直肠癌彩色血流平均密度与微血管密度的相关性及其临床意义

Objective To explore the relationship of the mean color vessels density (MCVD) and pathologic microvessel density(MVD) in rectal cancers and their relation with T stags and lymph node metastasis.Methods MCVD were caculated preoperationly with transrectal color power angiography(TRCPA).After operation MVD was assessed immunohistochemically using anti-CD105 monoclonal antibody.The relationships within MCVD, MVD and T stages and lymph node metastasis were analysed.Results There were positive correlation between MCVD and MVD (r=0.763, P＜0.01) in rectal cancer.There were significant difference of MCVD and MVD in both the depth of carcinoma invasion and metastasis of lymphatic nodes( P＜0.05).Conclusions MCVD can display features of the blood supply and distribution of pathologic microvessels and reflect the development of rectal cancers.MCVD is a credible index to choose available treatment and to evaluate prognosis before operation of rectal cancer.     

直肠癌彩色血流平均密度与微血管密度的相关性及其临床意义

Objective To explore the relationship of the mean color vessels density (MCVD) and pathologic microvessel density(MVD) in rectal cancers and their relation with T stags and lymph node metastasis.Methods MCVD were caculated preoperationly with transrectal color power angiography(TRCPA).After operation MVD was assessed immunohistochemically using anti-CD105 monoclonal antibody.The relationships within MCVD, MVD and T stages and lymph node metastasis were analysed.Results There were positive correlation between MCVD and MVD (r=0.763, P＜0.01) in rectal cancer.There were significant difference of MCVD and MVD in both the depth of carcinoma invasion and metastasis of lymphatic nodes( P＜0.05).Conclusions MCVD can display features of the blood supply and distribution of pathologic microvessels and reflect the development of rectal cancers.MCVD is a credible index to choose available treatment and to evaluate prognosis before operation of rectal cancer.     

Measurement of bone mineral density in patients with type 2 diabetes mellitus

AIM：To investigate into the changes in bone mineral density (BMD) in patients with Type 2 diabetes mellitus.METHODS:BMD of lumbar vertebrae 2-4 and femur in 63 cases of patients with type 2 diabetes mellitus were measured with dual energy X-ray absorptiometry (DEXA) and were compared with age, sex and BMI-matched normal control group. RESULTS:No significant differences were found in BMD of lumbar vertebrae 2-4 in female of menopause with Type 2 diabetes mellitus(P&;gt;0.05), but BMD of total were lower than that of the controls (P&;lt;0.05), BMD of neck were significantly lower than that of the controls (P&;lt;0.01); No significant differences were found in BMD of L2-4 and femur in male of 50 years old above with Type 2 diabetes mellitus (P&;gt;0.05). CONCLUSION:BMD of Type 2 diabetes mellitus is different according to different sex,BMD of female of menopause with type 2 diabetes mellitus were descended easily,especially in areas of neck BMD, it should couse to pay attention to in order to prevent pathologic bone fracture;BMD of male of 50 years old above with Type 2 diabetes mellitus have no the obvious changes than that of the controls.     

"篮筐"技术在颅内动脉瘤介入治疗中的应用

Objective To study the ways,mechanism,indication,curative effect of " Basket" skill applied in the interventional therapy for intracranial aneurysm. Methods Intracranial aneurysm with 1 : 1 ≥ neck/body ≥ 1 : 2 ," 3 D coil" was used to form a basket in it;in that with 1:2 > neck/body,common "2D coil" was applied. And the following coils were applied with hydrocoil or fibered coil combined with common platinum coil to increase the embol-ism density. Results In 156 cases with 158 aneurysms,143 aneurysms were 100% embolized (90. 5% ) ;131 ca-ses discharged with GOS 5 score(84.0% ),and 2 cases died ( 1.3% ). Conclusion " Basket" skill can increase the embolization density in aneurysm,reducing the residual of the neck,getting embolizated fully and improving the prognosis.     

"篮筐"技术在颅内动脉瘤介入治疗中的应用

Objective To study the ways,mechanism,indication,curative effect of " Basket" skill applied in the interventional therapy for intracranial aneurysm. Methods Intracranial aneurysm with 1 : 1 ≥ neck/body ≥ 1 : 2 ," 3 D coil" was used to form a basket in it;in that with 1:2 > neck/body,common "2D coil" was applied. And the following coils were applied with hydrocoil or fibered coil combined with common platinum coil to increase the embol-ism density. Results In 156 cases with 158 aneurysms,143 aneurysms were 100% embolized (90. 5% ) ;131 ca-ses discharged with GOS 5 score(84.0% ),and 2 cases died ( 1.3% ). Conclusion " Basket" skill can increase the embolization density in aneurysm,reducing the residual of the neck,getting embolizated fully and improving the prognosis.     

"篮筐"技术在颅内动脉瘤介入治疗中的应用

Objective To study the ways,mechanism,indication,curative effect of " Basket" skill applied in the interventional therapy for intracranial aneurysm. Methods Intracranial aneurysm with 1 : 1 ≥ neck/body ≥ 1 : 2 ," 3 D coil" was used to form a basket in it;in that with 1:2 > neck/body,common "2D coil" was applied. And the following coils were applied with hydrocoil or fibered coil combined with common platinum coil to increase the embol-ism density. Results In 156 cases with 158 aneurysms,143 aneurysms were 100% embolized (90. 5% ) ;131 ca-ses discharged with GOS 5 score(84.0% ),and 2 cases died ( 1.3% ). Conclusion " Basket" skill can increase the embolization density in aneurysm,reducing the residual of the neck,getting embolizated fully and improving the prognosis.     

体外诱导大鼠骨髓间充质干细胞向心肌细胞定向分化的研究

Objective To investigate the role of cardiac myocytes in the differentiation of bone marrow mesenchymal stem cells (MSCs) to cardiac myocytes and the biological properties in the course. Methods The bone marrow of the extremities of the rats was flushed, and bone marrow MSCs were obtained by method of density gradient centrifugation. They were cultured. The second passage of cultured MSCs were labelled with bromodeoxyuridine (BrdU). The cardiac myocytes were obtained from the apex of rat heart with trypsin digestion method, and they were cocultured with labeled MSCs. The developmental changes of bone marrow MSCs were observed under light microscope with immunohistochemical staining for BrdU and a-sarcomeric actin on the 3rd day, anti electron microscopic examination on the 5th day. Results MSCs proliferated fast in primary culture and subculture, positive rate was (90. 34± 2. 31)%, and there was statistical difference when it compared with control group [(4.07±1.35)%, P<0. 01]. The morphology of MSCs changed significantly after coculture. There were new cells nuclei of which were positively stained for BrdU and its cytoplasm positive for actin. Under transmissive electron microscope, sarcomeres like structure and abnormal Z line were observed in cytoplasm. Conclusion Cardiac myocytes can effectively induce bone marrow MSCs to differentiate into cardiac myocytes by coculturing.     

体外诱导大鼠骨髓间充质干细胞向心肌细胞定向分化的研究

Objective To investigate the role of cardiac myocytes in the differentiation of bone marrow mesenchymal stem cells (MSCs) to cardiac myocytes and the biological properties in the course. Methods The bone marrow of the extremities of the rats was flushed, and bone marrow MSCs were obtained by method of density gradient centrifugation. They were cultured. The second passage of cultured MSCs were labelled with bromodeoxyuridine (BrdU). The cardiac myocytes were obtained from the apex of rat heart with trypsin digestion method, and they were cocultured with labeled MSCs. The developmental changes of bone marrow MSCs were observed under light microscope with immunohistochemical staining for BrdU and a-sarcomeric actin on the 3rd day, anti electron microscopic examination on the 5th day. Results MSCs proliferated fast in primary culture and subculture, positive rate was (90. 34± 2. 31)%, and there was statistical difference when it compared with control group [(4.07±1.35)%, P<0. 01]. The morphology of MSCs changed significantly after coculture. There were new cells nuclei of which were positively stained for BrdU and its cytoplasm positive for actin. Under transmissive electron microscope, sarcomeres like structure and abnormal Z line were observed in cytoplasm. Conclusion Cardiac myocytes can effectively induce bone marrow MSCs to differentiate into cardiac myocytes by coculturing.     

体外诱导大鼠骨髓间充质干细胞向心肌细胞定向分化的研究

Objective To investigate the role of cardiac myocytes in the differentiation of bone marrow mesenchymal stem cells (MSCs) to cardiac myocytes and the biological properties in the course. Methods The bone marrow of the extremities of the rats was flushed, and bone marrow MSCs were obtained by method of density gradient centrifugation. They were cultured. The second passage of cultured MSCs were labelled with bromodeoxyuridine (BrdU). The cardiac myocytes were obtained from the apex of rat heart with trypsin digestion method, and they were cocultured with labeled MSCs. The developmental changes of bone marrow MSCs were observed under light microscope with immunohistochemical staining for BrdU and a-sarcomeric actin on the 3rd day, anti electron microscopic examination on the 5th day. Results MSCs proliferated fast in primary culture and subculture, positive rate was (90. 34± 2. 31)%, and there was statistical difference when it compared with control group [(4.07±1.35)%, P<0. 01]. The morphology of MSCs changed significantly after coculture. There were new cells nuclei of which were positively stained for BrdU and its cytoplasm positive for actin. Under transmissive electron microscope, sarcomeres like structure and abnormal Z line were observed in cytoplasm. Conclusion Cardiac myocytes can effectively induce bone marrow MSCs to differentiate into cardiac myocytes by coculturing.     

体外诱导大鼠骨髓间充质干细胞向心肌细胞定向分化的研究

Objective To investigate the role of cardiac myocytes in the differentiation of bone marrow mesenchymal stem cells (MSCs) to cardiac myocytes and the biological properties in the course. Methods The bone marrow of the extremities of the rats was flushed, and bone marrow MSCs were obtained by method of density gradient centrifugation. They were cultured. The second passage of cultured MSCs were labelled with bromodeoxyuridine (BrdU). The cardiac myocytes were obtained from the apex of rat heart with trypsin digestion method, and they were cocultured with labeled MSCs. The developmental changes of bone marrow MSCs were observed under light microscope with immunohistochemical staining for BrdU and a-sarcomeric actin on the 3rd day, anti electron microscopic examination on the 5th day. Results MSCs proliferated fast in primary culture and subculture, positive rate was (90. 34± 2. 31)%, and there was statistical difference when it compared with control group [(4.07±1.35)%, P<0. 01]. The morphology of MSCs changed significantly after coculture. There were new cells nuclei of which were positively stained for BrdU and its cytoplasm positive for actin. Under transmissive electron microscope, sarcomeres like structure and abnormal Z line were observed in cytoplasm. Conclusion Cardiac myocytes can effectively induce bone marrow MSCs to differentiate into cardiac myocytes by coculturing.     

Use of Quantitative Ultrasound for Identifying Low Bone Density in Older People

Objective. This study examined criterion, convergent, and discriminant validities of quantitative ultrasound (QUS) for identifying low bone density among people aged 55 years and older in Taiwan. Methods. We recruited 453 community‐dwelling volunteers and 30 patients with lower extremity fractures. Bone density was assessed using both calcaneal QUS and femoral neck dual‐energy x‐ray absorptiometry (DXA). Two QUS parameters, speed of sound (SOS) and broadband ultrasound attenuation (BUA), were also used to estimate heel bone mineral density (HBMD). Results. Using DXA as the criterion for identifying low bone density (DXA T score of 1.0 or lower), likelihood ratios for BUA and SOS at the 50th percentile and HBMD for men were 1.50, 1.75, and 1.28, respectively; the counterparts for women were 1.54, 2.13, and 1.29. As for identifying osteoporosis (DXA T score of ?2.5 or lower), higher likelihood ratios of the 3 QUS parameters were gained. For convergent validity, Pearson correlation coefficients for DXA with BUA, SOS, and HBMD ranged from 0.40 to 0.43 for men and from 0.48 to 0.53 for women. For the ability to discriminate men and women with lower extremity fractures from those without, no significant differences in the area under the receiver operating characteristic curve were detected between BUA, SOS, and HBMD and DXA after adjusting for age, body mass index, fall history, and current smoking. Conclusions. Although having very good convergent and discriminant validities and fair criterion validity, calcaneal QUS may be a screening tool for identifying low bone density.     

Comparison of the Achilles Express ultrasonometer with central dual-energy X-ray absorptiometry

BACKGROUND: Quantitative ultrasound (QUS) devices provide portable, easy-to-operate, low-cost options for point-of-care screening of bone mineral density (BMD). Community pharmacists should be aware of the precision, sensitivity, and specificity of these devices prior to their purchase. OBJECTIVE: To determine the precision, sensitivity, and specificity of the Achilles Express ultrasonometer compared with central dual-energy X-ray absorptiometry (cDXA) as well as its utility as a bone density screening device in the community pharmacy setting. METHODS: A prospective study in a community pharmacy and outpatient ambulatory clinic was conducted with 2 groups of white women. Group 1 participants were 25-35 years of age (young, healthy), and those in Group 2 were 45 years of age or older (postmenopausal). BMD assessments of the spine and the nondominant wrist and hip were performed using cDXA. Assessments of the heel were performed using the Achilles Express, a QUS device. The main outcome measures were correlation of t-scores between cDXA and QUS measurements using the Pearson correlation test. RESULTS: Twenty-two (30 +/- 4 years of age) and 31 (55 +/- 17 years of age) women were enrolled into Groups 1 and 2, respectively. Significant correlations between QUS and hip and spine cDXA t-scores were found in both groups. Correlation coefficients for QUS versus hip cDXA were 0.51 (95% CI 0.11 to 0.77) and 0.70 (95% CI 0.46 to 0.85) in Groups 1 and 2, respectively. Correlation coefficients for the QUS versus spine cDXA were 0.64 (95% CI 0.31 to 0.84) and 0.60 (95% CI 0.31 to 0.79) in Groups 1 and 2, respectively. The QUS device has a sensitivity level of 88% and specificity of 71% to detect a hip cDXA t-score of less than-1. CONCLUSIONS: The Achilles Express ultrasonometer is a reasonable screening tool to detect low BMD in postmenopausal women.     

定量超声测量甲亢患者骨质变化的临床价值

目的研究定量超声法测量甲亢患者骨质变化的临床价值。方法用定量超声法测量了347例存在高T3和T4的甲亢患者及性别和年龄相匹配的健康对照组的右跟骨超声参数超声振幅衰减(BUA)和超声传导速度(SOS)。结果甲亢患者的BUA值明显低于正常对照组(P＜0.01),骨质量丢失发生率明显高于正常对照组。BUA、SOS与T3、T4、促甲状腺激素(TSH)之间均无明显相关关系(|r|＜0.15,p＞0.05)。结论定量超声参数可以敏感地检测甲亢对骨质量的影响。     

Bone marrow influences quantitative ultrasound measurements in human cancellous bone

Quantitative ultrasound (QUS) transmission and backscatter measurements were made in 46 human cancellous bone specimens from the calcaneus. All QUS measurements were made at 35 degrees C, initially with marrow filling the pores and then repeated after substituting water for marrow. Bone mineral density (BMD) was determined using x-ray absorptiometry. Marrow significantly decreased ultrasound (US) velocity, but increased attenuation, attenuation slope and backscatter (p < 0.001 for all) compared to the water-saturated state. The impact of marrow on QUS measurements was greater at lower BMD values (p < 0.05), and was greater in women than in men (p < 0.05). QUS measurements in marrow-saturated specimens correlated less strongly with BMD than did corresponding measurements in water-saturated specimens (p < 0.05), consistent with interspecimen marrow heterogeneity. These data indicate that the potential impact of marrow should be considered when interpreting clinical QUS measurements. Understanding and exploiting these effects could lead to novel approaches for ultrasonic characterisation of both bone and marrow.     

Correlation of quantitative heel ultrasonography with central dual-energy X-ray absorptiometric bone mineral density in postmenopausal women.

OBJECTIVES: In this study, we sought the proper cutoff level for quantitative ultrasonography (QUS) of the heel in identifying bone mineral density (BMD) categories as determined by dual-energy x-ray absorptiometry (DXA) in postmenopausal women. METHODS: With the use of DXA, BMD categories of the lumbar spine and different areas of the left femur of 420 healthy women according to World Health Organization definitions were determined. Quantitative ultrasonography of the heel was also performed in each subject. Receiver operating characteristic curves were plotted, and sensitivity and specificity of QUS to diagnose osteoporosis were examined at different points to identify the best cutoff level. The diagnostic agreement between the two techniques in identifying osteoporosis was assessed with kappa scores. RESULTS: The kappa scores were 0.31 for the lumbar region and 0.5 for the femoral neck region. On the receiver operating characteristic study, a score of -1 was found to be the appropriate cutoff point for QUS studies, in which the sensitivity of QUS to diagnose BMD osteoporosis varied between 78% and 87.5% depending on the site of the DXA study. With the proposed cutoff point (-1), sensitivity and specificity of QUS in detecting osteoporosis at the lumbar spine were 83.9% and 51%, respectively, and at the femoral neck were 84% and 50%, respectively. CONCLUSIONS: Insufficient agreement between QUS and DXA led to uncertainty on expected BMD in people tested by QUS. The proposed cutoff value could achieve higher sensitivity but only by accepting higher rates of false-positive results.     

Attempt at standardization of bone quantitative ultrasound in Japan

Dual X-ray absorptiometry (DXA) is used to diagnose osteoporosis. On the other hand, quantitative ultrasound (QUS) is widely used to assess bone density as part of medical screening as it is relatively inexpensive and easy to perform. Current QUS devices do not share precise ultrasound-related parameters, such as frequency, waveform, beam pattern, transient response, definition of propagation time, definition of degree of attenuation, and precise measurement site, resulting in different measurements across models. The Japan Osteoporosis Society established a QUS Standardization Committee in 2007 to investigate standardization of speed of sound (SOS) and broadband ultrasonic attenuation (BUA) measurements to resolve this issue. The committee came up with a formula to convert SOS and BUA values yielded by each model available in Japan. This has made it possible to convert QUS measurements from different models into standardized values, greatly improving the effectiveness of QUS measurements.     

Does Quantitative Ultrasound at the Calcaneus Predict an Osteoporosis Diagnosis in Postmenopausal Women from the Silesia Osteo Active Study?

The aims of the study were to assess the clinical conformity between quantitative ultrasound (QUS) and densitometry with use of the standard World Health Organization T-score thresholds to determine optimal diagnostic cutoff values for QUS T-scores in different age groups. Three hundred sixty-five postmenopausal Caucasian women were enrolled into the study and divided into two age groups (<65 y and ≥65 y). Skeletal status was assessed using QUS measurements at the calcaneus and bone densitometry at the spine and proximal femur (Hologic Explorer, Bedford, MA, USA). QUS measurement results expressed as the stiffness index (SI) correlated significantly with both femoral neck bone mineral density (r = 0.51, p < 0.0001) and lumbar spine bone mineral density (r = 0.52, p < 0.0001). On the basis of receiver operating characteristic curve analyses, the thresholds for correspondence between QUS T-score values and T-score –2.5SD in dual X-ray absorptiometry (DXA) were established. They ranged between –1.63SD and –1.70SD in relation to femoral neck DXA and between –1.22SD and –1.51SD in relation to lumbar spine DXA, depending on age category. In conclusion, the study described here confirmed that QUS measurements at the calcaneus may provide information comparable to DXA examinations at the femoral neck and lumbar spine in postmenopausal women.     

Phalangeal quantitative ultrasound in children with phenylketonuria: a pilot study

Bone alterations in phenylketonuria (PKU) have been detected, especially with increasing age, in several studies by using different radiologic techniques. Quantitative ultrasound (QUS) assesses skeletal status by measuring the amplitude-dependent speed of sound (AD-SoS) and the bone transmission time (BTT), mainly dependent on mineral density and cortical thickness. Bone condition in 30 children and adolescents (mean age 15.1 +/- 6.4 y) affected by PKU was evaluated by phalangeal QUS, considering its relationship with their clinical, biochemical and therapeutic features. Measured AD-SoS Z-Score and BTT Z-Score were 0.27 +/- 1.42 and -0.26 +/- 1.21, respectively. In patients with previous fractures, the two QUS parameters were lower than in patients without history of fracture (p < 0.001 and p = 0.006, respectively). AD-SoS Z-Score and BTT Z-Score were negatively correlated with plasma phenylalanine (Phe) concentration in the year before QUS (p = 0.005 and p < 0.001, respectively) and with age (p < 0.001 for both parameters). These results parallel the previous findings obtained by different radiologic tools and suggest phalangeal QUS as an attractive option for the regular evaluation and longitudinal monitoring of bone condition in children and adolescents affected by PKU.     

The role of quantitative ultrasound in the assessment of bone: a review

Quantitative ultrasound (QUS) bone measurement is a promising, relatively new technique for the diagnosis of osteoporosis. Unlike to the more established method of bone densitometry [measurement of bone mineral density (BMD) e.g. using dual X-ray absorptiometry (DEXA)], QUS does not use ionizing radiation. It is cheaper, takes up less space and is easier to use than densitometry techniques. The two QUS parameters currently measured are broadband ultrasound attenuation (BUA) and speed of sound (SOS). The reported age-related changes for healthy women range from ?0·27% to ?1·62% per year for BUA and from ?0·06% to ?0·19% per year for SOS. Precision ranges from 1·0 to 3·8% (CV) for BUA and from 0·19 to 0·30% (CV) for SOS. The new method of imaging ultrasound has improved the precision of QUS measurements. QUS is significantly correlated with BMD. Studies with the latest equipment have shown r-values between 0·6 and 0·9 in site-specific measurements, and QUS is thus believed to reflect mainly BMD. However, other studies indicate that QUS measures something other than the actual mineral content of bone, namely bone quality, e.g. in vitro studies have shown that QUS reflects trabecular orientation independently of BMD. In both cross-sectional and prospective studies, QUS seems to be as good a predictor of osteoporotic fractures as BMD. In two large prospective studies, QUS also predicted fracture risk independently of BMD. QUS has just begun to be used systematically for monitoring the response to anti-osteoporotic treatments in prospective trials. In the studies performed, QUS has been found to be useful in the follow-up of patients. QUS is thus a promising new technique for bone assessment.     

Quantitative bone ultrasound at phalanges and calcaneus in osteoporotic postmenopausal women: influence of age and measurement site

Phalangeal and calcaneal quantitative ultrasound (QUS) measurements were tested in a postmenopausal osteoporotic population of a wide age range to assess their ability to identify subjects with vertebral fractures in a population of postmenopausal women with osteoporosis. A group of 127 osteoporotic women aged from 50 to 85 y, who had been postmenopausal for at least 5 y, were enrolled. All subjects underwent phalangeal and calcaneal QUS measurements, femoral neck and lumbar spine dual energy X-ray absorptiometry (DXA) measurements and lateral thoracic and lumbar spine radiography. Osteoporosis was defined on the basis of femoral neck or lumbar spine bone mineral density (BMD) T-score lower than -2.5 SD or of the presence of one or more vertebral atraumatic fractures, independently of BMD values. Fifty-two women had one or more vertebral fractures, while the remaining 75 had no evidence of previous fracture. Both QUS techniques were able to discriminate between fractured and nonfractured subjects in the whole group (p < 0.05). When patients aged <70 y (n = 43) and patients aged > or = 70 y (n = 84) were considered separately, phalangeal QUS and lumbar spine BMD were able to discriminate vertebral fractures in the younger group (p < 0.05), whereas calcaneal QUS was able to discriminate vertebral fractures in the older one (p < 0.05). The results of this study raise an issue of the optimal use of different QUS techniques and different skeletal sites in the management of osteoporosis in early or late postmenopausal life.