Objective Serum uric acid (SUA) levels have been identified to be associated with nonalcoholic fatty liver disease (NAFLD) which is often closely linked to obesity. However, few studies have examined the relationship between SUA levels and NAFLD in normal body mass index (BMI) people in whom NAFLD is noted not uncommon. We conducted this study to assess the association of SUA with NAFLD in Chinese normal-BMI people. Methods A total of 2 193 normal-BMI people (1 106 men and 1087 women) who participated in a health check-up were enrolled in this cross-sectional study. NAFLD was defined as a hepatic steatosis examined by liver ultrasonography in the absence of a second cause. Multiple regression analysis was performed to examine the relationship between SUA and NAFLD. Results Compared with people without NAFLD, those with NAFLD had significantly higher level of serum uric acid [males,(339.0±47.6)μmol/L vs.(309.3±53.5)μmol/L, t=3.296, P<0.01;female,(273.6±41.6)μmol/L vs. (243.9 ± 47.6)μmol/L, t=3.178, P<0.01]. Multiple regression analysis revealed that the quartile 3 and 4 of SUA in both sexes had a higher (P<0.05) odds ratio for the presence of NAFLD than the lowest quartile [males,odds ratio:2.508(1.255-3.374)and 3.383(2.058-5.490);females,odds ratio:2.186(1.090-4.384) and 2.420(1.214-4.821),respectively],after adjusting for age, body mass index, blood urea nitrogen, serum creatinine, the liver-function test, metabolic components, high sensitivity C-reactive protein, and smoking status.Conclusions Increased SUA level, even within the normal range, are independently associated with the presence of NAFLD among normal-BMI people.

Brain ; pathology ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Myotonic Dystrophy ; diagnosis ; pathology ; White Matter ; pathology

BACKGROUNDThere are few studies for evaluating plaque characteristics of nonstenotic basilar arteries (BA). Our aim was to determine entire BA plaques with a three-dimensional volumetric isotropic turbo spin-echo acquisition (VISTA) and investigate the differences between the patients with and without isolated pontine infarction (IPI).

METHODSTwenty-four consecutive symptomatic patients with nonstenotic BA on time of flight magnetic resonance angiography (TOF MRA) were enrolled from China-Japan Friendship Hospital between January 2014 and December 2014. BA was classified as "normal" or "irregular" based on TOF MRA, and "normal wall", "slight wall-thickening", and "plaque" based on three-dimensional VISTA images. Outcomes from MRA and VISTA were compared. Patients were categorized as IPI and non-IPI groups based on the diffusion-weighted imaging. Clinical and plaque characteristics were compared between the two groups.

RESULTSA total of 1024 image slices including 311 (30.37%) plaque slices, 427 (41.70%) slight wall-thickening slices, and 286 (27.93%) normal wall slices for the entire BA from 23 patients were finally included for analysis. VISTA images detected plaques in all the 9 (100%) irregular MRA patients and 7 of 14 (50%) normal MRA patients. IPI was found in 11 (47.83%) patients. Compared to non-IPI group, the IPI group had a higher percentage of plaque slices (P = 0.001) and lower percentage of normal wall slices (P = 0.014) than non-IPI group.

CONCLUSIONSThree-dimensional VISTA images enable detection of BA plaques not visualized by MRA. BA plaques could be found in both the IPI and non-IPI group. However, IPI group showed plaques more extensively in BA than the non-IPI group.

Adult ; Aged ; Basilar Artery ; pathology ; Female ; Humans ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Plaque, Atherosclerotic ; pathology ; Pons ; pathology

OBJECTIVETo analyze the changes of risk factors in cerebrovascular diseases in cohort-based population after intervention and evaluating the intervention effect.

METHODSIn 1987, an intervention cohort and a control cohort were selected randomly in urban areas of Changsha. Risk factors in cerebrovascular diseases were investigated in two cohort populations aged over 35 years as baseline indication. Then comprehensive prevention of cerebrovascular diseases was carried out in intervention cohort during 1987 - 2000. After intervention for 14 years, a reexamination was taken in the two groups noted above.

RESULTSAfter 14 years, the prevalence of diabetes mellitus, hypertension, mean systolic and diastolic pressure, weight increased from 33.8% to 35.7%, 30 to 129 per 10,000, 128.41 mm Hg to 134.49 mm Hg, 77.78 mm Hg to 78.54 mm Hg, 54.80 kg to 57.78 kg in the intervention group, respectively while the baseline indication increased from 35.9% to 56.8%, 30 to 228 per 10,000, 127.70 mm Hg to 141.80 mm Hg, 78.27 mm Hg to 82.89 mm Hg, 54.92 kg to 59.69 kg in the control one. The changes were of statistical significance in each group except diastolic pressure and the prevalence of hypertension in intervention group, but all the parameters increased significantly in the control group; rate of alcohol intake decreased significantly in two groups, but rate of cigarette smoking decreased with no significance. The changes between two groups were not significant either; the cumulative incidence of stroke was significantly lower in intervention cohort (3.4%) than in control cohort (4.7%).

CONCLUSIONThe risk factors for cerebrovascular diseases (such as hypertension, diabetes mellitus etc.) were increasing along with by aging. Intervention programs can delay the increase of risk factors and down-regulate the incidence of stroke.

Alcohol Drinking ; adverse effects ; Cerebrovascular Disorders ; etiology ; Cohort Studies ; Female ; Humans ; Hypertension ; complications ; Male ; Risk Factors ; Smoking ; adverse effects

OBJECTIVE: To investigate the clinical and pathologic features of melanocytic lesion of the central nervous system. METHODS: We analyzed the clinical features, neuroimages, and operational and neuropathological findings of 2 patients of neurocutaneous melanosis and 4 patients of primary leptomeningeal melanoma. RESULTS: All the 6 patients had the common clinical features of intracranial hypertension and epilepsy. Brain CT and MRI showed abnormal signals. More melanin pigment nevi were found on the skin of the 2 patients subjected to neurocutaneous melanosis. The other 4 patients subjected to primary leptomeningeal melanoma had no melanin pigment nevus on the skin, but the brain section displayed positive meningeal melanoma. CONCLUSION Intracranial hypertension and epilepsy are the main clinical manifestations of melanocytic lesion of the central nervous system, and cutaneous lesion and radiological findings are very important for the diagnosis.
Adolescent ; Adult ; Child ; Female ; Humans ; Male ; Melanosis ; pathology ; Meningeal Neoplasms ; pathology ; Middle Aged ; Nervous System Diseases ; pathology ; Neurocutaneous Syndromes ; pathology ; Young Adult

Adult ; Carotid Artery, Internal ; pathology ; physiopathology ; Headache ; pathology ; physiopathology ; Humans ; Male ; Migraine Disorders ; pathology ; physiopathology

BACKGROUNDThere are few studies for evaluating wall characteristics of intracranial vertebral artery hypoplasia (VAH). The aim of this study was to determine wall characteristics of VAH with three-dimensional volumetric isotropic turbo spin echo acquisition (3D VISTA) images and differentiate between acquired atherosclerotic stenosis and VAH.

METHODSThirty patients with suspicious VAH by luminograms were retrospectively enrolled between January 2014 and February 2015. The patients were classified as "acquired atherosclerotic stenosis" or "VAH" based on 3D VISTA images. The wall characteristics of VAH were assessed to determine the presence of atherosclerotic lesions, and the patients were classified into two subgroups (VAH with atherosclerosis and VAH with normal wall). Wall characteristics of basilar arteries and vertebral arteries were also assessed. The clinical and wall characteristics were compared between the two groups.

RESULTSFive of 30 patients with suspicious VAH were finally diagnosed as acquired atherosclerotic stenosis by 3D VISTA images. 25 patients were finally diagnosed as VAH including 16 (64.00%) patients with atherosclerosis and 9 (36.00%) patients with normal wall. In the 16 patients with atherosclerosis, plaque was found in 9 patients, slight wall thickening in 6 patients, and thrombus and wall thickening in 1 patient. Compared with VAH patients with normal wall, VAH patients with atherosclerosis showed atherosclerotic basilar arteries and dominant vertebral arteries more frequently (P = 0.000).

CONCLUSIONSThree-dimensional VISTA images enable differentiation between the acquired atherosclerotic stenosis and VAH. VAH was also prone to atherosclerotic processes.

Aged ; Female ; Humans ; Imaging, Three-Dimensional ; methods ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Plaque, Atherosclerotic ; pathology ; Retrospective Studies ; Vertebral Artery ; abnormalities ; pathology

Female ; Humans ; Middle Aged ; Sagittal Sinus Thrombosis

OBJECTIVETo discuss the feasibility and clinical value of high-resolution magnetic resonance vessel wall imaging (HRMR VWI) for intracranial arterial stenosis.

DATE SOURCESWe retrieved information from PubMed database up to December 2015, using various search terms including vessel wall imaging (VWI), high-resolution magnetic resonance imaging, intracranial arterial stenosis, black blood, and intracranial atherosclerosis.

STUDY SELECTIONWe reviewed peer-reviewed articles printed in English on imaging technique of VWI and characteristic findings of various intracranial vasculopathies on VWI. We organized this data to explain the value of VWI in clinical application.

RESULTSVWI with black blood technique could provide high-quality images with submillimeter voxel size, and display both the vessel wall and lumen of intracranial artery simultaneously. Various intracranial vasculopathies (atherosclerotic or nonatherosclerotic) had differentiating features including pattern of wall thickening, enhancement, and vessel remodeling on VWI. This technique could be used for determining causes of stenosis, identification of stroke mechanism, risk-stratifying patients, and directing therapeutic management in clinical practice. In addition, a new morphological classification based on VWI could be established for predicting the efficacy of endovascular therapy.

CONCLUSIONSThis review highlights the value of HRMR VWI for discrimination of different intracranial vasculopathies and directing therapeutic management.

Carotid Stenosis ; diagnosis ; Cerebral Angiography ; methods ; Humans ; Intracranial Arteriosclerosis ; diagnosis ; Magnetic Resonance Angiography ; methods

OBJECTIVETo investigate the value of the HCT-CI score in chemotherapy risk assessment and prognosis of elderly patients with acute myeloid leukemia (AML).

METHODSThe clinical data of 116 AML patients older than 60 years in the department of Hematology, Henan Provincial People's Hospital from January 2000 to December 2010 were analyzed retrospectively. All patients received cytarabine-based regimens, including protocol DA, MA, IA, AA or CAG, followed by cytarabine-based postremission treatment. (1) Comorbidities were evaluated by using HCT-CI score, the early death rates and median survival time were compared among these different groups. (2) These prognostic factors were analyzed by univariate and multivariate analyses.

RESULTS(1) All 116 cases were followed-up. The patient cohort was divided into those with HCT-CI scores of 0, 1 or 2, or ≥ 3. Early death rates were 3.7%, 12.1% and 23.21% in above three groups, respectively (P < 0.01). Overall survival were 345, 225 and 113 days, respectively (P < 0.01). (2) HCT-CI score ≥ 3 (P < 0.01), antecedent MDS history (P = 0.035), high-risk karyotype (P = 0.018), white blood cells at diagnosis ≥ 100×10(9)/L (P = 0.041) were independent adverse prognostic factors with multivariate analysis.

CONCLUSION(1) The HCT-CI score can objectively assess elderly AML patients with comorbidities and predict chemotherapy risk in older patients receiving AML induction therapy. (2) Antecedent MDS history, high-risk karyotype, high white blood cell, and HCT-CI score ≥ 3 are independent adverse prognostic factors of elderly AML patients.

Aged ; Aged, 80 and over ; Female ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Leukemia, Myeloid, Acute ; diagnosis ; Male ; Middle Aged ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk Assessment ; Treatment Outcome