Accuracy of duplex ultrasonography versus angiotomography for the diagnosis of extracranial internal carotid stenosis / Acurácia da ultrassonografia duplex comparada à angiotomografia para o diagnóstico de estenose de carótida interna extracraniana

ABSTRACT Introduction: Internal carotid artery (ICA) stenosis causes about 15% of ischemic strokes. Duplex ultrasonography (DUS) is the first line of investigation of ICA stenosis, but its accuracy varies in the literature and it is usual to complement the study with another more accurate exam when faced with significant stenosis. There is a lack of studies that compare DUS with angiotomography (CTA) in the present literature. Methods: we performed an accuracy study, which compared DUS to CTA of patients in a tertiary hospital with a maximum interval of three months between tests. Patients were selected retrospectively, and two independent and certified vascular surgeons evaluated each image in a masked manner. When there was discordance, a third evaluator was summoned. We evaluated the diagnostic accuracy of ICA stenosis of 50-94% and 70-94%. Results: we included 45 patients and 84 arteries after inclusion and exclusion criteria applied. For the 50-94% stenosis range, DUS accuracy was 69%, sensitivity 89%, and specificity 63%. For the 70-94% stenosis range, DUS accuracy was 84%, sensitivity 61%, and specificity 93%. There was discordance between CTA evaluators with a change from clinical to surgical management in at least 37.5% of the conflicting reports. Conclusion: DUS had an accuracy of 69% for stenoses of 50-94% and 84% for stenoses of 70-94% of the ICA. The CTA analysis depended directly on the evaluator with a change in clinical conduct in more than 37% of cases.

RESUMO Introdução: a estenose da artéria carótida interna (ACI) causa cerca de 15% dos acidentes vasculares cerebrais isquêmicos. A ultrassonografia duplex (USD) é a primeira linha de investigação da estenose de ACI, mas sua acurácia varia na literatura e é comum complementar o estudo com outro exame de maior acurácia diante de estenose significativa. Há uma escassez de estudos que comparem a USD com a angiotomografia computadorizada (ATC) na literatura atual. Métodos: realizamos um estudo de acurácia, que comparou a USD à ATC de pacientes de um hospital terciário com um intervalo máximo de três meses entre os exames. Os pacientes foram selecionados retrospectivamente e dois cirurgiões vasculares independentes e certificados avaliaram cada imagem de maneira mascarada. Quando houve discordância, um terceiro avaliador foi convocado. Avaliou-se a precisão diagnóstica da estenose da ACI de 50-94% e 70-94%. Resultados: foram incluídos 45 pacientes e 84 artérias após a aplicação dos critérios de inclusão e exclusão. Para a faixa de estenose de 50-94%, a acurácia da USD foi 69%, sensibilidade 89% e especificidade 63%. Para a faixa de estenose de 70-94%, a acurácia da USD foi 84%, sensibilidade 61% e especificidade 93%. Ocorreu discordância entre avaliadores da ATC com mudança de conduta clínica para cirúrgica em pelo menos 37,5% dos laudos conflitantes. Conclusão: a USD teve uma acurácia de 69% para estenoses de 50-94% e de 84% para estenoses de 70-94% da ACI. A análise das ATC dependeu diretamente do avaliador com mudança de conduta clínica em mais de 37% dos casos.

Duplex ultrasound and pedal acceleration time as tools to evaluate foot perfusion: a literature review / Ultrassonografia dúplex e tempo de aceleração plantar como ferramentas para avaliar a perfusão do pé: uma revisão da literatura

Abstract Currently, the standard non-invasive test for diagnosing Peripheral Arterial Disease is the Ankle-Brachial Index. However, this test becomes unfeasible in a certain population. New evidence proposes the pedal acceleration time, an ultrasound index, as an alternative test. An integrative bibliographic review was carried out between June 3, 2022 and January 8, 2023, to investigate this new index as a tool to assess foot perfusion. Papers published in English, Portuguese, or Spanish between 2012 and 2022 were searched on PubMed, Google Scholar, and Scielo, using the keywords "Peripheral Arterial Disease" AND "Acceleration Time" AND (Pedal OR Plantar). Research that didn't assess foot perfusion using the methods of interest or did not present human data and also case series or reports were excluded. Seven out of the sixty-six articles identified in the searches were selected for the review, all of which had notable methodological limitations. Pedal acceleration time seems to be able to diagnose and stratify and may reflect prognosis.

Resumo Atualmente, o teste não invasivo padrão para diagnosticar a doença arterial periférica é o índice tornozelo-braquial, porém, em uma determinada população, este torna-se inviável. Novas evidências propõem o tempo de aceleração plantar, que é um índice ultrassonográfico, como alternativa. Para investigá-lo no contexto do estudo da perfusão do pé, uma revisão bibliográfica integrativa foi realizada entre 03/06/2022 e 08/01/2023. Artigos em inglês, português ou espanhol, publicados entre 2012 e 2022 foram pesquisados através das ferramentas PubMed, Google Scholar e SciELO, com as palavras-chave "Peripheral Arterial Disease" AND "Acceleration Time" AND (Pedal OR Plantar). Pesquisas que não avaliaram a perfusão do pé pelos métodos de interesse, sem dados em humanos e relatos ou séries de casos, foram excluídos. Dos 66 artigos, 7 foram selecionados; todos com notáveis limitações metodológicas. O tempo de aceleração plantar aparenta ser capaz de diagnosticar, estratificar e prognosticar os doentes.

Efficacy of low intensity pulsed ultrasound in the treatment of erectile dysfunction / 现代泌尿外科杂志

【Objective】 To investigate the efficacy of low intensity pulsed ultrasound (LIPUS) in the treatment of erectile dysfunction (ED). 【Methods】 A total of 121 ED patients treated during June 2020 and June 2022 were selected as the research objects. According to the International Erectile Index Score (IIEF-EF), the patients were divided into three subgroups:mild (17-25 points), moderate (11-16 points), and severe (0-10 points). The total effective rate, erectile hardness scale (EHS), sex life log questions (SEP), general assessment questionnaire (GAQ), peak systolic velocity (PSV), end diastolic velocity (EDV), and adverse reactions of the three groups before treatment, 4 weeks and 12 weeks after treatment were analyzed. 【Results】 A total of 119 patients completed the follow-up. There were significant increases in IIEF-EF and EHS at week 4 and 12 (P<0.05), and the total effective rate was 69.75% and 76.47%, respectively. The total effective rate was significantly higher in the mild and moderate groups than in the severe group at week 4 and 12 (P<0.05). The patients who answered "yes" to SEP2 and SEP3 accounted for 91.60% and 71.43%, respectively at week 4, and 92.44% and 78.15% at week 12, both significantly higher than the rates before treatment (52.10% and 27.73%, P<0.05). The proportion of patients who answered "yes" to GAQl and GAQ2 at week 4 were 84.87% and 71.43%, respectively, and were 82.35% and 70.59% respectively at week 12, with no significant difference. The PSV level significantly increased at week 12 compared to that before treatment [(48.85±14.11) cm/s vs. (41.42±14.90) cm/s] (P<0.05), while the EDV level significantly decreased [(-0.57±7.01) cm/s vs. (2.25± 5.68)cm/s] (P<0.05). 【Conclusion】 LIPUS can improve erectile function in ED patients without obvious adverse reactions.

Evaluation of stability of Luc2P reporter cell lines by duplex digital PCR / 中国生物制品学杂志

@#Objective To develop a duplex digital PCR(dPCR) for evaluation of the stability of luciferase(Luc) gene in Luc2P reporter cell lines(CHO-K1,Hacat,HEK293 and UT7).Methods Genomic DNAs of Luc2P reporter cell lines were extracted,a duplex dPCR was developed to determine the copies of reference gene RPP30 and the target gene Luc,and the relative copy number of Luc(copies Luc/copy RPP30) was employed as the indicator for the stability evaluation of Luc gene;The developed method was verified for the specificity,precision,linearity,accuracy and durability,and analyzed for the applicability,according to the related requirements in Chinese Pharmacopoeia(Volume Ⅲ,2020 edition).Results All the original cells without reporter gene transfection were negative,while all the four reporter cell lines were positive,and the negative and positive regions in dPCR results were clearly distinguished;The relative standard deviation(RSD) of the eight repeated detections of the same genomic DNA sample and the six independent extractions of genomic DNA sample of the same cell were all less than 10%,and the linear fitting R~2 values were more than 0.99 for both Luc and RPP30.The spike recoveries of five groups of samples detected by the developed method were between 50% and 100%,and the results of chip-type dPCR and droplet-type dPCR were consistent.This method distinguished the relative copy number of Luc in different cell clones,and the results of detecting the relative copy number of Luc in three passages(P8,P12 and P31) were highly consistent.Conclusion The developed duplex dPCR method has good specificity,precision,linearity,accuracy,durability and applicability,and might be used to evaluate the stability of Luc gene in Luc2P reporter cell lines.

Safety of robot-assisted laparoscopic and laparoscopic heminephrectomy: a meta analysis / 现代泌尿外科杂志

【Objective】 To analyze the differences in efficacy of heminephrectomy with robot-assisted laparoscopy (RARN) and laparoscopic radical nephrectomy (LRN). 【Methods】 The published references in national and international databases on the comparison of clinical outcomes between heminephrectomy RARN and LRN for kidney neoplasms were searched. References were screened strictly according to PICOS criteria, and data including estimated amount of blood loss, operation time, length of hospital stay and complications were extracted from those that met the requirements. Sensitivity analysis was used to eliminate the included articles one by one to confirm the robustness of the results, and funnel plot and Eggers test were used to explore publication bias. 【Results】 A total of 16 studies involving 2 063 patients (1 097 in RARN group and 966 in LRN group) were included. The RARN group had less intraoperative blood loss and shorter hospital stay, but there were no significant differences between the two methods (P>0.05). The incidence of postoperative complications in RARN group was lower than that in LRN group (OR: 0.643, 95%CI: 0.467-0.886, P=0.007). 【Conclusion】 Compared with LRN, RARN has better control of complications in the treatment of renal tumor, but the overall effects of intraoperative bleeding, operation time, and hospital stay are comparable.

A duplex probe-directed recombinase amplification assay for detection of single nucleotide polymorphisms on 8q24 associated with prostate cancer

Single nucleotide polymorphisms (SNPs) have important application value in the research of population genetics, hereditary diseases, tumors, and drug development. Conventional methods for detecting SNPs are typically based on PCR or DNA sequencing, which is time-consuming, costly, and requires complex instrumentation. In this study, we present a duplex probe-directed recombinase amplification (duplex-PDRA) assay that can perform real-time detection of two SNPs (rs6983267 and rs1447295) in four reactions in two tubes at 39°C within 30 min. The sensitivity of duplex-PDRA was 2×103-104 copies per reaction and no cross-reactivity was observed. A total of 382 clinical samples (179 prostate cancer patients and 203 controls) from northern China were collected and tested by duplex-PDRA assay and direct sequencing. The genotyping results were completely identical. In addition, the association analysis of two SNPs with prostate cancer risk and bone metastasis was conducted. We found that the TT genotype of rs6983267 (OR: 0.42; 95%CI: 0.23-0.78; P=0.005) decreased the risk of prostate cancer, while the CA genotype of rs1447295 (OR: 1.89; 95%CI: 1.20-2.96; P=0.005) increased the risk of prostate cancer. However, no association between the two SNPs (rs6983267 and rs1447295) and bone metastasis in prostate cancer was found in this study (P>0.05). In conclusion, the duplex-PDRA assay is an effective method for the simultaneous detection of two SNPs and shows great potential for widespread use in research and clinical settings.

Application value of contrast-enhanced ultrasound combined with thyroid imaging reporting and data system classification in the differential diagnosis of benign and malignant thyroid nodules / 中国基层医药

Objective:To investigate the application value of contrast-enhanced ultrasound (CEUS) combined with thyroid imaging reporting and data system (TI-RADS) classification in the differential diagnosis of benign and malignant thyroid nodules.Methods:The clinical data of 157 thyroid nodules from 122 participants who underwent conventional ultrasound and CEUS examination from January 2016 to January 2017 in the First Hospital of Shanxi Medical University, China were collected. The image features were analyzed for conventional ultrasound and TI-RADS classification. According to CEUS results, the thyroid nodules were classified by TI-RADS. Based on pathological results, the efficacy of CEUS combined with TI-RADS classification versus conventional ultrasound combined with TI-RADS classification in the differential diagnosis of benign and malignant thyroid nodules was investigated. Results:The area under the curve of CEUS combined with TI-RADS classification (AUC = 0.900) was greater than that of conventional ultrasound combined with TI-RADS classification (AUC = 0.808). The sensitivity, specificity, accuracy, positive and negative predictive values of conventional ultrasound combined with TI-RADS classification in the differential diagnosis of benign and malignant thyroid nodules were 81.6% (80/98), 67.8% (40/59), 76.4% (120/157), 80.8% (80/99), 68.9% (40/58), respectively. They were 98.0% (96/98), 78.0% (34/59), 90.4% (142/157), 88.1% (96/109), 95.8% (46/48), respectively for CEUS combined with TI-RADS classification. The sensitivity of CEUS combined with TI-RADS classification in the differential diagnosis of benign and malignant thyroid nodules was significantly higher than that of conventional ultrasound combined with TI-RADS classification ( χ2 = 12.50, P < 0.001). Conclusion:CEUS combined with TI-RADS classification is more effective in the differential diagnosis of benign and malignant thyroid nodules than conventional ultrasound combined with TI-RADS classification.

Comportamiento ante el desgaste por deslizamiento en seco del acero inoxidable súper dúplex en un tribómetro bola sobre anillo / Dry sliding wear behavior of super duplex stainless steel in a ball on ring tribometer

RESUMEN En el presente trabajo se realiza la caracterización del comportamiento ante el desgaste por deslizamiento en seco de un acero inoxidable súper dúplex. Los ensayos fueron desarrollados en un tribómetro tipo bola sobre anillo. Como material del anillo se empleó el acero inoxidable dúplex tipo SAF 2507 sin tratamiento térmico y como material para la bola se usó el acero AISI 52100. Los ensayos se realizaron sin lubricante en condiciones de ambiente (aire), temperatura y humedad estándar de laboratorio. Los parámetros seleccionados, a fin de estudiar sus efectos en el coeficiente desgaste por deslizamiento, fueron: velocidad de deslizamiento (0,9 m/s y 2 m/s), carga normal (9 N, 19 N y 29 N) y distancias de deslizamiento (500 m, 1000 m y 2000 m). Se empleó un diseño experimental de Taguchi con nueve tratamientos y dos réplicas. En la caracterización del acero SAF 2507 se obtuvo valores del coeficiente de desgaste en el intervalo desde 0,19588 x 1012 m2/N hasta 0,72381 x 1012 m2/N, para las condiciones evaluadas. El factor que más afecta el coeficiente de desgaste es la velocidad de deslizamiento. El mecanismo de desgaste identificado para el SAF 2507 es de adhesión y delaminación de alta velocidad.

ABSTRACT In this paper the characterization of the behavior during dry sliding wear of a super duplex stainless steel was performed. The tests were developed in a ball on ring tribometer type. As material of the ring is used the duplex stainless steel type SAF 2507 without heat treatment and as material for the ball is used the steel AISI 52100. Tests were conducted without lubrication in ambient conditions (air), temperature and humidity laboratory standard was used. The parameters selected in order to study its effects on sliding wear coefficient were: sliding speed (0.9 m/s and 2 m/s), normal load (9 N, 19 N and 29 N) and distances slip (500 m, 1000 m and 2000 m). Taguchi experimental design with nine treatments and two replicates was used. In the characterization of steel SAF 2507 wear coefficient values was obtained in the range from 0.19588 x 10-12 m2/N to 0.72381 x 10-12 m2/N, for the conditions tested. The factor that most affects the wear coefficient is the sliding velocity. The wear mechanism identified for the SAF 2507 was adhesion and high speed delamination.

Reducing ultrasound in diagnosing deep vein thrombosis by using clinical scores and D-dimer testing

Background: To reduce unnecessary venous ultrasound examination in cases suspected to have deep venous thrombosis (DVT) in emergency department by using D dimer and wells score. venous duplex is widely used to diagnose DVT increasing burden on ultrasound in overcrowded emergency department. Authors can decrease this burden by using clinical probability scores and D dimer.Methods: This is prospective study done on 50 consecutive patients suspected to have DVT represented to emergency department of   Menoufia University Hospital during the period from June 2018 to June 2019. Full history, physical examination, assessment of clinical probability score, d dimer level and results of venous duplex collection.Results: According to wells score, the majority of cases diagnosed as DVT were of high probability group 13(68.4%), 5 patients with moderate probability and only one patient with low probability was diagnosed as DVT. The mean of D dimer level in cases diagnosed as DVT is (4173.6±2173.1) and in cases without DVT is (927.4±1064.6). Using wells score and D dimer together, sensitivity is 100%, Specificity is 94%. PPV is 90%, and NPV is 100% in predicting DVT. All cases with negative d dimer and low risk probability do not have DVT.Conclusions: Based on this result, using wells score and d dimer level in early work up of patients suspected to have DVT will decrease overusing and cost of venous duplex.

Duplex kidney anomalies and associated pathology: a single centre retrospective review

Background: Duplex kidneys are common developmental renal anomaly with an incidence of 1% in healthy adult population.Adult individuals may present as non-functional moiety, calculus disease or an incidental finding. Duplex kidney is defined as a renal unit comprised of two pelvicalyceal systems. Based on the degree of fusion, it can present as bifid renal pelvis, partial ureteric duplication (Y-shaped ureter), incomplete ureteric duplication with ureters joining near or in bladder wall (V-shaped ureter) and complete ureteric duplication with separate ureteric orifices. The purpose of this study is to retrospectively review the various duplex kidney anomalies and associated pathology.Methods: This is a retrospective study, performed at Department of Urology, Gauhati Medical College Hospital, a tertiary centre, from September, 2018 to August, 2019. Preoperative imaging, plain intravenous urography or computed tomography intravenous urography was done.Results: 29 patients were diagnosed with variants of duplex kidney anomaly. It includes right side, left side and bilateral anomalies. Among all the patients 4 had incidental findings. 16 patients had associated renal or ureteral calculus. 5 patients had associated ureteropelvic junction obstruction while 1 patient had ureterovesical junction stricture. We found single patient in each group of duplex kidney anomaly associated with non-functional moiety with renal cell carcinoma, ureterocele with urothelial malignancy and horseshoe kidney with ureteropelvic junction obstruction respectively.Conclusions: Duplex kidney anomaly in most individuals is of no clinical significance. High index of suspicion along with good quality imaging can accurately detect specific anomaly and associated condition.

Avaliação das artérias podais ao eco-Doppler / Assessment of the pedal arteries with Duplex Scanning

Resumo A ultrassonografia vascular com Doppler é um método não invasivo útil no diagnóstico e planejamento terapêutico da doença oclusiva das artérias podais. A artéria pediosa dorsal é a continuação direta da artéria tibial anterior e tem trajeto retilíneo no dorso do pé, dirigindo-se medialmente ao primeiro espaço intermetatarsiano, onde dá origem a seus ramos terminais. A artéria tibial posterior distalmente ao maléolo medial se bifurca e dá origem às artérias plantar lateral e plantar medial. A plantar medial apresenta menor calibre e segue medialmente na planta do pé, enquanto a plantar lateral é mais calibrosa, seguindo um curso lateral na região plantar e formando o arco plantar profundo, o qual se anastomosa com a artéria pediosa dorsal através da artéria plantar profunda. A avaliação das artérias podais pode ser realizada de maneira não invasiva com exame de eco-Doppler, com adequado nível de detalhamento anatômico.

Abstract Vascular Doppler ultrasound is a noninvasive method that can help in diagnostic and therapeutic planning in case of pedal arterial obstructive disease. The dorsalis pedis artery is the direct continuation of the anterior tibial artery and follows a straight course along the dorsum of the foot, leading medially to the first intermetatarsal space, where it gives off its terminal branches. The posterior tibial artery forks distal to the medial malleolus and gives rise to the lateral plantar and medial plantar arteries. The medial plantar artery has a smaller caliber and runs medially in the sole of the foot, while the lateral plantar artery is of larger caliber, following a lateral course in the plantar region and forming the deep plantar arch, which anastomoses with the dorsalis pedis artery via the deep plantar artery. The arteries of the foot can be assessed noninvasively with Doppler, providing an adequate level of anatomical detail.

Inversão total do fluxo em artéria carótida interna direita em paciente com estenose grave do tronco braquiocefálico / Total reversal of internal carotid blood flow in a patient with severe stenosis of the brachiocephalic trunk

RESUMO As estenoses graves e oclusões do tronco braquiocefálico (artéria inominada) são raras, e apresentam uma grande variedade de manifestações clínicas, com alterações relacionadas a isquemia cerebral hemisférica, vertebrobasilar e de membro superior direito. A causa mais comum é a aterosclerose. A ultrassonografia vascular com Doppler pode revelar inversão de fluxo na artéria vertebral direita, hipofluxo na subclávia, e vários tipos de alterações no fluxo da carótida direita, incluindo hipofluxo, inversão parcial do fluxo durante o ciclo cardíaco, e até mesmo inversão completa do fluxo na carótida interna, achado este bastante raro. Os autores descrevem o caso de paciente do sexo feminino, tabagista, com estenose grave do tronco braquiocefálico e crises de lipotimia. Além do roubo de artéria subclávia e do fluxo parcialmente invertido na carótida comum direita, a paciente apresentava exuberante fluxo invertido na carótida interna durante todo o ciclo cardíaco, achado este não encontrado na literatura em tamanha magnitude.

ABSTRACT Occlusions and severe stenoses of the innominate artery (brachiocephalic trunk) are rare and present with a wide variety of clinical manifestations, with hemispheric, vertebrobasilar and right upper limb ischemic symptoms. The most common cause is atherosclerosis. Duplex scanning may show right vertebral artery flow reversal, diminished subclavian flow, and several patterns of right carotid flow disturbance, including slow flow, partial flow reversal during the cardiac cycle and even complete reversal of flow in the internal carotid artery, which is a very uncommon finding. Herein, the authors describe the case of a female patient who was a heavy smoker, had severe stenosis of the brachiocephalic trunk, and had episodes of collapse. Besides the subclavian steal and partial flow reversal in the common carotid artery, duplex scanning also showed high-velocity reversed flow in the internal carotid artery during the entire cardiac cycle, a finding that is not reported in the literature at this magnitude.

A case report of duplex kidney and ureter abnormality accompanied with lower giant hydronephrosis / 中华泌尿外科杂志

Duplex kidney and ureter abnormality are one of the most common malformation in urinary system,with most of patients present no apparent symptom,and only a few patients being complicated by ureter obstruction and serious hydronephrosis,which is difficult to differentiate with renal cyst.Therefore a case with duplex kidney and ureter abnormality was reported to provide information for clinical practice.

A new method for simultaneous quantitative determination of hepatitis B virus pregenomic RNA and DNA / 第二军医大学学报

Objective To design and establish a new method for simultaneous determination of hepatitis B virus (HBV) pregenomic RNA (pgRNA) and DNA from nucleic acid extracts. Methods We established a duplex fluorescence quantitative PCR system to determine HBV pgRNA and DNA. DNA gel electrophoresis and quantitative PCR were used to test the specificity and sensitivity. We tested the feasibility and accuracy by determining the HBV pgRNA and DNA in HepG2.2.15 cells and the culture supernatants. Results The established duplex fluorescence quantitative PCR system has a good specificity and sensitivity. When it was used to determine cell culture supernatants with different dilution ratios, the dilution ratios and results were well correlated. However, this method was more suitable for the determination of HBV pgRNA and DNA in cell culture supernatants, rather than cell samples. Conclusion Our method can avoid inaccuracy of HBV RNA determination caused by HBV DNA contaminant in nucleic acid extracts, and realize simultaneous detection of HBV pgRNA and DNA in one PCR reaction, which greatly improves the determination efficiency and has potential clinical application value..

SinoDuplex: An Improved Duplex Sequencing Approach to Detect Low-frequency Variants in Plasma cfDNA Samples / 基因组蛋白质组与生物信息学报·英文版

Accurate detection of low frequency mutations from plasma cell-free DNA in blood using targeted next generation sequencing technology has shown promising benefits in clinical settings. Duplex sequencing technology is the most commonly used approach in liquid biopsies. Unique molecular identifiers are attached to each double-stranded DNA template, followed by production of low-error consensus sequences to detect low frequency variants. However, high sequencing costs have hindered application of this approach in clinical practice. Here, we have developed an improved duplex sequencing approach called SinoDuplex, which utilizes a pool of adapters containing pre-defined barcode sequences to generate far fewer barcode combinations than with random sequences, and implemented a novel computational analysis algorithm to generate duplex consensus sequences more precisely. SinoDuplex increased the output of duplex sequencing technology, making it more cost-effective. We evaluated our approach using reference standard samples and cell-free DNA samples from lung cancer patients. Our results showed that SinoDuplex has high sensitivity and specificity in detecting very low allele frequency mutations. The source code for SinoDuplex is freely available at https://github.com/SinOncology/sinoduplex.

Índice Ventricular De Levene Y Mensuración Del Tercer Ventrículo En Neonatos Ecuatorianos Mediante Ecografía Cerebral / Levene Ventricular Index And Measurement Of The Third Ventricle In Ecuadorian Neonates By Means Of Cerebral Ultrasound

Resumen Introducción: La aplicación del ultrasonido en la evaluación cerebral del neonato posibilita la mensuración de estructuras cerebrales. Objetivo: El objetivo de este trabajo es obtener las medidas del III ventrículo y del índice de Levene en un grupo de recién nacidos ecuatorianos, con la finalidad de determinar valores de normalidad que puedan ser utilizados en el trabajo diario del servicio de neonatología. Métodos: Se seleccionó un grupo de neonatos sin alteraciones neurológicas. A través de la fontanela anterior se determinó el índice de Levene. La mensuración del diámetro del III ventrículo se realizó a través de la ventana craneal temporal. Resultados: Se incluyeron en el estudio 66 pacientes con edad post menstrual de 37 semanas (rango 27-42 semanas), predominó el sexo masculino. El peso promedio al nacer fue de 2554 gramos. El valor medio del diámetro del III ventrículo es de 1,5 mm, rango entre 0,5 mm - 3,8 mm. El índice de Lindergaard promedio fue de 12,7 mm (8,2-27 mm). Tanto el diámetro del tercer ventrículo como el índice ventricular se vieron afectados por el peso al nacer. En relación con el momento del parto no existió diferencia significativa en el tamaño ventricular. Conclusiones: Comparado con los resultados de otras series nuestro estudio ofrece parámetros diferentes.

Abstract Introduction: The application of ultrasound in the brain evaluation of the neonate allows the measurement of brain structures. Objective: To obtain the sizes of the third ventricle and the ventricular index of Levene in a group of Ecuadorian neonates without neurological alterations. To establish normal ranges that can be used in the daily work of the neonatology service. Methods: A group of neonates without neurological alterations was studied. Through the anterior fontanelle, the Levene index was determined. The third ventricle's diameter was seized through the temporal cranial window. Results: Sixty-six patients of 37 weeks' gestational age at birth (range 27-42 weeks), predominantly male and an average weight at birth of 2554 grams, were included. The third ventricle's mean diameter was 1.5 mm (range: 0.5 mm - 3.8 mm). The average Lindergaard index was 12.7 mm (8.2-27 mm). Both, the diameter of the third ventricle and the ventricular index were affected by the birth weight of newborns. Regarding the moment of delivery, there was no significant difference in ventricular size. Conclusions: Compared with the results of other series, our study offers different parameters.

Preoperative carotid duplex scanning in patients undergoing coronary artery bypass grafting

Abstract Objective: The aim of this study was to determine the prevalence and risk factors of carotid artery stenosis (CAS) using carotid duplex ultrasound in patients undergoing coronary artery bypass grafting (CABG). Methods: This retrospective study was conducted between January 2017 and January 2018 and included 166 consecutive patients [130 males (78.31%), 36 females (21.69%); mean age: 64.25±9.78 years] who underwent elective and isolated CABG. Patients who had significant CAS (≥50% stenosis) were compared with patients who had non-significant CAS (<50% stenosis). Logistic regression analysis was applied across the selected parameters to identify risk factors for significant CAS. Results: Of all patients, 36 (21.68%) had CAS ≥50% and 8 (4.81%) had unilateral carotid stenosis ≥70%. Carotid endarterectomy/CABG was performed simultaneously in five (3.01%) patients. None of these patients had cardiac and neurological problems during the postoperative period. The overall incidence of cerebrovascular accident (CVA) after CABG was 1.20% (n=2). Age (P=0.011) and history of CVA (P=0.035) were significantly higher in the CAS ≥50 group than in the CAS <50 group. Significant CAS was identified as a risk factor for postoperative CVA (P=0.013). Conclusion: Age and history of CVA were identified as risk factors for significant CAS. Furthermore, significant CAS was identified as a risk factor for postoperative CVA. For this reason, carotid screening is recommended for patients undergoing CABG even in the absence of associated risk factors.

Cerebral Hemodynamics in Chronic Disorders of Cerebral Circulation

The experience of using different methods of magnetic resonance study of the arterial and venous parts of the vascular bed of the head and neck is analyzed, and the feasibility and possibility of simultaneous assessment of the state of the brain and the study of the anatomy of the cerebral bed are shown. 87 patients with chronic cerebral ischemia (CCI) on the background of hypertension (GB) were examined, of the 36 women and 51 men aged from 46 to 72 years. Allpatients underwent standard neurological examination, MRI of the brain with venography (MRV) of the brachiocephalic veins and venous sinuses of the brain, duplex scanning (DS) in the modes of color Doppler mapping and pulsed Doppler of extra-and intracranial vessels. Comparative assessment of brain MRI results in patients with CCI revealed diffuse changes in the signal intensity from the white matter of the brain (periventricular, subcortical leucoarea, LA), single or multiple ischemic foci of 115 mm, external and internal cerebral atrophy (CA). the feasibility and the possibility of a one-stage assessment of the state of the brain and the study of the anatomy of the cerebral bed are substantiated. The need for an extended magnetic resonance study of the vascular system in the defeat of the arterial bed of the brain is due to certain anatomical and functional relationships between the arterial and venous sections

The Relationship between Microalbuminuria and Atherosclerosis in Patients with Type II Diabetes and Evaluate the Parameters of Internal Carotid Artery Duplex Sonographic Scanning

We aimed to determine the relationship between microalbuminuria and atherosclerosis in patients with Type II diabetes and evaluate the parameters of extracranial internal carotid artery (ICA) duplex ultrasonographic scanning; pulsatile index (PI) and resistive

Effects of RuanJianXiaoYing Granule on expressions of Treg and Th17 cytokines in Hashimoto thyroiditis model rats with liver depression and spleen deficiency / 吉林大学学报(医学版)

Objective: To observe the effects of RuanJianXiaoYing Granule on the expressions of specific transcription factors and cytokines of Treg and Th17 in the Hashimoto thyroiditis (HT) rats with liver depression and spleen deficiency, and to investigate the therapeutic effect of RuanJianXiaoYing Granule on HT and its immunological mechanism. Methods: A total of 48 SD rats were randomly divided into normal group (12 rats) and modeling group (36 rats). The HT model was established by subcutaneous injection of excessive iodine drinking water and thyroglobulin, and then combined with chronic restraint stress, excessive fatigue and dietary disorders to prepare the rat models with liver depression and spleen deficiency. After modeling, the rats were randomly divided into model group (n=12), Tripterygium wilfordii group (n=12), and RuanJianXiaoYing group (n=12), and the rats were treated for 8 weeks. In addition to the dead rats and unqualified specimens during the experiment, the test results of 10 rats in each group were retained. The general situation of the rats in various groups was observed; the abdominal aortic blood and thyroid gland tissue of the rats in various groups were collected after the last administration; the levels of thyroglobulin antibody (TGAb), thyroid peroxidase antibody (TPOAb), free triiodothyronine (FT3), free thyroxine (FT4), thyrotropin-releasing hormone (TRH) and thyrotropin (TSH) in serum and the levels of IL-17, IL-23 and IL-10 were detected by ELISA method; the pathomorphology of thyroid gland tissue of the rats in various groups were detected by HE staining; the expression levels of Foxp3 and RORyt proteins in thyroid gland tissue of the rats in various groups were detected by Western blotting method. Results: Compared with normal group, the levels of serum TGAb and TPOAb of the rats in model group, Tripterygium wilfordii group and RuanJianXiaoYing - group were increased (P0. 05); the level of serum IL-10 was increased (P<0. 05), and the levels of serum IL-17 and IL-23 were decreased (P<0. 05). The follicular cavity of thyroid gland in normal group had regular morphology, complete structure and no lymphocyte infiltration. In model group, the follicular cavity of thyroid gland was enlarged, the follicular structure was destroyed, and a large number of lymphocyte infiltration was observed in and around the follicular cavity. In Tripterygium wilfordii group, the follicular cavity of thyroid gland was enlarged, part of the follicular structure was destroyed, and there was a small amount of lymphocyte infiltration in and around the follicular cavity, which was less than that in model group. The morphological changes of thyroid gland in RuanJianXiaoYing group were similar to those in Tripterygium wilfordii group Conclusion: RuanJianXiaoYing Granule has the therapeutic effect in the HT rats with liver depression and spleen deficiency by regulating the expressions of the specific transcription factors Foxp3 and RORγt protein and related cytokines of Treg and Th17.