Asymptomatic low-grade appendiceal mucinous neoplasm:A case report

BACKGROUND Low-grade appendiceal neoplasms(LAMN)are characterized by low incidence and atypical clinical presentations,often leading to misdiagnosis as acute or chronic appendicitis before surgery.The primary diagnostic tool for LAMN is abdominal computed tomography(CT)imaging.Surgical resection remains the cornerstone of LAMN management,necessitating en bloc tumor excision to minimize the risk of iatrogenic rupture.Laparoscopy,known for its minimal invasiveness,reduced postoperative discomfort,and expedited recovery,is a safe and reliable approach for LAMN treatment.Despite the possibility of pseudomyxoma peritonei development,appendectomy and partial appendectomy generally result in negative tumor margins and favorable outcomes,which can be attributed to the disease’s slow growth and lower malignancy.CASE SUMMARY A 71-year-old male patient was admitted to our hospital with a pelvic spaceoccupying lesion detected 1 mo prior.Physical examination showed a soft abdomen without tenderness or rebound and no palpable masses.No shifting dullness was noted,and digital rectal examination revealed no palpable mass.Enteroscopy revealed a raised,smooth-surfaced mass measuring 3.0 cm in the cecum.Abdominal contrast-enhanced CT showed a markedly thickened and dilated appendix with visible cystic shadows.Laparoscopic surgery was performed and revealed a significantly dilated appendix,leading to laparoscopic resection of the appendix and part of the cecum.Post-surgical pathologic analysis confirmed LAMN.The patient received symptomatic and supportive post-operative care and was discharged on postoperative day 4 without complications such as abdominal bleeding,intestinal obstruction,or incision infection.No tumor recurrence was observed during a 7-mo follow-up period.CONCLUSION LAMN is a rare disease that lacks specific clinical manifestations.Abdominal CT plays a crucial role in diagnosing LAMN,and laparoscopic surgery is a safe and effective diagnostic and therapeutic approach.

Cultivation Path of Nursing Undergraduates’Scientific Research and Innovation Ability

Objective: The cultivation of the innovation ability and scientific research is one of the nursing learning objectives for undergraduate students. To explore the method and effect of training system of scientific research innovation ability of nursing undergraduates based on “3332”. Methods: Three course learning modules are constructed: stage-based course learning module, systematic project practice training module and comprehensive practice training module. A practical training platform for scientific research innovation projects is built, and undergraduate scientific research innovation ability training is carried out from both in-class and out-of-class lines. Results: Since 2017, the students have obtained 7 national innovation and entrepreneurship training programs, 52 university-level undergraduate scientific research projects, published more than 10 academic papers, and obtained 2 patent authorization. Conclusions: The training system of scientific research innovation ability of nursing undergraduates based on “3332” is conducive to the development of scientific research innovation ability of nursing students, and to cultivate nursing talents who can adapt to the development of the new era and have better post competence.

Low-grade myofibrosarcoma of the maxillary sinus:Two case reports

BACKGROUND Low-grade myofibroblastic sarcoma(LGMS)is an extremely rare tumor characterized by the malignant proliferation of myofibroblasts.LGMS most commonly develops in adults,predominantly in males,in the head and neck region,oral cavity,especially on the tongue,mandible,and larynx.This article presents 2 cases of LGMS localized to the maxillary sinus and provides an overview of the available literature.CASE SUMMARY Two patients with LGMS located in the maxillary sinus underwent surgery at the Department of Head and Neck Surgery.Case 1:A 46-year-old patient was admitted to the clinic with suspected LGMS recurrence in the right maxillary sinus(rT4aN0M0),with symptoms of pain in the suborbital area,watering of the right eye,thick discharge from the right nostril,and augmented facial asymmetry.After open biopsy-confirmed LGMS,the patient underwent expanded maxillectomy of the right side with immediate palate reconstruction using a microvascular skin flap harvested surgically from the middle arm.The patient qualified for adjuvant radiotherapy for the postoperative bed,with an additional margin.Currently,the patient is under 1.5 years of observation with no evidence of disease.Case 2:A 45-year-old man was admitted to our clinic with facial asymmetry,strabismus,exophthalmos,and visual impairment in the right eye.Six months earlier,the patient had undergone partial jaw resection at another hospital for fibromatosis.A contrast-enhanced computed tomography scan revealed a tumor mass in the postoperative log after an earlier procedure.An open biopsy confirmed lowgrade fibrosarcoma(rT4aN0M0).The patient qualified for an extended total right maxillectomy with orbital excision and right hemimandibulectomy with immediate microvascular reconstruction using an anterolateral thigh flap.The patient subsequently underwent adjuvant radiotherapy to the postoperative area.After 9 months,recurrence occurred in the right mandibular arch below the irradiated area.The lesion infiltrated the base of the skull,which warranted the withdrawal of radiotherapy and salvage surgery.The patient qualified for palliative chemotherapy with a regimen of doxorubicin+dacarbazine+cyclophosphamide and palliative radiotherapy for bone metastases.The patient died 26 months after surgical treatment.The cases have been assessed and compared with cases in the literature.CONCLUSION No specific diagnostic criteria or treatment strategies have been developed for LGMS.The treatment used for LGMS is the same as that used for sinonasal cancer radical tumor excision;adjuvant radiotherapy or chemoradiotherapy should also be considered.They have low malignant potential but are highly invasive,tend to recur,and metastasize to distant sites.Patients should undergo regular follow-up examinations to detect recurrence or metastasis at an early stage.Patients should be treated and observed at the highest referral centers.

Problem Analysis and Effective Strategies of Ecological Civilization Education for Undergraduates in the New Age

The ecological civilization in the new age is one important aspect for undergraduates.We must enhance the concept of their civilization and improve the quality of civilization.Carrying out ecological civilization education in colleges and universities has a practical significance for enriching the contents of ideological and political education to realize their all-round development.Nowadays,some undergraduates lack awareness of ecological civilization and ignore its importance.For this reason,undergraduates need to pay attention to ecological civilization and improve their own ecological civilization literacy to promote the all-round development in qualities in the new age.This paper mainly analyzes the current problems in undergraduates’ecological civilization education and explores effective strategies to solve the current problems in undergraduates’ecological civilization education.The strategies include integrating ecological civilization resources,innovating methods of ecological civilization,strengthening ecological educator team construction,embodying ecological culture in campus construction and creating the atmosphere,emphasizing innovative practices for ecological civilization,strengthening publicity of social-ecological civilization,and attaching importance to family education of ecological civilization.

Research on the Employment View of Acupuncture and Tuina Undergraduates in Minority Border Areas from Students’ Perspective

With the popularization of higher education in China,the employment situation of college students is more complex and severe.This paper adopts the questionnaire method to explore the employment view of acupuncture and tuina undergraduates of Yunnan University of Traditional Chinese Medicine.The employment concept of acupuncture and tuina undergraduates in the minority border areas has changed greatly.After graduation,97.95%of students choose to work in fields related to medicine and acupuncture,prefer positions close to home,and are attracted to high-salary companies,among other factors.Therefore,enhancing the competitive advantages of medical students by guiding their career planning,providing employment selection advice,fostering innovation and entrepreneurship,improving basic skills,and offering graduate entrance examination guidance is crucial for broadening their employment opportunities.

Application of NSR-AISC Method in Reserve Estimation and Technical Economic Evaluation of Low-Grade Polymetallic Deposits: Taking a Low-Grade Copper-Molybdenum Mine in Guangdong Province as an Example

The development and utilization of low-grade polymetallic deposits with strategic mineral resources is one of the important measures to alleviate the current high dependence on strategic mineral resources in China. However, domestic mining enterprises and most mining consulting and design institutes usually use general industrial indicators to carry out reserve estimation and technical and economic feasibility studies on low-grade polymetallic deposits, which cannot truly reflect the economic value of such deposits. The article expounds on the definitions of net return value (NSR) and on-site total maintenance cost (AISC) of common ore smelters in the evaluation of overseas mineral resources. Taking a low-grade polymetallic copper-molybdenum mine in Guangdong Province as an example, comparing the research results showed the NSR-AISC method and the general industrial index method in low-grade polymetallic deposit. There are huge differences in the results of reserve estimation;through the further introduction of Taylor’s formula and the research results on the relationship between investment intensity and production scale, a more reasonable mine life and investment scale are recommended, and a more in-depth comparative study has been carried out in the dimension of technical and economic indicators. Based on the comparative study of the above two methods in reserve estimation and the evaluation results of technical and economic indicators, the author believes that the NSR-AISC method can better reflect the true value of low-grade polymetallic ore projects, and should be popularized and applied in resource evaluation and development practice. This article further describes the application status of the NSR-AISC method for reserve estimation and the evaluation of technical economic indicators, and suggests the main points that should be paid attention to in the use of the NSR-AISC method.

The Impact of Street Interviews on Chinese EFL Undergraduates’Intercultural Communicative Competence

The study adopts Byram’s Intercultural Communicative Competence(ICC)model as the theoretical framework,and structured interviews were conducted to explore the impact of street interviews on the participants’ICC.Analysis results revealed street interviews help students acquire knowledge in intercultural attitudes,intercultural knowledge,skills of discovery and interaction,and critical cultural awareness,aligning with the four components of Byram’s ICC model.Meanwhile,they have positive perceptions of street interviews.Therefore,street interviews have a positive effect on the development of participants’ICC.

Thermally Chargeable Proton Capacitor Based on Redox-Active Effect for Energy Storage and Low-Grade Heat Conversion

Thermal energy is abundantly available in our daily life and industrial production,and especially,low-grade heat is often regarded as a byproduct.Collecting and utilizing this ignored energy by low-cost and simple technologies may become a smart countermeasure to relieve the energy crisis.Here,a unique device has been demonstrated to achieve high value-added conversion of low-grade heat by introducing redox-active organic alizarin(AZ)onto N-doped hollow carbon nanofibers(N–HCNF)surface.As-prepared N–HCNF/AZ can deliver a high specific capacitance of 514.3 F g^(-1)(at 1 A g^(-1))and an outstanding rate capability of 60.3%even at 50 A g^(-1).Meanwhile,the assembled symmetric proton capacitor can deliver a high energy density of 28.0 Wh kg^(-1) at 350.0 W kg^(-1) and a maximum power density of 35.0 kW kg^(-1) at 17.0 Wh kg^(-1).Significantly,the thermally chargeable proton capacitors can attain a surprisingly high Seebeck coefficient of 15.3 mV K^(-1) and a power factor of 6.02µW g^(-1).Taking advantage of such high performance,a satisfying open-circuit voltage of 481.0 mV with a temperature difference of 54 K is achieved.This research provides new insights into construction of high value-added energy systems requiring high electrochemical performances.

Anlotinib in combination with pembrolizumab for low-grade myofibroblastic sarcoma of the pancreas: A case report

BACKGROUND Low-grade myofibroblastic sarcoma(LGMS)is a rare spindle cell sarcoma espe-cially in the pancreas,with myofibroblastic differentiation.Hitherto,only a few cases have been reported.CASE SUMMARY Herein,we report a case involving the discovery of a pancreatic mass detected during a routine physical examination.Subsequent imaging and pathological tests of the patient led to the diagnosis of LGMS of the pancreas.Following surgical intervention,the patient experienced recurrence and metastasis.Conventional treatment is not effective for postoperative recurrent pancreatic LGMS with multiple metastases.After communicating with the patients and their families,informed consent was obtained for the treatment of anlotinib combined with pembrolizumab.Evaluation of imaging and clinical symptoms post-treatment revealed a relatively favorable response to the combination of anlotinib and pembrolizumab.CONCLUSION Based on the comprehensive literature review,our report aimed to provide evidence for a better understanding of the disease characteristics,diagnostic criteria,imaging findings,and identification of LGMS.And explore novel treatment strategies for this disease.

Challenges Experienced by Nurse Educators in Promoting Acquisition of Clinical Reasoning Skills by the Undergraduate Nursing Students: A Qualitative Exploratory Study

Background: Clinical reasoning is an essential skill for nursing students since it is required to solve difficulties that arise in complex clinical settings. However, teaching and learning clinical reasoning skills is difficult because of its complexity. This study, therefore aimed at exploring the challenges experienced by nurse educators in promoting acquisition of clinical reasoning skills by undergraduate nursing students. Methods: A qualitative exploratory research design was used in this study. The participants were purposively sampled and recruited into the study. Data were collected using semi-structured interview guides. Thematic analysis method was used to analyze the collected data The principles of beneficence, respect of human dignity and justice were observed. Results: The findings have shown that clinical learning environment, lacked material and human resources. The students had no interest to learn the skill. There was also knowledge gap between nurse educators and clinical nurses. Lack of role model was also an issue and limited time exposure. Conclusion: The study revealed that nurse educators encounter various challenges in promoting the acquisition of clinical reasoning skills among undergraduate nursing students. Training institutions and hospitals should periodically revise the curriculum and provide sufficient resources to facilitate effective teaching and learning of clinical reasoning. Nurse educators must also update their knowledge and skills through continuous professional development if they are to transfer the skill effectively.

Assessing the Levels of Clinical Reasoning Skills Using Self-Assessment of Clinical Reflection and Reasoning in Undergraduate Nursing Students: A Descriptive Comparative Study

Background: Clinical reasoning is a critical cognitive skill that enables undergraduate nursing students to make clinically sound decisions. A lapse in clinical reasoning can result in unintended harm to patients. The aim of the study was to assess and compare the levels of clinical reasoning skills between third year and fourth year undergraduate nursing students. Methods: The study utilized a descriptive comparative research design, based on the positivism paradigm. 410 undergraduate nursing students were systematically sampled and recruited into the study. The researchers used the Self-Assessment of Clinical Reflection and Reasoning questionnaire to collect data on clinical reasoning skills from third- and fourth-year nursing students while adhering to ethical principles of human dignity. Descriptive statistics were done to analyse the level of clinical reasoning and an independent sample t-test was performed to compare the clinical reasoning skills of the student. A p value of 0.05 was accepted. Results: The results of the study revealed that the mean clinical reasoning scores of the undergraduate nursing students were knowledge/theory application (M = 3.84;SD = 1.04);decision-making based on experience and evidence (M = 4.09;SD = 1.01);dealing with uncertainty (M = 3.93;SD = 0.87);reflection and reasoning (M = 3.77;SD = 3.88). The mean difference in clinical reasoning skills between third- and fourth-year undergraduate nursing students was not significantly different from an independent sample t-test scores (t = −1.08;p = 0.28);(t = −0.29;p = 0.73);(t = 1.19;p = 0.24);(t = −0.57;p = 0.57). Since the p-value is >0.05, the null hypothesis (H0) “there is no significantno significant difference in clinical reasoning between third year and fourth year undergraduate nursing students”, was accepted. Conclusion: This study has shown that the level of clinical reasoning skills of the undergraduate nursing students was moderate to low. This meant that the teaching methods have not been effective to improve the students clinical reasoning skills. Therefore, the training institutions should revise their curriculum by incorporating new teaching methods like simulation to enhance students’ clinical reasoning skills. In conclusion, evaluating clinical reasoning skills is crucial for addressing healthcare issues, validating teaching methods, and fostering continuous improvement in nursing education.

Research and Practice on the Construction of Professional Cluster in Application-Oriented Local Undergraduate Universities:Taking Environ-mental Chemical Engineering Professional Cluster in Pingdingshan University as an Example

Based on the analysis of the importance of professional cluster construction by ecological theory,with the change of social demand for talents,this paper explores the practice of environmental chemical professional cluster construction in Pingdingshan University,including gradually perfecting teaching conditions and reforming teaching mode,breaking through the limitations of resources,integrating the boundaries of colleges and departments,integrating multiple resources,innovating systems and mechanisms,reconstructing professional clusters,decon-structing professional connotations,reorganizing curriculum systems,etc.,in order to better build the ecological chain network of education in application-oriented colleges and universities,realize the deep integration of industry and education,train future-oriented interdisciplinary applied talents of new engineering,and realize the construction of characteristic professional cluster in application-oriented colleges.

Innovation and Practice of the Cultivation Mode of Application-Oriented Undergraduate Talents in Agricultural and Forestry Colleges under the Guidance of the Spirit of the Great Northern Wilderness

Heilongjiang reclamation area has made great progress since its development and construction, among which the agricultural and forestry colleges in China have played a key role in the input of talents for the production of reclamation area, and the spirit of the Great Wilderness has important strategic significance for the cultivation of agricultural and forestry talents. Taking Heilongjiang Bayi Agricultural University as an example, this paper analyzes the ways of the Great Northern Wilderness Spirit for cultivating application-oriented undergraduate talents in agricultural and forestry colleges, improving the curriculum system of undergraduate talents through innovation, strengthening the cultivation of students’ innovative ability, leading students’ scientific research and academic level, and enhancing students’ practical ability. To innovate the cultivation mode of application-oriented undergraduate talents in agricultural and forestry colleges under the guidance of the spirit of the Great Northern Wilderness, and to provide a reference mode for the cultivation of undergraduate talents in agricultural and forestry colleges in China.

A Win-Win Undergraduate Graduation Design Model for Students, Teachers, and Training Platforms

Undergraduate graduation design is an important link in the process of undergraduate training,and university platforms have invested a lot of manpower and material resources for this purpose.However,while carrying out student training,it has gradually become the consensus of most university platforms to achieve a win-win situation for teachers and training platforms in order to achieve optimization of resource allocation and motivation of student training.After discussion and practice,this paper proposes a set of undergraduate graduation design training concepts and training modes with a win-win situation for students,teachers,and training platforms.

Progress in the Application of Reflective Education on Undergraduate Nursing Interns

Objective:To explore the implementation methods and effects of reflective education,and to provide references for the development of reflective education in Chinese nursing schools.Methods:Relevant literature was searched from China National Knowledge Infrastructure,Wanfang Database,Wipro Chinese Science and Technology Journal Database,and PubMed Database,and the included studies were analyzed descriptively.Results:The implementation of reflective education included work-site education,group discussion,video teaching,self-reflection,and expert lectures;the interventions mainly included study groups,role-playing,individual instruction,peer cooperation,demonstration and observation,field simulation,and video presentations.The implementation of reflective education can improve the sense of professional identity and professional competence of nursing interns,and reduce nursing errors and adverse events.Conclusion:Currently,nurses in China lack self-awareness and critical thinking skills,it is recommended that reflective education be incorporated into the teaching content of undergraduate nursing students during their internship in order to promote the development of professionalism and humanistic caring skills of nursing students.

Research on the Path of Cultivating High-Level Technical and Skilled Talents in Vocational Undergraduate Colleges and Universities

This paper explores strategies to cultivate high-level technical talents in vocational undergraduate colleges by analyzing their development,the essence of such talents,and proposing several key measures.Strategies include optimizing professional settings and curricula,enhancing school-enterprise cooperation and the integration of industry-university-research,improving teaching staff quality and educational standards,and expanding international cooperation.The importance of policy support and funding and establishing robust quality assurance systems is emphasized for effectively cultivating skilled talents in vocational undergraduate colleges.

Collaborative Cultivation of Ideological and Political Education and Undergraduate Management in Colleges and Universities Under the Guidance of Moral Education

Guided by moral education,improving the ideological and moral quality of college students is an important goal of college education.To achieve this goal,it is necessary to strengthen ideological and political education and continuously improve the level of undergraduate management.This paper outlines the feasibility of collaborative cultivation of ideological and political education and undergraduate management in colleges and universities and analyzes its significance and the specific implementation strategies,with a view to providing valuable references for relevant colleges and universities to carry out educational work.

Oxidation process of low-grade vanadium slag in presence of Na_(2)CO_3

The oxidation process of low-grade vanadium slag in the presence of Na2CO3 was investigated by XRD,SEM/EDS and TG-DSC techniques.The results show that the vanadium slag is oxidized in a temperature range from 273 to 700 °C.Olivine phases and spinel phases are completely decomposed at 500 and 600 °C,respectively.Most of water-soluble sodium vanadates are formed between 500 and 600 °C.When roasting temperature reaches above 700 °C,the vanadium-rich phases of sodium vanadates can be obviously observed.However,at temperature above 800 °C,the samples are sintered.Most of the vanadium is enwrapped by glassy phase compounds which lead to the decrease of the leaching rate of vanadium.At the same time,the effect of roasting temperature on extraction of vanadium and characterization of leach residues were discussed.

Leaching kinetics of low-grade copper ore containing calcium-magnesium carbonate in ammonia-ammonium sulfate solution with persulfate

The leaching kinetics of copper from low-grade copper ore was investigated in ammonia-ammonium sulfate solution with sodium persulfate. The effect parameters of stirring speed, temperature, particle size, concentrations of ammonia, ammonium sulfate and sodium persulfate were determined. The results show that the leaching rate is nearly independent of agitation above 300 r/min and increases with the increase of temperature, concentrations of ammonia, ammonium sulfate and sodium persulfate. The EDS analysis and phase quantitative analysis of the residues indicate that bornite can be dissolved by persulfate oxidization. The leaching kinetics with activation energy of 22.91 kJ/mol was analyzed by using a new shrinking core model （SCM） in which both the interfacial transfer and diffusion across the product layer affect the leaching rate. A semi-empirical rate equation was obtained to describe the leaching process and the empirical reaction orders with respect to the concentrations of ammonia, ammonium sulfate and sodium persulfate are 0.5, 1.2 and 0.5, respectively.

Cultivation Path of Nursing Undergraduates’ Scientific Research and Innovation Ability

Objective:The cultivation of the innovation ability and scientific research is one of the nursing learning objectives for undergraduate students.To explore the method and effect of training system of scientific research innovation ability of nursing undergraduates based on“3332”.Methods:Three course learning modules are constructed:stage-based course learning module,systematic project practice training module and comprehensive practice training module.A practical training platform for scientific research innovation projects is built,and undergraduate scientific research innovation ability training is carried out from both in-class and out-of-class lines.Results:Since 2017,the students have obtained 7 national innovation and entrepreneurship training programs,52 university-level undergraduate scientific research projects,published more than 10 academic papers,and obtained 2 patent authorization.Conclusions:The training system of scientific research innovation ability of nursing undergraduates based on“3332”is conducive to the development of scientific research innovation ability of nursing students,and to cultivate nursing talents who can adapt to the development of the new era and have better post competence.