Pillar effect induced by ultrahigh phosphorous/nitrogen doping enables graphene/MXene film with excellent cycling stability for alkali metal ion storage

Graphene's large theoretical surface area and high conductivity make it an attractive anode material for potassium-ion batteries(PIBs).However,its practical application is hindered by small interlayer distance and long ion transfer distance.Herein,this paper aims to address the issue by introducing MXene through a simple and scalable method for assembling graphene and realizing ultrahigh P doping content.The findings reveal that MXene and P-C bonds have a "pillar effect" on the structure of graphene,and the P-C bond plays a primary role.In addition,N/P co-doping introduces abundant defects,providing more active sites for K^(+) storage and facilitating K^(+) adsorption.As expected,the developed ultrahigh phosphorous/nitrogen co-doped flexible reduced graphene oxide/MXene(NPrGM) electrode exhibits remarkable reversible discharge capacity(554 mA hg^(-1) at 0.05 A g^(-1)),impressive rate capability(178 mA h g^(-1) at 2 A g^(-1)),and robust cyclic stability(0.0005% decay per cycle after 10,000 cycles at 2 A g^(-1)).Furthermore,the assembled activated carbon‖NPrGM potassium-ion hybrid capacitor(PIHC) can deliver an impressive energy density of 131 W h kg^(-1) and stable cycling performance with 98.1% capacitance retention after5000 cycles at 1 A g^(-1).Such a new strategy will effectively promote the practical application of graphene materials in PIBs/PIHCs and open new avenues for the scalable development of flexible films based on two-dimensional materials for potential applications in energy storage,thermal interface,and electromagnetic shielding.

Metallogenesis of the Baidi Au-Sb deposit, southwest Guizhou Province, China: mineralogical and geochemical evidence from sulfur-bearing minerals

The Baidi Au-Sb deposit, which contains 8 t of Au and 10,979 Mt of Sb, is a typical and rare paragenetic deposit located in southwestern Guizhou Province, China.Previous studies have focused on individual ores, but have not combined them to identify their paragenetic mechanism or metallogenic regularity. Therefore, we used field investigations, microscopic observations, and in situ analyses to identify the spatial distribution, mineral paragenesis, compositional evolution, and metallogenic material sources of the ore bodies. We also determined the Au and Sb paragenetic characteristics and the metallogenesis of the deposit. The main Au-bearing minerals in the deposit were early(Apy1–2) and late(Apy3) stage arsenopyrites, as well as pre-mineralization(Py1), mineralization(Py2–5), and late mineralization(Py6–7) stage pyrites. The main Sb-bearing minerals were stibnite(Snt), skinnerite, bournonite,and valentinite. The minerals formed in the order of Py1,Py2–3 + Apy1, Py4–5 + Apy2, Snt, and Py6–7 + Apy3.The δ34S values of the arsenopyrites and pyrites ranged from-5 to 5‰, while those of stibnite were mostly less than-5‰ in the later mineralization stages. Sulfur was provided by deep magmatic hydrothermal fluids, but sedimentary sulfur was added in the later stages. Moreover,the trace elemental contents fluctuated and eventually became similar to those of the sedimentary strata. By comprehensively considering the ores along with the geological characteristics of the deposit, we determined that deep magma provided the Au during ore formation. Later tectonic changes provided Sb from the sedimentary strata,which precipitated along fault expansion areas and produced Au and Sb paragenesis.

Topology Optimization of Two Fluid Heat Transfer Problems for Heat Exchanger Design

Topology optimization of thermal-fluid coupling problems has received widespread attention.This article proposes a novel topology optimization method for laminar two-fluid heat exchanger design.The proposed method utilizes an artificial density field to create two permeability interpolation functions that exhibit opposing trends,ensuring separation between the two fluid domains.Additionally,a Gaussian function is employed to construct an interpolation function for the thermal conductivity coefficient.Furthermore,a computational program has been developed on the OpenFOAM platform for the topology optimization of two-fluid heat exchangers.This program leverages parallel computing,significantly reducing the time required for the topology optimization process.To enhance computational speed and reduce the number of constraint conditions,we replaced the conventional pressure drop constraint condition in the optimization problem with a pressure inlet/outlet boundary condition.The 3D optimization results demonstrate the characteristic features of a surface structure,providing valuable guidance for designing heat exchangers that achieve high heat exchange efficiency while minimizing excessive pressure loss.At the same time,a new structure appears in large-scale topology optimization,which proves the effectiveness and stability of the topology optimization program written in this paper in large-scale calculation.

Drought-triggered repression of miR166 promotes drought tolerance in soybean

Drought stress limits agricultural productivity worldwide.Identifying and characterizing genetic components of drought stress-tolerance networks may improve crop resistance to drought stress.We show that the regulatory module formed by miR166 and its target gene,ATHB14-LIKE,functions in the regulation of drought tolerance in soybean(Glycine max).Drought stress represses the accumulation of miR166,leading to upregulation of its target genes.Optimal knockdown of miR166 in the stable transgenic line GmSTTM166 conferred drought tolerance without affecting yield.Expression of ABA signaling pathway genes was regulated by the miR166-mediated regulatory pathway,and ATHB14-LIKE directly activates some of these genes.There is a feedback regulation between ATHB14-LIKE and MIR166 genes,and ATHB14-LIKE inhibits MIR166 expression.These findings reveal that drought-triggered regulation of the miR166-mediated regulatory pathway increases plants drought resistance,providing new insights into drought stress regulatory network in soybean.

Predictive model for non-malignant portal vein thrombosis associated with cirrhosis based on inflammatory biomarkers

BACKGROUND Portal vein thrombosis(PVT),a complication of liver cirrhosis,is a major public health concern.PVT prediction is the most effective method for PVT diagnosis and treatment.AIM To develop and validate a nomogram and network calculator based on clinical indicators to predict PVT in patients with cirrhosis.METHODS Patients with cirrhosis hospitalized between January 2016 and December 2021 at the First Hospital of Lanzhou University were screened and 643 patients with cirrhosis who met the eligibility criteria were retrieved.Following a 1:1 propensity score matching 572 patients with cirrhosis were screened,and relevant clinical data were collected.PVT risk factors were identified using the least absolute shrinkage and selection operator(LASSO)and multivariate logistic regression analysis.Variance inflation factors and correlation matrix plots were used to analyze multicollinearity among the variables.A nomogram was constructed to predict the probability of PVT based on independent risk factors for PVT,and its predictive performance was verified using a receiver operating characteristic curve(ROC),calibration curves,and decision curve analysis(DCA).Finally,a network calculator was constructed based on the nomograms.RESULTS This study enrolled 286 cirrhosis patients with PVT and 286 without PVT.LASSO analysis revealed 13 variables as strongly associated with PVT occurrence.Multivariate logistic regression analysis revealed nine indicators as independent PVT risk factors,including etiology,ascites,gastroesophageal varices,platelet count,D-dimer,portal vein diameter,portal vein velocity,aspartate transaminase to neutrophil ratio index,and platelet-to-lymphocyte ratio.LASSO and correlation matrix plot results revealed no significant multicollinearity or correlation among the variables.A nomogram was constructed based on the screened independent risk factors.The nomogram had excellent predictive performance,with an area under the ROC curve of 0.821 and 0.829 in the training and testing groups,respectively.Calibration curves and DCA revealed its good clinical performance.Finally,the optimal cutoff value for the total nomogram score was 0.513.The sensitivity and specificity of the optimal cutoff values were 0.822 and 0.706,respectively.CONCLUSION A nomogram for predicting PVT occurrence was successfully developed and validated,and a network calculator was constructed.This can enable clinicians to rapidly and easily identify high PVT risk groups.

Pathological diagnosis and immunohistochemical analysis of giant retrosternal goiter in the elderly: A case report

BACKGROUND Elderly giant retrosternal thyroid goiter is a rare yet significant medical condition,often presenting clinical symptoms that can be confused with other diseases,posing diagnostic and therapeutic challenges.This study aims to delve into the characteristics and potential mechanisms of this ailment through pathological diagnosis and immunohistochemical analysis,providing clinicians with more precise diagnostic and treatment strategies.A 77-year-old male,was admitted to hospital with the chief complaint of finding a goiter in the semilunar month during physical examination,accompanied by dyspnea.Locally protruding into the superior mediastinum,the adjacent structure was compressed,the trachea was compressed to the right,and the local lumen was slightly narrowed.The patient was diagnosed with giant retrosternal goiter.Considering dyspnea caused by trachea compression,our department planned to perform giant retrosternal thyroidectomy.Immunohistochemical results:Tg(+),TTF-1(+),Calcitonin(CT)(I),Ki-67(+,about 20%),CD34(-).Retrosternal goiter means that more than 50%of the volume of the thyroid gland is below the upper margin of the sternum.As retrosternal goiter disease is a relatively rare disease,once the disease is diagnosed,it should be timely surgical treatment,and the treatment is more difficult,the need for professional medical team for comprehensive treatment.CONCLUSION The imaging manifestations of giant retrosternal goiter are atypical,histomorphology and immunohistochemistry can assist in its diagnosis.This article reviews the relevant literature of giant retrosternal goiter immunohisto-chemistry and shows that giant retrosternal goiter is positive for Tg,TTF-1,and Ki-67.

Enhanced recovery after surgery in elderly patients with non-small cell lung cancer who underwent video-assisted thoracic surgery

BACKGROUND This study was designed to investigate the clinical outcomes of enhanced recovery after surgery(ERAS)in the perioperative period in elderly patients with nonsmall cell lung cancer(NSCLC).AIM To investigate the potential enhancement of video-assisted thoracic surgery(VATS)in postoperative recovery in elderly patients with NSCLC.METHODS We retrospectively analysed the clinical data of 85 elderly NSCLC patients who underwent ERAS(the ERAS group)and 327 elderly NSCLC patients who received routine care(the control group)after VATS at the Department of Thoracic Surgery of Peking University Shenzhen Hospital between May 2015 and April 2017.After propensity score matching of baseline data,we analysed the postoperative stay,total hospital expenses,postoperative 48-h pain score,and postoperative complication rate for the 2 groups of patients who underwent lobectomy or sublobar resection.RESULTS After propensity score matching,ERAS significantly reduced the postoperative hospital stay(6.96±4.16 vs 8.48±4.18 d,P=0.001)and total hospital expenses(48875.27±18437.5 vs 55497.64±21168.63 CNY,P=0.014)and improved the satisfaction score(79.8±7.55 vs 77.35±7.72,P=0.029)relative to those for routine care.No significant between-group difference was observed in postoperative 48-h pain score(4.68±1.69 vs 5.28±2.1,P=0.090)or postoperative complication rate(21.2%vs 27.1%,P=0.371).Subgroup analysis showed that ERAS significantly reduced the postoperative hospital stay and total hospital expenses and increased the satisfaction score of patients who underwent lobectomy but not of patients who underwent sublobar resection.CONCLUSION ERAS effectively reduced the postoperative hospital stay and total hospital expenses and improved the satisfaction score in the perioperative period for elderly NSCLC patients who underwent lobectomy but not for patients who underwent sublobar resection.

CH_3NH_3 Formed by Electron Injection at Heterojunction Inducing Peculiar Properties of CH_3NH_3PbI_3 Material

The effect of formed CH_3NH_3 at the heterojunction on properties of CH_3NH_3PbI_3 material is investigated based on experiment and theoretical calculation. Our calculation results show that the giant dielectric constant, anomalous hysteresis and long-lasting polarization for CH_3NH_3PbI_3 originate from the formed CH_3NH_3 at the heterojunction. It is found that the induced weak EPS by the reorientation of CH_3NH_3 sub-group along the built-in electric field enables us to effectively increase the ordering of entire lead-halide framework. In addition, the heterojunction has an advantage of channel separation between carrier transport and electron diffusion. These properties of the heterojunction are the main origin of the high efficiency of CH_3NH_3PbI_3 solar cells.

Pathological diagnosis and immunohistochemical analysis of minute pulmonary meningothelial-like nodules:A case report

BACKGROUND Minute Pulmonary Meningothelial-like Nodules(MPMNs)are rare benign pulmonary nodules,which are more common in elderly women and have a higher detection rate in lung tissues of patients with lung malignant diseases.Its origin is not yet clear.At present,there are few reports on the diagnostic methods such as imaging and pathological manifestations of MPMNs.This article reports a 70-year-old female patient with pulmonary adenocarcinoma combined with MPMNs and reviews of the relevant literature.CASE SUMMARY A 70-year-old women was admitted to our institution with feeling sour in her back and occasional cough for more than 2 mo.Computerized electronic scanning scan and 3D reconstruction images in our institution showed there were multiple ground-glass nodules in both of her two lungs.The biggest one was in the apicoposterior segment of left upper lobe,about 2.5 mm×9 mm in size.We performed thoracoscopic resection of the left upper lung apicoposterior segment of the patient,and the final pathological report was minimally invasive adenocarcinoma.Re-examination of high resolution computed tomography 21 mo after surgery showed multiple ground-glass nodules in both lungs,and a new groundglass nodule was found in the superior segment of the right lower lobe.We took pathological biopsy of the right upper lung and right lower lung nodules for the patient under thoracoscopy.The histomorphology of the right lower lobe nodule showed multiple lesions in the lung tissue,and the small foci in the alveolar septum were distributed in mild form of the aggregation of short spindle cells.The immunohistochemistry showed that the lesion was epithelial membrane antigen(EMA)(+),somatostatin receptor 2a(SSTR2a)(+),S-100(-),chromogranin A(-),Syn(-),cytokeratin(-)and HMB-45(-).The final diagnosis was minimally invasive adenocarcinoma,accompanied by MPMNs.We recommend that patients continue to receive treatment after surgery and to do regular follow-up observations.CONCLUSION The imaging manifestations of MPMNs are atypical,histomorphology and immunohistochemistry can assist in its diagnosis.This article reviews the relevant literature of MPMNs immunohistochemistry and shows that MPMNs are positive for EMA,SSTR2a,and progesterone receptor.

Effects of individual shock wave therapy vs celecoxib on hip pain caused by femoral head necrosis

BACKGROUND Celecoxib has been used to treat hip discomfort and functional difficulties associated with osteonecrosis of the femoral head(ONFH),although significant adverse reactions often follow long-term use.Extracorporeal shock wave therapy(ESWT)can delay the progression of ONFH,alleviate the pain and functional limitations it causes,and avoid the adverse effects of celecoxib.AIM To investigate the effects of individual ESWT,a treatment alternative to the use of celecoxib,in alleviating pain and dysfunction caused by ONFH.METHODS This was a randomized,controlled,double-blinded,non-inferiority trial.We examined 80 patients for eligibility in this study;8 patients were excluded based on inclusion and exclusion criteria.A total of 72 subjects with ONFH were randomly assigned to group A(n=36;celecoxib+alendronate+sham-placebo shock wave)or group B(n=36;individual focused shock wave[ESWT based on magnetic resonance imaging three-dimensional(MRI-3D)reconstruction]+alendronate).The outcomes were assessed at baseline,at the end of treatment,and at an 8-wk follow-up.The primary outcome measure was treatment efficiency after 2 wk of intervention using the Harris hip score(HHS)(improvement of 10 points or more from the baseline was deemed sufficient).Secondary outcome measures were post-treatment HHS,visual analog scale(VAS),and Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores.RESULTS After treatment,the pain treatment efficiency of group B was greater than that of group A(69%vs 51%;95%CI:4.56%to 40.56%),with non-inferiority thresholds of-4.56%and-10%,respectively.Furthermore,the HHS,WOMAC,and VAS scores in group B dramatically improved during the follow-up period as compared to those in group A(P<0.001).After therapy,the VAS and WOMAC in group A were significantly improved from the 2nd to 8th wk(P<0.001),although HHS was only significantly altered at the 2 wk point(P<0.001).On the 1st d and 2nd wk after treatment,HHS and VAS scores were different between groups,with the difference in HHS lasting until week 4.Neither group had severe complications such as skin ulcer infection or lower limb motorsensory disturbance.CONCLUSION Individual shock wave therapy(ESWT)based on MRI-3D reconstruction was not inferior to celecoxib in managing hip pain and restrictions associated with ONFH.

Single-cell RNA sequencing reveals the dynamics of hepatic non-parenchymal cells in autoprotection against acetaminophen-induced hepatotoxicity

Gaining a better understanding of autoprotection against drug-induced liver injury(DILI)may provide new strategies for its prevention and therapy.However,little is known about the underlying mechanisms of this phenomenon.We used single-cell RNA sequencing to characterize the dynamics and functions of hepatic non-parenchymal cells(NPCs)in autoprotection against DILI,using acetaminophen(APAP)as a model drug.Autoprotection was modeled through pretreatment with a mildly hepatotoxic dose of APAP in mice,followed by a higher dose in a secondary challenge.NPC subsets and dynamic changes were identified in the APAP(hepatotoxicity-sensitive)and APAP-resistant(hepatotoxicity-resistant)groups.A chemokine(C-C motif)ligand 2^(+)endothelial cell subset almost disappeared in the APAP-resistant group,and an R-spondin 3^(+)endothelial cell subset promoted hepatocyte proliferation and played an important role in APAP autoprotection.Moreover,the dendritic cell subset DC-3 may protect the liver from APAP hepatotoxicity by inducing low reactivity and suppressing the autoimmune response and occurrence of inflammation.DC-3 cells also promoted angiogenesis through crosstalk with endothelial cells via vascular endothelial growth factor-associated ligand-receptor pairs and facilitated liver tissue repair in the APAP-resistant group.In addition,the natural killer cell subsets NK-3 and NK-4 and the Sca-1^(-)CD62L^(+)natural killer T cell subset may promote autoprotection through interferon-γ-dependent pathways.Furthermore,macrophage and neutrophil subpopulations with anti-inflammatory phenotypes promoted tolerance to APAP hepatotoxicity.Overall,this study reveals the dynamics of NPCs in the resistance to APAP hepatotoxicity and provides novel insights into the mechanism of autoprotection against DILI at a high resolution.

Intervention against information diffusion in static and temporal coupling networks

Information diffusion in complex networks has become quite an active research topic.As an important part of this field,intervention against information diffusion processes is attracting ever-increasing attention from network and control engineers.In particular,it is urgent to design intervention schemes for the coevolutionary dynamics between information diffusion processes and coupled networks.For this purpose,we comprehensively study the problem of information diffusion intervention over static and temporal coupling networks.First,individual interactions are described by a modified activitydriven network(ADN)model.Then,we establish a novel node-based susceptible-infected-recovered-susceptible(SIRS)model to characterize the information diffusion dynamics.On these bases,three synergetic intervention strategies are formulated.Second,we derive the critical threshold of the controlled-SIRS system via stability analysis.Accordingly,we exploit a spectral optimization scheme to minimize the outbreak risk or the required budget.Third,we develop an optimal control scheme of dynamically allocating resources to minimize both system loss and intervention expense,in which the optimal intervention inputs are obtained through optimal control theory and a forward-backward sweep algorithm.Finally,extensive simulation results validate the accuracy of theoretical derivation and the performance of our proposed intervention schemes.

Prognosis and immunological role of HLA-DMA in lung adenocarcinoma

Background:HLA-DMA presents pathogen-derived antigens to CD4+and CD8+T cells,respectively,and plays a significant part in initiating the immune response.So far,the impact of HLA expression on the prognosis of BC cells is controversial,because few studies have shown that the expressions of some HLA genes are related to the improvement of the survival rate.Up till now,however,the relationship between HLA-DMA and LUAD has not yet been assessed.Methods:We analyzed the TCGA database and assessed the prognostic value of HLA-DMA in LUAD.We conducted the Kruskal–Wallis and Wilcoxon signed-rank test and utilized logistic regression to assess the role of clinical-pathologic characteristics and HLA-DMA expression.Kaplan–Meier method and the multivariate and univariate Cox regression were also used for evaluating the prognosis-related factors of LUAD.GSEA was used to identify HLA-DMA-related key pathways.The ssGSEA of the TCGA data was used to investigate the correlations between HLA-DMA and cancer immune cell infiltration.Results:Low HLA-DMA expression was related to poorer disease-specific survival(DSS)and overall survival(OS)of LUAD patients.GSEA revealed that HLA-DMA was tightly interrelated with an immune response by the reactome activation of anterior hox genes in hindbrain development during the early embryogenesis signaling pathway.The expression of HLA-DMA was positively associated with cytotoxic cell infiltration and negatively related to the Th2 cell infiltration according to the ssGSEA.Western blotting and the CCK-8 assay showed that KD-HLA-DMA could significantly increase the proliferation of A549 cells and significantly reduce cell pyroptosis.Conclusion:All the observations implied that HLA-DMA was associated with patient prognosis and immune infiltration in LUAD.

Theoretical study of electron-impact broadening for highly charged Ar XV ion lines

Spectral line widths produced by collisions between charged particles and emitters are of special interest for precise plasma spectroscopy.The highly charged Ar XV ion is demonstrated to have strong intrashell electron interactions,which manifest as an atomic system with many resonance structures,due to the quasi-degeneracy of orbital energies.In this paper we use the relativistic R-matrix method to investigate the electron-impact broadening of highly charged Ar XV ion spectral lines under the impact approximation.It is found that the results considering resonance structures are significantly different from those of the distorted wave approach.Furthermore,we propose a new empirical formula with a correction term to take into account the effect of resonances for electron-impact widths over a relatively wide range of plasma conditions.The corresponding fitting parameters of the new empirical formula for all 47 calculated transitions are also given with an estimated accuracy within 1%,which should be convenient for practical applications.The dataset that supported the findings of this study is available in Science Data Bank,with the link https://doi.org/10.57760/sciencedb.j00113.00101.

Caudate lobe-sparing subtotal hepatectomy as treatment for extensive intrahepatic arterioportal fistula

Intrahepatic arterioportal fistulas(APFs)are abnormal hepatic artery and portal vein(PV)communications that develop as a result of congenital malformation,trauma,ruptured hepatic aneurysm,cirrhosis,tumor-related changes,biopsy,chemotherapy or iatrogenic causes[1,2].The most common symptoms are gastrointestinal bleeding and ascites secondary to portal hypertension;other symptoms include abdominal pain,pyrexia,edema,back pain and jaundice[3].The main goal of therapy is to decrease the portal pressure with variceal bleeding being the absolute indi-cation for surgical management.Transarterial embolization(TAE)should be the first choice to treat APFs,while resection,portocaval shunt and even transplantation may cure APFs in the case of TAE failure[4].In previous reports,caudate lobe-sparing subtotal hep-atectomy(CLSSH)has been applied for the treatment of primary hepatolithiasis and hepatocellular carcinoma[5,6].As far as we know,this is the first report describing CLSSH as treatment for an extensive intrahepatic APF,which involved segments 2 to 8,with corresponding hypertrophy of the caudate lobe.

An Environment-Friendly High-Performance Aqueous Mg-Na Hybrid-Ion Battery Using an Organic Polymer Anode

Aqueous Mg ion batteries(AMIBs)show great potential in energy storage for their advantages of high capacity,abundant resource,and environmental friendliness.However,the development of AMIBs is limited due to the scarcity of suitable anode materials.In this study,a new polymer anode material(PNTAQ)with flower-like nanosheet structure is synthesized for aqueous Mg-Na hybrid-ion battery(AMNHIB).PNTAQ possess carbonyl functional groups which can be oxidized and reduced reversibly in aqueous solution containing alkaline metal ions.PNTAQ displays a discharge specific capacity of 245 mAh g^(−1)at 50 mA g^(−1)in 1 M MgCl_(2)+0.5 M NaCl electrolyte,which is much higher than that in single 1 M MgCl_(2)or 0.5 M NaCl electrolyte.Even cycling at 1000 mA g^(−1)for 1000 times,the capacity retention can still maintain at 87.2%.A full Mg-Na hybrid-ion cell is assembled by employingβ-MnO_(2)as cathode and PNTAQ as anode material,it exhibits a specific capacity of 91.6 mAh g^(−1)at 100 mA g^(−1).The polymer electrode material well maintains its framework structure during the discharge/charge cycling process of the hybrid-ion battery.

Granular cell tumor of the breast:A case report and review of literature

BACKGROUND Granular cell tumor(GCT)of the breast(GCTB)is a rare neoplasm that can exhibit malignant characteristics both clinically and radiologically.This tumor can also coexist and colocalize with breast carcinoma.CASE SUMMARY We present a patient with this uncommon tumor and discuss the diagnostic and therapeutic approaches in order to further the knowledge of GCTB and prevent misdiagnosis and overtreatment.The characteristics of the tumor,methods of diagnosis,therapy and postoperative pathological outcomes were analyzed,and relevant literatures of GCTs were reviewed.The patient underwent surgery after core needle biopsy,and the excised neoplasm was sent for pathological examination.Histological analysis revealed nests of cells with abundant pink granular cytoplasm,confirming the diagnosis of GCTB.CONCLUSION As manifestations of GCT and malignancy can mimic each other,a careful histological examination is essential before major surgery.Treatment consisting of complete excision with close clinical follow-up is recommended.

7例原发膜性肾病合并IgA肾病的临床与病理特点分析

目的探讨膜性肾病合并IgA肾病患者的临床与病理特点。方法回顾分析天津市第一中心医院肾内科2012年1月-2018年2月经肾穿刺活检确诊的7例膜性肾病合并IgA肾病患者的临床和病理特点。结果男性4例,女性3例;年龄28~63岁,平均44.1岁;5例为双下肢浮肿,1例为尿中泡沫增多,1例以尿蛋白增多为主要表现;其中4例临床诊断为肾病综合征,3例诊断为慢性肾小球肾炎,仅1例有高血压病史,6例伴有镜下血尿,7例均有蛋白尿,肾功能均正常。肝炎、自身免疫性疾病、肿瘤等相关检查均为阴性。光光学显微镜下可见肾小球基底膜均弥漫增厚,6例伴有较明显的钉突形成,系膜细胞及系膜基质轻度增生,肾小管及肾间质未见明显病变。电子显微镜下7例毛细血管襻上皮下均见大小不等块状电子致密物沉积,6例可见节段钉突形成,系膜区及系膜旁区均可见少量中度电子致密物沉积。免疫荧光见IgG均沿毛细血管襻颗粒状沉积,IgA系膜区团块状及分支状沉积。免疫组织化学见C4d均沿毛细血管襻颗粒状沉积。结论膜性肾病合并IgA肾病发病率较低,临床以蛋白尿及镜下血尿为主要表现,发病时肌酐大部分正常。光学显微镜下以膜性肾病特点为主,肾小管及肾间质病变轻微,免疫荧光IgA是诊断该病的必要条件,C4d是诊断该病的重要标志物;治疗尚无统一标准,需要更多病例的进一步研究。

Dosimetric Evaluation of Body Contour Changes to Target Volumes and Organs at Risk for Cervix and Head and Neck Radiotherapy Plans

Purpose: To investigate how much dose discrepancy would be caused by the anatomy changes during the radiotherapy (RT) course. Methods: Ten cervical cancer and ten nasopharyngeal carcinoma (NPC) CT datasets from RT patients were enrolled. The body contour from different directions changed to simulate the weight loss or gain for cervical cancer patients, who had been treated with external-beam RT using intensity-modulated radiation therapy (IMRT) or volumetric modulated arc therapy (VMAT). Moreover, the body contour from facial and shoulder superior-inferior positional change had been also assessed for NPC patients using IMRT or VMAT. The new CT (n-CT) was generated by the body contour changes with different directions based on original CT datasets. The dosimetric parameters to target volumes and organs at risk (OARs) were evaluated in Eclipse based on n-CT. Results: The target volumes and OARs were influenced by the body contour changes. Body contour expansion resulted in coverage loss, whereas body contour shrinkage increased the dose to the OARs. These findings were generally consistent for both IMRT and VMAT plans. Over a course of research, the dose to 95% of the target volumes for cervical cancer decreased by up to 2.83% per cm for IMRT and 2.87% per cm for VMAT (P < 0.05). And the influence on H&N plans was that the dose to 95% of the target volumes (low risk regions) decreased by up to 4.45% per cm. Conclusions: The RT staff could determine whether resimulation and replaning or not according to which body contour directions were changed.

HOXD3在乳腺癌细胞干性和化疗耐药性中的作用及机制研究

目的:探讨HOXD3表达对乳腺癌细胞干性的影响,并研究HOXD3表达与乳腺癌细胞化疗耐药的关系。方法:收集2006年1月至2008年12月哈尔滨医科大学附属肿瘤医院87例乳腺癌患者组织标本。采用免疫组织化学染色法检测乳腺癌细胞和组织中HOXD3表达;采用RT-PCR、Western blot和免疫荧光染色法检测HOXD3在顺铂或阿霉素耐药细胞系MDA-MB-231和MDA-MB-435中的表达水平,分析HOXD3过表达对乳腺癌细胞系MDA-MB-231和MDA-MB-435的干细胞生物标志物表达水平的影响;采用MTT法和集落形成实验分析HOXD3在乳腺癌细胞化疗耐药中的作用。结果:乳腺癌组织中HOXD3 m RNA相对表达量显著高于癌旁正常组织,乳腺癌细胞系MDA-MB-231、MDA-MB-435和MCF-7的HOXD3 m RNA相对表达量均高于正常乳腺上皮细胞系MCF-10A(均P<0.05)。顺铂或阿霉素耐药的细胞系MDA-MB-231和MDA-MB-435的半抑制浓度(half maximal inhibi-tory concentration,IC50)分别为(20.82±0.05)μmol/L和(19.69±0.47)μmol/L,或(32.26±0.23)mmol/L和(26.08±0.55)mmol/L,均高于对应原始细胞系(均P<0.05);耐药倍数分别为2.47和3.10倍,或1.86和2.08倍。HOXD3过表达MDA-MB-231、MDA-MB-435的肿瘤球体数目、干细胞生物标志物的表达水平均明显增加(均P<0.05)。结论:HOXD3过表达对乳腺癌细胞干性的维持及化疗耐药性的发生发挥重要的作用,为制定针对肿瘤干细胞的分子靶向治疗提供理论参考。