Clinical Hemorheology and Microcirculation - Volume 88, issue 1

Authors: Caimi, Gregorio | Lo Presti, Rosalia | Urso, Caterina | Brucculeri, Salvatore | Carlisi, Melania

Article Type: Research Article

Abstract: BACKGROUND: Leukocyte count is a prognostic marker for cardiovascular diseases, with key role in atherosclerosis development. Specific number of neutrophils, lymphocytes and monocytes can predict cardiovascular risk, also in asymptomatic subjects. Among the lipoprotein fractions, HDL-C is a protective factor in the cardiovascular disorders. For the above reason, we have examined the peripheral count of leukocytes, neutrophils, lymphocytes and monocytes, and the ratios between neutrophils/HDL-cholesterol, lymphocytes/HDL-cholesterol, and monocytes/HDL-cholesterol, to evaluate the possible utility of the obtained values in progression of asymptomatic carotid atherosclerosis. METHODS: We performed our analysis in a cohort of 100 subjects with asymptomatic …carotid atherosclerosis, of which 43 men and 57 women. The data were expressed as medians and IQR. To analyse the differences in leukocyte, neutrophil, lymphocyte, monocytes count and their ratio with HDL-cholesterol the Mann-Whitney test was employed. RESULTS: The peripheral count of leukocyte subtypes and the ratios, they change in relation to the number of cardiovascular risk factors and the degree of insulin resistance. CONCLUSIONS: In this cohort of subjects, the percentage of observed cardiovascular risk factors significantly affect some leukocyte parameters. These results, allow us to underline the importance of the leukocyte indices in the evaluation of subjects with asymptomatic vascular atherosclerosis. Show more

Keywords: Leukocyte count, neutrophils, lymphocytes, monocytes, HDL-Cholesterol

DOI: 10.3233/CH-232019

Citation: Clinical Hemorheology and Microcirculation, vol. 88, no. 1, pp. 1-11, 2024

Authors: Wang, Jiaxing | Sun, Zhengzhong | Jiang, Liya | Xuan, Lyv | Ma, Yunya | Wang, Jiao | Gu, Yan | Zhang, Yuxiang

Article Type: Research Article

Abstract: OBJECTIVE: To investigate the role of Pink1/Parkin-mediated mitochondrial autophagy in exertional heat stroke-induced acute lung injury in rats. METHODS: Sixty SD rats were divided into four groups: normal group (CON group), normal Parkin overexpression group (CON + Parkin group), exertional heat stroke group (EHS group), and exertional heat stroke Parkin overexpression group (EHS + Parkin group). Adeno-associated virus carrying the Parkin gene was intravenously injected into the rats to overexpress Parkin in the lung tissue. An exertional heat stroke rat model was established, and survival curves were plotted. Lung micro-CT was performed, and lung coefficient and pulmonary microvascular permeability were measured. …RESULTS: Compared with the EHS group, the survival rate of rats in the EHS + Parkin overexpression group was significantly increased, lung coefficient and pulmonary microvascular permeability were reduced, and pathological changes such as exudation and consolidation were significantly reduced. The levels of inflammatory factors IL-6, IL-1β, TNF- α, and ROS were significantly decreased; the degree of mitochondrial swelling in type II alveolar epithelial cells was reduced, and no vacuolization was observed. Lung tissue apoptosis was reduced, and the colocalization fluorescence of Pink1 and Parkin, as well as LC3 and Tom20, were increased. The expression of Parkin and LC3-II/LC3-I ratio in lung tissue were both increased, while the expression of P62, Pink1, MFN2, and PTEN-L was decreased. CONCLUSION: Impairment of Pink1/Parkin-mediated mitochondrial autophagy function is one of the mechanisms of exertional heat stroke-induced acute lung injury in rats. Activation of the Pink1/Parkin pathway can alleviate acute lung injury caused by exertional heat stroke. Show more

Keywords: Exertional heat stroke, acute lung injury, mitochondrial autophagy, Pink1, Parkin

DOI: 10.3233/CH-242100

Citation: Clinical Hemorheology and Microcirculation, vol. 88, no. 1, pp. 13-31, 2024

Authors: Zhang, Yingtan | Chen, Xiao | Li, Peipei | Zhang, Jiesi | Yu, Qiujie | Li, Li

Article Type: Research Article

Abstract: OBJECTIVE: To evaluate the preoperative predictive value of contrast-enhanced ultrasound (CEUS) combined with microflow imaging (MFI) in microvascular invasion (MVI) of hepatocellular carcinoma (HCC). METHODS: In our study, 80 patients with HCC were analyzed retrospectively. According to the gold standard of postoperative pathology, the patients were divided into MVI positive group (n  = 39) and MVI negative group (n  = 41). we were to analyze the correlation between CEUS and MVI in combination with MFI, to identify independent risk factors for the occurrence of MVI positive, and to analyze the predictive efficacy of every independent risk factor and their combination …in preoperative prediction of MVI. RESULTS: In our study, 80 patients were enrolled, including 39 patients in the MVI-positive group and 41 patients in the MVI-negative group, with a MVI-positive rate of 48.8%. By univariate analysis and multivariate analysis, it was found that there were statistically significant differences in enhancement range extension, start time of wash out and CEUS-MFI between the two groups, which were independent risk factors for MVI-positive. The combination of three independent risk factors is more effective than single one in predicting MVI of HCC. CONCLUSIONS: CEUS combined with MFI is feasible for the preoperative prediction of MVI in HCC, and can provides meaningful help for individualized clinical treatment. Show more

Keywords: Hepatocellular carcinoma (HCC), microvascular invasion (MVI), contrast-enhanced ultrasound (CEUS)

DOI: 10.3233/CH-242130

Citation: Clinical Hemorheology and Microcirculation, vol. 88, no. 1, pp. 33-41, 2024

Authors: Magnusson, Marine M. M. | Schüpbach-Regula, Gertraud | Rieger, Juliane | Plendl, Johanna | Marin, Ilka | Drews, Barbara | Kaessmeyer, Sabine

Article Type: Research Article

Abstract: BACKGROUND: The use of endothelial cell cultures has become fundamental to study angiogenesis. Recent advances in artificial intelligences (AI) offer opportunities to develop automated assessment methods in medical research, analyzing larger datasets. OBJECTIVE: The aim of this study was to compare the application of AI with a manual method to morphometrically quantify in vitro angiogenesis. METHODS: Co-cultures of human microvascular endothelial cells and fibroblasts were incubated mimicking endothelial capillary-beds. An AI-software was trained for segmentation of endothelial capillaries on anti-CD31-labeled light microscope crops. Number of capillaries and branches and average capillary diameter were measured by …the AI and manually on 115 crops. RESULTS: The crops were analyzed faster by the AI than manually (3 minutes vs 1 hour per crop). Using the AI, systematically more capillaries (mean 48/mm2 vs 27/mm2 ) and branches (mean 23/mm2 vs 11/mm2 ) were counted than manually. Both methods had a strong linear relationship in counting capillaries and branches (r-capillaries = 0.88, r-branches = 0.89). No correlation was found for measurements of the diameter (r-diameter = 0.15). CONCLUSIONS: The present AI reduces the time required for quantitative analysis of angiogenesis on large datasets, and correlates well with manual analysis. Show more

Keywords: Artificial intelligence, HMVEC, machine learning, endothelial cells, angiogenesis

DOI: 10.3233/CH-242157

Citation: Clinical Hemorheology and Microcirculation, vol. 88, no. 1, pp. 43-58, 2024

Authors: Zeng, Rui | Wang, Yimin | Chen, Jun | Liu, Qiang

Article Type: Research Article

Abstract: BACKGROUND: In the pathogenesis of atherosclerotic cardiovascular disorders, vascular endothelium is crucial. A critical step in the development of atherosclerosis is endothelial dysfunction. Furin may play a factor in vascular remodeling, inflammatory cell infiltration, regulation of plaque stability, and atherosclerosis by affecting the adhesion and migration of endothelial cells. It is yet unknown, though, how furin contributes to endothelial dysfunction. METHODS: We stimulated endothelial cells with oxidized modified lipoprotein (ox-LDL). Endothelial-to-mesenchymal transition (EndMT) was found using immunofluorescence (IF) and western blot (WB). Furin expression level and Hippo/YAP signal activation were found using reverse transcription-quantitative PCR (RT-qPCR) and WB, …respectively. To achieve the goal of furin knockdown, we transfected siRNA using the RNA transmate reagent. Following furin knockdown, cell proliferation, and migration were assessed by the CCK-8, scratch assay, and transwell gold assay, respectively. WB and IF both picked up on EndMT. WB and RT-qPCR, respectively, were used to find furin’s expression level. We chose the important micrornas that can regulate furin and we then confirmed them using RT-qPCR. RESULTS: EndMT was created by ox-LDL, evidenced by the up-regulation of mesenchymal cell markers and the down-regulation of endothelial cell markers. Furin expression levels in both protein and mRNA were increased, and the Hippo/YAP signaling pathway was turned on. Furin knockdown dramatically reduced the aberrant migration and proliferation of endothelial cells by ox-LDL stimulation. Furin knockdown can also suppress ox-LDL-induced EndMT, up-regulate indicators of endothelial cells, and down-regulate markers of mesenchymal cells. After ox-LDL stimulation and siRNA transfection, furin’s expression level was up-regulated and down-regulated. CONCLUSION: Our study demonstrated that furin knockdown could affect ox-LDL-induced abnormal endothelial cell proliferation, migration, and EndMT. This implies that furin plays an important role in endothelial dysfunction. Show more

Keywords: Furin, EndMT, endothelial cells, endothelial dysfunction

DOI: 10.3233/CH-242171

Citation: Clinical Hemorheology and Microcirculation, vol. 88, no. 1, pp. 59-70, 2024

Authors: Wang, Guojuan | Yin, Ci | Wang, Yanfang | Li, Qi | Yang, Dan | Wang, Peihua | Nie, Fang

Article Type: Research Article

Abstract: OBJECTIVE: To investigate the diagnostic value of CEUS in atypical-enhanced PTC. METHODS: The clinical data, qualitative and quantitative parameters of CEUS in 177 Iso/hyper-enhanced thyroid nodules with definite pathological results were retrospectively analyzed in the Lanzhou University Second Hospital from June 2019 to January 2021. And the clinical value of CEUS in the diagnosis of atypical-enhanced PTC was assessed using univariate and multivariate analysis. RESULTS: Among the 177 thyroid nodules, 59 were benign and 118 were PTC. There were significant differences in age, enhancement border, ring enhancement, speed of wash in, speed of wash out, enhancement …pattern, capsule interruption, time to peak, time to wash out, RT, TPH, and TTP (P  < 0.05). Multivariate analysis showed unclear enhancement border and concentric enhancement were independent risk factors for the diagnosis of atypical-enhanced PTC by CEUS. The sensitivity, specificity, PPV, NPV, and accuracy of the model in diagnosing atypical-enhanced PTC were 88.1%, 71.2%, 86.0%, 75.0%, and 82.5%, respectively. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was 0.910. CONCLUSION: The diagnosis of atypical-enhanced PTC can be better performed by enhancement characteristics and time intensity curve (TIC) of CEUS, which have a good clinical application value. Show more

Keywords: Contrast-enhanced ultrasound, papillary thyroid carcinoma, atypical

DOI: 10.3233/CH-242173

Citation: Clinical Hemorheology and Microcirculation, vol. 88, no. 1, pp. 71-79, 2024

Authors: Wen, Peng | Liu, Lei | Pan, Lili | Li, Xiukun

Article Type: Research Article

Abstract: OBJECTIVE: The primary aim of this study is to assess the diagnostic efficacy of elastography and contrast-enhanced ultrasound (CEUS) in the identification of breast lesions subsequent to the optimization and correction of the BI-RADS category 4 classification obtained through conventional ultrasound. The objective is to augment both the specificity and accuracy of breast lesion diagnosis, thereby establishing a reliable framework for reducing unnecessary biopsies in clinical settings. METHODS: A cohort comprising 50 cases of breast lesions classified under BI-RADS category 4 was collected during the period from November 2022 and November 2023. These cases were examined utilizing strain …elastography (SE), shear wave elastography (SWE), and CEUS. Novel scoring methodologies for ultrasonic elastography (UE) and CEUS were formulated for this investigation. Subsequently, the developed UE and CEUS scoring systems were used to refine and optimize the conventional BI-RADS classification, either in isolation or in conjunction. Based on the revised classification, the benign group was classified as category 3 and the suspected malignant group was classified as category 4a and above, with pathological results serving as the definitive reference standard. The diagnostic efficacy of the optimized UE and CEUS, both independently and in combination, was meticulously scrutinized and compared using receiver operating characteristic (ROC) curve analysis, with pathological findings as the reference standard. RESULTS: Within the study group, malignancy manifested in 11 cases. Prior to the implementation of the optimization criteria, 78% (39 out of 50) of patients underwent biopsies deemed unnecessary. Following the application of optimization criteria, specifically a threshold of≥8.5 points for the UE scoring method and≥6.5 points for the CEUS scoring method, the incidence of unnecessary biopsies diminished significantly. Reduction rates were observed at 53.8% (21 out of 39) with the UE protocol, 56.4% (22 out of 39) with the CEUS protocol, and 89.7% (35 out of 39) with the combined UE and CEUS optimization protocols. CONCLUSION: The diagnostic efficacy of conventional ultrasound BI-RADS category 4 classification for breast lesions is enhanced following optimized correction using UE and CEUS, either independently or in conjunction. The application of the combined protocol demonstrates a notable reduction in the incidence of unnecessary biopsies. Show more

Keywords: BI-RADS 4 categories, breast lesions, contrast-enhanced ultrasound, elastography, optimization correction, scoring method

DOI: 10.3233/CH-242216

Citation: Clinical Hemorheology and Microcirculation, vol. 88, no. 1, pp. 81-95, 2024

Authors: Li, Yi-xiang | Li, Wen-jing | Xu, Yong-sheng | Jia, Lu-lu | Wang, Miao-miao | Qu, Meng-meng | Wang, Li-li | Lu, Xian-de | Lei, Jun-qiang

Article Type: Research Article

Abstract: OBJECTIVE: This study aimed to investigate the feasibility of using dual-layer spectral CT multi-parameter feature to predict microvascular invasion of hepatocellular carcinoma. METHODS: This retrospective study enrolled 50 HCC patients who underwent multiphase contrast-enhanced spectral CT studies preoperatively. Combined clinical data, radiological features with spectral CT quantitative parameter were constructed to predict MVI. ROC was applied to identify potential predictors of MVI. The CT values obtained by simulating the conventional CT scans with 70 keV images were compared with those obtained with 40 keV images. RESULTS: 50 hepatocellular carcinomas were detected with 30 lesions (Group A) with microvascular …invasion and 20 (Group B) without. There were significant differences in AFP,tumer size, IC, NIC,slope and effective atomic number in AP and ICrr in VP between Group A ((1000(10.875,1000),4.360±0.3105, 1.7750 (1.5350,1.8825) mg/ml, 0.1785 (0.1621,0.2124), 2.0362±0.2108,8.0960±0.1043,0.2830±0.0777) and Group B (4.750(3.325,20.425),3.190±0.2979,1.4700 (1.4500,1.5775) mg/ml, 0.1441 (0.1373,0.1490),1.8601±0.1595, 7.8105±0.7830 and 0.2228±0.0612) (all p  < 0.05). Using 0.1586 as the threshold for NIC, one could obtain an area-under-curve (AUC) of 0.875 in ROC to differentiate between tumours with and without microvascular invasion. AUC was 0.625 with CT value at 70 keV and improved to 0.843 at 40 keV. CONCLUSION: Dual-layer spectral CT provides additional quantitative parameters than conventional CT to enhance the differentiation between hepatocellular carcinoma with and without microvascular invasion. Especially, the normalized iodine concentration (NIC) in arterial phase has the greatest potential application value in determining whether microvascular invasion exists, and can offer an important reference for clinical treatment plan and prognosis assessment. Show more

Keywords: Hepatocellular carcinoma, microvascular invasion, dual-layer spectral CT, energy spectrum curve, effective atomic number

DOI: 10.3233/CH-242175

Citation: Clinical Hemorheology and Microcirculation, vol. 88, no. 1, pp. 97-113, 2024