In this paper, a novel efficient energy absorber with free inversion of a metal foam-filled circular tube(MFFCT) is designed, and the axial compressive behavior of the MFFCT under free inversion is studied analyticall...In this paper, a novel efficient energy absorber with free inversion of a metal foam-filled circular tube(MFFCT) is designed, and the axial compressive behavior of the MFFCT under free inversion is studied analytically and numerically. The theoretical analysis reveals that the energy is mainly dissipated through the radial bending of the metal circular tube, the circumferential expansion of the metal circular tube, and the metal filled-foam compression. The principle of energy conservation is used to derive the theoretical formula for the minimum compressive force of the MFFCT over free inversion under axial loading. Furthermore, the free inversion deformation characteristics of the MFFCT are analyzed numerically. The theoretical steady values are found to be in good agreement with the results of the finite element(FE) analysis. The effects of the average diameter of the metal tube, the wall thickness of the metal tube, and the filled-foam strength on the free inversion deformation of the MFFCT are considered. It is observed that in the steady deformation stage, the load-carrying and energy-absorbing capacities of the MFFCT increase with the increase in the average diameter of the metal tube, the wall thickness of the metal tube, or the filled-foam strength. The specific energy absorption(SEA) of free inversion of the MFFCT is significantly higher than that of the metal tube alone.展开更多
BACKGROUND Emergency surgical resection is a standard treatment for right-sided malignant colonic obstruction; however, the procedure is associated with high rates of mortality and morbidity. Although a bridge to surg...BACKGROUND Emergency surgical resection is a standard treatment for right-sided malignant colonic obstruction; however, the procedure is associated with high rates of mortality and morbidity. Although a bridge to surgery can be created to obviate the need for emergency surgery, its effects on long-term outcomes and the most practical management strategies for right-sided malignant colonic obstruction remain unclear.AIM To determine the appropriate management approach for right-sided malignant colonic obstruction.METHODS Forty patients with right-sided malignant colonic obstruction who underwent curative resection from January 2007 to April 2017 were included in the study.We compared the perioperative and long-term outcomes of patients who received bridges to surgery established using decompression tubes and those created using self-expandable metallic stents(SEMS). The primary outcome was the overall survival duration(OS) and the secondary endpoints were the diseasefree survival(DFS) duration and the preoperative and postoperative morbidity rates. Analysis was performed on an intention-to-treat basis.RESULTS There were 21 patients in the decompression tube group and 19 in the SEMS group. There were no significant differences in the perioperative morbidity rates of the two groups. The OS rate was significantly higher in the decompression tube group than in the SEMS group(5-year OS rate; decompression tube 79.5%,SEMS 32%, P = 0.043). Multivariate analysis revealed that the bridge to surgery using a decompression tube was significantly associated with the OS(hazard ratio, 17.41; P = 0.004). The 3-year DFS rate was significantly higher in thedecompression tube group than in the SEMS group(68.9% vs 45.9%; log-rank test,P = 0.032). A propensity score–adjusted analysis also demonstrated that the prognosis was significantly better in the decompression tube group than in the SEMS group.CONCLUSION The bridge to surgery using trans-nasal and trans-anal decompression tubes for right-sided malignant colonic obstruction is safe and may improve long-term outcomes.展开更多
We present here our investigations of the features of focused electron beam transport in free space at elevated pressures of a few pascals.We have explored the effect of the beam accelerating voltage,operating gas pre...We present here our investigations of the features of focused electron beam transport in free space at elevated pressures of a few pascals.We have explored the effect of the beam accelerating voltage,operating gas pressure,and magnetic focusing upon the trajectory of beam electrons in the crossover region,in particular on the beam convergence and divergence angles.It is shown that for the forevacuum pressure range of 2-5 Pa explored,a distinctive feature of the propagation of a focused electron beam with a current of up to 20 mA at an accelerating voltage of 10-20 kV is the difference in the angles of convergence(before the focus)and divergence(after the focus).Whereas at a low pressure of 2 Pa the divergence angle is smaller than the convergence angle,as the pressure increases the divergence angle increases and for pressures greater than 5 Pa the divergence angle is greater than the convergence angle.The results obtained were used in experiments on electron beam transport through a long narrow metal tube with a diameter of 5.8-9.2 mm and length of 10-30 cm.We show that for a 30 cm long tube of 7.5 mm diameter,the focused beam transmission can exceed 70%.展开更多
Based on the beam wave synchronous interaction in transverse and longitudinal directions at the same time and starting from Maxwell’s equation and linear Vlasov equation, the beam–wave interaction ‘hot’ dispersion...Based on the beam wave synchronous interaction in transverse and longitudinal directions at the same time and starting from Maxwell’s equation and linear Vlasov equation, the beam–wave interaction ‘hot’ dispersion equation considering both cyclotron resonance and Cherenkov resonance in a staggered double metallic grating traveling wave tube is deduced.Through the reasonable selection for geometric and electrical parameters, the numerical calculation and analysis of the ‘hot’ dispersion equation shows that the beam–wave interaction gain and frequency band with the cyclotron resonance enhancement effect are higher than those with only Cherenkov resonance radiation.展开更多
Through theoretical analysis and finite element simulation,the low-velocity impact of rectangular foam-filled fiber metal laminate(FML)tubes is studied in this paper.According to the rigid-plastic material approximati...Through theoretical analysis and finite element simulation,the low-velocity impact of rectangular foam-filled fiber metal laminate(FML)tubes is studied in this paper.According to the rigid-plastic material approximation with modifications,simple analytical solutions are obtained for the dynamic response of rectangular foam-filled FML tubes.The numerical calculations for low-velocity impact of rectangular foam-filled FML tubes are conducted.The accuracy of analytical solutions and numerical results is verified by each other.Finally,the effects of the metal volume fraction of FMLs,the number of the metal layers in FMLs,and the foam strength on the dynamic response of foam-filled tubes are discussed through the analytical model in details.It is shown that the force increases with the increase in the metal volume fraction in FMLs,the number of the metal layers in FML,and the foam strength for the given deflection.展开更多
Objective To compare the outcomes after self-expanding metallic stent (SEMS) or transanal drainage tube (TDT) placement in patients with malignant large-bowel obstruction (MLBO). Methods Seventy-three patients with ML...Objective To compare the outcomes after self-expanding metallic stent (SEMS) or transanal drainage tube (TDT) placement in patients with malignant large-bowel obstruction (MLBO). Methods Seventy-three patients with MLBO from the clinical unit underwent SEMS (n = 51) or TDT (n = 22) placement from 2012 to 2017. The success rates of placement, clinical outcomes after decompression, complications, the time to resuming enteral nutrition (EN), Karnofsky performance status (KPS) scoring and the following-up therapeutic options were investigated. Results Technical success were achieved in 100% of patients in both groups. The clinical success rates were 98.0%(50/51) for SEMS and 95.5%(21/22) for TDT. No perforation was found in any group, while 3.9%(2/51) in the SEMS and 18.2%(4/22) in TDT group experienced displacement (P = 0.26). It took 2.1 IQR (0~2) days and 3 IQR (2~5) days to resume EN in the SEMS and TDT groups, respectively (P < 0.001). The KPS scores were significantly higher in patients implanted with SEMS (70, IQR 50~80) than in those with TDT (35, IQR 30~50)(P < 0.001). In the SEMS group, 37.3%(19/51) of patients underwent stenting as a bridge to surgery, 9.8%(5/51) for chemotherapy only and 52.9%(27/51) for palliation, while 40.9%(9/22), 0 and 59.1%(13/22) underwent placement for these reasons in the TDT group, respectively. The majority (6/9) of the patients who underwent TDT placement as a bridge to surgery required stoma creation, while only 31.6%(6/19) of those in the SEMS group needed a stoma (P = 0.080). In addition, anastomotic leakage was only found in the TDT group (2/9)(P = 0.10). Conclusion Both SEMS and TDT placement could provide clinical relief for MLBO. However, SEMS placement is associated with earlier EN, fewer complications, and benefits for the postoperative quality-of-life.展开更多
High frequency shock load is often generated during pyrotechnic device working, which is detrimental to spacecraft structures and electric devices. Therefore, it is valuable to reduce the shock load in pyrotechnic dev...High frequency shock load is often generated during pyrotechnic device working, which is detrimental to spacecraft structures and electric devices. Therefore, it is valuable to reduce the shock load in pyrotechnic device design. Actually, there are several ways to decrease pyroshock loads, such as reduction of powder,installation of buffering structure, insulation of damageable devices, and so on. Considered assuring the function of pyrotechnic device and minimum of structure modification, shock absorbing structure is more propitious to be introduced in pyrotechnic device. In this paper, based on the method of thinwalled metal tube diameter-expanding, a thin-walled tube shock buffering structure was designed on a separate bolt. Built on the simplified structure of a separate bolt, the model of cone piston impacting thin-walled tube absorber was established, and the thin-walled tube shock absorbing characteristics and the relation between cone angles and absorber performance were analyzed. The results showed that the change of buffering force of thin-walled tube could be divided into four phases, and each phase was correspondent to the cone piston structure. In addition, as the cone angle increases, the max shock acceleration changes in the style of decrease-increase-decrease-increase, which is the result of coupled effects of cone piston max enter depth, buffering force and energy loss. In short, these results could establish the relationships between thin-walled tube absorbing performance and its structure, which is of significance to develop low-shock pyrotechnic device.展开更多
Tube and bar products of aluminum alloy composites reinforced by alumina short fiber were formed in a single process with liquid extrusion technology. The microstructure verifies that the reinforcing effect is obvious...Tube and bar products of aluminum alloy composites reinforced by alumina short fiber were formed in a single process with liquid extrusion technology. The microstructure verifies that the reinforcing effect is obvious in the deformation direction since fibers are distributed along this direction, which is resulted from the flow and crystallization under pressure of liquid metal and large plastic deformation of solidified metal in the process. The interface between fiber and matrix belongs to mechanical bonding. The fractograph demonstrates ductile mode. Liquid extrusion process opens up a new way for fabricating tube, bar and shaped products.展开更多
An open-cell porous bulk metallic glass (BMG) with a diameter of at least 6 mm was fabricated by using an U-turn quartz tube and infiltration casting around soluble NaCI placeholders. The pore formation and glassy s...An open-cell porous bulk metallic glass (BMG) with a diameter of at least 6 mm was fabricated by using an U-turn quartz tube and infiltration casting around soluble NaCI placeholders. The pore formation and glassy structure were examined by optical microscopy (OM), scanning electron microscopy (SEM) and X-ray diffraction (XRD). The results show that the pores or cells are connected to each other and the specimen is composed of a mostly glassy phase. This paper provides a suitable method for fabrication of porous BMG and BMG with larger size in diameter.展开更多
BACKGROUND Acute iatrogenic colorectal perforation(AICP)is a serious adverse event,and immediate AICP usually requires early endoscopic closure.Immediate surgical repair is required if the perforation is large,the end...BACKGROUND Acute iatrogenic colorectal perforation(AICP)is a serious adverse event,and immediate AICP usually requires early endoscopic closure.Immediate surgical repair is required if the perforation is large,the endoscopic closure fails,or the patient's clinical condition deteriorates.In cases of delayed AICP(>4 h),surgical repair or enterostomy is usually performed,but delayed rectal perforation is rare.CASE SUMMARY A 53-year-old male patient underwent endoscopic submucosal dissection(ESD)at a local hospital for the treatment of a laterally spreading tumor of the rectum,and the wound was closed by an endoscopist using a purse-string suture.Unfortunately,the patient then presented with delayed rectal perforation(6 h after ESD).The surgeons at the local hospital attempted to treat the perforation and wound surface using transrectal endoscopic microsurgery(TEM);however,the perforation worsened and became enlarged,multiple injuries to the mucosa around the perforation and partial tearing of the rectal mucosa occurred,and the internal anal sphincter was damaged.As a result,the perforation became more complicated.Due to the increased bleeding,surgical treatment with suturing could not be performed using TEM.Therefore,the patient was sent to our medical center for follow-up treatment.After a multidisciplinary discussion,we believed that the patient should undergo an enterostomy.However,the patient strongly refused this treatment plan.Because the position of the rectal perforation was relatively low and the intestine had been adequately prepared,we attempted to treat the complicated delayed rectal perforation using a self-expanding covered mental stent(SECMS)in combination with a transanal ileus drainage tube(TIDT).CONCLUSION For patients with complicated delayed perforation in the lower rectum and adequate intestinal preparation,a SECMS combined with a TIDT can be used and may result in very good outcomes.展开更多
Transnasal intubation is a clinical operation usually performed blindly at the bedside.Mild adverse events,such as epistaxis and tube misplacement,are relatively common.Esophageal bleeding or perforation and other ser...Transnasal intubation is a clinical operation usually performed blindly at the bedside.Mild adverse events,such as epistaxis and tube misplacement,are relatively common.Esophageal bleeding or perforation and other serious adverse events are rare.In the present study,two cases of severe diffuse esophageal bleeding caused by the blind placement of a nasogastric tube are described.These cases were successfully treated using a covered metal stent or Sengstaken-Blakemore tube.A review of the literature regarding the possible causes of such adverse events and the potential endoscopic treatments for severe hemorrhage are discussed.展开更多
基金Project supported by the National Natural Science Foundation of China (Nos. 12272290 and11872291)the State Key Laboratory of Automotive Safety and Energy of China (No. KFY2202)。
文摘In this paper, a novel efficient energy absorber with free inversion of a metal foam-filled circular tube(MFFCT) is designed, and the axial compressive behavior of the MFFCT under free inversion is studied analytically and numerically. The theoretical analysis reveals that the energy is mainly dissipated through the radial bending of the metal circular tube, the circumferential expansion of the metal circular tube, and the metal filled-foam compression. The principle of energy conservation is used to derive the theoretical formula for the minimum compressive force of the MFFCT over free inversion under axial loading. Furthermore, the free inversion deformation characteristics of the MFFCT are analyzed numerically. The theoretical steady values are found to be in good agreement with the results of the finite element(FE) analysis. The effects of the average diameter of the metal tube, the wall thickness of the metal tube, and the filled-foam strength on the free inversion deformation of the MFFCT are considered. It is observed that in the steady deformation stage, the load-carrying and energy-absorbing capacities of the MFFCT increase with the increase in the average diameter of the metal tube, the wall thickness of the metal tube, or the filled-foam strength. The specific energy absorption(SEA) of free inversion of the MFFCT is significantly higher than that of the metal tube alone.
文摘BACKGROUND Emergency surgical resection is a standard treatment for right-sided malignant colonic obstruction; however, the procedure is associated with high rates of mortality and morbidity. Although a bridge to surgery can be created to obviate the need for emergency surgery, its effects on long-term outcomes and the most practical management strategies for right-sided malignant colonic obstruction remain unclear.AIM To determine the appropriate management approach for right-sided malignant colonic obstruction.METHODS Forty patients with right-sided malignant colonic obstruction who underwent curative resection from January 2007 to April 2017 were included in the study.We compared the perioperative and long-term outcomes of patients who received bridges to surgery established using decompression tubes and those created using self-expandable metallic stents(SEMS). The primary outcome was the overall survival duration(OS) and the secondary endpoints were the diseasefree survival(DFS) duration and the preoperative and postoperative morbidity rates. Analysis was performed on an intention-to-treat basis.RESULTS There were 21 patients in the decompression tube group and 19 in the SEMS group. There were no significant differences in the perioperative morbidity rates of the two groups. The OS rate was significantly higher in the decompression tube group than in the SEMS group(5-year OS rate; decompression tube 79.5%,SEMS 32%, P = 0.043). Multivariate analysis revealed that the bridge to surgery using a decompression tube was significantly associated with the OS(hazard ratio, 17.41; P = 0.004). The 3-year DFS rate was significantly higher in thedecompression tube group than in the SEMS group(68.9% vs 45.9%; log-rank test,P = 0.032). A propensity score–adjusted analysis also demonstrated that the prognosis was significantly better in the decompression tube group than in the SEMS group.CONCLUSION The bridge to surgery using trans-nasal and trans-anal decompression tubes for right-sided malignant colonic obstruction is safe and may improve long-term outcomes.
文摘We present here our investigations of the features of focused electron beam transport in free space at elevated pressures of a few pascals.We have explored the effect of the beam accelerating voltage,operating gas pressure,and magnetic focusing upon the trajectory of beam electrons in the crossover region,in particular on the beam convergence and divergence angles.It is shown that for the forevacuum pressure range of 2-5 Pa explored,a distinctive feature of the propagation of a focused electron beam with a current of up to 20 mA at an accelerating voltage of 10-20 kV is the difference in the angles of convergence(before the focus)and divergence(after the focus).Whereas at a low pressure of 2 Pa the divergence angle is smaller than the convergence angle,as the pressure increases the divergence angle increases and for pressures greater than 5 Pa the divergence angle is greater than the convergence angle.The results obtained were used in experiments on electron beam transport through a long narrow metal tube with a diameter of 5.8-9.2 mm and length of 10-30 cm.We show that for a 30 cm long tube of 7.5 mm diameter,the focused beam transmission can exceed 70%.
基金supported by National Natural Science Foundation of China(No.61671431)
文摘Based on the beam wave synchronous interaction in transverse and longitudinal directions at the same time and starting from Maxwell’s equation and linear Vlasov equation, the beam–wave interaction ‘hot’ dispersion equation considering both cyclotron resonance and Cherenkov resonance in a staggered double metallic grating traveling wave tube is deduced.Through the reasonable selection for geometric and electrical parameters, the numerical calculation and analysis of the ‘hot’ dispersion equation shows that the beam–wave interaction gain and frequency band with the cyclotron resonance enhancement effect are higher than those with only Cherenkov resonance radiation.
基金the National Natural Science Foundation of China(Nos.11872291 and11972281)the Jiangsu Key Laboratory of Engineering Mechanics,Southeast University+2 种基金the Fundamental Research Funds for the Central Universities(No.LEM21B01)the Key Laboratory of Impact and Safety Engineering(Ningbo University),Ministry of Education(No.cj202002)the Natural Science Basic Research Plan in Shaanxi Province of China(No.2020JM-034)。
文摘Through theoretical analysis and finite element simulation,the low-velocity impact of rectangular foam-filled fiber metal laminate(FML)tubes is studied in this paper.According to the rigid-plastic material approximation with modifications,simple analytical solutions are obtained for the dynamic response of rectangular foam-filled FML tubes.The numerical calculations for low-velocity impact of rectangular foam-filled FML tubes are conducted.The accuracy of analytical solutions and numerical results is verified by each other.Finally,the effects of the metal volume fraction of FMLs,the number of the metal layers in FMLs,and the foam strength on the dynamic response of foam-filled tubes are discussed through the analytical model in details.It is shown that the force increases with the increase in the metal volume fraction in FMLs,the number of the metal layers in FML,and the foam strength for the given deflection.
文摘Objective To compare the outcomes after self-expanding metallic stent (SEMS) or transanal drainage tube (TDT) placement in patients with malignant large-bowel obstruction (MLBO). Methods Seventy-three patients with MLBO from the clinical unit underwent SEMS (n = 51) or TDT (n = 22) placement from 2012 to 2017. The success rates of placement, clinical outcomes after decompression, complications, the time to resuming enteral nutrition (EN), Karnofsky performance status (KPS) scoring and the following-up therapeutic options were investigated. Results Technical success were achieved in 100% of patients in both groups. The clinical success rates were 98.0%(50/51) for SEMS and 95.5%(21/22) for TDT. No perforation was found in any group, while 3.9%(2/51) in the SEMS and 18.2%(4/22) in TDT group experienced displacement (P = 0.26). It took 2.1 IQR (0~2) days and 3 IQR (2~5) days to resume EN in the SEMS and TDT groups, respectively (P < 0.001). The KPS scores were significantly higher in patients implanted with SEMS (70, IQR 50~80) than in those with TDT (35, IQR 30~50)(P < 0.001). In the SEMS group, 37.3%(19/51) of patients underwent stenting as a bridge to surgery, 9.8%(5/51) for chemotherapy only and 52.9%(27/51) for palliation, while 40.9%(9/22), 0 and 59.1%(13/22) underwent placement for these reasons in the TDT group, respectively. The majority (6/9) of the patients who underwent TDT placement as a bridge to surgery required stoma creation, while only 31.6%(6/19) of those in the SEMS group needed a stoma (P = 0.080). In addition, anastomotic leakage was only found in the TDT group (2/9)(P = 0.10). Conclusion Both SEMS and TDT placement could provide clinical relief for MLBO. However, SEMS placement is associated with earlier EN, fewer complications, and benefits for the postoperative quality-of-life.
文摘High frequency shock load is often generated during pyrotechnic device working, which is detrimental to spacecraft structures and electric devices. Therefore, it is valuable to reduce the shock load in pyrotechnic device design. Actually, there are several ways to decrease pyroshock loads, such as reduction of powder,installation of buffering structure, insulation of damageable devices, and so on. Considered assuring the function of pyrotechnic device and minimum of structure modification, shock absorbing structure is more propitious to be introduced in pyrotechnic device. In this paper, based on the method of thinwalled metal tube diameter-expanding, a thin-walled tube shock buffering structure was designed on a separate bolt. Built on the simplified structure of a separate bolt, the model of cone piston impacting thin-walled tube absorber was established, and the thin-walled tube shock absorbing characteristics and the relation between cone angles and absorber performance were analyzed. The results showed that the change of buffering force of thin-walled tube could be divided into four phases, and each phase was correspondent to the cone piston structure. In addition, as the cone angle increases, the max shock acceleration changes in the style of decrease-increase-decrease-increase, which is the result of coupled effects of cone piston max enter depth, buffering force and energy loss. In short, these results could establish the relationships between thin-walled tube absorbing performance and its structure, which is of significance to develop low-shock pyrotechnic device.
文摘Tube and bar products of aluminum alloy composites reinforced by alumina short fiber were formed in a single process with liquid extrusion technology. The microstructure verifies that the reinforcing effect is obvious in the deformation direction since fibers are distributed along this direction, which is resulted from the flow and crystallization under pressure of liquid metal and large plastic deformation of solidified metal in the process. The interface between fiber and matrix belongs to mechanical bonding. The fractograph demonstrates ductile mode. Liquid extrusion process opens up a new way for fabricating tube, bar and shaped products.
文摘An open-cell porous bulk metallic glass (BMG) with a diameter of at least 6 mm was fabricated by using an U-turn quartz tube and infiltration casting around soluble NaCI placeholders. The pore formation and glassy structure were examined by optical microscopy (OM), scanning electron microscopy (SEM) and X-ray diffraction (XRD). The results show that the pores or cells are connected to each other and the specimen is composed of a mostly glassy phase. This paper provides a suitable method for fabrication of porous BMG and BMG with larger size in diameter.
基金Supported by the Hangzhou Major Science and Technology Projects,No.202004A14the Hangzhou Medical and Health Science and Technology Plan,No.OO20190610 and No.A20200174+1 种基金the Zhejiang Medical and Health Science and Technology Plan,No.WKJ-ZJ-2136 and No.2019RC068the Natural Science Foundation of Zhejiang Province,No.LGF21H310004.
文摘BACKGROUND Acute iatrogenic colorectal perforation(AICP)is a serious adverse event,and immediate AICP usually requires early endoscopic closure.Immediate surgical repair is required if the perforation is large,the endoscopic closure fails,or the patient's clinical condition deteriorates.In cases of delayed AICP(>4 h),surgical repair or enterostomy is usually performed,but delayed rectal perforation is rare.CASE SUMMARY A 53-year-old male patient underwent endoscopic submucosal dissection(ESD)at a local hospital for the treatment of a laterally spreading tumor of the rectum,and the wound was closed by an endoscopist using a purse-string suture.Unfortunately,the patient then presented with delayed rectal perforation(6 h after ESD).The surgeons at the local hospital attempted to treat the perforation and wound surface using transrectal endoscopic microsurgery(TEM);however,the perforation worsened and became enlarged,multiple injuries to the mucosa around the perforation and partial tearing of the rectal mucosa occurred,and the internal anal sphincter was damaged.As a result,the perforation became more complicated.Due to the increased bleeding,surgical treatment with suturing could not be performed using TEM.Therefore,the patient was sent to our medical center for follow-up treatment.After a multidisciplinary discussion,we believed that the patient should undergo an enterostomy.However,the patient strongly refused this treatment plan.Because the position of the rectal perforation was relatively low and the intestine had been adequately prepared,we attempted to treat the complicated delayed rectal perforation using a self-expanding covered mental stent(SECMS)in combination with a transanal ileus drainage tube(TIDT).CONCLUSION For patients with complicated delayed perforation in the lower rectum and adequate intestinal preparation,a SECMS combined with a TIDT can be used and may result in very good outcomes.
基金This work was supported by the Natural Science Foundation of Fujian Province(grant 2020 J01974)Special Scientific Research Funds of Fujian Provincial Department of Finance(grant 22SCZZX012).
文摘Transnasal intubation is a clinical operation usually performed blindly at the bedside.Mild adverse events,such as epistaxis and tube misplacement,are relatively common.Esophageal bleeding or perforation and other serious adverse events are rare.In the present study,two cases of severe diffuse esophageal bleeding caused by the blind placement of a nasogastric tube are described.These cases were successfully treated using a covered metal stent or Sengstaken-Blakemore tube.A review of the literature regarding the possible causes of such adverse events and the potential endoscopic treatments for severe hemorrhage are discussed.