Clinical hemorheology and microcirculation最新文献

ObjectiveThe objective of this study is to examine the lifespan of red blood cells (RBCs) in individuals with systemic lupus erythematosus (SLE), explore the factors influencing this lifespan, and assess its significance in clinical contexts.MethodsThe experimental group comprised of 182 patients with SLE, while the control group consisted of 90 healthy participants. By using a non-invasive breath test, we measured the RBC lifespan in both groups. Subsequently, we conducted a comparative analysis of general clinical data and laboratory findings to explore the correlation between RBC lifespan in patients with SLE and various parameters associated with RBC characteristics, inflammatory markers, and immunological indicators. Furthermore, we examined the impact of COVID-19 infection on RBC lifespan among patients with SLE and assessed the diagnostic efficacy of RBC lifespan.ResultsRBC lifespan was notably reduced in the SLE group in comparison to the healthy control group (P = 0.002). A positive correlation was observed between RBC lifespan and hemoglobin (HB), complement 3, and complement 4, whereas a negative correlation was noted with IgG, erythrocyte sedimentation rate (ESR), C-reactive protein, and anti-dsDNA levels (all P < 0.05). Noteworthy independent contributors to the reduction in RBC lifespan among patients with SLE included disease activity and presence of anemia. While RBC lifespan remained unchanged in the control group before and after COVID-19 infection (P > 0.05), a reduction in RBC lifespan post-COVID-19 infection was observed among patients with SLE (P < 0.05). Also, RBC lifespan was notably shorter during the active disease phase of SLE compared to the stable phase, with post-COVID-19 active patients with SLE exhibiting even shorter RBC lifespan compared to the pre-COVID-19 active group (all P < 0.05). An optimal cutoff for the prediction of anemia in patients with SLE on the day of assessment was determined to be 93.5 days (AUC 0.792, P < 0.05).ConclusionPatients with SLE exhibited shorter RBC lifespan in contrast to the healthy population, which is notably linked with levels of inflammatory and immune markers, as well as the incidence of COVID-19 infection. This discovery holds crucial significance for both the diagnosis of anemia and the comprehension of its underlying pathogenic mechanisms within the context of SLE.

BackgroundThe ischemia-reperfusion injury (IRI) is unavoidable in vascular surgery. Damage to the microcirculation and endothelial glycocalyx might set up a shock with loss of circulatory coherence and organ failure. Sulodexide may help to protect endothelial glycocalyx and alleviate the ischemia-reperfusion injury.MethodsTwenty female piglets underwent surgery with a 30-min-long suprarenal aortic clamp, followed by two hours of reperfusion. Ten piglets received sulodexide before the clamp, and 10 received normal saline. Blood and urine samples were taken at baseline and in 20-min intervals until the 120^th minute to analyze the serum syndecan-1, E-selectin, and thrombomodulin. Albumin and glycosaminoglycans were examined in the urine. The kidney biopsies before and after the protocol were examined by light microscopy with hematoxylin-eosin staining. The sublingual microcirculation was recorded by side-stream dark field imaging at the time as blood and urine.ResultsBased on the 2-way ANOVA testing, there was no statistically significant difference in the parameters of sublingual microcirculation. Serum markers of endothelial cell activation and damage (E-selectin and thrombomodulin) did not show any statistically significant difference either. Syndecan-1, a marker of glycocalyx damage, showed statistically significantly higher values based on the 2-way ANOVA testing (p < 0.0001) with the highest difference in the 80^th minute: 7.8 (3.9-44) ng/mL in the control group and 1.8 (0.67-2.8) ng/mL in the sulodexide group. In the urine, the albuminuria was higher in the control group, although not statistically significant. Glycosaminoglycans were statistically significantly higher in the sulodexide group based on the mixed-effect analysis due to the intervention itself. Histological analysis of the renal biopsies showed necrosis in both groups after reperfusion.ConclusionAdministering sulodexide significantly reduced the level of endothelial markers of IRI. The study results support further research into using preemptive administration of sulodexide to modulate IRI in clinical medicine.

BackgroundThe evaluation of breast mass echo in the breast imaging reporting and data system (BI-RADS) is subjective, whereas ultrasound grayscale ratio (UGSR) provides a quantitative measure of ultrasound echo intensity. The purpose of this study is to investigate the value of UGSR, in conjunction with BI-RADS, for distinguishing between benign and malignant breast masses.MethodsA retrospective analysis was conducted on ultrasound imaging data from 179 malignant breast mass cases and 219 benign breast mass cases. The masses were categorized according to the BI-RADS grading standard, and the grayscale values of the masses, adjacent fat lobules, and mammary glands were measured using the RADinfo system. The f-UGSR (ratio of ultrasound grayscale of mass to ultrasound grayscale of fat lobule) and g-UGSR (ratio of ultrasound grayscale of mass to ultrasound grayscale of gland) were calculated. The receiver operating characteristic (ROC) curve was constructed, optimal thresholds for f-UGSR and g-UGSR were determined, and the diagnostic efficacy of the combination of f-UGSR, g-UGSR and BI-RADS grading was assessed.ResultsThe f-UGSR for malignant and benign breast masses were 0.57 ± 0.20 and 0.85 ± 0.23, respectively, while the g-UGSR were 0.23 (0.18, 0.30) and 0.38 (0.30, 0.47) respectively. The area under the ROC curve (AUC) for f-UGSR and g-UGSR in the diagnosis of breast malignant masses were 0.819 and 0.823, respectively, with the optimal thresholds of 0.69 and 0.29, respectively. The AUC for BI-RADS, g-UGSR, and their combination in the diagnosis of breast malignant masses were 0.849, 0.823, and 0.821, respectively. Sensitivity rates were approximately 74.30%, 73.74%, and 89.39%, and specificity rates were 95.43%, 77.17%, and 74.89%, respectively.ConclusionUGSR provides an objective and accurate method to evaluate the benign or malignant nature of breast masses. Combining UGSR with BI-RADS enhances sensitivity, reduces the missed diagnosis rate, and improves confidence in distinguishing between benign and malignant breast masses.

ObjectiveTo investigate the conventional ultrasound (US), contrast-enhanced ultrasound (CEUS) manifestations and the corresponding histopathological characteristics of patients diagnosed with breast encapsulated papillary carcinoma (EPC) and to explore the value of CEUS in diagnosis of EPC.MethodsThe clinical, pathological, US, and CEUS features of 16 patients (17 lesions) with EPC confirmed by postoperative histopathology were retrospectively analyzed.ResultsEPC was prevalent in the postmenopausal women. The majority of conventional US images of EPC showed complex cystic and solid masses with circumscribed margins (70.6%), enhanced posterior echo (94.1%), no sonographic calcification (88.2%), rich blood flow in the solid components within lesions (70.6%) on Color Doppler flow imaging, and high resistance index of blood flow (94.1%). Moreover, CEUS showed mainly centripetal hyperenhancement of the solid components within the lesions with irregular outline, and the enhancement area of the whole masses was essentially the same as the B-mode US area.ConclusionsEPC typically presents as a complex cystic and solid mass. CEUS is helpful to clarify the extent of the solid component and facilitate preoperative core-needle biopsy. A comprehensive evaluation by CEUS is valuable for diagnosing EPC and combining it with clinical features are helpful to further improve the diagnosis of this rare kind of breast cancer.

ObjectiveStem cell therapy can modify angiogenic pathways. Neural protein 3.1 (P311) possesses the pro-angiogenic property. This study strived to explore the action and mechanism of human adipose mesenchymal stem cells (hADSCs) in human brain microvascular endothelial cell (hBMEC) injury by regulating P311.MethodsThe hADSCs of the 3^rd passage were stained with oil red O, Alizarin red, and Alcian blue to assess adipogenic, osteogenic, and chondrogenic differentiation, followed by an analysis of immune phenotype via flow cytometry. After culturing hADSCs in hypoxic (5% oxygen) and normoxic (20% oxygen) conditions, extracellular vesicles (EVs) were extracted via ultracentrifugation, followed by morphology observation by microscopy, size distribution analysis via Nanoparticle tracking analysis, and surface marker determination by Western blot. hBMECs were treated with lipopolysaccharide (LPS) and cultured with normoxia or hypoxic hADSC-EVs. The effects of normoxia and hypoxic hADSC-EVs on proliferation, migration, and tube formation of hBMECs were assessed via CCK-8, Transwell, and tube formation assays. hBMECs were transfected with pcDNA3.0-P311 or P311 siRNA to evaluate the action of P311 on hBMEC injury.ResultsHypoxic hADSC-EVs had a larger mean diameter, a wider diameter distribution range, and a higher particle concentration than normoxic hADSC-EVs. Hypoxia and normoxic hADSC-EVs were internalized by hBMECs, and hypoxic hADSC-EVs were more internalized. LPS suppressed hBMEC proliferation, migration, and tube formation and induced hBMEC injury. Hypoxia and normoxic hADSC-EVs ameliorated hBMEC injury, and hypoxic hADSC-EVs were superior to normoxic hADSC-EVs. P311 overexpression mitigated hBMEC injury, whereas P311 knockdown partly averted hypoxic hADSC-EV-exerted suppression on hBMEC injury.ConclusionHypoxic hADSC-EVs can protect against LPS-induced hBMEC injury by upregulating P311.

PurposeThe aim of the study was to explore the possibility of subharmonic aided pressure estimation (SHAPE) measurement for noninvasive evaluation of portal hypertension in patients with decompensated liver cirrhosis.Materials and MethodsPatients diagnosed with decompensated liver cirrhosis were prospectively enrolled. SHAPE measurement was performed by using an ultrasound system. A continuous infusion of sonazoid at a rate of 0.18 ml/kg/h and saline at 120 ml/h was performed. The hepatic venous pressure gradient (HVPG) value are the gold standard for evaluating portal hypertension. The Pearson coefficient and areas under the receiver operating characteristic curves (AUCs) were analyzed.ResultsFrom February 2023 to August 2023, 15 patients (mean age, 61.1 ± 8.3 years; eight men and seven women) were included. The correlation coefficient of the SHAPE gradient and HVPG was 0.33. The mean SHAPE gradient of patients with clinically significant portal hypertension (CSPH) (HVPG ≥ 10 mmHg) was significantly higher than that of patients with lower risk (0.5 ± 4.4 dB vs. -7.4 ± 5.1 dB, P = 0.01). Patients with increased risk for variceal hemorrhage (HVPG ≥ 12 mmHg) had a significantly higher mean SHAPE gradient than patients with lower risk (HVPG < 12 mmHg) (1.3 ± 4.4 dB vs. -5.9 ± 4.8 dB; P = 0.01). The optimal cut-off values of the SHAPE gradient for diagnosing patients with CSPH and at increased risk for variceal hemorrhage were -1.3 dB and -0.6 dB (both AUC = 0.89), respectively.ConclusionSHAPE measurement is a potential noninvasive, effective imaging method to evaluate portal hypertension among patients diagnosed with decompensated liver cirrhosis in clinical practice.

ObjectiveThis study aims to identify risk factors associated with central lymph node metastasis (CLNM) in individuals with papillary thyroid carcinoma (PTC) and to develop a predictive nomogram model, thereby offering clinicians a valuable tool for guiding surgical treatment decisions in PTC management.MethodsClinical and ultrasound data were collected from 348 patients with PTC who underwent surgical treatment at our hospital between July 2022 and November 2023. The cohort was randomly divided into a training group (n = 243) and a validation group (n = 105 cases). Independent risk factors for CLNM were identified using multivariate logistic regression analysis, which was subsequently used to construct a predictive nomogram. The performance of the model was internally validated, and its predictive accuracy was evaluated using receiver operating characteristic (ROC) curves, decision curve analysis (DCA), and calibration curves.ResultsAmong the 348 patients, CLNM was observed in 115 (47.33%) patients in the training group and 48 (45.71%) patients in the validation group. Univariate and multivariate logistic regression analyses revealed that male sex, age under 55 years, nodular anteroposterior diameter of ≥1 cm, BRAF-V600E gene mutation, and tumor capsule invasion were independent risk factors for CLNM in PTC (P < 0.05). The constructed nomogram demonstrated strong predictive capability, with areas under the ROC curve (AUC) of 0.84 (95% CI, 0.78-0.89) for the training group and 0.85 (95% CI, 0.78-0.93) for the validation group.ConclusionThe nomogram constructed based on ultrasound and BRAF-V600E gene mutation status is a reliable predictive tool for CLNM in patients with PTC, potentially aiding clinicians in the formulation of personalized surgical treatment strategies.

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.

ObjectiveThe aim of this study is to examine the impact of controlled stepwise reperfusion by modulating pre-dilation balloon pressure during primary percutaneous coronary interventions (PPCI) in patients with ST-elevation myocardial infarction (STEMI).MethodsConsecutive STEMI patients requiring PPCI with thrombolysis in myocardial infarction (TIMI) flow grades 0 or 1, were randomly divided into an experimental group and a control group. For the control group, the pre-dilation balloon was removed immediately after achieving antegrade perfusion beyond the lesion. The experimental group underwent stepwise reperfusion, with the balloon pressure being gradually reduced. Baseline data, intra/post-procedural PPCI data, 3-month left ventricular ejection fraction (LVEF), and major adverse cardiac events (MACE) were documented and compared between the two groups.ResultsThe control group experienced more severe symptoms during the procedure (p = 0.034), higher post-procedural corrected TIMI frame counts (p = 0.047), more significant hemodynamic changes (p = 0.031), and increased rates of ventricular tachycardia/ventricular fibrillation (p = 0.035). Additionally, they had a higher total number of arrhythmias (p = 0.017), a lower 90-min ST segment resolution rate (p = 0.045), and elevated cTNI levels one week after the procedure (p = 0.047). Three months later, the control group demonstrated a lower LVEF compared to the experimental group (p = 0.048) and a trend towards more drug-treated arrhythmias (p = 0.073). No differences were observed in other statistical results.ConclusionIn patients with STEMI undergoing PPCI, controlled stepwise reperfusion by adjusting the pre-dilation balloon pressure effectively reduces myocardial ischemia-reperfusion injury, improves myocardial perfusion, and supports the recovery of cardiac function.

ObjectiveTo examine the diagnostic and prognostic value of multimodal ultrasound and serum human epidermal growth factor receptor 2 (HER2) and Ki-67 antigen (Ki-67) testing for breast cancer.MethodsWe enrolled 65 patients with breast cancer admitted to the Tianjin Fourth Centre Hospital between March 2018 and March 2019 as the study group, while the control group consisted of 65 patients with benign breast nodules admitted during the same time period. All cases underwent ultrasound elastography (UE), contrast-enhanced ultrasonography (CEUS), serum examination, and Ki-67 and HER2 testing to determine the differences in multimodal ultrasound parameters and biomarkers, respectively, between the two groups and their relationship to the pathological features of breast cancer; ROC curves were generated to determine the accuracy of the combined examination in predicting breast cancer prognosis.ResultsThe study group had significantly higher UE score and CEUS-PI, significantly lower time to peak (TTP) and mean transit time (MTT) levels than the control group (P < 0.001), and significantly higher serum HER2 and tumor tissue Ki-67 expression (P < 0.05).ConclusionIt is possible to improve the breast cancer diagnosis rate by using multimodal ultrasound in conjunction with serum Ki-67 and HER2 testing.