Objective To analyze clinical characteristics of acromegaly patients who have discordant growth hormone(GH)or insulin-like growth factor-1(IGF-1)levels and evaluate impact of different GH cut-offs on discordance rate....Objective To analyze clinical characteristics of acromegaly patients who have discordant growth hormone(GH)or insulin-like growth factor-1(IGF-1)levels and evaluate impact of different GH cut-offs on discordance rate.Methods A retrospective analysis was conducted on data from 66 acromegaly patients treated at Nanjing Drum Tower Hospital from November 2017 to March 2023.Patients were categorized based on the nadir GH(GHn)and ICF-1 levels at the last follow-up into four groups:controlled,high GH,high IGF-1,and active.Clinical and metabolic parameters were compared across these groups,and impact of different CHn and fasting growth hormone(GHf)cut-offs on discordance rate vwas evaluated.Results No statistically significant differences were observed among groups in age,duration of followup,imaging characteristics(all P>0.05).High IGF-1 group had higher fasting insulin and homeostasis model assessment forβcell function compared to controlled and high GH group(all P<0.05),while these parameters did not differ between high GH and controlled group.High ICF-1 group had higher carboxy-terminal crosslinked telopeptide of type 1 collagen,osteocalcin and procollagen type 1 N-terminal propeptide compared to controlled and high GH group,but differences were not statistically significant(all P>0.05).These parameters also did not differ between high CH and controlled group.Discordance rate was not significantly different when CHn cut-offs were 1.0μg/L or 0.4μg/L(30.3%vs 21.3%,P=0.146).Compared to 2.5μg/L,discordance rate was lower when CHf cut-off was 1.0μg/L(39.4%us 24.3%,P=0.041).Conclusion The discordance rate in treated acromegaly patients during follow-up is approximately 30%.Different CH measurement timings and cut-offs significantly impact discordance rate.Patients with normal GH and elevated IGF-1 levels are at potential risk of active disease,and require closer followup.This study provides a valuable reference for treatment of patients with discordant GH and IGF-1 levels.展开更多
Land use/cover change(LUCC)and climate change have important influences on ecosystem services(ESs)and their interactions,particularly in regions with rapid socioeconomic development.However,little research has disting...Land use/cover change(LUCC)and climate change have important influences on ecosystem services(ESs)and their interactions,particularly in regions with rapid socioeconomic development.However,little research has distinguished the impacts of these 2 factors on ES interactions.Therefore,the impacts of LUCC and climate change on water-related ecosystem service(WES)trade-offs in the Yangtze River Economic Belt(YREB)were measured by combining spatial analysis with ES valuation.These results indicated that water yield,soil retention,and water purification presented varying degrees of increase from 1990 to 2020,with rates of 4.53%,21.80%and 5.40%,respectively.The order of the mean WES tradeoffs in the upstream,midstream,and downstream regions remained stable at the grid scale from 1990 to 2020,while there were important changes at the county scale.Climate change had a greater impact on WES trade-offs than LUCC,with climate change dominating 88.17%of the total area.The effect of climate change on WES trade-offs across areas was in the order of downstream>midstream>upstream,while the effect of LUCC was not obvious.The relative importance of drivers on WES trade-offs from 1990 to 2020 was dominated by climate dominance(71.50%),followed by LUCC to climate dominance(13.66%)and least by LUCC dominance(0.65%).This research emphasized the importance of LUCC and climate change on ES trade-offs in heavily disturbed areas,providing important guidance for multi-objective land management that sustainably provides ESs.展开更多
Understanding intricate interactions between natural–social factors and ecosystem service synergies and trade-offs(ESS/EST)can be valuable for promoting the sustainable development of multiple ecosystem services(ESs)...Understanding intricate interactions between natural–social factors and ecosystem service synergies and trade-offs(ESS/EST)can be valuable for promoting the sustainable development of multiple ecosystem services(ESs).Taking Beijing as the study area,this study was conducted from the perspective of ecosystem service bundles(ESBs).First,based on the identification of key ecological risks,the supply of 5 ESs was quantified.Then,3 ESBs were identified through the cluster analysis of the ESs.We explored the synergies and trade-offs between ES pairs in different ESBs and quantified their strengths.By further exploring the influence of natural–social factors on ESS/EST,we developed targeted management policies in different ESBs to improve management efficiency.At the township scale,Beijing is divided into 3 ESBs.Marked differences in the ESS/EST were found among each bundle,indicating the necessity of zonal management.The results showed that landscape composition was the dominant factor affecting ESS in ESB3 and EST in ESB2,human activities had the greatest influence on ESS in ESB2,while biophysical indicators had the highest degree of contribution to ESS and EST in ESB1 and EST in ESB3.These results support the formulation of sustainable management strategies.The results of the study emphasize the importance of considering ESS/EST and their natural–social factors in different ESBs when formulating effective policies,which can provide useful guidance for sustainable urban planning and development and can be further applied to metropolitan areas around the world.展开更多
Recently,Gansu Jianxin Industrial Group suc- cessfully signed the 100,000-ton lead smelting project in Hui County of Gansu Province,indi- cating the new era of mining industry develop- ment for the place with new brea...Recently,Gansu Jianxin Industrial Group suc- cessfully signed the 100,000-ton lead smelting project in Hui County of Gansu Province,indi- cating the new era of mining industry develop- ment for the place with new breakthrough in investment invitation.展开更多
文摘Objective To analyze clinical characteristics of acromegaly patients who have discordant growth hormone(GH)or insulin-like growth factor-1(IGF-1)levels and evaluate impact of different GH cut-offs on discordance rate.Methods A retrospective analysis was conducted on data from 66 acromegaly patients treated at Nanjing Drum Tower Hospital from November 2017 to March 2023.Patients were categorized based on the nadir GH(GHn)and ICF-1 levels at the last follow-up into four groups:controlled,high GH,high IGF-1,and active.Clinical and metabolic parameters were compared across these groups,and impact of different CHn and fasting growth hormone(GHf)cut-offs on discordance rate vwas evaluated.Results No statistically significant differences were observed among groups in age,duration of followup,imaging characteristics(all P>0.05).High IGF-1 group had higher fasting insulin and homeostasis model assessment forβcell function compared to controlled and high GH group(all P<0.05),while these parameters did not differ between high GH and controlled group.High ICF-1 group had higher carboxy-terminal crosslinked telopeptide of type 1 collagen,osteocalcin and procollagen type 1 N-terminal propeptide compared to controlled and high GH group,but differences were not statistically significant(all P>0.05).These parameters also did not differ between high CH and controlled group.Discordance rate was not significantly different when CHn cut-offs were 1.0μg/L or 0.4μg/L(30.3%vs 21.3%,P=0.146).Compared to 2.5μg/L,discordance rate was lower when CHf cut-off was 1.0μg/L(39.4%us 24.3%,P=0.041).Conclusion The discordance rate in treated acromegaly patients during follow-up is approximately 30%.Different CH measurement timings and cut-offs significantly impact discordance rate.Patients with normal GH and elevated IGF-1 levels are at potential risk of active disease,and require closer followup.This study provides a valuable reference for treatment of patients with discordant GH and IGF-1 levels.
基金supported by the Youth Innovation Promotion Association of the Chinese Academy of Sciences(grant number 2021194)
文摘Land use/cover change(LUCC)and climate change have important influences on ecosystem services(ESs)and their interactions,particularly in regions with rapid socioeconomic development.However,little research has distinguished the impacts of these 2 factors on ES interactions.Therefore,the impacts of LUCC and climate change on water-related ecosystem service(WES)trade-offs in the Yangtze River Economic Belt(YREB)were measured by combining spatial analysis with ES valuation.These results indicated that water yield,soil retention,and water purification presented varying degrees of increase from 1990 to 2020,with rates of 4.53%,21.80%and 5.40%,respectively.The order of the mean WES tradeoffs in the upstream,midstream,and downstream regions remained stable at the grid scale from 1990 to 2020,while there were important changes at the county scale.Climate change had a greater impact on WES trade-offs than LUCC,with climate change dominating 88.17%of the total area.The effect of climate change on WES trade-offs across areas was in the order of downstream>midstream>upstream,while the effect of LUCC was not obvious.The relative importance of drivers on WES trade-offs from 1990 to 2020 was dominated by climate dominance(71.50%),followed by LUCC to climate dominance(13.66%)and least by LUCC dominance(0.65%).This research emphasized the importance of LUCC and climate change on ES trade-offs in heavily disturbed areas,providing important guidance for multi-objective land management that sustainably provides ESs.
基金supported by the Key Project of the State Forestry and Grassland Administration of China(2023132050)the Major Project of Teaching Reform of Beijing Forestry University 2023 (BJFU2023JYZD002)
文摘Understanding intricate interactions between natural–social factors and ecosystem service synergies and trade-offs(ESS/EST)can be valuable for promoting the sustainable development of multiple ecosystem services(ESs).Taking Beijing as the study area,this study was conducted from the perspective of ecosystem service bundles(ESBs).First,based on the identification of key ecological risks,the supply of 5 ESs was quantified.Then,3 ESBs were identified through the cluster analysis of the ESs.We explored the synergies and trade-offs between ES pairs in different ESBs and quantified their strengths.By further exploring the influence of natural–social factors on ESS/EST,we developed targeted management policies in different ESBs to improve management efficiency.At the township scale,Beijing is divided into 3 ESBs.Marked differences in the ESS/EST were found among each bundle,indicating the necessity of zonal management.The results showed that landscape composition was the dominant factor affecting ESS in ESB3 and EST in ESB2,human activities had the greatest influence on ESS in ESB2,while biophysical indicators had the highest degree of contribution to ESS and EST in ESB1 and EST in ESB3.These results support the formulation of sustainable management strategies.The results of the study emphasize the importance of considering ESS/EST and their natural–social factors in different ESBs when formulating effective policies,which can provide useful guidance for sustainable urban planning and development and can be further applied to metropolitan areas around the world.
文摘Recently,Gansu Jianxin Industrial Group suc- cessfully signed the 100,000-ton lead smelting project in Hui County of Gansu Province,indi- cating the new era of mining industry develop- ment for the place with new breakthrough in investment invitation.
