Subjects: Nuclear Science and Technology >> Nuclear Science and Technology submitted time 2024-05-12
Abstract： [Background]: The primary heat exchanger (PHX) used in the 10MWt Molten Salt Reactor Experiment (MSRE) at Oak Ridge National Laboratory (ORNL), is a U-tube heat exchanger, where the shell side (hot side) contains the fuel salt from the primary loop, while the tube side (cold side) carries the coolant salt from the secondary loop. [Purpose]: This study aims to deepen the understanding and mastery of the operational characteristics of molten salt heat exchangers, and to accumulate experience in their design and operation within molten salt reactors. [Methods]: the MSRE-PHX is modeled based on the design parameters, theoretical calculations for shell and tube hear exchanger (Kern method and Bell-Delaware method), software simulation (HTRI Xchanger Suite) and computational fluid dynamics (CFD) simulation are performed, critical performance metrics, such as the heat transfer coefficient, the pressure drop, and the heat transfer power, are obtained and compared to the MSRE operation data. [Results]: The findings indicate that the discrepancies from theoretical calculations, HTRI software, and CFD simulations, are all within acceptable margins to the experimental data. Notably, the greatest variance was found with the Kern method, which showed a deviation in heat transfer quantity of about 15%, while the smallest discrepancy was observed in the overall heat transfer coefficient calculated using HTRI software, differing by merely 0.16% from the experimental data; [Conclusions]: All of the methods are suitable and applicable for designing and studying a molten salt shell and tube heat exchanger; moreover, the CFD simulation can provide fine localized details of the heat transfer and flow of the molten salt fluid. This offers substantial theoretical support and practical guidance for the future design and improvement of molten salt heat exchangers.
Subjects: Digital Publishing >> New Media submitted time 2023-10-08 Cooperative journals: 《中国传媒科技》
Abstract：采用私有云储存的方法来建造非编制的高清制作网,这种方法不但可以有效地提高节目制作的水平与质量,而且提高了制作网的安全性。基于此,本文针对私有云储存在高清制作网中的应用进行分析,并研究了相关的优势所在。
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2019-11-15 Cooperative journals: 《协和医学杂志》
Abstract：目的 探讨乳腺原发性神经内分泌癌（primary neuroendocrine carcinoma of the breast, NEBC）和乳腺浸润性癌（非特殊型）（invasive carcinoma of no special type，NST）的临床病理差异以及淋巴结转移的相关影响因素。结果两组患者的年龄、瘤体直径、组织学分级、清扫淋巴结数目及TNM分期均无统计学差异，两组患者基线水平较为一致。50例原发性乳腺神经内分泌癌中有淋巴结转移的患者15例。雌激素受体阳性表达率为96%，孕激素受体阳性表达率为84%，HER-2 阳性表达率为8.5%，嗜铬素A阳性表达率为58%，突触素阳性表达率为97.9%。影响淋巴结转移的相关因素分析中，T分期在对照组NST患者中存在显著的差异（P=0.006），在研究组则没有显著差异（P=0.872），研究组淋巴结转移率与T分期、组织学分级及免疫组化指标尚未发现明确的差异性（P>0.05）。结论在原发性乳腺神经内分泌癌中，雌激素受体、孕激素受体阳性表达率高，HER-2 阳性表达率低，突触素阳性表达率较嗜铬素A高。虽然评估NEBC的预后标准尚有争议，但是仍然需要重视联合检测上述免疫组化指标及淋巴结状况。
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2019-03-11 Cooperative journals: 《协和医学杂志》
Abstract：随人口老龄化，乳腺癌的治疗需要面对更多的老年乳腺癌患者。近年来，乳腺癌的靶向治疗作为人表皮生长因子 2（HER2)阳性乳腺癌的全身治疗重要方法，在乳腺癌治疗中显示出越来越重要的地位。无心脏基础疾病的老年 HER2 阳性乳腺癌患者是否应使用曲妥珠单抗进行靶向治疗存在争议。目前证据表明60-70 岁老年 HER2 阳性乳癌患者可从曲妥珠单抗治疗中获益，心脏事件风险较低且可逆。70 岁以上目前无大规模试验证据支持。在选择辅助治疗方案是需平衡获益与风险，综合考虑患者本人意愿，身体状况，合并疾病情况，进行个体化治疗，如选择使用曲妥珠单抗，需避免与蒽环类化疗药物联用，并监测心功能，及时发现和处理心脏事件。
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2018-10-26 Cooperative journals: 《协和医学杂志》
Abstract：目的 探讨孕激素受体（PR）及 Ki-67 指数组合在激素受体阳性腋窝淋巴结阴性中分化乳腺癌的预后评估中的价值。方法 收集 389 例行 21 基因检测的中分化早期乳腺癌患者的临床病理资料，根据 21 基因复发风险评分（RS）将患者分为低危组（247 例）、中危组（115 例）和高危组（27 例），分析 PR 及 Ki-67 指数组合与 21 基因 RS 的相关性，比较两者在预后评估中的价值。 结果 按照 PR 表达及 Ki-67 指数将 389 例患者分为 PK 低危组（PR≥10%且 ki-67≤20%）248 例（63.8%），PK 中危组（非高危及低危组） 125 例（32.1%）及PK 高危组（PR＜10%且 ki-67＞20%）16 例（4.1%）。PK 组合对 RS 低危组和高危组的预测敏感性分别为 75.3%和 37.0%，阳性预测值分别为 75.0%和 62.5%，不一致性为 0.4%和 6.3%。中位随访 40 个月的结果显示，PK 低危、中危及高危组的总事件发生率分别为 3.6%、7.2%和12.5%，RS 低、中、高危组的总事件发生率为 3.2%、8.7%及 7.4%，两者 具有可比性。 结论 针对激素受体阳性腋窝淋巴结阴性中分化乳腺癌的 PR 与 Ki-67 组合具有与 21 基因 RS 相当的预后评估价值。
Subjects: Medicine, Pharmacy >> Preclinical Medicine submitted time 2018-06-14 Cooperative journals: 《协和医学杂志》
Abstract： Menopausal hormone therapy(MHT) is the medical treatment that mitigates menopausal symp-toms with administration of supplementary sexual hormones. Estrogen and progesterone are often involved in MHT.Experts from The Department of Gynecologic Endocrine and Breast Surgery have paid special attention to the risk of breast carcinoma related to MHT and reached consensuses on the following issues:MHT increases the risk of breast carcinoma;decision should be made after a careful and comprehensive assessment of the risk of breast carcinoma and the potential benefit of MHT. Since the administration of MHT has a window period，a thorough discussion with patients is essential to fully inform the indication and contraindication of MHT，and an informed consent should be obtained. There are still controversies over the risk of breast carcinoma with natural progesterone，tibolone，and single estrogen.
Subjects: Medicine, Pharmacy >> Preclinical Medicine submitted time 2018-06-14 Cooperative journals: 《协和医学杂志》
Abstract：本文分析并总结了北京协和医院乳腺外科诊治的 ２ 例乳腺恶性孤立性纤维性肿瘤 ( ｓｏｌｉｔａｒｙ ｆｉｂｒｏｕｓ ｔｕｍｏｒꎬＳＦＴ) 的临床及病理特点ꎮ ２ 例患者均以乳腺巨大肿物为主要表现ꎬ 行乳腺肿物局部扩大切除术治疗ꎬ 未处理患侧腋窝淋巴组织ꎻ 术后病理提示 ＣＤ３４ ( ＋) 、 Ｓ￣ １００ ( －)ꎬ 符合 ＳＦＴ 免疫组织化学检测特点ꎻ 因肿瘤细胞存在多形性及高核分裂相ꎬ故诊断为恶性 ＳＦＴꎮ 术后均未行辅助治疗ꎬ １ 例患者于术后 ６ 个月出现局部复发ꎬ 目前均无远处转移表现ꎮ 乳腺原发恶性ＳＦＴ 需病理明确诊断ꎬ 乳腺肿物局部扩大切除或患侧乳腺单纯切除是主要治疗手段ꎬ 目前无明确证据表明腋窝淋巴结清扫及辅助放化疗可延长患者生存期。
Subjects: Medicine, Pharmacy >> Preclinical Medicine submitted time 2018-06-14 Cooperative journals: 《协和医学杂志》
Abstract： Objection:To investigate the clinical and pathological features and the follow-ups of 173 patients with pathological nipple discharge,and to provide the evidence of diagnosis and treatment.Methods:We reviewed the data of the patients who suffered pathological nipple discharge and as well underwent surgery in 2015.Statistical analysis was conducted by spss 22.0.T test and Mann-Whitney U test,X2 test and Fisher exact test were engaged in mean comparision,comparision of count data.Result: There were no statistically significant difference in age，unilateral/ bilateral， single/multiple symptoms, duration of symptoms, positive findings of physical examination and Mammography between patients with bloody nipple discharge or not. Ultrasound revealed more positive findings in patients with bloody nipple discharge (P=0.016). Compared with unbloody discharge ,patients with bloody discharge showed higher rate of breast cancer(P=0.048).Among patients with bloody discharge, ages were significantly different between patients with and without breast cancer (P= 0.014) .Other factors showed no difference.Overall, no local or systemic recurrence or death was observed at a median follow-up of 17months. Conclusion: Bloody nipple discharge showed more risk of breast cancer, especially for the elder patients. Ultrasound revealed more lumps than physical examination and mammography. Since the examinations could not find the malignant lesions out of the symptoms of nipple discharge, surgery was always needed.
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