[Water-soluble Inorganic Ion Content of PM2.5 and Its Change Characteristics in Urban Area of Beijing in 2022].

To explore the content and variation characteristics of water-soluble ions of atmospheric fine particles (PM2.5) in a Beijing urban area and put forward the pollution prevention and control scheme, the water-soluble ions, gaseous precursors (SO2, NO2), and meteorological factors (temperature, RH) of PM2.5 in 2022 were analyzed and determined. The results showed that the water-soluble ions with the highest proportion in PM2.5 in the Beijing City urban area were NO3-, NH4+, and SO42-, accounting for 52.7% of PM2.5. The mass concentrations of PM2.5 and SNA were lower than the historical results, whereas the proportion of SNA, SOR, and NOR was higher than the historical results. This showed that the fine particulate matter pollution in Beijing has been significantly improved, but it still has strong secondary pollution characteristics. NO3-/SO42-(2.2) was higher than those of historical and nearby provinces and cities, reflecting the expanding influence of mobile sources. In terms of seasonal variation, PM2.5 showed the characteristic of high in autumn and low in summer. The proportion of NO3- was the highest in autumn, spring, and winter; the proportion of SO42- was the highest in summer; and the proportion of NH4+ changed little in each season. The seasonal variation rules of NOR and SOR were almost opposite, which reflected the difference in transformation factors between NOR and SOR. The main forms of SNA in the Beijing urban area were NH4NO3 and (NH4)2SO4. The neutralization degree of cations and anions was the highest in winter, the cation NH4+ was slightly insufficient in summer, and NH4+ was in excess in spring and autumn. The Beijing urban area was an ammonia-rich environment. In terms of pollution level, RH, particulate matter moisture, and water-soluble ions mass concentration all increased with the increase in pollution level, and SNA increased fastest, with its proportion in PM2.5 increasing first and then stabilizing, whereas the contribution rate of other water-soluble ions decreased gradually. In terms of spatial distribution, the mass concentration relationship of SNA at the central urban area and suburbs was NO3- > SO42- > NH4+, which reflected the pollution characteristics dominated by NO3-. The highest contribution rate of SNA to PM2.5 occurred in the eastern region, the central urban area, and the transmission point, indicating that the secondary reaction was relatively active in the central urban area and the eastern region, and the regional transport was also an important source of secondary ions.

[Analysis of the Jumping Characteristics and Influencing Factors of Ozone Pollution in Beijing].

Based on environmental monitoring data and meteorological observation data from 2016 to 2022 in Beijing, combined with backward trajectory clustering and potential source area contribution analysis, the characteristics, meteorological impacts, and potential source areas of ozone (O3) pollution were analyzed. The results showed that there was a total of 41 O3 pollution processes with jumping characteristics in Beijing from 2016 to 2022, with an average of 5.9 times a year. The occurrence time was concentrated in May to July, and the day of the jump (OJD2) was higher than the day before the jump (OJD1). The average value of ρ(O3-8h) was 78.3% higher, and the peak concentration was 78.9% higher. The high O3 concentration zone in the OJD2 region exhibited a characteristic of advancing from south to north. The main reasons for the occurrence of jumped O3 pollution in Beijing could be summarized as local accumulation caused by unfavorable meteorological conditions and regional transmission impact. The occurrence of jump-type ozone pollution was characterized by an increase in southerly wind frequency, temperature rise, pressure decrease, and precipitation decrease. The increase in southerly wind frequency provided conditions for the transport of O3 and its precursors, and rapid photochemical reactions occurred under local high temperatures, with less superimposed precipitation, comprehensively pushing up the ozone concentration level of OJD2. Six air mass transporting pathways were identified through clustering analysis; the air mass from the direction north of OJD2 decreased by 11.2%, whereas the air mass from the south and east directions increased by 6.7% and 4.4%, respectively, with the air masses mainly transmitting over short distances. The ozone concentration corresponding to the south and east directions was relatively high, making a significant contribution to Beijing's pollution. The analysis of potential source areas revealed that the main potential source areas of OJD2 ozone pollution were the central, southern, and eastern parts of Beijing-Tianjin-Hebei, which contributed 82.6% to the pollution trajectory. There was a significant contribution of regional transport during jump-type ozone pollution, and it is necessary to strengthen joint prevention and control in the Beijing-Tianjin-Hebei Region.

[Characteristics and Source Apportionment of VOCs Initial Mixing Ratio in Beijing During Summer].

To clarify the characteristics and source apportionment of the VOCs initial mixing ratio in Beijing in summer, continuous monitoring of VOCs was conducted in the Beijing urban area from May to August 2022, and the initial mixing ratio was calculated using the photochemical ratio method. The results showed that:① during the study period, initial φ(TVOCs) in the Beijing urban area were (30.0 ±11.5)×10-9, in which the proportion of VOCs and alkanes containing oxygen reached 34.2% and 33.2%, respectively. The species with high volume fractions were low carbon substances such as acetone, ethane, acetaldehyde, and propane. ② The initial TVOCs mixing ratio in Beijing showed a slightly unimodal trend, reaching the peak at 11:00 and slightly decreasing in the afternoon. ③ Isoprene, acetaldehyde, n-butanal, and ethylene were the major contributors to the generation of O3, whereas toluene, isoprene, m-paraxylene, and ethylbenzene were the major contributors to the generation of secondary organic aerosols. ④ Based on the initial mixing ratio of PMF analysis, it was found that aging background and secondary sources (30%) contributed the most to VOCs in Beijing, and motor vehicle sources (25%) were the main primary human sources. In addition, solvent and fuel volatile sources contributed 16%, combustion sources contributed 11%, industrial process sources contributed 9%, and natural sources contributed 9%. ⑤ The anthropogenic sources of Beijing were mainly from the eastern and southern regions, whereas the natural sources were from the western and northwestern regions. This research showed that vehicle emissions should be further reduced, and regional joint prevention and control to reduce VOCs in the whole region is an effective means to control VOCs in Beijing.

Ablative strategies for recurrent hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) is the most common primary liver cancer and is the fifth leading cause of cancer death worldwide and the third leading cause of all diseases worldwide. Liver transplantation, surgical resection and ablation are the three main curative treatments for HCC. Liver transplantation is the optimal treatment option for HCC, but its usage is limited by the shortage of liver sources. Surgical resection is considered the first choice for early-stage HCC, but it does not apply to patients with poor liver function. Therefore, more and more doctors choose ablation for HCC. However, intrahepatic recurrence occurs in up to 70% patients within 5 years after initial treatment. For patients with oligo recurrence after primary treatment, repeated resection and local ablation are both alternative. Only 20% patients with recurrent HCC (rHCC) indicate repeated surgical resection because of limitations in liver function, tumor location and intraperitoneal adhesions. Local ablation has become an option for the waiting period when liver transplantation is unavailable. For patients with intrahepatic recurrence after liver transplantation, local ablation can reduce the tumor burden and prepare them for liver transplantation. This review systematically describes the various ablation treatments for rHCC, including radiofrequency ablation, microwave ablation, laser ablation, high-intensity focused ultrasound ablation, cryablation, irreversible electroporation, percutaneous ethanol injection, and the combination of ablation and other treatment modalities.

[Pollution Characteristics and Factors Influencing the Reduction in Ambient PM2.5 in Beijing from 2018 to 2020].

Air quality data from 33 environment sites and five regional sites from 2018 to 2020, as well as meteorological data, were used to research PM2.5 variation,spatial and temporal change, diurnal variation, and heavy pollutions in Beijing. The annual average mass concentrations of PM2.5 in Beijing were 51, 42, and 38 µg·m-3, which showed great progress in air quality improvement. However, the PM2.5 concentration in 2020 was still 8.6% above the national limit value despite a 30.9% decline since 2017. The PM2.5 south-north gradient in Beijing remained throughout the three years, but this pattern showed a less significant trend. The highest monthly mean PM2.5 concentrations in Beijing tended to occur in January-March, with the lowest in August-September. NOx, CO, and PM2.5 concentrations were significantly higher in the heating season than in the non-heating season by 58.4%, 52.9%, and 27.5%, respectively. Diurnal variation showed that greater PM2.5 concentrations were observed at nighttime during the heating season and, conversely, at noontime during the non-heating season. Sixteen pollution episodes occurred in Beijing over the last three years, resulting in 25 heavy pollution days distributed in autumn-winter of 2018-2020. The regional heavy pollution characteristics of PM2.5 in Beijing were significant. Through analysis, a continuous pollution reduction was still the most important reason for the yearly decrease in PM2.5. The concentrations of organic matter, elemental carbon, and crustal matter in the PM2.5 in Beijing decreased by 43.3%, 53.2%, and 51.5% since 2017, respectively, and nitrate, sulfate, and ammonium decreased by 34.2%, 52.2%, and 43.7%.The results showed that the control effect of PM2.5 in Beijing was obvious.

[Characteristics and Sources of PM2.5 and Its Light-scattering Properties with Different Chemical Compositions in Urban Area of Beijing].

In recent years, the concentration of PM2.5 in the Beijing urban area has decreased with the increase in the proportion of secondary inorganic ions. In order to explore the characteristics and sources of the light scattering of PM2.5 with different chemical compositions, PM2.5 with its chemical components and scattering coefficient were continuously measured at hourly resolution in the Beijing urban area from December 2020 to November 2021. The components, scattering characteristics, and sources of PM2.5 were analyzed. The results showed that NO3- was the major component of PM2.5 in the Beijing urban area, and the ω(NO3-) and ω(SNA) were 24% and 46% in PM2.5, respectively. PM2.5 could be divided into six types according to mass concentration and component proportion. The occurrence frequency of the good-type was the highest during the study with a similar duration in the four seasons, and the ω(SNA), ω(OM), and ω(FS) were 32%, 32%, and 28% in PM2.5, respectively. The dust(D)-type and the OM(O)-type appeared mainly in spring and summer with the lowest frequency during the study. FS and OM were their major components, and the ω(FS) and ω(OM) were 66% and 46% in PM2.5, respectively. The OM+SO42-(OS)-type, OM+NO3-(ON)-type, and NO3-(N)-type appeared mainly in the afternoon in summer, in the early morning and morning in winter, and at approximately 07:00 every day in spring. Under the condition of low humidity[relative humidity (RH)<40%], the MSE of N-type PM2.5 was the highest (4.3 m2·g-1), and that of D-type PM2.5 was the lowest (2.1 m2·g-1), reflecting the high scattering ability of SNA. The MSE increased with relative humidity. Under the condition of high humidity (RH>80%), the MSE of all types of PM2.5 rose to 1.5 to 1.8 times the values under low humidity. The variation trends of SAE showed that particle size increased with the rising of RH level. Under non-high humidity conditions, the scattering coefficients reconstructed by the revised IMPROVE formula fitted well with the measured values at hourly resolution, the correlation coefficients were between 0.81 and 0.97, and the slopes were between 1.00 and 1.21 except for that of D-type. The N-type fitting result was the best. Under high-humidity conditions, the R and the slopes were from 0.82 to 0.84 and from 0.48 to 0.53, respectively. The annual Bsca was 203.8 Mm-1, and N-type PM2.5 contributed the most, accounting for 53%, in which the large particles of NH4NO3 were the major contributor. Bsca of good-type PM2.5 was 67.2 Mm-1, in which small particles of OM were the major contributor. Bsca was 1.5 times the annual Bsca(dry), whereas the Bsca values of SNA were 1.8 to 2.1 times the Bsca(dry). The peak value of NO3- and RH simultaneously appeared around 07:00, resulting in the maximum Bsca of NH4NO3 at this time. The peak value of SO42- and the Bsca of (NH4)2SO4 mainly appeared at 16:00 and at 04:00, respectively. The diurnal variation curves of OM concentration and Bsca were consistent, and the bimodal peaks appeared at 13:00 and 20:00, respectively. In spring and winter, NO3-, SO42- and OM mainly came from the plains east of the Taihang Mountains, and their potential source regions were not in any particular place in summer and autumn; the main potential source regions of FS were the northwest areas of Beijing in spring and autumn. The flow with high RH across the south and southeast of the north China plain and the eastern rim of Bohai Sea was likely to increase the weighted potential source contribution factor values of Bsca of SNA in this region.

[Analysis of Pollution Characteristics and Sources of Rainfall Runoff from Roofs in the Central District of Beijing].

The rainwater and rainfall runoff of roofs in the central district of Beijing from June to September in 2019 were sampled and analyzed to study the characteristics of the water quality, the first flush effect, and the main influential factors and sources of pollutants. The results showed that the roof runoff was seriously polluted by total nitrogen, ammonia nitrogen, chemical oxygen demand, and total suspended solids whose event mean concentration (EMC) exceeded the fifth level of environmental quality standards for surface water (GB 3838-2002) (the EMC of suspended solids exceeded the second level of discharge standard of pollutants for municipal wastewater treatment plants (GB 18918-2002)). The rainwater was relatively less polluted than the rainfall runoff, but the EMC of ammonia nitrogen and total nitrogen of the rainwater also exceeded the standard in some rainfall events. The first flush intensity of the rainfall runoffs was between weak and medium. The sequence of strength of the first flush of different pollutants was ammonia nitrogen>total suspended solids>chemical oxygen demand>total nitrogen>mercury>zinc>total phosphorus>lead. The concentration of total suspended solids, chemical oxygen demand, and total phosphorus in roof runoff were significantly positively correlated with the length of rainfall and the dry period and negatively correlated with the rainfall intensity. According to the results of principal component analysis, the main pollutant in rainwater was nitrogen emitted by vehicles, and the main pollutants in roof runoffs were suspended solids, organic matters, and phosphorus pollutants released from the aging of roofing materials and the corrosion of metal down pipes.

Treatment strategies for hepatocellular carcinoma with extrahepatic metastasis.

Extrahepatic metastasis (EHM) of hepatocellular carcinoma (HCC) has increasingly been seen due to improved survival with effective management of intrahepatic lesions. The presence of EHM indicates an advanced stage of HCC, for which systemic therapy serves as the standard treatment modality. Since the approval of Sorafenib as the first systemic agent in 2007, it took almost a decade to show its efficacy in both first and further lines of setting until the landscape of systemic drugs was finally expanded. Moreover, with inspiring results from immunotherapy trials in HCC, it appears that the introduction of immunotherapy may lead to an evolution in the portfolio of HCC treatment. Although the locoregional approach in the management of EHM is not recommended for advanced-stage HCC, efforts have been made to demonstrate its efficacy in symptom relief and potential benefit for overall survival. This review provides a summary of recent updates of the systemic agents in the treatment of advanced HCC, with an emphasis on aggressive locoregional management of EHM by various treatment modalities.

The Prognosis of Type III Biliary Atresia with Hilar Cyst.

OBJECTIVE: To compare the outcome of biliary atresia (BA) patients with and without hilar cyst on preoperative ultrasound. METHODS: A single center retrospective review of patients of BA with (n = 27) and without hilar cyst (n = 27) over a 5 y period was done. The patients were analyzed using propensity score matching to reduce selection bias. All patients were diagnosed as type III BA by histologic examination and cholangiograms. Clinicopathological characteristics and survival outcomes were compared between the two groups. RESULTS: There were no significant intergroup differences between baseline characteristics and outcomes after Kasai portoenterostomy surgery in two groups. BA with hilar cyst group showed comparable survival outcomes to the BA without cyst group (cumulative 1-y, 2-y and 5-y overall survival rates with native liver 61.4% vs. 65.8%, P = 0.041; 45.0% vs. 49.0%, P = 0.57; 45.0% vs. 49.0%, P = 0.57). And the Kaplan-Meier survival curves showed no significant difference in cumulative survival with native liver between the two groups (P = 0.58). CONCLUSIONS: Type III BA with hilar cyst had no better prognosis compared with Type III BA without cyst.

Multiple-Electrode Switching-Based Radiofrequency Ablation vs. Conventional Radiofrequency Ablation for Single Early-Stage Hepatocellular Carcinoma Ranging From 2 to 5 Cm.

Purpose: To retrospectively compare the treatment outcome of multiple-electrode switching-based radiofrequency ablation (switching RFA) and the conventional RFA for early-stage hepatocellular carcinoma (HCC). Methods: A total of 122 patients with single early-stage HCC ranging from 2.1 to 5.0 cm received ultrasonography-guided percutaneous RFA as the first-line treatment. Seventy-one patients underwent switching RFA, and 51 underwent conventional RFA. Tumor response, major complication, local tumor progression (LTP), and overall survival (OS) were compared between the two groups. Log-rank tests and Cox regression models were used for univariate and multivariate analyses to identify predictors of LTP and OS. Results: The rate of initial local complete response rates were 100% (71/71) in the switching RFA group and 98.0% (50/51) in the conventional RFA group (P > 0.05). No major complication occurred in the switching RFA group, whereas two in the conventional RFA group. After a median follow-up period of 45.9 months (range, 9.8-60.0 months), the rates of LTP in the switching RFA and conventional RFA groups were 19.7% (14/71) and 41.2% (21/51), respectively. The cumulative LTP rates at 1, 3, and 5 years were 11.3, 20.5, and 20.5% for switching RFA and 17.6, 38.7, and 46.7% for conventional RFA, respectively (p < 0.001). Switching RFA was an independent factor associated with a lower LTP rate (p = 0.022). Five-year OS rates were 75.8% after switching RFA vs. 66.2% after conventional RFA (p = 0.363). Extrahepatic recurrence was a significant prognostic factor for OS in multivariable analysis. Conclusion: Compared with conventional RFA, switching RFA provides a high local tumor control for single early-stage HCC. An ongoing randomized trial might help to clarify the role of this approach for the treatment of HCC.

Supramolecular Photothermal Nanomedicine Mediated Distant Tumor Inhibition via PD-1 and TIM-3 Blockage.

Supramolecular nanoparticles for photothermal therapy (PTT) have shown promising therapeutic efficacy in the primary tumor and great potential for turning the whole-body immune microenvironment from "cold" to "hot," which allows for the simultaneous treatment of the primary tumor and the metastatic site. In this work, we develop a liposome-based PTT nanoparticle through the self-assembly of FDA-approved intravenous injectable lipids and a photothermal agent, indocyanine green (ICG). The obtained ICG-liposome shows long-term storage stability, high ICG encapsulation efficiency (>95%), and enhanced near-infrared (NIR) light-triggered photothermal reaction both in vitro and in vivo. The ICG-liposome efficiently eradicated the primary tumor upon laser irradiation in two colon cancer animal models (CT26 and MC38) and promoted the infiltration of CD8 T cells to distant tumors. However, PTT from ICG-liposome shows only a minimal effect on the inhibition of distant tumor growth in long-term monitoring, predicting other immunosuppressive mechanisms that exist in the distant tumor. By immune-profiling of the tumor microenvironment, we find that the distant tumor growth after PTT highly correlates to compensatory upregulation of immune checkpoint biomarkers, including program death-1 (PD-1), T-cell immunoglobulin, and mucin domain-containing protein 3 (TIM-3), in tumor-infiltrating CD8 T cells. Based on this mechanism, we combine dual PD-1 and TIM-3 blockade with PTT in an MC38 tumor model. This combo successfully clears the primary tumor, generates a systemic immune response, and inhibits the growth of the distant tumor. The ICG-liposome-combined PD-1/TIM-3 blockade strategy sheds light on the future clinical use of supramolecular PTT for cancer immunotherapy.

Preoperative prediction of tumour deposits in rectal cancer by an artificial neural network-based US radiomics model.

OBJECTIVE: To develop a machine learning-based ultrasound (US) radiomics model for predicting tumour deposits (TDs) preoperatively. METHODS: From December 2015 to December 2017, 127 patients with rectal cancer were prospectively enrolled and divided into training and validation sets. Endorectal ultrasound (ERUS) and shear-wave elastography (SWE) examinations were conducted for each patient. A total of 4176 US radiomics features were extracted for each patient. After the reduction and selection of US radiomics features , a predictive model using an artificial neural network (ANN) was constructed in the training set. Furthermore, two models (one incorporating clinical information and one based on MRI radiomics) were developed. These models were validated by assessing their diagnostic performance and comparing the areas under the curve (AUCs) in the validation set. RESULTS: The training and validation sets included 29 (33.3%) and 11 (27.5%) patients with TDs, respectively. A US radiomics ANN model was constructed. The model for predicting TDs showed an accuracy of 75.0% in the validation cohort. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and AUC were 72.7%, 75.9%, 53.3%, 88.0% and 0.743, respectively. For the model incorporating clinical information, the AUC improved to 0.795. Although the AUC of the US radiomics model was improved compared with that of the MRI radiomics model (0.916 vs. 0.872) in the 90 patients with both ultrasound and MRI data (which included both the training and validation sets), the difference was nonsignificant (p = 0.384). CONCLUSIONS: US radiomics may be a potential model to accurately predict TDs before therapy. KEY POINTS: • We prospectively developed an artificial neural network model for predicting tumour deposits based on US radiomics that had an accuracy of 75.0%. • The area under the curve of the US radiomics model was improved than that of the MRI radiomics model (0.916 vs. 0.872), but the difference was not significant (p = 0.384). • The US radiomics-based model may potentially predict TDs accurately before therapy, but this model needs further validation with larger samples.

[Temporal Variation, Spatial Distribution, and Reactivity Characteristics of Air VOCs in Beijing 2015].

In 2015, continuous volatile organic compound (VOC) monitoring was conducted for Dongsi (urban site), the southeast boundary site Yongledian, and Dingling (background site). The average annual mole fraction of atmospheric VOCs in urban areas was(48.93±31.03)×10-9, the average annual mole fraction of the southeast boundary was (54.55±39.64)×10-9, and the average annual mole fraction for the background site was(28.25±21.26)×10-9. Considering VOC components, alkanes occupy the highest proportion, followed by oxygen-containing VOCs, olefins, aromatic hydrocarbons, halogenated hydrocarbons, and acetylene. VOC concentration was higher in winter, lower in summer, higher at night and lower in the daytime. The concentration of acetylene in urban areas was higher in spring, summer and autumn, but higher in winter at the southeast boundary site. However, in the background, a small amount of direct anthropogenic interference was detectable, with the concentration of oxygen VOCs higher at noon and in summer. The species with high mole fractions in the VOCs were identified as mainly ethane, acetylene, ethylene, acetaldehyde, propane, acetone, n-butane, dichloromethane, and other low-carbon substances. The concentrations of benzene and toluene in the high-carbon group was relatively high. From the toluene/benzene ratio, it was found that Beijing VOCs were influenced by many sources other than transportation. However, the ratio of ethane/acetylene has been found to be significantly dependent on the aging of air mass in Beijing, with the southeast boundary particularly affected by movement of the aging air mass. Changes in the ratio of isopentane/TVOC showed that high summer temperature enhanced gasoline volatilization. The southeastern boundary point of OFP was the highest, followed by the urban area, with Dingling lower. The species with greater contribution to OFP were ethylene, propylene, acetaldehyde, paraxylene and toluene, with the higher mole fraction of alkanes making little contribution to OFP.

Real-Time Shear Wave Ultrasound Elastography Differentiates Fibrotic from Inflammatory Strictures in Patients with Crohn's Disease.

Background and aim: The distinction of intestinal fibrosis from inflammation in Crohn's disease (CD) associated strictures has important therapeutic implications. Ultrasound elastography is useful in evaluating the degree of fibrosis in liver, but there is little evidence whether it can assess fibrosis in the bowel. We determined whether shear-wave elastography (SWE), a novel modification of elastography, quantifying tissue stiffness, could differentiate between inflammatory and fibrotic components in strictures of patients with CD. Methods: Consecutive CD patients with ileal/ileocolonic strictures who underwent SWE within 1 week to surgical resection were enrolled. The SWE value of the stenotic bowel wall was compared to the grade and severity of fibrosis and inflammation, respectively, in the resected bowel specimen. Results: Thirty-five patients were enrolled. The mean SWE value of stenotic bowel wall was significantly higher in severe fibrosis (23.0 ± 6.3 Kpa) than that in moderate (17.4 ± 3.8 Kpa) and mild fibrosis (14.4 ± 2.1 Kpa)(P = 0.008). Using 22.55 KPa as the cutoff value in discriminating between mild/moderate and severe fibrosis, the sensitivity and specificity was 69.6 % and 91.7% with an area under the curve (AUC) of 0.822 (P = 0.002). However, no significant difference regarding mean SWE existed among different grades of inflammation. The sensitivity and specificity of bowel vascularization score on conventional ultrasound in differentiating severe inflammation from mild/moderate was 87.5 % and 57.9% with AUC of 0.811 (P = 0.002). Combining SWE and conventional ultrasound (bowel vascularization score), we propose a bowel ultrasound classification of intestinal strictures. A moderate agreement between ultrasound and pathological classification was observed (κ = 0.536, P＜0.001). Conclusions: This pilot study suggests that SWE is feasible and accurate in detecting intestinal fibrosis in patients with CD. After validation, combing SWE and bowel vascularization on conventional ultrasound might be applied to guide a management strategy in CD patients through defining the type of intestinal stricture. 10.1093/ibd/izy115_video1izy115.video15777734754001.

Liver stiffness measurements with supersonic shear wave elastography in the diagnosis of biliary atresia: a comparative study with grey-scale US.

OBJECTIVES: To prospectively assess the diagnostic performance of supersonic shear wave elastography (SSWE) in identifying biliary atresia (BA) among infants with conjugated hyperbilirubinaemia by comparing this approach with grey-scale ultrasonography (US). METHODS: Forty infants were analysed as the control group to determine normal liver stiffness values. The use of SSWE values for identifying BA was investigated in 172 infants suspected of having BA, and results were compared with the results obtained by grey-scale US. The Mann-Whitney U test, unpaired t-test, Spearman correlation and linear regression were also performed. RESULTS: The success rates of SSWE measurements in the control and study group were 100% (40/40) and 96.4% (244/253), respectively. Age, direct bilirubin, and indirect bilirubin all significantly correlated with SSWE in the liver (all P < 0.001). Linear regression showed that age had a greater effect on SSWE values than direct or indirect bilirubin. The diagnostic performance of liver stiffness values in identifying BA was lower than that of grey-scale US (area under the receiver operating characteristic curve [AUC], 0.790 vs 0.893, P < 0.001). CONCLUSIONS: SSWE is feasible and valuable in differentiating BA from non-BA. However, its diagnostic performance does not exceed that of grey-scale US. KEY POINTS: • SSWE could be successfully performed in an infant population. • For infants, the liver stiffness will increase as age increases. • SSWE is potentially useful in assessing infants suspected of biliary atresia. • SSWE is inferior to grey-scale US in identifying biliary atresia.

[Pollution Characteristics of NH4+,NO3-,SO42- in PM2.5and Their Precursor Gases During 2015 in an Urban Area of Beijing].

Simultaneous measurements of precursor gases NH3,NO,NO2,SO2 and the main water-soluble ions in PM2.5 such as sulphate (SO42-),nitrate (NO3-) and ammonium (NH4+) (collectively called SNA)were carried out in the urban area of Beijing during 2015-01 to 2015-12,which obtained 325 groups of samples. PTFE membrane filters were used to collect particulate NH4+, NO3- and SO42-, followed by the online instruments to collect precursor gases. The pollution characteristics of the precursor gases and SNA were analyzed and their correlation was studied. The mean concentrations of NH3, NO, NO2, SO2, NH4+,NO3- and SO42- were 21.5, 17.7, 54.3, 14.2, 8.1, 13.5 and 12.7 µg·m-3 respectively during the period of monitoring, and SNA accounted for 43.4% of PM2.5. The concentrations of SO2,NOx and SNA declined compared to 2014. The concentrations of NO,NO2 and SO2 were highest in winter and lowest in summer. The concentration of NH3 was higher in summer and lower in autumn; The concentration and the percentage of NH4+ were stable during the four seasons,both the concentrations and the percentage of NO3- were lowest in summer. The concentrations of SO42- was highest in winter and the percentage was lowest in summer. The ratio of ([NO3-]+2[SO42-]) and NH4+ was 0.97 during the whole year, showing that anions mainly existed in the form of NO3- and SO42-. In summer, the ratio of[NO3-]+2[SO42-] and[NH4+] was slightly higher than 1.0, which was the reason why NO3- was bound to Ca2+, Mg2+ and Na+besides NH4+. With the increase of pollution, the mass concentration of precursor gases and SNA increased dramatically, among which NOx increased most rapidly, and SO2 decreased from severe pollution to serious pollution. The contribution rate of NH4+ was maintained at a relatively stable level. SO42- had a higher contribution when the pollution level was lower, whereas the concentration of NO3- was higher than others and contributed most to PM2.5 in heavy pollution. Heterogeneous transformation on the surface of particulate matter played a more important role in the formation of SO42- and NO3-. The correlations between NO3-, NO2 and NO,NH4+ and NH3,SO42- and SO2 were significant at the confidence level of 0.01. SO42- had negative correlation with SO2, and NO3- had positive correlation with NO2. Compared with NH3, the NH4+ concentration was more obviously affected by acid gases NO2, SO2.

[Analysis of Atmospheric Particulate Matter Pollution Characteristics by LIDAR in Beijing During Spring Festival, 2016].

Real-time aerosol extinction retrieved by Micro-pulse LIDAR and concentrations of PM2.5 and PM10 in Beijing were analyzed to investigate the air quality during the Spring Festival. The results showed that fireworks on the New Year's Eve resulted in a sharp increase in particulate matter concentrations in a short time. The maximum concentration of PM2.5 at Guanyuan station was 639.3 µg·m-3, which increased by nearly 30 times in 9 h. The maximum hourly concentration of particulate matter at Dingling and Liulihe suburban stations were significantly higher than that in Guanyuan station, the maximum values were more than 1000 µg·m-3. The particulate matter levels were continuously high on February 10-12 and the concentration of particulate matter at Dingling and Liulihe suburban stations were higher than that at Guanyuan. LIDAR results showed no obvious changes in the extinction coefficient at Dingling on the New Year's Eve. The extinction coefficient at Liulihe was greater than 1 km-1, but the particulate matter pollution was concentrated at altitudes less than 400 m. The extinction coefficient at Chegongzhuang was still higher than 0.4 km-1 at 500 m; however, the duration of pollution was shorter than that of Liulihe. The extinction coefficients at 105 m at all three stations during the New Year's Eve were significantly higher than those at 405 m. There were significant differences in the vertical extinction characteristics of the three sites. The background maximum values of Dingling, Chegongzhuang, and Liulihe were 0.09 km-1, 0.20 km-1, and 0.19 km-1 under 1.0 km, respectively. The maximum extinction coefficients at 00:00 (midnight) were 0.23 km-1, 1.36 km-1, and 1.19 km-1, which were 2.6 times, 6.8 times, and 6.0 times higher than the background value at the same time, respectively. In summary, discharge of fireworks led to a dramatic increase in the extinction coefficient of particulate matter. Temperature inversion and lower wind speeds were the main meteorological factors that contributed to this pollution event.

Elastography of shear wave speed imaging for the evaluation of liver fibrosis: A meta-analysis.

AIM: A meta-analysis was carried out to assess the accuracies of shear wave speed imaging (SWSI) in predicting significant fibrosis (stages F2-4) and cirrhosis (stage F4). METHODS: A review was performed of relevant studies published until October 2015. A bivariate binomial model was used to combine the sensitivity, specificity, and the area under the summary receiver operating characteristic (AUC), and 95% confidence intervals were derived to indicate the diagnostic accuracy of imaging modalities. RESULTS: In total, 10 studies with 2182 patients were included in the analysis. The sensitivity, specificity, and AUC (with 95% confidence intervals) of SWSI were: 0.84 (0.81-0.87), 0.83 (0.77-0.88), and 0.88 (0.85-0.90) for significant fibrosis, respectively; and 0.80 (0.66-0.89), 0.93 (0.88-0.96), and 0.95 (0.92-0.96) for cirrhosis, respectively. When SWSI was compared with well-evaluated transient elastography, the AUCs for the prediction of significant fibrosis were 0.93 and 0.86, respectively. The AUCs for the prediction of cirrhosis were both 0.94. CONCLUSION: Shear wave speed imaging is a trustworthy tool for staging hepatic fibrosis, with a high combination of sensitivity and specificity. Compared with transient elastography, SWSI showed better diagnostic performance for the prediction of significant fibrosis.

[Concentration Characteristics of PM2.5 in Beijing During Two Red Alert Periods].

Variations of PM2.5 concentrations and effects of pollution control measures during two red alert periods in 2015 in Beijing were analyzed based on atmospheric pollutant monitoring data. The results showed that during the first red alert, the highest hourly-averaged PM2.5 concentration occurred at 19:00 on 9th December with a value of 282 µg·m-3 and the highest hourly PM2.5 concentration appeared at Yongledian station which is near the southeast border of Beijing, with the peak concentration of 496 µg·m-3. During the second red alert, the highest hourly-averaged concentration of PM2.5 occurred at 20:00 on 22th with a value of 421 µg·m-3. The highest hourly PM2.5 concentration was monitored at Liulihe station which is near the southwest border of Beijing, with the peak concentration of 831 µg·m-3. During the duration period of both red alerts, the concentrations at the southern stations were higher than those at downtown stations and the PM2.5 concentrations at northern stations were found to be the smallest. The difference between these two red alerts was that during the second red alert, the PM2.5 concentrations in southern Beijing were significantly higher than those in the northern area, while the magnitude of this south-to-north gradient was much smaller during the first one. During the second red alert, up to 93% of Beijing area showed an average PM2.5 concentration of above 150 µg·m-3, which was much larger than that in the first one. The meteorological conditions during the two red alerts were both not conducive to the spread of pollutants. Formation of secondary pollutants and regional pollutant transport existed as well. Though the stagnant weather conditions were in favor of the development of severe pollution, large regional-wide pollutant emission was the main reason for these two heavy air pollutions in Beijing. PM2.5 concentrations were decreased by 20%-25% after the implementation of emergency response measures, which showed the significance of emission reduction in air pollution control.

[Comparison Test Between On-line Monitoring of Water-soluble Ions and Filter-based Manual Methods for PM2.5].

Concentrations of water-soluble ions were measured in Beijing during 2014 for comparison of URG online monitoring systems and filter-based manual methods. The differences of four main ions components in spring, summer, autumn and winter were compared. The total concentrations of eight ions measured by URG online were higher than those of filter-based manual method. There was no significant differences among the annual concentrations of Cl-,NO3-,Mg2+ and Ca2+ obtained by the two methods, while the concentrations of SO42-,NH4+,Na+,K+ from online were higher than those from filter. NO3-,SO42-,Cl- had good correlations in autumn and winter, and NH4+ only had better fitting performance in winter.