BACKGROUND The optimal apolipoprotein or lipid measures for identifying statin-treated patients with coronary artery disease(CAD)at residual cardiovascular risk remain controversial.This study aimed to compare the pre...BACKGROUND The optimal apolipoprotein or lipid measures for identifying statin-treated patients with coronary artery disease(CAD)at residual cardiovascular risk remain controversial.This study aimed to compare the predictive powers of apolipoprotein B(apoB),non-high-density lipoprotein cholesterol(non-HDL-C),low-density lipoprotein cholesterol(LDL-C),apoB/apolipoprotein A-1(apoA-1)and non-HDL-C/HDL-C for myocardial infarction(MI)in CAD patients treated with statins in the setting of secondary prevention.METHODS The study included 9191 statin-treated CAD patients with a five-year median follow-up.All measures were anal-yzed as continuous variables and concordance/discordance groups by medians.The hazard ratio(HR)with 95%CI was estimated by Cox proportional hazards regression.Patients were classified by the clinical presentation of CAD for further analysis.RESULTS The high-apoB-low-LDL-C and the high-non-HDL-C-low-LDL-C categories yielded HR of 1.40(95%CI:1.04–1.88)and 1.51(95%CI:1.07–2.13)for MI,respectively,whereas discordant high LDL-C with low apoB or non-HDL-C was not associa-ted with the risk of MI.No association of MI with discordant apoB versus non-HDL-C,apoB/apoA-1 versus apoB,non-HDL-C/HDL-C versus non-HDL-C,or apoB/apoA-1 versus non-HDL-C/HDL-C was observed.Similar patterns were found in patients with acute coronary syndrome.In contrast,no association was observed between any concordance/discordance category and the risk of MI in patients with chronic coronary syndrome.CONCLUSIONS ApoB and non-HDL-C better predict MI in statin-treated CAD patients than LDL-C,especially in patients with acute coronary syndrome.ApoB/apoA-1 and non-HDL-C/HDL-C show no superiority to apoB and non-HDL-C for predict-ing MI.展开更多
A composite rubber concrete(CRC)was designed by combining waste tire rubber particles with particle sizes of 3~5 mm,1~3 mm and 20 mesh.Taking the rubber content of different particle sizes as the influencing factors,t...A composite rubber concrete(CRC)was designed by combining waste tire rubber particles with particle sizes of 3~5 mm,1~3 mm and 20 mesh.Taking the rubber content of different particle sizes as the influencing factors,the range and variance analysis of the mechanical and impermeability properties of CRC was carried out by orthogonal test.Through analysis,it is concluded that the optimal proportion of 3~5 mm,1~3 mm,and 20 mesh particle size composite rubber is 1:2.5:5.5 kinds of CRC and 3 kinds of ordinary single-mixed rubber concrete(RC)with a total content of 10%~20%were designed under this ratio,and the salt-freezing cycle test was carried out with a concentration of 5%Na 2 SO4 solution.The physical and mechanical damage laws during 120 salt-freezing cycles are obtained,and the corresponding damage prediction model is established according to the experimental data.The results show that:on the one hand,the composite rubber in CRC produces a more uniform“graded”structure,forms a retractable particle group,and reduces the loss of mechanical properties of CRC.On the other hand,colloidal particles with different particle sizes are used as air entraining agent to improve the pore structure of concrete and introduce evenly dispersed bubbles,which fundamentally improves the durability of concrete.Under the experimental conditions,the CRC performance is the best when the overall content of composite rubber is 15%.展开更多
BACKGROUND: We aim to investigate effects of metabolic syndrome on onset age and long-termoutcomes in patients with acute coronary syndrome (ACS).METHODS: Patients with ACS (n=6,431) who underwent percutaneous coronar...BACKGROUND: We aim to investigate effects of metabolic syndrome on onset age and long-termoutcomes in patients with acute coronary syndrome (ACS).METHODS: Patients with ACS (n=6,431) who underwent percutaneous coronary interventionfrom January to December 2013 were enrolled. After excluding patients with previous coronary arterydisease, 1,558 patients were diagnosed with early-onset ACS (men aged ≤50 years;women aged≤60 years) and 3,044 patients with late-onset ACS. Baseline characteristics and five-year clinicaloutcomes were measured.RESULTS: Body mass index, triglyceride, low-density lipoprotein cholesterol, and uric acidconcentrations were significantly higher, while the high-density lipoprotein cholesterol (HDL-C)concentration was lower in the early-onset ACS group (P<0.001). Multivariate logistic regression revealedobesity (odds ratio [OR] 1.590, 95% confi dence interval [CI] 1.345–1.881), hypertriglyceridemia (OR 1.403,95% CI 1.185–1.660), and low HDL-C (OR 1.464, 95% CI 1.231–1.742) as independent risk factorsfor early-onset ACS (all P<0.001). The fi ve-year follow-up showed that the incidences of all cause death(1.5% vs. 3.8%, P<0.001), cardiac death (1.1% vs. 2.0%, P=0.023), and recurrent stroke (2.2% vs. 4.2%,P<0.001) were lower, while bleeding events were more frequent in the early-onset ACS group. A subgroupanalysis showed higher incidences of recurrent myocardial infarction (MI) and revascularization in patientswith early-onset ACS and metabolic syndrome.CONCLUSIONS: Obesity, hypertriglyceridemia, and lower HDL-C level are independent riskfactors for early-onset ACS, recurrent MI, and revascularization. The control of metabolic syndromemay reduce the incidence of early-onset ACS and improve the long-term prognosis.展开更多
Background and Objective Renal insufficiency(RI)is reported to be associated with increased ischemic and bleeding events after percutaneous coronary intervention(PCI),which is possibly due to high residual platelet re...Background and Objective Renal insufficiency(RI)is reported to be associated with increased ischemic and bleeding events after percutaneous coronary intervention(PCI),which is possibly due to high residual platelet reactivity(HRPR)during DAPT therapy.Therefore,we performed a large prospective observational study to evaluate the platelet reactivity and related clinical outcomes in real-world patients with different renal insufficiency stage after PCI,and to examine whether HRPR is associated with higher incidence of adverse cardiovascular events in a 2-year follow up.展开更多
Objective This study analyzed a large single-center sample in China to explain the impact of smoking state at baseline on long-term prognosis of coronary artery disease (CAD) patients who received percutaneous coronar...Objective This study analyzed a large single-center sample in China to explain the impact of smoking state at baseline on long-term prognosis of coronary artery disease (CAD) patients who received percutaneous coronary intervention (PCI).展开更多
Background and Objective Treatment strategy for unstable angina has underwent significant changes since the introduction of Braunwald classification of unstable angina nearly 30 years ago,yet re-evaluation of this rou...Background and Objective Treatment strategy for unstable angina has underwent significant changes since the introduction of Braunwald classification of unstable angina nearly 30 years ago,yet re-evaluation of this routinely used classification system is rarely published in recent years.We aim to re-evaluate the Braunwald unstable angina(UA)classification on its predictive value of clinical characteristics,angiographic features,and occurrence of future adverse events.展开更多
Background and Objective Prediabetes(Pre-DM)is a serious condition that is associated with an increase in cardiovascular morbidity and mortality.We sought to explore the prevalence of prediabetes in patients admitted ...Background and Objective Prediabetes(Pre-DM)is a serious condition that is associated with an increase in cardiovascular morbidity and mortality.We sought to explore the prevalence of prediabetes in patients admitted with coronary artery disease who were not known to have diabetes and to determine the impact of prediabetes on 2-year clinical outcomes versus non-diabetic patients.展开更多
Small cell lung cancer(SCLC)is a highly malignant and heterogeneous cancer with limited therapeutic options and prognosis prediction models.Here,we analyzed formalin-fixed,paraffin-embedded(FFPE)samples of surgical re...Small cell lung cancer(SCLC)is a highly malignant and heterogeneous cancer with limited therapeutic options and prognosis prediction models.Here,we analyzed formalin-fixed,paraffin-embedded(FFPE)samples of surgical resections by proteomic profiling,and stratified SCLC into three proteomic subtypes(S-I,S-II,and S-III)with distinct clinical outcomes and chemotherapy responses.The proteomic subtyping was an independent prognostic factor and performed better than current tumor–node–metastasis or Veterans Administration Lung Study Group staging methods.The subtyping results could be further validated using FFPE biopsy samples from an independent cohort,extending the analysis to both surgical and biopsy samples.The signatures of the S-II subtype in particular suggested potential benefits from immunotherapy.Differentially overexpressed proteins in S-III,the worst prognostic subtype,allowed us to nominate potential therapeutic targets,indicating that patient selection may bring new hope for previously failed clinical trials.Finally,analysis of an independent cohort of SCLC patients who had received immunotherapy validated the prediction that the S-II patients had better progression-free survival and overall survival after first-line immunotherapy.Collectively,our study provides the rationale for future clinical investigations to validate the current findings for more accurate prognosis prediction and precise treatments.展开更多
The oxygen evolution reaction(OER)plays an essential role in many energy storage and conversion technologies,but its high overpotential and sluggish kinetics seriously restrict its energy efficiency.The development of...The oxygen evolution reaction(OER)plays an essential role in many energy storage and conversion technologies,but its high overpotential and sluggish kinetics seriously restrict its energy efficiency.The development of efficient and inexpensive OER electrocatalysts remains a grand challenge.Twodimensional(2D)materials with their unique structure and electronic properties have wide application prospects for OER.In this review,first introducing OER electrocatalytic mechanisms and some crucial parameters for evaluating OER electrocatalysts,the latest progress in the design and construction of 2D materials for OER is systematically discussed,including layered double hydroxides,2D carbon materials,transition metal dichalcogenides,metal oxide and phosphide nanosheets,metal–organic frameworks,covalent-organic frameworks,and MXenes.Obviously,some effective design and optimization strategies to improve the electrocatalytic activity and durability of 2D materials such as OER electrocatalysts have been comprehensively generalized.The advantages and shortcomings of these 2D materials are analyzed in detail,and their practical applications are explained in depth,which is crucial for the rational design of high-performance OER electrocatalysts.Finally,the challenges and future development opportunities for 2D materials in enhanced OER are discussed.Our review is expected to provide clear guidance for the development of new low-cost 2D materials for advanced OER electrocatalysts.展开更多
Background:There are few data comparing clinical outcomes of complex percutaneous coronary intervention(CPCI)when using biodegradable polymer drug-eluting stents(BP-DES)or second-generation durable polymer drug-elutin...Background:There are few data comparing clinical outcomes of complex percutaneous coronary intervention(CPCI)when using biodegradable polymer drug-eluting stents(BP-DES)or second-generation durable polymer drug-eluting stents(DP-DES).The purpose of this study was to investigate the safety and efficacy of BP-DES and compare that with DP-DES in patients with and without CPCI during a 5-year follow-up.Methods:Patients who exclusively underwent BP-DES or DP-DES implantation in 2013 at Fuwai Hospital were consecutively enrolled and stratified into two categories based on CPCI presence or absence.CPCI included at least one of the following features:unprotected left main lesion,≥2 lesions treated,≥2 stents implanted,total stent length>40 mm,moderate-to-severe calcified lesion,chronic total occlusion,or bifurcated target lesion.The primary endpoint was major adverse cardiac events(MACE)including all-cause death,recurrent myocardial infarction,and total coronary revascularization(target lesion revascularization,target vessel revascularization[TVR],and non-TVR)during the 5-year follow-up.The secondary endpoint was total coronary revascularization.Results:Among the 7712 patients included,4882(63.3%)underwent CPCI.Compared with non-CPCI patients,CPCI patients had higher 2-and 5-year incidences of MACE and total coronary revascularization.Following multivariable adjustment including stent type,CPCI was an independent predictor of MACE(adjusted hazard ratio[aHR]:1.151;95%confidence interval[CI]:1.017–1.303,P=0.026)and total coronary revascularization(aHR:1.199;95%CI:1.037–1.388,P=0.014)at 5 years.The results were consistent at the 2-year endpoints.In patients with CPCI,BP-DES use was associated with significantly higher MACE rates at 5 years(aHR:1.256;95%CI:1.078–1.462,P=0.003)and total coronary revascularization(aHR:1.257;95%CI:1.052–1.502,P=0.012)compared with that of DP-DES,but there was a similar risk at 2 years.However,BP-DES had comparable safety and efficacy profiles including MACE and total coronary revascularization compared with DP-DES in patients with non-CPCI at 2 and 5 years.Conclusions:Patients underwent CPCI remained at a higher risk of mid-to long-term adverse events regardless of the stent type.The effect of BP-DES compared with DP-DES on outcomes was similar in CPCI and non-CPCI patients at 2 years but had inconsistent effects at the 5-year clinical endpoints.展开更多
With the requirements of self-powering sensors in flexible electronics,wearable triboelectric nanogenerators(TENGs)have attracted great attention due to their advantages of excellent electrical outputs and low-cost pr...With the requirements of self-powering sensors in flexible electronics,wearable triboelectric nanogenerators(TENGs)have attracted great attention due to their advantages of excellent electrical outputs and low-cost processing routes.The crosstalk effect between adjacent sensing units in TENGs significantly limits the pixel density of sensor arrays.Here,we present a skin-integrated,flexible TENG sensor array with 100 sensing units in an overall size of 7.5 cm×7.5 cm that can be processed in a simple,low-cost,and scalable way enabled by 3D printing.All the sensing units show good sensitivity of 0.11 V/kPa with a wide range of pressure detection from 10 to 65 kPa,which allows to accurately distinguish various tactile formats from gentle touching(as low as 2 kPa)to hard pressuring.The 3D printing patterned substrate allows to cast triboelectric layers of polydimethylsiloxane in an independent sensing manner for each unit,which greatly suppresses the cross talk arising from adjacent sensing units,where the maximum crosstalk output is only 10.8%.The excellent uniformity and reproducibility of the sensor array offer precise pressure mapping for complicated pattern loadings,which demonstrates its potential in tactile sensing and human-machine interfaces.展开更多
Background:Several platelet function tests are currently used to measure responsiveness to antiplatelet therapy.This study was to compare two tests,light transmittance aggregometry (LTA) and modified thrombelastograph...Background:Several platelet function tests are currently used to measure responsiveness to antiplatelet therapy.This study was to compare two tests,light transmittance aggregometry (LTA) and modified thrombelastography (mTEG),for predicting clinical outcomes in Chinese patients after percutaneous coronary intervention (PCI).Methods:Prospective,observational,single-center study of 789 Chinese patients undergoing PCI was enrolled.This study was investigated the correlations between the two tests and performed receiver operating characteristic curve (ROC) analysis for major adverse cardiovascular events (MACEs) at 1-year follow-up.Results:MACEs occurred in 32 patients (4.1％).Correlations were well between the two tests in the adenosine diphosphate induced platelet reactivity (Spearman r =0.733,P ＜ 0.001).ROC-curve analysis demonstrated that LTA (area under the curve [AUC]:0.677; 95％ confidence interval [CI]:0.643-0.710; P =0.0009),and mTEG (AUC:0.684; 95％ CI:0.650-0.716; P =0.0001) had moderate ability to discriminate between patients with and without MACE.MACE occurred more frequently in patients with high on-treatment platelet reactivity (HPR) when assessed by LTA (7.4％ vs.2.7％; P ＜ 0.001),and by TEG (6.7％ vs.2.6％; P ＜ 0.001).Kaplan-Meier analysis demonstrated that HPR based on the LTA and mTEG was associated with almost 3-fold increased risk of MACE at 1-year follow-up.Conclusions:The correlation between LTA and mTEG is relatively high in Chinese patients.HPR measured by LTA and mTEG were significantly associated with MACE in Chinese patients undergoing PCI.展开更多
Background:It is currently unclear if fibrinogen is a risk factor for adverse events in patients receiving percutaneous coronary intervention(PCI)or merely serves as a marker of pre-existing comorbidities and other ca...Background:It is currently unclear if fibrinogen is a risk factor for adverse events in patients receiving percutaneous coronary intervention(PCI)or merely serves as a marker of pre-existing comorbidities and other causal factors.We therefore investigated the association between fibrinogen levels and 2-year all-cause mortality,and compared the additional predictive value of adding fibrinogen to a basic model including traditional risk factors in patients receiving contemporary PCI.Methods:A total of 6293 patients undergoing PCI with measured baseline fibrinogen levels were enrolied from January to December 2013 in Fuwai Hospital.Patients were divided into three groups according to tertiles of baseline fibrinogen levels:low fibrinogen,<2.98 g/L;medium fibrinogen,2.98 to 3.58 g/L;and high fibrinogen,≥3.58 g/L.Independent predictors of 2-year clinical outcomes were determined by multivariate Cox proportional hazards regression modeling.The increased discriminative value of fibrinogen for predicting all-cause mortality was assessed using the C-statistic and integrated discrimination improvement(IDI).Results:The 2-year all-cause mortality rate was 1.2%.It was significantly higher in the high fibrinogen compared with the low and medium fibrinogen groups according to Kaplan-Meier analyses(1.7%vs.0.9%and 1.7%vs.1.0%,respectively;log-rank,P=0.022).Fibrinogen was significantly associated with all-cause mortality according to multivariate Cox regression(hazard ratio 1.339,95%confidence interval:1.109-1.763,P=0.005),together with traditional risk factors including age,sex,diabetes mellitus,left ventricular ejection fraction,creatinine clearance,and low-density lipoprotein cholesterol.The area under the curve for all-cause mortality in the basic model including traditional risk factors was 0.776,and this value increased to 0.787 when fibrinogen was added to the model(IDI=0.003,Z=0.140,P=0.889).Conclusions:Fibrinogen is associated with 2-year all-cause mortality in patients receiving PCI,but provides no additional information over a model including traditional risk factors.展开更多
基金supported by the China National Key R&D Program during the 13th Five-year Plan Period,China(2016YFC1301301)the CAMS Innovation Fund for Medical Sciences,China(2020-I2 M-C&T-B-049)the National Clinical Research Center for Cardiovascular Diseases,Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China(NCRC2020013).
文摘BACKGROUND The optimal apolipoprotein or lipid measures for identifying statin-treated patients with coronary artery disease(CAD)at residual cardiovascular risk remain controversial.This study aimed to compare the predictive powers of apolipoprotein B(apoB),non-high-density lipoprotein cholesterol(non-HDL-C),low-density lipoprotein cholesterol(LDL-C),apoB/apolipoprotein A-1(apoA-1)and non-HDL-C/HDL-C for myocardial infarction(MI)in CAD patients treated with statins in the setting of secondary prevention.METHODS The study included 9191 statin-treated CAD patients with a five-year median follow-up.All measures were anal-yzed as continuous variables and concordance/discordance groups by medians.The hazard ratio(HR)with 95%CI was estimated by Cox proportional hazards regression.Patients were classified by the clinical presentation of CAD for further analysis.RESULTS The high-apoB-low-LDL-C and the high-non-HDL-C-low-LDL-C categories yielded HR of 1.40(95%CI:1.04–1.88)and 1.51(95%CI:1.07–2.13)for MI,respectively,whereas discordant high LDL-C with low apoB or non-HDL-C was not associa-ted with the risk of MI.No association of MI with discordant apoB versus non-HDL-C,apoB/apoA-1 versus apoB,non-HDL-C/HDL-C versus non-HDL-C,or apoB/apoA-1 versus non-HDL-C/HDL-C was observed.Similar patterns were found in patients with acute coronary syndrome.In contrast,no association was observed between any concordance/discordance category and the risk of MI in patients with chronic coronary syndrome.CONCLUSIONS ApoB and non-HDL-C better predict MI in statin-treated CAD patients than LDL-C,especially in patients with acute coronary syndrome.ApoB/apoA-1 and non-HDL-C/HDL-C show no superiority to apoB and non-HDL-C for predict-ing MI.
基金supported by the National Key Research and Development Program of China under the Grant No.2018YFC0809400.
文摘A composite rubber concrete(CRC)was designed by combining waste tire rubber particles with particle sizes of 3~5 mm,1~3 mm and 20 mesh.Taking the rubber content of different particle sizes as the influencing factors,the range and variance analysis of the mechanical and impermeability properties of CRC was carried out by orthogonal test.Through analysis,it is concluded that the optimal proportion of 3~5 mm,1~3 mm,and 20 mesh particle size composite rubber is 1:2.5:5.5 kinds of CRC and 3 kinds of ordinary single-mixed rubber concrete(RC)with a total content of 10%~20%were designed under this ratio,and the salt-freezing cycle test was carried out with a concentration of 5%Na 2 SO4 solution.The physical and mechanical damage laws during 120 salt-freezing cycles are obtained,and the corresponding damage prediction model is established according to the experimental data.The results show that:on the one hand,the composite rubber in CRC produces a more uniform“graded”structure,forms a retractable particle group,and reduces the loss of mechanical properties of CRC.On the other hand,colloidal particles with different particle sizes are used as air entraining agent to improve the pore structure of concrete and introduce evenly dispersed bubbles,which fundamentally improves the durability of concrete.Under the experimental conditions,the CRC performance is the best when the overall content of composite rubber is 15%.
基金supported by the National Key Researchand Development Program of China (2016YFC130130 [Subtopic:2016YFC1301301]).
文摘BACKGROUND: We aim to investigate effects of metabolic syndrome on onset age and long-termoutcomes in patients with acute coronary syndrome (ACS).METHODS: Patients with ACS (n=6,431) who underwent percutaneous coronary interventionfrom January to December 2013 were enrolled. After excluding patients with previous coronary arterydisease, 1,558 patients were diagnosed with early-onset ACS (men aged ≤50 years;women aged≤60 years) and 3,044 patients with late-onset ACS. Baseline characteristics and five-year clinicaloutcomes were measured.RESULTS: Body mass index, triglyceride, low-density lipoprotein cholesterol, and uric acidconcentrations were significantly higher, while the high-density lipoprotein cholesterol (HDL-C)concentration was lower in the early-onset ACS group (P<0.001). Multivariate logistic regression revealedobesity (odds ratio [OR] 1.590, 95% confi dence interval [CI] 1.345–1.881), hypertriglyceridemia (OR 1.403,95% CI 1.185–1.660), and low HDL-C (OR 1.464, 95% CI 1.231–1.742) as independent risk factorsfor early-onset ACS (all P<0.001). The fi ve-year follow-up showed that the incidences of all cause death(1.5% vs. 3.8%, P<0.001), cardiac death (1.1% vs. 2.0%, P=0.023), and recurrent stroke (2.2% vs. 4.2%,P<0.001) were lower, while bleeding events were more frequent in the early-onset ACS group. A subgroupanalysis showed higher incidences of recurrent myocardial infarction (MI) and revascularization in patientswith early-onset ACS and metabolic syndrome.CONCLUSIONS: Obesity, hypertriglyceridemia, and lower HDL-C level are independent riskfactors for early-onset ACS, recurrent MI, and revascularization. The control of metabolic syndromemay reduce the incidence of early-onset ACS and improve the long-term prognosis.
文摘Background and Objective Renal insufficiency(RI)is reported to be associated with increased ischemic and bleeding events after percutaneous coronary intervention(PCI),which is possibly due to high residual platelet reactivity(HRPR)during DAPT therapy.Therefore,we performed a large prospective observational study to evaluate the platelet reactivity and related clinical outcomes in real-world patients with different renal insufficiency stage after PCI,and to examine whether HRPR is associated with higher incidence of adverse cardiovascular events in a 2-year follow up.
文摘Objective This study analyzed a large single-center sample in China to explain the impact of smoking state at baseline on long-term prognosis of coronary artery disease (CAD) patients who received percutaneous coronary intervention (PCI).
文摘Background and Objective Treatment strategy for unstable angina has underwent significant changes since the introduction of Braunwald classification of unstable angina nearly 30 years ago,yet re-evaluation of this routinely used classification system is rarely published in recent years.We aim to re-evaluate the Braunwald unstable angina(UA)classification on its predictive value of clinical characteristics,angiographic features,and occurrence of future adverse events.
文摘Background and Objective Prediabetes(Pre-DM)is a serious condition that is associated with an increase in cardiovascular morbidity and mortality.We sought to explore the prevalence of prediabetes in patients admitted with coronary artery disease who were not known to have diabetes and to determine the impact of prediabetes on 2-year clinical outcomes versus non-diabetic patients.
基金supported by the National Key R&D Program of China(Grant Nos.2018YFA0507503,2017YFA0505102,2017YFA0505103,and 2017YFA0505104)the National Natural Science Foundation of China(Grant Nos.82072597,62131009,31770892,31970725,31870828,81874237,and 81974016)+2 种基金the Beijing Municipal Natural Science Foundation(Grant No.7192199)the State Key Laboratory of Proteomics(Grant No.SKLP-K202002)the Kaifeng Science and Technology Development Plan Project(Grant No.1806005),China.
文摘Small cell lung cancer(SCLC)is a highly malignant and heterogeneous cancer with limited therapeutic options and prognosis prediction models.Here,we analyzed formalin-fixed,paraffin-embedded(FFPE)samples of surgical resections by proteomic profiling,and stratified SCLC into three proteomic subtypes(S-I,S-II,and S-III)with distinct clinical outcomes and chemotherapy responses.The proteomic subtyping was an independent prognostic factor and performed better than current tumor–node–metastasis or Veterans Administration Lung Study Group staging methods.The subtyping results could be further validated using FFPE biopsy samples from an independent cohort,extending the analysis to both surgical and biopsy samples.The signatures of the S-II subtype in particular suggested potential benefits from immunotherapy.Differentially overexpressed proteins in S-III,the worst prognostic subtype,allowed us to nominate potential therapeutic targets,indicating that patient selection may bring new hope for previously failed clinical trials.Finally,analysis of an independent cohort of SCLC patients who had received immunotherapy validated the prediction that the S-II patients had better progression-free survival and overall survival after first-line immunotherapy.Collectively,our study provides the rationale for future clinical investigations to validate the current findings for more accurate prognosis prediction and precise treatments.
基金the Youth Talents Program of China,the Key Research and Development Projects in Shaanxi Province(grant no.2021GXLH-Z-072)the State Key Laboratory of Power System and Generation Equipment(grant no.SKLD21KM07)the National Natural Science Foundation of China-NSAF Joint Fund(CN)(grant no.U2230113).
文摘The oxygen evolution reaction(OER)plays an essential role in many energy storage and conversion technologies,but its high overpotential and sluggish kinetics seriously restrict its energy efficiency.The development of efficient and inexpensive OER electrocatalysts remains a grand challenge.Twodimensional(2D)materials with their unique structure and electronic properties have wide application prospects for OER.In this review,first introducing OER electrocatalytic mechanisms and some crucial parameters for evaluating OER electrocatalysts,the latest progress in the design and construction of 2D materials for OER is systematically discussed,including layered double hydroxides,2D carbon materials,transition metal dichalcogenides,metal oxide and phosphide nanosheets,metal–organic frameworks,covalent-organic frameworks,and MXenes.Obviously,some effective design and optimization strategies to improve the electrocatalytic activity and durability of 2D materials such as OER electrocatalysts have been comprehensively generalized.The advantages and shortcomings of these 2D materials are analyzed in detail,and their practical applications are explained in depth,which is crucial for the rational design of high-performance OER electrocatalysts.Finally,the challenges and future development opportunities for 2D materials in enhanced OER are discussed.Our review is expected to provide clear guidance for the development of new low-cost 2D materials for advanced OER electrocatalysts.
基金supported by the National Key Research and Development Program of China(Nos.2016YFC1301300 and 2016YFC1301301)National Clinical Research Center for Cardiovascular Diseases,Fuwai Hospital,Chinese Academy of Medical Sciences(No.NCRC2020013)+1 种基金Chinese Academy of Medical Sciences(CAMS)Innovation Fund for Medical Sciences(CIFMS)(No.2020-I2M-C&T-B-049)the National Natural Science Foundation for Young Scholars of China(No.81900323).
文摘Background:There are few data comparing clinical outcomes of complex percutaneous coronary intervention(CPCI)when using biodegradable polymer drug-eluting stents(BP-DES)or second-generation durable polymer drug-eluting stents(DP-DES).The purpose of this study was to investigate the safety and efficacy of BP-DES and compare that with DP-DES in patients with and without CPCI during a 5-year follow-up.Methods:Patients who exclusively underwent BP-DES or DP-DES implantation in 2013 at Fuwai Hospital were consecutively enrolled and stratified into two categories based on CPCI presence or absence.CPCI included at least one of the following features:unprotected left main lesion,≥2 lesions treated,≥2 stents implanted,total stent length>40 mm,moderate-to-severe calcified lesion,chronic total occlusion,or bifurcated target lesion.The primary endpoint was major adverse cardiac events(MACE)including all-cause death,recurrent myocardial infarction,and total coronary revascularization(target lesion revascularization,target vessel revascularization[TVR],and non-TVR)during the 5-year follow-up.The secondary endpoint was total coronary revascularization.Results:Among the 7712 patients included,4882(63.3%)underwent CPCI.Compared with non-CPCI patients,CPCI patients had higher 2-and 5-year incidences of MACE and total coronary revascularization.Following multivariable adjustment including stent type,CPCI was an independent predictor of MACE(adjusted hazard ratio[aHR]:1.151;95%confidence interval[CI]:1.017–1.303,P=0.026)and total coronary revascularization(aHR:1.199;95%CI:1.037–1.388,P=0.014)at 5 years.The results were consistent at the 2-year endpoints.In patients with CPCI,BP-DES use was associated with significantly higher MACE rates at 5 years(aHR:1.256;95%CI:1.078–1.462,P=0.003)and total coronary revascularization(aHR:1.257;95%CI:1.052–1.502,P=0.012)compared with that of DP-DES,but there was a similar risk at 2 years.However,BP-DES had comparable safety and efficacy profiles including MACE and total coronary revascularization compared with DP-DES in patients with non-CPCI at 2 and 5 years.Conclusions:Patients underwent CPCI remained at a higher risk of mid-to long-term adverse events regardless of the stent type.The effect of BP-DES compared with DP-DES on outcomes was similar in CPCI and non-CPCI patients at 2 years but had inconsistent effects at the 5-year clinical endpoints.
基金This work was supported in part by InnoHK Project on Project 2.2-AI-based 3D ultrasound imaging algorithm at Hong Kong Centre for Cerebro-cardiovascular Health Engineering(COCHE),in part by Research Grants Council of the Hong Kong Special Administrative Region(21210820,and 11213721)in part by Shenzhen Science and Technology Innovation Commission(JCYJ20200109110201713)in part by National Natural Science Foundation of China(62122002,and U21A20492).
文摘With the requirements of self-powering sensors in flexible electronics,wearable triboelectric nanogenerators(TENGs)have attracted great attention due to their advantages of excellent electrical outputs and low-cost processing routes.The crosstalk effect between adjacent sensing units in TENGs significantly limits the pixel density of sensor arrays.Here,we present a skin-integrated,flexible TENG sensor array with 100 sensing units in an overall size of 7.5 cm×7.5 cm that can be processed in a simple,low-cost,and scalable way enabled by 3D printing.All the sensing units show good sensitivity of 0.11 V/kPa with a wide range of pressure detection from 10 to 65 kPa,which allows to accurately distinguish various tactile formats from gentle touching(as low as 2 kPa)to hard pressuring.The 3D printing patterned substrate allows to cast triboelectric layers of polydimethylsiloxane in an independent sensing manner for each unit,which greatly suppresses the cross talk arising from adjacent sensing units,where the maximum crosstalk output is only 10.8%.The excellent uniformity and reproducibility of the sensor array offer precise pressure mapping for complicated pattern loadings,which demonstrates its potential in tactile sensing and human-machine interfaces.
基金This work was supposed by grants from the National Research Key Project of the Twelfth Five-year Plan of Republic of China，National Natural Science Foundation of China，National Special Fund for Healthcare Research in the Public Interests of China
文摘Background:Several platelet function tests are currently used to measure responsiveness to antiplatelet therapy.This study was to compare two tests,light transmittance aggregometry (LTA) and modified thrombelastography (mTEG),for predicting clinical outcomes in Chinese patients after percutaneous coronary intervention (PCI).Methods:Prospective,observational,single-center study of 789 Chinese patients undergoing PCI was enrolled.This study was investigated the correlations between the two tests and performed receiver operating characteristic curve (ROC) analysis for major adverse cardiovascular events (MACEs) at 1-year follow-up.Results:MACEs occurred in 32 patients (4.1％).Correlations were well between the two tests in the adenosine diphosphate induced platelet reactivity (Spearman r =0.733,P ＜ 0.001).ROC-curve analysis demonstrated that LTA (area under the curve [AUC]:0.677; 95％ confidence interval [CI]:0.643-0.710; P =0.0009),and mTEG (AUC:0.684; 95％ CI:0.650-0.716; P =0.0001) had moderate ability to discriminate between patients with and without MACE.MACE occurred more frequently in patients with high on-treatment platelet reactivity (HPR) when assessed by LTA (7.4％ vs.2.7％; P ＜ 0.001),and by TEG (6.7％ vs.2.6％; P ＜ 0.001).Kaplan-Meier analysis demonstrated that HPR based on the LTA and mTEG was associated with almost 3-fold increased risk of MACE at 1-year follow-up.Conclusions:The correlation between LTA and mTEG is relatively high in Chinese patients.HPR measured by LTA and mTEG were significantly associated with MACE in Chinese patients undergoing PCI.
基金the National Key Technologies R&D Program in the 13th Five-Year Plan of China(No.2016YFC1301301)the National Natural Science Foundation of China(No.81770365).
文摘Background:It is currently unclear if fibrinogen is a risk factor for adverse events in patients receiving percutaneous coronary intervention(PCI)or merely serves as a marker of pre-existing comorbidities and other causal factors.We therefore investigated the association between fibrinogen levels and 2-year all-cause mortality,and compared the additional predictive value of adding fibrinogen to a basic model including traditional risk factors in patients receiving contemporary PCI.Methods:A total of 6293 patients undergoing PCI with measured baseline fibrinogen levels were enrolied from January to December 2013 in Fuwai Hospital.Patients were divided into three groups according to tertiles of baseline fibrinogen levels:low fibrinogen,<2.98 g/L;medium fibrinogen,2.98 to 3.58 g/L;and high fibrinogen,≥3.58 g/L.Independent predictors of 2-year clinical outcomes were determined by multivariate Cox proportional hazards regression modeling.The increased discriminative value of fibrinogen for predicting all-cause mortality was assessed using the C-statistic and integrated discrimination improvement(IDI).Results:The 2-year all-cause mortality rate was 1.2%.It was significantly higher in the high fibrinogen compared with the low and medium fibrinogen groups according to Kaplan-Meier analyses(1.7%vs.0.9%and 1.7%vs.1.0%,respectively;log-rank,P=0.022).Fibrinogen was significantly associated with all-cause mortality according to multivariate Cox regression(hazard ratio 1.339,95%confidence interval:1.109-1.763,P=0.005),together with traditional risk factors including age,sex,diabetes mellitus,left ventricular ejection fraction,creatinine clearance,and low-density lipoprotein cholesterol.The area under the curve for all-cause mortality in the basic model including traditional risk factors was 0.776,and this value increased to 0.787 when fibrinogen was added to the model(IDI=0.003,Z=0.140,P=0.889).Conclusions:Fibrinogen is associated with 2-year all-cause mortality in patients receiving PCI,but provides no additional information over a model including traditional risk factors.
