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Objective To investigate the correlations of plasma homocysteine(Hcy)levels with cerebral white matter lesion(WML)severity and cognitive impairment in elderly hypertension patients.Methods A retrospective case-control study was conducted.Ninty-eight elderly patients with hypertension were enrolled.Based on the presence or absence of hyperhomocysteinemia(hypertension with plasma Hcy levels ≥10μmol/L was defined as H-type hypertension),patients were divided into two groups:a control group(n =48) and an H-type hypertension group(n =50).The degree of WML was rated by the Fazekas scale using magnetic resonance imaging(MRI)analysis.Neuropsychological examinations including mini-mental state examination(MMSE)and Montreal cognitive assessment (MoCA)were taken to assess cognitive function.The degree of WML and cognitive impairment were compared between the two groups.Correlations of plasma Hcy levels with the degree of WML and cognitive impairment were analyzed.Results Compared with the control group,scores of the Fazekas scale(3.2 ± 1.0 vs.2.5 ± 1.0,P ＜0.05) and deep white matter hyperintensity on MRI(1.7 ± 0.8 vs.1.3±0.7,P＜0.05)increased,and scores of MMSE(24.9±3.3 vs.27.7±1.8,P＜0.05)and MoCA(18.6±3.9 vs.25.0±3.0,P＜0.05)decreased in the H-type hypertension group.Plasma Hcy levels were positively correlated with the degree of WML (r =0.430,P ＜ 0.01) and negatively correlated with cognitive function(r=-0.406 in MMSE and-0.663 in MoCA,P＜0.01).Multivariate logistic regression showed that Hcy,fasting blood-glucose,deep WML,low-density lipoprotein cholesterolin,age and systolic pressure were influencing factors for cognitive impairment (P ＜ 0.01).Conclusions WML and cognitive function are worse in elderly H-type hypertension patients than in hypertension patients with normal Hcy levels.WML and cognitive impairment are aggravated with increased plasma Hcy levels.The plasma Hcy level may be an effective clinical indicator of cognitive function in elderly people with hypertension.
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The content of endogenous anabolic steroids is extremely low in biological matrices.Its chemical structure contains polar functional groups such as hydroxyl and carbonyl, which limits their applicability in GC-MS.The lack of ionized groups in the chemical structure leads to poor sensitivity in LC-MS, which plays a significant role in various physiological activities analysis.It is an effective way to enhance the response of mass spectrometer by modifying the chemical structure of endogenous anabolic steroids through derivatization technology.This review summarizes various derivatization reagents and corresponding derivatization processes of endogenous anabolic steroids analysis in the methods based on different testing instruments and methodologies.The advantage and disadvantage of all kinds of derivatiaztion methods and the prospect of the endogenous anabolic steroids derivatiaztion techniques are also discussed.
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Objective To discuss the value of digital tomosynthesis for detection of pulmonary nodules. Methods Thirty patients suspected of having pulmonary nodules underwent chest radiography, digital tomosynthesis and CT examination. Above image data were transferred to postprocessing work station and were reviewed by 2 radiologists with 3 years of chest-radiology diagnosis experience in a double-blind method. The number, location and size of nodules were recorded. Then, 2 radiologists reviewed the all images once more, and discuss in consensus. The sensitivities of chest radiography and digital tomosynthesis for detection of pulmonary nodules were respectively calculated according to the CT results. Chi-square test was used for radiography, digital tomosynthesis and CT examination. Results Of 30 patients, 21 were detected having pulmonary nodules by X-ray radiography and 9 were negative, the total number of 40 nodules was detected, while 89 nodules in 26 patients were detected by digital tomosynthesis, and only 4 patients were negative. CT demonstrated 102 nodules in 27 patients, and 3 patients were negative. Taking CT as "gold standard", the sensitivities of X-ray radiography and digital tomosynthesis were 27.4%(28/102)and 87.2%(89/102), X~2=4.35, P<0.05, respectively. Conclusion Digital tomosynthesis has a high sensitivity for detection of pulmonary nodules compared with X-ray radiography, and could be an excellent and necessary supplementary technique of X-ray radiography.
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Objective To evaluate the feasibility and value of dual-energy perfusion imaging (DEPI) of dual-source CT(DSCT) in the diagnosis of acute experimental pulmonary embolism. Methods Acute pulmonary embolism ( PE ) model was made in 8 New Zealand rabbits, and non-enhanced and enhanced DSCT scans were performed before and after embelization. Postprocessing of image data was made on the workstation, and CT pulmonary angiography ( CTPA ), DEal and fusion images were obtained. The location and number of the emboli were recorded. The rabbits were killed immediately after DSCT scan, the location and number of the lung lobes with pulmonary emboli were evaluated pathologically. Based on the pathological results, the sensitivity, specificity, positive predictive value ( PPV), and negative predictive value (NPV) of CTA, DEal and fusion images for the diagnosis of PE were calculated. Weighted Kappa values were calculated to evaluate the consistency between CTPA and DEal. Results PE model was made successfully in 7 rabbits. Six rabbits with 30 lobes were evaluated with one exception because of the catheter affecting the quality of lung peffusian image. PE was found pathologically in 18 lobar arteries. On DEPI, the region with PE showed low peffusion area comparing with the normal parenchyma and CTPA showed the filling defect within corresponding pulmonary artery or interruption of the artery. The sensitivity, specificity, PPVand NPV of CTPA were 66. 7% (12/18), 100.0% (12/12), 100.0% (12/12) and 66. 7% (12/18), respectively. The Kappa value was 0. 651 indicating moderate correlation with pathology. The sensitivity, specificity, aPv, and NPV of DEal were 88. 9% ( 16/18), 91.7% ( 11/12, 94. 1% (16/17) and 84. 6% ( 11/13 ), respectively. The Kappa value was 0. 795 indicating excellent correlation with pathology. Conclusion Dual-energy lung perfusion imaging of DSCT can display the blood distribution of rabbit's lung and has a high sensitivity for the diagnosis of acute pulmonary embolism.