To develop an effective strategy for accurate diagnosis of focal liver lesions (FLLs) in patients with non-high risk for hepatocellular carcinoma (HCC).
From January 2012 to December 2015, ...consecutive patients with non-high risk for HCC who underwent contrast-enhanced ultrasound (CEUS) were included in this retrospective double-reader study. All patients were stratified into 2 different risks (intermediate, low-risk) groups according to criteria based on clinical characteristics, known as clinical risk stratification criteria. For the intermediate-risk group, the CEUS criteria for identifying benign lesions and HCCs were constructed based on selected CEUS features. The diagnostic performance of the clinical risk stratification criteria, and CEUS criteria for identifying benign lesions and HCCs was evaluated.
This study included 348 FLLs in 348 patients. The sensitivity and specificity of the clinical risk stratification criteria for malignancy was 97.8 and 69.8%. Patients were classified as intermediate risk if they were male, or older than 40 years of age, or HBcAb positive, or having positive tumor markers. Otherwise, patients were classified as low risk. Among the 348 patients, 327 were in the intermediate-risk group and 21 were in the low-risk group. In the intermediate-risk group, the CEUS criteria for identifying benign lesions were any of the following features: 1) hyper/isoenhancement in the arterial phase without washout, 2) nonenhancement in all phases, 3) peripheral discontinuous globular enhancement in the arterial phase, 4) centrifugal enhancement or peripheral enhancement followed by no central enhancement, or 5) enhanced septa. The accuracy, sensitivity, and specificity of the CEUS criteria for identifying benign lesions were 94.5, 83.0, and 99.6%, respectively. Arterial phase hyperenhancement followed by mild and late washout (>60 seconds) was more common in HCC patients than in non-HCC patients (P < .001). Using arterial phase hyperenhancement followed by mild and late washout as the CEUS criteria for identifying HCCs, the sensitivity and specificity were 52.6 and 95.3%, but unfortunately, the positive predictive value was only 82.0%. For the low-risk group, no further analysis was performed due to the small sample size.
Initial clinical risk stratification followed by assessment of certain CEUS features appears to be a promising strategy for the accurate diagnosis of FLLs in patients not at high risk for HCC.
Objective
To develop an effective strategy for accurate diagnosis of focal liver lesions (FLLs) in patients with non‐high risk for hepatocellular carcinoma (HCC).
Methods
From January 2012 to ...December 2015, consecutive patients with non‐high risk for HCC who underwent contrast‐enhanced ultrasound (CEUS) were included in this retrospective double‐reader study. All patients were stratified into 2 different risks (intermediate, low‐risk) groups according to criteria based on clinical characteristics, known as clinical risk stratification criteria. For the intermediate‐risk group, the CEUS criteria for identifying benign lesions and HCCs were constructed based on selected CEUS features. The diagnostic performance of the clinical risk stratification criteria, and CEUS criteria for identifying benign lesions and HCCs was evaluated.
Results
This study included 348 FLLs in 348 patients. The sensitivity and specificity of the clinical risk stratification criteria for malignancy was 97.8 and 69.8%. Patients were classified as intermediate risk if they were male, or older than 40 years of age, or HBcAb positive, or having positive tumor markers. Otherwise, patients were classified as low risk. Among the 348 patients, 327 were in the intermediate‐risk group and 21 were in the low‐risk group. In the intermediate‐risk group, the CEUS criteria for identifying benign lesions were any of the following features: 1) hyper/isoenhancement in the arterial phase without washout, 2) nonenhancement in all phases, 3) peripheral discontinuous globular enhancement in the arterial phase, 4) centrifugal enhancement or peripheral enhancement followed by no central enhancement, or 5) enhanced septa. The accuracy, sensitivity, and specificity of the CEUS criteria for identifying benign lesions were 94.5, 83.0, and 99.6%, respectively. Arterial phase hyperenhancement followed by mild and late washout (>60 seconds) was more common in HCC patients than in non‐HCC patients (P < .001). Using arterial phase hyperenhancement followed by mild and late washout as the CEUS criteria for identifying HCCs, the sensitivity and specificity were 52.6 and 95.3%, but unfortunately, the positive predictive value was only 82.0%. For the low‐risk group, no further analysis was performed due to the small sample size.
Conclusions
Initial clinical risk stratification followed by assessment of certain CEUS features appears to be a promising strategy for the accurate diagnosis of FLLs in patients not at high risk for HCC.
Fungal inflammatory pseudotumor (FIPT) of the liver is a rare disease that may be mistaken for a malignant tumor. It is difficult to diagnose because of its nonspecific clinical and imaging features. ...We report the case of a 46-year-old Asian man who presented with a mass in the right upper quadrant of the abdomen. The patient had undergone transcatheter arterial chemoembolization therapy at another institution 6 months earlier, but the mass had continued to enlarge. He had no history of chronic hepatitis B, and the serum α-fetoprotein was negative. Contrast-enhanced ultrasonography and computed tomography images were suggestive of hepatocellular carcinoma. However, ultrasound-guided biopsy revealed features of chronic inflammation. The mass was resected and found to be an FIPT. We discuss the details of the case and review related articles.
This study investigated total warpage of a type of motorcycle seat support made of polypropylene（PP） during the entire process of injection molding and free-cooling after demolding. Finite element ...modeling（FEM） analysis for injection molding and its associated thermal deformation was carried out in the study. The effects of processing parameters on warpage occurring in different stages were analyzed by Taguchi optimization method. It was found that packing pressure is the major factor that affects warpage in the injection stage, whereas cooling time is the major factor in free-cooling stage. From an overall evaluation, melt temperature affects the total warpage most, followed by cooling time, packing pressure, packing time and mold temperature. The result proved that optimum parameters for minimizing final warpage of the injected parts can be obtained only when the deformation in the entire manufacturing process is addressed in both molding and demolding stages.
AIM: To investigate the effects of 17β-estradiol via estrogen receptors(ER) or direct administration of ER agonists on human colorectal cancer. METHODS: Lo Vo cells were established from the ...Bioresource Collection and Research Center and cultured in phenol red-free DMEM(Sigma, United States). To investigate the effects of E2 and/or ER selective agonists on cellular proliferation, Lo Vo colorectal cells were treated with E2 or ER-selective agonists for 24 h and 48 h and subjected to the MTT(Sigma) assay to find the concentration. And investigate the effects of E2 and/or ER selective agonists on cell used western immunoblotting to find out the diversification of signaling pathways. In order to observe motility and migration the wound healing assay and a transwell chamber(Neuro Probe) plate were tased. For a quantitative measure, we counted the number of migrating cells to the wound area post-wounding for 24 h. We further examined the cellular migration-regulating factors urokinase-type plasminogen activator(u-PA), tissue-type plasminogen activator(t-PA) and matrix metalloproteinase(MMP)-9 in human Lo Vo cells so gelatin zymography that we used and gelatinolytic activity was visualized by Coomassie blue staining. And these results are presented as means ± SE, and statistical comparisons were made using Student’s t-test.RESULTS: The structure was first compared with E2 and ER agonists. We then treated the Lo Vo cells with E2 and ER agonists(10-8 mol/L) for 24 h and 48 h and subsequently measured the cell viability using MTT assay. Our results showed that treatment with 17β-estradiol and/or ER agonists in human Lo Vo colorectal cancer cells activated p53 and then up-regulated p21 and p27 protein levels, subsequently inhibiting the downstream target gene, cyclin D1, which regulates cell proliferation. Taken together, our findings demonstrate the anti-tumorigenesis effects of 17β-estradiol and/or ER agonists and suggest that these compounds may prove to be a potential alternative therapy in the treatment of human colorectal cancer. These results demonstrate that 17β-estradiol and/or ER agonists downregulate migration-related proteins through the p53 signaling pathway in human Lo Vo colorectal cancer cells. These findings suggest that p53 plays a critical role in the 17β-estradiol and/or ER agonist-mediated protective activity against colorectal cancer progression. In addition, 17β-estradiol and/or ER agonists dramatically inhibited cell migration and reduced the expression of u-PA, t-PA and MMP-9 as well as MMP-2/9 activity in Lo Vo cells, which regulate cell metastasis. Moreover, we observed that pretreatment with a p53 inhibitor significantly blocked the anti-migration effects of E2 and/or ER agonists on Lo Vo cells. That E2 and/or ER agonists may impair Lo Vo cell migration by modulating migration-related factors via the p53 tumor suppressor gene.CONCLUSION: Direct ER treatment may prove to be an attractive alternative therapy in the treatment of human colorectal tumors in the future.
Background: The programmed cell death-1 (PD-1)/programmed cell death-ligand 1 (PD-L1) pathway inhibits the activation of T cells and plays a crucial role in the negative regulation of cellular and ...humoral immune responses.Diffuse large B-cell lymphoma (DLBCL) is the most common lymphoid malignancy in adults. In the present study, we aimed to detect the expression of PD-L1 in DLBCL and to analyze its relationship with prognosis.Methods: We reviewed medical records of 204 newly diagnosed DLBCL patients in Sun Yat-sen University Cancer Center between October 2005 and August 2012. The expression of PD-L1 in tumor tissues from these 204 patients was detected using immunohistochemical (IHC) assay. The expression of anaplastic lymphoma kinase (ALK), CD5,CD30, and C-Myc in tumor specimens from 109 patients was detected using IHC, and Epstein–Barr virus (EBV)-encoded RNAs (EBERs) were detected using fluorescence in situ hybridization. The Spearman method was used for correlation analysis. The Kaplan–Meier method with log-rank test was used for univariate analysis. Cox proportional hazards model was used for multivariate analysis.Results: Of the 204 patients, 100 (49.0%) were PD-L1-positive in tumor cells and 44 (21.6%) were PD-L1-positive in tumor microenvironment. PD-L1 expression in tumor cells and tumor microenvironment were more common in the non-germinal center B-cell-like (GCB) subtype than in the GCB subtype (P = 0.02 and P = 0.04). Patients with PD-L1 expression in tumor microenvironment were more likely to be resistant to first-line chemotherapy when compared with the patients without PD-L1 expression in tumor microenvironment (P = 0.03). PD-L1 expression in tumor microenvironment was negatively correlated with C-Myc expression (r = ? 0.20, P = 0.04). No correlations were detected between PD-L1 expression and the expression of ALK, CD5, and CD30 as well as EBERs. The 5-year overall survival (OS)rates were 50.0% and 67.3% in patients with and without PD-L1 expression in tumor cells (P = 0.02). PD-L1 expression in tumor cells was an independent risk predictor for OS (P < 0.01).Conclusions: PD-L1 expression is more common in the non-GCB subtype than in the GCB subtype. PD-L1 expression in tumor microenvironment has a negative correlation with C-Myc. PD-L1 positivity predicts short survival in DLBCL patients. For patients with PD-L1 expression, more strategy such as anti-PD-L1 antibody treatment should be recommended.
The existence of relatively high protrusions above the sheets on most of the clinched joints could sometimes bring about an undesired result in the subsequent processing and, therefore, the ...application of the clinching technologies might be restricted. The current study proposed a countermeasure by imposing compression on the joints with a pair of contoured tools and then obtaining a controlled local plastic deformation of the joints, resulting in a reduction of the protrusion height. A typical two-layer clinching of 6063 aluminum alloy sheets with the thickness of 0.8 mm was employed to study the successional processes of clinching, reshaping, and separation. Geometrical parameters of the reshaping tools were optimized in terms of pull-out strength on the basis of numerical simulation and orthogonal design. It was found that diameter
d
of the truncated cone end on the reshaping die, inclination α of the truncated cone, and then fillets of the die and punch are of important influence on the connecting strength. Moreover, connecting strengths of the clinched joints before reshaping and after reshaped with the optimal parameters of the tools were compared experimentally. The results show that the protrusion height of the clinched joints can be reduced dramatically by the method without decreasing the connecting strength. In the example, the protrusion height of the clinched joint decreased from 1.7 to 0.68 mm, while the average pull-out strength of the joints increased from 230.8 to 331.4 N, and the shear strength increased from 559.7 to 657.5 N.
To explore the effect of problematic mobile phone use on college students' physical activity and their relationships.
A cross-sectional study was conducted among 3980 college students from three ...universities in Jiangsu province by random cluster sampling. The International Physical Activity Questionnaire Short (IPAQ-SF) measured college students' physical activity. The Mobile Phone Addiction Tendency Scale for College Students (MPATS) measured problematic mobile phone use tendencies. College students' physical activity was measured by the International Physical Activity Questionnaire Short (IPAQ-SF), and the Mobile Phone Addiction Tendency Scale measured their mobile phone addiction tendency for College Students (MPATS).
(1) The proportions of the low-, medium-, and high-intensity physical activity were 83.5%, 10.7%, and 5.8%, respectively, with gender differences; The score of problematic mobile phone use tendency was 38.725 ± 15.139. (2) There were significant differences in problematic mobile phone use tendency among college students with different physical activity intensity (F = 11.839,
< 0.001, η
= 0.007). (3) The level of physical activity was significantly correlated with the tendency of problematic mobile phone use (
= -0.173,
< 0.001). (4) Physical activity of college students could significantly predict the tendency of problematic mobile phone use (F (3,3605) = 11.296,
< 0.001).
The physical activity of college students was mainly moderate to low intensity, while the tendency of problematic mobile phone use was high. College students' physical activity level was one of the important constraints of problematic mobile phone use tendency.
Objectives
To characterize the hemodynamics comparing thulium laser vaporesection of the prostate with traditional transurethral resection of the prostate.
Methods
A total of 80 consecutive patients ...with benign prostatic hyperplasia were randomly assigned into the thulium laser vaporesection of the prostate group or transurethral resection of the prostate group. Transpulmonary thermodilution hemodynamic monitoring was used before and 1 h after surgery to assess patient hemodynamics. Acute complications and treatment efficiency were evaluated after surgery.
Results
There were no statistical differences in age, prostate volume, anticoagulants and International Prostate Symptom Score between the two groups. The postoperative Stroke Volume Index was significantly higher in the thulium laser vaporesection of the prostate group (P = 0.007). The extravascular lung water and intrathoracic blood volume indices differed significantly pre‐ and postoperatively, and were similar in both groups. Decreases in serum sodium and hemoglobin concentrations after surgery were lower in the thulium laser vaporesection of the prostate group (P < 0.01). Acute complications, and improvements in International Prostate Symptom Score and maximum urinary flow rates, were similar in both groups.
Conclusions
Transpulmonary thermodilution hemodynamic monitoring provides additional safety measures during surgical procedures. Thulium laser vaporesection of the prostate is associated with fewer hemodynamic changes and provides similar efficacy to transurethral resection of the prostate. Thus, it can be considered a safe and effective procedure.
Constitutive model plays an important role in the numerical simulations of metal forming. However, the influence of the models on the calculation is vague. Based on the stress-strain data of Al 7050 ...and Ti-6Al-4V alloys generated by isothermal compressive tests, the Johnson-Cook (JC) and Arrhenius-type (A-type) hyperbolic sine models were fitted to obtain the constants. Flow stresses directly calculated by the equations were compared with the experiment results, and rigid-plastic finite element analyses (FEA) utilizing these models were employed to simulate the same compression processes. The results show that A-type model has higher accuracy in the direct prediction of flow stress, even outside of the fit domain. The simulation results using A-type model also have higher agreement with the experiment; however, the suitability is affected by the referential parameters employed in the regression process. In terms of the overall deformation and strain distributions, there are slight differences among the simulation results using these two models.
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