肺癌合并间质性肺炎药物治疗研究进展

间质性肺病(interstitial lung disease,ILD)是肺癌发生的危险因素,临床上经常出现肺癌合并间质性肺病(lung cancer associated with ILD,LC-ILD)患者。治疗LC-ILD过程中有导致患者ILD急剧加重甚至死亡的风险,同时合并ILD成为多数肺癌前瞻性临床试验的排除标准,因此当肺癌合并ILD时常常成为肺癌的治疗难点。由于LCILD患者在临床中占有一定的比例,因此有必要探寻其最佳的治疗方案。在此我们综述了现有的临床研究结果以供参考。

New true-triaxial rock strength criteria considering intrinsic material characteristics

A reasonable strength criterion should reflect the hydrostatic pressure effect, minimum principal stress effect,and intermediate principal stress effect. The former two effects can be described by the meridian curves, and the last one mainly depends on the Lode angle dependence function. Among three conventional strength criteria, i.e.Mohr–Coulomb(MC), Hoek–Brown(HB), and Exponent(EP) criteria, the difference between generalized compression and extension strength of EP criterion experience a firstly increase then decrease process, and tends to be zero when hydrostatic pressure is big enough. This is in accordance with intrinsic rock strength characterization. Moreover, the critical hydrostatic pressure Icorresponding to the maximum difference of between generalized compression and extension strength can be easily adjusted by minimum principal stress influence parameter K. So, the exponent function is a more reasonable meridian curves, which well reflects the hydrostatic pressure effect and is employed to describe the generalized compression and extension strength.Meanwhile, three Lode angle dependence functions of L,L, and L, which unconditionally satisfy the convexity and differential requirements, are employed to represent the intermediate principal stress effect. Realizing the actual strength surface should be located between the generalized compression and extension surface, new true-triaxial criteria are proposed by combining the two states of EP criterion by Lode angle dependence function with a same lode angle. The proposed new true-triaxial criteria have the same strength parameters as EP criterion. Finally, 14 groups of triaxial test data are employed to validate the proposed criteria. The results show that the three new true-triaxial exponent criteria,especially the Exponent Willam-Warnke criterion(EPWW)criterion, give much lower misfits, which illustrates that the EP criterion and Lhave more reasonable meridian and deviatoric function form, respectively. The proposed new true-triaxial strength criteria can provide theoretical foundation for stability analysis and optimization of support design of rock engineering.

观察人性化护理在43例高危妊娠孕妇产前护理中的效果

目的观察人性化护理在高危妊娠孕妇产前护理中的临床效果。方法选择2017年2月-2018年3月我院收治的86例高危妊娠孕妇,将所有孕妇分为两组,各43例,对照组给予常规产前护理,实验组给予人性化护理,比较两组护理效果。结果应用焦虑自评量表(SAS)进行评价后,两组孕妇护理前SAS评分相似,P>0.05,差异无统计学意义,护理后实验组SAS评分明显低于对照组,而且实验组护理满意度明显高于对照组,P<0.05,差异有统计学意义。结论在高危妊娠孕妇产前护理中实施人性化护理可缓解孕妇焦虑情绪,提高护理满意度,值得在临床中推广应用。

Mantle contributions to granitoids associated with Sn mineralization:Geochemical and isotopic evidence from the giant Dachang deposit,South China

Major Sn deposits are commonly linked to crust-derived and highly evolved granites,with magma generation aided by mantle heating.However,whether and how the mantle components contribute to Sn polymetallic mineralization remains unclear.In this study,in combination with a compilation of equivalent data in the region,we provide new constraints on this issue based on detailed investigations on the petrogenesis and metallogenic significance of granitoids including the causative batholith and later granodiorite porphyry dike in the giant Dachang Sn deposit from South China.The former has zircon U-Pb ages of 93-91 Ma and belongs to highly evolved S-type biotite granite,which experienced fractionation of massive feldspar.The latter shows zircon U-Pb ages of 90 Ma and displays I-type granite features.The batholith was mainly derived from the dehydration melting of biotite in the metasedimentary sources,as revealed by the relatively low whole-rock Pb contents(<30 ppm)and high Ba/Pb ratios(2.71-17.1)and initial T(ti-zr)of 790℃.Compared with the adjacent crust-derived S-type granites(-24.8--5.1)and I-type granites(-11.0 to-5.2),the Dachang S-type biotite granites present higher zirconεHf(t)values(-9.1 to-2.1).Furthermore,the low magmatic zirconδ18O values(6.2‰)and higher apatite LREE(3277-4114 ppm)and Sr(1137-1357 ppm)contents than of arc-type basic rocks were discerned.These characteristics jointly hint the contributions of mantle components.The higher initial T(ti-zr)(>850℃),whole-rock Mg#(52 to 58),apatiteεNd(t)(-9.2 to-6.5)and zirconεHf(t)(-7.6 to 2.5)values but lower zirconδ18O values(6.33 to 8.30‰)of the later granodiorite porphyry dike than those of the batholith also suggest that mantle material was involved in the generation of the dikes,which is evident by the variational features of zircon and apatite trace elements.In addition,at the zircon Hf<12000 ppm and Eu/Eu*>0.05,the higher zirconΔFMQ values(mostly from-1.8 to 2.0)and H2O contents(100-1100 ppm)of the Dachang granitoids than the pure crust-derived S-type granites(ΔFMQ=mostly from-3.7 to-1.5;H2O<100 ppm)imply that mantle materials involved are relatively rich in water and oxidized.These suggest that the addition of mantle components is conducive to the extraction of Sn from metasedimentary sources,and moderately facilitates the increase of oxygen fugacity which still maintains the incompatibility of Sn in magmas withΔFMQ<2.Also,the involvement of mantle components upgrades the H2O contents in S-type magmas,favoring the migration of ore-forming elements from magmas to hydrothermal fluids.The sediment-derived causative granites displayed higherεHf(t)andεNd(t)values with greater Sn tonnages of their associated world-class Sn polymetallic deposits,supporting the opinion that the contributions of mantle components play an important role in the generation of giant Sn deposits.

Synchronization clusters located on epileptic onset zones in neocortical epilepsy

Background Brain function is thought to rely on complex interactions of dynamic neural systems,which depend on the integrity of structural and functional networks.Focal epilepsy is considered to result from excessive focal synchronization in the network.Synchronization analysis of multichannel electrocorticography(ECoG)contributes to the understanding of and orientation of epilepsy.The aim of this study was to explore the synchronization in multichannel ECoG recordings from patients with neocortical epilepsy and characterize neural activity inside and outside the onset zone.Methods Four patients with neocortical epilepsy,who became seizure-free for more than 1 year after surgery guided by ECoG monitoring,were included in this study.ECoG data recorded during pre-surgical evaluation were analyzed.Synchronizations in phase and amplitude of different frequency bands between ECoG channels was analyzed using MATLAB.We generated 100 surrogate data from the original ECoG data using Amplitude Adjusted Fourier Transform to calculate the enhanced synchronization.The relationship between synchronization characteristics and seizure onset zone was analyzed.Results We found synchronization clusters in the 14–30 Hz and 30–80 Hz bands around the onset areas during both interictal and the beginning of ictal periods in all four patients.Conclusions The enhanced-synchronization clusters play a central role in epilepsy,and may activate the onset areas and contribute to the spreading of epileptiform activity.

Behind ＂Burning＂： Women Writers＇ Self-Censorship and Self-Promotion

This article examines the phenomenon of women writers burning their own manuscripts, which took place during the Ming-Qing period. By analyzing women＇s poems and biographies of women, this study explores the reasons and implications behind ＂burning.＂ The self-censorship embodied by ＂burning＂ was geared towards protecting female virtue or enabling women writers to express their intense personal emotions while promoting an ideal public self-image. For example, due to their gender and class-consciousness, upper-class women tended to portray themselves as virtuous ladies, whereas, in contrast, courtesan writers were fascinated with the power of love. However, the act of burning manuscripts could both lead to partial loss of an author＇s works and imbue her writing with the tantalizing aura of an unfulfilled promise, thereby immortalizing the manuscripts that had almost been turned to ashes and publicizing the work of the formerly obscure author. In this sense, the ＂burning＂ is transformed into a literary conceit which promotes women＇s writings instead of destroying them. This article demonstrates the dual functions of manuscript burning by Ming-Qing women： self-censorship and self-promotion.