To evaluate the effect of dapagliflozin on myocardial function in early spontaneously hypertensive rats (SHR) with layer-specific global longitudinal strain (GLS).

A total of 45 male SHR aged 6 weeks were randomly divided into control group (normal saline), dapagliflozin group [1 mg/(kg·day)], and losartan group [10 mg/(kg·day)]. Fifteen male Wistar-Kyoto (WKY) rats at same age with normal blood pressure were subjected and served as blank control group. During 8 weeks of intervention, systolic blood pressure (SBP) was measured, and conventional echocardiography and two-dimensional speckle tracking echocardiography (2DSTE) were performed and the results were collected to acquire the longitudinal strain of each layer of left ventricular (LV) myocardium. The parameters were compared among the groups. The pathological changes of myocardium were observed in each group of rats.

Compared with the WKY group, LV ejection fraction (LVEF) and LV fraction shortening (LVFS) at week 8 were decreased in the control group (P<0.05), but no such decreases were observed in the dapagliflozin group and the losartan group. The GLS of endo-myocardium (GLSendo) at the 6th week was decreased, and GLSendo, GLSmid and GLSepi at the 8th week were all decreased in the control group than the WKY group (all P<0.05). But there were no statistical differences in the above 3 indicators in the dapagliflozin and losartan groups when compared with the WKY group (all P>0.05). The pathological results showed that myocardial interstitial fibrosis was observed in the control group at the 6th week.

Dapagliflozin can effectively improve myocardial function in early SHR.

To explore the value of preoperative ultrasound examination in the prediction of restenosis of arteriovenous fistula (AVF) after percutaneous transluminal angioplasty (PTA) in hemodialysis patients.

A case-control trial was conducted on 225 hemodialysis patients who undergoing PTA due to AVF in our hospital January 2023 to May 2024. After 3 months of follow-up, they were divided into a patency group (n=204) and a restenosis group (n=21) according to the occurrence of postoperative restenosis. The preoperative clinical data and ultrasound parameters were compared between the groups. Binary logistic regression analysis was used to identify the independent factors for AVF restenosis after PTA. Receiver operating characteristic (ROC) curve was drawn to evaluate the value of preoperative stenosis length in the prediction of the restenosis after PTA.

There were significant differences in preoperative internal diameter at the site of stenosis, stenosis length, stenosis number, intimal thickness, and brachial artery flow between the 2 groups (P < 0.05). Preoperative stenosis length (OR=1.856, 95%CI: 1.350~2.552, P < 0.001) was an independent factor of AVF restenosis in hemodialysis patients after PTA. ROC curve analysis showed that the area under the curve of preoperative stenosis length in predicting restenosis after PTA was 0.868 (95%CI: 0.784~0.953, P < 0.001), with a sensibility and specificity of 85.7% and 80.4%, respectively.

Preoperative stenosis length may be an independent factor for AVF restenosis after PTA in hemodialysis patients.

To evaluate the diagnostic performance of combining sonographic features with BRAF^V600E mutation for differentiating benign and malignant Bethesda category Ⅲ thyroid nodules.

This retrospective cohort study included 275 patients (278 nodules) diagnosed as Bethesda category Ⅲ by ultrasound-guided fine needle aspiration cytology (US-FNAC) at First Affiliated Hospital of Army Medical University between January 2020 and December 2024, with final confirmation via surgical pathology or repeated US-FNAC. Nodules were classified as benign or malignant based on pathological results. Diagnostic efficacy of age, sex, 9 sonographic features, ACR TI -RADS score, US-FNAC nuclear morphology, and BRAF^V600E mutation was analyzed using multivariate logistic regression.

Significant differences existed in age, nodule margin, aspect ratio, maximum diameter, echogenicity, Adler blood flow grading, ACR TI-RADS classification, US-FNAC nuclear morphology, and BRAF^V600E status between benign and malignant nodules (all P<0.05). Independent risk factors for malignancy included age≤52 years (OR=7.444), BRAF^V600E mutation (OR =108.218), ground-glass nuclei (OR =5.389), and abnormal cervical lymph nodes (OR=13.351, P<0.05). The combined model demonstrated accuracy was 0.823, sensitivity was 0.863, specificity was 0.925, positive predictive value was 0.977, negative predictive value was 0.649, and AUC was 0.955.

Integration of sonographic features and BRAF^V600E mutation provides high diagnostic performance for Bethesda category Ⅲ thyroid nodules.

To investigate the ultrasonographic characteristics and outcomes of fetal umbilical-portal-systemic venous shunts (UPSVS).

UPSVS cases at a single center between January 2015 and December 2022 were retrospectively investigated. The ultrasonographic features, types, and postnatal outcomes of fetal UPSVS were analyzed and the outcomes were followed up on. The study was approved by our institutional review board (Approval Number KY2021130).

Forty UPSVS cases, including 4 Type Ⅰ, 18 Type Ⅱ, and 18 Type Ⅲ (16 with Ⅲa and 2 with Ⅲb) were identified. Two Type Ⅰ cases were terminated because of the complete absence of the portal venous (PV) system. Genetic assessment revealed that one patient with Type Ⅰ had a q22.11 deletion in trisomy 21. Type Ⅱ is characterized by structural malformations, particularly cardiovascular abnormalities. Couples opted for pregnancy termination in four cases of Type Ⅱ. The most common anomaly in Type Ⅲ shunts was cardiac enlargement, followed by fetal growth restriction. Pregnancy was terminated in six cases of Type Ⅲa as requested by the couples, one resulting from premature birth, and two because of the completely absent PV system. Genetic tests showed that trisomy X had a microduplication in one patient. The shunt spontaneously closed after birth in all Type Ⅲa cases.

Prenatal diagnosis of UPSVS using ultrasonography is feasible and valuable for perinatal management and prenatal consultation. The fetal postnatal prognosis is determined by the presence of anomalies in the PV system, genetics, or structure.