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
目的:本研究旨在构建适合癌症相关性疼痛(简称癌痛)病人的疼痛评估量表,并探索评估量表用于癌痛病人的信度和效度,以期为临床癌痛病人的管理提供更加综合全面且简便易行的评估工具。方法:基于国内癌痛领域的指导性规范、临床诊疗指南、...目的:本研究旨在构建适合癌症相关性疼痛(简称癌痛)病人的疼痛评估量表,并探索评估量表用于癌痛病人的信度和效度,以期为临床癌痛病人的管理提供更加综合全面且简便易行的评估工具。方法:基于国内癌痛领域的指导性规范、临床诊疗指南、专家共识等,本研究构建了癌痛病人评估量表初始条目池,采取德尔菲法选取我国癌痛领域的二十余名专家进行两轮咨询,统计咨询结果,确认纳入的条目,形成最终的多维疼痛评估量表(multi-dimensional brief test scale for pain,BTS)。经过两轮德尔菲法专家咨询,第一轮纳入21位专家,第二轮纳入10位专家,第一轮纳入19个评估维度,选取重要性评分≥4.5分且变异系数≤20%的7个评估维度,进行第二轮专家咨询。这7个评估维度和条目的重要性结果与第一轮一致,由此最终构建的BTS共包含7个评估维度,15个条目。选取2022年7月至2023年2月中国人民解放军北部战区总医院收治的癌痛病人,使用构建的BTS评估量表进行信效度检验。结果:共纳入166例病人,经过数据清洗,最终纳入分析的病人例数为138例。BTS的信度检测Cronbachα系数为0.78,效度检测的KMO值为0.80,具有较好的信度和效度。结论:构建的BTS条目共纳入7个评估维度,15个条目,具有较好的信度和效度,可在临床实践中推广应用于癌痛病人的疼痛评估。展开更多
以自研土壤改良剂为材料,按照蔬菜园每667 m2施入改良剂0 kg (CK)、25 kg(B25)、50 kg (B50)和75 kg (B75)设置四个处理,分析土壤改良剂对土壤pH、有机质含量以及‘小白苗’小白菜内在与外在品质的影响。结果表明,施用土壤改良剂能维持...以自研土壤改良剂为材料,按照蔬菜园每667 m2施入改良剂0 kg (CK)、25 kg(B25)、50 kg (B50)和75 kg (B75)设置四个处理,分析土壤改良剂对土壤pH、有机质含量以及‘小白苗’小白菜内在与外在品质的影响。结果表明,施用土壤改良剂能维持土壤pH 7.0以上,改善土壤酸化。不同土层的有机质含量表现为随着土层加深而降低。31~45 cm土层中,B25处理下有机质含量最高,为5.35 g·kg–1,显著高于CK组(P<0.05);土壤改良剂能提高小白菜VC、可溶性蛋白和游离氨基酸含量,降低硝酸盐含量。其中B75处理下,VC、可溶性蛋白和游离氨基酸的含量均为最高,与CK组差异显著(P<0.05),硝酸盐含量最低,为0.4713 mg·g–1,与其他处理差异显著(P<0.05)。适量施用土壤改良剂能增加小白菜叶长、叶宽和叶片数,提高小白菜外在品质,B25和B50处理下,小白菜地上部鲜重相比于CK组分别增加了79 g和16 g,差异显著(P<0.05)。使用自研的土壤改良剂能明显提高小白菜产量和品质,改善土壤环境。展开更多
A mathematical model describing the flow field, heat transfer and the electromagnetic phenomenon in a DC electric arc furnace has been developed. First the governing equations in the arc plasma region are solved and t...A mathematical model describing the flow field, heat transfer and the electromagnetic phenomenon in a DC electric arc furnace has been developed. First the governing equations in the arc plasma region are solved and the calculated results of heat transfer, current density and shear stresses on the anode surface are used as boundary conditions in a model of molten bath. Then a two-dimensional time-dependent model is used to describe the flow field and electromagnetic phenomenon in the molten bath. Moreover, the effect of bottom electrode diameter on the circulation of molten bath is studied.展开更多
The effects of pulsing electromagnetic fields(PEMFs)on cells are very important subjects in the field of bioelectromagnetics.In this experiment,the cytogenetic effects of PEMF on domestic pig lymphocytes were tested i...The effects of pulsing electromagnetic fields(PEMFs)on cells are very important subjects in the field of bioelectromagnetics.In this experiment,the cytogenetic effects of PEMF on domestic pig lymphocytes were tested in vitro.Pig lymphocytes in RPMI 1640 medium were exposed to PEMFs of 100 kHz and 200 kHz for 12,24 and 48 hours.Chromosomal aberrations(aneuploidy,breaks,gaps,et al)were significantly increased in exposed cultures,and of these aberrations,56%chromosomal or chromatid breaks and 42%gaps induced by PEMFs were the points of pig chromosomal fragile sites.The baseline frequency of sister chromatid exchange(SCE)increased after exposing lymphocytes continuously to PEMFs of 100 kHz and 200 kHz for 48 hours.These results suggested that the exposure to PEMFs might induce a type of DNA lesion and chromosomal aberrations.展开更多
Cerebral blood flow is strongly associated with brain function, and is the main symptom and diagnostic basis for a variety of encephalopathies. However, changes in cerebral blood flow after mild traumatic brain injury...Cerebral blood flow is strongly associated with brain function, and is the main symptom and diagnostic basis for a variety of encephalopathies. However, changes in cerebral blood flow after mild traumatic brain injury remain poorly understood. This study sought to observe changes in cerebral blood flow in different regions after mild traumatic brain injury using pulsed arterial spin labeling. Our results demonstrate maximal cerebral blood flow in gray matter and minimal in the white matter of patients with mild traumatic brain injury. At the acute and subacute stages, cerebral blood flow was reduced in the occipital lobe, parietal lobe, central region, subcutaneous region, and frontal lobe. Cerebral blood flow was restored at the chronic stage. At the acute, subacute, and chronic stages, changes in cerebral blood flow were not apparent in the insula. Cerebral blood flow in the temporal lobe and limbic lobe diminished at the acute and subacute stages, but was restored at the chronic stage. These findings suggest that pulsed arterial spin labeling can precisely measure cerebral blood flow in various brain regions, and may play a reference role in evaluating a patient＇s condition and judging prognosis after traumatic brain injury.展开更多
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.
文摘目的:本研究旨在构建适合癌症相关性疼痛(简称癌痛)病人的疼痛评估量表,并探索评估量表用于癌痛病人的信度和效度,以期为临床癌痛病人的管理提供更加综合全面且简便易行的评估工具。方法:基于国内癌痛领域的指导性规范、临床诊疗指南、专家共识等,本研究构建了癌痛病人评估量表初始条目池,采取德尔菲法选取我国癌痛领域的二十余名专家进行两轮咨询,统计咨询结果,确认纳入的条目,形成最终的多维疼痛评估量表(multi-dimensional brief test scale for pain,BTS)。经过两轮德尔菲法专家咨询,第一轮纳入21位专家,第二轮纳入10位专家,第一轮纳入19个评估维度,选取重要性评分≥4.5分且变异系数≤20%的7个评估维度,进行第二轮专家咨询。这7个评估维度和条目的重要性结果与第一轮一致,由此最终构建的BTS共包含7个评估维度,15个条目。选取2022年7月至2023年2月中国人民解放军北部战区总医院收治的癌痛病人,使用构建的BTS评估量表进行信效度检验。结果:共纳入166例病人,经过数据清洗,最终纳入分析的病人例数为138例。BTS的信度检测Cronbachα系数为0.78,效度检测的KMO值为0.80,具有较好的信度和效度。结论:构建的BTS条目共纳入7个评估维度,15个条目,具有较好的信度和效度,可在临床实践中推广应用于癌痛病人的疼痛评估。
文摘以自研土壤改良剂为材料,按照蔬菜园每667 m2施入改良剂0 kg (CK)、25 kg(B25)、50 kg (B50)和75 kg (B75)设置四个处理,分析土壤改良剂对土壤pH、有机质含量以及‘小白苗’小白菜内在与外在品质的影响。结果表明,施用土壤改良剂能维持土壤pH 7.0以上,改善土壤酸化。不同土层的有机质含量表现为随着土层加深而降低。31~45 cm土层中,B25处理下有机质含量最高,为5.35 g·kg–1,显著高于CK组(P<0.05);土壤改良剂能提高小白菜VC、可溶性蛋白和游离氨基酸含量,降低硝酸盐含量。其中B75处理下,VC、可溶性蛋白和游离氨基酸的含量均为最高,与CK组差异显著(P<0.05),硝酸盐含量最低,为0.4713 mg·g–1,与其他处理差异显著(P<0.05)。适量施用土壤改良剂能增加小白菜叶长、叶宽和叶片数,提高小白菜外在品质,B25和B50处理下,小白菜地上部鲜重相比于CK组分别增加了79 g和16 g,差异显著(P<0.05)。使用自研的土壤改良剂能明显提高小白菜产量和品质,改善土壤环境。
文摘A mathematical model describing the flow field, heat transfer and the electromagnetic phenomenon in a DC electric arc furnace has been developed. First the governing equations in the arc plasma region are solved and the calculated results of heat transfer, current density and shear stresses on the anode surface are used as boundary conditions in a model of molten bath. Then a two-dimensional time-dependent model is used to describe the flow field and electromagnetic phenomenon in the molten bath. Moreover, the effect of bottom electrode diameter on the circulation of molten bath is studied.
文摘The effects of pulsing electromagnetic fields(PEMFs)on cells are very important subjects in the field of bioelectromagnetics.In this experiment,the cytogenetic effects of PEMF on domestic pig lymphocytes were tested in vitro.Pig lymphocytes in RPMI 1640 medium were exposed to PEMFs of 100 kHz and 200 kHz for 12,24 and 48 hours.Chromosomal aberrations(aneuploidy,breaks,gaps,et al)were significantly increased in exposed cultures,and of these aberrations,56%chromosomal or chromatid breaks and 42%gaps induced by PEMFs were the points of pig chromosomal fragile sites.The baseline frequency of sister chromatid exchange(SCE)increased after exposing lymphocytes continuously to PEMFs of 100 kHz and 200 kHz for 48 hours.These results suggested that the exposure to PEMFs might induce a type of DNA lesion and chromosomal aberrations.
文摘Cerebral blood flow is strongly associated with brain function, and is the main symptom and diagnostic basis for a variety of encephalopathies. However, changes in cerebral blood flow after mild traumatic brain injury remain poorly understood. This study sought to observe changes in cerebral blood flow in different regions after mild traumatic brain injury using pulsed arterial spin labeling. Our results demonstrate maximal cerebral blood flow in gray matter and minimal in the white matter of patients with mild traumatic brain injury. At the acute and subacute stages, cerebral blood flow was reduced in the occipital lobe, parietal lobe, central region, subcutaneous region, and frontal lobe. Cerebral blood flow was restored at the chronic stage. At the acute, subacute, and chronic stages, changes in cerebral blood flow were not apparent in the insula. Cerebral blood flow in the temporal lobe and limbic lobe diminished at the acute and subacute stages, but was restored at the chronic stage. These findings suggest that pulsed arterial spin labeling can precisely measure cerebral blood flow in various brain regions, and may play a reference role in evaluating a patient＇s condition and judging prognosis after traumatic brain injury.
