Clinical hemorheology and microcirculation最新文献

Introduction: The occurrence of Raynaud's phenomenon in patients with multiple sclerosis (MS) is infrequently documented in the literature. Some cases have been attributed to interferon-β therapy, while others have emerged in MS patients who sub-sequently developed Raynaud's phenomenon and/or systemic sclerosis. The association between microangiopathic damage and both Raynaud's phenomenon and systemic sclerosis is well-established, leading to the adoption of nailfold video-capillaroscopy (NVC) as a non invasive diagnostic tool for the initial clinical assessment of these conditions.

Case presentation: We present a case study of a 42-year-old female patient with Raynaud's phenomenon in MS. The patient underwent NVC in 2023 showing microvascular impairment and after one year and Natalizumab treatment she repeated NVC evaluation with significant improvement in previous microangiopathic changes. A comprehensive literature review regarding the relationship between MS and Raynaud's phenomenon was conducted using electronic databases (PUBMED, UpToDate, Google Scholar, ResearchGate), along with manual searches for relevant articles published up to December 2024.

Discussion: This case highlights the potential utility of NVC in the ongoing evaluation of microangiopathic damage in MS patients exhibiting Raynaud's phenomenon. By elucidating the overlap between these conditions, NVC may serve as a valuable tool in the clinical management of affected individuals.

PurposeTo explore the ultrasound features and the diagnostic values of CEUS LI-RADS and World Federation for Ultrasound in Medicine (WFUMB) - European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) criteria in serum biomarker negative hepatocellular carcinoma (HCC) and colorectal cancer liver metastasis (CRLM).MethodsA total of 161 patients with pathologically diagnosed alpha-fetoprotein (AFP)-negative HCC and carcinoembryonic antigen (CEA)-negative CRLM were retrospectively enrolled, including 101 HCC patients and 60 CRLM patients. The clinical characteristics and ultrasound characteristics of all cases were analyzed and lesions were categorized via two criteria.ResultsThe rate of HBV infection in HCC patients was higher than CRLM patients (P < 0.001). For the liver parenchyma, the rate of liver cirrhosis and liver steatosis in HCC patients were both higher than CRLM patients (P < 0.001 and P = 0.048, respectively). On CEUS, HCC lesions depicted higher rate of arterial phase hyperenhancement (APHE), mild washout and later wash-out onset, while rim-hyperenhancement, marked washout and earlier wash-out onset were more frequently observed in CRLM lesions. For diagnosing HCC, the sensitivity, specificity and accuracy of CEUS LR-5 were 55.4%, 93.3% and 69.6%, respectively, and of WFUMB-EFSUMB criteria were 87.1%, 73.3% and 82.0%, respectively. For diagnosing CRLM, the sensitivity, specificity and accuracy of CEUS LR-M were 100.0%, 63.4% and 77.0%, respectively, and of WFUMB-EFSUMB criteria were 76.7%, 94.1% and 87.6%, respectively.ConclusionIn patients with serum biomarker negative HCC and CRLM, both CEUS LI-RADS and WFUMB-EFSUMB criteria have each advantages and have high application value.

BackgroundPlantar fasciopathy is a common complication in diabetes patients.ObjectiveTo evaluate the effectiveness of ultrasound in detecting diabetic tendinopathy in type 2 diabetes mellitus (T2DM) patients by assessing plantar fascia (PF) thickness and stiffness.MethodsThis study included 70 T2DM patients with heel pain, diagnosed by American Diabetes Association (ADA). B mode ultrasound was used to evaluate PF thickness. Shear wave elastography (SWE) was used to assess PF stiffness.ResultsIn T2DM patients, the PF thickness (PFT) was significantly thicker (4.40 ± 0.79 mm vs. 2.87 ± 0.26 mm, P < 0.05) and the shear wave velocity (SWV) of PF was significantly lower (3.09 ± 0.57 m/s vs. 4.00 ± 1.01 m/s, P < 0.05) than the control group. PFT and SWV values were strongly correlated with age (r = 0.880, -0.888) and BMI (r = 0.814, -0.853). ROC analysis showed that PFT > 4.33 mm had a sensitivity of 98.0% and specificity of 77.2% for diabetic tendinopathy, with an area under the ROC curve (AUROC) of 0.956, SWV < 3.22 m/s had a sensitivity of 86.3% and specificity of 60.5% (AUROC = 0.789).ConclusionUltrasound is a non-invasive and efficient diagnostic tool for PF in T2DM patients.

BackgroundDuring cardiopulmonary bypass (CPB), which is frequently utilized in open-heart surgery, the maintenance of circulation in a non-physiological environment may lead to alterations in the properties of circulating blood components. In our study, we aimed to evaluate these changes using contemporary methodologies.MethodsThe study included 48 patients who underwent cardiac surgery with CPB. CPB duration and hypothermia degree were recorded and analyzed. Erythrocyte deformability (ED), erythrocyte aggregation (EA), whole blood viscosity (WBV), total oxidant status (TOS), and total antioxidant status (TAS) were measured; ED and EA were measured using LORRCA (RR Mechatronics, Hoorn, Netherlands).ResultsCompared to the preoperative period, a decrease in postoperative ED, EA, and WBV was observed. No significant change was detected in TAS levels; however, TOS levels were found to be elevated. No statistically significant correlation was observed between perioperative patient temperature, CPB duration, and ED, EA, or WBV values.ConclusionsIn patients undergoing surgery with CPB, a postoperative decrease in ED, EA, and WBV was demonstrated. Previous studies have suggested that the decline in ED is associated with blood transfusion. However, the significant reduction in ED observed in our study, even in patients who did not receive blood transfusions, is noteworthy.

BackgroundN6-methyladenosine (m6A) methylation plays an important role in myocardial infarction, which is related to cardiomyocyte pyroptosis. This study aimed to explore the effects of the m6A methyltransferase, METTL14, on pyroptosis and the underlying mechanisms.Materials and methodsThe role of METTL14 in vivo was assessed by TTC staining, biochemical indicators, and H&E assays. Cell pyroptosis was evaluated by PI staining, IF, and western blot assay. The m6A methylation of NLRP3 was evaluated by RIP, dual-luciferase reporter assay, Me-RIP, and stability test.ResultsThe results indicated that METTL14 was highly expressed in LAD-ligated mice and OGD-induced cardiomyocytes. Depletion of METTL14 inhibited OGD-induced pyroptosis of cardiomyocytes and suppressed myocardial injury. Mechanically, METTL14 promoted m6A methylation of NLRP3 to enhance mRNA stability. Overexpression of NLRP3 reversed the effects of METTL14 knockdown on pyroptosis.ConclusionsMETTL14 knockdown attenuated cardiomyocyte pyroptosis and myocardial infarction by suppressing NLRP3 m6A methylation. The findings suggested that METTL14 has the potential to be the therapeutic target of myocardial infarction.

Background: Current guidelines recommend Fine Needle Aspiration (FNA) based on nodule size and ultrasound characteristics; however, these guidelines still lead to a certain amount of unnecessary FNAs.

Objective: To develop a dynamic nomogram prediction model based on the ACR Thyroid Imaging, Reporting, and Data System (TI-RADS) to reduce unnecessary FNAs.

Methods: This multicenter study analyzed 3313 thyroid nodules undergoing FNA. Univariate and multivariate logistic regression models were constructed. Patients were divided into a training cohort and two validation cohorts to compare diagnostic performance and unnecessary FNAs.

Results: This nomogram achieved performance of Area Under the Curve (AUC) 0.914 (95%CI: 0.894-0.934), 0.923 (95%CI: 0.900-0.946), 0.948 (95%CI: 0.918-0.978) in the training, internal and external validation cohort. Using this model, the unnecessary FNA rates for nodules in ACR TI-RADS category 3 (TR3) have decreased from 99.4% to 0%, in TR4 from 77.6% to 47.1%, and in TR5 from 25.4% to 18.9% in Center1, in TR3 have decreased from 91.9% to 0%, in TR4 from 60.0% to 21.1%, and in TR5 from 11.5% to 4.5% in Center 2 (p < 0.01).

Conclusions: This dynamic nomogram achieved better prediction of malignant thyroid nodules compared with the mentioned risk stratification system, leading to a more rational FNA strategy.

Oxygen-gradient ektacytometry (oxygenscan) has been recently used in the context of sickle cell disease (SCD) to determine the ability of red blood cells (RBCs) to deform in normoxia and during deoxygenation. While several studies focused on the determinants of oxygenscan parameters in the homozygous form of SCD (i.e., HbSS), very few studies focused on hemoglobin SC disease (HbSC). Oxygenscan parameters were compared between HbSS (N = 304) and HbSC (N = 58) patients, with or without hydroxyurea (HU). RBC deformability measured in normoxia or at low oxygen level was lower in HbSS patients without HU compared to HbSS patients with HU and HbSC patients with or without HU. The propensity of RBCs to sickle during deoxygenation was greater in HbSS than in HbSC patients. Although no significant impact of HU was observed on RBC deformability/sickling in HbSC patients, those with HU had lower blood viscosity. The ability of RBC to recover their maximum deformability after a deoxygenation/reoxygenation cycle was lower in HbSC compared to HbSS patients. Finally, oxygenscan parameters and routine hematological parameters correlated differently in HbSS and HbSC patients. Our study showed difference in oxygenscan parameters between HbSS and HbSC individuals that could partly explain the difference in the clinical expression of SCD.

BackgroundSacubitril is an important and effective agent for cardiovascular remodeling. This study aims to evaluate its proangiogenic effects in an experimental model.MethodsThe chorioallantoic membrane (CAM) model was created for the investigation of the proangiogenic potential of sacubitril with different therapeutic doses (10^-7 M, 10^-6 M, 10^-5 M) and compared with drug-free pellet group (sham) and normal morphology (control) of chick embryo development in drug-free chick embryos. The developing embryo's vascularity and the pellets' effect were evaluated under a stereoscopic microscope. The density of vascular shoots and newly formed vascular nodules were not recorded.ResultsThere was no significant difference between the control and drug-free pellet groups (12.4 ± 2.8 vs. 14.1 ± 1.3 junctions per ROI, p = 0.48). The incremental angiogenic properties were detected in drug groups as follows: 15.3 ± 3.8 per ROI in Group I (10^-7 M concentration); 21.6 ± 5.4 per ROI in Group II (10^-6 M concentration); 22.9 ± 8.1 per ROI in Group III (10^-5 M concentration) (p < 0.001).ConclusionOur findings support that sacubitril provokes angiogenesis in a dose-dependent manner. Investigating these properties can be useful for understanding further effects of this agent in other cardiovascular diseases. Therapeutic angiogenesis is important for ameliorating the results.

Purpose: To evaluate in situ assessment of renal cortical microcirculation (RCM) in S-AKI rats using CEUS and SDF imaging.

Methods: CLP was performed to induce S-AKI in Sprague-Dawley rats; Sham rats served as control. CEUS and SDF imaging were sequentially applied at postoperative 24 h and 48 h to investigate the RCM.

Results: At postoperative 24 h and 48 h, CLP rats exhibited hemodynamic deterioration and AKI. Renal injury score and positive staining for pimonidazole were significantly increased (p < 0.05). In CLP rats, parameters of RCM, including peak enhancement (PE), rise time (RT), PE/RT, time to peak (TTP), total small vessel density (TVD), perfused small vessel density (PVD), microvascular flow index (MFI), and proportion of perfused vessels (PPV) were significantly deteriorated compared to Sham rats (p < 0.05). In CLP rats, Lac was significantly negatively correlated with PE, PE/RT, TVD, PVD, PPV and MFI, and significantly positively correlated with RT and TTP. TVD, PVD, PPV and MFI were significantly positively correlated with PE and PE/RT and negatively correlated with RT and TTP.

Conclusion: The RCM of S-AKI rats exhibited decreased blood perfusion and heterogeneity in early sepsis. CEUS and SDF imaging are effective methods for detecting the RCM.

BackgroundMyocardial ischemia-reperfusion injury (MI/RI) is a primary cause of cardiomyocyte death in various cardiovascular diseases. MicroRNAs (miRNAs) play significant roles in MI/RI.ObjectiveThis study aims to elucidate the function and mechanism of miR-379-3p in this context.MethodsThe Cell Counting Kit 8 (CCK-8) and flow cytometry were utilized to assess the proliferation and apoptosis of cardiomyocytes. The expression levels of cardiomyocyte injury-related proteins, including LDHA, cTnT, CK-MB, and cTnI, were measured using enzyme-linked immunoassay (ELISA) kits. The targeted regulatory relationship between miR-379-3p and dual-specificity protein phosphatase 1 (DUSP1) was investigated through dual luciferase reporter gene assays. Additionally, the expression levels of miR-379-3p/DUSP1 and mitogen-activated protein kinases (MAPKs) signaling pathway in MI/RI were evaluated using Western blotting.ResultsThe expression of miR-379-3p was significantly elevated in MI/RI, and the inhibition of miR-379-3p notably alleviated MI/RI. The specific binding of miR-379-3p to the 3'UTR of DUSP1 mRNA was confirmed by dual luciferase reporter gene assays. Furthermore, miR-379-3p exacerbated cardiomyocyte injury by negatively regulating DUSP1. Ultimately, miR-379-3p activated the MAPK/JNK/p38 pathway by downregulating DUSP1 expression, thereby promoting MI/RI.ConclusionsmiR-379-3p activates the MAPK/JNK/p38 pathway through the negative regulation of DUSP1 expression to promote MI/RI.