Significant improvement after sensory tricks and trunk strength training for Parkinson’s disease with antecollis and camptocormia:A case report

BACKGROUND Patients with Parkinson's disease(PD)exhibit symptoms such as antecollis(AC)and camptocormia(CC).The pathology of these two conditions is unclear.Additionally,standard treatment methods have not been established.The article reports the case of a 65-year-old female patient with AC and CC who was treated with central and peripheral interventions to alleviate symptoms.CASE SUMMARY We present the case of a 65-year-old female PD patient with AC and CC.The course of the disease was 5 years.She was treated with rehabilitation strategies such as sensory tricks and trunk strength training.During the inpatient period,we compared and analyzed the patient's gait,rehabilitation assessment scale score,and angles of her abnormal trunk posture in the first week,the third week,and the fifth week.The patient's stride length increased,indicating that the patient's walking ability was improved.The Unified Parkinson's Disease Scale Part Three score and CC severity score decreased.Furthermore,the score of the other scale increased.In addition,the patient showed significant improvements in AC,upper CC,and lower CC angles.CONCLUSION This case study suggested that sensory tricks and trunk strength training are beneficial and safe for patients with AC and CC.

Multiple pulp stones emerge across all teeth during mixed dentition:A case report

BACKGROUND This paper reports a rare presentation of multiple pulp stones(PSs)emerging in all teeth during mixed dentition.It offers valuable insights into the clinical diagnosis,treatment,and prognosis of multiple PSs,shedding light on their occurrence during the mixed dentition period.CASE SUMMARY A 10-year-old girl presented with repeated pain in the mandibular right posterior teeth.Intraoral examination revealed carious lesions,abnormal tooth shapes,and anomalies in tooth number.Radiographic examinations showed multiple PSs with diverse shapes,sizes,and quantities in all teeth,alongside anomalies in tooth shape and number.Root canal therapy was initiated,but the patient initially lacked timely follow-up.Upon return for treatment completion,an extracted tooth revealed irregular calculus within the pulp cavity.CONCLUSION This case underscores the importance of considering multiple PSs in mixed dentition,necessitating comprehensive evaluation and management strategies.

A Study on the Application of Audible Thinking Combined with Case Teaching Method in the Teaching of Nursing Room Visits for Trained Nurses

Objective:To investigate the effect of using audible thinking combined with the case teaching method in the teaching of nursing checkups for regulation nurses.Methods:The period was April 2023–April 2024,and a randomized controlled group study was carried out in which 76 regulation nurses in our hospital were randomly divided into a research group and a control group,with 38 regulation nurses in each group.The control group used conventional teaching methods,and the research group used audible thinking combined with the case teaching method,comparing the two groups’independent learning ability scores,assessment scores,and teaching satisfaction.Results:Independent learning ability score:after teaching,the research group was significantly higher than the control group(P<0.05);Assessment results:the research group was considerably higher than the control group(P<0.05);Teaching satisfaction:the research group was significantly higher than the control group(P<0.05).Conclusion:The use of audible thinking combined with the case teaching method in the teaching of nursing room visits for trained nurses can improve independent learning ability and assessment results and increase teaching satisfaction.

Rectal prolapse in a 30-year-old bladder stone male patient:A case report

BACKGROUND Rectal prolapse occurs most commonly in children and middle-aged and elderly women and is relatively rare in young men and is occasionally caused by bladder stones.Severe rectal prolapse,bilateral hydronephrosis,and renal insufficiency caused by bladder stones are rare in a 30-year-old man.CASE SUMMARY We report the case of a 30-year-old male patient with cerebral palsy who presented with a large bladder stone that resulted in severe rectal prolapse,bilateral hydronephrosis,and renal insufficiency.Following a definitive diagnosis,the bladder stone was successfully removed,and his kidney function returned to normal.We assessed the patient’s nutritional status and stone composition and concluded that the main cause was malnutrition.CONCLUSION Rectal prolapse is a rare clinical manifestation of bladder stones,particularly in young adults.Cerebral palsy patients are a vulnerable group in society because of their intellectual disabilities and communicative impairments.Accordingly,besides taking care of their daily diet,abnormal signs in their bodies should receive the doctors’attention in a timely manner.

Bladder stone due to late clip migration after prostatic urethral lift procedure: A case report

BACKGROUND Prostatic urethral lift(PUL)therapy is an alternative to minimally invasive and other surgeries in younger patients who want to preserve their sexual and ejaculatory functions,and in elderly male patients with benign prostatic hyperplasia who cannot be anesthetized because of the risk of anesthesia.The procedure can be performed as an outpatient and without anesthesia,and complications are few and temporary.In long-term follow-up,encrustations that require retreatment are rarely seen.CASE SUMMARY In our case,a 62-year-old prostate patient who had a PUL operation 8 years ago and had a stone on the PUL material near the bladder neck was treated.The patient’s stone was removed by endoscopic cystolithotripsy using pneumatic fragmentation.Bipolar transurethral resection of the prostate was applied to the patient in the same session.After the patient’s 7-year follow-up,the patient’s complaints relapsed,and cystoscopy was performed again.In cystoscopy,stone formation adjacent to the wall was observed at the junction of the bladder neck to the left lateral wall.The stone was fragmented with a pneumatic lithotripter.CONCLUSION Placing clips too close to bladder neck in the PUL procedure may result in clip migration.

Research and Design of Consistent Project Cases for the Software Engineering Course Group

In order to enhance the abilities of practical innovation and solving complex engineering problems of students in the engineering context,we design a course cluster teaching model based on a unified enterprise-level project case.The program divides the knowledge points required by the project into the corresponding courses,and divides their realization into the practical teaching cases,so as to realize the design of teaching practice cases embodied in the unified project framework.This model allows students to practice projects based on the unified project background while learning knowledge from different courses.It not only allows students to learn abstract,fragmented,and difficult-to-understand knowledge systems thoroughly,but also integrates the knowledge into the practice of the enterprise-level project development,helping students experience the value of knowledge in complex engineering projects and thus improving their ability to solve complex engineering problems while learning theoretical knowledge.

Stone accumulation overlying vaginal mesh exposure:A case report

BACKGROUND Vaginal stones are rare with current literature limited to case reports.Vaginal stones are classified as primary or secondary stones.Primary stones form in the vagina when there is urinary stasis.Secondary stones form in the presence of a vaginal foreign body that acts as a nidus for the deposition of urinary salts.Foreign bodies,such as surgical mesh,make vaginal stone formation more likely,particularly in patients with urinary incontinence and conditions that predispose them to urinary calculi formation.CASE SUMMARY A 71-year-old female with a history of sacrocolpopexy,hyperaldosteronism,and urgency urinary incontinence presented with vaginal stone accumulation overlying two areas of vaginal sacrocolpopexy mesh exposure.The vaginal stones were initially removed to permit examination,but the stones reaccumulated at the site of the exposed mesh,later requiring definitive surgical management.CONCLUSION Patients with vaginal mesh exposure and conditions that predispose them to kidney stones are not ideal candidates for expectant management of mesh exposure,particularly if they have coexisting urinary incontinence.These individuals should be counseled about possible vaginal stone accumulation,and surgical management should be considered.

Application Research of Fragmented Case Teaching in Standardized Training of Residents in Anesthesiology Department

Objective:To explore the effect of fragmented case teaching in the standardized training of residents in anesthesiology department.Methods:80 doctors who participated in the standardized training of residents in anesthesiology department from January 2021 to January 2022 were selected as the research objects,and the 80 doctors were divided into experimental groups according to the clinical teaching mode(n=40,implemented case fragmented teaching method)and the control group(n=40,traditional teaching method).The training lasted for 2 months,and the medical history collection,medical record analysis,practical operation ability,theoretical assessment results,and the degree of satisfaction towards the training of the two groups of doctors were compared.Results:After 2 months of training,the theoretical knowledge and operational ability of the doctors in the two groups have improved to a certain extent,but the medical history collection,medical record analysis,practical operation ability,theoretical assessment results and satisfaction of the doctors in the experimental group were significantly better than those in the control group(P<0.05).Conclusion:The effect of the fragmented case teaching method in the standardized training of anesthesiology residents is significantly better than the traditional teaching mode.The abilities of doctors have significantly improved after the training.Hence,the fragmented case teaching method is worthy of promotion in clinical practice.

Evaluation of Clinician Training in Autism Screening, Care Management, and Patient Education

Objective: The demand for pediatric developmental evaluations has far exceeded the workforce available to perform them, which creates long significant wait times for services. A year-long clinician training using the Extension for Community Healthcare Outcomes (ECHO®) model with monthly meetings was conducted and evaluated for its impact on primary care clinicians’ self-reported self-efficacy, ability to administer autism screening and counsel families, professional fulfillment, and burnout. Methods: Participants represented six community health centers and a hospital-based practice. Data collection was informed by participant feedback and the Normalization Process Theory via online surveys and focus groups/interviews. Twelve virtual monthly trainings were delivered between November 2020 and October 2021. Results: 30 clinicians participated in data collection. Matched analyses (n = 9) indicated statistically significant increase in self-rated ability to counsel families about autism (Pre-test Mean = 3.00, Post-test Mean = 3.89, p = 0.0313), manage autistic patients’ care (Pre-test Mean = 2.56, Post-test Mean = 4.11, p = 0.0078), empathy toward patients (Pre-test Mean = 2.11, Post-test Mean = 1.22, p = 0.0156) and colleagues (Pre-test Mean = 2.33, Post-test Mean = 1.22, respectively, p = 0.0391). Unmatched analysis revealed increases in participants confident about educating patients about autism (70.59%, post-test n = 12 vs. 3.33%, pre-test n = 1, p = 0.0019). Focus groups found increased confidence in using the term “autism”. Conclusion: Participants reported increases in ability and confidence to care for autistic patients, as well as empathy toward patients and colleagues. Future research should explore long-term outcomes in participants’ knowledge retention, confidence in practice, and improvements to autism evaluations and care.

Electrohydraulic lithotripsy and rendezvous nasal endoscopic cholangiography for common bile duct stone: A case report

BACKGROUND In patients with large stones in the common bile duct(CBD),advanced treatment modalities are generally needed.Here,we present an interesting case of a huge CBD stone treated with electrohydraulic lithotripsy(EHL)by the percutaneous approach and rendezvous endoscopic retrograde cholangiography(ERC)using a nasal endoscope.CASE SUMMARY A 91-year-old woman underwent ERC for a symptomatic large CBD stone with a diameter of 50 mm.She was referred to our institution after the failure of lithotomy by ERC,and after undergoing percutaneous transhepatic biliary drainage.We attempted to fragment the stone by transhepatic cholangioscopy using EHL.However,the stones were too large and partly soft clay-like for lithotripsy.Next,we attempted lithotomy with ERC and cholangioscopy by the rendezvous technique using a nasal endoscope and achieved complete lithotomy.No complication was observed at the end of this procedure.CONCLUSION Cholangioscopy by rendezvous technique using a nasal endoscope is a feasible and safe endoscopic method for removing huge CBD stones.

Bladder stones in a closed diverticulum caused by Schistosoma mansoni: A case report

BACKGROUND Genitourinary(GU)schistosomiasis is a chronic infection caused by a parasitic trematode,with Schistosoma haematobium(S.haematobium)being the prevalent species.The disease has a variable prevalence around the world,with a greater burden on,but not limited to Africa,South America,Asia,and the Middle East.CASE SUMMARY We report the case of a 30-year-old man who presented with symptoms of bladder stones.During endoscopic cystolithalopaxy,we did not detect any stones in the bladder.Upon careful scanning of the urinary bladder trigone,sandy patches were detected.We performed endoscopic resection,which revealed a closed diverticulum with bladder stones.The diverticular wall was sent for histopathology and revealed features of chronic granulomatous inflammation with numerous embedded Schistosoma eggs,with some of the eggs having lateral spines.The patient was treated with praziquantel,and his symptoms completely resolved.CONCLUSION GU schistosomiasis is primarily caused by S.haematobium.However,Schistosoma mansoni mediated GU schistosomiasis is unusual,making this a quite interesting case.

Femoral neck stress fracture and medial tibial stress syndrome following high intensity interval training: A case report and review of literature

BACKGROUND Femoral and tibial stress injuries are commonly found in long distance running athletes.Stress fractures have rarely been reported in athletes performing high intensity interval training(HIIT)exercise.The objective of this study was to report a case of a patient who presented with medial tibial stress syndrome and femoral neck stress fracture after performing HIIT exercises.CASE SUMMARY A 26 year old female presented with bilateral medial tibial pain.She had been performing HIIT exercise for 45 min,five times weekly,for a seven month period.Her tibial pain was gradual in onset,and was now severe and worse on exercise,despite six weeks of rest.Magnetic resonance imaging(MRI)revealed bilateral medial tibial stress syndrome.As she was taking norethisterone for birth control,a dual energy X-ray absorbitometry scan was performed which demonstrated normal bone mineral density of her lumbar spine and femoral neck.She was managed conservatively with analgesia and physiotherapy,but continued to exercise against medical advice.She presented again six months later with severe right hip pain.MRI of her right hip demonstrated an incomplete stress fracture of her subtrochanteric region.Her symptoms resolved with strict rest and physiotherapy.CONCLUSION HIIT may cause stress injury of the tibia and femur in young individuals.

Constructing Teaching Model for Training English Guides of Stone Inscription Relics

A teaching model based on constructivism is proposed in this paper. The model contains five teaching steps, e.g. interpretation teaching, questioning- dialogue, knowledge and skills teaching, discussion- collaboration and field training. Practice proves that it can effectively improve the training efficiency of the training of English guides of stone inscription relics and enhance their interpretation quality and English skills.

Massage and vocal training in a case of spasmodic dysphonia

A 35-year-old female patient with spasmodic dysphonia underwent massage and vocal training. Chinese manipulation was administered to Tiantu （CV 22） and Lianquan （CV 23）, the convergent acupoints of the conception meridian and Yin link vessel, Yamen （GV 15） and Fengfu （GV 16）, the convergent acupoints of Du meridian and Yang link vessel, as well as large intestine channel of hand Yangming Hegu （LI 4）, by gently pressing and rubbing for stimulation. In addition, throat muscle massage therapy and vocal training were performed. Results were evaluated using acoustic measurements in combination with a single statistical method. A comprehensive treatment combining vocal training and face-neck massage was shown to relieve dystonia of facial-cervical muscles in patients, as well as improve voice quality while providing a safe treatment method.

Case studies in psychotherapy training using Austria as an example

BACKGROUND Case studies(CS)are relevant for the development of theoretical and practical competencies in psychotherapy.Despite rapid progress in the development of methods and principles for establishing CS in the last three decades,research into the aims of CS,especially in training,or how CS are to be conducted is rare.AIM To elucidate the form and methodology of CS,the objectives of CS used in training institutions(TI),and if/how TIs handle therapist allegiance.Also,this preliminary investigation will suggest avenues for further research and attempt to establish certain guidelines.METHODS In order to counteract researcher bias and enlarge the question-pool,a focus group was established.The recorded and transcribed text was analyzed with Mayring’s method of qualitative content analysis,and the generated categories were formulated as questions.The resulting questionnaire with both qualitative and quantitative queries was sent out(after pre-testing)to all 39 Austrian TIs that provide professional psychotherapy training.The answers and text passages received were then also categorized with qualitative content analysis.Data analysis was discussed by a peer group consisting of three psychotherapists trained in differing schools of psychotherapeutic methods.RESULTS 94%of Austrian institutes use CS as part of their psychotherapeutic training.Understanding of the term“case study”is inconsistent and has a wide variety of interpretations.CS serve mainly:(1)For observation of training/progress in therapeutic practice and knowledge/acquisition of the theory specific to each psychotherapeutic school;(2)To improve(self-)reflection capabilities;and(3)To expand theoretical knowledge.Most of the CS written are not accessible for students nor for the research community.More than two thirds of the CS take only the position of the author into account(the client’s position is not described).15.5%of the TIs do not consider researcher or therapist allegiance at all.CONCLUSION A more precise formulation of the term case study is needed in psychotherapeutic training.The training therapists play a key function,as they exemplify and teach how to deal with distorting factors.General guidelines as to how to conduct CS in training institutions would provide more direction to students,increase scientific rigor,and enhance synergistic effects.

Primary squamous cell carcinoma with sarcomatoid differentiation of the kidney associated with ureteral stone obstruction: A case report

BACKGROUND Primary squamous cell carcinoma(SCC)with sarcomatoid differentiation of the kidney was rarely reported.This disease is usually related to renal stones,and due to a lack of symptoms and radiological features,patients usually attend the hospital with late stage disease.CASE SUMMARY A 54-years-old female presented with left flank pain and an abdominal mass for 6 mo.Imaging studies revealed that the left kidney was enlarged and massive hydronephrosis was present.A stone was seen in the ureteropelvic junction.The patient subsequently underwent left radical nephrectomy,and histopathological examination of the mass revealed a poorly differentiated renal SCC with sarcomatoid differentiation.After primary surgery,the patient received four cycles of tirelizumab.Four months later,the patient developed adrenal,lymph,and uterine appendage metastases.CONCLUSION SCC of the kidney has a poor prognosis,and should be considered in patients with a renal mass,long-standing urinary calculi and massive hydronephrosis.

Talent Training of Marine Cultural Industry Based on Collaborative Innovation of Governments, Enterprises, Colleges, Scientific Institutions and Users: A Case Study of Shanghai City

Based on the collaborative innovation of governments, enterprises, colleges, scientific institutions and users, the possible shortcomings of talent training of marine cultural industry in Shanghai City were analyzed by using the case study method, and some specific measures for talent trainingofmarineculturalindustryinShanghaiCitywereproposed.

Postoperative jaundice related to UGT1A1 and ABCB11 gene mutations:A case report and literature review

BACKGROUND Patients with obstructive jaundice caused by intrahepatic bile duct stones can be effectively managed by surgery.However,some patients may develop postope-rative complications,liver failure,and other life-threatening situations.Here,we report a patient with mutations in the uridine 5’-diphospho-glucuronosyltrans-ferase 1A1(UGT1A1)and bile salt export pump(adenosine triphosphate-binding cassette subfamily B member 11,ABCB11)genes who presented multiple intrahe-patic bile duct stones and cholestasis,and the jaundice of the patient increased after partial hepatectomy.CASE SUMMARY A 52-year-old male patient admitted to the hospital on October 23,2021,with a progressive exacerbation of jaundice,was found to have multiple intrahepatic bile duct stones with the diagnoses of obstructive jaundice and acute cholecystitis.Subsequently,the patient underwent left hepatectomy with biliary exploration,stone extraction,T-tube drainage,and cholecystectomy without developing any intraoperative complications.The patient had a dark urine color with worsening jaundice postoperatively and did not respond well to plasma exchange and other symptomatic and supportive treatments.Since the progressive increase in postoperative bilirubin could not be clinically explained with any potential reason,including,if not at all,viral infection,cholangitis,autoimmune liver disease,and other causes,the patient underwent whole-exon screening for any genetic diseases,which surprisingly identified UGT1A1 and ABCB11 gene mutations related to glucuronidation of indirect bilirubin as well as bile acid transport in hepatocytes,respectively.Thus,we hypothesized that postoperative refractory cholestasis might result from UGT1A1 and ABCB11 gene mutations and further recommended liver transplantation to the patient,who eventually declined it and died from liver failure six months later.CONCLUSION Surgery may aggravate cholestasis in patients with multiple intrahepatic bile duct stones and cholestasis associated with UGT1A1 and ABCB11 gene mutations.A liver transplant may be the best option if active medical treatment fails.

Formation of a rare curve-shaped thoracolith documented on serial chest computed tomography images:A case report

BACKGROUND Thoracolithiasis is a rare benign condition that manifests with one or more small nodules in the pleural cavity.In most cases,it is asymptomatic and found incidentally on chest imaging or during thoracic surgery.The thoracolithiasis formation process is rarely documented.Herein,we present a case of a rare,large,curve-shaped thoracolith,the formation of which was documented on serial computed tomography(CT)images.CASE SUMMARY A 46-year-old male patient who denied any prior systemic disease was evaluated due to intermittent right-sided lateral chest pain lasting for a year.Chest radiography and CT revealed a circumscribed calcified nodule measuring 3.5 mm in the right lower lung lobe.Nodule biopsy revealed fungal infection,which was treated with antifungal medication.After 2 years of follow-up,the patient developed intermittent chest discomfort caused by pleural adhesions,and underwent video-assisted thoracic surgery with pneumolysis.Postoperatively,he developed empyema,which fully resolved with antibiotic therapy.Thereafter,he was followed up at the outpatient clinic and underwent chest CT twice per year.Over time,we observed thickening of the right distal pleura near the lower posterior mediastinum,and several sporadic calcified nodules with gradually increasing intensity,which eventually merged into a single calcified curve-shaped thoracolith measuring approximately 9 cm in length during the 5-year follow-up.CONCLUSION This study documented the formation of a rare thoracolith shape observed for the first time.

Research of Genetic Training Algorithm for Identifying Mechanical Failure Modes within the Framework of Case-Based Reasoning

The combination of case-based reasoning （CBR） and genetic algorithm （GA） is considered in the problem of failure mode identification in aeronautical component failure analysis. Several imple- mentation issues such as matching attributes selection, similarity measure calculation, weights learning and training evaluation policies are carefully studied. The testing applications illustrate that an accuracy of 74.67 % can be achieved with 75 balanced-distributed failure cases covering 3 failure modes, and that the resulting learning weight vector can be well applied to the other 2 failure modes, achieving 73.3 % of recognition accuracy. It is also proved that its popularizing capability is good to the recognition of even more mixed failure modes.