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抗弯钢框架结构(MRF)是目前研究最广泛、最流行的抗震系统,具有建筑灵活度高和施工效率高等优点。然而,这种结构常常缺乏足够的侧向刚度来限制结构的位移角,会导致在强震下结构和非结构构件产生严重的破坏。相反,偏心支撑钢框架结构(EBF)却有很大的侧向刚度来限制结构的位移角和有专属的抗震耗能构件。但是,支撑结构并不为建筑师所广泛接纳。为了结合抗弯钢框架结构和偏心支撑钢框架结构的优点,于2007年首次提出一种新型的抗震系统——连柱框架结构(LCF)。这种双抗震系统有相似于偏心支撑钢框架结构的窄连梁框架作为主要的抗震系统,而抗弯钢框架结构则作为次要的抗震系统。连梁作为结构保险丝可以在中震到大震中消耗地震能量,而且在震后很容易就可以被替代和修复。另一方面,抗弯钢框架结构可以提供附加的侧向抵抗力来防止结构在大震下倒塌。采用2008年提出的基于性能的塑性设计方法(PBPD)对建筑原型位于美国强震地区——加州洛杉矶的连柱框架结构进行设计。最后,使用先进的基于性能的评估步骤对原型结构的抗震性能进行了研究。研究结果表明,连柱框架结构(LCF)是一种具有良好抗震性能的结构。

Objective: To investigate the correlation of body composition indices with exercise capacity and nutritional status in male chronic obstructive pulmonary disease (COPD) patients. Methods: The clinical data of 90 male COPD patients admitted to the Department of Respiratory and Critical Care Medicine of China-Japan Friendship Hospital from January 2021 to September 2022 were retrospectively collected, and the patients were subjected to a pulmonary function test, body composition measurement, 6-minute walking test distance (6MWD) test, and dominant handgrip strength measurement (HGS). The patients were categorized into COPD Global Initiative for COPD (GOLD) grade 1, 2, 3 and 4 groups according to the severity of lung function. Based on the fat-free mass index (FFMI), patients were categorized into a low FFMI group (FFMI<17 kg/m 2 ) and a normal FFMI group (FFMI≥17 kg/m 2 ). Based on phase angle (PhA), patients were categorized into the low PhA group (PhA<5°) and the normal PhA group (PhA≥5°). Based on 6MWD, patients were divided into impaired endurance group (6MWD<350 m) and normal endurance group (6MWD≥350 m). Differences in body composition indexes, exercise capacity, and nutritional status of patients in different subgroups were compared. A trend test was used to analyze the trend of GOLD grading and body composition indexes. Correlation analysis was used to analyze the correlation of FFMI, PhA, skeletal muscle mass index (SMI), basal metabolic rate (BMR), and visceral fat index (VFI) with 6MWD, HGS, post-diastolic exertional expiratory volume in the first second as a percentage of exertional lung capacity (FEV 1 %pred), and body mass index (BMI). Results: The age of 90 male COPD patients was 66 (59, 71) years. FFMI, PhA, SMI, BMR, VFI, HGS, and 6MWD tended to decrease with increasing GOLD levels (all P <0.05). In the low FFMI group (31 cases), PhA [5.0° (4.7°, 5.1°) vs 5.8° (5.6°, 6.3°)], SMI [6.3 (5.3, 6.9)vs 8.3 (7.7, 9.1) kg/m 2 ], and BMR [(1 294.5±387.2) vs (1 538.7±207.5) kcal(1 kcal=4.184 kJ)], VFI [(10.0±4.2) grades vs (14.2±3.3) grades], 6MWD [(430.5±90.8) vs (537.2±85.5) m], FEV 1 %pred [(37.8±7.9)% vs (73.7±21.5)%], BMI [(20.2±3.8) vs (25.5±2.9) kg/m 2 ] were lower than those in the normal FFMI group (59 cases, all P <0.05). In the low PhA group (23 cases), FFMI [(16.7±2.2) vs (19.5±1.5) kg/m 2 ], SMI [6.6 (5.9, 7.0) vs 7.3 (7.7, 9.0) kg/m 2 ], BMR [(1 251.8±246.2) vs (1 547.5±206.6) kcal], 6MWD [(451.0±47.1) vs (538.3±87.5) m], HGS [(29.6±4.0) vs (36.4±7.2) kg], FEV 1 %pred [(51.2±15.3)% vs (72.9±22.8)%], BMI [(20.9±3.7) vs (25.5±2.8) kg/m 2 ] were lower than those of the normal PhA group (67 cases, all P <0.05). In the impaired endurance group (21 cases) PhA [5.2° (5.1°, 5.3°) vs 5.8° (5.6°, 6.3°)], FEV 1 %pred [(34.2±15.4)% vs (72.7±22.2)%] were lower than those in the normal endurance group (69 cases, all P< 0.05). Correlation analysis showed that FFMI was positively correlated with HGS, FEV 1 %pred, and BMI ( r values of 0.327, 0.235, and 0.782, all P <0.05); PhA was positively correlated with 6MWD, FEV 1 %pred, and BMI ( r values of 0.341, 0.258, and 0.251, all P <0.05); SMI was positively correlated with HGS and BMI ( r values of 0.411 and 0.710, all P <0.05); BMR was positively correlated with 6MWD, HGS, FEV 1 %pred, and BMI ( r values of 0.338, 0.508, 0.285, and 0.676, all P <0.05); VFI was positively correlated with BMI ( r value of 0.791, P <0.001). Conclusions: FFMI is positively correlated with HGS, FEV 1 %pred, and BMI; PhA is positively correlated with 6MWD, FEV 1 %pred, and BMI; SMI is positively correlated with HGS and BMI; BMR is positively correlated with 6MWD, HGS, FEV 1 %pred, and BMI; VFI is positively correlated with BMI. Body composition indexes may reflect the exercise capacity and nutritional status of male COPD patients.

Objective: To investigate the clinicopathological characteristics of pancreatic lesions in children. Methods: The clinicopathological data of pancreatic lesions in children were analyzed including 42 cases of pancreatic tumors diagnosed from January 2000 to May 2021 in Guangzhou Women's and Children's Medical Center, Guangzhou, China. Histological and immunohistochemical assessments were performed . Related literature was reviewed. Results: The 42 pediatric patients with pancreatic lesions aged 1 day to 12 years (mean, 4.25 years). There were 23 males and 19 females. Clinical presentations included abdominal masses, abdominal pain, vomiting and persistent hypoglycemia after birth. Ultrasound and computerized tomography examination showed space-occupying pancreatic lesions in 31 cases, but no detectable pancreatic lesions in 11 cases. Histologically, among the 42 cases, 22 cases (52.4%) were neoplastic, including 18 cases of epithelial origin. Nine cases of pancreatoblastoma showed that the epithelial tumor cells were arranged in a trabecular pattern, with squamous nests. Six cases of solid-pseudopapillary tumors revealed hemorrhagic and necrotic cysts and monomorphic epithelioid cells arranged in solid sheets, nests or pseudopapillae. Two cases of neuroendocrine tumors showed tumor cells arranged in cords or nests; one case had a mitotic count of about 3/10 high power field, and a Ki-67 index of about 5%, which was consistent with G2 neuroendocrine tumor; the other case showed tumor cells with cytological atypia, brisk mitoses, about 25/10 HPF and a Ki-67 index of about 80%, consistent with small-cell type neuroendocrine carcinoma. The case of acinar cell carcinoma showed high cellularity, tumor cells in solid, cord-like or acinar-like arrangement with little stroma, and monotonous tumor cells with single distinct nucleolus. There were 4 cases of mesenchymal tumors, including 3 cases of Kaposi's hemangioendothelioma and 1 case of inflammatory myofibroblastic tumor. Among the 20 cases (47.6%) of non-neoplastic lesions, there were 11 cases of hyperinsulinism with ATP-sensitive potassium channel abnormality (HAPCA). Severn cases of diffuse type HAPCA in which the islets scattered between the pancreatic acinar tissue, enlarged, and prominent nuclei. Three cases of focal type HAPCA showed pancreatic islet hyperplasia in the form of nested nodules (0.6-1.5 cm). One case of atypical type HAPCA had extensive islet hyperplasia in pancreatic tissue, and scattered proliferation of nest-like nodules was noted. There were also 7 cases of pseudocyst and 2 cases of congenital cyst. Immunohistochemically, pancreatoblastomas were diffusely positive for CKpan, CK8/18, and β-catenin (nuclear staining of squamous nests only). Solid-pseudopapillary tumors expressed CD10, cyclin D1, CD99, vimentin, CD56, and β-catenin (nuclear staining). Neuroendocrine tumors were positive for CK, Syn, NSE, CgA, CD56, and β-catenin (membranous staining). The acinar cell carcinoma was positive for CK8/18, trypsin, and β-catenin (membranous staining). Conclusions: Pancreatic lesions in children have a wide range of histopathological types. HAPCA is the most common lesion of newborns. Pediatric pancreatic tumors are rare and mostly malignant. It is important to recognize them and make correct pathological diagnoses.

Objective: To explore the application of multidisciplinary treatment (MDT) and comprehensive management model in the diagnosis and treatment of early-stage lung cancer, and analyze its clinical value and the feasibility and significance of promotion. Methods: A retrospective study of 470 patients in Xijing Hospital who underwent surgery after MDT from January 8, 2018 to December 31, 2019. There were 172 males and 298 females, aged from 23 to 79 (54.46±11.08) years. Basic diagnosis and treatment information as well as postoperative pathology were analyzed, of which 441 cases were recommended for surgery by MDT and 29 cases were subjectively requested for surgery. The patients' general condition, preoperative diagnosis and pathological results were compared, and the specific content of the MDT and comprehensive management model were summarized. We also explored the value of MDT integrated management model in early stage lung cancer treatment in the context of the current lung cancer incidence in China. Results: Among 470 surgical patients, the majority of males had solid nodules (69/172,40.1%), and the majority of females had ground glass nodules (135/298,45.3%). The distribution of nodules showed a trend of more upper lobe(277/470)than lower lobe(161/470) and more right lung(276/470) than left lung(194/470). Among the 441 patients recommended for surgery, 98.11% of males (156/159) and 97.87% of females (276/282) showed malignant pathology after surgery. Adenocarcinoma was the main pathological type (93.59% of males, 146/156; 97.46% of females, 269/276). Among the malignant pathological results, carcinoma in situ (42.31% of males, 66/156; 47.10% of females, 130/276) and stage I lung cancer (50.64% of males, 79/156; 47.46% of females, 131/276) were the most common. In all patients, 1.89% of the males (3/159) and 2.13% of the females (6/282) recommended for surgery showed benign postoperative pathology, of which tuberculosis and fungal infection were the main pathological types (66.67% for each gender, males 2/3, females, 4/6). The postoperative pathology of 29 patients who subjectively requested surgery was also tuberculosis and fungal infection as the main pathological types (69.23% of males, 9/13; 68.75% of females, 11/16). The MDT comprehensive management model made full use of a variety of auxiliary diagnostic technologies and combined the experience advantages of multidisciplinary participation to make up for the limitations of single-diagnosis. The overall diagnosis coincidence rate reached 98.09%, with strong consistency (Kappa>0.81). The positive predictive value (PPV) was 97.96%, the negative predictive value (NPV) was 100%, and the average patient diagnosis and treatment cycle was 24.28-26.51 days. Conclusions: The MDT comprehensive management model meets the consensus requirements. It has great advantages in diagnostic efficiency and diagnosis and treatment cycle, and has a high promotion and application value for the diagnosis and treatment of early-stage lung cancer. At the same time, tuberculosis and fungal infection should be regarded as an important differential diagnosis item.

Summary Chiari malformation type Ⅰ（CMI） is a disorder characterized by tonsilla cerebelli herniating into an underdeveloped posterior cranial fossa, hearing loss is often covered by more striking neurological symptoms. Hearing loss in this syndrome is not specific in terms of gender side, degree, age of onset, and progression. The hearing improvement after posterior fossa decompression is controversial on the basis of literature, while satisfactory result was obtained after cochlear implantation in the patient reported here, who was diagnosed as CMI with hearing loss as the main symptom. Therefore, after ensuring the integrity of the auditory pathway, cochlear implantation may be considered in CMI patients with bilateral severe or profound without other severe neurological symptoms., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To investigate the therapeutic effect of Jin Long Capsule (JLC) combined with neoadjuvant chemotherapy on the invasive breast cancer, and to explore the mechanism of JLC in inhibiting multidrug resistance of breast cancer. Methods: 200 patients were divided into experimental group and control group (100 cases per group). The control group used TEC regimen for neoadjuvant chemotherapy. And the experimental group was treated with TEC regimen combined with oral JLC. According to the Miller & Payne grading system (MP), the efficacy of neoadjuvant chemotherapy was evaluated based on histopathological changes of breast cancer after neoadjuvant chemotherapy. Adverse effect was evaluated according to the classification criteria of the National Cancer Institute of the United States-The Common Terminology Criteria for Adverse Events (CTCAE) version 3.0. The expression of P-glycoprotein (P-gp), glutathione thiol transferase (GST)-π and topoisomerase Ⅱα (TopoⅡα) in breast cancer tissues before and after neoadjuvant chemotherapy were detected by immunohistochemical staining. Results: There were 83 effective cases (83%) in the experimental group, which was higher than that in the control group (65.0%, P <0.05). The incidence of leukopenia, gastrointestinal reactions and alopecia in grade 3 to 4 of the experimental group were lower than those of the control group (all P <0.05). The positive rates of P-gp, GST-π and TopoⅡα expression in the control group were 65.0% (65/100), 61.0% (61/100) and 69.0% (69/100), respectively, and they were 80.6% (75/93), 78.5% (73/93) and 37.6% (35/93) after chemotherapy. The positive rates of P-gp and GST-π expression were significantly higher than those before chemotherapy (both P <0.05), whereas the positive rate of TopoⅡα expression was significantly lower than that before chemotherapy ( P <0.05). In the experimental group, the positive rates of P-gp, GST-π and TopoⅡα expression before chemotherapy were 62.0% (62/100), 63.0% (63/100) and 69.0% (69/100), respectively, while after chemotherapy, they were 68.2% (60/88), 67.0% (59/88) and 63.6% (56/88). There was no significant difference in the positive rates and expression intensity of P-gp, GST-π and TopoⅡα before and after the chemotherapy ( P >0.05). Conclusion: Jin Long Capsule (JLC) can inhibit multidrug resistance, improve the efficacy of neoadjuvant chemotherapy, and reduce adverse reactions of breast cancer.

Objective: Observing the effect of maintain tension across suture between cartilages to fix new nasal structure on balance the asymmetric strength of the two sides of the cartilage and the recurrence of the postoperative crooked nose. Method: A L-shaped struct made of the nasal septum cartilage were fixed to maintain tension across structure between cartilage during rhinoplasty in 39 patients with crooked nasal deformity. Of 21 cases were type I deviation, of 12 cases were C-shaped deviation,and of 6 cases were S-shaped deviation. Result: A 1-5 years follow-up were performed. The effects were divided into three degrees: 30 cases excellent (76.92%), 6 cases good (15.38%) and 3 cases acceptable (7.69%).The rate of excellent and good was 92.31%(36/39). The type I improvement rate was 80.3%,the rate of type C was 83.6% and the improvement rate of type S was 84.1%,the overall improvement rate was about 81.9%. Conclusion: Suture under tension across cartilage can fix reconstruction of nasal structure effectively,improve the postoperative effect, reduce recurrence of crooked nose. The operation is simple and is an essential part of the nasal deformity correction technique., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To investigate the expression and clinicopathological significance of hypoxia-inducible factor 1 alpha (HIF-1α), glucose transporter 1(GLUT-1) and lactate dehydrogenase(LDH)-5 in colorectal cancer. Methods: The expression levels of HIF-1α, GLUT-1 and LDH-5 were detected by immunohistochemical staining in 142 specimens of human carcinoma in comparison with adjacent normal tissues. Results: The expression levels of HIF-1α(78.2%, 111/142), GLUT-1(75.4%, 107/142) and LDH-5(68.3%, 97/142) were higher in tumor tissues than in adjacent normal tissues(14.8%, 21/142; 11.3%, 16/142; 7.0%, 10/142; P <0.01 for all three proteins), and such over-expression was significantly associated with lymphovascular invasion, tumor grade and pathological stages(all P <0.01). Additional studies showed that HIF-1α, GLUT-1 and LDH-5 were positively associated with each other( r <0.3, P <0.05 for all three proteins). Conclusion: The data suggest that HIF-1α, GLUT-1 and LDH-5 expression may serve as prognostic indicators for colorectal cancer patients.

The immunologic phenotypes of 68 cases of acute nonlymphoblastic leukemia (ANLL) were analysed with a panel of monoclonal antibodies. The results showed that the frequencies of myeloid antigens expressed on ANLL cells are CD15 > CD33 > CD13 > CD14 and there were few cases expressing lymphoid antigens. The expression of myeloid antigen on leukemia cells is not only the evidence for diagnosis ANLL, but also is valuable predicting prognosis. In cases with the ratio of CD33/CD13 < 1, the complete remission (CR) rate was higher than those with CD33/CD13 > 1 (P < 0.05). Patients with expression of CD15 antigen on their leukemia cells appeared to be associated with long survival.

A method to determine the concentration of Ara-a in plasma by reversed phase high performance liquid chromatography is established. The method offers the advantage of rapid and simple preparation of plasma samples and sampling volumes as small as 0.5 ml. There is no need to extract Ara-A (adenine arabinoside) or to remove or modify sugar moieties to obtain samples of adequate separation. In pharmacokinetic studies, when amounts of clinical material are small and large numbers of assay are required, the present method is very useful. The calibration curve is linear for a wide range of concentration. The recovery is 87.5%. After a single dose of Ara-A-NC adenine arabinoside nanocapsules or Ara-A injection via intravenous administration in rabbits, the Ara-A concentration in plasma was determined by this method. The pharmaceutical parameters of Ara-A-NC and Ara-A injections were obtained by using PKBP-N1 program in NEC computer. The data obtained fitted an open two-compartment model well with two correlation coefficients more than 0.99. In mice given Ara-A injection a shorter elimination half-time (20.32 min), MRT (9.647 min) and a smaller AUC (233.4 micrograms.min.ml-1) were obtained compared with the group given Ara-A-NC injection. For the latter, the figures were 67.82 min, 156.7 min and 309.9 micrograms.min.ml-1, respectively. It can be concluded that NC can alter the pharmacokinetic behavior of Ara-A in mice significantly and keep the drug at a higher level and for a longer time.

Using 3H-TdR labelling radioautography in vitro, labelling index (LI) of the bone marrow cells from patients with CML was estimated before and after treatment by indirubin, and compared with myleran. The results showed that LI of the bone marrow cells was prone to decline after treatment by indirubin or myleran, and it was most marked on the myelocyte and polychromatophilic erythroblast. The LI reduction was less by indirubin than myleran. It suggests that the inhibition of indirubin on the bone marrow cells be weaker than that of myleran. However, long-term administration of indirubin would inhibit not only the granulocytic series but also the red cell series to a certain degree.