The rapid development of additive manufacturing technology provides a new opportunity for the fabrication and research of multi-layer lattice sandwich structures, and thereby some excellent performances can be further discovered. Based on the manufacturing-experiment-analysis technical route, the failure mode of the additive manufactured aluminum multi-layer alloy lattice sandwich structure under quasi-static compression is systematically studied in this paper. Through the combination of experimental observation and finite element analysis, the complex failure mechanism of the multi-layer lattice sandwich structure is revealed. The results show that the multi-layer lattice sandwich structure under quasi-static compression conditions mainly manifests as a layer-by-layer failure mode of the internal lattice structure, which includes the yield, plastic buckling and material damage. At the same time, in comparison with the force–displacement curve and the structural deformation in the key locations, the analysis accuracy of the finite element model can be verified by the compression experiment. Based on the verified finite element model, the most significant influence of different face panel thicknesses, as well the rod radiuses and tilting angles on the energy absorption (EA) is identified via sensitivity analysis. Furthermore, size factors on the structural EA are revealed. This study can provide a helpful guidance for the design of multi-layer lattice sandwich structures in practical applications.
Objective
To investigate the effect of acute normovolemic hemodilution on long-term prognosis of oral squamous cell carcinoma (OSCC) patients after tumor resection and flap reconstruction.
Methods
This study retrospectively analyzed follow-up data for 371 OSCC patients who underwent tumor resection and flap reconstruction for the first time at our hospital from January 1, 2015, to December 31, 2020. The patients were split into three groups: no blood transfusion (NBT), acute normovolemic hemodilution (ANH), and allogeneic blood transfusion (ABT). Measurement data were analyzed by ANOVA and enumeration data by χ2 tests. Survival analysis with the Cox model was used to confirm independent prognostic factors. Disease-free (DFS) and overall (OS) survival were calculated by the life table method and K-M curve.
Results
The ANH group had a 0.523-fold higher risk of recurrence than the NBT group (P = 0.010). The ABT group had a 1.844-fold higher risk of death than the NBT group (P = 0.033). Among those with lymph node metastasis, the ANH group had a lower risk of recurrence, 0.436 times higher than the NBT group (P = 0.017), and the ABT group had a higher risk of death, 2.186 times higher than the NBT group (P = 0.032).
Conclusion
ANH can reduce immune system suppression by decreasing the amount of allogeneic blood to reduce tumor recurrence and risk of tumor-specific death, and this result is more prominent in OSCC patients with lymph node metastasis.
Clinical relevance
Preoperative ANH can effectively reduce the recurrence rate of patients with OSCC.
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