The high rate of early recurrence in hepatocellular carcinoma(HCC)post curative surgical intervention poses a substantial clinical hurdle,impacting patient outcomes and complicating postoperative management.The advent...The high rate of early recurrence in hepatocellular carcinoma(HCC)post curative surgical intervention poses a substantial clinical hurdle,impacting patient outcomes and complicating postoperative management.The advent of machine learning provides a unique opportunity to harness vast datasets,identifying subtle patterns and factors that elude conventional prognostic methods.Machine learning models,equipped with the ability to analyse intricate relationships within datasets,have shown promise in predicting outcomes in various medical disciplines.In the context of HCC,the application of machine learning to predict early recurrence holds potential for personalized postoperative care strategies.This editorial comments on the study carried out exploring the merits and efficacy of random survival forests(RSF)in identifying significant risk factors for recurrence,stratifying patients at low and high risk of HCC recurrence and comparing this to traditional COX proportional hazard models(CPH).In doing so,the study demonstrated that the RSF models are superior to traditional CPH models in predicting recurrence of HCC and represent a giant leap towards precision medicine.展开更多
Approximately 50%-70%of patients with hepatocellular carcinoma experience recurrence within five years after curative hepatic resection or ablation.As a result,many patients receive adjuvant therapy after curative res...Approximately 50%-70%of patients with hepatocellular carcinoma experience recurrence within five years after curative hepatic resection or ablation.As a result,many patients receive adjuvant therapy after curative resection or ablation in order to prolong recurrence-free survival.The therapy recommended by national guidelines can differ,and guidelines do not specify when to initiate adjuvant therapy or how long to continue it.These and other unanswered questions around adjuvant therapies make it difficult to optimize them and determine which may be more appropriate for a given type of patient.These questions need to be addressed by clinicians and researchers.展开更多
Microvasculature of the retina is considered an alternative marker of cerebral vascular risk in healthy populations.However,the ability of retinal vasculature changes,specifically focusing on retinal vessel diameter,t...Microvasculature of the retina is considered an alternative marker of cerebral vascular risk in healthy populations.However,the ability of retinal vasculature changes,specifically focusing on retinal vessel diameter,to predict the recurrence of cerebrovascular events in patients with ischemic stroke has not been determined comprehensively.While previous studies have shown a link between retinal vessel diameter and recurrent cerebrovascular events,they have not incorporated this information into a predictive model.Therefore,this study aimed to investigate the relationship between retinal vessel diameter and subsequent cerebrovascular events in patients with acute ischemic stroke.Additionally,we sought to establish a predictive model by combining retinal veessel diameter with traditional risk factors.We performed a prospective observational study of 141 patients with acute ischemic stroke who were admitted to the First Affiliated Hospital of Jinan University.All of these patients underwent digital retinal imaging within 72 hours of admission and were followed up for 3 years.We found that,after adjusting for related risk factors,patients with acute ischemic stroke with mean arteriolar diameter within 0.5-1.0 disc diameters of the disc margin(MAD_(0.5-1.0DD))of≥74.14μm and mean venular diameter within 0.5-1.0 disc diameters of the disc margin(MVD_(0.5-1.0DD))of≥83.91μm tended to experience recurrent cerebrovascular events.We established three multivariate Cox proportional hazard regression models:model 1 included traditional risk factors,model 2 added MAD_(0.5-1.0DD)to model 1,and model 3 added MVD0.5-1.0DD to model 1.Model 3 had the greatest potential to predict subsequent cerebrovascular events,followed by model 2,and finally model 1.These findings indicate that combining retinal venular or arteriolar diameter with traditional risk factors could improve the prediction of recurrent cerebrovascular events in patients with acute ischemic stroke,and that retinal imaging could be a useful and non-invasive method for identifying high-risk patients who require closer monitoring and more aggressive management.展开更多
Accurately predicting fluid forces acting on the sur-face of a structure is crucial in engineering design.However,this task becomes particularly challenging in turbulent flow,due to the complex and irregular changes i...Accurately predicting fluid forces acting on the sur-face of a structure is crucial in engineering design.However,this task becomes particularly challenging in turbulent flow,due to the complex and irregular changes in the flow field.In this study,we propose a novel deep learning method,named mapping net-work-coordinated stacked gated recurrent units(MSU),for pre-dicting pressure on a circular cylinder from velocity data.Specifi-cally,our coordinated learning strategy is designed to extract the most critical velocity point for prediction,a process that has not been explored before.In our experiments,MSU extracts one point from a velocity field containing 121 points and utilizes this point to accurately predict 100 pressure points on the cylinder.This method significantly reduces the workload of data measure-ment in practical engineering applications.Our experimental results demonstrate that MSU predictions are highly similar to the real turbulent data in both spatio-temporal and individual aspects.Furthermore,the comparison results show that MSU predicts more precise results,even outperforming models that use all velocity field points.Compared with state-of-the-art methods,MSU has an average improvement of more than 45%in various indicators such as root mean square error(RMSE).Through comprehensive and authoritative physical verification,we estab-lished that MSU’s prediction results closely align with pressure field data obtained in real turbulence fields.This confirmation underscores the considerable potential of MSU for practical applications in real engineering scenarios.The code is available at https://github.com/zhangzm0128/MSU.展开更多
The term hepatolithiasis describes the presence of biliary stones within the intrahepatic bile ducts,above the hilar confluence of the hepatic ducts.The disease is more prevalent in Asia,mainly owing to socioeconomic ...The term hepatolithiasis describes the presence of biliary stones within the intrahepatic bile ducts,above the hilar confluence of the hepatic ducts.The disease is more prevalent in Asia,mainly owing to socioeconomic and dietary factors,as well as the prevalence of biliary parasites.In the last century,owing to migration,its global incidence has increased.The main pathophysiological mechanisms involve cholangitis,bile infection and biliary strictures,creating a self-sustaining cycle that perpetuates the disease,frequently characterised by recurrent episodes of bacterial infection referred to as syndrome of“recurrent pyogenic cholangitis”.Furthermore,long-standing hepatolithiasis is a known risk factor for development of intrahepatic cholangiocarcinoma.Various classifications have aimed at providing useful insight of clinically relevant aspects and guidance for treatment.The management of symptomatic patients and those with complications can be complex,and relies upon a multidisciplinary team of hepatologists,endoscopists,interventional radiologists and hepatobiliary surgeons,with the main goal being to offer relief from the clinical presentations and prevent the development of more serious complications.This comprehensive review provides insight on various aspects of hepatolithiasis,with a focus on epidemiology,new evidence on pathophysiology,most important clinical aspects,different classification systems and contemporary management.展开更多
Static Poisson’s ratio(vs)is crucial for determining geomechanical properties in petroleum applications,namely sand production.Some models have been used to predict vs;however,the published models were limited to spe...Static Poisson’s ratio(vs)is crucial for determining geomechanical properties in petroleum applications,namely sand production.Some models have been used to predict vs;however,the published models were limited to specific data ranges with an average absolute percentage relative error(AAPRE)of more than 10%.The published gated recurrent unit(GRU)models do not consider trend analysis to show physical behaviors.In this study,we aim to develop a GRU model using trend analysis and three inputs for predicting n s based on a broad range of data,n s(value of 0.1627-0.4492),bulk formation density(RHOB)(0.315-2.994 g/mL),compressional time(DTc)(44.43-186.9 μs/ft),and shear time(DTs)(72.9-341.2μ s/ft).The GRU model was evaluated using different approaches,including statistical error an-alyses.The GRU model showed the proper trends,and the model data ranges were wider than previous ones.The GRU model has the largest correlation coefficient(R)of 0.967 and the lowest AAPRE,average percent relative error(APRE),root mean square error(RMSE),and standard deviation(SD)of 3.228%,1.054%,4.389,and 0.013,respectively,compared to other models.The GRU model has a high accuracy for the different datasets:training,validation,testing,and the whole datasets with R and AAPRE values were 0.981 and 2.601%,0.966 and 3.274%,0.967 and 3.228%,and 0.977 and 2.861%,respectively.The group error analyses of all inputs show that the GRU model has less than 5% AAPRE for all input ranges,which is superior to other models that have different AAPRE values of more than 10% at various ranges of inputs.展开更多
Solid pseudopapillary tumor of the pancreas(SPTP)is a rare neoplasm predom-inantly observed in young females.Pathologically,CTNNB1 mutations,β-catenin nuclear accumulation,and subsequent Wnt-signaling pathway activat...Solid pseudopapillary tumor of the pancreas(SPTP)is a rare neoplasm predom-inantly observed in young females.Pathologically,CTNNB1 mutations,β-catenin nuclear accumulation,and subsequent Wnt-signaling pathway activation are the leading molecular features.Accurate preoperative diagnosis often relies on imaging techniques and endoscopic biopsies.Surgical resection remains the mainstay treatment.Risk models,such as the Fudan Prognostic Index,show promise as predictive tools for assessing the prognosis of SPTP.Establishing three types of metachronous liver metastasis can be beneficial in tailoring individu-alized treatment and follow-up strategies.Despite advancements,challenges persist in understanding its etiology,establishing standardized treatments for unresectable or metastatic diseases,and developing a widely recognized grading system.This comprehensive review aims to elucidate the enigma by consolidating current knowledge on the epidemiology,clinical presentation,pathology,molecular characteristics,diagnostic methods,treatment options,and prognostic factors.展开更多
While encryption technology safeguards the security of network communications,malicious traffic also uses encryption protocols to obscure its malicious behavior.To address the issues of traditional machine learning me...While encryption technology safeguards the security of network communications,malicious traffic also uses encryption protocols to obscure its malicious behavior.To address the issues of traditional machine learning methods relying on expert experience and the insufficient representation capabilities of existing deep learning methods for encrypted malicious traffic,we propose an encrypted malicious traffic classification method that integrates global semantic features with local spatiotemporal features,called BERT-based Spatio-Temporal Features Network(BSTFNet).At the packet-level granularity,the model captures the global semantic features of packets through the attention mechanism of the Bidirectional Encoder Representations from Transformers(BERT)model.At the byte-level granularity,we initially employ the Bidirectional Gated Recurrent Unit(BiGRU)model to extract temporal features from bytes,followed by the utilization of the Text Convolutional Neural Network(TextCNN)model with multi-sized convolution kernels to extract local multi-receptive field spatial features.The fusion of features from both granularities serves as the ultimate multidimensional representation of malicious traffic.Our approach achieves accuracy and F1-score of 99.39%and 99.40%,respectively,on the publicly available USTC-TFC2016 dataset,and effectively reduces sample confusion within the Neris and Virut categories.The experimental results demonstrate that our method has outstanding representation and classification capabilities for encrypted malicious traffic.展开更多
BACKGROUND Behcet’s disease(BD),a chronic vasculitic disorder affecting multiple organs,is characterized by recurrent oral and genital ulcers,arthritis,vasculitis,and intes-tinal ulcers.Although intestinal involvemen...BACKGROUND Behcet’s disease(BD),a chronic vasculitic disorder affecting multiple organs,is characterized by recurrent oral and genital ulcers,arthritis,vasculitis,and intes-tinal ulcers.Although intestinal involvement of BD is common in East Asia,the efficacy and long-term outcomes of surgical treatment of intestinal BD still remain to be established.AIM To evaluate the postoperative clinical course of intestinal BD and determine factors associated with its recurrence.METHODS Data from patients who underwent surgical treatment for intestinal BD between January 2010 and August 2021 were retrospectively reviewed.Patients’demo-graphics,clinical features,postoperative course,complications,and follow-up data were evaluated.RESULTS We analyzed 39 surgeries in 31 patients.The mean patient age was 45.1 years,and the mean interval between the diagnosis of intestinal BD and surgical treatment was 4.9 years(range 1.0-8.0 years).The most common indication for surgery was medical intractability(n=16,41.0%),followed by fistula or abscess(n=11,28.2%).Laparoscopic approaches were used in 19 patients(48.7%),and 5 patients(12.8%)underwent emergency surgeries.The most common surgical procedure was ileocecal resection(n=18,46.2%),followed by right colectomy(n=11,28.2%).A diverting stoma was created in only one patient(2.6%).During a mean follow-up period of 45(range 8-72)months,eight cases(20.5%)of recurrence in five patients required reoperation.The interval between operations was 12.1 months(range 6.3-17.8 mo).Four patients(10.3%)experienced recurrence within 1 year postoperatively,and all eight recurrences occurred within 2 years of the initial surgery.The reoperation rates at 1 and 3 years were 10.3%and 20.5%,respectively.A redo ileocolic anastomosis was performed in all recurrent cases.In multivariate Cox regression analysis,emergency surgery[hazard ratio(HR)9.357,95%confidence interval(CI):1.608-54.453,P=0.013]and elevated C-reactive protein(CRP)levels(HR 1.154,95%CI:1.002–1.328,P=0.047),but not medication use,were predictors of recurrence.CONCLUSION Surgical resection is a feasible treatment option for complicated BD.Reoperation is associated with severe inflam-matory conditions,reflected by increased CRP levels and the requirement for emergency surgery.展开更多
BACKGROUND Although intracorporeal anastomosis(IA)for colon cancer requires longer operative time than extracorporeal anastomosis(EA),its short-term postoperative results,such as early recovery of bowel movement,have ...BACKGROUND Although intracorporeal anastomosis(IA)for colon cancer requires longer operative time than extracorporeal anastomosis(EA),its short-term postoperative results,such as early recovery of bowel movement,have been reported to be equal or better.As IA requires opening the intestinal tract in the abdominal cavity under pneumoperitoneum,there are concerns about intraperitoneal bacterial infection and recurrence of peritoneal dissemination due to the spread of bacteria and tumor cells.However,intraperitoneal bacterial contamination and medium-term oncological outcomes have not been clarified.abdominal cavity in IA.METHODS Of 127 patients who underwent laparoscopic colon resection for colon cancer from April 2015 to December 2020,75 underwent EA(EA group),and 52 underwent IA(IA group).After propensity score matching,the primary endpoint was 3-year disease-free survival rates,and secondary endpoints were 3-year overall survival rates,type of recurrence,surgical site infection(SSI)incidence,number of days on antibiotics,and postoperative biological responses.RESULTS Three-year disease-free survival rates did not significantly differ between the IA and EA groups(87.2%and 82.7%,respectively,P=0.4473).The 3-year overall survival rates also did not significantly differ between the IA and EA groups(94.7%and 94.7%,respectively;P=0.9891).There was no difference in the type of recurrence between the two groups.In addition,there were no significant differences in SSI incidence or the number of days on antibiotics;however,postoperative biological responses,such as the white blood cell count(10200 vs 8650/mm^(3),P=0.0068),C-reactive protein(6.8 vs 4.5 mg/dL,P=0.0011),and body temperature(37.7 vs 37.5℃,P=0.0079),were significantly higher in the IA group.CONCLUSION IA is an anastomotic technique that should be widely performed because its risk of intraperitoneal bacterial contamination and medium-term oncological outcomes are comparable to those of EA.展开更多
BACKGROUND The recurrence rate of liver cancer after surgery is high.Radiofrequency ablation(RFA)combined with transcatheter arterial chemoembolization(TACE)is an effective treatment for liver cancer;however,its effic...BACKGROUND The recurrence rate of liver cancer after surgery is high.Radiofrequency ablation(RFA)combined with transcatheter arterial chemoembolization(TACE)is an effective treatment for liver cancer;however,its efficacy in recurrent liver cancer remains unclear.AIM To investigate the clinical effect of TACE combined with RFA in the treatment of recurrent liver cancer.METHODS Ninety patients with recurrent liver cancer were divided into 2 groups according to treatment plan:Control(RFA alone);and experimental[TACE combined with RFA(TACE+RFA)].The incidence of increased alanine aminotransferase levels,complications,and other indices were compared between the two groups before and after the procedures.RESULTS One month after the procedures,the short-term efficacy rate and Karnofsky Performance Status scores of the experimental group were significantly higher than those of the control group(P<0.05).Alpha-fetoprotein(AFP)and total bilirubin levels were lower than those in the control group(P<0.05);The overall response rate was 82.22%and 66.67%in the experimental and control groups,respectively;The disease control rate was 93.33%and 82.22%in the experimental and control groups,respectively,the differences are statistically significant(P<0.05).And there were no statistical differences in complications between the two groups(P>0.05).CONCLUSION TACE+RFA was effective for the treatment of recurrent liver cancer and significantly reduced AFP levels and improved various indices of liver function.展开更多
Background:The high incidence of gallstone recurrence was a major concern for laparoscopic gallbladderpreserving surgery.This study aimed to investigate the risk factors for gallstone recurrence after gallbladder-pres...Background:The high incidence of gallstone recurrence was a major concern for laparoscopic gallbladderpreserving surgery.This study aimed to investigate the risk factors for gallstone recurrence after gallbladder-preserving surgery and to establish an individualized nomogram model to predict the risk of gallstone recurrence.Methods:The clinicopathological and follow-up data of 183 patients who were initially diagnosed with gallstones and treated with gallbladder-preserving surgery at our hospital from January 2012 to January 2019 were retrospectively collected.The independent predictive factors for gallstone recurrence following gallbladder-preserving surgery were identified by multivariate logistic regression analysis.A nomogram model for the prediction of gallstone recurrence was constructed based on the selected variables.The C-index,receiver operating characteristic(ROC)curve and calibration curve were used to evaluate the predictive power of the nomogram model for gallstone recurrence.Results:During the follow-up period,a total of 65 patients experienced gallstone recurrence,and the recurrence rate was 35.5%.Multivariate logistic regression analysis revealed that the course of gallstones>2 years[odds ratio(OR)=2.567,95%confidence interval(CI):1.270-5.187,P=0.009],symptomatic gallstones(OR=2.589,95%CI:1.059-6.329,P=0.037),multiple gallstones(OR=2.436,95%CI:1.133-5.237,P=0.023),history of acute cholecystitis(OR=2.778,95%CI:1.178-6.549,P=0.020)and a greasy diet(OR=2.319,95%CI:1.186-4.535,P=0.014)were independent risk factors for gallstone recurrence after gallbladder-preserving surgery.A nomogram model for predicting the recurrence of gallstones was established based on the above five variables.The results showed that the C-index of the nomogram model was 0.692,suggesting it was valuable to predict gallstone recurrence.Moreover,the calibration curve showed good consistency between the predicted probability and actual probability.Conclusions:The nomogram model for the prediction of gallstone recurrence might help clinicians develop a proper treatment strategy for patients with gallstones.Gallbladder-preserving surgery should be cautiously considered for patients with high recurrence risks.展开更多
Although there has been significant advancement in the identification and management of colorectal cancer(CRC)in recent years,there is still room for improvement in the current standard treatment regimen.One area of c...Although there has been significant advancement in the identification and management of colorectal cancer(CRC)in recent years,there is still room for improvement in the current standard treatment regimen.One area of concern is the lack of reliable tumor markers to predict treatment efficacy and guide tailored care.Due to its dynamic,effective,and non-invasive benefits over tissue biopsy,the detection of minimal or molecular residual lesions(MRD)based on circulating tumor DNA(ctDNA)is beneficial to the clinical development of drugs for patients with CRC after radical treatment,as well as for continuous monitoring of tumor recurrence and malignancy molecular gene evolution.The detection of ctDNA can currently be used to guide individual postoperative auxiliary treatment decisions(upgrade or downgrade treatment)in CRC,stratify the risk of clinical recurrence more precisely,and predict the risk of recurrence in advance of imaging examination,according to a large number of observational or prospective clinical studies.With increasing clarity comes the possibility of selecting a regimen of treatment based on postoperative ctDNA,which also improves the accuracy of clinical recurrence risk assessment for CRC.Therefore,it is anticipated that the identification of ctDNA would alter the current framework for dealing with CRC and lead to individualized,stratified precision therapy;however,additional confirmation will require subsequent high-quality,prospective,large-scale randomized controlled studies.This article will provide an overview of the definition and clinical significance of MRD,the primary indications and technological challenges for MRD detection,along with the advancement in clinical research about ctDNA detection following radical resection of the CRC.展开更多
In order to improve the performance degradation prediction accuracy of proton exchange membrane fuel cell(PEMFC),a fusion prediction method(CKDG)based on adaptive noise complete ensemble empirical mode decomposition(C...In order to improve the performance degradation prediction accuracy of proton exchange membrane fuel cell(PEMFC),a fusion prediction method(CKDG)based on adaptive noise complete ensemble empirical mode decomposition(CEEMDAN),kernel principal component analysis(KPCA)and dual attention mechanism gated recurrent unit neural network(DA-GRU)was proposed.CEEMDAN and KPCA were used to extract the input feature data sequence,reduce the influence of random factors,and capture essential feature components to reduce the model complexity.The DA-GRU network helps to learn the feature mapping relationship of data in long time series and predict the changing trend of performance degradation data more accurately.The actual aging experimental data verify the performance of the CKDG method.The results show that under the steady-state condition of 20%training data prediction,the CKDA method can reduce the root mean square error(RMSE)by 52.7%and 34.6%,respectively,compared with the traditional LSTM and GRU neural networks.Compared with the simple DA-GRU network,RMSE is reduced by 15%,and the degree of over-fitting is reduced,which has higher accuracy.It also shows excellent prediction performance under the dynamic condition data set and has good universality.展开更多
Objective:To prospectively follow up a cohort of anterior urethral stricture disease patients managed with balloon dilation(BD)for 3 years to evaluate the long-term outcomes and to study factors that contribute to rec...Objective:To prospectively follow up a cohort of anterior urethral stricture disease patients managed with balloon dilation(BD)for 3 years to evaluate the long-term outcomes and to study factors that contribute to recurrence.Methods:This study included men who had urethral BD for significant anterior urethral stricture disease between January 2017 and March 2019.Data about the patient age,stricture characteristics,and recurrence date were recorded,along with information on postoperative indwelling catheter use and operative complications.Furthermore,information about the self-calibration procedure was collected and where available,free flow(FF)measurements during the follow-up period were recorded and analyzed.Success was defined as a lack of symptoms and acceptable FF rates(maximum flow rate>12 mL/s).Results:The final analysis was conducted on 187 patients.The mean follow-up period was 37 months.The long-term overall success rate at the end of our study was 66.8%.Our recurrence rate was 7.4%at 12 months,24.7%at 24 months,and reached 33.2%at the end of our study.The time to recurrence ranged from 91 days to 1635 days,with a mean of 670 days.The stricture-free survival was significantly shorter with lengthy peno-bulbar(p=0.031)and multiple strictures(p=0.015),and in the group of patients who were not committed to self-calibration protocol(p<0.011).However,post-procedural self-calibration was the most important factor that may have decreased the incidence of recurrence(odds ratioZ5.85).Adjuvant self-calibration after BD not only reduced the recurrence rate from 85.4%in the non-self-calibration group to 15.1%in the self-calibration one(p<0.001),but also improved the overall stricture-free survival and FF parameters.展开更多
Endoscopic resection(ER)of colorectal polyps has become a daily practice in most endoscopic units providing a colorectal cancer screening program and requires the availability of local experts and high-end endoscopic ...Endoscopic resection(ER)of colorectal polyps has become a daily practice in most endoscopic units providing a colorectal cancer screening program and requires the availability of local experts and high-end endoscopic devices.ER procedures have evolved over the past few years from endoscopic mucosal resection(EMR)to more advanced techniques,such as endoscopic submucosal dissection and endo-scopic full-thickness resection.Complete resection and disease eradication are the ultimate goals of ER-based techniques,and novel devices have been developed to achieve these goals.The EndoRotor®Endoscopic Powered Resection System(Interscope Medical,Inc.,Northbridge,Massachusetts,United States)is one such device.The EndoRotor is a powered resection tool for the removal of alimentary tract mucosa,including post-EMR persistent lesions with scarring,and has both CE Mark and FDA clearance.This review covers available published evidence documenting the usefulness of EndoRotor for the management of recurrent colorectal polyps.展开更多
Objective:The complexity of urethral strictures can predict outcomes following urethroplasty.The previously described urethral stricture score(U score)considered only stricture-related factors to grade the complexity ...Objective:The complexity of urethral strictures can predict outcomes following urethroplasty.The previously described urethral stricture score(U score)considered only stricture-related factors to grade the complexity of urethral strictures and to predict recurrence post urethroplasty,but not considered patient-related factors for the same.We aimed to study the correlation of both of these factors to the outcomes of oral mucosal graft urethroplasty.Methods:We retrospectively reviewed data of 101 patients who underwent oral mucosal graft urethroplasty in our institute with a minimum follow-up of 6 months.Baseline patient characteristics and stricture-related parameters were noted.The U score was calculated for all patients which consisted of the length,location,number,and etiology of stricture.Univariate and multivariate Cox proportional hazard regression models were used to determine significant risk factors of recurrence.Results:The mean follow-up of patients was 15 months.Recurrence was seen in 28 patients and the mean time for detection of recurrence was 8 months of follow-up.The Charlson Comorbidity Index,history of previous intervention,length of strictures,location of strictures,number of strictures,history of smoking,and etiology were independent predictors of recurrence following urethroplasty.Based on these parameters,we formulated the modified U score(MU score).The scores ranged from 0 to 6 and a score of>2 was found to be predictive of recurrence.On comparing receiver operating characteristic curves for both scores by the DeLong test,the MU score had larger area under the curve than the U score.Conclusion:The MU scoring system is the first of its kind attempt taking into consideration both patient-and stricture-related factors to predict recurrence following oral mucosal graft urethroplasty.展开更多
Friction and wear phenomenon is a complex nonlinear system,and it is also a significant problem in the process of metal cutting.In order to systematically analyze the friction and wear process of tool material-workpie...Friction and wear phenomenon is a complex nonlinear system,and it is also a significant problem in the process of metal cutting.In order to systematically analyze the friction and wear process of tool material-workpiece material friction pair in the cutting process of high hardness alloy steel under different lubrication conditions,the chaotic characteristics of friction process between high hardness alloy steel and cemented carbide under the lubrication C60 nano-particles fluid are studied based on the chaos theory.Firstly,the friction and wear experiments of the friction pair between high hardness alloy steel and cemented carbide tool are carried out based on the ring-block friction and wear tester,and the results of friction force signal in time domain and wear width are obtained.Then,the friction signals in time domain are processed and transformed based on phase space reconstruction and recurrence plot theory,and the recurrence plots of different experimental groups under different lubrication conditions are generated.The evolution law of recurrence plot is further observed and studied,and the recursive quantitative index is analyzed.Finally,the cutting experiments of tool wear are carried out.The results show that the proposed method can intuitively and accurately reveal the wear evolution process and the wear feature identification law of the tool material-high hardness alloy steel pair under different lubrication conditions.Meanwhile,it is found that when the concentration of C60 nanoparticles is 200∼300 ppm,the stability of the friction pair system is best.The proposed method can provide a strategy for wear prediction in cutting process,and provide a theoretical basis and technical support for antifriction lubrication methods in practical cutting applications.展开更多
We show that the nonlinear stage of the dual-wavelength pumped modulation instability(MI)in nonlinear Schrödinger equation(NLSE)can be effectively analyzed by mode truncation methods.The resulting complicated het...We show that the nonlinear stage of the dual-wavelength pumped modulation instability(MI)in nonlinear Schrödinger equation(NLSE)can be effectively analyzed by mode truncation methods.The resulting complicated heteroclinic structure of instability unveils all possible dynamic trajectories of nonlinear waves.Significantly,the latticed-Fermi-Pasta-Ulam recurrences on the modulated-wave background in NLSE are also investigated and their dynamic trajectories run along the Hamiltonian contours of the heteroclinic structure.It is demonstrated that there has much richer dynamic behavior,in contrast to the nonlinear waves reported before.This novel nonlinear wave promises to inject new vitality into the study of MI.展开更多
文摘The high rate of early recurrence in hepatocellular carcinoma(HCC)post curative surgical intervention poses a substantial clinical hurdle,impacting patient outcomes and complicating postoperative management.The advent of machine learning provides a unique opportunity to harness vast datasets,identifying subtle patterns and factors that elude conventional prognostic methods.Machine learning models,equipped with the ability to analyse intricate relationships within datasets,have shown promise in predicting outcomes in various medical disciplines.In the context of HCC,the application of machine learning to predict early recurrence holds potential for personalized postoperative care strategies.This editorial comments on the study carried out exploring the merits and efficacy of random survival forests(RSF)in identifying significant risk factors for recurrence,stratifying patients at low and high risk of HCC recurrence and comparing this to traditional COX proportional hazard models(CPH).In doing so,the study demonstrated that the RSF models are superior to traditional CPH models in predicting recurrence of HCC and represent a giant leap towards precision medicine.
基金the Specific Research Project of Guangxi for Research Bases and Talents,No.GuiKe AD22035057the National Natural Science Foundation of China,No.82060510 and No.82260569.
文摘Approximately 50%-70%of patients with hepatocellular carcinoma experience recurrence within five years after curative hepatic resection or ablation.As a result,many patients receive adjuvant therapy after curative resection or ablation in order to prolong recurrence-free survival.The therapy recommended by national guidelines can differ,and guidelines do not specify when to initiate adjuvant therapy or how long to continue it.These and other unanswered questions around adjuvant therapies make it difficult to optimize them and determine which may be more appropriate for a given type of patient.These questions need to be addressed by clinicians and researchers.
基金supported by the Youth Fund of Fundamental Research Fund for the Central Universities of Jinan University,No.11622303(to YZ).
文摘Microvasculature of the retina is considered an alternative marker of cerebral vascular risk in healthy populations.However,the ability of retinal vasculature changes,specifically focusing on retinal vessel diameter,to predict the recurrence of cerebrovascular events in patients with ischemic stroke has not been determined comprehensively.While previous studies have shown a link between retinal vessel diameter and recurrent cerebrovascular events,they have not incorporated this information into a predictive model.Therefore,this study aimed to investigate the relationship between retinal vessel diameter and subsequent cerebrovascular events in patients with acute ischemic stroke.Additionally,we sought to establish a predictive model by combining retinal veessel diameter with traditional risk factors.We performed a prospective observational study of 141 patients with acute ischemic stroke who were admitted to the First Affiliated Hospital of Jinan University.All of these patients underwent digital retinal imaging within 72 hours of admission and were followed up for 3 years.We found that,after adjusting for related risk factors,patients with acute ischemic stroke with mean arteriolar diameter within 0.5-1.0 disc diameters of the disc margin(MAD_(0.5-1.0DD))of≥74.14μm and mean venular diameter within 0.5-1.0 disc diameters of the disc margin(MVD_(0.5-1.0DD))of≥83.91μm tended to experience recurrent cerebrovascular events.We established three multivariate Cox proportional hazard regression models:model 1 included traditional risk factors,model 2 added MAD_(0.5-1.0DD)to model 1,and model 3 added MVD0.5-1.0DD to model 1.Model 3 had the greatest potential to predict subsequent cerebrovascular events,followed by model 2,and finally model 1.These findings indicate that combining retinal venular or arteriolar diameter with traditional risk factors could improve the prediction of recurrent cerebrovascular events in patients with acute ischemic stroke,and that retinal imaging could be a useful and non-invasive method for identifying high-risk patients who require closer monitoring and more aggressive management.
基金supported by the Japan Society for the Promotion of Science(JSPS)KAKENHI(JP22H03643)Japan Science and Technology Agency(JST)Support for Pioneering Research Initiated by the Next Generation(SPRING)(JPMJSP2145)+2 种基金JST Through the Establishment of University Fellowships Towards the Creation of Science Technology Innovation(JPMJFS2115)the National Natural Science Foundation of China(52078382)the State Key Laboratory of Disaster Reduction in Civil Engineering(CE19-A-01)。
文摘Accurately predicting fluid forces acting on the sur-face of a structure is crucial in engineering design.However,this task becomes particularly challenging in turbulent flow,due to the complex and irregular changes in the flow field.In this study,we propose a novel deep learning method,named mapping net-work-coordinated stacked gated recurrent units(MSU),for pre-dicting pressure on a circular cylinder from velocity data.Specifi-cally,our coordinated learning strategy is designed to extract the most critical velocity point for prediction,a process that has not been explored before.In our experiments,MSU extracts one point from a velocity field containing 121 points and utilizes this point to accurately predict 100 pressure points on the cylinder.This method significantly reduces the workload of data measure-ment in practical engineering applications.Our experimental results demonstrate that MSU predictions are highly similar to the real turbulent data in both spatio-temporal and individual aspects.Furthermore,the comparison results show that MSU predicts more precise results,even outperforming models that use all velocity field points.Compared with state-of-the-art methods,MSU has an average improvement of more than 45%in various indicators such as root mean square error(RMSE).Through comprehensive and authoritative physical verification,we estab-lished that MSU’s prediction results closely align with pressure field data obtained in real turbulence fields.This confirmation underscores the considerable potential of MSU for practical applications in real engineering scenarios.The code is available at https://github.com/zhangzm0128/MSU.
文摘The term hepatolithiasis describes the presence of biliary stones within the intrahepatic bile ducts,above the hilar confluence of the hepatic ducts.The disease is more prevalent in Asia,mainly owing to socioeconomic and dietary factors,as well as the prevalence of biliary parasites.In the last century,owing to migration,its global incidence has increased.The main pathophysiological mechanisms involve cholangitis,bile infection and biliary strictures,creating a self-sustaining cycle that perpetuates the disease,frequently characterised by recurrent episodes of bacterial infection referred to as syndrome of“recurrent pyogenic cholangitis”.Furthermore,long-standing hepatolithiasis is a known risk factor for development of intrahepatic cholangiocarcinoma.Various classifications have aimed at providing useful insight of clinically relevant aspects and guidance for treatment.The management of symptomatic patients and those with complications can be complex,and relies upon a multidisciplinary team of hepatologists,endoscopists,interventional radiologists and hepatobiliary surgeons,with the main goal being to offer relief from the clinical presentations and prevent the development of more serious complications.This comprehensive review provides insight on various aspects of hepatolithiasis,with a focus on epidemiology,new evidence on pathophysiology,most important clinical aspects,different classification systems and contemporary management.
基金The authors thank the Yayasan Universiti Teknologi PETRONAS(YUTP FRG Grant No.015LC0-428)at Universiti Teknologi PETRO-NAS for supporting this study.
文摘Static Poisson’s ratio(vs)is crucial for determining geomechanical properties in petroleum applications,namely sand production.Some models have been used to predict vs;however,the published models were limited to specific data ranges with an average absolute percentage relative error(AAPRE)of more than 10%.The published gated recurrent unit(GRU)models do not consider trend analysis to show physical behaviors.In this study,we aim to develop a GRU model using trend analysis and three inputs for predicting n s based on a broad range of data,n s(value of 0.1627-0.4492),bulk formation density(RHOB)(0.315-2.994 g/mL),compressional time(DTc)(44.43-186.9 μs/ft),and shear time(DTs)(72.9-341.2μ s/ft).The GRU model was evaluated using different approaches,including statistical error an-alyses.The GRU model showed the proper trends,and the model data ranges were wider than previous ones.The GRU model has the largest correlation coefficient(R)of 0.967 and the lowest AAPRE,average percent relative error(APRE),root mean square error(RMSE),and standard deviation(SD)of 3.228%,1.054%,4.389,and 0.013,respectively,compared to other models.The GRU model has a high accuracy for the different datasets:training,validation,testing,and the whole datasets with R and AAPRE values were 0.981 and 2.601%,0.966 and 3.274%,0.967 and 3.228%,and 0.977 and 2.861%,respectively.The group error analyses of all inputs show that the GRU model has less than 5% AAPRE for all input ranges,which is superior to other models that have different AAPRE values of more than 10% at various ranges of inputs.
文摘Solid pseudopapillary tumor of the pancreas(SPTP)is a rare neoplasm predom-inantly observed in young females.Pathologically,CTNNB1 mutations,β-catenin nuclear accumulation,and subsequent Wnt-signaling pathway activation are the leading molecular features.Accurate preoperative diagnosis often relies on imaging techniques and endoscopic biopsies.Surgical resection remains the mainstay treatment.Risk models,such as the Fudan Prognostic Index,show promise as predictive tools for assessing the prognosis of SPTP.Establishing three types of metachronous liver metastasis can be beneficial in tailoring individu-alized treatment and follow-up strategies.Despite advancements,challenges persist in understanding its etiology,establishing standardized treatments for unresectable or metastatic diseases,and developing a widely recognized grading system.This comprehensive review aims to elucidate the enigma by consolidating current knowledge on the epidemiology,clinical presentation,pathology,molecular characteristics,diagnostic methods,treatment options,and prognostic factors.
基金This research was funded by National Natural Science Foundation of China under Grant No.61806171Sichuan University of Science&Engineering Talent Project under Grant No.2021RC15+2 种基金Open Fund Project of Key Laboratory for Non-Destructive Testing and Engineering Computer of Sichuan Province Universities on Bridge Inspection and Engineering under Grant No.2022QYJ06Sichuan University of Science&Engineering Graduate Student Innovation Fund under Grant No.Y2023115The Scientific Research and Innovation Team Program of Sichuan University of Science and Technology under Grant No.SUSE652A006.
文摘While encryption technology safeguards the security of network communications,malicious traffic also uses encryption protocols to obscure its malicious behavior.To address the issues of traditional machine learning methods relying on expert experience and the insufficient representation capabilities of existing deep learning methods for encrypted malicious traffic,we propose an encrypted malicious traffic classification method that integrates global semantic features with local spatiotemporal features,called BERT-based Spatio-Temporal Features Network(BSTFNet).At the packet-level granularity,the model captures the global semantic features of packets through the attention mechanism of the Bidirectional Encoder Representations from Transformers(BERT)model.At the byte-level granularity,we initially employ the Bidirectional Gated Recurrent Unit(BiGRU)model to extract temporal features from bytes,followed by the utilization of the Text Convolutional Neural Network(TextCNN)model with multi-sized convolution kernels to extract local multi-receptive field spatial features.The fusion of features from both granularities serves as the ultimate multidimensional representation of malicious traffic.Our approach achieves accuracy and F1-score of 99.39%and 99.40%,respectively,on the publicly available USTC-TFC2016 dataset,and effectively reduces sample confusion within the Neris and Virut categories.The experimental results demonstrate that our method has outstanding representation and classification capabilities for encrypted malicious traffic.
文摘BACKGROUND Behcet’s disease(BD),a chronic vasculitic disorder affecting multiple organs,is characterized by recurrent oral and genital ulcers,arthritis,vasculitis,and intes-tinal ulcers.Although intestinal involvement of BD is common in East Asia,the efficacy and long-term outcomes of surgical treatment of intestinal BD still remain to be established.AIM To evaluate the postoperative clinical course of intestinal BD and determine factors associated with its recurrence.METHODS Data from patients who underwent surgical treatment for intestinal BD between January 2010 and August 2021 were retrospectively reviewed.Patients’demo-graphics,clinical features,postoperative course,complications,and follow-up data were evaluated.RESULTS We analyzed 39 surgeries in 31 patients.The mean patient age was 45.1 years,and the mean interval between the diagnosis of intestinal BD and surgical treatment was 4.9 years(range 1.0-8.0 years).The most common indication for surgery was medical intractability(n=16,41.0%),followed by fistula or abscess(n=11,28.2%).Laparoscopic approaches were used in 19 patients(48.7%),and 5 patients(12.8%)underwent emergency surgeries.The most common surgical procedure was ileocecal resection(n=18,46.2%),followed by right colectomy(n=11,28.2%).A diverting stoma was created in only one patient(2.6%).During a mean follow-up period of 45(range 8-72)months,eight cases(20.5%)of recurrence in five patients required reoperation.The interval between operations was 12.1 months(range 6.3-17.8 mo).Four patients(10.3%)experienced recurrence within 1 year postoperatively,and all eight recurrences occurred within 2 years of the initial surgery.The reoperation rates at 1 and 3 years were 10.3%and 20.5%,respectively.A redo ileocolic anastomosis was performed in all recurrent cases.In multivariate Cox regression analysis,emergency surgery[hazard ratio(HR)9.357,95%confidence interval(CI):1.608-54.453,P=0.013]and elevated C-reactive protein(CRP)levels(HR 1.154,95%CI:1.002–1.328,P=0.047),but not medication use,were predictors of recurrence.CONCLUSION Surgical resection is a feasible treatment option for complicated BD.Reoperation is associated with severe inflam-matory conditions,reflected by increased CRP levels and the requirement for emergency surgery.
基金This study was reviewed and approved by the Ethics Review Committee of the Research Ethics Committee,Tokai University School of Medicine(23RC011).
文摘BACKGROUND Although intracorporeal anastomosis(IA)for colon cancer requires longer operative time than extracorporeal anastomosis(EA),its short-term postoperative results,such as early recovery of bowel movement,have been reported to be equal or better.As IA requires opening the intestinal tract in the abdominal cavity under pneumoperitoneum,there are concerns about intraperitoneal bacterial infection and recurrence of peritoneal dissemination due to the spread of bacteria and tumor cells.However,intraperitoneal bacterial contamination and medium-term oncological outcomes have not been clarified.abdominal cavity in IA.METHODS Of 127 patients who underwent laparoscopic colon resection for colon cancer from April 2015 to December 2020,75 underwent EA(EA group),and 52 underwent IA(IA group).After propensity score matching,the primary endpoint was 3-year disease-free survival rates,and secondary endpoints were 3-year overall survival rates,type of recurrence,surgical site infection(SSI)incidence,number of days on antibiotics,and postoperative biological responses.RESULTS Three-year disease-free survival rates did not significantly differ between the IA and EA groups(87.2%and 82.7%,respectively,P=0.4473).The 3-year overall survival rates also did not significantly differ between the IA and EA groups(94.7%and 94.7%,respectively;P=0.9891).There was no difference in the type of recurrence between the two groups.In addition,there were no significant differences in SSI incidence or the number of days on antibiotics;however,postoperative biological responses,such as the white blood cell count(10200 vs 8650/mm^(3),P=0.0068),C-reactive protein(6.8 vs 4.5 mg/dL,P=0.0011),and body temperature(37.7 vs 37.5℃,P=0.0079),were significantly higher in the IA group.CONCLUSION IA is an anastomotic technique that should be widely performed because its risk of intraperitoneal bacterial contamination and medium-term oncological outcomes are comparable to those of EA.
文摘BACKGROUND The recurrence rate of liver cancer after surgery is high.Radiofrequency ablation(RFA)combined with transcatheter arterial chemoembolization(TACE)is an effective treatment for liver cancer;however,its efficacy in recurrent liver cancer remains unclear.AIM To investigate the clinical effect of TACE combined with RFA in the treatment of recurrent liver cancer.METHODS Ninety patients with recurrent liver cancer were divided into 2 groups according to treatment plan:Control(RFA alone);and experimental[TACE combined with RFA(TACE+RFA)].The incidence of increased alanine aminotransferase levels,complications,and other indices were compared between the two groups before and after the procedures.RESULTS One month after the procedures,the short-term efficacy rate and Karnofsky Performance Status scores of the experimental group were significantly higher than those of the control group(P<0.05).Alpha-fetoprotein(AFP)and total bilirubin levels were lower than those in the control group(P<0.05);The overall response rate was 82.22%and 66.67%in the experimental and control groups,respectively;The disease control rate was 93.33%and 82.22%in the experimental and control groups,respectively,the differences are statistically significant(P<0.05).And there were no statistical differences in complications between the two groups(P>0.05).CONCLUSION TACE+RFA was effective for the treatment of recurrent liver cancer and significantly reduced AFP levels and improved various indices of liver function.
文摘Background:The high incidence of gallstone recurrence was a major concern for laparoscopic gallbladderpreserving surgery.This study aimed to investigate the risk factors for gallstone recurrence after gallbladder-preserving surgery and to establish an individualized nomogram model to predict the risk of gallstone recurrence.Methods:The clinicopathological and follow-up data of 183 patients who were initially diagnosed with gallstones and treated with gallbladder-preserving surgery at our hospital from January 2012 to January 2019 were retrospectively collected.The independent predictive factors for gallstone recurrence following gallbladder-preserving surgery were identified by multivariate logistic regression analysis.A nomogram model for the prediction of gallstone recurrence was constructed based on the selected variables.The C-index,receiver operating characteristic(ROC)curve and calibration curve were used to evaluate the predictive power of the nomogram model for gallstone recurrence.Results:During the follow-up period,a total of 65 patients experienced gallstone recurrence,and the recurrence rate was 35.5%.Multivariate logistic regression analysis revealed that the course of gallstones>2 years[odds ratio(OR)=2.567,95%confidence interval(CI):1.270-5.187,P=0.009],symptomatic gallstones(OR=2.589,95%CI:1.059-6.329,P=0.037),multiple gallstones(OR=2.436,95%CI:1.133-5.237,P=0.023),history of acute cholecystitis(OR=2.778,95%CI:1.178-6.549,P=0.020)and a greasy diet(OR=2.319,95%CI:1.186-4.535,P=0.014)were independent risk factors for gallstone recurrence after gallbladder-preserving surgery.A nomogram model for predicting the recurrence of gallstones was established based on the above five variables.The results showed that the C-index of the nomogram model was 0.692,suggesting it was valuable to predict gallstone recurrence.Moreover,the calibration curve showed good consistency between the predicted probability and actual probability.Conclusions:The nomogram model for the prediction of gallstone recurrence might help clinicians develop a proper treatment strategy for patients with gallstones.Gallbladder-preserving surgery should be cautiously considered for patients with high recurrence risks.
基金supported by grants from Sanming Project of Medicine in Shenzhen(No.SZSM202211017)Shenzhen Key Medical Discipline Construction Fund(No.SZXK014).
文摘Although there has been significant advancement in the identification and management of colorectal cancer(CRC)in recent years,there is still room for improvement in the current standard treatment regimen.One area of concern is the lack of reliable tumor markers to predict treatment efficacy and guide tailored care.Due to its dynamic,effective,and non-invasive benefits over tissue biopsy,the detection of minimal or molecular residual lesions(MRD)based on circulating tumor DNA(ctDNA)is beneficial to the clinical development of drugs for patients with CRC after radical treatment,as well as for continuous monitoring of tumor recurrence and malignancy molecular gene evolution.The detection of ctDNA can currently be used to guide individual postoperative auxiliary treatment decisions(upgrade or downgrade treatment)in CRC,stratify the risk of clinical recurrence more precisely,and predict the risk of recurrence in advance of imaging examination,according to a large number of observational or prospective clinical studies.With increasing clarity comes the possibility of selecting a regimen of treatment based on postoperative ctDNA,which also improves the accuracy of clinical recurrence risk assessment for CRC.Therefore,it is anticipated that the identification of ctDNA would alter the current framework for dealing with CRC and lead to individualized,stratified precision therapy;however,additional confirmation will require subsequent high-quality,prospective,large-scale randomized controlled studies.This article will provide an overview of the definition and clinical significance of MRD,the primary indications and technological challenges for MRD detection,along with the advancement in clinical research about ctDNA detection following radical resection of the CRC.
基金funded by Shaanxi Province Key Industrial Chain Project(2023-ZDLGY-24)Industrialization Project of Shaanxi Provincial Education Department(21JC018)+1 种基金Shaanxi Province Key Research and Development Program(2021ZDLGY13-02)the Open Foundation of State Key Laboratory for Advanced Metals and Materials(2022-Z01).
文摘In order to improve the performance degradation prediction accuracy of proton exchange membrane fuel cell(PEMFC),a fusion prediction method(CKDG)based on adaptive noise complete ensemble empirical mode decomposition(CEEMDAN),kernel principal component analysis(KPCA)and dual attention mechanism gated recurrent unit neural network(DA-GRU)was proposed.CEEMDAN and KPCA were used to extract the input feature data sequence,reduce the influence of random factors,and capture essential feature components to reduce the model complexity.The DA-GRU network helps to learn the feature mapping relationship of data in long time series and predict the changing trend of performance degradation data more accurately.The actual aging experimental data verify the performance of the CKDG method.The results show that under the steady-state condition of 20%training data prediction,the CKDA method can reduce the root mean square error(RMSE)by 52.7%and 34.6%,respectively,compared with the traditional LSTM and GRU neural networks.Compared with the simple DA-GRU network,RMSE is reduced by 15%,and the degree of over-fitting is reduced,which has higher accuracy.It also shows excellent prediction performance under the dynamic condition data set and has good universality.
文摘Objective:To prospectively follow up a cohort of anterior urethral stricture disease patients managed with balloon dilation(BD)for 3 years to evaluate the long-term outcomes and to study factors that contribute to recurrence.Methods:This study included men who had urethral BD for significant anterior urethral stricture disease between January 2017 and March 2019.Data about the patient age,stricture characteristics,and recurrence date were recorded,along with information on postoperative indwelling catheter use and operative complications.Furthermore,information about the self-calibration procedure was collected and where available,free flow(FF)measurements during the follow-up period were recorded and analyzed.Success was defined as a lack of symptoms and acceptable FF rates(maximum flow rate>12 mL/s).Results:The final analysis was conducted on 187 patients.The mean follow-up period was 37 months.The long-term overall success rate at the end of our study was 66.8%.Our recurrence rate was 7.4%at 12 months,24.7%at 24 months,and reached 33.2%at the end of our study.The time to recurrence ranged from 91 days to 1635 days,with a mean of 670 days.The stricture-free survival was significantly shorter with lengthy peno-bulbar(p=0.031)and multiple strictures(p=0.015),and in the group of patients who were not committed to self-calibration protocol(p<0.011).However,post-procedural self-calibration was the most important factor that may have decreased the incidence of recurrence(odds ratioZ5.85).Adjuvant self-calibration after BD not only reduced the recurrence rate from 85.4%in the non-self-calibration group to 15.1%in the self-calibration one(p<0.001),but also improved the overall stricture-free survival and FF parameters.
文摘Endoscopic resection(ER)of colorectal polyps has become a daily practice in most endoscopic units providing a colorectal cancer screening program and requires the availability of local experts and high-end endoscopic devices.ER procedures have evolved over the past few years from endoscopic mucosal resection(EMR)to more advanced techniques,such as endoscopic submucosal dissection and endo-scopic full-thickness resection.Complete resection and disease eradication are the ultimate goals of ER-based techniques,and novel devices have been developed to achieve these goals.The EndoRotor®Endoscopic Powered Resection System(Interscope Medical,Inc.,Northbridge,Massachusetts,United States)is one such device.The EndoRotor is a powered resection tool for the removal of alimentary tract mucosa,including post-EMR persistent lesions with scarring,and has both CE Mark and FDA clearance.This review covers available published evidence documenting the usefulness of EndoRotor for the management of recurrent colorectal polyps.
文摘Objective:The complexity of urethral strictures can predict outcomes following urethroplasty.The previously described urethral stricture score(U score)considered only stricture-related factors to grade the complexity of urethral strictures and to predict recurrence post urethroplasty,but not considered patient-related factors for the same.We aimed to study the correlation of both of these factors to the outcomes of oral mucosal graft urethroplasty.Methods:We retrospectively reviewed data of 101 patients who underwent oral mucosal graft urethroplasty in our institute with a minimum follow-up of 6 months.Baseline patient characteristics and stricture-related parameters were noted.The U score was calculated for all patients which consisted of the length,location,number,and etiology of stricture.Univariate and multivariate Cox proportional hazard regression models were used to determine significant risk factors of recurrence.Results:The mean follow-up of patients was 15 months.Recurrence was seen in 28 patients and the mean time for detection of recurrence was 8 months of follow-up.The Charlson Comorbidity Index,history of previous intervention,length of strictures,location of strictures,number of strictures,history of smoking,and etiology were independent predictors of recurrence following urethroplasty.Based on these parameters,we formulated the modified U score(MU score).The scores ranged from 0 to 6 and a score of>2 was found to be predictive of recurrence.On comparing receiver operating characteristic curves for both scores by the DeLong test,the MU score had larger area under the curve than the U score.Conclusion:The MU scoring system is the first of its kind attempt taking into consideration both patient-and stricture-related factors to predict recurrence following oral mucosal graft urethroplasty.
基金The work is financially supported by National Natural Science Foundation of China(No.51605403)National Key Research and Development Project(2020YFB1713503)+3 种基金Natural Science Foundation of Guangdong Province,China(No.2015A030310010)Natural Science Foundation of Fujian Province,China(No.2016J01012)the Aero-nautical Science Foundation of China(No.20183368004)the Fundamental Research Funds for the Central Universities under Grant(No.20720190009).
文摘Friction and wear phenomenon is a complex nonlinear system,and it is also a significant problem in the process of metal cutting.In order to systematically analyze the friction and wear process of tool material-workpiece material friction pair in the cutting process of high hardness alloy steel under different lubrication conditions,the chaotic characteristics of friction process between high hardness alloy steel and cemented carbide under the lubrication C60 nano-particles fluid are studied based on the chaos theory.Firstly,the friction and wear experiments of the friction pair between high hardness alloy steel and cemented carbide tool are carried out based on the ring-block friction and wear tester,and the results of friction force signal in time domain and wear width are obtained.Then,the friction signals in time domain are processed and transformed based on phase space reconstruction and recurrence plot theory,and the recurrence plots of different experimental groups under different lubrication conditions are generated.The evolution law of recurrence plot is further observed and studied,and the recursive quantitative index is analyzed.Finally,the cutting experiments of tool wear are carried out.The results show that the proposed method can intuitively and accurately reveal the wear evolution process and the wear feature identification law of the tool material-high hardness alloy steel pair under different lubrication conditions.Meanwhile,it is found that when the concentration of C60 nanoparticles is 200∼300 ppm,the stability of the friction pair system is best.The proposed method can provide a strategy for wear prediction in cutting process,and provide a theoretical basis and technical support for antifriction lubrication methods in practical cutting applications.
基金Project supported by the National Natural Science Foundation of China(NSFC)(Grant No.12004309)the Shaanxi Fundamental Science Research Project for Mathematics and Physics(Grant No.22JSQ036)the Scientific Research Program funded by Shaanxi Provincial Education Department(Grant No.20JK0947).
文摘We show that the nonlinear stage of the dual-wavelength pumped modulation instability(MI)in nonlinear Schrödinger equation(NLSE)can be effectively analyzed by mode truncation methods.The resulting complicated heteroclinic structure of instability unveils all possible dynamic trajectories of nonlinear waves.Significantly,the latticed-Fermi-Pasta-Ulam recurrences on the modulated-wave background in NLSE are also investigated and their dynamic trajectories run along the Hamiltonian contours of the heteroclinic structure.It is demonstrated that there has much richer dynamic behavior,in contrast to the nonlinear waves reported before.This novel nonlinear wave promises to inject new vitality into the study of MI.