134例老年急性髓系白血病的临床特点及预后分析

目的:分析老年急性髓系白血病(acute myeloid leukemia,AML)(非早幼粒细胞白血病)的临床特点,治疗方式以及疗效和预后特点。方法:收集2015年1月至2023年2月北京大学国际医院收治的134例老年AML患者资料,回顾性分析患者初诊时的白细胞计数、骨髓原始细胞计数、细胞遗传学及分子学特点、ELN危险分层,根据不同治疗方案将患者分为高强度化疗组和低剂量治疗组,观察在治疗过程中强化疗是否能给患者带来生存获益以及影响老年患者生存的因素。结果:高强度化疗患者36例,22例完全缓解(complete response,CR)(61.1%),低剂量治疗90例中46例获得CR(51.1%),其中19例阿扎胞苷(AZA)联合维奈克拉(VEN)治疗换着中14例获得CR(73.7%);高强度化疗与低剂量治疗的总生存期(overall survival,OS)分别为15个月和14.5个月(P=0.226)。欧洲白血病网(ELN)危险分层低、中、高危组患者OS分别为18、14、9个月(P=0.009),低危组高强度化疗和低剂量治疗的OS分别为22个月和15个月(P=0.745),中危组分别为9个月和15个月(P=0.783),高危组分别为9个月和8个月(P=0.739)。强化疗(36例)与阿扎胞苷+维奈克拉治疗(19例)相比OS分别为15个月和17个月(P=0.689)。TP53基因突变者6例,预后明显差于无突变者,中位生存期分别为2个月和14个月(P=0.004)。低、中、高危患者的1年生存率为79%、53%和44%,3年生存率分别为41%、20%和3%。多因素分析显示外周血高白细胞计数(P=0.034)、ELN危险分层(P=0.002)、合并症(P=0.017)与OS相关,而治疗强度、年龄、性别、骨髓原始细胞计数与OS无明显相关性。高强度化疗在老年AML中没有显示明显的生存获益,但这一结果在低危患者中有待于进一步观察。TP53突变者预后较差。多因素分析预测老年AML的生存期时,基线的分子学特征、白细胞计数、合并症比治疗强度更重要。

Assessment of Different Instruments and Methods for Detecting Pollution Share Rate of Heavy Metals in Water Samples

[ Objective ] This study aimed to investigate the impacts of different instruments and methods on detection of water samples and evaluate the detection results and pollution share rate. [ Method] Concentrations of six heavy metals in three surface water samples and three underground water samples were detected by AAS and ICP-AES to analyze the differences in detection results and calculate the pollution share rate of heavy metals. [Result] As a result, the pollution share rate of six heavy metals varied significantly. Calculation results of comprehensive pollution share rate based on the lower pollution index of the same heavy metal in the same water sample detected by two methods were different from the results using either method. Due to different detection limits of instruments, detection results of heavy metals in the same water sample were different, which affected the accuracy of environmental quality assessment. [ Conclusion ] The detected pollution share rate varies with different detection limits. Therefore, instruments and methods with lower detection limit should be used. To be specific, AAS is suitable for detection of Pb and Cd, while ICP is suitable for detection of Cu, Zn, Fe and Mn.

Bimetallic nanoparticles as cascade sensitizing amplifiers for low-dose and robust cancer radio-immunotherapy

Radiotherapy(RT)is one of the most feasible and routinely used therapeutic modalities for treating malignant tumors.In particular,immune responses triggered by RT,known as radio-immunotherapy,can partially inhibit the growth of distantly spreading tumors and recurrent tumors.How-ever,the safety and efficacy of radio-immunotherapy is impeded by the radio-resistance and poor immu-nogenicity of tumor.Herein,we report oxaliplatin(IV)-iron bimetallic nanoparticles(OXA/Fe NPs)as cascade sensitizing amplifiers for low-dose and robust radio-immunotherapy.The OXA/Fe NPs exhibit tumor-specific accumulation and activation of OXA(I)and Fe^(2+)in response to the reductive and acidic microenvironment within tumor cells.The cascade reactions of the released metallic drugs can sensitize RT by inducing DNA damage,increasing ROS and O_(2) levels,and amplifying the immunogenic cell death(ICD)effect after RT to facilitate potent immune activation.As a result,OXA/Fe NPs-based low-dose RT triggered a robust immune response and inhibited the distant and metastatic tumors effectively by a strong abscopal effect.Moreover,a long-term immunological memory effect to protect mice from tumor rechal-lenging is observed.Overall,the bimetallic NPs-based cascade sensitizing amplifier system offers an effi-cient radio-immunotherapy regimen that addresses the key challenges.

Laplace metasurfaces for optical analog computing based on quasi-bound states in the continuum

Laplace operation,the isotropic second-order differentiation,on spatial functions is an essential mathematical calculation in most physical equations and signal processing.Realizing the Laplace operation in a manner of optical analog computing has recently attracted attention,but a compact device with a high spatial resolution is still elusive.Here,we introduce a Laplace metasurface that can perform the Laplace operation for incident lightfield patterns.By exciting the quasi-bound state in the continuum,an optical transfer function for nearly perfect isotropic second-order differentiation has been obtained with a spatial resolution of wavelength scale.Such a Laplace metasurface has been numerically validated with both 1D and 2D spatial functions,and the results agree well with that of the ideal Laplace operation.In addition,the edge detection of a concerned object in an image has been demonstrated with the Laplace metasurface.Our results pave the way to the applications of metasurfaces in optical analog computing and image processing.

InSe/hBN/graphite heterostructure for high-performance 2D electronics and flexible electronics

Two-dimensional(2D)materials as channel materials provide a promising alternative route for future electronics and flexible electronics,but the device performance is affected by the quality of interface between the 2D-material channel and the gate dielectric.Here we demonstrate an indium selenide(lnSe)/hexagonal boron nitride(hBN)/graphite heterostructure as a 2D field-effect transistor(FET),with InSe as channel material,hBN as dielectric,and graphite as gate.The fabricated FETs feature high electron mobility up to 1,146 cm2·V^-1·s^-1 at room temperature and on/off ratio up to 1010 due to the atomically flat gate dielectric.Integrated digital inverters based on InSe/hBN/graphite heterostructures are constructed by local gating modulation and an ultrahigh voltage gain up to 93.4 is obtained.Taking advantages of the mechanical flexibility of these materials,we integrated the heterostructured InSe FET on a flexible substrate,exhibiting little modification of device performance at a high strain level of up to 2%.Such high-performance heterostructured device configuration based on 2D materials provides a new way for future electronics and flexible electronics.

Analysis of physical properties of gas hydrate-bearing unconsolidated sediment samples from the ultra-deepwater area in the South China Sea

Marine natural gas hydrate has recently attracted global attention as a potential new clean energy source. Laboratory measurements of various physical properties of gas hydrate-bearing marine sediments can provide valuable information for developing efficient and safe extraction technology of natural gas hydrates. This study presents comprehensive measurement results and analysis of drilled hydrate-bearing sediments samples recovered from Qiongdongnan Basin in the South China Sea. The results show that the gas hydrate in the core samples is mainly methane hydrate with a methane content of approximately 95%, and the other components are ethane and carbon dioxide. The saturation of the samples fluctuates from 2%–60%, the porosity is approximately 38%–43%, and the water content is approximately 30%–50%, which indicate that high water saturation means that timely drainage should be paid attention to during hydrate extraction. In addition, the median diameter of the sediment samples is mainly distributed in the range of 15 to 34 µm, and attention should be paid to the prevention and control of sand production in the mining process. Moreover, the thermal conductivity is distributed in the range of 0.75 to 0.96 W/(m·K) as measured by the flat plate heat source method. The relatively low thermal conductivity of hydrates at this study site indicates that a combined approach is encouraged for natural gas production technologies. It is also found that clay flakes and fine particles are attached to the surface of large particles in large numbers. Such characteristics will lead to insufficient permeability during the production process.