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初诊超高龄多发性骨髓瘤患者硼替佐米基础方案治疗的生存预后分析

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中国全科医学 2024年第8期27卷 971-977页

作者：赵凤仪李新詹晓凯张佳佳申曼汤然范斯斌黄仲夏首都医科大学附属北京朝阳医院血液与肿瘤科北京市100020

背景多发性骨髓瘤(MM)是一种高度异质性疾病,超高龄老年MM患者是一类特殊群体,其治疗决策和一般评价缺乏一定的循证医学依据,在衰弱评估方面也有一定争议。目的分析以硼替佐米为基础方案治疗初诊超高龄MM患者的一般临床特征和生存预后... 详细信息

背景多发性骨髓瘤(MM)是一种高度异质性疾病,超高龄老年MM患者是一类特殊群体,其治疗决策和一般评价缺乏一定的循证医学依据,在衰弱评估方面也有一定争议。目的分析以硼替佐米为基础方案治疗初诊超高龄MM患者的一般临床特征和生存预后的影响因素,同时评价超高龄MM患者一般状况的最佳评估模式。方法回顾性分析2013年11月—2023年1月于首都医科大学附属北京朝阳医院石景山院区收治的29例初诊超高龄MM患者病例资料,通过首都医科大学附属北京朝阳医院病案系统进行生存随访,随访截至2023-04-01,本研究结局终点为总生存期(OS)和无进展生存期(PFS)。根据治疗方案将患者分为两药治疗组(n=18)和三药治疗组(n=11),比较两组患者临床和遗传学特征。采用老年评分系统(GA)评分、英国骨髓瘤研究联盟风险状况(MRP)评分和梅奥(Mayo)评分评估患者的衰弱状态,并进行疗效评价。采用Kaplan-Meier法绘制MM患者OS和PFS的生存曲线,不同影响因素的生存曲线比较采用Log-rank检验,采用多因素Cox比例风险回归分析探讨MM患者OS和PFS的影响因素。结果随访中位PFS为8.70(1.90~43.87)个月,中位OS为17.23(2.00~72.83)个月。至末次随访,共21例(72.41%)患者出现疾病进展(PD)或复发,12例(41.38%)患者死亡;一线治疗客观缓解率(ORR)为82.76%(24/29),部分缓解(PR)率为51.72%(15/29),非常好的部分缓解(VGPR)率为24.14%(7/29),完全缓解(CR)率为6.90%(2/29)。两组初诊超高龄MM患者CR率、VGPR率、PR率、ORR比较,差异均无统计学意义(P>0.05)。多因素Cox比例风险回归分析结果显示,MRP衰弱(HR=0.213,95%CI=0.049~0.924,P=0.039)、血清校正钙升高(HR=0.153,95%CI=0.041~0.570,P=0.005)和维持治疗(HR=4.301,95%CI=1.219~15.169,P=0.023)是初诊超高龄MM患者PFS的独立影响因素;维持治疗(HR=4.372,95%CI=1.049~18.221,P=0.043)是初诊超高龄MM患者OS的独立影响因素。结论含硼替佐米两药或三药治疗方案对初诊超高龄MM疗效和预后影响无明显差异,血清校正钙升高和维持治疗是影响生存的独立预后因素;MRP评分可用于评估初诊超高龄MM患者预后。

关键词：多发性骨髓瘤硼替佐米预后衰弱老年人,80以上总生存期无进展生存期

A thermochemical model description of CaO-SiO2-Al2O3 silicate system

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China Foundry 2023年第6期20卷 480-490页

作者： Qiu-lin Wen Feng-man shen Hai-yan Zheng Yun-bao Gao Yu Wang Yan-chun Lou National Key Laboratory of Advanced Casting Technologies Liaoning Academy of Materials 3. School of Metallurgy Northeastern University

A thermochemical model based on the ion and molecule coexistence theory(IMCT) was developed to calculate thermodynamic data in the CaO-SiO2-Al2O3slag system, considering the influential role of oxide activities on the thermodynamic properties of slags. Using this model, iso-activity contours were obtained for oxide components CaO, SiO2and Al2O3in this system at temperatures of 1,873 K and 1,773 K. When compared with the IMCT model, it is found that the predicted activities of oxide components in the CaO-SiO2-Al2O3system using the model developed in this study better matches experimental data from literature in terms of both trend and numerical value. Therefore, the model developed in this study can serve as a robust modeling tool for metallurgical processes, and the thermodynamic data predicted by this new model can be used to improve the metallurgical technology.

关键词： thermochemical model CaO-SiO 2 -Al 2 O 3 slag system thermodynamic properties molecule coexistence theory TG223 A

双靶点嵌合抗原受体-T细胞治疗复发难治多发性骨髓瘤患者疗效和安全性的Meta分析

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中国全科医学 2024年第8期27卷 985-994页

作者：于海搏张天宇李新张佳佳申曼詹晓凯汤然范斯斌赵凤仪黄仲夏首都医科大学附属北京朝阳医院血液与肿瘤科北京市100020

背景嵌合抗原受体(CAR)-T细胞免疫疗法已在多发性骨髓瘤(MM)中取得较好的疗效,最常见的靶点为B细胞成熟抗原(BCMA)。单靶点CAR-T细胞免疫疗法的缺点是会导致疾病抵抗和复发,可能与抗原逃逸有关。为此,改进开发了双靶点CAR-T细胞治疗复... 详细信息

背景嵌合抗原受体(CAR)-T细胞免疫疗法已在多发性骨髓瘤(MM)中取得较好的疗效,最常见的靶点为B细胞成熟抗原(BCMA)。单靶点CAR-T细胞免疫疗法的缺点是会导致疾病抵抗和复发,可能与抗原逃逸有关。为此,改进开发了双靶点CAR-T细胞治疗复发难治多发性骨髓瘤(RRMM),此方面尚缺乏系统的临床分析。目的对RRMM患者应用双靶点CAR-T细胞免疫疗法治疗的有效性及安全性进行Meta分析。方法计算机检索PubMed、Embase、Cochrane Library、Web of Science、中国知网、万方数据知识服务平台、维普网7个数据库中有关双靶点CAR-T细胞治疗RRMM的单组率研究,检索时限为建库至2023-02-06。由2名研究人员使用自制的数据表单来提取收集数据,并采用非随机对照试验方法学评价指标进行文献质量评价。采用R Studio软件进行数据分析。结果共纳入9篇文献,包括200例既往接受过多线治疗的RRMM患者。双靶点CAR-T细胞疗法根据不同靶点可分为4类:BCMA+CD19、BCMA+CD38,BCMA+跨膜剂与钙调节亲环素配体的相互作用者(TACI)、BCMA+人信号淋巴细胞激活分子家族成员7(CS1),其中BCMA+CD19靶点的研究较多。根据输注形式不同CAR-T细胞疗法可分为4类:双特异性CAR-T细胞、联合或序贯输注两种不同CAR-T细胞、双顺反子结构、共转导。Meta分析显示,双靶点CAR-T细胞治疗RRMM的总缓解率(ORR)为90.0%(95%CI=0.849~0.943),完全缓解率(CRR)为54.6%(95%CI=0.416~0.673),微小残留病(MRD)阴性率为75.6%(95%CI=0.489~0.952),髓外病变(EMD)总缓解率为55.1%(95%CI=0.234~0.851),最后一次随访时的复发率为29.7%(95%CI=0.141~0.454),最后一次随访时的生存率为75.6%(95%CI=0.554~0.915),3~4级细胞释放因子综合征(CRS)发生率为16.4%(95%CI=0.094~0.245),神经毒性(ICANS)发生率为4.0%(95%CI=0~0.120)。敏感性分析提示结果稳定。Egger's检验结果显示,ORR(P=0.03)及EMD总缓解率(P=0.02)提示存在一定的偏倚风险;CRR(P=0.53)、MRD阴性率(P=0.79)、最后一次随访时的复发率(P=0.71)、生存率(P=0.98)、3~4级CRS发生率(P=0.90)、ICANS发生率(P=0.30)提示不存在发表偏倚。结论双靶点CAR-T细胞免疫治疗RRMM显示出良好的疗效和安全性,未来需要多中心、大样本、更长随访期的研究来进一步评估其疗效和安全性。

关键词：多发性骨髓瘤复发难治多发性骨髓瘤双靶点CAR-T细胞免疫疗法 Meta分析

Rational design of F,N-rich artificial interphase via chemical prelithiation initiation strategy enabling high coulombic efficiency and stable micro-sized SiO anodes

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Journal of Energy Chemistry 2024年第5期92卷 224-232页

作者： Quanyan man Hengtao shen Chuanliang Wei Baojuan Xi shenglin Xiong Jinkui Feng Key Laboratory for Liquid-Solid Structural Evolution and Processing of Materials(Ministry of Education) School of Materials Science and EngineeringShandong UniversityJinan 250061ShandongChina School of Chemistry and Chemical Engineering Shandong UniversityJinan 250100ShandongChina

Silicon monoxide(SiO)is regarded as a potential candidate for anode materials of lithium-ion batteries(LIBs).Unfortunately,the application of SiO is limited by poor initial Coulombic efficiency(ICE)and unsteady solid electrolyte interface(SEI),which induce low energy,short cycling life,and poor rate *** address these drawbacks of SiO,we achieve in-situ construction of robust and fast-ion conducting F,N-rich SEI layer on prelithiated micro-sized SiO(P-μSiO)via the simple and continuous treatment ofμSiO in mild lithium 4,4′-dimethylbiphenyl solution and nonflammable hexafluorocyclotriphosphazene *** prelithiation eliminates irreversible capacity through pre-forming inactive lithium ***,the symbiotic F,N-rich SEI with good mechanical stability and fast Li^(+)permeability is conductive to relieve volume expansion ofμSiO and boost the Li+diffusion ***,the P-μSiO realizes an impressive electrochemical performance with an elevated ICE of 99.57%and a capacity retention of 90.67%after 350 ***,the full cell with P-μSiO anode and commercial LiFePO_(4) cathode displays an ICE of 92.03%and a high reversible capacity of 144.97 mA h g^(-1).This work offers a general construction strategy of robust and ionically conductive SEI for advanced LIBs.

关键词： Chemical prelithiation Silicon monoxide SEI Lithium-ion batteries Interphase engineering

A Non-canonical Excitatory PV RGC–PV SC Visual Pathway for Mediating the Looming-evoked Innate Defensive Response

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Neuroscience Bulletin 2024年第3期40卷 310-324页

作者： man Yuan Sen Jin Gao Tan Siyuan Song Yizong Liu Huadong Wang Yin shen Eye Center Renmin Hospital of Wuhan UniversityWuhan UniversityWuhan430060China The Brain Cognition and Brain Disease Institute Shenzhen Key Laboratory of Viral Vectors for BiomedicineShenzhen Institute of Advanced TechnologyChinese Academy of Sciences(CAS)Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research InstitutionsNational Medical Products Administration Key Laboratory for Research and Evaluation of Viral Vector Technology in Cell and Gene Therapy Medicinal ProductsShenzhen Key Laboratory of Quality Control Technology for Virus-Based TherapeuticsGuangdong Provincial Medical Products AdministrationShenzhen518055China Jan and Dan Duncan Neurological Research Institute Baylor College of MedicineHouston77030USA State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics Key Laboratory of Magnetic Resonance in Biological SystemsWuhan Center for Magnetic ResonanceInnovation Academy for Precision Measurement Science and TechnologyCASWuhan430071China Frontier Science Center of Immunology and Metabolism Medical Research InstituteWuhan UniversityWuhan430071China

Parvalbumin-positive retinal ganglion cells(PV+RGCs)are an essential subset of RGCs found in various ***,their role in transmitting visual information remains ***,we characterized PV+RGCs in the retina and explored the functions of the PV+RGC-mediated visual *** applying multiple viral tracing strategies,we investigated the downstream of PV+RGCs across the whole ***,we found that the PV+RGCs provided direct monosynaptic input to PV+excitatory neurons in the superficial layers of the superior colliculus(SC).Ablation or suppression of SC-projecting PV+RGCs abolished or severely impaired the flight response to looming visual stimuli in mice without affecting visual ***,using transcriptome expression profiling of individual cells and immunofluorescence colocalization for RGCs,we found that PV+RGCs are predominant glutamatergic ***,our findings indicate the critical role of PV+RGCs in an innate defensive response and suggest a non-canonical subcortical visual pathway from excitatory PV+RGCs to PV+SC neurons that regulates looming visual *** results provide a potential target for intervening and treating diseases related to this circuit,such as schizophrenia and autism.

关键词： Parvalbumin-positive retinal ganglion cell Innate fear Superior colliculus Excitatory-excitatory neuronal connection Looming-evoked defensive response Subcortical pathway

Diffusion behavior and distribution regulation of MgO in MgO-bearing pellets

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International Journal of Minerals,Metallurgy and Materials 2016年第9期23卷 1011-1018页

作者： Qiang-jian Gao Yan-song shen Guo Wei Xin Jiang Feng-man shen School of Metallurgy Northeastern University School of Chemical Engineering University of New South Wales

In this paper, the diffusion behavior between MgO and Fe2O3（the main iron oxide in pellets） is investigated using a diffusion couple method. In addition, the distribution regulation of MgO in MgO-bearing pellets is analyzed via pelletizing experiments. The results illustrate that MgO is prone to diffuse into Fe2O3 in the form of solid solution; the diffusion rate considered here is 13.64 μm·min^（-1）. Most MgO content distributes in the iron phase instead of the slag phase. The MF phase {（Mg（1-x）Fex）O·Fe2O3, x ≤ 1} is generated in the MgO-bearing pellets. However, the distribution of MgO in the radial direction of the pellets is inconsistent. The solid solution portion of MgO in the MF phase is larger in the outer layer of the pellets than in the inner layer. In this work, the approximate chemical composition of the MF phase in the outer layer of the pellets is {（Mg（0.35-0.77）·Fe（0.65-0.23）） O·Fe2O3} and in the inner layer is {（Mg（0.13-0.45）·Fe（0.87-0.55））O·Fe2O3}.

关键词： magnesia iron oxide ore pellets diffusion distribution

Clinical features and prognosis of multiple myeloma and orbital extramedullary disease:Seven cases report and review of literature

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World Journal of Clinical Cases 2022年第33期10卷 12365-12374页

作者： Wan-Li Hu Jia-Yin Song Xin Li Xiao-Jiao Pei Jia-Jia Zhang man shen Ran Tang Zhen-Yu Pan Zhong-Xia Huang Department of Hematology Multiple Myeloma Medical Center of BeijingBeijing Chao-Yang HospitalCapital Medical UniversityBeijing 100043China Department of Radiology Beijing Chao-Yang HospitalCapital Medical UniversityBeijing 100043China

BACKGROUND Multiple myeloma(MM)complicated with extramedullary disease(EMD)has a poor prognosis and is a limiting factor in the treatment of MM,and no standard treatment is recommended in international *** studies have reported MM with periorbital *** SUMMARY In this paper,the clinical characteristics and survival of seven patients with multiple myeloma and orbital are described and *** common ocular symptoms were blurred vision,proptosis and/or eye movement disorders,IgG type MM may be a risk factor for orbital *** them,six patients were treated with bortezomib-based *** median overall survival(OS)and progression free survival for the entire cohort were 48 and 33 mo,respectively,which was much worse than the OS reported for MM patients without orbital *** Orbital MM may have significantly shortened survival for the entire cohort,so multidisciplinary collaboration is emphasized and recommended in the diagnosis and treatment of these difficult cases.

关键词： Multiple myeloma Extramedullary disease Periorbital Treatment Survival Case report

Simulation study of the void space gas effect on slope instability triggered by an earthquake

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Journal of Mountain Science 2019年第6期16卷 1300-1325页

作者： ZHOU Zhou WANG Xiao-qun WEI Yu-feng shen Jun-hui shen man College of Environment Geology and Civil Engineering Chengdu University of TechnologyChengdu 610059China State Key Laboratory of Geohazard Prevention and Geoenvironment Protection Chengdu University of TechnologyChengdu 610059China

This study aims at exploring the void space gas effect of earthquake-triggered slope instability and providing a new method for studying the formation mechanism of earthquake-triggered landslides. We analysed the basic characteristics, kinematic characteristics, initiation mechanisms and physical mechanical parameters of the Daguangbao landslide, generalized a landslide prototype, and established a geological model and performed simulation tests. Based on the seismic wave propagation theory of rock-soil mass, rock fracture mechanics and the effective stress principle, we found that the void space gas effect is due to the occurrence of excess void space gas pressure when the dynamic response of seismic loads impacts the void space gas in weak intercalated layers of the slope. The excess void space gas pressure generated by the vibration(earthquake) damages the rock mass around the void space with a certain regularity. The model test results show that the effective shear strength of the rock mass can be reduced by 4.4% to 21.6% due to the void space gas effect.

关键词： Earthquake landslide Slope weak intercalated layer Void space gas effect Void-gas dynamic response Excess void space gas pressure Gas-rock interaction mechanism

双能C T联合临床病理特征预测结直肠癌Ki-67表达的价值

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中国CT和MRI杂志 2024年第2期22卷 142-145页

作者：朱文玲李雨蒙岳思宇陈新蕾邱慎满李绍东徐州医科大学附属医院影像科江苏徐州221002 徐州医科大学医学影像学院江苏徐州221002

目的探讨双能量CT(DECT)定量参数联合临床病理特征预测结直肠癌(CRC)增殖抗原Ki-67阳性表达的价值。方法回顾性收集行腹盆腔DECT双期增强检查且经手术病理证实的123例结直肠腺癌患者术前影像学资料及临床病理资料。根据术后病理结果将Ki... 详细信息

目的探讨双能量CT(DECT)定量参数联合临床病理特征预测结直肠癌(CRC)增殖抗原Ki-67阳性表达的价值。方法回顾性收集行腹盆腔DECT双期增强检查且经手术病理证实的123例结直肠腺癌患者术前影像学资料及临床病理资料。根据术后病理结果将Ki-67分为高表达和低表达两组。利用Siemens工作站进行图像后处理,获得入组患者动脉期和静脉期的碘浓度(IC)、标准化碘浓度(NIC)及能谱曲线斜率(λHU)。采用χ^(2)检验比较两组间临床病理资料的差异。采用独立样本t检验/mann-Whitney U检验比较两组间能谱参数的差异;采用受试者工作特征曲线(ROC)评估有统计学意义的参数的预测效能。结果结直肠癌Ki-67高表达组和低表达组之间血清CA199水平差异有统计学意义(χ^(2)=5.559,P<0.05)。Ki-67高表达组双期IC值、NIC值及能谱曲线斜率均高于Ki-67低表达组,差异具有统计学意义(P<0.05)。结论DECT定量参数IC、NIC、λHU及血清CA199可在一定程度上反映结直肠癌细胞增殖程度,预测结直肠癌Ki-67阳性表达的水平。

关键词：结直肠癌双能量CT 肿瘤标记物 Ki-67表达