Correlation Study of Aortic Velocity Propagation, Abdominal Aortic Intima-Media Thickness, and Epicardial Adipose Tissue Thickness in Subclinical Hypothyroidism Patients

Objective:To explore the correlation between epicardial fat thickness(EFT),aortic velocity propagation(AVP),and abdominal aortic intima-media thickness(AA-IMT)in patients with subclinical hypothyroidism(SH).Additionally,to compare these indicators between SH patients and healthy individuals,providing a new theoretical basis for the clinical prevention and treatment of cardiovascular diseases.Method:Clinical data from 50 SH patients(23 males and 27 females)and 50 healthy outpatient examinees(22 males and 28 females)were analyzed.The participants were selected from January 2022 to December 2023 at Loudi Central Hospital.EFT,AVP,and AA-IMT were measured,and their correlations were analyzed.Results:SH patients had significantly higher EFT and AA-IMT levels than the control group,while their AVP was significantly lower,with these differences being statistically significant(P<0.05).Correlation analysis revealed a significant negative correlation between EFT and AVP(P<0.001),a significant positive correlation between EFT and AAO-IMT(P<0.001),and a significant negative correlation between AVP and AAO-IMT(P<0.001).Multivariate binary logistic regression analysis identified increased EFT,decreased AVP,and increased AAO-IMT as independent risk factors for SH patients.Conclusion:In SH patients,EFT and AAO-IMT are elevated,whereas AVP is reduced.EFT and AVP are significantly correlated with AAO-IMT.EFT and AAO-IMT can serve as reliable indicators for evaluating subclinical atherosclerosis in SH patients,providing a diagnostic basis for clinical practice.

Subcutaneous fat thickness and abdominal depth are risk factors for surgical site infection after gastric cancer surgery

BACKGROUND Surgical site infection(SSI)is one of the most common complications after gastric cancer(GC)surgery.The occurrence of SSI can lead to a prolonged postoperative hospital stay and increased medical expenses,and it can also affect postoperative rehabilitation and the quality of life of patients.Subcutaneous fat thickness(SFT)and abdominal depth(AD)can be used as predictors of SSI in patients undergoing radical resection of GC.AIM To explore the potential relationship between SFT or AD and SSI in patients undergoing elective radical resection of GC.METHODS Demographic,clinical,and pre-and intraoperative information of 355 patients who had undergone elective radical resection of GC were retrospectively collected from hospital electronic medical records.Univariate analysis was performed to screen out the significant parameters,which were subsequently analyzed using binary logistic regression and receiver-operating characteristic curve analysis.RESULTS The prevalence of SSI was 11.27%(40/355).Multivariate analyses revealed that SFT[odds ratio(OR)=1.150;95%confidence interval(95%CI):1.090-1.214;P<0.001],AD(OR=1.024;95%CI:1.009-1.040;P=0.002),laparoscopic-assisted surgery(OR=0.286;95%CI:0.030-0.797;P=0.017),and operation time(OR=1.008;95%CI:1.001-1.015;P=0.030)were independently associated with the incidence of SSI after elective radical resection of GC.In addition,the product of SFT and AD was a better potential predictor of SSI in these patients than either SFT or AD alone.CONCLUSION SFT and AD are independent risk factors and can be used as predictors of SSI in patients undergoing radical resection of GC.

Usefulness of the epicardial fat tissue thickness as a diagnostic criterion for geriatric patients with metabolic syndrome

Objective To evaluate the epicardial fat tissue thickness （EFTT） as a diagnostic criterion for geriatric patients with metabolic syn- drome （MetS）. Methods Sixty geriatric patients over 65 years of age were recruited for the study. Patients were divided into two groups： Group 1 （n = 30） consisted of patients with MetS; Group 2 （n = 30） consisted of patients without MetS. Echocardiography was used to measure EFTT in all patients, and blood samples were analyzed for biochemical parameters. Results Compared to Group 2, EFTT levels of Group 1 were statistically higher （P 〈 0.05）. In a binary logistic regression analysis, EFTT levels served as the independent factor for meta- bolic syndrome 03 = 17.35, SE = 4.93, Wald = 12.36, P 〈 0.001）. Receivers operating characteristic Curve （ROC-curve） analysis revealed that EFTT predicted MetS with 96.7% sensitivity and 86.7% specificity above the level of 7.3 mm [area under the curve = 0.969; 95% con- fidence interval （CI）： 0.928-1.00]. Conclusions The present study demonstrated that serum EFTT levels were higher in geriatric patients with MetS and can therefore be used as a diagnostic criterion for MetS.

The relation between epicardial fat thickness and metabolic syndrome

To the editor We read the article Usefulness of the epicardial fat tissue thickness as a diagnostic criterion for geriatric patients with metabolic syndrome by Kaya, et al. The authors aimed to evaluate the epicardial fat tissue thickness （EFT） as a diagnostic criterion for geriatric patients with metabolic syndrome （MetS）. They concluded that EFT levels were higher in geriatric patients with MetS and can therefore be used as a diagnostic criterion for MetS.

Epicardial Fat Thickness and its Association as a Risk Factor for Coronary Artery Disease

Background of study aims and objective:Epicardial fat thickness is a novel parameter for predicting outcome and assessment of severity of coronary artery disease. Our present study aims to establish an association between epicardial fat thickness and coronary artery disease. Materials & Methods: Patients of suspected CAD underwent coronary angiography. 100 subjects proven as confirmed cases were included in the study. Routine clinical examination, risk factor profile and anthropometric variables were also done. Severity of CAD was assessed using Gensini Score. Epicardial fat thickness was measured using 2D ECHO. For comparative analysis, 50 healthy individuals were also included in the study. Results: Epicardial fat thickness was significantly higher in cases (7.53 ± 1.79 mm) than controls (4.24 ± 1.09 mm). Female sex, hypertension, dyslipidemia, obesity were observed to affect EFT significantly. No difference in mean EFT was observed with age, diabetes, smoking, ECG changes and arterial territory involvement. BMI and Gensini scores both showed strong positive correlation with epicardial fat thickness. Conclusion: Epicardial fat thickness is associated and linearly correlates with onset and severity of CAD.

Somatotypological Features of the Skin Fat Fold Thickness in Ethnic Kyrgyz Women

The purpose of this study was to determine the thickness of skin and fat folds in Kyrgyz women of various ages, taking into account their somatotypological profile. Using the method of complex anthropometry, including the determination of the values of 21 anthropometric parameters, the physical status of 1028 Kyrgyz women of different age groups was studied youth (16 - 20 years old 310 girls), mature age (1st period, 21 - 35 years old 308 women;2nd period, 36 - 55 years 410 women) living in Osh, Kyrgyzstan. For somatotyping, we used the scheme of constitutional diagnostics. Seven somatotypes distinguished within three constitutional groups. The subcutaneous fat was measured by caliperometry. Statistical processing carried out using the statistical programs Microsoft Excel and the STATISTICA package (v. 6.0). To determine the reliability of the differences between the indicators, the Student’s test was used (p < 0.05). The results demonstrate that within each somatotype there are broad changes in the studied anthropometric indicator. Thus, the thickness of the skin and fat folds is the smallest in women of asthenic, athletic and stenoplastic (p < 0.05), and the largest in representatives of the euriplastic and pycnic somatotypes (p < 0.05). Thus, indicators of physical status in adolescence and adulthood in women have a pronounced somatotypological specificity. These materials on the physical development and constitutional and typological characteristics of the studied population of women applicable for a personalized approach in the context of a relative norm.

The variation of skinfold thickness of Mulam adults in China

The skinfold thickness of six items （facial skinfold, subscapular skinfold, suprailiac skinfold, biceps skinfold, triceps skinfold and calf skinfold） were measured in 465 Mulam adults （232 male and 233 female）. The results were as follows： （1） The average skinfold thickness are higher in female at every age group. （2） As a whole, the skinfold thickness in the body of trunk is bigger than that in the limbs in both male and female. The curves of biceps skinfold thickness and calf skinfold thickness of male doesn＇t fluctuate with age. Body fat percentage of male was the lowest in the 30s group. In female, the skinfold thickness of trunk and triceps increase with age while calf skinfold decreases. Body fat percentage of female increases with age but then decreases after 50 years old. （3） The mean vales of Mulam skinfold thickness are relatively low compared with Daur, Uzbek and Han nationality.

Relation between Epicardial Adipose Tissue Thickness Assessed by Multidetector Computed Tomography and Significance of Coronary Artery Disease

Objective: To evaluate the relation between epicardial adipose tissue (EAT) thickness and also pericoronary fat assessed by Multidetector Computed Tomography (MDCT) with both calcium score and significance of coronary artery disease. Background: Epicardial adipose tissue (the visceral fat of the heart present under the visceral layer of the pericardium) has the same origin of abdominal visceral fat, which is known to be strongly related to the development of coronary artery atherosclerosis. Multidetector CT (MDCT) provides an accurate and reproducible quantification of EAT due to its high spatial and temporal resolution. Patients and Methods: The current study included 70 patients with low-intermediate probability of coronary artery disease. All patients were subjected to 256 Multidetectors CT to assess EAT thickness, the mean thickness of the pericoronary fat surrounding the three coronary arteries and coronary calcium score. Also coronary CT angiography was done and patients were then divided into 3 groups according to significance of coronary atherosclerosis: Group 1: No atherosclerosis (20 patients), Group 2: Non obstructive atherosclerosis (luminal narrowing less than 50% in diameter) (25 patients), Group3: Obstructive atherosclerosis (luminal narrowing ≥ 50%) (25 patients). Results: The mean EAT thickness and the mean pericoronary fat thickness were significantly higher in patients with obstructive coronary artery disease (CAD) with stenosis > 50% (group 3) compared to other groups with normal coronaries or non obstructive (CAD). ROC curve was used to define the best cut off value of the thickness of both EAT and pericoronary fat in predicting the obstructive CAD group which was ≥7.2 and 12.6 mm for epicardial and pericoronary fat respectively. Also there is a positive correlation between both epicardial adipose tissue and pericoronary fat thickness and the coronary calcium score. Conclusion: EAT thickness and pericoronary fat thickness can be used in predicting the significance of coronary artery disease.

系统性红斑狼疮患者心外膜脂肪厚度与心血管疾病风险的相关性

目的:研究系统性红斑狼疮(SLE)患者心外膜脂肪组织厚度(EFT)的改变,并探讨其与心脏彩超参数及心血管疾病(CVD)传统危险因素的相关性。方法:纳入2019年10月至2021年10月于我院住院的SLE患者作为病例组,同期健康人群作为对照组,测量2组的EFT,根据EFT是否增厚将SLE患者分为增厚组及不增厚组,比较2组炎症指标、心脏彩超参数及CVD传统危险因素之间的差异,并应用Logistic回归分析寻找EFT的危险因素。结果:SLE组患者的EFT[4.40(2.60)mm]较对照组[3.10(1.60)mm]显著增厚(P<0.001)。病例组患者中EFT增厚者占42.0%(76/131),对照组EFT增厚者仅占9.5%(9/95)。病例组中EFT增厚组与不增厚组比较结果显示,EFT增厚组的年龄、体质量指数(BMI)、左心房直径(LAD)、右心室内径(RVD)、室间隔厚度(IVST)、左心室后壁厚度(LVPWT)及颈动脉内膜中层厚度(CIMT)均显著高于不增厚组。EFT与年龄、病程、BMI、甘油三酯、低密度脂蛋白、LAD、RVD、IVST、LVPWT及CIMT等呈正相关。Logistic回归分析显示LVPWT增加是EFT增厚的危险因素。结论:SLE患者的EFT增厚与心脏结构或功能参数的改变相关,提示应对EFT增厚及心脏结构或功能参数异常的SLE患者进一步筛查心血管病变的危险因素。

皮肤至椎板距离和皮下脂肪厚度对微创腰椎减压术后的影响

目的探讨皮肤至椎板距离(skr-to-laminal distme,SLD)和皮下脂肪厚度对微创腰椎减压术后的影响。方法选择2021年1月至2023年6月在该院接受微创腰椎减压术的173例患者作为研究对象,收集患者SLD距离和皮下脂肪厚度数据,分别根据中位值分为低值组和高值组,观察两组患者术前、住院及出院资料差异。结果高SLD距离患者与低SLD距离患者的体质量指数(body mass index,BMI)、肥胖、年龄、ASA分级、高血压、糖尿病、饮酒等比较,差异存在统计学意义(P<0.05);两组患者性别、心脏病、脑血管疾病、慢性肾脏病、吸烟、手术类型、相邻节段病变、住院时间、即时并发症、住院并发症、出院并发症、总并发症、术前ODI、术后1年ODI、术前腰痛VAS、术后1年腰痛VAS、术前腿痛VAS、术后1年腿痛VAS比较,差异均无统计学意义(P>0.05)。高皮下脂肪厚度患者和低皮下脂肪厚度患者的BMI、肥胖、年龄、ASA分级、高血压、糖尿病、饮酒比较,差异存在统计学意义(P<0.05);两组患者性别、心脏病、脑血管疾病、慢性肾脏病、吸烟、手术类型、相邻节段病变、住院时间、即时并发症、住院并发症、出院并发症、总并发症、术前ODI、术后1年ODI、术前腰痛VAS、术后1年腰痛VAS、术前腿痛VAS和术后1年腿痛VAS比较,差异均无统计学意义(P>0.05)。Pearson相关性分析显示,SLD距离和皮下脂肪厚度与BMI均存在显著相关性(r=0.703、0.712,P<0.05)。结论手术部位局部软组织厚度对腰椎微创减压术的临床结果无显著影响。

手助腹腔镜下活体供肾切取手术时间的影响因素及其与术后并发症的关系分析

目的探究手助腹腔镜下活体供肾切取手术时间的影响因素,并探究其与术后并发症严重程度间的关系。方法回顾性分析91例行手助腹腔镜下活体供肾切取术的供者的临床资料,分析供者术前基线资料与手术时间之间的相关性,研究手术时间与术后并发症的关系并确定手术时间的阈值。结果肾动脉数量多、肾周脂肪及肾脏后侧脂肪较厚、罹患代谢综合征、梅奥粘连概率(MAP)评分及Clavien-Dindo评分较高均会导致手术时间延长。通过分析受试者工作特征(ROC)曲线发现,当手术时间≥138 min时,供者术后并发症的发生率显著升高(P<0.05)。结论对于具有多支肾动脉、肾周及肾脏后侧脂肪厚度较厚、罹患代谢综合征、MAP评分及Clavien-Dindo评分较高的供者,可选择手术经验更为丰富的医师,做好充分的术前准备并在术后予以密切关注,以及时发现术后并发症并降低并发症的严重程度,改善供者预后。

冠心病患者彩超下颈动脉弹性指标及心外膜脂肪层厚度与病情严重程度的关系分析

目的分析冠心病(CHD)患者彩超下颈动脉弹性指标、心外膜脂肪层厚度(EFT)与病情严重程度的关系。方法选取2019年1月至2022年2月赣州市中医院收治的120例CHD患者作为实验组,根据患者病情严重程度分为A组(轻度,n=30)、B组(中度,n=48)、C组(重度,n=42),另选取同期接受健康检查的50名健康者作为对照组。采用彩超检查患者颈动脉弹性指标、EFT并探讨两者与病情严重程度的关系。结果实验组内中膜厚度(IMT)、血管僵硬度(β)、弹性模量(Ep)均高于对照组,脉搏波传导速度(PWV-β)快于对照组,顺应性(AC)低于对照组,差异有统计学意义(P<0.05)。C组IMT、β、Ep均高于A组和B组,PWV-β快于A组和B组,AC低于A组和B组,且B组Ep高于A组,PWV-β快于A组,AC低于A组,差异有统计学意义(P<0.05),其余组间两两比较差异无统计学意义。实验组EFT厚于对照组,差异有统计学意义(P<0.05);C组EFT厚于B组、A组,B组厚于A组,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,IMT、β、Ep、AC、EFT升高,PWV-β加快,AC降低是影响CHD患者病情严重程度的独立危险因素(OR>1,P<0.05)。结论IMT、β、Ep、AC、EFT升高,PWV-β加快,AC降低是影响CHD患者病情严重程度的独立危险因素,颈动脉弹性指标、EFT可作为评估CHD患者疾病严重程度的重要指标,值得临床推广应用。

肾周脂肪厚度与高尿酸血症患者痛风发作及发作频率的相关性研究

目的探讨肾周脂肪厚度与高尿酸血症患者痛风发作及发作频率之间的关系。方法回顾性纳入2020年11月—2021年7月在首都医科大学附属北京潞河医院内分泌代谢与免疫性疾病中心接受治疗的高尿酸血症患者为研究对象,将其分为无痛风发作组(n=20)与有痛风发作组(n=80)。根据发作频率,将痛风发作组患者进一步分为发作1次组(n=44)与反复发作组(n=36)。收集纳入患者的人口学特征、疾病相关资料、内脏脂肪面积及肾周脂肪厚度,比较组间差异,并通过回归分析确定肾周脂肪厚度与痛风发作及发作频率的相关性。结果与无痛风发作组患者相比,有痛风发作组患者的肾周脂肪厚度增加[(1.09±0.39)cm比(1.37±0.45)cm,P=0.012];在有痛风发作组患者中,与发作1次组患者相比,反复发作组患者的肾周脂肪厚度增加[(1.26±0.40)cm比(1.50±0.47)cm,P=0.014]。Logistic回归分析显示,肾周脂肪厚度增加不仅与痛风发作存在相关,且与发作频率亦存在相关。结论肾周脂肪厚度与痛风发作及发作频率存在相关。

心外膜脂肪厚度在胎儿心脏代谢中的研究进展

心外膜脂肪组织归类为内脏脂肪组织的一种,内脏脂肪组织的异常堆积与代谢性疾病、心血管疾病等密切相关。最近心外膜脂肪组织(EAT)被认为是心脏代谢的关键因素;因EAT特殊的解剖位置、生物学功能及其临床预测价值,在妊娠期糖尿病、大于胎龄儿、先兆子痫和胎儿生长受限等疾病的发生和发展中发挥着重要作用。超声测量心外膜脂肪厚度(EFT)是一个简单而可靠的心脏代谢风险的成像指标。本文主要就心外膜脂肪组织的解剖与生物学功能、超声心动图评估及其胎儿心脏代谢的研究现状进行综述。

心外膜脂肪厚度联合左心耳功能参数在预测阵发性房颤射频消融术后复发的价值

目的探讨基于心外膜脂肪厚度(EFT)联合左心耳(LAA)功能参数的诊断模型在预测阵发性房颤(AF)患者射频消融术后复发的价值。方法收集行射频消融手术的阵发AF患者47例,其中男性22例,女性25例;年龄41~77岁,平均年龄62.72岁;身体质量指数(BMI)18.0~29.6 kg/m^(2),平均BMI 25.26 kg/m^(2);高血压24例,糖尿病5例,冠心病13例,卒中或短暂性脑缺血发作(TIA)6例;低密度脂蛋白1.30~3.86 mmol/L,平均低密度脂蛋白2.29 mmol/L;高密度脂蛋白0.67~1.59 mmol/L,平均高密度脂蛋白1.07 mmol/L;血尿酸123.0~514.0μmol/L,平均血尿酸303.70μmol/L。术前进行经胸超声心动图(TTE)和经食管超声心动图(TEE)检查。术后3个月开始随访,将患者分为复发组与未复发组。通过单因素及主成分分析的方法探索阵发性AF术后复发的预测因子并建立预测术后复发的联合诊断模型。结果单因素分析中,两组年龄、BMI、左心房(LA)前后径、EFT、LAA最大开口内径相比,复发组高于非复发组,差异有统计学意义[71(61.01,73.75)岁vs 65(54.25,69.02)岁、(26.81±2.19)kg/m^(2)vs(24.84±2.83)kg/m^(2)、(43.42±4.58)mm vs(40.34±4.16)mm、5.63(5.30,5.99)mm vs 4.15(3.67,5.03)mm、(21.24±3.67)mm vs(18.37±2.81)mm。P<0.05];复发组LAA排空速度、LAA充盈速度、LAA峰值应变低于非复发组,差异有统计学意义[33.55(27.93,40.28)cm/s vs 43.40(33.70,77.63)cm/s、(35.06±11.02)cm/s vs(45.26±14.86)cm/s、5.85(5.18,7.08)vs 9.90(8.70,13.10)。P<0.05]。采用主成分分析法构建的联合诊断模型综合评分截断值为16.695时,诊断阵发性AF射频消融术后复发的曲线下面积为0.895,对应的灵敏度、特异度、准确度分别为90.0%、78.4%、82.9%。结论EFT联合LAA功能参数在预测阵发性AF射频消融术后复发中有一定的诊断价值。

心外膜脂肪厚度与糖尿病慢性心力衰竭患者心功能分级的关系

目的:探讨心外膜脂肪厚度与糖尿病慢性心力衰竭患者心功能分级的关系。方法:选取2018年1月—2022年12月上海交通大学医学院苏州九龙医院收治的108例糖尿病慢性心力衰竭患者为研究对象,收集患者心外膜脂肪厚度、心功能分级等基本资料。分析不同心功能分级患者心外膜脂肪厚度情况,分析糖尿病慢性心力衰竭患者心外膜脂肪厚度与心功能分级的相关性。结果:心功能Ⅰ级患者心外膜脂肪厚度均低于心功能Ⅱ级、Ⅲ级、Ⅳ级患者,心功能Ⅱ级患者心外膜脂肪厚度均低于心功能Ⅲ级、Ⅳ级患者,心功能Ⅲ级患者心外膜脂肪厚度低于心功能Ⅳ级患者,差异有统计学意义(P<0.05)。Spearman相关性分析显示,糖尿病慢性心力衰竭患者心外膜脂肪厚度与心功能分级呈正相关(rs=0.697,P<0.001)。结论:糖尿病慢性心力衰竭患者心外膜脂肪厚度与心功能分级呈正相关,心外膜脂肪厚度对糖尿病慢性心力衰竭患者心功能分级具有一定指导意义。

超声测量心外膜脂肪厚度与中青年缺血性脑卒中的相关性研究

目的:探讨超声测量的心外膜脂肪厚度(EFT)与中青年缺血性脑卒中发病的相关性。方法:选取46例首次就诊的中青年缺血性脑卒中患者作为病例组;同期就诊年龄与性别匹配的50例中青年非缺血性脑卒中人群作为对照组。入组后超声测量颈动脉内-中膜厚度(IMT)及EFT等指标。分析两组EFT和IMT的差异;收缩末期EFT在左室长轴与左室短轴切面的相关性;分析IMT、EFT与缺血性脑卒中的相关性;绘制EFT预测中青年缺血性脑卒中发生的受试者工作特征(ROC)曲线。结果:病例组EFT高于对照组(P<0.05);两组IMT无统计学差异(P>0.05);收缩末期胸骨旁左室长轴切面与短轴切面测量的EFT正相关(r=0.983,P<0.05);EFT增厚为预测中青年缺血性脑卒中的危险因素;ROC曲线表明,收缩末期左室长轴切面EFT和左室短轴切面EFT预测缺血性脑卒中发生的曲线下面积分别为0.865、0.856,最佳阈值分别为3.81 mm、4.18 mm。结论:超声测量EFT增加与中青年缺血性脑卒中发生相关,是中青年缺血性脑卒中发生的危险因素之一,对中青年缺血性脑卒中高危对象有一定筛查价值。

艾可特肠佳粉剂对大菱鲆生长性能及肠道健康的影响

[目的]评估艾可特肠佳粉剂对大菱鲆幼鱼生长性能和肠道组织结构的影响,为艾可特肠佳粉剂在大菱鲆及其他鱼类养殖中的应用提供数据支撑。[方法]将3 000尾初始体质量为(10±1) g和(40±5) g大菱鲆幼鱼分为2组,即试验组和对照组,每组3个重复。试验组在饲料中添加0.1%艾可特肠佳粉剂,对照组不做任何处理,试验周期21周,测定大菱鲆幼鱼的肠道绒毛长度、肌层厚度、特定生长率、增重率和肥满度。[结果]与对照组相比,试验组大菱鲆肠道绒毛长度极显著增加65.8%,肌层厚度显著增加44.7%,绒毛长度与肌层厚度比值显著增加38.9%,增重率、特定生长率和肥满度差异不显著。[结论]在饲料中添加0.1%艾可特肠佳粉剂可以增加大菱鲆肠道绒毛长度和肌层厚度,改善其肠道组织结构。

磁共振FLAIR-FS序列成像在诊断早期膝关节滑膜炎中的应用研究

目的探讨磁共振(MRI)脂肪抑制液体衰减反转恢复(FLAIR-FS)序列成像对早期膝关节滑膜炎(KS)诊断价值。方法选择郑州大学附属郑州中心医院于2020年12月至2021年6月期间收治的50例KS患者(膝关节53个)设为观察组,50例健康志愿者(膝关节50个)设为对照组。入组受检者均接受双膝关节MRI检查,实施横轴位与矢状位FLAIR-FS序列、脂肪抑制质子密度加权(PDWI-FS)序列检查。记录滑膜厚度测量及分级的可重复评估结果,对比两组FLAIR-FS序列测定滑膜厚度、对滑膜定量评估结果;记录两种序列对KS患者的滑膜评分情况。结果FLAIR-FS图像测定15个膝关节的两次滑膜分级评估的一致性一般(Kappa值为0.376);测量滑膜厚度的组内相关系数(ICC)为0.984,95%CI为0.954~0.993;研究组滑膜厚度为(3.04±0.62)mm,高于对照组的(1.10±0.29)mm,有统计学差异(t值=20.042,P值<0.001);PDWI-FS序列、FLAIR-FS序列对滑膜评分0-1分的一致性一般(kappa值=0.352,P值=0.001),对滑膜评分2分的一致性较差(kappa值=0.475,P值<.001),对滑膜评分3分的一致性极低(kappa值=0.113,P值=0.074);3级滑膜评分者的滑膜厚度为(4.56±1.33)mm,明显高于1级者的(2.05±0.46)mm和2级者的(2.32±0.49)mm,有统计学差异(P值<0.05);1级、2级滑膜评分者的滑膜厚度相比,无统计学差异(P值>0.05)。结论MRI FLAIR-FS序列对KS滑膜形态和信号评估有一定优势,可用于评价KS分期。

Nonalcoholic fatty liver disease and vascular disease:State-of-the-art

Nonalcoholic fatty liver disease(NAFLD), the most common of chronic liver disease in Western Country, is closely related to insulin resistance and oxidative stress and includes a wide spectrum of liver diseases ranging from steatosis alone, usually a benign and non-progressive condition, to nonalcoholic steatohepatitis(NASH), which may progress to liver fibrosis and cirrhosis. NAFLD is considered the hepatic manifestation of the metabolic syndrome with which shares several characteristics, however recent data suggest that NAFLD is linked to increased cardiovascular risk independently of the broad spectrum of risk factors of metabolic syndrome. Accumulating evidence suggests that the clinical burden of NAFLD is not restricted to liver-related morbidity and mortality, with the majority of deaths in NAFLD patients related to cardiovascular disease and cancer and not to the progression of liver disease. Retrospective and prospective studies provide evidence of a strong association between NAFLD and subclinical manifestation of atherosclerosis(increased intima-media thickness, endothelial dysfunction, arterial stiffness, impaired left ventricular function and coronary calcification). A general agreement emerging from these studies indicates that patients with NASH are at higher risk of cardiovascular diseases than those with simple steatosis, emphasizing the role of chronic inflammation in the pathogenesis of atherosclerosis of these patients. It is very likely that the different mechanisms involved in the pathogenesis of atherosclerosis in patients with NAFLD have a different relevance in the patients according to individual genetic background. In conclusion, in the presence of NAFLD patients should undergo a complete cardiovascular evaluation to prevent future atherosclerotic complications. Specific lifestyle modification and aggressive pharmaceutical modification will not only reduce the progression of liver disease, but also reduce morbidity for cardiovascular disease improving overall prognosis and survival.