乳腺癌合并间质性肺疾病患者的临床特征及治疗情况

目的分析乳腺癌合并间质性肺疾病(ILD)患者的临床特征及治疗情况。方法收集76例乳腺癌患者的病历资料,分析其临床特征、检查结果、抗肿瘤药物的使用、ILD的发生及治疗情况。结果76例乳腺癌合并ILD患者中,9例患者无明显症状,其余67例均存在呼吸道等方面的症状;胸部CT检查均呈现不同程度的间质改变,其中52例患者表现为不同程度的低氧血症和呼吸衰竭;患者接受系统性化疗46例,靶向药物27例,恩美曲妥珠单抗2例,内分泌药物氟维司群1例;紫杉类药物ILD发生情况最多,靶向药物中依维莫司ILD发生情况最多,内分泌药物ILD发生情况最少;9例患者不良事件通用术语标准(CTCAE)分级为1级,59例CTCAE分级为2级,8例患者CTCAE分级为3级;所有患者经过治疗后ILD情况均明显好转。结论引起ILD的抗肿瘤药物主要以紫杉类及吉西他滨等细胞毒性药物和雷帕霉素靶蛋白(MTOR)抑制剂靶向药物为主。掌握ILD患者的临床特征及治疗方法,并有针对性地为乳腺癌合并ILD患者选择适宜的治疗方案,既可以增加药物疗效,也可以减少药物的不良反应,改善患者预后。

利拉鲁肽对糖尿病合并心肌梗死小鼠心功能的影响及其作用机制

目的探讨利拉鲁肽对糖尿病合并心肌梗死小鼠心功能的影响及其作用机制。方法按随机数字表法将75只KM雄性小鼠分为对照组15只和模型处理组60只。对模型处理组的60只小鼠建立糖尿病小鼠模型,建模成功后再按随机数字表法选取模型处理组的45只小鼠建立糖尿病合并心肌梗死小鼠模型,剩余的15只小鼠作为假手术组,且仅对小鼠开胸而不结扎冠状动脉。将45只糖尿病合并心肌梗死小鼠模型按随机数字表法分为模型组(n=15)、心梗干预组(n=15)、糖干预组(n=15),给予心梗干预组小鼠灌胃硫酸氢氯吡格雷+阿托伐他汀钙片干预,给予糖干预组小鼠腹腔注射利拉鲁肽注射液干预,其余小鼠均不做特殊处理。干预7d后,使用心电图机观察各组小鼠的心电图,采用HE染色及2,3,5-氯化三苯四氮唑染色观察各组小鼠的病理情况及心肌梗死面积,采用Western blot检测各组小鼠心肌组织磷脂酰肌醇3-激酶(PI3K)、蛋白激酶B(AKT)、糖原合成酶激酶3β(GSK-3β)的蛋白表达量。结果(1)对照组、假手术组小鼠心电图无明显异常,模型组小鼠心电图存在明显的ST段抬高及变异T波,心梗干预组、糖干预组小鼠心电图ST段抬高及变异T波较模型组明显改善,且心梗干预组的改善效果优于糖干预组。(2)对照组、假手术组小鼠心肌纤维排列整齐紧凑,心肌细胞形态完整;相比于对照组、假手术组,模型组小鼠心肌组织可见梗死区,梗死周边区域心肌细胞形态不完整,排列混乱,有大量炎症细胞浸润和纤维组织增生;相比于模型组,心梗干预组和糖干预组小鼠上述病理改变程度均得到改善,心梗干预组改善程度优于糖干预组。(3)与对照组相比,假手术组小鼠心肌梗死区面积百分比无明显变化(P>0.05);与对照组和假手术组相比,模型组小鼠的心肌梗死区面积百分比明显增加(P<0.05);与模型组相比,心梗干预组与糖干预组小鼠的心肌梗死区面积百分比均减少(P<0.05),且心梗干预组小鼠的心肌梗死区面积百分比小于糖干预组,但差异无统计学意义(P>0.05)。(4)与对照组相比,假手术组小鼠心肌组织的PI3K、AKT和GSK-3β蛋白表达量升高,而模型组小鼠心肌组织的AKT蛋白表达量降低,GSK-3β蛋白表达量则升高(P<0.05),PI3K蛋白表达量的变化无统计学意义(P>0.05);与模型组相比,糖干预组小鼠心肌组织的PI3K、AKT和GSK-3β蛋白表达量升高,而心梗干预组小鼠心肌组织的PI3K、AKT蛋白表达量升高(P<0.05),但GSK-3β蛋白表达量变化无统计学意义(P>0.05);与心梗干预组小鼠相比,糖干预组小鼠心肌组织的AKT、GSK-3β蛋白表达量升高(P<0.05),而PI3K蛋白表达量的变化无统计学意义(P>0.05)。结论利拉鲁肽可改善糖尿病合并心肌梗死小鼠模型的心功能损伤、心肌梗死面积及心肌间质纤维化,其可能通过PI3K/AKT信号通路调节GSK-3β的表达而发挥作用。

钢轨轨底裂纹扩展影响因素分析

【目的】为分析钢轨材质、残余应力、温度应力在钢轨使用中的内外因对轨底裂纹扩展的影响开展研究。【方法】基于断裂力学理论结合轨底伤损实测,建立钢轨轨底裂纹扩展模型,对轨底伤损扩展失效时的临界裂纹尺寸、裂纹平均扩展速率、剩余寿命等指标进行量化分析。【结果】结果表明:钢轨材料断裂韧性与轨底初始伤损扩展的剩余寿命存在正相关关系,U95Cr H材质钢轨的轨底裂纹扩展剩余寿命小于U78CrV H材质小于U75V H材质;以某线路实际使用的钢轨材质U78CrV H为例,轨底残余应力由0增加至300 MPa,轨底裂纹扩展的临界尺寸增长约2.5%,剩余寿命下降约6%;残余应力为200 MPa时,温度应力由0增加至200 MPa,轨底裂纹扩展的临界尺寸变化不大,在1%内。【结论】研究结果可为轨底裂纹扩展研究和养护维修提供参考。

血乳酸、IL-6联合SOFA评分对脓毒症患者28 d死亡风险的预测价值

目的:探讨血乳酸、IL-6联合序贯器官衰竭评估(SOFA)对脓毒症患者28 d死亡风险的预测价值。方法:回顾性分析2015年7月至2023年7月新疆医科大学第二附属医院重症医学科收治的145例脓毒症患者的临床资料,所有患者入院后完善血气分析及血常规等实验室检查,并进行SOFA评分。所有患者随访28 d,根据患者是否存活分为生存组46例和死亡组99例,比较两组血乳酸、IL-6及SOFA评分的区别,单因素和多因素Logistic回归分析临床基本资料,确定脓毒症患者死亡的独立影响因素,Spearman相关性分析血乳酸、IL-6及SOFA评分与脓毒症患者死亡的相关性,利用受试者工作特征(ROC)曲线评估血乳酸、IL-6、SOFA评分及三者联合检测对脓毒症患者死亡风险的预测价值。最后,基于R语言采用Bootstrap法对模型重抽样500次后,绘制校准曲线及临床决策曲线。结果:脓毒症死亡组患者血乳酸水平、IL-6及SOFA评分均明显高于生存组,差异均具有统计学意义(P<0.05)。脓毒症患者病死率为68%(99/145)。单因素Logistic回归分析显示,糖尿病、血乳酸、IL-6、SOFA评分是导致脓毒症患者死亡的相关因素。多因素Logistic回归分析显示,高SOFA评分、有糖尿病、高血乳酸、高IL-6是导致脓毒症患者死亡的独立危险因素。血乳酸、IL-6、SOFA评分与脓毒症患者死亡呈正相关,ROC曲线分析结果表明,血乳酸、IL-6、SOFA评分及三者联合检测预测脓毒症患者死亡的AUC依次为0.863、0.850、0.897、0.949。血乳酸最佳截断值为2.950 mmol/L时,诊断敏感度为77.800%,特异度为89.100%;IL-6最佳截断值为100.970 pg/mL时,诊断敏感度为70.700%,特异度91.300%;SOFA评分最佳截断值为7.500分时,诊断敏感度为93.900%,特异度为80.400%;三者联合检测的敏感度为90.900%,特异度为89.100%。结论:血乳酸、IL-6、SOFA评分升高是脓毒症患者死亡的独立危险因素,此次构建的临床预测模型的准确度及临床适用度较高,三者联合检测对脓毒症患者的预后分析具有良好的预测价值。

密花美登木化学成分及抗肿瘤活性研究

目的:研究卫矛科美登木属植物密花美登木Maytenus confertiflora J.Y.Luo et X.X.Chen茎叶的化学成分及其体外抗肿瘤活性。方法:采用正相硅胶、Sephadex LH-20葡聚糖凝胶、MCI以及Semi-Prep HPLC对密花美登木醇提物进行分离纯化,并采用MTT法对三萜化合物进行体外抗肿瘤活性评价。结果:从密花美登木中分离得到17个化合物,分别鉴定为:tridec-1-ene(1)、bis(2-ethylhexyl)phthalate(2)、二十五烷(3)、β-amyrenone(4)、3-hydroxyfriedel-3-en-2-one(5)、β-谷甾醇(6)、28,29-dihydroxyfriedelan-3-one(7)、friedelin(8)、3α-hydroxyfriedel-2-one(9)、3-oxofriedelan-28-oic acid(10)、canophyllol(11)、3-oxo-29-hydroxyfiedelane(12)、pentadecanoic acid(13)、华中冬青素(14)、lingueresinol(15)、飞龙掌血内酯(16)、橙黄胡椒酰胺乙酸酯(17)。结论:所有化合物均为首次从该植物中分离得到。化合物7对Eca-109、EJ细胞具有较强抑制作用,其IC_(50)分别为27.67、30.09μmol/L;化合物12对HepG_(2)、PANC-1细胞均具有较好的抑制作用,其IC_(50)分别为49.42、51.87μmol/L。

基于残差神经网络的鸡蛋分类识别研究

【目的】探究残差神经网络(residual neural network,ResNet)对不同种类鸡蛋的分类效果,明确深度学习应用存在智能鸡蛋巡检装置的可行性,为家禽养殖智能化进程提供新思路,并为鸡蛋分类研究提供数据支撑。【方法】在鸡舍实地取样,采用自适应矩估计优化器(adaptive moment estimation,Adam)以微调最后1层、微调所有层和重新训练所有层3种迁移学习策略分别训练,并通过调整模型权重参数及改变学习率的方式训练出最佳分类模型。【结果】得到识别准确率高达98.971%的鸡蛋分类模型。计算出模型在数据集上的各类评估指标,并借助混淆矩阵及语义特征降维可视化,分析出鸡蛋分类识别中易被误判的类别及语义。该模型部署后实时性良好,满足实际需求。【结论】鸡蛋的分类识别中光照条件是关键影响因素,应尽可能使鸡舍光照稳定均衡。针对6类鸡蛋,微调所有层并调整学习率参数为0.6,可得最佳模型。其在鸡舍场景下分类效果优良,尤其是颜色语义,应用于智能鸡蛋巡检装置,可有效降低人力成本。后续研究中应注重畸形蛋及软壳蛋的记录,为进一步优化提供数据支撑。

基于差值信噪比法的船载地波雷达一阶谱识别

本文提出了适用于船载地波雷达展宽一阶谱识别的差值信噪比方法。通过结合仿真分析和实测试验数据,开展了船载地波雷达展宽一阶谱的频移和展宽特性分析,确定了一阶谱的最大展宽范围与平台运动速度之间的定量关系。通过分析一维多普勒频点间的差值数量关系,确定了边界预筛选准则。利用展宽一阶谱的区域连续特性,实现展宽一阶谱边界最终识别。采用船载地波雷达仿真和实测数据对所提方法的有效性进行了验证,所提方法相对于传统方法取得了较好的识别效果。

Two-photon live imaging of direct glia-to-neuron conversion in the mouse cortex

Over the past decade,a growing number of studies have reported transcription factor-based in situ reprogramming that can directly conve rt endogenous glial cells into functional neurons as an alternative approach for n euro regeneration in the adult mammalian central ne rvous system.Howeve r,many questions remain regarding how a terminally differentiated glial cell can transform into a delicate neuron that forms part of the intricate brain circuitry.In addition,concerns have recently been raised around the absence of astrocyte-to-neuron conversion in astrocytic lineage-tra cing mice.In this study,we employed repetitive two-photon imaging to continuously capture the in situ astrocyte-to-neuron conversion process following ecto pic expression of the neural transcription factor NeuroD1 in both prolife rating reactive astrocytes and lineage-tra ced astrocytes in the mouse cortex.Time-lapse imaging over several wee ks revealed the ste p-by-step transition from a typical astrocyte with numero us short,tapered branches to a typical neuro n with a few long neurites and dynamic growth cones that actively explored the local environment.In addition,these lineage-converting cells were able to migrate ra dially or to ngentially to relocate to suitable positions.Furthermore,two-photon Ca2+imaging and patch-clamp recordings confirmed that the newly generated neuro ns exhibited synchronous calcium signals,repetitive action potentials,and spontaneous synaptic responses,suggesting that they had made functional synaptic connections within local neural circuits.In conclusion,we directly visualized the step-by-step lineage conversion process from astrocytes to functional neurons in vivo and unambiguously demonstrated that adult mammalian brains are highly plastic with respect to their potential for neuro regeneration and neural circuit reconstruction.

Establishing VIGS and CRISPR/Cas9 techniques to verify RsPDS function in radish

Virus-induced gene silencing(VIGS)and clustered regularly interspaced short palindromic repeats/CRISPR-associated protein(CRISPR/Cas)systems are effective technologies for rapid and accurate gene function verification in modern plant biotechnology.However,the investigation of gene silencing and editing in radish remains limited.In this study,a bleaching phenotype was generated through the knockdown of RsPDS using tobacco rattle virus(TRV)-and turnip yellow mosaic virus(TYMV)-mediated gene silencing vectors.The TYMV-mediated gene silencing efficiency was higher than the TRV-based VIGS system in radish.The expression level of RsPDS was significantly inhibited using VIGS in'NAU-067'radish leaves.The rootless seedlings of‘NAU-067'were infected with Agrobacterium rhizogenes using the 2300GN-Ubi-RsPDS-Cas9 vector with two target sequences.Nine adventitious roots were blue with GUs staining,and four of these adventitious roots were edited at target sequence 1 of the RsPDS gene as indicated by Sanger sequencing.Furthermore,albino lines were generated with A.tumefaciens-mediated transformation of radish cotyledons.Five base substitutions and three base deletions occurred at target sequence 2 in Line 1,and three base insertions and three base substitutions occurred at target sequence 1 in Line 2.This study shows that VIGS and CRISPR/Cas9 techniques can be employed to precisely verify the biological functions of genes in radish,which will facilitate the genetic improvement of vital horticultural traits in radish breeding programs.

A review of in situ carbon mineralization in basalt

Global warming has greatly threatened the human living environment and carbon capture and storage(CCS)technology is recognized as a promising way to reduce carbon emissions.Mineral storage is considered a reliable option for long-term carbon storage.Basalt rich in alkaline earth elements facilitates rapid and permanent CO_(2) fixation as carbonates.However,the complex CO_(2)-fluid-basalt interaction poses challenges for assessing carbon storage potential.Under different reaction conditions,the carbonation products and carbonation rates vary.Carbon mineralization reactions also induce petrophysical and mechanical responses,which have potential risks for the long-term injectivity and the carbon storage safety in basalt reservoirs.In this paper,recent advances in carbon mineralization storage in basalt based on laboratory research are comprehensively reviewed.The assessment methods for carbon storage potential are introduced and the carbon trapping mechanisms are investigated with the identification of the controlling factors.Changes in pore structure,permeability and mechanical properties in both static reactions and reactive percolation experiments are also discussed.This study could provide insight into challenges as well as perspectives for future research.

In situ observation of the phase transformation kinetics of bismuth during shock release

A time-resolved x-ray diffraction technique is employed to monitor the structural transformation of laser-shocked bismuth.Results reveal a retarded transformation from the shock-induced Bi-Ⅴphase to a metastable Bi-Ⅳphase during the shock release,instead of the thermodynamically stable Bi-Ⅲphase.The emergence of the metastable Bi-Ⅳphase is understood by the competitive interplay between two transformation pathways towards the Bi-Ⅳand Bi-Ⅲ,respectively.The former is more rapid than the latter because the Bi-Ⅴto B-Ⅳtransformation is driven by interaction between the closest atoms while the Bi-Ⅴto B-Ⅲtransformation requires interaction between the second-closest atoms.The nucleation time for the Bi-Ⅴto Bi-Ⅳtransformation is determined to be 5.1±0.9 ns according to a classical nucleation model.This observation demonstrates the importance of the formation of the transient metastable phases,which can change the phase transformation pathway in a dynamic process.

Establishment of a system for screening and identification of novel bactericide targets in the plant pathogenic bacterium Xanthomonas oryzae pv. oryzae using Tn-seq and SPR

Xanthomonas spp. cause severe bacterial diseases. However, effective strategies for prevention and management of these diseases are scarce. Thus, it is necessary to improve the efficiency of control of diseases caused by Xanthomonas. In this study, Xanthomonas oryzae pv. oryzae(Xoo), which causes rice bacterial leaf blight, has been studied as a representative. A transposon insertion library of Xoo, comprising approximately 200,000 individual insertion mutants, was generated. Transposon sequencing data indicated that the mariner C9 transposase mapped at 35.7–36.4% of all potential insertion sites, revealing 491 essential genes required for the growth of Xoo in rich media. The results show that, compared to the functions of essential genes of other bacteria, the functions of some essential genes of Xoo are unknown, 25 genes might be dangerous for the Xanthomonas group, and 3 are specific to Xanthomonas. High-priority candidates for developing broad-spectrum, Xanthomonas-specific, and environment-friendly bactericides were identified in this study. In addition, this study revealed the possible targets of dioctyldiethylenetriamine using surface plasmon resonance(SPR) in combination with high performance liquid chromatography–mass spectrometry(HPLC–MS). The study also provided references for the research of some certain bactericides with unknown anti-bacterial mode of action. In conclusion, this study urged a better understanding of Xanthomonas,provided meaningful data for the management of bacterial leaf blight, and disclosed selected targets of a novel bactericide.

Mechanical Performance of Bio-inspired Bidirectional Corrugated Sandwich Pressure Shell Under External Hydrostatic Pressure

This paper aims to enhance the compression capacity of underwater cylindrical shells by adopting the corrugated sandwich structure of cuttlebone.The cuttlebone suffers uniaxial external compression,while underwater cylindrical shells are in a biaxial compressive stress state.To suit the biaxial compressive stress state,a novel bidirectional corrugated sandwich structure is proposed to improve the bearing capacity of cylindrical shells.The static and buckling analysis for the sandwich shell and the unstiffened cylindrical shell with the same volume-weight ratio are studied by numerical simulation.It is indicated that the proposed sandwich shell can effectively reduce the ratio between circumferential and axial stress from 2 to 1.25 and improve the critical buckling load by about 1.63 times.Numerical simulation shows that optimizing and adjusting the structural parameters could significantly improve the advantage of the sandwich shell.Then,the hydrostatic pressure tests for shell models fabricated by 3D printing are carried out.According to the experimental results,the overall failure position of the sandwich shell is at the center part of the sandwich shell.It has been found the average critical load of the proposed sandwich shell models exceeds two times that of the unstiffened shell models.Hence,the proposed bio-inspired bidirectional corrugated sandwich structure can significantly enhance the pressure resistance capability of cylindrical shells.

AlLi-LDH中Al-O八面体环吸附锂的机制

采用共沉淀法合成铝锂层状双氢氧化物(AlLi-LDH)并进行提锂试验。AlLi-LDH的空间群为P32或C2/m,微观形貌呈直径为5~10μm的规则球形。AlLi-LDH吸附Li^(+)后,空间群转化为P32。当Li^(+)浓度为95.4 mg/L时,1 h后锂吸附量为8.98 mg/g;吸附48 h后,吸附量增加到16.50 mg/g;根据二级吸附模型预测Li^(+)吸附总量为17.57 mg/g。当Mg^(2+)/Li^(+)的质量比为1067时,Mg^(2+)/Li^(+)分离系数为29536。空间群为P32时,Li-O的相互作用强度变弱,且相互作用属于静电效应。具有P32空间基团的AlLi-LDH更容易吸附和解吸Li^(+)。

Establishment and validation of an adherence prediction system for lifestyle interventions in non-alcoholic fatty liver disease

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is the most common liver disease worldwide,affecting about 1/4th of the global population and causing a huge global economic burden.To date,no drugs have been approved for the treatment of NAFLD,making the correction of unhealthy lifestyles the principle method of treatment.Identifying patients with poor adherence to lifestyle correction and attempting to improve their adherence are therefore very important.AIM To develop and validate a scale that can rapidly assess the adherence of patients with NAFLD to lifestyle interventions.METHODS The Exercise and Diet Adherence Scale(EDAS)was designed based on com-pilation using the Delphi method,and its reliability was subsequently evaluated.Demographic and laboratory indicators were measured,and patients completed the EDAS questionnaire at baseline and after 6 months.The efficacy of the EDAS was evaluated in the initial cohort.Subsequently,the efficacy of the EDAS was internally verified in a validation cohort.RESULTS The EDAS consisted of 33 items in six dimensions,with a total of 165 points.Total EDAS score correlated significantly with daily number of exercise and daily reduction in calorie intake(P<0.05 each),but not with overall weight loss.A total score of 116 was excellent in predicting adherence to daily reduction in calorie intake(>500 kacl/d),(sensitivity/specificity was 100.0%/75.8%),while patients score below 97 could nearly rule out the possibility of daily exercise(sensitivity/specificity was 89.5%/44.4%).Total EDAS scores≥116,97-115,and<97 points were indicative of good,average,and poor adherence,respectively,to diet and exercise recommendations.CONCLUSION The EDAS can reliably assess the adherence of patients with NAFLD to lifestyle interventions and have clinical application in this population.

井工煤矿全波形反演的初始模型构建探究

为提高全波形反演在井工煤矿工作面的运算效果,探究了三维程函方程求解时间场的方法,由透射初至走时反演刻画出初始模型,通过建立含断层的复杂地质模型理论计算正反演来验证算法可靠性。依据小保当二号煤矿工作面实际数据,通过折射横纵波有效信息,初步刻画煤岩分界,改进初始模型,提升全波形反演梯度结果,研究成果可用于煤矿工作面的高精度探测,建立更优全波形反演系统。

水化学特征对砂加载混凝沉淀处理高悬浮矿井水效果的影响

砂加载技术被广泛应用于混凝沉淀高效处理高悬浮物矿井水。但对于原水水化学特征对石英砂加载混凝沉淀效果的影响则很少有系统的研究,影响机制也不清晰。为此,选用石英砂加载混凝处理高悬浮矿井水为研究对象,分析矿井水pH、Ca^(2+)、溶解性总固体(total dissolved solids,TDS)和乳化油含量对石英砂加载混凝处理高悬浮物矿井水效率的影响。分析结果表明:矿井水过低和过高的pH均不利于加载混凝沉淀处理的效率,pH为9.00时,混凝沉淀速率和效率最高。Ca^(2+)含量的增多和乳化油含量的降低能促进加载混凝沉淀效率的提升。而TDS含量的高低和水化学类型的差异并不是影响加载混凝沉淀处理高悬浮物矿井水的效率和沉降速率的主要因素。为进一步认知砂加载混凝处理工艺,提升其处理效率,实现中国煤矿矿井水资源保护和合理化利用具有重要的意义。

基于时序控制的固态开关串并联高压脉冲技术

针对生物医疗等高压陡脉冲应用需求,设计了基于固态开关串并联高压陡脉冲发生电路,并结合时序控制技术,提出一种脉冲陡化新方法;从理论上分析了脉冲陡化的关键、系统工作的过程以及设计要点。该方法能较好解决开关管增加后杂散参数、布线电感以及导线电感对开关速度的影响。以2 kV高压直流电源、110Ω的负载电阻进行实验,负载脉冲信号的上升沿约为50 ns,下降沿约为70 ns,输出电流幅值约18 A;最小脉宽信号的半高宽为100 ns,系统的最小分辨率为5 ns,可实现步进为5 ns脉宽的灵活调节,最大脉宽则与储能电容有关。

新实验开发:废弃PET塑料的电催化升级再造

本实验设计了一种利用可再生能源提供的电能驱动的聚对苯二甲酸乙二醇酯(PET)塑料电催化升级再造策略,将废弃PET塑料成功转化为对苯二甲酸、二甲酸钾等高附加值化学品,同时联产氢气(H_(2))。具体实验过程包括:首先通过水热法将PET塑料进行降解得到对苯二甲酸和乙二醇单体,随后利用自制的水滑石(LDH)催化剂将乙二醇选择性电催化氧化为甲酸盐同时阴极联产H_(2),最后将反应液经酸化、减压过滤、旋蒸、真空干燥等分离提纯步骤得到二甲酸钾和对苯二甲酸产品。本实验是将科研成果引入教学的典型案例,不仅为废弃PET塑料资源的绿色升级再造提供了新思路,而且有利于培养学生的科学思维能力,激发科学研究的兴趣。

Direct-acting antivirals failed to reduce the incidence of hepatocellular carcinoma occurrence in hepatitis C virus associated cirrhosis: A real-world study

BACKGROUND Direct-acting antivirals(DAAs)revolutionized the treatment of chronic hepatitis C virus(HCV)-associated disease achieving high rates of sustained virological response(SVR).However,whether DAAs can reduce the occurrence of hepatocellular carcinoma(HCC)in patients with HCV-associated cirrhosis who are at high risk have not been concluded.AIM To investigate the effect of DAAs on the occurrence of HCC in patients with HCVassociated cirrhosis after achieving SVR.METHODS Of 427 inpatients with HCV-associated cirrhosis were enrolled in Tianjin Second People's Hospital from January 2014 to April 2020.118 patients weren’t received antiviral treatment with any reasons named non-antiviral treatment group,and 236 patients obtained from the 309 DAAs treatment patients according to the propensity score matching named DAAs treatment group.Demographic information and laboratory data were collected from baseline and the following up.Kaplan-Meier curve and Log-Rank test were used to compare the incidence and cumulative incidence of HCC between the two groups.Cox proportional risk regression was used to re-evaluate the risk factors for HCC.RESULTS HCC incidence was 4.68/100PY(95%CI,3.09-6.81)in the DAAs treatment group,while it was 3.00/100PY(95%CI,1.50-5.37)in the non-antiviral treatment group,and the relative risk was 1.82(95%CI,0.93-3.53,P>0.05).The incidence of HCC at 12,24,36 and 48 months was 3.39%,6.36%,8.47%and 10.17%in the DAAs treatment group,and it was 0%,0%,3.39%and 9.32%in the non-antiviral treatment group,respectively.Age>58[hazard ratio(HR)=1.089;95%CI,1.033-1.147;P=0.002]and liver stiffness measurement>27.85 kPa(HR=1.043;95%CI,1.022-1.065;P=0.000)were risk factors for HCC in all patients(n=427),and DAAs treatment didn’t show protective efficacy.CONCLUSION DAAs treatment seems failed to reduce the incidence of HCC occurrence in HCV-associated cirrhosis in 48 months,and even increased the incidence of HCC in 36 months.