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Price: EUR 185.00Authors: Li, Shuangyu | Ma, Qiubo | Ma, Zengwei | Shi, Ying | Yu, Xiaoyan | Gu, Baohua | Sun, Shanshan | Yu, Chunlei | Pang, Lei
Article Type: Research Article
Abstract: AIM: To investigate the mechanism by which NF-κB p65 activates miR-150 to suppress TRPC6 expression and promote renal ischemia-reperfusion injury. METHODS: To assess the transcription of miR-150, NF-B p65, and TRPC6 in HK-2 cells treated with hypoxia reperfusion and rat kidney tissue damaged by ischemia-reperfusion (I/R), qPCR was implemented. The protein production of NF-κB p65 and TRPC6 was assessed by Western blot (WB) analysis. The histological score of rat kidney tissue was assessed using H&E (hematoxylin and eosin) staining. To assess the rate of apoptosis of renal tissue cells following I/R injury, we used the TACS TdT In …Situ Apoptosis Detection Kit. To find out the impairment of renal function, blood levels of creatinine (Cr) and blood urea nitrogen (BUN) were tested in rats. Concentrations of inflammatory cytokines, including IL-1β, IL-10, and TNF-α, were detected in HK-2 cells and rat renal tissue cells utilizing ELISA kits. FITC and CCK-8 were employed to analyze the death rate and cellular proliferation of HK-2 cells. To analyse the mechanism of engagement between NF-κB p65 and the miR-150 promoter, coupled with the detrimental impact of miR-150 on TRPC6, we adopted the dual-luciferase reporter assay. To confirm the activating effect of NF-κB p65 on miR-150,we implemented the ChIP assay. RESULTS: NF-κB p65 expression was significantly upregulated in rat renal tissue following IRI. Applying the dual-luciferase reporter assay, we demonstrated that the specific attachment of NF-B p65 with the miR-150 promoter location is viable, resulting in the promotion of the activity of the promoter. When miR-150 was overexpressed, we observed a notable reduction in cell proliferation. And it notably increased the rate of cellular apoptosis rate and amounts of the proinflammatory cytokines IL-1β, IL-10, and TNF-α. Employing the dual-luciferase reporter assay, we demonstrated that miR-150 transfection diminished the function of luciferase in the TRPC6-WT group, whereas luciferase activity in the TRPC6-MUT group remained unchanged, indicating that miR-150 is a targeted inhibitor of TRPC6. In the rat renal I/R model, when miR-150 was inhibited or TRPC6 was overexpressed in the rat kidney I/R model, the histological score of rat kidney tissue significantly decreased, so did the quantities of proinflammatory cytokines IL-1β, IL-10, TNF-α, creatinine (Cr) and blood urea nitrogen (BUN) contents and the rate of cell apoptosis in kidney tissue. CONCLUSION: Activation of miR-150 by NF-κB p65 results in downregulation of TRPC6 expression and promotion of IRI in the kidney. Show more
Keywords: NF-κB p65, gene targeting, miR-150, TRPC6, kidney, ischemia-reperfusion
DOI: 10.3233/CH-231979
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-14, 2023
Authors: Zhang, Qiubing | Gou, Fang | Shi, Ping | Xu, Zhe | Yan, Zhitao | He, Mingfang | Yin, Xiaohong | He, Yuanjun | Zhang, Jun
Article Type: Research Article
Abstract: BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEIs) were reported to protect from hypoxia-induced oxidative stress in coronary endothelial cells (CECs) after acute myocardial infarction (AMI). Nrf2 shows a protective effect in hypoxia-induced CECs after AMI. Plasmalemma vesicle-associated protein (PLVAP) plays a pivotal role in angiogenesis after AMI. AIM: To explore the protective effect of ACEIs and the involved mechanisms under hypoxia challenge. METHODS: Human coronary endothelial cells (HCAECs) were used to establish hypoxia-induced oxidative stress injury in vitro . Flow cytometry was used to evaluate the protective effect of ACEI on hypoxia conditions.ET-1, NO, ROS, and VEGF were …detected by ELISA. HO-1, Nrf2, and Keap-1, the pivotal member in the Nrf2 signaling pathway, eNOS and PLVAP were detected in HEAECs treated with ACEI by immunofluorescence, qPCR, and western blotting. RESULTS: The hypoxia ACEI or Nrf2 agonist groups showed higher cell viability compared with the hypoxia control group at 24 (61.75±1.16 or 61.23±0.59 vs. 44.24±0.58, both P < 0.05) and 48 h (41.85±1.19 or 59.64±1.13 vs. 22.98±0.25, both P < 0.05). ACEI decreased the levels of ET-1 and ROS under hypoxia challenge at 24 and 48 h (all P < 0.05); ACEI increased the VEGF and NO levels (all P < 0.05). ACEI promoted the expression level of eNOS, HO-1, Nrf2 and PLVAP but inhibited Keap-1 expression at the mRNA and protein levels (all P < 0.05). Blockade of the Nrf2 signaling pathway significantly decreased the expression level of PLVAP. CONCLUSION: ACEI protects hypoxia-treated HEAECs by activating the Nrf2 signaling pathway and upregulating the expression of PLVAP. Show more
Keywords: Acute myocardial infarction, angiotensin-converting enzyme inhibitor, nuclear factor erythroid 2 signaling pathway, human coronary endothelial cells, plasmalemma vesicle-associated protein
DOI: 10.3233/CH-232007
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-30, 2024
Authors: Betz, Thomas | Pfister, Karin | Schierling, Wilma | Sachsamanis, Georgios | Radunski, Jörn | Nolte Ernsting, Claus | Stehr, Alexander
Article Type: Research Article
Abstract: BACKGROUND: The popliteal artery is highly exposed to biomechanical stress, which is the primary factor associated with stent failure. However, information on the optimal endovascular treatment for the popliteal artery is lacking. OBJECTIVE: To report the efficacy of the GORE® TIGRIS® Vascular Stent for the endovascular treatment of popliteal artery lesions. METHODS: Retrospective analysis of all patients with symptoms of peripheral artery occlusive disease (PAD) and popliteal artery lesions who underwent implantation of a GORE® TIGRIS® Vascular Stent between August 2012 and August 2014 at a tertiary vascular centre. RESULTS: …Between August 2012 and August 2014, 48 patients (32 men, aged 75±8 years) were treated with a GORE® TIGRIS® Vascular Stent. The technical success rate was 100% . At 12 months, the primary and secondary patency rates were 74% and 85%, respectively. During follow-up, no stent fracture was observed. No major amputations were performed. CONCLUSIONS: Our study showed that isolated popliteal artery lesions in patients with symptomatic PAD could easily be treated with the GORE® TIGRIS® Vascular Stent, as good short-term results were achieved at 12 months. Therefore, the discontinuation of this product removed a useful tool with a simple release mechanism from the endovascular armamentarium of vascular specialists. Show more
Keywords: Popliteal artery lesion, GORE® TIGRIS® vascular stent, endovascular therapy, self-expandable nitinol stent
DOI: 10.3233/CH-231993
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Chen, Keke | Wang, Feihang | Deng, Minying | Yuan, Kai | Wang, Xi | Zhao, Qiannan | Dong, Yi | Wang, Wenping
Article Type: Case Report
Abstract: BACKGROUND: Hepatic reactive lymphoid hyperplasia (RLH) is a rare benign lymphoproliferative lesion and a poorly understood disease. It is usually asymptomatic and incidental, but it is difficult to distinguish from hepatocellular carcinoma and metastatic liver tumor on imaging, and percutaneous biopsy is not sufficient to distinguish from low-grade malignant lymphoma and extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), making diagnosis difficult. CASE SUMMARY: A 69-year-old woman came to our hospital for reexamination of pulmonary nodules followed by liver occupation. The lesions showed “wash-in and wash-out” on contrast-enhanced ultrasonography and magnetic resonance imaging. Enhanced …magnetic resonance also showed annular envelope enhancement and limited diffusion on the ADC map during the delay period. Imaging revealed metastatic liver cancer, and the patient underwent a partial hepatectomy. However, the final histopathological diagnosis was RLH. CONCLUSION: If small isolated nodules are found in the liver of middle-aged and elderly female patients with no risk factors for liver malignancy, when the enhanced imaging suggests “wash-in and wash-out”, further focus should be placed on whether the enhanced imaging shows perinodular enhancement and whether the DWI shows limited diffusion in MRI, in order to emphasize the possibility of liver RLH diagnosis. Show more
Keywords: Reactive lymphoid hyperplasia, pseudo lymphoma, ultrasound, MRI, CT, pathology, case report
DOI: 10.3233/CH-232087
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-7, 2024
Authors: Zhang, Wei | Liu, Yilun | Wu, Qiong | Wei, Xiaoer | Liu, Beibei | Jiao, Qiong | Zhang, Rui | Hu, Bing | Li, Yi | Ying, Tao
Article Type: Research Article
Abstract: OBJECTIVE: This article aims to clarify pitfalls and find strategies for the detecting and diagnosing hyperechoic liver metastases (LMs) using Sonazoid-contrast enhanced ultrasonography (Sonazoid-CEUS). METHODS: This study was a prospective self-controlled study. Patients with hepatic lesions suspected as LMs or benign lesions were included in the study. Baseline ultrasonography (BUS) and Sonazoid-CEUS were performed on every patient. Characteristics of LMs and benign nodules were compared by chi-square test and fisher test. Factors influenced the CEUS were demonstrated by univariate analysis and multivariate logistic regression analysis. RESULTS: 54 patients were included in this study. …CEUS found additional 75 LMs from 19 patients in Kupffer phase. We found hyperechoic focal liver lesions and deep seated in liver are main confounding factors in CEUS diagnosis. Sensitivity would be improved from 16.67% to 78.57%, negative predictive value (NPV) would be improved from 28.57% to 76.92% and accuracy would be improved from 37.5% to 87.50% when using rapid “wash-in” and “wash-out” as main diagnostic criteria. CONCLUSIONS: Hyperechoic LMs especially deeply seated ones are usually not shown typical “black hole” sign in Kupffer phase. Quickly “wash-in and wash out” shows high accuracy in diagnosing malignant nodules. We highly recommend CEUS as a routing exam to detect and diagnose LMs. Show more
Keywords: Contrast enhanced ultrasonography, focal liver lesion, liver metastases, Kupffer phase
DOI: 10.3233/CH-231995
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-13, 2023
Authors: Greiner, Barbara | Kaiser, Ulrich | Maurer, Katharina | Stroszczynski, Christian | Jung, Ernst Michael
Article Type: Research Article
Abstract: BACKGROUND: Rapid evolution of ultrasound technology has allowed widespread use of handheld ultrasound devices (HHUDs) for many possible applications. Along with the adult population, the use of HHUDs for Point of Care Ultrasound (POCUS) in pediatric medicine has been increasing over the last few years. However, pediatric-specific literature is still scarce on mobile vascular ultrasound. OBJECTIVE: To evaluate diagnostic capabilities of Vscan Air™ in comparison with high-end ultrasound for the assessment of the internal jugular vein in children and adolescents. METHODS: 42 Internal Jugular Veins (IJVs) of 21 pediatric patients were scanned by …an experienced examiner using a WLAN-supported handheld ultrasound device (Vscan Air™) and high-end cart-based ultrasound (LOGIQ E9) as reference. B-Mode and Color-coded Doppler (CCDS) were performed and compared. Image quality was assessed using a score of 0 to 5 and statistically analyzed. Results were interpreted independently by two readers in consensus. RESULTS: 21 patients (2–17 years; mean 11,00±4,5 years; female n = 11, male n = 10) were examined. The rating score never dropped below 3 for both devices. The median score evaluation of B-Mode and CCDS for the high-end device was 5.00, of Vscan Air™ 5.00 for B-Mode and 4.00 for CCDS. A significant difference was shown between the two devices in the evaluation of CCDS. CONCLUSIONS: Vscan Air™ ultrasound device allows sufficient assessability of the IJV in pediatric patients, opening up new possibilities for fast and mobile POCUS of cervical veins and potential guidance of central venous catheter placement. Show more
Keywords: Handheld ultrasound, Vscan Air, POCUS, internal jugular vein, pediatric
DOI: 10.3233/CH-231981
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: Wang, Nan | Yan, Xueliang | Zhang, Zhiqi | Liu, Luping | Zhu, Ju | Huang, Xiao | Nie, Fang
Article Type: Research Article
Abstract: OBJECTIVE: To explore whether the use of intravenous contrast-enhanced ultrasound (CEUS) can improve the diagnostic accuracy of T stage of gastric cancer on the basis of oral contrast-enhanced ultrasound (OCEUS). METHODS: Eighty-one patients with gastric cancer who underwent preoperative CEUS. Criteria for T staging was AJCC Stage 8th Edition. To compare the diagnostic accuracy, sensitivity and specificity of OCEUS and CEUS for T staging of gastric cancer using pathological results as the gold standard. RESULTS: There were differences in the diagnostic accuracy of T2 (P = 0.048), T3(P = 0.002) and T4 (P = 0.000) between OCEUS and CEUS. …And there was no difference in diagnostic accuracy for T1 (P = 0.118). CEUS significantly improved diagnostic sensitivity and specificity in T3 (42.86% to 61.90% for sensitivity, 86.96% to 93.75% for specificity), and T4 (64.71% to 76.47% for sensitivity, 78.33% to 95.74% for specificity). CONCLUSION: Compared with OCEUS, CEUS did improve the diagnostic accuracy of T2, T3, and T4 stages of gastric cancer. Show more
Keywords: T staging, ultrasonography, gastric cancer, intravenous contrast-enhanced ultrasound
DOI: 10.3233/CH-231949
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-8, 2023
Authors: Neira Agonh, Daniel | Scott, Cassidy | Trivedi, Purvi | Dickson, Kayle | White, Hannah | Zhou, Juan | Lehmann, Christian
Article Type: Research Article
Abstract: BACKGROUND: Pentobarbital and isoflurane are commonly used veterinary anesthetics. Due to the dangers of overdose by repeat-bolus regimen of pentobarbital, isoflurane has been recommended. However, literature suggests isoflurane-induced inhibition of cytokine and adhesion molecule release, impacting leukocyte adhesion. OBJECTIVE: This study aims to characterize the impacts of pentobarbital versus isoflurane on leukocyte interactions within the intestinal microcirculation with and without endotoxin challenge. METHODS: Female BALB/c mice were subjected to pentobarbital or isoflurane (N = 20) and challenged with endotoxin or saline by intraperitoneal injection. The mice were kept under anesthesia for 2 hours. Fluorochromes, rhodamine-6 G and fluorescein isothiocyanate, …were injected intravenously. To visualize leukocyte adhesion within the intestinal microcirculation, laparotomy and intravital microscopy was performed. Leukocyte rolling and adhesion was quantified offline in a blinded fashion. RESULTS: Within collecting venules, leukocyte rolling and adhesion showed no significant differences between pentobarbital and isoflurane anesthesia under basal conditions. Endotoxin challenge caused a similar response in both anesthetic groups. Within postcapillary venules, no statistical differences between the two anesthetics were found for adhering leukocytes under basal conditions or following endotoxin challenge either. However, leukocyte rolling after LPS-challenge was significantly decreased in postcapillary venules during isoflurane anesthesia compared to pentobarbital anesthesia. CONCLUSIONS: Isoflurane anesthesia showed only minor differences in the immune response to endotoxin within the intestinal microcirculation compared to pentobarbital anesthesia. Due to the superior safety profile of volatile anesthetics, immunological studies may choose isoflurane over pentobarbital as the veterinary anesthetic of choice. Show more
Keywords: Intravital microscopy, pentobarbital, isoflurane, leukocytes, microcirculation
DOI: 10.3233/CH-231989
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: Luo, Nan | Liang, Xiao-yu | Li, Lu | Zhang, Xiao | Zang, Chun-mei | Liu, Xi | Fan, Xiao-zhou
Article Type: Research Article
Abstract: A rare foreign body accompanied by thrombosis in the right internal jugular vein was accidentally observed. We collected the medical history of this special patient, analyzed the causes and characteristics of the foreign body and thrombosis formation, and subsequently observed the changes in thrombosis. Finally, we discussed the diagnostic value of ultrasound for such rare intravascular lesions.
Keywords: Ultrasound, internal jugular vein, foreign body, thrombosis
DOI: 10.3233/CH-231988
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-5, 2023
Authors: Huang, Yun-Lin | Tian, Xiao-Fan | Qiu, Yi-Jie | Lou, Wen-hui | Jung, Ernst-Michael | Dong, Yi | Wang, Han-Zhang | Wang, Wen-Ping
Article Type: Research Article
Abstract: OBJECTIVES: To evaluate the efficacy of the radiomics model based on preoperative B-mode ultrasound (BMUS) and shear wave elastography (SWE) for predicting the occurrence of clinically relevant-postoperative pancreatic fistula (CR-POPF). METHODS: Patients who were scheduled to undergo pancreatectomy were prospectively enrolled and received ultrasound assessment within one week before surgery. The risk factors of POPF (grades B and grades C) were analyzed. Preoperative BMUS images, SWE values of pancreatic lesions and surrounding parenchyma were used to build preoperative prediction radiomics models. Radiomic signatures were extracted and constructed using a minimal Redundancy Maximal Relevance (mRMR) algorithm and an L1 …penalized logistic regression. A combined model was built using multivariate regression which incorporated radiomics signatures and clinical data. RESULTS: From January 2020 to November 2021, a total of 147 patients (85 distal pancreatectomies and 62 pancreaticoduodenectomies) were enrolled. During the three-week follow-up after pancreatectomy, the incidence rates of grade B/C POPF were 28.6% (42/147). Radiomic signatures constructed from BMUS of pancreas parenchymal regions (panRS) achieved an area under the receiver operating characteristic curve (AUC) of 0.75, accuracy of 68.7%, sensitivity of 85.7 %, and specificity of 61.9 % in preoperative noninvasive prediction of CR-POPF. The AUC of the radiomics model increased to 0.81 when panRS was used for the prediction of CR-POPF after pancreaticoduodenectomy. CONCLUSIONS: Radiomics model based on ultrasound images was potentially useful for predicting CR-POPF. Patients with high-risk factors should be closely monitored when postoperation. Show more
Keywords: Postoperative pancreatic fistula, pancreatectomy, shear wave elastography, ultrasound radiomics, prediction
DOI: 10.3233/CH-231955
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-14, 2023
Authors: Zhang, Xiao-Long | Wang, Hang-Tao | Tang, Yang | Lu, Qing | Yuan, Hai-Xia | Wang, Xi | Liu, Li-Heng | Zhu, De-Xiang | Wang, Wen-Ping
Article Type: Research Article
Abstract: OBJECTIVE: To explore the prognostic impact of contrast-enhanced ultrasound (CEUS) features for initially unresectable colorectal liver metastases (CLMs) in a clinical setting of conversion therapy. METHODS: Between March 2015 and November 2020, consecutive patients with CLMs who received conversion treatment were prospectively enrolled. All participants underwent liver CEUS at baseline. The primary endpoint was conversion resection rate (R0 and overall resection). Secondary endpoints were objective response rate (ORR), overall survival (OS), and progression-free survival (PFS). RESULTS: 104 participants who completed conversion treatment were included. CEUS enhancement pattern was correlated with index lesion (size and echogenicity), primary …(site, differentiation, perineural invasion, and RAS genotype) and serum (CA19-9 level) characteristics (P = <0.001–0.016). CEUS enhancement pattern was significantly associated with R0 resection rate, ORR, PFS, and OS (P = 0.001–0.049), whereas enhancement degree was associated with PFS and OS (P = 0.043 and 0.045). Multivariate analysis showed that heterogeneous enhancement independently predicted R0 and overall resection (P = 0.028 and 0.024) while rim-like enhancement independently predicted ORR and OS (P = 0.009 and 0.026). CONCLUSION: CEUS enhancement pattern was significantly associated with tumor characteristics and clinical outcomes following conversion therapy, and thus might be of prognosis impact for initially unresectable CLMs. Show more
Keywords: Colorectal neoplasms, liver neoplasms, ultrasonography, contrast media, resection, prognosis
DOI: 10.3233/CH-231963
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-18, 2023
Authors: Ermolinskiy, Petr B. | Maksimov, Matvey K. | Muravyov, Alexey V. | Lugovtsov, Andrei E. | Scheglovitova, Olga N. | Priezzhev, Alexander V.
Article Type: Research Article
Abstract: Blood microrheology depends on the constituents of blood plasma, the interaction between blood cells resulting in red blood cell (RBC) and platelets aggregation, and adhesion of RBC, platelets and leukocytes to vascular endothelium. The main plasma protein molecule –actuator of RBC aggregation is fibrinogen. In this paper the effect of interaction between the endothelium and RBC at different fibrinogen concentrations on the RBC microrheological properties was investigated in vitro . Laser tweezers were used to measure the RBC-endothelium interaction forces. It was shown for the first time that the interaction forces between RBC and endothelium are comparable with the RBC …aggregation forces, they increase with fibrinogen concentration and reach the saturation level of about 4 pN at the concentration of 4 mg/ml. These results are important for better understanding the mechanisms of RBC and endothelium interaction and developing the novel therapeutic protocols of the microrheology correction in different pathologies. Show more
Keywords: Red blood cells, endothelium, fibrinogen, laser tweezers, red blood cell, aggregation, adhesion
DOI: 10.3233/CH-231941
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Chen, Jianghong | Wang, Bingshuang | Song, Jianshi | Qi, Zhengqin | Deng, Yandong
Article Type: Research Article
Abstract: AIM: To evaluate the important characteristics of the plaque vulnerability using multimodal ultrasound imaging methods (2D, contrast-enhanced ultrasound, and elastography), and to explore the relationship between plaque and acute stroke. METHODS: A total of 244 patients with carotid plaque were enrolled, including 104 patients with acute stroke ipsilateral to the plaque as the case group and 140 patients as the control group. All patients underwent conventional carotid ultrasound, contrast-enhanced ultrasound (CEUS) and elastography (SWE). The results of each examination were compared and analyzed, and the relationship between the results and the occurrence of stroke was discussed. …RESULTS: In the acute stroke group, the men, with a history of alcohol consumption the direction of contrast media diffusion was higher than that in the control group, but the plaque gray value (GSM), maximum, average and minimum Young’s elastic modulus imaging values (YM) were slightly lower than those in the control group (P < 0.05). Logistic regression analysis showed that waist to body ratio (WHtR), GSM, YM, neovascularization density and contrast diffusion direction were independent risk factors for predicting acute ischemic stroke. The influence degree of each factor from strong to weak was waist to body ratio, neovascularity density, GSM and YM, respectively. The area under the curve (AUC) for the diagnosis of acute ischemic stroke by regression model was 0.746. CONCLUSION: The combination of multiple ultrasound techniques to evaluate the vulnerability of carotid plaque and predict the occurrence of acute stroke provides valuable information for clinical decision making. Show more
Keywords: Contrast-enhanced ultrasound, elastography, carotid plaque, acute stroke
DOI: 10.3233/CH-231959
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Wiewiora, Maciej | Jopek, Janusz | Świętochowska, Elżbieta | Grynkiewicz, Michael | Piecuch, Jerzy
Article Type: Research Article
Abstract: BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy with a low 5-year survival rate. Biomarkers may be of value for the early diagnosis of pancreatic cancer. This study assessed blood- and tumour tissue-based biomarkers associated with pancreatic cancer. METHODS: We studied 61 patients who underwent pancreatic resection. Of these 61 patients, 46 patients had PDAC, and 15 patients had inflammatory tumours. Blood and tumour tissue levels of VEGF, hypoxia-inducible factor 1α (HIF-1α) and glucose transporter 1 (GLUT1) were measured. RESULTS: Blood concentrations of VEGF (p < 0.000001) and HIF-1α (p = 0.000002) were significantly higher …in the PDAC group than in the inflammatory tumour group. Tumour tissue concentrations of VEGF (p < 0.000001), HIF-1α (p = 0.000005) and GLUT1 (0.000002) were also significantly higher in the PDAC group. Univariate analyses revealed that age, BMI, and blood levels of CA19-9, VEGF, and HIF-1α were potential predictors of PDAC. Potential predictors of PDAC in tumour tissue were VEGF, HIF-1α and GLUT1. Multivariate analyses found that VEGF was the most powerful independent predictor of PDAC in blood (OR = 1.016; 95% CI: 1.007–1.025; 0.001) and tumour tissue (OR = 1.02; 95% CI: 1.008–1.032, p = 0.001). The cut-off point for blood VEGF was 134.56 pg/ml, with a sensitivity of 97.8%, specificity of 86.7%, PPV of 95.7%, and NPV of 92.9% . The cut-off point for tissue tumour VEGF in PDAC was 208.59 pg/mg, with a sensitivity, specificity, PPV and NPV of 97.7%, 92.9%, 97.7%, and 92.9%, respectively. CONCLUSIONS: There are significant differences in blood-based biomarkers for differentiating between PDAC and inflammatory tumours of the pancreas. VEGF was an independent predictor of PDAC independent of its addition to the routinely used tumour marker CA19-9 antigen. Show more
Keywords: Pancreatic cancer, biomarker, surgery
DOI: 10.3233/CH-231987
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Pan, Yanghong | Liu, Delin | Liang, Fei | Kong, Zixiang | Zhang, Xu | Ai, Qinqin
Article Type: Research Article
Abstract: BACKGROUND: No studies have been retrieved comparing perfluorobutane with sulfur hexafluoride for microwave ablation (MWA) in small hepatocellular carcinoma(sHCC). OBJECTIVE: To retrospective investigate the value of perfluorobutane ultrasonography contrast agent in ultrasonography (US)-guided MWA of sHCC. METHODS: We conducted a retrospective clinical controlled study about US-guided percutaneous MWA in patients with sHCC, and in patients undergoing intra-operative treatment with perfluorobutane or sulfur hexafluoride. In both groups, a contrast agent was injected to clear the tumor and then a needle was inserted. A 5-point needle prick difficulty score was developed to compare needle prick difficulty in the …two groups of cases. RESULTS: A total of 67 patients were included: 25 patients in group perfluorobutane, aged 41–82 (60.64±9.46), tumor size 1.1–2.8 (1.78±0.45) cm. 42 patients in group sulfur hexafluoride, aged 38–78 (62.26±9.27), with tumor size of 1.1–3.0 (1.89±0.49) cm. There was no significant difference in age or tumor size in both groups (P > 0.05). Puncture difficulty score (5-point): 2.0–2.7 (2.28±0.29) in group perfluorobutane, and 2.0–4.7 (2.95±0.85) in group sulfur hexafluoride, and the difference between the two groups was statistically significant (P < 0.05). Enhanced imaging results within 3 months after surgery: complete ablation rate was 100% (25/25) in the group perfluorobutane, 95.2% (40/42 in the group sulfur hexafluoride), with no significant difference between the two groups (P > 0.05). CONCLUSION: Perfluorobutane kupffer phase can make the operator accurately deploy the ablation needle and reduce the difficulty of operation. Show more
Keywords: Contrast-enhanced ultrasonography (CEUS), liver cancer, perfluorobutane (Sonazoid), kupffer, microwave ablation (MWA)
DOI: 10.3233/CH-232055
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Tzirakis, Konstantinos | Kontopodis, Nikolaos | Ioannou, Christos V.
Article Type: Research Article
Abstract: PURPOSE: To compare the hemodynamic performance of three (Bottom Up non-ballet, Top-Down non-ballet, Top Down ballet) idealized stent graft configurations used during endovascular repair of abdominal aortic aneurysms, under the influence of various rheological models. METHODS: Ten rheological models are assumed and a commercial finite volume solver is employed for the simulation of blood flow under realistic boundary conditions. An appropriate mesh convergence study is performed and five hemodynamic variables are computed: the time average wall shear stress (TAWSS), oscillatory shear index (OSI), relative residence time (RRT), endothelial cell activation potential and displacement force (DF) for all three …configurations. RESULTS: The choice of blood flow model may affect results, but does not constitute a significant determinant on the overall performance of the assumed stent grafts. On the contrary, stent graft geometry has a major effect. Specifically, the Bottom Up non-ballet type is characterized by the least favorable performance presenting the lowest TAWSS and the highest OSI, RRT and ECAP values. On the other hand, the Top Down ballet type presents hemodynamic advantages yielding the highest TAWSS and lowest OSI, RRT and ECAP average values. Furthermore, the ballet type is characterized by the lowest DF, although differences observed are small and their clinical relevance uncertain. CONCLUSIONS: The effect of the assumed rheological model on the overall performance of the grafts is not significant. It is thus relatively safe to claim that it is the type of stent graft that determines its overall performance rather than the adopted blood flow model. Show more
Keywords: Non-Newtonian blood flow, idealized stent graft, computational fluid dynamics, finite volume method, hemodynamic parameters
DOI: 10.3233/CH-232058
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-21, 2024
Authors: Yao, Miao-Miao | Lin, Ting-Ting | Shi, Xu | Chen, Mei-Gui | Wu, Jia-Xiang | Zhao, Yan-Ping | Lin, Bao-Shan
Article Type: Research Article
Abstract: OBJECTIVE: Deep vein thrombosis (DVT) formation of lower extremities can lead to serious complications including pulmonary embolism (PE) and chronic post-thrombotic syndrome (PTS). We aimed to explore the relationship between the ratio of thrombotic density and the occurrence of PE and PTS in patients with DVT of the lower extremities. METHODS: A retrospective analysis was conducted in patients who performed computed tomography venography, dividing into DVT with PE group (54 patients) and DVT-alone group (34 patients), The clinical data were recorded. Univariate and multivariate logistic regression analysis were used to analysis variables associated with PE. The ability of …thrombosis density ratio and Wells score to diagnose PE was evaluated by using the receiver operating characteristic curve (ROC) area under the curve (AUC). According to the treatment and follow-up results, subgroup analysis was performed, and the Villata score was used to determine the presence or absence of PTS and its severity. RESULTS: Compare with the DVT-alone group, more patients had dyspnea and chest pain in the DVT with PE group. DVT with PE group had lower the percentage of neutrophils, white blood cell count and platelet count, while had higher blood cell count, D-dimer, wells score, thrombus and thrombus density ratio. Multivariate logistic analysis showed that percentage of neutrophils (OR(95% CIs)=1.15 (1.01,1.31), P = 0.040), platelets (OR(95% CIs)=0.96 (0.93,0.99), P = 0.011), and thrombus density ratio (OR(95% CIs)=5.99 (1.96,18.35), P = 0.002) are independent predictors of PE. The Wells score and thrombosis density ratio were consistent in the diagnostic efficacy of PE. In the subgroup analysis, there was a relevance between the ratio of thrombosis density and the Villalta score. CONCLUSION: Percentage of neutrophils, platelets, and thrombus density ratio are independent predictors of PE. The thrombosis density of DVT patients may be an index to predict the risk of PE and PTS in DVT patients. Show more
Keywords: Deep vein thrombosis of lower limbs, thrombotic density ratio, pulmonary embolism, post-thrombotic syndrome
DOI: 10.3233/CH-231778
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Article Type: Research Article
Abstract: OBJECTIVE: The present study probes into the role and mechanism of ubiquitin specific peptidase 14 (USP14) in coronary heart disease (CHD)-triggered endothelial cell pyroptosis. METHODS: An in vitro CHD model was established by inducing human coronary artery endothelial cells (HCAECs) with oxidized low-density lipoprotein (ox-LDL). HCAECs were transfected with si-USP14, followed by evaluation of cell viability by CCK-8 assay, detection of lactate dehydrogenase (LDH) activity by assay kit, detection of USP14, miR-15b-5p, NLRP3, GSDMD-N, and Cleaved-Caspase-1 expressions by qRT-PCR or Western blot, as well as IL-1β and IL-18 concentrations by ELISA. Co-IP confirmed the binding between USP14 …and NLRP3. The ubiquitination level of NLRP3 in cells was measured after protease inhibitor MG132 treatment. Dual-luciferase reporter assay verified the targeting relationship between miR-15b-5p and USP14. RESULTS: USP14 and NLRP3 were highly expressed but miR-15b-5p was poorly expressed in ox-LDL-exposed HCAECs. USP14 silencing strengthened the viability of ox-LDL-exposed HCAECs, reduced the intracellular LDH activity, and diminished the NLRP3, GSDMD-N, Cleaved-Caspase-1, IL-1β, and IL-18 expressions. USP14 bound to NLRP3 protein and curbed its ubiquitination. Repression of NLRP3 ubiquitination counteracted the inhibitory effect of USP14 silencing on HCAEC pyroptosis. miR-15b-5p restrained USP14 transcription and protein expression. miR-15b-5p overexpression alleviated HCAEC pyroptosis by suppressing USP14/NLRP3. CONCLUSION: USP14 stabilizes NLRP3 protein expression through deubiquitination, thereby facilitating endothelial cell pyroptosis in CHD. miR-15b-5p restrains endothelial cell pyroptosis by targeting USP14 expression. Show more
Keywords: Coronary heart disease, endothelial cell pyroptosis, USP14, miR-15b-5p, NLRP3
DOI: 10.3233/CH-232003
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-14, 2023
Authors: Yang, Yun-Ping | Chiu, Ching-Tang | Chao, Anne | Yeh, Yu-Chang | Sun, Wei-Zen | Liu, Chih-Min | Chan, Wing-Sum
Article Type: Research Article
Abstract: OBJECTIVE: This study measured normal ranges of microcirculatory parameters in healthy individuals and investigated differences in parameters by age and sex. METHODS: Participants were enrolled into three groups with equal numbers of male and female: young (20–39 years), middle-aged (40–59 years), and elderly (60–79 years). Sublingual microcirculation images were obtained using the incident dark field (IDF). RESULTS: A total of 75 female and 75 male healthy individuals were enrolled. The elderly group had a higher TVD (26.5 [2 ] vs. 25.2 [1.8 ]; p = 0.019) and a lower PPV (97 [2 ] vs. 98 [3 ]; …p = 0.03) than did the young group. In the elderly group, systolic blood pressure (SBP) and mean arterial pressure (MAP) were moderately and positively correlated with MFI score (r = 0.407, p < 0.05, and r = 0.403, p < 0.05, respectively). The female participants had a lower MFI score than did the male participants (2.9 [2.8–3 ] vs. 3.0 [2.9–3 ]; p = 0.015). CONCLUSIONS: This study revealed the range of microcirculatory parameters between different ages and sexes in healthy individuals. We found that blood pressure levels were correlated with microcirculatory parameters, especially in elders and female. Show more
Keywords: microcirculation, healthy individuals, sublingual
DOI: 10.3233/CH-231807
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Astapenko, David | Zrzavecky, Marek | Gorskaja, Diana | Hyspler, Radomir | Ticha, Alena | Radochova, Vera | Lehmann, Christian | Malbrain, Manu L.N.G. | Cerny, Vladimir | Hahn, Robert G.
Article Type: Research Article
Abstract: BACKGROUND: Endothelial glycocalyx (EG) plays a crucial role in maintaining the plasma proteins within the intravascular space. OBJECTIVE: We studied whether exogenous albumin protects the EG in an experimental model of EG enzymatic damage in rats. METHODS: Rats were divided into three groups of 10 animals that received (1) Evans blue (2) Evans blue + hyaluronidase, or (3) Evans blue + hyaluronidase + 20% human albumin via the tail vein. Spectrophotometric analysis was performed 2 h later to quantify the leakage of Evans blue-labeled albumin into the heart, lungs, brain, kidneys, liver, small intestine, spleen, and skeletal muscle. RESULTS: Administration of …hyaluronidase numerically increased the capillary leakage of Evans blue in all examined tissues. Co-administration of albumin decreased the leakage of albumin in all tissues except the heart. In the lungs, the ratio between the absorbance and dry organ weight decreased from 5.3 ± 2.4 to 1.7 ± 0.5 (mean ± SD) (P < 0.002), and in the liver, the absorbance decreased from 2.2 ± 0.7 to 1.5 ± 0.4 (P < 0.011). CONCLUSION: Exogenous albumin decreased the capillary leakage of albumin which was interpreted as a sign of maintained EG integrity. Show more
Keywords: Albumin, endothelial glycocalyx, microcirculation, evans blue, spectrophotometry
DOI: 10.3233/CH-232027
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: Javakhishvili, I. | Sanikidze, T. | Mardaleishvili, K. | Momtselidze, N. | Urdulashvili, T. | Mantskava, M. | Prantl, L. | Jung, F.
Article Type: Research Article
Abstract: BACKGROUND: The functioning of the thyroid gland is a multi-component process that in some conditions may undergo alterations. The thyroid gland is part of the endocrine system that produces the iodine-containing hormones thyroxine and triiodothyronine. Thyroid hormones, control metabolism and energy, growth processes, maturation of tissues and organs, regulation of blood flow, and, therefore, providing vital functions of the body. The role of thyroid hormones in the regulation of blood flow is determined by the intensity of their production and the quantity in the blood. Presumably, in case of oncological and non-oncological diseases of the thyroid gland, the fluidity of …the blood, which depends on the rheological properties, will be different. OBJECTIVE: Our aim was investigating rheological characteristics for studying of changes of rheology in patients with thyrotoxicosis, with benign tumor pathology of the thyroid gland, with thyroid cancer and finding possible diagnostic markers for differentiating benign and malignant thyroid tumors METHODS: In this regard, we examined, using modern methods accepted in clinical practice, a standard list of recommended diagnostic tests in the group of patients (thyrotoxicosis: n = 25; benign tumor: n = 47), thyroid cancer: n = 35) and control group (n = 15), and with new original methods, parameters that describe the rheological properties of the blood, such as blood rheological index, volume, thickness, surface area of erythrocytes, erythrocyte aggregation index, deformation index, plasma viscosity, hematocrits. RESULTS: Against the background of relative changes in the studied values, it is necessary to pay attention to the fact that erythrocyte aggregation in patients with a benign form and control, as well as in patients with a malignant form and control, differ significantly from each other, in addition, there is a significant difference between aggregation in the group of patients with benign and control aggregation. malignant forms of the disease. It is significant that aggregability differs in patients with thyrotoxicosis and in controls. This indicates that erythrocyte aggregation is particularly informative. The blood rheological index most clearly demonstrated the difference between benign and malignant forms of the disease. Significantly changed compared to control in various forms of thyroid diseases. CONCLUSION: Additional diagnostic markers for differentiating benign and malignant thyroid tumors may be consideredeerythrocyte aggregation index and blood rheological index. Show more
Keywords: Thyroid gland, rheology, oncology
DOI: 10.3233/CH-249102
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Xu, Ya-Dan | Tang, Yang | Zhang, Qi | Zhao, Zheng-Yong | Zhao, Chong-Ke | Fan, Pei-Li | Jin, Yun-Jie | Ji, Zheng-Biao | Han, Hong | Xu, Hui-Xiong | Shi, Yi-Lei | Xu, Ben-Hua | Li, Xiao-Long
Article Type: Research Article
Abstract: BACKGROUND: At present, most articles mainly focused on the diagnosis of thyroid nodules by using artificial intelligence (AI), and there was little research on the detection performance of AI in thyroid nodules. OBJECTIVE: To explore the value of a real-time AI based on computer-aided diagnosis system in the detection of thyroid nodules and to analyze the factors influencing the detection accuracy. METHODS: From June 1, 2022 to December 31, 2023, 224 consecutive patients with 587 thyroid nodules were prospective collected. Based on the detection results determined by two experienced radiologists (both with more than 15 years …experience in thyroid diagnosis), the detection ability of thyroid nodules of radiologists with different experience levels (junior radiologist with 1 year experience and senior radiologist with 5 years experience in thyroid diagnosis) and real-time AI were compared. According to the logistic regression analysis, the factors influencing the real-time AI detection of thyroid nodules were analyzed. RESULTS: The detection rate of thyroid nodules by real-time AI was significantly higher than that of junior radiologist (P = 0.013), but lower than that of senior radiologist (P = 0.001). Multivariate logistic regression analysis showed that nodules size, superior pole, outside (near carotid artery), close to vessel, echogenicity (isoechoic, hyperechoic, mixed-echoic), morphology (not very regular, irregular), margin (unclear), ACR TI-RADS category 4 and 5 were significant independent influencing factors (all P < 0.05). With the combination of real-time AI and radiologists, junior and senior radiologist increased the detection rate to 97.4% (P < 0.001) and 99.1% (P = 0.015) respectively. CONCLUSONS: The real-time AI has good performance in thyroid nodule detection and can be a good auxiliary tool in the clinical work of radiologists. Show more
Keywords: Artificial intelligence, thyroid, nodule, ultrasonography
DOI: 10.3233/CH-242099
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Jung, Ernst Michael | Kaiser, Ulrich | Herr, Wolfgang | Stroszczynski, Christian | Jung, Friedrich
Article Type: Research Article
Abstract: BACKGROUND: The continuous development of ultrasound techniques increasingly enables better description and visualization of unclear lesions. New ultrasound systems must be evaluated with regard to all these diagnostic possibilities. METHODS: A multifrequency C1-7 convex probe (SC7-1M) with the new high-end system Resona A20 Series was used. Modern technologies, including HiFR CEUS, SR CEUS and multimodal tissue imaging with shear wave elastography (SWE), fat evaluation and viscosity measurements (M-Ref) were applied. RESULTS: Of n = 70 (mean value 48,3 years±20,3 years, range 18–84 years) cases examined, a definitive diagnosis could be made in n = 67 cases, confirmed by …reference imaging and/or follow-up. Of these, n = 22 cases were malignant changes (HCC (hepatocellular carcinoma) n = 9, CCC (cholangiocellular carcinoma) n = 3, metastases of colorectal carcinomas or recurrences of HCC n = 10). In all 12 cases of HCC or CCC, the elastography measurements using the shear wave technique (with values >2 m/s to 3.7 m/s) showed mean values of 2.3±0.31 m/s and a degree of fibrosis of F2 to F4. In n = 14 cases, changes in the fat measurement (range 0.51 to 0.72 dB/cm/MHz, mean values 0.58±0.12 dB/cm/MHz) in the sense of proportional fatty changes in the liver were detected. In the 4 cases of localized fat distribution disorders, the values were >0.7 dB/cm/MHz in the sense of significant fatty deposits in the remaining liver tissue. Relevant changes in the viscosity measurements with values >1.8 kPa were found in n = 31 cases, in n = 5 cases of cystic lesions with partially sclerosing cholangitis, in n = 13 cases of malignant lesions and in n = 9 cases post-interventionally, but also in n = 4 cases of benign foci with additional systemic inflammation. CONCLUSIONS: The results are promising and show a new quality of ultrasound-based liver diagnostics. However, there is a need for further investigations with regard to the individual aspects, preferably on a multi-center basis. Show more
Keywords: Multimodal liver tissue imaging (M-Ref), UMA, HiFR CEUS, SR CEUS, elastography, fat evaluation, viscosity
DOI: 10.3233/CH-249103
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Yan, Wentao | He, Xiuhua | Wang, Guanjun | Hu, Guochao | Cui, Bin
Article Type: Research Article
Abstract: INTRODUCTION: Visceral adipose tissue-derived serine protease inhibitor (vaspin) is an adipokine. It has been reported that decreased serum vaspin levels are significantly associated with stroke severity and prognosis. PURPOSE: This article aims to explore the theoretical feasibility of vaspin supplementation for cerebral ischemia-reperfusion (I/R) injury. METHODS: The I/R mouse models were constructed by the middle cerebral artery occlusion (MCAO) method, and the effects of vaspin on cerebral infarction, neurological function, angiogenesis and endoplasmic reticulum (ER) stress were explored. To verify the mediation of ER stress in the regulation of vaspin, human brain microvascular …endothelial cells (HBMECs) were subjected to ER stress agonist tunicamycin in vitro . The impacts of vaspin and tunicamycin on oxygen glucose deprivation/ recovery (OGD/R)-induced cell viability, apoptosis, and angiogenesis were examined. RESULTS: Vaspin inhibited blood-brain barrier breakdown and infarction occurred in the brain tissue of the I/R mice. Vaspin also enhanced cerebral neovascularization and reduced the apoptosis. Additional tunicamycin increased the apoptosis of HBMECs and inhibited angiogenesis, reversing the protective effect of vaspin on cells. CONCLUSION: Together, this study reveals that vaspin supplementation reduces cerebral infarction and works against neurological dysfunction. It maintains the survival and angiogenesis capacity of HBMECs by inhibiting ER stress. Show more
Keywords: Vaspin, ER stress, I/R injury, OGD/R, microvascular endothelial cell
DOI: 10.3233/CH-232077
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Sun, Hongshuang | Ren, Yunyun
Article Type: Research Article
Abstract: AIM: The aim of this study was to investigate the role of cerebroplacental ratio (CPR) in the final prenatal care for neonatal respiratory diseases and to analyze the risk of relevant factors associated with neonatal respiratory disorders. METHODS: A prospective cohort study of 795 singleton pregnancies was conducted. The pulsatility indices (PI) of the umbilical artery (UA) and the middle cerebral artery (MCA) were measured, and the MCA to UA ratio (CPR) was determined. The severity of the case is determined by whether or not the newborn has respiratory problems. Compare the CPR correlation between the two groups …and examine the illness prediction factors through a binary logistic regression method. RESULTS: Of the 801 participants, 114 had neonatal respiratory disorders. The mean values of CPR between neonatal respiratory diseases group and control group were 1.78±0.6, 1.97±0.9, respectively (P < 0.001). Maternal age, abortion history, cesarean section history, placental thickness, placental maturity, and amniotic fluid index (AFI) were determined to have no significant link between the two groups after comparison analysis (P > 0.05). It could be found that compared with the control group, CPR MoM indicators of neonatal respiratory distress syndrome, neonatal pneumonia and wet lung disease all show significant decreases. In binary logistic regression analysis, among the variables included in the model, CPR (OR:2.90, P = 0.015), fetal heart monitoring (OR:5.26, P < 0.001), delivery mode (OR:2.86, P < 0.001) and gestational age of delivery (OR:0.92, P < 0.001) were statistically significant in both groups. CONCLUSION: The findings of this study showed that infant respiratory problems were substantially related to CPR value. The correlation indicates that CPR was a powerful reference marker for respiratory disorders. Show more
Keywords: Cerebroplacental doppler ratio, fetal brain sparing, fetal lung maturation, neonatal respiratory disorders
DOI: 10.3233/CH-211333
Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-9, 2022
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