广州女性低剂量CT肺癌筛查结果及高危因素探索

背景与目的肺癌高居中国恶性肿瘤发病率和死亡率之首。既往肺癌筛查试验大多为针对吸烟者等高危人群的选择性筛查,然而亚洲肺癌病例非吸烟女性占相当比例。本研究旨在评估广州市社区女性的肺癌患病率并探究肺癌高危因素。方法采用胸部低剂量计算机断层扫描(low-dose computed tomography,LDCT)对广州市40-74岁女性居民行肺癌筛查,并根据2018版《中国肺癌低剂量螺旋CT筛查指南》对肺结节进行分类管理及计算阳性结节和肺癌检出率。筛查对象在行检查前均须完成“肺癌危险因素调研问卷”,后对问卷危险因素进行最小绝对收缩和选择算子惩罚Logistic回归分析。结果分析共纳入6256名女性,发现阳性结节1228例(19.63%),确诊肺癌117例(1.87%),其中原位癌6例,I期103例(占肺癌比例88.03%)。根据问卷变量行最小绝对收缩和选择算子(Least absolute shrinkage and selection operator,LASSO)惩罚Logistic回归分析发现,年龄≥50岁(OR=1.07,95%CI:1.06-1.07)、个人恶性肿瘤史(OR=3.29,95%CI:3.22-3.37)、纺织职业(OR=1.10,95%CI:1.08-1.13)、小时候使用煤为燃料(OR=1.14,95%CI:1.13-1.16)以及食物过敏史(OR=1.10,95%CI:1.07-1.13)是该地区女性肺癌的高危因素。结论胸部LDCT可以发现大量早期肺癌,可用于女性肺癌筛查。年龄≥50岁、个人恶性肿瘤史、纺织职业、小时候使用煤为燃料和食物过敏史是该地区女性人群肺癌的高危因素,需提高该群体对肺癌早筛的重视程度。

A novel square planar N_(4)^(2-)ring with aromaticity in BeN_(4)

A structural search leads to the prediction of a novel alkaline earth nitride BeN_(4)containing a square planar N_(4)^(2-)ring.This compound has a particular chemical bonding pattern giving it potential as a high-energy-density material.The P4/nmm phase of BeN_(4)may be stable under ambient conditions,with a bandgap of 3.72 eV.It is predicted to have high thermodynamic and kinetic stability due to transfer of the outer-shell s electrons of the Be atom to the N_(4)cluster,with the outer-shell 2p orbital accommodating the lone-pair electrons of N_(4)^(2-).The total of sixπelectrons is the most striking feature,indicating that the square planar N_(4)^(2-)exhibits aromaticity.Under ambient conditions,BeN_(4)has a high energy density(3.924 kJ/g relative to Be3N2 and N2 gas),and its synthesis might be possible at pressures above 31.6 GPa.

Regulation of Ionic Bond in GroupⅡB Transition Metal Iodides

Using a swarm intelligence structure search method combining with first-principles calculations,three new structures of Zn-I and Hg-I compounds are discovered and pressure-composition phase diagrams are determined.An interesting phenomenon is found,that is,the compounds that are stable at 0 GPa in both systems will decompose into their constituent elements under certain pressure,which is contrary to the general intuition that pressure always makes materials more stability and density.A detailed analysis of the decomposition mechanism reveals the increase of formation enthalpy with the increase of pressure due to contributions from bothΔU andΔ[P V].Pressure-dependent studies of theΔV demonstrate that denser materials tend to be stabilized at higher pressures.Additionally,charge transfer calculations show that external pressure is more effective in regulating the ionic bond of Hg-I,resulting in a lower decomposition pressure for HgI_(2)than for ZnI_(2).These findings have important implications for designs and syntheses of new materials,as they challenge the conventional understanding on how pressure affects stability.

A new transition metal diphosphideα-MoP_(2) synthesized by a high-temperature and high-pressure technique

Monoclinicα-MoP_(2),with the OsGe2-type structure(space group C2/m,Z=4)and lattice parameters a=8.7248(11)Å,b=3.2322(4)Å,c=7.4724(9)Å,andβ=119.263°,was synthesized under a pressure of 4~GPa at a temperature between 1100℃and 1200℃.The structure ofα-MoP_(2) and its relationship to other transition metal diphosphides are discussed.Surprisingly,the ambient pressure phase orthorhombicβ-MoP_(2)(space group Cmc21)is denser in structure thanα-MoP_(2).Room-temperature high-pressure x-ray diffraction studies exclude the possibility of phase transition fromβ-MoP_(2) to α-MoP_(2),suggesting thatα-MoP_(2) is a stable phase at ambient conditions;this is also supported by the total energy and phonon calculations.

Evidence for a High-Pressure Isostructural Transition in Nitrogen

We observed an isostructural phase transition in the solid nitrogen λ-N_(2) at approximately 50 GPa accompanied by anomalies in lattice parameters,atomic volume and Raman vibron modes.The anomalies are ascribed to a slight reorientation of the nitrogen molecules,which does not seem to affect the monoclinic symmetry(space group P2_(1)/c).Our ab initio calculations further confirm the phenomena,and suggest an optimized structure for the λ-N_(2) phase.In addition,a new high-pressure amorphous phase of η′-N_(2) was also discovered by a detailed investigation of the pressure-temperature phase diagram of nitrogen with the aim of probing the phase stability of λ-N_(2).Our result may provide helpful information about the crystallographic nature of dissociation transitions in diatomic molecular crystals(H_(2),O_(2),N_(2),etc).

EGFR-mutant non-small cell lung cancer patients harboring CDK4 amplification show favorable response to afatinib:Two case reports

To the Editor:Epidermal growth factor receptor tyrosine kinase inhibitors(EGFR-TKIs)show significant efficacy in patients with advanced-stage non-small cell lung cancer(NSCLC)with sensitive EGFR mutations and significantly prolong the survival of these patients.However,drug resistance emerges in most patients.Previous studies indicated that cyclin-dependent kinase 4/6(CDK4/6)gene amplification was one of the resistance mechanisms of the EGFR-TKI osimertinib,weakening its efficacy.Treatment options for EGFR-mutant NSCLC patients with CDK4 amplification are limited to add CDK4 inhibitors.

Light at night and lung cancer risk:A worldwide interdisciplinary and time-series study

Background:Light at night(LAN)has become a concern in interdisciplinary research in recent years.This global interdisciplinary study aimed to explore the exposure-lag-response association between LAN exposure and lung cancer incidence.Methods:LAN data were obtained from the Defense Meteorological Satellite Program’s Operational Linescan System.Data of lung cancer incidence,socio-demographic index,and smoking prevalence of populations in 201 countries/territories from 1992 to 2018 were collected from the Global Burden of Disease Study.Spearman correlation tests and population-weighted linear regression analysis were used to evaluate the correlation between LAN exposure and lung cancer incidence.A distributed lag nonlinear model(DLNM)was used to assess the exposure-lag effects of LAN exposure on lung cancer incidence.Results:The Spearman correlation coefficients were 0.286-0.355 and the population-weighted linear regression correlation coefficients were 0.361-0.527.After adjustment for socio-demographic index and smoking preva-lence,the Spearman correlation coefficients were 0.264-0.357 and the population-weighted linear regression correlation coefficients were 0.346-0.497.In the DLNM,the maximum relative risk was 1.04(1.02-1.06)at LAN exposure of 8.6 with a 2.6-year lag time.After adjustment for socio-demographic index and smoking prevalence,the maximum relative risk was 1.05(1.02-1.07)at LAN exposure of 8.6 with a 2.4-year lag time.Conclusion:High LAN exposure was associated with increased lung cancer incidence,and this effect had a specific lag period.Compared with traditional individual-level studies,this group-level study provides a novel paradigm of effective,efficient,and scalable screening for risk factors.

Downshift of d-states and the decomposition of silver halides

The ionicity of ionic solids is typically characterized by the electronegativity of the constituent ions.Electronegativity measures the ability of electron transfer between atoms and is commonly considered under ambient conditions.Howeve r,external stresses profoundly change the ionicity,and compressed ionic compounds may behave differently.Here,we focus on silver halides,with constituent ions from one of the most electropositive metals and some of the most electronegative nonme tals.Using first-principles calculations,we find that the strengths of the ionic bonds in these compounds change greatly under pressure owing to downshifting of the Ag 4d-orbital.The center of this orbital is lowered to fill the antibonding state below the Fermi level,leading to chemical decomposition.Our results suggest that under pressure,the orbital energies and correspondingly the electronegativities still tune the ionicity and control the electron transfer,ionicity,and reactivity of both the metal and the nonmetal elements.However,the effects of orbital energies start to become dominant under pressure,causing substantial changes to the chemistry of ionic compounds and leading to an unusual phenomenon in which elements with substantial electronegativity differences,such as Ag and Br,do not necessarily form ionic compounds,but remain in their elemental forms.

Structural and optical properties of Dy^(3+):YAlO3 phosphors for yellow light-emitting diode applications

The spectroscopic properties of a series of Dy^(3+)single-doped and Dy^(3+)/Nd^(3+),Dy^(3+)/Tb^(3+),and Dy^(3+)/Tm^(3+)co-doped YAlO_(3)(yttrium aluminum perovskite,YAP)phosphors were investigated and compared through the measurements of optical absorption,emission spectra,and fluorescence decay curves.For the Dy^(3+)ion single-doped samples,the intensity of each absorption band increases with an increment in Dy^(3+)ion doping concentration,and the identified strong absorption peak at 447 nm indicates that Dy^(3+):YAP phosphors are suitable to be pumped by a blue laser diode(LD).For all co-doped samples,absorption peaks of Dy^(3+)ion along with some of the absorption bands of Nd^(3+),Tb^(3+),and Tm^(3+)ions are observed.Under 351 and 447 nm excitation,a prominent emission peak at 572 nm was obtained in all the samples,corresponding to Dy^(3+):^(4)F_(9/2)→^(6)H_(13/2)transition.Here,2 at%Dy^(3+):YAP phosphor exhibits the highest yellow emission intensity under 447 nm pumping.Among the three kinds of Dy^(3+)co-doped phosphors,Dy^(3+)/Tb^(3+):YAP phosphor possesses the dominant yellow emission.The fluorescence decay curves show exponential behaviour and are fitted well.The Commission International de L’Eclairage(CIE)chromaticity coordinates were calculated following the respective emission spectra,and it is found that all the coordinates locate in the yellow region.The energy transfer(ET)processes were investigated and the concentration quenching mechanism was discussed.The obtained results suggest that Dy^(3+)-activated YAP phosphors are good candidates for yellow LED applications.

Progress in studies on bulk metallic glasses in China

Bulk metallic glasses (BMGs) are a new class of metallic materials possessing a unique microstructure without long-rangeorder, in contrast to crystalline solids which have periodic arrangements of atoms in space. Since the successful production ofbulk metallic glasses by copper mold casting around the end of the 1980s, great enthusiasm in the study on this new class

The activity and immune dynamics of PD-1 inhibition on high-risk pulmonary ground glass opacity lesions:insights from a single-arm,phase II trial

Immune checkpoint inhibitors targeting the programmed cell death-1(PD-1)protein significantly improve survival in patients with advanced non-small-cell lung cancer(NSCLC),but its impact on early-stage ground-glass opacity(GGO)lesions remains unclear.This is a single-arm,phase II trial(NCT04026841)using Simon’s optimal two-stage design,of which 4 doses of sintilimab(200 mg per 3 weeks)were administrated in 36 enrolled multiple primary lung cancer(MPLC)patients with persistent high-risk(Lung-RADS category 4 or had progressed within 6 months)GGOs.The primary endpoint was objective response rate(ORR).T/B/NK-cell subpopulations,TCR-seq,cytokines,exosomal RNA,and multiplexed immunohistochemistry(mIHC)were monitored and compared between responders and non-responders.Finally,two intent-to-treat(ITT)lesions(pure-GGO or GGO-predominant)showed responses(ORR:5.6%,2/36),and no patients had progressive disease(PD).No grade 3-5 TRAEs occurred.The total response rate considering two ITT lesions and three non-intent-to-treat(NITT)lesions(pure-solid or solid-predominant)was 13.9%(5/36).The proportion of CD8^(+)T cells,the ratio of CD8^(+)/CD4^(+),and the TCR clonality value were significantly higher in the peripheral blood of responders before treatment and decreased over time.Correspondingly,the mIHC analysis showed more CD8^(+)T cells infiltrated in responders.Besides,responders’cytokine concentrations of EGF and CTLA-4 increased during treatment.The exosomal expression of fatty acid metabolism and oxidative phosphorylation gene signatures were down-regulated among responders.Collectively,PD-1 inhibitor showed certain activity on high-risk pulmonary GGO lesions without safety concerns.Such effects were associated with specific T-cell re-distribution,EGF/CTLA-4 cytokine compensation,and regulation of metabolism pathways.

外源酚酸诱导枳菌根共生相关基因筛选

【目的】基于丛枝菌根(AM)真菌改变柑橘酚类现象,筛选外源酚酸诱导菌根共生差异基因,分析酚相关基因功能。【方法】以枳(Poncirus trifoliate L.)接种AM真菌,并施加外源酚酸,采用随机引物扩增,获得差异表达片段;继而克隆酚相关基因并进行生物信息学分析。【结果】试验采用20条随机引物和3条锚定引物扩增cDNA,共获得了154条差异显示的表达片段;对其中16条Northern杂交显示阳性的片段测序与比对,发现9条有相关功能注释,参与环境因子及内源信号的识别,调节共生体的形成;DD-11基因只有在外源酚酸添加和接种AM真菌的根系中表达,该片段cDNA全长序列长度为1382 bp,编码454个氨基酸,分子式为C2210H3427N603O657S31,其理论等电点和相对分子量分别为7.81和49950.03;磷酸化分析发现,该蛋白有22个丝氨酸残基、14个苏氨酸残基及7个酪氨酸残基可能成为蛋白激酶磷酸化位点。通过PredictProtein服务器对DD-11蛋白质的二级结构进行分析,该蛋白含有α螺旋22%、无规则卷曲58%、延伸链20%,不含有β折叠结构。【结论】本试验获得菌根共生过程酚相关基因,其功能与植物内源信号识别密切相关,为探讨酚类在菌根共生过程中的分子机制提供了新的视角。

The impact of postoperative EGFR-TKIs treatment on residual GGO lesions after resection for lung cancer

Dear Editor,In recent years,the incidence of multifocal lung cancer is increasing,called multiple primary lung cancer(MPLC).Synchronous MPLC(sMPLC)is defined by multiple malignant lesions occurring at the same time.1 In clinical practice,it was always extremely difficult to remove all lesions simultaneously for sMPLC patients.However,unresected GGO lesions after primary surgery frequently caught the risk of progression.

Predilection site and risk factor of second primary cancer:A pancancer analysis based on the SEER database

To the Editor:Over the past few years,the number of cancer survivors has continued to increase,primarily driven by the growing and aging population and the improvements in cancer detection and treatment.More than 16.9 million Americans with prior cancers were alive on January 1,2019,and the number of cancer survivors was estimated to reach>22.1 million by January 1,2030.[1]The lifetime risk of individual second primary cancer(SPC)has been confirmed when confronted with such a large amount of cancer survivors.[2]Definition of specific site is shown in supplementary material,http://links.lww.com/CM9/B616.

Asian,regional,and national burdens of respiratory tract cancers and associated risk factors from 1990 to 2019:A systematic analysis for the global burden of disease study 2019

Background:Respiratory cancer is the leading cause of cancer-related deaths worldwide,but its statistics vary between the East and West.This study aimed to estimate the burdens of tracheal,bronchus,and lung(TBL)cancer and larynx cancer and their attributable risks from 1990 to 2019 in Asia,and at regional and national levels.Methods:This research evaluated the incidence,mortality,years lived with disability,years of life lost,and disability-adjusted life years(DALYs)for respiratory tract cancers using the Global Burden of Diseases,Injuries,and Risk Factors Study(GBD)2019 database.Age-standardized rates were calculated for TBL cancer from 1990 to 2019,adjusted for smoking and socio-demographic index(SDI).Deaths from TBL cancer and larynx cancer attributable to each risk factor were estimated for 33 Asian countries.Results:The age-standardized incidence and death rates for TBL cancer in Asia declined from 2010 to 2019,while the incidence rate of larynx cancer increased.Smoking was the leading specific risk factor for deaths from both TBL and larynx cancers.The burden of TBL cancer in Asian countries was influenced by SDI and smoking,particularly among males in Central Asia.Deaths,DALYs,and incidences of larynx cancer in East Asia had not changed significantly over the past 30 years,but showed slight downward trends in males and both sexes combined,and an upward trend in females in recent years.Conclusions:The past decade saw increases in numbers of incident cases and deaths from TBL cancer and larynx cancer in Asia.SDI and smoking were the main factors influencing the disease burden of TBL cancer in Asian countries.This study highlights the need for tailored cancer control programs to address the burden of respiratory tract cancers in different Asian countries.