Body Mass Index z Scores Correlate with Epidermal Function in Chinese Children.

Background/Objective: Epidermal function is altered in a number of cutaneous and extracutaneous disorders. To determine whether epidermal function is also altered in children with obesity, we assessed the correlation between the body mass index (BMI) z score and epidermal function in children. Participants and Methods: Participants were enrolled from outpatient clinic, schools and kindergartens. Epidermal biophysical properties, including transepidermal water loss rate, stratum corneum hydration and skin surface pH, were measured on the flexor forearm and shin. Correlations between epidermal biophysical properties and BMI were analyzed. In addition, the association of epidermal biophysical properties with BMI z score was also determined. Results: Overall, BMI did not differ significantly between boys and girls among the age groups. BMI z scores correlated negatively with stratum corneum hydration levels and positively with skin surface pH in boys, but not in girls. The negative correlation between TEWL and BMI z score was not significant. Moreover, stratum corneum hydration levels were lower in boys with a BMI z score of ≥2 than in those with a BMI z score of -2 to 0.99. Conclusion: Both stratum corneum hydration levels and skin surface pH are significantly correlated with BMI z scores in boys, but not in girls. Whether epidermal function influences BMI or vice versa remains to be determined.

Trend of changes in epidermal biophysical properties in the Chinese aged 1 month to 17-year old.

BACKGROUND: Although it is known that epidermal biophysical properties vary with age and gender, the changes in epidermal biophysical properties over the time from baby to adolescence have not been elucidated yet. In the present study, we assessed the trend of changes in transepidermal water loss rates (TEWL), stratum corneum hydration, and skin surface pH in Chinese children. PARTICIPANTS AND METHODS: A total of 780 boys and 610 girls, aged 1 month to 17-year old, were enrolled in this study. TEWL and stratum corneum hydration on the forearm and the shin were measured with GPSkin Barrier, whereas skin surface pH was measured with portable skin pH meter. RESULTS: Overall, TEWL and stratum corneum hydration levels decreased, whereas skin surface pH increased in children from 1-month old to 17-year old. Significant decline in TEWL was observed on both the forearm and the shin of girls, and the shin of boys aged 13-17-year old. Similarly, marked decline in stratum corneum hydration levels started at ages of 6-12-year old. In contrast, decline in skin surface pH was observed in both girls and boys aged one to 12-month old except on the forearm of boys. Afterward, skin surface pH remained either stable or slight increase except on the shin of boys aged >12 months to 3-year old. CONCLUSIONS: These results demonstrate that both TEWL and stratum corneum hydration levels decrease, whereas skin surface pH increases in children aged 1 month to 17-year old. The changes in these biophysical properties vary with age, gender, and body site.

Resting Cardiac Power Predicts Adverse Outcome in Heart Failure Patients With Preserved Ejection Fraction: A Prospective Study.

Background: We sought to explore the significance of resting cardiac power/mass in predicting adverse outcome in patients with heart failure with preserved ejection fraction (HFpEF). Methods: This prospective cohort study included patients with HFpEF and without significant valve disease or right ventricular dysfunction. Cardiac power was normalized to left ventricular (LV) mass and expressed in W/100 g of LV myocardium. Multivariate Cox regression analysis was used to evaluate the association between resting cardiac power/mass and composite endpoint, which included all-cause mortality and heart failure (HF) hospitalization. Results: A total of 2,089 patients were included in this study. After an average follow-up of 4.4 years, 612 (29.30%) patients had composite endpoint, in which 331 (15.84%) died and 391 (18.72%) experienced HF hospitalization. In multivariate Cox regression analysis, resting power/mass < 0.7 W/m2 was independently associated with composite endpoint, all-cause mortality, cardiovascular mortality and HF hospitalization, with hazard ratios (HR) of 1.309 [95% confidence interval (CI): 1.108-1.546, P = 0.002], 1.697 (95%CI: 1.344-2.143, P < 0.001), 2.513 (95%CI: 1.711-3.689, P < 0.001), and 1.294 (95%CI: 1.052-1.592, P = 0.015), respectively. For composite endpoint, cardiovascular mortality and HF hospitalization, the C statistic increased significantly when incorporating resting cardiac power/mass into a model with established risk factors. For composite endpoint, the continuous net reclassification index after adding resting cardiac power/mass in the original model with N-terminal pro-brain natriuretic peptide was 13.1% (95%CI: 2.9-21.6%, P = 0.007), and the integrated discrimination index was 1.9% (95%CI: 0.8-3.2%, P < 0.001). Conclusion: Resting cardiac power determined by non-invasive echocardiography is independently associated with the risk of adverse outcomes in HFpEF patients and provides incremental prognostic information.

The value of whole-brain CT perfusion imaging combined with dynamic CT angiography in the evaluation of pial collateral circulation with middle cerebral artery occlusion.

BACKGROUND: Middle cerebral artery (MCA) occlusion is extremely common, especially unilateral artery, which can result in a significant incidence of cerebral infarction. OBJECTIVE: To assess the value of whole-brain computed tomography perfusion (CTP) imaging combined with dynamic CT angiography (dCTA) in the evaluation of pial collateral circulation in patients with MCA occlusion. METHODS: Whole-brain CTP and dCTA images were acquired in 58 patients with unilateral MCA occlusion. All patients were divided into three groups according to the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) collateral score (by CTA). The CTP parameters were analysed, including relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV), relative mean transit time (rMTT), and relative time to peak (rTTP). Patients were followed up with the modified Rankin scale (mRS). All cases in this study were confirmed by DSA. RESULTS: The CTP parameters of the MCA blood supply area on the affected side of patients with different degrees of stenosis were significantly different from those on the unaffected side. There are significant differences in the CTP parameters and openings of the Willis circle in patients with different degrees of stenosis. Significant differences were found in the number of patients with good prognosis. CONCLUSIONS: Whole-brain CT perfusion combined with dynamic CTA can structurally and functionally evaluate the establishment of pial collateral circulation and its effect on cerebral hemodynamic changes.

Application of intravoxel incoherent motion diffusion-weighted imaging in differential diagnosis and molecular subtype analysis of breast cancer.

OBJECTIVE: To explore the application of incoherent motion diffusion-weighted imaging (IVIM-DWI) in the differential diagnosis and molecular subtype analysis of breast cancer. METHODS: The clinical data of 225 patients with breast masses were selected, including breast cancers (n = 135) and benign breast tumors (n = 90). According to pathological results, breast cancers were divided into four subtypes: Luminal A (n = 24), Luminal B (n = 57), HER-2-overexpression (n = 27) and triple-negative breast cancers (n = 27). The patients were detected by IVIM-DWI, and then the average diffusion coefficient (ADC), perfusion fraction (f) value, true dispersion coefficient (D) value and false dispersion coefficient (D*) value were compared and analyzed. The above index were used to identify breast cancer and its molecular subtypes by using the receiver operating characteristic (ROC) curve. RESULTS: The ADC, D and D*-value in breast cancer group were significantly lower than those in benign tumor group, while the f-value in breast cancer group was higher than that in benign tumor group (P<0.001); The ADC, D, D*, f-value and the combination of four have high diagnostic value in breast cancer; The D-value in PR-positive group was higher than that in the PR-negative group, while it was lower in PR-positive group (P<0.05), and the ADC, D and D*-value in the ER-positive group were significantly lower than those in the ER-negative group (P<0.001); The f-value in HER-2 positive group was higher than that in human epidermal growth factor receptor-2 (HER-2) negative group (P<0.001); The ADC and D-value of Ki-67 high-expression was lower than those of Ki-67 low-expression, while the D-value of Ki-67 high-expression was higher than that of Ki-67 low expression group (P<0.05); The ADC, D, D*, f-value and the combination of four have high diagnostic value in triple negative breast cancer. CONCLUSION: IVIM-DWI technology has a significant value in differential diagnosis of benign and malignant breast tumors, and the relevant parameters of IVIM-DWI technology have definite value in the differential diagnosis of breast cancer molecular typing.

Comparison of spectral computed tomography imaging parameters between squamous cell carcinoma and adenocarcinoma at the gastroesophageal junction.

OBJECTIVE: To compare the spectral computed tomography (CT) imaging parameters between squamous cell carcinoma (SCC) and adenocarcinoma (AC) at the gastroesophageal junction (GEJ). METHODS: A total of 80 patients were enrolled in this retrospective study. Among them, 35 were diagnosed with SCC (SCC group) and 45 were diagnosed with AC (AC group). All patients underwent an enhanced scan with spectral CT. The following CT imaging parameters were evaluated: iodine concentration (IC), water content (WC), effective atomic number (Eff-Z) and slope of the spectral HU curve (λHU) of lesions. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of spectral CT imaging parameters for diagnosis of SCC and AC. RESULTS: Patients with SCC had lower IC, Eff-Z, and λHU in arterial phase and venous phase compared with AC (p< 0.05). There were no significant differences in WC between the two groups. ROC curve analyses revealed that IC, Eff-Z, and λHU in arterial phase and venous phase were predictors for diagnosis of SCC and AC (AUC > 0.5). Moreover, the IC, Eff-Z and λHU in venous phase had better differential diagnostic performances than that in arterial phase. CONCLUSIONS: Spectral CT could be useful in the differential diagnosis of SCC and AC at the GEJ. Therefore, a routine spectral CT scan is recommended for patients with carcinoma of the GEJ.