Association between visceral fat area measured with quantitative CT and fatty liver in normal weight population / 中华健康管理学杂志

Objective:To analyze the association between visceral fat area (VFA) and fatty liver based on quantitative CT (QCT) in people receiving health examination with normal body mass index (BMI).Methods:A cross-sectional study. A total of 1 305 physical examiners who underwent chest CT and QCT examination in the Department of Health Management of Henan Provincial People′s Hospital from January to December 2021 were retrospectively selected as subjects. The physical components at the central level of the lumbar two cone were measured with QCT, including subcutaneous fat area (SFA), VFA and liver fat content (LFC). And the metabolic indexes, such as blood lipids and blood glucose, were collected. The t-test and χ2 test were used to analyze the correlation between the detection rate of fatty live and LFCr and age and gender. According to level of VFA (<100 cm 2, 100-150 cm 2 and≥150 cm 2), the subjects were divided into three groups, and one-way ANOVA and χ2 test were used in comparison between groups. Multiple linear regression was used to analyze the correlation between VFA and metabolic indexes and LFC. Results:Of the 1 305 subjects, there were 634 males and 671 females. The detection rate of fatty liver in normal BMI population was 65.67%, and it was 72.71% and 59.02% respectively in men and women ( χ2=27.12, P<0.001), and the detection rate of fatty liver and LFC increased with age (both P<0.05). With the increase of VFA, the age, BMI, SFA, LFC, total cholesterol (TC), triacylglycerol (TG), low-density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG), alanine aminotransferase (ALT), blood uric acid and prevalence of fatty liver increased (all P<0.05), and the low-density lipoprotein cholesterol (HDL-C) decreased ( P<0.001). Multiple linear regression analysis showed that after adjustment for age factors, regardless of male or female, LFC was independently positively related with VFA, BMI, and ALT (male β=0.206, 0.145, 0.174, female β=0.194, 0.150, 0.184; all P<0.05). FBG was positively correlated with male independently ( β=0.134; P<0.001). The indicators related to female independently were TC, TG, and blood uric acid ( β=-0.121, 0.145, 0.141, all P<0.05) Conclusion:In the population receiving health examination with normal BMI, the VFA measured by QCT technique is closely related to fatty liver.

Effect of personalized intermittent energy restriction diet on gut microbiome associated with sleep in obese patients / 中华健康管理学杂志

Objective:To investigate the effects of personalized intermittent energy restriction (IER) diet on sleep related gut microbiome in obese patients.Methods:In this single-arm clinical trial, a total of 35 obese patients who visited Henan Provincial People′s Hospital from April to November 2018 were recruited as research subjects. They underwent a strict 32-day IER diet intervention, divided into 4 stages of 8 days each. Nutritional recipes were formulated and nutritious meals were provided to each obese patient with timed meals, including 55% carbohydrates, 15% protein, and 30% fat per meal. In stages 1, 2, 3, and 4, patients were provided with 2/3, 1/2, 1/3, and 1/4 of their previous calorie intake every other day, respectively, with meals at 8:00 and 16:00. During the remaining time, patients were allowed unrestricted eating at home. Physiological indicators (weight, body mass index, body fat percentage, waist circumference, hip circumference, fasting blood glucose, glycosylated hemoglobin, blood pressure, triglycerides, total cholesterol, high-density lipoprotein, low-density lipoprotein and Pittsburgh Sleep Quality Index (PSQI) scores were observed before and after the intervention. Gut microbiota changes were analyzed using metagenomic sequencing technology, and Spearman′s correlation analysis was used to assess the correlation between significantly different bacterial species and PSQI scores.Results:After the intervention, the body weight, body mass index, and PSQI scores of obese patients were all significantly lower than before intervention [(89.92±14.98) vs (97.53±15.67) kg, (31.94±3.95) vs (34.64±4.05) kg/m 2, (3.43±1.16) vs (5.42±2.27)], the abundance of gut microbiota was significantly higher after the intervention (all P<0.05). There were 45 significantly different bacterial species before and after the intervention, of which 6 bacterial species ( Enterobacter cloacae, Escherichia coli, Odoribacter splanchnicus, Oribacterium sinus, Streptococcus gordonii, and Streptococcus parasanguinis) showed significantly positive correlations with PSQI scores ( r=0.476, 0.475, 0.369, 0.391, 0.401, 0.423) (all P<0.05), and they were mainly enriched in the glutamate and tryptophan synthesis pathways. Conclusions:The personalized IER diet intervention can improve the sleep of obese patients while reducing weight, possibly mediated by changes in gut microbiota through the glutamate and tryptophan pathways.

Correlation between body fat distribution measured by quantitative CT and blood lipids in overweight and obese individuals undergoing physical examinations / 中华健康管理学杂志

Objective:To analyze the correlation between quantified body fat distribution measured by computed tomography (CT) and blood lipids in overweight and obese individuals undergoing physical examinations.Methods:In this retrospective cohort study, a total of 3 463 physical examination subjects who underwent chest CT combined with quantified CT examination in the Department of Health Management at Henan Provincial People′s Hospital from January to December 2021 were selected using a comprehensive sampling method. The subjects were divided into three groups: normal group (1, 424 cases), overweight group (1, 531 cases), and obese group (508 cases) based on their body mass index: 18.5 to <24.0 kg/m 2, 24.0 to <28.0 kg/m 2, and≥28.0 kg/m 2, respectively. General information, blood lipid parameters, and different body fat distributions measured by quantified CT (subcutaneous fat area, visceral fat area, total abdominal fat area, liver fat content, muscle fat content) were collected in the three groups. One-way analysis of variance was used to compare differences in body fat distribution and blood lipid parameters, and Pearson correlation analysis was performed to evaluate the correlation between body fat distribution and blood lipids. Results:In the obese group, compared to the normal and overweight groups, subcutaneous fat area, visceral fat area, total abdominal fat area, liver fat content, muscle fat content, total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglyceride levels were significantly higher [males: (152.80±49.27) vs (72.94±22.68), (103.79±28.30) cm 2; (287.95±57.55) vs (156.36±49.40), (224.67±53.10) cm 2; (440.75±72.44) vs (229.31±62.01), (328.46±62.77) cm 2; (12.92±8.61)% vs (6.82±3.31)%, (9.39±4.88)%; (9.06±9.34)% vs (4.55±5.06)%, (6.70±6.73)%; (6.52±0.94) vs (4.87±1.03), (6.27±0.96) mmol/L; (3.05±0.76) vs (2.92±0.86), (2.97±0.77) mmol/L; (2.34±1.42) vs (1.53±0.82), (1.99±1.28) mmol/L; females: (213.82±46.87) vs (104.69±30.62), (155.05±34.90) cm 2; (184.88±46.54) vs (90.67±34.09), (138.92±42.06) cm 2; (398.71±71.28) vs (195.37±55.32), (293.97±57.05) cm 2; (11.36±6.34)% vs (5.51±3.02)%, (7.98±4.77)%; (7.44±7.60)% vs (3.70±3.90)%, (5.56±5.94)%; (5.27±0.96) vs (5.04±0.86), (5.11±0.96) mmol/L; (3.26±0.84) vs (2.92±0.79), (3.01±0.74) mmol/L; (1.74±0.69) vs (1.27±0.65), (1.57±0.77) mmol/L], while high-density lipoprotein cholesterol (HDL-C) was significantly lower [males: (1.17±0.19) vs (1.38±0.28), (1.25±0.25) mmol/L; females: (1.36±0.22) vs (1.59±0.32), (1.42±0.27) mmol/L] (all P<0.001). In males, the visceral fat area and total abdominal fat area in the overweight group were positively correlated with triglycerides ( r=0.175, 0.113) and negatively correlated with HDL-C ( r=-0.125, -0.113), while liver fat content was positively correlated with total cholesterol, LDL-C, and triglycerides ( r=0.083, 0.075, 0.206) and negatively correlated with HDL-C ( r=-0.093) (all P<0.05). In the obese group, the liver fat content was positively correlated with triglycerides ( r=0.170) and negatively correlated with HDL-C ( r=-0.166) in males (both P<0.05). In females, the visceral fat area and total abdominal fat area in the overweight group were positively correlated with total cholesterol, LDL-C, and triglycerides (visceral fat area: r=0.129, 0.160, 0.348; total abdominal fat area: r=0.121, 0.130, 0.283) and negatively correlated with HDL-C ( r=-0.264, -0.173), while liver fat content was positively correlated with triglycerides ( r=0.352) and negatively correlated with HDL-C ( r=-0.195) (all P<0.05). In the obese group, the visceral fat area was positively correlated with triglycerides ( r=0.213) and negatively correlated with HDL-C ( r=-0.223) in females (both P<0.05). Conclusion:Blood lipids are correlated with body fat distribution in overweight and obese individuals undergoing physical examinations, and the degree of correlation varies between different genders and body regions, with triglycerides showing the strongest correlation with liver fat content.

Effects of GSK484 on ventilator-induced lung injury and neutrophil extracelluar traps in mice / 中华麻醉学杂志

Objective:To evaluate the effects of GSK484 on ventilator-induced lung injury (VILI) and neutrophil extracelluar traps (NETs) in mice.Methods:Forty-eight SPF healthy male C57BL/6 mice, aged 5-6 weeks, weighing 15-20 g, were divided into 4 groups ( n=12 each) by a random number table method: spontaneous breathing group (group S), spontaneous breathing+ GSK484 intervention group (group SG), VILI group (group V), and VILI + GSK484 intervention group (group VG). The animals kept spontaneous breathing for 4 h after tracheal intubation in S and SG groups. The animals were mechanically ventilated for 4 h (tidal volume 30 ml/kg, respiratory rate 75 breaths/min, inspiratory/expiratory ratio 1∶2, positive end-expiratory pressure 0 mmHg, fraction of inspired oxygen 21%) in V and VG groups. At 3 days before developing the VILI model, GSK484 4 mg/kg was intraperitoneally injected once a day in SG and VG groups, while the equal volume of normal saline was given instead in S and V groups. Blood samples were collected from the abdominal aorta for blood gas analysis at 4 h of spontaneous breathing or mechanical ventilation, and PaO 2 was recorded. The mice were then sacrificed and bronchoalveolar lavage fluid (BALF) was collected and lung tissues were obtained for microscopic examination of the pathological changes (with a light microscope after HE staining) which were scored and for determination of wet to dry weight ratio (W/D ratio), concentrations of interleukin-1beta (IL-1β), IL-6, tumor necrosis factor-alpha (TNF-α) and myeloperoxidase (MPO) in BALF (by enzyme-linked immunosorbent assay), expression of peptidylarginine deiminase 4 (PAD4), neutrophil elastase (NE), high mobility group box 1 (HMGB1) and citrullinated-histone 3 (Cit-H3) in lung tissues (by Western blot). Results:Compared with S and SG groups, the lung injury score and W/D ratio were significantly increased, PaO 2 was decreased, concentrations of IL-1β, IL-6, TNF-α and MPO in BALF were increased, and the expression of PAD4, NE, HMGB1 and Cit-H3 in lung tissues was up-regulated in V and VG groups ( P<0.05). Compared with group V, the lung injury score and W/D ratio were significantly decreased, PaO 2 was increased, the concentrations of IL-1β, IL-6, TNF-α and MPO in BALF were decreased, and the expression of PAD4, NE, HMGB1 and Cit-H3 was down-regulated in group VG ( P<0.05). Conclusions:GSK484 can alleviate VILI in mice, and the mechanism is associated with inhibition of PAD4, reduction of the production of NETs and attenuation of inflammatory responses in lung tissues.

Abnormal region homogeneity in striatum in idopathic REM sleep behavoir disorder by MRI / 中风与神经疾病杂志

@#Objective To explore early damaged evidence,we checked spontaneous brain activity by restingstate functional magnetic resonance imagine（rs-fMRI） in iRBD recalled preclincal to Parkinsion in order to provide reliable imaging information.Methods Recruited 21 iRBD patients according with international diagnostic criteria，and 22 gender，age matched health controls. All subjects were examined by cognitive tests，UPDRSⅢ and rsfMRI，and rsfMRI data were analyzed using region homogeneity（ReHo） means. Result The scores of Rey Osterrieth Complex Figure Test copy,N1,N2,and N3 of Auditory Verbal Learning Test（AVLT），symblo digit modalities test（SDMT），Digit order test attention（DOT-A）respectively in the iRBD group，which were significantly lower than that in the health control（HC）group respectively（U=133.5，t=-2.416，t=-2.873，U=134.5，U=81.0，U=144.5，P<0.05）.The scores of Trail Making Test B（TMT-B）and Unified Parkinson’s Disease Rating Scale motor section（UPDRSⅢmotor） were significantly lower than that in the HC group respectively（U=138.0，U=121.0，P<0.05）.Compare with the HC groups，decreased ReHo were in right caudate，bilateral putamen and right pillidum in iRBD group respectively（t=-4.611，t=-4.360，t=-4.298，t=-3.422，P<0.05）.Conclusion There were impairments in visual space，memory，executive function，attention and movement in iRBD patients，as well as abnormal brain spontaneous activity in striatum,which may be a early marker of striatum damage.

Degree centrality analysis of brain functional network in insomnia disorder based on voxel / 中国医学影像技术

Objective To explore the changes of brain functional network in insomnia disorder (ID) during resting-state with voxel-based degree centrality (DC).Methods Forty-five subjects underwent resting-state fMRI scans,including 22 patients with ID (ID group) and 23 sex-,age-,and education-matched healthy volunteers (control group).The subjects' sleep quality and emotion state were assessed with Pittsburgh sleep quality index (PSQI),Hamilton anxiety scale and Hamilton depression scale.The resting-state fMRI data were analyzed with voxel-based DC.The intra-and inter-groups parameters were compared using t-test.Correlation analysis was performed between DC values of ID group and clinical parameters.Results Compared with control group,DC values increased in left parahippocampal gyrus,left hippocampus and bilateral precuneus (all P＜0.05),while decreased in left middle occipital lobe,left precuneus,left inferior frontal gyrus and left middle frontal gyrus in ID group (all P＜0.05).DC values of the left hippocampus in ID patients showed significantly negative correlation with the score of Pittsburgh sleep quality index (r=-0.46,P=0.047).Conclusion ID patients have abnormal DC distribution of brain functional network,therefore providing basis for understanding pathophysiological mechanisms of ID.

Abnormal functional connectivity of the cores that control rapid eye movement sleep in idiopathic rapid eye movement sleep behavior disorder / 中华神经科杂志

Objective To investigate the abnormal functional connectivity (FC) between the cores (including sublaterodorsal nucleus (SLD) and ventrolateral periaqueductal gray matter (vlPAG)) and the whole brain in rapid eye movement sleep behavior disorder (RBD) by resting state functional magnetic resonance imaging (rfMRI).Methods A total of 41 subjects recruited in the Department of Neurology,the People's Hospital of Zhengzhou University were enrolled in this study according to international diagnosis criteria,including 20 with idiopathic RBD (iRBD group) and 21 age,sex-matched normal controls (control group).All subjects were examined by Hoehn-Yahr Staging,cognitive tests and rfMRI.Resluts HoehnYahr staging score was 0(0,0) in the iRBD group,which showed no significant difference from that in the control group (0 (0,0),Z =-1.820,P =0.069).The scores of Rey Auditory Verbal Learning Test (AVLT) N1,AVLT N2,Symbol Digital Modalities Test,Rey-Osterrieth Complex Figure Test-Copy were 3.80 ± 1.67,5.10 ± 1.77,33.00(31.25,34.00) and 22.00(20.25,26.00) respectively in the iRBD group,which were significantly lower than that in the control group (4.95 ± 1.28,t =2.482,P =0.017;6.43±1.16,t =2.848,P=0.007;33.00(29.50,35.50),Z=-3.792,P=0.000;35.00(33.00,36.00),Z =-2.351,P =0.019) respectively.The scores of Trail Making Test 1 (86.5 (70.0,100.0))and Trail Making Test 2 (197.0(180.5,211.5)) in the iRBD group were significantly higher than that in the control group (66.0(49.0,91.5),112.0(99.5,173.0) respectively,Z=-2.373,P=0.018;Z =-3.105,P =0.002).Compared with the control group,the FC analysis showed reduced connections from the right SLD to the bilateral cingnlate gyrus (t =-4.173) and bilateral frontal gyrus (t =-2.965(left),-3.662(right)),from the vlPAG to the left precentral-postcentral gyrus(t =3.930),and from the vlPAG to the right frontal gyrus (t =4.141) in the iRBD.There was no statistically significant difference from the left SLD to the whole brain.Conclusion There were abnormal FCs from the SLD and vlPAG to cognitive and motor areas in RBD patients,perhaps leading to clinical RBD symptoms such as cognitive deterioration and movement disorder.

Cerebral small vessel disease and post-stroke depression / 国际脑血管病杂志

The post-stroke depression (PSD) is one of the common complications of stroke.It can not only delay the recovery of the neurological function in patients, seriously affect the quality of life of patients, but also increase the mortality and morbidity.More and more attention has been paid to the pathogenesis of PSD.Recent studies have confirmed that brain small vessel disease is closely related to the occurrence of PSD.This article reviews relationship between brain small vessel diseases and PSD.

Functional connectivity between the substantia nigra and the motor cortex in the rapid eye movement sleep behavior disorder / 中华神经科杂志

Objective To investigate the abnormal functional connectivity (FC) between the substantia nigra (SN) and the brain motor area in rapid eye movement sleep behavior disorder (RBD) by Unified Parkinson′s Disease Rating Scale (UPDRS), Hoehn-Yahr Scale and resting state functional magnetic resonance imaging (rfMRI).Methods A total of 34 subjects (14 with RBD (RBD group), 12 with Parkinson′s disease (PD group), and 8 age, sex-matched normal controls (control group)) recruited in the Department of Neurology, Henan Provincial People′s Hospital from 2014 to 2015 were enrolled in this study according to international diagnosis criteria.All subjects were examined by UPDRS, Hoehn-Yahr Scale and rfMRI.Results UPDRS scores and Hoehn-Yahr staging were 0.00 (0.00, 3.75) and 0.00 (0.00, 0.50) respectively in the RBD group, which were significantly different from that in the PD group (30.5 (18.75, 33.00) and 1.75 (1.50, 2.50), respectively;Z=-3.782, P0.05 and Z=1.10, P>0.05).The FC analysis showed alterations from the right SN to bilateral cerebellum respectively among the three groups (Fright cerebellum=12.975, Fleft cerebellum=6.144;P0.05).Conclusions There was abnormal FC from the SN to motor areas in RBD patients, and partial alterations were similar as PD patients.rfMRI provided an evidence that RBD might be presymptom of PD.

Gender Differences in Healthy Volunteers Stimulated by Emotional Pictures Through Functional MRI / 中国医学影像学杂志

Purpose The study aimed to explore gender differences of brain activation in healthy volunteers under the stimulation of emotional pictures.Materials and Methods The cerebral functional imaging data of twenty healthy volunteers at Henan Medical College from Nov.2014 to Dec.2014 were prospectively studied (12 males and 8 females).Emotional pictures (30 positive,30 negative and 30 neutral pictures) from Chinese Affective Picture System (CAPS) were used randomly as visual stimuli for both males and females.Functional MRI was performed while each subject was stimulated by emotional pictures.The fMRI data were processed and the statistical analysis was performed to obtain the activated brain regions of males and females and to compare the gender differences.Results Under the stimuli of negative emotional pictures,bilateral temporal lobe,bilateral cuneus in men and bilateral cuneus in women were activated under the stimuli of positive emotional pictures (P＜0.05).Compared with men,increased activation of left amygdala,bilateral prefrontal gyrus,bilateral precuneus and right insula were observed in women under the stimuli of negative pictures.The differences were statistically significant (P＜0.05).Compared with women,no cerebral region was more activated in men under the stimuli of negative pictures.Under the stimuli of positive emotional pictures,the left prefrontal gyrus in women was more activated than that in men whilst the left temporal lobe in men was more activated than that in women.The differences were statistically significant (P＜0.05).Conclusion Gender differences of activated cerebral regions under stimuli of emotional pictures do exist in healthy volunteers.In particular,more cerebral regions and increased activation were observed in women compare to men,which demonstrates that women response stronger to negative emotion.

Discussion on the Importance of Medical Humanities Education in the Construction of Hospital Culture / 中国医学伦理学

Since human society entered the 21st century, the rapid development of medical technology also gave birth to a series of negative effects:medical service technology first, trust crisis of the doctor-patient relation-ship, and medical industry money worship. Especially in recent years, due to the lack of humanistic spirit in medi-cal institutions, the doctor -patient relationship is of the worst state in the history. Therefore, it is urgent to strengthen the medical humanities education in the construction of hospital culture. Aiming at the problems existing in the current medical industry, this paper expounds the importance of strengthening the humanistic education in the construction of hospital culture.

The contain of IL-1β in rat brain after subarachnoid hemorrhage and its relation to secondary brain edema / 中国基层医药

Objective To investigate the changes of interleukin-1β (IL-1β) in rat brain after subarachnoid hemorhage (SAH) and its relation to cerebral edema and vasospasm.Methods Subarachnoid hemorrhage rat model was produced by anterior cerebral artery perforation method.The brain water content was measured by dry-wet weight method.Hematoxylin-eosin (HE) staining was used to assess vasospasm in the basilar artery,and the expression of IL-1β after SAH was examined by Western blot.Results After SAH,the cerebral edema gradually occured from 1 d,reached the peak at 7d.The level of IL-1β protein started to increase in 1 d,reached its peak in 7d,and remained at a relative high level in 14d.There's correlation between the level of IL-1β protein and changes of cerebral edema.Conclusion After SAH,The level of IL-1β gradually rised and fits remarkably well with the time course of cerebral edema,which may indicate that IL-1β leads to the development of cerebral edema after SAH.

On the Legal Capacity of Fetal Rights——An Analysis from the Ethical and Legal Perspective / 中国医学伦理学

There are many arguments on the legal capacity of fetal rights for a long time,but no definite conclusion has ever been reached.Based on ethics and approached in jurisprudence,this article tries to jump out of the traditional mode to analyze the reasons for the independent personality of fetus and justify the view that legal capacity of fetal rights does not necessarily require additional restrictions.The legal capacity of fetal rights origins from social ethical values.Morality distinguishes right from wrong,law pursuits for justice,and moral value is the basis of the law and human nature.The definition of legal "person" should first respect for the objectivity of human development process and the nature of human.It's necessary to recognize the independent personality of fetus,protect the vulnerable groups,and the people in the most vulnerable stage of human development on the basis of social moral value.The directive function of law on morality should be enhanced in our nomocracy-favored society,so as to achieve the reunification of fetal rights in the context of harmonious society construction and realize the human virtue of excellence and harmony.