Objective To discuss the spiral CT features of the bowel obstruction induced incarcerated abdominal external hernia and its value in clinical application.Methods The spiral CT feature of the bowel obstmction induced incarcerated abdominal external hernia which were confirmed by surgery in 14 cases were retrospectively analyzed and were compared with surgical results.Results The hernia sac of incarcerated abdominal external hernia in all cases of bowel obstruction were displayed by CT,in which the positions and varieties of the hernia were determined in 12 CaSes.the intestinal images within the hernia SaC were displayed in 10 cases,the epiploon image within the hernia sac was displayed in 1 case.homogeneus soft tissue density shadows were displayed in 3 cases,the intestinal wall thickening within the hernia sac was displayed in 4 cases.in which in 2 cases were involved in delamination of the intestinal wall.The intestinal wall thickening in abdominal cavity was displayed in 2 cases,the nuidify in abdominal cavity was displayed in 3 cases.the volvulus was displayed in 2 cases.Conclusion The spiral CT has an important value in determing the positions of bowel obstruction,varieties of the contents of hernia sac,th blood supply of the bowel within the hernia sac and proximate obstmction and other complieations.

Objective By studying the prescriptions and medicines for treating rheumatoid arthritis (RA) prescribed by modem doctors, we tried to provide new ideas for developing the new medicines for treating rheumatoid arthritis. Methods 340 prescriptions on treating rheumatoid arthritis were collected from core medical periodicals and books published in the recent 20 years. Make a statistical analysis to the medicines in these prescriptions according to TCM etiological and pharmaceutical theories and modern researching foundlings. Results Among all 254 Chinese medicines used for treating RA, 32 medicines belong to worm and vine medicines, being used for 806 times. Conclusion The worm and vine medicines are frequently used in treating RA with good therapeutic effects combined with other kinds of medicines.

Objective To evaluate the CT appearances and diagnostic value of calcific metastases originated from the alimentary system mucous carcinoma.Methods CT appearances of calcific metastases originated from the alimentary system mucous carcinoma confirmed by surgery and pathology were retrospectively analysed.Results Calcification inside the metastatic tumors could be seen in all 9 patients.The calcification was multiple in 6,single in 3;4 lesions were in the brain and 5 in the liver.The calcific rate of tumors was 100%.Conclusion The metastases originated from malignant tumors of alimentary system are easy appearing calcification,CT scanning plays an important role in diagnosing the calcific metastases.

Objective To investigate the characteristics of resting-state functional magnetic resonance imaging (fMRI)in patients post-stroke depression (PSD).Methods Resting-state fMRI scans were performed in 13 patients with and without post-stroke depression.A regional homogeneity (ReHo) approach was used as an indicator.The brain function was analyzed in patients with post-stroke depression.Results Compared to a control group,the ReHo values decreased significantly in a PSD group in the left middle frontal gyrus,right superior frontal gyrus,right middle frontal gyrus,right anterior cingulate gyrus,right posterior cingutate gyrus,left insular lobe,left caudate nucleus,and left hippocampus.Conclusions The patients with PSD had restingstate neural circuit dysfunction,suggesting that the need to focus on the emotional state of stroke patients in the clinical treatment process.

Objective To investigate any changes in motor functional connectivity in the brains of acute ischemic stroke patients after low frequency electrical stimulation.Methods Twenty-five ischemic stroke patients were given low frequency electrical stimulation in addition to their conventional rehabilitation treatment.Another 20 patients received only conventional treatment as a control group.Resting-state functional magnetic resonance imaging (rs-fMRl)was employed to assess motor function connectivity in the brains of all 45 subjects before and after treatment.Any differences in functional impairment,extremity motor function or ability in the activities of daily living were also recorded before and after treatment.Results In both groups,average scores on the Canadian neurological scale (CNS)and the National Institutes of Health stroke scale (NIHSS) had been reduced significantly after treatment and FuglMeyer assessment (FMA) and modified Barthel index (MBI) scores had significantly increased.The average improvements in terms of FMA and MBI scores were significantly greater in the observation group.Compared with before treatment,the coefficient of functional connectivity of the bilateral motor cortex had decreased significantly after treatment in both groups.In the observation group the changes were significantly correlated with the improvements in FMA scores.Conclusion Neural functional impairment after ischemic stroke can be reduced significantly and extremity motor function and ability in the activities of daily living can be significantly improved by low frequency electrical stimulation.

ObjectiveTo investigate the brain function in the patients with transient ischemic attack (TIA) using index of regional homogeneity ( ReHo ).MethodsSixteen TIA patients ( TIA group ) and 16 age-matched normal controls(control group) underwent standard resting state functional MRI (fMRI)scan.The changes of the brain ReHo were studied by DPARSF analysis.ResultsCompared with that of control group,TIA group showed significantly decreased ReHo in the left cingulate gyrus (z =-3.72),left frontal gyrus (z =-3.02),right frontal gyrus (z =-3.23),right superior frontal gyrus (z =-3.75),right precuneus (z =-3.80),right inferior parietal lobule (z =-3.98 ),left inferior parietal lobule (z =-3.82),precentral gyrus ( z =- 3.85 ),right midfrontal gyrus ( z =-4.15 ),right midtemporal gyrus (z =- 3.43 ),and increased ReHo in the right hippocampus (z =3.37) and right cerebellum (z =3.55).Conclusion The rest-state brain function is abnormal in TIA interictal phase,and the increased ReHo in the hippocampus and cerebellum may reflect stress-induced brain protection of TIA and partial comoensatory response.

Objective To investigate the alteration and possible compensation mechanism of the default mode network (DMN) in patients with subacute pontine infarction.Methods Rs-fMRI data were collected from 23 patients with subacute pontine infarction and 23 normal controls.The data was analyzed with the functional connectivity (FC) method and compared between subacute pontine infarction patients and controls.All imaging was performed on a Philips Achieva 3.0T MRI scanner.Posterior cingulated cortox (PCC) was used as seed points to analyze the FC changes in the brain regions between the pontine infarction group and the controls.The discrepancies of experiment data between two groups were compared by using two-sample t-test analysis.Results The FC of the DMN showed a significant increase in the right postcentral gyrus, left medial prefrontal cortex and left precuneus compared with normal controls and a significant decrease in bilateral insula,posterior lobe of the left cerebellum,right parahippocampal gyrus and left inferior occipital gyrus.Conclusion The DMN altered in patients with subacute pontine infarction and the changes of the FC suggested the plasticity of cortical or compensation in the relevant brain areas.

Purpose To explore the significance of MR diffusion tensor imaging (DTI) in diagnosing and predicting the motor function of patients with acute ischemic stroke in the brainstem. Materials and Methods Twenty patients with acute ischemic stroke in the brainstem and 20 normal controls were enrolled in the study. DTI was performed on all 40 subjects. Fractional anisotropy (FA) in specific regions were measured including infarction lesions, cerebral peduncle, the posterior limb of the internal capsule in the affected side and corresponding unaffected regions. The number and the length of the corticospinal tracts (CST) of both affected and unaffected sides were also measured. The correlation of FA, the number and the length of the CST, the NIH stroke scale (NIHSS) at the admission, 3 months and 6 months was analyzed. Results The FA values of infarction, cerebral peduncle, and the posterior limb of the internal capsule, and the number of CST in the affected side were significantly less than that of the corresponding unaffected regions (P<0.05). The rFA (<7 d) in the affected cerebral peduncle was negatively correlated with NIHSS and the score of the upper and lower extremity muscle strength at the admission, after 3 months and after 6 months (P<0.05). However, the rFA of the infarction and the posterior limb of the internal capsule, the ratio of the number and the length of CST of affected/unaffected sides had no correlation with NIHSS score and the score of the muscle strength. Conclusion The rFA in the cerebral peduncle is helpful for early evaluation and predicting recovery of the motor function in the patients with acute ischemic stroke in the brainstem.

Objective To investigate the efficacy and safety of low-dose rituximab therapy and sequential maintenance for patients with refractory idiopathic thrombocytopenic purpura. Methods Thirty-three patients with refractory idiopathic thrombocytopenic purpura received intravenous rituximab at the dose of 100 mg once a week for 4 consecutive weeks. Complete blood cell count and serum concentrations of immunoglobulin (IgG,IgM and IgA) were monitored regularly. The numbers of CD3+ and CD19+ CD20+ lymphocyte cells were assayed by flow cytometry before and after therapy. Twenty-five patients with responses(complete response and response) were divided into maintained group (12 patients) and control group (13 patients) by random digits table method. The patients in maintained group were treated with rituximab 100 mg every 6 months. The efficacy of maintenance therapy was evaluated through long-term follow-up. Results The complete response(CR) rate, response (R) rate and no response(NR) rate were 48.48%(16/33), 27.27%(9/33) and 24.24% (8/33), respectively. As a result, total effective rate was 75.76% (25/33). There were no significant changes of peripheral blood white blood cell count,hemoglobin,serum immunoglobulin and CD3+lymphocyte counts before and after treatment (P>0.05). However, CD19+ CD20+ cells were almost depleted in patients treated with rituximab: (3.71±2.64)×106/L vs. (279.33±92.78)×106/L, P<0.01. Five patients suffered from allergic response, and 1 patient developed pneumonia and respiratory failure. The relapse rates of maintained group and control group were 1/12 and 4/13, respectively. Conclusions Treatment with low-dose rituximab may be an effective and safe approach in patients with idiopathic thrombocytopenic purpura. Relapse rates can be decreased through maintenance therapy with refractory low-dose rituximab. However, the optimal therapeutic schedule need further investigation.

Objective To prepare dual?modality single?photon emission computed tomography (SPECT)?MRI molecular nanoprobes targeting HAb18G/CD147 expressed on breast cancer cell membranes and investigate the physicochemical and biological properties in vitro. Methods Superparamagnetic iron oxide nanoparticles (SPIOs) were prepared by one?pot reaction method as described. The single?chain antibody fragments HAb18F(ab')2 were conjugated to SPIOs via chemical method and then labeled with 125I using Iodogen method. The final 125I?SPIO?HAbF18(ab')2 nanoprobes were purified. SPIOs or 125I?HAb18F(ab')2 were used as control. We carried preliminary evaluation on their physicochemical properties and biological characteristics in vitro: transmission electron microscope (TEM) and dynamic light scattering (DLS) were used to measure these nanoparticle sizes and the hydrodynamic diameters. The MRI T2 transverse relaxation efficiency of these nanoprobes at different Fe2+concentrations were measured with 1.5 T clinical MR scanner. The 125I?SPIO?HAb18F(ab')2 and 125I?HAb18F(ab')2 radiochemical purity were measured by thin layer chromatography and the radio chemical yield was calculated. We also conducted stability tests in vitro and octanol/water partition coefficient experiments. Two breast tumor cell lines, MDA?MB?231 (HAb18G?overexpressing cells,experimental group) and MDA?MB?468 (control), were used for assessment of cells viability at different Fe2 + concentrations (1, 5, 10, 20, 40 μg/ml) by methyl thiazolyl tetrazolium assay. Specific binding experiments in vitro included two parts:magnetic resonance imaging and radionuclide tests, the above?mentioned breast cancer cell lines were incubated with 125I?SPIO?HAb18F(ab')2 nanoprobes respectively and took MDA?MB?231 cells which were not treated as blank group. First comparing the MR signal intensity differences among experimental group, the control group and blank group, then calculated the rate of MRI signal changes;Two breast tumor cell lines, MDA?MB?231 and MDA?MB?468 were incubated with 125I?SPIO?HAb18F(ab')2 nanoprobes too, then measured radioactivity counting byγcounter at different time and calculated the cell binding rates, and did statistical analysis by using one?way ANOVA. Results The SPIOs were fairly homogeneous with an average core size of (10.32±1.30) nm;the SPIO and 125I?SPIO?HAb18F(ab')2 hydrodynamic diameter of 44.80 and 52.64 nm, and MRI scanning showed that the transverse relaxation efficiency of SPIO and 125I?SPIO?HAb18F(ab')2 were 38.79 and 106.73 mM-1 · s-1, respectively. The radio chemical yield of 125I?SPIO?HAbF18(ab')2 and 125I?HAb18F(ab')2 were 41.90% and 85.50%, respectively. The radio chemical yield of the two groups were >95%, suggesting well stability in vitro. The lipo?hydro partition coefficient values were -0.99 ± 0.03 and-1.49 ± 0.08, respectively, which demonstrated that they were both water?soluble substances. Different Fe2+concentrations (1,5,10,20,40μg/ml) of 125I?SPIO?HAb18F(ab')2 on breast cancer cell lines MDA?MB?231 and MDA?MB?468 showed no significant inhibition of cell proliferation (F values were 0.78, 0.66; P values were 0.58, 0.66). The cell?specific binding experiment showed: MRI signal intensity values on experimental group, the control group and the blank group were (1 670 ± 5), (1 930 ± 8), (2 349 ± 14), respectively, significant differences existed among these groups (F=4 408.48,P=0.000), the rate of signal intensity change of experimental group and the control group were 28.87%,17.78%. SPECT:MDA?MB?231 could uptake 125I?SPIO?HAb18F(ab')2, the cell binding rates were (6.52 ± 0.60)% and (10.52 ± 2.04)% in 20 min and 4 h, respectively.Conclusions Our results suggested that the dual?modality SPECT?MRI nanoprobes 125I?SPIO?HAb18F(ab')2 were prepared successfully with good physicochemical properties and biological characteristics in vitro. These dual?modality molecular imaging nano?probes may have potential to improvearly detection and diagnosis of HAb18G/CD147?expressing cancers and to facilitate the development of HAb18G/CD147?directed interventions.