AIM:To determine the resistance patterns of Helicobacter pylori(H.pylori) strains isolated from patients in Beijing and monitor the change of antibiotic resistance over time.METHODS:In this prospective,serial and cros...AIM:To determine the resistance patterns of Helicobacter pylori(H.pylori) strains isolated from patients in Beijing and monitor the change of antibiotic resistance over time.METHODS:In this prospective,serial and crosssectional study,H.pylori cultures were successfully obtained from 371 and 950 patients(never receiving eradication) during 2009-2010 and 2013-2014,respectively.Resistance to amoxicillin,clarithromycin,metronidazole,levofloxacin,tetracycline,and rifampicin was determined by Epsilometer test.RESULTS:The resistance rates of isolates obtained during 2009-2010 were 66.8%,39.9%,34.5%,15.4%,6.7%,and 4.9% to metronidazole,clarithromycin,levofloxacin,rifampicin,amoxicillin and tetracycline,respectively; and the corresponding rates for isolates during 2013-2014 were 63.4%,52.6%,54.8%,18.2%,4.4% and 7.3%,respectively.The resistance rates to clarithromycin and levofloxacin were significantly increased after four years.In 2009-2010,14.6% of H.pylori isolates were susceptible to all tested antibiotics,with mono(33.7%),double(28.3%),triple(16.7%),quadruple(6.2%),quintuple(0.3%) and sextuple resistance(0.3%) also being detected.In 2013-2014,9.4% were susceptible to all tested antibiotics,and mono(27.6%),double(28.4%),triple(24.9%),quadruple(7.3%),quintuple(2.3%) and sextuple resistance(0.1%) was also observed.More multiple resistant H.pylori isolates were found during 2013-2014.Gender(to levofloxacin and metronidazole),age(to levofloxacin) and endoscopic findings(to clarithromycin) were independent factors influencing antibiotic resistance.CONCLUSION:H.pylori resistance to commonly used antibiotics in Beijing is high with increased multiple antibiotic resistance.展开更多
The expansion of inland Asia deserts has considerably influenced the environmental, social and economic activities in Asia. Aridification of inland Asia, especially timing of the initiation of Asian desertification, i...The expansion of inland Asia deserts has considerably influenced the environmental, social and economic activities in Asia. Aridification of inland Asia, especially timing of the initiation of Asian desertification, is a contentious topic in paleoclimatology. Late Cenozoic eolian loess-red clay sequences on the Chinese Loess Plateau, which possess abundant paleoclimatic and paleo-environmental information, can be regarded as an indicator of inland Asia desertification. Here we present a detailed magnetostratigraphic investigation of a new red clay sequence about 654 m in Zhuanglang located at the western Chinese Loess Plateau. Sedimentological, geochemical, mineralogical, and quartz morphological lines of evidence show that the red clay is of eolian origin. Magnetostratigraphic correlations indicate that this core sequence spans from 25.6 to 4.8 Ma, and typical eolian red clay appears as early as 25 Ma. This extends the lower limit of the red clay on the Chinese Loess Plateau from the previously thought early Miocene back into the late Oligocene. This new red clay record further implies that the inland Asia desertification was initiated at least by the late Oligocene. This sequence provides a unique high-resolution geological record for understanding the inland Asia desertification process since the late Oligocene.展开更多
INTRODUCTIONThe prevalence of hyperuricenlia （HUA） has increased in China in the recent years in relation to socioeconomic developments and changing lifestyles and diets, with a trend toward onset at younger age. HU...INTRODUCTIONThe prevalence of hyperuricenlia （HUA） has increased in China in the recent years in relation to socioeconomic developments and changing lifestyles and diets, with a trend toward onset at younger age. HUA has become the second most common metabolic disease after diabetes mellitus. Like gout, HUA is also associated with the occurrence and progression of disorders of the urinary, endocrine, metabolic, cardio-cerebrovascular, and other systems.展开更多
Clayey silt reservoirs bearing natural gas hydrates(NGH)are considered to be the hydrate-bearing reservoirs that boast the highest reserves but tend to be the most difficult to exploit.They are proved to be exploitabl...Clayey silt reservoirs bearing natural gas hydrates(NGH)are considered to be the hydrate-bearing reservoirs that boast the highest reserves but tend to be the most difficult to exploit.They are proved to be exploitable by the first NGH production test conducted in the South China Sea in 2017.Based on the understanding of the first production test,the China Geological Survey determined the optimal target NGH reservoirs for production test and conducted a detailed assessment,numerical and experimental simulation,and onshore testing of the reservoirs.After that,it conducted the second offshore NGH production test in 1225 m deep Shenhu Area,South China Sea(also referred to as the second production test)from October 2019 to April 2020.During the second production test,a series of technical challenges of drilling horizontal wells in shallow soft strata in deep sea were met,including wellhead stability,directional drilling of a horizontal well,reservoir stimulation and sand control,and accurate depressurization.As a result,30 days of continuous gas production was achieved,with a cumulative gas production of 86.14×104 m3.Thus,the average daily gas production is 2.87×10^4 m^3,which is 5.57 times as much as that obtained in the first production test.Therefore,both the cumulative gas production and the daily gas production were highly improved compared to the first production test.As indicated by the monitoring results of the second production test,there was no anomaly in methane content in the seafloor,seawater,and atmosphere throughout the whole production test.This successful production test further indicates that safe and effective NGH exploitation is feasible in clayey silt NGH reservoirs.The industrialization of hydrates consists of five stages in general,namely theoretical research and simulation experiments,exploratory production test,experimental production test,productive production test,and commercial production.The second production test serves as an important step from the exploratory production test to exper展开更多
There is considerable potential for integrating transarterial chemoembolization(TACE),programmed death-(ligand)1(PD-[L]1)inhibitors,and molecular targeted treatments(MTT)in hepatocellular carcinoma(HCC).It is necessar...There is considerable potential for integrating transarterial chemoembolization(TACE),programmed death-(ligand)1(PD-[L]1)inhibitors,and molecular targeted treatments(MTT)in hepatocellular carcinoma(HCC).It is necessary to investigate the therapeutic efficacy and safety of TACE combined with PD-(L)1 inhibitors and MTT in real-world situations.In this nationwide,retrospective,cohort study,826 HCC patients receiving either TACE plus PD-(L)1 blockades and MTT(combination group,n=376)or TACE monotherapy(monotherapy group,n=450)were included from January 2018 to May 2021.The primary endpoint was progression-free survival(PFS)according to modified RECIST.The secondary outcomes included overall survival(OS),objective response rate(ORR),and safety.We performed propensity score matching approaches to reduce bias between two groups.After matching,228 pairs were included with a predominantly advanced disease population.Median PFS in combination group was 9.5 months(95%confidence interval[CI],8.4-11.0)versus 8.0 months(95%CI,6.6-9.5)(adjusted hazard ratio[HR],0.70,P=0.002).OS and ORR were also significantly higher in combination group(median OS,19.2[16.1-27.3]vs.15.7 months[13.0-20.2];adjusted HR,0.63,P=0.001;ORR,60.1%vs.32.0%;P<0.001).Grade 3/4 adverse events were observed at a rate of 15.8%and 7.5%in combination and monotherapy groups,respectively.Our results suggest that TACE plus PD-(L)1 blockades and MTT could significantly improve PFS,OS,and ORR versus TACE monotherapy for Chinese patients with predominantly advanced HCC in real-world practice,with an acceptable safety profile.展开更多
Objective:To investigate current status of diagnosis and treatment of bladder cancer in China.Methods:A database was generated by Chinese Bladder Cancer Consortium(CBCC).From January 2007 to December 2012,14,260 cases...Objective:To investigate current status of diagnosis and treatment of bladder cancer in China.Methods:A database was generated by Chinese Bladder Cancer Consortium(CBCC).From January 2007 to December 2012,14,260 cases from 44 CBCC centers were included.Data of diagnosis,treatment and pathology were collected.Results:The average age was 63.5 year-old and most patients were male(84.3%).The most common histologic types were urothelial carcinoma(91.4%),adenocarcinoma(1.8%),and squamous carcinoma(1.9%).According to 1973 and 2004 WHO grading system,42.0%,41.0%,and 17.0% of patients were grade 1,2,and 3,and 16.0%,48.7%,and 35.3% of patients were papillary urothelial neoplasms of low malignant potential,low,and high grade,respectively.Non-muscle invasive bladder cancer(NMIBC)and muscle invasive bladder cancer(MIBC)were 25.2% and 74.1%,respectively(0.8% not clear).Carcinoma in situ was only 2.4%.Most patients were diagnosed by white-light cystoscopy with biopsy(74.3%).Fluorescence and narrow band imaging cystoscopy had additional detection rate of 1.0% and 4.0%,respectively.Diagnostic transurethral resection(TUR)provided detection rate of 16.9%.Most NMIBCs were treated with TUR(89.2%).After initial TUR,2.6%accepted second TUR,and 45.7%,69.9%,and 58.7% accepted immediate,induced,and maintenance chemotherapy instillation,respectively.Most MIBCs were treated with radical cystectomy(RC,59.7%).Laparoscopic RCs were 35.1%,while open RC 63.4%.Extended and standard pelvic lymph node dissection were 7% and 66%,respectively.Three most common urinary diversions were orthotopic neobladder(44%),ileal conduit(31%),and ureterocutaneostomy(23%).Only 2.3% of patients accepted neo-adjuvant chemotherapy and only 18%of T3 and T4 patients accepted adjuvant chemotherapy.Conclusion:Disease characteristics are similar to international reports,while differences of diagnosis and treatment exist.This study can provide evidences for revisions of the guideline on bladder cancer in China.展开更多
Objective：To compare radiofrequency ablation （RFA） or microwave ablation （MWA） and transcatheter arterial chemoembolization （TACE） with RFA or MWA monotherapy in hepatocellular carcinoma （HCC）.Methods：A pros...Objective：To compare radiofrequency ablation （RFA） or microwave ablation （MWA） and transcatheter arterial chemoembolization （TACE） with RFA or MWA monotherapy in hepatocellular carcinoma （HCC）.Methods：A prospective,randomized,controlled trial was conducted on 94 patients with HCC ≤7 cm at a single tertiary referral center from June 2008 to June 2010 at the Department of Hepatobiliary Surgery,the Second Affiliated Hospital of Southeast University.The patients were randomly assigned into the TACERFA or TACE-MWA （combined treatment group） and the RFA-alone or MWA-alone groups （control group）.The primary end point was overall survival.The secondary end point was recurrence-free survival,and the tertiary end point was adverse effects.Results：Until the time of censor,17 patients in the TACE-RFA or TACE-MWA group had died.The median follow-up time of the patients who were still alive for the TACE-RFA or TACE-MWA group was 47.5±11.3 months （range,29 to 62 months）.The 1-,3-and 5-year overall survival for the TACE-RFA or TACE-MWA group was 93.6％,68.1％ and 61.7％,respectively.Twenty-five patients in the RFA or MWA group had died.The median follow-up time of the patients who were still alive for the RFA or MWA group was 47.0±12.9 months （range,28 to 62 months）.The 1-,3-and 5-year overall survival for the RFA or MWA group was 85.1％,59.6％ and 44.7％,respectively.The patients in the TACE-RFA or TACE-MWA group had better overall survival than the RFA or MWA group [hazard ratio （HR）,0.526; 95％ confidence interval （95％ CO,0.334-0.823; P=0.002],and showed better recurrence-free survival than the RFA or MWA group （HR,0.582; 95％ CI,0.368-0.895; P=0.008）.Conclusions：RFA or MWA combined with TACE in the treatment of HCC ≤7 cm was superior to RFA or MWA alone in improving survival by reducing arterial and portal blood flow due to TACE with iodized oil before RFA.展开更多
As a class of famous carbon materials,biochars(BCs)and their derivative materials with excellent physicochemical properties and diversified functionalities present great potential in wastewater treatment fields.This r...As a class of famous carbon materials,biochars(BCs)and their derivative materials with excellent physicochemical properties and diversified functionalities present great potential in wastewater treatment fields.This review focuses on the latest development in reported biochar-based materials as superior adsorbents or catalysts for removing harmful organic contaminants from wastewater.The construction and properties of biochar-based materials are briefly introduced at the beginning.As one of the major factors affecting the properties of BCs,the wide diversity of feedstocks,such as agricultural and forest residues,industrial by-products as well as municipal wastes,endows BCs different chemical compositions and structures.Woody and herbaceous BCs usually have higher carbon contents,larger surface areas and strong aromaticity,which is in favor of the organic contaminant removal.Driven by the desire of more cost-effective materials,several types of biochar-based hybrid materials,such as magnetic BC composites(MBC),nanometal/nanometallic oxides/hydroxide BC composites and layered nanomaterial-coated BCs,as well as physically/chemically activated BCs,have also been developed.With the help of foreign materials,these types of hybrid BCs have excellent capacities to remove a wide range of organic contaminants,including organic dyestuff,phenols and chemical intermediates,as well as pharmaceutically active compounds,from aquatic solutions.Depending on the different types of biochar-based materials,organic contaminants can be removed by different mechanisms,such as physical adsorption,electrostatic interaction,π-πinteraction and Fenton process,as well as photocatalytic degradation.In summary,the low cost,tunable surface chemistry and excellent physical-chemical properties of BCs allow it to be a potential material in organic contaminant removal.The combination of BCs with foreign materials endows BCs more functionalities and broader development opportunities.Considering the urgent demand of practical wastewater treatment,we展开更多
基于CASA模型、碳税法和工业制氧法,测算了粤港澳大湾区2015年固碳释氧量及其价值,并结合ESA CCI-LC产品探讨了2000—2015年研究区陆地生态系统演变及其导致的固碳释氧量和价值的变化。结果表明:(1)2000—2015年,研究区城市扩张明显,主...基于CASA模型、碳税法和工业制氧法,测算了粤港澳大湾区2015年固碳释氧量及其价值,并结合ESA CCI-LC产品探讨了2000—2015年研究区陆地生态系统演变及其导致的固碳释氧量和价值的变化。结果表明:(1)2000—2015年,研究区城市扩张明显,主要表现为城镇用地侵占农田和草地。(2)研究区陆地生态系统91.03%固碳释氧量及其价值集中在森林和农田生态系统,2000—2015年陆地生态系统演变造成区域内固碳量和释氧量分别减少了53.49 G g和518.65 G g,对应固碳释氧价值损失量分别为1.79亿元和2.06亿元,合计3.85亿元,91.57%损失量是由城市扩张导致的。(3)城市覆盖面积与固碳释氧价值呈现强负相关,其扩张会促使生态系统固碳释氧价值逐渐减少,林地覆盖面积与固碳释氧价值呈现强正相关,其比重增加将有利于生态系统固碳释氧价值的培育。本文利用"邻域代理法"获得了研究区多类陆地生态系统演变情况及其对固碳释氧服务的影响,具有一定的推广价值。在未来发展过程中,粤港澳大湾区应该优化陆地生态系统类型,合理控制城市扩张,保护森林和农田资源,减少人类活动作用,增强生态系统自然演变过程。展开更多
The influence of steel slag,a by-product from the processing of iron to steel,on the hydration of cement during the hydration process of complex binder was studied by calorimetry,X-ray diffraction analysis,and Ca(OH)2...The influence of steel slag,a by-product from the processing of iron to steel,on the hydration of cement during the hydration process of complex binder was studied by calorimetry,X-ray diffraction analysis,and Ca(OH)2 content determination.The results show that steel slag and cement affect each other’s hydration by changing the hydration environment.Steel slag does not react with the hydration products of cement.The dormant period of cement-steel slag complex binder during the hydration is longer than that of cement.The more the adding amount of steel slag is,the longer the dormant period of complex binder will be.The steel slag decreases the early hydration rate of cement.This phenomenon is more obvious with the increment of steel slag addition.However,the steel slag can promote the hydration degree of cement at later ages and the promoting effect becomes more obvious with the increment of steel slag addition and the hydration ages.展开更多
AIM: To investigate the inhibitory effects of emodin, baicalin, etc.on the hefA gene of multidrug resistance(MDR) in Helicobacter pylori(H.pylori).METHODS: The double dilution method was used to screen MDR H.pylori st...AIM: To investigate the inhibitory effects of emodin, baicalin, etc.on the hefA gene of multidrug resistance(MDR) in Helicobacter pylori(H.pylori).METHODS: The double dilution method was used to screen MDR H.pylori strains and determine the minimum inhibitory concentrations(MICs) of emodin, baicalin, schizandrin, berberine, clarithromycin, metronidazole, tetracycline, amoxicillin and levofloxacin against H.pylori strains.After the screened MDR stains were treated with emodin, baicalin, schizandrin or berberine at a 1/2 MIC concentration for 48 h, changes in MICs of amoxicillin, tetracycline, levofloxacin, metronidazole and clarithromycin were determined.MDR strains with reduced MICs of amoxicillin were selected to detect the hefA mR NA expression by realtime quantitative PCR.RESULTS: A total of four MDR H.pylori strains were screened.Treatment with emodin, baicalin, schizandrin and berberine significantly decreased the MICs of amoxicillin and tetracycline against some strains, decreased by 1 to 2 times, but did not significantly change the MICs of clarithromycin, levofloxacin, and metronidazole against MDR strains.In the majority of strains with reduced MICs of amoxicillin, hef A m RNA expression was decreased; one-way ANOVA(SPSS 12.0) used for comparative analysis, P < 0.05.CONCLUSION: Emodin, baicalin, schizandrin and berberine significantly decreased the MICs of amoxicillin and tetracycline against some H.pylori strains, possibly by mechanisms associated with decreasing hefA mR NA expression.展开更多
AIM： To investigate the feasibility and safety of monopolar electrocautery shovel （ES） in laparoscopic total mesorectal excision （TME） with anal sphincter preservation for rectal cancer in order to reduce the cos...AIM： To investigate the feasibility and safety of monopolar electrocautery shovel （ES） in laparoscopic total mesorectal excision （TME） with anal sphincter preservation for rectal cancer in order to reduce the cost of the laparoscopic operation, and to compare ES with the ultrasonically activated scalpel （US）. METHODS： Forty patients with rectal cancer, who underwent laparoscopic TME with anal sphincter preservation from June 2005 to June 2007, were randomly divided into ultrasonic scalpel group and monopolar ES group, prospectively. White blood cells （WBC） were measured before and after operation, operative time, blood loss, pelvic volume of drainage, time of anal exhaust, visual analogue scales （VAS） and surgery-related complications were recorded. RESULTS： All the operations were successful; no one was converted to open procedure. No significant differences were observed in terms of preoperative and postoperative d I and d 3 WBC counts （P = 0.493, P = 0.375, P = 0.559）, operation time （P = 0.235）, blood loss （P = 0.296）, anal exhaust time （P = 0.431）, pelvic drainage volume and VAS in postoperative d 1 （P = 0.431, P = 0.426） and d 3 （P = 0.844, P = 0.617） between ES group and US group. The occurrence of surgery-related complications such as anastomotic leakage and wound infection was the same in the two groups.CONCLUSION： ES is a safe and feasible tool as same as US used in laparoscopic TME with anal sphincter preservation for rectal cancer on the basis of the skillful laparoscopic technique and the complete understanding of laparoscopic pelvic anatomy. Application of ES can not only reduce the operation costs but also benefit the popularization of laparoscopic operation for rectal cancer patients.展开更多
基金Supported by National Science and Technology Pillar Program during the Twelfth Five-year Plan Period,No.2012BAI06B02the Capital Health Research and Development of Special,No.2011-4032-02
文摘AIM:To determine the resistance patterns of Helicobacter pylori(H.pylori) strains isolated from patients in Beijing and monitor the change of antibiotic resistance over time.METHODS:In this prospective,serial and crosssectional study,H.pylori cultures were successfully obtained from 371 and 950 patients(never receiving eradication) during 2009-2010 and 2013-2014,respectively.Resistance to amoxicillin,clarithromycin,metronidazole,levofloxacin,tetracycline,and rifampicin was determined by Epsilometer test.RESULTS:The resistance rates of isolates obtained during 2009-2010 were 66.8%,39.9%,34.5%,15.4%,6.7%,and 4.9% to metronidazole,clarithromycin,levofloxacin,rifampicin,amoxicillin and tetracycline,respectively; and the corresponding rates for isolates during 2013-2014 were 63.4%,52.6%,54.8%,18.2%,4.4% and 7.3%,respectively.The resistance rates to clarithromycin and levofloxacin were significantly increased after four years.In 2009-2010,14.6% of H.pylori isolates were susceptible to all tested antibiotics,with mono(33.7%),double(28.3%),triple(16.7%),quadruple(6.2%),quintuple(0.3%) and sextuple resistance(0.3%) also being detected.In 2013-2014,9.4% were susceptible to all tested antibiotics,and mono(27.6%),double(28.4%),triple(24.9%),quadruple(7.3%),quintuple(2.3%) and sextuple resistance(0.1%) was also observed.More multiple resistant H.pylori isolates were found during 2013-2014.Gender(to levofloxacin and metronidazole),age(to levofloxacin) and endoscopic findings(to clarithromycin) were independent factors influencing antibiotic resistance.CONCLUSION:H.pylori resistance to commonly used antibiotics in Beijing is high with increased multiple antibiotic resistance.
基金supported by National Basic Research Program of China (Grants Nos. 2010CB833400, 2004CB720200)Innovation Program of Chinese Academy of Sciences (Grant No. KZCX2-YW-Q09-04)+1 种基金National Natural Science Foundation of China (Grants Nos. 41072142, 40921120406 and 40772116)State Key Laboratory of Loess and Quaternary Geology (SKLLQG)
文摘The expansion of inland Asia deserts has considerably influenced the environmental, social and economic activities in Asia. Aridification of inland Asia, especially timing of the initiation of Asian desertification, is a contentious topic in paleoclimatology. Late Cenozoic eolian loess-red clay sequences on the Chinese Loess Plateau, which possess abundant paleoclimatic and paleo-environmental information, can be regarded as an indicator of inland Asia desertification. Here we present a detailed magnetostratigraphic investigation of a new red clay sequence about 654 m in Zhuanglang located at the western Chinese Loess Plateau. Sedimentological, geochemical, mineralogical, and quartz morphological lines of evidence show that the red clay is of eolian origin. Magnetostratigraphic correlations indicate that this core sequence spans from 25.6 to 4.8 Ma, and typical eolian red clay appears as early as 25 Ma. This extends the lower limit of the red clay on the Chinese Loess Plateau from the previously thought early Miocene back into the late Oligocene. This new red clay record further implies that the inland Asia desertification was initiated at least by the late Oligocene. This sequence provides a unique high-resolution geological record for understanding the inland Asia desertification process since the late Oligocene.
文摘INTRODUCTIONThe prevalence of hyperuricenlia （HUA） has increased in China in the recent years in relation to socioeconomic developments and changing lifestyles and diets, with a trend toward onset at younger age. HUA has become the second most common metabolic disease after diabetes mellitus. Like gout, HUA is also associated with the occurrence and progression of disorders of the urinary, endocrine, metabolic, cardio-cerebrovascular, and other systems.
基金This study is supported by the offshore NGH production test projects under the Marine Geological Survey Program initiated by the China Geological Survey(DD20190226,DD20190218)the Major Program of National Natural Science Foundation of China(41730528,51991365)。
文摘Clayey silt reservoirs bearing natural gas hydrates(NGH)are considered to be the hydrate-bearing reservoirs that boast the highest reserves but tend to be the most difficult to exploit.They are proved to be exploitable by the first NGH production test conducted in the South China Sea in 2017.Based on the understanding of the first production test,the China Geological Survey determined the optimal target NGH reservoirs for production test and conducted a detailed assessment,numerical and experimental simulation,and onshore testing of the reservoirs.After that,it conducted the second offshore NGH production test in 1225 m deep Shenhu Area,South China Sea(also referred to as the second production test)from October 2019 to April 2020.During the second production test,a series of technical challenges of drilling horizontal wells in shallow soft strata in deep sea were met,including wellhead stability,directional drilling of a horizontal well,reservoir stimulation and sand control,and accurate depressurization.As a result,30 days of continuous gas production was achieved,with a cumulative gas production of 86.14×104 m3.Thus,the average daily gas production is 2.87×10^4 m^3,which is 5.57 times as much as that obtained in the first production test.Therefore,both the cumulative gas production and the daily gas production were highly improved compared to the first production test.As indicated by the monitoring results of the second production test,there was no anomaly in methane content in the seafloor,seawater,and atmosphere throughout the whole production test.This successful production test further indicates that safe and effective NGH exploitation is feasible in clayey silt NGH reservoirs.The industrialization of hydrates consists of five stages in general,namely theoretical research and simulation experiments,exploratory production test,experimental production test,productive production test,and commercial production.The second production test serves as an important step from the exploratory production test to exper
基金The study was supported by National Key Research and Development Program(2018YFA0704100,2018YFA0704104)National Natural Science Foundation of China(81827805,82130060)Jiangsu Provincial Special Program of Medical Science(BE2019750).The funding sources had no role in the writing of the report,or decision to submit the paper for publication.
文摘There is considerable potential for integrating transarterial chemoembolization(TACE),programmed death-(ligand)1(PD-[L]1)inhibitors,and molecular targeted treatments(MTT)in hepatocellular carcinoma(HCC).It is necessary to investigate the therapeutic efficacy and safety of TACE combined with PD-(L)1 inhibitors and MTT in real-world situations.In this nationwide,retrospective,cohort study,826 HCC patients receiving either TACE plus PD-(L)1 blockades and MTT(combination group,n=376)or TACE monotherapy(monotherapy group,n=450)were included from January 2018 to May 2021.The primary endpoint was progression-free survival(PFS)according to modified RECIST.The secondary outcomes included overall survival(OS),objective response rate(ORR),and safety.We performed propensity score matching approaches to reduce bias between two groups.After matching,228 pairs were included with a predominantly advanced disease population.Median PFS in combination group was 9.5 months(95%confidence interval[CI],8.4-11.0)versus 8.0 months(95%CI,6.6-9.5)(adjusted hazard ratio[HR],0.70,P=0.002).OS and ORR were also significantly higher in combination group(median OS,19.2[16.1-27.3]vs.15.7 months[13.0-20.2];adjusted HR,0.63,P=0.001;ORR,60.1%vs.32.0%;P<0.001).Grade 3/4 adverse events were observed at a rate of 15.8%and 7.5%in combination and monotherapy groups,respectively.Our results suggest that TACE plus PD-(L)1 blockades and MTT could significantly improve PFS,OS,and ORR versus TACE monotherapy for Chinese patients with predominantly advanced HCC in real-world practice,with an acceptable safety profile.
文摘Objective:To investigate current status of diagnosis and treatment of bladder cancer in China.Methods:A database was generated by Chinese Bladder Cancer Consortium(CBCC).From January 2007 to December 2012,14,260 cases from 44 CBCC centers were included.Data of diagnosis,treatment and pathology were collected.Results:The average age was 63.5 year-old and most patients were male(84.3%).The most common histologic types were urothelial carcinoma(91.4%),adenocarcinoma(1.8%),and squamous carcinoma(1.9%).According to 1973 and 2004 WHO grading system,42.0%,41.0%,and 17.0% of patients were grade 1,2,and 3,and 16.0%,48.7%,and 35.3% of patients were papillary urothelial neoplasms of low malignant potential,low,and high grade,respectively.Non-muscle invasive bladder cancer(NMIBC)and muscle invasive bladder cancer(MIBC)were 25.2% and 74.1%,respectively(0.8% not clear).Carcinoma in situ was only 2.4%.Most patients were diagnosed by white-light cystoscopy with biopsy(74.3%).Fluorescence and narrow band imaging cystoscopy had additional detection rate of 1.0% and 4.0%,respectively.Diagnostic transurethral resection(TUR)provided detection rate of 16.9%.Most NMIBCs were treated with TUR(89.2%).After initial TUR,2.6%accepted second TUR,and 45.7%,69.9%,and 58.7% accepted immediate,induced,and maintenance chemotherapy instillation,respectively.Most MIBCs were treated with radical cystectomy(RC,59.7%).Laparoscopic RCs were 35.1%,while open RC 63.4%.Extended and standard pelvic lymph node dissection were 7% and 66%,respectively.Three most common urinary diversions were orthotopic neobladder(44%),ileal conduit(31%),and ureterocutaneostomy(23%).Only 2.3% of patients accepted neo-adjuvant chemotherapy and only 18%of T3 and T4 patients accepted adjuvant chemotherapy.Conclusion:Disease characteristics are similar to international reports,while differences of diagnosis and treatment exist.This study can provide evidences for revisions of the guideline on bladder cancer in China.
文摘Objective：To compare radiofrequency ablation （RFA） or microwave ablation （MWA） and transcatheter arterial chemoembolization （TACE） with RFA or MWA monotherapy in hepatocellular carcinoma （HCC）.Methods：A prospective,randomized,controlled trial was conducted on 94 patients with HCC ≤7 cm at a single tertiary referral center from June 2008 to June 2010 at the Department of Hepatobiliary Surgery,the Second Affiliated Hospital of Southeast University.The patients were randomly assigned into the TACERFA or TACE-MWA （combined treatment group） and the RFA-alone or MWA-alone groups （control group）.The primary end point was overall survival.The secondary end point was recurrence-free survival,and the tertiary end point was adverse effects.Results：Until the time of censor,17 patients in the TACE-RFA or TACE-MWA group had died.The median follow-up time of the patients who were still alive for the TACE-RFA or TACE-MWA group was 47.5±11.3 months （range,29 to 62 months）.The 1-,3-and 5-year overall survival for the TACE-RFA or TACE-MWA group was 93.6％,68.1％ and 61.7％,respectively.Twenty-five patients in the RFA or MWA group had died.The median follow-up time of the patients who were still alive for the RFA or MWA group was 47.0±12.9 months （range,28 to 62 months）.The 1-,3-and 5-year overall survival for the RFA or MWA group was 85.1％,59.6％ and 44.7％,respectively.The patients in the TACE-RFA or TACE-MWA group had better overall survival than the RFA or MWA group [hazard ratio （HR）,0.526; 95％ confidence interval （95％ CO,0.334-0.823; P=0.002],and showed better recurrence-free survival than the RFA or MWA group （HR,0.582; 95％ CI,0.368-0.895; P=0.008）.Conclusions：RFA or MWA combined with TACE in the treatment of HCC ≤7 cm was superior to RFA or MWA alone in improving survival by reducing arterial and portal blood flow due to TACE with iodized oil before RFA.
基金support from the National Key Research and Development Program of China(2017YFA0207002)the National Natural Science Foundation of China(21836001,21607042)the Fundamental Research Funds for the Central Universities(2018ZD11,2018MS114).
文摘As a class of famous carbon materials,biochars(BCs)and their derivative materials with excellent physicochemical properties and diversified functionalities present great potential in wastewater treatment fields.This review focuses on the latest development in reported biochar-based materials as superior adsorbents or catalysts for removing harmful organic contaminants from wastewater.The construction and properties of biochar-based materials are briefly introduced at the beginning.As one of the major factors affecting the properties of BCs,the wide diversity of feedstocks,such as agricultural and forest residues,industrial by-products as well as municipal wastes,endows BCs different chemical compositions and structures.Woody and herbaceous BCs usually have higher carbon contents,larger surface areas and strong aromaticity,which is in favor of the organic contaminant removal.Driven by the desire of more cost-effective materials,several types of biochar-based hybrid materials,such as magnetic BC composites(MBC),nanometal/nanometallic oxides/hydroxide BC composites and layered nanomaterial-coated BCs,as well as physically/chemically activated BCs,have also been developed.With the help of foreign materials,these types of hybrid BCs have excellent capacities to remove a wide range of organic contaminants,including organic dyestuff,phenols and chemical intermediates,as well as pharmaceutically active compounds,from aquatic solutions.Depending on the different types of biochar-based materials,organic contaminants can be removed by different mechanisms,such as physical adsorption,electrostatic interaction,π-πinteraction and Fenton process,as well as photocatalytic degradation.In summary,the low cost,tunable surface chemistry and excellent physical-chemical properties of BCs allow it to be a potential material in organic contaminant removal.The combination of BCs with foreign materials endows BCs more functionalities and broader development opportunities.Considering the urgent demand of practical wastewater treatment,we
文摘基于CASA模型、碳税法和工业制氧法,测算了粤港澳大湾区2015年固碳释氧量及其价值,并结合ESA CCI-LC产品探讨了2000—2015年研究区陆地生态系统演变及其导致的固碳释氧量和价值的变化。结果表明:(1)2000—2015年,研究区城市扩张明显,主要表现为城镇用地侵占农田和草地。(2)研究区陆地生态系统91.03%固碳释氧量及其价值集中在森林和农田生态系统,2000—2015年陆地生态系统演变造成区域内固碳量和释氧量分别减少了53.49 G g和518.65 G g,对应固碳释氧价值损失量分别为1.79亿元和2.06亿元,合计3.85亿元,91.57%损失量是由城市扩张导致的。(3)城市覆盖面积与固碳释氧价值呈现强负相关,其扩张会促使生态系统固碳释氧价值逐渐减少,林地覆盖面积与固碳释氧价值呈现强正相关,其比重增加将有利于生态系统固碳释氧价值的培育。本文利用"邻域代理法"获得了研究区多类陆地生态系统演变情况及其对固碳释氧服务的影响,具有一定的推广价值。在未来发展过程中,粤港澳大湾区应该优化陆地生态系统类型,合理控制城市扩张,保护森林和农田资源,减少人类活动作用,增强生态系统自然演变过程。
基金supported by the Beijing Natural Science Foundation(Grant No.8100001)the National Basic Research Program of China("973"Project)(Grant No.2009CB623106)
文摘The influence of steel slag,a by-product from the processing of iron to steel,on the hydration of cement during the hydration process of complex binder was studied by calorimetry,X-ray diffraction analysis,and Ca(OH)2 content determination.The results show that steel slag and cement affect each other’s hydration by changing the hydration environment.Steel slag does not react with the hydration products of cement.The dormant period of cement-steel slag complex binder during the hydration is longer than that of cement.The more the adding amount of steel slag is,the longer the dormant period of complex binder will be.The steel slag decreases the early hydration rate of cement.This phenomenon is more obvious with the increment of steel slag addition.However,the steel slag can promote the hydration degree of cement at later ages and the promoting effect becomes more obvious with the increment of steel slag addition and the hydration ages.
基金Supported by Grants from Guangxi Key Discipline Fund(Pathogenic Microbiology),No.[2013]16Key Laboratory Fund of Colleges and Universities in Guangxi,No.Gui Jiao Ke Yan[2014]6+1 种基金National Natural Science Foundation of China,No.31460023Natural Science Foundation of Guangxi,No.2014GXNSFAA118206
文摘AIM: To investigate the inhibitory effects of emodin, baicalin, etc.on the hefA gene of multidrug resistance(MDR) in Helicobacter pylori(H.pylori).METHODS: The double dilution method was used to screen MDR H.pylori strains and determine the minimum inhibitory concentrations(MICs) of emodin, baicalin, schizandrin, berberine, clarithromycin, metronidazole, tetracycline, amoxicillin and levofloxacin against H.pylori strains.After the screened MDR stains were treated with emodin, baicalin, schizandrin or berberine at a 1/2 MIC concentration for 48 h, changes in MICs of amoxicillin, tetracycline, levofloxacin, metronidazole and clarithromycin were determined.MDR strains with reduced MICs of amoxicillin were selected to detect the hefA mR NA expression by realtime quantitative PCR.RESULTS: A total of four MDR H.pylori strains were screened.Treatment with emodin, baicalin, schizandrin and berberine significantly decreased the MICs of amoxicillin and tetracycline against some strains, decreased by 1 to 2 times, but did not significantly change the MICs of clarithromycin, levofloxacin, and metronidazole against MDR strains.In the majority of strains with reduced MICs of amoxicillin, hef A m RNA expression was decreased; one-way ANOVA(SPSS 12.0) used for comparative analysis, P < 0.05.CONCLUSION: Emodin, baicalin, schizandrin and berberine significantly decreased the MICs of amoxicillin and tetracycline against some H.pylori strains, possibly by mechanisms associated with decreasing hefA mR NA expression.
基金Science and Technology Development Project of Hebei Province, No. 052761001D-26
文摘AIM： To investigate the feasibility and safety of monopolar electrocautery shovel （ES） in laparoscopic total mesorectal excision （TME） with anal sphincter preservation for rectal cancer in order to reduce the cost of the laparoscopic operation, and to compare ES with the ultrasonically activated scalpel （US）. METHODS： Forty patients with rectal cancer, who underwent laparoscopic TME with anal sphincter preservation from June 2005 to June 2007, were randomly divided into ultrasonic scalpel group and monopolar ES group, prospectively. White blood cells （WBC） were measured before and after operation, operative time, blood loss, pelvic volume of drainage, time of anal exhaust, visual analogue scales （VAS） and surgery-related complications were recorded. RESULTS： All the operations were successful; no one was converted to open procedure. No significant differences were observed in terms of preoperative and postoperative d I and d 3 WBC counts （P = 0.493, P = 0.375, P = 0.559）, operation time （P = 0.235）, blood loss （P = 0.296）, anal exhaust time （P = 0.431）, pelvic drainage volume and VAS in postoperative d 1 （P = 0.431, P = 0.426） and d 3 （P = 0.844, P = 0.617） between ES group and US group. The occurrence of surgery-related complications such as anastomotic leakage and wound infection was the same in the two groups.CONCLUSION： ES is a safe and feasible tool as same as US used in laparoscopic TME with anal sphincter preservation for rectal cancer on the basis of the skillful laparoscopic technique and the complete understanding of laparoscopic pelvic anatomy. Application of ES can not only reduce the operation costs but also benefit the popularization of laparoscopic operation for rectal cancer patients.
