Chronic liver disease is a major cause of morbidity and mortality worldwide and usually develops over many years, as a result of chronic inflammation and scarring, resulting in end-stage liver disease and its complica...Chronic liver disease is a major cause of morbidity and mortality worldwide and usually develops over many years, as a result of chronic inflammation and scarring, resulting in end-stage liver disease and its complications. The progression of disease is characterised by ongoing inflammation and consequent fibrosis, although hepatic steatosis is increasingly being recognised as an important pathological feature of disease, rather than being simply an innocent bystander. However, the current gold standard method of quantifying and staging liver disease, histological analysis by liver biopsy, has several limitations and can have associated morbidity and even mortality. Therefore, there is a clear need for safe and noninvasive assessment modalities to determine hepatic steatosis, inflammation and fibrosis. This review covers key mechanisms and the importance of fibrosis and steatosis in the progression of liver disease. We address non-invasive imaging and blood biomarker assessments that can be used as an alternative to information gained on liver biopsy.展开更多
BACKGROUND:Volume resuscitation has only been demonstrated to be effective in approximately fifty percent of patients.The remaining patients do not respond to volume resuscitation and may even develop adverse outcomes...BACKGROUND:Volume resuscitation has only been demonstrated to be effective in approximately fifty percent of patients.The remaining patients do not respond to volume resuscitation and may even develop adverse outcomes(such as acute pulmonary edema necessitating endotracheal intubation).We believe that point-of-care ultrasound is an excellent modality by which to adequately predict which patients may benefi t from volume resuscitation.DATA RESOURCES:We performed a search using PubMed,Scopus,and MEDLINE.The following search terms were used:fluid responsiveness,ultrasound,non-invasive,hemodynamic,fluid challenge,and passive leg raise.Preference was given to clinical trials and review articles that were most relevant to the topic of assessing a patient’s cardiovascular ability to respond to intravenous fl uid administration using ultrasound.RESULTS:Point-of-care ultrasound can be easily employed to measure the diameter and collapsibility of various large vessels including the inferior vena cava,common carotid artery,subclavian vein,internal jugular vein,and femoral vein.Such parameters are closely related to dynamic measures of fluid responsiveness and can be used by providers to help guide fluid resuscitation in critically ill patients.CONCLUSION:Ultrasound in combination with passive leg raise is a non-invasive,costand time-effective modality that can be employed to assess volume status and response to fluid resuscitation.Traditionally sonographic studies have focused on the evaluation of large veins such as the inferior vena cava,and internal jugular vein.A number of recently published studies also demonstrate the usefulness of evaluating large arteries to predict volume status.展开更多
<strong>Objectives:</strong> To elucidate the role of lung ultrasound in assessment of subclinical fluid overload in hemodialysis (HD) patients. <strong>Background:</strong> Volume overload has...<strong>Objectives:</strong> To elucidate the role of lung ultrasound in assessment of subclinical fluid overload in hemodialysis (HD) patients. <strong>Background:</strong> Volume overload has a significant role in HD patients with difficult blood pressure control. The clinical evaluation of fluid status is challenging and has poor diagnostic accuracy. Extravascular lung water (ELW) represents an important element of body fluid volume. Lung ultrasound (LUS) is increasingly used for ELW assessment through the analysis of B-lines artifacts. <strong>Methods:</strong> Eighty-eight HD patients were followed up prospectively. Patients were divided into 3 groups according to the changes of systolic blood pressure (SBP) during HD sessions. Group (1): patients with intra-dialytic hypertension (n = 12), group (2): patients with intra-dialytic hypotension (n = 28) and group (3): patients with no significant blood pressure variabilities (n = 48). Numbers of B-lines were measured by LUS and IVC diameters were measured pre and post-dialysis. In addition, Endothelin-1 (ET-1) and other routine laboratory tests were done. <strong>Results:</strong> There were significant increases in the number of B-lines and IVC diameter pre and post-dialysis in group (1) compared to the other two groups. There was significant decrease in post dialysis IVC diameter but not the number of B-lines in group (2) compared with the other two groups. ET-1 level was significantly increased in group 1 compared to the other two groups. There was a statistically significant positive correlation between the pre-dialysis number of B-lines and ET-1. <strong>Conclusion:</strong> Lung ultrasound can be considered a sensitive and specific modality for volume assessment in HD patients especially with intra-dialytic hypertension. We recommend serial LUS as a part of management in this group of patients.展开更多
Liver disease accounts for approximately 2 million deaths per year worldwide.All chronic liver diseases(CLDs),whether of toxic,genetic,autoimmune,or infectious origin,undergo typical histological changes in the struct...Liver disease accounts for approximately 2 million deaths per year worldwide.All chronic liver diseases(CLDs),whether of toxic,genetic,autoimmune,or infectious origin,undergo typical histological changes in the structure of the tissue.These changes may include the accumulation of extracellular matrix material,fats,triglycerides,or tissue scarring.Noninvasive methods for diagnosing CLD,such as conventional B-mode ultrasound(US),play a significant role in diagnosis.Doppler US,when coupled with B-mode US,can be helpful in evaluating the hemodynamics of hepatic vessels and detecting US findings associated with hepatic decompensation.US elastography can assess liver stiffness,serving as a surrogate marker for liver fibrosis.It is important to note that interpreting these values should not rely solely on a histological classification.Contrast-enhanced US(CEUS)provides valuable information on tissue perfusion and enables excellent differentiation between benign and malignant focal liver lesions.Clinical evaluation,the etiology of liver disease,and the patient current comorbidities all influence the interpretation of liver stiffness measurements.These measurements are most clinically relevant when interpreted as a probability of compensated advanced CLD.B-mode US offers a subjective estimation of fatty infiltration and has limited sensitivity for mild steatosis.The controlled attenuation parameter requires a dedicated device,and cutoff values are not clearly defined.Quan-titative US parameters for liver fat estimation include the attenuation coefficient,backscatter coefficient,and speed of sound.These parameters offer the advantage of providing fat quantification alongside B-mode evaluation and other US parameters.Multiparametric US(MPUS)of the liver introduces a new concept for complete noninvasive diagnosis.It encourages examiners to utilize the latest features of an US machine,including conventional B-mode,liver stiffness evaluation,fat quantification,dispersion imaging,Doppler US,and CEUS for focal liver lesion characterization.This comprehensive approach allows for diagnosis in a single examination,providing clinicians worldwide with a broader perspective and becoming a cornerstone in their diagnostic arsenal.MPUS,in the hands of skilled clinicians,becomes an invaluable predictive tool for diagnosing,staging,and monitoring CLD.展开更多
Atherosclerosis is the early stage of arterial disease, and underlies development of cardiovascular disease (CVD) and stroke. Although sophisticated models for assessing CVD and stroke risk have been derived based on ...Atherosclerosis is the early stage of arterial disease, and underlies development of cardiovascular disease (CVD) and stroke. Although sophisticated models for assessing CVD and stroke risk have been derived based on large-scale prospective studies, their abilities in detecting the presence or absence of atherosclerotic plaque have not been investigated. This study aimed to evaluate and compare discriminatory and risk stratifying abilities of 13 CVD risk assessment models against the ultrasound detection of carotid plaques in type 2 diabetes mellitus (T2DM) patients. Forty-nine T2DM subjects were recruited with informed consent, and major anthropomorphic and biomarker data for these models were collected. The model risk scores were evaluated against the carotid plaques detected by Doppler ultrasound. Only the FHS-Lpts-CHD-10Y model, which is a variant of the Framingham model, revealed an area under the receiver operating curve (AUROC) that was significantly different from a random scoring approach (AUROC: 0.681, p was able to stratify the risk levels of carotid plaque presence (Chi-Square statistic: 5.99,展开更多
The diameters of spermatic veins and blood reflux in sixty-two male patients with infertility caused by varicocele were assessed with Doppler ultrasound in this study. Scrotal thermograph, testes volume and semen anal...The diameters of spermatic veins and blood reflux in sixty-two male patients with infertility caused by varicocele were assessed with Doppler ultrasound in this study. Scrotal thermograph, testes volume and semen analysis were also applied to analysis of these patients. Among sixty-two patients, thirty-one received high ligation of internal spermatic vein. The results showed: 1. The diameter of spermatic veins was negatively correlated with fertility index and positively correlated with Doppler grading of blood reflux. 2. In operative patients, the effect of surgery was better in patients with blood reflux than in those without blood reflux. It was suggested the diameter of spermatic veins probably reflects the duration and serious degree of blood reflux in spermatic vein, and may be used for assessment of severity of male infertility in combination with semen analysis.展开更多
Objective: To analyze the effectiveness of musculoskeletal ultrasound in diagnosing rotator cuff injuries. Methods: A total of 80 patients with suspected rotator cuff injuries who were admitted and diagnosed between J...Objective: To analyze the effectiveness of musculoskeletal ultrasound in diagnosing rotator cuff injuries. Methods: A total of 80 patients with suspected rotator cuff injuries who were admitted and diagnosed between January 1, 2020, and December 31, 2024, were selected. Musculoskeletal ultrasound was performed on these patients, and the diagnostic efficacy of musculoskeletal ultrasound was evaluated by comparing the results with those of MRI. Results: The detection rates of musculoskeletal ultrasound for the location and extent of injury were similar to those of MRI (p > 0.05). Based on the MRI diagnosis results, the diagnostic accuracy rate of musculoskeletal ultrasound was 92.50%, with a sensitivity of 93.06% and a specificity of 87.50%. The morphological and signal characteristics, as well as ultrasound indicators, of patients with positive musculoskeletal ultrasound results differed significantly from those of patients with negative results (p < 0.05). Conclusion: Musculoskeletal ultrasound can effectively detect the location and extent of rotator cuff injuries, comprehensively assess the damage, and demonstrate high diagnostic efficacy. Furthermore, the morphological and signal characteristics, as well as ultrasound indicators, of musculoskeletal ultrasound can serve as diagnostic criteria for rotator cuff injuries, improving disease detection efficiency.展开更多
A biloma is a rare disease characterized by an abnormal intra-or extrahepatic bile collection due to a traumatic or spontaneous rupture of the biliary system.Laboratory findings are nonspecific.The diagnosis is usuall...A biloma is a rare disease characterized by an abnormal intra-or extrahepatic bile collection due to a traumatic or spontaneous rupture of the biliary system.Laboratory findings are nonspecific.The diagnosis is usually suspected on the basis of a typical history(right upper quadrant abdominal pain,chills,fever and recent abdominal trauma or surgery) and is confirmed by detection of typical radiologic features.We report the case of a patient with a history of previous cholecystectomy for lithiasis who presented with clinical symptoms and laboratory data suggestive of acute pancreatitis.Imaging studies also revealed the presence of a chronic and asymptomatic biloma,which could be mistaken for a pseudocyst.The atypical location and ultrasound findings suggested an alternative diagnosis.We therefore reviewed the known literature for bilomas,focusing on the role of ultrasonography,which can reveal some typical aspects,such as location and imaging features.Weconclude that ultrasound plays a key role in the assessment of a suspected biloma in patients with appropriate history and clinical features and provides valuable diagnostic clues even in the absence of these.展开更多
Advances in recent years in the understanding of, and the genetic diagnosis of hereditary hemochromatosis (HH) have changed the approach to iron overload he-reditary diseases. The ability to use a radiologic tool (MRI...Advances in recent years in the understanding of, and the genetic diagnosis of hereditary hemochromatosis (HH) have changed the approach to iron overload he-reditary diseases. The ability to use a radiologic tool (MRI) that accurately provides liver iron concentration determination, and the presence of non-invasive sero-logic markers for fibrosis prediction (ser um ferritin, platelet count, transaminases, etc), have diminished the need for liver biopsy for diagnosis and prognosis of this disease. Consequently, the role of liv er biopsy in iron metabolism disorders is changing. Furthermore, the irruption of transient elastography to assess liver stiffness, and, more recently, the ability to determine liver f ibrosis by means of MRI elastography will change this role even more, with a potential drastic decline in hepatic biopsies in years to come. This review will provide a brief summary of the different non-invasive methods available nowadays for diagnosis and prognosis in HH, and point out potential new techniques that could come about in the next years for fibrosis prediction, thus avoiding the need for liver biopsy in a greater number of patients. It is possible that liver biopsy will remain useful for the diagnosis of associated diseases, where other non-invasive means are not po-ssible, or for those rare cases displaying discrepancies between radiological and biochemical markers.展开更多
Hepatitis C virus(HCV)infection and unhealthy alcohol use are major drivers of the burden of liver disease worldwide and commonly co-occur.Assessment of underlying liver damage is a cornerstone of the clinical care of...Hepatitis C virus(HCV)infection and unhealthy alcohol use are major drivers of the burden of liver disease worldwide and commonly co-occur.Assessment of underlying liver damage is a cornerstone of the clinical care of patients with chronic HCV infection and/or unhealthy alcohol use because many of them are diagnosed at advanced stages of disease.Early diagnosis of liver disease before decompensated liver cirrhosis becomes established is essential for treatment with direct acting antivirals and/or abstinence from alcohol consumption,which are the main therapeutic approaches for clinical management.In this review,we discuss current knowledge around the use of non-invasive methods to assess liver disease,such as abdominal ultrasound,controlled attenuation parameter,transient elastography,magnetic resonance imaging,and indices based on serum markers of liver injury.展开更多
Chronic liver disease(CLD)is a significant global health concern and has become one of the leading causes of death worldwide.CLDs can be caused by various factors,including excessive alcohol consumption,obesity and me...Chronic liver disease(CLD)is a significant global health concern and has become one of the leading causes of death worldwide.CLDs can be caused by various factors,including excessive alcohol consumption,obesity and metabolic disorders,autoimmune hepatitis,and viral infections(HBV and HCV)(1).Of these,non-alcoholic fatty liver disease(NAFLD)is the most common,accounting for more than 50%of cases.NAFLD is characterized by the accumulation of lipids in liver cells and is often associated with a number of metabolic problems,including obesity,diabetes,dyslipidemia,hypertension and insulin resistance(2).NAFLD encompasses a spectrum of liver conditions ranging from simple fat accumulation to progressive non-alcoholic steatohepatitis(NASH),a more serious condition involving inflammation and further liver cell damage that can eventually lead to cirrhosis.The introduction of new terminology for NAFLD,specifically metabolic dysfunction-associated fatty liver disease(MAFLD)and more recently metabolic dysfunction-associated steatotic liver disease(MASLD),has sparked a discussion about whether these terms can be used interchangeably(3).展开更多
Objective:This study aims to evaluate the clinical efficacy of non-invasive positive pressure ventilation(NIPPV)in patients with severe bronchial asthma combined with respiratory failure.Methods:90 patients with sever...Objective:This study aims to evaluate the clinical efficacy of non-invasive positive pressure ventilation(NIPPV)in patients with severe bronchial asthma combined with respiratory failure.Methods:90 patients with severe bronchial asthma combined with respiratory failure between September 2022 and December 2023 were selected for the study and randomly divided into the experimental group(NIPPV-assisted treatment)and the control group.The differences between the two groups were compared in terms of total effective rate of treatment,days of clinical symptom disappearance,days of hospitalization,lung function indexes,incidence of adverse reactions,and quality of life.Results:Patients in the experimental group had a significantly higher total effective rate of treatment(97.78%)than the control group(75.56%).In terms of pulmonary function indexes,patients in the experimental group showed significant improvement after treatment,especially the increase in forced expiratory volume and forced vital capacity,while these improvements were not as obvious in the control group.In addition,the incidence of adverse reactions was significantly lower in the experimental group than in the control group,suggesting that the application of NIPPV is relatively safe.Quality of life assessment also showed that patients in the experimental group had significantly better quality of life than the control group after treatment.Conclusion:This study demonstrated the effectiveness of NIPPV as an adjunctive treatment for severe bronchial asthma combined with respiratory failure.NIPPV can improve lung function,reduce the incidence of adverse effects,increase the overall effectiveness of the treatment,and contribute to the improvement of patients'quality of life.Therefore,NIPPV should be regarded as an effective and safe treatment in clinical management,especially in patients with severe bronchial asthma combined with respiratory failure,where its application has potential clinical significance.展开更多
Vision restoration presents a considerable challenge in the realm of regenerative medicine,while recent progress in ultrasound stimulation has displayed potential as a non-invasive therapeutic approach.This narrative ...Vision restoration presents a considerable challenge in the realm of regenerative medicine,while recent progress in ultrasound stimulation has displayed potential as a non-invasive therapeutic approach.This narrative review offers a comprehensive overview of current research on ultrasound-stimulated neuromodulation,emphasizing its potential as a treatment modality for various nerve injuries.By examining of the efficacy of different types of ultrasound stimulation in modulating peripheral and optic nerves,we can delve into their underlying molecular mechanisms.Furthermore,the review underscores the potential of sonogenetics in vision restoration,which involves leveraging pharmacological and genetic manipulations to inhibit or enhance the expression of related mechanosensitive channels,thereby modulating the strength of the ultrasound response.We also address how methods such as viral transcription can be utilized to render specific neurons or organs highly responsive to ultrasound,leading to significantly improved therapeutic outcomes.展开更多
The authors regret the following typographical errors in the manuscript.Page 3:Eq.(1)as published:MC(t)=MC_(0)+mc_(1)(1-exp(-t/t_(1)))+mc_(2)(1+exp(-t/t_(2)))Should be:MC(t)=MC_(0)+mc_(1)(1-exp(-t/t_(1)))+mc_(2)(1-exp...The authors regret the following typographical errors in the manuscript.Page 3:Eq.(1)as published:MC(t)=MC_(0)+mc_(1)(1-exp(-t/t_(1)))+mc_(2)(1+exp(-t/t_(2)))Should be:MC(t)=MC_(0)+mc_(1)(1-exp(-t/t_(1)))+mc_(2)(1-exp(-t/t_(2)))We confirm that this was solely an error introduced during manu-script preparation and that it has no impact on the results,since all data analyses were performed using the correct equation(compare Supple-mentary Data,Fig.A1).展开更多
基金MMEC is supported by a Fellowship from the Sir Halley Stewart Trust (Cambridge, United Kingdom)SDT-R, MMEC, HKSF and RN have been participant workers in the PROLIFICA project in West Africafunded by the European Union Framework 7
文摘Chronic liver disease is a major cause of morbidity and mortality worldwide and usually develops over many years, as a result of chronic inflammation and scarring, resulting in end-stage liver disease and its complications. The progression of disease is characterised by ongoing inflammation and consequent fibrosis, although hepatic steatosis is increasingly being recognised as an important pathological feature of disease, rather than being simply an innocent bystander. However, the current gold standard method of quantifying and staging liver disease, histological analysis by liver biopsy, has several limitations and can have associated morbidity and even mortality. Therefore, there is a clear need for safe and noninvasive assessment modalities to determine hepatic steatosis, inflammation and fibrosis. This review covers key mechanisms and the importance of fibrosis and steatosis in the progression of liver disease. We address non-invasive imaging and blood biomarker assessments that can be used as an alternative to information gained on liver biopsy.
文摘BACKGROUND:Volume resuscitation has only been demonstrated to be effective in approximately fifty percent of patients.The remaining patients do not respond to volume resuscitation and may even develop adverse outcomes(such as acute pulmonary edema necessitating endotracheal intubation).We believe that point-of-care ultrasound is an excellent modality by which to adequately predict which patients may benefi t from volume resuscitation.DATA RESOURCES:We performed a search using PubMed,Scopus,and MEDLINE.The following search terms were used:fluid responsiveness,ultrasound,non-invasive,hemodynamic,fluid challenge,and passive leg raise.Preference was given to clinical trials and review articles that were most relevant to the topic of assessing a patient’s cardiovascular ability to respond to intravenous fl uid administration using ultrasound.RESULTS:Point-of-care ultrasound can be easily employed to measure the diameter and collapsibility of various large vessels including the inferior vena cava,common carotid artery,subclavian vein,internal jugular vein,and femoral vein.Such parameters are closely related to dynamic measures of fluid responsiveness and can be used by providers to help guide fluid resuscitation in critically ill patients.CONCLUSION:Ultrasound in combination with passive leg raise is a non-invasive,costand time-effective modality that can be employed to assess volume status and response to fluid resuscitation.Traditionally sonographic studies have focused on the evaluation of large veins such as the inferior vena cava,and internal jugular vein.A number of recently published studies also demonstrate the usefulness of evaluating large arteries to predict volume status.
文摘<strong>Objectives:</strong> To elucidate the role of lung ultrasound in assessment of subclinical fluid overload in hemodialysis (HD) patients. <strong>Background:</strong> Volume overload has a significant role in HD patients with difficult blood pressure control. The clinical evaluation of fluid status is challenging and has poor diagnostic accuracy. Extravascular lung water (ELW) represents an important element of body fluid volume. Lung ultrasound (LUS) is increasingly used for ELW assessment through the analysis of B-lines artifacts. <strong>Methods:</strong> Eighty-eight HD patients were followed up prospectively. Patients were divided into 3 groups according to the changes of systolic blood pressure (SBP) during HD sessions. Group (1): patients with intra-dialytic hypertension (n = 12), group (2): patients with intra-dialytic hypotension (n = 28) and group (3): patients with no significant blood pressure variabilities (n = 48). Numbers of B-lines were measured by LUS and IVC diameters were measured pre and post-dialysis. In addition, Endothelin-1 (ET-1) and other routine laboratory tests were done. <strong>Results:</strong> There were significant increases in the number of B-lines and IVC diameter pre and post-dialysis in group (1) compared to the other two groups. There was significant decrease in post dialysis IVC diameter but not the number of B-lines in group (2) compared with the other two groups. ET-1 level was significantly increased in group 1 compared to the other two groups. There was a statistically significant positive correlation between the pre-dialysis number of B-lines and ET-1. <strong>Conclusion:</strong> Lung ultrasound can be considered a sensitive and specific modality for volume assessment in HD patients especially with intra-dialytic hypertension. We recommend serial LUS as a part of management in this group of patients.
文摘Liver disease accounts for approximately 2 million deaths per year worldwide.All chronic liver diseases(CLDs),whether of toxic,genetic,autoimmune,or infectious origin,undergo typical histological changes in the structure of the tissue.These changes may include the accumulation of extracellular matrix material,fats,triglycerides,or tissue scarring.Noninvasive methods for diagnosing CLD,such as conventional B-mode ultrasound(US),play a significant role in diagnosis.Doppler US,when coupled with B-mode US,can be helpful in evaluating the hemodynamics of hepatic vessels and detecting US findings associated with hepatic decompensation.US elastography can assess liver stiffness,serving as a surrogate marker for liver fibrosis.It is important to note that interpreting these values should not rely solely on a histological classification.Contrast-enhanced US(CEUS)provides valuable information on tissue perfusion and enables excellent differentiation between benign and malignant focal liver lesions.Clinical evaluation,the etiology of liver disease,and the patient current comorbidities all influence the interpretation of liver stiffness measurements.These measurements are most clinically relevant when interpreted as a probability of compensated advanced CLD.B-mode US offers a subjective estimation of fatty infiltration and has limited sensitivity for mild steatosis.The controlled attenuation parameter requires a dedicated device,and cutoff values are not clearly defined.Quan-titative US parameters for liver fat estimation include the attenuation coefficient,backscatter coefficient,and speed of sound.These parameters offer the advantage of providing fat quantification alongside B-mode evaluation and other US parameters.Multiparametric US(MPUS)of the liver introduces a new concept for complete noninvasive diagnosis.It encourages examiners to utilize the latest features of an US machine,including conventional B-mode,liver stiffness evaluation,fat quantification,dispersion imaging,Doppler US,and CEUS for focal liver lesion characterization.This comprehensive approach allows for diagnosis in a single examination,providing clinicians worldwide with a broader perspective and becoming a cornerstone in their diagnostic arsenal.MPUS,in the hands of skilled clinicians,becomes an invaluable predictive tool for diagnosing,staging,and monitoring CLD.
文摘Atherosclerosis is the early stage of arterial disease, and underlies development of cardiovascular disease (CVD) and stroke. Although sophisticated models for assessing CVD and stroke risk have been derived based on large-scale prospective studies, their abilities in detecting the presence or absence of atherosclerotic plaque have not been investigated. This study aimed to evaluate and compare discriminatory and risk stratifying abilities of 13 CVD risk assessment models against the ultrasound detection of carotid plaques in type 2 diabetes mellitus (T2DM) patients. Forty-nine T2DM subjects were recruited with informed consent, and major anthropomorphic and biomarker data for these models were collected. The model risk scores were evaluated against the carotid plaques detected by Doppler ultrasound. Only the FHS-Lpts-CHD-10Y model, which is a variant of the Framingham model, revealed an area under the receiver operating curve (AUROC) that was significantly different from a random scoring approach (AUROC: 0.681, p was able to stratify the risk levels of carotid plaque presence (Chi-Square statistic: 5.99,
文摘The diameters of spermatic veins and blood reflux in sixty-two male patients with infertility caused by varicocele were assessed with Doppler ultrasound in this study. Scrotal thermograph, testes volume and semen analysis were also applied to analysis of these patients. Among sixty-two patients, thirty-one received high ligation of internal spermatic vein. The results showed: 1. The diameter of spermatic veins was negatively correlated with fertility index and positively correlated with Doppler grading of blood reflux. 2. In operative patients, the effect of surgery was better in patients with blood reflux than in those without blood reflux. It was suggested the diameter of spermatic veins probably reflects the duration and serious degree of blood reflux in spermatic vein, and may be used for assessment of severity of male infertility in combination with semen analysis.
文摘Objective: To analyze the effectiveness of musculoskeletal ultrasound in diagnosing rotator cuff injuries. Methods: A total of 80 patients with suspected rotator cuff injuries who were admitted and diagnosed between January 1, 2020, and December 31, 2024, were selected. Musculoskeletal ultrasound was performed on these patients, and the diagnostic efficacy of musculoskeletal ultrasound was evaluated by comparing the results with those of MRI. Results: The detection rates of musculoskeletal ultrasound for the location and extent of injury were similar to those of MRI (p > 0.05). Based on the MRI diagnosis results, the diagnostic accuracy rate of musculoskeletal ultrasound was 92.50%, with a sensitivity of 93.06% and a specificity of 87.50%. The morphological and signal characteristics, as well as ultrasound indicators, of patients with positive musculoskeletal ultrasound results differed significantly from those of patients with negative results (p < 0.05). Conclusion: Musculoskeletal ultrasound can effectively detect the location and extent of rotator cuff injuries, comprehensively assess the damage, and demonstrate high diagnostic efficacy. Furthermore, the morphological and signal characteristics, as well as ultrasound indicators, of musculoskeletal ultrasound can serve as diagnostic criteria for rotator cuff injuries, improving disease detection efficiency.
文摘A biloma is a rare disease characterized by an abnormal intra-or extrahepatic bile collection due to a traumatic or spontaneous rupture of the biliary system.Laboratory findings are nonspecific.The diagnosis is usually suspected on the basis of a typical history(right upper quadrant abdominal pain,chills,fever and recent abdominal trauma or surgery) and is confirmed by detection of typical radiologic features.We report the case of a patient with a history of previous cholecystectomy for lithiasis who presented with clinical symptoms and laboratory data suggestive of acute pancreatitis.Imaging studies also revealed the presence of a chronic and asymptomatic biloma,which could be mistaken for a pseudocyst.The atypical location and ultrasound findings suggested an alternative diagnosis.We therefore reviewed the known literature for bilomas,focusing on the role of ultrasonography,which can reveal some typical aspects,such as location and imaging features.Weconclude that ultrasound plays a key role in the assessment of a suspected biloma in patients with appropriate history and clinical features and provides valuable diagnostic clues even in the absence of these.
文摘Advances in recent years in the understanding of, and the genetic diagnosis of hereditary hemochromatosis (HH) have changed the approach to iron overload he-reditary diseases. The ability to use a radiologic tool (MRI) that accurately provides liver iron concentration determination, and the presence of non-invasive sero-logic markers for fibrosis prediction (ser um ferritin, platelet count, transaminases, etc), have diminished the need for liver biopsy for diagnosis and prognosis of this disease. Consequently, the role of liv er biopsy in iron metabolism disorders is changing. Furthermore, the irruption of transient elastography to assess liver stiffness, and, more recently, the ability to determine liver f ibrosis by means of MRI elastography will change this role even more, with a potential drastic decline in hepatic biopsies in years to come. This review will provide a brief summary of the different non-invasive methods available nowadays for diagnosis and prognosis in HH, and point out potential new techniques that could come about in the next years for fibrosis prediction, thus avoiding the need for liver biopsy in a greater number of patients. It is possible that liver biopsy will remain useful for the diagnosis of associated diseases, where other non-invasive means are not po-ssible, or for those rare cases displaying discrepancies between radiological and biochemical markers.
基金Institute of Health Carlos III,No.RETICS RD16/0017/0003,No.PI17/00174,and No.PI20/00883Institute of Health Carlos III,Juan Rodes Program,No.JR20/00016+3 种基金Institute of Health Carlos III,Sara Borrell Program,No.CD19/00019Institute of Health Carlos III,Physician Intensification Program,No.INT19/00026National Plan on Drugs,Spain,No.2018/020,and No.2020/024,Spainand Autonomous Government of Catalonia,Spain,Consolidated Research Group,No.2017-SGR-316.
文摘Hepatitis C virus(HCV)infection and unhealthy alcohol use are major drivers of the burden of liver disease worldwide and commonly co-occur.Assessment of underlying liver damage is a cornerstone of the clinical care of patients with chronic HCV infection and/or unhealthy alcohol use because many of them are diagnosed at advanced stages of disease.Early diagnosis of liver disease before decompensated liver cirrhosis becomes established is essential for treatment with direct acting antivirals and/or abstinence from alcohol consumption,which are the main therapeutic approaches for clinical management.In this review,we discuss current knowledge around the use of non-invasive methods to assess liver disease,such as abdominal ultrasound,controlled attenuation parameter,transient elastography,magnetic resonance imaging,and indices based on serum markers of liver injury.
文摘Chronic liver disease(CLD)is a significant global health concern and has become one of the leading causes of death worldwide.CLDs can be caused by various factors,including excessive alcohol consumption,obesity and metabolic disorders,autoimmune hepatitis,and viral infections(HBV and HCV)(1).Of these,non-alcoholic fatty liver disease(NAFLD)is the most common,accounting for more than 50%of cases.NAFLD is characterized by the accumulation of lipids in liver cells and is often associated with a number of metabolic problems,including obesity,diabetes,dyslipidemia,hypertension and insulin resistance(2).NAFLD encompasses a spectrum of liver conditions ranging from simple fat accumulation to progressive non-alcoholic steatohepatitis(NASH),a more serious condition involving inflammation and further liver cell damage that can eventually lead to cirrhosis.The introduction of new terminology for NAFLD,specifically metabolic dysfunction-associated fatty liver disease(MAFLD)and more recently metabolic dysfunction-associated steatotic liver disease(MASLD),has sparked a discussion about whether these terms can be used interchangeably(3).
文摘Objective:This study aims to evaluate the clinical efficacy of non-invasive positive pressure ventilation(NIPPV)in patients with severe bronchial asthma combined with respiratory failure.Methods:90 patients with severe bronchial asthma combined with respiratory failure between September 2022 and December 2023 were selected for the study and randomly divided into the experimental group(NIPPV-assisted treatment)and the control group.The differences between the two groups were compared in terms of total effective rate of treatment,days of clinical symptom disappearance,days of hospitalization,lung function indexes,incidence of adverse reactions,and quality of life.Results:Patients in the experimental group had a significantly higher total effective rate of treatment(97.78%)than the control group(75.56%).In terms of pulmonary function indexes,patients in the experimental group showed significant improvement after treatment,especially the increase in forced expiratory volume and forced vital capacity,while these improvements were not as obvious in the control group.In addition,the incidence of adverse reactions was significantly lower in the experimental group than in the control group,suggesting that the application of NIPPV is relatively safe.Quality of life assessment also showed that patients in the experimental group had significantly better quality of life than the control group after treatment.Conclusion:This study demonstrated the effectiveness of NIPPV as an adjunctive treatment for severe bronchial asthma combined with respiratory failure.NIPPV can improve lung function,reduce the incidence of adverse effects,increase the overall effectiveness of the treatment,and contribute to the improvement of patients'quality of life.Therefore,NIPPV should be regarded as an effective and safe treatment in clinical management,especially in patients with severe bronchial asthma combined with respiratory failure,where its application has potential clinical significance.
基金supported by R01EY032229(Biomechanical Mapping of the Optic Nerve Head and Peripapillary Sclera Using High Frequency Ultrasonic Elastography)R01EY028662(High-resolution Elastographic Assessment of the Optic Nerve Head)+2 种基金R01EY030126(Non-invasive Ultrasound Stimulated Retinal Prosthesis)(to QZ)Unrestricted Grant to the Department of Ophthalmology from Research to Prevent Blindness,New York,NY(to MSH)the National Eye Institute of the National Institutes of Health under Award Number P30EY029220(to MSH)。
文摘Vision restoration presents a considerable challenge in the realm of regenerative medicine,while recent progress in ultrasound stimulation has displayed potential as a non-invasive therapeutic approach.This narrative review offers a comprehensive overview of current research on ultrasound-stimulated neuromodulation,emphasizing its potential as a treatment modality for various nerve injuries.By examining of the efficacy of different types of ultrasound stimulation in modulating peripheral and optic nerves,we can delve into their underlying molecular mechanisms.Furthermore,the review underscores the potential of sonogenetics in vision restoration,which involves leveraging pharmacological and genetic manipulations to inhibit or enhance the expression of related mechanosensitive channels,thereby modulating the strength of the ultrasound response.We also address how methods such as viral transcription can be utilized to render specific neurons or organs highly responsive to ultrasound,leading to significantly improved therapeutic outcomes.
文摘The authors regret the following typographical errors in the manuscript.Page 3:Eq.(1)as published:MC(t)=MC_(0)+mc_(1)(1-exp(-t/t_(1)))+mc_(2)(1+exp(-t/t_(2)))Should be:MC(t)=MC_(0)+mc_(1)(1-exp(-t/t_(1)))+mc_(2)(1-exp(-t/t_(2)))We confirm that this was solely an error introduced during manu-script preparation and that it has no impact on the results,since all data analyses were performed using the correct equation(compare Supple-mentary Data,Fig.A1).
