Objective To study the clinical and imaging characteristics of Chinese atopic myelitis (AM) patients.Methods Three diagnosed AM patients were retrospectively analyzed for the clinical data,serum IgE level,antigen specific IgE,cerebrospinal fluid,spinal MRI and therapeutic efficacy profiles.Results All the three patients were male and presented as subacute AM with the onset at 25,47 and 49 years old respectively.Two patients were allergic to pollen and other drugs,while another patient suffered from allergic rhinitis.Elevated serum total IgE and mite antigen specific IgE were found in all cases.Paraesthesia in limb extremities and positive Lhermitte sign were the main clinical features,while no optic,motor,urinary and defecation disturbance were found.Oligoclonal banding of cerebrospinal fluid and serum aquaporin 4 (AQP4) antibody were both negative in all cases.Spinal MRI showed lesions were hypointense on T1 and hyperintense on T2 at the posterior column of T2-3 segment with abnormal enhancement in case 1,hypointense on T1 and hyperintense on T2 at C2/3 segment with mild swelling in case 2 and hypointense on T1 and hyperintense on T2 at C3-5 segments with swelling and abnormal enhancement in case 3.Vitamin B were used in one patient,while the other two patients improved after the treatment with high-dose corticosteroids.Conclusions Subacute myelitis predominantly presents as paraesthesia in limb extremities with elevated serum total IgE and mite antigen specific IgE,while severe motor disorders are rare.Swelling and abnormal enhancement lesions at the posterior column of cervical cord are the common imaging features.Treatment with corticosteroids is recommended to be sustained for 3-6 months.

Objective To investigate the direct and indirect MRI manifestations of anterior cruciate ligament(ACL)tears and discuss its mechanism and diagnostic value.Methods The study involved 40 patients with ACL tears including 37 males and three females at age range of 16-49 years(mean age of 33 years).Arthroscopy and operation confirmed 28 patients at acute phase of ACL tears,12 at chronic phase of ACL tears,35 with complete ACL tears and five with partial ACL tears.All patients were examined on 1.5T Siemens MRI scanner,with SE,TSE or Medic sequence in multiple directions.The direct and indirect MRI manifestations of ACL tears were retrospectively and statistically analyzed by employing three experienced doctors.Results Among 28 patients with acute tears,the direct MRI signs included signal interruption or non-consecutive(86%),uneven signal(64%)and swelling and thickening ligament(36%).While in 12 patients with chronic teats,the MRI signs manifested swelling ligament(92%),signal interruption or non-consecutive(75%)and uneven signal(58%).The sign of thickening ligament was mainly seen at chronic phase of ACL tears(P ＜0.01).Of 35 patients with complete ACL tears,80% occurred in the middle part of ACL,with low incidence of upper and lower parts.All five patients with partial ACL tears occurred in the anteriomedialis bundle.The indirect MRI signs of ACL tears included 7-shaped deformity of posterior cruciate ligament(PCL)(34 patients,85%),meniscus exposure(26 patients)including 16 with lateral meniscus exposure(62%),bone injury(15 patients)including segond fracture(8 patients,53%),widened joint space(9 patients)including 78% at chronic phase,and tibia antelocation(23 patients,57%).Among 40 patients,37 patients were diagnosed correctly preoperatively,with accuracy rate of 92%.While three patients with partial ACL tears were missed diagnosis preoperatively,with inaccuracy rate of 8%.Conclusion ACL tear is relatively easy to identify preoperatively according to direct and indirect MRI signs in combination with trauma history.

To select the most effective parameters of electroacupuncture (EA) at Hegu (LI4) and Sanyinjiao (SP6), a traditional acupuncture formula that induces labor, by comparing its effects on uterine contraction in late-stage pregnant rats, so as to improve the effects of acupuncture on induction of labor and its clinical maneuverability and provide the basis for further mechanism research.

Objective: To determine total phenylethanoid glycoside and acteoside in Plantago Herba to provide reference for evaluating the quality of medicinal materials.Methods: With acteoside as the control sample, a UV visible spectrophotometric method was used to determine total phenylethanoid glycosides in Plantago Herba.An HPLC method was applied to determine acteoside in Plantago Herba , and the conditions were as follows: an ODS2 C 18 (150 mm× 4.6 mm ,5 μm) chromatographic column was used with acetonitrile-0.1% formic acid (13∶87) as the mobile phase at a flow rate of 1.0 ml·min-1 , the detection wavelength was 332nm, the column temperature was 30℃, and the sample volume was 10 μl.Results: The reference solution and the sample solution had the maximum absorption at 332 nm, and the linear relationship was good within the range of 0.003 1-0.155 0 mg·ml-1 (r=0.999 5).The content of total benzene alcohol glycosides in 3 batches of samples was 2.73% , 2.61% and 2.84% , respectively;acteoside over the range of 0.000 6-0.155 0 mg·ml-1 (r=0.999 1) showed a good linear relationship with peak area,the sample recovery was 98.5% and the RSD was 1.6% (n =6), and the acteoside content in 3 batches of samples respectively was 0.54% , 0.51% and 0.56%.Conclusion: The method is simple, accurate and reproducible, and can be used for the determination of total phenylethanoid glycosides and acteoside in Plantago Herba.

Objective To evaluate the utility of short tau inversion recovery (STIR) sequence in the diagnosis of hippocampal sclerosis ( HS).Methods Twenty-one patients with medial temporal lobe epilepsy without neoplasm lesions or injuries by conventional MRI sequence including T1WI,T2WI and FLAIR were included in this study.STIR imaging in axial,coronal and sagittal sequences was performed on these patients. Diagnosis of HS was based on the findings of hippocampal atrophy,alteration signal,disturbed internal structure and enlargement of the inferior horn. The findings shown on conventional MRI were compared with those on STIR sequence. Furthermore,the correlation of radiologic and histological findings was investigated in 6 patients operated for refractory seizures. Results On conventional MRI sequence,14 patients (66.7％) were confirmed with unilateral HS and 4 patients were suspected with unilateral HS. In contrast,all these 18 patients (85.7％) were confirmed with unilateral HS by STIR.Particularly,STIR sequence delineated the internal structure of hippocampus more clearly than conventional MRI sequences did. C shaped contour in subiculum-CA1-CA2 was revealed in normal hippocampus on STIR sequence and disappeared in HS,correlated to the pathology finding of loss of neuron in CA1 in resected tissues in 6 operated patients.The patients with HS also showed areas of hypodensity in CA4 on STIR,in accordance with pathologic findings of gliosis in this area in the 6 operated patients.Conclusion STIR sequence could depict the internal anatomical structure of hippocampus with high resolution superior to conventional MRI sequences,and can be of great value in the diagnosis of HS.

Objective In the context of worldwide shortage of amytal,explore the intracarotidpropofol test for lateralizing language area and assessing hemispheric memory function.Methods Fourteen patients with refractory partial epilepsy who were candidates for surgical intervention were included in the study.With guide under a digital subtraction angiography,propofol was injected in bilateral intracarotidsequentially.Muscle power deceasing to level 0 at the contralateral limb and eyes gazing to contralateral side were used as the mark of hemispheric anesthesia completely.The immediate language alterations were recorded.To evaluate the bilateral language and memory functions,the visual and auditory memory tasks were performed sequentially once patient could concentrate his attention ; and after limb muscle power recovering to normal level,patients were required to perform a free recall test.Any abnormal responses were recorded.Results Language dominant hemisphere was determined in 14 patients.Nine patients were confirmed as left language dominance,2 patients were right language dominance.The remained 3 patients were considered as bilateral language dominance.Meanwhile,the hemispheric memory function was able be evaluated in 13 patients.More than 67％ memory function was sustained in hemisphere contralateral to mesial temporal lesions.Transient responses including eye pain,facial muscle spasms,laughers and involuntary movements were observed.Conclusion Hemispheric language and memory functions can be assessed with direct intracarotidpropofol injection,and propofol could be an alternative drug to amobarbital used in the Wada test.

Objective To observe the surface area temperature of dysmenorrhea rats with cold stagnation syndrome; To compare the different effects of Sanyinjiao (SP6) and Guanyuan (RN4).Methods Forty female SD rats were randomized into control group, model group, Sanyinjiao (SP6) group, and Guanyuan (RN4) group, 12 rats in each group. Whole body freezing method combined with estradiol benzoate injection was used to establish models. Sanyinjiao (SP6) group and Guanyuan (RN4) group received moxibustion at corresponding points for 3 times after modeling. Infrared thermal imaging was used to measure the skin temperature at the surface projection area of Sanyinjiao (SP6) and Xuehai (SP10) and Sanyinjiao-Xuehai lines before and after moxibustion.Results Compared with control group, the temperature gap between double sides of Sanyinjiao-Xuehai lines significantly increased in model group 5-30 min after moxibustion (P<0.05). 30 min after moxibustion, the temperature of right Sanyinjiao significantly decreased in other three groups (P<0.01). Compared with model group, the temperature gap between double sides of Sanyinjiao-Xuehai lines significantly decreased after 5-30 min in Sanyinjiao group (P<0.05), while Sanyinjiao-Xuehai lines significantly decreased after 10-30 min in Guanyuan group (P<0.05). Comparison between two moxibustion groups, the influence of Sanyinjiao group to temperature gap between double sides of Sanyinjiao-Xuehai lines was earlier than Guanyuan group (P<0.05).Conclusion Moxbustion can decrease the temperature gap between double sides of Sanyinjiao-Xuehai lines and ease the imbalance. And the influence of moxbustion SP6 to temperature gap between double sides of Sanyinjiao-Xuehai lines is earlier than moxibustion RN4.

Objective To compare the effects and explore mechanism of acupoints on various meridians or nerve segments in treating different symptoms in one disease.Methods Neonatal Wistar rats were randomly divided into 4 groups: normal control group, model group, ST36 group, and LI14 group (n=10-12 in each group).IBS model was established by administering acetic acid enema combining colorectal distension (CRD) test to rats in all groups except the normal control group.These rats were all isolated from their mothers.2-month old rats in the ST36 group and LI14 group received electro-acupuncture five times, once every two days for 20 minutes.Stool consistency was evaluated according to the Bristol Stool Form Scale (BSFS), and visceral sensitivity was observed based on abdominal withdraw reflection (AWR).Levels of TRPV1 and 5-HT2AR in rat colon tissues were measured with immunohistochemical method.Results Before electro-acupuncture stimulation, BSFS score of rats in all groups increased significantly (P<0.01) compared with the normal control group;after electro-acupuncture, BSFS score of the model group (P<0.01) and LI14 group (P<0.05) were increased;threshold value of intestinal pressure of model group and ST36 group decreased (P<0.01), and the contraction waves increased significantly (P<0.01).Positive TRPV1 expression increased (P<0.01);and TRPV1 expression in LI14 group increased (P<0.05).The level of 5-HT2AR in the model group and LI14 group were raised markedly (P<0.01).Compared with the model group, BSFS score of the EA groups decreased significantly (P<0.01);threshold value of intestinal pressure increased (P<0.01);contraction wave decreased significantly (P<0.01), and the expression of TRPV1 and 5-HT2AR reduced significantly (P<0.01).Compared with the ST36 group, BSFS score of the LI14 group increased significantly (P<0.05);expression of TRPV1 reduced (P<0.01), and the level of 5-HT2AR increased significantly (P<0.01).Conclusion Stimulating LI4 and ST36 with electro-acupuncture could reduce the visceral sensitivity and the gastrointestinal motility disorder in IBS model rat.LI4 has a better effect of treating gastrointestinal motility disorder, and ST36 has a better effect of relieving visceral pain.This study illustrates the existence of therapeutic specificity of acupoints, which means acupoints on different meridians or ganglions can be used to treat the same disease yet with different effects.

Objective To observe the effects of electro-acupuncturing (EA)at “Baihui”(DU20)and“Zusanli”(ST36)on the visceral sensitivity and emotional and psychological behavior of the irritable bowel syndrome (IBS)model rats,and to explore the double adjustment of electro-acupuncture on chron-ic visceral pain with emotional and psychological dysfunction.Methods Wistar immature rats were ran-domly divided into normal group,model group and electro-acupuncture group.The IBS model was in-duced by mechanical colorectal irritation of acetic acid combined with maternal separation in the postnatal period.Rats of normal group and model group underwent no intervention while those of electro-acupunc-ture group were needled at “Baihui”and “Zusanli”every other day for ten days.The visceral sensitivity was evaluated and the open-filed test was used,and the mRNA of neurokinin-1(NK1)receptor was de-tected by using RT-PCR.Results The treatment of acupuncture reduced significanty the visceral sensi-tivity,crossing activity and vertical activity in open field test,and the mRNA expression of NK1.Con-clusion The double adjustment of electro-acupuncturing at “Baihui”and “Zusanli”on chornic visceral sensitivity with emotional and psychological dysfunction was proved.

Objective:To explore the impact of social support, self-efficacy, and neurological function on disease acceptance in stroke patients.Methods:From September 2022 to February 2023, convenience sampling was used to select 322 stroke patients from Shanghai Hospital of Traditional Chinese Medicine and Yueyang Hospital of Integrated Traditional Chinese and Western Medicine as participants. The survey was conducted using the General Information Questionnaire, Perceived Social Support Scale (PSSS), Stroke Self-Efficacy Questionnaire (SSEQ), Acceptance of Illness Scale (AIS), and National Institute of Health Stroke Scale (NIHSS) .Results:The AIS, PSSS, SSEQ, and NIHSS scores of stroke patients were (21.88±10.66), (52.64±13.80), (73.92±28.91), and (5.37±3.64), respectively. Social support of patients had a positive impact on disease acceptance ( P<0.01). Self-efficacy partially mediated the relationship between social support and disease acceptance, with indirect effects accounting for 48.84% of the total effect. The second half of the mediating effect of "social support→self-efficacy→disease acceptance" (self-efficacy→disease acceptance) was regulated by neurological function ( β=-0.020, P<0.01) . Conclusions:Medical and nursing staff can increase patients' social support, enhance their self-efficacy, and strengthen targeted interventions for patients with high levels of neurological deficits, thereby improving their disease acceptance.