Background: Occult invasive cervical cancer discovered after simple hysterectomy is not common, radical parame?trectomy(RP) is a preferred option for young women. However, the morbidity of RP was high. The aim of our ...Background: Occult invasive cervical cancer discovered after simple hysterectomy is not common, radical parame?trectomy(RP) is a preferred option for young women. However, the morbidity of RP was high. The aim of our study is to assess the incidence of parametrial involvement in patients who underwent radical parametrectomy for occult cervical cancer or radical hysterectomy for early?stage cervical cancer and to suggest an algorithm for the triage of patients with occult cervical cancer to avoid RP.Methods: A total of 13 patients with occult cervical cancer who had undergone RP with an upper vaginectomy and pelvic lymphadenectomy were included in this retrospective study. Data on the clinicopathologic characteristics of the cases were collected. The published literature was also reviewed, and low risk factors for parametrial involvement in early?stage cervical cancer were analyzed.Results: Of the 13 patients, 9 had a stage IB1 lesion, and 4 had a stage IA2 lesion. There were four patients with grade 1 disease, seven with grade 2 disease, and two with grade 3 disease. The median age of the entire patients was 41 years. The most common indication for extrafascial hysterectomy was cervical intraepithelial neoplasia 3. Three patients had visible lesions measuring 10–30 mm, in diameter and ten patients had cervical stromal invasions with depths ranging from 4 to 9 mm; only one patient had more than 50% stromal invasion, and four patients had lymph?vascular space invasion(LVSI). Perioperative complications included intraoperative bowel injury, blood transfusion, vesico?vaginal istula, and ileus(1 case for each). Postoperative pathologic examination results did not show residual disease or parametrial involvement. One patient with positive lymph nodes received concurrent radiation therapy. Only one patient experienced recurrence.Conclusions: Perioperative complications following RP were common, whereas the incidence of parametrial involve?ment was very low among selected early?stage cervical cancer patients. Based on these results, we thought that patients with very low?risk parametrial involvement(tumor size ≤2 cm, no LVSI, less than 50% stromal invasion, nega?tive lymph nodes) may beneit from omitting RP. Further prospective data are warranted.展开更多
The development of basic oxygen furnace(BOF)intelligent steelmaking model based on artificial intelligence and big data is the focus of international research and development.In the view of the current situation that ...The development of basic oxygen furnace(BOF)intelligent steelmaking model based on artificial intelligence and big data is the focus of international research and development.In the view of the current situation that the BOF cannot continuously detect the composition and molten steel temperature,combined with the monitoring results of the high-definition and high-brightness camera at the converter mouth,an online BOF terminal temperature control model is established based on big data learning case-based reasoning model and expert system model.The on-site online operation shows that the model can effectively improve the"flying lance"phenomenon and the splashing condition,the stability and safety of smelting process are better than that of artificial smelting,the"flying lance"rate decreases from 39.2% to 0,the early splashing rate decreases from 21.4% to 13.3% and the late splashing rate decreases from 81.25% to 56.7%.When the temperature fluctuation is controlled at±15 oC,the hit rate of the terminal temperature under the automatic control of the model is 90.91%.展开更多
文摘Background: Occult invasive cervical cancer discovered after simple hysterectomy is not common, radical parame?trectomy(RP) is a preferred option for young women. However, the morbidity of RP was high. The aim of our study is to assess the incidence of parametrial involvement in patients who underwent radical parametrectomy for occult cervical cancer or radical hysterectomy for early?stage cervical cancer and to suggest an algorithm for the triage of patients with occult cervical cancer to avoid RP.Methods: A total of 13 patients with occult cervical cancer who had undergone RP with an upper vaginectomy and pelvic lymphadenectomy were included in this retrospective study. Data on the clinicopathologic characteristics of the cases were collected. The published literature was also reviewed, and low risk factors for parametrial involvement in early?stage cervical cancer were analyzed.Results: Of the 13 patients, 9 had a stage IB1 lesion, and 4 had a stage IA2 lesion. There were four patients with grade 1 disease, seven with grade 2 disease, and two with grade 3 disease. The median age of the entire patients was 41 years. The most common indication for extrafascial hysterectomy was cervical intraepithelial neoplasia 3. Three patients had visible lesions measuring 10–30 mm, in diameter and ten patients had cervical stromal invasions with depths ranging from 4 to 9 mm; only one patient had more than 50% stromal invasion, and four patients had lymph?vascular space invasion(LVSI). Perioperative complications included intraoperative bowel injury, blood transfusion, vesico?vaginal istula, and ileus(1 case for each). Postoperative pathologic examination results did not show residual disease or parametrial involvement. One patient with positive lymph nodes received concurrent radiation therapy. Only one patient experienced recurrence.Conclusions: Perioperative complications following RP were common, whereas the incidence of parametrial involve?ment was very low among selected early?stage cervical cancer patients. Based on these results, we thought that patients with very low?risk parametrial involvement(tumor size ≤2 cm, no LVSI, less than 50% stromal invasion, nega?tive lymph nodes) may beneit from omitting RP. Further prospective data are warranted.
基金the support from the Open Competition Scientific and Technological Research Projects of Heilongjiang Province(2022ZXJ03A02)Jiangxi Provincial Technical Innovation Guidance Program(20202BDH80002).
文摘The development of basic oxygen furnace(BOF)intelligent steelmaking model based on artificial intelligence and big data is the focus of international research and development.In the view of the current situation that the BOF cannot continuously detect the composition and molten steel temperature,combined with the monitoring results of the high-definition and high-brightness camera at the converter mouth,an online BOF terminal temperature control model is established based on big data learning case-based reasoning model and expert system model.The on-site online operation shows that the model can effectively improve the"flying lance"phenomenon and the splashing condition,the stability and safety of smelting process are better than that of artificial smelting,the"flying lance"rate decreases from 39.2% to 0,the early splashing rate decreases from 21.4% to 13.3% and the late splashing rate decreases from 81.25% to 56.7%.When the temperature fluctuation is controlled at±15 oC,the hit rate of the terminal temperature under the automatic control of the model is 90.91%.
