背景与目的肺部切除术后慢性咳嗽是最常见的并发症之一,严重影响患者术后生活质量,目前国内尚无关于肺部切除术后慢性咳嗽预测模型。因此,本研究旨在探讨肺部切除术后慢性咳嗽相关危险因素,构建预测模型并进行验证。方法回顾性分析2021...背景与目的肺部切除术后慢性咳嗽是最常见的并发症之一,严重影响患者术后生活质量,目前国内尚无关于肺部切除术后慢性咳嗽预测模型。因此,本研究旨在探讨肺部切除术后慢性咳嗽相关危险因素,构建预测模型并进行验证。方法回顾性分析2021年1月至2023年6月于中国科学技术大学附属第一医院接受肺部切除术的499例患者的临床资料和术后咳嗽情况,按7:3随机分配原则分为训练集(n=348)和验证集(n=151),根据训练集患者术后是否慢性咳嗽分为咳嗽组和非咳嗽组。使用中文版莱斯特咳嗽问卷(The Mandarin-Chinese version of Leicester cough questionnare,LCQ-MC)评估术前、术后咳嗽的严重程度及其对患者生活质量的影响,采用咳嗽视觉模拟量表(visual analog scale,VAS)和自拟的数字评分法(numerical rating scale,NRS)评估术后慢性咳嗽,采用单因素和多因素Logistic回归分析独立危险因素和模型构建,受试者工作特征(receiver operator characteristic,ROC)曲线评估模型区分度,校准曲线评估模型的一致性,绘制决策曲线分析(decision curve analysis,DCA)评估模型的临床应用价值。结果多因素Logistic分析筛选出术前用力呼气第1秒呼气量与用力肺活量比(forced expiratory volume in the first second/forced vital capacity,FEV_(1)/FVC)、手术方式、行上纵隔淋巴结清扫、行隆突下淋巴结清扫、术后胸腔闭式引流时间是术后慢性咳嗽的独立危险因素,基于多因素分析结果构建列线图预测模型。ROC曲线下面积为0.954(95%CI:0.930-0.978),最大约登指数所对应的临界值为0.171,此时敏感度为94.7%,特异度为86.6%。Bootstrap法抽样1000次,校准曲线图预测的肺部切除术后慢性咳嗽与实际发生风险高度一致。DCA显示当预测模型概率的预概率为0.1-0.9之间,患者表现为正的净收益。结论肺部切除术后慢性咳嗽严重影响患者生活质量。列线图的可视化展现形式有助于准确预测肺部切除术后慢性咳嗽,为临床决策提供支持。展开更多
背景与目的咳嗽是肺部手术后的主要并发症之一,严重影响患者术后生活质量。保留迷走神经肺支可能降低患者术后咳嗽发生率。因此,本研究旨在探究保留迷走神经肺支是否能够降低I期肺腺癌患者术后慢性咳嗽发生率。方法前瞻性选取2022年6月...背景与目的咳嗽是肺部手术后的主要并发症之一,严重影响患者术后生活质量。保留迷走神经肺支可能降低患者术后咳嗽发生率。因此,本研究旨在探究保留迷走神经肺支是否能够降低I期肺腺癌患者术后慢性咳嗽发生率。方法前瞻性选取2022年6月至2023年6月于中国科学技术大学附属第一医院胸外科行单孔胸腔镜肺癌根治术患者125例,根据术中是否保留迷走神经肺支分为保留迷走神经肺支组(n=61)和传统组(n=64)。记录两组患者一般临床资料、围手术期情况、淋巴结清扫情况、术前及术后8周中文版莱斯特咳嗽问卷(Mandarin Chinese version of the Leicester Cough Questionnaire,LCQ-MC)评分。将两组患者根据术中淋巴结清扫后是否填塞自体脂肪或吸收性明胶海绵分为填塞组及非填塞组,比较两组亚组间LCQ-MC评分及术后慢性咳嗽情况。结果传统组术后8周LCQ-MC评分在生理、心理、社会及总分方面明显低于保留迷走神经肺支组,差异均有统计学意义(P<0.05);咳嗽患者较保留迷走神经肺支组更多(P=0.006)。保留迷走神经肺支组和传统组分别进行亚组分析,保留迷走神经肺支组患者和传统组患者中,非填塞组术后8周LCQ-MC评分均低于填塞组(P<0.05),非填塞组术后8周咳嗽患者均较填塞组更多(P=0.001,P=0.024)。结论对于I期周围型肺腺癌患者行手术治疗时,保留迷走神经肺支安全有效,能够降低患者术后慢性咳嗽发生率,提高患者术后生活质量。展开更多
Two new ICRF antennas operating in the ion cyclotron radio frequency(ICRF) range have been developed for EAST to overcome the low coupling problem of the original antennas.The original ICRF antennas were limited in th...Two new ICRF antennas operating in the ion cyclotron radio frequency(ICRF) range have been developed for EAST to overcome the low coupling problem of the original antennas.The original ICRF antennas were limited in their power capacity due to insufficient coupling.The new antenna design takes into account both wave coupling and absorption processes through comprehensive wave coupling and absorption codes,with the dominant parallel wave number k∥of 7.5 m-1at dipole phasing.Through the use of these new ICRF antennas,we are able to achieve 3.8 MW output power and 360 s operation,respectively.The initial experimental results demonstrate the reliability of the antenna design method.展开更多
背景与目的肺癌的死亡率居所有恶性肿瘤的第一位,但对于早期肺腺癌患者不同的肺段切除术之间手术效果及对肺功能的影响研究较少。本研究旨在评估术前规划联合荧光胸腔镜精准肺段切除术与传统肺段切除术两种手术方式对早期肺腺癌患者肺...背景与目的肺癌的死亡率居所有恶性肿瘤的第一位,但对于早期肺腺癌患者不同的肺段切除术之间手术效果及对肺功能的影响研究较少。本研究旨在评估术前规划联合荧光胸腔镜精准肺段切除术与传统肺段切除术两种手术方式对早期肺腺癌患者肺功能保留程度和近期结果比较。方法前瞻性选取2020年1月1日-2020年10月31日于中国科学技术大学附属第一医院胸外科行胸腔镜肺段切除术患者60例,精准组30例,传统组30例,比较两组患者临床病理特征、围手术期资料和术后肺功能情况。结果精准组在手术时间上较传统组更短,差异有统计学意义(P<0.05)。术前肺功能精准组与传统组的用力肺活量(forced vital capacity, FVC)、一秒用力呼气容积(forced expiratory volume in one second, FEV1)和一氧化碳弥散量(carbon monoxide diffusing capacity, DLCO)分别为:(3.65±0.63)L vs (3.54±0.64)L、(2.72±0.50)L vs (2.54±0.48)L及(20.36±3.02)m L/mm Hg/min vs (19.16±3.18)m L/mm Hg/min,差异均无统计学意义(P>0.05)。术后1个月肺功能精准组与传统组的FVC、FEV1和DLCO分别为:(3.35±0.63)L vs (2.89±0.57)L、(2.39±0.54)L vs (2.09±0.48)L及(17.43±3.10)m L/mm Hg/min vs (15.78±2.86)m L/mm Hg/min,差异均有统计学意义(P<0.05);术后3个月肺功能精准组与传统组的FVC和DLCO分别为:(3.47±0.63)Lvs(3.20±0.56)L、(19.38±3.02)m L/mm Hg/min vs(17.79±3.21)m L/mm Hg/min,差异均无统计学意义(P>0.05)。结论术前规划联合荧光胸腔镜精准肺段切除术在段间平面识别、解剖血管及术后恢复等方便提供了优势,明显缩短了手术时间,使治疗更为精准。展开更多
The blood and immune system of coronavirus disease 2019(COVID-19)infected patients are dysfunctional,and numerous studies have been conducted to resolve their characteristics and pathogenic mechanisms.Nevertheless,the...The blood and immune system of coronavirus disease 2019(COVID-19)infected patients are dysfunctional,and numerous studies have been conducted to resolve their characteristics and pathogenic mechanisms.Nevertheless,the variations of immune responses along with disease severity have not been comprehensively documented.Here,we profiled the single-cell transcriptomes of 96,313 peripheral blood mononuclear cells(PBMCs)derived from 12 COVID-19 patients(including four moderate,four severe and four critical cases)and three healthy donors.We showed that proliferative CD8 effector T cells with declined immune functions and cytotoxicity accumulated in the critical stage.By contrast,the quantity of natural killer(NK)cells was significantly reduced,while they exhibited enhanced immune activities.Notably,a gradually attenuated responseto COVID-19 along with disease severity was observed in monocytes,in terms of cellular composition,transcriptional discrepancy and transcription factor regulatory network.Furthermore,we identified immune cell-type dependent cytokine signatures distinguishing the severity of COVID-19 patients.In addition,cell interactions between CD8 effector T/NK cells and monocytes mediated by inflammatory cytokines were enhanced in moderate and severe stages,but weakened in critical cases.Collectively,our work uncovers the cellular and molecular players underlying the disordered and heterogeneous immune responses associated with COVID-19 severity,which could provide valuable insights for the treatment of critical COVID-19 patients.展开更多
Dear Editor,Coronavirus disease 2019(COVID-19)is a global-spread infectious disease caused by a novel coronavirus,SARS-CoV-2.1 COVID-19 causes heterogeneous disease phenotype,of which most patients exhibit mild to mod...Dear Editor,Coronavirus disease 2019(COVID-19)is a global-spread infectious disease caused by a novel coronavirus,SARS-CoV-2.1 COVID-19 causes heterogeneous disease phenotype,of which most patients exhibit mild to moderate symptoms,and~15%progress to severe pneumonia,5%of whom were eventually admitted to the intensive care unit(ICU)due to acute respiratory distress syndrome(ARDS),septic shock and/or multiple organ failure,and exhibit a high mortality rate.Two major obstacles to the improvement of the clinical outcomes in these patients are inadequate identification of the determinant cytokines correlated with fatal outcomes,and an inability to determine whether an individual patient has high risks of ICU admission and fatality.展开更多
The Lower Member of the Longrnaxi Forma-tion is generally dominated by siliceous shale,but recently we found some siltstone-mudstone rhythm sections developed in the Lower Member of the Longmaxi Formation.The study of...The Lower Member of the Longrnaxi Forma-tion is generally dominated by siliceous shale,but recently we found some siltstone-mudstone rhythm sections developed in the Lower Member of the Longmaxi Formation.The study of formation mechanism of siltstone-mudstone rhythmic sedimentary sections may provide new insights into the shale sedimentary environ-ment.Therefore,we studied the characteristics and formation mechanism of siltstone-mudstone rhythmic sedimentary sections in the Lower Member of the Long-maxi Formation in the Changning area based on core observation,thin section identification,major elements and trace elements analysis.The results show the following:1)Two siltstone-mudstone rhythmic sedimentary sections are characterized by frequent interbed between black or gray-black shale and light gray siltstone,abundant argillaceous laminas and silty laminas,with obvious lithological boundaries having developed.Horizontal laminas and rhythmic laminas are well-developed in the shale layer,while the wavy laminas are well-developed in the siltstone layer.2)The major compositional elements are SiO2,Al2O3 and CaO,followed by Fe_(2)O_(3),MgO,K_(2)O and Na_(2)O.3)Compared with the world average shale,these siltstone-mudstone rhythmic sedimentary sections are rich in Mo,U and Ba,but less in V,Co,Ni,Cu.Compared with the shale layer,the siltstone layer has lower contents of V,Co and Ni.4).The geochemical redox indices,Mo-U and CIA values suggest the formation of the siltstone-mudstone rhythmic sedimentary sections are related to influences from bottom currents in an oxic condition with a warm and humid paleoclimate.展开更多
Dear Editor,Coronavirus disease 2019(COVID-19)is a global-spread infectious disease caused by a novel coronavirus,SARS-CoV-2.1 COVID-19 causes heterogeneous disease phenotype,of which most patients exhibit mild to mod...Dear Editor,Coronavirus disease 2019(COVID-19)is a global-spread infectious disease caused by a novel coronavirus,SARS-CoV-2.1 COVID-19 causes heterogeneous disease phenotype,of which most patients exhibit mild to moderate symptoms,and~15%progress to severe pneumonia,5%of whom were eventually admitted to the intensive care unit(ICU)due to acute respiratory distress syndrome(ARDS),septic shock and/or multiple organ failure,and exhibit a high mortality rate.Two major obstacles to the improvement of the clinical outcomes in these patients are inadequate identification of the determinant cytokines correlated with fatal outcomes,and an inability to determine whether an individual patient has high risks of ICU admission and fatality.展开更多
文摘背景与目的肺部切除术后慢性咳嗽是最常见的并发症之一,严重影响患者术后生活质量,目前国内尚无关于肺部切除术后慢性咳嗽预测模型。因此,本研究旨在探讨肺部切除术后慢性咳嗽相关危险因素,构建预测模型并进行验证。方法回顾性分析2021年1月至2023年6月于中国科学技术大学附属第一医院接受肺部切除术的499例患者的临床资料和术后咳嗽情况,按7:3随机分配原则分为训练集(n=348)和验证集(n=151),根据训练集患者术后是否慢性咳嗽分为咳嗽组和非咳嗽组。使用中文版莱斯特咳嗽问卷(The Mandarin-Chinese version of Leicester cough questionnare,LCQ-MC)评估术前、术后咳嗽的严重程度及其对患者生活质量的影响,采用咳嗽视觉模拟量表(visual analog scale,VAS)和自拟的数字评分法(numerical rating scale,NRS)评估术后慢性咳嗽,采用单因素和多因素Logistic回归分析独立危险因素和模型构建,受试者工作特征(receiver operator characteristic,ROC)曲线评估模型区分度,校准曲线评估模型的一致性,绘制决策曲线分析(decision curve analysis,DCA)评估模型的临床应用价值。结果多因素Logistic分析筛选出术前用力呼气第1秒呼气量与用力肺活量比(forced expiratory volume in the first second/forced vital capacity,FEV_(1)/FVC)、手术方式、行上纵隔淋巴结清扫、行隆突下淋巴结清扫、术后胸腔闭式引流时间是术后慢性咳嗽的独立危险因素,基于多因素分析结果构建列线图预测模型。ROC曲线下面积为0.954(95%CI:0.930-0.978),最大约登指数所对应的临界值为0.171,此时敏感度为94.7%,特异度为86.6%。Bootstrap法抽样1000次,校准曲线图预测的肺部切除术后慢性咳嗽与实际发生风险高度一致。DCA显示当预测模型概率的预概率为0.1-0.9之间,患者表现为正的净收益。结论肺部切除术后慢性咳嗽严重影响患者生活质量。列线图的可视化展现形式有助于准确预测肺部切除术后慢性咳嗽,为临床决策提供支持。
文摘背景与目的咳嗽是肺部手术后的主要并发症之一,严重影响患者术后生活质量。保留迷走神经肺支可能降低患者术后咳嗽发生率。因此,本研究旨在探究保留迷走神经肺支是否能够降低I期肺腺癌患者术后慢性咳嗽发生率。方法前瞻性选取2022年6月至2023年6月于中国科学技术大学附属第一医院胸外科行单孔胸腔镜肺癌根治术患者125例,根据术中是否保留迷走神经肺支分为保留迷走神经肺支组(n=61)和传统组(n=64)。记录两组患者一般临床资料、围手术期情况、淋巴结清扫情况、术前及术后8周中文版莱斯特咳嗽问卷(Mandarin Chinese version of the Leicester Cough Questionnaire,LCQ-MC)评分。将两组患者根据术中淋巴结清扫后是否填塞自体脂肪或吸收性明胶海绵分为填塞组及非填塞组,比较两组亚组间LCQ-MC评分及术后慢性咳嗽情况。结果传统组术后8周LCQ-MC评分在生理、心理、社会及总分方面明显低于保留迷走神经肺支组,差异均有统计学意义(P<0.05);咳嗽患者较保留迷走神经肺支组更多(P=0.006)。保留迷走神经肺支组和传统组分别进行亚组分析,保留迷走神经肺支组患者和传统组患者中,非填塞组术后8周LCQ-MC评分均低于填塞组(P<0.05),非填塞组术后8周咳嗽患者均较填塞组更多(P=0.001,P=0.024)。结论对于I期周围型肺腺癌患者行手术治疗时,保留迷走神经肺支安全有效,能够降低患者术后慢性咳嗽发生率,提高患者术后生活质量。
基金supported by the National Key Research and Development Program of China (Nos. 2019YFE03070000and 2019YFE03070003)National Natural Science Foundation of China (Nos. 11975265 and 11775258)+2 种基金Comprehensive Research Facility for Fusion Technology Program of China (No. 2018-000052-73-01-001228)the Open Fund of Magnetic Confinement Fusion Laboratory of Anhui Province (No. 2021AMF01001)Hefei Science Center,CAS(No. 2021HSC-KPRD001)。
文摘Two new ICRF antennas operating in the ion cyclotron radio frequency(ICRF) range have been developed for EAST to overcome the low coupling problem of the original antennas.The original ICRF antennas were limited in their power capacity due to insufficient coupling.The new antenna design takes into account both wave coupling and absorption processes through comprehensive wave coupling and absorption codes,with the dominant parallel wave number k∥of 7.5 m-1at dipole phasing.Through the use of these new ICRF antennas,we are able to achieve 3.8 MW output power and 360 s operation,respectively.The initial experimental results demonstrate the reliability of the antenna design method.
文摘背景与目的肺癌的死亡率居所有恶性肿瘤的第一位,但对于早期肺腺癌患者不同的肺段切除术之间手术效果及对肺功能的影响研究较少。本研究旨在评估术前规划联合荧光胸腔镜精准肺段切除术与传统肺段切除术两种手术方式对早期肺腺癌患者肺功能保留程度和近期结果比较。方法前瞻性选取2020年1月1日-2020年10月31日于中国科学技术大学附属第一医院胸外科行胸腔镜肺段切除术患者60例,精准组30例,传统组30例,比较两组患者临床病理特征、围手术期资料和术后肺功能情况。结果精准组在手术时间上较传统组更短,差异有统计学意义(P<0.05)。术前肺功能精准组与传统组的用力肺活量(forced vital capacity, FVC)、一秒用力呼气容积(forced expiratory volume in one second, FEV1)和一氧化碳弥散量(carbon monoxide diffusing capacity, DLCO)分别为:(3.65±0.63)L vs (3.54±0.64)L、(2.72±0.50)L vs (2.54±0.48)L及(20.36±3.02)m L/mm Hg/min vs (19.16±3.18)m L/mm Hg/min,差异均无统计学意义(P>0.05)。术后1个月肺功能精准组与传统组的FVC、FEV1和DLCO分别为:(3.35±0.63)L vs (2.89±0.57)L、(2.39±0.54)L vs (2.09±0.48)L及(17.43±3.10)m L/mm Hg/min vs (15.78±2.86)m L/mm Hg/min,差异均有统计学意义(P<0.05);术后3个月肺功能精准组与传统组的FVC和DLCO分别为:(3.47±0.63)Lvs(3.20±0.56)L、(19.38±3.02)m L/mm Hg/min vs(17.79±3.21)m L/mm Hg/min,差异均无统计学意义(P>0.05)。结论术前规划联合荧光胸腔镜精准肺段切除术在段间平面识别、解剖血管及术后恢复等方便提供了优势,明显缩短了手术时间,使治疗更为精准。
基金supported by grants from Ministry of Science and Technology of China(2018YFA0107801,2016YFA0100600,2017YFA0103400)the National Natural Science Foundation of China(81421002,81730006,81890990,81870086,81670106,81922002)CAMS Initiative for Innovative Medicine(2017-I2M-1-015,2019-I2M-1-006,2017-I2M-3-009).
文摘The blood and immune system of coronavirus disease 2019(COVID-19)infected patients are dysfunctional,and numerous studies have been conducted to resolve their characteristics and pathogenic mechanisms.Nevertheless,the variations of immune responses along with disease severity have not been comprehensively documented.Here,we profiled the single-cell transcriptomes of 96,313 peripheral blood mononuclear cells(PBMCs)derived from 12 COVID-19 patients(including four moderate,four severe and four critical cases)and three healthy donors.We showed that proliferative CD8 effector T cells with declined immune functions and cytotoxicity accumulated in the critical stage.By contrast,the quantity of natural killer(NK)cells was significantly reduced,while they exhibited enhanced immune activities.Notably,a gradually attenuated responseto COVID-19 along with disease severity was observed in monocytes,in terms of cellular composition,transcriptional discrepancy and transcription factor regulatory network.Furthermore,we identified immune cell-type dependent cytokine signatures distinguishing the severity of COVID-19 patients.In addition,cell interactions between CD8 effector T/NK cells and monocytes mediated by inflammatory cytokines were enhanced in moderate and severe stages,but weakened in critical cases.Collectively,our work uncovers the cellular and molecular players underlying the disordered and heterogeneous immune responses associated with COVID-19 severity,which could provide valuable insights for the treatment of critical COVID-19 patients.
基金supported by the Emergency Research Project of Tongji hospital(to J.Z.)Emergency Research Project of Tongji hospital of Huazhong University of Science and Technology(2020kfyXGYJ045,to J.Z.)Emergency Research Project of Hubei province(2020FCA006,to W.W.).
文摘Dear Editor,Coronavirus disease 2019(COVID-19)is a global-spread infectious disease caused by a novel coronavirus,SARS-CoV-2.1 COVID-19 causes heterogeneous disease phenotype,of which most patients exhibit mild to moderate symptoms,and~15%progress to severe pneumonia,5%of whom were eventually admitted to the intensive care unit(ICU)due to acute respiratory distress syndrome(ARDS),septic shock and/or multiple organ failure,and exhibit a high mortality rate.Two major obstacles to the improvement of the clinical outcomes in these patients are inadequate identification of the determinant cytokines correlated with fatal outcomes,and an inability to determine whether an individual patient has high risks of ICU admission and fatality.
基金supported by the National Natural Science Foundation of China(Grant No.41602147)Science and Technology Cooperation Project of the CNPC-SWPU Innovation Alliance(No.2020CX020000).
文摘The Lower Member of the Longrnaxi Forma-tion is generally dominated by siliceous shale,but recently we found some siltstone-mudstone rhythm sections developed in the Lower Member of the Longmaxi Formation.The study of formation mechanism of siltstone-mudstone rhythmic sedimentary sections may provide new insights into the shale sedimentary environ-ment.Therefore,we studied the characteristics and formation mechanism of siltstone-mudstone rhythmic sedimentary sections in the Lower Member of the Long-maxi Formation in the Changning area based on core observation,thin section identification,major elements and trace elements analysis.The results show the following:1)Two siltstone-mudstone rhythmic sedimentary sections are characterized by frequent interbed between black or gray-black shale and light gray siltstone,abundant argillaceous laminas and silty laminas,with obvious lithological boundaries having developed.Horizontal laminas and rhythmic laminas are well-developed in the shale layer,while the wavy laminas are well-developed in the siltstone layer.2)The major compositional elements are SiO2,Al2O3 and CaO,followed by Fe_(2)O_(3),MgO,K_(2)O and Na_(2)O.3)Compared with the world average shale,these siltstone-mudstone rhythmic sedimentary sections are rich in Mo,U and Ba,but less in V,Co,Ni,Cu.Compared with the shale layer,the siltstone layer has lower contents of V,Co and Ni.4).The geochemical redox indices,Mo-U and CIA values suggest the formation of the siltstone-mudstone rhythmic sedimentary sections are related to influences from bottom currents in an oxic condition with a warm and humid paleoclimate.
基金This work was supported by the Emergency Research Project of Tongji hospital(to J.Z.)Emergency Research Project of Tongji hospital of Huazhong University of Science and Technology(2020kfyXGYJ045,to J.Z.)Emergency Research Project of Hubei province(2020FCA006,to W.W.)。
文摘Dear Editor,Coronavirus disease 2019(COVID-19)is a global-spread infectious disease caused by a novel coronavirus,SARS-CoV-2.1 COVID-19 causes heterogeneous disease phenotype,of which most patients exhibit mild to moderate symptoms,and~15%progress to severe pneumonia,5%of whom were eventually admitted to the intensive care unit(ICU)due to acute respiratory distress syndrome(ARDS),septic shock and/or multiple organ failure,and exhibit a high mortality rate.Two major obstacles to the improvement of the clinical outcomes in these patients are inadequate identification of the determinant cytokines correlated with fatal outcomes,and an inability to determine whether an individual patient has high risks of ICU admission and fatality.
