Diagnostic performance of elastosonography in the differential diagnosis of benign and malignant salivary gland tumors: A meta-analysis.

Purpose: The clinical practice of elastosonography for the detection of salivary gland tumors is still a controversial issue. The objective of this meta-analysis was to evaluate the effect of elastosonography for the diagnosis of salivary gland tumors and to compare the diagnostic value of elastosonography and conventional ultrasound in the diagnosis of salivary gland tumors. Methods: A comprehensive literature search through PubMed, EMBASE, and Cochrane Library was carried out from inception to November 2021. Two researchers independently extracted the data from the enrolled papers using a standard data extraction form. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) were calculated to evaluate the diagnostic performance of elastosonography. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was utilized to evaluate the quality of each included study. Meta-DiSc version 1.4, Review Manager 5.3, and StataSE 15 were used. Results: Sixteen studies with a total of 1105 patients with 1146 lesions were included in this meta-analysis. The pooled sensitivity, specificity, PLR, NLR, and DOR of elastosonography for the differentiation between benign and malignant salivary gland tumors were 0.73 (95%CI, 0.66-0.78), 0.64 (95%CI, 0.61-0.67), 2.83 (95%CI, 1.97-4.07), 0.45 (95%CI, 0.32-0.62), and 9.86 (95%CI, 4.49-21.62), respectively, with an AUC of 0.82. Four studies provided data regarding the conventional ultrasound for the differentiation between benign and malignant salivary gland tumors. The pooled sensitivity, specificity, and DOR were 0.62 (95%CI, 0.50-0.73), 0.93 (95%CI, 0.90-0.96), and 25.07 (95%CI, 4.28-146.65), respectively. The meta-regression and subgroup analyses found that assessment methods were associated with significant heterogeneity, and quantitative or semiquantitative elastosonography performed better than the qualitative one. Conclusions: Elastosonography showed a limited value for diagnosing malignant salivary gland tumors; it could be considered as a supplementary diagnostic technology to conventional ultrasound, and quantitative or semiquantitative elastosonography was superior to the qualitative one.

Occupational Therapy and Prevention of Common Sports Injuries for Special Physical Training.

This paper provides an in-depth study of occupational therapy and the prevention of common sports injuries in special physical training. The issue of sports injuries and rehabilitation has always been a hot topic in special training. With the continuous development of sports, the increasing intensity of competition, and more stringent requirements for special techniques, the increase in difficulty and intensity of training has led to the increasing frequency of sports injuries, so how to prevent injuries in special physical training and rehabilitation and recovery of athletes after the injury is particularly important. Since the most common musculoskeletal injuries occur in the lower quadrant, this paper proposes a lower extremity functional test (LEFT) model as a means of identifying injury risk and guiding the implementation of training programs to prevent sports injuries. In this paper, a knee injury is used as an example, and an occupational therapy program of TCM physical therapy + aquatic rehabilitation is adopted for the already occurred sports injuries. Through interviews and clinical examinations of athletes, coaches, and medical personnel, this paper summarizes the sites, types, characteristics, and probability of occurrence of common sports injuries in special physical training. Experiments were conducted through clinical rehabilitation of common sports injuries with the addition of TCM manual massage. A series of effects of this modality on the rehabilitation of sports injuries were examined by monitoring physiological and biochemical indexes and by comparative analysis before and after testing physical function indexes using the Omega Wave system. Sports injuries are diverse. Traditional Chinese medicine physical therapy + water rehabilitation therapy is an effective physical therapy method. According to the relevant theories of traditional Chinese medicine treatment, diagnosis and treatment through meridians and related acupuncture points have significant curative effects. Traditional Chinese medicine, massage, and acupuncture have irreplaceable roles in the rehabilitation and treatment of sports injuries and can effectively improve and cure sports injuries.

Acute cardiac injury in adult hospitalized COVID-19 patients in Zhuhai, China.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has already became a public health emergency of international concern. COVID-19 related cardiac injury remains largely unclear. METHODS: We retrospectively analyzed demographic, clinical, laboratory and cardiovascular imaging data of all consecutively admitted adult COVID-19 patients in Zhuhai, China from January 17th, 2020 to February 18th, 2020. RESULTS: A total of 93 patients were included in the study. Acute cardiac injury was found in 9 (9.7%) COVID-19 patients with median level of hypersensitive cardiac troponin I (hs-cTnI) to be 0.085 µg/L (IQR 0.027-0.560 µg/L). Compared with patients without cardiac injury, the median age of patients with cardiac injury was significantly older (65.0 vs. 44.0, P<0.05), hypertension was significantly more common (44.4% vs. 14.3%, P<0.05), and the proportion of severe-critical cases were greater (77.8% vs. 17.9%, P<0.05). Patients with cardiac injury were more likely have elevation of N-terminal proBNP (NT-proBNP) in comparison (66.7% vs. 10.0%, P<0.05). There was no significant difference in echocardiographic parameters between patients with and without cardiac injury. Multivariable logistic regression analysis indicated that older age (OR: 1.093, 95% CI: 1.011-1.182) and increased NT-proBNP (OR: 10.979, 95% CI: 2.024-59.555) were independent risk factors for cardiac injury. Cardiac magnetic resonance (CMR) imaging performed on three patients at around one month after they underwent significant hs-cTnI elevation showed that they had underlying cardiovascular comorbidities. CONCLUSIONS: Acute cardiac injury was seen in the minority of hospitalized COVID-19 patients in Zhuhai, China. Older age and increased NT-proBNP were associated with acute cardiac injury. REGISTRATION NUMBER: ChiCTR2000030952.

Long-term cardiac-specific mortality among 44,292 acute myeloid leukemia patients treated with chemotherapy: a population-based analysis.

Background: Acute myeloid leukemia (AML) is a common hematological malignancy treated with regimens containing anthracycline, an agent with cardiotoxicity. However, the cardiac-specific mortality in AML patients receiving chemotherapy remains unknown. Methods: In this population-based study, patients diagnosed with AML between 1973 and 2015 were identified in the Surveillance, Epidemiology, and End Results database. Cumulative mortality by cause of death was calculated. To quantify the excessive cardiac-specific death compared with the general population, standardized mortality ratios (SMRs) were calculated. Multivariate Cox regression analyses were performed to identify risk factors associated with cardiac-specific death and AML-specific death. Results: A total of 64,679 AML patients were identified between 1973 and 2015; 68.48% of patients (44,292) received chemotherapy. Among all possible competing causes of death, AML was associated with the highest cumulative mortality. The AML patients who received chemotherapy showed excessive cardiac-specific mortality compared with the general population, with an SMR of 6.35 (95% CI: 5.89-6.82). Age, year of diagnosis, sex, and marital status were independently associated with patient prognosis. Conclusion: Cardiac-specific mortality in AML patients receiving chemotherapy is higher than that in the general population.

Combination of HGF and IGF-1 promotes connexin 43 expression and improves ventricular arrhythmia after myocardial infarction through activating the MAPK/ERK and MAPK/p38 signaling pathways in a rat model.

BACKGROUND: In this study, we hypothesized that the combination of hepatocyte growth factor (HGF) and insulin-like growth factor-1 (IGF-1) alters the expression of connexin 43 (Cx43) and results in a reduced frequency of induced ventricular arrhythmia in rats after myocardial infarction (MI) and explored the preliminary mechanisms involved. METHODS: Cardiomyocytes were cultured in vitro in medium with PBS, HGF, IGF-1, GFs (HGF + IGF-1), HGF + p38 inhibitor, HGF + ERK inhibitor, IGF-1 + p38 inhibitor or IGF-1 + ERK inhibitor. The expression of Cx43 was tested by real-time PCR and Western blotting after 48 hours. MI was induced in 48 male Sprague-Dawley rats. The rats were randomly divided into four groups and received an injection of PBS, HGF, IGF-1 or GFs into the infarct border zone two weeks after MI. Six weeks after injection, the expression levels of Cx43 and programmed stimulation-induced ventricular arrhythmias were examined. RESULTS: In vitro, the expression of Cx43 mRNA and the Cx43 protein in cardiomyocytes was higher in the HGF, IGF-1, and GFs groups than in the PBS group. GFs had a combinatorial effect on the Cx43 mRNA level but not on the Cx43 protein level. There was a significant reduction in Cx43 mRNA and Cx43 protein levels in the IGF-1 + p38 inhibitor group and IGF-1 + ERK inhibitor group compared to the IGF-1 group. In vivo, programmed stimulation significantly decreased the frequency of ventricular arrhythmia in the GFs, HGF and IGF-1 groups, and this effect was accompanied by increased immunohistochemical staining for Cx43, myocardial Cx43 protein levels and Cx43 mRNA levels in the infarct border zone of the left ventricle compared with those in the PBS group. The combinatorial effect of GFs on Cx43 expression was only observed at the mRNA level. CONCLUSIONS: Both HGF and IGF-1 enhanced the expression of Cx43 and improved induced ventricular arrhythmia in rats with MI. Both synergistic and antagonistic effects of HGF and IGF-1 were not observed. In addition, IGF-1 may function through the MAPK/p38 and ERK1/2 signaling pathways to regulate Cx43 expression.

[Modified Metaizeau's technique for the treatment of radial neck fractures of Judet III or IV in children].

OBJECTIVE: To explore the clinical effect of modified Metaizeau's technique for radial neck fractures of Judet II or IV in children, summarizing the value of clinical application. METHODS: From May 2014 to March 2017, 32 children of Judet III or IV radial neck fractures were treated with percutaneous Kirschner wire poking reduction and closed reduction with elastic intramedullary nailing fixation, including 21 boys and 11 girls, aged from 5.7 to 10.6 years old with a mean of 7.2 years old. The modified An-Morrey functional rating index were used to evaluate elbow range of motion, myodynamia, stability, and pain preoperatively and 1 year postoperatively in all the patients. RESULTS: All patients were available for an average follow-up from 12 to 15 months. No complications such as incision infection, wire or nail tail irritation and avascular necrosis of radial head and epiphyses was occurred. The fracture achieved solid healing at 8 to 10 weeks after operation. The modified An and Morrey functional score improved from 58.69±5.80 before operation to 99.13±1.79 at 1 year after operation, there was obvious difference of scores between preoperative and postoperative at 1 year. CONCLUSIONS: Modified Metaizeau's technique is a reliable and good treatment for Judet III or IV radial neck fractures in children, which has advantages of few complication, minimal invasion, quick fracture union and good recovery of elbow joint.

Proteomic analysis of the immunosuppressive effects of mesenchymal stem cells in a rat heart transplantation model.

BACKGROUND: Some reports suggest mesenchymal stem cells (MSCs) have immunosuppressive properties. However, conflicting evidence regarding the role of MSCs has emerged. OBJECTIVES: To gain a better understanding of the immunosuppressive properties of mesenchymal stem cells (MSCs) in a rat heart transplantation model. MATERIAL AND METHODS: MSCs were obtained from the femoral and tibial bone marrow of Sprague-Dawley rats and cultured. Heart-transplanted rats were allocated into a MSC-treated group and 2 control groups. On postoperative day 7, 1 rat was sacrificed and the pathological changes of heart tissues were assessed. Serum proteomic spectra were generated by surface-enhanced laser desorption/ionization-time-of-flight mass spectrometry (SELDI-TOF-MS). RESULTS: Rat MSCs displayed the typical spindle-shaped morphology in culture and significantly prolonged the graft survival up to 33.25 ± 2.54 days compared with controls (19.75 ± 1.56 and 11.16 ± 1.34 days, respectively). Pathological analysis showed the inflammatory cell infiltration in the MSC-treated group was significantly reduced. SELDI analysis showed that 5 protein/peptide peaks with M/Z 1272.33, 1986.65, 2323.42, 5375.59 and 12968.11 were up-regulated in the MSC-treated group (P < 0.001). CONCLUSIONS: Donor-derived MSCs clearly alleviate acute rejection following heart transplantation in rats and significantly prolong the isograft survival time.

[A study of effects of impaired glucose tolerance on ventricular remodeling].

OBJECTIVE: To evaluate the effects of impaired glucose tolerance (IGT) on ventricular remodeling. METHODS: Parameters of every subject including left ventricular mass (LVM), left ventricular mass index (LVMI), E/A ratio, 75 g oral glucose tolerance test (OGTT), ambulatory blood pressure monitoring (ABPM) data including 24-hour mean systolic blood pressure (mSBP) and 24-hour mean diastolic blood pressure (mDBP) were collected. Then the relationship of IGT and myocardial remodeling related parameters were analyzed. RESULTS: The rate of diastolic dysfunction was higher in the IGT combined with hypertensive group (74%) compared with the hypertensive group (39%) (χ(2) = 6.5, P < 0.05). The rate of diastolic dysfunction was higher in the IGT group (34%) compared with the normal group (10%) (χ(2) = 5.2, P < 0.05). The rate of Left Ventricular Hypertrophy (LVH) in the IGT combined with hypertensive group (24%) was higher than the other three groups (Hypertension group 7%, IGT group 0, Normal group 0) (χ(2) = 4.56 1, P < 0.05), and there was no significance between the rest three groups (P > 0.05). Stepwise multiple regression showed age and 2 Hours' Postprandial Blood Glucose were independent risk factors of E/A ratio. CONCLUSIONS: These results suggested that IGT is a possible contributor to left ventricular hypertrophy and diastolic dysfunction, and is one of the histopathology of left ventricular remodeling.