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Tuberculosis septic shock, an elusive pathophysiology and hurdles in management: A case report and review of literature 预览
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作者 Rashmi Mishra Harish K Patel +1 位作者 Rakesh Singasani Trupti Vakde 《世界重症医学杂志》 2019年第5期72-81,共10页
BACKGROUND Tuberculosis (TB) is a rare etiology of the septic shock. Timely administration of the anti-microbial agents has shown mortality benefit. Prompt diagnosis and a high index of suspicion are crucial to the ma... BACKGROUND Tuberculosis (TB) is a rare etiology of the septic shock. Timely administration of the anti-microbial agents has shown mortality benefit. Prompt diagnosis and a high index of suspicion are crucial to the management. We present three cases of TBSS with poor outcome in the majority despite timely and susceptible antibiotic administration. CASE SUMMARY Sixty-seven-year-old woman with latent TB presented with fever, cough, and shortness of breath. She was promptly diagnosed with active TB and started on the appropriate anti-microbial regimen;she had a worsening clinical course with septic shock and multi-organ failure after initiation of antibiotics. Thirty-threeyear- old man immunocompromised with acquired immune deficiency syndrome presented with fever, anorexia and weight loss. He had no respiratory symptoms, and first chest X-ray was normal. He had enlarged liver, spleen and lymph nodes suspicious for lymphoma. Despite broad-spectrum antibiotics, he succumbed to refractory septic shock and multi-organ failure. It was shortly before his death that anti-TB antimicrobials were initiated based on pathology reports of bone marrow and lymph node biopsies. Forty-nine-year-old woman with asthma and latent TB admitted with cough and shortness of breath. Although Initial sputum analysis was negative, a subsequent broncho-alveolar lavage turned out to be positive for acid fast bacilli followed by initiation of susceptible ant-TB regimen. She had a downward spiral clinical course with shock, multi-organ failure and finally death. CONCLUSION Worse outcome despite timely initiation of appropriate antibiotics raises suspicion of TB immune reconstitution as a possible pathogenesis for TB septic shock. 展开更多
关键词 TUBERCULOSIS SEPTIC shock TUBERCULOSIS and immune RECONSTITUTION TUBERCULOSIS in intensive care unit CASE FATALITY for TUBERCULOSIS SEPTIC shock CASE report
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Small cell lung cancer starting with diabetes mellitus:Two case reports and literature review 预览
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作者 Tong Zhou Yao Wang +4 位作者 Xue Zhao Yang Liu Ying-Xuan Wang Xiao-Kun Gang Gui-Xia Wang 《世界临床病例杂志》 2019年第10期1213-1220,共8页
BACKGROUND Small-cell lung cancer(SCLC)is a type of fatal tumor that is increasing in prevalence.While these are unpleasant facts to consider,it is vitally important to be informed,and it is important to catch the dis... BACKGROUND Small-cell lung cancer(SCLC)is a type of fatal tumor that is increasing in prevalence.While these are unpleasant facts to consider,it is vitally important to be informed,and it is important to catch the disease early.Typically,lung cancer does not show severe clinical symptoms in the early stage.Once lung cancer has progressed,patients might present with classical symptoms of respiratory system dysfunction.Thus,the prognosis of SCLC is closely related to the early diagnosis of the disease.Ectopic adrenocorticotropic hormone(ACTH)syndrome(EAS)is related to cancer occurrence,especially for SCLC with the presence of Cushing's syndrome,which is dependent on markedly elevated ACTH and cortisol levels.CASE SUMMARY In the current report,we describe two middle-age patients who were originally diagnosed with diabetes mellitus with no classical symptoms of lung cancer.The patients were eventually diagnosed with SCLC,which was confirmed by bronchoscopic biopsy and histopathology.SCLC-associated diabetes was related to EAS,which was an endogenous ACTH-dependent form of Cushing’s syndrome with elevated ACTH and cortisol levels.Multiple organ metastases were found in Patient 1,while Patient 2 retained good health at 2 years follow-up.EAS symptoms including thyroid dysfunction,hypercortisolism and glucose intolerance were all resolved after anticancer treatment.CONCLUSION In conclusion,SCLC might start with diabetes mellitus and increased cortisol and hypokalemia or other EAS symptoms.These complex clinical features were the most significant factors to deteriorate a patient’s condition.Early diagnosis and treatment from clinicians were essential for the anti-cancer treatment for patients with SCLC. 展开更多
关键词 Case report Small cell LUNG cancer Diabetes Ectopic adrenocorticotropic HORMONE syndrome Adrenocorticotropic HORMONE Diagnosis
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Significant benefits of osimertinib in treating acquired resistance to first-generation EGFR-TKIs in lung squamous cell cancer:A case report 预览
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作者 Yan Zhang Hui-Min Chen +6 位作者 Yong-Mei Liu Feng Peng Min Yu Wei-Ya Wang Heng Xu Yong-Sheng Wang You Lu 《世界临床病例杂志》 2019年第10期1221-1229,共9页
BACKGROUND Lung squamous cell cancer(LSCC)rarely harbors epidermal growth factor receptor(EGFR)mutations,even much rarer for acquired T790M mutation.Although clinical trials of AURA series illustrated that non-small c... BACKGROUND Lung squamous cell cancer(LSCC)rarely harbors epidermal growth factor receptor(EGFR)mutations,even much rarer for acquired T790M mutation.Although clinical trials of AURA series illustrated that non-small cell lung cancer(NSCLC)with EGFR T790M mutation can benefit from osimertinib,only five LSCC patients were enrolled in total;moreover,the efficacy for LSCC was not shown in the results.Therefore,the response of LSCC to osimertinib is still unclear to date.CASE SUMMARY We report an LSCC case with T790M-related acquired resistance after treatments with first-generation EGFR-tyrosine kinase inhibitors(EGFR-TKIs)and benefited from osimertinib significantly.A 63-year-old Chinese man was diagnosed with stage IV(cT2N2M1b)LSCC harboring an EGFR exon 19-deletion mutation.Following disease progression after gefitinib and multi-line chemotherapy,rebiopsy was conducted.Molecular testing of EGFR by amplification refractory mutation system-polymerase chain reaction detected the exon 19-deletion without T790M mutation.Therefore,the patient was given erlotinib,but progression developed only 3 mo later.Then the frozen re-biopsy tissue was tested by next-generation sequencing(NGS),which detected an EGFR T790M mutation.However,he was very weak with symptoms of dysphagia and cachexia.Fortunately,osimertinib was started,leading to alleviation from the symptoms.Four months later,normal deglutition was restored and partial response was achieved.Finally,the patient achieved an overall survival time period of 29 mo.CONCLUSION Our findings highlight that EGFR T790M mutation may also be an important acquired drug resistance mechanism for LSCC and offer direct evidence of the efficacy of osimertinib in LSCC with T790M mutation.NGS and better preservation conditions may contribute to higher sensitivity of EGFR T790M detection. 展开更多
关键词 LUNG SQUAMOUS cell CANCER LUNG CANCER EPIDERMAL growth factor receptor mutation T790M Osimertinib TYROSINE kinase inhibitor Targeted therapy Case report
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Successful endoscopic extraction of a proximal esophageal foreign body following accurate localization using endoscopic ultrasound:A case report 预览
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作者 Xiao-Ming Wang Shan Yu Xin Chen 《世界临床病例杂志》 2019年第10期1230-1233,共4页
BACKGROUND It is rare to find fish bones completely embedded in the wall of the esophagus with endoscopic findings similar to those of submucosal tumors.Most of the patients had the foreign body removed by thoracotomy... BACKGROUND It is rare to find fish bones completely embedded in the wall of the esophagus with endoscopic findings similar to those of submucosal tumors.Most of the patients had the foreign body removed by thoracotomy or thoracoscopy in the past,which resulted in great trauma.CASE SUMMARY We report a 58-year-old woman who experienced dysphagia for 6 d after eating fish.Cervical computed tomography(CT)and endoscopic ultrasonography(EUS)indicated a fish bone completely embedded in the wall of the esophagus with endoscopic findings similar to those of submucosal tumors.The results of CT reconstruction and EUS suggested that the fish bone was parallel to the longitudinal axis of the esophagus.We performed a longitudinal mucosal incision from the highest point of the uplift by using an Olympus dual knife to find the fish bone.Unfortunately,no fish bone was found,so we extended the incision and endoscopic submucosal dissection(ESD)technique was used to detect and remove the fish bone entirety.CONCLUSION The extraction of fish bone via ESD immediately after the injection of methylene blue into the submucous membrane under EUS guidance to obtain accurate localization of the foreign body may be the best treatment for such patients. 展开更多
关键词 Fish bone ENDOSCOPIC MUCOSAL DISSECTION Upper ESOPHAGEAL wall Case report
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Minimally invasive endoscopic maxillary sinus lifting and immediate implant placement:A case report 预览
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作者 Mahmoud Mudalal Xiao-Lin Sun +5 位作者 Xue Li Jiao Fang Man-Lin Qi Jia Wang Liu-Yi Du Yan-Min Zhou 《世界临床病例杂志》 2019年第10期1234-1241,共8页
BACKGROUND This case report discusses a modified approach for maxillary sinus augmentation,in which platelet-rich fibrin,endoscope,simultaneous implant placement,and sinus floor elevation(PESS)were applied for a maxil... BACKGROUND This case report discusses a modified approach for maxillary sinus augmentation,in which platelet-rich fibrin,endoscope,simultaneous implant placement,and sinus floor elevation(PESS)were applied for a maxillary sinus floor lift in a 40-year-old patient.CASE SUMMARY A 40-year-old woman suffered missing upper right first molar.Implant stability quotient and cone-beam computed tomography(CBCT)were used to evaluate the diagnosis.CBCT showed insufficient posterior maxillary bone with a mean residual alveolar bone height of only 3.5 mm.The patient underwent a minimally invasive sinus floor elevation endoscopically.The sinus membrane was elevated in two stages,and a 12-mm implant was placed immediately.At 3 mo postoperatively,the final impressions were accomplished,and a full-ceramic crown was fit-placed.A 6-mo follow-up demonstrated satisfactory aesthetic and functional results.CONCLUSION This is the first report to use an endoscope for maxillary sinus floor lifting in cases with severe and insufficient bone height.This case report demonstrates the advantages of the PESS technique,which include minimal invasiveness with high precision,being applicable in cases with a residual alveolar bone height<4 mm with a promising result,and a shortened treatment period from 12 to 3 mo. 展开更多
关键词 MAXILLARY SINUS augmentation Platelet-rich FIBRIN ENDOSCOPE Internal SINUS floor elevation Case report
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Induction chemotherapy with docetaxel, cisplatin and fluorouracil followed by concurrent chemoradiotherapy for unresectable sinonasal undifferentiated carcinoma: Two cases of report 预览
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作者 Sho Watanabe Yoshitaka Honma +13 位作者 Naoya Murakami Hiroshi Igaki Taisuke Mori Hidekazu Hirano Natsuko Okita Hirokazu Shoji Satoru Iwasa Atsuo Takashima Ken Kato Kenya Kobayashi Fumihiko Matsumoto Seiichi Yoshimoto Jun Itami Narikazu Boku 《世界临床病例杂志》 2019年第6期765-772,共8页
BACKGROUND Sinonasal undifferentiated carcinoma (SNUC) is a rare aggressive tumor that is often unresectable. Optimal treatment for patients with unresectable, locally advanced SNUC (LA-SNUC) has not been established,... BACKGROUND Sinonasal undifferentiated carcinoma (SNUC) is a rare aggressive tumor that is often unresectable. Optimal treatment for patients with unresectable, locally advanced SNUC (LA-SNUC) has not been established, and the patient outcome remains poor. We report two cases of unresectable LA-SNUC in which induction chemotherapy with docetaxel, cisplatin and fluorouracil (TPF) followed by radiotherapy with concurrent cisplatin (CCRT), a standard treatment option for locally advanced head and neck cancer, demonstrated promising outcomes. CASE SUMMARY A 39-year-old man presented with tearing and pain in the right eye. A biopsy of the tumor invading the sinonasal cavities, right orbit and cranial base confirmed the diagnosis of LA-SNUC. Induction TPF chemotherapy induced remarkable tumor shrinkage and rapidly improved the symptoms. He subsequently received CCRT and achieved complete remission of the disease. The other case is a 21-year-old man who presented with worsening vision. The unresectable tumor involving the nasal septum and cranial base was pathologically diagnosed as SNUC. TPF chemotherapy followed by CCRT yielded complete remission of the disease with preserved visual function. Both patients have been disease-free for 44 mo. CONCLUSION Induction TPF chemotherapy followed by CCRT may remarkably improve the outcomes in LA-SNUC patients. 展开更多
关键词 SINONASAL undifferentiated carcinoma CHEMOTHERAPY with docetaxel CISPLATIN and fluorouracil CHEMOTHERAPY DOCETAXEL CISPLATIN Fluorouracil INTENSITY-MODULATED radiotherapy Chemoradiotherapy Case REPORT
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基于产品设计的机器人案例分析 预览
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作者 刘宝红 何永义 《工业控制计算机》 2019年第8期106-108,共3页
基于产品设计对机器人案例进行分析。主要目的是对于实际机器人系统的初步建模仿真具体分析,以及开发机器人产品整个过程的案例分析。通过对现代设计、概念设计、产品创新、功能创新的理论介绍,有一个大致的概念掌握。然后,通过对概念... 基于产品设计对机器人案例进行分析。主要目的是对于实际机器人系统的初步建模仿真具体分析,以及开发机器人产品整个过程的案例分析。通过对现代设计、概念设计、产品创新、功能创新的理论介绍,有一个大致的概念掌握。然后,通过对概念设计的具体方法分析以及面向功能创新的主要的初步建模的思路分析,掌握具体的初步建模过程,对一个案例进行具体的分析建模仿真,熟悉整个流程。最后,对一个机器人系统进行分析解读,可以得到机器人产品设计的大致思路。 展开更多
关键词 产品创新 建模仿真 概念设计 功能创新 机器人
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Lump type crossed fused renal ectopia with bilateral vesicoureteral reflux: A case report 预览
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作者 Taesoo Choi Koo Han Yoo +1 位作者 Ran Song Dong-Gi Lee 《世界临床病例杂志》 2019年第6期773-777,共5页
BACKGROUND Crossed fused renal ectopia is a rare congenital anomaly of the ascent of the kidney. This anomaly may be observed as a solitary kidney during initial evaluation. A solitary kidney must be evaluated for ass... BACKGROUND Crossed fused renal ectopia is a rare congenital anomaly of the ascent of the kidney. This anomaly may be observed as a solitary kidney during initial evaluation. A solitary kidney must be evaluated for associated anomalies such as duplication, horseshoe kidney, or crossed renal ectopia. CASE SUMMARY An anomaly was observed in a 9-mo-old male child who was subsequently diagnosed with crossed fused renal ectopia and vesicoureteral reflux (VUR). In this condition, recurrent febrile urinary tract infection can be a serious problem, and can easily cause renal damage due to relatively short ureters and high pressure in the kidney. CONCLUSION To prevent urosepsis and preserve renal function, early diagnosis and proper management including surgical correction should be considered for the management of renal ectopia with VUR. 展开更多
关键词 Kidney CONGENITAL ABNORMALITIES Vesicoureteral REFLUX Ureteroneocystostomy Politano-Leadbetter Case report
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Multiple gastric angiolipomas: A case report 预览
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作者 Xin-He Lou Wen-Guo Chen +2 位作者 Long-Gui Ning Hong-Tan Chen Guo-Qiang Xu 《世界临床病例杂志》 2019年第6期778-784,共7页
BACKGROUND Angiolipoma is a benign tumor and is generally found in subcutaneous tissues. Angiolipomas are rare in the gastrointestinal tract, including the stomach. Preoperative diagnosis of the tumor is difficult, al... BACKGROUND Angiolipoma is a benign tumor and is generally found in subcutaneous tissues. Angiolipomas are rare in the gastrointestinal tract, including the stomach. Preoperative diagnosis of the tumor is difficult, although there are several radiological examinations such as computed tomography and endoscopic ultrasound. CASE SUMMARY We report a 24-year-old Chinese man with multiple gastric angiolipomas, with a positive stool occult blood examination. Endoscopic biopsy only showed nonspecific inflammation. Histological examination of the specimen by endoscopic snare resection showed that the tumor consisted of adipose tissues and blood vessels. We also performed a literature review. After the use of proton pump inhibitor, the fecal occult blood test was negative. Due to the difficulty of resecting multiple lesions in the stomach completely and the benign characteristics of angiolipoma, we chose to have regular upper gastrointestinal endoscopy evaluation of the lesion. No evidence of significant change in lesion size was detected after 3-years follow-up. CONCLUSION Gastric angiolipoma is rare, and benign neoplasm should be considered when lesions occur submucosally in the gastrointestinal tract. 展开更多
关键词 ANGIOLIPOMA GASTRIC ANGIOLIPOMA ENDOSCOPIC SNARE RESECTION Case report
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语文教学不过是个例子 预览
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作者 许斌 《科教文汇》 2019年第15期137-138,共2页
本文中,教师讲述了自己在多年的教学生涯中,始终立足文本教学,引导学生汲取篇章精华,努力教给学生带得走的能力。为了提升学生的语文素养,教师从三个方面展开话题。首先,以文本为例,把握作家巧妙的谋篇布局。例如“首尾呼应”“一波三... 本文中,教师讲述了自己在多年的教学生涯中,始终立足文本教学,引导学生汲取篇章精华,努力教给学生带得走的能力。为了提升学生的语文素养,教师从三个方面展开话题。首先,以文本为例,把握作家巧妙的谋篇布局。例如“首尾呼应”“一波三折”以及多角度表现一个人。其次,以文本为例,揣摩作家朴实无华的细节描写。教师详述了教学贾平凹《丑石》这篇文章时,如何引领学生在充分品鉴的基础上,提升了创作的热情。接着,以文本为例,体会作家情感,指导朗读。教师再次详述了教学《少年闰土》时,打磨“抓关键词,体会情感”这把朗读金钥匙的过程。总之,语文教学是一门慢的艺术,教师需要付出极大的耐心和毅力,才能让这艘艺术之船扬帆起航。 展开更多
关键词 语文教学 例子 把握谋篇布局 揣摩细节描写 体会作家情感
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基于问题引导教学模式的机械振动课程教学改革与实践 预览
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作者 袁春元 李磊 《教育教学论坛》 2019年第27期109-110,共2页
与传统的教学模式比,问题引导教学是在老师主导下的围绕问题学生开展自主学习的一种教学模式,可以扩大学生的参与度和激发其学习潜能,受到了教育界的广泛关注。机械振动是一门机械工程本科专业的学科平台课程,如何在课程教学中运用“问... 与传统的教学模式比,问题引导教学是在老师主导下的围绕问题学生开展自主学习的一种教学模式,可以扩大学生的参与度和激发其学习潜能,受到了教育界的广泛关注。机械振动是一门机械工程本科专业的学科平台课程,如何在课程教学中运用“问题引导教学”模式,提高学生参与度和教学效果是非常有意义的研究课题。本文结合机械振动特点,探索了问题引导教学在学科教育中的步骤和原则,并进行了教学改革实践。 展开更多
关键词 教学模式 数学建模 案例
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“双真教学”模式在《生物工程下游技术》课程中的应用 预览
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作者 陈金武 束磊 +1 位作者 李玲玲 徐忠东 《农业灾害研究》 2019年第4期124-126,共3页
随着生命科学的快速发展,生物产业领域的人才需求愈加旺盛。但是高校传统的重理论、轻实践的教学方式忽视了对学生综合运用能力的培养,难以培养出生物行业和企业需要的人才。将"双真教学"模式引入《生物工程下游技术》课程,... 随着生命科学的快速发展,生物产业领域的人才需求愈加旺盛。但是高校传统的重理论、轻实践的教学方式忽视了对学生综合运用能力的培养,难以培养出生物行业和企业需要的人才。将"双真教学"模式引入《生物工程下游技术》课程,将生物企业的生产实例和研发案例融入到教学中,将理论知识与实践技能相结合,培养应用型高水平生物技术人才。 展开更多
关键词 双真教学 《生物工程下游技术》课程 案例 教学改革
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中国古代手工艺设计标准案例研究 预览
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作者 陆江艳 郎玉帅 吕杰锋 《包装工程》 CAS 北大核心 2019年第16期275-280,共6页
目的研究分散在中国古代文献中的古代手工艺设计标准案例,找出这些古代手工艺的相关设计标准以及这些设计标准所体现出来的多方面文本内容。方法采用定性方法和定量方法分别对文献的主要问题进行分析归类,研究古代手工艺设计标准案例的... 目的研究分散在中国古代文献中的古代手工艺设计标准案例,找出这些古代手工艺的相关设计标准以及这些设计标准所体现出来的多方面文本内容。方法采用定性方法和定量方法分别对文献的主要问题进行分析归类,研究古代手工艺设计标准案例的类型与特质,从历史证据走进现代逻辑诠释。结论通过梳理中国古代文献中的手工艺设计标准案例,从形制、尺度、结构3个方面分析了设计标准的文本内容及其内涵与特质。研究发现,中国古代手工艺设计标准具有系统性的特征,它们并没有对创新构成阻碍,而是为手工艺的基本品质提供了保障。古代手工艺设计标准的实施存在着一些基本形式,目前来看有统一化、组合化、系列化、模块化、通用化等基本形式。 展开更多
关键词 设计标准 手工艺 中国古代 案例
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基于GF-3的不同极化方式SAR图像海面油膜识别的比较——以“桑吉”轮事故为例 预览
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作者 付弘涛 秦平 《海洋开发与管理》 2019年第3期54-56,共3页
基于我国自主研发的首颗分辨率达到1m的C频段多极化合成孔径雷达高分三号卫星(GF-3),通过典型溢油案例定性和定量地比较了双极化与单极化图像预处理性能,分析了不同的极化组合对海面油膜识别结果的影响。得出结论:同向极化与异向极化成... 基于我国自主研发的首颗分辨率达到1m的C频段多极化合成孔径雷达高分三号卫星(GF-3),通过典型溢油案例定性和定量地比较了双极化与单极化图像预处理性能,分析了不同的极化组合对海面油膜识别结果的影响。得出结论:同向极化与异向极化成像差异明显,VV极化明显比VH极化回波强度高,并且油膜识别度较高;相反,双极化VHVV方式与单极化VH方式图像效果区别不大,双极化方式并不能绝对性地提高地物识别度。 展开更多
关键词 合成孔径雷达 案例 双极化 单极化 油膜识别
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Primary hepatic follicular dendritic cell sarcoma: A case report 预览
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作者 Hui-Min Chen Ya-Li Shen Ming Liu 《世界临床病例杂志》 2019年第6期785-791,共7页
BACKGROUND Follicular dendritic cell sarcoma (FDCS) is an uncommon type of tumor with low incidence. To date, no standard treatment for the disease has been established. Surgery remains the main treatment. Adjuvant ch... BACKGROUND Follicular dendritic cell sarcoma (FDCS) is an uncommon type of tumor with low incidence. To date, no standard treatment for the disease has been established. Surgery remains the main treatment. Adjuvant chemotherapy and radiotherapy are optional approaches. Metastatic cases require multidisciplinary collaborative treatments. However, the choice of chemotherapeutic drugs is controversial. CASE SUMMARY A 66-year-old Chinese woman presented to our hospital complaining of intermittent pain of right upper quadrant. An enhanced computed tomography (CT) scan of the abdomen revealed hepatocellular carcinoma. Subsequently, the patient underwent a radical partial hepatectomy. Primary FDCS of the liver was diagnosed pathologically. Except for regular follow-up examinations, the patient did not receive adjuvant chemotherapy or radiotherapy. However, fluorine-18- fluorodeoxyglucose positron emission tomography/CT (PET/CT) confirmed lymph node metastases in the space of ligamentum hepatogastricum and pancreatic head, as well as the portacaval space. The patient was given systemic chemotherapy with gemcitabine and docetaxel for she was unsuitable for surgery. Satisfactorily, the metastatic lymph nodes were significantly reduced to clinical complete remission after eight cycles of chemotherapy. Then, strengthened radiotherapy was followed when the patient rejected the opportunity of surgery. Eventually, the carcinoma got better control and the patient was free of progression. CONCLUSION This case highlights the importance of making suitable chemotherapy regimens for the rare tumor. The combination of gemcitabine, docetaxel, and consolidated radiotherapy may offer a new promising option for the treatment of metastatic hepatic FDCS in the future. 展开更多
关键词 FOLLICULAR DENDRITIC cell SARCOMA Liver Chemotherapy GEMCITABINE DOCETAXEL RADIOTHERAPY Case report
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Effective chemotherapy for submandibular gland carcinoma ex pleomorphic adenoma with lung metastasis after radiotherapy: A case report 预览
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作者 Zhi-Yuan Chen Yu Zhang +2 位作者 Yan Tu Wei Zhao Mei Li 《世界临床病例杂志》 2019年第6期792-797,共6页
BACKGROUND Only a few cases of carcinoma ex pleomorphic adenoma arising in the submandibular gland have ever been reported, all with a poor prognosis. The standard treatment for salivary gland carcinoma ex pleomorphic... BACKGROUND Only a few cases of carcinoma ex pleomorphic adenoma arising in the submandibular gland have ever been reported, all with a poor prognosis. The standard treatment for salivary gland carcinoma ex pleomorphic adenoma is surgical resection combined with postoperative radiotherapy, but the necessity of chemotherapy as well as the most appropriate treatment regimen for patients with distant metastasis after radiotherapy remains controversial. CASE SUMMARY This report presents the case of a 73-year-old woman who suffered submandibular gland carcinoma ex pleomorphic adenoma. She accepted surgery to remove the mass;she was found to have lung metastasis after radiotherapy. Her condition was controlled by chemotherapy with liposomal doxorubicin plus cisplatin. CONCLUSION The positive clinical outcome in the patient reveals that this chemotherapy regimen may be an alternative treatment for such a condition. 展开更多
关键词 Malignant PLEOMORPHIC ADENOMA SALIVARY GLAND TUMORS CHEMOTHERAPY Carcinoma ex PLEOMORPHIC ADENOMA Case report
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Photodynamic therapy as salvage therapy for residual microscopic cancer after ultra-low anterior resection: A case report 预览
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作者 Si-Qi Zhang Kui-Jie Liu +5 位作者 Hong-Liang Yao San-Lin Lei Zhen-Dong Lei Wen-Jun Yi Li Xiong Hua Zhao 《世界临床病例杂志》 2019年第6期798-804,共7页
BACKGROUND The rate of positive resection margins (R1) in patients with low rectal cancer is substantial. Recommended remedies such as extended resection or chemoradiotherapy have their own serious drawbacks. It has b... BACKGROUND The rate of positive resection margins (R1) in patients with low rectal cancer is substantial. Recommended remedies such as extended resection or chemoradiotherapy have their own serious drawbacks. It has been reported that photodynamic therapy (PDT) as a remedial treatment for esophageal cancer. Colorectal cancer and esophageal cancer has many similarities, however, PDT as a salvage therapy for rectal cancer is rare. CASE SUMMARY Here, we describe a 56-year-old man who was admitted to the hospital due to a 6- mo history of hemafecia, which had been aggravated for 1 mo. Colonoscopy revealed a 3 × 4 cm ulcerated mass in the rectum 4 cm from the anus. Preoperative pathological examination showed villous adenoma, moderate-tohigh- grade dysplasia, good differentiation, and invasion of the mucosal muscle. The patient had R1 after ultra-low anterior resection, but he refused extended resection and experienced severe liver function impairment after 3 cycles of chemotherapy. Ultimately, the patient underwent PDT to remove R1. After five years of follow-up, there was no liver function impairment, recurrence, metastasis, sexual dysfunction, or abnormal defecation function. CONCLUSION This is the first case worldwide in which R1 of rectal cancer were successfully treated by PDT. 展开更多
关键词 Low RECTAL CANCER Photodynamic THERAPY Positive MICROSCOPIC distal margin SALVAGE THERAPY Removal RESIDUAL MICROSCOPIC CANCER Case report
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医学院校《时间序列分析》课程教学研究探讨 预览
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作者 李卫霞 曹莉 《教育教学论坛》 2019年第35期203-204,共2页
《时间序列分析》是医学院校中应用统计学专业的一门专业必修课程。基于学生的培养目标要求、学生知识背景及就业需求,分析《时间序列分析》课程教学现状,并探讨了实践课教学过程中案例、软件的选择及考核方式等问题,从而期望能达到提... 《时间序列分析》是医学院校中应用统计学专业的一门专业必修课程。基于学生的培养目标要求、学生知识背景及就业需求,分析《时间序列分析》课程教学现状,并探讨了实践课教学过程中案例、软件的选择及考核方式等问题,从而期望能达到提高教学效果的目的。 展开更多
关键词 《时间序列分析》 医学院校 案例 R软件
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试析《针灸大成》医案论治肿瘤的学术特色
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作者 卢超 杜纯 张庆乾 《中国针灸》 CAS CSCD 北大核心 2019年第7期781-784,共4页
《针灸大成》中记载了大量针灸医案,涉及多种病症,更有论治肿瘤医案多篇。《针灸大成》医案指出肿瘤为有形之邪,其病理因素常为痰作祟,宜早诊治,若拖延则易发危候。针灸治疗时要以治其瘤为治本,兼顾固本培元,治疗时应分清病情缓急、注... 《针灸大成》中记载了大量针灸医案,涉及多种病症,更有论治肿瘤医案多篇。《针灸大成》医案指出肿瘤为有形之邪,其病理因素常为痰作祟,宜早诊治,若拖延则易发危候。针灸治疗时要以治其瘤为治本,兼顾固本培元,治疗时应分清病情缓急、注重针刺时机、讲究针刺补泻手法、强调运用艾灸法等。《针灸大成》医案论治肿瘤的学术特色对后世产生了深远影响,对今日指导临床针灸治疗肿瘤病症仍有重要意义。 展开更多
关键词 杨继洲 针灸大成 医案 肿瘤 学术特色
Intraperitoneal rupture of the hydatid cyst: Four case reports and literature review 预览
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作者 Sami Akbulut Fatih Ozdemir 《世界肝病学杂志:英文版(电子版)》 2019年第3期318-329,共12页
BACKGROUND Most patients with hydatid cysts are asymptomatic, and they are diagnosed incidentally during radiological evaluations performed for other reasons. However, some patients develop symptoms and complications ... BACKGROUND Most patients with hydatid cysts are asymptomatic, and they are diagnosed incidentally during radiological evaluations performed for other reasons. However, some patients develop symptoms and complications due to cyst size, location, and the relationship between the cyst and adjacent structures. The most serious complications that can occur are rupture of the cysts into the biliary tract, vascular structures, hollow viscus, and peritoneal cavity. We aimed to describe the management of four cases of intraperitoneal rupture of hydatid cysts. CASE SUMMARIES Four patients aged between 27 and 44 years (two men and two women) were admitted to our clinic with sudden abdominal pain (n = 4), hypotension (n = 3), and anaphylaxis (n = 2). Three of the perforated cysts were located in the liver, and one was located in the spleen. Two patients developed cyst rupture after minor trauma, and the other two developed spontaneous rupture. Enzymelinked immunosorbent assay IgG results were positive for two patients and negative for the other two. All patients received albendazole treatment after surgical intervention (range: 2-6 mo). Two patients developed hepatic abscesses requiring drainage;one of these patients also developed hydatid cyst recurrence during postoperative follow-up (range: 25-80 mo). CONCLUSION Intraperitoneal rupture is a life-threatening complication of hydatid cysts. It is important to manage patients with surgical intervention as soon as possible with aggressive medical treatment for anaphylactic reactions. 展开更多
关键词 HYDATID CYST COMPLICATION Inraperitoneal RUPTURE Spontaneous RUPTURE TRAUMATIC RUPTURE Anaphylactic reactions Case report
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