This article,empowered by ChatGPT and through retrieving relevant historical literature,explores how the translator Sun Yat-sen flexibly employed strategies like domestication and foreignization,as well as methods lik...This article,empowered by ChatGPT and through retrieving relevant historical literature,explores how the translator Sun Yat-sen flexibly employed strategies like domestication and foreignization,as well as methods like omission,addition,and modification in his translation of Ambulance Lectures:First Aid to the Injured.Additionally,the research highlights the use of ChatGPT as a tool to assist in the study.While ChatGPT is able to provide comprehensive knowledge quickly and proper translations,improvements are still needed in terms of image accuracy and citation generation.By providing specific context,probing for factual evidence,clarifying the reference objects,and narrowing the scope,prompts can be gradually refined for increasingly satisfactory outcomes.展开更多
Concentrating Solar Power(CSP)is one of the most promising solar technologies for sustainable power generation in countrieswith high solar potential,likeChad.Identifying suitable sites is of great importance for deplo...Concentrating Solar Power(CSP)is one of the most promising solar technologies for sustainable power generation in countrieswith high solar potential,likeChad.Identifying suitable sites is of great importance for deploying solar power plants.This work focuses on the identification of potential sites for the installation of solar power plants in Chad as well as a comparative analysis using the Analytical Hierarchy Process(AHP),Fuzzy Analytical Hierarchy Process(FAHP),and Full Consistency Method(FUCOM).The results show that 35%of the Chadian territory,i.e.,an area of 449,400 km2,is compatible with the implementation of Concentrating Solar Power.The North,North,East,Southeast,and East zones are the most suitable.The main criteria for influence are direct normal irradiation,the soil slope,and the water resource.FUCOM gave a weight of 41.9%for Direct Normal Irradiation(DNI)compared to 32.71%and 31.81%for AHP and FAHP.This method can be applied to other renewable energy technologies such as photovoltaics,wind power,and biomass.Combining its different analyses will be a valuable tool for planning any renewable energy project in Chad.This work should also facilitate the techno-economic analysis of future CSP plants in Chad.展开更多
BACKGROUND Congenital duodenal webs are rare in adults and can lead to various symptoms such as nausea,vomiting,and postprandial fullness.The treatment for this disease is mostly surgical.Endoscopic treatment techniqu...BACKGROUND Congenital duodenal webs are rare in adults and can lead to various symptoms such as nausea,vomiting,and postprandial fullness.The treatment for this disease is mostly surgical.Endoscopic treatment techniques have been developed and attempted for this disease.Endoscopic radial incision and cutting(RIC)techniques are reportedly very effective in benign anastomotic stricture.This case report highlights the effectiveness and safety of endoscopic RIC as a minimally invasive treatment for adult congenital duodenal webs.CASE SUMMARY A 23-year-old female patient with indigestion was referred to a tertiary hospital.The patient complained of postprandial fullness in the epigastric region.Previous physical examinations or blood tests indicated no abnormalities.Computed tomography revealed an eccentric broad-based delayed-enhancing mass-like lesion in the second portion of the duodenum.Endoscopy showed an enlarged gastric cavity and a significantly dilated duodenal bulb;a very small hole was observed in the distal part of the second portion,and scope passage was not possible.Gastrografin upper gastrointestinal series was performed,revealing an intraduodenal barium contrast-filled sac with a curvilinear narrow radiolucent rim,a typical"windsock"sign.Endoscopic RIC was performed on the duodenal web.The patient recovered uneventfully.Follow-up endoscopy showed a patent duodenal lumen without any residual stenosis.The patient reported complete resolution of symptoms at the 18-month follow-up.CONCLUSION Endoscopic RIC may be an effective treatment for congenital duodenal webs in adults.展开更多
BACKGROUND Severe skeletal class II malocclusion is the indication for combined orthodontic and orthognathic treatment.CASE SUMMARY A woman with a chief complaint of a protruding chin and an inability to close her lip...BACKGROUND Severe skeletal class II malocclusion is the indication for combined orthodontic and orthognathic treatment.CASE SUMMARY A woman with a chief complaint of a protruding chin and an inability to close her lips requested orthodontic camouflage.The treatment plan consisted of extracting the right upper third molar,right lower third molar,left lower second molar,and left upper third molar and moving the maxillary dentition distally using a convenient method involving microimplant nail anchors,push springs,long arm traction hooks,and elastic traction chains.After 52 months of treatment,her overbite and overjet were normal,and her facial profile was favorable.CONCLUSION This method can be used for distal movement of the maxillary dentition and to correct severe skeletal class II malocclusion in adults.展开更多
Purpose:To analyze the role of the seminar teaching method+case-based learning(CBL)teaching method+problem-based learning(PBL)teaching method in oral clinical nursing teaching.Methods:13 undergraduate nursing students...Purpose:To analyze the role of the seminar teaching method+case-based learning(CBL)teaching method+problem-based learning(PBL)teaching method in oral clinical nursing teaching.Methods:13 undergraduate nursing students who entered the department from September 2020 to September 2021 were selected as the control group,adopting conventional nursing teaching methods;13 undergraduate nursing students who entered the department from September 2021 to August 2022 were selected as the observation group,adopting the seminar+CBL+PBL teaching method.The teaching effects were compared between the two groups.Results:All assessment scores of the observation group were higher than those of the control group;all teaching satisfaction levels were higher than those of the control group(P<0.05).Conclusion:Adopting the seminar+CBL+PBL teaching method during oral clinical nursing teaching can improve nursing students’assessment scores,strengthen their core competencies,and enhance teaching satisfaction.展开更多
BACKGROUND Combined spinal-epidural(CSE)anesthesia is the preferred anesthesia method for cesarean delivery.The use of an epidural catheter is essential for administering additional drugs intraoperatively and managing...BACKGROUND Combined spinal-epidural(CSE)anesthesia is the preferred anesthesia method for cesarean delivery.The use of an epidural catheter is essential for administering additional drugs intraoperatively and managing postoperative pain.However,the insertion of epidural catheters is associated with various complications,such as total spinal anesthesia,symptoms indicative of spinal nerve root irritation,and challenges in epidural catheter removal.CASE SUMMARY We present a case report of a challenging epidural catheter removal due to knotting.The lumbar computed tomography scan results revealed that the catheter formed a tight knot in the epidural space.We used a novel extubation method and successfully removed the catheter.CONCLUSION The operator can use opposite forces to"spiral"apart the spinal joints by positioning the patient's body in a specific position.The findings indicate that,when combined with imaging examination results,this method is effective for the removal of epidural catheters.展开更多
In this paper,the multi-body coupled dynamic characteristics of a semisubmersible platform and an HYSY 229 barge were investigated.First,coupled hydrodynamic analysis of the HYSY 229 barge and the semisubmersible plat...In this paper,the multi-body coupled dynamic characteristics of a semisubmersible platform and an HYSY 229 barge were investigated.First,coupled hydrodynamic analysis of the HYSY 229 barge and the semisubmersible platform was performed.Relevant hydrodynamic parameters were obtained using the retardation function method of three-dimensional frequency-domain potential flow theory.The results of the hydrodynamic analysis were highly consistent with the test findings,verifying the accuracy of the multifloating hydrodynamic coupling analysis,and key hydrodynamic parameters were solved for different water depths and the coupling effect.According to the obtained results,the hydrodynamic influence was the largest in shallow waters when the coupling effect was considered.Furthermore,the coupled motion equation combined with viscous damping,fender system,and mooring system was established,and the hydrodynamics,floating body motion,and dynamic response of the fender system were analyzed.Motion analysis revealed good agreement among the surge,sway,and yaw motions of the two floating bodies.However,when the wave period reached 10 s,the motion of the two floating bodies showed severe shock,and a relative motion was also observed.Therefore,excessive constraints should be added between the two floating bodies during construction to ensure construction safety.The numerical analysis and model test results of the semisubmersible platform and HYSY 229 barge at a water depth of 42 m and sea conditions of 0°,45°,and 90° were in good agreement,and the error was less than 5%.The maximum movement of the HYSY 229 barge reached 2.61 m in the sway direction,whereas that of the semisubmersible platform was 2.11 m.During construction,excessive constraints should be added between the two floating bodies to limit their relative movement and ensure construction safety.展开更多
Objective:To investigate the effect of using audible thinking combined with the case teaching method in the teaching of nursing checkups for regulation nurses.Methods:The period was April 2023–April 2024,and a random...Objective:To investigate the effect of using audible thinking combined with the case teaching method in the teaching of nursing checkups for regulation nurses.Methods:The period was April 2023–April 2024,and a randomized controlled group study was carried out in which 76 regulation nurses in our hospital were randomly divided into a research group and a control group,with 38 regulation nurses in each group.The control group used conventional teaching methods,and the research group used audible thinking combined with the case teaching method,comparing the two groups’independent learning ability scores,assessment scores,and teaching satisfaction.Results:Independent learning ability score:after teaching,the research group was significantly higher than the control group(P<0.05);Assessment results:the research group was considerably higher than the control group(P<0.05);Teaching satisfaction:the research group was significantly higher than the control group(P<0.05).Conclusion:The use of audible thinking combined with the case teaching method in the teaching of nursing room visits for trained nurses can improve independent learning ability and assessment results and increase teaching satisfaction.展开更多
BACKGROUND Tumoral calcinosis is a condition characterized by deposits of calcium phosphate crystals in extra-articular soft tissues,occurring in hemodialysis patients.Calcium phosphate crystals are mainly composed of...BACKGROUND Tumoral calcinosis is a condition characterized by deposits of calcium phosphate crystals in extra-articular soft tissues,occurring in hemodialysis patients.Calcium phosphate crystals are mainly composed of hydroxyapatite,which is highly infilt-rative to tissues,thus making complete resection difficult.An adjuvant method to remove or resolve the residual crystals during the operation is necessary.CASE SUMMARY A bicarbonate Ringer’s solution with bicarbonate ions(28 mEq/L)was used as the adjuvant.After resecting calcium phosphate deposits of tumoral calcinosis as much as possible,while filling with the solution,residual calcium phosphate deposits at the pseudocyst wall can be gently scraped by fingers or gauze in the operative field.A 49-year-old female undergoing hemodialysis for 15 years had swelling with calcium deposition for 2 years in the shoulders,bilateral hip joints,and the right foot.A shoulder lesion was resected,but the calcification remained and early re-deposition was observed.Considering the difficulty of a complete rection,we devised a bicarbonate dissolution method and excised the foot lesion.After resection of the calcified material,the residual calcified material was washed away with bicarbonate Ringer’s solution.CONCLUSION The bicarbonate dissolution method is a new,simple,and effective treatment for tumoral calcinosis in hemodialysis patients.展开更多
As China continues to develop its ecological civilization,it is crucial to quantitatively assess the ecological value to understand its potential impact on regional sustainable development.While previous studies have ...As China continues to develop its ecological civilization,it is crucial to quantitatively assess the ecological value to understand its potential impact on regional sustainable development.While previous studies have highlighted the importance of ecological value,they have not fully reflected the value of ecological restoration work or considered social costs and benefits,lacking a people-centered approach.Hence,this study analyzes the essence of ecological value from the perspective of sustainable development.By studying emblematic ecological restoration areas such as the Saihanba Mechanized Forest Farm in Chengde City,it aims to identify the significance of ecological restoration efforts in enhancing regional sustainable development capacity.The results underscore the necessity of comprehensively considering the value chain from ecological construction to ecological output,highlighting the value of ecological restoration in the ecological construction process as well as the well-being of people in the ecological output process.This approach assigns more economic and humanistic attributes to ecological value,thereby better serving the development of ecological restoration areas.展开更多
BACKGROUND Gallbladder neuroendocrine carcinoma(NEC)represents a subtype of gallbladder malignancies characterized by a low incidence,aggressive nature,and poor prognosis.Despite its clinical severity,the genetic alte...BACKGROUND Gallbladder neuroendocrine carcinoma(NEC)represents a subtype of gallbladder malignancies characterized by a low incidence,aggressive nature,and poor prognosis.Despite its clinical severity,the genetic alterations,mechanisms,and signaling pathways underlying gallbladder NEC remain unclear.CASE SUMMARY This case study presents a rare instance of primary gallbladder NEC in a 73-year-old female patient,who underwent a radical cholecystectomy with hepatic hilar lymphadenectomy and resection of liver segments IV-B and V.Targeted gene sequencing and bioinformatics analysis tools,including STRING,GeneMANIA,Metascape,TRRUST,Sangerbox,cBioPortal and GSCA,were used to analyze the biological functions and features of mutated genes in gallbladder NEC.Twelve mutations(APC,ARID2,IFNA6,KEAP1,RB1,SMAD4,TP53,BTK,GATA1,GNAS,and PRDM3)were identified,and the tumor mutation burden was determined to be 9.52 muts/Mb via targeted gene sequencing.A protein-protein interaction network showed significant interactions among the twelve mutated genes.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses were used to assess mutation functions and pathways.The results revealed 40 tumor-related pathways.A key regulatory factor for gallbladder NEC-related genes was identified,and its biological functions and features were compared with those of gallbladder carcinoma.CONCLUSION Gallbladder NEC requires standardized treatment.Comparisons with other gallbladder carcinomas revealed clinical phenotypes,molecular alterations,functional characteristics,and enriched pathways.展开更多
The separation-of-variable(SOV)methods,such as the improved SOV method,the variational SOV method,and the extended SOV method,have been proposed by the present authors and coworkers to obtain the closed-form analytica...The separation-of-variable(SOV)methods,such as the improved SOV method,the variational SOV method,and the extended SOV method,have been proposed by the present authors and coworkers to obtain the closed-form analytical solutions for free vibration and eigenbuckling of rectangular plates and circular cylindrical shells.By taking the free vibration of rectangular thin plates as an example,this work presents the theoretical framework of the SOV methods in an instructive way,and the bisection–based solution procedures for a group of nonlinear eigenvalue equations.Besides,the explicit equations of nodal lines of the SOV methods are presented,and the relations of nodal line patterns and frequency orders are investigated.It is concluded that the highly accurate SOV methods have the same accuracy for all frequencies,the mode shapes about repeated frequencies can also be precisely captured,and the SOV methods do not have the problem of missing roots as well.展开更多
Objective This study reports the first imported case of Lassa fever(LF)in China.Laboratory detection and molecular epidemiological analysis of the Lassa virus(LASV)from this case offer valuable insights for the preven...Objective This study reports the first imported case of Lassa fever(LF)in China.Laboratory detection and molecular epidemiological analysis of the Lassa virus(LASV)from this case offer valuable insights for the prevention and control of LF.Methods Samples of cerebrospinal fluid(CSF),blood,urine,saliva,and environmental materials were collected from the patient and their close contacts for LASV nucleotide detection.Whole-genome sequencing was performed on positive samples to analyze the genetic characteristics of the virus.Results LASV was detected in the patient’s CSF,blood,and urine,while all samples from close contacts and the environment tested negative.The virus belongs to the lineage IV strain and shares the highest homology with strains from Sierra Leone.The variability in the glycoprotein complex(GPC)among different strains ranged from 3.9%to 15.1%,higher than previously reported for the seven known lineages.Amino acid mutation analysis revealed multiple mutations within the GPC immunogenic epitopes,increasing strain diversity and potentially impacting immune response.Conclusion The case was confirmed through nucleotide detection,with no evidence of secondary transmission or viral spread.The LASV strain identified belongs to lineage IV,with broader GPC variability than previously reported.Mutations in the immune-related sites of GPC may affect immune responses,necessitating heightened vigilance regarding the virus.展开更多
Objective:To analyze the feasibility of adopting a combined ladder and case teaching method in otolaryngology nursing teaching.Method:Nursing students in the otolaryngology department were selected.According to the ad...Objective:To analyze the feasibility of adopting a combined ladder and case teaching method in otolaryngology nursing teaching.Method:Nursing students in the otolaryngology department were selected.According to the admission time of nursing students,30 nursing students formed a control group(conventional nursing teaching),and 30 nursing students who were admitted later formed an observation group(ladder and case teaching method).The learning performance and teaching effectiveness of nursing students under different teaching methods were analyzed.Result:The academic performance and teaching effectiveness of the observation group were higher than those of the control group(P<0.05).Conclusion:The implementation of the ladder and case teaching method during the teaching of otolaryngology nursing significantly improved the student’s academic performance and teaching effectiveness.This method has great practical value.展开更多
BACKGROUND Hydroxyurea,an antimetabolite,is frequently prescribed for various hemato-logical disorders,and its common side effects include gastrointestinal problems,cutaneous or mucosal lesions and pyrexia/fever.CASE ...BACKGROUND Hydroxyurea,an antimetabolite,is frequently prescribed for various hemato-logical disorders,and its common side effects include gastrointestinal problems,cutaneous or mucosal lesions and pyrexia/fever.CASE SUMMARY This study reports the case of a 67-year-old woman who developed recurrent abdominal pain after 10 years of continuous hydroxyurea therapy for primary thrombocythemia.Colonoscopy revealed an ileocecal ulcer.After discontinuing hydroxyurea therapy for 6 months,follow-up colonoscopy showed a significant reduction in the ulceration.CONCLUSION We consider cecal ulcers as a rare complication of hydroxyurea therapy which typically resolves upon stopping the drug.展开更多
BACKGROUND Gallbladder cancer(GBC)is the most common and aggressive subtype of biliary tract cancer(BTC)and has a poor prognosis.A newly developed regimen of gemcitabine,cisplatin,and durvalumab shows promise for the ...BACKGROUND Gallbladder cancer(GBC)is the most common and aggressive subtype of biliary tract cancer(BTC)and has a poor prognosis.A newly developed regimen of gemcitabine,cisplatin,and durvalumab shows promise for the treatment of advanced BTC.However,the efficacy of this treatment for GBC remains unclear.CASE SUMMARY In this report,we present a case in which the triple-drug regimen exhibited marked effectiveness in treating locally advanced GBC,thus leading to a long-term survival benefit.A 68-year-old man was diagnosed with locally advanced GBC,which rendered him ineligible for curative surgery.Following three cycles of therapy,a partial response was observed.After one year of combined therapy,a clinical complete response was successfully achieved.Subsequent maintenance therapy with durvalumab monotherapy resulted in a disease-free survival of 9 months for the patient.The patient experienced tolerable toxicities of reversible grade 2 nausea and fatigue.Tolerable adverse events were observed in the patient throughout the entirety of the treatment.CONCLUSION The combination of gemcitabine and cisplatin chemotherapy with durvalumab was proven to be an effective treatment approach for advanced GBC,with manageable adverse events.Further research is warranted to substantiate the effectiveness of the combined regimen in the context of GBC.展开更多
BACKGROUND Thrombophilia contributes to a significant increased risk of venous thromboembolism and can be either inherited or acquired.Hereditary thrombophilia may arise from various gene mutations,some of which have ...BACKGROUND Thrombophilia contributes to a significant increased risk of venous thromboembolism and can be either inherited or acquired.Hereditary thrombophilia may arise from various gene mutations,some of which have not even been adequately reported or poorly understood.Previous studies reported a rare and novel missense mutation in the prothrombin gene(p.Arg596Gln),known as prothrombin Belgrade.The mechanisms and therapeutic strategies associated with prothrombin Belgrade mutation have not been fully elucidated.CASE SUMMARY We present the case of a 26-year-old woman with recurrent systemic thrombosis induced by prothrombin Belgrade mutation.The patient suffered from cerebral venous sinus thrombosis that rapidly progressed to systemic thrombosis,alongside a family history of cerebral thrombosis,and no traditional risk factors or abnormal coagulation function.Whole-genome sequencing detected a novel and rare heterozygous prothrombin missense mutation,c.1787G>T(p.Arg596Gln),which was responsible for the major etiology of the systemic thrombosis.CONCLUSION This case strengthens our understanding about hereditary basis of thrombophilia and provokes considerations for therapeutic options on prothrombin Belgrade mutation.展开更多
BACKGROUND The majority of published reports on foreign bodies(FBs)involve the rectum and applied a transanal retrieval.Usually,patients with FB above the rectum are subjected to laparotomy for removal.Here,we illustr...BACKGROUND The majority of published reports on foreign bodies(FBs)involve the rectum and applied a transanal retrieval.Usually,patients with FB above the rectum are subjected to laparotomy for removal.Here,we illustrate the case of a man with an FB that had migrated into the descending colon,and its successful removal via a laparoscopic approach.CASE SUMMARY A 43-year-old man,who had the habit of FB insertion into his anus to aid defe-cation,presented upon experience of such an FB slipping through and migrating upward to the distal colon.Plain abdominal radiograph revealed a bottle-shaped FB,positioned in the left iliac fossa region.The FB was successfully removed via a laparoscopic-assisted procedure in which we combined diagnostic laparoscopic and endoscopic techniques during surgery.The patient was monitored for 2 d postoperatively and subsequently discharged home.CONCLUSION A minimally invasive approach should be adopted to aid extraction of colorectal FB as it is effective and safe.展开更多
BACKGROUND Acute hyperglycemia due to insulin resistance is common in critically ill patients,typically managed with insulin infusion.However,the occurrence of transient extreme insulin resistance(EIR)requiring except...BACKGROUND Acute hyperglycemia due to insulin resistance is common in critically ill patients,typically managed with insulin infusion.However,the occurrence of transient extreme insulin resistance(EIR)requiring exceptional high-dose insulin is rare.CASE SUMMARY We present the case of a 68-year-old woman with pneumonia who suffered an out-of-hospital cardiac arrest,subsequently developing transient EIR following a new episode of sepsis.Remarkably,insulin resistance rapidly reversed when the insulin infusion rate peaked at 960 units/hour(a total of 18224 units on that day),and it was promptly titrated down to zero upon achieving the target glucose level.CONCLUSION Exceptional high-dose insulin infusion may be required in critically ill patients with stress-related EIR,which is typically transient.Clinicians should be aware of the phenomenon and cautious to avoid hypoglycemia and fluid overload during the steep titration of high-dose insulin infusion.展开更多
基金Research on AI Empowered Bilingual Language Asset Management and English Language Teaching Reform(24JG29)Research on the Digital Empowerment in Business English Major Reform and Innovation in the Context of Language Services(National Higher Education Institutions 202412583HN)Chinese Academic Translation Project of“C-E Translation of The Transformation of Rural China”(21WSHB004)。
文摘This article,empowered by ChatGPT and through retrieving relevant historical literature,explores how the translator Sun Yat-sen flexibly employed strategies like domestication and foreignization,as well as methods like omission,addition,and modification in his translation of Ambulance Lectures:First Aid to the Injured.Additionally,the research highlights the use of ChatGPT as a tool to assist in the study.While ChatGPT is able to provide comprehensive knowledge quickly and proper translations,improvements are still needed in terms of image accuracy and citation generation.By providing specific context,probing for factual evidence,clarifying the reference objects,and narrowing the scope,prompts can be gradually refined for increasingly satisfactory outcomes.
文摘Concentrating Solar Power(CSP)is one of the most promising solar technologies for sustainable power generation in countrieswith high solar potential,likeChad.Identifying suitable sites is of great importance for deploying solar power plants.This work focuses on the identification of potential sites for the installation of solar power plants in Chad as well as a comparative analysis using the Analytical Hierarchy Process(AHP),Fuzzy Analytical Hierarchy Process(FAHP),and Full Consistency Method(FUCOM).The results show that 35%of the Chadian territory,i.e.,an area of 449,400 km2,is compatible with the implementation of Concentrating Solar Power.The North,North,East,Southeast,and East zones are the most suitable.The main criteria for influence are direct normal irradiation,the soil slope,and the water resource.FUCOM gave a weight of 41.9%for Direct Normal Irradiation(DNI)compared to 32.71%and 31.81%for AHP and FAHP.This method can be applied to other renewable energy technologies such as photovoltaics,wind power,and biomass.Combining its different analyses will be a valuable tool for planning any renewable energy project in Chad.This work should also facilitate the techno-economic analysis of future CSP plants in Chad.
文摘BACKGROUND Congenital duodenal webs are rare in adults and can lead to various symptoms such as nausea,vomiting,and postprandial fullness.The treatment for this disease is mostly surgical.Endoscopic treatment techniques have been developed and attempted for this disease.Endoscopic radial incision and cutting(RIC)techniques are reportedly very effective in benign anastomotic stricture.This case report highlights the effectiveness and safety of endoscopic RIC as a minimally invasive treatment for adult congenital duodenal webs.CASE SUMMARY A 23-year-old female patient with indigestion was referred to a tertiary hospital.The patient complained of postprandial fullness in the epigastric region.Previous physical examinations or blood tests indicated no abnormalities.Computed tomography revealed an eccentric broad-based delayed-enhancing mass-like lesion in the second portion of the duodenum.Endoscopy showed an enlarged gastric cavity and a significantly dilated duodenal bulb;a very small hole was observed in the distal part of the second portion,and scope passage was not possible.Gastrografin upper gastrointestinal series was performed,revealing an intraduodenal barium contrast-filled sac with a curvilinear narrow radiolucent rim,a typical"windsock"sign.Endoscopic RIC was performed on the duodenal web.The patient recovered uneventfully.Follow-up endoscopy showed a patent duodenal lumen without any residual stenosis.The patient reported complete resolution of symptoms at the 18-month follow-up.CONCLUSION Endoscopic RIC may be an effective treatment for congenital duodenal webs in adults.
基金Supported by Medical Science Research Project Plan by Health Commission of the Hebei Province,No.20220063.
文摘BACKGROUND Severe skeletal class II malocclusion is the indication for combined orthodontic and orthognathic treatment.CASE SUMMARY A woman with a chief complaint of a protruding chin and an inability to close her lips requested orthodontic camouflage.The treatment plan consisted of extracting the right upper third molar,right lower third molar,left lower second molar,and left upper third molar and moving the maxillary dentition distally using a convenient method involving microimplant nail anchors,push springs,long arm traction hooks,and elastic traction chains.After 52 months of treatment,her overbite and overjet were normal,and her facial profile was favorable.CONCLUSION This method can be used for distal movement of the maxillary dentition and to correct severe skeletal class II malocclusion in adults.
文摘Purpose:To analyze the role of the seminar teaching method+case-based learning(CBL)teaching method+problem-based learning(PBL)teaching method in oral clinical nursing teaching.Methods:13 undergraduate nursing students who entered the department from September 2020 to September 2021 were selected as the control group,adopting conventional nursing teaching methods;13 undergraduate nursing students who entered the department from September 2021 to August 2022 were selected as the observation group,adopting the seminar+CBL+PBL teaching method.The teaching effects were compared between the two groups.Results:All assessment scores of the observation group were higher than those of the control group;all teaching satisfaction levels were higher than those of the control group(P<0.05).Conclusion:Adopting the seminar+CBL+PBL teaching method during oral clinical nursing teaching can improve nursing students’assessment scores,strengthen their core competencies,and enhance teaching satisfaction.
文摘BACKGROUND Combined spinal-epidural(CSE)anesthesia is the preferred anesthesia method for cesarean delivery.The use of an epidural catheter is essential for administering additional drugs intraoperatively and managing postoperative pain.However,the insertion of epidural catheters is associated with various complications,such as total spinal anesthesia,symptoms indicative of spinal nerve root irritation,and challenges in epidural catheter removal.CASE SUMMARY We present a case report of a challenging epidural catheter removal due to knotting.The lumbar computed tomography scan results revealed that the catheter formed a tight knot in the epidural space.We used a novel extubation method and successfully removed the catheter.CONCLUSION The operator can use opposite forces to"spiral"apart the spinal joints by positioning the patient's body in a specific position.The findings indicate that,when combined with imaging examination results,this method is effective for the removal of epidural catheters.
基金the National Natural Science Foundation of China(No.U20A20328).
文摘In this paper,the multi-body coupled dynamic characteristics of a semisubmersible platform and an HYSY 229 barge were investigated.First,coupled hydrodynamic analysis of the HYSY 229 barge and the semisubmersible platform was performed.Relevant hydrodynamic parameters were obtained using the retardation function method of three-dimensional frequency-domain potential flow theory.The results of the hydrodynamic analysis were highly consistent with the test findings,verifying the accuracy of the multifloating hydrodynamic coupling analysis,and key hydrodynamic parameters were solved for different water depths and the coupling effect.According to the obtained results,the hydrodynamic influence was the largest in shallow waters when the coupling effect was considered.Furthermore,the coupled motion equation combined with viscous damping,fender system,and mooring system was established,and the hydrodynamics,floating body motion,and dynamic response of the fender system were analyzed.Motion analysis revealed good agreement among the surge,sway,and yaw motions of the two floating bodies.However,when the wave period reached 10 s,the motion of the two floating bodies showed severe shock,and a relative motion was also observed.Therefore,excessive constraints should be added between the two floating bodies during construction to ensure construction safety.The numerical analysis and model test results of the semisubmersible platform and HYSY 229 barge at a water depth of 42 m and sea conditions of 0°,45°,and 90° were in good agreement,and the error was less than 5%.The maximum movement of the HYSY 229 barge reached 2.61 m in the sway direction,whereas that of the semisubmersible platform was 2.11 m.During construction,excessive constraints should be added between the two floating bodies to limit their relative movement and ensure construction safety.
文摘Objective:To investigate the effect of using audible thinking combined with the case teaching method in the teaching of nursing checkups for regulation nurses.Methods:The period was April 2023–April 2024,and a randomized controlled group study was carried out in which 76 regulation nurses in our hospital were randomly divided into a research group and a control group,with 38 regulation nurses in each group.The control group used conventional teaching methods,and the research group used audible thinking combined with the case teaching method,comparing the two groups’independent learning ability scores,assessment scores,and teaching satisfaction.Results:Independent learning ability score:after teaching,the research group was significantly higher than the control group(P<0.05);Assessment results:the research group was considerably higher than the control group(P<0.05);Teaching satisfaction:the research group was significantly higher than the control group(P<0.05).Conclusion:The use of audible thinking combined with the case teaching method in the teaching of nursing room visits for trained nurses can improve independent learning ability and assessment results and increase teaching satisfaction.
文摘BACKGROUND Tumoral calcinosis is a condition characterized by deposits of calcium phosphate crystals in extra-articular soft tissues,occurring in hemodialysis patients.Calcium phosphate crystals are mainly composed of hydroxyapatite,which is highly infilt-rative to tissues,thus making complete resection difficult.An adjuvant method to remove or resolve the residual crystals during the operation is necessary.CASE SUMMARY A bicarbonate Ringer’s solution with bicarbonate ions(28 mEq/L)was used as the adjuvant.After resecting calcium phosphate deposits of tumoral calcinosis as much as possible,while filling with the solution,residual calcium phosphate deposits at the pseudocyst wall can be gently scraped by fingers or gauze in the operative field.A 49-year-old female undergoing hemodialysis for 15 years had swelling with calcium deposition for 2 years in the shoulders,bilateral hip joints,and the right foot.A shoulder lesion was resected,but the calcification remained and early re-deposition was observed.Considering the difficulty of a complete rection,we devised a bicarbonate dissolution method and excised the foot lesion.After resection of the calcified material,the residual calcified material was washed away with bicarbonate Ringer’s solution.CONCLUSION The bicarbonate dissolution method is a new,simple,and effective treatment for tumoral calcinosis in hemodialysis patients.
基金supported by the National Key Research and Development Program of China under the theme“Research on the evaluation methods and standards of urban sustainable development” [Grant No.2022YFC3802901]Central Public-Interest Scientific Institution Basal Research Fund,CNIS“Research on the implementation of ISO 37101 for Sustainable cities and communities in China” [Grant No.512024Y-11450].
文摘As China continues to develop its ecological civilization,it is crucial to quantitatively assess the ecological value to understand its potential impact on regional sustainable development.While previous studies have highlighted the importance of ecological value,they have not fully reflected the value of ecological restoration work or considered social costs and benefits,lacking a people-centered approach.Hence,this study analyzes the essence of ecological value from the perspective of sustainable development.By studying emblematic ecological restoration areas such as the Saihanba Mechanized Forest Farm in Chengde City,it aims to identify the significance of ecological restoration efforts in enhancing regional sustainable development capacity.The results underscore the necessity of comprehensively considering the value chain from ecological construction to ecological output,highlighting the value of ecological restoration in the ecological construction process as well as the well-being of people in the ecological output process.This approach assigns more economic and humanistic attributes to ecological value,thereby better serving the development of ecological restoration areas.
基金Supported by School-Level Key Projects at Bengbu Medical College,No.2021byzd109.
文摘BACKGROUND Gallbladder neuroendocrine carcinoma(NEC)represents a subtype of gallbladder malignancies characterized by a low incidence,aggressive nature,and poor prognosis.Despite its clinical severity,the genetic alterations,mechanisms,and signaling pathways underlying gallbladder NEC remain unclear.CASE SUMMARY This case study presents a rare instance of primary gallbladder NEC in a 73-year-old female patient,who underwent a radical cholecystectomy with hepatic hilar lymphadenectomy and resection of liver segments IV-B and V.Targeted gene sequencing and bioinformatics analysis tools,including STRING,GeneMANIA,Metascape,TRRUST,Sangerbox,cBioPortal and GSCA,were used to analyze the biological functions and features of mutated genes in gallbladder NEC.Twelve mutations(APC,ARID2,IFNA6,KEAP1,RB1,SMAD4,TP53,BTK,GATA1,GNAS,and PRDM3)were identified,and the tumor mutation burden was determined to be 9.52 muts/Mb via targeted gene sequencing.A protein-protein interaction network showed significant interactions among the twelve mutated genes.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses were used to assess mutation functions and pathways.The results revealed 40 tumor-related pathways.A key regulatory factor for gallbladder NEC-related genes was identified,and its biological functions and features were compared with those of gallbladder carcinoma.CONCLUSION Gallbladder NEC requires standardized treatment.Comparisons with other gallbladder carcinomas revealed clinical phenotypes,molecular alterations,functional characteristics,and enriched pathways.
基金supported by the National Natural Science Foundation of China(12172023).
文摘The separation-of-variable(SOV)methods,such as the improved SOV method,the variational SOV method,and the extended SOV method,have been proposed by the present authors and coworkers to obtain the closed-form analytical solutions for free vibration and eigenbuckling of rectangular plates and circular cylindrical shells.By taking the free vibration of rectangular thin plates as an example,this work presents the theoretical framework of the SOV methods in an instructive way,and the bisection–based solution procedures for a group of nonlinear eigenvalue equations.Besides,the explicit equations of nodal lines of the SOV methods are presented,and the relations of nodal line patterns and frequency orders are investigated.It is concluded that the highly accurate SOV methods have the same accuracy for all frequencies,the mode shapes about repeated frequencies can also be precisely captured,and the SOV methods do not have the problem of missing roots as well.
基金supported by Public Health Talent Training and Surport Plan(National Administration of Disease Prevention and Control)Research and application of new technology for rapid monitoring and tracing of emergent infectious diseases among entry-exit population(2024YFFK0056)Monitoring,Early warning and Response of Major Infectious Diseases(2022ZDZX0017).
文摘Objective This study reports the first imported case of Lassa fever(LF)in China.Laboratory detection and molecular epidemiological analysis of the Lassa virus(LASV)from this case offer valuable insights for the prevention and control of LF.Methods Samples of cerebrospinal fluid(CSF),blood,urine,saliva,and environmental materials were collected from the patient and their close contacts for LASV nucleotide detection.Whole-genome sequencing was performed on positive samples to analyze the genetic characteristics of the virus.Results LASV was detected in the patient’s CSF,blood,and urine,while all samples from close contacts and the environment tested negative.The virus belongs to the lineage IV strain and shares the highest homology with strains from Sierra Leone.The variability in the glycoprotein complex(GPC)among different strains ranged from 3.9%to 15.1%,higher than previously reported for the seven known lineages.Amino acid mutation analysis revealed multiple mutations within the GPC immunogenic epitopes,increasing strain diversity and potentially impacting immune response.Conclusion The case was confirmed through nucleotide detection,with no evidence of secondary transmission or viral spread.The LASV strain identified belongs to lineage IV,with broader GPC variability than previously reported.Mutations in the immune-related sites of GPC may affect immune responses,necessitating heightened vigilance regarding the virus.
文摘Objective:To analyze the feasibility of adopting a combined ladder and case teaching method in otolaryngology nursing teaching.Method:Nursing students in the otolaryngology department were selected.According to the admission time of nursing students,30 nursing students formed a control group(conventional nursing teaching),and 30 nursing students who were admitted later formed an observation group(ladder and case teaching method).The learning performance and teaching effectiveness of nursing students under different teaching methods were analyzed.Result:The academic performance and teaching effectiveness of the observation group were higher than those of the control group(P<0.05).Conclusion:The implementation of the ladder and case teaching method during the teaching of otolaryngology nursing significantly improved the student’s academic performance and teaching effectiveness.This method has great practical value.
基金Supported by National Natural Science Foundation of China,No.82370604Major Science and Technology innovation Project of Fujian Province,No.2023Y9269Natural Science Foundation of Fujian Province,China,No.2023J01239.
文摘BACKGROUND Hydroxyurea,an antimetabolite,is frequently prescribed for various hemato-logical disorders,and its common side effects include gastrointestinal problems,cutaneous or mucosal lesions and pyrexia/fever.CASE SUMMARY This study reports the case of a 67-year-old woman who developed recurrent abdominal pain after 10 years of continuous hydroxyurea therapy for primary thrombocythemia.Colonoscopy revealed an ileocecal ulcer.After discontinuing hydroxyurea therapy for 6 months,follow-up colonoscopy showed a significant reduction in the ulceration.CONCLUSION We consider cecal ulcers as a rare complication of hydroxyurea therapy which typically resolves upon stopping the drug.
基金Supported by General Project of Natural Science Foundation of Chongqing,China,No.cstc2021jcyj-msxmX0604Chongqing Doctoral"Through Train"Research Program,China,No.CSTB2022BSXM-JCX0045.
文摘BACKGROUND Gallbladder cancer(GBC)is the most common and aggressive subtype of biliary tract cancer(BTC)and has a poor prognosis.A newly developed regimen of gemcitabine,cisplatin,and durvalumab shows promise for the treatment of advanced BTC.However,the efficacy of this treatment for GBC remains unclear.CASE SUMMARY In this report,we present a case in which the triple-drug regimen exhibited marked effectiveness in treating locally advanced GBC,thus leading to a long-term survival benefit.A 68-year-old man was diagnosed with locally advanced GBC,which rendered him ineligible for curative surgery.Following three cycles of therapy,a partial response was observed.After one year of combined therapy,a clinical complete response was successfully achieved.Subsequent maintenance therapy with durvalumab monotherapy resulted in a disease-free survival of 9 months for the patient.The patient experienced tolerable toxicities of reversible grade 2 nausea and fatigue.Tolerable adverse events were observed in the patient throughout the entirety of the treatment.CONCLUSION The combination of gemcitabine and cisplatin chemotherapy with durvalumab was proven to be an effective treatment approach for advanced GBC,with manageable adverse events.Further research is warranted to substantiate the effectiveness of the combined regimen in the context of GBC.
文摘BACKGROUND Thrombophilia contributes to a significant increased risk of venous thromboembolism and can be either inherited or acquired.Hereditary thrombophilia may arise from various gene mutations,some of which have not even been adequately reported or poorly understood.Previous studies reported a rare and novel missense mutation in the prothrombin gene(p.Arg596Gln),known as prothrombin Belgrade.The mechanisms and therapeutic strategies associated with prothrombin Belgrade mutation have not been fully elucidated.CASE SUMMARY We present the case of a 26-year-old woman with recurrent systemic thrombosis induced by prothrombin Belgrade mutation.The patient suffered from cerebral venous sinus thrombosis that rapidly progressed to systemic thrombosis,alongside a family history of cerebral thrombosis,and no traditional risk factors or abnormal coagulation function.Whole-genome sequencing detected a novel and rare heterozygous prothrombin missense mutation,c.1787G>T(p.Arg596Gln),which was responsible for the major etiology of the systemic thrombosis.CONCLUSION This case strengthens our understanding about hereditary basis of thrombophilia and provokes considerations for therapeutic options on prothrombin Belgrade mutation.
文摘BACKGROUND The majority of published reports on foreign bodies(FBs)involve the rectum and applied a transanal retrieval.Usually,patients with FB above the rectum are subjected to laparotomy for removal.Here,we illustrate the case of a man with an FB that had migrated into the descending colon,and its successful removal via a laparoscopic approach.CASE SUMMARY A 43-year-old man,who had the habit of FB insertion into his anus to aid defe-cation,presented upon experience of such an FB slipping through and migrating upward to the distal colon.Plain abdominal radiograph revealed a bottle-shaped FB,positioned in the left iliac fossa region.The FB was successfully removed via a laparoscopic-assisted procedure in which we combined diagnostic laparoscopic and endoscopic techniques during surgery.The patient was monitored for 2 d postoperatively and subsequently discharged home.CONCLUSION A minimally invasive approach should be adopted to aid extraction of colorectal FB as it is effective and safe.
文摘BACKGROUND Acute hyperglycemia due to insulin resistance is common in critically ill patients,typically managed with insulin infusion.However,the occurrence of transient extreme insulin resistance(EIR)requiring exceptional high-dose insulin is rare.CASE SUMMARY We present the case of a 68-year-old woman with pneumonia who suffered an out-of-hospital cardiac arrest,subsequently developing transient EIR following a new episode of sepsis.Remarkably,insulin resistance rapidly reversed when the insulin infusion rate peaked at 960 units/hour(a total of 18224 units on that day),and it was promptly titrated down to zero upon achieving the target glucose level.CONCLUSION Exceptional high-dose insulin infusion may be required in critically ill patients with stress-related EIR,which is typically transient.Clinicians should be aware of the phenomenon and cautious to avoid hypoglycemia and fluid overload during the steep titration of high-dose insulin infusion.
