Objective To explore the value of apparent diffusion coefficient(ADC)values of magnetic resonance diffusion weighted imaging(MR-DWI)in predicting the prognosis of primary hepatocellular carcinoma(HCC)treated by radiofrequency ablation(RFA).Methods A prospective study was conducted on 178 patients with HCC.All patients were treated with RFA and followed up for 1 year after treatment.MR-DWI was performed before RFA and one month after RFA,and the changes in ADC value were calculated.These changes of the cancer in patients with different clinicopathological parameters were compared.The factors affecting the prognosis of HCC patients with RFA,and the value of ADC value changes in predicting the prognosis were analyzed.Results The changes of ADC values in patients with high alpha-fetoprotein,Barcelona clinic live cancer(BCLC)stage C,and poorly differentiated were lower than those in patients with low alpha-fetoprotein,BCLC stage B,and moderately well-differentiated(P<0.05).Six cases were lost to follow-up,and 120 of the remaining 172 patients survived.Cox regression analysis showed that the changes in ADC value,tumor stage and degree of differentiation were independent factors affecting the prognosis of HCC patients with RFA(P<0.05).Receiver operating characteristic(ROC)curve results showed that the best cut-off point,sensitivity,specificity and area under the curve(AUC)of ADC value change in predicting the prognosis of HCC patients with RFA were 0.42×10-3 mm2/s,75.00%,78.33%and 0.801.There were 16 deaths in the high change group of ADC value(>0.42)and 36 deaths in the low change group(≤0.42).The overall survival curve of the high change group of ADC value was better than that of the low change group(P<0.05).Conclusion The change in ADC value of MR-DWI sequence before and after short-term RFA treatment in HCC patients is related to the patient's pathology and prognosis,with a good predictive effect.The low change in ADC value has a higher risk of poor prognosis.

Objective:To analyze the clinical features of 6 patients with spontaneous intracranial hypotension caused by high-flow spinal cerebrospinal fluid leaks.Methods:The clinical characteristics, auxiliary examinations, treatment, and outcomes in 6 patients of spontaneous intracranial hypotension caused by high-flow spinal cerebrospinal fluid leaks enrolled in the Xuanwu Hospital, Capital Medical University from February 2021 to April 2022 were retrospectively reviewed.Results:All the 6 patients had orthostatic headaches. Brain magnetic resonance imaging showed dural enhancement and brain sagging and magnetic resonance myelography showed longitudinal extradural collection in all the patients. The high-flow spinal cerebrospinal fluid leaks were demonstrated in upper thoracic segments by the dynamic myelography. The headache disappeared after conservative treatment in 2 patients and treatment with targeted epidural blood patch in 4 patients.Conclusions:The diagnosis of spontaneous intracranial hypotension caused by high-flow spinal cerebrospinal fluid leaks with typical orthostatic headache and brain magnetic resonance imaging and myelography findings is not difficult. However, the localization of the site of high-flow spinal cerebrospinal fluid leaks in spontaneous intracranial hypotension depends on the dynamic myelography. Targeted epidural blood patch is effective, but conservative treatment does not always work.

Objective:To summarize the clinical features, radiological characteristics, therapy, and outcome of patients with spontaneous intracranial hypotension (SIH).Methods:The general information, clinical manifestations, auxiliary examinations, treatment, and outcomes in consecutive patients of SIH hospitalized in the Xuanwu Hospital, Capital Medical University from November 2018 to October 2022 were analyzed.Results:A total of 118 patients with a female-to-male ratio of 5∶4 were included and the ages were 17.00-71.00[39.00(34.00,46.75)]years with a preponderance in the age of 30-49 years. Almost all patients had orthostatic headaches (117/118, 99.2%), accompanied by nausea (90/118, 76.3%), vomiting (70/118, 59.3%), neck stiffness (88/118, 74.6%), tinnitus (57/118, 48.3%), and ear fullness (57/118, 48.3%). Brain magnetic resonance imaging (MRI) showed dural enhancement (97/113, 85.8%), enlarged venous sinus (88/113, 77.9%), subdural fluid collection (46/113, 40.7%), decreased suprasellar cistern (86/113, 76.1%), effacement of the prepontine cistern (86/113, 76.1%), diminished mamillopontine distance (80/113, 70.8%). The cerebrospinal fluid (CSF) leaks were detected in 90.7% (107/118) of the patients by magnetic resonance myelography but 54.3% (25/46) and 52.6% (20/38) by CT myelography and magnetic resonance myelography with gadolinium. Lumber puncture found CSF pressure<60 mmH 2O (1 mmH 2O=0.009 8 kPa) in 18.4% (19/103) of patients, increased CSF red blood cell counts in 50.6% (44/87) of patients, CSF pleocytosis in 44.8% (39/87) of patients, increased CSF protein concentrations in 57.5% (50/87) of patients. The headache completely disappeared after conservative treatment in 24.6% (31/118) of patients and after a single targeted epidural blood patch in 89.7% (78/87) of patients. A rebound headache after epidural blood patch treatment occurred in 66.0% (58/87) of patients. Conclusions:The patients with SIH almost manifested with orthostatic headache, and brain MRI and magnetic resonance myelography were suggested in those patients instead of CSF pressure by lumber puncture. Targeted epidural blood patch was effective and safe in SIH patients.

Spontaneous intracranial hypotension can frequently result in several complications including subdural hygroma, subdural hematoma and cerebral venous thrombosis, but coma rarely. A case of spontaneous intracranial hypotension presented with orthostatic headaches was described. He experienced somnolence, disorientation, incontinence, and then coma, though received conservative treatment. Brain imaging demonstrated acute-on-chronic subdural hematoma, magnetic resonance myelography using heavily T 2-weighted fast spin-echo pulse sequences showed spinal longitudinal extradural collection, and magnetic resonance myelography with intrathecal gadolinium revealed cerebrospinal fluid leak at the level of T 6, T 7. The patient recovered consciousness after surgical evacuation of the hematoma, and the headache disappeared after a targeted epidural blood patch. The hematoma resolved 2 months later and the patient kept free from headache during follow-up.

Objective To explore the clinical and neuroimaging features in a Chinese family with hereditary diffuse leukoencephalopathy with neuroaxonal spheroids (HDLS) caused by mutation of the colony stimulating factor 1 receptor gene (CSF1R). Methods The proband and another patient from a HDLS pedigree were assessed respectively through standardized clinical evaluation (medical history inquiry, physical examination),neuropsychology assessment,MRI,genetic sequencing, as well as brain PET imaging with carbon11-labelled Pittsburgh compound-B(11C-PIB). Results A HDLS pedigree with three patients was recruited to this study. Apathy, memory decline, slow behavior were the first symptoms for two of the patients. Being bedridden, urinary incontinence and epilepsy were developed at the later stage. A missense mutation c. 2381T>C(p. I794T) in exon 18 of the CSF1R gene of chromosome 5 was identified in the proband. The brain DWI illustrated multiple patchy high signal in periventricular white matter and centrum semiovale which was characterized by persistence, and the corpus callosum was affected in the early stage. Conclusion The multiple patchy high signal with persistence in periventricular white matter and centrum semiovale of DWI is helpful for the early diagnosis of HDLS.

Objective To observe the curative effect of herbal iontophoresis with rotation manipulation treating lumbar disc herniation.Methods 84 patients from July 2011 to July 2012 with lumber disc herniation in Electric Power hospital of Capital Medical University were randomly divided into two groups (a testing group n=42,a control group n=42).The testing group was treated with herbal iontophoresis and rotation manipulation,and the control group was treated with rotation manipulation only.The Visual Analogue Scale and Macnab standard for curative effect were observed before the treatment and 3 weeks later after the treatment.Results The total effective rate was 88.1％ and 66.7％ in the testing group and the control group respectively,the difference between two groups was statistically significant (chi-square=5.51,P=0.02＜0.05).The VAS before and after treatment in testing group were (7.31±1.39) and (2.41±1.62) respectively,compared with (7.19± 1.38) and (3.07± 1.28) in the control group.The VAS and curative effect indexes were both improved in the two groups,but the testing group increased more apparent,and the difference between the two groups was significant (P＜0.05).Conclusion The curative effect of herbal iontophoresis and rotation manipulation treating lumber disc herniation was sound.

Objective:To determine the relationship between serum resistin levels and carotid intima media(IMT)thickness in patients with essential hypertension. Methods:This study consisted of 272 patients with essential hypertension. The patients were divided into three groups according to their serum resistin levels. Group 1,n=91,serum resistin level 1.233-3.701 ng/ml;Group 2,n=91,serum resistin level 3.728-8.777 ng/ml;and Group 3,n=90,serum resistin level 8.809-28.658 ng/ml. Results:The carotid IMT and maximum carotid IMT of Group 3 were the highest in three groups.(P＜0.05).As shown in multivariate analysis for factors affecting carotid IMT,serum resistin level(β=0.220,t=5.793,P=0.000)was independently associated with the carotid IMT after controlling the age,blood glucose,uric acid,low-density lipoprotein cholesterol,systolic blood pressure and diastolic blood pressure. Serum resistin level(β=0.189,t=4.733,P=0.000)was independently associated with the maximum carotid IMT after controlling the age,blood glucose,body mass index,diastolic blood pressure,diabetes mellitus,high sensitivity C reactive protein,total cholesterol and triglyceride. Conclusion:Serum resistin was independently associated with the increased carotid IMT in essential hypertension patients.

Aim To establish a set of apparatus and method for the continued measurement of the oxygen consumption in mice. Methods The apparatus consists of a bottle with broad-neck for mice, basic burette, beaker containing water and some tubes for connection. Twenty mice were divided randomly into two groups and administered intragestrically propranolol 20 mg?kg -1 or equal volume of normal saline, respectively. The survival time and oxygen consumption were measured in mice subjected to normobaric and hypoxia.Results The survival time was prolonged by 43.35% (P