Value of superb micro-vascular imaging in predicting ischemic stroke in patients with carotid atherosclerotic plaques

BACKGROUND Unstable carotid atherosclerotic plaques are prone to cause ischemic stroke.Contrast-enhanced ultrasound(CEUS) is the primary method of assessing plaque stability, but CEUS cannot be a method for screening for unstable plaque. The emergence of superb micro-vascular imaging(SMI) offers the possibility of clinically screening for unstable plaque AIM To investigate the value of SMI in predicting ischemic stroke in patients with carotid atherosclerotic plaques.METHODS Patients with carotid atherosclerotic plaques(luminal stenosis of 50%-70%) were enrolled into the present study. All patients received conservative medication.The patient's clinical baseline data, serological data, CEUS and SMI data were analyzed. All patients underwent a 3-year follow-up. The follow-up endpoint was the occurrence of ischemic stroke and patients were divided into stroke group and non-stroke group according to whether the prognosis occurred or not.Subsequently, the difference in clinical data was compared, the correlation of SMI and CEUS was analyzed, and multiple Cox regression and receiver operating characteristic curve were applied to investigate the value of SMI and CEUS in predicting cerebral arterial thrombosis in three years.RESULTS In this study, 43 patients were enrolled in the stroke group and 82 patients were enrolled in the non-stroke group. Cox regression revealed that SMI level(P =0.013) and enhancement intensity(P = 0.032) were the independent factors influencing ischemic stroke. There was a positive correlation between SMI level and enhancement intensity(r = 0.737, P = 0.000). The area under curve of SMI level predicting ischemic stroke was 0.878. The best diagnostic point was ≥ level Ⅱ, and its sensitivity and specificity was 86.05% and 79.27%. The area under curve of enhancement intensity predicting ischemic stroke was 0.890. The best diagnostic point was 9.92 db, and its sensitivity and specificity was 88.37% and89.02%. As the SMI level gradually increased, the incidence of ischemic stroke increased gradually(X^2 = 108.931, P = 0.000).CONCLUSION SMI can be used as a non-invasive method of screening for unstable plaques and may help prevent ischemic stroke.

Role of shear wave elastography in the evaluation of the treatment and prognosis of supraspinatus tendinitis

BACKGROUND Supraspinatus tendinitis recurs easily after treatment.One of the main reasons is the lack of objective tools for the efficacy evaluation.Shear wave elastography(SWE)can quantitatively analyze the tissue elasticity of region of interest by measuring the Young’s modulus(YM)value.AIM To explore the role of SWE in the efficacy and prognostic evaluation of supraspinatus tendinitis.METHODS Eighty-seven patients with supraspinatus tendinitis treated in Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences were recruited.Another 30 healthy volunteers were enrolled as the control group.The visual analogue scale(VAS)and Constant-Murley Score(CMS)were recorded before treatment.All participants were scanned by SWE scan,and the YM value of the region of interest were recorded.Spearman correlation analysis was performed on YM values with VAS and CMS.Univariate repeated measures analysis of variance was used to calculate the changing trend of VAS,CMS and SWE under different treatment courses.After treatment,the patients were further grouped based on who achieved significantly effective and curative treatment.The patients in the continued treatment group continued to receive treatment according to the YM value,and the remaining patients who stopped receiving treatment were included in the stopped treatment group.All patients were followed up for 1 year,and the difference in recurrence rates between the continued treatment group and the stopped treatment group were compared.RESULTS The SWE images of supraspinatus muscle in healthy volunteers were mainly blue,while those of patients with supraspinatus tendinitis showed regional red and green areas.The average YM value of the supraspinatus muscle in healthy volunteers was 26.12±4.03 kPa.The average YM value of patients with supraspinatus muscle was greater than that of healthy volunteers(average YM=60.61±11.53 kPa,t=26.344,P<0.001).The YM value was positively correlated with VAS(r=0.564,P<0.001)and negatively correlated with CMS(r=-0.411,P<0.001).The changes of VAS and CMS were the most obvious in course 1 and then decreased gradually.The degree of change in YM values was similar in different courses.After a 1-year follow-up,the cumulative relapse-free rate in the continued treatment group was 91.43%,which was significantly higher than that in the stopped treatment group(64.71%,X2=7.379,P=0.007).CONCLUSION SWE can objectively indicate the severity of supraspinatus tendinitis.Using the YM value as a criterion for curative effect may reduce the recurrence rate.

Low-grade myofibroblastic sarcoma of the liver misdiagnosed as cystadenoma:A case report

BACKGROUND Low-grade myofibroblastic sarcoma(LGMS)is a rare malignant tumor.It has no specific clinical manifestations and commonly occurs in the head and neck,extremities and other body parts,with the liver not as its predisposing site.CASE SUMMARY We report a case report of a 58-year-old man with right upper abdominal pain for 11 d.Contrast-enhanced computed tomography(CECT),CE magnetic resonance imaging and CE ultrasound(US)all showed a cystic-solid mass in the right liver.As the initial clinical diagnosis was hepatic cystadenoma,surgical resection was performed,and the postoperative pathology indicated hepatic LGMS.The 3-mo follow-up showed favorable recovery of the patient.However,at 7-mo follow-up,two-dimensional US and CECT showed a suspected metastatic lesion in the rightmiddle abdomen.CONCLUSION Hepatic MS is particularly rare and easily misdiagnosed,more cases will contribute to the understanding and the diagnosis accuracy.

The anti-neoplastic activities of aloperine in HeLa cervical cancer cells are associated with inhibition of the IL-6-JAK1-STAT3 feedback loop

Cervical cancer(CC)is recognized as the most common neoplasm in the female reproductive system worldwide.The lack of chemotherapeutic agents with outstanding effectiveness and safety severely compromises the anti-cipated prognosis of patients.Aloperine(ALO)is a natural quinolizidine alkaloid with marked anti-cancer effects on multiple malignancies as well as favorable activity in relieving inflammation,allergies and infection.However,its therapeutic efficacy and underlying mechanism in CC are still unclear.In the current study,MTT assay was employed to evaluate the viability of HeLa cells exposed to ALO to preliminarily estimate the effectiveness of ALO in CC.Then,the effects of ALO on the proliferation and apoptosis of HeLa cells were further investigated by plate colony formation and flow cytometry,respectively,while the migration and invasion of ALO-treated HeLa cells were evaluated using Transwell assay.Moreover,nude mice were subcutaneously inoculated with HeLa cells to demonstrate the anti-CC properties of ALO in vivo.The molecular mechanisms underlying these effects of ALO were evaluated by Western blot and immunohistochemical analysis.This study experimentally demonstrated that ALO inhibited the proliferation of HeLa cells via G2 phase cell cycle arrest.Simultaneously,ALO promoted an increase in the percentage of apoptotic HeLa cells by increasing the Bax/Bcl-2 ratio.Additionally,the migration and invasion of HeLa cells were attenuated by ALO treatment,which was considered to result from inhibition of epithelial-to-mesenchymal transition.For molecular mechanisms,the expression and activation of the IL-6-JAK1-STAT3 feedback loop were markedly suppressed by ALO treatment.This study indicated that ALO markedly suppresses the proliferation,migration and invasion and enhances the apoptosis of HeLa cells.In addition,these prominent anti-CC properties of ALO are associated with repression of the IL-6-JAK1-STAT3 feedback loop.