The rapid spread of the coronavirus disease(COVID-19)pandemic in over 200 countries poses a substantial threat to human health.Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),which causes COVID-19,can be d...The rapid spread of the coronavirus disease(COVID-19)pandemic in over 200 countries poses a substantial threat to human health.Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),which causes COVID-19,can be discharged with feces into the drainage system.However,a comprehensive understanding of the occurrence,presence,and potential transmission of SARS-CoV-2 in sewers,especially in community sewers,is still lacking.This study investigated the virus occurrence by viral nucleic acid testing in vent stacks,septic tanks,and the main sewer outlets of community where confirmed patients had lived during the early days of the epidemic in Wuhan,China.The results indicated that the risk of long-term emission of SARS-CoV-2 to the environment via vent stacks of buildings was low after confirmed patients were hospitalized.SARS-CoV-2 were mainly detected in the liquid phase,as opposed to being detected in aerosols,and its RNA in the sewage of septic tanks could be detected for only four days after confirmed patients were hospitalized.The surveillance of SARS-CoV-2 in sewage could be a sensitive indicator for the possible presence of asymptomatic patients in the community,though the viral concentration could be diluted more than ten times,depending on the sampling site,as indicated by the Escherichia coli test.The comprehensive investigation of the community sewage drainage system is helpful to understand the occurrence characteristics of SARS-CoV-2 in sewage after excretion with feces and the feasibility of sewage surveillance for COVID-19 pandemic monitoring.展开更多
精准医学的发展正在改变癌症的诊疗方式,分子靶点的不断探索及新的药物和疗效数据涌现,为癌症患者带来生机。肺大细胞神经内分泌癌(large cell neuroendocrine carcinoma of the lung,LCNEC)是相对罕见的肿瘤,也在精准医学的蓬勃发展中...精准医学的发展正在改变癌症的诊疗方式,分子靶点的不断探索及新的药物和疗效数据涌现,为癌症患者带来生机。肺大细胞神经内分泌癌(large cell neuroendocrine carcinoma of the lung,LCNEC)是相对罕见的肿瘤,也在精准医学的蓬勃发展中迎来曙光。近年来,基因组和转录组分析揭示了LCNEC的不同亚型,为个性化的治疗带来希望。在靶向治疗方面,已有关于LCNEC携带EGFR、ALK、BRAF V600E突变位点的患者从靶向治疗中获益的报道,PI3K-AKT-MTOR通路、BDNF/TrkB信号通路的探索及抗体偶联物(antibody-drug conjugate,ADC)药物研究为LCNEC靶向治疗提供了新方向。免疫治疗方面,程序性死亡受体-1(programmed cell death protein-1,PD-1)及其配体(programmed cell death protein-ligand 1,PD-L1)抑制剂、PD-1/细胞毒性T淋巴细胞相关抗原(cytotoxic T lymphocyte antigen 4,CTLA-4)双抗在LCNEC中的应用已有研究,在后线缺乏治疗方案时,可考虑选择免疫治疗。尽管有关LCNEC患者应用免疫治疗及靶向治疗获得长期生存获益的病例被持续报道,但仍有待前瞻性及大样本研究确定其在LCNEC中的治疗价值。展开更多
BACKGROUND Ganglioneuroblastoma(GNB)is a peripheral neuroblastoma(NB)with malignant degree between highly malignant NB and benign ganglioma(GN).Pathology is the gold standard of diagnosis.Although GNB is not uncommon ...BACKGROUND Ganglioneuroblastoma(GNB)is a peripheral neuroblastoma(NB)with malignant degree between highly malignant NB and benign ganglioma(GN).Pathology is the gold standard of diagnosis.Although GNB is not uncommon in children,biopsy alone may lead to an inaccurate diagnosis,especially for giant tumors.However,surgical resection may be associated with significant complications.Here,we report a case of computer-assisted surgical resection of a giant GNB in a child and successful rescue of the inferior mesenteric artery.CASE SUMMARY A 4-year-old girl was admitted to our department for a giant retroperitoneal lesion,which was considered to be an NB by her local hospital.The symptoms of the girl disappeared spontaneously without treatment.On physical examination,a mass of about 10 cm×7 cm could be palpated in her abdomen.Ultrasonography and contrast-enhanced computed tomography performed in our hospital also showed an NB,and there was a very thick blood vessel inside the tumor.However,aspiration biopsy revealed GN.Surgical resection is the best treatment option for this giant benign tumor.For precise preoperative evaluation,threedimensional reconstruction was performed.It was clear that the tumor was close to the abdominal aorta.The superior mesenteric vein was pushed forward,and the inferior mesenteric artery passed through the tumor.Because GN generally does not invade blood vessels,we split the tumor with a CUSA knife during the operation and found that there was indeed a straight and intact vascular sheath.Arterial pulsation was observed in the completely exposed inferior mesenteric artery.The pathologists interpreting the tissue finally diagnosed it as a mixed GNB(GNBi),which is more malignant than GN.However,both GN and GNBi usually have a good prognosis.CONCLUSION This was a case of successful surgical resection of a giant GNB,and aspiration biopsy underestimated the pathological staging of the tumor.Preoperative three-dimensional reconstruction assisted with the radical resection of the tumor and rescue of the inferior mesenteric artery.展开更多
基金funded by the projects of the Major Program of National Natural Science Foundation of China(52091543)Tsinghua University Spring Breeze Fund(20213080026)the Chinese Academy of Engineering(2020-ZD-15).
文摘The rapid spread of the coronavirus disease(COVID-19)pandemic in over 200 countries poses a substantial threat to human health.Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),which causes COVID-19,can be discharged with feces into the drainage system.However,a comprehensive understanding of the occurrence,presence,and potential transmission of SARS-CoV-2 in sewers,especially in community sewers,is still lacking.This study investigated the virus occurrence by viral nucleic acid testing in vent stacks,septic tanks,and the main sewer outlets of community where confirmed patients had lived during the early days of the epidemic in Wuhan,China.The results indicated that the risk of long-term emission of SARS-CoV-2 to the environment via vent stacks of buildings was low after confirmed patients were hospitalized.SARS-CoV-2 were mainly detected in the liquid phase,as opposed to being detected in aerosols,and its RNA in the sewage of septic tanks could be detected for only four days after confirmed patients were hospitalized.The surveillance of SARS-CoV-2 in sewage could be a sensitive indicator for the possible presence of asymptomatic patients in the community,though the viral concentration could be diluted more than ten times,depending on the sampling site,as indicated by the Escherichia coli test.The comprehensive investigation of the community sewage drainage system is helpful to understand the occurrence characteristics of SARS-CoV-2 in sewage after excretion with feces and the feasibility of sewage surveillance for COVID-19 pandemic monitoring.
文摘精准医学的发展正在改变癌症的诊疗方式,分子靶点的不断探索及新的药物和疗效数据涌现,为癌症患者带来生机。肺大细胞神经内分泌癌(large cell neuroendocrine carcinoma of the lung,LCNEC)是相对罕见的肿瘤,也在精准医学的蓬勃发展中迎来曙光。近年来,基因组和转录组分析揭示了LCNEC的不同亚型,为个性化的治疗带来希望。在靶向治疗方面,已有关于LCNEC携带EGFR、ALK、BRAF V600E突变位点的患者从靶向治疗中获益的报道,PI3K-AKT-MTOR通路、BDNF/TrkB信号通路的探索及抗体偶联物(antibody-drug conjugate,ADC)药物研究为LCNEC靶向治疗提供了新方向。免疫治疗方面,程序性死亡受体-1(programmed cell death protein-1,PD-1)及其配体(programmed cell death protein-ligand 1,PD-L1)抑制剂、PD-1/细胞毒性T淋巴细胞相关抗原(cytotoxic T lymphocyte antigen 4,CTLA-4)双抗在LCNEC中的应用已有研究,在后线缺乏治疗方案时,可考虑选择免疫治疗。尽管有关LCNEC患者应用免疫治疗及靶向治疗获得长期生存获益的病例被持续报道,但仍有待前瞻性及大样本研究确定其在LCNEC中的治疗价值。
基金Supported by Qingdao Civic Science and Technology Program,No.17-3-3-8-nsh.
文摘BACKGROUND Ganglioneuroblastoma(GNB)is a peripheral neuroblastoma(NB)with malignant degree between highly malignant NB and benign ganglioma(GN).Pathology is the gold standard of diagnosis.Although GNB is not uncommon in children,biopsy alone may lead to an inaccurate diagnosis,especially for giant tumors.However,surgical resection may be associated with significant complications.Here,we report a case of computer-assisted surgical resection of a giant GNB in a child and successful rescue of the inferior mesenteric artery.CASE SUMMARY A 4-year-old girl was admitted to our department for a giant retroperitoneal lesion,which was considered to be an NB by her local hospital.The symptoms of the girl disappeared spontaneously without treatment.On physical examination,a mass of about 10 cm×7 cm could be palpated in her abdomen.Ultrasonography and contrast-enhanced computed tomography performed in our hospital also showed an NB,and there was a very thick blood vessel inside the tumor.However,aspiration biopsy revealed GN.Surgical resection is the best treatment option for this giant benign tumor.For precise preoperative evaluation,threedimensional reconstruction was performed.It was clear that the tumor was close to the abdominal aorta.The superior mesenteric vein was pushed forward,and the inferior mesenteric artery passed through the tumor.Because GN generally does not invade blood vessels,we split the tumor with a CUSA knife during the operation and found that there was indeed a straight and intact vascular sheath.Arterial pulsation was observed in the completely exposed inferior mesenteric artery.The pathologists interpreting the tissue finally diagnosed it as a mixed GNB(GNBi),which is more malignant than GN.However,both GN and GNBi usually have a good prognosis.CONCLUSION This was a case of successful surgical resection of a giant GNB,and aspiration biopsy underestimated the pathological staging of the tumor.Preoperative three-dimensional reconstruction assisted with the radical resection of the tumor and rescue of the inferior mesenteric artery.
