Identification of Galectin 9 and its antibacterial function in yellow drum (Nibea albiflora).

Galectins are a family of evolutionarily conserved lectins that contain carbohydrate recognition domains (CRDs) specifically recognizing ß-galactoside. Galectin-9 plays a crucial role in various biological processes during pathogenic infections. In a previous study, galectin-9 was identified as a candidate gene for resistance to Vibrio harveyi disease in yellow drum using a genome-wide association study (GWAS) analysis. In this study, a galectin-9 gene was identified from Nibea albiflora and named YdGal-9. The mRNA transcripts of YdGal-9 were distributed in all the detected tissues and the highest level was found in the kidney. The subcellular localization of YdGal-9-EGFP proteins was observed in both nucleus and cytoplasm in the kidney cells of N. albiflora. The expression of YdGal-9 in the brain increased significantly after infection with Vibrio harveyi. The red blood cells from rabbits, Larimichthys crocea, and N. albiflora were agglutinated by the purified recombinant YdGal-9 proteins. The results of the agglutination activity of deletion mutants of YdGal-9 proved that the conserved sugar binding motifs (H-NPR and WG-EE-) were critical for YdGal-9's agglutination activity. In addition, YdGal-9 killed some gram-negative bacteria by inducing cell wall destruction including Pseudomonas plecoglossicida, Aeromonas hydrophila, Escherichia coli, V. parahemolyticus, V. harveyi, and V. alginolyticus. Taken together, these results suggested that the YdGal-9 protein of N. albiflora played a vital role in fighting bacterial infections.

Generalizability and Diagnostic Performance of AI Models for Thyroid US.

Background Artificial intelligence (AI) models have improved US assessment of thyroid nodules; however, the lack of generalizability limits the application of these models. Purpose To develop AI models for segmentation and classification of thyroid nodules in US using diverse data sets from nationwide hospitals and multiple vendors, and to measure the impact of the AI models on diagnostic performance. Materials and Methods This retrospective study included consecutive patients with pathologically confirmed thyroid nodules who underwent US using equipment from 12 vendors at 208 hospitals across China from November 2017 to January 2019. The detection, segmentation, and classification models were developed based on the subset or complete set of images. Model performance was evaluated by precision and recall, Dice coefficient, and area under the receiver operating characteristic curve (AUC) analyses. Three scenarios (diagnosis without AI assistance, with freestyle AI assistance, and with rule-based AI assistance) were compared with three senior and three junior radiologists to optimize incorporation of AI into clinical practice. Results A total of 10 023 patients (median age, 46 years [IQR 37-55 years]; 7669 female) were included. The detection, segmentation, and classification models had an average precision, Dice coefficient, and AUC of 0.98 (95% CI: 0.96, 0.99), 0.86 (95% CI: 0.86, 0.87), and 0.90 (95% CI: 0.88, 0.92), respectively. The segmentation model trained on the nationwide data and classification model trained on the mixed vendor data exhibited the best performance, with a Dice coefficient of 0.91 (95% CI: 0.90, 0.91) and AUC of 0.98 (95% CI: 0.97, 1.00), respectively. The AI model outperformed all senior and junior radiologists (P < .05 for all comparisons), and the diagnostic accuracies of all radiologists were improved (P < .05 for all comparisons) with rule-based AI assistance. Conclusion Thyroid US AI models developed from diverse data sets had high diagnostic performance among the Chinese population. Rule-based AI assistance improved the performance of radiologists in thyroid cancer diagnosis. © RSNA, 2023 Supplemental material is available for this article.

Homemade Chinese herbal fumigation eye patch prevents myopia in children and adolescents.

OBJECTIVE: To demonstrate the clinical efficacy of a homemade Chinese herbal fumigation eye patch in the prevention and treatment of myopia in children and adolescents. METHODS: In this retrospective study, participants were grouped according to different intervention methods. A primary school was selected, wherein 50 myopic students in each grade and a total of 300 from the 6 grades were selected as the observation group. According to the 1:1 matching principle, another 300 myopic students matched with the uncorrected visual acuity (UCVA), gender, and class were selected as the control group. The observation group was treated with the Chinese herbal fumigation patch, once daily between 12:00 and 13:00, 10-15 min/time, for 30 consecutive days. The control group did not get any intervention measures. The UCVA, diopter (D), and axial length (AXL) of both groups were recorded on the 1st, 15th, and 30th day after enrollment. RESULTS: Six hundred children and adolescents, including 324 males and 276 females with an average age of (8.8±2.3) years and UCVA of (4.51±0.37), were included, with none lost to follow up. No statistical significance was determined in pre-interventional TCM syndrome distribution, D and AXL between groups (all P > 0.05). Univariate analysis identified that the UCVA of the observation group changed with time (P < 0.05), presenting a linear trend (P < 0.05). In the control group, the changes in UCVA, D, and AXL over time were also statistically significant (all P < 0.05), and the reverse changes showed a linear trend with statistical significance (all P < 0.05). Multivariate analysis determined the presence of statistical inter-group differences in UCVA, D, and AXL (all P < 0.05), as well as an interaction between grouping and time. CONCLUSIONS: The homemade Chinese herbal fumigation eye patch can improve UCVA, delaying D deterioration and preventing eye axial lengthening among myopic children and adolescents, with clinical popularization value.

Studies on competitive adsorption characteristics of bisphenol A and 17α-ethinylestradiol on thermoplastic polyurethane by site energy distribution theory.

Compound pollution of microplastics and estrogens is a growing ecotoxicological problem in aquatic environments. The adsorption isothermal properties of bisphenol A (BPA) and 17α-ethinyl estradiol (EE2) on polyamide (TPU) in monosolute and bisolute systems were studied. Under the same adsorption concentration (1-4 mg L-1), EE2 had a greater adsorption capacity than BPA in the monsolute system. Compared to the energy distribution features of the adsorption sites of EE2 and BPA, the BPA adsorption sites were located in the higher energy area and were more evenly distributed than those of EE2, while the quantity of BPA adsorption sites was less than that of EE2. In the bisolute system, the average site energy, site energy inhomogeneity, and adsorption site numbers of BPA increased by 1.674, -17.166, and 16.793%, respectively. In comparison, the average site energy, site energy inhomogeneity, and adsorption sites numbers of EE2 increased by 2.267, 4.416, and 8.585%, respectively. The results showed that BPA and EE2 had a cooperative effect on the competitive adsorption of TPU. XPS analysis showed that BPA and EE2 had electron transfer on TPU, although the chemisorption effects and hydrogen bonds between BPA and TPU were more significant. Comparing the changes in the relative functional group content of TPU in monosolute and bisolute systems, BPA and EE2 were synergistically absorbed on TPU. This study can provide a theoretical reference for the study of competitive adsorption between coexisting organic pollutants.

Development and validation of a nomogram for discriminating between benign and malignant breast masses by conventional ultrasound and dual-mode elastography: a multicenter study.

Background: This study developed and validated an ultrasound nomogram based on conventional ultrasound and dual-mode elastography to differentiate breast masses. Methods: The data of 234 patients were collected before they underwent breast mass puncture or surgery at 4 different centers between 2016 and 2021. Patients were divided into 5 datasets: internal validation and development sets from the same hospital, and external validation sets from the 3 other hospitals. In the development cohort, age and 294 different ultrasound and elastography features were obtained from ultrasound images. Univariate logistic regression and least absolute shrinkage and selection operator (LASSO) regression were used for data reduction and visualization. Multivariable logistic regression analysis was used to develop the prediction model and ultrasound nomogram. Receiver operating characteristic (ROC) curve analysis, calibration curves, integrated discrimination improvement, and the net reclassification index were used to evaluate nomogram performance; decision curve analysis (DCA) and clinical impact curves were used to estimate clinical usefulness. Results: In the development cohort, margin, posterior features, shape, vascularity, (the mean shear wave elastography value of 1.5 mm surrounding tissues in a breast mass) divided by (the mean shear wave elastography value of the breast mass)-shell mean/A mean1.5(E), (the ratio of strain elastography of adipose tissue near a breast mass) divided by [the ratio of strain elastography of (the breast mass adds the 1.5 mm surrounding tissues in the breast mass)]-B/A'1.5 were selected as predictors in multivariable logistic regression analysis, comprising Model 1. Among the 5 cohorts, Model 1 performed best, with areas under the curve (AUC) of 0.92, 0.84, 0.87, 0.93, and 0.89, respectively. The AUCs were 0.90, 0.82, 0.83, 0.91, and 0.85, respectively, in Model 2 (margin + posterior features + shape + vascularity) and 0.80, 0.76, 0.77, 0.87, and 0.80, respectively, in Model 3 [shell mean/A mean1.5(E) + B/A'1.5]. Conclusions: Our ultrasound nomograms facilitate exposure to the features and visualization of breast cancer. Shell mean/A mean1.5(E), B/A'1.5 integrated with margin, posterior features, shape, and vascularity are superior at identifying breast cancer, and are worthy of further clinical investigation.

Virtual elastography ultrasound via generative adversarial network for breast cancer diagnosis.

Elastography ultrasound (EUS) imaging is a vital ultrasound imaging modality. The current use of EUS faces many challenges, such as vulnerability to subjective manipulation, echo signal attenuation, and unknown risks of elastic pressure in certain delicate tissues. The hardware requirement of EUS also hinders the trend of miniaturization of ultrasound equipment. Here we show a cost-efficient solution by designing a deep neural network to synthesize virtual EUS (V-EUS) from conventional B-mode images. A total of 4580 breast tumor cases were collected from 15 medical centers, including a main cohort with 2501 cases for model establishment, an external dataset with 1730 cases and a portable dataset with 349 cases for testing. In the task of differentiating benign and malignant breast tumors, there is no significant difference between V-EUS and real EUS on high-end ultrasound, while the diagnostic performance of pocket-sized ultrasound can be improved by about 5% after V-EUS is equipped.

Molecular Cloning and Functional Characterization of Galectin-1 in Yellow Drum (Nibea albiflora).

Galectins are proteins that are involved in the innate immune response against pathogenic microorganisms. In the present study, the gene expression pattern of galectin-1 (named as NaGal-1) and its function in mediating the defense response to bacterial attack were investigated. The tertiary structure of NaGal-1 protein consists of homodimers and each subunit has one carbohydrate recognition domain. Quantitative RT-PCR analysis indicated that NaGal-1 was ubiquitously distributed in all the detected tissues and highly expressed in the swim-bladder of Nibea albiflora, and its expression could be upregulated by the pathogenic Vibrio harveyi attack in the brain. Expression of NaGal-1 protein in HEK 293T cells was distributed in the cytoplasm as well as in the nucleus. The recombinant NaGal-1 protein by prokaryotic expression could agglutinate red blood cells from rabbit, Larimichthys crocea, and N. albiflora. The agglutination of N. albiflora red blood cells by the recombinant NaGal-1 protein was inhibited by peptidoglycan, lactose, D-galactose, and lipopolysaccharide in certain concentrations. In addition, the recombinant NaGal-1 protein agglutinated and killed some gram-negative bacteria including Edwardsiella tarda, Escherichia coli, Photobacterium phosphoreum, Aeromonas hydrophila, Pseudomonas aeruginosa, and Aeromonas veronii. These results set the stage for further studies of NaGal-1 protein in the innate immunity of N. albiflora.

Study on the role of immune­related genes after intracranial subarachnoid hemorrhage.

We aimed to screen the feature genes related to subarachnoid hemorrhage (SAH). The datasets (GSE73378 and GSE36791) were downloaded from National Center for Biotechnology Information database. Limma package in R was used to screen the differentially expressed genes (DEGs). Single sample gene set enrichment analysis algorithm was used to evaluate the type of immune infiltration. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were used to analyze function of DEGs. The support vector machine (SVM) was used to constructed classifier, which was evaluated using receiver operating characteristic curves. The E­TABM­421 was used to verify the DEGs related to immunity and the classifier. Seven types of immune cells with significant differences were screened, such as activated CD8 T cell and center memory CD4 T cell. We then obtained 408 DEGs related to immune cell. Subsequently, 10 overlapped KEGG pathways related to the DEGs were obtained, such as hematopoietic cell lineage, NOD­like receptor signaling pathway and T cell receptor signaling pathway. Finally, 9 DEGs related to immune cells (CCL5, CD27, CD3D, CREB5, FYN, ITPR3, TAB1, NCR3 and S1PR5) were screened to constructed SVM classifier. The area under the curve was 0.865 in training dataset and the AUC was 0.75 in the validation set. A SVM classifier based on the 9 DEGs (CCL5, CD27, CD3D, CREB5, FYN, ITPR3, TAB1, NCR3 and S1PR5) related to immune cells might effectively identify SAH patients or healthy people.

Novel Human Artificial Intelligence Hybrid Framework Pinpoints Thyroid Nodule Malignancy and Identifies Overlooked Second-Order Ultrasonographic Features.

We present a Human Artificial Intelligence Hybrid (HAIbrid) integrating framework that reweights Thyroid Imaging Reporting and Data System (TIRADS) features and the malignancy score predicted by a convolutional neural network (CNN) for nodule malignancy stratification and diagnosis. We defined extra ultrasonographical features from color Doppler images to explore malignancy-relevant features. We proposed Gated Attentional Factorization Machine (GAFM) to identify second-order interacting features trained via a 10 fold distribution-balanced stratified cross-validation scheme on ultrasound images of 3002 nodules all finally characterized by postoperative pathology (1270 malignant ones), retrospectively collected from 131 hospitals. Our GAFM-HAIbrid model demonstrated significant improvements in Area Under the Curve (AUC) value (p-value < 10−5), reaching about 0.92 over the standalone CNN (~0.87) and senior radiologists (~0.86), and identified a second-order vascularity localization and morphological pattern which was overlooked if only first-order features were considered. We validated the advantages of the integration framework on an already-trained commercial CNN system and our findings using an extra set of ultrasound images of 500 nodules. Our HAIbrid framework allows natural integration to clinical workflow for thyroid nodule malignancy risk stratification and diagnosis, and the proposed GAFM-HAIbrid model may help identify novel diagnosis-relevant second-order features beyond ultrasonography.

Influence of Percutaneous Drainage Surgery and the Interval to Perform Laparoscopic Cholecystectomy on Acute Cholecystitis through Genetic Algorithm-Based Contrast-Enhanced Ultrasound Imaging.

To discuss the optimal interval time between genetic algorithm-based ultrasound imaging-guided percutaneous drainage surgery (PTGD) and laparoscopic cholecystectomy (LC), 64 cholecystitis patients were selected as the research objects and evenly divided into experimental group (intelligent algorithm was adopted to recognize patients' ultrasonic images) and control group (professional doctors carried out diagnosis). 92 acute cholecystitis patients undergoing PTGD were divided into three groups. 30 out of the 92 patients received LC within 2 months and were defined as the early group. 32 were performed with LC within 2 to 4 months and were defined as the metaphase group. 28 underwent LC over 4 months and were defined as the late-stage group. The average operation time, the transition from LC to laparotomy, the average postoperative hospital stay, and the incidence of complications of the three groups were compared. The results revealed that the comparison of the diagnostic accuracy and comprehensive effectiveness between experimental group and control group demonstrated that the differences were statistically significant (P < 0.05). When the optimal interval of implementing LC after PTGD was realized, the corresponding values of the early group were 88.5 minutes, 16.67%, 8.13 days, and 13.75%. Those of the metaphase group were 49.91 minutes, 3.13%, 4.97 days, and 9.52%. Those of the late stage group were 68.78 minutes, 10.71%, 7.09 days, and 11.96%. To sum up, the diagnostic accuracy and comprehensive effectiveness of intelligent algorithm were higher than those of conventional ultrasound, and the optimal interval time of implementing LC after PTGD was 2 to 4 months.

The severity of portal hypertension by a non-invasive assessment: acoustic structure quantification analysis of liver parenchyma.

BACKGROUND: Acoustic structure quantification (ASQ) has been applied to evaluate liver histologic changes by analyzing the speckle pattern seen on B-mode ultrasound. We aimed to assess the severity of portal hypertension (PHT) through hepatic ultrasonography. METHODS: Sixty patients diagnosed with PHT and underwent surgical treatment with portosystemic shunts were enrolled. Portal pressure (PP) was measured intraoperatively. Patients were divided into subgroups according to the severity of gastroesophageal varices and Child-Pugh class. Three difference ratio (Cm2) values on ASQ histogram mode were analyzed for their relationships with PP, degree of gastroesophageal varices and Child-Pugh liver function. Thirty healthy volunteers matched with the patients for gender and age were enrolled as controls. Comparisons among groups and correlation of the parameters with PP were analyzed. Area under the receive operating characteristic curve was used to evaluate the predicting value of ASQ parameters. RESULTS: In the patients, the ASQ parameters peak Cm2 (Cm2max), mean Cm2 (Cm2mean) and the highest occurred Cm2 value of the obtained red curve (RmaxCm2) were all greatly increased (P < 0.0001, P < 0.0001, P = 0.027). Multiple comparisons indicated that, regardless of Child-Pugh class and degree of gastroesophageal varices, the patients had significantly increased Cm2max and Cm2mean compared with the controls (all P < 0.0001). No differences among subgroups were observed. Cm2max was significantly statistically correlated with PP (r = 0.3505, P < 0.01), degree of varices (r = 0.4998, P < 0.0001). Youden's index for Cm2max with a cut-off value of 140.3 for predicting the presence of PHT, gastroesophageal varices and liver function equal to or worse than Child-Pugh class B were 0.8, 0.91 and 0.84, respectively. CONCLUSIONS: ASQ analysis of ultrasonographic images may have a role in the evaluation of the severity of PHT by detecting liver histologic changes in the speckle pattern caused by cirrhosis.

Comprehensive Risk System Based on Shear Wave Elastography and BI-RADS Categories in Assessing Axillary Lymph Node Metastasis of Invasive Breast Cancer-A Multicenter Study.

Purpose: To develop a risk stratification system that can predict axillary lymph node (LN) metastasis in invasive breast cancer based on the combination of shear wave elastography (SWE) and conventional ultrasound. Materials and Methods: A total of 619 participants pathologically diagnosed with invasive breast cancer underwent breast ultrasound examinations were recruited from a multicenter of 17 hospitals in China from August 2016 to August 2017. Conventional ultrasound and SWE features were compared between positive and negative LN metastasis groups. The regression equation, the weighting, and the counting methods were used to predict axillary LN metastasis. The sensitivity, specificity, and the areas under the receiver operating characteristic curve (AUC) were calculated. Results: A significant difference was found in the Breast Imaging Reporting and Data System (BI-RADS) category, the "stiff rim" sign, minimum elastic modulus of the internal tumor and peritumor region of 3 mm between positive and negative LN groups (p < 0.05 for all). There was no significant difference in the diagnostic performance of the regression equation, the weighting, and the counting methods (p > 0.05 for all). Using the counting method, a 0-4 grade risk stratification system based on the four characteristics was established, which yielded an AUC of 0.656 (95% CI, 0.617-0.693, p < 0.001), a sensitivity of 54.60% (95% CI, 46.9%-62.1%), and a specificity of 68.99% (95% CI, 64.5%-73.3%) in predicting axillary LN metastasis. Conclusion: A 0-4 grade risk stratification system was developed based on SWE characteristics and BI-RADS categories, and this system has the potential to predict axillary LN metastases in invasive breast cancer.

Practical and Scalable Manufacturing Process for the Key Intermediate of Poly(ADP-Ribose) Polymerase Inhibitor Olaparib.

Olaparib (Lynparza) is a potent, highly selective inhibitor of poly(ADP-ribose)polymerase enzymes, approved by the U.S. FDA and EMA for the treatment of ovarian cancer. Herein, we report a practical, economical, and scalable process for the synthesis of 2-fluoro-5-((4-oxo-3,4-dihydrophthalazin-1-yl)methyl)benzoic acid, a key intermediate for olaparib. The low-cost industrial byproduct phthalhydrazide was used as the starting material to construct the phthalazinone moiety, which allowed access to the key intermediate by the Negishi coupling reaction. Optimization of each step has enabled the development of an environmentally benign and robust process with effective control of impurities.

Bioinspired therapeutic platform based on extracellular vesicles for prevention of arterial wall remodeling in hypertension.

Arterial stiffness due to the vessel remodeling is closely linked to raised blood pressure, and its physiopathologic mechanism is still not fully understood. We here aimed to explore whether extracellular vesicle (EV) mediated intercellular communication between endothelium and smooth muscle cell contribute to the blood vessel remodeling under hypertension. We here revealed that the arterial endothelial cells robustly secreted EV, which in turn could be circulated and/or directly taken up by the subendothelial smooth muscle cells (SMC). Under hypertension, the EV secretion increased and the miRNA profile changed significantly mainly due to the raised mechanical force and subsequent enhanced reactive oxygen species generation. Among the miRNA cargos in the EV, miR-320d/423-5p were found increased most significantly. In vivo delivery of miR-320d/423-5p mimics via engineered EV increased their expression in arterial vessels, recapitulating the phenotype in hypertension. In contrast, therapeutic delivery of miR-320d/423-5p inhibitors via engineered EV alleviated the phenotype in spontaneous hypertension rat model. Together, we have found that the injured endothelium due to the raised mechanical force in hypertension contributes to the arterial wall remodeling via the secreted EV. Our study has not only provided novel insights on the mechanism of hypertension associated blood vessel wall remodeling, but also shed light on therapeutic intervention of hypertension associated vascular diseases.

Identification of upregulated NF-κB inhibitor alpha and IRAK3 targeting lncRNA following intracranial aneurysm rupture-induced subarachnoid hemorrhage.

BACKGROUND: This study was performed to identify genes and lncRNAs involved in the pathogenesis of subarachnoid hemorrhage (SAH) from ruptured intracranial aneurysm (RIA). METHODS: Microarray GSE36791 was downloaded from Gene Expression Omnibus (GEO) database followed by the identification of significantly different expressed RNAs (DERs, including lncRNA and mRNA) between patients with SAH and healthy individuals. Then, the functional analyses of DEmRNAs were conducted and weighted gene co-expression network analysis (WGCNA) was also performed to extract the modules associated with SAH. Following, the lncRNA-mRNA co-expression network was constructed and the gene set enrichment analysis (GSEA) was performed to screen key RNA biomarkers involved in the pathogenesis of SAH from RIA. We also verified the results in a bigger dataset GSE7337. RESULTS: Totally, 561 DERs, including 25 DElncRNAs and 536 DEmRNAs, were identified. Functional analysis revealed that the DEmRNAs were mainly associated with immune response-associated GO-BP terms and KEGG pathways. Moreover, there were 6 modules significantly positive-correlated with SAH. The lncRNA-mRNA co-expression network contained 2 lncRNAs (LINC00265 and LINC00937) and 169 mRNAs. The GSEA analysis showed that these two lncRNAs were associated with three pathways (cytokine-cytokine receptor interaction, neurotrophin signaling pathway, and apoptosis). Additionally, IRAK3 and NFKBIA involved in the neurotrophin signaling pathway and apoptosis while IL1R2, IL18RAP and IL18R1 was associated with cytokine-cytokine receptor interaction pathway. The expression levels of these genes have the same trend in GSE36791 and GSE7337. CONCLUSION: LINC00265 and LINC00937 may be implicated with the pathogenesis of SAH from RIA. They were involved in three important regulatory pathways. 5 mRNAs played important roles in the three pathways.

Preparation of multifunctional nanobubbles and their application in bimodal imaging and targeted combination therapy of early pancreatic cancer.

Pancreatic cancer will gradually become the second leading cause of cancer death due to its poor suitability for surgical treatment, frequent recurrence and metastasis, and insensitivity to radiotherapy and chemotherapy. Strategies for precise early detection and effective targeted treatment of pancreatic cancer are urgently needed. Because of its unique advantages, molecular targeted contrast-enhanced ultrasound imaging (CEUI) has generated new opportunities to overcome this challenge. The aim of this study was to explore multifunctional nanobubbles named IR780-NBs-DTX as novel ultrasound contrast agents (UCAs) for dual-mode targeted imaging and photothermal ablation combined with chemotherapy for pancreatic cancer. An optimized "film hydration method" was used to prepare IR780-NBs-DTX in this research. The characteristics and ability of the new UCAs were detected via in vitro, in vivo and ex vivo experiments. The initial dose of 0.15 mg IR-780 iodide/1.0 mg DTX was considered to be the best formula for IR780-NBs-DTX, and the concentration of 6 ×106 bubbles/mL was best for CEUI. The excellent characteristics of IR780-NBs-DTX, including a uniform nanoscale particle size (349.8± 159.1 nm, n= 3), good performance in dual-mode imaging, high stability and reliable biocompatibility, were also proven. In the in vitro cell experiments, IR780-NBs-DTX targeted more pancreatic cancer cells than the control treatments, and the targeting rate was approximately 95.6± 1.7%. Under irradiation with an 808 nm laser, most cells died. Furthermore, the in vivo study demonstrated that IR780-NBs-DTX could precisely detect pancreatic cancer through near infrared fluorescence (NIRF) imaging and CEUI, and the tumor almost disappeared at 18 days after combined treatment. In ex vivo experiments, immunohistochemistry (IHC) and immunofluorescence (IF) showed that the expression of HSP70 increased and that of PCNA decreased, and many apoptotic tumor cells were observed by TUNEL staining in the IR780-NBs-DTX group. The newly prepared IR780-NBs-DTX are novel nanosized UCAs with high efficiency for dual-mode molecular targeted imaging and combined therapy, and they may have future potential applications in the precise detection and effective targeted therapy of small and metastatic lesions in the early stage of pancreatic cancer.

Thyroid imaging reporting and data system (TIRADS) for ultrasound features of nodules: multicentric retrospective study in China.

PURPOSE: To establish a practical and simplified Chinese thyroid imaging reporting and data system (C-TIRADS) based on the Chinese patient database. METHODS: A total of 2141 thyroid nodules that were neither cystic nor spongy were used in the current study. These specimens were derived from 2141 patients in 131 alliance hospitals of the Chinese Artificial Intelligence Alliance for Thyroid and Breast Ultrasound. The ultrasound features, including location, orientation, margin, halo, composition, echogenicity, echotexture, echogenic foci and posterior features were assessed. Univariate and multivariate analyses were performed to investigate the association between ultrasound features and malignancy. The regression equation, the weighting, and the counting methods were used to determine the malignant risk of the thyroid nodules. The areas under the receiver operating characteristic curve (Az values) were calculated. RESULTS: Of the 2141 thyroid nodules, 1572 were benign, 565 were malignant, and 4 were borderline. Vertical orientation, ill-defined, or irregular margin (including extrathyroidal extension), microcalcifications, solid, and markedly hypoechoic were positively associated with malignancy, while comet-tail artifacts were negatively associated with malignancy. The logistic regression equation yielded the highest Az value of 0.913, which was significantly higher than that obtained using the weighting method (0.893) and the counting method (0.890); however, no significant difference was found between the latter two. The C-TIRADS, based on the counting method, was designed following the principle of balancing the diagnostic performance and sensitivity of the risk stratification with the ease of use. CONCLUSIONS: A relatively simple C-TIRADS was established using the counting value of positive and negative ultrasound features.

Novel biomimetic dual-mode nanodroplets as ultrasound contrast agents with potential ability of precise detection and photothermal ablation of tumors.

PURPOSE: Molecule-targeted ultrasound imaging has attracted extensive attention for precise diagnosis and targeted therapy of tumors. The aim of this research is to prepare novel biomimetic dual-mode nanoscale ultrasound contrast agents (UCAs), which can not only evade the immune clearance of reticuloendothelial system, but also have the potential ability of precise detection and photothermal ablation of tumors. METHODS: In this study, for the first time, the novel biomimetic UCAs were prepared by encapsulating liquid perfluorohexanes with red blood cell membranes carrying IR-780 iodide and named IR780-RBCM@NDs. The characteristics of that were verified through the particle size analyzer, scanning electron microscopy, transmission electron microscopy and laser scanning confocal microscopy. The stability of IR780-RBCM@NDs at 37 °C was explored. The abilities of immune escape, dual-mode imaging and photothermal effect for IR780-RBCM@NDs were verified via in vitro experiments. RESULTS: The novel prepared nanodroplets have good characteristics such as mean diameter, zeta potential, and relatively stability. Importantly, the integrin-associated protein expressed on the surface of RBCMs was detected on IR780-RBCM@NDs. Then, compared with control groups, IR780-RBCM@NDs performed excellent immune escape function away from macrophages in vitro. Furthermore, the IR-780 iodide was observed on the new nanodroplets and that was able to perform the dual-mode imaging with near-infrared fluorescence imaging and contrast-enhanced ultrasound imaging after the phase change. Finally, the effective photothermal ablation ability of IR780-RBCM@NDs was verified in tumor cells. CONCLUSION: The newly prepared biomimetic IR780-RBCM@NDs provided novel ideas for evading immune clearance, performing precise diagnosis and photothermal ablation of tumor cells.

Noninvasive stiffness assessment of the human lens nucleus in patients with anisometropia using an ultrasound elastography system.

AIM: To investigate the significance of ultrasound elastography for evaluating stiffness of the human lens nucleus in patients with anisometropia. METHODS: A total of 14 patients (28 eyes) with anisometropia were enrolled. The difference in refractive status between two eyes ≥-4.0 diopters (D) and the difference in axial length (AL) of the eyes was ≥3 mm. There were 5 males and 9 females with an average age of 62±3.3y. The test data of the long AL eye of each patient was included in group A (14 eyes), and test data of the eye with relative short AL was included in group B. Lens nuclear stiffness was measured with free-hand qualitative elastography by independent operators. Strain gray scale and color-coded elastography maps were recorded. In each case, three consecutive measurements were performed and strain ratio was used for statistical analysis. Photograph and sectional view of the lens were analyzed and archived by anterior segment image. RESULTS: In the long AL group, the strain rate in the nucleus of the lens was 0.16%±0.08%; in the short AL group, the strain rate in the nucleus of the lens was 0.54%±0.16%. Independent sample t-test analyses showed that the long AL group lens had a significantly smaller nuclear strain rate than the relatively short AL group, P<0.05. CONCLUSION: The relationship between human lens stiffness and different AL is demonstrated by ultrasound elastography. The long AL is associated with lower strain ratio and less resilience of the lens.