Interpretation of breast cancer screening guideline for Chinese women

Breast cancer is the most common malignant tumor in Chinese women.Early screening is the best way to improve the rates of early diagnosis and survival of breast cancer patients.The peak onset age for breast cancer in Chinese women is considerably younger than those in European and American women.It is imperative to develop breast cancer screening guideline that is suitable for Chinese women.By summarizing the current evidence on breast cancer screening in Chinese women,and referring to the latest guidelines and consensus on breast cancer screening in Europe,the United States,and East Asia,the China Anti-Cancer Association and National Clinical Research Center for Cancer(Tianjin Medical University Cancer Institute and Hospital)have formulated population-based guideline for breast cancer screening in Chinese women.The guideline provides recommendations on breast cancer screening for Chinese women at average or high risk of breast cancer according to the following three aspects:age of screening,screening methods,and screening interval.This article provides more detailed information to support the recommendations in this guideline and to provide more direction for current breast cancer screening practices in China.

Electron-Deficient Zn-N_(6) Configuration Enabling Polymeric Carbon Nitride for Visible-Light Photocatalytic Overall Water Splitting

Despite of suitable band structures for harvesting solar light and driving water redox reactions,polymeric carbon nitride(PCN)has suffered from poor charge transfer ability and sluggish surface reaction kinetics,which limit its photocatalytic activity for water splitting.Herein,atomically dispersed Zn-coordinated three-dimensional(3D)sponge-like PCN(Zn-PCN)is synthesized through a novel intermediate coordination strategy.Advanced characterizations and theoretical calculations well evidence that Zn single atoms are coordinated and stabilized on PCN in the form of Zn-N_(6) configura-tion featured with an electron-deficient state.Such an electronic configuration has been demonstrated contributive to promoted electron excitation,accelerated charge separation and transfer as well as reduced water redox barriers.Further benefited from the abundant surface active sites derived from the 3D porous structure,Zn-PCN realizes visible-light photocatalysis for overall water splitting with H_(2) and O_(2) simultaneously evolved at a stoichiometric ratio of 2:1.This work brings new insights into the design of novel single-atom photocatalysts by deepening the understanding of electronic configurations and reactive sites favorable to excellent photocatalysis for water splitting and related solar energy conversion reactions.

Unraveling the degradation mechanism of LiNi_(0.8)Co_(0.1)Mn_(0.1)O_(2) at the high cut-off voltage for lithium ion batteries

LiNi_(0.8)Co_(0.1)Mn_(0.1)O_(2)(NCM811)layered oxides have been regarded as promising alternative cathodes for the next generation of high-energy lithium ion batteries(LIBs)due to high discharge capacities and energy densities at high operation voltage.However,the capacity fading under high operation voltage still restricts the practical application.Herein,the capacity degradation mechanism of NCM811 at atomic-scale is studied in detail under various cut-off voltages using aberration-corrected scanning transmission electron microscopy(STEM).It is observed that the crystal structure of NCM811 evolution from a layered structure to a rock-salt phase is directly accompanied by serious intergranular cracks under 4.9 V,which is distinguished from the generally accepted structure evolution of layered,disordered layered,defect rock salt and rock salt phases,also observed under 4.3 and 4.7 V.The electron energy loss spectroscopy analysis also confirms the reduction of Ni and Co from the surface to the bulk,not the previously reported only Li/Ni interlayer mixing.The degradation mechanism of NCM811 at a high cut-off voltage of4.9 V is attributed to the formation of intergranular cracks induced by defects,the direct formation of the rock salt phase,and the accompanied reduction of Ni^(2+)and Co^(2+)phases from the surface to the bulk.

Cationic ordering transition in oxygen-redox layered oxide cathodes

Understanding the structural origin of the competition between oxygen 2p and transition-metal 3d orbitals in oxygen-redox(OR)layered oxides is eminently desirable for exploring reversible and high-energy-density Li/Na-ion cathodes.Here,we reveal the correlation between cationic ordering transition and OR degradation in ribbon-ordered P3-Na_(0.6)Li_(0.2)Mn_(0.8)O_(2) via in situ structural analysis.Comparing two different voltage windows,the OR capacity can be improved approximately twofold when suppressing the in-plane cationic ordering transition.We find that the intralayer cationic migration is promoted by electrochemical reduction from Mn^(4+)to Jahn–Teller Mn^(3+)and the concomitant NaO_(6) stacking transformation from triangular prisms to octahedra,resulting in the loss of ribbon ordering and electrochemical decay.First-principles calculations reveal that Mn^(4+)/Mn^(3+)charge ordering and alignment of the degenerate eg orbital induce lattice-level collective Jahn–Teller distortion,which favors intralayer Mn-ion migration and thereby accelerates OR degradation.These findings unravel the relationship between in-plane cationic ordering and OR reversibility and highlight the importance of superstructure protection for the rational design of reversible OR-active layered oxide cathodes.

基于BIM技术的大体量冷却塔模块化施工技术的研究

由于某超高层综合楼冷却塔及其附属管线施工体量大、工期紧、作业面窄、施工难度高等问题,先采用BIM三维建模技术进行管线路径漫游模拟,对冷却塔及其附属管线进行深化设计,包括管线预制安装、管线路径漫游模拟并出图、接驳口预制精准定位、平面布置三维深化、冷却塔机组内置管线设计优化、管线接驳口位置及接驳口管线尺寸优化。再采用BIM+模块化设计施工技术对大管径管线安装进行模块化设计施工,使得管线安装更高效准确,采用BIM预制拼接模拟使得管件焊接接口严丝合缝,使得管道下料更精准,成本把控更精确。预制加模块化设计安装使得现场焊接工作量大大降低,极大减少了现场立焊仰焊等高难度焊接作业,有效缓解了现场焊接作业对空间的需求,安装质量及安装效率得到显著提高。

Leukoaraiosis is associated with clinical symptom severity,poor neurological function prognosis and stroke recurrence in mild intracerebral hemorrhage:a prospective multi-center cohort study

Leukoaraiosis(LA)results from ischemic injury in small cerebral vessels,which may be attributable to decreased vascular density,reduced cerebrovascular angiogenesis,decreased cerebral blood flow,or microcirculatory dysfunction in the brain.In this study,we enrolled 357 patients with mild intracerebral hemorrhage(ICH)from five hospitals in China and analyzed the relationships between LA and clinical symptom severity at admission,neurological function prognosis at 3 months,and 1-year stroke recurrence.Patients were divided into groups based on Fazekas scale scores:no LA(n=83),mild LA(n=64),moderate LA(n=98)and severe LA(n=112).More severe LA,larger hematoma volume,and higher blood glucose level at admission were associated with more severe neurological deficit.More severe LA,older age and larger hematoma volume were associated with worse neurological function prognosis at 3 months.In addition,moderate-to-severe LA,admission glucose and symptom-free cerebral infarction were associated with 1-year stroke recurrence.These findings suggest that LA severity may be a potential marker of individual ICH vulnerability,which can be characterized by poor tolerance to intracerebral attack or poor recovery ability after ICH.Evaluating LA severity in patients with mild ICH may help neurologists to optimize treatment protocols.This study was approved by the Ethics Committee of Ruijin Hospital Affiliated to Shanghai Jiao Tong University(approval No.12)on March 10,2011.

Adjuvant tamoxifen switched to exemestane treatment in postmenopausal women with estrogen receptor-positive early breast cancer:A pragmatic,multicenter,and prospective clinical trial in China

Objective:This post-approval safety study assessed the efficacy and safety of exemestane after 2-3 years of tamoxifen treatment among postmenopausal women with estrogen receptor-positive(ER+)early breast cancer in China.Methods:Enrolled patients had received 2-3 years of tamoxifen and were then switched to exemestane for completion of 5 consecutive years of adjuvant endocrine therapy.The primary endpoint was the time from enrollment to the first occurrence of locoregional/distant recurrence of the primary breast cancer,appearance of a second primary or contralateral breast cancer,or death due to any cause.Other endpoints included the proportion of patients experiencing each event,incidence rate per annum,relationships between human epidermal growth factor receptor 2 status and time to event,and relationship between disease history variables and time to event.Results:Overall,558 patients were included in the full analysis set:397(71.1%)completed the study,20experienced an event,and 141 discontinued[47 owing to an adverse event(AE);37 no longer willing to participate].Median duration of treatment was 29.5(range,0.1-57.7)months.Median time to event was not reached.Eventfree survival probability at 36 months was 91.4%(95%CI,87.7%-95.1%).The event incidence over the total exposure time of exemestane therapy was 3.5 events/100 person-years(20/565).Multivariate analysis showed an association between tumor,lymph node,and metastasis stage at initial diagnosis and time to event[hazard ratio:1.532(95%CI,1.129-2.080);P=0.006].Most AEs were grade 1 or 2 in severity,with arthralgia(7.7%)being the most common treatment-related AE.Conclusions:This study supports the efficacy and safety of exemestane in postmenopausal Chinese women with ER+breast cancer previously treated with adjuvant tamoxifen for 2-3 years.No new safety signals were identified in the Chinese population.

钒掺杂钨青铜内通道氨配位的钌单原子用于高效析氢反应

通过电解水制备氢气是实现“碳中和”目标的理想途径之一.因此,可在全p H条件下使用的氢析出(HER)催化剂的研发是近年来电催化领域的研究热点.原子级分散的催化剂,能够在保留铂族金属(PGM)固有活性的同时,降低催化剂中PGM的用量.虽然可以通过X射线吸收光谱(XAS)来表征原子分散的PGM电催化剂的配位环境,但目前对原子空间分布的控制仍然具有挑战.本文制备了钒掺杂钨青铜内通道氨配位的钌单原子催化剂(Ru/V-NHWO),用于全p H范围内的HER反应.采用X射线衍射(XRD)、高角环形暗场扫描透射电镜(HAADF-STEM)、X射线光电子能谱(XPS)和原位X射线吸收光谱(XAS)等进行表征,研究了钌单原子与V-NHWO载体的结合方式以及构效关系,并采用密度泛函理论(DFT)计算探索了催化剂中诸多位点的活性贡献.在1 mol/LKOH, 0.5 mol/L H_(2)SO_(4)和1 mol/L磷酸盐缓冲溶液中,其在10 m Acm^(-2)下的过电位分别为28.0, 29.6和40.6 m V.同时,在过电位100 m V时,质量活性分别达到3930, 1941和602.8 m Amg^(-1)Ru,数倍于同等条件下的商业铂碳.XRD结果表明,钌的引入可以确保催化剂在氩气条件下热解后仍保持六方钨铵青铜晶相,证明钌与钨铵青铜六方晶体通道内氨物种,即“通道氨”的结合.HAADF-STEM结果表明,钌原子与NHWO间存在强烈相互作用,有助于提升HER性能.XPS和XAS结果表明, W5+信号出现在引入钌后,峰位置的结合能增加且峰面积降低,说明钌与通道氨之间存在相互作用.N的XPS结果表明,钌的引入导致了金属氨键的形成.XAS结果表明, Ru/V-NHWO/CC中钌单原子和钌团簇共存,钌单原子与通道氨配位,并且钒的引入会诱发V-NHWO中金属键长缩短,这表明催化剂的金属性得到了提升,有利于改善其导电性.采用DFT计算进一步研究了HER活性的来源.相比于V-NHWO载体和钌团簇修饰的V-NHWO,以单原子形式结合的钌具有更低的水解离能垒,该能垒在氨桥接的钌双原子垂直插入、钒掺杂和多通道插入等多种因素作用下进一步降低.同时,氢中间体结合能得到了相应的优化而趋近于0 e V.此外,差分电荷密度模拟结果表明,氢中间体结合后, V-NHWO对于钌单原子存在明显的供电子行为,有利于HER动力学过程.综上,本工作报道了金属载体对于高分散金属原子空间分布调控的重要作用,可为设计和构筑可应用于诸多能源转换过程的新型原子级分散催化剂提供参考.

在4H晶相Au纳米带上外延生长非常规晶相4H-Pd基合金纳米结构用于高效甲醇电催化氧化

Pd基合金纳米材料通常具有传统的面心立方(fcc)晶相。本文以密排六方4H相Au(4H-Au)纳米带为模板,外延生长非常规4H晶相的PdFe、PdIr和PdRu,形成4H-Au@PdM(M=Fe、Ir和Ru)核壳合金纳米带。合成的4H-Au@PdFe纳米带被用于碱性环境中甲醇电催化氧化反应(MOR)的催化剂,表现出优越的质量活性(3.69 A·mgPd^(−1)),分别为Pt/C和Pd黑催化剂质量活性的2.4和10.5倍,也跻身于最好的Pd基和Pt基MOR电催化剂之列。这一策略为合理设计和可控合成具有非常规晶相的多金属纳米结构提供了策略,从而为深入研究多金属纳米结构晶相依赖的性质和应用提供了可能。

Localized-domains staging structure and evolution in lithiated graphite

Intercalation provides to the host materials a means for controlled variation of many physical/chemical properties and dominates the reactions in metal‐ion batteries.Of particular interest is the graphite intercalation compounds with intriguing staging structures,which however are still unclear,especially in their nanostructure and dynamic transition mechanism.Herein,the nature of the staging structure and evolution of the lithium(Li)‐intercalated graphite was revealed by cryogenic‐transmission electron microscopy and other methods at the nanoscale.The intercalated Li‐ions distribute unevenly,generating local stress and dislocations in the graphitic structure.Each staging compound is found macroscopically ordered but microscopically inhomogeneous,exhibiting a localized‐domains structural model.Our findings uncover the correlation between the long‐range ordered structure and short‐range domains,refresh the insights on the staging structure and transition of Li‐intercalated/deintercalated graphite,and provide effective ways to enhance the reaction kinetic in rechargeable batteries by defect engineering.

装配式钢结构超高复合硅钙板防火隔墙施工技术

为解决钢结构超高复合硅钙板防火隔墙施工技术的难题,本技术以BIM技术为辅助,首先合理划分防火板的接头,使得防火板的竖向接头原则上在竖向轻钢龙骨上,横向接头在横向轻钢龙骨上;以施工升降车为主要作业机具,先安装主龙骨,后安装次龙骨。通过在广药生物医药城白云基地物流项目(一期)等若干项目的应用表明:利用BIM技术实现了材料的最优下料,减少了板材的切割和接缝;利用升降车可以减少甚至可以取消脚手架的搭设,减少技术间隙,节约工期。该技术应用点在于整个施工过程应合理策划便于施工升降车的撤场。

非规则防火分区面异型卷帘施工技术

异型防火卷帘在升降过程中能够达到精确同步控制的效果,是一种在满足功能的需要下,能达到结构、功能、装饰面一体化的施工技术。针对现有的防火卷帘造型单调,难以满足带有弧度或曲面的结构设计,实现不了单一卷扬机轴动控制同步升降。本文研究了C语言、单片机、整体定位架、定滑轮、钢丝绳、滚轴、自动调平限位装置等技术对非规则异型防火卷帘在运行时达到同步控制的影响。结果表明:C语言、单片机等技术的加入使异型防火卷帘启动控制时,可达到即时同步控制的效果。本文研究创造了一种异型防火卷帘施工技术,不但解决了各种异型大跨度的复杂结构以及有特殊形状要求的防火分区等技术难题,而且还解决了异型防火卷帘难以精确同步控制的技术难点。

Doping of group IVB elements for nickel-rich cobalt-free cathodes

Hetero-element doping is a promising strategy to improve the cycling stability of nickel-rich cobalt-free cathodes for the next-generation high energy-density Li ion batteries.To make doping effective,it is important to understand the mechanism of how the dopants regulate the electronic band,lattice parameter adjusting,or hetero-phase formation to achieve high stability.In this study,we investigate LiNi_(0.9)Mn_(0.1)O_(2)cathodes doped with IVB grouping elements via multiple characterization techniques.By utilizing in situ XRD and TEM methods,we found that the stronger Ti-O bond effectively improves the cathode stability via a dual protection mechanism.Specifically,the bulk lattice of cathode is wellpreserved during cycling as a result of the suppressed H_(2)-H_(3)phase transition,while a in situ formed Ti-rich surface layer can prevent continuous surface degradation.As a result,the 5%Ti doped LiNi_(0.9)Mn_(0.1)O_(2)cathode exhibits a high capacity retention of 96%after 100 cycles.Whereas,despite IVB group elements Zr and Hf have stronger bonding energy with oxygen,their larger ionic radii actually impede their diffusion into the cathode,thereby they can not improve the cycling stability.Our findings uncover the functional origin of doped elements with their dynamic modification on cathode structure,providing mechanistic insights into the design of nickel-rich cobalt-free cathodes.

Chrysophanol inhibits the progression of gastric cancer by activating nod-like receptor protein-3

Aim:Gastric cancer(GC)is one of the most common malignant tumors.Chrysophanol has been reported to possess antitumor effects on a variety of cancers;however,its role in GC remains unclear.This study aimed to investigate the effects of chrysophanol on the proliferation,pyroptosis,migration,and invasion of GC cells.Methods:Human GC cell lines MKN 28 and AGS cells were treated with different concentrations of chrysophanol,then cell proliferation,migration,invasion and pyroptosis were determined by CCK-8,colony-forming assay,wound healing assay,Transwell assay,and flow cytometry.Cell migration and invasion were reassessed in these transfected cells following the transfection of nod-like receptor protein-3(NLRP3)siRNA in MKN 28 and AGS cells.To examine the downstream signaling pathway of the NLRP3 signaling pathway,NLRP3,caspase-1,gasdermin-D,interleukin(IL)-1β,and IL-18 were detected by quantitative real-time-polymerase chain reaction or western blotting.Results:Chrysophanol inhibited the proliferation of GC cells,caused pyroptosis,inhibited cell migration and invasion,and increased the expression of NLRP3 inflammasomes in GC cells.Knockdown of NLRP3 inhibited the effects of chrysophanol on proliferation,pyroptosis,migration,and invasion of GC cells.Chrysophanol plays an anticancer role by enhancing NLRP3.Conclusions:Chrysophanol exerts anti-neoplastic effects in vitro in GC cells by modulating NLRP3,thus highlighting its therapeutic potential in GC.

Interfacial Oxygen Octahedral Coupling-Driven Robust Ferroelectricity in Epitaxial Na_(0.5)Bi_(0.5)TiO_(3)Thin Films

The oxygen octahedral rotation(OOR)forms fundamental atomic distortions and symmetries in perovskite oxides and definitely determines their properties and functionalities.Therefore,epitaxial strain and interfacial structural coupling engineering have been developed to modulate the OOR patterns and explore novel properties,but it is difficult to distinguish the 2 mechanisms.Here,different symmetries are induced in Na_(0.5)Bi_(0.5)TiO_(3)(NBT)epitaxial films by interfacial oxygen octahedral coupling rather than epitaxial strain.The NBT film grown on the Nb:SrTiO_(3)substrate exhibits a paraelectric tetragonal phase,while with La_(0.5)Sr_(0.5)MnO_(3)as a buffer layer,a monoclinic phase and robust ferroelectricity are obtained,with a remanent polarization of 42μC cm^(-2)and a breakdown strength of 7.89 MV cm^(-1),which are the highest record among NBT-based films.Moreover,the interfacial oxygen octahedral coupling effect is demonstrated to propagate to the entire thickness of the film,suggesting an intriguing long-range effect.This work provides a deep insight into understanding the structure modulation in perovskite heterostructures and an important avenue for achieving unique functionalities.

基于双转子连续混炼挤出机的聚乳酸/聚己内酯可降解共混物制备及性能

基于熔融共混法,采用双转子连续混炼挤出机制备聚乳酸(PLA)/聚己内酯(PCL)可降解共混物,研究PCL含量和转子转速对共混物性能的影响。通过拉伸测试、动态力学分析、热重分析、差示扫描量热分析等测试考察了PLA/PCL共混物的力学性能、热稳定性和结晶性能。结果表明,PCL对PLA/PCL共混物有明显的增韧效果,同时可提高共混物的热稳定性和结晶性能;提高转子转速可以改善分散相在连续相中的分散分布效果,但转速过高会导致PLA的生热降解和PCL的加剧破裂。当转子转速为500r/min时,PCL质量分数为40%或50%时,PLA/PCL共混物具有良好的综合性能,此时拉伸强度高于48 MPa、断裂伸长率高于466%、冲击强度高于82J/m,共混物中PCL相的结晶度高于56.08%、PLA相的结晶度高于52.90%。

《中国女性乳腺癌筛查指南》解读(精简版)

乳腺癌是中国女性最常见的恶性肿瘤,早期筛查是提高乳腺癌早诊早治最佳途径。中国女性乳腺癌发病高峰年龄与欧美国家乳腺癌发病高峰年龄明显不同,制定适合中国女性特点的群体性乳腺癌筛查指南势在必行。中国抗癌协会与国家肿瘤临床医学研究中心(天津医科大学肿瘤医院)组织专家在分析总结中国女性乳腺癌筛查数据的基础上,参考欧美及东亚等国家的最新乳腺癌筛查指南或共识,分别从筛查起始年龄、筛查方法、筛查时间间隔3个方面,针对中国女性乳腺癌一般风险人群和高危风险人群制定以人群为基础的《中国女性乳腺癌筛查指南》,本文对该指南进行解读以供乳腺癌筛查相关人士参考。

Experimental Realization of an Intrinsic Magnetic Topological Insulator

An intrinsic magnetic topological insulator(TI) is a stoichiometric magnetic compound possessing both inherent magnetic order and topological electronic states. Such a material can provide a shortcut to various novel topological quantum effects but remained elusive experimentally for a long time. Here we report the experimental realization of thin films of an intrinsic magnetic TI, MnBi2Te4, by alternate growth of a Bi2Te3 quintuple layer and a MnTe bilayer with molecular beam epitaxy. The material shows the archetypical Dirac surface states in angle-resolved photoemission spectroscopy and is demonstrated to be an antiferromagnetic topological insulator with ferromagnetic surfaces by magnetic and transport measurements as well as first-principles calculations. The unique magnetic and topological electronic structures and their interplays enable the material to embody rich quantum phases such as quantum anomalous Hall insulators and axion insulators at higher temperature and in a well-controlled way.

60岁以上乳腺癌的乳腺X线影像学表现及病灶微钙化与年龄的相关性研究

目的:比较年龄60岁以上老年乳腺癌与60岁以下非老年乳腺癌患者的乳腺X线影像学表现并分析病灶微钙化阳性率与年龄的相关性。方法:回顾性分析2012年6月至2013年4月天津医科大学肿瘤医院1959例经病理确诊的乳腺癌患者的乳腺X线影像学资料,以60岁为界分为老年组(n=512)和非老年组(n=1447)并进行统计学分析。结果:老年组和非老年组中高密度肿块的患者分别占73.0%(330/452)和46.0%(464/1008),等/低密度肿块的患者分别占27.0%(122/452)和54.0%(544/1008),两组比较差异具有统计学意义(P<0.05)。老年组和非老年组中病灶微钙化阳性率分别为34.8%(178/512)和41.7%(603/1447),两组比较差异具有统计学意义(P<0.05)。1959例患者根据年龄<30岁、30~39岁、40~49岁、50~59岁、60~69岁和年龄≥70岁进行分组,病灶微钙化阳性率分别占58.8%(10/17)、42.8%(74/173)、41.0%(259/632)、41.6%(260/625)、38.2%(137/359)和26.8%(41/153),随着年龄增长病灶微钙化阳性率整体呈下降趋势,差异具有统计学意义(P=0.008)。结论:老年组与非老年组乳腺X线影像学表现中的肿块密度及病灶微钙化阳性率不同,病灶微钙化阳性率呈随年龄增长而降低的趋势。

MicroRNA and histopathological characterization of pure mucinous breast carcinoma

Objective: Pure mucinous breast carcinoma (PMBC) is an uncommon histological type of breast cancer characterized by a large amount of mucin production. MicroRNA (miRNA) is a large class of small noncoding RNA of about 22 nt involved in the regulation of various biological processes. This study aims to identify the miRNA expression profile in PMBC. Methods: MiRNA expression profiles in 11 PMBCs were analyzed by miRNA-microarray and real-time polymerase chain reaction (PCR). Thirty-one PMBCs and 27 invasive ductal carcinoma of no special types (IDC-NSTs) were assessed by immunohistochemistry using antibodies against ER, PR-progesterone receptor, HER2, Ki-67, Bcl-2, p53, PCNA, and CK5 and 6. Results: We analyzed the miRNA expression in 11 PMBCs and corresponding normal tissues using miRNA-microarray and real-time PCR, and found that miR-143 and miR-224-5p were significantly downregulated in mucinous carcinoma tissue. Compared with IDC-NSTs, PMBC showed a significantly higher ER positive rate, lower HER-2 positive rate, and lower cell proliferation rates. Conclusions: To our knowledge, this is the first study to demonstrate the miRNA expression profile of PMBC, and our findings may lead to further understanding of this type of breast cancer.