Search

OBJECTIVE: To investigate the value of differential diagnosis between acinic cell carcinoma (ACC) and pleomorphic adenoma (PA) using the quantitative parameters of contrast-enhanced ultrasound (CEUS). PATIENTS AND METHODS: Twenty-two ACC and 98 PA were retrospectively analyzed. These patients had been examined via routine pre-surgical two-dimensional ultrasound and CEUS. The examination results were confirmed by biopsy pathology. Qontrast 4.0 imaging analysis software was applied to obtain the maximum intensity (PEAK), time to peak (TTP), regional blood volume (RBV), regional blood flow (RBF), maximum signal intensity (SImax) and mean signal intensity (SImean) through quantitative analysis. The differences between ACC and PA were compared regarding the conventional ultrasound images and the quantitative parameters of CEUS. ROC curves were drawn to evaluate the diagnostic value of these parameters. RESULTS: There were no statistically significant differences between salivary gland ACC and PA in the manifestations of conventional two-dimensional ultrasound examination regarding morphology, internal echo and the boundary (p > 0.05). However, there were significant differences in PEAK, RBV, RBF, SImax and SImean between ACC and PA (p < 0.05). Additionally, the five quantitative parameters of CEUS were all highly accurate diagnostic indicators. The maximum area under the curve of each parameter was 0.888, sensitivity 72.6%, specificity 90.9% and accuracy 81.8%. CONCLUSIONS: The quantitative parameters of CEUS are helpful for differentially diagnosing salivary ACC and PA. [ABSTRACT FROM AUTHOR]

Photosynthesis is sensitive to water deficit (WD) stress. Maize (Zea mays L.) yield is vulnerable to water stress, especially if it occurs during the reproductive stage. In this study, the expression patterns of photosynthesis-related genes, together with photosynthetic gas-exchange and fluorescence parameters were investigated in a maize inbred line exposed to 50% of field water capacity (moderate WD) for 15 d after tassel emergence. The results demonstrated that WD down-regulated expression of psbA, psbB, psbC, psbP, psaA, psaB, and cab, especially at later periods of WD stress. Besides, with the increased WD stress, the steady decline in the value of photosynthesis performance index, maximum quantum yield of primary photochemistry, quantum yield for electron transport, quantum yield for the reduction of end acceptors of PSI per photon absorbed, and the efficiency of an electron beyond QA - that reduced PSI acceptors, and a clear increase in the J-step and I-step, K-band as well as L-band were observed. The results suggested that WD might restrict light-harvesting and electron transport. Interestingly, leaf transcript levels of rbcL and rbcS were up-regulated at the later stage of water stress in maize inbred line, which helped repair injury to PSII centers and maintain PSII activity (increased quantum yield of dissipation and effective antenna size of an active reaction center) under 15-d lasting WD. [ABSTRACT FROM AUTHOR]

Instability of resin-dentin bonds is the Achilles' heel of adhesive dentistry. To address this problem, a chelate-and-rinse extrafibrillar dentin demineralization strategy has been developed that keeps intrafibrillar minerals within collagen fibrils intact to prevent activation of endogenous proteases that are responsible for collagen degradation within hybrid layers. The objective of the present study was to evaluate the potential of using chitosan >40 kDa as an antimicrobial extrafibrillar dentin-chelating agent to enhance bond durability. Transmission electron microscopy provided evidence for retention of intrafibrillar minerals and smear plugs in dentin conditioned with 1 wt% chitosan. Analyzed by Kruskal-Wallis analysis of variance, Dunn's statistic, and separate Mann-Whitney tests, tensile bond strengths to wet- and dry-bonded dentin indicated that chelating dentin with chitosan for 60 s prior to bonding did not result in a significant decline in resin-dentin bond strength when compared with that of phosphoric acid etching ( P > 0.05). Gelatinolytic activity within the hybrid layers was examined via in situ zymography after 24-h storage or after thermomechanical cycling and analyzed with 3-factor analysis of variance. After 24 h, enzymatic activity was detected only within completely demineralized phosphoric acid-etched dentin, with values derived from dry bonding significantly higher than those derived from wet bonding ( P < 0.05). Negligible fluorescence was detected within hybrid layers when dentin was conditioned with chitosan, even after thermomechanical cycling, as compared with the controls. Reduction in water permeability in chitosan-conditioned dentin, attributed to smear plug retention, also fostered long-term bond stability. Antibacterial testing performed with live/dead staining indicated that the acetic acid-solubilized chitosan possessed antibacterial activities against 3 single-species biofilms: Streptococcus mutans, Actinomyces naeslundii, and Enterococcus faecalis. Taken together, the new chitosan-based extrafibrillar demineralization strategy retains intrafibrillar minerals, reduces endogenous protease-initiated collagen degradation, prevents water permeation within hybrid layers, and kills bacteria on dentin surfaces, which are crucial factors for enhancing resin-dentin bond durability. [ABSTRACT FROM AUTHOR]

Performing forced vibration tests on full-scale structures is the most reliable way of determining the relevant modal parameters in structural dynamics, such as modal frequencies, mode shapes, modal damping, and modal masses. This study describes the modal identification of a double-level curved cable-stayed bridge with separate deck systems for pedestrians and vehicles via forced vibration tests. The steady-state structural responses to sinusoidal excitations produced by an electrodynamic shaker are recorded under varying excitation frequencies, and the frequency response functions are established. The measured frequency response functions are curve fitted to estimate the modal parameters. The numerical simulation of frequency response function-based modal parameter identification of an elastically multi-supported continuous beam structure is carried out, and the emphasis has been placed on the evaluation of the effect of an additional shaker mass, excitation frequency step and range, multi-mode vibration, and noise on identification results. Finally, the modal parameters for the first lateral mode of a double-level curved cable-stayed bridge are identified by forced vibration experiments, and the results are compared with those from ambient vibration tests and free vibration tests. The effect of the unmeasured wind excitation on identification is discussed. It is shown that the effect of ambient vibration is minor for wind velocity of 3-5 m/s. The damping ratios identified by forced and free vibration tests are comparable, while those from ambient vibration are subject to large variations. The modal mass obtained from forced vibration tests is in good agreement with finite element prediction, which provides design basis for mass-type dampers. [ABSTRACT FROM AUTHOR]

This paper proposes a simple approach for force finding analysis of suspended-domes based on the superposition principle. First, the feasibility of the superposition principle in a suspended-dome during tension is validated using an experimental model and the corresponding numerical model. Following that, a simplified computational method for force finding based on the superposition principle is presented. Taking a suspended-dome as an illustrative example, the initial strain at zero state is calculated by force finding, and the difference between the simplified computational method and the iterative method is investigated. The results show that the superposition principle is nearly feasible during tension and the proposed simple approach is accurate and can easily obtain the actual initial pre-stress of a suspended-dome. [ABSTRACT FROM AUTHOR]

Objective: To assess the effectiveness and security of CT-guided percutaneous implantation of iodine-125 (125I)- labelled seeds in pancreatic carcinoma. Methods: A total of 36 patients (25 males and 11 females) with an average age of 57 years (range, 39-84 years) were enrolled and categorized into Stage III (27 cases) and Stage IV (9 cases) of pancreatic cancer. There were 3 tumours in the pancreatic head and 33 tumours in the pancreatic body or tail. The average diameter of the tumours was 37.1 mm (range, 15-65 mm). The implantation of 125I seeds was performed by using 18-G needles (length, 150-200 mm) through the anterior, lateral and posterior approaches. Then, 125I seeds were loaded and released into the lesions. Results: Implantations were performed via the anterior (23 patients), lateral (9 patients) and posterior (4 patients) approaches. During implantation, 3-14 punctures were performed for each patient, and a total of 164 punctures were recorded. Meanwhile, a total of 657 seeds were implanted with an average of 25.27 (range, 12-50) seeds per patient, and the success rate was 100%. The activity of each seed ranged from 0.55 to 0.65 mCi. A main adverse event occurred in one puncture and minor events in seven punctures. No significant relationship between the punctures or adverse events was identified. No serious complication was detected after the implantations during follow-up visits. Conclusion: This study suggested that CT-guided percutaneous implantation of 125I seeds in a pancreatic carcinoma was relatively safe and effective for treating unresectable pancreatic cancer. Advances in knowledge: The CT-guided percutaneous implantation of 125I seeds in unresectable pancreatic cancer showed highly successful rates without serious complications. [ABSTRACT FROM AUTHOR]

There is considered the system of differentional equations on graph which is the mathematical model of traffic flows on network. The qualitative properties of solutions, stationary points and system behavior in the neighborhood of critical regimes are studied. The paper continues the investigation of flow stabiity on graphs [1]-[3]. [ABSTRACT FROM AUTHOR]

Thermal diffusion, caused by temperature gradients, tends to draw lighter molecules to warmer regions and to drive heavier molecules to cooler regions of a mixture. The influence of thermal diffusion on soot formation in coflow laminar ethylene/air diffusion flames is numerically investigated in this paper. Detailed reaction mechanisms and complex thermal and transport properties are employed. The fully elliptic governing equations are solved. Radiation heat transfer from the flames is calculated by the discrete-ordinates method coupled to an SNBCK-based wide band model. A simplified two-equation soot model is used. The interactions between soot and gas-phase chemistry are taken into account. The thermal diffusion velocities are calculated according to the thermal diffusion coefficients evaluated based on multicomponent properties. The results show that thermal diffusion does affect soot formation in ethylene/air diffusion flames. Although the effect on soot formation in pure ethylene/air flame is not significant, the influence is enhanced if lighter species, such as helium, are added to the fuel or the air stream. The peak integrated soot volume fraction doubles if thermal diffusion is not taken into account in the simulation of the flame with helium addition to the air stream. [ABSTRACT FROM AUTHOR]

Background: Immune checkpoint inhibitors in combination with tyrosine kinase inhibitors are standard treatments for advanced clear cell renal cell carcinoma (RCC). This phase III RENOTORCH study compared the efficacy and safety of toripalimab plus axitinib versus sunitinib for the first-line treatment of patients with intermediate-/poor-risk advanced RCC., Patients and Methods: Patients with intermediate-/poor-risk unresectable or metastatic RCC were randomized in a ratio of 1 : 1 to receive toripalimab (240 mg intravenously once every 3 weeks) plus axitinib (5 mg orally twice daily) or sunitinib [50 mg orally once daily for 4 weeks (6-week cycle) or 2 weeks (3-week cycle)]. The primary endpoint was progression-free survival (PFS) assessed by an independent review committee (IRC). The secondary endpoints were investigator-assessed PFS, overall response rate (ORR), overall survival (OS), and safety., Results: A total of 421 patients were randomized to receive toripalimab plus axitinib (n = 210) or sunitinib (n = 211). With a median follow-up of 14.6 months, toripalimab plus axitinib significantly reduced the risk of disease progression or death by 35% compared with sunitinib as assessed by an IRC [hazard ratio (HR) 0.65, 95% confidence interval (CI) 0.49-0.86; P = 0.0028]. The median PFS was 18.0 months in the toripalimab-axitinib group, whereas it was 9.8 months in the sunitinib group. The IRC-assessed ORR was significantly higher in the toripalimab-axitinib group compared with the sunitinib group (56.7% versus 30.8%; P < 0.0001). An OS trend favoring toripalimab plus axitinib was also observed (HR 0.61, 95% CI 0.40-0.92). Treatment-related grade ≥3 adverse events occurred in 61.5% of patients in the toripalimab-axitinib group and 58.6% of patients in the sunitinib group., Conclusion: In patients with previously untreated intermediate-/poor-risk advanced RCC, toripalimab plus axitinib provided significantly longer PFS and higher ORR than sunitinib and had a manageable safety profile TRIAL REGISTRATION: ClinicalTrials.gov NCT04394975., (Copyright © 2023 X. Yan, M. Ye, Q. Zou, P. Chen, Z. He, B. Wu, D. He, C. He, X. Xue, Z. Ji, H. Chen, S. Zhang, Y. Liu, X. Zhang, C. Fu, D. Xu, M. Qiu, J. Lv, J. Huang, X. Ren, Y. Cheng, W. Qin, X. Zhang, F. Zhou, L. Ma, J. Guo, D. Ding, S. Wei, Y. He, H. Guo, B. Shi, L. Liu, F. Liu, Z. Hu, X. Jin, L. Yang, S. Zhu, J. Liu, Y. Huang, T. Xu, B. Liu, T. Sun, Z. Wang, H. Jiang, D. Yu, A. Zhou, J. Jiang, G. Luan, C. Jin, J. Xu, J. Hu, Y. H, Jun, W. Zhai, X. Sheng, Shanghai Junshi Biosciences Co. LTD, Shanghai Junshi Biosciences Co. LTD., a. Published by Elsevier Ltd.. All rights reserved.)

A total of 106 patients who were diagnosed with Bosniak catergory ⅡF or Ⅲ cystic renal masses (CRM) and underwent surgery in Zhongshan-Xuhui Hospital and Xuhui District Central Hospital between January 2018 and December 2019 were retrospectively analyzed. The diagnostic accuracy of renal cyst index (RCI) and Bosniak classification system was compared by analyzing the relevant parameters including the sensitivity and specificity. There were 62 males and 44 females, with a median age of 56 years old. Among the 106 CRM, 72 were benign and 34 were malignant. The sensitivity and specificity of RCI was 94.12% and 81.94%, respectively, while the sensitivity and specificity of Bosniak classification system was 73.53% and 80.56%, respectively. Chi-square test revealed that the sensitivity of RCI was significantly higher than that of Bosniak classification system ( P =0.023). The current study indicates that RCI is a simple and feasible method which can provide quantitative evaluation for predicting characteristics of CRM.

Objective: To explore the expression of CD45 in newly diagnosed multiple myeloma (MM) and its relationship with clinical efficacy and prognosis. Methods: This study retrospectively analyzed expression and distribution of CD45 in 130 cases of newly diagnosed MM, comparing clinical efficacy and prognosis in CD45(+)/CD45(-) groups. Results: ①The CD45(+) group was 33 cases (25.38%) , and CD45(-) group was 97 cases (74.62%) . ②The objective remission rate (ORR) of CD45(+) and CD45(-)group was 33.33% and 64.95%, respectively. The difference was statistically significant ( P =0.002) . For patients in Bortezomib regimen, the ORR of CD45(+) and CD45(-) group was 35.71% and 66.25%, respectively. The difference was statistically significant ( P =0.005) . ③The median progress free survival (PFS) of CD45(+) group and CD45(-) group was 29.8 (95% CI 10.0-59.0) months vs 34.5 (95% CI 6.0-69.0) months ( χ (2)=14.59, P <0.001) and the median overall survival (OS) was 32.5 (95% CI 10.0-68.0) months vs 37.6 (95% CI 6.0-78.0) months ( χ (2)=11.42, P =0.001) , respectively. Among the patients in bortezomib regimen, The median PFS and median OS of CD45 (+) group and CD45(-) group were 30.3 (95% CI 10.0-59.0) months vs 36.3 (95% CI 6.0-69.0) months ( χ (2)=14.75, P =0.001) and 34.0 (95% CI 10.0-68.0) months vs 39.5 (95% CI 6.0-78.0) months ( χ (2)=10.62, P =0.001) . ④Cox risk regression model analysis showed that serum creatinine≥176.8 μmol/L ( HR =5.078, 95% CI 1.744-14.723, P =0.001) , CD45 positive ( HR =14.504, 95% CI 0.168-0.42, P =0.001) , LDH≥220 IU/L ( HR =1.308, 95% CI 1.16-2.417, P =0.015) were independent risk prognostic factors. Conclusion: CD45 expression is a risk prognostic factor of MM patients. Bortezomib did not improve the poor prognosis of CD45(+) MM patients.

Circular RNA is a class of non-coding RNAs, which are covalently closed and circular at both ends, showing dissimilar characteristics from linear RNA. Several studies have shown that circular RNAs play an important role in the occurrence and development of primary hepatic cancer. By combining with the latest research progress of this field at home and abroad, we summarized the mechanism regulating the occurrence and development of liver cancer, abnormal expression, and as potential molecular markers for disease diagnosis and treatment.

Objective: To explore the clinical characteristics and prognostic factors of the patients with non-Hodgkin's Lymphoma (NHL) complicated with HBV infection, so as to provide a basis for clinical accurate diagnosis and prognosis evaluation. Methods: The data of 313 newly diagnosed NHL patients from August 2012 to July 2016 were collected. The HBV serological markers were detected by ELISA, and HBV DNA was quantified by full automatic microparticle chemiluminescence immunoassay (≥1×10(5) copies/ml as high copy group, 1×10(3)-<1×10(5) copies/ml as low copy group). The relationship between HBV infection and prognosis was analyzed combined with the clinical features of the patients, and the HBV detection rate was compared with that of the common population (from the national HBV sero epidemiological data). Results: ①The positive rate of HBsAg in NHL patients was 12.5% (39/313), which was higher than 7.2% in the general population ( χ (2)=14.596, P <0.001). HBV infection in the past (HBsAg negative but HBcAb positive) in 114 cases (36.4%), the incidence was slightly higher than that in the general population (34.1%). ②Compared HBsAg positive group with the negative group, the proportion of B cell type (87.2% vs 70.3%, P =0.027), Ann Arbor stage Ⅲ-Ⅳ(69.2% vs 34.6%, P <0.001), IPI score 3-5 (74.4% vs 50%, P =0.004), LDH level (79.5% vs 47.8%, P <0.001) and liver involvement (45.5% vs 31.7%, P =0.006) were all higher. The difference was statistically significant. ③Compared the HBV infected group (114 cases) with the non-infected group (160 cases), the difference had statistical significance in the proportion of Ann Arbor stage Ⅲ-Ⅳ ( P =0.023) and IPI score 3-5 scores P =0.035). ④Compared HBV DNA positive group (30 cases) with negative group (71 cases), Ann Arbor stage Ⅲ-Ⅳ ( P =0.011), IPI score 3-5 score ( P =0.030), LDH level ( P =0.025) and liver involvement ( P <0.001) in the proportion of patients had statistical significance. The positive patients were divided into HBV DNA high and low copy groups with 1×10(5) copies of /ml as the boundary. The results showed that there was no statistical difference between the two groups ( P >0.05). Conclusions: The HBV infection rate of NHL patients is significantly higher than that of the general population, and HBV infection is more closely related to B cell type NHL. Patients with HBV infection and HBV DNA positive had late Ann Arbor stage, high IPI score, high LDH level and liver involvement, and the prognosis is poor.

Objective: To investigate the safety and feasibility of mini-flank open nephron sparing surgery (MI-OPN) via retroperitoneal route for the treatment of centrally located renal tumor. Methods: From May 2013 to April 2015, twenty-four cases of centrally located renal tumor were treated with MI-OPN via retroperitoneal route in Zhongshan Hospital. All cases were included in this study with whose clinical data and long term follow-up information retrospectively analyzed. Results: With the assistance of intraoperative ultrasonography to confirm tumor location and boundary, MI-OPN was successfully performed in all cases. Mean tumor maximum diameter was 3.3±0.6 cm, mean operation time was 113±16 minutes, mean ischemia time was 31±6 min, and mean estimated blood loss was 102±46 ml. Mean postoperative hospital stay was 5.0±0.8 days, postoperative complication was found in one patient (4%). The mean pre- and postoperative serum creatinine were 77.1±20.1 μmol/L and 90.3±20.0 μmol/L. Pathological examination confirmed negative surgical margin in all cases, with 18 cases of clear cell renal cell carcinoma, 2 cases of papillary renal cell carcinoma, 2 cases of chromophobe renal carcinoma, 1 case of renal oncocytoma and 1 case of renal angiomyolipoma. In up to 12-36 months postoperative follow-up, no local recurrence or systemic progression was witnessed. Conclusions: For the treatment of centrally localized renal tumor, MI-OPN via retroperitoneal route is a safe and feasible operation method. Importantly, rupture of the tumor capsule was effectively avoided during tumor resection with the assistance of ultrasonic position-setting. Furthermore, incidence of severe postoperative complications such as bleeding and damage of collection system were not found since surgical wound of kidney sewn tightly and finely. The last but not the least, by placing ice slush in retroperitoneal cavity, impairment of renal function caused by renal artery clamping can be alleviated due to decreased metabolism.