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简介：Splenicmetastasisisgenerallynotacommonclinicalevent.However,metastasistothespleenfromadrenalpheochromocytomaisextremelyrareandhasnotbeenreportedinliterature.Thisreportpresentsacaseofa58year-oldmalepatientwhodevelopedspleen-onlymetastasesinJuly2007.ThepatienthadaprevioushistoryofleftepinephroectomyforadrenalpheochromocytomainJanuary2003.Abdominalcomputedtomographydemonstratedmultipleenhancinglesionssuggestiveofmetastases;thussplenectomywasperformed.Pathologicalexaminationsconfirmedthediagnosisofsplenicmetastasesfrompheochromocytoma.Thepatientwasalivewithoutrecurrence48monthsaftersplenectomy.Thisstudyisthefirstreportonsplenicmetastasisfrompreviousadrenalpheochromocytoma,andlong-termsurvivalwasachievedbysplenectomy.Ahistoryofmalignancyindicatesahighindexofsuspicionforsplenicmetastasis,andlong-termsurvivalcanbeachievedbysplenectomyforspleen-onlymetastasis.

简介：Autoimmunehepatitis(AIH)hasrarelybeendescribedasanautoimmuneparaneoplasticsyndromeofthymoma.ThiscaseistheseventhcaseofAIHrevealedbycholestasisfewyearsafterthediagnosisofthymomaandthefirstcasetreatedwithchemotherapyalone.Wereportinthispaperanewapproachtothisrareseverecondition.A29year-oldmanpresentedwithchestpainanddyspneawithahistoryofthymomasurgicallyremoved4yearsago.CTscanshowedtherecurrenceofananteriormediastinalmass.Biologyshowedelevatedliverenzymesandprofoundcholestasis.Nosignofviralortoxichepatitisorbileductabnormalitieswereobserved.Autoimmuneantibodies,exceptfortheanti-nuclearantibody,werenegative.LiverbiopsyshowedactivechronicAIH.ThepatientwasdiagnosedwithrecurrentthymomawithAIHandunderwent6cyclesofchemotherapy.Acompleteresponseonthymomaandcholestasiswasobtainedafter10monthsoffollow-up.SteroidsandimmunosuppressorsarethestandardtreatmentforAIH.Theeffectofchemotherapyasaspecifictreatmentofthisparaneoplasticsyndromeneedstobeconsidered.

简介：Gingivaladenoidcysticcarcinoma(ACC)isararemalignancy.Wedescribethediagnosisandtreatmentofa43year-oldwomanwhopresentedwithapersistentoralulcerforapproximately1year,andsubsequentpainintheleftposteriormaxillaryregion.Clinicalexaminationrevealedanulcerintheleftuppermolargingiva,withswellingintheregionfromthesecondpremolartothethirdmolar.X-rayimagesdemonstratedtheinvolvementofthemaxillaryalveolarbone.ThehistopathologicalandimmunohistochemicalfeatureswerediagnosticofACC.ACCisoftenpresentedasagingivallesion;thus,itmayeasilybeneglectedbypatients.Theidentificationofthistumorusingspecificpathologicalanalysespreventsmisdiagnosisandenablesclinicianstodeterminetheappropriatetreatment.Inthiscase,norecurrenceordistantmetastasiswasobservedafter2yearsoffollow-up.

简介：IntroductionSuddensensorineuralhearingloss(SSNHL)isdefinedasahearinglossofatleast30dBoverthreecontiguousfrequenciesoccurringinlessthan3days[1].VertigoandprofoundhearinglossareconsideredpoorprognosticfactorsinSSNHL[2-4].ThemostcommondiseasesassociatedwithvertigoinSSNHLincludeBPPV,vestibularneu-[3]

简介：Inthecrucialperiodofbuildingamoderatelyprosperoussocietyanddeepeningreformandopeningup,andofacceleratingthetransformationofeconomicdevelopment,the18thNationalCongressoftheCommunistPartyofChina,whichwasheldinNovember2012,madecomprehensivearrangementsfortheundertakingsofboththePartyandtheState,furtherclarifiedthegoalsandgrandblueprintforfuturedevelopmentinthenextperiod,andleftanimportantandfarreachingimpactonthedevelopment

简介：Non-parasitichepaticcystswithbiliarycommunicationarerare.Theclinicalsymptomsinvolvedarenotspecifictothiscondition,therebymakingdiagnosisdifficultandtreatmentcontroversial.Here,wereportacaseof70-year-oldwomancomplainingofabdominalsatiety,combinedwithnon-specificpainintherightupperquadrant.Theabdominalcontrast-enhancedMRI-scanrevealedalargeandthick-walledseptuscysticlesionintheliver.Duringoperation,thebiliaryfistulawasconfirmedinthecystcavity.Asilicageltubewasinsertedviathecysticductforcholangiography,whichdemonstratedcommunicationbetweenthecystandbiliarytract.Weperformedwide-scalecystwallresection;thebiliaryfistulawascompletelyrepairedbytheclosureofcommunicatedbileducts.Thepostoperativecoursewasuneventful,andthepatientwasdischargedwithnosignofcholangitisoranyothersymptoms.Thenovelsurgicalmanagementviawideresectionofthecystwallandclosureofbiliarycommunicationprovedtobeanadequateandeffectiveprocedurefortreatingnonparasitichepaticcystswithbiliarycommunication.

简介：Extrapulmonarysmallcellcarcinoma(EPSCC)isarareneoplasmcomprising2.5%to5%ofsmallcellcarcinomas(SCCs).BladderSCCisthemostcommonsiteofgenitourinarytract.PrimaryrenalSCCisextremelyrare.WereportacaseofprimarySCCofthekidneywhichisrarelyreportedintheurinarytractandpresentsanaggressiveclinicalpicture.A59-year-oldfemalevisitedaurologicclinicwithcomplaintofpersistentleftflanksoreness10yearsafterundergoingrenaltransplantation.Abdominalcomputedtomographyshowedaleftrenalpelvistumor.Afterthepatientreceivedleftnephroureterectomywithbladdercuffresection,herpathologyresultsshowedSCC.Aftersurgery,shereceivedadjuvantsystemicchemotherapy,andherrecoveryhasbeenuneventfulasof8months.PrimaryrenalSCCpresentswithanadvancedtumorstageandashortmediansurvivalperiod,thereforeearlyinterventionandclosefollow-uparerecommended.

简介：Metastasisoflungcancertothetemporalboneisaveryrarediseaseandsubjectivetinnitusasthepresent-ingsymptominthesepatientsisevenrarer.Herewereportacaseinwhicha42-year-oldmalepresentedwithsubjectivetinnitusofthreemonths,withnopulmonarydiseasesymptoms.Puretoneaudiometryindi-catedmoderateconductivedeafnessinleftearwithanair-bonegapof21.3dB.HRCTtemporalbonescan-ningindicatedhigh-densityshadowsintheleftepitympaniccavity,sinustympaniandmastoidcavity.Chron-icotitismediawithcholesteatomawassuspectedandsurgicaltreatmentrecommended.However,preopera-tivechestx-rayrevealedhigh-densitymilletlesionsscatteredwidelyinbothlungs.HRCTlungscanningconfirmedthelungslesionsandindicatedlungcancer.Inordertodeterminecorrelationsbetweenthetempo-ralboneandpulmonarylesions,aCT-guidedtrans-mastoidaspirationbiopsyandimmunohistochemicalstudywereconducted,whichconfirmedthatthetemporalbonelesionwasmetastaticfromthelungs.Thepa-tientwasgivenaseriesofchemotherapyimmediatelyandhistinnitussignificantlyimprovedafterthreemonthsoftreatment,withfullrecoveryofhishearingandcompleteresolutionofshadowsinthemastoidcavity.Unfortunately,hesubsequentlydevelopedmultiplebonemetastasesinthe9thmonthandcerebralmetastasisinthe18thmonth.Multipleorganfailureresultedindeathin2.5years.

简介：TheResearchReportonYoungGirlProtectionjointlyissuedbyChinaChildrenandTeenagers’FundandBeijingNormalUniversityinBeijingonSeptember13,2013statesthatthedirectcauseforharmsdonetoyounggirlsisthelackofbasicsupervision.Ms.ChenXiaoxia,Secretary-GeneralofChinaChildrenandTeenagers’Fundsaidduringtheintroductionofthe

简介：Objective:Thisworkaimedtostudythesafetyandefficacyofpreoperativeintestinalstentdecompressioncombinedwithlaparoscopicsurgerytotreatleft-sidedcolorectalcancerwithobstruction(LCCO).Methods:Retrospectiveanalysiswasconductedondataobtainedfrom21LCCOpatientsadmittedtoTheFirstAffiliatedHospitalofZhejiangChineseMedicineUniversityduringMarch2008andDecember2011.Toremovetheintestinalobstruction,preoperativeintestinalstentplacementundercolonoscopicguidancewasperformed.Approximately7to10daysaftertheoperation,laparoscopicradicalsurgeryofcolorectalcancerwasconducted.Results:Amongthe21casesstudied,laparoscopicsurgerywassuccessfulin20patients.Emergentlaparotomywasconductedinonepatientbecauseoftumorinvasionintheureter.Thedurationoftheoperationrangedfrom180to320min,andtheaveragetimewas220min.Therecoverytimeforbowelfunctionrangedfrom2to5dayswithanaveragetimeof3days.Postoperativeinfectionoftheincisionoccurredinonecase.Noanastomoticleakagewasobservedinanyofthecases.Conclusion:Preoperativeintestinalstentdecompression,combinedwithprimarystagelaparoscopicsurgery,isasafeandeffectivemethodforthetreatmentofLCCO.

简介：“有效课堂”“高效课堂”是我们孜孜以求的目标。在英语教学中实施Danyreport是实现英语课堂教学有效性的重要载体之一，它可以让学生的英语学习状态发生根本性的改变。Dailyreport对学生英语口语表达能力、听力和写作等语言综合运用能力的培养具有很大的作用。实践证明，Dailyreport不只是一种课前“热身”，更重要的是能有效激发学生英语学习的兴趣，给每个学生一个表演的舞台，让他们充分展示自我的风采，使英语课堂因“此”亮起来。