健康体检人员脂肪肝超声诊断结果及其危险因素分析

目的:了解健康体检人员脂肪肝超声诊断结果,分析患病危险因素。方法:选择2018年2月至2018年8月我院体检科接受体检的人员1078例,应用超声对脂肪肝进行筛查,统计受检者脂肪肝超声诊断结果,分析脂肪肝发病的性别、年龄分布情况,应用单因素和多因素Logistic回归分析脂肪肝发病的临床相关因素。结果:1078例受检者中发现脂肪肝158例,占14.66%,其中女性43例,检出率为9.31%,男性115例,检出率为18.67%,男性脂肪肝检出率显著高于女性(P0.05)。男性受检者和女性受检者46～55岁年龄段检出率最高,不同年龄段男性、女性受检者脂肪肝检出率均有统计学差异(P0.05)。多因素Logistic回归分析显示:饮酒、体质指数(BMI)≥28 kg/m2、糖尿病、胆石症、总胆固醇(TC)升高、总甘油三酯(TG)升高、低密度脂蛋白胆固醇(LDL-C)升高、谷草转氨酶(ALT)和(或)谷丙转氨酶(AST)升高均为脂肪肝发病的独立危险因素(P0.05)。结论:我院健康体检人员脂肪肝检出率为14.66%,男性脂肪肝检出率显著高于女性,且46～55岁年龄段检出率最高。饮酒、BMI≥28 kg/m2、糖尿病、胆石症、TC升高、TG升高、LDL-C升高、ALT和(或)AST升高均为脂肪肝发病的独立危险因素,值得临床重点关注。     

Assessment of hemolytic activity of bee venom against some physicochemical factors

Bee venom (BV) is a biotoxin with biologically active peptides which have cell lysis and hemolytic activity properties. These properties can be affected under different storage conditions or during the production process. In present study, we investigated effects of a number of physicochemical factors, including temperature, pH, UV radiation, ultrasound waves and storage time on hemolytic activity of BV. Maximum absorption and melting temperature of BV solution were obtained as 280 nm and ~70 °C, respectively. Cell hemolysis 50 (CH₅₀) -concentration of BV that can lyse 50% of red blood cells- was determined as 0.94 μg/ml at ambient temperature. CH₅₀ was shown not to be importantly varied at temperature up to 60 °C, pH value 2 to 13 and under UV/ ultrasound radiation. Storage at ?20, 6 and 25 °C for 6 months made about 2.5, 35 and 1000 times increase in CH₅₀. From the results, it may be concluded that BV is a relatively resistant hemolytic agent and can be used in a variety of laboratory research and product manufacturing methods.     

Validation of shear wave elastography in skeletal muscle

Skeletal muscle is a very dynamic tissue, thus accurate quantification of skeletal muscle stiffness throughout its functional range is crucial to improve the physical functioning and independence following pathology. Shear wave elastography (SWE) is an ultrasound-based technique that characterizes tissue mechanical properties based on the propagation of remotely induced shear waves. The objective of this study is to validate SWE throughout the functional range of motion of skeletal muscle for three ultrasound transducer orientations. We hypothesized that combining traditional materials testing (MTS) techniques with SWE measurements will show increased stiffness measures with increasing tensile load, and will correlate well with each other for trials in which the transducer is parallel to underlying muscle fibers. To evaluate this hypothesis, we monitored the deformation throughout tensile loading of four porcine brachialis whole-muscle tissue specimens, while simultaneously making SWE measurements of the same specimen. We used regression to examine the correlation between Young′s modulus from MTS and shear modulus from SWE for each of the transducer orientations. We applied a generalized linear model to account for repeated testing. Model parameters were estimated via generalized estimating equations. The regression coefficient was 0.1944, with a 95% confidence interval of (0.1463–0.2425) for parallel transducer trials. Shear waves did not propagate well for both the 45° and perpendicular transducer orientations. Both parallel SWE and MTS showed increased stiffness with increasing tensile load. This study provides the necessary first step for additional studies that can evaluate the distribution of stiffness throughout muscle.     

Slack length of gastrocnemius medialis and Achilles tendon occurs at different ankle angles

Although muscle–tendon slack length is a crucial parameter used in muscle models, this is one of the most difficult measures to estimate in vivo. The aim of this study was to determine the onset of the rise in tension (i.e., slack length) during passive stretching in both Achilles tendon and gastrocnemius medialis. Muscle and tendon shear elastic modulus was measured by elastography (supersonic shear imaging) during passive plantarflexion (0° and 90° of knee angle, 0° representing knee fully extended, in a random order) in 9 participants. The within-session repeatability of the determined slack length was good at 90° of knee flexion (SEM=3.3° and 2.2° for Achilles tendon and gastrocnemius medialis, respectively) and very good at 0° of knee flexion (SEM=1.9° and 1.9° for Achilles tendon and gastrocnemius medialis, respectively). The slack length of gastrocnemius medialis was obtained at a significantly lower plantarflexed angle than for Achilles tendon at both 0° (P<0.0001; mean difference=19.4±3.8°) and 90° of knee flexion (P<0.0001; mean difference=25.5±7.6°). In conclusion, this study showed that the joint angle at which the tendon falls slack can be experimentally determined using supersonic shear imaging. The slack length of gastrocnemius medialis and Achilles tendon occurred at different joint angles. Although reporting this result is crucial to a better understanding of muscle–tendon interactions, further experimental investigations are required to explain this result.     

Serially homologous ears perform frequency range fractionation in the praying mantis, Creobroter (Mantodea, Hymenopodidae)

Unlike most praying mantises that have a single region of auditory sensitivity, species in the genus Creobroter have equally sensitive hearing at 2–4 and at 25–50 kHz and and are relatively insensitivity at 10–15 kHz — they have a W-shaped audiogram. Ultrasonic sensitivity originates from an auditory organ in the ventral midline of the metathorax that closely resembles the ear of other mantises. Ablation experiments demonstrate that low frequency sensitivity derives from a serially homologous mesothoracic auditory organ. Extracellular recordings suggest that these two ears operate largely, if not entirely, independently of one another in the thorax. The low frequency response has a longer latency, more action potentials per stimulus, and different patterns of change with increasing SPL than the high frequency response. Separate interneurons mediate responses in the two frequency ranges, but our evidence suggests that they are two serially homologous sets of cells. Neither auditory organ shows any physiological evidence of directional sensitivity. Ultrasound triggers a set of behaviors in flying hymenopodid mantises much like those in other mantises, but the behavioral significance of low frequency hearing in these animals is still unknown.Abbreviations SPL sound pressure level - dB SPL sound pressure level re: 20 Pa - HF high frequency - LF low frequency     

Is echogenicity a viable metric for evaluating tendon properties in vivo?

Material properties of tissue in vivo present an opportunity for clinical analysis of healing progression and pathologies as well as provide an excellent research tool yielding quantified data for longitudinal and cross population studies. Echogenicity is a material?s ability to reflect sound and, using ultrasound, it has been shown to increase with tendon tension in vitro, though this non-invasive measurement technique for determining mechanical properties has not been tested in vivo. The aim of this study was to establish if echogenicity, seen by the increase in image brightness, could be correlated to stress within a tissue. 18 Achilles tendons were imaged in the sagittal and transverse planes while producing a series of isometric contractions starting from rest and producing the torque equivalent of 0.5, 1.0, 1.5, and 2.0× body weights. Manual tracing identified the tendon in each of the images. The cross-sectional area determined from the transverse plane images in conjunction with the tendon force yielded the tendon stress. The echogenicity of the tendon was determined from the mean brightness change from rest to each of the contraction cases, measured from the sagittal plane images. A weak correlation existed between the echogenicity and stress (R=0.25) but it was found that there was no significant change in axial area during contraction (p=0.683) establishing the tendon as incompressible. Echogenicity proved to be non-functional for measuring the mechanical properties of the Achilles tendon due to the additional factors included with in vivo testing e.g. tendon twist and multi-axial loading.     

Influence of tendon tears on ultrasound echo intensity in response to loading

Acoustoelastic (AE) ultrasound image analysis is a promising non-invasive approach that uses load-dependent echo intensity changes to characterize stiffness of tendinous tissue. The purpose of this study was to investigate whether AE can detect localized changes in tendon stiffness due to partial and full-thickness tendon tears. Ovine infraspinatus tendons with different levels of damage (Intact, 33%, 66% and full thickness cuts initiated on the articular and bursal sides) were cyclically loaded in a mechanical testing system while cine ultrasound images were recorded. The load-induced changes in echo intensity on the bursal and articular side of the tendon were determined. Consistent with AE theory, the undamaged tendons exhibited an increase in echo intensity with tendon loading, reflecting the strain-stiffening behavior of the tissue. In the intact condition, the articular region demonstrated a significantly greater increase in echo intensity during loading than the bursal region. Cuts initiated on the bursal side resulted in a progressive decrease in echo intensity of the adjacent tissue, likely reflecting the reduced load transmission through that region. However, image intensity information was less sensitive for identifying load transmission changes that result from partial thickness cuts initiated on the articular side. We conclude that AE approaches may be useful to quantitatively assess load-dependent changes in tendon stiffness, and that disruption of AE behavior may be indicative of substantial tendon damage.     

Ultrasound characteristics of experimentally induced luteinized unruptured follicles (LUF) and naturally occurring hemorrhagic anovulatory follicles (HAF) in the mare

The development of hemorrhagic anovulatory follicles (HAF) involves luteinization and hemorrhage of the follicle. This is observed on ultrasound as an increase in the echogenicity of the granulosa layer and formation of echoic particles in the antrum. The inhibition of prostaglandin synthesis with flunixin meglumine (FM) during the periovulatory period induces ovulatory failure with development of luteinized unruptured follicles (LUF). These two types of anovulatory follicles appear to share similar ultrasound features but they have not been compared critically. The following endpoints: follicle diameter, follicular contents score, interval from hCG administration to beginning of follicular hemorrhage, interval from hemorrhage to organization of follicular contents, and cycle length were studied and compared in mares with HAF (n = 11) and LUF (n = 13). The objective of this study was to elucidate whether these two unruptured follicles have a consistent clinical pattern of development and therefore can be considered as part of the same anovulatory syndrome. None of the endpoints analyzed differed significantly between HAF and LUF. However, there was a greater individual variation in HAF as compared with LUF in regards to interval from hCG to hemorrhage, follicular diameter at the administration of hCG, and beginning of hemorrhage. In conclusion, HAF share a similar cascade of ultrasound characteristics with the experimentally induced LUF. This finding may provide new insights in elucidating the pathogenesis of HAF.     

Rapid direct detection of the major fish allergen, parvalbumin, by selected MS/MS ion monitoring mass spectrometry

Parvalbumins beta (β-PRVBs) are considered the major fish allergens. A new strategy for the rapid and direct detection of these allergens in any foodstuff is presented in this work. The proposed methodology is based on the purification of β-PRVBs by treatment with heat, the use of accelerated in-solution trypsin digestion under an ultrasonic field provided by High-Intensity Focused Ultrasound (HIFU) and the monitoring of only nineteen β-PRVB peptide biomarkers by Selected MS/MS Ion Monitoring (SMIM) in a linear ion trap (LIT) mass spectrometer. The present strategy allows the direct detection of the presence of fish β-PRVBs in any food product in less than 2 hours.     

Tendon vibration attenuates superficial venous vessel response of the resting limb during static arm exercise

Background

The superficial vein of the resting limb constricts sympathetically during exercise. Central command is the one of the neural mechanisms that controls the cardiovascular response to exercise. However, it is not clear whether central command contributes to venous vessel response during exercise. Tendon vibration during static elbow flexion causes primary muscle spindle afferents, such that a lower central command is required to achieve a given force without altering muscle force. The purpose of this study was therefore to investigate whether a reduction in central command during static exercise with tendon vibration influences the superficial venous vessel response in the resting limb.

Methods

Eleven subjects performed static elbow flexion at 35% of maximal voluntary contraction with (EX + VIB) and without (EX) vibration of the biceps brachii tendon. The heart rate, mean arterial pressure, and rating of perceived exertion (RPE) in overall and exercising muscle were measured. The cross-sectional area (CSA_vein) and blood velocity of the basilic vein in the resting upper arm were assessed by ultrasound, and blood flow (BF_vein) was calculated using both variables.

Results

Muscle tension during exercise was similar between EX and EX + VIB. However, RPEs at EX + VIB were lower than those at EX (P <0.05). Increases in heart rate and mean arterial pressure during exercise at EX + VIB were also lower than those at EX (P <0.05). CSA_vein in the resting limb at EX decreased during exercise from baseline (P <0.05), but CSA_vein at EX + VIB did not change during exercise. CSA_vein during exercise at EX was smaller than that at EX + VIB (P <0.05). However, BF_vein did not change during the protocol under either condition. The decreases in circulatory response and RPEs during EX + VIB, despite identical muscle tension, showed that activation of central command was less during EX + VIB than during EX. Abolishment of the decrease in CSA_vein during exercise at EX + VIB may thus have been caused by a lower level of central command at EX + VIB rather than EX.

Conclusion

Diminished central command induced by tendon vibration may attenuate the superficial venous vessel response of the resting limb during sustained static arm exercise.