Background:Combined hepatocellular-cholangiocarcinoma(CHC)is a rare subtype of primary hepatic malignancies,with variably reported incidence between 0.4%–14.2%of primary liver cancer cases.This study aimed to systema...Background:Combined hepatocellular-cholangiocarcinoma(CHC)is a rare subtype of primary hepatic malignancies,with variably reported incidence between 0.4%–14.2%of primary liver cancer cases.This study aimed to systematically review the epidemiological,clinicopathological,diagnostic and therapeutic data for this rare entity.Data sources:We reviewed the literature of diagnostic approach of CHC with special reference to its clinical,molecular and histopathological characteristics.Additional analysis of the recent literature in order to evaluate the results of surgical and systemic treatment of this entity has been accomplished.Results:The median age at CHC’s diagnosis appears to be between 50 and 75 years.Evaluation of tumor markers[alpha fetoprotein(AFP),carbohydrate antigen 19–9(CA19–9)and carcinoembryonic antigen(CEA)]along with imaging patterns provides better opportunities for CHC’s preoperative diagnosis.Reported clinicopathologic prognostic parameters possibly correlated with increased tumor recurrence and grimmer survival odds include advanced age,tumor size,nodal and distal metastases,vascular and regional organ invasion,multifocality,decreased capsule formation,stem-cell features verification and increased GGT as well as CA19–9 and CEA levels.In case of inoperable or recurrent disease,combinations of cholangiocarcinoma-directed systemic agents display superior results over sorafenib.Liver-directed methods,such as transarterial chemoembolization(TACE),percutaneous ethanol injection(PEI),hepatic arterial infusion chemotherapy(HAIC),radioembolization and ablative therapies,demonstrate inferior efficacy than in cases of hepatocellular carcinoma(HCC)due to CHC’s common hypovascularity.Conclusions:CHC demonstrates an overlapping clinical and biological pattern between its malignant ingredients.Natural history of the disease seems to be determined by the predominant tumor element.Gold standard for diagnosis is histology of surgical specimens.Regarding therapeutic interventions,major hepatectomy is ac展开更多
Increasing yield is one of the most important goals in crop breeding. Soybean （Glycine max L. Merr.）, one of the most economically important leguminous seed crops, provides the majority of plant proteins, and more t...Increasing yield is one of the most important goals in crop breeding. Soybean （Glycine max L. Merr.）, one of the most economically important leguminous seed crops, provides the majority of plant proteins, and more than a quarter of the world＇s food and animal feed （Graham and Vance, 2003）. The yield of soybean is finally determined by the number of seeds per unit area, which affected by many characters, such as height, branching number, photosynthesis, seed size, seed number. The number of seeds per pod is taken for one of the critical components that related to yield （You et al., 1995）.展开更多
Two land surface schemes, one the standard Biosphere / Atmosphere Transfer Scheme Version ie (BOZ) and the other B1Z based on B0Z and heterogeneously-treated by' combined approach' , were co 'pled to the m...Two land surface schemes, one the standard Biosphere / Atmosphere Transfer Scheme Version ie (BOZ) and the other B1Z based on B0Z and heterogeneously-treated by' combined approach' , were co 'pled to the meso-scale model MM4, respectively. Through the calculations of equations from the companion paper, parameters representing land surface heterogeneity and suitable for the coupling models were found out. Three cases were simulated for heavy rainfalls during 36 hours, and the sensitivity of short-term weather modeling to the land surface heterogeneity was tested. Through the analysis of the simulations of the three heavy rainfalls, it was demonstrated that BIZ, compared with BOZ, could more realistically reflect the features of the land surface heterogeneity, therefore could more realistically reproduce the circulation and precipitation amount in the heavy rainfall processes of the three cases. This shows that even short-term weather is sensitive to the land surface heterogeneity, which is more obvious with time passing, and whose influence is more pronounced in the lower layer and gradually extends to the middle and upper layer. Through the analysis of these simulations with BlZ, it is suggested that the bulk effect of smaller-scale fluxes (i.e., the momentum, water vapor and sensible heat fluxes) near the s ig nificantly-heterogeneous land surface is to change the larger-scale (i.e., meso-scale) circulation, and then to influence the development of the low-level jets and precipitation. And also, the complexity of the land-atmosphere interaction was shown in these simulations.展开更多
文摘Background:Combined hepatocellular-cholangiocarcinoma(CHC)is a rare subtype of primary hepatic malignancies,with variably reported incidence between 0.4%–14.2%of primary liver cancer cases.This study aimed to systematically review the epidemiological,clinicopathological,diagnostic and therapeutic data for this rare entity.Data sources:We reviewed the literature of diagnostic approach of CHC with special reference to its clinical,molecular and histopathological characteristics.Additional analysis of the recent literature in order to evaluate the results of surgical and systemic treatment of this entity has been accomplished.Results:The median age at CHC’s diagnosis appears to be between 50 and 75 years.Evaluation of tumor markers[alpha fetoprotein(AFP),carbohydrate antigen 19–9(CA19–9)and carcinoembryonic antigen(CEA)]along with imaging patterns provides better opportunities for CHC’s preoperative diagnosis.Reported clinicopathologic prognostic parameters possibly correlated with increased tumor recurrence and grimmer survival odds include advanced age,tumor size,nodal and distal metastases,vascular and regional organ invasion,multifocality,decreased capsule formation,stem-cell features verification and increased GGT as well as CA19–9 and CEA levels.In case of inoperable or recurrent disease,combinations of cholangiocarcinoma-directed systemic agents display superior results over sorafenib.Liver-directed methods,such as transarterial chemoembolization(TACE),percutaneous ethanol injection(PEI),hepatic arterial infusion chemotherapy(HAIC),radioembolization and ablative therapies,demonstrate inferior efficacy than in cases of hepatocellular carcinoma(HCC)due to CHC’s common hypovascularity.Conclusions:CHC demonstrates an overlapping clinical and biological pattern between its malignant ingredients.Natural history of the disease seems to be determined by the predominant tumor element.Gold standard for diagnosis is histology of surgical specimens.Regarding therapeutic interventions,major hepatectomy is ac
基金supported by the National Natural Science Foundation of China(Grant Nos.31271297 and 31222042) "One-hundred talents" Startup Funds from Chinese Academy of SciencesNational Key Basic Research Program(No. 2009CB 118402)
文摘Increasing yield is one of the most important goals in crop breeding. Soybean （Glycine max L. Merr.）, one of the most economically important leguminous seed crops, provides the majority of plant proteins, and more than a quarter of the world＇s food and animal feed （Graham and Vance, 2003）. The yield of soybean is finally determined by the number of seeds per unit area, which affected by many characters, such as height, branching number, photosynthesis, seed size, seed number. The number of seeds per pod is taken for one of the critical components that related to yield （You et al., 1995）.
基金the NKBRSF Project! G 1999043400 the CNSF Project! 49735180.
文摘Two land surface schemes, one the standard Biosphere / Atmosphere Transfer Scheme Version ie (BOZ) and the other B1Z based on B0Z and heterogeneously-treated by' combined approach' , were co 'pled to the meso-scale model MM4, respectively. Through the calculations of equations from the companion paper, parameters representing land surface heterogeneity and suitable for the coupling models were found out. Three cases were simulated for heavy rainfalls during 36 hours, and the sensitivity of short-term weather modeling to the land surface heterogeneity was tested. Through the analysis of the simulations of the three heavy rainfalls, it was demonstrated that BIZ, compared with BOZ, could more realistically reflect the features of the land surface heterogeneity, therefore could more realistically reproduce the circulation and precipitation amount in the heavy rainfall processes of the three cases. This shows that even short-term weather is sensitive to the land surface heterogeneity, which is more obvious with time passing, and whose influence is more pronounced in the lower layer and gradually extends to the middle and upper layer. Through the analysis of these simulations with BlZ, it is suggested that the bulk effect of smaller-scale fluxes (i.e., the momentum, water vapor and sensible heat fluxes) near the s ig nificantly-heterogeneous land surface is to change the larger-scale (i.e., meso-scale) circulation, and then to influence the development of the low-level jets and precipitation. And also, the complexity of the land-atmosphere interaction was shown in these simulations.
