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基于SEER数据库倾向评分匹配分析放疗对不同危险因素分组的pT_(1-2)N_(1)M_(0)期乳腺癌患者的生存影响
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作者 胡美雪 陈进 权毅 《四川医学》 CAS 2023年第3期248-256,共9页
目的本研究旨在确定pT_(1-2)N_(1)M_(0)期乳腺癌患者改良根治术后乳腺癌特异性生存(BCSS)的预后危险因素,并讨论可能省略术后放疗的患者的选择,以期提供临床决策。方法对SEER数据库中2010~2017年诊断的11351例患者数据进行回顾性分析,... 目的本研究旨在确定pT_(1-2)N_(1)M_(0)期乳腺癌患者改良根治术后乳腺癌特异性生存(BCSS)的预后危险因素,并讨论可能省略术后放疗的患者的选择,以期提供临床决策。方法对SEER数据库中2010~2017年诊断的11351例患者数据进行回顾性分析,运用倾向评分匹配法(PSM)将7928例匹配患者分为放疗组(n=3964)和未放疗组(n=3964),采用单因素成组X^(2)检验、t检验和多因素Cox回归分析确定总生存(OS)及BCSS的预后因素,并使用Kaplan-Meier进行亚组生存分析,log-rank检验进行组间比较。结果中位随访时间80个月,PSM后放疗对pT_(1-2)N_(1)M_(0)期乳腺癌总人群OS及BCSS均有显著获益,OS放疗组(86.6%)与未放疗组(82.8%)差异有统计学意义(P_(OS)<0.001);BCSS放疗组(91.3%)与未放疗组(89.5%)差异有统计学意义(P_(BCSS)=0.007);PSM后多因素分析显示年龄>62岁、Grade分级III级、腋窝淋巴结转移比例>7%、三阴型、肿瘤大小2.4~5 cm是BCSS的独立预后危险因素(P<0.05);亚组分析中,放疗改善了高风险组患者的BCSS,放疗组与未放疗组(89.5%vs.86.7%,P_(BCSS)=0.001);在中风险组中,放疗组与未放疗组差异无统计学意义(96.4%vs.96.0%,P_(BCSS)=0.764);在低风险组中,放疗组与未放疗组(94.6%vs.98.8%,P_(BCSS)=0.031),放疗增加了患者的特异性死亡率。结论pT_(1-2)N_(1)M_(0)期乳腺癌患者的放疗受益明显不同,因此对于该类人群的放疗应个体化建议。对于高风险组的患者应考虑采用放疗,对于中风险组的患者应谨慎建议,而对于低风险组的患者应不予使用。 展开更多
关键词 pt_(1-2)N_(1)M_(0)期乳腺癌 危险因素 放疗 SEER数据库 倾向评分匹配
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CoSe_(2)supported single Pt site catalysts for hydrogen peroxide generation via two-electron oxygen reduction
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作者 Xiao-Dong Zhu Qian Zhang +6 位作者 Xiaoxuan Yang Yingnan Wang Jinting Wu Jian Gao Ji-Jun Zou Gang Wu Yong-Chao Zhang 《SusMat》 2023年第3期334-344,共11页
Electrocatalytic oxygen reduction reaction(ORR)to prepare H_(2)O_(2)in acidic medium has the advantages of green,safety,and portability,which shows broad development prospects.However,it still suffers from low catalys... Electrocatalytic oxygen reduction reaction(ORR)to prepare H_(2)O_(2)in acidic medium has the advantages of green,safety,and portability,which shows broad development prospects.However,it still suffers from low catalyst activity,insufficient selectivity,and high cost.Herein,Pt_(1)/CoSe_(2)with ultralow 0.01 wt.%Pt atomic distribution was synthesized by a simple hydrothermal method.The Pt_(1)/CoSe_(2)with ultralow Pt content exhibits high activity,high selectivity,and long-term stability for ORR to H_(2)O_(2)in O_(2)-saturated 0.1 M HClO_(4).The onset potential is as low as 0.75 V versus reversible hydrogen electrode(RHE),H_(2)O_(2)selectivity is as high as 84%(0.4 V vs.RHE),and the electron transfer number is 2.3(0.4 V vs.RHE).Moreover,the hydrogen peroxide yield using the flow cell testing is 110.02 mmol g_(cat).^(−1)h^(−1) with high Faradaic efficiency of 78%(0 V vs.RHE)at 0.1 M HClO_(4),and the catalyst did not deactivate significantly after 60 h stability testing.Mechanistic studies and in situ X-ray photoelectron spectroscopy characterization confirm that the ultralow Pt content on CoSe_(2)can effectively regulate the electronic structure of Co as the real active site around the Pt site,which gives a suitable Δ_(dp) value(the difference between the d-band center of the active metal site and the p-band center of the terminal oxygen in*OOH),provides an ideal*OOH binding energy,and inhibits the O-O bond breakage.This work successfully improves the intrinsic activity of the Co active sites around Pt in Pt_(1)/CoSe_(2)for acidic ORR to H_(2)O_(2)by constructing ultralow-content Pt single atom. 展开更多
关键词 acidic ORR ELECTROCATALYSIS hydrogen peroxide pt_(1)/cose_(2) ultralow pt content
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