Clinical utility of two-dimensional shear-wave elastography in monitoring disease course in autoimmune hepatitis-primary biliary cholangitis overlap syndrome

BACKGROUND Autoimmune hepatitis-primary biliary cholangitis(AIH-PBC)overlap syndrome has a worse prognosis than AIH or PBC alone.Therefore,accurately staging liver fibrosis and dynamically monitoring disease progression are essential.AIM To investigate the performance of two-dimensional shear-wave elastography(2DSWE)for noninvasively staging liver fibrosis and assessing the clinical utility of repeated 2D-SWE for monitoring treatment response in AIH-PBC overlap syndrome.METHODS A total of 148 patients diagnosed with AIH-PBC overlap syndrome were retrospectively enrolled.Among them,82 patients had a 2D-SWE follow-up time of more than 1 year.The Scheuer scoring system was used to evaluate stages of hepatic inflammation and liver fibrosis.The performance of 2D-SWE for staging liver fibrosis was evaluated with the liver biopsy.Changes in liver stiffness(LS)measured by 2D-SWE in patients with or without complete biochemical remission were evaluated.RESULTS LS value was strongly correlated with liver fibrosis stage(Spearman r=0.84,P<0.0001).The areas under the receiver operating characteristic curves of LS for diagnosing significant fibrosis(≥S2),severe fibrosis(≥S3),and cirrhosis(S4)were 0.91,0.97,and 0.96,respectively.Patients with complete biochemical remission had a considerable decrease in LS values(P<0.0001).More importantly,the declined LS in patients with S0-S2 was significantly lower than that in patients with S3-S4(P=0.0002).In contrast,patients who failed to achieve biochemical remission had a slight but not significant decrease in LS(P=0.37).CONCLUSION LS measured by 2D-SWE is an accurate and reliable method in assessing liver fibrosis,especially for diagnosing severe fibrosis(≥3)and monitoring treatment response in patients with AIH-PBC overlap syndrome.

基于云-模糊模型的堆石坝施工质量评估（英文）

目的:施工质量对于大坝建设期及运行期的安全至关重要。由于施工过程中的信息不完备及碾压质量与影响因素之间的关系并不是完全确定等原因,传统的评估方法很少考虑不确定性对施工质量的影响。本文旨在探讨考虑不确定性影响的碾压质量评估方法,改善施工质量评估的可信性。创新点:1.通过研究模糊神经网络与径向基神经网络,结合云模型建立云-模糊模型;2.建立施工质量三指标体系评价方法。方法:1.通过碾压质量实时监控系统和现场试坑试验获取参数数据;2.通过云分析,建立云-模糊模型;3.对比不同的模型,验证云-模糊模型的可行性;4.利用验证的云-模糊模型对大坝施工仓面进行压实干密度预测;5.计算评价体系的三指标,对施工质量进行评估。结论:1.云-模糊模型不但能在精度上满足预测要求,而且能够综合考虑施工质量与影响因素之间的不确定性关系;2.云-模糊评价方法弥补了传统评价方法仅追求精度的单一性,使得施工质量评价更符合客观规律;3.提出的施工质量三指标评价体系充实了传统的评价方法,能够更客观地指导实际工程建设。