Abiotic stresses and soil nutrient limitations are major environmental conditions that reduce plant growth,productivity and quality.Plants have evolved mechanisms to perceive these environmental challenges,transmit th...Abiotic stresses and soil nutrient limitations are major environmental conditions that reduce plant growth,productivity and quality.Plants have evolved mechanisms to perceive these environmental challenges,transmit the stress signals within cells as well as between cells and tissues,and make appropriate adjustments in their growth and development in order to survive and reproduce.In recent years,significant progress has been made on many fronts of the stress signaling research,particularly in understanding the downstream signaling events that culminate at the activation of stress-and nutrient limitation-responsive genes,cellular ion homeostasis,and growth adjustment.However,the revelation of the early events of stress signaling,particularly the identification of primary stress sensors,still lags behind.In this review,we summarize recent work on the genetic and molecular mechanisms of plant abiotic stress and nutrient limitation sensing and signaling and discuss new directions for future studies.展开更多
Human pluripotent stem cells represent a potentially unlimited source of functional pancreatic endocrine lineage cells. Here we report a highly efficient approach to induce human embryonic stem （ES） cells and induce...Human pluripotent stem cells represent a potentially unlimited source of functional pancreatic endocrine lineage cells. Here we report a highly efficient approach to induce human embryonic stem （ES） cells and induced pluripo- tent stem （iPS） cells to differentiate into mature insulin-producing cells in a chemical-defined culture system. The differentiated human ES cells obtained by this approach comprised nearly 25% insulin-positive cells as assayed by flow cytometry analysis, which released insulin/C-peptide in response to glucose stimuli in a manner comparable to that of adult human islets. Most of these insulin-producing cells co-expressed mature β cell-specific markers such as NKX6-1 and PDX1, indicating a similar gene expression pattern to adult islet β cells in vivo. In this study, we also demonstrated that EGF facilitates the expansion of PDXl-positive pancreatic progenitors. Moreover, our protocol also succeeded in efficiently inducing human iPS cells to differentiate into insuIin-producing ceils. Therefore, this work not only provides a new model to study the mechanism of human pancreatic specialization and maturation in vitro, but also enhances the possibility of utilizing patient-specific iPS cells for the treatment of diabetes.展开更多
Although nitrogen （N） loss through runoff and leaching from croplands is suspected to contribute to the deterioration of surrounding water systems, there is no conclusive evidence for paddy soils to prove this hypot...Although nitrogen （N） loss through runoff and leaching from croplands is suspected to contribute to the deterioration of surrounding water systems, there is no conclusive evidence for paddy soils to prove this hypothesis. In this study, field plot experiments were conducted to investigate N losses through runoff and leaching for two consecutive years with 3 N fertilization rates in rice （Oryza sativa L.）-wheat （Triticum aestivum L.） rotations in the Taihu Lake region, China. A water collection system was designed to collect runoff and leachates for both the rice and wheat seasons. Results showed that dissolved N （DN）, rather than particulate N （PN）, was the main form of N loss by runoff. The NO3^--N concentration in runoff was between 0.1 and 43.7 mg L^-1, whereas the NH4^＋-N concentration ranged from below detection limit to 8.5 mg L^-1. Total N （TN） loads by runoff were 1.0-17.9 and 5.2-38.6 kg ha^-1 during rice and wheat seasons, respectively, and the main loss occurred at the early growing stage of the crops. Nitrogen concentrations in leachates during the rice seasons were below 1.0 mg L^-1 and independent of the N application rate, whereas those during the wheat season increased to 8.2 mg L^-1 and were affected by the fertilizer rate. Annual losses of TN through runoff and leaching were 13.7-48.1 kg ha^-1 from the rice-wheat cropping system, accounting for 5.6%-8.3% of the total applied N. It was concluded that reduction in the N fertilization rate, especially when the crop was small in biomass, could lower the N pollution potential for water systems.展开更多
The incidence of prostate cancer(PCa)within Asian population used to be much lower than in the Western population;however,in recent years the incidence and mortality rate of PCa in some Asian countries have grown rapi...The incidence of prostate cancer(PCa)within Asian population used to be much lower than in the Western population;however,in recent years the incidence and mortality rate of PCa in some Asian countries have grown rapidly.This collaborative report summarized the latest epidemiology information,risk factors,and racial differences in PCa diagnosis,current status and new trends in surgery management and novel agents for castration-resistant prostate cancer.We believe such information would be helpful in clinical decision making for urologists and oncologists,health-care ministries and medical researchers.展开更多
Background：Old pelvis fractures are among the most challenging fractures to treat because of their complex anatomy,difficult-to-access surgical sites,and the relatively low incidence of such cases.Proper evaluation a...Background：Old pelvis fractures are among the most challenging fractures to treat because of their complex anatomy,difficult-to-access surgical sites,and the relatively low incidence of such cases.Proper evaluation and surgical planning are necessary to achieve the pelvic ring symmetry and stable fixation of the fracture.The goal of this study was to assess the use of three-dimensional （3D） printing techniques for surgical management of old pelvic fractures.Methods：First,16 dried human cadaveric pelvises were used to confirm the anatomical accuracy of the 3D models printed based on radiographic data.Next,nine clinical cases between January 2009 and April 2013 were used to evaluate the surgical reconstruction based on the 3D printed models.The pelvic injuries were all type C,and the average time from injury to reconstruction was 11 weeks （range：8-17 weeks）.The workflow consisted of.：（1） Printing patient-specific bone models based on preoperative computed tomography （CT） scans,（2） virtual fracture reduction using the printed 3D anatomic template,（3） virtual fracture fixation using Kirschner wires,and （4） preoperatively measuring the osteotomy and implant position relative to landmarks using the virtually defined deformation.These models aided communication between surgical team members during the procedure.This technique was validated by comparing the preoperative planning to the intraoperative procedure.Results：The accuracy of the 3D printed models was within specification.Production of a model from standard CT DICOM data took 7 hours （range：6-9 hours）.Preoperative planning using the 3D printed models was feasible in all cases.Good correlation was found between the preoperative planning and postoperative follow-up X-ray in all nine cases.The patients were followed for 3-29 months （median：5 months）.The fracture healing time was 9-17 weeks （mean：l0 weeks）.No delayed incision healing,wound infection,or nonunions occurred.The results were excellent in two cases,g展开更多
Functional magnetic resonance imaging has been widely used to investigate the effects of acupuncture on neural activity. However, most functional magnetic resonance imaging studies have focused on acute changes in bra...Functional magnetic resonance imaging has been widely used to investigate the effects of acupuncture on neural activity. However, most functional magnetic resonance imaging studies have focused on acute changes in brain activation induced by acupuncture. Thus, the time course of the therapeutic effects of acupuncture remains unclear. In this study, 32 patients with amnestic mild cognitive impairment were randomly divided into two groups, where they received either Tiaoshen Yizhi acupuncture or sham acupoint acupuncture. The needles were either twirled at Tiaoshen Yizhi acupoints, including Sishencong（EX-HN1）, Yintang（EX-HN3）, Neiguan（PC6）, Taixi（KI3）, Fenglong（ST40）, and Taichong（LR3）, or at related sham acupoints at a depth of approximately 15 mm, an angle of ± 60°, and a rate of approximately 120 times per minute. Acupuncture was conducted for 4 consecutive weeks, five times per week, on weekdays. Resting-state functional magnetic resonance imaging indicated that connections between cognition-related regions such as the insula, dorsolateral prefrontal cortex, hippocampus, thalamus, inferior parietal lobule, and anterior cingulate cortex increased after acupuncture at Tiaoshen Yizhi acupoints. The insula, dorsolateral prefrontal cortex, and hippocampus acted as central brain hubs. Patients in the Tiaoshen Yizhi group exhibited improved cognitive performance after acupuncture. In the sham acupoint acupuncture group, connections between brain regions were dispersed, and we found no differences in cognitive function following the treatment. These results indicate that acupuncture at Tiaoshen Yizhi acupoints can regulate brain networks by increasing connectivity between cognition-related regions, thereby improving cognitive function in patients with mild cognitive impairment.展开更多
青少年早期专项化训练(Early sport specialization,ESS)是关乎青少年竞技运动训练科学化的重要问题,也是国内外体育科学领域持续关注的热点问题。通过文献资料法,明晰青少年早期专项化的概念,梳理早期专项化的基本内涵,归纳青少年早期...青少年早期专项化训练(Early sport specialization,ESS)是关乎青少年竞技运动训练科学化的重要问题,也是国内外体育科学领域持续关注的热点问题。通过文献资料法,明晰青少年早期专项化的概念,梳理早期专项化的基本内涵,归纳青少年早期专项化训练的国际经验及可能导致的负面影响,提出青少年专项化训练科学化的应对之策。基于此,拟定如下学者共识:第一、青少年早期专项化训练是指在青春期之前围绕一个特定运动项目进行的高强度的训练;第二、尽管诸如体操、跳水等运动项目要求很早(6~9岁)进行专项化训练,但绝不能忽视早期专项化训练极易对动作技能学习、运动技能学习、体能训练科学化、长期职业生涯发展及身体健康等造成的不良影响;第三、对于大多数运动项目来说,青少年相对较晚的进行专项化训练、或早期进行多样化训练且在晚期进行高水平专项化训练,成年后在竞技体育领域获得成功的概率更高;第四、技术主导类项目可以在正确动作模式基础上开展早期专项化训练,训练过程中应高度关注动作质量,避免出现动作模式异常诱发运动损伤;第五、青少年专项训练科学化的根本在于建立集体能、技术、战术、心理、运动智商及人文素养于一体的训练体系;第六、青少年专项训练科学化的关键在于依据生理年龄和身体机能发育特征,强化青少年各个时期体能训练科学化;第七、青少年早期专项化训练的综合应对策略为:选择合适的早期专项化训练时机、构建青少年长期发展模型、强化青少年多样化训练、训练与监控充分结合,以及建立与年龄相适应的赛事体系;第八、倡导以健康和快乐作为青少年参与体育运动的价值导向,以培养终身体育素养作为青少年参与体育运动的根本目标。展开更多
AIM： To compare the volumetric-modulated arc ther- apy （VMAT） plans with conventional sliding window intensity-modulated radiotherapy （c-IMRT） plans in esophageal cancer （EC）. METHODS： Twenty patients with EC ...AIM： To compare the volumetric-modulated arc ther- apy （VMAT） plans with conventional sliding window intensity-modulated radiotherapy （c-IMRT） plans in esophageal cancer （EC）. METHODS： Twenty patients with EC were selected, including 5 cases located in the cervical, the upper, the middle and the lower thorax, respectively. Five plans were generated with the eclipse planning sys- tem： three using c-IMRT with 5 fields （5F）, 7 fields （7F） and 9 fields （gF）, and two using VMAT with a single arc （1A） and double arcs （2A）. The treatment plans were designed to deliver a dose of 60 Gy to the plan-ning target volume （PTV） with the same constrains in a 2.0 Gy daily fraction, 5 d a week. Plans were normal- ized to 95% of the PTV that received 100% of the pre- scribed dose. We examined the dose-volume histogram parameters of PTV and the organs at risk （OAR） such as lungs, spinal cord and heart. Monitor units （MU） and normal tissue complication probability （NTCP） of OAR were also reported. RESULTS： Both c-IMRT and VMAT plans resulted in abundant dose coverage of PTV for EC of different Io- cations. The dose conformity to PTV was improved as the number of field in c-IMRT or rotating arc in VMAT was increased. The doses to PTV and OAR in VMAT plans were not statistically different in comparison with c-IMRT plans, with the following exceptions： in cervical and upper thoracic EC, the conformity index （CI） was higher in VMAT （1A 0.78 and 2A 0.8） than in c-IMRT （5F 0.62, 7F 0.66 and 9F 0.73） and homogeneity was slightly better in c-IMRT （7F 1.09 and 9F 1.07） than in VMAT （1A 1,1 and 2A 1.09）, Lung V30 was lower in VMAT （1A 12.52 and 2A 12.29） than in c-IMRT （7F 14.35 and 9F 14.81）. The humeral head doses were significantly increased in VMAT as against c-IMRT. In the middle and lower thoracic EC, CI in VMAT （1A 0.76 and 2A 0.74） was higher than in c-IMRT （5F 0.63 Gy and 7F 0.67 Gy）, and homogeneity was almost similar between VMAT and c-IMRT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
文摘Abiotic stresses and soil nutrient limitations are major environmental conditions that reduce plant growth,productivity and quality.Plants have evolved mechanisms to perceive these environmental challenges,transmit the stress signals within cells as well as between cells and tissues,and make appropriate adjustments in their growth and development in order to survive and reproduce.In recent years,significant progress has been made on many fronts of the stress signaling research,particularly in understanding the downstream signaling events that culminate at the activation of stress-and nutrient limitation-responsive genes,cellular ion homeostasis,and growth adjustment.However,the revelation of the early events of stress signaling,particularly the identification of primary stress sensors,still lags behind.In this review,we summarize recent work on the genetic and molecular mechanisms of plant abiotic stress and nutrient limitation sensing and signaling and discuss new directions for future studies.
文摘Human pluripotent stem cells represent a potentially unlimited source of functional pancreatic endocrine lineage cells. Here we report a highly efficient approach to induce human embryonic stem （ES） cells and induced pluripo- tent stem （iPS） cells to differentiate into mature insulin-producing cells in a chemical-defined culture system. The differentiated human ES cells obtained by this approach comprised nearly 25% insulin-positive cells as assayed by flow cytometry analysis, which released insulin/C-peptide in response to glucose stimuli in a manner comparable to that of adult human islets. Most of these insulin-producing cells co-expressed mature β cell-specific markers such as NKX6-1 and PDX1, indicating a similar gene expression pattern to adult islet β cells in vivo. In this study, we also demonstrated that EGF facilitates the expansion of PDXl-positive pancreatic progenitors. Moreover, our protocol also succeeded in efficiently inducing human iPS cells to differentiate into insuIin-producing ceils. Therefore, this work not only provides a new model to study the mechanism of human pancreatic specialization and maturation in vitro, but also enhances the possibility of utilizing patient-specific iPS cells for the treatment of diabetes.
基金the National Natural Science Foundation of China (Nos.40571077 and 30390080)and the Knowledge Innovation Project of the Chinese Academy of Sciences (No.KZCX2-413).
文摘Although nitrogen （N） loss through runoff and leaching from croplands is suspected to contribute to the deterioration of surrounding water systems, there is no conclusive evidence for paddy soils to prove this hypothesis. In this study, field plot experiments were conducted to investigate N losses through runoff and leaching for two consecutive years with 3 N fertilization rates in rice （Oryza sativa L.）-wheat （Triticum aestivum L.） rotations in the Taihu Lake region, China. A water collection system was designed to collect runoff and leachates for both the rice and wheat seasons. Results showed that dissolved N （DN）, rather than particulate N （PN）, was the main form of N loss by runoff. The NO3^--N concentration in runoff was between 0.1 and 43.7 mg L^-1, whereas the NH4^＋-N concentration ranged from below detection limit to 8.5 mg L^-1. Total N （TN） loads by runoff were 1.0-17.9 and 5.2-38.6 kg ha^-1 during rice and wheat seasons, respectively, and the main loss occurred at the early growing stage of the crops. Nitrogen concentrations in leachates during the rice seasons were below 1.0 mg L^-1 and independent of the N application rate, whereas those during the wheat season increased to 8.2 mg L^-1 and were affected by the fertilizer rate. Annual losses of TN through runoff and leaching were 13.7-48.1 kg ha^-1 from the rice-wheat cropping system, accounting for 5.6%-8.3% of the total applied N. It was concluded that reduction in the N fertilization rate, especially when the crop was small in biomass, could lower the N pollution potential for water systems.
文摘目的比较超声引导下腹横筋膜平面(TFP)阻滞与腹横肌平面(TAP)阻滞在剖宫产术后镇痛中的效果。方法择期蛛网膜下腔阻滞下行剖宫产术产妇60例,年龄20~35岁,体重50~75 kg,ASAⅠ或Ⅱ级,采用随机数字表法分为两组:腹横筋膜平面阻滞组(TFP组)和腹横肌平面阻滞组(TAP组),每组29例。术毕TFP组行超声引导下双侧腹横筋膜平面阻滞,TAP组行超声引导下双侧腹横肌平面阻滞,两组均每侧注射0.375%罗哌卡因1.25 mg/kg。术后均行曲马多PCIA,若VAS疼痛评分≥4分,肌肉注射曲马多100 mg行补救镇痛。记录术后6、12、24、36、48 h PCIA中曲马多累积用量;记录术后48 h内曲马多补救镇痛情况;记录镇痛期间恶心呕吐、局麻药中毒、呼吸抑制、穿刺部位血肿、穿刺部位感染、腹膜刺穿造成腹腔内注射等不良反应的发生情况。结果与TAP组比较,TFP组术后6、12、24、36、48 h PCIA中曲马多累积用量明显减少(P<0.05),术后48 h内曲马多补救镇痛率明显降低(P<0.05)。两组镇痛期间恶心呕吐发生率差异统计学意义。两组均无其他不良反应发生。结论与超声引导下腹横肌平面阻滞比较,腹横筋膜平面阻滞可减少剖宫产术后阿片类药物用量,镇痛效果更佳。
基金supported by the Program for Changjiang Scholars and Innovative Research Team in University scheme of the Ministry of Education of China(NO.IRT1111)the National Basic Research Program of China(2012CB518300)+2 种基金the National Natural Science Foundation of China(81101946)the Shanghai Pujiang Program(12PJD008)Prostate Cancer Foundation Young Investigator Award,Shanghai Municipal Health and Family Planning Commission Outstanding Young Investigator(XYQ2013077).
文摘The incidence of prostate cancer(PCa)within Asian population used to be much lower than in the Western population;however,in recent years the incidence and mortality rate of PCa in some Asian countries have grown rapidly.This collaborative report summarized the latest epidemiology information,risk factors,and racial differences in PCa diagnosis,current status and new trends in surgery management and novel agents for castration-resistant prostate cancer.We believe such information would be helpful in clinical decision making for urologists and oncologists,health-care ministries and medical researchers.
基金This study was supported by grants from the National Natural Science Foundation of China，the Beijing Municipal Committee of Science and Technology
文摘Background：Old pelvis fractures are among the most challenging fractures to treat because of their complex anatomy,difficult-to-access surgical sites,and the relatively low incidence of such cases.Proper evaluation and surgical planning are necessary to achieve the pelvic ring symmetry and stable fixation of the fracture.The goal of this study was to assess the use of three-dimensional （3D） printing techniques for surgical management of old pelvic fractures.Methods：First,16 dried human cadaveric pelvises were used to confirm the anatomical accuracy of the 3D models printed based on radiographic data.Next,nine clinical cases between January 2009 and April 2013 were used to evaluate the surgical reconstruction based on the 3D printed models.The pelvic injuries were all type C,and the average time from injury to reconstruction was 11 weeks （range：8-17 weeks）.The workflow consisted of.：（1） Printing patient-specific bone models based on preoperative computed tomography （CT） scans,（2） virtual fracture reduction using the printed 3D anatomic template,（3） virtual fracture fixation using Kirschner wires,and （4） preoperatively measuring the osteotomy and implant position relative to landmarks using the virtually defined deformation.These models aided communication between surgical team members during the procedure.This technique was validated by comparing the preoperative planning to the intraoperative procedure.Results：The accuracy of the 3D printed models was within specification.Production of a model from standard CT DICOM data took 7 hours （range：6-9 hours）.Preoperative planning using the 3D printed models was feasible in all cases.Good correlation was found between the preoperative planning and postoperative follow-up X-ray in all nine cases.The patients were followed for 3-29 months （median：5 months）.The fracture healing time was 9-17 weeks （mean：l0 weeks）.No delayed incision healing,wound infection,or nonunions occurred.The results were excellent in two cases,g
基金supported by the National Natural Science Foundation of China,No.81173354a grant from the Science and Technology Plan Project of Guangdong Province of China,No.2013B021800099a grant from the Science and Technology Plan Project of Shenzhen City of China,No.JCYJ20150402152005642
文摘Functional magnetic resonance imaging has been widely used to investigate the effects of acupuncture on neural activity. However, most functional magnetic resonance imaging studies have focused on acute changes in brain activation induced by acupuncture. Thus, the time course of the therapeutic effects of acupuncture remains unclear. In this study, 32 patients with amnestic mild cognitive impairment were randomly divided into two groups, where they received either Tiaoshen Yizhi acupuncture or sham acupoint acupuncture. The needles were either twirled at Tiaoshen Yizhi acupoints, including Sishencong（EX-HN1）, Yintang（EX-HN3）, Neiguan（PC6）, Taixi（KI3）, Fenglong（ST40）, and Taichong（LR3）, or at related sham acupoints at a depth of approximately 15 mm, an angle of ± 60°, and a rate of approximately 120 times per minute. Acupuncture was conducted for 4 consecutive weeks, five times per week, on weekdays. Resting-state functional magnetic resonance imaging indicated that connections between cognition-related regions such as the insula, dorsolateral prefrontal cortex, hippocampus, thalamus, inferior parietal lobule, and anterior cingulate cortex increased after acupuncture at Tiaoshen Yizhi acupoints. The insula, dorsolateral prefrontal cortex, and hippocampus acted as central brain hubs. Patients in the Tiaoshen Yizhi group exhibited improved cognitive performance after acupuncture. In the sham acupoint acupuncture group, connections between brain regions were dispersed, and we found no differences in cognitive function following the treatment. These results indicate that acupuncture at Tiaoshen Yizhi acupoints can regulate brain networks by increasing connectivity between cognition-related regions, thereby improving cognitive function in patients with mild cognitive impairment.
文摘青少年早期专项化训练(Early sport specialization,ESS)是关乎青少年竞技运动训练科学化的重要问题,也是国内外体育科学领域持续关注的热点问题。通过文献资料法,明晰青少年早期专项化的概念,梳理早期专项化的基本内涵,归纳青少年早期专项化训练的国际经验及可能导致的负面影响,提出青少年专项化训练科学化的应对之策。基于此,拟定如下学者共识:第一、青少年早期专项化训练是指在青春期之前围绕一个特定运动项目进行的高强度的训练;第二、尽管诸如体操、跳水等运动项目要求很早(6~9岁)进行专项化训练,但绝不能忽视早期专项化训练极易对动作技能学习、运动技能学习、体能训练科学化、长期职业生涯发展及身体健康等造成的不良影响;第三、对于大多数运动项目来说,青少年相对较晚的进行专项化训练、或早期进行多样化训练且在晚期进行高水平专项化训练,成年后在竞技体育领域获得成功的概率更高;第四、技术主导类项目可以在正确动作模式基础上开展早期专项化训练,训练过程中应高度关注动作质量,避免出现动作模式异常诱发运动损伤;第五、青少年专项训练科学化的根本在于建立集体能、技术、战术、心理、运动智商及人文素养于一体的训练体系;第六、青少年专项训练科学化的关键在于依据生理年龄和身体机能发育特征,强化青少年各个时期体能训练科学化;第七、青少年早期专项化训练的综合应对策略为:选择合适的早期专项化训练时机、构建青少年长期发展模型、强化青少年多样化训练、训练与监控充分结合,以及建立与年龄相适应的赛事体系;第八、倡导以健康和快乐作为青少年参与体育运动的价值导向,以培养终身体育素养作为青少年参与体育运动的根本目标。
基金Supported by The National Natural Science Foundation of China, No. 30870738
文摘AIM： To compare the volumetric-modulated arc ther- apy （VMAT） plans with conventional sliding window intensity-modulated radiotherapy （c-IMRT） plans in esophageal cancer （EC）. METHODS： Twenty patients with EC were selected, including 5 cases located in the cervical, the upper, the middle and the lower thorax, respectively. Five plans were generated with the eclipse planning sys- tem： three using c-IMRT with 5 fields （5F）, 7 fields （7F） and 9 fields （gF）, and two using VMAT with a single arc （1A） and double arcs （2A）. The treatment plans were designed to deliver a dose of 60 Gy to the plan-ning target volume （PTV） with the same constrains in a 2.0 Gy daily fraction, 5 d a week. Plans were normal- ized to 95% of the PTV that received 100% of the pre- scribed dose. We examined the dose-volume histogram parameters of PTV and the organs at risk （OAR） such as lungs, spinal cord and heart. Monitor units （MU） and normal tissue complication probability （NTCP） of OAR were also reported. RESULTS： Both c-IMRT and VMAT plans resulted in abundant dose coverage of PTV for EC of different Io- cations. The dose conformity to PTV was improved as the number of field in c-IMRT or rotating arc in VMAT was increased. The doses to PTV and OAR in VMAT plans were not statistically different in comparison with c-IMRT plans, with the following exceptions： in cervical and upper thoracic EC, the conformity index （CI） was higher in VMAT （1A 0.78 and 2A 0.8） than in c-IMRT （5F 0.62, 7F 0.66 and 9F 0.73） and homogeneity was slightly better in c-IMRT （7F 1.09 and 9F 1.07） than in VMAT （1A 1,1 and 2A 1.09）, Lung V30 was lower in VMAT （1A 12.52 and 2A 12.29） than in c-IMRT （7F 14.35 and 9F 14.81）. The humeral head doses were significantly increased in VMAT as against c-IMRT. In the middle and lower thoracic EC, CI in VMAT （1A 0.76 and 2A 0.74） was higher than in c-IMRT （5F 0.63 Gy and 7F 0.67 Gy）, and homogeneity was almost similar between VMAT and c-IMRT
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.
