cause of morbidity and mortality worldwide,the global burden of which is rising.It is still unclear the extent to which prediabetes contributes to the risk of CVD in various age brackets among adults.To develop a focused screening plan and treatment for Chinese adults with prediabetes,it is crucial to identify variations in the connection between prediabetes and the risk of CVD based on age.AIM To examine the clinical features of prediabetes and identify risk factors for CVD in different age groups in China.METHODS The cross-sectional study involved a total of 46239 participants from June 2007 through May 2008.A thorough evaluation was conducted.Individuals with prediabetes were categorized into two groups based on age.Chinese atherosclerotic CVD risk prediction model was employed to evaluate the risk of developing CVD over 10 years.Random forest was established in both age groups.SHapley Additive exPlanation method prioritized the importance of features from the perspective of assessment contribution.RESULTS In total,6948 people were diagnosed with prediabetes in this study.In prediabetes,prevalences of CVD were 5(0.29%)in the younger group and 148(2.85%)in the older group.Overall,11.11%of the younger group and 29.59% of the older group were intermediate/high-risk of CVD for prediabetes without CVD based on the Prediction for ASCVD Risk in China equation in ten years.In the younger age group,the 10-year risk of CVD was found to be more closely linked to family history of CVD rather than lifestyle,whereas in the older age group,resident status was more closely linked.CONCLUSION The susceptibility to CVD is age-specific in newly diagnosed prediabetes.It is necessary to develop targeted approaches for the prevention and management of CVD in adults across various age brackets.展开更多
BACKGROUND The incidence and mortality rate of colorectal cancer progressively increase with age and become particularly prominent after the age of 50 years.Therefore,the population that is≥50 years in age requires l...BACKGROUND The incidence and mortality rate of colorectal cancer progressively increase with age and become particularly prominent after the age of 50 years.Therefore,the population that is≥50 years in age requires long-term and regular colonoscopies.Uncomfortable bowel preparation is the main reason preventing patients from undergoing regular colonoscopies.The standard bowel preparation regimen of 4-L polyethylene glycol(PEG)is effective but poorly tolerated.AIM To investigate an effective and comfortable bowel preparation regimen for hospitalized patients≥50 years in age.METHODS Patients were randomly assigned to group 1(2-L PEG+30-mL lactulose+a lowresidue diet)or group 2(4-L PEG).Adequate bowel preparation was defined as a Boston bowel preparation scale(BBPS)score of≥6,with a score of≥2 for each segment.Non-inferiority was prespecified with a margin of 10%.Additionally,the degree of comfort was assessed based on the comfort questionnaire.RESULTS The proportion of patients with a BBPS score of≥6 in group 1 was not significantly different from that in group 2,as demonstrated by intention-to-treat(91.2%vs 91.0%,P=0.953)and per-protocol(91.8%vs 91.0%,P=0.802)analyses.Furthermore,in patients≥75 years in age,the proportion of BBPS scores of≥6 in group 1 was not significantly different from that in group 2(90.9%vs 97.0%,P=0.716).Group 1 had higher comfort scores(8.85±1.162 vs 7.59±1.735,P<0.001),longer sleep duration(6.86±1.204 h vs 5.80±1.730 h,P<0.001),and fewer awakenings(1.42±1.183 vs 2.04±1.835,P=0.026)than group 2.CONCLUSION For hospitalized patients≥50 years in age,the bowel preparation regimen comprising 2-L PEG+30-mL lactulose+a low-residue diet produced a cleanse that was as effective as the 4-L PEG regimen and even provided better comfort.展开更多
Introduction and Objectives: Soil-Transmitted-Helminthiasis (STH) is a public health problem in Cameroon. The control strategies currently in place, particularly chemoprevention, has shortcomings linked to the target ...Introduction and Objectives: Soil-Transmitted-Helminthiasis (STH) is a public health problem in Cameroon. The control strategies currently in place, particularly chemoprevention, has shortcomings linked to the target population, which are school-age children. The objective was to determine the prevalence and the risk factors associated with geo-helminthiasis in children aged 0 to 3 years in a rural health district. Method: From December 2020 to May 2021, a descriptive and analytical cross-sectional study of 376 children between 6 and 36 months was carried out in the Akonolinga health district. This was a cluster sampling in 4 health areas. Stool samples were collected and analysed using the mini-FLOTAC method. The results expressed as the number of eggs per gram of stool. A questionnaire on socio-demographic and lifestyle data was administered to the parents. The Chi-squared test was used to measure the association between geo-helminth infection and the data collected. A multivariate analysis using logistic regression was performed (p 0.05). Results: The prevalence of STH was 19.4% (Ascaris lumbricoides: 16% and Trichuris trichiura: 8%). Risk factors were: consumption of contaminated water (AOR = 1.93 [1.03 - 3.6];p = 0.040), early contact of the child with the ground (before age of 4 months) (AOR = 4.9 [2.1 - 11.37];p .001), habit of walking barefoot (AOR = 2.91 [1.1 - 7.97];p = 0.038), and living in a habitat with unpaved ground (AOR = 7.4 [1.55 - 35.7];p = 0.012). Conclusion: The prevalence of STHs in infants was high. Preventive chemotherapy should be extended to this age-group, and other measures intensified.展开更多
Due to its ubiquitous occurrence in igneous,metamorphic,and sedimentary rocks and its wide application in geochronology and geochemistry,zircon has become the most widely used accessory mineral in the geological commu...Due to its ubiquitous occurrence in igneous,metamorphic,and sedimentary rocks and its wide application in geochronology and geochemistry,zircon has become the most widely used accessory mineral in the geological community.Nevertheless,the decay of U and Th causes radiation damage to the zircon structure,resulting in various degrees of metamictization,which can affect the accuracy of U–Pb dates and Hf and O isotope results.If the degree of zircon radiation damage can be quantified,the influence on geochemical analyses can be evaluated,and the results can be corrected more precisely.In this paper,synthetic and natural zircon crystals with different crystallization ages were selected for Raman spectroscopy analysis,cathodoluminescence imaging,and determination of the U and Th concentrations.The results show that Raman FWHM(full width at half bandmaximum)and Raman shift correlate with alpha dose(Da)ofzirconsfollowingtheseequations,FWHM=44.36(±2.32)×[1-exp(-2.74×Da)]-+1.7(±0.19),Raman Shift=-6.53×Da+1007.69.Analysis of synthetic zircon crystals shows that doped REEs(rare earth elements and P)can also lead to an increase in the FWHM.However,this effect can be ignored for natural zircon samples with REE contents at a normal level of hundreds to a few thousand ppm.The FWHM and Raman shift can be used as proxies to measure the degree of zircon radiation damage.Using the updated equations to calculate the latest age when zircon began to accumulate radiation damage,a more accurate and more meaningful“radiation damage age”can be obtained.展开更多
BACKGROUND Upper gastrointestinal(GI)bleeding is a life-threatening condition with high mortality rates.AIM To compare the performance of pre-endoscopic risk scores in predicting the following primary outcomes:In-hosp...BACKGROUND Upper gastrointestinal(GI)bleeding is a life-threatening condition with high mortality rates.AIM To compare the performance of pre-endoscopic risk scores in predicting the following primary outcomes:In-hospital mortality,intervention(endoscopic or surgical)and length of admission(≥7 d).METHODS We performed a retrospective analysis of 363 patients presenting with upper GI bleeding from December 2020 to January 2021.We calculated and compared the area under the receiver operating characteristics curves(AUROCs)of Glasgow-Blatchford score(GBS),pre-endoscopic Rockall score(PERS),albumin,international normalized ratio,altered mental status,systolic blood pressure,age older than 65(AIMS65)and age,blood tests and comorbidities(ABC),including their optimal cut-off in variceal and non-variceal upper GI bleeding cohorts.We subsequently analyzed through a logistic binary regression model,if addition of lactate increased the score performance.RESULTS All scores had discriminative ability in predicting in-hospital mortality irrespective of study group.AIMS65 score had the best performance in the variceal bleeding group(AUROC=0.772;P<0.001),and ABC score(AUROC=0.775;P<0.001)in the non-variceal bleeding group.However,ABC score,at a cut-off value of 5.5,was the best predictor(AUROC=0.770,P=0.001)of inhospital mortality in both populations.PERS score was a good predictor for endoscopic treatment(AUC=0.604;P=0.046)in the variceal population,while GBS score,(AUROC=0.722;P=0.024),outperformed the other scores in predicting surgical intervention.Addition of lactate to AIMS65 score,increases by 5-fold the probability of in-hospital mortality(P<0.05)and by 12-fold if added to GBS score(P<0.003).No score proved to be a good predictor for length of admission.CONCLUSION ABC score is the most accurate in predicting in-hospital mortality in both mixed and non-variceal bleeding population.PERS and GBS should be used to determine need for endoscopic and surgical intervention,respectively.Lactate can be used as an additional tool to risk scores for predicting inhospital mortality.展开更多
In this paper, the interferences of X-ray image noise on a bone age model, Xception model, were studied. We conduct a comparative experiment test according to the output performance of the neural network model using b...In this paper, the interferences of X-ray image noise on a bone age model, Xception model, were studied. We conduct a comparative experiment test according to the output performance of the neural network model using both the original image training and noise-added (Gaussian noise plus salt-pepper noise) training, and analyze the anti-interference ability of the Xception model, hoping to improve it through noise enhancement training and generalize the application ability of the model. The results show that the model trained with noise-added (Gaussian noise plussalt-pepper noise) images can make predictions that are more robust and less affected by the image disturbances, such as image noise.展开更多
研究锌离子络合法快速分离纯化荞麦壳黄酮工艺,并评价纯化组分对晚期糖基化终末产物(AGEs)生成的抑制活性。根据络合转化率和络合强度,将荞麦壳黄酮提取物(BHF)经过二次锌离子络合,分别获得荞麦壳黄酮中间提取物(IBHF)和荞麦壳高黄酮组...研究锌离子络合法快速分离纯化荞麦壳黄酮工艺,并评价纯化组分对晚期糖基化终末产物(AGEs)生成的抑制活性。根据络合转化率和络合强度,将荞麦壳黄酮提取物(BHF)经过二次锌离子络合,分别获得荞麦壳黄酮中间提取物(IBHF)和荞麦壳高黄酮组分(HBHF)。采用Box-Behnken响应曲面分析法优化获得IBHF组分的最佳工艺参数:乙酸锌与样品质量比2∶1,乙醇体积分数30%,氨水体积分数0.05%,室温反应10 min。在该条件下络合转化率为97.44%。IBHF组分经过二次锌离子络合,分离获得HBHF组分,其总黄酮含量为57.08 g RE/100 g(三氯化铝-乙酸盐比色法),其纯度比分离纯化前提高了6.64倍。高效液相色谱分析(HPLC)表明,HBHF组分含有异荭草素、牡荆素、异牡荆素、芦丁、山奈酚-3-O芸香糖苷5种主要黄酮,其中芦丁占比62.34%。HBHF组分表现出良好的抗AGEs活性,在质量浓度为200μg/mL时,Glu-BSA体系的中的AGEs抑制率为63.16%,MGO-BSA体系中的AGEs抑制率为42.98%,抑制率均显著优于阳性对照氨基胍。展开更多
Treatment with metformin can lead to the recovery of pleiotropic biological activities after spinal cord injury.However,its effect on spinal cord injury in aged mice remains unclear.Considering the essential role of a...Treatment with metformin can lead to the recovery of pleiotropic biological activities after spinal cord injury.However,its effect on spinal cord injury in aged mice remains unclear.Considering the essential role of angiogenesis during the regeneration process,we hypothesized that metformin activates the adenosine monophosphate-activated protein kinase/endothelial nitric oxide synthase pathway in endothelial cells,thereby promoting microvascular regeneration in aged mice after spinal cord injury.In this study,we established young and aged mouse models of contusive spinal cord injury using a modified Allen method.We found that aging hindered the recovery of neurological function and the formation of blood vessels in the spinal cord.Treatment with metformin promoted spinal cord microvascular endothelial cell migration and blood vessel formation in vitro.Furthermore,intraperitoneal injection of metformin in an in vivo model promoted endothelial cell proliferation and increased the density of new blood vessels in the spinal cord,thereby improving neurological function.The role of metformin was reversed by compound C,an adenosine monophosphate-activated protein kinase inhibitor,both in vivo and in vitro,suggesting that the adenosine monophosphate-activated protein kinase/endothelial nitric oxide synthase pathway likely regulates metformin-mediated angiogenesis after spinal cord injury.These findings suggest that metformin promotes vascular regeneration in the injured spinal cord by activating the adenosine monophosphate-activated protein kinase/endothelial nitric oxide synthase pathway,thereby improving the neurological function of aged mice after spinal cord injury.展开更多
Plantations of Rupprecht's larch(Larix principis-rupprechtii)have been widely established in the drylands of northwest and north China under traditional fastgrowing plantation management strategies.These strategie...Plantations of Rupprecht's larch(Larix principis-rupprechtii)have been widely established in the drylands of northwest and north China under traditional fastgrowing plantation management strategies.These strategies and the long-term logging ban have led to over-populated stands with lower structural and functional stability,less economic benefit and higher water consumption.To guide the sustainable management of larch plantations,field surveys and historical data compilation were undertaken in the Liupan Mountains of northwest China.The main influencing factors(stand structure and site condition)and their effects on mean tree height,mean DBH and timber volumes were determined based on up-boundary line analysis.Tree growth models coupling the effects of tree age,stand density,and elevation were established.Both height and DBH markedly increased initially and then slowly with tree age,decreased with stand density,and showed unimodal change with elevation.The coupled growth models accounted for72-78%of the variations in tree height,DBH and timber growth.Recommendations for future plantation management are:(1)prolong the rotation to at least 60 years to produce large-diameter,high-quality timber and maintain greater carbon stocks;(2)zone the target functions of stands by elevation;and,(3)reduce stand density for balanced supply of multiple ecosystem services.The growth models developed can predict growth response of larch plantations to density alteration under given ages and elevations,and assist the transformation from traditional management for maximum timber production to site-specific and multifunctional management with longer rotations and moderate tree density.展开更多
Using high-precision zircon U-Pb ID-TIMS geochronology,tuffs from the Chang 9 shale and the Chang 7 shale were dated.The tuff in the Chang 9 shale is 241.47±0.17 Ma,which falls between the top tuff age of 241.06&...Using high-precision zircon U-Pb ID-TIMS geochronology,tuffs from the Chang 9 shale and the Chang 7 shale were dated.The tuff in the Chang 9 shale is 241.47±0.17 Ma,which falls between the top tuff age of 241.06±0.12 Ma and the bottom tuff age of 241.558±0.093 Ma in the Chang 7 shale.These reveal that the Chang 9 and Chang 7 shales are contemporaneous,belonging to the Ladinian stage of the Middle Triassic.This insight expands the region of the main source rock of Chang 7 to the northeast and will inform the search for the deep Chang 9 shale petroleum system,increasing the scope for exploring the Chang 7 shale system in northern Shaanxi.The research results clarify the relationship between the two sets of shale in the Yanchang Formation and redefine the distribution range of the Chang 7 shale in the Ordos Basin.At the same time,it shows that there is a cross-layer problem in the stratigraphic division of the Yanchang Formation in different regions,the high-precision U-Pb dating technology providing a reference for the fine stratigraphic correlation of other continental basins in the world.展开更多
BACKGROUND Extramedullary multiple myeloma(MM)(EMM)is a rare and aggressive subentity of MM that can be present at diagnosis or develop anytime during the disease course.There is a paucity of data on the clinical char...BACKGROUND Extramedullary multiple myeloma(MM)(EMM)is a rare and aggressive subentity of MM that can be present at diagnosis or develop anytime during the disease course.There is a paucity of data on the clinical characteristics and overall epidemiology of EMM.Furthermore,there is a scarcity of data on how the interaction of age and gender influences the survival of EMM.AIM To evaluate the clinical characteristics of patients with EMM over the past 2 decades and to identify epidemiologic characteristics that may impact overall prognosis.METHODS A total of 858 patients diagnosed with EMM,between 2000 and 2017,were ultimately enrolled in our study by retrieving the Surveillance,Epidemiology,and End Results database.We analyzed demographics,clinical characteristics,and overall mortality(OM)as well as cancer-specific mortality(CSM)of EMM.Variables with a P value<0.1 in the univariate Cox regression were incorporated into the multivariate Cox model to determine the independent prognostic factors,with a hazard ratio(HR)of greater than 1 representing adverse prognostic factors.RESULTS From a sample of 858 EMM,the male gender(63.25%),age range 60-79 years(51.05%),and non-Hispanic whites(66.78%)were the most represented.Central Nervous System and the vertebral column was the most affected site(33.10%).Crude analysis revealed higher OM in the age group 80+[HR=6.951,95%confidence interval(95%CI):3.299-14.647,P=0],Non-Hispanic Black population(HR=1.339,95%CI:1.02-1.759,P=0.036),Bones not otherwise specified(NOS)(HR=1.74,95%CI:1.043-2.902,P=0.034),and widowed individuals(HR=2.107,95%CI:1.511-2.938,P=0).Skin involvement(HR=0.241,95%CI:0.06-0.974,P=0.046)and a yearly income of$75000+(HR=0.259,95%CI:0.125-0.538,P=0)had the lowest OM in the crude analysis.Crude analysis revealed higher CSM in the age group 80+,Non-Hispanic Black,Bones NOS,and widowed.Multivariate cox proportional hazard regression analyses only revealed higher OM in the age group 80+(HR=9.792,95%CI:4.403-21.774,P=0)and widowed individuals(HR=1.609,95%CI:1.101-2.35,P=0.014).Multivariate cox proportional hazard regression analyses of CSM also revealed higher mortality of the same groups.Eyes,mouth,and ENT involvement had the lowest CSM in the multivariate analysis.There was no interaction between age and gender in the adjusted analysis for OM and CSM.CONCLUSION EMM is a rare entity.To our knowledge,there is a scarcity of data on the clinical characteristics and prognosis factors of patients with extramedullary multiple myeloma.In this retrospective cohort,using a United States-based population,we found that age,marital status,and tumor site were independent prognostic factors.Furthermore,we found that age and gender did not interact to influence the mortality of patients with EMM.展开更多
基金funded by the Fundamental Research Funds of Chinese Academy of Forestry(CAF)(CAFYBB2020QD002-2).
文摘Land use change affects the balance of organic carbon(C)reserves and the global C cycle.Microbial residues are essential constituents of stable soil organic C(SOC).However,it remains unclear how microbial residue changes over time following afforestation.In this study,16-,23-,52-,and 62-year-old Mongolian pine stands and 16-year-old cropland were studied in the Horqin Sandy Land,China.We analyzed changes in SOC,amino sugar content,and microbial parameters to assess how microbial communities influence soil C transformation and preservation.The results showed that SOC storage increased with stand age in the early stage of afforestation but remained unchanged at about 1.27-1.29 kg/m2 after 52 a.Moreover,there were consistent increases in amino sugars and microbial residues with increasing stand age.As stand age increased from 16 to 62 a,soil pH decreased from 6.84 to 5.71,and the concentration of total amino sugars increased from 178.53 to 509.99 mg/kg.A significant negative correlation between soil pH and the concentration of specific and total amino sugars was observed,indicating that the effects of soil acidification promote amino sugar stabilization during afforestation.In contrast to the Mongolian pine plantation of the same age,the cropland accumulated more SOC and microbial residues because of fertilizer application.Across Mongolian pine plantation with different ages,there was no significant change in calculated contribution of bacterial or fungal residues to SOC,suggesting that fungi were consistently the dominant contributors to SOC with increasing time.Our results indicate that afforestation in the Horqin Sandy Land promotes efficient microbial growth and residue accumulation in SOC stocks and has a consistent positive impact on SOC persistence.
文摘We are writing in response to the paper published in the World Journal of Gastroenterology by Zhou et al.The authors identified higher serum immunoglobulin(Ig)G4 levels and age over 55 years as independent risk factors for disease relapse.Despite notable strengths,it is crucial to address potential biases.Firstly,the cohort study included 189 patients with autoimmune pancreatitis(AIP)type 1(with higher IgG4 seropositivity and higher relapse)and 24 with type 2(with lower IgG4 seropositivity and lower relapse).Consequently,most,if not all,AIP type 2 patients were assigned to the normal group,possibly inflating the association of higher serum IgG4 levels with relapse and potentially exaggerating the association of older age with relapse.Secondly,the authors did not provide sufficient details regarding AIP diagnosis,such as the ratio of definitive vs probable cases and the proportion of biopsies.In cases where histological evidence is unavailable or indeterminate,AIP type 2 may be misdiagnosed as definitive type 1,and type 1 may also be misdiagnosed as probable type 2,particularly in cases with normal or mildly elevated serum IgG4 levels.Lastly,in this retrospective study,approximately one-third of the consecutive patients initially collected were excluded for various reasons.Accordingly,the impact of nonrandom exclusion on relapse outcomes should be carefully considered.In conclusion,the paper by Zhou et al offers plausible,though not entirely compelling,evidence suggesting a predictive role of elevated serum IgG4 levels and advanced age in AIP relapse.The foundation for future investigations lies in ensuring a reliable diagnosis and accurate disease subtyping,heavily dependent on obtaining histological specimens.In this regard,endoscopic ultrasound-guided fine-needle biopsy emerges as a pivotal component of the diagnostic process,contributing to mitigating biases in future explorations of the disease.
基金supported by the China Geological Survey(Grant No.DD20221649)National Natural Science Foundation of China(Grant Nos.42230308,42072266)+3 种基金Bureau of Geological Exploration and Development of Qinghai Province(Grant No.[2022]32)the Xingdian Scholar Fund of Yunnan Province(Grant No.C6213001155)China Postdoctoral Science Foundation(Grant No.2021M691702)High-level Talents Project of Qinghai Province.
文摘Identification and anatomy of oceanic arcs within ancient orogenic belt are significant for better understanding the tectonic framework and closure process of paleo-ocean basin.This article summarizes the geological,geochemical,and geochronological characteristics of upper crust of Proto-Tethyan Lajishan intra-oceanic arc and provides new data to constrain the subduction evolution of the South Qilian Ocean.The intra-oceanic arc volcanic rocks,including intermediate-mafic lava,breccia,tuff,and minor felsic rocks,are distributed along southern part of the Lajishan ophiolite belt.Geochemical and isotopic compositions indicate that the intermediate-mafic lava were originated from depleted mantle contaminated by sediment melts or hydrous fluids,whereas the felsic rocks were likely generated by partial melting of juvenile mafic crust in intra-oceanic arc setting.Zircons from felsic rocks yield consistent and concordant ages ranging from 506 to 523 Ma,suggesting these volcanic rocks represent the relicts of upper crust of the Cambrian intra-oceanic arc.Combined with the Cambrian forearc ophiolite and accretionary complex,we suggest that the Cambrian intra-oceanic arc in the Lajishan ophiolite belt is belonging to the intra-oceanic arc system which was generated by south-directed subduction in the South Qilian Ocean at a relatively short interval between approximately 530 and 480 Ma.
文摘In this paper,the covert age of information(CAoI),which characterizes the timeliness and covertness performance of communication,is first investigated in the short-packet covert communication with time modulated retrodirective array(TMRDA).Specifically,the TMRDA is designed to maximize the antenna gain in the target direction while the side lobe is sufficiently suppressed.On this basis,the covertness constraint and CAoI are derived in closed form.To facilitate the covert transmission design,the transmit power and block-length are jointly optimized to minimize the CAoI,which demonstrates the trade-off between covertness and timelessness.Our results illustrate that there exists an optimal block-length that yields the minimum CAoI,and the presented optimization results can achieve enhanced performance compared with the fixed block-length case.Additionally,we observe that smaller beam pointing error at Bob leads to improvements in CAoI.
文摘Objective This study aimed to determine the current epidemiological status of PLWHA aged≥50 years in China from 2018 to 2021.It also aimed to recommend targeted interventions for the prevention and treatment of HIV/AIDS in elderly patients.Methods Data on newly reported cases of PLWHA,aged≥50 years in China from 2018 to 2021,were collected using the CRIMS.Trend tests and spatial analyses were also conducted.Results Between 2018 and 2021,237,724 HIV/AIDS cases were reported among patients aged≥50 years in China.The main transmission route was heterosexual transmission(91.24%).Commercial heterosexual transmission(CHC)was the primary mode of transmission among males,while non-marital non-CHC([NMNCHC];60.59%)was the prevalent route in women.The proportion of patients with CHC decreased over time(Z=67.716,P<0.01),while that of patients with NMNCHC increased(Z=153.05,P<0.01).The sex ratio varied among the different modes of infection,and it peaked at 17.65 for CHC.The spatial analysis indicated spatial clustering,and the high-high clustering areas were mainly distributed in the southwestern and central-southern provinces.Conclusion In China,PLWHA,aged≥50 years,were predominantly infected through heterosexual transmission.The primary modes of infection were CHC and NMNCHC.There were variations in the sex ratio among different age groups,infected through various sexual behaviors.HIV/AIDS cases exhibited spatial clustering.Based on these results,the expansion of HIV testing,treatment,and integrated behavioral interventions in high-risk populations is recommended to enhance disease detection in key regions.
基金This research is partially supported by grant from the National Natural Science Foundation of China(No.72071019)grant from the Natural Science Foundation of Chongqing(No.cstc2021jcyj-msxmX0185)grant from the Chongqing Graduate Education and Teaching Reform Research Project(No.yjg193096).
文摘Bone age assessment(BAA)helps doctors determine how a child’s bones grow and develop in clinical medicine.Traditional BAA methods rely on clinician expertise,leading to time-consuming predictions and inaccurate results.Most deep learning-based BAA methods feed the extracted critical points of images into the network by providing additional annotations.This operation is costly and subjective.To address these problems,we propose a multi-scale attentional densely connected network(MSADCN)in this paper.MSADCN constructs a multi-scale dense connectivity mechanism,which can avoid overfitting,obtain the local features effectively and prevent gradient vanishing even in limited training data.First,MSADCN designs multi-scale structures in the densely connected network to extract fine-grained features at different scales.Then,coordinate attention is embedded to focus on critical features and automatically locate the regions of interest(ROI)without additional annotation.In addition,to improve the model’s generalization,transfer learning is applied to train the proposed MSADCN on the public dataset IMDB-WIKI,and the obtained pre-trained weights are loaded onto the Radiological Society of North America(RSNA)dataset.Finally,label distribution learning(LDL)and expectation regression techniques are introduced into our model to exploit the correlation between hand bone images of different ages,which can obtain stable age estimates.Extensive experiments confirm that our model can converge more efficiently and obtain a mean absolute error(MAE)of 4.64 months,outperforming some state-of-the-art BAA methods.
文摘BACKGROUND Cardiovascular disease(CVD)is a leading cause of morbidity and mortality worldwide,the global burden of which is rising.It is still unclear the extent to which prediabetes contributes to the risk of CVD in various age brackets among adults.To develop a focused screening plan and treatment for Chinese adults with prediabetes,it is crucial to identify variations in the connection between prediabetes and the risk of CVD based on age.AIM To examine the clinical features of prediabetes and identify risk factors for CVD in different age groups in China.METHODS The cross-sectional study involved a total of 46239 participants from June 2007 through May 2008.A thorough evaluation was conducted.Individuals with prediabetes were categorized into two groups based on age.Chinese atherosclerotic CVD risk prediction model was employed to evaluate the risk of developing CVD over 10 years.Random forest was established in both age groups.SHapley Additive exPlanation method prioritized the importance of features from the perspective of assessment contribution.RESULTS In total,6948 people were diagnosed with prediabetes in this study.In prediabetes,prevalences of CVD were 5(0.29%)in the younger group and 148(2.85%)in the older group.Overall,11.11%of the younger group and 29.59% of the older group were intermediate/high-risk of CVD for prediabetes without CVD based on the Prediction for ASCVD Risk in China equation in ten years.In the younger age group,the 10-year risk of CVD was found to be more closely linked to family history of CVD rather than lifestyle,whereas in the older age group,resident status was more closely linked.CONCLUSION The susceptibility to CVD is age-specific in newly diagnosed prediabetes.It is necessary to develop targeted approaches for the prevention and management of CVD in adults across various age brackets.
基金The study was approved by the Ethics Committee of Beijing Tongren Hospital Affiliated to Capital Medical University(Approval No.TRECKY2021-227).
文摘BACKGROUND The incidence and mortality rate of colorectal cancer progressively increase with age and become particularly prominent after the age of 50 years.Therefore,the population that is≥50 years in age requires long-term and regular colonoscopies.Uncomfortable bowel preparation is the main reason preventing patients from undergoing regular colonoscopies.The standard bowel preparation regimen of 4-L polyethylene glycol(PEG)is effective but poorly tolerated.AIM To investigate an effective and comfortable bowel preparation regimen for hospitalized patients≥50 years in age.METHODS Patients were randomly assigned to group 1(2-L PEG+30-mL lactulose+a lowresidue diet)or group 2(4-L PEG).Adequate bowel preparation was defined as a Boston bowel preparation scale(BBPS)score of≥6,with a score of≥2 for each segment.Non-inferiority was prespecified with a margin of 10%.Additionally,the degree of comfort was assessed based on the comfort questionnaire.RESULTS The proportion of patients with a BBPS score of≥6 in group 1 was not significantly different from that in group 2,as demonstrated by intention-to-treat(91.2%vs 91.0%,P=0.953)and per-protocol(91.8%vs 91.0%,P=0.802)analyses.Furthermore,in patients≥75 years in age,the proportion of BBPS scores of≥6 in group 1 was not significantly different from that in group 2(90.9%vs 97.0%,P=0.716).Group 1 had higher comfort scores(8.85±1.162 vs 7.59±1.735,P<0.001),longer sleep duration(6.86±1.204 h vs 5.80±1.730 h,P<0.001),and fewer awakenings(1.42±1.183 vs 2.04±1.835,P=0.026)than group 2.CONCLUSION For hospitalized patients≥50 years in age,the bowel preparation regimen comprising 2-L PEG+30-mL lactulose+a low-residue diet produced a cleanse that was as effective as the 4-L PEG regimen and even provided better comfort.
文摘Introduction and Objectives: Soil-Transmitted-Helminthiasis (STH) is a public health problem in Cameroon. The control strategies currently in place, particularly chemoprevention, has shortcomings linked to the target population, which are school-age children. The objective was to determine the prevalence and the risk factors associated with geo-helminthiasis in children aged 0 to 3 years in a rural health district. Method: From December 2020 to May 2021, a descriptive and analytical cross-sectional study of 376 children between 6 and 36 months was carried out in the Akonolinga health district. This was a cluster sampling in 4 health areas. Stool samples were collected and analysed using the mini-FLOTAC method. The results expressed as the number of eggs per gram of stool. A questionnaire on socio-demographic and lifestyle data was administered to the parents. The Chi-squared test was used to measure the association between geo-helminth infection and the data collected. A multivariate analysis using logistic regression was performed (p 0.05). Results: The prevalence of STH was 19.4% (Ascaris lumbricoides: 16% and Trichuris trichiura: 8%). Risk factors were: consumption of contaminated water (AOR = 1.93 [1.03 - 3.6];p = 0.040), early contact of the child with the ground (before age of 4 months) (AOR = 4.9 [2.1 - 11.37];p .001), habit of walking barefoot (AOR = 2.91 [1.1 - 7.97];p = 0.038), and living in a habitat with unpaved ground (AOR = 7.4 [1.55 - 35.7];p = 0.012). Conclusion: The prevalence of STHs in infants was high. Preventive chemotherapy should be extended to this age-group, and other measures intensified.
基金supported by funds from the Strategic Priority Research Program(B)of the Chinese Academy of Sciences(XDB 41000000)the National Natural Science Foundation of China(41973002,41772187)+1 种基金the Fundamental Research Funds for the Central UniversitiesNatural Sciences and Engineering Research Council of Canada(NSERC)Discovery Grant to J.M Hanchar(RGPIN/004649-2015)。
文摘Due to its ubiquitous occurrence in igneous,metamorphic,and sedimentary rocks and its wide application in geochronology and geochemistry,zircon has become the most widely used accessory mineral in the geological community.Nevertheless,the decay of U and Th causes radiation damage to the zircon structure,resulting in various degrees of metamictization,which can affect the accuracy of U–Pb dates and Hf and O isotope results.If the degree of zircon radiation damage can be quantified,the influence on geochemical analyses can be evaluated,and the results can be corrected more precisely.In this paper,synthetic and natural zircon crystals with different crystallization ages were selected for Raman spectroscopy analysis,cathodoluminescence imaging,and determination of the U and Th concentrations.The results show that Raman FWHM(full width at half bandmaximum)and Raman shift correlate with alpha dose(Da)ofzirconsfollowingtheseequations,FWHM=44.36(±2.32)×[1-exp(-2.74×Da)]-+1.7(±0.19),Raman Shift=-6.53×Da+1007.69.Analysis of synthetic zircon crystals shows that doped REEs(rare earth elements and P)can also lead to an increase in the FWHM.However,this effect can be ignored for natural zircon samples with REE contents at a normal level of hundreds to a few thousand ppm.The FWHM and Raman shift can be used as proxies to measure the degree of zircon radiation damage.Using the updated equations to calculate the latest age when zircon began to accumulate radiation damage,a more accurate and more meaningful“radiation damage age”can be obtained.
文摘BACKGROUND Upper gastrointestinal(GI)bleeding is a life-threatening condition with high mortality rates.AIM To compare the performance of pre-endoscopic risk scores in predicting the following primary outcomes:In-hospital mortality,intervention(endoscopic or surgical)and length of admission(≥7 d).METHODS We performed a retrospective analysis of 363 patients presenting with upper GI bleeding from December 2020 to January 2021.We calculated and compared the area under the receiver operating characteristics curves(AUROCs)of Glasgow-Blatchford score(GBS),pre-endoscopic Rockall score(PERS),albumin,international normalized ratio,altered mental status,systolic blood pressure,age older than 65(AIMS65)and age,blood tests and comorbidities(ABC),including their optimal cut-off in variceal and non-variceal upper GI bleeding cohorts.We subsequently analyzed through a logistic binary regression model,if addition of lactate increased the score performance.RESULTS All scores had discriminative ability in predicting in-hospital mortality irrespective of study group.AIMS65 score had the best performance in the variceal bleeding group(AUROC=0.772;P<0.001),and ABC score(AUROC=0.775;P<0.001)in the non-variceal bleeding group.However,ABC score,at a cut-off value of 5.5,was the best predictor(AUROC=0.770,P=0.001)of inhospital mortality in both populations.PERS score was a good predictor for endoscopic treatment(AUC=0.604;P=0.046)in the variceal population,while GBS score,(AUROC=0.722;P=0.024),outperformed the other scores in predicting surgical intervention.Addition of lactate to AIMS65 score,increases by 5-fold the probability of in-hospital mortality(P<0.05)and by 12-fold if added to GBS score(P<0.003).No score proved to be a good predictor for length of admission.CONCLUSION ABC score is the most accurate in predicting in-hospital mortality in both mixed and non-variceal bleeding population.PERS and GBS should be used to determine need for endoscopic and surgical intervention,respectively.Lactate can be used as an additional tool to risk scores for predicting inhospital mortality.
文摘In this paper, the interferences of X-ray image noise on a bone age model, Xception model, were studied. We conduct a comparative experiment test according to the output performance of the neural network model using both the original image training and noise-added (Gaussian noise plus salt-pepper noise) training, and analyze the anti-interference ability of the Xception model, hoping to improve it through noise enhancement training and generalize the application ability of the model. The results show that the model trained with noise-added (Gaussian noise plussalt-pepper noise) images can make predictions that are more robust and less affected by the image disturbances, such as image noise.
文摘研究锌离子络合法快速分离纯化荞麦壳黄酮工艺,并评价纯化组分对晚期糖基化终末产物(AGEs)生成的抑制活性。根据络合转化率和络合强度,将荞麦壳黄酮提取物(BHF)经过二次锌离子络合,分别获得荞麦壳黄酮中间提取物(IBHF)和荞麦壳高黄酮组分(HBHF)。采用Box-Behnken响应曲面分析法优化获得IBHF组分的最佳工艺参数:乙酸锌与样品质量比2∶1,乙醇体积分数30%,氨水体积分数0.05%,室温反应10 min。在该条件下络合转化率为97.44%。IBHF组分经过二次锌离子络合,分离获得HBHF组分,其总黄酮含量为57.08 g RE/100 g(三氯化铝-乙酸盐比色法),其纯度比分离纯化前提高了6.64倍。高效液相色谱分析(HPLC)表明,HBHF组分含有异荭草素、牡荆素、异牡荆素、芦丁、山奈酚-3-O芸香糖苷5种主要黄酮,其中芦丁占比62.34%。HBHF组分表现出良好的抗AGEs活性,在质量浓度为200μg/mL时,Glu-BSA体系的中的AGEs抑制率为63.16%,MGO-BSA体系中的AGEs抑制率为42.98%,抑制率均显著优于阳性对照氨基胍。
基金supported by the Natural Nature Science Foundation of China,Nos.82030071,81874004the Science and Technology Major Project of Changsha,No.kh2103008(all to JZH).
文摘Treatment with metformin can lead to the recovery of pleiotropic biological activities after spinal cord injury.However,its effect on spinal cord injury in aged mice remains unclear.Considering the essential role of angiogenesis during the regeneration process,we hypothesized that metformin activates the adenosine monophosphate-activated protein kinase/endothelial nitric oxide synthase pathway in endothelial cells,thereby promoting microvascular regeneration in aged mice after spinal cord injury.In this study,we established young and aged mouse models of contusive spinal cord injury using a modified Allen method.We found that aging hindered the recovery of neurological function and the formation of blood vessels in the spinal cord.Treatment with metformin promoted spinal cord microvascular endothelial cell migration and blood vessel formation in vitro.Furthermore,intraperitoneal injection of metformin in an in vivo model promoted endothelial cell proliferation and increased the density of new blood vessels in the spinal cord,thereby improving neurological function.The role of metformin was reversed by compound C,an adenosine monophosphate-activated protein kinase inhibitor,both in vivo and in vitro,suggesting that the adenosine monophosphate-activated protein kinase/endothelial nitric oxide synthase pathway likely regulates metformin-mediated angiogenesis after spinal cord injury.These findings suggest that metformin promotes vascular regeneration in the injured spinal cord by activating the adenosine monophosphate-activated protein kinase/endothelial nitric oxide synthase pathway,thereby improving the neurological function of aged mice after spinal cord injury.
基金funded by the National Natural Science Foundation of China (U20A2085,U21A2005,41971038)the Central Public-Interest Scientifi c Institution Basal Research Fund of Chinese Academy of Forestry (CAFYBB2021ZW002,CAFYBB2020QB004)。
文摘Plantations of Rupprecht's larch(Larix principis-rupprechtii)have been widely established in the drylands of northwest and north China under traditional fastgrowing plantation management strategies.These strategies and the long-term logging ban have led to over-populated stands with lower structural and functional stability,less economic benefit and higher water consumption.To guide the sustainable management of larch plantations,field surveys and historical data compilation were undertaken in the Liupan Mountains of northwest China.The main influencing factors(stand structure and site condition)and their effects on mean tree height,mean DBH and timber volumes were determined based on up-boundary line analysis.Tree growth models coupling the effects of tree age,stand density,and elevation were established.Both height and DBH markedly increased initially and then slowly with tree age,decreased with stand density,and showed unimodal change with elevation.The coupled growth models accounted for72-78%of the variations in tree height,DBH and timber growth.Recommendations for future plantation management are:(1)prolong the rotation to at least 60 years to produce large-diameter,high-quality timber and maintain greater carbon stocks;(2)zone the target functions of stands by elevation;and,(3)reduce stand density for balanced supply of multiple ecosystem services.The growth models developed can predict growth response of larch plantations to density alteration under given ages and elevations,and assist the transformation from traditional management for maximum timber production to site-specific and multifunctional management with longer rotations and moderate tree density.
基金supported by the Research Program of the Research Institute of Petroleum Exploration and Development of the Changqing Oilfield(Grant No.J2019168)。
文摘Using high-precision zircon U-Pb ID-TIMS geochronology,tuffs from the Chang 9 shale and the Chang 7 shale were dated.The tuff in the Chang 9 shale is 241.47±0.17 Ma,which falls between the top tuff age of 241.06±0.12 Ma and the bottom tuff age of 241.558±0.093 Ma in the Chang 7 shale.These reveal that the Chang 9 and Chang 7 shales are contemporaneous,belonging to the Ladinian stage of the Middle Triassic.This insight expands the region of the main source rock of Chang 7 to the northeast and will inform the search for the deep Chang 9 shale petroleum system,increasing the scope for exploring the Chang 7 shale system in northern Shaanxi.The research results clarify the relationship between the two sets of shale in the Yanchang Formation and redefine the distribution range of the Chang 7 shale in the Ordos Basin.At the same time,it shows that there is a cross-layer problem in the stratigraphic division of the Yanchang Formation in different regions,the high-precision U-Pb dating technology providing a reference for the fine stratigraphic correlation of other continental basins in the world.
文摘BACKGROUND Extramedullary multiple myeloma(MM)(EMM)is a rare and aggressive subentity of MM that can be present at diagnosis or develop anytime during the disease course.There is a paucity of data on the clinical characteristics and overall epidemiology of EMM.Furthermore,there is a scarcity of data on how the interaction of age and gender influences the survival of EMM.AIM To evaluate the clinical characteristics of patients with EMM over the past 2 decades and to identify epidemiologic characteristics that may impact overall prognosis.METHODS A total of 858 patients diagnosed with EMM,between 2000 and 2017,were ultimately enrolled in our study by retrieving the Surveillance,Epidemiology,and End Results database.We analyzed demographics,clinical characteristics,and overall mortality(OM)as well as cancer-specific mortality(CSM)of EMM.Variables with a P value<0.1 in the univariate Cox regression were incorporated into the multivariate Cox model to determine the independent prognostic factors,with a hazard ratio(HR)of greater than 1 representing adverse prognostic factors.RESULTS From a sample of 858 EMM,the male gender(63.25%),age range 60-79 years(51.05%),and non-Hispanic whites(66.78%)were the most represented.Central Nervous System and the vertebral column was the most affected site(33.10%).Crude analysis revealed higher OM in the age group 80+[HR=6.951,95%confidence interval(95%CI):3.299-14.647,P=0],Non-Hispanic Black population(HR=1.339,95%CI:1.02-1.759,P=0.036),Bones not otherwise specified(NOS)(HR=1.74,95%CI:1.043-2.902,P=0.034),and widowed individuals(HR=2.107,95%CI:1.511-2.938,P=0).Skin involvement(HR=0.241,95%CI:0.06-0.974,P=0.046)and a yearly income of$75000+(HR=0.259,95%CI:0.125-0.538,P=0)had the lowest OM in the crude analysis.Crude analysis revealed higher CSM in the age group 80+,Non-Hispanic Black,Bones NOS,and widowed.Multivariate cox proportional hazard regression analyses only revealed higher OM in the age group 80+(HR=9.792,95%CI:4.403-21.774,P=0)and widowed individuals(HR=1.609,95%CI:1.101-2.35,P=0.014).Multivariate cox proportional hazard regression analyses of CSM also revealed higher mortality of the same groups.Eyes,mouth,and ENT involvement had the lowest CSM in the multivariate analysis.There was no interaction between age and gender in the adjusted analysis for OM and CSM.CONCLUSION EMM is a rare entity.To our knowledge,there is a scarcity of data on the clinical characteristics and prognosis factors of patients with extramedullary multiple myeloma.In this retrospective cohort,using a United States-based population,we found that age,marital status,and tumor site were independent prognostic factors.Furthermore,we found that age and gender did not interact to influence the mortality of patients with EMM.
