Objectives: Using magnetic resonance imaging (MRI), we analysed the clinical manifestations of granulomatous lobular mastitis (GLM) before and after treatment with traditional Chinese medicine (TCM). Methods: This was a retrospective study. Clinical manifestations and imaging features of patients with biopsy-proven GLM before and after treatment were retrospectively analysed from April 2021 to April 2023 at Xiyuan Hospital, China Academy of Chinese Medical Sciences. Results: Among 29 women of childbearing age (mean age, 34.3 +/- 3.6 years), Compared to pre-therapy, the number of patients with lumps, ruptures, pain, and menstrual irregularities was significantly reduced (P < 0.05). The Chinese medicine staging demonstrated a transition from bulk to ulcerated (P=0.041). Pre- and post-treatment MRI changes included lesion number, distribution, maximal diameter, time-signal intensity curves (TIC), apparent diffusion coefficients (ADC), and BI-RADS categories 3 and 4a (all P<0.05). Furthermore, substantial changes were seen in chest wall invasion, nipple discharge, increased feeding arteries, and skin edema (all P<0.05). Conclusion: Combining internal and external Traditional Chinese Medicine (TCM) therapy proved successful for GLM. A reliable assessment of therapy efficacy is provided by MRI examination of lesion changes before and after treatment.

Objectives:To evaluate lesions of sacroiliac joint (SIJ) by combination of diffusion-weighted imaging (DWI) and magnetization transfer (MT).Methods:A retrospective study was used in this study. Forty-nine ankylosing spondylitis (AS) patients admitted to The China Academy of Chinese Medical Sciences Xiyuan Hospital from May 2020 to October 2020 were collected into active and inactive groups. Twenty-two healthy volunteers were recruited. Apparent diffusion coefficient (ADC) values for bone marrow edema (BME), sclerosis area, fat deposit area, and normal-appearing bone marrow (NABM) (both patients and healthy volunteers) and the magnetization transfer (MT) rate of the cartilage (MTRc) were analyzed in the groups. The above five parameters (ADC (NABM), ADC (BME) and ADC (fat deposit) and MTRc) between the active group and the inactive group were compared. The effectiveness of each parameter in diagnosing sacroiliac arthritis of ankylosing spondylitis were analyzed, and the predictive value of the parameters was compared.Result:ADC(BME), ADC(NABM) and MTRc showed statistically significant differences between the active and inactive groups (P <0.05). ADC (BME) and ADC (NABM) could predict the activity of AS sacroiliac arthritis (P <0.01). ADC (NABM) and MTRc were significantly different between healthy volunteers and the active group (P <0.01). The areas under the ROC curve (AUCs) of ADC (BME)_ADC(NABM), ADC(NABM)_MTR, and ADC(BME)_MTRc were 0.885 (cut-off value=0.69), 0.849 (cut-off value=0.56) and 0.864 (cut-off value=0.60), respectively. The predictive ability of the combined index ADC (BME)_MTRc and ADC(NABM)_MTRc was increased.Conclusion:The ability to diagnose and predict AS might be improved by the combination of diffusion-weighted imaging (DWI) and magnetization transfer (MT).

目的:探讨基于磁共振定量非对称回波的最小二乘估算法迭代水脂分离序列(IDEAL-IQ)的正常人群骶髂关节脂肪含量的初步定量评价.方法:前瞻性分析2017年4月-2017年11月中国中医科学院西苑医院接诊的60例正常骶髂关节的影像和临床资料.按照年龄(15～30岁、31～50岁、≥51岁)、性别、BMI(<18.5,18.5～23.9,>24.0)进行分组,测量每例受检者骶髂关节脂肪分量图像上髂侧(Fi)和骶侧(Fs)的脂肪分数值(FF).分别采用三因素、两因素以及多元方差分析方法对性别、年龄分组、BMI分组对Fi、Fs的影响进行分析.结果:31～50岁组、≥51岁组组内Fi和Fs差异有统计学意义(P=0.006,P=0.028);≥51岁组男性与女性Fi和Fs差异有统计学意义(P值分别为0.009、0.004);三组间BMI平均值差异无统计学意义(F=0.717,P=0.493).对于Fi和Fs,不存在性别、年龄分组、BMI分组三因素交互作用[F(2,45)=1.538,P=0.226;F(2,45)=0.371,P=0.692]、不存在两因素交互作用(性别和年龄分组,性别和BMI分组,年龄分组和BMI分组,P均>0.05);多元方差分析显示年龄对于Fi和Fs的影响差异具有统计学意义(F=4.252,P=0.019,partialη2=0.136;F=12.694,P<0.001,partialη2=0.320);性别对于Fs的影响差异具有统计学意义(F=9.007,P=0.004,partialη2=0.143).结论:基于IDEAL-IQ脂肪定量技术可定量分析正常人群骶髂关节脂肪含量.

SAPHO综合征是一组罕见的以皮肤和/或骨与关节炎性病变为主要临床表现的异质性疾病,其典型皮肤表现包括无菌性脓疱病及重度痤疮,此外还涉及化脓性汗腺炎、寻常型银屑病等,部分患者皮肤表现也可缺失.现代医学对本病的亚型分类尚未得到公认,各种亚型在治疗上是否应区别对待也未达成共识.既往中医药诊治SAPHO综合征的病例报道极少,尤其缺乏对痤疮型病例的治疗探讨.本文报道1例患者以"面部炎性丘疹、结节、囊肿3年,右臀区、右髋疼痛2周"为主诉于2017-04-27入住中国中医科学院西苑医院风湿病科,诊断为痤疮型SAPHO综合征,采用中医药治疗有效,揭示本型以湿热毒瘀为本,筋脉拘挛为标,临证应注意清热解毒药物、解痉止痛药物、入心经药物及藤类药物的使用,并结合文献研究探讨本病亚型分类的必要性与可行性.

目的:探讨DWI联合磁化传递对比成像(MT)能否提高对强直性脊柱炎(AS)骶髂关节炎活动性的诊断价值.方法:按照纽约标准将39例临床诊断的AS患者分为活动组和非活动组,测量骨髓水肿区(BME)、硬化区(Sc)、脂肪沉积区(FD)、正常骨髓区(NABM)的ADC值和骶髂关节软骨的磁化传递率(MTRc).采用独立样本t检验比较两组间5项参数值的差异,并采用ROC曲线分析各参数对骶髂关节炎活动性的诊断效能,将有预测价值的参数进行logistic回归联合,并采用ROC曲线分析回归方程对关节炎活动性的预测价值.结果:两组间ADCBME、ADCNABM和MTRc的差异有统计学意义(P =0.001,P＜0.001和P=0.025);ADCBME、ADCNABM、MTRc、ADCBME+ADCNABM、ADCNABM+MTRc和ADCBME+MTRc的ROC曲线下面积(AUC)分别为0.738、0.849、0.719、0.885、0.849和0.864(P值均＜0.05).联合指标(ADCBME+MTRc和ADCNABM+MTRc)预测骶髂关节炎活动性的价值提高.结论:DWI和MT联合能提高诊断AS的能力和预测AS活动性.

Objective Iterative decomposition of water and fat with echo asymmetry and least-squares estimation-iron quantification (IDEAL-IQ) is a noninvasive and objective method used to quantitatively measure fat content. Although this technique has been used in the entire abdomen, IDEAL-IQ findings in the sacroiliac joint (SIJ) have rarely been reported. This preclinical study was performed to quantify the amount of fat in the SIJ in healthy volunteers by IDEAL-IQ. Methods From April to November 2017, 60 healthy volunteers with low back pain were included in this retrospective study. The participants were allocated into groups by age (15–30, 31–50, and ≥51 years), sex (male and female), and body mass index (BMI) (<18.5, 18.5–23.9, and ≥24.0 kg/m2). The iliac-side (Fi) and sacral-side (Fs) fat fractions were obtained in all groups. Two- and three-factor multivariate analyses were performed to analyze the effects of sex, age, and BMI on the Fi and Fs. Results The interaction among sex, age, and BMI had no statistically significant effect on the dependent variable. Both Fi and Fs were significantly influenced by age. Fs was significantly influenced by sex. Conclusion The IDEAL-IQ sequence can be used to quantitatively assess the SIJ fat content in healthy volunteers.

Chinese medicine emergency knowledge includes tacit knowledge and explicit knowledge,of which tacit knowledge is an important part of traditional Chinese medicine emergency. Explicitness of tacit knowledge is an important measure for effective transmission,sharing and exchange of TCM. This paper explores the realization methods of explicit inheritance of tacit knowledge from the perspectives of reading theoretical writings,conducting academic interviews,using data mining,establishing learning organization and diligent in clinical practice,and so on,in order to better transmission of traditional Chinese medicine emergency tacit knowledge and promote the de-velopment of traditional Chinese medicine emergency science.

Tacit knowledge is the core of knowledge,and traditional Chinese medicine (TCM) tacit knowledge is an important part of TCM science.Externalization of tacit knowledge in TCM is a necessary condition for effective exchange and sharing of TCM knowledge,and important guarantee to promote the development and innovation of TCM.However,the process of externalizing tacit knowledge is affected by many factors.Data mining technology can extract unknown,potential,useful information and knowledge hidden in a large number of incomplete,fuzzy,random practical application data.By taking advantages of data mining technology in extracting implicit knowledge,this study focused on externalization of tacit knowledge in TCM with support of association rules analysis,complex system entropy clustering analysis,decision tree analysis,factor analysis,bayesian network analysis and other data mining technologies.Through literature analysis and collation,with specific data mining technology as classification criteria and main line,the study involved individual physicians,ancient medical classics and modern clinical researches,with content involving TCM pathogenesis,the rule of treatment,dialectical law,regularity of using prescriptions,regularity of herbal pairs and composition and other aspects of tacit TCM knowledge.The results showed that,according to the characteristics of the research content,specific data mining technology can be selected to externalize tacit TCM knowledge,which is beneficial to expand the channels of externalizing tacit knowledge of TCM,and improve the externalization of tacit TCM knowledge and maximize externalization and sharing of tacit knowledge in TCM.Based on the active role of data mining technology in the externalization of tacit knowledge of TCM,the data mining and inheritance platforms with TCM characteristics shall be popularized,integrated and optimized to promote the inheritance and innovation of TCM.

TCM tacit knowledge is an important part of TCM emergency medicine.In this paper,through the analysis of the necessity and influencing factors of tacit knowledge in TCM emergencies,this paper puts forward the corresponding implementation strategies to improve the degree of TCM tacit knowledge,maximize the transmission of tacit knowledge of TCM and promote TCM development and innovation of emergency.

目的 观察通腑清胰汤治疗重症急性胰腺炎的临床疗效.方法 72例患者按随机数字表法随机分为对照组与治疗组各36例.对照组予常规治疗,治疗组在对照组基础上加用通腑清胰汤治疗,7d后比较两组白细胞计数(WBC)、血淀粉酶(AMY)、胃肠功能评分情况及体温恢复正常时间、首次排大便时间、腹痛缓解时间、不良反应、临床疗效.结果 治疗后两组WBC、AMY及胃肠功能评分较治疗前均有改善(P＜ 0.05或P＜0.01),且治疗组改善程度优于对照组(P＜0.05).治疗组体温恢复正常时间、首次排大便时间、腹痛缓解时间明显短于对照组(P＜ 0.05或P＜0.01).治疗组总有效率91.67％,优于对照组的77.78％(P＜ 0.05).两组在治疗过程中均未出现不良反应.结论 通腑清胰汤能够改善重症急性胰腺炎胃肠功能,缩短病程,提高临床疗效.