Extracellular matrix stiffness and tumor-associated macrophage polarization: new fields affecting immune exclusion.

In the malignant progression of tumors, there is deposition and cross-linking of collagen, as well as an increase in hyaluronic acid content, which can lead to an increase in extracellular matrix stiffness. Recent research evidence have shown that the extracellular matrix plays an important role in angiogenesis, cell proliferation, migration, immunosuppression, apoptosis, metabolism, and resistance to chemotherapeutic by the alterations toward both secretion and degradation. The clinical importance of tumor-associated macrophage is increasingly recognized, and macrophage polarization plays a central role in a series of tumor immune processes through internal signal cascade, thus regulating tumor progression. Immunotherapy has gradually become a reliable potential treatment strategy for conventional chemotherapy resistance and advanced cancer patients, but the presence of immune exclusion has become a major obstacle to treatment effectiveness, and the reasons for their resistance to these approaches remain uncertain. Currently, there is a lack of exact mechanism on the regulation of extracellular matrix stiffness and tumor-associated macrophage polarization on immune exclusion. An in-depth understanding of the relationship between extracellular matrix stiffness, tumor-associated macrophage polarization, and immune exclusion will help reveal new therapeutic targets and guide the development of clinical treatment methods for advanced cancer patients. This review summarized the different pathways and potential molecular mechanisms of extracellular matrix stiffness and tumor-associated macrophage polarization involved in immune exclusion and provided available strategies to address immune exclusion.

[Carbon Emission Characteristics and Influencing Factors of Typical Processes in Drinking Water Treatment Plant].

Based on the actual operating conditions and data monitoring, the carbon emission characteristics of typical processes of a drinking water treatment plant (DWTP) in Tianjin were studied. The total carbon emission intensity measured by CO2-eq was 0.254 kg·m-3, and the proportion of carbon emissions from electricity consumption and reagent consumption was 81.76% and 9.15%, respectively. The key carbon emission sectors of electricity consumption were the water supply pump house, ultrafiltration membrane process, and inlet pump house, which accounted for 50.99%-73.51%, 17.64%-20.70%, and 17.97%-22.40% of the total carbon emission from electricity consumption in the DWTP, respectively. The contribution of sodium hypochlorite to the carbon emission of reagent consumption was 89.12%-90.30%, followed by ferric chloride, PAC, and ammonium sulfate. In the traditional water purification process, the carbon emission intensity of the process unit was in the order of inlet pump house > rapid filter > sedimentation tank. The order in the ultrafiltration membrane advanced treatment process was inlet pump house > ultrafiltration membrane > mechanical coagulation > clarification tank. The carbon emission intensity of the rapid filter process and the ultrafiltration membrane process were 0.070 9 kg·m-3 and 0.109 0 kg·m-3, respectively. The ultrafiltration membrane process could save 23% of the reagent consumption, and its carbon emission of electricity consumption was twice that of the traditional treatment process. The analysis of factors affecting carbon emission in key sectors showed that the raw water quality parameters such as turbidity, pH, ammonia nitrogen, temperature, etc., were significantly correlated with the carbon emission intensity of sodium hypochlorite. There was a significant linear regression relationship between ex-factory water pressure, daily water supply, and carbon emission intensity of the water supply pump house. The control measures of water quality and water pressure can effectively reduce the carbon emissions of the DWTP.

Simulation and validation studies of a large drift tube muon tracker.

Cosmic ray muons are massive, charged particles created from high energy cosmic rays colliding with atomic nuclei in Earth's atmosphere. Because of their high momenta and weak interaction, these muons can penetrate through large thicknesses of dense material before being absorbed, making them ideal for nondestructive imaging of objects composed of high-Z elements. A Giant Muon Tracker with two horizontal 8 × 6 in.2 and two vertical 6 × 6 in.2 modules of drift tubes was used to measure muon tracks passing through samples placed inside the detector volume. The experimental results were used to validate a Monte Carlo simulation of the Giant Muon Tracker. The imaging results of simulated samples were reconstructed and compared with those from the experiment, which showed excellent agreement.

Prognostic model for the prediction of cancer-specific survival in elderly patients with stage I-III gastric cancer.

Elderly patients with gastric cancer (GC) exhibit unique physiological conditions and population characteristics. However, no efficient predictive tools have been developed for this patient subgroup. We extracted data on elderly patients diagnosed with stage I-III GC between 2010 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database, and applied Cox regression analysis to examine factors associated with cancer-specific survival (CSS). A prognostic model was developed and validated to predict CSS. We assessed the performance of the prognostic model and stratified patients based on their prognostic scores. Notably, 11 independent prognostic factors, including age, race, grade, the tumor-node-metastasis (TNM) stage, T-stage, N-stage, operation, tumor size, regional nodes, radiation, and chemotherapy, associated with CSS were identified using multivariate Cox regression. A nomogram was constructed based on these predictors. The C-index score of the nomogram was 0.802 (95% (confidence interval) [CI]: 0.7939-0.8114), which is superior to the American Joint Commission on Cancer (AJCC) TNM staging prediction ability in the training cohort (C-index: 0.589; 95% CI: 0.5780-0.6017). Based on the receiver operating characteristic (ROC) and calibration curve, the predicted value of the nomogram demonstrated a satisfactory accuracy with the actual observation value. Additionally, decision curve analysis (DCA) showed that the nomogram had a more ideal clinical net benefit than TNM staging. Survival analysis of the different risk groups confirmed the noteworthy clinical and statistical utility of the nomogram in prognosis stratification. This retrospective study reports the successful creation and validation of a nomogram for predicting CSS at 1-, 3- and 5-years in elderly patients with stage I-III GC. This nomogram critically guides personalized prognostic assessments and may contribute to clinical decision-making and consultation for postoperative survival.

Socioeconomic deprivation and survival outcomes in patients with colorectal cancer.

Socioeconomic deprivation has been linked to detrimental healthcare outcomes. We sought to examine whether patients with colorectal cancer (CRC) from socioeconomically disadvantaged areas experience worse survival outcomes and how it interacts with other factors. In this population-based study, patients with CRC diagnosed between 2007 to 2015 in the SEER program were reviewed. Socioeconomic deprivation was measured using the Area Deprivation Index (ADI) linked to patients' residence addresses. The effect of ADI on cancer-specific survival and overall survival was evaluated using survival analysis. The Inverse Probability of Weighted (IPW) method and multiple regression was performed to account for the confounding bias. Subgroup analyses were used to test interactions. Multiple mediation analysis was used to estimate the mediating effects. Overall, 266,620 eligible patients were included in further analyses. Compared with low ADI patients, high ADI patients had more unfavorable characteristics and worse cancer-specific (hazard ratio [HR] 1.14, 95% CI 1.12-1.16, P<.001) and overall survival (HR 1.11, 95% CI 1.09-1.12, P<0.001). The results were similar after accounting for confounding factors using the IPW and multiple regression methods. Subgroup analyses revealed the relative robustness of ADI as a prognostic factor. They detected significant interactions between ADI and other covariates on cancer survival, such as age, race, insurance status, disease stage, and receipt of treatment. Multiple mediation analyses identified several factors mediating survival disparities, including anticancer therapy, insurance status, race, marital status, and age. This study suggested that high ADI CRC patients were associated with more unfavorable characteristics at presentation and lower cancer and noncancer survival after treatment than their low ADI counterparts. Multiple factors interacted and mediated these survival disparities associated with the ADI.

Efficacy of probiotics or synbiotics for critically ill adult patients: a systematic review and meta-analysis of randomized controlled trials.

Background: Microbial dysbiosis in critically ill patients is a leading cause of mortality and septic complications. Probiotics and synbiotics have emerged as novel therapy on gut microbiota to prevent septic complications. However, current evidence on their effects is conflicting. This work aims to systematically review the impact of probiotics or synbiotics in critically ill adult patients. Methods: A comprehensive search of the PubMed, CBM, Embase, CENTRAL, ISI, and CNKI databases was performed to identify randomized controlled trials that evaluate probiotics or synbiotics in critically ill patients. The quality assessment was based on the modified Jadad's score scale and the Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1. The major outcome measure was mortality. Secondary outcomes included incidence of septic complications, sepsis incidence, length of intensive care unit (ICU) stay, incidence of non-septic complication, and ventilator day. Data synthesis was conduct by Review Manager 5.4. Results: A total of 25 randomized controlled trials reporting on 5049 critically ill patients were included. In the intervention group, 2520 participants received probiotics or synbiotics, whereas 2529 participants received standard care or placebo. Pooling data from randomized controlled trials demonstrated a significant reduction in the incidence of ventilator-associated pneumonia (VAP) in the treatment group [(risk ratio (RR) 0.86; 95% confidence interval (CI): 0.78-0.95; p < 0.003, I2 = 85%)]. However, in the subgroup analysis, the reduction of incidence of VAP was only significant in patients receiving synbiotics (RR = 0.61, 95% CI: 0.47-0.80, p = 0.0004, I2 = 40%) and not significant in those receiving only probiotics (RR = 0.91, 95% CI: 0.82-1.01, p = 0.07, I2 = 65%). Moreover, sepsis incidence of critically ill patients was only significantly reduced by the addition of synbiotics (RR = 0.41; 95% CI: 0.22-0.72, p = 0.005, I2 = 0%). The incidence of ICU-acquired infections was significantly reduced by the synbiotics therapy (RR = 0.72; 95% CI: 0.58-0.89, p = 0.0007, I2 = 79%). There was no significant difference in mortality, diarrhea, or length of ICU stay between the treatment and control groups. Conclusions: Synbiotics is an effective and safe nutrition therapy in reducing septic complications in critically ill patients. However, in such patients, administration of probiotics alone compared with placebo resulted in no difference in the septic complications.

A Sports Nutrition Perspective on the Impacts of Hypoxic High-Intensity Interval Training (HIIT) on Appetite Regulatory Mechanisms: A Narrative Review of the Current Evidence.

High-intensity interval training (HIIT) and low-oxygen exposure may inhibit the secretion of appetite-stimulating hormones, suppress appetite, and inhibit dietary intake. Physiological changes affecting appetite are frequent and include appetite hormone (ghrelin, leptin, PYY, and GLP-1) effects and the subjective loss of appetite, resulting in nutritional deficiencies. This paper is a narrative review of the literature to verify the HIIT effect on appetite regulation mechanisms and discusses the possible relationship between appetite effects and the need for high-intensity exercise training in a hypoxic environment. We searched MEDLINE/PubMed and the Web of Science databases, as well as English articles (gray literature by Google Scholar for English articles) through Google Scholar, and the searched studies primarily focused on the acute effects of exercise and hypoxic environmental factors on appetite, related hormones, and energy intake. In a general normoxic environment, regular exercise habits may have accustomed the athlete to intense training and, therefore, no changes occurred in their subjective appetite, but there is a significant effect on the appetite hormones. The higher the exercise intensity and the longer the duration, the more likely exercise is to cause exercise-induced appetite loss and changes in appetite hormones. It has not been clear whether performing HIIT in a hypoxic environment may interfere with the exerciser's diet or the nutritional supplement intake as it suppresses appetite, which, in turn, affects and interferes with the recovery efficiency after exercise. Although appetite-regulatory hormones, the subjective appetite, and energy intake may be affected by exercise, such as hypoxia or hypoxic exercise, we believe that energy intake should be the main observable indicator in future studies on environmental and exercise interventions.

The Incidence and Treatment Response of Double Expression of MYC and BCL2 in Patients with Diffuse Large B-Cell Lymphoma: A Systematic Review and Meta-Analysis.

MYC/BCL2 protein co-expression (i.e., double expressor) has been shown to be a negative predictor of outcome in diffuse large B-cell lymphoma (DLBCL). We aimed to establish the incidence of double expressor status in patients with de novo DLBCL and identify the predictive value of this biomarker on treatment response through systematic review and meta-analysis. PubMed and Embase were searched for studies published through December 2019 that reported proportions of double expressor DLBCL. The pooled proportions of MYC and BCL2 expression, both alone and in combination, were computed using the inverse variance method for calculating weights and by the DerSimonian-Laird method. The pooled odds ratios (ORs) of complete remission (CR) rate were calculated, and meta-regression analysis was conducted to explore heterogeneity. Forty-one studies (7054 patients) were included. The pooled incidence of double expressor status in DLBCL was 23% (95% confidence interval [CI], 20-26%), with an adjusted estimate of 31% (95% CI, 27-36%). Neither MYC/BCL2 protein cutoff values, race, mean, or median age of included patients, or overall study quality was a significant factor of heterogeneity (p ≥ 0.20). Cases without double expressor status demonstrated a higher probability of CR to rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone treatment (OR, 2.69; 95% CI, 1.55-4.67). Our results reaffirm the predictive power of this important biomarker.

Oral contraceptive use is associated with smaller hypothalamic and pituitary gland volumes in healthy women: A structural MRI study.

The effects of hormonal contraceptives on structural features of the hypothalamus and pituitary are incompletely understood. One prior study reported microstructural changes in the hypothalamus with oral contraceptive pill (OCP) use. However, effects on hypothalamic volume have not been reported. One prior study reported volumetric changes in the pituitary. However, this study was limited by including participants evaluated for neurological symptoms. We sought to determine if OCP use is associated with alteration of hypothalamic or pituitary volume. High-resolution 3T MRI was performed for a prospective cohort of 50 healthy women from 2016 to 2018, which comprised 21 OCP users (age, 19-29) and 29 naturally cycling women (age, 18-36). Participants were excluded if they were pregnant or had significant medical conditions including neurological, psychiatric, and endocrine disorders. After confirming reliability of the image analysis techniques, 5 raters independently performed manual segmentation of the hypothalamus and semi-automated intensity threshold-based segmentation of the pituitary using ITK-SNAP. Total intracranial volume was estimated using FreeSurfer. A general linear model tested the association of OCP use with hypothalamic and pituitary volumes. Hypothalamic (B = -81.2 ± 24.9, p = 0.002) and pituitary (B = -81.2 ± 38.7, p = 0.04) volumes in OCP users were smaller than in naturally cycling women. These findings may be related to interference with known trophic effects of sex hormones and suggest a structural correlate of central OCP effects.

Moderate grazing increased alpine meadow soils bacterial abundance and diversity index on the Tibetan Plateau.

The response of grassland soil bacterial community characteristics to different grazing intensities is central ecological topics. However, the underlying mechanisms between bacterial abundance, diversity index, and grazing intensity remain unclear. We measured alpine meadow soil bacterial gene richness and diversity index under four grazing intensities using 16S rDNA sequence analysis on the Tibetan Plateau. The results suggest that extreme grazing significantly decreased alpine meadow both bacterial gene abundance and diversity index (p < .05). The lowest operational taxonomic unit numbers were 3,012 ± 447 copies under heavy grazing in the growing season. It was significantly lower than heavy grazing with approximately 3,958 ± 119 copies (p < .05). The Shannon index for medium and high grazing grassland bacterial diversity was slightly higher than for light grazing in the growing season. Furthermore, the lowest index was approximately 9.20 ± 0.50 for extreme grazing of grassland in the growing season. The average bacterial gene abundance and diversity index in the dormancy period were slightly higher than that in the growing season. Soil bulk density, pH, ammonium, and nitrate nitrogen were the main positive factors driving grazed grassland bacterial communities. Our study provides insight into the response of alpine meadows to grazing intensity, demonstrating that moderate grazing increases bacterial community diversity in grazed grasslands.

Biomass allocation and productivity-richness relationship across four grassland types at the Qinghai Plateau.

Aboveground biomass (AGB) and belowground biomass (BGB) allocation and productivity-richness relationship are controversial. Here, we assessed AGB and BGB allocation and the productivity-richness relationship at community level across four grassland types based on the biomass data collected from 80 sites across the Qinghai Plateau during 2011-2012. The reduced major axis regression and general linear models were used and showed that (a) the median values of AGB were significantly higher in alpine meadow than in other three grassland types; the ratio of root to shoot (R/S) was significantly higher in desert grassland (36.06) than intemperate grassland (16.60), alpine meadow (13.35), and meadow steppe (19.46). The temperate grassland had deeper root distribution than the other three grasslands, with about 91.45% roots distributed in the top 30 cm soil layer. (b) The slopes between log AGB and log BGB in the temperate grassland and meadow steppe were 1.09 and 1, respectively, whereas that in the desert grassland was 1.12, which was significantly different from the isometric allocation relationship. A competitive relationship between AGB and BGB was observed in the alpine meadow with a slope of -1.83, indicating a trade-off between AGB and BGB in the alpine meadow. (c) A positive productivity-richness relationship existed across the four grassland types, suggesting that the positive productivity-richness relationship might not be affected by the environmental factors at the plant location. Our results provide a new insight for biomass allocation and biodiversity-ecosystem functioning research.

Moderate grazing promotes the root biomass in Kobresia meadow on the northern Qinghai-Tibet Plateau.

Grazing is an important modulator of both plant productivity and biodiversity in grassland community, yet how to determine a suitable grazing intensity in alpine grassland is still controversy. Here, we explore the effects of different grazing intensities on plant biomass and species composition, both at community level and functional group level, and examines the productivity-species richness relationship under four grazing patterns: no grazing (CK), light grazing (LG), moderate grazing, (MG) and heavy grazing (HG), attempt to determine a suitable grazing intensity in alpine grassland. The results were as follows. The total aboveground biomass (AGB) reduced with increasing grazing intensity, and the response of plant functional groups was different. AGB of both sedges and legumes increased from MG to HG, while the AGB of forbs reduced sharply and the grass AGB remained steady. There was a significant positive relationship between productivity and species richness both at community level and functional group level. In contrast, the belowground biomass (BGB) showed a unimodal relationship from CK to HG, peaking in MG (8,297.72 ± 621.29 g/m2). Interestingly, the grassland community tends to allocate more root biomass to the upper soil layer under increasing grazing intensities. Our results suggesting that moderate levels of disturbance may be the optimal grassland management strategy for alpine meadow in terms of root production.

Nitrogen controls the net primary production of an alpine Kobresia meadow in the northern Qinghai-Tibet Plateau.

Net primary production (NPP) is a fundamental property of natural ecosystems. Understanding the temporal variations of NPP could provide new insights into the responses of communities to environmental factors. However, few studies based on long-term field biomass measurements have directly addressed this subject in the unique environment of the Qinghai-Tibet plateau (QTP). We examined the interannual variations of NPP during 2008-2015 by monitoring both aboveground net primary productivity (ANPP) and belowground net primary productivity (BNPP), and identified their relationships with environmental factors with the general linear model (GLM) and structural equation model (SEM). In addition, the interannual variation of root turnover and its controls were also investigated. The results show that the ANPP and BNPP increased by rates of 15.01 and 143.09 g/m2 per year during 2008-2015, respectively. BNPP was mainly affected by growing season air temperature (GST) and growing season precipitation (GSP) rather than mean annual air temperature (MAT) or mean annual precipitation (MAP), while ANPP was only controlled by GST. In addition, available nitrogen (AN) was significantly positively associated with BNPP and ANPP. Root turnover rate averaged 30%/year, increased with soil depth, and was largely controlled by GST. Our results suggest that alpine Kobresia meadow was an N-limited ecosystem, and the NPP on the QTP might increase further in the future in the context of global warming and nitrogen deposition.

Responses of biomass allocation across two vegetation types to climate fluctuations in the northern Qinghai-Tibet Plateau.

The Qinghai-Tibet Plateau (QTP) is particularly sensitive to global climate change, especially to elevated temperatures, when compared with other ecosystems. However, few studies use long-term field measurements to explore the interannual variations in plant biomass under climate fluctuations. Here, we examine the interannual variations of plant biomass within two vegetation types (alpine meadow and alpine shrub) during 2008-2017 and their relationships with climate variables. The following results were obtained. The aboveground biomass (AGB) and belowground biomass (BGB) response differently to climate fluctuations, the AGB in KPM was dominated by mean annual precipitation (MAP), whereas the AGB in PFS was controlled by mean annual air temperature (MAT). However, the BGB of both KPM and PFS was only weakly affected by climate variables, suggesting that the BGB in alpine ecosystems may remain as a stable carbon stock even under future global climate change. Furthermore, the AGB in PFS was significantly higher than KPM, while the BGB and R/S in KPM were significantly higher than PFS, reflecting the KPM be more likely to allocate more photosynthates to roots. Interestingly, the proportion of 0-10 cm root biomass increased in KPM and PFS, whereas the other proportions both decreased, reflecting a shift in biomass toward the surface layer. Our results could provide a new sight for the prediction how alpine ecosystem response to future climate change.

The Response of Shallow Groundwater Levels to Soil Freeze-Thaw Process on the Qinghai-Tibet Plateau.

The Qinghai-Tibet plateau has the world's largest area of seasonally frozen ground. Here, shallow groundwater displays behavior that is distinct from that elsewhere in the world. In the present study, we explore the seasonal and interannual variation of the shallow groundwater levels from 2012 to 2016, and attempt to quantitatively evaluate the relative influences of individual driving factors on the shallow groundwater levels based on boosted regression trees. The results show that: (1) on a seasonal scale, the groundwater levels were characterized by a double peak and double valley relationship, while on an interannual scale the groundwater levels showed a slightly downwards trend from 2012 to 2016; and (2) during the frozen period, the seasonal variation of groundwater levels was determined by mean air temperature through its effect on the soil thaw-freeze process, accounting for 53.15% of total variation. Meanwhile, ET0 and rainfall exerted little impact on the seasonal variation of groundwater levels, which might be attributed to the aquitard of frozen soil that impedes the exchange between surface water and groundwater. Moreover, there was a lag between groundwater levels and soil freezing-thawing. During the non-frozen period, the mean air temperature was again the most important factor impacting the variation of groundwater levels, through its effect on ET0 , and accounted for 40.75% of total variation, while rainfall had little effect on groundwater levels when rainfall intensity was less than 12 mm/day. These results will benefit predictions of future trends in groundwater levels within the context of global warming.

Biomechanical bearing-based typing method for osteonecrosis of the femoral head: ABC typing.

Type classification of osteonecrosis of the femoral head (ONFH) is important for collapse prediction in ONFH, which depends on a complexity of factors. At present, most typing is based on single factors, including the location or size of the necrosis, or the bone repair capacity after ONFH, and is therefore limited. The present study proposes an 'ABC' method for ONFH typing based on biomechanics and the stress distribution characteristics of the femoral head's bone trabeculae. In total, 132 ONFH patients (223 hips) were enrolled at Guanganmen Hospital (Beijing, China). Each of the hip joints included was subjected to computerized tomography and/or magnetic resonance imaging. The images with the maximum necrotic area in the coronal femoral head were selected, and the femoral head's maximum transverse diameter was divided into three pillars (A, B and C, from the outside to the inside) according to a 3:4:3 diameter ratio. ONFH was typed according to the number of pillars involved in the necrosis. Differences in the collapse rate of different ONFH types, and the correlation between the theoretical collapse risk and the observed collapse rate was analysed. The ONFH types significantly differed in their collapse rate (χ2=76.93, P<0.001) in the following order: A-C (88.6%)>AB (74.1%)>BC (52.4%)>A (50%)>B (9.5%)>C (0%). The collapse risk was significantly correlated with the collapse rate (correlation coefficient R=1). The types A-C and AB had high collapse rates/risks, whereas types B and C had a satisfactory prognosis. The ABC typing proposed in the present study is thus suitable for collapse risk prediction in ONFH. Type classification using this method may provide a valuable reference for selecting regimens for ONFH treatment.

Selenylation modification: enhancement of the antioxidant activity of a Glycyrrhiza uralensis polysaccharide.

Selenium (Se) is an essential trace element for human beings and many other forms of life. Organic selenium from natural foods has greater bioavailability and is safer than inorganic selenium species. In this article, the structural properties and antioxidant activities of a Glycyrrhiza uralensis polysaccharide (GUP) after selenylation modification were investigated. The GUP was extracted by water decoction and ethanol precipitation and purified via protein elimination using the trichloroacetic acid method and column chromatography. The purified product was subsequently modified by the nitric acid-sodium selenite (HNO3-Na2SeO3) method. The selenized GUP (SeGUP) product was characterized by Fourier transform-infrared (FT-IR) spectroscopy, and its thermal stability, particle size, and antioxidant activities were investigated. FT-IR analysis indicated that the selenium in SeGUP existed mainly as O-Se-O. The thermal stability and particle size of SeGUP differed significantly from those of GUP. Moreover, compared to GUP, SeGUP exhibited greater antioxidant activities in vitro and in vivo. These results indicate that selenylation modification significantly enhances the antioxidant activity of SeGUP, increasing its potential for application as an antioxidant. Graphical abstract ᅟ.

Black phosphorus flakes covered microfiber for Q-switched ytterbium-doped fiber laser.

We demonstrate a passively Q-switched ytterbium-doped fiber laser based on black phosphorus (BP) flakes covered microfiber. The BP saturable absorber is fabricated by sandwiching a microfiber between two pieces of polydimethylsiloxane supported BP flakes film, which is prepared by the mechanical exfoliation method. In this case the BP flakes can be well protected from the action of air and moisture. By incorporating BP flakes covered microfiber into a ytterbium-doped ring fiber laser, stable and reliable Q-switched operation at 1064 nm can be realized via interaction between few-layers BP flakes and the evanescent field of the laser. The laser allows Q-switched pulse generation with a repetition rate in the range of 26-76 kHz and a pulse duration in the range of 5.5-2.0 µs, by varying the pump power from 38 mW to 100 mW.