Acupuncture, Tuina and combination of acupuncture and Tuina were used to treat 250 cases of shoulder periarthritis who were randomly divided into three groups. Bingfeng (SI 12) and Ashi points were selected and cupping therapy was also given following acupuncture in acupuncture group; pressing, kneading and plucking manipulations were performed in Tuina group,acupuncture plus Tuina were employed in group of acupuncture plus Tuina. The therapeutic results showed acupuncture plus Tuina was better than simple Tuina, and statistical analyses demonstrated P ＜0.05.

Objective To search for a better way than DSA to display the bronchial arterial (BA) supply of spinal cord, esophagus, trachea, etc., and for further evaluation of BA supply to the above structures, along with reducing the complications of trans-BA infusion and/or embolization. Methods Multislice CT angiography of BA (BA-MSCTA) was performed on 19 patients suffering from lung cancer or hemoptysis due to bronchiectasis after undergoing digital subtraction angiography BA (BA-DSA). Totally 10ml of 45% contrast medium was injected into BA (1～2 ml/s), BA-MSCTA was started 5 s after the injection, scanning from low cervical region to the bottom of lung (collimation: 5 mm; no overlapping reconstruction ). The intra-spinal canal, esophagus, trachea, etc. were enhanced. Results On BA-DSA, except one case in which a bronchial artery was faintly displayed, no spinal artery, intra-spinal canal, esophagus or trachea enhancement could be demonstrated. While on BA-MSCTA, intra-spinal canal associated with an intercostobronchial trunk enhancement due to truncus formation were observed in seven cases, including five cases of spinal enhancement (5/19,26.3%). 15 cases of esophageal enhancement and 18 cases of tracheal enhancement were also observed. Conclusion BA-CTA is superior to BA-DSA in displaying the BA supply of spinal cord, esophagus, trachea, etc.. Spinal arteries are more likely to appear in intercostobronchial truncus cases.

Objective To explore the feasibility of low dose in MSCT thoracic angiography using Z-axis modulation. Methods The consecutive 60 patients were averagely divided into 3 groups and underwent thoracic angiography with a Toshiba Aquilion 16 scanner. The whole chest acquisition was commenced in automatic exposure control with Z-axis modulation 20-25 seconds after the contrast material was administered at the rate of 3.5-4. 0 ml/s. With the noise index (SD) as the variable, three study groups were classified as A (SD = 12) , B (SD = 15 ), and C (SD = 18 ). The mAs value per slice and the number of slices were recorded. The noises and artifacts of the axial images and the acceptability of CT angiogram were evaluated. The difference among the groups was compared by using ANOVA or nonparametric Kruskal-Wallis test. The threshold of the P value was 0. 05. Results The mean mAs value (46. 4 ± 15.6) mAs in group A was the highest but the SD value (21.6 ±7.7) was the lowest. The mean mAs value ( 37. 0 ± 13.5 ) and the SD value ( 24. 0 t 5.4 ) in group B were the mediate. The mean mAs value ( 20. 7 ±6.3) mAs in group C was the lowe(s)t but the SD value ( 30. 7 ± 6.9) was the highest ( H = 31. 390, P =0. 000). The middle slice images in all patients had the smallest mAs (40. 9,31.3,17. 1 for group A,B,C,respectively; F =9. 578, H =22. 230, F =21. 180,P =0. 000) and SD values( 16. 3, 20. 0,25.4 for group A,B,C, respectively; H = 28. 982, H = 20. 824, H = 24. 396, P = 0. 000). The acceptability of CT angiogram in all patients was excellent. The CT value of descending aorta in group A, B, and C was ( 335 ± 85 ) HU,(334 ±56)HU, and (427 ± 63 )HU, respectively. Conclusion Low dose in MSCT thoracic angiography using Z-axis modulation is feasible. We can use low dose (20 mAs, etc. ) for CT angiography when the contrast is significant.

Objective To evaluate the CT findings of multicentric Castleman disease(CD).Methods The CT findings of thorax and abdomen in a patient with multicentric CD biopsy-proved were retrospectively analyzed, and a literature review was conducted.Results The patient had systemic symptoms, polyclonal hypergammaglobulinemia, extensive lymph node enlargement and mild enhancement, and specific pulmonary infiltration. The lung lesions on thin-section CT were showed poorly-defined centrilobular nodules, ground-glass attenuation, thin-walled cysts, thickening of the bronchovascular bundles, and interlobular septal thickening. The above were highly coincident with that in the literatures.Conclusion Multicentric CD is characterized by the presence of systemic symptoms, extensive lymph node enlargement and mild enhancement, and specific pulmonary lesions when infiltrated. Typical manifestation might suggest multicentric CD.

Objective: To study the CT features and its diagnosis of spontaneous renal vein shunt (SPVA) in portal hypertension. Methods: Totally 220 cirrhosis patients with portal hypertension diagnosed clinically underwent multi-slice CT scanning. The parameters were 5 mm/6. 5 mm/2. 0 mm(collimation/effective thickness/interval) in 180 patients and 2. 5 mm/3. 2 mm/1. 6 mm in 40 patients. An arterial-phase (delaying 26-28 s) and a portal venous phase (55-60 s) were included. All images were showed by cine and CTA was displayed with volume rendering and thin-slab maximum projection when ah normal vessels were suspected. Results: The spontaneous renal shunt were found in 26 patients (11. 8%), including spleno left renal shunt(20 patients), gastro-left renal shunt (16 patients), and portal-right renal shunt(2 patients). The veins sur rounding renal hilum were rich and thick in 7 patients. Conclusion: The SPVA is not rare in portal hypertension, enhanced CT scan and angiography with multi-slice CT can effectively display the shunt vessels, contributing to the correct diagnosis and right therapy.

Objective: To investigate the clinical effect of combination therapy on ankylosing spondylitis. Methods: 160 Cases were divided into treatment group and control group randomly. The patients of treatment group were given Bushenqingdu Decoction and Hanbiwaiyongfang by external use. The patients of control group were given Wangbi Granule. The symptoms and signs were observed before and after treatment in both groups. Results: There was significant difference between treatment group and control group in total effective rate as well as morning stiffness and signs (P

The Adamkiewicz artery(AKA)is the major blood supply of the spinal cord in the thoracolumbar region.The anterior two thirds of the spinal cord receive blood supply from the AKA and 75% blood supply of the spinal cord comes from the AKA.The AKA diameter is reported to be only 0.8 ～ 1.3 mm in the thoracolumbar region.In order to prevent ischemic injury to the spinal cord,the anatomy of the blood supply of the spinal cord needs to be recognized completely before invasive treatment taken in the descending thoracic and proximal abdominal aorta.Although selective angiography has been recommended,but it is time-consuming and hazardous.Multi-detector row helical CT can provide a simple protocol of scanning and relatively brief postprocessing depicting the Adamkiewicz artery with a high successful rate.Optimizing the flow velocity of contrast medium and the using of scan-triggering CT threshold are the keys of success.

Objective The purpose of this study was to present the characteristic features on MSCT angiography of arterial sequestration.Methods The MSCT images of 5 patients with arterial sequestration were retrospectively reviewed All patients underwent MSCT contrast-enhanced angiography.3D rendering was made to evaluate the lung parenchyma,bronchial system,and vascular anatomy.Results All S cases demonstrated the anomalous systemic artery(ASA)as an isolated and tortuous artery arising from the descending thoracic aorta,taking a sigmoid course and running along with airway,entering the basal segments of the left lower lobe.The inferior pulmonary vein(IPV)was significantly engorged.The typical AS was diagnosed in 4 patients.Its ASA intercrossed with the IPV and two branches entering segments 7 and 8 over the IPV,and two branches entering segments 9 and 10 under the IPV.The volume of involved lung shrunk with the artery markedly engorged.A characteristic avascular section was found between the pulmonary artery supplying area and the ASA supplying area,and the bronchi did not accompany the arteries.One was diagnosed atypical AS because of coexistence with bronchial atresia.Conclusion The arterial sequestration had characteristic MSCT findings.The typical type can be definitely diagnosed,but the atypical type needs further three-dimensional analysis.

Objective To investigate the differential diagnostic values of CT bronchial sign for peripheral solitary pulmonary lesions(SPLs).Methods One hundred and eleven patients with peripheral SPLs were scanned using multi-slice helical CT(MSCT),and multiplanar reconstruction was performed to show the relationship between the lesion and bronchus,the diffefences between the benign and malignancy were compared by using chi-square test.Results Bronchial cutoff rate in malignant lesions(47/95,49.5%)was markedly hi er than that in benign lesions(10/42,23.8%.X12=7.896,P＜0.05),the frequency of type Ⅰ and type Ⅱ air bronchogram presented in malignant lesions(10/11.8/9)was higher than benign lesions(1/11,1/9.X2=6.975,4.818,P＜0.05),but type Ⅳ in benign lesions(12/17)was more common than that in malignant lesions(5/17.X2=7.390,P＜0.05).No significant difference was found in bronchus ran at the periphery of the lesion and bronchus dragged by the lesion between benign(9/24.1/4)and malignant lesions(15/24,3/4.X2=0.641,0.062,P＞0.05).The focal bronchial wall thickening in malignancy(21/22)was markedly higher than benign lesions(1/22.X2=4.185.P＜0.05),whereas the extensive thickening in benign lesiom(4/7)was more common(3/7.X2=8.650,P＜0.05).Conclusion CT bronchial sign is very important in the differentiation of benign and malignant pulmonary lesions.

Objective To observe the changes of tongue and pulse parameters in the patients with chronic hepatitis B(CHB)after pegylated interferon alpha-2a(PEG-IFNα-2a)treatment,to investigate its value in evaluation clinical efficacy of PEG-IFNα-2a treatment.Methods 120 patients with CHB who confirmed to the standard received PEG-IFNα-2a antiviral therapy for 48 weeks,and followed up for 24 weeks.The tongue and pulse parameters were detected by DS01-A type digital tongue and pulse presentation analyzer.The changes of liver function,serum HBV markers,HBV DNA,tongue and pulse parameters were observed before and after treatment.Results 113 patients completed the course of treatment,46 cases received complete response(response rate 40.7%).The response rate of liver stagnation and spleen deficiency group was higher than that of blood stasis group(95%CI:0.010-0.677,P <0.05).The baseline of tongue and pulse parameters had no significant difference between response group and non response group(h3 /h1,t =1.799,P =0.074;h4 /h1,t =1.383,P =0.169;h5 /h1,t′=0.461,P >0.05;W/t,t′=0.688,P >0.05;R,t =1.317,P =0.190;G,t =0.346,P =0.729;B,t =1.720,P =0.088).After 48 weeks treat-ment,and followed up for 24 weeks,the tongue and pulse parameters of response group and non response group were compared with baseline,h3 /h1,h4 /h1 decreased,R value and G value increased,the differences were statistically sig-nificant(Response group:h3 /h1,t =3.004,P =0.003;h4 /h1,t =2.702,P =0.008;R,t′=2.258,P <0.05;G,t′=3.052,P <0.05.Non response group:h3 /h1,t =1.978,P =0.049;h4 /h1,t =2.487,P =0.014;R,t′=2.661,P <0.05;G,t′=2.318,P <0.05).But there were no significant differences between the response group and no response group after treatment(h3 /h1,t′=0.191,P >0.05;h4 /h1,t =0.390,P =0.697 2;h5 /h1,t′=0.957,P >0.05;W/t,t =0.149,P =0.881;R,t =1.343,P =0.181;G,t =0.994,P =0.322;B,t =0.565,P =0.572).Conclusion The changes of tongue and pulse parameters have improved after treatment with PEG-IFNαin patients with CHB. However,the value in predicting the efficacy of antiviral therapy may be limited.