Endoscopic radial incision and cutting method for adult congenital duodenal webs:A case report

BACKGROUND Congenital duodenal webs are rare in adults and can lead to various symptoms such as nausea,vomiting,and postprandial fullness.The treatment for this disease is mostly surgical.Endoscopic treatment techniques have been developed and attempted for this disease.Endoscopic radial incision and cutting(RIC)techniques are reportedly very effective in benign anastomotic stricture.This case report highlights the effectiveness and safety of endoscopic RIC as a minimally invasive treatment for adult congenital duodenal webs.CASE SUMMARY A 23-year-old female patient with indigestion was referred to a tertiary hospital.The patient complained of postprandial fullness in the epigastric region.Previous physical examinations or blood tests indicated no abnormalities.Computed tomography revealed an eccentric broad-based delayed-enhancing mass-like lesion in the second portion of the duodenum.Endoscopy showed an enlarged gastric cavity and a significantly dilated duodenal bulb;a very small hole was observed in the distal part of the second portion,and scope passage was not possible.Gastrografin upper gastrointestinal series was performed,revealing an intraduodenal barium contrast-filled sac with a curvilinear narrow radiolucent rim,a typical"windsock"sign.Endoscopic RIC was performed on the duodenal web.The patient recovered uneventfully.Follow-up endoscopy showed a patent duodenal lumen without any residual stenosis.The patient reported complete resolution of symptoms at the 18-month follow-up.CONCLUSION Endoscopic RIC may be an effective treatment for congenital duodenal webs in adults.

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.

Endoscopic treatment of extreme esophageal stenosis complicated with esophagotracheal fistula: A case report

BACKGROUND At present,there is no unified and effective treatment for extreme corrosive esophageal stenosis(CES)with esophagotracheal fistula(ETF).This case had extreme and severe esophageal stenosis(ES)and ETF after ingesting an enzyme-based chemical detergent,resulting in a serious pulmonary infection and severe malnutrition.Upper gastrointestinal imaging showed that he had an ETF,and endoscopy showed that he had extreme and severe esophageal stricture.This case was complex and difficult to treat.According to the domestic and foreign lite-rature,there is no universal treatment that is low-risk.CASE SUMMARY A patient came to our hospital with extreme ES,an ETF,and severe malnutrition complicated with pulmonary tuberculosis 1 mo after the consumption of an enzy-me-based detergent.The ES was serious,and the endoscope was unable to pass through the esophagus.We treated him by endoscopic incision method(EIM),esophageal stent placement(ESP),and endoscopic balloon dilation(EBD)by using the bronchoscope and gastroscope.This treatment not only closed the ETF,but also expanded the esophagus,with minimal trauma,greatly reducing the pain of the patient.According to the literature,there are no similar reported cases.CONCLUSION We report,for the first time,a patient with extreme CES complicated with ETF,where the endoscope could not be passed through his esophagus but he could be examined by bronchoscopy and treated by EIM,ESP,and EBD.

Novel method of primary endoscopic realignment for high-grade posterior urethral injuries:A case report

BACKGROUND A male urethral disruption injury is a urological emergency.Primary endoscopic realignment(PER)refers to reestablishment of urethral alignment via indwelling urethral catheter by cystoscope,which is recommended as the optimal emergent treatment approach for reducing the likelihood of complications following injury.However,the prior literature suggests the success rate of PER to be relatively low due to complicated urethral disruption.We report a modified PER approach that serves to improve both the success rate and safety of the treatment.CASE SUMMARY A 19-year-old male patient presented with multiple pelvic fractures and complete urethral disruption following a high-velocity traffic accident.The patient’s abdominal computed tomography and retrograde urethrography results revealed complete urethral disruption at the bulbar urethra,with hematoma and contrast medium extravasation that extended into the extraperitoneal space.The conventional retrograde PER by cystoscope failed due to severe disruption and considerable hematoma.Modified simultaneous antegrade and retrograde PER was performed by means of semi-rigid ureteroscopy via a suprapubic Foley catheter and cystoscopy via the external urethra.An antegrade guidewire was passed through the bladder neck and then pulled out through the external urethral meatus with a cystoscope.Urethral continuity was achieved after a 16-Fr silicone Foley catheter was indwelled into the bladder along the guidewire.The patient recovered well,achieving voiding continence and avoiding further operation for urethral stricture.CONCLUSION Modified PER via suprapubic Foley catheter represents a promising and safe treatment approach in patients with posterior urethral injuries.

A case of 9p deletion syndrome with congenital infantile glaucoma,effective method of diagnosis,and treatment

Dear Editor,I am Dr.Jia X from the Department of Ophthalmology,Second Xiangya Hospital,Central South University,Changsha,China.I write to present a rare case report of 9p deletion syndrome with congenital infantile glaucoma in an infant,accompanying with an effective method of both diagnosis and treatment.

Acupuncture Combined with Plucking Muscle Method for Treatment of 48 Cases of Acute Lumbar Sprain

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Aka Canturk Oral Autopsy Method for the Dental Identification of Fetus and Infant Cases

Forensic research requires the application of reliable identification methods for unidentified individuals, among which the dental analysis has prime importance. The most significant source of dental evidence is oral autopsy applications, which consist of an examination and evidence collection from the oral cavity of a deceased individual. Oral autopsies show variations depending on the age of the person due to rigor mortis. The oral autopsy of a child may require an easier operation than adults, and thus, the procedures are usually simpler for fetus or infant cases. The aim of this study is to propose the theoretical and experimental aspects of an oral autopsy protocol for a special age group of fetus or infant cases, which is a method for extracting tooth germs in their developmental stages for identification purposes and entitled by the authors’ names as the “Aka-Canturk Oral Autopsy Method”.

A Mapping Method of Using the Compound Use Cases to Generate User Interface

To support the requirement analysis of the user interfaces and the auto generation of the final user interfaces, we should improve the traditional modeling method which centered on the system and the implementation, and turn to use the modeling method which centered on the usage and the user. The compound use cases describe the system function from the user point of view. Based on the compound use cases, we can generate the final user interfaces.

TCM Treatment of 18 Cases of Sicca Syndrome with the Heat-Removing and Dampness-Eliminating Method

With rich clinic experience of over 30 years, the author have treated 18 cases of sicca syndrome with the heat-removing and dampness eliminating method, and obtained satisfactory therapeutic results. A report follows.……

A Research on the Application of Case Teaching Method in Curriculum-Based Ideological and Political Education in College English Course under the Concept of OBE

Since the idea of“Curriculum-Based Ideological and Political Education”was formally proposed in 2016,it has rapidly become a research hotspot in education reform.Although a large number of relevant studies have focused on the effective paths to curriculum-based ideological and political education in specific courses,there are few studies on how to integrate ideological and political education contents into particular courses under specific educational concepts and by particular teaching methods.Thus,this paper will explore how to improve the teaching effectiveness of curriculumbased ideological and political education in College English course with the OBE concept as the driving force and the case teaching method as the means.Finally,a few thoughts on the application of case teaching method in College English course are offered.

Design Method and Classic Case Analysis of Low Carbon Community

Realizing “carbon peaking” and “carbon neutrality” is a major strategic decision made by China to coordinate domestic and international situations.In order to achieve the “double carbon” goal,it is also necessary for relevant practitioners to actively put into practice to improve the participation of residents and advocate low carbon life while formulating the policy action plan.Community is an important place for human activities and one of the main spatial types of carbon emissions in cities.Doing a good job in planning energy conservation and emission reduction in the community plays an important role in achieving the “double carbon” goal.Through the analysis of classic low carbon community practice cases at home and abroad,6 planning and design methods for low carbon community are concluded,and the development status of low carbon community in China is reflected and summarized.

External application of Chinese medicine formula combined with analgesic drugs to treat lung squamous cell carcinoma pain： A case study with mixed methods

Objective： To investigate the effectiveness of the external application of Chinese medicine combined with analgesicdrugs to treat lung squamous cell carcinoma pain. Methods： A 54-year-old patient with upper lobe of the left lungsquamous cell carcinoma was studied, who suffered from severe cancer pain with the initial numeric rating scale （NRS）7 point when admitted. Exterior-use formula was applied to pain spot to relieve the pain. Mixed methods approachcomprising NRS, Short-form of McGill Pain Questionnaire, quality of life scale, times of breakout pain, records ofadverse reactions and semi-structured interviews were utilized to evaluate the effect. Results： With the combination useof the formula and analgesic drugs, the patient’s NRS score dropped from 7 to 3 point. Quality of life scale scoreimproved from 33 to 42 point. Times of breakout pain reduced from twice to none. The amount of oxycodone decreasedfrom 30 mg Bid to 10 mg Bid. No adverse effect appeared. The patient’s felt more energetic with good sleep and appetite.Conclusion： This formula is effective and safe for pain relief when combined with analgesic drugs, and may be a goodoption in dealing with local cancer pain. Future randomized, controlled studies are needed to better evaluate the efficacy.

ON THE LIMIT CASE OF THE STEP-REDUCTION METHOD FOR CALCULATING NON-UNIFORM BEAM WITH VARIOUS SECTIONS

In this paper, the step reduction method is discussed, which was advanced by Prof. Yeh Kai-yuan for calculating a non-uniform beam with various sections. The following result is proved. The approximate solution by this method approaches the true solution if the number of the steps approaches the infinity. However, the measure of the error between the limit solution and the ture solution is not in the pure mathematics sense but in the mechanics sense.

Case Study of a Chinese Girl's English Learning Methods in the American Elementary School

The goal of this research is to explore a more successful method for Mainland Chinese students to learn English.This newmethod will be illustrated by using the experiences of my daughter while a student in an elementary school in the United States for oneyear.From the analysis of her learning experiences,the following conclusions were drawn:1) Immerse language learning is important tolanguage input.2) Phonics is an effective tool to improve reading for Chinese English

The Application of Case Method in the Teaching of Investment Project Evaluation

Case Method originated in the 1920s and was initiated by Harvard Business School in the United States.At that time,it adopted a unique style of case study,which was based on real situations or events in business management,in this way,it is helpful to cultivate and develop students’active participation in class discussion.For investment students,specialized courses such as Investment Project Evaluation and corporate finance are concentrated in the upper grades,and in the freshman,sophomore phase has completed the Finance,finance,macroeconomics and other basic courses.On the basis of students’existing knowledge structure,the course“Investment Project Evaluation”needs to fully tap students’potential in learning and train students’practical problem-solving ability,to cultivate students’thinking ability of combining theoretical knowledge with practical cases,to avoid the teaching mode of“I tell you to listen”,and to guide students to think,analyze and solve problems actively.

Research on the Teaching Reform of Polymer Materials Foundation Course-Based on the Case Analysis Method

In today's education and teaching reform,the traditional teaching method in the teaching of polymer materials has been gradually replaced with various new teaching methods.Among them,the case analysis method is a very efective teaching method,which has been applied to the teaching of polymer materials.Through example-based teaching,students 125 participation can be effectively improved,and their theoretical knowledge can be fully utilized.This would have a positive role in promoting the improvement of students'knowledge system and their learning ability.In regard to this,this article analyzes the application of case analysis in the teaching of polymer materials so as to improve its efficiency and quality.

Iterative Case-Driven Method and Practice of Java Language Teaching

This project intends to study and discuss the teaching method of programming languages through an iterative case-driven model, to break through the traditional syntax-based teaching method so that students can actively participate in the case analysis and design which are closely related to enterprise applications. The purpose of teaching is achieved through the gradual iterative case-driven model. This project can form the best practice for the iterative case teaching method and promote programming language course innovation.

如何在旅游管理研究中使用严谨规范的扎根理论和案例研究方法

扎根理论和案例研究方法在当前旅游管理、工商管理研究中应用普遍,但学界对于这两种方法的本质特征、评价标准和关键操作步骤仍然存在诸多争议和不清晰之处。因此,本文围绕如何用好扎根理论和案例研究方法这一话题展开讨论,得出主要结论为:(1)高质量的质性与案例研究方法具有5个主要特征,即研究设计具有高可信度及高可靠性、样本与案例选择与研究问题及研究范式相匹配、数据分析过程严谨及规范、理论构建能找到“最优区分”平衡点、文章写作注重研究方法的独特性。(2)学界需要深入反思扎根理论的内涵体系并规避4种典型误区,要重视处理理论抽样、编码技巧、信效度检验等核心问题。(3)扎根理论数据分析的规范性特别是编码过程在文章中的说明与展示越来越受到重视,但值得注意的是对数据进行“持续比较”与合理解释才是扎根理论数据分析的核心,不能为了编码而编码。(4)案例研究的数据分析与理论构建可以概括为“数据—概念—概念间关系—理论”逻辑链条,首先是从数据到概念,即通过将案例数据进行压缩和抽象,使之与相关概念联系到一起,其次是概念间关系及理论解释,即将这些概念以一定的逻辑联系起来,描述案例现象的模式,解释其背后的机制。(5)案例研究适用于揭示理论机制和构建新理论,选择相匹配的数据处理方法能有效提升案例研究的质量,根据理论类型不同可将案例研究分为过程理论型和因素理论型,且分别适配不同的研究设计和数据处理方法。

高等医学教育PBL病例讨论课的教学设计改革

采用PBL教学法进行病例讨论式教学方式,已经在高等医学教育中得到广泛应用。PBL病例讨论课普遍存在部分学生参与度不高的现象。为了解决这个问题,在PBL病例讨论课中进行分小组讨论式的教学设计改革,将10人组拆分成3组或4组,每组2~~3人;调整教学评价模式,将原来的指导教师综合评价转变为组对组之间学生评价并设置加分项。教学组织形式和评价模式改革有助于所有学生积极参与讨论,取得了较好的课堂教学效果。