Correlation analysis of bone mineral density, hemoglobin and serum albumin in healthy population / 中华健康管理学杂志

Objective:To use quantitative computed tomography (QCT) technology to measure the bone mineral density of the spine of the Chinese healthy population, and to explore its correlation with hemoglobin and serum albumin.Methods:The data in this study came from the China Health Quantitative CT Big Data Project (China Biobank). The spine bone density was measured by using QCT Pro Image Analysis System and all cooperating centers used the European spine phantom (NO.145) for quality control. Total of 50 053 healthy persons who met the criteria for entry were selected as the research subjects. The subjects were divided into 7 groups according to age. The general data, spine bone density, serum albumin, hemoglobin of the subjects were collected. The single-factor analysis of variance, Pearson correlation analysis and multi-classification logistic regression model were applied to analyze the correlation between bone density and hemoglobin and serum albumin.Results:The bone mineral density of healthy people decreased with age ( P<0.05), and there were significant differences in hemoglobin, serum albumin and body mass index (BMI) among different age groups (all P<0.05). Linear correlation analysis showed that there were positive correlation between bone mineral density and hemoglobin in healthy males in different age groups ( r=0.086, 0.101, 0.076, 0.090, 0.072, 0.123, 0.100, all P<0.01). There were negative correlation between bone mineral density and hemoglobin in certain age groups in women (40-49 years group: r=-0.027; 70-79 yearsgroup: r=-0.077; both P<0.05). And corelation were found between bone mineral density and serum levels of albumin in certain age groups of healthy subjects (among men, 30-39 years group: r=-0.048; 40-49 years group, r=-0.027; 70-79 years group, r=-0.051; among women, 30-39 years group: r=-0.044; 40-49 years group, r=-0.042; 50-59 years group, r=-0.086; 70-79 years group, r=-0.070; all P<0.05). After adjusting for age and BMI, the multi-category logistic regression analysis showed that the hemoglobin level was protective factor of normal bone density ( OR=1.022, 95% CI:1.017-1.027) and decreased bone density ( OR=1.012, 95% CI:1.007-1.016) in healthy males, and the serum albumin was risk factor for normal bone density ( OR=0.926, 95% CI:0.905-0.948) and decreased bone density ( OR=1.006, 95% CI:0.951-1.011) in healthy women. Conclusion:There is a correlation between bone mineral density and hemoglobin and serum albumin in Chinese healthy population. Hemoglobin is a protective factor for bone mineral density in men, and serum albumin is a risk factor for bone mineral densityin women.

Reference value of lumbar spine bone mineral density and regional differences based on quantitative CT examination in healthy adult female in China / 中华健康管理学杂志

Objective:To establish the normal reference value of lumbar bone mineral density (BMD) under quantitative CT (QCT) in Chinese healthy adult females and to explore the regional differences.Methods:Total of 35 431 healthy women who met the inclusion criteria of Chinese health quantitative CT big data program were selected in this study. The BMD of the central plane of L 1 and L 2 vertebrae was measured by Mindways′s QCT system, and the mean value was taken. One-way analysis of variance was used to compare the BMD differences of lumbar vertebrae in women of different ages and regions. The subjects were grouped by an age interval of 10 years, and the level of BMD in different regions of the same age group were compaired. Results:The peak BMD of Chinese healthy adult women appeared in the age group of 20-29 years (Northeast China(183.01±24.58) mg/cm 3, North China (188.93±24.80) mg/cm 3, East China (187.54±27.71) mg/cm 3, South China (186.22±33.72) mg/cm 3, Central China (176.33±24.91) mg/cm 3, Southwest China(182.25±28.00) mg/cm 3), and then it decreased with age. The level of BMD in different regions decreased with the age. Before the age of 70 years, BMD in Central and Southwest China was always at a low level((176.23±24.91) to (90.38±28.12) mg/cm 3, 182.25±28.00 to (88.55±25.68) mg/cm 3), lower than those in Northeast China ((183.01±24.58) to (99.69±27.85) mg/cm 3), North China ((188.93±24.80) to (95.89±26.12) mg/cm 3), East China ((187.54±27.71) to (95.65±27.86) mg/cm 3). After 70 years of age, BMD tended to be the same in different regions ( P>0.05). The BMD values in Central China and Southwest China were similar in the age group of 40-60 years ( P>0.05). The BMD values in the health adult femles in the age group of 60 years in different regions of Chinawere all lower than those of bone mass abnormality (all P<0.05). The detection rate of osteoporosis in females over 50 years was the highest in Southwest China (25.65%) and it was the lowest in North China (17.30%). Conclusions:This study establishes reference values of BMD under QCT in healthy Chinese women, which can be used as a reference basis for identifying women with low BMD who are at risk of osteoporosis. The BMD value is the lowest in Southwest China and the highest in South China.

Normal reference and regional variation of spinal bone mineral density under the quantitative CT in Chinese male population / 中华健康管理学杂志

Objective:To investigate the normal reference values of spinal bone mineral density measured by quantitative computed tomography (QCT) and the differences of bone mineral density (BMD) in different regions of in Chinese adult males.Methods:Men who underwent low-dose CT lung scan for cancer screening in regions of Northeast, North, East, South, Central and Southwest of China from January 2018 to December 2019 were selected. And the lumbar vertebrae BMD values in the male subjects were measured by the QCT system (Mindways Software, Inc.). The mean BMD values and their decline rates were calculated at an age interval of 10 years, and the prevalence of osteoporosis was calculated according to the American College of Radiology spine QCT osteoporosis diagnostic criteria.Results:A total of 50 682 males with a mean age of (50.22±12.79) years (ranged 20 to 98 years) were included in this study. The peak BMD of (173.11±28.56) mg/cm 3 in the healthy Chinese adult male population appeared in the age group of 20 to 29 years and then declined with age. Before the age of 70 years, the BMD was relatively higher in males in South China, and it was lower in Central China and Southwest China, and it was intermediate in Northeast, North and East of China, with statistically significant differences. There was no significant differences in BMD in the males in the two age groups of 70 to 79 years and 80 and older among the regions in China. The overall decline rate of spinal BMD in Chinese males under QCT was about 46.92% over the lifetime, and it declined obviouslyin the 40-49 age group. The overall prevalence of osteoporosis in Chinese male population aged 50 years and above was approximately 11.42%, with the highest prevalence in Southwest China and Central China (14.72% and 13.87%, respectively) and the lowest in North China and South China (8.53% and 7.71%, respectively). Conclusions:A reference of lumbar spine BMD values for healthy males in China based on QCT is established. BMD values were highest in South China and Lowest in Central China.

Baseline characteristics of the Chinese health quantitative CT big data program in 2018—2019 / 中华健康管理学杂志

Objective:To describe the baseline characteristics of the subjects enrolled in the China Quantitative CT (QCT) big data program in 2018—2019.Methods:Based on baseline data from the Chinese health big data project from January 2018 to December 2019 from the eligible enrolled population, measurements of bone mineral density (BMD) and visceral adipose tissue (VAT) were performed using Mindways′ QCT Pro Model 4 system. The baseline data of age, gender, regional distribution, height, weight, abdominal circumference, blood pressure, blood routine and blood biochemical tests were analyzed. And the single factor analysis of variance (ANOVA) was used to check the age related trend of BMD and VAT in both genders.Results:After screening the inclusion exclusion criteria and outliers of the main indicators, 86 113 people were enrolled in the project. The enrollment rate was 92.47%, including 35 431 (41.1%) women and 50 682 (58.9%) men, and the ratio of men to women was 1.43. The mean age was (50.3±12.7) years in all the subjects, and it was (50.2±12.8) years and (50.4±12.5) years in men and women, respectively, and there was no statistical difference between the two genders ( P>0.05). Total of 43 833 people were enrolled in east China, it was the largest group by region (50.90%), it was followed by central China (16 434 people, 19.08%), and the number of people enrolled in Northeast China was the lowest (2 914 people, 3.38%). The rate of completing of health information indicators related to the main outcome of the study were all above 70%, and there were significant differences between men and women (all P<0.05). The mean BMD was (139.33±46.76) mg/cm 3 in women, (135.90±36.48) mg/cm 3 in men, which showed a decreasing trend with age in both gender (both P<0.001); the mean intra-abdominal fat area was (116.39±56.23) cm 2 in women, (191.67±77.07) cm 2 in men, and there was an increasing trend with age in both men and women (both P<0.001). Conclusions:There are gender differences in BMD and VAT measured by QCT with different age tendency, and there are gender differences in health information index. Regional factors should also be taken into account for regional differences in the inclusion of data.

Quantitative computed tomography-derived abdominal visceral adipose tissue and cardiometabolic risk in a large-scale population / 中华健康管理学杂志

Objective:To investigate the relationship between abdominal visceral adipose tissue (VAT) and cardiometabolic risk (CMR) through quantitative computed tomography (QCT).Methods:The present study included 76226 participants. Abdominal fat areas were measured using the QCT Pro Model 4 system. Cardiometabolic indices were collected, including systolic and diastolic blood pressures, fasting plasma glucose, total cholesterol, triglyceride, and low-density and high-density lipoprotein cholesterols CMR score was the sum of abnormal blood pressure, fasting glucose, triglyceride, and high-density lipoprotein cholesterol. Restricted cubic spline and ordered logistic regression models were applied.Results:The mean age was 50±13 years and the percentage of men was 58.8%. The level of VAT area was higher in men than in women (191.7±77.1 cm 2 vs 116.4±56.2 cm 2, P<0.0001 for all). After adjustment for age, the cardiometabolic indices except high-density lipoprotein cholesterol increased with increasing VAT area. When VAT area was 300 cm 2, age-adjusted odds ratios and 95% confidence intervals of a CMR score ≥ 1 were 14.61 (13.31, 16.04) for men and 5.46 (4.06, 7.36) for women, and the age-adjusted probability of a CMR score ≥ 3 was 31.7% for men and 31.3% for women. Conclusions:QCT-derived VAT is closely related to CMR. The findings suggest that measurement of visceral fat is recommended for the management of abdominal obesity in subjects who agree to undergo lung cancer screening via low-dose CT without additional radiation exposure.

Progress in computer-assisted Alberta stroke program early computer tomography score of acute ischemic stroke based on different modal images / 生物医学工程学杂志

Clinically, non-contrastive computed tomography (NCCT) is used to quickly diagnose the type and area of ​​stroke, and the Alberta stroke program early computer tomography score (ASPECTS) is used to guide the next treatment. However, in the early stage of acute ischemic stroke (AIS), it's difficult to distinguish the mild cerebral infarction on NCCT with the naked eye, and there is no obvious boundary between brain regions, which makes clinical ASPECTS difficult to conduct. The method based on machine learning and deep learning can help physicians quickly and accurately identify cerebral infarction areas, segment brain areas, and operate ASPECTS quantitative scoring, which is of great significance for improving the inconsistency in clinical ASPECTS. This article describes current challenges in the field of AIS ASPECTS, and then summarizes the application of computer-aided technology in ASPECTS from two aspects including machine learning and deep learning. Finally, this article summarizes and prospects the research direction of AIS-assisted assessment, and proposes that the computer-aided system based on multi-modal images is of great value to improve the comprehensiveness and accuracy of AIS assessment, which has the potential to open up a new research field for AIS-assisted assessment.

Analysis of epidemic characteristics and spatial clustering of pulmonary tuberculosis in Wuhan , 2011-2018 / 公共卫生与预防医学

Objective To explore the epidemic characteristics and spatial clustering of pulmonary tuberculosis in Wuhan from 2011 to 2019, and to provide a scientific basis for formulating intervention strategies and measures. Methods Descriptive statistical analysis was conducted on the epidemic characteristics of tuberculosis data in Wuhan registered in the national tuberculosis information management system in the last 9 years, and spatial autocorrelation analysis was performed on the incidence of tuberculosis in 155 communities or in the city using Arcgis10.5 software. Results From 2011 to 2019, there were 56,432 cases of tuberculosis reported in Wuhan, and the annual average reported incidence rate of tuberculosis was 59.24/100 000. The overall incidence rate showed a fluctuating downward trend, with an average annual decline rate of 1.99%. The ratio of the number of cases between men and women was 2.35:1, and the incidence rate in males was higher than that in females (χ2=285.36，P0,P<0.001), and the high-high aggregation areas of tuberculosis were mainly distributed in Erqi community, Baibuting community, Liujiaoting community, Yijiadun community, Heping Street, Changqian Street, Tonghu farm, Yuxian Town, Zhifang Town, Wulijie Town, Fenghuang Street, Liji Street, and Daoguanhe Street. Conclusion The overall epidemic situation of pulmonary tuberculosis in Wuhan showed a slow downward trend. The main population and the clustering time of cases were relatively fixed, and the overall epidemic showed a certain spatial clustering. Active screening should be carried out for high-risk populations and high-aggregation areas, and effective prevention and control strategies should be developed based on time and location classification.

Correction to: EGFR signaling augments TLR4 cell surface expression and function in macrophages via regulation of Rab5a activation

In the original publication the bands in Fig. 1J and Fig. 2B were not visible. The correct versions of Fig. 1J and Fig. 2B are provided in this correction.

Correction to: EGFR signaling augments TLR4 cell surface expression and function in macrophages via regulation of Rab5a activation

In the original publication the bands in Fig. 1J and Fig. 2B were not visible. The correct versions of Fig. 1J and Fig. 2B are provided in this correction.

Delay on care-seeking and related influencing factors among tuberculosis patients in Wuhan, 2008-2017 / 中华流行病学杂志

Objective@#To analyze the epidemiological characteristics, trend and related factors of tuberculosis patients that delayed for care, in Wuhan from 2008 to 2017.@*Methods@#Data regarding tuberculosis (TB) patients was collected from the tuberculosis management information system (TMIS), a part of the China information system for disease control and prevention from 2008 to 2017. A total of 64 208 tuberculosis patients, aged 0 to 95 years were included for the analysis. Unconditional logistic regression method was used to estimate those factors that associated with this study.@*Results@#Days of delay among TB patients appeared as M=10 (P25-P75: 3-28) day, in Wuhan, 2008-2017. The prevalence of the delay was 52.5% (33 703/64 208), presenting a downward trend from 2008 to 2017 (trend χ2=10.64, P<0.001), but the proportions of women and ≥65 year-olds were gradually increasing. Results from the multivariate logistic regression analysis showed that factors as: patients living far away from the city vs. near the city (OR=1.29, 95%CI: 1.25-1.35), and age above 45 years vs. younger than 25 years (the age 45-64 years group vs. aged less than 25 years group, OR=1.22, 95%CI: 1.15-1.29; the age 65 or above group vs. aged less than 25 years group, the OR=1.30, 95%CI: 1.22-1.39) were under higher risk on the delay of seeking care. Occupation, way of case-finding and classification of tuberculosis patients also appeared as influencing factors on this issue.@*Conclusions@#Prevalence on the delay of care was 52.5% among tuberculosis patients in Wuhan, 2008-2017, but with an annual decrease. Attention should be paid to female, wrinkly or elderly tuberculosis patients regarding the delay of care on TB, in Wuhan.

Research Development of MR Diffusion Tensor Imaging and Track Density Imaging in Central Nervous System / 中国医疗器械杂志

Diffusion tensor imaging (DTI) is being used more and more widely in the diagnosis of central nervous system. Based on DTI, track density imaging (TDI) is an emerging technique applied to clinical use. This article introduced the principle and clinical application, analyzed pros and cons, and made conclusion and prospect of these two techniques.

Prevalence of Decreased Myocardial Blood Flow in Symptomatic Patients with Patent Coronary Stents: Insights from Low-Dose Dynamic CT Myocardial Perfusion Imaging

OBJECTIVE: To study the prevalence and clinical characteristics of decreased myocardial blood flow (MBF) quantified by dynamic computed tomography (CT) myocardial perfusion imaging (MPI) in symptomatic patients without in-stent restenosis. MATERIALS AND METHODS: Thirty-seven (mean age, 71.3 ± 10 years; age range, 48–88 years; 31 males, 6 females) consecutive symptomatic patients with patent coronary stents and without obstructive de novo lesions were prospectively enrolled to undergo dynamic CT-MPI using a third-generation dual-source CT scanner. The shuttle-mode acquisition technique was used to image the complete left ventricle. A bolus of contrast media (50 mL; iopromide, 370 mg iodine/mL) was injected into the antecubital vein at a rate of 6 mL/s, followed by a 40-mL saline flush. The mean MBF value and other quantitative parameters were measured for each segment of both stented-vessel territories and reference territories. The MBFratio was defined as the ratio of the mean MBF value of the whole stent-vessel territory to that of the whole reference territory. An MBFratio of 0.85 was used as the cut-off value to distinguish hypoperfused from non-hypoperfused segments. RESULTS: A total of 629 segments of 37 patients were ultimately included for analysis. The mean effective dose of dynamic CT-MPI was 3.1 ± 1.2 mSv (range, 1.7–6.3 mSv). The mean MBF of stent-vessel territories was decreased in 19 lesions and 81 segments. Compared to stent-vessel territories without hypoperfusion, the mean MBF and myocardial blood volume were markedly lower in hypoperfused stent-vessel territories (77.5 ± 16.6 mL/100 mL/min vs. 140.4 ± 24.1 mL/100 mL/min [p < 0.001] and 6.4 ± 3.7 mL/100 mL vs. 11.5 ± 4 mL/100 mL [p < 0.001, respectively]). Myocardial hypoperfusion in stent-vessel territories was present in 48.6% (18/37) of patients. None of clinical parameters differed statistically significantly between hypoperfusion and non-hypoperfusion subgroups. CONCLUSION: Decreased MBF is commonly present in patients who are symptomatic after percutaneous coronary intervention, despite patent stents and can be detected by dynamic CT-MPI using a low radiation dose.

Clinical study of traditional Chinese medicine anti-inflammatory mixture for the microcirculation disturbance in patients with sepsis targetting at vascular endothelium / 国际中医中药杂志

Objective To observe the clinical effect of traditional Chinese medicine inflammatory mixture on vascular endothelial cell injury, mcrocirculation disorder and organ dysfunction in sepsis. Methods 73 patients with sepsis were randomly divided into two groups: Anti-inflammatory mixture-treated group (40 cases) and control group (33 cases). Routine medicine therapy was given in both groups.Additionally, in the Anti-inflammatory mixture-treated group, 100 ml Anti-inflammatory mixture was given By oral or nasal feeding, every 12 hours for consecutive 7 days. Vascular endothelial injury index (Soluble thrombomodulin,Vascular endothelial growth factor-2, endothelial specific molecule-1), mcrocirculation disorder index (arterial blood lactate, central venous oxygen saturation, total vessel density, perfused vessel density, proportion of perfused vessels, microcirculatory flow index) of two group patients before and after therapy were observed and the sequential organ failure score (SOFA) was recorded before and after treatment. Results After treatment, the indexes of vascular endothelial injury sTM (12.37 ± 5.08 μg/L vs. 18.77 ± 6.88 μg/L, t=3.448), VEGF-2 [45.6 ng/L (14.3, 112.5) vs. 52.4 ng/L (17.2, 123.6), Z=4.009], ESM-1 (15.54 ± 4.09 ng/ml vs. 17.64 ± 6.79 ng/ml, t=-1.551), Lac (2.6 ± 1.2 mmol/L vs. 3.7 ± 1.8 mmol/L, t=4.115) and SOFA (4.1 ± 1.7 vs. 6.1 ± 3.2, t=-2.118) in anti-inflammatory mixture group decreased significantly than those in the control group. but the ScvO2(0.719 ± 0.243 vs. 0.603 ± 0.201, t=-2.773), PVD (14.8 ± 5.8 mm/mm2 vs. 13.1±5.1 mm/mm2, t=-5.114), PPV (59.1% ± 22.5% vs. 53.9% ± 20.6%, t=1.779), MFI (9.4 ± 4.6 vs. 7.2 ± 2.2, t=4.339) in the anti-inflammatory mixture group were significantly higher than those in the control group. Correlation analysis showed that the sTM and PPV were significantly negatively correlated (r=-0.875, P＜0.01), ESM-1 was significantly negatively correlated with PVD, PPV and MFI (r=-0.877, P＜0.01; r=-0.799, P＜0.01; r=-0.821, P＜0.01) and ESM-1 and SOFA were significantly positively correlated (r=0.840, P＜0.01). Conclusions Anti-inflammatory mixture of Chinese medicine has a certain therapeutic effect on sepsis by protecting vascular endothelial cell function.

Natural History of Untreated Coronary Total Occlusions Revealed with Follow-Up Semi-Automated Quantitative Coronary CT Angiography: The Morphological Characteristics of Initial CT Predict Occlusion Shortening

OBJECTIVE: To investigate the morphological changes of coronary chronic total occlusion (CTO) as determined by coronary computed tomography angiography (CCTA) follow-up using semi-automated quantitative analysis. MATERIALS AND METHODS: Thirty patients with 31 CTO lesions confirmed by invasive coronary angiography and baseline/follow-up CCTA were retrospectively included. CTOs were quantitatively analyzed by a semi-automated coronary plaque analysis software (Coronary Plaque Analysis, version 2.0, Siemens) after manually determining the lesion border. Recanalized lumen was defined as the linear-like enhanced opacity traversing the non-opacified occluded segment. Other parameters, such as total occlusion length, total occlusion volume, volume with low attenuation component (< 30 Hounsfield unit [HU]), volume with middle to high attenuation component (30–190 HU) as well as the calcification volume, were also recorded. RESULTS: Recanalized lumen was found within 48.4% (15/31) occlusions on the follow-up CCTA, compared to 45.2% (14/31) occlusions on the baseline CCTA. Eleven of 14 lesions (78.6%) with CT-visible recanalized lumen within CTOs had a shorter occlusion length on follow-up compared to only 3 of 17 lesions (17.6%) without CT-visible recanalized lumen (odds ratio, 17.1, p < 0.001). The percentage of low attenuation component of occlusions was smaller on follow-up CCTA compared to baseline value (18.1 ± 20.1% vs. 22.6 ± 19.6%, p = 0.033). CONCLUSION: Coronary computed tomography angiography enables non-invasive characterization of natural progression of untreated CTO lesions. Recanalized lumen within CTOs observed at baseline CCTA was associated with shortening of occlusion length on follow-up. Compared to their earlier stage, occlusions of later stage were presented with higher density of non-calcified components.

The combination of ultrasound patterns and superb microvascular imaging of ATA(2015) guidelines in the differentiation of benign and malignant thyroid nodules / 中华内分泌代谢杂志

The study included 197 thyroid nodules which were confirmed by fine-needle aspiration cytology or histopathologic examination. All nodules were graded with malignancy risk stratification of thyroids nodule accordingto the 2015 American Thyroid Association(ATA)management guidelines. Both color Doppler flow imaging (CDFI) and superb microvascular imaging(SMI) were used to classify blood flows of thyroid nodules according to Adler's grading criteria. Morphologic and distribution features of blood flow were also observed by monochrome (mSMI). The optimal threshold drawing from ROC curve and diagnostic efficacy of single and combinative modality were calculated. The results showed that mSMI was more sensitive to detect blood flow of thyroid nodules than other Doppler techniques(P<0.01). Microvascular morphologic features between benign and malignant thyroid nodules were significantly different(P<0.01). The area under ROC curves of ATA,mSMI,and ATA+mSMI were 0.745, 0.740,and 0.834,respectively,suggesting that the diagnostic performance of ATA+mSMI is superior to that of ATA or mSMI alone. There was no significant deference in the sensitivity among ATA, mSMI, and ATA+mSMI (P>0.05). But the specficity and accuracy of combinative modality ATA+mSMI was significantly higher than that of ATA or mSMI alone(P<0.05).

Percentage of attenuation drop of intra-mural coronary segment at diastolic phase coronary CTA in prediction of significant systolic compression of myocardial bridge / 中国医学影像技术

Objective To explore the diagnostic value of the percentage of attenuation drop measured by diastolic phase coronary CTA (CCTA) in identifying significant dynamic compression of myocardial bridge (MB).Methods Totally 135 patients with MB confirmed by CCTA were enrolled.The CT value of MB segment and proximal MB segment was measureed respectively.Attenuation of mural coronary artery(％) =(CT value of proximal MB segment-CT value of MB segment)/CT value of MB segment × 100 ％.Systolic compression ≥50 ％ was considered significant.The percentage of attenuation drop of MB vessel,length and depth of MB were measured and correlated with the presence and degree of dynamic compression.Results Attenuation drop of mural coronary artery(％),length of MB in MB patients with significant systolic compression,slight systolic compression and without systolic compression had significant statistical differences (all P＜0.05).ROC curve showed the percentage of attenuation had the best accuracy of 73.3％ in diagnosis of MB with significant systolic compression with the cutoff value of 15％ and the area under the curve (AUC) of 0.75 (95％ CI [0.67,0.82],P＜0.01).Conclusion Attenuation drop of MB segment has relationship with the extent of dynamic compression of MB and it has value to identify significant dynamic compression of MB.

A magnetic resonance spectroscopy study in the anterior cingulate cortex ofperimenopausal women with depression / 实用放射学杂志

Objective To investigate the changes of gamma-aminobutyric acid (GABA) in the anterior cingulate cortex of perimenopausal women with depression.Methods Forty perimenopausal women as the experimental group and ten healthy women as the control group were recruited and followed up for 18 to 24 months.The proton magnetic resonance spectroscopy (1H-MRS) was used to acquire the concentrations of GABA in the anterior cingulate cortex.The experimental group was examined before and after menopause.The control group was examined before into the group and after out of the group.The experimental group after menopause was further divided into the anxiety group and the depression group according to the Classification and Diagnostic Criteria of Mental Disorders in China-Third Edition (CCMD-3), 14-item Hamilton Anxiety Scale (HAMA-14) and 17-item Hamilton Depression Scale (HAMD-17).The data of three groups were compared respectively.Results The results showed that the concentrations of GABA after menopause in both of the anxiety group and depression group were significantly lower (P<0.05) than those before menopause, and were also significantly lower (P<0.05) than those in the control group.The concentrations of GABA after menopause in the depression group were significantly lower(P<0.05) than those in the anxiety group.Conclusion The changes of GABA in the anterior cingulate cortex are related with the pathophysiology mechanism of perimenopausal depression and the symptoms of perimenopausal depression.

Clinical study of therapeutic effect of Xuebijing injection on the treatment of vascular endothelial cell injury,microcirculation disorder and organ diysfunction in patients with sepsis / 中国综合临床

Objective To observe the clinical therapeutic effect of Xuebijing injection on vascular endothelial cell ( VEC) injury,microcirculation disorder and organ dysfunction in patients with sepsis. Methods Seventy?three patients with sepsis were randomly divided into two groups:Xuebijing injection?treated group (40 cases) and control group (33 cases). Routine medicine therapy was applied in both groups. Additionally, the Xuebijing injection?treated group was treated with Xuebijing injection 100 ml and saline 100 ml by intravenous drip every 12 hours for consecutive 5 days. Vascular endothelial injury index, including soluble thrombomodulin( sTM) ,vascular endothelial growth factor 2 ( VEGF?2) ,endothelial specific molecule 1 ( ESM?1),microcirculation index of arterial blood lactic acid (Lac),central venous oxygen saturation (ScvO2),total microvessel density (TVD),the perfusion vascular density (PVD),proportion of perfused vessels (PPV) and microvessel flow index ( MFI) of the two groups before and after therapy were observed and the sequential organ failure score ( SOFA) was recorded before and after treatment. Results Senventy?three patients with sepsis had different degrees of increase in vascular endothelial damage markers,lactate and sequential organ failure scores in arterial blood, while the central venous blood oxygen saturation ( ScvO2 ) , the total vascular density of the sublingual microvasculature ( TVD) ,perfused vessel density ( PVD) ,proportion of perfused vessels ( PPV) and microcirculatory flow index ( MFI) decreased before treatment. After 5?day treatment,the above indicators of all patients were improved,the indexes in the Xuebijing injection group decreased significantly,compared with the control group ,sTM ( (16. 91±4. 55) μg/L,(19. 51±4. 09) μg/L,t=-6. 021,P<0. 05),VEGF?2 (50. 8 (17. 8,127. 7) ng/L vs. 74. 9(22. 7,155. 1) ng/L,t=4. 227,P<0. 05),ESM?1 ( (10. 20 ±2. 43) μg/L vs. (14. 80±3. 52) μg/L,t=-4. 113,P<0. 05),Lac( (2. 1±0. 7) mmol/L vs. (3. 7±1. 1) mmol/L,t=2. 366,P<0. 05) and SOFA ( (5. 9±2. 1) vs. (8. 7±2. 6),t=-7. 990,P<0. 05). ScvO2( (0. 771±0. 153) % vs. (0. 641±0. 113) %,t=5. 061,P<0. 05),PVD ( (16. 8±6. 1) mm/mm2 vs. (12. 1±5. 1) mm/mm2,t=4. 002, P<0. 05),PPV ( (66. 2±21. 3) % vs. (50. 4±19. 3) %,t=-2. 550,P<0. 05) and MFI (6. 2 ±2. 4) vs. (3. 8 ±2. 2),t=-5. 001,P<0. 05) were significantly higher than those in the control group in the same period. sTM and PPV had a significant negative correlation (r=-0. 755,P=0. 000),PVD,PPV,ESM?1 and MFI were negatively correlated (r=-0. 665,P=0. 000; r=-0. 600,P=0. 000; r=-0. 469,P=0. 000),PPV,MFI and SOFA were negatively correlated ( r=-0. 798,P=0. 000;r=-0. 995,P=0. 000);sTM,ESM?1 and SOFA were significantly positively correlated ( r = 0. 883, P = 0. 000;r = 0. 881, P = 0. 000 ) . Conclusion Vascular endothelial cell dysfunction probably plays an important role in the pathophysiology of sepsis and Xuebijing injection has therapeutic effect on sepsis by protecting vascular endothelial cell function.

Advances in the research of mechanism in prevention and treatment of scar with botulinum toxin type A and its clinical application / 中华烧伤杂志

Scar is a common complication in wound healing process, and how to effectively prevent and treat it is a hot and difficult problem in burns and plastic surgery field. Botulinum toxin type A is a neurotoxin that has been widely and effectively used in the cosmetic surgery field such as anti-wrinkle and thin face. In recent years, botulinum toxin type A has been applied in prevention and treatment of scar, which causes a great concern. Nowadays, the relevant reports have gradually increased, and the mechanisms have been explored more deeply. This article aims to summarize the possible mechanisms and clinical reports on the prevention and treatment of scar by botulinum toxin type A to provide a new way for the prevention and treatment of scar after surgery.

Calcification Remodeling Index Characterized by Cardiac CT as a Novel Parameter to Predict the Use of Rotational Atherectomy for Coronary Intervention of Lesions with Moderate to Severe Calcification

OBJECTIVE: To assess the feasibility of calcification characterization by coronary computed tomography angiography (CCTA) to predict the use of rotational atherectomy (RA) for coronary intervention of lesions with moderate to severe calcification. MATERIALS AND METHODS: Patients with calcified lesions treated by percutaneous coronary intervention (PCI) who underwent both CCTA and invasive coronary angiography were retrospectively included in this study. Calcification remodeling index was calculated as the ratio of the smallest vessel cross-sectional area of the lesion to the proximal reference luminal area. Other parameters such as calcium volume, regional Agatston score, calcification length, and involved calcium arc quadrant were also recorded. RESULTS: A total of 223 patients with 241 calcified lesions were finally included. Lesions with RA tended to have larger calcium volume, higher regional Agatston score, more involved calcium arc quadrants, and significantly smaller calcification remodeling index than lesions without RA. Receiver operating characteristic curve analysis revealed that the best cutoff value of calcification remodeling index was 0.84 (area under curve = 0.847, p < 0.001). Calcification remodeling index ≤ 0.84 was the strongest independent predictor (odds ratio: 251.47, p < 0.001) for using RA. CONCLUSION: Calcification remodeling index was significantly correlated with the incidence of using RA to aid PCI. Calcification remodeling index ≤ 0.84 was the strongest independent predictor for using RA prior to stent implantation.