Axillary lymph node status is one of the most important prognostic indicator of survival for breast cancer, especially in ductal carcinoma in situ （DCIS）. The purpose of this study was to investigate whether sentine...Axillary lymph node status is one of the most important prognostic indicator of survival for breast cancer, especially in ductal carcinoma in situ （DCIS）. The purpose of this study was to investigate whether sentinel lymph node biopsy （SLNB） should be performed in patients with an initial diagnosis of DCIS. Methods： A retrospective study was performed of 124 patients with an initial diagnosis of DCIS between March 2000 and June 2014. The patients were treated with either SLNB or axillary node dissection during the surgery, and we compared the clinicopathologic characteristics, image features, and immunohistochemical results. Results： Eighty-two patients （66.1%） had pure DCIS and 25 （20.2%） had DCIS with microinvasion （DCISM）, 17 （13.7%） updated to invasive breast cancer （IBC）. 115 patients （92.7%） underwent SLNB, among them, 70 patients （56.5%） underwent axillary node dissection. 3 of 115 patients （2.6%） had a positive sentinel lymph node, only 1 （1.4%） of 70 patients had axillary lymph node metastasis, in 84 patients （66.7%） who were diagnosed DCIS by core needle biopsy （CNB） and vacuum-assisted biopsy （VAB）. 26 patients （31.0%） were upstaged into IBC or DCISM in the final histological diagnosis. The statistically significant factors predictive of underestimation were large tumor size, microcalcifications, comedo necrosis, positive Her-2 status, negative estrogen receptor status. Conclusion： The metastasis of sentinel lymph nodes in pure DCIS is very low, but the underestimation of invasive carcinoma in patients with an initial diagnosis of DCIS is an usual incident, especially in the cases when DCIS is diagnosed by CNB or VAB. Our findings suggest patients presenting with a preoperative diagnosis of DCIS associated with large tumor sizes, microcalcifications, comedo necrosis, positive Her-2 status, negative ER status are more likely to be DCISM and IBC in final diagnosis. SLNB should be performed in this part of patients.展开更多
Objective： The objective of this study was to compare the underestimation rate of invasive carcinoma cases with ductal carcinoma in situ （DCIS） at percutaneous ultrasound-guided core biopsies of breast lesions betw...Objective： The objective of this study was to compare the underestimation rate of invasive carcinoma cases with ductal carcinoma in situ （DCIS） at percutaneous ultrasound-guided core biopsies of breast lesions between 14-gauge automated core needle biopsy （ACNB） and 11-gauge vacuum-assisted biopsy （VAB）, and analyze the diagnostic advantages and insufficiencies in DCIS between this two methods, and to determine the relationship between the lesion type （masses or microcalcifications on radiological findings ） and DCIS underestimation rate. Methods： We collected 152 breast lesions which were diagnosed as DCIS by retrospectively reviewing data about ultrasound-guided biopsies of breast lesions （from February 2003 to July 2010）. There were 98 lesions in 95 patients by 14-gauge ACNB, and 54 lesions in 52 patients by 11-gauge VAB （The system used in this study called Mammatome, MMT）. The clinical and radiological findings were reviewed; meanwhile all the selected patients had histological results of the biopsies and follow-up surgeries which also achieved the reliable pathological results to compare with the biopsy results. The differences between two correlated histological results defined as underestimation, and the histological DCIS underestimation rates were compared between the two groups. According to the radiological characteristics, each group was classified into two subgroups （masses or micrecalcifications group）, and the differences between subgroups were also analyzed. Results： The DCIS underestimation rate was 45.9% （45/98） for 14-gauge ACNB and 16.6% （9/54） for MMT. According to the lesion type on ultrasonography, DCIS underestimation was 31.0% （26/84） in masses （43.1% using ACNB and 12.1% using MMT; P = 0.003） and 42.6% （29/68） in microcalcifications （48.9% using ACNB and 23,8% using MMT; P = 0,036）, Conclusion： The underestimation rate of invasive carcinoma in cases with DCIS at ultrasound-guided core biopsies is significantly higher for ACNB than for MMT. Furthermore, this difference does not alter among the two lesion types presented on ultrasonography. So ultrasound-guided VAB （MMT system） could be an effective and useful method for the diagnosis of DCIS lesions no matter what the lesion type is.展开更多
A laboratory test was performed to assess the effectiveness of vacuum preloading incorporated with electroosmotic (EOM) treatment on silty clay (combined method) for reclamation projects like new disposal ponds, where...A laboratory test was performed to assess the effectiveness of vacuum preloading incorporated with electroosmotic (EOM) treatment on silty clay (combined method) for reclamation projects like new disposal ponds, where the horizontal electrode configurations beneath the soil layer were possible and the drainage pipes and the prefabricated vertical drains (PVDs) system could be easily installed in advance before the sludge dragged from sea bed or river bed was filled into the site. Three groups of tests were conducted on the silty clay from Qinhuai River in Nanjing, China. The model is able to apply vacuum pressure at the bottom of the soil layer and a direct current electric field simultaneously. It is also possible to measure the pore pressures at different depths of soil column, and the changes in settlement and volume with the elapsed time. In this study, the vacuum preloading method, vacuum preloading applied at the bottom (VAB method), was applied and the cathodes were installed beneath the soil layer. The results obtained indicate substantial reduction in water content, and increases in dry density and undrained shear strength in comparison with those obtained by the vacuum preloading only, particularly at the positions close to the anode. The combined method utilizes the vertical drainage flow created by the electroosmosis integrating the horizontal drainage flow created mostly by the vacuum pressure. The total drainage flow can be calculated as a result of the vertical drainage flow by electroosmosis only and the horizontal drainage flow by the vacuum preloading only. The way of placement of the cathode and the anode in the combined method also overcomes the disadvantage of EOM method itself, i.e. the appearance of cracks between the anode and the surrounding soil. Moreover, it is observed that the vacuum preloading plays a primary role in earlier stage in deduction of free pore water; meanwhile, the electroosmotic method is more efficient in later stage for absorbing water in the diffused double layers of soil.展开更多
The Euler-Bernoulli beam model coupled with the sectional properties obtained by the variational asymptotic beam sectional analysis(VABS)method is used to construct the blade structure model.Combined the aerodynamic l...The Euler-Bernoulli beam model coupled with the sectional properties obtained by the variational asymptotic beam sectional analysis(VABS)method is used to construct the blade structure model.Combined the aerodynamic loads calculated by unsteady blade element momentum model with a dynamic inflow and the dynamic stall correction,the dynamics equations of blade are built.The Newmark implicit algorithm is used to solve the dynamics equations.Results of the sectional properties and blade structure model are compared with the multi-cell beam method and the ANSYS using shell elements.It is proved that the method is effective with high precision.Moreover,the effects on the aeroelastic response caused by bend-twist coupling are analyzed.Torsional direction is deflected toward the upwind direction as a result of coupling effects.The aerodynamic loads and the displacement are reduced.展开更多
文摘Axillary lymph node status is one of the most important prognostic indicator of survival for breast cancer, especially in ductal carcinoma in situ （DCIS）. The purpose of this study was to investigate whether sentinel lymph node biopsy （SLNB） should be performed in patients with an initial diagnosis of DCIS. Methods： A retrospective study was performed of 124 patients with an initial diagnosis of DCIS between March 2000 and June 2014. The patients were treated with either SLNB or axillary node dissection during the surgery, and we compared the clinicopathologic characteristics, image features, and immunohistochemical results. Results： Eighty-two patients （66.1%） had pure DCIS and 25 （20.2%） had DCIS with microinvasion （DCISM）, 17 （13.7%） updated to invasive breast cancer （IBC）. 115 patients （92.7%） underwent SLNB, among them, 70 patients （56.5%） underwent axillary node dissection. 3 of 115 patients （2.6%） had a positive sentinel lymph node, only 1 （1.4%） of 70 patients had axillary lymph node metastasis, in 84 patients （66.7%） who were diagnosed DCIS by core needle biopsy （CNB） and vacuum-assisted biopsy （VAB）. 26 patients （31.0%） were upstaged into IBC or DCISM in the final histological diagnosis. The statistically significant factors predictive of underestimation were large tumor size, microcalcifications, comedo necrosis, positive Her-2 status, negative estrogen receptor status. Conclusion： The metastasis of sentinel lymph nodes in pure DCIS is very low, but the underestimation of invasive carcinoma in patients with an initial diagnosis of DCIS is an usual incident, especially in the cases when DCIS is diagnosed by CNB or VAB. Our findings suggest patients presenting with a preoperative diagnosis of DCIS associated with large tumor sizes, microcalcifications, comedo necrosis, positive Her-2 status, negative ER status are more likely to be DCISM and IBC in final diagnosis. SLNB should be performed in this part of patients.
文摘Objective： The objective of this study was to compare the underestimation rate of invasive carcinoma cases with ductal carcinoma in situ （DCIS） at percutaneous ultrasound-guided core biopsies of breast lesions between 14-gauge automated core needle biopsy （ACNB） and 11-gauge vacuum-assisted biopsy （VAB）, and analyze the diagnostic advantages and insufficiencies in DCIS between this two methods, and to determine the relationship between the lesion type （masses or microcalcifications on radiological findings ） and DCIS underestimation rate. Methods： We collected 152 breast lesions which were diagnosed as DCIS by retrospectively reviewing data about ultrasound-guided biopsies of breast lesions （from February 2003 to July 2010）. There were 98 lesions in 95 patients by 14-gauge ACNB, and 54 lesions in 52 patients by 11-gauge VAB （The system used in this study called Mammatome, MMT）. The clinical and radiological findings were reviewed; meanwhile all the selected patients had histological results of the biopsies and follow-up surgeries which also achieved the reliable pathological results to compare with the biopsy results. The differences between two correlated histological results defined as underestimation, and the histological DCIS underestimation rates were compared between the two groups. According to the radiological characteristics, each group was classified into two subgroups （masses or micrecalcifications group）, and the differences between subgroups were also analyzed. Results： The DCIS underestimation rate was 45.9% （45/98） for 14-gauge ACNB and 16.6% （9/54） for MMT. According to the lesion type on ultrasonography, DCIS underestimation was 31.0% （26/84） in masses （43.1% using ACNB and 12.1% using MMT; P = 0.003） and 42.6% （29/68） in microcalcifications （48.9% using ACNB and 23,8% using MMT; P = 0,036）, Conclusion： The underestimation rate of invasive carcinoma in cases with DCIS at ultrasound-guided core biopsies is significantly higher for ACNB than for MMT. Furthermore, this difference does not alter among the two lesion types presented on ultrasonography. So ultrasound-guided VAB （MMT system） could be an effective and useful method for the diagnosis of DCIS lesions no matter what the lesion type is.
文摘A laboratory test was performed to assess the effectiveness of vacuum preloading incorporated with electroosmotic (EOM) treatment on silty clay (combined method) for reclamation projects like new disposal ponds, where the horizontal electrode configurations beneath the soil layer were possible and the drainage pipes and the prefabricated vertical drains (PVDs) system could be easily installed in advance before the sludge dragged from sea bed or river bed was filled into the site. Three groups of tests were conducted on the silty clay from Qinhuai River in Nanjing, China. The model is able to apply vacuum pressure at the bottom of the soil layer and a direct current electric field simultaneously. It is also possible to measure the pore pressures at different depths of soil column, and the changes in settlement and volume with the elapsed time. In this study, the vacuum preloading method, vacuum preloading applied at the bottom (VAB method), was applied and the cathodes were installed beneath the soil layer. The results obtained indicate substantial reduction in water content, and increases in dry density and undrained shear strength in comparison with those obtained by the vacuum preloading only, particularly at the positions close to the anode. The combined method utilizes the vertical drainage flow created by the electroosmosis integrating the horizontal drainage flow created mostly by the vacuum pressure. The total drainage flow can be calculated as a result of the vertical drainage flow by electroosmosis only and the horizontal drainage flow by the vacuum preloading only. The way of placement of the cathode and the anode in the combined method also overcomes the disadvantage of EOM method itself, i.e. the appearance of cracks between the anode and the surrounding soil. Moreover, it is observed that the vacuum preloading plays a primary role in earlier stage in deduction of free pore water; meanwhile, the electroosmotic method is more efficient in later stage for absorbing water in the diffused double layers of soil.
基金supported jointly by the National Basic Research Program of China(″973″Program)(No.2014CB046200)the Natural Science Foundation of Jiangsu Province(No.BK2014059)+1 种基金the Priority Academic Program Development of Jiangsu Higher Education Institutionsthe National Natural Science Foundation of China(No.11172135)
文摘The Euler-Bernoulli beam model coupled with the sectional properties obtained by the variational asymptotic beam sectional analysis(VABS)method is used to construct the blade structure model.Combined the aerodynamic loads calculated by unsteady blade element momentum model with a dynamic inflow and the dynamic stall correction,the dynamics equations of blade are built.The Newmark implicit algorithm is used to solve the dynamics equations.Results of the sectional properties and blade structure model are compared with the multi-cell beam method and the ANSYS using shell elements.It is proved that the method is effective with high precision.Moreover,the effects on the aeroelastic response caused by bend-twist coupling are analyzed.Torsional direction is deflected toward the upwind direction as a result of coupling effects.The aerodynamic loads and the displacement are reduced.
