Objective:To explore the etiology, clinical features and treatment of superficial siderosis of central nervous system (SSCNS) in China.Methods:The clinical data of four patients with SSCNS diagnosed by magnetic resonance imaging (MRI) and susceptibility weighted imaging (SWI) from Qilu Hospital of Shandong University during 2015—2019 were retrospectively reviewed. The etiology and clinical features of the four cases were summarized and analyzed.Results:All the four patients were male, with an average age of 60.5 years. Clinical symptoms included headache, hearing loss, and cerebellar ataxia. Brain MRI and SWI showed that hemosiderin mainly deposited (short linear T 2 signal, low SWI signal) on the surface of cerebellum, brainstem, temporal lobe, frontal lobe, and spinal cord. Potential bleeding sites were found in all four patients, including brain traumatic history, spinal intradural extramedullary cavernous hemangioma, brain metastasis and intracranial aneurysm. Patients were followed up for six months to four years. Headache symptoms improved in only one patient who received surgical treatment, while symptoms of the other three patients progressed. Conclusions:SSCNS is mainly characterized by hearing loss, progressive cerebellar ataxia and myelopathy. The diagnosis of this disease mainly depends on imaging examination. The linear low signal on the surface of T 2WI is the main basis for the diagnosis of SSCNS. Surgical treatment of bleeding sites and iron chelator are the main treatments of the disease.

Objective To explore more effective methods in vaginal tightening surgery for vaginal relaxation treatment. Methods 132 cases of patients who suffered the decline in quality of sex life owing to vaginal relaxation, requiring improved vaginal tightening surgery. The vaginal surgery was performed to repair the muscles and fascia of the anterior and posterior walls effectively, meanwhile the perineal laceration was also repaired. According to the hammock theory of the treatment of urethral disruption, patients with urinary incontinence with tension was treated to strengthen one suture needle on muscle fascia in the middle of urethra, when repairing anterior of vagina. For patients with constipation, the posterior of vagina was repaired to strengthen 3 suture needles on levator ani during repairing the anterior and posterior wall, so that the vaginal mucosa could get maximum protection. Results 118 patients had been followed up for 2-7 years. A questionnaire survey was conducted about four elements targeted on improving sexual satisfaction, tension incontinence, constipation and vaginal discharge. The clinical results were satisfactory. Conclusions The surgical design is professional and highly effective, and the patients are satisfied with the results. It is suitable for experienced specialists to perform the procedures.