TypeⅡdiabetes mellitus(T2DM)has experienced a dramatic increase globally across countries of various income levels over the past three decades.The persistent prevalence of T2DM is attributed to a complex interplay of...TypeⅡdiabetes mellitus(T2DM)has experienced a dramatic increase globally across countries of various income levels over the past three decades.The persistent prevalence of T2DM is attributed to a complex interplay of genetic and environmental factors.While numerous pharmaceutical therapies have been developed,there remains an urgent need for innovative treatment approaches that offer effectiveness without significant adverse effects.In this context,the exploration of the gut microbiome presents a promising avenue.Research has increasingly shown that the gut microbiome of individuals with T2DM exhibits distinct differences compared to healthy individuals,suggesting its potential role in the disease’s pathogenesis and progression.This emerging field offers diverse applications,particularly in modifying the gut environment through the administration of prebiotics,probiotics,and fecal microbiome transfer.These interventions aim to restore a healthy microbiome balance,which could potentially alleviate or even reverse the metabolic dysfunctions associated with T2DM.Although current results from clinical trials have not yet shown dramatic effects on diabetes management,the groundwork has been laid for deeper investigation.Ongoing and future clinical trials are critical to advancing our understanding of the microbiome’s impact on diabetes.By further elucidating the mechanisms through which microbiome alterations influence insulin resistance and glucose metabolism,researchers can develop more targeted interventions.The potential to harness the gut microbiome in developing new therapeutic strategies offers a compelling prospect to transform the treatment landscape of T2DM,potentially reducing the disease’s burden significantly with approaches that are less reliant on traditional pharmaceuticals and more focused on holistic,systemic health improvements.展开更多
Diabetes mellitus is associated with foot ulcers,which frequently pave the way to lower-extremity amputation.Neuropathy,trauma,deformity,high plantar pressures,and peripheral vascular disease are the most common under...Diabetes mellitus is associated with foot ulcers,which frequently pave the way to lower-extremity amputation.Neuropathy,trauma,deformity,high plantar pressures,and peripheral vascular disease are the most common underlying causes.Around 15%of diabetic patients are affected by diabetic foot ulcer in their lifetime.64 million people are affected by diabetics in India and 40000 amputations are done every year.Foot ulcers are evaluated and classified in a systematic and thorough manner to assist in determining the best course of therapy.This paper proposes a novel model which predicts the threat of diabetic foot ulcer using independent agents for various input values and a combination of fuzzy expert systems.The proposed model uses a classification system to distinguish between each fuzzy framework and its parameters.Based on the severity levels necessary prevention,treatment,and medication are recommended.Combining the results of all the fuzzy frameworks derived from its constituent parameters,a risk-specific medication is recommended.The work also has higher accuracy when compared to other related models.展开更多
Based on the observation data of meteorological stations,Doppler radar observation data of Ulanqab City,and ERA-5 reanalysis data,a snowstorm process in Ulanqab City from March 17 to 18,2022 was analyzed.The results s...Based on the observation data of meteorological stations,Doppler radar observation data of Ulanqab City,and ERA-5 reanalysis data,a snowstorm process in Ulanqab City from March 17 to 18,2022 was analyzed.The results show that this was a type Ⅱ snowstorm process generated under the joint influence of upper trough and ground low inverted trough and frontal cyclone.The main period of snowfall can be divided into two time stages,and the total snowfall was more in the south and less in the north,which was consistent with that of average specific humidity field.Water vapor conditions provided by strong water vapor transport and convergence,strong upward movement shown by large vertical velocity field,and the suction action of high-and low-layer divergence and convergence were the reasons for the hourly heavy snowfall on the 18^(th).During the process,radar echoes were mainly sheet-shaped,and composite reflectivity was 15-25 dBZ in most areas.The zero speed line in the first period was positively"S"-shaped,and there was warm advection and southwest wind.On the morning of the 18^(th),after the cold front transited the city,Ulanqab City was gradually controlled by northwest wind,and the snow tended to end.展开更多
针对逐步Ⅱ型删失数据下Burr Type X分布的参数估计问题,提出模型参数的一种新的贝叶斯估计及相应的最大后验密度(HPD)置信区间.假设伽玛分布为待估参数的先验分布,考虑待估参数的条件后验分布未知、单峰且近似对称,选取以正态分布为提...针对逐步Ⅱ型删失数据下Burr Type X分布的参数估计问题,提出模型参数的一种新的贝叶斯估计及相应的最大后验密度(HPD)置信区间.假设伽玛分布为待估参数的先验分布,考虑待估参数的条件后验分布未知、单峰且近似对称,选取以正态分布为提议分布的Metropolis-Hastings(MH)算法生成后验样本,基于后验样本在平方误差损失函数下得到待估参数的贝叶斯估计和HPD置信区间.将基于MH算法得到的贝叶斯估计和HPD置信区间与基于EM算法得到的极大似然估计和置信区间在均方误差准则和精度意义下进行比较.Monte-Carlo模拟结果表明,基于MH算法得到的估计在均方误差准则下优于基于EM算法得到的极大似然估计,基于MH算法得到的HPD置信区间长度小于基于EM算法得到的置信区间长度.展开更多
目的研究TGF-1β、BM P-2和typeⅡco llagen在退行性腰椎滑脱(degenerative lum bar spondy lo listhes is,DLS)和腰椎间盘突出症(lum bar d isc hern iation,LDH)黄韧带中的表达及其意义。方法37例手术切除的腰椎椎板间部黄韧带标本分...目的研究TGF-1β、BM P-2和typeⅡco llagen在退行性腰椎滑脱(degenerative lum bar spondy lo listhes is,DLS)和腰椎间盘突出症(lum bar d isc hern iation,LDH)黄韧带中的表达及其意义。方法37例手术切除的腰椎椎板间部黄韧带标本分为3组,第1组为退行性腰椎滑脱组(DLS)10例;第2组为腰椎间盘突出症组(LDH)17例,第3组为正常对照组10例,其中7例取自腰椎骨折手术病人,3例取自意外死亡者。应用EnV is ion二步免疫组化的方法检测其TGF-1β、BM P-2和typeⅡco llagen的表达情况,普通光镜观察,计算出各标本的表达阳性率和表达强度,数据以x-±s标准差及表达强度表示,结果分别用Spss统计软件和R id it进行分析。结果TGF-1β、BM P-2和typeⅡco llagen的阳性表达产物见于成纤维细胞、成软骨细胞和软骨细胞中,而Ⅱ型胶原染色还可同时见于基质。TGF-1β、BM P-2和typeⅡco llagen在DLS组中的表达明显高于LDH组和正常组(P<0.01或P<0.05),Ⅱ型胶原基质染色明显深于LDH组和对照组。LDH组的TGF-1β和typeⅡco llagen的表达阳性率和表达强度与正常组之间差异无显著性(P>0.05),而BM P-2的表达阳性率和表达强度在LDH组与正常组之间具有统计学意义(P<0.01)。结论黄韧带所受到的异常机械牵张力可以增加TGF-1β在黄韧带细胞中的合成,而TGF-1β则促进退行性腰椎滑脱黄韧带中的Ⅱ型胶原合成,导致黄韧带的退变和肥厚。BM P-2在退变黄韧带中的表达异常增高,可能与黄韧带的软骨化倾向有关。展开更多
Glycosides of Cistanche（GC）is a preparation used extensively for its neuroprotective effect against neurological diseases,but its mechanisms of action remains incompletely understood.Here,we established a bilateral ...Glycosides of Cistanche（GC）is a preparation used extensively for its neuroprotective effect against neurological diseases,but its mechanisms of action remains incompletely understood.Here,we established a bilateral common carotid artery occlusion model of vascular dementia in rats and injected the model rats with a suspension of GC（10 mg/kg/day,intraperitoneally）for 14 consecutive days.Immunohistochemistry showed that GC significantly reduced p-tau and amyloid beta（Aβ）immunoreactivity in the hippocampus of the model rats.Proteomic analysis demonstrated upregulation of mitochondrial precursor protein and downregulation of keratin type II cytoskeletal6A after GC treatment compared with model rats that had received saline.Western blot assay confirmed these findings.Our results suggest that the neuroprotective effect of GC in vascular dementia occurs via the promotion of neuronal cytoskeleton regeneration.展开更多
AIM: To investigate the roles of nuclear factor(NF)-κB and angiotensin Ⅱ receptor type 1(AT1R) in the pathogenesis of non-alcoholic fatty liver disease(NAFLD).METHODS: Forty-two healthy adult male SpragueDawley rats...AIM: To investigate the roles of nuclear factor(NF)-κB and angiotensin Ⅱ receptor type 1(AT1R) in the pathogenesis of non-alcoholic fatty liver disease(NAFLD).METHODS: Forty-two healthy adult male SpragueDawley rats were randomly divided into three groups:the control group(normal diet), the model group,and the intervention group(10 wk of a high-fat diet feeding, followed by an intraperitoneal injection of PDTC); 6 rats in each group were sacrificed at 6, 10,and 14 wk. After sacrifice, liver tissue was taken,paraffin sections of liver tissue specimens were prepared, hematoxylin and eosin(HE) staining was performed, and pathological changes in liver tissue(i.e., liver fibrosis) were observed by light microscopy.NF-κB expression in liver tissue was detected by immunohistochemistry, and the expression of AT1 R in the liver tissue was detected by reverse transcriptionpolymerase chain reaction(RT-PCR). The data are expressed as mean ± SD. A two-sample t test was used to compare the control group and the model group at different time points, paired t tests were used to compare the differences between the intervention group and the model group, and analysis of variance was used to compare the model group with the control group. Homogeneity of variance was analyzed with single factor analysis of variance. H variance analysis was used to compare the variance. P < 0.05 wasconsidered statistically significant.RESULTS: The NAFLD model was successful after 6wk and 10 wk. Liver fibrosis was found in four rats in the model group, but in only one rat in the intervention group at 14 wk. Liver steatosis, inflammation, and fibrosis were gradually increased throughout the model. In the intervention group, the body mass,rat liver index, serum lipid, and transaminase levels were not increased compared to the model group.In the model group, the degree of liver steatosis was increased at 6, 10, and 14 wk, and was significantly higher than in the control group(P < 0.01). In the model group, different degrees of liver cell necrosis were visible and small leaves, punctated inflammation,focal necrosis, and obvious ballooning degeneration were observed. Partial necrosis and confluent necrosis were observed. In the model group, liver inflammatory activity scores at 6, 10, and 14 wk were higher than in the control group(P < 0.01). Active inflammation in liver tissue in the intervention group was lower than in the model group(P < 0.05). HE staining showed liver fibrosis only at 14 wk in 4/6 rats in the model group and in 1/6 rats in the intervention group. NF-κB positive cells were stained yellow or ensemble yellow,and NF-κB was localized in the cytoplasm and/or nucleus. The model group showed NF-κB activation at6, 10, and 14 wk in liver cells; at the same time points,there were statistically significant differences in the control group(P < 0.01). Over time, NF-κB expression increased; this was statistically lower(P < 0.05) at14 weeks in the intervention group compared to the model group, but significantly increased(P < 0.05)compared with the control group; RT-PCR showed that AT1 R mRNA expression increased gradually in the model group; at 14 wk, the expression was significantly different compared with expression at 10 weeks as well as at 6 weeks(P < 0.05). In the model group, AT1 R mRNA expression was significantly higher than at the same time point in the control group(P <0.01).CONCLUSION: With increasing severity of NAFLD,NF-κB activity is enhanced, and the inhibition of NF-κB activity may reduce AT1 R mRNA expression in NAFLD.展开更多
AIM To evaluate whether a high risk macroscopic appearance(Type Ⅳ and giant Type Ⅲ) is associated with a dismal prognosis after curative surgery, because its prognostic relevance remains elusive in pathological sta...AIM To evaluate whether a high risk macroscopic appearance(Type Ⅳ and giant Type Ⅲ) is associated with a dismal prognosis after curative surgery, because its prognostic relevance remains elusive in pathological stage Ⅱ/Ⅲ(p Stage Ⅱ/Ⅲ) gastric cancer.METHODS One hundred and seventy-two advanced gastric cancer(defined as pT2 or beyond) patients with p Stage Ⅱ/Ⅲ who underwent curative surgery plus adjuvant S1 chemotherapy were evaluated, and the prognostic relevance of a high-risk macroscopic appearance was examined. RESULTS Advanced gastric cancers with a high-risk macroscopic appearance were retrospectively identified by preoperative recorded images. A high-risk macroscopic appearance showed a significantly worse relapse free survival(RFS)(35.7%) and overall survival(OS)(34%) than an average risk appearance(P = 0.0003 and P < 0.0001, respectively). A high-risk macroscopic appearance was significantly associated with the 13^(th) Japanese Gastric Cancer Association(JGCA) pT(P = 0.01), but not with the 13^(th) JGCA pN. On univariate analysis for RFS and OS, prognostic factors included 13^(th) JGCA p Stage(P < 0.0001)and other clinicopathological factors including macroscopic appearance. A multivariate Cox proportional hazards model for univariate prognostic factors identified highrisk macroscopic appearance(P = 0.036, HR = 2.29 for RFS and P = 0.021, HR = 2.74 for OS) as an independent prognostic indicator. CONCLUSION A high-risk macroscopic appearance was associated with a poor prognosis, and it could be a prognostic factor independent of 13^(th) JGCA stage in p Stage Ⅱ/Ⅲ advanced gastric cancer.展开更多
As energy crisis and environment pollution all around the world threaten the widespread use of fossil fuels,compressed natural gas(CNG)vehicles are explored as an alternative to the conventional gasoline powered vehic...As energy crisis and environment pollution all around the world threaten the widespread use of fossil fuels,compressed natural gas(CNG)vehicles are explored as an alternative to the conventional gasoline powered vehicles.Because of the limited space available for the car,the composite pressure vessel(TypeⅡ)has been applied to the CNG vehicles to reach large capacity and weight lightening vehicles.High pressure vessel(TypeⅡ)is composed of a composite layer and a metal liner.The metal liner is formed by the deep drawing and ironing(D.D.I.)process,which is a complex process of deep drawing and ironing.The cylinder part is reinforced by composite layer wrapped through the filament winding process and is bonded to the liner by the curing process.In this study,an integrated design method was presented by establishing the techniques for FE analysis of entire processes(D.D.I.,filament winding and curing processes)to manufacture the CNG composite pressure vessel(TypeⅡ).Dimensions of the dies and the punches of the 1 st(cup drawing),2 nd(redrawing-ironing 1-ironing 2)and 3 rd(redrawing-ironing)stages were calculated theoretically,and shape of tractrix die to be satisfied with the minimum forming load was suggested for life improvement and manufacturing costs in the D.D.I.process.Thickness of the composite material was determined in the filament winding process,finally,conditions of the curing process(number of heating stage,curing temperature,heating rate and time)were proposed to reinforce adhesive strength between the composite layers.展开更多
文摘TypeⅡdiabetes mellitus(T2DM)has experienced a dramatic increase globally across countries of various income levels over the past three decades.The persistent prevalence of T2DM is attributed to a complex interplay of genetic and environmental factors.While numerous pharmaceutical therapies have been developed,there remains an urgent need for innovative treatment approaches that offer effectiveness without significant adverse effects.In this context,the exploration of the gut microbiome presents a promising avenue.Research has increasingly shown that the gut microbiome of individuals with T2DM exhibits distinct differences compared to healthy individuals,suggesting its potential role in the disease’s pathogenesis and progression.This emerging field offers diverse applications,particularly in modifying the gut environment through the administration of prebiotics,probiotics,and fecal microbiome transfer.These interventions aim to restore a healthy microbiome balance,which could potentially alleviate or even reverse the metabolic dysfunctions associated with T2DM.Although current results from clinical trials have not yet shown dramatic effects on diabetes management,the groundwork has been laid for deeper investigation.Ongoing and future clinical trials are critical to advancing our understanding of the microbiome’s impact on diabetes.By further elucidating the mechanisms through which microbiome alterations influence insulin resistance and glucose metabolism,researchers can develop more targeted interventions.The potential to harness the gut microbiome in developing new therapeutic strategies offers a compelling prospect to transform the treatment landscape of T2DM,potentially reducing the disease’s burden significantly with approaches that are less reliant on traditional pharmaceuticals and more focused on holistic,systemic health improvements.
文摘Diabetes mellitus is associated with foot ulcers,which frequently pave the way to lower-extremity amputation.Neuropathy,trauma,deformity,high plantar pressures,and peripheral vascular disease are the most common underlying causes.Around 15%of diabetic patients are affected by diabetic foot ulcer in their lifetime.64 million people are affected by diabetics in India and 40000 amputations are done every year.Foot ulcers are evaluated and classified in a systematic and thorough manner to assist in determining the best course of therapy.This paper proposes a novel model which predicts the threat of diabetic foot ulcer using independent agents for various input values and a combination of fuzzy expert systems.The proposed model uses a classification system to distinguish between each fuzzy framework and its parameters.Based on the severity levels necessary prevention,treatment,and medication are recommended.Combining the results of all the fuzzy frameworks derived from its constituent parameters,a risk-specific medication is recommended.The work also has higher accuracy when compared to other related models.
文摘Based on the observation data of meteorological stations,Doppler radar observation data of Ulanqab City,and ERA-5 reanalysis data,a snowstorm process in Ulanqab City from March 17 to 18,2022 was analyzed.The results show that this was a type Ⅱ snowstorm process generated under the joint influence of upper trough and ground low inverted trough and frontal cyclone.The main period of snowfall can be divided into two time stages,and the total snowfall was more in the south and less in the north,which was consistent with that of average specific humidity field.Water vapor conditions provided by strong water vapor transport and convergence,strong upward movement shown by large vertical velocity field,and the suction action of high-and low-layer divergence and convergence were the reasons for the hourly heavy snowfall on the 18^(th).During the process,radar echoes were mainly sheet-shaped,and composite reflectivity was 15-25 dBZ in most areas.The zero speed line in the first period was positively"S"-shaped,and there was warm advection and southwest wind.On the morning of the 18^(th),after the cold front transited the city,Ulanqab City was gradually controlled by northwest wind,and the snow tended to end.
文摘针对逐步Ⅱ型删失数据下Burr Type X分布的参数估计问题,提出模型参数的一种新的贝叶斯估计及相应的最大后验密度(HPD)置信区间.假设伽玛分布为待估参数的先验分布,考虑待估参数的条件后验分布未知、单峰且近似对称,选取以正态分布为提议分布的Metropolis-Hastings(MH)算法生成后验样本,基于后验样本在平方误差损失函数下得到待估参数的贝叶斯估计和HPD置信区间.将基于MH算法得到的贝叶斯估计和HPD置信区间与基于EM算法得到的极大似然估计和置信区间在均方误差准则和精度意义下进行比较.Monte-Carlo模拟结果表明,基于MH算法得到的估计在均方误差准则下优于基于EM算法得到的极大似然估计,基于MH算法得到的HPD置信区间长度小于基于EM算法得到的置信区间长度.
文摘目的研究TGF-1β、BM P-2和typeⅡco llagen在退行性腰椎滑脱(degenerative lum bar spondy lo listhes is,DLS)和腰椎间盘突出症(lum bar d isc hern iation,LDH)黄韧带中的表达及其意义。方法37例手术切除的腰椎椎板间部黄韧带标本分为3组,第1组为退行性腰椎滑脱组(DLS)10例;第2组为腰椎间盘突出症组(LDH)17例,第3组为正常对照组10例,其中7例取自腰椎骨折手术病人,3例取自意外死亡者。应用EnV is ion二步免疫组化的方法检测其TGF-1β、BM P-2和typeⅡco llagen的表达情况,普通光镜观察,计算出各标本的表达阳性率和表达强度,数据以x-±s标准差及表达强度表示,结果分别用Spss统计软件和R id it进行分析。结果TGF-1β、BM P-2和typeⅡco llagen的阳性表达产物见于成纤维细胞、成软骨细胞和软骨细胞中,而Ⅱ型胶原染色还可同时见于基质。TGF-1β、BM P-2和typeⅡco llagen在DLS组中的表达明显高于LDH组和正常组(P<0.01或P<0.05),Ⅱ型胶原基质染色明显深于LDH组和对照组。LDH组的TGF-1β和typeⅡco llagen的表达阳性率和表达强度与正常组之间差异无显著性(P>0.05),而BM P-2的表达阳性率和表达强度在LDH组与正常组之间具有统计学意义(P<0.01)。结论黄韧带所受到的异常机械牵张力可以增加TGF-1β在黄韧带细胞中的合成,而TGF-1β则促进退行性腰椎滑脱黄韧带中的Ⅱ型胶原合成,导致黄韧带的退变和肥厚。BM P-2在退变黄韧带中的表达异常增高,可能与黄韧带的软骨化倾向有关。
基金supported by the National Natural Science Foundation of China,No.30960520the Natural Science Foundation of Inner Mongolia Autonomous Region of China,No.2016MS0837
文摘Glycosides of Cistanche（GC）is a preparation used extensively for its neuroprotective effect against neurological diseases,but its mechanisms of action remains incompletely understood.Here,we established a bilateral common carotid artery occlusion model of vascular dementia in rats and injected the model rats with a suspension of GC（10 mg/kg/day,intraperitoneally）for 14 consecutive days.Immunohistochemistry showed that GC significantly reduced p-tau and amyloid beta（Aβ）immunoreactivity in the hippocampus of the model rats.Proteomic analysis demonstrated upregulation of mitochondrial precursor protein and downregulation of keratin type II cytoskeletal6A after GC treatment compared with model rats that had received saline.Western blot assay confirmed these findings.Our results suggest that the neuroprotective effect of GC in vascular dementia occurs via the promotion of neuronal cytoskeleton regeneration.
基金Supported by grants from the Science and Technology Department of Sichuan Province,No.2011SZ0094
文摘AIM: To investigate the roles of nuclear factor(NF)-κB and angiotensin Ⅱ receptor type 1(AT1R) in the pathogenesis of non-alcoholic fatty liver disease(NAFLD).METHODS: Forty-two healthy adult male SpragueDawley rats were randomly divided into three groups:the control group(normal diet), the model group,and the intervention group(10 wk of a high-fat diet feeding, followed by an intraperitoneal injection of PDTC); 6 rats in each group were sacrificed at 6, 10,and 14 wk. After sacrifice, liver tissue was taken,paraffin sections of liver tissue specimens were prepared, hematoxylin and eosin(HE) staining was performed, and pathological changes in liver tissue(i.e., liver fibrosis) were observed by light microscopy.NF-κB expression in liver tissue was detected by immunohistochemistry, and the expression of AT1 R in the liver tissue was detected by reverse transcriptionpolymerase chain reaction(RT-PCR). The data are expressed as mean ± SD. A two-sample t test was used to compare the control group and the model group at different time points, paired t tests were used to compare the differences between the intervention group and the model group, and analysis of variance was used to compare the model group with the control group. Homogeneity of variance was analyzed with single factor analysis of variance. H variance analysis was used to compare the variance. P < 0.05 wasconsidered statistically significant.RESULTS: The NAFLD model was successful after 6wk and 10 wk. Liver fibrosis was found in four rats in the model group, but in only one rat in the intervention group at 14 wk. Liver steatosis, inflammation, and fibrosis were gradually increased throughout the model. In the intervention group, the body mass,rat liver index, serum lipid, and transaminase levels were not increased compared to the model group.In the model group, the degree of liver steatosis was increased at 6, 10, and 14 wk, and was significantly higher than in the control group(P < 0.01). In the model group, different degrees of liver cell necrosis were visible and small leaves, punctated inflammation,focal necrosis, and obvious ballooning degeneration were observed. Partial necrosis and confluent necrosis were observed. In the model group, liver inflammatory activity scores at 6, 10, and 14 wk were higher than in the control group(P < 0.01). Active inflammation in liver tissue in the intervention group was lower than in the model group(P < 0.05). HE staining showed liver fibrosis only at 14 wk in 4/6 rats in the model group and in 1/6 rats in the intervention group. NF-κB positive cells were stained yellow or ensemble yellow,and NF-κB was localized in the cytoplasm and/or nucleus. The model group showed NF-κB activation at6, 10, and 14 wk in liver cells; at the same time points,there were statistically significant differences in the control group(P < 0.01). Over time, NF-κB expression increased; this was statistically lower(P < 0.05) at14 weeks in the intervention group compared to the model group, but significantly increased(P < 0.05)compared with the control group; RT-PCR showed that AT1 R mRNA expression increased gradually in the model group; at 14 wk, the expression was significantly different compared with expression at 10 weeks as well as at 6 weeks(P < 0.05). In the model group, AT1 R mRNA expression was significantly higher than at the same time point in the control group(P <0.01).CONCLUSION: With increasing severity of NAFLD,NF-κB activity is enhanced, and the inhibition of NF-κB activity may reduce AT1 R mRNA expression in NAFLD.
文摘AIM To evaluate whether a high risk macroscopic appearance(Type Ⅳ and giant Type Ⅲ) is associated with a dismal prognosis after curative surgery, because its prognostic relevance remains elusive in pathological stage Ⅱ/Ⅲ(p Stage Ⅱ/Ⅲ) gastric cancer.METHODS One hundred and seventy-two advanced gastric cancer(defined as pT2 or beyond) patients with p Stage Ⅱ/Ⅲ who underwent curative surgery plus adjuvant S1 chemotherapy were evaluated, and the prognostic relevance of a high-risk macroscopic appearance was examined. RESULTS Advanced gastric cancers with a high-risk macroscopic appearance were retrospectively identified by preoperative recorded images. A high-risk macroscopic appearance showed a significantly worse relapse free survival(RFS)(35.7%) and overall survival(OS)(34%) than an average risk appearance(P = 0.0003 and P < 0.0001, respectively). A high-risk macroscopic appearance was significantly associated with the 13^(th) Japanese Gastric Cancer Association(JGCA) pT(P = 0.01), but not with the 13^(th) JGCA pN. On univariate analysis for RFS and OS, prognostic factors included 13^(th) JGCA p Stage(P < 0.0001)and other clinicopathological factors including macroscopic appearance. A multivariate Cox proportional hazards model for univariate prognostic factors identified highrisk macroscopic appearance(P = 0.036, HR = 2.29 for RFS and P = 0.021, HR = 2.74 for OS) as an independent prognostic indicator. CONCLUSION A high-risk macroscopic appearance was associated with a poor prognosis, and it could be a prognostic factor independent of 13^(th) JGCA stage in p Stage Ⅱ/Ⅲ advanced gastric cancer.
基金Supported by National Research Foundation of Korea(NRF)Korea Government(MSIT)(Grant No.2019R1F1A1058521)
文摘As energy crisis and environment pollution all around the world threaten the widespread use of fossil fuels,compressed natural gas(CNG)vehicles are explored as an alternative to the conventional gasoline powered vehicles.Because of the limited space available for the car,the composite pressure vessel(TypeⅡ)has been applied to the CNG vehicles to reach large capacity and weight lightening vehicles.High pressure vessel(TypeⅡ)is composed of a composite layer and a metal liner.The metal liner is formed by the deep drawing and ironing(D.D.I.)process,which is a complex process of deep drawing and ironing.The cylinder part is reinforced by composite layer wrapped through the filament winding process and is bonded to the liner by the curing process.In this study,an integrated design method was presented by establishing the techniques for FE analysis of entire processes(D.D.I.,filament winding and curing processes)to manufacture the CNG composite pressure vessel(TypeⅡ).Dimensions of the dies and the punches of the 1 st(cup drawing),2 nd(redrawing-ironing 1-ironing 2)and 3 rd(redrawing-ironing)stages were calculated theoretically,and shape of tractrix die to be satisfied with the minimum forming load was suggested for life improvement and manufacturing costs in the D.D.I.process.Thickness of the composite material was determined in the filament winding process,finally,conditions of the curing process(number of heating stage,curing temperature,heating rate and time)were proposed to reinforce adhesive strength between the composite layers.
