Clinical Study on Acupuncture Treatment for Parkinson's Non-motor Symptoms / 上海针灸杂志

Parkinson disease (PD) is a neurodegenerative disorder resulting from alpha-synuclein lesions, which affects about eight million patients over the world. PD is manifested in progressive motor and non-motor symptoms. With understanding of PD gradually deepened, motor symptoms mainly manifested in resting tremor are not the only manifestations of PD. Clinically many non-motor symptoms such as autonomic nervous symptoms, mental symptoms and paresthesia are also the important manifestations of PD and can appear earlier than motor symptoms. The effect of the non-motor symptoms on the patients' life is often not less than that of the motor symptoms. Clinically the changeable non-motor symptoms are far more complex and more difficult to treat than the motor symptoms. Conventional anti-PD drugs such as levodopa have little effect on the non-motor symptoms. Present clinical studies have showed that acupuncture has a certain therapeutic effect on the non-motor symptoms of PD. This provides important help for expanding the way to treat PD.

White matter tractography by diffusion tensor imaging in prognosis of acute lacunar infarctions / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To evaluate diffusion tensor tractography (DTT) of white matter in prognosis of acute lacunar infarctions.</p><p><b>METHODS</b>Twenty-eight patients of pyramidal tract strokes at the acute phase (<3 days) with a marked motor defect were examined. Lesions were identified on diffusion weighted imaging and isotropic imaging of DTI, and infarctions and the tract were shown on the DTT images simultaneously. The anatomic location and pattern of the lesions were visualized on DTT, with regard of the corticospinal tract (CST), all patients were divided into three clinical subgroups: in Group 1 infarction lesions were close to CST, in Group 2 CST was partial involved, in Group 3 lesions centered in the pyramidal tract. Subsequently, they were compared with the National Institutes of Health Stroke Scale (NIHSS) scores at acute phase (<3 days), early chronic phase (8 approximately 14 days), and outcome(30 approximately 60 days).</p><p><b>RESULT</b>NIHSS scores of Group 1(12/28) were not different with those of Group 2 (11/28) at the acute phase (U=-1.430, P>0.05), and NIHSS scores in Group 2 were significantly lower than those of Group 3(5/28) (U= -2.676, P <0.01). In the outcome, NIHSS scores of Group 1 were significantly lower than those of Group 2 (U= -2.501, P<0.05), NIHSS scores of Group 2 were significantly lower than those of Group 3 (U= -2.948, P<0.01). Among these three groups,Group 1 all had good recovery, Group 2 also had good recovery but sometimes with some mild motor disfunction, and Group 3 always had marked defect and minor improvement. Both rADC value and rFA value were induced in the acute lacunar infarctions.</p><p><b>CONCLUSION</b>DTT is helpful in prognestic valuation of acute lacunar infarction by providing visualized stereo localization of CST and infarction lesions.</p>

Functional MRI study on thalamus activation induced by electrical stimulation of different intensities / 中南大学学报(医学版)

OBJECTIVE@#To detect the activation pattern of the thalamus in human by the functional magnetic resonance imaging (fMRI) with the electrical stimulation of different intensities, and to explore the mechanism of this area in pain modulation.@*METHODS@#Ten healthy right-handed volunteers were given different electrical stimulations of 1-, 2-, and 3- times pain threshold respectively. The whole-brain was scanned simultaneously by GE 1.5T magnetic resonance imaging system. The data were postprocessed by analysis of functional neuroimages (AFNI) to establish the regional activity maps of the thalamus.@*RESULTS@#Patterns of functional activity showed a positive linear relationship between the activation signals and stimulation intensity in bilateral thalamus, whereas the BOLD signal of bilateral medial thalamus demonstrated that the curve was similar to the exponential function. Meanwhile, the activation in the contralateral lateral thalamus (cThl), but not the contralateral medial thalamus (cThm), was prominent compared with the corresponding ipsilateral subregions, and only the lateral thalamus displayed a contralateral biased representation while the medial thalamus lacked this property.@*CONCLUSION@#Thalamus is one of the vital components in the pain modulation network, which can present spatial segregation activations with unique characteristics of stimulation intensity-response in each subregion. All the results are helpful to understand the crucial role of thalamus in processing the pain information.

Functional magnetic resonance imaging study of writer's cramp / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Writer's cramp is a type of task specific idiopathic focal dystonia and has an incompletely understood pathophysiology. The present study utilized functional magnetic resonance imaging (fMRI) to investigate what type of brain activity correlates with writer's cramp and its physiological mechanism.</p><p><b>METHODS</b>Ten patients with writer's cramp were age and gender matched with ten healthy control subjects in a block design. Subjects were scanned by fMRI while performing three consecutive, visually instructive, tasks with MR Vision 2000: (1) suppositional writing, (2) writing with finger and (3) writing with a pencil. Data was analysed using AFNI software for groups of patients and controls.</p><p><b>RESULTS</b>The patients with writer's cramp showed significant activations of contralateral basal ganglion (especially the putamen), motor cortex (primary sensorimotor cortex, supplementary motor cortex, premotor cortex) and ipsilateral cerebellar hemisphere in writing with a pencil compared with controls; whereas there was no obvious difference between patients and controls during writing with finger. Furthermore, these differences exist in the subtractive activated maps for "writing with a pencil" minus "writing with finger" of patients, when the activation of subcortical area and insula in controls disappeared.</p><p><b>CONCLUSIONS</b>Abnormal activations of contralateral basal ganglion, motor cortex and ipsilateral cerebellar hemisphere of the patients with writer's cramp suggest dysfunction of basal ganglion and subcortical-cortical loop might play a pathophysiological role in writer's cramp.</p>

Researching the character and stenosis of coronary calcified plaques by using 16-slice spiral CT / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the characters of coronary calcified plaques by using 16-slice spiral CT and determine their stenosis degree according to the results of catheter coronary angiography.</p><p><b>METHODS</b>Twenty patients who had received 16-slice spiral CT coronary angiography and conventional coronary angiography (CAG) were found to be with calcified plaques. The characters of these plaques, including the diameter of calcified plaques and lumen diameter of the exact artery segment, were retrospectively analyzed. The stenosis degree of the corresponding segment was judged in accordance with the results of CAG.</p><p><b>RESULTS</b>Totally 84 calcified plaques were observed in 16-slice spiral CT images in these 20 patients. Among them there were 16 small nodules (diameter: < 0.15 cm), 56 purely calcified plaques (diameter: > or = 0. 15 cm), and 12 complex plaques with calcify component. There was no obvious stenosis in artery segments with little calcified nodules. The stenosis degree of most segments with purely calcified plaques (75%) was less than 50%. The stenosis degree had no significant correlation with the size of plaques (P > 0.05). However, the stenosis degree of complex plaques had much closer relationship with the characters of mixed plaques.</p><p><b>CONCLUSIONS</b>Most coronary segments with calcified plaques have slight stenosis. Their stenosis degree is not related with the size of plaques. The stenosis degree of complex plaques has a closer relationship with the characters of mixed plaques.</p>

Diagnostic value of spiral computed tomography in adhesive ileus / 中国医学科学院学报

<p><b>OBJECTIVE</b>To discuss the diagnostic value of spiral computed tomography (CT) in adhesive ileus.</p><p><b>METHODS</b>We retrospectively analyzed 40 patients with adhesive ileus who were diagnosed by CT and confirmed by operations. The main reconstruction method included multi-planar reconstruction (MPR) and sliding thin slab-maximum intensity projection (STS-MIP).</p><p><b>RESULTS</b>Among all the 40 patients, localization diagnosis was correct in 32 patients (80%) and partially correct in 8 patients (20%). The main signs included: (1) dilated proximal intestinal canal and collapsed distal intestinal canal in 40 patients (100%); (2) smooth transitional zone in 39 patients (97.5%); (3) delayed enhancement of regional bowel in 33 patients (82.5%); (4) beak sign in 32 patients (80%); (5) adhesions balteum in 6 patients (15%); and (6) pseudotumor appearance in one patient (2.5%).</p><p><b>CONCLUSION</b>Spiral CT has an important value in detecting adhesive ileus.</p>

MRI diagnosis of benign sacrococcygeal teratomas of the infants / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the value of MR imaging in the diagnosis of benign sacrococcygeal teratomas of the infants.</p><p><b>METHODS</b>MR imaging of benign sacrococcygeal teratomas in 6 cases proved by surgery and pathology was retrospectively reviewed. In all patients, a fast imaging sequence, fast spin echo sequence was employed, together with short time inversion recovery sequence and contrast enhancement scanning by intravenous injection of Gd-DTPA.</p><p><b>RESULTS</b>There were 6 benign sacrococcygeal teratomas, which were heterogeneous masses and arose from the distal sacrococcygeal region in the pelvis. The MR imaging appearances of the benign sacrococcygeal teratomas were characteristic, T1- and T2-weighted images demonstrated a large mass containing round, well-defined areas of varying signal intensity representing its cystic, solid, and sometimes fat, calcification within the lesions.</p><p><b>CONCLUSION</b>MR imaging provides definitive information of benign sacrococcygeal teratomas and clearly shows both extra-and intra-pelvic components, and even better anatomic details, which facilitates the surgical planning adequately.</p>

Study on brain response to acupuncture by functional magnetic resonance imaging--observation on 14 healthy subjects / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the signal changes of brain functional area during needling Sanyinjiao (ST36), Zusanli (SP6) and Yanglingquan (GB34), the three acupoints in three different meridians, in human by functional magnetic resonance imaging (fMRI), in order to preliminary explore the neural mechanism of acupuncture.</p><p><b>METHODS</b>Needling was complemented with 30 s of maneuver applying followed by 30 s of rest as a circle on an acupoint, and at the same time, fMRI was performed once 5 min and 12 s. Then the same program was repeated with the same mode on another acupoint, until ending the experiment.</p><p><b>RESULTS</b>The commonly activated regions were postcentral gyrus and right inferior frontal gyrus when needling at ST36 and SP6, and the different activated areas included left inferior frontal gyrus, left insula, left inferior parietal lobule, left culmen, left middle temporal gyrus and left middle frontal gyrus, while no cortical signal enhanced region was found when needling at GB34. Signal weakened regions could be found when needling at all the three points, the commonly activated regions were bilateral parahippocampal, hippocampal, callosal gyrus, bilateral praecuneus and cerebellum.</p><p><b>CONCLUSION</b>Brain response in special regions could be obtained by needling at different acupoints.</p>

Functional MRI of human brain in musicians and non-musicians / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To explore the differences in brain activation between musicians and non-musicians by use of functional MRI.</p><p><b>METHODS</b>Twelve right-handed musicians and twelve right-handed non-musicians were recruited in the study. During a listening task, they were scanned on the Sigma 1.5T scanner (GE) while they were passively listening to several segments of music of "the Butterfly Love" and the white noise with same physical energy.</p><p><b>RESULT</b>Both musicians and non-musicians demonstrated bilateral transverse gyrus weak activated while listening to the white noise. But when listening to music, they showed bilateral temporal areas strongly activated including superior temporal gyrus, transverse gyrus and some middle temporal areas. Moreover, musicians showed relative left dominance (10/12), whereas non-musicians demonstrated right dominance(11/12). Furthermore,besides bilateral temporal areas, more and stronger activated areas were found in musicians such as cuneus, precuneus,medial frontal and left middle occipital gyrus.</p><p><b>CONCLUSION</b>There are different neuro-patterns between musicians and non-musicians.</p>

Angiographic diagnosis of gastrointestinal stromal tumors / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the angiographic feature and its diagnostic value in gastrointestinal stromal tumor (GIST).</p><p><b>METHODS</b>Twelve patients with pathologically proved GIST underwent angiography using PUCK and DSA one week before operation. The origin, size, morphology and angiographic appearance of the lesion were retrospectively analyzed.</p><p><b>RESULTS</b>It was found that two tumors originated from stomach, eight from jejunum, and two from ileum. Seven cases were benign but five malignant. Obviously thickened and enlarged feeding artery was detected in eight tumors, and early-developed vein was found in three. Two types of angiographic changes of GIST were observed: 1) twisted irregular neoplastic vessels with partially coarse and indistinct margin were found in four cases, which were all malignant; 2) ball-like neoplastic vessels with homogeneous stain in tumor were found in eight cases, seven of them were benign but one was malignant.</p><p><b>CONCLUSION</b>Angiography may be helpful in localization and diagnosis as well as defining the size of GIST, and especially in patients with melena of unknown origin.</p>

Inferior orbital fissure and groove: axial CT findings and their anatomic variation / 法医学杂志

OBJECTIVE@#To show imaging findings of inferior orbital fissure (IOF) and groove (IOG) on axial CT scans and to discover their anatomic variations, so as to avoid misdiagnosing them as orbital fracture.@*METHODS@#25 normal skull were used to investigate the configurations of IOF and IOG. Five skulls were performed axial CT scans. 20 normal orbital axial scans were studied as well. MPR and RT-3D reconstructions were used in this study.@*RESULTS@#Skulls scans and normal orbital images on axial CT showed three sorts of findings: (1) single bony dehiscence between lateral and inferior walls; (2) first type of double bony dehiscence between lateral and inferior walls, among the dehiscence interposing a small bone. The long axis of the small bone was parallel to orbital wall; (3) second type of double bony dehiscence between lateral and inferior walls, but the long axis of the small bone was in anteroposterior direction. Anatomy and variation of three sorts of CT findings were corresponded respectively to: (1) a baseball club-shaped IOF; (2) a "V"-shaped IOF, that is composed of both of lateral and internal ramus, lateral ramus situates between the zygoma and the lateral portion of greater wing of sphenoid, and internal ramus between the maxilla and the internal portion of greater wing of sphenoid, both rami intercross caudally and open upwards in a "V"-shaped configuration; (3) a deep IOG with a protuberant lateral wall.@*CONCLUSION@#Familiarity of imaging features on the axial CT scans and understanding of their anatomy of IOF and IOG would be helpful for avoiding misdiagnosis of orbital fracture.

Virtual colonoscopy in diagnosis of colorectal neoplasia / 浙江大学学报·医学版

OBJECTIVE: To evaluate the value of virtual colonoscopy in diagnosis of colorectal neoplasia. METHODS: Virtual colonoscopy was performed in 29 patients with colorectal neoplasia confirmed by colonoscopy. The results were compared with colonoscopy for each case. RESULTS: Virtual colonoscopy was successfully performed in each patient without any complications. All colorectal carcinomas detected by colonoscopy were identified by virtual colonoscopy. Twenty-five polyps were detected with colonoscopy, whereas only 16 identified by virtual colonoscopy. Compared with the results of colonoscopy, detection rate of polyps greater than 1.0 cm between 0.5 approximate, equals 0.9 cm and less than 0.5 cm in size was 90.0% 62.5% and 28.6% respectively. CONCLUSION: Virtual colonoscopy is fast, minimal invasive and well tolerated. This technique is a valuable clinical method in diagnosis of colorectal cancer and polyps larger than 0.5 cm in size.

Value of multi-slice computer tomography enterography in the diagnosis of small intestinal diseases / 中华消化杂志

Objective To assess the value of multi-slice computer tomography enterography (MSCTE) in demonstrating small intestinal diseases.Methods MSCTE was performed with iso-osmotic manitol (2.5%) as oral contrast in 98 patients with various kinds of suspected small intestinal diseases.All patients were inter- viewed about their tolerance of the procedure.Demonstration of features of various kinds of small intestinal dis- eases was analyzed.MSCTE diagnosis of different small intestinal diseases were compared with the final clinical diagnosis.Results The procedure was acceptable by all patients and no obvious complication was found. MSCTE was performed for 2 patients because of the failure of conventional small bowel enteroclysis.CT features of many kinds of diseases such as tumors,Crohn's disease were clearly displayed.The sensitivity of MSCTE was 96.5% (83/86),accuracy 90.8% (89/98).Conclusion MSCTE is a simple,rapid,noninvasive and effective method in evaluating small intestinal diseases.