原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)是累及脑脊液、脊髓、眼内结构、颅神经及软脑膜的侵袭性结外非霍奇金淋巴瘤,无中枢神经系统以外部位受累的一种罕见浸润性恶性肿瘤。PCNSL对放化疗敏感,治疗...原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)是累及脑脊液、脊髓、眼内结构、颅神经及软脑膜的侵袭性结外非霍奇金淋巴瘤,无中枢神经系统以外部位受累的一种罕见浸润性恶性肿瘤。PCNSL对放化疗敏感,治疗包括以大剂量甲氨蝶呤为基础的诱导缓解治疗,手术和全脑放疗的巩固治疗。近年来出现包括BTK抑制剂、PD-1抑制剂、来那度胺、利妥昔单抗、培美曲塞、CAR-T疗法、核输出抑制剂等新药进入临床试验或使用阶段,并显示出良好的治疗效果。本文对PCNSL患者的传统治疗方法及新的靶向药物治疗进展进行综述。展开更多
We explored a time series of the Asian summer monsoon(ASM) variability during the transition period from the middle to the late Holocene in the marginal Asian monsoon region. We used an absolutely dated ^(230)Th recor...We explored a time series of the Asian summer monsoon(ASM) variability during the transition period from the middle to the late Holocene in the marginal Asian monsoon region. We used an absolutely dated ^(230)Th record with only a ~20-year dating error, and oxygen isotope data with an 8-year average temporal resolution from the top 22-mm segment of stalagmite WXB07-4 from Wanxiang Cave, western Loess Plateau. The ASM intensity weakened gradually from 6420 to 4920 a BP, which was mainly characterized by three phases:(1) a strengthening phase with a higher precipitation amount between 6420 and 6170 a BP;(2) a smooth fluctuating interval during 6170–5700 a BP; and(3) a sudden extreme weakening period from 5700 to 4920 a BP. Interestingly, the extreme weakening interval of the ASM occurred during the period between 5700 and 4920 a BP, an abrupt change dated at 5430 a BP, which is known as the 5400 a BP, or 5.4 ka BP, event. The period included 290 years of gradual weakening, and 350 years of slow strengthening. This was synchronous with some cave records from the Asian monsoon region within dating errors. Comparing with Chinese archaeological archives over the past 7000 years, the early decline of the Yangshao Culture in the Yellow River Basin and the Hongshan Culture in the West Liao River Basin occurred during the period of gradual decrease of ASM precipitation. The dramatic decline in precipitation, caused by the extreme weakening of the ASM at 5400 a BP,may have been partly related to the decline of the Miaodigou Culture at the Yangguanzhai site in the Weihe River valley; the middle Yangshao Culture in western Henan in the Yellow River Basin; the early Dawenkou Culture on the lower reaches of the Yellow River; and the middle Hongshan Culture in the west of the Liaohe River valley. During the later period of the 5400 a BP event(5430–4920 a BP), a small amplitude increase and a subsequent sharp decrease of ASM precipitation may have also been linked to the contemporaneous prosperity and disappearance of the late Yangshao and Hongshan cultures; the disappearance of the late Yangshao Culture represented by the Yangguanzhai site in the Guanzhong basin on the Weihe River; the fourth phase of the late Yangshao Culture on the upstream Dadiwan site; the beginning of the middle Dawenkou Culture, the formation of its late stage,and the rise of the Longshan culture; and the rise of the Qujialing and Liangzhu cultures on the lower Yangtze River. Compared with the stalagmite precipitation records on the Qinghai-Tibetan Plateau, the rise and expansion of the Majiayao Culture in the upper Yellow River valley at 5300 a BP may have also been connected to the more dramatic increase of the summer monsoon precipitation at higher, rather than lower, altitudes during the late 5400 a BP event.展开更多
文摘原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)是累及脑脊液、脊髓、眼内结构、颅神经及软脑膜的侵袭性结外非霍奇金淋巴瘤,无中枢神经系统以外部位受累的一种罕见浸润性恶性肿瘤。PCNSL对放化疗敏感,治疗包括以大剂量甲氨蝶呤为基础的诱导缓解治疗,手术和全脑放疗的巩固治疗。近年来出现包括BTK抑制剂、PD-1抑制剂、来那度胺、利妥昔单抗、培美曲塞、CAR-T疗法、核输出抑制剂等新药进入临床试验或使用阶段,并显示出良好的治疗效果。本文对PCNSL患者的传统治疗方法及新的靶向药物治疗进展进行综述。
基金supported by the National Natural Science Foundation of China (Grants Nos. 41473009, 41273014, 40973007 & 40772110)
文摘We explored a time series of the Asian summer monsoon(ASM) variability during the transition period from the middle to the late Holocene in the marginal Asian monsoon region. We used an absolutely dated ^(230)Th record with only a ~20-year dating error, and oxygen isotope data with an 8-year average temporal resolution from the top 22-mm segment of stalagmite WXB07-4 from Wanxiang Cave, western Loess Plateau. The ASM intensity weakened gradually from 6420 to 4920 a BP, which was mainly characterized by three phases:(1) a strengthening phase with a higher precipitation amount between 6420 and 6170 a BP;(2) a smooth fluctuating interval during 6170–5700 a BP; and(3) a sudden extreme weakening period from 5700 to 4920 a BP. Interestingly, the extreme weakening interval of the ASM occurred during the period between 5700 and 4920 a BP, an abrupt change dated at 5430 a BP, which is known as the 5400 a BP, or 5.4 ka BP, event. The period included 290 years of gradual weakening, and 350 years of slow strengthening. This was synchronous with some cave records from the Asian monsoon region within dating errors. Comparing with Chinese archaeological archives over the past 7000 years, the early decline of the Yangshao Culture in the Yellow River Basin and the Hongshan Culture in the West Liao River Basin occurred during the period of gradual decrease of ASM precipitation. The dramatic decline in precipitation, caused by the extreme weakening of the ASM at 5400 a BP,may have been partly related to the decline of the Miaodigou Culture at the Yangguanzhai site in the Weihe River valley; the middle Yangshao Culture in western Henan in the Yellow River Basin; the early Dawenkou Culture on the lower reaches of the Yellow River; and the middle Hongshan Culture in the west of the Liaohe River valley. During the later period of the 5400 a BP event(5430–4920 a BP), a small amplitude increase and a subsequent sharp decrease of ASM precipitation may have also been linked to the contemporaneous prosperity and disappearance of the late Yangshao and Hongshan cultures; the disappearance of the late Yangshao Culture represented by the Yangguanzhai site in the Guanzhong basin on the Weihe River; the fourth phase of the late Yangshao Culture on the upstream Dadiwan site; the beginning of the middle Dawenkou Culture, the formation of its late stage,and the rise of the Longshan culture; and the rise of the Qujialing and Liangzhu cultures on the lower Yangtze River. Compared with the stalagmite precipitation records on the Qinghai-Tibetan Plateau, the rise and expansion of the Majiayao Culture in the upper Yellow River valley at 5300 a BP may have also been connected to the more dramatic increase of the summer monsoon precipitation at higher, rather than lower, altitudes during the late 5400 a BP event.
