Correlating nerve conduction studies with cross-sectional area measured using ultrasound in patients with neuromuscular disease / 中华神经科杂志

Objective:To determine whether there is a correlation between the cross-sectional area (CSA) and the parameters as measured on nerve conduction studies.Methods:Twenty-one patients with neuromuscular diseases in Beijing Tiantan Hospital from March 3, 2022 to May 4, 2023 underwent ultrasound measurement of the CSA of the median nerves and ulnar nerves at the wrist, elbow and the upper arm, followed by nerve conduction studies (NCS). A linear regression model was performed to compare NCS and CSA.Results:A total of 180 sets of motor nerve conduction velocity (MCV) and CSA at the different sites including 102 sets of median nerve and 78 sets of ulnar nerve, 220 sets of compound muscle action potential (CMAP) amplitude and CSA at the different sites including 104 sets of median nerve and 116 sets of ulnar nerve, 60 sets of sensory nerve conduction velocity (SCV) and CSA and sensory nerve action potential (SNAP) amplitude and CSA at the wrist including 32 sets of median nerve and 28 sets of ulnar nerve were recorded. The linear correlation between MCV and CSA was statistically significant both in median nerve ( r2=0.10,adjusted r2=0.09, P=0.001) and in ulnar nerve ( r2=0.18,adjusted r2=0.17, P<0.001).When CSA>10 mm 2, the linear correlation between CMAP amplitude and CSA was statistically significant both in median nerve ( r2=0.09,adjusted r2=0.08, P=0.024) and ulnar nerve ( r2=0.19,adjusted r2=0.17, P=0.004). The correlation between CMAP and CSA was not statistically significant when CSA≤10 mm 2. And the correlations between SCV and CSA and between SNAP and CSA were not statistically significant. Conclusions:CSA can better show the characteristics of changes in motor nerve conduction especially in motor conduction velocity. It is suggested that its application prospect in demyelinating peripheral neuropathy with motor nerve damage may be more extensive.

Effects of early standardized enteral nutrition on preventing acute muscle loss in the acute exacerbation of chronic obstructive pulmonary disease patients with mechanical ventilation / 世界急诊医学杂志（英文）

@#BACKGROUND: To investigate the effects of early standardized enteral nutrition (EN) on the cross-sectional area of erector spine muscle (ESMcsa), plasma growth differentiation factor-15 (GDF-15), and 28-day mortality of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients with invasive mechanical ventilation (MV). METHODS: A total of 97 AECOPD patients with invasive MV were screened in the ICUs of the First People's Hospital of Lianyungang. The conventional EN group (stage I) and early standardized EN group (stage II) included 46 and 51 patients, respectively. ESMcsa loss and GDF-15 levels on days 1 and 7 of ICU admission and 28-day survival rates were analyzed. RESULTS: On day 7, the ESMcsa of the early standardized EN group was significantly higher than that of the conventional EN group, while the plasma GDF-15 levels were significantly lower than those in the conventional EN group (ESMcsa: 28.426±6.130 cm2 vs. 25.205±6.127 cm2; GDF-15: 1661.608±558.820 pg/mL vs. 2541.000±634.845 pg/mL; all P<0.001]. The 28-day survival rates of the patients in the early standardized EN group and conventional EN group were 80.40% and 73.90%, respectively (P=0.406). CONCLUSION: ESMcsa loss in AECOPD patients with MV was correlated with GDF-15 levels, both of which indicated acute muscular atrophy and skeletal muscle dysfunction. Early standardized EN may prevent acute muscle loss and intensive care unit-acquired weakness (ICU-AW) in AECOPD patients.

Is pre-oxygenation with high-flow nasal oxygen safe? randomized control trial of 56 cases of elderly patients during induction of general anesthesia with endotracheal intubation / 南方医科大学学报

OBJECTIVE@#To evaluate the safety of preoxygenation with high-flow nasal oxygenation in elderly patients during induction of general anesthesia with endotracheal intubation.@*METHODS@#Fifty-six elderly patients without difficult airway were randomized equally into high-flow nasal oxygen group (HF group) and conventional mask oxygen group (M group). Preoxygenation was performed for 5 min before induction of general anesthesia and endotracheal intubation. Oxygenation was maintained during laryngoscopy in HF group, and ventilation lasted until laryngoscopy in M group. For all the patients, the general data, cross-sectional area (CSA) of the gastric antrum measured by ultrasonography, arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2) and arterial oxygen saturation (cSO2) were recorded before preoxygenation (T1), at 5 min of preoxygenation (T2) and immediately after intubation (T3). The safety time of asphyxia, intubation time, times of mask ventilation and postoperative complications were compared between the two groups.@*RESULTS@#The general data were comparable between the two groups. After 5 min of preoxygenation, PaO2 and cSO2 were significantly increased in both groups, and PaO2 was significantly higher in HF group than in M group (F=118.108 vs 9.511, P < 0.05). Both PaO2 and cSO2 decreased after intubation, but PaO2 decreased more slowly in HF group and still remained higher than that at T1; cSO2 decreased significantly in M group to a lower level than that at T1. Compared with those in M group, the patients in HF group showed a significantly longer safety time of asphyxia (t=5.305, P < 0.05) with fewer times of mask ventilation (χ2= 6.720, P < 0.05). PaCO2 increased after intubation in both groups but was comparable between the two groups (F=3.138, P > 0.05).@*CONCLUSION@#High-flow nasal oxygen is safe, simple and effective for pre-oxygenation, which, as compared with the conventional oxygen mask, improves arterial oxygen partial pressure and prolongs the safety time of asphyxia to ensure the safety of airway management during induction of general anesthesia in elderly patients with endotracheal intubation.

Cone-beam computed tomography study of upper airway morphology in children with obstructive sleep apnea-hypopnea syndrome / 口腔疾病防治

Objective @#To evaluate the morphology of the upper airway of children with obstructive sleep apnea-hypopnea syndrome (OSAHS) using cone-beam computed tomography (CBCT) combined with polysomnography (PSG) and provide references for clinical practice.@*Methods@# CBCT data of 45 OSAHS children and 45 normal children and PSG data of the OSAHS group were retrospectively collected. Three-dimensional reconstructions were performed using NNT 9.0 software. The total upper airway volume, nasopharyngeal volume, palatopharyngeal volume, glossopharyngeal volume, laryngopharyngeal volume, minimum cross-sectional area, anterior-posterior diameter of the minimum cross-section, and lateral diameter of the minimum cross-section were measured and recorded. According to PSG monitoring results, patients with an obstructive apnea hypopnea index (OAHI) and lowest oxygen saturation (LSaO2) were assessed. Body mass index (BMI) was recorded. The correlation between airway volume parameters, BMI and PSG test results was analyzed. @*Results@#The total upper airway volume, nasopharyngeal volume, palatopharyngeal volume, glossopharyngeal volume, laryngopharyngeal volume, minimum cross-sectional area, anterior-posterior diameter of the minimum cross-section, and lateral diameter of the minimum cross-section of the OSAHS group were significantly reduced compared with those of the control group (P<0.05). In the OSAHS group, the total upper airway volume, the minimum cross-sectional area and the lateral diameter of the minimum cross-section showed moderate negative correlations with the obstructive apnea hypopnea index (OAHI) (P<0.05). Moreover, the total upper airway volume, minimum cross-sectional area, anterior-posterior diameter of the minimum cross-section and lateral diameter of the minimum cross-section showed no correlation with the minimum blood oxygen saturation (P>0.05). No significant correlation was noted between BMI and PSG in the OSAHS group (P>0.05).@*Conclusion @#The morphology of the upper airway of children with OSAHS was significantly smaller than that of normal children. CBCT three-dimensional technology for analyzing the upper airway has a certain value in evaluating the morphology and degree of obstruction of the upper airway in children with OSAHS.

A study on the shape change of the rectus femoris muscle with knee flexion / 体力科学

Since the rectus femoris muscle is associated with trauma and disorders such as muscle strain, it is often a target for evaluation and treatment. However, in many studies, measurement results were obtained from only a part of the rectus femoris muscle and used as a representative value without considering the differences across the muscle. The rectus femoris muscle may change shape with knee flexion because the structure is complicated; it has an intramuscular tendon. The purpose of this study was to assess the changes in shape of the rectus femoris muscle during flexion of the knee joint in different directions. Twelve lower limbs of 12 male university students were analyzed. The rectus femoris muscle was divided into eight parts, and short-axis images were taken with an ultrasonic diagnostic imaging device at the knee joint; in extension; flexion at 30 °, 60 °, 90 °, and 120 °; muscle thickness; muscle width; and cross-sectional area. It was suggested that the thickness of the rectus femoris muscle increased from “A” to “F” due to knee flexion, and that this increase occurred because of stretching at the same site. In “G,” there was no difference between the angle conditions; conversely, in “H,” the muscle thickness decreased due to knee flexion. It should also be noted that D and E have the greatest muscle thickness when measuring in the knee flexion position.

Clinical, electrophysiological, and ultrasound evaluation for early detection of musculoskeletal hand disorders and nerve entrapment in mobile phone users

ABSTRACT Introduction: Smartphone overuse may lead to musculoskeletal manifestations, such as carpal tunnel syndrome (CTS) and arthritis of hand joints, with an increased median nerve cross-sectional area (CSA). Objective: The aim of this study is the early detection of musculoskeletal hand disorders using ultrasound techniques, and to detect nerve entrapment using clinical evaluation, ultrasound, and electrophysiological studies, in university employees younger than 35 years using mobile phones. Function is assessed using the Michigan Hand Outcomes Questionnaire (MHQ). Materials and methods: Cross-sectional controlled study included 74 smartphone users classified into two groups according to a smartphone addiction scale (SAS), into high and low smart phone users, with 35 non-smartphone users with matched age and gender as a control group. A clinical assessment of nerve entrapment symptoms was performed, and the Michigan Hand Outcomes Questionnaire (MHQ), with a total score from 0 to100, was used to assess hand function. Electrodiagnostic studies of median and ulnar nerves were used to detect early nerve entrapment. Bilateral ultrasound was performed in order to assess the median nerve CSA and involvement of thumb and small hand joints. The data collected were analyzed using the SPSS program version 20. Results: CSAs of median nerves were significantly higher in the dominant hand of high smartphone users than in low and non-smartphone users (p < 0.001). There was a significant positive correlation between CSA and SAS (r = 0.45), visual analogue scale (VAS) (r = 0.61), and duration of smartphone use (r = 0.80), with negative correlation with MHQ (r = -0.63). Significant differences in were found in the electrophysiological studies of median and ulnar nerves. The mean ultrasound score for both hands was higher in the high smartphone users compared to low smartphone users (15.08 ± 4.17 vs. 6.46 ± 1.38, p < .001). Conclusions: There is increased median nerve CSAs among high smartphone users associated with prolongation of both sensory and motor latencies and slow conduction velocities. Caution should be exercised when using mobile phones, in order to minimize the risk of developing hand musculoskeletal disorders.

Measurement and evaluation of the quadriceps muscle mass in young men based on magnetic resonance imaging / 北京大学学报(医学版)

OBJECTIVE@#To investigate the correlation between the quadriceps cross-sectional area (CSA) and quadriceps muscle volume (QMV) at different horizontal levels from the upper edge of the patella, and to determine the best observation position.@*METHODS@#Thigh magnetic resonance imaging (MRI) images of 22 Chinese young men [age: (29±6) years] with anterior cruciate ligament (ACL) rupture were examined. The CSA was measured at 18, 15, and 12 cm above the upper edge of the pate-lla (denoted by CSA-18, CSA-15 and CSA-12 respectively), and the QMV and CSA were determined by semiautomatic segmentation. A curve model was established to estimate QMV. Bland-Altman analysis was performed to determine the confidence limits of the volumes.@*RESULTS@#On the unaffected side, the mean QMV was (1 944.45±323.77) cm3. The quadriceps CSA at the upper edge of the patella at 18, 15, and 12 cm was (80.80±12.16) cm2, (77.53±12.03) cm2, and (72.68±10.51) cm2, respectively. The coefficients of determination (R2), ascertained using curve estimation models, for the 3 positions were 0.819, 0.755, and 0.684 (P < 0.001), and the standard deviations of the volume estimated value (SEE) were 7.4%, 8.7%, and 9.8%. The fitting equations of the three horizontal positions were all good, but the fitting degree of CSA-18 was the highest. The Bland-Altman scatter plot showed that the arithmetic means of the QMV at 18, 15 and 12 cm from the upper edge of the patella 0.8 cm3, -1.1 cm3, and 0.9 cm3 and 95% limits of agreement (LoA) were (-268.8, 270.5), (-315.2, 313.1), and (-355.7, 357.5), respectively. The estimated QMV was in good agreement with the measured value. The difference between the estimated CSA-18 and measured values was the smallest. The results on the affected side were consistent.@*CONCLUSION@#The correlation between QMV and CSA in the young men with the upper edge of patella as baseline was reliable and consistent. Among them, CSA-18 had the highest correlation with the QMV. However, different observation sites could be selected for different injuries of the quadriceps.

Sex-related differences and cross-sectional age-related changes to the cross-sectional area of the psoas major muscles corrected for fat-free mass / 体力科学

In the present study, we examined the sex-related differences and cross-sectional age-related changes in the cross-sectional area of the psoas major muscle. The cross-sectional area was corrected for fat-free mass (FFM-corrected), which was calculated as the 2/3rd power of the total fat-free mass. A total of 240 adults (114 men, 126 women, age: 20-81 years) were included in the study. The cross-sectional area of the psoas major muscle was measured by 0.2T magnetic resonance imaging (MRI), and the total fat-free mass was measured by air displacement plethysmography. We demonstrated that the FFM-corrected cross-sectional area of the psoas major muscle was greater in males than females across all age groups. Furthermore, we examined the mean FFM-corrected cross-sectional area of the psoas major muscle across different age groups and demonstrated that it decreased with age. Our findings, when combined with previous results, show a peak in the 20s, which declined with age. Our study revealed sex-related differences and cross-sectional age-related changes in the FFM-corrected cross-sectional area of the psoas major muscle. Our findings also suggest that it is important to define reference values and ranges that take into account age- and sex-related differences when assessing the psoas major muscle by FFM-corrected cross-sectional area.

Are cluster sets an effective method to induce muscular hypertrophy in response to resistance training?

ABSTRACT There are a plethora of studies that have analyzed the effects of different resistance training methods on muscle hypertrophy. Recent studies have pointed out some potential advantage of training using cluster sets (CS) compared with traditional sets. It is still unclear whether CS are an effective method. The objective of this review was to investigate and discuss the current knowledge about the effect of CS on muscle hypertrophy. Four studies investigating the effect of CS on muscle hypertrophy were found. These studies demonstrated that CS induced similar or lower muscle hypertrophy than traditional sets. Thus, CS may lead to muscle hypertrophy, but did not provide a superior stimulus when compared to traditional sets of equated load.

RESUMO Um conjunto de estudos que tem analisado o efeito de diferentes métodos de treinamento resistido na hipertrofia muscular. Estudos têm pontuado várias potenciais vantagens do treinamento usando séries em conglomerados (SC) quando comparado com séries tradicionais. Ainda não está claro se as SC é um método efetivo. O objetivo desta revisão foi investigar e discutir o conhecimento recente sobre o efeito das SC na hipertrofia muscular. Quatro estudos investigando o efeito das SC na hipertrofia muscular foram encontrados. Esses estudos demonstraram que as SC induziram similar ou menor hipertrofia muscular do que séries tradicionais. Portanto, as SC podem induzir hipertrofia, porém não fornecem um estímulo superior quando comparado às séries tradicionais com carga equiparada.

RESUMEN Muchos estudios han analizado los efectos de diferentes métodos de entrenamiento de la fuerza en la hipertrofia muscular. Algunos estudios han resaltado las ventajas de introducir períodos de recuperación intra-serie (series cluster, SC) al compararlo con las series tradicionales. No está todavía claro si las SC son un método efectivo. El objetivo de esta revisión fue investigar y discutir el conocimiento actual sobre el efecto de las SC en la hipertrofia muscular. Se encontraron cuatro estudios investigando el efecto de las SC en la hipertrofia. Estos estudios demuestran que las SC inducen igual o menor hipertrofia que las series tradicionales. Así, las SC podrían inducir hipertrofia muscular pero no proporcionan un estímulo superior al compararlas con las series tradicionales.

Effect of laryngeal mask and endotracheal tube ventilation on gastric insufflation during general anesthesia with ultrasound evaluation / 上海交通大学学报（医学版）

Objective • To observe the correlation between streamlined liner of pharynx airway (SLIPA) and gastric insufflation. Methods • Seventy patients who underwent elective general anesthesia in Jiading District Central Hospital Affiliated to Shanghai University of Medicine & Health Sciences from September 2017 to May 2018 were included. They were randomly divided into SLIPA group (S group, n=35) and endotracheal tube group (T group, n=35). The gastric antrum ultrasonography was performed at four time points before induction, immediately after intubation (insertion of laryngeal mask), before extubation (laryngeal mask), and immediately after extubation (laryngeal mask), to measure the cross sectional area (CSA) of gastric insufflation. Gastric intake was assessed by ultrasonic measurement of CSA and "comet tail sign" in ultrasound imaging. Pulse oxygen saturation (SpO2), end-tidal pressure of carbon dioxide (PETCO2), peak inspiratory pressure (PIP) and CSA were recorded and compared at the corresponding time points. Results • There was no significant difference in gastric insufflation rate between the two groups during anesthesia (P=0.894). There was no significant difference in SpO2 at each time point between the two groups (all P>0.05). At the end of surgery, PETCO2 in group S was significantly higher than that in group T (P=0.000). Conclusion • Compared with endotracheal tube, the SLIPA does not increase gastric insufflation during general anesthesia.

Morphometric analysis of retinal arterioles in control and hypertensive population using adaptive optics imaging

Purpose: To measure the wall-to-lumen ratio (WLR) and the vascular wall cross-sectional area (WCSA) of retinal arterioles by an Adaptive Optics (AO) retinal camera using semi-automated software and comparing them between control and hypertensive population. Methods: This was a cross-sectional observational study including a hypertensive group and a control group. Subjects were examined and their medical history recorded. Retinal arteriolar morphometry was assessed by rtx1 AO retinal camera using AOdetect Artery semiautomated software. Main Outcome Measures: WLR and WCSA were measured on the basis of retinal arteriolar wall thickness (W1, W2), lumen diameter (LD) and vessel diameter (VD). Influence of age and arterial hypertension on the WLR and WCSA were examined. Results: A total of 150 human subjects were included out of which 110 were controls and 40 were hypertensives under treatment. There was statistically significant difference in the age, systolic and diastolic blood pressures between the control and hypertensive groups (P < 0.01). We found no significant correlation between age and WLR (R2 = 0.049, P > 0.05) or age and WCSA (R2 = 0.045, P > 0.05). We observed a significant difference in WLR and WCSA measurements between control and hypertensive groups (P < 0.01). On measuring intra-observer variability (IOV) we found excellent consistency. Conclusion: AO retinal imaging allows a direct measurement of the retinal vessel wall and LD with excellent IOV. WLR and WCSA reflect the remodelling process and can be used to further aid the early detection and monitoring of systemic hypertension.

Sexual dimorphism of foramen magnum: a NCCT based study

Background:Radiological determination of gender relies predominantly on the skeletal radiology and assumes importance in mass natural disasters, bomb explosions, exhumations and warfare where skeletal fragmentation is common. Varied literature is present regarding the role of foramen magnum in establishing gender identification.The objective of the study wasto establish normative values of cross-sectional area of foramen magnum in both genders using NCCT and try to ascertain any significant difference in cross-sectional area in the two genders which may help in gender identification.Methods:NCCT head images of 378 subjects were analysed in individuals beyond the age of skeletal immaturity. Free ROI technique using electronic calliper tool was used. The cross-sectional area of foramen magnum was automatically obtained after tracing its whole inner circumference.Results:Mean cross-sectional area of foramen magnum in females was 806.79±106.58 mm2and was 878.33±98.42 mm2in males. Although the cross-sectional area in males was greater than females no statistically significant difference was found. The correlation coefficient was found to be weaker (R=0.0413). Conclusions: No statistically significant difference was found between the two genders. The correlation coefficient was also weak to draw any inference about the gender of the skull on CT imaging. Further studies are needed to include other parameters like the sagittal and transverse diameters of foramen magnum in a larger sample to show importance of foramen magnum, if any, in helping gender identification of skeletal remains

Partial Lateral Bridges And Supratransverse Foramen In Human Atlas Vertebrae: An Osteological Study In Punjab

Background: The lateral outgrowth from the superior articular facet(SAF) to the posterior root of the transverseprocess of the atlas forms the partial lateral bridge(PLB) and when complete forms the supratransverse foramen(STF). Presence of such bridges may predispose to vertebrobasilar insufficiency. Since there are fewer studies onthe lateral bridge therefore the present study was aimed to know the incidence of lateral bridges and STF and alsoto know the dimensions of STF as the knowledge about such dimensions helps in interpretation of radiologicalfindings, provide guidance for neurosurgical intervention.Materials and methods: A total of 80 undamaged, dry human atlas vertebrae were obtained from the Departmentof Anatomy, Government Medical College and SGRDIMSAR, Amritsar, Punjab, India. The Partial lateral bridge(PLB)and Supratransverse Foramen(STF) were identified following the criteria used by Mitchell (1998a, 1998b).Measurements were taken of the maximum dimensions of the STF in (Supero-inferior and Medio-lateral planes)and ipsilateral Foramen Transversarium (FT) in (Ventro-dorsal and Medio-lateral planes). The cross-sectionalarea of STF and ipsilateral FT was calculated.Results: Total 7 (8.75%) lateral bridges in atlas vertebrae occurred. 6 (7.5%) lateral bridges occurred in associationwith the posterior bridges and 1(1.25%) isolated partial lateral bridge occurred on the left side. Partial lateralbridges were found in 2 bones(2.5%) on right side and 4(2.5%)bones on left side. 1 (0.625%) Complete lateralbridges forming STF was observed on right side. Rt. Supra-Transverse Foramen Height (STFH) and Width (STFW)was found to be 5.4mm and 6.2mm. Ipsilateral Foramen Transversarium Length (FTL) and Width (FTW) was foundto be 6.4mm and 5.9mm. The cross-sectional area of Rt. STF was 26.28mm2 and the cross-sectional area ofipsilateral FT was 29.64mm2 and ipsilateral FT area was smaller than STF.Conclusion: The findings in the present study indicate a higher prevalence of lateral bridges on the left side.Difference in the cross sectional area of STF and ipsilateral FT may lead to compression of V.A and this compressionbecomes evidently symptomatic in extreme manipulations of the neck. Patients presenting with vertebrobasilarinsufûciency or cervicogenic syndromes should be evaluated to explore the possibility of the presence of lateralatlas bridges as etiological factor

Study on the characteristics of nerve damage by ultrasound combined with nerve conduction velocity in diabetic peripheral neuropathy / 中国医师进修杂志

Objective To analyze the characteristics of nerve damage in diabetic peripheral neuropathy by ultrasound and neuroelectrophysiological techniques and provide a basis for early diagnosis and treatment of diabetic peripheral neuropathy. Methods From January 2016 to May 2018, 225 patients with type 2 diabetes admitted to the hospital were divided into DPN group (110 cases) and non-diabetic peripheral neuropathy (NDPN) group (115 cases),and 120 healthy volunteers were as controls. Ultrasound and nerve conduction velocity(NCV) were used to analyze the characteristics of nerve damage in diabetic peripheral neuropathy(DPN). Results Among the three study groups, the sensory nerves conduction velocity and motor nerves conduction velocity of the ulnar nerve, median nerve, and common peroneal nerve were significantly reduced in the DPN group. But in the same group,the ulnar nerve, median nerve, and common peroneal nerve cross-sectional area (CSA) was significantly increased [(8.68 ± 1.89) mm2 vs. (6.79 ± 1.69) and (5.82 ± 1.57) mm2, (10.59 ± 1.82) mm2 vs. (7.98 ± 1.97) and (7.25 ± 1.71) mm2, (21.24 ± 2.53 )mm2 vs. (16.54 ± 2.49) and (15.40 ± 2.20) mm2]. In the measurement of sensory nerve conduction velocity, the abnormalities of ulnar nerve, median nerve and common peroneal nerve were significantly higher than thoseof motor nerve [34.54%(38/110) vs. 18.18%(20/110), 36.36% (40/110)vs. 20.90% (23/110), 52.72% (58/110) vs. 20.00% (22/110)]. In ultrasound and SCV, the proportion of ulnar nerve and median nerve injury was higher in patients aged 45 years or older or patients over 10 years of course (P<0.05). The proportion of median nerve injury was higher in patients with larger MAGE (P < 0.05). In the abnormal performance of ultrasound: the proportion of abnormal ulnar nerve, median nerve and common peroneal nerve in patients with large MAGE was significantly higher than that in patients with small MAGE (P<0.05); the results of ultrasound measurement of CSA showed that the ulnar nerve, median nerve and common peroneal nerve thickening were more obvious in patients with MAGE>4 mmol/L. Conclusions DPN affects sensory nerves first, and the proportion of injury is significantly higher than that of motor nerves; lower limb nerves are more susceptible to damage, compared with upper limb nerves; patients aged 45 years or older or patients with course over 10 years have a higher proportion of ulnar nerve and median nerve damage; patients with larger MAGE (>4 mmol/L) have a higher proportion of median nerve damage. The characteristics above can provide an effective basis for the prevention, diagnosis and treatment of DPN.

Clinical assessment of gastric contents before cesarean section: antral cross-sectional area measured using ultrasonography / 中华麻醉学杂志

Objective To assess the gastric contents before cesarean section using antral cross-sectional area (CSA) measured by ultrasonography.Methods One hundred and seventy-seven American Society of Anesthesiologists physical status Ⅰ-Ⅲ patients,aged 20-44 yr,undergoing cesarean section,were enrolled in this study.The antral CSA in the semi-recumbent and right lateral decubitus positions was measured through the ultrasound images of the antrum in the sagittal plane below xiphoid before anesthesia and qualitatively graded.Qualitative grade 0 was considered as the gold standard,and the receiver operating characteristic (ROC) curve of CSA in assessing the preoperative gastric contents was plotted.Results The critical value of ROC curve of CSA in the semi-recumbent position was 6.025 cm2.The critical value of ROC curve of CSA in the right lateral decubitus position was 9.095 cm2.Conclusion CSA ＜ 6.025 cm2 measured by ultrasonography in the semi-recumbent position or CSA＜9.095 cm2 measured by ultrasonography in the right lateral decubitus position can confirm that the gastric emptying state is achieved before cesarean section.

Application of cross‐sectional area measurement under high frequency ultrasound in diagnosis of congenital adrenal hyperplasia in infants / 中华超声影像学杂志

To disscuss the role of cross‐sectional area measurement under high frequency ultrasound in the diagnosis of congenital adrenal hyperplasia ( CA H ) in infants . Methods T he abdominal ultrasound images of 20 infants with CA H w hich were admitted to our hospital and clinical diagnosised from November 2013 to August 2018 were analyzed retrospectively . T he size of adrenal glands were evaluated by measuring the maximum cross‐sectional area .Fifty normal full‐term infants were selected as control group synchronism . T he size of adrenal glands between infants with CA H and normal infants were compared . T he area under the curve ( AUC ) and best cutoff value were obtained by drawing ROC curve .Sensitivity and specificity were also obtained . Results T here was significant difference in maximum cross‐sectional area of adrenal gland between CA H group and control group[ ( 129 .70 ± 37 .34) mm2 vs ( 54 .41 ± 20 .84) mm2 , t ＝10 .004 , P ＝0 .001] . T he AUC of cross‐sectional area measurement was 0 .966 ,and best cutoff value was 87 .5 mm2 . T he sensitivity and specificity were 95 .0% and 92 .5% . Conclusions High‐frequency ultrasound is convenient and accurate in measuring the maximum cross‐sectional area of adrenal gland in infants . Cross‐sectional area measurement has high sensitivity and specificity to the diagnosis of CA H . T he presence of CA H is highly suspected w hen the area of adrenal gland reached 87 .5 mm2 .

Is the weekly sets volume training performed by trained subjects in accordance with training recommendations guidelines for muscle hypertrophy?

Abstract AIM the aim of this study was to analyze the weekly sets volume (WSV) performed by trained men and women for each muscle group in muscle hypertrophy programs. METHODS One hundred and five resistance training practitioners of both sex (42 women, 29.8±5.7 years; 63 men, 28.5±5.7 years) consented to the analysis of their current training programs. Their training plains were analyzed by a researcher that used the following equation to determine the WSV performed for each muscle group: "number of exercises per muscle group per training session X number of sets per exercise in each training session X weekly training frequency per muscle group". The median values ​​by each muscle group were compared within and between genders. RESULTS Between group analysis demonstrated that men performed higher WSV for upper body (UB) muscles than women (47.2±14,6 vs. 18.2±7.4 sets). Conversely, women performed a higher WSV for lower body (LB) muscle groups than men (23.8±11.2 vs. 11.5±7.0 sets). The training volume for the abdominal muscles did not differ between groups. When comparing the WSV for the UB, LB and core musculature within groups, men perform higher training volumes for the UB compared to the LB and core, while women train the LB with a higher volume compared to the other musculature. CONCLUSION For some muscle groups, the WSV is higher than recommended in the literature for muscle hypertrophy. Men emphasize the UB training, while women emphasize training the LB. Moreover, the WSV performed by subjects of both genders is disproportionate between different muscle groups.

Relationship between lumbar multifidus muscles and degeneration of facet joint with MRI / 实用医学杂志

Objectives To investigate the relationship between the degeneration of lumbar multifidus mus-cles and facet joint osteoarthritis(FJOA)by MRI. Methods This retrospective study included 248 patients with low back and leg pain,aged from 55 to 70.MRI was used to measure TCSA,FCSA,fCSA and FI% of the L4~5and L5~S1segments on the both sides of their multifidus muscle in the cross section in T2weighted image.All the cases were divided into three grades:grade 0~1,grade 2 and grade 3 according to their FJOA grades. The relationship between the FJOA grades at the same level and TCSA,FCSA and FI% of both sides was analyzed retrospectively. Results There were significant differences of the FI% of the multifidus muscle between both sides of the two seg-ments(P < 0.05);The TCSA,FCSA and fCSA of the left and right multifidus muscle all showed an increasing trend from L4~5to L5~S1segment and the difference was statistically significant(P<0.05);the FI% of two sides of multifidus muscle was negatively correlated with the right FJOA grade at L5~S1segment(P<0.05).There was a re-lationship between females and right FJOA grade at L5~S1segment(all P < 0.05). Whereas,no significant differ-ence was found in other parameters(all P>0.05).Conclusions There is no relationship between the cross-sec-tional area of the multifidus muscle and the FJOA grade. The higher FI% degree of multifidus muscle in the L5~S1 segment is accompanied with a lower grade of FJOA.The degeneration of multifidus muscle occurs earlier than the degeneration of articular process joints,so the earlier exercise of lumbar muscle is recommended.

The study on the ratio of carotid artery/vein cross-sectional area measured by ultrasound to evaluate volume responsiveness / 中华急诊医学杂志

Objective To investigate the application of the cross-sectional area ratio of internal jugular vein and common carotid artery (IJV/CCA) in the evaluating the volume responsiveness of critically ill patients. Methods The capacity of critically ill patients were prospectively assessed. The diameter and sectional area of the IJV and CCA were measured by bedside ultrasonography. The cross-sectional area ratio of IJV/CCA was calculated and compared with the variety of cardiac output (ΔCO) after passive leg raising (PLR). Then the correlation index between the cross-sectional area ratio of IJV/CCA and ΔCO was evaluated, and the sensitivity and specificity parameters of capacity status were assessed by the cross-sectional area ratio of IJV/CCA. Results Of 55 critically ill patients in this study, 34 cases had positive volume responsiveness, and 21 case negative volume responsiveness.The general clinical data of the two groups had no statistically significant difference. The cross-sectional area ratio of IJV/CCA in the positive group was significantly less than that of the negative group (1.38±0.55 vs. 2.16±0.68, P<0.01). There was a significant correlation between the IJV/CCA cross-sectional area ratio and the ΔCO value of PLR (r=-0.67, P<0.01). When the ratio of the cross-sectional area of IJV/CCA was 1.65, the sensitivity of the assessment capacity was 86.4％ and the specificity was 78.8％. Conclusions The use of portable bedside ultrasonography is a noninvasive, convenient and reliable method to evaluate the capacity state of the critically ill patients.

Comparison Thigh Skeletal Muscles between Snowboarding Halfpipe Athletes and Healthy Volunteers Using Quantitative Multi-Parameter Magnetic Resonance Imaging at Rest / 中华医学杂志(英文版)

<p><b>Background</b>Magnetic resonance (MR) imaging provides a unique, noninvasive diagnostic platform to quantify the physiological and biochemical variables of skeletal muscle at rest. This study was to investigate the difference in thigh skeletal muscles between snowboarding halfpipe athletes and healthy volunteers via multiparametric MR imaging.</p><p><b>Methods</b>A comparative study was conducted between 12 healthy volunteers and 14 snowboarding halfpipe athletes. MR scanning targeted the left leg at the level of the proximal thigh on a 3.0T MR system. The measured parameters compared between the two groups included T1, T2, T2* relaxation times, fat fraction (FF), and cross-sectional area (CSA) of the quadriceps femoris and the hamstring muscles. Statistical analysis was carried out using independent sample t-test. Interrater reliability was also assessed with intraclass correlation coefficients (ICCs).</p><p><b>Results</b>It was statistically equivalent between two groups in age, body mass index, thigh circumference, calf circumference, systolic blood pressure, and resting heart rate (all P > 0.05). However, the T1 and T2 values of the hamstring muscles in the athlete group were found to be significantly shorter than those in control group (T1: 1063.3 ± 24.1 ms vs. 1112.0 ± 38.2 ms in biceps femoris, 1050.4 ± 31.2 ms vs. 1095.0 ± 39.5 ms in semitendinosus, 1053.1 ± 31.7 ms vs. 1118.4 ± 40.0 ms in semimembranosus, respectively; T2: 33.4 ± 0.7 ms vs. 36.1 ± 1.9 ms in biceps femoris, 34.6 ± 2.0 ms vs. 37.0 ± 1.9 ms in semitendinosus, 36.9 ± 1.5 ms vs. 38.9 ± 2.4 ms in semimembranosus, respectively; all P < 0.05) although T2* relaxation time was detected with no significant difference. The FF of the hamstring muscles was obviously less than the control group (5.5 ± 1.9% vs. 10.7 ± 4.7%, P < 0.001). In addition, the quadriceps' CSA in the athlete group was substantially larger than the control group (8039.0 ± 1072.3 vs. 6258.2 ± 852.0 mm, P < 0.001). Interrater reliability was excellent (ICC: 0.758-0.994).</p><p><b>Conclusion</b>Multiple MR imaging parameters indicated significant differences between snowboarding halfpipe athletes and healthy volunteers in the thigh skeletal muscles.</p>