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To investigate the relationship between the number of hyperintense foci of T2-weighted imaging (T2WI) and the efficacy of high-intensity focused ultrasound (HIFU) in the treatment of adenomyosis.This prospective cohort study enrolled 102 patients with adenomyosis. Participants were classified into two groups: 50 patients in whom the number of hyperintense foci on magnetic resonance imaging (MRI) T2WI was more than five were placed in the5 group and 52 patients in whom the number of hyperintense foci on MRI T2WI was five or fewer were placed in the ≤5 group. Uterine fibroid symptoms (UFS) and visual analog scale (VAS) scores were recorded as indicators for the course of adenomyosis treatment.Among the enrolled patients, 84 received HIFU treatment and were followed up. At 6, 12, 24, and 36 months after HIFU treatment, the UFS score of women in the5 group was higher than that of the patients in the ≤5 group (P 0.05). The ablation rate of MRI T2WI in the hyperintense foci ≤5 group was higher than the hyperintense foci5 group (P 0.05).Number of MRI T2WI hyperintense foci is a factor affecting the ablation rate and the clinical efficacy of HIFU treatment in women with adenomyosis. It is likely to be a predictor of the efficacy of HIFU in adenomyosis treatment.

The role of cytoskeleton-associated membrane protein 4 (CKAP4) in hepatocellular carcinoma (HCC) is controversial. The present study aimed to investigate the association between tumor CKAP4 mRNA expression and clinicopathological characteristics and prognosis in patients with HCC. Data relating to CKAP4 mRNA expression in HCC tumor and normal adjacent liver tissues, and clinicopathological characteristics, were downloaded from the Gene Expression Omnibus and The Cancer Genome Atlas databases. The CKAP4 mRNA levels in tumor tissues were compared with those in normal adjacent liver tissues, their association with clinicopathological parameters was analyzed, and diagnostic and prognostic values were evaluated in patients with HCC. In all 4 datasets (total samples, n=693), CKAP4 mRNA levels were significantly higher in tumor tissues compared with adjacent tissues (all P3 years (P=0.003). The high-level CKAP4 mRNA group also exhibited lower overall survival (OS) and disease-free survival (DFS) rates compared with the low-level group [hazard ratio (HR)=1.494; 95% confidence interval (CI), 1.044–2.138; P=0.028] for OS and (HR=1.616; 95% CI, 1.022–2.555; P=0.040) for DFS. The results of the present study suggest that CKAP4 mRNA is upregulated in HCC tumor tissues compared with normal adjacent tissues, and is associated with poor clinical prognosis, pathological features and survival in patients with HCC. Thus, CKAP4 is a potential biomarker for HCC diagnosis and prognosis.

Torsional vibrations are unavoidable in beam-type structures in various engineering practices, and the advent of metamaterials provides a solution through the generation of bandgaps. However, unlike their flexural counterparts, tunable torsional bandgaps are seldomly studied due to two major difficulties: the existing metamaterial's units are less torsional-sensitive and the reliable torsional sensing techniques for validations are less available. In this work, switchable torsional bandgaps are realized in a metamaterial beam with a bistable resonator design based on Kresling origami with attached eccentric balls. We find that, through compression–torsion interaction of the proposed origami resonators and the corresponding wave-coupling phenomenon, torsional bandgaps can be generated and efficiently tuned, which leads to lower and wider vibration isolation frequency zones. Thanks to bistability, Kresling resonators arranged with eccentric balls can achieve bandgap switching. Specifically, based on the compression–torsion interaction of the bistable Kresling origami, wave coupling will be weakened/enhanced when the Kresling resonators arranged with eccentric balls turn from the 1st/2nd state to the 2nd/1st state, and, thus, the switching of torsional bandgaps can be realized. In order to experimentally validate the tunable torsional bandgaps, a high-sensitive fiber Bragg grating (FBG) displacement sensing system containing two parallel FBG sensors is set up to extract the torsional responses. This research will be helpful for future studies focusing on regulating torsional waves through compression–torsion interaction and mode conversion utilizing wave coupling.

This cohort study examines the association of comutation of tumor protein p53 (TP53) and ataxia-telangiectasia mutated (ATM) genes with response to immune checkpoint inhibitor (ICI) treatment and overall survival among patients with non–small cell lung cancer (NSCLC)., Key Points Question What are the prevalence and association of tumor protein p53 (TP53) and ataxia-telangiectasia mutated (ATM) comutation with response to immune checkpoint inhibitors in patients with non–small cell lung cancer (NSCLC)? Findings In this multiple-cohort study, TP53 and ATM comutation sites were scattered throughout the genes analyzed. Comutation in TP53 and ATM was associated with a higher tumor mutation burden and better overall survival compared with sole mutations and no mutation. Meaning Patients with TP53 and ATM comutation compose a subgroup of patients with NSCLC associated with an increased tumor mutation burden and better response to immune checkpoint inhibitors; TP53 and ATM may be a clinically relevant biomarker in guiding immunotherapy treatment of NSCLC., Importance Immune checkpoint inhibitors (ICIs) can elicit durable antitumor responses in patients with non–small cell lung cancer (NSCLC), but only 20% to 25% of patients respond to treatment. As important genes in the DNA damage response pathway, comutation in the tumor protein p53 (TP53) and ataxia-telangiectasia mutated (ATM) genes may be associated with genomic instability and hypermutation. However, the prevalence of TP53 and ATM comutation and its association with response to ICIs are not fully understood. Objective To examine the prevalence of the TP53 and ATM comutation, the potential mechanism, and its association with response to ICIs among patients with NSCLC. Design, Setting, and Participants This multiple-cohort study included patients with NSCLC from the Geneplus Institute, the Cancer Genome Atlas (TCGA), and the Memorial Sloan Kettering Cancer Center (MSKCC) databases and from the POPLAR and OAK randomized controlled trials. Samples in the Geneplus cohort were collected and analyzed from April 30, 2015, through February 28, 2019. Data from TCGA, the MSKCC, and the POPLAR and OAK cohorts were obtained on January 1, 2019, and analyzed from January 1 to April 10, 2019. Next-generation sequencing assays were performed on tumor samples by the Geneplus Institute. Genomic, transcriptomic, and clinical data were obtained from TCGA and MSKCC databases. Exposures Comprehensive genetic profiling was performed to determine the prevalence of TP53 and ATM comutation and its association with prognosis and response to ICIs. Main Outcomes and Measures The main outcomes were TP53 and ATM comutation frequency, overall survival (OS), progression-free survival, gene set enrichment analysis, and immune profile in NSCLC. Results Patients with NSCLC analyzed in this study included 2020 patients in the Geneplus cohort (mean [SD] age, 59.5 [10.5] years; 1168 [57.8%] men), 1031 patients in TCGA cohort (mean [SD] age, 66.2 [9.5] years; 579 [56.2%] men), 1527 patients in the MSKCC cohort (662 [43.4%] men), 350 patients in the MSKCC cohort who were treated with ICIs (mean [SD] age, 61.4 [13.8] years; 170 [48.6%] men), and 853 patients in the POPLAR and OAK cohort (mean [SD] age, 63.0 [9.1] years; 527 [61.8%] men). Sites of TP53 and ATM comutation were found scattered throughout the genes, and no significant difference was observed in the frequency of TP53 and ATM comutation within the histologic subtypes and driver genes. In 5 independent cohorts of patients with NSCLC, TP53 and ATM comutation was associated with a significantly higher tumor mutation burden compared with the sole mutation and with no mutation (TCGA, MSKCC, Geneplus, and POPLAR and OAK cohort). Among patients treated with ICIs in the MSKCC cohort, TP53 and ATM comutation was associated with better OS than a single mutation and no mutation among patients with any cancer (median OS: TP53 and ATM comutation, not reached; TP53 mutation alone, 14.0 months; ATM mutation alone, 40.0 months; no mutation, 22.0 months; P = .001; NSCLC median OS: TP53 and ATM comutation, not reached; TP53 mutation alone, 11.0 months; ATM mutation alone, 16.0 months; no mutation, 14.0 months; P = .24). Similar results were found in the POPLAR and OAK cohort in which the disease control benefit rate, progression-free survival, and OS were all greater in patients with the TP53 and ATM comutation compared with the other 3 groups (median progression-free survival: TP53 and ATM comutation, 10.4 months; TP53 mutation, 1.6 months; ATM mutation, 3.5 months; no mutation, 2.8 months; P = .01; median OS: TP53 and ATM comutation, 22.1 months; TP53 mutation, 8.3 months; ATM mutation, 15.8 months; no mutation, 15.3 months; P = .002). Conclusions and Relevance This study’s findings suggest that the TP53 and ATM comutation occurs in a subgroup of patients with NSCLC and is associated with an increased tumor mutation burden and response to ICIs. This suggests that TP53 and ATM comutation may have implications as a biomarker for guiding ICI treatment.

Objective: This study aimed to develop and validate a simple-to-use nomogram for early hepatocellular carcinoma (HCC) patients undergoing a preoperative consultation and doctors conducting a postoperative evaluation.Methods: A total of 2,225 HCC patients confirmed with stage I or II were selected from the Surveillance, Epidemiology, and End Results database between January 2010 and December 2015. The patients were randomly divided into two groups: a training group (n = 1,557) and a validation group (n = 668). Univariate and multivariate hazards regression analyses were used to identify independent prognostic factors. The Akaike information criterion (AIC) was used to select variables for the nomogram. The performance of the nomogram was validated concerning its ability of discrimination and calibration and its clinical utility.Results: Age, alpha-fetoprotein (AFP), race, the degree of differentiation, and therapy method were significantly associated with the prognosis of early HCC patients. Based on the AIC results, five variables (age, race, AFP, degree of differentiation, and therapy method) were incorporated into the nomogram. The concordance indexes of the simple nomogram in the training and validation groups were 0.707 (95% CI: 0.683–0.731) and 0.733 (95% CI: 0.699–0.767), respectively. The areas under the receiver operating characteristic (ROC) curve of the nomogram in the training and validation groups were 0.744 and 0.764, respectively, for predicting 3-year survival, and 0.786 and 0.794, respectively, for predicting 5-year survival. Calibration plots showed good consistency between the predictions of the nomogram and the actual observations in both the training and validation groups. Decision curve analysis (DCA) showed that the simple nomogram was clinically useful, and the overall survival significantly differed between low- and high-risk groups divided by the median score of the nomogram in the training group (P < 0.001).Conclusion: A simple-to-use nomogram based on a large population-based study is developed and validated, which is a conventional tool for doctors to facilitate the individual consultation of preoperative patients and the postoperative personalized evaluation.

Background Extrahepatic metastasis is the independent risk factor of poor survival of primary hepatic carcinoma (PHC), and most occurs in the chest and abdomen. Currently, there is still no available method to predict thoracoabdominal extrahepatic metastasis in PHC. In this study, a novel nomogram model was developed and validated for prediction of thoracoabdominal extrahepatic metastasis in PHC, thereby conducted individualized risk management for pretreatment different risk population. Methods The nomogram model was developed in a primary study that consisted of 330 consecutive pretreatment patients with PHC. Large-scale datasets were extracted from clinical practice. The nomogram was based on the predictors optimized by data dimension reduction through Lasso regression. The prediction performance was measured by the area under the receiver operating characteristic (AUROC), and calibrated to decrease the overfit bias. Individualized risk management was conducted by weighing the net benefit of different risk population via decision curve analysis. The prediction performance was internally and independently validated, respectively. An independent-validation study using a separate set of 107 consecutive patients. Results Four predictors from 55 high-dimensional clinical datasets, including size, portal vein tumor thrombus, infection, and carbohydrate antigen 125, were incorporated to develop a nomogram model. The nomogram demonstrated valuable prediction performance with AUROC of 0.830 (0.803 in internal-validation, and 0.773 in independent-validation, respectively), and fine calibration. Individual risk probability was visually scored. Weighing the net benefit, threshold probability was classified for three-independent risk population, which was 71.8%, respectively. According to this classification, pretreatment risk management was based on a treatment-flowchart for individualized clinical decision-making. Conclusions The proposed nomogram is a useful tool for pretreatment risk management of thoracoabdominal extrahepatic metastasis in PHC for the first time, and may handily facilitate timely individualized clinical decision-making for different risk population. Electronic supplementary material The online version of this article (10.1186/s12967-019-1861-z) contains supplementary material, which is available to authorized users.

In this paper, we present two definitions of the orthogonality and orthogonal rate of an encryption operator, and we provide a verification process for the former. Then, four improved ternary quantum encryption schemes are constructed. Compared with Scheme 1 (see Section 2.3), these four schemes demonstrate significant improvements in term of calculation and execution efficiency. Especially, under the premise of the orthogonal rate e as secure parameter, Scheme 3 (see Section 4.1) shows the highest level of security among them. Through custom interpolation functions, the ternary secret key source, which is composed of the digits 0, 1 and 2, is constructed. Finally, we discuss the security of both the ternary encryption operator and the secret key source, and both of them show a high level of security and high performance in execution efficiency.

In all-solid-state lithium batteries, the impedance at the cathode/electrolyte interface shows close relationship with the cycle performance. Cathode coatings are helpful to reduce the impedance and increase the stability at the interface effectively. LiTi2(PO4)3 (LTP), a fast ion conductor with high ionic conductivity approaching 10−3 S⋅cm−1, is adopted as the coating materials in this study. The crystal and electronic structures, as well as the Li+ ion migration properties are evaluated for LTP and its doped derivatives based on density functional theory (DFT) and bond valence (BV) method. Substituting part of Ti sites with element Mn, Fe, or Mg in LTP can improve the electronic conductivity of LTP while does not decrease its high ionic conductivity. In this way, the coating materials with both high ionic conductivities and electronic conductivities can be prepared for all-solid-state lithium batteries to improve the ion and electron transport properties at the interface.

In the three-dimensional flash memory manufacturing technology, the etching process of high aspect ratio multi-level contact holes structure was studied. Using capacitive coupled plasma (CCP) etching equipment, the effects of C 4 F 6/ /C 4 F 8 /O 2 /Ar mixed gas atmosphere on the deep holes’ total profile were investigated to optimize bowing profile of the hole. Furthermore, multi-level stop layer loss was optimized by adjusting over etching time and lithography exposure critical dimension (CD), which proved good compatibility with existing process. Results show that adding proper amount of C 4 F 8 into C 4 F 6 gas atmosphere can achieve better verticality and less stop layer loss. Enlarging middle layer exposure CD can reduce specific stop layer loss independently while reducing over etching time can reduce all stop layer loss together. Under the optimized process parameters, the multi-level contact holes with aspect ratio range from 2.5/1 to 30/1 on staircase can be achieved at one etching time, and each stop layer loss is less than 50%.

Currently, accompanied by rapid development of Chinese agricultural featured clusters, the cooperative innovation of clusters is increasing rapidly, but there also existed problems under low-carbon circumstances which prohibited the transform and upgrade for clusters. On the basis of analyzing current innovation situation of agricultural featured clusters, from the view of systematic, this thesis analyzed dynamic factors for innovation system of agricultural featured clusters, then, by introducing the triple-helix model of industrial innovation, the thesis constructed innovative system for clusters based on triple helix model. Based on these exploration, this thesis further researched the systems’ actual operation from perspective of systematic dynamics research, thus probed how to strengthen the collaborative innovation of university-cluster-government, so as to accelerate the continuous innovation and development of agricultural featured clusters under the low-carbon background.

Objective: To explore the expression of cyclophilin A (CypA) in esophageal tissues and its clinical significance. Method: Expression of CypA was detected in 236 esophageal cancer tissues and 236 normal tissues by using an immunohistochemical method, and the relationship between CypA expression and clinical outcomes was observed. Results: There were 166 patients with high expression of CypA (70.23%) and a higher expression in 69.3% of males and 73.3% in females. The CypA expression was irrelevant to age, tumor location, lymph node metastasis, and tumor differentiation degree. The Kaplan–Meier survival curve analysis showed that the expression of CypA was associated with the prognosis of patients with esophageal squamous cell carcinoma. Conclusion: The poor prognosis of esophageal cancer patients was associated with high expression of CypA.

Nowadays internationalization has been thought of as an important tendency in engineering education. The teaching practice for a certain course, therefore, should also adapt to the needs for talents development within such a background. Recently, following the education internationalization concept, the authors performed a systematic teaching reform on a course for postgraduates majoring in chemical engineering, including update and improvement on syllabus, contents, teaching methods as well as outcome assessment. In this paper we presented our thoughts and specific practice, in hope of being beneficial to other higher education practioners.

The stress distribution properties in a single lap-jointed cantilevered adhesive beam have been investigated using three dimensional finite element methods. Finite element solutions of the stress distributions in the adhesive layer have been obtained for three typical boundary conditions. It was found that the stress concentrations are confined to a very small region near the free ends of interfaces between the adherend and the adhesive layer while the centre region of the adhesive layer is mostly stress-free. This suggests that the first failure may be expected at the free ends of interfaces between the adherend and the adhesive layer. This also implies that the adhesive material near the free ends of the adhesive layer is mainly bearing the load being transferred through the adhesive joint. The analysis results show that by choosing suitable boundary condition, the bending effect can be reduced and the strength, fatigue life and reliability of the bond can be improved.

Adhesively bonding is becoming a widespread candidate technique for joining light-weight structural components. This paper investigates normal stress distribution in a single-lap adhesive joint using finite element method. Five layers of solid elements were used across the adhesive for obtaining an accurate indication of the variation of normal stress. All the numerical results obtained from the finite element analysis show that the spatial distribution of normal stress are similar for different interfaces. It can also be seen from the results that the left hand region is subjected to very high stress.

This paper studied the performance of self-piercing riveting (SPR) and adhesive hybrid joints of different adhesive, including strength, capacity of energy absorption, failure mode and failure mechanism of the hybrid joints. The performances of SPR-adhesive hybrid joints were compared with SPR joints. SPR-adhesive hybrid joints and SPR joints were tested under a tension loading. The test results showed that adhesive have a function of improving the strength of SPR joints; however, the capacity of energy absorption of SPR joints was weakened. While the adhesive have no effect on the failure modes of SPR joints. When appropriate adhesive was selected, the overall performance of SPR-adhesive hybrid joints was superior to SPR joints. In a word, the combination of SPR and adhesive could get a well jointing structure.

The purpose of this study is to propose the analytical model for clinched joint, which can be used to predict the joint strength based on the neck-thickness and undercut of clinched joint. The analytical model has been defined as a function of neck-thickness and undercut based on the neck fracture mode which is the most reasonable and common failure mode for clinched joints. Clinching joining experiment with different joint geometric variables with RIVCLINCH 1106 P50 and tensile-shear test with MTS landmark were conducted. The comparison of the clinched joint strength between experiment and analytical model shows good similarity within 7.2% error. The analytical model proposed for clinched joint strength is valid to calculate the clinched joint strength.

The research status of crystallization process and crystallizer of gypsum is introduced in this paper. Progress in 3D mathematical simulation of crystallizer based on Fluent is summarized, and the application of the 3D model in the construction and optimization analysis is also described. Furthermore, the prospect of Fluent applied in the design and optimization of gypsum crystallizer is introduced. Finally, the potential and prospect of Fluent basing on the 3D mathematical simulation of crystallizer in the production of gypsum is put forward.

Electrolysis is the main method of refined copper smelting. In order to obtain high-quality refined copper, it needs to ensure that the negative plate in the electrolytic cell has a high flatness. The precise straightening device in roller leveler is the last step to ensure the negative plate of high quality flatness. Studying the influence of parameters of precise straightening in roller leveler on the flatness of the negative plate has an important significance. Precise straightening process were simulated in ANSYS/LS-DYNA. The results of simulation were analyzed, on the basis of better meeting the requirements of enterprise, the most reasonable set of matching parameters was chosen to provide a reference for the enterprise designing and studying the roller leveler.

The adhesive-bond of paster single lap joints was put forward firstly. The strength of 5052Al-Al adhesive-bond of single lap joints (SLJ) and 5052Al-Al paster adhesive-bond of SLJ were investigated using finite element method (FEM). Results from the simulation showed that the paster adhesive-bond of SLJ was stronger than the adhesive-bond of SJL. So it can use the paster adhesive joints to improve the strength of adhesive joints.

Vertical planetary mill is a kind of efficient grinding equipment. Due to its unique design, the materials can suffer combined effects of squeezing, shearing and grinding. this paper developed the virtual prototype of vertical planetary grinding wheel sand reclamation equipment based on virtual prototyping technology, and did the dynamic simulation with this virtual prototype. It will use ADAMS to do the dynamic simulation, and it can provide reference price for staff.

On the platform of the UG Software’s CAD/MoldWizard/CAM components, the whole process of design and NC manufacturing of the plastic injection mold of a hair dryer’s shell was completed. The CAD/CAM process of the plastic injection mold was introduced by the practical application. The large advantage of the UG platform over the traditional method in the field of plastic injection molds’ design and manufacturing was reflected. The plastic injection molds’ design and manufacturing is a great challenge to the traditional design and manufacturing method, and the UG solutions can promote mold manufacturers’ ability of design and manufacturing remarkably.

Copper is important to the national economy as a kind of raw material, the Copper metal with higher purity is got by electrolysis in generally. In order to ensure the uniform space between cathode and anode when they are in electro-groove, to attain the better quality of cathode copper and raising production efficiency, verticality of the cathode and anode must be well. So it is very necessary to straighten the Copper starting sheet to acquire the better verticality, this paper adopt the roller type straightening machine to straighten the Copper starting sheet by analysis and comparison according to the material and structure characteristic of Copper starting sheet .this paper will analysis and research the straightening parameter of straightening machine .

In order to meet the requirements of synchronous output among multiple parallel-axis in some light industry machinery and avoid the traditional transmission ways’ defects, we put forward a kind of new transmission mechanism which is called the crank-group driving mechanism. This paper introduced the mechanism's inquiry process as follows: the movement that we need is a kind of uniform transmission , we choose the configurations of mechanism according to the requirements of movement; after comparison among various kinds of mechanism, we choose the parallelogram linkage as the prototype of the new mechanism, and the new mechanism is a evolution of it; we demonstrated the movability of the new mechanism from the point of view of freedom, and introduced the configurations of new mechanism.

To drive multiple parallel-axis to rotate synchronously，this paper put forward a kind of new transmission mechanism——crank-group driving mechanism， introduced the concept of it and its working principles，and demonstrated the feasibility of its movement .

This paper illustrated the characteristics of parallelogram linkage，introduced the origin of the crank-group driving mechanism and its design principles, analyzed some problems of virtual constraints，and verified the feasibility of this mechanism.

In a cigarette silk production line of a cigarette factory, the noise of vibrating conveyor not only endangers the health of workers’ listening, but also reduces work efficiency. In this paper, the modal of the frame was analyzed with the ANSYS software. The analysis results show that the frame has torsion vibration and swing. These vibrations will bring adverse effects and noise. Through designing a vibration isolation system on the vibrating conveyor, the reasonableness and effectiveness of the isolation component were proved with static and dynamic analysis of the vibration isolation system with finite element method. At the same time, some rules what select the spring parameters were summed up. Through analyzing the isolation effect of the vibration isolation system in different parameters, these regularity conclusions will provide a basis for the noise reduction [1].

Stamping process is a complex system, in the case of determined sheets, whether it can produce qualified parts has a great relationship with the setting of mold process parameters. Therefore, whether it is reasonable, the structure parameters of the parts are directly related to the forming quality of sheets. This paper uses the finite element numerical simulation, by setting different process parameters for single-factor simulation study, combines with the designers’ experience and repeats simulations to find the appropriate range of factors, and to obtain the optimum process parameters, thereby reducing repeated mold testing and repair costs, shorting the development time of new products.

This paper put forward a kind of crank-group driving mechanism on the basis of parallelogram mechanism , introduced its concept, design process, and analyzed the feasibility of its movement. It can drive multiple parallel-axis synchronously, and it is a new way of transmission.

Vertical planetary mill is a kind of efficient grinding equipment. Due to its unique design, the materials can suffer combined effects of squeezing, shearing and grinding.[1] This paper study the feasibility of the usage of the vertical planetary mill in the field of foundry sand reclamation. It will use Solid Edge to Design and modeling, and it can provide reference price for staff.

The iron ladle is a kind of large metallurgy equipments and used for collecting and carrying iron water. According to the factual demand of produce, some corporation wanted to enlarge the capacity of the idle from 65t to 75t only by increasing the height of ladle. This paper is aimed at the changing idle which the capacity is 75t and built up its 3D numerical model. According to the constant of the iron water capacity, it used the method of modeling to find the angle of the ladle taphole and made sure the ladle couldn't overturn automatically by studying the process of overturning. Then this paper worked out the overturning moment so that it could provide mechanics data for the analysis of the finite element and the reformation of the corporation.

According to the factual demand of produce, some corporation wants to enlarge the capacity of the idle from 65t to 75t. This paper aims at the changing ladle which the capacity is 75t. It makes research to the iron ladle's promotion process and stress analysis. This paper uses ANSYS-Workbench software to make the finite element analysis of the iron ladle and extracts the largest stress, strain and the location. Then this paper analyses whether the changing ladle can be fit for the intensity demand or not so that it could provide the important theory gist to the corporation

With the introduction of Be-doped AlxGa1-xAs template, self-assembled In0.79Mn0.21As quantum dots samples were prepared on semi-insulating (001) GaAs substrates by molecular beam epitaxy. High quantum dots density was confirmed by the atomic force microscopy. The ferromagnetism of the samples was revealed by superconducting quantum interference device magnetometer analysis at 10K, and the Curie temperatures ranging from 292 to 314K were able to be regulated by adjusting Al content and Be dopant in Be-doped AlxGa1-xAs templates, implying the feasible application of spintronic devices.

This study aimed to retrospectively summarize the clinical signs, diagnosis, and treatment of congenital bronchial atresia (CBA) in 12 patients. Chest radiographs and computed tomographic (CT) images of 12 patients with CBA treated in the Chinese People's Liberation Army General Hospital were reviewed. Analysis of chest radiographs revealed ten patients had hilar mass-like shadows and two had pneumonia-like shadows; most patients (n = 8) showed hyperlucency of the peripheral lung fields. CT revealed a mucocele in all the patients (n = 12); the mucoceles were round in four patients and club-like in eight. In 80% of the cases (n = 10), associated anomalies, including occlusions of the bronchus central to the mucocele, emphysematous changes of the peripheral lung fields, bronchogenic cyst, and anomalous branching of the bronchial tree and vascular structure were observed. CBA was detected in the right lobe in eight patients and the left lobe in the remaining four. No surgical intervention was performed in 5 CBA patients and the remaining 7 patients underwent surgery, including lobectomy in 5 patients and local resection in 2 patients. Among these 7 patients, 3 had a preoperative diagnosis of malignant disease, and the remaining 4 had severe clinical symptoms that could not be effectively treated by medicines. All patients were followed up, and none experienced obvious discomfort. CBA is a relatively rare and benign malformation disease. Chest CT is the procedure of choice for diagnosis. The presence of a bronchocele and surrounding emphysematous changes are typical radiologic findings in CBA. Surgery should be reserved only for patients with serious complications secondary to the atretic bronchus.

Background Stent graft-induced new entry (SINE), defined as the new tear caused by the stent graft and excluding those arising from natural disease progression or iatrogenic injury from the endovascular manipulation, has been increasingly observed after thoracic endovascular aortic repair (TEVAR) for Stanford type B dissection in our center. SINE appears to be remarkably life threatening. We investigated the incidence, mortality, causes, and preventions of SINE after TEVAR for Stanford type B dissection. Methods Data for 22 patients with SINE were retrospectively collected and analyzed from 650 patients undergoing TEVAR for type B dissection from August 2000 to June 2008. An additional patient was referred to our center 14 months after TEVAR was performed in another hospital. The potential associations of SINE with Marfan syndrome, location of SINE and endograft placement, and the oversizing rate were analyzed by Fisher exact probability test or t test. Results We found 24 SINE tears in 23 patients, including SINE at the proximal end of the endograft in 15, at the distal end in 7, and at both ends in 1. Six patients died. SINE incidence and mortality reached 3.4% and 26.1%, respectively. Two SINE patients were diagnosed with Marfan syndrome, whereas there were only 6 Marfan patients among the 651 patients. The 16 proximal SINEs were evidenced at the greater curve of the arch and caused retrograde type A dissection. The eight distal SINEs occurred at the dissected flap, and five caused enlarging aneurysm whereas three remained stable. The endograft was placed across the distal aortic arch during the primary TEVAR in all 23 patients. The incidence of SINE was 33.33% among Marfan patients vs 3.26% among non-Marfan patients ( P = .016). There was no significant difference in mortality between proximal and distal SINE (25% vs 28.6%, P > .99), incidence of SINE between endograft placement across the arch and at the straight portion of descending thoracic aorta (23 of 613 vs 0 of 38, P = .39), and the oversizing rate between SINE and non-SINE patients (13% ± 4.5% vs 16% ± 6.5%, P = .98). Conclusions SINE appears not to be rare after TEVAR for type B dissection and is associated with substantial mortality. The stress yielded by the endograft seems to play a predominant role in its occurrence. It is important to take this stress-induced injury into account during both design and placement of the endograft.

Introduction Hirudin is a direct thrombin inhibitor that has potential mechanistic advantages over indirect inhibitors. Peptides containing the RGD motif competitively inhibit binding of fibrinogen to glycoprotein IIb/IIIa on platelets, thus inhibiting platelet aggregation. A novel hirudin derivative, recombinant RGD-hirudin (r-RGD-hirudin), was engineered by fusing the tripeptide RGD sequence to the native hirudin. We tested the antithrombotic effect of r-RGD-hirudin using a carotid artery reconstruction model in rabbits. Materials and methods A fusion gene encoding r-RGD-hirudin was constructed and expressed at high levels in Pichia pastoris. Following traumatic injury and anastomosis, 42 New Zealand White rabbits were randomized to receive normal saline, abciximab, wild-type hirudin, or r-RGD-hirudin. Fibrinogen concentration, aPTT, TT, PT, and PAGm were measured prior to and following the operation. Carotid angiography and pathological examination of the anastomotic site were performed to compare patency rates among the groups. Results The r-RGD-hirudin significantly prolonged aPTT, TT, PT and inhibited PAGm following carotid anastomosis in rabbits. The median dose of r-RGD-hirudin (0.5 mg/kg) had a therapeutic effect equal to that of wild-type hirudin (1.0 mg/kg) and higher than that of abciximab (0.2 mg/kg) with regard to patency rates. Conclusions Compared to wild-type hirudin or antiplatelet agent, the novel anticoagulant, r-RGD-hirudin was capable of inhibiting both thrombin activity and platelet aggregation, and was demonstrated to be effective in the prevention of thrombosis.

e18013Background: Emerging evidences have showed that immune checkpoint inhibitors lead to durable responses in a variety of advanced cancers, including recurrent/metastatic nasopharyngeal carcinom...

Background— Retrograde type A aortic dissection has been deemed a rare complication after endovascular stent graft placement for type B dissection. However, this life-threatening event appears to be underrecognized and is worth being investigated further. Methods and Results— Eleven of 443 patients developed retrograde type A aortic dissection during or after stent grafting for type B dissection from August 2000 to June 2007. Of these 11 patients, 3 had Marfan syndrome. The Kaplan–Meier estimate of the rate of freedom from this event at 36 months is 97.4% (95% confidence interval, 0.95 to 0.99). The new entry was located at the tip of the proximal bare spring of the stent graft in 9 patients, was within the anchoring area of the proximal bare spring in 1, and remained unknown in 1 patient. Eight patients were converted to open surgery, and 2 received medical treatment. One patient suddenly died 2 hours after the primary stent grafting, and 2 died within 1 week after the surgical conversion, so mortality reached 27.3%. During the follow-up from 3 to 50 months, type I endoleak was identified in 1 patient 3 months after the surgical exploration and disappeared at 6 months. Conclusions— Retrograde type A aortic dissection after stent grafting for type B dissection appears not to be rare and results from mixed causes. Fragility of the aortic wall and disease progression may predispose to it, whereas stent grafting–related factors make important and provocative contributions. Avoiding aortic arch stent grafting in Marfan patients, preferably selecting the endograft without the proximal bare spring for patients with a kinked aortic arch or with Marfan syndrome (if endografting is used), improving the device design, and standardizing endovascular manipulation might lessen its occurrence.

Background To discuss failures and lessons in the endovascular treatment of symptomatic isolated dissection of the superior mesenteric artery (SIDSMA). Methods Data from 33 patients with SIDSMA treated between July 2007 and September 2013 were retrospectively collected. The technical failures in and lessons from endovascular management were analyzed in terms of causes and prophylaxis. Results Eighteen patients were successfully treated medically, 13 underwent stent placement, 1 underwent a hybrid procedure, and 1 had open fenestration. Full follow-ups (37 ± 21 months) were achieved in 28 patients. Failures to cannulate the true lumen occurred in 8 patients. Among these patients, femoral and brachial approaches were taken in 6 and 2 patients, respectively, and a 2-sided Fisher's exact test revealed no significant differences ( P = 0.204). Among the 6 femoral failures, the true lumina were cannulated after conversion to the brachial approach in 3 cases. The perfusion of the distal SMA was not improved until the second stent was distally placed to cover the entire expanded false lumen in 1 case. Numerous branches originating from the false lumen were overlooked in 1 patient and were apparently compromised after stenting. Consequently, the patient died of intestinal necrosis. In a patient with a huge dissecting aneurysm, a stent was misplaced across the false lumen. Fortunately, a remarkable aneurysmal thrombosis formed at 3 months. In a patient who received a hybrid procedure, the stent was occluded at 2 weeks, most likely because the thrombus protruded into the stent. Conclusions Difficulty in cannulating the true lumen is not uncommon in the endovascular treatment of SIDSMA, and the selection of the arterial approach would benefit from being based on the morphology of the SMA arch. The lengths and branches of the involvement of the false lumen should be evaluated beforehand. Covered stents would be a reasonable option for lumina that contain thrombi.

To evaluate the potential role of external beam radiation therapy (EBRT) in the treatment of patients with hepatocellular carcinoma (HCC) who have portal vein (PV) and/or inferior vena cava (IVC) tumor thrombi.One hundred fifty-eight patients with HCC who had PV and/or IVC tumor thrombus were reviewed and analyzed by Kaplan-Meier and Cox regression analysis. Forty-four patients with HCC who received local limited EBRT (in addition to other treatment modalities) were classified as the EBRT group. The total radiation dose was 36-60 Gy (median, 50 Gy) and was focused on the tumor thrombi. One hundred fourteen patients with HCC who did not receive EBRT were selected from hospitalized patients with HCC who had PV and/or IVC thrombi during the same period; these were classified as the non-EBRT group, and their intrahepatic tumors were treated with transarterial chemoembolization or resection, on the basis of the patients' status. Parameters observed included survival rates and the tumor thrombus response to EBRT as seen on CT scan or MRI.Of the 44 patients who received EBRT, 15 (34.1%) showed complete disappearance of tumor thrombi, 5 (11.4%) were in partial remission, 23 (52.3%) were stable in their tumor thrombi, and 1 (2.3%) showed disease progression at the end of the study period. The median survival was 8 months, and the 1-year survival rate was 34.8% in the EBRT group. In the non-EBRT group, the median survival and 1-year survival rates were 4 months and 11.4%, respectively. In stepwise multivariate analysis, EBRT showed a strongly protective value (relative risk = 0.324, p0.001). Survival was not related to intrahepatic tumor status in the non-EBRT patients. However, in the EBRT group, poorer prognosis was significantly related to intrahepatic multifocal or diffusion lesions, and the most common reason for death was liver failure caused by uncontrolled intrahepatic disease.Although EBRT is palliative in intent, it is preferred for prolonging survival in the treatment of tumor thrombi.

Copper is important to the national economy as a kind of raw material, the Copper metal with higher purity is got by electrolysis in generally. In order to ensure the uniform space between cathode and anode when they are in electro-groove, to attain the better quality of cathode copper and raising production efficiency, verticality of the cathode and anode must be well. So it is very necessary to straighten the Copper starting sheet to acquire the better verticality, this paper adopt the roller type straightening machine to straighten the Copper starting sheet by analysis and comparison according to the material and structure characteristic of Copper starting sheet . In order to test the straightening ,this paper will use the ANSYS/LS-DYNA to simulate straightening machine to meet the need of company.

A new method for growing a GaN initial layer on a GaAs(0 0 1) substrate is reported. The experiments show that the optimized growth condition for a smooth GaN initial layer is to grow a two monolayer thick layer at 600°C under As pressure. The pure cubic GaN films of 500 nm has been obtained on such an initial layer, the X-ray diffraction and photoluminescence show that the C–GaN film has a very high quality. There is no yellow or DA band emission of PL spectrum and the FWHM of the X-ray rocking curve is only 10 min.

Since Parodi et all reported the first successful case of endovascular treatment for abdominal aortic aneurysm (AAA) in 1991, the endovascular repair has become an important option for the surgical treatment of aortic aneurysms. 2-4 The occluder is a newly-developed device introduced intraluminally to block the blood flow in certain arteries. It was mainly adopted by cardiologists in occluding the ventricular septal defect (VSD) and atrial septal defect (ASD). 5-6 Afterwards, vascular surgeons found it could also be used in endovascular repair of aortic aneurysms, especially when the aorto-uni-iliac (AUI) stent-grafts were implanted. 7 Herein we present 6 patients with AAA, who were treated with endovascular deployment of AUI stent-grafts combined with a newly-designed occluder.

To effectively isolate thoracic aortic lesions in thoracic endovascular aortic repair (TEVAR), an adequate proximal landing zone length is required. The left subclavian artery (LSCA) and other branches of the aortic arch commonly impose limitations on proximal landing zone length, restricting the use of TEVAR. In this study, we investigated the outcomes of LSCA coverage during TEVAR.Between March 2009 and February 2010, we recruited patients with thoracic dissection, aneurysm or trauma from a single center for TEVAR. We categorized patients into 3 groups: full coverage, partial coverage, or noncoverage of the LSCA. We measured pre- and postoperative blood pressures and evaluated complications during follow-up.We recruited 111 patients for our study: 55 (50%) and 25 (23%) patients had full and partial LSCA coverage, respectively. The upper left arm blood pressures before and after the operations were significantly different between the full-coverage group and the other groups (P0.0001). Follow-up occurred between 6 and 20 months, and the mean follow-up time was 10.4 months. Thirteen patients (24%) in the full-coverage group and 2 patients (8%) in the partial-coverage group suffered from simple vertebrobasilar ischemia (VBI). Eleven of the patients with VBI (20%) in the full-coverage group and 2 (8%) patients with VBI in the partial-coverage group had left subclavian steal syndrome at follow-up. No paraplegia or stroke was observed.Intentional coverage of the LSCA to obtain an adequate proximal landing zone for TEVAR can be a treatment option for thoracic aortic lesions, although some patients experienced mil complications.

This paper comes up with multilevel grey evaluation method by applying Grey system theory and Analytic hierarchy process (AHP), and sums up the risk evaluation index system for Chinese oil companies’ transnational mergers and acquisitions (M&A) in the light of the characteristics of international M&A. On the basis of this, the paper carries on risk evaluation by using multilevel grey evaluation method combined with practical example. The research shows that the method has the advantages of feasible, high precision, etc.

The clinical signs, diagnosis, and surgical management experiences of 51 cases of pulmonary fungal infections were retrospectively summarized. The clinical data were taken from 51 pulmonary fungal infection patients treated in the Thoracic Surgery Department of the Chinese PLA General Hospital from 1981 to 2008. This case series included 3 cases of Candida albicans, 22 cases of Aspergillus, and 26 cases ofCryptococcus infection. Forty-eight of the patients underwent a standard thoracotomy operation, whereas the remaining 3 patients underwent a thoracoscopy or a thoracoscopy-assisted minithoracotomy. Seventeen patients underwent pulmonary lobectomies, and 34 underwent wedge resections. All of the diagnoses were confirmed by postoperative pathology. There was no operative mortality, but there were 4 postoperative complications. In conclusion, primary pulmonary fungal infections lack characteristic clinical manifestations and imaging findings. A pathological examination can provide evidence for a definitive diagnosis. Surgical intervention is effective for the diagnosis and treatment of this disease. There is no significant difference between the long-term efficacy of wedge resection and standard lobar resection. Pre- and postoperative antifungal medications can effectively prevent fungal dissemination and recurrence. Key words: Fungus, lung, diagnosis, surgical, treatment.

Objective To present the short- to midterm outcomes after management of 14 patients with symptomatic isolated dissection of superior mesenteric artery (SIDSMA) and propose a preliminary treatment algorithm. Background SIDSMA is a rare but potentially fatal entity. However, most of these reports were isolated case reports, and a consensus treatment protocol remains lacking so far. It would be meaningful to propose a reasonable treatment algorithm for it. Methods Patients with SIDSMA who were treated in our center between July 2007 and June 2011 were retrospectively collected and analyzed. Based upon the abdominal pain and signs, the clinical manifestations have been retrospectively classified into grade I (peritonitis absent) and grade II (peritonitis present). Medical treatment mainly included anticoagulation, antiplatelet, and bowel rest. Endovascular stent placement and surgical fenestration with exploratory laparotomy have been selected according to the grade classification. Computed tomographic angiography, magnetic resonance angiography, or duplex scans have been used for diagnosis and follow-up. Results Fourteen consecutive patients with SIDSMA were collected; among them, 13 cases belonged to grade I and one to grade II. The mean duration from the onset to the admission was 12 ± 12 days (range, 0.5-45 days). The mean distance from the primary tear to the ostium of superior mesenteric artery (SMA) was 26 ± 4 mm (range, 15-32 mm). Medical treatment was given for 13 patients of grade I for the first 3 to 5 days after admission, and the abdominal pain remarkably or completely resolved in four patients who received continued medical treatment, whereas the other unresolved nine patients were converted to endovascular stent placement that succeeded in four and failed in five patients. Since these five cases were free from peritoneal signs, medical treatment was given again instead of an immediate surgical intervention, and ultimately achieved complete alleviation of abdominal pain within the following 1 week. The mean duration from the start of medical treatment to the alleviation of symptoms, including the continued medical treatment after the failed endovascular stent placement, was 8 ± 3 days (range, 4-12 days). The grade II patient underwent a successful emergency surgical SMA fenestration without bowel resection. Follow-up was accomplished in all 14 cases, ranging from 2 to 48 months (mean, 30 ± 15 months). No intestinal necrosis, morbidity, or mortality developed during hospitalization. During the follow-up, all patients were free from aneurysmal formation of SMA or chronic intestinal ischemia, and all stents remained patent. Conclusions For grade I SIDSMA, most cases might be successfully treated with medical therapy, and the endovascular stent placement appears to be an acceptable alternative if medical treatment fails. For grade II SIDSMA, the endovascular stenting combined with laparoscopic exploration and/or open surgery could be a reasonable option.