Objective To study the characteristics of MR imaging and proton MR spectrscopy(~1H MRS)of stroke-like lesions in MELAS.Methods Clinical,MR imaging and proton spectroscopic findings of stroke-like lesions in 7 patients with confirmed MELAS were analyzed retrospectively.Results A total of 12 MR investigations had been performed in 7 patients.Stroke-like lesions showed by MR imaging included superacute in 12,acute in 12,subacute in 10 and chronic stage in 6.Early stroke-like lesions were demonstrated as focal edematous foci mainly involved cortex/subcotical areas of occipital,temporal and parietal lobes.At MR diffusion imaging,stroke-like lesions in the superacute(＜3 days)stage were showed as well-circumscribed lesions with high signal intensities for cytotoxic edema.During the acute(4～7 days),sub-acute(2～4 weeks)and chronic(＞4 weeks)stages,the lesions gradually expanded,and became blur,and presented with vasogenic edema mainly.Proton spectroscopy showed a prominently elevated lactate,varied decrease of NAA concentration and other brain motabolites in the stroke-like lesions early after onset,and depicted gradual decrease of lactate level and partial recovery of NAA concentration subsequently.Conclusion Stroke-like lesions in MELAS mainly involve the cerebral cortex and subcortical areas,in which cytotoxic edema appears early but for a short period.In ~1H MRS,the lesions are characterized by a double lactate peak with decrease of NAA concentration.

Objective To explore the application value of VCT 64-row with 128-layer spiral extremities arterial imaging techniques and methods in the double lower limb artery.Methods 60 patients on lower limbs MSCTA angiography after Saul,flat on intravenous regiment note contrast agents CT angiography,image the maximum intensity projection(MIP),curved planner reconstruction(CPR),volume rendering(VR)after-treatment technology reconstructed vessels.Results All 60 patients showed the lower limb arterial and main branch.Conclusion 64-row helical VCT angiographic with 128-layer could clearly show that lower limb artery and pathological changes,and become main methods of preoperative evaluation and selection for the lower limb artery disease.

Objective To compare the curative effect and safety of high-frequency and low-frequency repetitive tran-scranial magnetic stimulation(r-TMS) in the treatment of Parkinson's disease complicated with depressive disorder. Methods All 92 patients with Parkinson's disease complicated with depressive disorder were randomly allocated to three groups. High frequency group received antiparkinsonian drugs combined with high frequency r-TMS (5 Hz);Low frequency group received antiparkinsonian drugs combined with low frequency r-TMS (0.5 Hz);Sham group re-ceived antiparkinsonian drugs combined with sham r-TMS (s-rTMS). Each group received r-TMS twice a week for four weeks. UPDRS and HAMD-17 were assessed every two weeks , adverse events were recorded , and clinical global im-pression was carried out four weeks after the treatment. Results Upon enrollment, scores of HAMD and UPDRS among the three groups were not significantly different (P>0.05). During the second week of the intervention, the HAMD score in high frequency group improved significantly , and the differences between three groups were statistically signif-icant according to one-way ANOVA (P=0.0144). The differences changed larger in the fourth week, with greatly sig-nificant differences between the two groups (P=0.0000);During the second week of the intervention, the differences of UPDRSⅡscores in high frequency, low frequency and sham group were not statistically significant according to one-way ANOVA (P=0.1981). The differences appeared in the fourth week, but the differences between groups were not statistically significant according to one-way ANOVA (P=0.0219). During the second week and the fourth week of the intervention, UPDRS Ⅲ scores in the three groups were not significantly different (P=0.6105, 0.4248 respectively). Adverse events in the three groups were rare, and the differences were not statistically significant. Conclusion High-frequency stimulation on dorsal-lateral left prefrontal cortex is effective in alleviating depression for patients with Parkinson's disease, and is also effective in improving capabilities in daily life, which shows exact clinical effect and rare adverse events.