Globally,2023 was the warmest observed year on record since at least 1850 and,according to proxy evidence,possibly of the past 100000 years.As in recent years,the record warmth has again been accompanied with yet more...Globally,2023 was the warmest observed year on record since at least 1850 and,according to proxy evidence,possibly of the past 100000 years.As in recent years,the record warmth has again been accompanied with yet more extreme weather and climate events throughout the world.Here,we provide an overview of those of 2023,with details and key background causes to help build upon our understanding of the roles of internal climate variability and anthropogenic climate change.We also highlight emerging features associated with some of these extreme events.Hot extremes are occurring earlier in the year,and increasingly simultaneously in differing parts of the world(e.g.,the concurrent hot extremes in the Northern Hemisphere in July 2023).Intense cyclones are exacerbating precipitation extremes(e.g.,the North China flooding in July and the Libya flooding in September).Droughts in some regions(e.g.,California and the Horn of Africa)have transitioned into flood conditions.Climate extremes also show increasing interactions with ecosystems via wildfires(e.g.,those in Hawaii in August and in Canada from spring to autumn 2023)and sandstorms(e.g.,those in Mongolia in April 2023).Finally,we also consider the challenges to research that these emerging characteristics present for the strategy and practice of adaptation.展开更多
Introduction: Ectopic secretion of GHRH is a rare cause of acromegaly. However, its recognition is clinically important because different therapeutic approaches are required. Case Presentation: We present a challengin...Introduction: Ectopic secretion of GHRH is a rare cause of acromegaly. However, its recognition is clinically important because different therapeutic approaches are required. Case Presentation: We present a challenging case of acromegaly secondary to ectopic GHRH secretion from pancreatic neuroendocrine tumor in a 52-year-old female. The patient is treated with different modalities which include pegvisomant in an attempt to control the stimulated GH-axis considering the limited data about its use in treatment of ectopic acromegaly. Conclusion: GHRH-secreting tumor is a rare cause of acromegaly. Surgical resection of the tumor is the therapy of choice whenever possible. However, further studies are warranted for unresectable tumor or resistant cases.展开更多
基金supported by the National Natural Science Foundation of China(42275038)China Meteorological Administration Climate Change Special Program(QBZ202306)。
文摘Globally,2023 was the warmest observed year on record since at least 1850 and,according to proxy evidence,possibly of the past 100000 years.As in recent years,the record warmth has again been accompanied with yet more extreme weather and climate events throughout the world.Here,we provide an overview of those of 2023,with details and key background causes to help build upon our understanding of the roles of internal climate variability and anthropogenic climate change.We also highlight emerging features associated with some of these extreme events.Hot extremes are occurring earlier in the year,and increasingly simultaneously in differing parts of the world(e.g.,the concurrent hot extremes in the Northern Hemisphere in July 2023).Intense cyclones are exacerbating precipitation extremes(e.g.,the North China flooding in July and the Libya flooding in September).Droughts in some regions(e.g.,California and the Horn of Africa)have transitioned into flood conditions.Climate extremes also show increasing interactions with ecosystems via wildfires(e.g.,those in Hawaii in August and in Canada from spring to autumn 2023)and sandstorms(e.g.,those in Mongolia in April 2023).Finally,we also consider the challenges to research that these emerging characteristics present for the strategy and practice of adaptation.
文摘Introduction: Ectopic secretion of GHRH is a rare cause of acromegaly. However, its recognition is clinically important because different therapeutic approaches are required. Case Presentation: We present a challenging case of acromegaly secondary to ectopic GHRH secretion from pancreatic neuroendocrine tumor in a 52-year-old female. The patient is treated with different modalities which include pegvisomant in an attempt to control the stimulated GH-axis considering the limited data about its use in treatment of ectopic acromegaly. Conclusion: GHRH-secreting tumor is a rare cause of acromegaly. Surgical resection of the tumor is the therapy of choice whenever possible. However, further studies are warranted for unresectable tumor or resistant cases.
