Moyamoya disease is an uncommon cerebral disease, but its morbidity is relatively high in East Asian populations. Ivy sign refers to the dot or linear high signal phenomenon in MRI T1 enhanced sequence in patients with moyamoya disease. It mainly distributes in the pial surface of cerebral cortex or within subarachnoid space. It has important significance for diagnosing moyamoya disease and assessing the staging and prognosis of moyamoya disease. This article briefly reviews this imaging finding and its significance.

Moyamoya disease is a rare cerebrovascular disease.Its incidence is higher in the East Asia.The pathogenesis of MMD remains unclear at present,but the epidemiological research both at home and abroad suggests that the genetic factors play an important role in the onset of MMD.This article briefly reviews the recent progress in research on MMD related genes.

Objective To investigate the relationship between the numbers of deep medullary veins (DMV) beside the ipsilateral lateral ventricle and the stenotic degree of large artery of ipsilateral internal carotid artery (ICA) system and cerebrovascular reactivity (CVR) in patients with acute cerebral infarction showed on susceptibility-weighted imaging (SWI) in middle cerebral artery (MCA) territory.Methods The patients with acute cerebral infarction in MCA territory who underwent SWI,cerebral angiography and the transcranlal Doppler carbon dioxide challenge test during the hospital stay were enrolled retrospectively.According to the numbers of DMV beside the lateral ventricle on SWI,they were classified into 3 grades:Grade 1:DMV ＜5; Grade 2:DMV 5-10; Grade 3:DMV ＞ 10.The correlations of the DMV grades and the degree of ipsilateral ICA/MCA and CVR were analyzed.Results A total of 44 patients with acute cerebral infarction in MCA territory were enrolled.Twenty-four patients were DMV 1,15 were DMV2,and 5 were DMV 3.The mean stenosis degree of the main arteries of the ipsilateral ICA system was 40.52％ ±30.62％.The mean CVR of MCA was 0.41 ± 0.16.The stenosis degrees in the DMA grade 1,2,and 3groups were 31.31％ ± 26.02％,44.93％ ± 31.03％,and 71.76％ ± 26.68％,respectively.There were significant differences among the 3 groups (F=4.589,P =0.018),and the stenosis degree in the DMV grade 3 group was significantly higher than that in the DMV grade 1 group (P=0.014).The CVRs in the grade 1,2,and 3 groups were 0.45 ± 0.12,0.41 ± 0.18,and 0.22 ± 0.12,respectively.There were significant differences among the 3 groups (F=6.179,P=0.005),and the CVR in the DMV grade 3 group was significantly lower than that in the DMV grade 1 group (P =0.006) and in the DMV grade 2 group (P =0.038).Spearman correlation analysis showed that DMV grade was significantly positively correlated with the stenosis degree (rs =0.381,P =0.013),and was significantly negatively correlated with CVR (rs =-0.375,P=0.012).Conclusions The DMV grade in patients with cerebral infarction was positively correlated with the stenosis degree of responsible large artery and was negatively correlated with the MCA CVR in the responsible side.

Cerebral hemodynamic changes are an important pathophysiologic process for the occurrence and development of Moyamoya disease. Cerebral hemodynamic changes of Moyamoya disease have been a research focus. This article mainly reviews the cerebral hemodynamic parameters and detecting methods, characteristics of cerebral hemodynamic changes in patients with Moyamoya disease and their new progress.

Objective To observe the role of resting metabolic rate (RMR) in evaluation of animal model of glucocorticoid-induced Kidney Yin deficiency and Kidney Yang deficiency syndrome.Methods Male BALB/c mice were divided into control group,model group,Jinkuishenqi pill group,and Zhibaidihuang pill group.The later 3 groups were given drinking water containing corticosterone (first dissolved in 1% ethanol,with a final concentration of corticosterone 100 μg/mL).The control group was given drinking water containing 1% ethanol.RMR was measured by closed fluid pressure respirometer.At the end of the experiment,the mice were sacrificed to detect the weight index of perirenal fat,epididymal fat,quadriceps,and tibialis anterior muscle.ELISA assay was used to detect the level of serum hormones.Histological changes of the liver and kidney were examined by HE staining.Malondialdehyde (MDA) content,succinate dehydrogenase (SDH) activity,cytochrome c oxidase (COX) activity and ATP level were measured.Results Compared with the control group,the RMR of model group was significantly increased at the 2nd day of beginning of the experiment,reached the highest on the 4th day (P<0.01),then decreased gradually,and to the 66th day,the RMR was significantly reduced (P<0.05).Use of corticosterone resulted in decrease of the serum levels of thyroxine (T4),muscle mass index,SDH activity,COX activity and ATP level,while increase of fat mass index and MDA level.The two Kidney nourishing prescriptions reduced animal mortality,and reduced the content of MDA in liver tissue.But only Jinkuishenqi pill increased the RMR at the 4th and 66th days (P<0.05),and significantly improved the liver SDH activity,COX activity and ATP level (P<0.01).The Zhibaidihuang pill showed no such effects.Conclusions RMR can be used for evaluation of animal model of Kidney Yin or Kidney Yang deficiency induced by glucocorticoids.

Objective To investigate the expression and significance of signal pathway Wnt/β-catenin in prostate cancer stem cells.Methods Prostate cancer tissues,hyperplasia prostate tissues and normal prostate tissues were collected,then prostate cancer stem cells were selected from cell suspension in the culture system of serum-free medium by magnetic activated cell sorting system.Immunohistochemical SP test,RT-PCR and Western blot were applied to test the expression of Wnt and β-Catenin mRNA or protein in prostate cancer stem cells,hyperplasia prostate tissues and normal prostate tissues.Results The protein expression of Wnt and β-Catenin was higher in prostate cancer tissues compared with that in hyperplasia prostate tissues and normal prostate tissues;mRNA expression of Wnt and β-Catenin was higher in prostate cancer stem cells (4.57±0.83,3.93±0.78) than in hyperplasia prostate tissues (1.32±0.35,1.48±0.44) and normal prostate tissues (1.00±0.12,1.00±0.11),and the difference was statistically significant (F＝13.287,12.648,P＝0.000).Protein expression of Wnt and β-Catenin was higher in prostate cancer stem cells(0.87±0.10,1.12±0.23) than in hyperplasia prostate tissues(0.39±0.08,0.64±±0.11) and normal prostate tissues (0.33±0.09,0.45±0.10),and the difference was statistically significant (F＝16.625,14.417,P＝0.000).Conclusion Signal pathway Wnt/β-catenin is stimulated abnormally in prostate cancer stem cells,causing the occurrence of prostate cancer,providing a new research direction for treatment of prostate cancer.

Objective To investigate the therapeutic efficacy of endoscopic sphincterotomy (EST) for treatment of choledocholithiasis. Methods The clinical data of 326 patients receiving EST from July 1990 to January 2009 were retrospectively analyzed. Long-term follow-up was performed in 195 of the 326 patients. Results The common bile duct stones were removed in 301 cases (92. 33%).The occurring rate of complications after EST was 6.13% (20/326). Of the 20 patients, 10 had pancreatitis (3.07%), 7 hemorrhage (2. 14%), 4 cholangitis (1. 220%) and 1 duodenal perforation (0.09%). Only 1 patient died. The follow-up showed that 20 patients had reflux cholangitis and 18 recurrence of common bile duct stones. Conclusion Therapeutic endoscopy is safe and effective for treatment of choledocholithiasis.

Objective To provide anatomical evidence for the repair of wounds of finger distal phalanx,espe-cially for the recovery of feeling. Methods 10 samples of fresh adult hand were dissected under microscope. The course,branches,distribution and external diameter of nerves and blood vessels in finger distal phalanx and morpho-logical relationship between nerves and vessels were measured. Results Proper palmar digital nerves mostly step over digital arteries at section starts of distal finger arterial arcades and go to finger pulps and latero-backs. Their thinks di-vide into 2 branches. Transverse diameters of interior and exterior branches are 0.8 ～ 1.2 mm and 0.9 ～ 1.4 mm re-spectively at liner semilunaris levels. Distributionsof left and right branches are reciprocal chiasmas. Conclusion Finger nerve mostly ramifies to finger pulp,finger tip and finger back at the level of phalangette bottom. Its branches are lower and thinner than concomitant arteries. The suitable anatomy region for anastomosis of nerves and blood ves-sels is the middle1/3 section from the distal interphalangeal joint to the nail during replanation of amputated finger pa-ratelum.

Objective To compare the effects of electroacupuncture (EA) at different acupoints on the neuroethology and expression of neurocan after focal cerebral infarction in rats. Methods The healthy male adult Sprague-Dawley rats were randomly divided into sham group (n=5), model group (n=20), Shuigou-Baihui (SB) group (n=20), Ganshu-Shenshu (GS) group (n=20) and Zusanli-Quchi (ZQ) group.All the rats were modeled with middle cerebral artery occlusion (MCAO) except sham group, and were randomly divided into 5 sub-groups as 1 d, 3 d, 7 d, 14 d and 21 d after cerebral ischemia. Their neuroethology was evaluated with Longa's score, and the expressions of neurocan mRNA and protein were detected with RT-PCR and immunohistochemistry in ischemic cortex. Results No dysfunction was found in the sham group. The neurological function recovered gradually 3 d after modeled, and improved significantly 7~21 d after modeled in each EA group compared with those in the model group (P<0.05). The expression of neurocan mRNA and protein gradually increased 1 d after modeled in the model group, peaked 14 d after modeled, and remained high level 21 d after modeled (P<0.01). The expressions of neurocan mRNA and protein were less in each EA group than in the model group 3 d after modeled (P<0.05), and were less in the SB group and GS group than in ZQ group (P<0.05). Conclusion The expression of neurocan increased significantly in ischemic cortex. EA may down-regulate the expression of neurocan after acute cerebral infarction, and improve the neuroethology. EA at SB and GS is more effective than at ZQ.

Tandem lesions are relatively rare type of acute large vascular occlusion. At present, the clinical treatment strategy of tandem lesions is still unclear and lack of definite evidence-based medicine. This article reviews the characteristics, endovascular treatment strategy and clinical prognosis of anterior circulation tandem lesions, and looks forward to the treatment of tandem lesions.