Assessing muscle stiffness using shear wave elastography / 中华物理医学与康复杂志

Objective:To measure the change in Young′s modulus of the biceps brachii during passive stretching and to assess the potential of shear wave elastography (SWE) as an auxiliary quantitative technique for assessing muscle tone.Methods:Forty-nine stroke survivors and 30 healthy subjects were evaluated using the modified Ashworth scale (MAS). According to their MAS scores they were divided into a healthy group, a healthy elbow group, an MAS class-0 group, an MAS class-1 group, an MAS class-1 + group and an MAS class-2 group. During passive extension of the subjects′ elbows, shear wave elastography was used to image the biceps brachii. Six points of the elbow were selected to record the instantaneous Young′s modulus ( EX) and calculate its change during the movement (Δ E). Those data were correlated with the MAS scores and compared among the groups. Results:Persons with higher MAS scores tended to have a higher Young′s modulus of the biceps brachii, and the modulus was likely to increase more with increases in the angle of elbow extension. From half of the range of motion to full extension there were significant differences in EX and Δ E between MAS class-0 and class-1 groups, as well as between the class-0 and class-1 + groups. There were, however, no significant differences between MAS class-1 and MAS class-1 + . Conclusions:MAS scores can usefully predict biceps brachii stiffness during passive elbow flexion. Shear wave elastography can quantify that stiffness and also muscle tone.

Fracture Resistance of Endodontically Restored Teeth with Two System Root Post

ABSTRACT: The objective of this study was to determinate the fracture resistance of endodontically treated teeth and restored with two root post systems: i) resin post, ii) fiber post. A total of 60 teeth were freshly extracted, endodontic ally treated and randomly divided in two groups (n= 30/each group) for standardized restoration; Group 1 (Group R): Resin post and resin restoration, Group 2 (Group FP): Fiberglass post and resin restoration. Both groups' samples were mounted in a metallic base at 135º to allow them to be stabilized and held in the universal testing machine by applying a vertical force at cross speed of 1mm/min. Data were recorded in Newtons (N) Previous to test the fracture resistance; all samples were stored in distilled water at 37 ºC for 24 hours. Data were subject to the Saphiro-Wilk test for normality distribution and Student's t test. Significance was considered at 0.05 values. The values of fiber post group showed normal distribution compared to the resin group, demonstrating less variability among the values. The group FP displayed higher fracture resistance (299.77±100 N) than group R (205.57±86.40 N), with significant differences (p= 0.00002). The greatest fracture resistance was recorded for the group having fiber post reinforced and composite cores. It is suggested that fiberglass post restoration is the first option when endodontic treatment requires core restoration.

RESUMEN: El objetivo del estudio fue determinar la resistencia a la fractura de dientes tratados endodónticamente y restaurados con dos sistemas de endopostes radiculares: I) poste de resina, II) poste de fibra. Un total de 60 dientes recién extraídos fueron tratados endodónticamente y divididos al azar en dos grupos (n= 30/ cada grupo) para la restauración estandarizada; Grupo 1 (Grupo R): Pilares de resina y restauración, Grupo 2 (Grupo FP): Pilares de fibra de vidrio y restauración de resina. Las muestras de ambos grupos se montaron en una base metálica a 135º para permitir su estabilización y sujeción en la máquina universal de ensayos aplicando una fuerza vertical a velocidad transversal de 1 mm/min. Los datos se registraron en Newtons (N), para probar la resistencia a la fractura; todas las muestras se almacenaron en agua destilada a 37 ºC durante 24 horas. Los datos se sometieron a la prueba de normalidad de Saphiro-Wilk y la pruebas t de Student. La significancia se consideró con un valor de 0,05. Los valores del grupo de postes de fibra mostraron una distribución normal en comparación con el grupo de resinas, demostrando menor variabilidad entre los valores. El grupo FP mostró mayor resistencia a la fractura (299,77±100 N) que el grupo R (205,57±86,40 N) que el grupo con diferencias significativas (p= 0,00002). La mayor resistencia a la fractura se registró para el grupo que tenía núcleos compuestos y reforzados con postes de fibra. Se sugiere que la restauración posterior de fibra de vidrio es la primera opción cuando el tratamiento de endodoncia requiere una restauración del núcleo.

The clinical application study of multimodal ultrasound on the quantitative measurement of muscle mass and hardness in sarcopenia patients / 中华老年医学杂志

Objective:To evaluate the clinical value of musculoskeletal ultrasound in the diagnosis of sarcopenia by measuring the muscle mass and hardness of medial head of gastrocnemius.Methods:According to the diagnostic criteria of Asian Working Group for Sarcopenia(AWGS), 60 patients with sarcopenia were selected as the case group and 24 normal elderly people with matched age as the control group.Two dimensional gray-scale ultrasound was used to measure the muscle thickness, pinnate angle and fascicle length of the right gastrocnemius muscle, and the shear wave elastography was used to measure the Young's modulus(the dynamic stiffness)of the muscle in the states of relaxation and contraction, respectively.The differences of various ultrasound parameters between the two groups were compared, and the relativity of muscle thickness of the medial head of the right gastrocnemius muscle, the feather horn, fascicle length in the case group with sarcopenia was analyzed.The value of the ultrasound measurements in predicting sarcopenia was analyzed by ROC curve.Results:The muscle thickness(10.0±2.1)mm, pinnate angle(16.9±3.2)°, fascicle length(30.5±3.2)mm and Young's modulus[(11.5±2.2)kPa in relaxation state, (23.2±4.0)kPa in contraction state]of the right gastrocnemius muscle were lower in the sarcopenia group than in the control group with matched age[(14.8±1.2)mm, (21.7±2.5)°, (34.2±1.6)mm, (15.0±1.5)kPa, (30.6±2.8)kPa, respectively, t=10.454, 3.612, 5.631, 6.922, 8.173, all P<0.05]. The Young's modulus value was lower in relaxed state than in the contraction state.Pearson correlation analyses showed the muscle thickness and Young modulus were negatively correlated with the age( r=-0.307, -0.285, P<0.05), and the muscle thickness was positively correlated with the limb skeletal muscle mass index( r=0.838, 0.761, P<0.01). Logistic regression analysis showed the muscle thickness and Young's modulus were significantly correlated with sarcopenia( OR=4.576, 3.867). ROC analysis revealed that the threshold values of ultrasound examination of the right gastrocnemius muscle medial head for diagnosis of sarcopenia were as follows: muscle thickness of 11 mm, pinnate angle of 17 degrees, fascicle length of 32 mm, Young modulus at the relaxation state of 12.4 kPa.The sensitivity and specificity of muscle thickness for diagnosis of sarcopenia were the best(86.7% and 100%, respectively)as compared with other measurements. Conclusions:The measurement of muscle mass and muscle hardness of the medial head of gastrocnemius by ultrasound can reflect the decrease of muscle mass and muscle hardness quantitatively, and provide imaging indicators for the prediction of sarcopenia.

A preliminary study of ultrasound shear-wave elastography in evaluation of lumbar multifidus stiffness in healthy adults / 中华超声影像学杂志

Objective:To explore the repeatability of ultrasound shear wave elastography (SWE) in evaluating the Young′s modulus (E) of the lumbar multifidus (LM) and the difference in E of the bilateral LM, and to analyze the E′s change ratio of LM and its impact factors at upright and 90° forward bend positions.Methods:A total of 60 healthy volunteers, selected from interns, standardized training residents and refresher doctors in department of diagnostic ultrasound of Sir Run Run Shaw Hospital of Zhejiang University School of Medicine from July to December in 2020, were examined twice by SWE to estimate the E value of LM at prone, upright and 90° flexion positions, respectively. Firstly, the intraclass correlation coefficient (ICC) was applied to test the reliability between the two repeated measurements.Secondly, the differences in E of the bilateral LM were discussed. The discrepancies in the E value of male and female volunteers at prone, upright and 90° flexion positions and the change ratio of the E value at upright and 90° forward bend positions were also discussed, respectively. Finally, Spearman correlation coefficient was utilized to evaluate the correlations of E and its change ratio with gender, age, BMI and activity level at upright and 90° forward bend positions, respectively.Results:The ICC value in LM measured by SWE was in the range of 0.691 to 0.951. No obvious change in bilateral E values of the same posture was observed for an individual(all P>0.05). The change ratios of E at upright and 90° flexion positions were approximate to 2 and 7, respectively. Moreover, at prone position, the E value exhibited negative correlation with age and activity level of self-assessment ( rs=-0.300, P=0.020; rs=-0.383, P=0.002). The E in female was higher compared with that in male. At active states the change ratio in E was positively correlated with age and activity level ( rs=0.278, P=0.031; rs=0.495, P<0.001), and the E′s change ratio in male was higher than that in female. Conclusions:SWE possesses excellent repeatability in evaluating the E value of LM with no significant difference in E of bilateral LM. The E′s change ratio in LM varies with different contraction strategies and changes with age, sex and self-reported activity level.

Electroacupuncture on motor function in patients with primary osteoporosis: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effect of electroacupuncture on motor function and muscle state in patients with primary osteoporosis (POP).@*METHODS@#A total of 60 female patients with POP were randomized into an observation group (30 cases, 1 case dropped off) and a control group (30 cases, 1 case dropped off). On the basis of adjusting lifestyle, caltrate was given orally in the control group, 2 pills a day for 4 weeks. On the basis of the treatment in the control group, electroacupuncture was applied at Zusanli (ST 36), Yanglingquan (GB 34), Ganshu (BL 18), Pishu (BL 20), Shenshu (BL 23), etc. in the observation group, with disperse-dense wave of 2 Hz/10 Hz in frequency, once every other day, 3 times a week for 4 weeks. The time of timed up-and-go test (TUGT) and the value of 10 m maximal walking speed (10 m MWS) before and after treatment were compared in the two groups, and the Young's modulus values of bilateral multifidus muscles in prone position and sitting position before and after treatment were compared by real-time shear wave elastography (SWE) in the two groups.@*RESULTS@#After treatment, the TUGT time was decreased compared before treatment in the observation group (P<0.01), and that in the observation group was shorter than the control group (P<0.01). After treatment, the value of 10 m MWS test was increased compared before treatment in the observation group (P<0.05). After treatment, the Young's modulus values of bilateral multifidus muscles in prone position and sitting position were increased compared before treatment in the observation group (P<0.01); except for the left side in sitting position, the Young's modulus values of multifidus muscles in the observation group were higher than those in the control group (P<0.01, P<0.05).@*CONCLUSION@#On the basis of oral caltrate, electroacupuncture can improve the motor function and muscle state in patients with POP.

Effect of thunder-fire moxibustion combined with vibration training on low back pain of primary osteoporosis / 中国针灸

OBJECTIVE@#To compare the therapeutic effect of thunder-fire moxibustion combined with vibration training and simple vibration training on low back pain of primary osteoporosis by 's modulus of ultrasonic wave, and seek an objective evaluating method.@*METHODS@#A total of 60 patients were randomized into an observation group and a control group, 30 cases in each one. The patients in the two groups were treated with vibration training using whole body vibration treatment bed. In the observation group, thunder-fire moxibustion was applied at Yaoyangguan (GV 3), Mingmen (GV 4), Ganshu (BL 18), Shenshu (BL 23) and Dachangshu (BL 25). The treatment was given once every other day, 3 times a week for 4 weeks. The visual analogue score (VAS), real-time shear wave elastography (RTSWE) and medical outcomes study 36-item short-form hearth survey (SF-36) were used to evaluate pain intensity, multifidus muscle tone ('s modulus) and quality of life before treatment, after 4-week treatment and 1 month after treatment.@*RESULTS@#Compared before treatment, the VAS scores, 's modulus of multifidus muscle and 5 dimensions of SF-36 (physical condition, body pain, general health, social function and mental health) after 4-week treatment and 1 month after treatment were significantly improved in the two groups (all <0.05), the physiological role in the observation group after 4-week treatment and 1 month after treatment were improved (both <0.05). In the observation group, the VAS scores, 's modulus of multifidus muscle and 3 dimensions of SF-36 (physiological role, body pain and general health) after 4-week treatment and 1 month after treatment were superior to the control group (all <0.05).@*CONCLUSION@#The therapeutic effect of thunder-fire moxibustion combined with vibration training is superior to simple vibration training in relieving low back pain intensity and multifidus muscle tone, and improving quality of life for primary osteoporosis. RTSWE technique can be an objective examination method to evaluate pain.

Evaluation of combining transvaginal conventional ultrasonography and shear wave elastography on the diagnosis of endometrial cancer / 中华超声影像学杂志

Objective To evaluate the combination of transvaginal conventional ultrasonography and shear wave elastography ( SWE) on the diagnosis of endometrial cancer ,and establish a predictive Logistic regression model . Methods Clinical information collection ,transvaginal conventional ultrasonography ,and SWE check were performed in 112 patients w ho were post‐menopausal vaginal bleeding with ≥5 mm thick endometrium . T he Emax and Emean of Young′s modulus for the endometrium were obtained . Pathology was used as the gold standard ,ROC curve was plotted ,which could be used to evaluate the Young′s modulus on the diagnostic effectiveness on endometrial cancer . Single factor analysis and bring logistic regression methods were applied to assess the values of the clinical variables ,transuaginal conventional ultrasonography variables ,and Young′s modulus in the identification of endometrial cancer . Results In 112 cases of endometrial lesions diagnosed by pathology ,there were 84 cases of benign lesions ( benign group) and 28 cases of cancer( malignant group) . Both Emax and Emean in malignant group were larger than benign group [ (53 .00 ± 16 .07) kPa vs ( 31 .99 ± 13 .89) kPa ,( 27 .25 ± 9 .28) kPa vs ( 19 .94 ± 10 .37) kPa ,all P ＜0 .001] . In the logistical regression analysis ,body mass index ,endometrial thickness ,blood flow grading and Young′s modulus were identified as independent risk factors for endometrial cancer . T he accuracy ,sensitivity and specificity of the logistic regression model in the prediction of endometrial cancer were 89 .29% ,82 .14% , and 91 .67% , respectively . T he area under the ROC curve was 0 .928 . Conclusions T ransvaginal conventional ultrasonography combined SWE technique has an important value in the diagnosis of endometrial cancer .

Effects of Astragalus Polysaccharide on Mechanical Characterization of Liver Sinusoidal Endothelial Cells by Atomic Force Microscopy at Nanoscale / 中国结合医学杂志

<p><b>OBJECTIVE</b>To study the effects of Astragalus polysaccharide (APS), the primary effective component of the Chinese herb medicine Astragalus membranaceus (frequently used for its anti-hepatic fibrosis effects), on nanoscale mechanical properties of liver sinusoidal endothelial cells (SECs).</p><p><b>METHODS</b>Using endothelial cell medium as the control, 5 experimental groups were established utilizing different concentrations of APS, i.e. 12.5, 25, 50, 100, and 200 μg/mL. By using atomic force microscopy along with a microcantilever modified with a silicon dioxide microsphere as powerful tools, the value of Young's modulus in each group was calculated. SAS 9.1 software was applied to analyze the values of Young's modulus at the pressed depth of 300 nm. Environmental scanning electron microscopy was performed to observe the surface microtopography of the SECs.</p><p><b>RESULTS</b>The value of Young's modulus in each APS experimental group was significantly greater than that of the control group: as APS concentration increased, the value of Young's modulus presented as an increasing trend. The difference between the low-concentration (12.5 and 25 μg/mL) and high-concentration (200 μg/mL) groups was statistically significant (P<0.05), but no significant differences were observed between moderateconcentration (50 and 100 μg/mL) groups versus low- or high-concentration groups (P>0.05). Surface topography demonstrated that APS was capable of increasing the total area of fenestrae.</p><p><b>CONCLUSIONS</b>The values of Young's modulus increased along with increasing concentrations of APS, suggesting that the stiffness of SECs increases gradually as a function of APS concentration. The observed changes in SEC mechanical properties may provide a new avenue for mechanistic research of anti-hepatic fibrosis treatments in Chinese medicine.</p>

Quantitative evaluation on puborectalis function in patients with pelvic organ prolapse using shear wave elastography / 中国医学影像技术

Objective To evaluate the contraction function of puborectalis (PR) with shear wave elastography (SWE).Methods Twenty-eight patients with pelvic organ prolapse (POP-Q Ⅲ group and POP-Q Ⅳ group,each n=14) and 28 healthy volunteers (control group) were enrolled.The Young's modulus of PR in the front,middle and back of pubic rectal muscles of each group at resting and maximal rectal state were measured with shear wave elastography,and then were statistically analyzed.Results Youngs modulus of maximum rectal state of each group was higher than that of resting state (all P＜0.05).At resting and maximal rectal state,the Young's modulus and their differences in POP-Q Ⅲ group and POP-Q Ⅳ group were significantly different compared with control group (all P＜0.05),but those in POP-Q Ⅲ group and POP-Q Ⅳ group were not (all P＞0.05).Conclusion Decrease of PR systolic function can be observed in patients with pelvic organ prolapse,and SWE can be used to detect abnormal function of PR systolic function.

The clinical value of real-time shear wave elastography imaging in diagnosis of salivary gland manifesta-tion in sjogren syndrome / 实用医学杂志

Objective To asses the value of shear wave elastorgraphy(SWE)in the diagnosis of salivary gland manifestation in sjogren syndrome.Methods Seventy-nine patients with suspected diagnosis of Sjogren syn-drome and thirty healthy volunteers were enrolled. aned divided to the SS group,non-SS group and healthy group accoroding to the 2002 American-European Consensus Group.The bilateral parotid and submandibular gland of all patients were examined with shear wave Elastography,then the mean Young's modulus(YM)of bilateral gland were obtained. The differences of Emean between all groups were compared. Receiver operating characteristic curve(ROC)was drawn to evaluate the best cut-off value in diagnosis of Sjogren syndrome. Results The differ-ences of YM between the two sides of parotid gland and submaxillary gland were not statistically significant(P >0.05).On ROC curve,the areas under the curve(AUC),threshold,sensitivity,specificity of the mean YM value in Parotid and Submaxillary gland were 0.921 and 0.916(P<0.05),18.30 and 16.57(kPa),71.7%and 86.8%, 94.4% and 78.5%,respectively. Conclusion The mean YM value of Parotid and Submaxillary gland of Sjogren syndrome can quantitatively assess the gland's elasticity.SWE can provide clincal evidence for diagnosis of sjogren syndrome.

Textural behavior of gels formed by rice starch and whey protein isolate: Concentration and crosshead velocities / Comportamento de textura de géis formados por amido de arroz e isolado proteico de soro: Concentrações e velocidades de teste

ABSTRACT Fabricated food gels involving the use of hydrocolloids are gaining polpularity as confectionery/convenience foods. Starch is commonly combined with a hydrocolloid (protein our polyssacharides), particularly in the food industry, since native starches generally do not have ideal properties for the preparation of food products. Therefore the texture studies of starch-protein mixtures could provide a new approach in producing starch-based food products, being thus acritical attribute that needs to be carefully adjusted to the consumer liking. This work investigated the texture and rheological properties of mixed gels of different concentrations of rice starch (15%, 17.5%, and 20%) and whey protein isolate (0%, 3%, and 6%) with different crosshead velocities (0.05, 5.0, and 10.0 mm/s) using a Box-Behnken experimental design. The samples were submitted to uniaxial compression tests with 80% deformation in order to determinate the following rheological parameters: Young's modulus, fracture stress, fracture deformation, recoverable energy, and apparent biaxial elongational viscosity. Gels with a higher rice starch concentration that were submitted to higher test velocities were more rigid and resistant, while the whey protein isolate concentration had little influence on these properties. The gels showed a higher recoverable energy when the crosshead velocity ​​was higher, and the apparent biaxial elongational viscosity was also influenced by this factor. Therefore, mixed gels exhibit different properties depending on the rice starch concentration and crosshead velocity.

RESUMO Géis fabricados que envolvem o uso de hidrocolóides estão ganhando polpularidade como alimentos de confeitaria/conveniência. O amido é geralmente combinado com um hidrocolóide (proteínas ou polissacarideos), particularmente na indústria de alimentos, uma vez que os amidos nativos geralmente não têm propriedades ideais para a preparação de produtos alimentares. Por conseguinte, os estudos de textura de misturas de amido-proteína podem proporcionar uma nova abordagem na produção de produtos alimentares à base de amido, sendo assim um atributo acrítico que precisa ser cuidadosamente ajustado ao gosto do consumidor. Este trabalho investigou as propriedades reológicas de textura de géis mistos de diferentes concentrações de amido de arroz (15%, 17,5% e 20%) e isolado proteico de soro (0%, 3% e 6%) com diferentes velocidades de teste (0,05, 5,0 e 10,0 mm/s) utilizando um delineamento experimental por Box-Behnken. As amostras foram submetidas a testes de compressão uniaxial com deformação de 80% para determinar os seguintes parâmetros reológicos: módulo de Young, tensão de fratura, deformação da fratura, energia recuperável e aparente viscosidade elongacional biaxial. Géis com maior concentração de amido de arroz e que foram submetidos a velocidades de teste mais altas mostraram-se mais rígidos e resistentes, enquanto que a concentração de isoldado proteico de soro teve pouca influência nessas propriedades. Os géis mostraram uma energia recuperável mais alta quando a velocidade de teste foi maior, e a viscosidade elongacional biaxial aparente também foi influenciada por este fator, exibindo propriedades diferentes dependendo da concentração de amido de arroz e da velocidade de teste.

Study on evaluation of prednisone in the treatment of Hashimoto′s thyroiditis by real-time shear wave elas-tography / 实用医学杂志

Objective To investigate the clinical application value of the real-time shear wave elastography (SWE)technology in the curative evaluation on Hashimoto′s thyroiditis(HT)patients treated with prednisone. Methods Applying SWE technology to determine the Young′s modulus value of thyroid tissue of 45 HT cases with subclinical hypothyroidism before and one month after treatment. Results 1 month after prednisone treat-ment,the Young′s modulus value and serum thyroid stimulating hormone(TSH),thyroid-peroxidase antibody (TPOAb)and thyroglobulin antibody(TGAb)were observed significantly changed before and one month after treatment(P < 0.05,respectively). The various modulus value was found reduced with different degrees,but the serum TSH was shown back to normal after the treatment with prednisone. Conclusions By quantitative determi-nation of Young′s modulus value,the hardness of organization information was obtained objectively,which could provide more meaningful reference basis to evaluate the treatment of prednisone for HT.

The effect of heterogeneity in different parts of deep venous thrombus on the ultrasound shear wave elasticity in rabbit / 中华医学超声杂志（电子版）

Objective To study the effect of heterogeneity in different parts of acute and chronic deep venous thrombus on the ultrasound shear wave elasticity value.Methods Fifteen Japanese rabbits were used to create an inferior vena cava (IVC) thrombus model via IVC ligation.Young's modulus of the thrombus head,body and tail were measured using ultrasonic shear wave elasticity technique on the fifth day (acute phase) and 14th day (chronic phase) of thrombus formation.Pathological sections were obtained from the IVC thrombus in five rabbits at the two points of time mentioned above.Pair t-test and one-way analysis of variance (ANOVA) were used to compare the data between groups.Results On the fifth day,Young's modulus values of the thrombus head,body and tail were (5.73 ±0.47)kPa,(7.82±0.63)kPa and (4.76±0.45)kPa respectively.ANOVA showed significant difference among three parts (F=134.468,P ＜ 0.01).The value of the thrombus body was significantly higher than that of the head and tail (both P ＜ 0.01),and the value of the head was significantly higher than that of the tail (P ＜ 0.01).On the 14th day,Young's modulus values of the thrombus head,body and tail were (12.46 ± 2.59)kPa,(15.08 ±2.71)kPa and (10.03 ± 2.02)kPa,respectively.ANOVA analysis also showed significant difference among three parts (F=10.539,P ＜ 0.01).The value of the thrombus body was significantly higher than that of the tail (P ＜ 0.01),and also higher than that of the head,although the difference was not significant (P ＞ 0.05).There was no significant difference between the head and tail (P ＞ 0.05).Young's modulus values of the thrombus head,body and tail in the chronic phase were significantly higher than those in the acute phase (t=-7.456,-7.989 and-8.159,respectively,all P ＜ 0.01).Pathological results showed that there was significant difference in thrombus structure and composition among different parts of the thrombus and among the thrombi in different individuals at corresponding points of time following thrombus formation.Conclusion There is significant heterogeneity among different parts of the same thrombus and among different thrombi at corresponding points of time after thrombus formation.Continual monitoring of the thrombus with ultrasound elasticity imaging may help to improve the accuracy of thrombosis staging.

Quantitative Analysis on Staging of Chronic Viral Hepatitis B and Hepatic Fibrosis by Real-time Shear Wave Elastography / 昆明医科大学学报

Objective To explore the application value of real-time shear wave elastography (SWE) technique in diagnosing and staging of chronic viral hepatitis B and hepatic fibrosis and to establish Young's modulus reference range for diagnosing and staging of hepatic fibrosis.Methods Forty-eight patients with chronic hepatitis B and fifty-eight healthy adults were enrolled and their Young's modulus values of S5 and S6 segments of liver were measured.Histopathologic examination was performed on 48 patients with chronic hepatitis B.Comparative analysis was conducted between the pathological findings and Young's modulus values,by means of which Young's modulus reference range for diagnosis and staging of hepatic fibrosis was obtained.Results There was significant difference in Young's modulus values of S5 and S6 segments of liver between chronic hepatitis B group and the normal control group (P＜0.05).Young's modulus values of S5 and S6 segments of liver in chronic hepatitis B group were (11.7 ± 2.9) kPa and (12.1 ± 3.2) kPa respectively,which were significantly higher than those in the normal control group,(5.7 ± 1.1) kPa and (5.8 ± 1.3) kPa respectively.Significant differences of Young's modulus values were detected in every staging of hepatic fibrosis (P＜0.05).S5 segment of liver Young's modulus values in S0-S4 stages were (5.8 ± 2.2) kPa,(7.3 ± 1.9) kPa,(10.3 ± 2.8) kPa,(10.3 ± 2.8) kPa,and (25.3 ± 3.6) kPa,respectively.S6 segment of liver Young's modulus values in S0-S4 stages were (5.7 ± 2.3) kPa,(9.2±2.1) kPa,(10.5±2.1) kPa,(14.7±4.5) kPa,and (26.1 ±2.1) kPa,respectively.Young's modulus value of the liver rose with the increase of S stage.Conclusion SWE technique can establish the Young's modulus reference range for hepatic fibrosis stage.Besides,it features high sensitivity,specificity and accuracy.

Effects of DSF/Cu on surface ultrastructures and mechanical properties of human breast cancer and normal breast epithelial cells / 中国病理生理杂志

AIM: To study the effects of disulfiram/copper complex (DSF/Cu) on ultrastructures and mechan-ical properties of human breast cancer and normal breast epithelial cells by atomic force microscopy (AFM) based on the nanoscale resolution and piconewton force measurement level.METHODS: The change of cell cycle and apoptotic rate of MCF-7 cells and MCF-10A cells induced by DSF/Cu were compared by flow cytometry.The cell surface morphology, ultra-structure, height, width and roughness were detected by AFM.The effects of DSF/Cu on the hardness (Young’s modu-lus) of the 2 kinds of cells were determined by AFM with indentation technique.RESULTS: DSF/Cu significantly in-duced apoptosis of the MCF-7 cells in a dose-dependent manner, whereas had little effect on the MCF-10A cells.The cell cycle analysis showed that DSF/Cu induced G2 /M arrest in the MCF-7 cells, but led to G0 /G1 arrest in the MCF-10A cells.The AFM images showed that the MCF-7 cells shrank and showed smaller and smoother morphology, and the filopo-dia were retracted obviously, even some became into lamellipodia, or disappeared completely after treated with DSF/Cu at concentrations of 400 and 800 nmol/L.The quantitative analysis indicated that the MCF-7 cells showed smaller width and larger height, and the root mean square roughness and average roughness were decreased significantly in a dose-dependent manner after treated with DSF/Cu at concentrations of 400 and 800 nmol/L.However, little effect in the MCF-10A cells was observed.The biomechanics test at a single cell level demonstrated that the Young’s modulus of the MCF-7 cells and MCF-10A cells were both increased, yet the proportion increased in the MCF-7 cells was much higher than that in the MCF-10A cells after treated with DSF/Cu at concentrations of 400 and 800 nmol/L.CONCLUSION: DSF/Cu has strong antitumor effect on breast cancer with high efficiency and low toxicity by changing the properties of the biomechanics specifically.

Renal ultrasound elastography can reflect clinical-pathological changes in chronic kidney disease patients / 中华肾脏病杂志

Objective To analyze how is the elastography of renal tissue correlated to clinical biochemical indexes and pathological changes in patients with chronic kidney disease (CKD), and toexplore the potential of renal elastography to become a new noninvasive method available for the dynamic monitoring of renal disease progression, as well as its efficacy assessment and prognosis evaluation. Methods Patients admitted to the department of nephrology of the First Affiliated Hospital of China Medical University and received renal biopsy from August 2014 to January 2015 were selected. One hundred and thirteen cases of CKD patients, 61 males and 52 females were enrolled, including 23 cases of IgA nephropathy, 39 cases of membranous nephropathy, 15 cases of minimal change nephropathy and 7 cases of focal segmental glomerulosclerosis. The Young modulus of renal cortex and medulla (YMcortex and YMmedul a) were detected by Aix Plorer type full digital color Doppler ultrasound. The correlations between the YMs and clinical biochemical indicators in blood and urine, and the difference of YMs among different pathological changes in patients with CKD were analyzed by statistics. Results The YMcortex and YMmedul a in CKD patients were higher than those in the control group (all P<0.05); and with the progression of CKD, the YMcortex and YMmedul a gradually increased. The YMcortex in CKD G5 patients was higher than that in CKD G1?3 patients (all P<0.05). The YMmedul a in CKD G3?5 patients was higher than that in CKD G1?2 patients (all P<0.05). The YMcortex was correlated with systolic pressure, serum creatinine, cystatin C, serum albumin, serum phosphorus, calcium and phosphorus product, uric acid, intact parathyroid hormone (iPTH), urinary NAG, estimate glomerular filtration rate (eGFR) and hemoglobin (all P<0.05). The YMmedul a was correlated with systolic pressure, serum creatinine, serum albumin, uric acid, iPTH, urine microalbumin (MA), urinary NAG and hemoglobin (all P<0.05). Serum cystatin C (β=0.485, P=0.018) and uric acid (β=0.418, P=0.039) were independently correlated with the YMcortex. Serum creatinine (β=0.380, P=0.019), uric acid (β=0.482, P=0.004) and smoking (β=0.337, P=0.009) were independently correlated with YMmedul a. The YMcortex and YMmedul a in different pathological types were statistically significant (P<0.001, P=0.003). The YMcortex and YMmedul a in patients with membranous nephropathy and IgA nephropathy were higher than those in the patients with minimal change nephropathy (all P<0.05). The YMmedul a in patients with focal segmental glomerulosclerosis was higher than that in the patients with minimal change nephropathy (P<0.05). The YMcortex in the patients with phases Ⅳ and Ⅴ based on the Lee grading system of IgA nephropathy was higher than that in the patients with phases Ⅱ andⅢ (P<0.05). According the Oxford classification for IgA nephropathy, the YMcortex and YMmedul a in the T1 and T2 patients were higher than those in the T0 patients (P<0.05). The YMcortex and YMmedul a showed no statistically significant differences among different stages of membranous nephropathy. Conclusions The YMcortex and YMmedul a are associated with the progress of renal insufficiency, which may become new indicators for determining CKD progression. The renal ultrasound elastography may become a new non?invasive method for early diagnosing CKD, dynamic monitoring disease progression, and assessing efficacy and prognosis.

Evaluation of polymethyl methacrylate resin mechanical properties with incorporated halloysite nanotubes

PURPOSE: This study inspects the effect of incorporating halloysite nanotubes (HNTs) into polymethyl methacrylate (PMMA) resin on its flexural strength, hardness, and Young's modulus. MATERIALS AND METHODS: Four groups of acrylic resin powder were prepared. One group without HNTs was used as a control group and the other three groups contained 0.3, 0.6 and 0.9 wt% HNTs. For each one, flexural strength, Young's modulus and hardness values were measured. One-way ANOVA and Tukey's test were used for comparison (P<.05). RESULTS: At lower concentration (0.3 wt%) of HNT, there was a significant increase of hardness values but no significant increase in both flexural strength and Young's modulus values of PMMA resin. In contrast, at higher concentration (0.6 and 0.9 wt%), there was a significant decrease in hardness values but no significant decrease in flexural strength and Young's modulus values compared to those of the control group. CONCLUSION: Addition of lower concentration of halloysite nanotubes to denture base materials could improve some of their mechanical properties. Improving the mechanical properties of acrylic resin base material could increase the patient satisfaction.

Effect of Low Shrinkage Monomers on Physicochemical Properties of Dental Resin Composites

The aim of this study was to evaluate the effect of low shrinkage monomers on physicochemical properties of dental resin composites. Two low shrinkage resin composites: one with a crosslink branching monomer (Kalore, GC Corp) and a novel monomer (Venus Diamond, Heraeus Kulzer) were compared to a conventional resin composite formulation (Filtek Z250, 3M/ESPE). The volumetric shrinkage was evaluated by µCT analysis (n=5) and the physicochemical properties by degree of C=C conversion (DC), flexural strength (FS) and Young's modulus (YM) (n=10). All samples were light cured by a LED device (Radii, SDI) with 16 J/cm2. The results were analysed by one-way ANOVA and Tukey test for multiple comparisons (α=0.05). No statistical difference was found between µCT shrinkage values to Kalore (1.8%) and Venus Diamond (1.7%) (p≥0.05); Z250 presented statistical highest shrinkage value (2.0%). Kalore presented higher statistical DC (60.8%) than Venus Diamond (49.5%) and Z250 (49.6%). No statistical difference was found between FS or YM properties to Venus Diamond and Z250; Kalore presented statistical lowest FS and YM properties (p≥0.05). Conclusion: Using novel monomers seem to reduce polymerization shrinkage without affecting the physicochemical properties evaluated of resin composites rather than using crosslink branching monomers.

O objetivo deste trabalho foi avaliar o efeito de monômeros de baixa contração de polimerização nas propriedades físico-químicas de resinas compostas. Duas resinas de baixa contração de polimerização com monômeros do tipo crosslink (Kalore GC Corp) ou do tipo novelar (Venus Diamond Heraeus Kulzer) foram comparadas a uma resina composta convencional (Filtek Z250 3M/ESPE). A contração de polimerização foi avaliada através da análise por µCT (n=5) e as propriedades físico-químicas através da análise do grau de conversão C=C (GC) resistência flexural (RF) e módulo de Young (MY) (n=10). Todas as amostras foram fotoativadas com uma fonte de LED (Radii SDI) com 16 J/cm2. Todos os resultados foram submetidos aos testes de análise de variância de 1 fator e ao teste de Tukey para comparações múltiplas (α=0,05). Nenhuma diferença estatística foi encontrada para os valores de contração de polimerização para Kalore (1,8 %) e Venus Diamond (1,7 %) (p≥0,05). Z250 apresentou estatisticamente maior contração de polimerização (2,0%). Kalore apresentou estatisticamente maior GC (60,8%) que Venus Diamond (49,5%) e Z250 (49,6%). Nenhuma diferença estatística foi encontrada para as propriedades RF e MY entre Venus Diamond e Z250. Kalore apresentou os menores valores estatisticos para FS e MY (p≥0,05). O monômero novelar parece reduzir a contração de polimerização sem afetar as propriedades físico-químicas avaliadas das resinas compostas de forma mais adequada que a utilização de monômeros do tipo crosslinker.

Characterization of atherosclerotic plaque components and identification of vulnerablity by shear wave elastography:in vivo study on a rabbit model / 中华超声影像学杂志

Objective To investigate the value of shear wave elastography (SWE)on characterizing components and identifying the vulnerability of atherosclerotic plaques in vivo on a rabbit model.Methods The accuracy,as well as the inter-and intra-observer variance of quantifying the Young's modulus by SWE technique was first evaluated with the CIRS? phantoms as the golden standard.Animal model was developed by abdominal aorta endothelium denudation and high-cholesterol diet for 24 weeks on 20 purebred New Zealand rabbits.SWE images of atherosclerotic plaques found in the abdominal aortas were acquired in situ to acquire the Young's modulus.Then the plaques were harvested and matched with the distance between the right renal artery and the plaques recorded during SWE imaging.Histological slices were stained for fat,collagen,smooth muscle cells (SMC)and macrophages by Oil O red,picric Sirius red and anti-α-SMC,anti-RAM-1 1 immunohistology.Vulnerability index was also calculated as the percentage of (macrophage+fat)/(smooth muscle cell+collagen ).The correlation between the Young's modulus and plaque components and vulnerability index was analyzed.The value of SWE on differentiating plaque types was evaluated by ROC analysis.Results High agreement was found between the estimated Young's modulus by SWE and the gold standard.The coefficient of variant of inter-and intra-observer was very low at the range of 1.0%-3.8%.Ten fatty and twenty fibro-fatty plaques were obtained,totally.The maximal and mean Young's moduli of the fatty plaque were (49.90±22.95)kPa and (40.15±22.60)kPa,which were lower than those of the fibro-fatty plaques [(88.49±37.27)kPa and (72.93±29.21)kPa,respectively].The maximal Young's modulus obtained by SWE correlated positively with collagen and SMC (r =0.567 and 0.561,respectively with P <0.001),and negatively with fat and macrophage infiltration (r =-0.542 and-00.482,respectively with P <0.005).The mean Young's modulus also correlated positively with collagen and SMC (r=0.532 and 0.550,respectively with P <0.05),and negatively with fat and macrophage (r=-0.527 and -0.421,respectively with P <0.05).The same inclination could be observed between the minimal Young's modulus and the above components without statistical significance.Both the maximal and the mean Young's modulus correlated negatively with the vulnerable index (r =-0.620 and -0.619, respectively with P <0.001 ).ROC analysis revealed high sensitivity (85%)and specificity (80%)for differentiating fatty plaques from fibro-fatty plaques by Young's modulus.Conclusions SWE can be used for estimation of the Young's modulus of atherosclerotic plaques with high accuracy and reproducibility. Good correlation is evidenced between the Young's modulus and plaque components and vulnerability.Fatty and fibro-fatty plaques can be differentiated by Young's modulus with high sensitivity and specificity.Thus, SWE technique is promising for identifying vulnerable plaques.

Comparison of the liver Young's modulus value range of cirrhotic patients with different etiologies by real-time ;shear wave elastography / 中华超声影像学杂志

Objective To analyze the difference of Young's modulus between cirrhotic patients with different etiologies.Methods There were 1 99 patients with decompensated cirrhosis enrolled in this study, all of them had been diagnosed clinically.There were 139 cases of hepatitis B patients with cirrhosis,26 cases of hepatitis C patients with liver cirrhosis,34 cases of patients with alcoholic cirrhosis,and selected 50 healthy volunteers as control group in the same period.All subj ects underwent liver shear wave elastography examination,measured and recorded the Young's modulus,and compared the difference between each groups.Results The Young's modulus of liver in the healthy control group was (4.81±0.9)kPa,which was lowest in all groups.The Young's modulus of hepatitis B cirrhosis,hepatitis C cirrhosis,alcoholic cirrhosis increased successively,which was (16.3±8.9)kPa,(17.8±4.8)kPa,(30.6±12.3)kPa,respectively,and the difference between the groups was statistically significant(F =27.95,P <0.01).Conclusions There were some differences of the Young's modulus of cirrhotic patients with different etiologies by real-time shear wave elastography.