A Study of the Impact of the Digital Economy on the Efficiency of Urban Green Economy--Based on the Yangtze River Delta City Cluster

This paper adopts the non-expected output-super-efficiency SBM(Slacks-Based Model)model and principal component analysis to calculate the green economy efficiency and the digital economy level of 27 prefecture-level cities in China’s Yangtze River Delta urban agglomeration between 2011 and 2019,respectively,and examines the impact of the digital economy on the green economy efficiency by using benchmark regression and mechanism analysis.The findings show that,first,the digital economy has a significant contribution to the green economic efficiency of cities,and this conclusion still holds after robustness tests such as replacing explanatory and interpreted variables and introducing province-fixed effects.Second,through the mechanism test,it is found that the digital economy can indirectly promote urban green economic efficiency through the positive mechanism effect of promoting industrial structure upgrading.

Prevention and Control Strategies of Nosocomial Infection and Effectiveness Evaluation in a Tertiary Teaching Hospital during the Epidemic of COVID-19

Objective: To evaluate the role of prevention and control strategies for nosocomial infection in a tertiary teaching hospital during the sudden outbreak of Corona Virus Disease 2019 (COVID-19). Methods: The hospital initiated an emergency plan involving multi-departmental defense and control. It adopted a series of nosocomial infection prevention and control measures, including strengthening pre-examination and triage, optimizing the consultation process, improving the hospital’s architectural composition, implementing graded risk management, enhancing personal protection, and implementing staff training and supervision. Descriptive research was used to evaluate the short-term effects of these in-hospital prevention and control strategies. The analysis compared changes in related evaluation indicators between January 24, 2020 and February 12, 2020 (Chinese Lunar New Year’s Eve 2020 to lunar January 19) and the corresponding lunar period of the previous year. Results: Compared to the same period last year, the outpatient fever rate increased by 1.85-fold (P P Conclusion: The nosocomial infection prevention and control strategies implemented during this specific period improved the detection and control abilities for the COVID-19 source of infection and enhanced the compliance with measures. This likely contributed significantly to avoiding the occurrence of nosocomial infection.

Serum Tumor Markers Combined with 18F-FDG PET/CT Volumetric Metabolic Parameters in the Prognosis of Ovarian Cancer

Ovarian cancer (OC) is the most fatal gynecological malignancy, and identifying reliable prognostic indicators can help guide therapeutic treatment. Various tumor marker-guided treatment regimens can considerably improve patient prognosis with a better understanding of the molecular underpinnings of ovarian cancer recurrence and metastasis. Fluorine-18-fluorodeoxyglucose Positron emission tomography/computed tomography (18F-FDG PET/CT) is a molecular imaging tool that provides anatomical and functional information about the tumor, and its volume-based metabolic parameters allow for quantifiable observation of ovarian cancer recurrence, prognosis, and therapeutic efficacy. The combined utilization of serological and radiologic markers has been found to provide increased clinical benefit. This article reviewed the predictive value of serum tumor markers and 18F-FDG PET/CT volumetric metabolic parameters for the prognosis of patients with ovarian cancer.

Evaluation of novel decellularizing corneal stroma for cornea tissue engineering applications

AIM:To develop a new decellularization method depended upon the natural corneal structure and to harvest an ideal scaffold with good biocompatibilities for corneal reconstruction.METHODS:The acellular cornea matrix (ACM) were prepared from de-epithelium fresh porcine corneas (DFPCs) by incubation with 100% fresh human sera and additional electrophoresis at 4℃. Human corneal epithelial cells (HCEs) were used for the cytotoxicity tests of ACM. ACM were implanted into the Enhanced Green Fluorecence Protein (eGFP) transgenic mouse anterior chamber for evaluation of histocompatibility.RESULTS:HE and GSIB4 results showed fresh porcine cornea matrix with 100% human sera and electrophoresis could entirely decellularize stromal cell without reducing its transparency. ACM has no cytotoxic effect ex vivo. Animal test showed there was no rejection for one month after surgery.CONCLUSION:These results provide a decellularizing approach for the study of corneal tissue engineering and had the broader implications for the field of biological tissue engineering in other engineered organ or tissue matrix.

Sequential therapy according to distinct disease progression patterns in advanced ALK-positive non-small-cell lung cancer after crizotinib treatment

Objective: Crizotinib is recommended as the first-line therapy for advanced anaplastic lymphoma kinase(ALK)-positive non-small-cell lung cancer(NSCLC). Despite its initial efficacy, patients ultimately acquire resistance to crizotinib within 1 year. In such patients, the optimal sequential therapy after crizotinib treatment remains unknown. This study explored which sequential therapy option confers the greatest benefit.Methods: A total of 138 patients with advanced ALK-positive NSCLC resistant to crizotinib were studied. Based on patterns of disease progression of metastases, patients were divided into 3 groups: brain progression, non-liver progression, and liver progression. Sequential therapies included crizotinib continuation plus local therapy, nextgeneration ALK inhibitors(ALKi's), and chemotherapy. The primary endpoint was overall survival(OS) from the time of crizotinib resistance to death or last follow-up.Results: The 138 patients included 64 cases with progression in brain, 57 cases in non-liver sites and 17 cases in liver. A significant difference in OS was observed among the distinct progression pattern(median OS, 25.4 months in brain, 15.8 months in non-liver, and 10.8 months in liver, respectively, P=0.020). The difference in OS among sequential therapies was statistically significant in the non-liver progression group(median OS, 27.6 months with next-generation ALKi's, 13.3 months with crizotinib continuation, and 10.8 months with chemotherapy,respectively, P=0.019). However, crizotinib continuation plus local therapy seems to provide non-inferior median OS compared with next-generation ALKi's for patients with brain progression(median OS, 28.9 months vs.32.8 months, P=0.204). And no significant differences in OS were found in patients with progression in liver(P=0.061).Conclusions: Crizotinib continuation together with local therapy might be a feasible strategy for patients with progression in brain beyond crizotinib resistance, as well as next-generation ALKi's. Next-generation ALKi's tended to provide a survival benefit in patients with non-liver progression.

Constructing 3D interweaved MXene/graphitic carbon nitride nanosheets/graphene nanoarchitectures for promoted electrocatalytic hydrogen evolution

The technique of electrocatalytic hydrogen evolution reaction (HER) represents a development trend of clean energy generation and conversion,while the electrode catalysts are bound to be the core unit in the electrochemical HER system.Herein,we demonstrate a bottom-up approach to the construction of three-dimensional (3D) interconnected ternary nanoarchitecture originated from Ti_(3)C_(2)T_(x)MXene,graphitic carbon nitride nanosheets and graphene (MX/CN/RGO) through a convenient co-assembly process.By virtue of the 3D porous frameworks with ultrathin walls,large specific surface areas,optimized electronic structures,high electric conductivity,the resulting MX/CN/RGO nanoarchitecture expresses an exceptional HER performance with a low onset potential of only 38 m V,a small Tafel slop of 76 m V dec^(-1) as well as long lifespan,all of which are more competitive than those of the bare Ti_(3)C_(2)T_(x),g-C_(3)N_(4),graphene as well as binary MX/RGO and CN/RGO electrocatalysts.Theoretical simulations further verify that the ternary MX/CN/RGO nanoarchitecture with ameliorative band structure is able to facilitate the electron transport and meanwhile offer multistage catalytically active sites,thereby guaranteeing rapid HER kinetics during the electrocatalytic process.

Research on Pressure Drop Performance of the Packing-Flotation Column

A packing-flotation column was proposed to optimize the flotation environment A research system was es- tablished using a 100 mm diameter cyclonic micro-bubble flotation column to study fluid properties. Dry-plate and wet- plate pressure drops were studied and the corresponding pressure drop equations developed. The results show that the dry-plate pressure drop of the packing cyclonic micro-bubble flotation column is 10–15 times less than that of the chemical tower, which is principally shown in its relatively small resistance coefficient, ξ ≈0.0207. The wet-plate pressure drop is 2–3 times higher than that of the chemical tower, which is largely caused by the separation materials and characteristics of the equipment. With flotation, the greater the pressure drop, the better the flotation environment.

创新驱动下的临床专科能力建设策略研究

目的进一步推进临床重点专科建设“百千万工程”,探索强化临床专科能力建设的有效举措。方法以某大型三级甲等医院为样本医院,采用智力激励法、专题小组讨论法、案例分析法,运用鱼骨图等质量工具展开研究。结果分析临床专科能力建设存在的问题与短板,从体系创新、模式创新、技术创新、管理创新4个方面,梳理临床专科能力建设举措并系统性评价建设成效。结论基于“4个创新”的有力实践,促进临床专科发展,带动诊疗能力和水平的提升,助力公立医院高质量发展。

A Phase Ⅱ Trial of Gefitinib as Maintenance Therapy after First-Line Chemotherapy for Advanced Non-Small Cell Lung Cancer in China

Objective： To investigate the efficacy and safety of gefitinib as maintenance therapy for advanced non-small cell lung cancer （NSCLC） patients who obtained disease control （DC） after first-line chemotherapy in Chinese population. Methods： Chinese patients with advanced NSCLC treated with standard chemotherapy and obtained DC were assigned to receive gefitinib as maintenance treatment. The primary end point was overall survival time （OS）, the second end point was disease control rate （DCR） and progression-free survival time （PFS）. DCR included complete response （CR） plus partial response （PR） and plus stable disease （SD）. The impact of epidermal growth factor receptor （EGFR） mutation status on the treatment as exploratory point was also evaluated by denaturing high-performance liquid chromatography （DHPLC）. Results： Among 75 enrolled patients, the overall response rate was 37% and the DCR （CR ＋ PR ＋SD） was 66%. The median PFS and OS were 17.13 months and 26.13 months respectively, with 1- and 2-year survival rates 89.3% and 34.7%. Patients harboring somatic EGFR mutations obtained a prolonged median PFS and OS compared with EGFR wide type （25.1 vs. 13.0 months, P=0.019 and 33.37 vs. 25.57 months, P=0.014, respectively）. In COX regression model, only EGFR mutation status was the independently factor influencing both PFS and OS （P=0.029 and 0.017, respectively）, however, rash status was the predictor in terms of PFS （P=0.027）. Conclusion： Gefitinib produced encouraging survival when delivered as maintenance therapy in Chinese patients obtaining DC after first-line chemotherapy, especially for patients carrying somatic EGFR mutations. EGFR mutation is an independently predictive factor of survival.

Self-heating Probe Instrument and Method for Measuring High Temperature Melting Volume Change Rate of Material

The castings defects are affected by the melting volume change rate of material. The change rate has an important effect on running safety of the high temperature thermal storage chamber, too. But the characteristics of existing measuring installations are complex structure, troublesome operation and low precision. In order to measure the melting volume change rate of material accurately and conveniently, a self-designed measuring instrument, self-heating probe instrument, and measuring method are described. Temperature in heating cavity is controlled by PID temperature controller; melting volume change rate υ and molten density are calculated based on the melt volume which is measured by the instrument. Positive and negative υ represent expansion and shrinkage of the sample volume after melting, respectively. Taking eutectic LiF＋CaF2 for example, its melting volume change rate and melting density at 1 123 K are -20.6% and 2 651 kg/m–3 measured by this instrument, which is only 0.71% smaller than literature value. Density and melting volume change rate of industry pure aluminum at 973 K and analysis pure NaCl at 1 123 K are detected by the instrument too. The measure results are agreed with report values. Measuring error sources are analyzed and several improving measures are proposed. In theory, the measuring errors of the change rate and molten density which are measured by the self-designed instrument is nearly 1/20-1/50 of that measured by the refitted mandril thermal expansion instrument. The self-designed instrument and method have the advantages of simple structure, being easy to operate, extensive applicability for material, relatively high accuracy, and most importantly, temperature and sample vapor pressure have little effect on the measurement accuracy. The presented instrument and method solve the problems of complicated structure and procedures, and large measuring errors for the samples with high vapor pressure by existing installations.

群智创新设计研究现状与进展

人工智能时代下,群智创新设计是将创新设计同下一代互联网、人工智能、大数据、区块链等新兴数字技术结合,来解决社会复杂设计问题的综合创新手段。从计算机科学、设计学和社会学的角度出发,通过文献调研的方式,探讨了不同创新阶段的代表性研究、社会创新范式的衍变和群体智慧的发展;分析了群智创新设计的研究现状,系统地提出群智创新设计的体系内容,包括本体—行为—价值三层次理论模型、群智创新主体、群智创新环节、关键技术及研究范围。最后,针对群智计算与群智创新设计的融合发展路径,提出群智创新设计未来的发展趋势。研究对推动人工智能时代下创新设计的发展具有重要意义。

Impact of cirrhosis-related complications on posttransplant survival in patients with acute-on-chronic liver failure

Background:Acute-on-chronic liver failure(ACLF)is a life-threatening syndrome defined as acute decompensation in patients with chronic liver disease.Liver transplantation(LT)is the most effective treatment.We aimed to assess the impact of cirrhosis-related complications pre-LT on the posttransplant prognosis of patients with ACLF.Methods:This was an observational cohort study conducted between January 2018 and December 2020.Clinical characteristics,cirrhosis-related complications at LT and patient survival post-LT were collected.All liver recipients with ACLF were followed for 1 year post-LT.Results:A total of 212 LT recipients with ACLF were enrolled,including 75(35.4%)patients with ACLF-1,64(30.2%)with ACLF-2,and 73(34.4%)with ACLF-3.The median waiting time for LT was 11(4-24)days.The most prevalent cirrhosis-related complication was ascites(78.8%),followed by hepatic encephalopathy(57.1%),bacterial infections(48.1%),hepatorenal syndrome(22.2%)and gastrointestinal bleeding(11.3%).Survival analyses showed that patients with complications at LT had a significantly lower survival probability at both 3 months and 1 year after LT than those without complications(all P<0.05).A simplified model was developed by assigning one point to each complication:transplantation for ACLF with cirrhosis-related complication(TACC)model.Risk stratification of TACC model identified 3 strata(≥4,=3,and≤2)with high,median and low risk of death after LT(P<0.001).Moreover,the TACC model showed a comparable ability for predicting the outcome post-LT to the other four prognostic models(chronic liver failure-consortium ACLF score,Chinese Group on the Study of Severe Hepatitis B-ACLF score,model for end-stage liver disease score and Child-Turcotte-Pugh score).Conclusions:The presence of cirrhosis-related complications pre-LT increases the risk of death post-LT in patients with ACLF.The TACC model based on the number of cirrhosis-related complications pre-LT could stratify posttransplant survival,which might help to determine transplant timing for ACLF.

西部某大型综合医院学科建设SWOT分析及推进策略

加强学科建设是提升医院核心竞争力的重要抓手。通过系统梳理学科建设相关政策文件,基于SWOT分析法,从优势、劣势、挑战和机遇4个方面,对西部某大型三级甲等综合医院的学科建设展开剖析,总结近年来学科建设取得的成效,提出推动学科建设的重点举措与策略,为布局学科发展规划,擘画学科建设蓝图,实现学科跨越式发展提供参考。

PIK3CA mutation in Chinese patients with lung squamous cell carcinoma

Objective： To investigate PIK3CA mutation in Chinese patients with lung squamous cell carcinoma （LSCC） and explore their relationship with clinicopathological profiles. Methods： Tumor samples from 123 cases of LSCC were included in this study. PIK3CA mutations in exon 9 and 20 were screened by pyrosequencing and confirmed by clone sequencing or amplification refractory mutation system （ARMS）. Denaturing performance liquid chromatography （DHPLC） was employed for evaluation of EGFR mutation in exon 19, 21 and KRAS mutation. Results： PIK3CA mutations were found in 3 （2.4%） patients. The mutation type included E545K, E452Q and H1047R. Of these three patients, one coupled with EGFR mutation, and the other two coupled with PIK3CA amplification. All the three patients shared the same clinicopathologic characteristics： male, less than 60 years old, had smoke history, stage III and carried wild-type KRAS. Conclusions： The frequency of PIK3CA mutation is low in Chinese patients with LSCC. The mutational status of PIK3CA is not mutually exclusive to EGFR mutation.

Evaluation of the Added Value of Probabilistic Nowcasting Ensemble Forecasts on Regional Ensemble Forecasts

Ensemble forecasting systems have become an important tool for estimating the uncertainties in initial conditions and model formulations and they are receiving increased attention from various applications.The Regional Ensemble Prediction System(REPS),which has operated at the Beijing Meteorological Service(BMS)since 2017,allows for probabilistic forecasts.However,it still suffers from systematic deficiencies during the first couple of forecast hours.This paper presents an integrated probabilistic nowcasting ensemble prediction system(NEPS)that is constructed by applying a mixed dynamicintegrated method.It essentially combines the uncertainty information(i.e.,ensemble variance)provided by the REPS with the nowcasting method provided by the rapid-refresh deterministic nowcasting prediction system(NPS)that has operated at the Beijing Meteorological Service(BMS)since 2019.The NEPS provides hourly updated analyses and probabilistic forecasts in the nowcasting and short range(0-6 h)with a spatial grid spacing of 500 m.It covers the three meteorological parameters:temperature,wind,and precipitation.The outcome of an evaluation experiment over the deterministic and probabilistic forecasts indicates that the NEPS outperforms the REPS and NPS in terms of surface weather variables.Analysis of two cases demonstrates the superior reliability of the NEPS and suggests that the NEPS gives more details about the spatial intensity and distribution of the meteorological parameters.

Mechanical Analysis and Performance Optimization for the Lunar Rover’s Vane-Telescopic Walking Wheel

It is well-known that optimizing the wheel system of lunar rovers is essential.However,this is a difficult task due to the complex terrain of the moon and limited resources onboard lunar rovers.In this study,an experimental prototype was set up to analyze the existing mechanical design of a lunar rover and improve its performance.First,a new vane-telescopic walking wheel was proposed for the lunar rover with a positive and negative quadrangle suspension,considering the complex terrain of the moon.Next,the performance was optimized under the limitations of preserving the slope passage and minimizing power consumption.This was achieved via analysis of the wheel force during movement.Finally,the effectiveness of the proposed method was demonstrated by several simulation experiments.The newly designed wheel can protrude on demand and reduce energy consumption;it can be used as a reference for lunar rover development engineering in China.

Immediate Versus Delayed Treatment with EGFR Tyrosine Kinase Inhibitors after First-line Therapy in Advanced Non-small-cell Lung Cancer

Objective： To analyze the outcomes of patients who received TKI immediately after the first-line without progression as maintenance treatment （immediate group） vs. those received delayed treatment upon disease progression as second-line therapy （delayed group）. Methods： The study included 159 no-small-cell lung cancer （NSCLC） patients who received gefitinib or erlotinib as maintenance treatment in the immediate group （85 patients） or as second-line therapy in the delayed group （74 patients）. The primary end point was progression-free survival （PFS）. EGFR mutation status was detected using denaturing high-performance liquid chromatography （DHPLC）. Results： PFS was 17.3 and 16.4 months in the immediate and delayed groups, respectively （hazard ratio [HR], 0.99; 95% Confidence Interval [CI]： 0.69-1.42; P=0.947）. In a subgroup analysis that included only patients with EGFR mutation, however, PFS was significantly longer in the immediate group than in the delayed group （HR, 0.48; 95% CI： 0.27-0.85; P=0.012）. In patients with wild type EGFR, the risk for disease progression was comparable between the two groups （HR, 1.23; 95% CI： 0.61-2.51; P=0.564）. No significant difference was demonstrated between the immediate and delayed group in terms of the overall survival （OS） （26.1 months vs. 21.6 months, respectively; HR=0.53; 95% CI： 0.27 to 1.06; P=0.072）. There was also no difference in the incidence of adverse events between the two groups. Conclusions： EGFR TKI maintenance improves PFS in patients with EGFR mutation. Prospectively designed clinical studies that compare TKI immediate vs. delayed treatment after first-line chemotherapy upon disease progression are needed.

碳中和相关问题研究综述与展望

剖析碳中和的具体含义以及与之相关且容易被混淆的概念,归纳达成碳中和的技术路径,从理论层面梳理碳中和的经济和就业影响。研究指出,能源转型、碳税、碳抵消、碳技术是实现碳中和的重要路径;实现碳中和目标取决于碳捕获和封存等技术的研发与应用,自愿碳抵消只是一种辅助性工具;实现碳中和对经济发展和就业的影响是复杂的,需要综合考虑能源转型、环境规制、技术创新等多种因素。基于此,探讨目前碳中和问题存在的争议并指出了未来的研究方向。

真菌病毒Beauveria bassiana chrysovirus 2(BbCV2)外壳蛋白多克隆抗体制备及应用

球孢白僵菌Beauveriabassiana是一种在害虫生物防治中应用广泛的虫生真菌,真菌病毒能够影响球孢白僵菌的致病力和生物学性状,但真菌病毒相关蛋白的抗体制备和利用其进行病毒检测和定位鲜有报道。本研究原核表达了一株普遍流行并且造成寄主球孢白僵菌毒力下降的双链RNA(double stranded RNA,dsRNA)病毒Beauveria bassiana chrysovirus 2(Bb CV2)的外壳蛋白(Coat protein,CP),并制备了多克隆抗体,进行了病毒在寄主球孢白僵菌胞内和胞外的检测,以及利用间接免疫荧光进行病毒在寄主内的定位。结果表明,表达的BbCV2-CP蛋白主要以包涵体的形式存在,相对分子质量约为85.7kD;经间接ELISA方法测定,制备的BbCV2-CP兔源多抗效价达到1:8192000;Westernblot结果显示,制备的BbCV2兔源多抗能与抗原蛋白进行特异性结合,且能检测出感染寄主球孢白僵菌的BbCV2;ELISA测定结果表明病毒BbCV2可在寄主真菌体内复制,并能够游离到寄主体外;经间接免疫荧光观察,发现BbCV2病毒定位于真菌细胞核中。本研究建立了球孢白僵菌真菌病毒的血清学检测体系,为球孢白僵菌-真菌病毒互作机制研究提供材料。

东北大黑鳃金龟幼虫高毒力球孢白僵菌菌株的筛选及应用

为了筛选到针对靶标害虫东北大黑鳃金龟幼虫高毒力球孢白僵菌菌株,通过室内生物测定,明确球孢白僵菌Bb QCGZL-1对东北大黑鳃金龟幼虫的致病力,并与其他药剂进行防效对比;同时通过盆栽试验测定了球孢白僵菌BbQCGZL-1在不同农作物上对东北大黑鳃金龟幼虫的防治效果。球孢白僵菌BbQCGZL-1在施药14d时校正死亡率达到75%以上,高于其他供试菌株;施药7d时LC50为1.21×10^(7)cfu/mL,当菌悬液浓度为1.0×10^(8)cfu/mL时,LT_(50)为8.82 d;室内生测试验和室外盆栽试验结果表明,在东北地区利用球孢白僵菌防治东北大黑鳃金龟幼虫时,球孢白僵菌Bb QCGZL-1与商品化的微生物源药剂在防治效果上无显著差异。球孢白僵菌BbQCGZL-1可作为防治东北大黑鳃金龟幼虫的有效微生物源药剂。