Objective To evaluate MRI measurement of basal ganglia volumes in patients with Tourette's syndrome.Methods Ten patients with Tourette's syndrome(TS)and 10 healthy volunteers were studied.Volumes of bilateral candate,putamen and pallidum were measured,and the results were analyzed using paired t test.The basal ganglia volume was normalized according to individual brain volume.The basal ganglia volumes of TS patients were compared with normal control group using independent-sample t tesL Results In 10 healthy volunteers,volumes of the left caudate,putamen,pallidum were significantly larger compared with those of the right side(P＜0.05).However,there were no significant differenees between bilateral basal ganglia volumes(P＞0.05)in TS patients.After normalized processing,the volumes oftlle left candate(7.06±0.48)cm3,putamen(8.81 ± 1.01)cm3,pallidum(2.64 ± 0.38)cm3were smaller than those of control group[caudate(11.05±1.86)cm3,putamen(9.97 ±1.11 ) cm3, paUidum (3.04 ± 0.37 ) cm3 ] (t= - 6.577, - 2.457, - 2.376, P＜0.05 ).The volume of the right caudate (7.32 ± 0.26) em3 in "IS patients was significantly smaller compared with the control group (9.81±1.83) cm3 (t = -4.258, P ＜0.01 ).However, the volumes of the right putamen and pallidum had no significant difference between two groups (P＞0.05).Conclusion The basal ganglia volumes were significantly decreased in patients with TS.MRI volumetric measurement was an important tool for evaluating pathologic changes of TS.

BACKGROUND:The correct and effective acupuncture manipulation of famous doctors are used to generate the realistic visual, auditory and tactile integrated computer virtual environments for acupuncture simulation based on the various techniques with the core of computer, which can greatly enhance the realism of the operator, and reduce the clinical acupuncture accidents. OBJECTIVE:To establish the virtual Shenshu acupuncture force feedback simulation system. METHODS:Based on the force feedback device, the Shenyu manipulations from the famous acupuncturists were col ected and integrated into the digital virtual body. On the three-dimensional digital human body integrated with information of Shenshu, the interaction force of needle body and tissues during the acupuncture process was analyzed with the virtual reality technology according to physical characteristics of the tissues within Shenshu, in order to establish the mechanical model to simulate needle body force, and to transmit truly to the operator by the force feedback device. RESUTLS AND CONCLUSION:Shenshu virtual acupuncture force feedback simulation was preliminary established, and the sense of touch could be reproduced lively during mimic the acupuncture of Shenshu on the visualized virtual acupuncture human. Shenyu acupuncture force feedback researches have provided a preliminary exploration for virtual acupuncture that integrated with the information of visual, tactile and force feedback, and also provided a dynamic one-on-one simulation means for acupuncture teaching.

Objective To evaluate the 80 mm volume shuttle cerebral CT perfusion(CTP) and 4D-CT angiography (CTA) in patients with stenosis or occlusion in Willis circle.Methods Conventional cerebral plain CT, 80 mm CTP and dynamic 4D-CTA were performed in 55 patients with unilateral MCA/ ICA stenosis or occlusion.The parameter maps of cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT) and time to peak (TTP) were analyzed.Meanwhile dynamic 4D-CTA images were also obtained.The significance of the differences of CBF, CBV, MTT and TTP between the affected side and the contralateral side was assessed using K Independent Samples analysis.Results In 40 patients with unilateral stenosis or occlusion of MCA/ICA, CTP was found abnormal in 36 patients.MTT and TTP of affected side [(7.18 ±1.34), (19.65 ±1.81) s] were significantly prolonged compared to contralateral side [(5.22±1.14) s, (17.62±1.65) s, X~2 =30.833,25.817, P<0.017].Centrum ovale or parietal lobe ischemic lesions were observed in 16 patients on CTP.In 15 patients with bilateral stenosis or occlusion of MCA/ICA, CTP was observed abnormal in 10 patients.CBF, CBV, MTT and TTP of affected side [(42.85 ±6.09) ml·100 g~(-1)·min~(-1), (2.63 ±0.42) ml·100 g~(-1), (11.27 ±1.43) s, (21.07 ±1.44) s)] were significantly different from those of contralateral side [(71.20 ±6.30) ml·100 g~(-1)·min~(-1), (2.29 ±0.15) ml·100 g~(-1), (3.38 ±0.61) s, (17.64 ±1.70) s (X~2 =17.314, 5.913,17.334,13.834,P<0.017)].On 4D-CTA covering 80 mm (0.625 mm×l28), unilateral stenosis of MCA were observed in 22 patients (13 right MCA and 9 left MCA), unilateral occlusion were observed in 5 patients (1 right MCA and 4 left MCA) and bilateral MCA stenosis/occlusion were observed in 9 patients.4D-CTA covering Willis cycle can display stenosis/occlsion of MCA as same as conventional CTA and DSA.Conclusion 80 mm volume shuttle CTP and 4D-CTA provide valuable information about the hemodynamic changes and the abnormalities of intracranial artery in patients with MCA/ICA stenosis or occlusion.

Objective:To evaluate the efficacy of esketamine combined with propofol for colonic transendoscopic enteral tubing (TET) in pediatric patients with autism.Methods:Sixty pediatric patients with autism of both sexes, aged 3-12 yr, weighing 15-45 kg, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, who underwent painless transendoscopic enteral tubing (TET) from October 2022 to August 2023, were selected and divided into 2 groups ( n=30 each) by a random number table method: normal saline + propofol group (group NP) and esketamine + propofol group (group EP). In group NP, normal saline 10 ml was intravenously injected, and 30 s later propofol 2.0 mg/kg was given. In group EP, esketamine 0.3 mg/kg (diluted to 10 ml in normal saline) was intravenously injected, and 30 s later propofol 2.0 mg/kg was given. TET was performed when the Modified Observer′s Assessment of Alertness/Sedation Scale score ≤2. Propofol 0.5-1.0 mg/kg was added if the sedation depth was not enough, and the Modified Observer′s Assessment of Alertness/Sedation Scale score was maintained ≤2 until the end of surgery. The degree of body movement during TET was observed and recorded. The injection pain during induction, total consumption of propofol, operation time, spontaneous emergence time, and completion of operation were recorded. Adverse reactions such as respiratory depression, nausea and vomiting, hypotension, bradycardia, and postoperative agitation were recorded during operation and in the emergence period. Results:Compared with group NP, the degree of intraoperative body movement was significantly lighter, the total consumption of propofol and incidence of injection pain and intraoperative hypotension were significantly lower, and no significant change was found in the spontaneous emergence time and incidence of adverse reactions during recovery in group EP ( P<0.05). Conclusions:Esketamine (0.3 mg/kg) combined with propofol (2.0 mg/kg) can be safely and effectively used for colonic TET in pediatric patients with autism, and esketamine does not increase the risk of adverse reactions during resuscitation in a resuscitation strategy without early awakening.