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Introduction: Current radiologic and endoscopic studies for pancreatic cystic lesions have known poor sensitivity and accuracy for distinguishing any particular cystic lesion. The current case describes the use of two novel EUS-guided tools for the diagnosis and management of a large, symptomatic pancreatic cyst. Case Description: 30 year old female with prior history of pancreatitis presented with left upper quadrant abdominal pain. MRCP revealed a large 28 mm x 39 mm unilocular cyst in the tail of the pancreas. Based on the history, the possibility of a pancreatic pseudocyst was raised. However, given the patient's young age and female gender, as well as the cyst morphology and location, a clinical suspicion was raised for a possible mucinous cystic neoplasm (MCN). Given the diagnostic uncertainty, and the vast differences in management of these lesions, the decision was made to perform further diagnostic testing to help guide management. EUS evaluation with multimodality sampling was performed. nCLE imaging revealed multiple thickened epithelial bands lining the cyst wall. Four biopsies were then obtained using the MFB. Following this, FNA was performed. Seventeen ml of dark brown watery fluid was obtained. Cyst fluid analysis demonstrated glucose 1,500 ng/ml, amylase 11,859 u/L. Cytology revealed foamy macrophages and a few clusters of bland glandular cells. MFB pathology yielded tissue with ovarian-like stroma with mucinproducing epithelial lining consistent with an MCN. The patient was referred for a distal pancreatectomy. Final surgical pathology revealed the cyst wall to be lined by flat cuboidal epithelium and ovarian-type stroma without cytologic atypia, papillary architecture or epithelial proliferation. Final diagnosis favored an endometrial cyst of the pancreas over an atypical MCN. The patient had resolution of her symptoms following surgery. Discussion: Standard EUS-FNA and cyst fluid analysis are suboptimal in their ability to make a cytopathologic diagnosis of a pancreatic cyst. In the current case, standard biochemical fluid analysis produced conflicting results showing both an elevated cyst fluid CEA and amylase, and thus unable to distinguish an inflammatory pseudocyst from a neoplastic or non-inflammatory cystic lesion. Cyst fluid cytology was similarly non-diagnostic. However, the combined use of EUS-guided nCLE and MFB produced highly detailed diagnostic information allowing for appropriate management. Watch the video: https://goo.gl/XkPkfy

The usage of manufactured sand concrete is widespread in modern engineering, and it is important to study its performance to improve the overall engineering quality. This paper presents an experimental study on the working performance and durability of 12 groups of manufactured sand high-performance concrete (MSHPC) with varying mix ratios, in the context of the construction of the Dalian Bay undersea immersed tube tunnel. The study reveals that the stone powder content significantly affects the physical and mechanical properties, as well as the durability, of manufactured sand concrete. At an approximately 9% stone powder content, the concrete achieves the highest slump and best workability. However, excessive stone powder reduces early crack resistance. Furthermore, an optimal stone powder content (ranging from 5% to 13%) enhances the compressive strength, with the 28-day compressive strength reaching 60 MPa at a 13% stone powder content, while the effect on the splitting tensile strength is negligible. The stone powder content does not significantly impact impermeability and frost resistance, but at 7–9%, the RCM method shows the lowest chloride ion diffusion coefficient. Additionally, a lower water–binder ratio enhances resistance to chloride ion diffusion. High-performance RCM concrete with a 9% stone powder content was used in the construction of the Dalian Bay Cross-Harbor Tunnel, achieving 28-day and 56-day compressive strengths of C45 and C50, respectively, an impermeability grade of P14, a chloride ion diffusion coefficient of 1.9 × 10−12 m2/s, and a frost durability index of 92%, meeting the project’s 100-year lifespan design requirements.

Electric discharge phenomenon is often observed during the passage of sandstorms over desert regions and sometimes does great damage to human beings. Based on previous researches on the electrification of sandstorms by the scholars both at home and aboard, the authors conducted the simulation experiments on the electric fields of sandstorm-triggered creeping-saltating sand, suspending sand and watered suspending sand in the large-scale wind tunnel. According to the experimental results the electric field structure and its formation mecha-nism were analysed and discussed, the quantity of electric charges and electric field strength were measured and calculated, and finally several conclusions were drawn.