1.Olfactory Receptors Expressed in The Intestine and Their Functions
Pei-Wen YANG ; Meng-Meng YUAN ; Ying ZHOU ; Peng LI ; Gui-Hong QI ; Ying YANG ; Zhong-Yi MAO ; Meng-Sha ZHOU ; Xiao-Shuang MAO ; Jian-Ping XIE ; Yi-Nan YANG ; Shi-Hao SUN
Progress in Biochemistry and Biophysics 2026;53(3):534-549
Olfactory receptors (ORs) form the largest superfamily of G protein-coupled receptors (GPCRs). Traditionally recognized for their role in the nasal olfactory epithelium, where they mediate the sense of smell, accumulating evidence has firmly established their ectopic expression in non-olfactory tissues, including the intestine, lungs, and kidneys. The intestine, as the primary site for nutrient digestion and absorption, harbors a highly complex chemical environment. To adapt to this environment, the gut employs a sophisticated network of “chemosensors” to monitor luminal contents and maintain homeostasis. Among these sensors, intestinal ORs have emerged as crucial functional components, serving as a molecular bridge that connects environmental chemical signals—such as food-derived odorants—to specific physiological responses. This discovery has significantly deepened our understanding of how dietary flavors and compounds influence intestinal physiology at the molecular level. This review systematically summarizes the expression profiles, ligand classification, and biological functions of ORs within the gastrointestinal tract. Studies indicate that intestinal ORs exhibit distinct spatial distribution patterns across different gut segments and display cell-type specificity, particularly within enterocytes and enteroendocrine cells. These receptors function as versatile sensors capable of recognizing a wide variety of ligands, including exogenous dietary components, gut microbiota metabolites such as short-chain fatty acids, and endogenous small molecules like azelaic acid. Upon activation by specific ligands, intestinal ORs trigger intracellular signaling cascades, primarily involving the AC-cAMP-PKA pathway or calcium influx channels. A major focus of this review is to elucidate the molecular mechanisms by which these receptors regulate the secretion of gut hormones. Activation of specific ORs in enteroendocrine cells has been shown to stimulate the release of hormones such as glucagon-like peptide-1 (GLP-1), peptide YY (PYY), and serotonin (5-HT), thereby modulating systemic energy metabolism, glucose homeostasis, and gastrointestinal motility. Furthermore, the review addresses the critical roles of ORs in immune regulation and pathology. Evidence suggests that specific ORs contribute to the maintenance of intestinal immune homeostasis and may offer protection against inflammation. Beyond their involvement in inflammatory responses, ORs such as Olfr78 have been shown to regulate the differentiation and function of intestinal endocrine cells. Similarly, Olfr544 has been demonstrated to alleviate intestinal inflammation by remodeling the gut microbiome and metabolome. These findings collectively suggest that specific ORs hold promise as therapeutic targets for mitigating intestinal inflammation and maintaining gut homeostasis. Additionally, the review explores the emerging role of ORs in cancer. Although OR expression is often downregulated in tumor tissues compared to normal mucosa, activation of specific ORs by certain ligands can inhibit tumor cell proliferation and migration and induce apoptosis via pathways such as MEK/ERK and p38 MAPK. Conversely, other receptors, such as OR7C1, may serve as biomarkers for cancer-initiating cells. In conclusion, intestinal ORs represent a vital component of the gut’s sensory network. The review also discusses the translational potential of these findings. By elucidating the precise pairing relationships between dietary components and specific ORs, novel therapeutic strategies could be developed. Intestinal ORs may thus emerge as promising targets for nutritional and pharmacological interventions in metabolic diseases, inflammatory bowel diseases, and malignancies.
2.Targeting ER lipid raft-associated 1 reveals a coordinated cholesterol-dependent vulnerability in hepatocellular carcinoma
Yiming ZHANG ; Yushan HOU ; Xinxin WANG ; Kaikun XU ; Pei JIANG ; Siqi WANG ; Huimin KANG ; Hu ZHANG ; Jingzhuo JIN ; Xiaofen HUANG ; Zifeng LIU ; Songpeng YANG ; Jiaqi LIU ; Lingqiang ZHANG ; Fuchu HE ; Chunyan TIAN ; Aihua SUN
Clinical and Molecular Hepatology 2026;32(2):866-883
Background/Aims:
Dysregulated cholesterol metabolism is a hallmark of hepatocellular carcinoma (HCC) that drives tumor initiation and progression. However, clinical targeting of cholesterol metabolism has yielded limited benefits due to stringent feedback in tumor cells. Identifying a central mediator capable of restoring cholesterol homeostasis within the cell’s intrinsically fine-tuned regulatory framework is urgently needed.
Methods:
We integrated a proteomic dataset from patients with cholesterol-dysregulated HCC into a global cholesterol metabolic regulatory network to identify potential therapeutic targets for disrupted cholesterol homeostasis. The prognostic significance of the candidate targets was further validated in an independent cohort through immunohistochemistry. Functional and mechanistic studies were conducted in vitro using HCC cell lines and in vivo using mouse models. The pharmacological efficacy of the candidate agent was evaluated in both subcutaneous and orthotopic HCC mouse models.
Results:
ER lipid raft-associated 1 (ERLIN1), a pivotal regulator of cholesterol metabolism reprogramming, was identified as an independent favorable prognostic indicator in HCC. ERLIN1 constrains HCC progression both in vitro and in vivo by stabilizing the INSIG1–SCAP–SREBP2 axis and maintaining the metabolic balance of intracellular cholesterol. Under hypoxia, impaired factor-inhibiting hypoxia-1-dependent hydroxylation of ASB11 at asparagine residues 90 and 92 enhances ASB11-mediated ERLIN1 degradation. Pharmacological targeting of this axis using zoledronic acid (ZoA) attenuated HCC progression by weakening the ASB11–ERLIN1 interaction and restoring cholesterol homeostasis.
Conclusions
ERLIN1 represents a druggable metabolic vulnerability in cholesterol-dysregulated HCC. Targeting the ASB11–ERLIN1 axis with the clinically approved ZoA reestablishes cholesterol homeostasis and offers a promising therapeutic strategy to overcome the current limitations of cholesterol-targeted HCC therapies.
3.ERP-P300 and resting-state fNIRS characteristics of patients with cerebral small vessel disease-related cognition impairment and their correlations with white matter lesions
Shanshan ZHANG ; Pei SUN ; Rui YANG ; Hao TANG ; Xiaoming WANG
Sichuan Mental Health 2026;39(3):212-219
BackgroundThe prevalence, disability rate and mortality rate of cerebral small vessel disease (CSVD) are relatively high among the elderly population, imposing a heavy burden on families and society. Among the various clinical manifestations of CSVD, cognitive impairment is the most common, and it is also the most closely related neuro-psychiatric syndrome to clinical practice in psychiatry. Previous studies on CSVD-related cognitive impairment (CSVD-CI) have mostly focused on the field of imaging, while studies on non-invasive electrophysiological and cerebral hemodynamic assessments are relatively scarce. ObjectiveTo analyze the characteristics of event-related potential (ERP) and functional near-infrared spectroscopy (fNIRS) in patients with CSVD-CI, and to explore their correlations with the severity of white matter lesions, in order to provide references for the objective assessment and early identification of CSVD-CI. MethodsA total of 40 patients with CSVD who met the diagnostic criteria of the Chinese Guideline for Diagnosis and Treatment of Cerebral Small Vessel Disease (2020) and had cognitive impairment, as well as were admitted to the Affiliated Hospital of North Sichuan Medical College from December 2024 to December 2025, were enrolled as the case group. Meanwhile, 40 healthy volunteers matched for gender, age and education level were recruited as the control group. Both groups underwent assessment using the Mini-Mental State Examination (MMSE), ERP-P300 detection, and fNIRS examination. The ERP-P300 indicators, functional connectivity strength of the whole brain and cognitive-related regions of interest (ROI) in fNIRS of the two groups were compared. The severity of the patients' white matter lesions was classified as follows: the Fazekas grade I group (mild white matter lesions) and the Fazekas grades II to III group (moderate to severe white matter lesions). Spearman correlation analysis was employed to investigate the correlation between the Fazekas grading of brain white matter lesions and the latency of ERP-P300, as well as the strength of functional connectivity measured by fNIRS. ResultsThe MMSE score of the CSVD-CI group was lower than that of the control group (Z=-6.250, P<0.01), and ERP-P300 lantency was significantly longer than that of the control group (t=12.291, P<0.01). The MMSE score of the sub-group with Fazekas grade I was higher than that of the sub-groups with grades II to III (Z=-2.420, P<0.05), and showed a shorter P300 latency than that of the sub-groups with grades II to III (Z=-4.210, P<0.01). All the differences were statistically significant. The resting-state whole-brain functional connectivity strength in the CSVD-CI group was lower than that in the control group, and the difference was statistically significant (t=10.243, P<0.05). Compared with the control group, the differences in the functional connectivity strength within the left premotor cortex (PMC), right PMC, left frontopolar cortex (FPC), right FPC, left dorsolateral prefrontal cortex (DLPFC), right DLPFC, left orbitofrontal cortex (OFC), and right OFC regions in the CSVD-CI group were all statistically significant (PFDR correction<0.01). The differences in the functional connectivity strength between multiple prefrontal-related brain regions between the CSVD-CI group and the control group were all statistically significant (PFDR correction<0.01). The severity of white matter lesions in CSVD-CI patients was positively correlated with the P300 latency (rs=0.891, P<0.05), and negatively correlated with the fNIRS functional connectivity strength (rs=-0.359, P<0.05). ConclusionPatients with CSVD-CI exhibit prolonged P300 latency, as well as decreased functional connectivity strength in multiple brain regions including the whole brain and the prefrontal lobe during the resting state. Moreover, these indicators are correlated with the severity of white matter lesions.
4.Ditantang Ameliorates MAFLD in Rats Through UDPG-S1P-SREBP Axis-mediated Glycogen Synthesis
Lu PAN ; Zhe ZHAND ; Nan SONG ; Dongyu MIN ; Jiaxin WANG ; Yuanguang DONG ; Yang HONG ; Meiling ZHANG ; Xiaofei SUN ; Jiaru WANG ; Yunfei GAO ; Yupeng PEI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(22):40-50
ObjectiveTo investigate the effects of Ditantang on metabolic dysfunction-associated fatty liver disease (MAFLD) in rats by focusing on the regulation of glycogen synthesis mediated by the uridine diphosphate glucose (UDPG)-site-1-protease (S1P)-sterol regulatory element-binding protein (SREBP) axis. MethodsMAFLD was modeled in SD rats by feeding a high-fat diet for 12 weeks. Rats were randomized into a control group, a model group, low-, medium-, and high-dose (2.68, 5.36, and 10.72 g·kg-1·d-1, respectively) Ditantang groups, and a positive control (Yishanfu, 0.18 g·kg-1·d-1) group. Starting from week 9 of modeling, each treatment group received corresponding drug interventions via gavage. After the experiment, the serum levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were measured. The levels of TG, non-esterified fatty acids (NEFA), glycogen, glucose-6-phosphate (G6P), glucose-1-phosphate (G1P), and UDPG in the liver tissue samples were measured by biochemical assay kits. Liver pathological morphology and lipid/glycogen deposition were observed via hematoxylin-eosin (HE) staining, oil red O staining, and Periodic acid-Schiff (PAS) staining. Immunofluorescence assay was conducted to detect the expression and localization of phosphoglucomutase-1 (Pgm1) and UDP-glucose pyrophosphorylase 2 (Ugp2) in the rat liver. Real-time PCR and Western blot were employed to quantify mRNA and protein levels, respectively, of key glycogen synthesis enzymes (Pgm1 and Ugp2), key lipogenesis-related transcription factor SREBP and its target genes [acetyl-CoA carboxylase (ACC), fatty acid synthetase (FASN), and stearoyl-CoA desaturase (SCD1)], as well as S1P. ResultsCompared with the control group, the model group exhibited elevated levels of TC, TG, LDL-C in the serum and TG and NEFA in the liver, decreased serum HDL-C level (P<0.01), reduced hepatic levels of G1P, G6P, UDPG, and glycogen (P<0.01), appearance of fat vacuoles of varying sizes and abundant red lipid droplets, with prominent lipid deposition and reduced areas of deep glycogen staining in the liver tissue, upregulated mRNA and protein levels of SREBP1, S1P, ACC, FASN, and SCD1 (P<0.01), and downregulated mRNA and protein levels of Pgm1 and Ugp2 (P<0.01). Compared with the model group, all doses of Ditantang reduced the levels of TC and TG in the serum and TG and NEFA in the liver, while elevating the serum HDL-C level. Additionally, medium- and high-dose Ditantang reducted the LDL-C level (P<0.05). Ditantang at all doses increased the hepatic levels of G1P, G6P, UDPG, and glycogen, alleviated hepatic steatosis and lipid deposition, enhanced glycogen storage, downregulated the mRNA and protein levels of SREBP1, S1P, ACC, FASN, and SCD1 (P<0.05), while upregulating the expression of Pgm1 and Ugp2 (P<0.01). Immunofluorescence analysis revealed decreased fluorescence intensity of S1P and enhanced fluorescence intensity of Ugp2 (P<0.01). ConclusionDitantang can regulate glycogen synthesis through the UDPG-S1P-SREBP axis to prevent and treat MAFLD.
5.Clinical Efficacy of Tangning Tongluo Tablets for Nonproliferative Diabetic Retinopathy
Fuwen ZHANG ; Junguo DUAN ; Wen XIA ; Tiantian SUN ; Yuheng SHI ; Shicui MEI ; Xiangxia LUO ; Xing LI ; Yujie PAN ; Yong DENG ; Chuanlian RAN ; Hao CHEN ; Li PEI ; Shuyu YANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(3):132-139
ObjectiveTo observe the clinical efficacy and safety of Tangning Tongluo tablets in the treatment of nonproliferative diabetic retinopathy (DR). MethodsFourteen research centers participated in this study, which spanned a time interval from September 2021 to May 2023. A total of 240 patients with nonproliferative DR were included and randomly assigned into an observation group (120 cases) and a control group (120 cases). The observation group was treated with Tangning Tongluo tablets, and the control group with calcium dobesilate capsules. Both groups were treated for 24 consecutive weeks. The vision, DR progression rate, retinal microhemangioma, hemorrhage area, exudation area, glycosylated hemoglobin (HbA1c) level, and TCM syndrome score were assessed before and after treatment, and the safety was observed. ResultsThe vision changed in both groups after treatment (P<0.05), and the observation group showed higher best corrected visual acuity (BCVA) than the control group (P<0.05). The DR progression was slow with similar rates in the two groups. The fundus hemorrhage area and exudation area did not change significantly after treatment in both groups, while the observation group outperformed the control group in reducing the fundus hemorrhage area and exudation area. There was no significant difference in the number of microhemangiomas between the two groups before treatment. After treatment, the number of microhemangiomas decreased in both the observation group (Z=-1.437, P<0.05) and the control group (Z=-2.238, P<0.05), and it showed no significant difference between the two groups. As the treatment time prolonged, the number of microhemangiomas gradually decreased in both groups. There was no significant difference in the HbA1c level between the two groups before treatment. After treatment, the decline in the HbA1c level showed no significant difference between the two groups. The TCM syndrome score did not have a statistically significant difference between the two groups before treatment. After treatment, neither the TCM syndrome score nor the response rate had significant difference between the two groups. With the extension of the treatment time, both groups showed amelioration of TCM syndrome compared with the baseline. ConclusionTangning Tongluo tablets are safe and effective in the treatment of nonproliferative DR, being capable of improving vision and reducing hemorrhage and exudation in the fundus.
6.Development of a general practitioner training program for carotid plaque screening using portable intelligent point-of-care ultrasonography
Xiaochuan LIU ; Sichen YAO ; Pei SUN ; Hua YANG ; Zhigang PAN
Chinese Journal of General Practitioners 2025;24(12):1533-1540
Objective:To develop a training program for general practitioners (GPs) on carotid plaque screening using portable intelligent point-of-care ultrasonography (POCUS).Methods:A draft training program for GPs on carotid plaque screening using POCUS was initially formulated through focus group discussions involving experts in ultrasonography and general practice. Two rounds of Delphi consultation were conducted with 15 ultrasound experts from 6 secondary and tertiary public hospitals in Shanghai in February and April 2023. The analytic hierarchy process (AHP) was applied to assign weights to the indicators in the final program.Results:The final program consisted of 4 first-level indicators, 10 second-level indicators, and 47 third-level indicators. Among the first-level indicators,"training objects" had the lowest weight (7.69%), while the other three indicators were equally weighted (30.77% each). The top 3 third-level indicators by combined weight were "mastering key diagnostic points of carotid plaque"(10.26%),"mastering carotid plaque screening using portable POCUS"(6.84%), and "primary care hands-on training sessions"(6.39%).Conclusion:A structured training program for GPs has been successfully developed for carotid plaque screening using portable intelligent POCUS, comprising 4 first-level, 10 second-level, and 47 third-level indicators.
7.Clinicopathological features and prognosis of rectal neuroendocrine tumor with grade 2
Zhenkai LUO ; Qi ZHANG ; Xiaoting MA ; Renshen XIANG ; Shuaibing LU ; Deyang KONG ; Yu SUN ; Yingying FENG ; Wei PEI ; Lin FENG ; Yuelu ZHU ; Lin YANG ; Haizeng ZHANG
Chinese Journal of Oncology 2025;47(1):108-117
Objective:To explore the clinicopathological features of rectal neuroendocrine tumor (R-NET) G2, identify prognostic factors, and summarize treatment experience.Methods:The clinical data of patients diagnosed with R-NET G2 by pathological diagnosis admitted to Cancer Hospital of the Chinese Academy of Medical Sciences from January 2003 to September 2023 were retrospectively analyzed. The Fisher's exact test and Kaplan-Meier curves were performed to analyze the association between pathological features and prognosis.Results:A total of 22 patients were enrolled in this study and 21 patients were followed up for a period of 6-98 months with a median follow-up time of 42 months. 5 patients died due to tumor progression during the follow-up period. The 1-, 3-, and 5-year cancer-specific survival (CSS) of the whole group were 100.0%, 92.9%, and 69.6%, respectively. Of the 22 patients, 20 underwent surgical treatment, of which 15 underwent postoperative adjuvant therapy; 2 underwent medical treatment for liver and bone multiple metastases. The 5-year survival rates of patients with tumours ≥2 cm in length, T2-3 stage, lymph node metastasis, and distant metastasis (57.1%, 68.8%, 66.7%, and 63.6%, respectively) were shorter than those of patients with tumours <2 cm in length, T1 stage, no lymph node metastasis, and no distant metastasis (all 100.0%, P<0.001). In addition, patients with liver metastases had larger primary tumor diameters and higher T-stages compared with those without distant metastasis ( P<0.05). Conclusions:R-NET G2 has a high degree of malignancy compared with G1 and a high propensity for metastasis. Clinicians should formulate appropriate diagnostic and treatment strategies based on factors such as tumor size, depth of invasion, lymph node status, presence of distant metastasis, and the location and extent of distant metastasis.
8.CT and MRI findings of giant cell reparative granuloma in lateral skull base
Pengfeng SUN ; Jiping DONG ; Xiaoping WU ; Xiangchun YANG ; Caixia PEI ; Hongsheng LIU ; Run LIU
Journal of Practical Radiology 2025;41(4):560-563
Objective To investigate the CT and MRI features of giant cell reparative granuloma(GCRG)in lateral skull base.Methods The CT,MRI and clinicopathological data of 8 patients with GCRG in lateral skull base were collected and analyzed.Results All of the eight lesions were unilateral and solitary(three on the left side and five on the right side),with widespread involvement affecting two or more bony structures of the lateral skull base.All lesions showed expansile and lytic bone destruction on CT scans,the margins were clear(7/8),and the sclerotic changes could be seen at the margin of all eight lesions.On MRI,the lesions revealed heterogeneous isointense and hypointense on T1WI,and heterogeneous hypointense with focal cystic changes on T2WI,without fluid-fluid levels.The enhanced scan showed heterogeneous enhancement.Seven cases extended to the middle cranial fossa,caused com-pression of the temporal lobe brain tissue,with thickened and strengthened adjacent meninges.Conclusion The GCRG in lateral skull base has certain characteristic appearances on CT and MRI;understanding these characteristic manifestations can provide a basis for accurate diagnosis.
9.Protective effect of achyranthes bidentata against doxorubicin-induced spermatogenic disorder in mice:An investigation based on the glycolytic metabolic pathway
Man-yu WANG ; Yang FU ; Pei-pei YUAN ; Li-rui ZHAO ; Yan ZHANG ; Qing-yun MA ; Yan-jun SUN ; Wei-sheng FENG ; Xiao-ke ZHENG
National Journal of Andrology 2025;31(2):99-107
Objective:To investigate the protective effect of achyranthes bidentata(AB)on sperm quality in mice with sper-matogenic disorder through the glycolytic metabolic pathway and its action mechanism.Methods:We equally randomized 40 Kun-ming mice into a normal control,a model control,a low-dose AB(3.5 g/kg)and a high-dose AB group(7.0 g/kg),and established the model of spermatogenic disorder in the latter three groups of mice by intraperitoneal injection of doxorubicin(30 mg/kg).Two days after modeling,we collected the testis and kidney tissues and blood samples from the mice for observation of the pathological changes in the testis tissue by HE staining,detection of perm motility with the sperm quality analyzer,examination of the apoptosis of testis cells by flow cytometry,measurement of the levels of testosterone(T),malondialdehyde(MDA),superoxide dismutase(SOD)and cata-lase(CAT)in the serum and testis tissue by ELISA,and determination of expressions of the key enzymes of glycolysis hexokinase Ⅱ(HK2),pyruvate kinase M2(PKM2),platelet phosphofructokinase(PFKP),lactate dehydrogenase A(LDHA)and the meiosis pro-teins REC8 and SCP3 by Western blot,and the mRNA expressions of glycolytic phosphofructokinase 1(PFK1),phosphoglycerate ki-nase 1(PGK1),tumor necrosis factor-α(TNF-α)and interleukin-1 β(IL-1β)by fluorescence quantitative PCR(FQ-PCR).Results:Compared with the model controls,the mice in the AB groups showed significant increases in the testis coefficient,kidney in-dex,sperm concentration,sperm motility,spermatogonia,primary spermatocytes,spermatids,sperm count and the serum T level(P<0.05 orP<0.01),but dramatic decreases in the apoptosis of testis cells and percentage of morphologically abnormal sperm(P<0.01).Achyranthes bidentata also significantly elevated the levels of SOD and CAT,and down-regulated the mRNA expressions of MDA,TNF-α and IL-1β(P<0.05 or P<0.01),and up-regulated the protein expressions of HK2,PKM2,PFKP,LDHA,REC8 and SCP3,and expressions of the glycolysis key genes Pfk1 and Pgk1(P<0.05 orP<0.01).Conclusion:Achyranthes bidentata ameliorates doxorubicin-induced spermatogenic disorder in mice by regulating the glycolytic pathway and reducing oxidative stress and the expressions of inflammatory factors.
10.Intelligent handheld ultrasound improving the ability of non-expert general practitioners in carotid examinations for community populations: a prospective and parallel controlled trial
Pei SUN ; Hong HAN ; Yi-Kang SUN ; Xi WANG ; Xiao-Chuan LIU ; Bo-Yang ZHOU ; Li-Fan WANG ; Ya-Qin ZHANG ; Zhi-Gang PAN ; Bei-Jian HUANG ; Hui-Xiong XU ; Chong-Ke ZHAO
Ultrasonography 2025;44(2):112-123
Purpose:
The aim of this study was to investigate the feasibility of an intelligent handheld ultrasound (US) device for assisting non-expert general practitioners (GPs) in detecting carotid plaques (CPs) in community populations.
Methods:
This prospective parallel controlled trial recruited 111 consecutive community residents. All of them underwent examinations by non-expert GPs and specialist doctors using handheld US devices (setting A, setting B, and setting C). The results of setting C with specialist doctors were considered the gold standard. Carotid intima-media thickness (CIMT) and the features of CPs were measured and recorded. The diagnostic performance of GPs in distinguishing CPs was evaluated using a receiver operating characteristic curve. Inter-observer agreement was compared using the intragroup correlation coefficient (ICC). Questionnaires were completed to evaluate clinical benefits.
Results:
Among the 111 community residents, 80, 96, and 112 CPs were detected in settings A, B, and C, respectively. Setting B exhibited better diagnostic performance than setting A for detecting CPs (area under the curve, 0.856 vs. 0.749; P<0.01). Setting B had better consistency with setting C than setting A in CIMT measurement and the assessment of CPs (ICC, 0.731 to 0.923). Moreover, measurements in setting B required less time than the other two settings (44.59 seconds vs. 108.87 seconds vs. 126.13 seconds, both P<0.01).
Conclusion
Using an intelligent handheld US device, GPs can perform CP screening and achieve a diagnostic capability comparable to that of specialist doctors.

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