Effect of Intermittent Oro-Esophageal Tube Feeding in Bulbar Palsy After Ischemic Stroke: A Randomized Controlled Study.

BACKGROUND: Nasogastric tube feeding (NG) has been widely used in patients with bulbar palsy after ischemic stroke but is associated with a significant risk of complications including malnutrition and pneumonia. Intermittent oro-esophageal tube feeding (IOE) can help alleviate these concerns. This study explored the clinical effect of IOE versus NG on nutritional status, swallowing function, stroke-associated pneumonia, and depression in patients with bulbar palsy after ischemic stroke. METHODS: This randomized controlled study included 148 patients with bulbar palsy after ischemic stroke who underwent routine treatment and swallowing rehabilitation training in the Department of Rehabilitation Medicine between July 2017 and July 2019 in China. The participants were randomly divided into the IOE group (n=74) and NG group (n=74) with IOE and NG as nutritional supports, respectively. The primary outcome was nutritional status including (1) body mass index (kg/m2), (2) serum ALB (albumin, g/L), and (3) PA (prealbumin, mg/L). The secondary outcomes were (1) swallowing function including (i) Functional Oral Intake Scale (FOIS) and (ii) Penetration-Aspiration Scale, (2) pneumonia, (3) depression, and (4) adverse events. Statistical analyses for continuous outcomes were performed using t test, Mann-Whitney U test and Wilcoxon signed-rank test and categorical variables using χ2 test. SPSS 21.0 was used for all analysis. RESULTS: There were no significant baseline differences between the 2 groups. After the treatment, the IOE group demonstrated significantly better results compared with the NG group in ALB ([32.71±0.94] versus [32.28±0.81] g/L; P=0.003), PA ([278.15±13.81] versus [270.31±15.08] mg/L; P=0.001], body mass index ([19.77±1.03] versus [19.41±0.98] kg/m2; P=0.002], FOIS (P<0.001), Penetration-Aspiration Scale (P<0.001), stroke-associated pneumonia ([1, 4.05%] versus [26, 35.14%]; P<0.001), depression ([1, 1.35%] versus [44, 59.46%]; P<0.001) and overall less adverse events (reflux, fever, discomfort in the throat; P<0.001). CONCLUSIONS: In patients with dysphagia with bulbar palsy after ischemic stroke who received routine treatment and swallowing rehabilitation training, IOE is safer and more conducive to the improvement of nutritional status, swallowing function, stroke-associated pneumonia, and depression than NG. REGISTRATION: URL: https://www.chictr.org.cn; Unique identifier: ChiCTR-INC-17011741.

The Relationship Between Congenital Heart Disease in Newborns and Maternal Prenatal Folic Acid Supplementation, and Analysis of Other High-Risk Factors.

Objective: To analyze the relationship between congenital heart disease (CHD) in newborns and maternal prenatal folic acid supplementation, as well as other high-risk factors. Method: A retrospective analysis was conducted on clinical data of 114 pregnant women diagnosed with congenital heart disease (CHD) in the prenatal stage at our hospital between January 2021 and January 2023. These pregnant women were included in the case group. Additionally, an equal number of pregnant women with normal examination results during the same period were selected as the control group at a 1:1 ratio. Basic information about the families of pregnant women and information about relevant exposure factors during the periconception period were analyzed based on survey forms previously completed by pregnant women during their prenatal check-ups at the hospital. Possible influencing factors were analyzed through multifactor logistic regression. Results: High-risk factors during the perinatal period for new CHD in newborns include maternal age at this pregnancy >35 years (OR=1.907), the presence of adverse pregnancy history (OR=2.213), a family history of CHD (OR=3.049), exposure to secondhand smoke during the perinatal period (OR=2.934), the use of cold medications (OR=1.719), fever (OR=2.034), exposure to noisy environments (OR=1.981), prolonged use of electronic devices (OR=1.827), consumption of pickled foods (OR=1.892). Prenatal folic acid supplementation is a protective factor for new CHD in newborns (OR=0.342). Conclusion: Pregnant women should choose an appropriate gestational age for conception. During the perinatal period, pregnant women should avoid exposure to the aforementioned high-risk factors as much as possible and supplement folic acid appropriately. It is essential to cultivate good dietary and lifestyle habits, as this has significant implications for preventing and reducing the occurrence of CHD in newborns. Healthcare professionals should prioritize educating pregnant women about the risks associated with the identified high-risk factors and emphasize the importance of early prenatal care. Furthermore, promoting appropriate folic acid supplementation during the periconception period should be an integral part of prenatal care protocols. By implementing these recommendations, healthcare providers can contribute to reducing the occurrence of CHD in newborns and improving maternal and infant health outcomes.

Comparison of [68Ga]Ga-DOTA-FAPI-04 and [18F] FDG PET/CT for the diagnosis of primary and metastatic lesions in patients with various types of cancer.

PURPOSE: We evaluated the potential usefulness of [68Ga]Ga-DOTA-FAPI-04 positron emission tomography/computed tomography (PET/CT) for the diagnosis of primary and metastatic lesions in various types of cancer, compared with [18F] FDG PET/CT. METHODS: A total of 75 patients with various types of cancer underwent contemporaneous [68Ga]Ga-DOTA-FAPI-04 and [18F] FDG PET/CT either for an initial assessment or for recurrence detection. Tumour uptake was quantified by the maximum standard uptake value (SUVmax). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of [18F] FDG and [68Ga]Ga-DOTA-FAPI-04 PET/CT were calculated and compared to evaluate the diagnostic efficacy. RESULTS: The study cohort consisted of 75 patients (47 males and 28 females; median age, 61.5 years; age range, 32-85 years). Fifty-four patients with 12 different tumour entities underwent paired [68Ga]Ga-DOTA-FAPI-04 and [18F] FDG PET/CT for initial assessment, while the other 21 patients underwent paired scans for recurrence detection. [68Ga]Ga-DOTA-FAPI-04 PET/CT was able to clearly identify 12 types of malignant tumours with favourable tumour-to-background contrast, which resulted in a higher detection rate of primary tumours than did [18F] FDG PET/CT (98.2% vs. 82.1%, P = 0.021). Meanwhile, [68Ga]Ga-DOTA-FAPI-04 PET/CT showed a better sensitivity than [18F] FDG PET/CT in the detection of lymph nodes (86.4% vs. 45.5%, P = 0.004) and bone and visceral metastases (83.8% vs. 59.5%, P = 0.004). CONCLUSION: [68Ga]Ga-DOTA-FAPI-04 PET/CT showed a superior diagnostic efficacy than [18F] FDG PET/CT for the diagnosis of primary and metastatic lesions in patients with various types of cancer, especially in identifying liver metastases, peritoneal carcinomatosis, and brain tumours.

An Experimental Investigation of the Effects of Block Proportion on Bimrocks, Considering Different Block-to-Matrix Strength Ratios.

The rock block proportion is one of the most important factors affecting the mechanical properties of bimrocks. Under different block-to-matrix strength ratios, the influence of rock block proportion is different. To explore the influence of rock block proportion on the mechanical properties of specimens under different block-to-matrix strength ratios, a new indoor test method for making bimrocks was proposed. A uniaxial compression test and a direct shear test were carried out on specimens with different rock block proportions. The results show that this method can control the block-to-matrix strength ratio well, and the influence of rock block proportion is obviously different under different block-to-matrix strength ratios. The strong matrix sample will decrease significantly after reaching the peak compressive strength, while the weak matrix will decrease slowly after reaching the peak strength. The rock block proportion is negatively correlated with the uniaxial compressive strength of strong matrix samples (the reduction was 12.53%) and is positively correlated with the uniaxial compressive strength of weak matrix samples as a whole, but it changes when block proportion is more than 50%. With the increase in normal stress and rock block proportion increases from 30% to 60%, the shear failure zone of the weak matrix sample increases, and the cracks are inclined, while the strong matrix sample has more secondary cracks. The results of this study also show that the effect of volumetric block proportion (VBP) on the internal friction angle and cohesion of the sample is less related to the block-to-matrix strength ratio.

[Preliminary exploration of clinical prediction model of severe swallowing disorder after acute ischemic stroke based on nomogram model].

OBJECTIVE: To establish a predictive model for severe swallowing disorder after acute ischemic stroke based on nomogram model, and evaluate its effectiveness. METHODS: A prospective study was conducted. The patients with acute ischemic stroke admitted to Mianyang Central Hospital from October 2018 to October 2021 were enrolled. Patients were divided into severe swallowing disorder group and non-severe swallowing disorder group according to whether severe swallowing disorder occurred within 72 hours after admission. The differences in general information, personal history, past medical history, and clinical characteristics of patients between the two groups were compared. The risk factors of severe swallowing disorder were analyzed by multivariate Logistic regression analysis, and the relevant nomogram model was established. The bootstrap method was used to perform self-sampling internal validation on the model, and consistency index, calibration curve, receiver operator characteristic curve (ROC curve), and decision curve were used to evaluate the predictive performance of the model. RESULTS: A total of 264 patients with acute ischemic stroke were enrolled, and the incidence of severe swallowing disorder within 72 hours after admission was 19.3% (51/264). Compared with the non-severe swallowing disorder group, the severe swallowing disorder group had a higher proportion of patients aged of ≥ 60 years old, with severe neurological deficits [National Institutes of Health stroke scale (NIHSS) score ≥ 7], severe functional impairments [Barthel index, an activity of daily living functional status assessment index, < 40], brainstem infarction and lesions ≥ 40 mm (78.43% vs. 56.81%, 52.94% vs. 28.64%, 39.22% vs. 12.21%, 31.37% vs. 13.62%, 54.90% vs. 24.41%), and the differences were statistically significant (all P < 0.01). Multivariate Logistic regression analysis showed that age ≥ 60 years old [odds ratio (OR) = 3.542, 95% confidence interval (95%CI) was 1.527-8.215], NIHSS score ≥ 7 (OR = 2.741, 95%CI was 1.337-5.619), Barthel index < 40 (OR = 4.517, 95%CI was 2.013-10.136), brain stem infarction (OR = 2.498, 95%CI was 1.078-5.790) and lesion ≥ 40 mm (OR = 2.283, 95%CI was 1.485-3.508) were independent risk factors for severe swallowing disorder after acute ischemic stroke (all P < 0.05). The results of model validation showed that the consistency index was 0.805, and the trend of the calibration curve was basically consistent with the ideal curve, indicating that the model had good prediction accuracy. ROC curve analysis showed that the area under the ROC curve (AUC) predicted by nomogram model for severe swallowing disorder after acute ischemic stroke was 0.817 (95%CI was 0.788-0.852), indicating that the model had good discrimination. The decision curve showed that within the range of 5% to 90%, the nomogram model had a higher net benefit value for predicting the risk of severe swallowing disorder after acute ischemic stroke, indicating that the model had good clinical predictive performance. CONCLUSIONS: The independent risk factors of severe swallowing disorder after acute ischemic stroke include age ≥ 60 years old, NIHSS score ≥ 7, Barthel index < 40, brainstem infarction and lesion size ≥ 40 mm. The nomogram model established based on these factors can effectively predict the occurrence of severe swallowing disorder after acute ischemic stroke.

The DDUP protein encoded by the DNA damage-induced CTBP1-DT lncRNA confers cisplatin resistance in ovarian cancer.

Sustained activation of DNA damage response (DDR) signaling has been demonstrated to play vital role in chemotherapy failure in cancer. However, the mechanism underlying DDR sustaining in cancer cells remains unclear. In the current study, we found that the expression of the DDUP microprotein, encoded by the CTBP1-DT lncRNA, drastically increased in cisplatin-resistant ovarian cancer cells and was inversely correlated to cisplatin-based therapy response. Using a patient-derived human cancer cell model, we observed that DNA damage-induced DDUP foci sustained the RAD18/RAD51C and RAD18/PCNA complexes at the sites of DNA damage, consequently resulting in cisplatin resistance through dual RAD51C-mediated homologous recombination (HR) and proliferating cell nuclear antigen (PCNA)-mediated post-replication repair (PRR) mechanisms. Notably, treatment with an ATR inhibitor disrupted the DDUP/RAD18 interaction and abolished the effect of DDUP on prolonged DNA damage signaling, which resulted in the hypersensitivity of ovarian cancer cells to cisplatin-based therapy in vivo. Altogether, our study provides insights into DDUP-mediated aberrant DDR signaling in cisplatin resistance and describes a potential novel therapeutic approach for the management of platinum-resistant ovarian cancer.

A prospective single-arm study on the relationship between dose-volume parameters of pelvic functional bone marrow and acute hematological toxicities during intensity-modulated radiotherapy with or without concurrent chemotherapy for uterine cervical/endometrial cancer.

BACKGROUND: FLT-PET/CT can accurately identify and locate functional bone marrow (FBM) with hematopoietic capability, the FBM were divided into two levels as FBM1 (strongest hemopoietic ability region)and FBM2 (moderate hemopoietic ability region) via FLT-PET/CT. The purpose of this study was to explore the relationship between dose-volume parameters of pelvic FBM and hematologic toxicity (HT) during radiotherapy with or without concurrent chemotherapy for uterine cervical/endometrial cancer. METHODS: From December 2016 to September 2021, ninety-seven uterine cervical/endometrial cancer patients received intensity-modulated radiation therapy were prospectively recruited in this single-arm, prospective, phase II trial. Blood counts were reviewed weekly during radiotherapy. Single- and multifactor regression methods were used to analyze the relationships between dose-volume parameters of FBM1/2 and grade ≥ 2 HT. ROC curves were used to determine the cutoff values for the dose-volume parameters of FBM1/2. RESULTS: The incidence of grade ≥ 2 leukopenia, neutropenia, thrombocytopenia and anemia in patients during radiotherapy was 63.9%, 45.4%, 19.6% and 38.8% respectively, and the median occurrence time was the 29th, 42th, 35th and 31th day, respectively. Multivariate regression analysis showed that the Dmax of FBM1 was significantly related to grade ≥ 2 leukopenia (OR = 1.277 95% CI 1.067-1.528, P = 0.008), Dmean of FBM2 was significantly related to grade ≥ 2 thrombocytopenia (OR = 1.262 95% CI 1.066-1.494, P = 0.007), and V10 of FBM1 was significantly related to grade ≥ 2 anemia (OR = 1.198 95% CI 1.003-1.431, P = 0.046). The incidence of grade ≥ 2 leukopenia for patients with FBM1 Dmax < 53 Gy was lower than that for patients with FBM1 Dmax ≥ 53 Gy (53.4% vs. 95.8%, P < 0.001). The incidence of grade ≥ 2 thrombocytopenia in patients with FBM2 Dmean < 33 Gy was lower than that in patients with FBM2 Dmean ≥ 33 Gy (0 vs. 28.4%, P < 0.001). The incidence of grade ≥ 2 anemia for patients with FBM1 V10 < 95% was lower than that in patients with FBM1 V10 ≥ 95% (24.4% vs. 57.1%, P = 0.003). CONCLUSIONS: Grade ≥ 2 HT usually occurs in the 4th week of radiotherapy for patients with uterine cervical/endometrial cancer. The Dmax and V10 of FBM1 and the Dmean of FBM2 were significantly associated with the occurrence of grade ≥ 2 HT. The recommended optimal dose constraints were FBM1 Dmax < 53 Gy, V10 < 95%, and FBM2 Dmean <33 Gy.

A survey of caregiver burden for stroke survivors in non-teaching hospitals in Western China.

The social factors that moderate stroke caregiver burden have been found to be culture- and gender-specific. We examined the factors that influence the social support and self-efficacy of caregivers of stroke survivors and the burden of caregiving in China. To determine the caregiver burden of stroke survivors, their social support, and their self-efficacy. A total of 328 stroke survivors and their caregivers were recruited from 4 tertiary medical centers to participate in this cross-sectional study. The sociodemographic and stroke-related characteristics of the participants were obtained. Perceived social support and self-efficacy were assessed using the Social Support Rating Scale and General Self-efficacy Scale, respectively. Caregiver burden was assessed using the Zarit Burden Interview Scale. Relationships between the variables were assessed using Pearson's correlation, the chi-square test, and a paired t test. A total of 27.4% of the caregivers reported receiving adequate social support, while 20.7% reported high levels of self-efficacy. A total of 67.1% of the caregivers experienced varying degrees of care burden, while the remaining 32.9% felt no burden. Participants' sociodemographic characteristics (age, daily care time, self-rated health, and financial situation) were significantly related to caregiver burden, social support, and self-efficacy (P < .001). The findings indicate an inverse relationship between caregiver burden, social support and self-efficacy. Adequate social support and self-efficacy can reduce stroke caregivers' burden. Hospital departments should provide assistance to stroke caregivers through educational programs and group training to increase their social support and self-efficacy, thereby alleviating their burden.

Health inequalities during 20 years of rapid economic development in China (1980-2000): a mortality analysis.

OBJECTIVE: To examine the influence of China's economic reforms on population health and regional mortality rates. METHODS: Longitudinal study measuring the mortality trends and their regional variations. Using data from the three most recent national censuses, we used the model life table to adjust the mortality levels within the population for each census, and to calculate life expectancy. We then examined the variation in patterns of mortality and population health by economic status, region and gender from 1980-2000. RESULTS: Life expectancy varied with economic status, province, and gender. Results showed that, although life expectancy in China had increased overall since the early 1980s, regional differences became more pronounced. Life expectancy for populations who live in the eastern coastal provinces are greater than those in the western regions. CONCLUSION: Differences in life expectancy are primarily related to differences in regional economic development, which in turn exacerbate regional health inequalities. Therefore, it is necessary to improve economic development in less developed regions and to improve health policies and the public health system that address the needs of everyone.

68Ga-Fibroblast Activation Protein Inhibitor, a Promising Radiopharmaceutical in PET/CT to Detect the Primary and Metastatic Lesions of Chromophobe Renal Cell Carcinoma.

ABSTRACT: 18F-FDG PET/CT was performed to locate the primary lesion in a 71-year-old man with bone metastasis. However, no abnormal 18F-FDG activity likely presenting the primary tumor was observed. 68Ga-fibroblast activation protein inhibitor PET/CT was then performed for further detecting the primary tumor, which showed a higher activity in lesions of bone metastases than 18F-FDG. Additionally, another lesion with intense uptake was observed in the inferior pole of right kidney, likely presenting the primary tumor. A renal biopsy revealed the diagnosis of chromophobe renal cell carcinoma. This case highlighted that 68Ga-fibroblast activation protein inhibitor could be a promising radiopharmaceutical in the diagnosis of renal cell carcinoma.

Use of 68Ga-FAPI PET/CT for Evaluation of Peritoneal Carcinomatosis Before and After Cytoreductive Surgery.

ABSTRACT: A 55-year-old woman underwent 18F-FDG and 68Ga-FAPI PET/CT for tumor detection and staging under the prospective study NCT04416165. Both scans showed a mass lesion with increased tracer uptake in the pancreas. Moreover, 68Ga-FAPI PET/CT showed a greater number of abnormal foci in the mesentery and omentum than that shown with 18F-FDG. These abnormal foci were suspected to be metastases from pancreatic cancer. The patient subsequently underwent a cytoreductive surgery, and postoperative histopathology confirmed the diagnosis of acinar cell carcinoma of pancreas. Follow-up 68Ga-FAPI PET/CT (3 months after surgery) showed an excellent response with decreasing 68Ga-FAPI activity in the whole abdomen.

Two-layer detection framework with a high accuracy and efficiency for a malware family over the TLS protocol.

The transport layer security (TLS) protocol is widely adopted by apps as well as malware. With the geometric growth of TLS traffic, accurate and efficient detection of malicious TLS flows is becoming an imperative. However, current studies focus on either detection accuracy or detection efficiency, and few studies take into account both indicators. In this paper, we propose a two-layer detection framework composed of a filtering model (FM) and a malware family classification model (MFCM). In the first layer, a new set of TLS handshake features is presented to train the FM, which is devised to filter out a majority of benign TLS flows. For identifying malware families, both TLS handshake features and statistical features are applied to construct the MFCM in the second layer. Comprehensive experiments are conducted to substantiate the high accuracy and efficiency of the proposed two-layer framework. A total of 96.32% of benign TLS flows can be filtered out by the FM with few malicious TLS flows being discarded provided the threshold of the FM is set to 0.01. Moreover, a multiclassifier is selected to construct the MFCM to provide better performance than a set of binary classifiers under the same feature set. In addition, when the ratio of benign and malicious TLS flows is set to 10:1, the detection efficiency of the two-layer framework is 188% faster than that of the single-layer framework, while the average detection accuracy reaches 99.45%.

Quantitative evaluation of salivary gland scintigraphy in Sjögren's syndrome: comparison of diagnostic efficacy and relationship with pathological features of the salivary glands.

OBJECTIVE: The value of salivary gland scintigraphy (SGS) in the evaluation of Sjögren's syndrome (SS) remains controversial. The aim of this study was to evaluate the diagnostic efficacy of quantitative SGS in patients with xerostomia and to assess the correlation between scintigraphic parameters and pathological features of salivary glands. METHODS: Medical records of 165 patients with xerostomia who underwent [99mTc] pertechnetate SGS and labial biopsy were retrospectively reviewed. The maximum accumulation ratio (MAR), maximum secretion ratio (MSR), and time interval from stimulation to minimum count (Tmin) of the parotid glands were calculated to quantify the glandular activity. Furthermore, pre-stimulatory oral activity index (PRI) and post-stimulatory oral activity index (POI) were calculated to quantify the oral activity. RESULTS: All parameters except for Tmin were significantly lower in patients with SS than in those without SS. Among the five SGS parameters, PRI showed the highest areas under the curve value (0.9005; p < 0.001), and PRI > 32.75 was associated with a sensitivity of 78.5% and specificity of 86.4% for the diagnosis of SS. A decrease in MAR, MSR, PRI, and POI and an increase in Tmin correlate significantly with the histopathologic grade of labial gland biopsy and disease severity of SS. No significant differences in glandular parameters (MAR, MSR, and Tmin) were found between the non-SS and early-stage SS groups. CONCLUSION: Conventional scintigraphic parameters could be used as simple, reliable, and sensitive indicators for the early diagnosis of SS and determination of disease severity.

Silencing LGR6 Attenuates Stemness and Chemoresistance via Inhibiting Wnt/ß-Catenin Signaling in Ovarian Cancer.

Leucine-rich-repeat-containing G protein-coupled receptors (LGRs) have been widely found to be implicated with development and progression in multiple cancer types. However, the clinical significance and biological functions of LGR6 in ovarian cancer remains unclear. In this study, LGR6 expression was mainly examined by immunohistochemistry. Functional assays in vitro and animal experiments in vivo were carried out to explore the effect of LGR6 on cancer stem cell (CSC) characteristics and chemotherapeutic responses in ovarian cancer cells. Luciferase assays and GSEA were used to discern the underlying mechanisms contributing to the roles of LGR6 in ovarian cancer. Here, we reported that LGR6 was upregulated in ovarian cancer, which positively correlated with poor chemotherapeutic response and progression survival in ovarian cancer patients. Loss-of-function assays showed that downregulating LGR6 abrogated the CSC-like phenotype and chemoresistance in vitro. More importantly, silencing LGR6 improved the chemoresistance of ovarian cancer cells to cisplatin in vivo. Mechanistic investigation further revealed that silencing LGR6 inhibited stemness and chemoresistance by repressing Wnt/ß-catenin signaling. Collectively, our results uncover a novel mechanism contributing to LGR6-induced chemotherapeutic resistance in ovarian cancer, providing the evidence for LGR6 as a potential therapeutic target in ovarian cancer.

Clinical role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in post-operative follow up of gastric cancer: initial results.

AIM: To evaluate the clinical role of (18)F-fluorodeoxyglucose positron emission and computed tomography ((18)F-FDG PET/CT) in detection of gastric cancer recurrence after initial surgical resection. METHODS: In the period from January 2007 to May 2008, 23 patients who had previous surgical resection of histopathologically diagnosed gastric cancer underwent a total of 25 (18)F-FDG PET/CT scans as follow-up visits in our center. The standard of reference for tumor recurrence consisted of histopathologic confirmation or clinical follow-up information for at least 5 mo after PET/CT examinations. RESULTS: PET/CT was positive in 14 patients (61%) and negative in 9 (39%). When correlated with final diagnosis, which was confirmed by histopathologic evidence of tumor recurrence in 8 of the 23 patients (35%) and by clinical follow-up in 15 (65%), PET/CT was true positive in 12 patients, false positive in 2, true negative in 8 and false negative in 2. Overall, the accuracy of PET/CT was 82.6%, the negative predictive value (NPV) was 77.7%, and the positive predictive value (PPV) was 85.7%. The 2 false positive PET/CT findings were actually chronic inflammatory tissue lesions. For the two patients with false negative PET/CT, the final diagnosis was recurrence of mucinous adenocarcinoma in the anastomosis in one patient and abdominal wall metastasis in the other. Importantly, PET/CT revealed true-positive findings in 11 (47.8%) patients who had negative or no definite findings by CT. PET/CT revealed extra-abdominal metastases in 7 patients and additional esophageal carcinoma in one patient. Clinical treatment decisions were changed in 7 (30.4%) patients after introducing PET/CT into their conventional post-operative follow-up program. CONCLUSION: Whole body (18)F-FDG PET/CT was highly effective in discriminating true recurrence in post-operative patients with gastric cancer and had important impacts on clinical decisions in a considerable portion of patients.

Highly metabolic thrombus of the portal vein: 18F fluorodeoxyglucose positron emission tomography/computer tomography demonstration and clinical significance in hepatocellular carcinoma.

AIM: To assess the ability of (18)F-fluorodeoxyglucose positron emission tomography/computer tomography ((18)F-FDG PET/CT) to differentiate between benign and malignant portal vein thrombosis in hepatocellular carcinoma (HCC) patients. METHODS: Five consecutive patients who had HBV cirrhosis, biopsy-proven HCC, and thrombosis of the main portal vein and/or left/right portal vein on ultrasound (US), computer tomography (CT) or magnetic resonance imaging (MRI) were studied with (18)F-FDG PET/CT. The presence or absence of a highly metabolic thrombus on (18)F-FDG PET/CT was considered diagnostic for malignant or benign portal vein thrombosis, respectively. All patients were followed-up monthly with US, CT or MRI. Shrinkage of the thrombus or recanalization of the vessels on US, CT or MRI during follow-up was considered to be definitive evidence of the benign nature of the thrombosis, whereas enlargement of the thrombus, disruption of the vessel wall, and parenchymal infiltration over follow-up were considered to be consistent with malignancy. (18)F-FDG PET/CT, and US, CT or MRI results were compared. RESULTS: Follow-up (1 to 10 mo) showed signs of malignant thrombosis in 4 of the 5 patients. US, CT or MRI produced a true-positive result for malignancy in 4 of the patients, and a false-positive result in 1. (18)F-FDG PET/CT showed a highly metabolic thrombus in 4 of the 5 patients. (18)F-FDG PET/CT achieved a true-positive result in all 4 of these patients, and a true-negative result in the other patient. No false-positive result was observed using (18)F-FDG PET/CT. CONCLUSION: (18)F-FDG PET/CT may be helpful in discriminating between benign and malignant portal vein thrombi. Patients may benefit from (18)F-FDG PET/CT when portal vein thrombi can not be diagnosed exactly by US, CT or MRI.

Tensile Behavior of Polyurethane Organic Polymer and Polypropylene Fiber-Reinforced Sand.

Physical and chemical reinforcements are commonly used to improve sand properties for engineering requirements. Many researchers have concluded that composite reinforcement can greatly improve sand property strength. In this paper, polyurethane organic polymer (PU) and polypropylene fiber (PF) were used to reinforce sand. It is found that composite reinforcement has great effects on tensile strength. A series of direct tensile tests were conducted to demonstrate this reinforcement and to investigate the effects of PF content, PU content, dry density, and curing time. Additionally, the reinforcement mechanism was analyzed by scanning electron microscope images. The tensile strength increases with curing time until it reaches a plateau. The composite reinforcement improves the tensile strength exponentially with the increase of PF and PU contents. For the effect due to dry density, the tensile strength first increased and then decreased with the peak at approximately 1.55 g/cm³. Through the interaction force among fibers and sand particles and the bonding force of polymer among sand particles, tensile strength of reinforced sand is greatly improved.

An Experimental Study on the Shear Behaviors of Polymer-Sand Composite Materials after Immersion.

Sand mixed with geotextile/fiber/cement/lime or non-traditional chemical additives to form composite materials is recognized as an effective method for improving the sand properties. In this work, the variation in properties of composite materials after immersion is reported which has rarely appeared in the literature. The focus of this study is to evaluate the shear behaviors of polymer-sand composite material after immersion with direct shear tests. Several factors which may influence the shear behaviors after immersion are analyzed. The results demonstrate that this composite material still has good shear behaviors after immersion when compared to the purely sand material. The shear behaviors are improved with an increment in the curing time, polymer content and sand dry density while there is a decrease in the shear behaviors with increasing immersion time. The interaction between sand particles and the polymer are analyzed with Scanning Electron Microscope (SEM). The polymer membranes are formed by polymer enwrapping and connected sand particles to build an elastic and viscous structure in the sand that increases the interlocking forces between sand particles and decreases the void ratio of this material. The membranes are softened in water resulting in a decrease in the shear strength. Moreover, other factors affect the shear behaviors by improving the completeness and stability of this structure.

Effect of Sisal Fiber and Polyurethane Admixture on the Strength and Mechanical Behavior of Sand.

One major problem related to sandy soil is its low shear strength and cohesion in engineering. Although much effort has been made to strengthen sand mass with satisfactory performances, most undertakings lack environmental considerations. Thus, a combination of natural fiber and macromolecule polymer material attempts to achieve both strength and eco-friendliness. In the present investigation, sisal fiber (SF) and water-based polyurethane (PU) were used to reinforce sand. A series of unconfined compression tests were carried out on sand specimens at different percentages of fiber contents (0.2%, 0.4%, 0.6%, and 0.8% by weight of dry sand) and polymer contents (1%, 2%, 3%, and 4% by weight of dry sand). The results showed within our test range that the unconfined compressive strength (UCS) as well as post-peak strength of specimens increase with fiber and polymer contents. The inclusion of fiber and polymer significantly improve the ductility of specimens. The effect of dry densities on UCS were studied with three proportions. It is found that a high dry density led to an increase of UCS due to an effective contact area increase. The interactions were studied by observation through scanning electron microscopy (SEM) images. The presence of water-based polyurethane has the potential to improve the interparticle cohesion of sand due to its unique network membrane structure. The fiber reinforcement benefit depends strongly on the friction, interlocking force, and bond strength at the interface.