动态增强磁共振定量参数评估儿童先天性胆总管囊肿致肝纤维化

目的 探讨动态增强磁共振（DCE-MRI）定量参数评估儿童先天性胆总管囊肿（CCC）所致肝纤维化的价值。方法 纳入33例CCC致肝纤维化患儿（病例组），以14例无肝肾疾患儿童为对照组。采集肝脏DCE-MRI后，拟合Tofts模型，获得参数K^trans、K_ep及V_e，观察不同肝纤维化分期定量参数差异及其相关性，以ROC曲线分析各参数诊断肝纤维化的AUC和最佳截界值。结果 K^trans、K_ep在不同纤维化亚组间差异均有统计学意义（P均<0.05），且随肝纤维化程度增加而下降（r=-0.764、-0.720，P均<0.05）；V_e在不同纤维化亚组中差异无统计学意义（P>0.05），与肝纤维化程度无明显相关（r=-0.249，P>0.05）。K^trans、K_e判别正常与肝纤维化、轻度与重度肝纤维化的AUC分别为0.949、0.748和0.933、0.731，截界值分别为0.239、0.186和1.814、1.663。结论 DCE-MRI定量灌注参数K^trans、K_ep对诊断儿童CCC致肝纤维化及其分期具有一定价值。     

Left ventricular diastolic function is enhanced after peak exercise in endurance‐trained adolescents as well as in their non‐trained controls

The aims of the study were to explore the temporal change of cardiac function after peak exercise in adolescents, and to investigate how these functional changes relate to maximal oxygen uptake (VO_2max). The cohort consisted of 27 endurance‐trained adolescents aged 13–19 years, and 27 controls individually matched by age and gender. Standard echocardiography and colour tissue Doppler were performed at rest, and immediately after as well as 15 min after a maximal cardio pulmonary exercise test (CPET) on a treadmill. The changes in systolic and diastolic parameters after exercise compared to baseline were similar in both groups. The septal E/e′‐ratio increased immediately after exercise in both the active and the control groups (from 9·2 to 11·0; P<0·001, and from 8·7 to 10·2; P = 0·008, respectively). In a comparison between the two groups after CPET, the septal E/e′‐ratio was higher in the active group both immediately after exercise and 15 min later compared to the control group (P = 0·007 and P = 0·006, respectively). We demonstrated a positive correlation between VO_2max and cardiac function including LVEF and E/e′ immediately after CPET, but the strongest correlation was found between VO_2max and LVEDV (r = 0·67, P<0·001) as well as septal E/e′ (r = 0·34, P = 0·013). Enhanced diastolic function was found in both groups, but this was more pronounced in active adolescents. The cardiac functional response to exercise, in terms of LVEF and E/e′, correlates with the increase in VO₂ uptake. These findings in trained as well as un‐trained teenagers have practical implications when assessing cardiac function.     

动态对比增强MRI衍生的药代动力学参数鉴别诊断原发性中枢神经系统淋巴瘤与胶质母细胞瘤

目的 探讨原发性中枢神经系统淋巴瘤（PCNSL）与胶质母细胞瘤（GBM）动态对比增强MRI衍生的药代动力学参数差异。方法 收集17例PCNSL与21例GBM,均接受常规及动态对比增强MR检查,测量双室Tofts模型下药代动力学参数容量转移常数（K^trans）、回流速率常数（K_ep）、血管外细胞外间隙容积分数（V_e）,及初始（60 s）对比剂浓度-时间曲线下面积（iAUC）。采用单因素方差分析比较PCNSL与GBM各自的强化瘤灶（ET）、瘤旁脑组织（PT）、正常侧脑组织（NP）间各参数差异;采用独立样本t检验比较二者间ET、PT、NP各参数的差异。结果 PCNSL与GBM间ET的K^trans、K_ep差异均有统计学意义（P均<0.05）,PT的K_ep差异有统计学意义（P<0.05）。PCNSL、GBM的ET与PT间K^trans、K_ep、V_e、iAUC差异均有统计学意义（P均<0.05）;PCNSL的PT与NP间K^trans差异有统计学意义（P<0.05）;GBM的PT与NP间K^trans及K_ep差异均有统计学意义（P均<0.05）。结论 动态对比增强MRI基于Tofts双室模型的药代动力学分析对PCNSL与GBM具有鉴别诊断价值。     

The age‐related reduction in cerebral blood flow affects vertebral artery more than internal carotid artery blood flow

Ageing reduces cerebral blood flow (CBF), while mean arterial pressure (MAP) becomes elevated. According to ‘the selfish brain’ hypothesis of hypertension, a reduction in vertebral artery blood flow (VA) leads to increased sympathetic activity and thus increases MAP. In twenty‐two young (24 ± 3 years; mean ± SD) and eleven elderly (70 ± 5 years) normotensive men, duplex ultrasound evaluated whether the age‐related reduction in CBF affects VA more than internal carotid artery (ICA) blood flow. Pulse‐contour analysis evaluated MAP while near‐infrared spectroscopy determined frontal lobe oxygenation and transcranial Doppler middle cerebral artery mean blood velocity (MCA V_mean). During supine rest, MAP (90 ± 13 versus 78 ± 9 mmHg; P<0·001) was elevated in the older subjects while their frontal lobe oxygenation (68 ± 7% versus 77 ± 7%; P<0·001), MCA V_mean (49 ± 9 versus 60 ± 12 cm s^?1; P = 0·016) and CBF (754 ± 112 versus 900 ± 144 ml min^?1; P = 0·004) were low reflected in VA (138 ± 48 versus 219 ± 50 ml min^?1; P<0·001) rather than in ICA flow (616 ± 96 versus 680 ± 120 ml min^?1; P = 0·099). In conclusion, blood supply to the brain and its oxygenation are affected by ageing and the age‐related decline in VA flow appears to be four times as large as that in ICA and could be important for the age‐related increase in MAP.     

Microcirculation of skeletal muscle adapts differently to a resistive exercise intervention with and without superimposed whole‐body vibrations

Whole‐body vibration (WBV) training is commonly practiced and may enhance peripheral blood flow. Here, we investigated muscle morphology and acute microcirculatory responses before and after a 6‐week resistive exercise training intervention without (RE) or with (RVE) simultaneous whole‐body vibrations (20 Hz, 6 mm peak‐to‐peak amplitude) in 26 healthy men in a randomized, controlled parallel‐design study. Total haemoglobin (tHb) and tissue oxygenation index (TOI) were measured in gastrocnemius muscle (GM) with near‐infrared spectroscopy (NIRS). Whole‐body oxygen consumption (VO₂) was measured via spirometry, and skeletal muscle morphology was determined in soleus (SOL) muscle biopsies. Our data reveal that exercise‐induced muscle deoxygenation both before and after 6 weeks training was similar in RE and RVE (P = 0·76), although VO₂ was 20% higher in the RVE group (P<0·001). The RVE group showed a 14%‐point increase in reactive hyperaemia (P = 0·007) and a 27% increase in blood volume (P<0·01) in GM after 6 weeks of training. The number of capillaries around fibres was increased by 15% after 6 weeks training in both groups (P<0·001) with no specific effect of superimposed WBV (P = 0·61). Neither of the training regimens induced fibre hypertrophy in SOL. The present findings suggest an increased blood volume and vasodilator response in GM as an adaptation to long‐term RVE, which was not observed after RE alone. We conclude that RVE training enhances vasodilation of small arterioles and possibly capillaries. This effect might be advantageous for muscle thermoregulation and the delivery of oxygen and nutrients to exercising muscle and removal of carbon dioxide and metabolites.     

Dynamics of the heart rate variability and oxygen saturation response to acute normobaric hypoxia within the first 10 min of exposure

Although the heart rate variability (HRV) response to hypoxia has been studied, little is known about the dynamics of HRV after hypoxia exposure. The purpose of this study was to assess the HRV and oxygen saturation (SpO₂) responses to normobaric hypoxia (FiO₂ = 9·6%) comparing 1 min segments to baseline (normoxia). Electrocardiogram and SpO₂ were recorded during a 10‐min hypoxia exposure in 29 healthy male subjects aged 26·0 ± 4·9 years. Baseline HRV values were obtained from a 5‐min recording period prior to hypoxia. The hypoxia period was split into 10 non‐overlapping 1‐min segments and time domain HRV indexes (RMSSD and SDNN) were calculated for each segment. Differences (Δ) from baseline values were calculated and transformed using natural logarithm (Ln). This study revealed that the decrease in ΔSpO₂ became significant (P<0·001) in the first minute of hypoxia, the decrease in ΔLn RMSSD became significant (P = 0·002) in the second minute, and the decrease in ΔLn SDNN became significant (P = 0·001) in the third minute. Between the second and fifth minute of hypoxia, ΔSpO₂ correlated with ΔLn RMSSD (r = 0·57, P<0·001) and ΔLn SDNN (r = 0·44, P<0·001). Five min after the onset of hypoxia, ΔSpO₂ was significantly (P = 0·002) decreased but changes in ΔLn RMSSD (P = 0·344) and ΔLn SDNN (P = 0·558) were not significant. In conclusion, the decrease in HRV was proportional to desaturation but only during the first 5 min of hypoxia.     

Relationship between ultrasound muscle thickness and MRI‐measured muscle cross‐sectional area in the forearm: a pilot study

Previous studies have investigated the relationship between ultrasound‐measured muscle thickness (MT) and individual muscle cross‐sectional area (CSA); however, the forearm muscle had not yet been studied. The purpose of this study was to examine the relationship between forearm MT by ultrasound and the muscle CSA of the forearm obtained by magnetic resonance imaging (MRI). Ten young and middle‐aged adults had both ultrasound and MRI measurements at 30% the distance from the styloid process of the ulna to the head of the radius. Handgrip strength (HGS) was also measured. Strong correlations (P<0·001) were observed between MRI‐measured muscle CSA (total and flexor and extensor components) and MT‐ulna (ranged r = 0·937–0·946) and MT‐radius (ranged r = 0·884–0·891). HGS was also correlated (P<0·001) with forearm MT (MT‐ulna, r = 0·877; MT‐radius, r = 0·852) and MRI‐measured muscle CSA (flexor CSA, r = 0·910; extensor CSA, r = 0·923). Our results suggest that forearm MT is closely associated with MRI‐measured forearm muscle CSA in young and middle‐aged adults and suggest that ultrasound‐measured forearm muscle thickness may be a useful variable for evaluating muscle CSA and function in the forearm.     

Influence of skin blood flow and source‐detector distance on near‐infrared spectroscopy‐determined cerebral oxygenation in humans

Most near‐infrared spectroscopy (NIRS) apparatus fails to isolate cerebral oxygenation from an extracranial contribution although they use different source‐detector distances. Nevertheless, the effect of different source‐detector distances and change in extracranial blood flow on the NIRS signal has not been identified in humans. This study evaluated the extracranial contribution, as indicated by forehead skin blood flow (SkBF) to changes in the NIRS‐determined cerebral oxyhaemoglobin concentration (O₂Hb) by use of a custom‐made multidistance probe. Seven males (age 21 ± 1 year) were in a semi‐recumbent position, while extracranial blood flow was restricted by application of four different pressures (+20 to +80 mmHg) to the left temporal artery. The O₂Hb was measured at the forehead via a multidistance probe (source‐detector distance; 15, 22·5 and 30 mm), and SkBF was determined by laser Doppler. Heart rate and blood pressure were unaffected by application of pressure to the temporal artery, while SkBF gradually decreased (P<0·001), indicating that extracranial blood flow was manipulated without haemodynamic changes. Also, O₂Hb gradually decreased with increasing applied pressure (P<0·05), and the decrease was related to that in SkBF (r = 0·737, P<0·01) independent of the NIRS source to detector distance. These findings suggest that the NIRS‐determined cerebral oxyhaemoglobin is affected by change in extracranial blood flow independent of the source‐detector distance from 15 to 30 mm. Therefore, new algorithms need to be developed for unbiased NIRS detection of cerebral oxygenation.     

Technetium‐99m‐anti‐tumour necrosis factor alpha scintigraphy as promising predictor of response to corticotherapy in chronic active Graves' ophthalmopathy

It has been suggested that technetium‐99m (99mTc)‐anti‐tumour necrosis factor alpha (TNF‐α) scintigraphy (SCI) may be a useful diagnostic tool in Graves' ophthalmopathy (GO). This study evaluated whether orbit total radioactivity uptake on SCI could be used to predict corticosteroid therapy (CorT) responses in active‐GO patients. A longitudinal study of patients with active GO defined by Clinical Active Score (CAS) >3/7 was done. Clinical, laboratory and SCI evaluations were performed at baseline and 3 months after concluding intravenous CorT. SCI (planar and tomographic) was assessed after intravenous injection of 10 mCi of 99mTc‐anti‐TNF‐α. Orbits and cerebral hemispheres were defined as regions of interest (ROIs) to enable orbit/hemisphere ROI‐ratios of total radioactive uptake. ROI‐ratios were considered positive at >2·5. Average total radiation uptake (TRU) was also determined for each orbit (AVG_ROI). Clinical, laboratory and SCI data were compared between responders (CAS became inactive) and non‐responders to CorT (18 patients). At baseline, AVG_ROI were higher in active OG orbits (67·3 cps) than in inactive ones (33·6 cps; P<0·05). AVG_ROI (absolute values) reduced (?29·9 cps) in CorT responders and tended (P = 0·067) to differ from variations occurred in non‐responders (+6·9 cps in patients with maintained CAS positivity post‐treatment). Higher baseline ROI‐ratios (4·9 versus 3·3; P = 0·056) and its pronounced reductions following CorT (?37% versus +56% in non‐responders; P = 0·036) tended to be associated with good CorT responses in the subgroup of GO history ≥1 year. SCI showed a good association with active eye disease and may be an additional tool to identify CorT responders.     

不同月经状态女性正常子宫动态增强MRI定量参数变化特性及其临床意义

目的 探讨不同月经状态女性正常子宫动态增强MRI定量参数值的特点及其临床意义。方法 收集我院46例不同月经状态女性资料,均行动态增强MR检查,测量子宫内膜、结合带及肌层定量参数值,包括体积转运常数（K^trans）、速率转运常数（K_ep）及体积分数（V_e）。根据不同月经状态将受试者分为绝经前和绝经后（n=14）。采用单因素方差或秩和检验比较子宫不同层面、不同月经状态的定量参数。结果 相同子宫层面,不同月经状态子宫内膜K^trans、K_ep值及子宫结合带V_e值总体比较差异有统计学意义（P均<0.05）;子宫内膜绝经后K^trans、K_ep值与分泌期和增殖期、分泌期K_ep值与增殖期差异均有统计学意义（P均<0.05）;结合带增殖期V_e值与绝经后间差异有统计学意义（P<0.05）。相同的月经状态,子宫内膜、结合带及肌层的K^trans值、K_ep值及V_e值差异均有统计学意义（P均<0.05）;子宫各层面分泌期K^trans值两两比较差异均有统计学意义（P均<0.05）,子宫结合带和肌层的增殖期和绝经后K^trans值与子宫内膜同一月经状态差异有统计学意义（P均<0.05）;除绝经后结合带与肌层间K_ep值差异无统计学意义,子宫各层面同一月经状态K_ep值两两比较差异均有统计学意义（P<0.05）。结论 采用动态增强MRI定量参数评判子宫疾病时应考虑不同月经状态下K^trans、K_ep和V_e的变化。     

Influence of exercise intensity on systemic oxidative stress and antioxidant capacity

The aim of the current study was to examine the influence of exercise intensity on systemic oxidative stress (OS) and endogenous antioxidant capacity. Non‐smoking, sedentary healthy adult males (n = 14) participated in two exercise sessions using an electronically braked cycle ergometer. The first session consisted of a graded exercise test to determine maximal power output and oxygen consumption (VO_2max). One week later, participants undertook 5‐min cycling bouts at 40%, 55%, 70%, 85% and 100% of VO_2max, with passive 12‐min rest between stages. Measures of systemic OS reactive oxygen metabolites (dROM), biological antioxidant potential (BAP), heart rate (HR), VO₂, blood lactate and rating of perceived exertion were assessed at rest and immediately following each exercise stage. Significant (P<0·05) differences between exercise bouts were examined via repeated measures ANOVA and post hoc pairwise comparisons with Bonferroni correction. Increasing exercise intensity significantly augmented HR (P<0·001), VO₂ (P<0·001), blood lactate (P<0·001) and perceived exertion (P<0·001) with no significant effect on dROM levels compared with resting values. In contrast, increasing exercise intensity resulted in significantly (P<0·01) greater BAP at 70% (2427 ± 106), 85% (2625 ± 121) and 100% (2651 ± 92) of VO_2max compared with resting levels (2105 ± 57 μmol Fe²⁺/L). The current results indicate that brief, moderate‐to‐high‐intensity exercise significantly elevates endogenous antioxidant defences, possibly to counteract increased levels of exercise‐induced reactive oxygen species. Regular moderate‐to‐high‐intensity exercise may protect against chronic OS associated diseases via activation, and subsequent upregulation of the endogenous antioxidant defence system.     

Cardiac power output and its response to exercise in athletes and non‐athletes

Cardiac power output (CPO) is an integrative measure of overall cardiac function as it accounts for both, flow‐ and pressure‐generating capacities of the heart. The purpose of the present study was twofold: (i) to assess cardiac power output and its response to exercise in athletes and non‐athletes and (ii) to determine the relationship between cardiac power output and reserve and selected measures of cardiac function and structure. Twenty male athletes and 32 age‐ and gender‐matched healthy sedentary controls participated in this study. CPO was calculated as the product of cardiac output and mean arterial pressure, expressed in watts. Measures of hemodynamic status, cardiac structure and pumping capability were assessed by echocardiography. CPO was assessed at rest and after peak bicycle exercise. At rest, the two groups had similar values of cardiac power output (1·08 ± 0·2 W versus 1·1 ± 0·24 W, P>0·05), but the athletes demonstrated lower systolic blood pressure (109·5 ± 6·2 mmHg versus 117·2 ± 8·2 mmHg, P<0·05) and thicker posterior wall of the left ventricle (9·8 ± 1 mm versus 9 ± 1·1 mm, P<0·05). Peak CPO was higher in athletes (5·87 ± 0·75 W versus 5·4 ± 0·69 W, P<0·05) as was cardiac reserve (4·92 ± 0·66 W versus 4·26 ± 0·61 W, P<0·05), respectively. Peak exercise CPO and reserve were only moderately correlated with end‐diastolic volume (r = 0·54; r = 0·46, P<0·05) and end‐diastolic left ventricular internal diameter (r = 0·48; r = 0·42, P<0·05), respectively. Athletes demonstrated greater maximal cardiac pumping capability and reserve than non‐athletes. The study provides new evidence that resting measures of cardiac structure and function need to be considered with caution in interpretation of maximal cardiac performance.     

Serum paraoxonase‐I activity is unaffected by short‐term administration of simvastatin,bezafibrate, and their combination in type 2 diabetes mellitus

Background The high‐density lipoprotein (HDL)‐associated anti‐oxidative and anti‐inflammatory enzyme, paraoxonase‐I, has been found previously to be lower in type 2 diabetes mellitus. We studied whether statin and fibrate treatment, alone and in combination, affect serum paraoxonase‐I activity in conjunction with changes in HDL cholesterol in diabetic patients. Subjects and methods A placebo‐controlled crossover study was carried out in 14 type 2 diabetic patients to test the effect of 8 weeks of active treatment with simvastatin (40 mg daily), bezafibrate (400 mg daily), and their combination on serum paraoxonase‐I activity, measured as its activity towards arylesterase and paraoxon. Serum paraoxonase‐I activity was also compared between these diabetic patients and 49 non‐diabetic control subjects. Results Serum arylesterase activity was lower in type 2 diabetic patients compared to control subjects (P < 0·001), but the difference in paraoxonase activity was not significant (P = 0·22). Neither arylesterase (P = 0·24) nor paraoxonase activity (P = 0·37) was increased in response to treatment, despite higher HDL cholesterol and apolipoprotein A‐I during combination therapy (P < 0·05 for both). Conclusion Short‐term administration of simvastatin and bezafibrate, even when combined, is ineffective in raising serum paraoxonase‐I activity in type 2 diabetes.     

动态对比增强MRI定量分析鉴别不同级别前列腺癌

目的 观察阴囊内腺瘤样瘤的声像图表现,并分析超声误诊原因。方法 回顾性分析15例经手术病理证实的阴囊内腺瘤样瘤患者的术前超声资料,并与病理结果对照,分析其超声表现及误诊原因。结果 15例阴囊内腺瘤样瘤中,8例位于附睾尾部,5例位于附睾头部,2例位于睾丸;3例超声误诊为炎性改变,3例误诊为囊肿,2例误诊为恶性肿瘤,7例未定性。超声表现为实性（12例）或囊性（3例）肿块。实性肿块中,7例边界清晰、形态规则,5例边界欠清晰;其中6例内部回声均匀,6例内部回声欠均匀,可见无回声及点状强回声。囊性肿块均为多囊,其内可见分隔。15例中,8例可探及血流信号,7例未见明显血流信号。结论 阴囊内腺瘤样瘤的超声表现缺乏特异性,结合病史及其他影像学手段有助于减少误诊。     

Whole body,regional fat accumulation,and appetite‐related hormonal response after hypoxic training

The present study was conducted to determine change in regional fat accumulation and appetite‐related hormonal response following hypoxic training. Twenty sedentary subjects underwent hypoxic (n = 9, HYPO, FiO₂ = 15%) or normoxic training (n = 11, NOR, FiO₂ = 20·9%) during a 4‐week period (3 days per week). They performed a 4‐week training at 55% of maximal oxygen uptake (O_2max) for each condition. Before and after the training period, O_2max, whole body fat mass, abdominal fat area, intramyocellular lipid content (IMCL), fasting and postprandial appetite‐related hormonal responses were determined. Both groups showed a significant increase in O_2max following training (P<0·05). Whole body and segmental fat mass, abdominal fat area, IMCL did not change in either group. Fasting glucose and insulin concentrations significantly reduced in both groups (P<0·05). Although area under the curve for the postprandial blood glucose concentrations significantly decreased in both groups (P<0·05), the change was significantly greater in the HYPO group than in the NOR group (P<0·05). Changes in postprandial plasma ghrelin were similar in both groups. A significant reduction of postprandial leptin response was observed in both groups (P<0·05), while postprandial glucagon‐like peptide‐1 (GLP‐1) concentrations increased significantly in the NOR group only (P<0·05). In conclusion, hypoxic training for 4 weeks resulted in greater improvement in glucose tolerance without loss of whole body fat mass, abdominal fat area or IMCL. However, hypoxic training did not have synergistic effect on the regulation of appetite‐related hormones.     

Plasma oxidative stress is induced by single‐sprint anaerobic exercise in young cigarette smokers

Cigarette smoking increases oxidative stress, which is a risk factor for several diseases. Smoking has also been reported to enhance plasma oxidative stress during strenuous exercise. However, no prior study has examined the changes in plasma oxidative stress after single‐sprint anaerobic exercise in cigarette smokers. The purpose of this study was to investigate these changes in young cigarette smokers by measuring reactive oxygen species generation and total antioxidant content. Participants were 15 male smokers (mean age: 25·9 ± 2·9 years) and 18 male non‐smokers (mean age: 24·2 ± 4·3 years). Hydroperoxide concentration and biological antioxidant potential (BAP) in plasma were measured at baseline and after the Wingate anaerobic test. A significant interaction between group and time was observed for plasma hydroperoxide concentration (P = 0·037). Plasma hydroperoxide concentration was significantly increased after exercise in both smokers and non‐smokers (P = 0·001 and <0·001, respectively). However, no significant interaction was observed between groups by time on plasma BAP (P = 0·574), and a main effect of time was observed (P<0·001). Plasma BAP was significantly increased after exercise in both groups (both, P<0·001). These findings indicate that plasma oxidative stress is higher in cigarette smokers than in non‐smokers after single‐sprint anaerobic exercise, which may increase the risk of oxidative damage.     

Relationship between sarcopenic obesity-related phenotypes and inflammatory markers in postmenopausal women

Ageing is associated with changes in body composition that may result in sarcopenic obesity (SO). Interleukin-6 (IL-6) and C-reactive protein (CRP) are important inflammatory markers related to ageing. SO has been examined as an important public health problem, but its association with inflammatory markers has yet to be investigated. The aim of this study was to investigate the association between SO-related phenotypes and inflammatory markers in postmenopausal women. A total of 130 women (66·7 ± 5·2 years) underwent body composition evaluation using dual-energy X-ray absorptiometry. Volunteers were classified according to a SO definition previously described in the literature. Waist circumference (WC) and handgrip strength (HG) were also measured. Blood samples were collected for CRP, tumour necrosis factor and IL-6 measurements. All the inflammatory markers were higher in SO individuals when compared to non-SO; however, only IL-6 reached statistical significance (median 3·34 versus 1·37 pg ml⁻¹; P<0·05). Also, CRP was significantly correlated (P<0·01) with body mass index (r_s = 0·34), fat mass (FM; r_s = 0·25) and WC (r_s = 0·33). Similarly, IL-6 levels were significantly correlated (P<0·05) to age (r_s = 0·19), FM (r_s = 0·19) and WC (r_s = 0·17). HG was found to be significantly reduced among subjects with higher IL-6 levels (P = 0·02). In summary, the combination of reduced muscle mass and excess body fat (i.e. SO) is associated with elevated inflammatory markers in postmenopausal women. Moreover, CRP and IL-6 are associated with SO-related phenotypes in this population.     

动态对比增强MRI放射状采集容积内插屏气序列(Radial-VIBE)定量参数预测膀胱癌病理学分级

目的 评价动态对比增强MRI（DCE-MRI）放射状采集容积内插屏气检查（Radial-VIBE）序列定量参数预测膀胱癌病理学分级的价值。方法 前瞻性纳入60例经术后病理证实为膀胱尿路上皮癌的膀胱癌患者,将其分为低级别组（n=36）和高级别组（n=24）。比较组间DCE-MRI参数,包括容积转运常数（K^trans）、速率常数（K_ep）、血管外细胞外间隙容积（V_e）及对比剂浓度-时间曲线下初始面积（IAUC）的差异;采用组内相关系数（ICC）评价观察者间测量结果的一致性。采用Spearman秩相关分析评价各参数与膀胱癌病理分级的相关性。绘制受试者工作特征（ROC）曲线,计算曲线下面积（AUC）,评价各参数预测高级别膀胱癌的效能。结果 观察者间测量定量参数K^trans、K_ep、V_e及IAUC结果的一致性良好（ICC=0.82、0.83、0.83、0.85,P均<0.05）。高级别组K^trans、K_ep及IAUC均显著高于低级别组（P均<0.05）,V_e显著低于低级别组（P<0.05）。K^trans、K_ep及IAUC均与病理分级呈正相关（r=0.61、0.54、0.29,P均<0.05）,V_e与病理分级呈负相关（r=-0.36,P<0.05）。K^trans、K_ep及IAUC预测高级别尿路上皮癌的AUC分别为0.86、0.82及0.67。结论 DCE-MRI Radial-VIBE序列定量参数K^trans、K_ep、Ve及IAUC可辅助预测膀胱癌病理学分级。