Intradural extramedullary capillary hemangioma with intramedullary component: A case series

Rationale:Capillary hemangioma in the spinal cord is an exceedingly rare entity that is liable to be misdiagnosed. To summarize the clinical presentation, radiological characteristics, and pathological features of capillary hemangioma in the spinal cord and to share our experience for the diagnosis and treatment of intradural extramedullary capillary hemangioma.Patient concerns:Three patients underwent surgical treatment at our hospital between January 2020 and August 2020. All patients were male[median age at presentation: 57 years (range: 56–60)]. Two patients were experiencing pain and numbness in the lower back, and 1 patient was experiencing numbness and weakness in the left lower limb. The duration of symptoms ranged from 1 to 5 months.Diagnosis:All patients were diagnosed with spinal cord capillary hemangioma after treatment. All lesions were in an intradural extramedullary location and involved spinal cord components. Two patients had lesions in thoracic segments (T8, Th9-10), and 1 patient had a lesion in lumbar segment (L1).Interventions:All patients underwent microscopic laminectomy and complete resection of the extramedullary and intramedullary components of the spinal cord capillary hemangiomas.Outcomes:Postoperatively, all patients experienced transient numbness and pain in the lower limbs, which gradually decreased over time. None of the patients experienced bleeding, severe numbness or pain, or recurrence of symptoms at 3-month follow-up.Conclusion:Intradural extramedullary capillary hemangioma has unique morphological characteristics. Gross-total resection of the extramedullary and intramedullary components of spinal cord capillary hemangioma is recommended for patients with symptoms of spinal cord compression. Careful preoperative imaging and intraoperative decision-making may help avoid residual lesions or reoperation.     

Gingival metastasis from primary hepatocellular carcinoma: a case report

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide; however, cases with metastasis to the oral cavity are extremely rare. Herein, we report a 68-year-old man who was diagnosed with HCC. Ten months after surgical removal of the right half of his liver, the patient developed gingival metastasis. Unfortunately, the patient died 4 months after the diagnosis. We discuss treatment options, pathological results, and disease prognosis. When a mandibular gingival mass is found, metastatic tumors should be considered in the differential diagnosis. In this regard, the patient’s medical history and physical examination are valuable indicators for the diagnosis of mandibular gingival metastasis. This case provides a basis for the clinical diagnosis of metastatic HCC involving the oral cavity.     

BrainAGE and regional volumetric analysis of a Buddhist monk: a longitudinal MRI case study

ABSTRACT

Yongey Mingyur Rinpoche (YMR) is a Tibetan Buddhist monk, and renowned meditation practitioner and teacher who has spent an extraordinary number of hours of his life meditating. The brain-aging profile of this expert meditator in comparison to a control population was examined using a machine learning framework, which estimates “brain-age” from brain imaging. YMR’s brain-aging rate appeared slower than that of controls suggesting early maturation and delayed aging. At 41 years, his brain resembled that of a 33-year-old. Specific regional changes did not differentiate YMR from controls, suggesting that the brain-aging differences may arise from coordinated changes spread throughout the gray matter.     

弓形体病12例临床分析

报道弓形体病12例，其中，男女各6例，以20－30岁者为多，农民和农村学生占7例。主要症状是发热，乏力，头昏，畏寒，腹胀和纳差；主要体征有肝，脾，淋巴结肿大和下肢出血点。根据临床表现和血清免疫学检查阳性而确诊。以螺旋霉素和复方新诺明联合治疗，7天为一疗程，1－4个疗程后，11例好转或痊愈，1例死亡。有免疫缺陷或免疫务受损者以及胎儿易感染本病。急性感染的后果取决于宿主的免疫状态。     

PBL教学法在儿内科教学中的实践与探索

目的 探索新的高等医学教育的教学方式，以适应医学科学的发展及医学模式的转变。方法 在临床医学院三个大班共182名本科生的《儿内科学》教学中，开展以问题为基础的学习(PBL)教学法尝试，每班分成三个小组，在三位教师辅导下，“以问题为基础”对病例进行讨论学习，要求学生课前阅读教科书和有关参考文献。结果 PBL教学法使学生掌握有关该疾病的更多知识，并在期终考试的成绩及不定期的临床测验中得到证实。结论 PBL教学法有利于调动学生的学习积极性、主动性，有利于培养学生的自学能力和创新精神，在教与学两方面促进了教学质量的提高，受到学生和教师的普遍认可，值得进一步实践和推广。     

中医医案的特点及其价值

中医医案是中医学的宝贵财富,整理研究中医医案是发展中医学术、提高临床水平的一条重要途径。从古代医案和近现代医案、个案和类案、验案和误案、地域差异与医案特色等几个方面,从时代、数量、疗效、地域等角度对中医医案加以探讨,阐发其各自的特点及其价值,有助于认识中医医案特色,拓展医案研究思路,促进中医医案学的发展。     

案例教学法在普通外科实习医师教学中的应用

普通外科是所有外科实习科室中最重要的科室之一,如何在较短的实习时间内将普通外科常见病和多发病的诊疗知识掌握好,这是普通外科实习教学教师必须面对的问题.采用案例教学法与传统教学法进行教学效果比较研究,发现前者能明显提高普通外科实习质量.     

Microstructural Evolution and an Improved Dynamic Recrystallization Kinetic Model of a Ni-Cr-Mo Alloy in Hot Deformation

Microstructural evolution and dynamic recrystallization (DRX) behaviors of a Ni-Cr-Mo alloy were researched utilizing hot compressive experiments. The changed features of dislocation, subgrain and grain structure correlating to forming parameters were examined by transmission electron microscope (TEM) and electron backscatter diffraction (EBSD). Results illustrate that the consumption of dislocation and the coarsening of substructure/DRX grain are prominently enhanced with an increased forming temperature. However, the annihilation/interaction of dislocation and the expansion of subgrain/DRX grain boundary can be limited at a larger strain rate. Meanwhile, considering the discrepancy in DRX variation rates concerning the strain rate’s ranges, an improved DRX kinetic model was developed. Compared to the classical DRX kinetic model, the good consistency between the forecasted and tested results demonstrates that the established improved DRX kinetic model can precisely characterize the DRX features of the Ni-Cr-Mo alloy over a wide strain rate range. Additionally, the EBSD’s quantitative statistical results proved that the variation of DRX grain size can be supremely defined as the power formulation of the forming temperature and strain rate.     

Giant cervical goiter in Hashimoto’s thyroiditis: A case report

A giant cervical goiter, defined as a thyroid mass larger than 8 cm in diameter, is usually a nodular or adenomatous goiter. A giant cervical goiter can also be caused by hyperthyroidism (i.e., Hashimoto’s thyroiditis). The surgical indications for patients with Hashimoto’s disease include suspected malignant tumors, persistent symptoms related to the disease, or persistent enlargement of the goiter. We herein describe a woman who developed symptoms of compression from a thyroid tumor, the volume of which was almost the largest reported in the relevant literature to date. The bilateral lobes of the giant thyroid tumor were removed by total en bloc excision. We protected the bilateral recurrent laryngeal nerve and preserved the bilateral upper and lower parathyroid glands in situ. The excised left lobe tumor was 16 × 9 × 5.5 cm, whereas the right lobe tumor was 12 × 8 × 4 cm. The pathological diagnosis was Hashimoto’s thyroiditis. Although surgical excision is difficult, it is still the main treatment modality for giant goiters in patients with Hashimoto’s thyroiditis and can help to reduce the occurrence of complications.     

Microstructure Evolution and Deformation Mechanisms of As-Cast Antibacterial Ti6Al4V-5Cu Alloy for Isothermal Forging Process

The hot workability behavior of antibacterial Ti6Al4V-5Cu alloy was investigated using a hot compression experiment in the temperature range of 790–1040 °C and strain rate of 10⁻³–10 s⁻¹ with a strain of 0.4. The deformation behavior of the alloy was characterized by Gleeble 3800 compression experiment, and the relationship among deformed microstructures and deformation parameters was established. The deformations of Ti6Al4V-5Cu alloy were temperature and strain rate-dependent. Higher temperature and lower strain rate made power dissipation efficiency (η) increase and reach 89%. The activation energies (Q) in the dual-phase (α + β) and single β phase regions were calculated as 175.43 and 159.03 kJ mol⁻¹, respectively. In the dual (α + β) phase region, with an increase in strain rate, flow-softening behavior was dominated, however in the single β phase region such as processing at 940 °C. Flow stress increased slightly in which work-hardening behavior was dominated (especially between strain rates of 10⁻³–1 s⁻¹). The deformation at various conditions exhibited different stress-strain profiles, providing an insight that work hardening and flow softening coexisted in Ti6Al4V-5Cu alloy. The relative intensity of oscillatory change in flow stress profile decreased as the strain rate decreased. The hot workability of Ti6Al4V-5Cu alloy was also accessed from the viewpoint of the sub-grain structure.