Relationship between sonographically measured median nerve cross-sectional area and presence of peripheral neuropathy in diabetic subjects

BACKGROUND Neuropathy is a common complication of diabetes mellitus resulting from direct damage by hyperglycemia to the nerves and/or ischemia by microvascular injury to the endoneurial vessels which supply the nerves. Median nerve is one of the peripheral nerves commonly affected in diabetic neuropathy. The median nerve size has been studied in non-Nigerian diabetic populations. In attempt to contribute to existing literature, a study in a Nigerian population is needed.AIM To evaluate the cross-sectional area(CSA) of the median nerve using B-mode ultrasonography(USS) and the presence of peripheral neuropathy(PN) in a cohort of adult diabetic Nigerians.METHODS Demographic and anthropometric data of 85 adult diabetes mellitus(DM) and 85 age-and sex-matched apparently healthy control(HC) subjects were taken. A complete physical examination was performed on all study subjects to determine the presence of PN and modified Michigan Neuropathy Screening Instrument(MNSI) was used to grade its severity. Venous blood was taken from the study subjects for fasting lipid profile(FLP), fasting blood glucose(FBG) and glycated haemoglobin(HbA1 c) while their MN CSA was evaluated at a point 5 cm proximal to(5 cmCATL) and at the carpal tunnel(CATL) by high-resolution Bmode USS. Data was analysed using SPSS version 22.RESULTS The mean MN CSA was significantly thicker in DM subjects compared to the HC at 5 cmCATL(P < 0.01) and at the CATL(P < 0.01) on both sides. The presence of diabetic peripheral neuropathy(DPN) further increased the MN CSA at the CATL(P < 0.05) but not at 5 cmCATL(P > 0.05). However, the severity of DPN had no additional effect on MN CSA 5 cm proximal to and at the CATL. There was no significant association between MN CSA and duration of DM and glycemic control.CONCLUSION Thickening of the MN CSA at 5 cmCATL and CATL is seen in DM. Presence of DPN is associated with worse thickening of the MN CSA at the CATL but not at5 cmCATL. Severity of DPN, duration of DM, and glycemic control had no additional effect on the MN CSA.

Ultrasonographic measurement of median nerve cross-sectional area reference values in a healthy Han population from Guiyang,China

High-resolution ultrasonography was used to analyze the nerve cross-sectional area （CSA） of the median nerve at 7 sites： the wrist crease, pisiform bone, hamate bone, 6 cm proximal to the tip of the wrist crease, proximal forearm （where the nerve enters the pronator teres muscle）, 4 cm proximal to the tip of the medial epicondyle, and mid-humerus （mid-point between elbow crease and axilla） in 200 healthy volunteers from Guiyang, China. Results showed similar CSA values between the left and right sides, but the CSA 6 cm proximal to the tip of the wrist crease, proximal forearm, 4 cm proximal to tip of the medial epicondyle, and mid-humerus in males was greater than that of females. Moreover, CSA values at the wrist crease, pisiform bone, and hamate bone were greater in the middle-aged and old groups when compared to the young group, and correlated with body mass and height. Thus, reference values of median nerve CSA of the upper limbs can facilitate the analysis of abnormal nerve conditions.

Antizyme 1 Gene is Associated with Loin Muscle Area and Marbling in Landrace × Lantang F_2 Resource Population

The expression level of antizyme 1 （AZ1） gene in Longissimus dorsi muscle of Landrace pigs is significantly higher than that of Lantang pigs based on our previous studies. The AZ1 is a key regulator of the concentration of polyamines in cells. It is a good candidate gene for pig＇s performance because polyamines regulate the growth and development of cells. Four PCR-RFLPs were selected to study the relation between AZ1 genotypes and porcine performance. Results showed that the loci of -713 C/T, -584 A/C, and ＋2 432 G/A had significant or highly significant opposite effects on loin muscle area and marbling.

Genome-wide association study for rib eye muscle area in a Large White×Minzhu F_2 pig resource population

Rib eye muscle area（REMA） is an economically important trait and one of the main selection criteria for breeding in the swine industry. In the genome-wide association study（GWAS）, the Illumina Porcine SNP60 Bead Chip containing 62 163 single nucleotide polymorphisms（SNPs） was used to genotype 557 pigs from a porcine Large White×Minzhu intercross population. The REMA（at the 5th–6th, 10th–11th and the last ribs） was measured after slaughtered at the age of（240±7） d for each animal. Association tests between REMA trait and SNPs were performed via the Genome-Wide Rapid Association using the Mixed Model and Regression-Genomic Control（GRAMMAR-GC） approach. From the Ensembl porcine database, SNP annotation was implemented using Sus scrofa Build 10.2. Thirty-three SNPs on SSC12 and 3 SNPs on SSC2 showed significant association with REMA at the last rib at the chromosome-wide significance level. None of the SNPs of REMA at the 5th–6th rib and only a few numbers of the SNPs of REMA at the 10th–11th ribs were found in this study. The Haploview V3.31 program and the Haplo.Stats R package were used to detect and visualize haplotype blocks and to analyze the association of the detected haplotype blocks with REMA at the last rib. A linkage analysis revealed that 4 haplotype blocks contained 4, 4, 2, and 4 SNPs, respectively. Annotations from pig reference genome suggested 2 genes（NOS2, NLK） in block 1（266 kb）, one gene（TMIGD1） in block 2（348 kb）, and one gene（MAP2K4） in block 3（453 kb）. A functional analysis indicated that MYH3 and MYH13 genes are the potential genes controlling REMA at the last rib. We screened several candidate intervals and genes based on the SNPs location and the gene function, and inferred that NOS2 and NLK genes maybe the main genes of REMA at the last ribs.

Does the ratio of the carpal tunnel inlet and outlet cross-sectional areas in the median nerve reflect carpal tunnel syndrome severity?

Although ultrasound measurements have been used in previous studies on carpal tunnel syndrome to visualize injury to the median nerve, whether such ultrasound data can indicate the severity of carpal tunnel syndrome remains controversial. The cross-sectional areas of the median nerve at the tunnel inlet and outlet can show swelling and compression of the nerve at the carpal. We hypothesized that the ratio of the cross-sectional areas of the median nerve at the carpal tunnel inlet to outlet accurately reflects the severity of carpal tunnel syndrome. To test this, high-resolution ultrasound with a linear array transducer at 5–17 MHz was used to assess 77 patients with carpal tunnel syndrome. The results showed that the cut-off point for the inlet-to-outlet ratio was 1.14. Significant differences in the inlet-to-outlet ratio were found among patients with mild, moderate, and severe carpal tunnel syndrome. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.29 between mild and more severe（moderate and severe） carpal tunnel syndrome patients with 64.7% sensitivity and 72.7% specificity. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.52 between the moderate and severe carpal tunnel syndrome patients with 80.0% sensitivity and 64.7% specificity. These results suggest that the inlet-to-outlet ratio reflected the severity of carpal tunnel syndrome.

Sarcopenia diagnosed using masseter muscle area predictive of early mortality following severe traumatic brain injury

Traumatic brain injury（TBI）represents a global pandemic and is currently a leading cause of injury related death worldwide.Unfortunately,those who survive initial injury often suffer devastating functional,social,and economic consequences.

Impact of Lifestyle Intervention on the Estimated Visceral Fat Area and Skeletal Muscle Mass in Men with Obesity

Background: The lifestyle modification remains the fundamental approach for the obesity treatment. The aim of this study is to demonstrate the effect of the multimodal lifestyle intervention on the estimated visceral fat area versus changes in musculoskeletal mass in a cohort of adult men with obesity. Subjects and Methods: A retrospective cohort study in which the file of eighty-two male subjects, aged 20 - 60 years, was studied for three months. Patients had been instructed to follow a balanced-hypocaloric diet, physical activity plan and general advice for combating the unhealthy lifestyle habits through the study period. Those who succeeded to loss > 5% of their body weight were classified as weight loser (WL) group, while others as weight resistant (WR) group. The results of In Body-720 bioelectric impedance analysis were used to report the fat mass (FM), visceral fat area (VFA), skeletal muscle mass (SMM), SMM/VFA ratio, osseous mass (OM), and basal metabolic rate (BMR) before and after the study period. Anthropometric measures, glucose, and lipid profile were also analyzed. Paired t-test was used to detect the significance of change between before and after measures, independent sample t-test was used to compare WL vs. WR groups. Results: There were significant decreases in weight, FM (p 0.05) and VFA (p 0.001), in addition to a significant rise of SMM/VFA ratio (p 0.05), together with insignificant changes of osseous mass, SMM and BMR after 3 months. Additionally, total cholesterol, low-density lipoprotein, and triglycerides were significantly reduced (P 0.05). The percentages of reduction in weight, FM and VFA in WL vs. WR groups were highly significant (p 0.001), while the percentages of change in SMM, SMM/VFA ratio and BMR were significant (p 0.05). Conclusion: Lifestyle modification might be effective in production of positive changes in the body composition of patients with obesity. These changes were more significant in weight losers.

Usefulness of the acromioclavicular joint cross-sectional area as a diagnostic image parameter of acromioclavicular osteoarthritis

BACKGROUND Acromioclavicular joint(ACJ)space narrowing has been considered to be an important diagnostic image parameter of ACJ osteoarthritis(ACJO).However,the morphology of the ACJ space is irregular because of osteophyte formation,subchondral irregularity,capsular distention,sclerosis,and erosion.Therefore,we created the ACJ cross-sectional area(ACJCSA)as a new diagnostic image parameter to assess the irregular morphologic changes of the ACJ.AIM To hypothesize that the ACJCSA is a new diagnostic image parameter for ACJO.METHODS ACJ samples were obtained from 35 patients with ACJO and 30 healthy individuals who underwent shoulder magnetic resonance(S-MR)imaging that revealed no evidence of ACJO.Oblique coronal,T2-weighted,fat-suppressed SMR images were acquired at the ACJ level from the two groups.We measured the ACJCSA and the ACJ space width(ACJSW)at the ACJ on the S-MR images using our imaging analysis program.The ACJCSA was measured as the cross-sectional area of the ACJ.The ACJSW was measured as the narrowest point between the acromion and the clavicle.RESULTS The average ACJCSA was 39.88±10.60 mm;in the normal group and 18.80±5.13 mm;in the ACJO group.The mean ACJSW was 3.51±0.58 mm in the normal group and 2.02±0.48 mm in the ACJO group.ACJO individuals had significantly lower ACJCSA and ACJSW than the healthy individuals.Receiver operating characteristic curve analyses demonstrated that the most suitable ACJCSA cutoff score was 26.14 mm^(2),with 91.4%sensitivity and 90.0%specificity.CONCLUSION The optimal ACJSW cutoff score was 2.37 mm,with 88.6%sensitivity and 96.7%specificity.Even though both the ACJCSA and ACJSW were significantly associated with ACJO,the ACJCSA was a more sensitive diagnostic image parameter.

Age-dependent Changes in Skeletal Muscle Mass and Visceral Fat Area in a Chinese Population

Objective:The present study was conducted to demonstrate the age-dependent changes in skeletal muscle mass and visceral fat area in a population of Chinese adults aged 30-92 years old.Methods:A total of 6669 healthy Chinese men and 4494 healthy Chinese women aged 30-92 years old were assessed for their skeletal muscle mass and visceral fat area.Results:The results showed age-dependent decreases in the total skeletal muscle mass indexes in both men and women aged 40-92 years old as well as age-dependent increases in the visceral fat area in men aged 30-92 years old and in women aged 30-80 years old.Multivariate regression models showed that the total skeletal muscle mass index was positively associated with the body mass index and negatively associated with the age and visceral fat area in both sexes.Conclusion:The loss of skeletal muscle mass becomes obvious at approximately 50 years of age,and the visceral fat area commences to increase at approximately 40 years of age in this Chinese population.

Correlation between current and cross-sectional area of parallel fixed-movable dual electrodes in ESC

Electroslag casting with parallel fixed-movable dual electrodes is a new method for achieving better quality of castings in complex mold cavities.In this work,a mathematical model,y=kx^2+(k+1)x,was established to describe the ideal correlation between the current ratio(y)and the cross-sectional area ratio(x)of the dual electrodes,where k is the filling ratio.Investigation was conducted on the electroslag casting process with dual electrodes of various cross-sectional areas,but at a constant k value.The experimental results indicated that the ideal correlation was obtained at the stable casting stage,and the fitting results were consistent with the experimental results at certain k values.The experimental findings show that better castings can be obtained when the current ratio is greater than 1.536 and the cross-sectional area ratio is greater than 0.5.

Association between the fMRI manifestations of activated brain areas and muscle strength in patients with space-occupying lesions in motor cortex

BACKGROUND ： Functional magnetic resonance imaging （fMRI） studies have disclosed the changes of the motor function in the motor cortex of ipsilateral and contralateral hemispheres of tumor, which have special significance for making the surgical planning and most greatly minimizing the postoperative functional damages. OBJECTIVE： To analyze the association between the manifestation characteristics of hand functional area and motor dysfunction using fMRI in patients with space-occupying lesions of tumor in motor cortex. DESIGN ： A case-controlled observation SETTING： Department of Radiology, Second Affiliated Hospital, Shantou University Medical College .PARTICIPANTS： Twenty-three patients （13 males and 10 females） with space-occupying lesions of central sulcus area, aged 21-53 years with a mean age of （47±1） years were selected from the Second Affiliated Hospital of Shantou University Medical College. All the patients were diagnosed by MR scanning as space-occupying lesions of motor area, and pathologically confirmed that the lesions involved central sulcus and central Iobule; Lesions occurred in left and right hemispheres in 13 and 10 cases respectively. The tumor types were astrocytoma （n =8）, metastatic tumours （n =7）, meningiomas （n =5） and oligodendroglioma （n =3）. The muscle strength was normal in 11 cases （grade 5） and obviously decreased in 12 cases （grade 2-3 in 3 cases and grade 4 in 9 cases）; muscle strengths of both upper and lower limbs were decreased in 7 cases, and only that of upper limbs was decreased in 5 cases. Informed consents were obtained from all the subjects. Meanwhile, 9 healthy physical examinees （5 males and 4 females） of 20-56 years old with an average of （34±1） years were taken as controls. All the patients and healthy subjects were right-handed. METHODS： All the enrolled subjects were examined with MR scanning and functional imaging. Twenty cases whose clinical symptoms were mild in the patient group and 9 healthy volunteers adopted simple active finger-tapping movements, and for the 3 cases whose clinical symptoms were severe in the patient group, the simple passive finger-tapping movements were used. The manifestations in the activated brain areas were analyzed in the patients with brain tumor of different muscle strength and the controls. The motor deficit and activation of contralateral primary motor cortex （M1） in simple finger-tapping movements were observed in the patient group. MAIN OUTCOME MEASURES： （1） Brain areas activated by finger-tapping movements in each group： （2） Activated volumes in hemisphere by finger-tapping movements between groups. RESULTS： The contralateral M1 area could not be activated in 1 case in the patient group,, all the other 22 patients and 9 healthy subjects were involved in the analysis of results. （1） In the control group, unilateral finger tapping movement activated the contralateral primary motor cortex （M1）, bilateral SMA and bilateral PMC. The activation volume was the largest in contralateral primary motor cortex （M1）, smaller in the SMA, and the smallest in PMC. The finger tapping movement in healthy subjects could activate contralateral primary motor cortex （M1）, bilateral SMA and bilateral PMC, which had no obvious differences from the manifestations of brain functional area activated by active finger tapping. There was no significant difference in the volume of activated functional areas between right and left hands. In the patient group, the central sulcos around the tumor in the activated M1 area displaced towards dorsal or ventral side, also extended. The distance of displacement in the functional area was determined as compared with the contralateral central sulcus, and the results suggested the M1 displacement, including that there were 10 cases with the M1 displacement larger than 10 mm in the patients with motor deficit, which were obviously more than in those without motor deficit （n =1, P 〈 0.01）, and the activated volume in contralateral M1 area was obvious smaller in the patients with motor deficit than in those without motor deficit （P 〈 0.01）. （2） The M1 activation and changes were observed in contralateral hemisphere in the patient group, and the activated volume was obviously larger than that in the control group （P 〈 0.01）. The activated volumes of M1 and PMC in ipsilateral hemisphere were obviously larger than those in the control group （P 〈 0.05）, but that of SMA had no obvious difference between the two groups （P 〉 0.05）. CONCLUSION： fMRI can be used to observe the activation of the brain motor functional areas of patient with space-occupying lesions in motor area, and evaluate the state of their motor function. The larger the distance of displacement of M1 compressed by tumor, the more obviously the muscle strength decreases in the patients.

Eff ects of early standardized enteral nutrition on preventing acute muscle loss in the acute exacerbation of chronic obstructive pulmonary disease patients with mechanical ventilation

BACKGROUND:To investigate the eff ects of early standardized enteral nutrition(EN)on the crosssectional area of erector spine muscle(ESMcsa),plasma growth diff erentiation 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 cm^(2) vs.25.205±6.127 cm^(2);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.

Papillary Muscle Relocation in Secondary Mitral Regurgitation: Midterm Outcomes

Background: Mitral valve repair in secondary mitral regurgitation is still uncertain as the chance of recurrence is approximately 30 percent after solely undersized annuloplasty. Some procedures adding to the subvalvular level are proposed to alleviate the recurrent rate. This study was to evaluate the clinical and echocardiographic outcomes of papillary muscle relocation plus undersized ring in secondary mitral regurgitation (2nd MR). Methods: Medical records of moderate to severe 2nd MR with tethering depth of more than 1 cm patients who underwent papillary muscle relocation plus undersized ring from 2014 to 2020 were reviewed. Clinical and echocardiographic parameters before and after operation were analyzed. Results: Thirty-two patients were included during the 6-year period. There was no perioperative mortality. Two patients died at one year from ischemic stroke and car accidents with overall 5-year survival of 93.7%. All patients were in NYHA class I and II with MR grading as trivial or mild at a median follow-up of 33 months. Postoperative mean tenting depth, area and posterior leaflet angle decreased remarkably from 1.18 cm, 2.61 cm2 and 46.5 degree to 0.65 cm, 1.22 cm2 and 28.6 degree, respectively (p 0.001, 0.02, and 0.01). Moreover, left ventricular function and remodeling were also notably improved (EF;38.2% vs 49.1%: p = 0.018, LVEDD;62.8 vs 54.6 mm: p = 0.005, LVESD;50.2 vs 42.4 mm: p = 0.01). Conclusions: Papillary muscle relocation combined with undersized annuloplasty improved mid-term clinical outcomes. Apart from reduction of recurrent MR rate, restoration of mitral configuration and reverse LV remodeling could be the effect of adding subvalvular correction in this pathology.

Quantification Threshold Pixel Technique of Magnetic Resonance Imaging in Paraspinal Muscles Atrophy among Discopathy Patients

Purpose: To evaluate the relationship between lumbosacral discopathy status and paraspinal atrophic changes (Cross-sectional area (CSA) and fatty infiltration (FI)) among different age groups. Materials and Methods: We retrospectively evaluated 200 patients with confirmed discopathy who were examined by lumbosacral Magnetic Resonance Imaging (MRI) at the two main governmental hospitals in Gaza Strip. Using ImageJ software and quantification threshold technique, we measured the CSA and FI of paraspinal muscles {multifidus (MF) & erector spinae (ES)}. The interpretation of MRI images was performed by two radiologists with a good inter-observer agreement between the radiological discopathy findings. Results: The highest percentage and severity of discopathy were noticed at the level of L4/5 (89.5%), followed by L5/S1 (14.5%). The FI is increased towards lower levels of L3/4 to L5/S1. No correlation was found between discopathy level, the severity of discopathy, and CSA of MF & ES muscles. In contrast, a correlation was observed between FI of MF & ES muscles, discopathy level, and severity. Also, the results illustrated no significant relation was observed between CSA of MF & ES muscles and age groups (P > 0.05), while a significant correlation was reported between FI and age groups (P Conclusion: The MRI quantification threshold pixel technique for paraspinal muscles reflected the atrophic changes like CSA and FI in discopathy patients.

低频脉冲磁场慢性暴露对健康成年股四头肌收缩力及形态的影响

背景:目前已有关于低频脉冲磁场对骨骼肌结构形态影响研究发现了骨骼肌质量变化,但对接受慢性暴露后的形态变化未见相关研究。目的:观察低频脉冲磁场慢性暴露对腿部股四头肌最大自主收缩力与形态指标的影响,为使用该技术作为肌肉功能改善策略提供组织形态变化的参考依据。方法:招募普通健康受试者70名,随机分为接受磁场刺激的试验组与进行假治疗的对照组,每组35名,试验时长共计4周,试验组受试者每隔48 h进行1次15 min的低频脉冲磁刺激干预,对照组进行假治疗,干预间隔与时长与试验组一致,干预4周后观察不同组别受试者股四头肌最大自主收缩力值变化,利用B型超声影像作为评估手段,观察肌肉厚度、肌肉横截面积及羽状角指标的变化。结果与结论:①经过4周的低频脉冲磁场慢性暴露,68名受试者完成试验,试验组受试者股四头肌最大自主收缩力测试值显著增长(P=0.000),提升幅度显著高于对照组(P=0.008);②试验组受试者的肌肉形态3项指标均显著高于试验前测(P=0.000),而对照组肌肉厚度指标呈显著性下降(P=0.020),羽状角无显著性变化,横截面积显著性提升(P=0.000);③组间对比发现,试验组关于肌肉形态的肌肉厚度(P=0.012)、羽状角(P=0.003)及横截面积(P=0.049)3项指标均显著高于对照组;④上述数据证实,健康成年受试者经过4周的低频脉冲磁场慢性暴露,股四头肌的最大自主收缩力显著提升,同时观察到试验组的肌肉厚度、横截面积及羽状角3项肌肉形态指标的显著增长,对使用该技术作为肌肉改善的运动替代与医疗策略提供了肌组织形态改善的支持依据。

峡部裂腰椎滑脱患者椎旁肌对脊柱-骨盆矢状面的影响:肌肉数量和质量的评估

背景:横截面积和脂肪浸润为量化椎旁肌的标准参数,但是太过繁琐和费时,需要引入新的量化指标。目的:探讨峡部裂性腰椎滑脱患者椎旁肌和脊柱-骨盆矢状面参数测量值之间的关系,以及腰椎压痕值对矢状面平衡的预测价值。方法:选择诊断为峡部裂性腰椎滑脱的患者87例,均为Meyerding分型Ⅱ度滑脱,男40例,女47例,平均年龄(51.4±9.1)岁。测量患者脊柱-骨盆矢状面参数矢状面轴向距离、骨盆入射角、骨盆倾斜角、骶骨倾斜角、腰椎前凸角、胸椎后凸角、骨盆投射角与腰椎前凸角之差,以及腰椎旁肌的总横截面积、功能横截面积和脂肪浸润。使用Pearson相关分析法探讨矢状面参数与椎旁肌测量值的相关性;使用多元线性回归分析腰椎压痕值、年龄、性别和体质量指数对脊柱骨盆矢状面平衡的影响。通过受试者工作特征曲线寻找腰椎压痕值的最佳截断点,评价矢状面轴向距离和骨盆投射角与腰椎前凸角之差的关系。结果与结论:(1)根据Pearson相关分析结果,多裂肌总横截面积与腰椎前凸角(r=0.464,P <0.01)和骨盆投射角与腰椎前凸角之差(r=-0.306,P <0.01)显著相关;多裂肌功能横截面积与腰椎前凸角(r=0.367,P <0.01)和骨盆投射角与腰椎前凸角之差(r=-0.228,P <0.05)存在显著相关性;腰椎压痕值与矢状面轴向距离(r=-0.300,P <0.01)、腰椎前凸角(r=0.417,P <0.01)、胸椎后凸角(r=0.351,P <0.01)和骨盆投射角与腰椎前凸角之差(r=-0.319,P <0.01)有显著相关性;(2)根据多元线性回归分析结果,腰椎压痕值和骨盆投射角与腰椎前凸角之差以及矢状面轴向距离独立相关;腰椎压痕值≤11.5 mm的患者矢状面轴向距离≤50 mm发生率为55%(11/20),而腰椎压痕值> 11.5 mm的患者矢状面轴向距离≤50 mm发生率为96%(64/67);骨盆投射角与腰椎前凸角之差≤11.5 mm的患者骨盆投射角与腰椎前凸角之差≤10°的发生率为30%(6/20),而腰椎压痕值> 11.5 mm的患者骨盆投射角与腰椎前凸角之差≤10°的发生率为66%(44/67);(3)提示多裂肌总横截面积和功能横截面积均与腰椎前凸角和骨盆投射角与腰椎前凸角之差显著相关;腰椎压痕值作为评价椎旁肌退变的新指标,与矢状面轴向距离和骨盆投射角与腰椎前凸角之差独立相关,对术后矢状面矫正有一定的预测价值,是一种简单实用的评估脊柱-骨盆矢状面和椎旁肌退变的方法;椎旁肌的退变与脊柱-骨盆矢状面平衡有关。

Association of ratios of visceral fat area/subcutaneous fat area and muscle area/standard body weight at T12 CT level with the prognosis of acute respiratory distress syndrome

Background:It is well-known that body composition metrics can influence the prognosis of various diseases.This study investigated how body composition metrics predict acute respiratory distress syndrome(ARDS)prognosis,focusing on the ratio of visceral fat area(VFA)to subcutaneous fat area(SFA),SFA to standard body weight(SBW),VFA to SBW,and muscle area(MA)to SBW.These metrics were assessed at the level of the twelfth thoracic vertebra(T12 computed tomography[CT]level)to determine their correlation with the outcomes of ARDS.The goal was to utilize these findings to refine and personalize treatment strategies for ARDS.Methods:Patients with ARDS admitted to the intensive care units(ICUs)of three hospitals from January 2016 to July 2023 were enrolled in this study.Within 24 hours of ARDS onset,we obtained chest CT scans to mea-sure subcutaneous fat,visceral fat,and muscle area at the T12 level.We then compared these ratios between survivors and non-survivors.Logistic regression was employed to identify prognostic risk factors.Receiver oper-ating characteristic(ROC)curve analysis was utilized to determine the optimal cutofffor predictors of in-hospital mortality.Based on this cutoff,patients with ARDS were stratified.To reduce confounding factors,1:1 propensity score matching(PSM)was applied.We conducted analyses of clinical feature and prognostic differences pre-and post-PSM between the stratified groups.Additionally,Kaplan-Meier survival curves were generated to compare the survival outcomes of these groups.Results:Of 258 patients with ARDS,150 survived and 108 did not.Non-survivors had a higher VFA/SFA ra-tio(P<0.001)and lower SFA/SBW and MA/SBW ratios(both P<0.001).Key risk factors were high VFA/SFA ratio(OR=2.081;P=0.008),age,acute physiology and chronic health evaluation(APACHE)II score,and lac-tate levels,while MA/SBW and albumin were protective.Patients with a VFA/SFA ratio≥0.73 were associated with increased mortality,while those with an MA/SBW ratio>1.55 cm^(2)/kg had lower mortality,both pre-and post-PSM(P=0.001 and P<0.001,respectively).Among 170 patients with pulmonary-origin ARDS,87 survived and 83 did not.The non-survivor group showed a higher VFA/SFA ratio(P<0.001)and lower SFA/SBW and MA/SBW(P=0.003,P<0.001,respectively).Similar risk and protective factors were observed in this cohort.For VFA/SFA,a value above the cutoffof 1.01 predicted higher mortality,while an MA/SBW value below the cutoffof 1.48 cm2/kg was associated with increased mortality(both P<0.001 pre-/post-PSM).Conclusions:Among all patients with ARDS,the VFA to SFA ratio,MA to SBW ratio at the T12 level,age,APACHE II score,and lactate levels emerged as independent risk factors for mortality.

Exposed Cross-section of the Archaean Lower Crustin the Shanxi-Hebei-Inner Mongolia Border Region:Problems and Prospects

The Archaean lower crust represented by granulite facies rocks, which is rare in China, is found to be exposed in the Shanxi-Hebei-Inner Mongolia border region. Studies of the regional structure and deformation and metamorphism of the region indicate that there occurred at least two phases of deformation and metamorphism in the region. Early-phase nearly E-W-directed deformational structure is well preserved in the Zhangjiakou-Xuanhua area. Observations of the features of the geological structure from north to south (in the Hengshan metamorphic terrain) have revealed a possible exposed cross-section through the Archaean lower crust. The structure was superimposed by a NE-SW-trending high-temperature ductile shear zone in the Datong area in the late phase, thus reworking the Archaean sequence.

Optimal Minimum Number of CT Slices Required to Measure Cross Sectional Areas of Small Pulmonary Vessels

The cross-sectional area (CSA) of small pulmonary vessels can be quantified by CT, which is a reliable method of evaluating vascular alterations in such vessels. However, the optimal number of slices required for accurate quantitation remains unknown. We evaluated relationships among all slices at 10-mm interval and all slices at 3-cm interval, 6-cm interval, and 3-slices and found the closest correlation (0.939) between all slices at 10-mm intervals and 3-cm intervals. Thus, all slices at 3-cm intervals are suitable for accurately measuring CSA.