Schwannomatosis patient who was followed up for fifteen years: A case report.

BACKGROUND: Schwannomatosis is a rare disease characterized by multiple schwannomas of the whole body. Although benign, schwannomatosis that occurs in important areas of the body, such as the brain and spinal canal, can cause considerable disability and mortality. The disease is rare, frequent and relapsing, and this poses a diagnostic and therapeutic challenge. CASE SUMMARY: A 40-year-old male had multiple masses all over his body, starting at the age of 19. Four years prior, he started to experience a progressive decrease in muscle strength in both lower limbs and developed urinary and defecation dysfunctions, and gradual paralysis. One month prior, the patient developed pain and numbness in his left forearm. The patient had undergone five surgical procedures for this disease in our department. Based on the family history, imaging examinations, pathological biopsy and molecular biological examinations, the diagnosis of schwannomatosis was confirmed. This time, the patient was admitted to our hospital again for a 6th operation because of the pain and numbness in his left forearm. After the operation, the patient's symptoms improved significantly; the patient recovered and was discharged from the hospital. At the last telephone follow-up, the patient reported a poor general condition but was alive. CONCLUSION: Here, we report a rare case of schwannomatosis. We conducted 15 years of patient follow-up and treatment, and analyzed the timing of surgery and patient psychology. This case will further extend our overall understanding of the diagnosis and treatment of this rare tumor.

[Comparison of the effect of arthroscopy assisted TightRope plate and Triple-Endobutton plate and Double Endobutton plate in the treatment of acromioclavicular dislocation].

OBJECTIVE: To investigate the clinical effect of arthroscopic assisted TightRope plate, Triple-Endobutton plate and Double Endobutton plate in treating of Rockwood type Ⅲ-Ⅴ acromioclavicular dislocation. METHODS: From January 2014 to January 2018, 128 patients with acromioclavicular dislocation were treated by operation. According to the operation plan, the patients were divided into three groups:Double Endobutton group, Triple-Endobutton group and TightRope group. All patients with acromioclavicular dislocation were operated by the same operation team, and the chief surgeon was the same chief physician. General baseline data such as gender, age, operation time, incision length, intraoperative blood loss, VAS score of pain and Constant-Murley shoulder function score were recorded. RESULTS: The wound healed well and no recent complications occurred. One hundred and eleven patients were followed up for 6 to 12(9.1±3.1) months. There was no significant difference on general data among three groups (P >0.05). Among three groups, the operation time of Triple -Endobutton group was the longest, significantly higher than that of other two groups(P<0.05);the operation time of TightRope group was the shortest, significantly lower than that of other two groups (P<0.05). At 1 month after operation, VAS score comparison of three groups, TightRope group was significantly lower than other two groups, with statistical difference (P<0.05). At 12 months after operation of three groups, the Constant-Murley score of TightRope group was significantly higher than that of two group (P<0.05). The incidence of incision infectionin TightRope group was significantly lower than that of other two groups(P<0.05); the incidence of reduction loss in Double Endobton group was significantly higher than that of other two groups(P<0.05), the incidence of reduction loss in TightRope group was significantly higher than that of Triple endobton group(P<0.05);the incidence of joint adhesion in TightRope group was significantly lower than that of other two groups(P<0.05). CONCLUSION: TightRope plate fixation with arthroscopy is more advantageous than Double Endobutton plate fixation and Triple-Endobutton plate fixation.

Thrombospondin 1 promotes synaptic formation in bone marrow-derived neuron-like cells.

In this study, a combination of growth factors was used to induce bone marrow mesenchymal stem cells differentiation into neuron-like cells, in a broader attempt to observe the role of thrombospondin 1 in synapse formation. Results showed that there was no significant difference in the differentiation rate of neuron-like cells between bone marrow mesenchymal stem cells with thrombospondin induction and those without. However, the cell shape was more complex and the neurites were dendritic, with unipolar, bipolar or multipolar morphologies, after induction with thrombospondin 1. The induced cells were similar in morphology to normal neurites. Immunohistochemical staining showed that the number of positive cells for postsynaptic density protein 95 and synaptophysin 1 protein was significantly increased after induction with thrombospondin 1. These findings indicate that thrombospondin 1 promotes synapse formation in neuron-like cells that are differentiated from bone marrow mesenchymal stem cells.

Inhibition of inflammatory mediator release from microglia can treat ischemic/hypoxic brain injury.

Interleukin-1α and interleukin-1ß aggravate neuronal injury by mediating the inflammatory reaction following ischemic/hypoxic brain injury. It remains unclear whether interleukin-1α and interleukin-1ß are released by microglia or astrocytes. This study prepared hippocampal slices that were subsequently subjected to oxygen and glucose deprivation. Hematoxylin-eosin staining verified that neurons exhibited hypoxic changes. Results of enzyme-linked immunosorbent assay found that interleukin-1α and interleukin-1ß participated in this hypoxic process. Moreover, when hypoxic injury occurred in the hippocampus, the release of interleukin-1α and interleukin-1ß was mediated by the P2X4 receptor and P2X7 receptor. Immunofluorescence staining revealed that during ischemia/hypoxia, the P2X4 receptor, P2X7 receptor, interleukin-1α and interleukin-1ß expression was detectable in rat hippocampal microglia, but only P2X4 receptor and P2X7 receptor expression was detected in astrocytes. Results suggested that the P2X4 receptor and P2X7 receptor, respectively, mediated interleukin-1α and interleukin-1ß released by microglia, resulting in hippocampal ischemic/hypoxic injury. Astrocytes were activated, but did not synthesize or release interleukin-1α and interleukin-1ß.