SOAP笔记生成器

二、整理Vue.js的学习笔记，要求如下：

• 按照“内置指令”、“组件”、“路由”、“状态管理”、“UI插件”等内容进行笔记的整理。

• 笔记要求详略得当，并辅以代码示例。

• 学习Vue.js3.0组合式API，并整理好笔记。

發燒38度，咳嗽，流鼻水

患者姓名：陳冠宇 出生日期：1998/03/30 年齡性別：26/M 病歷號碼：9044649  Chief Complaint: I went to local dental clinic for a checkup and was diagnosed with cyst over right jaw. I was referred to TSGH OS OPD for further evaluation  Present Illness: The patient, a 26-year-old male, native Taiwanese, went to local dental clinic for a checkup and was diagnosed with cyst over right jaw. He was then referred to TSGH OS OPD for further evaluation. After physical and imaging examinations, cyst of right mandible (suspect OKC) and deep caries/periodontitis of 46 was noted. Therefore, he was arranged admission for surgical treatment.  Past History: Systemic disease: HTN (denied); DM (denied); heart disease (denied); HBV (denied); HCV (denied); GU (denied); DU (denied); TB (denied); COPD (denied); CVA (denied); asthma (denied)  Operation History (or Trauma): None of this kind of history.  Personal History: Occupational history: pet shop Alcoholic drinking: denied Betel nut chewing: denied Cigarette smoking: 2 cigarettes per day for 2 years Allergy: NKA Traveling history: no traveling history within 3 months Marital Status: married Education: University  Family History: As family pedigree.  Allergy History: No history of allergy.  Drug Resistance: No history of drug resistance.  Psychological Assessment: 生理：右側下顎牙齦腫痛 心理：配合治療 家庭：家庭健全 靈性：無特殊信仰，生活舒適  Review of Systems: General: no weight change, no fever, no chills Skin: no hair nail change, no rash, no itching Head: slight asymmetric appearance due to local swelling, no trauma Eyes: have vision glasses, no blurring, no diplopia, no scotomata Ears: no hearing loss, no tinnitus, no vertigo Nose: no epistaxis, no obstruction, no postnasal drip Mouth: no mouth opening limitation Pulmonary. no wheezing, no sputum, no chest pain Breast: no mass, no discharge, no pain Cardiovascular: no orthopnea, no cyanosis, no palpitation Gastrointestinal: no vomiting, no abdominal pain, no jaundice, no bleeding Genitourinary: no dysuria, no incontinence Sexual history: no sore discharge Endocrine: no heat intolerance, no cold intolerance Bone, joint, muscle: no pain, no cramps Blood, lymphatic: no bruising, no lymph node enlargement Neurologic: normal sensation, speech clear  Physical Examinations: 2024-06-29 22:5 血壓：137/96mmHg 耳溫：36.2℃ 脈搏：87次/分 呼吸18次/分 2024-06-29 22:43 昏迷指標：E4V5M6 2024-06-29 22:43 昏述指標：EAVSM5 BH: 169 cm BW: 62 kg  OS Findings: Extraoral findings: normal Intraoral findings: cyst over right jaw (suspect OKC), about 2.3 cm in diameter. Gingival redness and swelling over lower right posterior region was noted.  X-Ray Data: PANO findings:

• Missing of 11 18 21 28 37 47

• Previous RCT: 22 46

• Prosthesis: nil

• Cyst over right jaw (suspect OKC), about 2.3 cm in diameter  Impression: Cyst of right mandible, suspected odontogenic keratocyst. Deep caries of 46 with periodontitis and odontogenic infection  Diagnostic Plans: Collect B/R, E-8, electrolytes examinations and serology tests Chest X-ray (P-A view) Panoramic radiographic examination Arrange CNCT to check condition of cyst  Therapeutic Plans: Pain control and control the inflammatory conditions with medication. Full mouth scaling with ultrasonic device. Arrange surgical intervention of teeth extraction, debridement and cyst enucleation under general anesthesia to reduce the risk of infection.  Educational Plans: Explained the current conditions and treatment plan to the patient and family. Well explained to the patient and patient's family about the surgery procedure. Oral hygiene instructions. Post operative care.

Odontogenic Keratocyst (OKC): 好發族群與部位：10-40歲女性的下顎後牙區 成因：源於dental lamina；與PTCH基因有關 症狀：較大成長能力且增生速度快，顎骨中以前後的方向生長；針抽吸有棕色cheesy material或黃綠色澄清液（keratin） 影像學：邊界清楚的multilocular RL包裹一顆阻生齒，使原始位置缺牙 病理組織學：與primordial cyst相同 未發炎 Rete pegs消失，有薄（6-8層）、均勻厚度的lining epi.；最靠近cavity的細胞有parakeratin且呈波浪狀；有立方或柱狀的basal cell呈柵狀排列；cyst wall中有小的cyst稱daughter cyst 發炎

上皮parakeratin消失，且變厚形成rete ridge；basal cell的柵狀排列消失

預後：易復發（30％） 相關syndrome： Nevoid basal cell carcinoma syndrome (= basal cell nevus syndrome = Gorlin syndrome) 成因：9th 體染色體顯性遺傳，PTCH基因異常 症狀：

• 顎骨中多發odontogenic keratocyst (OKC)

• 大腦鐮鈣化

• 神經疾病，如胼胝體發育不全

• 基底細胞癌

• 眼距變大

• 皮膚上皮囊腫

• 手、腳掌小凹窩

• 女性卵巢腫瘤

• 脊柱彎曲、肋骨分叉 診斷：有5個major criteria，分別為多發性OKC、大腦鐮鈣化、B.C.C.、手、腳掌小凹窩與一等親友N.B.C.C. syndrome

Chapter 9: Homeostasis

Subtopic 9.1: Concept of Homeostasis

• Homeostasis: The maintenance of a stable internal environment within a tolerable range.

• It is a dynamic process, meaning conditions fluctuate within narrow limits.

• Regulated by negative feedback loops (most common) and positive feedback loops (less frequent).

• Components of homeostasis: Stimulus, Receptor, Control Center, Effector.

Mechanism Involved in Homeostasis

• Negative Feedback Mechanism:

  • Corrects deviations from the set point.

  • Example: Regulation of body temperature and blood glucose level.

• Positive Feedback Mechanism:

  • Enhances or amplifies changes in the same direction until an endpoint is reached.

  • Example: Childbirth contractions, blood clotting.

Subtopic 9.2: Negative Feedback Mechanism in Blood Glucose Regulation

• Increase in Blood Glucose Level:

  • Receptor: Beta (β) cells of Islets of Langerhans in the pancreas.

  • Control Center: Pancreas, which releases insulin.

  • Effector: Liver and muscle cells store glucose as glycogen.

  • Result: Blood glucose level decreases to normal.

• Decrease in Blood Glucose Level:

  • Receptor: Alpha (α) cells of Islets of Langerhans in the pancreas.

  • Control Center: Pancreas, which releases glucagon.

  • Effector: Liver converts glycogen to glucose.

  • Result: Blood glucose level increases to normal.

Subtopic 9.3: Human Homeostatic Organ - Kidney

Structure of Nephron

• Glomerulus: A cluster of blood capillaries for ultrafiltration.

• Bowman’s Capsule: Surrounds the glomerulus; collects the filtrate.

• Proximal Convoluted Tubule: Reabsorbs useful substances.

• Loop of Henle: Creates a concentration gradient for water reabsorption.

• Distal Convoluted Tubule: Further reabsorption and secretion; regulated by hormones.

• Collecting Duct: Final concentration of urine before it enters the ureter.

Processes in Urine Formation

• Ultrafiltration:

  • Occurs in the glomerulus and Bowman’s capsule.

  • High hydrostatic pressure forces small molecules (glucose, ions, water, urea) into the filtrate.

• Reabsorption:

  • Occurs in the proximal tubule, Loop of Henle, distal tubule, and collecting duct.

  • Useful substances (glucose, ions, water) are reabsorbed into blood.

  • Loop of Henle functions as a counter-current multiplier to create a high salt concentration in the medulla.

• Secretion:

  • Occurs in proximal and distal convoluted tubules.

  • Removal of unwanted substances (H+, NH3, K+, drugs) into the filtrate.

Regulation of Blood Water Content (Role of ADH)

• Dehydration (High Blood Osmotic Pressure):

  • Detected by osmoreceptors in the hypothalamus.

  • Posterior pituitary gland releases ADH.

  • Effect: Increased water permeability in the distal tubule and collecting duct → More water reabsorbed → Small volume of concentrated urine.

• Excess Water Intake (Low Blood Osmotic Pressure):

  • Detected by osmoreceptors in the hypothalamus.

  • Inhibition of ADH release.

  • Effect: Reduced water permeability → Less water reabsorbed → Large volume of dilute urine.

Homeostatic Imbalance and Disease

• Diabetes Mellitus: Failure in blood glucose regulation.

• Diabetes Insipidus: Failure in ADH production or kidney response to ADH.

• Aging: Reduces efficiency of homeostatic mechanisms, making elderly more susceptible to diseases (e.g., heat stroke due to impaired thermoregulation).