ObjectivesThis study investigated haemorheological alterations in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE).MethodsA total of 136 individuals were enrolled, comprising 52 healthy controls, 51 RA patients, and 33 SLE patients. Blood samples were collected at the University of Health Sciences Sultan Abdulhamid Han Training and Research Hospital in Istanbul, Türkiye. Whole blood and plasma viscosity, along with red blood cell (RBC) deformability and aggregation, were analysed using a Brookfield viscometer and a laser-assisted optical rotational cell analyser (LORRCA).ResultsRBC deformability was reduced in both patient groups compared to controls (EImax: RA 0.645, SLE 0.642, control 0.648), while RBC aggregation was markedly increased (AI: RA 75.66, SLE 74.73, control 65.5) (p < 0.05). Plasma and whole blood viscosity were also elevated in RA and SLE groups, with the highest values observed in SLE patients (PV: RA 1.43, SLE 1.48, control 1.31).ConclusionsRA and SLE patients show notable impairments in haemorheological parameters. Evaluating RBC deformability, aggregation, and plasma viscosity may help clarify disease mechanisms and guide therapeutic strategies to mitigate vascular complications and tissue damage in autoimmune disorders.

BackgroundSteatosis hepatis is of outstanding clinical importance. The aim of this study was to apply the new parametric method "Ultrasound Derived Fat Fraction" (UDFF) to monitor changes of liver fat in obese patients undergoing weight loss measures.MethodsIn 53 obese patients BMI, absolute body fat, waist circumference and UDFF were measured before and after a three-month weight loss intervention. UDFF measurements were performed using a Siemens ultrasound system (DAX, 1.0-3.5 Mz). We analysed the correlation of change in BMI (≥-1 vs < -1), body fat (≥-2 kg vs < -2 kg) and waist circumference (≥-10 cm vs < -10 cm) with the change in UDFF (≥-30% vs < -30%) (significance level:  < 0.0167).ResultsAt baseline, mean BMI was 39.2 (range: 29.8-63.6), body fat 51.3 kg (range: 29.9-111.7), waist circumference 120.2 cm (range: 95-164) and UDFF 26% (range: 7-41%). 54.7% of patients lost at least 2 kg of body fat. These patients were significantly more likely to have a reduction in UDFF of at least 30% (≥2 kg fat: 58.6% vs. < 2 kg fat: 20.8%;  = 0.011). For BMI and waist circumference changes no significant correlation with UDFF was observed.ConclusionThis study underlines that UDFF could be a promising, non-invasive tool to monitor changes in liver fat.

ObjectiveTo explore the preoperative predictive efficacy of multimodal ultrasound based on microflow imaging(MFI) in Glypican-3(GPC-3) in hepatocellular carcinoma(HCC).MethodsThe general data and ultrasonographic data of patients with HCC confirmed by histopathology and hepatectomy from January 2019 to June 2023 were analyzed retrospectively. According to the gold standard of postoperative pathology, the patients were divided into GPC-3 positive group and GPC-3 negative group. Through analyze the correlation between multimodal ultrasound features and GPC-3, to determine the independent predictors of GPC-3, and to further analyze the preoperative predictive efficiency of Two-dimensional ultrasound(2D-US), contrast-enhanced ultrasound(CEUS) and microflow imaging(MFI) for GPC-3 of HCC.ResultsA total of 102 patients were enrolled in this study, including 60 GPC-3 positive patients(58.8%) and 42 GPC-3 negative patients(41.2%). Through univariate and multivariate analysis, it was found that there were significant differences in diameter(95%CI: 1.080-7.741, P = 0.034), start washout time(95%CI: 0.105-0.694, P = 0.007) and CEUS-MFI(95%CI: 1.180-4.553, P = 0.015) between the two groups, which were independent predictors of GPC-3 positive occurrence. The prediction efficiency of multimodal ultrasound combined with GPC-3 for HCC is better than that of single mode(<0.05).ConclusionThe feasibility of multimodal ultrasound in predicting GPC-3 of HCC before operation is confirmed.

The rheological properties of blood are influenced by red blood cell (RBC) mechanics and cell-cell aggregates, which yield important clinical information; however, measurement of rheological parameters is often not possible at phlebotomy-sites. We investigated the effect of short-term storage on the stability of RBC aggregation and deformability. Blood was obtained from apparently healthy volunteers and anticoagulated with lithium heparin or ethylenediaminetetraacetic acid (EDTA). Samples were stored either at ambient (22 °C) or cold (4 °C) temperature for up to 48 h. Aggregation and deformability were measured utilising light transmission and laser backscatter methods, and laser diffractometry, respectively. EDTA significantly lowered aggregation when compared with heparin-anticoagulated blood. During ambient temperature storage, EDTA preserved baseline RBC aggregation for up to 4 h, while lithium heparin-anticoagulated blood showed significant changes within 1 h. Deformability was altered after 8 h of storage, irrespective of anticoagulant. Cold storage extended stability most effectively in EDTA. It remains that EDTA should be the anticoagulant of choice to preserve blood physical properties. Even short-term storage of blood has a remarkable impact on physical properties; when unavoidable, however, EDTA blood should be stored at 4 °C for same day testing without negative effect.

AimAim of the study was to differentiate solid liver lesions according to their microvascularization. Therefore, we analyzed perfusion using time intensity curves (TIC) measured during contrast-enhanced intraoperative ultrasound (CE-IOUS).Material and MethodsData of 40 patients who underwent hepatic surgery with the diagnosis of hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (CCC), or liver metastases (LM) were retrospectively collected. CE-IOUS was performed using a linear multifrequency T-probe connected to a high-resolution device. Digital Imaging and Communications in Medicine (DICOM) loops were recorded, and TIC were analyzed for time to peak (TTP) and area under the curve (AUC) in tumor center, margin and reference tissue.ResultsAnalyses of the tumor center revealed significant higher AUC in HCC lesions than in CCC ( = 0.0310). HCC patients also showed longer TTP in reference tissue compared to CCC ( = 0.0251). Within the HCC cohort, TTP was shorter at tumor margins compared to reference tissue ( = 0.0420). For LM, AUC measured at tumor margins was higher than in center and reference tissue ( = 0.0266,  = 0.0064).ConclusionTIC analysis of solid liver lesions during CE-IOUS revealed significant differences in their microvascularization, improving, intraoperative differentiation. Artificial intelligence tools may enhance IOUS in the future by standardization and motion compensation.

The occurrence of Raynaud's phenomenon in patients with multiple sclerosis (MS) is infrequently documented in the literature. Some cases have been attributed to interferon-β therapy, while others have emerged in MS patients who sub-sequently developed Raynaud's phenomenon and/or systemic sclerosis. The association between microangiopathic damage and both Raynaud's phenomenon and systemic sclerosis is well-established, leading to the adoption of nailfold video-capillaroscopy (NVC) as a non invasive diagnostic tool for the initial clinical assessment of these conditions.

ObjectiveCervical tuberculous lymphadenitis (CTBL) and cervical lymph node metastasis (CLNM) share similar imaging characteristics, making differentiation challenging. This study aims to evaluate the clinical utility of a multimodal radiomics model combining grayscale ultrasound (GUS), elastography ultrasound (EUS), and contrast-enhanced ultrasound (CEUS) for distinguishing CTBL from CLNM.MethodsA high-quality dataset comprising 203 cases of CTBL was used to train and test the radiomics models. The performance of single-modal (GUS, EUS, CEUS) and combined models was compared using AUC, sensitivity, specificity, and accuracy metrics. An independent test set of 45 cases was included for validation.ResultsThe combined GUS + EUS + CEUS model outperformed single-modal models, achieving AUCs of 0.894, 0.832, and 0.919 in the training, validation, and test sets, respectively. Its diagnostic performance was comparable to a clinical model in validation and test sets, demonstrating superior generalizability and robustness. Wavelet features accounted for all selected features, enhancing the model's discrimination ability.ConclusionsThe integration of three ultrasound modalities captures multidimensional imaging features, reducing reliance on subjective interpretation. This multimodal radiomics approach provides a standardized diagnostic tool with significant clinical potential, particularly for less experienced physicians. Further validation with diverse datasets is needed to confirm its utility.

PurposeTo explore the ultrasound features and the diagnostic values of CEUS LI-RADS and World Federation for Ultrasound in Medicine (WFUMB) - European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) criteria in serum biomarker negative hepatocellular carcinoma (HCC) and colorectal cancer liver metastasis (CRLM).MethodsA total of 161 patients with pathologically diagnosed alpha-fetoprotein (AFP)-negative HCC and carcinoembryonic antigen (CEA)-negative CRLM were retrospectively enrolled, including 101 HCC patients and 60 CRLM patients. The clinical characteristics and ultrasound characteristics of all cases were analyzed and lesions were categorized via two criteria.ResultsThe rate of HBV infection in HCC patients was higher than CRLM patients ( < 0.001). For the liver parenchyma, the rate of liver cirrhosis and liver steatosis in HCC patients were both higher than CRLM patients ( < 0.001 and  = 0.048, respectively). On CEUS, HCC lesions depicted higher rate of arterial phase hyperenhancement (APHE), mild washout and later wash-out onset, while rim-hyperenhancement, marked washout and earlier wash-out onset were more frequently observed in CRLM lesions. For diagnosing HCC, the sensitivity, specificity and accuracy of CEUS LR-5 were 55.4%, 93.3% and 69.6%, respectively, and of WFUMB-EFSUMB criteria were 87.1%, 73.3% and 82.0%, respectively. For diagnosing CRLM, the sensitivity, specificity and accuracy of CEUS LR-M were 100.0%, 63.4% and 77.0%, respectively, and of WFUMB-EFSUMB criteria were 76.7%, 94.1% and 87.6%, respectively.ConclusionIn patients with serum biomarker negative HCC and CRLM, both CEUS LI-RADS and WFUMB-EFSUMB criteria have each advantages and have high application value.

ObjectiveThis study aims to explore the effects of obstructive sleep apnea (OSA) on hemorheological parameters.MethodsBetween February 2023 and March 2024, 882 patients were screened, and 787 were included in the study. The participants were divided into a non-OSA group (72 individuals) and an OSA group (715 individuals). Propensity score overlap weighting was used to balance the clinical variables, red blood cell count, and blood biochemistry results between the two groups, and regression analysis was conducted to assess the relationship between OSA and hemorheological parameters. Sensitivity analysis was conducted using propensity score covariate adjustment to ensure the robustness of the results.ResultsCompared to non-OSA patients, OSA patients exhibited a significant increase in whole blood viscosity at high shear rates by 0.18 mPa.s (95% CI: [0.03, 0.32]) and in plasma viscosity by 0.05 mPa.s (95% CI: [0.01, 0.10]). However, there was no significant difference in whole blood viscosity at low shear rates between the two groups (95%CI: [-0.01, 0.56]).ConclusionAfter adjusting the effects of comorbidities such as hypertension, diabetes, and cardiovascular diseases, OSA still had a significant impact on high-shear whole blood viscosity and plasma viscosity.

BackgroundBorderline ovarian tumors (BOTs) represent a rare group of neoplasms exhibiting abnormal epithelial proliferation with cellular atypia while lacking stromal invasion or infiltrative destructive growth. And postoperative recurrence may be associated with histological features and lymph node status. Therefore, preoperative prediction of BOTs' histological characteristics and lymph node status is of paramount importance for formulating surgical plans and follow-up treatments.ObjectiveTo investigate the value of conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS) characteristics for preoperative identification of histological features and lymph node status in BOTs.MethodsPatients with pathologically confirmed primary BOTs were enrolled, which classified into high-risk and low-risk groups based on whether the presence of at least one of microinvasion, micropapillary pattern, extraovarian implantation, or lymph node invasion. CEUS was performed at the maximal solid tumor component identified on gray-scale imaging, with bolus injection of contrast agent and dynamic recording of the wash-in to wash-out phases for quantitative contrast kinetics analysis. A comparative analysis of US and CEUS characteristics was conducted between the groups, with subsequent longitudinal assessment of recurrence-free survival (RFS) curves employing Kaplan-Meier methodology.ResultsThe study comprised 58 patients with BOTs, stratified into low-risk (n = 37) and high-risk (n = 21) groups, with mean patient ages of 42.8 ± 11.8 years. No statistically significant differences were observed in tumor size (maximum diameter,  = 0.840) or location (unilateral versus bilateral,  = 0.077) between the two groups on US. The type of tumor, proportion of solid components, and color score were observed to statistically significantly differ between the two groups (all  < 0.05). Iso- or hyper-enhancement, early or synchronously wash-in, and early wash-out were more likely to occur in the high-risk group (16/21, 76.2%; 11/21, 52.4%; 11/21, 52.4%) than in the low-risk group (15/37, 40.5%; 5/37, 13.5%; 9/37, 24.3%). In quantitative parameters, there were significant differences in MeanLin, PE, RT, TTP, WiR, WiPI, WoAUC, WiWoAUC, FT, and WoR between the two groups (all  < 0.05). During the follow-up, there were 3 cases recurrence in the high-risk group, while no recurrence was observed in the low-risk group.ConclusionThe combination of US and CEUS is capable of facilitating preoperative prediction of the histological features and lymph node status of BOTs, and holds potential value for identifying the recurrence risk.

BackgroundPlantar fasciopathy is a common complication in diabetes patients.ObjectiveTo evaluate the effectiveness of ultrasound in detecting diabetic tendinopathy in type 2 diabetes mellitus (T2DM) patients by assessing plantar fascia (PF) thickness and stiffness.MethodsThis study included 70 T2DM patients with heel pain, diagnosed by American Diabetes Association (ADA). B mode ultrasound was used to evaluate PF thickness. Shear wave elastography (SWE) was used to assess PF stiffness.ResultsIn T2DM patients, the PF thickness (PFT) was significantly thicker (4.40 ± 0.79 mm vs. 2.87 ± 0.26 mm, P < 0.05) and the shear wave velocity (SWV) of PF was significantly lower (3.09 ± 0.57 m/s vs. 4.00 ± 1.01 m/s, P < 0.05) than the control group. PFT and SWV values were strongly correlated with age (r = 0.880, -0.888) and BMI (r = 0.814, -0.853). ROC analysis showed that PFT > 4.33 mm had a sensitivity of 98.0% and specificity of 77.2% for diabetic tendinopathy, with an area under the ROC curve (AUROC) of 0.956, SWV < 3.22 m/s had a sensitivity of 86.3% and specificity of 60.5% (AUROC = 0.789).ConclusionUltrasound is a non-invasive and efficient diagnostic tool for PF in T2DM patients.

BackgroundSacubitril is an important and effective agent for cardiovascular remodeling. This study aims to evaluate its proangiogenic effects in an experimental model.MethodsThe chorioallantoic membrane (CAM) model was created for the investigation of the proangiogenic potential of sacubitril with different therapeutic doses (10 M, 10 M, 10 M) and compared with drug-free pellet group (sham) and normal morphology (control) of chick embryo development in drug-free chick embryos. The developing embryo's vascularity and the pellets' effect were evaluated under a stereoscopic microscope. The density of vascular shoots and newly formed vascular nodules were not recorded.ResultsThere was no significant difference between the control and drug-free pellet groups (12.4 ± 2.8 vs. 14.1 ± 1.3 junctions per ROI, p = 0.48). The incremental angiogenic properties were detected in drug groups as follows: 15.3 ± 3.8 per ROI in Group I (10 M concentration); 21.6 ± 5.4 per ROI in Group II (10 M concentration); 22.9 ± 8.1 per ROI in Group III (10 M concentration) (p < 0.001).ConclusionOur findings support that sacubitril provokes angiogenesis in a dose-dependent manner. Investigating these properties can be useful for understanding further effects of this agent in other cardiovascular diseases. Therapeutic angiogenesis is important for ameliorating the results.

Oxygen-gradient ektacytometry (oxygenscan) has been recently used in the context of sickle cell disease (SCD) to determine the ability of red blood cells (RBCs) to deform in normoxia and during deoxygenation. While several studies focused on the determinants of oxygenscan parameters in the homozygous form of SCD (i.e., HbSS), very few studies focused on hemoglobin SC disease (HbSC). Oxygenscan parameters were compared between HbSS (N = 304) and HbSC (N = 58) patients, with or without hydroxyurea (HU). RBC deformability measured in normoxia or at low oxygen level was lower in HbSS patients without HU compared to HbSS patients with HU and HbSC patients with or without HU. The propensity of RBCs to sickle during deoxygenation was greater in HbSS than in HbSC patients. Although no significant impact of HU was observed on RBC deformability/sickling in HbSC patients, those with HU had lower blood viscosity. The ability of RBC to recover their maximum deformability after a deoxygenation/reoxygenation cycle was lower in HbSC compared to HbSS patients. Finally, oxygenscan parameters and routine hematological parameters correlated differently in HbSS and HbSC patients. Our study showed difference in oxygenscan parameters between HbSS and HbSC individuals that could partly explain the difference in the clinical expression of SCD.

BackgroundN6-methyladenosine (m6A) methylation plays an important role in myocardial infarction, which is related to cardiomyocyte pyroptosis. This study aimed to explore the effects of the m6A methyltransferase, METTL14, on pyroptosis and the underlying mechanisms.Materials and methodsThe role of METTL14 was assessed by TTC staining, biochemical indicators, and H&E assays. Cell pyroptosis was evaluated by PI staining, IF, and western blot assay. The m6A methylation of NLRP3 was evaluated by RIP, dual-luciferase reporter assay, Me-RIP, and stability test.ResultsThe results indicated that METTL14 was highly expressed in LAD-ligated mice and OGD-induced cardiomyocytes. Depletion of METTL14 inhibited OGD-induced pyroptosis of cardiomyocytes and suppressed myocardial injury. Mechanically, METTL14 promoted m6A methylation of NLRP3 to enhance mRNA stability. Overexpression of NLRP3 reversed the effects of METTL14 knockdown on pyroptosis.ConclusionsMETTL14 knockdown attenuated cardiomyocyte pyroptosis and myocardial infarction by suppressing NLRP3 m6A methylation. The findings suggested that METTL14 has the potential to be the therapeutic target of myocardial infarction.

BackgroundDuring cardiopulmonary bypass (CPB), which is frequently utilized in open-heart surgery, the maintenance of circulation in a non-physiological environment may lead to alterations in the properties of circulating blood components. In our study, we aimed to evaluate these changes using contemporary methodologies.MethodsThe study included 48 patients who underwent cardiac surgery with CPB. CPB duration and hypothermia degree were recorded and analyzed. Erythrocyte deformability (ED), erythrocyte aggregation (EA), whole blood viscosity (WBV), total oxidant status (TOS), and total antioxidant status (TAS) were measured; ED and EA were measured using LORRCA (RR Mechatronics, Hoorn, Netherlands).ResultsCompared to the preoperative period, a decrease in postoperative ED, EA, and WBV was observed. No significant change was detected in TAS levels; however, TOS levels were found to be elevated. No statistically significant correlation was observed between perioperative patient temperature, CPB duration, and ED, EA, or WBV values.ConclusionsIn patients undergoing surgery with CPB, a postoperative decrease in ED, EA, and WBV was demonstrated. Previous studies have suggested that the decline in ED is associated with blood transfusion. However, the significant reduction in ED observed in our study, even in patients who did not receive blood transfusions, is noteworthy.

Current guidelines recommend Fine Needle Aspiration (FNA) based on nodule size and ultrasound characteristics; however, these guidelines still lead to a certain amount of unnecessary FNAs.

To evaluate in situ assessment of renal cortical microcirculation (RCM) in S-AKI rats using CEUS and SDF imaging.

BackgroundMyocardial ischemia-reperfusion injury (MI/RI) is a primary cause of cardiomyocyte death in various cardiovascular diseases. MicroRNAs (miRNAs) play significant roles in MI/RI.ObjectiveThis study aims to elucidate the function and mechanism of miR-379-3p in this context.MethodsThe Cell Counting Kit 8 (CCK-8) and flow cytometry were utilized to assess the proliferation and apoptosis of cardiomyocytes. The expression levels of cardiomyocyte injury-related proteins, including LDHA, cTnT, CK-MB, and cTnI, were measured using enzyme-linked immunoassay (ELISA) kits. The targeted regulatory relationship between miR-379-3p and dual-specificity protein phosphatase 1 (DUSP1) was investigated through dual luciferase reporter gene assays. Additionally, the expression levels of miR-379-3p/DUSP1 and mitogen-activated protein kinases (MAPKs) signaling pathway in MI/RI were evaluated using Western blotting.ResultsThe expression of miR-379-3p was significantly elevated in MI/RI, and the inhibition of miR-379-3p notably alleviated MI/RI. The specific binding of miR-379-3p to the 3'UTR of DUSP1 mRNA was confirmed by dual luciferase reporter gene assays. Furthermore, miR-379-3p exacerbated cardiomyocyte injury by negatively regulating DUSP1. Ultimately, miR-379-3p activated the MAPK/JNK/p38 pathway by downregulating DUSP1 expression, thereby promoting MI/RI.ConclusionsmiR-379-3p activates the MAPK/JNK/p38 pathway through the negative regulation of DUSP1 expression to promote MI/RI.

ObjectivesTo investigate the role of high-frequency ultrasound in detection of occult focal liver lesions (FLLs).MethodsIn this retrospective study from April 2016 to March 2019, eighty-five patients with indistinctive FLLs were included. High-frequency and low-frequency B-mode ultrasound (BMUS) and contrast-enhanced ultrasound (CEUS) were performed for each lesion. The detection rates of two methods and the ultrasound performance of co-detected lesions were compared. Subgroup analysis was performed according to different liver backgrounds.ResultsFor 85 FLLs with mean diameter of 11.80 ± 4.66 mm and mean depth of 20.91 ± 6.89 mm, high-frequency BMUS detected 77 (90.6%) lesions, significantly more than low-frequency BMUS (36, 42.4%,  < 0.001). Among the lesions co-detected by low-frequency and high-frequency ultrasound, the lesions at high-frequency mainly showed heterogeneous echogenicity ( < 0.001), regular morphology ( < 0.001), well-defined boundary ( < 0.001) and inhomogeneous enhancement ( < 0.001) in arterial phase. Even in the presence of cirrhosis or fatty liver, high-frequency ultrasound still performed excellently.ConclusionHigh-frequency ultrasound improves the detection of small and superficially located FLLs.