Research on Dynamic Performance of CRTSⅢ Type Slab Ballastless Track under Long-Term Service

To fill the blank in the research on the dynamic performance of track structure under long-term service, the dynamic response study of China Railway Track System Ⅲ type slab ballastless track (CRTSIII SBT) under the action of fatigue for 30 million times and the parting between track slab and self-compacting concrete (SCC) was carried out. By establishing the finite element model of the CRTSIII SBT structure and taking the stiffness change of isolation layer and fastener under fatigue state and the parting during service as the research objects, combined with the full-scale model test, the dynamic response amplitude and vibration law of track structure was analyzed based on the finite element model of axle falling test method. The results show the following: (1) Under the fatigue load, the acceleration of rail and base increases obviously, the longitudinal tensile stress of SCC surface decreases, the longitudinal tensile stress of base surface increases, and the vertical stress of each layer of track structure increases as well. (2) Under the action of the parting, the dynamic response of each structural layer increases, and the change of acceleration and stress of each layer under the action point of axle falling is the most obvious. (3) The fatigue load will weaken the vibration damping performance of the track, and the parting will continue to develop under the action of the falling axle, resulting in partial or total failure of the SCC layer. Both of them will aggravate the dynamic response of the track structure and affect driving safety, which should be paid attention to during maintenance.     

CT 能谱成像定量评估胃癌 Lauren 分型的应用价值

目的：探讨 CT 能谱成像(GSI)定量评估胃癌 Lauren 分型的价值。方法对52例胃镜确诊胃癌的患者于术前行 CT GSI 增强扫描,通过 GSI Viewer 分析软件获得单能量图、碘基图,测得病灶的 CT 值、碘浓度,计算标准化碘浓度比,并与术后病理对照,采用单因素方差分析多重比较进行统计学分析。结果肠型、混合型、弥漫型胃癌的动脉期碘浓度、标化碘浓度比、40~70 keV、40~140 keV、70~140 keV 各能量区间能谱曲线斜率分别为12.86±6.80(100μg/mL)、0.13±0.06、2.50±1.26、0.99±0.51、0.34±0.20,18.54±6.49(100μg/mL)、0.19±0.07、3.56±1.24、1.42±0.50、0.50±0.18和24.52±9.68(100μg/mL)、0.24±0.09、4.73±1.76、1.90±0.73、0.68±0.29。其中,肠型胃癌的各组数值均明显低于弥漫型胃癌,2组间差异有统计学意义(P <0.05);肠型-混合型、混合型-弥漫型两两比较,除肠型-混合型碘浓度比 P 值为0.037,其余各指标组间差异均无显著性(P >0.05)。结论GSI 能谱曲线斜率、碘浓度、标准化碘浓度比有助于术前评估胃癌的 Lauren 分型。     

诊间自动预约模式在超声检查预约中的应用

目的描述和分析诊间自动预约模式对超声检查预约的影响。方法在诊间自动预约应用前后,分别以187名和160名患者为调查对象,采用两独立样本数据的t检验对数据进行对比。结果 81.0%的超声检查患者减少了1次排队,预约排队等候时间缩短了23.6分钟(P<0.05),检查等候时间缩短了7.0分钟(P<0.05)。结论诊间自动预约模式优化了超声检查预约服务,缩短了患者的排队等候时间,可推广至其他医技检查。     

Double contrast-enhanced ultrasonography evaluation of preoperative Lauren classification of advanced gastric carcinoma

Introduction

The clinical value of double contrast-enhanced ultrasonography (DCUS) in determining the Lauren classification of advanced gastric carcinoma needed investigation.

Material and methods

Fifty-eight patients with gastric cancer proved by endoscopic biopsy underwent preoperative DCUS examination in which an oral contrast agent was combined with an intravenous agent, and the findings were compared with the postoperative pathological findings using haematoxylin-eosin and Alcian Blue-Periodic Acid Schiff (AB-PAS) staining.

Results

Of 58 patients, 34 (59%) were the intestinal type and 24 (41%) the diffuse type on pathological examination of resected specimens. Among intestinal type patients, 30 (88%) showed homogeneous vascular enhancement and 4 (12%) heterogeneous enhancement with the “sandwich” pattern in 2 patients (50%) and “barrier” pattern in 2 patients (50%). In the diffuse type, 22 of 24 patients (92%) enhanced heterogeneously, with stippled and peripheral enhancement in 9 (41%), the “sandwich” pattern in 8 (36%) and “barrier” pattern in 5 (23%). Two of 24 patients (8%) with the diffuse type enhanced homogeneously. The proportion of heterogeneous enhancement was significantly different between the 2 subtypes of tumour (p = 0.0001). The sensitivity and specificity of heterogeneous enhancement in diagnosing the diffuse type of advanced gastric cancer were 92% and 88%, respectively. Youden’s index was 0.8.

Conclusions

Double contrast-enhanced ultrasonography is a new and useful method to determine Lauren classification in patients with gastric carcinoma.     

High microsatellite instability predicts good prognosis in intestinal-type gastric cancers

Background and Aim: A subset of gastric cancers showed high microsatellite instability (MSI‐H). The reported clinicopathological features of MSI‐H gastric cancers are heterogeneous, and specific factors associated with prognosis have not been identified. Methods: We analyzed the clinicopathological characteristics and prognostic factors in a large series (161 cases) of MSI‐H gastric cancers, and compared the results to 315 cases of microsatellite‐stable or low microsatellite‐instable gastric cancers. Results: The frequency of MSI‐H gastric cancers was 9% (161/1786). MSI‐H gastric cancers have distinct clinicopathological features, including female sex, older age, antral location, well‐to‐moderate differentiation, intestinal‐type Lauren classification, expanding‐type Ming classification, a non‐signet‐ring cell component, the presence of a mucinous component, a moderate‐to‐severe lymphoid stromal reaction, and a lower tumor stage. The MSI‐H phenotype was associated with better prognosis (P = 0.044), and male sex (P = 0.035, hazard ratios [HR]: 0.23), intestinal‐/mixed‐type Lauren classification (P < 0.001, HR: 0.09) and lower tumor stages (1 and 2, P = 0.001, HR: 0.08) were independently‐favorable prognostic factors. Conclusions: With unique clinicopathological features, intestinal‐type MSI‐H gastric cancers are associated with good prognosis and can be classified as a different subset of gastric cancers.     

间歇性外斜视患者分型对眼位控制能力的影响

目的:分析间歇性外斜视患者分型对眼位控制能力的影响.方法:选取我院2014-06/2016-07收治的50例行斜视手术治疗的间歇性外斜视患者作为研究对象,依据所有患者视近与视远斜视度数差值将其分为基本型24例(视近斜视角与视远斜视角基本相等或相差≤15△)、分离过强型17例(视远斜视角≥视近斜视角15△)、集合不足型9例(视近斜视角≥视远斜视角15△)三组,采用注视33cm视标(视近)、注视6m视标(视远)、注视户外视标、1h遮盖试验四种检测方法对其眼位控制能力进行比较.结果:基本型间歇性外斜视患者注视33cm视标、注视6m视标、注视户外视标、1h遮盖试验四种检测结果分别为55.10±1.62、45.32±1.21、64.85±1.77、68.33±1.66PD,分离过强型间歇性外斜视患者检测结果为50.23±1.88、67.46±1.17、76.95±1.64、78.15±1.56PD,集合不足型间歇性外斜视患者检测结果为50.98±1.29、33.48±1.40、43.65±1.49、54.64±1.12PD,组间差异具有统计学意义(P＜0.05).结论:间歇性外斜视患者分型对眼位控制能力存在着显著的影响关系,确定其分型将有助于提高斜视手术治疗效果.     

633例胃癌患者临床病理特征及生存分析

目的 对比不同Lauren分型胃癌的临床病理特征,对其进行生存分析,并筛选预后因子。方法 回顾性分析2007年1月1日—2008年6月30日在哈尔滨医科大学附属肿瘤医院接受手术治疗的胃癌患者的临床病理学资料,将收集到的633例胃癌患者分为肠型胃癌、弥漫型胃癌,对两组的临床病理特征及生存数据等进行统计分析。结果 对比弥漫型胃癌而言,肠型胃癌比例略高(51.66% vs. 48.34%),男性比例较高(2.94:1 vs. 2.03:1,P=0.035),更易发生于老年患者(发病年龄≥60岁比例54.43% vs. 35.94%,P＜0.001)。肠型胃癌预后明显好于弥漫性胃癌(中位生存时间:90.90个月 vs. 37.33个月,P=0.014)。多因素分析显示年龄≥60岁、CA199异常、肿瘤较大、分化较差、浆膜侵犯、初始淋巴结转移、姑息性手术、非幽门切除术是胃癌的不良预后因素。结论 Lauren分型可以较好的反应不同胃癌的临床病理学特征,并指导预后。     

Lack of cyclin D1 overexpression in gastric carcinogenesis

AIMS: Cyclin D1 overexpression was examined in early gastric carcinomas and precursor lesions with the following aims; (1) to assess the chronology of cyclin D1 overexpression in various stages of gastric carcinogenesis, (2) to correlate cyclin D1 overexpression with the Lauren type, the grade of differentiation and the type of growth pattern of the tumours and (3) to correlate cyclin D1 overexpression with clinical parameters, in particular lymph node metastasis and overall prognosis. METHODS AND RESULTS: Forty-five paraffin-embedded gastrectomy specimens from early carcinomas were examined for the presence of various precursor lesions. The Lauren type, the grade of differentiation and the type of growth pattern were reassessed for all early carcinomas. Cyclin D1 overexpression was examined using the monoclonal antibody DCS-6. Cyclin D1 overexpression was absent from all precursor lesions. Ten early carcinomas (22%) were cyclin D1 positive without significant differences when stratified according to Lauren type, grade of differentiation, type of growth pattern or lymph node status. Univariate analysis failed to show a significant difference in 5-year surival rate between cyclin D1 positive and negative early carcinomas (90% vs. 94%). CONCLUSIONS: Cyclin D1 protein overexpression does not play a role in the progression from normal to neoplastic gastric mucosa and does not discriminate between intestinal and diffuse type early gastric carcinomas of Caucasian origin. Moreover, mechanisms other than cyclin D1 protein overexpression underlie the reported difference in biological behaviour of early gastric carcinomas with different types of growth pattern. Finally, although it appears that cyclin D1 does not have prognostic significance, studies on larger numbers, including advanced carcinomas, are warranted.