Is new American Thyroid Association risk classification for hereditary medullary thyroid carcinoma applicable to Chinese patients? A single-center study

Objective: The American Thyroid Association (ATA) proposed a new risk classification for hereditary medullary thyroid carcinoma (MTC) in 2015. This study aimed to assess whether the new guidelines are suitable for the Chinese population, and reported our experience on prophylactic thyroidectomy. Methods: A total of 73 patients from 22 families were screened as rearranged during transfection (RET) mutation carriers from 2010 to 2016 in Cancer Hospital, Chinese Academy of Medical Science; the medical history for each patient was collected. Based on the initial treatment, we identified the risk factors for poor prognosis by univariate and multivariate logistic regression. Then, 4 RET mutation carriers were enrolled for prophylactic thyroidectomy, and their pathological data and follow-up outcomes were recorded. Results: In univariate and multivariate logistic regression analyses, age at initial surgery and risk classification were significant risk factors for stage III/IV hereditary MTC at initial diagnosis. The likelihood was increased by 11.6% per year of age at initial surgery [95% confidence interval (95% CI), 1.040-1.198; P=0.002). It was 7.888 times more likely to have III/IV stage disease for ATA highest risk patients, compared to ATA moderate risk individuals (95% CI, 1.607-38.717; P=0.003). Postoperative pathological results showed all 4 multiple endocrine neoplasia type 2A (MEN2A) patients had C-cell hyperplasia (CCH); multifocal malignancies were detected in 3 of them. All 4 patients were cured biochemically, and none developed permanent hypoparathyroidism. Conclusions: In Chinese individuals, hereditary MTC aggressiveness is in line with the new ATA risk classification. Germline RET gene mutation carriers should undergo prophylactic thyroidectomy according to basal serum calcitonin levels.

Carbon Price Forecasting Approach Based on Multi-Scale Decomposition and Transfer Learning

Accurate carbon price forecasting is essential to provide the guidance for production and investment.Current research is mainly dependent on plenty of historical samples of carbon prices,which is impractical for the newly launched carbon market due to its short history.Based on the idea of transfer learning,this paper proposes a novel price forecasting model,which utilizes the correlation between the new and mature markets.The model is firstly pretrained on large data of mature market by gated recurrent unit algorithm,and then fine-tuned by the target market samples.An integral framework,including complexity decomposition method for data pre-processing,sample entropy for feature selection,and support vector regression for result post-processing,is provided.In the empirical analysis of new Chinese market,the root mean square error,mean absolute error,mean absolute percentage error,and determination coefficient of the model are 0.529,0.476,0.717%and 0.501 respectively,proving its validity.

Consolidation of MA W-Ni-Fe Alloyed Powder by Microwave-Assisted Sintering

MA W-Ni-Fe alloyed powder compact was sintered by microwave technology, and the influence of microwave sintering on consolidation of W-Ni-Fe alloy was studied. The fracture morphology and microstructure of alloys were measured by SEM and metallurgical microscope. The experimental results showed that microwave sintering promoted the densification of MA W-Ni-Fe alloyed powder quickly with the higher heating rate. The density of the sintered samples increased with the increase of sintering temperature, and significant densification shrinkage occured at 1300 ~ 1400°C. The tungsten grain grew rapidly at 1450°C. When the alloy was microwave sintered at 1550°C, the inner structure of alloy is more homogeneous, the average W grain size is about 15 μm, and the relative density of sintered specimen is 99%.

终轧温度对低屈强比桥梁耐候钢组织及力学性能的影响

采用Gleeble-3800热模拟试验机、拉伸试验机、显微硬度计等设备,并结合光学显微镜(OM)和电子背散射衍射(EBSD)等表征方法,研究了终轧温度对Cu-Cr-Ni低屈强比桥梁耐候钢组织和力学性能的影响,并阐明了其具体的变化机理。结果表明,终轧温度880℃下的Cu-Cr-Ni桥梁耐候钢组织为粒状贝氏体,随着终轧温度由880℃降低至800℃,组织中出现针状铁素体并逐渐增多;M/A岛的平均尺寸由1.3μm增大至3.3μm,且面积分数由21.7%增大至32.3%;基体中的位错密度显著升高,主要是由基体回复程度大幅降低导致的。此外,Cu-Cr-Ni桥梁耐候钢的硬度及屈服强度随着终轧温度的降低而有所升高,屈服强度由435 MPa增大至496 MPa,抗拉强度基本不变,约为710 MPa,这是由显微组织中的针状铁素体、M/A组元和位错密度等因素共同决定。屈强比增大但总体低于0.7,塑性略有提高。

胰腺癌新辅助化疗后腹腔镜手术治疗的效果分析

目的探讨胰腺癌接受新辅助化疗后行腹腔镜手术治疗的临床效果。方法回顾性分析2019年9月至2020年6月在复旦大学附属肿瘤医院胰腺外科接受腹腔镜手术治疗的8例新辅助化疗后胰腺癌患者的临床资料。其中男性5例,女性3例;年龄47~72岁。所有患者术前均行腹部增强CT检查和PET-CT检查,以准确评估肿瘤分期,并排除远处转移。结果8例患者术前均接受AG方案(吉西他滨1000 mg/m2+白蛋白结合型紫杉醇125 mg/m2,第1、8、15天,每4周1个周期)新辅助化疗2~6周期,并顺利完成手术。其中接受胰十二指肠切除术5例,根治性顺行模块化胰脾切除术2例,全胰腺切除术1例,无中转开腹或腹腔镜辅助手术。手术时间240~450 min,术中出血量100~500 ml,术后住院时间10~16 d。随访截至2020年12月31日,术后发生并发症1例(B级胰瘘伴腹腔感染),无围手术期死亡。淋巴结清扫数目为9~31枚。所有患者均获得R0切除。随访时间4.5~9.5个月,其中1例胰体尾癌患者术后2个月发生肝转移,其余7例患者仍无瘤存活。结论在经验丰富的胰腺微创外科中心,胰腺癌患者新辅助化疗后接受腹腔镜手术治疗具有较好的临床效果。

In silico design of novel proton-pump inhibitors with reduced adverse effects

The development of new proton-pump inhibitors (PPIs) with less adverse effects by lowering the pKa values of nitrogen atoms in pyrimidine rings has been previously suggested by our group. In this work, we proposed that new PPIs should have the following features:(1) number of ring II = number of ring I+ 1;(2) preferably five, six, or seven-membered heteroatomic ring for stability;and (3) 1<pKa1<4. Six molecular scaffolds based on the aforementioned criteria were constructed, and R groups were extracted from compounds in extensive data sources. A virtual molecule dataset was established, and the pKa values of specific atoms on the molecules in the dataset were calculated to select the molecules with required pKa values. Drug-likeness screening was further conducted to obtain the candidates that significantly reduced the adverse effects of long-term PPI use. This study provided insights and tools for designing targeted molecules in silico that are suitable for practical applications.

Decoupling effect and driving factors of carbon footprint in megacity Wuhan,Central China

Background China’s 35 largest cities,including Wuhan,are inhabited by approximately 18%of the Chinese popula-tion,and account for 40%energy consumption and greenhouse gas emissions.Wuhan is the only sub-provincial city in Central China and,as the eighth largest economy nationwide,has experienced a notable increase in energy con-sumption.However,major knowledge gaps exist in understanding the nexus of economic development and carbon footprint and their drivers in Wuhan.Methods We studied Wuhan for the evolutionary characteristics of its carbon footprint(CF),the decoupling relation-ship between economic development and CF,and the essential drivers of CF.Based on the CF model,we quantified the dynamic trends of CF,carbon carrying capacity,carbon deficit,and carbon deficit pressure index from 2001 to 2020.We also adopted a decoupling model to clarify the coupled dynamics among total CF,its accounts,and eco-nomic development.We used the partial least squares method to analyze the influencing factors of Wuhan’s CF and determine the main drivers.Results The CF of Wuhan increased from 36.01 million t CO_(2)eq in 2001 to 70.07 million t CO_(2)eq in 2020,a growth rate of 94.61%,which was much faster than that of the carbon carrying capacity.The energy consumption account(84.15%)far exceeded other accounts,and was mostly contributed by raw coal,coke,and crude oil.The carbon deficit pressure index fluctuated in the range of 8.44-6.74%,indicating that Wuhan was in the relief zone and the mild enhancement zone during 2001-2020.Around the same time,Wuhan was in a transition stage between weak and strong CF decoupling and economic growth.The main driving factor of CF growth was the urban per capita residen-tial building area,while energy consumption per unit of GDP was responsible for the CF decline.Conclusions Our research highlights the interaction of urban ecological and economic systems,and that Wuhan’s CF changes were mainly affected by four factors:city size,economic development,social consumption,and technological progress.The findings are of realistic significance in promoting low-carbon urban development and improving the city’s sustainability,and the related policies can offer an excellent benchmark for other cities with similar challenges.