The combination of dual-main-phase(DMP)(Nd,Ce)-Fe-B magnets and grain boundary diffusion process(GBDP)is currently a research topic for obtaining high-cost performance materials in rare earth permanent magnet fields.T...The combination of dual-main-phase(DMP)(Nd,Ce)-Fe-B magnets and grain boundary diffusion process(GBDP)is currently a research topic for obtaining high-cost performance materials in rare earth permanent magnet fields.The novel structural features of GBDP(Nd,Ce)-Fe-B magnets give a version of different domain reversal processes from those of non-diffused magnets.In this work,the in-situ magnetic domain evolution of the DMP magnets was observed at elevated temperatures,and the temperature demagnetization and coercivity mechanism of the GBDP dual-main-phase(Nd,Ce)-Fe-B magnets are discussed.The results show that the shell composition of different types of grains in DMP magnets is similar,while the magnetic microstructure results indicate the Ce-rich grains tend to demagnetize first.Dy-rich shell with a high anisotropic field caused by GBDP leads to an increase in the nucleation field,which enhances the coercivity.It is found that much more grains exhibit single domain characteristics in the remanent state for GBDP dual-main-phase(Nd,Ce)-Fe-B magnets.In addition,the grains that undergo demagnetization first are Ce-rich or Nd-rich grains,which is different from that of non-diffused magnets.These results were not found in previous studies but can be intuitively characterized from the perspective of magnetic domains in this work,providing a new perspective and understanding of the performance improvement of magnetic materials.展开更多
Background:The prognostic significance of the chemokine receptor CCR7 in diffuse large B-cell lymphoma(DLBCL)has been reported previously.However,the detailed mechanisms of CCR7 in DLBCL,particularly regarding its int...Background:The prognostic significance of the chemokine receptor CCR7 in diffuse large B-cell lymphoma(DLBCL)has been reported previously.However,the detailed mechanisms of CCR7 in DLBCL,particularly regarding its interaction with lenalidomide treatment,are not fully understood.Methods:Our study utilized bioinformatics approaches to identify hub genes in SU-DHL-2 cell lines treated with lenalidomide compared to control groups.Immunohistochemical data and clinical information from 122 patients with DLBCL were analyzed to assess the correlation of CCR7 and p-ERK1/2 expression with the prognosis of DLBCL.Furthermore,in vitro and in vivo experiments were conducted to clarify the role of CCR7 in the response of DLBCL to lenalidomide treatment.Results:Our bioinformatics analysis pinpointed CCR7 as a hub gene in the context of lenalidomide treatment in DLBCL.Notably,31.14%and 36.0%(44/122)of DLBCL cases showed positive expression for CCR7 and ERK1/2 respectively,establishing them as independent prognostic factors for adverse outcomes in DLBCL via multivariate Cox regression analysis.Additionally,our studies demonstrated that the external application of the protein CCL21 promoted proliferation,migration,invasion,and activation of the ERK1/2 pathway in SU-DHL-2 and OCI-LY3 cell lines with high levels of CCR7 expression.This effect was mitigated by CCR7 silencing through siRNA,application of ERK inhibitors,or lenalidomide treatment.In vivo experiments reinforced the efficacy of lenalidomide,significantly reducing tumor growth rate,tumor mass,serum total LDH levels,and expression of CCR7 and p-ERK1/2 in a SUDHL-2 xenograft model in nude mice(p<0.05).Conclusion:Our study clarifies the potential role of the CCL21/CCR7/ERK1/2 axis in the therapeutic effects of lenalidomide in DLBCL treatment.展开更多
BACKGROUND Diffuse panbronchiolitis(DPB)is a rare,chronic inflammatory lung disease mar-ked by chronic cough,breathlessness,and preceding sinusitis.Symptoms often persist for years and can be misdiagnosed as asthma,pa...BACKGROUND Diffuse panbronchiolitis(DPB)is a rare,chronic inflammatory lung disease mar-ked by chronic cough,breathlessness,and preceding sinusitis.Symptoms often persist for years and can be misdiagnosed as asthma,particularly in children.This report describes a DPB case resolved with long-term azithromycin therapy,em-phasizing the need for a timely and accurate diagnosis.CASE SUMMARY A 12-year-old girl,diagnosed with asthma at age five and managed with inhaled corticosteroids and long-acting beta-2 agonists,developed a history of chronic productive cough and chronic sinusitis for a year.On examination,she exhibited wheezing and coarse crackles.Despite receiving treatment for an asthma exacer-bation,her symptoms did not improve.A chest X-ray revealed reticulonodular infiltration in both lower lungs,prompting further evaluation with high-resolu-tion computed tomography(HRCT).The HRCT confirmed centrilobular nodule opacities,a'tree-in-bud'pattern,and non-tapering bronchi,suggesting DPB.Elevated cold hemagglutinin titers at 128 further supported the diagnosis.Her cough and sinusitis resolved within a month after starting azithromycin therapy,chosen for its anti-inflammatory and immunomodulatory effects.Follow-up HRCT scans after 1 year of continuous treatment showed complete normalization.CONCLUSION This case highlights the importance of early diagnosis and prompt treatment in achieving favorable outcomes for DPB.展开更多
We demonstrate an integrating sphere to cool~(87)Rb atoms and measure the recoil-induced resonance and electromagnetically induced absorption spectrum.We measure the relationship between their linewidth and light shif...We demonstrate an integrating sphere to cool~(87)Rb atoms and measure the recoil-induced resonance and electromagnetically induced absorption spectrum.We measure the relationship between their linewidth and light shift with variation of the detuning and power of the cooling laser and study the performance of the diffuse laser cooling mechanism by the absorption linewidth radio?ν_E/?ν_R and light shift|?_R-?_E|using nonlinear spectroscopy.Specifically,when?ν_E/?ν_R reaches a value of 1.57,the temperature and number of cold atoms achieve the optimal cooling effect.This characterization of absorption linewidth and light shift will provide a method to estimate whether diffuse light cooling achieves the best cooling effect,contributing to the future development of isotropic laser cooling for application in quantum sensing.展开更多
BACKGROUND Hepatic hemangioma represents the most common benign primary hepatic neo-plasm.Although most such tumors are small and asymptomatic,giant cavernous hemangioma(GCH)is frequently symptomatic,and needs interve...BACKGROUND Hepatic hemangioma represents the most common benign primary hepatic neo-plasm.Although most such tumors are small and asymptomatic,giant cavernous hemangioma(GCH)is frequently symptomatic,and needs intervention.More-over,diffuse hepatic hemangiomatosis(DHH)is not rare in the liver parenchyma adjacent to a GCH.The management strategy for hepatic hemangiomas can differ depending on the presence of associated hemangiomatosis and the amount and distribution of the residual hepatic parenchyma.CASE SUMMARY Herein,we report two patients with GCH coexistent with DHH successfully treated by laparoscopic microwave ablation.The two GCHs were ablated com-pletely and the ablated zone atrophied obviously in imaging follow-ups after ablation.Surprisingly,there was a trend toward gradual reduction and dimini-shment of DHH.CONCLUSION Thermal ablation treatment might be an effective and less invasive treatment for GCH coexistent with DHH around the hemangioma.展开更多
BACKGROUND Drug-induced lung injury is a common adverse effect of chemotherapeutic agents.Diffuse alveolar hemorrhage(DAH)is a fatal complication associated with druginduced lung injury.Early diagnosis and treatment o...BACKGROUND Drug-induced lung injury is a common adverse effect of chemotherapeutic agents.Diffuse alveolar hemorrhage(DAH)is a fatal complication associated with druginduced lung injury.Early diagnosis and treatment of DAH is critical,as delayed management can lead to respiratory failure and poor outcomes.However,the diagnosis of DAH is difficult because of the nonspecific clinical manifestations;as such,bronchoscopy is necessary to establish a diagnosis.CASE SUMMARY The patient presented with fever and dry cough.He had been receiving fluoropyrimidine and oxaliplatin therapy for esophageal squamous cell carcinoma.Chest imaging revealed diffuse ground-glass opacities.Bronchoscopy with bronchoalveolar lavage was performed,which confirmed the diagnosis of DAH.Although the patient’s respiratory status rapidly worsened,high-dose corticosteroid therapy with respiratory support gradually improved the patient’s condition and he was successfully extubated.CONCLUSION Prompt DAH diagnosis and bronchoscopy in patients receiving oxaliplatincontaining chemotherapy presenting with acute respiratory failure are critical for improving outcomes.展开更多
The thermocline energy storage tank(TEST)serves as a crucial component in thermal energy storage systems,utilizing the working fluid that enters through a diffuser to store and harness energy.However,the conventional ...The thermocline energy storage tank(TEST)serves as a crucial component in thermal energy storage systems,utilizing the working fluid that enters through a diffuser to store and harness energy.However,the conventional double-plate radial diffuser is ill-suited for a single-medium TEST’s full tank storage due to its unidirectional fluid inflow.There has been a notable lack of optimization analysis of diffusers.Two innovative tubular diffuser designs with reduced cross-sectional areas have been introduced:the annular-arranged diffuser(AAD)and the cross-arranged diffuser(CAD).To elucidate the impact of diffuser designs on energy storage efficiency,a 3D transient computational fluid dynamics(CFD)model was established to simulate a thermocline formation under two diffuser types.The model was validated against experimental data.Results showed that the thermocline of AAD was 11.39%thinner than that of a traditional double-plate diffuser.In the process of charging and discharging,the time-varying thermocline and factors influencing thermocline thickness were analyzed.Results indicate that in the mixed dominant region,increased turbulent kinetic energy correlates with reduced thermocline thickness.Notably,the AAD’s stable thermocline was 4.23%and 5.41%thinner than the CAD’s during charging and discharging,respectively,making the AAD preferable for engineering applications.The effects of tube diameter and orifice opening angle on temperature stratification performance were also examined.The findings suggest that an inclined impact jet and large-diameter tubes are more conducive to temperature stratification.Moreover,an orifice diameter optimization method was developed,which can decrease the thermocline by 6.78%.展开更多
Size reduction of the gas turbines(GT)by reducing the inlet S-shaped diffuser length increases the powerto-weight ratio.It improves the techno-economic features of the GT by lesser fuel consumption.However,this Length...Size reduction of the gas turbines(GT)by reducing the inlet S-shaped diffuser length increases the powerto-weight ratio.It improves the techno-economic features of the GT by lesser fuel consumption.However,this Length reduction of a bare S-shaped diffuser to an aggressive S-shaped diffuser would risk flow separation and performance reduction of the diffuser and the air intake of the GT.The objective of this research is to propose and assess fitted energy promoters(EPs)to enhance the S-shaped diffuser performance by controlling and modifying the flow in the high bending zone of the diffuser.After experimental assessment,the work has been extended to cover more cases by numerical investigations on bare,bare aggressive,and aggressive with energy promoters S-shaped diffusers.Three types of EPs,namely co-rotating low-profile,co-rotating streamline sheet,and trapezoidal submerged EPs were tested with various combinations over a range of Reynolds numbers from 40,000 to 75,000.The respective S-shaped diffusers were simulated by computational fluid dynamics(CFD)using ANSYS software adopting a steady,3D,standard k-εturbulence model to acquire the details of the flow structure,which cannot be visualized in the experiment.The diffuser performance has been evaluated by the performance indicators of static pressure recovery coefficient,total pressure loss coefficient,and distortion coefficient(DC(45°)).The enhancements in the static pressure recovery of the S-shaped aggressive diffuser with energy promoters are 19.5%,22.2%,and 24.5%with EPs at planes 3,4 and 5,respectively,compared to the aggressive bare diffuser.In addition,the installation of the EPs resulted in a DC(45°)reduction at the outlet plane of the diffuser of about 43%at Re=40,000.The enhancements in the performance parameters confirm that aggravating the internal flow eliminates the flow separation and enhances the GT intake efficiency.展开更多
BACKGROUNDA mid-esophageal diverticulum is an outpouching located in the midsection ofthe esophagus, posterior to the bifurcation of the right and left bronchi. The conditionis characterized by an outward protrusion o...BACKGROUNDA mid-esophageal diverticulum is an outpouching located in the midsection ofthe esophagus, posterior to the bifurcation of the right and left bronchi. The conditionis characterized by an outward protrusion of the inner esophageal wall. Midesophagealdiverticula are relatively rare and may coexist with diffuse esophagealspasm. However, the potential esophageal motility disorders associated withthese lesions are frequently overlooked in clinical practice. The use of endoscopicinterventions may offer a novel approach for the alleviation of dysphagia associatedwith this condition.CASE SUMMARYWe present a case of a 74-year-old woman with dysphagia, diagnosed with midesophagealdiverticulum and diffuse esophageal spasm. Due to her physical condition,submucosal tunneling endoscopic septum division (STESD) was initiallyperformed for the diverticulum. One month later, the esophageal spasm wastreated using per-oral endoscopic myotomy (POEM). This combined treatmentsignificantly improved her dysphagia, and she was discharged.CONCLUSIONSTESD and POEM are effective and safe for the treatment of dysphagia caused bymid-esophageal diverticula with diffuse esophageal spasm.展开更多
BACKGROUND Whole-body magnetic resonance imaging(wbMRI)allows general assessment of systemic cancers including lymphomas without radiation burden.AIM To evaluate the diagnostic performance of wbMRI in the staging of d...BACKGROUND Whole-body magnetic resonance imaging(wbMRI)allows general assessment of systemic cancers including lymphomas without radiation burden.AIM To evaluate the diagnostic performance of wbMRI in the staging of diffuse large B-cell lymphoma(DLBCL),determine the value of individual MRI sequences,and assess patients’concerns with wbMRI.METHODS In this single-center prospective study,adult patients newly diagnosed with systemic DLBCL underwent wbMRI on a 3T scanner[diffusion weighted images with background suppression(DWIBS),T2,short tau inversion recovery(STIR),contrast-enhanced T1]and fluorodeoxyglucose(18F-FDG)positron emission tomo-graphy/computed tomography(PET/CT)(reference standard).The involvement of 12 nodal regions and extranodal sites was evaluated on wbMRI and PET/CT.The utility of wbMRI sequences was rated on a five-point scale(0=not useful,4=very useful).Patients received a questionnaire regarding wbMRI.RESULTS Of 60 eligible patients,14(23%)were enrolled and completed the study.The sensitivity of wbMRI in the nodal involvement(182 nodal sites)was 0.84,with 0.99 specificity,positive predictive value of 0.96,negative predictive value of 0.97,and 0.97 accuracy.PET/CT and wbMRI were concordant both in extranodal involvement(13 instances)and staging(κ=1.0).The mean scores of the utility of MRI sequences were 3.71±0.73 for DWIBS,2.64±0.84 for T1,2.14±0.77 for STIR,and 1.29±0.73 for T2(P<0.0001).Patients were mostly concerned about the enclosed environment and duration of the MRI examination(27%of patients).CONCLUSION The wbMRI exhibited excellent sensitivity and specificity in staging DLBCL.DWIBS and contrast-enhanced T1 were rated as the most useful sequences.Patients were less willing to undergo wbMRI as a second examination parallel to PET/CT,especially owing to the long duration and the enclosed environment.展开更多
One of the issues of plasma technologies is the design of a high-performance plasma source.Due to its properties,a diffuse vacuum arc discharge may be one of the promising options.In this study,the dependence of the c...One of the issues of plasma technologies is the design of a high-performance plasma source.Due to its properties,a diffuse vacuum arc discharge may be one of the promising options.In this study,the dependence of the charge composition of a diffuse vacuum arc plasma with a hot cathode on the value of the external axial magnetic field and discharge voltage was investigated.The study was conducted with a thermionic gadolinium(Gd)cathode.Monitoring the charge composition was done by analyzing the emission spectra of the plasma.Steady states of arc discharge were obtained for a range of parameters.The arc currents were 30 and 40 A,the arc voltage was up to 29 V and the external magnetic field was varied from 0 to 20 mT.It was found that in the presence of the eternal magnetic field the defining factor of the charge composition was the arc voltage.Moreover,for a fixed arc voltage,an increase in magnitude causes an increase in intensities of all atomic and ionic plasma components(Gd,Gd+,Gd++).The potential causes of this effect were discussed.It was established that in an axial magnetic field it is possible to implement discharge modes with predominance of single-charge ions by increasing the magnitude of the external magnetic field.Potentially,these discharge modes will be of use for the implementation of plasma methods for reprocessing spent nuclear fuel.展开更多
Background:Primary bone marrow diffuse large B-cell lymphoma(PBM-DLBCL)represents an uncommon yet clinically aggressive hematologic malignancy.Despite its significant clinical impact,this entity lacks standardized dia...Background:Primary bone marrow diffuse large B-cell lymphoma(PBM-DLBCL)represents an uncommon yet clinically aggressive hematologic malignancy.Despite its significant clinical impact,this entity lacks standardized diagnostic criteria in current WHO classifications.Methods:We performed a retrospective analysis of 55 PBM-DLBCL cases from our institutional database and published literature(2001–2022)to characterize disease features and identify prognostic factors,with particular focus on assessing how different treatment regimens influence therapeutic efficacy and long-term outcomes.Results:The data suggested a potential link between international prognostic index(IPI)scores and poorer survival,albeit without conclusive statistical evidence(p 0.05).Treatment=response emerged as a significant prognostic factor,and patients with complete response(CR)demonstrating superior survival in Cox univariate and multivariate analysis(p 0.001).Intensive therapeutic regimens were associated with<improved clinical outcomes compared to conventional therapies.While incorporating rituximab into conventional chemotherapy regimens has demonstrated superior clinical outcomes compared to chemotherapy alone in PBM-DLBCL patients.Conclusion:Our findings highlight the aggressive nature of PBM-DLBCL and underscore the importance of early recognition,risk stratification,and optimized treatment selection for this rare disease entity.展开更多
CD5-positive(CD5+)diffuse large B-cell lymphoma(DLBCL)represents a special subgroup of DLBCL with a more aggressive disease course and is more likely to develop into relapsed/refractory(r/r)DLBCL in response to immuno...CD5-positive(CD5+)diffuse large B-cell lymphoma(DLBCL)represents a special subgroup of DLBCL with a more aggressive disease course and is more likely to develop into relapsed/refractory(r/r)DLBCL in response to immunochemotherapy.The incidence of CD5+DLBCL is 5%–10%among DLBCL patients1.展开更多
Diffuse large B-cell lymphoma(DLBCL),the most common subtype of non-Hodgkin’s lymphoma(NHL)worldwide,accounts for 39% and 44% of nodal and extranodal NHL cases in China,respectively1.Standard first-line treatment for...Diffuse large B-cell lymphoma(DLBCL),the most common subtype of non-Hodgkin’s lymphoma(NHL)worldwide,accounts for 39% and 44% of nodal and extranodal NHL cases in China,respectively1.Standard first-line treatment for DLBCL is chemo-immunotherapy with rituximab,cyclophos-phamide,doxorubicin,vincristine,and prednisone,which cures 50%-60% of patients2.展开更多
BACKGROUND Primary testicular lymphoma(PTL)is a rare,aggressive malignancy,representing a small fraction of testicular tumors and non-Hodgkin lymphomas,yet it is the most common testicular malignancy in older men.Diff...BACKGROUND Primary testicular lymphoma(PTL)is a rare,aggressive malignancy,representing a small fraction of testicular tumors and non-Hodgkin lymphomas,yet it is the most common testicular malignancy in older men.Diffuse large B-cell lymphoma(DLBCL),which is typically the aggressive subtype,dominates PTL and shows diffuse B-cell infiltration.Venous tumor thrombus,uncommon in lymphomas,is uniquely reported in this case of testicular DLBCL with gonadal vein involvement.CASE SUMMARY A 62-year-old man presented with a two-month history of painless left testicular swelling and stiffness.Diagnostic imaging[ultrasonography,computed tomography(CT),and 18F-fluorodeoxyglucose positron emission tomography/CT(18FFDG-PET/CT)]revealed bilateral testicular masses and a gonadal vein tumor thrombus(SUVmax 16.5).Left orchiectomy confirmed DLBCL with CD20,Bcl-2,and MUM1 positivity(Ki-67:approximately 80%).The disease was staged as Ann Arbor stage IVA(International Prognostic Index score 3,high-intermediate risk).The patient received Rituximab,Polatuzumab Vedotin,Cyclophosphamide,Epirubicin,and Prednisolone chemotherapy,completing the first cycle with good tolerability.No adverse events were reported,and follow-up is ongoing to assess long-term outcomes.This case highlights the diagnostic utility of 18F-FDGPET/CT and the importance of multidisciplinary management in rare PTL presentations with tumor thrombus.CONCLUSION This case demonstrates the diagnostic complexities of PTL with gonadal vein tumor thrombus,underscoring the importance of considering lymphoma in elderly patients with testicular masses and venous involvement.A multi-disciplinary team including urologists,hematologists,and radiation oncologists is needed to ensure appropriate therapy.展开更多
The microstructure of(Nd,Ce)-Fe-B sintered magnets with different diffusion depths was characterized by a magnetic force microscope,and the relationship between the magnetic properties and the local structure of grain...The microstructure of(Nd,Ce)-Fe-B sintered magnets with different diffusion depths was characterized by a magnetic force microscope,and the relationship between the magnetic properties and the local structure of grain boundary diffused magnets is discussed.The domains perpendicular to the c-axis(easy magnetization direction)show a typical maze-like pattern,while those parallel to the c-axis show the characte ristics of plate domains.The significant gradient change is shown in the concentration of Dy with the direction of diffusion from the surface to the interior.Dy diffuses along grain boundaries and(Dy,Nd)_(2)Fe_(14)B layer with a high anisotropy field formed around the grains.Through in-situ electron probe micro-analysis/magnetic force microscopy(EPMA/MFM),it is found that the average domain width decreases,and the proportion of single domain grains increases as diffusion depth increases.This is caused by both the change of concentration and distribution of Dy.The grain boundary diffusion process changes the microstructure and microchemistry inside the magnet,and these local magnetism differences can be reflected by the configuration of the magnetic domain structure.展开更多
基金supported by the National Key Research and Development Program of China(Nos.2021YFB3503003,2021YFB3503100,and 2022YFB3505401).
文摘The combination of dual-main-phase(DMP)(Nd,Ce)-Fe-B magnets and grain boundary diffusion process(GBDP)is currently a research topic for obtaining high-cost performance materials in rare earth permanent magnet fields.The novel structural features of GBDP(Nd,Ce)-Fe-B magnets give a version of different domain reversal processes from those of non-diffused magnets.In this work,the in-situ magnetic domain evolution of the DMP magnets was observed at elevated temperatures,and the temperature demagnetization and coercivity mechanism of the GBDP dual-main-phase(Nd,Ce)-Fe-B magnets are discussed.The results show that the shell composition of different types of grains in DMP magnets is similar,while the magnetic microstructure results indicate the Ce-rich grains tend to demagnetize first.Dy-rich shell with a high anisotropic field caused by GBDP leads to an increase in the nucleation field,which enhances the coercivity.It is found that much more grains exhibit single domain characteristics in the remanent state for GBDP dual-main-phase(Nd,Ce)-Fe-B magnets.In addition,the grains that undergo demagnetization first are Ce-rich or Nd-rich grains,which is different from that of non-diffused magnets.These results were not found in previous studies but can be intuitively characterized from the perspective of magnetic domains in this work,providing a new perspective and understanding of the performance improvement of magnetic materials.
基金supported by the Key Research and Development Program of Science and Technology Department of Guizhou Province(No.20204Y147).
文摘Background:The prognostic significance of the chemokine receptor CCR7 in diffuse large B-cell lymphoma(DLBCL)has been reported previously.However,the detailed mechanisms of CCR7 in DLBCL,particularly regarding its interaction with lenalidomide treatment,are not fully understood.Methods:Our study utilized bioinformatics approaches to identify hub genes in SU-DHL-2 cell lines treated with lenalidomide compared to control groups.Immunohistochemical data and clinical information from 122 patients with DLBCL were analyzed to assess the correlation of CCR7 and p-ERK1/2 expression with the prognosis of DLBCL.Furthermore,in vitro and in vivo experiments were conducted to clarify the role of CCR7 in the response of DLBCL to lenalidomide treatment.Results:Our bioinformatics analysis pinpointed CCR7 as a hub gene in the context of lenalidomide treatment in DLBCL.Notably,31.14%and 36.0%(44/122)of DLBCL cases showed positive expression for CCR7 and ERK1/2 respectively,establishing them as independent prognostic factors for adverse outcomes in DLBCL via multivariate Cox regression analysis.Additionally,our studies demonstrated that the external application of the protein CCL21 promoted proliferation,migration,invasion,and activation of the ERK1/2 pathway in SU-DHL-2 and OCI-LY3 cell lines with high levels of CCR7 expression.This effect was mitigated by CCR7 silencing through siRNA,application of ERK inhibitors,or lenalidomide treatment.In vivo experiments reinforced the efficacy of lenalidomide,significantly reducing tumor growth rate,tumor mass,serum total LDH levels,and expression of CCR7 and p-ERK1/2 in a SUDHL-2 xenograft model in nude mice(p<0.05).Conclusion:Our study clarifies the potential role of the CCL21/CCR7/ERK1/2 axis in the therapeutic effects of lenalidomide in DLBCL treatment.
文摘BACKGROUND Diffuse panbronchiolitis(DPB)is a rare,chronic inflammatory lung disease mar-ked by chronic cough,breathlessness,and preceding sinusitis.Symptoms often persist for years and can be misdiagnosed as asthma,particularly in children.This report describes a DPB case resolved with long-term azithromycin therapy,em-phasizing the need for a timely and accurate diagnosis.CASE SUMMARY A 12-year-old girl,diagnosed with asthma at age five and managed with inhaled corticosteroids and long-acting beta-2 agonists,developed a history of chronic productive cough and chronic sinusitis for a year.On examination,she exhibited wheezing and coarse crackles.Despite receiving treatment for an asthma exacer-bation,her symptoms did not improve.A chest X-ray revealed reticulonodular infiltration in both lower lungs,prompting further evaluation with high-resolu-tion computed tomography(HRCT).The HRCT confirmed centrilobular nodule opacities,a'tree-in-bud'pattern,and non-tapering bronchi,suggesting DPB.Elevated cold hemagglutinin titers at 128 further supported the diagnosis.Her cough and sinusitis resolved within a month after starting azithromycin therapy,chosen for its anti-inflammatory and immunomodulatory effects.Follow-up HRCT scans after 1 year of continuous treatment showed complete normalization.CONCLUSION This case highlights the importance of early diagnosis and prompt treatment in achieving favorable outcomes for DPB.
基金Project supported by Shandong Provincial Natural Science Foundation(Grant No.ZR2023LLZ003)the National Natural Science Foundation of China(Grant No.62005145)Fundamental Research Fund of Shandong University,and Shandong Provincial Postdoctoral Science Foundation(Grant No.SDBX202302002)。
文摘We demonstrate an integrating sphere to cool~(87)Rb atoms and measure the recoil-induced resonance and electromagnetically induced absorption spectrum.We measure the relationship between their linewidth and light shift with variation of the detuning and power of the cooling laser and study the performance of the diffuse laser cooling mechanism by the absorption linewidth radio?ν_E/?ν_R and light shift|?_R-?_E|using nonlinear spectroscopy.Specifically,when?ν_E/?ν_R reaches a value of 1.57,the temperature and number of cold atoms achieve the optimal cooling effect.This characterization of absorption linewidth and light shift will provide a method to estimate whether diffuse light cooling achieves the best cooling effect,contributing to the future development of isotropic laser cooling for application in quantum sensing.
文摘BACKGROUND Hepatic hemangioma represents the most common benign primary hepatic neo-plasm.Although most such tumors are small and asymptomatic,giant cavernous hemangioma(GCH)is frequently symptomatic,and needs intervention.More-over,diffuse hepatic hemangiomatosis(DHH)is not rare in the liver parenchyma adjacent to a GCH.The management strategy for hepatic hemangiomas can differ depending on the presence of associated hemangiomatosis and the amount and distribution of the residual hepatic parenchyma.CASE SUMMARY Herein,we report two patients with GCH coexistent with DHH successfully treated by laparoscopic microwave ablation.The two GCHs were ablated com-pletely and the ablated zone atrophied obviously in imaging follow-ups after ablation.Surprisingly,there was a trend toward gradual reduction and dimini-shment of DHH.CONCLUSION Thermal ablation treatment might be an effective and less invasive treatment for GCH coexistent with DHH around the hemangioma.
文摘BACKGROUND Drug-induced lung injury is a common adverse effect of chemotherapeutic agents.Diffuse alveolar hemorrhage(DAH)is a fatal complication associated with druginduced lung injury.Early diagnosis and treatment of DAH is critical,as delayed management can lead to respiratory failure and poor outcomes.However,the diagnosis of DAH is difficult because of the nonspecific clinical manifestations;as such,bronchoscopy is necessary to establish a diagnosis.CASE SUMMARY The patient presented with fever and dry cough.He had been receiving fluoropyrimidine and oxaliplatin therapy for esophageal squamous cell carcinoma.Chest imaging revealed diffuse ground-glass opacities.Bronchoscopy with bronchoalveolar lavage was performed,which confirmed the diagnosis of DAH.Although the patient’s respiratory status rapidly worsened,high-dose corticosteroid therapy with respiratory support gradually improved the patient’s condition and he was successfully extubated.CONCLUSION Prompt DAH diagnosis and bronchoscopy in patients receiving oxaliplatincontaining chemotherapy presenting with acute respiratory failure are critical for improving outcomes.
基金supported by the National Natural Science Foundation of China(No.52375274)the Zhejiang Provincial Natural Science Foundation of China(No.LD21E050003)+1 种基金the Key R&D Program of Zhejiang Province(No.2023C01229)the Central Government Fund for Regional Science and Technology Development of China(No.2023ZY1033).
文摘The thermocline energy storage tank(TEST)serves as a crucial component in thermal energy storage systems,utilizing the working fluid that enters through a diffuser to store and harness energy.However,the conventional double-plate radial diffuser is ill-suited for a single-medium TEST’s full tank storage due to its unidirectional fluid inflow.There has been a notable lack of optimization analysis of diffusers.Two innovative tubular diffuser designs with reduced cross-sectional areas have been introduced:the annular-arranged diffuser(AAD)and the cross-arranged diffuser(CAD).To elucidate the impact of diffuser designs on energy storage efficiency,a 3D transient computational fluid dynamics(CFD)model was established to simulate a thermocline formation under two diffuser types.The model was validated against experimental data.Results showed that the thermocline of AAD was 11.39%thinner than that of a traditional double-plate diffuser.In the process of charging and discharging,the time-varying thermocline and factors influencing thermocline thickness were analyzed.Results indicate that in the mixed dominant region,increased turbulent kinetic energy correlates with reduced thermocline thickness.Notably,the AAD’s stable thermocline was 4.23%and 5.41%thinner than the CAD’s during charging and discharging,respectively,making the AAD preferable for engineering applications.The effects of tube diameter and orifice opening angle on temperature stratification performance were also examined.The findings suggest that an inclined impact jet and large-diameter tubes are more conducive to temperature stratification.Moreover,an orifice diameter optimization method was developed,which can decrease the thermocline by 6.78%.
文摘Size reduction of the gas turbines(GT)by reducing the inlet S-shaped diffuser length increases the powerto-weight ratio.It improves the techno-economic features of the GT by lesser fuel consumption.However,this Length reduction of a bare S-shaped diffuser to an aggressive S-shaped diffuser would risk flow separation and performance reduction of the diffuser and the air intake of the GT.The objective of this research is to propose and assess fitted energy promoters(EPs)to enhance the S-shaped diffuser performance by controlling and modifying the flow in the high bending zone of the diffuser.After experimental assessment,the work has been extended to cover more cases by numerical investigations on bare,bare aggressive,and aggressive with energy promoters S-shaped diffusers.Three types of EPs,namely co-rotating low-profile,co-rotating streamline sheet,and trapezoidal submerged EPs were tested with various combinations over a range of Reynolds numbers from 40,000 to 75,000.The respective S-shaped diffusers were simulated by computational fluid dynamics(CFD)using ANSYS software adopting a steady,3D,standard k-εturbulence model to acquire the details of the flow structure,which cannot be visualized in the experiment.The diffuser performance has been evaluated by the performance indicators of static pressure recovery coefficient,total pressure loss coefficient,and distortion coefficient(DC(45°)).The enhancements in the static pressure recovery of the S-shaped aggressive diffuser with energy promoters are 19.5%,22.2%,and 24.5%with EPs at planes 3,4 and 5,respectively,compared to the aggressive bare diffuser.In addition,the installation of the EPs resulted in a DC(45°)reduction at the outlet plane of the diffuser of about 43%at Re=40,000.The enhancements in the performance parameters confirm that aggravating the internal flow eliminates the flow separation and enhances the GT intake efficiency.
基金Supported by Natural Science Foundation of Shandong Province,No.81700472Clinical+X Project Fund of Binzhou Medical College,No.BY2021LCX11and Binzhou Medical University Science and Technology Program Projects,No.BY2019KJ13.
文摘BACKGROUNDA mid-esophageal diverticulum is an outpouching located in the midsection ofthe esophagus, posterior to the bifurcation of the right and left bronchi. The conditionis characterized by an outward protrusion of the inner esophageal wall. Midesophagealdiverticula are relatively rare and may coexist with diffuse esophagealspasm. However, the potential esophageal motility disorders associated withthese lesions are frequently overlooked in clinical practice. The use of endoscopicinterventions may offer a novel approach for the alleviation of dysphagia associatedwith this condition.CASE SUMMARYWe present a case of a 74-year-old woman with dysphagia, diagnosed with midesophagealdiverticulum and diffuse esophageal spasm. Due to her physical condition,submucosal tunneling endoscopic septum division (STESD) was initiallyperformed for the diverticulum. One month later, the esophageal spasm wastreated using per-oral endoscopic myotomy (POEM). This combined treatmentsignificantly improved her dysphagia, and she was discharged.CONCLUSIONSTESD and POEM are effective and safe for the treatment of dysphagia caused bymid-esophageal diverticula with diffuse esophageal spasm.
基金Supported by the Czech Ministry of Health,General University Hospital in Prague,No.VFN00064165。
文摘BACKGROUND Whole-body magnetic resonance imaging(wbMRI)allows general assessment of systemic cancers including lymphomas without radiation burden.AIM To evaluate the diagnostic performance of wbMRI in the staging of diffuse large B-cell lymphoma(DLBCL),determine the value of individual MRI sequences,and assess patients’concerns with wbMRI.METHODS In this single-center prospective study,adult patients newly diagnosed with systemic DLBCL underwent wbMRI on a 3T scanner[diffusion weighted images with background suppression(DWIBS),T2,short tau inversion recovery(STIR),contrast-enhanced T1]and fluorodeoxyglucose(18F-FDG)positron emission tomo-graphy/computed tomography(PET/CT)(reference standard).The involvement of 12 nodal regions and extranodal sites was evaluated on wbMRI and PET/CT.The utility of wbMRI sequences was rated on a five-point scale(0=not useful,4=very useful).Patients received a questionnaire regarding wbMRI.RESULTS Of 60 eligible patients,14(23%)were enrolled and completed the study.The sensitivity of wbMRI in the nodal involvement(182 nodal sites)was 0.84,with 0.99 specificity,positive predictive value of 0.96,negative predictive value of 0.97,and 0.97 accuracy.PET/CT and wbMRI were concordant both in extranodal involvement(13 instances)and staging(κ=1.0).The mean scores of the utility of MRI sequences were 3.71±0.73 for DWIBS,2.64±0.84 for T1,2.14±0.77 for STIR,and 1.29±0.73 for T2(P<0.0001).Patients were mostly concerned about the enclosed environment and duration of the MRI examination(27%of patients).CONCLUSION The wbMRI exhibited excellent sensitivity and specificity in staging DLBCL.DWIBS and contrast-enhanced T1 were rated as the most useful sequences.Patients were less willing to undergo wbMRI as a second examination parallel to PET/CT,especially owing to the long duration and the enclosed environment.
基金supported by the Russian Science Foundation(No.23-72-10073)。
文摘One of the issues of plasma technologies is the design of a high-performance plasma source.Due to its properties,a diffuse vacuum arc discharge may be one of the promising options.In this study,the dependence of the charge composition of a diffuse vacuum arc plasma with a hot cathode on the value of the external axial magnetic field and discharge voltage was investigated.The study was conducted with a thermionic gadolinium(Gd)cathode.Monitoring the charge composition was done by analyzing the emission spectra of the plasma.Steady states of arc discharge were obtained for a range of parameters.The arc currents were 30 and 40 A,the arc voltage was up to 29 V and the external magnetic field was varied from 0 to 20 mT.It was found that in the presence of the eternal magnetic field the defining factor of the charge composition was the arc voltage.Moreover,for a fixed arc voltage,an increase in magnitude causes an increase in intensities of all atomic and ionic plasma components(Gd,Gd+,Gd++).The potential causes of this effect were discussed.It was established that in an axial magnetic field it is possible to implement discharge modes with predominance of single-charge ions by increasing the magnitude of the external magnetic field.Potentially,these discharge modes will be of use for the implementation of plasma methods for reprocessing spent nuclear fuel.
基金supported by grants from the Jinling Hospital Affiliated to Medical School of Nanjing University(2023LCZLXB055).
文摘Background:Primary bone marrow diffuse large B-cell lymphoma(PBM-DLBCL)represents an uncommon yet clinically aggressive hematologic malignancy.Despite its significant clinical impact,this entity lacks standardized diagnostic criteria in current WHO classifications.Methods:We performed a retrospective analysis of 55 PBM-DLBCL cases from our institutional database and published literature(2001–2022)to characterize disease features and identify prognostic factors,with particular focus on assessing how different treatment regimens influence therapeutic efficacy and long-term outcomes.Results:The data suggested a potential link between international prognostic index(IPI)scores and poorer survival,albeit without conclusive statistical evidence(p 0.05).Treatment=response emerged as a significant prognostic factor,and patients with complete response(CR)demonstrating superior survival in Cox univariate and multivariate analysis(p 0.001).Intensive therapeutic regimens were associated with<improved clinical outcomes compared to conventional therapies.While incorporating rituximab into conventional chemotherapy regimens has demonstrated superior clinical outcomes compared to chemotherapy alone in PBM-DLBCL patients.Conclusion:Our findings highlight the aggressive nature of PBM-DLBCL and underscore the importance of early recognition,risk stratification,and optimized treatment selection for this rare disease entity.
基金supported by funding from the National Natural Science Foundation of China(Grant No.82170167 to Xiaoxi Zhou and Grant No.82300226 to Hui Luo)。
文摘CD5-positive(CD5+)diffuse large B-cell lymphoma(DLBCL)represents a special subgroup of DLBCL with a more aggressive disease course and is more likely to develop into relapsed/refractory(r/r)DLBCL in response to immunochemotherapy.The incidence of CD5+DLBCL is 5%–10%among DLBCL patients1.
基金sponsored by Shanghai Roche Pharmaceuticals Ltd.
文摘Diffuse large B-cell lymphoma(DLBCL),the most common subtype of non-Hodgkin’s lymphoma(NHL)worldwide,accounts for 39% and 44% of nodal and extranodal NHL cases in China,respectively1.Standard first-line treatment for DLBCL is chemo-immunotherapy with rituximab,cyclophos-phamide,doxorubicin,vincristine,and prednisone,which cures 50%-60% of patients2.
文摘BACKGROUND Primary testicular lymphoma(PTL)is a rare,aggressive malignancy,representing a small fraction of testicular tumors and non-Hodgkin lymphomas,yet it is the most common testicular malignancy in older men.Diffuse large B-cell lymphoma(DLBCL),which is typically the aggressive subtype,dominates PTL and shows diffuse B-cell infiltration.Venous tumor thrombus,uncommon in lymphomas,is uniquely reported in this case of testicular DLBCL with gonadal vein involvement.CASE SUMMARY A 62-year-old man presented with a two-month history of painless left testicular swelling and stiffness.Diagnostic imaging[ultrasonography,computed tomography(CT),and 18F-fluorodeoxyglucose positron emission tomography/CT(18FFDG-PET/CT)]revealed bilateral testicular masses and a gonadal vein tumor thrombus(SUVmax 16.5).Left orchiectomy confirmed DLBCL with CD20,Bcl-2,and MUM1 positivity(Ki-67:approximately 80%).The disease was staged as Ann Arbor stage IVA(International Prognostic Index score 3,high-intermediate risk).The patient received Rituximab,Polatuzumab Vedotin,Cyclophosphamide,Epirubicin,and Prednisolone chemotherapy,completing the first cycle with good tolerability.No adverse events were reported,and follow-up is ongoing to assess long-term outcomes.This case highlights the diagnostic utility of 18F-FDGPET/CT and the importance of multidisciplinary management in rare PTL presentations with tumor thrombus.CONCLUSION This case demonstrates the diagnostic complexities of PTL with gonadal vein tumor thrombus,underscoring the importance of considering lymphoma in elderly patients with testicular masses and venous involvement.A multi-disciplinary team including urologists,hematologists,and radiation oncologists is needed to ensure appropriate therapy.
基金Project supported by the National Key Research and Development Program of China(2021YFB3503003,2021YFB3503100,2022YFB3505401)。
文摘The microstructure of(Nd,Ce)-Fe-B sintered magnets with different diffusion depths was characterized by a magnetic force microscope,and the relationship between the magnetic properties and the local structure of grain boundary diffused magnets is discussed.The domains perpendicular to the c-axis(easy magnetization direction)show a typical maze-like pattern,while those parallel to the c-axis show the characte ristics of plate domains.The significant gradient change is shown in the concentration of Dy with the direction of diffusion from the surface to the interior.Dy diffuses along grain boundaries and(Dy,Nd)_(2)Fe_(14)B layer with a high anisotropy field formed around the grains.Through in-situ electron probe micro-analysis/magnetic force microscopy(EPMA/MFM),it is found that the average domain width decreases,and the proportion of single domain grains increases as diffusion depth increases.This is caused by both the change of concentration and distribution of Dy.The grain boundary diffusion process changes the microstructure and microchemistry inside the magnet,and these local magnetism differences can be reflected by the configuration of the magnetic domain structure.
