肺肉瘤样癌分子病理学与靶向治疗的研究进展

肺肉瘤样癌是指含有肉瘤或肉瘤样分化成分的非小细胞肺癌,其发病率占非小细胞肺癌总数的2%~3%。肺肉瘤样癌分化极差,具有高度侵袭性,对铂类为基础的化疗不敏感,治疗手段有限,一直是临床研究关注的重点和难点。现有研究发现肺肉瘤样癌中存在多种基因突变,包括TP53、EGFR、KRAS、MET和ALK等,以及高PD-L1阳性率,这些分子病理学特征有望成为肺肉瘤样癌靶向治疗的新希望。本文聚焦于肺肉瘤样癌分子病理学与靶向治疗研究进展作一综述。

Infection within 2 weeks before liver transplantation closely related to prognosis of posttransplant infection:A single-center retrospective observational study in China

Background:Infections still represent the main factors influencing morbidity and mortality following liver transplantation.This study aimed to evaluate the incidence and risk factors for infection and survival after liver transplantation.Methods:We retrospectively examined medical records in 210 liver recipients who underwent liver transplantation between April 2015 and October 2017 in our hospital.Clinical manifestations and results of pathogen detection test were used to define infection.We analyzed the prevalence,risk factors and prognosis of patients with infection.Results:The median follow-up was 214 days;the incidence of infection after liver transplantation was 46.7%(n=98)which included pneumonia(43.4%),biliary tract infection(21.9%),peritonitis(21.4%)and bloodstream infection(7.6%).Among the pathogens in pneumonia,the most frequently isolated was Acinetobacter baumanii(23.5%)and Klebsiella pneumoniae(21.2%).Model for end-stage liver disease(MELD)score(OR=1.083,95%CI:1.045–1.123;P<0.001),biliary complication(OR=4.725,95%CI:1.119–19.947;P=0.035)and duration of drainage tube(OR=1.040,95%CI:1.007–1.074;P=0.017)were independent risk factors for posttransplant infection.All-cause mortality was 11.0%(n=23).The prognostic factors for postoperative infection in liver recipients were prior-transplant infection,especially pneumonia within 2 weeks before transplantation.Kaplan-Meier curves of survival showed that recipients within 2 weeks prior infection had a significantly lower cumulative survival rate compared with those without infection(65.2%vs.90.0%;hazard ratio:4.480;P<0.001).Conclusions:Infection,especially pneumonia within 2 weeks before transplantation,complication with impaired renal function and MELD score after 7 days of transplantation was an independent prognostic factor for postoperative infection in liver transplant recipients.

Hourly land surface temperature retrieval over the Tibetan Plateau using Geo-LightGBM framework: Fusion of Himawari-8 satellite, ERA5 and site observations

The Tibetan Plateau(TP)is highly sensitive to even minor fluctuations in land surface temperature(LST),which can result in permafrost melting and degradation of alpine grasslands,leading to serious ecological consequences.Therefore,it is crucial to have high-temporal-resolution and seamless hourly estimating and monitoring of LST for a better understanding of climate change on the TP.Here,we employed Himawari-8 satellite,Digital Elevation Model(DEM),ERA5 reanalysis and meteorological station observations data to develop a new LightGBM framework(called Geo-LightGBM)for estimating LST on the TP,and then analyzed the spatiotemporal variations of those LST.Geo-LightGBM demonstrated excellent LST estimation accuracy,with an R2(coefficient of determination)of 0.971,RMSE(root-mean-square error)of 2.479℃,and MAE(mean absolute error)of 1.510℃.The estimated LST values for the year 2020 agreed well with observed values,with remarkable differences in hourly LST variations.Meanwhile,the estimated LST was more accurate than that from FY-4A.Spatially,there were two high LST centers,located in the Yarlung Zangbo River Basin and the Qaidam Basin,and a low LST center located in the central TP.The SHAP(SHapley Additive exPlanations)and correlation analyses revealed DSCS(the mean ground downward shortwave radiation under clear-sky conditions)to be the most importantly input variable for estimating LST.Spatiotemporal dummy variables(e.g.,longitude,latitude,DEM)were also found to be crucial for model accuracy improvement.Our findings indicate the potential for constructing a high-precision and seamless 24-h LST real-time retrieval and monitoring platform for the TP by combining satellite and China's independently developed CLDAS(China Land Data Assimilation System)data in future.

The nearest neutron star candidate in a binary revealed by optical time-domain surveys

The near-Earth(within~100 pc)supernova explosions in the past several million years can cause the global deposition of radioactive elements(e.g.,60Fe)on Earth.The remnants of such supernovae are too old to be easily identified.It is therefore of great interest to search for million-year-old near-Earth neutron stars or black holes,the products of supernovae.However,neutron stars and black holes are challenging to find even in our Solar neighbourhood if they are not radio pulsars or X-ray/γ-ray emitters.Here we report the discovery of one of the nearest(127.7±0.3 pc)neutron star candidates in a detached single-lined spectroscopic binary LAMOST J235456.73+335625.9(hereafter J2354).Utilizing the time-resolved ground-based spectroscopy and space photometry,we find that J2354 hosts an unseen compact object with M_(inv)being 1.4-1.6 M_(⊙).The follow-up Swift ultraviolet(UV)and X-ray observations suggest that the UV and X-ray emission is produced by the visible star rather than the compact object.Hence,J2354 probably harbours a neutron star rather than a hot ultramassive white dwarf.Two-hour exceptionally sensitive radio follow-up observations with Five-hundred-meter Aperture Spherical radio Telescope fail to reveal any pulsating radio signals at the 6σflux upper limit of 12.5μJy.Therefore,the neutron star candidate in J2354 can only be revealed via our time-resolved observations.Interestingly,the distance between J2354 and our Earth can be as close as~50 pc around 2.5 million years(Myrs)ago,as revealed by the Gaia kinematics.Our discovery demonstrates a promising way to unveil the hidden near-Earth neutron stars in binaries by exploring the optical time domain,thereby facilitating understanding of the metal-enrichment history in our Solar neighbourhood.