During radical cystectomy(RC),the neurovascular bundles are easily removed or damaged,leading to varying rates of incontinence and erectile dysfunction.The nervesparing technique was developed to preserve urinary and ...During radical cystectomy(RC),the neurovascular bundles are easily removed or damaged,leading to varying rates of incontinence and erectile dysfunction.The nervesparing technique was developed to preserve urinary and erectile function.The adoption of laparoscopic and robot-assisted technology has improved visualization and dexterity of pelvic surgeries,thus facilitate the nerve-sparing technique.Although nerve-sparing RC is technically similar with nerve-sparing radical prostatectomy,there are still some anatomical differences.There are mainly three different types of nerve-sparing techniques.Pelvic lymph node dissection(PLND)is another important factor to influence erectile function and urinary continence.Nerve-sparing laparoscopic radical cystectomy(LRC)and robot-assisted radical cystectomy(RARC)may be an optimal treatment choice in well-selected younger patients with lowvolume,organ-confined disease.We should attempt to do,whenever possible,a nerve-sparing cystectomy at least on oneside.However,due to the need of a well-refined surgical technique,nerve-sparing LRC and RARC is now being performed only by experienced urological surgeons.展开更多
Promoting inorganic-rich solid-electrolyte interphase (SEI) formation by constructing anion-rich solvated structures is a promising strategy for improving the long-term cycling of lithium-metal batteries.However,the i...Promoting inorganic-rich solid-electrolyte interphase (SEI) formation by constructing anion-rich solvated structures is a promising strategy for improving the long-term cycling of lithium-metal batteries.However,the increase of anions within the solvated structure inevitably reduces the coordination of Li^(+) with the solvent,which leads to a low lithium diffusion coefficient and a decreased lithium conductivity.Here,high entropy electrolyte is achieved by increasing the molecular diversity in electrolyte.Multiple anions (TFSI^(-),FSI^(-),NO_(3)^(-) and PF_(6)^(-)) presented in entropy electrolyte individually coordinate with Li^(+),creating a diverse and anion-rich solvation structure.The large variety of solvation structures leads to a diversified Li^(+) diffusion barriers in the electrolyte,which results in the increase of channels available for Li^(+) diffusion.Thus,three-dimensional diffusion with high Li^(+) diffusion coefficient occurs in HE electrolytes.Furthermore,the anion-rich solvation structures promote the formation of the inorganic-rich SEI.As a result,over 2000 h of reversible Li plating/stripping with a low overpotential less than 27 mV is achieved in Li||Li cell using electrolyte modified by high-entropy strategy.Besides,the Li||LFP full cell with a negative capacity/positive capacity (N/P) ratio of 4.52 exhibits remarkably enhanced cycling stability,retaining 83.6% of its initial capacity after 150 cycles.This strategy offers a novel approach for accelerating Li^(+) transport kinetics and constructing stable SEI in lithium metal batteries.展开更多
Background:Clinical outcome of adrenocortical carcinoma(ACC)varies because of its heterogeneous nature and reliable prognostic prediction model for adult ACC patients is limited.The objective of this study was to deve...Background:Clinical outcome of adrenocortical carcinoma(ACC)varies because of its heterogeneous nature and reliable prognostic prediction model for adult ACC patients is limited.The objective of this study was to develop and externally validate a nomogram for overall survival(OS)prediction in adult patients with ACC after surgery.Methods:Based on the data from the Surveillance Epidemiology,and End Results(SEER)database,adults patients diagnosed with ACC between January 1988 and December 2015 were identified and classified into a training set,comprised of 404 patients diagnosed between January 2007 and December 2015,and an internal validation set,com-prised of 318 patients diagnosed between January 1988 and December 2006.The endpoint of this study was OS.The nomogram was developed using a multivariate Cox proportional hazards regression algorithm in the training set and its performance was evaluated in terms of its discriminative ability,calibration,and clinical usefulness.The nomogram was then validated using the internal SEER validation,also externally validated using the Cancer Genome Atlas set(TCGA,82 patients diagnosed between 1998 and 2012)and a Chinese multicenter cohort dataset(82 patients diag-nosed between December 2002 and May 2018),respectively.Results:Age at diagnosis,T stage,N stage,and M stage were identified as independent predictors for OS.A nomo-gram incorporating these four predictors was constructed using the training set and demonstrated good calibration and discrimination(C-index 95%confidence interval[CI],0.715[0.679-0.751]),which was validated in the internal validation set(C-index[95%CI],0.672[0.637-0.707]),the TCGA set(C-index[95%CI],0.810[0.732-0.888])and the Chi-nese multicenter set(C-index[95%CI],0.726[0.633-0.819]),respectively.Encouragingly,the nomogram was able to successfully distinguished patients with a high-risk of mortality in all enrolled patients and in the subgroup analyses.Decision curve analysis indicated that the nomogram was clinically useful and applicable.Conclusions:T展开更多
Background:Programmed cell death-1/ligand 1 inhibitors are a new treatment strategy for advanced urothelial carcinoma.Therefore,a comparative evaluation of their efficacy and toxicity compared with chemotherapy is nec...Background:Programmed cell death-1/ligand 1 inhibitors are a new treatment strategy for advanced urothelial carcinoma.Therefore,a comparative evaluation of their efficacy and toxicity compared with chemotherapy is necessary.Methods:We comprehensively searched PubMed,Web of Science,Embase,and Cochrane Library databases and performed a meta-analysis of randomized controlled trials up to July 2021.We considered overall survival as the primary outcome,and progression-free survival,objective response rate,and treatment-related adverse events as secondary outcomes.Results:Overall,3584 patients from five studies were evaluated.Compared with first-line chemotherapy,programmed cell death-1/ligand 1 inhibitors were significantly associated with worse progression-free survival(p<0.001)and adverse objective response rates(p<0.001).However,the treatments were not significantly different in terms of overall survival(p=0.33).Compared with second-line chemotherapy,programmed cell death-1/ligand 1 inhibitors significantly improved overall survival(p<0.001),and there was no statistically significant difference in progression-free survival(p=0.89)or objective response rate(p=0.34).Compared with chemotherapy,programmed cell death-1/ligand 1 inhibitors were well tolerated(first-line chemotherapy:p<0.001;second-line chemotherapy:p<0.001).Conclusions:The efficacy of programmed cell death-1/ligand 1 inhibitors in patients with advanced urothelial carcinoma is not superior to that of first-line platinum-based chemotherapy but is better than second-line chemotherapy;however,programmed cell death-1/ligand 1 inhibitors are safer than first-and second-line chemotherapy and have a broader prospect for use in combination therapy.展开更多
To the Editor:Ankylosing spondylitis(AS)is a chronic inflammatory disease that causes bony fusion of spine and sacroiliac joints,resulting in restricted spinal movement and deformity.In China,the prevalence of AS is a...To the Editor:Ankylosing spondylitis(AS)is a chronic inflammatory disease that causes bony fusion of spine and sacroiliac joints,resulting in restricted spinal movement and deformity.In China,the prevalence of AS is about 0.29%with a male to female ratio of approximately 3:1,and most cases occur in the adolescent period.[1]The misdiagnosis rate of AS patients in China is>50%.展开更多
Diffusion-tensor imaging can be used to observe the microstructure of brain tissue. Fractional ani- sotropy reflects the integrity of white matter fibers. Fractional anisotropy of a young adult brain is low in gray ma...Diffusion-tensor imaging can be used to observe the microstructure of brain tissue. Fractional ani- sotropy reflects the integrity of white matter fibers. Fractional anisotropy of a young adult brain is low in gray matter, high in white matter, and highest in the splenium of the corpus callosum. Thus, we selected the anterior and posterior limbs of the internal capsule, head of the caudate nucleus, semioval center, thalamus, and corpus callosum （splenium and genu） as regions of interest when using diffusion-tensor imaging to observe fractional anisotropy of major white matter fiber tracts and the deep gray matter of healthy rhesus monkeys aged 4-8 years. Results showed no laterality dif- ferences in fractional anisotropy values. Fractional anisotropy values were low in the head of cau- date nucleus and thalamus in gray matter. Fractional anisotropy values were highest in the sple- nium of corpus callosum in the white matter, followed by genu of the corpus callosum and the pos- terior limb of the internal capsule. Fractional anisotropy values were lowest in the semioval center and posterior limb of internal capsule. These results suggest that fractional anisotropy values in major white matter fibers and the deep gray matter of 4-8-year-old rhesus monkeys are similar to those of healthy young people.展开更多
基金supported by Yat-sen Clinical Trail Project(No.200501).
文摘During radical cystectomy(RC),the neurovascular bundles are easily removed or damaged,leading to varying rates of incontinence and erectile dysfunction.The nervesparing technique was developed to preserve urinary and erectile function.The adoption of laparoscopic and robot-assisted technology has improved visualization and dexterity of pelvic surgeries,thus facilitate the nerve-sparing technique.Although nerve-sparing RC is technically similar with nerve-sparing radical prostatectomy,there are still some anatomical differences.There are mainly three different types of nerve-sparing techniques.Pelvic lymph node dissection(PLND)is another important factor to influence erectile function and urinary continence.Nerve-sparing laparoscopic radical cystectomy(LRC)and robot-assisted radical cystectomy(RARC)may be an optimal treatment choice in well-selected younger patients with lowvolume,organ-confined disease.We should attempt to do,whenever possible,a nerve-sparing cystectomy at least on oneside.However,due to the need of a well-refined surgical technique,nerve-sparing LRC and RARC is now being performed only by experienced urological surgeons.
基金supported by the National Natural Science Foundation of China (21905033, 52271201)the Science and Technology Department of Sichuan Province (2022YFG0100,2022ZYD0045)。
文摘Promoting inorganic-rich solid-electrolyte interphase (SEI) formation by constructing anion-rich solvated structures is a promising strategy for improving the long-term cycling of lithium-metal batteries.However,the increase of anions within the solvated structure inevitably reduces the coordination of Li^(+) with the solvent,which leads to a low lithium diffusion coefficient and a decreased lithium conductivity.Here,high entropy electrolyte is achieved by increasing the molecular diversity in electrolyte.Multiple anions (TFSI^(-),FSI^(-),NO_(3)^(-) and PF_(6)^(-)) presented in entropy electrolyte individually coordinate with Li^(+),creating a diverse and anion-rich solvation structure.The large variety of solvation structures leads to a diversified Li^(+) diffusion barriers in the electrolyte,which results in the increase of channels available for Li^(+) diffusion.Thus,three-dimensional diffusion with high Li^(+) diffusion coefficient occurs in HE electrolytes.Furthermore,the anion-rich solvation structures promote the formation of the inorganic-rich SEI.As a result,over 2000 h of reversible Li plating/stripping with a low overpotential less than 27 mV is achieved in Li||Li cell using electrolyte modified by high-entropy strategy.Besides,the Li||LFP full cell with a negative capacity/positive capacity (N/P) ratio of 4.52 exhibits remarkably enhanced cycling stability,retaining 83.6% of its initial capacity after 150 cycles.This strategy offers a novel approach for accelerating Li^(+) transport kinetics and constructing stable SEI in lithium metal batteries.
基金This work was supported by the Natural Science Foundation of China(81572514,U1301221,81402106,81272808,81825016)the Natural Science Foundation of Guangdong,China(2016A030313244)Grant[2013]163 from Key Laboratory of Malignant Tumor Molecular Mechanism and Translational Medicine of Guangzhou Bureau of Science and Information Technology,Grant KLB09001 from the Key Laboratory of Malignant Tumor Gene Regulation and Target Therapy of Guangdong Higher Education Institutes,and grants from the Guangdong Science and Technology Department(2015B050501004,2017B020227007).
文摘Background:Clinical outcome of adrenocortical carcinoma(ACC)varies because of its heterogeneous nature and reliable prognostic prediction model for adult ACC patients is limited.The objective of this study was to develop and externally validate a nomogram for overall survival(OS)prediction in adult patients with ACC after surgery.Methods:Based on the data from the Surveillance Epidemiology,and End Results(SEER)database,adults patients diagnosed with ACC between January 1988 and December 2015 were identified and classified into a training set,comprised of 404 patients diagnosed between January 2007 and December 2015,and an internal validation set,com-prised of 318 patients diagnosed between January 1988 and December 2006.The endpoint of this study was OS.The nomogram was developed using a multivariate Cox proportional hazards regression algorithm in the training set and its performance was evaluated in terms of its discriminative ability,calibration,and clinical usefulness.The nomogram was then validated using the internal SEER validation,also externally validated using the Cancer Genome Atlas set(TCGA,82 patients diagnosed between 1998 and 2012)and a Chinese multicenter cohort dataset(82 patients diag-nosed between December 2002 and May 2018),respectively.Results:Age at diagnosis,T stage,N stage,and M stage were identified as independent predictors for OS.A nomo-gram incorporating these four predictors was constructed using the training set and demonstrated good calibration and discrimination(C-index 95%confidence interval[CI],0.715[0.679-0.751]),which was validated in the internal validation set(C-index[95%CI],0.672[0.637-0.707]),the TCGA set(C-index[95%CI],0.810[0.732-0.888])and the Chi-nese multicenter set(C-index[95%CI],0.726[0.633-0.819]),respectively.Encouragingly,the nomogram was able to successfully distinguished patients with a high-risk of mortality in all enrolled patients and in the subgroup analyses.Decision curve analysis indicated that the nomogram was clinically useful and applicable.Conclusions:T
基金Guangdong Province Higher Vocational Colleges&Schools Pearl River Scholar Funded SchemeScience and Technology Planning Project of Guangdong Province,Grant/Award Number:2017B020227007+4 种基金Guangdong Provincial Clinical Research Center for Urological Diseases,Grant/Award Number:2020B1111170006National Natural Science Foundation of China,Grant/Award Numbers:81825016,81772719,8217326,81772728,819723856,81961128027,82002679National Key Research and Development Program of China,Grant/Award Number:2018YFA0902803Key Areas Research and Development Program of Guangdong,Grant/Award Number:2018B010109006Key Laboratory of Malignant Tumor。
文摘Background:Programmed cell death-1/ligand 1 inhibitors are a new treatment strategy for advanced urothelial carcinoma.Therefore,a comparative evaluation of their efficacy and toxicity compared with chemotherapy is necessary.Methods:We comprehensively searched PubMed,Web of Science,Embase,and Cochrane Library databases and performed a meta-analysis of randomized controlled trials up to July 2021.We considered overall survival as the primary outcome,and progression-free survival,objective response rate,and treatment-related adverse events as secondary outcomes.Results:Overall,3584 patients from five studies were evaluated.Compared with first-line chemotherapy,programmed cell death-1/ligand 1 inhibitors were significantly associated with worse progression-free survival(p<0.001)and adverse objective response rates(p<0.001).However,the treatments were not significantly different in terms of overall survival(p=0.33).Compared with second-line chemotherapy,programmed cell death-1/ligand 1 inhibitors significantly improved overall survival(p<0.001),and there was no statistically significant difference in progression-free survival(p=0.89)or objective response rate(p=0.34).Compared with chemotherapy,programmed cell death-1/ligand 1 inhibitors were well tolerated(first-line chemotherapy:p<0.001;second-line chemotherapy:p<0.001).Conclusions:The efficacy of programmed cell death-1/ligand 1 inhibitors in patients with advanced urothelial carcinoma is not superior to that of first-line platinum-based chemotherapy but is better than second-line chemotherapy;however,programmed cell death-1/ligand 1 inhibitors are safer than first-and second-line chemotherapy and have a broader prospect for use in combination therapy.
文摘To the Editor:Ankylosing spondylitis(AS)is a chronic inflammatory disease that causes bony fusion of spine and sacroiliac joints,resulting in restricted spinal movement and deformity.In China,the prevalence of AS is about 0.29%with a male to female ratio of approximately 3:1,and most cases occur in the adolescent period.[1]The misdiagnosis rate of AS patients in China is>50%.
基金supported by the National Natural Science Foundation of China,No.30960398,81260213the Forty-Seventh Batch of China Postdoctoral Science Foundation,No.20100470376
文摘Diffusion-tensor imaging can be used to observe the microstructure of brain tissue. Fractional ani- sotropy reflects the integrity of white matter fibers. Fractional anisotropy of a young adult brain is low in gray matter, high in white matter, and highest in the splenium of the corpus callosum. Thus, we selected the anterior and posterior limbs of the internal capsule, head of the caudate nucleus, semioval center, thalamus, and corpus callosum （splenium and genu） as regions of interest when using diffusion-tensor imaging to observe fractional anisotropy of major white matter fiber tracts and the deep gray matter of healthy rhesus monkeys aged 4-8 years. Results showed no laterality dif- ferences in fractional anisotropy values. Fractional anisotropy values were low in the head of cau- date nucleus and thalamus in gray matter. Fractional anisotropy values were highest in the sple- nium of corpus callosum in the white matter, followed by genu of the corpus callosum and the pos- terior limb of the internal capsule. Fractional anisotropy values were lowest in the semioval center and posterior limb of internal capsule. These results suggest that fractional anisotropy values in major white matter fibers and the deep gray matter of 4-8-year-old rhesus monkeys are similar to those of healthy young people.
