Transapical mitral valve edge-to-edge repair (TA-TEER) offers a therapeutic option for obstructive hypertrophic cardiomyopathy with severe mitral regurgitation and systolic anterior motion. In this case series, we present 3 elderly patients with obstructive hypertrophic cardiomyopathy who underwent TA-TEER after declining conventional surgical options. Patient 1: A 66-year-old woman achieved immediate resolution of mitral regurgitation and systolic anterior motion, but developed hemolysis and hypotension at 2 weeks, requiring mechanical valve replacement. Patient 2: A 65-year-old man showed sustained improvement with resolved mitral regurgitation and systolic anterior motion at 4-month follow-up. Patient 3: A 70-year-old woman demonstrated immediate resolution with stable results. TA-TEER successfully addressed mitral regurgitation and systolic anterior motion in all cases, though 1 patient experienced serious complications requiring reoperation. Although TA-TEER may serve as a salvage option for high-risk patients, careful patient selection and awareness of potential complications are essential.

Background and objective:Aortic regurgitation (AR) is a common valvular heart disease. Despite advances in surgical techniques, unplanned readmission rates after surgery remain high. This study aimed to investigate the risk of postoperative unplanned readmission in patients with only mildly impaired left ventricular ejection fraction (LVEF 55%-60%) but concomitant left ventricular enlargement. Methods:This single-center retrospective cohort study enrolled 841 adult patients diagnosed with aortic regurgitation who underwent surgical treatment at our hospital between January 2020 and December 2024. All patients underwent transthoracic echocardiography (TTE) within 3 days before surgery. The primary endpoint event was unplanned readmission during postoperative follow-up. Results:During follow-up, 46 patients experienced unplanned readmission. Risk factor analysis for readmission indicated that patients in the LVEF 55%-60% group had significantly higher risk of postoperative readmission [HR (95% CI): 4.118 (1.488-11.397), P = 0.006]. Further Cox proportional hazards regression analysis revealed that LVEDD > 65 mm and LVEF <60% were significant risk factors for unplanned readmission during postoperative follow-up (P < 0.05). Among all patients with unplanned readmissions, 21 cases had both LVEDD > 65 mm and LVEF < 60%, of whom 12 patients (57.14%) had an LVEF of 55%-60%. Cox regression analysis showed that patients meeting both risk factors had a significantly higher risk of unplanned readmission compared to those with neither risk factor [HR (95% CI): 2.548 (1.174-5.534), P = 0.018]. Conclusion:Patients with mildly impaired left ventricular ejection fraction (LVEF 55%-60%) combined with significant left ventricular dilation (LVEDD >65 mm) constitute a high-risk cohort for unplanned readmission postoperatively. For patients with aortic regurgitation, even those exhibiting only mildly impaired LVEF, coexisting significant left ventricular dilation warrants heightened vigilance regarding readmission risk.

Both obstructive sleep apnea (OSA)and patent foramen ovale (PFO) can lead to changes in blood oxygen. However, it is unclear whether PFO exacerbates the blood oxygen indicators of OSA. This case series study included patients who underwent contrast-enhanced transcranial Doppler (c-TCD) and polysomnography (PSG examination) between January 2017 to December 2023 at the Third Affiliated Hospital of Yan’an University. Based on c-TCD and PSG results, patients were categorized into two groups: OSA and PFO double-positive group (OSA + PFO), OSA single-positive group (OSA). Furthermore, both the OSA + PFO and OSA groups were further subdivided into mild (5 times/hour ≤ AHI < 15 times/hour), moderate (15 times/hour ≤ AHI < 30 times/hour) and severe (AHI ≥ 30 times/hour) groups according to their apnea-hypopnea index (AHI). This study compared the minimum oxygen saturation, oxygen desaturation index (ODI), the percentage of cumulative time with oxygen saturation < 90

Objective:This research intends to probe the clinical value of combining Sonazoid-contrast-enhanced ultrasound (S-CEUS) quantitative analysis with shear wave elastography (SWE) for discriminating and diagnosing the nature of breast tumors. Methods:A total of 108 breast tumor patients (comprising 120 breast lesions) who were classified as category 4 breast tumor cases and underwent routine ultrasound examinations (June 2022-June 2023) were selected for this study. S-CEUS and SWE examinations were conducted on these breast lesions. The morphological characteristics of S-CEUS were assessed, including morphology (regular, irregular), boundary (clear, unclear), and internal enhancement (no enhancement, homogeneous enhancement, heterogeneous enhancement), along with dynamic enhancement features. Additionally, the maximum Young's modulus (Emax) from SWE examinations was recorded, and the results were compared to the gold standard in pathology. The diagnostic efficacy of S-CEUS quantitative analysis, SWE alone, or their combined assessment in determining the nature of breast tumors was evaluated. Results:Among the cohort of 108 patients, a total of 120 category 4 breast lesions were analyzed, revealing 68 cases (56.67%) of pathologically confirmed malignant breast tumors and 52 cases (43.33%) of benign breast tumors. Malignant breast tumors exhibited irregular morphology, unclear boundaries, heterogeneous internal enhancement, high enhancement levels, increased enhancement ranges, perfusion defects, and predominantly washout-type time-signal intensity curve patterns. These characteristics were significantly more prevalent in malignant tumors compared to benign tumors (p<0.05). Furthermore, quantitative assessment denoted that malignant breast tumors showcased higher CEUS quantitative scores than benign tumors (p<0.05). The Emax for malignant breast tumors was (91.36 ± 24.15) kPa, which was considerably higher than that for benign breast tumors [(49.86 ± 20.31) kPa] (t=9.981, p<0.05). Receiver operating characteristic (ROC) curve analysis demonstrated favorable diagnostic performance in evaluating the nature of breast tumors using S-CEUS quantitative analysis (AUC: 0.845) or SWE alone (AUC: 0.789). Particularly noteworthy was the optimal diagnostic efficacy achieved through the combined assessment of S-CEUS quantitative analysis and SWE (AUC: 0.916), yielding sensitivities and specificities of 95.59% and 80.77%, respectively. Conclusion:Both S-CEUS quantitative analysis and SWE are valuable tools for the evaluation of benign and malignant characteristics in breast tumors. Particularly, their combined application demonstrates superior diagnostic efficacy.

Secondary hyperparathyroidism (SHPT) is characterized by parathyroid hyperplasia, persistently elevated parathyroid hormone levels, and disturbances in mineral metabolism. Currently, a considerable amount of literature has consistently shown that thermal ablation is effective in maintaining parathyroid hormone levels within an appropriate range, normalizing calcium and phosphorus levels, improving clinical symptoms, and reducing the volume of parathyroid glands. However, there are currently no established guidelines regarding its utilization. The Asian consensus statement of experts on thermal ablation for SHPT in chronic kidney disease was jointly initiated by experts from China and Korea in the fields of nephrology, interventional ultrasound or radiology, thyroid surgery, ultrasound medicine, nuclear medicine, and diagnostic radiology-to formulate recommendations aimed at establishing standardized protocols for thermal ablation targeting the parathyroid glands. Based on the systematic review of literatures related to ultrasound-guided thermal ablation of parathyroid glands and the professional opinions of experts, the consensus statement covers the relevant content regarding thermal ablation treatment for SHPT, including indications, contraindications, pre-ablation evaluation, operational procedures, post-ablation follow-up, therapeutic effect evaluation, complications prevention and treatment. According to the Grading of Recommendations Assessment, Development and Evaluation, a total of 18 recommendations were given. This consensus statement will positively promote the standardization of ultrasound-guided thermal ablation of parathyroid glands.

OBJECTIVE:To explore the diagnostic value of shear wave elastography (SWE) for clinically significant prostate cancer (csPCa). METHODS:We retrospectively analyzed the clinical data of 359 cases with suspected prostate cancer (PCa) in Baoji Central Hospital from June 2017 to July 2023. All the patients underwent the following examinations in the order of serum prostate-specific antigen (PSA) testing, transrectal ultrasonography (TRUS), measurement of the stiffness of the entire prostate gland by SWE, and TRUS-guided prostate puncture biopsy. The stiffness of the entire prostate gland was defined as the average of Young's modulus at both sides of the base, middle, and apex of the prostate, including the maximum Young's modulus (Emax), mean Young's modulus (Emean), and minimum Young's modulus (Emin). We analyzed the correlation of the parameters of the stiffness of the entire prostate gland with the pathological results, focusing on their diagnostic performance for csPCa. RESULTS:Of the 359 cases, 189 were diagnosed by pathological puncture biopsy as BPH, 26 as non-csPCa, and 144 as csPCa. The PSA level, Emax, Emean and Emin were significantly higher in the csPCa than those in the BPH and non-csPCa groups (all P < 0.01), but showed no statistically significant difference between the BPH and non-csPCa groups (all P > 0.05). The area under the receiver operating characteristic curve (AUC), optimal cut-off value, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of Emax in the diagnosis of csPCa were 0.852, 143.92 kPa, 72.22%, 84.65%, 75.91%, 81.98% and 79.67%; those of Emean were 0.868, 82.42 kPa, 67.36%, 91.16%, 83.62%, 80.66% and 81.62%; and those of Emin were 0.682, 32.73 kPa, 47.22%, 89.30%, 73.91%, 71.54% and 72.14%, respectively. In the non-csPCa group, Emax, Emean and Emin were found below the optimal cut-off value in 73.08% (19/26), 92.31% (24/26) and 88.46% (23/26), respectively. CONCLUSION:The stiffness of the entire prostate gland measured by SWE contributes to the diagnosis of csPCa, reduces unnecessary detection of non-csPCa, and provides some reference for its active surveillance.

Using contrast-enhanced ultrasound (CEUS) and ultrasound resolution microscopy (URM) imaging, this study aimed to evaluate the relationship between microvascular parameters of small hepatocellular carcinoma (sHCC) (≤ 3 cm) and microscopic histological features, which include vessels encapsulating tumour clusters (VETC), microvascular invasion (MVI), and histological grade. Sixteen patients with solitary resected sHCC were prospectively enrolled. CEUS and URM were performed one week before resection. All “ratio” refers to comparisons between the active area (where CEUS microbubble show visible motion track by URM) and the entire lesion. Blood vessel complexity (ratio), blood vessel density (ratio), area (ratio), flow velocity, blood vessel diameter, and perfusion index (“flow velocity” × “vessel ratio”) were analysed using URM. The relationships between URM parameters and microscopic histological features (MVI, VETC, and histological grade) were analysed. There were 5 (31.3

Purpose: OSA and PFO both can lead to changes in blood oxygen. In this study, we sought to determine whether blood oxygen changes were further exacerbated with OSA combined with PFO. Methods: Based on c-TCD and PSG results, 623 patients were retrospectively included. According to the results, the patients were divided into 4 groups: OSA and PFO double-positive group, PFO single-positive group, OSA single-positive group, and OSA and PFO double-negative group. In addition, based on the AHI results, we extracted all the severe and moderate patients, and then used the PFO results to group them into the OSA single-positive Moderate-Severe group and the OSA and PFO double-positive Moderate-Severe group. The minimum oxygen saturation, ODI, sleep time with oxygen saturation <90% (TST90) and the percentage of cumulative time with oxygen saturation below 90% in total sleep time(T90) were analysis. Results: The minimum oxygen saturation, ODI: There were statistical differences the four groups (P < 0.000). However, there was no statistical difference between the double-positive group and the OSA single-positive group. At the same time, there was no statistical difference between the PFO single-positive group and the all-negative group either. In addition, there was no statistical difference between the all-positive group and the OSA single-positive group in the Moderate-Severe group. TST90 and T90: There were statistical differences between the OSA single-positive Moderate-Severe group and the OSA and PFO double-positive Moderate-Severe group. Conclusions: Patients with OSA-PFO overlap had more severe intermittent hypoxia during sleep than patients with OSA alone.

To establish clinical prediction models of vessels encapsulating tumor clusters (VETC) pattern using preoperative contrast-enhanced ultrasound (CEUS) and gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid magnetic resonance imaging (EOB-MRI) in patients with hepatocellular carcinoma (HCC). A total of 111 resected HCC lesions from 101 patients were included. Preoperative imaging features of CEUS and EOB-MRI, postoperative recurrence, and survival information were collected from medical records. The best subset regression and multivariable Cox regression were used to select variables to establish the prediction model. The VETC-positive group had a statistically lower survival rate than the VETC-negative group. The selected variables were peritumoral enhancement in the arterial phase (AP), hepatobiliary phase (HBP) on EOB-MRI, intratumoral branching enhancement in the AP of CEUS, intratumoral hypoenhancement in the portal phase of CEUS, incomplete capsule, and tumor size. A nomogram was developed. High and low nomogram scores with a cutoff value of 168 points showed different recurrence-free survival rates and overall survival rates. The area under the curve (AUC) and accuracy were 0.804 and 0.820, respectively, indicating good discrimination. Decision curve analysis showed a good clinical net benefit (threshold probability > 5%), while the Hosmer-Lemeshow test yielded excellent calibration (P = 0.6759). The AUC of the nomogram model combining EOB-MRI and CEUS was higher than that of the models with EOB-MRI factors only (0.767) and CEUS factors only (0.7). The nomogram verified by bootstrapping showed AUC and calibration curves similar to those of the nomogram model. The Prediction model based on CEUS and EOB-MRI is effective for preoperative noninvasive diagnosis of VETC.

Background: Cervical cancer is the fourth most common cancer among women worldwide. The zinc finger transcription factor 281 (ZNF281)/ZBP-99 protein specifically binds to GC-rich DNA sequences and regulates gene expression, and it has been shown to promote tumor progression. In this study, we aim to investigate the function and molecular mechanism of ZNF281 in uterine cervical carcinoma. Methods: We conducted immunohistochemistry and Western blot assays to determine the expression of ZNF281 in eight human cervical cancer tissues. And, xenograft experiments involving the injection of HeLa cells into nude mice was used to determine the function of ZNF281 on proliferation. Transwell assays were used to detect the migration and invasion of HeLa cells after indicated that ZNF281 overexpression. Results: Our results indicated that ZNF281 protein levels were higher in cervical cancer tissues compared to normal cervical tissues. Additionally, ZNF281 was expressed in human cervical carcinoma cell lines, including HeLa, SiHa, C-33 A, CaSki, and HT-3, and is localized in both the cell nucleus and cytoplasm. ZNF281 overexpression did not influence HeLa cell proliferation or tumor size in situ. Moreover, nude mice injected with ZNF281-overexpressing cell lines developed more tumor lesions in the lungs compared to those injected with control cell lines. Conclusions: These findings suggest that ZNF281 is associated with tumor metastasis without affecting cell proliferation, both in vivo and in vitro.

Purpose: To use Sonazoid contrast-enhanced ultrasound (S-CEUS) and Gadolinium-Ethoxybenzyl-Diethylenetriamine Penta-Acetic Acid magnetic-resonance imaging (EOB-MRI), exploring a non-invasive preoperative diagnostic strategy for microvascular invasion (MVI) of hepatocellular carcinoma (HCC). Methods: 111 newly developed HCC cases were retrospectively collected. Both S-CEUS and EOB-MRI examinations were performed within one month of hepatectomy. The following indicators were investigated: size; vascularity in three phases of S-CEUS; margin, signal intensity, and peritumoral wedge shape in EOB-MRI; tumoral homogeneity, presence and integrity of the tumoral capsule in S-CEUS or EOB-MRI; presence of branching enhancement in S-CEUS; baseline clinical and serological data. The least absolute shrinkage and selection operator regression and multivariate logistic regression analysis were applied to optimize feature selection for the model. A nomogram for MVI was developed and verified by bootstrap resampling. Results: Of the 16 variables we included, wedge and margin in HBP of EOB-MRI, capsule integrity in AP or HBP/PVP images of EOB-MRI/S-CEUS, and branching enhancement in AP of S-CEUS were identified as independent risk factors for MVI and incorporated into construction of the nomogram. The nomogram achieved an excellent diagnostic efficiency with an area under the curve of 0.8434 for full data training set and 0.7925 for bootstrapping validation set for 500 repetitions. In evaluating the nomogram, Hosmer-Lemeshow test for training set exhibited a good model fit with P > 0.05. Decision curve analysis of nomogram model yielded excellent clinical net benefit with a wide range (5-80 % and 85-94 %) of risk threshold. Conclusions: The MVI Nomogram established in this study may provide a strategy for optimizing the preoperative diagnosis of MVI, which in turn may improve the treatment and prognosis of MVI-related HCC.

Background: We investigated the relationship between remnant cholesterol and carotid intraplaque neovascularization (IPN) assessed by contrast -enhanced ultrasonography (CEUS) in patients with ischemic stroke. Methods: This was a single -center study. Remnant cholesterol is calculated as total cholesterol minus low -density lipoprotein cholesterol (LDL-C) minus high -density lipoprotein cholesterol (HDL-C). All patients underwent CEUS. IPN is graded according to the presence and location of microbubbles within each plaque. Results: The cohort included 110 patients with ischemic stroke. Patients with an IPN grading of 2 had higher triglyceride (TG), nonHDL-C, and remnant cholesterol concentrations than those with an IPN grading of < 2 (TG: 1.45 +/- 0.69 vs. 0.96 +/- 0.24 mmol/L, P < 0.001; non-HDL-C: 2.63 +/- 0.85 vs. 2.31 +/- 0.64 mmol/L, P = 0.037; remnant cholesterol: 0.57 +/- 0.23 vs. 0.44 +/- 0.07 mmol/L, P < 0.001). The multivariate -adjusted odds ratio (95% confidence interval) for remnant cholesterol was 27.728 (2.714 - 283.253) for an IPN grading of 2 in the subset of patients with an optimal LDL-C concentration. Conclusions: The remnant cholesterol concentration is significantly associated with carotid IPN on CEUS in patients with ischemic stroke with an optimal LDL-C concentration. Remnant cholesterol may be an important indicator of risk stratification in patients with ischemic stroke.

Post-transplant lymphoproliferative disease (PTLD) is a rare but life-threatening disease that occurs after organ transplantation. Histopathology is the gold standard for the diagnosis of PTLD. Because of its rarity and atypical symptoms, many patients are misdiagnosed with liver abscess, liver cancer, or missed diagnosis long before pathological diagnosis is obtained, thus delaying treatment. Early and accurate diagnosis, in addition to histopathological examination, is difficult. Contrast-enhanced ultrasound (CEUS) imaging techniques have overwhelming advantages of being safe (noninvasive, radiation-free) and sensitive for evaluating the microcirculation of lesions, thus making them widely used in the diagnosis of hepatic lesions. Unfortunately, there are few reports of CEUS data on hepatic PTLD (HPTLD). This study reported and analyzed four cases of HPTLD in detail, all of which underwent pre-biopsy CEUS examinations and had a complete diagnosis and treatment process. By offering readers comprehensive knowledge of CEUS in the diagnosis of HPTLD, our study aims to help reduce misdiagnoses and missed diagnoses, thereby improving patient treatment and prognosis.

Preeclampsia (PE) is a pregnancy-related syndrome that can lead to a variety of pathophysiological processes, such as impaired implantation. The pathogenesis of PE involves circular RNA (circRNA). The study aims to determine the role of a novel circRNA, circ_0003314, in trophoblast cell phenotypes. Circ_0003314, microRNA-26b-5p (miR-26b-5p) and IL-1 receptor accessory protein (IL1RAP) expression were detected by quantitative real-time polymerase chain reaction (qRT-PCR). Cell proliferation was investigated by MTT assay and 5-Ethynyl-2'-deoxyuridine assay. Cell migration and invasion were investigated by transwell assay. Cell apoptotic rate and angiogenesis were investigated by flow cytometry analysis and tube formation assay, respectively. Protein expression was detected by western blotting. The binding relationship between miR-26b-5p and circ_0003314 or IL1RAP was identified using dual-luciferase reporter assay and RNA pull-down assay. Circ_0003314 and IL1RAP expression were significantly increased, while miR-26b-5p was decreased in placental tissues of PE patients. Circ_0003314 overexpression inhibited trophoblast cell proliferation, migration, invasion and angiogenesis and induced cell apoptosis. Additionally, circ_0003314 acted as a sponge for miR-26b-5p, and miR-26b-5p bound to IL1RAP. Introduction of miR-26b-5p or silencing of IL1RAP attenuated the effects of circ_0003314 overexpression on trophoblast cell phenotypes. Further, circ_0003314 induced IL1RAP expression through miR-26b-5p in trophoblast cells. Circ_0003314 regulated trophoblast cell phenotypes by increasing IL1RAP expression through binding to miR-26b-5p.

OBJECTIVE:This study aimed to establish a clinical prediction model for vessels encapsulating tumor clusters (VETC) based on preoperative ultrasonography (US) and contrast-enhanced computed tomography (CECT) imaging in patients with hepatocellular carcinoma (HCC). METHODS:Data were retrospectively collected from 215 patients who underwent hepatectomy for solitary HCC lesions. They were divided into training and validation cohorts at a ratio of 6:4. Preoperative imaging features were extracted (seven from US and nine from CECT imaging) to explore their relationship with VETC. A VETC prediction model was constructed and graphically depicted as a nomogram. Its performance was evaluated via the receiver operating characteristic (ROC) curve, the calibration curve, and decision curve analysis (DCA). RESULTS:The VETC incidence for all the lesions was 37.7%. The final variables included in the nomogram were "peritumoral enhancement in CECT", "alpha-fetoprotein level > 200 ng/Ml," "halo in US," "capsule enhancement in CECT," and "posterior acoustic enhancement in US." The area under the curve (AUC) values for the training and validation cohorts were 0.824 and 0.725, respectively. The Hosmer-Lemeshow fit test showed no statistical difference (p = 0.369 and p = 0.067 for the training and validation cohorts, respectively). DCA demonstrated that our nomogram provided clinical benefits to a wide range of patients. According to the nomogram score, the VETC-positive and -negative groups demonstrated significant differences in both the training (p < 0.001) and validation (p = 0.001) cohorts. CONCLUSION:Our prediction model based on US and CECT imaging features can accurately predict VETC in HCC.

BackgroundEnhanced imaging techniques have the overwhelming advantages of being noninvasive and sensitive enough to evaluate the microcirculation of lesions, thus making them accurate in the diagnosis of hepatic lesions. Unfortunately, there is very little research on and knowledge of the imaging features of a rare cancerous condition: hepatic angiosarcoma (HA).Case summaryIn this study, we retrospectively collected the data of six patients who underwent both contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT), and subsequently obtained a definitive histopathologic diagnosis of HA. We described the imaging appearances of HA by comparing CEUS and CECT images. Furthermore, we analyzed these imaging characteristics from the perspective of histopathology and tumorigenesis. The study included the largest number (six) of histopathologically confirmed HA patients who had received CEUS examinations to date.ConclusionBy offering readers comprehensive knowledge of contrast imaging, especially CEUS, in the diagnosis of HA, our study may reduce misdiagnosis and further improve treatment options.

Background:Significant differences exist in the classification outcomes for radiologists using ultrasonography-based Breast Imaging Reporting and Data Systems for diagnosing category 3-5 (BI-RADS 3-5) breast nodules, due to a lack of clear and distinguishing image features. Consequently, this retrospective study investigated the improvement of BI-RADS 3-5 classification consistency using a transformer-based computer-aided diagnosis (CAD) model. Methods:Independently, 5 radiologists performed BI-RADS annotations on 21,332 breast ultrasonographic images collected from 3,978 female patients from 20 clinical centers in China. All images were divided into training, validation, testing, and sampling sets. The trained transformer-based CAD model was then used to classify test images, for which sensitivity (SEN), specificity (SPE), accuracy (ACC), area under the curve (AUC), and calibration curve were evaluated. Variations in these metrics among the 5 radiologists were analyzed by referencing BI-RADS classification results for the sampling test set provided by CAD to determine whether classification consistency (the k value), SEN, SPE, and ACC could be improved. Results:After the training set (11,238 images) and validation set (2,996 images) were learned by the CAD model, the classification ACC of the CAD model applied to the test set (7,098 images) was 94.89% in category 3, 96.90% in category 4A, 95.49% in category 4B, 92.28% in category 4C, and 95.45% in category 5 nodules. Based on pathological results, the AUC of the CAD model was 0.924 and the predicted probability of CAD was a little higher than the actual probability in the calibration curve. After referencing BI-RADS classification results, the adjustments were made to 1,583 nodules, of which 905 were classified to a lower category and 678 to a higher category in the sampling test set. As a result, the ACC (72.41-82.65%), SEN (32.73-56.98%), and SPE (82.46-89.26%) of the classification by each radiologist were significantly improved on average, with the consistency (k values) in almost all of them increasing to >0.6. Conclusions:The radiologist's classification consistency was markedly improved with almost all the k values increasing by a value greater than 0.6, and the diagnostic efficiency was also improved by approximately 24% (32.73% to 56.98%) and 7% (82.46% to 89.26%) for SEN and SPE, respectively, of the total classification on average. The transformer-based CAD model can help to improve the radiologist's diagnostic efficacy and consistency with others in the classification of BI-RADS 3-5 nodules.

Introduction: Remnant cholesterol is a risk factor for cardiovascular disease, especially when low-density lipoprotein cholesterol (LDL-C) levels are normal. However, there are few studies on the relationship between remnant cholesterol and subclinical atherosclerosis. Common carotid artery intima-media thickness (cIMT) is an imaging marker of subclinical atherosclerosis. This study aimed to investigate the relationship between remnant cholesterol and cIMT in a community population with normal LDL-C. Methods: This study is a retrospective analysis; 1,101 community population with available carotid artery imaging and fasting lipid data with LDL-C <4.1 mmol/L were included in this analysis. Remnant cholesterol was calculated as total cholesterol minus LDL-C minus high-density lipoprotein cholesterol. Abnormal cIMT was defined as maximum cIMT value ≥1 mm. Logistic regression was used to assess the relationships between remnant cholesterol levels and abnormal cIMT. Results: As the remnant cholesterol level increased from the lowest to the highest quartile, the rate of abnormal cIMT increased from 24.5% to 38.6% (p trend <0.001) in the community population with normal LDL-C level. In the unadjusted model, the odds ratios (ORs, 95% confidence intervals) in the highest quartile group were 1.937 (1.338–2.803) for abnormal cIMT compared with the lowest quartile. The multivariable-adjusted ORs (95% confidence intervals) for the highest versus lowest quartile of remnant cholesterol were 2.132 (1.420–3.202) for abnormal cIMT. Conclusion: Elevated fasting remnant cholesterol levels were positively associated with abnormal cIMT in community population with normal LDL-C levels. Remnant cholesterol may be an important indicator of risk stratification in community population with normal LDL-C level.

Abstract Background Zinc finger transcription factor ZNF281 was first named GC-box-binding zinc-finger protein. Relevant studies have confirmed that ZNF281 protein is involved in the process of cell proliferation, cell apoptosis, cell differentiation and tumorigenesis. However, the function of ZNF281 in cervical cancer remains unknown. Methods Both IHC and western blot assays demonstrated that the expression of ZNF281 protein in cervical cancer tissue was much higher than that in normal cervical tissue. ZNF281 was also expressed in human cervical carcinoma cell lines of HeLa, SiHa, C-33 A, CaSki and HT-3. Immunocytochemistry results showed that ZNF281 protein expresses both in the cell nucleus and cytoplasm. Results ZNF281 overexpression didn’t affect HeLa cells proliferation and tumor size in situ according to xenograft experiments in nude mice. However, trans-well experiments indicated ZNF281 overexpression facilitated migration and invasion. More tumor lesions were found in the lungs of the nude mice injected with ZNF281 overexpression cell lines than mice injected with control lines. Conclusion All these results suggest ZNF281 promoted tumor metastasis without affecting cell proliferation.

Background:The purpose of this study was to explore the value of the left internal mammary artery flow velocity (LIMAV) measured by ultrasound before coronary artery bypass grafting (CABG) in predicting the prognosis of patients after left internal mammary artery (LIMA) bypass grafting.Methods:One hundred and four patients who underwent CABG with LIMA as the bridge vessel in the cardiovascular surgery department of our hospital between May 2018 and June 2019 were selected. All patients underwent transthoracic Doppler ultrasonography to measure LIMAV preoperatively. Intraoperatively, mean graft flow (MGF) and pulsatility index (PI) of the LIMA bridge were measured using transit time flow measurement (TTFM). The primary endpoint event in this study was cardiac death within 18 months after surgery.Results:The Cox survival analysis showed that the MGF, the LIMAV and left ventricular ejection fraction (LVEF) were risk factors for death after CABG. The cut-offs of MGF, LIMAV and LVEF for the prediction of death after CABG were ≤ 14 mL/min (area under the curve (AUC): 0.830; sensitivity: 100%; specificity: 65.6%), ≤ 60 cm/s (AUC: 0.759; sensitivity: 65.5%; specificity: 85.3%), and ≤ 44% (AUC: 0.724; sensitivity: 50%; specificity: 88.5%), respectively. Compared with the use of MGF, MGF + LIMAV, combination of the MGF + LIMAV + LVEF (AUC: 0.929; sensitivity: 100%; specificity: 81.1%) resulted in a stronger predictive value (MGF vs. MGF + LIMAV + LVEF: P = 0.02).Conclusion:LIMAV measured by preoperative transthoracic ultrasound combined with intraoperative MGF and LVEF may have a greater value in predicting patients' risk of cardiac death after CABG.