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.

Simple and effective method for treating severe adult skeletal class II malocclusion: A case report

BACKGROUND Severe skeletal class II malocclusion is the indication for combined orthodontic and orthognathic treatment.CASE SUMMARY A woman with a chief complaint of a protruding chin and an inability to close her lips requested orthodontic camouflage.The treatment plan consisted of extracting the right upper third molar,right lower third molar,left lower second molar,and left upper third molar and moving the maxillary dentition distally using a convenient method involving microimplant nail anchors,push springs,long arm traction hooks,and elastic traction chains.After 52 months of treatment,her overbite and overjet were normal,and her facial profile was favorable.CONCLUSION This method can be used for distal movement of the maxillary dentition and to correct severe skeletal class II malocclusion 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.

American tegumentary leishmaniasis mimicking myiasis and granulomatous vasculitis:A case report

Rationale:American tegumentary leishmaniasis comprises cutaneous and mucocutaneous manifestations caused by parasitic infections by various Leishmania species.This report details the clinical interventions for a patient with American tegumentary leishmaniasis in Mendoza,Argentina,a non-endemic region.Patient concerns:A 43-year-old male was admitted to a tertiary care hospital in Mendoza,Argentina Republic with a history of progressive nasal discharge,septal perforation,facial pain,and pruritus.Despite treatment for presumed nasal myiasis and vasculitis with granulomatosis,symptoms persisted.Diagnosis:American tegumentary leishmaniasis.Interventions:Intravenous liposomal amphotericin B.Outcomes:Follow-up at 30 days showed no recurrence of symptoms with a remarkable clinical improvement of the nasal lesion.Lessons:This case sheds light on the necessity of accurate identification for timely intervention and the need to recognize the diverse manifestations of American tegumentary leishmaniasis to avoid misdiagnosis.

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.

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.

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.

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.

Synthesis of Vanadium Nitride by a One Step Method

Vanadium nitrides were prepared via one step method of carbothermal reduction and nitridation of vanadium trioxide. Thermalgravimetric analysis （TGA） and X-ray diffraction were used to determine the reaction paths of vanadium carbide, namely the following sequential reaction： V2O3→V8C7 in higher temperature stage, the rule of vanadium nitride synthesized was established, and defined conditions of temperature for the production of the carbides and nitrides were determined. Vanadium oxycarbide may consist in the front process of carbothermal reduction of vanadium trioxide. In one step method for vanadium nitride by carbothermal reduction and nitridation of vanadium trioxide, the nitridation process is simultaneous with the carbothermal reduction. A one-step mechanism of the carbothermal reduction with simultaneous nitridation leaded to a lower terminal temperature in nitridation process for vanadium nitride produced, compared with that of carbothermal reduction process without nitridation. The grain size and shape of vanadium nitride were uniform, and had the shape of a cube. The one step method combined vacuum carborization and nitridation （namely two step method） into one process. It simplified the technological process and decreased the costs.

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.

Gradient Step Method to Predict the Ozone Solubility in Water

In this work it presents a strategy to obtain the ozone solubility in water by gradient step method. In this methodology, the ozone in mixture with oxygen is bubbling in a reactor with distilled water at 21℃ and pH 7. The ozone concentration on gas phase is continually increased after the saturation is reached. The method proposed is faster than conventional method （isocratic method）. The solubility from the gradient method is compared with that values obtained from correlations founded in the literature.

Design System of the Two-step Gear Reducer on Case-based Reasoning

The design of the two-step gear reducer is a tedious and time-consuming process. For the purpose of improving the efficiency and intelligence of design process, case-based reasoning（CBR） technology was applied to the design of the two-step gear reducer. Firstly, the current design method for the two-step gear reducer was analyzed and the principle of CBR was described. Secondly, according to the characteristics of the reducer, three key technologies of CBR were studied and the corresponding methods were provided, which are as follows： （a） an object-oriented knowledge representation method, （b） a retrieval method combining the nearest neighbor with the induction indexing, and （c） a case adaptation algorithm combining the revision based on rule with artificial revision. Also, for the purpose of improving the credibility of case retrieval, a new method for determining the weights of characteristics and a similarity formula were presented, which is a combinatorial weighting method with the analytic hierarchy process（AHP） and roughness set theory. Lastly, according to the above analytic results, a design system of the two-step gear reducer on CBR was developed by VC＋＋, UG and Access 2003. A new method for the design of the two-step gear reducer is provided in this study. If the foregoing developed system is applied to design the two-step gear reducer, design efficiency is improved, which enables the designer to release from the tedious design process of the gear reducer so as to put more efforts on innovative design. The study result fully reflects the feasibility and validity of CBR technology in the process of the design of the mechanical parts.

Temperature-dependent photoluminescence on organic inorganic metal halide perovskite CH_3NH_3Pb I_(3-)Cl_ prepared on ZnO/FTO substrates using a two-step method

Temperature-dependent photoluminescence characteristics of organic-inorganic halide perovskite CH3NH3Pb I3-xClx films prepared using a two-step method on ZnO/FTO substrates were investigated. Surface morphology and absorption characteristics of the films were also studied. Scanning electron microscopy revealed large crystals and substrate coverage. The orthorhombic-to-tetragonal phase transition temperature was-140 K. The films＇ exciton binding energy was 77.6 ± 10.9 meV and the energy of optical phonons was 38.8 ± 2.5 meV. These results suggest that perovskite CH3NH3Pb I（3-x）Clx films have excellent optoelectronic characteristics which further suggests their potential usage in perovskitebased optoelectronic devices.

Applying the Dynamic Two-Step Method to Forecast Remaining Oil Distribution of Lower Series ,Xiaermen Oilfield

The distribution of remaining oil is often described qualitatively. The remaining oil distributed in the whole reservoir is calculated according to the characteristics of the space distribution of the saturation of remaining oil. Logging data are required to accomplish this. However, many such projects cannot be completed. Since the old study of remaining oil distribution could not be quantified efficiently, the ＂dynamic two-step method＂ is presented. Firstly, the water cut of every flow unit in one well at one time is calculated according to the comprehensive water cut of a single well at one time. Secondly, the remaining oil saturation of the flow unit of the well at one time is calculated based on the water cut of the flow unit at a given time. The results show that ＂dynamic two-step method＂ has characteristics of simplicity and convenience, and is especially suitable for the study of remaining oil distribution at high water-cut stage. The distribution of remaining oil presented banding and potato form, remaining oil was relatively concentrated in faultage neighborhood and imperfect well netting position, and the net thickness of the place was great. This proposal can provide an effective way to forecast remaining oil distribution and enhance oil recovery, especially applied at the high water-cut stage.

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 LOW-PRESSURE AND ONE-STEP METHOD FOR THE SYNTHESIS OF ALKYLIDYNETRICOBALT NONACARBONYL CLUSTERS:RCCo_8(CO)_9

Metal clusters RCCo_3(CO)_9(R-H,C1,Br,CH_3,Ph) were prepared in 18.8-57.3% yields from the reaction of cobalt(Ⅱ)salt and RCX_a under mild PTC conditions(latm CO,25℃).The cobalt salt was reduced to Co(CO)_4 in the presence of Na_3S_2O_4.

When important steps for a reliable Meta-analysis are missing: the bevacizumab versus ranibizumab case

【正】Dear Sir,W e have read with attention and interest the systematic review on the effectiveness and safety of bevacizumab and ranibizumab in the treatment of age-related macular degeneration(AMD)written by Zhang et al[1]and published on number of April 2014 of International Journal of Ophthalmology.The authors,who collected data from 4randomized clinical trials(RCTs)and 11 observational

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.……