<Emphasis Type="Italic">ERBB4</Emphasis> polymorphism and family history of psychiatric disorders on age-related cortical changes in healthy children

Genetic variations in ERBB4 were associated with increased susceptibility for schizophrenia (SCZ) and bipolar disorders (BPD). Structural imaging studies showed cortical abnormalities in adolescents and adults with SCZ or BPD. However, less is known about subclinical cortical changes or the influence of ERBB4 on cortical development. 971 healthy children (ages 3–20 years old; 462 girls and 509 boys) were genotyped for the ERBB4-rs7598440 variants, had structural MRI, and cognitive evaluation (NIH Toolbox ®). We investigated the effects of ERBB4 variants and family history of SCZ and/or BPD (FH) on cortical measures and cognitive performances across ages 3–20 years using a general additive model. Variations in ERBB4 and FH impact differentially the age-related cortical changes in regions often affected by SCZ and BPD. The ERBB4-TT-risk genotype children with no FH had subtle cortical changes across the age span, primarily located in the left temporal lobe and superior parietal cortex. In contrast, the TT-risk genotype children with FH had more pronounced age-related changes, mainly in the frontal lobes compared to the non-risk genotype children. Interactive effects of age, FH and ERBB4 variations were also found on episodic memory and working memory, which are often impaired in SCZ and BPD. Healthy children carrying the risk-genotype in ERBB4 and/or with FH had cortical measures resembling those reported in SCZ or BPD. These subclinical cortical variations may provide early indicators for increased risk of psychiatric disorders and improve our understanding of the effect of the NRG1–ERBB4 pathway on brain development.     

Long Term Effect of Intensive Lifestyle Intervention on Cerebral Blood Flow

Objectives

To determine whether long‐term behavioral intervention targeting weight loss through increased physical activity and reduced caloric intake would alter cerebral blood flow (CBF ) in individuals with type 2 diabetes mellitus.

Design

Postrandomization assessment of CBF.

Setting

Action for Health in Diabetes multicenter randomized controlled clinical trial.

Participants

Individuals with type 2 diabetes mellitus who were overweight or obese and aged 45 to 76 (N = 310).

Interventions

A multidomain intensive lifestyle intervention (ILI ) to induce weight loss and increase physical activity for 8 to 11 years or diabetes support and education (DSE ), a control condition.

Measurements

Participants underwent cognitive assessment and standardized brain magnetic resonance imaging (MRI ) (3.0 Tesla) to assess CBF an average of 10.4 years after randomization.

Results

Weight changes from baseline to time of MRI averaged ?6.2% for ILI and ?2.8% for DSE (P < .001), and increases in self‐reported moderate or intense physical activity averaged 444.3 kcal/wk for ILI and 114.8 kcal/wk for DSE (P = .03). Overall mean CBF was 6% greater for ILI than DSE (P = .04), with the largest mean differences between ILI and DSE in the limbic region (3.39 mL /100 g per minute, 95% confidence interval (CI ) = 0.07–6.70 mL /100 g per minute) and occipital lobes (3.52 mL /100 g per minute, 95% CI = 0.20–6.84 mL /100 g per minute). In ILI , greater CBF was associated with greater decreases in weight and greater increases in physical activity. The relationship between CBF and scores on a composite measure of cognitive function varied between intervention groups (P = .02).

Conclusions

Long‐term weight loss intervention in overweight and obese adults with type 2 diabetes mellitus is associated with greater CBF .

     

OMERACT workshop: repair of structural damage in rheumatoid arthritis

This article describes the process and results of a workshop aimed at reviewing data on repair of structural damage collected by the OMERACT Subcommittee on Healing of Erosions and at defining a priority list for the subsequent research agenda.     

肺癌伴大量胸水的CT观察（附33例分析）

目的：探讨大量胸水并肺癌的ＣＴ征象,提高诊断正确率。材料与方法：对３３例经病理证实为肺癌病人的ＣＴ资料进行回顾性分析,患者均为大量的胸水并肺组织受压不张,肿瘤又位于不张的肺内,对ＣＴ征象及其它影像学检查的诊断率进行了对比分析。结果：ＣＴ和ＲＩ诊断率在８０％左右,Ｘ线平片及Ｂ超在２０左右,二者比较差异有高度显著性（≤０．０１）。肺不张的异常改变包括形态、密度、支气管的改变。胸膜改变仅２０％,肺门及纵隔侵犯为５８％,两者间差异有显著性（０．５〉Ｐ≥０．０５）。结论：（１）大量胸水并肺癌的影像学检查首选ＣＴ;（２）不张肺的形态、密度、支气管的异常对诊断超重要作用,可使诊断率达到８５％;（３）纵隔、肺门侵犯有辅助诊断作用,而胸膜改变发生率较低,无特异性。     

颈内动脉狭窄或闭塞侧支循环途径的DSA和MR血管成像研究

目的　研究DSA、MR血管成像 (MRA)对颈内动脉狭窄或闭塞后侧支循环途径评价的意义。方法　颈内动脉狭窄或闭塞者 74例 ,DSA和MRA上脑血管正常表现者各 6 0例为对照组 ,分析其DSA和MRA表现。结果　 74例患者均有颈内动脉分叉以上狭窄或闭塞。病变同侧后交通动脉在DSA上的出现率 ,疾病组低于对照组 (P =0 0 2 5 ) ;在时间飞跃 (TOF)法MRA上的出现率 ,疾病组明显高于对照组 (P =0 0 0 0 )。后交通动脉DSA、MRA测量值均较对照组增大 (P =0 0 0 0 )。眼动脉直径DSA测量值较对照组增大 (P =0 0 0 3)。疾病组后交通动脉出现率在DSA上高于MRA (P <0 0 5 )。结论　DSA对本病侧支途径评价有重要意义 ,为术前必要检查。MRA安全 ,可从形态和功能上评价侧支循环 ,可做为首选方法     

红外热像图对乳腺癌诊断价值的探讨(附21例分析)

目的：探讨红外热像图对乳腺癌的诊断价值。方法：采用医用红外热像仪对287例临床拟诊为乳腺病患者进行了检查。常规取正前位及左右斜位扫描，并逐一测量异常病灶的温度。结果：287例患者中，共检出乳腺癌21例，均经手术及病理证实。其中浸润性乳头状导管癌8例，髓样癌4例，硬癌5例，单纯癌2例，腺癌和肉瘤各1例。结论：红外热像图对乳腺癌的早期诊断有独到之处。     

肝局灶性结节增生的不典型螺旋CT征象分析

目的探讨肝局灶性结节增生(FNH)不典型的螺旋CT征象。方法对病理证实或临床确诊的32例FNH患者37个病灶的螺旋CT征象进行回顾性分析。结果 37个病灶中,有 14个病灶直径≤3 cm,23个病灶直径>3 cm;7个病灶周边存在假包膜;22个病灶存在中央瘢痕, 其中有20个病灶直径>3 cm;所有病灶在动脉期均呈高密度,其中31个病灶肿瘤实质均匀强化。结论多发病灶、存在假包膜、无中央瘢痕、动脉期不均匀强化是FNH不典型的CT征象。征象的多样性与病灶的病理类型和病灶的直径相关。