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Objective The Ki-67 protein is frequently employed in pathological immunohistochemistry to indicate cell proliferation activity. The principal aim of this study was to examine the impact of stratified management of Ki-67 on the clinicopathological characteristics and prognosis of patients with small-cell lung cancer (SCLC). Methods A total of 175 patients with SCLC who underwent surgical treatment were included in the study, with available data on the results of postoperative immunohistochemistry of the Ki-67 protein. A retrospective analysis was conducted to investigate the correlation between the protein and various clinicopathological features of SCLC, as well as its impact on survival. Results The cut-off value for the Ki-67 level was determined to be 75% through receiver operating characteristic (ROC) analysis. An elevated Ki-67 level was found to be associated with preoperative chemotherapy (χ2 = 4.980, P  = 0.028), preoperative radiotherapy (χ2 = 4.600, P  = 0.032), T stage (χ2 = 4.173, P  = 0.041), TNM staging (χ2 = 10.472, P  = 0.005), and lymph node involvement (χ2 = 16.721, P  < 0.0001). The results of the survival analysis indicated that patients with SCLC exhibiting high levels of Ki-67 had a poorer prognosis than those with low Ki-67 levels ( P  = 0.0004). This was particularly evident in patients aged 60 years or older ( P  = 0.034), in males ( P  = 0.046), smoking for a minimum of 30 years ( P  < 0.001), advanced T staging (T3 + T4) ( P  = 0.031), lymph node involvement ( P  = 0.038), and TNM staging ( P  = 0.015), were associated with poorer outcomes. The univariate Cox regression analysis indicated that exposure to tobacco consumption ( P  = 0.040), pathologic T stage ( P  = 0.047), lymph node metastasis ( P  = 0.002), TNM staging [Stage I vs. II ( P  = 0.016), Stage I vs. III ( P  = 0.003)], and Ki-67 positive rate ( P  < 0.001) were the factors related to prognosis in SCLC. The results of the multivariate regression analysis indicated that T stage(HR: 1.519, 95% CI: 1.116–2.015, P  = 0.022), TNM staging[Stage I vs. III (HR: 2.310, 95% CI: 1.320–4.040, P  < 0.001)], and Ki-67 expression(HR: 1.405, 95% CI: 1.025–1.810, P  < 0.001) was identified as an additional risk factor for SCLC-related mortality. Conclusion In summary, the Ki-67 protein is not only strongly associated with the malignant characteristics of SCLC, but also the stratification of Ki-67 has significant implications for the treatment and prognosis of patients with small-cell lung cancer. Clinical trial number Not applicable.

Lung cancer remains one of the deadliest cancers, marked by uncontrolled cell growth in the lungs and often diagnosed at later stages. This study presents a novel hydrogel‐embedded nanocomposite responsive to Near‐Infrared (NIR) light (CN‐Pt‐DOX@CS+NIR) to induce necroptosis in lung cancer cells. The composite, created by combining Carbon Nanodots (CNs), Platinum Nanoparticles (PtNPs), and Doxorubicin (DOX) within a Chitosan (CS)‐based hydrogel, demonstrated favorable properties for sustained drug release. Upon NIR irradiation, the CNs increase oxidative stress and initiate apoptosis due to the generation of reactive oxygen species (ROS) and caspase activation (3, 8, and 9). The PtNPs enhance ROS production and disrupt mitochondrial membrane potential (MMP), further promoting cell death. DOX, a well‐known chemotherapeutic, intercalates DNA and inhibits topoisomerase II, leading to apoptosis. These combined effects result in significant cytotoxicity under NIR stimulation, as shown in vitro on A549 and H1299 cells, confirmed through various assays including AO/EB and DAPI staining, flow cytometry, and RT‐PCR. Additionally, the hydrogel matrix provides a controlled release of the therapeutic agents and improves localized delivery. Combining CNs, PtNPs, and DOX with NIR enhanced in vitro cytotoxic effects, apoptosis, ROS generation, and potential for targeted lung cancer therapy. Representation of fabrication of carbon nanodots/platinum functionalized nanocomposite hydrogel formulation for near‐infrared responsive delivery of doxorubicin for lung cancer treatment.

Habitat suitability assessment is critical for wildlife population conservation and management planning. The MaxEnt model is widely used in species habitat suitability modeling. In order to investigate the habitat status of the black-necked crane in the Zoige grassland wetland ecological function area, this study evaluated the habitat suitability of the black-necked crane using the MaxEnt model with 152 occurrence records and 13 environmental variables. Based on the Akaike information criterion corrected for the small sample size, the best optimal parameter combination (feature class LQPHT, regularization multiplier 3.0) was selected. The results show that the Maxent model had good accuracy with an area under the curve (AUC) value of 0.895. Distance to roads, average summer precipitation, distance to lakes, and altitude are the dominant environmental variables affecting the potential distribution of black-necked cranes, with the contribution rates of 31.6%, 29.8%, 14.3%, and 8.2%, respectively. The suitable habitat area of black-necked cranes is mainly distributed in and around the Zoige Wetland National Nature Reserve, accounting for 46.49% of the Zoige Grassland Wetland National Key Ecological Function Zone. The potential distribution area has a tendency to spread to Hongyuan County in the south of the functional zone, and the unsuitable habitat is mainly distributed in the high-altitude area in the southwest of the functional zone. This study recommends focusing on the distribution area of black-necked cranes around Zoige Wetland National Nature Reserve and Hongyuan County to improve conservation strategies and strengthen protection efforts.

Accurate high-resolution soil moisture mapping is critical for surface studies as well as climate change research. Currently, regional soil moisture retrieval primarily focuses on a spatial resolution of 1 km, which is not able to provide effective information for environmental science research and agricultural water resource management. In this study, we developed a quantitative retrieval framework for high-resolution (250 m) regional soil moisture inversion based on machine learning, multisource data fusion, and in situ measurement data. Specifically, we used various data sources, including the normalized vegetation index, surface temperature, surface albedo, soil properties data, precipitation data, topographic data, and soil moisture products from passive microwave data assimilation as input parameters. The soil moisture products simulated based on ground model simulation were used as supplementary data of the in situ measurements, together with the measured data from the Maqu Observation Network as the training target value. The study was conducted in the Zoige region of the Tibetan Plateau during the nonfreezing period (May–October) from 2009 to 2018, using random forests for training. The random forest model had good accuracy, with a correlation coefficient of 0.885, a root mean square error of 0.024 m³/m³, and a bias of −0.004. The ground-measured soil moisture exhibited significant fluctuations, while the random forest prediction was more accurate and closely aligned with the field soil moisture compared to the soil moisture products based on ground model simulation. Our method generated results that were smoother, more stable, and with less noise, providing a more detailed spatial pattern of soil moisture. Based on the permutation importance method, we found that topographic factors such as slope and aspect, and soil properties such as silt and sand have significant impacts on soil moisture in the southeastern Tibetan Plateau. This highlights the importance of fine-scale topographic and soil property information for generating high-precision soil moisture data. From the perspective of inter-annual variation, the soil moisture in this area is generally high, showing a slow upward trend, with small spatial differences, and the annual average value fluctuates between 0.3741 m3/m3 and 0.3943 m3/m3. The intra-annual evolution indicates that the monthly mean average soil moisture has a large geographical variation and a small multi-year linear change rate. These findings can provide valuable insights and references for regional soil moisture research.

Background It is commonly accepted that surgical treatment is an essential component of the comprehensive management of metastatic spinal malignancies. However, up until now, the clinical classification of metastatic spinal malignancies has not been well-structured. Methods After IRB approval, 86 patients with metastatic spinal malignancies were adopted. According to the vascular distribution, stability of vertebrae, and degree of nerve compression, metastatic spinal malignancies can be classified into five types. Tumors classified as type I typically appear in the vertebral body. Type II tumors are those that develop in the transverse processes, superior and inferior articular processes, and spinal pedicles. Type III denotes malignancies that are present in the spinous process and vertebral plate. Types IVa and IVb are included in type IV. Type IVa combines type I and type II, whereas type IVb combines type II and type III. Type V tumors are those of types I, II, and III that co-occur and spread in different directions into the spinal canal. 20 of included 86 patients who did not receive segmental arterial embolization were set as the non-embolization group. The embolization group included 24 patients who received segmental arterial embolization on both sides of the diseased vertebrae. 42 patients were included in the offending embolization group after receiving responsible arterial embolization. A surgical intervention was performed within 24 h following an embolization. Surgical intervention with the purpose of removing as much of the tumor as possible and providing an effective reconstruction of the spinal column. Results In comparison with the non-embolization group and embolization group, the offending embolization group presented unique advantages in terms of bleeding volume (p<0.001), operation time (p<0.001), and local recurrence rate within 12 months (p=0.006). Conclusion By significantly reducing surgical trauma and local recurrence rate (12 months), responsible arterial vascular embolization procedures together with associated surgical protocols developed on the basis of the clinical classification of metastatic spinal malignancies, are worthy of clinical dissemination.

Global climate change and disturbances from human activities lead to habitat loss and changes in habitat quality, resulting in a reduction in biodiversity. The continental coastline of China distributes some cities with highly developed economies and coastal wetlands with rich biodiversity, and both economic development and biodiversity conservation are important topics. In order to clarify the spatial distribution of bird biodiversity in coastal areas, based on the MaxEnt model and GIS spatial analysis, the distribution data of 488 species of birds and 15 environmental variables were used to simulate the suitable distribution areas of birds, and to analyze the spatial distribution and hotspots of bird biodiversity in coastal areas. The main findings of this study are as follows. (1) A total of 488 species in 249 genera of 21 orders and 81 families of birds were involved in the modeling of coastal areas. The main environmental factors affecting the potential distribution of birds in general are: land use, monthly mean diurnal temperature range, and precipitation of the driest month. (2) High value areas of bird richness are distributed in different locations in the four sea areas: In the Bohai Rim region, they are mainly distributed in the Liaohe Estuary Wetland in Liaoning Province, the vicinity of the Yongdingxin River and Haihe River in Tianjin, the eastern part of Tianjin, and the Yellow River and Yellow River Delta Wetland in Shandong Province; In the coastal area of the Yellow Sea, they are primarily found in Kunyu Mountain National Nature Reserve, Laoshan Provincial Nature Reserve in Shandong Province, and Yancheng Wetland Rare Birds National Nature Reserve in Jiangsu Province; In the coastal areas of the East China Sea, they are mainly found at the mouth of the Yangtze River, at the national nature reserve of Dongtan birds on Chongming Island, along the southeastern coast of Zhejiang Province, near the Min River and along the coast of Quanzhou in Fujian Province; In the coastal areas of the South China Sea, they are mainly distributed in the Pearl River Delta wetlands of Guangdong Province, the southeastern coastal areas of the Guangdong-Hong Kong-Macao Greater Bay Area, and the Shiwanda Mountain National Nature Reserve in Guangxi Province. (3) The spatial trends in the distribution of hotspots of birds of national priority protection in coastal areas are generally consistent, but more concentrated than the distribution of all birds. (4) After the high-value areas of bird richness were superimposed with protected areas, it was found that the intersecting area accounted for a small proportion of the protected area, and many areas near the inland had low bird richness. Finally, the findings provide references for bird biodiversity conservation and planning in coastal areas.

Background Autogenous granular bone graft (AG), autogenous massive bone graft (AM), and titanium mesh bone graft (TM) are the three commonly utilized bone implant methods for spinal tuberculosis. However, the gold standard is still controversial. Therefore, this study aimed to compare the clinical efficacy and surgical safety of three primary bone graft modalities. Methods For systematic literature review, several databases, including PubMed, Embase, and Web of Science, were searched up to December 2022. Stata (version 14.0) was employed for data analysis. Results Our network meta-analysis included 517 patients from 7 articles whose qualities are acceptable based on our quality assessment criteria. In direct comparison, AG was associated with a shorter operation time (MD = 73.51; CI 30.65–116.37) and a lesser blood loss (MD = 214.30; CI 7.17–421.44) than AM. TM had fewer loss of Cobb angle than AG (MD = 1.45; CI 0.13–2.76) and AM (MD = 1.21; CI 0.42–1.99). Compared with AG, TM (MD = 0.96; CI 0.06–1.87) was related to a shorter bone graft fusion time. In indirect comparison, for the clinical parameters, the rank of CRP (from best to worst) was as follows: TM (58%) > AM (27%) > AG (15%), the rank of ESR (from best to worst) was as follows: AG (61%) > AM (21%) > TM (18%), and the rank of VAS (from best to worst) was as follows: AG (65%) > TM (33%) > AM (2%). In the aspect of surgical data, what is noteworthy is that AG showed less blood loss [AG (93%) > TM (6%) > AM (1%)], operative time [AG (97%) > TM (3%) > AM (0)], and complications [AG (75%) > TM (21%) > AM (4%)] than AM and TM. As for imaging parameters, the rank of the loss of Cobb angle (from best to worst) was as follows: TM (99%) > AM (1%) > AG (0). Moreover, TM showed a shorter bone graft fusion time than AM and AG: TM (96%) > AM (3%) > AG (1%). Conclusions The results indicated that AG might be the optional treatment for spinal tuberculosis owing to the outcomes of surgical safety. Moreover, TM is another right choice which can significantly reduce the loss of Cobb angle and shorten bone graft fusion time with long‐term follow‐up.

The relationship between pore architecture and structure performance needs to be explored, as well as confirm the optimized porous structure. Because of the linear correlation between constant C and pore architecture, triply periodic minimal surface (TPMS) based porous structures could be a controllable model for the investigation of the optimized porous structure. In the present work, three types of TPMS porous scaffolds (S, D and G) combined with four constants (0.0, 0.2, 0.4 and 0.6) were designed, and built successfully via the selective laser melting (SLM) technology. The designed feature and mechanical property of porous scaffolds were investigated through mathematical method and compression test. And the manufactured samples were co-cultured with rMSCs for the compatibility study. The results indicated that the whole manufacturing procedure was good in controllability, repeatability, and accuracy. The linear correlation between the porosity of TPMS porous scaffolds and the constant C in equations was established. The different TPMS porous scaffolds possess the disparate feature in structure, mechanical property and cell compatibility. Comprehensive consideration of the structure features, mechanical property and biology performance, different TPMS structures should be applied in appropriate field. The results could guide the feasibility of apply the different TPMS architectures into the different part of orthopedic implants.

Background Although a high C-reactive protein-to-albumin ratio (CAR) is believed to increase mortality risk, the association between the physical activity (PA), CAR, and mortality among cancer survivors has not been investigated. This study aimed to examine this association among cancer survivors in the United States. Methods This cohort study used data from the National Health and Nutrition Examination Survey from 1999 to 2010. PA was self-reported using the Global Physical Activity Questionnaire, and C-reactive protein and albumin levels were obtained from laboratory data files. Mortality data were obtained by linkage of the cohort database to the National Death Index as of December 31, 2019. The analysis was conducted from November 1 to December 31, 2023. We used Cox proportional hazards multivariable regression to assess hazard ratios (HRs) and 95% confidence interval (CIs) for total and cancer-specific mortality risks attributable to PA and CAR. Results Among 2,232 cancer survivors, 325 (14.6%) reported no PA with a high CAR. During a follow-up of up to 20.75 years (median, 12.3 years; 27,453 person-years), 1,174 deaths occurred (cancer, 335; other, 839). A high CAR was observed to be consistently associated with the highest risks of total (HR, 1.59; 95% CI, 1.37–1.85) and cancer-specific (HR, 2.06; 95% CI, 1.55–2.73) mortality compared with a low CAR in a series of adjusted models. Multivariable models showed that PA was associated with a lower risk of all-cause (HR, 0.60; 95% CI, 0.52–0.69) and cancer-specific (HR, 0.64; 95% CI, 0.49–0.84) mortality compared with no PA. In the joint analyses, survivors with PA ≥ 600 metabolic equivalent min/wk and a low CAR were more likely to reduce the risk of total (HR, 0.41; 95% CI, 0.32–0.51) and cancer-specific (HR, 0.32; 95% CI, 0.20–0.50) mortality by 59% and 68% compared with those with no PA and a high CAR. Conclusion The pairing of adequate PA and a low CAR was significantly associated with reduced all-cause and cancer-related mortality risks.