Purpose To investigate the value of simultaneousnon-contrast angiographyand intra-plaquehemorrhage (SNAP) in assessing Willis circle integrity of the brain using three-dimensional time of flight (TOF) MRA as a reference. Materials and Methods According to the inclusion criteria, a total of 62 patients with stroke symptoms within 3 months were collected. All patients underwent head SNAP and TOF on Philips 3.0T MR scanner. TOF and SNAP were treated respectively at the Philips workstation using maximum and minimum intensity projections to generate non-enhanced MRA images which were, afterwards, interpreted using blind reading to determine the presence or absence of individual blood vessels in the circle of Willis. In order to assess the consistency of the interpretation, all images were interpreted again 2 weeks later to avoid memory bias. Finally, The consistency of the two interpretations was analyzed, and the ability of SNAP and TOF in evaluating the integrity of Willis circle was compared. In addition, for 15 patients with VISTA images, the plaque of Willis circle vascular wall was evaluated using SNAP and VISTA images to compare their evaluation ability. Results The results of the first and second interpretations of SNAP and TOF were highly consistent. The arteries with exactly the same interpretation included left anterior cerebral artery A1 (LA1), right anterior cerebral artery A1 (RA1), left posterior cerebral artery P1 (LP1) and right posterior cerebral artery P1 (RP1) (Kappa=1.000). The results in terms of left posterior communicating artery (LPCoA) (Kappa=0.926 and 0.924, respectively), right posterior communicating artery (RPCoA) (Kappa=0.931 and 0.732, respectively) and integrity (Kappa=0.815 and 0.816, respectively) were relatively consistent, while there was a relatively low consistency in terms of anterior communicating artery (ACoA) (Kappa=0.640 and 0.675, respectively). In evaluating the constituent vessels of the circle of Willis and its integrity, SNAP and TOF showed good consistency. Vessels with identical SNAP and TOF interpretations include LA1, RA1, LP1, and RP1 (Kappa=1.000). The interpretation consistency of the two imaging techniques on LPCoA (Kappa=0.852 and 0.848), RPCoA (Kappa=0.796 and 0.796, respectively), and integrity (Kappa=0.701 and 0.742, respectively) was relatively high. While the consistency of SNAP and TOF in terms of ACoA was slightly lower (Kappa=0.680 and 0.714, respectively). In assessing the plaque of Willis circle vascular wall, the evaluation results of SNAP and VISTA were consistent. Conclusion As a non-enhanced angiography technique, the magnetic resonance SNAP sequence can well evaluate the integrity of Willis circle, as well as the presence or absence of plaque on Willis circle vascular wall.

Objective To evaluate the curative effect ofeliminating flatulence and laxative cream on patients with advanced hepatocellular carcinoma and opioid-associated constipation（OIC）. Methods 120 patients with advanced liver cancer complicated with OIC who were treated at the Third Affiliated Hospital of Naval Medical University from June 2021 to December 2022 were selected as the study subjects. The patients were divided into a control group（lactulose+conventional treatment）and an experimental group（eliminating flatulence and laxative cream + conventional treatment）using a randomized numerical table method. Two groups were compared in terms of defecation, quality of life, and comprehensive post-treatment evaluation（economic cost, number of occurrences of diarrhea, and whether or not there was a change in the dosage of opioids used）. Results After 28 d of intervention, both groups showed better results in relieving OIC（P<0.05）, and the experimental group was significantly better than the control group in terms of the quality of life of patients with advanced hepatocellular carcinoma, the economic cost and the number of diarrhea（P<0.05）. Conclusion In the treatment of OIC in patients with advanced hepatocellular carcinoma, constipation could be relieved by using both topicaleliminating flatulence and laxative cream and oral lactulose solution. Among them, antieliminating flatulence and laxative cream was more acceptable to patients and superior in terms of quality of life and economic cost, which could be a better choice for improving patient satisfaction and safety.