An analytical model for chatter aero-engine casings is presented in this paper stability prediction in bull-nose end milling of And the mechanics and dynamics variations due to the complex cutter and workpiece geomet...An analytical model for chatter aero-engine casings is presented in this paper stability prediction in bull-nose end milling of And the mechanics and dynamics variations due to the complex cutter and workpiece geometry are considered by analyzing the effects of the lead angle on the milling process. Firstly, the tool-workpiece engagement region is obtained by using a previously developed method and divided into several disk elements along the tool-axis direction. Secondly, a 3D dynamic model for stability limit calculation is developed and simplified into a 1D model in normal direction considering only the dominant mode of the workpiece. Then the cutting force coefficients, the start and exit angles corresponding to each disk element are determined. And the total stability lobe diagram is calculated using an iterative algorithm. Finally, several experimental tests are carried out to validate the feasibility and effectiveness of the proposed ~rediction approach.展开更多
In order to satisfy the machining requirements of aero-engine casing in modern aviation industry, this paper investigates three main issues during the design and development process of a five-axis machine tool with hi...In order to satisfy the machining requirements of aero-engine casing in modern aviation industry, this paper investigates three main issues during the design and development process of a five-axis machine tool with high accuracy, stiffness and efficiency, including whole structure design,key components design, and supporting stiffness design. First, an appropriate structure of five-axis machine tool is determined considering the processing characteristics of aero-engine casing. Then, a dual drive swing head and a compact motorized spindle are designed with enough drive capability and stiffness, and related structure, assembly method, cooling technology, and performance simulation are given in detail. Next, a design method of supporting stiffness of guide is proposed through the deformation prediction of the spindle end. Based on above work, a prototype of machine tool is developed, and some experiments are carried out, including performance tests of swing head and motorized spindle, and machining of a simulated workpiece of aero-engine casing. All experimental results show that the machine tool has satisfactory accuracy, stiffness and efficiency, which meets the machining requirements of aero-engine casing. The main work can be used as references for engineers and technicians, which are meaningful in practice.展开更多
The original monitoring data from aero-engines possess characteristics such as high dimen-sionality,strong noise,and imbalance,which present substantial challenges to traditional anomalydetection methods.In response,t...The original monitoring data from aero-engines possess characteristics such as high dimen-sionality,strong noise,and imbalance,which present substantial challenges to traditional anomalydetection methods.In response,this paper proposes a method based on Fuzzy Fusion of variablesand Discriminant mapping of features for Clustering(FFD-Clustering)to detect anomalies in originalmonitoring data from Aircraft Communication Addressing and Reporting System(ACARS).Firstly,associated variables are fuzzily grouped to extract the underlying distribution characteristics and trendsfrom the data.Secondly,a multi-layer contrastive denoising-based feature Fusion Encoding Network(FEN)is designed for each variable group,which can construct representative features for each variablegroup through eliminating strong noise and complex interrelations between variables.Thirdly,a featureDiscriminative Mapping Network(DMN)based on reconstruction difference re-clustering is designed,which can distinguish dissimilar feature vectors when mapping representative features to a unified fea-ture space.Finally,the K-means clustering is used to detect the abnormal feature vectors in the unifiedfeature space.Additionally,the algorithm is capable of reconstructing identified abnormal vectors,thereby locating the abnormal variable groups.The performance of this algorithm was tested ontwo public datasets and real original monitoring data from four aero-engines'ACARS,demonstratingits superiority and application potential in aero-engine anomaly detection.展开更多
By using fatigue crack propagation testing and microstructural characterization,the crack fracture and propagation mechanisms of K4169 superalloy under various loads were investigated.The results demonstrate that the ...By using fatigue crack propagation testing and microstructural characterization,the crack fracture and propagation mechanisms of K4169 superalloy under various loads were investigated.The results demonstrate that the grain sizes of K4169 superalloy significantly increase,and the precipitation of the needle-likeδphase and the Laves phase is observed.Voids and microcracks form at location of Laves phase enrichment,creating conditions for crack propagation.By the a−N(a is the crack length,and N is the number of cycles)relationship curve,the change in the fatigue crack growth rate with the increasing number of cycles progresses through three separate stages.The fracture process of K4169 superalloy under low-stress cyclic loading(3 kN)exhibits the ductile fracture.Subsequently,the fracture process starts to change from the ductile fracture to the brittle fracture as the stress increases to 4.5 kN.In the microstructures of fractures in both stress states,intergranular propagation is the mechanism responsible for crack propagation.Moreover,the Laves phase exists near the fracture crack,which is in line with the post-service structural phenomenon.展开更多
This paper analyzes the nonlinear dynamic characteristics and stability of Aero-Engine Dual-Rotor(AEDR)systems under high-frequency excitation,based on the Adaptive Harmonic Balance with the Asymptotic Harmonic Select...This paper analyzes the nonlinear dynamic characteristics and stability of Aero-Engine Dual-Rotor(AEDR)systems under high-frequency excitation,based on the Adaptive Harmonic Balance with the Asymptotic Harmonic Selection(AHB-AHS)method.A finite element dynamic equation for the AEDR system is introduced,considering complex nonlinearities of the intershaft bearing,unbalanced excitations,and high-frequency excitation.A solving strategy combining the AHB-AHS method and improved arclength continuation method is proposed to solve highdimensional dynamic equations containing complex nonlinearities and to track periodic solutions with parameter variations.The Floquet theory is used to analyze the types of bifurcation points in the system and the stability of periodic motions.The results indicate that high-frequency excitation can couple high-order and low-order modes,especially when the system undergoes superharmonic resonance.High-frequency excitation leads to more combination frequency harmonics,among which N_(f)ω_(1)-2ω_(2)dominates.Furthermore,changing the parameters(amplitude and frequency)of high-frequency excitation widens or shifts the unstable regions of the system.These findings contribute to understanding the mechanism of high-frequency excitation on aero-engines and demonstrate that the proposed AHB-AHS method is a powerful tool for analyzing highdimensional complex nonlinear dynamic systems under multi-frequency excitation.展开更多
Quantitative measurement of Soot Volume Fraction (SVF) is an essential prerequisite for controlling soot particle emissions from aero-engine combustors. As an in-situ and non-intrusive optical diagnostic technique, La...Quantitative measurement of Soot Volume Fraction (SVF) is an essential prerequisite for controlling soot particle emissions from aero-engine combustors. As an in-situ and non-intrusive optical diagnostic technique, Laser-Induced Incandescence (LII) has been increasingly applied for soot concentration quantification in various combustion environments such as laminar flame, vehicle exhaust, internal combustion chamber as well as aero-engine combustor. In this work, we experimentally measured the spatial and temporal distribution of SVF using two-color LII technique at the outlet of a single-sector dual-swirl aero-engine model combustor. The effect of inlet pressure and air preheat temperature on the SVF distribution was separately investigated within a pressure range of 241–425 kPa and a temperature range of 292–500 K. The results show that soot production increases with the inlet pressure but generally decreases with the air preheat temperature. Qualitative analysis was provided to explain the above results of parametric studies. The LII experiments were also conducted under 3 designed conditions to evaluate soot emission under practical operations. Particularly, weak soot emission was detected at the outlet under the idle condition. Our experimental results provide a valuable benchmark for evaluating soot emission in the exhaust plume of this aero-engine combustor during practical operations.展开更多
The spatiotemporal distribution of soot concentration in aero-engine combustor is important for assessing its combustion performance.Here,we report experimental measurements of soot concentration in terms of Soot Volu...The spatiotemporal distribution of soot concentration in aero-engine combustor is important for assessing its combustion performance.Here,we report experimental measurements of soot concentration in terms of Soot Volume Fraction(SVF)and its spatiotemporal distribution in a single-sector dual-swirl aero-engine combustor using Two-Color Laser-Induced Incandescence(2C-LII).It is shown that soot predominantly forms in the symmetrical vortices of the primary combustion zone,exhibiting a V-type distribution with higher concentration in the lower half of the zone than the upper half,with a small amount distributed in the secondary recirculation zone.Soot emissions at the combustor outlet are relatively low under three typical operating conditions by LII experiments,which is aligned with Smoke Number(SN)from gas analysis.The effect of inlet air temperature on SVF distribution and dynamics in the primary combustion zone is studied,which suggests that the SVF level in the primary combustion zone monotonically increases with the temperature.Meanwhile,the SVF distribution becomes more symmetrical as the inlet temperature increases,although the overall SVF level in the lower half of the zone is still higher.We also investigate the influence of the inlet air pressure on the SVF distribution at the combustor outlet.The soot concentration at the combustor outlet increases with inlet pressure,mainly distributed irregularly across both sides and the center.On both sides,the distribution is continuous,while the center exhibits dot-like and linear patterns.Numerical simulations correlated SVF distribution with the flow field in the primary combustion zone,qualitatively explaining the observed SVF distribution behavior.These results under various conditions can provide valuable insights for improving the performance of this specific combustor and designing high-temperature-rise combustors in the future.展开更多
BACKGROUND Ganglioneuroma is a rare,well-differentiated,slow-growing benign tumor of the peripheral nerves,with surgical resection being the only curative treatment.Surgical resection of ganglioneuromas encasing major...BACKGROUND Ganglioneuroma is a rare,well-differentiated,slow-growing benign tumor of the peripheral nerves,with surgical resection being the only curative treatment.Surgical resection of ganglioneuromas encasing major blood vessels remains a substantial clinical challenge.Traditionally,these cases often require open abdominal surgery or combined organ resections,and in some instances,the tumors are considered unresectable.Currently,no reports have described the resection of such tumors via laparoscopy.CASE SUMMARY A 35-year-old woman was admitted to our hospital after the incidental discovery of a retroperitoneal space-occupying lesion.Imaging revealed a mass with the celiac axis and superior mesenteric artery passing through it.A neurogenic tumor was suspected,with ganglioneuroma being the most likely diagnosis.Following comprehensive preoperative preparation,the retroperitoneal tumor was resected using a three-dimensional laparoscopy combined with an organ suspension technique.The surgical approach involved incising the tumor along the vascular axis and conducting meticulous,vascular-preserving tumor excision.The operation lasted approximately 458 minutes,with an estimated blood loss of 50 mL.The patient was discharged on the 8th postoperative day.A transient liver injury occurred after surgery but improved rapidly.After 11 months of postoperative follow-up,no complications or tumor recurrence were observed.CONCLUSION This case illustrates the feasibility of minimally invasive laparoscopic resection for retroperitoneal ganglioneuromas encasing major blood vessels.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
BACKGROUND Phaeochromocytoma and paragangliomas(PPGL)are rare neuroendocrine tumors usually caused by parasympathetic or sympathetic nerves,with an overall incidence of approximately 0.66 cases per 100000 people per y...BACKGROUND Phaeochromocytoma and paragangliomas(PPGL)are rare neuroendocrine tumors usually caused by parasympathetic or sympathetic nerves,with an overall incidence of approximately 0.66 cases per 100000 people per year.Most PPGLs are asymptomatic,and a few develop symptoms,such as elevated blood pressure and rapid heart rate,because of the release of catecholamines.According to the literature,surgical resection is the mainstay of PPGL treatment.However,the choice between minimally invasive surgery and open surgery remains controversial,particularly in cases involving complex anatomical relationships.We successfully resected a tumor located between the inferior vena cava and abdominal aorta using a minimally invasive approach with the assistance of computed tomography(CT)angiography and three-dimensional reconstruction,resulting in a favorable outcome.CASE SUMMARY A 56-year-old woman was admitted to the hospital with right upper abdominal discomfort for more than 6 months,experiencing occasional pins and needles sensation and radiation from the right shoulder and back.Prehospital CT of the upper abdomen revealed a retroperitoneal mass suspected to be a retroperitoneal ganglioneuroma.Surgery was recommended,and an enhanced CT scan of the upper abdomen,along with preoperative three-dimensional reconstruction,was performed after admission.The imaging indicated that the mass,measuring approximately 4.1 cm×3.8 cm×4.8 cm,was situated between the abdominal aorta and the inferior vena cava,extending downward to the level of the left renal vein.After ruling out any contraindications to surgery,a minimally invasive laparoscopy was performed to excise the mass precisely.The surgery was successful without any postoperative complications,and the 2-month follow-up revealed no abnormal signs of recurrence.CONCLUSION This case report describes successful and precise laparoscopic resection of a retroperitoneal tumor.The patient recovered well during the 2-month follow-up,and postoperative pathology revealed a paraganglioma.展开更多
BACKGROUND Middle meningeal artery embolization(MMAE)is emerging as a promising treatment for chronic subdural hematoma(CSDH),serving both as an adjunct to surgery and as a primary therapeutic option depending on pati...BACKGROUND Middle meningeal artery embolization(MMAE)is emerging as a promising treatment for chronic subdural hematoma(CSDH),serving both as an adjunct to surgery and as a primary therapeutic option depending on patient presentation.Due to its low recurrence rate and minimal complications,MMAE has gained increasing acceptance among clinicians in recent years.This report presents a case of diplopia following MMAE due to the presence of a potential anastomotic artery,aiming to enhance awareness of this complication.CASE SUMMARY A 60-year-old male patient presented with a headache following head trauma,and cranial computed tomography revealed a left-sided CSDH.The patient underwent left MMAE;however,polyvinyl alcohol particles inadvertently flowed into the lacrimal artery through an anastomotic artery,resulting in diplopia due to impaired abduction of the left eye.The diplopia resolved by postoperative day 40.The patient’s headache resolved by postoperative day 7,and the hematoma completely resolved by postoperative day 108.CONCLUSION Potential anastomotic arteries in the middle meningeal artery(MMA)can lead to serious complications.Superselective angiography of the MMA or its branches prior to embolization is essential.Performing embolization distal to potential anastomotic sites can reduce risks,and the presence of an anastomosis may warrant coil embolization or termination of the procedure.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
BACKGROUND The incidence of malignant gastrointestinal(GI)tumors is increasing,and advancements in medical care have significantly improved patient survival rates.As a result,the number of cases involving multiple pri...BACKGROUND The incidence of malignant gastrointestinal(GI)tumors is increasing,and advancements in medical care have significantly improved patient survival rates.As a result,the number of cases involving multiple primary cancers(MPC)has also increased.The rarity of MPC and the absence of sensitive and specific dia-gnostic markers often lead to missed or incorrect diagnoses.It is,therefore,of vital importance to improve the vigilance of clinicians and the accurate diagnosis of this disease.Patients with GI malignancies face a higher relative risk of deve-loping additional primary malignant tumors compared to those with other systemic tumors.Vigilant monitoring and follow-up are crucial,especially for high-risk groups,which include older adults,men,those with addictions to alcohol and tobacco,those with a family history of tumors,and those who have undergone radiotherapy.CASE SUMMARY In this article,we report three cases of MPC,each involving malignant tumors of the GI tract as the initial primary carcinoma,offering insights that may aid in effectively managing similar cases.CONCLUSION Patients with GI malignancies face a higher MPC risk.Developing screening and follow-up protocols may enhance detection and treatment outcomes.展开更多
BACKGROUND While existing literature on ischiofemoral impingement syndrome(IFI)predominantly emphasizes surgical interventions or generalized physical therapy approaches,there remains a paucity of evidence regarding s...BACKGROUND While existing literature on ischiofemoral impingement syndrome(IFI)predominantly emphasizes surgical interventions or generalized physical therapy approaches,there remains a paucity of evidence regarding structured,multimodal rehabilitation programs targeting biomechanical deficits in IFI.This case report evaluates the efficacy of a multimodal rehabilitation program addressing a critical gap in conservative management strategies.CASE SUMMARY The patient underwent comprehensive physical and clinical examination,including hip X-ray and magnetic resonance imaging investigations.The patient completed the Musculoskeletal Health Questionnaire(MSK-HQ)and numerical pain rating scale(NPRS).The patient underwent a two-month tailored structured physical therapy intervention and repeated the same assessment afterwards.The patient's substantial reduction in pain,reflected by a significant decrease in the patient’s NPRS score from 9 to 3 points,signifies a positive clinical response.This outcome,coupled with the significant improvement in the patient's health-related quality of life according to the MSK-HQ score,which increased from 12 to 48 points,underscores the success of our research.CONCLUSION The study highlights the importance of a comprehensive approach to diagnosing and managing IFI,combining clinical assessment with imaging and implementing a multimodal rehabilitation program for optimal outcomes.展开更多
BACKGROUND Pubic ramus fractures are generally considered fragility fractures in the elderly population,commonly deriving from a low-impact fall.Treatment is ordinarily conservative and hemodynamic complications are e...BACKGROUND Pubic ramus fractures are generally considered fragility fractures in the elderly population,commonly deriving from a low-impact fall.Treatment is ordinarily conservative and hemodynamic complications are exceedingly infrequent.Notwithstanding,patients with copious comorbidities should be carefully monitored for potential vascular injury.CASE SUMMARY This case report presents the management of a 75-year-old male patient with a history of diabetes mellitus and arterial hypertension who was admitted to the emergency room with a superior pubic ramus fracture.The patient experienced a significant drop in hematocrit and hemoglobin levels post-admission,necessi-tating urgent intervention.A computed tomography angiography revealed active bleeding,leading to the embolization of the medial femoral branch.The patient was stabilized hemodynamically and was discharged after 15 days,with recom-mendations for home-based follow-up care.CONCLUSION This report denotes the various challenges and strategies in managing simple fractures that are treated conservatively,but need prompt monitoring for occult vascular injuries that can be fatal.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
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 Nocardiosis is a rare bacterial infection with unclear epidemiology,pathogenesis,and characteristics.Its clinical manifestations are diverse and nonspecific,making diagnosis prone to errors,including misdia...BACKGROUND Nocardiosis is a rare bacterial infection with unclear epidemiology,pathogenesis,and characteristics.Its clinical manifestations are diverse and nonspecific,making diagnosis prone to errors,including misdiagnosis and missed diagnosis.Additionally,this disease is difficult to treat,often requiring months or even years of antibacterial therapy,and can be fatal in patients with underlying conditions.CASE SUMMARY A 93-year-old male patient with chronic renal insufficiency sustained a skin injury at the tip of his right thumb.As a result of an initial misdiagnosis and inadequate treatment,the infection progressed,resulting in multiple rashes on his right upper limb.Local incision and drainage of pus,combined with oral antibiotics administered at a different hospital,yielded no significant improvement.Upon hospitalization,the patient’s immune function was assessed,and further local incision and drainage were performed.Cultures of the pus identified Nocardia brasiliensis.Treatment involved intravenous infusion of piperacillin-tazobactam sodium and oral administration of sulfamethoxazole-trimethoprim,leading to the patient’s recovery.After discharge,the patient continued to take sulfamethoxazole tablets for 6 months,with complete healing of the skin lesions and no recurrence.CONCLUSION Nocardiosis should be considered in patients with underlying conditions and compromised immunity.Prompt and accurate diagnosis is crucial.展开更多
BACKGROUND Simultaneous acute ischemic stroke(AIS)and myocardial infarction(cardio-cerebral ischemic attack)have rarely been reported in the literature.Currently,no clear evidence-based guidelines or clinical trials e...BACKGROUND Simultaneous acute ischemic stroke(AIS)and myocardial infarction(cardio-cerebral ischemic attack)have rarely been reported in the literature.Currently,no clear evidence-based guidelines or clinical trials exist to determine the optimal therapeutic strategy for these patients.CASE SUMMARY We present the case of a 27-year-old Chinese man who simultaneously experie-nced acute concomitant cerebrocardiac infarction(CCI)and painless ST-elevation myocardial infarction.The patient was successfully treated with elective percu-taneous coronary intervention(PCI)after receiving urgent systemic thrombolysis at the standard dose for AIS.CONCLUSION Urgent thrombolysis followed by elective PCI was an appropriate strategy for the management of simultaneous CCI.展开更多
基金supported by the National Basic Research Program of China(No.2013CB035802)the 111 Project of China(No.B13044)
文摘An analytical model for chatter aero-engine casings is presented in this paper stability prediction in bull-nose end milling of And the mechanics and dynamics variations due to the complex cutter and workpiece geometry are considered by analyzing the effects of the lead angle on the milling process. Firstly, the tool-workpiece engagement region is obtained by using a previously developed method and divided into several disk elements along the tool-axis direction. Secondly, a 3D dynamic model for stability limit calculation is developed and simplified into a 1D model in normal direction considering only the dominant mode of the workpiece. Then the cutting force coefficients, the start and exit angles corresponding to each disk element are determined. And the total stability lobe diagram is calculated using an iterative algorithm. Finally, several experimental tests are carried out to validate the feasibility and effectiveness of the proposed ~rediction approach.
基金co-supported by the Natural Science Foundation of Beijing(No.3214043)the Project of State Key Lab of Tribology of Tsinghua University(No.SKLT2021D16)the National Natural Science Foundation of China(No.51975319)。
文摘In order to satisfy the machining requirements of aero-engine casing in modern aviation industry, this paper investigates three main issues during the design and development process of a five-axis machine tool with high accuracy, stiffness and efficiency, including whole structure design,key components design, and supporting stiffness design. First, an appropriate structure of five-axis machine tool is determined considering the processing characteristics of aero-engine casing. Then, a dual drive swing head and a compact motorized spindle are designed with enough drive capability and stiffness, and related structure, assembly method, cooling technology, and performance simulation are given in detail. Next, a design method of supporting stiffness of guide is proposed through the deformation prediction of the spindle end. Based on above work, a prototype of machine tool is developed, and some experiments are carried out, including performance tests of swing head and motorized spindle, and machining of a simulated workpiece of aero-engine casing. All experimental results show that the machine tool has satisfactory accuracy, stiffness and efficiency, which meets the machining requirements of aero-engine casing. The main work can be used as references for engineers and technicians, which are meaningful in practice.
基金co-supported by the National Science and Technology Major Project,China(No.J2019-I-0001-0001)the National Natural Science Foundation of China(No.52105545)。
文摘The original monitoring data from aero-engines possess characteristics such as high dimen-sionality,strong noise,and imbalance,which present substantial challenges to traditional anomalydetection methods.In response,this paper proposes a method based on Fuzzy Fusion of variablesand Discriminant mapping of features for Clustering(FFD-Clustering)to detect anomalies in originalmonitoring data from Aircraft Communication Addressing and Reporting System(ACARS).Firstly,associated variables are fuzzily grouped to extract the underlying distribution characteristics and trendsfrom the data.Secondly,a multi-layer contrastive denoising-based feature Fusion Encoding Network(FEN)is designed for each variable group,which can construct representative features for each variablegroup through eliminating strong noise and complex interrelations between variables.Thirdly,a featureDiscriminative Mapping Network(DMN)based on reconstruction difference re-clustering is designed,which can distinguish dissimilar feature vectors when mapping representative features to a unified fea-ture space.Finally,the K-means clustering is used to detect the abnormal feature vectors in the unifiedfeature space.Additionally,the algorithm is capable of reconstructing identified abnormal vectors,thereby locating the abnormal variable groups.The performance of this algorithm was tested ontwo public datasets and real original monitoring data from four aero-engines'ACARS,demonstratingits superiority and application potential in aero-engine anomaly detection.
基金National Natural Science Foundation of China (No. 51975200)Hunan Provincial Innovation Foundation for Postgraduate,China (No. QL20220201)。
文摘By using fatigue crack propagation testing and microstructural characterization,the crack fracture and propagation mechanisms of K4169 superalloy under various loads were investigated.The results demonstrate that the grain sizes of K4169 superalloy significantly increase,and the precipitation of the needle-likeδphase and the Laves phase is observed.Voids and microcracks form at location of Laves phase enrichment,creating conditions for crack propagation.By the a−N(a is the crack length,and N is the number of cycles)relationship curve,the change in the fatigue crack growth rate with the increasing number of cycles progresses through three separate stages.The fracture process of K4169 superalloy under low-stress cyclic loading(3 kN)exhibits the ductile fracture.Subsequently,the fracture process starts to change from the ductile fracture to the brittle fracture as the stress increases to 4.5 kN.In the microstructures of fractures in both stress states,intergranular propagation is the mechanism responsible for crack propagation.Moreover,the Laves phase exists near the fracture crack,which is in line with the post-service structural phenomenon.
基金the financial support from the National Key R&D Program of China(No.2023YFE0125900)National Natural Science Foundation of China(Nos.12372008 and 12102234)+1 种基金Natural Science Foundation of Heilongjiang Province,China(No.YQ2022A008)Taif University,Saudi Arabia,for supporting this work through Project number(TU-DSPP-2024-73).
文摘This paper analyzes the nonlinear dynamic characteristics and stability of Aero-Engine Dual-Rotor(AEDR)systems under high-frequency excitation,based on the Adaptive Harmonic Balance with the Asymptotic Harmonic Selection(AHB-AHS)method.A finite element dynamic equation for the AEDR system is introduced,considering complex nonlinearities of the intershaft bearing,unbalanced excitations,and high-frequency excitation.A solving strategy combining the AHB-AHS method and improved arclength continuation method is proposed to solve highdimensional dynamic equations containing complex nonlinearities and to track periodic solutions with parameter variations.The Floquet theory is used to analyze the types of bifurcation points in the system and the stability of periodic motions.The results indicate that high-frequency excitation can couple high-order and low-order modes,especially when the system undergoes superharmonic resonance.High-frequency excitation leads to more combination frequency harmonics,among which N_(f)ω_(1)-2ω_(2)dominates.Furthermore,changing the parameters(amplitude and frequency)of high-frequency excitation widens or shifts the unstable regions of the system.These findings contribute to understanding the mechanism of high-frequency excitation on aero-engines and demonstrate that the proposed AHB-AHS method is a powerful tool for analyzing highdimensional complex nonlinear dynamic systems under multi-frequency excitation.
基金supported by the National Key Research and Development Program of China(No.2020YFA0405700).
文摘Quantitative measurement of Soot Volume Fraction (SVF) is an essential prerequisite for controlling soot particle emissions from aero-engine combustors. As an in-situ and non-intrusive optical diagnostic technique, Laser-Induced Incandescence (LII) has been increasingly applied for soot concentration quantification in various combustion environments such as laminar flame, vehicle exhaust, internal combustion chamber as well as aero-engine combustor. In this work, we experimentally measured the spatial and temporal distribution of SVF using two-color LII technique at the outlet of a single-sector dual-swirl aero-engine model combustor. The effect of inlet pressure and air preheat temperature on the SVF distribution was separately investigated within a pressure range of 241–425 kPa and a temperature range of 292–500 K. The results show that soot production increases with the inlet pressure but generally decreases with the air preheat temperature. Qualitative analysis was provided to explain the above results of parametric studies. The LII experiments were also conducted under 3 designed conditions to evaluate soot emission under practical operations. Particularly, weak soot emission was detected at the outlet under the idle condition. Our experimental results provide a valuable benchmark for evaluating soot emission in the exhaust plume of this aero-engine combustor during practical operations.
基金support of the National Science and Technology Major Project of China(No.J2019-V-0005-0096)the National Key Research and Development Program of China(No.2020YFA0405700).
文摘The spatiotemporal distribution of soot concentration in aero-engine combustor is important for assessing its combustion performance.Here,we report experimental measurements of soot concentration in terms of Soot Volume Fraction(SVF)and its spatiotemporal distribution in a single-sector dual-swirl aero-engine combustor using Two-Color Laser-Induced Incandescence(2C-LII).It is shown that soot predominantly forms in the symmetrical vortices of the primary combustion zone,exhibiting a V-type distribution with higher concentration in the lower half of the zone than the upper half,with a small amount distributed in the secondary recirculation zone.Soot emissions at the combustor outlet are relatively low under three typical operating conditions by LII experiments,which is aligned with Smoke Number(SN)from gas analysis.The effect of inlet air temperature on SVF distribution and dynamics in the primary combustion zone is studied,which suggests that the SVF level in the primary combustion zone monotonically increases with the temperature.Meanwhile,the SVF distribution becomes more symmetrical as the inlet temperature increases,although the overall SVF level in the lower half of the zone is still higher.We also investigate the influence of the inlet air pressure on the SVF distribution at the combustor outlet.The soot concentration at the combustor outlet increases with inlet pressure,mainly distributed irregularly across both sides and the center.On both sides,the distribution is continuous,while the center exhibits dot-like and linear patterns.Numerical simulations correlated SVF distribution with the flow field in the primary combustion zone,qualitatively explaining the observed SVF distribution behavior.These results under various conditions can provide valuable insights for improving the performance of this specific combustor and designing high-temperature-rise combustors in the future.
基金Supported by the Zhejiang Medical Science and Technology Project,No.2022KY1325 and No.2023KY381Public Welfare Project of Jinhua Science and Technology Plan,No.2023-4-084Major Project of Jinhua Science and Technology Plan,No.2023-3-066.
文摘BACKGROUND Ganglioneuroma is a rare,well-differentiated,slow-growing benign tumor of the peripheral nerves,with surgical resection being the only curative treatment.Surgical resection of ganglioneuromas encasing major blood vessels remains a substantial clinical challenge.Traditionally,these cases often require open abdominal surgery or combined organ resections,and in some instances,the tumors are considered unresectable.Currently,no reports have described the resection of such tumors via laparoscopy.CASE SUMMARY A 35-year-old woman was admitted to our hospital after the incidental discovery of a retroperitoneal space-occupying lesion.Imaging revealed a mass with the celiac axis and superior mesenteric artery passing through it.A neurogenic tumor was suspected,with ganglioneuroma being the most likely diagnosis.Following comprehensive preoperative preparation,the retroperitoneal tumor was resected using a three-dimensional laparoscopy combined with an organ suspension technique.The surgical approach involved incising the tumor along the vascular axis and conducting meticulous,vascular-preserving tumor excision.The operation lasted approximately 458 minutes,with an estimated blood loss of 50 mL.The patient was discharged on the 8th postoperative day.A transient liver injury occurred after surgery but improved rapidly.After 11 months of postoperative follow-up,no complications or tumor recurrence were observed.CONCLUSION This case illustrates the feasibility of minimally invasive laparoscopic resection for retroperitoneal ganglioneuromas encasing major blood vessels.
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.
文摘BACKGROUND Phaeochromocytoma and paragangliomas(PPGL)are rare neuroendocrine tumors usually caused by parasympathetic or sympathetic nerves,with an overall incidence of approximately 0.66 cases per 100000 people per year.Most PPGLs are asymptomatic,and a few develop symptoms,such as elevated blood pressure and rapid heart rate,because of the release of catecholamines.According to the literature,surgical resection is the mainstay of PPGL treatment.However,the choice between minimally invasive surgery and open surgery remains controversial,particularly in cases involving complex anatomical relationships.We successfully resected a tumor located between the inferior vena cava and abdominal aorta using a minimally invasive approach with the assistance of computed tomography(CT)angiography and three-dimensional reconstruction,resulting in a favorable outcome.CASE SUMMARY A 56-year-old woman was admitted to the hospital with right upper abdominal discomfort for more than 6 months,experiencing occasional pins and needles sensation and radiation from the right shoulder and back.Prehospital CT of the upper abdomen revealed a retroperitoneal mass suspected to be a retroperitoneal ganglioneuroma.Surgery was recommended,and an enhanced CT scan of the upper abdomen,along with preoperative three-dimensional reconstruction,was performed after admission.The imaging indicated that the mass,measuring approximately 4.1 cm×3.8 cm×4.8 cm,was situated between the abdominal aorta and the inferior vena cava,extending downward to the level of the left renal vein.After ruling out any contraindications to surgery,a minimally invasive laparoscopy was performed to excise the mass precisely.The surgery was successful without any postoperative complications,and the 2-month follow-up revealed no abnormal signs of recurrence.CONCLUSION This case report describes successful and precise laparoscopic resection of a retroperitoneal tumor.The patient recovered well during the 2-month follow-up,and postoperative pathology revealed a paraganglioma.
文摘BACKGROUND Middle meningeal artery embolization(MMAE)is emerging as a promising treatment for chronic subdural hematoma(CSDH),serving both as an adjunct to surgery and as a primary therapeutic option depending on patient presentation.Due to its low recurrence rate and minimal complications,MMAE has gained increasing acceptance among clinicians in recent years.This report presents a case of diplopia following MMAE due to the presence of a potential anastomotic artery,aiming to enhance awareness of this complication.CASE SUMMARY A 60-year-old male patient presented with a headache following head trauma,and cranial computed tomography revealed a left-sided CSDH.The patient underwent left MMAE;however,polyvinyl alcohol particles inadvertently flowed into the lacrimal artery through an anastomotic artery,resulting in diplopia due to impaired abduction of the left eye.The diplopia resolved by postoperative day 40.The patient’s headache resolved by postoperative day 7,and the hematoma completely resolved by postoperative day 108.CONCLUSION Potential anastomotic arteries in the middle meningeal artery(MMA)can lead to serious complications.Superselective angiography of the MMA or its branches prior to embolization is essential.Performing embolization distal to potential anastomotic sites can reduce risks,and the presence of an anastomosis may warrant coil embolization or termination of the procedure.
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 Gansu Provincial Natural Science Foundation,No.21JR1RA010In-Hospital Research Fund of Gansu Provincial Hospital,No.23GSSYD-5.
文摘BACKGROUND The incidence of malignant gastrointestinal(GI)tumors is increasing,and advancements in medical care have significantly improved patient survival rates.As a result,the number of cases involving multiple primary cancers(MPC)has also increased.The rarity of MPC and the absence of sensitive and specific dia-gnostic markers often lead to missed or incorrect diagnoses.It is,therefore,of vital importance to improve the vigilance of clinicians and the accurate diagnosis of this disease.Patients with GI malignancies face a higher relative risk of deve-loping additional primary malignant tumors compared to those with other systemic tumors.Vigilant monitoring and follow-up are crucial,especially for high-risk groups,which include older adults,men,those with addictions to alcohol and tobacco,those with a family history of tumors,and those who have undergone radiotherapy.CASE SUMMARY In this article,we report three cases of MPC,each involving malignant tumors of the GI tract as the initial primary carcinoma,offering insights that may aid in effectively managing similar cases.CONCLUSION Patients with GI malignancies face a higher MPC risk.Developing screening and follow-up protocols may enhance detection and treatment outcomes.
文摘BACKGROUND While existing literature on ischiofemoral impingement syndrome(IFI)predominantly emphasizes surgical interventions or generalized physical therapy approaches,there remains a paucity of evidence regarding structured,multimodal rehabilitation programs targeting biomechanical deficits in IFI.This case report evaluates the efficacy of a multimodal rehabilitation program addressing a critical gap in conservative management strategies.CASE SUMMARY The patient underwent comprehensive physical and clinical examination,including hip X-ray and magnetic resonance imaging investigations.The patient completed the Musculoskeletal Health Questionnaire(MSK-HQ)and numerical pain rating scale(NPRS).The patient underwent a two-month tailored structured physical therapy intervention and repeated the same assessment afterwards.The patient's substantial reduction in pain,reflected by a significant decrease in the patient’s NPRS score from 9 to 3 points,signifies a positive clinical response.This outcome,coupled with the significant improvement in the patient's health-related quality of life according to the MSK-HQ score,which increased from 12 to 48 points,underscores the success of our research.CONCLUSION The study highlights the importance of a comprehensive approach to diagnosing and managing IFI,combining clinical assessment with imaging and implementing a multimodal rehabilitation program for optimal outcomes.
文摘BACKGROUND Pubic ramus fractures are generally considered fragility fractures in the elderly population,commonly deriving from a low-impact fall.Treatment is ordinarily conservative and hemodynamic complications are exceedingly infrequent.Notwithstanding,patients with copious comorbidities should be carefully monitored for potential vascular injury.CASE SUMMARY This case report presents the management of a 75-year-old male patient with a history of diabetes mellitus and arterial hypertension who was admitted to the emergency room with a superior pubic ramus fracture.The patient experienced a significant drop in hematocrit and hemoglobin levels post-admission,necessi-tating urgent intervention.A computed tomography angiography revealed active bleeding,leading to the embolization of the medial femoral branch.The patient was stabilized hemodynamically and was discharged after 15 days,with recom-mendations for home-based follow-up care.CONCLUSION This report denotes the various challenges and strategies in managing simple fractures that are treated conservatively,but need prompt monitoring for occult vascular injuries that can be fatal.
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.
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.
基金Supported by Zhejiang Provincial Traditional Chinese Medicine Science and Technology Program,No.2023ZF075.
文摘BACKGROUND Nocardiosis is a rare bacterial infection with unclear epidemiology,pathogenesis,and characteristics.Its clinical manifestations are diverse and nonspecific,making diagnosis prone to errors,including misdiagnosis and missed diagnosis.Additionally,this disease is difficult to treat,often requiring months or even years of antibacterial therapy,and can be fatal in patients with underlying conditions.CASE SUMMARY A 93-year-old male patient with chronic renal insufficiency sustained a skin injury at the tip of his right thumb.As a result of an initial misdiagnosis and inadequate treatment,the infection progressed,resulting in multiple rashes on his right upper limb.Local incision and drainage of pus,combined with oral antibiotics administered at a different hospital,yielded no significant improvement.Upon hospitalization,the patient’s immune function was assessed,and further local incision and drainage were performed.Cultures of the pus identified Nocardia brasiliensis.Treatment involved intravenous infusion of piperacillin-tazobactam sodium and oral administration of sulfamethoxazole-trimethoprim,leading to the patient’s recovery.After discharge,the patient continued to take sulfamethoxazole tablets for 6 months,with complete healing of the skin lesions and no recurrence.CONCLUSION Nocardiosis should be considered in patients with underlying conditions and compromised immunity.Prompt and accurate diagnosis is crucial.
文摘BACKGROUND Simultaneous acute ischemic stroke(AIS)and myocardial infarction(cardio-cerebral ischemic attack)have rarely been reported in the literature.Currently,no clear evidence-based guidelines or clinical trials exist to determine the optimal therapeutic strategy for these patients.CASE SUMMARY We present the case of a 27-year-old Chinese man who simultaneously experie-nced acute concomitant cerebrocardiac infarction(CCI)and painless ST-elevation myocardial infarction.The patient was successfully treated with elective percu-taneous coronary intervention(PCI)after receiving urgent systemic thrombolysis at the standard dose for AIS.CONCLUSION Urgent thrombolysis followed by elective PCI was an appropriate strategy for the management of simultaneous CCI.
