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Hip fracture, increasing exponentially with age, is osteoporosis's most severe clinical consequence. Intertrochanteric fracture, one of the main types of hip fracture, is associated with higher mortality and morbidity. The current research hotspots lay in improving the treatment effect and optimizing the secondary stability after intertrochanteric fracture surgery. Cortex buttress reduction is a widely accepted method for treating intertrochanteric fracture by allowing the head-neck fragment to slide and rigidly contact the femoral shaft's cortex. Medial cortical support is considered a more effective option in treating young patients. However, osteo-degenerations features, including bone weakness and cortical thickness thinning, affect the performance of cortex support in geriatric intertrochanteric fracture treatment. Literature focusing on the age-specific difference in cortex performance in the fractured hip is scarce. We hypothesized that this osteo-19 degenerative feature affects the performance of cortex support in treating intertrochanteric fractures between the young and the elderly. We established twenty models for the old and the young with intertrochanteric fractures and performed static and dynamic simulations under one-legged stance and walking cycle conditions. The von Mises stress and displacement on the femur, proximal femoral nail anti-rotation (PFNA) implant, fracture plane, and the cutting volume of cancellous bone of the femur were compared. It was observed that defects in the anterior and posterior cortical bone walls significantly increase the stress on the PFNA implant, the displacement of the fracture surface, and cause a greater volume of cancellous bone to be resected. We concluded that ensuring the integrity and alignment of the anterior and posterior cortical bones is essential for elderly patients, and sagittal support is recommended. This finding suggests that the treatment method for intertrochanteric fracture may differ, considering the patient's age difference.
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Tripartite motif-containing 67 (TRIM67), a member of the TRIM protein family, is an E3 ubiquitin ligase. Our previous study revealed a relationship between TRIM67 expression and carcinogenesis, showing that TRIM67 expression is linked to p-TNM stage, lymph node metastasis, tumour size, cancer cell differentiation, and poor prognosis. Additionally, TRIM67 immunostaining results were associated with clinicopathological features. TRIM67 activated the Notch pathway in a favourable manner to enhance cell invasion, migration, and proliferation. Atypical ligand delta like non-canonical Notch ligand 1 (DLK1) inhibits the function of the Notch1 receptor, which in turn prevents activation of the Notch pathway. In addition, we investigated the mechanism by which TRIM67 influences the Notch pathway. We found that TRIM67 altered the behaviour of non-small cell lung cancer (NSCLC) cells by ubiquitinating DLK1 via its RING domain, which in turn activates the Notch pathway. Taken together, these findings indicate that TRIM67 may be involved in promoting the growth of NSCLC.
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We present a rare case of fibromuscular dysplasia (FMD) manifesting in the mid segment of right renal artery, which led to the development of refractory hypertension. The patient received balloon angioplasty to a severe lesion on the middle of right renal artery and subsequently had normalisation of blood pressures. Fractional flow reserve (FFR) detection of the renal artery before and after balloon dilatation was 0.71 and 0.98, respectively. The patient showed renal artery stenosis (RAS) with distal tumour-like dilatation, and multiple tortuosity and stenosis in carotid artery and coronary artery. At follow-up 2 months later, her blood pressures had normalised.
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Displasia Fibromuscular , Reserva del Flujo Fraccional Miocárdico , Obstrucción de la Arteria Renal , Femenino , Humanos , Arteria Renal , Displasia Fibromuscular/terapia , Dilatación , Obstrucción de la Arteria Renal/terapia , Obstrucción de la Arteria Renal/cirugíaRESUMEN
High electrical conductivity and super high hardness are two sought-after material properties, but both are contradictory because the effective suppression of dislocation movement generally increases the scattering of conducting electrons. Here we synthesized a high-entropy dodecaboride composite (HEDC) with a large number of atomic-scale interlocking layers. It shows a Vickers hardness of 51.2 ± 3.6 GPa under an applied load of 0.49 N and an electrical resistivity of 44.5 µΩ·cm at room temperature. Such HEDC achieves superhardness by inheriting the high intrinsic hardness of its constituent phases and restricting the dislocation motion to further enhance the extrinsic hardness through forming numerous atom-scale interlocks between different slip systems. Moreover, the HEDC maintains the excellent electrical conductivity of the constituent borides, and the competition between two correlating structures produces the special kind of coherent boundary that minimizes the scattering of conducting electrons and does not largely deteriorate the electrical conductivity.
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To verify the advantages of Virtual Fixtures (VFs) by comparing the result of guide plate navigation (GPN) and VFs in robot-assisted osteotomy. Robot-assisted surgery has been extensively applied in traditional orthopedic surgeries. It fundamentally improves surgeries' cutting accuracy. In addition, many key techniques have been applied in bone cutting to increase the procedure's safety in various ways. In this paper, two robot-assisted osteotomy methods are proposed. Three operators with no osteotomy experience performed plane cutting with the assistance of a robot. GPN and VFs were applied to assist the Sawbones cutting. Each operator has five attempts using each method to perform bone cutting, distance errors and angular errors were recorded. The advantage of Sawbones is that there is no influence from soft tissues and blood. It can give a more precise measurement. The results show that both methods have high accuracy with the robot's assistance. VFs have higher accuracy in comparison with GPN. With GPN, the mean distance and angular error of the three operators were 2.974 ± 0.282 mm and 4.737 ± 0.254°. With VFs, the mean range and angular error of the three operators were 1.857 ± 0.349 mm and 2.24 ± 0.123°, respectively. VFs limited the robot's end in the planned area, increasing the accuracy and safety of robot-assisted osteotomy.
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BACKGROUND AND OBJECTIVES: Virtual reality has been proved indispensable in computer-assisted surgery, especially for surgical planning, and simulation systems. Collision detection is an essential part of surgery simulators and its accuracy and computational efficiency play a decisive role in the fidelity of simulations. Nevertheless, current collision detection methods in surgical simulation and planning struggle to meet precise requirements, especially for detailed and complex physiological structures. To address this, the primary objective of this study was to develop a new algorithm that enables fast and precise collision detection to facilitate the improvement of the realism of virtual reality surgical procedures. METHODS: The method consists of two main parts, bounding spheres formation and two-level collision detection. A specified surface subdivision method is devised to reduce the radius of basic bounding spheres formed by circumcenters of underlying triangles. The spheres are then clustered and adjusted to obtain a compact personalized hierarchy whose position is updated in real time during surgical simulation, followed by two-level collision detection. Triangular facets with collision potential through interaction between hierarchies and then accurate results are obtained by means of precise detection phase. The effectiveness of the algorithm was evaluated in various models and surgical scenarios and was compared with prior relevant implementations. RESULTS: Results on multiple models demonstrated that the method can generate a personalized hierarchy with fewer and smaller bounding spheres for tight wrapping. Simulation experiments proved that the proposed approach is significantly superior to comparable methods under the premise of error-free detection, even for severe model-model collision. CONCLUSIONS: The algorithm proposed through this study enables higher numerical efficiency and detection accuracy, which is capable of significantly enlarging the fidelity/realism of haptic simulators and surgical planning methods.
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Cirugía Asistida por Computador , Realidad Virtual , Simulación por Computador , Algoritmos , Interfaz Usuario-ComputadorRESUMEN
BACKGROUND: Cuproptosis, a form of copper-dependent programmed cell death recently presented by Tsvetkov et al., have been identified as a potential therapeutic target for refractory cancers and ferroptosis, a well-known form describing iron-dependent cell death. However, whether the crossing of cuproptosis-related genes and ferroptosis-related genes can introduce some new idea, thus being used as a novel clinical and therapeutic predictor in esophageal squamous cell carcinoma (ESCC) remains unknown. METHODS: We collected ESCC patient data from the Gene Expression Omnibus and the Cancer Genome Atlas databases and used Gene Set Variation Analysis to score each sample based on cuproptosis and ferroptosis. We then performed weighted gene co-expression network analysis to identify cuproptosis and ferroptosis-related genes (CFRGs) and construct a ferroptosis and cuproptosis-related risk prognostic model, which we validated using a test group. We also investigated the relationship between the risk score and other molecular features, such as signaling pathways, immune infiltration, and mutation status. RESULTS: Four CFRGs (MIDN, C15orf65, COMTD1 and RAP2B) were identified to construct our risk prognostic model. Patients were classified into low- and high-risk groups based on our risk prognostic model and the low-risk group showed significantly higher survival possibilities (P < 0.001). We used the "GO", "cibersort" and "ESTIMATE" methods to the above-mentioned genes to estimate the relationship among the risk score, correlated pathways, immune infiltration, and tumor purity. CONCLUSION: We constructed a prognostic model using four CFRGs and demonstrated its potential clinical and therapeutic guidance value for ESCC patients.
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Neoplasias Esofágicas , Carcinoma de Células Escamosas de Esófago , Ferroptosis , Humanos , Carcinoma de Células Escamosas de Esófago/genética , Pronóstico , Ferroptosis/genética , Neoplasias Esofágicas/genética , Apoptosis , Proteínas de Unión al GTP rapRESUMEN
BACKGROUND: Myocardial ischemia/reperfusion (I/R) contributes to serious myocardial injury and even death. Therefore, prevention and mitigation of myocardial I/R is particularly important. LncRNA HOTAIR has been reported to be implicated in myocardial I/R progression. However, the detailed molecular mechanism of HOTAIR in cardiomyocyte was explored in myocardial I/R. METHODS: Firstly, cell model of myocardial I/R was established through hypoxia/reoxygenation (H/R). Apoptosis and cell cycle were evaluated utilizing flow cytometry. The corresponding test kits were conducted to monitor the levels of LDH, Caspase3 and Caspase9. The gene expression and protein levels were detected by qPCR and western blot, respectively. RNA pull-down and RIP were performed to verify the interaction between FUS and lncRNA HOTAIR. RESULTS: In AC16 cardiomyocytes treated with H/R, lncRNA HOTAIR and SIRT3 expression were obviously decreased. Overexpression of HOTAIR or SIRT3 could ameliorate H/R-induced cardiomyocyte injury by promoting cell viability, lowering LDH levels, and suppressing cell apoptosis. Further, lncRNA HOTAIR upregulated the expression of SIRT3 via interacting with FUS, thereby promoting the survival of H/R-injured cardiomyocytes. CONCLUSION: LncRNA HOTAIR can improve myocardial I/R by affecting cardiomyocyte survival through regulation of SIRT3 by binding to the RNA binding protein FUS.
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Enfermedad de la Arteria Coronaria , Isquemia Miocárdica , Daño por Reperfusión Miocárdica , ARN Largo no Codificante , Proteína FUS de Unión a ARN , Sirtuina 3 , Humanos , Apoptosis , Enfermedad de la Arteria Coronaria/metabolismo , Isquemia Miocárdica/genética , Daño por Reperfusión Miocárdica/genética , Daño por Reperfusión Miocárdica/prevención & control , Daño por Reperfusión Miocárdica/metabolismo , Miocitos Cardíacos/metabolismo , ARN Largo no Codificante/genética , ARN Largo no Codificante/metabolismo , Proteína FUS de Unión a ARN/genética , Proteína FUS de Unión a ARN/metabolismo , Sirtuina 3/metabolismoRESUMEN
Pelvic fracture is the most serious bone trauma and has the highest mortality and disability rate. Surgical treatment of pelvic fracture is very challenging for surgeons. Minimally invasive close reduction of pelvic fracture is considered the most difficult operation due to the complex pelvic morphology and abundant soft tissue anatomy, both of which increase the difficulty of pelvic fracture reduction. The most challenging aspect of such surgery is how to hold the pelvic bone and effectively transmit the reduction force to the bone. Therefore, a safe and effective pelvic holding pathway for reduction is necessary for pelvic fracture operations. Existing research on the pelvic holding pathway addresses anatomical position and dimension. Few studies have focused on biomechanical properties or on surgical techniques related to these pathways. This paper studies the three holding pathways that are most commonly used in clinical practice. The most effective force direction for each holding pathway is identified through finite element modeling. Pathway 1 is suitable for internal rotation operation and open/close-book operation of the pelvis; Pathway 2 is suitable for translation of the fractured pelvis toward the sacrum and internal pelvic rotation operations; Pathway 3 is suitable for pulling and lifting of the fractured pelvis against gravity and open/close-book operation of the pelvis. In addition, we find through our simulation that the use of a combined holding strategy can reduce the reduction force during the reduction process. We compared the performances of the 2-pin combined holding strategy (2P-CH) and the 3-pin combined strategy (3P-CH). During translational reduction, 2P-CH and 3P-CH showed little difference in pelvic reduction force. However, in rotational reduction, 3P-CH shows advantages. It has less reduction force and the least combined muscle resistance. It can also maximize the displacement of the iliac crest under the same conditions. The results of this study can be applied to surgical planning and to the development of robot-assisted surgery systems in selecting holding pathways and operation strategies for fractured pelvis.
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Fracturas Óseas , Huesos Pélvicos , Humanos , Fijación Interna de Fracturas/métodos , Fracturas Óseas/cirugía , Huesos Pélvicos/cirugía , Fijación de Fractura , PelvisRESUMEN
Background: Compared to bare-metal stent implantation, coronary drug-eluting stent (DES) implantation is more likely to reduce restenosis and the need for a subsequent repeat revascularization procedure. Diabetes increases the risk of coronary heart disease and the population of diabetic patients has increased significantly in China in recent years. It's essential to know more about the outcome in these patients underwent DES implantation. To date, the long-term safety and efficacy of coronary DES implantation in Chinese patients with diabetes has rarely been investigated. Methods: In this study, according to inclusion and exclusion criteria, 580 patients who underwent DES implantations between July 2014 and January 2016 were included and divided into the diabetic group (n=173) and non-diabetic group (n=407). Clinical baseline characteristics and follow-up outcomes were collected from electronic medical record. Serial clinical follow-up was conducted at 1-, 3-, and 5-year. The primary end point was a composite of major adverse cardiac events (MACEs), including cardiac death, recurrent myocardial infarction (re-MI), and target lesion revascularization (TLR) in 5-year follow-up. The long-term outcomes observed in the 5-year follow-up period were compared between the diabetic and non-diabetic patients. Results: Non-cardiac death was more common in the diabetic than non-diabetic patients in the 5-year follow-up period (8.7% vs. 3.2% P=0.00). Conversely, the risk of occurrence of MACEs, cardiac death, re-MI, and TLR were comparable. The all-cause mortality rate in 5-year follow-up was higher in the diabetic than non-diabetic patients (14.5% vs. 6.1%, P=0.00). The incidence of stent thrombosis was also comparable between the diabetic and non-diabetic patients. Conclusions: Compared to the non-diabetic patients, the diabetic patients were at higher risk for all-cause mortality after coronary DES implantation during the long-term follow-up period.
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BACKGROUND AND OBJECTIVE: Recent studies have shown that colorectal cancer (CRC) patients with microsatellite instability high (MSI-H) are more likely to benefit from immunotherapy. However, current MSI testing methods are not available for all patients due to the lack of available equipment and trained personnel, as well as the high cost of the assay. Here, we developed an improved deep learning model to predict MSI-H in CRC from whole slide images (WSIs). METHODS: We established the MSI-H prediction model based on two stages: tumor detection and MSI classification. Previous works applied fine-tuning strategy directly for tumor detection, but ignoring the challenge of vanishing gradient due to the large number of convolutional layers. We added auxiliary classifiers to intermediate layers of pre-trained models to help propagate gradients back through in an effective manner. To predict MSI status, we constructed a pair-wise learning model with a synergic network, named parameter partial sharing network (PPsNet), where partial parameters are shared among two deep convolutional neural networks (DCNNs). The proposed PPsNet contained fewer parameters and reduced the problem of intra-class variation and inter-class similarity. We validated the proposed model on a holdout test set and two external test sets. RESULTS: 144 H&E-stained WSIs from 144 CRC patients (81 cases with MSI-H and 63 cases with MSI-L/MSS) were collected retrospectively from three hospitals. The experimental results indicate that deep supervision based fine-tuning almost outperforms training from scratch and utilizing fine-tuning directly. The proposed PPsNet always achieves better accuracy and area under the receiver operating characteristic curve (AUC) than other solutions with four different neural network architectures on validation. The proposed method finally achieves obvious improvements than other state-of-the-art methods on the validation dataset with an accuracy of 87.28% and AUC of 94.29%. CONCLUSIONS: The proposed method can obviously increase model performance and our model yields better performance than other methods. Additionally, this work also demonstrates the feasibility of MSI-H prediction using digital pathology images based on deep learning in the Asian population. It is hoped that this model could serve as an auxiliary tool to identify CRC patients with MSI-H more time-saving and efficiently.
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Neoplasias Colorrectales , Aprendizaje Profundo , Neoplasias Colorrectales/diagnóstico por imagen , Neoplasias Colorrectales/genética , Humanos , Inestabilidad de Microsatélites , Redes Neurales de la Computación , Estudios RetrospectivosRESUMEN
p16 and Ki67 are immunohistochemical markers related to cervical squamous intraepithelial lesions. p16 has been widely used to assist in the diagnosis of high-grade squamous intraepithelial lesions. However, a conclusion about the role of Ki67 in the diagnosis of squamous intraepithelial lesions has not been established. The aim of this study was to analyze the role of p16 and Ki67 immunohistochemical staining in assisting cervical squamous intraepithelial lesions. This study performed immunohistochemical staining for p16 and Ki67 on 1024 cervical biopsy specimens at our hospital to compare the differences between p16 and Ki67 in different cervical lesions using the chi-squared test and Fisher's exact test. This study also evaluated the value of Ki67 for the diagnosis of low-grade squamous intraepithelial lesions (LSILs) using the receiver operating characteristic curve. The results indicated that Ki67 had high specificity and sensitivity in distinguishing LSIL from normal cervix. p16 was diffusely and strongly positive in some LSILs, and some problems were encountered in the interpretation of p16 staining. Therefore, we believe that Ki67 can be used as an immunohistochemical marker to help in the diagnosis of LSIL, to distinguish lesions that are difficult to morphologically determine and to avoid misdiagnosis. The practical application of p16 staining is still problematic. It may be necessary to find other auxiliary means to distinguish this small proportion of cervical lesions.
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Infecciones por Papillomavirus , Lesiones Intraepiteliales Escamosas , Displasia del Cuello del Útero , Neoplasias del Cuello Uterino , Biomarcadores de Tumor , Inhibidor p16 de la Quinasa Dependiente de Ciclina , Femenino , Humanos , Antígeno Ki-67 , Infecciones por Papillomavirus/diagnóstico , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/patología , Displasia del Cuello del Útero/diagnósticoRESUMEN
Genes play regulatory roles in plants' response to low-temperature stress. Our understanding of the mechanism of plants' response to low-temperature stress can be expanded by studying the functions of these genes. SfGPX was cloned from Spiraea fritschiana (S. fritschiana) with the highest low-temperature tolerance, to explore the molecular mechanisms of SfGPX in response to low-temperature stress and the physiological mechanisms involved in the regulation of SfGPX to adapt to low temperature, in two species of Spiraea. SfGPX, which was localized in the cytoplasm, was induced by low temperature. The low-temperature tolerance of Spiraea fritschiana was decreased via the interference of SfGPX, and the low-temperature tolerance of Spiraea japonica 'Gold Mound' (S. japonica 'Gold Mound') was elevated via the overexpression of SfGPX. Under low-temperature stress, the photosynthetic capacity of two species of Spiraea was affected by SfGPX; it was higher in the cold-tolerant plants and lower in the cold-intolerant plants. Under low-temperature stress, the transfer intensity of Ca2+ was affected by SfGPX. The transfer intensity of cold-tolerant plants with lower influx level of Ca2+ kinetics was weaker than that of cold-intolerant plants. Under low-temperature stress, the transfer velocity of Ca2+ was affected by SfGPX, and there were slower effluxes of Ca2+ from Ca2+ reservoir in cold-tolerant plants than in cold-intolerant plants. The above results indicate that the response of Spiraea to low temperature is regulated by SfGPX through affecting photosynthetic capacity as well as intensity and velocity of Ca2+ transfer in response to low temperature in Spiraea.
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Spiraea , Frío , Regulación de la Expresión Génica de las Plantas , Proteínas de Plantas/metabolismo , Spiraea/metabolismo , TemperaturaRESUMEN
Hierarchical porous silicon carbide (SiC) attracts great attention due to its superior chemical resistance, high thermal shock resistance, and excellent thermal stability. The preparation of a porous SiC monolith via a simple sol-gel method is limited by either the high cost of the raw materials or the special time-consuming drying process. Herein, we report an ambient drying sol-gel approach for the synthesis of organic-inorganic hybrid monolithic gels which can be converted into hierarchical porous SiC monoliths upon pyrolysis at 1400 °C. The as-synthesized SiC monoliths possess hierarchical pores with macropores of 4.5 µm and mesopores of 2.0 nm. The porosities, specific surface areas and compressive strengths of the hierarchical porous SiC monoliths are 71.3%, 171.5 m2/g and 7.0 ± 0.8 MPa, respectively.
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The authors wish to make the following correction to their paper [...].
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Aldosterone reductase family 1 member B10 (AKR1B10) is a nicotinamide adenine dinucleotide phosphate (reduced coenzyme II)-dependent oxidoreductase, and its biological functions include carbonyl detoxification, hormone metabolism, osmotic adjustment, and lipid synthesis. Studies suggested that AKR1B10 is a new biomarker for cancer based on its overexpression in epithelial tumors, such as breast cancer, cervical cancer, and lung cancer. At present, studies on the expression of AKR1B10 in laryngeal cancer have not been reported. However, we found that AKR1B10 is upregulated in laryngeal carcinoma, and its expression was negatively correlated with the degree of differentiation. In addition, AKR1B10 expression was positively correlated with tumor size; lymph node metastasis; alcohol use; and Ki-67, mutant p53, and matrix metalloproteinase 2 expression. AKR1B10 was overexpressed in Hep-2 laryngeal carcinoma cells. Oleanolic acid inhibited AKR1B10 activity and expression in Hep-2 cells and suppressed Hep-2 cell proliferation, migration, and invasion. Therefore, AKR1B10 may be related to the development of laryngeal carcinoma, suggesting its use as a prognostic indicator for laryngeal cancer.
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Aldo-Ceto Reductasas/genética , Biomarcadores de Tumor/genética , Carcinoma de Células Escamosas/metabolismo , Neoplasias Laríngeas/metabolismo , Células A549 , Adulto , Anciano , Aldo-Ceto Reductasas/metabolismo , Biomarcadores de Tumor/metabolismo , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/patología , Movimiento Celular , Proliferación Celular , Femenino , Células Hep G2 , Humanos , Neoplasias Laríngeas/genética , Neoplasias Laríngeas/patología , Metástasis Linfática , Masculino , Metaloproteinasa 2 de la Matriz/genética , Metaloproteinasa 2 de la Matriz/metabolismo , Persona de Mediana Edad , Carga Tumoral , Proteína p53 Supresora de Tumor/genética , Proteína p53 Supresora de Tumor/metabolismo , Regulación hacia ArribaRESUMEN
Gastric cancer (GC) is one of the most common fatal cancers worldwide. The communication between GC and other cells in the GC microenvironment directly affects GC progression. Recently, exosomes have been revealed as new players in intercellular communication. They play an important role in human health and diseases, including cancer, owing to their ability to carry various bioactive molecules, including non-coding RNAs (ncRNAs). NcRNAs, including micro RNAs, long non-coding RNAs, and circular RNAs, play a significant role in various pathophysiological processes, especially cancer. Increasing evidence has shown that exosomal ncRNAs are involved in the regulation of tumor proliferation, invasion, metastasis, angiogenesis, immune regulation, and treatment resistance in GC. In addition, exosomal ncRNAs have promising potential as diagnostic and prognostic markers for GC. Considering the biocompatibility of exosomes, they can also be used as biological carriers for targeted therapy. This review summarizes the current research progress on exosomal ncRNAs in gastric cancer, focusing on their biological role in GC and their potential as new biomarkers for GC and therapeutics. Our review provides insight into the mechanisms involved in GC progression, which may provide a new point cut for the discovery of new diagnostic markers and therapeutic strategies.
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A 125 cm long catheter makes it possible to perform renal arteriography via radial artery, but its feasibility and safety remain unclear. Our study recruited 1,323 patients grouped by two different vascular accesses to renal arteriography, i.e., femoral artery access and radial artery access. The success rate of angiography was 100% in both groups. Differential analysis showed that the overall complication incidence of radial artery access group was significantly lower (2.5% for radial artery access vs. 4.8% for femoral artery access, p = 0.03). From this study, we suggest that using the 125 cm angiographic catheter to perform renal arteriography via radial artery access is feasible and safe.
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Angiografía , Catéteres/efectos adversos , Riñón , Arteria Radial/cirugía , Arteria Renal/diagnóstico por imagen , Adulto , Anciano , Anciano de 80 o más Años , Angiografía/efectos adversos , Angiografía/instrumentación , Angiografía/métodos , Femenino , Arteria Femoral/cirugía , Humanos , Riñón/irrigación sanguínea , Riñón/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
Thyroid-like follicular renal cell carcinoma is a rare subtype of renal cell carcinoma that has only been recently recognized, as most cases involve a solid tumor in one kidney. In this study, we report a rare case of bilateral renal cell carcinoma wherein the tumor in the left kidney was diagnosed as clear cell carcinoma, while the tumor in right kidney as thyroid-like follicular renal cell carcinoma. The difference between this case and the ones described in previous reports is that thyroid-like follicular renal cell carcinoma showed cystic changes on imaging. This suggests that when renal cystic lesions are encountered, we should consider the possibility of such rare tumors.
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An efficient strategy that can guide the synthesis of materials with superior mechanical properties is important for advanced material/device design. Here, we report a feasible way to enhance hardness in transition-metal monocarbides (TMCs) by optimally filling the bonding orbitals of valence electrons. We demonstrate that the intrinsic hardness of the NaCl- and WC-type TMCs maximizes at valence electron concentrations of about 9 and 10.25 electrons per cell, respectively; any deviation from such optimal values will reduce the hardness. Using the spark plasma sintering technique, a number of W1-xRexC (x = 0-0.5) have been successfully synthesized, and powder X-ray diffractions show that they adopt the hexagonal WC-type structure. Subsequent nanoindentation and Vickers hardness measurements corroborate that the newly developed W1-xRexC samples (x = 0.1-0.3) are much harder than their parent phase (i.e., WC), marking them as the hardest TMCs for practical applications. Furthermore, the hardness enhancement can be well rationalized by the balanced occupancy of bonding and antibonding states. Our findings not only elucidate the unique hardening mechanism in a large class of TMCs but also offer a guide for the design of other hard and superhard compounds such as borides and nitrides.