Objective To evaluate HRCT features of otosclerosis.Methods HRCT findings of 61 ears with the diagnosis of otosclerosis based on clinical diagnostic criteria in 34 patients were evaluated retrospectively.Results Hypodense regions in the bony otic capsule were found on HRCT in 55 ears and no abnormality was identified on HRCT in 6 ears.In 55 ears with abnormal HRCT findings, HRCT demonstrated the hypodense region of bony otic capsule anterior to oval window alone in 6 ears, the hypodense region anterior to oval window associated with thicked stapedial footplate and pericochlear hypodensity in 6 ears, the hypodense region anterior to oval window associated with thicked stapedial footplate and hypodensity posterior to oval window in 11 ears, the hypodense region anterior to oval window associated with thicked stapedial footplate in 20 ears, the hypodense region anterior to oval window associated with pericochlear hypodensity in 10 ears, and pericochlear hypodensity in the bony otic capsule alone in 2 ears.Conclusion HRCT can detect abnormalities in the bony otic capsule and the stapedial footplate,contributing to confirming diagnosis of otosclerosis.

Objective To investigate the characteristic imaging findings of metastatic neuroblastoma in the craniofacial bone in children. Methods Imaging findings in 12 patients with metastatic neuroblastoma in the craniofacial bone were analyzed retrospectively. Among them, 10 patients underwent plain CT scan, 6 underwent MRI and 7 underwent whole body single-photon emission computed tomography bone scanning.Results In the 10 patients with CT images, lytic bone destruction and soft tissue masses were found in 9 cases, in which periosteal reaction was observed in 8 patients with spiculated periosteal reaction in 3 patients.The remaining 1 patient didn't show any abnormalities on CT images but had abnormal findings in bone scanning.Six patients with MR images showed abnormal signal intensity in the bone marrow of the craniofacial bone and adjacent soft tissue masses. Postcontrast T1-weighted imaging in 5 patients demonstrated remarkable enhancement of the bone marrow and soft tissue masses. Bone scanning of 7 patients showed abnormal foci of increased radionuclide activity of the craniofacial bone in 7 patients and metastasis at other body parts in 6 patients.Conclusion The metastatic neuroblastoma in the craniofacial bone has its characteristic imaging findings which are helpful for correct diagnosis.

Objective To analyze the diseases responsible for ophthalmoplegia and determine the optimal technique identifying the lesions. Methods CT and MR imaging findings of 1376 patients with ophthalmoplegia were analyzed. The total positive rate and ratio of the diseases causing ophthalmoplegia were calculated. The efficiency of various methods and sequences was compared in the evaluation of cavernous sinus inflammation and other lesions. Multi-paired samples Friedman test was used to compare five kinds of images from different methods and sequences, and Wilcoxon test was used to compare between every two kinds of images. Results The total positive rate was 91.9% (1264/1376). In 50 patients who underwent both CT and MRI, the positive rate of MRI (92. 0% ,46/50) was higher than that of CT (48.0% ,24/50)(Z = -4. 8, P ＜ 0. 01). There were 552 cases (43.7%) of cavernous sinus lesions, 518 cases (41.0%)of extraocular muscle diseases, 108 cases (8. 5%) of cranio-orbital communicating lesions and 86 patients (6. 8%) of other lesions. The five kinds of images from various methods and sequences had significant difference in the detection of 283 cavernous sinus inflammation (χ2 = 1047. 1, P ＜ 0. 01) cases. Transverse T1WI with thin slice thickness[(2. 71 ± 0. 69)scores]was better than that with thick slice thickness [(1.67 ± 0. 64) scores], contrast transverse T1 WI with thin slice thickness[(3.92 ± 0. 27) scores]was better than transverse T2WI with thick slice thickness, transverse T1WI and coronal T1 WI with thin slice thickness[(3. 10 ± 0. 39) scores]. Coronal T1 WI with thin slice thickness was better than transverse T1 WI with thin slice thickness and transverse T2WI, and the contrast coronal T1WI with thin slice thickness [(3.95 ± 0. 22) scores]was better than transverse T, WI with thin slice thickness, transverse T2 WI and coronal T1WI (P ＜0. 01 separately). The positive rate of enhanced MRI (100% ,39/39) was higher than that of nonenhanced MRI (82. 1% ,32/39) (Z = - 2. 1, P ＜ 0. 05). Conclusion CT and MRI can show the lesions responsible for ophthalmoplegia. MRI is the best examination method in displaying these lesions.

OBJECTIVE: To analyze the indications of the therapies for rheumatoid arthritis (RA) with neural network model analysis. METHODS: Three hundred and ninety-seven patients were included in the clinical trial from 9 clinical centers. They were randomly divided into Western medicine (WM) treated group, 194 cases; and traditional Chinese herbal medicine (CM) treated group, 203 cases. A complete physical examination and 18 common clinical manifestations were prepared before the randomization and after the treatment. The WM therapy included voltaren extended action tablet, methotrexate and sulfasalazine. The CM therapy included Glucosidorum Tripterygii Totorum Tablet and syndrome differentiation treatment. The American College of Rheumatology 20 (ACR20) was taken as efficacy evaluation. All data were analyzed on SAS 8.2 statistical package. The relationships between each variable and efficacy were analyzed, and the variables with P<0.2 were included for the data mining analysis with neural network model. All data were classified into training set (75%) and verification set (25%) for further verification on the data-mining model. RESULTS: Eighteen variables in CM and 24 variables in WM were included in the data-mining model. In CM, morning stiffness, swollen joint number, peripheral immunoglobulin M (IgM) level, tenderness joint number, tenderness, rheumatoid factor (RF), C-reactive protein (CRP) and joint pain were positively related to the efficacy, and disease duration and more urination at night negatively related to the efficacy. In WM, erythrocyte sedimentation rate (ESR), weak waist, white fur in tongue, joint pain, joint stiffness and swollen joint were positively related to the efficacy, and yellow fur in tongue, red tongue, white blood negatively related to the efficacy. In the analysis with the neural network model in the patients of verification set, the predictive response rates of 20% patients would be 100% and 90% in the treatment with CM and WM, respectively. CONCLUSION: Neural network model analysis, based on the full clinical trial data with collection of both traditional Chinese medicine and modern medicine diagnostic information, shows a good predictive role for the information in the efficacy in rheumatoid arthritis.

OBJECTIVE: To evaluate the correlations between clinical symptoms and treatment efficacy in patients with rheumatoid arthritis (RA). METHODS: Four hundred and thirteen patients were included in the clinical trial from 9 clinical centers. They were randomly divided into Western medicine-treated group with 204 cases and Chinese herbal drug-treated group with 209 cases. Eighteen clinical symptoms were evaluated before and after treatment. The Western medicine therapy included voltaren extended release tablets, methotrexate and sulfasalazine. The Chinese herbal drug therapy included glucosidorum Tripterygii totorum tablets and Yishen Juanbi Tablets combined with treatment based on syndrome differentiation. The American College of Rheumatology 20 (ACR20) was used as efficacy evaluation criteria. RESULTS: In the Chinese herbal drug-treated group, clinical symptoms such as arthralgia and tenderness of joints were positively correlated with the efficacy after 12-week treatment, while frequent urination at night was negatively correlated. In the same group, tenderness of joints and fever were positively correlated with the efficacy after 24-week treatment, while deep-colored and turbid urine was negatively correlated. In the Western medicine-treated group, tenderness of joints and thirst were positively correlated with the efficacy after 12-week treatment, while vertigo was negatively correlated. And in the same group, tenderness of joints was positively correlated with the efficacy after 24-week treatment, while heaviness of limbs was negatively correlated to the efficacy. The statistical results showed that the treatment efficacy was improved when the correlated symptoms were included in the indications. CONCLUSION: The treatment efficacy of RA is correlated with some symptoms, so further studies should proceed on these correlations in order to achieve better treatment outcome.

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.