Objective To explore the central mechanisms when induced by acupuncture at ST36 using different needling techniques with functional magnetic resonance imaging (fMRI). Methods Thirty-two healthy young volunteers were enrolled in the experiment. Eleven volunteers accepted acupuncture at ST36 using reinforcing techniques for electroacupuncture (EA), 11 accepted acupuncture using reducing techniques for EA, and the rest 10 accepted acupuncture at sham EA. The data of fMRI were collected and analyzed with statistical parametric mapping (SPM2) after real EA at ST36 or sham EA in right leg. Results Five minutes after acupuncture, fMRI data of reinforcing group demonstrated significant activation in the bilateral caudate nucleus, thalamus, left insula, cingulate gyrus, dentate body of cerebellum. From 20 to 30 minutes after acupuncture, fMRI data demonstrated significant activation of true acupuncture groups in the left thalamus, paracentral lobule, gyrus precentralis, middle temporal gyrus, middle frontal gyrus, insula, bilateral caudate nucleus, hemisphaerium cerebelli, anterior and posterior cingulate gyrus. The signal of the reinforcing group for EA was stronger than the reducing group for EA. Acupunture of the false point activated the paracentral lobe and the hemisphere of cerebellum only. Conclusion Stimulation of acupoint ST36 with acupuncture activated different parts of the autonomic nerve system, including imbic system, supplementary motor area, grey matter, etc. Reinforcing technique for EA is better than reducing technique at ST36.

Objective To preliminary investigate the brain areas associated with Chinese when they speak Chinese . Methods In order to determine the neural anatomic substrates employed in repeatedly speaking Chinese , 22 Chinese health volunteers were performed using blood oxygenation level dependent (BOLD) contrast functional magnetic resonance imaging (fMRI) on a 1.5T system .Results Our block-design fMRI studies have found many cortical areas that are associated with Chinese-English bilinguals. The cortical areas were shown as bilateral motor cortex , left anterior inferior frontal Gyrus , left anterior insula , bilateral superior temporal gyrus and bilateral cerebellum. Conclusion BOLD fMRI can reveal cortical areas that are associated with Chinese when they speak Chinese ,and it is a powerful utility to investigate language.

Objective To study the imaging features of sacroiliac joints(SIJ) in patients who were misdiagnosed as spondyloarthritis(SpA).Methods A total of 34 patients with chief complaint of back pain and misdiagnosed as SpA from January 2007 to April 2013 in Department of Rheumatology Chinese PLA General Hospital were enrolled.The imaging,clinical manifestations,laboratory examinations data were analyzed.Result The main reason for misdiagnosis as SpA was because of sacroiliitis presenting on imaging.The final diagnoses included 24 patients as SIJ infection,4 patients as neoplastic diseases,2 patients as metabolic bone diseases,2 patients as sacroiliac joint degeneration,1 patient as gout of sacroiliac joint,1 patient as diffuse idiopathic bone hypertrophy.For patients with infection,there were 10 patients receiving X-ray and 22 patients receiving CT of SIJ.However,5 and 7 patients had negative results respectively.These patients with infection had abnormalities in MRI including all with bone marrow edema,21 patients with erosion of bone and joint,22 patients with muscle involved.As to the patients with malignancies,SIJ CT scan appeared normal.Bone marrow edema and erosion in MRI were found in all neoplasm patients expect one as ependymoma.Adjacent muscles were involved in the patient with Ewing's sarcoma.Either X-ray or CT in other patients demonstrated obvious abnormalities,but only mild erosion of bone was found in MRI.Conclusion Bone marrow edema of SIJ in MRI represented not only in patients with SpA.Rheumatologists should analyze the clinical manifestations and laboratory examinations comprehensively in order to avoid the misdiagnoses.

Objective To optimize the enzymolysis technology of ginsenoside Rg1.Methods Taking ginsenoside Rg1 content as the index,orthogonal design method was used for optimization and HPLC for determination.Results Cellulase enzymolysis was the best extracting process,and enzyme amount,enzymolysis time,and enzymolysis temperature had obvious effect on the extraction of ginsenoside Rg1.The optimum extraction technologies were as follows: cellulase amount was 1.4%,enzymolysis time 60 min,the enzymolysis temperature 45 ℃.Conclusion The optimization extraction technology is simple,steady,and the extracting rate is high.

Objective To discuss the image features of different types of pneumonia. Methods The method and flow for CR chest radiography at fever clinics were described. Results The method and flow for CR chest radiography at fever clinics were improved. Conclusion Method improvement is very significant.

Objective To evaluate the cause and the treatment of the vagus nerve reflex in patients with hemoptysis during bron-chial artery embolization (BAE).Methods 1 12 patients with much hemoptysis were enrolled,9 of whom represented vagus nerve reflex in the process of interventional embolization.Results In 9 patients with mixed vagal reflex,5 occurred in the process of bron-chial artery embolization,1 in removing of sheath,1 in hemostasis by compression and 2 in returning to the ward.The intraoperative vagus reflex during BAE was related to over tension and unnormolized operation,and it improved by block of vagus nerve,raising blood pressure and fluid expansion without serious complications.Conclusion Vagus nerve reflex during BAE should be noticed, and early detection and timely intervention may improve its prognosis.

PurposeTo investigate the correlation between iodine concentration and clinical severity of acute pancreatitis (AP) through the quantitative evaluation with dual-energy spectral computed tomography (DESCT), so as to find out an effective imaging technology in the evaluation of clinical severity of AP.Materials and Methods Sixty patients with AP confirmed clinically (AP group) and 30 patients with normal pancreas (control group) were retrospectively analyzed. All the patients underwent enhanced CT scan in the spectral imaging mode. Iodine concentration and normalized iodine concentration (NIC) were respectively measured during arterial phase and portal phase in the material-decomposition images by using a spectral imaging viewer (GSI Viewer). Results Iodine concentration and NIC were significantly higher in the control group than in the AP group (P<0.05,P<0.001). In the AP group, according to Ranson grading, 24 patients were in the mild grade, 20 patients were moderate, and 16 patients were severe. Iodine concentration and NIC decreased along with the increase of their Ranson grade. There were significant difference in iodine concentration and NIC among the three subgroups (iodine concentration on arterial phase:F=8.776,P<0.01; iodine concentration on portal phase:F=4.019,P<0.05; NIC on arterial phase:F=12.700,P<0.001; NIC on portal phase:F=8.732,P<0.01). Iodine concentration and NIC on arterial and portal phases in the mild grade group were both significantly higher than those in the moderate grade group (P<0.05); however, iodine concentration on arterial and portal phases, and NIC on arterial phase in the severe grade group were significantly lower than those in the moderate grade group (P<0.05).Conclusion DESCT can analyze hemodynamic changes in AP quantitatively, which is of great value in evaluating changes in AP of each grade.

Objective To observe characteristics of the activity in resting brain of asymptomatic reflux esophagitis (RE) patients,and explore the role of default network in the pathogenesis of asymptomatic RE.Methods Functional magnetic resonance imaging (fMRI) was performed to scan the brains of 15 asymptomatic RE patients,15 symptomatic RE patients and 15 healthy volunteers under no-mission-stimulation state.With fractional amplitude of low frequency fluctuation (fALFF),characteristics of the strengthened and weakened regions of asymptomatic RE patients,symptomatic RE patients and healthy individuals were compared and analyzed.SPM 5 was applied for data preprocessing.Single-sample t test was performed to observe the noticeable active regions of each group under resting state,and then double-sample t test was used to compare the characteristics of active regions of the entire brain between asymptomatic RE patients and symptomatic RE patients or healthy individuals.Results Under resting state,the active brain regions of asymptomatic RE patients,symptomatic RE patients and healthy individuals were similar.The activity of only small part of brain regions in visceral sensory processing relevant networks changed.There was no significant difference in the active regions of default network under resting state between asymptomatic RE patients and healthy individuals.Compared with symptomatic RE patients,fALEF decreased at right central sulcus cover,right superior temporal gyrus,right insula,right transverse temporal gyrus,right postcentral gyrus,superior temporal gyrus and temporal pole (X=50,Y=-6,Z=12,t=2.7874,P＜0.01).Conclusion The difference in characteristics of activity in default network under resting state may play an important role in the pathogenesis of asymptomatic RE.

Objective To understand the features of immunoglobulin G4-related diseases and to improve its diagnosis and treatment.Methods The clinical data of 20 cases discharged from our hospital were analyzed retrospectively.Results Twenty cases with IgG4 related diseases were reviewed retrospectively.IgG4-related diseasesis more prevalent in male than in female (14∶6),and the mean age was 58 years.Pancreas and bile ducts were the most commonly affected organs,2 and more than 2 organs were involved in 17 patients.All patients had significantly elevated serum immunoglobulin G4.Histopathological findings included diffuse tissue fibrosis with extensive lymphoplasmacytes infiltration.On immunohistochemical staining,the ratio of IgG4-positive plasma cells to IgG-positive plasma cells was higher than 40％.One patient deceased and one patient was left untreated,other patients responded well to the treatment.Conclusion There is no characteristic clinical symptoms for IgG4-related diseases,and serum immunoglobulin G4 is the essential diagnostic method in suspected cases.IgG4-related diseases can be well controlled with prompt use of glucocorticosteroid.

Objective To discuss the value of combining superselective mesenteric angiography (SSMA)with methylene blue in-jection for localization of the Obscure Gastrointestinal Bleeding (OGIB).Methods 12 patients presenting with OGIB had preopera-tive localization of the bleeding site by SSMA.The microcatheter was remained inside the bleeding artery branch after angiography. Then the methylene blue was injected via the microcatheter for localization during exploratory laparotomy and the dyed intestine was then removed.Results The detected rate of bleeding sites by using preoperative SSMA was 100%.The lesions in total 12 patients were found quickly during the exploratory laparotomy.The length of the removed intestine was 9 -12 cm (median,10 cm).After followed up for 10-24 months (median,18 months),all patients with OGIB had no recurrence.Conclusion The method of SSMA combined with the use of methylene blue injection is a safe and effective procedure for the localization of OGIB and could be beneficial for increasing the surgical success rate of hemostasis.