“Case Teaching”模式在大气污染控制工程教学中的探索与实践

大气污染控制工程是高校环境工程专业的主干专业课程之一。随着国内外大气污染与控制的不断变化和发展,传统大气污染控制工程课程教学模式已面临挑战。文章在对该课程体系内容和问题的综合分析的基础之上,以九江学院为例,从教学内容、教学方法、教学条件及教学效果等方面,对"Case teaching"模式(案例教学法)在课程教学中的应用进行了探讨和实践。

Idiopathic Intracranial Hypertension without Papilloedema “Case Report”

Purpose: The purpose of this case report is to share and spread the awareness of diagnosing and managing idiopathic intracranial hypertension in atypical scenarios as in this case, who presented with multiple other medical conditions, and had no papilloedema. The presenting signs and symptoms of mere headache were misleading. The other medical conditions could have explained the patient’s headache. These included cervical spine osteoporosis, and middle ear otolith disease. This case is unique because she was found to have IIH without papilloedema, and despite having multiple cancers in the uterus, breasts, and recently the thyroid, she had no malignant cells in the CSF. The patient was treated for IIH, and her malignancies were treated separately by the corresponding physicians. Method: The patient was assessed in 2019, and was followed up closely till 2021, in collaboration with her neurologist, oncologist, and orthopedist. Result: The patient had IIH after her neurologist attempted a lumbar puncture, which showed high CSF pressure. Conclusion: Headache is a common symptom presented by patients of different ages and backgrounds. The absence of papilloedema does not exclude the diagnosis of IIH. When possible etiologies for headache are ruled out (e.g. middle and inner ear infections, anemia, intracranial tumors, glaucoma, etc.), chronic headaches that do not respond to medications, and present with visual field changes may require a lumbar puncture.

Palinopsia as a Rare Presenting Symptom of Occipital Stroke “Case Report”

Palinopsia is the recurrence or persistence of visual images after cessation of the stimulus. Palinopsia has been associated with a wide variety of etiologies and mechanisms such as drug induced, seizures, migraine, psychiatric conditions, head trauma and structural lesions in the brain. We report a case of occipital stroke who presented with oscillating palinopsia. Sudden-onset palinopsia is a very rare symptom of stroke, but it must be recognized early as it is a highly time dependent, and potentially treatable condition. A 57-year-old woman with a history of poorly controlled type 2 diabetes, hyperlipidemia, and hypertension presented with sudden onset right sided palinopsia with images of her face and right forearm with hand, occurring several times in a day, lasting for a few minutes each time, and appearing in the same location each time. There are few case reports in literature secondary to stroke and what makes it interesting also is that she reported persistence of image even when her eyes are closed. Moreover, the sudden onset is not common in literature. The Magnetic Resonance Imaging (MRI) of the brain showed evidence of left Posterior Cerebral Artery (PCA) territorial (Fusiform gyrus) subacute ischemic infarction. Visual field assessment showed a right homonymous hemianopia. She was treated with aspirin and clopidogrel. The frequency and intensity of palinopsia reduced subsequently. The face image disappeared in the first week while the forearm image disintegrated gradually over the next few weeks. Palinopsia may be a rare presenting symptom of stroke. It is important for the clinician or emergency room doctors to be alert to the possibility of undiagnosed structural neurological lesions like occipital stroke and differentiate it from non-organic causes, as prompt management may reduce the risk of visual or motor disability.

Large Conventional Osteosarcoma of the Proximal Humerus in a 13-Year-Old Child: Case Report

Introduction: Osteosarcoma is the most common primary malignant bone tumor in children. It is highly aggressive and has a poor prognosis. A late presentation modifies and makes difficult the management affecting the survival of children. We report the case of a large conventional osteosarcoma in a 13-year-old girl. Case Presentation: Adolescent girl admitted for painful swelling of the left shoulder with absolute functional impotence of the thoracic limb and severe anemia. The painful swelling was thought to have been caused by a minor trauma that had occurred six months previously. The patient’s general condition was poor, and she presented with a large, shiny, painful mass over the shoulder and upper 2/3 of the left arm, measuring 28 cm long by 28 cm wide and 57 cm in circumference, and a large fistulous axillary adenopathy. CT scan showed a tumour lesion of the left humerus with liver and lung metastases, raising suspicion of osteogenic osteosarcoma. The tumor was classified according to TNM staging: T2N1M1(a + b). Management was modified when uncontrolled bleeding developed. It consisted of an extended amputation of the left thoracic limb. Pathological analysis showed a high-grade conventional osteosarcoma. Quality improvement was obtained for thirty days, followed by the onset of dyspnea. The evolution was towards death at forty days post-operatively. Conclusion: Osteosarcoma is a highly aggressive cancer. Delayed treatment leads to a fatal outcome. Early diagnosis is one of the challenges to be met in order to improve survival.

Minimally Invasive Surgery for Necrotizing Pancreatitis: A Case Report

Introduction: Necrotizing pancreatitis management is complex and varies significantly among clinicians. Minimally invasive approaches like transgastric necrosectomy via laparoscopy are emerging as effective treatment options. This case report underscores the technique’s efficacy, clinical outcomes, and role in reducing complications. Clinical Observation: A 59-year-old male with a history of smoking and alcoholism presented with severe abdominal pain, nausea, and vomiting. Over the following weeks, he developed symptoms including asthenia, weight loss, and melena. Diagnostic workup revealed severe anemia and Balthazar E necrotizing pancreatitis, with significant intra-abdominal fluid collections and signs of infection. After initial conservative management, the patient underwent transgastric necrosectomy via laparoscopy due to deteriorating clinical status. The procedure involved removing necrotic tissue and performing a cystogastroanastomosis and jejunostomy. Postoperative care included fasting, parenteral nutrition, broad-spectrum antibiotics, and enzymatic replacement. The patient recovered well, with reduced necrotic tissue on follow-up imaging, and was discharged twelve days post-surgery [1]. Conclusion: Transgastric necrosectomy by laparoscopy is a valuable first-line surgical option for patients with symptomatic necrotizing pancreatitis, particularly in cases without prior interventions. This minimally invasive technique helps reduce major complications and mortality, offering a less invasive alternative to traditional open necrosectomy. The multidisciplinary approach and careful postoperative management were crucial to the patient’s favorable outcome. The case highlights the potential of transgastric necrosectomy as an effective treatment strategy in managing complex pancreatitis cases, including those with associated duodenal perforation [2].

Traumatic Diaphragmatic Hernia in Children: A Case Report

Introduction: Traumatic diaphragmatic hernia is a rare condition in children complicating closed or penetrating trauma to the abdomen and thorax. We report the case of an 11-year-old girl with a traumatic diaphragmatic hernia. Case Presentation: An 11-year-old girl was seen in the paediatric surgery department for a thoracolumbar spine deformity and intermittent chest pain. These symptoms occurred after a domestic accident involving a fall from a low wall onto the thoracolumbar spine 5 months previously. The diagnosis was suggested by the presence of a left hemithoracic hydroaera and confirmed by a thoraco-abdominal CT scan. Surgical exploration revealed a linear rupture of the entire left hemi-diaphragm with herniation of the stomach, small intestine, cecum, transverse colon and omentum. We performed a double-layer suture of the diaphragmatic rupture with a non-absorbable suture without edge rejuvenation after the reduction of the hernia. The outcome was favourable with normal postoperative radiographs at one year follow-up. Conclusion: Traumatic diaphragmatic hernia, although uncommon and difficult to diagnose, is a condition that is relatively easy to manage surgically, even if it is discovered late. In all cases of trauma to the thoracolumbar spine, regular follow-up and repeat X-rays are necessary if pain persists.

Neonatal Intestinal Obstruction in Acute Renal Failure in Premature Infant: A Case Report

Introduction: Intestinal obstruction is a common cause of abdominal surgery in the neonate. Diagnosis is straightforward using standard radiology, and surgical technique depends on the underlying anatomical lesion. Peritoneal dialysis (PD) is an effective, albeit invasive, therapy for neonatal renal failure. We report a case of neonatal obstruction with severe renal failure treated by PD to highlight our hospital practice and possible remedies in a context of limited resources. Case Presentation: This was a female neonate of moderate prematurity admitted on day 4 of life for management of a flat neonatal obstruction. Radiological diagnosis suggested small bowel atresia. Biological tests revealed severe renal failure with creatinine levels of 416 micromoles per liter and blood urea of 27.1 micromoles per liter. Management consisted of preoperative peritoneal dialysis for 48 hours followed by laparotomy. The intraoperative diagnosis was GROSFELD type IIIa digestive atresia. The postoperative course was favourable, transit was resumed on day 5 and the patient returned home on day 12. Progress at 3 months was satisfactory. Conclusion: Neonatal intestinal obstruction with renal failure in premature infants is associated with a poor prognosis, even more so if there is a delay in treatment. Peritoneal dialysis seems to be a suitable alternative for this management in our working conditions with limited resources.

Community Caregivers’ Experiences and Programmatic Strategies to Improve Active Case Finding in Community Tuberculosis Care in Botswana 2016-2021

Background: The community tuberculosis care program was started to reduce the impact of TB and increase successful treatment outcomes, thus contributing to meeting WHO targets on TB. According to the Botswana Ministry of Health, community tuberculosis care was introduced with the main goal of reducing tuberculosis-related morbidity and mortality among communities through the expansion of direct observed therapy and community involvement to community settings. The community caregivers were to support tuberculosis patients throughout their treatment period until they were cured or had completed their treatment. Settings: Two major cities of Botswana, Francistown and Gaborone, with more than twenty-two health clinics offering tuberculosis care. Objective: To investigate community caregivers’ experiences and identify programmatic strategies to improve active TB case findings under the community TB care (CTBC) program in Botswana during 2016-2021. Methods: We adopted a descriptive qualitative research design, followed by convenience purposive sampling. We obtained consent and interviewed 40 participants who met the inclusion criteria, 16 out of 73 in Gaborone and 24 out of 38 from Francistown. Results: We interviewed 40 caregivers with a mean age of 43.4 years. Accepting the caregiving role was identified as the main experience by more than two thirds of the caregivers. While at least more than two-fifth felt obligated to care for the patient at home due to personal relations. More than half of the respondents found caregiving difficult or frustrating due to some challenges encountered during the caregiving role. Behavioral modifications were suggested under different subthemes as strategies to improve active case finding. [-rId13-]Conclusion: Acceptance was the major experience in CTBC. Intensification of known programmatic strategies was suggested by caregivers to improve tuberculosis active case finding in CTBC.

Childhood Papillary Thyroid Carcinoma: A Case Report

Background: Thyroid cancer is a rare disease yet the most common endocrine malignancy in pediatrics. Unlike adult patients, children with thyroid nodules typically don’t complain of pain, soreness, or difficulty swallowing. Additionally, using the recommended therapy for adults to treat paediatrics is not appropriate. There is an unmet need for updated unique guidelines for the management of papillary thyroid carcinoma (PTC) in paediatrics and adolescents. Case Report: A 12-year-old girl had an atypical presentation of metastatic PTC in lymph nodes. She was treated initially with hemi-thyroidectomy, followed by total thyroidectomy. A multidisciplinary team followed her up till successful results were found. Conclusion: Due to the difference in pathophysiology between thyroid tumors in children and adults, a unique approach to PTC management is to be implemented. Further trials are required for a better understanding of risk factors, the likelihood of recurrence, and the long-term side effects of the chosen management plan.

Benefits of Dielectric Oil Regeneration Systems in Power Transmission Networks: A Case Study

The criticality of transformers and reactors in the power transmission network and the paramount importance of ensuring their reliability through maintenance of the insulating oil is known. This paper presents a comprehensive examination of the efficacy and economic viability of a dielectric oil regeneration system, as implemented by the Transmission System Maintenance Department (TSMD) of the Independent Power Transmission Operator (IPTO), Greece’s sole transmission operator. Through a detailed chemical analysis and performance evaluation, we assess the impact of the regeneration system on treated insulating oil quality over multiple cycles. The study reveals that the electrical properties of the insulating oil are fully restored after regeneration, negating the need to fully replace it, while the investment becomes cost-neutral within weeks from the commissioning of the regeneration system. This economic analysis, coupled with the system’s environmental benefits of reducing waste oil generation, positions the dielectric oil regeneration system as a compelling solution for the maintenance of power transmission assets.

Atypical Weight Loss in Two Patients with Schizophrenia Treated with Clozapine: A Case Report

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.

Investigating the Air Quality Parameters in Louisiana’s Industrial Corridor: A Baton Rouge Case Study

In a local context, sustainable development entails utilizing the current resources—material and immaterial, measurable and immeasurable, popular and unpopular—of the community in a manner that avoids overexploitation and ensures intergenerational equity. This approach prioritizes the safety and health of local citizens, placing communal productivity above corporate profitability. This research aims to assess air quality surrounding 28 chemical industry sites in Baton Rouge, Louisiana, to understand the environmental and health impacts of industrial pollutants, with a focus on environmental justice. Air quality pollutants, including PM2.5, PM10, O3, NO2, CO, and SO2, were monitored for 75 days during the Summer, using the BreezoMeter app. Python, Mapize, and QGIS software technologies were utilized for data analysis and visualization. Findings indicate a reduction in NO2 and CO levels, compared to existing literature. However, the persistent challenge of particulate matter suggests areas for further environmental management efforts. Additionally, the research suggests a significant disparity in air pollution exposure, probably affecting marginalized communities. Although the nature of the study might not fully capture annual pollution trends, the findings highlight the urgent need for the chemical industry to adopt efficient production methods and for policymakers to enhance air quality standards and enforcement, particularly in pollution-sensitive areas. The disproportionate impact of air pollution on vulnerable communities calls for a more inclusive approach to environmental justice, ensuring equitable distribution of clean air benefits and community involvement in pollution management decisions.

Comparison of Oral Manifestations in Hospitalized COVID-19 Positive Patients and COVID-19 Negative Dental Outpatients. A Case Series Study and Literature Review

Background: The Coronavirus disease 2019 (COVID-19) is a respiratory infectious disease, also named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which can cause various systemic manifestations that pose a threat to human life. Oral lesions in patients with COVID-19 may appear during or after the illness and may or may not be a consequence of the viral infection. Objective: In this case series we compare the oral manifestations in hospitalized COVID-19 positive patients and COVID-19 negative dental outpatients. Methods: 60 hospitalized COVID-19 patients and 41 control patients, were examined for oral signs and symptoms. The controls were dental patients who visited the hospital for dental care without complaining of any problems related to the oral cavity itself. Results: We have observed a strong association between certain clinical findings and COVID-19, including alterations in taste (ageusia, dysgeusia, and hypogeusia), anosmia, hairy tongue, tongue imprints, red tongue, erythematous candidiasis, pseudomembranous candidiasis, and exfoliative cheilitis. A trend but not statistically significant association at the level of 5% was also noted for colored tongue, linea alba, and pale mucosa. On the contrary, fissured tongue and oral mucosa pigmentation were more frequent in the controls, statistically significant at the level of 5%. Conclusion: COVID-19 has been found to impact the oral cavity, resulting in various oral lesions that can be attributed to either the direct action of the virus or the patient’s immune response.

干酪乳杆菌(Lactobacillus casei)FV006对发酵食品中生物胺的降解性能

为验证干酪乳杆菌(Lactobacillus casei)对生物胺的降解性能及潜在应用价值。本研究利用高效液相色谱法,探究该菌在液态培养条件下的降胺性能和应用于贵州6种市售发酵食品中的降胺效果。结果表明,在液态培养试验中该菌对组胺、亚精胺、苯乙胺、腐胺、尸胺、酪胺和色胺的降胺率分别为9.44%、23.39%、16.27%、13.68%、19.14%、18.16%和12.45%。此外,研究发现该菌对道菜中色胺的降胺率为56.68%;对豆瓣酱中尸胺、组胺和亚精胺的降胺率分别为68.06%、74.52%和85.82%;对酱油中色胺和尸胺的降胺率为66.75%%、81.53%;对泡菜中色胺的降胺率为45.74%;对鱼罐头中色胺、尸胺、组胺和亚精胺的降胺率分别为55.66%、63.92%、45.96%、52.62%;对香肠中色胺、组胺和亚精胺的降胺率分别为71.15%、56.26%、75.54%。研究还发现该菌既具有产生物胺的能力,也具有降解生物胺的能力,且对不同食品中同一种生物胺的降解具有差异性。本研究为干酪乳杆菌(Lactobacillus casei)在低胺发酵食品中的应用提供理论依据。

稠油热采井射孔孔眼应力分析及影响因素

针对稠油热采井生产过程中,射孔井段套管频繁出现损伤断裂的问题,基于弹塑性和热力学理论,采用有限元方法建立注汽—焖井—生产过程射孔套管有限元热力学耦合模型,对各阶段射孔套管应力分布特征进行研究,并开展不同射孔参数下射孔套管强度影响规律分析。研究表明:生产过程中射孔孔眼位置出现明显应力集中现象,在温差及内外压差等共同作用下,注采前期套管应力最大可达498.16 MPa,并逐渐产生塑性失效现象,当注采作业完成时,套管塑性失效现象最严重;随着射孔相位角增大,射孔密度对Mises应力值的影响逐渐减小,而套管孔眼最大应力与射孔相位角成反比关系。该研究对延长稠油热采井射孔套管使用年限和保障正常生产作业具有十分重要的意义。

仪器分析实验课程思政案例设计与实践——以气质联用实验为例

中国科学技术大学化学国家级实验教学中心所开设的“仪器分析实验”为安徽省课程思政示范课程,在实验项目“气质联用法测定饮料中塑化剂含量”的教学过程中,课程组针对课程的特点和教学过程,对该项目进行思政示范教学案例设计。思政案例库的建设,有助于教师充分挖掘专业课程中的德育元素,激发学生的学习兴趣,培养学生的自主创新意识,取得了良好的教学效果。

麻醉科进修医师临床教学培训模式的探索研究

目的建立麻醉科进修医师临床教学培训模式,并评价其实施效果。方法选取2023年3—9月在北京协和医院麻醉科进修学习的25名医师为研究对象,在其进修期间实施“导师制⁃知识更新⁃临床实践”的临床教学培训模式。于进修学习前、后分别进行测试(包括基础知识、临床思维和沟通技巧),比较进修医师两次测试的答题成绩,评价培训模式的有效性。同时,收集进修医师对教学培训模式的满意度评价。结果进修学习前、后试卷的有效回收率分别为84%和100%;学员进修学习后的平均成绩显著高于进修学习前[(10.1±1.1)分比(5.6±1.8)分,P<0.01];92%的学员给予了积极反馈。结论“导师制⁃知识更新⁃临床实践”的临床教学培训模式可有效提升进修医师的基础知识、临床思维和沟通技巧,学员满意度较高,具有一定应用价值。

基于Comsol软件的电磁兼容课程案例式教学设计

该文介绍基于Comsol软件的电磁兼容课程案例式教学方法。通过案例教学和仿真,学生将理论知识应用于实际问题,深入理解电磁兼容的概念和原理。通过仿真案例的可视化结果,学生直观地理解电磁辐射和传导,观察不同参数对电磁兼容性的影响。结果表明,仿真案例具有直观性和可视化等优势,同时又有简化模型、缺乏实际操作经验和对计算机的依赖等局限性。在设计仿真案例时,要充分发挥其优势,规避不足,为学生的学习提供实践性、直观性和灵活性,培养学生的工程设计与研发能力。

仪器分析实验课程思政案例设计与实践——以青蒿素的提取与结构鉴定的探究实验为例

中医药文化被喻为中华优秀传统文化的璀璨明珠,是中华传统文化的重要组成和典型代表。而作为抗疟明星的中医药青蒿素来源于天然产物,因此,天然产物中的青蒿素的提取和结构鉴定显得十分必要。课程团队结合课程特点,将青蒿素的提取和结构鉴定引入实验教学并进行课程思政教学案例设计。以此项目为载体,培养学生自主查阅文献、设计实验方案和运用仪器分析技术表征分子结构的科学素养。该教学案例的建立实施有助于教师充分挖掘课程中的思政元素,激发学生的学习兴趣,培养其自主创新意识,增强爱国情怀和民族文化自信,取得了良好的课程思政教学示范效果。

国有企业的低碳双元战略发展路径——基于上海申通地铁集团的案例研究

在中国特色社会主义经济制度下,国有企业始终肩负着发展经济和服务社会的双重使命。根据企业所处的行业特点与所承担的业务特征,国有企业很可能面临高耗能的挑战。选取上海申通地铁集团有限公司作为典型案例,基于双元理论探究国有企业低碳双元战略的动态发展路径。研究发现,国有企业的低碳发展首先是将低碳理念融入其“经济—社会”双元目标,形成具有经济属性的成本性和效益性低碳导向,以及具有社会属性的政策性和公益性低碳导向。基于此,国有企业开发低碳双元战略实践,包括具有经济属性的低碳成本管理和低碳业务投资,以及具有社会属性的低碳政策落实和产业低碳引领。此外,知识和资源开发促进了低碳双元战略实践的相互转化,实现了低碳双元战略的协调统一。研究结论既为国有企业低碳发展中的协同辩证关系提供了新的理解,又拓展了双元理论在企业低碳管理领域的应用。