Clinical hemorheology and microcirculation最新文献

ObjectiveTo investigate the application value of ultrasound artificial intelligence S-Detect technology in the differential diagnosis of benign and malignant breast nodules.MethodsSuspicious breast nodules were examined using S-Detect technology, conventional ultrasound (US), and contrast-enhanced ultrasound (CEUS). The differential diagnoses were compared with final pathological results to analyze the diagnostic efficacy of these three techniques in distinguishing benign from malignant breast nodules.ResultsThe accuracy of S-Detect in diagnosing benign and malignant breast nodules was 0.859, with a sensitivity of 0.915, specificity of 0.839, and an area under the ROC curve (AUC) of 0.877. The value of AUC was significantly higher than that of US (0.727, P < 0.01), but lower than US + CEUS (0.908, P < 0.05). According to the final pathological classification, S-Detect demonstrated higher accuracy in distinguishing benign from malignant lesions in complex cysts, hyperplastic nodules, and adenomas compared to US (P < 0.05), with no significant difference when compared to US + CEUS. In differentiating malignant breast tumors, there was no significant difference in accuracy between S-Detect and US.ConclusionUltrasound artificial intelligence S-Detect technology exhibits high diagnostic efficacy in the differential diagnosis of benign and malignant breast nodules.

ObjectiveTo investigate the possible correlation between changes in haemorheology and the HIF-1/EPO pathway in children with Mycoplasma pneumoniae pneumonia (MPP) to provide new ideas for the early clinical identification of hypercoagulability and reduce the incidence of thrombosis.MethodsA total of 205 children with newly diagnosed MPP were selected from our department and divided into a general MPP group (100 patients) and a severe MPP group (105 patients) according to diagnostic criteria. In addition, 30 healthy children were selected as the control group. Routine blood and coagulation function data were collected, and the expression levels of T-cell factors, HIF-1α, EPO and haemorheology were detected.ResultsThe levels of D-dimer, FDP and fibrinogen in the MPP group were significantly greater than those in the control group and more obvious in the severe group than in the general group. Compared with those in the control group, the whole blood viscosity (low, medium, high tangential), plasma viscosity, whole blood low tangential reductive viscosity and erythrocyte aggregation index in the haemorheology of children in the MPP group were significantly greater, and the range of increase in the severe group was greater than those in the general group. The red blood cell (RBC) count and haematocrit (HCT) of children in the MPP group were significantly greater than those in the control group at admission and were more altered in the severe group than in the general group. Moreover, the serum expression levels of TNF-a, IFN-γ, IL-6, IL-8, IL-10, IL-17, HIF-1α and EPO in the MPP group were significantly greater than those in the healthy control group. With the exception of IFN-γ, the cytokines levels in the severe group were significantly greater than those in the general group. The expression level of HIF-1α was significantly correlated with the elevated levels of TNF-a, IL-6 and IL-8.ConclusionHypercoagulability occurs during the course of MPP in children, especially those with severe disease. The increase in blood viscosity may be an important reason for hypercoagulability, and highly inflammatory cytokines such as TNF-a, IL-6 and IL-8 in children may increase the RBC and HCT levels by activating the HIF-1α/EPO pathway, which may lead to changes in haemorheology and thus participate in the development of hypercoagulability.

ObjectiveSeptic shock is a serious medical condition characterized by extreme inflammation and blood vessel permeability. Fluid resuscitation is a crucial treatment for septic shock, but the optimal approach for fluid management remains controversial. In this study, we explored how blood perfusion index (PI) monitoring can help direct fluid resuscitation therapy for septic shock.MethodsBetween January 2019 and December 2021, 50 patients with septic shock were admitted to The Affiliated Hospital of Hangzhou Normal University and randomly assigned to either a control or study group (25 cases each). All patients were given the sepsis treatment bundle recommended by the 2018 guidelines and were subjected to Pulse Indicator Continuous Cardiac Output (PiCCO) -based hemodynamic monitoring. Fluid resuscitation was administered based on specific indicators in the control group. We used PI to direct fluid resuscitation in the research group. Several parameters were assessed, including blood lactate (BLAC), hemoglobin (Hb), stroke volume index (SVI), norepinephrine dosage, extravascular lung water (EVLW), volume of resuscitation fluid and the ICU mortality.ResultsThere were statistically significant reductions in BLAC in the study group compared to the control group 6 h, 24 h, and 48 h after treatment (P < 0.05). In the study group, the SVI was higher 24 and 48 h post-treatment compared to the control group (P < 0.05). Norepinephrine doses were similarly lowered in the study group. In the comparison of extravascular lung water between the two groups, the extravascular lung water in the study group was less than that in the control group 24 h after fluid resuscitation, and the difference was statistically significant. the ICU mortality [44%vs. 56% (X²= 0.720, P = 0.572)] in the study group were lower than those in the control group, but the difference had no statistical significance.ConclusionsIn patients with septic shock, fluid resuscitation guided by PI monitoring improves BLAC and SVI while decreasing norepinephrine dosage, and avoid the risk of fluid overload due to increased EVLW fluid overload, demonstrating clinical significance and application value.

Objectives: In practical clinical work, when sonographers extract image features, there may be large intra-observer and inter-observer variability in subjective description and visual evaluation. Lymph node tuberculosis is often confused with other diseases of lymphadenopathy. To avoid the shortcomings of ultrasound such as strong subjectivity and low repeatability, we discussed the clinical value of imaging models based on B-mode ultrasound (B-US), elastic ultrasound (EUS) and contrast-enhanced ultrasound (CEUS) images in predicting cervical lymph node tuberculosis (CLNT).

Methods: Herein, 215 patients with cervical lymph node enlargement confirmed via international diagnostic criteria at our hospital between January 2018 and May 2023 were included. Patients were randomly divided into training (n = 151) and validation (n = 64) sets in a 7:3 ratio. Thereafter, 42 patients with cervical lymphadenopathy who underwent ultrasound-guided lymph node puncture from March 2023 to September 2023 were considered as a prospective internal validation set. Three models (radiomics model, clinical model and clinical-radiomics model) were established. Receiver operating characteristic curves (ROCs) of different models were drawn, and the area under the curve (AUC),were compared among them. Finally, the visual color band nomogram was established.

Results: The AUC of the clinical-radiomics model in the training dataset, validation dataset and prospective validation dataset reached 0.959, 0.906 and 0.865, respectively. The clinical-radiomics model has good diagnostic efficacy in predicting CLNT.

Conclusions: The Multimodal ultrasound radiomics combined with clinical manifestations and imaging features, showed good judgment in identifying CLNT ability and good stability.

BackgroundA non-invasive and reliable method is essential for diagnosing sub-1 cm thyroid lesions.ObjectiveWe have developed a nomogram that integrates ultrasound features and clinical risk factors to effectively diagnosed sub-1 cm thyroid lesions.MethodsOur study included 406 patients with sub-1 cm thyroid lesions. We collected their demographic data and ultrasound characteristics of the thyroid, followed by conducting univariate and multivariate analyses to identify the risk factors. Subsequently, we developed a nomogram for predicting sub-1 cm thyroid lesions, comparing its diagnostic performance with that of American College of Radiology TIRADS (ACR TI-RADS) and Chinese Thyroid Imaging Reporting and Data Systems (C TI-RADS).ResultsSix variables, including female gender, capsular invasion, solid composition, aspect ratio >1, irregular margin and microcalcification, were identified as potential predictors and used to develop a predictive nomogram. Receiver operating characteristic curves were constructed and compared with ACR TI-RADS and C TI-RADS classifications. The area under the curve of the nomogram was found to be at 0.85, while the AUC of ACR TI-RADS classification and C TI-RADS classification were at 0.771 and 0 .736 respectively.ConclusionsBy utilizing this user-friendly nomogram, the likelihood of sub-1 cm malignancy in thyroid lesions can be objectively quantified.

The aim of the present study was to test the effects of dalcetrapib and voxelotor on red blood cells (RBC) of sickle cell patients. Oxygen gradient ektacytometry was performed to measure RBC deformability in normoxia and hypoxia, as well as the propensity of RBC to sickle. Voxelotor and dalcetrapib reduced the propensity of RBC to sickle under deoxygenation and increased RBC deformability in hypoxia. Dalcetrapib did not affect the affinity of hemoglobin S (HbS) to oxygen. Combining the two molecules caused greater RBC rheological improvement. Our findings suggest that dalcetrapib could block HbS polymerization without affecting HbS oxygen affinity.

Unspecific peroxygenases (UPO, EC 1.11.2.1) are a valuable tool for the biocatalytic synthesis of specialty chemicals such as pharmaceutical metabolites. However, the search for new UPOs that are recombinantly expressible can be tedious and dependent on expensive equipment, especially when a large number of clones has to be examined. In this study, we present a simple agar plate-based method for the screening of active, secreted UPOs heterologously expressed in Saccharomyces cerevisiae. This allows a real high-throughput of several thousand clones at once. The approach was successfully tested with a small gene library comprising putative UPO genes and resulted in the identification of two clones producing short UPOs from the filamentous fungi Dendrothele bispora (DbiUPO) and Aspergillus niger (AniUPO). Both UPOs were partly purified and characterized with respect to their catalytic properties. With differing efficiencies and product specificities, they catalyzed the formation of human drug metabolites, e.g., lipid mediators from polyunsaturated fatty acids and the active metabolite of the prodrug clopidogrel, respectively.

ObjectiveTo evaluate the diagnostic performance of novel tissue attenuation imaging (TAI) and tissue scatter distribution imaging (TSI) tools in detecting and grading hepatic steatosis using controlled attenuation parameter (CAP) as reference standard.MethodsA total of 185 participants with suspected metabolic dysfunction-associated steatotic liver disease (MASLD) were prospectively enrolled, and all underwent CAP and quantitative ultrasound (QUS) testing. Correlations between CAP, biological data, TAI and TSI were assessed. The influence factors of TAI and TSI as well as the diagnostic performance of TAI and TSI in detecting hepatic steatosis were evaluated.ResultsThe QUS parameters (TAI and TSI) showed good intra-observer reliability with ICC of 0.972 and 0.777, respectively. The correlation of CAP with TAI was higher than that of TSI (0.724 vs 0.360, P < 0.05). Multivariate Regression analysis showed that CAP was an important influence factor of TAI and TSI (P < 0.001). The area under the ROC curve (CAP > 250 dB/m) of TAI and TSI tools for detecting hepatic steatosis was 0.876 (95% CI: 0.813-0.923; P < 0.0001) and 0.797(95% CI: 0.724-0.857; P < 0.001), respectively; the sensitivity was 67.18% and 83.21%, the specificity was 95.65% and 69.57%, and the cut-off values were 0.93 dB/cm/MHz and 91.28, respectively. When TAI and TSI were combined, the area under the ROC curve was 0.881, with a sensitivity of 80.92% and a specificity of 82.61%. The Delong test showed that the combined diagnosis of TAI and TSI was equivalent to the use of TAI alone (P > 0.05).ConclusionTAI and TSI provided good intra-observer reliability, correlated well with CAP, and helped to detect and stage hepatic steatosis.

BackgroundResearch has shown that S100A4 is upregulated in endothelial cells when exposed to serum from septic patients. This article aims to explore the role of endogenous S100A4 in lipopolysaccharide (LPS)-induced endothelial cells.MethodsA septic HUVECs injury model was established using LPS and transfected with siRNA-S100A4 or Ov-BRD4 plasmid. Targets of S100A4 were predicted using online databases, and immunoprecipitation (IP) was used to verify the binding of S100A4 and targets. Cell viability, levels of apoptosis, and the expression of apoptosis-related proteins were measured to assess cell injury. Transendothelial electrical resistance (TER) and the expression of tight junction proteins were measured to assess cell barrier function. Assessed the inflammatory response by measuring the levels of inflammatory factors, the adhesion of THP-1 monocytes, and the expression of adhesion molecules.ResultsDatabase prediction and IP verification indicated that S100A4 could bind to BRD4 in LPS-induced HUVECs, and the expression of S100A4 and BRD4 was increased in LPS-induced HUVECs. Interference with S100A4 significantly enhanced the cell viability and TER, reduced the apoptosis, TNFα, IL-1β, and IL-6 levels, and THP-1 adhesion number in LPS-treated HUVECs. Additionally, interference with S100A4 upregulated the expression of Bcl2, ZO-1, occludin, and claudin-4 proteins, and downregulated the expression of BRD4, Bax, cleaved caspase-3, ICAM-1, VCAM-1, and E-selectin proteins in LPS-induced HUVECs. However, overexpression of BRD4 significantly attenuated the protective effect of interfering with S100A4 on LPS-induced HUVECs.ConclusionS100A4 is involved in LPS-induced inflammatory response and barrier damage in HUVECs by binding to BRD4.

Objective: The aim of this study is to explore the protective mechanism of proline hydroxylase (PHD) in reducing myocardial ischemia-reperfusion injury (MIRI) through the hypoxia-inducible factor (HIF)-1α-adenosine-MAPK/ERK signaling pathway, with the goal of identifying potential drug targets and therapeutic strategies for the clinical management of MIRI. Methods: A rat model of MIRI was established using 45 male Sprague-Dawley (SD) rats, which were randomly divided into the following three groups: sham operation (n = 15), MIRI model (n = 15), and MIRI + FG-4592 preconditioning (n = 15) groups. Cardiac function was assessed by echocardiographic measurements of the left ventricular end-diastolic diameter (LVIDd), left ventricular contractile diameter (LVIDs), left ventricular shortening fraction (FS), and left ventricular ejection fraction (EF). Cardiomyocyte apoptosis was evaluated using hematoxylin-eosin (HE) and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining. Myocardial infarct size was determined with 23,5-triphenyltetrazolium chloride (TTC) staining, while levels of inflammatory factors such as interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) were quantified using enzyme-linked immunosorbent assays (ELISA). Western blot (WB) analysis was performed to assess the expression of apoptotic proteins ERK1/2, phosphorylated-ERK1/2 (p-ERK1/2), AKT, phosphorylated-AKT (p-AKT), caspase-3, BCL-2, and BAX in the infarct boundary area. Adenosine levels within myocardial tissue were also measured. Results: FG-4592 preconditioning significantly improved cardiac function, lowered cardiomyocyte apoptosis and myocardial infarction size, reduced myocardial tissue damage, and inhibited inflammation. Additionally, FG-4592 increased the expression of anti-apoptotic proteins and enhanced adenosine levels in myocardial tissue in the treatment group compared with the MIRI model group. Conclusions: Inhibition of HIF-1α degradation plays a significant role in enhancing extracellular adenosine levels and reducing MIRI, possibly regulating apoptosis through the MAPK/ERK signaling pathway. These findings highlight the potential of targeting the PHD-HIF-adenosine axis in developing treatment strategies for MIRI, meriting future exploration.