Objective To evaluate CT and MRI for the diagnosis of cranial extradural empyema.Methods The imaging features in 4 patients with cranial extradural empyema were analyzed.Results 2 cases in frontal,1 case in frontalparietal,1 case in posterier cranial fossa,in this series of 4 cranial extradural empyemas was found homogenous enhancement of dural,and thickened meninges surrounding the empyema.In the series of 1 case show bony thickening and thin.Conclusion The CT and MR of cranial extradural empyema can well demonstrate the morphological and pathological evidence of ivolved menings.Therefore,CT and MR is the most diagnostic value in cranial extradural empyema.

Objective To evaluate the correlations of vascular structures,hemodynamic changes and recanalization before receiving carotid endarterectomy ( CEA) in patients with subtotal or complete occlusion of carotid artery using color Doppler flow imaging (CDFI) and transcranial Doppler (TCD) ultrasonography. Methods A total of 107 patients were diagnosed as subtotal ( stenosis rate 95% to 99%) or complete occlusion of carotid artery with DSA and treated with CEA at Beijing Xuanwu Hospital, Capital Medical University from January 2005 to January 2014 were enrolled retrospectively. The mean age of patients was 61 ± 9 years. According to the findings of DSA,they were divided into either a carotid artery subtotal occlusion group (n=63) or a complete occlusion group (n=44). The vascular diameter,the locations of the lesions ( internal carotid artery or common carotid artery) ,the lumen echo characteristics,and whether internal-external artery collateral circulation patent or not at different stages in patients of both groups were documented. Results The lumen diameter of distal segment was significant wider in patients of the complete occlusion group compared with the subtotal occlusion group (4. 1 ± 1. 1 mm vs. 3. 2 ± 0. 8 mm). There was significant difference between the 2 groups (P <0. 01). There was no significant difference between the location of occlusion and the recanalization rate (P=0. 460). The recanalization rate of the lumen homogeneous echo ( hypoecho and echodense) filling patients (94. 1% vs. 86. 7%) was significantly higher than that of the patients of heterogeneity echo. In patients with complete occlusion of internal carotid artery,the recanalization of CEA would increase when the internal-external collateral arteries were patent. For general comparison,the recanalization rate of the subtotal occlusion group was significantly higher than that of the complete occlusion group (P<0. 01). Conclusion The carotid artery diameter normal or broadening ,the homogeneous echo in the occlusive lumen and the internal-external collateral arteries patency are closely associated with the recanalization rate. The preoperative ultrasonography has great value for the assessment of recanalization of carotid artery occlusive disease after CEA.

Objective To investigate the clinical efficacy of a period of joint fusion and plate internal fixation for four parts calcaneal fractures.Methods The clinical data of 53 patients with four parts calcaneal fractures from January 2009 to January 2013 were analyzed retrospectively.Twenty-two patients were performed a period of joint fusion (joint fusion group),31 patients were performed plate internal fixation (plate internal fixation group).The Bohler angle and Gissane corner before and after operation,operation time and bleeding,the Maryland foot function score between two groups were compared.Results Compared with before operation,the Bohler angle and Gissane corner in plate internal fixation group and joint fusion group were improved significantly after operation (34.6° ± 4.2° vs.5.7° ± 2.4°,125.4° ± 8.2° vs.87.2° ± 6.8°,32.8° ± 3.9° vs.5.4° ± 2.7°,127.6° ± 7.8° vs.86.9° ± 6.7°),and there were significant differences (P ＜0.05),but the Bohler angle and Gissane corner before and after operation between two groups had no significant difference (P ＞ 0.05).The operation time and bleeding were (52.1 ± 5.1) min,(50.0 ± 10.2) ml in plate internal fixation group and (70.3 ± 5.2) min,(105.0 ± 20.5) ml in joint fusion group,and there were significant differences between two groups (P ＜ 0.05).The fineness rate of Maryland foot function at 6 months follow-up between two groups had no significant difference (P ＞ 0.05).Conclusions The plate internal fixation and joint fusion is therapeutic equivalence in treatment of four parts calcaneal fractures.Due to the small surgical trauma and less bleeding of plate internal fixation,it may be preferred in the treatment of four parts calcaneal fractures.

Objectives Todynamicallyobservethechangesofhemodynamicparametersinpatients with severe stenosis of unilateral middle cerebral artery (MCA)by transcranial Doppler ultrasound (TCD) andtoevaluateandanalyzetherelatedfactorsforinfluencingthestenoticprocess.Methods Atotalof 113 consecutive patients with severe stenosis of unilateral MCA screened by TCD and confirmed by computed tomography angiography (CTA)and digital subtraction angiography (DSA)were enrolled retrospectively. They were divided into either a progressive group (n =43 )or a non-progressive group (n=90)according to the variation of MCA hemodynamic parameters. The effects of age,sex,major risk factors for cerebrovascular disease,clinical symptoms,clinical medication,and drug compliance on the stenotic process were documented and analyzed. Results (1)The comparison of detection rate of the risk factors for cerebrovascular disease:The patients with a history of smoking (72. 1%[n=31])in the progressive group was significantly higher than that (51. 1%[n=46])in the non-progressive group (P=0.022). The period of smoking of the patients in the progressive group were longer than that in the non-progressive group (28 ± 12 years vs. 21 ± 10 years,P=0. 011). (2)Comparison of MCA hemodynamic parameters:The distal pulsatility indexes of MCA stenosis at the first diagnosis in the progressive group were all lower than those in the non-progressive group (0. 66 ± 0. 10 vs. 0. 70 ± 0. 13;t= -2. 096,P=0. 038),and the distal pulsatility indexes of MCA stenosis at the end point in the patients of the progressive group were lower than those in the non-progressive group (0. 61 ± 0. 15 vs. 0. 74 ± 0. 15). There were significant differences (t=-2. 718,P= 0. 008). The peak systolic velocity (PSV)of the progressive MCA stenotic segments at the end point in 10 patients of the progressive group was higher than that in the non-progressive group (299 ± 23 cm/s vs. 244 ± 50 cm/s,t=3. 437;P=0. 001),while PSV of MCA in 33 patients with occlusion in the progressive group were significantly lower than those in the non-progressive group (56 ± 18 cm/s vs. 244 ± 50 cm/s,t= -20. 905;P=0. 000). (3)The regular medication:The patients using statins (atorvastatin calcium)were significantly lower than those of the non-progressive group (2. 3%[n=1] vs. 54. 4%[n=49],χ2 =33. 690;P<0. 01). (4)During the follow up period,the recurrence rates of transient ischemic attack and stroke of the progressive group were significantly higher than those of the non-progressive group (27. 9%[n=12]vs. 6. 7%[n=6],32. 6%[n=14]vs. 2. 2%[n=2];all P<0.01). (5)Multivariate Logistic regression analysis showed that smokers (OR,4. 403,95%CI 1. 094-14.017),cerebrovascular event recurrence (OR,10. 648,95%CI 2. 530 -41. 261),and irregularly taking statins (OR,5. 675,95%CI 1. 631-152. 740)were all closely associated with the progress of severeMCAstenosis.Conclusion EvaluationofthehemodynamicchangesofsevereMCAstenosiswith TCD follow up study can be used as an important basis for clinical assessment of the outcomes. Stop smoking and regularly taking statins may help to delay the progress of MCA stenosis.

Objective: To explore the clinical and echocardiography characteristics between noncompaction of ventricular myocardium (NVM) and dilated cardiomyopathy (DCM) combining hypertrabeculation in order to distinguish NVM from DCM.
Methods: Our research included 2 groups of patients: NVM group,n=31 and DCM combining hypertrabeculation group, n=50. The basic information as gender, age, family history, symptoms, ECG, plasma levels of BNP and echocardiography were recorded and examined in all patients; the size of cardiac chambers, myocardium, endocardium and hemodynamics were particularly focused. The trabeculation was analyzed by 17 segments method.
Results:①Compared with NVM group, the patients in DCM combining hypertrabeculation group had the worse cardiac classiifcation, higher plasma levels of BNP (P<0.05) and more obvious cardiac dilatation.②The patients in NVM group had the most trabeculation segments (9.82 ± 2.02) and the apical (17th segment) was involved, patients had the higher ratio of noncompacton/compaction (NC/C) as (2.84 ± 0.61), there were (4.12 ± 2.68) segments with NC/C > 2.③The patients in DCM combining hypertrabeculation group had the less trabeculation segments (5.56 ± 1.56) and the apical was seldom involved, patients had the lower ration of NC/C as (1.91± 0.42), there was at most 1 segment with NC/C > 2. All P<0.05.
Conclusion: Echocardiography is a simple, practical and noninvasive method to distinguish NVM from DCM. NVM could be diagnosed by obvious left ventricular apex involvement with NC/C >2 in at least 2 segments of free ventricular walls.

Objective To observe ultrasonic and PET/CT features of malignant lymphoma after chemotherapy and to determine the value in assessment of lymphoma treatment response.Methods Seventy-seven lymph nodes in 32 patients were observed and measured with color Doppler ultrasound and PET/CT after chemotherapy comparing with pathologic results.Results Seventy-two lymph nodes were exactly certified by ultrasound(94.8%),and seventy-five nodes were exactly confirmed by PET/CT(97.4%).There were significant differences in L/S,blood supply type,Vmax,Vmin,RI(P＜0.05)between nodes groups with and without residual tumor.The PET/CT inspection demonstrates that lymph nodes with residual tumor was in the high metabolism condition.The positive nodes'index of ultrasound were connected with their metabolism condition.Conclusions The two methods all have high rate of accuracy.Ultrasound can be used as normal method in assessment of lymphoma treatment response.

OBJECTIVE:To establish a method for the simultaneous determination of chlorogenic acid,vitexin glucoside,vi-texin rhamnoside,vitexin,rutin and hyperoside in Crataegus pinnatifida. METHODS:With reference peak of vitexin glucoside, HPLC was conducted to calculate the relative correction factor(RCF)of chlorogenic acid,vitexin glucoside,vitexin rhamnoside, vitexin,rutin and hyperoside,then the contents of above-mentioned 5 components in C. pinnatifida were calculated. The column was Agilent ZORBAX SB C18 with mobile phase of 0.1% formic acid-acetonitrile-tetrahydrofuran (gradient elution) at a flow rate of 1.0 ml/min,the detection wavelength was 350 nm,column temperature was 30 ℃,and the injection volume was 10 μl. RE-SULTS:The linear range was 12.50-400.0 μg for chlorogenic acid(r=0.999 8),25.00-800.0 μg for vitexin glucoside(r=0.999 9), 31.25-1 000.0 μg for vitexin rhamnoside(r=0.999 9),6.470-260.0 μg for vitexin(r=0.999 9),2.50-80.0 μg for rutin(r=0.999 8) and 9.375-300.0 μg for hyperoside(r=0.999 9);RSDs of precision,stability and reproducibility tests were lower than 2.0%;re-coveries were 99.2%-103.9%(RSD=1.6%,n=6),97.9%-100.8%(RSD=1.2%,n=6),99.2%-100.8%(RSD=0.5%,n=6), 97.3%-101.3%(RSD=1.5%,n=6),98.0%-103.0%(RSD=1.9%,n=6)and 95.5%-101.5%(RSD=2.2%,n=6). RCFs of vitex-in glucoside with chlorogenic acid,vitexin rhamnoside,vitexin,rutin and hyperoside were 1.119,1.009,0.706,1.063 and 0.830, respectively. CONCLUSIONS:The method is simple with good precision,stability and reproducibility,and it can be sued for the simultaneous determination of 6 components in C. pinnatifida.

The spectrum of idiopathic rolandic epilepsy syndromes (IRES) is a concept proposed by Scheffer and other scientists,based on plenty of researches and followed by the classification of International League Against Epilepsy.This spectrum is characterized by centrotemporal spikes and includes several syndromes,such as benign epilepsy of childhood with centrotemporal spikes,atypical benign partial epilepsy,Landau-Kleffner syndrome,continuous spikes and waves during sleep,autosomal dominant Rolandic epilepsy and speech dyspraxia.The spectrum has obvious genetic predisposition and the main modes of inheritance are autosomal dominant inheritance and polygenic inheritance.The exact inheritance mechanism needs further study.Several genes,such as elongation protein 4,recombinant glutamate receptor,ionotropic,N-methyl-D-aspartate 2A,γ-aminobutyric acid A receptor,potassium channel,voltage-gated,KQT-like subfamily,member 2/3,brain-derived neurotrophic factor,DEP domaincontaining 5,RNA binding protein fox-1 homolog 1/3 gene and a variety of copy number variations are related to the spectrum.In this review,we summarize the genetics,clinical and electrophysiological characteristics of the spectrum,to comprehensively understand the IRES spectrum and to provide support for clinical diagnosis and treatment.

OBJECTIVE: To observe the effects of pressure level in veil on upper airway in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and normal adults. METHOD: We scanned the upper airway from roof of nasopharynx to glottis with SIMENS 16 layer spiral CT scanner. The area and the dimensions of palate, uvula, and the region after lingua and epiglottis were measured by application of image work station. Forty-six patients with OSAHS and 35 normal adults were scanned by CT at 0 kPa water column and 0.784 kPa water column pressures in face mask, respectively. RESULT: The area and inner diameter of OSAHS patients upper airways were less than those of normal adults at the same pressure in face mask. The area and inner diameter of upper airway at the pressure of 0.784 kPa water column were more than those at 0 kPa water column in both OSAHS patients and normal adults, and the increased extent of normal adults were more than those of OSAHS patients. We measured the minimum increased normal Cross sectional area of palate, uvula, and the region after lingua and epiglottis when the pressure in the mask increased from 0 kPa to 0.784 kPa, and we made it as the standard. The 46 OSAHS patients were sorted into 17 cases (group 1) with normal dilation and 29 cases (group 2) with less dilation in such standard. There was not significant difference between the two groups at 0 kPa pressures in area and inner diameter, but the area and inner diameter of group 1 were more than those of group 2 at 0.784 kPa pressure. CONCLUSION The increased pressure in face mask would lead to upper airway dilation both in OSAHS patients and normal adults, and the dilated extents of normal adults were significant more than those of OSAHS patients. The less dilation of OSAHS may be duo to anatomic constriction and some pharynx wall pathological changes.
Adolescent ; Adult ; Case-Control Studies ; Female ; Humans ; Male ; Masks ; Middle Aged ; Palate ; diagnostic imaging ; Pharynx ; diagnostic imaging ; Pressure ; Sleep Apnea, Obstructive ; diagnostic imaging ; physiopathology ; Tomography, X-Ray Computed ; Tongue ; diagnostic imaging ; Uvula ; diagnostic imaging ; Young Adult

Objective To observe the effect of kinesthetic imagery and visual imagery on upper limb rehabilitation among stroke survivors.Methods Forty-five hemiplegic stroke survivors were randomly assigned into a kinesthetic imagery training group (n=14),a visual imagery training group (n=15) or a control group (n=16).In addition to conventional rehabilitation,patients in the kinesthetic and visual imagery training groups were given 30 minutes of the appropriate imagery training once a day,five days per week for four weeks,while the control group relaxed or received health education for the same time.Before and after the 4-week intervention,the upper limb section of the Fugl-Meyer assessment (FMA-UE) and the modified Barthel index (MBI) were used to evaluate the motor function of the subjects' upper limb and their ability in the activities of daily living respectively.Results Before the intervention,there were no significant differences in the average FMA-UE and MBI scores among the 3 groups.After the intervention there was no significant difference between the average FMA-UE and MBI scores of the two training groups,but both were significantly better than the control group's averages.Conclusion Either kinesthetic or visual imagery training can improve the upper limb function of stroke survivors and their abihty in the activities of daily living.Their effectiveness is not significantly different.