Introduction: Little is known about the feasibility and effectiveness of rehabilitative treatment for systemic lupus erythematosus (SLE) in individuals with progressive multifocal leukoencephalopathy (PML). We describ...Introduction: Little is known about the feasibility and effectiveness of rehabilitative treatment for systemic lupus erythematosus (SLE) in individuals with progressive multifocal leukoencephalopathy (PML). We describe a patient with SLE complicated by PML and ameliorated by comprehensive rehabilitation. We also review the epidemiology, pathology, imaging characteristics, and treatment of PML. Patient Concerns: We found a patient with SLE with PML improved by multidisciplinary rehabilitation techniques. Diagnoses, Interventions, and Outcomes: We diagnosed a PML with a 13-year history of SLE and lupus nephritis after longtime immunosuppressive therapy. The patient underwent a comprehensive, multifaceted rehabilitation program, including drug therapy, integrated physical therapy, occupational therapy, acupuncture, music therapy, computer-aided cognitive rehabilitation training, and behavioral management training. This rehabilitation program improved her motor function and activities of daily living. Conclusions: Her condition improved in the short term through comprehensive rehabilitation, including physical, speech, and cognitive therapy. Therefore, we recommend comprehensive rehabilitation to improve the function and activities of daily living in patients with PML.展开更多
A dissertation is a research report or scientific paper written by an author to obtain a certain degree. It reflects postgraduates’ research achievements and the educational quality of an institute, even a country. T...A dissertation is a research report or scientific paper written by an author to obtain a certain degree. It reflects postgraduates’ research achievements and the educational quality of an institute, even a country. To construct an optimized quality evaluation system for postgraduate dissertation (QESPD), we summarized the influencing factors and invited 10 experienced specialists to rate and prioritize them based on fuzzy analytic hierarchy process. Four primary indicators (innovation, integrity, scientificity and normativity) and 16 sub-indicators were selected to form the evaluation system. The order of primary indicators by weight, was innovation (0.4269), scientificity (0.2807), integrity (0.1728) and normativity (0.1196). The top five sub-dimensions were theoretical originality, scientific value, data reliability, design rationality and evidence credibility. To demonstrate the effectiveness of the proposed system, a case study was performed. In the case study, it was demonstrated that the established two-index-hierarchy QESPD in this study was a more scientific and reasonable evaluation system worthy of promotion and application.展开更多
Computer aided process planning system played a key role for integrating design and manufacturing or assembly systems properly considering available resources and design constraints.To take advantage of the enterprise...Computer aided process planning system played a key role for integrating design and manufacturing or assembly systems properly considering available resources and design constraints.To take advantage of the enterprise resource,the web CAPP framework was established.Case based reasoning and multi agent system were integrated in the system.The multi agent mecha- nism was discussed in the paper.And an instance of case base was introduced.They made the system run independently and contin- uously in the network environment of process planning problems.展开更多
BACKGROUND Duodenal varices are a lesser-known complication with non-cirrhotic portal hypertension. We report a circuitous route from missed diagnosis of duodenal varices to correction. An extremely rare case of duode...BACKGROUND Duodenal varices are a lesser-known complication with non-cirrhotic portal hypertension. We report a circuitous route from missed diagnosis of duodenal varices to correction. An extremely rare case of duodenal variceal bleeding secondary to idiopathic portal hypertension(IPH) is expounded in this study, which was controlled by transjugular intra-hepatic porto-systemic shunt(TIPS) plus embolization. CASE SUMMARY A 46-year-old woman with anemia for two years was frequently admitted to the local hospital. Upon examination, anemia was attributed to gastrointestinal tract bleeding, which resulted from duodenal variceal bleeding detected by repeated esophagogastroduodenoscopy. At the end of a complete workup, IPH leadingto duodenal varices was diagnosed. Portal venography revealed that the remarked duodenal varices originated from the proximal superior mesenteric vein. TIPS plus embolization with coils and Histoacryl was performed to obliterate the rupture of duodenal varices. The anemia resolved, and the duodenal varices completely vanished by 2 mo after the initial operation. CONCLUSION TIPS plus embolization may be more appropriate to treat the bleeding of large duodenal varices.展开更多
BACKGROUND New-onset systemic lupus erythematosus(SLE)during pregnancy and in the postpartum period is rare,especially when complicated with pre-eclampsia,which is difficult to diagnose accurately.Here,we report a pat...BACKGROUND New-onset systemic lupus erythematosus(SLE)during pregnancy and in the postpartum period is rare,especially when complicated with pre-eclampsia,which is difficult to diagnose accurately.Here,we report a patient with newonset SLE and antiphospholipid syndrome during pregnancy,which presented as pre-eclampsia at admission.CASE SUMMARY A 28-year-old primigravid woman was admitted to our hospital in the 27th wk of gestation with the primary diagnosis of severe pre-eclampsia.Although spasmolysis and antihypertensive therapy were administered since admission,the 24-h proteinuria of the 2nd day after admission reached 10311.0 mg.In the 47th h of admission,immunologic examinations revealed increased levels of antidouble stranded DNA antibody,anti-nuclear antibody,anti-cardiolipin antibody,anti-Sj?gren’s syndrome-related antigen A antibody and anti-nucleosome antibody and decreased levels of complement C3 and C4.One hour later,ultrasonography of the lower limbs showed thrombus of the bilateral popliteal veins.The diagnosis of SLE and antiphospholipid syndrome was indicated.In the 54th h,the patient manifested with convulsion,dyspnea and blurred vision.Ten hours later,intrauterine death was revealed by ultrasonography.Emergent surgery consisting of inferior vena cava filter implantation and subsequent cesarean section was performed.Following glucocorticoid and anticoagulation therapy after delivery,the patient had an optimal response with improvements in symptoms and immunological markers.CONCLUSION Obstetricians should be aware of the symptoms and immunological examination results to distinguish pre-eclampsia and underlying SLE for optimal pregnancy outcomes.展开更多
In this paper we discuss the topological structure near the singular point O (0,0) of the plane cubic system in the undetermined sign case, and give their coefficient conditions.
BACKGROUND Lupus enteritis is a rare manifestation of systemic lupus erythematosus (SLE). Diagnosis of this condition is difficult, especially in the absence of other symptoms related to active SLE. We present the cas...BACKGROUND Lupus enteritis is a rare manifestation of systemic lupus erythematosus (SLE). Diagnosis of this condition is difficult, especially in the absence of other symptoms related to active SLE. We present the case of a 25-year-old female with lupus enteritis as the sole initial manifestation of active SLE. CASE SUMMARY A 25-year-old African American female presented to the Emergency Department complaining of diffuse abdominal pain, diarrhea, nausea, and vomiting for 2 days. Her past medical history was significant for seasonal allergies and family history was pertinent for discoid lupus in her father and SLE in a cousin. The patient’s vital signs on presentation were normal. Her physical exam was remarkable for significant lower abdominal tenderness without guarding or rigidity. A computed tomography of the abdomen and pelvis revealed marked circumferential wall thickening and edema of the proximal and mid small bowel predominantly involving the submucosa. Our main differential diagnoses were intestinal angioedema and mesenteric vein thrombosis. However, mesenteric vessels were patent, and laboratory testing for hereditary angioedema showed a normal C1 Esterase Inhibitor level and low C3 and C4 levels. Infectious work-up was negative. Autoimmune tests showed elevated anti-nuclear antibodies (ANA)(13.6), anti-Smith antibody, and anti-ribonucleoprotein (anti-RNP) antibody. The patient was diagnosed with SLE enteritis. She was maintained on bowel rest, given intravenous hydration, and started on methylprednisolone 60 mg IV daily. She had significant improvement in her abdominal pain, diarrhea, and emesis after 2 days of treatment. Steroids were tapered and maintained on Hydroxychloroquine with no relapses one year after presentation.CONCLUSION This case of lupus enteritis represents a rare manifestation of SLE. Diagnosis requires clinical suspicion, characteristic imaging and laboratory tests. Endoscopic appearance and biopsies usually yield non-specific findings. High dose steroids are the preferred treatment modality for moderate and severe cases.展开更多
BACKGROUND Macrophage activation syndrome(MAS)is defined as a specific secondary hemophagocytic lymphohistiocytosis that refers particularly to those triggered by autoimmune diseases.MAS is a rare and highly lethal co...BACKGROUND Macrophage activation syndrome(MAS)is defined as a specific secondary hemophagocytic lymphohistiocytosis that refers particularly to those triggered by autoimmune diseases.MAS is a rare and highly lethal complication of systemic lupus erythematosus(SLE),which can be associated with,or mimic,disease flare.However,the data regarding the clinical course,management and outcome of SLE with MAS is limited,especially in adults.Lack of clinical recognition of the disease often leads to poor prognosis.CASE SUMMARY We report a 36-year-old Chinese woman without relevant past medical history who was admitted to hospital with a 6-d history of jaundice and a high fever of 39.4°C lasting one day.Abdominal magnetic resonance imaging excluded obstructive jaundice,no infection was identified and empiric superior antibiotic treatment(meropenem)showed no clinical improvement.However,newly emerged pancytopenia and respiratory failure endangered the patient’s life.Autoimmune work-up finally led to the diagnosis of SLE,which initially presented as MAS and manifested respiratory failure,although neither bone marrow biopsy nor lymph node biopsy showed hemophagocytosis.To our knowledge,such a scenario has never been reported in detail before.The patient had a favorable reaction to combination treatment with corticosteroid and cyclosporine A and has been in clinical remission during the 1-year follow up period.CONCLUSION Respiratory failure and MAS can be an onset of SLE.Early diagnosis and appropriate treatment are extremely important for a better prognosis.展开更多
To establish the institutional mechanism for land conflict coordination in China, a case-based reasomng system is developed as an intelligent support and effective manner to resolve such issues. The establishment of t...To establish the institutional mechanism for land conflict coordination in China, a case-based reasomng system is developed as an intelligent support and effective manner to resolve such issues. The establishment of the case library is discussed, previous land conflict cases are archived in a structural representation format for retrieval, and the similarity algorithm is adopted to compare the case features. Group tests show a good classification performance, which reveals that the system is feasible.展开更多
BACKGROUND Systemic sclerosis is a rare connective tissue disease characterized by localized or diffuse skin thickening and fibrosis,which usually accumulates in various organs throughout the body.Tachyarrhythmia is a...BACKGROUND Systemic sclerosis is a rare connective tissue disease characterized by localized or diffuse skin thickening and fibrosis,which usually accumulates in various organs throughout the body.Tachyarrhythmia is a common clinical manifestation of cardiovascular damage in systemic sclerosis patients.However,few studies have reported the use of catheter ablation and an implantable cardioverter defibrillator in patients with systemic sclerosis complicated by ventricular tachycardia.CASE SUMMARY A 39-year woman with an 11-year history of systemic sclerosis was referred to our hospital due to three syncopal episodes in the past 6 mo.The results of an electrocardiogram and a transthoracic echocardiogram revealed ventricular tachycardia and left ventricular systolic and ventricular septum segmental motion abnormalities,respectively.The results of an electrocardiogram showed a sinus rhythm with complete blockage of the left bundle branch.In light of the progressive nature of systemic sclerosis,the presence of a left bundle branch block,and the decreased ejection fraction,a cardiac resynchronization therapydefibrillator was implanted.The patient’s clinical conditions improved,and at the3-mo follow-up,the patient was free of ventricular tachycardia and all cardiac symptoms.CONCLUSION We report the first case of systemic sderosis complicated by ventricular tachycardia that was successfully treated with a cardiac resynchronization therapy-defibrillator.展开更多
BACKGROUND Patellar tendon rupture is a rare disease,and reports regarding patellar tendon reconstruction with ligament augmentation reconstruction system(LARS)ligaments are limited,with only three reports available i...BACKGROUND Patellar tendon rupture is a rare disease,and reports regarding patellar tendon reconstruction with ligament augmentation reconstruction system(LARS)ligaments are limited,with only three reports available in the literature.LARS ligaments are made of polyethylene terephthalate and have been certified as a more favorable option than other tendon transplants.To our knowledge,this is the first report of patellar tendon reconstruction with LARS for suture fixation due to poor quality of the tendon after multiple operations to enable early mobilization and quick rehabilitation.CASE SUMMARY A 65-year-old woman had limited ability in extending her leg and an inability to perform a straight leg raise after multiple operations due to patella fracture.The patient underwent patellar tendon reconstruction with LARS artificial ligaments.After 12 mo of follow-up,the patient was able to perform a straight leg raise,and the incision healed well without complications.The Lysholmscore was 95 and the range of motion of the knee was 0-130°.CONCLUSION This study revealed that patellar tendon reconstruction with LARS artificial ligaments is possible in a patient with a patellar tendon rupture who required rapid postoperative recovery.展开更多
文摘Introduction: Little is known about the feasibility and effectiveness of rehabilitative treatment for systemic lupus erythematosus (SLE) in individuals with progressive multifocal leukoencephalopathy (PML). We describe a patient with SLE complicated by PML and ameliorated by comprehensive rehabilitation. We also review the epidemiology, pathology, imaging characteristics, and treatment of PML. Patient Concerns: We found a patient with SLE with PML improved by multidisciplinary rehabilitation techniques. Diagnoses, Interventions, and Outcomes: We diagnosed a PML with a 13-year history of SLE and lupus nephritis after longtime immunosuppressive therapy. The patient underwent a comprehensive, multifaceted rehabilitation program, including drug therapy, integrated physical therapy, occupational therapy, acupuncture, music therapy, computer-aided cognitive rehabilitation training, and behavioral management training. This rehabilitation program improved her motor function and activities of daily living. Conclusions: Her condition improved in the short term through comprehensive rehabilitation, including physical, speech, and cognitive therapy. Therefore, we recommend comprehensive rehabilitation to improve the function and activities of daily living in patients with PML.
文摘A dissertation is a research report or scientific paper written by an author to obtain a certain degree. It reflects postgraduates’ research achievements and the educational quality of an institute, even a country. To construct an optimized quality evaluation system for postgraduate dissertation (QESPD), we summarized the influencing factors and invited 10 experienced specialists to rate and prioritize them based on fuzzy analytic hierarchy process. Four primary indicators (innovation, integrity, scientificity and normativity) and 16 sub-indicators were selected to form the evaluation system. The order of primary indicators by weight, was innovation (0.4269), scientificity (0.2807), integrity (0.1728) and normativity (0.1196). The top five sub-dimensions were theoretical originality, scientific value, data reliability, design rationality and evidence credibility. To demonstrate the effectiveness of the proposed system, a case study was performed. In the case study, it was demonstrated that the established two-index-hierarchy QESPD in this study was a more scientific and reasonable evaluation system worthy of promotion and application.
文摘Computer aided process planning system played a key role for integrating design and manufacturing or assembly systems properly considering available resources and design constraints.To take advantage of the enterprise resource,the web CAPP framework was established.Case based reasoning and multi agent system were integrated in the system.The multi agent mecha- nism was discussed in the paper.And an instance of case base was introduced.They made the system run independently and contin- uously in the network environment of process planning problems.
基金Supported by National Natural Science Foundation of China under Grant No.81503437
文摘BACKGROUND Duodenal varices are a lesser-known complication with non-cirrhotic portal hypertension. We report a circuitous route from missed diagnosis of duodenal varices to correction. An extremely rare case of duodenal variceal bleeding secondary to idiopathic portal hypertension(IPH) is expounded in this study, which was controlled by transjugular intra-hepatic porto-systemic shunt(TIPS) plus embolization. CASE SUMMARY A 46-year-old woman with anemia for two years was frequently admitted to the local hospital. Upon examination, anemia was attributed to gastrointestinal tract bleeding, which resulted from duodenal variceal bleeding detected by repeated esophagogastroduodenoscopy. At the end of a complete workup, IPH leadingto duodenal varices was diagnosed. Portal venography revealed that the remarked duodenal varices originated from the proximal superior mesenteric vein. TIPS plus embolization with coils and Histoacryl was performed to obliterate the rupture of duodenal varices. The anemia resolved, and the duodenal varices completely vanished by 2 mo after the initial operation. CONCLUSION TIPS plus embolization may be more appropriate to treat the bleeding of large duodenal varices.
基金Supported by the Natural Science Foundation of Tianjin Municipal Science and Technology Commission,No.16JCYBJC26400
文摘BACKGROUND New-onset systemic lupus erythematosus(SLE)during pregnancy and in the postpartum period is rare,especially when complicated with pre-eclampsia,which is difficult to diagnose accurately.Here,we report a patient with newonset SLE and antiphospholipid syndrome during pregnancy,which presented as pre-eclampsia at admission.CASE SUMMARY A 28-year-old primigravid woman was admitted to our hospital in the 27th wk of gestation with the primary diagnosis of severe pre-eclampsia.Although spasmolysis and antihypertensive therapy were administered since admission,the 24-h proteinuria of the 2nd day after admission reached 10311.0 mg.In the 47th h of admission,immunologic examinations revealed increased levels of antidouble stranded DNA antibody,anti-nuclear antibody,anti-cardiolipin antibody,anti-Sj?gren’s syndrome-related antigen A antibody and anti-nucleosome antibody and decreased levels of complement C3 and C4.One hour later,ultrasonography of the lower limbs showed thrombus of the bilateral popliteal veins.The diagnosis of SLE and antiphospholipid syndrome was indicated.In the 54th h,the patient manifested with convulsion,dyspnea and blurred vision.Ten hours later,intrauterine death was revealed by ultrasonography.Emergent surgery consisting of inferior vena cava filter implantation and subsequent cesarean section was performed.Following glucocorticoid and anticoagulation therapy after delivery,the patient had an optimal response with improvements in symptoms and immunological markers.CONCLUSION Obstetricians should be aware of the symptoms and immunological examination results to distinguish pre-eclampsia and underlying SLE for optimal pregnancy outcomes.
文摘In this paper we discuss the topological structure near the singular point O (0,0) of the plane cubic system in the undetermined sign case, and give their coefficient conditions.
文摘BACKGROUND Lupus enteritis is a rare manifestation of systemic lupus erythematosus (SLE). Diagnosis of this condition is difficult, especially in the absence of other symptoms related to active SLE. We present the case of a 25-year-old female with lupus enteritis as the sole initial manifestation of active SLE. CASE SUMMARY A 25-year-old African American female presented to the Emergency Department complaining of diffuse abdominal pain, diarrhea, nausea, and vomiting for 2 days. Her past medical history was significant for seasonal allergies and family history was pertinent for discoid lupus in her father and SLE in a cousin. The patient’s vital signs on presentation were normal. Her physical exam was remarkable for significant lower abdominal tenderness without guarding or rigidity. A computed tomography of the abdomen and pelvis revealed marked circumferential wall thickening and edema of the proximal and mid small bowel predominantly involving the submucosa. Our main differential diagnoses were intestinal angioedema and mesenteric vein thrombosis. However, mesenteric vessels were patent, and laboratory testing for hereditary angioedema showed a normal C1 Esterase Inhibitor level and low C3 and C4 levels. Infectious work-up was negative. Autoimmune tests showed elevated anti-nuclear antibodies (ANA)(13.6), anti-Smith antibody, and anti-ribonucleoprotein (anti-RNP) antibody. The patient was diagnosed with SLE enteritis. She was maintained on bowel rest, given intravenous hydration, and started on methylprednisolone 60 mg IV daily. She had significant improvement in her abdominal pain, diarrhea, and emesis after 2 days of treatment. Steroids were tapered and maintained on Hydroxychloroquine with no relapses one year after presentation.CONCLUSION This case of lupus enteritis represents a rare manifestation of SLE. Diagnosis requires clinical suspicion, characteristic imaging and laboratory tests. Endoscopic appearance and biopsies usually yield non-specific findings. High dose steroids are the preferred treatment modality for moderate and severe cases.
文摘BACKGROUND Macrophage activation syndrome(MAS)is defined as a specific secondary hemophagocytic lymphohistiocytosis that refers particularly to those triggered by autoimmune diseases.MAS is a rare and highly lethal complication of systemic lupus erythematosus(SLE),which can be associated with,or mimic,disease flare.However,the data regarding the clinical course,management and outcome of SLE with MAS is limited,especially in adults.Lack of clinical recognition of the disease often leads to poor prognosis.CASE SUMMARY We report a 36-year-old Chinese woman without relevant past medical history who was admitted to hospital with a 6-d history of jaundice and a high fever of 39.4°C lasting one day.Abdominal magnetic resonance imaging excluded obstructive jaundice,no infection was identified and empiric superior antibiotic treatment(meropenem)showed no clinical improvement.However,newly emerged pancytopenia and respiratory failure endangered the patient’s life.Autoimmune work-up finally led to the diagnosis of SLE,which initially presented as MAS and manifested respiratory failure,although neither bone marrow biopsy nor lymph node biopsy showed hemophagocytosis.To our knowledge,such a scenario has never been reported in detail before.The patient had a favorable reaction to combination treatment with corticosteroid and cyclosporine A and has been in clinical remission during the 1-year follow up period.CONCLUSION Respiratory failure and MAS can be an onset of SLE.Early diagnosis and appropriate treatment are extremely important for a better prognosis.
基金The National Natural Science Foundationof China (No70573036)
文摘To establish the institutional mechanism for land conflict coordination in China, a case-based reasomng system is developed as an intelligent support and effective manner to resolve such issues. The establishment of the case library is discussed, previous land conflict cases are archived in a structural representation format for retrieval, and the similarity algorithm is adopted to compare the case features. Group tests show a good classification performance, which reveals that the system is feasible.
文摘BACKGROUND Systemic sclerosis is a rare connective tissue disease characterized by localized or diffuse skin thickening and fibrosis,which usually accumulates in various organs throughout the body.Tachyarrhythmia is a common clinical manifestation of cardiovascular damage in systemic sclerosis patients.However,few studies have reported the use of catheter ablation and an implantable cardioverter defibrillator in patients with systemic sclerosis complicated by ventricular tachycardia.CASE SUMMARY A 39-year woman with an 11-year history of systemic sclerosis was referred to our hospital due to three syncopal episodes in the past 6 mo.The results of an electrocardiogram and a transthoracic echocardiogram revealed ventricular tachycardia and left ventricular systolic and ventricular septum segmental motion abnormalities,respectively.The results of an electrocardiogram showed a sinus rhythm with complete blockage of the left bundle branch.In light of the progressive nature of systemic sclerosis,the presence of a left bundle branch block,and the decreased ejection fraction,a cardiac resynchronization therapydefibrillator was implanted.The patient’s clinical conditions improved,and at the3-mo follow-up,the patient was free of ventricular tachycardia and all cardiac symptoms.CONCLUSION We report the first case of systemic sderosis complicated by ventricular tachycardia that was successfully treated with a cardiac resynchronization therapy-defibrillator.
基金Supported by National Natural Science Foundation of China,No.81871814Natural Science Foundation of Shandong Province,No.ZR2017MH119
文摘BACKGROUND Patellar tendon rupture is a rare disease,and reports regarding patellar tendon reconstruction with ligament augmentation reconstruction system(LARS)ligaments are limited,with only three reports available in the literature.LARS ligaments are made of polyethylene terephthalate and have been certified as a more favorable option than other tendon transplants.To our knowledge,this is the first report of patellar tendon reconstruction with LARS for suture fixation due to poor quality of the tendon after multiple operations to enable early mobilization and quick rehabilitation.CASE SUMMARY A 65-year-old woman had limited ability in extending her leg and an inability to perform a straight leg raise after multiple operations due to patella fracture.The patient underwent patellar tendon reconstruction with LARS artificial ligaments.After 12 mo of follow-up,the patient was able to perform a straight leg raise,and the incision healed well without complications.The Lysholmscore was 95 and the range of motion of the knee was 0-130°.CONCLUSION This study revealed that patellar tendon reconstruction with LARS artificial ligaments is possible in a patient with a patellar tendon rupture who required rapid postoperative recovery.
