Uterine cervical cancer is the second most common gynecological malignancy. It is estimated that over 35% of tumors are diagnosed at locally advanced disease, stage ⅠB2-ⅡB with an estimated 5-year overall survival o...Uterine cervical cancer is the second most common gynecological malignancy. It is estimated that over 35% of tumors are diagnosed at locally advanced disease, stage ⅠB2-ⅡB with an estimated 5-year overall survival of 60%. During the last decades, the initial treatment for these women has been debated and largely varies through different countries. Thus, radical concurrent chemoradiation is the standard of care in United Sated and Canada, and neoadjuvant chemotherapy followed by radical surgery is the first line of treatment in some institutions of Europe, Asia and Latin America. Until today, there is no evidence of which strategy is better over the other. This article describe the evidence as well as the advantages and disadvantages of the main strategies of treatment for women affected by uterine cervical cancer stage ⅠB2-ⅡB.展开更多
In this paper internal characterizations on certain quotient images of locally separable metric spaces are discussed.We obtain some descriptions of quotient s-images,pseudo-open s- images,quotient compact images and c...In this paper internal characterizations on certain quotient images of locally separable metric spaces are discussed.We obtain some descriptions of quotient s-images,pseudo-open s- images,quotient compact images and closed images of locally separable metric spaces,and establish some relations between these and certain quotient images of metric spaces by the local separability of suitable subspaces.展开更多
AIM:To provide efficacy and safety data about the combined use of radiotherapy and chemo-radiotherapy in nasopharyngeal carcinoma(NPC).METHODS:We reviewed data of 40 patients with locally advanced NPC treated with ind...AIM:To provide efficacy and safety data about the combined use of radiotherapy and chemo-radiotherapy in nasopharyngeal carcinoma(NPC).METHODS:We reviewed data of 40 patients with locally advanced NPC treated with induction chemotherapy followed by concomitant chemo-radiotherapy(CCRT)(22/40 patients)or CCRT alone(18/40)from March 2006 to March 2012.Patients underwent fiberoscopy with biopsy of the primitive tumor,and computed tomography scan of head,neck,chest and abdomen with and without contrast.Cisplatin was used both as induction and as concomitant chemotherapy,while 3D conformal radiation therapy was delivered to the nasopharynx and relevant anatomic regions(total dose,70 Gy).The treatment was performed using 6 MV photons of the linear accelerator administered in 2 Gy daily fraction for five days weekly.This retrospective analysis was approved by the review boards of the participating institutions.Patients gave their consent to treatment and to anonymous analysis of clinical data.RESULTS:Thirty-three patients were males and 7 were females.Median follow-up time was 58 mo(range,1-92 mo).In the sub-group of twenty patients with a follow-up time longer than 36 mo,the 3-year survival and disease free survival rates were 85%and 75%,respectively.Overall response rate both in patients treated with induction chemotherapy followed by CCRT and in those treated with CCRT alone was 100%.Grade 3 neutropenia was the most frequent acute side-effect and it occurred in 20 patients.Grade 2 mucositis was seen in 29 patients,while grade 2 xerostomia was seen in 30 patients.Overall toxicity was manageable and it did not cause any significant treatment delay.In the whole sample population,long term toxicity included grade 2 xerostomia in 22 patients,grade 1 dysgeusia in 17 patients and grade 1 subcutaneous fibrosis in 30 patients.CONCLUSION:Both CCRT and induction chemotherapy followed by CCRT showed excellent activity in locally advanced NPC.The role of adjuvant chemotherapy remains to be defined.展开更多
To clarify the role of neoadjuvant concurrent chemoradiotherapy (NACCRT) followed by surgical resection for localized or locally advanced perihilar cholangiocarcinoma (CCA).METHODSWe retrospectively reviewed 57 patien...To clarify the role of neoadjuvant concurrent chemoradiotherapy (NACCRT) followed by surgical resection for localized or locally advanced perihilar cholangiocarcinoma (CCA).METHODSWe retrospectively reviewed 57 patients who underwent surgical resection with or without NACCRT for perihilar CCA; 12 patients received NACCRT and 45 patients did not received NACCRT. Patients with locally advanced perihilar CCA requiring NACCRT were defined as follows: (1) a mass involving unilateral branches of the portal vein or hepatic artery with insufficient volume of the anticipated remnant lobe; or (2) an infiltrating mass in the main portal vein that was too long for reconstruction, identified at preoperative staging.RESULTSThe median disease-free survival (DFS) durations of the neoadjuvant and non-neoadjuvant CCRT groups were 26.0 and 15.1 mo, respectively (P = 0.91). The median overall survival (OS) durations of the neoadjuvant and non-neoadjuvant CCRT groups were 32.9 and 27.1 mo, respectively (P = 0.26). The NACCRT group showed a downstaging tendency compared to the non-NACCRT group as compared with the tumor stage confirmed by histological examination after surgery and the tumor stage confirmed by imaging test at the time of diagnosis (P = 0.01).CONCLUSIONNACCRT does not prolong DFS and OS in localized or locally advanced perihilar CCA. However, NACCRT may allow tumor downstaging and improve tumor resectability.展开更多
The concept of locally strong compactness on domains is generalized to general topological spaces. It is proved that for each distributive hypercontinuous lattice L, the space SpecL of nonunit prime elements endowed w...The concept of locally strong compactness on domains is generalized to general topological spaces. It is proved that for each distributive hypercontinuous lattice L, the space SpecL of nonunit prime elements endowed with the hull-kernel topology is locally strongly compact, and for each locally strongly compact space X, the complete lattice of all open sets O(X) is distributive hypercontinuous. For the case of distributive hyperalgebraic lattices, the similar result is given. For a sober space X, it is shown that there is an order reversing isomorphism between the set of upper-open filters of the lattice O(X) of open subsets of X and the set of strongly compact saturated subsets of X, which is analogous to the well-known Hofmann-Mislove Theorem.展开更多
AIM： TO estimate the prevalence of small intestinal bacterial overgrowth （SIBO） in our geographical area （Western Sicily, Italy） by means of an observational study, and to gather information on the use of locally...AIM： TO estimate the prevalence of small intestinal bacterial overgrowth （SIBO） in our geographical area （Western Sicily, Italy） by means of an observational study, and to gather information on the use of locally active, non-absorbable antibiotics for treatment of SIBO.METHODS： Our survey included 115 patients fulfilling the Rome II criteria for diagnosis of irritable bowel syndrome （IBS）; a total of 97 patients accepted to perform a breath test with lactulose （BTLact）, and those who had a positive test, received Rifaximin （Normix , Alfa Wassermann） 1200 mg/d for 7 d; 3 wk after the end of treatment, the BTLact was repeated.RESULTS： Based on the BTLact results, SIBO was present in about 56% of IBS patients, and it was responsible for some IBS-related symptoms, such as abdominal bloating and discomfort, and diarrhoea. 1-wk treatment with Rifaximin turned the BTLact to negative in about 50% of patients and significantly reduced the symptoms, especially in those patients with an alternated constipation/diarrhoea-variant IBS. CONCLUSION： SIBO should be always suspected in patients with IBS, and a differential diagnosis is done by means of a ＂breath test＂. Rifaximin may represent a valid approach to the treatment of SIBO.展开更多
Thermally sprayed coatings are essentially layered materials and contain large numbers of lamellar pores. It is thus quite necessary to clarify the formation mechanism of lamellar pores which significantly influence c...Thermally sprayed coatings are essentially layered materials and contain large numbers of lamellar pores. It is thus quite necessary to clarify the formation mechanism of lamellar pores which significantly influence coating performances. In the present study, to elaborate the formation mechanism of lamellar pores, the yttria-stabilized zirconia(ZrO_2–7 wt% Y_2O_3, 7YSZ) splats, which have high fracture toughness and tetragonal phase stability, were employed. Interestingly, anomalous epitaxial growth occurred for all deposition temperatures in spite of the extremely high cooling rate,which clearly indicated chemical bonding and complete contact at splat/substrate interface before splat cooling. However, transverse spallation substantially occurred for all deposition temperatures in spite of the high fracture toughness of 7YSZ, which revealed that the lamellar pores were from transverse cracking/spallation due to the large stress during splat cooling. Additionally, fracture mechanics analysis was carried out, and it was found that the stress arose from the constraint effect of the shrinkage of the splat by locally heated substrate with the value about 1.97 GPa. This clearly demonstrated that the stress was indeed large enough to drive transverse cracking/spallation forming lamellar pores during splat cooling. All of these contribute to understanding the essential features of lamellar bonding and further tailoring the coating structures and performance.展开更多
The purpose of this paper is to give a selective survey on recent progress in random metric theory and its applications to conditional risk measures.This paper includes eight sections.Section 1 is a longer introductio...The purpose of this paper is to give a selective survey on recent progress in random metric theory and its applications to conditional risk measures.This paper includes eight sections.Section 1 is a longer introduction,which gives a brief introduction to random metric theory,risk measures and conditional risk measures.Section 2 gives the central framework in random metric theory,topological structures,important examples,the notions of a random conjugate space and the Hahn-Banach theorems for random linear functionals.Section 3 gives several important representation theorems for random conjugate spaces.Section 4 gives characterizations for a complete random normed module to be random reflexive.Section 5 gives hyperplane separation theorems currently available in random locally convex modules.Section 6 gives the theory of random duality with respect to the locally L0-convex topology and in particular a characterization for a locally L0-convex module to be L0-pre-barreled.Section 7 gives some basic results on L0-convex analysis together with some applications to conditional risk measures.Finally,Section 8 is devoted to extensions of conditional convex risk measures,which shows that every representable L∞-type of conditional convex risk measure and every continuous Lp-type of convex conditional risk measure(1 ≤ p < +∞) can be extended to an L∞F(E)-type of σ,λ(L∞F(E),L1F(E))-lower semicontinuous conditional convex risk measure and an LpF(E)-type of T,λ-continuous conditional convex risk measure(1 ≤ p < +∞),respectively.展开更多
Based on a better understanding of the lattice vibration modes, two simple spring-mass models are constructed in order to evaluate the frequencies on both the lower and upper edges of the lowest locally resonant band ...Based on a better understanding of the lattice vibration modes, two simple spring-mass models are constructed in order to evaluate the frequencies on both the lower and upper edges of the lowest locally resonant band gaps of the ternary locally resonant phononic crystals. The parameters of the models are given in a reasonable way based on the physical insight into the band gap mechanism. Both the lumped-mass methods and our models are used in the study of the influences of structural and the material parameters on frequencies on both edges of the lowest gaps in the ternary locally resonant phononic crystals. The analytical evaluations with our models and the theoretical predictions with the lumped-mass method are in good agreement with each other. The newly proposed heuristic models are helpful for a better understanding of the locally resonant band gap mechanism, as well as more accurate evaluation of the band edge frequencies.展开更多
Background： Locally advanced pancreatic carcinoma （LAPC） is characterized by poor prognosis despite recommended concurrent chemoradiotherapy. Irreversible electroporation （IRE） has emerged as a potential option f...Background： Locally advanced pancreatic carcinoma （LAPC） is characterized by poor prognosis despite recommended concurrent chemoradiotherapy. Irreversible electroporation （IRE） has emerged as a potential option for the management of unresectable pancreatic cancer. This study was conducted to evaluate the safety and short-term efficacy of open IRE for the treatment of LAPC. Methods： Retrospective data of 25 consecutive patients receiving IRE for T3 lesions from July 2015 to June 2016 at a single center were analyzed. The perioperative and long-term IRE-related complications were reviewed to evaluate the safety of the procedure. The tumor reduction and biological response were analyzed through computed tomography/magnetic resonance imaging; the serum level of CA19-9 was measured as a secondary endpoint to evaluate the short-term efficacy of IRE. Results： All patients were successfully treated; the median tumor size was 4.2 cm and the median IRE time was 36 min. Four intraoperative procedure-related complications were observed （16%）： two transient hypertensive episodes, one hypotension case, and one transient supraventricular tachycardia case. Nine postoperative complications were described, including three Grade A pancreatic fistulas, three delayed gastric emptying, one acute pancreatitis, one upper gastrointestinal hemorrhage, and one portal vein thrombosis. The overall rate of stable disease was 28%, 36% achieved partial response, and lower serum CA19-9 levels were recorded in all patients at discharge. Conclusions： IRE is feasible for the treatment of LAPC and is a reasonable intervention strategy owing to its combined attributes of safety and efficacy.展开更多
Compared with input-to-state stability(ISS) in global version,the concept of local input-to-state stability(LISS) is more relevant and meaningful in practice.The key of assessing LISS properties lies in investigating ...Compared with input-to-state stability(ISS) in global version,the concept of local input-to-state stability(LISS) is more relevant and meaningful in practice.The key of assessing LISS properties lies in investigating three main ingredients,the local region of initial states,the local region of external inputs and the asymptotic gain.It is the objective of this paper to propose a numerical algorithm for estimating LISS properties on the theoretical foundation of quadratic form LISS-Lyapunov function.Given developments of linear matrix inequality(LMI) methods,this algorithm is effective and powerful.A typical power electronics based system with common DC bus is served as a demonstration for quantitative results.展开更多
In the current era of cloud computing, data stored in the cloud is being generated at a tremendous speed, and thus the cloud storage system has become one of the key components in cloud computing. By storing a substan...In the current era of cloud computing, data stored in the cloud is being generated at a tremendous speed, and thus the cloud storage system has become one of the key components in cloud computing. By storing a substantial amount of data in commodity disks inside the data center that hosts the cloud, the cloud storage system must consider one question very carefully： how do we store data reliably with a high efficiency in terms of both storage overhead and data integrity？ Though it is easy to store replicated data to tolerate a certain amount of data losses, it suffers from a very low storage efficiency. Conventional erasure coding techniques, such as Reed-Solomon codes, are able to achieve a much lower storage cost with the same level of tolerance against disk failures. However, it incurs much higher repair costs, not to mention an even higher access latency. In this sense, designing new coding techniques for cloud storage systems has gained a significant amount of attention in both academia and the industry. In this paper, we examine the existing results of coding techniques for cloud storage systems. Specifically, we present these coding techniques into two categories： regenerating codes and locally repairable codes. These two kinds of codes meet the requirements of cloud storage along two different axes： optimizing bandwidth and I/O overhead. We present an overview of recent advances in these two categories of coding techniques. Moreover, we introduce the main ideas of some specific coding techniques at a high level, and discuss their motivations and performance.展开更多
Many patients with pancreas cancer present with locally advanced pancreatic cancer(LAPC).The principle tools used for diagnosis and staging of LAPC include endoscopic ultrasound,axial imaging with computed tomography ...Many patients with pancreas cancer present with locally advanced pancreatic cancer(LAPC).The principle tools used for diagnosis and staging of LAPC include endoscopic ultrasound,axial imaging with computed tomography and magnetic resonance imaging,and diagnostic laparoscopy.The definition of resectability has historically been vague,as there is considerable debate and controversy as to the definition of LAPC.For the patient with LAPC,there is some level of involvement of the surrounding vascular structures,which include the superior mesenteric artery,celiac axis,hepatic artery,superior mesenteric vein,or portal vein.When feasible,most surgeons would recommend possible surgical resection for patients with borderline LAPC,with the goal of an R0 resection.For initially unresectable LAPC,neoadjuvant should be strongly considered.Specifically,these patients should be offered neoadjuvant therapy,and the tumor should be assessed for possible response and eventual resection.The efficacy of neoadjuvant therapy with this approach as a bridge to potential curative resection is broad,ranging from 3%-79%.The different modalities of neoadjuvant therapy include sin-gle or multi-agent chemotherapy combined with radiation,chemotherapy alone,and chemotherapy followed by chemotherapy with radiation.This review focuses on patients with LAPC and addresses recent advances and controversies in the field.展开更多
Locally advanced pancreatic cancer is associated with a very poor prognosis. This study was performed to evaluate whether patients with locally advanced pancreatic cancer benefit from 125 ^I seed implantation. This re...Locally advanced pancreatic cancer is associated with a very poor prognosis. This study was performed to evaluate whether patients with locally advanced pancreatic cancer benefit from 125 ^I seed implantation. This retrospective study included 224 patients with locally advanced pancreatic cancer, with 137 patients（61.2%） in the implantation（IP） group and 87（38.9%） in the non-implantation（NIP） group. The survival status, complications and objective curative effects were compared between the groups. The average operative time in the IP group was significantly longer than that in the NIP group（243±51 vs. 214±77 min）. The tumor response rates were 9.5% and 0 at the 2nd month after surgery in the IP and NIP groups, respectively（P〈0.05）. The IP group exhibited a trend toward pain relief at the 6th month after surgery. The global health status scores of the IP group were higher than those of the NIP group at the 3rd and 6th month after surgery. The median survival time in the IP group was significantly longer than that in the NIP group. In conclusion, patients with locally advanced pancreatic cancer can benefit from 125 I seed implantation in terms of local tumor control, survival time, pain relief and quality of life.展开更多
AIM: To evaluate the 5-year survival after laparoscopic surgery vs open surgery for stages Ⅱ and Ⅲ rectal cancer.METHODS:This study enrolled 406 consecutive patients who underwent curative resection for stagesⅡand...AIM: To evaluate the 5-year survival after laparoscopic surgery vs open surgery for stages Ⅱ and Ⅲ rectal cancer.METHODS:This study enrolled 406 consecutive patients who underwent curative resection for stagesⅡandⅢrectal cancer between January 2000 and December 2009[laparoscopic rectal resection(LRR),n=152;open rectal resection(ORR),n=254].Clinical characteristics,operative outcomes,pathological outcomes,postoperative recovery,and 5-year survival outcomes were compared between the two groups.RESULTS:Most of the clinical characteristics were similar except age(59 years vs 55 years,P=0.033)between the LRR group and ORR group.The proportion of anterior resection was higher in the LRR group than that in the ORR group(81.6%vs 66.1%,P=0.001).The LRR group had less estimated blood loss(50m L vs 200 m L,P<0.001)and a lower rate of blood transfusion(4.6%vs 11.8%,P=0.019)compared to the ORR group.The pathological outcomes of the two groups were comparable.The LRR group was associated with faster recovery of bowel function(2.8 d vs 3.7 d,P<0.001)and shorter postoperative hospital stay(11.7 d vs 13.7 d,P<0.001).The median followup time was 63 mo in the LRR group and 65 mo in the ORR group.As for the survival outcomes,the 5-year local recurrence rate(16.0%vs 16.4%,P=0.753),5-year disease-free survival(DFS)rate(63.0%vs63.1%,P=0.589),and 5-year overall survival(OS)rate(68.1%vs 63.5%,P=0.682)were comparable between the LRR group and the ORR group.Stageby stage,there were also no statistical differences between the LRR group and the ORR group in terms of the 5-year local recurrence rate(stageⅡ:6.3%vs 8.7%,P=0.623;stageⅢ:26.4%vs 23.2%,P=0.747),5-year DFS rate(stageⅡ:77.5%vs 77.6%,P=0.462;stageⅢ:46.5%vs 50.9%,P=0.738),and5-year OS rate(stageⅡ:81.4%vs 74.3%,P=0.242;stageⅢ:53.9%vs 54.1%,P=0.459).CONCLUSION:LRR for stagesⅡandⅢrectal cancer can yield comparable long-term survival while achieving short-term benefits compared to open surgery.展开更多
A new class of locally finite continuous topological spaces （for short, locally FC-spaces） and a class of system of generalized vector quasi-equilibrium problems are introduced. By applying a generalized Himmelberg ...A new class of locally finite continuous topological spaces （for short, locally FC-spaces） and a class of system of generalized vector quasi-equilibrium problems are introduced. By applying a generalized Himmelberg type fixed point theorem for a set-valued mapping with KKM-property due to the author, a collectively fixed point and an equilibrium existence theorem of generalized game are first proved in locally FC-spaces. By applying our equilibrium existence theorem of generalized game, some new existence theorems of equilibrium points for the system of generalized vector quasi-equilibrium problems are proved in locally FC-spaces. These theorems improve, unify and generalize many known results in the literatures.展开更多
Advancements in rectal cancer treatment have resulted in improvement only in locoregional control and have failed to address distant relapse, which is the predominant mode of treatment failure in rectal cancer. As the...Advancements in rectal cancer treatment have resulted in improvement only in locoregional control and have failed to address distant relapse, which is the predominant mode of treatment failure in rectal cancer. As the efficacy of conventional chemoradiotherapy（CRT） followed by total mesorectal excision（TME） reaches a plateau, the need for alternative strategies in locally advanced rectal cancer（LARC） has grown in relevance. Several novel strategies have been conceptualized to address this issue, including： 1） neoadjuvant induction and consolidation chemotherapy before CRT; 2） neoadjuvant chemotherapy alone to avoid the sequelae of radiation; and 3） nonoperative management for patients who achieved pathological or clinical complete response after CRT. This article explores the issues, recent advances and paradigm shifts in the management of LARC and emphasizes the need for a personalized treatment plan for each patient based on tumor stage, location, gene expression and quality of life.展开更多
AIM:To evaluate the clinical value of diffusion-weighted magnetic resonance imaging(DW-MRI)in predicting the response of rectal cancer to neoadjuvant chemoradiation.METHODS:This prospective study was approved by our i...AIM:To evaluate the clinical value of diffusion-weighted magnetic resonance imaging(DW-MRI)in predicting the response of rectal cancer to neoadjuvant chemoradiation.METHODS:This prospective study was approved by our institutional review board,and informed consent was obtained from each patient.Fifteen patients(median age 56 years)with locally advanced rectal cancer were treated in our hospital from June 2006 to December 2007.All patients were stageⅢB-C according to the results of MRI and endorectal ultrasound examinations.All patients underwent pelvic irradiation with 45 Gy/25 fx per 35 days.The concurrent chemotherapy regimen consisted of capecitabine 625mg/m2,bid(Monday-Friday),and oxaliplatin 50 mg/m2,weekly.The patients underwent surgery 5-8 wk after the completion of neoadjuvant therapy.T downstaging was defined as the downstaging of the tumor from cT3to ypT0-2 or from cT4 to ypT0-3.Good regression was defined as TRG 3-4,and poor regression was defined as TRG 0-2.Diffusion-weighted magnetic resonance images were obtained prior to and weekly during the course of neoadjuvant chemoradiation,and the apparent diffusion coefficient(ADC)values were calculated from the acquired tumor images.RESULTS:Comparison with the mean pretreatment tumor ADC revealed an increase in the mean tumor ADC during the course of neoadjuvant chemoradiation,especially at the 2ndweek(P=0.004).We found a strong negative correlation between the mean pretreatment tumor ADC and tumor regression after neoadjuvant chemoradiation(P=0.021).In the T downstage and tumor regression groups,we found a significant increase in the mean ADC at the 2ndweek of neoadjuvant therapy(P=0.011;0.004).CONCLUSION:DW-MRI might be a valuable clinical tool to help predict or assess the response of rectal cancer to neoadjuvant chemoradiation at an early timepoint.展开更多
A class of the associative and Lie algebras A[D] = A × F[D] of Weyl type are studied, where Ais a commutative associative algebra with an identity element over a field F of characteristic zero, and F[D] isthe pol...A class of the associative and Lie algebras A[D] = A × F[D] of Weyl type are studied, where Ais a commutative associative algebra with an identity element over a field F of characteristic zero, and F[D] isthe polynomial algebra of a finite dimensional commutative subalgebra of locally finite derivations of A suchthat A is D-simple. The derivations of these associative and Lie algebras are precisely determined.展开更多
文摘Uterine cervical cancer is the second most common gynecological malignancy. It is estimated that over 35% of tumors are diagnosed at locally advanced disease, stage ⅠB2-ⅡB with an estimated 5-year overall survival of 60%. During the last decades, the initial treatment for these women has been debated and largely varies through different countries. Thus, radical concurrent chemoradiation is the standard of care in United Sated and Canada, and neoadjuvant chemotherapy followed by radical surgery is the first line of treatment in some institutions of Europe, Asia and Latin America. Until today, there is no evidence of which strategy is better over the other. This article describe the evidence as well as the advantages and disadvantages of the main strategies of treatment for women affected by uterine cervical cancer stage ⅠB2-ⅡB.
基金Supported by the National Natural Science Foundation of China
文摘In this paper internal characterizations on certain quotient images of locally separable metric spaces are discussed.We obtain some descriptions of quotient s-images,pseudo-open s- images,quotient compact images and closed images of locally separable metric spaces,and establish some relations between these and certain quotient images of metric spaces by the local separability of suitable subspaces.
文摘AIM:To provide efficacy and safety data about the combined use of radiotherapy and chemo-radiotherapy in nasopharyngeal carcinoma(NPC).METHODS:We reviewed data of 40 patients with locally advanced NPC treated with induction chemotherapy followed by concomitant chemo-radiotherapy(CCRT)(22/40 patients)or CCRT alone(18/40)from March 2006 to March 2012.Patients underwent fiberoscopy with biopsy of the primitive tumor,and computed tomography scan of head,neck,chest and abdomen with and without contrast.Cisplatin was used both as induction and as concomitant chemotherapy,while 3D conformal radiation therapy was delivered to the nasopharynx and relevant anatomic regions(total dose,70 Gy).The treatment was performed using 6 MV photons of the linear accelerator administered in 2 Gy daily fraction for five days weekly.This retrospective analysis was approved by the review boards of the participating institutions.Patients gave their consent to treatment and to anonymous analysis of clinical data.RESULTS:Thirty-three patients were males and 7 were females.Median follow-up time was 58 mo(range,1-92 mo).In the sub-group of twenty patients with a follow-up time longer than 36 mo,the 3-year survival and disease free survival rates were 85%and 75%,respectively.Overall response rate both in patients treated with induction chemotherapy followed by CCRT and in those treated with CCRT alone was 100%.Grade 3 neutropenia was the most frequent acute side-effect and it occurred in 20 patients.Grade 2 mucositis was seen in 29 patients,while grade 2 xerostomia was seen in 30 patients.Overall toxicity was manageable and it did not cause any significant treatment delay.In the whole sample population,long term toxicity included grade 2 xerostomia in 22 patients,grade 1 dysgeusia in 17 patients and grade 1 subcutaneous fibrosis in 30 patients.CONCLUSION:Both CCRT and induction chemotherapy followed by CCRT showed excellent activity in locally advanced NPC.The role of adjuvant chemotherapy remains to be defined.
文摘To clarify the role of neoadjuvant concurrent chemoradiotherapy (NACCRT) followed by surgical resection for localized or locally advanced perihilar cholangiocarcinoma (CCA).METHODSWe retrospectively reviewed 57 patients who underwent surgical resection with or without NACCRT for perihilar CCA; 12 patients received NACCRT and 45 patients did not received NACCRT. Patients with locally advanced perihilar CCA requiring NACCRT were defined as follows: (1) a mass involving unilateral branches of the portal vein or hepatic artery with insufficient volume of the anticipated remnant lobe; or (2) an infiltrating mass in the main portal vein that was too long for reconstruction, identified at preoperative staging.RESULTSThe median disease-free survival (DFS) durations of the neoadjuvant and non-neoadjuvant CCRT groups were 26.0 and 15.1 mo, respectively (P = 0.91). The median overall survival (OS) durations of the neoadjuvant and non-neoadjuvant CCRT groups were 32.9 and 27.1 mo, respectively (P = 0.26). The NACCRT group showed a downstaging tendency compared to the non-NACCRT group as compared with the tumor stage confirmed by histological examination after surgery and the tumor stage confirmed by imaging test at the time of diagnosis (P = 0.01).CONCLUSIONNACCRT does not prolong DFS and OS in localized or locally advanced perihilar CCA. However, NACCRT may allow tumor downstaging and improve tumor resectability.
基金Project supported by the National Natural Science Foundation of China (Nos. 10331010, 10861007)the Foundation for the Author of National Excellent Doctoral Dissertation of China (No. 2007B14)+2 种基金the Jiangxi Provincial Natural Science Foundation of China (Nos. 0411025, 2007GZS0179)the Foundation of the Education Department of Jiangxi Province (No. GJJ08162)the Doctoral Fund of Jiangxi Normal University
文摘The concept of locally strong compactness on domains is generalized to general topological spaces. It is proved that for each distributive hypercontinuous lattice L, the space SpecL of nonunit prime elements endowed with the hull-kernel topology is locally strongly compact, and for each locally strongly compact space X, the complete lattice of all open sets O(X) is distributive hypercontinuous. For the case of distributive hyperalgebraic lattices, the similar result is given. For a sober space X, it is shown that there is an order reversing isomorphism between the set of upper-open filters of the lattice O(X) of open subsets of X and the set of strongly compact saturated subsets of X, which is analogous to the well-known Hofmann-Mislove Theorem.
文摘AIM： TO estimate the prevalence of small intestinal bacterial overgrowth （SIBO） in our geographical area （Western Sicily, Italy） by means of an observational study, and to gather information on the use of locally active, non-absorbable antibiotics for treatment of SIBO.METHODS： Our survey included 115 patients fulfilling the Rome II criteria for diagnosis of irritable bowel syndrome （IBS）; a total of 97 patients accepted to perform a breath test with lactulose （BTLact）, and those who had a positive test, received Rifaximin （Normix , Alfa Wassermann） 1200 mg/d for 7 d; 3 wk after the end of treatment, the BTLact was repeated.RESULTS： Based on the BTLact results, SIBO was present in about 56% of IBS patients, and it was responsible for some IBS-related symptoms, such as abdominal bloating and discomfort, and diarrhoea. 1-wk treatment with Rifaximin turned the BTLact to negative in about 50% of patients and significantly reduced the symptoms, especially in those patients with an alternated constipation/diarrhoea-variant IBS. CONCLUSION： SIBO should be always suspected in patients with IBS, and a differential diagnosis is done by means of a ＂breath test＂. Rifaximin may represent a valid approach to the treatment of SIBO.
基金supported by National Basic Research Program of China(No.2013CB035701)the Fundamental Research Funds for the Central Universitiesthe National Program for Support of Top-notch Young Professionals
文摘Thermally sprayed coatings are essentially layered materials and contain large numbers of lamellar pores. It is thus quite necessary to clarify the formation mechanism of lamellar pores which significantly influence coating performances. In the present study, to elaborate the formation mechanism of lamellar pores, the yttria-stabilized zirconia(ZrO_2–7 wt% Y_2O_3, 7YSZ) splats, which have high fracture toughness and tetragonal phase stability, were employed. Interestingly, anomalous epitaxial growth occurred for all deposition temperatures in spite of the extremely high cooling rate,which clearly indicated chemical bonding and complete contact at splat/substrate interface before splat cooling. However, transverse spallation substantially occurred for all deposition temperatures in spite of the high fracture toughness of 7YSZ, which revealed that the lamellar pores were from transverse cracking/spallation due to the large stress during splat cooling. Additionally, fracture mechanics analysis was carried out, and it was found that the stress arose from the constraint effect of the shrinkage of the splat by locally heated substrate with the value about 1.97 GPa. This clearly demonstrated that the stress was indeed large enough to drive transverse cracking/spallation forming lamellar pores during splat cooling. All of these contribute to understanding the essential features of lamellar bonding and further tailoring the coating structures and performance.
基金supported by National Natural Science Foundation of China (Grant No.10871016)
文摘The purpose of this paper is to give a selective survey on recent progress in random metric theory and its applications to conditional risk measures.This paper includes eight sections.Section 1 is a longer introduction,which gives a brief introduction to random metric theory,risk measures and conditional risk measures.Section 2 gives the central framework in random metric theory,topological structures,important examples,the notions of a random conjugate space and the Hahn-Banach theorems for random linear functionals.Section 3 gives several important representation theorems for random conjugate spaces.Section 4 gives characterizations for a complete random normed module to be random reflexive.Section 5 gives hyperplane separation theorems currently available in random locally convex modules.Section 6 gives the theory of random duality with respect to the locally L0-convex topology and in particular a characterization for a locally L0-convex module to be L0-pre-barreled.Section 7 gives some basic results on L0-convex analysis together with some applications to conditional risk measures.Finally,Section 8 is devoted to extensions of conditional convex risk measures,which shows that every representable L∞-type of conditional convex risk measure and every continuous Lp-type of convex conditional risk measure(1 ≤ p < +∞) can be extended to an L∞F(E)-type of σ,λ(L∞F(E),L1F(E))-lower semicontinuous conditional convex risk measure and an LpF(E)-type of T,λ-continuous conditional convex risk measure(1 ≤ p < +∞),respectively.
基金Project supported by the National Natural Science Foundation of China （Grant No 50575222） and the State Key Development Program for Basic Research of China （Grant No 51307）.
文摘Based on a better understanding of the lattice vibration modes, two simple spring-mass models are constructed in order to evaluate the frequencies on both the lower and upper edges of the lowest locally resonant band gaps of the ternary locally resonant phononic crystals. The parameters of the models are given in a reasonable way based on the physical insight into the band gap mechanism. Both the lumped-mass methods and our models are used in the study of the influences of structural and the material parameters on frequencies on both edges of the lowest gaps in the ternary locally resonant phononic crystals. The analytical evaluations with our models and the theoretical predictions with the lumped-mass method are in good agreement with each other. The newly proposed heuristic models are helpful for a better understanding of the locally resonant band gap mechanism, as well as more accurate evaluation of the band edge frequencies.
文摘Background： Locally advanced pancreatic carcinoma （LAPC） is characterized by poor prognosis despite recommended concurrent chemoradiotherapy. Irreversible electroporation （IRE） has emerged as a potential option for the management of unresectable pancreatic cancer. This study was conducted to evaluate the safety and short-term efficacy of open IRE for the treatment of LAPC. Methods： Retrospective data of 25 consecutive patients receiving IRE for T3 lesions from July 2015 to June 2016 at a single center were analyzed. The perioperative and long-term IRE-related complications were reviewed to evaluate the safety of the procedure. The tumor reduction and biological response were analyzed through computed tomography/magnetic resonance imaging; the serum level of CA19-9 was measured as a secondary endpoint to evaluate the short-term efficacy of IRE. Results： All patients were successfully treated; the median tumor size was 4.2 cm and the median IRE time was 36 min. Four intraoperative procedure-related complications were observed （16%）： two transient hypertensive episodes, one hypotension case, and one transient supraventricular tachycardia case. Nine postoperative complications were described, including three Grade A pancreatic fistulas, three delayed gastric emptying, one acute pancreatitis, one upper gastrointestinal hemorrhage, and one portal vein thrombosis. The overall rate of stable disease was 28%, 36% achieved partial response, and lower serum CA19-9 levels were recorded in all patients at discharge. Conclusions： IRE is feasible for the treatment of LAPC and is a reasonable intervention strategy owing to its combined attributes of safety and efficacy.
基金supported by the National Natural Science Foundation of China (Grant Nos 50977047 and 50907038)
文摘Compared with input-to-state stability(ISS) in global version,the concept of local input-to-state stability(LISS) is more relevant and meaningful in practice.The key of assessing LISS properties lies in investigating three main ingredients,the local region of initial states,the local region of external inputs and the asymptotic gain.It is the objective of this paper to propose a numerical algorithm for estimating LISS properties on the theoretical foundation of quadratic form LISS-Lyapunov function.Given developments of linear matrix inequality(LMI) methods,this algorithm is effective and powerful.A typical power electronics based system with common DC bus is served as a demonstration for quantitative results.
文摘In the current era of cloud computing, data stored in the cloud is being generated at a tremendous speed, and thus the cloud storage system has become one of the key components in cloud computing. By storing a substantial amount of data in commodity disks inside the data center that hosts the cloud, the cloud storage system must consider one question very carefully： how do we store data reliably with a high efficiency in terms of both storage overhead and data integrity？ Though it is easy to store replicated data to tolerate a certain amount of data losses, it suffers from a very low storage efficiency. Conventional erasure coding techniques, such as Reed-Solomon codes, are able to achieve a much lower storage cost with the same level of tolerance against disk failures. However, it incurs much higher repair costs, not to mention an even higher access latency. In this sense, designing new coding techniques for cloud storage systems has gained a significant amount of attention in both academia and the industry. In this paper, we examine the existing results of coding techniques for cloud storage systems. Specifically, we present these coding techniques into two categories： regenerating codes and locally repairable codes. These two kinds of codes meet the requirements of cloud storage along two different axes： optimizing bandwidth and I/O overhead. We present an overview of recent advances in these two categories of coding techniques. Moreover, we introduce the main ideas of some specific coding techniques at a high level, and discuss their motivations and performance.
文摘Many patients with pancreas cancer present with locally advanced pancreatic cancer(LAPC).The principle tools used for diagnosis and staging of LAPC include endoscopic ultrasound,axial imaging with computed tomography and magnetic resonance imaging,and diagnostic laparoscopy.The definition of resectability has historically been vague,as there is considerable debate and controversy as to the definition of LAPC.For the patient with LAPC,there is some level of involvement of the surrounding vascular structures,which include the superior mesenteric artery,celiac axis,hepatic artery,superior mesenteric vein,or portal vein.When feasible,most surgeons would recommend possible surgical resection for patients with borderline LAPC,with the goal of an R0 resection.For initially unresectable LAPC,neoadjuvant should be strongly considered.Specifically,these patients should be offered neoadjuvant therapy,and the tumor should be assessed for possible response and eventual resection.The efficacy of neoadjuvant therapy with this approach as a bridge to potential curative resection is broad,ranging from 3%-79%.The different modalities of neoadjuvant therapy include sin-gle or multi-agent chemotherapy combined with radiation,chemotherapy alone,and chemotherapy followed by chemotherapy with radiation.This review focuses on patients with LAPC and addresses recent advances and controversies in the field.
文摘Locally advanced pancreatic cancer is associated with a very poor prognosis. This study was performed to evaluate whether patients with locally advanced pancreatic cancer benefit from 125 ^I seed implantation. This retrospective study included 224 patients with locally advanced pancreatic cancer, with 137 patients（61.2%） in the implantation（IP） group and 87（38.9%） in the non-implantation（NIP） group. The survival status, complications and objective curative effects were compared between the groups. The average operative time in the IP group was significantly longer than that in the NIP group（243±51 vs. 214±77 min）. The tumor response rates were 9.5% and 0 at the 2nd month after surgery in the IP and NIP groups, respectively（P〈0.05）. The IP group exhibited a trend toward pain relief at the 6th month after surgery. The global health status scores of the IP group were higher than those of the NIP group at the 3rd and 6th month after surgery. The median survival time in the IP group was significantly longer than that in the NIP group. In conclusion, patients with locally advanced pancreatic cancer can benefit from 125 I seed implantation in terms of local tumor control, survival time, pain relief and quality of life.
基金Supported by National Key Clinical Specialty Construction Project of China,the National High Technology Research and Development Program of China No.2012AA021103the Research Fund of Public Welfare in Health Industry,National Health and Family Planning Commission of China,No.201502039
文摘AIM: To evaluate the 5-year survival after laparoscopic surgery vs open surgery for stages Ⅱ and Ⅲ rectal cancer.METHODS:This study enrolled 406 consecutive patients who underwent curative resection for stagesⅡandⅢrectal cancer between January 2000 and December 2009[laparoscopic rectal resection(LRR),n=152;open rectal resection(ORR),n=254].Clinical characteristics,operative outcomes,pathological outcomes,postoperative recovery,and 5-year survival outcomes were compared between the two groups.RESULTS:Most of the clinical characteristics were similar except age(59 years vs 55 years,P=0.033)between the LRR group and ORR group.The proportion of anterior resection was higher in the LRR group than that in the ORR group(81.6%vs 66.1%,P=0.001).The LRR group had less estimated blood loss(50m L vs 200 m L,P<0.001)and a lower rate of blood transfusion(4.6%vs 11.8%,P=0.019)compared to the ORR group.The pathological outcomes of the two groups were comparable.The LRR group was associated with faster recovery of bowel function(2.8 d vs 3.7 d,P<0.001)and shorter postoperative hospital stay(11.7 d vs 13.7 d,P<0.001).The median followup time was 63 mo in the LRR group and 65 mo in the ORR group.As for the survival outcomes,the 5-year local recurrence rate(16.0%vs 16.4%,P=0.753),5-year disease-free survival(DFS)rate(63.0%vs63.1%,P=0.589),and 5-year overall survival(OS)rate(68.1%vs 63.5%,P=0.682)were comparable between the LRR group and the ORR group.Stageby stage,there were also no statistical differences between the LRR group and the ORR group in terms of the 5-year local recurrence rate(stageⅡ:6.3%vs 8.7%,P=0.623;stageⅢ:26.4%vs 23.2%,P=0.747),5-year DFS rate(stageⅡ:77.5%vs 77.6%,P=0.462;stageⅢ:46.5%vs 50.9%,P=0.738),and5-year OS rate(stageⅡ:81.4%vs 74.3%,P=0.242;stageⅢ:53.9%vs 54.1%,P=0.459).CONCLUSION:LRR for stagesⅡandⅢrectal cancer can yield comparable long-term survival while achieving short-term benefits compared to open surgery.
基金This project is supported by the NSF of Sichuan Education Department of China (2003A081 and SZD0406)
文摘A new class of locally finite continuous topological spaces （for short, locally FC-spaces） and a class of system of generalized vector quasi-equilibrium problems are introduced. By applying a generalized Himmelberg type fixed point theorem for a set-valued mapping with KKM-property due to the author, a collectively fixed point and an equilibrium existence theorem of generalized game are first proved in locally FC-spaces. By applying our equilibrium existence theorem of generalized game, some new existence theorems of equilibrium points for the system of generalized vector quasi-equilibrium problems are proved in locally FC-spaces. These theorems improve, unify and generalize many known results in the literatures.
文摘Advancements in rectal cancer treatment have resulted in improvement only in locoregional control and have failed to address distant relapse, which is the predominant mode of treatment failure in rectal cancer. As the efficacy of conventional chemoradiotherapy（CRT） followed by total mesorectal excision（TME） reaches a plateau, the need for alternative strategies in locally advanced rectal cancer（LARC） has grown in relevance. Several novel strategies have been conceptualized to address this issue, including： 1） neoadjuvant induction and consolidation chemotherapy before CRT; 2） neoadjuvant chemotherapy alone to avoid the sequelae of radiation; and 3） nonoperative management for patients who achieved pathological or clinical complete response after CRT. This article explores the issues, recent advances and paradigm shifts in the management of LARC and emphasizes the need for a personalized treatment plan for each patient based on tumor stage, location, gene expression and quality of life.
文摘AIM:To evaluate the clinical value of diffusion-weighted magnetic resonance imaging(DW-MRI)in predicting the response of rectal cancer to neoadjuvant chemoradiation.METHODS:This prospective study was approved by our institutional review board,and informed consent was obtained from each patient.Fifteen patients(median age 56 years)with locally advanced rectal cancer were treated in our hospital from June 2006 to December 2007.All patients were stageⅢB-C according to the results of MRI and endorectal ultrasound examinations.All patients underwent pelvic irradiation with 45 Gy/25 fx per 35 days.The concurrent chemotherapy regimen consisted of capecitabine 625mg/m2,bid(Monday-Friday),and oxaliplatin 50 mg/m2,weekly.The patients underwent surgery 5-8 wk after the completion of neoadjuvant therapy.T downstaging was defined as the downstaging of the tumor from cT3to ypT0-2 or from cT4 to ypT0-3.Good regression was defined as TRG 3-4,and poor regression was defined as TRG 0-2.Diffusion-weighted magnetic resonance images were obtained prior to and weekly during the course of neoadjuvant chemoradiation,and the apparent diffusion coefficient(ADC)values were calculated from the acquired tumor images.RESULTS:Comparison with the mean pretreatment tumor ADC revealed an increase in the mean tumor ADC during the course of neoadjuvant chemoradiation,especially at the 2ndweek(P=0.004).We found a strong negative correlation between the mean pretreatment tumor ADC and tumor regression after neoadjuvant chemoradiation(P=0.021).In the T downstage and tumor regression groups,we found a significant increase in the mean ADC at the 2ndweek of neoadjuvant therapy(P=0.011;0.004).CONCLUSION:DW-MRI might be a valuable clinical tool to help predict or assess the response of rectal cancer to neoadjuvant chemoradiation at an early timepoint.
基金This work was supported by the Natronal Natural Science Foundation of China(Grant No.10171064)and an EYTP grant of MOE of China.
文摘A class of the associative and Lie algebras A[D] = A × F[D] of Weyl type are studied, where Ais a commutative associative algebra with an identity element over a field F of characteristic zero, and F[D] isthe polynomial algebra of a finite dimensional commutative subalgebra of locally finite derivations of A suchthat A is D-simple. The derivations of these associative and Lie algebras are precisely determined.
