Objective To study MRI features of tanycytic ependymoma (TE)in central nervous system,to improve the further understanding of this rare tumor.Methods 26 cases with TE of central nervous system proved by pathology and surgery were analyzed retrospectively in terms of location,size,signal intensity,the presence or absence cyst,hemorrhage,“cap sign”,syringes,edema, implantation metastasis and enhancement pattern etc.Results In 26 cases,2 cases were located in the left frontal lobe,with macro-cyst and micro-nodules,and the left ventricle was interlinked.The signal of cystic region was similar to CSF,and nodule-regions were a bit iso-intensity signal on T1 WI and hypo-intensity on T2 WI with significantly enhanced.The other 24 cases were located in the spinal cord,in which 1 6 cases were in the cervical and thoracic cord.1 case of cystic masses had hemorrhagic fluid level,the others were solid masses with iso-intensity signal on T1 WI and iso or bit hyper-intensity signal on T2 WI,in which 4 cases with hypo-intensity signal on T2 WI and cystic were seen frequently,cystic were common,and 6 cases with “cap sign”.Most of masses were medium enhanced and 1 2 cases were well-defined.1 3 cases with syringomyelia and 1 case with the medulla oblongata and cerebellum implantation.The lesions located in thoracic and lumbar cord in 8 cases with iso-intensity signal on T1 WI and iso or bit hyper-intensity signal on T2 WI, in which 4 cases were hypo-intensity signal on T2 WI,and 3 cases showed small round cystic changes,and 1 case showed syringomyelia and no “cap sign”.8 cases were medium enhanced.Conclusion TE in central nervous system shows characteristic manifestations on MRI,which are helpful in differential diagnosis and guide for treatment.

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 investigate the clinical efficacy of shoulder-three-points warm needling moxibustion plus conventional rehabilitation in recovery from arthroscopic rotator cuff repair.Method Seventy patients who had undergone arthroscopic rotator cuff repair for rotator cuff injury were enrolled and randomly allocated to groups A and B, 35 cases each. Group A received conventional rehabilitation and group B, shoulder-three-points warm needling moxibustion in addition. Functional activity and pain in the affected shoulder were scored using the American Shoulder Elbow Scale (ASES), the University of California at Los Angeles (UCLA) Shoulder Scale and the Constant-Murley Shoulder Outcome Score in the two groups before and after treatment.Result There were statistically significant pre-/post-treatment differences in the ASES, UCLA and Constant-Murley scores in the two groups (P<0.01). After treatment, the scores were higher in group B than in group A, but there was no significant difference in the UCLA function subscore (P>0.05) and a significant difference in the UCLA pain subscore (P<0.01) between groups A and B. Conclusion shoulder-three-points warm needling moxibustion plus conventional rehabilitation training can markedly promote postoperative rehabilitation and especially relieve postoperative pain in patients with rotator cuff injury. It provides a new idea for clinical shoulder rehabilitation in the future.

Objective To study the imaging findings of cerebral venous sinus occlusion and to improve the knowledge of this disease.Methods CT,MRI and DSA data in thirty six cases with cerebral venous sinous occlusion were retrospectively reviewed.There were 15 male and 21 female,ranged in age from 23 to 59 years old.Results On T_1WI and T_2WI,abnormal signals in cerebral parenchyma were found in 26 cases,of that there were brain hemorrhage with abnromal long T_1 and long T_2 signal in 16 cases,only abnromal long T_1 and long T_2 signal in 6 cases,cerebral ventrical enlargment in 4 cases and brain swelling in 4 cases.The abnormal venous enhancement was found in 25 cases on contrast-enhanced MRI.On CT scan,low density in cerebral parenchyma was found in 10 cases,it might be edema or ischemia,astime goes by,the density of cerebral venous sinus became slightly high density to isodensity.DSA showed dural sinus occlusion includingsuperior sagittal sinus in 15 cases,transverse sinus in 8 cases,sigmoid sinus in 7 cases,straight sinus in 4 cases and inferior sagittal sinus in 2 cases.Conclusion The venous sinus occlusive disease is distinctively different from arterial occlusive disease.CT and MR imaging is very important in diagnosing the cerebral venous sinus occlusive disease,but DSA is still the gold standard.

Objective To compare the difference of MRI characteristics of pilomyxoid astrocytomas (PMA)and pilocytic astrocy-tomas (PA)in hypothalamus/optic chiasma region.Methods The MR images and clinical materials of 20 PMAs and 20 PAs proved by pathology were reviewed retrospectively.Imaging characteristics and clinical materials were analyzed,including age,gender, size,the signal characteristics of the tumor,growth,enhancement pattern,hydrocephalus and leptomeningeal dissemination.Results There were statistically significant differences in streaky low signal intensity among the high intensity of T2 WI and leptomeningeal dissemination between PMA and PA (P <0.05).However,no statistically significant differences were found in the other character-istics and clinical materials between the two types of tumors.Conclusion PMA and PA in hypothalamus/optic chiasma region are difficult to make differential diagnosis.The streaky low signal intensity among the high intensity of T2 WI and more frequent lepto-meningeal dissemination are helpful differential features of PMA as compared to PA.

Objective To explore the value of spiral CT in venous phase in measuring the diameter of bilateral transverse sinus.Methods The CT vascular imaging findings of 200 cases at torcular herophili area in our hospital were analyzed retrospectively.The resource images, volume rendering (VR) and maximum intensity projection (MIP) were performed to observe the presentation of vascular anatomy in the torcular herophili area, and to determine the dominant transverse sinus and types of torcular herophili (typeⅠ-Ⅵ).The diameters of bilateral transverse sinus were measured by original CT images.Two groups were categorized according to the genders, and four ones (20-30 years, 30-40 years, 40-50 years and 50-60 years) according to the age.Results Between different genders, there was significant difference in right transverse diameter (P<0.05), and there was no significant difference in left transverse diameter (P>0.05).There was no significant difference among four age groups in bilateral transverse diameter (P>0.05).Conclusion Spiral CT is helpful for the evaluation of the diameter of bilateral transverse sinus.These findings can provide anatomical basis for clinical disease with significant implication.

OBJECTIVE To explore the dry ears and improving the auditory level of postaural bipedicle musculo-periosteal flap to obliterate the mastoid cavity. METHODS 78 cases(ears) of chronic otitis media were treated with radical mastoidectomy,open-ended tympanoplasty and conchaplasty,and received mastoid plombabge by postaural bipedicle musculo-periosteal flap.RESULTS In 78 cases(ears),the time of dry ears were reduced to 10 or 15 days and the auditory level in 58 ears was impoved(17.2?4.9) dB after treatment.CONCLUSION The surgery with postaural bipedicle musculo-periosteal flap to plombabge the mastoid cavity can achieve the epithelization in the operation cavity more quickly,achieve a short duration to dry ear shortly and improve the auditory level.

Diabetes,characterized by chronic increase of blood glucose,is a group of metabolic diseases.It is usually treated by oral administration with antidiabetic drug and insulin with western medicine.Diabetes is called consumptive thirst in TCM.Professor NAN Zheng thought the pathogenesis of consumptive was yin defi ciency and dryness-heat at the early stage,and at the protracted stage it was usually characterized by qi defi ciency,blood stasis,pathogen intruding into collateral and poison damaging zang and fu.He established a series of treatment plan,involving diet,movement,and the Chinese materia medica.Professor NAN opposed to abusing insulin and the insulin multi-purpose theory,and proposed the treatment should start from change of bad life style and combine with application of Chinese medicine to regulate yin-yang and qi-blood of fi ve viscera,treat triple diabetes at the same time.So long as syndrome differentiation was accurate,the Chinese materia medica may replace the insulin and prolong the life.In conclusion,this article enumerates 3 typical cases diabetes withdrawal of insulin with TCM by Professor NAN Zheng.

Objective To observe the effect of dynamic articulars panning external fixation combined with limited internal fixation for distal radius comminuted fracture.Methods 100 comminuted distal radius fractures patients during September 2014 and September 2014 in our hospital were selected and randomly divided into control group and research group,50 cases in each group.Patients of the control group accepted conventional manual reduc-tion combined with plaster external fixation,patients of the research group accepted dynamic articulars panning exter-nal fixation combined with limited internal fixation treatment.Curative effect,the palm inclination angle and feet were compared between the two groups.Results (1)After surgical treatment and rehabilitation therapy,15 patients in the control group achieved optimal degree,28 cases in the research group achieved optimal degree(P =0.086);9 cases in the control group were the poor degree;only 2 patients in the research group were poor degree(P =0.025).Statistical analysis showed that two differences were statistically significant,(P <0.05).(2)After 3 months,the palmar tilt of patients in the control group was (6.5 ±2.2)°,while that of the research group was (8.5 ±2.5)°(t =4.25,P <0.000 1 );The average ulnar deviation of control group was (12.3 ±4.3)°,and that of the research group was (15.6 ±6.6)°(t =2.96,P =0.003 8).In a word,the average palmar tilt and ulnar deviation of the research group were greater than those in the control group,the difference showed statistically significant.6 months later,the average palmar tilt of the control group patients was (6.2 ±2.3)°,that of the research group was (8.8 ±2.5)°(t =5.41, P <0.000 1 );the ulnar deviation of the control group was (12.1 ±4.1 )°,and that of the research group was (16.3 ±4.4)°(t =4.93,P <0.000 1),the difference was statistically significant.Conclusion Dynamic articulars panning external fixation combined with limited internal fixation for the treatment of distal radius comminuted fracture effect is significant,which is worthy of clinical promotion.

Objective To observe the cerebral hemodynamics in ischemic stroke patients after compound anisodine acupoint injection.Methods 40 stroke patients were measured with transcranial color Doppler before and 4 h,24 h after compound anisodine acupoint injection.Results After injection,the velocity of the cerebral artery showed some increase,the end diastolic velocity of the ophthalmic artery increased and the pulsitility index decreased(P<0.05).Conclusion The compound anisodine acupoint injection may improve the flow velocity of ophthalmic artery and cerebral artery.