2015年 · 第49卷第02期

subintimal angioplasty (SIA) is a minimally invasive technique mainly used for the recanalization of lower extremity artery occlusion. The basic principle is to use a guidewire and catheter to enter the subintimal dissection at or above the occlusion segment of the blood vessel, and walk to the distal end of the occlusion segment to return to the true lumen^[1]。 The main reason for SIA treatment failure is the inability to return to the true cavity^[2]。 Outback catheter is a kind of device that assists the return to the real cavity. The author systematically evaluated the effectiveness, safety and influence of Outback catheter-assisted subintimoplasty in the treatment of lower extremity arteriosclerosis obliterans by searching relevant literatures.

A 21-year-old male was seen on December 8, 2013 with the main complaint of "dry cough for more than half a month, nausea and fatigue for 1 week". The patient was diagnosed with acute myeloid leukemia M in September 2011₂Type, who was still undergoing chemotherapy at the time of consultation. Half a month ago, there was no obvious trigger for dry cough, nausea and limb weakness, which could be relieved after rest. No headache, dizziness, fever, expectoration, diarrhea, abdominal pain and other symptoms. Physical examination on admission: the right pupil was about 3.5 mm in diameter and sensitive to light reflection; The left pupil is approximately 4.0 mm in diameter and is obtuse to light reflection; The abduction of both eyes was insufficient, obvious on the left side, and bilateral fundus examination showed bilateral papilla edema. The teeth were not deviated, the tongue was extended in the center, the muscle strength of both upper limbs was grade V, the muscle strength of both lower limbs was grade IV, the bilateral knee tendon reflex was positive, and the bilateral Babinsky sign was not drawn out. Biochemical examination: white blood cell count 5.6×10⁹/L, hemoglobin 132.0 g/L, total platelet count 220×10⁹/L.

The patient was a 48-year-old male. In May 2013, he was admitted to the hospital with "intracranial mass occupation for half a year and intermittent headache for 1 week". The patient was found to occupy intracranial space during local MRI examination six months ago, but no treatment was performed. Physical examination: Conscious, muscle strength of limbs grade V, muscle tone normal, pathological reflex not drawn out.

Female, 45 years old, was seen on March 21, 2012 due to chest tightness for more than 5 years, aggravated for 1 week. Physical examination showed no abnormalities. The tumor marker sugar chain antigen-125 (CA125) was 53 U/ml, (normal<35 U/ml). Cardiac ultrasound showed a 5.6 cm ×4.7 cm hyperechoic mass in the right atrium and a large amount of pericardial effusion. The echo in the mass was uneven, and multiple small dark areas were visible, attached to the lateral wall of the right atrium, with little activity. After admission, the patient underwent pericardial puncture and drainage. Cardiac MRI enhanced scan showed that the right atrial cavity was enlarged, and an abnormal signal mass with a size of about 6.7 cm ×7.7 cm ×3.7 cm was seen in the cavity. The edge was irregular and slightly lobulated, and the internal signal was uneven.₁WI showed isomyocardial signals (Figure 1), T₂WI showed a significantly uneven high signal (Figure 2), and see a small amount of pericardial effusion; The film sequence showed no obvious signs of obstruction in the right ventricular inflow tract (tricuspid valve orifice); The boundary between the tumor and the lateral wall of the right atrium is unclear, and it locally breaks through the right atrial wall and grows into the pericardium; After enhancement, there was a significant heterogeneous enhancement (Figure 3）。

The patient was a 51-year-old female. In 2006, he underwent radical mastectomy for left breast cancer in an external hospital due to left breast mass, and the pathological result was intraductal carcinoma. The patient was given paclitaxel and cisplatin combined chemotherapy for 5 cycles after operation, and the patient had no discomfort after regular review. One year ago, the patient developed a tumor of 2.0 cm ×3.0 cm ×2.5 cm on the chest, which was tough and hard, with mild tenderness. In the past 3 months, the tumor continued to increase to 20.0 cm ×25.0 cm ×30.0 cm, and the tumor surface ruptured and bleeded. The patient had intermittent fever and chest pain. Physical examination: The surface of the tumor is ulcerated, and one of the blood vessels continues to bleed a lot (Figure 1）。

The patient was a 26-year-old female. Menopause 30⁺³Zhou, due to high blood glucose for 12 d and vaginal bleeding for 6 h, was seen on January 6, 2013. The patient underwent embryo transfer in an external hospital on 24 June 2012. Laboratory test: alpha-fetoprotein (AFP) 111 μ g/L (normal value<7 μ g/L), carcinoembryonic antigen (CEA) 1.36 μ g/L (normal<3.40 μ g/L), CA125 33 kU/L (normal<35 k U/L), CA199 1 k U/L (normal<27 k U/L); Human chorionic gonadotropin (HCG) 32 IU/L (normal<5 IU/L).

Since the 1990s, the development of fMRI technology has caused revolutionary changes in neuroscience research, which has greatly enriched people's understanding of the brain. However, at present, fMRI data analysis generally takes hours or even days, which brings problems such as quality control difficulties and lagging adjustment. In this context, real-time fMRI (rtfMRI) came into being. 1995 Cox et al.^[1]The construction of rtfMRI system is proposed for the first time. In recent ten years, the neurofeedback technology based on rtfMRI has gradually attracted the attention of researchers in the fields of neuroscience and clinical medicine. In February 2012, the first rtfMRI conference was held at ETH Zurich, Switzerland. The research progress and existing problems of rtfMRI neurofeedback were reviewed^[2]。 The author mainly introduces the rtfMRI neural feedback system, its paradigm and its research progress in neuroscience and clinical medicine.

apolipoprotein E (APOE) has the function of binding lipids and proteins, plays a key role in lipid metabolism and maintaining cholesterol balance, and also participates in the normal development and growth process of nervous system and repair after damage. The APOE gene is located on human chromosome 19 and has 3 major allelic subtypes (ε 2, ε 3, ε 4). Among them, ε 4 has arginine residues, which makes its conformation unstable, affects the function of APOE, and may have toxic effects on the nervous system. At present, the ApoE ε 4 allele has been confirmed to be the most significant risk gene for sporadic and delayed-onset Alzheimer's disease (AD), and ApoE ε 4 allele carriers account for 65% to 80% of AD patients^[1,2]。 Therefore, in the study of AD, there is an increasing number of studies on the ApoE ε 4 allele^[3]。 The rapid development of MRI technology provides new perspectives and means for non-invasive research on the changes of brain structure, function and blood flow. Studying the changes of brain structure, function and blood flow of APOE ε 4 allele carriers will help to elucidate the relationship between APOE ε 4 allele and AD, understand the pathophysiological mechanism of the disease, find out its sensitive and specific bioimaging markers, and provide important auxiliary means for early intervention and treatment of AD.

On October 16th, 2014, the first meeting of the 10th editorial board of Chinese Journal of Radiology was held in Beijing International Convention Center. The meeting was chaired by Gao Hong, director of the editorial department of Chinese Journal of Radiology. Professor Liu Yuqing, academician of Chinese Academy of Engineering, Professor Dai Jianping, vice president of Chinese Medical Association, Professor Luo Ling, deputy secretary-general of Chinese Medical Association, and Jiang Yongmao, president of Chinese Medical Association Magazine, attended the meeting and made important speeches. Professor Guo Qiyong, editor-in-chief of the 9th editorial board of Chinese Journal of Radiology, summarized the work of the 9th editorial board, Professor Feng Xiaoyuan, editor-in-chief of the 10th editorial board, put forward the work assumptions and plans of the 10th editorial board, and Director Gao Hong of the editorial department made a work report on the review requirements of Chinese Journal of Radiology. The meeting also commended outstanding editorial board members, reviewers and authors.