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Purpose: To evaluate whether postoperative circulating tumor DNA (ctDNA) in plasma of patients with non-small cell lung cancer (NSCLC) can be used as a biomarker for early detection of molecular residual disease (MRD) and prediction of postoperative recurrence. Methods: This study subjects were evaluated patients with surgical resected non-small cell lung cancer. All eligible patients underwent radical surgery operation followed by adjuvant therapy. Tumor tissue samples collected during operation were used to detect tumor mutation genes, and blood samples collected from peripheral veins after operation were used to collect ctDNA. Molecular residue disease (MRD) positive was defined as at least 1 true shared mutation identified in both the tumor sample and a plasma sample from the same patient was. Results: Positive postoperatively ctDNA was associated with lower recurrence-free survival (RFS).The presence of MRD was a strong predictor of disease recurrence. The relative contribution of ctDNA-based MRD to the prediction of RFS is higher than all other clinicopathological variables, even higher than traditional TNM staging. In addition, MRD-positive patients who received adjuvant therapy had improved RFS compared to those who did not, the RFS of MRD-negative patients receiving adjuvant therapy was lower than that of patients not receiving adjuvant therapy. Conclusions: Post-operative ctDNA analysis is an effective method for recurrence risk stratification of NSCLC, which is beneficial to the management of patients with NSCLC.

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With the advancement of industrialization and urbanization, the issue of water shortage has become a bottleneck for China's economic development. Based on the structural decomposition analysis and multi-regional input-output tables of China in 2002 and 2012, this paper explores the drivers of the change in China's production water usage from the regional relevance perspective. Results show a significant increase in China's production water usage during the study period. The relationship between production water usage and per capita GDP shows an inverted U-shaped curve, and the economic scale by provinces has been improved, while the trend of production water usage differs. There are rapid increases in production water usage in economically developing provinces, while it is falling sharply in developed provinces. The crucial factors promoting its growth are changes in consumption level, population scale, and regional economic patterns. The technical effect is the most important factor in curbing the growth, followed by effects of final demand sectoral and distribution structure. The provinces and sectors with more production water usage shows higher technical and final demand effects. Therefore, it is necessary to promote water-saving activities, enhance the water-saving technical effect, and optimize final demand structure to promote economic growth with low-water usage.

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OBJECTIVE: To explore the characteristics of congenital vaginal atresia, further improve its classification, and therefore help the clinical diagnosis and treatment of congenital vaginal atresia. METHODS: This was a retrospective study of 67 patients with congenital vaginal atresia (from March 1984 to March 2015). Clinical and surgical characteristics were analyzed. RESULTS: For lower vaginal atresia, 25 patients successfully underwent vaginoplasty at the lower portion of the vagina. For complete vagina atresia, 25 patients with type i cervical atresia were treated with artificial vaginoplasty+tracheloplasty, and all showed no dysmenorrhea within six months after surgery. Four patients with type ii cervical atresia and two patients with type iii cervical atresia successfully underwent hysterectomy+artificialvaginoplasty. Two patients with type iv cervical atresia underwent combined abdominoperineal artificial vaginoplasty+tracheloplasty. One patient with upper vaginal atresia successfully underwent hysterectomy via the narrow segment of the cervix. Three patients with top vaginal atresia had no dysmenorrhea after transvaginaltracheloplasty. CONCLUSION: This study suggests two new categories of vaginal atresia (upper vaginal atresia and top vaginal atresia), which could be used as a reference for treatment of this condition. Appropriate treatments were performed using a personalized approach and satisfactory results were achieved.

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