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Large cell neuroendocrine carcinoma (LCNEC) is an extremely rare malignant tumor of the colon, presenting with more severe clinical outcomes in comparison to colonic adenocarcinoma. There are very few reported cases in the literature. We hereby add our voice to the incidence of this disease by presenting the first report of a patient with ileocolic intussusception secondary to a large cell neuroendocrine cancer of the cecum. The patient was a 48-year-old woman who presented with acute onset of generalized abdominal pain and leukocytosis. CT scan revealed an ileocecal intussusception and multiple liver metastases suggestive of a malignant bowel lesion. She underwent emergency surgery, and an extended right hemicolectomy with ileo-transverse anastomosis was performed. Histology of the resected lesion revealed large cell neuroendocrine carcinoma of the cecum with invasion through the muscularis propria into peri colorectal tissues. The tumor retained mismatch repair (MMR) proteins with low potential for microsatellite instability (MSI). With a clinical diagnosis of stage IV LCNEC, the patient began platinum doublet chemotherapy with carboplatin and etoposide; however, her disease progressed, and the patient expired within a few months after her diagnosis. Clinical diagnosis of adult intussusception should prompt clinicians to rule out malignant etiology. This patient had a large cell neuroendocrine carcinoma of the colon, a rare and extremely aggressive malignancy. Patients with LCNEC will benefit from a multidisciplinary approach to treatment.
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Red doctor’s culture is a characteristic cultural system in the field of red and health during the revolutionary period， as well as an important part of China’s revolutionary culture. It differs from general medical culture， and its formation and development has unique historical implications. Therefore， it is necessary to deeply analyze the basic connotation of red doctor’s culture and explore the contemporary value it contains. In the new era， inheriting the red doctor’s culture is of great significance， which can effectively promote the construction of a healthy China in the new era， provide high-quality resources for ideological and political education in the new era， and become a new approach to inheriting the red gene. The successful inheritance of the red doctor’s culture is inseparable from the joint efforts of all sectors of society. Strengthening scientific research， optimizing the educational environment， and increasing cultural propaganda， can assist in the inheritance of red doctor’s culture， open a new chapter of it， make the red doctor’s culture deeply penetrate people’s hearts， and let the red bloodline be passed down from generation to generation.
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Red culture embodies the spirit and character of the Communist Party of China of continuous struggle and indomitable for more than 100 years， and is an important resource to promote the construction of academic style in colleges and universities. Red culture is of great help in strengthening the ideals and beliefs of medical students， improving medical ethics and self-cultivation， and cultivating professional spirit. However， the current integration of red culture into the construction of academic style has problems， such as the backwardness of teachers’ media literacy， outdated educational discourse， and weak awareness of collaborative education. Based on these， colleges and universities should optimize the integration mechanism of red culture and academic style construction through innovative methods of publicity and education， changing educational discourse， expanding educational channels， and other methods. They should fully leverage the role of red culture in cultivating the foundation and solidifying the soul， enlightening wisdom and infiltrating the heart， and inspiring the fighting spirit. A vibrant and upward academic style should be actively created， as well as excellent academic style should be used to guide people’s paths， nourish people’s hearts， and urge people to make progress.
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The red doctor’s spirit was formed during the medical and health practice led by the Communist Party of China during the Soviet Area of the Communist Party of China. The red doctor’s spirit has distinct characteristics, which is consistent with the value orientation of medical humanities. At the same time, there are some problems in the ideological and political construction of red doctor’s spirit and medical humanities course. It is necessary to explore ways to better integrate red doctor’s spirit into the construction of medical humanities course, so as to promote the improvement and development of medical humanities course. Through the combination of red doctor’s spirit and medical humanities course, this paper developed the ideological and political elements in medical humanities course, expanded the breadth and depth of medical humanities education, so that the majority of medical students can be actively guided in medical humanities course, form firm ideals and beliefs, good moral quality, and achieve the good effect of curriculum ideological and political construction. Guide medical students’ thoughts to develop in the right direction and to lay a solid foundation for medical work in the future.
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Lymphangioleiomyomatosis (LAM) is a rare disorder of abnormal proliferation of smooth muscle-like cells which results in the formation of thin-walled cysts and progressive lung destruction. It commonly presents with progressive dyspnea that is often associated with a history of pneumothorax or chylothorax particularly among females of reproductive age. In this report, we present a case of hydropneumothorax as the initial presentation of LAM in a 33-year-old woman, a rather rare presentation. We also discuss the pathogenetic mechanisms, the diagnosis, and treatment strategies using mTOR inhibitors like sirolimus.
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The role of energy and natural resources rent has been studied in the literature but very few research works investigated the impacts of economic policy uncertainty and energy structure on ecological footprints (EFs) in the group of ten G-10 countries. Therefore, this research is designed to probe the impacts of economic policy uncertainty (EP), natural resources rent, energy structure, economic growth, and total factor productivity on EF. The annual data for 1995-2018 is analyzed by adopting second-generation methods. The empirical results from the CS-ARDL unveiled that EP is significantly and positively related to EF, indicating that EP is not environmentally friendly in these nations. A 1% increase in EP contributes to EF by 0.025% in the long run. In addition, the results show that natural resource rents and energy structure positively contribute to mitigating EF by 0.012% and 0.095% respectively, while economic growth increases EF by 0.237%. Based on the empirical results, this work suggests addressing the economic policy uncertainty and economic progress to lower ecological deprivation can be a viable solution to attain sustainable development goals. This work recommends adopting feasible economic policies with sound efforts. For this purpose, the economic sector has to be strong enough with sustainable production. They should ensure the supply of continuous renewable energy to the economic sector.
Subject(s)
Economic Development , Natural Resources , Uncertainty , Renewable Energy , Technology , Carbon DioxideABSTRACT
Objective:To investigate the safety and efficacy of robot-guided ventricular partition puncture drainage in severe intraventricular hemorrhage.Methods:A total of 23 patients with severe intraventricular hemorrhage who underwent robot-guided ventricular partition puncture drainage (experimental group) and 19 patients who underwent robot-guided bilateral ventricular puncture drainage (control group) at Department of Neurosurgery, People's Hospital of Baise from January 2021 to December 2021 were included. The differences in residual hematoma volume within 24 h of surgery, drainage tube retention time, mortality rate within 30 d of surgery, incidence of complications (re-bleeding, intracranial infection, pulmonary infection, hydrocephalus) within 6 months of surgery, and scores of Glasgow coma scale (GCS), activity of daily living (ADL), and National Institutes of Health stroke scale (NIHSS) at 6 months after surgery were compared between the 2 groups.Results:Compared with the control group, the experimental group had significantly lower residual hematoma volume within 24 h of surgery ([8.854±3.519] mL vs. [5.668±2.873] mL), shorter drainage tube retention time ([6.580±1.981] d vs. [4.910±2.763] d), lower incidence of hydrocephalus within 6 months of surgery (42.105% vs. 8.696%), and significantly higher GCS and ADL scores and lower NIHSS scores at 6 months after surgery (8.790±2.898 vs. 11.610±2.948; 69.470±12.899 vs. 78.480±12.861; 13.950±5.265 vs. 9.870±4.124, P<0.05). Conclusion:Robot-guided ventricular partition puncture drainage is a safe and effective surgical method for severe intraventricular hemorrhage.
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Objective:To compare the application value of ultrasound-guided lumbar plexus block (LPB) and continuous adductor canal nerve block (ACNB) in total hip arthroplasty (THA), and to explore the anesthesia scheme of THA.Methods:A prospective randomized controlled trial was used. Ninety patients who received THA admitted to in Lishui People′s Hospital from March 2019 to February 2022 were selected as the study subjects. According to the random number table method, 90 patients were divided into the test group and the control group, with 45 patients in each. The control group received LPB + general anesthesia, and the test group received ACNB + general anesthesia. By evaluating the hemodynamic parameters heart rate (HR) and mean arterial pressure (MAP) at the time of entry (T 1), osteotomy (T 2), prosthesis implantation (T 3) and immediately after surgery (T 4); the pain degree visual analogue score (VAS) at 6 h (S 1), 12 h (S 2), 24 h (S 3), 48 h (S 4) after awakening; the dosage of anesthetic drugs, the anesthetic effects of LPB and ACNB in THA were compared. Results:From T 2 to T 4, HR of patients in the two groups had a trend of increase: (85.24 ± 4.26) times/min vs. (86.13 ± 4.86) times/min, (83.82 ± 5.11) times/min vs. (85.16 ± 3.56) times/min and (81.64 ± 4.32) times/min vs. (82.24 ± 4.62) times/min, while MAP was in a downward trend: (86.54 ± 4.25) mmHg (1 mmHg = 0.133 kPa) vs. (85.35 ± 4.66) mmHg, (86.15 ± 3.92) mmHg vs. (84.86 ± 4.13) mmHg and (90.65 ± 5.25) mmHg vs. (92.12 ± 4.62) mmHg. The difference at different time points was statistically significant ( P<0.05). There was no statistically significant difference in HR, MAP and change trend between the two groups at different time ( P>0.05). The VAS score of the two groups increased from S 2 time point, and the difference between different time points was statistically significant ( P<0.05). The rising trend of VAS score in the test group was lower than that in the control group, and the VAS score at different time points was lower than that in the control group ( P<0.05). The dosage of sufentanil used in the test group was less than that in the control group: (114.37 ± 16.61) μg vs. (131.36 ± 18.31) μg, and the number of press of analgesia pump was less than that in the control group: 6.00 (5.00, 6.50) times vs. 8.00 (7.00, 9.00) times ( P<0.05). Conclusions:Ultrasound-guided LPB and ACNB could maintain hemodynamic stability in THA. Especially, ACNB could play an analgesic role within 48 h after THA and reduce the dosage of analgesic drugs.
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Wu Liande’s spirit was formed during the development of modern public health in China. It is a unity of the spirit of patriotism, humanitarianism, scientific exploration, and dedication, and a valuable resource and vivid textbook for medical students to carry out professional spirit education. Promoting Wu Liande’s spirit in the new era is not only conducive to inspiring the patriotism of medical students, bravely undertaking the mission of the times, and devoting themselves to the cause of human health, but also conducive to guiding medical students to refine benevolence and skill, and fulfill the sacred oath of medical students. To cultivate the professional spirit of medical students with Wu Liande’s spirit, it is necessary to achieve the "integration of specialized courses and ideological and political education" , promote the collaborative development of ideological and political courses and curriculum ideological and political education, innovate teaching methods and use modern information technology to empower Wu Liande’s spirit to be visualized and expressed, and take discipline practice as the starting point to expand the new path of professional spirit practice education for medical students.
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Intracranial plasmacytoma is an exceedingly rare presentation of plasma cell neoplasms. Usually presenting late in the course of the disease, progression from the presentation can be abrupt. Hence, a low threshold to biopsy the lesion should be maintained during diagnostic evaluation. Multiple myeloma workup should also be sent and treated concomitantly along with local treatment. Here, we present a case of extramedullary plasmacytoma of the clivus leading to progressive visual deficits with undiagnosed multiple myeloma requiring pulse steroids, intracranial irradiation, and high-dose chemotherapy with improvement in symptoms.
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Objective To improve the efficiency of radiation work preparation, promote the comprehensive and whole-process control of radiation risk, strengthen the accumulation of experience feedback data, and improve the timeliness of approval. Methods According to the application of radiation work permits in Tianwan Nuclear Power Plant and other nuclear power plants, the radiation work permit software in Tianwan Nuclear Power Plant was improved in terms of work order connection, examination and approval process integration, approval of radiation work at different levels, unification of level classification standard, radiation risk database establishment and maintenance, and closed loop management and mobile approval of radiation work permit. Results A radiation work permit software for nuclear power plant was developed according to the requirement of radiation risk control. Conclusion The radiation work permit software effectively improves the radiation work regarding work preparation efficiency, risk control, experience feedback data accumulation, and timeliness of approval. Subsequently, information transmission efficiency and experience sharing can be improved through connection and communication with other software in nuclear power plants.
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The red doctor’s spirit was formed during the medical and health practice led by the Communist Party of China during the Soviet Area of the Communist Party of China. The red doctor’s spirit has distinct characteristics, which is consistent with the value orientation of medical humanities. At the same time, there are some problems in the ideological and political construction of red doctor’s spirit and medical humanities course. It is necessary to explore ways to better integrate red doctor’s spirit into the construction of medical humanities course, so as to promote the improvement and development of medical humanities course. Through the combination of red doctor’s spirit and medical humanities course, this paper developed the ideological and political elements in medical humanities course, expanded the breadth and depth of medical humanities education, so that the majority of medical students can be actively guided in medical humanities course, form firm ideals and beliefs, good moral quality, and achieve the good effect of curriculum ideological and political construction. Guide medical students’ thoughts to develop in the right direction and to lay a solid foundation for medical work in the future.
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Red doctor’s spirit, an ideological system formed in the revolutionary war era, includes four dimensions of ideal and faith, professional technology, professional value and work style. It is a valuable resource for medical students to carry out medical ethics and medical style education. In the new era, the use of information technology to integrate red doctor’s spirit into medical ethics education not only provides an important guarantee for medical students to "classes suspended but learning continues" under the normalization of the epidemic situation, but also effectively responds to the cognitive needs and expectations of medical students in the context of education informationization, and has cultivated a continuous stream of high-quality medical talents for the implementation. The red doctor’s spirit should be integrated into medical ethics education through technology to ensure proper selection and actively implement the principle of intelligent teaching; adhere to the principle of "content is the most important" and enhance the presentation and ideological guidance of red doctor’s spirit; focus on the innovation of methods to realize the activation presentation and visual expression of red doctor’s spirit.
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Advanced biliary tract carcinoma (ABC) tends to have a poor prognosis, with trials done having limited data from oncologists' perspectives. Squamous cell variant of gallbladder cancer (GBC) is one of the rarest forms of cancer known in the literature, with a very aggressive course and dismal prospects. Herein, we present a case of a 67-year-old man who got diagnosed with squamous cell carcinoma, which initially masqueraded as liver abscess and was associated with severe hypercalcemia, pyrexia, jaundice, and submassive pulmonary embolism.
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Background@#Antimicrobial peptides (AMPs) have been identified as promising compounds for consideration as novel antimicrobial agents. @*Objectives@#This study analyzed the efficacy of cecropin B against Haemophilus parasuis isolates through scanning electron microscopy (SEM) and atomic force microscopy (AFM) experiments. @*Results@#Cecropin B exhibited broad inhibition activity against 15 standard Haemophilus parasuis (HPS) strains and 5 of the clinical isolates had minimum inhibition concentrations (MICs) ranging from 2 to 16 μg/mL. Microelectrophoresis and hexadecane adsorption assays indicated that the more hydrophobic and the higher the isoelectric point (IEP) of the strain, the more sensitive it was to cecropin B. Through SEM, multiple blisters of various shapes and dents on the cell surface were observed. Protrusions and leakage were detected by AFM. @*Conclusions@#Based on the results, cecropin B could inhibit HPS via a pore-forming mechanism by interacting with the cytoplasmic membrane of bacteria. Moreover, as cecropin B concentration increased, the bacteria membrane was more seriously damaged. Thus, cecropin B could be developed as an effective anti-HPS agent for use in clinical applications.
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Background@#Antimicrobial peptides (AMPs) have been identified as promising compounds for consideration as novel antimicrobial agents. @*Objectives@#This study analyzed the efficacy of cecropin B against Haemophilus parasuis isolates through scanning electron microscopy (SEM) and atomic force microscopy (AFM) experiments. @*Results@#Cecropin B exhibited broad inhibition activity against 15 standard Haemophilus parasuis (HPS) strains and 5 of the clinical isolates had minimum inhibition concentrations (MICs) ranging from 2 to 16 μg/mL. Microelectrophoresis and hexadecane adsorption assays indicated that the more hydrophobic and the higher the isoelectric point (IEP) of the strain, the more sensitive it was to cecropin B. Through SEM, multiple blisters of various shapes and dents on the cell surface were observed. Protrusions and leakage were detected by AFM. @*Conclusions@#Based on the results, cecropin B could inhibit HPS via a pore-forming mechanism by interacting with the cytoplasmic membrane of bacteria. Moreover, as cecropin B concentration increased, the bacteria membrane was more seriously damaged. Thus, cecropin B could be developed as an effective anti-HPS agent for use in clinical applications.
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Objective:To evaluate the efficacy of Tui Na therapy combined with self-made Jianpi-Tiaogan Decoction in the treatment of anorexia in children. Methods:A total of 92 patients with pediatric anorexia in our hospital from January 2018 to June 2019 who met the inclusion criteria were divided into 2 groups by random number table method, with 46 patients in each group. The control group was treated with the Tui Na therapy mainly by manipulating on the abdomen and pushing the spleen, and the treatment group was given the self-made Jianpi-Tiaogan Decoction on the basis of the treatment of the control group. Both groups were treated for 4 weeks. The TCM syndrome scores were performed, serum Leptin and Ghrelin levels were measures by enzyme linked immunosorbent assay, serum neuropeptide Y (NPY) was measured by radioimmunoassay, contents of blood zinc and salivary amylase ptyalase were measured by flame atomic absorption spectrometry and Western blot, and D-xylose absorption test was carried out respectively before and after treatment. And the clinical efficacy was evaluated. Results:The total effective rate was 91.3% (42/46) in the treatment group and 73.9% (34/46) in the control group. The difference between the two groups was statistically significant ( χ2=4.821, P=0.028). After treatment, the scores of anorexia, antifeedance, irritability, agitation, hiccup and belching, fullness of chest and flank, thin shape, sleep difficulty and total score in the treatment group were significantly lower than those in the control group ( t values were 6.782, 7.524, 9.100, 5.643, 4.796, 6.066, 4.069, 3.197, 5.073, respectively, all Ps<0.01). After treatment, the serum NPY (133.7 ± 12.4 ng/L vs. 105.6 ± 10.8 ng/L, t=11.589) and Ghrelin (329.6 ± 26.1 ng/L vs. 275.4 ± 25.0 ng/L, t=12.211) levels in the treatment group were significantly higher than those in the control group ( P<0.01), but Leptin (21.7 ± 4.0 g/L vs. 25.2 ± 4.3 g/L, t=4.042) was significantly lower than that of the control group ( P<0.01). After treatment, blood zinc (9.9 ± 2.5 mol/L vs. 8.7 ± 2.3 mol/L, t=2.396), salivary amylase ptyalase content (23.5 ± 4.2 U/L vs. 17.9 ± 3.6 U/L, t=6.866), D-xylose absorption test (0.9 ± 0.4 ng/L vs. 0.7 ± 0.3 ng/L, t=2.713) were significantly higher than those in the control group ( P<0.05 or P<0.01). Conclusions:Tui Na therapy combined with self-made Jianpi-Tiaogan Decoction can improve TCM syndromes of children, regulate the levels of NPY, Leptin and Ghrelin, and improve clinical efficacy.
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Ubiquitin specific peptidase 28 (USP28) is closely associated to the occurrence and development of various malignancies, and thus has been validated as a promising therapeutic target for cancer therapy. To date, only few USP28 inhibitors with moderate inhibitory activity have been reported, highly potent and selective USP28 inhibitors with new chemotypes remain to be discovered for pathologically investigating the roles of deubiquitinase. In this current study, we reported the synthesis and biological evaluation of new [1,2,3]triazolo[4,5-]pyrimidine derivatives as potent USP28 inhibitors. Especially, compound potently inhibited USP28 (IC = 1.10 ± 0.02 μmol/L, = 40 nmol/L), showing selectivity over USP7 and LSD1 (IC > 100 μmol/L). Compound was cellularly engaged to USP28 in gastric cancer cells. Compound reversibly bound to USP28 and directly affected its protein levels, thus inhibiting the proliferation, cell cycle at S phase, and epithelial-mesenchymal transition (EMT) progression in gastric cancer cell lines. Docking studies were performed to rationalize the potency of compound . Collectively, compound could serve as a new tool compound for the development of new USP28 inhibitors for exploring the roles of deubiquitinase in cancers.
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Objective To investigate the clinical features and risk factors of multidrug－resistant bacteria (multi drug resistant organisms, MDROs) infection in Department of Neurosurgery, and to provide evidence for the prevention and control of MDRO infection. Methods Data from 437 cases of infection in hospitalized patients on January 2012－2016 year in December Third Affiliated Hospital of Guizhou Medical University were retrospectively analyzed. Patients were divided into MDROs group and non MDROs group based on the results of MDROs detection. Multi factor Logistic regression analysis model was used to analyze risk factors. Results The infection rate of MDROs was 35.51%, and the detection rate of MDROs was 33.23% . ESBLs, CR－AB and MRSA were the most common bacterial species, and the infection of respiratory tract, urinary tract and wound infection were the main infection sites. Multivariate logistic regression analysis showed that hospitalization time ＞20 d, level of consciousness (coma), occupancy of ICU ≥7 d, ventilation (invasive), number of antibiotics used≥3, combined use of antibiotics≥3, mechanical ventilation Time≥7 d were possible risk factors for MDROs infection in neurosurgical patients (P＜0.05). Conclusion The situation of MDROs infection in neurosurgery is severe. To reduce MDROs infection, it is important to shorten unnecessary hospitalization time, promptly assess and transfer out of ICU as soon as possible, improve microbial examination, avoid frequent change of antibiotics or unnecessary use of use of broad－spectrum antibiotics, reduce unnecessary mechanical ventilation time, change to non－invasive ventilation as far as possible when the condition permits, focus on patients with poor consciousness, and prevent aspiration by mistake.
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Histone lysine specific demethylase 1 (LSD1) has been recognized as an important modulator in post-translational process in epigenetics. Dysregulation of LSD1 has been implicated in the development of various cancers. Herein, we report the discovery of the hit compound (IC = 3.93 μmol/L) and further medicinal chemistry efforts, leading to the generation of compound (IC = 49 nmol/L, and = 16 nmol/L), which inhibited LSD1 reversibly and competitively with H3K4me2, and was selective to LSD1 over MAO-A/B. Docking studies were performed to rationalize the potency of compound . Compound also showed strong antiproliferative activity against four leukemia cell lines (OCL-AML3, K562, THP-1 and U937) as well as the lymphoma cell line Raji with the IC values of 1.79, 1.30, 0.45, 1.22 and 1.40 μmol/L, respectively. In THP-1 cell line, significantly inhibited colony formation and caused remarkable morphological changes. Compound induced expression of CD86 and CD11b in THP-1 cells, confirming its cellular activity and ability of inducing differentiation. The findings further indicate that targeting LSD1 is a promising strategy for AML treatment, the triazole-fused pyrimidine derivatives are new scaffolds for the development of LSD1/KDM1A inhibitors.