The novel coarse-mesh CFD tool Subchannel-CFD (SubChCFD) is coupled with the Monte Carlo transport code Serpent using a segregated multi-physics coupling algorithm. The multi-physics model is validated using the CASL VERA Core Physics Benchmark Progression Problem #6, showing good agreement of pin powers and exit coolant temperatures. The model is also used to simulate an assembly from the K-SMR soluble-boron-free small modular reactor, which shows good agreement with a full-scale CFD model from the software STAR-CCM+, with the exception of a small gap region between two large control rod guide tube and burnable poison rods, which induces a periodic flow instability that SubChCFD cannot fully replicate. Nevertheless, the oscillatory characteristics of the instabilities modelled by both codes show some similarity.

Ring-oscillator (RO)-based digital PLLs (DPLLs) are well-suited for multi-PLL -integrated SoC designs owing to their compactness and immunity to magnetic coupling. However, their inferior phase noise (PN) limits their utilization in low-jitter applications. To tackle this, both the quantization noise (Q-noise) and RO PN $(\mathsf{PN}_{\mathsf{R}0})$ need to be well suppressed. Previous techniques reported in the literature to address these limitations are often prone to process, voltage, and temperature (PVT) variations or are energy inefficient. Figure 19.1.1 reviews popular PN-quantization and $\mathsf{PN}_{\mathsf{R}0}$ -suppression schemes. The classic time-to-digital-converter (TDC) scheme suffers from high Q-noise due to the technology-limited delay (T) and simultaneously hig $\mathsf{h} \ T$ variation over PVT, thus significantly compromising the PN performance and loop stability. Alternatively, the optimal-threshold-TDC (OT-TDC) scheme [1], [2] can achieve ultra-low Q-noise, which in turn necessitates a statistical-based background calibration for threshold delays $(+T_{\mathsf{U}}$ and $-T_{\mathrm{L}})$. Similarly, for the $\mathsf{PN}_{\mathsf{R}0}$ suppression, the fast phase-error correction (FPEC) [1], [2] is as effective as the phase realignment. However, its phase-correction gain (K-gain) requires correlation-based background calibration. The cascaded RO-PLL [3] offers a PVT-stable $\mathsf{PN}_{\mathsf{R}02}$ suppression but relies on a high-frequency and low-PN PLL 1 with a power-consuming R01. This work presents a low-jitter fractional-N cascaded RO-DPLL that leverages the time-to-voltage converter (TVC) and analog-to-digital converter (ADC) to retain a PVT-robust and low-Q-noise PN quantization. It simultaneously facilitates a voltage-domain feedforward noise cancellation (V-FFNC), removing the need for gain calibration and consuming low power. A self-reference-generation scheme enables a fast restoration of the cancellation gain of a delta-sigma-modulator (DSM) Q-noise during the fractional-frequency-control word $(\mathsf{FCW}_{\mathsf{F}})$ transitions. The prototype RO-DPLL achieves 290.8fs rms jitter and -62dBc worst fractional spurs at an output frequency near 5.5GHz. With -20-to-1 OO°C-temperature and $\pm$ 5%-supply-voltage $(V_{\mathsf{DD}})$ variations, the measured jitter deviations remain within 7.5%.

T-junctions are critical components within the primary circuit of pressurised water reactors (PWRs). They connect the pressuriser (PRZ), with the steam generator (SG), and the reactor pressure vessel (RPV). As such, it is crucial to have a mechanistic understanding of the turbulent fluid flow and thermal mixing within such T-junctions. Computational fluid dynamics (CFD) studies of flows within T-junctions usually involve understanding the effects of variations in momentum and Reynolds numbers on the turbulent flow structures and thermal mixing phenomena. In this paper, we utilise proper orthogonal decomposition (POD) and spectral proper orthogonal decomposition (SPOD) methods to analyse the complex flow structures arising from various test cases for a PWR T-junction with an upstream elbow.The first aim is to compare the flow structures resulting from different momentum ratios and/or Reynolds numbers of the inlet branch flow to identify the dominant factor. These parameters are adjusted by varying the branch pipe diameter and inlet branch velocity. The final aim is to compare flow structures obtained using POD and SPOD analysis. While both methods produce explicable patterns, they reveal vastly different structures that can be interpreted differently.Momentum ratios have traditionally guided engineering design optimization. Our findings indicate that altering the Reynolds number of the inlet branch flow can help avoid turbulent flow structures that may compromise the structural integrity of nuclear components in NPPs. While POD is widely used for fluid flow analysis, SPOD offers a more detailed examination of turbulent fluid flow structures.

In this paper, we introduce an efficient sparse Gaussian process (E-SGP) for the surrogate modelling of fluid mechanics. This novel Bayesian machine learning algorithm allows efficient model training using databases of different structures. It is a further development of the approximated sparse GP algorithm, combining the concept of efficient GP (E-GP) and variational energy free sparse Gaussian process (VEF-SGP). The developed E-SGP approach exploits the arbitrariness of inducing points and the monotonically increasing nature of the objective function with respect to the number of inducing points in VEF-SGP. By specifying the inducing points on the orthogonal grid/input subspace and using the Kronecker product, E-SGP significantly improves computational efficiency without imposing any constraints on the covariance matrix or increasing the number of parameters that need to be optimised during training. The E-SGP algorithm developed in this paper outperforms E-GP not only in scalability but also in model quality in terms of mean standardized logarithmic loss (MSLL). The computational complexity of E-GP suffers from the cubic growth regarding the growing structured training database. However, E-SGP maintains computational efficiency whilst the resolution of the model, (i.e., the number of inducing points) remains fixed. The examples show that E-SGP produces more accurate predictions in comparison with E-GP when the model resolutions are similar in both. E-GP benefits from more training data but comes with higher computational demands, while E-SGP achieves a comparable level of accuracy but is more computationally efficient, making E-SGP a potentially preferable choice for fluid mechanic problems. Furthermore, E-SGP can produce more reasonable estimates of model uncertainty, whilst E-GP is more likely to produce over-confident predictions.

Bladder cancer (BC) exhibits diversity in clinical outcomes and is characterized by heterogeneity. Anoikis, a form of programmed cell death, plays a crucial role in facilitating tumor invasion and metastasis. This study comprehensively investigated the genetic landscape of BC progression, identifying 300 differentially expressed Anoikis-related genes (DE-ARGs) through in-depth analysis of the GSE13507 datasets. Functional enrichment analysis revealed associations with diverse diseases and biological processes. Employing machine learning algorithms, a logistic regression model based on nine marker genes demonstrated superior accuracy in distinguishing BC from normal samples. Validation in TCGA datasets highlighted the prognostic significance of LRP1, FASN, and SIRT6, suggesting their potential as cancer biomarkers. Particularly, FASN emerged as an independent prognostic indicator, regulating BC cell proliferation and metastasis through the Wnt/β-catenin pathway. The study provides crucial insights into altered genetic landscapes and potential therapeutic strategies for BC, emphasizing the significance of FASN in BC prognosis and progression.

Aiming at the problems of incomplete extraction on candidate flame region, a video flame recognition method is proposed based on Gaussian mixture model with adaptive learning rate α (α-GMM) and weight kernel sparse representation. Firstly, a Gaussian mixture model (GMM) for foreground extraction is constructed. Its learning rate α is adjusted adaptively according to the complexity of background change, and candidate flame region is extracted completely by combining the color features in the HSI space. Secondly, dynamic and static features of the flame are extracted from the candidate region, and a feature dictionary is constructed. Finally, a weighted kernel sparse representation classification model based on Mahalanobis distance (MD) is established to implement flame recognition. The kernel function is adopted to solve the nonlinear distribution problem effectively. In order to strengthen the discrimination between classes and improve the flame recognition rate, MD is employed to measure the similarity information between data and construct the weight matrix. The experiment results show that the candidate flame region obtained by the proposed α-GMM is more complete, and the segmentation accuracy is higher. Compared with other classifiers, the accuracy of the proposed weight kernel sparse representation classifier is improved by 10.94% on average, and the false positive rate is reduced by 55.19% on average, which indicates that the proposed method has a higher recognition rate and strong robustness.

Introduction: Treatment of anterior cerebral artery (ACA) aneurysms is still not well established. The Leo stent with blood flow direction is a retrievable stent for intracranial aneurysms, whereas it needs to be studied clearly in patients with ACA aneurysms. Methods: Consecutive patients with ACA aneurysms were retrospectively enrolled in three neurosurgical centers between January 2016 and October 2021. The data on demographics, aneurysm characteristics, symptom resolution, and postoperative course were collected and analyzed. The aneurysm occlusion status was appraised by Raymond-Ray Occlusion Class (RROC). Results: A total of 57 patients with ACA aneurysms were included in our study. Immediate postprocedural angiograms showed that 20 aneurysms (35.1%) were in complete occlusion (RROC 1), 26 aneurysms (45.6%) were in near-complete occlusion (RROC 2), 11 aneurysms (19.3%) were in incomplete occlusion (RROC 3). The angiographic follow-up found that the rate of complete occlusion increased to 57.9%, and near-completion and incomplete occlusion dropped to 29.8% and 12.3%, respectively. The angiographic result of the last follow-up improved significantly (Z=- 2.805, P=0.005). Univariate analysis indicated that distal location of aneurysms (Z=4.538, P=0.033) and ruptured aneurysms (χ2=.6120, P=0.032) were potential risk factors for intra-parent artery narrowing. Furthermore, multivariate logistic regression analysis found that A3 aneurysms (95% CI 1.427~32.744, P=0.016) are the key risk factor for intra-parent artery narrowing. Conclusions: The Leo stent is safe and effective for aneurysms located in ACA circulations. The overall occlusion degree improved during follow-up. A distal, small artery was the risk factor for intra-parent artery narrowing.

Alkaline fuel cells can permit the adoption of platinum group metal-free (PGM-free) catalysts and cheap bipolar plates, thus further lowering the cost. With the exploration of PGM-free hydrogen oxidation reaction (HOR) catalysts, nickel-based compounds have been considered as the most promising HOR catalysts in alkali. Here we report an interfacial engineering through the formation of nickel-vanadium oxide (Ni/V2O3) heterostructures to activate Ni for efficient HOR catalysis in alkali. The strong electron transfer from Ni to V2O3 could modulate the electronic structure of Ni sites. The optimal Ni/V2O3 catalyst exhibits a high intrinsic activity of 0.038 mA cm-2 and outstanding stability. Experimental and theoretical studies reveal that Ni/V2O3 interface as the active sites can enable to optimize the hydrogen and hydroxyl bindings, as well as protect metallic Ni from extensive oxidation, thus achieving the notable activity and durability.

The integration of digital technologies is exhibiting an upward trend in Chinese enterprises, and the degree of corporate credit risk is directly proportional to their financial sustainability. Based on panel data of new energy enterprises from 2012 to 2020, this article makes an empirical study on the direct effect, mediating effect, and moderating effect of the digital economy (DE) on the new energy enterprises’ credit risk. It is found that the digital economy could significantly mitigate the credit risk of new energy enterprises by improving total factor productivity and amplifying the potential default cost. When the digital economy affects corporate credit risk, the development of the new energy industry acts as an intermediary, and knowledge spillover acts as a moderator. Furthermore, considering knowledge spillover as the threshold variable, the digital economy has a double-threshold effect. The marginal impact fluctuates from dropping to increasing as the knowledge spillover level increases. As for the region’s heterogeneity, the digital economy has benefited eastern China more than central and western China, possibly due to the differences in economic structure, capital intensity, and policy institutions. In view of these findings, this study provides a reference for China to mitigate corporate credit risk in the digital economy era.

Here, we reported a simple and rapid colorimetric assay for the quantification of Prorocentrum minimum that is named as aptamer-gold nanoparticles (GNPs) based colorimetric assay (AGBCA). The GNPs maintain a dispersed state and have a strong characteristic absorption peak at 520 nm due to the electrostatic repulsion force by absorbing negative citric acid anion. With the addition of NaCl, the stability of the solution will be destroyed and the dispersed GNPs will aggregate. Therefore, the maximum absorption peak of the GNPs solution will change from 520 nm to 670 nm. Aptamers can be adsorbed on the surface of GNPs, effectively preventing the aggregation of GNPs. In the presence of P. minimum, aptamers will specifically bind to P. minimum, causing the dissociation of the aptamers from GNPs. Consequently, the GNPs without aptamers will aggregate in the NaCl solution, corresponding to a new absorption peak at 670 nm. The linear range was from 1 × 102 cells mL−1 to 1 × 107 cells mL−1, with a low detection limit of 8 cells mL−1. The developed AGBCA is characterized by simplicity, rapidity, strong specificity, and high sensitivity and is thus promising for the quantitative detection of P. minimum in natural samples.

Technological innovation, the financial market, and the real economy are mutually promoting and restricting. Considering the interference of market-noise information, this paper applies the wavelet-denoising method of the soft- and hard-threshold compromise functions to process the original information so as to eliminate the noise information, and combines multifractal detrended cross-correlation analysis with the sliding-window approach, focusing on the change in the Hurst index and the parameter change in the multifractal spectrum to explore the interaction in between. The research results show that there is a certain cross-correlation among technological-innovation, financial-market, and real-economy indices. Firstly, the cross-correlation among them has significant multifractal characteristics rather than single-fractal characteristics. Secondly, the fractal characteristics reveal the long memory of the interaction among the three indices. Thirdly, there are also obvious differences in the degree of local chaos and volatility of the interaction. Fourthly, the cross-correlation among technological-innovation, financial-market, and real-economy indices has significant multifractal characteristics rather than single-fractal characteristics. In comparison, the cross-correlation multifractal characteristics among technological innovation, the financial market, and the real economy are time-varying, and the cross-correlation multifractal characteristics between the technological-innovation index and the real-economy index are the most obvious.

IntroductionMoyamoya disease (MMD) is associated with a risk of postoperative cerebral hyperperfusion syndrome (CHS) after revascularization surgery. This study aimed to explore the feasibility of using three-dimensional pulsed arterial spin labeling (3D PASL) and phase contrast (PC) magnetic resonance imaging (MRI) for predicting CHS occurrence in patients with MMD before revascularization surgery.MethodsOverall, 191 adult patients (207 hemispheres) with MMD who underwent combined revascularization surgery were included in this study. Preoperative 3D PASL-MRI and PC-MRI were performed before surgery. The PASL-MRI data were analyzed using SPM12. Patient clinical information, average flow, and preoperative cerebral blood flow (CBF) were compared between the non-CHS and CHS groups.ResultsAmong the patients, 45 (21.74%) developed CHS after revascularization surgery. No significant differences were noted in age, sex, clinical symptoms, hypertension, diabetes, surgical side, or history of revascularization surgery between the non-CHS and CHS groups. However, the average flow in the superficial temporal artery was significantly lower in the CHS group than in the non-CHS group (p < 0.05). Furthermore, 11 clusters of preoperative CBF values were significantly greater in the CHS group than in the non-CHS group [p < 0.05, false discovery rate (FDR) corrected]. A significant correlation was also observed between the preoperative time-to-flight MR angiography (MRA) scores and CBF values in patients with MMD (p < 0.05).ConclusionCompare patients with lower preoperative CBF and higher preoperative average flow in the STA, patients with higher preoperative CBF and lower preoperative average flow in the STA are more likely to develop postoperative CHS Preoperative PASL-MRI and PC-MRI examinations may help to screen patients at high risk of developing CHS after revascularization surgery.

Chronic pelvic pain syndrome (CPPS) is generally defined as pain in the pelvic area that persisted for 3–6 months or longer. The pain can be constant or episodic and functionally disabling. Any dysfunction of the central nervous system can lead to central sensitization, which enhances and maintains pain as well as other symptoms that are mediated by the central nervous system. It occurs in subgroups of nearly every chronic pain condition and is characterized by multifocal pain and co-occurring somatic symptoms. Somatic symptom disorder (SSD) is defined as a condition in which having one or more somatic symptoms, such as excessive worries, pressure, and catastrophic events. These symptoms can be very disruptive to a patient’s life and can cause significant distress. SSD cases with severe symptoms frequently undergo repeated medical investigations and the symptoms often lead patients to seek emergency medical treatment and consult with specialists repeatedly, which is a source of frustration for patients and clinicians. Here we report a case that Asian female with persistent CPPS with comorbid SSD, who got in trouble for up to 8 years. This case reminds clinicians to pay excessive attention to the diagnosis of CPPS with comorbid SSD after recovery from acute COVID-19, with hope of raising awareness in the identification of SSD and present new insight into appropriate treatment for each woman who suffers from it.

The nanoscale Zero-Valent Iron (nZVI) is vulnerable to being oxidized and aggregated, which weakens its reactivity and hampers application potential, manganese sulfide (MnS) modification and biochar supporter could provide a new possibility for this issue. In this work, the nZVI was firstly anchored onto bagasse biochar and then vulcanized by MnS (MnS-nZVI@BC) to achieve low aggregation and preeminent removal capacity. The flaky nZVI was uniformly in-situ growth on the biochar's surface to construct flower-like gullies, of which the surface was covered with some amorphous MnS layer. The monolayer chemical reaction dominated the Cr(VI) removal process, and higher temperature benefited the redox reaction to enhance the prominent removal capacity at 405.10 mg/g at 318.15 K, and it was slightly promoted with the coexisting ions. The quadruplicity of redox, electrostatic attraction, adsorption, and co-deposition should be taken into consideration in the mechanism, in which MnS could not only enhance the reducibility from dominant contributor nZVI, but also directly participate in the redox reaction; and Fe(II) also played an important role in the process; whereafter, Fe(III) and Cr(III) form Cr(III)/Fe(III) hydroxide deposited on the surface of the material. Overall, the findings exhibited the great potential of MnS-nZVI@BC in wastewater treatment while also providing an alternative basis to reveal mecha-nisms involving versatile aspects.

This paper investigates the effects of different inlet flow profiles on thermal mixing within a T-junction using CFD simulations with the IDDES-SST turbulence model. The different combinations of inlet flow profiles are related to different stage in the flow entry region. The effects of the inlet flow profile on the mean and transient flow behaviour are assessed, while a spectral proper orthogonal decomposition and power spectral density analysis are performed to assess the underlying flow structures and the predominant frequency modes. It is found that the vortical structures associated with the horseshoe and hovering vortex systems consist of a single roll-up vortex for cases with uniformly distributed boundary conditions (BCs) at the branch inlet whereas a double roll-up vortex is observed for the other cases. The double roll-up vortex enhances the mixing locally due to the entrainment of fluid from the branch pipe in these vortical structures, which then results in a lower mean temperature distribution. The appearance of the secondary vortex pair and the nested vortices is delayed for cases with uniformly distributed BCs at the branch inlet, which again results in lower thermal mixing and consequently higher values of mean temperature when compared with the other cases. It is also found that the vorticity related to the counter-rotating vortex pair as well as to the second pair of vortices rotating in the opposite direction is higher for cases with uniformly distributed BCs at the branch inlet. Lastly, the combinations of inlet flow profiles lead to different coherent structures, and the dominant frequencies are of a Strouhal number of around 0.7 for uniformly distributed profiles at the branch inlet and in the range 0.4–0.5 for the other cases.

The performance degradation via sintering phenomenon is a critical issue for the application of supported nanoparticles in industrial catalysis. However, the challenges to combine in situ stimulation and three-dimensional (3D) characterization hinder a profound understanding of sintering behaviors, thus the effect of spatial location on nanoparticles sintering has long been neglected. Herein, based on a homemade holder integrated with in situ Joule heating and electron tomography, a quasi-four-dimensional (4D) transmission electron microscope characterization approach is developed to reveal the spatial location of supported nanoparticles and its pronounced impact on size distribution and sintering behaviors. The results of 3D visualization and statistical analysis demonstrate a strong location-dependent sintering behavior of supported nanoparticles, where external nanoparticles sinter via migration coalescence, and internal nanoparticles sinter via Ostwald ripening. The quasi-4D methods developed in this work can also be extended to the study on 3D configuration evolution of other nanomaterials under an external stimulus.

Objective To explore the feasibility of 2D phase-contrast MRI (PC-MRI) and intravoxel incoherent motion (IVIM) MRI to assess cerebrovascular hemodynamic changes after surgery in adult patients with moyamoya disease (MMD). Methods In total, 33 patients with MMD who underwent 2D PC-MRI and IVIM examinations before and after surgery were enrolled. Postsurgical changes in peak and average velocities, average flow, forward volume, and the area of superficial temporal (STA), internal carotid (ICA), external carotid (ECA), and vertebral (VA) arteries were evaluated. The microvascular perfusion status was compared between the hemorrhage and non-hemorrhage groups. Results The peak velocity, average flow, forward volume, area of both the ipsilateral STA and ECA, and average velocity of the ipsilateral STA were increased (p < 0.05). The average flow and forward volume of both the ipsilateral ICA and VA and the area of the ipsilateral VA were increased (p < 0.05). The peak velocity, average velocity, average flow and forward volume of the contralateral STA, and the area of the contralateral ICA and ECA were also increased (p < 0.05), whereas the area of the contralateral VA was decreased (p < 0.05). The rf value of the ipsilateral anterior cerebral artery (ACA) supply area was increased (p < 0.05) and more obvious in the non-hemorrhage group (p < 0.05). Conclusion Two-dimensional PC-MRI and IVIM may have the potential to non-invasively evaluate cerebrovascular hemodynamic changes after surgery in patients with MMD. An improvement in the microvascular perfusion status is more obvious in patients with ischemic MMD than in patients with hemorrhagic MMD.

Crack formation is inevitable on the surface of the cement-based material, considerably leading to shortening service life. A sustainable self-healing technique based on microbial induced calcite precipitate (MICP) is recognized as a promising solution to increase durability and prevent structural failure. This research investigated the potential of bleaching earth immobilized bacteria incorporated normal and glass fiber mortars to enhance autogenous crack-healing ability. The viability of immobilized bacteria in the cement slurry and the influence of self-healing agents on the mechanical strength of mortar were examined first. The crack healing efficiency was evaluated by comparing the recovery of watertightness, the crack width and area healing ratio. Experimental results showed that the permeability coefficient of the specimens with immobilized bacteria (77.4%-93.3%) decreased more than in those with free bacteria (10.1%-12.6%). The maximum crack width healed and fracture area repair ratio were 0.44 mm and 96%, respectively. The crack healing compounds was calcite crystals with dense accumulation according to X-ray diffraction and scanning electron microscopy. This crack healing method from inside to outside has important guiding significance for the sustainable development of cement-based materials.

Background and purposeThe treatment of aneurysms located in the posterior and distal anterior circulations remains a challenge. Leo stents with a flow diversion (FD) effect may be a potential option, which needs to be clearly studied.MethodsFrom January 2016 to October 2021, 133 patients with 145 aneurysms in the posterior and distal anterior circulations, treated with Leo stents, were retrospectively analyzed in three neurosurgical centers. Data on demographic information, aneurysm characteristics, procedural outcomes, postoperative course, and aneurysm occlusion were retrospectively analyzed.ResultsAfter immediate surgery, 90 aneurysms (60.1%) were in complete occlusion [Raymond-Ray Occlusion Class (RROC) 1 and O'Kelly Marotta (OKM) grade D], 29 aneurysms (20%) in good occlusion (RROC 2 and OKM grade C), 17.9% in incomplete occlusion (RROC 3a or OKM grade B), and no aneurysms in invalid occlusion (RROC 3b and OKM grade A). A total of 112 patients with 117 aneurysms received angiographic follow-up (mean 11.4 months), and the degree of occlusion showed a significant improvement (Z = 3.900, p < 0.001). The complete occlusion rate increased to 84.6% (99/117), while good and incomplete occlusion decreased to 6.8% (8/117) and 8.6% (10/117), respectively. A total of 14 cases (10.5%) presented narrowing of the parent artery, and nine cases (6.8%) had injured side branches. Cerebral hemorrhage occurred in four patients (3.0%), and symptomatic ischemic infarction occurred in six patients (4.5%). The final permanent morbidity (mCS ≥3) and mortality were 2.8% (3/133) and 0.8% (1/133), respectively. For 82 aneurysms treated by stent-assisted with coiling (SAC), large-sized, ruptured aneurysms (χ2 = 7.767, p = 0.005) occurred. For 63 aneurysms treated by LEO stent monotherapy (LSM), multiple aneurysms, fusiform aneurysms (χ2 = 18.958, p < 0.01), and/or small-sized aneurysms (Z = −2.692, p = 0.007) occurred.ConclusionsLeo stents are safe and effective for aneurysms located in the posterior and distal anterior circulations. The overall degree of occlusion improved during a follow-up because of the FD effect of Leo stents. Aneurysms in these areas should be treated with personalized measures.

Rhabdomyosarcoma (RMS) is a soft tissue tumor, which is the most common in the head, neck, limbs, and trunk. RMS originating from the epididymis is extremely rare. Herein, we reported a 34-year-old patient with RMS on the right epididymis. For this case, right epididymal mass resection was performed and intraoperative freezing suggested a malignant tumor. Right testicular radical resection was subsequently adopted, with right epididymal alveolar RMS being pathologically diagnosed. Alternating VAC/VI chemotherapy was given after surgery, and tumor recurrence has not been found so far.