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Objective:To investigate the association of body weight and body mass index (BMI) with bone mineral density (BMD) and osteoporotic risk in elderly men with type 2 diabetes mellitus (T2DM).Methods:210 elderly male patients with T2DM admitted to the Department of Endocrinology of the First Hospital of Changsha from June 2017 to May 2018 were selected as the research objects. The height, weight and bone mass index (BMI) were measured. BMDs of the left hip [including femoral neck (FN), greater trochanter (G.T.), intertrochanter (InTro), and total hip (TH)] and lumbar spine (LS) were measured in 210 elderly male patients with T2DM by dual-energy X-ray absorption method. Patients were divided into three groups according to BMI: the overweight group (24.0 kg/m 2≤BMI<28.0 kg/m 2), the obesity (BMI≥28.0 kg/m 2) group, and the normal group (18.5 kg/m 2≤BMI<24.0 kg/m 2). The influence of body weight and BMI on BMD and osteoporotic risk in these elderly men with T2DM was analyzed. Results:The BMDs in various sites of the hip of the overweight group and obesity group were higher compared with those in the normal weight group ( P<0.05). There was a positive correlation between weight and BMI with BMDs in various sites of the hip femoral neck (including FN, G. T., InTro, and TH) ( r=0.239-0.427, P<0.05). All patients were divided into different tertiles (T1-T3) stratified by weight and BMI respectively. The BMDs in various sites of the hip increased with tertiles stratified by weight ( P<0.05). The TH-BMD also increased with tertiles stratified by BMI ( P<0.05). The odd ratios ( OR) were calculated using T3 as the control group and T1 as the case group, using T2 as the control group and T1 as the case group, respectively. The osteoporotic risks of T1/T3, T1/T2 at FN stratified by weight were significantly increased by 4.50 times ( OR=4.50, 95% CI: 1.41-14.35) and 9.27 times ( OR=9.27, 95% CI: 2.03-42.30); The osteoporotic risks of T1/T3, T1/T2 at TH were significantly increased by 3.25 times ( OR=3.25, 95% CI: 1.10-9.59) and 8.50 times ( OR=8.50, 95% CI: 1.85-38.99). The osteoporotic risks of T1/T3, T1/T2 at FN stratified by BMI respectively were significantly increased by 4.13 times ( OR=4.13, 95% CI: 1.28-13.25) and 5.58 times ( OR=5.58, 95% CI: 1.53-20.42); while the osteoporotic risks of T1/T3, T1/T2 at TH stratified by BMI were not significantly increased ( P>0.05). There was no statistically significant difference in BMDs and the osteoporotic risks of the LS among T1, T2, and T3, regardless of stratified by weight or BMI ( P>0.05). Conclusions:For elderly males with T2DM, weight and BMI are important factors affecting BMDs in the hip, and also affecting the osteoporotic risks of the hip, especially that of FN. Osteoporotic risks of the FN decrease with the increase of weight and BMI within a certain range.
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Objective To improve the recognition and knowledge of autosomal dominant polycystic kidney disease (ADPKD) related male infertility through investigation for MRI characteristics of this disease. Methods Fourteen patients confirmed with ADPKD related obstructive azoospermia were retrospectively analyzed. All patients referred to clinic with male infertility, and obstructive azoospermia were additionally confirmed by laboratory tests and clinical examination. Subsequent abdominopelvic MR examinations were performed to comfirm obstructive factors and obstructive location. All patients were performed an abdominopelvic MR examination including non-enhanced and enhanced MR. MR imaging characteristics were analyzed and summarized by two experienced radiologists. Results MRI results for all cases were classified into 4 groups:10 cases with bilateral polycystic kidneys and bilateral seminal vesicle cysts, 2 cases with bilateral polycystic kidneys, polycystic liver and bilateral seminal vesicle cysts, 1 case with bilateral polycystic kidneys, polycystic liver and absence of bilateral seminal vesicles, 1 case with bilateral cystic kidneys, bilateral seminal vesicle cysts as well as Müllerian duct cyst. A wide range of coronal T2WI scan was necessary to observe cystic lesions in both liver and bilateral kidneys as well as abnormal changes in pelvis. The obstructive sites in all cases were located in level from ejaculatory duct to seminal vesicle. Bilateral seminal vesicle cysts presented as significantly dilated glandular ducts of seminal vesicles, in which flocculence or nodular sediment can be found. Conclusion Male infertility caused by ADPKD-related deferential duct obstrution is characterized by bilateral polycystic kidney disease and Seminal vesicle ejaculatory duct obstruction in MRI, which can be combined with other abnormalities.
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Objective To observe imaging features of uterus duplication combined with mesonephric duct dysplasia related abnormalities.Methods Imaging data of 17 female with uterus duplication and renal dysplasia were retrospectively analyzed.Seven patients underwent CT and 10 patients underwent MR scanning.Results The basic abnormalities in 17 patients were uterus duplication combined with unilateral renal-ureter dysplasia with/without other associated malformation which were further classified as follows:①7 patients presented as basic abnormalities without other associated malformations,include 5 (CT diagnosed 1,MR diagnosed 4) with uterus duplex and unilateral renal-ureter agenesis,2 (CT 1,MR 1) with uterus bifidus and unilateral renal-ureter dysplasia;②2 patients (CT 1,MR 1) presented as basic abnormalities accompanied with ectopic ureter orifice,uterus duplex and unilateral renal dysplasia with ectopic ureter orifice opening in vagina;③5 patients (CT 3,MR 2) of Herlyn-Werner-Wunderlich syndrome presented as uterus duplication,oblique vagina septum as well as unilateral renal-ureter dysplasia,which shown as uterus duplex,oblique vaginal septum with hematocolpos,also unilateral renal-ureter agenesis;④2 patients presented as basic abnormalities accompanied with mesonephric residual cyst,CT showed one with uterus duplex and unilateral renal-ureter agenesis with ipsilateral mesonephric residual cyst,MRI showed as the other one with Herlyn-Werner-Wunderlich syndrome combined with mesonephric residual cyst opening in vagina;⑤MRI showed 1 patient with basic abnormalities and a nephrogenic adenoma,which demonstrated as uterus duplex combined with left renal-ureter agenesis,and a tumor on the left wall of bladder accompanied with endometriosis.Conclusion Further classification into 5 types from simple to complex based on uterus duplication combined with unilateral renal-ureter dysplasia with/without other associated malformations is helpful to the diagnosis and treatment of these abnormalities.
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Objective To explore prenatal MRI findings of fetal midline dural sinus malformation(DSM).Methods Eleven fetuses of midline DSM were collected.Abnormalities in the fetal occipital or cerebellar area were found from 21 to 27 weeks of gestation.Then MR scanning in the following week was performed.Of all 11 fetuses,9 were pathologically proved to be midline DSM,and the other 2 were followed up and proved after birth.The imaging findings and pathological features were analyzed.Results MRI of 11 fetuses showed cystic dilation of the occipital cranium of torcular herophili area,with the size of 10 mm× 15 mm to 35 mm× 55 mm,and the adjacent sinuses were also dilated.On axial or coronal images,the lesions were cuneiform,while on sagittal images,the lesions were spindle-or crescent-shaped.The lesions displayed isointensity or slightly hyperintensity on T1WI,while slightly hypointensity,isointensity or slightly hyperintensity on T2WI.In 9 of the 11 fetuses,class round or bar thrombosis on the side wall of the cystic mass were observed,which were hyperintensity on T1WI and isointensity and hypointensity,isointensity or hyperintensity on T2WI.Hemosiderin deposition was observed around the thrombi in 6 fetuses.Lesion diameters in 2 fetuses were more than 30 mm,and the adjacent brain tissue was significantly dislocated.Nine fetuses of postmortem pathology after induced labor showed deformed and dilated venous sinuses,in which eccentric thrombi were seen in 7 fetuses with side branches around them.Normal brain development was observed in 2 live birth newborns.Conclusion Prenatal MRI can accurately diagnose fetal midline dural sinus malformation,and estimate the development of fetal brain,which may be helpful to prognosis prediction.
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Objective To investigate the imaging characteristics of female Skene-gland (periurethral glands) disease. Methods A retrospective analysis of preoperative imaging findings was performed in 15 female patients with surgical-pathological proven Skene gland disease. MRI scans were performed in 8 cases, CT scans were performed in 5 cases, both CT and MRI were performed in 2 cases. Imaging characteristics were observed and summarized.Results There were 3 types of diseases,including:(1) Skene gland cyst (n=3), located in the distal and posterolateral urethra or close to the proximity of urethra, presenting as cystic lesions with teardrop shape on sagittal images, which appeared as hypo-attenuation on non-enhanced CT, and hypo-intensity on T1WI, hyper-intensity on T2WI, and without enhancement. One case complicated with infection presented as hyper-intensity on T1WI and gaseous intensity inside,with thickened cystic wall and enhancement.(2)Urethral diverticulum communicating with Skene gland (n=10), located in the middle or distal and posterolateral urethra, presented as a horseshoe shaped cystic lesion partially surrounding the urethral(n=3)or spoke wheel-like cystic lesion with multiple septum completely surrounding the urethra (n=7). They appeared as fluid attenuation on unenhanced CT, and hypo-intensity on T1WI, hyper-intensity on T2WI and without enhancement. Heterogenous signal or attenuation and enhanced septum or cystic wall were found in 6 cases complicated with infection. (3) Malignant tumor (n=2, one adenocarcinoma and one neuroendocrine carcinoma), presented as cystic-solid mass surrounding the urethral, showing heterogenous low attenuation on nonenhanced CT and iso-to hyper-intensity on T2WI and hypo-to iso-intensity on T1WI with significant enhancement.Conclusions Female Skene-gland disease has specific occurrence location and imaging characteristics.
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Objective To review the influence of 131I therapy on bone mineral density (BMD) in patients with hyperthyroidism.Methods Published articles of prospective randomized controlled study,clinical controlled study or case-control study on BMD change in patients with hyperthyroidism after 131I therapy were selected from PubMed,the Excerpta Media Database (Embase),Cochrane library,Chinese Journal Full-text Database,Wanfang Database,Vip Database and Chinese Biomedical Literature Database.Data from the date of database establishment to October 2015 were all reviewed.The languages were restricted to English and Chinese.Meta-analysis was performed with RevMan 5.3.Results Thirteen trials with a total of 668 hyperthyroidism patients were included.The meta-analysis showed that BMD of the lumbar spine,hip joint,femoral neck and osteocalcin were significantly improved after 131I therapy.The weighted mean difference (WMD) for BMD of the lumbar spine was 0.07 (95％ CI:0.04-0.11),P=0.O00 2;that of the hip joint and the femoral neck was 0.13(95％ CI:0.09-0.16) and 0.05(95％ CI:0.03-0.06),respectively(both P＜0.01).The standardized mean difference (SMD) of osteocalcin was-1.20(95％ CI:-1.43--0.97) with P＜0.01.Furthermore,the improvements were time dependent within the 2 years' follow-up.Conclusions 131I therapy improves the BMD and osteocalcin in patients with hyperthyroidism in a time dependent manner within 2 years' follow-up.
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Objective To explore imaging findings and pathological features of ovarian collision tumors. Methods A retrospective analysis of preoperative imaging findings was performed in 8 female patients with surgical-pathological proven ovarian collision tumors. CT scans were performed in 5 cases, both CT and MRI were performed in 2 cases, and non-enhanced MR scans were performed in 1 pregnancy woman. Imaging results were compared with pathologic findings. Results Ovarian collision tumors in the eight patients consisted of 2 types tumors, originated from different ovarian tissues including surface epithelial cells, germ cell, or sex cord-stromal cell. Of the 8 ovarian collision tumors, 5 were located in the left ovary, and 3 in the right ovary. Ovarian collision tumors consisted of surface epithelial tumor and germ cell tumor (n=6) including mucinous cystadenoma and teratoma (n=4), mixed cystadenoma and teratoma (n=1), and serous cystadenoma and struma-ovarii (n=1). Ovarian collision tumors in two cases consisted of surface epithelial tumor and sex cord-stromal tumor, and were mucinous cystadenoma and fibroma, respectively. Imaging findings included:all tumors in the 8 cases presented big or huge multiple complicated cystic mass with 9 to 26 cm in diameter. Germ cell tumor or sex cord-stromal tumor in collision tumor was smaller and located inside the tumor (n=3) and on the tumor wall (n=5). The boundary between two types of tumors in ovarian collision tumor was distinct and clear. Typical imaging features and densities (signals) of different tumors in ovarian collision tumors can be found on CT or MRI. Conclusions Ovarian collision tumors has some specific imaging and pathological characteristics. Imaging examination is helpful for most accurate diagnosis of ovarian collision tumors.
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<p><b>OBJECTIVE</b>To review the advances of studies on vitamin D receptor and its role in the pathogenesis of diabetic nephropathy.</p><p><b>DATA SOURCES</b>A comprehensive search of the PubMed literatures without restriction on the publication date was carried out using keywords such as vitamin D receptor and diabetic nephropathy.</p><p><b>STUDY SELECTION</b>Articles related to vitamin D receptor and diabetic nephropathy were selected and carefully analyzed.</p><p><b>RESULTS</b>The ligands as well as construction and tissue distribution of vitamin D receptor were summarized. Pathogenesis of diabetic nephropathy was analyzed. The mechanisms underlying the renoprotective role of vitamin D receptor including inhibition of renin-angiotensin system, anti-inflammation, anti-fibrosis and the reduction of proteinuria were reviewed. Mounting evidences from animal and clinical studies have suggested that vitamin D therapy has beneficial effects on the renal systems and the underlying renoprotective mechanisms of the vitamin D receptor-mediated signaling pathways is a hot research topic.</p><p><b>CONCLUSION</b>Our study suggests that vitamin D receptor has a great potential for preventing the progression of diabetic nephropathy via multiple mechanisms.</p>
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Animals , Humans , Diabetic Nephropathies , Metabolism , Proteinuria , Metabolism , Receptors, Calcitriol , Metabolism , Renin-Angiotensin System , PhysiologyABSTRACT
Objective:To observe the effect of blood glucose lfuctuation and the sustained high blood glucose on renal pathological change and collagen IV (Col IV) expression in diabetic rats. Methods:hTe 60 male Sprague-Dawley (SD) rats were randomly assigned into a normal control group (NC) and a model group (DM). hTe rats in the normal control group were fed with normal diet, while the rats in the model group were fed with high-sucrose-high-fat diet for 6 weeks. Atfer that,streptozocin (STZ, 30 mg/kg) was injected to induce diabetic model. The model group was then randomly divided into 2 subgroups:a sustained high blood glucose group and a fluctuation blood glucose group (animals in the latter group were subcutaneously injected with insulin twice daily). Rats were sacriifced atfer 3 months and kidney tissues were dissected for HE and PAS staining, Col IV immunohistochemistry and Western blot. Results:Compared with the normal control group, the renal glomeruli and capillary basal membrane in the diabetic rats was getting larger and thicker, respectively;the capsular space and ground substance was extended and increased, respectively;the volume of renal tubule, kidney hypertrophy index, glomeruler sclerosis index and Col IV content were all increased in the diabetic rats (P Conclusion:The capillary basal membrane of kidney in diabetic rats is thicker and the ground substance is increased. The degree of glomeruler sclerosis is more serious in the blood glucose lfuctuation group compared with the sustained high blood glucose group, which is conifrmed by the increased level of Col IV.
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Objective To explore the MRI features of ejaculatory duct obstruction.Methods During January 2003 to Dccember 2010,transrectal ultrasonography (TRUS) was performed for 106 patients and underwent surgical treatment for ejaculatory duct obstruction.Among them,16 patients underwent MRI examination.The MRI features of ejaculatory duct obstruction in these patients were summarized.Results Ejaculatory duct cysts,ranging in size from 4 mm ×4 mm ×7 mm to 4 mm ×4 mm ×9 mm and locating in the paramedian line,were detected in 5 of the 16 patients; ejaculatory duct dilation located in the paramedian line was detected in 7 patients,with the internal diameter of 5 to 30 mm. After contrast injection,significant enhancement of the wall of the ejaculatory duct was observed in 2 patients.Mullerian duct cysts complicated with dilated ejaculatory duct and seminal vesicles were detected in 4 patients,in whom the cysts were located in the median line,ranging in size from 4 mm × 5 mm × 6 mm to 34 mm×35 mm ×44 mm,with inverted teardrop shaped pointing toward the seminal colliculus.ConclusionThe most common MRI features of ejaculatory duct obstruction are ejaculatory duct dilation and ejaculatory duct cysts.