Clinicopathological analysis of small intestinal metastasis from extra-abdominal/extra-pelvic malignancy

BACKGROUND The metastatic tumors in the small intestine secondary to extra-abdominal/extrapelvic malignancy are extremely rare.However,the small intestine metastases are extremely prone to misdiagnosis and missed diagnosis due to the lack of specific clinical manifestations and examination methods,thus delaying its treatment.Therefore,in order to improve clinical diagnosis and treatment capabilities,it is necessary to summarize its clinical pathological characteristics and prognosis.AIM To summarize the clinicopathological characteristics of patients with small intestinal metastases from extra-abdominal/extra-pelvic malignancy,and to improve the clinical capability of diagnosis and treatment for rare metastatic tumors in the small intestine.METHODS The clinical data of patients with small intestinal metastases from extra-abdominal/extra-pelvic malignancy were retrieved and summarized,who admitted to and treated in the Air Force Medical Center,Chinese People’s Liberation Army.Then descriptive statistics were performed on the general conditions,primary tumors,secondary tumors in the small intestine,diagnosis and treatment processes,and prognosis.RESULTS Totally 11 patients(9 males and 2 females)were enrolled in this study,including 8 cases(72.3%)of primary lung cancer,1 case(9.1%)of malignant lymphoma of the thyroid,1 case(9.1%)of cutaneous malignant melanoma,and 1 case(9.1%)of testicular cancer.The median age at the diagnosis of primary tumors was 57.9 years old,the median age at the diagnosis of metastatic tumors in the small intestine was 58.81 years old,and the average duration from initial diagnosis of primary tumors to definite diagnosis of small intestinal metastases was 9 months(0-36 months).Moreover,small intestinal metastases was identified at the diagnosis of primary tumors in 4 cases.The small intestinal metastases were distributed in the jejunum and ileum,with such clinical manifestations as hematochezia(5,45.4%)and abdominal pain,vomiting and other obstruction(4,36.4%).In addition,2 patients had no obvious symptoms at the diagnosis of small intestinal metastases,and 5 patients underwent radical resection of small intestinal malignancies and recovered well after surgery.A total of 3 patients did not receive subsequent treatment due to advanced conditions.CONCLUSION Small intestinal metastases of extra-abdominal/extra-pelvic malignancy is rare with high malignancy and great difficulty in diagnosis and treatment.Clinically,patients with extra-abdominal/extra-pelvic malignancy should be alert to the occurrence of this disease,and their prognosis may be improved through active surgery combined with standard targeted therapy.

Comprehensive security risk factor identification for small reservoirs with heterogeneous data based on grey relational analysis model

Identification of security risk factors for small reservoirs is the basis for implementation of early warning systems.The manner of identification of the factors for small reservoirs is of practical significance when data are incomplete.The existing grey relational models have some disadvantages in measuring the correlation between categorical data sequences.To this end,this paper introduces a new grey relational model to analyze heterogeneous data.In this study,a set of security risk factors for small reservoirs was first constructed based on theoretical analysis,and heterogeneous data of these factors were recorded as sequences.The sequences were regarded as random variables,and the information entropy and conditional entropy between sequences were measured to analyze the relational degree between risk factors.Then,a new grey relational analysis model for heterogeneous data was constructed,and a comprehensive security risk factor identification method was developed.A case study of small reservoirs in Guangxi Zhuang Autonomous Region in China shows that the model constructed in this study is applicable to security risk factor identification for small reservoirs with heterogeneous and sparse data.

Improved seismoacoustic analysis model and its application to source parameter inversion of near-surface small-yield chemical explosions

The seismoacoustic analysis method has broad potential applications to source parameter estimation for near-surface explosion events such as industrial explosions and terrorist attacks.In this study,current models were improved by modifying the acoustic model and adopting the Bayesian Markov-chain-Monte-Carlo inversion method.The source parameters of near-surface small-yield chemical explosions were analyzed via the improved seismoacoustic analysis model and by the estimation accuracy of seismoacoustic joint inversion.Estimation and analysis results showed that the improved seismoacoustic analysis model considered ground shock coupling and the impact of explosion products ejecting from the surface so that the improved acoustic impulse relation was more consistent with the measured data than the Ford impulse relation.It is suitable for deep-burial,shallow-burial,and near-surface aerial explosions.Furthermore,trade-off relationships were declined through the application of the improved model to source parameter inversion for near-surface small-yield chemical explosions,and source parameter estimation accuracy was improved.

Paclitaxel-etoposide-carboplatin/cisplatin versus etoposidecarboplatin/cisplatin as first-line treatment for combined small-cell lung cancer: a retrospective analysis of 62 cases

Objective: To compare the efficacy and adverse effects of paclitaxel-etoposide-carboplatin/cisplatin(TEP/TCE) regimen with those of etoposide-carboplatin/cisplatin(EP/CE) regimen as first-line treatment for combined small-cell lung cancer(CSCLC).Methods: A retrospective study was conducted on 62 CSCLC patients who were treated at Tianjin Medical University Cancer Institute and Hospital from July 2000 to April 2013 and administered with TEP/TCE regimen(n=19) or EP/CE regimen(n=43) as first-line CSCLC treatment. All patients received more than two cycles of chemotherapy, and the response was evaluated every two cycles. The primary endpoint was overall survival(OS), and the secondary endpoints were progression-free survival(PFS), objective response rate(ORR), disease control rate(DCR), and adverse effects. Results: ORR between the TEP/TCE and EP/CE groups showed a statistical difference(90% vs. 53%, P=0.033). Both groups failed to reach a statistical difference in DCR(100% vs. 86%, P=0.212). The median PFS and OS of the TEP/TCE group were slightly longer than those of the EP/CE group, although both groups failed to reach a statistical difference(10.5 vs. 8.9 months, P=0.484; 24.0 vs. 17.5 months, P=0.457). However, stratified analysis indicated that the PFS of patients with stages III and IV CSCLC showed marginally significant difference between the TEP/TCE and EP/CE groups(19.5 vs. 7.6 months; P=0.071). Both rates of grade IV bone marrow depression and termination of chemotherapy in the TEP/TCE group were significantly higher than those in the EP/CE group(26.3% vs. 7.0%, P=0.036; 31.6% vs. 14.7%, P=0.004). Conclusion: The TEP/TCE regimen may not be preferred for CSCLC, and this three-drug regimen requires further exploration and research. To date, the EP/CE regimen remains the standard treatment for CSCLC patients.

Shenqi Fuzheng injection combined with GP chemotherapy in the treatment of advanced non-small cell lung cancer： a meta-analysis

Objective： To evaluate the clinical efficacy of Shenqi Fuzheng injection combined with gemcitabine plus cisplatin（GP） in the treatment of advanced non-small cell lung cancer （NSCLC）. Methods： we performed a systematicsearch in the electronic databases such as Cochrane Library, Pubmed, Embase, Chinese Journal Full-text Database,Chinese Biomedical Literature Database, Chinese Science and Technology Periodical Full-text Database andWanfang Database up to 30 January 2017. Randomized controlled trials （RCT） of Shenqi Fuzheng Injectioncombined with GP chemotherapy in the treatment of advanced NSCLC were searched, and all the RCTs wereconducted on methodological quality assessment. Data extraction and data analysis were according to standards ofCochrane systematic review. Results： Eight trials were included including a total of 701 patients. Meta-analysisresults： Shenqi Fuzheng injection combined with GP chemotherapy could significantly improve the functionalstatus of patients with NSCLC （OR = 3.44, 95% CI [2.26, 5.25], P 〈 0.0001） and clinical treatment efficacy （OR =（OR = 0.31, 95%CI [0.20, 0.47], P 〈 0.0001. The rate of leukopenia （OR = .31, 95%CI [0.20,0.47], P 〈 0.0001）,thrombocytopenia （OR = 0.58, 95%CI [0.37, 0.91], P = 0.020）, hemoglobin decline （（OR = 0.31, 95%CI [0.16,0.59], P = 0.0004） and incidence of gastrointestinal reactions （OR = 0.58,P 〈 0.05） could be reduced. Conclusion：Shenqi Fuzheng injection combined with GP chemotherapy in the treatment of advanced NSCLC obtainedsignificantly clinical efficacy. The quality of the literature incorporated is low, the conclusion requires high-qualityresearch to further prove.

Analysis of the effect of bore centerline on projectile exit conditions in small arms

Most finite element models of small arms focus on an idealized barrel,typically one with a perfectly straight bore centerline.Using five different experimentally measured bore centerlines,this investigation analyzes the effect centerline nonlinearity has on projectile exit conditions.This includes the effect of rotating a centerline through several orientations.Modeled using Abaqus/Explicit,this dynamic analysis simulates a single firing cycle for each centerline.Projectile jump is calculated for each model as a measure of the effects of warped centerlines.The warped centerlines have a small effect on barrel dynamics.

Design and Comparative Analysis of Small Modular Reactors for Nuclear Marine Propulsion of a Ship

The fast growth in the size and difficulty of nuclear power plant in the 1970s produced an interest in smaller, modest designs that are intrinsically safe over the usage of design features. With the development of nuclear technology, there is the need for revolution in the Maritime sector, especially the advance marine propulsion. In current years, numerous reactor manufacturers are dynamically improving small modular reactor designs with even superior use of safety features. Several designs integrate the ultimate in greater safety. They totally remove specific accident initiators from the design. Other design features benefit to reduce different types of accident or help to mitigate the accident’s consequences. Although some safety features are mutual to maximum SMR designs, irrespective of the coolant technology, other features are specific to liquid-metal cooled, water, gas, or SMR designs. Results: There have been more reactor concepts investigated in the marine propulsion area by different assemblies and research laboratories than in the power generation field, and much can be learned from their experience for land applications. The extensive use of safety features in SMRs potential to make these power plants extremely vigorous, protecting both the public and the investor. Conclusion: For these two considerations, it is recognized that a nuclear reactor is the ideal engine for naval advanced propulsion. The paper will present the work to analyze the concept design of SMRs and design a modular vessel consisting of a propulsion module.

A Multifractal Detrended Fluctuation Analysis of the Ising Financial Markets Model with Small World Topology

We present a multifractal detrended fluctuation analysis （MFDFA） of the time series of return generated by our recently-proposed Ising financial market model with underlying small world topology. The result of the MFDFA shows that there exists obvious multifractal scaling behavior in produced time series. We compare the MFDFA results for original time series with those for shuffled series, and find that its multifractal nature is due to two factors： broadness of probability density function of the series and different correlations in small- and large-scale fluctuations. This may provide new insight to the problem of the origin of multifractality in financial time series.

Clinical outcomes of small incision lenticule extraction versus femtosecond laser-assisted LASIK for myopia: a Meta-analysis

AIM：To evaluate the possible differences in visual quality between small incision lenticule extraction（SMILE）and femtosecond laser in situ keratomileusis（FS-LASIK）for myopia.METHODS：A Meta-analysis was performed.Patients were from previously reported comparative studies treated with SMILE versus FS-LASIK.The Pub Med,EMBASE,Cochrane,Web of Science and Chinese databases（i.e.WANFANG and CNKI）were searched in Nov.of 2016 using Rev Man 5.1 version software.The differences in visual acuity,aberration and biomechanical effects within six months postoperatively were showed.Twenty-seven studies including 4223 eyes were included.RESULTS：No significant differences were observed between SMILE and FS-LASIK in terms of the proportion of eyes that lost one or more lines of corrected distance visual acuity after surgery（P=0.14）,the proportion of eyes achieving an uncorrected distance visual acuity of 20/20or better（P=0.43）,the final refractive spherical equivalent（P=0.89）,the refractive spherical equivalent within±1.00diopter of the target values（P=0.80）,vertical coma（P=0.45）and horizontal coma（P=0.06）.Compared with the FSLASIK group,total higher-order aberration（P〈0.001）and spherical aberration（P〈0.001）were higher and the decrease in corneal hysteresis（P=0.0005）and corneal resistance factor（P=0.02）were lower in the SMILE group.CONCLUSION：SMILE and FS-LASIK are comparable in efficacy,safety and predictability for correcting myopia.However,the aberration in the SMILE group is superior to that in the FS-LASIK group,and the loss of biomechanical effects may occur less frequently after SMILE than after FS-LASIK.

A new package:MySAS for small angle scattering data analysis

In this paper,A MySAS package,which is verified on Windows XP,can easily convert two-dimensional data in small angle neutron and X-ray scattering analysis,operate individually and execute one particular operation as numerical data reduction or analysis,and graphical visualization.This MySAS package can implement the input and output routines via scanning certain properties,thus recalling completely sets of repetition input and selecting the input files.On starting from the two-dimensional files,the MySAS package can correct the anisotropic or isotropic data for physical interpretation and select the relevant pixels.Over 50 model functions are fitted by the POWELL code using x^2 as the figure of merit function.

Small-incision lenticule extraction versus femtosecond lenticule extraction for myopic:a systematic review and Meta-analysis

AIM： To examine differences in efficacy, accuracy, safety, aberrations and corneal biomechanical between Small incision lenticule extraction （SMILE） and femtosecond lenticule extraction （FLEx） for myopia. METHODS： Comprehensive studies were conducted on the PubMed, MEDLINE, EMBASE, and Cochrane Controlled Trials Register before 31 July, 2015. Meta-analyses were performed on the primary outcomes [loss of ≥2 lines of corrected distance visual acuity （CDVA）, uncorrected distance visual acuity （UDVA） ≥20/20, spherical equivalent （SE） within ±0.50 diopters （D）, final refractive SE], secondary outcomes were high-order aberrations （HOAs） and corneal biomechanical [central corneal thickness （CCT）, corneal hysteresis （CH） and corneal resistance factor （CRF）]. RESULTS： Seven trials describing a total of 320 eyes with myopia were included in this Meta-analysis. No significant differences were found in the efficacy [UDVA weighted mean difference （WMD） -0.01; 95%CI： -0.04 to 0.01; P=0.37, UDVA ≥20/20, OR 1.49; 95%CI： 0.78 to 2.86; P=0.23], accuracy （SE WMD -0.03; 95%CI： -0.12 to 0.07; P=0.58 , SE within ±0.5 D OR 1.25; 95%CI： 0.34 to 4.65; P=0.74）, HOAs （WMD -0.04; 95%CI： -0.09 to 0.01; P=0.14） and CCT WMD 1.83; 95%CI： -7.07 to 10.72; P=0.69, CH WMD -0.01; 95%CI： -0.42 to 0.40; P=0.97, CRF WMD 0.17; 95%CI： -0.33 to 0.67; P=0.50） in the last fellow-up. But for safety, FLEx may achieve fewer CDVA lost two or more two lines （OR 11.11; 95%CI： 1.27 to 96.86; P=0.03） than SMILE, however CDVA （WMD 0.00; 95%CI： -0.03 to 0.02; P=0.77） is similar. CONCLUSION： SMILE and FLEx are comparable in terms of both efficacy, accuracy, aberrations and corneal biomechanical measures in the follow-up,but FLEx seems to be better in safety measures. The results should be interpreted cautiously since relevant evidence is still limited, although it is accumulating. Further large-scale, well-designed randomized controlled trials are urgently needed.

Dry eye and corneal sensitivity after small incision lenticule extraction and femtosecond laser-assisted in situ keratomileusis:a Meta-analysis

AIM：To assess the corneal sensitivity and the incidences of dry eye after small incision lenticule extraction（SMILE） and femtosecond laser-assisted in situ keratomileusis（FSLASIK）.METHODS：The Meta-analysis was performed using Rev Man 5.3.We searched on Pub Med from inception to March 2016.Summary weighted mean difference（WMD） and 95% confidence intervals（CIs） were used to analyze the datum.Random-effects or fixed-effects models were chosen up to between-study heterogeneity.The main outcomes were composed of the Ocular Surface Disease Index（OSDI） scores,tear film break-up time（TBUT）,Schirmer Test and corneal sensitivity.RESULTS：Eight eligible studies including 772 eyes（386 in SMILE group and 386 in FS-LASIK group） were identified.The parameters have no significiant difference heterogeneity between SMILE and FS-LASIK group preoperatively.There were significant differences between the two groups in OSDI scores at one and three months postoperatively,in TBUT at one and three months postoperatively,in corneal sensitivity at one week,about one month and three months postoperatively.However,there was no significant difference observed in Schirmer Test at the follow-up periods.CONCLUSION：Compare to FS-LASIK,dry eye and the corneal sensitivity recover better in the SMILE group,in first three months after the surgery.

Analysis of Additional Damping Control Strategy and Parameter Optimization for Improving Small Signal Stability of VSC-HVDC System

The voltage source converter based high voltage direct current(VSC-HVDC)system is based on voltage source converter,and its control system is more complex.Also affected by the fast control of power electronics,oscillation phenomenon in wide frequency domain may occur.To address the problem of small signal stability of the VSCHVDC system,a converter control strategy is designed to improve its small signal stability,and the risk of system oscillation is reduced by attaching a damping controller and optimizing the control parameters.Based on the modeling of the VSC-HVDC system,the general architecture of the inner and outer loop control of the VSCHVDC converter is established;and the damping controllers for DC control and AC control are designed in the phase-locked loop and the inner and outer loop control parts respectively;the state-space statemodel of the control system is established to analyze its performance.And the electromagnetic transient simulation model is built on the PSCAD/EMTDC simulation platform to verify the accuracy of the small signal model.The influence of the parameters of each control part on the stability of the system is summarized.The main control parts affecting stability are optimized for the phenomenon of oscillation due to changes in operation mode occurring on the AC side due to faults and other reasons,which effectively eliminates system oscillation and improves system small signal stability,providing a certain reference for engineering design.

Recursive Partitioning Analysis Classification and Graded Prognostic Assessment for Non-Small Cell Lung Cancer Patients with Brain Metastasis:A Retrospective Cohort Study

Objective：To assess prognostic factors and validate the effectiveness of recursive partitioning analysis （RPA） classes and graded prognostic assessment （GPA） in 290 non-small cell lung cancer （NSCLC） patients with brain metastasis （BM）.Methods：From Jan 2008 to Dec 2009,the clinical data of 290 NSCLC cases with BM treated with multiple modalities including brain irradiation,systemic chemotherapy and tyrosine kinase inhibitors （TKIs） in two institutes were analyzed.Survival was estimated by Kaplan-Meier method.The differences of survival rates in subgroups were assayed using log-rank test.Multivariate Cox＇s regression method was used to analyze the impact of prognostic factors on survival.Two prognostic indexes models （RPA and GPA） were validated respectively.Results：All patients were followed up for 1-44 months,the median survival time after brain irradiation and its corresponding 95% confidence interval （95% CI） was 14 （12.3-15.8） months.1-,2-and 3-year survival rates in the whole group were 56.0%,28.3%,and 12.0%,respectively.The survival curves of subgroups,stratified by both RPA and GPA,were significantly different （P0.001）.In the multivariate analysis as RPA and GPA entered Cox＇s regression model,Karnofsky performance status （KPS） ≥ 70,adenocarcinoma subtype,longer administration of TKIs remained their prognostic significance,RPA classes and GPA also appeared in the prognostic model.Conclusion：KPS ≥70,adenocarcinoma subtype,longer treatment of molecular targeted drug,and RPA classes and GPA are the independent prognostic factors affecting the survival rates of NSCLC patients with BM.

PRIMARY TUMORS OF THE SMALL INTESTINE (ANALYSIS OF 102 PATIENTS)

Primary tumors of the small intestine are uncommon and a correct preoperative diagnosis is extremely difficult. From 1964 to 1983, 102 cases of this disease were detected surgically at our hospital. In order to investigate the problems involved in diagnosis and treatment, a comprehensive analysis of small intestinal tumors is made in this paper.

Daikenchuto for postoperative adhesive small bowel obstruction:A systematic review and meta-analysis

AIMTo assess the effectiveness of Daikenchuto for patients with postoperative adhesive small bowel obstruction （ASBO）.METHODSA systematic search of PubMed （MEDLINE）, CINAHL, the Cochrane Library and Ichushi Web was conducted, and the reference lists of review articles were hand-searched. The outcomes of interest were the incidence rate of surgery, the length of hospital days and mortality. The quality of the included studies, publication bias and between-study heterogeneity were also assessed.RESULTS Three randomized controlled trials （RCTs） and three retrospective cohort studies were selected for analysis. In the three RCTs, Daikenchuto signifcantly reduced the incidence of surgery （pOR = 0.13; 95%CI： 0.03-0.50）. Similarly, Daikenchuto signifcantly reduced the incidence of surgery （pOR = 0.53; 95%CI： 0.32-0.87） in the three cohort studies. The length of hospital stay and mortality were not measured or described consistently.CONCLUSIONThe present meta-analysis demonstrates that admini-stering Daikenchuto is associated with a lower incidence of surgery for patients with postoperative ASBO in the Japanese population. In order to better generalize these results, additional studies will be needed.

A Meta-analysis Reveals Prognostic Role of Programmed Death Ligand-1 in Asian Patients with Non-small Cell Lung Cancer

Accumulating studies explored the clinicopathologic and prognostic value of programmed death ligand-1（PD-L1） in non-small cell lung cancer（NSCLC）, but the results were controversial. We therefore conducted a meta-analysis to evaluate the predictive role of PD-L1 in NSCLC patients. We systematically collected relevant studies from Pub Med, Embase, Web of Science and China National Knowledge Infrastructure. The pooled hazard ratios（HRs） with 95% confidence intervals（CIs） for overall survival（OS）, and odd ratios（ORs） with 95% CIs for clinicopathologic factors were calculated. A total of 15 studies involving 3605 patients were included in this meta-analysis. The results showed no prognostic role of PD-L1 in the whole patients（HR=1.60, 95% CI： 0.88–2.89, P=0.123）. Subgroup analysis showed that PD-L1 was associated with decreased OS in Asian patients（HR=2.00, 95% CI： 1.55–2.57, P〈0.001）. Among all the clinicopathologic factors, PD-L1 overexpression was significantly in relevance with poor tumor cell differentiation（HR=1.84, 95% CI： 1.49–2.28, P〈0.001）, late stage（HR=1.21, 95% CI： 1.02–1.43, P=0.026） and anaplastic lymphoma kinase（ALK） translocation（HR=2.63, 95% CI： 1.08–6.40, P=0.034）, but not with other factors. In conclusion, our meta-analysis demonstrated that PD-L1 has a prognostic role in Asian patients with NSCLC.

Reliability analysis of small failure probability based on subset simulation method

In the engineering.to ensure the quality and safety,it is necessary to carry out reliability analysis on it.When conducting reliability analysis in engineering.a 1arge rumber of small1 failure probability problems will be encountered.For such problems,the traditional Monte Carlo method needs a 1ot of samples,and the calculation efficiency is extremely 1ow,while the subset sinmulation method can efficiently estimate the relLability index of the small failure probability problem with litle samples.Therefore,this paper takes the application of the subset simulation method in the reliability analysis of the small failure probability structure as the object,constructs the reliability analysis method of the single failure mode of the system and applies the method to a mathematical example and a single-story gate.Through the rigid frame example,it can be seen that this method is beneficial to improve the calculation efficiency and accuracy.

Research on Technology Opportunity Identification of Small and Medium-sized Vaccine Enterprises Based on Patent Analysis

Objective To propose a method for identifying cooperation partners and technology opportunities based on technological similarity and technological capability analysis at the critical moment for the survival of small and medium-sized vaccine companies.This method can provide a direction for small and medium-sized enterprises that lack human and financial resources to make full use of its existing technologies.Methods Data analysis was carried out based on patent data.First,through cosine similarity and patent index evaluation,companies with high technological similarity and strong technological capabilities were selected as the target of cooperation.Then evaluation index system of technological development potential was built from three dimensions:technological competitiveness,technological creativity,and potential for industrialization.AHP-CRITIC method was used to determine the comprehensive development potential of each technology.Finally,technology opportunities based on K-means and text mining were identified.Results and Conclusion This method can help small and medium vaccine companies in China to identify technological opportunities and provide directions for product development.

Analysis on Risk Prevention Mechanism for Farmers' Default in Small Amount Credit

Through analysis, it is believed that major reasons for default risks in operation of small amount credit include low management level and vacancy of normative system, vacancy of risk sharing mechanism, rating distortion due to imperfect credit investigation system, and uncertainty of borrower's credit. On the basis of these, static and dynamic models are established to analyze the prevention mechanism for default risk in small amount credit. It is concluded that we must establish a restriction mechanism during operation of small amount credit as long as three values increase, namely, N (potential loss of bad credit record due to farmers' default), Q (probability of successful recovery by small amount credit institution), and S (cost of small amount credit institution punishing farmers after successful recovery). Finally, following countermeasures and suggestions are put forward: perfect laws and regulations and credit reward and punishment mechanism for risk management of small amount credit; bring into play proper function of loan officer in small amount credit practice; widely promote rural "Group Credit Union" system.