Myasthenia-like paraneoplastic syndrome with multiple cranial nerve tumor infiltration: A case report and literature review.

RATIONALE: Approximately 0.001% of patients with cancer have paraneoplastic nerve system syndrome, which can affect the central nervous system, neuromuscular junction, or peripheral nervous system. Although myasthenia gravis (MG) may exist as a thymic paraneoplastic syndrome (PNPS), its association with primary lung cancer remains unknown. PATIENT CONCERNS: A 55-year-old female presented with slurred speech, weakness in chewing, sporadic difficulty in swallowing, and weakness in both lower limbs for half a year. DIAGNOSES: Based on cerebrospinal fluid and electromyography findings, we present the case of a female patient diagnosed with overlapping multicranial nerve tumor infiltration and MG-like neurological PNPS secondary to lung adenocarcinoma. INTERVENTIONS: The patient received intrathecal injections of pemetrexed and neurotrophic (vitamin B) therapy before ceasing chemoradiotherapy and chose cabozantinib on her own. OUTCOMES: Weakness of the proximal limbs, choking cough, and chewing problems did not improve significantly. LESSONS: Although it is unclear why MG coexists with lung cancer, it is probable that MG is a paraneoplastic condition. Cerebrospinal fluid testing should be carried out along with electrophysiological, serological, and pharmacological procedures pertinent to the diagnosis of MG to thoroughly examine if people simultaneously experience MG-like PNPS and tumor growth. Starting immunotherapy and anticancer medication at the same time that tumor development and MG-like syndrome are discovered is crucial.

Research on Ecological Effect Assessment Method of Ecological Restoration of Open-Pit Coal Mines in Alpine Regions.

Open-pit mining is an important form of coal mining in China, and its damage to the ecological environment is particularly obvious in alpine regions. The ecological restoration of alpine open-pit coal mines faces severe challenges, and its restoration effect will directly affect the ecological security of China. Meanwhile, comprehensive and system-oriented evaluation of ecological restoration effects is still insufficient in current research. In this study, we selected different quantities of assessment factors on the two scales of ecological project area and ecological impact area to evaluate the ecological restoration effect of an alpine open-pit coal mine. Then, we formed a multi-scale and multi-dimensional ecological restoration effect assessment model of the alpine open-pit coal mine and used this model to analyze the implementation effect of the ecological restoration project of the Baiyinhua No. 2 Open-pit Mine. The results show that the multi-scale and multi-dimensional ecological restoration effect assessment model of alpine open-pit coal mine proposed in this study can accurately characterize the restoration effect of open-pit coal mines in alpine regions and can also be used as a significant evaluation tool in the future ecological construction of mining areas. This study hopes the multi-scale and multi-dimensional ecological restoration effect assessment model of alpine open-pit coal mine can provide a comprehensive, systematic, and scientific evaluation method for the ecological restoration of alpine open-pit coal mines and provide a scientific basis for the ecological restoration and green development of relevant mining areas.

Electro-Fenton oxidation of coking wastewater: optimization using the combination of central composite design and convex optimization method.

The electro-Fenton treatment of coking wastewater was evaluated experimentally in a batch electrochemical reactor. Based on central composite design coupled with response surface methodology, a regression quadratic equation was developed to model the total organic carbon (TOC) removal efficiency. This model was further proved to accurately predict the optimization of process variables by means of analysis of variance. With the aid of the convex optimization method, which is a global optimization method, the optimal parameters were determined as current density of 30.9 mA/cm2, Fe2+ concentration of 0.35 mg/L, and pH of 4.05. Under the optimized conditions, the corresponding TOC removal efficiency was up to 73.8%. The maximum TOC removal efficiency achieved can be further confirmed by the results of gas chromatography-mass spectrum analysis.