Neuroleptic malignant syndrome after the use of venlafaxine in a patient with generalized anxiety disorder.

Neuroleptic malignant syndrome (NMS) is a potentially lethal adverse reaction to neuroleptics, which is characterized by hyperthermia, extrapyramidal symptoms, altered consciousness and autonomic dysfunction. Although NMS is most commonly induced by the high-potency neuroleptics, its development has also been associated with the use of non-neuroleptic agents that block central dopamine pathways. A 68-year-old man with generalized anxiety disorder and depressive symptoms presented at the emergency department (ED) with high fever, tremor, muscle rigidity, rhabdomyolysis and altered mental status. NMS was considered to have been caused by the recent addition and subsequent dose increase in his treatment regimen of venlafaxine, a serotonin norepinephrine reuptake inhibitor. He was successfully treated with bromocriptine, lorazepam, and fluid hydration in the ED and intensive care unit.     

Myositis ossificans of the chest wall simulating malignant neoplasm

Myositis ossificans originating from the chest wall is extremely rare. We report a case of myositis ossificans occurring in a young woman with progressive painful swelling in the chest wall. Preoperative examination suggested a malignant neoplasm originating from soft tissue. Although rare, myositis ossificans is one of the potential causes of painful swelling in the chest wall, and can be mistaken for a malignant neoplasm.     

Can large B-cell lymphoma mimic cystic lesions of the spleen?

A 58-yr-old male with a history of hepatitis C virus infection, presented with a 2-mo history of intractable left upper abdominal pain. He had fallen from a ladder 2 yr previously, landing on his left side. Abdominal computed tomography identified a large cystic mass in the spleen. The patient was brought to the operating room with a presumptive diagnosis of symptomatic, post-traumatic, false cyst of the spleen. Instead, at surgery, a splenic mass with dense adhesions to the diaphragm and stomach was found. On final histological analysis, it was diagnosed to be a large B-cell lymphoma. Despite its rarity, gastroenterologists and surgeons should be aware of large B-cell lymphoma when encountering cystic lesions of the spleen, because the management of benign cystic disease is usually nonsurgical.     

Medial cortex strain distribution during noncemented total hip arthroplasty

Intraoperative proximal femur fractures are a significant concern during noncemented total hip arthroplasty. The current study was performed to investigate the hypothesis that broaching the femur and inserting the stem without using mallet applied impact loads will reduce the risk of intraoperative fracture. Rosette strain gauges were applied to the medial and anteromedial cortex of six human anatomic specimen femurs to compare the strain distribution for broaching and stem insertion. Eight additional femurs were used to compare the strain distribution for stem insertion using impact loading and constant rate stem insertion. For the impact loading stem insertions, the soft tissues surrounding the femur were modeled. Constant rate stem insertions were performed using a mechanical testing machine. The largest strains measured at the medial and anteromedial sites primarily were aligned with the femur hoop axis. The largest strain magnitude, orientation, and sign (tensile or compressive) varied widely among femurs. The stem insertion strains were significantly larger than the broaching strains (two-way analysis of variance with replication). The impact stem insertion strains were not significantly different from the constant rate stem insertion strains. The results indicate that the femur geometry and material properties have a greater influence on the strain distribution than does the implantation technique.     

Use of Ilizarov Device to Gain Early Range of Motion in the Treatment of Pediatric Talus Body Fractures: A Series of Four Cases and Literature Review

BackgroundTalus fractures are rare in children but can lead to severe outcomes if untreated. The Ilizarov external fixator has been used in the treatment of a variety of lower extremity pathologies. The purpose of this study was to investigate the clinical outcomes of talus body fractures treated with the Ilizarov external fixator.Case PresentationFour male pediatric patients (age range, 5–11 years) with talus body fractures who were treated by open reduction and internal fixation combined with Ilizarov external fixator between November 2015 and April 2016 were reviewed. Mean follow‐up period was 4 years (range, 4–5). Clinical outcome was evaluated using the clinical rating scale of the American Orthopaedic Foot and Ankle Society (AOFAS). All four patients achieved good to excellent results at the last follow‐up. None of the patients developed avascular necrosis. One patient developed automatic fusion of tibiotalar joint.ConclusionUse of the Ilizarov external fixator to gain early range of motion is a valuable option for treatment of talus body fractures in children.     

新型冠状病毒感染相关急性黄斑区神经视网膜病变的神经眼科特征

目的：总结新型冠状病毒(SARS-CoV-2)感染相关急性黄斑区神经视网膜病变(AMN)的神经眼科特征。

方法：纳入2022-12-27/2023-02-01就诊于西安市第一医院(西北大学附属第一医院)神经眼科并经相关检查确诊为AMN的患者8例(6例女性,2例男性)共14眼纳入本次研究。所有患者病前均有SARS-CoV-2感染史。收集患者的临床资料。纳入最佳矫正视力(BCVA)、非接触间接眼压测定、眼底彩色照相、近红外成像(IR)、频域光学相干断层扫描(SD-OCT)、OCT血流成像(OCTA)、眼底荧光素血管造影(FFA)、吲哚菁绿血管造影(ICGA)、视野、视觉诱发电位(VEP)和视网膜电流图(ERG)检查结果。对纳入患者的神经眼科特征进行分析总结。

结果：纳入的8例患者年龄20-43(平均30±6.63)岁。病前3-11(平均5±3.51)d有SARS-CoV-2感染史,8例患者中有6例在感染SARS-CoV-2的5 d内出现视觉症状。患者的临床表现为视力下降或视物遮挡感; 纳入患者的视力0.08-1.0; 视野缺损表现为中心、旁中心暗点或合并周边暗点。VEP可见P100或P2峰时延迟; ERG提示视网膜感光细胞 功能受损。在疾病早期,SARS-CoV-2感染相关AMN患者可能存在视力、视野和视网膜外层病变大小及形状可能不匹配的情况,并发现视力越低,VEP峰时越迟。

结论：除眼底多模影像,SARS-CoV-2感染相关AMN的神经眼科特征需要临床医师关注,视功能及电生理可以辅助临床更加全面评估患者及判断预后。     

腓骨髓内钉与切开复位钉板系统治疗腓骨远端骨折的疗效分析

目的 比较腓骨髓内钉与切开复位钉板系统治疗腓骨远端骨折的疗效.方法 回顾性分析2017年10月至2019年10月于锦州医科大学附属第一医院采用手术治疗腓骨骨折的患者,按照纳入、排除标准筛选病例,最终A组髓内钉组25例纳入研究、B组钉板内固定组35例纳入研究.比较两组入院至行腓骨手术的时间,手术时长,腓骨术口总长度,AO...     

细节管理在老年留置普通硅胶胃管患者鼻饲饮食中的应用

目的 研究细节管理减少老年留置普通硅胶胃管患者鼻饲饮食后并发症、减少感染及死亡率的作用.方法 选取80例老年留置普通硅胶胃管患者,随机分为对照组40例与干预组40例,对照组患者鼻饲饮食实施常规管理,干预组患者鼻饲饮食实施管理,比较两组干预效果.结果 干预组发生胃肠道并发症6例,无堵管现象,肺部感染2例;对照组发生胃肠道...     

The Uncertainty Propagation for Carbon Atomic Interactions in Graphene under Resonant Vibration Based on Stochastic Finite Element Model

Graphene is one of the most promising two-dimensional nanomaterials with broad applications in many fields. However, the variations and fluctuations in the material and geometrical properties are challenging issues that require more concern. In order to quantify uncertainty and analyze the impacts of uncertainty, a stochastic finite element model (SFEM) is proposed to propagate uncertainty for carbon atomic interactions under resonant vibration. Compared with the conventional truss or beam finite element models, both carbon atoms and carbon covalent bonds are considered by introducing plane elements. In addition, the determined values of the material and geometrical parameters are expanded into the related interval ranges with uniform probability density distributions. Based on the SFEM, the uncertainty propagation is performed by the Monte Carlo stochastic sampling process, and the resonant frequencies of graphene are provided by finite element computation. Furthermore, the correlation coefficients of characteristic parameters are computed based on the database of SFEM. The vibration modes of graphene with the extreme geometrical values are also provided and analyzed. According to the computed results, the minimum and maximum values of the first resonant frequency are 0.2131 and 16.894 THz, respectively, and the variance is 2.5899 THz. The proposed SFEM is an effective method to propagate uncertainty and analyze the impacts of uncertainty in the carbon atomic interactions of graphene. The work in this paper provides an important supplement to the atomic interaction modeling in nanomaterials.