There are lots of researches on fixture layout optimization for large thin-walled parts.Current researches focus on the positioning problem,i.e.,optimizing the positions of a constant number of fixtures.However,how to...There are lots of researches on fixture layout optimization for large thin-walled parts.Current researches focus on the positioning problem,i.e.,optimizing the positions of a constant number of fixtures.However,how to determine the number of fixtures is ignored.In most cases,the number of fixtures located on large thin-walled parts is determined based on engineering experience,which leads to huge fixture number and extra waste.Therefore,this paper constructs an optimization model to minimize the number of fixtures.The constraints are set in the optimization model to ensure that the part deformation is within the surface profile tolerance.In addition,the assembly gap between two parts is also controlled.To conduct the optimization,this paper develops an improved particle swarm optimization(IPSO)algorithm by integrating the shrinkage factor and adaptive inertia weight.In the algorithm,particles are encoded according to the fixture position.Each dimension of the particle is assigned to a sub-region by constraining the optional position range of each fixture to improve the optimization efficiency.Finally,a case study on ship curved panel assembly is provided to prove that our method can optimize the number of fixtures while meeting the assembly quality requirements.This research proposes a method to optimize the number of fixtures,which can reduce the number of fixtures and achieve deformation control at the same time.展开更多
An increasing number of researchers have researched fixture layout optimization for thin-walled part assembly during the past decades.However,few papers systematically review these researches.By analyzing existing lit...An increasing number of researchers have researched fixture layout optimization for thin-walled part assembly during the past decades.However,few papers systematically review these researches.By analyzing existing literature,this paper summarizes the process of fixture layout optimization and the methods applied.The process of optimization is made up of optimization objective setting,assembly variation/deformation modeling,and fixture layout optimization.This paper makes a review of the fixture layout for thin-walled parts according to these three steps.First,two different kinds of optimization objectives are introduced.Researchers usually consider in-plane variations or out-of-plane deformations when designing objectives.Then,modeling methods for assembly variation and deformation are divided into two categories:Mechanism-based and data-based methods.Several common methods are discussed respectively.After that,optimization algorithms are reviewed systematically.There are two kinds of optimization algorithms:Traditional nonlinear programming and heuristic algorithms.Finally,discussions on the current situation are provided.The research direction of fixture layout optimization in the future is discussed from three aspects:Objective setting,improving modeling accuracy and optimization algorithms.Also,a new research point for fixture layout optimization is discussed.This paper systematically reviews the research on fixture layout optimization for thin-walled parts,and provides a reference for future research in this field.展开更多
Lightweight thin-walled structures with lattice infill are widely desired in satellite for their high stiffness-to-weight ratio and superior buckling strength resulting fromthe sandwich effect.Such structures can be f...Lightweight thin-walled structures with lattice infill are widely desired in satellite for their high stiffness-to-weight ratio and superior buckling strength resulting fromthe sandwich effect.Such structures can be fabricated bymetallic additive manufacturing technique,such as selective laser melting(SLM).However,the maximum dimensions of actual structures are usually in a sub-meter scale,which results in restrictions on their appliance in aerospace and other fields.In this work,a meter-scale thin-walled structure with lattice infill is designed for the fuel tank supporting component of the satellite by integrating a self-supporting lattice into the thickness optimization of the thin-wall.The designed structure is fabricated by SLM of AlSi10Mg and cold metal transfer welding technique.Quasi-static mechanical tests and vibration tests are both conducted to verify the mechanical strength of the designed large-scale lattice thin-walled structure.The experimental results indicate that themeter-scale thin-walled structure with lattice infill could meet the dimension and lightweight requirements of most spacecrafts.展开更多
Pitting corrosion is harmful during bridge construction,which will lead to uneven roughness of steel surfaces and reduce the thickness of steel.Hence,the effect of pitting corrosion on the mechanical properties of col...Pitting corrosion is harmful during bridge construction,which will lead to uneven roughness of steel surfaces and reduce the thickness of steel.Hence,the effect of pitting corrosion on the mechanical properties of cold-formed thin-walled steel stub columns is studied,and the empirical formulas are established through regression fitting to predict the ultimate load of web and flange under pitting corrosion.In detail,the failure modes and load-displacement curves of specimens with different locations,area ratios,and depths are obtained through a large number of non-linear finite element analysis.As for the specimens with pitting corrosion on the web,all the specimens are subject to local buckling failure,and the failure mode will not change with pitting corrosion,but the failure location will change with pitting corrosion location;the size,location,and area ratio of pitting corrosion have little influence on the ultimate load of cold-formed thin-walled steel short columns,but the loss rate of pitting corrosion section area has a greater impact on the ultimate bearing capacity.As for the specimen with flange pitting corrosion,the location and area ratio of pitting corrosion have less influence on the ultimate load of cold-formed thin-walled steel short columns,and the section area loss rate has greater influence on the ultimate bearing capacity;the impact of web pitting corrosion on the ultimate load is greater than that of flange pitting corrosion under the same condition of pitting corrosion section area.The prediction formulas of limit load which are suitable for pitting corrosion of web and flange are established,which can provide a reference for performance evaluation of corroded cold-formed thin-walled steel.展开更多
This paper develops a new numerical framework for modeⅢcrack problems of thin-walled structures by integrating multiple advanced techniques in the boundary element literature.The details of special crack-tip elements...This paper develops a new numerical framework for modeⅢcrack problems of thin-walled structures by integrating multiple advanced techniques in the boundary element literature.The details of special crack-tip elements for displacement and stress are derived.An exponential transformation technique is introduced to accurately calculate the nearly singular integral,which is the key task of the boundary element simulation of thin-walled structures.Three numerical experiments with different types of cracks are provided to verify the performance of the present numerical framework.Numerical results demonstrate that the present scheme is valid for modeⅢcrack problems of thin-walled structures with the thickness-to-length ratio in the microscale,even nanoscale,regime.展开更多
Casing wear and casing corrosion are serious problems affecting casing integrity failure in deep and ultra-deep wells.This paper aims to predict the casing burst strength with considerations of both wear and corrosion...Casing wear and casing corrosion are serious problems affecting casing integrity failure in deep and ultra-deep wells.This paper aims to predict the casing burst strength with considerations of both wear and corrosion.Firstly,the crescent wear shape is simplified into three categories according to common mathematical models.Then,based on the mechano-electrochemical(M-E)interaction,the prediction model of corrosion depth is built with worn depth as the initial condition,and the prediction models of burst strength of the worn casing and corroded casing are obtained.Secondly,the accuracy of different prediction models is validated by numerical simulation,and the main influence factors on casing strength are obtained.At last,the theoretical models are applied to an ultra-deep well in Northwest China,and the dangerous well sections caused by wear and corrosion are predicted,and the corrosion rate threshold to ensure the safety of casing is obtained.The results show that the existence of wear defects results in a stress concentration and enhanced M-E interaction on corrosion depth growth.The accuracy of different mathematical models is different:the slot ring model is most accurate for predicting corrosion depth,and the eccentric model is most accurate for predicting the burst strength of corroded casing.The burst strength of the casing will be overestimated by more than one-third if the M-E interaction is neglected,so the coupling effect of wear and corrosion should be sufficiently considered in casing integrity evaluation.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
Recently, demand for the lightweight alloy in electric/electronic housings has been greatly increased. However, among the lightweight alloys, aluminum alloy thin-walled die casting is problematic because it is quite d...Recently, demand for the lightweight alloy in electric/electronic housings has been greatly increased. However, among the lightweight alloys, aluminum alloy thin-walled die casting is problematic because it is quite difficult to achieve sufficient fluidity and feedability to fill the thin cavity as the wall thickness becomes less than 1mm. Therefore, in this study, thin-walled die casting of aluminum (Al-Si-Cu alloy: ALDC 12) in size of notebook computer housing and thickness of 0.8 mm was investigated by solidification simulation (MAGMA soft) and actual casting experiment (Buhler Evolution B 53D). Three different types of gating design, finger, tangential and split type with 6 vertical runners, were simulated and the results showed that sound thin-walled die casting was possible with tangential and split type gating design because those gates allowed aluminum melt to flow into the thin cavity uniformly and split type gating system was preferable gating design comparing to tangential type gating system at the point of view of soundness of casting and distortion generated after solidification. Also, the solidification simulation agreed well with the actual die-casting and the casting showed no casting defects and distortion.展开更多
BACKGROUND Clear cell sarcoma(CCS)is a rare soft-tissue sarcoma.The most common metastatic sites for CCS are the lungs,bones and brain.CCS is highly invasive and mainly metastasizes to the lung,followed by the bone an...BACKGROUND Clear cell sarcoma(CCS)is a rare soft-tissue sarcoma.The most common metastatic sites for CCS are the lungs,bones and brain.CCS is highly invasive and mainly metastasizes to the lung,followed by the bone and brain;however,pancreatic metastasis is relatively rare.CASE SUMMARY We report on a rare case of CCS with pancreatic metastasis in a 47-year-old man.The patient had a relevant medical history 3 years ago,with abdominal pain as the main clinical manifestation.No abnormalities were observed on physical examination and the tumor was found on abdominal computed tomography.Based on the medical history and postoperative pathology,the patient was diagnosed with CCS with pancreatic metastasis.The patient was successfully treated with surgical interventions,including distal pancreatectomy and sple-nectomy.CONCLUSION This report summarizes the available treatment modalities for CCS and the importance of regular postoperative follow-up for patients with CCS.展开更多
The application of continuous natural fibers as reinforcement in composite thin-walled structures offers a feasible approach to achieve light weight and high strength while remaining environmentally friendly.In additi...The application of continuous natural fibers as reinforcement in composite thin-walled structures offers a feasible approach to achieve light weight and high strength while remaining environmentally friendly.In addition,additive manufacturing technology provides a favorable process foundation for its realization.In this study,the printability and energy absorption properties of 3D printed continuous fiber reinforced thin-walled structures with different configurations were investigated.The results suggested that a low printing speed and a proper layer thickness would mitigate the printing defects within the structures.The printing geometry accuracy of the structures could be further improved by rounding the sharp corners with appropriate radii.This study successfully fabricated structures with vari-ous configurations characterized by high geometric accuracy through printing parameters optimization and path smoothing.Moreover,the compressive property and energy absorption characteristics of the structures under quasi-static axial compression were evaluated and compared.It was found that all studied thin-walled structures exhibited progressive folding deformation patterns during compression.In particular,energy absorption process was achieved through the combined damage modes of plastic deformation,fiber pullout and delamination.Furthermore,the com-parison results showed that the hexagonal structure exhibited the best energy absorption performance.The study revealed the structure-mechanical property relationship of 3D printed continuous fiber reinforced composite thin-walled structures through the analysis of multiscale failure characteristics and load response,which is valuable for broadening their applications.展开更多
AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a tota...AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.展开更多
BACKGROUND Mediastinal emphysema is a condition in which air enters the mediastinum between the connective tissue spaces within the pleura for a variety of reasons.It can be spontaneous or secondary to chest trauma,es...BACKGROUND Mediastinal emphysema is a condition in which air enters the mediastinum between the connective tissue spaces within the pleura for a variety of reasons.It can be spontaneous or secondary to chest trauma,esophageal perforation,medi-cally induced factors,etc.Its common symptoms are chest pain,tightness in the chest,and respiratory distress.Most mediastinal emphysema patients have mild symptoms,but severe mediastinal emphysema can cause respiratory and circulatory failure,resulting in serious consequences.CASE SUMMARY A 75-year-old man,living alone,presented with sudden onset of severe epigastric pain with chest tightness after drinking alcohol.Due to the remoteness of his residence and lack of neighbors,the patient was found by his nephew and brought to the hospital the next morning after the disease onset.Computed tomography(CT)showed free gas in the abdominal cavity,mediastinal emph-ysema,and subcutaneous pneumothorax.Upper gastrointestinal angiography showed that the esophageal mucosa was intact and the gastric antrum was perforated.Therefore,we chose to perform open gastric perforation repair on the patient under thoracic epidural anesthesia combined with intravenous anesthesia.An operative incision of the muscle layer of the patient's abdominal wall was made,and a large amount of subperitoneal gas was revealed.And a continued incision of the peritoneum revealed the presence of a perforation of approx-imately 0.5 cm in the gastric antrum,which we repaired after pathological examination.Postoperatively,the patient received high-flow oxygen and cough exercises.Chest CT was performed on the first and sixth postoperative days,and the mediastinal and subcutaneous gas was gradually reduced.CONCLUSION After gastric perforation,a large amount of free gas in the abdominal cavity can reach the mediastinum through the loose connective tissue at the esophageal hiatus of the diaphragm,and upper gastrointestinal angiography can clarify the site of perforation.In patients with mediastinal emphysema,open surgery avoids the elevation of the diaphragm caused by pneumoperitoneum compared to laparoscopic surgery and avoids increasing the mediastinal pressure.In addition,thoracic epidural anesthesia combined with intravenous anesthesia also avoids pressure on the mediastinum from mechanical ventilation.展开更多
BACKGROUND Bezoars usually compile human fibers and debris.A special form of bezoar in case of psychologically altered individuals is the trichobezoar.It consists of voluntarily swallowed hair bulks and is normally re...BACKGROUND Bezoars usually compile human fibers and debris.A special form of bezoar in case of psychologically altered individuals is the trichobezoar.It consists of voluntarily swallowed hair bulks and is normally removed via gastroscopy.Trichobezoars leading to ileus have rarely been reported.CASE SUMMARY A 24-year-old female patient presented to the emergency room with abdominal pain,nausea,and vomiting for 3 d.Her previous medical and psychiatric history was unremarkable.Laboratory analysis showed iron deficiency anemia,leukocytosis,and elevated liver enzymes.An abdominal CT scan revealed a dense structure in the patients’stomach which turned out to be a huge trichobezoar completely obstructing the pylorus.The trichobezoar had to be removed surgi-cally.During her postoperative course,a subcutaneous seroma formed.After a single puncture,the rest of the recovery process was unremarkable,and the patient recovered fully.CONCLUSION A mechanical bowel obstruction is a potentially life-threatening event for every patient.In our case a young female was suffering from severe symptoms of an obstruction which might have resulted in serious harm without successful surgical management.展开更多
BACKGROUND Early adenocarcinoma mixed with a neuroendocrine carcinoma(NEC)component arising in the gastroesophageal junctional(GEJ)region is rare and even rarer in young patients.Here,we report such a case in a 29-yea...BACKGROUND Early adenocarcinoma mixed with a neuroendocrine carcinoma(NEC)component arising in the gastroesophageal junctional(GEJ)region is rare and even rarer in young patients.Here,we report such a case in a 29-year-old Chinese man.CASE SUMMARY This patient presented to our hospital with a 3-mo history of dysphagia and regurgitation.Upper endoscopy revealed an elevated nodule in the distal esophagus 1.6 cm above the GEJ line,without Barrett’s esophagus or involvement of the gastric cardia.The nodule was completely resected by endoscopic submu-cosal dissection(ESD).Pathological examination confirmed diagnosis of intra-mucosal adenocarcinoma mixed with an NEC component,measuring 1.5 cm.Immunohistochemically,both adenocarcinoma and NEC components were positive for P53 with a Ki67 index of 90%;NEC was positive for synaptophysin and chromogranin.Next-generation sequencing of 196 genes demonstrated a novel germline mutation of the ERCC3 gene in the DNA repair pathway and a germline mutation of the RNF43 gene,a common gastric cancer driver gene,in addition to pathogenic somatic mutations in P53 and CHEK2 genes.The patient was alive without evidence of the disease 36 mo after ESD.CONCLUSION Early adenocarcinoma with an NEC component arising in the distal esophageal side of the GEJ region showed evidence of gastric origin.展开更多
BACKGROUND Microwave endometrial ablation(MEA)is a minimally invasive treatment method for heavy menstrual bleeding.However,additional treatment is often required after recurrence of uterine myomas treated with MEA.Ad...BACKGROUND Microwave endometrial ablation(MEA)is a minimally invasive treatment method for heavy menstrual bleeding.However,additional treatment is often required after recurrence of uterine myomas treated with MEA.Additionally,because this treatment ablates the endometrium,it is not indicated for patients planning to become pregnant.To overcome these issues,we devised a method for ultrasound-guided microwave ablation of uterine myoma feeder vessels.We report three patients successfully treated for heavy menstrual bleeding,secondary to uterine myoma,using our novel method.CASE SUMMARY All patients had a favorable postoperative course,were discharged within 4 h,and experienced no complications.Further,no postoperative recurrence of heavy menstrual bleeding was noted.Our method also reduced the myoma’s maximum diameter.CONCLUSION This method does not ablate the endometrium,suggesting its potential appli-cation in patients planning to become pregnant.展开更多
BACKGROUND Whether hyperbaric oxygen therapy(HBOT)can cause paradoxical herniation is still unclear.CASE SUMMARY A 65-year-old patient who was comatose due to brain trauma underwent decompressive craniotomy and gradua...BACKGROUND Whether hyperbaric oxygen therapy(HBOT)can cause paradoxical herniation is still unclear.CASE SUMMARY A 65-year-old patient who was comatose due to brain trauma underwent decompressive craniotomy and gradually regained consciousness after surgery.HBOT was administered 22 d after surgery due to speech impairment.Paradoxical herniation appeared on the second day after treatment,and the patient’s condition worsened after receiving mannitol treatment at the rehabilitation hospital.After timely skull repair,the paradoxical herniation was resolved,and the patient regained consciousness and had a good recovery as observed at the follow-up visit.CONCLUSION Paradoxical herniation is rare and may be caused by HBOT.However,the underlying mechanism is unknown,and the understanding of this phenomenon is insufficient.The use of mannitol may worsen this condition.Timely skull repair can treat paradoxical herniation and prevent serious complications.展开更多
BACKGROUND Mycobacterium tuberculosis(TB)is the causative agent of TB,a chronic granulo-matous illness.This disease is prevalent in low-income countries,posing a significant global health challenge.Gastrointestinal TB...BACKGROUND Mycobacterium tuberculosis(TB)is the causative agent of TB,a chronic granulo-matous illness.This disease is prevalent in low-income countries,posing a significant global health challenge.Gastrointestinal TB is one of the three forms.The disease can mimic other intra-abdominal conditions,leading to delayed diagnosis owing to the absence of specific symptoms.While gastric outlet obs-truction(GOO)remains a frequent complication,its incidence has declined with the advent of proton pump inhibitors and Helicobacter pylori eradication therapy.Gastroduodenal TB can cause upper gastrointestinal hemorrhage,obstruction,and malignancy-like tumors.CASE SUMMARY A 23-year-old male presented with recurrent epigastric pain,distension,nausea,vomiting,and weight loss,prompting a referral to a gastroenterologist clinic.Endoscopic examination revealed distorted gastric mucosa and signs of chronic inflammation.However,treatment was interrupted,possibly owing to vomiting or comorbidities such as human immunodeficiency virus infection or diabetes.Subsequent surgical intervention revealed a dilated stomach and diffuse thickening of the duodenal wall.Resection revealed gastric wall effacement with TB.CONCLUSION Primary gastric TB is rare,frequently leading to GOO.Given its rarity,suspicions should be promptly raised when encountering relevant symptoms,often requiring surgical intervention for diagnosis and treatment.展开更多
BACKGROUND High-grade pancreatic intraepithelial neoplasia(PanIN)exhibits no mass and is not detected by any examination modalities.However,it can be diagnosed by pancreatic juice cytology from indirect findings.Most ...BACKGROUND High-grade pancreatic intraepithelial neoplasia(PanIN)exhibits no mass and is not detected by any examination modalities.However,it can be diagnosed by pancreatic juice cytology from indirect findings.Most previous cases were diagnosed based on findings of a focal stricture of the main pancreatic duct(MPD)and caudal MPD dilatation and subsequent pancreatic juice cytology using endoscopic retrograde cholangiopancreatography(ERCP).We experienced a case of high-grade PanIN with an unclear MPD over a 20-mm range,but without caudal MPD dilatation on magnetic resonance cholangiopancreatography(MRCP).CASE SUMMARY A 60-year-old female patient underwent computed tomography for a follow-up of uterine cancer post-excision,which revealed pancreatic cysts.MRCP revealed an unclear MPD of the pancreatic body at a 20-mm length without caudal MPD dilatation.Thus,course observation was performed.After 24 mo,MRCP revealed an increased caudal MPD caliber and a larger pancreatic cyst.We performed ERCP and detected atypical cells suspected of adenocarcinoma by serial pancreatic juice aspiration cytology examination.We performed a distal pancreatectomy and obtained a histopathological diagnosis of high-grade PanIN.Pancreatic parenchyma invasion was not observed,and curative resection was achieved.CONCLUSION High-grade Pan-IN may cause MPD narrowing in a long range without caudal MPD dilatation.展开更多
BACKGROUND Chronic hepatitis C virus(HCV)infection is a major global health concern that leads to liver fibrosis,cirrhosis,and cancer.Regimens containing direct-acting antivirals(DAAs)have become the mainstay of HCV t...BACKGROUND Chronic hepatitis C virus(HCV)infection is a major global health concern that leads to liver fibrosis,cirrhosis,and cancer.Regimens containing direct-acting antivirals(DAAs)have become the mainstay of HCV treatment,achieving a high sustained virological response(SVR)with minimal adverse events.CASE SUMMARY A 74-year-old woman with chronic HCV infection was treated with the DAAs ledipasvir,and sofosbuvir for 12 wk and achieved SVR.Twenty-four weeks after treatment completion,the liver enzyme and serum IgG levels increased,and antinuclear antibody became positive without HCV viremia,suggesting the development of autoimmune hepatitis(AIH).After liver biopsy indicated AIH,a definite AIH diagnosis was made and prednisolone was initiated.The treatment was effective,and the liver enzyme and serum IgG levels normalized.However,multiple strictures of the intrahepatic and extrahepatic bile ducts with dilatation of the peripheral bile ducts appeared on magnetic resonance cholangiopancreatography after 3 years of achieving SVR,which were consistent with primary sclerosing cholangitis.CONCLUSION The potential risk of developing autoimmune liver diseases after DAA treatment should be considered.展开更多
BACKGROUND Regarding the incidence of malignant tumors in China,the incidence of liver cancer ranks fourth,second only to lung,gastric,and esophageal cancers.The case fatality rate ranks third after lung and cervical ...BACKGROUND Regarding the incidence of malignant tumors in China,the incidence of liver cancer ranks fourth,second only to lung,gastric,and esophageal cancers.The case fatality rate ranks third after lung and cervical cancer.In a previous study,the whole-process management model was applied to patients with breast cancer,which effectively reduced their negative emotions and improved treatment adherence and nursing satisfaction.METHODS In this single-center,randomized,controlled study,60 randomly selected patients with liver cancer who had been admitted to our hospital from January 2021 to January 2022 were randomly divided into an observation group(n=30),who received whole-process case management on the basis of routine nursing mea-sures,and a control group(n=30),who were given routine nursing measures.We compared differences between the two groups in terms of anxiety,depression,the level of hope,self-care ability,symptom distress,sleep quality,and quality of life.RESULTS Post-intervention,Hamilton anxiety scale,Hamilton depression scale,memory symptom assessment scale,and Pittsburgh sleep quality index scores in both groups were lower than those pre-intervention,and the observation group had lower scores than the control group(P<0.05).Herth hope index,self-care ability assessment scale-revision in Chinese,and quality of life measurement scale for patients with liver cancer scores in both groups were higher than those pre-intervention,with higher scores in the observation group compared with the control group(P<0.05).CONCLUSION Whole-process case management can effectively reduce anxiety and depression in patients with liver cancer,alleviate symptoms and problems,and improve the level of hope,self-care ability,sleep quality,and quality of life,as well as provide feasible nursing alternatives for patients with liver cancer.展开更多
基金Supported by National Natural Science Foundation of China(Grant No.52005371)Shanghai Pujiang Program of China(Grant No.2020PJD071)+1 种基金Shanghai Municipal Natural Science Foundation of China(Grant No.22ZR1463900)Fundamental Research Funds for the Central Universities of China.
文摘There are lots of researches on fixture layout optimization for large thin-walled parts.Current researches focus on the positioning problem,i.e.,optimizing the positions of a constant number of fixtures.However,how to determine the number of fixtures is ignored.In most cases,the number of fixtures located on large thin-walled parts is determined based on engineering experience,which leads to huge fixture number and extra waste.Therefore,this paper constructs an optimization model to minimize the number of fixtures.The constraints are set in the optimization model to ensure that the part deformation is within the surface profile tolerance.In addition,the assembly gap between two parts is also controlled.To conduct the optimization,this paper develops an improved particle swarm optimization(IPSO)algorithm by integrating the shrinkage factor and adaptive inertia weight.In the algorithm,particles are encoded according to the fixture position.Each dimension of the particle is assigned to a sub-region by constraining the optional position range of each fixture to improve the optimization efficiency.Finally,a case study on ship curved panel assembly is provided to prove that our method can optimize the number of fixtures while meeting the assembly quality requirements.This research proposes a method to optimize the number of fixtures,which can reduce the number of fixtures and achieve deformation control at the same time.
基金Supported by National Natural Science Foundation of China(Grant No.52005371)Shanghai Municipal Natural Science Foundation of China(Grant No.22ZR1463900)+1 种基金Fundamental Research Funds for the Central Universities of China(Grant No.22120220649)State Key Laboratory of Mechanical System and Vibration of China(Grant No.MSV202318).
文摘An increasing number of researchers have researched fixture layout optimization for thin-walled part assembly during the past decades.However,few papers systematically review these researches.By analyzing existing literature,this paper summarizes the process of fixture layout optimization and the methods applied.The process of optimization is made up of optimization objective setting,assembly variation/deformation modeling,and fixture layout optimization.This paper makes a review of the fixture layout for thin-walled parts according to these three steps.First,two different kinds of optimization objectives are introduced.Researchers usually consider in-plane variations or out-of-plane deformations when designing objectives.Then,modeling methods for assembly variation and deformation are divided into two categories:Mechanism-based and data-based methods.Several common methods are discussed respectively.After that,optimization algorithms are reviewed systematically.There are two kinds of optimization algorithms:Traditional nonlinear programming and heuristic algorithms.Finally,discussions on the current situation are provided.The research direction of fixture layout optimization in the future is discussed from three aspects:Objective setting,improving modeling accuracy and optimization algorithms.Also,a new research point for fixture layout optimization is discussed.This paper systematically reviews the research on fixture layout optimization for thin-walled parts,and provides a reference for future research in this field.
基金The authors are grateful for the support by National Key Research and Development Program of China(2021YFF0500300,2020YFB1708300)the National Natural Science Foundation of China(52205280,12172041).
文摘Lightweight thin-walled structures with lattice infill are widely desired in satellite for their high stiffness-to-weight ratio and superior buckling strength resulting fromthe sandwich effect.Such structures can be fabricated bymetallic additive manufacturing technique,such as selective laser melting(SLM).However,the maximum dimensions of actual structures are usually in a sub-meter scale,which results in restrictions on their appliance in aerospace and other fields.In this work,a meter-scale thin-walled structure with lattice infill is designed for the fuel tank supporting component of the satellite by integrating a self-supporting lattice into the thickness optimization of the thin-wall.The designed structure is fabricated by SLM of AlSi10Mg and cold metal transfer welding technique.Quasi-static mechanical tests and vibration tests are both conducted to verify the mechanical strength of the designed large-scale lattice thin-walled structure.The experimental results indicate that themeter-scale thin-walled structure with lattice infill could meet the dimension and lightweight requirements of most spacecrafts.
基金funded by the‘Research Project of the Sucheng to Sihong Section of the Yanluo Expressway-Measurement Technology and Application of Bridge Quality Project Based on UAV Binocular Imaging(No.00-00-JSFW-20230203-029)’,received by H.Z.Wang.
文摘Pitting corrosion is harmful during bridge construction,which will lead to uneven roughness of steel surfaces and reduce the thickness of steel.Hence,the effect of pitting corrosion on the mechanical properties of cold-formed thin-walled steel stub columns is studied,and the empirical formulas are established through regression fitting to predict the ultimate load of web and flange under pitting corrosion.In detail,the failure modes and load-displacement curves of specimens with different locations,area ratios,and depths are obtained through a large number of non-linear finite element analysis.As for the specimens with pitting corrosion on the web,all the specimens are subject to local buckling failure,and the failure mode will not change with pitting corrosion,but the failure location will change with pitting corrosion location;the size,location,and area ratio of pitting corrosion have little influence on the ultimate load of cold-formed thin-walled steel short columns,but the loss rate of pitting corrosion section area has a greater impact on the ultimate bearing capacity.As for the specimen with flange pitting corrosion,the location and area ratio of pitting corrosion have less influence on the ultimate load of cold-formed thin-walled steel short columns,and the section area loss rate has greater influence on the ultimate bearing capacity;the impact of web pitting corrosion on the ultimate load is greater than that of flange pitting corrosion under the same condition of pitting corrosion section area.The prediction formulas of limit load which are suitable for pitting corrosion of web and flange are established,which can provide a reference for performance evaluation of corroded cold-formed thin-walled steel.
基金supported by the National Natural Science Foundation of China(No.11802165)the China Postdoctoral Science Foundation(Grant No.2019M650158).
文摘This paper develops a new numerical framework for modeⅢcrack problems of thin-walled structures by integrating multiple advanced techniques in the boundary element literature.The details of special crack-tip elements for displacement and stress are derived.An exponential transformation technique is introduced to accurately calculate the nearly singular integral,which is the key task of the boundary element simulation of thin-walled structures.Three numerical experiments with different types of cracks are provided to verify the performance of the present numerical framework.Numerical results demonstrate that the present scheme is valid for modeⅢcrack problems of thin-walled structures with the thickness-to-length ratio in the microscale,even nanoscale,regime.
文摘Casing wear and casing corrosion are serious problems affecting casing integrity failure in deep and ultra-deep wells.This paper aims to predict the casing burst strength with considerations of both wear and corrosion.Firstly,the crescent wear shape is simplified into three categories according to common mathematical models.Then,based on the mechano-electrochemical(M-E)interaction,the prediction model of corrosion depth is built with worn depth as the initial condition,and the prediction models of burst strength of the worn casing and corroded casing are obtained.Secondly,the accuracy of different prediction models is validated by numerical simulation,and the main influence factors on casing strength are obtained.At last,the theoretical models are applied to an ultra-deep well in Northwest China,and the dangerous well sections caused by wear and corrosion are predicted,and the corrosion rate threshold to ensure the safety of casing is obtained.The results show that the existence of wear defects results in a stress concentration and enhanced M-E interaction on corrosion depth growth.The accuracy of different mathematical models is different:the slot ring model is most accurate for predicting corrosion depth,and the eccentric model is most accurate for predicting the burst strength of corroded casing.The burst strength of the casing will be overestimated by more than one-third if the M-E interaction is neglected,so the coupling effect of wear and corrosion should be sufficiently considered in casing integrity evaluation.
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Recently, demand for the lightweight alloy in electric/electronic housings has been greatly increased. However, among the lightweight alloys, aluminum alloy thin-walled die casting is problematic because it is quite difficult to achieve sufficient fluidity and feedability to fill the thin cavity as the wall thickness becomes less than 1mm. Therefore, in this study, thin-walled die casting of aluminum (Al-Si-Cu alloy: ALDC 12) in size of notebook computer housing and thickness of 0.8 mm was investigated by solidification simulation (MAGMA soft) and actual casting experiment (Buhler Evolution B 53D). Three different types of gating design, finger, tangential and split type with 6 vertical runners, were simulated and the results showed that sound thin-walled die casting was possible with tangential and split type gating design because those gates allowed aluminum melt to flow into the thin cavity uniformly and split type gating system was preferable gating design comparing to tangential type gating system at the point of view of soundness of casting and distortion generated after solidification. Also, the solidification simulation agreed well with the actual die-casting and the casting showed no casting defects and distortion.
文摘BACKGROUND Clear cell sarcoma(CCS)is a rare soft-tissue sarcoma.The most common metastatic sites for CCS are the lungs,bones and brain.CCS is highly invasive and mainly metastasizes to the lung,followed by the bone and brain;however,pancreatic metastasis is relatively rare.CASE SUMMARY We report on a rare case of CCS with pancreatic metastasis in a 47-year-old man.The patient had a relevant medical history 3 years ago,with abdominal pain as the main clinical manifestation.No abnormalities were observed on physical examination and the tumor was found on abdominal computed tomography.Based on the medical history and postoperative pathology,the patient was diagnosed with CCS with pancreatic metastasis.The patient was successfully treated with surgical interventions,including distal pancreatectomy and sple-nectomy.CONCLUSION This report summarizes the available treatment modalities for CCS and the importance of regular postoperative follow-up for patients with CCS.
基金Supported by National Natural Science Foundation of China(Grant Nos.51905555,52105523)Hu-Xiang Youth Talent Program of China(Grant No.2020RC3009)Innovation-Driven Project of Central South University of China(Grant No.2019CX017).
文摘The application of continuous natural fibers as reinforcement in composite thin-walled structures offers a feasible approach to achieve light weight and high strength while remaining environmentally friendly.In addition,additive manufacturing technology provides a favorable process foundation for its realization.In this study,the printability and energy absorption properties of 3D printed continuous fiber reinforced thin-walled structures with different configurations were investigated.The results suggested that a low printing speed and a proper layer thickness would mitigate the printing defects within the structures.The printing geometry accuracy of the structures could be further improved by rounding the sharp corners with appropriate radii.This study successfully fabricated structures with vari-ous configurations characterized by high geometric accuracy through printing parameters optimization and path smoothing.Moreover,the compressive property and energy absorption characteristics of the structures under quasi-static axial compression were evaluated and compared.It was found that all studied thin-walled structures exhibited progressive folding deformation patterns during compression.In particular,energy absorption process was achieved through the combined damage modes of plastic deformation,fiber pullout and delamination.Furthermore,the com-parison results showed that the hexagonal structure exhibited the best energy absorption performance.The study revealed the structure-mechanical property relationship of 3D printed continuous fiber reinforced composite thin-walled structures through the analysis of multiscale failure characteristics and load response,which is valuable for broadening their applications.
基金Supported by the Key Innovation and Guidance Program of the Eye Hospital,School of Ophthalmology&Optometry,Wenzhou Medical University(No.YNZD2201903)the Scientific Research Foundation of the Eye Hospital,School of Ophthalmology&Optometry,Wenzhou Medical University(No.KYQD20180306)the Nursing Project of the Eye Hospital of Wenzhou Medical University(No.YNHL2201908).
文摘AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.
文摘BACKGROUND Mediastinal emphysema is a condition in which air enters the mediastinum between the connective tissue spaces within the pleura for a variety of reasons.It can be spontaneous or secondary to chest trauma,esophageal perforation,medi-cally induced factors,etc.Its common symptoms are chest pain,tightness in the chest,and respiratory distress.Most mediastinal emphysema patients have mild symptoms,but severe mediastinal emphysema can cause respiratory and circulatory failure,resulting in serious consequences.CASE SUMMARY A 75-year-old man,living alone,presented with sudden onset of severe epigastric pain with chest tightness after drinking alcohol.Due to the remoteness of his residence and lack of neighbors,the patient was found by his nephew and brought to the hospital the next morning after the disease onset.Computed tomography(CT)showed free gas in the abdominal cavity,mediastinal emph-ysema,and subcutaneous pneumothorax.Upper gastrointestinal angiography showed that the esophageal mucosa was intact and the gastric antrum was perforated.Therefore,we chose to perform open gastric perforation repair on the patient under thoracic epidural anesthesia combined with intravenous anesthesia.An operative incision of the muscle layer of the patient's abdominal wall was made,and a large amount of subperitoneal gas was revealed.And a continued incision of the peritoneum revealed the presence of a perforation of approx-imately 0.5 cm in the gastric antrum,which we repaired after pathological examination.Postoperatively,the patient received high-flow oxygen and cough exercises.Chest CT was performed on the first and sixth postoperative days,and the mediastinal and subcutaneous gas was gradually reduced.CONCLUSION After gastric perforation,a large amount of free gas in the abdominal cavity can reach the mediastinum through the loose connective tissue at the esophageal hiatus of the diaphragm,and upper gastrointestinal angiography can clarify the site of perforation.In patients with mediastinal emphysema,open surgery avoids the elevation of the diaphragm caused by pneumoperitoneum compared to laparoscopic surgery and avoids increasing the mediastinal pressure.In addition,thoracic epidural anesthesia combined with intravenous anesthesia also avoids pressure on the mediastinum from mechanical ventilation.
文摘BACKGROUND Bezoars usually compile human fibers and debris.A special form of bezoar in case of psychologically altered individuals is the trichobezoar.It consists of voluntarily swallowed hair bulks and is normally removed via gastroscopy.Trichobezoars leading to ileus have rarely been reported.CASE SUMMARY A 24-year-old female patient presented to the emergency room with abdominal pain,nausea,and vomiting for 3 d.Her previous medical and psychiatric history was unremarkable.Laboratory analysis showed iron deficiency anemia,leukocytosis,and elevated liver enzymes.An abdominal CT scan revealed a dense structure in the patients’stomach which turned out to be a huge trichobezoar completely obstructing the pylorus.The trichobezoar had to be removed surgi-cally.During her postoperative course,a subcutaneous seroma formed.After a single puncture,the rest of the recovery process was unremarkable,and the patient recovered fully.CONCLUSION A mechanical bowel obstruction is a potentially life-threatening event for every patient.In our case a young female was suffering from severe symptoms of an obstruction which might have resulted in serious harm without successful surgical management.
基金Changzhou High-level Medical Talents Training Project of the Health Commission of the Changzhou City,No.2022CZBJ079Changzhou Sci&Tech Program,No.CE20235064.
文摘BACKGROUND Early adenocarcinoma mixed with a neuroendocrine carcinoma(NEC)component arising in the gastroesophageal junctional(GEJ)region is rare and even rarer in young patients.Here,we report such a case in a 29-year-old Chinese man.CASE SUMMARY This patient presented to our hospital with a 3-mo history of dysphagia and regurgitation.Upper endoscopy revealed an elevated nodule in the distal esophagus 1.6 cm above the GEJ line,without Barrett’s esophagus or involvement of the gastric cardia.The nodule was completely resected by endoscopic submu-cosal dissection(ESD).Pathological examination confirmed diagnosis of intra-mucosal adenocarcinoma mixed with an NEC component,measuring 1.5 cm.Immunohistochemically,both adenocarcinoma and NEC components were positive for P53 with a Ki67 index of 90%;NEC was positive for synaptophysin and chromogranin.Next-generation sequencing of 196 genes demonstrated a novel germline mutation of the ERCC3 gene in the DNA repair pathway and a germline mutation of the RNF43 gene,a common gastric cancer driver gene,in addition to pathogenic somatic mutations in P53 and CHEK2 genes.The patient was alive without evidence of the disease 36 mo after ESD.CONCLUSION Early adenocarcinoma with an NEC component arising in the distal esophageal side of the GEJ region showed evidence of gastric origin.
文摘BACKGROUND Microwave endometrial ablation(MEA)is a minimally invasive treatment method for heavy menstrual bleeding.However,additional treatment is often required after recurrence of uterine myomas treated with MEA.Additionally,because this treatment ablates the endometrium,it is not indicated for patients planning to become pregnant.To overcome these issues,we devised a method for ultrasound-guided microwave ablation of uterine myoma feeder vessels.We report three patients successfully treated for heavy menstrual bleeding,secondary to uterine myoma,using our novel method.CASE SUMMARY All patients had a favorable postoperative course,were discharged within 4 h,and experienced no complications.Further,no postoperative recurrence of heavy menstrual bleeding was noted.Our method also reduced the myoma’s maximum diameter.CONCLUSION This method does not ablate the endometrium,suggesting its potential appli-cation in patients planning to become pregnant.
文摘BACKGROUND Whether hyperbaric oxygen therapy(HBOT)can cause paradoxical herniation is still unclear.CASE SUMMARY A 65-year-old patient who was comatose due to brain trauma underwent decompressive craniotomy and gradually regained consciousness after surgery.HBOT was administered 22 d after surgery due to speech impairment.Paradoxical herniation appeared on the second day after treatment,and the patient’s condition worsened after receiving mannitol treatment at the rehabilitation hospital.After timely skull repair,the paradoxical herniation was resolved,and the patient regained consciousness and had a good recovery as observed at the follow-up visit.CONCLUSION Paradoxical herniation is rare and may be caused by HBOT.However,the underlying mechanism is unknown,and the understanding of this phenomenon is insufficient.The use of mannitol may worsen this condition.Timely skull repair can treat paradoxical herniation and prevent serious complications.
文摘BACKGROUND Mycobacterium tuberculosis(TB)is the causative agent of TB,a chronic granulo-matous illness.This disease is prevalent in low-income countries,posing a significant global health challenge.Gastrointestinal TB is one of the three forms.The disease can mimic other intra-abdominal conditions,leading to delayed diagnosis owing to the absence of specific symptoms.While gastric outlet obs-truction(GOO)remains a frequent complication,its incidence has declined with the advent of proton pump inhibitors and Helicobacter pylori eradication therapy.Gastroduodenal TB can cause upper gastrointestinal hemorrhage,obstruction,and malignancy-like tumors.CASE SUMMARY A 23-year-old male presented with recurrent epigastric pain,distension,nausea,vomiting,and weight loss,prompting a referral to a gastroenterologist clinic.Endoscopic examination revealed distorted gastric mucosa and signs of chronic inflammation.However,treatment was interrupted,possibly owing to vomiting or comorbidities such as human immunodeficiency virus infection or diabetes.Subsequent surgical intervention revealed a dilated stomach and diffuse thickening of the duodenal wall.Resection revealed gastric wall effacement with TB.CONCLUSION Primary gastric TB is rare,frequently leading to GOO.Given its rarity,suspicions should be promptly raised when encountering relevant symptoms,often requiring surgical intervention for diagnosis and treatment.
文摘BACKGROUND High-grade pancreatic intraepithelial neoplasia(PanIN)exhibits no mass and is not detected by any examination modalities.However,it can be diagnosed by pancreatic juice cytology from indirect findings.Most previous cases were diagnosed based on findings of a focal stricture of the main pancreatic duct(MPD)and caudal MPD dilatation and subsequent pancreatic juice cytology using endoscopic retrograde cholangiopancreatography(ERCP).We experienced a case of high-grade PanIN with an unclear MPD over a 20-mm range,but without caudal MPD dilatation on magnetic resonance cholangiopancreatography(MRCP).CASE SUMMARY A 60-year-old female patient underwent computed tomography for a follow-up of uterine cancer post-excision,which revealed pancreatic cysts.MRCP revealed an unclear MPD of the pancreatic body at a 20-mm length without caudal MPD dilatation.Thus,course observation was performed.After 24 mo,MRCP revealed an increased caudal MPD caliber and a larger pancreatic cyst.We performed ERCP and detected atypical cells suspected of adenocarcinoma by serial pancreatic juice aspiration cytology examination.We performed a distal pancreatectomy and obtained a histopathological diagnosis of high-grade PanIN.Pancreatic parenchyma invasion was not observed,and curative resection was achieved.CONCLUSION High-grade Pan-IN may cause MPD narrowing in a long range without caudal MPD dilatation.
文摘BACKGROUND Chronic hepatitis C virus(HCV)infection is a major global health concern that leads to liver fibrosis,cirrhosis,and cancer.Regimens containing direct-acting antivirals(DAAs)have become the mainstay of HCV treatment,achieving a high sustained virological response(SVR)with minimal adverse events.CASE SUMMARY A 74-year-old woman with chronic HCV infection was treated with the DAAs ledipasvir,and sofosbuvir for 12 wk and achieved SVR.Twenty-four weeks after treatment completion,the liver enzyme and serum IgG levels increased,and antinuclear antibody became positive without HCV viremia,suggesting the development of autoimmune hepatitis(AIH).After liver biopsy indicated AIH,a definite AIH diagnosis was made and prednisolone was initiated.The treatment was effective,and the liver enzyme and serum IgG levels normalized.However,multiple strictures of the intrahepatic and extrahepatic bile ducts with dilatation of the peripheral bile ducts appeared on magnetic resonance cholangiopancreatography after 3 years of achieving SVR,which were consistent with primary sclerosing cholangitis.CONCLUSION The potential risk of developing autoimmune liver diseases after DAA treatment should be considered.
基金This study protocol was approved by the General Hospital of the Yangtze River Shipping,and all the families have voluntarily participated in the study and have signed informed consent forms.
文摘BACKGROUND Regarding the incidence of malignant tumors in China,the incidence of liver cancer ranks fourth,second only to lung,gastric,and esophageal cancers.The case fatality rate ranks third after lung and cervical cancer.In a previous study,the whole-process management model was applied to patients with breast cancer,which effectively reduced their negative emotions and improved treatment adherence and nursing satisfaction.METHODS In this single-center,randomized,controlled study,60 randomly selected patients with liver cancer who had been admitted to our hospital from January 2021 to January 2022 were randomly divided into an observation group(n=30),who received whole-process case management on the basis of routine nursing mea-sures,and a control group(n=30),who were given routine nursing measures.We compared differences between the two groups in terms of anxiety,depression,the level of hope,self-care ability,symptom distress,sleep quality,and quality of life.RESULTS Post-intervention,Hamilton anxiety scale,Hamilton depression scale,memory symptom assessment scale,and Pittsburgh sleep quality index scores in both groups were lower than those pre-intervention,and the observation group had lower scores than the control group(P<0.05).Herth hope index,self-care ability assessment scale-revision in Chinese,and quality of life measurement scale for patients with liver cancer scores in both groups were higher than those pre-intervention,with higher scores in the observation group compared with the control group(P<0.05).CONCLUSION Whole-process case management can effectively reduce anxiety and depression in patients with liver cancer,alleviate symptoms and problems,and improve the level of hope,self-care ability,sleep quality,and quality of life,as well as provide feasible nursing alternatives for patients with liver cancer.