Heterointerface engineering of rhombic Rh nanosheets confined on MXene for efficient methanol oxidation

Although metallic rhodium(Rh)is regarded as a promising platinum-alternative anode catalyst of direct methanol fuel cell(DMFC),the conventional"particle-to-face"contact model between Rh and matrix largely limits the overall electrocatalytic performance due to their insufficient cooperative effects.Herein,we report a controllable and robust heterointerface engineering strategy for the bottom-up fabrication of rhombic Rh nanosheets in situ confined on Ti_3C_(2)T_x MXene nanolamellas(Rh NS/MXene)via a convenient stereoassembly process.This unique design concept gives the resulting 2D/2D Rh NS/MXene heterostructure intriguing textural features,including large accessible surface areas,strong"face-toface"interfacial interactions,homogeneous Rh nanosheet distribution,ameliorative electronic structure,and high electronic conductivity.As a consequence,the as-prepared Rh NS/MXene nanoarchitectures exhibit exceptional electrocatalytic methanol oxidation properties in terms of a large electrochemically active surface area of 126.2 m~2 g_(Rh)~(-1),a high mass activity of 1056.9 mA mg_(Rh)-~1,and a long service life,which significantly outperform those of conventional particle-shaped Rh catalysts supported by carbon black,carbon nanotubes,reduced graphene oxide,and MXene matrixes as well as the commercial Pt nanoparticle/carbon black and Pd nanoparticle/carbon black catalysts with the same noble metal loading amount.Density functional theory calculations further demonstrate that the direct electronic interaction at the well-contacted 2D/2D heterointerfaces effectively enhances the adsorption energy of Rh nanosheets and induces a left shift of the d-band center,thereby making the Rh NS/MXene configuration suffer less from CO poisoning.This work highlights the importance of rational heterointerface design in the construction of advanced noble metal/MXene electrocatalysts,which may provide new avenues for developing the next-generation DMFC devices.

Controllable synthesis of grain boundary-enriched Pt nanoworms decorated on graphitic carbon nanosheets for ultrahigh methanol oxidation catalytic activity

Although one-dimensional Pt nanocrystals have long been regarded as ideal electrode catalysts for fuel cells,the synthetic techniques commonly involve the use of various complicated templates or surfactants,which have largely hampered their large-scale industrial application.Herein,we present a convenient and cost-effective approach to the stereoassembly of quasi-one-dimensional grain boundary-enriched Pt nanoworms on nitrogen-doped low-defect graphitic carbon nanosheets(Pt NWs/NL-CNS).Benefiting from its numerous catalytically active grain boundaries as well as optimized electronic structure,the as-derived Pt NWs/NL-CNS catalyst possesses exceptionally good electrocatalytic properties for methanol oxidation,including an ultrahigh mass activity of 1949.5 mA mg^(-1), reliable long-term durability,and strong poison tolerance,affording one of the most active Pt-based electrocatalysts for methanol oxidation reaction.Density functional theory calculation further reveals that the formation of worm-shape Pt morphology is attributed to the modified electronic structure as well as controllable defect density of the carbon matrix,which could also weaken the adsorption ability of Pt towards CO molecule and meanwhile synergistically promotes the catalytic reaction kinetics.

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.

Efficiency-loss analysis of monolithic perovskite/silicon tandem solar cells by identifying the patterns of a dual two-diode model’s current-voltage curves

In this work,we developed a simple and direct circuit model with a dual two-diode model that can be solved by a SPICE numerical simulation to comprehensively describe the monolithic perovskite/crystalline silicon(PVS/c-Si)tandem solar cells.We are able to reveal the effects of different efficiency-loss mechanisms based on the illuminated current density-voltage(J-V),semi-log dark J-V,and local ideality factor(m-V)curves.The effects of the individual efficiency-loss mechanism on the tandem cell’s efficiency are discussed,including the exp(V/VT)and exp(V/2VT)recombination,the whole cell’s and subcell’s shunts,and the Ohmic-contact or Schottky-contact of the intermediate junction.We can also fit a practical J-V curve and find a specific group of parameters by the trial-and-error method.Although the fitted parameters are not a unique solution,they are valuable clues for identifying the efficiency loss with the aid of the cell’s structure and experimental processes.This method can also serve as an open platform for analyzing other tandem solar cells by substituting the corresponding circuit models.In summary,we developed a simple and effective methodology to diagnose the efficiency-loss source of a monolithic PVS/c-Si tandem cell,which is helpful to researchers who wish to adopt the proper approaches to improve their solar cells.

Analysis of Channeling-Path Phenomena in a Complex Fault-Block Reservoir with Low Recovery Factor and High Water-Cut Ratio

Current methods for the analysis of channeling-path phenomena in reservoirs cannot account for the influence of time and space on the actual seepage behavior.In the present study,this problem is addressed considering actual production data and dynamic characteristic parameters quantitatively determined in the near wellbore area by fitting the water-cut curve of the well.Starting from the dynamic relationship between injection and production data,the average permeability is determined and used to obtain a real-time quantitative characterization of the seepage behavior of the channeling-path in the far wellbore area.For the considered case study(Jidong oilfield),it is found that the seepage capacity of the channeling-path in the far wellbore area is far less(10 times smaller)than that of the channeling-path in the near wellbore area.The present study and the proposed model(combining near wellbore area and far wellbore area real-time data)have been implemented to support the definition of relevant adjustment measures to ultimately improve oil recovery.

Effects of Heat Stress during Seed Filling Stage on Brassica napus Seed Oil Accumulation and Chlorophyll Fluorescence Characteristics

As global temperature rise,the threat of heat stress to rapeseed production is becoming more obvious.Exploring the response characteristics of two important biological pathways,oil accumulation and photosynthesis,to heat stress during B.napus seed filling is helpful in the genetic improvement of heat-tolerant rapeseed.The effects of heat stress on seed oil accumulation and chlorophyll fluorescence characteristics of 29 B.napus germplasms with different oil content and environmental sensitivity,including 6 rapeseed varieties which exhibited environmentsensitive/insensitive and with high,medium or low oil content,were tested by whole plant heat stress or the in vitro silique culture system.Both assay exhibited similar trend on oil content of the rapeseed germplasms.The heat effect on the chlorophyll fluorescence kinetic parameters F_(v)/F_(m),ETR and Y(Ⅱ)were also consistent.Heat stress significantly decreased oil content,although there was abundant genetic variation on heat tolerance among the genotypes.Correlation analysis showed that the decrease rate of F_(v)/F_(m) of silique heat-stressed B.napus developing seed was positive correlative to the decrease rate of mature seed oil content of the whole plant heat-stressed rapeseed(R=0.9214,P-value<0.01).Overall,the results indicated that heat stress inhibited oil accumulation and photosynthesis in B.napus developing seed.The decrease rate of chlorophyll fluorescence parameter F_(v)/F_(m) of heat-stressed developing seed could be used as the index of heat tolerant rapeseed identification.Further,two heat insensitive rapeseed varieties with high oil content were identified.

Highly ordered crystallization of α-FAPbl_(3) films via homogeneous seeds for efficient perovskite solar cells

Formamidine lead triiodide(FAPbI_(3))perovskites have become the most promising photovoltaic materials for perovskite solar cells with record power conversion efficiency(PCE).However,random nucleation,phase transition,and lattice defects are still the key challenges limiting the quality of FAPbI_(3) films.Previous studies show that the introduction or adding of seeds in the precursor is effective to promote the nucleation and crystallization of perovskite films.Nevertheless,the seed-assisted approach focuses on heterogeneous seeds or hetero-composites,which inevitably induce a lattice-mismatch,the genera-tion of strain or defects,and the phase segregation in the perovskite films.Herein,we first demonstrate that high-quality perovskite films are controllably prepared using α-and δ-phases mixed FAPbI_(3) micro-crystal as the homogeneous seeds with the one-step antisolvent method.The partially dissolved seeds with suitable sizes improve the crystallinity of the perovskite flm with preferable orientation,improved carrier lifetime,and increased carrier mobility.More importantly,the α-phase-containing seeds promote the formation of α-phase FAPbI_(3) films,leading to the reduction of residual lattice strain and the suppres-sion of I-ion migration.Besides,the adding of dimethyl 2,6-pyridine dicarboxylate(DPD)into the pre-cursor further suppresses the generation of defects,contributing to the PCE of devices prepared in air ambient being significantly improved to 23.75%,among the highest PCEs for fully air-processed FAPbI_(3) solar cells.The unpackaged target devices possess a high stability,maintaining 80%of the initial PCE under simulated solar illumination exceeding 800 h.

Preventive strategies for feeding intolerance among patients with severe traumatic brain injury:A cross-sectional survey

This study aimed to investigate the application status of preventive measures for feeding intolerance in patients with severe traumatic brain injury(STBI)in China and analysis the differences and their causes.Methods A cross-sectional survey was conducted.From December 2019 to January 2020,ICU nurses and physicians of 89 hospitals in China were surveyed by using a questionnaire on preventive strategies for feeding intolerance in patients with STBI.The questionnaire included two parts:the general information of participants(10 items)and application of preventive measures for feeding intolerance in STBI patients(18 items).Results Totally 996 nurses and physicians completed the questionnaire.Among various methods,gastrointestinal symptoms(85.0%)and injury severity(71.4%)were mostly used to assess gastrointestinal functions and risk of feeding intolerance among STBI patients,respectively.Initiating enteral nutrition(EN)within 24–48 h(61.5%),nasogastric tubes(91.2%),30°–45°of head-of-bed elevation(89.5%),continuous feeding by pump(72.9%),EN solution temperature of 38–40°C(65.5%),<500 ml initial volume of EN solution(50.0%),monitoring gastric residual volume with a syringe(93.7%),and assessing gastric residual volume every 4 h(51.5%)were mostly applied for EN delivery among STBI patients.Prokinetic agents(73.3%),enema(73.6%),probiotics(79.0%),antacid agents(84.1%),and non-nutritional preparations as initial EN formula(65.6%)were commonly used for preventing feeding intolerance among STBI patients.Conclusions The survey showed that nurses and clinicians in China have a positive attitude towards preventive strategies for feeding intolerance.However,some effective new technologies and methods have not been timely applied in clinical practice.We suggest that managers,researchers,clinicians,nurses,and other health professionals should collaborate to explore effective and standard preventive strategies for feeding intolerance among patients with STBI.

One Novel Zn(Ⅱ)Nitro-containing Metal Organic Framework for Dye-Adsorption and Photo Degradation

A novel metal-organic framework[Zn0.5(L1)(4,4'-Bpy)0.5],(HU21,HU for Hohai University,L1=4-hydroxy-3-nitrobenzoic acid,4,4'-bipyridine=4,4'-Bpy),has been isolated through hydro-thermal reaction.Single-crystal X-ray diffraction reveals the compound features a 1D fishbone-like chain.A fast adsorption rate of methylene blue with HU21 was observed in the dark,but under irritation the degradation rate of the dye was obviously increased.The degradation of methylene blue dye reached 248 mg/g under light irritation,and the photocatalytic activity reached 96.1%.

One dimensional terpyridine-based metal organic framework for stable supercapacitor

In summary,a novel structure of MOF based on 1,4-di([2,2':6',2''terpyridin]-4'-yl)benzene and 1,4-naphthalenedicarboxylic acid has been constructed through hydrothermal reaction.The Ni-MOF displays one dimensional zigzag chain,which connect each other by hydrogen bonding to form three dimensional supramolecule with large channels.The conjugated systems of the terpyridin and benzene ligands enhance the chain rigidity,accelerate the electron transport.The massive channels provides electrolyte rapid transfer.By the structural feature aforementioned,the Ni-MOF demonstrates stable electrochemical performance as suprocapacitor.

Aerobic glycolysis promotes tumor immune evasion and tumor cell stemness through the noncanonical function of hexokinase 2

The Warburg effect is a key metabolic feature of cancer cells and manifests as substantially increased glycolysis regardless of the presence of oxygen[1].The initial step of glycolysis is catalyzed by hexokinase(HK),which converts glucose to the metabolic intermediate glucose-6-phosphate(G-6-P).Four kinds of HK isozymes,HK1,HK2,HK3 and HK4,have been found in mammals.HK1 and HK2 bind to the mitochondrial outer membrane through interac-tions with voltage-dependent anion channels(VDACs),and both of thesemolecules have a high affinity for glucose[2].HK2 overexpression is frequently detected in cancer cells,leading to enhanced aerobic glycolysis and tumorigenesis that renders HK2 an attractive target for cancer treatment[3].Important advances in research on cancer metabolism in recent decades have revealed thatmetabolic enzymes have non-metabolic functions,which play pivotal roles in tumor development and progression[4–6].Recent studies uncovered that HK2 directly promoted tumor immune evasion through the activity of a previously unidentified protein kinase and tumor cell stemness via upregulation of CD133 expression.

Continuous chemical redistribution following amorphous-to-crystalline structural ordering in a Zr-Cu-Al bulk metallic glass

Bulk metallic glasses(BMGs)are thermodynamically metastable.As such,crystallization occurs when a BMG is thermally annealed at a temperature above the glass transition temperature.While extensive studies have been performed on the crystallization kinetics of BMGs,most of them have focused on the amorphous-to-crystalline structural ordering,and little attention has been paid to chemical distribution and its relationship with the structural ordering during the crystallization process.In this paper,a new approach,with simultaneous differential scanning calorimetry(DSC)and small angle neutron scatter-ing(SANS)measurements,was applied to study in situ the crystallization of a Zr_(45.5)Cu_(45.5)Al_(9)BMG upon isothermal annealing at a temperature in the supercooled liquid region.Quantitative analysis of the DSC and SANS data showed that the structural evolution during isothermal annealing could be classified into three stages:(Ⅰ)incubation;(Ⅱ)amorphous-to-crystalline structural ordering;(Ⅲ)continuous chemical redistribution.This finding was validated by composition analysis with atom probe tomography(APT),which further identified a transition region formed by expelling Al into the matrix.The transition re-gion,with a composition of(Cu,Al)_(50)Zr_(50),served as an intermediate step facilitating the formation of a thermodynamically stable crystalline phase with a composition of(Cu,Al)_(10)Zr_(7).

Determiners of cell fates: the tricarboxylic acid cycle versusthe citrate-malate shuttle

The tricarboxylic acid(TCA)cycle identified in 1937 by Hans Adolf Krebs and William Arthur Johnson(also known as the Krebs cycle or citric acid cycle)is a central route for oxidative metabolism to generate cellular energy and intermediates for the biosynthesis of amino acids,lipids,and nucleic acids(Krebs and Johnson 1937).The TCA cycle connects carbohydrate,fat,and protein metabolism and converts these nutrient catabolism-derived acetyl-CoA into carbon dioxide and water,with the production of reduced NAD+(NADH),reduced flavin adenine dinucleotide(FADH2),and guanosine triphosphate(GTP).The generated NADH and FADH2 are,in turn,used by the oxidative phosphorylation pathway to generate energy-rich adenosine triphosphate(ATP)(Chakrabarty and Chandel 2021).

Higher efficacy of oral etoposide for mobilization of peripheral blood stem cells in patients with multiple myeloma

This study compares the efficacy,toxicity,hematopoietic recovery,and cost of stem-cell mobilization using intermediate-dose cyclophosphamide(IDCy)plus granulocyte colony-stimulating factor(G-CSF)compared with etoposide(VP-16)plus pegylated granulocyte colony-stimulating factor(PEG-rhG-CSF)in multiple myeloma(MM)patients.Two hundred forty-four consecutive patients undergoing mobilization with IDCy(3-3.5g/m^(2))plus G-CSF(n=155)were compared with patients receiving VP-16 plus PEG-rhG-CSF(n=89),including oral etoposide(n=65)and intravenous etoposide(n=24).Compared with IDCy,VP-16 use was associated with significantly higher median peak peripheral blood CD34+cell count(8.20[range:1.84-84]×10^(6)/kg vs 4.58[range:0.1-27.9]×10^(6)/kg,P=.000),and ideal CD34+cell yield of more than 6×10^(6)/kg(56.8%vs 35.1%,P=.001),notably with a higher efficacy in oral VP-16 use compared with IDCy use(CD 34+cell counts:median peak peripheral blood 5.87 vs 4.58?106/kg and≥6×10^(6)/kg[48.4%vs 35.1%]).The median number of apheresis courses was reduced from two in the IDCy group to one in the VP-16 group(P=.000).IDCy use was associated with significantly more frequent episodes of neutropenia(70.2%vs 35.2%;P=.000),intravenous antibiotic use(13.2%vs 11.4%;P=.672),and hospitalization(P=.000).The recoveries of neutrophils and platelets after autologous stem-cell transplantation were significantly faster in the VP-16 group compared with the IDCy group(P=.000).Our data indicate robust stem-cell mobilization in MM patients with VP-16 delivered either orally or intravenously.When compared with intravenous VP-16,oral VP-16 mobilization was associated with significantly more convenient,lower average total costs,and especially decreased the risk of hospital visits and exposure.

一种蜱源性耐盐耐碱菌株Oceanobacillus oncorhynchi IMH的首次分离与鉴定

【目的】本试验以源自呼伦贝尔地区的优势蜱种草原革蜱为材料,从其体内分离得到可疑细菌,应用常规方法和分子生物学方法对该菌株进行分离及鉴定,并对其致病性进行探索,为内蒙古地区蜱虫生物多样性和环境相关性研究奠定了基础。【方法】首先,通过形态学观察,生理生化试验、药物敏感试验以及16S r RNA序列分析,并构建系统发育树,确定该菌株的分类地位;其次对昆明小鼠进行致病性实验。【结果】该菌株革兰氏染色呈G+杆菌,在高盐培养基(5%Na Cl)和p H为9的碱性培养基中生长良好;该菌对不同糖类发酵能力非常有限,只利用部分糖类(如西蒙氏枸橼酸盐试验结果为阳性)产气,但是不产酸;对个别化学药(如环丙沙星)和多数抗生素(如复方新诺明、庆大霉素、红霉素及头孢噻肟等)显示为敏感,而对抗生素卡那霉素和阿莫西林表现为耐药性;经16S r RNA基因序列和系统发育树分析发现,该菌株与GenBank数据库中已注册的多株Oceanobacillus oncorhynchi的同源性为99%以上;该菌在血平板溶血试验中呈现出不完全α溶血,而感染昆明小鼠,观察7 d无明显致病性。【结论】本试验首次分离鉴定了一株蜱源性O.oncorhynchi,并对上述菌株重新命名为O.oncorhynchi IMH,并在Gen Bank中进行注册(LC213016.1),更加丰富了Gen Bank中相关数据。

Facilitating Lithium-Ion Diffusion in Layered Cathode Materials by Introducing Li^(+)/Ni^(2+) Antisite Defects for High-Rate Li-Ion Batteries

Li^(+)/Ni^(2+) antisite defects mainly resulting from their similar ionic radii in the layered nickel-rich cathode materials belong to one of cation disordering scenarios.They are commonly considered harmful to the electrochemical properties,so a minimum degree of cation disordering is usually desired.However,this study indicates that LiNi_(0.8)Co_(0.15)Al_(0.05)O_(2)as the key material for Tesla batteries possesses the highest rate capability when there is a minor degree(2.3%)of Li^(+)/Ni^(2+) antisite defects existing in its layered structure.By combining a theoretical calculation,the improvement mechanism is attributed to two effects to decrease the activation barrier for lithium migration:(1)the anchoring of a low fraction of high-valence Ni^(2+) ions in the Li slab pushes uphill the nearest Li^(+)ions and(2)the same fraction of low-valence Li^(+) ions in the Ni slab weakens the repulsive interaction to the Li^(+) ions at the saddle point.

A novel low-cost and environment-friendly cathode with large channels and high structure stability for potassium-ion storage

Potassium-ion batteries (KIBs) are promising candidates for large-scale energy storage due to the abundance of potassium and its chemical similarity to lithium.Nevertheless,the performances of KIBs are still unsatisfactory for practical applications,mainly hindered by the lack of suitable cathode materials.Herein,combining the strong inductive effect of sulphate and the feasible preparation of Fe^(2+)-containing compounds in oxalate system,a compound with novel architecture,K_(4)Fe_(3)(C_(2)O_(4))_(3)(SO_(4))_(2),has been identified as a lowcost and environmentally friendly cathode for stable potassium-ion storage.Its unique crystal structure possesses an unprecedented two-dimensional framework of triple layers,with 3.379Åinterlayer distance and large intralayer rings in the size of 4.576×6.846Å.According to first-principles simulations,such a configuration is favorable for reversible K-ion migration with a very low volume change of 6.4%.Synchrotron X-ray absorption spectra and X-ray diffraction characterizations at different charging/discharging states and electrochemical performances based on its half and full cells further verify its excellent reversibility and structural stability.Although its performance needs to be improved via further composition tuning with multi-valent transition metals,doping,structural optimization,etc.,this study clearly presents a stable structural model for K-ion cathodes with merits of low cost and environmental friendliness.

A numerical method for two-dimensional nonlinear modified time-fractional fourth-order diffusion equation

In this paper,we consider the finite element method for two-dimensional nonlinear modified time-fractional fourth-order diffusion equation.In order to avoid using higher order elements,we introduce an intermediate variableσ=∆u and translate the fourth-order derivative of the original problem into a second-order coupled system.We discretize the fractional time derivative terms by using the L1-approximation and discretize the first-order time derivative term by using the second-order backward differentiation formula.In the fully discrete scheme,we implement the finite element method for the spatial approximation.Unconditional stability of the fully discrete scheme is proven and its optimal convergence order is obtained.Numerical experiments are carried out to demonstrate our theoretical analysis.

Arsenic trioxide induced rhabdomyolysis, a rare but severe side effect, in an APL patient： a case report

Arsenic trioxide （ATO）, a component of the traditional Chinese medicine arsenic sublimate, promotes apoptosis and induces leukemic cell differentiation. Combined with all-trans-retinotic acid （ATRA）, ATO has become the first-line induction therapy in treating acute promyelocytic leukemia （APL）. The most common side effects of ATO include hepatotoxicity, gastrointestinal symptoms, water-sodium retention, and nervous system damage. In this report, we present a rare side effect, rhabdomyolysis, in a 68-year-old female APL patient who was treated with ATO. After taking 10 mg ATO daily for 6 days, she presented shortness of breath, myodynia, elevated creatine kinase, and acute renal insufficiency. This report describes the first case of ATO-induced rhabdomyolysis.

Prognostic analysis of chronic myeloid leukemia in Chinese population in an imatinib era

We evaluated the outcomes of chronic myeloid leukemia(CML)patients receiving imatinib treatment in chronic(CP),accelerated(AP),and blast crisis(BP)phases.The single-institution treatment experiences of Chinese patients with CML were presented.A total of 275 CML patients(CP,210;AP,24;and BP,41)who received imatinib between February 2001 and April 2008 were enrolled in this study.We evaluated the treatment responses(hematologic,cytogenetic,and molecular),overall survival(OS),event-free survival(EFS),and prognostic factors of outcome.At the cut-off point,the complete cytogenetic response(CCyR)and complete molecular response rates of patients in the CP were 84.7% and 61.9%,respectively,which were significantly higher than those of patients in the AP(50% and 29.1%,respectively,both P<0.001)and BP(24.3% and 9.7%,respectively,both P<0.001).The estimated five-year OS and five-year EFS rates were 93.2% and 86.4% for CP patients,as well as 64.5% and 50.9% for AP patients,which were significantly higher than those for BP patients(P<0.001).In CP patients,univariate analysis revealed that early treatment with imatinib,achieving CCyR within 12 months,additional cytogenetic abnormalities,and kinase domain mutations were associated with the treatment outcome.More patients are needed to carry out multivariate analysis.