BACKGROUND Human cystic echinococcosis(CE)is a life-threatening zoonosis caused by the Echinococcus granulosus(sensu lato).Hepatocellular carcinoma(HCC)is a leading cause of cancer-related mortality in the world.The c...BACKGROUND Human cystic echinococcosis(CE)is a life-threatening zoonosis caused by the Echinococcus granulosus(sensu lato).Hepatocellular carcinoma(HCC)is a leading cause of cancer-related mortality in the world.The coexistence of CE and HCC is exceedingly rare,and only several well-documented cases have been reported.In addition to this coexistence,there is no report of the coexistence of CE,HCC,and liver abscess to date.Herein,we aimed to report a case of coexistence of liver abscess,hepatic CE,and HCC.CASE SUMMARY A 65-year-old herdsman presented to the department of interventional therapy with jaundice,right upper abdominal distension and pain for 10 d.Laboratory test showed that he had positive results for HBsAg,HBeAb,HBcAb,and echino-coccosis IgG antibody.The test also showed an increased level of alpha fetopro-tein of 3400 ng/mL.An abdominal computed tomography(CT)scan revealed an uneven enhanced lesion of the liver at the arterial phase with enhancement and was located S4/8 segment of the liver.In addition,CT scan also revealed a mass in the S6 segment of the liver with a thick calcified wall and according to current guideline and medical images,the diagnoses of hepatic CE(CE4 subtype)and HCC were established.Initially,transarterial chemoembolization was performed for HCC.In the follow-up,liver abscess occurred in addition to CE and HCC;thus,percutaneous liver puncture drainage was performed.In the next follow-up,CE and HCC were stable.The liver abscess was completely resolved,and the patient was discharged with no evidence of recurrence.CONCLUSION This is the first reported case on the coexistence of liver abscess,hepatic CE,and HCC.Individualized treatment and multidisciplinary discussions should be performed in this setting.Therefore,treatment and diagnosis should be based on the characteristics of liver abscess,hepatic CE,and HCC,and in future clinical work,it is necessary to be aware of the possibility of this complex composition of liver diseases.展开更多
Effective management of large basins necessitates pinpointing the spatial and temporal drivers of primary index exceedances and urban risk factors,offering crucial insights for basin administrators.Yet,comprehensive e...Effective management of large basins necessitates pinpointing the spatial and temporal drivers of primary index exceedances and urban risk factors,offering crucial insights for basin administrators.Yet,comprehensive examinations of multiple pollutants within the Yangtze River Basin remain scarce.Here we introduce a pollution inventory for urban clusters surrounding the Yangtze River Basin,analyzing water quality data from 102 cities during 2018e2019.We assessed the exceedance rates for six pivotal indicators:dissolved oxygen(DO),ammonia nitrogen(NH_(3)-N),chemical oxygen demand(COD),biochemical oxygen demand(BOD),total phosphorus(TP),and the permanganate index(COD_(Mn))for each city.Employing random forest regression and SHapley Additive exPlanations(SHAP)analyses,we identified the spatiotemporal factors influencing these key indicators.Our results highlight agricultural activities as the primary contributors to the exceedance of all six indicators,thus pinpointing them as the leading pollution source in the basin.Additionally,forest coverage,livestock farming,chemical and pharmaceutical sectors,along with meteorological elements like precipitation and temperature,significantly impacted various indicators'exceedances.Furthermore,we delineate five core urban risk components through principal component analysis,which are(1)anthropogenic and industrial activities,(2)agricultural practices and forest extent,(3)climatic variables,(4)livestock rearing,and(5)principal polluting sectors.The cities were subsequently evaluated and categorized based on these risk components,incorporating policy interventions and administrative performance within each region.The comprehensive analysis advocates for a customized strategy in addressing the discerned risk factors,especially for cities presenting elevated risk levels.展开更多
文摘BACKGROUND Human cystic echinococcosis(CE)is a life-threatening zoonosis caused by the Echinococcus granulosus(sensu lato).Hepatocellular carcinoma(HCC)is a leading cause of cancer-related mortality in the world.The coexistence of CE and HCC is exceedingly rare,and only several well-documented cases have been reported.In addition to this coexistence,there is no report of the coexistence of CE,HCC,and liver abscess to date.Herein,we aimed to report a case of coexistence of liver abscess,hepatic CE,and HCC.CASE SUMMARY A 65-year-old herdsman presented to the department of interventional therapy with jaundice,right upper abdominal distension and pain for 10 d.Laboratory test showed that he had positive results for HBsAg,HBeAb,HBcAb,and echino-coccosis IgG antibody.The test also showed an increased level of alpha fetopro-tein of 3400 ng/mL.An abdominal computed tomography(CT)scan revealed an uneven enhanced lesion of the liver at the arterial phase with enhancement and was located S4/8 segment of the liver.In addition,CT scan also revealed a mass in the S6 segment of the liver with a thick calcified wall and according to current guideline and medical images,the diagnoses of hepatic CE(CE4 subtype)and HCC were established.Initially,transarterial chemoembolization was performed for HCC.In the follow-up,liver abscess occurred in addition to CE and HCC;thus,percutaneous liver puncture drainage was performed.In the next follow-up,CE and HCC were stable.The liver abscess was completely resolved,and the patient was discharged with no evidence of recurrence.CONCLUSION This is the first reported case on the coexistence of liver abscess,hepatic CE,and HCC.Individualized treatment and multidisciplinary discussions should be performed in this setting.Therefore,treatment and diagnosis should be based on the characteristics of liver abscess,hepatic CE,and HCC,and in future clinical work,it is necessary to be aware of the possibility of this complex composition of liver diseases.
基金financial support from the National Natural Science Foundation of China(Grant No.52170073)the National Engineering Research Center for Bioenergy(Harbin Institute of Technology,Grant No.2021A001)+2 种基金the State Key Laboratory of UrbanWater Resource and Environment(Harbin Institute of Technology)(Grant No.2021TS03)We gratefully thank the financial support from the Joint Research program for ecological conservation and high-quality development of the Yellow River Basin(Grant No.2022-YRUC-01-0204)We gratefully thank the contribution of the algorithm model and tool support by the artificial intelligence department of CECEP Digital Technology Co.,Ltd.We gratefully acknowledge the support of the Heilongjiang Province Touyan Team.
文摘Effective management of large basins necessitates pinpointing the spatial and temporal drivers of primary index exceedances and urban risk factors,offering crucial insights for basin administrators.Yet,comprehensive examinations of multiple pollutants within the Yangtze River Basin remain scarce.Here we introduce a pollution inventory for urban clusters surrounding the Yangtze River Basin,analyzing water quality data from 102 cities during 2018e2019.We assessed the exceedance rates for six pivotal indicators:dissolved oxygen(DO),ammonia nitrogen(NH_(3)-N),chemical oxygen demand(COD),biochemical oxygen demand(BOD),total phosphorus(TP),and the permanganate index(COD_(Mn))for each city.Employing random forest regression and SHapley Additive exPlanations(SHAP)analyses,we identified the spatiotemporal factors influencing these key indicators.Our results highlight agricultural activities as the primary contributors to the exceedance of all six indicators,thus pinpointing them as the leading pollution source in the basin.Additionally,forest coverage,livestock farming,chemical and pharmaceutical sectors,along with meteorological elements like precipitation and temperature,significantly impacted various indicators'exceedances.Furthermore,we delineate five core urban risk components through principal component analysis,which are(1)anthropogenic and industrial activities,(2)agricultural practices and forest extent,(3)climatic variables,(4)livestock rearing,and(5)principal polluting sectors.The cities were subsequently evaluated and categorized based on these risk components,incorporating policy interventions and administrative performance within each region.The comprehensive analysis advocates for a customized strategy in addressing the discerned risk factors,especially for cities presenting elevated risk levels.
