Search

The choice between endoscopic surgery and re-radiotherapy as the main treatment modality in patients with advanced recurrent nasopharyngeal carcinoma (rNPC) remains controversial. Therefore, in this study, we compared the efficacies of endoscopic surgery and intensity-modulated radiotherapy (IMRT) in patients with rNPC.All patients with advanced rNPC (T3 and T4) who underwent salvage treatment were enrolled from January 2009 to December 2020. Overall survival (OS) was analyzed using a log-rank analysis. Univariate and multivariate analyses of OS were performed using a Cox regression model. Common treatment-related complications of endoscopic surgery were compared with those of IMRT.The numbers of patients with T3 and T4 tumors were 163 (64.2%) and 91 (35.8%), respectively; 192 patients underwent endoscopic surgery, 51 received IMRT, and 11 received three-dimensional conformal radiotherapy (3D-CRT). The 3-year OS of patients treated with endoscopic surgery was 59.3%, which was significantly higher than that of patients treated with IMRT (34.7%, p 0.001) or 3D-CRT (43.6%, p = 0.012). Multivariate analyses showed that IMRT was an independent risk factor for OS compared with endoscopic surgery (hazard ratio, 2.068; 95% confidence interval, 1.395-3.069, p 0.001). Complications of aural fullness (p = 0.001), nasopharyngeal necrosis (p = 0.004), nasopharyngeal hemorrhage (p = 0.004), dysphagia (p 0.001), and cerebral infarction (p = 0.030) were significantly lower in the endoscopic surgery group than in the IMRT group.Endoscopic surgery may be a more promising salvage treatment than IMRT to maximize survival and minimize treatment-related complications in advanced rNPC. These results will be significant in deciding the optimal treatment for patients with advanced rNPC.

In this study, the microstructure and mechanical properties of a Cu-rich multiple-principal-element alloy with the composition (Cu50Ni20Cr20Mn10)95Al5 (at.%) were investigated. It was found that after 900 °C/1 h annealing process, the as-cast alloy has achieved promising mechanical properties with a yield stress of 510 MPa, an ultimate tensile stress of 820 MPa and tensile elongation of 30 %. These properties are superior to those of traditional nickel–aluminum bronze (NAB) alloys. Moreover, the as-annealed alloy exhibited much better anti-corrosion properties with respect to the NBA alloys. Transmission electron microscopy observations showed that high-number-density nano-scaled L12-type ordered particles have precipitated in the Cu-rich phase after heat treatment and this was regarded as the main mechanism responsible for the enhancement of yield stress.

Chemical bonds, including covalent and ionic bonds, endow semiconductors with stable electronic configurations but also impose constraints on their synthesis and lattice-mismatched heteroepitaxy. Here, the unique multi-scale van der Waals (vdWs) interactions are explored in one-dimensional tellurium (Te) systems to overcome these restrictions, enabled by the vdWs bonds between Te atomic chains and the spontaneous misfit relaxation at quasi-vdWs interfaces. Wafer-scale Te vdWs nanomeshes composed of self-welding Te nanowires are laterally vapor grown on arbitrary surfaces at a low temperature of 100 °C, bringing greater integration freedoms for enhanced device functionality and broad applicability. The prepared Te vdWs nanomeshes can be patterned at the microscale and exhibit high field-effect hole mobility of 145 cm2/Vs, ultrafast photoresponse below 3 μs in paper-based infrared photodetectors, as well as controllable electronic structure in mixed-dimensional heterojunctions. All these device metrics of Te vdWs nanomesh electronics are promising to meet emerging technological demands.

In the context of the rapid development of bionic technology, inspired by the swimming behavior of fish, a variety of robotic fish have been designed and applied to different underwater works and even military applications. However, in some operations, such as detection and salvage, vehicles need to travel under mud, a medium that is different from fluids. This complicating factor put higher requirements on robotic fish design. In this study, Paramisgurnus dabryanus, a fish species adept at swimming into the mud, was taken as a research object to investigate its profile and mud swimming behavior. First, a three-dimensional (3D) image scanner is used for profile scanning to acquire the point cloud data of the profile features of the loach. After modification, data coordinate points are extracted and used to fit the profile curve of loach and build geometric and mathematical models by means of Fourier function fitting. The next step includes the analysis of the motion of loach, determination of main parameters of the wave equation, and establishment of the fish body wave curve of a loach in the swimming using MATLAB software. Saturated mud having a water content of 37% is adopted as an environmental medium to numerically simulate the swimming behavior in mud, identifying the distribution of vortex path, and velocity field of loach’s motion. The rationality of simulation results is verified by the loach mud swimming test, and the simulating results agree well with the experimental data. This study lays a preliminary foundation for the outer contour design of the robotic fish operating under mud and aims to carry out the drag reduction and accelerating design of the robotic fish. The robotic loach may be applied in fishery breeding, shipwreck salvage operations, and so on.

The traditional approaches for improving corrosion resistance of alloys typically lead to the sacrifice of mechanical properties because the microstructures needed for improving corrosion resistance often contradict those for high strength. Here we demonstrate that selected laser melting (SLM), a net-shape additive manufacture technique, can maintain good mechanical properties while double the corrosion-resistance of a N-doped CoCrFeNi HEA. The SLM processed sample possesses a heterogeneous microstructure with 3D dislocation cells inside each grain. The SLM-induced 3D dislocation cell structure can provide effective diffusion paths to significantly promote Cr outward segregation, forming a thick protective Cr oxide layer, which renders excellent corrosion resistance. Furthermore, Cr segregation along cell boundaries provides numerous sites for nucleation of oxides, and stabilizes the cell structure for good mechanical properties. The strategy discovered here may also be applied to other HEAs with multiple strengthening mechanisms.

SummaryOlfactory neuroblastoma (ONB) is an uncommon malignant tumor known to originate from the olfactory epithelial. The complex tumor ecosystem of this pathology remained unclear. Here, we explored the cellular components with ONB tumors based on scRNA profiles of 96,325 single-cells derived from 10 tumors and 1 olfactory mucosa sample. We discovered 11 major cell types, including 6 immune cell, 3 stromal cell subtypes and epithelial cluster in the tumor microenvironment (TME), and identified 5 common expression programs from malignant epithelial cells. We analyzed subclusters of TME and the interactions among different cell types in the TME. An innovative three-classification of ONB was established via scRNA analysis. Markers for categorizing tumor samples into new subtypes were elucidated. Different responses towards certain chemotherapy regimens could be inferred according to the molecular features of three tumor types. Relative abundance of immunosuppressive TAMs indicated the benefits of immunotherapies targeting myeloid cells.

Background The efficacy and safety of internal carotid artery (ICA) embolization as a treatment strategy in recurrent nasopharyngeal carcinoma (rNPC) patients with tumors invading the ICA remain unclear. Methods We enrolled all rNPC patients with tumors invading the ICA, who underwent salvage endoscopic surgery. Using propensity scores to adjust for specific potential prognostic factors, a well-balanced cohort of 42 patients with limited rNPC was formed by matching each patient who underwent ICA embolization (study group) with one who did not (control group). The survival rates and common treatment-related complications were compared between the two groups. Results The cohort included patients with the following tumor stages: rT2 (n = 3), rT3 (n = 24), and rT4 (n = 15). During a median follow-up of 15 months (2-63), the 3-year overall survival and progression-free survival rates were significantly higher in the ICA embolization group than in the ICA non-embolization group (72.4% vs. 17.8% and 53.4% vs. 33.0%, respectively; P = 0.022 and P = 0.006, respectively). Additionally, the incidence of treatment-related complications such as nasal obstruction, nasopharyngeal hemorrhage, and nasopharyngeal necrosis was significantly lower in the ICA embolization group than in the non-embolization group (P = 0.001, P = 0.014, and P = 0.038, respectively). Conclusions The innovative application of ICA embolization in endoscopic surgery in patients with rNPC invading the ICA significantly improved patient survival and reduced the risk of treatment-related complications. Therefore, this may be a safe and effective method with potential to improve the outcomes in rNPC patients. This article is protected by copyright. All rights reserved.

Postoperative paralytic ileus prolongs hospitalization duration, increases medical expenses, and is even associated with postoperative mortality; however, effective prevention of postoperative paralytic ileus is not yet available. This trial aimed to assess the preventative effectiveness of transcutaneous electrical acupoint stimulation applied in the lower limbs on postoperative paralytic ileus incidence after colorectal surgery.After ethics approval and written informed consent, 610 patients from 10 hospitals who were scheduled for colorectal surgery between May 2018 and September 2019 were enrolled. Patients were randomly allocated into the transcutaneous electrical acupoint stimulation (stimulated on bilateral Zusanli, Shangjuxu, and Sanyinjiao acupoints in lower limbs for 30 minutes each time, total 4 times) or sham (without currents delivered) group with 1:1 ratio. The primary outcome was postoperative paralytic ileus incidence, defined as no flatus for72 hours after surgery.Compared to the sham treatment, transcutaneous electrical acupoint stimulation lowered the postoperative paralytic ileus incidence by 8.7% (32.3% vs 41.0%, P = .026) and decreased the risk of postoperative paralytic ileus by 32% (OR, 0.68; P = .029). Transcutaneous electrical acupoint stimulation also shortened the recovery time to flatus, defecation, normal diet, and bowel sounds. Transcutaneous electrical acupoint stimulation treatment significantly increased median serum acetylcholine by 55% (P = .007) and interleukin-10 by 88% (P.001), but decreased interleukin-6 by 47% (P.001) and inducible nitric oxide synthase by 42% (P = .002) at 72 hours postoperatively.Transcutaneous electrical acupoint stimulation attenuated the postoperative paralytic ileus incidence and enhanced gastrointestinal functional recovery, which may be associated with increasing parasympathetic nerve tone and its anti-inflammatory actions.

A novel strategy was developed to fabricate nano-porous silver (NPS) with a three-dimensional bi-continuous open porous structure. A high temperature oxidation (HTO) craft and a strong oxidant-assisted low-temperature oxidation method were used to tune the dealloying of AgXCu(1-X) ribbons. The NPS fabricated from the Ag15Cu85 ribbon by the HTO pretreatment exhibited a ligament size of ∼841 nm after 1 h of dealloying. However, the NPS fabricated from the Ag15Cu85 ribbon by the H2O2 craft exhibited a ligament size of ∼61 nm after 1 h of dealloying. In addition, the NPS fabricated by the strong oxidant-assisted dealloying craft exhibited an ultrahomogeneous ligament pore structure and a higher Tafel slope in regard to its hydrogen evolution reaction.

To investigate the expression characteristics of long non-coding RNA SNHG14 in nasopharyngeal carcinoma (NPC) and its effects on epithelial-mesenchymal transition and development of nano-coated si-SNHG14 as an anti-tumor agent. The SNHG14 expression in cancerous and adjacent non-cancerous tissues was monitored using reverse transcriptionpolymerase chain reaction (RT-PCR). Gain- and loss-of-function experiments tested the regulation of SNHG14, miR- 5590-3p, and ZEB1 on PD-L1. The binding association between the above three factors was verified using bioinformatics analysis. EMT-related E-cadherin, N-cadherin, and Vimentin were tested using Western blot. Animal experiments in nude mice verified the function of SNHG14 in the EMT of NPC in vivo. The nano-coated si-SNHG14 was developed as an anti-tumor agent and was verified NPC cell in vitro. SNHG14 was upregulated in NPC tissues. Knocking down SNHG14 markedly inhibited the EMT of NPC. Additionally, the expression of ZEB1 was positively related to that of the SNHG14, while it was inversely correlated with that of miR-5590-3p. Moreover, ZEB1 transcription upregulated PD-L1 and promoted the EMT, while SNHG14 could accelerate the EMT of NPC in vivo by regulating the PD-1 and PD-L1. SNHG14-miR-5590- 3p-ZEB1 positively regulated PD-L1 and facilitate the EMT of NPC. Nano-coated si-SNHG14 significantly downregulated PD-L1 expression and decreased EMT.

Adhesive bonding between titanium (Ti) alloy and carbon fiber reinforced plastic (CFRP) is extensively utilized to achieve lightweight and sufficient strength in aircraft structures. In this study, acid pickling, anodizing, heating treatments and chemical vapor deposition (CVD) method were applied to Ti-6Al-4V Ti substrates, and CFRPs were grinded to compare the performances. The resin pre-coating (RPC) technique was employed to improve voids defects at substrate channel root. SEM images indicated Ti substrates surface were covered with growing carbon nanotubes (CNTs) via CVD and epoxy resin were guided into channel root to reduce defects using RPC treatment. Single lap shear tests results exhibited adhesive bonding strengths of anodized composites were higher than that of acid pickled composites. RPC technique applied to Ti substrates after growing CNTs improved shear strengths by 22.3% than adhesive bonding directly. The combined treatments of anodizing, CVD and RPC had the shear strength of 23.98 MPa improved by 123.5% than that of acid pickling, which was higher and more stable than the one by external introduction of CNTs via RPC. The failure mode changed from adhesive failure to dominated cohesive failure. Therefore, the novel combined treatments are effective and suitable for aerospace industries.

Aiming at solid waste resources reuse and energy saving issue, a novel flexible paraffin/carbon fiber@carbon nanotubes (Paraffin/CF@CNTs) composite PCM was prepared in this study. In the flexible composite PCM, CNTs grow surrounding with recycled CF trunk via chemical vapor deposition to construct the fiber net-structure utilized as the supporting material, and paraffin as thermal energy storage material was absorbed into spongy CF@CNTs by vacuum impregnation methods. TG results show the paraffin/CF@CNTs composite decomposes over 215.6℃ with totally 51.9% mass loss. DSC results indicate Paraffin/CF@CNTs composite melts at 40.01 ℃ with latent heat of 81.94 Jg-1 after solid-solid phase transition with 15.28 Jg-1, while the thermal conductivity of Paraffin/CF@CNTs composite (1.551 Wm-1K-1) is enhanced by 573% than that of pure paraffin. Moreover, thermal cycling measurements show the Paraffin/CF@CNTs composite PCM has adequate structure, chemical component and thermal stability even after being subjected to 300 melting/freezing cycles. In result, the novel flexible composite PCM looks promising for applications in electronic device temperature control, near-infrared stealth, smart wear and textile industry.

American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) rT staging have great clinical impracticality. The aim of the present study was to establish a new rT staging to guide endoscopic surgery for the treatment of recurrent nasopharyngeal carcinoma (rNPC).This surgical rT staging (named Fudan rT staging) was constructed using two significant risk factors: the distance from the tumor margin to the internal carotid artery, and dural invasion. Log-rank and receiver operating characteristic (ROC) curve analyses were used to evaluate its effectiveness.Fudan rT staging can effectively separate the overall survival (OS) and progression-free survival (PFS) of patients with rNPC according to the different rT stages (p 0.05). In addition, ROC analysis showed that the Fudan rT staging exhibited enhanced prognostic value for OS and PFS compared with the AJCC/UICC rT staging.The innovative Fudan rT staging has a better predictive value for the survival of patients with rNPC than AJCC/UICC rT staging.

Circular RNAs (circRNAs) act as competing endogenous RNAs, which are involved in the regulation of many types of cancers. They primarily function by sponging microRNAs (miRNAs) and influencing the expression of miRNA by target messenger RNA. However, the role of circRNAs in the progression of nasopharyngeal carcinoma (NPC) remains largely unclear. In this study, differentially expressed miRNAs associated with NPC were screened using microarray analyses, from which miR-107 was identified. Increased miR-107 expression was associated with poor prognosis in NPC, and miR-107 promoted the proliferation and migration of NPC cells. TGFBR2 was identified as the direct target of miR-107, which could reverse its effect on NPC cells. Furthermore, the expression of circTGFBR2 was downregulated in NPC tissue samples, while circTGFBR2 overexpression correlated with favorable prognosis in NPC. Functionally, circTGFBR2 overexpression inhibited the proliferation and migration of NPC cells both in vitro and in vivo. Further analysis showed that circTGFBR2 sponged miR-107, leading to the upregulation of TGFBR2 expression and suppression of NPC progression. Therefore, circTGFBR2 may serve as a novel tumor suppressive factor and potential target for new therapies in NPC patients.

Purpose There has been a lack of evidence-based management strategies on the nasal presentations of Rosai–Dorfman disease (RDD). We aim to investigate the clinical manifestation, treatment, and outcomes in patients with nasal RDD. Methods We retrospectively reviewed available medical records of patients diagnosed with nasal RDD from 2014 to 2021 at our department. Results A total of 26 patients were included with a marked female preponderance (2.25:1). The most common symptom and affected sites were nasal congestion (31%) and nasal cavity (73%), respectively. The average times of biopsies was 1.5 times (range: 1–3). The histiocytes were positive about S100 and CD68 and negative for CD1a with common emperipolesis. The mean duration of follow-up was 34 months (range, 3–87). One patient with concomitant nasal small B-cell lymphoma achieved complete remission after chemoradiotherapy. Recommended treatments were endoscopic resection (92%) and oral corticosteroids (21%). Surgery was performed to remove the resectable lesion as completely as possible. Corticosteroids induced almost 100% overall remission. Of the relapses, two patients achieved an overall response and one remained in progressive stage after subsequent excision. Two patients only received dissection biopsy that responded to oral corticosteroid administration and combined therapies of lenalidomide and dexamethasone, respectively. Conclusions Diffuse lesions in nasal cavity and sinuses, and even widely affected nasal skull base, laryngopharynx, orbit, and cavernous sinus, should be considered the possibility of Rosai–Dorfman disease. Characteristic immunohistochemical staining is helpful for the diagnosis. Endoscopic surgical therapy remains the mainstream treatment for patients enduring an unbearable course. Oral corticosteroid administration serves as an adjuvant therapy for first-line treatments.

Background Sinonasal inverted papilloma (IP) is a rare and benign epithelial tumor in the sinonasal tract. Recent study suggested the potential role of chronic inflammation in the pathogenesis of IP. This study aims to compare the inflammatory pattern, the capacity of epithelial cell proliferation and EGFR mutation status of unilateral IP with contralateral polyp tissue. Methods Sixteen patients with unilateral IP and contralateral nasal polyps (NP) were identified through a retrospective chart review. The neutrophil and eosinophil infiltration in IP and NP were assessed by immunostaining for neutrophil elastase and major basic protein (MBP). Immunohistochemistry was also used to assess the expression of FoxM1, Ki67 and cyclin D1 in IP tissue and contralateral NP. Sanger sequencing was used to evaluate the EGFR mutations. Results The neutrophil count in IP was significantly higher than contralateral NP and 68.8% patients presented with neutrophilic inflammation, whereas only 37.5% contralateral NP tissue showed neutrophilic inflammation. The percentage of positive FoxM1-staining cells was significantly increased in IP, and positively correlated with the percentage of cells with positive staining for cyclin D1 and ki67 as well as neutrophil counts. EGFR exon 20 insertions were detected in 14 (87.5%) IP samples and no EGFR mutations were found in contralateral NP sample. Conclusion Our study demonstrated distinct inflammatory pattern between IP and contralateral NP and implied the oncogenic role of neutrophils in the pathogenesis of IP. EGFR mutations may be the early event to initiate IP development by enhancing epithelial cell proliferation.

Solar energy as one type of renewable energy is the cleanest and most abundant energy source available. It is mainly used for photovoltaics, solar heating and cooling, and solar power generation. With the crisis of energy and environment, the solar energy generation is becoming a research hotspot in clean energy production. In this paper, the solar energy generation in Asia Pacific including Australia, South Korea, China, Japan and India are studied by a new nonlinear univariate grey Bernoulli model with time power term. Analytical solution of the model is derived by the grey technique, the theory of ordinary differential equations and the two-point Gauss quadrature rule of integration. And the nonlinear parameters are determined by the grey wolf optimizer and the linearized form of the new model. According to historical data from 2011 to 2018 stated by British Petroleum, forecasting models are built to calculate the solar energy generation of the five countries from 2019 to 2023.

The self-crosslinked hyaluronic acid (scHA) and steroids are considered as efficient factors for postoperative management after chronic rhinosinusitis (CRS) nasal surgery. This randomized clinical trial is designed to investigate the efficacy and potential of scHA gel as a topical drug sustained release carrier for steroid of budesonide. The study is performed with 30 patients of chronic rhinosinusitis with nasal polyps (CRSwNP) who underwent functional endoscopic sinus surgery (FESS). The single application of scHA was assessed in the control patient group for postoperative recovery. In the treatment patient group, the combination of scHA/budesonide was applied for postoperative management. The patients are followed up in 2 weeks, 4 weeks and 12 weeks after surgery. The combination of scHA/budesonide results in better endoscopic scoring and mucus evaluation than the single scHA application. The results indicate that the combination of scHA/budesonide is a valuable treatment for the FESS postoperative management and implies the potential of scHA gel as a topical drug sustained release scaffold.

This paper investigates the natural gas consumption of the United States, Germany, the United Kingdom, China, and Japan by a new Grey Bernoulli model. Analytical formulations of the time response function, restored values, and linear parameters estimation are derived. Further, the nonlinear parameter is determined by the Particle Swarm Optimization algorithm based on the linearized form of the model. Three numerical cases are considered to verify the effectiveness of the model. Finally, with observations from 2005 to 2017 claimed by British Petroleum Statistical Review of World Energy 2018, this new model is built to compute the natural gas consumption of the selected countries from 2018 to 2022. The numerical results show that the natural gas consumption will be increasing in the coming years.

BackgroundIt was recently suggested that the upregulation of podoplanin (PDPN) in cancer cells plays a significant role in tumor invasion and metastasis and that it is significantly associated with poor prognosis in oral, cutaneous, and esophageal squamous cell carcinoma. The aim of this study was to investigate the expression pattern of PDPN in sinonasal squamous cell carcinoma (SNSCC) and to evaluate its role as a prognostic factor for survival outcome.Patients and methodsThis study included 59 subjects with SNSCC. We retrospectively collected the clinical features of these patients from medical records and retrieved the associated formalin-fixed, paraffin-embedded tissues for PDPN immunohistochemical staining. Furthermore, PDPN expression was analyzed in relation to the patients’ clinicopathological features and prognosis.ResultsWe observed positive staining for PDPN in both cancer cells and stromal cancer-associated fibroblasts (CAFs). Positive expression of PDPN in cancer cells of patients with SNSCC was significantly correlated with the primary tumor site (p = 0.009) and local recurrence (p = 0.024). In addition, patients with PDPN-positive cancer cells had significantly lower overall survival (OS) and disease-free survival (DFS) rates than did patients with PDPN-negative cancer cells (both p ConclusionsOur findings demonstrated that PDPN overexpression may be both an independent prognostic biomarker and a therapeutic target in SNSCC.

Purpose Tension pneumocephalus (TP) caused by endoscopic endonasal surgery is a serious complication. We report four cases of TP caused by endoscopic surgery and review other cases in the literature, with special attention devoted to symptoms, imaging features, and therapeutic approaches. Methods A retrospective chart review of patients who experienced TP caused by endoscopic surgery in our institution between 2015 and 2018 was performed. Additionally, the MEDLINE database was searched for all case series or reports of TP caused by endoscopic surgery. Results Eighteen articles were identified for review, including four cases from the authors' institution; ultimately, 26 cases were included in the present study. The main symptoms of TP were headache and a change in mental status. Cerebrospinal fluid (CSF) leakage was reported in 21 of the 26 patients (80.8%). Eight of the 26 patients (30.8%) presented with the "Mount Fuji sign" imaging feature. Twenty-four patients were treated with surgical intervention for TP (endoscopic multilayer closure of skull base defect, cranial burr hole, or bifrontal craniotomy). In addition, the present study is the first to report two patients with TP who were successfully treated conservatively. Conclusion The therapeutic method for treating TP should depend on the degree of the mass effect and clinical symptoms. When patients with TP present with obvious symptoms of CSF leakage and intracranial hypertension, urgent surgical multilayer repair of the skull base defects and/or release of the intracranial pressure are keys to treating these patients. However, conservative treatment under close observation is also feasible when the related symptoms are not overtly obvious.

Objectives: The purpose of this study is to explore the curative effect of open surgical excision and endoscopic radiofrequency ablation (RA) in the treatment of piriform fossa fistula (PSF). Methods: Retrospective study of 80 cases of PSF in the Department of Otolaryngology-Head and Neck Surgery, Shanghai Children’s Hospital, from June 2009 to June 2017. Results: In this series, there were 43 males and 37 females, and the mean age was 5.2 years (17 days to 12 years). Surgical excision was performed for 62 patients. Radiofrequency ablation was performed for 18 patients. Six cases of postoperative temporary hoarseness occurred, and the hoarseness rates were not significantly different between the excision and RA groups (6.4% vs 11.1%, respectively, P = .88). Two cases of temporary neck abscess occurred in the RA group. After the mean follow-up period of 3.1 years (1-8 years), no recurrence was found between the excision and RA groups. Conclusions: The curative effect of excision and RA for PSF is not significantly different; each of the 2 methods has its advantages and disadvantages. However, RA for PSF has the merit of being minimally invasive, easy to operate, and safe; this procedure seems to be more suitable in the clinic.

The (FeCoNi)86Ti7Al7 multi-principal-element alloy with a dual heterogeneous microstructure was successfully fabricated by selective laser melting, exhibiting an excellent combination of strength (ultimate tensile strength, 1085.2 ± 23.2 MPa) and ductility (30.5 ± 2.6%). It is evidenced that the joint effects of the hetero-deformation induced hardening from grains with heterogeneous geometrically necessary dislocations densities, in-situ formed B2 phase, and the coherent precipitation hardening from in-situ formed nano L12 phase were responsible for the strength. This work sheds light on the feasibility of simplifying the production of multi-mechanism strengthened alloys within one step and paves a new avenue to produce high-performance complex-shaped components. (FeCoNi)86Ti7Al7 multi-principal-element alloy exhibiting heterogeneity on the grains structure and in-situ precipitation was successfully fabricated by selective laser melting. It shows both good tensile strength and ductility.

OBJECTIVES The purpose of this meta-analysis was to discuss the efficacy and safety of bioabsorbable steroid-impregnated implants following endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS) patients. METHODS PubMed, Cochrane, EMBASE, Web of Science, and the Cochrane Central Register of Controlled Trials were comprehensively searched for studies comparing the experimental group (bioabsorbable steroid-impregnated implants) with the control group (bioabsorbable nonsteroid-impregnated implants). Lund-Kennedy scores, Perioperative Sinus Endoscopy (POSE) scores, polyp change, significant adhesion, middle turbinate lateralization, and adverse events were extracted from the final eligible studies. RevMan 5.3 software was used to analyze the data. RESULTS Eight randomized controlled trials were included in our analysis. The experimental group showed no significant differences from the control group in Lund-Kennedy scores (weighted mean difference (WMD) -0.40; 95% confidence interval [confidence interval (CI)] -1.05 to -0.62; P = 0.23). The experimental group had lower POSE scores compared with the control group, and there was a significant difference (WMD -1.88; 95% CI -2.32 to -1.43, P

Nasopharyngeal carcinoma (NPC) is a malignant epithelial tumor of the nasopharyngeal mucosa with a high incidence rate in southern China and Southeast Asia and an evident ethnic and geographical distribution. Circular RNAs (circRNAs) are single-stranded noncoding RNAs with covalent, closed-loop structures. They are characterized by high stability and abundance, are evolutionarily conserved, and exhibit tissue/developmental stage specificity. Previous studies have shown that circRNAs are associated with the occurrence and development of various malignant tumors. However, the expression patterns and clinical significance of circRNAs in NPC remain ambiguous. Hence, the present review focuses on the biogenesis and regulation of circRNAs, and the functional roles of abnormally expressed circRNAs in NPC. In addition, the current review discusses the possibility of utilizing circRNAs as potential clinical biomarkers for the diagnosis and prognosis of NPC.

Objective Dermoid cysts (DCs) are congenital, slowly growing, and may cause nervous system symptoms. Related literature is limited and mainly includes case reports. We report a case series of DCs originating from the middle cranial fossa floor (MCFF) and investigate their demographic information, clinical characteristics, imaging findings, surgical procedures, and prognostic outcomes. Methods We reviewed the patients with DCs arising from the MCFF undergoing endoscopic endonasal surgery (EES) in our center between 2012 and 2022. Results A total of 5 patients with DCs were enrolled (2 males and 3 females), with a mean age of 46.2 years at the onset. All DCs originated from the MCFF with 1 case involving the middle cranial fossa bone and another 1 case affecting the dura mater. One (20.0%) patient had neurological involvement. After admission, all patients received EES with a total resection rate of 100.0% (5 of 5). After a median follow-up of 73.2 months, all patients achieved complete clinical and radiological improvements. No surgical-related complications or relapses were observed during the long-term follow-up. Conclusion Endoscopic endonasal surgery is considered a safe and effective approach for the treatment of DCs in the MCFF. A larger sample size and longer follow-up time are needed.

BackgroundSalvage endoscopic nasopharyngectomy has better survival prognosis and fewer complications in the management of early stage rNPC, compared to re-irradiation. However, the treatment modality of advanced recurrent nasopharyngeal carcinoma (rNPC) remains controversial. Thus, the purpose of this study was to investigate the demographics, clinical outcomes, and prognostic factors associated with salvage endoscopic nasopharyngectomy in advanced rNPC.MethodsThis study conducted a retrospective analysis of advanced rNPC patients who underwent salvage surgery betweenm January 2014 and December 2019. The overall survival (OS) and progression-free survival (PFS) were analyzed. Univariable and multivariable analyses of OS and PFS were performed using the Cox regression model. The predicted values of the parameters were determined by means of the receiver operating characteristic (ROC) curve analysis.ResultsAmong the 120 patients included, there were 75 patients with rT3 stage and 45 patients with rT4 stage. With the median follow-up time of 18 months,the 3 -year OS and PFS were 55.2% and 29.4%, respectively. Multivariate analyses showed that the rNPC patients with older age, low BMI (Body Mass Index), rT4 stage, tumor necrosis, and tumor invasion into the ICA was predictive of worse OS, whereas low BMI and rT4 stage were associated with worse PFS. In addition, the rT stage was identified as a better predictor of OS (area under the ROC curve: 0.669; P=0.003) than the other clinical features.ConclusionsSalvage treatment using endoscopic nasopharyngectomy appears to be an effective treatment in the management of patients with advanced rNPC. In addition, case matching studies and prospective studies with larger clinical samples are required to further evaluate the efficacy of endoscopic surgery compared with re-irradiation in advanced rNPC.

The purpose of this study was to explore the demographics, multimodality therapeutic outcomes*** and prognostic factors in sinonasal rhabdomyosarcoma (SNRMS). We conducted a retrospective analysis of 40 patients who underwent treatment of SNRMS from March 2007 to March 2018. The Kaplan–Meier method and the log-rank test were used to assess survival rates. The Cox regression model was used for multivariate survival analysis. In total, 25 males and 15 females were included in the study; the median age was 33 years (range, 2–67 years). All patients underwent surgical resection, and surgery prior to or after adjuvant therapy (chemotherapy and radiotherapy) was performed in 91.4% of the patients. The overall 1-, 3- and 5-year survival rates were 77.0%, 46.5% and 46.5%, respectively, during a mean follow-up time of 27.9 (range, 2–128) months in all patients. The log-rank test showed Intergroup Rhabdomyosarcoma Study (IRS) group and infiltration of the skull base influenced overall survival (p = 0.001; p = 0.022). Advanced IRS stage, lymph node metastasis and tumor size ≥ 5 cm were also associated with an unfavorable outcome on overall survival (p = 0.01; p = 0.035; p = 0.02). The results of multivariate regression analysis showed patients with IRS group I were associated with better prognosis outcome on overall survival. Patients with SNRMS have poor 5-year overall survival, and IRS group is the independent prognostic factor for overall survival.

Wanpeng Li, Hanyu Lu, Huankang Zhang, Yuting Lai, Jia Zhang, Yang Ni, Dehui WangDepartment of Otolaryngology-Head and Neck Surgery, Affiliated Eye Ear Nose and Throat Hospital, Fudan University, Shanghai 200031, People’s Republic of ChinaObjective: The aim of this study was to review demographic data, location, clinical symptoms, therapeutic methods, pathological features and relapse in sinonasal/nasopharyngeal pleomorphic adenoma (PA) and carcinoma ex pleomorphic adenoma (CXPA).Methods: We conducted a retrospective analysis of 17 patients who were referred to our hospital during a 5-year period from 2013 to 2018.Results: In this series, there were 7 males and 10 females. The tumors originated from the nasal septum in 4 cases, from the lateral wall of the nasal cavity in 2 cases, from the maxillary sinus in 1 case, and from the nasopharynx in 7 cases. The origin sites of 3 cases were not clear. The main symptoms were usually unilateral nasal congestion and epistaxis. All patients underwent endoscopic resection surgery. The postoperative period was uneventful. Ten patients were diagnosed with benign PA, and 7 patients were diagnosed with CXPA, including 5 cases of adenocarcinoma, 1 patient with mucoepidermoid carcinoma, and 1 patient with adenoid cystic carcinoma. After a mean follow-up period of 2.2 years (6 months–5.3 years), the recurrence rate of benign PA was 10% (1/10); the rate of malignant recurrence was 42.8% (3/7).Conclusion: Sinonasal/nasopharyngeal PA and CXPA are rare neoplasms, and the most common primary site of PA and CXPA is the nasopharynx. As any salivary carcinoma type can arise in PA, these PA sites should be thoroughly sampled and closely examined to exclude the possibility of malignant transformation. Furthermore, PA and CXPA should be treated as soon as possible after definitive diagnosis, and endoscopic resection of tumor-negative margins may be helpful in preventing recurrence.Keywords: sinonasal, nasopharyngeal, pleomorphic adenoma, carcinoma ex- pleomorphic adenoma, endoscopic

PurposeBased on the DVS1608-2011 and IIW-2008 and BS EN15085-3 standards, the stress state grade of welded joints of aluminum alloy EMU (Electric Multiple Units) body was studied.Design/methodology/approachFirst, the calculation methods of the stress state grade of aluminum alloy welded joints analyzed by DVS1608-2011 and IIW-2008 standards were studied, and the two methods were programmed by the APDL language of ANSYS. Then, the finite element model of aluminum alloy EMU body was established; the static strength calculation result of the body was compared with the test result, and the error is basically within 10%. Finally, under the acceleration fatigue load provided by BS EN12663 standard, the fatigue analysis was carried out on the welded joint of the vehicle body, and the stress state of the welded joint of the vehicle body was studied according to IIW-2008 and DVS1608 standards, respectively.FindingsThe results show that the assessment method based on IIW-2008 standard is more rigorous, and the maximum stress factor of the longitudinal weld between the side beam and the side wall is 0.811; the position occurs in the area where the longitudinal weld of the side beam and the side wall is close to the lower door angle.Originality/valueThe stress state is medium, and the rest of the weld stress states are low.

Background The aim of the present study was to establish and validate a nomogram to predict the overall survival (OS) in nasopharyngeal carcinoma (NPC) patients with lymph node metastasis (LNM). Methods A novel nomogram was constructed using 863 patients with LNM-positive NPC from the Surveillance, Epidemiology, and End Results (SEER) database. Significant prognostic factors in the nomograms were determined using multivariate Cox risk analysis. The predictive capability was evaluated using calibration curves and decision curve analysis (DCA). Results Multivariate analysis identified seven factors that could be used to construct the nomogram: age, pathological type, T stage, M stage, surgery of primary site, radiotherapy, and chemotherapy. The calibration curves and DCA demonstrated optimal agreement. Based on the nomogram, all patients could be stratified into three risk groups: low, middle, and high. Conclusions The novel nomogram demonstrated its potential as an individualized tool to predict OS.

Background This study aimed to investigate the demographics, treatment outcomes, and prognostic factors of salvage endoscopic nasopharyngectomy in recurrent nasopharyngeal carcinoma (NPC). Methods We conducted a retrospective analysis of 189 patients who underwent treatment for recurrent NPC from January 2006 to June 2018. The Kaplan–Meier method and log-rank test were used to assess survival rates. A Cox regression model was used for multivariate survival analyses. Results We included 132 men and 57 women in the study, with a median age of 51 (range, 25–85) years. The overall 1-, 3-, and 5-year survival rates were 82.2%, 59.5%, and 43.6%, respectively, during a median follow-up of 24 (range, 2–111) months. In subjects over 50 years of age, diabetes, low body mass index (BMI 2), low hemoglobin (Conclusions In subjects over 50 years of age, diabetes, low BMI, increased NLR, advanced T stage, lymph node metastasis, and tumor necrosis were independent prognostic factors for overall survival.

Improving the proportion of natural gas consumption of the manufacturing industry would make significant contributions to the low-carbon and sustainable development of China, which is one of the largest manufacturers in the world. However, it is very difficult to catch the trend of natural gas consumption of the concerning manufacturing industry as not enough trustable data can be collected. To fill this gap, a novel time-delayed fractional grey model is developed to forecast the natural gas consumption concerning time-delayed effect. Theoretical analysis shows it has more general formulation, unbiasedness and higher flexibility than the existing similar model. Being optimized by the Particle Swarm Optimization algorithm, the proposed model presents higher accuracy in four validation cases. Finally, it is used to forecast the natural gas consumption of the manufacturing industry of China, and the results show that the proposed model significantly outperforms the other seven existing grey models.

Currently widely used federated login (single sign-on) systems, notably those based on OAuth 2.0, offer very little privacy for the user, and as a result the identity provider (e.g. Google or Facebook) can learn a great deal about user web behaviour, in particular which sites they access. This is clearly not desirable for privacy reasons, and in particular for privacy-conscious users who wish to minimise the information about web access behaviour that they reveal to third party organisations. In this paper we give a systematic analysis of the user access privacy properties of OAuth 2.0 and OpenID Connect systems, and in doing so describe how simple it is for an identity provider to track user accesses. We also propose possible ways in which these privacy issues could to some extent be mitigated, although we conclude that to make the protocols truly privacy-respecting requires significant changes to the way in which they operate. In particular, it seems impossible to develop simple browser-based mitigations without modifying the protocol behaviour. We also briefly examine parallel research by Hammann et al., who have proposed a means of improving the privacy properties of OpenID Connect.

Objectives To develop and validate a nomogram to predict survival in patients with recurrent nasopharyngeal carcinoma (NPC) after salvage endoscopic surgery. Materials and methods A total of 229 eligible patients with recurrent NPC were divided into training (n = 115) and validation (n = 114) cohorts. A multivariate Cox proportional risk regression model was used to identify significant prognostic factors for overall survival (OS) in the training cohort. A nomogram was then developed based on the regression model. The performance of the nomogram was assessed with regard to discrimination and calibration. Patients were divided into low-risk or high-risk groups based on the risk scores derived from the nomogram. Furthermore, decision curve analysis (DCA) was used to assess the clinical utility of the nomogram. Results Six significant predictors were identified: diabetes mellitus, body mass index (BMI), neutrophil-to-lymphocyte ratio (NLR), T stage, lymph node metastasis, and tumor necrosis. The nomogram incorporating these six predictors demonstrated favorable discrimination and calibration in the training cohort, with a C-index of 0.746 (95% confidence interval [CI] 0.656–0.836), which was subsequently confirmed in the validation cohort (C-index 0.768 [95% CI 0.675–0.861]). Furthermore, the nomogram successfully distinguished patients into low- and high-risk groups. DCA indicated that the nomogram was clinically useful. Conclusions The novel nomogram demonstrated its potential as an individual tool to predict survival in patients with recurrent NPC after salvage endoscopic surgery.