It has often been thought that severe spastic and athetoid cerebral palsy children respond poorly to rehabilitative training effects and have a poor prognosis after school age. The present study included a nine-year-o...It has often been thought that severe spastic and athetoid cerebral palsy children respond poorly to rehabilitative training effects and have a poor prognosis after school age. The present study included a nine-year-old severe spastic and athetoid cerebral palsy boy, who received 2 years of physical therapy, supplemented with drugs and orthotic devices and who acquired good therapeutic effects. The beneficial rehabilitative effects were as follows： After discharge, primitive reflex disappeared, and both vertical reflex and parachute reflex were found; In the establishment of balance reflex, sitting position was rated as level III, and standing position was rated as level II. The boy could independently walk for 30-50 meters. In the assessment of muscle tone, the level was rated according to the Modified Ashworth Scale and was decreased from three, four to one, two, and the level rated according to the Clonus Scale decreased from V to II. Motor function was noticeably improved. The level was rated according to the Gross Motor Function Classification System and was decreased from V to II. The total score of 88 items of the Gross Motor Function Measure was increased from 6.1% to 72.2%. The Berg Balance Scale score increased from 0 to 42. The Holden Walking Functional Classification level increased from 0 to 3. The score of activities of daily living increased from 9.5 to 70. The symptoms of dysarthria were alleviated from severe to moderate, and those of salivation were alleviated from level V to level I. These results demonstrated that after systemic and scientific treatment and training, the spastic and athetoid cerebral palsy boy had the ability to walk independently and to care for himself.展开更多
Clozapine is widely recognized as an effective antipsychotic medication for treatment-resistant schizophrenia, but it is typically associated with significant weight gain. This case report presents two unusual cases o...Clozapine is widely recognized as an effective antipsychotic medication for treatment-resistant schizophrenia, but it is typically associated with significant weight gain. This case report presents two unusual cases of patients with schizophrenia who experienced substantial weight loss while on long-term clozapine therapy. The first case involves a 35-year-old male who lost 21.3% of his initial body weight, and the second case describes a 54-year-old female who lost 30.2% of her initial weight, despite having comorbid hypothyroidism. Both patients showed improvement in psychiatric symptoms concurrent with the weight loss. Comprehensive investigations did not reveal other clear etiologies for the weight reduction. These cases challenge the conventional understanding of clozapine’s metabolic effects and highlight the potential for atypical responses in some individuals. The report discusses possible mechanisms for this unusual phenomenon, including genetic factors and altered pharmacokinetics. It also emphasizes the need for individualized monitoring and management strategies in clozapine therapy. These findings contribute to the growing body of evidence suggesting that metabolic responses to clozapine may be more complex and varied than previously thought, underscoring the importance of personalized approaches in schizophrenia treatment.展开更多
Dear editor, We report a case of a 47-year-old female who presented with a toxic bupropion ingestion leading to cardiac arrest. She initially exhibited a loss of brainstem reflexes in conjunction with burst-suppressio...Dear editor, We report a case of a 47-year-old female who presented with a toxic bupropion ingestion leading to cardiac arrest. She initially exhibited a loss of brainstem reflexes in conjunction with burst-suppression pattern on EEG. Burst suppression is an EEG waveform pattern of alternating isoelectric suppressions and high voltage bursts, Our patient ultimately made a full neurologic recovery a few days later. While there are two other cases in the literature of bupropion overdose resulting in EEG burst-suppression and loss of brainstem reflexes, we believe this is the only reported adult case complicated by cardiac arrest.展开更多
BACKGROUND Oncologic immunotherapy is attracting attention as an effective strategy for cancer treatment. Currently, there are two kinds of inhibitors: Anti-PD-1 antibodies and anti-PD-L1 antibodies. These inhibitors ...BACKGROUND Oncologic immunotherapy is attracting attention as an effective strategy for cancer treatment. Currently, there are two kinds of inhibitors: Anti-PD-1 antibodies and anti-PD-L1 antibodies. These inhibitors have shown significant implications in improving the outcomes of certain cancer types in recent years.However, along with its effectiveness, adverse events cannot be ignored. As an anti-PD-1 antibody, camrelizumab(SHR-1210) has some side effects in tumor immunotherapy. The most common adverse event is reactive capillary hemangioma. While it is widely reported to occur in the skin, gingival reactive capillary hemangioma is rarely reported.CASE SUMMARY A 54-year-old man complained of gingival overgrowth on the anterior aspect of the maxilla and mandible for more than 6 mo. He had been placed on SHR-1210 for lung cancer for 7 mo. A gingival mass extending from canine to canine was noted on the lingual surfaces of the mandible. Gingival enlargement was noted in the front teeth. A clinical diagnosis of gingival reactive capillary hemangioma and chronic periodontitis was made. The treatment involved a complex local treatment(repeated local applications of an antibiotic paste, scaling and root planning, and surgery). The excised tissue was sent for histopathological examination, which confirmed the diagnosis of capillary hemangioma. After the operation, most of the gingival enlargement was reduced. At the 2-mo follow-up,it was noted that the gingival overgrowth was immediately reduced after the replacement of the anti-PD-1 agent with an anti-PD-L1 agent.CONCLUSION As the prescription for SHR-1210 has increased considerably in recent years, the occurrence of its possible side effects, including gingival reactive capillary hemangioma, has increased. It is recommended that regular oral examinations be performed before and during the treatment of tumors with SHR-1210.展开更多
The purpose of this paper is to deliver a better perception of the project success,and how reporting system might increase the probability of project success in construction projects in UAE.Further,it aims at explorin...The purpose of this paper is to deliver a better perception of the project success,and how reporting system might increase the probability of project success in construction projects in UAE.Further,it aims at exploring the relationship between effective reporting system in terms of the characteristic of its outputs(mainly effectiveness of financial reporting system)and project success.Semi-structured interviews with a number of interior auditors,accountants,and chief financial officers(CFOs)from different corporations in construction sector in UAE in order to recognize how effective reporting system in terms of the characteristic of its outputs(broad scope,timeliness,aggregation,and integration)might contribute to increase the probability of project success.There are several success factors in construction projects in UAE,thus it is very hard to capture all these factors in one paper.Hence,this paper is not considering all project success factors rather it focuses on the characteristic of outputs of the reporting system generally and the financial reporting system particularly(broad scope,timeliness,aggregation,and integration),as most of the studies in the literature considered the reporting system as a key factor of project success.This paper adds to both project management and accounting research by evidencing results from an exploration how effective reporting might impact the project success,with valuable implications for standard officials,customers,investors,stakeholders,sponsors,shareholders,CFOs,project developer,consultants,internal auditors,and accounting academics.The effective reporting system in United Arab Emirates(UAE)construction projects enables possessors,customers,and contractors of projects to get timely information about the progress of project in a brief and significant format which in turn improve the decision-making process and contribute to project success.This paper implies a contribution for both project management literature and accounting research by investigative the effectiveness of reporting system in project successes from historical point of view and contemporary point of view.展开更多
BACKGROUND Although few studies have reported hyponatremia due to carbamazepine or oxcarbazepine in patients with epilepsy,no study has investigated cases of carbamazepine-or oxcarbazepine-induced hyponatremia or unst...BACKGROUND Although few studies have reported hyponatremia due to carbamazepine or oxcarbazepine in patients with epilepsy,no study has investigated cases of carbamazepine-or oxcarbazepine-induced hyponatremia or unsteady gait in patients with neuropathic pain.Herein,we report a case of oxcarbazepineinduced lower leg weakness in a patient with trigeminal neuralgia and summarize the diagnosis,treatment,and changes of clinical symptoms.CASE SUMMARY A 78-year-old male with a history of lumbar spinal stenosis was admitted to the hospital after he experienced lancinating pain around his right cheek,eyes,and lip,and was diagnosed with trigeminal neuralgia at the right maxillary and mandibular branch.He was prescribed oxcarbazepine(600 mg/d),milnacipran(25 mg/d),and oxycodone/naloxone(20 mg/10 mg/d)for four years.Four years later,the patient experienced symptoms associated with spinal stenosis,including pain in the lower extremities and unsteady gait.His serum sodium level was 127 mmol/L.Assuming oxcarbazepine to be the cause of the hyponatremia,oxcarbazepine administration was put on hold and the patient was switched to topiramate.At subsequent visit,the patient’s serum sodium level had normalized to 143 mmol/L and his unsteady gait had improved.CONCLUSION Oxcarbazepine-induced hyponatremia may cause lower extremity weakness and unsteady gait,which should be differentiated from those caused by spinal stenosis.展开更多
In this study, a scintillation detector was developed to measure the space proton effective dose for astronauts based on the proton effective dose conversion coefficients provided by International Commission on Radiol...In this study, a scintillation detector was developed to measure the space proton effective dose for astronauts based on the proton effective dose conversion coefficients provided by International Commission on Radiological Protection Report No. 116. In the Monte Carlo N-Particle Transport Code X(version 2.6.0) simulation process, by modulating the depth and solid angle of truncated conical holes in an iron shell from lower-energy protons to higher-energy protons, the energy deposited in the scintillator by isotropic protons was nearly proportional to the corresponding effective dose, with a maximum relative deviation of 13.28% at thirteen energy points in the energy range of 10–400 MeV. Therefore, the detector can monitor proton effective dose indirectly in real time by measuring the deposited energy. We calibrated the photoelectric conversion efficiency of the detector at the cobalt source, tested the response of the detector in the energy range of 30–100 MeV in unidirectional proton field, and validated the simulation with the experimental results.展开更多
文摘It has often been thought that severe spastic and athetoid cerebral palsy children respond poorly to rehabilitative training effects and have a poor prognosis after school age. The present study included a nine-year-old severe spastic and athetoid cerebral palsy boy, who received 2 years of physical therapy, supplemented with drugs and orthotic devices and who acquired good therapeutic effects. The beneficial rehabilitative effects were as follows： After discharge, primitive reflex disappeared, and both vertical reflex and parachute reflex were found; In the establishment of balance reflex, sitting position was rated as level III, and standing position was rated as level II. The boy could independently walk for 30-50 meters. In the assessment of muscle tone, the level was rated according to the Modified Ashworth Scale and was decreased from three, four to one, two, and the level rated according to the Clonus Scale decreased from V to II. Motor function was noticeably improved. The level was rated according to the Gross Motor Function Classification System and was decreased from V to II. The total score of 88 items of the Gross Motor Function Measure was increased from 6.1% to 72.2%. The Berg Balance Scale score increased from 0 to 42. The Holden Walking Functional Classification level increased from 0 to 3. The score of activities of daily living increased from 9.5 to 70. The symptoms of dysarthria were alleviated from severe to moderate, and those of salivation were alleviated from level V to level I. These results demonstrated that after systemic and scientific treatment and training, the spastic and athetoid cerebral palsy boy had the ability to walk independently and to care for himself.
文摘Clozapine is widely recognized as an effective antipsychotic medication for treatment-resistant schizophrenia, but it is typically associated with significant weight gain. This case report presents two unusual cases of patients with schizophrenia who experienced substantial weight loss while on long-term clozapine therapy. The first case involves a 35-year-old male who lost 21.3% of his initial body weight, and the second case describes a 54-year-old female who lost 30.2% of her initial weight, despite having comorbid hypothyroidism. Both patients showed improvement in psychiatric symptoms concurrent with the weight loss. Comprehensive investigations did not reveal other clear etiologies for the weight reduction. These cases challenge the conventional understanding of clozapine’s metabolic effects and highlight the potential for atypical responses in some individuals. The report discusses possible mechanisms for this unusual phenomenon, including genetic factors and altered pharmacokinetics. It also emphasizes the need for individualized monitoring and management strategies in clozapine therapy. These findings contribute to the growing body of evidence suggesting that metabolic responses to clozapine may be more complex and varied than previously thought, underscoring the importance of personalized approaches in schizophrenia treatment.
文摘Dear editor, We report a case of a 47-year-old female who presented with a toxic bupropion ingestion leading to cardiac arrest. She initially exhibited a loss of brainstem reflexes in conjunction with burst-suppression pattern on EEG. Burst suppression is an EEG waveform pattern of alternating isoelectric suppressions and high voltage bursts, Our patient ultimately made a full neurologic recovery a few days later. While there are two other cases in the literature of bupropion overdose resulting in EEG burst-suppression and loss of brainstem reflexes, we believe this is the only reported adult case complicated by cardiac arrest.
文摘BACKGROUND Oncologic immunotherapy is attracting attention as an effective strategy for cancer treatment. Currently, there are two kinds of inhibitors: Anti-PD-1 antibodies and anti-PD-L1 antibodies. These inhibitors have shown significant implications in improving the outcomes of certain cancer types in recent years.However, along with its effectiveness, adverse events cannot be ignored. As an anti-PD-1 antibody, camrelizumab(SHR-1210) has some side effects in tumor immunotherapy. The most common adverse event is reactive capillary hemangioma. While it is widely reported to occur in the skin, gingival reactive capillary hemangioma is rarely reported.CASE SUMMARY A 54-year-old man complained of gingival overgrowth on the anterior aspect of the maxilla and mandible for more than 6 mo. He had been placed on SHR-1210 for lung cancer for 7 mo. A gingival mass extending from canine to canine was noted on the lingual surfaces of the mandible. Gingival enlargement was noted in the front teeth. A clinical diagnosis of gingival reactive capillary hemangioma and chronic periodontitis was made. The treatment involved a complex local treatment(repeated local applications of an antibiotic paste, scaling and root planning, and surgery). The excised tissue was sent for histopathological examination, which confirmed the diagnosis of capillary hemangioma. After the operation, most of the gingival enlargement was reduced. At the 2-mo follow-up,it was noted that the gingival overgrowth was immediately reduced after the replacement of the anti-PD-1 agent with an anti-PD-L1 agent.CONCLUSION As the prescription for SHR-1210 has increased considerably in recent years, the occurrence of its possible side effects, including gingival reactive capillary hemangioma, has increased. It is recommended that regular oral examinations be performed before and during the treatment of tumors with SHR-1210.
文摘The purpose of this paper is to deliver a better perception of the project success,and how reporting system might increase the probability of project success in construction projects in UAE.Further,it aims at exploring the relationship between effective reporting system in terms of the characteristic of its outputs(mainly effectiveness of financial reporting system)and project success.Semi-structured interviews with a number of interior auditors,accountants,and chief financial officers(CFOs)from different corporations in construction sector in UAE in order to recognize how effective reporting system in terms of the characteristic of its outputs(broad scope,timeliness,aggregation,and integration)might contribute to increase the probability of project success.There are several success factors in construction projects in UAE,thus it is very hard to capture all these factors in one paper.Hence,this paper is not considering all project success factors rather it focuses on the characteristic of outputs of the reporting system generally and the financial reporting system particularly(broad scope,timeliness,aggregation,and integration),as most of the studies in the literature considered the reporting system as a key factor of project success.This paper adds to both project management and accounting research by evidencing results from an exploration how effective reporting might impact the project success,with valuable implications for standard officials,customers,investors,stakeholders,sponsors,shareholders,CFOs,project developer,consultants,internal auditors,and accounting academics.The effective reporting system in United Arab Emirates(UAE)construction projects enables possessors,customers,and contractors of projects to get timely information about the progress of project in a brief and significant format which in turn improve the decision-making process and contribute to project success.This paper implies a contribution for both project management literature and accounting research by investigative the effectiveness of reporting system in project successes from historical point of view and contemporary point of view.
文摘BACKGROUND Although few studies have reported hyponatremia due to carbamazepine or oxcarbazepine in patients with epilepsy,no study has investigated cases of carbamazepine-or oxcarbazepine-induced hyponatremia or unsteady gait in patients with neuropathic pain.Herein,we report a case of oxcarbazepineinduced lower leg weakness in a patient with trigeminal neuralgia and summarize the diagnosis,treatment,and changes of clinical symptoms.CASE SUMMARY A 78-year-old male with a history of lumbar spinal stenosis was admitted to the hospital after he experienced lancinating pain around his right cheek,eyes,and lip,and was diagnosed with trigeminal neuralgia at the right maxillary and mandibular branch.He was prescribed oxcarbazepine(600 mg/d),milnacipran(25 mg/d),and oxycodone/naloxone(20 mg/10 mg/d)for four years.Four years later,the patient experienced symptoms associated with spinal stenosis,including pain in the lower extremities and unsteady gait.His serum sodium level was 127 mmol/L.Assuming oxcarbazepine to be the cause of the hyponatremia,oxcarbazepine administration was put on hold and the patient was switched to topiramate.At subsequent visit,the patient’s serum sodium level had normalized to 143 mmol/L and his unsteady gait had improved.CONCLUSION Oxcarbazepine-induced hyponatremia may cause lower extremity weakness and unsteady gait,which should be differentiated from those caused by spinal stenosis.
基金supported by the National Natural Science Foundation of China(No.11305127)the State Key Lab of Intense Pulsed Radiation Simulation and Effect Basic Research Foundation(No.SKLIPR1216)
文摘In this study, a scintillation detector was developed to measure the space proton effective dose for astronauts based on the proton effective dose conversion coefficients provided by International Commission on Radiological Protection Report No. 116. In the Monte Carlo N-Particle Transport Code X(version 2.6.0) simulation process, by modulating the depth and solid angle of truncated conical holes in an iron shell from lower-energy protons to higher-energy protons, the energy deposited in the scintillator by isotropic protons was nearly proportional to the corresponding effective dose, with a maximum relative deviation of 13.28% at thirteen energy points in the energy range of 10–400 MeV. Therefore, the detector can monitor proton effective dose indirectly in real time by measuring the deposited energy. We calibrated the photoelectric conversion efficiency of the detector at the cobalt source, tested the response of the detector in the energy range of 30–100 MeV in unidirectional proton field, and validated the simulation with the experimental results.
