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BACKGROUND/PURPOSE To explore the risk factors of splenic vessel preservation in laparoscopic distal pancreatectomy (LDP) and to guide with the appropriate selection of surgical methods through three-dimensional (3D) reconstruction. METHODS Patients suffering from benign or low-grade malignant tumors of pancreatic body and tail having undergone LDP in Ningbo Medical Center Lihuili Hospital from January 2014 to September 2019 were selected for quantitative analysis of the anatomical data of patients' pancreas, tumors, splenic vessels and spleens by 3D reconstruction. According to the final surgical methods, the patients were divided into the laparoscopic spleen-preserving distal pancreatectomy with splenic vessel preservation (lap-SVP) group and the non-lap-SVP group. Clinical data of the two groups were compared to assess the risk factors for surgical failure of lap-SVP and logistic regression model was applied to predict the choice of surgical methods. RESULTS A total of 218 patients were included in the study, including 144 in the lap-SVP group and 74 in the non-lap-SVP group. Multivariate analysis confirms that large tumor volume, large contact area between the pancreas to be resected and the splenic vein, and large maximum ratio of the circumference of the splenic vessel embedded in the pancreas to be resected to the circumference of the splenic vessel are independent risk factors for surgical failure of lap-SVP (OR > 1, P

We experimentally study intracavity four-wave mixing (FWM) using Λ -type, three-level electromagnetically induced transparency (EIT) atoms confined in an optical ring cavity. The original dark-state peak disappears accompanying the generation of intracavity FWM when the coupling light is changed from traveling-wave to standing wave. Additionally, this FWM signal is on resonance with the optical cavity only when the coupling laser is detuned from the atomic resonance center, where the absorption is drastically reduced for both the probe and FWM fields. At last, we do theoretically analysis for the susceptibility of this composite atom–cavity system.

Purpose This study reports a case of primary mucinous carcinoma of the thyroid gland with signet-ring-cell differentiation, and reviews the literature to evaluate its real incidence and the prognosis of these patients. Patients and methods A 74-year-old Chinese woman, presenting with a mass in the right lobe of thyroid gland, came to the hospital. Computed tomography revealed a mass in the right lobe of the thyroid gland, accompanied with right neck lymphadenectasis and airway deviation caused by tumor compression. Thyroid imaging suggested a thyroid malignant tumor and suspicious lymph node metastasis. Histologically, the tumor was characterized by the tumor cells arranged in small nests or trabeculae with an abundant extracellular mucoid matrix. The tumor cells formed diffuse invasion among thyroid follicles. In the peripheral regions, prominent signet-ring-cells formed a sheet-like structure and extended into the extrathyroidal fat tissue. The tumor cells were diffusely positive for thyroid transcription factor-1 (TTF-1) and PAX8, while they were focally positive for pan-cytokeratin (AE1/AE3) and weakly expressed thyroglobulin. Results Based on the histological features and immunohistochemical profile, a diagnosis of primary mucinous carcinoma of the thyroid gland with signet-ring-cell differentiation was rendered. Conclusion Using a panel of immunohistochemical markers may be helpful for differential diagnosis and for determining whether the tumor is primary or not.

Objective This study was designed to investigate the effects of curcumin on inflammatory factors and ECM expression in exercise-induced renal ischemia reperfusion injury in rats. Methods Sixty 7-week-old male SD rats were divided randomly into three groups: group A (normal control group, n=12), group B (overtraining group, n=24) and group C (curcumin + overtraining group, n=24). Group B and C performed 6 weeks of incremental load training on the treadmill. 24 hours after the last training, the rats were anesthetized intraperitoneally, the morphology of renal tissue and the deposition of glomerular ECM were observed using light microscope，the related biochemical indexes were tested. Results (1) the renal structure of rats in group A were normal, histopathological changes were observed in group B and C, Paller score of group B were significantly higher than group A(P

Objective Silt diaphragm is the most important and bioactive membrane structure in the filtration barrier of kidney, and the root cause of proteinuria is the structural and functional abnormalities of Silt diaphragm. So far, there is little literature on the changes of silt diaphragm caused by overtraining. This research establishes a model of rats with exercise-induced proteinuria with long-term intensitive treadmill exercise, and it simulates the progressive-load training in the cycle of athletes. Histological and ultrastructural changes of kidney immediately and 24 h after exercise are observed, and it aims to analyze the change law of silt diaphragm during the occurrence of persistent proteinuria. Methods this study selects 36 Sprague-Dawley rats, which are randomly divided into 3 groups: a control group (group C, 12), a group drawn immediately after exercise(group EI, 12), a group drawn 24 h after exercise(group EA, 12). Group C does not train. The rats in group EI and EA train on the treadmill with an increasing load for 6 weeks(10% grade, 6 d/w): in the first week, the rats run for 10 min at 10 m/min. Starting from the second week, the running speed increases by 5m/min/w, and the training time increases by 30min/w. In the last week the rats run to exhaustion if they could not maintain the target intensity. Record the exhausting time of rats, then group EI and group EA are respectively drawn immediately and 24 hours after exercise. Observe the histological changes of renal glomerulus by optical microscope, and the ultrastructure of silt diaphragm by TEM. Detect urine total protein by BCA, serum and urine creatinine by Jaffe, serum testosterone and corticosterone by radioimmunoassay, serum urea by two-point dynamic method, and the expression of Nephrin by western-blot. Results The rats in group EI and EA gradually lose weight at the first weekend of training, and their weight drop significantly from the third weekend to the end, it shows a significant difference compared with group C(p0.05). Conclusions The rats suffer from overtraining syndrome caused by intensitive training, and with persistent proteinuria, their renal function is disordered and cannot be effectively recovered after 24 h rest. Meanwhile, the renal morphology and ultrastructure of silt diaphragm in rats undergo "pathogenical-like" changes, which do not significantly decrease with the extension of recovery time. It is revealed that the injury of renal structure and ultrastructure of silt diaphragm caused by overtraining are the structural basis of continuous exercise-induced proteinuria.

Objective Long-term intensive training may led to ischemia oxygen reaction and increase the ROS. Astaxanthin, as the super antioxidant, was investigated to against anti-oxidative stress. By supplementing the astaxanthin, we wanted to observe if it can mediated Nrf2 reduces myocardial cell oxidative injury in rats after high intensity training of 6 weeks. Methods 7-week SD male rats were divided into 3 groups randomly: control group ( C group，n =10)，high intensity training group ( HT group，n = 15)，astaxanthin and high intensity training group (HTA group，n = 15) . The rats in HTA group were given with astaxanthin 20 mg /kg·d and in HT group were given with oil during the training day．The serum cTnI，myocardial apoptosis index, the expression of myocardial BAX, Bcl2, Nrf2, HO-1, myocardial MDA，SOD and T- AOC activity were measured 24 hours after the last training． Results After 6-week tranning of high intensity, compared with group C, the serum cTNI, myocardial apoptosis index, the expression of BAX and myocardial MDA were significantly higher in group HT(P

To compare the potency of recipient-derived, antigen-specific regulatory T cells induced by different dendritic cells (DCs; iTregs) and freshly isolated natural regulatory T cells (nTregs) in preventing mouse graft-versus-host disease (GVHD) after allogeneic bone marrow transplantation (BMT). CD4+ T cells from recipient BALB/c mice were stimulated with DCs from recipient BALB/c (syn-DCs), donor B6 (allo-DCs), and third-party C3H (third-party-DCs) mice to induce different iTregs. In parallel, nTregs were isolated from spleen cells of recipient BALB/c (syn-nTregs) and donor B6 (allo-nTregs) mice using magnetic-activated cell sorting. Mixed lymphocyte reaction (MLR) assays were performed to evaluate the suppressive ability of these various regulatory T cells (Tregs). Both the iTregs and nTregs were transfused to GVHD mice on Days 0, 1, 3, and 5. Body weight, GVHD score, and survival time were monitored. Peripheral Tregs were subsequently examined on Days 7, 14, 21, and 28 after BMT, while chimerism was evaluated on Days 14 and 60. Histopathology of colon, liver, and spleen were also performed. DCs markedly induced CD25+ and Foxp3+ expression on CD4+ T cells. The allo-DC-induced Tregs (allo-iTregs) suppressed the proliferation of alloreactive T cells better than the other iTregs/nTregs in MLR assays (P < 0.05). Meanwhile, transfusion of the allo-iTregs reduced the severity of GVHD (P < 0.05), increased survival time compared with the GVHD group (P < 0.05), and enhanced the chimerism proportion. On Day 28 after BMT, the allo-iTregs group had the highest frequency of peripheral Tregs (P < 0.05). Recipient-derived allo-iTregs induced by donor DCs included predominant clones that specifically recognized donor antigens. These allo-iTregs not only prevented GVHD by suppressing the proliferation of donor-alloreactive T cells, but also promoted engraftment, and prolonged the survival of GVHD mice. Anat Rec, 2018. © 2018 Wiley Periodicals, Inc. Anat Rec, 302:825-836, 2019. © 2018 Wiley Periodicals, Inc.

Purpose – The purpose of this paper is to present a constraint and corresponding algorithm enhancing the evolutionary structural optimization (ESO) method, aiming to circumvent its structure break down problem in some special cases, such as the tie-beam problem. Design/methodology/approach – A virtual soft material introduced to an element will change the stiffness of the element and may consequently change the stress distribution of that element and its neighbors. With this property, the virtual stiffness of the selected element is calculated and the threshold of the stress changes is derived. The stress threshold is used to evaluate the role of an element on the load path and therefore decide the contribution of the element to the structure. Adding this checking operation into the original ESO iterations enables validation of element removal. Findings – The reason for structure break down with the ESO method is that the element removal criterion of ESO only works for certain optimal objectives. It cannot guarantee that the structure does not fail. The proposed operation offers a stronger and stricter constraint condition for ESO’s element removal process, preventing the structure from breaking down in some special cases. Originality/value – The tests on several examples reported in the literature show that the proposed method has the same ability to achieve an optimum solution as the original ESO methods do, while avoiding incorrect deletion of structurally important elements. The benchmark tie-beam problem is solved successfully with this algorithm. The method can be used in other situations as well.

Acute pulmonary embolism (APE) is a serious disease which is life-threatening. Since it is crucial for APE patients to assess the changes of cardiac function safely and timely, the imaging research of cardiac morphology and function is becoming more and more important. The correlation of computed tomography (CT) measured cardiac parameters and pulmonary obstruction index (POI) was analyzed to discuss the morphological changes of the heart of APE patients in order to provide a new method to evaluate cardiac functions accurately and effectively. 118 APE patients confirmed with CT pulmonary angiography (CTPA) were divided into high-risk group (47 cases, POI ≥ 20) and low-risk group (71 cases, POI

To solve the problems of installed trival, resource waste, hammerhead falling off and improve the poor abrasion resistance of hammer handle under the crusher hammers working condition, the new combined type crusher hammers were designed by connecting separated hammer handle and separated hammer head. When hammer head were worn badly, we just replaced hammer head and don't have to remove the shaft rod. This design can save a lot of time and labor force, improve production efficiency and we can save a lot of resources by reusing the hammer handle; At the same time, hammer tip was casted with liquid-liquid bimetal composite casting technology of casting, under the premise of guaranteeing the wear-resisting, which can also ensure that the impact toughness of the joint. Validated by actual working condition, hammer handle can be replaced at least five times for this design of hammer, and each group has 24 hammer heads, every 5 sets of hammer heads can save 1200 kg metallic materials, 1800 KWh and CO2 emissions dropped by 1795 kg.

The cloud storage is the evolution of the cloud computing system, which is based on data storage and management. This thesis is focused on the discussion of the cloud storage model that is built on the Cloud Storage Access Protocol of SNIA, and puts forward the concept of storage pooling at storage management layer with unified virtualization and dynamic management on physical storage devices. The thesis also compares the typical DFS (Distributed File System) on the data management layer in different data conditions.

With the development of cloud computing, cloud storage distributed the endless file system,but not a better copy strategy compatible with various file systems.This paper proposed ontology-based metadata replica which make different file systems mutual fusion ,and give a policy of replica allocation of low-load access .

The optimization database of radiation protection was designed on nuclear facilities maintenance with SQL Server 2008 in this paper. The database includes four modules, namely system login module, statistical data module, daily module and optimization module. Twenty-three data tables were designed, which could store a mass of data in orderly. The optimization database of radiation protection on nuclear facilities maintenance could store the original monitoring data such as plant radiation levels measurement figure on nuclear facilities for maintenance and maintenance daily. This database also combines with the actual demand in the engineering project to statistics and analysis the data.

Precise analysis on large-span spatial structures depends on accurate numerical material constitutive model, According to the axial tension stress-strain curve, the paper proposes a new numerical multiline material model, with material effects of intenerating effect, material hardening effect and damage effects considered, and corresponding calculation method applicable to beam element. Simulation of axial tension test and bi-level loading test on cantilever column proves that the material model and algorithm are effective and correct.

The steel-plate-masonry composite structure is an innovative type of structural scheme popular in masonry structures with load-bearing walls removed for a large space. A total of 4 column specimens under static loading were tested to mainly study the failure modes, load-carrying capacity, and strain distribution in the critical cross-section. Results show that the composite columns started an initial failure from local buckling of the steel plate located between binding bolts; the main factors influencing load-carrying capacity included thickness of the steel plate, type of injected material, and initial column eccentricity; the working performance of the composite column with epoxy adhesive was better than that with cement grout; and re-distribution of compressive stress existed in the steel plates of the column. Also, the ratio of service load-carrying capacity to ultimate capacity of the steel-plate-masonry composite column is about 70%.

This paper demonstrates the natural frequency varying rule with differently critical design parameters for the free vibration characteristics and change features of structural response with different geometric parameters under the simple harmonic excitation.

The static stability capacity is the main index to measure the whole mechanical performance of single-layer latticed shells. Three single-layer cylindrical latticed shells with different height to span ratio were modeled, and their seismic damage were assessed by the degradation of static stability capacity incurred by earthquakes. Two different static load patterns were considered: dead load and the combination of dead load and half span live load. The results show that the damage assessment method is applicable to single-layer cylindrical latticed shells, and the static load patterns have no big influence on the damage assessment of the single-layer cylindrical latticed shells.

To analysis progressive collapse behavior of single-layer reticulated shell under severe earthquake, based on spatial fiber beam element failure criteria, a simulation method on progressive collapse of shell is presented, which account of mechanical properties of components after buckling and damage accumulation effect of combine hardening material. And a computation program is developed correspondingly. At last the method and program proves to be applicable by an example.

The cavity transmission spectrum is experimentally investigated in Λ-type three-level atoms coupled to a standing-wave cavity system. It is shown that the dark-state polariton peak is not generated at resonance but rather at off-resonance. The theoretical analysis reveals that the absence of an on-resonance dark-state polariton peak is mainly caused by the strong absorption of the intracavity medium to the probe cavity mode counterpropagating with the coupling field due to the Doppler shift in the hot atoms. Moreover, the optimal frequency position of the cavity mode for an efficient dark-state polariton peak is also demonstrated.

Optical diodes controlling the flow of light are of principal significance for optical information processing. They transmit light from an input to an output, but not in the reverse direction. This breaking of time reversal symmetry is conventionally achieved via Faraday or nonlinear effects. For applications in a quantum network, features such as the abilities of all-optical control, on-chip integration, and single-photon operation are important. Here we propose an all-optical optical diode which requires neither magnetic fields nor strong input fields. It is based on a “moving” photonic crystal generated in a three-level electromagnetically induced transparency medium in which the refractive index of a weak probe is modulated by the moving periodic intensity of a strong standing coupling field with two detuned counterpropagating components. Because of the Doppler effect, the frequency range of the crystal’s band gap for the probe copropagating with the moving crystal is shifted from that for the counterpropagating probe. This mechanism is experimentally demonstrated in a room temperature Cs vapor cell.

Study Design. A retrospective study of surgical outcome of 33 patients with irreducible atlantoaxial dislocation (IAAD). Objective. To evaluate the safety efficacy of one stage anterior release and posterior fixation and fusion to reduce and stabilize IAAD. Summary of Background Data. The traditional treatment of symptomatic IAAD is ventral decompression by transoral approach. This procedure is accompanied with high morbidity and mortality. It does not correct the swan neck deformity, which could precipitate the degenerative changes in the lower cervical spine. Our hypotheses were that it is the contraction of the muscles, ligaments, and capsules of atlantoaxial joint that prevent reduction, and that most of IAADs might be reduced by anterior atlantoaxial joint release without the odontoid resection, and that further reduction and stabilization might be achieved by special posterior fixation. Methods. A consecutive series of 33 patients with IAAD were surgically treated. Dislocation or reduction was assessed before surgery, immediately after surgery, and at the final follow-up. Etiology, instrumentation, levels fused, and complications were documented. All patients were assessed clinically for neurologic recovery by Odom's method. Results. The mean age was 32 years (range, 7–63 years). The pathology included os odontoideum in 8 patients, occipitalization of C1 in 19 patients, malunion of odontoid fracture in 5, and relaxation of transverse ligament of atlas in 1. Twenty five patients presented neurologic signs and symptoms. Anterior release was performed without odontoid resection in all cases. Four patients underwent transarticular C1–C2 screw fixation, 3 had C1–C2 pedicle screw and plate fixation, and 26 required occipitocervical fixation. Twenty-five cases resulted in an anatomic reduction, 8 had partial reduction. Complication included one dysphagia and two nasal phonations. The mean follow-up period was 33.7 months (range, 24–55 months). There was no pseudarthrosis, and all but 1 of the patients with neurologic deficit showed improvement. Conclusion. This series has demonstrated the safety and efficacy of the transoral anterior atlantoaxial release in the reduction of IAAD. Most of the so-called irreducible/fixed AAD could become reducible after anterior release without odontoid resection. The posterior short-segment atlantoaxial or occipitocervical fixation, especially the plate screw instrumentation, could achieve further reduction and provide immediate stabilization. One-stage anterior release and posterior instrumentation and fusion are a safe and reliable operation in experienced hands.

Introduction Preoperative chemoradiotherapy (CRT), followed by total mesorectal excision, has become the standard of care for patients with clinical stages II and III rectal cancer. Patients with pathologic complete response (pCR) to preoperative CRT have been reported to have better outcomes than those without pCR. However, the factors that predict the response to neoadjuvant CRT have not been well defined. In this study, we aimed to investigate the impact of clinical parameters on the development of pCR after neoadjuvant chemoradiation for rectal cancer. Methods A total of 323 consecutive patients from a single institution who had clinical stage II or III rectal cancer and underwent a long-course neoadjuvant CRT, followed by curative surgery, between 2005 and 2013 were included. Patients were divided into two groups according to their responses to neoadjuvant therapy: the pCR and non-pCR groups. The clinical parameters were analyzed by univariate and multivariate analyses, with pCR as the dependent variable. Results Of the 323 patients, 75 (23.2%) achieved pCR. The two groups were comparable in terms of age, sex, body mass index, tumor stage, tumor location, tumor differentiation, radiation dose, and chemotherapy regimen. On multivariate analysis, a pretreatment carcinoembryonic antigen (CEA) level of ≤5 ng/mL [odds ratio (OR) = 2.170, 95% confidence interval (CI) = 1.195–3.939, P = 0.011] and an interval of >7 weeks between the completion of chemoradiation and surgical resection (OR = 2.588, 95% CI = 1.484–4.512, P = 0.001) were significantly associated with an increased rate of pCR. Conclusions The pretreatment CEA level and neoadjuvant chemoradiotherapy-surgery interval were independent clinical predictors for achieving pCR. These results may help clinicians predict the prognosis of patients and develop adaptive treatment strategies.