BACKGROUND Focal nodular hyperplasia(FNH)-like lesions are hyperplastic formations in patients with micronodular cirrhosis and a history of alcohol abuse.Although pathologically similar to hepatocellular carcinoma(HCC...BACKGROUND Focal nodular hyperplasia(FNH)-like lesions are hyperplastic formations in patients with micronodular cirrhosis and a history of alcohol abuse.Although pathologically similar to hepatocellular carcinoma(HCC)lesions,they are benign.As such,it is important to develop methods to distinguish between FNH-like lesions and HCC.AIM To evaluate diagnostically differential radiological findings between FNH-like lesions and HCC.METHODS We studied pathologically confirmed FNH-like lesions in 13 patients with alco-holic cirrhosis[10 men and 3 women;mean age:54.5±12.5(33-72)years]who were negative for hepatitis-B surface antigen and hepatitis-C virus antibody and underwent dynamic computed tomography(CT)and magnetic resonance imaging(MRI),including superparamagnetic iron oxide(SPIO)and/or gadoxetic acid-enhanced MRI.Seven patients also underwent angiography-assisted CT.RESULTS The evaluated lesion features included arterial enhancement pattern,washout appearance(low density compared with that of surrounding liver parenchyma),signal intensity on T1-weighted image(T1WI)and T2-weighted image(T2WI),central scar presence,chemical shift on in-and out-of-phase images,and uptake pattern on gadoxetic acid-enhanced MRI hepatobiliary phase and SPIO-enhanced MRI.Eleven patients had multiple small lesions(<1.5 cm).Radiological features of FNH-like lesions included hypervascularity despite small lesions,lack of“corona-like”enhancement in the late phase on CT during hepatic angiography(CTHA),high-intensity on T1WI,slightly high-or iso-intensity on T2WI,no signal decrease in out-of-phase images,and complete SPIO uptake or incomplete/partial uptake of gadoxetic acid.Pathologically,similar to HCC,FNH-like lesions showed many unpaired arteries and sinusoidal capillarization.CONCLUSION Overall,the present study showed that FNH-like lesions have unique radiological findings useful for differential diagnosis.Specifically,SPIO-and/or gadoxetic acid-enhanced MRI and CTHA features might facilitate differential diagnosis of FNH-like lesions and HCC.展开更多
This study systematically investigated the effects of graphite nodule parameters,including count,average diameter,and nodularity,on microstructure and mechanical properties of austempered ductile irons(ADIs).The ADI s...This study systematically investigated the effects of graphite nodule parameters,including count,average diameter,and nodularity,on microstructure and mechanical properties of austempered ductile irons(ADIs).The ADI specimens with graphite nodule counts of 212±11 mm^(-2),308±9 mm^(-2),415±10 mm^(-2),and 589±13 mm^(-2) were designated as G-200,G-300,G-400,and G-600,respectively.Results indicate a progressive refinement of graphite with an increase in nodule counts.Specifically,the average nodule diameter decreases from 33.3±1.3μm for G-200 to 17.0±0.7μm for G-600.The nodularity of all samples is above 90%.Furthermore,the nodularity exhibits a corresponding increasing trend with the rise of graphite nodule count in ADIs.Additionally,the volume fraction of the austenite phase in ADIs decreases with an increase in graphite nodule count.The graphite nodule count changes the tensile strength and elongation of ADIs.The specimen G-400 exhibits the ultimate tensile strength of 897±11 MPa and an elongation of 9.8%±0.6%,representing 5.3%and 44.1%improvements respectively compared to G-200.To explore the wear resistance of ADIs with different graphite nodule counts,dry sliding friction and wear test of different samples was carried out at room temperature.At a high load of 25 N,G-400 exhibits superior wear resistance,achieving a 42%reduction in worn volume compared to G-200.Worn micromorphology identifies three primary wear mechanisms:microcutting-dominated abrasive wear,adhesive wear,and fatigue wear.展开更多
BACKGROUND Gastric antral vascular ectasia(GAVE)accounts for up to 4%of nonvariceal upper gastrointestinal bleeding.Argon plasma coagulation and radiofrequency ablation have been primary treatment modalities for patie...BACKGROUND Gastric antral vascular ectasia(GAVE)accounts for up to 4%of nonvariceal upper gastrointestinal bleeding.Argon plasma coagulation and radiofrequency ablation have been primary treatment modalities for patients with linear and punctate subtypes,with a newer trend of utilization of endoscopic band ligation(EBL).This study evaluates the outcomes of patients undergoing treatment for nodular GAVE.We hypothesize that patients treated initially with EBL will achieve higher rates of clinical remission with fewer endoscopic treatments and a shorter treatment interval.AIM To investigate the effects of EBL as an initial treatment therapy on outcomes associated with nodular GAVE.METHODS A total of 37 patients at a tertiary medical center with nodular GAVE were included in this retrospective study.The study population was divided between those treated initially with EBL(initial EBL)and initial endoscopic thermal therapy.Pretreatment and post-treatment hemoglobin values,the model for end-stage liver disease scores,hospitalization rates,and other outcomes.Additionally,endoscopic treatment modality type and frequency were recorded,including radiofrequency ablation,argon plasma coagulation,and EBL.Continuous variables were compared using a t-test,while categorical variables were compared using Fisher’s exact.RESULTS Linear regression analysis displayed a positive relationship between the time interval from initial therapeutic esophagogastroduodenoscopy to first EBL treatment and overall treatment interval(t=7.39,P<0.001),as well as between the number of endoscopic treatments(t=8.09,P<0.001).Hemoglobin levels increased in both the initial EBL group(8.7 vs 11.4,P<0.001)and the initial endoscopic thermal therapy group(8.6 vs 10.4,P=0.042).Clinical remission rates were higher in the initial EBL group(90%vs 69%P=0.041),with a non-significant trend of higher endoscopic remission rates(57.1%vs 37.5%,P=0.270).CONCLUSION The observed trend favoring EBL,combined with its association with improved clinical remission and reduced treatment burden,supports its consideration as a preferred initial treatment approach.展开更多
The static drill rooted nodular pile is a new type of pile foundation consisting of precast nodular pile and the surrounding cemented soil.This composite pile has a relatively high bearing capacity and the mud polluti...The static drill rooted nodular pile is a new type of pile foundation consisting of precast nodular pile and the surrounding cemented soil.This composite pile has a relatively high bearing capacity and the mud pollution will be largely reduced during the construction process by using this type of pile.In order to investigate the bearing capacity and load transfer mechanism of this pile,a group of experiments were conducted to provide a comparison between this new pile and the bored pile.The axial force of a precast nodular pile was also measured by the strain gauges installed on the pile to analyze the distribution of the axial force of the nodular pile and the skin friction supported by the surrounding soil,then 3D models were built by using the ABAQUS finite element program to investigate the load transfer mechanism of this composite pile in detail.By combining the results of field tests and the finite element method,the outcome showed that the bearing capacity of a static drill rooted nodular pile is higher than the bored pile,and that this composite pile will form a double stress dispersion system which will not only confirm the strength of the pile,but also make the skin friction to be fully mobilized.The settlement of this composite pile is mainly controlled by the precast nodular pile;meanwhile,the nodular pile and the surrounding cemented soil can be considered as deformation compatibility during the loading process.The nodes on the nodular pile play an important role during the load transfer process,the shear strength of the interface between the cemented soil and the soil of the static drill rooted pile is larger than that of the bored pile.展开更多
BACKGROUND: Focal nodular hyperplasia (FNH), the second most common benign hepatic tumor after hemangioma, is characterized by a stellate central scar and hyperplastic nodules. Although some large FNH may be associate...BACKGROUND: Focal nodular hyperplasia (FNH), the second most common benign hepatic tumor after hemangioma, is characterized by a stellate central scar and hyperplastic nodules. Although some large FNH may be associated with significant symptoms, more frequently they are discovered incidentally on physical examination or the work-up of unrelated symptoms. Since its nature and pathogenesis are still controversial, accurate diagnosis of FNH based on clinical presentation and radiographic studies is difficult. The purpose of this study was to explore the diagnosis and treatment of FNH. METHODS: Eighty-six FNH patients confirmed pathologically were treated at the Liver Cancer Institute in our hospital from 1996 to 2006. Their clinical manifestions, imaging presentation, pathological findings, and surgical results were analyzed retrospectively. RESULTS: Of the 86 patients with 99 foci, 54 were male and 32 female, with a mean age of 37 years. Eighty patients had a single solitary focus and 6 had multiple foci. Tumor diameter was less than 5 cm in 69 patients, 5-10 cm in 15, and more than 10 cm in 2. The overall rate of correct preoperative diagnosis was 59.3% (51/86) including 32.9% (26/79) by color Doppler flow imaging (CDFI), 60.3% (35/58) by CT, and 77.4% (24/31) by MRI. All the 86 patients underwent resection with good curative effect. CONCLUSIONS: CT and MRI are important diagnostic methods for FNH but it is difficult to make a definite preoperative diagnosis for partial classical and all non-classical FNH patients. We suggest that patients with clinical symptoms or with indefinite diagnosis should accept surgical removal.展开更多
文摘BACKGROUND Focal nodular hyperplasia(FNH)-like lesions are hyperplastic formations in patients with micronodular cirrhosis and a history of alcohol abuse.Although pathologically similar to hepatocellular carcinoma(HCC)lesions,they are benign.As such,it is important to develop methods to distinguish between FNH-like lesions and HCC.AIM To evaluate diagnostically differential radiological findings between FNH-like lesions and HCC.METHODS We studied pathologically confirmed FNH-like lesions in 13 patients with alco-holic cirrhosis[10 men and 3 women;mean age:54.5±12.5(33-72)years]who were negative for hepatitis-B surface antigen and hepatitis-C virus antibody and underwent dynamic computed tomography(CT)and magnetic resonance imaging(MRI),including superparamagnetic iron oxide(SPIO)and/or gadoxetic acid-enhanced MRI.Seven patients also underwent angiography-assisted CT.RESULTS The evaluated lesion features included arterial enhancement pattern,washout appearance(low density compared with that of surrounding liver parenchyma),signal intensity on T1-weighted image(T1WI)and T2-weighted image(T2WI),central scar presence,chemical shift on in-and out-of-phase images,and uptake pattern on gadoxetic acid-enhanced MRI hepatobiliary phase and SPIO-enhanced MRI.Eleven patients had multiple small lesions(<1.5 cm).Radiological features of FNH-like lesions included hypervascularity despite small lesions,lack of“corona-like”enhancement in the late phase on CT during hepatic angiography(CTHA),high-intensity on T1WI,slightly high-or iso-intensity on T2WI,no signal decrease in out-of-phase images,and complete SPIO uptake or incomplete/partial uptake of gadoxetic acid.Pathologically,similar to HCC,FNH-like lesions showed many unpaired arteries and sinusoidal capillarization.CONCLUSION Overall,the present study showed that FNH-like lesions have unique radiological findings useful for differential diagnosis.Specifically,SPIO-and/or gadoxetic acid-enhanced MRI and CTHA features might facilitate differential diagnosis of FNH-like lesions and HCC.
基金supported by the Science and Technology Project of Hebei Education Department(Grant No.BJK2023075)the Science and Technology Project of Tianjin Education Department(Grant No.2022K1087)the Chunhui Project Foundation of the Education Department of China(Grant No.HZKY20220264).
文摘This study systematically investigated the effects of graphite nodule parameters,including count,average diameter,and nodularity,on microstructure and mechanical properties of austempered ductile irons(ADIs).The ADI specimens with graphite nodule counts of 212±11 mm^(-2),308±9 mm^(-2),415±10 mm^(-2),and 589±13 mm^(-2) were designated as G-200,G-300,G-400,and G-600,respectively.Results indicate a progressive refinement of graphite with an increase in nodule counts.Specifically,the average nodule diameter decreases from 33.3±1.3μm for G-200 to 17.0±0.7μm for G-600.The nodularity of all samples is above 90%.Furthermore,the nodularity exhibits a corresponding increasing trend with the rise of graphite nodule count in ADIs.Additionally,the volume fraction of the austenite phase in ADIs decreases with an increase in graphite nodule count.The graphite nodule count changes the tensile strength and elongation of ADIs.The specimen G-400 exhibits the ultimate tensile strength of 897±11 MPa and an elongation of 9.8%±0.6%,representing 5.3%and 44.1%improvements respectively compared to G-200.To explore the wear resistance of ADIs with different graphite nodule counts,dry sliding friction and wear test of different samples was carried out at room temperature.At a high load of 25 N,G-400 exhibits superior wear resistance,achieving a 42%reduction in worn volume compared to G-200.Worn micromorphology identifies three primary wear mechanisms:microcutting-dominated abrasive wear,adhesive wear,and fatigue wear.
文摘BACKGROUND Gastric antral vascular ectasia(GAVE)accounts for up to 4%of nonvariceal upper gastrointestinal bleeding.Argon plasma coagulation and radiofrequency ablation have been primary treatment modalities for patients with linear and punctate subtypes,with a newer trend of utilization of endoscopic band ligation(EBL).This study evaluates the outcomes of patients undergoing treatment for nodular GAVE.We hypothesize that patients treated initially with EBL will achieve higher rates of clinical remission with fewer endoscopic treatments and a shorter treatment interval.AIM To investigate the effects of EBL as an initial treatment therapy on outcomes associated with nodular GAVE.METHODS A total of 37 patients at a tertiary medical center with nodular GAVE were included in this retrospective study.The study population was divided between those treated initially with EBL(initial EBL)and initial endoscopic thermal therapy.Pretreatment and post-treatment hemoglobin values,the model for end-stage liver disease scores,hospitalization rates,and other outcomes.Additionally,endoscopic treatment modality type and frequency were recorded,including radiofrequency ablation,argon plasma coagulation,and EBL.Continuous variables were compared using a t-test,while categorical variables were compared using Fisher’s exact.RESULTS Linear regression analysis displayed a positive relationship between the time interval from initial therapeutic esophagogastroduodenoscopy to first EBL treatment and overall treatment interval(t=7.39,P<0.001),as well as between the number of endoscopic treatments(t=8.09,P<0.001).Hemoglobin levels increased in both the initial EBL group(8.7 vs 11.4,P<0.001)and the initial endoscopic thermal therapy group(8.6 vs 10.4,P=0.042).Clinical remission rates were higher in the initial EBL group(90%vs 69%P=0.041),with a non-significant trend of higher endoscopic remission rates(57.1%vs 37.5%,P=0.270).CONCLUSION The observed trend favoring EBL,combined with its association with improved clinical remission and reduced treatment burden,supports its consideration as a preferred initial treatment approach.
文摘The static drill rooted nodular pile is a new type of pile foundation consisting of precast nodular pile and the surrounding cemented soil.This composite pile has a relatively high bearing capacity and the mud pollution will be largely reduced during the construction process by using this type of pile.In order to investigate the bearing capacity and load transfer mechanism of this pile,a group of experiments were conducted to provide a comparison between this new pile and the bored pile.The axial force of a precast nodular pile was also measured by the strain gauges installed on the pile to analyze the distribution of the axial force of the nodular pile and the skin friction supported by the surrounding soil,then 3D models were built by using the ABAQUS finite element program to investigate the load transfer mechanism of this composite pile in detail.By combining the results of field tests and the finite element method,the outcome showed that the bearing capacity of a static drill rooted nodular pile is higher than the bored pile,and that this composite pile will form a double stress dispersion system which will not only confirm the strength of the pile,but also make the skin friction to be fully mobilized.The settlement of this composite pile is mainly controlled by the precast nodular pile;meanwhile,the nodular pile and the surrounding cemented soil can be considered as deformation compatibility during the loading process.The nodes on the nodular pile play an important role during the load transfer process,the shear strength of the interface between the cemented soil and the soil of the static drill rooted pile is larger than that of the bored pile.
文摘BACKGROUND: Focal nodular hyperplasia (FNH), the second most common benign hepatic tumor after hemangioma, is characterized by a stellate central scar and hyperplastic nodules. Although some large FNH may be associated with significant symptoms, more frequently they are discovered incidentally on physical examination or the work-up of unrelated symptoms. Since its nature and pathogenesis are still controversial, accurate diagnosis of FNH based on clinical presentation and radiographic studies is difficult. The purpose of this study was to explore the diagnosis and treatment of FNH. METHODS: Eighty-six FNH patients confirmed pathologically were treated at the Liver Cancer Institute in our hospital from 1996 to 2006. Their clinical manifestions, imaging presentation, pathological findings, and surgical results were analyzed retrospectively. RESULTS: Of the 86 patients with 99 foci, 54 were male and 32 female, with a mean age of 37 years. Eighty patients had a single solitary focus and 6 had multiple foci. Tumor diameter was less than 5 cm in 69 patients, 5-10 cm in 15, and more than 10 cm in 2. The overall rate of correct preoperative diagnosis was 59.3% (51/86) including 32.9% (26/79) by color Doppler flow imaging (CDFI), 60.3% (35/58) by CT, and 77.4% (24/31) by MRI. All the 86 patients underwent resection with good curative effect. CONCLUSIONS: CT and MRI are important diagnostic methods for FNH but it is difficult to make a definite preoperative diagnosis for partial classical and all non-classical FNH patients. We suggest that patients with clinical symptoms or with indefinite diagnosis should accept surgical removal.
