Objective To investigate insula cortex activation evoked by stimulating different acupoints of lower extremity.Methods Twenty healthy male right-handed subjects were recruited to receive functional magnetic resonance imaging(fMRI)examination with a whole-body 3T Siemens Trio system for whole-brain imaging.Participants were at rest during scanning and were instructed to relax with their eyes closed,without falling asleep.A blockdesigned method was applied for acupoint stimulation.The examined acupoints on the right lower extremity were stimulated,respectively,resulting in 4 experimental conditions.Stimulation was performed by brushing the subject's skin over each acupoint with a sponge at a frequency of approximately 2 Hz.Images were analyzed using SPM5 software package.Group analysis was performed with the mixed-effects model.Small volume correction was used to investigate insula cortex activation under each condition at a threshold of P ＜ O.01,with a 6-mm radius centered on the local maxima of activation in insula cortex.The scope of insula cortex was determined with SPM anatomy toolbox.Results All the examined acupoints induced activation in contralateral insula cortex.Activation clusters evoked by different acupoints presented various types of locations and shapes,and all of them located in the posterior part of insula cortex.Activation in the ipsilateral insula cortex was not found for all examined acupoints.Conclusions Stimulating lower extremity acupoints can activate posterior insula cortex.This effect may promote the recovery of dysphagia via several mechanisms including facilitating the initiation of swallowing,improving oral and pharyngeal sensation,and reducing taste disturbance.

Objective To provide objective parameters for differentiating pancreatic cystic tumors via using computed tomography texture analysis (CTTA) to quantify the special imaging features of pancreatic cystadenomas.Methods Enhanced CT images of pancreas from patients who were admitted in Department of Radiology in First Hospital affiliated with Zhejiang University and First People's Hospital of Hangzhou City and pathologically diagnosed as pancreatic serous cystadenomas (n =48) and mucinous cystadenomas (n =34) from January 2009 to December 2016 were retrospectively analyzed.Regions of interest were drawn on the parenchymal phase CT images in 5 slices according to the border of the tumors.Mean grey level intensity (M),variance (V),entropy (E),skewness (Ske) and kurtosis (Kur) were obtained from fine texture (σ =1.0) to coarse texture (σ =2.5).Receiver operating characteristic (ROC) curve for texture parameters with statistically difference was drawn,and the area under curve (AUC),diagnostic sensitivity and specificity were calculated.The diagnostic accuracy of senior and junior doctors was compared with the traditional CT analysis method.Results Reliability coefficient of the two radiologists was 0.809 ～ 0.997 with high consistency.Compared with mucinous cystic tumors,serous cystadenomas had a significantly different V (5.93 ± 9.02 vs 1.29±0.62),E (2.39±0.61 vs2.02±0.39) and Kur(30.18 ±42.55 vs 8.80-±4.34) in Ske0 of 2.5 (P ＜0.05),and there were no statistically significant differences on other parameters.The AUC of differential parameters for diagnosing two kinds of cystic tumors ranged from 0.56 to 0.84.The diagnostic accuracy of the traditional CT analysis method by junior doctor and senior radiologist was 60％ and 71％,respectively.Conclusions CTTA can not only effectively quantify the heterogeneity of pancreatic cystadenomas,but also is effective in the differentiation.