Pub Date : 2025-02-13DOI: 10.1177/13860291241305514
David Astapenko, Diana Gorskaja, Marek Zrzavecky, Hanako Kawashima, Edward Ssali, Pavel Navratil, Ludek Hana, Jan Motesicky, Vera Radochova, Radomir Hyspler, Alena Ticha, Christian Lehmann, Manu Lng Malbrain, Zdenek Zadak, Vladimir Cerny
Background: Sulodexide is a glycosaminoglycan-based drug prescribed to patients with angiopathy. We performed a pilot study to investigate whether sulodexide positively modulates the endothelial glycocalyx (EG) layer and the microcirculation in a porcine model of EG enzymatic damage. The EG is a sugar-based endothelial lining that is involved in the physiology of the capillary wall and the pathogenesis of many diseases.
Methods: EG damage was induced in eight piglets by hyaluronidase III and heparanase I given intravenously. Four animals received sulodexide 600 IU intravenously before the enzymes and four animals after the enzymes were administered. Four animals constituted a control group. Sublingual microcirculation by side-stream dark field imaging and plasmatic concentration of syndecan-1 by ELISA were measured at baseline, 20 min after intervention, and at the 40th, and 60th minute onwards. The statistics were performed with a one-way ANOVA test with Turkey's correction for multiple comparisons testing. Timepoint comparison was performed by Student t-test or Mann-Whitney test.
Results: At baseline, there were no statistically significant differences between the animal groups. After the intervention, the levels of syndecan-1 were significantly lower in the control group. While there were no differences between the two intervention groups. The sublingual microcirculation analysis showed that the DeBacker score was significantly higher in the control group. At 60 min, there was also a statistically significant difference in DeBacker score between the groups (8.1 ± 1.6 mm-1 in the group with enzymes given first and 11 ± 0.92 mm-1 in the group with sulodexide given first, p = 0.03). The analysis of the proportion of perused vessels did not show any statistically significant differences.
Conclusion: The results of the study demonstrated a working model of EG damage but no specific action of sulodexide on EG modulation. In the sublingual microcirculation analysis, the sulodexide reduced the fall in absolute tissue perfusion in 60 min.
{"title":"The modulation of endothelial glycocalyx by sulodexide on the porcine model of enzymatic endothelial glycocalyx damage - a pilot study.","authors":"David Astapenko, Diana Gorskaja, Marek Zrzavecky, Hanako Kawashima, Edward Ssali, Pavel Navratil, Ludek Hana, Jan Motesicky, Vera Radochova, Radomir Hyspler, Alena Ticha, Christian Lehmann, Manu Lng Malbrain, Zdenek Zadak, Vladimir Cerny","doi":"10.1177/13860291241305514","DOIUrl":"https://doi.org/10.1177/13860291241305514","url":null,"abstract":"<p><strong>Background: </strong>Sulodexide is a glycosaminoglycan-based drug prescribed to patients with angiopathy. We performed a pilot study to investigate whether sulodexide positively modulates the endothelial glycocalyx (EG) layer and the microcirculation in a porcine model of EG enzymatic damage. The EG is a sugar-based endothelial lining that is involved in the physiology of the capillary wall and the pathogenesis of many diseases.</p><p><strong>Methods: </strong>EG damage was induced in eight piglets by hyaluronidase III and heparanase I given intravenously. Four animals received sulodexide 600 IU intravenously before the enzymes and four animals after the enzymes were administered. Four animals constituted a control group. Sublingual microcirculation by side-stream dark field imaging and plasmatic concentration of syndecan-1 by ELISA were measured at baseline, 20 min after intervention, and at the 40th, and 60th minute onwards. The statistics were performed with a one-way ANOVA test with Turkey's correction for multiple comparisons testing. Timepoint comparison was performed by Student t-test or Mann-Whitney test.</p><p><strong>Results: </strong>At baseline, there were no statistically significant differences between the animal groups. After the intervention, the levels of syndecan-1 were significantly lower in the control group. While there were no differences between the two intervention groups. The sublingual microcirculation analysis showed that the DeBacker score was significantly higher in the control group. At 60 min, there was also a statistically significant difference in DeBacker score between the groups (8.1 ± 1.6 mm<sup>-1</sup> in the group with enzymes given first and 11 ± 0.92 mm<sup>-1</sup> in the group with sulodexide given first, p = 0.03). The analysis of the proportion of perused vessels did not show any statistically significant differences.</p><p><strong>Conclusion: </strong>The results of the study demonstrated a working model of EG damage but no specific action of sulodexide on EG modulation. In the sublingual microcirculation analysis, the sulodexide reduced the fall in absolute tissue perfusion in 60 min.</p>","PeriodicalId":93943,"journal":{"name":"Clinical hemorheology and microcirculation","volume":" ","pages":"13860291241305514"},"PeriodicalIF":0.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-12DOI: 10.1177/13860291241302593
Wei Guo, Xin Yi
Panvascular disease is characterized by the involvement of blood vessels across multiple regions of the body, and is associated with high morbidity, disability, and mortality rates. Its pathogenesis is multifaceted, necessitating risk assessment and treatment approaches that differ from those applied to single-organ diseases. Given that panvascular disease affects multiple vital organs, an integrated, multi-system management strategy offers significant advantages over conventional, organ-specific approaches. This article provides a comprehensive review of the epidemiological features, traditional and emerging risk factors, pathophysiological mechanisms, screening and risk assessment methods, as well as new strategies for the prevention and management of panvascular disease. The objective is to offer a theoretical foundation and technical support for enhancing prevention and control measures for this condition.
{"title":"Advancements and future prospects in the study of panvascular disease.","authors":"Wei Guo, Xin Yi","doi":"10.1177/13860291241302593","DOIUrl":"https://doi.org/10.1177/13860291241302593","url":null,"abstract":"<p><p>Panvascular disease is characterized by the involvement of blood vessels across multiple regions of the body, and is associated with high morbidity, disability, and mortality rates. Its pathogenesis is multifaceted, necessitating risk assessment and treatment approaches that differ from those applied to single-organ diseases. Given that panvascular disease affects multiple vital organs, an integrated, multi-system management strategy offers significant advantages over conventional, organ-specific approaches. This article provides a comprehensive review of the epidemiological features, traditional and emerging risk factors, pathophysiological mechanisms, screening and risk assessment methods, as well as new strategies for the prevention and management of panvascular disease. The objective is to offer a theoretical foundation and technical support for enhancing prevention and control measures for this condition.</p>","PeriodicalId":93943,"journal":{"name":"Clinical hemorheology and microcirculation","volume":" ","pages":"13860291241302593"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-12DOI: 10.1177/13860291241291411
Fatemeh Sangtarash, Azadeh Shadmehr, Haniyeh Choobsaz, Sara Fereydounnia, Alireza Sadeghi, Friedrich Jung, Muhammad Sarfraz
After menopause, there is an imbalance between bone formation and resorption activity, which could lead to postmenopausal osteopenia or osteoporosis. Resistance training (RT) can induce mechanical stress on bone which is necessary for bone remodeling and angiogenic-osteogenic response. This systematic review aims to assess the effects of RT on bone microcirculation and bone turnover markers (BTMs) in postmenopausal women with osteopenia or osteoporosis. We conducted a comprehensive search for related studies published up to April 2023 to identify eligible articles. Out of 316 articles identified, the full texts of 69 articles were screened. There is not any study which consider the effect of resistance exercises on bone microcirculation in PMOP women, but four articles aseess the effect of RT on BTMs and were reviewed. The quality of the articles was assessed by using the Physiotherapy Evidence Database (PEDro) scale. In one study, after 6- and 12 -months RT, bone formation and bone resorption biomarkers decreased not significantly. According to another study, bone formation and resorption biomarkers increased significantly after 3-months RT. Two other studies reported increases in biomarkers of bone formation along with decreases of biomarkers in bone resorption after 6-months of RT, but these were not significant. However, these results suggest that RT had some beneficial effects on BTMs but it is not an effective tool for modifying BTMs in women with osteoporosis or osteopenia. This may be due to the site-specific skeletal stimulation that RT provides. In addition considering the effect of RT on microcirculation of bone are important . So, there is a need for further, high-quality studies in this field.
{"title":"Effects of resistance training on microcirculation of bone tissue and bone turnover markers in postmenopausal women with osteopenia or osteoporosis: A systematic review.","authors":"Fatemeh Sangtarash, Azadeh Shadmehr, Haniyeh Choobsaz, Sara Fereydounnia, Alireza Sadeghi, Friedrich Jung, Muhammad Sarfraz","doi":"10.1177/13860291241291411","DOIUrl":"https://doi.org/10.1177/13860291241291411","url":null,"abstract":"<p><p>After menopause, there is an imbalance between bone formation and resorption activity, which could lead to postmenopausal osteopenia or osteoporosis. Resistance training (RT) can induce mechanical stress on bone which is necessary for bone remodeling and angiogenic-osteogenic response. This systematic review aims to assess the effects of RT on bone microcirculation and bone turnover markers (BTMs) in postmenopausal women with osteopenia or osteoporosis. We conducted a comprehensive search for related studies published up to April 2023 to identify eligible articles. Out of 316 articles identified, the full texts of 69 articles were screened. There is not any study which consider the effect of resistance exercises on bone microcirculation in PMOP women, but four articles aseess the effect of RT on BTMs and were reviewed. The quality of the articles was assessed by using the Physiotherapy Evidence Database (PEDro) scale. In one study, after 6- and 12 -months RT, bone formation and bone resorption biomarkers decreased not significantly. According to another study, bone formation and resorption biomarkers increased significantly after 3-months RT. Two other studies reported increases in biomarkers of bone formation along with decreases of biomarkers in bone resorption after 6-months of RT, but these were not significant. However, these results suggest that RT had some beneficial effects on BTMs but it is not an effective tool for modifying BTMs in women with osteoporosis or osteopenia. This may be due to the site-specific skeletal stimulation that RT provides. In addition considering the effect of RT on microcirculation of bone are important . So, there is a need for further, high-quality studies in this field.</p>","PeriodicalId":93943,"journal":{"name":"Clinical hemorheology and microcirculation","volume":" ","pages":"13860291241291411"},"PeriodicalIF":0.0,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wenying Li, Jun Jiang, Jiaying Cao, Li Wei, Rui Cheng, Xiuyun Lu, Yi Dong
Objective: To investigate the value of ultrasound viscosity imaging in preoperative differential diagnosis between malignant and benign breast lesions.
Methods: This prospective study was approved by our institutional review board and informed consents were signed by all patients. Patients diagnosed with focal solid breast lesions who plan to undergo surgical or ultrasound guided core needle biopsy were included. A Mindray Resona R9 Elite diagnostic ultrasound system equipped with a linear array transducer (L15-3 MHz) was used. First BMUS was used to identify the lesions, afterwards, ultrasound viscosity imaging and shear wave elastography measurements were performed for each lesion. Viscosity (Pa*s) coefficient and shear-wave speed (m/s) of each breast lesion were measured. Taking the final histopathological results as the gold standard, the optimal cut-off value of viscosity and elastography values in differential diagnosis between malignant and benign breast lesions were evaluated. Diagnostic performance was assessed by using the area under the receiver operating characteristic curve (ROC).
Results: From July 2023 to March 2024, 159 consecutive patients with a total of 184 solid breast lesions were included. Among which 74 (40.2%) malignant lesions and 110 (59.8%) benign ones were diagnosed according to the final histopathological results. The mean maximal viscosity coefficient (7.56±3.63 Pa*s) of malignant lesions was significantly higher than that of benign ones (4.52±2.33 Pa*s), whereas the mean maximal SWE value (6.53±1.87 m/s) of malignant lesions was also obviously higher than that of benign ones (4.80±1.62 m/s) (P < 0.05). The cut-off value for diagnosis of malignant breast tumors was 5.39 Pa*s for viscosity, with 75.68% sensitivity, 68.18% specificity and 0.763 AUROC (P < 0.05). When combined viscosity with SWE values, the sensitivity and specificity was 75.68% and 75.45%, with an-area under the receiver operating characteristic curve (AUC) 0.787.
Conclusions: The value of viscosity measurement may provide additional value for preoperative non-invasive differential diagnosis between malignant and benign breast lesions.
{"title":"The value of ultrasound viscosity imaging in preoperative differential diagnosis between malignant and benign breast lesions: Preliminary clinical applications.","authors":"Wenying Li, Jun Jiang, Jiaying Cao, Li Wei, Rui Cheng, Xiuyun Lu, Yi Dong","doi":"10.3233/CH-242405","DOIUrl":"https://doi.org/10.3233/CH-242405","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the value of ultrasound viscosity imaging in preoperative differential diagnosis between malignant and benign breast lesions.</p><p><strong>Methods: </strong>This prospective study was approved by our institutional review board and informed consents were signed by all patients. Patients diagnosed with focal solid breast lesions who plan to undergo surgical or ultrasound guided core needle biopsy were included. A Mindray Resona R9 Elite diagnostic ultrasound system equipped with a linear array transducer (L15-3 MHz) was used. First BMUS was used to identify the lesions, afterwards, ultrasound viscosity imaging and shear wave elastography measurements were performed for each lesion. Viscosity (Pa*s) coefficient and shear-wave speed (m/s) of each breast lesion were measured. Taking the final histopathological results as the gold standard, the optimal cut-off value of viscosity and elastography values in differential diagnosis between malignant and benign breast lesions were evaluated. Diagnostic performance was assessed by using the area under the receiver operating characteristic curve (ROC).</p><p><strong>Results: </strong>From July 2023 to March 2024, 159 consecutive patients with a total of 184 solid breast lesions were included. Among which 74 (40.2%) malignant lesions and 110 (59.8%) benign ones were diagnosed according to the final histopathological results. The mean maximal viscosity coefficient (7.56±3.63 Pa*s) of malignant lesions was significantly higher than that of benign ones (4.52±2.33 Pa*s), whereas the mean maximal SWE value (6.53±1.87 m/s) of malignant lesions was also obviously higher than that of benign ones (4.80±1.62 m/s) (P < 0.05). The cut-off value for diagnosis of malignant breast tumors was 5.39 Pa*s for viscosity, with 75.68% sensitivity, 68.18% specificity and 0.763 AUROC (P < 0.05). When combined viscosity with SWE values, the sensitivity and specificity was 75.68% and 75.45%, with an-area under the receiver operating characteristic curve (AUC) 0.787.</p><p><strong>Conclusions: </strong>The value of viscosity measurement may provide additional value for preoperative non-invasive differential diagnosis between malignant and benign breast lesions.</p>","PeriodicalId":93943,"journal":{"name":"Clinical hemorheology and microcirculation","volume":"89 1","pages":"111-122"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Recent studies have shown that dexmedetomidine may improve microcirculation and prevent organ failure. However, most evidence was obtained from experimental animals and patients receiving cardiac surgery with cardiopulmonary bypass. This study aimed to investigate the effect of dexmedetomidine on microcirculation and organ injuries in critically ill general surgical patients.
Methods: In this prospective randomized trial, patients admitted to the surgical intensive care unit after general surgery were enrolled and randomly allocated to the dexmedetomidine or propofol groups. Patients received continuous dexmedetomidine or propofol infusions to meet their requirement of sedation according to their grouping. At each time point, sublingual microcirculation images were obtained using the incident dark field video microscope.
Results: Overall, 60 patients finished the trial and were analyzed. Microcirculation parameters did not differ significantly between two groups. Heart rate at 4 h after ICU admission and mean arterial pressures at 12 h and 24 h after ICU admission were lower in the dexmedetomidine group than in the propofol group. At 24 h, serum aspartate aminotransferase (41 (25-118) vs 86 (34-129) U/L, p = 0.035) and alanine aminotransferase (50 (26-160) vs 68 (35-172) U/L, p = 0.019) levels were significantly lower in the dexmedetomidine group than in the propofol group.
Conclusion: Microcirculation parameters did not differ significantly between the dexmedetomidine and propofol groups. At 24 h after ICU admission, serum liver enzyme levels were lower in patients receiving dexmedetomidine as compared to propofol.
{"title":"Comparison of dexmedetomidine versus propofol sedation on microcirculation and organ injuries in critically ill surgical patients: A randomized controlled pilot study.","authors":"Po-Yu Chen, Hsing-Hao Huang, Wing-Sum Chan, Chih-Min Liu, Tsung-Ta Wu, Jyun-Han Chen, Anne Chao, Yu-Wen Tien, Ching-Tang Chiu, Yu-Chang Yeh","doi":"10.3233/CH-232093","DOIUrl":"10.3233/CH-232093","url":null,"abstract":"<p><strong>Background: </strong>Recent studies have shown that dexmedetomidine may improve microcirculation and prevent organ failure. However, most evidence was obtained from experimental animals and patients receiving cardiac surgery with cardiopulmonary bypass. This study aimed to investigate the effect of dexmedetomidine on microcirculation and organ injuries in critically ill general surgical patients.</p><p><strong>Methods: </strong>In this prospective randomized trial, patients admitted to the surgical intensive care unit after general surgery were enrolled and randomly allocated to the dexmedetomidine or propofol groups. Patients received continuous dexmedetomidine or propofol infusions to meet their requirement of sedation according to their grouping. At each time point, sublingual microcirculation images were obtained using the incident dark field video microscope.</p><p><strong>Results: </strong>Overall, 60 patients finished the trial and were analyzed. Microcirculation parameters did not differ significantly between two groups. Heart rate at 4 h after ICU admission and mean arterial pressures at 12 h and 24 h after ICU admission were lower in the dexmedetomidine group than in the propofol group. At 24 h, serum aspartate aminotransferase (41 (25-118) vs 86 (34-129) U/L, p = 0.035) and alanine aminotransferase (50 (26-160) vs 68 (35-172) U/L, p = 0.019) levels were significantly lower in the dexmedetomidine group than in the propofol group.</p><p><strong>Conclusion: </strong>Microcirculation parameters did not differ significantly between the dexmedetomidine and propofol groups. At 24 h after ICU admission, serum liver enzyme levels were lower in patients receiving dexmedetomidine as compared to propofol.</p>","PeriodicalId":93943,"journal":{"name":"Clinical hemorheology and microcirculation","volume":" ","pages":"43-53"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141094225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Atherosclerosis is a chronic inflammatory disease of the arteries, and its pathogenesis is related to endothelial dysfunction. It has been found that the protein convertase subtilin/kexin9 type (PCSK9) plays an important role in AS, but its specific mechanism is still unclear.
Methods: In this study, we first cultured human umbilical vein endothelial cells (HUVECs) with 50 or 100μg/ml oxidized low-density lipoprotein (ox-LDL) for 24 hours to establish a coronary atherosclerosis cell model.
Results: The results showed that ox-LDL induced HUVEC injury and autophagy and upregulated PCSK9 protein expression in HUVECs in a concentration-dependent manner. Silencing PCSK9 expression with siRNA inhibited ox-LDL-induced HUVEC endothelial dysfunction, inhibited the release of inflammatory factors, promoted HUVEC proliferation and inhibited apoptosis. In addition, ox-LDL increased the expression of LC3B-I and LC3B-II and decreased the expression of p62. However, these processes are reversed by sh-PCSK9. In addition, sh-PCSK9 can inhibit PI3K, AKT and mTOR phosphorylation and promote autophagy.
Conclusion: Taken together, our research shows that silencing PCSK9 inhibits the PI3K/ATK/mTOR pathway to activate ox-LDL-induced autophagy in vascular endothelial cells, alleviating endothelial cell injury and inflammation.
{"title":"PCSK9 induces endothelial cell autophagy by regulating the PI3K/ATK pathway in atherosclerotic coronary heart disease.","authors":"Wei-Wei Li, Ze-Ming Guo, Bing-Cai Wang, Qing-Quan Liu, Wen-An Zhao, Xiao-Lan Wei","doi":"10.3233/CH-242172","DOIUrl":"10.3233/CH-242172","url":null,"abstract":"<p><strong>Objective: </strong>Atherosclerosis is a chronic inflammatory disease of the arteries, and its pathogenesis is related to endothelial dysfunction. It has been found that the protein convertase subtilin/kexin9 type (PCSK9) plays an important role in AS, but its specific mechanism is still unclear.</p><p><strong>Methods: </strong>In this study, we first cultured human umbilical vein endothelial cells (HUVECs) with 50 or 100μg/ml oxidized low-density lipoprotein (ox-LDL) for 24 hours to establish a coronary atherosclerosis cell model.</p><p><strong>Results: </strong>The results showed that ox-LDL induced HUVEC injury and autophagy and upregulated PCSK9 protein expression in HUVECs in a concentration-dependent manner. Silencing PCSK9 expression with siRNA inhibited ox-LDL-induced HUVEC endothelial dysfunction, inhibited the release of inflammatory factors, promoted HUVEC proliferation and inhibited apoptosis. In addition, ox-LDL increased the expression of LC3B-I and LC3B-II and decreased the expression of p62. However, these processes are reversed by sh-PCSK9. In addition, sh-PCSK9 can inhibit PI3K, AKT and mTOR phosphorylation and promote autophagy.</p><p><strong>Conclusion: </strong>Taken together, our research shows that silencing PCSK9 inhibits the PI3K/ATK/mTOR pathway to activate ox-LDL-induced autophagy in vascular endothelial cells, alleviating endothelial cell injury and inflammation.</p>","PeriodicalId":93943,"journal":{"name":"Clinical hemorheology and microcirculation","volume":" ","pages":"55-67"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140904988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p><strong>Objective: </strong>This study aims to evaluate the diagnostic efficacy of a novel system called contrasted enhanced ultrasound thyroid imaging reporting and data system (CEUS TI-RADS) for benign and malignant thyroid nodules. We also seek to assess inter-observer agreement.</p><p><strong>Methods: </strong>The study recruited 433 patients who underwent thyroid ultrasound (US) and CEUS between January 2019 and June 2023 at Affiliated Hospital of Guangdong Medical University. A retrospective analysis of 467 thyroid nodules confirmed by fine-needle aspiration (FNA) and/or surgery was performed. Further, a CEUS TI-RADS classification was assigned to each thyroid nodule based on the CEUS TI-RADS scoring criteria for US and CEUS features of the nodule. The nodules were grouped based on their sizes, i.e., size≤1 cm for Group A, 1 cm < size≤4 cm for Group B, and size > 4 cm for Group C. Multivariate logistic regression was used to analyze independent risk factors for malignant thyroid nodules. Pathological assessment was the reference standard for establishing sensitivity (SEN), specificity (SPE), accuracy (ACC), positive predictive value (PPV), and negative predictive value (NPV) of CEUS TI-RADS for diagnosing malignant thyroid nodules. Receiver operating characteristic curve (ROC) analysis was performed to compare the diagnostic efficacy of the scoring system in predicting malignancy in three groups of nodules. The intragroup correlation coefficient (ICC) was adopted to assess the inter-observer agreement of the CEUS TI-RADS score.</p><p><strong>Results: </strong>Out of the 467 thyroid nodules, 262 were malignant and 205 were benign. Logistic regression analysis revealed that the independent risk factors for malignant thyroid nodules included punctate echogenic foci (P < 0.001), taller than wide (P = 0.015), extrathyroidal invasion (P = 0.020), irregular margins/lobulated (P = 0.036), hypoechoic (P = 0.038) on US and hypo-enhancement (P < 0.001) on CEUS. The ROC for CEUS TI-RADS diagnosis of malignant thyroid nodules was 0.898 (95% CI:0.867-0.924, P < 0.05) for all nodules, 0.795 (95% CI: 0.721-0.857, P < 0.05) for group A, 0.949 (95% CI: 0.916-0.971, P < 0.05) for group B, and 0.801 (95% CI: 0.644-0.910, P < 0.05) for group C with optimal cut-off values of CEUS TI-RADS 5 points (all nodules), CEUS TI-RADS 6 points (group A), CEUS TI-RADS 5 points (group B), CEUS TI- RADS 5 points (group C), respectively. Among these groups of nodules, group B had the highest ROC, with SEN, SPE, ACC, PPV, and NPV for diagnosing malignant nodules being 95.9%, 88.1%, 92.8%, 92.6%, and 93.2%, respectively. The ICC of the CEUS TI-RADS classification between highly senior and lowly senior physicians was 0.862 (P < 0.001).</p><p><strong>Conclusion: </strong>In summary, CEUS TI-RADS demonstrated significant efficacy in distinguishing thyroid nodules. Nonetheless, there were variations in its capacity to detect malignant nodules across diverse sizes, demonstrating o
{"title":"Diagnostic efficacy of CEUS TI-RADS classification for benign and malignant thyroid nodules.","authors":"Guo-Li Zhang, Yu-Ping Yang, Hong-Lian Zhou, Hai-Xia Dai, Xing Huang, Li-Juan Liu, Jie-Xin Wang, Hua-Juan Li, Xin Liang, Qian Yuan, Yan-Hao Zeng, Xiao-Hong Xu","doi":"10.3233/CH-232080","DOIUrl":"https://doi.org/10.3233/CH-232080","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the diagnostic efficacy of a novel system called contrasted enhanced ultrasound thyroid imaging reporting and data system (CEUS TI-RADS) for benign and malignant thyroid nodules. We also seek to assess inter-observer agreement.</p><p><strong>Methods: </strong>The study recruited 433 patients who underwent thyroid ultrasound (US) and CEUS between January 2019 and June 2023 at Affiliated Hospital of Guangdong Medical University. A retrospective analysis of 467 thyroid nodules confirmed by fine-needle aspiration (FNA) and/or surgery was performed. Further, a CEUS TI-RADS classification was assigned to each thyroid nodule based on the CEUS TI-RADS scoring criteria for US and CEUS features of the nodule. The nodules were grouped based on their sizes, i.e., size≤1 cm for Group A, 1 cm < size≤4 cm for Group B, and size > 4 cm for Group C. Multivariate logistic regression was used to analyze independent risk factors for malignant thyroid nodules. Pathological assessment was the reference standard for establishing sensitivity (SEN), specificity (SPE), accuracy (ACC), positive predictive value (PPV), and negative predictive value (NPV) of CEUS TI-RADS for diagnosing malignant thyroid nodules. Receiver operating characteristic curve (ROC) analysis was performed to compare the diagnostic efficacy of the scoring system in predicting malignancy in three groups of nodules. The intragroup correlation coefficient (ICC) was adopted to assess the inter-observer agreement of the CEUS TI-RADS score.</p><p><strong>Results: </strong>Out of the 467 thyroid nodules, 262 were malignant and 205 were benign. Logistic regression analysis revealed that the independent risk factors for malignant thyroid nodules included punctate echogenic foci (P < 0.001), taller than wide (P = 0.015), extrathyroidal invasion (P = 0.020), irregular margins/lobulated (P = 0.036), hypoechoic (P = 0.038) on US and hypo-enhancement (P < 0.001) on CEUS. The ROC for CEUS TI-RADS diagnosis of malignant thyroid nodules was 0.898 (95% CI:0.867-0.924, P < 0.05) for all nodules, 0.795 (95% CI: 0.721-0.857, P < 0.05) for group A, 0.949 (95% CI: 0.916-0.971, P < 0.05) for group B, and 0.801 (95% CI: 0.644-0.910, P < 0.05) for group C with optimal cut-off values of CEUS TI-RADS 5 points (all nodules), CEUS TI-RADS 6 points (group A), CEUS TI-RADS 5 points (group B), CEUS TI- RADS 5 points (group C), respectively. Among these groups of nodules, group B had the highest ROC, with SEN, SPE, ACC, PPV, and NPV for diagnosing malignant nodules being 95.9%, 88.1%, 92.8%, 92.6%, and 93.2%, respectively. The ICC of the CEUS TI-RADS classification between highly senior and lowly senior physicians was 0.862 (P < 0.001).</p><p><strong>Conclusion: </strong>In summary, CEUS TI-RADS demonstrated significant efficacy in distinguishing thyroid nodules. Nonetheless, there were variations in its capacity to detect malignant nodules across diverse sizes, demonstrating o","PeriodicalId":93943,"journal":{"name":"Clinical hemorheology and microcirculation","volume":"89 1","pages":"27-41"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F Sangtarash, A Shadmehr, H Choobsaz, S Fereydounnia, A Sadeghi, F Jung, M Sarfraz
After menopause, there is an imbalance between bone formation and resorption activity, which could lead to postmenopausal osteopenia or osteoporosis. Resistance training (RT) can induce mechanical stress on bone which is necessary for bone remodeling and angiogenic-osteogenic response. This systematic review aims to assess the effects of RT on bone microcirculation and bone turnover markers (BTMs) in postmenopausal women with osteopenia or osteoporosis. We conducted a comprehensive search for related studies published up to April 2023 to identify eligible articles. Out of 316 articles identified, the full texts of 69 articles were screened. There is not any study which consider the effect of resistance exercises on bone microcirculation in PMOP women, but four articles aseess the effect of RT on BTMs and were reviewed. The quality of the articles was assessed by using the Physiotherapy Evidence Database (PEDro) scale. In one study, after 6 and 12 months of RT, bone formation and bone resorption biomarkers decreased not significantly. According to another study, bone formation and resorption biomarkers increased significantly after 3-months RT. Two other studies reported increases in biomarkers of bone formation along with decreases of biomarkers in bone resorption after 6-months of RT, but these were not significant. However, these results suggest that RT had some beneficial effects on BTMs but it is not an effective tool for modifying BTMs in women with osteoporosis or osteopenia. This may be due to the site-specific skeletal stimulation that RT provides. In addition considering the effect of RT on microcirculation of bone are important. So, there is a need for further, high-quality studies in this field.
{"title":"Effects of resistance training on microcirculation of bone tissue and bone turnover markers in postmenopausal women with osteopenia or osteoporosis: A systematic review.","authors":"F Sangtarash, A Shadmehr, H Choobsaz, S Fereydounnia, A Sadeghi, F Jung, M Sarfraz","doi":"10.3233/CH-249105","DOIUrl":"https://doi.org/10.3233/CH-249105","url":null,"abstract":"<p><p>After menopause, there is an imbalance between bone formation and resorption activity, which could lead to postmenopausal osteopenia or osteoporosis. Resistance training (RT) can induce mechanical stress on bone which is necessary for bone remodeling and angiogenic-osteogenic response. This systematic review aims to assess the effects of RT on bone microcirculation and bone turnover markers (BTMs) in postmenopausal women with osteopenia or osteoporosis. We conducted a comprehensive search for related studies published up to April 2023 to identify eligible articles. Out of 316 articles identified, the full texts of 69 articles were screened. There is not any study which consider the effect of resistance exercises on bone microcirculation in PMOP women, but four articles aseess the effect of RT on BTMs and were reviewed. The quality of the articles was assessed by using the Physiotherapy Evidence Database (PEDro) scale. In one study, after 6 and 12 months of RT, bone formation and bone resorption biomarkers decreased not significantly. According to another study, bone formation and resorption biomarkers increased significantly after 3-months RT. Two other studies reported increases in biomarkers of bone formation along with decreases of biomarkers in bone resorption after 6-months of RT, but these were not significant. However, these results suggest that RT had some beneficial effects on BTMs but it is not an effective tool for modifying BTMs in women with osteoporosis or osteopenia. This may be due to the site-specific skeletal stimulation that RT provides. In addition considering the effect of RT on microcirculation of bone are important. So, there is a need for further, high-quality studies in this field.</p>","PeriodicalId":93943,"journal":{"name":"Clinical hemorheology and microcirculation","volume":"89 1","pages":"161-174"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ya-Dan Xu, Fei-Hang Wang, Kai-Ling Chen, Yang Tang, Qi Zhang, Hong Han, Yi Dong, Wen-Ping Wang
Objective: To explore the value of a new clinical prediction model combined serological indicators and tumor burden score (TBS) in predicting microvascular invasion (MVI) in hepatocellular carcinoma (HCC) patients.
Methods: This study retrospectively analyzed a total of 605 patients who underwent liver tumor resection at our hospital from January 2021 to December 2023. The required clinical data before surgery were collected from the electronic medical record system. All patients were randomly divided into a training group and a validation group according to the ratio of 7 : 3. Univariate and multivariate analyses were conducted to identify factors associated with MVI. Based on the combined factors, a nomogram for predicting MVI was constructed and its diagnostic performance was evaluated.
Results: There were 123 (20.3%) female patients and 482 (79.7%) male patients were enrolled, with an average age of 59 years. There were 182 (30.1%) patients with positive MVI and 423 (69.9%) patients with negative MVI. On multivariate logistic analysis, prealbumin (0.993 [0.986, 1.000]), AFP (0.993 [0.987, 1.000]), PIVKA-II (1.000 [1.000, 1.000]) were independently associated with MVI. The nomogram constructed based on the aforementioned variables and TBS exhibited area under the curve (AUC) of 0.804 and 0.742 in the training group and a validation group, respectively. The calibration curves in both training group and a validation group showed good fit, and the decision curve analysis revealed a net benefit across a wide range of threshold probabilities.
Conclusions: The newly developed nomogram was an independent biomarker for predict MVI, which might take precision medicine one step further.
{"title":"The value of clinical indicators combined with imaging tumor burden score in predicting microvascular invasion of hepatocellular carcinoma.","authors":"Ya-Dan Xu, Fei-Hang Wang, Kai-Ling Chen, Yang Tang, Qi Zhang, Hong Han, Yi Dong, Wen-Ping Wang","doi":"10.3233/CH-242407","DOIUrl":"https://doi.org/10.3233/CH-242407","url":null,"abstract":"<p><strong>Objective: </strong>To explore the value of a new clinical prediction model combined serological indicators and tumor burden score (TBS) in predicting microvascular invasion (MVI) in hepatocellular carcinoma (HCC) patients.</p><p><strong>Methods: </strong>This study retrospectively analyzed a total of 605 patients who underwent liver tumor resection at our hospital from January 2021 to December 2023. The required clinical data before surgery were collected from the electronic medical record system. All patients were randomly divided into a training group and a validation group according to the ratio of 7 : 3. Univariate and multivariate analyses were conducted to identify factors associated with MVI. Based on the combined factors, a nomogram for predicting MVI was constructed and its diagnostic performance was evaluated.</p><p><strong>Results: </strong>There were 123 (20.3%) female patients and 482 (79.7%) male patients were enrolled, with an average age of 59 years. There were 182 (30.1%) patients with positive MVI and 423 (69.9%) patients with negative MVI. On multivariate logistic analysis, prealbumin (0.993 [0.986, 1.000]), AFP (0.993 [0.987, 1.000]), PIVKA-II (1.000 [1.000, 1.000]) were independently associated with MVI. The nomogram constructed based on the aforementioned variables and TBS exhibited area under the curve (AUC) of 0.804 and 0.742 in the training group and a validation group, respectively. The calibration curves in both training group and a validation group showed good fit, and the decision curve analysis revealed a net benefit across a wide range of threshold probabilities.</p><p><strong>Conclusions: </strong>The newly developed nomogram was an independent biomarker for predict MVI, which might take precision medicine one step further.</p>","PeriodicalId":93943,"journal":{"name":"Clinical hemorheology and microcirculation","volume":"89 1","pages":"123-135"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: The purpose of this research was to examine the relationship between the hemoglobin-to-red blood cell distribution width ratio (HRR) and cardiovascular disease (CVD)-related mortality in people who have diabetes.
Methods: Data derived from the National Health and Nutrition Examination Survey (NHANES), between the years 1999 to 2018, were meticulously analyzed. Mortality data, encompassing events until December 31, 2019, were systematically collected. A comprehensive group comprising of 8,732 participants were subjected to scrutiny, and subsequently, classified into four distinct groups predicated upon quartiles of baseline HRR levels: Q1 (n = 2,183), Q2 (n = 2,181), Q3 (n = 2,185), and Q4 (n = 2,183). The correlation between HRR and CVD-related mortality was examined through the use of survival curves and Cox proportional hazard regression models, the latter incorporating weights as advised by NHANES.
Results: Among the 8,732 participants in the study cohort, CVD-related mortality was identified in 710 cases. The Kaplan-Meier analysis demonstrated a significant association, indicating that a decreased HRR was correlated with a reduction in survival in cases with CVD. Both univariate and multivariable Cox proportional hazard regression analyses consistently indicated that patients exhibiting a lower HRR exhibited a markedly elevated risk of CVD-related mortality in comparison to those with higher HRR. Notably, the correlation between HRR and decreasing CVD-related mortality was discerned to be non-linear.
Conclusion: In patients with diabetes, a decreased HRR was associated with an increased risk of CVD-related mortality.
{"title":"Association between reduced hemoglobin-to-red cell distribution width ratio and elevated cardiovascular mortality in patients with diabetes: Insights from the National Health and Nutrition Examination Study, 1999-2018.","authors":"Jiayi Deng, Weihao Wu, Zimiao Zhang, Xiaomei Ma, Congjie Chen, Yanhong Huang, Yueyuan Lai, Liling Chen, Longtian Chen","doi":"10.3233/CH-242209","DOIUrl":"10.3233/CH-242209","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this research was to examine the relationship between the hemoglobin-to-red blood cell distribution width ratio (HRR) and cardiovascular disease (CVD)-related mortality in people who have diabetes.</p><p><strong>Methods: </strong>Data derived from the National Health and Nutrition Examination Survey (NHANES), between the years 1999 to 2018, were meticulously analyzed. Mortality data, encompassing events until December 31, 2019, were systematically collected. A comprehensive group comprising of 8,732 participants were subjected to scrutiny, and subsequently, classified into four distinct groups predicated upon quartiles of baseline HRR levels: Q1 (n = 2,183), Q2 (n = 2,181), Q3 (n = 2,185), and Q4 (n = 2,183). The correlation between HRR and CVD-related mortality was examined through the use of survival curves and Cox proportional hazard regression models, the latter incorporating weights as advised by NHANES.</p><p><strong>Results: </strong>Among the 8,732 participants in the study cohort, CVD-related mortality was identified in 710 cases. The Kaplan-Meier analysis demonstrated a significant association, indicating that a decreased HRR was correlated with a reduction in survival in cases with CVD. Both univariate and multivariable Cox proportional hazard regression analyses consistently indicated that patients exhibiting a lower HRR exhibited a markedly elevated risk of CVD-related mortality in comparison to those with higher HRR. Notably, the correlation between HRR and decreasing CVD-related mortality was discerned to be non-linear.</p><p><strong>Conclusion: </strong>In patients with diabetes, a decreased HRR was associated with an increased risk of CVD-related mortality.</p>","PeriodicalId":93943,"journal":{"name":"Clinical hemorheology and microcirculation","volume":" ","pages":"69-81"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}