ObjectiveTo evaluate the value of microsurgery for acoustic neuromas.MethodsThe author performed a retrospective study of 63 consecutive patients after vestibular schwannomas (VSs) microsurgery with the retrosigoid approaches. The tumor was debulked firstly and dissected from surrounding neural and vascular structures by gripping the tumor capsule,and then drilled of the IAC.Intraoperative electrophysiological monitoring of facial nerve function during operation.Results Total tumor resection was achieved in 52 cases, subtotal resection was achieved in 11 cases. The anatomic preservation of facial nerve was achieved in 58 cases,the acoustic nerve was preserved anatomically in 29 cases.Fifty-eight cases received a follow-up, the mean follow-up time was 7.2 years. Two recurrent patients were found and there were no operative deaths. A long term facial nerve status:twenty-three cases were in grade Ⅰ, twenty-nine cases in grade Ⅱ ,five cases in grade Ⅲ , one cases in grade Ⅳ.Hearing level had an improvement in 9 cases and remained unchanged in 8 cases.ConclusionMicrosurgery treatment is the main choice of the treatment of VSs, could achieve better result in control of tumor and facial and acoustic nerve function restoration.

Objective To study the value of magnetic resonance vessel wall imaging in assessing the atherosclerotic plaque burden of rabbit model.Methods We built up abdominal atherosclerotic animal model in 30 New Zealand rabbits by high lipid diet combined with abdominal artery denudation.The animals were divided into 3 groups randomly,which were the 1-week group,1-month group and 2-months group.The MRI and histology examination were carried out at relative time points.The correlations of area or thickness of vessel wall by MRI with histology examination were analyzed.Results Among the 30 rabbits,3 died due to anesthesia or surgery,one rabbit model failed because of the thin vessel,and another 3 died of diarrhea or inflammation during the high lipid diet feeding.Eventually,totally 23 rabbits fulfilled the examinations (7 in 1-week group,7 in 1-month group and 9 in 2-months group).The vessel wall area of histology examination grew larger along with the post-surgery duration,from 1.7663 mm2of 1-week group to 2.4371 mm2 of the 1-month group till 3.5978 mm2 of 2-months group,with statistic significant difference among 3 groups (F=5.052,P=0.017).There were strong correlations of area or thickness vessel wall resulted from MRI with histology examination(r=0.688,0.642;P=0.001,0.002).Conclusions High resolution MR vessel wall imaging technique may evaluate and follow up the plaque burden in the early stage of atherosclerosis.

Objective To evaluate diagnostic value of CT coronal scan to foreign body in bronchus of children.Methods 30 cases appearances of CT coronal scan to foreign body in bronchus of children were analysed.The appearances between CT coronal scan and axial scan,X-ray examination of chest were contrasted in some cases.Results Foreign body in bronchus or granuloma around part of foreign body were shown clearly by CT coronal scan in 30 cases,28 cases obstructive emphysema,13 cases obstructive pneumonia and 3 cases obstructive atelectasis were also shown clearly.Another,CT coronal scan showed the double margin sign of 16 cases diaphragm and 11 cases mediastinum.Conclusion CT coronal scan could show direct and indirect signs of the most foreign body in bronchus of children and it may be acte as primary examintion.

Objective: To understand the incidence of school bullying and its influencing factors among adolescents in low-income and middle-income countries, and to explore the association between school bullying and mental health of adolescent students, so as to provide reference for prevention and control of school bullying and mental health intervention. Methods: Data was obtained from the 2009-2015 Global School Student Health Survey from 19 low-income and middle-income countries (n=22 963). Binary Logistic regression was used to analyze the influencing factors of school bullying, and multiple linear regression was used to analyze the relationship between school bullying and mental health. Results: The average score of students mental health was(5.75±2.09), and approximately 35.1% of adolescent students reported suffering from school bullying. The rates of school bullying among students in low-income and middle-income countries were 39.4% amd 34.3%, respectively. Students with lower grades, overweight, poor family economic status, low family learning and psychological support, poor perceived family relationship, more truancy, and poor relationship with classmates were more likely to suffer from school bullying(P<0.05). Exposure to school bullying was positively associated with adverse mental health outcomes for women(B=1.27, P<0.01). Conclusion Not only were school bullying more common in low-income countries, but also school bullying had a greater negative impact on the mental health of girls. We need to pay more attention to school bullying among adolescent students, especially in low-income countries and girls, with cost-effective interventions to reduce or mitigate the consequences of bullying.

Objective: To compare the distribution characteristics of left ventricular configuration in Chinese adult patients with hypertension under Chinese and international standard using echocardiography. Methods: A total of 201 patients with primary hypertension were included in the study.Left ventricular end systolic left atrial diameter (LAD), ascending aortic diameter (AO), left ventricular end diastolic diameter (LVDd), left ventricular posterior wall thickness (PWTd) and ventricular septal thickness (IVSd) were measured and then relative wall thickness (RWT), left ventricular mass (LVM), left ventricular mass index (LVMI) were calculated. Left ventricular systolic left atrial volume (LAV) was measured by Simpson′s biplane method and left atrial volume index (LAVI) was then calculated. Ganau classification was done according to Chinese and international standard respectively. The differences of left ventricular configuration in hypertension were compared. Results: According to the Chinese standard, the analytic results of left ventricular configuration showed that there were 103 cases (51.2%) in normal configuration (NG) group, 28 cases (13.9%) in concentric remodeling (CR) group, 52 cases (25.9%) in eccentric hypertrophy (EH) group and 18 patients (9.0%) in hypertrophic (CH) group, respectively. Whereas, according to the international standard, there were 47 cases (23.4%) in NG group, 93 cases (46.3%) in CR group, 18 cases (8.9%) in EH group and 43 cases (21.4%) in CH group.Each group in the configuration analysis had significant difference between Chinese and international standard (P<0.01). Patients with left atrial enlargement according to the Chinese and international standard had statistical difference in the EH and CH groups (P<0.05). Conclusions Analysis of left ventricular configuration according to the Chinese and international standard has significant difference. According to Chinese standard, it may be more accurate to reflect the changes of left ventricular configuration in Chinese hypertensive population, so as to evaluate the changes of left heart structure and function more accurately.

Adiponectin, an adipocytokine secreted by adipocytes, has emerged as a potential treatment agent for type 2 diabetes. Adiponectin plays a variety of physiological roles in regulating glucolipid metabolism, oxidative stress, inflammatory responses and bone metabolism by binding to its receptors expressed on a variety of cells and tissues. Numerous studies have confirmed the strong association of adiponectin with type 2 diabetes-related periodontitis. Adiponectin can improve systemic insulin resistance by increasing insulin sensitivity and promoting insulin secretion. It improves the periodontal inflammatory response by inhibiting the expression of proinflammatory cytokines induced by Porphyromonas gingivalis lipopolysaccharide and promoting M2-type polarization of macrophages. In addition, adiponectin inhibits osteoclast differentiation and maturation through various pathways, such as Wnt/β-catenin and NF-κ, and promotes osteoblast differentiation to regulate bone metabolism, thus improving periodontal bone resorption and destruction. Therefore, adiponectin is expected to become a therapeutic target for type 2 diabetes-related periodontitis. Due to the physiological characteristics of adiponectin, its clinical application has been somewhat limited. This article reviews the latest research progress on adiponectin in type 2 diabetes-related periodontitis, aiming to elucidate the possible effects of adiponectin on type 2 diabetes-related periodontitis in terms of glycemic control, anti-inflammation and bone metabolism and to provide some opinions on the treatment of this disease and the development of relevant drugs.

Background and purpose:Gastric-type endocervical adenocarcinoma(G-EAC)is a rare variant of endocervical adenocarcinoma,characterized by atypical clinical manifestations and elusive lesions.Due to these factors,G-EAC is prone to being missed or misdiagnosed,significantly impacting the prognosis.Lobular endocervical glandular hyperplasia(LEGH)and atypical LEGH(aLEGH)are considered to be precancerous lesions of G-EAC.These conditions also present overlapping clinical,pathologic and imaging manifestations,making it challenging to differentiate between them preoperatively.The purpose of this study was to investigate the correlation between magnetic resonance imaging(MRI)findings of cystic-solid lesions in the cervix and their underlying pathology in order to enhance the accuracy of distinguishing between LEGH and G-EAC,ultimately aiding in the early diagnosis and appropriate management of these conditions.Methods:Clinical,imaging and pathological data of 37 LEGH and 53 G-EAC patients who attended the Obstetrics and Gynecology Hospital of Fudan University from July 2016 to August 2023 were collected.Analysis was conducted using Pearson Chi-square χ2,Fisher's exact tests and so on.Multivariate analyses were performed using logistic regression.Receiver operating characteristic(ROC)curves were used for performance evaluation.Results:In this study,differences in age,symptoms,extent,size,composition,degree of enhancement,cervical stromal ring,endometrium invasion,pelvic lymph nodes enlargement,and hydrohystera were statistically significant between the two groups(P＜0.05).In the LEGH and aLEGH groups,lesions were primarily localized to the epithelial layer of the endocervical canal.These lesions were predominantly simple cystic(32/37),and the cystic walls often displayed significant enhancement(31/37).In contrast,the G-EAC group presented with lesions involving the myometrium of the uterine cervix(42/53).These lesions were characterized by a solid component in the majority of cases(52/53),a tendency for the disappearance of the cervical stromal ring(46/53).Logistic regression analysis revealed that among the MRI features,lesion composition(OR=50.064)and incomplete cervical stromal ring(OR=40.180)were significant predictors for G-EAC.ROC analysis,incorporating lesion size,composition,enhancement degree,cervical stromal ring,and endometrial involvement,yielded an area under curve(AUC)of 0.970(95%CI:0.931-1.008).Conclusion:Combining multiple MRI features of cystic-solid lesions in the cervix aids in distinguishing between LEGH and G-EAC.

Bruton tyrosine kinase (BTK) is a key mediator of B-cell receptor signalling cascade and an effective target for treating mantle cell lymphoma (MCL). BTK inhibitors play a critical role in the treatment of MCL. Here we introduced the mechanism of action of BTKI in the treatment of MCL. Though generally well prescribed, Ibrutinib, as the first BTKI, still has limitations of toxicity and resistance. New BTK inhibitors, such as zanubrutinib, acalabrutinib and orelabrutinib, are designed to improve on the safety and efficacy as first-generation BTK inhibitors. Comparing the similarities and differences of the two generations of BTKI in structure and function provides a basis for better clinical application of BTKI. On November 15, 2019, FDA approved zanubrutinib for marketing for patients with adult mantle cell lymphoma. Compared with Ibrutinib, zanubrutinib was found with higher target selectivity, longer-lasting inhibition, fewer adverse reactions, and better patient benefit. Zanubrutinib provides a viable treatment option for patients with r/r MCL. At the same time, it is also actively carrying out clinical researches on the treatment of other B-cell lymphomas. It is a very promising targeted drug.

Objective:To systematically summarize and comparatively analyze the development, establishment and usage of oncology drugs speedy review approaches in China and in the United States between 2012 and 2021.Methods:Based on National Medical Products Administration (NMPA) and Food and Drug Administration (FDA) websites, the development and current status of the speedy review approaches were consulted and summarized. Approved oncology drugs in China and in the United States (87 in China, 118 in the United States) over the past decade were analyzed using chi-square test for group comparison.Results:Five speedy approaches have been established in China and in the United States, three of which are the same, priority review, conditional approval or accelerated approval and breakthrough therapy. The rest two are special review and approval, special examination and approval in China, and fast track and real-time oncology review in the United States. Compared to the United States, speedy review approaches in China set up late (1992 vs. 2005). The overall utilization rates of the oncology drugs speedy review approaches were similar between the China and United States (90.8% vs. 92.4%, P=0.800) in the previous 10 years, and priority review have highest utilization rates in both China and the United States without significant group difference (77.0% vs. 82.2%, P=0.381); relatively low utilization rates of conditional approval (31.0% vs. 44.9%, P=0.041) and breakthrough therapy (2.3% vs. 50.0%, P＜0.001) were seen in China. 52.9% of new drugs applied for special examination and approval in China and 40.7% of new drugs applied for fast track in the United States. Overall, the priority review both in China and the United States are stable, with a similar average annual utilization rate (84.8% vs. 83.7%); accelerated approval and breakthrough therapies in the United States fluctuate wildly, but the situation is tending towards stability in the last 3 years. Conclusions:Both China and the United States have established a relatively complete accelerated review system, with an overall utilization rate over 90%; China's accelerated review started late, although the overall utilization rate is close to that of the United States. The utilization rates of conditional approval and breakthrough therapy are still relatively low. Flexible usage of speedy review approaches, gaining regulatory recognition to use alternative endpoints, achieving real-time review and guidance are keys to accelerate new drug development in China.

Objective:To systematically summarize and comparatively analyze the development, establishment and usage of oncology drugs speedy review approaches in China and in the United States between 2012 and 2021.Methods:Based on National Medical Products Administration (NMPA) and Food and Drug Administration (FDA) websites, the development and current status of the speedy review approaches were consulted and summarized. Approved oncology drugs in China and in the United States (87 in China, 118 in the United States) over the past decade were analyzed using chi-square test for group comparison.Results:Five speedy approaches have been established in China and in the United States, three of which are the same, priority review, conditional approval or accelerated approval and breakthrough therapy. The rest two are special review and approval, special examination and approval in China, and fast track and real-time oncology review in the United States. Compared to the United States, speedy review approaches in China set up late (1992 vs. 2005). The overall utilization rates of the oncology drugs speedy review approaches were similar between the China and United States (90.8% vs. 92.4%, P=0.800) in the previous 10 years, and priority review have highest utilization rates in both China and the United States without significant group difference (77.0% vs. 82.2%, P=0.381); relatively low utilization rates of conditional approval (31.0% vs. 44.9%, P=0.041) and breakthrough therapy (2.3% vs. 50.0%, P＜0.001) were seen in China. 52.9% of new drugs applied for special examination and approval in China and 40.7% of new drugs applied for fast track in the United States. Overall, the priority review both in China and the United States are stable, with a similar average annual utilization rate (84.8% vs. 83.7%); accelerated approval and breakthrough therapies in the United States fluctuate wildly, but the situation is tending towards stability in the last 3 years. Conclusions:Both China and the United States have established a relatively complete accelerated review system, with an overall utilization rate over 90%; China's accelerated review started late, although the overall utilization rate is close to that of the United States. The utilization rates of conditional approval and breakthrough therapy are still relatively low. Flexible usage of speedy review approaches, gaining regulatory recognition to use alternative endpoints, achieving real-time review and guidance are keys to accelerate new drug development in China.