Asymptomatic low-grade appendiceal mucinous neoplasm:A case report

BACKGROUND Low-grade appendiceal neoplasms(LAMN)are characterized by low incidence and atypical clinical presentations,often leading to misdiagnosis as acute or chronic appendicitis before surgery.The primary diagnostic tool for LAMN is abdominal computed tomography(CT)imaging.Surgical resection remains the cornerstone of LAMN management,necessitating en bloc tumor excision to minimize the risk of iatrogenic rupture.Laparoscopy,known for its minimal invasiveness,reduced postoperative discomfort,and expedited recovery,is a safe and reliable approach for LAMN treatment.Despite the possibility of pseudomyxoma peritonei development,appendectomy and partial appendectomy generally result in negative tumor margins and favorable outcomes,which can be attributed to the disease’s slow growth and lower malignancy.CASE SUMMARY A 71-year-old male patient was admitted to our hospital with a pelvic spaceoccupying lesion detected 1 mo prior.Physical examination showed a soft abdomen without tenderness or rebound and no palpable masses.No shifting dullness was noted,and digital rectal examination revealed no palpable mass.Enteroscopy revealed a raised,smooth-surfaced mass measuring 3.0 cm in the cecum.Abdominal contrast-enhanced CT showed a markedly thickened and dilated appendix with visible cystic shadows.Laparoscopic surgery was performed and revealed a significantly dilated appendix,leading to laparoscopic resection of the appendix and part of the cecum.Post-surgical pathologic analysis confirmed LAMN.The patient received symptomatic and supportive post-operative care and was discharged on postoperative day 4 without complications such as abdominal bleeding,intestinal obstruction,or incision infection.No tumor recurrence was observed during a 7-mo follow-up period.CONCLUSION LAMN is a rare disease that lacks specific clinical manifestations.Abdominal CT plays a crucial role in diagnosing LAMN,and laparoscopic surgery is a safe and effective diagnostic and therapeutic approach.

Low-grade myofibrosarcoma of the maxillary sinus:Two case reports

BACKGROUND Low-grade myofibroblastic sarcoma(LGMS)is an extremely rare tumor characterized by the malignant proliferation of myofibroblasts.LGMS most commonly develops in adults,predominantly in males,in the head and neck region,oral cavity,especially on the tongue,mandible,and larynx.This article presents 2 cases of LGMS localized to the maxillary sinus and provides an overview of the available literature.CASE SUMMARY Two patients with LGMS located in the maxillary sinus underwent surgery at the Department of Head and Neck Surgery.Case 1:A 46-year-old patient was admitted to the clinic with suspected LGMS recurrence in the right maxillary sinus(rT4aN0M0),with symptoms of pain in the suborbital area,watering of the right eye,thick discharge from the right nostril,and augmented facial asymmetry.After open biopsy-confirmed LGMS,the patient underwent expanded maxillectomy of the right side with immediate palate reconstruction using a microvascular skin flap harvested surgically from the middle arm.The patient qualified for adjuvant radiotherapy for the postoperative bed,with an additional margin.Currently,the patient is under 1.5 years of observation with no evidence of disease.Case 2:A 45-year-old man was admitted to our clinic with facial asymmetry,strabismus,exophthalmos,and visual impairment in the right eye.Six months earlier,the patient had undergone partial jaw resection at another hospital for fibromatosis.A contrast-enhanced computed tomography scan revealed a tumor mass in the postoperative log after an earlier procedure.An open biopsy confirmed lowgrade fibrosarcoma(rT4aN0M0).The patient qualified for an extended total right maxillectomy with orbital excision and right hemimandibulectomy with immediate microvascular reconstruction using an anterolateral thigh flap.The patient subsequently underwent adjuvant radiotherapy to the postoperative area.After 9 months,recurrence occurred in the right mandibular arch below the irradiated area.The lesion infiltrated the base of the skull,which warranted the withdrawal of radiotherapy and salvage surgery.The patient qualified for palliative chemotherapy with a regimen of doxorubicin+dacarbazine+cyclophosphamide and palliative radiotherapy for bone metastases.The patient died 26 months after surgical treatment.The cases have been assessed and compared with cases in the literature.CONCLUSION No specific diagnostic criteria or treatment strategies have been developed for LGMS.The treatment used for LGMS is the same as that used for sinonasal cancer radical tumor excision;adjuvant radiotherapy or chemoradiotherapy should also be considered.They have low malignant potential but are highly invasive,tend to recur,and metastasize to distant sites.Patients should undergo regular follow-up examinations to detect recurrence or metastasis at an early stage.Patients should be treated and observed at the highest referral centers.

Application of NSR-AISC Method in Reserve Estimation and Technical Economic Evaluation of Low-Grade Polymetallic Deposits: Taking a Low-Grade Copper-Molybdenum Mine in Guangdong Province as an Example

The development and utilization of low-grade polymetallic deposits with strategic mineral resources is one of the important measures to alleviate the current high dependence on strategic mineral resources in China. However, domestic mining enterprises and most mining consulting and design institutes usually use general industrial indicators to carry out reserve estimation and technical and economic feasibility studies on low-grade polymetallic deposits, which cannot truly reflect the economic value of such deposits. The article expounds on the definitions of net return value (NSR) and on-site total maintenance cost (AISC) of common ore smelters in the evaluation of overseas mineral resources. Taking a low-grade polymetallic copper-molybdenum mine in Guangdong Province as an example, comparing the research results showed the NSR-AISC method and the general industrial index method in low-grade polymetallic deposit. There are huge differences in the results of reserve estimation;through the further introduction of Taylor’s formula and the research results on the relationship between investment intensity and production scale, a more reasonable mine life and investment scale are recommended, and a more in-depth comparative study has been carried out in the dimension of technical and economic indicators. Based on the comparative study of the above two methods in reserve estimation and the evaluation results of technical and economic indicators, the author believes that the NSR-AISC method can better reflect the true value of low-grade polymetallic ore projects, and should be popularized and applied in resource evaluation and development practice. This article further describes the application status of the NSR-AISC method for reserve estimation and the evaluation of technical economic indicators, and suggests the main points that should be paid attention to in the use of the NSR-AISC method.

Thermally Chargeable Proton Capacitor Based on Redox-Active Effect for Energy Storage and Low-Grade Heat Conversion

Thermal energy is abundantly available in our daily life and industrial production,and especially,low-grade heat is often regarded as a byproduct.Collecting and utilizing this ignored energy by low-cost and simple technologies may become a smart countermeasure to relieve the energy crisis.Here,a unique device has been demonstrated to achieve high value-added conversion of low-grade heat by introducing redox-active organic alizarin(AZ)onto N-doped hollow carbon nanofibers(N–HCNF)surface.As-prepared N–HCNF/AZ can deliver a high specific capacitance of 514.3 F g^(-1)(at 1 A g^(-1))and an outstanding rate capability of 60.3%even at 50 A g^(-1).Meanwhile,the assembled symmetric proton capacitor can deliver a high energy density of 28.0 Wh kg^(-1) at 350.0 W kg^(-1) and a maximum power density of 35.0 kW kg^(-1) at 17.0 Wh kg^(-1).Significantly,the thermally chargeable proton capacitors can attain a surprisingly high Seebeck coefficient of 15.3 mV K^(-1) and a power factor of 6.02µW g^(-1).Taking advantage of such high performance,a satisfying open-circuit voltage of 481.0 mV with a temperature difference of 54 K is achieved.This research provides new insights into construction of high value-added energy systems requiring high electrochemical performances.

Anlotinib in combination with pembrolizumab for low-grade myofibroblastic sarcoma of the pancreas: A case report

BACKGROUND Low-grade myofibroblastic sarcoma(LGMS)is a rare spindle cell sarcoma espe-cially in the pancreas,with myofibroblastic differentiation.Hitherto,only a few cases have been reported.CASE SUMMARY Herein,we report a case involving the discovery of a pancreatic mass detected during a routine physical examination.Subsequent imaging and pathological tests of the patient led to the diagnosis of LGMS of the pancreas.Following surgical intervention,the patient experienced recurrence and metastasis.Conventional treatment is not effective for postoperative recurrent pancreatic LGMS with multiple metastases.After communicating with the patients and their families,informed consent was obtained for the treatment of anlotinib combined with pembrolizumab.Evaluation of imaging and clinical symptoms post-treatment revealed a relatively favorable response to the combination of anlotinib and pembrolizumab.CONCLUSION Based on the comprehensive literature review,our report aimed to provide evidence for a better understanding of the disease characteristics,diagnostic criteria,imaging findings,and identification of LGMS.And explore novel treatment strategies for this disease.

Leaching kinetics of low-grade copper ore containing calcium-magnesium carbonate in ammonia-ammonium sulfate solution with persulfate

The leaching kinetics of copper from low-grade copper ore was investigated in ammonia-ammonium sulfate solution with sodium persulfate. The effect parameters of stirring speed, temperature, particle size, concentrations of ammonia, ammonium sulfate and sodium persulfate were determined. The results show that the leaching rate is nearly independent of agitation above 300 r/min and increases with the increase of temperature, concentrations of ammonia, ammonium sulfate and sodium persulfate. The EDS analysis and phase quantitative analysis of the residues indicate that bornite can be dissolved by persulfate oxidization. The leaching kinetics with activation energy of 22.91 kJ/mol was analyzed by using a new shrinking core model （SCM） in which both the interfacial transfer and diffusion across the product layer affect the leaching rate. A semi-empirical rate equation was obtained to describe the leaching process and the empirical reaction orders with respect to the concentrations of ammonia, ammonium sulfate and sodium persulfate are 0.5, 1.2 and 0.5, respectively.

Oxidation process of low-grade vanadium slag in presence of Na_(2)CO_3

The oxidation process of low-grade vanadium slag in the presence of Na2CO3 was investigated by XRD,SEM/EDS and TG-DSC techniques.The results show that the vanadium slag is oxidized in a temperature range from 273 to 700 °C.Olivine phases and spinel phases are completely decomposed at 500 and 600 °C,respectively.Most of water-soluble sodium vanadates are formed between 500 and 600 °C.When roasting temperature reaches above 700 °C,the vanadium-rich phases of sodium vanadates can be obviously observed.However,at temperature above 800 °C,the samples are sintered.Most of the vanadium is enwrapped by glassy phase compounds which lead to the decrease of the leaching rate of vanadium.At the same time,the effect of roasting temperature on extraction of vanadium and characterization of leach residues were discussed.

A Phase II Study of Antineoplastons A10 and AS2-1 in Children with Low-Grade Astrocytomas—Final Report (Protocol BT-13)

Nonresectable Low-Grade Astrocytomas (LGA) can compromise function and threaten life. For the majority of patients, the most appropriate strategy is initial chemotherapy followed by Radiation Therapy (RT). Since curative treatment is not available for most of these patients, it is reasonable to conduct clinical studies to evaluate new agents. This Phase II study evaluates efficacy and safety of Antineoplastons A10 and AS2-1 (ANP) in LGA. Sixteen children diagnosed with LGA were treated. They included 12 males and 4 females, ages 1.6 - 17.4 years (median 10.6). Efficacy was evaluated in 16 patients. The majority of patients were previously treated, but 1 patient had stereotactic biopsy only. Out of the remaining 15 patients, 6 patients received chemotherapy, and 7 patients had surgery, and 2 patients received RT and chemotherapy after surgery. The patients received treatment with ANP administered daily every 4 hours (median dose of A10 was 7.71 g/kg/d and AS2-1 was 0.26 g/kg/d) until objective response or stable disease was documented and for 8 months thereafter. The duration of ANP IV ranged from 1.4 to 286 weeks with a median of 83 weeks. A complete response was documented in 25.0%, partial response in 12.5%, and stable disease in 37.5%. Overall survival was 67.7% at 5 years, and 54.2% at 10 and 15 years. Progression-free survival was 48.1%, 34.4% and 34.4% at 5, 10, and 15 years respectively. The treatment was associated with grade 3 or grade 4 Adverse Drug Experiences (ADE) in 6 patients. There were two hypernatremias of grade 4 (12%). Grade 3 ADE included urinary frequency (6%), fatigue (6%) and hypernatremia (6%). There were no chronic toxicities, and there was a high quality of survival. ANP shows efficacy with a very good toxicity profile in this cohort of children with low-grade astrocytoma.

Hepatic steatosis,low-grade chronic inflammation and hormone/growth factor/adipokine imbalance

Non-alcoholic fatty liver disease (NAFLD), a further expression of metabolic syndrome, strictly linked to obesity and diabetes mellitus, is characterized by insulin resistance (IR), elevated serum levels of free fatty acids and fatty infi ltration of the liver, which is known as hepatic steatosis. Hepatocyte apoptosis is a key feature of this disease and correlates with its severity. Free-fatty-acidinduced toxicity represents one of mechanisms for the pathogenesis of NAFLD and hormones, growth factors and adipokines influence also play a key role. This review highlights the various pathways that contribute to the development of hepatic steatosis. Circulating concentrations of inflammatory cytokines are reckoned to be the most important factor in causing and maintaining IR. Low-grade chronic inflammation is fundamental in the progression of NAFLD toward higher risk cirrhotic states.

Even low-grade inflammation impacts on small intestinal function

Independent of the cause and location,inflammation-even when minimal-has clear effects on gastrointestinal morphology and function.These result in altered digestion,absorption and barrier function.There is evidence of reduced villus height and crypt depth,increased permeability,as well as altered sugar and peptide absorption in the small intestine after induction of inflammation in experimental models,which is supported by some clinical data.Identification of inflammatory factors which may promote the process of gastrointestinal dysfunction as well as clinical research to verify experimental observations of inflammatory modulation of gastrointestinal function are required.Moreover,nutritional strategies to support functional restitution are needed.

Low-grade myofibroblastic sarcoma of the palate

Low-grade myofibroblastic sarcoma （LGMS） is a rare, malignant tumor with myofibroblastic differentiation. Despite it being classified as a distinct entity by the World Health Organization, a few cases were reported in the oral and maxillofacial region. Here, a LGMS developed on the palate of a 73-year-old man who presented with a 1-cm tumor on the posterior border of the palate. Based on the histological and immunohistochemical features, a diagnosis of LGMS was established. The tumor was resected, and no recurrence was observed over 2 years. Although the tongue is the most preferred site for LGMS, it may occur in any region of the oral cavity.

Extraction of valuable metals from low-grade nickeliferous laterite ore by reduction roasting-ammonia leaching method

Nickel and cobalt were extracted from low-grade nickeliferous laterite ore using a reduction roasting-ammonia leaching method.The reduction roasting-ammonia leaching experimental tests were chiefly introduced,by which fine coal was used as a reductant.The results show that the optimum process conditions are confirmed as follows:in reduction roasting process,the mass fraction of reductant in the ore is 10%,roasting time is 120 min,roasting temperature is 1 023-1 073 K;in ammonia leaching process,the liquid-to-solid ratio is 4:1(mL/g),leaching temperature is 313 K,leaching time is 120 min,and concentration ratio of NH3 to CO2 is 90 g/L:60 g/L.Under the optimum conditions,leaching efficiencies of nickel and cobalt are 86.25% and 60.84%,respectively.Therefore,nickel and cobalt can be effectively reclaimed,and the leaching agent can be also recycled at room temperature and normal pressure.

Review on development of low-grade scheelite recovery from molybdenum tailings in Luanchuan, China: A case study of Luoyang Yulu Mining Company

Luanchuan area is one of the regions with the largest scale of scheelite beneficiation and the largest output of scheelite concentrate in the world. After years of innovation and progress, the beneficiation technology of low-grade scheelite associated with molybdenum tailings in Luanchuan area is becoming more and more perfect. In this study, the development process of low-grade scheelite recycling technology in Luanchuan area was reviewed, including raw ore properties, beneficiation process, flotation equipment and flotation reagents. Meanwhile, taking Luoyang Yulu Mining Co., Ltd. as an example, the effects of various technical transformations such as the optimization of the beneficiation process, the column-machine combined process, and the high-efficiency flotation reagents were elucidated in detail. However, the recycling technology of low-grade scheelite of Luanchuan area is still possible to be improved. As a result, coupled with the latest research progress, the development direction of low-grade scheelite beneficiation in Luanchuan area was also prospected. It is of great significance to further improve the recovery efficiency of low-grade scheelite resources in Luanchuan area and this can provide technical reference for other scheelite plants.

Transformation and leaching kinetics of silicon from low-grade nickel laterite ore by pre-roasting and alkaline leaching process

The mineralogical phase transformation of a low-grade nickel laterite ore during pre-roasting process and the extraction of silicon during alkaline leaching process were investigated.The results indicate that the reaction activity of nickel ores is effectively improved by pre-roasting at650°C for2h,because of the transformation of lizardite into magnesium olivine and protoenstatite.When finely ground ore samples(44-61μm)pre-roasted firstly react with sodium hydroxide solution(60g/L)with a solid/liquid ratio of1:5at140°C for120min,the extraction of silicon can reach89.89%,and the other valuable elements of magnesium,iron and nickel are accumulated in the solid residues.The leaching kinetics of nickel laterite ore can be described successfully by the diffusion through the product layer control model.The activation energy is calculated to be11.63kJ/mol and the kinetics equation can be expressed as1-3(1-x)2/3+2(1-x)=13.53×10-2exp[-11.63/(RT)]t.

Optimal management of biopsy-proven low-grade gastric dysplasia

Gastric adenocarcinoma generally culminates via the inflammation-metaplasia-dysplasia-carcinoma sequence progression. The prevalence of gastric adenomas shows marked geographic variation. Recently, the rate of diagnosis of low-grade dysplasia(LGD) has increased due to increased use of upper endoscopy. Many investigators have reported that gastric highgrade dysplasia has high potential for malignancy and should be removed; however, the treatment for gastric LGD remains controversial. Although the risk of LGD progression to invasive carcinoma has been reported to be inconsistent, progression has been observed during follow-up. Additionally, the rate of upgraded diagnosis in biopsy-proven LGD is high. Therefore, endoscopic resection(ER) may be useful in the treatment and diagnosis of LGD, especially if lesions are found to have risk factors for upgraded histology after ER, such as large size, surface erythema or depressed morphology. Fatal complications in endoscopic submucosal dissection(ESD) are extremely low and its therapeutic and diagnostic outcomes are excellent. Therefore, ESD should be applied preferentially instead of endoscopic mucosal resection.

Recovery of Zn, Pb, Fe and Si from a low-grade mining ore by sulfidation roasting-beneficiation-leaching processes

To recover Zn, Pb, Fe and Si from a low-grade mining ore in the Lanping basin, Yunnan Province, China, a novel technology using the roasting with pyrite and carbon followed by beneficiation and hydrochloric acid leaching was proposed. Firstly, several factors such as pyrite dosage, roasting temperature, carbon powder dosage, holding time and particle size affecting on the flotation performance of Zn(Pb) and magnetic separation performance of Fe were simultaneously examined and the optimum process parameters were determined. A flotation concentrate, containing 17.46% Zn and 3.93% Pb, was obtained, and the Zn and Pb recoveries were 86.04% and 69.08%, respectively. The obtained flotation tailing was concentrated by a low-intensity magnetic separator. The grade of iron increased from 5.45% to 43.45% and the recovery of iron reached 64.87%. Hydrochloric acid leaching was then carried out for the magnetic separation tailing and a raw quartz concentrate containing 81.05% SiO2 was obtained. To further interpret the sulfidation mechanism of smithsonite, surface morphology and component of the sample before and after reactions were characterized by XRD and EPMA-EDS. The aim was to achieve the comprehensive utilization of the low-grade mining ore.

Roasting oxidation behaviors of ReS_2 and MoS_2 in powdery rhenium-bearing, low-grade molybdenum concentrate

The oxidation roasting process of molybdenum concentrate has significant advantages in industrial applications.However,utilization of low-grade mineral has many problems because it is more complex than the standard concentrate.In this study,the oxidation behaviors of powdery rhenium-bearing low-grade molybdenum concentrate were investigated through thermodynamic calculation,roasting experiments,thermogravimetric analysis,and phase analysis.The results obtained show that oxidation of MoS2 begins at 450℃,and MoO3 reacts with metal-oxide forming molybdate at 600℃.Finally,MoO3 can be dissolved in ammonia with a maximum content of approximately 80%.The volatile speed of Re was considerably slower than the oxidation speed of MoS2 because the nonvolatile products ReO2 and ReO3 were generated in reactions among MoS2,SO2,and Re2O7.The final volatilization rate of Re was almost 70%.This study determined the problems related to the roasting of low-grade molybdenum concentrate,which lays the scientific foundations for subsequent enhancement of molybdenum and rhenium extraction.

Application of response surface methodology(RSM) for optimization of leaching parameters for ash reduction from low-grade coal

Coal is the world＇s most abundant energy source because of its abundance and relatively low cost. Due to the scarcity in the supply of high-grade coal, it is necessary to use low-.grade coal for fulfilling energy demands of modern civilization. However, due to ItS high ash and moisture content, low-grade coal exerts the substantial impact on their consumption like pyrolysis, liquefaction, gasification and combus- tion process. The present research aimed to develop the efficient technique for the production of clean coal by optimizing the operating parameters with the help of response surface methodology. The effect of three independent variables such as hydrofluoric acid （HF） concentration （10-20% by vo!ume ）,. temper- ature （60-100 ~C）, and time （90-180 min）, for ash reduction from the low-grade coal was Investigated.. A quadratic model was proposed to correlate the independent variables for maximum ash reduction at the optimum process condition by using central composite design （CC.D）method. The study reveals that HF concentration was the most effective parameter for ash reduction in comparison with time and temper- ature. It may be due to the higher F-statistics value for HF concentration, which effects to large extent of ash reduction. The characterization of coal was evaluated by Fourier transform infrared spectroscopy （FTIR） analysis and Field-emission scanning electron microscopy with energy-dispersive X-ray （FESEM- EDX） analysis for confirmation of the ash reduction.

An active pipe-embedded building envelope for utilizing low-grade energy sources

An active pipe-embedded building envelope, which is an external wall or roof with pipes embedded inside, was presented. This structure may utilize the circulating water in the pipe to transfer heat or coolth inside directly. This kind of structure is named ＂active pipe-embedded building envelope＂ due to dealing with the thermal energy actively inside the structure mass by circulating water. This structure not only deals with thermal energy before the external disturbance becomes cooling/heating load by using the circulating water, but also may use low-grade energy sources such as evaporative cooling, solar energy, and geothermal energy. In the meantime, this structure can also improve the indoor thermal comfort by tempering the internal wall surface temperature variation due to the thermal removal in the mass. This work further presents the thermal performance of this structure under a typical hot summer weather condition by comparing it with that of the conventional external wall/roof with numerical simulation. The results show that this pipe-embedded structure may reduce the external heat transfer significantly and reduce the internal wall surface temperature for improving thermal comfort. This work also presents the effects of the water temperature and the pipe spacing on the heat transfer of this structure. The internal surface heat transfer may reduce by about 2.6 W/mE when the water temperature reduces by 1℃ as far as a brick wall with pipes embedded inside is concerned. When the pipe spacing reduces by 50 mm, the internal wall surface heat flux can also reduce by about 2.3 W/m2.

Acid equilibrium during bioleaching of alkaline low-grade sulfide copper ore

This article reports the study on acid equilibrium during bioleaching of alkaline low-grade copper sulfide ore. Adding auxiliary agents 1# （sulfur） and 2# （pyrite） makes bacterial leaching of copper and acid production carried out simultaneously because the auxiliary agents can be oxidized by bacteria and the oxidation products involve acid. The acid required for dissolving alkaline gangue during bacterial leaching is produced, and acid equilibrium is reached during the ore bio-leaching. The recovery of copper reaches more than 95%.