Changes in infraspinatus cross-sectional area and shoulder range of motion with repetitive eccentric external rotator contraction

Background

Repetitive eccentric loading results in muscle damage and subsequent changes in muscle stiffness and edema accumulation, which manifest as reduced joint range of motion and increased muscle cross-sectional area. The purpose of the study was to evaluate changes in shoulder range of motion and the infraspinatus cross-sectional area with repetitive eccentric contraction.

Methods

Twenty physically active participants performed 9 sets of 25 repetitions of eccentric external rotator contractions. The ultrasonographic measurement of the infraspinatus cross-sectional area, and shoulder internal/external rotation and horizontal adduction range of motion were measured before, immediately after, and 24 h after the intervention.

Findings

Infraspinatus cross-sectional area significantly increased from baseline immediately after exercise (P < 0.001), and remained elevated from baseline at the 24-hour follow up (P < 0.001). Internal rotation and horizontal adduction range of motion did not change significantly between baseline and post-exercise (P > 0.05), but were significantly decreased at the 24-hour follow up from the baseline (internal rotation: P < 0.001, horizontal adduction: P < 0.001) and the immediate post-exercise (internal rotation: P = 1.012, horizontal adduction: P = 0.016).

Interpretation

These changes observed after the eccentric contractions may have implications for injury development in pitchers, because 1) the infraspinatus endures repetitive eccentric loading with pitching and 2) decreased internal rotation and horizontal adduction range of motion have been linked to upper extremity injuries. However, since the muscle response after eccentric loading varies by the task and previous exposure to similar stress, future study needs to investigate the time course of recovery of the muscle cross-sectional area and range of motion after pitching in competitive pitchers.     

Reliability of the rectus femoris muscle cross-sectional area measurements by ultrasonography

The skeletal muscle system can adapt to an external stimulus from either physiological or pathological conditions. This plasticity is measured by imaging techniques such as magnetic resonance imaging or ultrasound. The anatomical cross-sectional area of a muscle is one of the muscle architecture parameters that relates to the maximum muscle strength. The aim of this study was to determine the reliability of anatomical cross-sectional area rectus femoris measurements, obtained by ultrasound, with two different protocols. Acquisition of four anatomical cross-sectional area images of the right rectus femoris in two distinct regions (15 cm above the patella and 50% of the thigh length) was performed in 2 days, from a group of 15 young healthy subjects. The cross-sectional area of each image was measured five times. The reliability of the anatomical cross-sectional area measures was determined by the coefficient of variation (CV), intraclass correlation coefficient (ICC) and typical error of measurement (TEM). In each protocol, there were no significant differences between the means of anatomical cross-sectional area in measurements, images and days (P>0·05). The CVs were 8·53% and 8·9%, the ICCs 0·88 and 0·87 and the TEMs 65·59 and 94·25 between the 2 days in the regions of 15 cm and 50% of the thigh length, respectively. The average values of the cross-sectional area at 50% of the thigh length were significantly higher than those for at 15 cm above the patella (P<0·001). The measurement of rectus femoris anatomical cross-sectional area by ultrasound proved reliable.     

胰腺CT密度和最大截面积联合NLR可评估重症胰腺炎的预后

目的  探讨胰腺CT密度和最大截面积联合中性粒细胞淋巴细胞比值（NLR）检测在重症胰腺炎预后的评估价值。方法  选取2020年6月~2022年1月我院收治的46例重症胰腺炎患者作为观察组,另选同期40例健康体测者作为对照组,对所有研究对象进行CT检查,结合Image J计算胰腺CT密度和最大截面积,检测NLR,利用ROC曲线分析三者联合对重症胰腺炎预后评估的价值。结果  观察组患者胰腺CT密度小于对照组（P < 0.05）,最大截面积大于对照组（P < 0.05）;观察组患者NLR高于对照组（P < 0.05）,BISAP评分较高;CT密度和最大截面积评估重症胰腺炎预后的曲线下面积为0.786,敏感度为80.31%,特异性为80.84%;NLR评估重症胰腺炎预后的曲线下面积为0.775,敏感度为62.51%,特异性为56.27%;CT密度及最大截面积联合NLR评估重症胰腺炎预后的曲线下面积为0.884,敏感度为87.51%,特异性为82.15%。结论  利用胰腺CT密度和最大截面积联合NLR检测对重症胰腺炎预后进行评估具有一定的临床应用价值。     

The effect of high-resistance training on the strength and cross-sectional area of the human quadriceps

Seventeen volunteers performed unilateral strength-training of the quadriceps with high-resistance, low-repetition, dynamic exercise, thrice weekly for an average of 5 weeks. Both before and after the training period, bilateral measurements were made of isometric quadriceps strength, quadriceps cross-sectional area (by ultrasound scanning), and thigh circumference. There were no significant changes in the untrained thighs. The trained quadriceps increased their isometric strength by more than they changed their cross-sectional area (mean increments = 15% and 6% respectively). Quadriceps hypertrophy was underestimated by measurements of thigh circumference and could not be predicted from them. We conclude that studies of localized muscle growth require direct measurements of the size of the muscle(s) concerned. Nevertheless, these may still underestimate the improvements in strength produced by high-resistance training.     

Morphological and functional relationships with ultrasound measured muscle thickness of the upper extremity and trunk

Unless a subject’s muscle is relatively small, a single image from a standard ultrasound can only measure muscle thickness (MT). Thus, it is important to know whether MT is related to morphological and functional characteristics of individual muscles of the extremity and trunk. In this review, we summarize previously published articles in the upper extremity and trunk demonstrating the relationships between ultrasound-measured MT and muscle morphology (cross-sectional area, CSA and muscle volume, MV) and muscular or respiratory function. The linear relationship between MT and muscle CSA or MV has been observed in biceps brachii, triceps brachii, pectoralis major, psoas major, and supraspinatus muscles. Previous studies suggest that MT in the upper arm and trunk may reflect muscle CSA and MV for the individual muscles. Unfortunately, few studies exist regarding the functional relationship with ultrasound MT in the upper extremity and trunk. Future research is needed to investigate these findings further.     

Atrophy of individual thigh muscles measured by MRI in older adults with knee osteoarthritis: A cross-sectional study

BackgroundThe characteristics of thigh-muscle cross-sectional area (CSA) in older adults with knee osteoarthritis (KOA) remain controversial.ObjectivesThis study aimed to evaluate atrophy of individual thigh muscles in older adults with KOA and to determine which muscle CSA should be measured to detect KOA-related muscle atrophy of the thigh.MethodsIn older adults, individual thigh-muscle CSA measured by 1.5 Tesla MRI was analyzed at 5% intervals of the femoral length (FL) around the mid-thigh between the proximal 25% of the FL and the distal 25%. Participants with KOA grade ≤ 1 and grade ≥ 2 were compared for ratios of quadriceps muscle (QM) CSA to total thigh, individual QM CSA to QM, and individual hamstring (HAM) CSA to HAM at 5% intervals.ResultsWe included 40 older adults [20 males; mean (SD) age 73.3 (4.7) years; 20 with KOA grade ≤ 1 and 20 with KOA grade ≥ 2]. The ratio of vastus medialis (VM) CSA to QM from the proximal 25% to distal 15% and the ratio of semi-membranosus (SM) CSA to HAM at the distal 10% to 25% were significantly lower with KOA grade ≥ 2 than grade ≤ 1; the effect sizes were 0.34 to 0.67 for VM and 0.40 to 0.60 for SM. The effect sizes were greatest for the ratios of VM CSA to QM at the mid-thigh with 5% intervals and the ratio of SM CSA to HAM at the distal 25%.ConclusionsThe ratio of VM CSA to QM and/or that of SM CSA to HAM were low and were the best indicators to detect KOA-related muscle atrophy of the thigh. However, to detect KOA-related muscle atrophy, the VM CSA ratio should be analyzed in the thigh region around the mid-thigh, whereas the SM CSA ratio should be analyzed in the thigh region at the muscle belly.     

The reliability of routine anthropometric data collected by health workers: A cross-sectional study

Background

Reliable data on child growth is a prerequisite for monitoring and improving child health. Despite the extensive resources invested in recording anthropometry, there has been little research into the reliability of these data. If these measurements are unreliable growth may be misreported, and health problems may go undetected.

Objectives

To assess the reliability of routine infant growth data, following anthropometric training of health workers responsible for collecting these data, in Bradford, UK. To determine whether being observed by an external administrator influenced reliability.

Design

A test-retest design was used.

Participants

All health workers (n = 192) responsible for growth monitoring in Bradford were included in the study, of which 36.5% (n = 70) had complete data.

Methods

Following training in basic anthropometry all health workers were asked to complete a test-retest study, using infants aged 0-2 years. Health workers took two recordings of weight, length, head circumference, and abdominal circumferences on five infants. A peer health worker recorded a third set of measurements on each infant. Twenty-two individuals were selected to be observed by an external administrator during data collection. Technical error of measurements (TEMs) were produced to assess intra-observer and inter-observer reliability. Differences between groups were tested to determine whether external observation influences reliability.

Results

None of the TEMs were excessively large, and coefficients of reliability ranged from 0.96 to 1.00. All intra-observer and inter-observer TEMs for the observed group were larger than those for the non-observed group. For example, the observed group’s intra-observer TEMs for weight, length, abdominal circumference, and head circumference (46.18 g, 0.60 cm, 0.65 cm, 0.47 cm) were larger than the non-observed group’s TEMS (9.14 g, 0.35 cm, 0.34 cm, 0.19 cm). TEMs for weight, abdominal circumference, and head circumference were significantly larger for the observed group, compared to the non-observed group (p < 0.001). Inter-observer TEMs for length were also significantly larger for the observed group (p = 0.031), whilst intra-observer TEMs for length were not significantly different between the two groups (p = 0.137).

Conclusions

Following training in anthropometry health workers in Bradford can, in general, reliably measure child growth. TEMs were comparable to data from other research studies and all coefficients of reliability were indicative of good quality control. Reliability measurement provides a method of quality assurance for routine data monitoring. If commissioners of health services are to be informed by these data then some form of reliability assessment should be considered, and if employed external observation is recommended to improve validity.     

一氧化氮、一氧化氮合成酶及血小板参数与脑梗死面积的相关性研究

目的探讨脑梗死患者发病过程中一氧化氮(NO)、一氧化氮合成酶(NOS)及血小板(PLT)、血小板分布宽度(PDW)、平均血小板体积(MPV)的意义及与梗死面积的相关性。方法检测53例脑梗死患者和40例健康对照者血清中NO、NOS、PLT、PDW、MPV的含量。结果脑梗死急性期MPV、NOS显著增高(P<0.05);PDW、NO显著增高(P<0.01);PLT显著减低(P<0.01)。NO、NOS分别与PDW、MPV之间呈显著正相关,与PLT呈负相关。结论PDW、MPV、NO、NOS的变化值随梗死面积的增加而增加,PLT则随梗死面积增加而减少。     

Crown rump length: a comparison of real time scanning and conventional compound scanning. The interindividual measuring variation between two operators

Ultrasonic measurements of crown rump length (CRL) obtained by conventional compound scanning and real time scanning were compared. Normal growth curves for fetal CRL were determined for both types of equipments. The curve for mean values found on the real time scanner ran parallel to and above the mean values found on the compound scanner because of a systematic underestimation by one operator on the latter scanner.A comparison of the interindividual measuring variation was done in 39 patients where both authors independently on the same day measured CRL on the same patient using both equipments. The conclusion drawn is that the real time scanner offers an advantage over conventional compound scanner by facilitating location of the fetal long axis and improving reproducibility of measurements, particularly in the hands of an inexperienced operator.     

The reliability,responsiveness and clinical utility of the proximat: A new tool for measuring hip range of movement in children with cerebral palsy

Background and Purpose . Monitoring range of movement is a key aspect of managing hip problems in children with cerebral palsy. The aim of this study was to assess the clinical utility, reliability and responsiveness of a new measurement tool, the Proximat, for hip range of movement. Method . Passive hip abduction, adduction, medial and lateral rotation were measured by using the Proximat on 26 children with cerebral palsy attending three special schools: 16 of whom are boys, mean age = 7 years and 6 months (standard deviation = 4.2 years), range 2–15 years. Testing was undertaken by two physiotherapists to assess interrater reliability and repeated the following day to assess test–retest reliability. Total, random and systematic errors were calculated for interrater and test–retest. Results . The Proximat was quick and easy to use and acceptable to the children. High reliability was found for all movements (intraclass correlation coefficient = 0.83–0.93) with reasonable responsiveness; total error was 2.5–12 degrees. Most of the error was random with little evidence of systematic bias. Conclusions . The Proximat is a reliable, responsive and acceptable method of measuring passive hip movements in children with cerebral palsy in day‐to‐day clinical practice. A change of 8–12 degrees is needed to overcome measurement error and to indicate that a ‘true’ change in range of movement has occurred. Copyright © 2008 John Wiley & Sons, Ltd.     

中药颈复贴外敷治疗椎动脉性颈椎病的临床研究

目的采用中药穴外敷来治疗CSA以期为该病的治疗提供新的思路和方法。方法将颈敷贴(NA)贴在穴位上, 并与单纯口服西比灵做对比。结果颈复贴外用能抑制血小板聚集,同时它能有效的扩张小血管,从而改善了血流变学的变化。结论该研究证实颈复贴能抑制红细胞聚集,因而能改善椎基底动脉的血液循环,改善脑的缺血、缺氧状态。     

三维超声自由解剖切面联合容积对比成像技术测量肛提肌裂孔面积

目的 观察三维超声自由解剖切面(Omniview)联合容积对比成像(VCI)技术(O+V技术)测量肛提肌裂孔面积的价值.方法 回顾性分析283名接受经会阴实时三维盆底超声检查女性,对比观察不同医师(医师1、医师2)采用O+V技术及立体渲染模式(R模式)测量最大瓦尔萨尔瓦状态下最小肛提肌裂孔面积所用时长,并采用组内相关系...     

The value of intraoperative ultrasound during hepatic resection compared with improved preoperative magnetic resonance imaging

BACKGROUND: Patients with colorectal metastases confined to the liver may be cured by resection. Combined bimanual palpation and intraoperative ultrasound (IOUS) augment the detection of colorectal hepatic metastases. The importance of IOUS in the surgical management of hepatic tumors has been demonstrated and should arguably be considered the final diagnostic procedure. OBJECTIVE: To determine the relevance of routine IOUS prior to hepatic resection compared with improved preoperative Magnetic resonance imaging (MRI). PATIENTS AND METHODS: Eighty patients with metastatic colorectal adenocarcinoma underwent hepatic resection between 1998 and 2001. The IOUS results were compared with preoperative MRI, bimanual palpation, and resection histopathology. The preoperative surgical plan was compared with the surgical procedure performed. Data were retrospectively analyzed. RESULTS: IOUS provided additional useful information not available preoperatively for 37 (47%) patients, including the identification of subcentimetre metastatic lesions, characterization of the lesion, and the anatomy of the hepatic vasculature. The preoperative surgical plan was changed secondary to the IOUS findings alone in 14/80 (18%) patients. IOUS did not provide any additional useful information for 43 (53%) patients. A correlation was demonstrated between the preoperative diagnosis, intraoperative findings, and resection histopathology. CONCLUSION: Accurate diagnostic studies facilitate critically decisive actions during planned hepatic resection(s). The current findings suggest that IOUS provide the most useful additional information for hepatic lesions, despite recent improvements in preoperative MRI scanning. Furthermore, routine IOUS should be employed during hepatic resection for colorectal metastases.     

瞬时波强负向波面积(NA)与脉象参数的相关性研究

目的通过检测正常人颈动脉瞬时波强负向波面积(NA)及桡动脉脉象各参数,分析WI技术用于脉象研究的可行性探讨脉象研究的新思路。方法应用ALOKA公司Prosoundα10彩色多普勒超声诊断仪和DDMX-100脉象仪对53例正常人颈动脉瞬时波强负向波面积和桡动脉脉象相关指标进行检测。结果NA与h_3/h_1呈正相关(r=0.375,P0.01),与h_4/h_1呈正相关(r=0.361,P0.01),与t_4呈正相关(r=0.309,P0.05),与h_5呈负相关(r=-0.349,P0.05),与h_5/h_1呈负相关(r=-0.330,P0.05),与h_1/t_1呈负相关(r=-0.294,P0.05)。NA与h_1、h_3、h_4、t_1、t_5、t、t_5/t_4、As Ad无相关性。结论将WI技术应用于脉象研究,具有可行性,能为中医脉象的研究拓展新思路。应用脉图技术定量检测心血管功能具有科学性、可能性。     

中青年腰椎间盘突出症患者的腰椎间盘自护行为水平及影响因素分析

目的:研究中青年腰椎间盘突出症患者对腰椎间盘的自护行为水平及其影响因素。方法:采用自行设计的中青年腰椎间盘突出症患者认知与行为调查问卷和改良版ODI功能障碍指数量表对福州市和莆田市两所三级甲等医院内526名中青年腰椎间盘突出症患者进行横断面调查,分析其对腰椎间盘自护行为的影响因素及其与功能障碍的相关性。结果:中青年腰椎间盘突出症患者对腰椎间盘自护行为水平得分为(86.49±14.04)分,百分制得分为(52.42±8.51)分,处于较低水平。多元线性回归分析显示,职业、病程、对腰椎的自我关注程度和疾病认知水平是中青年腰椎间盘突出症患者对腰椎间盘自护行为水平的影响因素(P<0.05),患者对腰椎间盘自护行为与功能障碍呈负相关(r=-0.329,P<0.001)。结论:中青年腰椎间盘突出症患者对腰椎间盘自护行为水平较低,有待提高。医护人员应加强对腰椎间盘自护行为方面的相关教育,指导患者掌握对腰椎间盘自护行为技能,改善患者功能障碍水平,帮助患者实现自我康复。     

超声测量髂腰肌横截面积在老年2型糖尿病肌少症诊断中应用价值分析

目的： 探究超声测量指标髂腰肌横截面积（Cross Sectional Area,CSA）在诊断老年（≥65岁）2型糖尿病（Type 2 diabetes mellitus,T2DM）肌肉减少症（简称：肌少症）中的应用价值。 方法：选取自贡市第四人民医院2022年11月至2023年5月间的133例确诊的老年T2DM患者作为观察组,根据肌少症的诊断标准,采用生物电阻抗分析法测量的四肢骨骼肌质量（Appendicular skeletal muscle mass,ASM）和手持式握力计测量的握力（Handgrip strength,HGS）值作为判断指标,将研究对象划分为肌少症组和无肌少症组。随后,通过超声技术测量并记录两组成员的髂腰肌横截面积（Cross sectional area, CSA）、DFY软件测量髂腰肌平均灰度和声强。利用单因素分析寻找与有无肌少症存在联系的关键变量,随后构建多变量Logistic回归模型（逐步法）揭示肌少症发生的独立危险因素,并将有意义的指标纳入回归模型,采用灵敏度、特异度、准确率、AUC判断诊断肌少症的应用价值。最后通过Pearson相关分析CSA与ASM、HGS的关联性。 结果：肌少症组和无肌少症组患者的年龄、髂腰肌平均灰度和声强无明显差异（P >0.05）,BMI和超声髂腰肌CSA组间差异具有统计学意义（P <0.01）,肌少症人群BMI和超声髂腰肌CSA更低,其中男性超声髂腰肌CSA分别为5.85 ± 1.73cm2,7.51 ± 1.74cm2,女性分别为4.51 ± 0.93cm2,5.76 ± 1.30cm2;Logistic回归模型显示BMI（OR=0.852,P =0.036）、超声髂腰肌CSA（OR=0.593,P =0.001）是肌少症发生的保护因素;CSA、BMI、CSA+BMI分别纳入回归模型诊断肌少症,BMI断肌少症灵敏度、特异度、准确率、AUC分别为53.8%、74.2%、72.2%、0.656;CSA诊断肌少症灵敏度、特异度、准确率、AUC分别为64.7%、78.6%、74.7 %、0.723;BMI联合CSA诊断肌少症灵敏度、特异度、准确率、AUC分别为62.4%、81.2%、75.9%、0.753,联合模型效果较为理想;CSA与ASM（r=0.53,P <0.01）、HGS（r=0.55,P <0.01）均存在相关,其中CSA与ASM的相关性女性（r = 0.50, P < 0.01）高于男性（r = 0.30, P < 0.05）,CSA与HGS的相关性男性（r=0.40, P <0.01）高于女性（r = 0.30, P <0.01）。 结论：超声测量髂腰肌CSA可能是一个在诊断老年T2DM肌少症中很高价值的参数,有助于评估肌肉质量、筛查肌少症。     

多发性骨髓瘤患者的自测健康评定

目的了解多发性骨髓瘤(multiple myeloma,MM)患者的健康状况。方法采用自测健康评定量表(self-ratedhealth measurement scale,SRHMS)对50例MM患者和50例正常人群进行评定并比较。结果 MM患者在生理、心理及社会维度上的评分均低于正常人群(P<0.05或P<0.01),而在认知功能和角色活动与社会适应上与正常人群相比,差异无统计学意义。结论加强对MM患者的生活护理、心理护理对患者的健康恢复是必要的。     

多普勒超声收缩期峰值与阻力指数在鉴别诊断乳腺肿瘤中的应用价值

目的 探讨多普勒超声收缩期峰值血流速度(PSV)与阻力指数(RI)在乳腺良恶性肿瘤鉴别诊断中的价值.方法 回顾分析经手术证实的120例乳腺肿瘤患者(良性46例,恶性74例)的血流参数PSV、RI,比较两者在鉴别诊断乳腺良恶性肿瘤中的敏感性、特异性和准确性.结果 乳腺恶性肿瘤RI较良性肿瘤明显增高,两者差异有统计学意义,而PSV差异无统计学意义.以PSV>20 cm/s,RI>0.7作为乳腺恶性肿块的判定标准,PSV与RI的诊断准确性分别为55.8%、77.5%;敏感性为50.0%、77.0%;特异度为65.2%、78.3%.联合PSV与RI两项指标其鉴别准确率为79.4%.结论 彩色多普勒血流参数PSV、RI有助于乳腺良恶性肿瘤的鉴别诊断;RI的鉴别诊断价值明显优于PSV;联合两者判定可提高诊断准确性,但与单独使用RI并无明显差别.     

内镜黏膜下剥离术治疗大面积早期食管癌的疗效分析

目的 探讨内镜黏膜下剥离术（ESD）治疗大面积早期食管癌的疗效。方法 回顾性分析该院消化内科2013年12月-2020年12月行ESD治疗的179例病变长径大于3 cm的早期食管癌患者的临床资料,按病变长径将患者分为3组,分别为：3 cm≤d <5 cm组、5 cm≤d <7 cm组和d≥7 cm组。分析3组患者手术安全性（迟发穿孔率、气体相关并发症发生率、术后出血率和狭窄率）及有效性（整块切除率、治愈性切除率和局部复发率）的差异。结果 3组患者迟发性穿孔率均为0.00%,3 cm≤d <5 cm组、5 cm≤d <7 cm组和d≥7 cm组气体相关并发症发生率分别为5.21%、8.33%和13.04%,出血率分别为1.04%、3.33%和8.70%,整块切除率分别为98.96%、95.00%和91.30%,3组患者气体相关并发症发生率、术后出血率和整块切除率比较,差异均无统计学意义（P> 0.05）;3组患者病变狭窄率分别为9.38%、23.33%和47.83%,差异有统计学意义（P <0.05）。3 cm≤d <5 cm组和5 cm≤d &...