骨骼放射学会骨影像报告和数据系统(Bone-RADS):成人偶发孤立性骨病变CT和MRI诊断管理指南解读

常规临床实践中,CT和MRI经常发现偶发的孤立性骨病变,而这些病变的诊断管理一直缺乏清晰一致的指南。针对以上情况,2022年9月份,国际骨骼放射学会(SSR)实践指南和技术标准委员会发布了全球第1版骨影像报告和数据系统(Bone-RADS),旨在规范孤立性骨病变的CT和MRI诊断管理流程,对CT骨透亮影、硬化性、混杂密度骨病变,以及MRI T1WI高信号、T1WI等或低信号、T2WI高和低信号骨病变做了详细定义,并依据两种CT分类(透亮影、硬化性或混杂密度影)、两种MRI分类(T1WI高信号、T1WI低信号)分别提供了对应的诊断管理流程,共分为4类:Bone-RADS 1,无需处理;Bone-RADS 2,建议其他影像学检查;Bone-RADS 3,建议随访复查;Bone-RADS 4,建议活检和/或骨肿瘤转诊。文章拟对该Bone-RADS进行详细解读,有利于广大放射科医师更好地掌握成人CT和MRI偶发孤立性骨病变的诊断管理。

α-骨化醇(BONE-ONE)治疗Ⅱ型糖尿病合并骨质疏松症的临床观察

本研究目的在于观察α－骨化醇（ＢＯＮＥ－ＯＮＥ）对糖尿病合并骨质疏松长期治疗的安全性和有效性。绝经后女性Ⅱ型糖尿病合并骨质疏松２９例，随机选择其中２０例为糖尿病治疗组，９例为糖尿病对照组，年龄等相匹配老年女性骨质疏松１０例（老年治疗组）共三组病人进行６个月药物治疗，糖尿病治疗组及老年治疗组服用α－骨化醇剂量为０．５μｇ·ｄ－１。研究结果：糖尿病与老年治疗组在治疗３个月、６个月后骨密度增高、骨形成指标增加（ＢＰＧ）、骨吸收指标减少（Ｃｒｏｓｓｌａｐ／Ｃｒ）和骨痛缓解率明显增加，分别是：骨密度由０．３２３±０．０１，０．２９７±０．０３（ｇ／ｃｍ２）升至０．４１５±０．０６，０．３７８±０．０３（ｇ／ｃｍ２）；ＢＧＰ由１０．１９±０．７９，９．２４±１．２６（ｍｇ·Ｌ－１）升至１５．８９±０．１２，１４．５５±１．１２（ｍｇ·Ｌ－１）；骨吸收指标Ｃｒｏｓｌａｐ／Ｃｒ由３６３．７±９１．３，４２０．２±１０７．９（μｇ·ｍｍｏｌ－１）减至２２６．９±５３．７，１６２．１４±５３．７（μｇ·ｍｍｏｌ－１）但两组间无显著差异，糖尿病对照组无变化。研究结果表明：糖尿病合并骨质疏松病人在良好控制血糖基础上服用α－骨化醇?

Modulation of Isoflavones on Bone-nodule Formation in Rat Calvaria Osteoblasts in vitro

Objective To observe the effects of two main isoflavones, daidzein and genistein on the bone-nodule formation in rat calvaria osteoblasts in vitro. Methods Osteoblasts obtained from newborn Sprague-dawley rat calvarias were cultured for several generations. The second generation cells were cultured in Minimum Essential Medium supplemented with ascorbic acid and Na-beta-glycerophosphate for several days, in the presence of daidzein and genistein, with or without the estrogen receptor antagonist ICI 182780. Number of nodules was counted at the end of the incubation period (day 20) by staining with Alizarin Red S calcium stain. The release of osteocalcin, as a marker of osteoblast activity, was also determined on day 7 and day 12 during the incubation period. Results Compared with the control, the numbers of nodules were both increased by incubation with daidzein and genistein. 17β-estradiol was used as a positive control and proved to be a more effective inducer of the increase in bone-nodules formation than daidzein and genistein. The release of osteocalcin into culture media was also increased in the presence of daidzein and genistein, as well as 17β-estradiol on day 7 and day 12 (day 12 were higher). The estrogen receptor antagonist ICI 182780 completely blocked the genistein- and 17β-estradiol-induced increase of nodule numbers and osteocalcin release in osteoblasts. However, the effects induced by daidzein could not be inhibited by ICI 182780. Conclusion These findings suggest that geinistein can stimulate bone-nodule formation and increase the release of osteocalcin in rat osteoblasts. The effects, like those induced by 17β-estradiol, are mediated by the estrogen receptor dependent pathway. Daidzein also can stimulate bone-nodule formation and increase the release of osteocalcin in rat osteoblasts, but it is not, at least not merely, mediated by the estrogen receptor dependent pathway.

Anterolateral rotatory instability in vivo correlates tunnel position after anterior cruciate ligament reconstruction using bone-patellar tendon-bone graft

AIM To quantitatively assess rotatory and anterior-posterior instability in vivo after anterior cruciate ligament(ACL) reconstruction using bone-patellar tendon-bone(BTB) autografts, and to clarify the influence of tunnel positions on the knee stability.METHODS Single-bundle ACL reconstruction with BTB autograft was performed on 50 patients with a mean age of 28 years using the trans-tibial(TT)(n = 20) and trans-portal(TP)(n = 30) techniques. Femoral and tibial tunnel positions were identified from the high-resolution 3 D-CT bone models two weeks after surgery. Anterolateral rotatory translation was examined using a Slocum anterolateral rotatory instability test in open magnetic resonance imaging(MRI) 1.0-1.5 years after surgery, by measuring anterior tibial translation at the medial and lateral compartments on its sagittal images. Anterior-posterior stability was evaluated with a Kneelax3 arthrometer.RESULTS A total of 40 patients(80%) were finally followed up. Femoral tunnel positions were shallower(P < 0.01) and higher(P < 0.001), and tibial tunnel positions were more posterior(P < 0.05) in the TT group compared with the TP group. Anterolateral rotatory translations in reconstructed knees were significantly correlated with the shallow femoral tunnel positions(R = 0.42, P < 0.01), and the rotatory translations were greater in the TT group(3.2 ± 1.6 mm) than in the TP group(2.0 ± 1.8 mm)(P < 0.05). Side-to-side differences of Kneelax3 arthrometer were 1.5 ± 1.3 mm in the TT, and 1.7 ± 1.6 mm in the TP group(N.S.). Lysholm scores, KOOS subscales and reinjury rate showed no difference between the two groups.CONCLUSION Anterolateral rotatory instability significantly correlated shallow femoral tunnel positions after ACL reconstruction using BTB autografts. Clinical outcomes, rotatory and anterior-posterior stability were overall satisfactory in both techniques, but the TT technique located femoral tunnels in shallower and higher positions, and tibial tunnels in more posterior positions than the TP technique, thus increased the anterolateral rotation. Anatomic ACL reconstruction with BTB autografts may restore knee function and stability.

Skin reactions caused by bone-anchored hearing aid(BAHA) implantation

Objective: To report a case of intractable skin reactions caused by bone-anchored hearing aid (BAHA) implantation to improve our under-standing and treatment of BAHA implantation-caused skin reactions. Methods:We reported a case of severe skin reactions caused by BAHA implantation. Related literature were also reviewed. Results:We found grade IV skin reactions, including hyperplasia around the implant, which led to the removal of the BAHA implant 10 months after implantation. The findings indicated poor skin hygiene, allergy to titanium and inadequate surgicals skills as the possible causes of the skin reaction. Conclusion: Skin adverse reactions, usually rare in BAHA implantation patients, may cause implant removal and implantation failure. We suggest to further investigate the mechanisms underlying titanium allergy. Copyright ? 2016, PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Speech Signal Detection Based on Bayesian Estimation by Observing Air-Conducted Speech under Existence of Surrounding Noise with the Aid of Bone-Conducted Speech

In order to apply speech recognition systems to actual circumstances such as inspection and maintenance operations in industrial factories to recording and reporting routines at construction sites, etc. where hand-writing is difficult, some countermeasure methods for surrounding noise are indispensable. In this study, a signal detection method to remove the noise for actual speech signals is proposed by using Bayesian estimation with the aid of bone-conducted speech. More specifically, by introducing Bayes’ theorem based on the observation of air-conducted speech contaminated by surrounding background noise, a new type of algorithm for noise removal is theoretically derived. In the proposed speech detection method, bone-conducted speech is utilized in order to obtain precise estimation for speech signals. The effectiveness of the proposed method is experimentally confirmed by applying it to air- and bone-conducted speeches measured in real environment under the existence of surrounding background noise.

Novel Bone-targeted Agents for Treatment of Osteoporosis

The novel bone-targeted agents were designed and synthesized by the combination of raloxifene and bisphosphonates. The anti-osteoporosis effect was evaluated by bone mineral density (BMD) obtained from OVX mice in vivo. The results indicated that the compound 8, 9 not only prevented ovariectomy induced loss of bone but also enhanced BMD to 0.87% and 19.67% compared to Sham, respectively.

Preparation of Bone-like Hydroxyapatite via a Reverse Microemulsion

Bone-like hydroxyapatite （ HAp ） powders were synthesized using a reverse microemulsion method without further calcine processing. Synthesis conditions had significant effects on the formation of HAp. According to the results of XRD patterns and FFIR spectra, the obtained needle shape HAp powder with poorly crystallized and carbonate substitution was chemically and structurally similar to the human bone powders. The alkaline of emulsion was responsible for the obtained HAp without calcine route, and carbonate came from CO2 in air during preparation. By ultrasonic treatment, the morphology of HAp particles changed from spherical to needle shape for the reverse micelles broke up due to the high energy of ultrasonic.

The Origin of Neointimal Smooth Muscle Cells in Transplant Arteriosclerosis from Recipient Bone-marrow Cells in Rat Aortic Allograft

In order to investigate the origin of neointimal smooth muscle cells in transplant arterio- sclerosis in rat aortic allograft, sex-mismatched bone marrow transplantation was performed from male Wistar rats to female Wistar rats. Four weeks after transplantation, the aortic transplant model was established by means of micro-surgery in rats. The recipients were divided into 4 groups: female Wistar-female Wistar aortic isografts, female SD-female Wistar aortic allografts, male SD-male Wis- tar aortic allografts, female SD-chimera Wistar aortic allografts. Eight weeks after transplantation, aortic grafts were removed at autopsy and processed for histological evaluation and immunohisto- chemistry. The results indicated that excessive accumulation of α-SMA-positive smooth muscle cells resulted in significant neointima formation and vascular lumen stricture in rat aortic allografts. Neointima assay revealed that the neointimal area and NIA/MA ratio of transplanted artery were sig- nificantly increased in all of aortic allograft groups as compared with those in aortic isograft group (P<0.01). Neointimal smooth muscle cells were harvested from cryostat sections of aortic allograft by microdissection method. The Sry gene-specific PCR was performed, and the result showed that a dis- tinct DNA band of 225 bp emerged in the male-male aortic allograft group and chimera aortic al- lograft group respectively, but not in the female-female aortic allograft group. It was suggested that recipient bone-marrow cells, as the origin of neointimal smooth muscle cells, contributed to the pathological neointimal hyperplasia of aortic allograft and transplant arteriosclerosis.

Heritage and Development of Ningbo Bone-Inlaid Wooden Works

Bone-inlaid wooden art is a very old artistic form that has a strong artistic appeal and local flavor. It can be traced back to the Longshan Culture in the late Neolithic Age, and becomes mature in the late Qing Dynasty. As time lapses, however, bone-inlaid wooden art is gradually out of sight. It was not until June 2008 when Ningbo bone-inlaid wooden art was included in the "second batch of national intangible cultural heritage protection list" that it once again caused social concern. Ningbo bone-inlaid wooden art has a long history, and its craftsmanship is complex. Many bone-inlaid wooden works in Ningbo have been damaged more or less. Therefore, workers in the field of heritage protection should undertake a more systematic protection and repair work based on scientific research, making contributions to the heritage and development of intangible cultural heritage.

Effects of Lanthanum on Formation and Bone-Resorbing Activity of Osteoclast-Like Cells

The effect of La^(3+) on formation of osteoclast-like cells in rabbit bone marrow cells induced by 1,25-dihydroxyvitamin D_3 and their bone-resorbing activity was evaluated by counting the number of tartrate resistant-acid phosphatase-positive [TRAP(+)] multi-nucleated cells and measuring the number and surface area of bone resorption pits with photomicrography and image analysis. The formation and morphological characteristics of osteoclast-like cells and bone resorption pits were observed under a phase contrast inverted microscope. La^(3+) promotes the formation of osteoclast-like cells at the concentration of 1.00×10^(-8)mol·L^(-1) compared with the control group(P<(0.01)), whereas no significant change in cell number is observed at higher concentrations(1.00×10^(-5), (1.00×)10^(-6) and 1.00×10^(-7) mol·L^(-1))(P>0.05). La^(3+) at the concentration of 1.00×10^(-8)mol·L^(-1) also increases the number and surface area of the resorption pits(P<0.01), but inhibits the bone-resorbing activity dose-dependently(P<0.01)at higher concentrations(1.00×10^(-5), 1.00×10^(-6) and 1.00×10^(-7) mol·L^(-1)). These findings suggest that La^(3+) may promote or inhibit the formation and bone-resorbing activity of osteoclast-like cells depending on its concentration.

Bone-marrow mesenchymal stem cells reduce rat intestinal ischemia-reperfusion injury, ZO-1 downregulation and tight junction disruption via a TNF-α-regulated mechanism

AIM: To investigate the effect of bone-marrow mesenchymal stem cells (BM MSCs) on the intestinal mucosa barrier in ischemia/reperfusion (I/R) injury. METHODS: BM MSCs were isolated from male Sprague-Dawley rats by density gradient centrifugation, cultured, and analyzed by flow cytometry. I/R injury was induced by occlusion of the superior mesenteric artery for 30 min. Rats were treated with saline, BM MSCs (via intramucosal injection) or tumor necrosis factor (TNF)-α blocking antibodies (via the tail vein). I/R injury was assessed using transmission electron microscopy, hematoxylin and eosin (HE) staining, immunohistochemistry, western blotting and enzyme linked immunosorbent assay.RESULTS: Intestinal permeability increased, tight junctions (TJs) were disrupted, and zona occludens 1 (ZO-1) was downregulated after I/R injury. BM MSCs reduced intestinal mucosal barrier destruction, ZO-1 downregulation, and TJ disruption. The morphological abnormalities after intestinal I/R injury positively correlated with serum TNF-α levels. Administration of anti-TNF-α IgG or anti-TNF-α receptor 1 antibodies attenuated the intestinal ultrastructural changes, ZO-1 downregulation, and TJ disruption. CONCLUSION: Altered serum TNF-α levels play an important role in the ability of BM MSCs to protect against intestinal I/R injury.

Biologically Inspired Self-assembling Synthesis of Bone-like Nano-hydroxyapatite/PLGA-(PEG-ASP)_n Composite: A New Biomimetic Bone Tissue Engineering Scaffold Material

A new biomimetic bone tissue engineering scaffold material, nano-HAI PLGA-（ PEG-Asp ）n composite, was synthesized by a biologically inspired self-assembling approach. A novel biodegradable PLGA- （ PEG-Asp ）n copolymer with pendant amine functional groups and enhanced hydrophilicity woo synthesized by bulk ring-opening copolymerization by DL-lactide（ DLLA） and glycolide（ GA ） with Aspartic acid （ Asp ）-Polyethylene glycol（PEG） alt-prepolymer. A Three-dimensional, porous scaffold of the PLGA-（ PEG- Asp）n copolymer was fabricated by a solvent casting , particulate leaching process. The scaffold woo then incubated in modified simulated body fluid （naSBF）. Growth of HA nanocrystals on the inner pore surfaces of the porous scaffold is confirmed by calcium ion binding analyses, SEM , mass increooe meoourements and quantification of phosphate content within scaffolds. SEM analysis demonstrated the nucleation and growth of a continuous bonelike, low crystalline carbonated HA nanocrystals on the inner pore surfaces of the PLGA- （ PEG-Asp ）n scaffolds. The amount of calcium binding, total mass and the mass of phosphate on experimental PLGA- （ PEG-Asp ） n scaffolds at different incubation times in mSBF was significantly greater than that of control PLGA scaffolds. This nano-HA/ PLGA-（ PEG- Asp ）n composite stunts some features of natural bone both in main composition and hierarchical microstrueture. The Asp- PEG alt-prepolymer modified PleA copolymer provide a controllable high surface density and distribution of anionic functional groups which would enhance nucleation and growth of bonelike mineral following exposure to mSBF. This biomimetic treatment provides a simple method for surface functionalization and sabsequent mineral nucleation and self-oosembling on bodegradable polymer scaffolds for tissue engineering.

An elevated serum miR-141 level in patients with bone-metastatic prostate cancer is correlated with more bone lesions

The skeleton is the most common metastatic organ in patients with prostate cancer （PCa）. Non-invasive biomarkers that can facilitate the detection and monitoring of bone metastases are highly desirable. We designed this study to assess the expression patterns of serum miR-141 in patients with bone-metastatic PCa. Serum samples were collected to measure the miR-141 level in 56 patients, including six with benign prostatic hyperplasia （BPH）, 20 with localized PCa and 30 with bone-metastatic PCa （10 with hormone-naive PCa, 10 with hormone-sensitive PCa and 10 with hormone-refractory PCa）. A bone scan was performed for each patient with PCa to assess the number of bone lesions. The quantification of serum miR-141 levels was assayed by specific TaqMan qRT-PCR. The results showed that serum miR-141 levels were elevated in patients with bone metastasis （P〈O.O01）. There was no statistically significant difference in the serum miR-141 levels between patients with BPH and patients with localized PCa. Using Kendall＇s bivariate correlation test, both the Gleason score and the number of bone-metastatic lesions were found to correlate with serum miR-141 levels （P=0.012 and P〈O.O01, respectively）. The serum miR-141 level was found to be positively correlated with alkaline phosphatase （ALP） level in patients with skeletal metastasis, using Pearson＇s bivariate correlation test. No relationship was found between the serum miR-141 level and the serum prostate-specific antigen （PSA） level. We concluded that serum miR-141 levels are elevated in patients with bone-metastatic PCa and that patients with higher levels of serum miR-141 developed more bone lesions. Furthermore, serum miR-141 levels are correlated with serum ALP levels but not serum PSA levels.

Bone-like apatite formation on HA/316L stainless steel composite surface in simulated body fluid

HA/316L stainless steel(316L SS) biocomposites were prepared by hot-pressing technique. The formation of bone-like apatite on the biocomposite surfaces in simulated body fluid(SBF) was analyzed by digital pH meter,plasma emission spectrometer,scanning electron microscope(SEM) and energy dispersive X-ray energy spectrometer(EDX). The results indicate that the pH value in SBF varies slightly during the immersion. It is a dynamic process of dissolution-precipitation for the formation of apatite on the surface. With prolonging immersion time,Ca and P ion concentrations increase gradually,and then approach equilibrium. The bone-like apatite layer forms on the composites surface,which possesses benign bioactivity and favorable biocompatibility and achieves osseointegration,and can provide firm fixation between HA60/316L SS composite implants and human body bone.

SUBJECTIVE TINNITUS AS FIRST PRESENTATION IN A PATIENT WITH METASTATIC LUNG CANCER IN TEMPORAL BONE-A CASE REPORT

Metastasis of lung cancer to the temporal bone is a very rare disease and subjective tinnitus as the present-ing symptom in these patients is even rarer. Here we report a case in which a 42-year-old male presented with subjective tinnitus of three months, with no pulmonary disease symptoms. Pure tone audiometry indi-cated moderate conductive deafness in left ear with an air-bone gap of 21.3 dB. HRCT temporal bone scan-ning indicated high-density shadows in the left epitympanic cavity, sinus tympani and mastoid cavity. Chron-ic otitis media with cholesteatoma was suspected and surgical treatment recommended. However, preopera-tive chest x-ray revealed high-density millet lesions scattered widely in both lungs. HRCT lung scanning confirmed the lungs lesions and indicated lung cancer. In order to determine correlations between the tempo-ral bone and pulmonary lesions, a CT-guided trans-mastoid aspiration biopsy and immunohistochemical study were conducted, which confirmed that the temporal bone lesion was metastatic from the lungs. The pa-tient was given a series of chemotherapy immediately and his tinnitus significantly improved after three months of treatment, with full recovery of his hearing and complete resolution of shadows in the mastoid cavity. Unfortunately, he subsequently developed multiple bone metastases in the 9th month and cerebral metastasis in the 18th month. Multiple organ failure resulted in death in 2.5 years.

Fish bone-induced myocardial injury leading to a misdiagnosis of acute myocardial infarction: A case report

BACKGROUND Acute chest pain(ACP)is very common among patients presenting to emergency departments.Nevertheless,ACP caused by esophageal foreign body is relatively rarely reported.CASE SUMMARY A 56-year-old man suffering from chest pain(increased pain for the last 9 h)was admitted to our hospital on October 25,2015.After undergoing physical examination and laboratory blood testing,he was diagnosed with acute anterior myocardial infarction.Consequently,the patient underwent emergency percutaneous coronary angiography;however,no myocardial infarction signs were observed.Later on,the patient experienced respiration failure and therefore was transferred to intensive care unit.Cardiac ultrasound showed pericardial effusion,which was considered as the cause of shock.He then underwent pericardium puncture drainage and the circulation temporarily improved.Nevertheless,persistent pericardial bleeding,unclear bleeding causes,and clot formation induced poor drainage led to worsening of cardiac tamponade symptoms.Consequently,the patient underwent emergency exploratory thoracotomy,which revealed a fish bone causing pericardial bleeding.The bone was removed,and the damaged blood vessels were mended.Eventually,the patient was discharged in good clinical condition.CONCLUSION For patients with chest pain,it is necessary to consider the possibility of foreign body in the esophagus or even in the heart.Careful history taking and the corresponding inspection can help to avoid unnecessary damage and safeguard patients from unnecessary pain.

Approach to reducing the effect of bone-coal power station on radiation environment

The effect of two bone-coal power stations(6MWe) on environment was investigated within the scope of the dose contribution caused by various radionucildes in different ways.It is found that the best measures to reduce the effect of bone-coal power station on radiation environment include to select a fine boiler system and a comprehensive utilization of the bone-coal cinder(BCC),soot and ash in the catchers.

Odd couple: The unexpected partnership of glucocorticoid hormones and cysteinyl-leukotrienes in the extrinsic regulation of murine bone-marrow eosinopoiesis

Granulopoiesis in murine bone-marrow is regulated by both intrinsic and extrinsic factors(including hormones, drugs, inflammatory mediators and cytokines). Eosinophils, a minor subpopulation of circulating leukocytes, which remains better understood in its contributions to tissue injury in allergic disease than in its presumably beneficial actions in host defense, provide a striking example of joint regulation of granulopoiesis within murine bone-marrow by all of these classes of extrinsic factors. We first described the upregulation of eosinopoiesis in bone-marrow of allergen-sensitized mice following airway allergen challenge. Over the last decade, we were able to show a critical role for endogenous glucocorticoid hormones and cytokines in mediating this phenomenon through modification of cytokine effects, thereby supporting a positive association between stress hormones and allergic reactions. We have further shown that cysteinylleukotrienes(Cys LT), a major proinflammatory class of lipid mediators, generated through the 5-lipoxygenase pathway, upregulate bone-marrow eosinopoiesis in vivo and in vitro. Cys LT mediate the positive effects of drugs(indomethacin and aspirin) and of proallergic cytokines(eotaxin/CCL11 and interleukin-13) on in vitro eosinopoiesis. While these actions of endogenous GC and Cys LT might seem unrelated and even antagonistic, we demonstrated a critical partnership of these mediators in vivo, shedding light on mechanisms linking stress to allergy: GC are required for Cys LT-mediated upregulation of bone-marrow eosinopoiesis in vivo, but also attenuate subsequent ex vivo responses to Cys LT. GC and Cys LT therefore work together to induce eosinophilia, but through subtle regulatory mechanisms also limit the magnitude of subsequent bone-marrow responses to allergen.

Natural radioactivity level of associated bone-coal mining area in Zhejiang Province

The geographic distribution, γ-radiation level and specific activity of radionuclides of the bone-coal mines in Zhejiang Province were reported. The weighted average of γ-radiation dose rate of the bone-coal mines is 566 nGy/h for 107 main bone-coal mines. The weighted mean activity of 238U, 226Ra, 232Th and 40K in the samples are 949, 918, 34 and 554 Bq/kg for 171 samples of bone-coal, respectively.