[Objectives]To explore the effects of single application of chemical fertilizers on soil carbon fixation capacity and soil fertility under plastic film mulching conditions in eastern Qinghai,and to provide a theoretic...[Objectives]To explore the effects of single application of chemical fertilizers on soil carbon fixation capacity and soil fertility under plastic film mulching conditions in eastern Qinghai,and to provide a theoretical basis for realizing the sustainable development of film mulching planting method in this area.[Methods]The effects of single application of chemical fertilizer cultivation mode under film mulching conditions on the soil organic carbon(SOC),labile organic carbon(LOC),carbon management index(CMI),extractable humus carbon(CHE),humic acid carbon(CHA),and fulvic acid carbon(CFA)in the cultivated layer(0-20 cm)were studied through three consecutive years of field experiments on dryland maize farmland in the eastern Qinghai.[Results]Under the film mulching condition,the SOC,LOC and CMI of the single application of chemical fertilizer cultivation mode were lower than that of the open field control.CHE,CHA and CFA increased with the increase of planting years,but the degree of increase was generally less than that of the open field control.With the increase of planting years,by 2020,the soil LOC/SOC value of film mulching decreased by 4.97%compared with before the start of the experiment,while the open field control increased by 1.11%;the organic carbon oxidation stability coefficient(KOS)of the film mulching was higher than that of the open field control;the soil CHA/CFA value and PQ value were higher than that of the open field control.[Conclusions]Under the condition of single application of chemical fertilizers,the continuous film mulching cultivation mode reduces the soil carbon fixation capacity,and soil organic carbon tends to be stable,which is not conducive to biological utilization and could reduce the soil fertility and degrade the soil quality,causing adverse effects on the stability of crop yield and sustainable production in the long run.展开更多
On January 19, 2008, the ground breaking ceremony of prebaked anode carbon project with 400 thousand tons annual capacity of Pingguo Haohai Carbon Co. , Ltd was held in Pingguo Industry Zone of Guangxi province. After...On January 19, 2008, the ground breaking ceremony of prebaked anode carbon project with 400 thousand tons annual capacity of Pingguo Haohai Carbon Co. , Ltd was held in Pingguo Industry Zone of Guangxi province. After being put into production, the project with an investment of CNY 0.8 billion, will reach CNY 1.6 billion annual production value.展开更多
AIM: To study the presence of sustained low diffusing capacity (DLco) after liver transplantation (LT) in patients with hepatopulmonary syndrome (HPS). METHODS: Six patients with mild-to-severe HPS and 24 with...AIM: To study the presence of sustained low diffusing capacity (DLco) after liver transplantation (LT) in patients with hepatopulmonary syndrome (HPS). METHODS: Six patients with mild-to-severe HPS and 24 without HPS who underwent LT were prospectively followed before and after LT at mid-term (median, 15 mo). HPS patients were also assessed at Iong-tem (median, 86 mo). RESULTS: Before LT, HPS patients showed lower PaO2 (71 ± 8 mmHg), higher AaPO2 (43 ± 10 mmHg) and lower DLco (54% ± 9% predicted), due to a combination of moderate-to-severe ventilation-perfusion (VA/Q) imbalance, mild shunt and diffusion limitation, than non- HPS patients (94 ± 4 mmHg and 19 ± 3 mmHg, and 85% ± 3% predicted, respectively) (P 〈 0.05 each). Seven non-HPS patients had also reduced DLco (70% ± 4% predicted). At mid- and long-term after LT, compared to pre- LT, HPS patients normalized PaO2 (91 ± 3 mmHg and 87 ± 5 mmHg), AaPO2 (14 ± 3 mmHg and 23 ± 5 mmHg) and all VA/Q descriptors (P 〈 0.05 each) without changes in DLco (53% ± 8% and 56% ± 7% predicted, respectively). Post-LT DLco in non-HPS patients with pre- LT low DLco was unchanged (75% ± 6% predicted). CONCLUSION: While complete VA/Q resolution in HPS indicates a reversible functional disturbance, sustained low DLco after LT also present in some non-HPS patients, points to persistence of sub-clinical liver-induced pulmonary vascular changes.展开更多
Facile production of high quality activated carbons from biomass materials has greatly triggered much attention presently. In this paper, a series of interconnected porous carbon materials from lotus root shells bioma...Facile production of high quality activated carbons from biomass materials has greatly triggered much attention presently. In this paper, a series of interconnected porous carbon materials from lotus root shells biomass are prepared via simple pyrolysis and followed by a KOH activation process. The prepared carbons exhibit high specific surface areas of up to 2961 m^2/g and large pore volume~1.47 cm3/g. In addition, the resultant porous carbons served as electrode materials in supercapacitor exhibit high specific capacitance and outstanding recycling stability and high energy density. In particular, their specific capacitance retention was almost 100% after 10500 cycles at a current density of 2 A/g. Remarkabely, the impact of the tailored specific surface areas of various carbon samples on their capacitive performances is systematically investigated.Generally, it was believed that the highly-developed porosity features(including surface areas and pore volume and pore size-distributions), together with the good conductivity of activated carbon species, play a key role in effectively improving the storage energy performances of the porous carbon electrode materials in supercapacitor.展开更多
The use of sequestered carbon dioxide(CO) as the heat exchange fluid in enhanced geothermal system(EGS) has significant potential to increase their productivity, contribute further to reducing carbon emissions and inc...The use of sequestered carbon dioxide(CO) as the heat exchange fluid in enhanced geothermal system(EGS) has significant potential to increase their productivity, contribute further to reducing carbon emissions and increase the economic viability of geothermal power generation. Coupled COsequestration and geothermal energy production from hot dry rock(HDR) EGS were first proposed 15 years ago but have yet to be practically implemented. This paper reviews some of the issues in assessing these systems with particular focus on the power generation and COsequestration capacity. The Habanero geothermal field in the Cooper Basin of South Australia is assessed for its potential COstorage capacity if supercritical COis used as the working fluid for heat extraction. The analysis suggests that the major COsequestration mechanisms are the storage in the fracture-stimulation damaged zone followed by diffusion into the pores within the rock matrix. The assessment indicates that 5% of working fluid loss commonly suggested as the storage capacity might be an over-estimate of the long-term COsequestration capacity of EGS in which supercritical COis used as the circulation fluid.展开更多
Soil organic carbon (SOC) retaining capacities of epipedon (EP), subsoil (SS) and soil cover (SC) as a whole, are soil type specific. Depending on individual and sites characteristics, the generalized humus status ind...Soil organic carbon (SOC) retaining capacities of epipedon (EP), subsoil (SS) and soil cover (SC) as a whole, are soil type specific. Depending on individual and sites characteristics, the generalized humus status indices of soil types (EP and SC thickness and SOC stocks) may vary. Land use and land use change primarily influence the properties and fabric of the EP, but the humus status (SOC concentration and stock, fabric of horizons) of the SS remains practically unchangeable. The mean mineral soils SOC stocks, EP quality and SOC distribution in soil profiles depend mainly on the water regime, mineral composition (texture, calcareousness), development of eluvial processes and the land use peculiarities of soils. The mean area weighted SC SOC stock of Estonian mineral soils is 99.9 Mg ha–1, thereby the mean hydromorphic soils SOC retention capacity considerably exceeds the SOC retention capacity of automorphic soils (means are accordingly 127.5 and 78.9 Mg ha–1). The sustainable management of SOC is based on adequate information about actual SOC stocks and theoretically established or optimal humus status levels of soil types. The aggregate of SOC retained in the mineral soils of Estonia (3,235,100 ha) amounts to 323 ± 46 Tg (1 Tg = 1012 g). Approximately 42% of this is sequestered into stabilized humus, 40% into instable raw-humous material and 18% into forest (grassland) floor and shallow peat layers.展开更多
Control of desertification can not only ameliorate the natural environment of arid regions but also convert desertified land into significant terrestrial carbon sinks,thereby bolstering the carbon sequestration capaci...Control of desertification can not only ameliorate the natural environment of arid regions but also convert desertified land into significant terrestrial carbon sinks,thereby bolstering the carbon sequestration capacity of arid ecosystems.However,longstanding neglect of the potential carbon sink benefits of desertification management,and its relationship with environmental factors,has limited the exploration of carbon sequestration potential.Based on CO_(2) flux and environmental factors of artificial protective forest in the Taklamakan Desert from 2018 to 2019,we found that the carbon storage capacity of the desert ecosystem increased approximately 140-fold after the establishment of an artificial shelter forest in the desert,due to plant photosynthesis.Precipitation levels less than 2 mm had no impact on carbon exchange in the artificial shelter forest,whereas a precipitation level of approximately 4 mm stimulated a decrease in the vapor pressure deficit over a short period of about three days,promoting photosynthesis and enhancing the carbon absorption of the artificial shelter forest.Precipitation events greater than 8 mm stimulated soil respiration to release CO_(2) and promoted plant photosynthesis.In the dynamic equilibrium where precipitation stimulates both soil respiration and photosynthesis,there is a significant threshold value of soil moisture at 5 cm(0.12 m^(3) m^(-3)),which can serve as a good indicator of the strength of the stimulatory effect of precipitation on both.These results provide important data support for quantifying the contribution of artificial afforestation to carbon sequestration in arid areas,and provide guidance for the development and implementation of artificial forest management measures.展开更多
As the integration point of urban blue-green spaces,wetland parks play an important role in the construction of urban carbon pools.It is of great significance for achieving carbon neutrality and peak carbon emissions ...As the integration point of urban blue-green spaces,wetland parks play an important role in the construction of urban carbon pools.It is of great significance for achieving carbon neutrality and peak carbon emissions by reasonably evaluating the carbon sequestration capacity of wetland parks and optimizing wetland structure.In this paper,Guangzhou wetland park is taken as the research object.Through field research,the carbon sequestration potential of ecosystems at multiple levels,including forest vegetation,seedlings,and wetland ecosystems is studied,and policy recommendations are put forward for carbon sequestration in wetland systems.The results show that the annual carbon sequestration capacity of the wetland is 1296.59 t,and the annual net carbon sequestration value is 100485 yuan.Among the three regions,proportions of annual carbon sequestration of the forest vegetation plate,seedling plate,and wetland ecosystem plate account for 28.4%,41.3%,and 30.3%,respectively.展开更多
Forests play an important role in acting as a carbon sink of terrestrial ecosystem.Although global forests have huge carbon carrying capacity(CCC)and carbon sequestration potential(CSP),there were few quantification r...Forests play an important role in acting as a carbon sink of terrestrial ecosystem.Although global forests have huge carbon carrying capacity(CCC)and carbon sequestration potential(CSP),there were few quantification reports on Chinese forests.We collected and compiled a forest biomass dataset of China,a total of 5841 sites,based on forest inventory and literature search results.From the dataset we extracted 338 sites with forests aged over 80 years,a threshold for defining mature forest,to establish the mature forest biomass dataset.After analyzing the spatial pattern of the carbon density of Chinese mature forests and its controlling factors,we used carbon density of mature forests as the reference level,and conservatively estimated the CCC of the forests in China by interpolation methods of Regression Kriging,Inverse Distance Weighted and Partial Thin Plate Smoothing Spline.Combining with the sixth National Forest Resources Inventory,we also estimated the forest CSP.The results revealed positive relationships between carbon density of mature forests and temperature,precipitation and stand age,and the horizontal and elevational patterns of carbon density of mature forests can be well predicted by temperature and precipitation.The total CCC and CSP of the existing forests are 19.87 and 13.86 Pg C,respectively.Subtropical forests would have more CCC and CSP than other biomes.Consequently,relying on forests to uptake carbon by decreasing disturbance on forests would be an alternative approach for mitigating greenhouse gas concentration effects besides afforestation and reforestation.展开更多
Background: Pulmonary alveolar proteinosis (PAP) is a rare lung disease, the most common type of which is autoimmune PAP. The gold standard therapy for PAP is whole lung lavage (WLL). Few studies have reported th...Background: Pulmonary alveolar proteinosis (PAP) is a rare lung disease, the most common type of which is autoimmune PAP. The gold standard therapy for PAP is whole lung lavage (WLL). Few studies have reported the optimal technique with which to evaluate the response to WLL. In this study, we aimed to identify parameters with which to assess the need for repeat WLL during a long-term 8-year follow-up. Methods: We conducted a retrospective analysis of 120 patients with autoimmune PAP with 80 of whom underwent WLL. Physiologic, serologic, and radiologic features of the patients were analyzed during an 8-year follow-up after the first WLL treatment. Results: Of the 40 patients without any intervention, 39 patients either achieved remission or remained stable and only one died of pulmonary infection. Of the 56 patients who underwent WLL for 1 time, 55 remained free from a second WLL and 1 patient died of cancer. Twenty-four required additional treatments after their first WLL. The baseline PaO2, (P = 0.000), PA-aO2 (P = 0.000), shunt fraction rate (P = 0.001), percent of predicted normal diffusing capacity of the lung for carbon monoxide (DLCO%Pred) (P = 0.016), 6-rain walk test (P = 0.013), carcinoembryonic antigen (CEA) (P = 0.007), and neuron-specific enolase (NSE) (P = 0.003) showed significant differences among the three groups. The need for a second WLL was significantly associated with PaO2 (P = 0.000), CEA (P= 0.050), the 6-minute walk test (P= 0.026), and DLCO%Pred (P = 0.041 ). The DLCO%Pred on admission with a cut-off value of42.1% (P = 0.001) may help to distinguish whether patients with PAP require a second WLL. Conclusions: WLL is the optimal treatment method for PAP and provides remarkable improvements for affected patients. The DLCO%Pred on admission with a cut-offvalue of 42.1% may distinguish whether patients with PAP require a second WLL.展开更多
基金Project of Natural Science Foundation of Qinghai Province(2018-ZJ-724)Major Science and Technology Program of Qinghai Province(2019-NK-A11).
文摘[Objectives]To explore the effects of single application of chemical fertilizers on soil carbon fixation capacity and soil fertility under plastic film mulching conditions in eastern Qinghai,and to provide a theoretical basis for realizing the sustainable development of film mulching planting method in this area.[Methods]The effects of single application of chemical fertilizer cultivation mode under film mulching conditions on the soil organic carbon(SOC),labile organic carbon(LOC),carbon management index(CMI),extractable humus carbon(CHE),humic acid carbon(CHA),and fulvic acid carbon(CFA)in the cultivated layer(0-20 cm)were studied through three consecutive years of field experiments on dryland maize farmland in the eastern Qinghai.[Results]Under the film mulching condition,the SOC,LOC and CMI of the single application of chemical fertilizer cultivation mode were lower than that of the open field control.CHE,CHA and CFA increased with the increase of planting years,but the degree of increase was generally less than that of the open field control.With the increase of planting years,by 2020,the soil LOC/SOC value of film mulching decreased by 4.97%compared with before the start of the experiment,while the open field control increased by 1.11%;the organic carbon oxidation stability coefficient(KOS)of the film mulching was higher than that of the open field control;the soil CHA/CFA value and PQ value were higher than that of the open field control.[Conclusions]Under the condition of single application of chemical fertilizers,the continuous film mulching cultivation mode reduces the soil carbon fixation capacity,and soil organic carbon tends to be stable,which is not conducive to biological utilization and could reduce the soil fertility and degrade the soil quality,causing adverse effects on the stability of crop yield and sustainable production in the long run.
文摘On January 19, 2008, the ground breaking ceremony of prebaked anode carbon project with 400 thousand tons annual capacity of Pingguo Haohai Carbon Co. , Ltd was held in Pingguo Industry Zone of Guangxi province. After being put into production, the project with an investment of CNY 0.8 billion, will reach CNY 1.6 billion annual production value.
基金Supported by Red Respira-ISCIII-RTIC-03/11 and Generalitat de Catalunya, No. 2005SGR-00822
文摘AIM: To study the presence of sustained low diffusing capacity (DLco) after liver transplantation (LT) in patients with hepatopulmonary syndrome (HPS). METHODS: Six patients with mild-to-severe HPS and 24 without HPS who underwent LT were prospectively followed before and after LT at mid-term (median, 15 mo). HPS patients were also assessed at Iong-tem (median, 86 mo). RESULTS: Before LT, HPS patients showed lower PaO2 (71 ± 8 mmHg), higher AaPO2 (43 ± 10 mmHg) and lower DLco (54% ± 9% predicted), due to a combination of moderate-to-severe ventilation-perfusion (VA/Q) imbalance, mild shunt and diffusion limitation, than non- HPS patients (94 ± 4 mmHg and 19 ± 3 mmHg, and 85% ± 3% predicted, respectively) (P 〈 0.05 each). Seven non-HPS patients had also reduced DLco (70% ± 4% predicted). At mid- and long-term after LT, compared to pre- LT, HPS patients normalized PaO2 (91 ± 3 mmHg and 87 ± 5 mmHg), AaPO2 (14 ± 3 mmHg and 23 ± 5 mmHg) and all VA/Q descriptors (P 〈 0.05 each) without changes in DLco (53% ± 8% and 56% ± 7% predicted, respectively). Post-LT DLco in non-HPS patients with pre- LT low DLco was unchanged (75% ± 6% predicted). CONCLUSION: While complete VA/Q resolution in HPS indicates a reversible functional disturbance, sustained low DLco after LT also present in some non-HPS patients, points to persistence of sub-clinical liver-induced pulmonary vascular changes.
基金National Science Foundation of China(No.21173167)the Science and Technology Committee of Shaanxi Province(Grant No.2014KW09-03)+1 种基金Program for New Century Excellent Talents in University(NCET-13-0953)the Research Fund of the State Key Lab of Solidification Processing(NWPU),China(Grant No.15-BZ-2015)
文摘Facile production of high quality activated carbons from biomass materials has greatly triggered much attention presently. In this paper, a series of interconnected porous carbon materials from lotus root shells biomass are prepared via simple pyrolysis and followed by a KOH activation process. The prepared carbons exhibit high specific surface areas of up to 2961 m^2/g and large pore volume~1.47 cm3/g. In addition, the resultant porous carbons served as electrode materials in supercapacitor exhibit high specific capacitance and outstanding recycling stability and high energy density. In particular, their specific capacitance retention was almost 100% after 10500 cycles at a current density of 2 A/g. Remarkabely, the impact of the tailored specific surface areas of various carbon samples on their capacitive performances is systematically investigated.Generally, it was believed that the highly-developed porosity features(including surface areas and pore volume and pore size-distributions), together with the good conductivity of activated carbon species, play a key role in effectively improving the storage energy performances of the porous carbon electrode materials in supercapacitor.
基金funded by Australian Research Council Discovery Project(Grant No.DP110104766)financial support from the China Australia Geological Storage of CO_2 Project(CAGS)Australia-China Young Researchers Exchange Program 2012
文摘The use of sequestered carbon dioxide(CO) as the heat exchange fluid in enhanced geothermal system(EGS) has significant potential to increase their productivity, contribute further to reducing carbon emissions and increase the economic viability of geothermal power generation. Coupled COsequestration and geothermal energy production from hot dry rock(HDR) EGS were first proposed 15 years ago but have yet to be practically implemented. This paper reviews some of the issues in assessing these systems with particular focus on the power generation and COsequestration capacity. The Habanero geothermal field in the Cooper Basin of South Australia is assessed for its potential COstorage capacity if supercritical COis used as the working fluid for heat extraction. The analysis suggests that the major COsequestration mechanisms are the storage in the fracture-stimulation damaged zone followed by diffusion into the pores within the rock matrix. The assessment indicates that 5% of working fluid loss commonly suggested as the storage capacity might be an over-estimate of the long-term COsequestration capacity of EGS in which supercritical COis used as the circulation fluid.
基金Funding for the research was provided by the Estonian Ministry of Education and Research(Project No.0172613AGML03).
文摘Soil organic carbon (SOC) retaining capacities of epipedon (EP), subsoil (SS) and soil cover (SC) as a whole, are soil type specific. Depending on individual and sites characteristics, the generalized humus status indices of soil types (EP and SC thickness and SOC stocks) may vary. Land use and land use change primarily influence the properties and fabric of the EP, but the humus status (SOC concentration and stock, fabric of horizons) of the SS remains practically unchangeable. The mean mineral soils SOC stocks, EP quality and SOC distribution in soil profiles depend mainly on the water regime, mineral composition (texture, calcareousness), development of eluvial processes and the land use peculiarities of soils. The mean area weighted SC SOC stock of Estonian mineral soils is 99.9 Mg ha–1, thereby the mean hydromorphic soils SOC retention capacity considerably exceeds the SOC retention capacity of automorphic soils (means are accordingly 127.5 and 78.9 Mg ha–1). The sustainable management of SOC is based on adequate information about actual SOC stocks and theoretically established or optimal humus status levels of soil types. The aggregate of SOC retained in the mineral soils of Estonia (3,235,100 ha) amounts to 323 ± 46 Tg (1 Tg = 1012 g). Approximately 42% of this is sequestered into stabilized humus, 40% into instable raw-humous material and 18% into forest (grassland) floor and shallow peat layers.
基金jointly supported by the Natural Science Foundation of Xinjiang Uygur Autonomous Region(Grant No.2022D01E104)the National Natural Science Foundation General Project(Grant No.41975010)+1 种基金the China Post doctoral Science Foundation(Grant No.2022MD723851)the Scientific and Technological Innovation Team(Tianshan Innovation Team)project(Grant No.2022TSYCTD0007).
文摘Control of desertification can not only ameliorate the natural environment of arid regions but also convert desertified land into significant terrestrial carbon sinks,thereby bolstering the carbon sequestration capacity of arid ecosystems.However,longstanding neglect of the potential carbon sink benefits of desertification management,and its relationship with environmental factors,has limited the exploration of carbon sequestration potential.Based on CO_(2) flux and environmental factors of artificial protective forest in the Taklamakan Desert from 2018 to 2019,we found that the carbon storage capacity of the desert ecosystem increased approximately 140-fold after the establishment of an artificial shelter forest in the desert,due to plant photosynthesis.Precipitation levels less than 2 mm had no impact on carbon exchange in the artificial shelter forest,whereas a precipitation level of approximately 4 mm stimulated a decrease in the vapor pressure deficit over a short period of about three days,promoting photosynthesis and enhancing the carbon absorption of the artificial shelter forest.Precipitation events greater than 8 mm stimulated soil respiration to release CO_(2) and promoted plant photosynthesis.In the dynamic equilibrium where precipitation stimulates both soil respiration and photosynthesis,there is a significant threshold value of soil moisture at 5 cm(0.12 m^(3) m^(-3)),which can serve as a good indicator of the strength of the stimulatory effect of precipitation on both.These results provide important data support for quantifying the contribution of artificial afforestation to carbon sequestration in arid areas,and provide guidance for the development and implementation of artificial forest management measures.
文摘As the integration point of urban blue-green spaces,wetland parks play an important role in the construction of urban carbon pools.It is of great significance for achieving carbon neutrality and peak carbon emissions by reasonably evaluating the carbon sequestration capacity of wetland parks and optimizing wetland structure.In this paper,Guangzhou wetland park is taken as the research object.Through field research,the carbon sequestration potential of ecosystems at multiple levels,including forest vegetation,seedlings,and wetland ecosystems is studied,and policy recommendations are put forward for carbon sequestration in wetland systems.The results show that the annual carbon sequestration capacity of the wetland is 1296.59 t,and the annual net carbon sequestration value is 100485 yuan.Among the three regions,proportions of annual carbon sequestration of the forest vegetation plate,seedling plate,and wetland ecosystem plate account for 28.4%,41.3%,and 30.3%,respectively.
基金supported by the National Basic Research Program of China(2010CB833504)the CAS Strategic Priority Research Program(XDA05050702)the National Natural Science Foundation of China(31290221)
文摘Forests play an important role in acting as a carbon sink of terrestrial ecosystem.Although global forests have huge carbon carrying capacity(CCC)and carbon sequestration potential(CSP),there were few quantification reports on Chinese forests.We collected and compiled a forest biomass dataset of China,a total of 5841 sites,based on forest inventory and literature search results.From the dataset we extracted 338 sites with forests aged over 80 years,a threshold for defining mature forest,to establish the mature forest biomass dataset.After analyzing the spatial pattern of the carbon density of Chinese mature forests and its controlling factors,we used carbon density of mature forests as the reference level,and conservatively estimated the CCC of the forests in China by interpolation methods of Regression Kriging,Inverse Distance Weighted and Partial Thin Plate Smoothing Spline.Combining with the sixth National Forest Resources Inventory,we also estimated the forest CSP.The results revealed positive relationships between carbon density of mature forests and temperature,precipitation and stand age,and the horizontal and elevational patterns of carbon density of mature forests can be well predicted by temperature and precipitation.The total CCC and CSP of the existing forests are 19.87 and 13.86 Pg C,respectively.Subtropical forests would have more CCC and CSP than other biomes.Consequently,relying on forests to uptake carbon by decreasing disturbance on forests would be an alternative approach for mitigating greenhouse gas concentration effects besides afforestation and reforestation.
文摘Background: Pulmonary alveolar proteinosis (PAP) is a rare lung disease, the most common type of which is autoimmune PAP. The gold standard therapy for PAP is whole lung lavage (WLL). Few studies have reported the optimal technique with which to evaluate the response to WLL. In this study, we aimed to identify parameters with which to assess the need for repeat WLL during a long-term 8-year follow-up. Methods: We conducted a retrospective analysis of 120 patients with autoimmune PAP with 80 of whom underwent WLL. Physiologic, serologic, and radiologic features of the patients were analyzed during an 8-year follow-up after the first WLL treatment. Results: Of the 40 patients without any intervention, 39 patients either achieved remission or remained stable and only one died of pulmonary infection. Of the 56 patients who underwent WLL for 1 time, 55 remained free from a second WLL and 1 patient died of cancer. Twenty-four required additional treatments after their first WLL. The baseline PaO2, (P = 0.000), PA-aO2 (P = 0.000), shunt fraction rate (P = 0.001), percent of predicted normal diffusing capacity of the lung for carbon monoxide (DLCO%Pred) (P = 0.016), 6-rain walk test (P = 0.013), carcinoembryonic antigen (CEA) (P = 0.007), and neuron-specific enolase (NSE) (P = 0.003) showed significant differences among the three groups. The need for a second WLL was significantly associated with PaO2 (P = 0.000), CEA (P= 0.050), the 6-minute walk test (P= 0.026), and DLCO%Pred (P = 0.041 ). The DLCO%Pred on admission with a cut-off value of42.1% (P = 0.001) may help to distinguish whether patients with PAP require a second WLL. Conclusions: WLL is the optimal treatment method for PAP and provides remarkable improvements for affected patients. The DLCO%Pred on admission with a cut-offvalue of 42.1% may distinguish whether patients with PAP require a second WLL.