Objective To study the characteristics of new ischemic stroke,especially asymptomatic ischemic stroke,in elderly patients with intracranial vertebrobasilar artery stenosis after stenting by analyzing their DWI before and after stenting.Methods Fifty-four patients with symptomatic intracranial vertebrobasilar atherosclerotic artery stenosis who underwent multimodal imagingguided stenting in our hospital were included in this study.The patients undertwent head MRI scanning within 24 h after stenting and were followed up for 30 days during which the incidence of ischemic stroke and death,and findings on head MRI were recorded.Results The success rate of stenting was 100.0％.Of the 54 patients,2 (3.7％) were diagnosed with symptomatic perforating infarction and 1 with intracranial hemorrhage after stenting.Out of the 24 asymptomatic patients who underwent head DWI,asymptomatic ischemic stroke,perforating ischemic stroke,embolic ischemic stroke and mixed ischemic stroke occurred in 7 (29.2％),1 (14.3％),5 (71.4％) and 1 (14.3％) respectively.Out of the 6 patients with embolic ischemic stroke,embolic ischemic stroke involving osterior inferior cerebellar artery,inferior cerebellar artery and superior cerebellar artery occurred in 4 (66.7％),3 (50.0％) and 2 (33.3％) respectively.Conclusion MRI can show the characteristics of new ischemic stroke in elderly patients with intracranial vertebrobasilar artery stenosis after stenting.The incidence of asymptomatic ischemic stroke is 29.2 ％.Embolic ischemic stroke is the main type of new asymptomatic ischemic stroke.

Atrial fibrillation (AF) is one of the most common arrhythmias.The treatment and management for AF is similar to that for other chronic diseases but is more complex.In recent years,research on the management of AF has been carried out continuously,guidelines have been constantly updated,and new strategies for the management of AF have been proposed.Although there are many deficiencies in the management of AF in our country,considerable progress has been made with the establishment of AF centers.This manuscript reviews new advances in the management of AF.

随着军事斗争准备的需要,为了全面提高官兵的军事素质,军事训练任务强度逐渐加大,作训伤的发生不可避免.腰椎间盘突出症是作训伤中比较常见的疾病之一,不及时治疗将直接影响伤病员的战斗力.腰椎间盘突出症主要是指因腰椎间盘的退变与损伤,尤其是L3～4、L4～5、L5～S1的纤维环破裂和髓核组织突出压迫和刺激相应水平的一侧或双侧坐骨神经所引起的一系列综合征[1].临床表现多样,主要为腰骶部疼痛、下肢酸麻痛等.本病属于中医学“腰痛”“痹证”范畴.2011年5月-2013年4月,我们综合运用腰椎牵引配合针刺治疗腰椎间盘突出症65例,并与单纯腰椎牵引治疗的59例对照观察,报道如下.

目的:运用旷场、高架十字迷宫分析Shank3基因敲除(Shank3-KO)自闭症小鼠的焦虑样行为.方法:成年Shank3-KO小鼠和同窝野生型(wild type,WT)小鼠.摄像机记录小鼠在旷场和高架十字迷宫中的活动.Smart 3.0行为学软件对活动轨迹进行数据分析,统计小鼠在旷场“中央区域移动距离”、“中央区域移动时间百分比”,在高架十字迷宫中“总移动距离”、“开臂进入次数”、“开臂滞留时间百分比”等数据.结果:与WT小鼠相比,Shank3-KO小鼠在旷场中“总移动距离”显著下降,它们更偏爱在靠近旷场外壁的区域活动,对中心区域的探索欲望低下.在高架十字上,Shank3-KO小鼠更偏爱待在封闭安全环境中,比WT小鼠更恐高,开臂探索次数显著减少.结论:Shank3-KO小鼠自发性焦虑行为与WT小鼠有明显不同,旷场、高架十字环境会刺激其产生更高的焦虑水平.

Objective To study the characteristics and clinical value of contrast-enhanced ultrasound (CEUS) of Budd-Chiari syndrome(BCS).Methods The examination data of two-dimensional ultrasound and color Doppler ultrasound and CEUS of 32 patients with BCS retrospectively were analysed,the inferior vena cava,hepatic vein blood flow imaging characteristics were observed,all patients were confirmed by angiography and interventional treatment or surgery.Results The characteristic of CEUS of BCS:inferior vena cava and/or hepatic vein stenosis in local blood flow pattern turn narrowed,blocking local without enhancement.Post-hepatic inferior vena cava imaging was delayeds or not development,when the stenosis or obstruction was improved or removed after treatment,the post-hepatic inferior vena cava development time was significantly shortened.Development time had no obvious difference between narrow one and normal one among three main hepatic vein.Blood flow edge inner vessel can be well displayed,which is beneficial to show lunmen shape of narrow section and blood flow beam direction.The blood flow information inner vascular stent can be displayed.There was no angle dependence,can improve signal detection rate of low flow and low velocity blood flow.Conclusions CEUS can well display inferior vena cava,hepatic vein stenosis or obstruction with position,extent and degree,especially in identification of inferior vena cava or hepatic vein occlusion with severe stenosis,which has important value to the choice of operation method,the judgment of therapeutic effect and postoperative follow-up.

Objective To explore main points of ultrasonic differential diagnosis of Budd-Chiari syndrome(BCS) and similar diseases in order to reduce the misdiagnosis rate.Methods Clinical and iconography data of 12 patients misdiagnosed as having Budd-Chiari syndrome by color Doppler ultrasound were retrospectively analyzed.Results Main clinical manifestations of this group were seroperitoneum,hepatosplenomegaly,esophageal or abdominal varicose veins.Patients were misdiagnosed as having BCS by ultrasound in our hospital or other hospitals,and BCS was excluded by the inferior vena cavography.There were 6 patients with liver cirrhosis,2 patients with Abernethy malformation,2 patients with cavernous transformation of portal vein,1 patient with omental cysts,and 1 patient with abdominal cystic lymphangioma.The 6 patients with cirrhosis underwent conservative treatment,and others underwent corresponding surgical treatment.All patients' conditions improved and were discharged.Conclusion Ultrasonogram of Budd-Chiari syndrome may be easily confused with causes of inferior vena cava compression narrow,hepatic vein lesion and portal hypertension disease.Clinicians should combine it with the patient's posture,respiratory change,and change of the inferior vena cava in diagnosing so as to reduce the misdiagnosis rate.

Objective To study the color Doppler ultrasound image characteristics and ultrasonic diagnosis classification of Budd-Chiari syndrome (BCS),so as to facilitate the treatment choice.Methods The clinical material of 126 BCS patients were retrospectively analyzed.All patients were proved by angiography,intervention or surgical treatment,and were classified according to the main color Doppler ultrasound images.Results According to the image characteristics of color Doppler ultrasound,BCS patients were divided into eight types:type Ⅰ,incomplete membrane of inferior vena cava in 30 cases; type Ⅱ,complete membrane of inferior vena cava in 3 cases;type Ⅲ,stenosis of inferior vena cava in 8 patients;type Ⅳ,inferior vena cava obstruction in 3 patients;type Ⅴ,stenosis of big hepatic vein in 20 cases;type Ⅵ,big hepatic vein obstruction in 15 cases; type Ⅶ,extensive obstruction of small hepatic vein in 9 cases; type Ⅷ,38 cases of mixed lesions.Conclusions Color Doppler ultrasound can display the stenosis or obstruction of the inferior vena cava,hepatic vein with property,position,degree and the hemodynamic changes,which are accurate and reliable to the diagnosis and classification of BCS.

>1995-2009年间我院疑诊Abernethy畸形3例,经静脉造影或增强CT/MRI证实后行手术治疗,现报告如下。病例1,女,15岁,因反复便血15年入院。肠镜检查:上半结肠黏膜充血水肿,乙状结肠至直肠黏膜广泛糜烂、溃疡、渗

Purpose:The accuracy and the safety of seminal vesicle punctures by transrectal and transperineal means under the guidance of ultrasound were compared. Materials and Methods: 86 seminal vesicles were punctured by transrectal means and 53 by transperineal means under the guidance of transrectal ultrasound. Results:All transrectal puncture was successful, and transperineal puncture succeed in 48/53 cases (90. 57% ). Conclusion:Both puncture procedures were safe,harmless and practical, with the transrectal means being superior because of no anesthesia needed, shorter duration and higher success rate.

患者女,44岁,因患风心病14年,感心前区不适一周,来我院门诊就医.查体:二尖瓣面容,心前区可闻及4/6级舒张期杂音,肺部听诊未见异常,双下肢浮肿.