BACKGROUND Kaposi’s sarcoma(KS)is one of the most common cancers in human immunodeficiency virus(HIV)-positive patients and leads to a high prevalence of morbidity and mortality.It usually appears as cutaneous or muc...BACKGROUND Kaposi’s sarcoma(KS)is one of the most common cancers in human immunodeficiency virus(HIV)-positive patients and leads to a high prevalence of morbidity and mortality.It usually appears as cutaneous or mucous lesions.Patients with visceral KS are asymptomatic and clinically silent.As the disease advances,patients may progress from a normal condition to exhibiting severe symptoms.CASE SUMMARY A 27-year-old man presented with a 2-mo history of fever,bearing-down pain,and rectal bleeding.His hepatitis B virus DNA level was 2.7×107 IU/mL.Abdominal computed tomography(CT)indicated liver cirrhosis.Before he was admitted to our hospital,he was diagnosed with HIV infection.His CD4 count was 24 cells/μL.Pelvic cavity CT suggested a thickened rectum wall accompanied by multiple enlarged lymph nodes.The patient was initially treated as having haemorrhoidal varices with bleeding,telbivudine for anti-hepatitis B virus treatment,and antibiotics for anti-infection.After half a month of treatment,the patient felt that his lower lumbus ache and bearing-down pain had not improved,and a colonoscopy was conducted.The result revealed a rectal mass that was histologically confirmed as KS with rectal spindle cells that were positive for cluster of differentiation 117(CD117),CD34,human herpes virus 8,and CD31.He was administered systemic chemotherapy with 36 mg/d liposomal doxorubicin six times.The patient experienced no sign of lower gastrointestinal bleeding again.CONCLUSION This case highlights the diagnosis of primary KS with lower gastrointestinal bleeding in HIV-positive patients,which means visceral KS could not be excluded.The gold standard relies on colonoscopy and biopsy findings.展开更多
High-grade renal trauma rarely occurs due to low-velocity mechanisms. With its clinical presentation, delayed diagnosis rarely happens. We report the case of a 12-year-old girl diagnosed seven days post-trauma with gr...High-grade renal trauma rarely occurs due to low-velocity mechanisms. With its clinical presentation, delayed diagnosis rarely happens. We report the case of a 12-year-old girl diagnosed seven days post-trauma with grade IV renal trauma complicated with infected urinoma and bilateral lower polar vessels. She was non-operatively managed with ultrasound-guided percutaneous drainage of the urinoma, which resolved, and had unremarkable six months follow-up. We discuss the role of preexistent hydronephrosis in low-velocity impact, pitfalls of diagnosis in resource-constrained settings, and management of high-grade trauma.展开更多
In this paper, the k-partitioning problem with partition matroid constraint is considered. LPT algorithm is modified to fit the problem and its worst-ease performance is analyzed. The lower bounds of optimal solution ...In this paper, the k-partitioning problem with partition matroid constraint is considered. LPT algorithm is modified to fit the problem and its worst-ease performance is analyzed. The lower bounds of optimal solution for the min-max problem are given.展开更多
<strong>Background:</strong> Bilateral Ectopic Kidney is uncommon and usually diagnosed during a routine medical checkup. It could be misdiagnosed as an abdominopelvic mass. In-depth knowledge of its prese...<strong>Background:</strong> Bilateral Ectopic Kidney is uncommon and usually diagnosed during a routine medical checkup. It could be misdiagnosed as an abdominopelvic mass. In-depth knowledge of its presentation will aid in its management. A poor anatomical relation of the kidneys with other abdominopelvic organs could lead to renal complications and surgical errors. This is of gynaecological importance and worthy of discussion for a lady of her reproductive age. <strong>Case presentation:</strong> A 20-year-old nulliparous lady of African descent presented with a long-standing history of dull lower abdominal pain. The pain has been intermittent and occasionally associated with a sensation of movement in the lower abdomen. She has a regular and normal menstrual cycle and has no lower urinary tract symptoms. Physical examination was unremarkable with intact secondary sexual characteristics. The abdomen was soft, non-tender and without any organomegaly. Abdominal ultrasonography, renal pyelogram and urinalysis were carried out after her consent was sought in accordance with the institution’s protocol. Urine analysis was normal and culture was negative. However further imaging revealed a bilateral pelvic ectopic kidney. <strong>Conclusion:</strong> Most of the cases reported are usually unilateral ectopic kidneys. It is, therefore, our belief that this information will be useful to medical practitioners such as surgeons, urologists, radiologists and gynaecologists. Such a diagnosis will enable clinicians to follow up with the client and preserve the renal function whiles preventing iatrogenic injuries during surgical procedures.展开更多
目的探析下肢骨折临床教学中三维人体解剖模型+以案例为基础教学法(case based learning,CBL)的应用效果。方法选取2023年1—6月重庆建设医院临床医学专业本科实习生25名应用传统教学法进行下肢骨折临床教学(A组),2023年7月—2024年1月2...目的探析下肢骨折临床教学中三维人体解剖模型+以案例为基础教学法(case based learning,CBL)的应用效果。方法选取2023年1—6月重庆建设医院临床医学专业本科实习生25名应用传统教学法进行下肢骨折临床教学(A组),2023年7月—2024年1月25名实习生进行三维人体解剖模型+CBL教学法(B组)。对比两组考核成绩、教学效果评价结果以及教学满意度。结果B组理论成绩(93.75±4.11)分、实践技能成绩(93.46±4.11)分高于A组的(90.89±4.03)分、(90.05±4.28)分,差异均有统计学意义(t=2.484,2.873;P均<0.05)。相较于A组,B组教学吸引力、获取信息能力、临床思维能力、理论联系实际能力、掌握知识程度、激发学习兴趣等评分更高,差异均有统计学意义(P均<0.05)。相较于A组,B组对教学满意度更高,差异有统计学意义(P<0.05)。结论在下肢骨折临床教学中采取三维人体解剖模型+CBL教学法,可激发实习生学习兴趣,提升实习生沟通能力、批判性思维能力等,有效提高考核成绩,教学效果为实习生所广泛认可满意。展开更多
基金Supported by Chinese National Special Research Program for Important Infectious Diseases,No.2017ZX10202102-002-002National Science and Technology Major Project,No.2018ZX10715-014-004
文摘BACKGROUND Kaposi’s sarcoma(KS)is one of the most common cancers in human immunodeficiency virus(HIV)-positive patients and leads to a high prevalence of morbidity and mortality.It usually appears as cutaneous or mucous lesions.Patients with visceral KS are asymptomatic and clinically silent.As the disease advances,patients may progress from a normal condition to exhibiting severe symptoms.CASE SUMMARY A 27-year-old man presented with a 2-mo history of fever,bearing-down pain,and rectal bleeding.His hepatitis B virus DNA level was 2.7×107 IU/mL.Abdominal computed tomography(CT)indicated liver cirrhosis.Before he was admitted to our hospital,he was diagnosed with HIV infection.His CD4 count was 24 cells/μL.Pelvic cavity CT suggested a thickened rectum wall accompanied by multiple enlarged lymph nodes.The patient was initially treated as having haemorrhoidal varices with bleeding,telbivudine for anti-hepatitis B virus treatment,and antibiotics for anti-infection.After half a month of treatment,the patient felt that his lower lumbus ache and bearing-down pain had not improved,and a colonoscopy was conducted.The result revealed a rectal mass that was histologically confirmed as KS with rectal spindle cells that were positive for cluster of differentiation 117(CD117),CD34,human herpes virus 8,and CD31.He was administered systemic chemotherapy with 36 mg/d liposomal doxorubicin six times.The patient experienced no sign of lower gastrointestinal bleeding again.CONCLUSION This case highlights the diagnosis of primary KS with lower gastrointestinal bleeding in HIV-positive patients,which means visceral KS could not be excluded.The gold standard relies on colonoscopy and biopsy findings.
文摘High-grade renal trauma rarely occurs due to low-velocity mechanisms. With its clinical presentation, delayed diagnosis rarely happens. We report the case of a 12-year-old girl diagnosed seven days post-trauma with grade IV renal trauma complicated with infected urinoma and bilateral lower polar vessels. She was non-operatively managed with ultrasound-guided percutaneous drainage of the urinoma, which resolved, and had unremarkable six months follow-up. We discuss the role of preexistent hydronephrosis in low-velocity impact, pitfalls of diagnosis in resource-constrained settings, and management of high-grade trauma.
基金Supported by the National Natural Science Foundation of China(10671177)
文摘In this paper, the k-partitioning problem with partition matroid constraint is considered. LPT algorithm is modified to fit the problem and its worst-ease performance is analyzed. The lower bounds of optimal solution for the min-max problem are given.
文摘<strong>Background:</strong> Bilateral Ectopic Kidney is uncommon and usually diagnosed during a routine medical checkup. It could be misdiagnosed as an abdominopelvic mass. In-depth knowledge of its presentation will aid in its management. A poor anatomical relation of the kidneys with other abdominopelvic organs could lead to renal complications and surgical errors. This is of gynaecological importance and worthy of discussion for a lady of her reproductive age. <strong>Case presentation:</strong> A 20-year-old nulliparous lady of African descent presented with a long-standing history of dull lower abdominal pain. The pain has been intermittent and occasionally associated with a sensation of movement in the lower abdomen. She has a regular and normal menstrual cycle and has no lower urinary tract symptoms. Physical examination was unremarkable with intact secondary sexual characteristics. The abdomen was soft, non-tender and without any organomegaly. Abdominal ultrasonography, renal pyelogram and urinalysis were carried out after her consent was sought in accordance with the institution’s protocol. Urine analysis was normal and culture was negative. However further imaging revealed a bilateral pelvic ectopic kidney. <strong>Conclusion:</strong> Most of the cases reported are usually unilateral ectopic kidneys. It is, therefore, our belief that this information will be useful to medical practitioners such as surgeons, urologists, radiologists and gynaecologists. Such a diagnosis will enable clinicians to follow up with the client and preserve the renal function whiles preventing iatrogenic injuries during surgical procedures.
文摘目的探析下肢骨折临床教学中三维人体解剖模型+以案例为基础教学法(case based learning,CBL)的应用效果。方法选取2023年1—6月重庆建设医院临床医学专业本科实习生25名应用传统教学法进行下肢骨折临床教学(A组),2023年7月—2024年1月25名实习生进行三维人体解剖模型+CBL教学法(B组)。对比两组考核成绩、教学效果评价结果以及教学满意度。结果B组理论成绩(93.75±4.11)分、实践技能成绩(93.46±4.11)分高于A组的(90.89±4.03)分、(90.05±4.28)分,差异均有统计学意义(t=2.484,2.873;P均<0.05)。相较于A组,B组教学吸引力、获取信息能力、临床思维能力、理论联系实际能力、掌握知识程度、激发学习兴趣等评分更高,差异均有统计学意义(P均<0.05)。相较于A组,B组对教学满意度更高,差异有统计学意义(P<0.05)。结论在下肢骨折临床教学中采取三维人体解剖模型+CBL教学法,可激发实习生学习兴趣,提升实习生沟通能力、批判性思维能力等,有效提高考核成绩,教学效果为实习生所广泛认可满意。
