Adaptability of bipedicled scalp advancement flap for coverage of huge scalp defects after tumor resection

Background:Several reconstructive techniques have been used to reconstruct scalp defects.Numerous researchers have studied the utilization of bipedicled scalp advancement flaps for scalp defect coverage.In this study,we will assess the adaptability of a bipedicled scalp advancement flap for coverage of huge scalp defects after tumor resection.Methods:This study was performed at the Plastic Surgery Department,Fayoum University Hospital,on 20 patients with huge scalp tumors treated by adequate excision and reconstructed using a bipedicled scalp advancement flap from December 2021 to July 2023.Results:The study was conducted on 20 patients:16(80%)were men and 4(20%)were women presenting with large scalp tumors.The mean age was 57.4 years(33-68 years).The sites of the tumors were 10(50%)occipital,6(30%)parietal,and 4(20%)parieto-occipital.No major complications occurred postoperatively,and the bipedicled flaps survived well in all cases,with no necrosis.Conclusion:Huge scalp defects after tumor resection can be safely reconstructed with a large versatile bipedicled advancement scalp flap,either transversely or longitudinally oriented,with favorable functional results and accepted aesthetic results,apart from the alopecic area over the grafted donor site,which can be treated by tissue expansion if desired later.

Singing Star's School Hugely Popular Across China

AFTER winning an award at the Third National Singers’ Contest sponsored by China Central Television in 1988, Hang Tianqi gained star status in China. Hang’s attempts at writing lyrics and composing songs is not news but the September 1993 opening of the Tianqi Art School on the compound of the Air Force Political Department’s Drama Troupe has given Hang a new chance to display her talents. Today, the first art school in China to be named after a contemporary singing star has become well known across the country. Huge ad campaigns have helped to spread the word about the school, but Hang’s name did much to enhance it’s fame. Within a year, nearly 20,000 people have enrolled in the school’s correspondence courses. The students are located all

Survey of lightweighting methods of huge 3D models for online Web3D visualization

Background With the rapid development of Web3D technologies, the online Web3D visualization, particularly for complex models or scenes, has been in a great demand. Owing to the major conflict between the Web3D system load and resource consumption in the processing of these huge models, the huge 3D model lightweighting methods for online Web3D visualization are reviewed in this paper. Methods By observing the geometry redundancy introduced by man-made operations in the modeling procedure, several categories of light-weighting related work that aim at reducing the amount of data and resource consumption are elaborated for Web3D visualization. Results By comparing perspectives, the characteristics of each method are summarized, and among the reviewed methods, the geometric redundancy removal that achieves the lightweight goal by detecting and removing the repeated components is an appropriate method for current online Web3D visualization. Meanwhile, the learning algorithm, still in improvement period at present, is our expected future research topic. Conclusions Various aspects should be considered in an efficient lightweight method for online Web3D visualization, such as characteristics of original data, combination or extension of existing methods, scheduling strategy, cache man-agement, and rendering mechanism. Meanwhile, innovation methods, particularly the learning algorithm, are worth exploring.

Huge Bartholin’s cyst managed by primary marsupialization:A case report

BACKGROUND We report on the case of a 21-year-old female who could not walk due to a huge Bartholin's cyst occupying the right vulvar region.The patient was treated by marsupialization of the Bartholin’s cyst and postoperative antibiotic therapy.CASE SUMMARY A 21-year-old female without a medical history of sexually transmitted diseases presented to our outpatient clinic with complaints of a painful vulvar lump and a green-yellowish discharge for 4 d.A large Bartholin’s cyst,10 cm in diameter,was suspected over the right side of the vulva.She was advised to be admitted to the ward for intravenous antibiotic treatment and to perform marsupialization several days later.However,the patient requested immediate surgery because of time limitations.The patient underwent marsupialization under local anesthesia.The procedure was well-tolerated.After making the incision,a significant amount of malodorous pus(approximately 30 mL)was removed from the abscess.The patient was followed up for 1 wk postoperatively.The Bartholin’s cyst regressed,and the surgical wound healed well.CONCLUSION Our case shows that an initial marsupialization followed by oral antibiotic therapy can be an appropriate treatment option for a large Bartholin’s cyst.However,depending on the patient’s condition,a suitable treatment,either cystectomy or marsupialization,can be considered.

Long-term rare giant sialolithiasis for 30 years:A case report and review of literature

BACKGROUND Sialolithiasis is one of the most common salivary gland disorders,most commonly affecting the submandibular gland.Submandibular sialolithiasis can be treated using non-invasive conservative measures and invasive treatments.Treatment selection was based on the ductal system anatomy and the size and location of the stones.This study aimed to review the updates on sialolithiasis treatment and compare the different management strategies of the variables.CASE SUMMARY This report presents a case of a long-term,rare,and giant sialolithiasis within the submandibular gland parenchyma for 30 years in an older adult.Our patient presented with painless right submandibular swelling.Computed tomography revealed a calcified mass measuring 35 mm×20 mm within the right submandibular gland.In this case,the infection and fibrosis of the affected gland and size of the stone did not provide us with other alternatives except for the excision of the involved gland.Thus,right submandibular sialoadenectomy was performed via the transcervical approach.After the surgery,the patient recovered without any complaints,side effects,or complications.CONCLUSION Tailored management is important for preserving gland function,maintaining low risk,and reducing patient discomfort.

Hepatectomy for huge hepatocellular carcinoma in 634 cases

AIM： To clarify the safety and feasibility of hepatectomy for huge hepatocellular carcinoma （HCC）. METHODS： A total of 4765 patients with HCC operated at Tongji Hospital were retrospectively studied, of them, 780 patients had huge HCC （10 cm or more in diameter）. Hepatectomy was carried out on 634 patients （81.2%）. The majority of the liver resection were major resections, and combined resection of the adjacent organs or structures was common （17.2%）. The liver resection was combined with portal vein thrombectomy in 139 patients （21.9%）. RESULTS： Postoperative complications were common （26.8%） and required another laparotomy to prevent the complications in 5 patients （0.8%）. The 30-d mortality was 2.2%. The main causes of postoperative deaths were liver failure （n = 9）, postoperative bleeding （n = 4） and septic complication （n = 1）. The 3-, 5- and 10-year survival rates after liver resection were 35.1%, 18.2% and 3.5%, respectively. CONCLUSION： Hepatectomy for huge HCC is safe and effective. It should be used to treat patients with low surgical risks and resectable tumours.

Positron emission tomography/computer tomography in guidance of extrahepatic hepatocellular carcinoma metastasis management

Hepatocellular carcinoma （HCC） is one of the most common primary cancers in the world. Surgery is the gold standard for treatment of patients with HCC. Recurrence and metastasis are the major obstacles to further improve the prognosis of HCC. Most recurrences are intrahepatic. However, 30% of the recurrences are extrahepatic. The role of resection in intrahepatic recurrences is widely accepted. The role of resection in extrahepatic HCC recurrence and metastasis is not well established. 18F fluorodeoxyglucose （18F-FDG） positron emission tomography/computer tomography （PET/CT） is useful in detecting distant metastasis from a variety of malignancies and shows superior accuracy to conventional imaging modalities in identification of intrahepatic and extrahepatic metastasis. We present one patient with one new isolated omental lymph node metastasis, who had a history of huge HCC resected six years ago. The metastatic focus was identified with 18 F-FDG PET/CT and resected. The follow-up revealed good prognosis with a long-term survival potential after resection of the omental lymphatic metastasis.

Novel Discrete Particle Swarm Optimization Based on Huge Value Penalty for Solving Engineering Problem

For the purpose of solving the engineering constrained discrete optimization problem, a novel discrete particle swarm optimization（DPSO） is proposed. The proposed novel DPSO is based on the idea of normal particle swarm optimization（PSO）, but deals with the variables as discrete type, the discrete optimum solution is found through updating the location of discrete variable. To avoid long calculation time and improve the efficiency of algorithm, scheme of constraint level and huge value penalty are proposed to deal with the constraints, the stratagem of reproducing the new particles and best keeping model of particle are employed to increase the diversity of particles. The validity of the proposed DPSO is examined by benchmark numerical examples, the results show that the novel DPSO has great advantages over current algorithm. The optimum designs of the 100-1 500 mm bellows under 0.25 MPa are fulfilled by DPSO. Comparing the optimization results with the bellows in-service, optimization results by discrete penalty particle swarm optimization（DPPSO） and theory solution, the comparison result shows that the global discrete optima of bellows are obtained by proposed DPSO, and confirms that the proposed novel DPSO and schemes can be used to solve the engineering constrained discrete problem successfully.

Laparoscopic hysterectomy as optimal approach for 5400 grams uterus with associated polycythemia: A case report

BACKGROUND Uterine myomas are the most common benign gynecological soft tissue tumors in women but polycythemia associated with these tumors is rare.Polycythemia is significantly associated with risk of venous thromboembolism(VTE),which is further increased in case of a large pelvic mass and obesity.Here we report the surgical challenges in the case of an obese patient with a giant fibromatous uterus and associated polycythemia.CASE SUMMARY A 42-year-old obese woman was referred to our department for treatment for a huge fibromatous uterus.She suffered of pelvic pressure and abdominal distension and reported severe dyspnea from several months.Laboratory analyses including hemoglobin(Hb)19.2 g/dL and hematocrit(Hct)59.7%were indicative of polycythemia.Arterial blood gas analysis showed arterial oxygen pressure(pO2)of 81.5 mmHg.Abdominal computed tomography confirmed a giant fibromatous uterus measuring 28.2 cm×17 cm×25 cm.To reduce the thromboembolic risk,the patient underwent low molecular weight heparin,phlebotomy twice before surgery,and we opted for a laparoscopic hysterectomy.The uterus weighed 5400 g and the histology confirmed a diagnosis of leiomyoma.We did not find increased erythropoietin levels in the supernatant of the myomatous uterine tissue.There were no complications.On postoperative day 1,the Hb and the Hct levels normalized to 13.3 g/dL and 41.7%,respectively.Arterial blood gas analysis after surgery showed a pO2 of 144.7 mmHg.These results suggested the diagnosis of myomatous erythrocytosis syndrome.The patient was discharged on the second postoperative day in very good condition with no symptoms.CONCLUSION We believe this is the first reported laparoscopic hysterectomy in a patient with a giant uterus,polycythemia and obesity.Multiple VTE risk factors warranted a laparoscopic approach.

解决计算机内存不足方法探讨

论述了处理大型数据时内存不足的几种主要方法 ,尽可能空闲基本内存 ;利用覆盖技术、虚拟存储技术、编译程序、huge指针等 ,并且分析了几种方法的使用范围和特点。

Splenic lymphoma with massive splenomegaly: Case report with review of literature

As per strict criteria of Das Gupta et al, primary splenic lymphoma is very rare. Herein, we are reporting an unusual case of primary large cell splenic lymphoma of B lineage in a middle aged female presenting with massive splenomegaly(3.8 kg) and hypersplenism. After performing therapeutic splenectomy for hypersplenism, a precise diagnosis of diffuse large B cell lymphoma was made on histopathology and confirmed by immunohistochemistry. The patient responded well to standard(Cyclophosphamide, Hydroxydaunorubicin, Oncovin(vincristine), Prednisone or prednisolone) regimen last year and is now in full remission. The splenectomy thereby has prevented the potential grave complications related to hypersplenism and splenic rupture. Our aim behind highlighting the topic is to specify that emergency splenectomy followed by anticoagulation therapy is an effective plan of management to prevent untoward complications related to disease and treatment.

Huge thick conglomerate movement induced by full thick longwall mining huge thick coal seam

A discrete elemental method was used to study the thickness of conglomerate layer in a full thick seam mining activities under the influence of the law, pointing out the thickness of the conglomerate at different seam mining, and during the destruction and instability of existing state of laws. At 21141 thick seam mining, the face toward the direction of separation between the thick layer of conglomerate rock and the next bit after reaching its maximum capacity due to pull from the bottom of the plastic zone, formed a stratified and hierarchical down collapse. The shape of caving area is a ''triangular block'', the length of the plastic zone and face advancement from the linear fit between the height of the plastic zone and the advancing face is a quadratic function of distance, while the top layer of thick gravel layer is the overall bending subsidence trend. Tilting the direction of the face, a thick gob of collapsed conglomerate layer is formed in the coal gob entity on both sides of the thick conglomerate at the top of the overall fracture morphology performance, thus forming a mutual extrusion of articulated block structure. The instability, separation and balance of the thick conglomerate layer in the hinged block stope stress leads to abnormal occurrence of rock burst induced by face as the major factor in the accident. This research reveals the form of stress distribution in the destroyed layer of the thick conglomerate rock, analyzes the stope law of coupling for the pressure burst behavior law for the mining work face, and the choice of preventive measures to provide a theoretical basis and implementation.

Studies on marine dynamic disasters

Marine dynamic disasters,including storm surges,huge waves,and sea ice,are the most harmful natural disasters aff ecting coastal countries in the world.Under the infl uence of global climate change,the mechanisms,frequencies,and damage severity of marine dynamic disasters are exhibiting new characteristics.The enormity,unpredictability,and chain eff ects of these disasters have become increasingly prominent,and the losses endured by coastal countries around the world have been increasing year by year.Therefore,the prediction of,risk assessment for,and emergency response to marine dynamic disasters are important issues for disaster prevention and mitigation worldwide.

Huge primary dedifferentiated pancreatic liposarcoma mimicking carcinosarcoma in a young female: A case report

BACKGROUND Pancreatic liposarcoma is a rare tumor. According to a literature review, the patient described in this study is the seventh case of pancreatic liposarcoma reported in the English literature and the third case of dedifferentiated liposarcoma. Furthermore, this case had the largest primary tumor volume, and a primary pancreatic liposarcoma was diagnosed based on sufficient evidence. CASE SUMMARY We here report a rare case of a 28-year-old female with a huge dedifferentiated liposarcoma in the pancreatic tail. In June 2015, the patient underwent distal pancreatectomy with splenectomy. During the operation, a huge liposarcoma of approximately 28.0 cm × 19.0 cm × 8.0 cm was found, which had a yellow and white fish-like incisal surface. Based on both pathology and MDM2 gene amplification, the tumor was diagnosed as a dedifferentiated liposarcoma. The patient was treated with surgery but declined postoperative chemotherapy. She was well at the 26-mo follow-up, and no relapse was observed. CONCLUSION Pancreatic liposarcoma has a low incidence. Chemotherapy should be included in the treatment regimens. Complete resection is the only effective treatment.

Thoracoscopic resection of a huge esophageal dedifferentiated liposarcoma: A case report

BACKGROUND Esophageal liposarcoma is a rare malignant tumor and an esophageal dedifferentiated liposarcoma(DDL)is extremely rare.There are no reports on the treatment of DDL by thoracoscopic surgery.CASE SUMMARY A 38-year-old woman presented with dysphagia and dyspnea.Imaging examination showed a large mass in the posterior mediastinum.The patient also developed respiratory failure and it was unclear whether this was caused by a mass from inside or outside the esophagus.We decided to perform thoracoscopic exploration to relieve the obstruction caused by tracheal compression.The upper segment of the esophagus was split longitudinally,and most of the mass could be removed from the esophageal lumen to the thoracic cavity.The pedicle was excised by linear cutting closers under mirrors.Little residual mass was visualized by gastroscopy.The mucous and muscular layers were closed by interrupted sutures.Pathological examination showed that the mass was a DDL.The patient did not have any dysphagia or dyspnea 2 wk postoperatively and refused any further treatment.Computed tomography and esophagoscopy did not find any recurrence at up to 20 mo postoperatively.CONCLUSION Thoracoscopy can be used to treat large esophageal masses.

在Windows环境下如何避开huge指针传递的雷区

直接使用ｈｕｇｅ指针来进行子程序参数传递是相当危险的，本文提出一个在Ｗｉｎｄｏｗｓ环境下使用句柄代替ｈｕｇｅ指针进行传递的新方法，从而避开了这个“雷区”。

Electromagnetic Emissions Recorded by a Borehole TOA Installment before Four Huge Destructive <i>M</i>_S≥ 8.0 Earthquakes in Asia

In this paper, electromagnetic emissions recorded by a borehole TOA installment with three observing channels of CH1 (0.01 - 0.1 Hz), CH2 (0.1 - 1.0 Hz) and CH3 (1 - 9 kHz) before four large earthquakes with magnitudes more than 8.0 have been depicted. These abnormities present different fluctuating processes from one another. For the Wenchuan MS 8.0 earthquake on 12 May 2008, the nearest one among these four events and only 660 km from the TOA station, electromagnetic information appeared at least 5 months ago in two low frequency bands of CH1 and CH2 and it was subjected to an obvious fluctuating process with several developing stages: initial information, intensive anomaly and large amplitude signals. The typical pulse-like emissions in CH2 happened group by group with large various magnitudes, which can be of 10 mV in the climax period. While during this period, compatible wave-like information with little magnitudes also happened in CH1 channel and a few pulses in CH3. Anomalous emissions occurred about 4 months prior to the 25 April 2015 Nepal MS 8.1 event, 1560 km away from the TOA station. The abnormal information in CH2 also appeared group by group but with small various magnitudes, more than 2 mV during their climax. This process is also effective for the Sumatra MS 8.9 earthquake on 26 December 2004, 2500 km from the borehole TOA, only with a different duration of 2 months and less magnitudes of 0.1 mV in CH1 and 1 mV in CH2 in this case. However, there is no obvious fluctuation and only small constant amplitude signals being ~0.15 mV appeared during 2 weeks before the Japan MS 9.0 earthquake on 11 March 2011. It is the farthest one among these four events and beyond 4000 km from the observing station. So, we can make a conclusion that there is a near relationship between the properties of the abnormities associated with these four earthquakes, such as amplitudes, duration and signal types, and the distances from TOA station: on one hand, the amplitude and duration decreases as the distance increases;on the other hand, there is an evolution for emission properties from complex various magnitude signals to single equal magnitude ones as the distance changes to be far. However, one common feature of the anomalous information related to these four events is that almost electromagnetic emissions were collected in two low frequency bands of CH2 and CH1 instead of CH3 band, which means ULF band (0.01 - 1.0 Hz) is more sensitive than VLF band (1 - 9 kHz) at this TOA station.

Safety and coping strategy for high dam under complex natural conditions

In respect to current situation and new challenges for high dam construction in China, safety problems are an- alyzed for high dam construction under complex natural conditions such as high elevation, cold area, high seismic inten- sity, large-seale landslide and high dam and huge reservoirs with dam types such as concrete surface rock-fill, asphalt concrete core, roller compacted concrete （RCC） arch dam and so on. From several aspects, including risk response measures for high dam, strengthening safety awareness for high dam design and construction, improving high dam con- struetion technique, intelligent dam safety management system based on IT, developing dam rehabilitation and mainte- nance technologies, useful dam safety and coping strategy is proposed.

Research on the Seismic-Geological Conditions for a Large Transformer Substation-A Case Study in the Shimian Region,Sichuan Province

A seismic-geological disaster can obviously affect an engineering site in three aspects:the first is ground faulting caused by the earthquake;the second is strong ground motion;the third is geological disasters such as landslides,mud-rock flows and liquefaction.Through the case study of selection of the huge transformer substation in the Shimian region of Sichuan Province,this paper proposes that the activity pattern and spatial distribution of faults near the site are crucial factors for evaluating the seismic-geological conditions for the location of huge transformer substations.

Simulation by Dislocation Model and Anomaly Property Determination of Huge Leveling Deformation at Linfen Seismic Station

In this study,under the assumption that the two huge leveling deformation anomalies at Linfen seismic station were caused by the Luoyunshan fault( Tumen-Yuli section)movement, we computed the vertical deformation field distribution based on the rectangular fault dislocation model and measured the ground deformation field of the study area using D-InS AR technology. The results are as follows:( 1) Theoretically,the ground vertical deformation field caused by fault movement could be within the elliptical deformation area with the long axis parallel to the fault strike. The largest deformation region is located in the center of the area in the hanging wall of the fault,and the deformation gradually decreases to zero toward the periphery; the impact range induced by the two deformations is respectively as follows: The long axes are about 18 km and26km,the short axes are about 12 km and 17 km and the obvious deformation amplitude is about 1- 3mm and 4- 14 mm.( 2) The measured deformation field by D-InS AR shows that there is no continuous deformation area consistent with the fault strike,and only the presence of land subsidence possibly caused by groundwater excessive exploitation,with the deformation amplitude about 10- 12 mm and 1- 5mm.( 3) The measured deformation field is not consistent with the theoretical result on deformation area and amplitude,which indicates that the fault movement is not the main cause of Linfen huge leveling deformation,but may rather be because of local deformation of the soil layers in the hanging wall of the fault.( 4) By combining the fault dislocation model simulation with the D-InS AR technology measurement,we can determine effectively the nature of the anomalyof the huge cross-fault leveling deformation,thus provide scientific basis for verification of significant leveling anomalies.