Jiaan Zhu

Introduction: Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus. Surgical decompression of distal DPN has been shown to reduce ulceration and amputation rates, though recurrence risk persists, warranting postoperative follow-up. Current DPN evaluation relies on clinical symptoms, signs, and nerve conduction studies (NCS), which have inherent limitations. Shear wave elastography (SWE) is a non-invasive, cost-effective technique that quantifies tissue stiffness and reflects underlying pathology, and has been reported as a potential tool for early detection of diabetic neuropathy. This study aimed to assess the value of SWE for quantitative evaluation of nerve stiffness after sciatic nerve decompression in diabetic rats, providing a preliminary theoretical basis for future clinical research. Methods: A total of 24 male Sprague–Dawley (SD) rats were used in this study. Six served as normal controls ( n = 6). The remaining 18 underwent sciatic nerve compression to establish a diabetic neuropathy model. Four weeks later, 6 of these were assigned to the diabetic sciatic nerve compression 4-week group (DSNC, n = 6), while the other 12 received surgical decompression and were further divided into 2-week (DSND2, n = 6) and 8-week (DSND8, n = 6) post-decompression groups. Nerve stiffness was assessed by SWE, alongside motor nerve conduction velocity (MNCV) and histopathological examination. Results: In the DSND2 group, sciatic nerve stiffness was significantly decreased compared with the DSNC group ( p < 0.01), with a further decrease in the DSND8 group ( p < 0.05 vs. DSND2). No significant differences in MNCV, myelinated fiber density, myelin sheath thickness, or average axon diameter were found between the DSND2 and DSNC groups ( p > 0.05). In contrast, the DSND8 group showed significant improvements in all these parameters versus the DSNC group ( p < 0.05), with MNCV reaching 49.17 ± 4.71 m/s. Moreover, myelinated fiber density and myelin sheath thickness were also significantly higher in the DSND8 group than in the DSND2 group ( p < 0.05). Conclusion: Dynamic SWE assessment of decreased neural stiffness after sciatic nerve decompression predicts functional improvement in diabetic rats, and may serve as a noninvasive evaluation method.

Background/Objectives: The aim of this study was to develop and validate a high-frequency ultrasound radiomics-based model for quantitative assessment of metacarpophalangeal (MCP) joint cartilage damage in early rheumatoid arthritis (RA). Methods: 656 MCP joints from 99 early RA patients and 65 healthy controls were prospectively enrolled and graded according to the Outcome Measures in Rheumatology (OMERACT) system. After radiomics feature extraction, five machine learning classifiers were evaluated. Radiomics, clinical, and combined models were constructed and assessed. Radiomics scores were compared among healthy grade 0 joints, early RA grade 0 joints stratified into two risk subgroups, and RA grade ≥ 1 joints. SHapley Additive exPlanations (SHAP) analysis was used for interpretation. Results: Eight stable radiomics features were selected. Among classifiers, support vector machine achieved the highest cross-validated performance and was selected as the final radiomics classifier (validation AUC = 0.804). The combined model, integrating radiomics features with age, disease duration, and Disease Activity Score in 28 joints, achieved the best diagnostic performance (AUC = 0.855), significantly outperforming both the radiomics and clinical models. Among OMERACT grade 0 joints, the high-risk subgroup demonstrated elevated radiomics-derived scores. SHAP analysis identified original_shape2D_PerimeterSurfaceRatio as the strongest contributor. Conclusions: High-frequency ultrasound radiomics combined with clinical features demonstrated strong performance in detecting MCP joint cartilage damage in early RA and may provide a quantitative extension to conventional semiquantitative assessment.

Full Papers; Authors: Y. Xin, M. Li, D. Li, Y. Liu, W. Li, J. Zhu

Original Article Automatic knowledge extraction from Chinese electronic medical records and rheumatoid arthritis knowledge graph construction Feifei Liu, Mingtong Liu, Meiting Li, Yuwei Xin, Dongping Gao, Jun Wu, Jiaan Zhu

Objectives: To explore the influence of the surrounding environment of the target tissue, lesion size, and rectangular sampling box size on shear wave speed (SWS).Methods: The tendon SWS was acquired ex‐vivo. Then the tendons were dissected and buried in the couplant (gel) and evaluated by two‐dimensional shear wave elastography (2D‐SWE). Finally, the tendons were placed in the isolated muscles to simulate the intramuscular lesions, and their elasticity was tested under two rectangular sampling box conditions. The isolated complete liver SWS was acquired. Similarly, the large and small pieces of livers were cut out, placed in the muscles, and assessed by SWE under two rectangular sampling box conditions. The SWS acquired under different conditions was compared. Variability was evaluated using the coefficient of variation (CV). The intraclass correlation coefficient (ICC) was used to evaluate repeatability.Results: The SWS of the tendons ex‐vivo, buried in the couplant and placed in the isolated muscles showed significant differences (p < 0.001). The ex‐vivo condition produced the highest SWS and CV values. There were significant differences in SWS of livers with different sizes placed in muscles (p < 0.001). The highest SWS value was associated with small pieces of livers. No significant difference was found in SWS acquired under different rectangular box sizes (p > 0.05).Conclusions: Under the present study conditions, the surrounding environment of the target tissue makes a big difference to lesion SWS values. The lesion size will affect the assessment of its inherent elasticity. The size of the sampling frame has no significant effect on the tissue SWS.

Background: Early detection of local recurrence would improve the survival rate of patients with recurrent bone tumors. There is still no consensus on how to follow up after surgery of primary malignant bone tumors. Therefore, the purpose of this study is to evaluate the diagnostic value of ultrasound (US) for local recurrence after limb salvage by comparing it with other imaging modalities.Methods: We retrospectively reviewed the medical records of patients who were regularly examined by US in our hospital after primary bone tumor surgery from January 2016 to December 2019, some of which underwent x-ray, computed tomography (CT), or ⁹⁹mTc-MDP bone scan. Recurrence was determined by pathologic confirmation. The cases were considered a true negative for no recurrence if no clinical or pathologic evidence for recurrence was found at least 6 months after the US examination. The Chi-square test or Fisher exact test was used to compare categorical data. p-values < 0.0083 were considered statistically significant.Results: A total of 288 cases were finally enrolled in our research, including 66 cases with pathologic results. The sensitivity of US was 95.0%, higher than that of x-ray (29.6%) (p = 0.000). The accuracy of US was 96.9%, higher than that of x-ray (85.6%) (p = 0.000).Conclusion: As a nonradiative and cost-effective examination, US may be used as a routine imaging method for postoperative surveillance of primary bone tumors, especially those with metal implants, if more multicenter prospective studies can be done in the future.