Objectives:To investigate the relationships between vertebral marrow fat in lumbar spine and age and gender in adults using iterative decomposition of water and fat with echo asymmetry and least-squares estimation image quantitation(IDE AL-IQ)magnetic resonance imaging technology.Methods:The IDEAL-IQ fat fraction images from 298 subjects(Male:138,Female:160,age range:20-69 years old)were collected.All the patients were divided into 5 groups based on age,with each group spanning a range of 10 years:age range 20-29 years(Twenties):24 males,20 females;30-39 years(Thirties):47 males,39 females;40-49 years(Forties):36 males,47 females;50-59 years(Fifties):20 males,37 females;60～69 years(Sixties):11 males,17 females.The bone marrow proton density fat fration(PDFF)were measured using GE ADW4.6 processing work station.Results:In the same age group,there were differences in vertebral bone marrow PDFF between gen-ders.PDFF of L1-L5 vertebrae was significantly higher in males than females in twenties,thirties and forties(P＜0.05).In the fifties,there was no statistically significant difference in the L1-L5 vertebrae PDFF between males and females(P＞0.05);while in the sixties,the PDFF of the L1-L5 vertebrae was lower in males than that in females(P＜0.05).The PDFF of lumbar vertebral bone marrow was positively correlated with age,with a higher correlation observed in females(r=0.72,P＜0.05)than that in males(r=0.32,P＜0.05).From the age of 20 to 69,the L4 vertebra PDFF in males had the highest growth rate(21.08％),while the L1 vertebra PDFF in female had the highest growth rate(65.68％).For males,the growth of PDFF was primarily concentrated in the thirties and fifties;The PDFF of L1,L4,and L5 vertebrae showed the largest increase in the fifties,while that of L2 and L3 vertebrae had the highest increase rate in the thirties.For females,vertebral PDFF showed a slight decrease trend in the group of thirties,which gradually increased subsequently in all vertebare in the group of forties,fifties,and sixties,with the largest increase rate observed in the fifties.Conclusions:There are differences in vertebral fat distribution between males and females across different age groups,and the growth rates of vertebral PDFF also vary;the PDFF of vertebral bodies in different segments of the lumbar spine is positively correlated with age.

Objective:To evaluate the feasibility of brain injury after cardiopulmonary resuscitation (CPR) in rats based on T2WI image texture analysis.Methods:Eighteen SD rats were randomly divided into the sham group ( n=8) and model group ( n=10). The rats in the model group underwent MRI scanning at 6 h after return of spontaneous circulation (ROSC), and the rats in the sham group received MRI scanning at 6 h after the operation. The differences in the texture features of T2WI images and the expressions of AQP4 and NSE between the two groups were analyzed. The receiver operating characteristic curve (ROC) was used to evaluate the diagnostic efficacy of statistically different texture features between the two groups for brain injury. The associations between texture features and AQP4 and NSE expressions in the sham group and model group were analyzed using Spearman correlation coefficients. Results:The minimum intensity, standard deviation, and inverse difference moment of the whole brain T2WI texture features of the model group were significantly lower than those of the sham group ( P<0.05), while the difference entropy and characteristics of high gray in homogeneity were significantly higher than those of the sham group ( P<0.05). The difference entropy was the best with an area under curve (AUC) of 0.922, a sensitivity of 100% and a specificity of 75%. The AQP4 and NSE expressions in the model group were significantly higher than those in the sham group ( P<0.05). The minimum intensity value was positively correlated with AQP4 and NSE expressions ( r=0.501, 0.568, P=0.048, 0.022). The standard deviation was positively correlated with AQP4 and NSE expressions ( r=0.620, 0.530, P=0.010, 0.035). The difference entropy was negatively correlated with AQP4 expression ( r=-0.535, P=0.033). Conclusions:Texture analysis on T2WI images can evaluate the degree of brain edema and neuronal damage. The minimum intensity, standard deviation, and difference entropy are sensitive indicators to evaluate brain injury after CPR, and difference entropy has the highest sensitivity and specificity.

Objective:To examine the short and long-term clinical outcomes of total arterial coronary artery bypass grafting.Methods:Clinic data of 208 patients with left main and multiple vessel coronary artery disease and undertaken total arterial coronary artery bypass grafting from February 2009 to December 2019 in Department of Cardiac Surgery, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine were analyzed retrospectively. There were 188 males and 20 females with an age of (54.7±10.7) years (range: 32 to 79 years). The harvest of arterial conduits and grafting strategies were depended upon the individual patient characteristics and surgeon′s experience. Left internal thoracic artery (LITA) was applied in 207 cases, right internal thoracic artery (RITA) in 38 cases (bilateral internal thoracic artery (BITA) in 37 cases), and radial artery (RA) in 187 cases (188 grafts). The graft number per case was 2.6±0.7 (range: 2 to 4). Surgical procedures was completed with off-pump technique in 98.1% patients (204/208). Subgroup analysis was carried out between subgroup BITA ( n=37) and subgroup SITA (single ITA+RA) ( n=171). The t test, χ 2 test or Fisher exact test were used to compare the clinic characteristics between the two subgroups. The Kaplan-Meier curve was used to estimate the rate of late mortality, major adverse cardiac cerebrovascular event (MACCE), and target vessel revascularization (TVR). A Cox proportional hazards model was used to identify the independent prognosis factors of late mortality. Results:The overall mortality within 30 days postoperatively was 1.4%(3/208). The incidences of perioperative MACCE, re-operation for bleeding and deep sternal wound infection (DSWI) were 1.9%(4/208), 0.5%(1/208) and 1.4%(3/208), respectively. Perioperative myocardial infarction and TVR were not observed. There was no significant difference of 30-day mortality, MACCE, bleeding and DSWI between subgroup BITA and SITA+RA (all P>0.05). In a follow-up period of (5.4±2.8)years (range: 0.2 to 10.9 years), the incidence of all-cause mortality at 1-, 5- and 10-year was 2.3%, 3.4% and 6.9%, respectively. The incidence of MACCE was 3.9%,11.2% and 28.5%, respectively. The rate of TVR was 0.4%, 3.7% and 11.9%, respectively. Age>65 was an independent prognosis factor of late mortality ( HR=1.125, 95 % CI:1.050 to 1.205, P<0.01). Conclusions:Total arterial coronary bypass grafting is safe and achievable with proper patient selection and surgical strategies. It significantly decreases the risks of late mortality and repeated revascularization.

Objective To explore the clinical application value of MRI fat quantification parameter[verte-bral bone marrow fat fraction(FF)]combined with 25-hydroxyvitamin D[25(OH)D]in predicting fracture risk in patients with osteoporosis.Methods A total of 90 patients with osteoporosis who were admitted to the hospital from January 2023 to April 2024 were selected as the subjects.Among them,50 patients with osteoporotic vertebral com-pression fractures were included in the fracture group,and 40 patients without fractures were included in the control group.All patients underwent the iterative decomposition of water and fat with echo asymmetry and least-squares estimation(IDEAL-IQ)method of MRI to measure the FF of each vertebra among L1-5 and the average FF of L1-5.Serum 25(OH)D level was detected by electrochemiluminescence method.FF and serum 25(OH)D levels of the two groups were compared.The correlation of FF,25(OH)D and bone mineral density(BMD)was analyzed.Multi-variate logistic regression analysis was conducted to screen the risk factors for fracture in patients with osteoporosis.Receiver operating characteristic(ROC)curves were used to evaluate the predictive value of FF,25(OH)D,and their combination for fracture in patients with osteoporosis.Results Patients in the fracture group were older than those in the control group.BMD and serum 25(OH)D level were lower than those of the control group(P<0.05).The FF of L2 and average FF of L1-5 in the fracture group were higher than those in the control group(P<0.05).Correlation analysis results showed that the FF of L2 and the average FF of L1-5 were negatively correlated with BMD(P<0.05),while serum 25(OH)D level was positively correlated with BMD(P<0.05).Multivariate logistic regression analysis showed that age and FF of L2 were independent risk factors for fracture in patients with osteoporo-sis,while BMD and 25(OH)D were protective factors(P<0.05).ROC curves indicated that the AUC values of FF of L2 and 25(OH)D for predicting fracture were 0.714(95%CI:0.606～0.822)and 0.774(95%CI:0.672～0.876).The AUC of joint prediction was 0.923(95%CI:0.867～0.978),which was significantly larger than that of separate prediction(P<0.05).Conclusions FF of L2 and serum 25(OH)D are related to fracture in patients with osteopo-rosis.Age and BMD are factors influencing the occurrence of fracture in patients with osteoporosis.FF of L2 and 25(OH)D have certain predictive value for fracture risk in patients with osteoporosis,and combined detection of the two can improve predictive efficiency.

Evaluate the feasibleness of forecast the prognostic of sick person acute ischemic stroke Intravenous thrombolysis based on multi-phase CT angiography（mCTA）united with medical message. MethodsThe sufferer acute ischemic stroke accomplished mCTA scan were choose. The multi-phase ASPECTS collateral circulation，blood glucose results red blood cell distribution width（RDW）and neutrophil to lymphocyte ratio（NLR）were record. Pursuant to the modified Rankin Scale（mRS）as the criterion，90 daytime after therapy，sufferer mRS score≤2 were specified as set A（n=18），and sufferer mRS score≥3 were specified as set B（n=33）. The information with statistics discrepancies in univariate analysis were contained in binary Logistics regression analysis. The standalone risk elements for forecast the prognostic of sick person acute ischemic stroke were sifted out and the prognostic modeling was effected. The ROC curvature of all the variable with statistics meaning and the binary Logistics regression analysis was used to assess the diagnosis effectivity，Delong test was used to evaluate the discrepancies in between the ROC curvature. ResultsThe blood glucose results，RDW and NLR of set A were higher than those of set B，and the multi-phase score of set A was lower Compare of set B（P<0.05）. Binary Logistics regression analysis showed multi-phase score and NLR were standalone risk factor for 90 daytime prognostic of sick person acute ischemic stroke. The prediction model was logit（P）=-4.877+aspects score×-0.624+NLR×When the threshhold was 0.5288，the sensitivities and specificity were 77.8% and 93.9%，respectively. ConclusionAspects score and NLR are independent risk factors for predicting 90 daytime prognosis of patients with AIS. multi-phase CTA combined with laboratory examination can forecast the prognostic of sick person acute ischemic stroke and bestow precise forecast information for clinical sick person acute ischemic stroke.

Objective:To examine the short and long-term clinical outcomes of total arterial coronary artery bypass grafting.Methods:Clinic data of 208 patients with left main and multiple vessel coronary artery disease and undertaken total arterial coronary artery bypass grafting from February 2009 to December 2019 in Department of Cardiac Surgery, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine were analyzed retrospectively. There were 188 males and 20 females with an age of (54.7±10.7) years (range: 32 to 79 years). The harvest of arterial conduits and grafting strategies were depended upon the individual patient characteristics and surgeon′s experience. Left internal thoracic artery (LITA) was applied in 207 cases, right internal thoracic artery (RITA) in 38 cases (bilateral internal thoracic artery (BITA) in 37 cases), and radial artery (RA) in 187 cases (188 grafts). The graft number per case was 2.6±0.7 (range: 2 to 4). Surgical procedures was completed with off-pump technique in 98.1% patients (204/208). Subgroup analysis was carried out between subgroup BITA ( n=37) and subgroup SITA (single ITA+RA) ( n=171). The t test, χ 2 test or Fisher exact test were used to compare the clinic characteristics between the two subgroups. The Kaplan-Meier curve was used to estimate the rate of late mortality, major adverse cardiac cerebrovascular event (MACCE), and target vessel revascularization (TVR). A Cox proportional hazards model was used to identify the independent prognosis factors of late mortality. Results:The overall mortality within 30 days postoperatively was 1.4%(3/208). The incidences of perioperative MACCE, re-operation for bleeding and deep sternal wound infection (DSWI) were 1.9%(4/208), 0.5%(1/208) and 1.4%(3/208), respectively. Perioperative myocardial infarction and TVR were not observed. There was no significant difference of 30-day mortality, MACCE, bleeding and DSWI between subgroup BITA and SITA+RA (all P>0.05). In a follow-up period of (5.4±2.8)years (range: 0.2 to 10.9 years), the incidence of all-cause mortality at 1-, 5- and 10-year was 2.3%, 3.4% and 6.9%, respectively. The incidence of MACCE was 3.9%,11.2% and 28.5%, respectively. The rate of TVR was 0.4%, 3.7% and 11.9%, respectively. Age>65 was an independent prognosis factor of late mortality ( HR=1.125, 95 % CI:1.050 to 1.205, P<0.01). Conclusions:Total arterial coronary bypass grafting is safe and achievable with proper patient selection and surgical strategies. It significantly decreases the risks of late mortality and repeated revascularization.