Analyzing the clinical significance of postoperative methotrexate in the management of early abdominal pregnancy: analysis of 10 cases

Objectives: To assess the clinical value and treatment outcomes of postoperative methotrexate (MTX) therapy in the management of early abdominal pregnancy.  Material and methods: We retrospectively analyzed ten (10) cases of early abdominal pregnancy at our hospital between 7th August, 2006 and 20th April, 2017.  Results: Out of the ten (10) cases identified, six (6) patients and four (4) patients underwent surgery (laparotomy or laparoscopy) only and surgery (laparotomy or laparoscopy) plus IM 50 mg/m2 methotrexate (MTX) within 24 hours of surgery respectively. The gestation age and serum β-HcG levels were significantly lower (p < 0.05, 6.0 ± 1.82 and 8073.2 ± 9561.0) in the surgery plus MTX group in comparison to (7.33 ± 3.61 and 15625 ± 21275.2) for the surgery only group. Ultrasound imaging findings reported extra uterine pregnancy in all cases and diagnostic surgery was necessary to locate precise site of implantation to plan further treatment. Days of hospitalization were shorter in the surgery + MTX group than in the surgery only group (3.00 ± 0.816 versus 5.66 ± 2.80).  Conclusions: Earliness in diagnosis coupled with the appropriate (methotrexate) MTX regime could help prevent unwanted complications that could arise from delayed or misdiagnosis

Research on the impact of fiscal environmental protection expenditure on agricultural carbon emissions

China’s agricultural and rural greenhouse gas emissions account for about 15% of its total emissions. Studying how to reduce China’s agricultural carbon emissions (ACEs) is of great strategic significance. Based on the panel data of 31 provinces (cities) in China from 2007 to 2020, this paper empirically tests the impact of fiscal environmental protection expenditure (FEPE) on ACEs. The results reveal that: FEPE has significant negative impacts on ACEs; FEPE has a heterogeneous impact on ACEs in different regions, which shows that it has a significant impact on the eastern and central regions and provinces with relatively “high” carbon emissions, while it has no significant impact on the western regions and provinces with relatively “low” carbon emissions; Further the results of mechanism analysis show that the impact of FEPE on ACEs is mainly manifested in its inhibiting effect on agricultural diesel, fertilizer and film use of carbon emissions. In light of these findings, it is imperative for the government to ensure steady and substantial investments in environmental protection. Moreover, implementing region-specific measures is essential to effectively curbing ACEs. The findings of this study offer invaluable insights that can guide the formulation of policies aimed at effectively reducing ACEs

The impact of cities’ transportation network connections on regional market integration: the case of China’s urban agglomerations

Author accepted versionDespite growing scholarly attention on the role of urban networks for understanding regional dynamics, there has been limited research examining the impact of cities’ transportation network connections on regional market integration. This paper analyzes China’s four major urban agglomerations: the Yangtze River Delta, the Pearl River Delta, Beijing-Tianjin-Hebei, and Chengdu-Chongqing. Applying a spatial Durbin model to cross-sectional datasets for 2019, we provide insight into the role of cities’ transportation network connections in promoting regional market integration, considering both the potentially heterogeneous impact of network connections and the interplay between network and agglomeration externalities. Our results indicate that: (1) cities’ transportation network connections have an inverted ‘U’-shaped effect on regional market integration; (2) transportation network connections have spatial spillover effects; (3) the positive impact of transportation network connections on regional market integration becomes more pronounced as city size decreases; and (4) there are neither complementary nor substitution effects between network and agglomeration externalities. We reflect on the broader implications of our empirical findings for regional development strategies and discuss possible avenues for further research

Quantitative determination, by real-time reverse transcription polymerase chain reaction, of aromatase mRNA in invasive ductal carcinoma of the breast

BACKGROUND: Estrogen is a mitogenic factor that is implicated in the genesis and progression of breast cancer via its binding to estrogen receptor (ER)-α. Synthesis of estrogen in situ is believed to be catalyzed mainly by aromatase. Previous studies comparing the relative contributions from tumor cells and stromal cells to local estrogen synthesis, as assessed by immunohistochemical analysis, were quite controversial and no consistent relationship was found between the presence of aromatase and any clinicopathologic factor. In addition, previous studies into aromatase gene expression and clinicopathologic factors are limited. METHODS: We assessed the level of expression of aromatase mRNA, using quantitative real-time RT-PCR, in 162 cases of invasive ductal carcinoma of the breast. Associations between aromatase expression and different clinicopathologic factors were sought. RESULTS: It was found that aromatase mRNA was expressed at significantly higher levels in patients older than 50 years, in those without axillary lymph node involvement, in those with tumor size less than 2 cm, and in ER-α positive tumors. However, no relationship was found between aromatase mRNA expression and any other clinicopathologic factor, including histologic grade and progesterone receptor status. Patients with high levels of expression of aromatase mRNA tended to have a better prognosis than did those patients with low expression. CONCLUSION: These findings imply that ER-α and aromatase may be coexpressed in endocrine responsive patients. They may also indicate that aromatase expression could be a marker of endocrine responsiveness, and it may have prognostic implications for breast cancer progression

Association of Serum Uric Acid with Arterial Stiffness in Peritoneal Dialysis Patients

Background/Aims: Serum uric acid (SUA) has been proposed as a mediator associated with increased cardiovascular risk and arterial stiffness. However, evidence on the association between SUA and arterial stiffness in peritoneal dialysis (PD) patients is lacking. The aim of this study was to examine the relationship between SUA and arterial stiffness in PD patients. Methods: The patients who performed vascular profiler test from January 1, 2014 to October 31, 2016, and with SUA values were enrolled. Arterial stiffness was evaluated by brachial-ankle pulse wave velocity (baPWV). The relationship between SUA and baPWV was tested by multiple linear regression models. Results: Of 645 PD patients, mean SUA was 6.80 (±1.29) mg/dL, mean baPWV was 1713 (±505) cm/s. In fully adjusted linear regression models, higher SUA was significantly associated with higher baPWV in young [standardized coefficients (β), 0.085; 95% confidence interval (95% CI), 0.013 to 0.130; P=0.02] but not in elderly (β, -0.194; 95% CI, -0.774 to 0.093; P=0.1) PD patients. In gender-stratified models of young patients, there was a significant association between SUA and baPWV in male (β, 0.115; 95% CI, 0.015 to 0.182; P=0.02) but not in female. Male in the highest gender-specific SUA quartile had a higher baPWV than those in the lowest quartile (β, 0.132; 95% CI, 0.011 to 0.209; P=0.03). This gender difference was reversed when selecting male patients with lower SUA levels (quartile 1 and 2) and female patients with higher SUA levels (quartile 3 and 4). Conclusion: SUA was positively associated with baPWV in young PD patients, and this association was significant in males but not in females, which is possibly explained by the higher SUA level in males than in females