A Case of Waldenström’s Macroglobulinemia Complained of Anorexia

It has been reported that an 82-year-old man had complained of “anorexia with wasting away (weight loss of 35 pounds) over the past six months”. The cause was unknown, and his appetite dropped to only liquid milk and soy milk every day. On further examination, his CA-199 (a tumor marker) was in the normal range, but the serum IgM level was found to be 4 times higher than normal, and lymphoplasmacytic cells in his bone marrow were 2 times higher than normal. His myeloid differentiation factor (MYD88) was detected to be positive in gene mutations, confirming a diagnosis of “Waldenström’s macroglobulinemia” (WM) complicated with “Bing-Neel syndrome” (BNS); as a result, the anorexia was attributed to it, and the symptomatic treatment with Traditional Chinese Medicine (TCM) was proposed to improve his condition

Re-conceptualization of the “Chinese Expert Guidelines for the Prevention of Stroke Associated with Patent Foramen Ovale” for the Management of Perioperative Stroke in Patients with Lung Cancer

The Chinese Heart Journal published the “Chinese Expert Guidelines for the Prevention of Stroke Associated with Patent Foramen Ovale” (hereafter referred to as “the Guidelines”) in 2021. The Guidelines were initiated by Professor Yushun Zhang of the No.1 Affiliated Hospital of Xi’an Jiaotong University, and 55 domestic experts participated in their discussion and formulation. The Guidelines focus on eight key issues in the prevention of stroke associated with patent foramen ovale (PFO), including definition and epidemiology, anatomical features, ultrasound diagnosis, clinical screening, and prevention and treatment of PFO-associated stroke. The prevention and treatment of PFO-associated stroke include pharmacological prevention, prevention of PFO with transcatheter occlusion and transcatheter occlusion of PFO. Patients with PFO are at elevated risk of perioperative stroke. In China, lung cancer ranks first in incidence among malignant tumors. The number of lung cancer surgeries is increasing each year, and the incidence of PFO in the population is approximately 25%. Although perioperative stroke in patients with lung cancer due to the presence of PFO has rarely been reported, given the high disability rate of stroke, incidence of PFO, and incidence of lung cancer, herein, we consider the Guidelines for the management of perioperative stroke in lung cancer. Our aim is to provide further perspectives in decreasing the risk of perioperative stroke in patients with lung cancer and PFO, to improve their quality of life and increase the safety of surgery

Effect of Detail Nursing Intervention on Headache and Negative Emotion in Patients with Subarachnoid Hemorrhage

objective: to explore the effect of detail nursing intervention on headache and negative emotion in patients with subarachnoid hemorrhage. Methods: the clinical data of 100 cases of subarachnoid hemorrhage from January 2015 to January 2017 of neurosurgery in our hospital were randomly divided into the control group and the experimental group, Detail nursing intervention inexperimental group, Comparison of two groups of clinical nursing effects. Results the duration of hospitalization and headache in the experimental group were shorter than those in the control group. Fewer headaches than control group (P<0.05) Less headache than control group (p<0.05). Results: the results of SAS and SDS scores were signifcantly lower than those in the control group (p<0.05) after nursing in the experimental group. Conclusion: the patients with subarachnoid hemorrhage receive detailed nursing intervention;contribute to the alleviation of their headache symptoms, Relieves the patient of negative emotional problem

Assessment of Agricultural Best Management Practices Using Models: Current Issues and Future Perspectives

Best management practices (BMPs) are the most effective and practicable means to control nonpoint source (NPS) pollution at desired levels. Models are valuable tools to assess their effectiveness. Watershed managers need to choose appropriate and effective modelling methods for a given set of conditions. This paper considered state-of-the-art modelling strategies for the assessment of agricultural BMPs. Typical watershed models and specific models were analyzed in detail. Further improvements, including simplified tools, model integration, and incorporation of climate change and uncertainty analysis were also explored. This paper indicated that modelling methods are strictly scale dependent, both spatially and temporally. Despite current achievements, there is still room for future research, such as broadening the range of the pollutants considered, introducing more local BMPs, improving the representation of the functionality of BMPs, and gathering monitoring date for validation of modelled results. There is also a trend towards agricultural decision support systems (DSSs) for assessing agricultural BMPs, in which models of different scales are seamlessly integrated to bridge the scale and data gaps. This review will assist readers in model selection and development, especially those readers concerned about NPS pollution and water quality control

A topography analysis incorporated optimization method for the selection and placement of best management practices.

Best Management Practices (BMPs) are one of the most effective methods to control nonpoint source (NPS) pollution at a watershed scale. In this paper, the use of a topography analysis incorporated optimization method (TAIOM) was proposed, which integrates topography analysis with cost-effective optimization. The surface status, slope and the type of land use were evaluated as inputs for the optimization engine. A genetic algorithm program was coded to obtain the final optimization. The TAIOM was validated in conjunction with the Soil and Water Assessment Tool (SWAT) in the Yulin watershed in Southwestern China. The results showed that the TAIOM was more cost-effective than traditional optimization methods. The distribution of selected BMPs throughout landscapes comprising relatively flat plains and gentle slopes, suggests the need for a more operationally effective scheme, such as the TAIOM, to determine the practicability of BMPs before widespread adoption. The TAIOM developed in this study can easily be extended to other watersheds to help decision makers control NPS pollution