Intravascular large B-cell lymphoma (IVLBCL) is a rare non-Hodgkin lymphoma with variable clinical manifestations. Although neurological symptoms are common in patients with IVLBCL, isolated cauda equina-conus medullaris syndrome is rarely reported. We herein report a case of IVLBCL whose initial presentation was cauda equina-conus medullaris syndrome with neither dermatological nor hematological manifestations. A 54-year-old man without known immune-compromised state presented with progressive ascending numbness and weakness of bilateral legs and urine incontinence for 2 months. Lumbar-sacral magnetic resonance images showed gadolinium-enhanced conus medullaris and cauda equina nerve roots. Cerebrospinal fluid analysis revealed lymphocyte predominant pleocytosis and elevated protein level without malignant cells. Focal seizure and mental status changes followed several weeks later. Brain biopsy led to the diagnosis of IVLBCL. Conclusions: IVLBCL should be included in the differential diagnosis of patients with isolated cauda equina-conus medullaris syndrome. A survey of previously published cases in the literature also showed that early initiation of chemotherapy has better outcome.

Objective To evaluate the relationship between intraplaque hemorrhage of cerebral arteries and acute cerebral infarcts. Methods 35 patients with severe stenosis in M1 segment of middle cerebral arteries (MCA)were included in this study.Intracranial TOF MRA (time of flight MR angiography)was performed to detect the stenosis in MCA,and DWI (diffusion weighted imaging) was performed to detect cerebral acute infarcts.T1 MPRAGE sequence was positioned on the stenosis in M1 segment of MCA,and intraplaque hemorrhage was determined according to high signal on T1 MRRAGE images.35 patients were divided into two groups:one group with intraplaque hemorrhage and the other group without intraplaque hemorrhage.Whether there was significant differ-ence in the incidences of acute cerebral infarcts between the two groups were determined byχ2 test.Results Intraplaque hemorrhage was detected in 1 5 patients,in which 12 patients had acute cerebral infarcts.There were no intraplaque hemorrhage in 20 patients,in which 9 patients had acute cerebral infarcts.There was significant difference in the incidences of acute cerebral infarcts between the two groups (P =0.046 <0.05).Conclusion There is a higher incidence of acute cerebral infarcts in patients with intraplaque hem-orrhage than those without intraplaque hemorrhage.Intraplaque hemorrhage in severe stenosis of cerebral arteries is a high-risk indi-cation for acute cerebral infarction.

Objective To observe the morphologic changes of pancreatic islets in diabetic rats and the protective effects of rosiglitazone natrium (RSG) on the remnant islet.Methods 8 rats were randomly selected from 68 male Sprague-Dawley rats for normal control group (group A),the rest were administered with STZ,and those with FBG≥16.7mmol/L were served as diabetic models,then the rats were randomly assigned as RSG-treated group (group B,n=24).RSG were applied via intragastric administration at a dose of 5mg/(kg·d) in group B.72 hours after the administration of STZ and 1-,2-,4 and 7 week after the administration of RSG,4 rats were randomly selected respectively,pancreas specimens were obtained and preserved.The morphologie changes were observed under light microscopes and transmission electron microscope.Results The diabetic symptoms of the rats in groupe B lessened significantly,and the FBG levels were decreased gradually,the morphologic injuries of remnant islet were recovering. The amount of secretory granule in beta cells increased gradually.Conclusion Rosiglitazone natrium call attenuate morphologic injuries of the islets and protect the remnant islet in type 1 diabetes mellilus rats.

OBJECTIVETo compare the clinical effects of different surgical methods for the epicanthus corrective surgery.

METHODSCanthoplasty with asymmetric Z-flap is applied in 46 cases, Y-V advancement procedure for epicanthoplasty is applied in 42 cases. The epicanthus aesthetic measurement were measured and calculated by software before and after surgery, the diameter of the iris was measured as a reference value,and the postoperative scar was assessed by VSS scale. At the same time, by measuring the lateral canthal distance, the accuracy of the measurement method can be verified.

RESULTSAll patients were satisfied with the long-term results and there were no recurrences of the epicanthal fold. The shortening ratio of the ICD is 8.36% in the group with the Z-plasty, and 5.88% in Y-V plasty. the lateral canthal distance have no diffrence before and after surgery.

CONCLUSIONSTwo surgical methods can get good results. The magnitude of correction in Z-plasty may larger than Y-V plasty, but postoperative retraction may existed in Z plasty.

Blepharoplasty ; methods ; Cicatrix ; Esthetics ; Eyelids ; surgery ; Humans ; Recurrence ; Software ; Surgical Flaps

Objective To determine the clinical value of the multi-slice spiral CT virtual endoscopy (CTVE) for the detection of biliary pancreatic junction lesions. Method MSCT and virtual endoscopic reconstruction were performed in 30 healthy volunteers, 18 cases of common bile duct stones and 7 cases of ampullary carcinoma to observe patterns of duodenal papilla and measure its size.Results Reconstructed image of CTVE showed that the normal duodenal papilla was nodular in 16,shaped like "V" in 8 "Y-shaped" in 6 of the healthy volunteers. Its diameter was (0.84±0.17)cm. In the patients with common bile duct stones, it was nodular and its diameter (1.72±0.32)cm. In the patients with ampullary cancer, it was of irregular protruded type and its diameter (2.30±0.85)cm.There was significant difference among the 3 groups in the overall mean values (P＜0.01). Conclusion CTVE is a convenient, non-invasive and precise clinical examination to observe the shape of duodenal papilla and determine its size.

?Dry eye is a multi-factorial disease of tear film and ocular surface, and it can result in discomfort, visual disturbance and tear film instability and potential damage of ocular surface, accompanied by hyper osmolarity of tears and ocular surface inflammation. lnflammation is the key factor to dry eye. Many kinds of immune cells and inflammatory factors are involved in the occurrence and development of dry eye syndrome. Cell apoptosis, nerve dysregulation, disorders of sex hormones also play an important role in pathologic process of dry eye. Recently, while illustrating the pathophysiology and pathogenesis of dry eye has been made some progress, there is still no single standard. The possible mechanisms of ocular surface inflammation and tear dysfunction of dry eye were reviewed in this article.

OBJECTIVE:To explore the comprehensive model for the prevention and treatment of community hypertension.METHODS:By questionnaire survey,the community hypertension target population was screened and the drug use in hypertensive patients was analyzed statistically.RESULTS:Of the 65 000 community residents investigated,1 250 were found to be hypertensive patients,with a total treatment rate of 80.0%;only 32.8% were treated with at least 2 kinds of drugs,and the overall blood pressure control efficacy was poor.CONCLUSION:The program of prevention and treatment for community hypertensive patients is conducive to patients' long term adherence to medication,scientific and rational drug use and effective and stable control of blood pressure.

Objective To explore the effects of anxiety-like behaviors on the levels of sex hormones and severity of erectile dysfunction(ED) in young men.Methods A total of 120 young men with ED,between the ages of 23 and 35 years,were prospectively studied,and all of them were the outpatients from the Affiliated Hospital of Jining Medical University from January 2012 to October 2013.Self-Rating Anxiety Scale (SAS) was used.According to the scores of SAS,the patients were divided into four groups.26 were rated by SAS as in the normal,36 in the mild,32 in the moderate and 26 in the severe state of anxiety.The levels of serum sex hormone (FSH,LH,PRL,T,E2) were detected by immunochemiluminometric assays.ED was assessed using the IIEF-5.Further,the responses were divided into three diagnosing groups on the basis of cutoff scores for IIEF-5.The relationship between the SAS scores of measuring anxiety,serum sex hormone levels,and the indicators for ED,Spearman rank correlations were carried out.Results Comparing with the normal control group,the levels of serum sex hormones (FSH,LH,PRL,E2) increased in other groups,but there were no significant differences (F=0.28,P=0.08 ; F=2.91,P=0.06; F=0.90,P=0.44; F=0.80,P=0.15).The levels of serum testosterone and the scores of IIEF-5 in the moderate and severe anxiety group decreased.The more severe symptoms of anxiety,the more likely that the ED would occur(x2=72.423,P=0.00),and ED was significantly positively correlated with anxiety(r=0.637,P=0.00).Testosterone played the partial intermediary role on the relationship between anxiety score and the IIEF-5 score.Conclusion Anxiety may contribute to ED through disturbing the sex hormone and lowering the level of serum testosterone.

Objective To study the DCE-MRI findings of laryngeal and hypopharyngeal carcinoma.Methods 26 new patients di-agnosed laryngeal and hypopharyngeal cancer by pathology were collected and took DCE-MRI before therapy.The TIC type,ADC value,peak time (Tpeak),peak signal enhancement percentage (SERmax),positive enhancement integral(PEI),maximum slope of increase(MSI)and maximum slope of decrease(MSD)were obtained respectively.These semi-quantitative parameters of primary cancer,normal pharyngeal tissue and the same layer neck muscles were compared and P <0.05 was considered statistical signifi-cance.Results The TIC types for primary tumor including type Ⅰ(5),type Ⅱ(6),type Ⅲ(1 5),a significant difference of Tpeak、MSI、MSD were observed(P < 0.05 )no difference in ADC values (P > 0.05 )was found.Different b values (b = 300 s/mm2 , 500 s/mm2 )for ADC values were significantly different.There was statistical significance in semi-parameters among the primary cancer,normal pharyngeal wall tissue and the same layer neck muscles.Setting MSI value 58.32 threshold to distinguish abnormal and normal tissues,sensitivity and specificity both were 84.6%.Conclusion DCE-MRI can reflect morphology and signal differences among neck muscles,normal and abnormal laryngeal and hypopharyngeal tissues,providing help for diagnosis of primary carcino-ma.

Objective To analyze and summarize the CT features of medullary thyroid carcinoma (MTC).Methods 30 patients with MTC proved by surgery and pathology were scanned by CT.And the CT manifestations were analyzed retrospectively.Results In a total of 30 patients,a single lesion in 25 (83.3%)patients and multiple ones in 5 (16.7%)were found with irregular shape in 27 (90.0%),unclear border in 26 (86.7%),heterogenous enhancement with irregular internal hypodensity in 27 (90.0%),cal-cifications in 4 (13.3%)and invasion of trachea in 4 (13.3%).As for the 29 patients underwent the neck surgery ,26 (89.7%) were pathologically confirmed with lymph nodes metastasis.CT showed the metastatic lymph nodes with well-defined border in 1 2 (46.2%)and ill-defined one in 14 (53.8%),calcifications in 5 (19.2%)and heterogenous enhancement with irregular internal hy-podensity in all (100.0%).Conclusion CT features of MTC and metastatic lymph nodes appeared as heterogenous enhancement with irregular internal low attenuation area,which can improve the accuracy of preoperative diagnosis.