Multifocal pontine glioblastoma exhibiting an exophytic growth pattern in the cerebello-pontine angle (CPA) is rare. We present a case of a 5-year-old girl with consecutive neurological imaging and other clinical findings indicat-ing progressive multifocal exophytic pontine glioblastoma. Three lesions were reported, of which two were initially presented, and one was developed 2 months later. One lesion demonstrated a progressing exophytic extension in the cistern of the left side of the CPA. The other two lesions were located and confined within the pons. Initial magnetic resonance imaging and positron emission tomography–computed tomography indicated low-grade glioma or inflammatory disease. However, 2 and 3 months later, subsequent magnetic resonance spectroscopy (MRS) displayed elevated choline and depressed N-acetyl aspartate peaks compared with the peaks on the initial MRS, indicating a high-grade glioma. Subtotal resection was performed for the CPA lesion. Histopathologic examination showed discrepant features of different parts of the CPA lesion. The patient received no further chemotherapy or radiotherapy and died 2 months after surgery. The multifocal and exophytic features of this case and the heterogeneous manifes-tations on neurological images were rare and confusing for both diagnosis and surgical decision-making. Our case report may contribute knowledge and helpful guidance for other medical doctors.

Objective To obtain a better understaning of the clinical features of Castleman tumor associated paraneoplastic pemphigus. Methods The clinical features and therapy of 10 cases of this disease, diagnosed in the Department of Dermatology of Peking University First Hospital were analyzed. Results Castleman tumor was shown to be the most common neoplasm associated with paraneoplastic pemphigus in China. The clinical presentations, histopathologic characteristics, CT scan findings, and immunologic features were all unique. The early diagnosis and removal of the Castleman tumor are crucial for the treatment of this tumor-associated autoimmune disease. Conclusions Because Castleman tumor is directly related to the induction of autoimmunity, early diagnosis and prompt removal of the tumor are essential to the management of this disease.

Objective:To systematically evaluate the qualitative research of virtual reality rehabilitation experience of cardiovascular disease patients, and provide reference for clinical application and improvement of virtual reality rehabilitation.Methods:Qualitative research on virtual reality rehabilitation experience of cardiovascular disease patients was electronically retrieved in the Cochrane Library, PubMed, Embase, Web of Science, CINAHL, Medline, China National Knowledge Infrastructure, WanFang Data, VIP, and China Biomedical Database. The search period was from database establishment to October 2023. The literature was evaluated according to the quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center. The aggregation integration method was used to integrate research results.Results:Six articles were included and 25 research results were extracted. Similar results were summarized and integrated into 10 new categories, and synthesized into three integrated results, including perceived benefits of virtual reality rehabilitation for cardiovascular disease patients, perceived barriers to virtual reality rehabilitation for cardiovascular disease patients, and the needs and expectations of cardiovascular disease patients for virtual reality rehabilitation.Conclusions:Virtual reality rehabilitation is a supplement and continuation of traditional cardiac rehabilitation, and its effectiveness has been recognized by most cardiovascular disease patients. Future research should enrich the content and participation forms of virtual reality rehabilitation based on patients' personalized needs, strengthen team building, provide social support, and enhance the accessibility and experience of using virtual reality rehabilitation systems for cardiovascular disease patients.

OBJECTIVETo observe the differences in the clinical therapeutic effects on idiopathic tinnitus between the combined therapy with acupuncture and the modified formula of and and the simple administration of the modified formula of and .

METHODSA total of 60 patients were randomized into a combined treatment group and an herbal medicine group, 30 cases in each one and 2 cases dropped out in the herbal medicine group. In the combined treatment group, acupuncture was given at the local acupoints for tinnitus, such as Yifeng (TE 17), penetrating needling technique from Ermen (TE 21) to Tinggong (SI 19) and Tinghui (GB 2) combined with the scalp acupuncture [the vertigo-auditory area, Baihui (GV 20)] and the oral administration of the modified formula of and . In the herbal medicine group, the oral administration of the modified formula of and was only applied. The treatment was given once a day in each group, 5 times a week for acupuncture and 7 times a week for the oral administration of herbal medicine. Totally, the treatment for 6 weeks was required in the two groups. Before and after treatment, the tinnitus severity score (TSS) and the score of tinnitus handicap inventory (THI) were observed and the clinical therapeutic effects were compared between the two groups.

RESULTSAfter treatment, the TSS and THI scores reduced as compared with those before treatment in the two groups (all <0.05). The scores in the combined treatment group were lower than those in the herbal medicine group (both <0.05). The total effective rate in the combined treatment group was 93.3% (28/30), better than 67.9% (19/28) in the herbal medicine group (<0.05).

CONCLUSIONThe combined treatment with scalp acupuncture, acupuncture around the ear and the modified formula of and achieve the superior therapeutic effects on idiopathic tinnitus as compared with the simple oral administration of the modified formula of and .

Acupuncture Points ; Acupuncture Therapy ; Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Phytotherapy ; Tinnitus ; therapy ; Treatment Outcome

Objective:To explore the application effect of case-based learning (CBL) based on UMU interactive mobile learning in the teaching of standardized training of respiratory medicine.Methods:A total of 80 trainees who had standardized training in Department of Respiratory Medicine of Daping Hospital from June 2019 to June 2020 were enrolled as the research objects. They were randomly divided into observation group ( n=42) and control group ( n=38). The control group was given traditional teaching mode, while observation group was given CBL based on UMU interactive mobile learning. The assessment results, control situations of core competence and teaching satisfaction after training were compared between the two groups. SPSS 20.0 was conducted for chi-square test and t test. Results:The scores of professional theoretical knowledge, case analysis ability and clinical operation skills in observation group were higher than those in control group ( P<0.05). The total control rate of core competence in observation group was significantly higher than that in control group (95.24% vs. 78.95%) ( P<0.05), and the teaching satisfaction rate of observation group was significantly higher than that of control group (100% vs. 84.21%) ( P<0.05). Conclusion:Application of CBL based on UMU interactive mobile learning in the teaching of standardized training of respiratory medicine is not only conducive to improving the teaching quality, but also conducive to cultivating core competence, clinical thinking ability and problem-solving ability of the training students, with higher teaching satisfaction.

Clouston syndrome (OMIM #129500), also known as hidrotic ectodermal dysplasia type 2, is a rare autosomal dominant skin disorder. To date, four mutations in the GJB6 gene, G11R, V37E, A88V, and D50N, have been confirmed to cause this condition. In previous studies, the focus has been mainly on gene sequencing, and there has been a lack of research on clinical manifestations and pathogenesis. To confirm the diagnosis of this pedigree at the molecular level and summarize and analyse the clinical phenotype of patients and to provide a basis for further study of the pathogenesis of the disease, we performed whole-exome and Sanger sequencing on a large Chinese Clouston syndrome pedigree. Detailed clinical examination included histopathology, hair microscopy, and scanning electron microscopy. We found a novel heterozygous missense variant (c.134G>C:p.G45A) for Clouston syndrome. We identified a new clinical phenotype involving all nail needling pain in all patients and found a special honeycomb hole structure in the patients' hair under scanning electron microscopy. Our data reveal that a novel variant (c.134G>C:p.G45A) plays a likely pathogenic role in this pedigree and highlight that genetic testing is necessary for the diagnosis of Clouston syndrome.
Humans ; Connexin 30/genetics* ; Connexins/genetics* ; East Asian People ; Ectodermal Dysplasia/pathology* ; Phenotype