von Hippel-Lindau (VHL) disease is an autosomal dominant hereditary tumor predisposition syndrome. Central nervous system hemangioblastoma is one of its major clinical manifestations, commonly occurring in the infratentorial region and spinal cord, while supratentorial involvement is rare. A 23-year-old female patient with sellar and spinal hemangioblastomas, along with polycystic pancreas, who presented with back pain and decreased vision in the left eye, was reported. The diagnosis of VHL disease was confirmed based on family history, pathological findings, and genetic testing. This case was reported to enhance clinicians′ awareness of this disease, facilitating early diagnosis and intervention for patients and their families to improve clinical outcomes.

Purpose To explore the clinical manifestations,imaging features,and histopathological characteristics of intravascular large B-cell lymphoma(IVL-BCL)involving the central nervous system(CNS).Methods Clinical and imaging data from 5 cases of IVL-BCL were collected.Immunohistochemical staining and FISH were performed to analyze their clinicopathological characteristics,with a comprehensive review of relevant literatures.Results All 5 pa-tients were elderly,with a male-to-female ratio of 4∶1,and an age of onset ranging from 53 to 67 years.The disease course varied from 4 months to 2 years.All patients had varying degrees of neurological damage symptoms.In this study,4 patients experienced varying degrees of weakness in the lower limbs.MRI findings were nonspecific,but all 5 patients showed evidence of cerebrovascular lesions.Histologically,the lesions were characterized by aggregates of lymphoid tumor cells within the lumens of small cerebral vessels,which could obstruct the lumens and cause ischemic and hypoxic changes.Tumor cells did not involve the extravascular brain parenchyma.Immunohistochemically,tumor cells widely expressed mature B-cell markers(CD19,CD20,CD79a,PAX5)with a high Ki67 proliferation index.All 5 patients received systemic chemotherapy after diagnosis,1 patient died,2 patients achieved clinical and physical symptom relief and were still under follow-up.2 patients were undergoing systemic examination before chemotherapy.Conclusion Intravascular large B-cell lymphoma involving the central nervous system is rare,and both clinical mani-festations and imaging examinations lack specific indicators.Preoperative diagnosis is very difficult and can only rely on diagnostic brain biopsy or pathological diagnosis after craniotomy.

Purpose To explore the clinical manifestations,imaging features,and histopathological characteristics of intravascular large B-cell lymphoma(IVL-BCL)involving the central nervous system(CNS).Methods Clinical and imaging data from 5 cases of IVL-BCL were collected.Immunohistochemical staining and FISH were performed to analyze their clinicopathological characteristics,with a comprehensive review of relevant literatures.Results All 5 pa-tients were elderly,with a male-to-female ratio of 4∶1,and an age of onset ranging from 53 to 67 years.The disease course varied from 4 months to 2 years.All patients had varying degrees of neurological damage symptoms.In this study,4 patients experienced varying degrees of weakness in the lower limbs.MRI findings were nonspecific,but all 5 patients showed evidence of cerebrovascular lesions.Histologically,the lesions were characterized by aggregates of lymphoid tumor cells within the lumens of small cerebral vessels,which could obstruct the lumens and cause ischemic and hypoxic changes.Tumor cells did not involve the extravascular brain parenchyma.Immunohistochemically,tumor cells widely expressed mature B-cell markers(CD19,CD20,CD79a,PAX5)with a high Ki67 proliferation index.All 5 patients received systemic chemotherapy after diagnosis,1 patient died,2 patients achieved clinical and physical symptom relief and were still under follow-up.2 patients were undergoing systemic examination before chemotherapy.Conclusion Intravascular large B-cell lymphoma involving the central nervous system is rare,and both clinical mani-festations and imaging examinations lack specific indicators.Preoperative diagnosis is very difficult and can only rely on diagnostic brain biopsy or pathological diagnosis after craniotomy.

von Hippel-Lindau (VHL) disease is an autosomal dominant hereditary tumor predisposition syndrome. Central nervous system hemangioblastoma is one of its major clinical manifestations, commonly occurring in the infratentorial region and spinal cord, while supratentorial involvement is rare. A 23-year-old female patient with sellar and spinal hemangioblastomas, along with polycystic pancreas, who presented with back pain and decreased vision in the left eye, was reported. The diagnosis of VHL disease was confirmed based on family history, pathological findings, and genetic testing. This case was reported to enhance clinicians′ awareness of this disease, facilitating early diagnosis and intervention for patients and their families to improve clinical outcomes.

To investigate the clinical and pathological characteristics of duodenal-type follicular lymphoma (D-FL), and to deepen the understanding of Duodenal-type follicular lymphoma. The clinical symptoms, endoscopic features, pathologic features, immunophenotype, molecular pathological features and treatment follow-up of 18 D-FL patients diagnosed in Department of Pathology, Beijing Tiantan Hospital affiliated to Capital Medical University between January 2020 and July 2023 were summarized. A total of 18 patients with D-FL were included, including 10 males and 8 females. The median age was 49 (32-69) years respectively. Most of the patients were found during gastroenteroscopy or presented with the common gastrointestinal symptoms of stomach pain, acid reflux, vomiting and diarrhea. Most endoscopic findings were multiple small gray and white polyposis. In the pathological morphology, the mucous layer and submucous layer showed lymphoid follicular structures with full and strained follicles. The immunophenotype showed that the tumor cells strongly expressed CD20 and BCL2 and had low proliferation activity. Immunoglobulin clonal analysis of 1 case showed IgK monoclonal rearrangement (1/1). FISH showed 1 case of BCL2 gene rearrangement (1/3). All patients did not receive targeted chemotherapy and adopted a wait-and-see strategy. Median follow-up was 12 (2-34) months. This study shows that D-FL is an indolent lymphoma, which tends to occur in the duodenum and has a good prognosis.

Objective:To observe the clinical effect when Lee Silverman voice therapy (LSVT) is used to treat stroke survivors with dysarthria.Methods:Forty-nine stroke survivors with dysarthria were randomly divided into a control group ( n=25) and a treatment group ( n=24). The control group received conventional treatment, while the treatment group received daily one-hour sessions of LSVT, 4 times per week for 4 weeks. Before and after the treatment, both groups were given a speech intelligibility (SI) test, a Frenchay dysarthria assessment (FDA), and acoustic analysis including intensity, pitch, triangular vowel space area (tVSA), vowel articulation index (VAI), and formant centralization ratio (FCR). Their maximum phonation time (MPT) was measured and a voice handicap index (VHI) was assigned. Results:Before and after treatment, there were significant differences in VHI observed in the observation group, as well as significant differences in their average SI, FDA, MPT, tVSA, VAI and FCR values. In the control group the significant changes were limited to the VAI, FDA, MPT and FCR measurements. However, after the intervention, no significant differences were found between the two groups in VAI, nor in their SI, FDA, VHI, MPT, intensity, pitch, tVSA and FCR scores.Conclusions:LSVT has similar therapeutic effects to conventional treatment in relieving voice impairment, improving speech intelligibility, improving the motor functioning of articulation organs and improving the articulation accuracy of stroke survivors with dysarthria. Therefore, it is worthy of clinical application.

Objective:To observe the clinical effect when Lee Silverman voice therapy (LSVT) is used to treat stroke survivors with dysarthria.Methods:Forty-nine stroke survivors with dysarthria were randomly divided into a control group ( n=25) and a treatment group ( n=24). The control group received conventional treatment, while the treatment group received daily one-hour sessions of LSVT, 4 times per week for 4 weeks. Before and after the treatment, both groups were given a speech intelligibility (SI) test, a Frenchay dysarthria assessment (FDA), and acoustic analysis including intensity, pitch, triangular vowel space area (tVSA), vowel articulation index (VAI), and formant centralization ratio (FCR). Their maximum phonation time (MPT) was measured and a voice handicap index (VHI) was assigned. Results:Before and after treatment, there were significant differences in VHI observed in the observation group, as well as significant differences in their average SI, FDA, MPT, tVSA, VAI and FCR values. In the control group the significant changes were limited to the VAI, FDA, MPT and FCR measurements. However, after the intervention, no significant differences were found between the two groups in VAI, nor in their SI, FDA, VHI, MPT, intensity, pitch, tVSA and FCR scores.Conclusions:LSVT has similar therapeutic effects to conventional treatment in relieving voice impairment, improving speech intelligibility, improving the motor functioning of articulation organs and improving the articulation accuracy of stroke survivors with dysarthria. Therefore, it is worthy of clinical application.

Objective To investigate the effect of transcatheter arterial chemoembolization (TACE)combined with radiofrequency ablation (RFA) in the treatment of liver cancer,and its influence on the serum markers.Methods 108 patients with primary liver cancer were selected as the subjects of this study.According to the random number table method,the patients were divided into two groups.The control group (54 cases) received TACE treatment,and the observation group (54 cases) received TACE combined with RFA treatment.The treatment effects,the changes of tumor recurrence related indicators and the levels of tumor related indicators were compared and analyzed.Results The effective rate of the observation group was 79.7 ％ (43/54),which was significantly higher than 50.0％ (27/54) of the control group (x2 =10.391,P =0.001).After treatment,the E-calcium protein (EC),vascular endothelial growth factor (VEGF),matrix metalloproteinase (MMP),tumor recurrence index alpha fetoprotein (AFP),CA199,glutamate transferase (GGT) levels in the observation group were (1 738.8 ± 114.8) μg/L,(207.9 ± 37.2) ng/L,(34.9 ± 4.6) ng/L,(72.2 ± 19.5) μg/L,(34.2 ± 5.1) U/L,(88.9 ± 9.4) U/L,respectively,which were significantly lower than those in the control group [(2 382.4 ± 159.4) μg/L,(367.3 ± 49.3) ng/L,(72.1 ± 7.4) ng/L,(135.2 ± 21.8) μg/L,(66.9 ± 8.2) U/L,(124.6 ± 12.5) U/L],the differences were statistically significant(t =24.076,18.967,31.373,15.828,24.884,16.774,all P ＜0.05).Conclusion TACE combined with RFA is effective in the treatment of liver cancer,which can effectively kill tumor cells and reduce the contents of serum tumor markers,and it is worthy of popularizing in clinic.

Objective To observe the effect of speech therapy on children with Down syndrome. Methods 30 children with Down syndrome were reviewed. Results Their speech and intelligence quotient improved after training, especially in the children younger than 6 years old. Conclusion Speech therapy can improve the speech and intelligence in children with Down syndrome.

Objective To explore the effect of Chinese traditional massage on the rehabilitation of dysphagia in cerebral palsy children in the early stage. Methods 90 cerebral children with dysphagia were divided into control group and experimental group with 45 cases in each group. The control group received conventional treatment and the experimental group received Chinese traditional massage in addition. The curative effects were evaluated according to the section two of deglutition disorders survey before and 2 months after treatment. Results There was no difference in the score of dysphagia between 2 groups before treatment (P>0.05). The scores decreased both in 2 groups (P<0.001) after treatment. The score was lower in the experiment group than in the control group (P<0.01) and the clinical efficiency was better in the experiment group than in the control group (P<0.01). Conclusion Chinese traditional massage combined with conventional treatment can facilitate the recovery of dysphagia in cerebral palsy children.