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1.
Artigo em Inglês | MEDLINE | ID: mdl-31378750

RESUMO

PURPOSE: Our study aimed to investigate the potential pathogenetic theories of different phenotype prevalence in bicuspid aortopathy. METHODS: A total of 407 bicuspid aortic valve (BAV) patients with aortic dilation were retrospectively reviewed. Association was determined between aortic valve lesion types and aortic configurations to confirm the homogeneous BAV subsets, and then, dominance analysis was used to evaluate the relative importance of two components of aortic valve lesion (BAV phenotype and valvular dysfunction) that associated with aortic configurations in each subgroup. RESULTS: Dominance analysis showed that Type-1 LR was the dominant contributor (79.0% and 79.6%) associated with the higher prevalence of the dilation of aortic root (AoR) and ascending aorta (AAo) in BAV patients with Type-1 LR and aortic regurgitation (AR) or aortic stenosis (AS) + AR. However, AS was the main contributor (60.0%) associated with the raised incidence of the dilation of AAo and proximal aortic arch (PArc) in Type-0 LAT and AS. CONCLUSIONS: Different dominant pathogenetic theory determined the phenotype of BAV aortopathy. In patients of Type-1 LR with AR, inherent disposition is mainly responsible for the higher frequency of AoR dilation. Valve-related hemodynamics determined greater prevalence of the dilation of AAo and PArc in patients of Type-0 LAT with AS.

2.
Biochem Biophys Res Commun ; 515(1): 37-43, 2019 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-31122697

RESUMO

miR-613 has been demonstrated to play critical roles in tumorigenesis and progression of a various type of cancers. However, its role and expression significance remain unclear in gastric cancer (GC). We detected the expression of miR-613 in 176 paired GC tissues and adjacent normal tissues, and found that miR-613 was significantly downregulated in GC tissues and its downregulation was correlated with T stage, lymph node invasion and advanced AJCC stages. Moreover, miR-613 expression could be an independent prognostic factor of GC. Biological function analysis indicated that miR-613 inhibited cell proliferation and invasion. Further analysis suggested that miR-613 inhibited Warburg effect of GC cells. Mechanically, we identified that miR-613 could directly bind to the 3'UTR of PFKFB2, thereby suppressing the expression of PFKFB2, which in turn, regulating glycolysis metabolism and cell growth. In conclusion, miR-613 served as a tumor suppressor by targeting PFKFB2, indicating that detecting miR-613 and modulation of miR-613 expression could be potential marker and clinical approach in GC patients.

3.
Biosci Rep ; 39(1)2019 01 31.
Artigo em Inglês | MEDLINE | ID: mdl-30578380

RESUMO

A consensus about the prognostic role of NIMA-related kinase 2 (NEK2) expression in various solid tumors has not been made yet. Thus, this meta-analysis aimed to systematically assess the prognostic role of NEK2 expression in patients with solid tumors. The eligible studies were identified through searching PubMed, Web of Science, and EMBASE. The hazard ratios (HRs) with their corresponding 95% confidence intervals (CIs) were used to evaluate the link between NEK2 overexpression and overall survival (OS) and disease-free survival/recurrence-free survival (DFS/RFS) of patients with solid tumors. A total of 17 studies with 4897 patients were included in this meta-analysis. Among these studies, all of them explored the association between NEK2 expression and OS of patients with solid tumors. Our pooled analysis indicated that NEK2 overexpression was significantly related to adverse OS (HR = 1.66; 95% CI: 1.38-2.00; P = 0.001). Additionally, there were six studies with 854 patients that investigated the association between NEK2 expression and DFS/RFS. Our pooled result indicated that there was a substantial relationship between NEK2 overexpression and poorer DFS/RFS (HR = 2.00; 95% CI: 1.61-2.48; P = 0.003). In conclusion, our meta-analysis indicated that NEK2 may be a useful predictor of prognosis and an effective therapeutic target in solid tumors. Nevertheless, more high-quality studies are warranted to further support our conclusions because of several limitations in our meta-analysis.


Assuntos
Biomarcadores Tumorais/genética , Quinases Relacionadas a NIMA/genética , Neoplasias/genética , Prognóstico , Intervalo Livre de Doença , Humanos , Neoplasias/patologia
4.
Medicine (Baltimore) ; 97(41): e12455, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30313035

RESUMO

BACKGROUND: Digestive system cancers are recognized as associated with high morbidity and mortality. It is generally accepted that N-myc downstream-regulated gene 1 (NDRG1) is aberrantly overexpressed or downregulated in digestive system cancers, and its prognostic value remains controversial. Accordingly, we herein conducted a meta-analysis to explore whether NDRG1 expression is correlated with overall survival (OS) and clinicopathological characteristics of patients with digestive system cancers. METHODS: We systematically searched PubMed, EMBASE, and Web of Science for eligible studies up to June 6, 2017. In all, 19 publications with 21 studies, were included. RESULTS: The pooled results showed that low NDRG1 expression was significantly associated with worse OS in colorectal cancer (pooled HR = 1.67, 95% CI: 1.22-2.28, P < .001) and pancreatic cancer (pooled HR = 1.87, 95% CI: 1-3.5, P < .0001). Moreover, the relationships between low NDRG1 expression and higher OS ratio of patients with liver cancer (pooled HR = 0.44, 95% CI: 0.32-0.62, P = .009) and gallbladder cancer (pooled HR = 0.56, 95% CI: 0.23-1.38, P = .01) were observed. Nevertheless, no significant association was observed between low NDRG1 expression and OS in gastric cancer (pooled HR = 0.81, 95% CI: 0.45-1.43, P = .46) or esophageal cancer (pooled HR = 0.76, 95% CI: 0.26-2.24, P = .62). CONCLUSION: The prognostic significance of NDRG1 expression varies according to cancer type in patients with DSCs. Considering that several limitations existed in this meta-analysis, more studies are required to further assess the prognostic value of NDRG1 expression in patients with DSCs and relevant mechanisms.


Assuntos
Biomarcadores Tumorais/metabolismo , Carcinoma/diagnóstico , Carcinoma/mortalidade , Proteínas de Ciclo Celular/metabolismo , Neoplasias do Sistema Digestório/diagnóstico , Neoplasias do Sistema Digestório/mortalidade , Peptídeos e Proteínas de Sinalização Intracelular/metabolismo , Carcinoma/metabolismo , Neoplasias do Sistema Digestório/metabolismo , Regulação para Baixo , Humanos , Prognóstico , Análise de Sobrevida , Regulação para Cima
5.
Ultrasound Med Biol ; 44(1): 85-93, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29122316

RESUMO

This study assessed the diagnostic accuracy of 2-D shear wave elastography (2-D-SWE) for the non-invasive staging of liver fibrosis and compared the findings with those for biochemical markers (the aspartate aminotransferase-to-platelet index and fibrosis-4 index) of liver fibrosis in patients with elevated alanine aminotransferase (ALT) levels (>5 × the upper limit of normal). Patients with chronic liver diseases and elevated ALT levels who underwent liver biopsy were consecutively included. Receiver operating characteristic (ROC) curves were constructed to assess overall accuracy and to identify optimal cutoff values. After exclusions, data from 105 patients were analyzed. The areas under the ROC curves (AUROCs) for significant fibrosis, severe fibrosis and cirrhosis were 0.83, 0.86 and 0.91, respectively. The optimal cutoff values for predicting significant fibrosis, severe fibrosis and cirrhosis were 10.6, 13.2 and 17.6 kPa, respectively. The AUROCs of 2-D-SWE were significantly higher than those of biochemical markers for predicting significant fibrosis, severe fibrosis and cirrhosis (all p values < 0.05). Therefore, the diagnostic performance of 2-D-SWE in assessing liver fibrosis stages in patients with elevated ALT levels was promising. The optimal cutoff values were increased but appropriate for this cohort because the baseline levels of liver stiffness measurements were increased in these patients, even in the absence of fibrosis.


Assuntos
Alanina Transaminase/sangue , Técnicas de Imagem por Elasticidade/métodos , Cirrose Hepática/sangue , Cirrose Hepática/diagnóstico por imagem , Adolescente , Adulto , Idoso , Feminino , Humanos , Fígado/diagnóstico por imagem , Fígado/patologia , Cirrose Hepática/patologia , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Adulto Jovem
6.
World J Gastroenterol ; 23(26): 4839-4846, 2017 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-28765706

RESUMO

AIM: To determine the diagnostic accuracy of two-dimensional shear wave elastography (2D-SWE) for the non-invasive assessment of liver fibrosis in patients with autoimmune liver diseases (AILD) using liver biopsy as the reference standard. METHODS: Patients with AILD who underwent liver biopsy and 2D-SWE were consecutively enrolled. Receiver operating characteristic (ROC) curves were constructed to assess the overall accuracy and to identify optimal cut-off values. RESULTS: The characteristics of the diagnostic performance were determined for 114 patients with AILD. The areas under the ROC curves for significant fibrosis, severe fibrosis, and cirrhosis were 0.85, 0.85, and 0.86, respectively, and the optimal cut-off values associated with significant fibrosis (≥ F2), severe fibrosis (≥ F3), and cirrhosis (F4) were 9.7 kPa, 13.2 kPa and 16.3 kPa, respectively. 2D-SWE showed sensitivity values of 81.7% for significant fibrosis, 83.0% for severe fibrosis, and 87.0% for cirrhosis, and the respective specificity values were 81.3%, 74.6%, and 80.2%. The overall concordance rate of the liver stiffness measurements obtained using 2D-SWE vs fibrosis stages was 53.5%. CONCLUSION: 2D-SWE showed promising diagnostic performance for assessing liver fibrosis stages and exhibited high cut-off values in patients with AILD. Low overall concordance rate was observed in the liver stiffness measurements obtained using 2D-SWE vs fibrosis stages.


Assuntos
Doenças Autoimunes/diagnóstico por imagem , Técnicas de Imagem por Elasticidade , Hepatopatias/diagnóstico por imagem , Fígado/diagnóstico por imagem , Adolescente , Adulto , Idoso , Feminino , Fibrose , Humanos , Fígado/patologia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
7.
J Gastrointest Surg ; 21(10): 1591-1598, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28752402

RESUMO

BAKCGROUND: The recently proposed 8th American Joint Committee on Cancer (AJCC) staging for gastric cancer (GC) did not include the evaluated lymph node (ELN) count as a prognostic indicator. In this study, we performed recursive partitioning analysis (RPA) to objectively combine the 15-ELN threshold and 8th AJCC stage to refine the staging for GC. METHODS: We analyzed 19,018 patients with non-metastatic GC from the Surveillance, Epidemiology, and End Results database. The dataset was randomly divided into training and validation sets. RESULTS: For each 8th AJCC stage, survival was significantly better for patients with ≥15 ELNs versus those with <15 ELNs (P < 0.001 for all). RPA divided non-metastatic GC into seven stages: RPA-IA (8th AJCC IA with ≥15 ELNs), RPA-IB (IA with <15 ELNs and IB/IIA with ≥15 ELNs), RPA-IIA (IB with <15 ELNs and IIB with ≥15 ELNs), RPA-IIB (IIA with <15 ELNs and IIIA with ≥15 ELNs), RPA-IIIA (IIB with <15 ELNs), RPA-IIIB (IIIA with <15 ELNs and IIIB ≥15 ELNs), and RPA-IIIC (IIIB with <15 ELNs and IIIC). The corresponding 5-year survival rates were 84.1, 70.3, 52.8, 41.4, 32.9, 21.7, and 10.2%, respectively (P < 0.001 for all pairwise comparisons). The RPA staging outperformed the 8th AJCC staging in terms of discrimination and homogeneity among the SEER training and validation sets, as well as an independent Chinese cohort. CONCLUSION: By equipping the 8th AJCC stage with the 15-ELN threshold, the proposed RPA staging is superior to the 8th AJCC staging without overcomplicating.


Assuntos
Linfonodos/patologia , Estadiamento de Neoplasias/métodos , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Estudos de Coortes , Feminino , Humanos , Linfonodos/cirurgia , Masculino , Pessoa de Meia-Idade , Prognóstico , Programa de SEER , Taxa de Sobrevida , Estados Unidos/epidemiologia
8.
Ultrasound Med Biol ; 43(8): 1563-1570, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28483579

RESUMO

This study compared 2-D shear wave elastography (SWE) and transient elastography (TE) for liver fibrosis staging in patients with chronic hepatitis B (CHB) infection using liver biopsy as the reference standard. Patients with CHB infection who underwent liver biopsy were consecutively included. After exclusions, 257 patients were analyzed. Two-dimensional SWE resulted in a significantly higher rate of reliable measurements (98.1%, 252/257) than TE (93.0%, 239/257) (p = 0.011). Liver stiffness measurements of the two examinations exhibited a strong correlation (r = 0.835, p < 0.001). In patients given a confirmed histologic diagnosis, Spearman's rank coefficients were 0.520 in stage F0 (p < 0.001), 0.684 in stage F1 (p < 0.001), 0.777 in stage F2 (p < 0.001), 0.672 in stage F3 (p < 0.001) and 0.755 in stage F4 (p < 0.001). There were no significant differences between the areas under the receiver operating characteristic (ROC) curves of 2-D SWE and TE for liver fibrosis staging (all p values > 0.05). Two-dimensional SWE had diagnostic accuracy comparable to that of TE for liver fibrosis staging. The measurements that the two techniques provide are not interchangeable.


Assuntos
Técnicas de Imagem por Elasticidade/métodos , Hepatite B Crônica/complicações , Cirrose Hepática/diagnóstico por imagem , Cirrose Hepática/etiologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Fígado/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Adulto Jovem
9.
Med Oncol ; 33(11): 122, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27730526

RESUMO

Previous studies of pancreatic ductal adenocarcinoma (PDAC) have demonstrated that the addition of tumor grade to the 7th American Joint Committee on Cancer (AJCC) staging can provide improved prognostication and that the recently proposed 8th edition AJCC staging exhibited superior reproducibility to the 7th edition in resectable PDAC. Thus, we aimed to combine tumor grade and 8th AJCC stage to develop a refined staging scheme for resectable PDAC. We analyzed 7719 patients with resectable PDAC from the 2004-2012 Surveillance, Epidemiology, and End Results database. We performed recursive partitioning analysis (RPA) to objectively incorporate tumor grade with 8th AJCC stage into a novel staging system. The performance of the proposed RPA staging was assessed against the 8th AJCC staging in terms of discriminatory ability and prognostic homogeneity. For each 8th AJCC stage, survival was significantly worse for high-grade versus low-grade tumors. RPA divided resectable PDAC into five stages: RPA-IA (low-grade T1N0), RPA-IB (high-grade T1N0 or low-grade T2N0), RPA-IIA (high-grade T2N0 or low-grade T3N0/T1-T3N1), RPA-IIB (high-grade T3N0/T1-T3N1 or low-grade T1-T3N2), and RPA-III (high-grade T1-T3N2; median survival: 42, 26, 19, 15, and 12 months, respectively; P < 0.001). The RPA staging outperformed the 8th AJCC classifications in terms of discrimination (concordance index, 0.585 versus 0.565; P < 0.001) and prognostic homogeneity. Tumor grade can provide additional prognostic information to the 8th AJCC staging. The proposed RPA staging is a superior risk-stratified tool to the 8th AJCC staging and is not substantially more complex.


Assuntos
Carcinoma Ductal Pancreático/patologia , Estadiamento de Neoplasias/métodos , Neoplasias Pancreáticas/patologia , Idoso , Carcinoma Ductal Pancreático/mortalidade , Carcinoma Ductal Pancreático/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/mortalidade , Neoplasias Pancreáticas/cirurgia , Prognóstico
10.
J Biomech ; 48(13): 3665-71, 2015 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-26341460

RESUMO

Mesenchymal stem cells (MSCs) are the common precursors of several functionally disparate cell lineages. A plethora of chemical and physical stimuli contribute to lineage decisions and guidance, including mechanical stretch concomitant with physical movement. Here, we examined how stretch regulates MSC differentiation into adipocytes and the intracellular signaling pathways involved. MSCs were cultured under adipogenic conditions and divided into a control and an experimental group. Cultures in the experimental group were subjected to a sinusoidal stretch regimen delivered via flexible culture bottoms (5% magnitude, 10 times per min, 6h/day, 3 or 5 days). Expression levels of the adipocyte markers PPARγ-2, adiponectin, and C/EBPα were measured as indices of differentiation. Compared to controls, MSCs exposed to mechanical stretch exhibited downregulated PPARγ-2, adiponectin, and C/EBPα mRNA expression. Alternatively, stretch upregulated phosphorylation of Smad2. This stretch-induced increase in Smad2 phosphorylation was suppressed by pretreatment with the TGFß1/Smad2 pathway antagonist SB-431542. Pretreatment with the TGFß1/Smad2 signaling agonist TGFß1 facilitated the inhibitory effect of stretch on the expression levels of PPARγ-2, adiponectin, and C/EBPα proteins, while pretreatment with SB-431542 reversed the inhibitory effects of subsequent stretch on the expression levels of these markers. These results strongly suggest that the anti-adipogenic effects of mechanical stretch on MSCs are mediated, at least in part, by activation of the TGFß1/Smad2 signaling pathway.


Assuntos
Adipogenia , Células-Tronco Mesenquimais/fisiologia , Proteína Smad2/metabolismo , Estresse Mecânico , Fator de Crescimento Transformador beta1/metabolismo , Adipócitos/citologia , Adiponectina/metabolismo , Animais , Benzamidas , Proteína alfa Estimuladora de Ligação a CCAAT/metabolismo , Diferenciação Celular/fisiologia , Células Cultivadas , Dioxóis , Regulação para Baixo , Células-Tronco Mesenquimais/citologia , PPAR gama/metabolismo , Fosforilação , Ratos Sprague-Dawley , Transdução de Sinais
11.
World J Gastroenterol ; 21(17): 5345-51, 2015 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-25954109

RESUMO

AIM: To investigate the feasibility and clinical value of magnetic resonance imaging (MRI)-MRI image fusion in assessing the ablative margin (AM) for hepatocellular carcinoma (HCC). METHODS: A newly developed ultrasound workstation for MRI-MRI image fusion was used to evaluate the AM of 62 tumors in 52 HCC patients after radiofrequency ablation (RFA). The lesions were divided into two groups: group A, in which the tumor was completely ablated and 5 mm AM was achieved (n = 32); and group B, in which the tumor was completely ablated but 5 mm AM was not achieved (n = 29). To detect local tumor progression (LTP), all patients were followed every two months by contrast-enhanced ultrasound, contrast-enhanced MRI or computed tomography (CT) in the first year after RFA. Then, the follow-up interval was prolonged to every three months after the first year. RESULTS: Of the 62 tumors, MRI-MRI image fusion was successful in 61 (98.4%); the remaining case had significant deformation of the liver and massive ascites after RFA. The time required for creating image fusion and AM evaluation was 15.5 ± 5.5 min (range: 8-22 min) and 9.6 ± 3.2 min (range: 6-14 min), respectively. The follow-up period ranged from 1-23 mo (14.2 ± 5.4 mo). In group A, no LTP was detected in 32 lesions, whereas in group B, LTP was detected in 4 of 29 tumors, which occurred at 2, 7, 9, and 15 mo after RFA. The frequency of LTP in group B (13.8%; 4/29) was significantly higher than that in group A (0/32, P = 0.046). All of the LTPs occurred in the area in which the 5 mm AM was not achieved. CONCLUSION: The MRI-MRI image fusion using an ultrasound workstation is feasible and useful for evaluating the AM after RFA for HCC.


Assuntos
Carcinoma Hepatocelular/patologia , Carcinoma Hepatocelular/cirurgia , Ablação por Cateter , Interpretação de Imagem Assistida por Computador/métodos , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/cirurgia , Imagem por Ressonância Magnética/métodos , Adulto , Idoso , Ablação por Cateter/efeitos adversos , Meios de Contraste/administração & dosagem , Desenho de Equipamento , Estudos de Viabilidade , Feminino , Humanos , Interpretação de Imagem Assistida por Computador/instrumentação , Imagem por Ressonância Magnética/instrumentação , Masculino , Pessoa de Meia-Idade , Neoplasia Residual , Valor Preditivo dos Testes , Estudos Prospectivos , Resultado do Tratamento
12.
Biomed Res Int ; 2015: 873251, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25922842

RESUMO

This study examined the effects of mechanical strain on osteogenic and adipogenic differentiation of cultured MSCs by stimulating MSCs cultured in general and adipogenic differentiation media using a mechanical strain device. Markers of osteogenic (Runx2, Osx, and I-collagen) and adipogenic (PPARγ-2, C/EBPα, and lipid droplets) differentiation were examined using real-time PCR, western blot, immunocytochemical, or histochemical stain analyses. Levels of Runx2 and Osx gradually increased in MSC groups in general medium subject to strain stimulation, as compared with in unstrained groups. After adding the stress signal, I-collagen protein levels of expression were obviously promoted in cells in comparison to the controls. The levels of PPARγ-2 and C/EBPα were decreased, and the emergence of lipid droplets was delayed in MSCs groups in adipogenic differentiation medium subject to strain stimulation, as compared with in unstrained groups. Mechanical strain can promote differentiation of MSCs into osteoblasts and can impede differentiation into adipocytes. These results clarify the mechanisms underlying the effects of exercise on bone repair and reconstruction and provide a more adequate scientific basis for the use of exercise therapy in the treatment of obesity and metabolic osteoporosis.


Assuntos
Adipogenia , Antígenos de Diferenciação/biossíntese , Células da Medula Óssea/metabolismo , Diferenciação Celular , Células-Tronco Mesenquimais/metabolismo , Estresse Mecânico , Animais , Células da Medula Óssea/patologia , Feminino , Masculino , Células-Tronco Mesenquimais/patologia , Obesidade/mortalidade , Obesidade/patologia , Ratos , Ratos Sprague-Dawley
13.
Radiology ; 275(1): 290-300, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25575116

RESUMO

PURPOSE: To evaluate the individual and combined performances of two-dimensional (2D) shear-wave elastography (SWE) and conventional ultrasonography (US) in assessing liver fibrosis and cirrhosis to determine when 2D SWE should be added to routine US. MATERIALS AND METHODS: This prospective study was approved by the institutional ethics committee, and the patients provided written informed consent. Between April 2012 and March 2013, conventional US and 2D SWE examinations were performed in 198 patients (mean age, 37.7 years; age range, 18-67 years) with chronic liver disease. Liver biopsy was used as a reference standard for 167 patients; the other 31 patients had decompensated liver cirrhosis. Receiver operating characteristic (ROC) curves were obtained to assess the diagnostic performance. Differences between the areas under the ROC curves (AUCs) were compared by using a Delong test. RESULTS: Two-dimensional SWE was significantly superior to US in diagnosis of significant fibrosis (score of F2 or greater) (AUC, 0.862 vs 0.725; P = .001) and early cirrhosis (score of F4) (AUC, 0.926 vs 0.789; P = .007). Combining 2D SWE with US did not increase the performance of depicting either significant fibrosis or liver cirrhosis (P = .713 and 0.410, respectively) relative to 2D SWE alone. There was no significant difference between 2D SWE and US in diagnosis of decompensated cirrhosis (AUC, 0.878 vs 0.925; P = .323). In addition, combining 2D SWE with US did not increase the performance relative to that of US alone (P = .372). CONCLUSION: Conventional US is sufficient to detect decompensated cirrhosis. Two-dimensional SWE is significantly superior to US in detecting liver fibrosis. Combining 2D SWE and US did not improve the diagnostic performance for either fibrosis or cirrhosis.


Assuntos
Técnicas de Imagem por Elasticidade , Cirrose Hepática/diagnóstico por imagem , Adulto , Idoso , Antropometria , Biópsia , Feminino , Humanos , Cirrose Hepática/patologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Ultrassonografia de Intervenção
14.
Zhonghua Gan Zang Bing Za Zhi ; 22(10): 731-4, 2014 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-25496860

RESUMO

OBJECTIVE: To compare the abilities of transient elastography (TE) versus real-time tissue elastography (RTE) for assessing liver fibrosis in patients with chronic liver disease. METHODS: Ninetytwo patients with chronic liver disease were enrolled in the study, and included 77 cases of chronic hepatitis B, 4 cases of chronic hepatitis C, 4 cases of autoimmune liver disease, 2 cases of primary biliary cirrhosis, I case of abnormal bile duct development, and 4 cases of unknown etiology.All patients were assessed by both TE and RTE in a single day.The correlation coefficient of liver fibrosis level and the receiver operating characteristic (ROC) curve of S more than 2 and =4 of TE and RTE were determined.The values were compared using findings fiom pathological analysis as reference. RESULTS: The correlation coefficient of liver fibrosis level was significantly higher for TE (r =0.755, 95% CI:0.651-0.831, P =0.000) than for RTE (r=0.481, 95% CI:0.306-0.624, P =0.000) (Z=3.07, P =0.002).The areas under the ROC curves for S more than 2 and =4 were 0.903 and 0.740 for TE and 0.915 and 0.786 for RTE, respectively, indicating that the performance of TE was superior to that of RTE. CONCLUSION: TE was superior to RTE for assessment of liver fibrosis.


Assuntos
Hepatite B Crônica/diagnóstico por imagem , Hepatite C Crônica/diagnóstico por imagem , Cirrose Hepática Biliar/diagnóstico por imagem , Doenças Autoimunes , Técnicas de Imagem por Elasticidade , Humanos , Curva ROC
15.
Ultrasound Med Biol ; 40(11): 2549-55, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25282481

RESUMO

Real-time shear wave elastography (SWE) is a novel two-dimensional elastographic method that is used to estimate the severity of liver fibrosis. However, the normal range of liver stiffness (LS) and the possible factors that influence SWE are not well understood. The aims of the current study are to define the normal range of LS in healthy subjects and to explore the factors that may affect SWE. A total of 509 healthy subjects underwent SWE to determine the stiffness of their livers, and the effects of gender, age and body mass index (BMI) on LS were analyzed. The effects of different factors on SWE, including the testing position, measurement depth and size of the region of interest (ROI), were analyzed in 137 subjects. SWE imaging was successfully performed in 502 healthy subjects (98.6%, 502/509). The mean value of the SWE measurements in 502 individuals was 5.10 ± 1.02 kPa, and the 95% confidence interval was 5.02-5.19 kPa (range: 2.4-8.7 kPa). We found that the detective position within the liver had a significant impact on the liver stiffness measurement (LSM), and the lowest coefficient of variation (CV = 8%) was obtained for LSMs made at segment V. LS was greater at a depth >5 cm (5.78 ± 1.66 kPa) compared with depths ≤5 cm (4.66 ± 0.77 kPa, p < 0.001); LS was also greater in men than in women (5.45 ± 1.02 kPa vs. 4.89 ± 0.96 kPa, p < 0.001). However, there were no significant differences in the LS values regarding the size of the ROI, age or BMI (all p > 0.05). The mean LS value in all 502 healthy subjects was 5.10 ± 1.02 kPa. The mean LS value obtained by SWE was not influenced by the size of the ROI, age or BMI, but the mean value was significantly influenced by the different segments of the liver, the detection depth and gender.


Assuntos
Módulo de Elasticidade/fisiologia , Técnicas de Imagem por Elasticidade/métodos , Fígado/diagnóstico por imagem , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Feminino , Humanos , Interpretação de Imagem Assistida por Computador/métodos , Masculino , Pessoa de Meia-Idade , Postura , Valores de Referência , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Fatores Sexuais , Adulto Jovem
16.
Neuropsychiatr Dis Treat ; 10: 1361-8, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25092981

RESUMO

BACKGROUND: Although many studies have reported that glucose and lipid metabolism disorders are a significant side effect associated with the use of antipsychotic drugs, the characteristics of glucose and lipid metabolism disorders in patients with schizophrenia who are taking antipsychotic drugs remain poorly understood, and the possible effects that antipsychotic discontinuation may have on glucose and lipid metabolism remain unclear. METHODS: The sample consisted of 131 Chinese patients with schizophrenia, including 70 first-episode, drug-naïve patients; 33 patients who had received continuous antipsychotic drug treatment for ≥1 year prior to the beginning of the study; and 28 patients who had discontinued antipsychotic drug treatment for ≥3 months prior to the beginning of study. We compared the glucose and lipid metabolic parameter levels among the three groups of patients with schizophrenia. All assessments were performed upon hospital admission. RESULTS: The characteristics of glucose and lipid metabolism disorders in Chinese patients with schizophrenia who are taking antipsychotic drugs included significant augmentation of the body mass index and waist circumference, significantly higher levels of fasting plasma insulin and insulin resistance, and significantly lower plasma high-density lipoprotein cholesterol levels. Antipsychotic discontinuation appeared to not significantly improve any plasma glucose and lipid metabolic parameter levels. CONCLUSION: The results suggest that antipsychotic drugs aggravate glucose and lipid metabolism disorders and that antipsychotic discontinuation is generally not associated with improvements in the parameters that indicate glucose and lipid metabolism disorders in Chinese patients with schizophrenia.

17.
World J Gastroenterol ; 20(28): 9578-84, 2014 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-25071355

RESUMO

AIM: To investigate enough valid measurements (VMs) to assess liver fibrosis in chronic hepatitis B patients (CHB). METHODS: One hundred and twelve CHB patients (25 women, 87 men) with a mean age of 38.43 years received liver stiffness evaluations using real-time shear wave elastography for 10 VMs. All patients underwent liver biopsy. Based on the biopsy pathology, the liver stiffness data obtained from different VMs (1, 2, 3, 5 and 10 times) were compared for the evaluation of liver fibrosis. The correlation between the elastic modulus means of the liver obtained from different VMs of detection at each pathological stage was analysed. The receiver operating characteristic (ROC) curve was employed to determine the diagnostic performance of different VMs of detection, and the areas under the ROC curve of different groups were compared. RESULTS: The liver stiffness values obtained from 1 VM, 2 VMs, 3 VMs, 5 VMs and all 10 VMs for stage F0 were 6.95 ± 2.01 kPa, 6.87 ± 1.83 kPa, 6.90 ± 1.88 kPa, 6.95 ± 1.93 kPa and 7.15 ± 1.89 kPa, respectively (F = 0.043, P = 0.996). For stage F1, these values were 7.12 ± 1.72 kPa, 7.24 ± 1.72 kPa, 7.21 ± 1.74 kPa, 7.10 ± 1.78 kPa and 7.04 ± 1.70 kPa, respectively (F = 0.075, P = 0.990). For stage F2, they were 9.37 ± 3.87 kPa, 9.18 ± 3.68 kPa, 9.19 ± 3.81 kPa, 9.18 ± 3.81 kPa and 9.19 ± 3.53 kPa, respectively (F = 0.012, P = 1.000). For stage F3, these were 11.91 ± 3.88 kPa, 11.78 ± 4.04 kPa, 11.83 ± 4.07 kPa, 11.94 ± 4.17 kPa and 12.00 ± 4.02 kPa, respectively (F = 0.010, P = 1.000). For stage F4, the readings were 19.30 ± 7.63 kPa, 19.40 ± 7.36 kPa, 19.54 ± 7.43 kPa, 19.73 ± 7.21 kPa and 20.25 ± 7.22 kPa, respectively (F = 0.054, P = 0.995). There were no significant differences between these groups. Intraclass correlation coefficients among different pathological stages (F0-F4) with different detection VMs were 0.995, 0.993, 0.996, 0.994 and 0.996, respectively. The mean elasticity values from 1 VM, 2 VMs, 3 VMs, 5 VMs and 10 VMs can accurately distinguish fibrosis stages (F0 vs F1234, F01 vs F234, F012 vs F34 and F0123 vs F4) with no significant differences in the five groups (P > 0.05 for all). CONCLUSION: One VM may be sufficient to assess liver fibrosis by using SWE without any significant loss of accuracy in patients with CHB. However, future studies of larger patient samples are necessary for the validation of this method.


Assuntos
Técnicas de Imagem por Elasticidade/métodos , Hepatite B Crônica/complicações , Cirrose Hepática/diagnóstico , Fígado/patologia , Adulto , Área Sob a Curva , Biópsia , Módulo de Elasticidade , Feminino , Hepatite B Crônica/diagnóstico , Humanos , Cirrose Hepática/etiologia , Cirrose Hepática/patologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Curva ROC , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Fatores de Tempo
18.
Eur Radiol ; 24(10): 2572-81, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25027837

RESUMO

OBJECTIVES: To determine the accuracy of two-dimensional shear wave elastography (2D-SWE) for noninvasive staging of hepatic fibrosis in chronic hepatitis B (CHB). METHODS: Patients with CHB infection who underwent liver biopsy were consecutively included. Receiver-operating characteristic (ROC) curves were constructed to assess the overall accuracy and identify optimal cutoff values. RESULTS: Three hundred three patients were analysed. The diagnostic performance characteristics were determined for the first 202 patients (the index cohort) and were validated on the next 101 patients (validation cohort). The areas under the ROC curves for significant fibrosis, severe fibrosis and cirrhosis were all greater than 0.90 and did not differ significantly between the index and validation cohorts. Using the cutoff values generated from the index cohort, the validation cohort 2D-SWE had negative predictive values of 82.6 % (95 % confidence interval [CI]: 68.4 % - 92.3 %) for significant fibrosis, 95.1 % (95 % CI: 86.3 % - 99.0 %) for severe fibrosis and 97.4 % (95 % CI: 90.8 % - 99.7 %) for cirrhosis. The positive predictive values were 83.6 % (95 % CI: 71.2 % - 92.2 %), 65.0 % (95 % CI: 48.1 - 79.5 %) and 60.0 % (95 % CI: 38.7 % - 78.9 %), respectively. CONCLUSION: The 2D-SWE showed good diagnostic accuracy in staging liver fibrosis in patients with CHB infection and assisted in excluding liver fibrosis and cirrhosis. KEY POINTS: • Two-dimensional shear wave elastography showed good diagnostic accuracy in assessing liver fibrosis. • Diagnostic performance did not differ significantly between the index and validation cohorts. • Two-dimensional shear wave elastography assisted in excluding liver fibrosis and cirrhosis.


Assuntos
Técnicas de Imagem por Elasticidade/métodos , Hepatite B Crônica/diagnóstico , Cirrose Hepática/diagnóstico , Adolescente , Adulto , Idoso , Biópsia , Diagnóstico Diferencial , Feminino , Seguimentos , Hepatite B Crônica/complicações , Humanos , Cirrose Hepática/etiologia , Masculino , Pessoa de Meia-Idade , Curva ROC , Reprodutibilidade dos Testes , Estudos Retrospectivos , Adulto Jovem
19.
PLoS One ; 9(4): e93843, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24736589

RESUMO

The aim of this study is to evaluate the efficacy of qualitative analysis of contrast-enhanced ultrasound (CEUS) in discrimination of adnexal masses which were undetermined by conventional ultrasound (US). A total of 120 patients underwent transabdominal CEUS. The initial enhancement time and intensity compared with the uterine myometrium, contrast agent distribution patterns and dynamic changes of enhancement were assessed. The sensitivity (Sen), specificity (Spe), positive predictive value (PPV), negative predictive value (NPV), accuracy (ACC) and Youden's index were calculated for contrast variables. The gold standard was the histological diagnosis. There were 48 malignant tumors and 72 benign tumors. The enhancement features of malignant masses were different from benign ones. Earlier or simultaneous enhancement with inhomogeneous enhancement yielded the highest capability in differential diagnosis, and Sen, Spe, PPV, NPV, ACC, Youden's index was 89.6%, 97.2%, 93.2%, 95.6%, 93.3%, and 0.88, respectively. The qualitative evaluation of CEUS is useful in the differential diagnosis of adnexal masses where conventional US is indeterminate.


Assuntos
Doenças dos Anexos/diagnóstico por imagem , Doenças dos Anexos/patologia , Neoplasias/diagnóstico por imagem , Doenças dos Anexos/diagnóstico , Adulto , Meios de Contraste , Diagnóstico Diferencial , Feminino , Humanos , Aumento da Imagem , Neoplasias/diagnóstico , Ultrassonografia , Adulto Jovem
20.
Ultrasound Med Biol ; 40(3): 461-9, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24361224

RESUMO

The purpose of this study was to determine the measurement depth range within which liver stiffness can be reliably assessed using real-time shear wave elastography (SWE) technology. Measurements were performed on phantoms and healthy volunteers. In the first group of patients, measurements were performed at depths of 2-8 cm from the probe surface. In the second group of patients, measurements were conducted 0-7 cm below the liver capsule. Success rate of measurements (SRoM), success rate of patients (SRoS) and coefficients of variation (CVs) of repeated measurements were compared. The SRoMs at 3-7 cm and the CVs at 2-5 cm from the probe surface were significantly higher and lower than those at other depths (p < 0.001), respectively. SRoS was zero 0-1 cm below the liver capsule. Furthermore, the features of 2-D stiffness mapping images were also found to change with depth. According to our results, the depth range for the most reliable liver stiffness assessment using SWE should be 3-5 cm from the probe surface and simultaneously 1-2 cm below the liver capsule.


Assuntos
Algoritmos , Técnicas de Imagem por Elasticidade/métodos , Aumento da Imagem/métodos , Interpretação de Imagem Assistida por Computador/métodos , Imagem Tridimensional/métodos , Fígado/diagnóstico por imagem , Fígado/fisiologia , Adulto , Módulo de Elasticidade/fisiologia , Técnicas de Imagem por Elasticidade/instrumentação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Imagens de Fantasmas , Valores de Referência , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Resistência ao Cisalhamento
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