ObjectiveTo investigate the effectiveness and safety of coblopasvir hydrochloride combined with sofosbuvir （CLP/SOF） in the treatment of patients with chronic hepatitis C （CHC） and those with genotype 3b in terms of virologic response rate， changes in liver and renal function parameters， and adverse events， and to provide a reference for clinical diagnosis and treatment. MethodsThe patients with CHC who were admitted to Maanshan Fourth People’s Hospital from March 1， 2023 to July 31， 2024 were enrolled and treated with CLP/SOF for a course of 12 weeks. Follow-up assessments were conducted at weeks 4， 8， and 12 of treatment and at 12 weeks after the end of treatment， and related data were collected， including HCV RNA， routine blood test results， and liver and renal function parameters. Sustained virologic response at 12 weeks after treatment （SVR12） and safety profile were evaluated. The Friedman test was used for comparison of liver and renal function parameters， routine blood test results， and liver fibrosis score at different time points. ResultsA total of 107 CHC patients treated with CLP/SOF were enrolled， with an age of 22 — 92 years， and there were 55 male patients. The predominant genotypes were 1b （46.73%） and 3b （28.97%）. Comorbidities mainly included liver cirrhosis （15 patients）， fatty liver disease （27 patients）， syphilis （15 patients）， HBV infection （8 patients）， and HIV infection （2 patients）. The overall SVR12 rate was 100% （107/107）， with an SVR12 rate of 100% for subgroups with different genotypes and those with liver cirrhosis， fatty liver disease， syphilis， HBV infection， or HIV infection. The patients with HCV genotype 3b comorbid with liver cirrhosis， fatty liver disease， syphilis， HBV infection， hypertension or diabetes also achieved an SVR12 rate of 100%. After CLP/SOF treatment， the patients showed significant reductions in the levels of the liver function parameters alanine aminotransferase， aspartate aminotransferase， total bilirubin， and hemoglobin （all P<0.001） and significant reductions in the liver fibrosis scores fibrosis-4 and aspartate aminotransferase-to-platelet ratio index （both P<0.001）. The median creatinine level was 66 μmol/L before treatment， which decreased to 52 μmol/L at week 12 of treatment （P<0.001）. No adverse events were reported. ConclusionPatients with CHC achieve a high SVR12 rate and significant improvements in liver function parameters and liver fibrosis markers after treatment with the CLP/SOF regimen， and this regimen has no significant impact on renal function and shows a favorable safety profile. Therefore， it holds promise for clinical application.

OBJECTIVETo explore the value of the strain means of the quantitative parameters of organization diffusion in determining the degree of liver fibrosis.

METHODSA total of 130 patients with chronic hepatitis B were examined for quantitative analysis of organization diffusion before liver biopsy to analyze the performance of the strain means in liver fibrosis of different degrees. All the cases were confirmed by pathology.

RESULTSThe strain means differed significantly between different stages of liver fibrosis. Using the best cut-off values of 116.2, 111.4, 101.6 and 97.5 for diagnosis of S≥1, S≥2, S≥3 and S=4, the diagnostic sensitivities were 91.2%, 90.8%, 95.8% and 89.7%, with specificities of 90.4%, 98.6%, 93.8% and 95.6% and accuracies of 90.6%, 94.7%, 95.5% and 91.8%, respectively.

CONCLUSIONThe strain mean can provide specific numerical indicators to determine the degree of liver fibrosis.

Biopsy ; Diffusion ; Hepatitis B, Chronic ; Humans ; Liver Cirrhosis ; diagnosis ; Sensitivity and Specificity

Objective To explore the value of the strain means of the quantitative parameters of organization diffusion in determining the degree of liver fibrosis. Methods A total of 130 patients with chronic hepatitis B were examined for quantitative analysis of organization diffusion before liver biopsy to analyze the performance of the strain means in liver fibrosis of different degrees. All the cases were confirmed by pathology. Results The strain means differed significantly between different stages of liver fibrosis. Using the best cut-off values of 116.2, 111.4, 101.6 and 97.5 for diagnosis of S≥1, S≥2, S≥3 and S=4, the diagnostic sensitivities were 91.2%, 90.8%, 95.8% and 89.7%, with specificities of 90.4%, 98.6%, 93.8% and 95.6% and accuracies of 90.6%, 94.7%, 95.5% and 91.8%, respectively. Conclusion The strain mean can provide specific numerical indicators to determine the degree of liver fibrosis.

Objective To explore the value of the strain means of the quantitative parameters of organization diffusion in determining the degree of liver fibrosis. Methods A total of 130 patients with chronic hepatitis B were examined for quantitative analysis of organization diffusion before liver biopsy to analyze the performance of the strain means in liver fibrosis of different degrees. All the cases were confirmed by pathology. Results The strain means differed significantly between different stages of liver fibrosis. Using the best cut-off values of 116.2, 111.4, 101.6 and 97.5 for diagnosis of S≥1, S≥2, S≥3 and S=4, the diagnostic sensitivities were 91.2%, 90.8%, 95.8% and 89.7%, with specificities of 90.4%, 98.6%, 93.8% and 95.6% and accuracies of 90.6%, 94.7%, 95.5% and 91.8%, respectively. Conclusion The strain mean can provide specific numerical indicators to determine the degree of liver fibrosis.

OBJECTIVETo study the value of ROI A value in the strain ratio and the elasticity scores by the 4-score system in ultrasonic elastography in differential diagnosis of benign and malignant thyroid nodules.

METHODSA total of 124 patients with 166 thyroid nodules underwent examinations with real-time ultrasonic elastography to obtain the elasticity score and the ROI A value in strain ratio. Receiver operating characteristic (ROC) curves were used to assess the diagnostic value of ROI A value, and the best cutoff point was determined. The results of diagnosis based on ROI A value, elasticity scores, and their combination were compared with the results of pathological diagnosis.

RESULTSThe area under the ROC curve (Az) of ROI A value for differentiating benign and malignant thyroid nodules was 0.825. The best diagnostic cut-off point of ROI A value was 0.00165. In differentiating benign and malignant thyroid nodules, the sensitivity, specificity, accuracy and odds ratio were 82.93%, 72.80%, 75.30%, and 13.0 for ROI A value, 87.80%, 80.00%, 81.93%, and 28.8 for the elasticity scores, and 73.17%, 91.20%, 86.75%, and 32.1 for their combination, respectively. The odds ratio of the combined diagnosis was the highest, and the accuracy of the combined diagnosis was significantly higher than that of ROI A value (χ(2)=19.31, P<0.05) and the elasticity scores (χ(2)=12.03, P<0.05).

CONCLUSIONROI A value has moderate diagnostic value and clinical practicability in differentiating thyroid nodules. The diagnostic accuracy of ROI A value can be improved by combining with the elasticity scores.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Diagnosis, Differential ; Elasticity Imaging Techniques ; methods ; Female ; Humans ; Male ; Middle Aged ; ROC Curve ; Thyroid Nodule ; diagnostic imaging ; Young Adult

Objective To explore the best cutoff point of the quantitative analysis of organization diffusion for differentiating liver fibrosis and to assess its diagnostic value.Methods Sixty-five patients with chronic hepatitis B were examined with quantitative analysis of organization diffusion before liver biopsy,and made a ROC analysis of diagnostic test.All cases confirmed by pathology.Results 114.95 was the best cutoff point of the strain average value which was one parameter of the quantitative analysis of organization diffusion,the area under the curve of ROC was 0.950 (P=0.000),and the sensitivity,specificity,accuracy were 92.3%,87.2% and 89.2%,respectively.Conclusions The quantitative analysis of organization diffusion is helpful in diagnosing liver fibrosis.

Objective To investigate the value of ultrasound elastosonography in the diagnosis of liver fibrosis. Methods One hundred and twenty patients with chronic hepatitis B were examined by ultrasound elastosonography and given elasticity scores,the correlation coefficient between the elasticity scores and the histologic fibrosis stage was evaluated and its difference in the diagnosis of liver fibrosis was compared. Results The Spearman's correlation coefficient between the elasticity scores and the histologic fibrosis stage was 0. 875,which was highly significant ( P＜0. 01). There was no significantly difference between elasticity scores and fibrosis staging in the diagnosis of liver fibrosis by Marginal Homogeneity (Z=- 1. 144, P = 0. 149). The sensitivity,specificity and accuracy of ultrasonic elastography for diagnosing liver fibrosis were 92. 5%, 85.0%, 90.0%, respectively. Conclusions Elastosonography is helpful for the diagnosis of liver fibrosis.