[Objective]To summarize the clinical experience of a Master of traditional Chinese medicine(TCM),Professor XIONG Jibai,in treating severe cerebrovascular diseases(CVD)with modified Ditan Decoction combined with Tianma Zhijing Powder based on syndrome differentiation.[Methods]By tracing the historical understanding of severe CVD in both Chinese and western medicine,and summarizing Professor XIONG Jibai's diagnostic and therapeutic system for treating apoplexia from the phlegm-wind perspective by using insect drugs,this study analyzes the formulation principles and synergistic effects of Tianma Zhijing Powder and Ditan Decoction.Using a clinical case of severe CVD as example,it extracted the syndrome differentiation and treatment experience of applying modified Ditan Decoction combined with Tianma Zhijing Powder in managing severe CVD.[Results]Severe CVD falls under the category of apoplexia involving the Zang-Fu organs in TCM.Professor XIONG Jibai attributes this condition to the simultaneous pathogenic effects of phlegm and wind.The treatment requires the use of insect drugs to eliminate phlegm,unblock collaterals and reinforce healthy Qi.The combination of Ditan Decoction and Tianma Zhijing Powder works to dispel wind-phlegm and dredge the meridians and collaterals.These two formulas mutually reinforce each other's effects,enhancing their therapeutic potency.In the clinical case,adding heat-clearing and orifice-opening ingredients helped restore consciousness in comatose patient,demonstrating the favorable clinical efficacy of this approach in treating severe CVD.[Conclusion]Professor XIONG Jibai postulates the theory of internal wind complicated by phlegm and successfully treated patients with severe CVD.Using Ditan Decoction combined with Tianma Zhijing Powder as the core formula,he applies insect drugs to eliminate phlegm,unblock collaterals and reinforce healthy Qi.This case provided a novel approach to overcome therapeutic bottlenecks in severe CVD management,highlight the potential for further exploration of TCM in treating this critical condition.

[Objective]To summarize the clinical experience of a Master of traditional Chinese medicine(TCM),Professor XIONG Jibai,in treating severe cerebrovascular diseases(CVD)with modified Ditan Decoction combined with Tianma Zhijing Powder based on syndrome differentiation.[Methods]By tracing the historical understanding of severe CVD in both Chinese and western medicine,and summarizing Professor XIONG Jibai's diagnostic and therapeutic system for treating apoplexia from the phlegm-wind perspective by using insect drugs,this study analyzes the formulation principles and synergistic effects of Tianma Zhijing Powder and Ditan Decoction.Using a clinical case of severe CVD as example,it extracted the syndrome differentiation and treatment experience of applying modified Ditan Decoction combined with Tianma Zhijing Powder in managing severe CVD.[Results]Severe CVD falls under the category of apoplexia involving the Zang-Fu organs in TCM.Professor XIONG Jibai attributes this condition to the simultaneous pathogenic effects of phlegm and wind.The treatment requires the use of insect drugs to eliminate phlegm,unblock collaterals and reinforce healthy Qi.The combination of Ditan Decoction and Tianma Zhijing Powder works to dispel wind-phlegm and dredge the meridians and collaterals.These two formulas mutually reinforce each other's effects,enhancing their therapeutic potency.In the clinical case,adding heat-clearing and orifice-opening ingredients helped restore consciousness in comatose patient,demonstrating the favorable clinical efficacy of this approach in treating severe CVD.[Conclusion]Professor XIONG Jibai postulates the theory of internal wind complicated by phlegm and successfully treated patients with severe CVD.Using Ditan Decoction combined with Tianma Zhijing Powder as the core formula,he applies insect drugs to eliminate phlegm,unblock collaterals and reinforce healthy Qi.This case provided a novel approach to overcome therapeutic bottlenecks in severe CVD management,highlight the potential for further exploration of TCM in treating this critical condition.

The protection of language function is one of the major challenges of brain surgery. Over the past century, neurosurgeons have attempted to seek the optimal strategy for the preoperative and intraoperative identification of language-related brain regions. Neurosurgeons have investigated the neural mechanism of language, developed neurolinguistics theory, and provided unique evidence to further understand the neural basis of language functions by using intraoperative cortical and subcortical electrical stimulation. With the emergence of modern neuroscience techniques and dramatic advances in language models over the last 25 years, novel language mapping methods have been applied in the neurosurgical practice to help neurosurgeons protect the brain and reduce morbidity. The rapid advancements in brain-computer interface have provided the perfect platform for the combination of neurosurgery and neurolinguistics. In this review, the history of neurolinguistics models, advancements in modern technology, role of neurosurgery in language mapping, and modern language mapping methods (including noninvasive neuroimaging techniques and invasive cortical electroencephalogram) are presented.
Brain Mapping ; Brain Neoplasms ; Humans ; Language ; Neurosurgery ; Neurosurgical Procedures

The Singapore Health Services cluster (SingHealth) radiology film archives are a valuable repository of local radiological cases dating back to the 1950s. Some of the cases in the archives are of historical medical interest, i.e. cerebral angiography in the workup of patients with hemiplegia. Other cases are of historical social interest, being conditions seen during earlier stages of Singapore's development, i.e. bound feet. The archives form a unique portal into the development of local radiology as well as the national development of Singapore. A selection from the archives is published in commemoration of the International Day of Radiology in 2020, as well as the 200th anniversary of the Singapore General Hospital in 2021. This pictorial essay comprises gastroenterology, musculoskeletal and obstetrics and gynaecology cases from the archives.

The Singapore Health Services cluster (SingHealth) radiology film archives are a valuable repository of local radiological cases dating back to the 1950s. Some of the cases in the archives are of historical medical interest, i.e. cerebral angiography in the workup of patients with hemiplegia. Other cases are of historical social interest, being conditions seen during earlier stages of Singapore's development, i.e. bound feet. The archives form a unique portal into the development of local radiology as well as the national development of Singapore. A selection from the archives is published in 2020 in commemoration of the 20th anniversary of the formation of SingHealth, the 55th National Day of Singapore, and the 125th anniversary of the International Day of Radiology. This pictorial essay comprises cardiovascular, respiratory and neurological cases from the archives.

Objective: To explore the mediation mechanism of coronary artery lesion among both male and female Kawasaki disease (KD) children. Methods: Children with KD that hospitalized in the Wenzhou Medical University affiliated Yuying Children’s Hospital from January 2009 to December 2014, were included in this study. Differences on demographical characteristics, clinical manifestations, laboratory indicators, regimen and time of treatment, results from pre/post echocardiography and treatment between male and female patients, were compared. The independent effect of gender on the risk of coronary artery lesions (CAL) was evaluated, and the mediating effect of BMI, visiting time and KD type on the association between gender and CAL were also studied. Results: The average BMI level of male patients was higher than that of female patients. The difference was statistically significant (P<0.001). The prevalence of overweight among male patients (20.9%) was higher than female (14.1%). The difference was statistically significant (P=0.011). Data from the multivariate logistic regression analysis confirmed that the incidence of CAL in male patients was higher than that in female patients (aOR=1.50, 95%CI: 1.06-2.12) but the CAL was mainly different before on the immunoglobulin therapy. Results from the mediation analysis showed that BMI was an important mediator in the association between gender and CAL, with the indirect effect as 1.05 (95%CI: 1.01- 1.10) and the proportion mediated as 13.0%. Conclusions Male patients presented higher incidence of CAL but was mainly reflected in the difference of CAL before the treatment. BMI was probably an important mediator related to the association between gender and CAL.