Radiologists play a key role in establishing an early and accurate diagnosis,especially for rare diseases.Mahvash disease(OMIM 619290)is an autosomal recessive hereditary disease caused by inactivating mutations of th...Radiologists play a key role in establishing an early and accurate diagnosis,especially for rare diseases.Mahvash disease(OMIM 619290)is an autosomal recessive hereditary disease caused by inactivating mutations of the glucagon receptor and its main clinical consequences are pancreatic neuroendocrine tumors and in some cases,porto-sinusoidal vascular disease and portal hypertension.Untreated Mahvash disease can be lethal.The diagnosis of Mahvash disease has almost always been delayed in the past due to radiologists’unawareness of or unfamiliarity with the unique imaging features of Mahvash disease which are moderately to enormously enlarge pancreas with preserved pancreas contour and parenchyma without vascular involvement or lymphadenopathy.These features help differentiate Mahvash disease from other etiologies of diffusely enlarged pancreas such as diffuse pancreatic ductal carcinoma,diffuse pancreatic lymphoma,and autoimmune pancreatitis.Invoking Mahvash disease in the differential diagnosis of an enlarged pancreas has recently been shown to facilitate early diagnosis.To prevent missing the diagnosis of this significant disease,I sincerely ask radiologists to consider Mahvash disease in their differential diagnoses of diffusely enlarged pancreas.展开更多
The influence of enlarged section parameters on pressure transients of high-speed train passing through a tunnel was investigated by numerical simulation.The calculation results obtained by the structured and unstruct...The influence of enlarged section parameters on pressure transients of high-speed train passing through a tunnel was investigated by numerical simulation.The calculation results obtained by the structured and unstructured grid and the experimental results of smooth wall tunnel were verified.Numerical simulation studies were conducted on three tunnel enlarged section parameters,the enlarged section distribution along circumferential direction,the enlarged section area and the enlarged section distribution along tunnel length direction.The calculation results show that the influence of the different enlarged section distributions along tunnel circumferential direction on pressure transients in the tunnel is basically consistent.There is an optimal enlarged section area for the minimum value of the pressure variation amplitude and the average pressure variation in the tunnel.The law of the pressure variation amplitude and the average pressure variation of the enlarged section distribution along tunnel length direction are obtained.展开更多
Background:Nasopharyngeal carcinoma(NPC) shows a high proportion of lymph node metastasis,and treatment guidelines have been developed for positive nodes.However,no irradiation guidelines have been proposed for patien...Background:Nasopharyngeal carcinoma(NPC) shows a high proportion of lymph node metastasis,and treatment guidelines have been developed for positive nodes.However,no irradiation guidelines have been proposed for patients with enlarged neck lymph nodes(ENLNs) that do not meet the radiological criteria of 10 mm in diameter for positive lymph nodes.This study aimed to determine the prognostic value and radiation dose for ENLNs in NO-category NPC patients treated with intensity-modulated radiotherapy(IMRT).Methods:We reviewed the medical data of 251 patients with non-metastatic,NO-category NPC treated with IMRT.Receiver operating characteristic curves were used to calculate the cut-off value of the ENLN diameter for the prediction of disease failure.The biological equivalent dose(BED) for ENLNs was calculated.Patient survival was compared between the small and large ENLN groups.Independent prognostic factors were identified using the Cox proportional hazards model.Results:The estimated 4-year regional relapse-free survival rate was higher in patients with ENLNs ≥5.5 mm than in those with ENLNs <5.5 mm(100%vs.98.8%,P=0.049),whereas disease-free,overall,and distant metastasis-free survival rates were similar between the two groups.After adjusting for various factors,ENLN diameter was not identified as an independent prognostic factor(P > 0.05 for all survival rates).In the subgroup analysis,patients receiving BED ≥72 Gy had a similar prognosis as patients receiving BED <72 Gy in both the small and large ENLN groups.The multivariate analysis also confirmed that BED≥72 Gy was not associated with significantly improved prognosis in patients with NO-category NPC.Conclusions:A BED of 72 Gy to ENLNs is considerably sufficient to provide a clinical benefit to patients with NO-category NPC.Prospective studies are warranted to validate the findings in the present study.展开更多
BACKGROUND Accurate diagnosis of the depth of gastric cancer invasion is crucial in clinical practice.The diagnosis of gastric cancer depth is often made using endoscopic characteristics of the tumor and its margins;h...BACKGROUND Accurate diagnosis of the depth of gastric cancer invasion is crucial in clinical practice.The diagnosis of gastric cancer depth is often made using endoscopic characteristics of the tumor and its margins;however,evaluating invasion depth based on endoscopic background gastritis remains unclear.AIM To investigate predicting submucosal invasion using the endoscopy-based Kyoto classification of gastritis.METHODS Patients with gastric cancer detected on esophagogastroduodenoscopy at Toyoshima Endoscopy Clinic were enrolled.We analyzed the effects of patient and tumor characteristics,including age,sex,body mass index,surveillance endoscopy within 2 years,current Helicobacter pylori infection,the Kyoto classification,and Lauren’s tumor type,on submucosal tumor invasion and curative endoscopic resection.The Kyoto classification included atrophy,intestinal metaplasia,enlarged folds,nodularity,and diffuse redness.Atrophy was characterized by non-reddish and low mucosa.Intestinal metaplasia was detected as patchy whitish or grayish-white flat elevations,forming an irregular uneven surface.An enlarged fold referred to a fold width≥5 mm in the greater curvature of the corpus.Nodularity was characterized by goosebump-like multiple nodules in the antrum.Diffuse redness was characterized by uniform reddish nonatrophic mucosa in the greater curvature of the corpus.RESULTS A total of 266 gastric cancer patients(mean age,66.7 years;male sex,58.6%;mean body mass index,22.8 kg/m2)were enrolled.Ninety-three patients underwent esophagogastroduodenoscopy for surveillance within 2 years,and 140 had current Helicobacter pylori infection.The mean Kyoto score was 4.54.Fifty-eight cancers were diffuse-type,and 87 cancers had invaded the submucosa.Multivariate analysis revealed that low body mass index(odds ratio 0.88,P=0.02),no surveillance esophagogastroduodenoscopy within 2 years(odds ratio 0.15,P<0.001),endoscopic enlarged folds of gastritis(odds ratio 3.39,P=0.001),and Lauren’s diffuse-type(odds ratio 5.09,P<0.001)were independently associated with submucosal invasion.Similar results were obtained with curative endoscopic resection.Among cancer patients with enlarged folds,severely enlarged folds(width≥10 mm)were more related to submucosal invasion than mildly enlarged folds(width 5-9 mm,P<0.001).CONCLUSION Enlarged folds of gastritis were associated with submucosal invasion.Endoscopic observation of background gastritis as well as the lesion itself may help diagnose the depth of cancer invasion.展开更多
BACKGROUND High-riding nipple is one of the common complications after mastopexty and breast reconstruction.However,to date,a limited number of techniques have concentrated on how to lower the high-riding nipple with ...BACKGROUND High-riding nipple is one of the common complications after mastopexty and breast reconstruction.However,to date,a limited number of techniques have concentrated on how to lower the high-riding nipple with enlarged areola.CASE SUMMARY This is a case report describing a combination of surgical techniques to decrease high-riding nipple.A 26-year-old woman,who previously underwent several breast operations,sought correction for high-riding nipple with enlarged areola.Expanders were used and multi-stage techniques were performed.After one year of follow-up,lowered nipple,reduced areola size,ensured nipple blood supply,and improved breast ptosis were achieved,and the patient was satisfied with the breast contour.CONCLUSION The proposed technique offers a feasible treatment option for postoperative nipple over-elevation combined with areola dilation.展开更多
Based on conformal construction of physical model in a three-dimensional Cartesian grid,an integral-based conformal convolutional perfectly matched layer（CPML） is given for solving the truncation problem of the open...Based on conformal construction of physical model in a three-dimensional Cartesian grid,an integral-based conformal convolutional perfectly matched layer（CPML） is given for solving the truncation problem of the open port when the enlarged cell technique conformal finite-difference time-domain（ECT-CFDTD） method is used to simulate the wave propagation inside a perfect electric conductor（PEC） waveguide.The algorithm has the same numerical stability as the ECT-CFDTD method.For the long-time propagation problems of an evanescent wave in a waveguide,several numerical simulations are performed to analyze the reflection error by sweeping the constitutive parameters of the integral-based conformal CPML.Our numerical results show that the integral-based conformal CPML can be used to efficiently truncate the open port of the waveguide.展开更多
Digito-rectal examination （DRE） of the prostate provides useful information on the state of prostate growth and on the presence of suspected peripheral nodules. The aim of this study is to describe the clinical and ...Digito-rectal examination （DRE） of the prostate provides useful information on the state of prostate growth and on the presence of suspected peripheral nodules. The aim of this study is to describe the clinical and biochemical correlates of finding an enlarged prostate size at DRE in subjects with sexual dysfunction （SD）. A consecutive series of 2379 patients was retrospectively studied. The analysis was focused on a subset of subjects （n = 1823; mean age 54.7± 11.4） selected for being free from overt prostatic diseases. Several parameters were investigated. After adjusting for confounders, the presence of an enlarged prostate size at DRE was associated with a higher risk of metabolic syndrome （HR = 1.346 （1,129-1.759）; P = 0.030）, type 2 diabetes mellitus （HR = 1.489 （1.120-1.980）; P = 0.006）, increased LDL cholesterol （〉100mgdl^-1; HR = 1.354 （1.018-1.801）; P = 0.037） and increased mean blood pressure （BP） values （HR = 1.017 （1.007-1.027） for each mmHg increment; P = 0.001）. Accordingly, enlarged prostate size was also associated with a higher risk of arteriogenic erectile dysfunction （ED）, as well as with other andrological conditions, such as varicocele and premature ejaculation （PE）. PSA levels were significantly higher in subjects with enlarged prostate size when compared to the rest of the sample （HR = 3.318 （2.304; 4.799） for each log unit increment in PSA levels; P 〈 0.0001）. Arteriogenic ED, according to different criteria, was also associated with increased PSA levels. In conclusion, our data support the need to examine prostate size either by clinical （DRE） or biochemical （PSA） inspection in subjects with SD, in order to have insights into the nature of the SD and the metabolic and cardiovascular （CV） background of the patient.展开更多
The permeability is a key factor to determine the efficiency of coalbed methane(CBM)production.The borehole enlargement technology using hydraulic and mechanical measures to cut coal is an effective method to increase...The permeability is a key factor to determine the efficiency of coalbed methane(CBM)production.The borehole enlargement technology using hydraulic and mechanical measures to cut coal is an effective method to increase the coal seam permeability and improve the efficiency of gas drainage.Reasonable design of the layout of boreholes is the prerequisite for efficient and economical gas drainage.In this paper,based on the strain-softening model,the stress and permeability model of the coal seam around the enlarged borehole was built,and based on the dual-medium model,the gas migration model in the coal seam was established.Then the borehole enlargement gas drainage engineering of E9/10 coal seam in Pingdingshan No.8 coal mine was simulated by using COMSOL Multiphysics software.The distribution of stress and permeability in the coal seam around a borehole was analyzed,and the reasonable borehole radius of 0.25 m and reasonable borehole spacing of 6 m were determined.Finally,in Pingdingshan No.8 coal mine,field application was carried out in E9/10 coal seam-21070 working face from the high-level gas drainage roadway.The results show that the actual average coal slag discharge rate is 77.82%,which achieved borehole enlargement.The natural gas flow rate from an enlarged borehole is 2.3–7.3 times that of a normal borehole,and the influence range of enlarged boreholes is more than 6 m.The average gas drainage concentration of a group of enlarged boreholes is about 42%,and the average gas drainage amount is about 0.53 m3/min.After two months of gas extraction,the outburst risk in this area was eliminated,which provides a guarantee for safe coal mining.展开更多
Numerical results of three-dimensional separated flow and heat transfer in an enlarged rectangular channel are presented in this paper. The expansion ratio and aspect ratio of the channel are 2.0 and 8.0, respectively...Numerical results of three-dimensional separated flow and heat transfer in an enlarged rectangular channel are presented in this paper. The expansion ratio and aspect ratio of the channel are 2.0 and 8.0, respectively. Reynolds number of the flow is 200 and it is over the critical Reynolds number. Over the value, the flow in the symmetric channel becomes to deflect to one side of the walls. Transient response characteristics of the flow and heat transfer in the channel with the fully developed flow imposed one cycle of a pulsating fluctuation at the inlet are investigated. Vortex structure generated in the channel is visualized with a helicity isosurface. In the case of the fluctuation of Strouhal number 0.05, small streamwise vortices appear near the side walls and slightly upstream of the reattachment region of the short separation bubble. The vortices elongate and shed some vortices. These vortices attract some pairs of the streamwise vortices near the reattachment region quickly and they drift downstream along the side walls. They are inclined from the walls and are decaying gradually. It is clarified that high Nusselt number area appears and shifts downstream in accordance with the root of the vortices.展开更多
This paper is focused on studying an important concept of the system analysis, which is the regional enlarged observability or constrained observability of the gradient for distributed parabolic systems evolving in th...This paper is focused on studying an important concept of the system analysis, which is the regional enlarged observability or constrained observability of the gradient for distributed parabolic systems evolving in the spatial domain Ω We will explore an approach based on the Hilbert Uniqueness Method (HUM), which can reconstruct the initial gradient state between two prescribed functions f1 and f2 only in a critical subregion ω of Ω without the knowledge of the state. Finally, the obtained results are illustrated by numerical simulations.展开更多
In this paper, we study the notion of the enlarged observability for distributed parabolic systems, where the aim is to reconstruct the initial state between two prescribed profiles P1 and P2 in an internal subregion ...In this paper, we study the notion of the enlarged observability for distributed parabolic systems, where the aim is to reconstruct the initial state between two prescribed profiles P1 and P2 in an internal subregion c0 of the evolution domain f2. We give some definitions and properties of this concept, and then we solve the problem of the reconstruction of initial state using the Hilbert Uniqueness Method （HUM）. This leads to several interesting results which are performed through numerical example and simulations.展开更多
In an effort to encourage investments toenergy sector and transportation infrastructures,and promote the development in the Westernand central China, the State Council recentlydecided to expand a tax preferential policy
Objective To introduce surgical strategy of enlarged laminectomy (with partial facet joint dissection to expose nerve root) ,and to discuss its benefit for cervicalossification of posterior longitudinal ligament (OPLL)
Baogang Rare Earth Group received 5 new members December 27, 1995, making the total members of the group reach 14 and becoming the largest rare earth group in the world. Originally, some subsidiaries such as No. 3 Pla...Baogang Rare Earth Group received 5 new members December 27, 1995, making the total members of the group reach 14 and becoming the largest rare earth group in the world. Originally, some subsidiaries such as No. 3 Plant of Baotou Steel and Rare Earth Company (Baogang) joined the group as independent members. To straighten out the confusion, Baogang展开更多
The enlarged production scale of underground non-ferrous metal mines is affected by many uncertain factors difficult to describe mathematically with any level of accuracy.The problem can be solved by a synthesis of ar...The enlarged production scale of underground non-ferrous metal mines is affected by many uncertain factors difficult to describe mathematically with any level of accuracy.The problem can be solved by a synthesis of artificial intelligence.Based on the analysis of the major factors affecting the scale of enlarged production,we first interpreted in detail the design principles and structure of the intelligent system.Secondly,we introduced an ANN subsystem.In order to ensure technological and scale efficien- cies of the training samples for ANN,we filtrated the samples with a DEA method.Finally,we trained the intelligent system,which was proved to be very efficient.展开更多
We present a rare case of rapidly enlarging inflamematory hepatocellular adenoma (IHCA) in a 60-year-old Japanese man. Screening abdominal computed tomography (CT) for the fatty liver patient revealed a 1.7-cm liver m...We present a rare case of rapidly enlarging inflamematory hepatocellular adenoma (IHCA) in a 60-year-old Japanese man. Screening abdominal computed tomography (CT) for the fatty liver patient revealed a 1.7-cm liver mass in the anterior segment of the liver. After 19 months, the lesion had rapidly enlarged to 6 cm in diameter and the patient was referred to our hospital. On perflubutane microbubble contrast-enhanced ultrasonography, the tumor showed a characteristic centripetal filling pattern in the vascular phase. We performed hepatic anterior segment resection because we could not rule out malignant tumor. Histopathological examination showed hyperplasia of mildly atypical hepatocytes and sinusoidal dilatation with marked inflammatory cell infiltration. Immunohistological staining revealed positive staining for serum amyloid A and C-reactive protein;therefore, we diagnosed this tumor as IHCA. The patient remains alive 42 months after operation without evidence of recurrence.展开更多
The uplift of the Tibetan Plateau significantly altered the geomorphology and climate of the Euroasia by creating large mountains and rivers.Fishes are more likely to be affected relative to other organisms,as they ar...The uplift of the Tibetan Plateau significantly altered the geomorphology and climate of the Euroasia by creating large mountains and rivers.Fishes are more likely to be affected relative to other organisms,as they are largely restricted to river systems.Faced with the rapidly flowing water in the Tibetan Plateau,a group of catfish has evolved greatly enlarged pectoral fins with more numbers of fin-rays to form an adhesive apparatus.However,the genetic basis of these adaptations in Tibetan catfishes remains elusive.In this study,we performed comparative genomic analyses based on the chromosome-level genome of Glyptosternum maculatum in family Sisoridae and detected some proteins with conspicuously high evolutionary rates in particular in genes involved in skeleton development,energy metabolism,and hypoxia response.We found that the hoxd12a gene evolved faster and a loss-of-function assay of hoxd12a supports a potential role for this gene in shaping the enlarged fins of these Tibetan catfishes.Other genes with amino acid replacements and signatures of positive selection included proteins involved in low temperature(TRMU)and hypoxia(VHL)responses.Functional assays reveal that the G.maculatum TRMU allele generates more mitochondrial ATP than the ancestral allele found in low-altitude fishes.Functional assays of VHL alleles suggest that the G.maculatum allele has lower transactivation activity than the low-altitude forms.These findings provide a window into the genomic underpinnings of physiological adaptations that permit G.maculatum to survive in the harsh environment of the Tibetan Himalayas that mirror those that are convergently found in other vertebrates such as humans.展开更多
In this article,an Enlarged Polygon/Polyhedron(ELP)method without binary variables is proposed to represent the Convex Polygonal/Polyhedral Obstacle Avoidance(CPOA)constraints in trajectory optimization.First,the equi...In this article,an Enlarged Polygon/Polyhedron(ELP)method without binary variables is proposed to represent the Convex Polygonal/Polyhedral Obstacle Avoidance(CPOA)constraints in trajectory optimization.First,the equivalent condition of a point outside the convex set is given and proved rigorously.Then,the ELP condition describing the CPOA constraints equivalently is given without introducing binary variables,and its geometric meaning is explained.Finally,the ELP method is used to transform the CPOA trajectory optimization problem into an optimal control problem without binary variables.The effectiveness and validity of ELP method are demonstrated through simulations with both simple linear dynamic model(unmanned aerial vehicle)and complex nonlinear dynamic model(hypersonic glide vehicle).Comparison indicates the computational time of ELP method is only 1%-20%of that of the traditional Mixed-Integer Programming(MIP)method.展开更多
Hypertension is a primary risk factor for the progression of cognitive impairment caused by cerebral small vessel disease,the most common cerebrovascular disease.Howeve r,the causal relationship between hypertension a...Hypertension is a primary risk factor for the progression of cognitive impairment caused by cerebral small vessel disease,the most common cerebrovascular disease.Howeve r,the causal relationship between hypertension and cerebral small vessel disease remains unclear.Hypertension has substantial negative impacts on brain health and is recognized as a risk factor for cerebrovascular disease.Chronic hypertension and lifestyle factors are associated with risks for stro ke and dementia,and cerebral small vessel disease can cause dementia and stroke.Hypertension is the main driver of cerebral small vessel disease,which changes the structure and function of cerebral vessels via various mechanisms and leads to lacunar infarction,leukoaraiosis,white matter lesions,and intracerebral hemorrhage,ultimately res ulting in cognitive decline and demonstrating that the brain is the to rget organ of hypertension.This review updates our understanding of the pathogenesis of hypertensioninduced cerebral small vessel disease and the res ulting changes in brain structure and function and declines in cognitive ability.We also discuss drugs to treat cerebral small vessel disease and cognitive impairment.展开更多
Objective:To design and manufacture medical scrotal support shorts for patients with enlarged scrotum and observe its application and effect.Methods:40 patients with enlarged scrotum admitted to the basic surgery depa...Objective:To design and manufacture medical scrotal support shorts for patients with enlarged scrotum and observe its application and effect.Methods:40 patients with enlarged scrotum admitted to the basic surgery department from February 2021 to March 2023 were selected and divided into a test group and a control group according to their time of admission,with the test group using scrotal support shorts and the control group using ordinary shorts without scrotal support pockets or diapers.Results:The complication rate of skin injury in the scrotum and the surrounding inguinal area of the patients in the test group was significantly lower than that of the control group(P<0.01).The medical cost covered by patients in the test group was significantly lower than that of the control group(P<0.01)and the hospitalization satisfaction of the patients in the test group was significantly higher than that of the control group(P<0.01).The difference in the therapeutic effect of the test groups was statistically significant when compared with the control group(P<0.05).Conclusion:Homemade medical scrotal support shorts reduced the local enlargement of the scrotum and bleeding,but also protected the scrotum and the surrounding skin to prevent secondary injuries.The process of patient care was simple and promoted their recovery.The length of hospitalization was also decreased,the burden of health care costs was reduced,and the overall comfort and satisfaction of the patient was improved.展开更多
文摘Radiologists play a key role in establishing an early and accurate diagnosis,especially for rare diseases.Mahvash disease(OMIM 619290)is an autosomal recessive hereditary disease caused by inactivating mutations of the glucagon receptor and its main clinical consequences are pancreatic neuroendocrine tumors and in some cases,porto-sinusoidal vascular disease and portal hypertension.Untreated Mahvash disease can be lethal.The diagnosis of Mahvash disease has almost always been delayed in the past due to radiologists’unawareness of or unfamiliarity with the unique imaging features of Mahvash disease which are moderately to enormously enlarge pancreas with preserved pancreas contour and parenchyma without vascular involvement or lymphadenopathy.These features help differentiate Mahvash disease from other etiologies of diffusely enlarged pancreas such as diffuse pancreatic ductal carcinoma,diffuse pancreatic lymphoma,and autoimmune pancreatitis.Invoking Mahvash disease in the differential diagnosis of an enlarged pancreas has recently been shown to facilitate early diagnosis.To prevent missing the diagnosis of this significant disease,I sincerely ask radiologists to consider Mahvash disease in their differential diagnoses of diffusely enlarged pancreas.
基金Project (2016YFB1200602-11) supported by National Key R&D Plan of China
文摘The influence of enlarged section parameters on pressure transients of high-speed train passing through a tunnel was investigated by numerical simulation.The calculation results obtained by the structured and unstructured grid and the experimental results of smooth wall tunnel were verified.Numerical simulation studies were conducted on three tunnel enlarged section parameters,the enlarged section distribution along circumferential direction,the enlarged section area and the enlarged section distribution along tunnel length direction.The calculation results show that the influence of the different enlarged section distributions along tunnel circumferential direction on pressure transients in the tunnel is basically consistent.There is an optimal enlarged section area for the minimum value of the pressure variation amplitude and the average pressure variation in the tunnel.The law of the pressure variation amplitude and the average pressure variation of the enlarged section distribution along tunnel length direction are obtained.
基金supported by grants from the Health & Medical Collaborative Innovation Project of Guangzhou City,China(No.201400000001)the Sun Yat-sen University Clinical Research 5010 Program(No.2012011)+1 种基金the Science and Technology Project of Guangzhou City,China(No.14570006)the Planned Science and Technology Project of Guangdong Province,China(No. 2013B020400004)
文摘Background:Nasopharyngeal carcinoma(NPC) shows a high proportion of lymph node metastasis,and treatment guidelines have been developed for positive nodes.However,no irradiation guidelines have been proposed for patients with enlarged neck lymph nodes(ENLNs) that do not meet the radiological criteria of 10 mm in diameter for positive lymph nodes.This study aimed to determine the prognostic value and radiation dose for ENLNs in NO-category NPC patients treated with intensity-modulated radiotherapy(IMRT).Methods:We reviewed the medical data of 251 patients with non-metastatic,NO-category NPC treated with IMRT.Receiver operating characteristic curves were used to calculate the cut-off value of the ENLN diameter for the prediction of disease failure.The biological equivalent dose(BED) for ENLNs was calculated.Patient survival was compared between the small and large ENLN groups.Independent prognostic factors were identified using the Cox proportional hazards model.Results:The estimated 4-year regional relapse-free survival rate was higher in patients with ENLNs ≥5.5 mm than in those with ENLNs <5.5 mm(100%vs.98.8%,P=0.049),whereas disease-free,overall,and distant metastasis-free survival rates were similar between the two groups.After adjusting for various factors,ENLN diameter was not identified as an independent prognostic factor(P > 0.05 for all survival rates).In the subgroup analysis,patients receiving BED ≥72 Gy had a similar prognosis as patients receiving BED <72 Gy in both the small and large ENLN groups.The multivariate analysis also confirmed that BED≥72 Gy was not associated with significantly improved prognosis in patients with NO-category NPC.Conclusions:A BED of 72 Gy to ENLNs is considerably sufficient to provide a clinical benefit to patients with NO-category NPC.Prospective studies are warranted to validate the findings in the present study.
文摘BACKGROUND Accurate diagnosis of the depth of gastric cancer invasion is crucial in clinical practice.The diagnosis of gastric cancer depth is often made using endoscopic characteristics of the tumor and its margins;however,evaluating invasion depth based on endoscopic background gastritis remains unclear.AIM To investigate predicting submucosal invasion using the endoscopy-based Kyoto classification of gastritis.METHODS Patients with gastric cancer detected on esophagogastroduodenoscopy at Toyoshima Endoscopy Clinic were enrolled.We analyzed the effects of patient and tumor characteristics,including age,sex,body mass index,surveillance endoscopy within 2 years,current Helicobacter pylori infection,the Kyoto classification,and Lauren’s tumor type,on submucosal tumor invasion and curative endoscopic resection.The Kyoto classification included atrophy,intestinal metaplasia,enlarged folds,nodularity,and diffuse redness.Atrophy was characterized by non-reddish and low mucosa.Intestinal metaplasia was detected as patchy whitish or grayish-white flat elevations,forming an irregular uneven surface.An enlarged fold referred to a fold width≥5 mm in the greater curvature of the corpus.Nodularity was characterized by goosebump-like multiple nodules in the antrum.Diffuse redness was characterized by uniform reddish nonatrophic mucosa in the greater curvature of the corpus.RESULTS A total of 266 gastric cancer patients(mean age,66.7 years;male sex,58.6%;mean body mass index,22.8 kg/m2)were enrolled.Ninety-three patients underwent esophagogastroduodenoscopy for surveillance within 2 years,and 140 had current Helicobacter pylori infection.The mean Kyoto score was 4.54.Fifty-eight cancers were diffuse-type,and 87 cancers had invaded the submucosa.Multivariate analysis revealed that low body mass index(odds ratio 0.88,P=0.02),no surveillance esophagogastroduodenoscopy within 2 years(odds ratio 0.15,P<0.001),endoscopic enlarged folds of gastritis(odds ratio 3.39,P=0.001),and Lauren’s diffuse-type(odds ratio 5.09,P<0.001)were independently associated with submucosal invasion.Similar results were obtained with curative endoscopic resection.Among cancer patients with enlarged folds,severely enlarged folds(width≥10 mm)were more related to submucosal invasion than mildly enlarged folds(width 5-9 mm,P<0.001).CONCLUSION Enlarged folds of gastritis were associated with submucosal invasion.Endoscopic observation of background gastritis as well as the lesion itself may help diagnose the depth of cancer invasion.
文摘BACKGROUND High-riding nipple is one of the common complications after mastopexty and breast reconstruction.However,to date,a limited number of techniques have concentrated on how to lower the high-riding nipple with enlarged areola.CASE SUMMARY This is a case report describing a combination of surgical techniques to decrease high-riding nipple.A 26-year-old woman,who previously underwent several breast operations,sought correction for high-riding nipple with enlarged areola.Expanders were used and multi-stage techniques were performed.After one year of follow-up,lowered nipple,reduced areola size,ensured nipple blood supply,and improved breast ptosis were achieved,and the patient was satisfied with the breast contour.CONCLUSION The proposed technique offers a feasible treatment option for postoperative nipple over-elevation combined with areola dilation.
基金supported by the National Natural Science Foundation of China(Grant No.61231003)
文摘Based on conformal construction of physical model in a three-dimensional Cartesian grid,an integral-based conformal convolutional perfectly matched layer（CPML） is given for solving the truncation problem of the open port when the enlarged cell technique conformal finite-difference time-domain（ECT-CFDTD） method is used to simulate the wave propagation inside a perfect electric conductor（PEC） waveguide.The algorithm has the same numerical stability as the ECT-CFDTD method.For the long-time propagation problems of an evanescent wave in a waveguide,several numerical simulations are performed to analyze the reflection error by sweeping the constitutive parameters of the integral-based conformal CPML.Our numerical results show that the integral-based conformal CPML can be used to efficiently truncate the open port of the waveguide.
文摘Digito-rectal examination （DRE） of the prostate provides useful information on the state of prostate growth and on the presence of suspected peripheral nodules. The aim of this study is to describe the clinical and biochemical correlates of finding an enlarged prostate size at DRE in subjects with sexual dysfunction （SD）. A consecutive series of 2379 patients was retrospectively studied. The analysis was focused on a subset of subjects （n = 1823; mean age 54.7± 11.4） selected for being free from overt prostatic diseases. Several parameters were investigated. After adjusting for confounders, the presence of an enlarged prostate size at DRE was associated with a higher risk of metabolic syndrome （HR = 1.346 （1,129-1.759）; P = 0.030）, type 2 diabetes mellitus （HR = 1.489 （1.120-1.980）; P = 0.006）, increased LDL cholesterol （〉100mgdl^-1; HR = 1.354 （1.018-1.801）; P = 0.037） and increased mean blood pressure （BP） values （HR = 1.017 （1.007-1.027） for each mmHg increment; P = 0.001）. Accordingly, enlarged prostate size was also associated with a higher risk of arteriogenic erectile dysfunction （ED）, as well as with other andrological conditions, such as varicocele and premature ejaculation （PE）. PSA levels were significantly higher in subjects with enlarged prostate size when compared to the rest of the sample （HR = 3.318 （2.304; 4.799） for each log unit increment in PSA levels; P 〈 0.0001）. Arteriogenic ED, according to different criteria, was also associated with increased PSA levels. In conclusion, our data support the need to examine prostate size either by clinical （DRE） or biochemical （PSA） inspection in subjects with SD, in order to have insights into the nature of the SD and the metabolic and cardiovascular （CV） background of the patient.
基金supported by the Assistance Program for Future Outstanding Talents of China University of Mining and Technology(No.2020WLJCRCZL041)the Postgraduate Research&Practice Innovation Program of Jiangsu Province(No.SJCX20_0816).
文摘The permeability is a key factor to determine the efficiency of coalbed methane(CBM)production.The borehole enlargement technology using hydraulic and mechanical measures to cut coal is an effective method to increase the coal seam permeability and improve the efficiency of gas drainage.Reasonable design of the layout of boreholes is the prerequisite for efficient and economical gas drainage.In this paper,based on the strain-softening model,the stress and permeability model of the coal seam around the enlarged borehole was built,and based on the dual-medium model,the gas migration model in the coal seam was established.Then the borehole enlargement gas drainage engineering of E9/10 coal seam in Pingdingshan No.8 coal mine was simulated by using COMSOL Multiphysics software.The distribution of stress and permeability in the coal seam around a borehole was analyzed,and the reasonable borehole radius of 0.25 m and reasonable borehole spacing of 6 m were determined.Finally,in Pingdingshan No.8 coal mine,field application was carried out in E9/10 coal seam-21070 working face from the high-level gas drainage roadway.The results show that the actual average coal slag discharge rate is 77.82%,which achieved borehole enlargement.The natural gas flow rate from an enlarged borehole is 2.3–7.3 times that of a normal borehole,and the influence range of enlarged boreholes is more than 6 m.The average gas drainage concentration of a group of enlarged boreholes is about 42%,and the average gas drainage amount is about 0.53 m3/min.After two months of gas extraction,the outburst risk in this area was eliminated,which provides a guarantee for safe coal mining.
文摘Numerical results of three-dimensional separated flow and heat transfer in an enlarged rectangular channel are presented in this paper. The expansion ratio and aspect ratio of the channel are 2.0 and 8.0, respectively. Reynolds number of the flow is 200 and it is over the critical Reynolds number. Over the value, the flow in the symmetric channel becomes to deflect to one side of the walls. Transient response characteristics of the flow and heat transfer in the channel with the fully developed flow imposed one cycle of a pulsating fluctuation at the inlet are investigated. Vortex structure generated in the channel is visualized with a helicity isosurface. In the case of the fluctuation of Strouhal number 0.05, small streamwise vortices appear near the side walls and slightly upstream of the reattachment region of the short separation bubble. The vortices elongate and shed some vortices. These vortices attract some pairs of the streamwise vortices near the reattachment region quickly and they drift downstream along the side walls. They are inclined from the walls and are decaying gradually. It is clarified that high Nusselt number area appears and shifts downstream in accordance with the root of the vortices.
文摘This paper is focused on studying an important concept of the system analysis, which is the regional enlarged observability or constrained observability of the gradient for distributed parabolic systems evolving in the spatial domain Ω We will explore an approach based on the Hilbert Uniqueness Method (HUM), which can reconstruct the initial gradient state between two prescribed functions f1 and f2 only in a critical subregion ω of Ω without the knowledge of the state. Finally, the obtained results are illustrated by numerical simulations.
文摘In this paper, we study the notion of the enlarged observability for distributed parabolic systems, where the aim is to reconstruct the initial state between two prescribed profiles P1 and P2 in an internal subregion c0 of the evolution domain f2. We give some definitions and properties of this concept, and then we solve the problem of the reconstruction of initial state using the Hilbert Uniqueness Method （HUM）. This leads to several interesting results which are performed through numerical example and simulations.
文摘In an effort to encourage investments toenergy sector and transportation infrastructures,and promote the development in the Westernand central China, the State Council recentlydecided to expand a tax preferential policy
文摘Objective To introduce surgical strategy of enlarged laminectomy (with partial facet joint dissection to expose nerve root) ,and to discuss its benefit for cervicalossification of posterior longitudinal ligament (OPLL)
文摘Baogang Rare Earth Group received 5 new members December 27, 1995, making the total members of the group reach 14 and becoming the largest rare earth group in the world. Originally, some subsidiaries such as No. 3 Plant of Baotou Steel and Rare Earth Company (Baogang) joined the group as independent members. To straighten out the confusion, Baogang
基金Project 50374005 supported by the National Natural Science Foundation of China
文摘The enlarged production scale of underground non-ferrous metal mines is affected by many uncertain factors difficult to describe mathematically with any level of accuracy.The problem can be solved by a synthesis of artificial intelligence.Based on the analysis of the major factors affecting the scale of enlarged production,we first interpreted in detail the design principles and structure of the intelligent system.Secondly,we introduced an ANN subsystem.In order to ensure technological and scale efficien- cies of the training samples for ANN,we filtrated the samples with a DEA method.Finally,we trained the intelligent system,which was proved to be very efficient.
文摘We present a rare case of rapidly enlarging inflamematory hepatocellular adenoma (IHCA) in a 60-year-old Japanese man. Screening abdominal computed tomography (CT) for the fatty liver patient revealed a 1.7-cm liver mass in the anterior segment of the liver. After 19 months, the lesion had rapidly enlarged to 6 cm in diameter and the patient was referred to our hospital. On perflubutane microbubble contrast-enhanced ultrasonography, the tumor showed a characteristic centripetal filling pattern in the vascular phase. We performed hepatic anterior segment resection because we could not rule out malignant tumor. Histopathological examination showed hyperplasia of mildly atypical hepatocytes and sinusoidal dilatation with marked inflammatory cell infiltration. Immunohistological staining revealed positive staining for serum amyloid A and C-reactive protein;therefore, we diagnosed this tumor as IHCA. The patient remains alive 42 months after operation without evidence of recurrence.
基金supported by the Strategic Priority Research Program of Chinese Academy of Sciences(XDB31000000)the National Natural Science Foundation of China(32170480,31972866,31702016,31601858,32022009)+5 种基金Chinese Academy of Sciences(Youth Innovation Promotion Association),Chinese Academy of Sciences(http://www.yicas.cn)the Pioneer Hundred Talents Program,and ZDBS-LYSM005)the Second Tibetan Plateau Scientific Expedition and Research Program(STEP,2019QZKK0501)State Key Laboratory of Genetic Resources and Evolution,Kunming Institute of Zoology,Chinese Academy of Sciences(GREKF21-04)the Young Top-notch Talent Cultivation Program of Hubei Provincesupported by the Wuhan Branch,Supercomputing Center,Chinese Academy of Sciences,China。
文摘The uplift of the Tibetan Plateau significantly altered the geomorphology and climate of the Euroasia by creating large mountains and rivers.Fishes are more likely to be affected relative to other organisms,as they are largely restricted to river systems.Faced with the rapidly flowing water in the Tibetan Plateau,a group of catfish has evolved greatly enlarged pectoral fins with more numbers of fin-rays to form an adhesive apparatus.However,the genetic basis of these adaptations in Tibetan catfishes remains elusive.In this study,we performed comparative genomic analyses based on the chromosome-level genome of Glyptosternum maculatum in family Sisoridae and detected some proteins with conspicuously high evolutionary rates in particular in genes involved in skeleton development,energy metabolism,and hypoxia response.We found that the hoxd12a gene evolved faster and a loss-of-function assay of hoxd12a supports a potential role for this gene in shaping the enlarged fins of these Tibetan catfishes.Other genes with amino acid replacements and signatures of positive selection included proteins involved in low temperature(TRMU)and hypoxia(VHL)responses.Functional assays reveal that the G.maculatum TRMU allele generates more mitochondrial ATP than the ancestral allele found in low-altitude fishes.Functional assays of VHL alleles suggest that the G.maculatum allele has lower transactivation activity than the low-altitude forms.These findings provide a window into the genomic underpinnings of physiological adaptations that permit G.maculatum to survive in the harsh environment of the Tibetan Himalayas that mirror those that are convergently found in other vertebrates such as humans.
基金supported by the National Natural Science Foundation of China(No.52232014)the National Natural Science Foundation of China Joint Fund(No.U2241215)。
文摘In this article,an Enlarged Polygon/Polyhedron(ELP)method without binary variables is proposed to represent the Convex Polygonal/Polyhedral Obstacle Avoidance(CPOA)constraints in trajectory optimization.First,the equivalent condition of a point outside the convex set is given and proved rigorously.Then,the ELP condition describing the CPOA constraints equivalently is given without introducing binary variables,and its geometric meaning is explained.Finally,the ELP method is used to transform the CPOA trajectory optimization problem into an optimal control problem without binary variables.The effectiveness and validity of ELP method are demonstrated through simulations with both simple linear dynamic model(unmanned aerial vehicle)and complex nonlinear dynamic model(hypersonic glide vehicle).Comparison indicates the computational time of ELP method is only 1%-20%of that of the traditional Mixed-Integer Programming(MIP)method.
基金supported by the National Natural Science Foundation of China,Nos.82274611 (to LZ),82104419 (to DM)Capital Science and Technology Leading Talent Training Project,No.Z1 91100006119017 (to LZ)+3 种基金Beijing Hospitals Authority Ascent Plan,No.DFL20190803 (to LZ)Cultivation Fund of Hospital Management Center in Beijing,No.PZ2022006 (to DM)R&D Program of Beijing Municipal Education Commission,No.KM202210025017 (to DM)Beijing Gold-Bridge Project,No.ZZ20145 (to DM)。
文摘Hypertension is a primary risk factor for the progression of cognitive impairment caused by cerebral small vessel disease,the most common cerebrovascular disease.Howeve r,the causal relationship between hypertension and cerebral small vessel disease remains unclear.Hypertension has substantial negative impacts on brain health and is recognized as a risk factor for cerebrovascular disease.Chronic hypertension and lifestyle factors are associated with risks for stro ke and dementia,and cerebral small vessel disease can cause dementia and stroke.Hypertension is the main driver of cerebral small vessel disease,which changes the structure and function of cerebral vessels via various mechanisms and leads to lacunar infarction,leukoaraiosis,white matter lesions,and intracerebral hemorrhage,ultimately res ulting in cognitive decline and demonstrating that the brain is the to rget organ of hypertension.This review updates our understanding of the pathogenesis of hypertensioninduced cerebral small vessel disease and the res ulting changes in brain structure and function and declines in cognitive ability.We also discuss drugs to treat cerebral small vessel disease and cognitive impairment.
文摘Objective:To design and manufacture medical scrotal support shorts for patients with enlarged scrotum and observe its application and effect.Methods:40 patients with enlarged scrotum admitted to the basic surgery department from February 2021 to March 2023 were selected and divided into a test group and a control group according to their time of admission,with the test group using scrotal support shorts and the control group using ordinary shorts without scrotal support pockets or diapers.Results:The complication rate of skin injury in the scrotum and the surrounding inguinal area of the patients in the test group was significantly lower than that of the control group(P<0.01).The medical cost covered by patients in the test group was significantly lower than that of the control group(P<0.01)and the hospitalization satisfaction of the patients in the test group was significantly higher than that of the control group(P<0.01).The difference in the therapeutic effect of the test groups was statistically significant when compared with the control group(P<0.05).Conclusion:Homemade medical scrotal support shorts reduced the local enlargement of the scrotum and bleeding,but also protected the scrotum and the surrounding skin to prevent secondary injuries.The process of patient care was simple and promoted their recovery.The length of hospitalization was also decreased,the burden of health care costs was reduced,and the overall comfort and satisfaction of the patient was improved.
