Objective To explore the characteristics and applied value of diffusion-weighted MR imaging of kidney in healthy people.Methods Using Philips Gyroscan Intera 1.5T MR System,DWI of kidney was performed in 40 healthy adult volunteers,the ADCs of renal cortex and medulla were measured.Results The cortex and medulla of the normal kidney could be clearly showed by DWI.The ADCs of the cortex medulla and average were 3.08?0.52,2.74?0.68 and 2.91?0.58;2.79?0.51,2.53?0.65 and 2.63?0.62;2.64?0.43,2.32?0.47 and 2.48?0.44 when the b values were 300,500 and 800 s/mm2,respectively.The ADC was higher in the cortex than that in the medulla.Conclusion DWI can be used in kidney,it may be helpful for the diagnosis of renal diseases.

Objective To study the applied value of MR diffusion-weighted imaging(DWI)and apparent diffusion coefficient(ADC)value in chronic kidney disease(CKD).Methods 10 healthy volunteers and 45 patients with different period of CKD underwent routine MRI and DWI.The DWI features were observed.The ADC values were acquired by using Philips soft package on the ADC images.Results Under different b value(300 s/mm2,500 s/mm2 and 800 s/mm2),the ADC value of CKD were 2.29?0.27,2.07?0.21 and 1.91?0.22,respectively,which were significantly lower than that in normal kidneys,and there was statistical difference between different group of CKD.Conclusion DWI may be a noninvasive method to evaluate the renal function.

OBJECTIVE:To provide reference for rational use of TCM injection in the clinic. METHODS:In retrospective survey,the application of TCM injections in 3 hospitals from Changshu area during 2013-2015 were analyzed statistically in re-spects of consumption sum,annual growth rate,constituent ratio,DDDs,B/A,DDC,etc. RESULTS:During 2013-2015,in the sample hospitals,consumption sum of TCM injections in 2014 and 2015 declined by 5.27% and 15.92%,compared with last year. The proportion of consumption sum of TCM injections in total consumption sum were 4.40% in 2013,3.86% in 2014 and 3.13%in 2015. Top 3 TCM injections in the list of consumption sum and DDDs were blood activating and stasis eliminating drugs,the re-suscitation and reviving yang first aid class drugs and tonic drugs. The top single types in the list of consumption sum were Xing-naojing injection,Shuxuetong injection,Xuebijing injection,Shenmai injection and Xue shuantong for injection;the top single types in the list of DDDs were Shenmai injection,Reduning injection,Shuxuetong for injection,etc. B/A of Shenmai injection and Reduning injection were higher,while DDC of Xuebijing injection was the highest. CONCLUSIONS:The utilization of TCM injec-tion is basically reasonable,and shows decreasing tendency in sample hospitals,but great importance should be attached to the safe-ty and effectiveness of TCM injections and reasonable choice.

Objective To observe the effect of low-frequency, repetitive transcranial magnetic stimulation ( rTMS) at different frequencies on the cognitive function of traumatic brain injury patients with a history of epilepsy. Methods Sixty traumatic brain injury patients were randomly divided into a 0. 5 Hz group, a 1. 0 Hz group and a control group, each of 20. In addition to routine drug therapy and cognition training, the control group was given fake stimulation, the 0.5 Hz group was treated with 0.5 Hz rTMS, and the 1.0 Hz group was provided with 1.0 Hz rTMS for 4 weeks, eleven times per week. Before and after treatment, the cognitive function of all three groups was assessed using the Montreal cognitive assessment ( MOCA) , the Rivermead behavior memory test ( RBMT) and a symbol can-cellation test. The number of patients reporting headache or epilepsy during the treatment period was also counted. Results During the treatment, there was no headache case in any of the groups, and no significant difference was found in the occurrence of seizures. After the treatment, all of the measurements in all 3 groups had improved signifi-cantly. The average MOCA and RBMT scores in the 1.0 Hz group were all significantly better than those in the control group, but there was no significant difference between the 0.5 Hz group and the control group. The symbol cancella-tion test efficiency of the 1. 0 Hz group was not significantly better than that of the 0. 5 Hz and control groups. Conclusions Repeated 1.0 Hz transcranial magnetic stimulation can significantly improve cognition after traumatic brain injury among patients with a history of epilepsy without increasing the risk of seizures.

Objective To observe the influence of transplanting neural stem cells (NSCs) on angiogenesis in rats with spinal cord injury (SCI).Methods The Allen's method was used to create SCI models in sixty adult Sprague-Dawley (SD) rats.They were then randomly classified into a control group which received injections of phosphate buffered solution (PBS) and an NSC group which received injections of NSCs via the tail vein,with 30 rats in each group.Another group of 30 similar rats without SCI received injections of NSCs via the tail vein as the normal group.Each rat was evaluated before transplantation and at days 7 and 14 post-transplantation using the Basso,Beattie and Bresnahan (BBB) scale for testing hindlimb function.After sacrifice,the distribution of yon Willebrand factor (vWF) in both groups was determined by immunofluorescence,and Western blotting was used to detect vascular endothelial growth factor (VEGF) protein.Results The average BBB score of the normal group was 21 at every time point.Before transplantation,the BBB scoresof the control and NSC groups were both 0,however they increased over time.At day 7 post-transplantation,the BBB scores showed no significant difference between the control group and the NSC group.At day 14 post-transplantation,the average BBB score of the NSC group was significantly higher than that in the control group.At days 7 and 14,the counts of vWF-positive cells in the normal group were significantly higher than in the control and NSC groups.VEGF protein expression in the normal group was significantly lower than in the NSC and control groups.Conclusions NSC transplantation may promote angiogenesis after spinal cord injury and improve motor function by inducing the expression of VEGF.

Objective To study the CT manifestations and diagnostic value of stromal tumor.Methods CT documentation of 25 stromal tumor cases confirmed by surgery and pathology were analyzed retrospectively,all cases underwent 64 row or 256 row spiral CT plain scan and enhanced scan.Results Within 25 cases,1 7 cases were gastrointestinal,of which,10 cases were found in stom-ach,1 case in duodenum,3 cases in jejunum and 3 cases in ileum;and 8 cases were extra-gastrointestinal,of which,6 cases were found in enterocoelia,1 cases in inguinal region,1 case in abdominal wall;the ratio was 2.1 ︰ 1.In 25 cases,highly malignant dan-ger level were 1 1 cases,7 cases of moderate and 7 cases of low malignant danger;Transfer occurred in 7 cases and 3 cases of postop-erative recurrence.Conclusion The volume CT has great advantages in displaying information in lesion,and has high value in loca-ting the lesion and qualitative diagnosis of disease.

Objective To explore the change of the pre-swallow peak pressure of upper esophageal sphincter (UES) in patients with post-stroke cricopharyngeal achalasia,and investigate the effect of pre-swallowing peak UES pressure on swallowing function by quantitative analysis.Methods Fifty-seven stroke patients with cricopharyngeal achalasia were recruited and divided into balloon dilation group,combined training group and routine swallowing training group with 19 patients in eachp.All the three groups accepted routine swallowing training.In addtion,the routine swallowing training group and balloon dilation group accepted larynx elevation training and balloon dilation training,respectively,while the combined training group accepted larynx elevation training and balloon dilation training simultaneously.The pre-swallow peak UES pressure was measured by using PC polygraph high rate gastrointestinal dynamical detection system (PC Polygraf HR,CTD-synectics,Sweden) before and after 8 weeks of treatment.The swallowing function was assessed using swallowing function classification and water swallowing test.Results Before treatment,there was no significant difference among the 3 groups in terms of the pre-swallow peak UES pressure,swallowing function classification,water swallowing test and VFSS (P ＞ 0.05).After treatment,pre-swallow peak UES pressure,swallowing function classification,water swallowing test and VFSS of the balloon dilation group and combined training group improved significantly compared with those before treatment (P ＜ 0.05),and the improvement in the combined training group was to a significantly better extent than in the balloon dilation group(P ＜O.05).Conclusion Balloon dilation and larynx elevation training plus routine swallowing training can increase pre-swallow peak UES pressure,decrease the UES resting pressure of stroke patients with cricopharyngeal achalasia,which is of great importance for their recovery.

Objective To observe the effect of different ways of balloon catheter dilation techniques on cricopharyngeal achalasia and its mechanisms.Methods Thirty patients with deglutition disorder after brain stem infarction,whose cricopharyngeal achalasias were proven by videofluoroscopic swallowing study(VFSS),were randomly divided into three groups: No.14 conventional catheter group A,No.14 modified bicavitary silica-gel catheter group B and No.22 conventional catheter group C with 10 cases in each group,respectively.All the patients of 3 groups received multiple times corresponding balloon catheter dilatation per nasal or per os(No.22 conventional catheter group C only per os).Results After an average of 30 d of balloon catheter dilatation,the level of dysphagia and VFSS evaluation of all patients improved significantly(P ＜ 0.05).However,the No.14 conventional catheter group A and No.22 conventional catheter group C improved to a greater extent than No.14 modified bicavitary silica-gel catheter group B(P ＜ 0.05).The saccule perimeter,saccule diameter and saccule intracapsular pressure of No.14 conventional catheter group A and No.22 conventional catheter group C increased significantly(P ＜ 0.05)when compared to those of No.14 modified bicavitary silica-gel catheter group B,but there was no significant diffference beween No.14 conventional catheter group A and No.22 conventional catheter group C(P ＞ 0.05).Conclusions The balloon catheter dilation technique can significantly improve swallowing function of deglutition disorders patients with cricopharyngeal achalasia after brain stem infarction,which is related positively to saccule diameter and saccule intracapsular pressure.

Objective To explore the application of videofluoroscopic swallowing study (VFSS) in the treatment of dysphagia post-stroke. Methods Eighty patients were assigned into control and treatment groups. Both groups accepted routine drug treatments and physical therapy, and all patients underwent VFSS on the 1 st and 28th day of the study. The patients in the treatment group accepted weekly VFSS in addition, and their swal-lowing training schedules were formulated according to the VFSS assessment results. Water drinking tests and de-glutition disorders were adopted to assess the patients' swallowing function before and after therapy. Results In treatment group, where the therapy schedule was adjusted using VFSS every week, the adjustment proportion at the 2nd, 3rd and 4th week was 20.6% , 40.7% and 15.8% , respectively. Before treatment there was no difference between the two groups with regard to water drinking, deglutition or VFSS scores. After training the water drinking and deglutition results and the time for iodine to transit the oral cavity and pharynx all improved significantly in both groups. The improvements in the treatment group were significantly greater than in the con-trol group. Conclusions Swallowing training based on videofluoroscopic assessment can significantly alleviate post-stroke dysphagia.

Objective To observe the surface electromyographic characteristics of the bilateral submen-tal muscles in dysphagia secondary to unilateral brainstem stroke. Methods A total of 25 subjects were recrui-ted. There were 8 stroke patients with dysphagia secondary to a left brainstem stroke and 7 stroke patients with dysphagia secondary to a right brainstem stroke. There were also 10 healthy controls matched in age and gender. The duration and peak amplitude of the submental muscle when swallowing 5 ml of warm water were recorded u-sing a surface electromyograph. Results The average amplitude of the left submental muscle in patients with a left brainstem stroke was significantly longer than that of those with a right brainstem stroke, but no significant differences in average duration were observed. Conversely, the amplitude of the right submental muscle in pa-tients with a right brainstem stroke was significantly longer than that of those with left brainstem stroke, but again there were no significant differences in duration. No significant differences were observed among the healthy con-trols. The amplitude and duration of both the affected and healthy sides of the patients were of course significantly longer or stronger than those of the healthy controls. Conclusion The swallowing function of the bilateral sub-mental muscles may be impaired among unilateral stroke survivors with dysphagia. The damage on the affected side is more severe than on the opposite side.