Further understanding of an uncommon disease of combined small cell lung cancer： clinical features and prognostic factors of 114 cases

Objective： Combined small cell lung cancer （C-SCLC） is an uncommon subgroup of small cell lung cancer （SCLC） and few clinical data can be referred. Our study is to investigate the clinical features and prognostic factors of C-SCLC, as well as the role of multimodality treatment.Methods： Between January 2004 and December 2012, patients with histologically diagnosed C-SCLC were retrospectively analyzed. The survivals were evaluated with the Kaplan-Meier method. Univariate and multivariate analyses were used to evaluate potential prognostic factors.Results： One hundred and fourteen patients were enrolled, with a median age of 59 （range： 20-79） years old. The most common combined component was squamous cell carcinoma （52.6%）. Among these patients, the disease was stage I, II, III and IV in 9.6%, 19.3%, 46.5% and 24.6% of the patients, respectively. Eighty patients （70.2%） received at least two of the three modalities containing chemotherapy, radiotherapy and surgery. The median follow-up was 32.5 months. The median time of overall survival （OS） was 26.2 months. On univariate analysis, smoking （P=0.029）, Karnofsky performance score （KPS） 〈80 （P=0.000）, advanced TNM stage （P=0.000）, no surgery （P=0.010）, positive resection margin （P=0.000）, positive lymph nodes ≥4 （P=0.000）, positive lymph node ratio 〉10% （P=0.000） and non-multimodality treatment （P=0.004） were associated with poor OS. Multivariate analysis confirmed that smoking, advanced TNM stage, positive resection margin and positive lymph nodes ratio 〉 10% were poor prognostic features. Conclusions： C-SCLC has a relatively early stage and good prognosis, which may due to the underestimated diagnosis in non-surgical patients. Multimodality therapy is recommended, especially for limited disease. Smoking, advanced TNM stage, positive resection margin and positive lymph nodes ratio 〉10% are poor prognostic factors.

利用过渡金属氧化物调控金属铋纳米片的p轨道从而实现CO_(2)的高效电还原

p-d轨道之间的相互作用是一种提升电催化性能的有效方法.然而,其对主族金属的电催化CO_(2)还原(eCO_(2)RR)的增强机制尚不清晰.因此,我们向金属Bi纳米片中引入了一系列过渡金属氧化物(TMO:Fe_(2)O_(3)、Co_(3)O_(4)、NiO),并以此研究引入TMO对Bi物种eCO_(2)RR性能的影响.根据原位傅里叶变换红外光谱(FTIR)和CO_(2)-程序升温脱附(TPD)的结果,Bi/TMO中的TMO可以增强CO_(2)的吸附和活化能力.密度泛函理论(DFT)计算结果表明,Bi活性位点^(*)OCHO吸附能及p轨道的优化可以降低CO_(2)到^(*)OCHO过程和^(*)OCHO到HCOOH过程的理论过电位.同时,由于Bi与TMO之间因复合而发生的电子重排也促进了催化剂与反应物之间的电子传输.因此,在热力学和动力学的双重作用下,Bi/TMO中的Bi活性位点表现出最佳的催化能力,在更宽的电位区间内实现了更高的催化活性和甲酸选择性.其中,Bi/Fe_(2)O_(3)的增强效果最为显著.在500 mV的宽电位区间内达到较高的甲酸的法拉第效率(>90%),在-0.8 VRHE时,甲酸的法拉第效率达到最大值99.7%(Bi的1.11倍),甲酸局部电流密度达到12.65 mA cm^(-2)(Bi的1.86倍).这一研究不仅建立了eCO_(2)RR性能增强与引入TMO之间的关系,也为理性设计高性能电催化剂提供了一条实用的、可扩展的途径.