Purpose To explore the value of the clinical radiomics nomogram based on ultrasound in evaluating the degree of fibrosis in chronic kidney disease(CKD).Materials and Methods This retrospective study included 350 patients with CKD in Nanchong Central Hospital from January 2014 to July 2022 who underwent renal biopsy.The patients were categorized by the tubule atrophy with interstitial fibrosis(TA/IF)and divided into a training cohort(n=245)and test cohort(n=105).The patient demographics were evaluated to establish a clinical prediction model.The XGBoost machine learning model was constructed by extracting the radiomics features from the ultrasound images.The clinical radiomics nomogram prediction model was constructed by combining the radiomics score(Rad score)and important clinical features.The diagnostic performance of the three models was evaluated using receiver operating characteristic curve analysis.Results Among the 350 patients with CKD,226 had TA/IF 0 and 124 had TA/IF 1.Based on the clinical characteristics and Rad score,the clinical radiomics nomogram prediction model had the highest area under the curve in the training and testing cohorts,with the area under the curve of 0.938(95%CI 0.909-0.969)and 0.933(95%CI 0.891-0.980),respectively.Conclusion The ultrasound-based radiomics prediction model has potential value for the noninvasive diagnosis of TA/IF in CKD.Nomogram prediction models based on renal Rad scores and clinic may help clinicians to manage patients.

Purpose To explore the value of the clinical radiomics nomogram based on ultrasound in evaluating the degree of fibrosis in chronic kidney disease(CKD).Materials and Methods This retrospective study included 350 patients with CKD in Nanchong Central Hospital from January 2014 to July 2022 who underwent renal biopsy.The patients were categorized by the tubule atrophy with interstitial fibrosis(TA/IF)and divided into a training cohort(n=245)and test cohort(n=105).The patient demographics were evaluated to establish a clinical prediction model.The XGBoost machine learning model was constructed by extracting the radiomics features from the ultrasound images.The clinical radiomics nomogram prediction model was constructed by combining the radiomics score(Rad score)and important clinical features.The diagnostic performance of the three models was evaluated using receiver operating characteristic curve analysis.Results Among the 350 patients with CKD,226 had TA/IF 0 and 124 had TA/IF 1.Based on the clinical characteristics and Rad score,the clinical radiomics nomogram prediction model had the highest area under the curve in the training and testing cohorts,with the area under the curve of 0.938(95%CI 0.909-0.969)and 0.933(95%CI 0.891-0.980),respectively.Conclusion The ultrasound-based radiomics prediction model has potential value for the noninvasive diagnosis of TA/IF in CKD.Nomogram prediction models based on renal Rad scores and clinic may help clinicians to manage patients.

Purpose To explore the value of monitoring liver-shear wave elastography(L-SWE)and spleen-shear wave elastography(S-SWE)by two-dimensional shear wave elastography after transjugular intrahepatic portosystemic shunt(TIPS)in predicting stent dysfunction.Materials and Methods A total of 40 patients with hepatitis B cirrhosis in the First Affiliated Hospital of Anhui Medical University from January 2016 to September 2022 who underwent TIPS were retrospectively selected.Among them,22 patients without stent dysfunction within 1 month were included in the normal group,and 18 patients without stent dysfunction within 1 week but with stent dysfunction within 1 month were included in the dysfunction group.The changes of L-SWE and S-SWE were monitored 1 day before operation,1 week and 1 month after operation.Results Mauchly test showed that the data corresponded to sphericity(P>0.05).There was no significant difference in L-SWE within the two groups before and after operation(Ftime=0.003,Ftime×group=0.842,Fgrous=0.027;all P>0.05),while the S-SWE differences were statistically significant(Ftime=51.249,Ftime×group=30.676,Fgrous=11.986;all P<0.01).The S-SWE in the normal group showed a gradually decreasing trend 1 day before operation,1 week after operation and 1 month after operation,and the difference was statistically significant(P<0.05).The L-SWE in the dysfunction group decreased 1 week after operation compared with 1 day before operation(P<0.05),and the L-SWE increased 1 month after operation,with no significant difference compared with 1 day before operation(P>0.05).The difference of ΔS-SWE(1 month after operation-1 week after operation)and ΔS-SWE(1 month after operation-1 day before operation)was statistically significant(t=-2.612,4.368,P<0.05).Conclusion Quantitative measurement of S-SWE before and after TIPS and observation of its variation trend are helpful to estimate whether there is stent dysfunction and evaluate the surgical effect.

Objective:To investigate the value of using ultrasound excited contrast agents to assess extracorporeal hydrostatic pressure on the basis of ultrasound contrast imaging.Methods:An extracorporeal hydrostatic pressure evaluation system was established. The changes in contrast intensity was first evaluated for the same concentration of microbubble contrast agent at ambient pressures of 20, 25, 30, 35, 40, and 45 cmH 2O. Contrast agents with the same initial intensity were placed at different pressures for 1 s, 3 s, and 5 s, and the percentage change in contrast agent intensity was analyzed to select the optimal excitation time. Finally, the contrast agent at different pressures was stimulated using an acoustic excitation device, and correlation analysis was performed using the Pearson product moment correlation coefficient. Linear regression analysis was used to establish the relationship between different pressures and the percentage change in intensity. Results:When the ambient pressure was varied under 6 gradients of 20, 25, 30, 35, 40, and 45 cmH 2O, the contrast strength decreased with the pressure increased, and there was a negative correlation between contrast strength and the pressure ( r=-0.971, P<0.001). Under different pressures, the contrast agent intensity showed different degrees of natural decrease in 1 s, 3 s, and 5 s. The difference in the percentage change in contrast agent intensity in each pressure gradient was not statistically significant in 1 s ( P>0.05), whereas the differences in the percentage change in contrast agent intensity in 3 s and 5 s were statistically significant in each pressure gradient (all P<0.05). After microbubble contrast agent was stimulated by ultrasound excitation for 1s, the percentage change in contrast agent intensity was significantly correlated with ambient pressure ( r=-0.976, P<0.001). A linear regression model was fitted with the percentage change in contrast agent intensity after 1 s of stimulation as the independent variable and the pressure as the dependent variable, with the model equation: y=60.075-2.559×x1, where x1 is the percentage change in contrast agent ( R2=0.952, P<0.001). Conclusions:The percentage change in contrast intensity after 1 s of ultrasound excitation of microbubble contrast agent is a favorable predictor of hydrostatic pressure at 6 pressure gradients of 20, 25, 30, 35, 40, and 45 cmH 2O, which may provide a new method for noninvasive monitoring of portal vein pressure for clinicans.

Background::Carotid intima-media thickness (IMT) and diameter, stiffness, and wave reflections, are independent and important clinical biomarkers and risk predictors for cardiovascular diseases. The purpose of the present study was to establish nationwide reference values of carotid properties for healthy Chinese adults and to explore potential clinical determinants.Methods::A total of 3053 healthy Han Chinese adults (1922 women) aged 18-79 years were enrolled at 28 collaborating tertiary centers throughout China between April 2021 and July 2022. The real-time tracking of common carotid artery walls was achieved by the radio frequency (RF) ultrasound system. The IMT, diameter, compliance coefficient, β stiffness, local pulse wave velocity (PWV), local systolic blood pressure, augmented pressure (AP), and augmentation index (AIx) were then automatically measured and reported. Data were stratified by age groups and sex. The relationships between age and carotid property parameters were analyzed by Jonckheere-Terpstra test and simple linear regressions. The major clinical determinants of carotid properties were identified by Pearson’s correlation, multiple linear regression, and analyses of covariance.Results::All the parameters of carotid properties demonstrated significantly age-related trajectories. Women showed thinner IMT, smaller carotid diameter, larger AP, and AIx than men. The β stiffness and PWV were significantly higher in men than women before forties, but the differences reversed after that. The increase rate of carotid IMT (5.5 μm/year in women and 5.8 μm/year in men) and diameter (0.03 mm/year in both men and women) were similar between men and women. For the stiffness and wave reflections, women showed significantly larger age-related variations than men as demonstrated by steeper regression slopes (all P for age by sex interaction <0.05). The blood pressures, body mass index (BMI), and triglyceride levels were identified as major clinical determinants of carotid properties with adjustment of age and sex. Conclusions::The age- and sex-specific reference values of carotid properties measured by RF ultrasound for healthy Chinese adults were established. The blood pressures, BMI, and triglyceride levels should be considered for clinical application of corresponding reference values.

Objective: To investigate the value of left ventricular global longitudinal strain( LVGLS) in predicting early chemotherapy related cardiotoxicity in breast cancer patients after chemotherapy． Methods : Eighty-six breast cancer patients were enrolled in this study and received 6 cycles of doxorubicin + cyclophosphamide．Conventional echocardiography parameters were measured before chemotherapy ( T0 ) ，immediately after chemotherapy ( T1 ) ，6 months(T2) and 12 months after chemotherapy ( T3 ) ． LVGLS was obtained by 2D speck tracing imaging (2DSTI) ，and the relative change of LVGLS( △LVGLS) was calculated at T1．With the occurrence of cardiotoxicity as the clinical outcome，receiver operating characteristic ( ROC) curve was plotted．The parameters were analyzed at T1 to evaluate the value of △LVGLS in predicting cardiotoxicity. Results: ① Although the change in LVEF was not different between T0 and T1 (P ＞0. 05) ，LVEF decreased significantly at T2 and T3 (P ＜0. 05) . ② Compared with T0，LVGLS decreased at T1，which was further damaged at T2 and T3 (P＜0. 05) . ③ Seven patients (8. 1% ) developed chemotherapy-related cardiotoxicity．LVGLS and △LVGLS were correlated with cardiotoxicity at T1 stage ，and △LVGLS was more significant ( r = 0. 64，P ＜0. 001 ) . ROC curve analysis showed that a △LVGLS ＞12% at T1 predicted cardiotoxicity，with sensitivity of 92. 2% ，specificity of 76% ，and area under the curve was 0. 88. Conclusion The LVGLS decreased earlier than LVEF in breast cancer patients after doxorubicin treatment. △LVGLS ＞12% is a good predictor of cardiotoxicity in patients with breast cancer.

Objective:To explore the method of sequential sector scan with 2D ultrasound through oral fissure (SSTOF) and its utilization in the cleft palate screening.Methods:Based on features of oral anatomy and ultrasonic beam, SSTOF was designed to screen cleft palate and the accuracy had been verified using specimens of aborted fetuses. This study recruited 7 154 women with singleton pregnancy who were screened for fetal malformations during 20-28 gestational weeks in the First Affiliated Hospital of Anhui Medical University from May 2020 to October 2020. In medical addition to routine screening, these subjects also underwent SSTOF to further verify its feasibility and imaging performance. Follow-up was performed by telephone and medical record review.Results:Clear images of the upper palate were acquired in five specimens of induced fetuses using SSTOF. Except for 56 cases lost to follow-up, a total of 7 098 fetuses were finally enrolled, of which 6 885 acquired satisfactory images using SSTOF, 213 did not due to inappropriate position, with a success image rate of 97%. SSTOF found cleft palate in 31cases, which were all confirmed after birth or induction, noting an accuracy rate of 100%.Conclusion:Sequential sector scan through oral fissure has a high clinical value on cleft palate screening in the second trimester with advantages of clear image, easy operation, and access to section views.

Objective : To investigate the predictive value of platelet volume distribution width ( PDW) , mean platelet volume (MPV) , and D ⁃dimer (D⁃D) on early shunt dysfunction in patients with decompensated cirrhosis treated with transjugular intrahepatic portosystemic shunt(TIPS) . Methods : A total of 28 patients with decompensated cirrhosis who developed shunt dysfunction within 6 months after TIPS were selected as the case group , and a 1 ∶ 2 matched control study was conducted. 56 patients matched by age ( ± 2) and gender who did not develop shunt dysfunction within 6 months after TIPS were selected as the control group. Spss23. 00 software was used to conduct univariate analysis to obtain statistically significant variables , and then conditional Logistic regression analysis was conducted with paired design , with P < 0. 05 being statistically significant. Results : Patients with a history of splenectomy , portal vein thrombosis , and those with poor liver function grade were more likely to have functional dysfunction after TIPS. Platelet count (PLT) , platelet volume distribution width (PDW) , mean platelet volume (MPV) , D ⁃dimer ( D⁃D) and Fibrinogen monomer ( FDPI) had statistically significant differences between the case group and the control group. The values of D ⁃D、PDW、MPV and FDPI in the case group were higher than those in the control group , while the value of PLT in the case group was lower than that in the control group. The OR values of PDW , MPV and D ⁃D were 2. 164 , 3. 826 and 1. 382 , respectively. ROC analysis results showed that the areas under PDW , MPV and D ⁃D curves were 0. 746 , 0. 773 and 0. 690 , respectively. Conclusion Compared with ultrasound , D ⁃D , PLT and PDW could predict shunt dysfunction earlier after TIPS. Patients with normal shunt function indicated by color Doppler ultrasonography in postoperative follow⁃up of TIPS should be closely observed for indicators such as D ⁃D , PLT and PDW , which is of important significance for clinical indication of shunt dysfunction in TIPS.

Objective:To explore the blood pressure levels and the influencing factors of hypertension among Hainan centenarians, and provide basic data for the further blood pressure related studies of the centenarian population.Methods:The baseline data were from China Hainan Centenarian Cohort Study (CHCCS). This cross-sectional data, based on the community population, was a complete sample study of centenarians, including questionnaire survey, physical examination and physiological index detection. A total of 1 002 centenarians were recruited to describe the blood pressure level. According to the guidelines for the prevention and treatment of hypertension in Chinese adults in 2018, the prevalence of hypertension was analyzed.Results:The median levels of systolic blood pressure, diastolic pressure and pulse pressure were 152.0, 76.0 and 76.5 mmHg, respectively. Blood pressure level was higher in females than in males. The prevalence of hypertension was 71.9%, mainly in isolated systolic hypertension with the prevalence of 60.1%. The results of multivariate analysis showed that the risk of hypertension in women was higher than that in men ( OR=1.624, 95% CI: 1.155-2.283), and the risk of hypertension in the northern ( OR=0.625, 95% CI: 0.434-0.901) and central areas ( OR=0.586, 95% CI: 0.346-0.993) was lower than that of the Eastern. Conclusion:The prevalence of hypertension, mainly in isolated systolic hypertension, showing gender and regional distribution differences.

Objective:To investigate the prevalence of depression and to analyze its determinants among centenarians in Hainan.Methods:A cross-sectional study on centenarians was conducted in Hainan from June 2014 to December 2016.A total of 910 centenarians, including 166 males and 744 females, were interviewed in their domiciles by trained investigators.A 15-item Geriatric Depression Scale(GDS-15)was used to assess depression for centenarians, and general sociodemographic details, sleep quality, cognitive function, activities of daily living, and lifestyles were recorded.Multivariate logistic regression analysis was used to determine major related factors for depression in centenarians.Results:Of the 910 centenarians, 292 were regarded as depressed and the prevalence was 32.1%.Univariate analysis showed that there were significant differences in gender, education, marital status, self-reported health, incontinence, dietary habits, sleep quality, activities of daily living, cognitive function, outdoor activities, watching TV, and social engagement between subjects with and without depression( P<0.05). Multivariate logistic regression analysis showed that living conditions, self-reported health, activities of daily living, and sleep quality were independent related factors for depression in centenarians( P<0.05). Among the above related factors, living with families( OR=0.50, P=0.026)and good sleep quality( OR=0.67, P=0.010)were protective factors for depression, whereas poor self-reported health( OR=3.34, P<0.001)and disability( OR=2.37, P=0.002)were risk factors for depression in centenarians. Conclusions:Living conditions, self-reported health, activities of daily living, and sleep quality were independently correlated with depression in Hainan centenarians.This study provides empirical evidence for depression interventions and mental health improvement in centenarians.