BACKGROUND Polyneuropathy,organomegaly,endocrinopathy,M-protein,skin changes(POEMS)syndrome is a rare paraneoplastic syndrome that encompass multiple systems.The most common clinical symptoms of POEMS syndrome are pro...BACKGROUND Polyneuropathy,organomegaly,endocrinopathy,M-protein,skin changes(POEMS)syndrome is a rare paraneoplastic syndrome that encompass multiple systems.The most common clinical symptoms of POEMS syndrome are pro-gressive sensorimotor polyneuropathy,organ enlargement,endocrine disorders,darkening skin,a monoclonal plasma cell proliferative disorder,and lymph node hyperplasia.The organomegaly consists of hepatosplenomegaly and/or lym-phadenopathy;cases of cardiomyopathy are rare.Diagnoses are often delayed because of the atypical nature of the syndrome,exposing patients to possibly severe disability.Therefore,identifying atypical symptoms can improve the prognosis and quality of life among POEMS syndrome patients.lenalidomide and dexamethasone.CONCLUSION When patients with cardiomyopathy have systemic manifestations such as numb limbs and darkening skin,the POEMS syndrome is the most possible diagnosis.展开更多
BACKGROUND Polyneuropathy organomegaly endocrinopathy M-protein and skin changes(POEMS)syndrome is a rare paraneoplastic syndrome caused by a potential plasma cell tumor.The clinical manifestations of POEMS syndrome a...BACKGROUND Polyneuropathy organomegaly endocrinopathy M-protein and skin changes(POEMS)syndrome is a rare paraneoplastic syndrome caused by a potential plasma cell tumor.The clinical manifestations of POEMS syndrome are diverse.Due to the insidious onset and lack of specific early-stage manifestations,POEMS syndrome is easily misdiagnosed or never diagnosed,leading to delayed treatment.Neurological symptoms are usually the first clinical manifestation,while ascites is a rare symptom in patients with POEMS syndrome.CASE SUMMARY A female patient presented with unexplained ascites as an initial symptom,which is a rare early-stage manifestation of the condition.After 1 year,the patient gradually developed progressive renal impairment,anemia,polyserosal effusion,edema,swollen lymph nodes on the neck,armpits,and groin,and decreased muscle strength of the lower extremities.The patient was eventually diagnosed with POEMS syndrome after multidisciplinary team discussion.Treatment comprised bortezomib+dexamethasone,continuous renal replacement therapy,chest and abdominal closed drainage,transfusions of erythrocytes and platelets,and other symptomatic and supportive treatments.The patient’s condition initially improved after treatment.However,then her symptoms worsened,and she succumbed to the illness and died.CONCLUSION Ascites is a potential early manifestation of POEMS syndrome,and this diagnosis should be considered for patients with unexplained ascites.Furthermore,multidisciplinary team discussion is helpful in diagnosing POEMS syndrome.展开更多
1 Introduction Shale formations bear abundant mineral resource and*unconventional petroleum resource,and the unconventional petroleum resource that contain in the shale formation should be integrated and researched.
With the artificial alder and cypress mixed forest being planted, there has been a marked land use change since 1970s' in Hilly Area of Central Sichuan Basin, China. Data from meteorological observations or posts ...With the artificial alder and cypress mixed forest being planted, there has been a marked land use change since 1970s' in Hilly Area of Central Sichuan Basin, China. Data from meteorological observations or posts operated over long time, measurement and calculation of NPP (net primary production) and biomass of biological community, and analysis of soil organic matter content show that the artificial alder and cypress mixed forest has outstanding eco-environmental effect: adjusting local climate, raising soil fertility, alleviating menace of drought, and raising NPP and biomass of biological community. It is very beneficial for improving ecological environment to afforest artificial alder and cypress mixed forest in populous Hilly Area of Central Sichuan Basin, China. Key Words: land use/land cover change (LUCC); eco-environmental effect; Hilly Area of Central Sichuan Basin; the artificial alder and cypress mixed forest展开更多
The Intergovernmental Panel on Climate Change (IPCC), established by the United Nations and World Meteorological Organization, has determined that humans have very likely influenced a net warming to the Earth from the...The Intergovernmental Panel on Climate Change (IPCC), established by the United Nations and World Meteorological Organization, has determined that humans have very likely influenced a net warming to the Earth from the increase of greenhouse gases, aerosols and land use changes. This warming has caused the amount of ice on the Earth to continue to decrease and sea levels to rise. In addition, extreme precipitation events are happening more often in selected regions of the world. A case study that assesses the impacts of, and adaptations to, these changes in climate is presented here. Two modeling programs, Sim CLIM and Train CLIM, (CLIM Systems, Hamilton, New Zealand) were used to support assessments for water supply, coastal zones and tropical cyclones in a fictitious island group in the South Pacific region. In the case study, a consulting group was “hired” to carry out these assessments. A final analysis and synthesis report were created to help the Ministry of the Environment of the made-up nation decide how to improve the governmental actions to address the real concerns posed by changing climate and sea level. Although a simulated island group is used in this article, there are sincere concerns about climate change and extreme weather events in this part of the world. It is important to address the real and dangerous threat that these islands and people face in the wake of a changing climate and a growing global society.展开更多
Dear Sir, I＇m Boris Severinsky from the New England College of Optometry, Boston, USA. I write you to present an interesting case of extreme refractive and corneal topography changes induced by daily wearing of Acuv...Dear Sir, I＇m Boris Severinsky from the New England College of Optometry, Boston, USA. I write you to present an interesting case of extreme refractive and corneal topography changes induced by daily wearing of Acuvue Advance （Johnson＆Johnson, Vision Care） contact lens （CL）.展开更多
By using the fixed point theorem under the case structure, we study the existence of sign-changing solutions of A class of second-order differential equations three-point boundary-value problems, and a positive soluti...By using the fixed point theorem under the case structure, we study the existence of sign-changing solutions of A class of second-order differential equations three-point boundary-value problems, and a positive solution and a negative solution are obtained respectively, so as to popularize and improve some results that have been known.展开更多
BACKGROUND Although minimal change disease(MCD)and focal segmental glomerulosclerosis(FSGS)have been described as two separate forms of nephrotic syndrome(NS),they are not completely independent.We report a case of a ...BACKGROUND Although minimal change disease(MCD)and focal segmental glomerulosclerosis(FSGS)have been described as two separate forms of nephrotic syndrome(NS),they are not completely independent.We report a case of a patient transitioning from MCD to FSGS,review the literature,and explore the relationship between the two diseases.CASE SUMMARY A 42-year-old male welder,presenting with lower extremity edema and elevated serum creatinine,was diagnosed with NS and end-stage kidney disease(ESKD)based on laboratory test results.The patient had undergone a kidney biopsy for NS 20 years previously,which indicated MCD,and a second recent kidney biopsy suggested FSGS.The patient was an electric welder with excessive levels of cadmium and lead in his blood.Consequently,we suspect that his aggravated pathology and occurrence of ESKD were related to metal nephrotoxicity.The patient eventually received kidney replacement therapy and quit his job which involved long-term exposure to metals.During the 1-year follow-up period,the patient was negative for metal elements in the blood and urine and recovered partial kidney function.CONCLUSION MCD and FSGS may be different stages of the same disease.The transition from MCD to FSGS in this case indicates disease progression,which may be related to excessive metal contaminants caused by the patient’s occupation.展开更多
Since the 1970s,there have been more and more uncertainties in the living environment faced by enterprises.Today,due to the trend of economic globalization,China is also actively involved in the wave of the world econ...Since the 1970s,there have been more and more uncertainties in the living environment faced by enterprises.Today,due to the trend of economic globalization,China is also actively involved in the wave of the world economy to promote economic development.Role of the leader is particularly important and in organizational change,the leader’s style and behavior can even determine the result of organizational change.But in the different development stages,the leadership style will be different.Therefore,this paper aims to study the two issues,that is,how the leadership style changes under different development stages of corporates and what the characteristics of the leader are in the different stages of organizational change.This paper will use the research method of case study,selecting Lenovo and Haier to make a comprehensive analysis.It also fills the vacancies for academic research on the relationship among leadership,organizational change,and organizational management in China.展开更多
BACKGROUND Polycythemia vera(PV),often attributed to the JAK2 V617F mutation,is characterized by enhanced red blood cell counts in the peripheral blood.PV-associated renal disease is clinically rare;to date,there have...BACKGROUND Polycythemia vera(PV),often attributed to the JAK2 V617F mutation,is characterized by enhanced red blood cell counts in the peripheral blood.PV-associated renal disease is clinically rare;to date,there have been reports of other chronic kidney diseases related to PV,but no reports on PV-associated minimal change disease.CASE SUMMARY A 37-year-old man presented with proteinuria and high red blood cell count on January 4,2021.The patient underwent bone marrow and renal biopsies,then was subsequently diagnosed with PV and minimal change in disease.Hydroxyurea was administered and proteinuria remission was achieved.The patient’s last visit was on April 14,2022.CONCLUSION We inferred that there may be a causal relationship between PV and minimal change disease.展开更多
The study area is located between the cities of Comitan (16°10'43"N and 92°04'20''W) a city with 150,000 inhabitants and La Esperanza (16°9'15''N and 91°...The study area is located between the cities of Comitan (16°10'43"N and 92°04'20''W) a city with 150,000 inhabitants and La Esperanza (16°9'15''N and 91°52'5''W) a town with 3000 inhabitants. Both weather stations are 30 km from each other in the Chiapas State, México. 54 years of daily records of the series of maximum (<em>t</em><sub>max</sub>) and minimum temperatures (<em>t</em><sub>min</sub>) of the weather station 07205 Comitan that is on top of a house and 30 years of daily records of the weather station 07374 La Esperanza were analyzed. The objective is to analyze the evidence of climate change in the Comitan valley. 2.07% and 19.04% of missing data were filled, respectively, with the WS method. In order to verify homogeneity three methods were used: Standard Normal Homogeneity Test (SNHT), the Von Neumann method and the Buishand method. The heterogeneous series were homogenized using climatol. The trends of <em>t</em><sub>max</sub> and <em>t</em><sub>min</sub> for both weather stations were analyzed by simple linear regression, Sperman’s rho and Mann-Kendall tests. The Mann-Kendal test method confirmed the warming trend at the Comitan station for both variables with <em>Z<sub>MK</sub></em> statistic values equal to 1.57 (statistically not significant) and 4.64 (statistically significant). However, for the Esperanza station, it determined a cooling trend for tmin and a slight non-significant warming for <em>t</em><sub>max</sub> with a <em>Z</em><sub><em>MK</em></sub> statistic of -2.27 (statistically significant) and 1.16 (statistically not significant), for a significance level <em>α</em> = 0.05.展开更多
BACKGROUND Polyneuropathy,organomegaly,endocrinopathy,M-protein,and skin changes(POEMS)syndrome is a rare paraneoplastic syndrome caused by a plasma cell proliferative disorder.The syndrome is characterized by elevate...BACKGROUND Polyneuropathy,organomegaly,endocrinopathy,M-protein,and skin changes(POEMS)syndrome is a rare paraneoplastic syndrome caused by a plasma cell proliferative disorder.The syndrome is characterized by elevated plasma cells,platelets,and vascular endothelial growth factor levels.Although heart disease rarely occurs in POEMS syndrome,the death rate increases sharply after heart failure.We report a patient who initially presented with an endocrine disease and developed congestive heart failure related to POEMS syndrome 9 years later.CASE SUMMARY A 23-year-old woman with no history of menstruation and a 9-year history of type I diabetes reported feeling breathless after activities.She could not lie down and rest at night.Three months prior,she experienced pain and increased tension in her left thigh accompanied by tenderness and edema in both lower extremities.The chief complaint upon hospital admission was that blood sugar has increased for more than 9 years,pain in the left thigh,and edema in both legs for more than 2 mo.After a multisystem evaluation,she was diagnosed with POEMS syndrome.Her echocardiogram showed left ventricular dilation with systolic dysfunction,and the left ventricular ejection fraction was only 38%with severely elevated brain natriuretic peptide.She received a combination of dexamethasone and thalidomide for 1 mo,but her symptoms did not improve.Therefore,we added a two-per-week bortezomib injection.After 2 wk,the patient’s heart function had improved significantly.CONCLUSION This case provides information about the treatment of POEMS syndrome with complications and highlights the challenges of developing a standardized treatment.展开更多
文摘BACKGROUND Polyneuropathy,organomegaly,endocrinopathy,M-protein,skin changes(POEMS)syndrome is a rare paraneoplastic syndrome that encompass multiple systems.The most common clinical symptoms of POEMS syndrome are pro-gressive sensorimotor polyneuropathy,organ enlargement,endocrine disorders,darkening skin,a monoclonal plasma cell proliferative disorder,and lymph node hyperplasia.The organomegaly consists of hepatosplenomegaly and/or lym-phadenopathy;cases of cardiomyopathy are rare.Diagnoses are often delayed because of the atypical nature of the syndrome,exposing patients to possibly severe disability.Therefore,identifying atypical symptoms can improve the prognosis and quality of life among POEMS syndrome patients.lenalidomide and dexamethasone.CONCLUSION When patients with cardiomyopathy have systemic manifestations such as numb limbs and darkening skin,the POEMS syndrome is the most possible diagnosis.
文摘BACKGROUND Polyneuropathy organomegaly endocrinopathy M-protein and skin changes(POEMS)syndrome is a rare paraneoplastic syndrome caused by a potential plasma cell tumor.The clinical manifestations of POEMS syndrome are diverse.Due to the insidious onset and lack of specific early-stage manifestations,POEMS syndrome is easily misdiagnosed or never diagnosed,leading to delayed treatment.Neurological symptoms are usually the first clinical manifestation,while ascites is a rare symptom in patients with POEMS syndrome.CASE SUMMARY A female patient presented with unexplained ascites as an initial symptom,which is a rare early-stage manifestation of the condition.After 1 year,the patient gradually developed progressive renal impairment,anemia,polyserosal effusion,edema,swollen lymph nodes on the neck,armpits,and groin,and decreased muscle strength of the lower extremities.The patient was eventually diagnosed with POEMS syndrome after multidisciplinary team discussion.Treatment comprised bortezomib+dexamethasone,continuous renal replacement therapy,chest and abdominal closed drainage,transfusions of erythrocytes and platelets,and other symptomatic and supportive treatments.The patient’s condition initially improved after treatment.However,then her symptoms worsened,and she succumbed to the illness and died.CONCLUSION Ascites is a potential early manifestation of POEMS syndrome,and this diagnosis should be considered for patients with unexplained ascites.Furthermore,multidisciplinary team discussion is helpful in diagnosing POEMS syndrome.
基金supported by funding the National Basic Research Program of China (973 Program) and the grant number is 2014CB239000
文摘1 Introduction Shale formations bear abundant mineral resource and*unconventional petroleum resource,and the unconventional petroleum resource that contain in the shale formation should be integrated and researched.
基金Supported by the Knowledge Innovation Program of Chinese Academy of Sciences(KZCX1-SW-01-01B)Cultivatlon Foundation of Institute of Mountain Hazards and Environment,CAS
文摘With the artificial alder and cypress mixed forest being planted, there has been a marked land use change since 1970s' in Hilly Area of Central Sichuan Basin, China. Data from meteorological observations or posts operated over long time, measurement and calculation of NPP (net primary production) and biomass of biological community, and analysis of soil organic matter content show that the artificial alder and cypress mixed forest has outstanding eco-environmental effect: adjusting local climate, raising soil fertility, alleviating menace of drought, and raising NPP and biomass of biological community. It is very beneficial for improving ecological environment to afforest artificial alder and cypress mixed forest in populous Hilly Area of Central Sichuan Basin, China. Key Words: land use/land cover change (LUCC); eco-environmental effect; Hilly Area of Central Sichuan Basin; the artificial alder and cypress mixed forest
文摘The Intergovernmental Panel on Climate Change (IPCC), established by the United Nations and World Meteorological Organization, has determined that humans have very likely influenced a net warming to the Earth from the increase of greenhouse gases, aerosols and land use changes. This warming has caused the amount of ice on the Earth to continue to decrease and sea levels to rise. In addition, extreme precipitation events are happening more often in selected regions of the world. A case study that assesses the impacts of, and adaptations to, these changes in climate is presented here. Two modeling programs, Sim CLIM and Train CLIM, (CLIM Systems, Hamilton, New Zealand) were used to support assessments for water supply, coastal zones and tropical cyclones in a fictitious island group in the South Pacific region. In the case study, a consulting group was “hired” to carry out these assessments. A final analysis and synthesis report were created to help the Ministry of the Environment of the made-up nation decide how to improve the governmental actions to address the real concerns posed by changing climate and sea level. Although a simulated island group is used in this article, there are sincere concerns about climate change and extreme weather events in this part of the world. It is important to address the real and dangerous threat that these islands and people face in the wake of a changing climate and a growing global society.
文摘Dear Sir, I＇m Boris Severinsky from the New England College of Optometry, Boston, USA. I write you to present an interesting case of extreme refractive and corneal topography changes induced by daily wearing of Acuvue Advance （Johnson＆Johnson, Vision Care） contact lens （CL）.
文摘By using the fixed point theorem under the case structure, we study the existence of sign-changing solutions of A class of second-order differential equations three-point boundary-value problems, and a positive solution and a negative solution are obtained respectively, so as to popularize and improve some results that have been known.
文摘BACKGROUND Although minimal change disease(MCD)and focal segmental glomerulosclerosis(FSGS)have been described as two separate forms of nephrotic syndrome(NS),they are not completely independent.We report a case of a patient transitioning from MCD to FSGS,review the literature,and explore the relationship between the two diseases.CASE SUMMARY A 42-year-old male welder,presenting with lower extremity edema and elevated serum creatinine,was diagnosed with NS and end-stage kidney disease(ESKD)based on laboratory test results.The patient had undergone a kidney biopsy for NS 20 years previously,which indicated MCD,and a second recent kidney biopsy suggested FSGS.The patient was an electric welder with excessive levels of cadmium and lead in his blood.Consequently,we suspect that his aggravated pathology and occurrence of ESKD were related to metal nephrotoxicity.The patient eventually received kidney replacement therapy and quit his job which involved long-term exposure to metals.During the 1-year follow-up period,the patient was negative for metal elements in the blood and urine and recovered partial kidney function.CONCLUSION MCD and FSGS may be different stages of the same disease.The transition from MCD to FSGS in this case indicates disease progression,which may be related to excessive metal contaminants caused by the patient’s occupation.
文摘Since the 1970s,there have been more and more uncertainties in the living environment faced by enterprises.Today,due to the trend of economic globalization,China is also actively involved in the wave of the world economy to promote economic development.Role of the leader is particularly important and in organizational change,the leader’s style and behavior can even determine the result of organizational change.But in the different development stages,the leadership style will be different.Therefore,this paper aims to study the two issues,that is,how the leadership style changes under different development stages of corporates and what the characteristics of the leader are in the different stages of organizational change.This paper will use the research method of case study,selecting Lenovo and Haier to make a comprehensive analysis.It also fills the vacancies for academic research on the relationship among leadership,organizational change,and organizational management in China.
基金Supported by the National Natural Science Foundation of China,No.81874437 and 81904126Science and Technology Commission of Shanghai Municipality,No.20Y21901800.
文摘BACKGROUND Polycythemia vera(PV),often attributed to the JAK2 V617F mutation,is characterized by enhanced red blood cell counts in the peripheral blood.PV-associated renal disease is clinically rare;to date,there have been reports of other chronic kidney diseases related to PV,but no reports on PV-associated minimal change disease.CASE SUMMARY A 37-year-old man presented with proteinuria and high red blood cell count on January 4,2021.The patient underwent bone marrow and renal biopsies,then was subsequently diagnosed with PV and minimal change in disease.Hydroxyurea was administered and proteinuria remission was achieved.The patient’s last visit was on April 14,2022.CONCLUSION We inferred that there may be a causal relationship between PV and minimal change disease.
文摘The study area is located between the cities of Comitan (16°10'43"N and 92°04'20''W) a city with 150,000 inhabitants and La Esperanza (16°9'15''N and 91°52'5''W) a town with 3000 inhabitants. Both weather stations are 30 km from each other in the Chiapas State, México. 54 years of daily records of the series of maximum (<em>t</em><sub>max</sub>) and minimum temperatures (<em>t</em><sub>min</sub>) of the weather station 07205 Comitan that is on top of a house and 30 years of daily records of the weather station 07374 La Esperanza were analyzed. The objective is to analyze the evidence of climate change in the Comitan valley. 2.07% and 19.04% of missing data were filled, respectively, with the WS method. In order to verify homogeneity three methods were used: Standard Normal Homogeneity Test (SNHT), the Von Neumann method and the Buishand method. The heterogeneous series were homogenized using climatol. The trends of <em>t</em><sub>max</sub> and <em>t</em><sub>min</sub> for both weather stations were analyzed by simple linear regression, Sperman’s rho and Mann-Kendall tests. The Mann-Kendal test method confirmed the warming trend at the Comitan station for both variables with <em>Z<sub>MK</sub></em> statistic values equal to 1.57 (statistically not significant) and 4.64 (statistically significant). However, for the Esperanza station, it determined a cooling trend for tmin and a slight non-significant warming for <em>t</em><sub>max</sub> with a <em>Z</em><sub><em>MK</em></sub> statistic of -2.27 (statistically significant) and 1.16 (statistically not significant), for a significance level <em>α</em> = 0.05.
文摘BACKGROUND Polyneuropathy,organomegaly,endocrinopathy,M-protein,and skin changes(POEMS)syndrome is a rare paraneoplastic syndrome caused by a plasma cell proliferative disorder.The syndrome is characterized by elevated plasma cells,platelets,and vascular endothelial growth factor levels.Although heart disease rarely occurs in POEMS syndrome,the death rate increases sharply after heart failure.We report a patient who initially presented with an endocrine disease and developed congestive heart failure related to POEMS syndrome 9 years later.CASE SUMMARY A 23-year-old woman with no history of menstruation and a 9-year history of type I diabetes reported feeling breathless after activities.She could not lie down and rest at night.Three months prior,she experienced pain and increased tension in her left thigh accompanied by tenderness and edema in both lower extremities.The chief complaint upon hospital admission was that blood sugar has increased for more than 9 years,pain in the left thigh,and edema in both legs for more than 2 mo.After a multisystem evaluation,she was diagnosed with POEMS syndrome.Her echocardiogram showed left ventricular dilation with systolic dysfunction,and the left ventricular ejection fraction was only 38%with severely elevated brain natriuretic peptide.She received a combination of dexamethasone and thalidomide for 1 mo,but her symptoms did not improve.Therefore,we added a two-per-week bortezomib injection.After 2 wk,the patient’s heart function had improved significantly.CONCLUSION This case provides information about the treatment of POEMS syndrome with complications and highlights the challenges of developing a standardized treatment.
