Abstract Introduction To explore how to measure LAP Eq accurately and quantitatively, that is, the left atrial pressure (LAP) measured and calculated by equation method using mitral regurgitation spectrum. Methods The mitral regurgitation spectrum, pulmonary arteriolar wedge pressure (PAWP) and invasive arterial systolic pressure of radial artery of 28 patients were collected simultaneously, including 3 patients with rheumatic heart disease, 15 patients with mitral valve prolapse and 10 patients with coronary artery bypass grafting, patients with moderate or above aortic stenosis were excluded. LAP Bp (Doppler sphygmomanometer method), LAP Eq (Equation method) and LAP C (Catheter method) were measured synchronously, and the measurement results of the three methods were compared and analyzed. A special intelligent Doppler spectrum analysis software was self-designed to accurately measure LAP Eq . This study had been approved by the ethics committee of the Northern Theater General Hospital (K-2019-17), and applied for clinical trial (No. Chictr 190023812). Results It was found that there was no significant statistical difference between the measurement results of LAP C and LAP Eq ( t = 0.954, P = 0.348), and significant correlation between the two methods [ r = 0.908(0.844, 0.964), P < 0.001]. Although the measurement results of LAP C and LAP BP are consistent in the condition of non-severe eccentric mitral regurgitation, there are significant differences in the overall case and weak correlation between the two methods [ r = 0.210, (−0.101, 0.510), P = 0.090]. In MVP patients with P1 or P3 prolapse, the peak pressure difference of MR was underestimated due to the serious eccentricity of MR, which affected the accuracy of LAP BP measurement. Conclusions It was shown that there is a good correlation between LAP Eq and LAP C , which verifies that the non-invasive and direct quantitative measurement of left atrial pressure based on mitral regurgitation spectrum is feasible and has a good application prospect.
Abstract Background: This study performed an overall assessment of the accuracy of ultrasound-guided fine-needle aspiration (FNA) and core needle biopsy (CNB) for detecting axillary lymph nodes in women with breast cancer based on qualified studies. Methods: Eligible studies and pertinent literature resources were identified on Cochrane, PubMed, Embase, CNKI, VIP, and Wanfang databases through searching key words or terms. The latest study was published in the March 2020. The eligible publications contained cohort and cross-sectional researches. All the publications obtained were tested for heterogeneity, and corresponding effect models were used to calculate amalgamative values of sensitivity, specificity and diagnostic odds ratio (DOR). Analysis of summary receiver operating characteristic (SROC) was performed on suspicious axillary lymph nodes. Results: A total of 22 studies involving 3548 patients were included to explore the accuracy of FNA in identifying axillary lymph nodes in women with breast cancer. 11 studies involving 758 patients were included to explore the accuracy of CNB in identifying axillary lymph nodes in women with breast cancer. The accuracy of FNA in identifying suspicious axillary lymph nodes was specifically as follows: overall sensitivity was 79% (95%CI: 73%-84%), global specificity was 96% (95%CI: 92%-98%), overall positive likelihood ratio was 18.55 (95% CI: 10.53-32.69), overall negative likelihood ratio was 0.22 (95% CI: 0.17-0.28), the overall DOR was 71.68 (95%CI: 37.19-138.12), and the acreage under the SROC was (AUC = 0.94; 95% CI: 0.92-0.96). The accuracy of CNB in identifying suspicious axillary lymph nodes was specifically as follows: overall sensitivity was 85% (95%CI: 81%-89%), global specificity was 93% (95%CI: 87%-96%), overall positive likelihood ratio was 11.88 (95% CI: 6.56-21.50), overall negative likelihood ratio was 0.16 (95% CI: 0.12-0.21), the overall DOR was 66.83 (95%CI: 33.28-134.21), and the acreage under the SROC was (AUC = 0.96; 95% CI: 0.94-0.97). Conclusions : The results indicated that both FNA and CNB had high accuracy for suspicious axillary lymph nodes.
Objective To investigate the value of Vector Flow Imaging (V Flow) in the assessment of post-stenotic turbulence in the canine arterial stenosis model. Materials and Methods Canine femoral artery stenosis models were established using ameroid constrictors in 12 beagle dogs. 50% and then 70% femoral artery stenoses were confirmed by selective femoral artery angiography. V Flow was used to measure femoral artery flow turbulence index (Tur) preoperatively as a baseline. After establishing of a 50% and then 70% stenoses, the Tur indices were recorded in the femoral artery at 1, 3, 5, 7, 9, 11, 13, 15, 17, and 19 mm distal to the stenosis. Results Baseline Tur indices of normal canine femoral arteries were <1% in 11 of 12 cases (91.7%). Distal to a 50% stenosis, the Tur index (>1%) was recorded in 83.3–100% cases between 1 and 9 mm, 41.7–58.3% between 11 and 17 mm, and 16.7% at 19 mm. For a 70% stenosis, the Tur index (>1%) occurred in 81.8–100% cases between 1 and 17 mm distal to the stenosis, and 63.6% at 19 mm. The Tur index peaked around 7 mm or 2.3 times of the initial vessel diameter (3 mm) downstream for a 50% stenosis and 11 mm or 3.7 times of vessel diameter downstream for a 70% stenosis. Conclusion V Flow with Tur index measurement adds quantitative information of post-stenotic turbulence when assessing an arterial stenosis with ultrasound. Tur index of 1% seems a useful threshold for assessment of flow turbulence in this small sample study. Further studies with larger sample size are needed to evaluate the value of V Flow in clinical applications.
Previous studies have shown that both hepatitis A virus and hepatitis C virus inhibit innate immunity by cleaving the mitochondrial antiviral signaling (MAVS) protein, an essential component of the virus-activated signaling pathway that activates NF-kappaB and IFN regulatory factor-3 to induce the production of type I IFN. For human hepatitis B virus (HBV), hepatitis B s-Ag, hepatitis B e-Ag, or HBV virions have been shown to suppress TLR-induced antiviral activity with reduced IFN-beta production and subsequent induction of IFN-stimulated genes. However, HBV-mediated suppression of the RIG-I-MDA5 pathway is unknown. In this study, we found that HBV suppressed poly(deoxyadenylate-thymidylate)-activated IFN-beta production in hepatocytes. Specifically, hepatitis B virus X (HBX) interacted with MAVS and promoted the degradation of MAVS through Lys(136) ubiquitin in MAVS protein, thus preventing the induction of IFN-beta. Further analysis of clinical samples revealed that MAVS protein was downregulated in hepatocellular carcinomas of HBV origin, which correlated with increased sensitivities of primary murine hepatocytes isolated from HBX knock-in transgenic mice upon vesicular stomatitis virus infections. By establishing a link between MAVS and HBX, this study suggests that HBV can target the RIG-I signaling by HBX-mediated MAVS downregulation, thereby attenuating the antiviral response of the innate immune system.
Objective:To explore the clinical effect of domestic lauromacrogol as a new foam sclerosing agent in the treatment of varicose veins of lower extremity. Methods:The data of 30 patients with varicose veins who were treated with 1% lauromacrogol foam sclerosing agent inserted in the great saphenous vein (GSV) through a catheter was collected from April to August 2008 in our hospital, and the occlusions of GSV in 2 weeks and 3 months after the treatment were observed. Results: Thirty patients were successfully treated by catheter-directed foam sclerotherapy. The average volume of foam sclerosing agent in each case was 6.2 mL. Axial reflux in GSV disappeared immediately in 27 of 30 patients (90%) after the treatment. There were 27 patients (90%) showing the occlusions of GSV examined by colour duplex vascular ultrasound in 2 weeks and 3 months after the procedure. Obvious abnormal varicose veins as well as the soreness and fatigue of lower extremity disappeared in 27 patients in 3-month follow-up. Mild and localized varicose veins of leg were found in 4 patients (15%). No severe complication was reported. Five patients developed superficial phlebitis, while the symptom was spontaneous remission in two weeks. Conclusion: The effect of domestic lauromacrogol foam sclerosing agent in the treatment of varicose veins was considerable, and the sclerotherapy can be a relatively new option for minimally invasive treatment of patient with varicose veins of lower extremity.
Background Innate immunity to viruses involves receptors such as RIG-I, which senses viral RNA and triggers an IFN-β signaling pathway involving the outer mitochondrial membrane protein MAVS. However, the functional status of MAVS phosphorylation remains elusive. Methodology/Principal Findings Here we demonstrate for the first time that MAVS undergoes extensive tyrosine phosphorylation upon viral infection, indicating that MAVS phosphorylation might play an important role in MAVS function. A tyrosine-scanning mutational analysis revealed that MAVS tyrosine-9 (Y9) is a phosphorylation site that is required for IFN-β signaling. Indeed, MAVS Y9F mutation severely impaired TRAF3/TRAF6 recruitment and displayed decreased tyrosine phosphorylation in response to VSV infection compared to wild type MAVS. Functionally, MAVS Y9 phosphorylation contributed to MAVS antiviral function without interfering with its apoptosis property. Conclusions/Significance These experiments identify a novel residue of MAVS that is crucially involved in the recruitment of TRAF3/TRAF6 and in downstream propagation of MAVS signaling.
Objective
To find a new method for evaluating the left ventricular relaxation time constant Tau with aortic regurgitation by continuous wave Doppler.
Methods
Twelve Beagle dogs were included in the study. The dog aortic regurgitation model was produced under ultrasound guiding by carotid artery puncture. Aortic pressure was measured by pressure catheter and left ventricular pressure was measured by Millar catheter which was introduced into the left ventricular through cardiac apex. Then microspheres were injected into the left coronary artery under the guidance of ultrasound to induce acute ischemic left ventricular dysfunction, when left ventricular end-diastolic pressure increased more than 5 mmHg (1 mmHg=0.133 kPa). Dobutamine or esmolol was infused to alter left ventricular function. Aortic regurgitation velocity spectrum was recorded by the continuous-wave Doppler echocardiography in different hemodynamic status. At the same time, left ventricular pressure, dp/dt, aortic pressure and continuous ECG tracing were displayed on the multi-channel physiological recorder. Measurement was recorded of –dp/dtmax in the dp/dt tracings and the pressure at the time of –dp/dtmax in the left ventricular pressure tracings. Tau =-P/(dp/dtmax), Tau was the catheter-derived time constant (Taucatheter). Aortic regurgitation spectrum of original audio data was post-processed with MATLAB mathematical software. The spectral lines refresh time of about 300 μs was chosen to form a new Doppler spectrum. Three points: (t1,1 m/s), (t2, 2 m/s) and (t3, 3 m/s) were selected in aortic regurgitation velocity spectrum and t1, t2 and t3 was put into the corresponding Tau formula: Tau=(t2-t1)/ln[(ADP-C-4)/(ADP-C-16)], Tau=(t3-t1)/ln[(ADP-C-4)/(ADP-C-36)]. Tau was the aortic regurgitant time constant (Tauultrasound). The difference between Taucatheter and Tauultrasound was compared by paired t test. The correlation between Taucatheter and Tauultrasound was analyzed by Pearson correlation analysis.
Results
Twelve dogs were successfully produced aortic regurgitation model. Two dogs died of ventricular fibrillation during the procedure of acute ischemic left ventricular diastolic dysfunction. The range of the Taucatheter was between 27.12 ms and 86.88 ms with an average of (48.973±14.667) ms; the range of the Tauultrasound was between 28.13 ms and 90.18 ms with an average of (51.236±15.146) ms. The difference was not statistically significant (t=1.841, P>0.05). Pearson correlation analysis showed that Taucatheter was positively correlated with Tauultrasound (r=0.89, P=0.000).
Conclusion
Choosing three points: (t1, 1 m/s), (t2, 2 m/s) and (t3, 3 m/s) in aortic regurgitant velocity spectrum and putting into the corresponding formula, we can calculate Tau, which had a good correlation with the catheter-derived Tau.
Key words:
Left ventricular relaxation time constant; Continuous wave Doppler; Aortic valve insufficiency
OBJECTIVE To assess the effect of obstructive sleep apnea hypopnea syndrome (OSAHS) on brachial-ankle pulse wave velocity (b-aPWV) in untreated diagnosed patients. METHODS This study involved 24 consecutive male patients with newly diagnosed untreated OSAHS (aged 39.13±8.31 years) and 22 normal male individuals (aged 39.59±10.86 years) matched for age and body mass index. Carotid and extremities ultrasound were performed in all the subjects, and none of them had atherosclerosis, arterial calcification, or aneurysm. No subject had a history of hypertension, coronary heart disease or stroke. All the subjects underwent arterial stiffness evaluation by means of b-aPWV measurements. RESULTS The b-aPWV in OSAHS patients was significantly higher than that in normal subjects (1346.86±123.48 vs 1237.91±84.46, P<0.01), and the rate of positive b-aPWV in OSAHS patients was significantly higher (13/24 vs 1/22, P<0.01). CONCLUSION The value and positive rate of b-aPWV in OSAHS patients are higher than those in normal people, suggesting increased arterial stiffness in OSAHS patients.
Objective
To study the changes of Young′s modulus value of the renal cortex, vertebral body and sinus when there was a different degree of acute renal artery stenosis.
Methods
10 Japanese white rabbits were used for this study. The left renal artery was dissected. An ultrasound probe was placed on the left kidney, Young′s modulus of the renal cortex, vertebral body and sinus were recorded using shear wave ultrasound elastic imaging technique during three stages: when the renal artery was intact (0% stenosis), tied with a suture (> 50% stenosis), and ligated (100% stenosis). Renal tissue elasticity with different degrees of renal artery stenosis were compared. Pathological study was carried out in the kidneys, each with either 0%, >50% or 100% renal artery stenosis.
Results
The mean values of Young′s modulus from the renal cortex, vertebral body and sinus with different degrees of renal artery stenosis were as follows: 0% stenosis, (16.31±1.70) kPa, (13.38±1.63) kPa, and (12.75±2.26) kPa; >50% stenosis, (14.16±2.34) kPa, (11.49±2.70) kPa, and (10.72±2.56) kPa; 100% stenosis, (11.35±1.48) kPa, (8.39±1.29) kPa, and (7.08±1.52) kPa. The mean value of Young′s modulus from the renal cortex was significantly higher than those from the renal vertebral body and sinus (P<0.05). The mean values of Young′s modulus from different parts of the kidney decreased progressively with an increase in renal artery stenosis (P<0.05). The pathological study demonstrated that with the increase in the severity of renal artery stenosis, glomerular volume, renal interstitial capillary diameter and red blood cells decreased. When renal artery stenosis reached 100%, there was patch degeneration and inflammatory cell infiltration within the renal interstitium, and mild degeneration of tubular epithelial cells with obscure cell borders.
Conclusions
The value of Young′s modulus from the renal cortex was higher than those from the renal pyramid and sinus in rabbits. The values of Young′s modulus from the renal cortex, pyramid and sinus decreased with an increase in the severity of renal artery stenosis, which suggest that, in the study of the elasticity of the kidney, the renal artery blood flow dynamic state can obviously affect the value of the elasticity of the kidney.
Key words:
Renal artery obstruction; Elasticity imaging techniques; Rabbits
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