Malignant gastroduodenal obstruction can occur in up to 20%of patients with primary pancreatic,gastric or duodenal carcinomas.Presenting symptoms include nausea,vomiting,abdominal distention,pain and decreased oral in...Malignant gastroduodenal obstruction can occur in up to 20%of patients with primary pancreatic,gastric or duodenal carcinomas.Presenting symptoms include nausea,vomiting,abdominal distention,pain and decreased oral intake which can lead to dehydration, malnutrition,and poor quality of life.Endoscopic stent placement has become the primary therapeutic modality because it is safe,minimally invasive,and a cost-effective option for palliation.Stents can be successfully deployed in the majority of patients. Stent placement appears to lead to a shorter time to symptomatic improvement,shorter time to resumption of an oral diet,and shorter hospital stays as compared with surgical options.Recurrence of the obstructive symptoms resulting from stent occlusion,due to tumor ingrowth or overgrowth,can be successfully treated with repeat endoscopic stent placement in the majority of the cases.Both endoscopic stenting and surgical bypass are considered palliative treatments and,to date,no improvement in survival with either modality has been demonstrated.A tailored therapeutic approach,taking into consideration patient preferences and involving a multidisciplinary team including the therapeutic endoscopist,surgeon,medical oncologist, radiation therapist,and interventional radiologist, should be considered in all cases.展开更多
Hepatocellular carcinoma （HCC） metastasizes to the mandible is infrequently seen. Solitary bony metastasis to the mandible is rarer. The intractable bleeding caused by rupture of the metastatic HCC is challenging to...Hepatocellular carcinoma （HCC） metastasizes to the mandible is infrequently seen. Solitary bony metastasis to the mandible is rarer. The intractable bleeding caused by rupture of the metastatic HCC is challenging to clinicians. We present a case of a 74-year-old woman with HCC under control without progression for 3 years. Left facial swelling and episodes of bleeding developed recently and biopsy revealed a metastatic HCC. Computer tomography showed a large tumor in parapharyngeal space with evident mandibular ramus destruction. Bleeding occurred from the metastatic tumor but could not be controlled by electrocauterization, SurgicelTM, tissue glue, and bone wax and angiographic embolization. Palliative radiotherapy （2400 cGy in 6 fractions） was tried and the intractable bleeding was successfully stopped after the radiotherapy. Because of the hypervascular and osteolytic nature of the solitary mandibular metastatic lesion, the bleeding was troublesome. Radiotherapy provided successful control of intractable bleeding from the metastatic tumor.展开更多
Objectives:This study aimed to assess the effects of modified pulmonary rehabilitation(PR)on patients with moderate to severe chronic obstructive pulmonary disease(COPD).Methods:A total of 125 patients(63 in the PR gr...Objectives:This study aimed to assess the effects of modified pulmonary rehabilitation(PR)on patients with moderate to severe chronic obstructive pulmonary disease(COPD).Methods:A total of 125 patients(63 in the PR group and 62 in the control group)were recruited in this study.The patients in the PR group received 12 weeks of conventional treatment,nursing,and modified pulmonary rehabilitation,while the patients in the control group underwent 12 weeks of conventional treatment,nursing,pursed-lip breathing training,and abdominal breathing training.Baseline characteristics,St.George's Respiratory Questionnaire(SGRQ),the six-minute walk test(6MWT),modified medical research council(MMRC)dyspnea scale,and lung function were compared between the two groups.Results:A total of 112 patients(58 patients in the PR group and 54 patients in the control group)completed the 12-week monitoring and follow-up.The SGRQ scores,symptoms(54.933±11.900),activity(52.644±14.334),impact(55.400±9.905),and total score(54.655±10.681)of the PR group did not significantly differ in pre-and post-treatments(P<0.05).No significant change was also observed in the control group(P>0.05).6MWT[(372.089±67.149)m]was significantly improved in the PR group(P<0.05)but was not significantly different in the control group(P>0.05).MMRC(actual rank sum 1719,rank sum 2047.5)was significantly reduced in the PR group(P<0.05)but not in the control group(P>0.05).The lung function(FVC,FEV1,FEV1/FVC,FEV1%and PEF)of the patients in both groups did not significantly change(P>0.05).Conclusion:Modified PR reduces the symptoms of dyspnea,increases exercise capacity,and improves the quality of life of patients with moderate to severe COPD.展开更多
Tissues from 30 human pituitary adenomas are monolayer-cell-cultured in vitro.Hormone secretion of GH, PRL, TSH, LH and FSH by cells into medium is detected by radioimmunoassay. The pattern and amount of hormone(s) in...Tissues from 30 human pituitary adenomas are monolayer-cell-cultured in vitro.Hormone secretion of GH, PRL, TSH, LH and FSH by cells into medium is detected by radioimmunoassay. The pattern and amount of hormone(s) in the medium are used to determine the nature of the cells and thus to establish functional classification of pituitary adenomas. The results show that cell culture technique provides an easy and suitable mode for investigating the nature of pituitary adenomas. Hormone radioimmunoassay of culture medium is precise and reliable and represents the whole adenoma tissue. Further studies can lead to clearer understandings of the pathology of pituitary adenomas.展开更多
The aim of this paper is to challenge the traditional or standard view of the current processes of decentralisation within institutions and administrations, in order to reconstruct the dynamic of such processes in ter...The aim of this paper is to challenge the traditional or standard view of the current processes of decentralisation within institutions and administrations, in order to reconstruct the dynamic of such processes in terms of new values and new rights. Therefore, this paper censures the ＂reductionist＂ vision of decentralisation that envisages it merely as an administrative and institutional event and, in contrast, develops a concept of decentralisation as a social, political, and legal process linked to new constitutional values and new fundamental rights, whereby, it might be included within the sphere of a general theory of rights and take on an important role within this area. This work vindicates the idea that contemporary decentralization must form a part of the historical processes of the generalisation and specification of rights where in the goal is the fulfilment of the following maxim： rights for all and not merely for a few. To achieve this goal, decentralisation can incorporate the instrument of ＂positive discrimination＂ as a ＂strategy for equality＂, which can employ to create ＂specific rights＂ aims primarily at the members of the most vulnerable groups.展开更多
The purpose of this article is to raise the question of how important decentralisation and local governments are for the successful transition and eventually for sustainable human development of a state. The paper foc...The purpose of this article is to raise the question of how important decentralisation and local governments are for the successful transition and eventually for sustainable human development of a state. The paper focuses on the gap between development or transition and decentralisation within academic and international policy discourse. In article, the author tries to answer such questions as how local government can contribute to SHD （sustainable human development）. And how should the international community contribute to and support the transition and development process of the developing countries？ Article shows that local self-government can be a school of democracy and responsibility for the wealth of the state and citizens. By sharing the Polish decentralisation experience, the author shows how important decentralisation might be for successful transition, democratization and sustainable development. The paper also includes a short introduction to the European Charter, recent African efforts like AMCOD or UCLGA and European Union development assistance policy. The purpose of this is to show how little attention is paid to local governments and decentralisation within international policy and how huge is the gap between Europe＇s （developed） states and Africa＇s （developing） states related to their decentralisation policy, law and practice.展开更多
Gamma spectrometric method was used to determine the natural radioactivity of the groundwater obtained from hand dug wells in Sango-Ilorin, North Central Nigeria. The purpose of the study is to ascertain whether the g...Gamma spectrometric method was used to determine the natural radioactivity of the groundwater obtained from hand dug wells in Sango-Ilorin, North Central Nigeria. The purpose of the study is to ascertain whether the groundwater radioactivity level in the area that was previously used as a waste dumpsite and farmland poses any significant health hazard to the populace. The main radionuclides analysed in the samples were 226Ra and 22SRa （progenies of 218Su and 232Th respectively）, and the naturally occurring 40K. The activity concentrations of the radionuclides range from 0.02 to 7.35 Bql1 for 226Ra with a mean of 4.04 ± 0.18 Bql-1, 0.009 to 3.98 Bql-1 for 22SRa having a mean of 0.77 - 0.09 Bql-1. 40K concentration ranges from 0.45 to 30.14 Bq1-1 and has a mean of 4.81 ± 0.62 Bql1. The derived Annual Effective Dose received by the population as a result of the ingestion of 40K is estimated to range from 0 to 0.01 mSvy-1 with an average of 0.01 and standard deviation of 0.02 mSvyl; 226Ra ranged from 0 to 0.8 mSvy-1 with an average of 0.41 and standard deviation of 0.23 mSvy-1 and 228Ra ranged from 0 to 1 mSvy-1 with an average of 0.2 and standard deviation of 0.31 mSvy-1. The results show that the calculated average annual effective dose/ingestion dose for some of the wells are above WHO recommended level of 0.1 mSvylfor drinking water but falls within the tolerable level of 1 mSv/yr to the general public for prolonged exposure as recommended by ICRP. Therefore, it is suggested that detailed radiological monitoring be conducted in the area.展开更多
文摘Malignant gastroduodenal obstruction can occur in up to 20%of patients with primary pancreatic,gastric or duodenal carcinomas.Presenting symptoms include nausea,vomiting,abdominal distention,pain and decreased oral intake which can lead to dehydration, malnutrition,and poor quality of life.Endoscopic stent placement has become the primary therapeutic modality because it is safe,minimally invasive,and a cost-effective option for palliation.Stents can be successfully deployed in the majority of patients. Stent placement appears to lead to a shorter time to symptomatic improvement,shorter time to resumption of an oral diet,and shorter hospital stays as compared with surgical options.Recurrence of the obstructive symptoms resulting from stent occlusion,due to tumor ingrowth or overgrowth,can be successfully treated with repeat endoscopic stent placement in the majority of the cases.Both endoscopic stenting and surgical bypass are considered palliative treatments and,to date,no improvement in survival with either modality has been demonstrated.A tailored therapeutic approach,taking into consideration patient preferences and involving a multidisciplinary team including the therapeutic endoscopist,surgeon,medical oncologist, radiation therapist,and interventional radiologist, should be considered in all cases.
文摘Hepatocellular carcinoma （HCC） metastasizes to the mandible is infrequently seen. Solitary bony metastasis to the mandible is rarer. The intractable bleeding caused by rupture of the metastatic HCC is challenging to clinicians. We present a case of a 74-year-old woman with HCC under control without progression for 3 years. Left facial swelling and episodes of bleeding developed recently and biopsy revealed a metastatic HCC. Computer tomography showed a large tumor in parapharyngeal space with evident mandibular ramus destruction. Bleeding occurred from the metastatic tumor but could not be controlled by electrocauterization, SurgicelTM, tissue glue, and bone wax and angiographic embolization. Palliative radiotherapy （2400 cGy in 6 fractions） was tried and the intractable bleeding was successfully stopped after the radiotherapy. Because of the hypervascular and osteolytic nature of the solitary mandibular metastatic lesion, the bleeding was troublesome. Radiotherapy provided successful control of intractable bleeding from the metastatic tumor.
基金This work was financially supported by the Instructive Research Program of Changzhou Municipal Commission of Health and Family Planning(WZ201417)
文摘Objectives:This study aimed to assess the effects of modified pulmonary rehabilitation(PR)on patients with moderate to severe chronic obstructive pulmonary disease(COPD).Methods:A total of 125 patients(63 in the PR group and 62 in the control group)were recruited in this study.The patients in the PR group received 12 weeks of conventional treatment,nursing,and modified pulmonary rehabilitation,while the patients in the control group underwent 12 weeks of conventional treatment,nursing,pursed-lip breathing training,and abdominal breathing training.Baseline characteristics,St.George's Respiratory Questionnaire(SGRQ),the six-minute walk test(6MWT),modified medical research council(MMRC)dyspnea scale,and lung function were compared between the two groups.Results:A total of 112 patients(58 patients in the PR group and 54 patients in the control group)completed the 12-week monitoring and follow-up.The SGRQ scores,symptoms(54.933±11.900),activity(52.644±14.334),impact(55.400±9.905),and total score(54.655±10.681)of the PR group did not significantly differ in pre-and post-treatments(P<0.05).No significant change was also observed in the control group(P>0.05).6MWT[(372.089±67.149)m]was significantly improved in the PR group(P<0.05)but was not significantly different in the control group(P>0.05).MMRC(actual rank sum 1719,rank sum 2047.5)was significantly reduced in the PR group(P<0.05)but not in the control group(P>0.05).The lung function(FVC,FEV1,FEV1/FVC,FEV1%and PEF)of the patients in both groups did not significantly change(P>0.05).Conclusion:Modified PR reduces the symptoms of dyspnea,increases exercise capacity,and improves the quality of life of patients with moderate to severe COPD.
文摘Tissues from 30 human pituitary adenomas are monolayer-cell-cultured in vitro.Hormone secretion of GH, PRL, TSH, LH and FSH by cells into medium is detected by radioimmunoassay. The pattern and amount of hormone(s) in the medium are used to determine the nature of the cells and thus to establish functional classification of pituitary adenomas. The results show that cell culture technique provides an easy and suitable mode for investigating the nature of pituitary adenomas. Hormone radioimmunoassay of culture medium is precise and reliable and represents the whole adenoma tissue. Further studies can lead to clearer understandings of the pathology of pituitary adenomas.
文摘The aim of this paper is to challenge the traditional or standard view of the current processes of decentralisation within institutions and administrations, in order to reconstruct the dynamic of such processes in terms of new values and new rights. Therefore, this paper censures the ＂reductionist＂ vision of decentralisation that envisages it merely as an administrative and institutional event and, in contrast, develops a concept of decentralisation as a social, political, and legal process linked to new constitutional values and new fundamental rights, whereby, it might be included within the sphere of a general theory of rights and take on an important role within this area. This work vindicates the idea that contemporary decentralization must form a part of the historical processes of the generalisation and specification of rights where in the goal is the fulfilment of the following maxim： rights for all and not merely for a few. To achieve this goal, decentralisation can incorporate the instrument of ＂positive discrimination＂ as a ＂strategy for equality＂, which can employ to create ＂specific rights＂ aims primarily at the members of the most vulnerable groups.
文摘The purpose of this article is to raise the question of how important decentralisation and local governments are for the successful transition and eventually for sustainable human development of a state. The paper focuses on the gap between development or transition and decentralisation within academic and international policy discourse. In article, the author tries to answer such questions as how local government can contribute to SHD （sustainable human development）. And how should the international community contribute to and support the transition and development process of the developing countries？ Article shows that local self-government can be a school of democracy and responsibility for the wealth of the state and citizens. By sharing the Polish decentralisation experience, the author shows how important decentralisation might be for successful transition, democratization and sustainable development. The paper also includes a short introduction to the European Charter, recent African efforts like AMCOD or UCLGA and European Union development assistance policy. The purpose of this is to show how little attention is paid to local governments and decentralisation within international policy and how huge is the gap between Europe＇s （developed） states and Africa＇s （developing） states related to their decentralisation policy, law and practice.
文摘Gamma spectrometric method was used to determine the natural radioactivity of the groundwater obtained from hand dug wells in Sango-Ilorin, North Central Nigeria. The purpose of the study is to ascertain whether the groundwater radioactivity level in the area that was previously used as a waste dumpsite and farmland poses any significant health hazard to the populace. The main radionuclides analysed in the samples were 226Ra and 22SRa （progenies of 218Su and 232Th respectively）, and the naturally occurring 40K. The activity concentrations of the radionuclides range from 0.02 to 7.35 Bql1 for 226Ra with a mean of 4.04 ± 0.18 Bql-1, 0.009 to 3.98 Bql-1 for 22SRa having a mean of 0.77 - 0.09 Bql-1. 40K concentration ranges from 0.45 to 30.14 Bq1-1 and has a mean of 4.81 ± 0.62 Bql1. The derived Annual Effective Dose received by the population as a result of the ingestion of 40K is estimated to range from 0 to 0.01 mSvy-1 with an average of 0.01 and standard deviation of 0.02 mSvyl; 226Ra ranged from 0 to 0.8 mSvy-1 with an average of 0.41 and standard deviation of 0.23 mSvy-1 and 228Ra ranged from 0 to 1 mSvy-1 with an average of 0.2 and standard deviation of 0.31 mSvy-1. The results show that the calculated average annual effective dose/ingestion dose for some of the wells are above WHO recommended level of 0.1 mSvylfor drinking water but falls within the tolerable level of 1 mSv/yr to the general public for prolonged exposure as recommended by ICRP. Therefore, it is suggested that detailed radiological monitoring be conducted in the area.
