Since China became an aging society in 2000, the regional inequality of population aging has been highlighted, and the phenomenon of "aging before getting rich" has gradually become a core issue in China's coordinated socioeconomic development. This paper aims to comprehensively assess the spatial differences and driving forces of China's population aging through two-stage nested Theil decomposition, ESDA, and spatial econometric models. Empirical results show that spatial differences in population aging were evident at different spatial scales, and the distribution gradually decreased from east to west, showing a positive spatial correlation of similar value aggregation. Moreover, China's population aging was determined by the demographic, socioeconomic, and natural environment, and there are different leading factors in different regions. The demographic aspects played a decisive role and had a direct influence, while the socioeconomic and natural environment indirectly affected population aging through demographic factors and became the root cause of regional differences in population aging. These findings provide an empirical basis for establishing a cooperative mechanism and formulating a targeted response to the problem of population aging in various regions in China.Sustainability 2019, 11, 5959 2 of 20 accumulation [4]. With regard to the social environment, population aging will have various effects on health care, the employment system, the pension insurance system, urban housing and transportation, and old-age service facilities [5]. Furthermore, the regional development imbalance associated with population development factors and socioeconomic characteristics has become a major feature of China's population aging. In view of this, studying the evolution of the spatial differences of China's population aging and its driving factors is conducive to identifying the geographical characteristics of China's population aging and provides a reference for narrowing regional differences, reducing unfavorable socioeconomic impacts and formulating reasonable population development strategies and policies.With the development of industrialization, modernization, and urbanization after the Second World War, developed countries took the lead in completing the modern transformation of population reproduction from high birth and high death rates to low birth and low death rates. The population age structure also changed from young to old. Some scholars have begun to explore the health problems of the elderly and the prevention and treatment of diseases caused by aging from the perspective of biology and medicine [6][7][8]. In the 1970s, geographers interested in aging broadened the understanding of the spatial issues of population aging due to advances in geography, and explored the spatial distribution of the elderly, the dynamic changes in the distribution over time [9][10][11], and the problems urban living spaces create for the elderly [12][13][14]. During this period, several scholars summarized the research on t...

The present meta-analysis was carried out to determine whether supplementation with glutamine (Gln) would reduce the intestinal inflammatory response and mucosal permeability in patients undergoing abdominal surgery. The PubMed, EMBASE, Web of Science, and The Cochrane Library databases were searched for randomized controlled trials on the effects of supplementation with Gln, and published from August, 1966 to June 2014. Inclusion criteria for the meta-analysis were: i) Study design was a randomized controlled trial, ii) study included patients undergoing abdominal surgery, iii) study patients received a supplementation with Gln peptide (Ala-Gln or Gly-Gln) whereas control patients did not use any supplements, and iv) study outcomes included inflammatory markers [C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin (IL)-6, and IL-2 receptor] and markers of intestinal permeability [lactulose/mannitol, diamine oxidase, D(−)lactic acid, and endotoxin]. Qualities of controlled trials were assessed using the Jadad score. Meta-analyses were performed with fixed- or random-effect models depending on the heterogeneity of studies. There were 21 trials meeting the inclusion criteria. The meta-analysis revealed that the levels of CRP, TNF-α, and IL-6 in patients supplemented with Gln were significantly lower than those in control patients, whereas the levels of IL-2 receptor were increased by Gln supplementation. Gln also significantly decreased the lactulose/mannitol ratio, the levels of diamine oxidase and endotoxin, and tended to decrease the levels of cyclic D-lactic acid. In conclusion, Gln appears to effectively reduce the inflammatory response and intestinal mucosal permeability in patients after abdominal surgery.

Background: Current guidelines lack recommendations for the use of immunotherapy and immunerelated biomarkers for hepatocellular carcinoma (HCC). We aim to provide reliable evidence of the association of survival with HCC immunotherapy and to demonstrate that genomic mutation signature could be an effective biomarker to predict immunotherapy efficacy of HCC patients. Methods:We conducted a meta-analysis of 17 randomized trials with 2055 patients and an individual patient-level analysis of 31 patients. Trial data were identified in PubMed, EMBASE and Cochrane Central library, and individual patient data were obtained from the cBioPortal database. Overall survival (OS) and progression-free survival (PFS) were assessed with the hazard ratio (HR) and 95% CI. This study is registered with PROSPERO, number CRD42018083991. Results:The meta-analysis showed that compared to conventional therapy, immunotherapy resulted in prolonged OS (HR =0.65, P<0.0001, high quality) and PFS (HR =0.81, P<0.0001, high quality); the benefits were observed for cellular immunotherapy, tumor vaccine, and cytokine immunotherapy. Findings were robust to subgroup and trial sequential analyses. In the individual patient-level analysis of patients treated with immune checkpoint inhibitor, mutations in TERT, CTNNB1, BRD4, or MLL, and co-mutations in TP53 and TERT or BRD4 were associated with significantly worse survival. These oncogenes were used to develop a novel integrated mutation risk score, which exhibited better utility in predicting survival than the tumor mutation burden (TMB). Patients with low-versus high-mutation risk score had longer OS (HR =0.18, P=0.02) and PFS (HR =0.33, P=0.018). A nomogram comprising the mutation risk score and essential clinical factors further improved the predictive accuracy (AUC =0.840 for both 1-and 2-year OS).Conclusions: Immunotherapy showed longer OS and PFS than conventional therapy among HCC patients, especially patients with a low mutation risk score. The nomogram based on genomic and clinical characteristics is effective in predicting survival of HCC patients undergoing immune checkpoint inhibitor.

In this study, a mechanistic model is developed to predict flow patterns, pressure gradient, and liquid holdup for gas/liquid flow in upward vertical annuli. The flow-pattern-transition model consists of a modified Zhang et al. (2003a) unified model for dispersedbubble flow and annular-flow-pattern transitions, a Caetano (1986) model for bubbly-flow transition, and a modified Kaya et al. (2001) model for slug-to churn-flow transition. The hydrodynamic models are developed on the basis of the dynamics of slug flow, and the film zone is used as the control volume. The two liquid films are taken into account in the annulus-slug-flow and annular-flow model developments. The churn-flow model is developed on the basis of the Zhang et al. (2003a) unified model for pipe flow by using a much shorter slug length.