BACKGROUND Gallbladder cancer(GBC)is the most common and aggressive subtype of biliary tract cancer(BTC)and has a poor prognosis.A newly developed regimen of gemcitabine,cisplatin,and durvalumab shows promise for the ...BACKGROUND Gallbladder cancer(GBC)is the most common and aggressive subtype of biliary tract cancer(BTC)and has a poor prognosis.A newly developed regimen of gemcitabine,cisplatin,and durvalumab shows promise for the treatment of advanced BTC.However,the efficacy of this treatment for GBC remains unclear.CASE SUMMARY In this report,we present a case in which the triple-drug regimen exhibited marked effectiveness in treating locally advanced GBC,thus leading to a long-term survival benefit.A 68-year-old man was diagnosed with locally advanced GBC,which rendered him ineligible for curative surgery.Following three cycles of therapy,a partial response was observed.After one year of combined therapy,a clinical complete response was successfully achieved.Subsequent maintenance therapy with durvalumab monotherapy resulted in a disease-free survival of 9 months for the patient.The patient experienced tolerable toxicities of reversible grade 2 nausea and fatigue.Tolerable adverse events were observed in the patient throughout the entirety of the treatment.CONCLUSION The combination of gemcitabine and cisplatin chemotherapy with durvalumab was proven to be an effective treatment approach for advanced GBC,with manageable adverse events.Further research is warranted to substantiate the effectiveness of the combined regimen in the context of GBC.展开更多
Patients with complete spinal cord injury retain the potential for volitional muscle activity in muscles located below the spinal injury level.However,because of prolonged inactivity,initial attempts to activate these...Patients with complete spinal cord injury retain the potential for volitional muscle activity in muscles located below the spinal injury level.However,because of prolonged inactivity,initial attempts to activate these muscles may not effectively engage any of the remaining neurons in the descending pathway.A previous study unexpectedly found that a brief clinical round of passive activity significantly increased volitional muscle activation,as measured by surface electromyography.In this study,we further explored the effect of passive activity on surface electromyographic signals during volitional control tasks among individuals with complete spinal cord injury.Eleven patients with chronic complete thoracic spinal cord injury were recruited.Surface electromyography data from eight major leg muscles were acquired and compared before and after the passive activity protocol.The results indicated that the passive activity led to an increased number of activated volitional muscles and an increased frequency of activation.Although the cumulative root mean square of surface electromyography amplitude for volitional control of movement showed a slight increase after passive activity,the difference was not statistically significant.These findings suggest that brief passive activity may enhance the ability to initiate volitional muscle activity during surface electromyography tasks and underscore the potential of passive activity for improving residual motor control among patients with motor complete spinal cord injury.展开更多
BACKGROUND Cirrhotic patients with super-giant hepatocellular carcinoma(HCC)and portal vein invasion generally have a poor prognosis.This paper presents a patient with super-giant HCC and portal vein invasion,who unde...BACKGROUND Cirrhotic patients with super-giant hepatocellular carcinoma(HCC)and portal vein invasion generally have a poor prognosis.This paper presents a patient with super-giant HCC and portal vein invasion,who underwent hepatectomy followed by a combination of sorafenib and camrelizumab,resulting in complete remission(CR)for 5 years.CASE SUMMARY A 40-year-old male with compensated hepatitis B-related cirrhosis was diagnosed with HCC,Barcelona Clinic Liver Cancer stage C.Enhanced computed tomography imaging revealed a 152 mm×171 mm tumor in the right liver,invading the portal vein and hepatic vein.Liver function was normal.The patient successfully underwent hepatectomy on July 18,2019.However,by December 2019,HCC recurrence with lung metastases and portal vein invasion were detected.He started treatment with sorafenib(200 mg twice daily)and camrelizumab(200 mg every 3 weeks).By May 12,2020,the patient was confirmed to have CR.Camrelizumab was adjusted to 200 mg every 12 weeks from June 16,2021,with the last infusion on March 29,2024.Although no further tumor recurrence was observed,he experienced two episodes of gastrointestinal bleeding due to esophagogastric varices,which were managed with endoscopic therapy.To date,the patient has remained in CR for 5 years.CONCLUSION The combination of hepatectomy with sorafenib and camrelizumab can achieve durable CR in patients with supergiant HCC and portal vein invasion.Further research is necessary to address these challenges and improve patient outcomes.展开更多
Spinal cord injury is a condition in which the parenchyma of the spinal cord is damaged by trauma or various diseases.While rapid progress has been made in regenerative medicine for spinal cord injury that was previou...Spinal cord injury is a condition in which the parenchyma of the spinal cord is damaged by trauma or various diseases.While rapid progress has been made in regenerative medicine for spinal cord injury that was previously untreatable,most research in this field has focused on the early phase of incomplete injury.However,the majority of patients have chronic severe injuries;therefore,treatments for these situations are of fundamental importance.The reason why the treatment of complete spinal cord injury has not been studied is that,unlike in the early stage of incomplete spinal cord injury,there are various inhibitors of neural regeneration.Thus,we assumed that it is difficult to address all conditions with a single treatment in chronic complete spinal cord injury and that a combination of several treatments is essential to target severe pathologies.First,we established a combination therapy of cell transplantation and drug-releasing scaffolds,which contributes to functional recovery after chronic complete transection spinal cord injury,but we found that functional recovery was limited and still needs further investigation.Here,for the further development of the treatment of chronic complete spinal cord injury,we review the necessary approaches to the different pathologies based on our findings and the many studies that have been accumulated to date and discuss,with reference to the literature,which combination of treatments is most effective in achieving functional recovery.展开更多
In this article,we study Kahler metrics on a certain line bundle over some compact Kahler manifolds to find complete Kahler metrics with positive holomorphic sectional(or bisectional)curvatures.Thus,we apply a strateg...In this article,we study Kahler metrics on a certain line bundle over some compact Kahler manifolds to find complete Kahler metrics with positive holomorphic sectional(or bisectional)curvatures.Thus,we apply a strategy to a famous Yau conjecture with a co-homogeneity one geometry.展开更多
In the context of big data, many large-scale knowledge graphs have emerged to effectively organize the explosive growth of web data on the Internet. To select suitable knowledge graphs for use from many knowledge grap...In the context of big data, many large-scale knowledge graphs have emerged to effectively organize the explosive growth of web data on the Internet. To select suitable knowledge graphs for use from many knowledge graphs, quality assessment is particularly important. As an important thing of quality assessment, completeness assessment generally refers to the ratio of the current data volume to the total data volume.When evaluating the completeness of a knowledge graph, it is often necessary to refine the completeness dimension by setting different completeness metrics to produce more complete and understandable evaluation results for the knowledge graph.However, lack of awareness of requirements is the most problematic quality issue. In the actual evaluation process, the existing completeness metrics need to consider the actual application. Therefore, to accurately recommend suitable knowledge graphs to many users, it is particularly important to develop relevant measurement metrics and formulate measurement schemes for completeness. In this paper, we will first clarify the concept of completeness, establish each metric of completeness, and finally design a measurement proposal for the completeness of knowledge graphs.展开更多
At present,although knowledge graphs have been widely used in various fields such as recommendation systems,question and answer systems,and intelligent search,there are always quality problems such as knowledge omissi...At present,although knowledge graphs have been widely used in various fields such as recommendation systems,question and answer systems,and intelligent search,there are always quality problems such as knowledge omissions and errors.Quality assessment and control,as an important means to ensure the quality of knowledge,can make the applications based on knowledge graphs more complete and more accurate by reasonably assessing the knowledge graphs and fixing and improving the quality problems at the same time.Therefore,as an indispensable part of the knowledge graph construction process,the results of quality assessment and control determine the usefulness of the knowledge graph.Among them,the assessment and enhancement of completeness,as an important part of the assessment and control phase,determine whether the knowledge graph can fully reflect objective phenomena and reveal potential connections among entities.In this paper,we review specific techniques of completeness assessment and classify completeness assessment techniques in terms of closed world assumptions,open world assumptions,and partial completeness assumptions.The purpose of this paper is to further promote the development of knowledge graph quality control and to lay the foundation for subsequent research on the completeness assessment of knowledge graphs by reviewing and classifying completeness assessment techniques.展开更多
In this paper,we investigate the complete convergence and complete moment conver-gence for weighted sums of arrays of rowwise asymptotically negatively associated(ANA)random variables,without assuming identical distri...In this paper,we investigate the complete convergence and complete moment conver-gence for weighted sums of arrays of rowwise asymptotically negatively associated(ANA)random variables,without assuming identical distribution.The obtained results not only extend those of An and Yuan[1]and Shen et al.[2]to the case of ANA random variables,but also partially improve them.展开更多
Gestational trophoblastic disease is an abnormal proliferation of trophoblastic tissue during pregnancy. It occurs in women of childbearing age, although a few cases have also been observed in post-menopausal women, a...Gestational trophoblastic disease is an abnormal proliferation of trophoblastic tissue during pregnancy. It occurs in women of childbearing age, although a few cases have also been observed in post-menopausal women, although it is extremely rare in the latter. Here we describe a rare case of complete hydatidiform mole in a 56-year-old female patient who presented with genital bleeding combined with nausea and vomiting and a gravid uterus 16 cm in height. The ultrasound findings and the increase in serum β-HCG to 182566.00 mIU/ml suggested a diagnosis of complete hydatidiform mole. Given the post-menopausal state and the future risk of post-molar gestational trophoblastic neoplasia, we opted for total hysterectomy without preservation of the adnexa via a transabdominal approach, followed by antimitotic treatment with methotrexate. The uterus measured 18.45 cm × 11.18 cm with intra cavitary vesicles. Microscopic examination showed chorionic villi of variable size and shape, most of which were dilated and oedematous, associated with trophoblastic cell proliferation and haemorrhage suggestive of complete benign hydatidiform mole. Follow-up showed a consistent decrease in serum β-HCG levels and no evidence of residual disease. A suspicion of gestational trophoblastic disease should be borne in mind when evaluating a patient with peri- or post-menopausal bleeding to avoid delay in diagnosis and treatment.展开更多
his study focused on exploring the specificity of mechanical behavior for completely weathered granite,as a special soil,by consolidated drained triaxial tests.The influences of dry density(1.60,1.70,1.80 and 1.90 g/c...his study focused on exploring the specificity of mechanical behavior for completely weathered granite,as a special soil,by consolidated drained triaxial tests.The influences of dry density(1.60,1.70,1.80 and 1.90 g/cm^(3)),confining pressure(100,200,400 and 600 kPa),and moisture content(13.0%,that is,natural moisture content)were investigated in the present work.A newly developed Duncan-Chang model was established based on the experimental data and Duncan-Chang model.The influence of each parameter on the type of the proposed model curve was also evaluated.The experimental results revealed that with varying dry density and confining pressure,the deviatoric stress–strain curves have diversified characteristics including strain-softening,strain-stabilization and strain-hardening.Under high confining pressure condition,specimens with different densities all showed strain-hardening characteristic.Whereas at the low confining pressure levels,specimens with higher densities gradually transform into softening characteristics.Except for individual compression shear failure,the deformation modes of the specimens all showed swelling deformation,and all the damaged specimens maintained good integrity.Through comparing the experiment results,the strain-softening or strain-hardening behavior of CWG specimens could be predicted following the proposed model with high accuracy.Additionally,the proposed model can accurately characterize the key mechanical indicators,such as tangent modulus,peak value and residual strength,which is simple to implement and depends on fewer parameters.展开更多
BACKGROUND Breast cancer ranks as one of the most prevalent malignant tumors among women,significantly endangering their health and lives.While radical surgery has been a pivotal method for halting disease progression...BACKGROUND Breast cancer ranks as one of the most prevalent malignant tumors among women,significantly endangering their health and lives.While radical surgery has been a pivotal method for halting disease progression,it alone is insufficient for enhancing the quality of life for patients.AIM To investigate the correlation between ultrasound characteristic parameters of breast cancer lesions and clinical efficacy in patients undergoing neoadjuvant chemotherapy(NAC).METHODS Employing a case-control study design,this research involved 178 breast cancer patients treated with NAC at our hospital from July 2019 to June 2022.According to the Miller-Payne grading system,the pathological response,i.e.efficacy,of the NAC in the initial breast lesion after NAC was evaluated.Of these,59 patients achieved a pathological complete response(PCR),while 119 did not(non-PCR group).Ultrasound characteristics prior to NAC were compared between these groups,and the association of various factors with NAC efficacy was analyzed using univariate and multivariate approaches.RESULTS In the PCR group,the incidence of posterior echo attenuation,lesion diameter≥2.0 cm,and Alder blood flow grade≥II were significantly lower compared to the non-PCR group(P<0.05).The area under the curve values for predicting NAC efficacy using posterior echo attenuation,lesion diameter,and Alder grade were 0.604,0.603,and 0.583,respectively.Also,rates of pathological stage II,lymph node metastasis,vascular invasion,and positive Ki-67 expression were significantly lower in the PCR group(P<0.05).Logistic regression analysis identified posterior echo attenuation,lesion diameter≥2.0 cm,Alder blood flow grade≥II,pathological stage III,vascular invasion,and positive Ki-67 expression as independent predictors of poor response to NAC in breast cancer patients(P<0.05).CONCLUSION While ultrasound characteristics such as posterior echo attenuation,lesion diameter≥2.0 cm,and Alder blood flow grade≥II exhibit limited predictive value for NAC efficacy,they are significantly associated with poor response to NAC in breast cancer patients.展开更多
Colon cancer has the fifth highest incidence worldwide and has the sixth highest mortality.Compared with rectal cancer,colon cancer currently has the worst 5-year overall survival for patients with stage Ⅱ and Ⅲ dis...Colon cancer has the fifth highest incidence worldwide and has the sixth highest mortality.Compared with rectal cancer,colon cancer currently has the worst 5-year overall survival for patients with stage Ⅱ and Ⅲ disease.Complete mesocolic excision has been developed as a standardized and optimized surgical technique for the excision of colon cancers.This technique has traditionally been performed through an open approach since laparoscopy is generally considered technically challenging.The robotic approach has been slowly implemented for colon cancer,but the newest robotic platforms allow for a safer and optimized approach for right colon cancer.Several robotic approaches have been developed and explored.The expansion of the current robotic platform ecosystem is gradually providing new outputs in the application of the robotic approach to complete mesocolic excision.This review gains an oversight of existing literature on robotic complete mesocolic excision for right colon cancer(learning curve,training,techniques,approach,platforms,and future perspectives).展开更多
Collaborative coverage path planning(CCPP) refers to obtaining the shortest paths passing over all places except obstacles in a certain area or space. A multi-unmanned aerial vehicle(UAV) collaborative CCPP algorithm ...Collaborative coverage path planning(CCPP) refers to obtaining the shortest paths passing over all places except obstacles in a certain area or space. A multi-unmanned aerial vehicle(UAV) collaborative CCPP algorithm is proposed for the urban rescue search or military search in outdoor environment.Due to flexible control of small UAVs, it can be considered that all UAVs fly at the same altitude, that is, they perform search tasks on a two-dimensional plane. Based on the agents’ motion characteristics and environmental information, a mathematical model of CCPP problem is established. The minimum time for UAVs to complete the CCPP is the objective function, and complete coverage constraint, no-fly constraint, collision avoidance constraint, and communication constraint are considered. Four motion strategies and two communication strategies are designed. Then a distributed CCPP algorithm is designed based on hybrid strategies. Simulation results compared with patternbased genetic algorithm(PBGA) and random search method show that the proposed method has stronger real-time performance and better scalability and can complete the complete CCPP task more efficiently and stably.展开更多
The assessment of the completeness of earthquake catalogs is a prerequisite for studying the patterns of seismic activity.In traditional approaches,the minimum magnitude of completeness(MC)is employed to evaluate cata...The assessment of the completeness of earthquake catalogs is a prerequisite for studying the patterns of seismic activity.In traditional approaches,the minimum magnitude of completeness(MC)is employed to evaluate catalog completeness,with events below MC being discarded,leading to the underutilization of the data.Detection probability is a more detailed measure of the catalog's completeness than MC;its use results in better model compatibility with data in seismic activity modeling and allows for more comprehensive utilization of seismic observation data across temporal,spatial,and magnitude dimensions.Using the magnitude-rank method and Maximum Curvature(MAXC)methods,we analyzed temporal variations in earthquake catalog completeness,finding that MC stabilized after 2010,which closely coincides with improvements in monitoring capabilities and the densification of seismic networks.Employing the probability-based magnitude of completeness(PMC)and entire magnitude range(EMR)methods,grounded in distinct foundational assumptions and computational principles,we analyzed the 2010-2023 earthquake catalog for the northern margin of the Ordos Block,aiming to assess the detection probability of earthquakes and the completeness of the earthquake catalog.The PMC method yielded the detection probability distribution for 76 stations in the distance-magnitude space.A scoring metric was designed based on station detection capabilities for small earthquakes in the near field.From the detection probabilities of stations,we inferred detection probabilities of the network for diff erent magnitude ranges and mapped the spatial distribution of the probability-based completeness magnitude.In the EMR method,we employed a segmented model fitted to the observed data to determine the detection probability and completeness magnitude for every grid point in the study region.We discussed the sample dependency and low-magnitude failure phenomena of the PMC method,noting the potential overestimation of detection probabilities for lower magnitudes and the underestimation of MC in areas with weaker monitoring capabilities.The results obtained via the two methods support these hypotheses.The assessment results indicate better monitoring capabilities on the eastern side of the study area but worse on the northwest side.The spatial distribution of network monitoring capabilities is uneven,correlating with the distribution of stations and showing significant diff erences in detection capabilities among diff erent stations.The truncation eff ects of data and station selection aff ected the evaluation results at the edges of the study area.Overall,both methods yielded detailed descriptions of the earthquake catalog,but careful selection of calculation parameters or adjustments based on the strengths of diff erent methods is necessary to correct potential biases.展开更多
BACKGROUND Neonatal sepsis is defined as an infection-related condition characterized by signs and symptoms of bacteremia within the first month of life.It is the leading cause of mortality and morbidity among newborn...BACKGROUND Neonatal sepsis is defined as an infection-related condition characterized by signs and symptoms of bacteremia within the first month of life.It is the leading cause of mortality and morbidity among newborns.While several studies have been conducted in other parts of world to assess the usefulness of complete blood count parameters and hemogram-derived markers as early screening tools for neonatal sepsis,the associations between sepsis and its complications with these blood parameters are still being investigated in our setting and are not yet part of routine practice.AIM To evaluate the diagnostic significance of complete blood cell count hemogramderived novel markers for neonatal sepsis among neonates attending public hospitals in the southwest region of Oromia,Ethiopia,through a case control study.METHODS A case control study was conducted from October 2021 to October 2023 Sociodemographic,clinical history,and laboratory test results data were collected using structured questionnaires.The collected data were entered into Epi-data 3.1 version and exported to SPSS-25 for analysis.Chi-square,independent sample ttest,and receiver operator characteristics curve of curve were used for analysis.A P-value of less than 0.05 was considered statistically significant.RESULTS In this study,significant increases were observed in the following values in the case group compared to the control group:In white blood cell(WBC)count,neutrophils,monocyte,mean platelet volume(MPV),neutrophils to lymphocyte ratio,monocyte to lymphocyte ratio(MLR),red blood cell width to platelet count ratio(RPR),red blood width coefficient variation,MPV to RPR,and platelet to lymphocyte ratio.Regarding MLR,a cut-off value of≥0.26 was found,with a sensitivity of 68%,a specificity of 95%,a positive predictive value(PPV)of 93.2%,and a negative predictive value(NPV)of 74.8%.The area under the curve(AUC)was 0.828(P<0.001).For WBC,a cutoff value of≥11.42 was identified,with a sensitivity of 55%,a specificity of 89%,a PPV of 83.3%,and a NPV of 66.4%.The AUC was 0.81(P<0.001).Neutrophils had a sensitivity of 67%,a specificity of 81%,a PPV of 77.9%,and a NPV of 71.1%.The AUC was 0.801,with a cut-off value of≥6.76(P=0.001).These results indicate that they were excellent predictors of neonatal sepsis diagnosis.CONCLUSION The findings of our study suggest that certain hematological parameters and hemogram-derived markers may have a potential role in the diagnosis of neonatal sepsis.展开更多
BACKGROUND Colorectal cancer is currently the third most common malignant tumor and the second leading cause of cancer-related death worldwide.Neoadjuvant chemoradiotherapy(nCRT)is standard for locally advanced rectal...BACKGROUND Colorectal cancer is currently the third most common malignant tumor and the second leading cause of cancer-related death worldwide.Neoadjuvant chemoradiotherapy(nCRT)is standard for locally advanced rectal cancer(LARC).Except for pathological examination after resection,it is not known exactly whether LARC patients have achieved pathological complete response(pCR)before surgery.To date,there are no clear clinical indicators that can predict the efficacy of nCRT and patient outcomes.AIM To investigate the indicators that can predict pCR and long-term outcomes following nCRT in patients with LARC.METHODS Clinical data of 128 LARC patients admitted to our hospital between September 2013 and November 2022 were retrospectively analyzed.Patients were categorized into pCR and non-pCR groups.Univariate analysis(using the χ^(2) test or Fisher’s exact test)and logistic multivariate regression analysis were used to study clinical predictors affecting pCR.The 5-year disease-free survival(DFS)and overall survival(OS)rates were calculated using Kaplan-Meier analysis,and differences in survival curves were assessed with the log-rank test.RESULTS Univariate analysis showed that pretreatment carcinoembryonic antigen(CEA)level,lymphocyte-monocyte ratio(LMR),time interval between neoadjuvant therapy completion and total mesorectal excision,and tumor size were correlated with pCR.Multivariate results showed that CEA≤5 ng/mL(P=0.039),LMR>2.73(P=0.023),and time interval>10 wk(P=0.039)were independent predictors for pCR.Survival analysis demonstrated that patients in the pCR group had significantly higher 5-year DFS rates(94.7%vs 59.7%,P=0.002)and 5-year OS rates(95.8%vs 80.1%,P=0.019)compared to the non-pCR group.Tumor deposits(TDs)were significantly correlated with shorter DFS(P=0.002)and OS(P<0.001).CONCLUSION Pretreatment CEA,LMR,and time interval contribute to predicting nCRT efficacy in LARC patients.Achieving pCR demonstrates longer DFS and OS.TDs correlate with poor prognosis.展开更多
Understanding the strength characteristics and deformation behaviour of the tunnel surrounding rock in a fault zone is significant for tunnel stability evaluation.In this study,a series of unconfined compression tests...Understanding the strength characteristics and deformation behaviour of the tunnel surrounding rock in a fault zone is significant for tunnel stability evaluation.In this study,a series of unconfined compression tests were conducted to investigate the mechanical characteristics and failure behaviour of completely weathered granite(CWG)from a fault zone,considering with height-diameter(h/d)ratio,dry densities(ρd)and moisture contents(ω).Based on the experimental results,a regression mathematical model of unconfined compressive strength(UCS)for CWG was developed using the Multiple Nonlinear Regression method(MNLR).The research results indicated that the UCS of the specimen with a h/d ratio of 0.6 decreased with the increase ofω.When the h/d ratio increased to 1.0,the UCS increasedωwith up to 10.5%and then decreased.Increasingρd is conducive to the improvement of the UCS at anyω.The deformation and rupture process as well as final failure modes of the specimen are controlled by h/d ratio,ρd andω,and the h/d ratio is the dominant factor affecting the final failure mode,followed byωandρd.The specimens with different h/d ratio exhibited completely different fracture mode,i.e.,typical splitting failure(h/d=0.6)and shear failure(h/d=1.0).By comparing the experimental results,this regression model for predicting UCS is accurate and reliable,and the h/d ratio is the dominant factor affecting the UCS of CWG,followed byρd and thenω.These findings provide important references for maintenance of the tunnel crossing other fault fractured zones,especially at low confining pressure or unconfined condition.展开更多
BACKGROUND The prognosis for patients with advanced metastatic cervix cancer(MCC)is poor,and this disease continues to pose a considerable therapeutic challenge.Despite the administration of first-line regimens consis...BACKGROUND The prognosis for patients with advanced metastatic cervix cancer(MCC)is poor,and this disease continues to pose a considerable therapeutic challenge.Despite the administration of first-line regimens consisting of cisplatin,paclitaxel,and bevacizumab,survival rates for patients with metastasis remain poor.The emergence of bispecific antibodies(BsAbs)offers a novel treatment option for patients diagnosed with MCC.CASE SUMMARY In this report,we present a patient with MCC who was treated with cadonilimab monotherapy at a dose of 6 mg/kg every two weeks after chemotherapy was proven to be intolerable.The patient exhibited a sustained complete response for a duration of 6 months,demonstrating an optimistic outlook.CONCLUSION This case illustrates the considerable efficacy of cadonilimab for treating advanced MCC.Therefore,BsAb therapy is a promising strategy for effectively treating patients with advanced MCC and should be considered as an option when patients are intolerant to standard chemotherapy.展开更多
This paper applies Gödel’s Incompleteness Theorems to the evolution and development of human social systems.Although Gödel’s Incompleteness Theorems originated in the field of mathematics,their influence h...This paper applies Gödel’s Incompleteness Theorems to the evolution and development of human social systems.Although Gödel’s Incompleteness Theorems originated in the field of mathematics,their influence has long extended beyond mathematics,making an impact on philosophy,systems science,and the humanities and social sciences.The paper analyzes the autonomy and completeness of human social systems,arguing that evolving human societies are generally self-consistent.However,if the completeness of a human social system is compromised,the system either maintains self-consistency,ceases to evolve forward,enters a death spiral,and eventually decays and disintegrates.Or the system addresses the completeness issue,enters a state of non-self-consistency,introduces new axioms,becomes self-governing again,and enters a new form.From the sociological perspective,this is articulated as social revolution-the system continues to evolve forward;the absence of social revolution-the system does not evolve forward(Jin,1988).展开更多
In colon cancer surgery,ensuring the complete removal of the primary tumor and draining lymph nodes is crucial.Lymphatic drainage in the colon follows the vascular supply,typically progressing from pericolic to paraao...In colon cancer surgery,ensuring the complete removal of the primary tumor and draining lymph nodes is crucial.Lymphatic drainage in the colon follows the vascular supply,typically progressing from pericolic to paraaortic lymph nodes.While NCCN guidelines recommend the removal of 10-12 lymph nodes for ade-quate oncological resection,achieving complete oncological resection involves more than just meeting these numerical targets.Various techniques have been developed and studied over time to attain optimal oncological outcomes.A key technique central to this goal is identifying the ileocolic vessels at their origin from the superior mesenteric vessels.Complete excision of the visceral and parietal mesocolon ensures the intact removal of the specimen,while D3 lymphade-nectomy targets all draining regional lymph nodes.Although these principles emphasize different aspects,they ultimately converge to achieve the same goal of complete oncological resection.This article aims to simplify the surgical steps that align with the principle of central vascular ligation and mesocolon mobilization while ensuring adequate D3 dissection.展开更多
基金Supported by General Project of Natural Science Foundation of Chongqing,China,No.cstc2021jcyj-msxmX0604Chongqing Doctoral"Through Train"Research Program,China,No.CSTB2022BSXM-JCX0045.
文摘BACKGROUND Gallbladder cancer(GBC)is the most common and aggressive subtype of biliary tract cancer(BTC)and has a poor prognosis.A newly developed regimen of gemcitabine,cisplatin,and durvalumab shows promise for the treatment of advanced BTC.However,the efficacy of this treatment for GBC remains unclear.CASE SUMMARY In this report,we present a case in which the triple-drug regimen exhibited marked effectiveness in treating locally advanced GBC,thus leading to a long-term survival benefit.A 68-year-old man was diagnosed with locally advanced GBC,which rendered him ineligible for curative surgery.Following three cycles of therapy,a partial response was observed.After one year of combined therapy,a clinical complete response was successfully achieved.Subsequent maintenance therapy with durvalumab monotherapy resulted in a disease-free survival of 9 months for the patient.The patient experienced tolerable toxicities of reversible grade 2 nausea and fatigue.Tolerable adverse events were observed in the patient throughout the entirety of the treatment.CONCLUSION The combination of gemcitabine and cisplatin chemotherapy with durvalumab was proven to be an effective treatment approach for advanced GBC,with manageable adverse events.Further research is warranted to substantiate the effectiveness of the combined regimen in the context of GBC.
基金supported by the Fundamental Research Funds for Central Public Welfare Research Institute,No.2020CZ-5(to WS and GS)the National Natural Science Foundation of China,No.31970970(to JSR)Fundamental Research Funds for the Central Universities,No.YWF-23-YG-QB-010(to JSR)。
文摘Patients with complete spinal cord injury retain the potential for volitional muscle activity in muscles located below the spinal injury level.However,because of prolonged inactivity,initial attempts to activate these muscles may not effectively engage any of the remaining neurons in the descending pathway.A previous study unexpectedly found that a brief clinical round of passive activity significantly increased volitional muscle activation,as measured by surface electromyography.In this study,we further explored the effect of passive activity on surface electromyographic signals during volitional control tasks among individuals with complete spinal cord injury.Eleven patients with chronic complete thoracic spinal cord injury were recruited.Surface electromyography data from eight major leg muscles were acquired and compared before and after the passive activity protocol.The results indicated that the passive activity led to an increased number of activated volitional muscles and an increased frequency of activation.Although the cumulative root mean square of surface electromyography amplitude for volitional control of movement showed a slight increase after passive activity,the difference was not statistically significant.These findings suggest that brief passive activity may enhance the ability to initiate volitional muscle activity during surface electromyography tasks and underscore the potential of passive activity for improving residual motor control among patients with motor complete spinal cord injury.
文摘BACKGROUND Cirrhotic patients with super-giant hepatocellular carcinoma(HCC)and portal vein invasion generally have a poor prognosis.This paper presents a patient with super-giant HCC and portal vein invasion,who underwent hepatectomy followed by a combination of sorafenib and camrelizumab,resulting in complete remission(CR)for 5 years.CASE SUMMARY A 40-year-old male with compensated hepatitis B-related cirrhosis was diagnosed with HCC,Barcelona Clinic Liver Cancer stage C.Enhanced computed tomography imaging revealed a 152 mm×171 mm tumor in the right liver,invading the portal vein and hepatic vein.Liver function was normal.The patient successfully underwent hepatectomy on July 18,2019.However,by December 2019,HCC recurrence with lung metastases and portal vein invasion were detected.He started treatment with sorafenib(200 mg twice daily)and camrelizumab(200 mg every 3 weeks).By May 12,2020,the patient was confirmed to have CR.Camrelizumab was adjusted to 200 mg every 12 weeks from June 16,2021,with the last infusion on March 29,2024.Although no further tumor recurrence was observed,he experienced two episodes of gastrointestinal bleeding due to esophagogastric varices,which were managed with endoscopic therapy.To date,the patient has remained in CR for 5 years.CONCLUSION The combination of hepatectomy with sorafenib and camrelizumab can achieve durable CR in patients with supergiant HCC and portal vein invasion.Further research is necessary to address these challenges and improve patient outcomes.
文摘Spinal cord injury is a condition in which the parenchyma of the spinal cord is damaged by trauma or various diseases.While rapid progress has been made in regenerative medicine for spinal cord injury that was previously untreatable,most research in this field has focused on the early phase of incomplete injury.However,the majority of patients have chronic severe injuries;therefore,treatments for these situations are of fundamental importance.The reason why the treatment of complete spinal cord injury has not been studied is that,unlike in the early stage of incomplete spinal cord injury,there are various inhibitors of neural regeneration.Thus,we assumed that it is difficult to address all conditions with a single treatment in chronic complete spinal cord injury and that a combination of several treatments is essential to target severe pathologies.First,we established a combination therapy of cell transplantation and drug-releasing scaffolds,which contributes to functional recovery after chronic complete transection spinal cord injury,but we found that functional recovery was limited and still needs further investigation.Here,for the further development of the treatment of chronic complete spinal cord injury,we review the necessary approaches to the different pathologies based on our findings and the many studies that have been accumulated to date and discuss,with reference to the literature,which combination of treatments is most effective in achieving functional recovery.
文摘In this article,we study Kahler metrics on a certain line bundle over some compact Kahler manifolds to find complete Kahler metrics with positive holomorphic sectional(or bisectional)curvatures.Thus,we apply a strategy to a famous Yau conjecture with a co-homogeneity one geometry.
基金supported by the National Key Laboratory for Comp lex Systems Simulation Foundation (6142006190301)。
文摘In the context of big data, many large-scale knowledge graphs have emerged to effectively organize the explosive growth of web data on the Internet. To select suitable knowledge graphs for use from many knowledge graphs, quality assessment is particularly important. As an important thing of quality assessment, completeness assessment generally refers to the ratio of the current data volume to the total data volume.When evaluating the completeness of a knowledge graph, it is often necessary to refine the completeness dimension by setting different completeness metrics to produce more complete and understandable evaluation results for the knowledge graph.However, lack of awareness of requirements is the most problematic quality issue. In the actual evaluation process, the existing completeness metrics need to consider the actual application. Therefore, to accurately recommend suitable knowledge graphs to many users, it is particularly important to develop relevant measurement metrics and formulate measurement schemes for completeness. In this paper, we will first clarify the concept of completeness, establish each metric of completeness, and finally design a measurement proposal for the completeness of knowledge graphs.
基金supported by the National Key Laboratory for Complex Systems Simulation Foundation(6142006190301)。
文摘At present,although knowledge graphs have been widely used in various fields such as recommendation systems,question and answer systems,and intelligent search,there are always quality problems such as knowledge omissions and errors.Quality assessment and control,as an important means to ensure the quality of knowledge,can make the applications based on knowledge graphs more complete and more accurate by reasonably assessing the knowledge graphs and fixing and improving the quality problems at the same time.Therefore,as an indispensable part of the knowledge graph construction process,the results of quality assessment and control determine the usefulness of the knowledge graph.Among them,the assessment and enhancement of completeness,as an important part of the assessment and control phase,determine whether the knowledge graph can fully reflect objective phenomena and reveal potential connections among entities.In this paper,we review specific techniques of completeness assessment and classify completeness assessment techniques in terms of closed world assumptions,open world assumptions,and partial completeness assumptions.The purpose of this paper is to further promote the development of knowledge graph quality control and to lay the foundation for subsequent research on the completeness assessment of knowledge graphs by reviewing and classifying completeness assessment techniques.
基金National Natural Science Foundation of China (Grant Nos.12061028, 71871046)Support Program of the Guangxi China Science Foundation (Grant No.2018GXNSFAA281011)。
文摘In this paper,we investigate the complete convergence and complete moment conver-gence for weighted sums of arrays of rowwise asymptotically negatively associated(ANA)random variables,without assuming identical distribution.The obtained results not only extend those of An and Yuan[1]and Shen et al.[2]to the case of ANA random variables,but also partially improve them.
文摘Gestational trophoblastic disease is an abnormal proliferation of trophoblastic tissue during pregnancy. It occurs in women of childbearing age, although a few cases have also been observed in post-menopausal women, although it is extremely rare in the latter. Here we describe a rare case of complete hydatidiform mole in a 56-year-old female patient who presented with genital bleeding combined with nausea and vomiting and a gravid uterus 16 cm in height. The ultrasound findings and the increase in serum β-HCG to 182566.00 mIU/ml suggested a diagnosis of complete hydatidiform mole. Given the post-menopausal state and the future risk of post-molar gestational trophoblastic neoplasia, we opted for total hysterectomy without preservation of the adnexa via a transabdominal approach, followed by antimitotic treatment with methotrexate. The uterus measured 18.45 cm × 11.18 cm with intra cavitary vesicles. Microscopic examination showed chorionic villi of variable size and shape, most of which were dilated and oedematous, associated with trophoblastic cell proliferation and haemorrhage suggestive of complete benign hydatidiform mole. Follow-up showed a consistent decrease in serum β-HCG levels and no evidence of residual disease. A suspicion of gestational trophoblastic disease should be borne in mind when evaluating a patient with peri- or post-menopausal bleeding to avoid delay in diagnosis and treatment.
基金Project(42202318)supported by the National Natural Science Foundation of China。
文摘his study focused on exploring the specificity of mechanical behavior for completely weathered granite,as a special soil,by consolidated drained triaxial tests.The influences of dry density(1.60,1.70,1.80 and 1.90 g/cm^(3)),confining pressure(100,200,400 and 600 kPa),and moisture content(13.0%,that is,natural moisture content)were investigated in the present work.A newly developed Duncan-Chang model was established based on the experimental data and Duncan-Chang model.The influence of each parameter on the type of the proposed model curve was also evaluated.The experimental results revealed that with varying dry density and confining pressure,the deviatoric stress–strain curves have diversified characteristics including strain-softening,strain-stabilization and strain-hardening.Under high confining pressure condition,specimens with different densities all showed strain-hardening characteristic.Whereas at the low confining pressure levels,specimens with higher densities gradually transform into softening characteristics.Except for individual compression shear failure,the deformation modes of the specimens all showed swelling deformation,and all the damaged specimens maintained good integrity.Through comparing the experiment results,the strain-softening or strain-hardening behavior of CWG specimens could be predicted following the proposed model with high accuracy.Additionally,the proposed model can accurately characterize the key mechanical indicators,such as tangent modulus,peak value and residual strength,which is simple to implement and depends on fewer parameters.
文摘BACKGROUND Breast cancer ranks as one of the most prevalent malignant tumors among women,significantly endangering their health and lives.While radical surgery has been a pivotal method for halting disease progression,it alone is insufficient for enhancing the quality of life for patients.AIM To investigate the correlation between ultrasound characteristic parameters of breast cancer lesions and clinical efficacy in patients undergoing neoadjuvant chemotherapy(NAC).METHODS Employing a case-control study design,this research involved 178 breast cancer patients treated with NAC at our hospital from July 2019 to June 2022.According to the Miller-Payne grading system,the pathological response,i.e.efficacy,of the NAC in the initial breast lesion after NAC was evaluated.Of these,59 patients achieved a pathological complete response(PCR),while 119 did not(non-PCR group).Ultrasound characteristics prior to NAC were compared between these groups,and the association of various factors with NAC efficacy was analyzed using univariate and multivariate approaches.RESULTS In the PCR group,the incidence of posterior echo attenuation,lesion diameter≥2.0 cm,and Alder blood flow grade≥II were significantly lower compared to the non-PCR group(P<0.05).The area under the curve values for predicting NAC efficacy using posterior echo attenuation,lesion diameter,and Alder grade were 0.604,0.603,and 0.583,respectively.Also,rates of pathological stage II,lymph node metastasis,vascular invasion,and positive Ki-67 expression were significantly lower in the PCR group(P<0.05).Logistic regression analysis identified posterior echo attenuation,lesion diameter≥2.0 cm,Alder blood flow grade≥II,pathological stage III,vascular invasion,and positive Ki-67 expression as independent predictors of poor response to NAC in breast cancer patients(P<0.05).CONCLUSION While ultrasound characteristics such as posterior echo attenuation,lesion diameter≥2.0 cm,and Alder blood flow grade≥II exhibit limited predictive value for NAC efficacy,they are significantly associated with poor response to NAC in breast cancer patients.
文摘Colon cancer has the fifth highest incidence worldwide and has the sixth highest mortality.Compared with rectal cancer,colon cancer currently has the worst 5-year overall survival for patients with stage Ⅱ and Ⅲ disease.Complete mesocolic excision has been developed as a standardized and optimized surgical technique for the excision of colon cancers.This technique has traditionally been performed through an open approach since laparoscopy is generally considered technically challenging.The robotic approach has been slowly implemented for colon cancer,but the newest robotic platforms allow for a safer and optimized approach for right colon cancer.Several robotic approaches have been developed and explored.The expansion of the current robotic platform ecosystem is gradually providing new outputs in the application of the robotic approach to complete mesocolic excision.This review gains an oversight of existing literature on robotic complete mesocolic excision for right colon cancer(learning curve,training,techniques,approach,platforms,and future perspectives).
基金supported by the National Natural Science Foundation of China (61903036, 61822304)Shanghai Municipal Science and Technology Major Project (2021SHZDZX0100)。
文摘Collaborative coverage path planning(CCPP) refers to obtaining the shortest paths passing over all places except obstacles in a certain area or space. A multi-unmanned aerial vehicle(UAV) collaborative CCPP algorithm is proposed for the urban rescue search or military search in outdoor environment.Due to flexible control of small UAVs, it can be considered that all UAVs fly at the same altitude, that is, they perform search tasks on a two-dimensional plane. Based on the agents’ motion characteristics and environmental information, a mathematical model of CCPP problem is established. The minimum time for UAVs to complete the CCPP is the objective function, and complete coverage constraint, no-fly constraint, collision avoidance constraint, and communication constraint are considered. Four motion strategies and two communication strategies are designed. Then a distributed CCPP algorithm is designed based on hybrid strategies. Simulation results compared with patternbased genetic algorithm(PBGA) and random search method show that the proposed method has stronger real-time performance and better scalability and can complete the complete CCPP task more efficiently and stably.
基金funded by Director Fund of the Inner Mongolia Autonomous Region Seismological Bureau(No.2023GG02,2023MS05)the Inner Mongolia Natural Science Foundation(No.2024MS04021)。
文摘The assessment of the completeness of earthquake catalogs is a prerequisite for studying the patterns of seismic activity.In traditional approaches,the minimum magnitude of completeness(MC)is employed to evaluate catalog completeness,with events below MC being discarded,leading to the underutilization of the data.Detection probability is a more detailed measure of the catalog's completeness than MC;its use results in better model compatibility with data in seismic activity modeling and allows for more comprehensive utilization of seismic observation data across temporal,spatial,and magnitude dimensions.Using the magnitude-rank method and Maximum Curvature(MAXC)methods,we analyzed temporal variations in earthquake catalog completeness,finding that MC stabilized after 2010,which closely coincides with improvements in monitoring capabilities and the densification of seismic networks.Employing the probability-based magnitude of completeness(PMC)and entire magnitude range(EMR)methods,grounded in distinct foundational assumptions and computational principles,we analyzed the 2010-2023 earthquake catalog for the northern margin of the Ordos Block,aiming to assess the detection probability of earthquakes and the completeness of the earthquake catalog.The PMC method yielded the detection probability distribution for 76 stations in the distance-magnitude space.A scoring metric was designed based on station detection capabilities for small earthquakes in the near field.From the detection probabilities of stations,we inferred detection probabilities of the network for diff erent magnitude ranges and mapped the spatial distribution of the probability-based completeness magnitude.In the EMR method,we employed a segmented model fitted to the observed data to determine the detection probability and completeness magnitude for every grid point in the study region.We discussed the sample dependency and low-magnitude failure phenomena of the PMC method,noting the potential overestimation of detection probabilities for lower magnitudes and the underestimation of MC in areas with weaker monitoring capabilities.The results obtained via the two methods support these hypotheses.The assessment results indicate better monitoring capabilities on the eastern side of the study area but worse on the northwest side.The spatial distribution of network monitoring capabilities is uneven,correlating with the distribution of stations and showing significant diff erences in detection capabilities among diff erent stations.The truncation eff ects of data and station selection aff ected the evaluation results at the edges of the study area.Overall,both methods yielded detailed descriptions of the earthquake catalog,but careful selection of calculation parameters or adjustments based on the strengths of diff erent methods is necessary to correct potential biases.
文摘BACKGROUND Neonatal sepsis is defined as an infection-related condition characterized by signs and symptoms of bacteremia within the first month of life.It is the leading cause of mortality and morbidity among newborns.While several studies have been conducted in other parts of world to assess the usefulness of complete blood count parameters and hemogram-derived markers as early screening tools for neonatal sepsis,the associations between sepsis and its complications with these blood parameters are still being investigated in our setting and are not yet part of routine practice.AIM To evaluate the diagnostic significance of complete blood cell count hemogramderived novel markers for neonatal sepsis among neonates attending public hospitals in the southwest region of Oromia,Ethiopia,through a case control study.METHODS A case control study was conducted from October 2021 to October 2023 Sociodemographic,clinical history,and laboratory test results data were collected using structured questionnaires.The collected data were entered into Epi-data 3.1 version and exported to SPSS-25 for analysis.Chi-square,independent sample ttest,and receiver operator characteristics curve of curve were used for analysis.A P-value of less than 0.05 was considered statistically significant.RESULTS In this study,significant increases were observed in the following values in the case group compared to the control group:In white blood cell(WBC)count,neutrophils,monocyte,mean platelet volume(MPV),neutrophils to lymphocyte ratio,monocyte to lymphocyte ratio(MLR),red blood cell width to platelet count ratio(RPR),red blood width coefficient variation,MPV to RPR,and platelet to lymphocyte ratio.Regarding MLR,a cut-off value of≥0.26 was found,with a sensitivity of 68%,a specificity of 95%,a positive predictive value(PPV)of 93.2%,and a negative predictive value(NPV)of 74.8%.The area under the curve(AUC)was 0.828(P<0.001).For WBC,a cutoff value of≥11.42 was identified,with a sensitivity of 55%,a specificity of 89%,a PPV of 83.3%,and a NPV of 66.4%.The AUC was 0.81(P<0.001).Neutrophils had a sensitivity of 67%,a specificity of 81%,a PPV of 77.9%,and a NPV of 71.1%.The AUC was 0.801,with a cut-off value of≥6.76(P=0.001).These results indicate that they were excellent predictors of neonatal sepsis diagnosis.CONCLUSION The findings of our study suggest that certain hematological parameters and hemogram-derived markers may have a potential role in the diagnosis of neonatal sepsis.
基金Supported by the National Natural Science Foundation of China,No.82073476the National Key R&D Program of China,No.2022YFC2503700 and No.2022YFC2503703+1 种基金Jiangsu Provincial Medical Key Discipline,No.ZDXK202235Innovation Research Project of Medical and Industrial Cooperation in Suzhou,No.SLJ2021005.
文摘BACKGROUND Colorectal cancer is currently the third most common malignant tumor and the second leading cause of cancer-related death worldwide.Neoadjuvant chemoradiotherapy(nCRT)is standard for locally advanced rectal cancer(LARC).Except for pathological examination after resection,it is not known exactly whether LARC patients have achieved pathological complete response(pCR)before surgery.To date,there are no clear clinical indicators that can predict the efficacy of nCRT and patient outcomes.AIM To investigate the indicators that can predict pCR and long-term outcomes following nCRT in patients with LARC.METHODS Clinical data of 128 LARC patients admitted to our hospital between September 2013 and November 2022 were retrospectively analyzed.Patients were categorized into pCR and non-pCR groups.Univariate analysis(using the χ^(2) test or Fisher’s exact test)and logistic multivariate regression analysis were used to study clinical predictors affecting pCR.The 5-year disease-free survival(DFS)and overall survival(OS)rates were calculated using Kaplan-Meier analysis,and differences in survival curves were assessed with the log-rank test.RESULTS Univariate analysis showed that pretreatment carcinoembryonic antigen(CEA)level,lymphocyte-monocyte ratio(LMR),time interval between neoadjuvant therapy completion and total mesorectal excision,and tumor size were correlated with pCR.Multivariate results showed that CEA≤5 ng/mL(P=0.039),LMR>2.73(P=0.023),and time interval>10 wk(P=0.039)were independent predictors for pCR.Survival analysis demonstrated that patients in the pCR group had significantly higher 5-year DFS rates(94.7%vs 59.7%,P=0.002)and 5-year OS rates(95.8%vs 80.1%,P=0.019)compared to the non-pCR group.Tumor deposits(TDs)were significantly correlated with shorter DFS(P=0.002)and OS(P<0.001).CONCLUSION Pretreatment CEA,LMR,and time interval contribute to predicting nCRT efficacy in LARC patients.Achieving pCR demonstrates longer DFS and OS.TDs correlate with poor prognosis.
基金supported by the National Natural Science Foundation of China,NSFC(No.42202318).
文摘Understanding the strength characteristics and deformation behaviour of the tunnel surrounding rock in a fault zone is significant for tunnel stability evaluation.In this study,a series of unconfined compression tests were conducted to investigate the mechanical characteristics and failure behaviour of completely weathered granite(CWG)from a fault zone,considering with height-diameter(h/d)ratio,dry densities(ρd)and moisture contents(ω).Based on the experimental results,a regression mathematical model of unconfined compressive strength(UCS)for CWG was developed using the Multiple Nonlinear Regression method(MNLR).The research results indicated that the UCS of the specimen with a h/d ratio of 0.6 decreased with the increase ofω.When the h/d ratio increased to 1.0,the UCS increasedωwith up to 10.5%and then decreased.Increasingρd is conducive to the improvement of the UCS at anyω.The deformation and rupture process as well as final failure modes of the specimen are controlled by h/d ratio,ρd andω,and the h/d ratio is the dominant factor affecting the final failure mode,followed byωandρd.The specimens with different h/d ratio exhibited completely different fracture mode,i.e.,typical splitting failure(h/d=0.6)and shear failure(h/d=1.0).By comparing the experimental results,this regression model for predicting UCS is accurate and reliable,and the h/d ratio is the dominant factor affecting the UCS of CWG,followed byρd and thenω.These findings provide important references for maintenance of the tunnel crossing other fault fractured zones,especially at low confining pressure or unconfined condition.
文摘BACKGROUND The prognosis for patients with advanced metastatic cervix cancer(MCC)is poor,and this disease continues to pose a considerable therapeutic challenge.Despite the administration of first-line regimens consisting of cisplatin,paclitaxel,and bevacizumab,survival rates for patients with metastasis remain poor.The emergence of bispecific antibodies(BsAbs)offers a novel treatment option for patients diagnosed with MCC.CASE SUMMARY In this report,we present a patient with MCC who was treated with cadonilimab monotherapy at a dose of 6 mg/kg every two weeks after chemotherapy was proven to be intolerable.The patient exhibited a sustained complete response for a duration of 6 months,demonstrating an optimistic outlook.CONCLUSION This case illustrates the considerable efficacy of cadonilimab for treating advanced MCC.Therefore,BsAb therapy is a promising strategy for effectively treating patients with advanced MCC and should be considered as an option when patients are intolerant to standard chemotherapy.
文摘This paper applies Gödel’s Incompleteness Theorems to the evolution and development of human social systems.Although Gödel’s Incompleteness Theorems originated in the field of mathematics,their influence has long extended beyond mathematics,making an impact on philosophy,systems science,and the humanities and social sciences.The paper analyzes the autonomy and completeness of human social systems,arguing that evolving human societies are generally self-consistent.However,if the completeness of a human social system is compromised,the system either maintains self-consistency,ceases to evolve forward,enters a death spiral,and eventually decays and disintegrates.Or the system addresses the completeness issue,enters a state of non-self-consistency,introduces new axioms,becomes self-governing again,and enters a new form.From the sociological perspective,this is articulated as social revolution-the system continues to evolve forward;the absence of social revolution-the system does not evolve forward(Jin,1988).
文摘In colon cancer surgery,ensuring the complete removal of the primary tumor and draining lymph nodes is crucial.Lymphatic drainage in the colon follows the vascular supply,typically progressing from pericolic to paraaortic lymph nodes.While NCCN guidelines recommend the removal of 10-12 lymph nodes for ade-quate oncological resection,achieving complete oncological resection involves more than just meeting these numerical targets.Various techniques have been developed and studied over time to attain optimal oncological outcomes.A key technique central to this goal is identifying the ileocolic vessels at their origin from the superior mesenteric vessels.Complete excision of the visceral and parietal mesocolon ensures the intact removal of the specimen,while D3 lymphade-nectomy targets all draining regional lymph nodes.Although these principles emphasize different aspects,they ultimately converge to achieve the same goal of complete oncological resection.This article aims to simplify the surgical steps that align with the principle of central vascular ligation and mesocolon mobilization while ensuring adequate D3 dissection.
