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Background: There are inconsistent results regarding the relationships of adiposity anthropometric indices and blood pressure (BP) and hypertension, and whether these relationships differ by sex is unclear. We aimed to elucidate the associations of adiposity indices measured using quantitative computed tomography (QCT) with BP and hypertension and to determine the effect of sex on the relationships in a Chinese population. Methods: Abdominal adipose fat, including visceral adipose tissue (VAT) area and subcutaneous adipose tissue (SAT) area, was measured by QCT in 1488 participants. Body mass index (BMI), waist circumference (WC), hip circumference (HC) and systolic (SBP) and diastolic BP (DBP) were measured. Results: Compared to women, men had significantly greater VAT but less SAT regardless of hypertension status. VAT, SAT and WC correlated more with SBP in men than in women. After controlling for body weight, height and age, VAT area and WC in women and VAT area in men were positively associated with SBP and DBP level. VAT area correlated more with the increased risk of hypertension in men than in women [men: odds ratio (OR) = 1.013, women: OR = 1.011]. WC had a significant correlation with an increased risk of hypertension in women but a borderline association in men (P = 0.059) when adjusted for VAT area and SAT area. Conclusions: The association of abdominal adiposity with blood pressure components and hypertension differs qualitatively by sex. WC may be an important determinant of hypertension and may be used for risk stratification for hypertension among Chinese individuals.

Using the data observed by Rossi X-ray Timing Explorer, a systematic study of temporal phenomena of the black-hole transient XTE J1650-500 in its 2001–2002 outburst is presented. By using the time lag in the Fourier frequency domain, three characteristic frequency ranges are analysed, namely the band limited noise, red noise, and QPOs (Quasi-Periodic Oscillations). The properties and evolution behaviours in these frequency ranges may be dominated by different accretion regions. It is commonly believed that the smaller timescale corresponds to the more inner region. The low-hard state and hard intermediate state are especially highlighted. The results of data analysis are discussed in the framework of Lense-Thirring precession. Results are in favor of the disturbance propagation model for explaining the observed time lags. Although the timing analysis in the frequency ranges of band-limited noise and red noise is carried out, and a possibly existed inflection point is found, the model to explain them is still not well established. More work is needed to understand the innermost accretion region.

a Department of Cardiology, Beijing Jishuitan Hospital, Peking University, Beijing, China b Institute of Vascular Medicine, Institute of Innovative Medicine, Heart Education And Research Training (HEART) Center, Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong c Department of Ultrasound, Beijing Jishuitan Hospital, Peking University, Beijing, China d Department of Radiology, Beijing Jishuitan Hospital, Peking University, Beijing, China

Background/Aims: To assess the antiviral efficacy of lamivudine (LAM), entecavir (ETV), telbivudine (LDT), and lamivudine and adefovir dipivoxil (CLA) combination in previously untreated hepatitis B patients at different time points during a 52-week treatment period. Patients and Methods: A total of 164 patients were included in this prospective, open-label, head-to-head study. Serum levels of alanine transaminase (ALT), hepatitis B virus (HBV) DNA, and hepatitis B e antigen (HBeAg) were measured at baseline, and at 12, 24, and 52 weeks of treatment. Results: Median reductions in serum HBV DNA levels at 52 weeks (log 10 copies/mL) were as follows: LAM, 3.98; ETV, 3.89; LDT, 4.11; and CLA, 3.36. The corresponding HBV DNA undetectability rates were 83%, 96%, 91%, and 89%, respectively. These two measures showed no significant intergroup differences. Clinical efficacy appeared related to HBV DNA level reduction after 24 weeks of therapy. Patients were divided into three groups based on HBV DNA levels at week 24: Undetectable (10 4 copies/mL. Patients with levels below quantitation limit (QL) were analyzed at 52 weeks for HBV DNA undetectability rate (94%), ALT normalization rate (83%), and viral breakthrough rate (0%). The corresponding values in the QL-10 4 copies/mL group were 50%, 75%, and 13%, whereas those in the above 10 4 copies/mL group were 53%, 65%, and 18%. There were significant differences at week 52 for HBV DNA levels and viral breakthrough rate between the three groups. Conclusions: Different nucleos(t)ide (NUC) analogues tested exhibited no significant differences in effectiveness for Chinese NUC-naive HBV patients during 1-year treatment period.

Using MR T2-mapping and histopathologic score for articular cartilage to evaluate the effect of structural changes in subchondral bone on articular cartilage.Twenty-four male Beagle dogs were randomly divided into a subchondral bone defect group (n = 12) and a bone cement group (n = 12). Models of subchondral bone defectin the medial tibial plateau and subchondral bone filled with bone cement were constructed. In all dogs, the left knee joint was used as the experimental sideand the right knee as the sham side. The T2 value for articular cartilage at the medial tibial plateau was measured at postoperative weeks 4, 8, 16, and 24. The articular cartilage specimens were stained with hematoxylin and eosin, and evaluated using the Mankin score.There was a statistically significant difference (P0.05) in Mankin score between the bone defect group and the cement group at postoperative weeks 16 and 24. There was a statistically significant difference in the T2 values between the bone defect group and its sham group (P0.05) from week 8, and between the cement group and its sham group (P0.05) from week 16. There was significant difference in T2 values between the two experimental groups at postoperative week 24 (P0.01). The T2 value for articular cartilage was positively correlated with the Mankin score (ρ = 0.758, P0.01).Structural changes in subchondral bone can lead to degeneration of the adjacent articular cartilage. Defects in subchondral bone cause more severe degeneration of cartilage than subchondral bone filled with cement. The T2 value for articular cartilage increases with the extent of degeneration. MR T2-mapping images and the T2 value for articular cartilage can indicate earlycartilage degeneration.

Our study surveyed age-related bone mineral density (BMD), bone loss rate, and prevalence of osteoporosis in women at multiple research centers in China. Survey results were used to establish a BMD reference database for the diagnosis of osteoporosis in Chinese women nationwide. We used dual-energy X-ray absorptiometry bone densitometers to measure BMD at posteroanterior (PA) lumbar spine (L1-L4; n=8142) and proximal femur (n=7290) in female subjects of age 20-89 yr from Beijing, Shanghai, Guangzhou, Chengdu, Nanjing, and Jiaxing. A cubic regression-fitting model was used to describe the change of BMD with age at various skeletal sites. Peak BMD occurred between 30 and 34 yr of age for femur neck and total femur, and between 40 and 44 yr for spine and trochanter measurement sites. Young adult (YA) BMD values (mean and standard deviation [SD], calculated as the average BMD in the age range of 20-39, were 1.116+/-0.12, 0.927+/-0.12, 0.756+/-0.11, and 0.963+/-0.13 g/cm2 at PA spine, femoral neck, trochanter, and total femur, respectively. The BMD of 85-yr-old women reflected a loss of 32% at the spine and 30-35% at femur measurement sites. The prevalence of osteoporosis, defined as a BMD of

As part of an effort to quantify device-dependent differences in forearm bone density, 101 women, aged 20 – 80 years (16 women in each age decade), were scanned on six forearm bone densitometers: the Aloka DCS-600EX, the Hologic QDR-4500A, the Lunar PIXI, the Norland pDEXA, the Osteometer DTX-200, and the Pronosco X-posure System. Regression statistics are reported for all similar regions of interest (ROIs). However, comparisons were confounded because of large differences in the ROI size and placement. The number of ROIs reported for a single scan by each device varied from 1 to 12. The correlation coefficients ranged from 0.7 < r < 0.97, with the highest correlation coefficients and lowest SEs for comparisons between the most similar ROIs. Standardized units of bone mineral density are derived for distal (sdBMD), mid(smBMD), and proximal (spBMD) ROIs that allow for comparable mean bone densities to be derived for patient populations. Five phantoms were scanned and characterized on five of the devices and the precision and mean values were reported. These phantom values will aid in the in vitro cross-calibration between manufacturers to recreate the presented in vivo relationships. Care should be exercised when using these equations for cross-calibrating patient databases or pooling clinical data from different devices because the least significant differences detectable from measurements taken on two different machines can be increased substantially. (J Bone Miner Res 2002;17:734 –745)

Eukaryotic translation initiation factor 4E (eIF4E) is the rate-limiting translation initiation factor for many oncogenes. Previous studies have shown eIF4E overexpression in nasopharyngeal carcinoma (NPC). We aimed to study whether viral oncogene latent membrane protein 1 (LMP1) stimulates the transcription of eIF4E to promote NPC malignancy. In NPC cell lines (CNE1 and CNE2), ectopic LMP1 significantly increased the mRNA and protein levels of eIF4E and the transcriptional activity of the eIF4E promoter in a LMP1–plasmid-transfected dose-dependent manner. As a backward experiment, knocking down of LMP1 significantly reduced eIF4E mRNA in B95-8 cells. In the high LMP1 expression condition, knocking down of c-Myc significantly reduced eIF4E mRNA in both NPC and B95-8 cells, and knocking down of eIF4E significantly inhibited the tumor proliferation, migration and invasion promoted by LMP1. The results indicated that LMP1 stimulates the transcription of eIF4E via c-Myc to promote NPC. To the best of our knowledge, this is the first evidence that LMP1 stimulates the transcription of eIF4E. This might be an important cause of the overexpression of eIF4E in NPC and be the novel mechanism by which LMP1 initiates cancer. LMP1-stimulated eIF4E initiates the translation of those oncogenes transcriptionally activated by LMP1 to amplify and pass down the carcinogenesis signals launched by LMP1.

To analyze the X-ray, CT and MR imaging findings in skeletal disease with primary hyperparathyroidism (PHPT), so as to discuss the clinic feature and differential diagnosis.Thirty patients with PHPT were confirmed by surgery and pathological examination. In 15 patients the lesion were found in femur. There were 15 tibia, 12 fibula, and 14 iliac lesions. In three patients lesions were found in vertebrae. Three patients had lesions in humeri. In five patients lesions were found in rib. Twelve patients had lesions in phalanges. Thirty patients were studied preoperatively with radiographs, CT and MR imaging. The imaging findings were compared with the pathologic diagnosis and confirmed by double blind method.Radiographs of the bone in 30 patients showed generalised osteopaenia. There were 20 (66.7%) cases with bone resorption, which include 12 (40.0%) cases with subperiosteal resorption, 11 (36.7%) cases with cortical bone resorption, and 10 (33.3%) cases with subchondral resorption. There were 19 (63.3%) cases with osteitis fibrosa cystica/brown tumor. There were 5 (16.7%) patients sustained a pathological fracture.X-ray, CT and MR imaging founding reflect the imaging and pathology features in skeletal disease of PHPT. The iliac lesions could been found in common, and usually eroding sacroiliac joint. Skeletal disease of PHPT should be differentiated from osteolytic metastatic tumor of bone, osteodysplasia fibrosa, giant cell tumor of bone and aneurysmal bone cysts.

To investigate the correlation of magnetic resonance imaging (MRI) with histopathological changes, and to evaluate T2 mapping in assessing muscle trauma in a rabbit model of muscle injury.We divided 35 rabbits into seven groups that each represented a different time point after intramuscular hemorrhage and muscle injury. Hemorrhage was created by injecting autologous blood into the left legs, and muscle injury was created by scalpel incision of the biceps femoris of the right legs. At different time points, the rabbits underwent T1-weighted imaging and T2-weighted imaging (T1WI and T2WI) and T2 mapping. T2 relaxation times were measured, and the corresponding samples were evaluated for pathological changesAfter 2 h, the intramuscular hemorrhage model demonstrated an increased signal intensity on both T1WI and T2WI. Histological examination showed erythrocytes within the muscle bundle. On days 1 and 3, the MRI signals were decreased, and there were no significant changes after day 7. From 2 h to 3 days, the muscle-injury model showed a high signal on both T1WI and T2WI. Corresponding pathological changes included rupture and edema of muscle fibers, and inflammation. The abnormal signals were reduced on day 7. After day 14, the T2WI intensity remained high. T1WI showed no abnormal changes, but some models showed a high signal, representing fresh bleeding and fatty tissue. T2 relaxation times were significantly different between the central and marginal regions, and between the marginal and normal regions.MRI clearly demonstrates intramuscular hemorrhage and muscle injury, which correlate well with histopathological changes. T2 mapping is useful in assessing the extent of injury.

To evaluate the effect of proliferation and apoptosis of parathyroid cell in rabbits with primary hyperparathyroidism (PHPT).A total of 80 adult Chinese rabbits were randomly divided into two groups (n = 40 each). The control group was fed with a normal diet (Ca: P, 1:0.7) while the experimental group a high phosphate diet (Ca: P,1:7) for 3-, 4-, 5-, or 6-month intervals to establish the animal model of PHPT. The parathyroid was totally removed for pathological examination after all rabbits were sacrificed. The thyroparathyroid complex was removed en bloc, fixed in neutral formalin and prepared for histological examination. The number of parathyroid cell in PHPT was calculated. Proliferation was determined by immunohistochemistry of proliferation cell nuclear antigen (PCNA) while apoptosis assessed by in situ dUTP biotin nick-end labeling (TUNEL).The number of parathyroid cell was 1.61 times in PHPT than that in the normal control (673 +/- 151, 418 +/- 25, t = - 12.112, P0.01). Apoptotic index (AI) increased significantly more in PHPT than that in normal control (200.2 per thousand +/- 125.6 per thousand, 11.0 per thousand +/- 3.0 per thousand, t = -10.193, P0.01). The rate of PCNA positive-cell increased significantly more in PHPT than that in control (50.5 per thousand +/- 11.6 per thousand, 26.7 per thousand +/- 2.8 per thousand, t = -13.120, P0.05). So did Bcl-2 (460 per thousand +/- 190 per thousand, 67 per thousand +/- 4 per thousand, t = -14. 120, P0.05). There was a positive correlation between AI and PCNA (r = 0.861, P0.05). It was the same as between AI and Bcl-2 (r = 0.871, P0.05). The value of bone mineral density decreased significantly more in PHPT than that in normal control (152 +/- 34, 189 +/- 12, t = 9.236, P0.05).PHPT may be mainly induced by an excessive proliferation of parathyroid cells and an acceleration of apoptotic process.

to study the biochemistry of blood and feature of pathology of an animal model in rabbits with the early primary hyperparathyroidism(PHPT).60 rabbits were divided into six groups of 10 each and fed a control diet (Ca:P, 1:0.7) or a high-phosphate diet (Ca:P, 1:7) for 1-, 2- or 3-month intervals. Compared with the control animals, serum PTH levels, serum calcium levels and serum phosphorus levels were determined. The parathyroid and kidneys of all animals were performed by the histologic examination.compared with the control animals, serum parathyroid hormone (PTH) levels were elevated at 1-, 2-, 3-month intervals in experimental group (t = -7.665, t = -16.033, t = 12.877 respective, P0.05), whereas serum calcium levels were decreased at all three time intervals (t = 6.184, t = 9.329, t = 13.842, respective, P0.05), but serum phosphorus levels did not change (t = 0.611, t = 1.041, t = 1.941, respective, P0.05). Parathyroid histopathologic studies demonstrated no change at 1 month whereas six of ten experimental animals showed mild hyperplasia at 2 months and nine of ten showed mild to moderate hyperplasia with gland enlargement at 3 months compared with control animals. Histopathologic examination of the kidneys showed no change at 1 month but focal parenchymal inflammation with calcium deposition at 2- and 3-month in the experimental groups.the high-phosphate diet successfully induced an animal model in rabbits with the early primary hyperparathyroidism, which has a better stability and reproducibility.

To evaluate the effect of axial rotation of lumbar vertebrae on the accuracy of pedicle screw placement using the traditional method, as well as to assess the value of intraoperative three-dimensional (3D) navigation in improving the accuracy.Sixteen lumbar simulation models at different degrees of axial rotation (0°, 5°, 10° and 20°), with every four assigned with the same degree, were equally divided into two groups (traditional method group and intraoperative 3D navigation group). Random placement of pedicle screws was carried out, followed by CT scan postoperatively. Then the outer pedicle cortex contours were depicted from reconstructed sectional pedicle images using Photoshop. The accuracy of pedicle screw placement was evaluated by determining the interrelationship between screw trajectory and pedicle cortex (qualitative) and measuring the shortest distance from pedicle screw axis to outer cortex of the pedicle (quantitative).Eighty pedicle screws were implanted respectively in each group. In traditional method group, statistical difference existed in the accuracy of pedicle screw placement at different axial rotational degrees (P0.05). With degrees increasing, the accuracy declined. The accuracy of intraoperative 3D navigation group was higher than traditional method group in vertebrae with axial rotation (P0.01). In qualitative evaluation, the accuracy of the two methods had statistical difference when the degree was 20°, and in quantitative evaluation, statistical difference existed in 5°, 10° and 20° of vertebral axial rotation.Screw malposition can be caused by vertebral axial rotation in lumbar spine using traditional method. Accuracy of pedicle screw placement declines with the increase of axial rotational degrees. However, the accuracy can be improved by using intraoperative 3D navigation.

The solitary pulmonary nodule (SPN) is one of the most common findings on chest radiographs. The objectives of clinical practice are to differentiate malignant nodules from benign nodules in the least invasive way and to make a specific diagnosis. This study was aimed to evaluate the correlation between perfusion imaging features and microvessel density (MVD) and vascular endothelial growth factors (VEGF) in SPNs using multi-slice computed tomography (MSCT); and to provide the theoretical basis for SPN blood flow pattern and blood flow quantitative features. Also, the study called for the discussion of the method's clinical application value in the differential diagnosis of benign and malignant SPNs.Sixty-eight patients with SPN underwent multi-location dynamic contrast enhanced (nonionic contrast material was administrated via the antecubital vein at a rate of 4 ml/s) MSCT. Precontrast and postcontrast attenuations on every scan was studied. Perfusion, peak height, and the ratio of the peak height of the SPN to that of the aorta were analyzed. Perfusion was calculated using the maximum gradient of the time-density curves (TDC) and the peak height of the aorta. The quantitative parameters (perfusion, peak height, ratio of peak height of the SPN to that of the aorta) of the blood flow pattern were compared with MVD and the VEGF expression of immunohistochemistry.The perfusion peak heights of malignant ((96.15 +/- 11.55) HU) and inflammatory ((101.15 +/- 8.41) HU) SPNs were significantly higher than those of benign ((47.24 +/- 9.15) HU) SPNs (P0.05, P0.05). Ratios of SPN-to-aorta of malignant and inflammatory SPNs were significantly higher than those of benign SPNs (P0.05, P0.05). No significant differences were found between the peak height and SPN-to-aorta ratio of malignant SPNs and inflammatory SPNs (P0.05, P0.05). The precontrast densities of inflammatory SPNs were lower than those of malignant SPNs (P0.05). Perfusion values of malignant and inflammatory SPNs were significantly higher than those of the benign SPNs (P0.05, P0.05). The VEGF positive expressions appeared in 32 patients with malignant SPNs and 2 patients with benign SPNs, and the average value of the MVD was higher in patients with malignant SPNs (36.88 +/- 6.76) than in patients with either benign (4.51 +/- 0.60) or inflammatory (26.11 +/- 5.43) SPNs (P0.05, P0.05). There were statistically significant correlations between the CT perfusion feature and the MVD. The highest correlation was between the peak height of SPN and the MVD (r = 0.657, P0.05).Tumor microvessel density and VEGF expression facilitate the exploration of the pathophysiological basis of CT perfusion in SPNs. Multi-slice CT perfusion has shown strong positive correlations with angiogenesis in SPNs.

To investigate the clinical importance of discography and CT after discography (CTD) in the lumbar disc diseases, and make a comparison between CTD and magnetic resonance imaging (MRI).265 patients with back and leg pain 177 males and 79 females, age 39 +/- 16, underwent discography and CT 2 hours later on 298 discs. All the patients' discs were classified into 7 types according to the findings by discography and CTD. Comprehensive MRI pictures were available in 237 of the 265 patients (with 257 discs); they accepted the MRI classification and were compared with the CT-discographic findings.245 patients underwent operation, among which 247 discs showed visual lesions during the procedure and 238 cases (96.4%) had their disc diseases diagnosed accurately through discography and CTD. Considering the positive screening rate for the discogenic abnormality, the difference was of statistical significance between the CTD and MRI groups (P0.01). MRI was considered to have limited value in the disc diseases with passive discographic finding.Discography is an efficient, sound and safe assistant diagnostic tool, which can get some special information about disc. The matched-group study shows that the MRI and CTD can not be re placed by each other. MRI may act as the screening tool for disc diseases, but is inferior to CTD, especially for the contiguous disc structure in the spinal fixation procedure.

To explore the correlation between the dosage of corticosteroid, time of onset and incidence of osteonecrosis (ON) in patients with SARS.From July 2003 to January 2004, general survey carried out for ON in 551 patients with SARS. Five hundred and fifty-one patients except 12 were administrated by corticosteroid from 80 mg to 30 000 mg. The age of patients was (33 +/- 9) years old ranging from 19 to 59 years old. One hundred and thirty-one were male, and four hundred and twenty were female. MRI and X-ray film were taken in all patients including both hips, knees, shoulders, ankles and wrists. CT scan was taken in partial patients. Common classification system were used for staging of hip (ARCO), knee (Lotka) and shoulder (Cruess). Independent test, rank-sum test and multiple factor logistic regression analysis were used for statistical analysis.No osteonecrosis was detected in 12 patients without corticosteroid. Osteonecrosis was detected in 176 patients (32.7 percent) among 539 patients. There were ON of femoral head in 130 cases (210 hips), ON of knee in 98 cases (130 knees), ON of humeral head in 21 cases (36 shoulders), ON of talus and calcaneus in 16 cases (26 ankles), ON of scaphoid and lunate in 11 cases (17 wrists), ON of patella in 3 cases (4 patella), ON of ilium in 1 case and bone infarction (femur, tibia) in 18 cases. One hundred and nineteen cases (195 hips) with ONFH were in stage I (IA 45 hips, IB 77 hips, IC 73 hips). Eleven cases (15 hips) were in stage II. All osteonecrosis of the knee and humoral head was stage I. Thirty-four patients with ON had one joint affected, 45 patients had 2 joints, 93 patients had more than 3 joints. The dosage of corticosteroid was (5842 +/- 4988) mg in ON group and (2719 +/- 2571) mg in non-ON group (P0.0001). The duration of steroid was (38 +/- 17) d in ON group and (27 +/- 15) d in non-ON group (P0.01). The dosage of pulse treatment was (340 +/- 207) mg/d in ON group and (211 +/- 160) mg/d in non-ON group (P0.01). The duration of pulse treatment was (28 +/- 13) d in ON group and (18 +/- 11) d in non-ON group (P0.01). All patients with ON were detected within 6 months from administration.About one-third patients with SARS who were treated with a high dose of corticosteroid occurred osteonecrosis. ON is frequently multiple focuses. The actual time of onset of ON is early of steroid used. MRI is golden standard for early diagnosis of ON. The patients who were treated with a high dose of corticosteroid should be inspected initially by MRI.

The (4R)-hydroxylated analogues of annonaceous acetogenin mimicking compound 2 were designed and synthesized structurally on the basis of the naturally occurring annonaceous acetogenin bullatacin, which was discovered as a typical member of the novel family of polyketides with potent cytotoxicity, antitumoral, and other biological activities. The preliminary screenings show that the IC(50) values of 2 were 1.6 x 10(-3) and 8 x 10(-2) microg/mL against HT-29 and HCT-8, respectively. A remarkable enhancement effect was observed by the activity comparison of 1c and its (4R)-hydroxylated analogue 2.