The lack of a precisely-dated, unequivocal climate proxy from northern China, where precipitation variability is traditionally considered as an East Asian summer monsoon (EASM) indicator, impedes our understanding of the behaviour and dynamics of the EASM. Here we present a well-dated, pollen-based, ~20-yr-resolution quantitative precipitation reconstruction (derived using a transfer function) from an alpine lake in North China, which provides for the first time a direct record of EASM evolution since 14.7 ka (ka = thousands of years before present, where the “present” is defined as the year AD 1950). Our record reveals a gradually intensifying monsoon from 14.7–7.0 ka, a maximum monsoon (30% higher precipitation than present) from ~7.8–5.3 ka, and a rapid decline since ~3.3 ka. These insolation-driven EASM trends were punctuated by two millennial-scale weakening events which occurred synchronously to the cold Younger Dryas and at ~9.5–8.5 ka, and by two centennial-scale intervals of enhanced (weakened) monsoon during the Medieval Warm Period (Little Ice Age). Our precipitation reconstruction, consistent with temperature changes but quite different from the prevailing view of EASM evolution, points to strong internal feedback processes driving the EASM, and may aid our understanding of future monsoon behaviour under ongoing anthropogenic climate change.

The Levant constitutes an important region for assessing linkages between climate and societal changes throughout the course of human history. However, large uncertainties remain in our understanding of the region's hydroclimate variability under varying boundary conditions. Here we present a new high‐resolution, precisely dated speleothem oxygen‐carbon isotope and Sr/Ca records, spanning the last 20 ka from Jeita Cave, northern Levant. Our record reveals a higher (lower) precipitation‐evaporation (P‐E) balance during the Last Glacial Maximum and Bølling interstadial (Heinrich stadial 1). The early‐middle Holocene is characterized by a trend toward higher P‐E state, culminating between ~7 and 6 ka. The middle‐late Holocene is characterized by two millennial‐length drier periods during 5.3–4.2 and 2.8–1.4 ka. On submillennial time scale, the northern Levant climate variability is dominated by 500 year periodicity. Comparisons with the regional proxy records suggest persistent out‐of‐phase climate variability between the northern and southern Levant on a wide range of timescales.

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OBJECTIVES:Tumor-associated macrophages have been implicated in promoting tumor growth, progression and metastasis. However, the activated phenotype (M1 or M2) of tumor-associated macrophages remains unknown in solid tumors. Therefore, this study examined the density and prognostic significance of M2-polarized tumor-associated macrophages in lung adenocarcinoma.METHODS:Tumor specimens from 65 lung adenocarcinoma patients were assessed by ELISA for Th1/Th2 cytokine concentrations. The activated phenotype (M1 or M2) of tumor-associated macrophages was determined utilizing immunofluorescence staining. Additionally, to evaluate lymphangiogenesis, peritumoral lymphatic microvessel density was measured using D2-40. The correlation between tumor-associated macrophage subtype and overall patient survival was analyzed using the Kaplan-Meier method and compared using the log-rank test.RESULTS:A shift toward Th2 cytokine expression was detected within lung adenocarcinoma microenvironments. Approximately 79.71±16.27% of tumor-associated macrophages were M2 polarized; the remaining 20.35±5.31% were M1 polarized. The infiltration of M2-polarized macrophages was significantly associated with P-TNM staging and lymph node metastasis. The peritumoral lymphatic microvessel density was significantly higher in the high M2-polarized tumor-associated macrophage group than in the low M2-polarized tumor-associated macrophage group. A significant difference in overall patient survival was detected not only between patients with tumors with high and low macrophage counts but also between patients with tumors with high and low counts of M2-polarized macrophages. CONCLUSION:Tumor-associated macrophages in lung adenocarcinoma have an M2-polarized subtype and are associated with poor prognoses, perhaps resulting from accelerated lymphangiogenesis and lymph node metastasis.

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