Picture archiving and communication system ( PACS ) based on digital teaching platform of medical imaging consists of web teaching system and teaching resource library of medical imaging.The web teaching system includes four function modules of classroom management,work management,teaching management and test management.The teaching resource library includes script,pictures,and audio,video and animation materials of theoretical books,typical cases,examination techniques and medical imaging equipments.Utilized in theoretical and practical classes,the teaching characteristic of medical imaging is made prominent,and the subjective motility of the students is brought into play.

Objective To summarize the imaging features of neurofibromatosis.Methods Imaging data of 7 patients with neurofibromatosis proven by operation and clinical syndrome,were retrospectively analyzed.Results In 7 cases of neurofibromatosis,the findings of CT and MRI displayed 3 cases of bilateral vestibular schwannoma,2 of which were combined with optical nerve glioma;1 case of optical nerve glioma complicated with neurofibromatosis under cervical dura;1 case of meningioma and 2 cases with the changes of dura spinal sac.The last two cases displayed abnormal skull and spinal canal,concave change of vertebra and enlarged dura spinal sac,partially stretched to never root on CT plain flim and MRI.Conclusion Neurofibromatosis can be definitely diagnosed by optimal imaging examination based on comprehensive analysis of imaging features and typical syndromes.

This paper introduced the current situation of WeChat's official accounts of medical imaging.According to the operation agents,they can be divided into different categories,including professional societies,hospitals and departments,medical companies,academic journals,medical imaging websites and personal accounts.This paper also analyzed the advantages and disadvantages of WeChat's official accounts of medical imaging.Some measures were proposed to improve their application value in continue medical education (CME),such as establishing a platform of WeChat's official account with high approval and authority to award CME credit,integrating various kinds of network resources,strengthening the abundance,systematicness,chronergy and practicality of the resources,setting up and improving the evaluation mechanism of CME credit award,so as to provide a CME platform for the staff of medical imaging.

Objective To investigate changes in bone mineral density (BMD) and analyze its related factors in community populations to provide the early diagnosis of osteoporosis (OP) and give right guidance to prevent osteoporosis. Methods The quantitative ultrasound BMD analyzer was used to measure BMD of heel in 8 711 adults in community. At the same time a questionnaire survey was conducted among these subjects. The data were analyzed by Logistic stepwise regression analysis. Results With the age changing, males and females tended to have different BMD variation. Male and female's BMD peak values were respectively in 35-age group, 30-age group and decreased as age increased. T value of BMD was different between male and female (-1.40(-2.0--0.7)vs-1.3(-2.0--0.5))(P<0.001). Both men and women had a higher incidence of low bone mass (53.34%vs 47.46%), and the difference was significant (P<0.001), whereas the incidence of osteoporosis after 55 years of age between men and women was statistically significance (P<0.05). BMD was the lowest for female than for male in 50-age group, and the prevalence rate of OP was remarkably increased. Analysis of related factors of BMD showed that body mass index (BMI), age, diabetes and menopause were risk facts. Conclusion The BMD among adults is related to many factors, in which the age, BMI and menopause are the most important factors. Much attention should be paid to low bone mass phenomenon, timely monitoring, timely intervention, develop healthy working and living habits, is important to the prevention of osteoporosis and its complications.

Objective To analyze the relationship between obesity and arterial stiffness among population of different glucose tolerance status. Methods A cross-sectional study recruited the population aged 40 years or older from ShiJingShan district in Beijing. 9080 subjects were included by measured weight, waist circumference (WC), body mass index (BMI), waist/hip ratio (WHR) and WC/height ratio (WHtR) and hemodynamic indexes and the aortic stiffness (using brachial-ankle pulse wave velocity(baPWV). They were divided into 3 groups based on the results of OGTT and diabetes history: normal glucose tolerance group ( NGT group) ,impaired glucose regulation group ( IGR group) and diabetes mellitus group ( DM group) . The association between baPWV and different obese indexes was analyzed by multi-ple linear regression. Results According to the criterion of WC, WHR and WHtR, baPWV of central obesity group was significantly higher than the normal group(P<0. 01). There was no statistically significant differences based on BMI in DM group(P>0. 05), but it was of sta-tistically significant differences in NGT group and IGR group. Central obese indexes( WC、WHR、WHtR) showed a positive correlation to PWV in the studied groups(P<0. 05). BMI was only positively correlated with baPWV in NGT group, there was no significant correlation in IGR and DM group(P>0. 05). After adjusting for age, gender and cardiovascular risk factors, the multiple regression analysis found that for every 0. 1 point increase in WHR and WHtR, the PWV increased 40. 6 cm/s and 55. 3cm/s respectively. Conclusion There is a positive correlation between central obese indexes (WC、WHR、WHtR) and arterial stiffness, and the central obese indexes correlated with arterial stiffness better than BMI.

Objective:To investigate the influence of hemoglobin glycation index (HGI) on the risk of incident chronic kidney disease (CDK) among nondiabetic patients.Methods:Prospective cohort study. At baseline, a total of 7 407 nondiabetic patients without a history of CKD from Pingguoyuan Community of the Shijingshan District in Beijing were included from December 2011 to August 2012, who were then divided into three groups according to the tertiles of their baseline HGI levels. The CKD incidence rate was compared among the different HGI groups at last follow-up. Cox multivariable regression was applied to evaluate whether HGI measures predicted CKD risk. Test for trend across tertiles were examined using ordinal values in separate models.Results:The mean age of the subjects was (56.4±7.5) years, and 4 933 (66.6%) were female. At mean follow-up of 3.23 years, 107 (1.4%) individuals developed CKD. The incidence of CKD was gradually increasing from the low to high HGI groups [1.1% (28/2 473) vs. 1.2% (31/2 564) vs. 2.0% (48/2 370), P=0.016]. In the multivariate Cox regression analysis, after adjustment for potential confounders, the high HGI group had a 68.5% increased risk of CKD compared with the low HGI group ( HR=1.685, 95% CI 1.023 to 2.774). CKD risk increased with increasing HGI tertiles ( P for trend=0.028). Conclusion:High HGI is associated with an increased risk for CKD in the nondiabetic population, indicating that HGI may help identify individuals at high risk for CKD.

Objective:To investigate the impact of daily step count on glycemic outcomes in community residents with impaired glucose tolerance (IGT).Methods:This was a prospective cohort study, in October 2018, 204 residents who met the criteria of IGT were recruited in the Shijingshan District in Beijing. The subjects were tested for fasting blood glucose, oral glucose tolerance test 2-hour blood glucose (2hBG), glycated hemoglobin A 1c (HbA 1c), lipid profile, liver and kidney function, as well as measurements of height, weight and waist circumference. A dedicated mobile application was used to deliver prediabetes health knowledge monthly. Online guidance was provided to answer questions and daily step count was collected using the application. Three years later, a follow-up was conducted to assess the participants′ glycemic outcomes and other indexes, and a total of 142 participants completed the follow-up review. According to daily step count, the subjects were categorized into high step count group (42 cases,>7 000 steps daily), moderate step count group (54 cases, 5 000-7 000 steps daily), and low step count group (46 cases,<5 000 steps daily). Subjects were categorized into diabetes group (30 cases), prediabetes group (77 cases) and normal glucose tolerance group (35 cases) with glycemic outcomes. Independent sample t test was used to compare the differences in blood glucose, blood lipids, and step counts between the two groups. Kruskal-Wallis H test or one-way ANOVA was used to compare the differences in blood glucose, blood lipids, and step counts between multiple groups. The χ2 test was used to compare the differences in glycemic outcomes between multiple groups. Multivariate logistic regression analysis was used to assess the impact of daily step counts and body mass index on glycemic outcomes. Linear regression analysis was used to evaluate the relationship between daily step counts and 2 h BG. Results:A total of 142 participants completed the 3-year follow-up, including 43 males and 99 females, with a mean age of (60.15±5.67) years. At baseline, males had significantly higher body mass index, waist circumference, and fasting blood glucose when compared to those in females [(26.97±2.43) vs (24.89±2.93) kg/m 2, (92.68±7.75) vs (83.83±8.60) cm, (5.83±0.61) vs (5.62±0.52) mmol/L], the total cholesterol and HDL-C were also significantly lower in males than those in females [(5.10±1.16) vs (5.55±0.95) mmol/L, (1.35±0.34) vs (1.56±0.35) mmol/L] (all P<0.05). After 3-year follow-up, 21.1% (30/142) of IGT participants progressed to diabetes, with an annual conversion rate of approximately 7%. The normal glucose tolerance group showed significantly higher daily step counts when compared with the prediabetes and diabetes groups [(7 886±2 867) vs (5 981±2 655) vs (4 117±2 674) steps] ( H=31.778, P<0.001). Individuals with higher daily step counts exhibited lower body mass index, 2 h BG, and HbA 1c level when compared with those in the ones with moderate and low step counts [(24.26±3.09) vs (25.44±3.38) vs (26.26±3.59) kg/m 2, (7.50±1.71) vs (9.15±3.30) vs (11.19±3.84) mmol/L, 5.97%±0.46% vs 6.14%±0.99% vs 6.40%±0.96%] (all P<0.05). Higher step count was positively correlated with the reversal of prediabetes to normal blood glucose levels (moderate step count, OR=0.297, 95% CI: 0.109-0.804; low step count, OR=0.055, 95% CI: 0.010-0.287), lower daily step count correlated positively with prediabetes progressing to diabetes ( OR=4.857, 95% CI: 1.140-20.689) (all P<0.05). For every additional 1 000 steps per day, the 2 h BG decreased by 0.5 mmol/L. Conclusion:As daily step count increases, the glucose metabolism improves in IGT community residents. Higher daily step count is associated with reversal of IGT to normal glucose tolerance, while lower daily step count may be associated with the progression of IGT to diabetes.

ObjectiveTo investigate the effect and mechanism of cordycepin in inhibiting fat infiltration after rotator cuff injuries in rats by regulating the Wnt/β-catenin signaling pathway， providing a theoretical basis for clinical treatment of rotator cuff injuries. MethodsFifty SPF-grade female SD rats were used in this study， with 10 randomly selected as the blank group. A rotator cuff injury repair model was established by supraspinatus tendon and suprascapular nerve compression. The successfully modeled rats were randomized into model and low-dose （20 mg·kg^-1）， medium-dose （40 mg·kg^-1）， and high-dose （80 mg·kg^-1） cordycepin groups. After 6 weeks of treatment， the gait analysis was performed to assess the limb function in rats. Oil red O staining and Masson staining were employed to observe pathological changes in the muscle tissue. Enzyme-linked immunosorbent assay （ELISA） was used to measure the levels of interleukin-1β （IL-1β）， interleukin-6 （IL-6）， and tumor necrosis factor-α （TNF-α） in the serum. Immunohistochemistry （IHC） was employed to detect the expression of peroxisome proliferator-activated receptor γ （PPARγ） and CCAAT/enhancer-binding protein α （C/EBPα）， which are markers of adipogenesis. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot were employed to determine the mRNA and protein levels， respectively， of Wnt3a， Wnt10b， and β-catenin. ResultsCompared with the blank group， the model group showed decreases in stride length and paw print area （P<0.01）， an increase in ratio of wet muscle mass reduction and a decrease in muscle fiber cross-sectional area （P<0.05）， and decreased ratios of fat infiltration area and collagen fiber area （P<0.01）. Additionally， the model group showed elevated levels of IL-1β， IL-6， and TNF-α （P<0.05）， up-regulated protein levels of PPARγ and C/EBPα （P<0.01）， and down-regulated mRNA and protein levels of Wnt3a， Wnt10b， and β-catenin （P<0.05， P<0.01）. Compared with the model group， the low-， medium-， and high-dose cordycepin groups showed increases in stride length and paw print area （P<0.01）， a decrease in ratio of wet muscle mass reduction and an increase in muscle fiber cross-sectional area （P<0.05）， and increases in ratios of fat infiltration area and collagen fiber area （P<0.05， P<0.01）. In addition， cordycepin lowered the serum levels of IL-1β， IL-6， and TNF-α （P<0.05， P<0.01）， down-regulated the protein levels of PPARγ and C/EBPα （P<0.01）， and up-regulated the mRNA and protein levels of Wnt3a， Wnt10b， and β-catenin （P<0.05， P<0.01）. ConclusionCordycepin can improve the limb function， alleviate rotator cuff muscle atrophy， fat infiltration， and fibrosis， and inhibit inflammation in rats by regulating the Wnt/β-catenin signaling pathway.