Alzheimer’s disease is a common neurodegenerative disorder defined by decreased reasoning abilities,memory loss,and cognitive deterioration.The presence of the blood-brain barrier presents a major obstacle to the dev...Alzheimer’s disease is a common neurodegenerative disorder defined by decreased reasoning abilities,memory loss,and cognitive deterioration.The presence of the blood-brain barrier presents a major obstacle to the development of effective drug therapies for Alzheimer’s disease.The use of ultrasound as a novel physical modulation approach has garnered widespread attention in recent years.As a safe and feasible therapeutic and drug-delivery method,ultrasound has shown promise in improving cognitive deficits.This article provides a summary of the application of ultrasound technology for treating Alzheimer’s disease over the past 5 years,including standalone ultrasound treatment,ultrasound combined with microbubbles or drug therapy,and magnetic resonance imaging-guided focused ultrasound therapy.Emphasis is placed on the benefits of introducing these treatment methods and their potential mechanisms.We found that several ultrasound methods can open the blood-brain barrier and effectively alleviate amyloid-βplaque deposition.We believe that ultrasound is an effective therapy for Alzheimer’s disease,and this review provides a theoretical basis for future ultrasound treatment methods.展开更多
Advancements in healthcare technology have improved mortality rates and extended lifespans,resulting in a population with multiple comorbidities that complicate patient care.Traditional assessments often fall short,un...Advancements in healthcare technology have improved mortality rates and extended lifespans,resulting in a population with multiple comorbidities that complicate patient care.Traditional assessments often fall short,underscoring the need for integrated care strategies.Among these,fluid management is particularly challenging due to the difficulty in directly assessing volume status especially in critically ill patients who frequently have peripheral oedema.Effective fluid ma-nagement is essential for optimal tissue oxygen delivery,which is crucial for cellular metabolism.Oxygen transport is dependent on arterial oxygen levels,haemoglobin concentration,and cardiac output,with the latter influenced by preload,afterload,and cardiac contractility.A delicate balance of these factors ensures that the cardiovascular system can respond adequately to varying ph-ysiological demands,thereby safeguarding tissue oxygenation and overall organ function during states of stress or illness.The Venous Excess Ultrasound(VExUS)Grading System is instrumental in evaluating fluid intolerance,providing detailed insights into venous congestion and fluid status.It was originally developed to assess the risk of acute kidney injury in postoperative cardiac patients,but its versatility has enabled broader applications in nephrology and critical care settings.This mini review explores VE×US’s application and its impact on fluid management and patient outcomes in critically ill patients.展开更多
BACKGROUND Endoscopic ultrasound(EUS)is crucial for diagnosing solid pancreatic lesions,especially pancreatic ductal adenocarcinoma(PDAC),a highly aggressive cancer which represents the majority with a prevalence of a...BACKGROUND Endoscopic ultrasound(EUS)is crucial for diagnosing solid pancreatic lesions,especially pancreatic ductal adenocarcinoma(PDAC),a highly aggressive cancer which represents the majority with a prevalence of approximately 85%.AIM To identify EUS features that differentiate PDAC from other lesions such as neuroendocrine tumors(NETs)and helping in the differential diagnosis,by analyzing a large sample of solid pancreatic lesions.METHODS This observational,retrospective,multicenter study analyzed the endosonographic characteristics of 761 patients with a radiological diagnosis of solid pancreatic lesion,who underwent pancreatic EUS for typing and staging with needle biopsies between 2015 and 2023.General patient characteristics(age and sex)and solid lesion features were collected and described,such lesion size(Bmode),vessel involvement(compression or invasion),ductal dilation,lymphadenopathy,echogenicity,echopattern,margin regularity,multifocality,internal vascularization and elastography.Subsequently,a predictive analysis was performed through univariate and multivariate logistic regression to identify predictive features for PDAC or NET diagnoses.RESULTS Our study enrolled 761 patients,predominantly male with a mean age of 68.6.PDACs were generally larger(mean 33 mm×27 mm),often had irregular margins,and displayed significant upstream ductal dilation.Hypoechogenicity was common across malignant lesions.In contrast,NETs were smaller(mean 20 mm×17 mm)and typically had regular margins with multiple lesions.Vascular involvement,although predominant in PDAC,is a common feature of all malignant neoplasms.Multifocality,however,although a rare finding,is more typical of NETs and metastases,and practically absent in the remaining lesions.Predictive analyses showed that ductal dilation and irregular margins were the most significant predictors for PDAC[odds ratio(OR)=5.75 and 3.83],with hypoechogenicity,heterogeneous echopattern and lymphadenopathies also highly significant(OR=3.51,2.56 and 1.99).These features were inversely associated with NETs,with regular margins and absence of ductal involvement or lymphadenopathies(OR=0.24,0.86 and 0.45 respectively),as already shown by the descriptive analysis.Finally,age,despite achieving statistical significance,lacks clinical value given an OR trending towards 1.CONCLUSION This study provides a comprehensive overview of EUS features for solid pancreatic lesions,identifying distinct features like upstream ductal dilation and irregular margins for PDAC vs regular margins for NETs as strong diagnostic predictors.These findings enhance the understanding of pancreatic pathologies,offering valuable insights for improved differential diagnosis and clinical management,especially in complex cases.Further prospective studies could build on these results.展开更多
Conventional echocardiography can sometimes pose a challenge to diagnosis due to sub-optimal images.Ultrasound contrast agents(UCAs)have been shown to drastically enhance imaging quality,particularly depicting the lef...Conventional echocardiography can sometimes pose a challenge to diagnosis due to sub-optimal images.Ultrasound contrast agents(UCAs)have been shown to drastically enhance imaging quality,particularly depicting the left ventricular endocardial borders.Their use during echocardiography has become a valuable tool in non-invasive diagnostics.UCAs provide higher-quality images that may ultimately reduce the length of hospital stays and improve patient care.The higher cost associated with UCAs in many situations has been an impediment to frequent use.However,when used as an initial diagnostic test,UCA during rest echocardiogram is more cost-effective than the traditional diagnostic approach,which frequently includes multiple tests and imaging studies to make an accurate diagnosis.They can be easily performed across multiple patient settings and provide optimal images that allow clinicians to make sound medical decisions.This consequently allows for better diagnostic accuracies and improvement in patient care.展开更多
Point-of-care ultrasound(POCUS) is recognized as a valuable diagnostic tool,especially in resourcelimited settings(RLS).POCUS provides rapid diagnostic information that enables health professionals to make critical de...Point-of-care ultrasound(POCUS) is recognized as a valuable diagnostic tool,especially in resourcelimited settings(RLS).POCUS provides rapid diagnostic information that enables health professionals to make critical decisions at the bedside.^([1]) Despite the welldocumented benefits of POCUS,access to longitudinal,comprehensive training programs and a lack of trainee feedback are barriers to the widespread use of this technology in such settings.^([2])展开更多
As a non-invasive surgical procedure ultrasound cycloplasty(UCP)has gained attention among ophthalmologists in recent years.Derived from the application of highintensity focused ultrasound,it has been utilized for the...As a non-invasive surgical procedure ultrasound cycloplasty(UCP)has gained attention among ophthalmologists in recent years.Derived from the application of highintensity focused ultrasound,it has been utilized for the treatment of various types of glaucoma,demonstrating notable efficacy and safety.This review focuses on the efficacy and safety of UCP in treating glaucoma among Asian populations.By summarizing and analyzing existing literature on indications,therapeutic outcomes,and safety profiles,this review further highlights the unique advantages of UCP in glaucoma treatment compared to traditional surgical approaches.These advantages include broader indications,non-invasive nature,quantifiable treatment,excellent intraocular pressure-lowering effects,fewer adverse reactions,and high safety.Additionally,by introducing the underlying mechanism of action,this review explores the factors influencing its therapeutic efficacy,providing theoretical insights for clinical practice and demonstrating UCP’s potential in glaucoma management.展开更多
Laparoscopic or robotic surgery accounts for an increasing proportion of liver surgery.However,the lack of haptic feedback results in a certain amount of risk.The use of laparoscopic ultrasound(LUS)enables the operato...Laparoscopic or robotic surgery accounts for an increasing proportion of liver surgery.However,the lack of haptic feedback results in a certain amount of risk.The use of laparoscopic ultrasound(LUS)enables the operator to observe internal structures of the liver in real time to easily avoid the main blood vessels.It also allows for the detection of tumor boundaries and the extent of tumor thrombi,considerably improving the success rate of the operation.Besides its advantages in detecting small lesions that are not detectable through preoperative imaging,thus assisting diagnosis and staging,the LUS can also be used to monitor ablation therapy,portal vein puncture staining,and lesion blood perfusion.Recent advances in technology like contrast-enhanced intraoperative ultrasound and realtime virtual sonography can help surgeons better perform laparoscopic surgery.For liver surgeons,LUS is an essential technique for safely performing laparoscopic surgery,making their proficiency in the use of LUS vital.This article reviews the application of LUS in laparoscopic hepatic resection of liver tumors and the new technology of LUS to help liver surgeons understand the current application status of LUS and the future research directions.展开更多
BACKGROUND Endoscopic ultrasound(EUS)has evolved from a diagnostic tool to a management technique for various gastroenterological conditions,including biliary strictures.AIM To summarize the current evidence on EUS’s...BACKGROUND Endoscopic ultrasound(EUS)has evolved from a diagnostic tool to a management technique for various gastroenterological conditions,including biliary strictures.AIM To summarize the current evidence on EUS’s role in diagnosing and managing biliary strictures.METHODS Two independent reviewers searched five electronic databases(PubMed,CENTRAL,Science Direct,Google Scholar,and EMBASE)for articles published up to January 2025.Included articles met specific criteria,and statistical software was used to analyze reported outcomes.RESULTS Of 935 articles,19 met the inclusion criteria.Ten articles focused on diagnostic EUS,while nine focused on EUSguided therapeutic interventions.EUS fine-needle aspiration demonstrated superior sensitivity[0.43-1.00;95%confidence interval(CI):0.24-1.00]compared to conventional techniques(0.36-0.96;95%CI:0.19-0.99)for diagnosing malignant biliary strictures.Both EUS-fine-needle aspiration and conventional methods exhibited high specificity,with most achieving 100%specificity.EUS-guided interventions showed significantly higher clinical success rates than control interventions(odds ratio=2.89;95%CI:1.22-6.84;P=0.02).No significant difference was observed in technical success rates(odds ratio=0.97;95%CI:0.30-3.16;P=0.96).CONCLUSION EUS is a promising tool for diagnosing and managing biliary strictures.Combining EUS-guided and conventional interventions improves diagnostic performance.Further research is needed to investigate the feasibility and use of EUS-guided interventions in this field.展开更多
As an innovative endoscopic intervention,endoscopic ultrasound-guided pan-creatic duct drainage(EUS-PD)demonstrates significant clinical value in re-solving pancreatic ductal hypertension syndrome.By integrating real-...As an innovative endoscopic intervention,endoscopic ultrasound-guided pan-creatic duct drainage(EUS-PD)demonstrates significant clinical value in re-solving pancreatic ductal hypertension syndrome.By integrating real-time ultrasound guidance with catheter-based intervention techniques,this approach provides a safe and effective alternative for cases where conventional endoscopic retrograde cholangiopancreatography has failed.Current evidence indicates that EUS-PD achieves technical success rates ranging from 82%to 95%in alleviating symptomatic pancreatic duct hypertension caused by malignant obstructions and chronic pancreatitis-related strictures,with an overall complication rate(15%-20%)substantially lower than surgical interventions.Compared to conventional imaging modalities,EUS-PD offers superior anatomical visualization capabilities:Its high-frequency ultrasound probe enables precise identification of 3 mm-level pancreatic duct branches,while contrast-enhanced imaging significantly improves diagnostic accuracy in differentiating benign from malignant strictures(sensitivity 91%vs 73%,P<0.05).Nevertheless,technical challenges persist,including diffi-cult ductal puncture localization(particularly in pancreatic head lesions),complex guidewire axial control,and postoperative pancreatic fistula risks(7%-12%).This review systematically examines the clinical indications/contraindications,pro-cedural protocols,device selection criteria,and management strategies for early/late complications associated with EUS-PD.Special emphasis is placed on establishing anatomical pathway selection standards for transgastric-pancreatic duct vs transduodenal-pancreatic duct approaches.Advancements in auxiliary technologies(e.g.,three-dimensional elastography,AI-assisted navigation)and multidisciplinary team collab-oration are pivotal to developing standardized protocols.We propose establishing international multicenter registry databases and conducting prospective randomized controlled trials to clarify EUS-PD's position within pancreatic disease management systems.Such initiatives will facilitate the clinical transformation of EUS-PD from an"alternative option"to a"preferred strategy",ultimately enhancing treatment precision and improving clinical outcomes in pancreatic disorders.展开更多
In this letter we comment on the article by Zhang et al published in the recent issue of the World Journal of Gastrointestinal Endoscopy 2024.We focus specifically on the management of gastric varices(GV),which is a s...In this letter we comment on the article by Zhang et al published in the recent issue of the World Journal of Gastrointestinal Endoscopy 2024.We focus specifically on the management of gastric varices(GV),which is a significant consequence of portal hypertension,is currently advised to include beta-blocker therapy for primary prophylaxis and transjugular intrahepatic portosystemic shunt for secondary prophylaxis or active bleeding.Although it has been studied,direct endoscopic injection of cyanoacrylate glue has limitations,such as the inability to fully characterize GV endoscopically and the potential for distant glue embolism.In order to achieve this,endoscopic ultrasound has been used to support GV characterization,real-time therapy imaging,and Doppler obliteration verification.展开更多
In this article we comment on the paper by Xu et al describing retrospective data on endoscopic treatment outcome of esophageal gastrointestinal stromal tumors(GISTs).Esophageal GIST is a rare type of mesenchymal tumo...In this article we comment on the paper by Xu et al describing retrospective data on endoscopic treatment outcome of esophageal gastrointestinal stromal tumors(GISTs).Esophageal GIST is a rare type of mesenchymal tumor.GISTs originate from the interstitial cells of Cajal,which are pacemaker cells involved in gut motility.GISTs are most commonly found in the stomach and small intestine,but esophageal involvement is rare.Esophageal GISTs account for<1%of all GISTs.Endoscopic resection remains the mainstay for small,localized tumors with excellent outcomes.However,larger tumors may require multidisciplinary strategies to provide the best oncological outcomes.Here,we discuss the usefulness of endoscopic ultrasound(EUS)of subepithelial tumors of the upper gastrointestinal tract.EUS is a crucial tool in the diagnosis,staging,and management of subepithelial masses.Given the subepithelial nature of these tumors,standard endoscopy is not adequate,making EUS essential for a comprehensive assessment.EUS provides accurate tumor size assessment and enables fine needle aspirations guided biopsy,for treatment planning.展开更多
BACKGROUND Congenital cytomegalovirus(CMV)infection represents a significant public health concern as the most prevalent viral infection in newborns,potentially leading to severe neurological and developmental complic...BACKGROUND Congenital cytomegalovirus(CMV)infection represents a significant public health concern as the most prevalent viral infection in newborns,potentially leading to severe neurological and developmental complications.The majority of cases are asymptomatic and remain undetected during pregnancy due to the absence of effective screening methods.CASE SUMMARY A 27-year-old primigravida presented for early pregnancy ultrasound,which revealed an atypical finding:A normal anechoic thalamus appearing hyperechoic on the mid-sagittal view of the fetal head.Subsequent ultrasound examinations during mid and late gestation demonstrated classic intracranial features sug-gestive of congenital CMV infection.Chromosomal karyotyping and microarray analysis of the fetus yielded no significant abnormalities.Following compre-hensive prenatal counseling regarding potential adverse fetal outcomes,the patient elected to continue her pregnancy.She ultimately underwent cesarean delivery at 42 weeks gestation at another facility,resulting in the birth of a female neonate.At five months of age,the infant presented with epilepsy and significant growth and developmental delays.CONCLUSION Congenital CMV infection occurs during the first trimester may manifest as hyperechoic thalamus which can be revealed by ultrasound in the mid-saggital view of the fetal head.Future research should investigate the correlation between echogenic thalamus and developmental outcomes,as well as explore early sc-reening techniques for suspected congenital CMV infection cases.展开更多
This study aimed to investigate the effect of ultrasound-assisted alkaline extraction(UAE)(at 20 kHz and different powers of 0,200,300,400,500 and 600 W for 10 min)on the yield,structure and emulsifying properties of ...This study aimed to investigate the effect of ultrasound-assisted alkaline extraction(UAE)(at 20 kHz and different powers of 0,200,300,400,500 and 600 W for 10 min)on the yield,structure and emulsifying properties of chickpea protein isolate(CPI).Compared with the non-ultrasound group,ultrasound treatment at 400 W resulted in the largest increase in CPI yield,and both the particle size and turbidity decreased with increasing ultrasound power from 0 to 400 W.The scanning electron microscope results showed a uniform structural distribution of CPI.Moreover,itsα-helix content increased,β-sheet content decreased,and total sulfhydryl group content and endogenous fluorescence intensity rose,illustrating that UAE changed the secondary and tertiary structure of CPI.At 400 W,the solubility of the emulsion increased to 63.18%,and the best emulsifying properties were obtained;the emulsifying activity index(EAI)and emulsifying stability index(ESI)increased by 85.42%and 46.78%,respectively.Furthermore,the emulsion droplets formed were smaller and more uniform.In conclusion,proper UAE power conditions increased the extraction yield and protein content of CPI,and effectively improved its structure and emulsifying characteristics.展开更多
Objective Primary liver cancer,predominantly hepatocellular carcinoma(HCC),is a significant global health issue,ranking as the sixth most diagnosed cancer and the third leading cause of cancer-related mortality.Accura...Objective Primary liver cancer,predominantly hepatocellular carcinoma(HCC),is a significant global health issue,ranking as the sixth most diagnosed cancer and the third leading cause of cancer-related mortality.Accurate and early diagnosis of HCC is crucial for effective treatment,as HCC and non-HCC malignancies like intrahepatic cholangiocarcinoma(ICC)exhibit different prognoses and treatment responses.Traditional diagnostic methods,including liver biopsy and contrast-enhanced ultrasound(CEUS),face limitations in applicability and objectivity.The primary objective of this study was to develop an advanced,lightweighted classification network capable of distinguishing HCC from other non-HCC malignancies by leveraging the automatic analysis of brightness changes in CEUS images.The ultimate goal was to create a user-friendly and cost-efficient computer-aided diagnostic tool that could assist radiologists in making more accurate and efficient clinical decisions.Methods This retrospective study encompassed a total of 161 patients,comprising 131 diagnosed with HCC and 30 with non-HCC malignancies.To achieve accurate tumor detection,the YOLOX network was employed to identify the region of interest(ROI)on both B-mode ultrasound and CEUS images.A custom-developed algorithm was then utilized to extract brightness change curves from the tumor and adjacent liver parenchyma regions within the CEUS images.These curves provided critical data for the subsequent analysis and classification process.To analyze the extracted brightness change curves and classify the malignancies,we developed and compared several models.These included one-dimensional convolutional neural networks(1D-ResNet,1D-ConvNeXt,and 1D-CNN),as well as traditional machine-learning methods such as support vector machine(SVM),ensemble learning(EL),k-nearest neighbor(KNN),and decision tree(DT).The diagnostic performance of each method in distinguishing HCC from non-HCC malignancies was rigorously evaluated using four key metrics:area under the receiver operating characteristic(AUC),accuracy(ACC),sensitivity(SE),and specificity(SP).Results The evaluation of the machine-learning methods revealed AUC values of 0.70 for SVM,0.56 for ensemble learning,0.63 for KNN,and 0.72 for the decision tree.These results indicated moderate to fair performance in classifying the malignancies based on the brightness change curves.In contrast,the deep learning models demonstrated significantly higher AUCs,with 1D-ResNet achieving an AUC of 0.72,1D-ConvNeXt reaching 0.82,and 1D-CNN obtaining the highest AUC of 0.84.Moreover,under the five-fold cross-validation scheme,the 1D-CNN model outperformed other models in both accuracy and specificity.Specifically,it achieved accuracy improvements of 3.8%to 10.0%and specificity enhancements of 6.6%to 43.3%over competing approaches.The superior performance of the 1D-CNN model highlighted its potential as a powerful tool for accurate classification.Conclusion The 1D-CNN model proved to be the most effective in differentiating HCC from non-HCC malignancies,surpassing both traditional machine-learning methods and other deep learning models.This study successfully developed a user-friendly and cost-efficient computer-aided diagnostic solution that would significantly enhances radiologists’diagnostic capabilities.By improving the accuracy and efficiency of clinical decision-making,this tool has the potential to positively impact patient care and outcomes.Future work may focus on further refining the model and exploring its integration with multimodal ultrasound data to maximize its accuracy and applicability.展开更多
BACKGROUND Adrenocortical oncocytoma is a rare,mostly benign,nonfunctional tumor that is typically detected incidentally.Its diagnosis is challenging because of the absence of distinctive imaging characteristics,neces...BACKGROUND Adrenocortical oncocytoma is a rare,mostly benign,nonfunctional tumor that is typically detected incidentally.Its diagnosis is challenging because of the absence of distinctive imaging characteristics,necessitating pathological validation.CASE SUMMARY We present a case report of a 35-year-old woman with an adrenal mass located on the left side,where endoscopic ultrasound-guided fine-needle aspiration(EUSFNA)was performed after comprehensive diagnostic assessment.Our results are consistent with those of previously documented cases regarding tumor demographics and anatomical location.Given the limited number of reports on this condition,long-term follow-up is crucial to enhance our understanding of its prognosis.CONCLUSION For patients with adrenocortical oncocytoma,EUS-FNA can enables collection of preoperative tissue specimens leading to suitable treatment strategies.展开更多
Background: Undergoing ultrasound scanning (USS) during the first trimester of pregnancy is highly imperative for expecting mothers, as it supports the early detection of any malformations, identifying the fetal numbe...Background: Undergoing ultrasound scanning (USS) during the first trimester of pregnancy is highly imperative for expecting mothers, as it supports the early detection of any malformations, identifying the fetal number, fetal growth, fetal sex, and calculation of delivery. Previous studies have shown that undergoing such prenatal screening procedures could reduce the antenatal anxiety levels of expectant mothers. The present study aimed to explore the impact of first-trimester ultrasound scanning towards the antenatal anxiety and identify the predictors of antenatal anxiety among expectant mothers in the first trimester. Methods: A repeated measure design study was conducted in Maternity Clinics of University Hospital KDU, Ninewells Care Hospital and Navy General Hospital over 4 months with one hundred and fifteen (n = 115) expectant mothers. Participants completed a general information sheet first and State Trait Anxiety Inventory (STAI) (Spielberger et al., 1970) was administered before and after undergoing the USS. Results: Mean age of the participants was 28.84 ± 3.68. The Wilcoxon Signed Rank test showed that there is a significant reduction of participants’ antenatal anxiety levels following the USS z = −5.658, p Conclusions: Findings suggest that undergoing the first trimester USS significantly reduces the antenatal state anxiety and partner’s support is an important factor in reducing the antenatal anxiety experienced by expectant mothers in the first trimester. Future studies can focus on how USS can contribute to alleviating antenatal anxiety in second and third trimesters.展开更多
Background: Wrist pain is prevalent. Activities such as dexterous sports, prolonged use of personal handheld devices, and extensive desktop keyboard usage are common contributors to wrist pain. Intersection syndrome, ...Background: Wrist pain is prevalent. Activities such as dexterous sports, prolonged use of personal handheld devices, and extensive desktop keyboard usage are common contributors to wrist pain. Intersection syndrome, a form of inflammatory tenosynovitis, occurs at the intersection of the first and second dorsal compartments of the wrist. The first dorsal compartment is comprised of the tendons of abductor pollicis longus and extensor pollicis brevis, while the second dorsal compartment contains the tendons of extensor carpi radialis longus and extensor carpi radialis brevis. Intersection syndrome is diagnosed by pain localized to the dorsoradial forearm, approximately five cm proximal to the wrist joint, which worsens with resisted wrist and thumb extension. To date, the use of hydro dissection with 5% dextrose under ultrasound guidance as a treatment for Intersection syndrome has not been reported. This case report presents the first report on ultrasound-guided hydro dissection as a therapeutic approach for intersection syndrome. Methods: A case report, with informed consent, involving a 32-year-old male athlete. The patient, a hurling player, presented with chronic right wrist pain diagnosed as intersection syndrome. The condition significantly affected his work, sporting activities, and daily living activities. Previous conservative management and physiotherapy had failed to alleviate his symptoms. To confirm the diagnosis, relevant imaging was performed, supplemented by dynamic ultrasound assessment. The procedure was performed aseptically. Continuous ultrasound guidance was employed to ensure accurate needle placement. Once the needle tip position was confirmed, an initial injection of 5 mL of 0.25% chirocaine was administered. 10 mL of 5% dextrose was injected under ultrasound guidance for hydro dissection, with good visualization of the solution’s distribution. Conclusion: Ultrasound-guided hydro dissection has not previously been documented as a treatment option for intersection syndrome. In this case, it proved to be an effective pain-relieving therapy with sustained effect at three-month clinical follow-up. Further studies are required.展开更多
Endoscopic ultrasound(EUS)is an indispensable tool for the diagnosis and management of various diseases,particularly biliopancreatic disorders,as it provides detailed visualization of the gastrointestinal tract and su...Endoscopic ultrasound(EUS)is an indispensable tool for the diagnosis and management of various diseases,particularly biliopancreatic disorders,as it provides detailed visualization of the gastrointestinal tract and surrounding structures.As the demand for diagnostic and interventional EUS procedures increases,ensuring high-quality training for endoscopists is essential to improve patient outcomes.This mini-review provides an overview of the current state of EUS training and emphasizes the importance of a structured approach that integrates theoretical knowledge and hands-on experience.We discuss different training methods,focusing on the main courses available worldwide,and highlight their advantages and limitations.In addition,we examine the challenges of training for diagnostic and interventional EUS,such as limited access to training centers and the need for personalized feedback.Overall,improving EUS training programs is essential to enhance physician skills and ensure this advanced technique is used safely and efficiently in clinical practice.展开更多
Background:Stimuli-responsive drug delivery systems introduced nowadays to enable enhanced drug release upon exogenous stimulus.Research focuses on developing systems for co-administration of drugs to overcome limitat...Background:Stimuli-responsive drug delivery systems introduced nowadays to enable enhanced drug release upon exogenous stimulus.Research focuses on developing systems for co-administration of drugs to overcome limitations of single-drug chemotherapy,such as low response rates,ineffective treatment completion,and drug resistance,leading to aggressive proliferation and recurrence.This research focuses on utilizing the amphiphilic polymer quaternary ammonium palmitoyl glycol chitosan(GCPQ)as a carrier to load hydrophobic curcumin(CUR)and hydrophilic doxorubicin(DOX)to reach the desired target and release the cargo upon exogenous stimuli of ultrasound.Methods:The nanoformulation synthesized using a biocompatible approach,resulting in a stable DOX-CUR-GCPQ nano-formulation upon physicochemical characterization and in vitro analysis using ultrasound.Results:The mean hydrodynamic diameter of DOX-CUR-GCPQ nanomicelles was measured as 95±1.23 nm,PDI 0.32±0.87,zeta potential−35±1.78 mV,and encapsulation efficiency 87.32%±0.3 and 79.42%±0.5 for DOX and CUR respectively.Biocompatibility studies revealed minimal hemolytic activity and biocompatible behavior of the nano-formulation,the co-loaded polymer-based nano-formulation when exposed to Ultrasound at a frequency of 1.5 MHz,for 40 s,on Hep2c cancer cell lines showed a higher release of 89% after 48 h.Moreover,a higher amount of drug internalized within the cells(P<0.0001).Conclusion:The exhibited lower cell viability and IC50(70μg/mL)which demonstrated that ultrasound waves likely facilitated the penetration and uptake of the amphiphilic polymer encapsulating dual drugs into the Hep2c cancer cells,allowing for more efficient delivery of the drugs(DOX and CUR)and broadens the spectrum of anticancer therapy.展开更多
Sustained antigen release from delivery systems is a pivotal strategy to enhance vaccine-induced immune responses,primarily by mimicking the antigen exposure kinetics of natural infections to synchronously boost humor...Sustained antigen release from delivery systems is a pivotal strategy to enhance vaccine-induced immune responses,primarily by mimicking the antigen exposure kinetics of natural infections to synchronously boost humoral and cellular immunity.However,the absence of an"antigen boost"effect in current approaches stands as a critical bottleneck,limiting the intensity and durability of immune responses.To address the critical gap of insufficient antigen boosting in sustained-release vaccine platforms,we engineered an ultrasound-responsive hydrogel(URH)with diselenide-functionalized 4-arm PEG-ONH_(2)(4-arm PEG-Se-Se-ONH_(2)),4-arm PEG-ONH_(2)and ODEX.Leveraging its exceptional ultrasonic sen-sitivity,the URH enables timely controlled,multiple-boost antigen release both in vitro and in vivo,overcoming the limitations of conventional sustained-release systems.With the multiple boost release mode triggered by ultrasound,the immune response in lymph nodes was significant-ly stronger than that in sustained release group without ultrasonic trigger.At the same time,it also greatly improved the humoral immunity level,URH+US-OVA elicited 7.5×10^(4)-fold higher anti-OVA IgG titers over commercial AI-OVA vaccines and 440-fold higher than URH-OVA vaccines at day 40 post-vaccination,while the levels of blood routine and inflammatory factors were within the normal range,which proved that the safety of URH vaccines.The results support that the antigen release mode is a key factor affecting the immunological efficacy of vaccines,and URH can be modularized to regulate the multiple boost antigen releasemode.展开更多
基金supported by the National Natural Science Foundation of China,Nos.82371886(to JY),81925020(to DM),82202797(to LW),and 82271218(to CZ).
文摘Alzheimer’s disease is a common neurodegenerative disorder defined by decreased reasoning abilities,memory loss,and cognitive deterioration.The presence of the blood-brain barrier presents a major obstacle to the development of effective drug therapies for Alzheimer’s disease.The use of ultrasound as a novel physical modulation approach has garnered widespread attention in recent years.As a safe and feasible therapeutic and drug-delivery method,ultrasound has shown promise in improving cognitive deficits.This article provides a summary of the application of ultrasound technology for treating Alzheimer’s disease over the past 5 years,including standalone ultrasound treatment,ultrasound combined with microbubbles or drug therapy,and magnetic resonance imaging-guided focused ultrasound therapy.Emphasis is placed on the benefits of introducing these treatment methods and their potential mechanisms.We found that several ultrasound methods can open the blood-brain barrier and effectively alleviate amyloid-βplaque deposition.We believe that ultrasound is an effective therapy for Alzheimer’s disease,and this review provides a theoretical basis for future ultrasound treatment methods.
文摘Advancements in healthcare technology have improved mortality rates and extended lifespans,resulting in a population with multiple comorbidities that complicate patient care.Traditional assessments often fall short,underscoring the need for integrated care strategies.Among these,fluid management is particularly challenging due to the difficulty in directly assessing volume status especially in critically ill patients who frequently have peripheral oedema.Effective fluid ma-nagement is essential for optimal tissue oxygen delivery,which is crucial for cellular metabolism.Oxygen transport is dependent on arterial oxygen levels,haemoglobin concentration,and cardiac output,with the latter influenced by preload,afterload,and cardiac contractility.A delicate balance of these factors ensures that the cardiovascular system can respond adequately to varying ph-ysiological demands,thereby safeguarding tissue oxygenation and overall organ function during states of stress or illness.The Venous Excess Ultrasound(VExUS)Grading System is instrumental in evaluating fluid intolerance,providing detailed insights into venous congestion and fluid status.It was originally developed to assess the risk of acute kidney injury in postoperative cardiac patients,but its versatility has enabled broader applications in nephrology and critical care settings.This mini review explores VE×US’s application and its impact on fluid management and patient outcomes in critically ill patients.
基金Supported by the Italian Ministry of Health-Current research IRCCS(Funds Dedicated to the Research of the Gastroenterology and Digestive Endoscopy Unit,Fondazione IRCCS Ca’Granda,Ospedale Maggiore Policlinico,Milano).
文摘BACKGROUND Endoscopic ultrasound(EUS)is crucial for diagnosing solid pancreatic lesions,especially pancreatic ductal adenocarcinoma(PDAC),a highly aggressive cancer which represents the majority with a prevalence of approximately 85%.AIM To identify EUS features that differentiate PDAC from other lesions such as neuroendocrine tumors(NETs)and helping in the differential diagnosis,by analyzing a large sample of solid pancreatic lesions.METHODS This observational,retrospective,multicenter study analyzed the endosonographic characteristics of 761 patients with a radiological diagnosis of solid pancreatic lesion,who underwent pancreatic EUS for typing and staging with needle biopsies between 2015 and 2023.General patient characteristics(age and sex)and solid lesion features were collected and described,such lesion size(Bmode),vessel involvement(compression or invasion),ductal dilation,lymphadenopathy,echogenicity,echopattern,margin regularity,multifocality,internal vascularization and elastography.Subsequently,a predictive analysis was performed through univariate and multivariate logistic regression to identify predictive features for PDAC or NET diagnoses.RESULTS Our study enrolled 761 patients,predominantly male with a mean age of 68.6.PDACs were generally larger(mean 33 mm×27 mm),often had irregular margins,and displayed significant upstream ductal dilation.Hypoechogenicity was common across malignant lesions.In contrast,NETs were smaller(mean 20 mm×17 mm)and typically had regular margins with multiple lesions.Vascular involvement,although predominant in PDAC,is a common feature of all malignant neoplasms.Multifocality,however,although a rare finding,is more typical of NETs and metastases,and practically absent in the remaining lesions.Predictive analyses showed that ductal dilation and irregular margins were the most significant predictors for PDAC[odds ratio(OR)=5.75 and 3.83],with hypoechogenicity,heterogeneous echopattern and lymphadenopathies also highly significant(OR=3.51,2.56 and 1.99).These features were inversely associated with NETs,with regular margins and absence of ductal involvement or lymphadenopathies(OR=0.24,0.86 and 0.45 respectively),as already shown by the descriptive analysis.Finally,age,despite achieving statistical significance,lacks clinical value given an OR trending towards 1.CONCLUSION This study provides a comprehensive overview of EUS features for solid pancreatic lesions,identifying distinct features like upstream ductal dilation and irregular margins for PDAC vs regular margins for NETs as strong diagnostic predictors.These findings enhance the understanding of pancreatic pathologies,offering valuable insights for improved differential diagnosis and clinical management,especially in complex cases.Further prospective studies could build on these results.
文摘Conventional echocardiography can sometimes pose a challenge to diagnosis due to sub-optimal images.Ultrasound contrast agents(UCAs)have been shown to drastically enhance imaging quality,particularly depicting the left ventricular endocardial borders.Their use during echocardiography has become a valuable tool in non-invasive diagnostics.UCAs provide higher-quality images that may ultimately reduce the length of hospital stays and improve patient care.The higher cost associated with UCAs in many situations has been an impediment to frequent use.However,when used as an initial diagnostic test,UCA during rest echocardiogram is more cost-effective than the traditional diagnostic approach,which frequently includes multiple tests and imaging studies to make an accurate diagnosis.They can be easily performed across multiple patient settings and provide optimal images that allow clinicians to make sound medical decisions.This consequently allows for better diagnostic accuracies and improvement in patient care.
文摘Point-of-care ultrasound(POCUS) is recognized as a valuable diagnostic tool,especially in resourcelimited settings(RLS).POCUS provides rapid diagnostic information that enables health professionals to make critical decisions at the bedside.^([1]) Despite the welldocumented benefits of POCUS,access to longitudinal,comprehensive training programs and a lack of trainee feedback are barriers to the widespread use of this technology in such settings.^([2])
基金Supported by National Natural Science Foundation of China(No.82070964)Shaanxi Science Fund for Distinguished Young Scholars(No.2022JC-60)+3 种基金the International Scientific and Technological Cooperation Projects(No.2024GH-YBXM-20)Xi’an Medical University Undergraduate Open Experimental Research Fund(No.2024DXS02)Yizhen Genetic Talent Development Program(No.2023YZ10)The Open Research Funds of the State Key Laboratory of Ophthalmology(No.83000-32030002).
文摘As a non-invasive surgical procedure ultrasound cycloplasty(UCP)has gained attention among ophthalmologists in recent years.Derived from the application of highintensity focused ultrasound,it has been utilized for the treatment of various types of glaucoma,demonstrating notable efficacy and safety.This review focuses on the efficacy and safety of UCP in treating glaucoma among Asian populations.By summarizing and analyzing existing literature on indications,therapeutic outcomes,and safety profiles,this review further highlights the unique advantages of UCP in glaucoma treatment compared to traditional surgical approaches.These advantages include broader indications,non-invasive nature,quantifiable treatment,excellent intraocular pressure-lowering effects,fewer adverse reactions,and high safety.Additionally,by introducing the underlying mechanism of action,this review explores the factors influencing its therapeutic efficacy,providing theoretical insights for clinical practice and demonstrating UCP’s potential in glaucoma management.
基金Supported by Liaoning Province People's Livelihood Science and Technology(Health)Plan Joint Project,No.2021JH2/10300127the State Scholarship Funding of CSC,No.201908865001。
文摘Laparoscopic or robotic surgery accounts for an increasing proportion of liver surgery.However,the lack of haptic feedback results in a certain amount of risk.The use of laparoscopic ultrasound(LUS)enables the operator to observe internal structures of the liver in real time to easily avoid the main blood vessels.It also allows for the detection of tumor boundaries and the extent of tumor thrombi,considerably improving the success rate of the operation.Besides its advantages in detecting small lesions that are not detectable through preoperative imaging,thus assisting diagnosis and staging,the LUS can also be used to monitor ablation therapy,portal vein puncture staining,and lesion blood perfusion.Recent advances in technology like contrast-enhanced intraoperative ultrasound and realtime virtual sonography can help surgeons better perform laparoscopic surgery.For liver surgeons,LUS is an essential technique for safely performing laparoscopic surgery,making their proficiency in the use of LUS vital.This article reviews the application of LUS in laparoscopic hepatic resection of liver tumors and the new technology of LUS to help liver surgeons understand the current application status of LUS and the future research directions.
文摘BACKGROUND Endoscopic ultrasound(EUS)has evolved from a diagnostic tool to a management technique for various gastroenterological conditions,including biliary strictures.AIM To summarize the current evidence on EUS’s role in diagnosing and managing biliary strictures.METHODS Two independent reviewers searched five electronic databases(PubMed,CENTRAL,Science Direct,Google Scholar,and EMBASE)for articles published up to January 2025.Included articles met specific criteria,and statistical software was used to analyze reported outcomes.RESULTS Of 935 articles,19 met the inclusion criteria.Ten articles focused on diagnostic EUS,while nine focused on EUSguided therapeutic interventions.EUS fine-needle aspiration demonstrated superior sensitivity[0.43-1.00;95%confidence interval(CI):0.24-1.00]compared to conventional techniques(0.36-0.96;95%CI:0.19-0.99)for diagnosing malignant biliary strictures.Both EUS-fine-needle aspiration and conventional methods exhibited high specificity,with most achieving 100%specificity.EUS-guided interventions showed significantly higher clinical success rates than control interventions(odds ratio=2.89;95%CI:1.22-6.84;P=0.02).No significant difference was observed in technical success rates(odds ratio=0.97;95%CI:0.30-3.16;P=0.96).CONCLUSION EUS is a promising tool for diagnosing and managing biliary strictures.Combining EUS-guided and conventional interventions improves diagnostic performance.Further research is needed to investigate the feasibility and use of EUS-guided interventions in this field.
基金Supported by the Liaoning Provincial Science and Technology Plan Joint Program(Applied Basic Research Project),Undertaken by Shengjing Hospital of China Medical University in Collaboration with China Resources Health(Liaoning)Group Co.,Ltd.,No.2023JHZ/101700190.
文摘As an innovative endoscopic intervention,endoscopic ultrasound-guided pan-creatic duct drainage(EUS-PD)demonstrates significant clinical value in re-solving pancreatic ductal hypertension syndrome.By integrating real-time ultrasound guidance with catheter-based intervention techniques,this approach provides a safe and effective alternative for cases where conventional endoscopic retrograde cholangiopancreatography has failed.Current evidence indicates that EUS-PD achieves technical success rates ranging from 82%to 95%in alleviating symptomatic pancreatic duct hypertension caused by malignant obstructions and chronic pancreatitis-related strictures,with an overall complication rate(15%-20%)substantially lower than surgical interventions.Compared to conventional imaging modalities,EUS-PD offers superior anatomical visualization capabilities:Its high-frequency ultrasound probe enables precise identification of 3 mm-level pancreatic duct branches,while contrast-enhanced imaging significantly improves diagnostic accuracy in differentiating benign from malignant strictures(sensitivity 91%vs 73%,P<0.05).Nevertheless,technical challenges persist,including diffi-cult ductal puncture localization(particularly in pancreatic head lesions),complex guidewire axial control,and postoperative pancreatic fistula risks(7%-12%).This review systematically examines the clinical indications/contraindications,pro-cedural protocols,device selection criteria,and management strategies for early/late complications associated with EUS-PD.Special emphasis is placed on establishing anatomical pathway selection standards for transgastric-pancreatic duct vs transduodenal-pancreatic duct approaches.Advancements in auxiliary technologies(e.g.,three-dimensional elastography,AI-assisted navigation)and multidisciplinary team collab-oration are pivotal to developing standardized protocols.We propose establishing international multicenter registry databases and conducting prospective randomized controlled trials to clarify EUS-PD's position within pancreatic disease management systems.Such initiatives will facilitate the clinical transformation of EUS-PD from an"alternative option"to a"preferred strategy",ultimately enhancing treatment precision and improving clinical outcomes in pancreatic disorders.
文摘In this letter we comment on the article by Zhang et al published in the recent issue of the World Journal of Gastrointestinal Endoscopy 2024.We focus specifically on the management of gastric varices(GV),which is a significant consequence of portal hypertension,is currently advised to include beta-blocker therapy for primary prophylaxis and transjugular intrahepatic portosystemic shunt for secondary prophylaxis or active bleeding.Although it has been studied,direct endoscopic injection of cyanoacrylate glue has limitations,such as the inability to fully characterize GV endoscopically and the potential for distant glue embolism.In order to achieve this,endoscopic ultrasound has been used to support GV characterization,real-time therapy imaging,and Doppler obliteration verification.
文摘In this article we comment on the paper by Xu et al describing retrospective data on endoscopic treatment outcome of esophageal gastrointestinal stromal tumors(GISTs).Esophageal GIST is a rare type of mesenchymal tumor.GISTs originate from the interstitial cells of Cajal,which are pacemaker cells involved in gut motility.GISTs are most commonly found in the stomach and small intestine,but esophageal involvement is rare.Esophageal GISTs account for<1%of all GISTs.Endoscopic resection remains the mainstay for small,localized tumors with excellent outcomes.However,larger tumors may require multidisciplinary strategies to provide the best oncological outcomes.Here,we discuss the usefulness of endoscopic ultrasound(EUS)of subepithelial tumors of the upper gastrointestinal tract.EUS is a crucial tool in the diagnosis,staging,and management of subepithelial masses.Given the subepithelial nature of these tumors,standard endoscopy is not adequate,making EUS essential for a comprehensive assessment.EUS provides accurate tumor size assessment and enables fine needle aspirations guided biopsy,for treatment planning.
文摘BACKGROUND Congenital cytomegalovirus(CMV)infection represents a significant public health concern as the most prevalent viral infection in newborns,potentially leading to severe neurological and developmental complications.The majority of cases are asymptomatic and remain undetected during pregnancy due to the absence of effective screening methods.CASE SUMMARY A 27-year-old primigravida presented for early pregnancy ultrasound,which revealed an atypical finding:A normal anechoic thalamus appearing hyperechoic on the mid-sagittal view of the fetal head.Subsequent ultrasound examinations during mid and late gestation demonstrated classic intracranial features sug-gestive of congenital CMV infection.Chromosomal karyotyping and microarray analysis of the fetus yielded no significant abnormalities.Following compre-hensive prenatal counseling regarding potential adverse fetal outcomes,the patient elected to continue her pregnancy.She ultimately underwent cesarean delivery at 42 weeks gestation at another facility,resulting in the birth of a female neonate.At five months of age,the infant presented with epilepsy and significant growth and developmental delays.CONCLUSION Congenital CMV infection occurs during the first trimester may manifest as hyperechoic thalamus which can be revealed by ultrasound in the mid-saggital view of the fetal head.Future research should investigate the correlation between echogenic thalamus and developmental outcomes,as well as explore early sc-reening techniques for suspected congenital CMV infection cases.
文摘This study aimed to investigate the effect of ultrasound-assisted alkaline extraction(UAE)(at 20 kHz and different powers of 0,200,300,400,500 and 600 W for 10 min)on the yield,structure and emulsifying properties of chickpea protein isolate(CPI).Compared with the non-ultrasound group,ultrasound treatment at 400 W resulted in the largest increase in CPI yield,and both the particle size and turbidity decreased with increasing ultrasound power from 0 to 400 W.The scanning electron microscope results showed a uniform structural distribution of CPI.Moreover,itsα-helix content increased,β-sheet content decreased,and total sulfhydryl group content and endogenous fluorescence intensity rose,illustrating that UAE changed the secondary and tertiary structure of CPI.At 400 W,the solubility of the emulsion increased to 63.18%,and the best emulsifying properties were obtained;the emulsifying activity index(EAI)and emulsifying stability index(ESI)increased by 85.42%and 46.78%,respectively.Furthermore,the emulsion droplets formed were smaller and more uniform.In conclusion,proper UAE power conditions increased the extraction yield and protein content of CPI,and effectively improved its structure and emulsifying characteristics.
文摘Objective Primary liver cancer,predominantly hepatocellular carcinoma(HCC),is a significant global health issue,ranking as the sixth most diagnosed cancer and the third leading cause of cancer-related mortality.Accurate and early diagnosis of HCC is crucial for effective treatment,as HCC and non-HCC malignancies like intrahepatic cholangiocarcinoma(ICC)exhibit different prognoses and treatment responses.Traditional diagnostic methods,including liver biopsy and contrast-enhanced ultrasound(CEUS),face limitations in applicability and objectivity.The primary objective of this study was to develop an advanced,lightweighted classification network capable of distinguishing HCC from other non-HCC malignancies by leveraging the automatic analysis of brightness changes in CEUS images.The ultimate goal was to create a user-friendly and cost-efficient computer-aided diagnostic tool that could assist radiologists in making more accurate and efficient clinical decisions.Methods This retrospective study encompassed a total of 161 patients,comprising 131 diagnosed with HCC and 30 with non-HCC malignancies.To achieve accurate tumor detection,the YOLOX network was employed to identify the region of interest(ROI)on both B-mode ultrasound and CEUS images.A custom-developed algorithm was then utilized to extract brightness change curves from the tumor and adjacent liver parenchyma regions within the CEUS images.These curves provided critical data for the subsequent analysis and classification process.To analyze the extracted brightness change curves and classify the malignancies,we developed and compared several models.These included one-dimensional convolutional neural networks(1D-ResNet,1D-ConvNeXt,and 1D-CNN),as well as traditional machine-learning methods such as support vector machine(SVM),ensemble learning(EL),k-nearest neighbor(KNN),and decision tree(DT).The diagnostic performance of each method in distinguishing HCC from non-HCC malignancies was rigorously evaluated using four key metrics:area under the receiver operating characteristic(AUC),accuracy(ACC),sensitivity(SE),and specificity(SP).Results The evaluation of the machine-learning methods revealed AUC values of 0.70 for SVM,0.56 for ensemble learning,0.63 for KNN,and 0.72 for the decision tree.These results indicated moderate to fair performance in classifying the malignancies based on the brightness change curves.In contrast,the deep learning models demonstrated significantly higher AUCs,with 1D-ResNet achieving an AUC of 0.72,1D-ConvNeXt reaching 0.82,and 1D-CNN obtaining the highest AUC of 0.84.Moreover,under the five-fold cross-validation scheme,the 1D-CNN model outperformed other models in both accuracy and specificity.Specifically,it achieved accuracy improvements of 3.8%to 10.0%and specificity enhancements of 6.6%to 43.3%over competing approaches.The superior performance of the 1D-CNN model highlighted its potential as a powerful tool for accurate classification.Conclusion The 1D-CNN model proved to be the most effective in differentiating HCC from non-HCC malignancies,surpassing both traditional machine-learning methods and other deep learning models.This study successfully developed a user-friendly and cost-efficient computer-aided diagnostic solution that would significantly enhances radiologists’diagnostic capabilities.By improving the accuracy and efficiency of clinical decision-making,this tool has the potential to positively impact patient care and outcomes.Future work may focus on further refining the model and exploring its integration with multimodal ultrasound data to maximize its accuracy and applicability.
文摘BACKGROUND Adrenocortical oncocytoma is a rare,mostly benign,nonfunctional tumor that is typically detected incidentally.Its diagnosis is challenging because of the absence of distinctive imaging characteristics,necessitating pathological validation.CASE SUMMARY We present a case report of a 35-year-old woman with an adrenal mass located on the left side,where endoscopic ultrasound-guided fine-needle aspiration(EUSFNA)was performed after comprehensive diagnostic assessment.Our results are consistent with those of previously documented cases regarding tumor demographics and anatomical location.Given the limited number of reports on this condition,long-term follow-up is crucial to enhance our understanding of its prognosis.CONCLUSION For patients with adrenocortical oncocytoma,EUS-FNA can enables collection of preoperative tissue specimens leading to suitable treatment strategies.
文摘Background: Undergoing ultrasound scanning (USS) during the first trimester of pregnancy is highly imperative for expecting mothers, as it supports the early detection of any malformations, identifying the fetal number, fetal growth, fetal sex, and calculation of delivery. Previous studies have shown that undergoing such prenatal screening procedures could reduce the antenatal anxiety levels of expectant mothers. The present study aimed to explore the impact of first-trimester ultrasound scanning towards the antenatal anxiety and identify the predictors of antenatal anxiety among expectant mothers in the first trimester. Methods: A repeated measure design study was conducted in Maternity Clinics of University Hospital KDU, Ninewells Care Hospital and Navy General Hospital over 4 months with one hundred and fifteen (n = 115) expectant mothers. Participants completed a general information sheet first and State Trait Anxiety Inventory (STAI) (Spielberger et al., 1970) was administered before and after undergoing the USS. Results: Mean age of the participants was 28.84 ± 3.68. The Wilcoxon Signed Rank test showed that there is a significant reduction of participants’ antenatal anxiety levels following the USS z = −5.658, p Conclusions: Findings suggest that undergoing the first trimester USS significantly reduces the antenatal state anxiety and partner’s support is an important factor in reducing the antenatal anxiety experienced by expectant mothers in the first trimester. Future studies can focus on how USS can contribute to alleviating antenatal anxiety in second and third trimesters.
文摘Background: Wrist pain is prevalent. Activities such as dexterous sports, prolonged use of personal handheld devices, and extensive desktop keyboard usage are common contributors to wrist pain. Intersection syndrome, a form of inflammatory tenosynovitis, occurs at the intersection of the first and second dorsal compartments of the wrist. The first dorsal compartment is comprised of the tendons of abductor pollicis longus and extensor pollicis brevis, while the second dorsal compartment contains the tendons of extensor carpi radialis longus and extensor carpi radialis brevis. Intersection syndrome is diagnosed by pain localized to the dorsoradial forearm, approximately five cm proximal to the wrist joint, which worsens with resisted wrist and thumb extension. To date, the use of hydro dissection with 5% dextrose under ultrasound guidance as a treatment for Intersection syndrome has not been reported. This case report presents the first report on ultrasound-guided hydro dissection as a therapeutic approach for intersection syndrome. Methods: A case report, with informed consent, involving a 32-year-old male athlete. The patient, a hurling player, presented with chronic right wrist pain diagnosed as intersection syndrome. The condition significantly affected his work, sporting activities, and daily living activities. Previous conservative management and physiotherapy had failed to alleviate his symptoms. To confirm the diagnosis, relevant imaging was performed, supplemented by dynamic ultrasound assessment. The procedure was performed aseptically. Continuous ultrasound guidance was employed to ensure accurate needle placement. Once the needle tip position was confirmed, an initial injection of 5 mL of 0.25% chirocaine was administered. 10 mL of 5% dextrose was injected under ultrasound guidance for hydro dissection, with good visualization of the solution’s distribution. Conclusion: Ultrasound-guided hydro dissection has not previously been documented as a treatment option for intersection syndrome. In this case, it proved to be an effective pain-relieving therapy with sustained effect at three-month clinical follow-up. Further studies are required.
文摘Endoscopic ultrasound(EUS)is an indispensable tool for the diagnosis and management of various diseases,particularly biliopancreatic disorders,as it provides detailed visualization of the gastrointestinal tract and surrounding structures.As the demand for diagnostic and interventional EUS procedures increases,ensuring high-quality training for endoscopists is essential to improve patient outcomes.This mini-review provides an overview of the current state of EUS training and emphasizes the importance of a structured approach that integrates theoretical knowledge and hands-on experience.We discuss different training methods,focusing on the main courses available worldwide,and highlight their advantages and limitations.In addition,we examine the challenges of training for diagnostic and interventional EUS,such as limited access to training centers and the need for personalized feedback.Overall,improving EUS training programs is essential to enhance physician skills and ensure this advanced technique is used safely and efficiently in clinical practice.
文摘Background:Stimuli-responsive drug delivery systems introduced nowadays to enable enhanced drug release upon exogenous stimulus.Research focuses on developing systems for co-administration of drugs to overcome limitations of single-drug chemotherapy,such as low response rates,ineffective treatment completion,and drug resistance,leading to aggressive proliferation and recurrence.This research focuses on utilizing the amphiphilic polymer quaternary ammonium palmitoyl glycol chitosan(GCPQ)as a carrier to load hydrophobic curcumin(CUR)and hydrophilic doxorubicin(DOX)to reach the desired target and release the cargo upon exogenous stimuli of ultrasound.Methods:The nanoformulation synthesized using a biocompatible approach,resulting in a stable DOX-CUR-GCPQ nano-formulation upon physicochemical characterization and in vitro analysis using ultrasound.Results:The mean hydrodynamic diameter of DOX-CUR-GCPQ nanomicelles was measured as 95±1.23 nm,PDI 0.32±0.87,zeta potential−35±1.78 mV,and encapsulation efficiency 87.32%±0.3 and 79.42%±0.5 for DOX and CUR respectively.Biocompatibility studies revealed minimal hemolytic activity and biocompatible behavior of the nano-formulation,the co-loaded polymer-based nano-formulation when exposed to Ultrasound at a frequency of 1.5 MHz,for 40 s,on Hep2c cancer cell lines showed a higher release of 89% after 48 h.Moreover,a higher amount of drug internalized within the cells(P<0.0001).Conclusion:The exhibited lower cell viability and IC50(70μg/mL)which demonstrated that ultrasound waves likely facilitated the penetration and uptake of the amphiphilic polymer encapsulating dual drugs into the Hep2c cancer cells,allowing for more efficient delivery of the drugs(DOX and CUR)and broadens the spectrum of anticancer therapy.
基金supported by the National Natural Science Foundation of China(Nos.W2412020,22222509)China Science and Technology Exchange Center Joint Project on Vaccine Research and Development(No.2024VTJP1004)Jilin Provincial International Cooperation Key Laboratory of Biomedical Polymers(No.YDZJ202402077CXJD).
文摘Sustained antigen release from delivery systems is a pivotal strategy to enhance vaccine-induced immune responses,primarily by mimicking the antigen exposure kinetics of natural infections to synchronously boost humoral and cellular immunity.However,the absence of an"antigen boost"effect in current approaches stands as a critical bottleneck,limiting the intensity and durability of immune responses.To address the critical gap of insufficient antigen boosting in sustained-release vaccine platforms,we engineered an ultrasound-responsive hydrogel(URH)with diselenide-functionalized 4-arm PEG-ONH_(2)(4-arm PEG-Se-Se-ONH_(2)),4-arm PEG-ONH_(2)and ODEX.Leveraging its exceptional ultrasonic sen-sitivity,the URH enables timely controlled,multiple-boost antigen release both in vitro and in vivo,overcoming the limitations of conventional sustained-release systems.With the multiple boost release mode triggered by ultrasound,the immune response in lymph nodes was significant-ly stronger than that in sustained release group without ultrasonic trigger.At the same time,it also greatly improved the humoral immunity level,URH+US-OVA elicited 7.5×10^(4)-fold higher anti-OVA IgG titers over commercial AI-OVA vaccines and 440-fold higher than URH-OVA vaccines at day 40 post-vaccination,while the levels of blood routine and inflammatory factors were within the normal range,which proved that the safety of URH vaccines.The results support that the antigen release mode is a key factor affecting the immunological efficacy of vaccines,and URH can be modularized to regulate the multiple boost antigen releasemode.
