Publications by authors named "Xiao-Guang Cheng"

29 Publications

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In Memory of Prof. Harry Genant, MD/PhD.

J Orthop Translat 2021 Mar 6;27:A1. Epub 2021 Apr 6.

Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China.

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http://dx.doi.org/10.1016/j.jot.2021.03.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8071632PMC
March 2021

Prevalence of Lumbar Spondylolisthesis in Middle-Aged People in Beijing Community.

Orthop Surg 2021 Feb 12;13(1):202-206. Epub 2021 Jan 12.

Fourth Clinical Medical College of Peking University, Beijing Jishuitan Hospital, Beijing, China.

Objective: Lumbar spondylolisthesis (LS) is a common lumbar disease, and the prevalence of LS in different countries or regions was not consistent in the past. This study intends to make statistics on the prevalence of lumbar spondylolisthesis in middle-aged people in Beijing community.

Methods: This is an epidemiological study. 4548 people in Beijing community aged 50 to 64 years were recruited from the local communities by advertisements placed in housing estates and community centres for people to take part in a prospective cohort study from August from September 2013 to March 2014. There is no intervention on the subjects. RadiAnt DICOM Viewer is adopted to read the lateral CT positioning images of all the studied objects, adjust the image as bone window, observe and evaluate the slide of L1 to L5 vertebra in the lateral CT positioning image.

Results: Among the 4,548 subjects included in the study, 2,490 (54.75%) were male and 2,058 (45.25%) were female. A total of 785 subjects had lumbar spondylolisthesis, with a total incidence of 17.26%. There was no significant difference between prevalence of males and females in the subgroup 50-54 years old (13.55% males / 12.53% females) and 55-59 years old (14.77% males / 14.93% females). But the prevalence of LS in 60-64 years old females (28.57%) increased significantly, compared with 55-59 years old females (14.93%) and 60-64 years old males (18.76%). There were 847 levels that had slipped, L5S1 > L4/5 > L3/4 > L2/3 > L1/2. The retrolisthesis was the most, accounting for 61.51% (521/847), and the anterolisthesis was 38.49% (326/847), including anterolisthesis gradeI for 95.71% (312/326), anterolisthesis gradeII for 4.29% (14/326). Neither of anterolisthesis and retrolisthesis presented more than grade III. Among all the subjects, 318 had anterolisthesis, with a total incidence of 6.99%, and 467 subjects only had retrolisthesis.

Conclusion: The total prevalence of LS in the middle-aged people in Beijing community was 17.26%, 15.98% in males and 18.80% in females, and women are more likely to suffer from LS after 60 years old.
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http://dx.doi.org/10.1111/os.12871DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7862163PMC
February 2021

Semi-quantitative grading and extended semi-quantitative grading for osteoporotic vertebral deformity: a radiographic image database for education and calibration.

Ann Transl Med 2020 Mar;8(6):398

Department of Radiology, Hospital of Traumatology, Carretera de Jaen SN, Granada, Spain.

The Genant's semi-quantitative (GSQ) criteria is currently the most used approach in epidemiology studies and clinical trials for osteoporotic vertebral deformity (OVD) evaluation with radiograph. The qualitative diagnosis with radiological knowledge helps to minimize false positive readings. However, unless there is a face-to-face training with experienced readers, it can be difficult to apply GSQ criteria by only reading the text description of Genant (in 1993), even for a musculoskeletal radiologist. We propose an expanded semi-quantitative (eSQ) OVD classification with the following features: (I) GSQ grade-0.5 is noted as minimal grade (eSQ grade-1) for OVDs with height loss <20%; (II) GSQ mild grade (grade-1) is the same as eSQ mild grade (grade-2); (III) GSQ moderate grade (grade-2) is subdivided into eSQ grade-3 (moderate, >25%-1/3 height loss) and eSQ grade-4 (moderately-severe, >1/3-40% height loss); (IV) GSQ severe grade is subdivided into eSQ grade-5 (severe, >40%-2/3 height loss) and eSQ grade-6 (collapsed, with >2/3 height loss). We advocate to estimate vertebral height loss with adjacent vertebral heights as the reference (rather than using individual vertebra's posterior height as the reference). This article presents radiographs of 36 cases with OVD, together with gradings using GSQ criteria and eSQ criteria. The examples in this article can serve as teaching material or calibration database for readers who will use GSQ criteria or eSQ criteria. Our approach for quantitative measurement is explained graphically.
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http://dx.doi.org/10.21037/atm.2020.02.23DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186643PMC
March 2020

Discordance in diagnosis of osteoporosis by quantitative computed tomography and dual-energy X-ray absorptiometry in Chinese elderly men.

J Orthop Translat 2019 Jul 21;18:59-64. Epub 2018 Dec 21.

Department of Radiology, Beijing Jishuitan Hospital, No. 31 Xinjiekoudongjie Street, Xicheng District, Beijing 100035, China.

Objective: The objective of this study was to investigate the diagnostic discordance of osteoporosis by quantitative computed tomography (QCT) and dual-energy X-ray absorptiometry (DXA) in Chinese elderly men.

Methods: A total of 313 males older than 60 years, who underwent both spinal QCT and lumbar spine and hip DXA in our department, were included. The diagnostic criteria established by the World Health Organisation in 1994 were used for DXA to diagnose osteoporosis, and the criteria recommended by the International Society of Clinical Densitometry were used for QCT. The osteoporosis detection rate by the two techniques was calculated, and the difference was compared. The minor discordance was considered present when the different diagnostic classes between the two techniques were adjacent. Major discordance was present when the diagnosis by one technique was osteoporosis and the other was normal. The computed tomography images were reviewed by radiologists to assess whether vertebral fracture, aorta calcification or degeneration was present.

Results: In the 313 participants (mean age, 79.6 ± 7.2 years), the osteoporosis detection rate was 10.9% for DXA (lumbar spine and hip) and 45.1% for QCT, a significant difference ( < 0.001). The major discordance, minor discordance and concordance of diagnosis between the two techniques were seen in 8.3%, 50.8% and 40.9%, respectively. QCT detected osteoporosis better than DXA. The causes of this discordance were degeneration of spine, abdominal aorta calcification and vertebral fractures.

Conclusion: Our study demonstrated that discordance was common when using QCT and DXA to diagnose osteoporosis and that spinal degeneration, aorta calcification and fracture obscure the bone mineral density measurement of spine by DXA. QCT is a more sensitive method of choice to identify osteoporosis in elderly Chinese men.

The Translational Potential Of This Article: This study investigated the diagnostic discordance of osteoporosis by quantitative computed tomography (QCT) and dual-energy X-ray absorptiometry (DXA) in Chinese elderly men. The results demonstrated that QCT is a more sensitive method of choice to identify osteoporosis in elderly Chinese men. This work may help clinicians make an appropriate choice of technique for the accurate diagnosis of osteoporosis and identify the patients at high risk of osteoporosis who should be treated early to prevent fractures. This may influence the therapeutic plan and the overall prognosis of patients.
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http://dx.doi.org/10.1016/j.jot.2018.11.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6718941PMC
July 2019

The spatial differences in bone mineral density and hip structure between low-energy femoral neck and trochanteric fractures in elderly Chinese using quantitative computed tomography.

Bone 2019 07 17;124:62-68. Epub 2019 Apr 17.

Department of Radiology, Beijing Jishuitan Hospital, Beijing, China. Electronic address:

The purpose of this study was to investigate the differences in bone mineral density (BMD) and hip structure between femoral neck and trochanteric fractures in elderly Chinese individuals using quantitative computed tomography (QCT). A total of 625 Chinese patients (mean age 75.8 years) who sustained low-energy hip fractures (female: 293 femoral neck, 175 trochanteric; male: 82 femoral neck, 75 trochanteric) were recruited. Each patient underwent a hip QCT scan. The areal BMD (aBMD) of the contralateral normal hip was obtained using a computed tomography X-ray absorptiometry module. Using the bone investigation toolkit (BIT) module, the femoral neck was divided into four quadrants: supero-anterior (SA), infero-anterior (IA), infero-posterior (IP), and supero-posterior (SP). Estimated cortical thickness, cortical BMD, and trabecular BMD were measured in each quadrant. Using the hip structure analysis (HSA) function, several parameters were calculated. Stratified by sex, covariance analyses were applied to compare the femoral neck fractures group with trochanteric fractures group after adjustments for age, height, and weight. In women, trochanteric fractures exhibited lower trabecular BMD and estimated cortical thickness at three quadrants of the femoral neck (IA: P = 0.02, P < 0.01; IP: P < 0.01, P = 0.01; SP: P = 0.01, P < 0.01), and lower aBMD at the trochanter area (P < 0.01); femoral neck fractures exhibited lower cortical BMD and estimated cortical thickness at the SA quadrant (P = 0.04, P = 0.01). Differences in HSA parameters were not statistically significant. Among all parameters, the most valuable ones to discrimination of hip fracture type are estimated cortical thickness of the SA quadrant of femoral neck and the aBMD of the trochanter area. In men, only lower cortical BMD at the SP quadrant and aBMD at the trochanter were found in the trochanteric fractures (P = 0.02, P < 0.01). QCT outcomes indicate that spatial differences are helpful to explore the pathogenesis of different type of hip fractures. In women, trochanteric fractures are related to severer osteoporosis, whereas cortical fragility in the SA region of the femoral neck predominates in cases of femoral neck fractures. In men, trochanteric fractures are related to more bone loss of trochanter.
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http://dx.doi.org/10.1016/j.bone.2019.04.007DOI Listing
July 2019

Discrimination of vertebral fragility fracture with lumbar spine bone mineral density measured by quantitative computed tomography.

J Orthop Translat 2019 Jan 10;16:33-39. Epub 2018 Oct 10.

Department of Radiology, Beijing Jishuitan Hospital, Beijing, China.

Background/objective: This study is a case-control study to explore risk and protective factors, including clinical data and bone mineral density (BMD), affecting vertebral body fragility fracture in elderly men and postmenopausal women. In addition, we investigate the effectiveness of lumbar spine BMD by quantitative computed tomography (QCT) in discriminating vertebral fragility fracture.

Methods: In this case-control study, 52 males and 198 females with vertebral fragility fracture were compared with sex- and age-matched healthy controls to analyse the risk factors that may affect vertebral fragility fracture. The L1-L3 vertebral BMDs were measured by QCT. The difference in risk factors between fracture cases and controls were analysed using student test and Mann-Whitney U test. The correlation between BMD, age, height and weight were analysed using univariate analysis. Multiple logistic regression analysis was used to study statistically significant indexes. The receiver operating characteristic curve was used to calculate the cut-off values for positive and negative predictive values of BMD for vertebral fracture discrimination.

Results: In males, body weight and BMD were significantly different between the fracture group and the control group, whereas BMD was only weakly correlated with age (r = -0.234). In females, only BMD was significantly different between the fracture and control groups. BMD was weakly correlated with height (r = 0.133) and weight (r = 0.120) and was moderately correlated with age (r = -0.387). There was no correlation between BMD and the remaining variables in this study. In both men and women, the BMD ( = 0.000) was the independent protective factor against vertebral fracture. The cut-off values of vertebral BMD for fractures were 64.16 mg/cm for males and 55.58 mg/cm for females. QCT-measured BMD has a high positive predictive value and negative predictive value for discriminating vertebral fragility fracture across a range of BMD values.

Conclusion: This study suggests that BMD is closely related to vertebral fragility fracture and that QCT is an effective technique to accurately discriminate vertebral fragility fracture.

The Translational Potential Of This Article: The spine BMD measured by QCT is closely related to fracture, which may allow clinicians to more accurately discriminate which individuals are likely to experience vertebral fragility fracture.
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http://dx.doi.org/10.1016/j.jot.2018.08.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6350047PMC
January 2019

Orthopaedic imaging for translational research and clinical application.

J Orthop Translat 2018 Oct 30;15:A1-A2. Epub 2018 Nov 30.

Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong Special Administrative Region.

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http://dx.doi.org/10.1016/j.jot.2018.10.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6286467PMC
October 2018

The protocol for the Prospective Urban Rural Epidemiology China Action on Spine and Hip status study.

Quant Imaging Med Surg 2018 Aug;8(7):667-672

Department of Prevention and Healthcare, Hospital of Xidian University, Xi'an 710071, China.

The Prospective Urban Rural Epidemiology (PURE) China Action on Spine and Hip status (CASH) study focused on the prevalence of osteoporosis and spinal fracture in China. The aim of the PURE CASH study is to determine the prevalence of osteoporosis and spinal fracture, and explore the potential relationship between spinal fracture and bone mineral density (BMD). This study is a prospective large-scale population study with a community-based sampling and recruitment strategy. The aim is to determine the prevalence of osteoporosis and vertebral fracture in this population, to evaluate the association between vertebral fractures and BMD values, and to assess the prediction power of BMD for incident fractures. Participants in the PURE CASH study are all from the PURE study in China, recruited from 12 centers in 7 Chinese provinces. The inclusion criteria are that participants should be aged more than 40 years and able to give informed consent. Exclusion criteria are pregnant women, individuals with metal implants in the lumbar spine, use of medications or the existence of any disease or condition known to have a major influence on BMD, and inability to give informed consent. A total of 3,457 participants undergo a quantitative computed tomography (QCT) scan of the upper abdomen. The scanning parameters are as follows: 120 kVp at all centers, mAs between 75 and 200, FOV 40 cm×40 cm. The BMD values of L1 to L3 are measured, and the average BMD calculated. The American College of Radiology QCT criteria for the diagnosis of osteoporosis is applied to determine the presence of osteoporosis. The scout view images of T4-L4 vertebrae are reviewed by two experienced radiologists for semi-quantification of vertebral fractures according to Genant's method.
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http://dx.doi.org/10.21037/qims.2018.08.07DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6127527PMC
August 2018

Correlation between Non-Alcoholic Fatty Liver Disease and Visceral Adipose Tissue in Non-Obese Chinese Adults: A CT Evaluation.

Korean J Radiol 2018 Sep-Oct;19(5):923-929. Epub 2018 Aug 6.

Department of Radiology, Beijing Jishuitan Hospital, the 4th Medical College of Peking University, Beijing 100035, China.

Objective: To investigate the correlation between non-alcoholic fatty liver disease and visceral adipose tissue in non-obese Chinese adults using computed tomography (CT).

Materials And Methods: The study included 454 subjects undergoing abdominal CT scan. Degree of CT attenuation in liver and spleen, and the degree of fat infiltration in liver were evaluated according to three indices: the attenuation value of liver parenchyma (CT), the attenuation ratio of liver and spleen (LS) and the attenuation difference between liver and spleen (LS). Visceral fat area (VFA) and total fat area (TFA) at L2/3 and L4/5 levels were measured, and the abdominal subcutaneous fat area (SFA) was calculated. Bivariate correlation analysis was carried out to determine the correlation among these factors.

Results: In men, VFA, SFA and TFA at L2/3 and L4/5 levels showed significant differences in terms of the three indices to distinguish fatty liver from non-fatty liver (all, < 0.001). In men, all the three indices showed negative correlation with TFA, SFA and VFA (all, < 0.001). The negative correlation between the three indices and VFA at the L2/3 level was higher than at L4/5 level ( = -0.476 vs. = -0.340 for CT, = -0.502 vs. = -0.413 for LS, = -0.543 vs. = -0.422 for LS, < 0.001, respectively). The negative correlation between LS, LS and VFA at L2/3 and L4/5 levels was higher than SFA at the corresponding level. In women, all the three indices showed negative correlation with VFA and TFA at L2/3 and L4/5 levels, and the negative correlation between CT and VFA was higher at L2/3 level than at L4/5 level ( = -0.294 vs. = -0.254, < 0.001).

Conclusion: In non-obese Chinese adults, the degree of hepatic fatty infiltration showed a strong correlation with abdominal fat on CT. VFA at L2/3 level was more closely related to fatty liver compared with VFA at L4/5 level.
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http://dx.doi.org/10.3348/kjr.2018.19.5.923DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6082759PMC
April 2019

Effects of Structural Changes in Subchondral Bone on Articular Cartilage in a Beagle Dog Model.

Biomed Environ Sci 2017 Mar;30(3):194-203

Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.

Objective: Using MR T2-mapping and histopathologic score for articular cartilage to evaluate the effect of structural changes in subchondral bone on articular cartilage.

Methods: 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.

Results: There was a statistically significant difference (P < 0.05) 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 (P < 0.05) from week 8, and between the cement group and its sham group (P < 0.05) from week 16. There was significant difference in T2 values between the two experimental groups at postoperative week 24 (P < 0.01). The T2 value for articular cartilage was positively correlated with the Mankin score (ρ = 0.758, P < 0.01).

Conclusion: 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.
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http://dx.doi.org/10.3967/bes2017.022DOI Listing
March 2017

Heterogeneity in Spinal Bone Mineral Density Among Young Adults From Three Eastern Provincial Capital Cities in Mainland China.

J Clin Densitom 2017 Apr - Jun;20(2):198-204. Epub 2016 Apr 29.

Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing, China. Electronic address:

This study compares spinal volumetric bone mineral density (vBMD) with spinal areal bone mineral density (aBMD) among young adults from 3 eastern provincial capital cities in Mainland China. A total of 416 young adults (age range: 20-40 yr) from 3 eastern provincial capital cities (Beijing, Shanghai, and Guangzhou) in Mainland China were recruited in this study. From each subject, the vBMD of the lumbar spine was measured by the Mindways quantitative computed tomography system. Moreover, the aBMD of the lumbar spine, measured by the dual-energy X-ray absorptiometry, was extracted from a previous multicenter large-scale study, and the 420 participants were matched by age, gender, height, weight, as well as geographic territory. The vBMD and the aBMD values were further compared and analyzed. Generally, the bone mineral density (BMD) results were significantly different among participants from the 3 cities (p <0.05). Specifically, both vBMD and aBMD values of participants from Beijing were significantly different from those from Guangzhou (p <0.05). Additionally, a statistically significant difference in aBMD values was also found between participants from Beijing and Shanghai (p <0.05). However, no significant differences were found between participants from Shanghai and Guangzhou in terms of the aBMD and vBMD values (p > 0.05 and p > 0.05). Interestingly, the overall mean vBMD value was 5.9% greater in women than those in men for all the 3 cities (p <0.001). This study demonstrated an overall heterogeneity in spinal BMD among young adults from 3 eastern provincial capital cities in Mainland China. Specifically, the taller and heavier young adults from the northern part of China have smaller spinal vBMD but higher spinal aBMD values than those who were shorter and lighter from the southern part of China.
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http://dx.doi.org/10.1016/j.jocd.2016.03.009DOI Listing
June 2018

A Rare Etiology of Severe Acute Heart Failure: Subacute Spinal Subdural Hematoma in a Young Woman.

Int J Cardiol 2015 Sep 15;195:61-3. Epub 2015 May 15.

Department of Cardiology, Beijing Jishuitan Hospital, Peking University, Beijing, China.

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http://dx.doi.org/10.1016/j.ijcard.2015.05.083DOI Listing
September 2015

Comparison of the antiviral effects of different nucleos(t)ide analogues in chinese patients with chronic hepatitis B: a head-to-head study.

Saudi J Gastroenterol 2014 Nov-Dec;20(6):350-5

Department of Infectious Disease, The First Affiliated Hospital of Anhui Medical University, Hefei, 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(3) copies/mL), detectable but <10(4) copies/mL, and >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.
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http://dx.doi.org/10.4103/1319-3767.145320DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4271009PMC
September 2015

LMP1 stimulates the transcription of eIF4E to promote the proliferation, migration and invasion of human nasopharyngeal carcinoma.

FEBS J 2014 Jul 30;281(13):3004-18. Epub 2014 May 30.

Pathology Department, Cancer Institute of Guangdong Medical College, Dongguan, China; Microbiology and Immunology Department, Guangdong Medical College, Dongguan, China.

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.
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http://dx.doi.org/10.1111/febs.12838DOI Listing
July 2014

Magnetic resonance imaging and histopathological analysis of experimental muscle injuries in a rabbit.

Biomed Environ Sci 2013 Oct;26(10):841-8

Department of Radiology, Beijing Jishuitan Hospital, Fourth Clinical Hospital of Peking University Health Science Center, Beijing 100035, China.

Objective: 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.

Methods: 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 changes

Results: After 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.

Conclusion: MRI clearly demonstrates intramuscular hemorrhage and muscle injury, which correlate well with histopathological changes. T2 mapping is useful in assessing the extent of injury.
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http://dx.doi.org/10.3967/bes2013.007DOI Listing
October 2013

Correlation between the prevalence of herniation pits and the α angle of the hip: computed tomography evaluation in healthy Chinese adults.

BMC Musculoskelet Disord 2013 Oct 9;14:288. Epub 2013 Oct 9.

Department of Radiology, Beijing Jishuitan Hospital, 31 Xinjiekou East Street, Xicheng District, Beijing 100035, China.

Background: Herniation pits (HPs) commonly develop over time at the femoral head-neck junction in adults, but their cause is still under debate. The purpose of study reported here was to investigate the correlation between the prevalence of HPs of the femoral neck and the alpha angle of the hips of healthy Chinese adults, by using computed tomography (CT).

Methods: Six hundred and seventy Chinese adults (representing 1145 hips) who had no known diseases affecting the proximal femur and had no symptoms of femoroacetabular impingement underwent a 64-slice CT scan for medical purposes that included the hip in the scan range. Their CT data were analyzed for the prevalence of HPs in the femoral necks and for hip alpha angles.

Results: The overall prevalence of femoral-neck HPs was 12.5% (143 of 1145 hips). The prevalence in the left versus right femoral necks was 12.1% (69 of 569 hips) versus 12.8% (74 of 576 hips). There was no statistically significant difference between the two sides (χ2 = 0.136; p = 0.712). The prevalence of HPs was greater in men than in women (15.9% vs 7.7%; p < 0.01) and greater in adults older than 30 years than in adults younger than 30 years (χ2= 14.547; p < 0.01). The alpha angles were greater in the 143 proximal femora with HPs than in the 1002 without pits (39.95° ± 6.01° vs 37.97° ± 5.14°; p < 0.01).

Conclusions: The prevalence of HPs of the femoral neck in healthy adults was 12.5%, and the prevalence was greater in men than in women. There is a correlation between the prevalence of HPs and the contour of the femoral head-neck junction. The formation of pits may be attributed to the combination of degeneration and morphologic variances in the femoral head-neck junction.
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http://dx.doi.org/10.1186/1471-2474-14-288DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4124729PMC
October 2013

Comparison of QCT and DXA: Osteoporosis Detection Rates in Postmenopausal Women.

Int J Endocrinol 2013 27;2013:895474. Epub 2013 Mar 27.

Department of Radiology, Beijing Jishuitan Hospital, No. 31 Xinjiekou Street, Xicheng District, Beijing 100035, China.

Objective. To compare the osteoporosis detection rates in postmenopausal women when measuring bone mineral density (BMD) with quantitative computed tomography (QCT) in the spine versus dual X-ray absorptiometry (DXA) in the spine and hip and to investigate the reasons for the discrepancy between the two techniques. Methods. Spinal volumetric BMD was measured with QCT, and areal spinal and hip BMDs were measured with DXA in 140 postmenopausal women. We calculated the osteoporosis detection rate for the two methods. Lumbar CT images of patients who had a discrepancy between QCT and DXA findings were reviewed to evaluate vertebral fractures, spinal degeneration, and abdominal aortic calcification. Results. For the entire 140 patients, the detection rate was 17.1% for DXA and 46.4% for QCT, a significant difference (P < 0.01). Of the 41 patients with conflicting diagnoses, 7 whose diagnosis by QCT was osteoporosis had vertebral fractures even though their DXA findings did not indicate osteoporosis. Varying degrees of spinal degeneration were seen in all of the 41 patients. Conclusion. QCT may avoid the overestimation of BMD by DXA associated with spinal degeneration, abdominal aortic calcification, and other sclerotic lesions. It may be more sensitive than DXA for detecting osteoporosis in postmenopausal women.
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http://dx.doi.org/10.1155/2013/895474DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3623474PMC
April 2013

[Skeletal disease in primary hyperparathyroidism: X-ray, CT and MR imaging founding].

Zhonghua Yi Xue Za Zhi 2013 Jan;93(1):30-3

Department of Radiology, Beijing Jishuitan Hospital, Beijing, China.

Objective: 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.

Methods: 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.

Results: 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.

Conclusion: 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.
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January 2013

Comparison of two bioelectrical impedance analysis devices with dual energy X-ray absorptiometry and magnetic resonance imaging in the estimation of body composition.

J Strength Cond Res 2013 Jan;27(1):236-43

Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

We compared a 4-limb bioelectrical impedance analysis (BIA) system, HBF 359 (Omron), and a 2-limb foot-to-foot device, BC 532 (Tanita), with the standard dual energy X-ray absorptiometry (DXA) and magnetic resonance imaging (MRI) methods for the measurement of body fat percentage (BF), skeletal muscle mass percentage (SMM, or fat-free mass [FFM] for BC 532), and visceral fat level (VF). Body composition was measured in 200 healthy volunteers (100 men and 100 women, mean age 48 years) by HBF 359 and BC 532 and by DXA and MRI. The agreement was assessed by correlation analysis and paired t-test. The correlation coefficients between BIA and DXA or MRI ranged from 0.71 to 0.89 for BF, SMM, and VF by HBF 359 and from 0.77 to 0.90 for BF, FFM, and VF by BC 532 in all subjects and in men and women separately (p < 0.001 for all). Compared with DXA, HBF 359 significantly (p < 0.001) underestimated BF by -5.8% in men and -9.6% in women. Compared with MRI, the corresponding underestimatons (negative) or overestimations (positive) by HBF 359 in men and women were, respectively, +1.9% (p = 0.02) and +1.7% (p = 0.10) for SMM, and +13.3% (p < 0.001) and -8.5% (p = 0.006), for VF. The corresponding values by BC 532 in men and women were -10.7 and -6.2% for BF, -1.4 and -2.5% for FFM, and +20.4 and -18.0% for VF. The BIA devices are accurate in the estimation of body composition, especially skeletal muscle mass or FFM.
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http://dx.doi.org/10.1519/JSC.0b013e31824f2040DOI Listing
January 2013

[Relationship between proliferation and apoptosis of parathyroid cell in rabbits with primary hyperparathyroidism].

Zhonghua Yi Xue Za Zhi 2011 Jul;91(25):1770-4

Department of Radiology, China-Japan Friendship Hospital, Beijing 100029, China.

Objective: To evaluate the effect of proliferation and apoptosis of parathyroid cell in rabbits with primary hyperparathyroidism (PHPT).

Methods: 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).

Results: The number of parathyroid cell was 1.61 times in PHPT than that in the normal control (673 +/- 151, 418 +/- 25, t = - 12.112, P < 0.01). 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, P < 0.01). 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, P < 0.05). So did Bcl-2 (460 per thousand +/- 190 per thousand, 67 per thousand +/- 4 per thousand, t = -14. 120, P < 0.05). There was a positive correlation between AI and PCNA (r = 0.861, P < 0.05). It was the same as between AI and Bcl-2 (r = 0.871, P < 0.05). The value of bone mineral density decreased significantly more in PHPT than that in normal control (152 +/- 34, 189 +/- 12, t = 9.236, P < 0.05).

Conclusion: PHPT may be mainly induced by an excessive proliferation of parathyroid cells and an acceleration of apoptotic process.
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July 2011

[The study of an animal model in rabbits with the early primary hyperparathyroidism].

Zhonghua Yi Xue Za Zhi 2010 Nov;90(43):3087-90

Department of Radiology, China-Japan Friendship Hospital, Beijing 100029, China.

Objective: to study the biochemistry of blood and feature of pathology of an animal model in rabbits with the early primary hyperparathyroidism(PHPT).

Methods: 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.

Results: 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, P < 0.05), whereas serum calcium levels were decreased at all three time intervals (t = 6.184, t = 9.329, t = 13.842, respective, P < 0.05), but serum phosphorus levels did not change (t = 0.611, t = 1.041, t = 1.941, respective, P > 0.05). 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.

Conclusion: the high-phosphate diet successfully induced an animal model in rabbits with the early primary hyperparathyroidism, which has a better stability and reproducibility.
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November 2010

[Study of pedicle screw placement assisted by intraoperative three-dimensional navigation in lumbar vertebrae with axial rotation].

Zhonghua Wai Ke Za Zhi 2010 Jun;48(11):838-41

Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing 100035, China.

Objective: 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.

Methods: 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).

Results: 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 (P < 0.05). With degrees increasing, the accuracy declined. The accuracy of intraoperative 3D navigation group was higher than traditional method group in vertebrae with axial rotation (P < 0.01). 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.

Conclusions: 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.
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June 2010

Solitary pulmonary nodules: comparison of multi-slice computed tomography perfusion study with vascular endothelial growth factor and microvessel density.

Chin Med J (Engl) 2009 Mar;122(5):541-7

Department of Radiology, Beijing Jishuitan Hospital, Peking University, China.

Background: 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.

Methods: 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.

Results: 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 (P < 0.05, P < 0.05). Ratios of SPN-to-aorta of malignant and inflammatory SPNs were significantly higher than those of benign SPNs (P < 0.05, P < 0.05). No significant differences were found between the peak height and SPN-to-aorta ratio of malignant SPNs and inflammatory SPNs (P > 0.05, P > 0.05). The precontrast densities of inflammatory SPNs were lower than those of malignant SPNs (P < 0.05). Perfusion values of malignant and inflammatory SPNs were significantly higher than those of the benign SPNs (P < 0.05, P < 0.05). 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 (P < 0.05, P < 0.05). 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, P < 0.05).

Conclusions: 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.
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March 2009

Age-related bone mineral density, bone loss rate, prevalence of osteoporosis, and reference database of women at multiple centers in China.

J Clin Densitom 2007 Jul-Sep;10(3):276-84. Epub 2007 Jun 28.

Ji Shui Tan Hospital, Beijing, China.

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
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http://dx.doi.org/10.1016/j.jocd.2007.05.004DOI Listing
December 2007

[Comparison between CT-discography and magnetic resonance imaging in lumbar disc diseases].

Zhonghua Yi Xue Za Zhi 2006 Aug;86(31):2166-70

Department of Spine Surgery, Beijing Jishuitan Hospital, Peking University, Beijing 100035, China.

Objective: 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).

Methods: 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.

Results: 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 (P < 0.01). MRI was considered to have limited value in the disc diseases with passive discographic finding.

Conclusion: 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.
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August 2006

[Clinical research of correlation between osteonecrosis and steroid].

Zhonghua Wai Ke Za Zhi 2005 Aug;43(16):1048-53

Center for Osteonecrosis & Joint-preserving Reconstruction, China-Japan Friendship Hospital, Beijing 100029, China.

Objective: To explore the correlation between the dosage of corticosteroid, time of onset and incidence of osteonecrosis (ON) in patients with SARS.

Methods: 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.

Results: 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 (P < 0.0001). The duration of steroid was (38 +/- 17) d in ON group and (27 +/- 15) d in non-ON group (P < 0.01). The dosage of pulse treatment was (340 +/- 207) mg/d in ON group and (211 +/- 160) mg/d in non-ON group (P < 0.01). The duration of pulse treatment was (28 +/- 13) d in ON group and (18 +/- 11) d in non-ON group (P < 0.01). All patients with ON were detected within 6 months from administration.

Conclusion: 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.
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August 2005

[MRI in the diagnosis of hip joint transient osteoporosis--a case report].

Zhonghua Yi Xue Za Zhi 2004 Sep;84(17):1495

Department of Radiology, Jishuitan Hospital, Beijing 100035, China

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September 2004

Mimicry of annonaceous acetogenins: enantioselective synthesis of a (4R)-hydroxy analogue having potent antitumor activity.

J Org Chem 2002 May;67(10):3404-8

State Key Laboratory of Bioorganic and Natural Products Chemistry, Shanghai Institute of Organic Chemistry, 354 Fenglin Road, Shanghai 200032, China.

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.
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http://dx.doi.org/10.1021/jo016396uDOI Listing
May 2002

Universal standardization of forearm bone densitometry.

J Bone Miner Res 2002 Apr;17(4):734-45

Department of Radiology, University of California San Francisco, 94143-1349, USA.

As part of an effort to quantify device-dependent differences in forearm bone density, 101 women, aged 20-80 years (approximately 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) ROTs 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.
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http://dx.doi.org/10.1359/jbmr.2002.17.4.734DOI Listing
April 2002