BACKGROUND Granuloma annulare(GA)has diverse clinical manifestations,multiple subtypes,and unknown etiology and pathogenesis.Existing studies regarding GA in children are scarce.AIM To examine the correlation between ...BACKGROUND Granuloma annulare(GA)has diverse clinical manifestations,multiple subtypes,and unknown etiology and pathogenesis.Existing studies regarding GA in children are scarce.AIM To examine the correlation between clinical manifestation and histopathology of pediatric GA.METHODS A total of 39 patients under 18 years of age with both a clinical and pathological diagnosis of GA at Kunming Children's Hospital from 2017 to 2022 were retrieved.Their medical records were consulted,and clinical data of the children were recorded and summarized,including gender,age,disease site,etc.Existing wax blocks of skin lesion specimens of children and pathological films were retrieved for further study and relevant histology,including hematoxylin-eosin,Alcian blue,elastic fiber(Victoria blue-Lichon red method),and antacid staining.Finally,the children’s clinical manifestations,histopathological results,and special staining characteristics were analyzed.RESULTS The clinical manifestations of granuloma annulare in children were diverse:11 cases presented with a single lesion,25 with multiple lesions,and 3 with generalized lesions.The pathological typing comprised histiocytic infiltration,palisading granuloma,epithelioid nodular,and mixed types in 4,11,9,and 15 cases,respectively.Thirty-nine cases were negative for antacid staining.The positive rate of Alcian blue staining was 92.3%,and that of elastic fiber staining was 100%.The degree of elastic fiber dissolution and granuloma annulare histopathological typing were positively correlated(r=0.432,P<0.05).No correlation was found between clinical presentation and histopathological typing of the granuloma annulare in children.In the pathological diagnosis of granuloma annulare,the positive elastic fiber staining rate was higher than that of Alcian blue staining.A correlation was found between elastic fiber dissolution degree and histopathological staging.However,the differences in pathological staging may have been related to the pathological manifestation of granuloma annulare at different periods.CONCLUSION Elastic fiber degradation may be a critical step in the pathogenesis of pediatric granuloma annulare.This is also one of the first studies focused on granuloma annulare in children.展开更多
BACKGROUND Thin-walled lung cancer manifests as a cystic lesion,mostly adenocarcinoma.It is often misdiagnosed as a benign lesion in clinical practice,thus delaying the diagnosis and surgical treatment.Its natural cou...BACKGROUND Thin-walled lung cancer manifests as a cystic lesion,mostly adenocarcinoma.It is often misdiagnosed as a benign lesion in clinical practice,thus delaying the diagnosis and surgical treatment.Its natural course is rarely recorded and observed;thus,the pathogenesis and diagnosis need to be clarified and improved.CASE SUMMARY A 66-year-old man developed a mass in the upper lobe of the right lung and a small,thin-walled cavity in the lower lobe of the right lung in 2007.The right upper lobe mass was confirmed to be adenocarcinoma after surgery.The cavity diameter increased from 11 mm to 31 mm over 10 years,and a ground glass opacity lesion appeared around the bulla on computed tomography.A second operation confirmed that the lesion was lepidic predominant adenocarcinoma.Here we report a rare case of lung cancer developing from a focal bulla to a thinwalled adenocarcinoma for more than 10 years and confirm that the check-valve mechanism explains the pathogenesis.CONCLUSION Solitary thin-walled lung adenocarcinoma is a rare tumor in terms of its clinical manifestations,pathogenesis,and disease progression.The check-valve mechanism can explain the cause of thin-walled lung cancer.Close follow-up and accurate imaging are necessary.展开更多
BACKGROUND There is a high annual incidence of acute,nonvariceal upper gastrointestinal bleeding in Chinese adults.Early endoscopic intervention can reduce rates of rebleeding,surgery,and mortality.The metal clip is t...BACKGROUND There is a high annual incidence of acute,nonvariceal upper gastrointestinal bleeding in Chinese adults.Early endoscopic intervention can reduce rates of rebleeding,surgery,and mortality.The metal clip is the most common method for establishing homeostasis;however,it possesses several limitations.In patients with bleeding secondary to large gastric ulcers,the clip will often fail to stop the bleeding.This article highlights the use of an elastic traction ring as a novel hemostatic method for patients with upper gastrointestinal bleeding.CASE SUMMARY An elderly male presented to the emergency room with complaints of hematemesis and melena.Endoscopic examination revealed an ulcer(Forrest IIa)in the lesser curvature of the gastric antrum.Six tissue clips and one elastic traction ring were inserted into the stomach cavity to suture the ulcer.The patient recovered quickly without postoperative gastrointestinal bleeding.Two months later,the patient's ulcer was significantly healed.CONCLUSION To our best knowledge,this is the first report to demonstrate the safety and efficacy of elastic traction rings for upper gastrointestinal bleeding.Elastic traction rings should be considered a routine therapeutic modality for patients with upper gastrointestinal bleeds.展开更多
BACKGROUND Peroral endoscopic myotomy(POEM)is an established treatment option for esophageal achalasia.However,technical challenges and failures exist.Submucosal fibrosis is a rare cause of aborted POEM procedures.CAS...BACKGROUND Peroral endoscopic myotomy(POEM)is an established treatment option for esophageal achalasia.However,technical challenges and failures exist.Submucosal fibrosis is a rare cause of aborted POEM procedures.CASE SUMMARY We performed POEM with an elastic ring for achalasia with obvious submucosal fibrosis.The short-term outcome was excellent,surgery time was significantly shorter,and success rate was higher with POEM for achalasia with obvious submucosal fibrosis.CONCLUSION POEM performed with an elastic ring is a feasible and effective endoscopic treatment modality for achalasia with obvious submucosal fibrosis.展开更多
Between 1981 and 1988, 234 cases of cancerof the esophagus or gastric cardia were treatedby resection and intraluminal elastic circularligation for esophagogastric anastomosis. Thispresent study advances the results d...Between 1981 and 1988, 234 cases of cancerof the esophagus or gastric cardia were treatedby resection and intraluminal elastic circularligation for esophagogastric anastomosis. Thispresent study advances the results described inour earlier study. The details of technicalrefinements are here reported, based on the展开更多
A three-dimensional finite element model was established for the milling of thin-walled parts. The physical model of the milling of the part was established using the AdvantEdge FEM software as the platform. The alumi...A three-dimensional finite element model was established for the milling of thin-walled parts. The physical model of the milling of the part was established using the AdvantEdge FEM software as the platform. The aluminum alloy impeller was designated as the object to be processed and the boundary conditions which met the actual machining were set. Through the solution, the physical quantities such as the three-way cutting force, the tool temperature, and the tool stress were obtained, and the calculation of the elastic deformation of the thin-walled blade of the free-form surface at the contact points between the tool and the workpiece was realized. The elastic deformation law of the thin-walled blade was then predicted. The results show that the maximum deviation between the predicted value and the actual measured machining value of the elastic deformation was 26.055 μm; the minimum deviation was 2.011 μm, with the average deviation being 10.154 μm. This shows that the prediction is in close agreement with the actual result.展开更多
This paper explores an analytical model for Elastic Ring Squeeze Film Damper(ERSFD) with thin-walled ring and turbulent-jet orifices, and uncovers its Oil Film Pressure Performance(OFPP). Firstly, the ring deformation...This paper explores an analytical model for Elastic Ring Squeeze Film Damper(ERSFD) with thin-walled ring and turbulent-jet orifices, and uncovers its Oil Film Pressure Performance(OFPP). Firstly, the ring deformation is addressed by using the Fourier series expansion approach and the orifice outflow rate is characterized with the Prandtl boundary layer theory. Secondly, applying finite difference scheme, the influence of elastic ring flexibility, orifice diameter, and attitude angle on the OFPP is analyzed. Finally, Outer chamber pressure was measured experimentally at different rotor speeds. The results indicate that the outer chamber pressure coats an individual load-carrying region and spreads symmetrically pertaining to the attitude angle. Its amplitude drops as the elastic ring flexibility decreases but boosts with the reduction of the orifice diameter.For inner chamber pressure, the orifice diameter effects a similar trend to the outer cavity, but exhibits more stable distribution regarding the attitude angle. Minimizing the elastic ring flexibility causes an increase in amplitude. The model is validated by the test results giving that the outer chamber pressure shifts synchronously and periodically with the variation of the attitude angle,while the pressure amplitude increases slightly at higher rotor speeds.展开更多
BACKGROUND Lung cancer is the leading cause of cancer-related death.Early diagnosis is critical to improving a patient’s chance of survival.However,lung cancer associated with cystic airspaces is often misdiagnosed o...BACKGROUND Lung cancer is the leading cause of cancer-related death.Early diagnosis is critical to improving a patient’s chance of survival.However,lung cancer associated with cystic airspaces is often misdiagnosed or underdiagnosed due to the absence of clinical symptoms,poor imaging specificity,and high risk of biopsy-related complications.CASE SUMMARY We report an unusual case of cancer in a 55-year-old man,in which the lesion evolved from a small solitary thin-walled cyst to lung squamous cell carcinoma(SCC)with metastases in both lungs.The SCC manifested as rare clustered cystic lesions,detected on chest computed tomography.There were air-fluid levels,compartments,and bronchial arteries in the cystic lesions.Additionally,there was no clear extrathoracic metastasis.After chemotherapy,the patient achieved a partial response,type I respiratory failure was relieved,and the lung lesions became a clustered thin-walled cyst.CONCLUSION Pulmonary cystic lesions require regular imaging follow-up.Lung SCC should be a diagnostic consideration in cases of thin-walled cysts as well as multiple clustered cystic lesions.展开更多
Considering the elastic supports,the finite element model of rotor-bladed disk-casing system is established using commercial software ANSYS/LS-DYNA.Assuming that broken blade is released from the disk,the complicate r...Considering the elastic supports,the finite element model of rotor-bladed disk-casing system is established using commercial software ANSYS/LS-DYNA.Assuming that broken blade is released from the disk,the complicate rubbing responses of unbalanced rotor-bladed disk-casing system are studied under different operational speeds.In addition,influences of both plastic deformation of blade and casing failure are analyzed.The results show that there exist some multiple even fractional frequencies in the transient and steady vibration responses of unbalanced rotor.Besides,one nodal diameter vibration of bladed disk coupling with the lateral vibration of the shaft as well as the first order bending vibration of blade can be excited under low operational speed,while the first order bending vibration of blade coupling with the lateral vibration of disk-shaft is easily excited under high operational speed.During rubbing process,three distinct contact states can be observed:broken blade-casing contact,broken blade-blade component-casing contact and broken blade-casing contact/blade component-casing contact/blade selfcontact.It is worth noting that the third contact state is related to the operational speed.With the increase of operational speed,self-contact in the blade may occur.展开更多
This paper presents a study on effects of carburized parts on residual stresses of thin-rimmed spur gears with symmetric web arrangements due to the case-carburizing. The carbon content of each element of the FEM gear...This paper presents a study on effects of carburized parts on residual stresses of thin-rimmed spur gears with symmetric web arrangements due to the case-carburizing. The carbon content of each element of the FEM gear model due to carburizing was obtained according to Vickers hardness Hv - carbon content C% and C% - d (distance from surface) charts. A heat conduction analysis and an elastic-plastic stress analysis during the case-carburizing process of thin-rimmed spur gears with symmetric web arrangements were carried out for various case-carburizing conditions by using the three-dimensional finite element method (3D-FEM) program developed by authors, and then residual stresses were obtained. The effects of the carburized part, the web structure, and the rim thickness on the residual stress were determined.展开更多
Distribution laws of casing external pressure,which are obtained by different scholars in different conditions,are not the same.Thus,a model to calculate the external pressure of casing is established with finite elem...Distribution laws of casing external pressure,which are obtained by different scholars in different conditions,are not the same.Thus,a model to calculate the external pressure of casing is established with finite element method.In the model a contact is built between the outer wall of the casing and the inner wall of the cement sheath.The casing external pressure can be got through extracting contact force of results.The numerical results and analysis show that:The largest casing external pressure exists in the direction of minimum horizontal stress of formation rather than in the direction of the maximum horizontal stress.There exists such matching between the cement sheath elastic modulus and formation elastic modulus:When the elastic modulus of the cement sheath is small,reducing its value is conducive to reduce the casing external pressure and to prolong casing service life.When the elastic modulus of the cement sheath is large,increasing its value is conducive to reduce the casing external pressure and to prolong casing service life.The casing external pressure will become large with the increase of Poisson's ratio of cement sheath.With the increase of the degree of the formation stress unevenness,the maximum casing external pressure increases and the smallest external decreases.The increasing of the non-uniformity degree of formation stress makes the non-uniformity degree of casing external pressure and the risk of casing failure increase.The study can provide certain reference for drilling workers to take measures to prolong service life of casing.展开更多
基金Supported by Spring City Project Famous Doctor Special
文摘BACKGROUND Granuloma annulare(GA)has diverse clinical manifestations,multiple subtypes,and unknown etiology and pathogenesis.Existing studies regarding GA in children are scarce.AIM To examine the correlation between clinical manifestation and histopathology of pediatric GA.METHODS A total of 39 patients under 18 years of age with both a clinical and pathological diagnosis of GA at Kunming Children's Hospital from 2017 to 2022 were retrieved.Their medical records were consulted,and clinical data of the children were recorded and summarized,including gender,age,disease site,etc.Existing wax blocks of skin lesion specimens of children and pathological films were retrieved for further study and relevant histology,including hematoxylin-eosin,Alcian blue,elastic fiber(Victoria blue-Lichon red method),and antacid staining.Finally,the children’s clinical manifestations,histopathological results,and special staining characteristics were analyzed.RESULTS The clinical manifestations of granuloma annulare in children were diverse:11 cases presented with a single lesion,25 with multiple lesions,and 3 with generalized lesions.The pathological typing comprised histiocytic infiltration,palisading granuloma,epithelioid nodular,and mixed types in 4,11,9,and 15 cases,respectively.Thirty-nine cases were negative for antacid staining.The positive rate of Alcian blue staining was 92.3%,and that of elastic fiber staining was 100%.The degree of elastic fiber dissolution and granuloma annulare histopathological typing were positively correlated(r=0.432,P<0.05).No correlation was found between clinical presentation and histopathological typing of the granuloma annulare in children.In the pathological diagnosis of granuloma annulare,the positive elastic fiber staining rate was higher than that of Alcian blue staining.A correlation was found between elastic fiber dissolution degree and histopathological staging.However,the differences in pathological staging may have been related to the pathological manifestation of granuloma annulare at different periods.CONCLUSION Elastic fiber degradation may be a critical step in the pathogenesis of pediatric granuloma annulare.This is also one of the first studies focused on granuloma annulare in children.
文摘BACKGROUND Thin-walled lung cancer manifests as a cystic lesion,mostly adenocarcinoma.It is often misdiagnosed as a benign lesion in clinical practice,thus delaying the diagnosis and surgical treatment.Its natural course is rarely recorded and observed;thus,the pathogenesis and diagnosis need to be clarified and improved.CASE SUMMARY A 66-year-old man developed a mass in the upper lobe of the right lung and a small,thin-walled cavity in the lower lobe of the right lung in 2007.The right upper lobe mass was confirmed to be adenocarcinoma after surgery.The cavity diameter increased from 11 mm to 31 mm over 10 years,and a ground glass opacity lesion appeared around the bulla on computed tomography.A second operation confirmed that the lesion was lepidic predominant adenocarcinoma.Here we report a rare case of lung cancer developing from a focal bulla to a thinwalled adenocarcinoma for more than 10 years and confirm that the check-valve mechanism explains the pathogenesis.CONCLUSION Solitary thin-walled lung adenocarcinoma is a rare tumor in terms of its clinical manifestations,pathogenesis,and disease progression.The check-valve mechanism can explain the cause of thin-walled lung cancer.Close follow-up and accurate imaging are necessary.
文摘BACKGROUND There is a high annual incidence of acute,nonvariceal upper gastrointestinal bleeding in Chinese adults.Early endoscopic intervention can reduce rates of rebleeding,surgery,and mortality.The metal clip is the most common method for establishing homeostasis;however,it possesses several limitations.In patients with bleeding secondary to large gastric ulcers,the clip will often fail to stop the bleeding.This article highlights the use of an elastic traction ring as a novel hemostatic method for patients with upper gastrointestinal bleeding.CASE SUMMARY An elderly male presented to the emergency room with complaints of hematemesis and melena.Endoscopic examination revealed an ulcer(Forrest IIa)in the lesser curvature of the gastric antrum.Six tissue clips and one elastic traction ring were inserted into the stomach cavity to suture the ulcer.The patient recovered quickly without postoperative gastrointestinal bleeding.Two months later,the patient's ulcer was significantly healed.CONCLUSION To our best knowledge,this is the first report to demonstrate the safety and efficacy of elastic traction rings for upper gastrointestinal bleeding.Elastic traction rings should be considered a routine therapeutic modality for patients with upper gastrointestinal bleeds.
文摘BACKGROUND Peroral endoscopic myotomy(POEM)is an established treatment option for esophageal achalasia.However,technical challenges and failures exist.Submucosal fibrosis is a rare cause of aborted POEM procedures.CASE SUMMARY We performed POEM with an elastic ring for achalasia with obvious submucosal fibrosis.The short-term outcome was excellent,surgery time was significantly shorter,and success rate was higher with POEM for achalasia with obvious submucosal fibrosis.CONCLUSION POEM performed with an elastic ring is a feasible and effective endoscopic treatment modality for achalasia with obvious submucosal fibrosis.
文摘Between 1981 and 1988, 234 cases of cancerof the esophagus or gastric cardia were treatedby resection and intraluminal elastic circularligation for esophagogastric anastomosis. Thispresent study advances the results described inour earlier study. The details of technicalrefinements are here reported, based on the
基金Project(U1530138)supported by the National Natural Science Foundation of ChinaProject(A1-8903-17-0103)supported by the Natural Science Foundation of Shanghai Municipal Education Commission,China
文摘A three-dimensional finite element model was established for the milling of thin-walled parts. The physical model of the milling of the part was established using the AdvantEdge FEM software as the platform. The aluminum alloy impeller was designated as the object to be processed and the boundary conditions which met the actual machining were set. Through the solution, the physical quantities such as the three-way cutting force, the tool temperature, and the tool stress were obtained, and the calculation of the elastic deformation of the thin-walled blade of the free-form surface at the contact points between the tool and the workpiece was realized. The elastic deformation law of the thin-walled blade was then predicted. The results show that the maximum deviation between the predicted value and the actual measured machining value of the elastic deformation was 26.055 μm; the minimum deviation was 2.011 μm, with the average deviation being 10.154 μm. This shows that the prediction is in close agreement with the actual result.
基金supported by the National Natural Science Foundation of China(No.52005158)。
文摘This paper explores an analytical model for Elastic Ring Squeeze Film Damper(ERSFD) with thin-walled ring and turbulent-jet orifices, and uncovers its Oil Film Pressure Performance(OFPP). Firstly, the ring deformation is addressed by using the Fourier series expansion approach and the orifice outflow rate is characterized with the Prandtl boundary layer theory. Secondly, applying finite difference scheme, the influence of elastic ring flexibility, orifice diameter, and attitude angle on the OFPP is analyzed. Finally, Outer chamber pressure was measured experimentally at different rotor speeds. The results indicate that the outer chamber pressure coats an individual load-carrying region and spreads symmetrically pertaining to the attitude angle. Its amplitude drops as the elastic ring flexibility decreases but boosts with the reduction of the orifice diameter.For inner chamber pressure, the orifice diameter effects a similar trend to the outer cavity, but exhibits more stable distribution regarding the attitude angle. Minimizing the elastic ring flexibility causes an increase in amplitude. The model is validated by the test results giving that the outer chamber pressure shifts synchronously and periodically with the variation of the attitude angle,while the pressure amplitude increases slightly at higher rotor speeds.
基金Yantai City Science and Technology Development Plan Item,No.2019YD008.
文摘BACKGROUND Lung cancer is the leading cause of cancer-related death.Early diagnosis is critical to improving a patient’s chance of survival.However,lung cancer associated with cystic airspaces is often misdiagnosed or underdiagnosed due to the absence of clinical symptoms,poor imaging specificity,and high risk of biopsy-related complications.CASE SUMMARY We report an unusual case of cancer in a 55-year-old man,in which the lesion evolved from a small solitary thin-walled cyst to lung squamous cell carcinoma(SCC)with metastases in both lungs.The SCC manifested as rare clustered cystic lesions,detected on chest computed tomography.There were air-fluid levels,compartments,and bronchial arteries in the cystic lesions.Additionally,there was no clear extrathoracic metastasis.After chemotherapy,the patient achieved a partial response,type I respiratory failure was relieved,and the lung lesions became a clustered thin-walled cyst.CONCLUSION Pulmonary cystic lesions require regular imaging follow-up.Lung SCC should be a diagnostic consideration in cases of thin-walled cysts as well as multiple clustered cystic lesions.
基金supported by the National Natural Science Foundation of China(No.11772089)the Fundamental Research Funds for the Central Universities (Nos. N160312001and N160313004)the Research Project of State Key Laboratory of Mechanical System and Vibration(No.MSV201707)
文摘Considering the elastic supports,the finite element model of rotor-bladed disk-casing system is established using commercial software ANSYS/LS-DYNA.Assuming that broken blade is released from the disk,the complicate rubbing responses of unbalanced rotor-bladed disk-casing system are studied under different operational speeds.In addition,influences of both plastic deformation of blade and casing failure are analyzed.The results show that there exist some multiple even fractional frequencies in the transient and steady vibration responses of unbalanced rotor.Besides,one nodal diameter vibration of bladed disk coupling with the lateral vibration of the shaft as well as the first order bending vibration of blade can be excited under low operational speed,while the first order bending vibration of blade coupling with the lateral vibration of disk-shaft is easily excited under high operational speed.During rubbing process,three distinct contact states can be observed:broken blade-casing contact,broken blade-blade component-casing contact and broken blade-casing contact/blade component-casing contact/blade selfcontact.It is worth noting that the third contact state is related to the operational speed.With the increase of operational speed,self-contact in the blade may occur.
文摘This paper presents a study on effects of carburized parts on residual stresses of thin-rimmed spur gears with symmetric web arrangements due to the case-carburizing. The carbon content of each element of the FEM gear model due to carburizing was obtained according to Vickers hardness Hv - carbon content C% and C% - d (distance from surface) charts. A heat conduction analysis and an elastic-plastic stress analysis during the case-carburizing process of thin-rimmed spur gears with symmetric web arrangements were carried out for various case-carburizing conditions by using the three-dimensional finite element method (3D-FEM) program developed by authors, and then residual stresses were obtained. The effects of the carburized part, the web structure, and the rim thickness on the residual stress were determined.
基金The authors would like to thank the National“863”Plan Project of China(No.2013AA09A215)CNPC's Science and Technology Research Project(No.2014B-4315)for providing financial support to this research work.
文摘Distribution laws of casing external pressure,which are obtained by different scholars in different conditions,are not the same.Thus,a model to calculate the external pressure of casing is established with finite element method.In the model a contact is built between the outer wall of the casing and the inner wall of the cement sheath.The casing external pressure can be got through extracting contact force of results.The numerical results and analysis show that:The largest casing external pressure exists in the direction of minimum horizontal stress of formation rather than in the direction of the maximum horizontal stress.There exists such matching between the cement sheath elastic modulus and formation elastic modulus:When the elastic modulus of the cement sheath is small,reducing its value is conducive to reduce the casing external pressure and to prolong casing service life.When the elastic modulus of the cement sheath is large,increasing its value is conducive to reduce the casing external pressure and to prolong casing service life.The casing external pressure will become large with the increase of Poisson's ratio of cement sheath.With the increase of the degree of the formation stress unevenness,the maximum casing external pressure increases and the smallest external decreases.The increasing of the non-uniformity degree of formation stress makes the non-uniformity degree of casing external pressure and the risk of casing failure increase.The study can provide certain reference for drilling workers to take measures to prolong service life of casing.
