Rehabilitation of anterior pituitary dysfunction combined with extrapontine myelinolysis: A case report

BACKGROUND Extramedullary myelinolysis is a rare demyelinating disease, often caused by rapid increases in serum sodium concentration in patients with hyponatremia.Clinical manifestations are neuropsychiatric symptoms, limb weakness, and dysarthria. Because of its poor prognosis and high disability rate, it poses a huge burden on the global economy, societies, and families. This article reports rehabilitation in a patient with pituitary dysfunction combined with extramedullary myelinolysis.CASE SUMMARY A 27-year-old Chinese man developed anorexia, vomiting, and limb weakness and was diagnosed with pituitary insufficiency. He had low serum sodium, slow movement, muscle weakness, and muscle tone abnormalities after sodium supplementation, involuntary limb shaking, ataxia, and dysarthria. According to the symptoms and signs and imaging reports, he was diagnosed with extramedullary myelinolysis. After treatment with hormone therapy and neurotrophic drugs, motor and speech function did not improve, so he was treated in the rehabilitation department for 4 wk. The patient's physical status was improved substantially during his stay at the rehabilitation department.CONCLUSION Patients with extramedullary myelinolysis who actively participate in rehabilitation intervention can significantly improve their activities of daily living.

Role of a wireless surface electromyography in dystonic gait in functional movement disorders: A case report

BACKGROUND Dystonic gait(DG) is one of clinical symptoms associated with functional dystonia in the functional movement disorders(FMDs). Dystonia is often initiated or worsened by voluntary action and associated with overflow muscle activation. There is no report for DG in FMDs caused by an abnormal pattern in the ankle muscle recruitment strategy during gait.CASE SUMMARY A 52-year-old male patient presented with persistent limping gait. When we requested him to do dorsiflexion and plantar flexion of his ankle in the standing and seating positions, we didn’t see any abnormality. However, we could see the DG during the gait. There were no evidences of common peroneal neuropathy and L5 radiculopathy in the electrodiagnostic study. Magnetic resonance imaging of the lumbar spine, lower leg, and brain had no definite finding. No specific finding was seen in the neurologic examination. For further evaluation, a wireless surface electromyography(EMG) was performed. During the gait, EMG amplitude of left medial and lateral gastrocnemius(GCM) muscles was larger than right medial and lateral GCM muscles. When we analyzed EMG signals for each muscle, there were EMG bursts of double-contraction in the left medial and lateral GCM muscles, while EMG analysis of right medial and lateral GCM muscles noted regular bursts of single contraction. We could find a cause of DG in FMDs.CONCLUSION We report an importance of a wireless surface EMG, in which other examination didn’t reveal the cause of DG in FMDs.

Establishing minimum clinically important difference values for the Patient-Reported Outcomes Measurement Information System Physical Function, hip disability and osteoarthritis outcome score for joint reconstruction, and knee injury and osteoarthritis out

AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the Patient-Reported Outcomes Measurement Information System Physical Function(PROMIS~? PF) computerized adaptive test(CAT), hip disability and osteoarthritis outcome score for joint reconstruction(HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction(KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchorbased and distribution-based methods. Patient reports of meaningful change in function since their first clinic encounter were used as an anchor.RESULTS There were 2226 patients who participated with a mean age of 61.16(SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS~? PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS~? PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS JR.CONCLUSION This is the first comprehensive study providing a wide range of MCIDs for the PROMIS? PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments.

Analysis on the Modality of English News Report

Modality is used to express subjective judgment as well as the speaker’s opinions and attitudes.This paper aims to analyze the reporters’orientation reflected by linguistic modal expressions in English news reports from the perspective of Systemic-Functional Grammar,especially from the perspective of type,value,orientation and polarity.

Open anterior glenohumeral dislocation with associated supraspinatus avulsion: A case report

BACKGROUND Open dislocation of the glenohumeral joint is a very rare complication with only six cases described in the literature. Most cases resulted in severe complications like avascular necrosis of the humeral head or septic arthritis with poor functional results. The "mandatory" treatment of choice is surgery, with accurate debridement and reconstruction of the damaged soft tissues. However, the results in these cases do not approach those seen in classical dislocations.CASE SUMMARY This case report is the first description of an anterior open glenohumeral dislocation without associated fractures, but with complete avulsion of the soft tissue envelope of the proximal humerus. Surgical treatment consisted of copious lavage with saline solution, meticulous debridement of the nonviable soft tissues,reduction of the dislocated humeral head and reconstruction of the soft tissue envelope of the humeral head. The selected surgical approach was an inferior extension of the wound at the level of the delto-pectoral groove, as the best choice to be able to perform an adequate debridement and capsulo-tendinous reinsertion. At 6 mo there were no clinical signs of instability of the glenohumeral joint, the functionality of the joint was restricted to 90o of anterior elevation,internal rotation to L2, with severe limitation of abduction(60o) and external rotation(0o) but without residual pain, with an Oxford shoulder Score of 28.CONCLUSION Thorough reconstruction of the soft tissues surrounding the shoulder joint and an early rehabilitation program are key points to a good functional result.

A Comparative Study of Chinese and English Mood System from the Perspective of System-Functional Grammar

This essay compares modality in a Chinese and a corresponding English news report. Modalities can be expressed in different parts of clauses, such as modal verbs, adjuncts, predicators and complements. It is found that in spit of the similarity in contents, the modal verbs and their frequencies are quite different. The Chinese news report contains more modal verbs.

Truth Retold? A Comparative Study of Two News Reports on Farah Incident

Based on systemic functional linguistics, this study carries out a comparative analysis of the Arab News and the CNN's reportage on the Farah Incident. Through the analysis, this study shows that there exist striking differences between the representations of the Farah Incident in the two news media. It is argued that these differences are not arbitrary but ideologically motivated.

A Study of News Reports in China Daily from the Perspective of Transitivity

News is very important in our daily life, which we can get sufficient information from different kinds of news. In this paper, I take Halliday's systemic-functional grammar as the theoretical foundation to analyze the news. Halliday categorizes the metafunctions into experiential function, interpersonal function and textual function. Here, I will make a detailed analysis of the English news reports in China Daily from transitivity of experiential function to find out the linguistic characteristics of the English news reports.

Preliminary Report on Phenom^®Femoral Component in Total Hip Replacement: The Correlation between Outcome Scores in a Cross-Seccional Study

Background: The main purpose of the present study was to assess the short term performance of a cementless femoral stem in total hip replacement. Methods: Cross-sectional observational study of a 48-patient cohort with Phenom? femoral stems implanted between June 1, 2014 and September 1, 2018, to determine clinical performance, stability, and radiographic osseointegration. Patients were followed-up from 13 to 76 months (mean: 44.5 months) and assessed using the Harris Hip Score-HHS, the Hip Disability and Osteoarthritis Outcome Score-HOOS and radiographs. Results: All stems were radiologically stable. Mean Harris Hip Score was 89.8 and the HOOS was 80.4. No statistical differences were observed among patients with different diagnoses. Conclusions: The short-term results revealed satisfactory clinical outcomes and radiological signs of implant stability in all cases. Using two functional scores was useful in detecting biases and a low to moderate agreement was found between the scores.

Successful kidney transplantation from an expanded criteria donor with long-term extracorporeal membrane oxygenation treatment: A case report

BACKGROUND Due to a shortage of donor kidneys, many centers have utilized graft kidneys from brain-dead donors with expanded criteria. Kidney transplantation(KT)from donors on extracorporeal membrane oxygenation(ECMO) has been identified as a successful way of expanding donor pools. However, there are currently no guidelines or recommendations that guarantee successful KT from donors undergoing ECMO treatment. Therefore, acceptance of appropriate allografts from those donors is solely based on clinician decision.CASE SUMMARY We report a case of successful KT from a brain-dead donor supported by ECMO for the longest duration to date. A 69-year-old male received a KT from a 63-yearold brain-dead donor who had been on therapeutic ECMO treatment for the previous three weeks. The recipient experienced slow recovery of graft function after surgery but was discharged home on post-operative day 17 free from hemodialysis. Allograft function gradually improved thereafter and was comparatively acceptable up to the 12 mo follow-up, with serum creatinine level of 1.67 mg/d L.CONCLUSION This case suggests that donation even after long-term ECMO treatment could provide successful KT to suitable candidates.

Functional outcomes assessment in shoulder surgery

The effective evaluation and management of orthopaedic conditions including shoulder disorders relies upon understanding the level of disability created by the disease process. Validated outcome measures are critical to the evaluation process. Traditionally, outcome measures have been physician derived objective evaluations including range of motion and radiologic evaluations. However, these measures can marginalize a patient's perception of their disability or outcome. As a result of these limitations, patient self-reported outcomes measures have become popular over the last quarter century and are currently primary tools to evaluate outcomes of treatment. Patient reported outcomes measures can be general health related quality of life measures, health utility measures, region specific health related quality of life measures or condition specific measures. Several patients self-reported outcomes measures have been developed and validated for evaluating patients with shoulder disorders. Computer adaptive testing will likely play an important role in the arsenal of measures used to evaluate shoulder patients in the future. The purpose of this article is to review the general health related quality-of-life measures as well as the jointspecific and condition specific measures utilized in evaluating patients with shoulder conditions. Advancesin computer adaptive testing as it relates to assessing dysfunction in shoulder conditions will also be reviewed.

A Contrastive Study of the Interpersonal Meanings of Modality in English and Chinese News Reports

The news,a special form of discourse,can easily influence people's emotion and evaluation.Although its characteristics require the reported messages to be objective and fair,there is no absolute objectivity.This paper aims to conduct a systematic analysis of finite modal operator and modal adjuncts under the framework of Halliday's systemic-functional grammar.The linguistic data is drawn from two pieces of news reports on hand-foot-mouth disease in English and Chinese.Both qualitative and quantitative research methods are adopted to discover the difference as well as similarity between the two languages with regards to the realization of modality.

颈淋巴结清扫术后颈肩功能障碍患者报告结局测量工具的研究进展

对国内外颈淋巴结清扫术后颈肩功能障碍患者报告结局测量工具进行综述,旨在为我国临床护理人员选择和开发颈淋巴结清扫术后颈肩功能障碍患者报告结局测量工具提供参考。

《寻乌调查》“子”尾名词英译的信息对等与缺失

方言蕴含着深厚的文化气息,中西方文化的不同,给方言英译也带了难题。为了促进方言英译和传播,本文以汤若杰(Thompson,Roger R)的《寻乌调查》英译本为研究对象,尤金·奈达的功能对等理论为指导,借助NVivo质性研究软件,探析其中客家方言“子”尾名词英译信息对等与缺失。为了实现“子”尾名词英译的信息对等,译者应首先分析汉语“子”尾的功能,才能够准确无误地理解其蕴含的信息,进一步实现语义和文化信息对等。研究发现,《寻乌调查》英译本中关于“子”尾词的英译绝大多数实现了信息对等,让原文读者和译文读者之间能够最大程度地接收到相同的信息;少部分由于译者汤若杰未能很好地理解到“子”尾功能,导致译文信息存在部分的缺失。

上市公司审计委员会与年报风险信息披露--基于管理层信息操纵视角

上市公司年报风险信息是了解公司经营现状与预测未来发展的重要信息来源,它具有信息增量价值,但容易受到管理层信息操纵的影响。审计委员会作为公司治理的独立机制,对管理层具有内部监督作用。基于此,利用2010—2021年上市公司风险信息披露数据,实证检验了审计委员会对管理层信息操纵的治理作用。研究发现,审计委员会独立性、勤勉性和专业性越强,年报风险信息披露水平越高,且在不同性质市场环境中审计委员会的治理作用存在差异。机制检验结果表明,内部控制发挥了部分中介作用;此外,在内部治理环境较弱与外部监督压力较大时,审计委员会的治理作用更加显著。结论拓展了年报风险信息披露的影响因素研究,并通过构建不同维度的风险信息指标来综合衡量披露水平,证实了审计委员会对管理层信息操纵的治理效应,为审计委员会更好发挥监督效果以及监管部门进一步完善上市公司风险信息披露制度提供了重要支撑。

Attention-Deficit/Hyperactivity Disorder in Adults with High-Functioning Pervasive Developmental Disorders in Japan

Aims: This study was designed to verify the proportion of Japanese adults with pervasive developmental disorder (PDD) who met the diagnostic criteria (other than E) for attention-deficit/hyperactivity disorder (ADHD) in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Furthermore, we examined to what extent adults with PDD think that they exhibit ADHD symptoms. Methods: We developed an original Japanese self-report questionnaire to determine the presence or absence of 18 symptoms from the diagnostic criteria for ADHD in the DSM-IV-TR. We administered the questionnaire to 64 adults with high-functioning PDD (45 men and 19 women) and 21 adults with ADHD (10 men and 11 women), aged 18 to 59 years, with a full-scale intelligence quotient ≥75. Target patients were evaluated for ADHD by their psychiatrists. Results: Twenty-nine (45.3%) adults with PDD also had ADHD. The percentage of these adults who had over six perceived inattention symptoms from the DSM-IV-TR was 96.6%. The percentage of these adults who had over six perceived hyperactivity-impulsivity symptoms was 65.5%. Thirty-five (55.6%) adults with PDD responded that they were aware of having ADHD symptoms at the level of the relevant diagnostic criteria. Conclusions: The present study is the first to examine the frequency of objective and perceived ADHD symptoms in adults with PDD in Japan. Our results show that both objective and perceived ADHD symptoms frequently appear in a large number of adults with PDD. This suggests that it is necessary to attend to concomitant ADHD symptoms in the medical care of adults with PDD.

基于语料库的《政府工作报告》英译本情态动词的人际意义研究

情态是表达人际意义的重要语义系统。《政府工作报告》英译本受到学界广泛关注,但大多数研究集中在原文和各种译本之间的比较上,对于翻译所传达的主次人际意义鲜有深入讨论。鉴于此,基于自建语料库,运用Halliday的功能语法,从情态动词的角度对2013—2024年《政府工作报告》英译本中不同语态进行分析,发现:(1)在《政府工作报告》英译本中,非中动态主动句是主要传达政府情态意义的句式;(2)《政府工作报告》英译本中we will、we should和we must占比分别为36.83%、6.75%和3.11%,其中主要人际意义以we will和we should为主,体现了对英语读者阅读习惯的尊重,传达了中国政府谦虚低调的态度和团结带领中国人民共同发展的强烈意愿,而次要人际意义以we must为主,强化了中国政府的严肃性和权威性。通过情态动词的人际意义分析可为翻译实践提供一些参考,有助于译者更好地传达政治经济文本所期望传递的人际意义。

平衡训练对慢性踝关节不稳影响效果的Meta分析

目的:慢性踝关节不稳临床上主要表现为肌无力、间断性疼痛和反复崴脚等症状,严重影响运动锻炼和日常生活。本体感觉缺失、腓骨反应时间延长和外翻力量减弱等可能是造成慢性踝关节不稳的主要原因,因此通过运动干预可以有效改善踝关节不稳相关症状。通过Meta分析定量评价平衡训练对慢性踝关节不稳康复干预的效果,为慢性踝关节不稳患者科学制定运动处方提供可靠的理论基础和实践依据。方法:检索中国知网、维普、Web of Science和PubMed数据库关于平衡训练对慢性踝关节不稳患者症状康复和动态平衡影响的随机对照试验文献,文献发表时间为各数据库建库至2022-11-23。包括2名评审人员依据物理治疗证据量表对纳入文献进行文献质量评估,主要结局指标为自我功能评分量表,次要结局指标为星形偏移平衡测试,均为连续性变量。采用RevMan 5.3和Stata-SE 15软件对纳入文献进行森林图绘制、Meta回归、亚组分析、敏感性分析和发表偏倚评价。结果:①共纳入18篇随机对照试验文献,包括慢性踝关节不稳患者641例。整体上文献的方法学质量较高。②Meta分析结果显示,平衡训练可以改善慢性踝关节不稳患者的功能康复效果(SMD=0.82,95%CI:0.41-1.23,P<0.0001)。Meta回归显示干预时间可能是产生异质性的主要原因(P=0.008)。③亚组分析结果显示,干预6周(SMD=0.98,95%CI:0.31-1.65,P=0.03)、每周干预大于3次(SMD=0.87,95%CI:0.30-1.44,P=0.003)和每次干预时间小于20 min(SMD=0.89,95%CI:0.61-1.66,P<0.0001)是改善慢性踝关节不稳患者功能康复效果的最佳康复方案。④Meta分析结果还显示,平衡训练可以改善星形偏移平衡测试前侧(SMD=0.56,95%CI:0.31-0.80,P<0.05)、后内侧(SMD=0.88,95%CI:0.45-1.32,P<0.05)和后外侧(SMD=0.84,95%CI:0.22-1.46,P<0.05)伸展程度。结论:当前临床证据表明,平衡训练可以改善慢性踝关节不稳患者的踝关节不稳功能症状和提高动态平衡能力,建议通过每周干预大于3次,每次干预小于20 min的干预时间以获得更好的康复效果。

Cystic fibrosis transmembrane conductance regulator functional evaluations in a G542X+/-IVS8Tn:T7/9 patient with acute recurrent pancreatitis

BACKGROUND Acute recurrent pancreatitis(ARP)is characterized by episodes of acute pancreatitis in an otherwise normal gland.When no cause of ARP is identifiable,the diagnosis of"idiopathic"ARP is given.Mutations in the cystic fibrosis transmembrane conductance regulator(CFTR)gene increase the risk of ARP by 3-to 4-times compared to the general population,while cystic fibrosis(CF)patients present with a 40-to 80-times higher risk of developing pancreatitis.CASE SUMMARY In non-classical CF or CFTR-related disorders,CFTR functional tests can help to ensure a proper diagnosis.We applied an individualized combination of standardized and new CFTR functional bioassays for a patient referred to the Verona CF Center for evaluation after several episodes of acute pancreatitis.The CFTR genotype was G542X+/-with IVS8Tn:T7/9 polymorphism.The sweat(Cl-)values were borderline.Intestinal current measurements were performed according to the European Cystic Fibrosis Society Standardized Operating Procedure.Recent nasal surgery for deviated septum did not allow for nasal potential difference measurements.Lung function and sputum cultures were normal;azoospermia was excluded.Pancreas divisum was excluded by imaging but hypoplasia of the left hepatic lobe was detected.Innovative tests applied in this case include sweat rate measurement by image analysis,CFTR function in monocytes evaluated using a membrane potential-sensitive fluorescent probe,and the intestinal organoids forskolin-induced swelling assay.CONCLUSION Combination of innovative CFTR functional assays might support a controversial diagnosis when CFTR-related disorders and/or non-classical CF are suspected.