Objective To assess the value of outflow angle-assisted (OA-assisted) approach in diagnosing and differentiating sidewall cerebral aneurysms (SCAs) with magnetic resonance angiography (MRA). Methods A total of 438 patients with suspected SCAs and other cerebrovascular diseases were separately evaluated by OA-assisted approach MRA and digital subtraction angiography (DSA). An OA of ≥90o was considered to represent SCA. The diagnostic accuracy, sensitivity, and specificity of SCAs with OA assisted approach were evaluated with the number of aneurysms and the size of aneurysms. Results DSA revealed 301 SCAs in 267 patients, and no SCAs was detected in the remaining 171 patients, among them a total of 55 infundibulae were observed in 52 patients. OA-assisted approach MRA revealed 300 SCAs in 267 patients, among which 271 aneurysms in 238 patients had an OA of ≥90o(true positive of 90.3％) and 29 aneurysms in 29 patients had an OA of <90° (false negative of 9.7％). Based on the patient, the number of aneurysms and the size of aneurysms, OA-assisted approach MRA had higher accuracy, sensitivity and specificity in diagnosing SCAs. The OA of all 54 infundibulae observed in 51 patients was <90°(98.2％), and only one infundibula in one patient was ≥90° (false positive). Conclusion MRA with OA-assisted approach has higher accuracy in diagnosing SCAs and in differentiating SCAs with infundibula, therefore, it can substitute DSA for the diagnosis and differentiation of SCAs.

Objectives To provide reliable information concerning the presence or the absence of Histoplasma capsulatum (H. capsulatum) infection in China, and data concerning this respect.Methods Three hundred normal people and 435 hospitalized patients, who lived in Hunan and Jiangsu provinces, and the Xinjiang Autonomous Region, were tested with yeast-phase histoplasmin (ALK/Berkerley Biologicals Laboratories, USA) and human pure protein derivative of tuberculin (PPD) on the volar surface of the forearm. Any reaction to the antigens over 5.0?mm in diameter of induration at 48-72?hours was considered positive. Results A total of 138 subjects (18.8%) in 735 patients reacted to histoplasmin with 5.0-45.0 (9.1±4.3)?mm indurations. Significant differences of positive skin reaction rates in normal subjects were found in Hunan, Jiangsu and Xinjiang (8.9% vs 15.1% vs 2.1%). The overall positive rate of patients was 25.5%. Patients with tuberculosis [31.7% (78/246)] had a significantly higher positive skin reaction rate in comparison with those suffering from pneumonia [17.7% (11/62)], lung cancer [20.9% (9/43)], chronic obstructive pulmonary disease [17.3% (9/52)] and other diseases [12.5% (4/32)] (P<0.01). Of 562 cases, 292 cases (52.0%) reacted to PPD with indurations of 5-50 (13.7±4.9)mm in diameter, 63 cases (11.2%) reacted to both histoplasmin and PPD, while 38 cases (6.9%) reacted to histoplasmin but not to PPD.Conclusions The data suggest that there is H. capsulatum herd infection in China. The infection rate in Southeast China is higher than that in the Northwest, and the infection rate of patients with pulmonary tuberculosis is higher than that of normal persons and other pneumonopathy patients.