Extracranial carotid athcrosclcrosis is the major cause of ischcmic stroke.The intumescence of carotid atherosclerotic plaque in meries results in lumen stenosis or detachment of plaque organisms.causing the distal vascular embolization,and thus resulting in a reduced cerebral blood supply and cerebral ischemic event.The volume data acquisition of multislice spiral CT angiography can provide high-quality two-dimensional and three-dimensional images,its imaging technique has become a very effective detection tool for carotid atherosclerosis.This article reviews the diagnosis application of multislice spiral CT angiograohy of carotid atherosclerosis and its pitfalls.

Objective: To evaluate the application value and potential faults of Dual-source CT in carotid arterial angiography.Methods: We retrospectively analyzed the images of 477 patients with symptomatic carotid atherosclerosis detected by dual-source CT angiography(CTA) from February 2007 to January 2008,and evaluated the quality of the images,which were classified into 3 quality grades: excellent(with clear display of the lesion and no noticeable motion artifacts,good(with a few motion artifacts but still diagnostically applicable),and poor(with heavy motion artifacts,unclear display and no diagnostic value).Results: Of the 477 images,420(88.1%) were of excellent quality,44(9.2%) of good quality and 13(2.7%) of poor quality.Among the total number of cases,134(28.1%) were shown to be normal and 34(7.1%) abnormal in anatomic structure.Atheromatous plaques were detected in 295 cases(61.8%),carotid artery stenting in 11(2.3%),internal carotid artery occlusion in 1,common carotid artery occlusion in 1,and cervical tumor in 3.Conclusion: Dual-source CT,faster,effective and minimally invasive,is particularly valuable in the diagnosis of carotid arterial lesion and stenosis.

Objective To discuss the application of DWI and DTI in diagnosis and evaluation of brain tumor. Methods Combining with literatures, the application of DWI and DTI in brain tumor diagnosis, differential diagnosis, tumors classi- fication, preoperative evaluation, operation plan establishment, follow-up role of treatment were reviewed and evaluated. Results The DWI and DTI were available to brain tumor diagnosis, differential diagnosis and tumor grade. The DTI could be clearly shown the influence of tumor with white matter quality, it was important in operation plan establishment. The combination of intra-operative MRI, functional MRI and DTI was valuable for brain tumor resection. In the meantime, the treatment response of tumor and the changes of treatment-induced white matter were accurately assessed by DTI. Conclu- sion With the MRI hardware and software technology development, the DWI and DTI imaging information can be provided important value in brain tumor pathological changes diagnosis, evaluation, therapeutic planning and post treatment assess- ment.

Objective To observe the effect of sling exercise therapy combined with acupuncture at Jiaji acupoints on balance function of stroke patients with hemiplegia. Methods From October, 2013 to October, 2015, 40 hemiplegic stroke patients with balance dysfunction were randomized to control group and treatment group equally. Both groups accepted routine rehabilitation, while the treatment group com-bined with sling exercise therapy and acupuncture at Jiaji acupoints. They were assessed with Berg Balance Scale (BBS), 10-metre maxi-mum walking speed (10MWS), Fugl-Meyer Assessment of lower limbs (FMA-L) and modified Barthel Index (MBI) before and four weeks after treatment. Results The scores of BBS, FMA-L and MBI, and 10MWS improved in both groups (t>2.249, P<0.05), and improved more in the treatment group than in the control group (t>2.954, P<0.01). Conclusion Sling exercise therapy combined with acupuncture at Jiaji acupoints can further improve the function of balance, walking and activities of daily living in stroke patients with hemiplegia.

Objective To analyze the cost-effectiveness of integrated pharmaceutical care (IPC) in community-based patients with chronic obstructive pulmonary disease (COPD).Methods The COPD patients were divided randomly into intervention group (group A,n =79) and control group (group B,n =71).Group A received the IPC intervention measures,including serial lectures of pharmaceutical knowledge,home supervision and web-based communications for while group B group had none.Results As compared with group B,group A obviously improved on the knowledge of pharmaceutical treatment effect and side effect (95.1％,67.4％ vs.63.1％,21.9％,x2 =12.445,P=0.000 vs.x2 =55.557,P=0.000).There were notable differences between two groups [ ( 1.77 ± 1.23 ) vs.( 2.42 ± 1.66 ) s,t =2.583,P=0.011],pulmonary rales [ (0.01 vs.0.01)s,Z =2.370,P=0.018],6-min walk distance (6 MWD) [ (457 ± 67 ) vs.(425 ± 72) m,t =2.760,P =0.007 ],vital capacity ( VC ) [ ( 1.60 ± 0.25 ) vs.( 1.49 ± 0.23 ) L,t =2.718,P =0.007 ) ] andquality-of-life items ( 48 ± 10 vs.52 ± 11,t =2.624,P =0.010) after intervention.Analyze of cost-effectiveness show that groupA was superior to group B [ total effect total cost(TE/TC =764.6/4936,15.49％ )vs.(TE/TC =1509.4/4708),32.06％,x2 =6.183,P ＜ 0.01 ].Conclusion IPC can improve the disease condition and achieve excellent cost-effectiveness for community-based COPD patients.

Objective To discuss the feasibility and long-term effect of free latissimus dorsi muscle flap in repair of severe lower extremity injury in children. Methods From July 1999 to June 2004, nine child patients (at age of 6-13 years) with severe lower extremity injury involving soft tissue defects a-round the calf and the foot associated with complex open fractures, bare dislocation, and injury of the nerve, tendon and artery were repaired with free latissimus donsi flap, with flap area ranging from 30 cm ×12 cm to 10 cm × 5 cm. Results All the latissimus dorsi flaps survived, with success rate of 100%. A follow-up for 4-9 years showed that the flap had sound shape and function and normal blood supply, without significant influence on donor area. Conclusion Latissimus dorsi flap has advantages of constant anatomical site, abundant blood supply, massive area, strong anti-infection ability and less in-fluence on donor area and hence is an ideal method for repairing severe lower extremity injury in children.

Objective Different grades of glioma lead to different clinical course,treatments and prognosis,thus it is important to predict histological grades of glioma preoperatively.18F-FDG PET/CT imaging and MR perfusion imaging is considered a promising method to evaluate glioma,and the present study was to evaluated the contribution of 18F-FDG PET/CT imaging and MR perfusion imaging in grading intracranial glioma.Methods Eighteen consecutive patients with suspected primary brain glioma underwent 18F-FDG PET/CT scanning and MR perfusion scanning in our hospital.To evaluate the relative sensitivity among standardized uptake value (SUV),L/W,and rCBV,the PET/CT imaging were analyzed,and the SUV and Lesion-to-white matter ratio (L/W) were calculated.The rCBV ratios of lesions were calculated relative to the region of interest (ROI) values in contra lateral normal white matter.Results Eighteen brain gliomas were confirmed by pathologic diagnosis,including 7 WHOⅡ tumors,6 WHOⅢ tumors,and 5 WHOⅣ tumors.SUV and rCBV could not differentiate between WHOⅡ tumor and WHOⅢ tumor,however significant difference could be found among the three using L/W.Conclusion 18F-FDG PET/CT imaging and MR perfusion imaging could offer more diagnostic information than conventional MRI.All of the three semiquantitative data offer some contribution in grading intracranial gliomas,and L/W might be the best one.

Objective To study the radiographic features of the chordoid glioma and its differential diagnosis,and increase neuroradiologists'awareness of this newly described tumor,facilitating prospective diagnosis.Methods Three patients with chordoid glioma were reviewed retrospectively to determine whether any characteristic radiographic findings and clinical-pathologic findings would emerge,and the relevant literatures were reviewed.Routine CT(2 cases)and MR(3 cases),contrast-enhanced MR(3 cases)were performed.Results The masses were well circumscribed and located in the region of the hypothalamus/third ventricle-suprasellar region(2 cases)and intrasuprasellar region(1 case).Tumors were isointense to gray matter on CT scans and were isointense or hypointense on T_1WI and hyperintense on T_2WI.In two patients,vasogenic edema extended into the optic tracts and cystic or necrotic area was seen.All cases were remarkably enhanced following contrast administration.Conclusions Radiologic findings of the chordoid glioma has some unique features.Tumor,in the region of the hypothalamus-third ventricle-suprasellar region,if it is well circumscribed and remarkably enhancing following contrast administration,should be included in the differential diagnosis.