Combining serum AFP and CEUS LI-RADS for better diagnostic performance in Chinese high-risk patients.

PURPOSE: To evaluate and compare the diagnostic performance of revised contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System version by combining LR-M category and serum alpha-fetoprotein (AFP) under different cut-off values. MATERIAL AND METHODS: This retrospective study enrolled 152 high-risk patients with 152 histology-proven nodules. For revised LI-RADS, nodules in LR-M with different elevated AFP thresholds have been reclassified as the LR-5 category. The diagnostic performances of original and revised CEUS LI-RADS were evaluated and compared. RESULTS: To compare with the original version, the sensitivity of revised LR-5 (adjusted with AFP value > 200 ng/ml or 400 ng/ml) for the diagnosis of hepatocellular carcinoma (HCC) improved from 52.5 to 69.2% or 65.0%, respectively (both p < 0.001) without compromising specificity (87.5% vs. 71.9% or 78.1%, respectively, both p > 0.05). For the diagnosis of non-HCC malignancy, the specificity of the LR-M after reclassification was improved (69.6% vs. 84.4% or 80.7%, respectively, both p < 0.001) with a non-significant sensitivity reduction (100.0 vs. 70.6% or 82.4%, respectively, both p > 0.05). After modification, the sensitivity of LR-5 also increased to 69.1% or 64.9% (both p < 0.001), while the specificity and PPV did not change (both p > 0.05) for larger nodules (> 20 mm). CONCLUSION: The diagnostic performance of CEUS LI-RADS can be further improved by reclassifying LR-M nodules with elevated AFP thresholds to LR-5.

A colorimetric analytical method based on a TCPP-CuCo2O4-like peroxidase for the detection of trichlorfon.

In this work, a highly sensitive colorimetric sensing platform was designed for the detection of trichlorfon based on inhibiting thiocholine (TCh)-induced redox reaction. 5,10,15,20-Tetracarboxyphenylporphyrin (TCPP) functionalized CuCo2O4 (TCPP-CuCo2O4) was synthesized to construct a colorimetric sensing platform for trichlorfon. In the presence of H2O2, TCPP-CuCo2O4 can oxidize colorless 3,3',5,5'-tetramethylbenzidine (TMB) into blue ox-TMB, accompanied by a strong absorption peak at 652 nm, while acetylcholinesterase (AChE) can specifically hydrolyze acetylthiocholine (ATCh) into TCh, which can reduce ox-TMB back into colorless TMB, resulting in a lower absorbance at 652 nm. Trichlorfon can irreversibly inhibit the activity of AChE and thus recover the absorption peak. Under the optimized conditions, detection of trichlorfon has a wide linear range of 40-4000 ng mL-1 with a linear correlation coefficient of 0.9904. The proposed method can be applied to the detection of trichlorfon in vegetables and has good application prospects.

How Green Mindfulness and Green Shared Vision Interact to Influence Green Creative Behavior.

Aim: The study is based on the self-determination theory and aims to investigate the mediating role of green intrinsic motivation and the moderating role of green shared vision in the association between frontline managers' green mindfulness and green creative behavior to leverage their capacity to think creatively and act sustainably. Methods: The study employs a time-lagged, multi-source research methodology to collect data from frontline managers of service businesses in the tourism and hospitality industry. Data are analyzed using SmartPLS Structural Equation Model to evaluate the structural and measurement models. The authors evaluated the measurement model by employing the criteria of internal consistency: reliability and Cronbach's alpha, validity: convergent and discriminant validity; and the structural model using the path coefficient, coefficient of determination, predictive relevance, and goodness-of-fit metrics. Results: Our findings indicate that green mindfulness significantly improves frontline managers' green creative behavior. Additionally, green intrinsic motivation mediates the connection between green mindfulness and green creative behavior. In addition, the direct effect of green mindfulness on green intrinsic motivation as well as the indirect effect of green mindfulness on green creative behavior through green intrinsic motivation, are both significantly moderated by green shared vision. Discussion: To the best of the authors' knowledge, this is one of the few efforts that outstretch the boundary conditions of green mindfulness and green creative behavior through the mediating role of green intrinsic motivation and the moderating role of green shared vision.

Application value of conventional ultrasound and real-time shear wave elastography in patients with type 2 diabetic polyneuropathy.

PURPOSE: To explore the application value of conventional ultrasound and real-time shear wave elastography (SWE) to the tibial nerve (TN) and the common peroneal nerve (CPN) in diabetic peripheral neuropathy (DPN). MATERIALS AND METHODS: Thirty-three healthy volunteers, 33 diabetic patients without DPN, and 30 diabetic patients with DPN were enrolled in this study. The anteroposterior diameter (APD), the cross-sectional area (CSA), and the perimeter of the TN and the CPN were measured by conventional ultrasound, and the stiffness of the nerves was measured by SWE. RESULTS: The conventional ultrasound parameters and stiffness of the TN in patients with DPN were significantly larger than those of the other two groups (P < 0.01). The conventional ultrasound parameters of the CPN were significantly higher in patients with DPN than in the other two groups (P < 0.01).The patients with DPN demonstrated a greater stiffness of the CPN compared to the control group (P < 0.05). The comparison of all parameters for the left and right TNs and CPNs among the three groups showed no significant difference. The area under the curve (AUC) of TN stiffness for the diagnosis of DPN was significantly greater than that of conventional ultrasound parameters. CONCLUSION: The conventional ultrasound parameters and the stiffness of the TN and the CPN were significantly higher in patients with DPN. The stiffness of the TN could better diagnose DPN than conventional ultrasound parameters. In short, conventional ultrasound and SWE of nerves are of good application value in the diagnosis of DPN.

[Topotecan-based combined chemotherapy for refractory or relapsed hematologic malignancies].

OBJECTIVE: To evaluate the efficacy and toxicity of topotecan-based combined chemotherapy for refractory or relapsed hematologic malignancies. METHODS: Twenty-one patients with refractory or relapsed acute leukemia (AL), non-Hodgkin's lymphoma (NHL) or high risk myelodysplastic syndrome (MDS) were treated by topotecan with cytarabine, amsacrine or cyclophosphamide. All patients received a single course as salvage therapy. RESULTS: The overall response rate of one course was 61.9% with 9/21 (42.9%) CR and 4/21 (19%) PR. Severe myelosuppression was observed in all patients. Agranulocytic time was 12.6 days in AL and 7.5 days in NHL. Sixteen of 21 patients received G-CSF 300 micro g/d All patients received supportive treatment of transfusion. Fever and documented infection developed in 15 patients. Non-hematologic toxicity was mild. CONCLUSION: Topotecan-based combined chemotherapy has significant antitumour activity and acceptable toxicity as salvage therapy for high risk hematologic malignancies.