目的比较不同的术后辅助治疗方式在宫颈癌术后治疗中的疗效。方法检索中国知网、万方数据知识服务平台、中国生物医学文献数据库、维普中文科技期刊全文数据库、Medline、Embase、The Cochrane Library、Web of Science数据库、国际临...目的比较不同的术后辅助治疗方式在宫颈癌术后治疗中的疗效。方法检索中国知网、万方数据知识服务平台、中国生物医学文献数据库、维普中文科技期刊全文数据库、Medline、Embase、The Cochrane Library、Web of Science数据库、国际临床试验注册中心和中国临床试验注册中心中相关的随机对照试验(randomized controlled trials,RCTs),时限为从建库至2022年5月。采用校正漏斗图评估发表偏倚,利用贝叶斯网状Meta分析比较不同术后辅助治疗,总生存期(overall survival,OS)和无病生存期(disease-free survival,DFS)以风险比(hazard ratio,HR)和95%置信区间(credible intervals,CI)进行报告;骨髓抑制以比值比(odds ratio,OR)及其95%CI进行报告。根据累积排序曲线下面积(surface under the cumulative ranking curve,SUCRA)对生存获益及骨髓抑制进行排序。结果共纳入23项研究,包含6098例患者。在提高OS方面,同步放化疗(concurrent chemoradiotherapy,CCRT)(HR:0.75,95%CI:0.56~0.98)、序贯放化疗(sequential chemoradiotherapy,SCRT)(HR:0.64,95%CI:0.45~0.93)相对于单纯放疗(radiotherapy,RT)差异有统计学意义。在提高DFS方面,同步放化疗后巩固化疗(consolidation chemotherapy followed by concurrent chemoradiotherapy,CCRT+CT)相对于单纯化疗(chemotherapy,CT)(HR=0.37,95%CI:0.16~0.87)、RT(HR=0.48,95%CI:0.27~0.80)差异均有统计学意义;SCRT相对于RT的差异有统计学意义(HR=0.64,95%CI:0.45~0.96)。在骨髓抑制发生方面,CCRT、RT和SCRT之间的差异无统计学意义(P>0.05)。SCURA结果显示,在提高OS方面,SCRT排名第一(SUCRA值=0.75),CCRT+CT排在第2名(SUCRA值=0.68);在提高DFS期方面,CCRT+CT排名第一(SUCRA值=0.95),第2名为SCRT(SUCRA值=0.70);在骨髓抑制发生方面,RT排在第1名(SUCRA值=0.82),其次是SCRT(SUCRA值=0.36)。结论在宫颈癌术后辅助治疗方式中,CCRT+CT及SCRT在提高有效性方面较好,RT及SCRT在保证安全性方面较好,结果还需要更多的高质量RCTs予以验证。展开更多
The present study focuses on the influence of the swirling flows on flow behaviors and performance of a radial-flow turbocharger turbine under pulsating inflow condition.To characterize the effects of swirling flow,th...The present study focuses on the influence of the swirling flows on flow behaviors and performance of a radial-flow turbocharger turbine under pulsating inflow condition.To characterize the effects of swirling flow,three sets of simulations of the turbine were carried out,which are an unsteady simulation under pulsating swirling inflow,an unsteady simulation under equivalent pulsating uniform inflow,and quasi-steady simulations under uniform inflow.Results proved that swirling flow has a considerable negative influence on turbine instantaneous performance and lead to 2.5%cycle-averaged efficiency reduction under pulsating flow condition.Swirling inflow would lead to significant losses in both the volute and the rotor,while the pulsating inflow leads to higher losses in the rotor and shows little influence on the losses in the volute.The instantaneous efficiency reduction of the turbine could be correlated with the time-varying inlet swirl strength.Under the influence of unsteady inlet swirls,the volute flow field is highly distorted and the free vortex relation is no longer valid.The swirling flow has strong interactions with the wake flow of the volute tongue,leading to additional losses.Relative flow angle at rotor inlet is remarkably reduced and its distribution is significantly distorted.Strong separation flows and passage vortices would appear in the rotor because of the swirling inflow,leading to inferior rotor performance.展开更多
文摘目的比较不同的术后辅助治疗方式在宫颈癌术后治疗中的疗效。方法检索中国知网、万方数据知识服务平台、中国生物医学文献数据库、维普中文科技期刊全文数据库、Medline、Embase、The Cochrane Library、Web of Science数据库、国际临床试验注册中心和中国临床试验注册中心中相关的随机对照试验(randomized controlled trials,RCTs),时限为从建库至2022年5月。采用校正漏斗图评估发表偏倚,利用贝叶斯网状Meta分析比较不同术后辅助治疗,总生存期(overall survival,OS)和无病生存期(disease-free survival,DFS)以风险比(hazard ratio,HR)和95%置信区间(credible intervals,CI)进行报告;骨髓抑制以比值比(odds ratio,OR)及其95%CI进行报告。根据累积排序曲线下面积(surface under the cumulative ranking curve,SUCRA)对生存获益及骨髓抑制进行排序。结果共纳入23项研究,包含6098例患者。在提高OS方面,同步放化疗(concurrent chemoradiotherapy,CCRT)(HR:0.75,95%CI:0.56~0.98)、序贯放化疗(sequential chemoradiotherapy,SCRT)(HR:0.64,95%CI:0.45~0.93)相对于单纯放疗(radiotherapy,RT)差异有统计学意义。在提高DFS方面,同步放化疗后巩固化疗(consolidation chemotherapy followed by concurrent chemoradiotherapy,CCRT+CT)相对于单纯化疗(chemotherapy,CT)(HR=0.37,95%CI:0.16~0.87)、RT(HR=0.48,95%CI:0.27~0.80)差异均有统计学意义;SCRT相对于RT的差异有统计学意义(HR=0.64,95%CI:0.45~0.96)。在骨髓抑制发生方面,CCRT、RT和SCRT之间的差异无统计学意义(P>0.05)。SCURA结果显示,在提高OS方面,SCRT排名第一(SUCRA值=0.75),CCRT+CT排在第2名(SUCRA值=0.68);在提高DFS期方面,CCRT+CT排名第一(SUCRA值=0.95),第2名为SCRT(SUCRA值=0.70);在骨髓抑制发生方面,RT排在第1名(SUCRA值=0.82),其次是SCRT(SUCRA值=0.36)。结论在宫颈癌术后辅助治疗方式中,CCRT+CT及SCRT在提高有效性方面较好,RT及SCRT在保证安全性方面较好,结果还需要更多的高质量RCTs予以验证。
基金the foundation of Science and Technology on Diesel Engine Turbocharging Laboratory(No.6142212190101)Young Elite Scientists Sponsorship Program by CAST(2021QNRC001)for the supports。
文摘The present study focuses on the influence of the swirling flows on flow behaviors and performance of a radial-flow turbocharger turbine under pulsating inflow condition.To characterize the effects of swirling flow,three sets of simulations of the turbine were carried out,which are an unsteady simulation under pulsating swirling inflow,an unsteady simulation under equivalent pulsating uniform inflow,and quasi-steady simulations under uniform inflow.Results proved that swirling flow has a considerable negative influence on turbine instantaneous performance and lead to 2.5%cycle-averaged efficiency reduction under pulsating flow condition.Swirling inflow would lead to significant losses in both the volute and the rotor,while the pulsating inflow leads to higher losses in the rotor and shows little influence on the losses in the volute.The instantaneous efficiency reduction of the turbine could be correlated with the time-varying inlet swirl strength.Under the influence of unsteady inlet swirls,the volute flow field is highly distorted and the free vortex relation is no longer valid.The swirling flow has strong interactions with the wake flow of the volute tongue,leading to additional losses.Relative flow angle at rotor inlet is remarkably reduced and its distribution is significantly distorted.Strong separation flows and passage vortices would appear in the rotor because of the swirling inflow,leading to inferior rotor performance.
