We studied the influence of doctor-patient communication skills training on brain functional architecture using resting-state functional MRI（rs-fMRI） with a regional homogeneity（ReHo） method. Ten medical students ...We studied the influence of doctor-patient communication skills training on brain functional architecture using resting-state functional MRI（rs-fMRI） with a regional homogeneity（ReHo） method. Ten medical students participated in the study. A 1-year long doctor-patient communication skills training program was conducted. RsfMRI data were collected at baseline, one month and one year after training. There was a significant increase in the communication skills test average scores between baseline and 1-month duration of training（P〈0.001）. After one month of communication skills training, medical students had decreased ReHo in the right superior temporal gyrus compared with the baseline. After one year of communication skills training, students had increased ReHo in multiple regions and decreased ReHo in several regions（P 〈0.05, Alphasim corrected）. The change of ReHo values in the superior temporal gyrus negatively correlated with the change of communication skills scale score between one month after communication skills training and baseline（r=-0.734, P= 0.036）. The training program we used can be an effective approach of improving doctor-patient communication skills, and the training resulted in functional plasticity of the brain’s architecture toward optimizing locally functional organization.展开更多
目的探究自我肯定理论在老年结直肠癌患者造口护理中的应用效果,以及对患者并发症、造口周围皮肤健康程度、自我效能和生活质量的影响。方法选择于2019年12月-2020年12月复旦大学附属华山医院收治的老年结直肠癌造口患者76例,采用随机...目的探究自我肯定理论在老年结直肠癌患者造口护理中的应用效果,以及对患者并发症、造口周围皮肤健康程度、自我效能和生活质量的影响。方法选择于2019年12月-2020年12月复旦大学附属华山医院收治的老年结直肠癌造口患者76例,采用随机数表法分为观察组(n=39)和对照组(n=37)。对照组患者采用常规护理,观察组患者在与对照组常规护理的基础上,加用自我肯定理论干预护理。观察并比较2组并发症发生情况、造口周围皮肤健康程度(det score of skin health around stoma,DET)评分、一般自我效能感量表(general self-efficacy Scale,GSES)评分和生活质量综合评定问卷(generic quality of life inventory,GQOL-74)评分。结果干预后,观察组坏死缺血和造口旁疝并发症发生率明显低于对照组(P<0.05),而2组的粪水性皮炎和造口脱垂发生率无显著差异(P>0.05);干预后第7 d和第3个月,观察组DET评分均明显低于对照组(P<0.05);干预后第4周,观察组GSES以及GQOL-74各指标评分均显著高于对照组(P<0.05)。结论自我肯定理论护理可有效改善结直肠癌患者造口周围皮肤状况,提高患者的自我效能及生活质量,降低并发症,具有一定的临床应用价值。展开更多
Sodium metal battery(SMB)technology is one of the most promising candidates for next-generation rechargeable energy storage systems due to its high theoretical capacity and economical costeffectiveness.Unfortunately,i...Sodium metal battery(SMB)technology is one of the most promising candidates for next-generation rechargeable energy storage systems due to its high theoretical capacity and economical costeffectiveness.Unfortunately,its practical implementation is hindered by several challenges including short life-span and fast capacity decay,which is closely related to the uncontrollable generation of the sodium dendrites.Herein,a nitrogen and oxygen co-doped three-dimensional carbon cloth with hollow tubular fiber units was constructed as the host material for Na plating(Na@CC)to tackle these challenges.The obtained composite electrode can effectively reduce the nucleation overpotential of Na,guide the homogeneous Na^(+)flux,increase the kinetics of Na electrodeposition,lower the effective current density and eventually suppress the formation of electrochemically inactive Na dendrites.As a result,batteries built with the Na@CC composites exhibited stable long-term cycling stability.To gain an in-depth and comprehensive understanding of such phenomena,non-destructive and three-dimensional synchrotron X-ray tomography was employed to investigate the cycled batteries.Moreover,the COMSOL Multiphysics simulation was further employed to reveal the Na electrodeposition mechanisms.The current work not only showcases the feasibility of currently proposed sodiophilic 3 D Na@CC composite electrode but also provides fundamental insights into the underlying working mechanisms that govern its outstanding electrochemical performance.展开更多
Five new alkaloids(1–5)were isolated from the leaves and twigs of Cephalotaxus lanceolata and C.fortunei var.alpina along with 24 known alkaloids.The new structures were elucidated based on spectroscopic data includi...Five new alkaloids(1–5)were isolated from the leaves and twigs of Cephalotaxus lanceolata and C.fortunei var.alpina along with 24 known alkaloids.The new structures were elucidated based on spectroscopic data including 1D and 2D NMR,FTIR,UV and MS.These new alkaloids showed no cytotoxicity to HeLa,SGC-7901 gastric cancer,and A-549 lung cancer cell lines.展开更多
With the enrollment expansion of college and continuous reform of college education system and college charging system,the number of college students with financial difficulties is increasing. The college students wit...With the enrollment expansion of college and continuous reform of college education system and college charging system,the number of college students with financial difficulties is increasing. The college students with family financial difficulties not only bear the huge economic burden,but also bear the huge pressure of learning and mental stress,and they have many kinds of psychological problems including psychological distress of tension and anxiety,psychological conflict of self-respect and self-abasement,conflict of desire for interpersonal interaction and self-containment and strong vanity and dependence mentality. This paper puts forward the corresponding recommendations to solve these problems.展开更多
Although PD-L1/PD-1 blockade therapy has been approved to treat many types of cancers,the majority of patients with solid tumors do not respond well,but the underlying reason remains unclear.Here,we studied ovarian ca...Although PD-L1/PD-1 blockade therapy has been approved to treat many types of cancers,the majority of patients with solid tumors do not respond well,but the underlying reason remains unclear.Here,we studied ovarian cancer(OvCa),a tumor type generally resistant to current immunotherapies,to investigate PD-1-independent immunosuppression.We found that PD-L1 was not highly expressed in the tumor microenvironment(TME)of human OvCa.Instead,B7-H3,another checkpoint molecule,was highly expressed by both tumor cells and tumor-infiltrating antigen-presenting cells(APCs),which correlated with T-cell exhaustion in patients.Using ID8 OvCa mouse models,we found that B7-H3 expressed on tumor cells,but not host cells,had a dominant role in suppressing antitumor immunity.Therapeutically,B7-H3 blockade,but not PD-1 blockade,prolonged the survival of ID8 tumorbearing mice.Collectively,our results demonstrate that tumor-expressed B7-H3 inhibits the function of CD8^(+)T cells and suggest that B7-H3 may be a target in patients who are not responsive to PD-L1/PD-1 inhibition,particularly OvCa patients.展开更多
Dear Editor,Tumors evade immune surveillances,in part via negative regulatory pathways(also called checkpoints)that also regulate immune toleranee to autoimmunity(Thommen et al.,2018).Checkpoint inhibitor therapy,i.e....Dear Editor,Tumors evade immune surveillances,in part via negative regulatory pathways(also called checkpoints)that also regulate immune toleranee to autoimmunity(Thommen et al.,2018).Checkpoint inhibitor therapy,i.e.,anti-CTLA-4 and anti-PD-1,has been approved to be an effective therapeutic approach in a variety of cancers(Mariathasan et al.,2018).However,only a subset of cancer patients shows durable responses(Callahan et al.,2016),urging for a broader investigation beyond PD-1 and CTLA-4.展开更多
Cellular and humoral immunity are both important in host defense against severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Although defects in SARS-CoV-2-specific T cell immunity have been found in patients ...Cellular and humoral immunity are both important in host defense against severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Although defects in SARS-CoV-2-specific T cell immunity have been found in patients with severe lung pathology,it is still largely unclear whether virus-specific T cells are sufficient for host protection.Here,we found that in a previously characterized cohort of convalescent subjects,one individual,though lacking detectable anti-viral neutralizing IgG antibodies,showed virus-specific T cell responses,both in CD4^(+)and CD8^(+)T cells.SARS-CoV-2-specific T cells in this and other individuals are maintained for up to 10 months.This study thus further supports a critical role of T cells in host defense against SARS-CoV-2,offering new insights into the design and evaluation of COVID-19 vaccines.展开更多
Most patients diagnosed with hepatocellular carcinoma(HCC)present with advanced or metastatic disease.The lack of therapeutic options in the treatment of advanced HCC accounts for its high mortality and recurrence rat...Most patients diagnosed with hepatocellular carcinoma(HCC)present with advanced or metastatic disease.The lack of therapeutic options in the treatment of advanced HCC accounts for its high mortality and recurrence rate.HCC is known as an immunogenic tumor,which develops in chronically inflamed livers.Anti-PD-1/PD-L1 antibodies(immune checkpoint inhibitors,ICB)were approved by the FDA to treat advanced HCC in patients previously treated with sorafenib as a second line.This has opened up a new era of anticancer treatment,although the response rate of HCC to anti-PD-1/PD-L1 antibodies is only around 20%.Other than ICB treatment,adoptive cell transfer,dendritic cell-based vaccines and oncolytic therapy are currently under clinical trials.In this review,different immunotherapy approaches for HCC is presented.Current knowledge on the mechanisms of action for each approach is discussed and relevant,ongoing clinical trials are presented.We also discuss the future of immunotherapy and combination treatment for HCC patients.展开更多
文摘We studied the influence of doctor-patient communication skills training on brain functional architecture using resting-state functional MRI（rs-fMRI） with a regional homogeneity（ReHo） method. Ten medical students participated in the study. A 1-year long doctor-patient communication skills training program was conducted. RsfMRI data were collected at baseline, one month and one year after training. There was a significant increase in the communication skills test average scores between baseline and 1-month duration of training（P〈0.001）. After one month of communication skills training, medical students had decreased ReHo in the right superior temporal gyrus compared with the baseline. After one year of communication skills training, students had increased ReHo in multiple regions and decreased ReHo in several regions（P 〈0.05, Alphasim corrected）. The change of ReHo values in the superior temporal gyrus negatively correlated with the change of communication skills scale score between one month after communication skills training and baseline（r=-0.734, P= 0.036）. The training program we used can be an effective approach of improving doctor-patient communication skills, and the training resulted in functional plasticity of the brain’s architecture toward optimizing locally functional organization.
文摘目的探究自我肯定理论在老年结直肠癌患者造口护理中的应用效果,以及对患者并发症、造口周围皮肤健康程度、自我效能和生活质量的影响。方法选择于2019年12月-2020年12月复旦大学附属华山医院收治的老年结直肠癌造口患者76例,采用随机数表法分为观察组(n=39)和对照组(n=37)。对照组患者采用常规护理,观察组患者在与对照组常规护理的基础上,加用自我肯定理论干预护理。观察并比较2组并发症发生情况、造口周围皮肤健康程度(det score of skin health around stoma,DET)评分、一般自我效能感量表(general self-efficacy Scale,GSES)评分和生活质量综合评定问卷(generic quality of life inventory,GQOL-74)评分。结果干预后,观察组坏死缺血和造口旁疝并发症发生率明显低于对照组(P<0.05),而2组的粪水性皮炎和造口脱垂发生率无显著差异(P>0.05);干预后第7 d和第3个月,观察组DET评分均明显低于对照组(P<0.05);干预后第4周,观察组GSES以及GQOL-74各指标评分均显著高于对照组(P<0.05)。结论自我肯定理论护理可有效改善结直肠癌患者造口周围皮肤状况,提高患者的自我效能及生活质量,降低并发症,具有一定的临床应用价值。
基金sponsored by the National Natural Science Foundation of China(U1904216)the QIBEBT I201922,Dalian National Laboratory for Clean Energy(DNL),CAS。
文摘Sodium metal battery(SMB)technology is one of the most promising candidates for next-generation rechargeable energy storage systems due to its high theoretical capacity and economical costeffectiveness.Unfortunately,its practical implementation is hindered by several challenges including short life-span and fast capacity decay,which is closely related to the uncontrollable generation of the sodium dendrites.Herein,a nitrogen and oxygen co-doped three-dimensional carbon cloth with hollow tubular fiber units was constructed as the host material for Na plating(Na@CC)to tackle these challenges.The obtained composite electrode can effectively reduce the nucleation overpotential of Na,guide the homogeneous Na^(+)flux,increase the kinetics of Na electrodeposition,lower the effective current density and eventually suppress the formation of electrochemically inactive Na dendrites.As a result,batteries built with the Na@CC composites exhibited stable long-term cycling stability.To gain an in-depth and comprehensive understanding of such phenomena,non-destructive and three-dimensional synchrotron X-ray tomography was employed to investigate the cycled batteries.Moreover,the COMSOL Multiphysics simulation was further employed to reveal the Na electrodeposition mechanisms.The current work not only showcases the feasibility of currently proposed sodiophilic 3 D Na@CC composite electrode but also provides fundamental insights into the underlying working mechanisms that govern its outstanding electrochemical performance.
基金This project was financially supported by the Young Academic and Technical Leader Raising Foundation of Yunnan Province(No.2010CI049).
文摘Five new alkaloids(1–5)were isolated from the leaves and twigs of Cephalotaxus lanceolata and C.fortunei var.alpina along with 24 known alkaloids.The new structures were elucidated based on spectroscopic data including 1D and 2D NMR,FTIR,UV and MS.These new alkaloids showed no cytotoxicity to HeLa,SGC-7901 gastric cancer,and A-549 lung cancer cell lines.
基金Supported by Basic Scientific Research Project on Ideological and Political Theory in Northwest Forestry and Forestry University in 2017(2017RWSZ01)Fine Student Project in Northwest Forestry and Forestry University in 2016(2016JP002)
文摘With the enrollment expansion of college and continuous reform of college education system and college charging system,the number of college students with financial difficulties is increasing. The college students with family financial difficulties not only bear the huge economic burden,but also bear the huge pressure of learning and mental stress,and they have many kinds of psychological problems including psychological distress of tension and anxiety,psychological conflict of self-respect and self-abasement,conflict of desire for interpersonal interaction and self-containment and strong vanity and dependence mentality. This paper puts forward the corresponding recommendations to solve these problems.
基金The authors are grateful to Dr.Xueguang Zhang(Soochow University,China)and Jiajia Li(Fudan University Shanghai Cancer Center)for providing the mouse and human OvCa cell lines.This project was funded in part by the Key Program of the National Natural Science Foundation of China(81730039&81671460 to L.-P.J.)the National Key Research and Development Program of China(2017YFC1001401 to L.-P.J.)+2 种基金Beijing Municipal Science and Technology Projects(Z181100006318015 and Z181100001318007 to C.D.)Shanghai Municipal Medical and Health Discipline Construction Projects(2017ZZ02015 to L.-P.J.)the National Basic Research Program of China(2015CB943300 to L.-P.J.).
文摘Although PD-L1/PD-1 blockade therapy has been approved to treat many types of cancers,the majority of patients with solid tumors do not respond well,but the underlying reason remains unclear.Here,we studied ovarian cancer(OvCa),a tumor type generally resistant to current immunotherapies,to investigate PD-1-independent immunosuppression.We found that PD-L1 was not highly expressed in the tumor microenvironment(TME)of human OvCa.Instead,B7-H3,another checkpoint molecule,was highly expressed by both tumor cells and tumor-infiltrating antigen-presenting cells(APCs),which correlated with T-cell exhaustion in patients.Using ID8 OvCa mouse models,we found that B7-H3 expressed on tumor cells,but not host cells,had a dominant role in suppressing antitumor immunity.Therapeutically,B7-H3 blockade,but not PD-1 blockade,prolonged the survival of ID8 tumorbearing mice.Collectively,our results demonstrate that tumor-expressed B7-H3 inhibits the function of CD8^(+)T cells and suggest that B7-H3 may be a target in patients who are not responsive to PD-L1/PD-1 inhibition,particularly OvCa patients.
基金This work was supported by grants from Beijing Municipal Science and Technology(Grant No.Z181100001318007 to CD)National key research and development program of China(Grant No.2016YFC130390 to LN and Grant No.2018YFC0115905 to JL)and National Natural Science Foundation of China(NSFC)(Grant No.81570679 to QY).
文摘Dear Editor,Tumors evade immune surveillances,in part via negative regulatory pathways(also called checkpoints)that also regulate immune toleranee to autoimmunity(Thommen et al.,2018).Checkpoint inhibitor therapy,i.e.,anti-CTLA-4 and anti-PD-1,has been approved to be an effective therapeutic approach in a variety of cancers(Mariathasan et al.,2018).However,only a subset of cancer patients shows durable responses(Callahan et al.,2016),urging for a broader investigation beyond PD-1 and CTLA-4.
基金supported in part by grants from the National Key Research and Development Program of China(2020YFA0707800 and 2021YFC2302403)Tsinghua University Spring Breeze Fund(2020Z99CFG008)+2 种基金the National Natural Science Foundation of China(31991173,31821003 and 31991170)Beijing Municipal Science and Technology(Z181100001318007,Z181100006318015 and Z171100000417005)Tsinghua University-Xiamen Chang Gung Hospital Joint Research Center for Anaphylactic Disease and Science and Technology Plan of Beijing Chaoyang District(CYSF2061).
文摘Cellular and humoral immunity are both important in host defense against severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Although defects in SARS-CoV-2-specific T cell immunity have been found in patients with severe lung pathology,it is still largely unclear whether virus-specific T cells are sufficient for host protection.Here,we found that in a previously characterized cohort of convalescent subjects,one individual,though lacking detectable anti-viral neutralizing IgG antibodies,showed virus-specific T cell responses,both in CD4^(+)and CD8^(+)T cells.SARS-CoV-2-specific T cells in this and other individuals are maintained for up to 10 months.This study thus further supports a critical role of T cells in host defense against SARS-CoV-2,offering new insights into the design and evaluation of COVID-19 vaccines.
基金This work was supported by grants from Beijing Municipal Science and Technology(Grant No.Z181100001318007)National Natural Science Foundation of China(NSFC)(Grant No.31991173).
文摘Most patients diagnosed with hepatocellular carcinoma(HCC)present with advanced or metastatic disease.The lack of therapeutic options in the treatment of advanced HCC accounts for its high mortality and recurrence rate.HCC is known as an immunogenic tumor,which develops in chronically inflamed livers.Anti-PD-1/PD-L1 antibodies(immune checkpoint inhibitors,ICB)were approved by the FDA to treat advanced HCC in patients previously treated with sorafenib as a second line.This has opened up a new era of anticancer treatment,although the response rate of HCC to anti-PD-1/PD-L1 antibodies is only around 20%.Other than ICB treatment,adoptive cell transfer,dendritic cell-based vaccines and oncolytic therapy are currently under clinical trials.In this review,different immunotherapy approaches for HCC is presented.Current knowledge on the mechanisms of action for each approach is discussed and relevant,ongoing clinical trials are presented.We also discuss the future of immunotherapy and combination treatment for HCC patients.
