Though our previous study has demonstrated that the single-incision plus one-port laparoscopic surgery (SILS + 1) is safe and feasible for sigmoid colon and upper rectal cancer and has better ...short-term outcomes compared with conventional laparoscopic surgery (CLS), the long-term outcomes of SILS + 1 remains uncertain and are needed to evaluated by an RCT.
Patients with clinical stage T1-4aN0-2M0 rectosigmoid cancer were enrolled. The participants were randomly assigned to either SILS + 1 (n = 99) or CLS (n = 99). The 3-year DFS, 5-year OS, and recurrence patterns were analyzed.
Between April 2014 and July 2016, 198 patients were randomly assigned to either the SILS + 1 group (n = 99) or CLS group (n = 99). The median follow-up in the SILS + 1 group was 64.0 months and in CLS group was 65.0 months. The 3-year DFS was 87.8% (95% CI, 81.6-94.8%) in SILS + 1 group and 86.9% (95% CI, 81.3-94.5%) in CLS group (hazard ratio: 1.09 (95% CI, 0.48-2.47; P = 0.84)). The 5-year OS was 86.7% (95% CI,79.6-93.8%) in the SILS + 1 group and 80.5% (95% CI,72.5-88.5%) in the CLS group (hazard ratio: 1.53 (95% CI, 0.74-3.18; P = 0.25)). There were no significant differences in the recurrence patterns between the two groups.
We found no significant difference in 3-year DFS and 5-year OS of patients with sigmoid colon and upper rectal cancer treated with SILS + 1 vs. CLS. SILS + 1 is noninferior to CLS when performed by expert surgeons.
ClinicalTrials.gov: NCT02117557 (registered on 21/04/2014).
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Increasing evidence shows that repetitive transcranial magnetic stimulation (rTMS) promotes neurogenesis and the expression of microRNA (miR)‑106b. The present study investigated whether rTMS ...promotes the proliferation of neural progenitor cells (NPCs) and whether the effect is associated with the expression of miR‑106b. NPCs were cultured from the rat hippocampus and exposed to rTMS daily, comprising 1,000 stimuli for 3 days at 10 Hz, with 1.75 T output. The proliferation ability of the NPCs was revealed by EdU staining, and the levels of miR‑106b and downstream gene p21 in the NPCs were measured by reverse transcription‑quantitative polymerase chain reaction and western blot analyses. For analysis of the mechanism, the NPCs were transfected with Lenti‑miR‑106b or small interfering RNAs prior to rTMS. The results showed that: i) rTMS increased NPC proliferation, as revealed by the increased proportion of EdU‑positive cells; ii) rTMS was able to upregulate the expression of miR‑106b and downregulate the level of p21 in NPCs; iii) overexpression of miR‑106b further enhanced the effects of rTMS, whereas knockdown of miR‑106b had the opposite effects. Taken together, these data indicated that rTMS can promote NPC proliferation by upregulating the expression of miR‑106b and possibly inhibiting the expression of p21.
Computed tomography (CT) appearance pattern after lung tumor stereotactic body radiation therapy(SBRT) might predicts survival. This study aimed to investigate the correlation between CT appearance ...pattern after SBRT and outcomes in patients with early-stage non-small-cell lung cancer (NSCLC).
Clinical data of inoperable patients with early-stage NSCLC undergoing SBRT were retrospectively analyzed from 2012 to 2015 at the Zhejiang Cancer Hospital. The relationship between CT appearance pattern after SBRT and patient's survival was analyzed.
The data from 173 patients with early-stage lung cancer treated with SBRT were analyzed. One month after SBRT, diffuse consolidation was seen in 17 patients, patchy consolidation in 28 patients, diffuse ground-glass opacity (GGO) in 10 patients, and patchy GGO in 22 patients. The survival time was significantly longer in the "no evidence of increased density" group compared with the "consolidation or GGO" group 2-year overall survival (OS) rate, 96.1% vs 89.3%; hazard ratio (HR), 0.36; 95% confidence interval (CI), 0.16-0.85;
= 0.015. A similar trend was found in the progression-free survival (PFS) analysis (2-year PFS rate, 91.3% vs 85.0%; HR, 0.35; 95% CI, 0.13-0.95;
= 0.015) and distant metastasis free survival(DMFS) (2-year DMFS rate, 93.3% vs 87.1%; HR, 0.41; 95% CI, 0.20-0.86;
= 0.031). However, no significant difference was found in recurrence-free survival between the two groups (
= 0.212).
One month after SBRT, the radiological change "no evidence of increased density" was prevalent. The OS, PFS, and DMFS were significantly longer in the "no evidence of increased density" group compared with the "consolidation or GGO" group. Further studies are needed to validate these findings.
•A multiple instance-solver framework is presented for multi-component moving configurations.•The framework can automatically instantiate multiple full-functional solvers from one template ...solver.•The array configuration flow can be solved by multiple instance-solvers in a one-to-one correspondence manner.•The framework is parallel, modular, automated, and easily extended to multi-disciplinary solvers.
This paper presents a novel computational fluid dynamics (CFD) framework for flow simulation of complex configurations containing relatively moving components. The framework is based on the dynamic overset grid method and is intrinsically parallel. The user only needs to decompose complex configurations into topologically simple components according to the geometric features and generate high-quality computational meshes around these components. The framework can then automatically instantiate multiple fully functional CFD solvers to solve the flow fields on the meshes of all components simultaneously in a one-to-one correspondence. Thus, the geometric relationships of the components are transformed into concurrent states of the instance solvers, and accordingly, their flow fields are coupled through the intercommunication among instance solvers. The framework is implemented in a parallel environment based on the Message Passing Interface (MPI). An instantiation space is formed by splitting the world communicator into desired number of fully functional sub-communicators. Within this space, the same number of independent solvers with complete input and output interfaces can be instantiated from the same template solver. The data coupling between instance solvers is realised using the dynamic overset grid method, and the whole process is achieved automation by approaches of collision detection, Exact Inverse Maps (EIM)-based donor cell search, and robust Implicit Hole Cutting (IHC). Numerical results show that the framework is effective for configurations with complex topologies, and it is particularly suitable for numerical simulations of array configurations with relatively moving components.
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China has 50% of the worldwide hepatocellular carcinoma (HCC) cases, and the HBV-related cases accounts for approximately 85%. Over the past few decades, although a series of standardized management ...methods for HCC has been implemented in China, most HCC patient in China still suffered from advanced-stage disease, in consequence, reducing the opportunity of curable treatment that can be offered to achieve long-term disease-free survival for HCC patient. Accordingly, strategies including screening and diagnose HCC at an earlier stage are urgently needed in China. In this study, the current status, challenges, and prospects of early detection of HCC in China have been analyzed. The result indicated the need for using multi serum biomarkers for early HCC detection. During the past ten years, the research on the clinical usefulness of novel serum biomarkers of des-γ-carboxy-prothrombin (DCP), Dickkopf-1 (DKK1) and Midkine (MDK) in early HCC detection for Chinese patients found that the novel serum biomarker can complete the measurement of α-fetoprotein (AFP) in the diagnosis process of HCC, particularly for the patient with negative AFP with/or at an early stage. More large-scale, multi-center studies are expected to be performed in China to provide further evidence, and using novel and reliable serum biomarkers to complement AFP as a new trend is expected to be extensively used in clinical practice to facilitate early detection for those patients with HCC in China.
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With the continuously increasing installed capacity of offshore wind turbines, highly adaptable vertical axis wind turbines (VAWTs) are facing new opportunities. Large-scale offshore platforms need a ...megawatt installed capacity, at least 1∼2 MW, which requires the feasibility analysis of aerodynamic characteristics for large-scale VAWTs. Due to the unsteady aerodynamic phenomenon, i.e. the dynamic stall phenomenon, the power output of VAWTs is very sensitive to the variations of Reynolds number and reduced frequency, which are closely related to the scale of wind turbines. In order to explore the large-scale VAWTs for offshore platforms, three design methods are proposed: Increasing the Reynolds number; Decreasing reduced frequency; Forming an array. Their feasibility and economies are verified by a high-resolution numerical method, and the results show that increasing the Reynolds number could improve their power coefficients to 0.259 for a one-blade VAWT, while an excessive decrease of reduced frequency would lead to power losses. The form of installing one or more levels of VAWT arrays on a single platform is a better design scheme with averaged power coefficient of 0.326 and a blade weighing 2.7 tons per 10 MW, and for large offshore platforms, it could reach the lowest levelized cost of energy.
•Different design schemes of offshore VAWTs are analyzed.•Turbine performance is investigated by a high-resolution numerical method.•The most suitable design scheme for large-scale VAWTs is proposed.•Feasibility of various scales and designs are studied based on cost analysis.
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In urban areas, vertical axis wind turbines have been installed on both sides of the road and rooftop. Compared with rooftop, vertical axis wind turbines mounted on the side of a building have a ...larger swept area with longer blades, and the effect of tip vortices can be reduced at the same time. Around the building, there are several high wind speed regions that can provide more wind energy. In this paper, a high-resolution numerical method composed of overset grid and adaptive mesh refinement techniques is adopted to verify the feasibility of vertical axis wind turbines mounted on the side of the building. Firstly, the complex flow field around the building is simplified into the flow field around the cylindrical building. Five typical flow regions with different flow conditions are determined: windward zone, crosswind zone, tailwind zone, recirculation zone and leeward zone. Secondly, wind turbines are installed evenly around the building. The simulation results show that the energy output of wind turbines in tailwind zone can be increased by 120% compared with the reference value. Thirdly, multiple wind turbines are coupled with the building. In order to get the optimal arrangement, power outputs of four arrangements are compared for the best choice. The results indicate that the arrangement with six wind turbines in crosswind zone and tailwind zone can achieve the best performance. Through changing the rotational directions, the forward blades of wind turbines can be close to the wall, and the energy output of all the wind turbines around the building can be improved.
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•The feasibility of wind turbine installation around a single building is verified.•Adaptive mesh refinement method is implemented for simulating several wind turbines' flow physics.•The best installation location around the building is obtained by the comparison of time-averaged power coefficients.•The arrangements method of several wind turbines is discussed.
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•A high-resolution solver is used for simulating the flow field.•The contribution of winglet is verified with the same swept area.•The position of winglet is selected by the proper orthogonal ...decomposition method.•It revealed the reason for benefit of winglet.
Vertical axis wind turbines can harvest kinetic energy in the air stream from all directions and therefore have distinct advantages in the effective utilization of wind resource. Its aerodynamic performance highly depends on the blade geometrical configuration, especially on the tip shapes due to the negative effects of the shedding vortices. In this paper, spatially high-resolution numerical methods are adopted to study the evolution and mutual interaction process for the vortex system formed behind a vertical axis wind turbine with and without blade tip winglet, aiming at further understand the mechanism of the winglet effects on the turbine aerodynamic performance. For the cases without tip winglet, it has been shown that the high-resolution methods can properly capture the evolution and interaction of the omega-shaped vortices system and revealed the differences of the vortex mutual induction in the near wake region under three tip speed ratios. Then, the region in spanwise dominated by the effects of tip vortex is determined by proper orthogonal decomposition survey on the flow field of vertical profiles and based on which the winglet is installed hoping to maximize its three-dimensional effects on the spanwise flow field. The comparison of power coefficients for cases with and without winglet under the same swept area show that the winglet has significantly improved the effectiveness of energy harvesting in the studied tip speed ratios. Finally, the analysis of tip vortex circulation evolution demonstrates that the enhancement of power coefficient for the winglet case comes from the reduction of the spanwise region affected by tip vortex, instead of the strength decrease of the tip vortex itself. The conclusions can further reveal the flow mechanism of winglet effects on the vertical axis wind turbine aerodynamic performance, and therefore are helpful for guiding the optimized blade winglet design to achieve higher efficiency.
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Vertical axis wind turbines can harvest wind energy from every direction, and they are suitable for the complex flow conditions in urban areas. The flow field around buildings consists some high ...speed regions, and the blockage effect can provide higher wind velocity. Meanwhile, they can be installed at a certain altitude with no interference to pedestrians and vehicles. In this paper, we investigate the characteristics of wind turbines in an array by arranging them between two buildings. For this aim, a high-resolution numerical simulation method is adopted to simulate the accurate flow field and force coefficients. The high-resolution numerical simulation method is composed of adaptive mesh refinement and overset grid techniques. Firstly, there are two array types with wind turbines uniformly arranged in a line, which is perpendicular to the free stream. The result shows that array type A with asymmetric wake achieves a greater mean power coefficient. It reveals that the wake matching phenomenon of array type B causes a loss of wind energy between each couple. Secondly, five column positions between the two buildings are arranged in different positions. The five positions correspond to different flow conditions, and they belong to three typical processes: contraction acceleration process, uniform velocity process, and expansion deceleration process. When mounting array type A in contraction acceleration or expansion deceleration regions, the velocity profile is non-uniform along with the array. The power coefficients of wind turbines in one array are significantly different from each other. The array in the contraction acceleration region reaches the maximum mean power coefficient. Thirdly, in order to evaluate the influence of wind directions in urban area, there are four cases with different wind directions. The simulation results show that the array at α∞=15∘ obtains the maximum mean power coefficient. In summary, the mean output power of the wind turbine array in urban areas is always greater than that of a single wind turbine.
•Two combinations of wind turbines array are compared.•The feasibility of wind turbines array between buildings is demonstrated.•The performances of wind turbines at different locations are compared.•The effect of different wind directions is evaluated.
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