Analysis and prediction of 5-year survival in patients with cutaneous melanoma: a model-based period analysis

BackgroundThe survival and prognosis of patients are significantly threatened by cutaneous melanoma (CM), which is a highly aggressive disease. It is therefore crucial to determine the most recent survival rate of CM. This study used population-based cancer registry data to examine the 5-year relative survival rate of CM in the US.MethodsPeriod analysis was used to assess the relative survival rate and trends of patients with CM in the Surveillance, Epidemiology, and End Results (SEER) database during 2004–2018. And based on the data stratified by age, gender, race and subtype in the SEER database, a generalized linear model was 12established to predict the 5-year relative survival rate of CM patients from 2019 to 2023.ResultsThe 5-year relative survival increased to various degrees for both total CM and CM subtypes during the observation period. The improvement was greatest for amelanotic melanoma, increasing from 69.0% to 81.5%. The 5-year overall relative survival rates of CM were 92.9%, 93.5%, and 95.6% for 2004–2008, 2009–2013, and 2014–2018, respectively. Females had a marginally higher survival rate than males for almost all subtypes, older people had lower survival rates than younger people, white patients had higher survival rates than nonwhite ones, and urban locations had higher rates of survival from CM than rural locations did. The survival rate of CM was significantly lower for distant metastasis.ConclusionThe survival rate of patients with CM gradually improved overall during 2004–2018. With the predicted survival rate of 96.7% for 2019–2023, this trend will still be present. Assessing the changes experienced by patients with CM over the previous 15 years can help in predicting the future course of CM. It also provides a scientific foundation that associated departments can use to develop efficient tumor prevention and control strategies

Application of Angiotensin Receptor–Neprilysin Inhibitor in Chronic Kidney Disease Patients: Chinese Expert Consensus

Chronic kidney disease (CKD) is a global public health problem, and cardiovascular disease is the most common cause of death in patients with CKD. The incidence and prevalence of cardiovascular events during the early stages of CKD increases significantly with a decline in renal function. More than 50% of dialysis patients die from cardiovascular disease, including coronary heart disease, heart failure, arrhythmia, and sudden cardiac death. Therefore, developing effective methods to control risk factors and improve prognosis is the primary focus during the diagnosis and treatment of CKD. For example, the SPRINT study demonstrated that CKD drugs are effective in reducing cardiovascular and cerebrovascular events by controlling blood pressure. Uncontrolled blood pressure not only increases the risk of these events but also accelerates the progression of CKD. A co-crystal complex of sacubitril, which is a neprilysin inhibitor, and valsartan, which is an angiotensin receptor blockade, has the potential to be widely used against CKD. Sacubitril inhibits neprilysin, which further reduces the degradation of natriuretic peptides and enhances the beneficial effects of the natriuretic peptide system. In contrast, valsartan alone can block the angiotensin II-1 (AT1) receptor and therefore inhibit the renin–angiotensin–aldosterone system. These two components can act synergistically to relax blood vessels, prevent and reverse cardiovascular remodeling, and promote natriuresis. Recent studies have repeatedly confirmed that the first and so far the only angiotensin receptor–neprilysin inhibitor (ARNI) sacubitril/valsartan can reduce blood pressure more effectively than renin–angiotensin system inhibitors and improve the prognosis of heart failure in patients with CKD. Here, we propose clinical recommendations based on an expert consensus to guide ARNI-based therapeutics and reduce the occurrence of cardiovascular events in patients with CKD

DEM-based analysis of tectonic geomorphologic characteristics and tectonic activity intensity of the Dabanghe River Basin in South China Karst

The Dabanghe River Basin, in the west of Guizhou Plateau, consists of numerous prominent geological structural features, such as the Shuicheng–Wangmo, Yadu–Ziyun, and Yongningzhen Faults, the Huangguoshu Waterfall, and the Guanjiao Knickpoint. The topographic conditions and structural systems are highly complex, making this a suitable area to study neotectonics. However, research on the geomorphology of the region is lacking. Combined with geomorphic parameters, quantitative exploration of tectonic geomorphic and tectonic activity in the Dabanghe River Basin is of great significance to reveal the formation of the Huangguoshu Waterfall, the development of landforms in western Guizhou, and the regularity of uplift of Guizhou Plateau. Therefore, based on a Digital Elevation Model, GIS software extracted and calculated six geomorphic parameters of the basin: Hypsometric Integral, Asymmetry Factor, Basin Shape Ratio, Stream-Gradient, and Valley Floor Width–Valley Height Ratio (VF) indexes. The tectonic geomorphic characteristics of the Dabanghe River Basin were analyzed, combined with the tectonic activity level classification method, and the Index of Relative Active Tectonics (IAT) of each sub-catchment was calculated. The geomorphic parameters of the basin were found to indicate its geomorphic characteristics well. The tectonic activity in the study area midstream is the most active, and the geomorphic evolution of some upstream and downstream reaches is affected by lithology, topography, and structure. The tectonic geomorphology of the basin is significantly affected by the fault system. Under the control of the Yadu–Ziyun Fault, the tectonic activity in the basin gradually weakens from west to east, and the differential tectonic activity (strong in the mid-reach and eastwards decrease) is consistent with observed seismic intensity. It is confirmed that our research results are consistent with the regional geological background and geomorphic characteristics through field geological survey. Therefore, this study confirms that the use of tectonic geomorphic parameters to classify active tectonics can be an important method to evaluate the stability of the crust in the region and further extends the application of geomorphic parameters in tectonics

Chemical Weathering and Riverine Carbonate System Driven by Human Activities in a Subtropical Karst Basin, South China

In the context of climate change, the input of acid substances into rivers, caused by human activities in the process of industrial and agricultural development, has significantly disrupted river systems and has had a profound impact on the carbon cycle. The hydrochemical composition and which main sources of the Lianjiang River (LR), a subtropical karst river in northern Guangdong Province, South China, were analyzed in January 2018. The objective was to explicate the influence on the deficit proportion of CO2 consumption, resulting from carbonate chemical weathering (CCW), driven by nitric acid (HNO3) and sulfuric acid (H2SO4), which is affected by exogenous acids from the industrial regions in north of the Nanling Mountains and the Pearl River Delta. The response of the riverine carbonate system to exogenous acid-related weathering was also discussed. HCO3− and Ca2+, respectively, accounted for 84.97% of the total anions and 78.71% of the total cations in the surface runoff of the LR, which was characterized as typical karst water. CCW was the most important material source of river dissolved loads in the LR, followed by human activities and silicate chemical weathering (SCW). Dissolved inorganic carbon (DIC), derived from CCW induced by carbonic acid (H2CO3), had the largest contribution to the total amount of DIC in the LR (76.79%), and those from CCW induced by anthropogenic acids (HNO3 and H2SO4) and SCW contributed 13.56% and 9.64% to the total DIC, respectively. The deficit proportion of CO2 consumption associated with CCW resulting from sulfuric acid and nitric acid (13.56%), was slightly lower than that of the Guizhou Plateau in rainy and pre-rainy seasons (15.67% and 14.17%, respectively). The deficit percentage of CO2 uptake associated with CCW induced by sulfuric acid and nitric acid, accounted for 38.44% of the total CO2 consumption related to natural CCW and 18.84% of the anthropogenic acids from external areas. DIC derived from CCW induced by human activities, had a significant positive correlation with the total alkalinity, SIc and pCO2 in river water, indicating that the carbonate system of the LR was also driven by exogenous acids, with the exception of carbonic acid. More attention should be paid to the effects of human activities on the chemical weathering and riverine carbonate system in the karst drainage basin

Association of diet quality with the risk of Sarcopenia based on the Chinese diet balance index 2016: a cross-sectional study among Chinese adults in Henan Province

Abstract Background Sarcopenia can lead to a series of unfavourable health outcomes. Diet is an important factor influencing sarcopenia. In this study, we aimed to evaluate the association of sarcopenia with diet quality assessed by the Chinese Diet Balance Index 2016 (DBI-16). Methods A cross-sectional study was conducted to collect information on nutrition and health in Henan Province, China, and a total of 644 individuals were studied. Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS) criteria updated in 2019. Diet quality was assessed by using the Chinese Diet Balance Index 2016 (DBI-16), which includes three indicators: the lower bound score (LBS), higher bound score (HBS) and diet quality distance (DQD). Binary logistic regression analysis was used to estimate the risk of sarcopenia associated with diet quality. Results A total of 49 of the 644 participants were diagnosed with sarcopenia. Excessive intake (score > 0) of cereals, meat, eggs and salt, inadequate intake (score < 0) of vegetables, fruits, dairy products, soybeans and low diet variety were commonly seen in both groups of participants. The participants with sarcopenia had a more serious inadequate intake of fruit than those without sarcopenia (p < 0.05). The overall LBS, HBS and DQD in both groups were in the interval of low-level problems. Compared with participants with a suitable LBS, those with an unsuitable LBS were more likely to have a low gait speed (OR: 2.58; 95%CI: 1.13–7.04) after multiple adjustments. However, the other two DBI-16 indicators, the HBS and DQD, were not associated with sarcopenia or its related diagnostic variables. Conclusion Unfavourable diet quality, mainly referring to inadequate dietary intake in this study, may be a risk factor for low gait speed

Characteristics of and Influencing Factors of Hydrochemistry and Carbon/Nitrogen Variation in the Huangzhouhe River Basin, a World Natural Heritage Site

In karst areas, the characteristics of water chemistry and carbon and nitrogen are of great significance to basic research. The contents of Ca2+, Mg2+, K+, Na+, HCO3&minus;, SO42&minus;, NO3&minus;, Cl&minus;, dissolved organic carbon (DOC), and total nitrogen (TN) in water samples from 18 rivers and 14 springs in the Huangzhouhe River Basin were determined. The results showed that the water chemistry type in the Huangzhouhe River Basin is HCO3-Ca-Mg. The chemical composition is mainly affected by dolomite weathering and also by ion exchange and other human activities. The river and spring DIC remain at the same level in the upper and middle reaches and decrease in the lower reaches. The NO3-N and TN of river water and TN of spring water increase in the middle reaches, while NO3-N of spring water decreases in the lower reaches. The DOC in the basin increases with the increase of SO42&minus; and Cl&minus;, mainly due to the human influence of agricultural and domestic sewage. In the basin, the NO3-N and TN in spring water are larger, and the DOC in river water is larger, mainly because there are more phytoplankton and human activities in the river water. The carbon and nitrogen in the Huangzhouhe River Basin are mainly HCO3&minus; and NO3&minus; ions. The evaluation of pH, Cl&minus;, NO3-N, SO42&minus;, and TDS shows that the water quality is good and the ecological environment is good

Temporal and Spatial Variations in Carbon/Nitrogen Output in the Karst Critical Zone and Its Response to the Forest Ecosystem of Karst Desertification Control

Rocky desertification is a common phenomenon in karst areas. Soil carbon and nitrogen storage is of great significance to the formation and evolution of ecosystems. Soil leakage is one of the important indicators in evaluating ecosystem stability. There are few studies on the response of carbon and nitrogen leakage below the surface of karst critical zones to forest ecosystems. The karst springs in the study area of Shibing Heichong, Bijie Salaxi and Guanling-Zhenfeng Huajiang in Guizhou, China, were selected to determine the variation characteristics of carbon and nitrogen content and karst spring outputs and their response to soil leakage. The results showed the following: (1) The content and output of carbon and nitrogen in karst springs in the three study areas showed obvious spatial differences. The carbon and nitrogen output of karst spring water was mainly concentrated in the rainy season. The carbon and nitrogen contents and output of karst springs in the Shibing Heichong study area were higher than those in the Bijie Salaxi and Guanling-Zhenfeng Huajiang study areas. (2) The carbon and nitrogen outputs of karst springs were mainly affected by flow. Land cover and land use in forests affect the carbon and nitrogen contents of karst springs and thus affect the output. (3) The higher the soil leakage of the karst spring was, the higher the carbon and nitrogen output. The leakage of the overlying soil in the Shibing Heichong study area was high, but the soil decline was small, and the stability of the forest ecosystem was relatively good. In summary, a lower degree of rocky desertification results in higher leakage from karst springs and higher risks of soil leakage; however, the ecosystem was relatively stable. Evaluating forest soil carbon and nitrogen loss and ecosystem stability in karst areas through the nutrient output of karst springs is of great significance for the prevention and control of rocky desertification areas

Carbon Nitrogen Isotope Coupling of Soils and Seasonal Variation Characteristics in a Small Karst Watershed in Southern China

Carbon and nitrogen are among the most important biogenic elements in terrestrial ecosystems, and carbon and nitrogen stable isotopes (δ13C and δ15N) are often used to indicate the sources of carbon and nitrogen elements and turnover processes, and the study of C and N isotopes coupling can provide more precise indications. To this end, this study was conducted to investigate the effects of different land use types on soil organic carbon (SOC), soil organic nitrogen (SON) and the coupling relationship of C-N isotopes, as well as to reveal the seasonal variation characteristics of soil C and N. The results showed that SOC and SON contents of forest land were significantly higher than those of agricultural land and grassland. The soil C/N was significantly higher in the dry season than in the rainy season (p 13C and δ15N coupling showed seasonal characteristics: soil δ13C and δ15N did not have a good linear relationship in the rainy season, but showed a significant positive correlation in the dry season (r2 = 0.75, p < 0.05), indicating that there are differences in the soil C-N isotope fractionation coupling under the influence of climatic factors. This study provides a reference for regional land resource management as well as carbon and nitrogen cycle studies in karst areas

Analysis of the Three-Dimensional Fluorescence Spectroscopy Characteristics of Dissolved Organic Matter in Groundwater from a Subtropical Cave in Dry Season&mdash;Daxiao Cave in South China Karst

Groups in dissolved organic matter (DOM) emit fluorescence information at characteristic wavelengths when irradiated by excitation waves, which can reveal the geochemical behavior of dissolved organic matter in the environment and its sources, but there are few relevant studies in cave groundwater systems. In order to investigate the relationship between drip hydrochemistry characteristics and DOM in cave systems after subsurface leakage, in this study, from the perspective of dissolved organic matter in the karst cave water system, the groundwater in the dry season of Daxiao Cave was selected as the research object. Five drip points and one water pool (DX-1, DX-2, DX-3, DX-4, DX-5, and DX-C) in Daxiao Cave were monitored and consecutively sampled for four months. The parallel factor analysis method (PARAFAC), three-dimensional (3D) fluorescence parameters, and excitation-emission matrix fluorescence spectroscopy (EEM), combined with the hydrochemistry characteristics of the drip water and correlation analysis, were used to analyze the 3D fluorescence spectral characteristics of the DOM of the drip water of Daxiao Cave and their influencing factors. The results show that (1) the hydrochemistry type of the drip water in Daxiao Cave was within the Ca&ndash;Mg&ndash;HCO3 type, and Ca2+, Mg2+, and HCO3&minus; were the dominant ions in Daxiao Cave; (2) the fluorescence fractions of drip water in dry season caves were dominated by C1 (humus-like), C2 (tryptophan-like), and C3 (tyrosine-like), and the fluorescence fractions of drip water DOM were controlled by protein fluorophores; (3) the DOM in the drip water of Daxiao Cave in the dry season was controlled in part by subsurface leakage and was largely the result of microbial degradation; and (4) the DOM of the drip water may be influenced by the chemical composition of the water, but the exact process is not clear

Evaluation of a Novel Microfocused Ultrasound with Three‐Dimensional Digital Imaging for Facial Tightening: A Prospective, Randomized, Controlled Trial

Abstract Background The excellent efficacy is mitigated by the limited safety profile of microfocused ultrasound procedures. Objective We sought to assess the safety and tightening efficacy of a novel microfocused ultrasound. Methods The randomized middle and lower face and submental region of the participants were treated with the novel device using the following transducers: M4.5, D4.5, M3.0, and D3.0. Improvement in paired comparison of pretreatment and posttreatment photographs, three-dimensional (3D) volumetric assessments, skin thickness measured by B-ultrasonography, and skin photoaging parameters were evaluated. Adverse events and patient satisfaction were also recorded. Results A total of 20 participants (20 female) were enrolled. Fourteen of 20 participants (70%) were judged to show clinically significant facial tightening during 3-month follow-up (P < 0.05). The mean volumetric change in the lower face, as quantitatively assessed after 3 months was −0.29 mL compared with +0.42 mL on the control side (P < 0.05). The VAS pain score was 3.00 ± 1.19 without any oral or intramuscular anesthesia. Conclusions A small sample size, lack of clinical scales, and impersonalized treatment parameters. The novel microfocused ultrasound appears to be a safe and effective modality for lower-face tightening. Clinical Trial Registration Number ChiCTR 2200064666