基于SEER数据库的胰腺癌患者自杀风险因素分析

目的 探讨胰腺癌患者自杀的风险因素。方法 利用SEER(Surveillance,Epidemiology,and End Results)Research Plus数据库筛选1975—2018年胰腺癌患者,描述自杀死亡者、非自杀死亡者和存活者的分布特征,计算人年自杀率、标准化死亡比并分析相应群体特点。使用回归分析探索胰腺癌患者自杀的风险因素,并进一步分析男性患者的自杀风险因素。结果 153 612例胰腺癌患者中,白色人种(80.68%)、65岁及以上(65.02%)、不建议手术(70.57%)、肿瘤远处转移(57.28%)、已婚(56.06%)、家庭年收入中位数在50 000~74 999美元(47.17%)、未采取化疗(52.48%)的患者群体占比较高,且与138名胰腺癌自杀患者的群体特征分布相似。回归分析结果显示,男性[aRR=12.81,95%CI (6.85,23.96),P <0.001]、白色人种[aRR=3.56,95%CI(1.43,8.85),P=0.006]、诊断年龄为65岁及以上[aRR=1.55,95%CI(1.07,2.26),P=0.022]、不建议手术[aRR=2.06,95%CI(1.23,3.44),P=0.006]、建议但未采取手术[aRR=2.86,95%CI(1.37,5.98),P=0.005]的患者具有更高的自杀风险,而肿瘤区域转移[aRR=0.56,95%CI(0.37,0.85),P=0.006]和局部转移[aRR=0.44,95%CI(0.23,0.86),P=0.015]、已婚[aRR=0.57,95%CI(0.40,0.82),P=0.002]、化疗[aRR=0.34,95%CI(0.23,0.51),P <0.001]的患者自杀风险相对较低。男性胰腺癌患者的自杀风险显著高于女性患者,不同种族、手术选择、婚姻状态及化疗选择的男性胰腺癌患者,自杀风险具有显著差异。结论 性别、种族、诊断年龄、是否采取手术治疗、SEER阶段、婚姻状态及化疗选择是胰腺癌患者自杀的重要风险因素。对于男性、白色人种、诊断年龄为65岁及以上、不建议手术或建议但未采取手术治疗、肿瘤处于远处转移阶段、单身、未采取化疗的胰腺癌患者需加强识别、干预和护理。

A review of energy and environment electrocatalysis based on high-index faceted nanocrystals

Today,nanocrystals enclosed by high-index facets(HIFs)are attracting widely attentions of researchers due to their tremendous potential in the field of catalysis,especially in electrocatalysis,such as electro-oxidation of small organic molecule(such as formic acid,methanol,and ethanol),oxygen reduction reaction(ORR),hydrogen evolution reaction(HER),as well as the oxygen evolution reaction(OER).However,the practical applications of nanocrystals enclosed by HIFs still face many limitations in preparations of advanced electrocatalysts,including preparation strategy,limited life-time and stability.The development of advanced electrocatalysts enclosed with HIFs is crucial for solving these problems if the large-scale application of them is to be realized.Herein,we firstly detailedly demonstrate the identification methods of nanocrystals enclosed by HIFs,and then preparation strategies are elaborated in detail in this review.Current advanced nanocrystals enclosed by HIFs in electrocatalytic application are also summarized and we present representative achievements to further reveal the relationship of excellent electrocatalytic performance and nanocrystals with HIFs.Finally,we predict the remaining challenges and present our perspectives with regards of design strategies of improving electrocatalytic performance of Ptbased catalysts in the future.