To review the diagnosis and treatment of a case of hypercalcium crisis caused by primary hyperparathyroidism（PHPT） and prophylactic treatment of hungry bone syndrome. In a 32-year-old male with hypercalcemia, the main manifestations were loss of appetite, nausea, polyuria, polydipsia, fatigue, lethargy, etc. parathyroid hormone, serum calcium increased, thyroid function was normal, thyroid color ultrasound and MRI showed space-occupying behind the right thyroid, radionuclide examination showed abnormal imaging agent concentration in the right parathyroid area, there was a history of pathological fracture. Clinically diagnosed as hypercalcemia crisis secondary to PHPT.
Male ; Humans ; Adult ; Hypercalcemia/diagnosis* ; Hyperparathyroidism, Primary/surgery* ; Parathyroid Hormone ; Hypocalcemia/complications* ; Thyroid Gland ; Calcium

Objective:To investigate the application effect of reverse abdominal wall advancement flap in repairing chest wall soft tissue defect after breast tumor resection.Methods:From October 2020 to April 2021, the Department of Plastic Surgery and Breast Surgery of Hainan Cancer Hospital cooperated to repair the chest wall wounds of 4 female patients with unilateral giant breast tumors after primary lesion resection. Patients aged 40-63 years old, with an average of 51.5 years old. The size of the tumor estimated by physical examination was 7 cm × 6 cm-15 cm × 20 cm. The flaps were closely monitored after surgery, and complications were recorded. Local recurrence was followed-up.Results:The wound size of 4 patients after mastectomy was 16 cm×14 cm-20 cm×18 cm. Abdomen separation range reached anterior axillary line laterally and contralateral clavicle midline medially. Inferiorly, 1 case reached umbilical level, 1 case reached 2 cm below the umbilicus, and 2 cases reached 3 cm below the umbilicus. Three cases were diagnosed as breast lobulated tumors, and 1 case invasive lobular carcinoma. Among the 4 cases, 3 flaps survived completely and healed by first intention, while another flap healed under blister scab. There was no necrosis, infection, hematoma, seroma, or vascular crisis of the flap. All patients were satisfied. Three patients received radiotherapy and one received radiotherapy combined with oral chemotherapy. All patients were followed up for 3-6 months. No local recurrence was discovered. The abdomen was tighter than before operation, but no stiffness was found. There was no abdominal pain, abdominal wall bulging or abdominal hernia.Conclusions:Reverse abdominal wall advancedment flap was used to repair soft tissue defect of the chest wall after breast tumor resection. The operation was simple and fast, with no need for additional donor site incision. Quick recovery allowed shorter interval between surgery and next scheduled treatments.

Objective:To investigate the application effect of reverse abdominal wall advancement flap in repairing chest wall soft tissue defect after breast tumor resection.Methods:From October 2020 to April 2021, the Department of Plastic Surgery and Breast Surgery of Hainan Cancer Hospital cooperated to repair the chest wall wounds of 4 female patients with unilateral giant breast tumors after primary lesion resection. Patients aged 40-63 years old, with an average of 51.5 years old. The size of the tumor estimated by physical examination was 7 cm × 6 cm-15 cm × 20 cm. The flaps were closely monitored after surgery, and complications were recorded. Local recurrence was followed-up.Results:The wound size of 4 patients after mastectomy was 16 cm×14 cm-20 cm×18 cm. Abdomen separation range reached anterior axillary line laterally and contralateral clavicle midline medially. Inferiorly, 1 case reached umbilical level, 1 case reached 2 cm below the umbilicus, and 2 cases reached 3 cm below the umbilicus. Three cases were diagnosed as breast lobulated tumors, and 1 case invasive lobular carcinoma. Among the 4 cases, 3 flaps survived completely and healed by first intention, while another flap healed under blister scab. There was no necrosis, infection, hematoma, seroma, or vascular crisis of the flap. All patients were satisfied. Three patients received radiotherapy and one received radiotherapy combined with oral chemotherapy. All patients were followed up for 3-6 months. No local recurrence was discovered. The abdomen was tighter than before operation, but no stiffness was found. There was no abdominal pain, abdominal wall bulging or abdominal hernia.Conclusions:Reverse abdominal wall advancedment flap was used to repair soft tissue defect of the chest wall after breast tumor resection. The operation was simple and fast, with no need for additional donor site incision. Quick recovery allowed shorter interval between surgery and next scheduled treatments.

Objective To discuss the clinicopathological features and prognostic factors of patients with triple negative breast cancer (TNBC) in Shanxi province. Methods The medical records of 958 female TNBC patients who were admitted to Shanxi Provincial Cancer Hospital and the First Hospital of Shanxi Medical University from January 2005 to December 2015 were retrospectively analyzed. The clinicopathological features and prognostic factors were summarized. Results The median age of TNBC patients in Shanxi province was 46 years old (21-87 years old), the median body mass index (BMI) was 24.42 kg/m2 (15.0-37.5 kg/m2), and the rural population was slightly more. The left breast cancer was more than the right breast cancer, and 492 patients (51.4％) were in stage T2. The main histological type was invasive ductal carcinoma. The main surgical method was modified radical mastectomy. Univariate Cox regression analysis showed that the patient's place of residence, fertility status, age at first birth, breastfeeding history, tumor size, American Joint Committee on Cancer Staging, lymph node metastasis, and surgical approach were associated with the risk of death in TNBC patients (all P<0.05);but the BMI, menstrual status, menarche age, and family history were not associated with the risk of death (all P>0.05). Multivariate Cox regression analysis showed that rural residents (HR= 1.46, P= 0.044), positive lymph node metastasis (HR= 2.51, P< 0.01), non-fertility (HR=1.08, P= 0.009) and no surgery (HR= 2.53, P= 0.004) were independent risk factors affecting the risk of death, a history of breastfeeding was a protective factor affecting the risk of death in TNBC patients (HR=0.44, P=0.013). Conclusions In Shanxi province, TNBC is more common in premenopausal women and the main pathological type is invasive ductal carcinoma. Rural population, lymph node positive, non-fertility, and no surgical treatment are independent risk factors for the prognosis of TNBC patients.

Objective To explore how to apply the teaching mode combined flipped class with PBL teaching method to improve college students' ability of English reading and writing and the effectiveness of classroom. Methods In the class of college English reading and writing, students at grade 2015 were randomly divided into two groups. The experimental group (43 students) was adopted the class teaching with " flipped class and PBL teaching method"and the control group (43 students) was adopted traditional class teaching mode taught by the same teacher. The teaching effects of two groups were studied in a comparative way. The students' final grade, related data in the learning process, students'view of the two teaching modes are studied by analysis of basic data and questionnaire. Results At the end of the semester, the results of the experimental group are better than those of the control group. In the survey of the two class teaching modes, the students in the experimental group spent more time in the learning process than that of the control group.Students think that the teaching mode combined flipped class and PBL teaching method not only improves their autonomic learning ability, classroom participation, the English reading and writing ability, but also helps them perform better in the average scores in the final exam compared to the traditional classroom. Students are more satisfied with the new classroom teaching mode than with traditional one. Conclusion The teaching mode combined flipped class with PBL teaching method can promote the students'autonomous learning, contribute to absorb and internalize knowledge, improve the students'learning interest and learning efficiency, and improve teachers teaching ability.

Objective To quantitatively estimate the range and area of environmental contamination by the feces of Schistoso?ma japonicum?infected that were freely grazed,so as to provide the theoretical evidence for the scientific assessment of the role of the freely grazed goat in the transmission of schistosomiasis japonica and development of control strategy. Methods All the fecal samples excreted by the infected goat at daytime(12 h)were collected by using a self?made goat fecal collector,weighed and counted. The quantity and dispersal of the feces excreted by the freely grazed goat at daytime under a natural condition were investigated,and the walking route and speed of the freely grazed goat at daytime were recorded with a multifunction GPS data logger. The maximum range and area of the environment contaminated by the feces of the freely grazed goat at daytime were esti?mated,and the maximum range and area of the Oncomelania hupensis snails that may be infected by the schistosome miracidium released from the eggs in the fecal samples of the freely graze goat at daytime were calculated. Results During the walking along the marshland at daytime(12 h),the quantity of the feces execrated by the freely grazed infected goat was(232.8 ± 39.8) g per goat,and the fecal samples were composed of(819.2 ± 152.1)pellets. The goat had a mean walking speed of(0.522 7 ± 0.099 7)km/h,and the longest distance,largest radius and largest range of walking activity were(6.272 4 ± 1.195 8)km, 3.136 2 km and(3 191.113 0 ± 1 189.709 4)hm2at daytime,respectively. The area of the snails that may be infected by the mi?racidium released from the eggs in the fecal samples of the freely graze goat(range of key regions for infected snails detection and control)at daytime was estimated to be(3 210.717 5 ± 1 190.907 3)hm2. Conclusions The intensity of environmental contamination by the eggs in the fecal samples of the freely grazed goat is linked to the number of infected goat. The contamina?tion range caused by the feces of the freely grazed goat with fixed fences is relatively stably kept within the walking range at day?time,and the range and area of goat fecal contamination is associated with the number of households that breed goat and the dis?tribution of goat fence. The area of the snails that may be infected by the miracidium released from the eggs in the fecal samples of the freely graze goat is larger than the area of setting contaminated by the eggs in the goat feces ,indicating that the range of in?fected snail examination and control is larger than the range of goat feces detected.

This review describes the major species,number,breeding pattern,ratio of fenced to freely grazed goat,suscepti?bility to Schistosoma japonicum,pattern of S. japonicum infection,infection rate,intensity of infection,fecal contamination of goat that were bred in 5 marshland and lake provinces of Hunan,Hubei,Jiangxi,Anhui and Jiangsu,and two mountainous provinces of Yunnan and Sichuan,and demonstrates the associations of infected goat distribution with the distribution of infect?ed Oncomelania hupensis snails and humans. Considering the huge number of goat which were predominantly grazed freely in marshland and lake endemic regions of China,the high infection rate,numerous environmental pollution by goat feces,as well as the close correlation between the infected goat distribution and infected snail distribution,goat is considered as a major infec?tious source for schistosomiasis japonica in China,and to play a critical role in the transmission of the disease. Since the control of schistosomiasis in animals is critical to schistosomiasis interruption and elimination,it is suggested that the integrated man?agement of goat schistosomiasis should be included in the national schistosomiasis control program of China.

There has always been no lack of discussion on Biaoben and Genjie theory in traditional Chinese medical acupuncture circles, but many questions still exist. This article expounds the original meaning of Biaoben and Genjie, traces the origin of the theory and sorts out the questions in Biaoben and Genjie theory, e.g. the difference in the position between Biaoben and Genjie, no record of the location of Genjie of six hand meridians, regularities in meridional qi circulation, understanding and valuing, and application and development to confirm the importance of Biaoben and Genjie theory and to give reference.

Objective To investigate the survival of Schistosoma japonicum eggs in goat feces in natural marshlands and the factors affecting its survival,so as to provide evidences for understanding of the role of eggs in goat feces in the transmission of schistosomiasis and the development of the interventions pertaining to disease control and elimination. Methods The goat ani?mals of schistosomiasis japonica were modeled in laboratory,and the feces of infected goat were collected. In laboratory,the ef?fects of environmental temperature and water content in goat feces on egg hatching were evaluated,and in the field,the effect of duration of goat feces on marshland on egg hatching and the effect of direct sunshine on egg survival were evaluated. Results At 25℃in laboratory,the hatching rate of eggs in goat feces was high?positively correlated with the water content in goat feces (r=0.87). If the water content reduced to 7.6%in goat feces,the eggs in goat feces lost the ability to hatch. Under the same wa?ter content in goat feces,the hatching rate of eggs gradually decreased with the extension of the duration of exposure of goat feces to-5℃,which reduced to 0 following 5 h exposure. At 5,15 and 25℃,the hatching rates of eggs gradually decreased with the extension of the duration of exposure of goat feces,and the miracidium hatching rates of eggs were 2.3%,5%and 0.9%respec?tively following the exposure for 52 d. At 35℃,the hatching rate of eggs gradually decreased with the extension of the duration of exposure,which reduced to 0 following 13 d exposure. In winter(-2?10℃),the hatching rate of eggs gradually decreased with the extension of the duration of exposure of goat feces on marshlands,which reduced to 0 after 21 d of exposure,and in spring(16?19℃),the hatching rate of eggs gradually decreased with the extension of the duration of exposure of goat feces on marshlands,which reduced to 0.9%after 5 d of exposure. At the same time point on the same marshland,the hatching rate of eggs in goat feces exposed to marshlands with direct sunshine was lower than that without direct sunshine. Conclusion The sur?vival of S. japonicum eggs in goat feces is associated with environmental temperature and water content(humidity)in goat feces, and the temperature and humidity are major natural factors affecting egg hatching.

Objective To develop a simple,feasible goat feces collector to improve the collection accuracy and integrity of goat fecal samples without pollution,and to modify the miracidium hatching test with a plastic tube to achieve simple,standard and comparative procedures,so as to provide technical support for pathogenic diagnosis and scientific research of goat schistoso?miasis japonica. Methods According to the body features of goat in marshland regions,a goat fecal collector,which was made of coarse fabric cottons,was devised,which was able to be fixed onto the goat buttocks and avoid urine pollution. Prior to mira?cidium hatching test,the goat fecal samples were pieced by using a mechanical method instead of the conventional artificial piec? ing method,and the effect of mechanical piecing treatment on miracidium hatching was evaluated. A filter membrane was added between the tube and rubbery ring to block the floater in fecal residues into the tube. The effects on miracidium hatching by us?ing thin fat?free cotton,thick fat?free cotton,nylon gauze at 100 pores/25.4 mm2 and 150 pores/25.4 mm2 were compared. Re?sults The goat feces collector was composed of foreleg fixing garment,hindleg fixing garment and stool bag. The functions of the fixing garment were as a fixed collector to allow non?shift and tolerance of weight during goat activity ,while the major func?tion of stool bag was in storage of stool. The goat activity was not influenced by the use of collector ,and all fecal samples were ex?creted to the bag. This collector was easy to perform and could avoid urine pollution,which was reusable after cleaning. Prior to miracidium hatching,the goat fecal samples,together with water,were pieced at 18 000 to 23 000 r/min for successive three times in a cooking machine,of 10 s each time at an interval of 5 s. Mechanical piecing had no clear?cut effect on miracidium hatching of eggs in fecal samples. A total of 541,620,344 and 211 miracidia were detected by using the miracidium hatching test with nylon gauze at 100 pores/25.4 mm2 and 150 pores/25.4 mm2,thin fat?free cotton and thick fat?free cotton respectively, indicating a better detection efficacy by using nylon gauze at 100 pores/25.4 mm2 and 150 pores/25.4 mm2. Conclusions The goat fecal collector is an easy?to?perform,accurate,unpolluted and reusable device to collect goat feces,which is suitable for pathogenic diagnosis of goat schistosomiasis. Mechanical piecing and use of nylon gauze at 150 pores/25.4 mm2 allow a simple, accurate and stable technique for parasitological diagnosis of schistosomiasis japonica,which provides a reliable tool for schisto?somiasis control and research.