Background:Current preoperative imaging methods, such as ultrasound, are limited by operator dependency and suboptimal sensitivity for detecting central lymph node metastasis (CLNM). This study aimed to propose a method that integrates deep learning and radiomics to accurately predict lymph node metastasis in thyroid cancer by analyzing intra- and peri-tumoral imaging features, thereby improving the preoperative prediction accuracy. Methods:From July 2020 to June 2022, 405 patients diagnosed with PTC were enrolled from two centers: Center 1 (Shanghai Sixth People's Hospital) with 294 patients divided into a training set (n=294) and an internal validation set, and Center 2 (Tongji Hospital Affiliated to Tongji University) with 111 patients as the external test set. Postoperative pathological confirmation served as the reference standard for CLNM diagnosis. A total of 1,561 radiomics features and 2,048 deep learning features were extracted from intra- and peri-tumoral regions of each ultrasound image. Feature selection was performed using analysis of variance (ANOVA) and least absolute shrinkage and selection operator (LASSO), resulting in the selection of relevant features for constructing support vector machine (SVM) models. Additionally, radiomics-deep learning fusion models were developed by combining selected radiomics and deep learning features. Results:Among 405 patients (mean age: 46.59±12.74 years; 68.6% female), 171 exhibited CLNM, highlighting the clinical urgency for accurate prediction. Among the 405 patients, 171 exhibited CLNM. The radiomics models demonstrated area under the curve (AUC) values of 0.760 in internal validation and 0.748 in the external test cohort. The deep learning models demonstrated improved performance with AUCs of 0.794 and 0.756 in the internal and external test sets. Notably, the highest AUC values of 0.897 (internal validation) and 0.881 (external test set) were obtained by the radiomics-deep learning fusion SVM model incorporating both intra- and peri-tumoral regions. DeLong's test confirmed statistically significant improvements (P<0.05) of the fusion model over the intra-tumoral radiomics model (P=0.008), intra-tumoral deep learning model (P=0.005), and combined intra-tumoral radiomics-deep learning model (P=0.01). However, no significant differences were observed compared to the combined intra- and peri-tumoral deep learning model (P=0.17). Decision curve analysis indicated that the fusion model offers greater clinical utility in predicting CLNM. Conclusions:The integration of radiomics and deep learning features significantly enhances the diagnostic performance for predicting CLNM in papillary thyroid carcinoma (PTC). The radiomics-deep learning fusion SVM model outperforms individual radiomics and deep learning models, demonstrating substantial potential for clinical application in improving surgical decision-making and patient management. The fusion model could reduce unnecessary central lymph node dissections (CLNDs) and improve surgical planning by providing personalized risk stratification.

This study aimed to investigate the association between obesity indices and endothelial dysfunction, and evaluate the temporal effects of Metabolic and bariatric surgery (MBS)-induced weight loss on vascular endothelial function and structural remodeling. A total of 224 individuals completed the study before and 1, 3, 6, and 12 months after MBS. Body Mass Index (BMI) and Conicity Index (CI) were used to quantify obesity severity, while Flow-Mediated Dilation (FMD) and Carotid Intima-Media Thickness (cIMT) served as indicators of endothelial function and vascular structural integrity, respectively. The impact of MBS on endothelial function and structure was then evaluated through a longitudinal study. Preoperative analysis showed a negative linear correlation between FMD and BMI (r = -0.173, p < 0.05). This association was markedly amplified in the abdominal obesity parameter of CI (r = -0.434, p < 0.05). CI gradually decreased at 3, 6, and 12 months after surgery, accompanied by a gradual increase in FMD values, while cIMT did not change until 3 months. Subgroup analysis showed that in diabetic patients, as blood glucose and insulin resistance reduced, FMD gradually recovered and approached normal. Individuals with abdominal obesity exhibit obvious endothelial dysfunction. MBS can effectively achieve sustained weight loss within 12 months, improve endothelial function, and reduce cardiovascular disease risk factors.

Benign and malignant breast tumors differ in their microvasculature morphology and distribution. Histologic biomarkers of malignant breast tumors are also correlated with the microvasculature. There is a lack of imaging technology for evaluating the microvasculature. Ultrasound localization microscopy (ULM) can provide detailed microvascular architecture at super-resolution. The objective of this trial is to explore the role of ULM in distinguishing benign from malignant breast tumors and to explore the correlations between ULM qualitative and quantitative parameters and histologic biomarkers in malignant breast tumors. This prospective and multicenter study will include 83 patients with breast tumors that will undergo ULM. 55 patients will be assigned to the malignant group, and 28 patients will be assigned to the benign group. The primary outcome is the differences in the qualitative parameters (microvasculature morphology, distribution, and flow direction) between benign and malignant breast tumors on ULM. Secondary outcomes include (1) differences in the quantitative parameters (microvasculature density, tortuosity, diameter, and flow velocity) between benign and malignant breast tumors based on ULM; (2) diagnostic performance of the qualitative parameters in distinguishing benign and malignant breast tumors; (3) diagnostic performance of the quantitative parameters in distinguishing benign and malignant breast tumors; (4) relationships between the qualitative parameters and histologic biomarkers in malignant breast tumors; (5) relationships between the quantitative parameters and histologic biomarkers in malignant breast tumors; and (6) the evaluation of inter-reader and intra-reader reproducibility. Detecting vascularity in breast tumors is of great significance to differentiate benign from malignant tumors and to predict histologic biomarkers. These histologic biomarkers, such as ER, PR, HER2 and Ki67, are closely related to prognosis evaluation. This trial will provide maximum information about the microvasculature of breast tumors and thereby will help with the formulation of subsequent differential diagnosis and the prediction of histologic biomarkers. Chinese Clinical Trial Registry ChiCTR2100048361/6th/July/2021. This study is a part of that clinical trial.

Stent-assisted coiling is a main treatment modality for intracranial aneurysms (IAs) in clinics, but critical challenges remain to be overcome, such as exogenous implant-induced stenosis and reliance on antiplatelet agents. Herein, an endovascular approach is reported for IA therapy without stent grafting or microcatheter shaping, enabled by active delivery of thrombin (Th) to target aneurysms using innovative phase-change material (PCM)-coated magnetite-thrombin (Fe3O4-Th@PCM) FTP nanorobots. The nanorobots are controlled by an integrated actuation system of dynamic torque-force hybrid magnetic fields. With robust intravascular navigation guided by real-time ultrasound imaging, nanorobotic collectives can effectively accumulate and retain in model aneurysms constructed in vivo, followed by controlled release of the encapsulated Th for rapid occlusion of the aneurysm upon melting the protective PCM (thermally responsive in a tunable manner) through focused magnetic hyperthermia. Complete and stable aneurysm embolization is confirmed by postoperative examination and 2-week postembolization follow-up using digital subtraction angiography (DSA), contrast-enhanced ultrasound (CEUS), and histological analysis. The safety of the embolization therapy is assessed through biocompatibility evaluation and histopathology assays. This strategy, seamlessly integrating secure drug packaging, agile magnetic actuation, and clinical interventional imaging, avoids possible exogenous implant rejection, circumvents cumbersome microcatheter shaping, and offers a promising option for IA therapy. A nanorobotic platform engineered to treat intracranial aneurysms (IAs) through rapid and stable embolization by deploying thermal-responsive FTP nanorobots consisting of phase-change material (PCM)-encapsulated magnetite-thrombin (Fe3O4-Th@PCM), which synergistically integrate smart material design, secure drug packaging, agile magnetic actuation, and clinical interventional imaging to circumvent exogenous implant rejection and cumbersome microcatheter shaping for quicker and after IA therapy in clinics. image

Background and aim: New quantitative ultrasound techniques can be used to quantify hepatic steatosis, including tissue attenuation imaging (TAI), tissue scatter -distribution imaging (TSI), and the hepatorenal index (HRI). However, the measurement norms and the effects of fasting on these measurements remain unclear. The present study performed a methodological exploration and investigated the reliability of these measurements. Methods: In total, 103 participants were prospectively recruited for ultrasonography and magnetic resonance imaging (MRI) scans. For the TAI and TSI data, the upper (2 cm), middle (4 cm) and lower (6 cm) areas determined according to the depth of the region of interest from the liver capsule, were sampled three times. Correlation analyses were performed to compare the measurements of TAI, TSI, and HRI with the controlled attenuation parameter (CAP) or MRI-proton density fat fraction (MRI-PDFF). Intra- and inter-operator repeatability was assessed using intraclass correlation coefficients. The effects of fasting on these measurements were then compared. Results: The TAI and TSI measurements obtained from the upper and middle depths exhibited stronger correlations with the CAP measurements than those obtained from the lower depth. Specifically, the mean TAI had a significant positive correlation with MRI-PDFF (r = 0.753, P < 0.0001). TAI and TSI measurements exhibited excellent intra- (0.933 and 0.925, respectively) and inter- (0.896 and 0.766, respectively) examiner reliability. However, the correlation between HRI and CAP measurements was only 0.281, with no significant correlation with MRI-PDFF, and intraand inter-examiner reproducibility of 0.458 and 0.343, respectively. Fasting did not affect these measurements. Conclusions: TAI , TSI measurements demonstrated good intra- and interobserver reliability and correlated well with CAP and MRI-PDFF measurements. However, in practice -based clinical applications, the sampling depth should be controlled within 2 -4 cm of the hepatic capsule; no fasting is required before the examination.

ObjectiveThis study aims to investigate the diagnostic value of three-dimensional pelvic ultrasound in the preoperative assessment of anal fistula compared with findings of MRI and surgery.MethodsA total of 67 patients (62 males) with suspected anal fistula were analyzed retrospectively. Preoperative three-dimensional pelvic ultrasound and magnetic resonance imaging were performed in all patients. The number of internal openings and the type of fistula were recorded. The accuracy of three-dimensional pelvic ultrasound was determined by comparing these parameters with surgical outcomes.ResultsAt surgery, 5 (6%) were extrasphincteric, 10 (12%) were suprasphincteric, 11 (14%) were intersphincteric, and 55 (68%) were transsphincteric. There was no significant difference in the accuracy of pelvic 3D US and MRI, based on internal openings (97.92%, 94.79%), anal fistulas (97.01%, 94.03%), and those under Parks classification (97.53%, 93.83%).ConclusionThree-dimensional pelvic ultrasound is a reproducible and accurate method for determining the type of fistula and detecting internal openings and anal fistulas.

Purpose:Endothelial dysfunction, which was associated with chronic hypothyroidism, was an early event in atherosclerosis. Whether short-term hypothyroidism following thyroxine withdrawal during radioiodine (RAI) therapy was associated with endothelial dysfunction in patients with differentiated thyroid cancer (DTC) was unclear. Aim of the study was to assess whether short-term hypothyroidism could impair endothelial function and the accompanied metabolic changes in the whole process of RAI therapy.Methods:We recruited fifty-one patients who underwent total thyroidectomy surgery and would accept RAI therapy for DTC. We analyzed thyroid function, endothelial function and serum lipids levels of the patients at three time points: the day before thyroxine withdrawal(P1), the day before 131I administration(P2) and 4-6 weeks after RAI therapy(P3). A high-resolution ultrasound named flow-mediated dilation (FMD) was used to measure endothelial function of the patients.Results:We analyzed the changes of FMD, thyroid function and lipids at three time points. FMD(P2) decreased significantly compared to FMD(P1) (P1vsP2, 8.05 ± 1.55vs 7.26 ± 1.50, p<0.001). There was no significant difference between FMD(P3) and FMD(P1) after restoring TSH (thyroid stimulating hormone) suppression therapy (P1 vs P3, 8.05 ± 1.55 vs 7.79 ± 1.38, p=0.146). Among all parameters, the change of low-density lipoprotein (ΔLDL) was the only factor correlated negatively with the change of FMD (ΔFMD) throughout the RAI therapy process (P1-2, r=-0.326, p=0.020; P2-3, r=-0.306, p=0.029).Conclusion:Endothelial function was transiently impaired in DTC patients at short-term hypothyroidism state during the RAI therapy, and immediately returned to the initial state after restoring TSH suppression therapy.

OBJECTIVE:To establish a nomogram for predicting cervical lymph node metastasis (CLNM) based on the preoperative conventional ultrasound (US) and shear wave velocity (SWV) features of papillary thyroid carcinoma (PTC). METHODS:A total of 101 patients with pathologically confirmed thyroid nodules were enrolled. These patients were divided into the CLNM-positive (n = 40) and CLNM-negative groups (n = 61). All patients underwent the preoperative conventional US and shear wave elastography (SWE) evaluation, and the US parameters and SWV data were collected. The association between SWV ratio and CLNM was compared to assess the diagnostic efficacy of SWV ratio alone as opposed to SWV ratio in combination with the conventional US for predicting CLNM. RESULTS:There were significant differences in shape, microcalcification, capsule contact, SWV mean, and SWV ratio between the CLNM-positive and CLNM-negative groups (P < 0.05). Logistic regression analysis showed that taller-than-wide shape, microcalcification, capsule contact, and SWV ratio > 1.3 were risk factors for CLNM; Logistic(P)=-6.93 + 1.647 * (microcalcification)+1.138 * (taller-than-wide-shape)+1.612 * (capsule contact)+2.933 * (SWV ratio > 1.3). The area under the curve (AUC) of the receiver operating characteristic (ROC) of the model for CLNM prediction was 0.87, with 81.19% accuracy, 77.5% sensitivity, and 85.25% specificity. CONCLUSION:The nomogram based on conventional US imaging in combination with SWV ratio has the potential for preoperative CLNM risk assessment. This nomogram serves as a useful clinical tool for active surveillance and treatment decisions.

Background The differences in benign and malignant breast tumors are not only within the nodules but also involve changes in the surrounding tissues. Radiomics can reveal many details that are not discernible to the naked eye. This study aimed to distinguish between benign and malignant breast nodules using an ultrasound-based intra- and peritumoral radiomics model. Methods This study retrospectively collected the information from 379 patients with Breast Imaging Reporting and Data System (BI-RADS) category 3–5 nodules and clear pathological diagnosis of breast nodules screened by routine ultrasound examination in the Sixth People’s Hospital Affiliated to Medical College of Shanghai Jiao Tong University from January 2017 to December 2022. The largest dimension of the lesion on the 2D ultrasound image was selected to outline the area of interest which was conformally and outwardly expanded automatically by 5 mm to extract intra- and peritumor radiomics features. The included cases were randomly divided into training sets and test sets in a ratio of 7:3. The optimal features of the included models were retained by statistical and machine learning methods of dimensionality reduction, and logistic regression was used as the classifier to build an intratumoral model and a combined intratumoral-peritumoral radiomics model, respectively; through single-factor and multifactor logistic regression, the optimal features that could predict benign and malignant breast tumors were screened. The clinical and imaging models were established by selecting independent risk factors as clinical and imaging features through univariate and multifactorial logistic regression. Results Among 379 BI-RADS category 3–5 breast nodules, there were 124 malignant nodules and 255 benign nodules; patients were aged 14 to 88 (46.22±15.51) years, and the age differences, radiomics score, and mass diameter between the training and test sets were not statistically significant (P>0.05). The intra- and peritumor radiomics model had an area under the curve (AUC) of 0.840 [95% confidence interval (CI): 0.766–0.914] in the test set. The model with intra- and peritumoral ultrasound radiomics features combined with clinical features had an AUC value of 0.960 (95% CI: 0.920–0.999). Conclusions The nomogram, developed using intratumoral and peritumoral radiomics features combined with clinical risk features, demonstrated superior performance in distinguishing between benign and malignant BI-RADS 3–5 lesions.

Viral pneumonia has always been a problem faced by clinicians because of its insidious onset, strong infectivity, and lack of effective drugs. Patients with advanced age or underlying diseases may experience more severe symptoms and are prone to severe ventilation dysfunction. Reducing pulmonary inflammation and improving clinical symptoms is the focus of current treatment. Low-intensity pulsed ultrasound (LIPUS) can mitigate inflammation and inhibit edema formation. We aimed to investigate the efficacy of therapeutic LIPUS in improving lung inflammation in hospitalized patients with viral pneumonia. Sixty eligible participants with clinically confirmed viral pneumonia will be assigned to either (1) intervention group (LIPUS stimulus), (2) control group (null stimulus), or (3) self-control group (LIPUS stimulated areas versus non-stimulated areas). The primary outcome will be the difference in the extent of absorption and dissipation of lung inflammation on computed tomography. Secondary outcomes include changes in lung inflammation on ultrasonography images, pulmonary function, blood gas analysis, fingertip arterial oxygen saturation, serum inflammatory factor levels, the sputum excretion volume, time to the disappearance of pulmonary rales, pneumonia status score, and course of pneumonia. Adverse events will be recorded. This study is the first clinical study of the efficacy of therapeutic LIPUS in the treatment of viral pneumonia. Given that the current clinical recovery mainly depends on the body’s self-limiting and conventional symptomatic treatment, LIPUS, as a new therapy method, might be a major advance in the treatment of viral pneumonia. ChiCTR2200059550 Chinese Clinical Trial Registry, May 3, 2022.

Introduction: We explored whether visceral fat accumulation mediates the development of hepatic steatosis in individuals living with overweight and obesity. Methods: This cross-sectional study enrolled 769 outpatients with overweight and obesity aged 18–65 years. The controlled attenuation parameter (CAP) was used to quantify the degree of hepatic steatosis. Visceral fat accumulation, represented by the visceral fat area (VFA), was measured using magnetic resonance imaging. The associations of body mass index (BMI), VFA, and CAP with each other were assessed by univariate analysis, multivariate linear regression, and mediation analysis, respectively. Results: Compared with women, male subjects had higher BMI, VFA, and CAP levels. In both sex, CAP was positively correlated with BMI and VFA by the univariate analysis. After adjusting for demographic and serum characteristics, the linear correlation coefficients between BMI and CAP were 1.738 (95% confidence interval (CI): 1.100, 2.377), 1.524 (95% CI: 0.798, 2.249), and 2.650 (95% CI: 1.292, 4.009) in all subjects, females, and males, respectively, while those between VFA and CAP were 0.190 (95% CI: 0.133, 0.247), 0.184 (95% CI: 0.117, 0.252), and 0.194 (95% CI: 0.086, 0.301). Mediation analysis showed that visceral fat accumulation contributed to 51.37%, 53.85%, and 26.51% of obesity-induced hepatic steatosis in the total, female, and male subjects, respectively. Conclusion: Visceral fat accumulation partially mediates obesity-induced hepatic steatosis in individuals with overweight and obesity, especially in women. More focus on visceral fat reduction is needed in individuals with obesity.

Purpose As a public health emergency of international concern, coronavirus disease 2019 (COVID-19) still lacks specific antiviral drugs, and symptomatic treatment is currently the mainstay. The overactivated inflammatory response in COVID-19 patients is associated with a high risk of critical illness or even death. Low-intensity pulsed ultrasound (LIPUS) can mitigate inflammation and inhibit edema formation. We aimed to investigate the efficacy of LIPUS therapy for COVID-19 pneumonia.Materials and Methods 62 patients were randomly assigned to a treatment group (LIPUS treatment area - Group 1; self-control area - Group 2) and an external control group (Group 3). The primary outcomes were the volume absorption rate (VAR) and the area absorption rate (AAR) of lung inflammation in CT images.Results After an average duration of treatment 7.2 days, there were significant differences in AAR and VAR between Group 1 and Group 2 (AAR 0.25 vs 0.12, p=0.013; VAR 0.35 vs 0.11, p=0.005), and between Group 1 and Group 3 (AAR 0.25 vs 0.11, p=0.047; VAR 0.35 vs 0.19, p=0.042). Neither AAR nor VAR was statistically different between Group 2 and Group 3. After treatment, C-reactive protein, interleukin-6, leukocyte, and fingertip arterial oxygen saturation (SaO2) improved in Group 1, while in Group 3 only fingertip SaO2 increased.Conclusion LIPUS therapy reduced lung inflammation and serum inflammatory factor levels in hospitalized COVID-19 patients, which might be a major advancement in COVID-19 pneumonia therapy.

ObjectivesThe study aimed to observe, measure the size and elastic value of perineal body (PB) and assess its association with levator hiatus.MethodsDatasets were acquired in 45 nulliparous, 66 POP women and 70 postpartum women using ultrasound. The PB was measured in depth, height, and Young’s modulus. The datasets were compared to assess whether there are some differences in the morphology, dimension and elastography modulus of PB among women. Pearson correlation analysis was used to evaluate the association between the morphology measurements (ΔValsalva-rest[v-r]), tissue mechanical properties (ΔValsalva-rest[v-r]) of the PB and levator hiatus area (ΔValsalva-rest[v-r]) to preliminarily explore whether PB can influence levator hiatus.ResultsFour representative manifestations of PB were presented in our study. Nulliparous women had smaller diameters and bigger Young’s modulus while postpartum women had bigger diameters and smaller Young’s modulus. POP and postpartum women had bigger levator hiatal distensibility and PB extensibility. There was no statistical association between PB measurements and levator hiatal area.ConclusionIt is feasible to observe the morphology of PB and assess the dimension and elastography modulus by high-frequency ultrasound. The manifestations and measurements of PB are influenced by parity and long-term increased abdominal pressure. Our study preliminarily shows that PB has little effect on levator hiatus area.

Increasing data indicate that long noncoding RNA (lncRNA) DLEU2 is implicated in carcinogenesis in multiple malignancies including hepatocellular carcinoma (HCC). However, the role and molecular mechanism by which lncRNA DLEU2 contributes to HCC remain unknown. The association of lncRNA DLEU2 with clinicopathological characteristics and prognosis in patients with HCC was analyzed by qRT-PCR, and public TCGA dataset. CCK-8, colony formation and Transwell assays were performed to verify the role of lncRNA DLEU2 in HCC. RNA immunoprecipitation (RIP), luciferase gene report and qRT-PCR assays were employed to uncover lncRNA DLEU2-spevific binding with miR-30a-5p. The effect of lncRNA DLEU2 and (or) miR-30a-5p on PTP4A1 expression was examined by Western blot analysis. As a consequence, we found that lncRNA DLEU2 was upregulated in HCC tissue samples and associated with distant metastasis and poor survival in patients with HCC. Knockdown of lncRNA DLEU2 impaired HCC cell proliferation, colony formation and invasion, but ectopic expression of lncRNA DLEU2 abolished these effects. Furthermore, lncRNA DLEU2 harbored a negative correlation and specific binding with miR-30a-5p in HCC cells. Knockdown of lncRNA DLEU2 upregulated miR-30a-5p, but downregulated its target PTP4A1, and miR-30a-5p abrogated lncRNA DLEU2-induced tumor-promoting effects and PTP4A1 upregulation. Taken together, our findings demonstrate that lncRNA DLEU2 promotes growth and invasion of HCC cells by regulating miR-30a-5p/ PTP4A1 axis.

目的 针对目前有效提高纳米颗粒在肿瘤内富集的研究较少,文中旨在探讨微泡辅助低频超声(MAUS)联合纳米颗粒表面结构的优化对纳米颗粒在前列腺癌原位瘤内富集和抗前列腺癌治疗的增效作用.方法 制备表面修饰IR825的二氧化硅包裹内部磁性Fe3 O4的特殊核壳结构纳米颗粒,并进行性质评价.通过溶血实验、主要器官的HE染色评价纳米颗粒的体内安全性.将小鼠随机分为6组:MSSN-IR825组(仅尾静脉注射MSSN-IR825)、MSSN-IR825+MAUS组(尾静脉注射MSSN-IR825,同时采用MAUS递送)、MMSN-IR825组(仅尾静脉注射MMSN-IR825)、MMSN-IR825+MAUS组(尾静脉注射MMSN-IR825,同时采用MAUS递送)、MVSN-IR825组(仅尾静脉注射MVSN-IR825)、MVSN-IR825+MAUS组(尾静脉注射MVSN-IR825,同时采用MAUS递送).每组5只,尾静脉前及给药后20 h监测采集肿瘤光声信号.将小鼠随机分为对照组(单纯尾静脉注射相同体积的等渗盐水)和激光辐照组(尾静脉注射MVSN-IR825,同时采用MAUS递送,注射20 h后开始近红外激光辐照原位肿瘤治疗),通过超声监测激光辐照后荷瘤小鼠的肿瘤大小、肿瘤组织HE染色、Ki67染色及活性氧染色评价抑瘤效果.结果 合成了粒径相仿、生物相容性较好的光滑、介孔、仿病毒表面的纳米颗粒.HE染色及溶血性实验表明纳米颗粒具有较好的生物安全性.光声成像显示MVSN-IR825瘤内富集的光声信号明显多于MSSN-IR825和MMSN-IR825;当联合使用MAUS后,瘤内光声信号显著增强.超声监测激光辐照后的原位瘤大小所示,对照组原位瘤10 d后体积显著增加,激光辐照组的原位瘤大小得到明显抑制.与对照组相比,MVSN-IR825+MAUS组DHE染色可见明显活性氧产生的红色荧光.HE染色可见肿瘤细胞部分破坏、Ki67染色表达相对降低.结论 联合使用MAUS及仿病毒结构优化可提高纳米颗粒在前列腺原位瘤的摄取,近红外激光辐照后可通过光热及光动力效果抑制PC-3前列腺癌原位瘤.

ObjectiveVascular endothelial dysfunction is considered an early predictor of endothelial injury and the initiating factor of atherosclerosis (AS). Brachial artery flow-mediated dilation (FMD) can detect endothelial injury early and provide important prognostic information beyond traditional cardiovascular (CV) risk factors. This study aimed to find the influencing factors of FMD and develop a simple prediction model in populations with different body mass indices (BMIs).MethodsIn total, 420 volunteers with different BMIs were recruited in our study. Subjects were randomly assigned to the derivation and validation cohorts (the ratio of the two was 1:2) with simple random sampling. The former was used for influencing factors searching and model construction of FMD and the latter was used for verification and performance evaluation.ResultsThe population was divided into two groups, i.e., 140 people in the derivation group and 280 people in the verification group. Analyzing in the training data, we found that females had higher FMD than males (p < 0.05), and FMD decreased with age (p < 0.05). In people with diabetes, hypertension or obesity, FMD was lower than that in normal individuals (p < 0.05). Through correlation analysis and linear regression, we found the main influencing factors of FMD: BMI, age, waist-to-hip radio (WHR), aspartate aminotransferase (AST) and low-density lipoprotein (LDL). And we developed a simple FMD prediction model: FMD = −0.096BMI−0.069age−4.551WHR−0.015AST−0.242LDL+17.938, where R2 = 0.599, and adjusted R2 = 0.583. There was no statistically significant difference between the actual FMD and the predicted FMD in the verification group (p > 0.05). The intra-class correlation coefficient (ICC) was 0.77. In a Bland-Altman plot, the actual FMD and the predicted FMD also showed good agreement. This prediction model had good hints in CV risk stratification (area under curve [AUC]: 0.780, 95 % confidence intervals [95% CI]: 0.708–0.852, p < 0.001), with a sensitivity and specificity of 73.8 and 72.1%, respectively.ConclusionsMales, older, obesity, hypertension, diabetes, smoking, etc. were risk factors for FMD, which was closely related to CV disease (CVD). We developed a simple equation to predict FMD, which showed good agreement between the training and validation groups. And it would greatly simplify clinical work and may help physicians follow up the condition and monitor therapeutic effect. But further validation and modification bears great significance.

Abstract Purpose The first aim of this study was to observe the morphology of perineal body (PB) through two-dimensional (2D) high-frequency ultrasound. Secondary aims were to estimate PB tissue properties using shear wave elastography (SWE) technology, and to explore the supportive mechanism of PB on levator hiatus (LH) and different pelvic compartments preliminarily. Methods This retrospective study investigated 258 women who went to urogynecological clinic. Women were divided into different groups after clinical examination and ultrasound scan. 2D ultrasound with SWE technology was peformed to observe the morphology of PB and estimate elastic module. The supportive function of PB on pelvic compartments was evaluated by studying the relationship between the mobility of PB and bladder, uterus and anorectal junction. The supportive function of PB on LH was evaluated by studying the measurements varieties. ANOVA and Pearson analysis were used for statistical analysis.Results Four representative ultrasonic manifestations of PB morphology were presented in our study. The PB diameters and Young’s modulus showed statistical difference between groups. Compared with bladder and uterus, the mobility of PB is more related to anorectal junction. There was no statistical difference between the changes of both PB morphology measurements and Young’s modulus and LH dimensions.Conclusion The study confirmed that it was feasible to observe the morphology of PB and evaluated elastic function by ultrasound scan. PB is influenced by parity and strongly associated with posterior pelvic compartment. PB has no significant effect on limiting the size of LH.

目的:探讨三维超声技术对于评估压力性尿失禁(SUI)女性患者盆底肌肉收缩及膀胱颈活动度的价值.方法:选取2020年1月至2021年8月本院的收治的因产后SUI的女性患者60例作为观察组,另选择同期产后正常的女性受试者60例作为对照组,所有受试者均行经会阴三维超声检查.比较两组之间盆底肌肉收缩及膀胱颈活动度等相关指标的差异.结果:在静息状态和最大Valsalva状态下,观察组中盆膈裂孔前后径、左右径、肛提肌裂孔面积以及膀胱颈后角均显著大于对照组(P＜0.05),观察组尿道长度显著低于对照组(P＜0.05);而仅在最大Valsalva状态下,观察组的膀胱颈位置显著低于对照组(P＜0.05);此外观察组膀胱漏斗化所占比例显著高于对照组(P＜0.05).结论:三维超声技术可以清晰直观地显示女性盆底组织结构和功能,对于评估SUI女性患者盆底肌肉收缩及膀胱颈活动度具有一定的诊断价值,并为临床提供真实客观的影像学证据.

BackgroundDiastolic wall shear stress (WSS), assessed by using vector flow mapping (VFM), is the result of the interaction between the blood flow and the ventricular wall. This study aimed to evaluate the trend of left ventricular (LV) WSS in normal subjects.Methods and resultsA total of 371 healthy volunteers were recruited and divided into four age groups (group I: 18–30 years; group II: 31–43 years; group III: 44–56 years; group IV: 57–70 years). LV WSS of different age groups was measured at each diastolic phase (P1: isovolumic diastolic period, P2: rapid filling period, P3: slow filling period, and P4:atrial contraction period) to evaluate the change trend of LV WSS. In each age group, LV WSS coincided with a trend of increasing-decreasing-increasing during P1–P4 (P < 0.05). Besides, among groups I, II, III, and IV, WSS of anterolateral, inferoseptal, and anteroseptal in P1 and WSS of inferolateral, inferoseptal, and anteroseptal in P4 all showed an increasing trend with age (P < 0.05). Regarding sex differences, women had greater diastolic WSS compared to men (P < 0.05).ConclusionLV WSS showed a regular variation and had specific age- and sex-related patterns in different diastolic phases.

ObjectiveNon-alcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver disease. The controlled attenuation parameter (CAP) obtained by FibroScan reflects the level of liver steatosis in patients with obesity. Our study aimed to construct a simple equation to predict the CAP, to facilitate the screening and monitoring of patients at high risk for NAFLD.MethodsA total of 272 subjects were randomly divided into derivation and validation cohorts at a ratio of 1:2. The derivation set was used for constructing a multiple linear regression model; the validation set was used to verify the validity of the model.ResultsSeveral variables strongly correlated with the CAP were used to construct the following equation for predicting CAP values:CAP1 = 2.4 × BMI + 10.5 × TG+ 3.6 × NC + 10.3 × CP +31.0, where BMI is body mass index, TG is triglyceride, NC is neck circumference and CP is C-peptide. The CAP1 model had an R2 of 0.764 and adjusted R2 of 0.753. It was then simplified to derive CAP2 included only simple anthropometric parameters: CAP2 = 3.5 × BMI + 4.2 × NC + 20.3 (R2 = 0.696, adjusted R2 = 0.689). The data were well fitted by both models. In the verification group, the predicted (CAP1 and CAP2) values were compared to the actual CAP values. For the CAP1 equation, R2 = 0.653, adjusted R2 = 0.651. For the CAP2 equation, R2 = 0.625, adjusted R2 = 0.623. The intra-class correlation coefficient (ICC) values were 0.781 for CAP1 and 0.716 for CAP2 (p < 0.001). The actual CAP and the predicted CAP also showed good agreement in Bland-Altman plot.ConclusionThe equations for predicting the CAP value comprise easily accessible variables, and showed good stability and predictive power. Thus, they can be used as simple surrogate tools for early screening and follow-up of NAFLD in the Chinese population.