Neurofibromatosis type 2 (NF2) is a dominantly inherited genetic condition. Bilateral vestibular schwannoma, which are benign tumors, composed of neoplastic Schwann cells that arise from the eighth cranial nerve, are the hallmark of NF2. Standard approaches for treatment of growing vestibular schwannoma include observation, surgical removal and radiation therapy. Molecular targeted therapies also present great prosperity in recent years. In this review, we summarize the latest progresses on the treatment of NF2-associated vestibular schwannoma.
Humans ; Molecular Targeted Therapy ; Neurofibromatosis 2 ; radiotherapy ; surgery ; therapy ; Neuroma, Acoustic ; radiotherapy ; surgery ; therapy

A random sample survey was conducted in 17 community medical institutes in 4 districts in Beijing.Among an effective sample of 385 residents.47.5％ (n =183)of community residents chose community medical institutes for first contact care while 52.5％ (n =202) opted for class other hospitals.Residents with lower education levels tended to choose community medical institutes (P =0.01).And those with chronic diseases preferred to choose communities (P=0.00).

Objective To explore the effects of salmeterol/fluticasone propionate complicated or combined with N-acetylcysteine on the pulmonary function and arterial blood gas analysis of the patients with chronic obstructive pulmonary disease (COPD), and to evaluate its curative effect.Methods 84 cases of COPD patients were randomly divided into combination treatment group (n=44)and simple treatment group (n=40).The patients in combination treatment group were treated with salmeterol/fluticasone propionate combinated with N-acetylcysteine while the patients in simple treatment group were treated only with salmeterol/fluticasone propionate, both of which were followed up for 6 months.The changes of pulmonary function (FEV1%FVC,FEV1%Pred,PEF daily variation rate:ΔPEF%)and the arterial blood gas analysis indexes (PaO2 and PaCO2 )of the patients in two groups were recorded before treatment, 3 months after treatment, and 6 months after treatment. Results The FEV1%FVC,FEV1%Pred and PaO2 of the patients in combination treatment group and simple treatment group were obviously increased 3 and 6 months after treatment compared with before treatment (P<0.01 ), and the PaCO2 were obviously decreased (P<0.01).And there were significant differences of the indexes mentioned above of the patients between two groups (P<0.05 );but the indexes of each group had no significant differences between 3 months and 6 months after treatment (P>0.05).TheΔPEF% of the patients in two groups had no significant differences between inter-group and intra-group before and after treatment (P > 0.05 ). Conclusion Combination of salmeterol/fluticasone propionate and N-acetylcysteine can obviously improve the pulmonary function and arterial blood gas analysis indexes of the COPD patients, which is superior to the simple application of salmeterol/fluticasone propionate and has definite and lasting curative effect on the treatment of COPD.

SUMMARY Pheochromocytomaisrareinpregn’ancy.Clinicalfeaturesofacaseofpheochromocytoma during pregnancy in the Peking University People’s Hospital was investigated and the literature reviewed to discuss the diagnosis and treatment of this disease.The patient manifested with hypertension and pro-teinuria,who was easily misdiagnosed with gestational hypertension disease.When she was transferred to our hospital,the symptoms such as,paroxysmal palpitation,dizziness,vomiting were noticed,and the possibility of pheochromocytoma was considered due to the accompanying abdominal mass.An emergent cesarean section was performed successfully due to preterm labor during the treatment of the disease.Af-ter the delivery the drug preparation continued.And the laparoscopic resection of pheochromocytoma pro-ceeded when the blood pressure was steady.The patient recovered fully after the surgery.The final diag-nosis of pheochromocytoma was confirmed with the pathology.Its diagnosis and treatment experiences could improve our understanding and treatment of secondary hypertension due to pheochromocytoma in pregnancy.

Objective To examine the changing levels of serum iron and hemoglobin in Streptococcus pneumoniae-induced rat pneumonia model and the relationship among infection severity,serum iron and hemoglobin.Methods Sixty Sprague Dawley (SD)rats were randomly assigned to one of the four groups,1 5 SD rats in each group,including three treatment groups and one control group. Low, medium and high doses of bacteria were administered to the animals in the treatment groups respectively through tracheal cannula.The severity of pneumonia was indicated by the level of bacterial load.The animals in the control group did not receive bacterial challenge.The mean serum iron and hemoglobin levels were calculated on day 3,5, and 7 to analyze the relationship between bacterial dose and serum iron or hemoglobin levels.Results The serum iron level in the animals receiving medium or high doses of bacteria was significantly lower compared with that in control group on day 3 (P=0.009,P=0.005).The serum iron level in the animals receiving low dose of bacteria showed significant difference compared with that in the control group on day 5 (P=0.007).The hemoglobin level in the animals receiving medium or high doses of bacteria was significantly different from that in the control group on day 5 (P=0.031,P=0.046).The hemoglobin level in the animals receiving low dose of bacteria did not show significant difference compared with that in the control group on day 3,5 or 7.The bacterial dose level was negatively correlated with the mean level of serum iron (correlation coefficient r=-0.65,r=-0.53,r=-0.61,respectively).There was no definite correlation between the bacterial dose and the mean hemoglobin level.Conclusions Streptococcus pneumoniae infection may be associated with lower serum iron and hemoglobin levels in rats.The severity of infection is negatively correlated with serum iron level,but not hemoglobin level.

Objective To study the molecular characteristics of the Staphylococcus aureus isolated from the intensive care units (ICUs) of children's hospital.Methods From January 2016 to December 2016,a total of 39 S.aureus strains were collected and identified from various clinical specimens that were obtained from patients who were confined in the neonatal and pediatric ICUs of Beijing Childreng Hospital.Methicillin-resistant S.aureus (MRSA) and methicillin-susceptible S.aureus (MSSA) were identified using the cefoxitin disc method and the detection of the mecA gene.Multilocus sequence typing (MLST) and spa typing were analyzed using the PCR,and the staphylococcal chromosomal cassette mec (SCCmec) type was analyzed for the MRSA isolates.Twenty-one superantigen genes and the Panton-Valentine leukocidin (pvl) gene were also detected by PCR.Their susceptibility to 12 antibiotics was evaluated using the E-test method.The differences in prevalence of virulence genes and antimicrobial resistance were compared between the MRSA and MSSA isolates by Fisherg exact test.Results All the S.aureus strains were isolated from secretion inside the airway of pneumonia (including severe pneumonia),the blood of patients with bacteremia,and exudate of skin and soft tissue infections.ST59-SCCmecⅣa-t437 (55.6％) and ST398-t571 (28.6％) were the most predominant clones of MRSA and MSSA,respectively.Of the 39 isolates,26 strains (66.7％) had at least one superantigen gene,and seb (38.5％),sek (30.8％),and seq (20.5％) were the most common genes;seb-sek-seq (18.0％) was the main virulence genotype.The pvl geneg positive rate was 25.6％,and no significant difference between MRSA and MSSA was observed (P ＞ 0.05).Notably,79.9％ of the S.aureus isolates were multidrug resistant,and 94.9％,53.8％,and 51.3％ of the isolates were resistant to erythromycin,clindamycin,and chloramphenicol,respectively.The tested isolates were susceptible to trimethoprim/sulfamethoxazole,rifampicin,and vancomycin.Conclusions The S.aureus strains from the ICUs of childreng hospital were isolated from the secretion inside the airway of pneumonia (including severe pneumonia),the blood of patients with bacteremia,and exudate of skin and soft tissue infections.ST59-SCCmecⅣa-t437 (55.6％) and ST398-t571 (28.6％) were the common clones of MRSA and MSSA,respectively.The prevalence of superantigen genes and the multidrug resistant rate were relatively high.

This paper was aimed to observe the effect of Yisui Shengxue (YSSX) granules on CD4+ CD25 + regulatory T cells (Treg cells) and its treatment mechanism in aplastic anemia (AA) rats.Male SD rats were selected and randomly divided into different groups according to their weight.In the model group,subcutaneous injection of benzene (1 mL· kg-1)was given every other day for 7 consecutive weeks.Ten days before the rats were sacrificed,intraperitoneal injection of CTX (25 mL · kg-1) was given for 3 consecutive days.On the 4th week,model rats were divided into the model group,stanozolol group,and the YSSX granules group.Intragastric administration of corresponding drug was given.Same volume of normal saline was given to the normal group and the model group.At the end of the experiment,WBC,RBC,HGB and PLT in peripheral blood were detected.Blood smear and bone marrow smear were prepared.The Foxp3 protein expression of Treg cells in spleen tissues was detected by immunohistochemistry (IHC).RT-PCR was used to detect the Foxp3 mRNA expression in bone marrow tissues.The results showed that compared with the normal group,WBC,RBC,HGB and PLT in the model group were significantly reduced (P ＜ 0.01).The blood smear showed poor permeability of blood cells,reduced WBCs,and increased degenerated cells.The bone marrow smear indicated significantly increased fat drops,significantly reduced hematopoietic cells,and increased nonhematopoietic cells.After the treatment of YSSX granules,WBC,RBC,HGB and PLT were significantly increased (P ＜ 0.01).Both the blood smear and bone marrow smear showed cell permeability improvement,cell form returns to normal,fat drops significantly reduced,significantly increased hematopoietic cells,significantly increased Foxp3 protein expression in spleen tissues and Foxp3 mRNA expression in bone marrow tissues (P ＜ 0.01).It was concluded that YSSX granules can upregulate both gene and protein expression of Foxp3,regulate AA immune function in order to improve the AA immune environment,promote the recovery of bone marrow hematopoietic function,which played an important role in AA treatment.

Objective To compare the planning quality and volume of organ at risk (OAR) between volumetric-modulated arc therapyv (VMAT) and nine-field dynamic intensity-modulated radiation therapy (IMRT) in radiotherapy for cervical cancer patients,explore the best way to cervical cancer radiotherapy,Methods Selected 20 patients with cervical cancer were divided into 2 groups,10 cases for each group.Cervical cancer patients with no surgery was performed for A group (group A),received the radical radiotherapy,prescription dose gross tumor volume (GTV) 56 Gy,clinical target volume (CTV) 50 Gy.Another group of patients with cervical cancer radical surgery (group B),giving the whole basin lymph node auxiliary radiation therapy,prescription dose CTV 50 Gy.Each cervical cancer patient received VMAT and IMRT program designs,the differences in dose volume histogram (DVH),irradiated volume of organ at risk (OAR),heterogeneity index (HI),conformity index (CI),maximum dose (PTVmax),minimum dose (PTVmin) and mean dose (PTV mean) were compared between two plans in 2 groups.Results Two kinds of radiation technology in target area dosimetry were not statistical difference between two groups (P ＞ 0.05).In endanger organs on the protection of two groups of VMAT planning groups in the small intestine V20 and left femoral head V20 had obvious advantages with statistically significance (P ＜ 0.05).Conclusions Two groups of dosimetry between VMAT and IMRT program design are similar in cervical cancer.Two groups of VMAT planning groups to protect endanger organ slightly better than that of IMRT group,but VMAT planning group shortens treatment time and improves the accuracy and efficacy of treatment.

Objective To detect the relationship between the pathological degrees of chronic cholecystitis and coincident diseases. Method The pathological degree was divided into mild,moderate and severe degree according to the pathological changes in 442 cases of chronic cholecystitis,and the proliferation of mucosa cell was detected by SP immunohistochemical staining in 105 cases. Results The coincident calculus, polyp, adenoma in the mild chronic cholecystitis were 65.0%,17.1% and 0.5%, respectively. The coincident calculus, polyp, adenoma and malignant neoplasms in the moderate chronic cholecystitis were 70.1%, 19.4%, 3.7% and 2.2%. The coincident calculus, polyp, adenoma and malignant neoplasms in the severe chronic cholecystitis were 88.0%, 26.4%, 24.2% and 9.9%. The positive expression rates of PCNA in mild, moderate and severe chronic cholecystitis were 12.3%, 17.5% and 38.7%, respectively. The results showed that the pathological degree of chronic cholecystitis was obviously related to the coincidence of calculus, polyp, adenoma, malignant neoplasms. Conclusions Severe chronic cholecystitis is a high-risk lesion of gallbladder carcinoma,it should be removed surgically.

OBJECTIVE: To investigate the expression and clinical significance of BUB1 protein in laryngeal squa mous cell carcinoma (LSCC) tissues. METHOD: The expression of BUB1 protein was measured by immunohistochemistry (EliVision two steps) in 55 cases of LSCC tissues,30 cases of adjacent normal laryngeal mucosa tissues, the relationship of BUB1 expression with clinical pathologic factors in LSCC was also analyzed. RESULT: The positive rate of BUB1 protein in LSCC tissues (50.9%, 28/55) was significantly lower than that in adjacent normal laryngeal mucosa tissues (83.3%, 25/30), P < 0.01. The positive rate of BUB1 protein was correlated with differentiation grading and lymph node metastasis of LSCC (P < 0.05, respectively), but not with patient's sex, age, smoking, tumor site, T-stage and clinical stage(P > 0.05, respectively). CONCLUSION The low expresssion of BUB1 protein is closely related to the tumorigenesis and development of LSCC, and can be a molecular marker for prognosticating metastasis and prognosis of LSCC.
Adult ; Aged ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Female ; Humans ; Immunohistochemistry ; Laryngeal Mucosa ; metabolism ; Laryngeal Neoplasms ; metabolism ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Proteins ; metabolism ; Prognosis ; Protein-Serine-Threonine Kinases ; metabolism