Studies in recent years have suggested that the basic characteristics of the identified cerebral autosomal dominant arteriopathy with subeortical infarcts and leukoencepha-lopathy (CADASIL) are the onset of the disorder with a form of familial hereditary, middle-age onset with progressive ischemic stroke-like course and multiple diffuse white matter lesions, the identified MRI abnormal white matter signals and pathology. Molecular genetic studies have suggested that the multiple mutations of the Notch3 gene are associated with CADASIL. The combination of gene diagnosis with peripheral tissue biopsy may be the most valuable diagnostic means before death. To study CADASIL from the aspects of pathogenesis and clinical manifestations contributes to improve clinical diagnosis rate.

Objective To evaluate the clinical effects in t he treatment of femoral peritrochan teric frac-tures by PFN(proximal femoral nail).Methods A retrospective analysis was done in the treatment of femoral peritrochanteric fractures(72cases).38cases were male and 44cases female.Their age ranged 64～96years old with the average age being 78years old.70cases were intertrochanteric f ractures(EvensⅠtype 16,Ⅱtype 31,ⅢA type 14,ⅢB type 6,Ⅳtype 3),and 2cases subtrochanteric fractu res.Results65patients were followed up for over 6months.All fractures healed and all patients could take care of themselves and were satisfied with t he clinical curative effect except one patient who had the lag screw pulled o ut and coxa vara because of serious os-teoporosis.Conclusion PFNis a better way to cure femoral peritrochanteric fractures because of few complications and simple surgical procedure.Bein g a micro-trauma technique,it is worthy of wide application in clinic.[

[Objective]To discuss the methods selection for lumbar compressed fracture.[Method]137 cases were respectively treated with non-operation,AF nail,Z-Plate steel board internal fixation and protruding formation behind centrum.[Result]All were cured in 10~14w,(12?0.6)w in average;the pain VAS score,Frankel score,Cobb’s angle,the height of front and back edge of centrum were all relieved a lot after treatment,without operation sequela or marked loss of injured vertebra.[Conclusion]The methods shall be selected for lumbar compressed fracture under compressing degree,bone occupation degree in lumbar tube,nerve injure degree,stability of spine structure or fracture dislocation,etc.The stable fracture shall rest in bed with cushion under back.

Objective To explore the relationship between retinal nerve fiber layer (RNFL) thickness and central corneal thickness (CCT) in myopia eyes.Methods 91 cases (91eyes) were selected from ophthalmological outpatients including 28cases with low myopia ( spherical equivalence [ SE ] ＞ -3.0D), 33 cases with moderate myopia (SE -0.3D ～ -6.0D) and 30 cases with high myopia (SE ＜ -6.0D).All patients received ocular standard examination including intraocular pressure, refraction, slitlamp biomicroscopy and fundus examination.Other ocular diseases except refractive error were excluded.RNFL thickness and CCT were measured by RTVue Fourior-OCT ( Optovue Inc, USA).Refraction diopter was shown as SE.Results The mean RNFL thickness and CCT was ( 108.5 ± 10.1 ) μm, (524.7 ±36.8)μm respectively.These were no significantly different among low, moderate and high myopia ( P ＞ 0.05 ).Temporal RNFL thickness( tl1 ,tu1 ) was significantly positive related with CCT( r =0.281,0.093 of tl1, r= 0.352,0.167 of tu1 respectively in single and multiple variable analysis; P ＜ 0.05 ), nasal ( nl2, nu2)and inferior nasal RNFL thickness( in2,in1 )was significantly positive related with SE( P ＜0.05), inferior temporal RNFL thickness( it2)was significantly negative related with SE( P ＜0.05), and RNFL thickness in other regions were not significant related with CCT and SE ( P ＞ 0.05 ) in single and multiple variable regressive analysis.Conclusion Relationship between RNFL thickness of local paradisc region and CCT in myopia eyes suggested that CCT should be correlative with some sensible structural parameters in glaucomatous neuropathy and might be important in the diagnosis and therapy of glaucoma.

0.05). The postoperative incidence of AFL was significantly lower than preoperative ( P

Objective To observe the clinical efficacy of auricular acupuncture plus acupoint injection at Zusanli (ST 36) in treating shoulder pain due to gynecologic laparoscopy.Method Totally 120 patients with shoulder pain due to gynecologic laparoscopy were randomized into a treatment group and a control group, 60 cases in each group. The treatment group was intervened by auricular acupuncture plus acupoint injection at Zusanli (ST 36), while the control group was by ordinary analgesics. The clinical efficacies were compared after 2 treatment courses.Result The Visual Analogue Scale (VAS) scores, Present Pain Intensity (PPI), and the item scores of the Short-Form (36) Health Survey (SF-36) were significantly changed in both groups after treatment (P<0.01,P<0.05). There were no significant differences in comparing the VAS score, PPI, and the item scores of SF-36 between the two groups (P>0.05). The total effective rate was 95.0% in the treatment group versus 75.0% in the control group, and the difference was statistically significant (P<0.05).Conclusion Auricular acupuncture plus acupoint injection at Zusanli (ST 36) is effective in treating shoulder pain due to gynecologic laparoscopy, and it can effectively reduce the occurrence of complications.

Objective To evaluate the clinical features, diagnosis, and outcome of the treatment of cytomegalovirus (CMV) retinitis, and the relationship between CMV retinitis and acquired immunodeficiency syndrome (AIDS). Methods A total of 95 eyes of 56 patients with cytomegalovirus retinitis and AIDS were studied. The fundus feature, visual acuity and CD4 + T lymphocyte counts were analyzed and the follow up periods ranged from 2 weeks to 18 months. Results Before the definitive diagnosis of CMV retinitis, the courses of AIDS were 4 to 26 months in all patients. In the initial examination, the granular form of CMV retinal lesion was noted in 55 eyes (57%) in which retinal lesion of 46 eyes was peripheral. The fulminant form of CMV retinitis of 25 eyes (26%) was found in the posterior pole and consisted of densely opaque retinal lesions with blotchy hemorrhage and vasculitis. The overlap between these two presentations was noted in 15 eyes. Papillitis was observed in 7 eyes of CMV retinitis in this series of patients. The visual acuity ranged from finger counting to 0.5. The patients with extensive CMV retinitis or CMV retinitis in the posterior pole got poorer vision. The CD4 + T lymphocyte counts of 30 patients was 0 30 (mean, 15?9/?l), and the survival time ranged from 2 weeks to 18 months (mean, 6.4?3.3 months). The vision was improved and CD4 + T lymphocyte counts was significantly higher in the group treated with ganciclovir, and progression of CMV retinitis occured and the vision decreased in the non treated group. Conclusion CMV retinitis is the most common intraocular complication in patients with AIDS. Diagnosis of CMV retinitis is based on the characteristic of necrotizing retinitis which was typically associated with retinal hemorrhage and vasculitis. Ganciclovir is effective for the treatment of CMV retinitis.

According to the traditional point of view,CT and lumabar puncture are the main means in the diagnosis of subarachnoid hemorrhage(SAH).The values of conventional MRI T1-weighted imaging(T1WI)and T2 weighted imaging(T2WI)are very little in the diagnosis of SAH.With the development of MRI technique and the research and application of novel MRI sequences,the value of MRI are gradually recognized and affirmed in the diagnosis of SAH.and has shown its superiority.MRI isn't inferior to CT in the diagnosis of acute SAH.evidently superior to CT in the diagnosis of subacute,chronic and atypical SAHs and superior to CT in the diagnosis of the complications of SAH.MRI is valuable in screening for intraeranial aneurysms and postoperative follow-up.

Transient ischemic attack (TIA) traditionally refers to temporary brain dysfunction lasting no longer than 24 hours due to a shortage of blood and oxygen, without any residual neurological deficit. In recent years, the development of imaging technology enables us to have a new awareness about TIA. This article reviews the effects of MRI, especially diffusion-weighted imaging, in the diagnosis and prognostic prediction of TIA.

So far, the method of detection of patent foramen ovale (PFO) by transcranial Doppler (TCD) has had two decades of history. Standardization in contrast-enhanced transcranial Doppler US procedures for cardiac right-to-left shunt detection was proposed in the Venice Consensus Paper in 1999, and some questions were raised at the same time. Over the past 10 years, the researchers have conducted a more in depth study on the method. This article reviews the related research progress.