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Objective:To explore the risk factors of microvascular invasion (MVI) in hepatocellular carcinoma (HCC), and to predict MVI preoperatively, non-invasively and accurately.Methods:A total of 150 HCC patients (183 HCC lesions) were retrospectively collected in the First Affiliated Hospital of Xi′an Jiaotong University from January 2016 to June 2022.The clinical data and hematological data, gray-scale ultrasonography (US), contrast-enhanced ultrasonography (CEUS), enhanced magnetic resonance imaging with gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (EOB-MRI) and pathological data of these patients were recorded. According to the pathological diagnosis of MVI, the lesions were divided into MVI (+ ) group and MVI (-) group. The indicators between the two groups were compared. All 183 lesions were put into the training set, and the prediction model with nomogram was constructed according to the risk factors of MVI selected by multivariate Logistic regression. The internal verification was carried out by ten-fold cross-validation method.Results:There were significant statistical differences in the following parameters between MVI (+ ) group ( n=109) and MVI (-) group ( n=74) (all P<0.05). These were cirrhosis, serological parameters (alpha-fetoprotein, albumin, total bilirubin), qualitative indexes of US (size, boundary, internal echo), qualitative indexes of CEUS (hyper/iso/hypovascularity of lesions in arterial phase, portal phase, and delayed phase compared with hepatic parenchyma), and quantitative indexes of EOB-MRI [post enhancement rate (post ratio) and gadolinium disodium rate (EOB ratio)] calculated mainly in terms of lesions and surrounding liver parenchyma in hepatobiliary phase and unenhanced T1 images). Finally, cirrhosis of patients, the size, boundary, internal echo of lesions in US; arterial phase (AP), portal phase (PP), post-vascular phase (PVP) features in CEUS; the EOB rate and post rate of EOB-MRI entered the prediction model of MVI. The training set exhibited good calibration and net gain rate. The areas under the ROC curve for the training set and the validation set were 0.981 and 0.961, respectively, while the diagnostic accuracy were 92.9% and 85.8%, respectively. Conclusions:The model constructed mainly by multimodality imaging methods can achieve favorable predictive performance for MVI, which provides valuable ideas for noninvasively predicting the incidence of MVI and optimizing the MVI-related treatment of MVI in HCC patients.
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Objective To explore the ultrasonographic features of the gallbladder with malaria in stage of attack (MSA) at Sudan.Methods A total of 67 cases of MSA patients were divided into common type of malaria (CM) and sever malaria (SM).All patients underwent routine abdominal ultrasound examination and the ultrasonographic features of the gallbladder were divided into type Ⅰ,Ⅱ and Ⅲ according to the volume of gallbladder,thickness of the gallbladder wall and chole stasis.The relationship between clinical types and the ultrasonic types were analyzed.Then the differences of liver function among normal,Ⅰ,Ⅱ and Ⅲ types were compared statistically.Results In all of the 67 MSA patients,52 cases were CM and 15 cases were SM.The gallbladder ultrasonography showed that normal gallbladder were in 14 cases,type Ⅰ in 28 ca ses,type Ⅱ in 19 cases,type Ⅲ in 6 cases.The ultrasonic types of the gallbladder had significant difference in SM patients (type Ⅰ 3 cases,type Ⅱ 7 cases,type lⅢ 5 cases) and CM patients (normal 14 cases,type Ⅰ 25 cases,type Ⅱ 12 cases,type Ⅲ 1 case;P＜0.001).Ultrasonic types of the gallbladder had no difference between Chinese and Sudanese (P＞ 0.05).There were statistical significant differences of liver function among normal,Ⅰ,Ⅱ and Ⅲ types of the gallbladder (P＜0.001).Conclusion Most of the MSA patients have ultrasonic changes of gallbladder.And there are more serious pathological changes of gallbladder in SM than that in CM.
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Objective To explore the diagnostic value of ultrasonic elastography and fine flow imaging in differential diagnosis of cervical lymph nodes.Methods Totally 87 lymph nodes were examined with ultrasonic elastography,fine flow and conventional ultrasonography.The results were confirmed with postoperative pathology or fine-needle biopsy as well as follow-up.Using consistency check of Kappa and ROC curve to analyse the accuracy of three types of ultrasonic examination.Results Taking the results of postoperative pathology or fine-needle biopsy as well as follow-up as golden standards,the Kappa value of conventional ultrasonography was poor (Kappa =0.153,P =0.078),fine flow was moderate (Kappa =0.526,P ＜0.01) and ultrasonic elastography was better (Kappa =0.741,P ＜0.01).The area under ROC of ultrasonic elastography,fine flow and conventional ultrasonography was 0.899 (P ＜0.01),0.787 (P ＜0.01) and 0.568 (P =0.241),respectively.Conclusions Ultrasonic elastography is more valuable to differentiate malignant from benign lymph nodes.
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Objective To investigate whether gut microbiome dysbiosis and translocation occurred in experimental uremia,and whether they consequently contribute to microinflammation.Methods Health male SD rats were randomly divided into uremic group and sham group.Uremic group were operated for 5/6 nephrectomy to establish uremic models,while sham group were only operated for nephrocapsulotomy.Postoperative blood,livers,spleens,and mesenteric lymph nodes (MLNs) were subjected to bacterial 16S ribosomal DNA amplification to determine if bacteria were present.Bacterial genomic DNA samples from the MLNs and colon were amplified with specific primers designed by the 16SrRNA sequence of the species obtained from blood,livers and spleens.Pyrosequencing was used to analyze the ileum and colonic microbio.me of each subject.Intestinal permeability to 99mTc-DTPA,plasma hs-CRP,and IL-6 were measured.Results Bacterial DNA in extraiutestinal sites and altered colonic microbiomes at the phylum,family,and genus levels were detected in some rats in the uremic group.Bacterial genomic DNA in MLNs and colon were obtained by primers specific for bacterial species observed from blood,livers,and spleens of identical individuals.Intestinal permeability,plasma hs-CRP,and IL-6 levels were statistically higher in the uremic group compared with that in sham group(all P ＜ 0.05).Conclusion Gut microbiome dysbiosis occurs and presumably bacteria translocate to the systemic and lymph circulation,thereby contributing to microinflammation in experimental uremia.