Effectiveness of Osteoporosis Self-Assessment Tool for Asians in Screening for Osteoporosis in Healthy Males Over 40 Years Old in China.

In this study, we evaluated the effectiveness of the Osteoporosis Self-assessment Tool for Asians (OSTA) in screening for osteoporosis in the elderly male population in the Chengdu area, China. The Lunar Prodigy Advance bone densitometer was used to measure the bone mineral density of 11,039 healthy males over the age of 40 years. Men with OSTA scores of >-1, -4 < OSTA ≤ -1, or ≤-4 were assigned to the low-risk, moderate-risk, or high-risk group, respectively. The T-scores measured with dual-energy X-ray absorptiometry at the different sites were compared across the groups. The bone mineral density of the lumbar spines L1-L4, the left femur, and other sites decreased gradually with age. With increasing age, the screening sensitivity of OSTA for osteoporosis in the lumbar spine and femur gradually increased, whereas its specificity decreased. The areas under the receiver operating characteristic curves for the OSTA index in different age groups and at different sites were 0.644-0.831. Therefore, the OSTA index demonstrated some value in screening for osteoporosis in men over the age of 50 years. Significant differences in its effectiveness were observed among different age groups.

Performance of the Osteoporosis Self-Assessment Tool for Asians (OSTA) in Screening Osteoporosis Among Middle-Aged and Old Women in the Chengdu Region of China.

The purpose of this study was to assess the performance of an osteoporosis self-assessment tool for Asians (OSTA) for screening middle-aged and old healthy women in the Chengdu region of China. OSTA scores were used to evaluate the effect of age on the development of osteoporosis. A total of 15,752 healthy women older than 40 yr, who reside in the Chengdu region, were assigned to 9 age groups divided by 5-yr intervals. Bone mineral density of the lumbar vertebrae, L1-L4, and the left hip was measured with a GE Lunar Prodigy advance dual-energy X-ray absorptiometry system (GE Healthcare, Cincinnati, OH). All subjects were classified into 3 categories according to OSTA cutoff values. The OSTA values used to define the categories were ≥-1, >-4 and <-1, and ≤-4. The accuracy of the OSTA index was compared with T-scores measured by dual-energy X-ray absorptiometry at various skeletal sites. All statistical analyses were performed using SPSS, version 17.0 (SPSS, Inc., Chicago, IL). The detection rate of osteoporosis and osteopenia at the lumbar vertebrae and the femur was found to increase with age. Furthermore, the sensitivity of OSTA value for detection of osteoporosis also gradually enhanced with subject age. In contrast, the specificity gradually decreased with age. The sensitivity and negative predictive value of the OSTA index for detecting osteoporosis gradually increased with higher OSTA cutoff values, and the specificity and positive predictive value appeared to gradually decline. It was concluded that the OSTA is a useful screening tool to detect osteoporosis in middle-aged and old women in the Chengdu region of China. Furthermore, specific OSTA cutoff values should be selected for screening individuals who belong to different age groups.

Cortical-limbic regions modulate depression and anxiety factors in functional dyspepsia: a PET-CT study.

OBJECTIVE: To observe some specific brain areas or cerebral functional network participating in the modulation of depression and anxiety factors in functional dyspepsia (FD) patients by detecting cerebral glucose metabolism (CGM) in fluorine-18 fluorodeoxyglucose ((18)F-FDG) positron emission tomography-computed tomography (PET-CT) scans. METHODS: Eight FD patients with depression and anxiety (DA-FD group) and eight FD patients without depression and anxiety (non-DA-FD group) were recruited and evaluated by the Nepean Dyspepsia Index (NDI) and Dyspepsia Symptom Scores (DSS). Cerebral (18)F-FDG PET-CT scans were performed on the DA-FD group and non-DA-FD group, respectively. The differences in CGM between the two groups were analyzed with SPM2. RESULTS: Extensive changes in the CGM signals were observed in the cerebral cortex and limbic system of FD patients with depression and anxiety. Compared to non-DA-FD patients, DA-FD patients showed a higher glucose metabolism in the right postcentral gyrus (BA 1 and 5), inferior frontal gyrus (BA 45), superior temporal gyrus (BA 22), middle temporal gyrus (BA 22), inferior parietal lobule (BA 40), lingual gyrus (BA 18) and the left middle occipital gyrus (BA 37), as well as the limbic system including the left thalamus, lateral globus pallidus, parahippocampal gyrus (BA 35), right insular cortex (BA 13) and parahippocampal gyrus (BA 18); a lower glucose metabolism was presented in the left middle cingulated gyrus (BA 24), the right superior frontal gyrus (BA 6), the medial frontal gyrus (BA 6) and middle temporal gyrus (BA 21). CONCLUSION: An extensive cortical-limbic brain network might modulate the procession of FD patients with depression and anxiety factors.

Brain areas involved in acupuncture treatment on functional dyspepsia patients: a PET-CT study.

Neuroimaging studies on brain responses to acupuncture stimulations have received considerable attention recently. The majority of these studies are centered on healthy controls (HC) and neuropathy, while little work has addressed other disorders. This study aimed to investigate the influence of acupuncture stimulations on brain activities in functional dyspepsia (FD) patients. Eight FD patients and eight healthy controls (HC) were involved in this study. Each HC received an 18F-FDG PET-CT scan at baseline, while each patient received scans at baseline and after acupuncture stimulations. Manual acupuncture stimulations were performed at ST34 (Liangqiu), ST36 (Zusanli), ST40 (Fenglong) and ST42 (Chongyang) in FD patients. The images were analyzed with the Statistical Parametric Mapping software 2.0. Compared to HC, the FD patients showed a lower glycometabolism in the right orbital gyrus, the left caudate tail and the cingulate gyrus, and a higher glycometabolism in the left inferior temporal gyrus (p<0.005). After acupuncture stimulations, the FD patients showed a glycometabolism decrease in the postcentral gyrus and the cerebella, and an increase in the visual-related cortices(p<0.005). The results suggest that the anterior cingulate cortex, the prefrontal cortices and the caudate tail involve in processing gastric perceptions in FD patients and that the deactivation of the primary somatosensory area and the cerebella is contributable to acupuncture stimulation, while activation of the visual-related cortex is a response to pain or acupoint actions.

[Effects of trimetazidine on myocardial metabolism evaluated by PET-CT in patients with ischemic cardiomyopathy].

OBJECTIVE: Trimetazidine (TZM) has been shown to have anti-ischemia properties by optimizing ischemic myocardium metabolism. We evaluated the effect of TZM on myocardial metabolism with Positron Emission Computed Tomography (PET-CT) in patients with ischemic cardiomyopathy. METHODS: TZM (60 mg/d, n = 15) or placebo (n = 15) was randomly applied to ischemic cardiomyopathy patients on top of conventional therapy for 12 months. Color Doppler Flow Imaging (CDFI), (18)F-FDP PET-CT imaging and (99m)Tc-MIBI gated single photon emission computerized tomography (SPECT) imaging were performed at study begin and after 12 months. LVEF with CDFI, summed rest scores (SRS) with SPECT and standard uptake value (SUV) with PET-CT of the segments which were perfusion-metabolism matched and decreased were determined respectively. RESULTS: After 12 months, LVEF of the therapy group was increased from (37.9 +/- 5.0)% to (42.3 +/- 10.4)% (P < 0.05), while the control group increased from (37.9 +/- 4.6)% to (40.1 +/- 5.5)% (P > 0.05); SRSs of the matched segments of the therapy and the control were reduced from 3.9 +/- 1.0 to 2.4 +/- 2.3 (P < 0.01) and 4.0 +/- 0.7 to 2.8 +/- 1.8 (P < 0.05) respectively, while LVEF and SRSs were similar at study begin and after 12 months between these two groups. SUV of myocardial segments classified as myocardial perfusion-metabolism matched was increased from 5.3 +/- 1.5 to 9.8 +/- 4.7 in the therapy group (P < 0.05) and from 5.4 +/- 1.2 to 6.0 +/- 2.3 (P > 0.05) in the placebo group, SUV was significantly higher in the therapy group than that in placebo group after 12 months (P < 0.05). CONCLUSION: SPECT and (18)F-FDG imaging combination could be used to detect the surviving myocardium and chronic trimetazidine treatment could increase the glucose metabolism of ischemic cardiomyocytes in patients with ischemic cardiomyopathy.

[Effect of acupuncture at acupoints of the Shaoyang Meridian on cerebral glucose metabolism in the patient of chronic migraine].

OBJECTIVE: To observe response characteristics of human brain to acupuncture of corresponding channel point selection and probe into the central nervous mechanism of acupuncture at the points selected along channel. METHODS: Six cases of chronic migraine were treated with acupuncture at Fengchi (GB 20), Waiguan (TE 5), Yang-lingquan (GB 34) on the Shaoyang Channel. Positron emission computerized tomography (PET-CT) was used for scanning and statistic parameter map (SPM 2) software was used to analyze the data and compare with healthy human brain function imaging and investigate the changes of metabolism of glucose in the brain of the patient of migraine before and after acupuncture. RESULTS: After acupuncture, excitation areas of the pain brain regions such as the brain stem, insula, etc. obviously reduced, and the brain function-reducing area turned from the right temporal lobe as main to bilateral temporal lobes with symmetry. CONCLUSION: The pons, insula, anterior frontal gyrus, etc. possibly are the target points of analgesic effect of acupuncture at the Shaoyang Channel on chronic migraine, and the change of metabolism reduction on bilateral temporal lobes induced by acupuncture possibly is one of the mechanisms for acu-puncture at points on the Shaoyang Channel for treatment of migraine. Acupuncture achieves whole and beneficial therapeutic effect possibly through coordination and redistribution of energy metabolism in the brain.

[Manufacture and evaluation of a spine phantom used in the cross-calibration of DXA bone densitometry].

OBJECTIVE: To design and manufacture a reliable spine phantom used in the cross calibration and quality control of dual X-ray absorptiometry (DXA). METHODS: A hydroxyapatite quality control phantom was designed and made through three steps: solid water, bone phantom material and integration, then evaluated the phantom on four different types of DXA machines made by LUNAR company. RESULTS: Among the four DXA densitometers, the Expert fan beam densitometer had the biggest accuracy errors of bone mineral density (BMD), bone mineral content(BMC) and area values while the other three one narrow fan beam (Prodigy) and two pencil beam densitometers-had small errors. Of the three indexes measured by all the machines, BMD error was the smallest (-15.4%-11.5%), with the Prodigy's BMD was most outstanding. BMD errors at the higher density ends were small, tend to be positive values while the errors at the lower ends were big, tend to be negative. In cross calibration, giving consideration to the differences between the both ends, it is better to use the regression equation to correct. The base line of precision error derived by scanning the phantom once a day for consecutive 25 days was better than that derived by scanning the phantom 25 times consecutively on the same day. As to precision error, the coefficient of variation (CV) of scanning-25 times-a day was the smallest (0.0043) while the CV of 12 adults measurements was the biggest (0.0078). CONCLUSIONS: This phantom can be used in the quality control and cross-calibration of different types of DXA machines.