Objective To explore the application of 64-slice spiral CT angiography (CTA) in the evaluation of cerebral vascular disease. Methods 160 cases with suspected cerebral vascular disease underwent CTA with 64-slice spiral CT. Two dimensional and three dimensional reformation were performed in all cases including multiplanar reconstruction (MPR), maximum intensity projection (MIP), volume rendering (VR). Both axial and reformatted images were analyzed by two radiologists. Results 94 cases of 160 were diagnosed as abnormal, including 50 stenosis or obstructive disease, 21 aneurysm, 1 post-intravascular stent, 4 cliped aneurysm, 3 arteriovenous malformation, 4 moyamoya disease, 4 carotid-cavernous fistula, 4 venous sinus thrombus, 1 straight sinus occlusion with perpetual falcial sinus, 1 great cerebral venous aneurysm, 1 perpetual sublingual artery. Conclusion 64-slice spiral CTA is a valuable diagnostic method for various cerebral vascular disease.

Moyamoya disease (MMD) is a chronic and progressive cerebrovascular disease which is characterized by the bilateral internal carotid artery ends and (or) stenosis or occlusion of anterior cerebral artery and middle cerebral artery initial segments,compensatory proliferation of small blood vessels in the skull base and formation of abnormal vascular network.Its etiology and pathogenesis remains unclear.The present studies speculate that MMD may be a polygenic disease,inflammation,immune response,abnormal cytokine secretion,endothelial progenitor cell change and nitric oxide level change are associated with the occurrence and development of MMD.This article reviews the advances in research on the genetics and pathophysiological mechanism of MMD.

Portal vein stricture complicated with superior mesenteric venous thrombosis is rarely seen in clinical practice. On December 26, 2009, a 51-year-old male patient who had a liver transplantation history was admitted to The General Hospital of Chinese People's Armed Police Forces with the chief complaint of intermittent abdominal pain and diarrhea.A plain and enhanced CT scan showed that the portal vein was constrictive and thrombosis had formed in the main trunk of the superior mesenteric vein, and varicose veins were seen in surrounding tissues of the esophagus. Edema was observed at the end of the ileum and cecum. The results of colonoscopy showed inflammatory changes and varicose veins of the colon. The patient received medical treatment. The thrombosis was dissolved 9 days later, and all symptoms disappeared 12 days later.

Plasmablastic myeloma is a rare pathological classification of multiple myeloma. This condition must be differentially diag-nosed because of lack of a distinctive phenotype. Involvement of the central nervous system is a rare complication of multiple myelo-ma. The choice of treatment is important for plasmablastic myeloma. Thus, this article presents a rare case of plasmablastic myeloma with multiple cranial nerve involvement. We clarify the diagnosis through the multidisciplinary team and select the optimal therapy for the patient.

Objective To investigate the clinical characteristics and prognostic factors in patients with primary gastric non-Hodgkin lymphoma (PG-NHL).Methods The pathological data of 51 PG-NHL patients admitted in our hospital from 2003 to 2013 were analyzed retrospectively.Results In 51 patients with PG-NHL,there were 26 males and 25 females.The patients' age ranged from 18 to 80 years old with median age as 56 years old.The median survival time was 32 months (range from 1 to 114 months).The oneyear overall survival (OS),three-year OS and five-year OS were 90.2 ％,82.4 ％ and 80.4 ％,respectively.The surgery did not significantly improve PG-NHL patients' progress free survival and OS.Only 1 (2.0 ％) patient had gastrointestinal hemorrhage and perforation after chemotherapy.However,6 (46.2 ％) patients suffered from early satiety,gastric emptying disorder,alkaline reflux gastritis and dumping syndrome in surgery group.Conclusions Surgery did not improve the survival of PG-NHL patients.The life quality in chemotherapygroup is better than that in surgical group.

Objective To explore the diagnostic value of oligoclonal band (OB) detected by isoelectric focusing (IEF) with immunoblotting in inflammatory demyelinating diseases (IDD) in nervous system.Methods Serum and cerebrospinal fluid (CSF) OB was detected by IEF with immunoblotting in 112 patients with IDD ( multiple sclerosis ( MS):n = 48;neuromyelitis optica ( NMO):n = 21:acute disseminated encephalomyelitis ( ADEM):n = 4;secondary IDD from systemic autoimmune diseases:n = 19;peripheral nervous system IDD:n =20) and 24 patients with non-inflammatory neurological disease (NIND).Results CSF-restricted OB was detected in 91.7% (44/48) of MS patients,23.8% (5/21) of NMO patients(x2nmO vs MS= 32.679),1/4 of ADEM patients (Fisher' s excact test),15.8% (3/19) of secondary IDD patients (x2secondary IDD vs MS = 37.425 ),0 of peripheral nervous system IDD patients (x2peripheral nervous system IDD vs MS =37.425) and 0 of NIND patients (x2NIND vs MS =37.425).MS patients had significantly higher percentage of patients with CSF-restricted OB ( all P ＜0.01),compared with NIND and other IDD patients.The sensitivity and specificity of OB detected by IEF with immunoblotting for MS were 91.7% and 89.8%,which were higher than that of OB detected by other methods.Identical serum and CSF OB ( mirror pattern ) was detected in 2 of 4 ADEM patients and 1 of 48 MS patients.Conclusion IEF with immunoblotting to detect OB is a reliable method of diagnosis for MS.

Objective To analyze the clinical manifestations and the criteria for the diagnosis of POEMS syndrome.Methods The clinical characteristics of 36 cases of POEMS syndrome were retrospectively reviewed and compared with the cases reported in literature.Results In addition to the typical characteristics of polyneuropathy(100%),organomegaly(92%),endocrinopathy(86%),monoclonal plasmaproliferative disorder(100%) and skin changes(86%),the patients of POEMS syndrome also have other important features including extravascular volume overload(97%),papilledema(57%) and bone lesions(25%).Furthermore,25% of POEMS syndrome patients have co-existent Castleman disease.Conclusion To make the diagnosis of POEMS syndrome,both major and minor criteria are required.The former includes polyneuropathy and monoclonal plasmaproliferative disorder and the latter includes osteosclerotic bone lesions,Castleman disease,papilledema,organomegaly,edema or serous cavity effusion,endocrinopathy and skin changes.

Objective Myelodysplastic spndrome (MDS) patients' chromosome aberrations were detected by CC and FISH method respectively,to establish standard FISH platform of diagnosis of MDS,to compare the differences of FISH and CC in the detection of MDS chromosome aberrations.Methods Chinese MDS patients fulfilled with the Vienna minimum diagnostic criteria were tested by CC and FISH method,and the patients' clinical data was collected at the same time.Results The standard FISH platform of diagnosis of MDS was established successfully,including probe combination of-5/5q-,+8,-7/7q-,20q-,-Y,the success rate was 100 ％.In 83 cases of MDS,chromosome aberrations rate detected by two methods was 42.2 ％,30.1％ of CC method and 33.7 ％ of FISH method,the accordant diagnostic rate was 76.1％.FISH had higher positive rate than CC method (29.6 ％ vs 18.6 ％,P =0.049) in the IPSS intermedian-risk 1 group,but lower positive rate in IPSS intermedian-risk 2 group (62.5 ％ vs 81.2 ％,P =0.036).There were 11 (19.0 ％) cases of clonal chromosome aberrations detected by FISH method but not detected by CC method,in which 10 (90.9 ％) cases were intermedian-risk 1 group (IPSS grouping).Evaluate IPSS by FISH and CC respectively,the accordant rate was 86.7 ％.Evaluate IPSS by CC alone will result in 3 patients (3.6 ％)decline in risk stratification,and evaluate IPSS by FISH alone will result in 8 patients (9.6 ％) decline in risk stratification.There were 35 (42.2 ％) cases of chromosome aberrations detected by the two methods,including 13 (15.7 ％) cases of complex karyotype and 22 (26.5 ％) cases of single abnormal karyotype.The most common chromosomal aberration was +8,a total of 9 (10.8 ％) cases,followed by abnormalities of chromosome 7,a total of 7 (8.4 ％) cases.Conclusion The study has established standard FISH platform of diagnosis of MDS,the method is stable,sensitive and rapid.FISH technology joint CC technology can improve the patients with MDS chromosome aberration detection rate.Compared to CC,FISH technique can improve the detection rate of the intermedian-risk 1 IPSS grouping MDS patients.Because of limited probe,FISH technique can not entirely replace the role of CC method in MDS,but can complement each other.

Objective To explore the efficacy and immune reconstitution of autologous peripheral blood stem cell transplantation (APBSCT) in the treatment of refractory autoimmune thrombocytopenia purpura (ITP). MethodsOne patient with refractory ITP was treated with APBSCT, the effectiveness and the process of immune reconstitution were analyzed retrospectively. Results The case was mobilized by cyclophosphamide (CY) plus G-CSF and 4.7?106/kg CD34+ cell was gained totally. Neutrophil and platelet were engrafted at 11th and 12th day without severe complications following the conditioning of TBI and CY. Although the each phenotype of the peripheral blood lymphocytes recovered gradually 6 months after the transplant,inverted CD4/CD8 ratio exited and memory T cell was improved much earlier than naive T cell. The platelete count was constantly over 100?109/L and the patient was in complete remission after a follow-up of 31 months.Conclusion APBSCT is a potential approach in the treatment of refractory ITP.

Objective To evaluate the effect of minimally invasive therapy for treating intraventricular hemorrhage.Methods The minimally invasive therapy with unilateral or bilateral drainage were received according to quantity and shape of intraventricular hemorrhage.Results It was operated 22 cases with unilateral drainage and 28 cases with bilateral drainage in the 50 cases intraventricular hemorrhage.Death was 3 cases and mortality rate was 6% in the minimally invasive therapy.ADL1 15 cases(30%),ADL2 18 CRSeS(36%),ADL3 8 cases(16%),ADLA4 cases(8%),ADL5 2 cases(4%)in leave hospital.Conclusion Minimal invasive therapy of intraventrieular hemorrhage has great superiority,such as it can operate simple,trauma mild,decrease complications and enhance curative effect.It can generalize in the basic hospital.