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关键词： 紧固件   螺栓   硬度   检测  

摘要： 建筑工程中常用主要有普通螺栓和高强度螺栓两大类。在工地塔式起重机、脚手架、钢结构构件中都有应用;施工单位送检时需分清螺栓的类别并选择相应的产品标准;进行螺栓硬度检测时需关注检测部位并选择正确的检测方法。

关键词： 上海歌剧院   《茶花女》   歌剧艺术   歌剧作品   上海音乐厅   沉浸式   激发创作   《罗密欧与朱丽叶》  

摘要： 阳台上响起《咏叹调》,回廊上演绎《茶花女》——日前,一场特别呈现的"阳台歌剧"亮相上海音乐厅。这场由上海歌剧院艺术家创作和表演的沉浸式歌剧演出,选取了《茶花女》《罗密欧与朱丽叶》《贾尼·斯基基》等多部歌剧作品中的经典段落,华丽曼妙的歌声萦绕在金色的雕花穹顶下、汉白玉的旋转楼梯上、冬日暖阳的阳台上,观众们也纷纷盛装出席,感受建筑和歌剧艺术的融合之美。

关键词： 装配式   钢结构   外墙材料   研究现状  

摘要： 装配式外墙体系是发展装配式钢结构建筑的关键技术之一.为了对近年来出现的大量装配式外墙体系进行梳理归纳,本文总结了装配式钢结构建筑外墙体的国内外研究现状,按照构造形式及加工方式进行了分类,并讨论了不同类型墙体的制作工艺、优点、缺点和应用范围,最后提出了装配式钢结构建筑外墙体应满足的共性标准和有待研发的问题,为后续装配式钢结构建筑外墙体的开发应用提供参考.

关键词： Merkel cell carcinoma   Metastasis   Laterality   Primary tumor anatomic site  

摘要： Merkel cell carcinoma (MCC) is a neuroendocrine skin malignancy associated with ultraviolet radiation exposure and the Merkel cell polyomavirus. This study aims to examine associations between primary tumor anatomic site, laterality, and metastases in MCC in the Surveillance Epidemiology and End Results (SEER) database and an academic center MCC database in Rhode Island (RI). A retrospective chart review of 92 MCC cases from RI Hospital and 2845 subjects from the SEER registry was analyzed. Logistic regressions in each cohort were performed to calculate odds ratios (OR), adjusting for sex, age at diagnosis, race, and marital status. The majority of tumors were left-sided in the SEER cohort (53.0%) and RI cohort (56.5%), and located on the head and neck region in the RI cohort (60.9%) and the trunk and extremities in the SEER cohort (70.8%). Left-sided tumors compared to right-sided tumors were marginally associated with increased odds of metastasis in the SEER cohort (OR 1.05, 95% CI 0.87, 1.27); however, decreased risk of MCC was found in the RI cohort (OR 0.33, 95% CI 0.13, 0.80). Tumors located on the trunk and extremities were marginally associated with decreased odds of metastasis compared to head and neck tumors in both databases (SEER: OR 0.88, 95% CI 0.72, 1.08 and RI cohort: OR 0.62, 95% CI 0.25, 1.50). Left-sided tumors located on head and neck showed a suggestive evidence of increased odds of MCC among females in the SEER data (OR 1.77, 95% CI 0.98, 3.23). Our study potentially has important implications for clinical tumor diagnosis and prognostication as well as improved understanding about the epidemiology of MCC.

关键词： GLUCOSE-PRODUCTION   CARDIOVASCULAR-DISEASE   FAT ACCUMULATION   GLYCEMIC CONTROL   WEIGHT-LOSS   SENSITIVITY   DYSFUNCTION   TOLERANCE   SECRETION   INDEXES  

摘要： In order to assess whether previous hepatic IR (Hepatic-IRfasting) and beta-cell functionality could modulate type 2 diabetes remission and the need for starting glucose-lowering treatment, newly-diagnosed type 2 diabetes participants who had never received glucose-lowering treatment (190 out of 1002) from the CORonary Diet Intervention with Olive oil and cardiovascular PREVention study (a prospective, randomized and controlled clinical trial), were randomized to consume a Mediterranean or a low-fat diet. Type 2 diabetes remission was defined according to the American Diabetes Association recommendation for levels of HbA1c, fasting plasma glucose and 2h plasma glucose after oral glucose tolerance test, and having maintained them for at least 2 consecutive years. Patients were classified according to the median of Hepatic-IRfasting and beta-cell functionality, measured as the disposition index (DI) at baseline. Cox proportional hazards regression determined the potential for Hepatic-IRfasting and DI indexes as predictors of diabetes remission and the probability of starting pharmacological treatment after a 5-year follow-up. Low-Hepatic-IRfasting or high-DI patients had a higher probability of diabetes remission than high-Hepatic-IRfasting or low-DI subjects (HR:1.79; 95% CI 1.06-3.05; and HR:2.66; 95% CI 1.60-4.43, respectively) after a dietary intervention with no pharmacological treatment and no weight loss. The combination of low Hepatic-IRfasting and high-DI presented the highest probability of remission (HR:4.63; 95% CI 2.00-10.70). Among patients maintaining diabetes, those with high Hepatic-IRfasting and low-DI showed the highest risk of starting glucose-lowering therapy (HR:3.24;95% CI 1.50-7.02). Newly-diagnosed type 2 diabetes patients with better beta-cell functionality and lower Hepatic-IRfasting had a higher probability of type 2 diabetes remission in a dietary intervention without pharmacological treatment or weight loss, whereas among patients not ach

关键词： Composite lymphoma   Sequential lymphoma   Population-based study   Primary mediastinal lymphoma   diffuse large   B-cell lymphoma   Classical Hodgkin lymphoma   GRAY ZONE LYMPHOMA   FEATURES INTERMEDIATE   OUTCOMES   DISEASE   DLBCL  

摘要： Background: Data on composite and sequential lymphoma between primary mediastinal lymphoma/diffuse large B-cell lymphoma (LBCL) and classical Hodgkin lymphoma (cHL) are rare. Methods: We identified 25 cases with composite lymphoma (CL), 116 cases developing LBCL as a second primary cancer after cHL (cHL-LBCL), and 74 cases developing cHL as a second primary cancer after LBCL (LBCL-cHL) from the Surveillance, Epidemiology, and End Results (SEER) 18 database. Comparisons of overall survival (OS) and lymphoma cause-specific survival (CSS) between patients with cHL-LBCL or cHL-LBCL and their de novo counterparts were performed. Results: The 5-year OS of patients with CL was 74.8 %. No significant difference in unadjusted OS and lymphoma CSS were observed between patients with de novo LBCL (LBCL-1 group) and patients with cHL-LBCL. However, the age- and stage-adjusted cHL-LBCL group had inferior OS and lymphoma CSS compared with that in the LBCL1 group. The unadjusted and adjusted OS and lymphoma CSS in the LBCL-cHL group were significantly worse than patients with de novo cHL. Conclusions: CL between LBCL and cHL may have good outcomes. cHL survivors had poorer outcomes after a LBCL diagnosis versus patients with LBCL-1. Significantly poor outcomes were observed in patients with LBCLcHL compared with patients with de novo cHL.

关键词： Adrenal myelolipoma   lymphoma  

摘要： Adrenal myelolipoma (AML) is a benign tumor that consists of mature adipose tissue and bone marrow elements. We report a case of a 57-year-old woman who presented with complaint of lower abdominal discomfort. Computed tomography scan of abdomen and pelvis revealed a mass in the left adrenal measuring 2.0 cm which was radiologically considered to be AML. Pathological evaluation of the lesion showed foci of lymphoid aggregate in a background of AML that were confirmed to be diffuse large B cell lymphoma by immunohistochemistry and gene rearrangement. To our knowledge, this collision tumor has not been reported previously. The clinical, radiological, pathological features, and treatment are discussed. (c) 2021 Elsevier Inc. All rights reserved.

关键词： Adjuvant   Renal cell carcinoma   Meta-analysis   SUNITINIB   NEPHRECTOMY   PLACEBO  

摘要： The indications for adjuvant vascular endothelial growth factor-tyrosine kinase inhibitor (VEGF-TKI) agents after curative intent nephrectomy for renal cell carcinoma are still a matter of debate. The ASSURE, PROTECT and ATLAS trials have failed to meet their primary end-points. Conversely, 5-TRAC has shown a disease free survival (DFS) benefit. To date, meta-analyses have repeatedly proved the absence of a clinical benefit, in term of DFS and overall survival (OS). Nevertheless, the results of the SORCE trial have been recently released and might add valuable information. We pooled the results of all five reported trials testing for any potential DFS and OS benefits associated with VEGF-TKI use. Interestingly, for pooled DFS we found a marginal positive hazard ratio (HR) of 0.92 (95% confidence interval [CI] 0.85-1.00; P-value = 0.049) in favor of adjuvant VEGF-TKI agents. This benefit was more pronounced for DFS in the sub-groups of only high-risk patients (HR: 0.89, 95% CI 0.80-0.99; P-value = 0.026), but less pronounced in clear-cell only subgroup (HR 0.92, 95% CI: 0.85-1.00; P-value = 0.044). Overall survival benefit was instead not reached. However, pooled relative risk for high-grade (grade >= 3 according to CTCAE classification) adverse events was irremediably high, 2.56 (95% CI: 2.15-3.04; P-value < 0.001). Given the marginal benefit in terms of DFS and the drawback of high-grade adverse events, even after the SORCE trial publication, adjuvant VEGF-TKIs therapy cannot be considered in the whole group of patients with non-metastatic high-risk renal cell carcinoma after surgery. (C) 2021 Elsevier Inc. All rights reserved.

关键词： Adjuvant therapy   Leibovich score   Disease-free survival   Immunotherapy   VEGFR-TKI   HIGH-RISK   SUNITINIB   NEPHRECTOMY   PROGRESSION   PLACEBO  

摘要： Trials with adjuvant anti-angiogenic therapy failed to demonstrate significant benefit in high-risk, resected clear-cell renal cell carcinoma. We show that molecular subtypes and angiogenesis-related gene expression are associated with disease-free and overall survival. Clinically high-risk tumors are infrequently angiogenic but can display either high or low immunogenic gene expression. Molecular characterization could therefore better guide patient selection for adjuvant immunotherapy. Background: Trials with adjuvant vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) failed to demonstrate meaningful benefit in clinically high-risk, fully resected clear cell renal cell carcinoma (ccRCC). We evaluated whether the ccrcc1-4 molecular subtypes and gene expression signatures (GES) are associated with outcomes in this setting. Materials and Methods: We determined molecular subtypes as well as angiogenesis- and immune-related GES through RNA sequencing of 75 fresh frozen (FF) and 62 formalin-fixed, paraffin-embedded (FFPE) tumor samples. We studied disease-free (DFS) and overall survival (OS) and determined correlations among GES and Leibovich score. Results: Angiogenesis-related GES and molecular subtypes were associated with longer DFS and OS across both cohorts, whereas immune-related GES were not. In the FF cohort, molecular subtypes (ccrcc2 & 3 vs. ccrcc1 & 4) were associated with DFS and OS, on bivariable analysis with Leibovich score (HR 0.62, 95%CI 0.39-0.98, P = .04 and HR 0.35, 95%CI 0.19-0.64, P < .001). In the FFPE cohort, molecular subtypes (ccrcc2 & 3 vs. ccrcc1&4) were also associated with DFS (HR 0.53, 95%CI 0.31-0.93, P = .03), but not OS (HR 0.59, 95%CI 0.31-1.13, P = .11) on bivariable analysis with Leibovich score. Leibovich score was significantly inversely correlated with all angiogenesis-related GES (all P < .01), but not correlated with immune-related GES. Conclusions: Molecular subtypes and angiogenesis-related GE