Hepatic venous pressure gradient evaluates the Scheuer stage of liver fibrosis by transjugular liver biopsy: a multicenter study.

BACKGROUND: Hepatic venous pressure gradient (HVPG) is the criterion for assessing sinusoidal portal hypertension. Using HVPG to assess the degree of liver fibrosis by transjugular liver biopsy (TJLB) is still being explored, as no data has been shown that portal hypertension may already be present in patients with advanced hepatic fibrosis (Scheuer stage ≥ S3). The objective of this study was to observe whether portal hypertension exists before progressing to cirrhosis (Scheuer stage = S4). METHODS: Fifty patients who underwent TJLB and HVPG were enrolled. The correlation between Scheuer stage and HVPG was analyzed using the Pearson correlation coefficient, and the ROC curve predicted the diagnostic value of HVPG in patients with hepatic fibrosis. RESULTS: The Scheuer stage and HVPG significantly correlated (r = 0.654, p < 0.001). The AUC of HVPG in predicting advanced liver fibrosis was 0.896, and of cirrhosis was 0.810. There were 45 patients with portal hypertension (HVPG> 5 mmHg), 12 with S3, 29 with S4; There were 42 patients with CSPH (HVPG≥ 10 mmHg), 11 with S3, and 29 with S4. CONCLUSION: HVPG is valuable in evaluating the Scheuer stage of liver fibrosis in patients with TJLB. Portal hypertension might already exist before the progression to cirrhosis in some patients.

Wearable respiration monitoring using an in-line few-mode fiber Mach-Zehnder interferometric sensor.

Continuous respiratory monitoring is extensively important in clinical applications. To effectively assess respiration rate (RR), tidal volume (TV), and minute ventilation (MV), we propose and experimentally demonstrate a respiration monitoring system using an in-line few-mode fiber Mach-Zehnder interferometer (FMF-MZI), which is the first to introduce in-line MZI into an optimal wearable design for respiration rate and volume monitoring. The optimal linear region of the proposed sensor is analyzed and positioned by a flexible arch structure with curvature sensitivity up to 8.53 dB/m-1. Respiration monitoring results are in good agreement with a standard spirometer among different individuals. The difference in TV estimation is ± 0.2 L, and the overall error of MV estimation is less than 5%.