Spleen Stiffness Performance in the Noninvasive Assessment of Gastroesophageal Varices after Transjugular Intrahepatic Portosystemic Shunts.

OBJECTIVES: To investigate the performance of spleen stiffness (SS) by using two-dimensional shear-wave elastography (2D-SWE) for assessing the severity of gastroesophageal varices (GEVs) after transjugular intrahepatic portosystemic shunt (TIPS). METHODS: 102 eligible patients were categorized as in the post-TIPS short-term (n = 69) and long-term (n = 38) follow-up groups. The performance of SS by using 2D-SWE for evaluating the severity of GEVs was compared with liver stiffness (LS), spleen stiffness-to-liver stiffness ratio (SS/LS), liver stiffness spleen-diameter-to-platelet-ratio score (LSPS), portal hypertension (PH) risk score, platelet count-to-spleen diameter ratio (PSR), and varices risk score by using receiver operating characteristic (ROC) curve and DeLong test. RESULTS: In the post-TIPS short-term follow-up group, area under the receiver operating characteristic curves (AUCs) of SS were 0.585 for mild (cutoff value = 30.3 kPa), 0.655 for moderate (cutoff value = 30.6 kPa), and 0.739 for severe (cutoff value = 31.9 kPa) GEVs, which were higher than other parameters for severe GEVs. AUCs of SS were lower than other parameters for mild and moderate GEVs, but no difference was found (p > 0.05). In the post-TIPS long-term follow-up group, AUCs of SS were 0.778 for mild (cutoff value = 28.9 kPa), 0.82 for moderate (cutoff value = 29.9 kPa), and 0.824 for severe (cutoff value = 37.7 kPa) GEVs, which were higher than other parameters except for severe GEVs. AUC of SS was lower than other parameters for severe GEVs, but no significant difference was found (p > 0.05). CONCLUSION: SS is an effective noninvasive tool to predict GEV severity during the post-TIPS follow-up.

An approach to assessment of Keshan disease elimination at the township level.

BACKGROUND: The aim of this study was to pilot a method of a small-scale survey for the assessment of Keshan disease (KD) elimination at township level. METHODS: The prevalence of chronic KD was obtained by case-searching the whole population. The endemic village with the highest prevalence of chronic KD was selected as the key village for the survey of latent KD prevalence rate among permanent residents. The selenium levels in the head hair of individuals in the key village was measured. The professionals of the department of endemic disease control, the township and village doctors were surveyed by pre-designed questionnaire survey for KD interventions. RESULTS: We conducted this study in 2013. Yuanbao township had a population of 16 487 people and 14 862 permanent residents. There were no acute or subacute KD cases in the previous 5 years. The prevalence rate of chronic KD and natural chronic KD were 6.7/10 000 and 3.4/10 000 respectively. The prevalence rate of latent KD was 250.6/10 000, higher than the elimination criterion. The head hair selenium levels were 0.23±0.18 mg/kg. CONCLUSIONS: The small-scale survey methodology for assessing KD elimination at township level was feasible. KD among the people living in Yuanbao township has not been eliminated.