Introduction Highly technique-demanding liver resections(LRs)associated with multiple vascular reconstructions under total vascular exclusion(TVE)with/without hypothermic perfusion or using extracorporeal approaches(a...Introduction Highly technique-demanding liver resections(LRs)associated with multiple vascular reconstructions under total vascular exclusion(TVE)with/without hypothermic perfusion or using extracorporeal approaches(ante situm,ex situ)have been incorporated within the scope of extreme liver surgery(1,2).From our perspective,in situ liver resection under venovenous bypass(LR-VVB)or venoarterial bypass(LR-VAB),adjunct to TVE,also qualifies as extreme liver surgery.To comprehend this,understanding their current technical foundations is necessary.展开更多
A laboratory test was performed to assess the effectiveness of vacuum preloading incorporated with electroosmotic (EOM) treatment on silty clay (combined method) for reclamation projects like new disposal ponds, where...A laboratory test was performed to assess the effectiveness of vacuum preloading incorporated with electroosmotic (EOM) treatment on silty clay (combined method) for reclamation projects like new disposal ponds, where the horizontal electrode configurations beneath the soil layer were possible and the drainage pipes and the prefabricated vertical drains (PVDs) system could be easily installed in advance before the sludge dragged from sea bed or river bed was filled into the site. Three groups of tests were conducted on the silty clay from Qinhuai River in Nanjing, China. The model is able to apply vacuum pressure at the bottom of the soil layer and a direct current electric field simultaneously. It is also possible to measure the pore pressures at different depths of soil column, and the changes in settlement and volume with the elapsed time. In this study, the vacuum preloading method, vacuum preloading applied at the bottom (VAB method), was applied and the cathodes were installed beneath the soil layer. The results obtained indicate substantial reduction in water content, and increases in dry density and undrained shear strength in comparison with those obtained by the vacuum preloading only, particularly at the positions close to the anode. The combined method utilizes the vertical drainage flow created by the electroosmosis integrating the horizontal drainage flow created mostly by the vacuum pressure. The total drainage flow can be calculated as a result of the vertical drainage flow by electroosmosis only and the horizontal drainage flow by the vacuum preloading only. The way of placement of the cathode and the anode in the combined method also overcomes the disadvantage of EOM method itself, i.e. the appearance of cracks between the anode and the surrounding soil. Moreover, it is observed that the vacuum preloading plays a primary role in earlier stage in deduction of free pore water; meanwhile, the electroosmotic method is more efficient in later stage for absorbing water in the diffused double layers of soil.展开更多
Axillary lymph node status is one of the most important prognostic indicator of survival for breast cancer, especially in ductal carcinoma in situ （DCIS）. The purpose of this study was to investigate whether sentine...Axillary lymph node status is one of the most important prognostic indicator of survival for breast cancer, especially in ductal carcinoma in situ （DCIS）. The purpose of this study was to investigate whether sentinel lymph node biopsy （SLNB） should be performed in patients with an initial diagnosis of DCIS. Methods： A retrospective study was performed of 124 patients with an initial diagnosis of DCIS between March 2000 and June 2014. The patients were treated with either SLNB or axillary node dissection during the surgery, and we compared the clinicopathologic characteristics, image features, and immunohistochemical results. Results： Eighty-two patients （66.1%） had pure DCIS and 25 （20.2%） had DCIS with microinvasion （DCISM）, 17 （13.7%） updated to invasive breast cancer （IBC）. 115 patients （92.7%） underwent SLNB, among them, 70 patients （56.5%） underwent axillary node dissection. 3 of 115 patients （2.6%） had a positive sentinel lymph node, only 1 （1.4%） of 70 patients had axillary lymph node metastasis, in 84 patients （66.7%） who were diagnosed DCIS by core needle biopsy （CNB） and vacuum-assisted biopsy （VAB）. 26 patients （31.0%） were upstaged into IBC or DCISM in the final histological diagnosis. The statistically significant factors predictive of underestimation were large tumor size, microcalcifications, comedo necrosis, positive Her-2 status, negative estrogen receptor status. Conclusion： The metastasis of sentinel lymph nodes in pure DCIS is very low, but the underestimation of invasive carcinoma in patients with an initial diagnosis of DCIS is an usual incident, especially in the cases when DCIS is diagnosed by CNB or VAB. Our findings suggest patients presenting with a preoperative diagnosis of DCIS associated with large tumor sizes, microcalcifications, comedo necrosis, positive Her-2 status, negative ER status are more likely to be DCISM and IBC in final diagnosis. SLNB should be performed in this part of patients.展开更多
基金supported by grants from the Beijing Hospitals Authority Youth Program(No.12022B4010)BTCH Young Talent Enlightenment Program(No.2024QMRC24).
文摘Introduction Highly technique-demanding liver resections(LRs)associated with multiple vascular reconstructions under total vascular exclusion(TVE)with/without hypothermic perfusion or using extracorporeal approaches(ante situm,ex situ)have been incorporated within the scope of extreme liver surgery(1,2).From our perspective,in situ liver resection under venovenous bypass(LR-VVB)or venoarterial bypass(LR-VAB),adjunct to TVE,also qualifies as extreme liver surgery.To comprehend this,understanding their current technical foundations is necessary.
文摘A laboratory test was performed to assess the effectiveness of vacuum preloading incorporated with electroosmotic (EOM) treatment on silty clay (combined method) for reclamation projects like new disposal ponds, where the horizontal electrode configurations beneath the soil layer were possible and the drainage pipes and the prefabricated vertical drains (PVDs) system could be easily installed in advance before the sludge dragged from sea bed or river bed was filled into the site. Three groups of tests were conducted on the silty clay from Qinhuai River in Nanjing, China. The model is able to apply vacuum pressure at the bottom of the soil layer and a direct current electric field simultaneously. It is also possible to measure the pore pressures at different depths of soil column, and the changes in settlement and volume with the elapsed time. In this study, the vacuum preloading method, vacuum preloading applied at the bottom (VAB method), was applied and the cathodes were installed beneath the soil layer. The results obtained indicate substantial reduction in water content, and increases in dry density and undrained shear strength in comparison with those obtained by the vacuum preloading only, particularly at the positions close to the anode. The combined method utilizes the vertical drainage flow created by the electroosmosis integrating the horizontal drainage flow created mostly by the vacuum pressure. The total drainage flow can be calculated as a result of the vertical drainage flow by electroosmosis only and the horizontal drainage flow by the vacuum preloading only. The way of placement of the cathode and the anode in the combined method also overcomes the disadvantage of EOM method itself, i.e. the appearance of cracks between the anode and the surrounding soil. Moreover, it is observed that the vacuum preloading plays a primary role in earlier stage in deduction of free pore water; meanwhile, the electroosmotic method is more efficient in later stage for absorbing water in the diffused double layers of soil.
文摘Axillary lymph node status is one of the most important prognostic indicator of survival for breast cancer, especially in ductal carcinoma in situ （DCIS）. The purpose of this study was to investigate whether sentinel lymph node biopsy （SLNB） should be performed in patients with an initial diagnosis of DCIS. Methods： A retrospective study was performed of 124 patients with an initial diagnosis of DCIS between March 2000 and June 2014. The patients were treated with either SLNB or axillary node dissection during the surgery, and we compared the clinicopathologic characteristics, image features, and immunohistochemical results. Results： Eighty-two patients （66.1%） had pure DCIS and 25 （20.2%） had DCIS with microinvasion （DCISM）, 17 （13.7%） updated to invasive breast cancer （IBC）. 115 patients （92.7%） underwent SLNB, among them, 70 patients （56.5%） underwent axillary node dissection. 3 of 115 patients （2.6%） had a positive sentinel lymph node, only 1 （1.4%） of 70 patients had axillary lymph node metastasis, in 84 patients （66.7%） who were diagnosed DCIS by core needle biopsy （CNB） and vacuum-assisted biopsy （VAB）. 26 patients （31.0%） were upstaged into IBC or DCISM in the final histological diagnosis. The statistically significant factors predictive of underestimation were large tumor size, microcalcifications, comedo necrosis, positive Her-2 status, negative estrogen receptor status. Conclusion： The metastasis of sentinel lymph nodes in pure DCIS is very low, but the underestimation of invasive carcinoma in patients with an initial diagnosis of DCIS is an usual incident, especially in the cases when DCIS is diagnosed by CNB or VAB. Our findings suggest patients presenting with a preoperative diagnosis of DCIS associated with large tumor sizes, microcalcifications, comedo necrosis, positive Her-2 status, negative ER status are more likely to be DCISM and IBC in final diagnosis. SLNB should be performed in this part of patients.
