Background: Previous studies have provided conflicting evidence about the increased overall survival (OS) in lung cancer patients with diabetes mellitus (DM) compared with those without DM. This study assessed progression-free survival (PFS)/OS in lung cancer patients with or without DM and tentatively analyzed the impact of blood glucose levels on PFS/OS in lung cancer patients. Methods: Data were collected from lung cancer patients based upon admission records from January 2010 to January 2012 and follow-up records from January 2010 to January 2015 in the Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai. The data included patient sex, age, body mass index (BMI), smoking status, history of DM, level of blood glucose, pathological type, clinical stage of cancer, chemotherapy regimen, and history of anti-DM drugs. The Cox regression model and Kaplan-Meier method were used for the analysis of hazard factors and PFS/OS. For comparison of PFS/OS in lung cancer with or without DM, patients were divided into three groups: lung cancer with DM, lung cancer without DM but with elevated level of blood glucose, lung cancer without DM or elevated level of blood glucose. Results: In total, the data from 200 lung cancer patients (138 males/62 females, aged 29.0 to 78.0 years, mean 60.0 ± 8.6 years) were collected. For the comparison of PFS/OS in lung cancer patients with or without DM, patients were divided into three groups: lung cancer with DM (n = 31); lung cancer without DM but with elevated levels of blood glucose (n = 40); and lung cancer without both DM and elevated levels of blood glucose (n = 128), whereas 1 patient dropped out of the study. All the patients underwent complete chemotherapy and were followed up for 36.0 to 60.0 months. Kaplan-Meier survival analysis showed that lung cancer patients with DM had increased PFS and OS compared with those without DM (log-rank, P < 0.05, P < 0.01); the median PFS in lung cancer with DM was 12.0 months (95% confidence interval [CI], 4.0–16.0) vs. 6.0 months in those without DM (95% CI, 5.8–6.3); and the median OS in lung cancer patients with DM was 37.0 months (95% CI, 29.0–46.6) vs. 12.0 months in those without DM (95% CI, 10.9–13.1). For the other two groups of patients without DM, there was a trend toward a shorter PFS and OS in patients with elevated blood glucose compared with those without elevated blood glucose. Cox regression showed that PFS in lung cancer patients was favorably associated with the usage of anti-DM drugs, BMI, clinical stage of cancer, and chemotherapy regimen (all P < 0.05) but was inversely associated with the level of blood glucose (P < 0.05). Conclusions: Lung cancer patients with DM have prolonged PFS and OS compared with those without DM, and the level of blood glucose was inversely associated with PFS. The current results indicate that PFS may be a meaningful intermediate endpoint for OS and that the levels of blood glucose hopefully represent a prognostic factor in lung cancer patients.

Linear non-sulfated hyaluronan (HA) does not bind complement proteins yet inhibits their hemolytic function. We have previously induced the complement inhibitory function of HA by heat treatment. However, heated HA readily loses its anti-complementary activity probably due to instantaneous interchain re-association. Here, HA solutions were heated and then freeze-dried. Compared to native HA, heated/freeze-dried HA stably restricted serum complement-mediated hemolysis via the classical pathway, in which serum C1 hemolytic function and C3 activation were blocked. Also, treated HA had a significantly increased binding of component C1q, C1r, C1s, C2, C5, C9, P, D and H. Further, when HA was gel-fractionated by electrophoresis and then freeze-dried, its anti-complementary activity was stably induced. Both native and heated/freeze-dried HA stimulated ERK phosphorylation in prostate DU145 cells. However, treated HA suppressed the expression of tumor suppressors WOX1 and WOX2. Together, HA with an altered conformation stabilizes its inhibition and binding of complement proteins. It may recognize cell surface receptors differently from native HA, thereby differentially regulating the expression of cellular proteins.

Climate change and socio-economic transformation increasingly challenge the stability of China’s food supply. This study aims to optimize grain crop layouts by integrating natural suitability and nutritional supply within a unified analytical framework. Using the MaxEnt model incorporating bioclimatic, topographic, and soil variables, we simulated the natural suitability of major grain crops and compared it with actual planting patterns based on the SPAM dataset. Results revealed substantial spatial discrepancies between actual and suitable distributions, with national planting diversity index increasing by 26.42% (from 0.53 to 0.67) under suitable conditions. Wheat and maize are most suited to northern China, rice and tuber crops to southern regions, while soybean performs optimally in the northeast. Nutrient supply potential also improved substantially under the suitable scenario, with energy, protein, fat, and carbohydrate increasing by 56.9 × 10⁸ KJ, 77.2 × 10⁶ g, 23.3 × 10⁶ g, and 48.6 × 10⁶ g per million people, respectively. Among alternative structures, maize-soybean and maize-based planting structures better aligned with both natural adaptability and nutritional balance (e.g., in Inner Mongolia and Heilongjiang), whereas rice-based structure showed weaker correspondence (e.g., in Shanghai). These findings demonstrate that naturally adaptive optimization can enhance both environmental compatibility and nutritional adequacy, providing scientific guidance for developing climate-resilient and nutrition-oriented crop layout strategies in China.

Yunnan Province, which is located in the mountainous plateau region of China, faces numerous challenges, including the population decline of rural areas. Achieving coordinated development between the transportation and rural population systems is crucial for fostering sustainable growth. In this study, we developed a rural population pressure state response (PPSR) model and a comprehensive transport superiority (TS) model that considers the influence of aviation. We quantified the rural population system and horizontal transportation superiority across Yunnan’s districts and counties for the period 2013 to 2021, examining their temporal and spatial heterogeneity. Using a spatial autocorrelation model, we also explored the trade-offs and synergy between Yunnan’s TS and PPSR. The main findings are as follows. (1) From 2013 to 2021, the spatial polarization pattern of PPSR in Yunnan Province gradually weakened, and there were different degrees of rural contraction overall. (2) From 2013 to 2021, Yunnan’s TS significantly increased, with aviation conditions having a notably positive impact, further strengthening Kunming’s position as the regional core. (3) In Yunnan, the relationship between TS and PPSR is significant, with a collaborative pattern emerging across districts and counties, reflecting distinct regional characteristics and a degree of polarization. This study provides valuable insights for integrating urban and rural development in plateau and mountainous areas and offers a new perspective for rural revitalization.

Plateau lake regions face escalating conflicts between food production and ecosystem conservation under rapid urbanization and strict ecological regulation. However, existing evaluations often overlook the positive ecosystem services generated by cultivated land and fail to capture the nonlinear mechanisms shaping eco-efficiency of cultivated land use (ECLU). This study develops an ecosystem service-based framework to assess the ECLU of Kunming, a typical plateau lake-basin city in southwest China, from 2005 to 2022. Ecosystem service value (ESV) is incorporated as a desirable output within a super-efficiency SBM model, and an XGBoost–SHAP approach is applied to identify the intensity, nonlinear thresholds and interaction mechanisms. Results show an average ECLU of 1.12 with a fluctuating downward trend and widening spatial disparities. High-efficiency zones cluster in central–southern regions, while urbanizing cores experience ecological function degradation despite productivity gains. Cultivated land fragmentation is the dominant barrier, with a critical threshold of 31.90 mu, and fertilizer intensity turns detrimental beyond 0.19 t/ha. Urbanization exhibits an inverted-U pattern—initially suppressive (55%)—with the promotion phase weakened by approximately 67% under severe fragmentation. Globally, threshold-based zoning and fragmentation mitigation must precede fertilizer optimization to ensure synergistic benefits.