Objective To investigate the clinical efficacy of acupuncture plus massotherapy in treating cervicogenic headache. Methods Ninety-seven patients with cervicogenic headache were randomly allocated to a treatment group of 62 cases and a control group of 35 cases. The treatment group received acupuncture plus massotherapy and the control group, massotherapy alone. The VAS score was recorded and plasma nitric oxide (NO) and endothelin (ET) levels were measured in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups. Results The total efficacy rate was 95.2% in the treatment group and 82.9% in the control group; there was a statistically significant difference between the two groups (P<0.05). There were statistically significant pre-/post-treatment differences in the VAS score, neck mobility, and plasma NO and ET levels in the two groups (P<0.05). There were statistically significant post-treatment differences in the VAS score, neck mobility, and plasma NO and ET levels in the treatment and control groups (P<0.05). Spearman’s correlation analysis showed a positive correlation between plasma NO and ET levels and the VAS score.Conclusions Acupuncture plus massotherapy is an effective way to treat cervicogenic headache. Its improving effect on headache is closely related to changes in plasma NO and ET levels.

Purpose To investigate the diagnostic value of parameters derived from intravoxel incoherent motion (IVIM) model for benign and malignant breast lesions,and to provide reference for the identification of breast lesions.Materials and Methods 27 cases with 28 benign breast lesions and 34 cases with 35 malignant breast lesions were collected and analyzed retrospectively.All of the patients were examined with IVIM-DWI scans.GE AW 4.4 workstation was used to calculate the value of ADC,D,D* and f.The diagnostic performance of different parameters was evaluated by receiver operating characteristic curve (ROC curve).The ADC,D,D* and f value of malignant group and the benign group were compared,respectively.Results The value of ADC and D were significantly lower in malignant group than in benign group (P＜0.05),and the value of D* and fwere significantly higher in malignant group than in benign group (P＜0.05).The cutoff value of D was 0.74× 10-3 mm2/s,and the AUC were 0.907,the specificity,sensitivity in the diagnosis of malignant breast lesions was 0.86,0.95,respectively.Conclusions Parameters of IVIM-DWI are helpful in the differential diagnosis of benign and malignant breast lesions.

Objective To evaluate the effect of assertive case management on relapse and health economic evalua?tion in schizophrenics living in communities. Methods Two hundred outpatients were randomly divided into the study group (107 enrolled, 107 completed) which received assertive case management and the control group (93 enrolled, 91 completed) which received normal management treatment for 12 months. Clinical global impression scale (CGI) and the cost of treatment were assessed every three months. Medication adherence and family burden were evaluated before treat?ment and 3, 6 and 12 months after the treatment using Medication Adherence Rating Scale (MARS) and Family Burden Instructing, respectively. Results The study group was less likely to relapse compared with the control group over the 12-month follow-up and the relapse rates were 1.9%and 11.0%in study and control groups, respectively (P<0.01). The repeated-measures analysis of variance indicated that time main effect was significant in severity of illness factor score of CGI (P<0.01). The time main effect and group main effect in factor 1 and factor 3 scores of MARS were significant (all P<0.05) and there was an interaction effect in factor1 score of MARS (P<0.01). In the study group, time effect were signifi?cant in factor 1 score of MARS (P<0.01). The time main effects in indirect cost and total cost were significant and so were interaction effects in direct cost and total cost (P<0.05). In the study group, time effects were significant in direct cost and total cost (P<0.01). Comparison of FBI dimensions before and after the intervention showed that family relation?ship was much more decreased in the study group than in the control group (P<0.01). Conclusions Assertive Case Man?agement can reduce the recurrence of schizophrenia living in communities, improve compliance medication and family re?lationship as well as reduce the cost of treatment.

Objective ToinvestigatethevalueofDWIhyperintensityinvenoussinusindiagnosisandrecanalizationpredictionof cerebralvenoussinusthrombosis(CVST).Methods Clinicaland MRIdataof19patientswithCVST wereanalyzedretrospectively. BasedonDWIsignalcharacteristicsoftheCVST,thepatientsweredividedintoasthehyperintensegroupandthenon-hyperintense group.TheintervaltimebetweenthefirstMRIexaminationandtheonset,andtherecanalizationratewithin1 monthand3 months werecomparedbetweenthetwogroups.Results Therewere76 CVSTinthe19patients,withhyperintensein16venoussinus (21%)andin11patients(57.9%).Theintervaltimewaslongerinthehypertensegroupthanthenon-hypertensegroupbutnosta-tisticalsignificance[(12.81±11.10)daysversus(5.70±7.82)days,P=0.165].17patientsunderwentthesecond MRIexamination in1month,andtherecanalizationrateoftheobstructedsinuswaslowerinthehypertensegroupthanthenon-hypertensegroupwith nostatisticalsignificance(P=0.130).14patientsunderwenttheMRIexaminationafter3 months,andtherecanalizationrateofthe obstructedsinuswaslowerinthehypertensegroupthanthenon-hypertensegroupwithstatisticalsignificance(P=0.047).Conclu-sion ThehypertenseonDWIhashighsensitivityforthedetectionofsubacuteCVST.Thepresenceofhypertenseinoccludedsinus onDWIhasthepredictivevalueforvesselrecanalization.

Objective To investigate the atypical MRI manifestations in patients with primary central nervous system lymphoma(PCNSL). Methods The clinical and MRI manifestations of 17 patients with pathologically confirmed atypical PCNSL in the First Affiliated Hospital of Henan University of Science and Technology (from May 2011 to Dec 2016) and Nanfang Hospital (from Sep 2003 to May 2009) were analyzed retrospectively in this study. Both conventional and contrast-enhanced MR images were acquired for each patient. The MRI manifestations including the number, location, size, shape, signal intensity, enhancement patterns of lesions were evaluated by two senior radiologists.Results Of the 17 cases,8 were solitary and 9 were multiple.Two types of atypical MR findings were found:(1)Atypical location:For the 9 patients showed atypical location,7 patients had solitary masses which were located in the brainstem(n=3), the supratentorial superficial parts(n=2), the cerebellum(n=1)and the sella(n=1). Two patients had multiple lesions, showing multiple subependymal nodules and no abnormalities in the brain parenchyma. Six of the 7 solitary lesions and the 2 multiple cases showed isointense or hypointense on T1-weighted scans and isointense or hyperintense on T2-weighted scans as well as significant homogenous enhancement on contrast-enhanced T1-weighted scans.(2)Atypical signal features:Ten cases were found with atypical signal features including:①Patchy lesions were observed in 6 patients( one patient with single lesion, and five patients with multiple lesions),appearing as hyperintense spots on T2-weighted image and subtle hypointense on T1-Weighted image. Corresponding contrast-enhanced T1-weighted MR image showed multiple patchy/linear enhancement. ②Two cases showed diffuse supratentorial periventricular and infra-tentorial white matter T2hyperintensity and absence of contrast enhancement. ③Nodular lesions with inhomogeneous internal signals were found in 2 cases with calcification(n=1) and cystic necrosis (n=1, ring-like enhancement).Conclusions The atypical imaging manifestations of PCNSL could lead to misdiagnosis or delay in the diagnosis.It is important to understand its atypical imaging features and combine with clinical manifestations to improve the accuracy of differential diagnosis of intracranial lesions.