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.

Clinical efficacy and prognostic risk factors of endoscopic radiofrequency ablation for gastric low-grade intraepithelial neoplasia

BACKGROUND The use of radiofrequency ablation(RFA)has been reported in the treatment of gastric low-grade intraepithelial neoplasia(LGIN).However,its efficacy and prognostic risk factors have not been well analyzed.AIM To explore the efficacy and prognostic risk factors of RFA for gastric LGIN in a large,long-term follow-up clinical study.METHODS The clinical data of 271 consecutive cases from 198 patients who received RFA for treatment of gastric LGIN at the Chinese PLA General Hospital from October 2014 to October 2020 were reviewed in this retrospective study.Data on operative parameters,complications,and follow-up outcomes including curative rates were recorded and analyzed.RESULTS The curative rates of endoscopic RFA for gastric LGIN at 3 mo,6 mo,and 1-5 years after the operation were 93.3%,92.8%,91.5%,90.3%,88.5%,85.7%,and 83.3%,respectively.Multivariate analyses revealed that Helicobacter pylori(H.pylori)infection and disease duration>1 year had a significant effect on the curative rate(P<0.001 and P=0.013,respectively).None of patients had bleeding,perforation,infection,or other serious complications after RFA,and the main discomfort was postoperative abdominal pain.CONCLUSION RFA was safe and effective for gastric LGIN during long-term follow-up.H.pylori infection and disease course>1 year may be the main risk factors for relapse of LGIN after RFA.

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.

Design and impact estimation of a reform program of China's tax and fee policies for low-grade oil and gas resources

With China＇s rapid economic development,it is important to formulate reasonable and feasible tax and fee policies to promote the development and utilization of low-grade oil and gas resources to guarantee China＇s energy supply security.In this paper,by analyzing major problems of China＇s current tax and fee policies for oil and gas resources,a reform program for low-grade oil and gas resources is designed from the aspects of tax/fee items and tax/fee rates.The impacts of this reform program on China and China＇s oil companies during the ＂Twelfth Five-Year Plan＂ are investigated according to the related data in 2008.The results show that the proposed tax and fee reform program will lower the tax burden of oil companies,promote the development of low-grade oil and gas resources,and increase China＇s GDP and national fiscal revenue.Besides that,it will bring positive social effects by increasing employment opportunities.

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.

Novel Methodologies for Preventing Crack Propagation in Steel Gas Pipelines Considering the Temperature Effect

Using the software ANSYS-19.2/Explicit Dynamics,this study performedfinite-element modeling of the large-diameter steel pipeline cross-section for the Beineu-Bozoy-Shymkent gas pipeline with a non-through straight crack,strengthened by steel wire wrapping.The effects of the thread tensile force of the steel winding in the form of single rings at the crack edges and the wires with different winding diameters and pitches were also studied.The results showed that the strengthening was preferably executed at a minimum value of the thread tensile force,which was 6.4%more effective than that at its maximum value.The analysis of the influence of the winding dia-meters showed that the equivalent stresses increased by 32%from the beginning of the crack growth until the wire broke.The increment in winding diameter decelerated the disclosure of the edge crack and reduced its length by 8.2%.The analysis of the influence of the winding pitch showed that decreasing the distance between the winding turns also led to a 33.6%reduction in the length of the straight crack and a 7.9%reduction in the maximum stres-ses on the strengthened pipeline cross-section.The analysis of the temperature effect on the pipeline material,within a range from-40℃ to+50℃,resulted in a crack length change of up to 5.8%.As the temperature dropped,the crack length decreased.Within such a temperature range,the maximum stresses were observed along the cen-tral area of the crack,which were equal to 413 MPa at+50℃ and 440 MPa at-40℃.The results also showed that the presence of the steel winding in the pipeline significantly reduced the length of crack propagation up to 8.4 times,depending on the temperature effect and design parameters of prestressing.This work integrated the existing methods for crack localization along steel gas pipelines.

Mutual regulation of microglia and astrocytes after Gas6 inhibits spinal cord injury

Invasive inflammation and excessive scar formation are the main reasons for the difficulty in repairing nervous tissue after spinal cord injury.Microglia and astrocytes play key roles in the spinal cord injury micro-environment and share a close interaction.However,the mechanisms involved remain unclear.In this study,we found that after spinal cord injury,resting microglia(M0)were polarized into pro-inflammatory phenotypes(MG1 and MG3),while resting astrocytes were polarized into reactive and scar-forming phenotypes.The expression of growth arrest-specific 6(Gas6)and its receptor Axl were significantly down-regulated in microglia and astrocytes after spinal cord injury.In vitro experiments showed that Gas6 had negative effects on the polarization of reactive astrocytes and pro-inflammatory microglia,and even inhibited the cross-regulation between them.We further demonstrated that Gas6 can inhibit the polarization of reactive astrocytes by suppressing the activation of the Yes-associated protein signaling pathway.This,in turn,inhibited the polarization of pro-inflammatory microglia by suppressing the activation of the nuclear factor-κB/p65 and Janus kinase/signal transducer and activator of transcription signaling pathways.In vivo experiments showed that Gas6 inhibited the polarization of pro-inflammatory microglia and reactive astrocytes in the injured spinal cord,thereby promoting tissue repair and motor function recovery.Overall,Gas6 may play a role in the treatment of spinal cord injury.It can inhibit the inflammatory pathway of microglia and polarization of astrocytes,attenuate the interaction between microglia and astrocytes in the inflammatory microenvironment,and thereby alleviate local inflammation and reduce scar formation in the spinal cord.

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.

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.

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.

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.

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.

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.

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.

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.

Research on new beneficiation process of low-grade magnesite using vertical roller mill

We investigated whether the vertical roller mill can be efficiently used in the beneficiation of low-grade magnesite and whether it can improve upon the separation indices achieved by the ball mill.We conducted experiments involving the reverse flotation and positive flotation of low-grade magnesite to determine the optimum process parameters,and then performed closed-circuit beneficiation experiments using the vertical roller mill and ball mill.The results show that the optimum process parameters for the vertical roller mill are as follows:a grinding fineness of 81.6wt%of particles less than 0.074 mm,a dodecyl amine(DDA)dosage in magnesite reverse flotation of 100 g·t?1,and dosages of Na2CO3,(NaPO3)6,and NaOL in the positive flotation section of 1000,100,and 1000 g·t?1,respectively.Compared with the ball mill,the use of the vertical roller mill in the beneficiation of low-grade magnesite resulted in a 1.28%increase in the concentrate grade of MgO and a 5.88%increase in the recovery of MgO.The results of our causation mechanism analysis show that a higher specific surface area and greater surface roughness are the main reasons for the better flotation performance of particles ground by the vertical roller mill in the beneficiation of lowgrade magnesite.

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.

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.

Suspension calcination and alkali leaching of low-grade high-sulfur bauxite:Desulfurization, mineralogical evolution and desilication

To enable the utilization of low-grade and high-sulfur bauxite, the suspension calcination was used to remove the sulfur and the activate silica minerals, and the calcinated bauxite was subjected to a desilication process in Na OH solution under atmospheric pressure. The desulfurization and desilication properties and mineralogical evolution were studied by X-ray diffraction, thermogravimetry–differential thermal analysis, scanning electron microscopy, and FactSage methods. The results demonstrate that the suspension calcination method is efficient for sulfur removal: 84.21% of S was removed after calcination at 1000°C for 2 min. During the calcination process, diaspore and pyrite were transferred to α-Al2O3, magnetite, and hematite. The phase transformation of pyrite follows the order FeS2 → Fe3O4 → Fe2O3, and the iron oxides and silica were converted into iron silicate. In the alkali-soluble desilication process, the optimum condition was an alkali solution concentration of 110 g/L, a reaction time of 20 min, and a reaction temperature of 95°C. The corresponding desilication ratio and alumina loss ratio were 44.9% and 2.4%, respectively, and the alumina-to-silica mass ratio of the concentrate was 7.9. The Al2O3·2SiO2, SiO2, and Al2O3 formed during the calcination process could react with Na OH solution, and their activity decreased in the order of Al2O3·2 SiO2, SiO2, and Al2O3.