Most patients with hepatocellular carcinoma (HCC) are diagnosed when the disease is already at an advanced stage, so they are not eligible for resection and their prognosis is poor. The combination of transarterial chemoembolization (TACE) with immune checkpoint inhibitors or tyrosine kinase inhibitors can improve unresectable HCC to the point that patients can be treated with surgery. Here we describe two cases of such “conversion therapy”. One patient was a 52-year-old man in Child-Pugh class A with treatment-naive HCC whose 11.3-cm tumor had invaded the middle hepatic vein and right branch of the portal vein. He was treated with TACE plus camrelizumab, and radical resection was performed 3 months later. No evidence of recurrence was observed during 5-month follow-up. The other patient was a 42-year-old man in Child-Pugh class A with HCC involving a 11.4-cm tumor and severe liver cirrhosis. The patient was treated with TACE and lenvatinib, but the embolic effect after one month was unsatisfactory, so the regional treatment was changed to hepatic artery infusion chemotherapy and transcatheter arterial embolization. Radical resection was performed 2 months later, and no recurrence was evident at 1-month follow-up. These cases demonstrate two conversion therapies that may allow patients with initially unresectable HCC to benefit from resection.
Ordinary cement is not environmentally friendly, has high cost and lacks superior performance. Many scholars use various admixtures to adjust the properties of cement slurry, but admixtures are usually not environmentally friendly, and it is difficult to ensure that the properties after deployment meet engineering requirements. In this study, a variety of admixtures were obtained using the environmental protection method, and the optimal mixing ratio was analyzed by combining the entropy weight method and the Taguchi grey relational analysis method. The developed cement slurry was compared with conventional slurry from both macroscopic and microscopic aspects. Aiming at the problem that previous scholars lacked the engineering feasibility verification of the developed slurry, this study combined the constitutive equation regression analysis method, discrete element numerical simulation and other methods to study various actual engineering conditions. The results show that the optimal mix ratio of silica fume cement slurry has good permeability characteristics under the conditions of different roughness, grouting pressure and confining pressure. At the same time, under different geological temperatures and different erosive liquid states, the cement slurry stone body shows good properties of reinforcement materials.
Laboratory experiments on fluid flow through fracture are important in solving the fluid-in-rush problems that happen during the tunnel excavation. In order to study the mechanism of fluid flow through a rough-walled microfracture, fluid flow experiments were carried out and the fiber Bragg grating (FBG) strain sensors were applied to monitor the deformation of the microfracture surface during the seepage process. Considering the difficulty of collection of undisturbed rock samples from the deep locations, a methodology to simulate fluid flow through a fractured rock mass using analog materials containing a single fracture was developed. This method is easy to simulate the fluid flow through a fracture of certain aperture. Experimental data showed that Forchheimer equation could provide an excellent description of the nonlinear relationship between hydraulic gradient and flow velocity, and the variations of Forchheimer coefficients with joint roughness coefficient (JRC) were studied. It was found that the deformation of the microfracture surface subjected to seepage could be accurately captured by the quasi-distributed FBG strain sensors. The test results also demonstrated that the surface strain is significantly affected by hydraulic pressure.
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