BACKGROUND Colorectal cancer(CRC)is one of the most common malignant tumors of the digestive tract.Lymphatic metastases of this tumor are mostly confined to the regional lymph nodes,and distant supraclavicular lymph n...BACKGROUND Colorectal cancer(CRC)is one of the most common malignant tumors of the digestive tract.Lymphatic metastases of this tumor are mostly confined to the regional lymph nodes,and distant supraclavicular lymph node metastases are very rare.CASE SUMMARY In this report,we describe a patient with sigmoid carcinoma and isolated synchronous supraclavicular lymph node metastases.A 56-year-old male presented with a left cervical mass that was confirmed as a lymph node metastasis from sigmoid cancer by several auxiliary examinations.After 6 cycles of chemotherapy with the 5-fluorouracil,leucovorin and oxaliplatin+cetuximab regimen,the sigmoid colon tumor and Virchow’s lymph node metastasis were significantly smaller than before treatment,and no new metastatic sites were observed.Considering the effects of chemotherapy on quality of life,resection of the primary tumor was performed followed by 4 cycles of chemotherapy with the original chemotherapy regimen.Virchow’s lymph node dissection was selected by mutual consultation between the patient and us.After the second surgery,the patient received capecitabine and cetuximab chemotherapy and did not experience recurrence or metastasis during follow-up.CONCLUSION In conclusion,supraclavicular lymph node metastasis without any other solid organ metastasis is a potential metastatic pathway for CRC.In addition,after resection of the primary lesion,postoperative chemotherapy combined with supraclavicular lymph node dissection is feasible for the treatment of patients with CRC and isolated synchronous Virchow’s lymph node metastases.展开更多
Wireless sensor Mobile ad hoc networks have excellent potential in moving and monitoring disaster area networks on real-time basis.The recent challenges faced in Mobile Ad Hoc Networks(MANETs)include scalability,local...Wireless sensor Mobile ad hoc networks have excellent potential in moving and monitoring disaster area networks on real-time basis.The recent challenges faced in Mobile Ad Hoc Networks(MANETs)include scalability,localization,heterogeneous network,self-organization,and self-sufficient operation.In this background,the current study focuses on specially-designed communication link establishment for high connection stability of wireless mobile sensor networks,especially in disaster area network.Existing protocols focus on location-dependent communications and use networks based on typically-used Internet Protocol(IP)architecture.However,IP-based communications have a few limitations such as inefficient bandwidth utilization,high processing,less transfer speeds,and excessive memory intake.To overcome these challenges,the number of neighbors(Node Density)is minimized and high Mobility Nodes(Node Speed)are avoided.The proposed Geographic Drone Based Route Optimization(GDRO)method reduces the entire overhead to a considerable level in an efficient manner and significantly improves the overall performance by identifying the disaster region.This drone communicates with anchor node periodically and shares the information to it so as to introduce a drone-based disaster network in an area.Geographic routing is a promising approach to enhance the routing efficiency in MANET.This algorithm helps in reaching the anchor(target)node with the help of Geographical Graph-Based Mapping(GGM).Global Positioning System(GPS)is enabled on mobile network of the anchor node which regularly broadcasts its location information that helps in finding the location.In first step,the node searches for local and remote anticipated Expected Transmission Count(ETX),thereby calculating the estimated distance.Received Signal Strength Indicator(RSSI)results are stored in the local memory of the node.Then,the node calculates the least remote anticipated ETX,Link Loss Rate,and information to the new location.Freeway Heuristic algorithm improves the data speed,efficiency and determines the path and optimization problem.In comparison with other models,the proposed method yielded an efficient communication,increased the throughput,and reduced the end-to-end delay,energy consumption and packet loss performance in disaster area networks.展开更多
基金by Key Research and Development Program of Shandong Province,No.2019JZZY010104Special Foundation for Taishan Scholars Program of Shandong Province,No.ts20190978and Science and Technology Innovation Development Program of Jinan,No.2020019082.
文摘BACKGROUND Colorectal cancer(CRC)is one of the most common malignant tumors of the digestive tract.Lymphatic metastases of this tumor are mostly confined to the regional lymph nodes,and distant supraclavicular lymph node metastases are very rare.CASE SUMMARY In this report,we describe a patient with sigmoid carcinoma and isolated synchronous supraclavicular lymph node metastases.A 56-year-old male presented with a left cervical mass that was confirmed as a lymph node metastasis from sigmoid cancer by several auxiliary examinations.After 6 cycles of chemotherapy with the 5-fluorouracil,leucovorin and oxaliplatin+cetuximab regimen,the sigmoid colon tumor and Virchow’s lymph node metastasis were significantly smaller than before treatment,and no new metastatic sites were observed.Considering the effects of chemotherapy on quality of life,resection of the primary tumor was performed followed by 4 cycles of chemotherapy with the original chemotherapy regimen.Virchow’s lymph node dissection was selected by mutual consultation between the patient and us.After the second surgery,the patient received capecitabine and cetuximab chemotherapy and did not experience recurrence or metastasis during follow-up.CONCLUSION In conclusion,supraclavicular lymph node metastasis without any other solid organ metastasis is a potential metastatic pathway for CRC.In addition,after resection of the primary lesion,postoperative chemotherapy combined with supraclavicular lymph node dissection is feasible for the treatment of patients with CRC and isolated synchronous Virchow’s lymph node metastases.
文摘Wireless sensor Mobile ad hoc networks have excellent potential in moving and monitoring disaster area networks on real-time basis.The recent challenges faced in Mobile Ad Hoc Networks(MANETs)include scalability,localization,heterogeneous network,self-organization,and self-sufficient operation.In this background,the current study focuses on specially-designed communication link establishment for high connection stability of wireless mobile sensor networks,especially in disaster area network.Existing protocols focus on location-dependent communications and use networks based on typically-used Internet Protocol(IP)architecture.However,IP-based communications have a few limitations such as inefficient bandwidth utilization,high processing,less transfer speeds,and excessive memory intake.To overcome these challenges,the number of neighbors(Node Density)is minimized and high Mobility Nodes(Node Speed)are avoided.The proposed Geographic Drone Based Route Optimization(GDRO)method reduces the entire overhead to a considerable level in an efficient manner and significantly improves the overall performance by identifying the disaster region.This drone communicates with anchor node periodically and shares the information to it so as to introduce a drone-based disaster network in an area.Geographic routing is a promising approach to enhance the routing efficiency in MANET.This algorithm helps in reaching the anchor(target)node with the help of Geographical Graph-Based Mapping(GGM).Global Positioning System(GPS)is enabled on mobile network of the anchor node which regularly broadcasts its location information that helps in finding the location.In first step,the node searches for local and remote anticipated Expected Transmission Count(ETX),thereby calculating the estimated distance.Received Signal Strength Indicator(RSSI)results are stored in the local memory of the node.Then,the node calculates the least remote anticipated ETX,Link Loss Rate,and information to the new location.Freeway Heuristic algorithm improves the data speed,efficiency and determines the path and optimization problem.In comparison with other models,the proposed method yielded an efficient communication,increased the throughput,and reduced the end-to-end delay,energy consumption and packet loss performance in disaster area networks.
