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Objective:To explore the repeatability of ultrasound shear wave elastography (SWE) in evaluating the Young′s modulus (E) of the lumbar multifidus (LM) and the difference in E of the bilateral LM, and to analyze the E′s change ratio of LM and its impact factors at upright and 90° forward bend positions.Methods:A total of 60 healthy volunteers, selected from interns, standardized training residents and refresher doctors in department of diagnostic ultrasound of Sir Run Run Shaw Hospital of Zhejiang University School of Medicine from July to December in 2020, were examined twice by SWE to estimate the E value of LM at prone, upright and 90° flexion positions, respectively. Firstly, the intraclass correlation coefficient (ICC) was applied to test the reliability between the two repeated measurements.Secondly, the differences in E of the bilateral LM were discussed. The discrepancies in the E value of male and female volunteers at prone, upright and 90° flexion positions and the change ratio of the E value at upright and 90° forward bend positions were also discussed, respectively. Finally, Spearman correlation coefficient was utilized to evaluate the correlations of E and its change ratio with gender, age, BMI and activity level at upright and 90° forward bend positions, respectively.Results:The ICC value in LM measured by SWE was in the range of 0.691 to 0.951. No obvious change in bilateral E values of the same posture was observed for an individual(all P>0.05). The change ratios of E at upright and 90° flexion positions were approximate to 2 and 7, respectively. Moreover, at prone position, the E value exhibited negative correlation with age and activity level of self-assessment ( rs=-0.300, P=0.020; rs=-0.383, P=0.002). The E in female was higher compared with that in male. At active states the change ratio in E was positively correlated with age and activity level ( rs=0.278, P=0.031; rs=0.495, P<0.001), and the E′s change ratio in male was higher than that in female. Conclusions:SWE possesses excellent repeatability in evaluating the E value of LM with no significant difference in E of bilateral LM. The E′s change ratio in LM varies with different contraction strategies and changes with age, sex and self-reported activity level.
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Objective To identify the cytotoxicity of different local anesthetics (LAs) to the adipose-derived mesenchymal stem cells (ADMSCs) during early chondrogenic differentiation.Methods Adipose-derived stem cells (ADMSCs) were isolated from 4-month old New Zealand white rabbits,and cultured and induced to differentiate into cartilage.The third generation chondrogenic differentiating ADMSCs were isolated and incubated with 1％ lidocaine,2％ methylpivacaine,0.5％ bupivacaine and 0.5％ ropivacaine,respectively,for 30 min and 60 min,so as to screen out the LA of least toxicity.Control cells were incubated in phosphate buffer.The LAs were washed away and the chondrogenic differentiation medium was added to promote differentiation.Apoptosis and morphological changes during the chondrogenic differentiation were measured using flow cytometry and safranine-fast green double dyeing on the 3rd and 7th days of the culturing.The least toxic LA was diluted to 25％,50％,75％ and 100％ of the original concentration and incubated with ADMSCs for 30 and 60 minutes.On days 3 and 7 after the exposure,a quantitative real-time reverse-transcriptase polymerase chain reaction (qRT-PCR) and western blotting were employed to analyze the expression of chondrogenesis-related genes including the collagen Ⅰ,collagen Ⅲ and SOX9.Results Apoptosis increased significantly after the lidocaine,ropivacaine,bupivacaine and mepivacaine treatments compared to the PBS control.LAs are cytotoxic to rADMSCs during early chondrogenesis in a type-and time-dependent manner.Lidocaine was the least toxic LA tested.The chondrogenesis-related markers all decreased significantly by days 3 and 7 after the exposure to lidocaine at different concentrations compared with the control group.Conclusions LAs are cytotoxic to ADMSCs during early chondrogenesis in a dose-and time-dependent manner.1％ lidocaine was the least toxic LA tested.
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@#ObjectiveTo investigate the clinical characteristics of post-stroke depression (PSD) and correlative factors.Methods116 patients with PSD were randomly divided into the treatment group (n=69) and control group (n=47). The patients of the treatment group were treated with selective serotonin re-uptake inhibitors (SSRI) 20 mg/d and combined with psychological counselling, those of the control group only with SSRI. All patients were examined with Self-rating Depression Scale (SDS) when admission and one month after treatment.ResultsAfter treatment, the SDS scores of all patients in two groups decreased ( P<0.05～0.01), but the therapeutic effect of the treatment group was better than that of the control group ( P<0.05).ConclusionThe PSD is correlated with psych-social circumstances except body disease.